Bhagavathi

Short course radiation therapy is the one of the most talked about subject in recent years and also a fascinating research zone. Hypofractionated radiation therapy is an old concept, but only in recent years with tremendous improvement in radiation therapy delivery technologies there is a significant visible surge in it’s applicability in clinical practice. Modern radiation therapy technology is capable of delivering high dose to the target while sparing majority of the adjacent critical structures. Hence, it is possible to deliver short course of treatment regimen with higher dose per fraction without increasing in toxicity. In brain tumours, radiosurgery with gamma-knife is considered standard of care in many of the clinical indications such as small meningiomas, acaustic schwannomas, residual low grade gliomas, AVMs and solitary/ oligo brain metastasis. Gamma-knife radiosurgery is in clinical practice for more than five decades.

There are several prospective and randomized studies (level I evidence) with long-term follow up data supporting the use of radiosurgery in these clinical indications. Other indications of radiosurgery are pituitary tumour, craniopharyngiomas, glomus tumours, chordomas and others. Robotic radiosurgery (CyberKnife®) is precision radiosurgery delivery system and an extension of gamma-knife system. CyberKnife uses the principle of gamma-knife, but with linear accelerator source instead of multiple cobalt sources. CyberKnife is capable to treating all tumours indicated for gamma-knife with similar accuracy.

This modern tool has some additional advantages from gamma-knife, such as 1) CyberKnife can use fractionated treatment, hence relatively larger tumours can be treated, 2) require only thermoplastic mask, no need for invasive frame, 3) has inverse planning system, can spare critical structure, 4) there is a ‘intra-fraction’ correction technology with imaging, 5) there is no need to change the source, hence may be more cost effective and 6) can be used to treat extra-cranial tumours also. CyberKnife has a linear accelerator attached with a robot and is capable of treatment from various coplanar and non-coplanar field arrangements. CyberKnife has sub-millimeter accuracy and unmatched dose distribution.

The advanced technology behind CyberKnife uses image guidance technology and computer-controlled robotics to deliver and extremely precise dose of radiation to targets, avoiding the surrounding healthy tissue, and adjusting for patient and tumor movement during treatment. In conclusion, CyberKnife is an extension of gammaknife radiosurgery delivery system. This machine has immense promise to treat with short course regimens with high dose and improve local control without increasing toxicities.

Migraine is a severe headache affecting 1 or more in 10 people, and is basically caused by excessive stimulation of blood vessels. Indigestion, anger, stress, intake of salty and spicy food, excessive exposure to sunlight, skipping meals, tension headaches and alcohol are some common causes of this intolerable headache. Ayurveda has numerous effective remedies for migraine. Here are a few solutions to help you fight this problem.

1. Shirolepa and shiro dhara are popularly used ayurveda treatments on all types of migraine patients. Shirolepa is the application of effective herbal pastes containing camphor, sandalwood, jatamansi and many more on the affected area. Shiro dhara is the process of pouring stream of thin to thick liquids over the scalp for a specified amount of time. These remedies are very commonly used and are known for their successful healing properties.
2. Ayurveda presents to you a number of ancient herbs that guarantee you 100 percent relief from migraine. These may include bala, kumari, mallika, amalaki, sariva, yastimadhu, hareetaki and many more. These, when blended and mixed in appropriate quantities, give amazing results.
3. Apart from these ayurveda treatments, a number of ayurveda medicines are also available. Godnati bhasma, Chandrakala rasa, Kamadugha rasa (mouktika yukta), Bhoonimbadi khada , Shirashooladi vajra rasa, Pathyadi khada are used in the treatment of various types of migraines.
4. If due to some reason you are unable to access these ayurveda treatments and want immediate relief from the severe headaches, then don’t worry. There are a number of ayurveda home remedies that give you excellent results in a very short period of time. You can use an ice pack and rub it on your temples to reduce pain. Tinospora cordifolia, commonly known as giloy, can be taken with raw honey for instant relief.
5. You can drop a few drops of paste of saffron and ghee into each of your nostrils and inhale deeply. This can give you amazing results and can reduce your intolerable pain. Applying sandalwood on forehead or a paste of black pepper, rice with bringaraaja juice on your forehead will do wonders to your migraine pain.

Thus, try to avoid things that trigger your pain including alcohol, caffeine, onions, beans, nuts, hunger, stress, pressure and many others, and follow these remedies to help you get rid of your headache that gets worse with time. Try not to skip meals and keep your body hydrated as much as you can. It is advisable to take the medicines and treatments under the guidance of an Ayurveda physician.

Brain surgery involves several medical procedures, which incorporate fixing issues with the brain, including changes in the tissues of the brain, cerebrospinal fluid and brain blood flow. Brain surgery is quite a complicated method of surgery and the type of surgery to be conducted depends on the underlying conditions.

Reasons for Brain Surgery:
Brain surgery is performed for the correction of physical brain abnormalities. These abnormalities could occur because of diseases, birth defects and injuries. A brain surgery is required when the following conditions arise in the brain:

1. Abnormal blood vessels
2. Aneurysm
3. Bleeding
4. Blood clots in the brain
5. When the protective tissue or dura is damaged
6. Epilepsy
7. Due to nerve damage
8. Parkinson's disease
9. Any kind of pressure after an injury
10. Abscesses
11. Skull fractures
12. In case of stroke and tumors

A surgery may not be required for all the above mentioned conditions, but in case of many, a brain surgery is very important as the conditions may worsen health problems.

Types of brain surgeries:

1. Craniotomy: During this open brain surgery, an incision is made in the scalp, and a hole is created in the skull, near the area, which is being treated. After this process is complete, the hole or bone flap is secured in its place using plates or wires.
2. Biopsy: This form of brain surgery helps in the removal of a small amount of brain tissues or tumors. After removal, the tissues or tumors are examined under a microscope. The creation of a small incision and a hole in the skull is indicated as a part of this process.
3. Minimally invasive endonasal endoscopic surgery: This form of brain surgery enables the removal or lesions and tumors via the nose and sinuses. Private parts of the brain can be accessed without creating an incision. An endoscope is utilized in the process which is used to examine tumors all across the brain.
4. Minimally Invasive neuroendoscopy: This process is similar to the minimally invasive endonasal endoscopic surgery. This method also involves the use of an endoscope for removal of brain tumors. Small, dime sized holes may be made in the skull to access some brain parts.

Risks:
Brain surgeries may be associated with several risks. They may be:

1. Allergic reactions to anesthesia
2. Bleeding
3. Blood clot formations
4. Swelling of the brain
5. A state of coma
6. Impairment in speech, coordination and vision.
7. Problems in memory
8. Strokes and seizures
9. Infections in the brain

A brain surgery is a serious and very complex surgery. There are different kinds of brain surgeries, which are conducted depending on the condition and severity of the disease. If you wish to discuss about any specific problem, you can consult a Neurosurgeon.

Alzheimer's Disease is a neurological problem that is characterised by a cognitive decline and memory loss. It is a type of neurodegenerative dementia. The symptoms of Alzheimer's Disease include not being able to absorb and retain new information, lack of reasoning and judging, not being able to take on complex tasks, impaired visuospatial abilities, problems in reading, writing and speech, among many others. If a person has at least two of these symptoms in a debilitating manner, then the diagnosis can be made in favour of Alzheimer's Disease. The main causes of Alzheimer's are shrinkage of the brain size and death of the brain cells. The immune system is also said to trigger this neurodegenerative disease.

Let us find out what medical science has found so far:

1. Connections: Many a times, in Alzheimer's disease, the memory and behaviour of the person changes because the brain is unable to make proper neural connections which can lead to memory loss of how a person behaved and the elements that formed the basis of the patient's cognition. Apparently, the immune system behaves in the same way within the brain and blocks the connection. This happens because there is constant communication between the brain and immune system along neurological lines, which is where the disease first emanates.
2. Inflammation: The brain is prone to inflammation or swelling that is not the normal kind. This inflammation happens as a result of the activation of the infection fighting neurotransmitters and the chemical changes that happen in the brain when an infection strikes. The inflammation usually happens in the plaques or clumps which the brain tries to protect. These clumps are made up of a protein called Amyloid. The immune system is responsible for creating this inflammation in the brain of the patient.
3. Pattern Recognition Receptors: Many of these receptors work in different manners and cooperate with each other to create a response in the brain. These PRRs can be found in the brain plaques, and they develop the signs of danger which further fuels the inflammation in the brain as a matter of protection.
4. Activation of Cells Linked with the Immune System: When the PRRs begin to respond, it basically activates the immune system and the cells of the same. This is the basic reaction that causes the changes in brain which then leads to the attachment of the protein to the tissue that is diseased, in which case Alzheimer's Disease starts. The inflammation that we had spoken about earlier basically happens in the nervous tissue.

It is important to recognise and act on the initial signs of Alzheimer's Disease before it progresses beyond one's control. If you wish to discuss about any specific problem, you can consult a Neurologist.

Sleep apnea is a disorder that affects nighttime breathing and is caused by either a malfunction in the brain that temporarily stops sending signals to the muscles that control breathing, or by an obstruction in the airway. 

Causes of Sleep Apnea-
It occurs when muscles in the back of your throat relax, tonsillitis, adenoids, obesity, middle-aged, heart disease, stroke, sedative medicines, large neck circumference, large tongue etc.

Symptoms of Sleep Apnea-

1. Feeling of excessively sleepy during a day
2. Lack concentration and low memory status
3. Depression
4. Short temper
5. Irritability
6. Hyperactive children
7. Leg swelling
8. Impotency in males
9. Insomnia
10. Frequent waking up for urination in night
11. Tiresome feeling in morning

Homeopathic  Treatment of Sleep Apnea-
Homeopathy is one of the most popular holistic systems of medicine. The selection of remedy is based upon the theory of individualization and symptoms similarity by using holistic approach. This is the only way through which a state of complete health can be regained by removing all the sign and symptoms from which the patient is suffering.

The aim of homeopathy is not only to treat sleep apnoea but to address its underlying cause and individual susceptibility. As far as therapeutic medication is concerned, several well-proved medicines are available for sleep apnoea treatment that can be selected on the basis of cause, sensation and modalities of the complaints. For individualized remedy selection and treatment, the patient should consult a qualified homeopathic doctor in person. Some of the most common homeopathic medicines for Sleep Apnea are-

1. Arsenicum Album: Arsenicum album is often prescribed for individuals who have breathing difficulties at night and is considered for people with a fearful, tense and agitated response to illness. 
2. Lachesis: Lachesis is a remedy prescribed for conditions that worsen at night. This medicine is designed for people who are typically fearful and anxious, but also prone to jealousy and excessive talking. 
3. Sulphur: By reputation, sulphur is a commonly prescribed homeopathic remedy, especially for nighttime congestion and sweating. Homeopathic sulphur combats a wheezy cough and congested head, both of which are suffered in sleep apnea. 
4. Spongia Tosta: This remedy for croup may help congestive sleep apnea sufferers as it treats respiratory symptoms that worsen when lying down. 

Before taking these medications, it is important to visit the doctor who will take a detailed case history of your problem and prescribe the right dosage and combination of medication.
 

हमारे शरीर का महत्वपूर्ण अंग हमारी नसें होती हैं, जो हमारे शरीर में रक्त संचारित करती रहती है, जो हमें जिन्दा रहने के लिए बहुत अहम होता है। पर कई बार कुछ कारणों से ये कमजोर पड़ जाती हैं जिसकी वजह से हमें कई शरीरिक समस्याओं का सामना करना पड़ता है। तो आइए दोस्तों आज हम जानेंगे इन नसों की कमज़ोरी के कारण और इससे निजात पाने के आसन घरेलू उपायों की।

दरसल शरीर का कोई भी हिस्सा जैसे पीठ, कमर, हाथ, गर्दन आदि की नस के दबने से होने वाला दर्द काफी तकलीफदेय होता है। इसकी वजह से हम कोई भी काम सही ढंग से नही कर पाते। नसें हमारे शरीर मे मौजूद भिन्न- भिन्न अंगों से होकर गुजरती है और जब कोई अंग कमज़ोर पड़ता है तो सबसे पहले वहां की नसों पर इफ़ेक्ट पड़ता है। कई बार हमारे शरीर की नसें गलत व्यायाम करने से या वज़न बढ़ने की वजह से या किसी अन्य वजहों के कारण दब जाती है और शरीर के उस हिस्से में दर्द होने लगता है। जिसकी वजह से हमारा रक्त उस अंग में नही पहुंच पाता, जिससे वह कमज़ोर पड़ने लगती हैं। ऐसे में हम इस समस्या का समाधान किसी अच्छे डॉक्टर की मदद से या खुद घर बैठे भी कर सकते है ।

•  पर ध्यान रहे नसों में होने वाले दर्द का इलाज़ करने की जानकारी आपको पूरी तरह से होना बेहद जरूरी है, क्योंकि नसें बहुत ही डेलिकेट होती है और गलत इलाज करने से इसे काफी नुकसान पहुंच सकता है। 
• यदि आपके शरीर के किसी भी अंग की नसें कमज़ोर हो गई हों तो उसका घर बैठ इलाज करने से पहले इन कुछ बातों का विशेष ध्यान रखें।
• दबी हुई नस को जितना हो सके दबाना या मोड़ना टालें।
• यदि सूजन हो तो सूजन कम करने के लिए बर्फ और गर्म चीज़ों से बारी-बारी से मसाज करें।
• ज्यादा से ज्यादा आराम करें।
• आराम पाने के लिए ज्यादा दबाव न डालें हल्की मालिश ही करें।
• जितना हो सके सफेद या ब्राउन पट्टी की मदद से नस को एक जगह पर स्थिर रखें।
• हद से ज्यादा दर्द हो तो ही कोई दर्द निवारक दवा लें अथवा किसी भी तरह की दवा लेने से बचें।

नसों के कमजोर होने के लक्षण

• यदि आपके शरीर की नसें कमज़ोर हो गई हैं, तो इससे शरीर में होने वाले इफ़ेक्ट की पहचान करना जरूरी होता है जिससे सही इलाज करने में सहायता मिलती है। 
• यदि आपकी याददास्त घटने लगे तो समझ लीजिये की आपकी नसें कमजोर पड़ने लगी हैं।
• चक्कर आना भी एक संकेत है कि आपकी नसें कमज़ोर है क्योंकि रक्त संचारित नही हो पा रहा।
• रक्त जब शरीर में सही ढंग से नही सर्क्युलेट होता तो आंखों के आगे उठने-बैठने के समय अंधेरा छाने लगता है।
• अपच होना भी एक संकेत है।
• अनिन्द्रा भी दर्शाता है आपके नसों की कमज़ोरी।
• हदय-स्पंदन
• शरीर में खून की कमी होना।

नसों की कमज़ोरी का इलाज
 इनमें से कोई भी लक्षण जब शरीर में घटित होता है तो नसों में बहुत तेजी के साथ दर्द होने लगता है, जो परेशानी का सबब बन जाता है। तो अब जानते हैं  नसों के दर्द को दूर करने के कुछ आसान घरेलू इलाज जिसे आप ठीक से फॉलो करेंगे तो यकीनन फायदा होगा।
1. पुदीने का तेल 
यदि आपके नसों में बहुत दर्द होता है, तो दर्द से प्रभावित क्षेत्र में पुदीने के तेल से मालिश करें । इससे आपको नसों के दर्द से राहत मिलेगी।
2. सरसो का तेल
सरसों के तेल से नसों के दर्द से छुटकरा पाया जा सकता है। सरसों के तेल को गरम करके इससे मालिश करे। ऐसा करने से आपको निश्चित ही लाभ होगा।
3. लेवेंडर का फूल
लेवेंडर का फूल तथा सुइया को नहाने के पानी में मिला कर नहाएं ।
4. बेर की गुठलियां
नसों की कंजोरी को दूर करने के लिए आप बेर की गुठलियों को गुड़ के साथ खाएं जिससे की नसों में मज़बूती आएगी और शरीर बलवान बन जाता है।
5. गाय का दूध 
नसों की कमजोरी को दूर करने के लिए आप गाय के दूध के साथ मक्खन, मिश्री भी खा सकते है, जिससे काफी हद तक नसों की कमजोरी में आराम मिलता है।
6. किसमिस
किसमिस खाने की आदत डाल लें। यह शरीर में अन्य लाभ पहुंचाने के साथ ही नसों की कमजोरी का भी बेहतरीन इलाज  है। पर हाँ इसका इस्तेमाल आप सर्दियों के मौसम में ही करने की कोशिश करें।
7. आयुर्वेद का साथ
अश्वगन्धा 100 ग्राम, सतावर 100 ग्राम, बाहीपत्र 100 ग्राम, इसबगोल की भूसी 100 ग्राम, तालमिश्री 400 ग्राम इस सबका एक मिश्रण बना ले और उस मिश्रण को सुबह व शाम को दूध के साथ लें। लगभग एक महीने के प्रयोग से ही शरीर की रक्त क्षमता बढ़ जाती है। और नशों में ताक़त आजाती है ।
8. व्यायाम 
यदि आपकी नसों में बहुत दर्द होता है तो आपको नियमित व्यायाम करना चाहिए जिससे नसों को बहुत लाभ होता है और इसमें पड़ी हुई गांठ भी धीरे-धीरे ठीक हो जाती है।
9. भ्रस्तिका प्राणायाम
भ्रस्तिका प्राणायाम करने से भी नसों के रोगी को बहुत लाभ होता है। लाभ होता है इसलिए रोजाना यह प्राणायाम करें
10. अनुलोम विलोम 
अनुलोम विलोम प्राणायाम करने से भी नसों में होने वाली दिक्कत को एक दम से दूर किया जा सकता है और बहुत दिनों तक करेंगे तो ये बीमारी जड़ से ख़त्म हो जाएगी।
11. मसाज का सहारा
नस में होने वाले दर्द पर दबाव डालने से तनाव को मुक्त करने और दर्द कम करने में मदद मिल सकती है। पूरे शरीर की मालिश करने से सभी मांसपेशियों की शिथिलता को बढाने में और साथ ही प्रभावित हिस्से को आराम देने में हेल्प मिलती हैं।
 

Autism is defined as a Neurobiological pervasive development disorder that includes lack of social skills and inability to reciprocate to social interactions. The patient may also have intellectual and cognitive deficits and problems in communication (verbal as well as non-verbal).

Ayurveda is the oldest study of medicine and has proved to be very effective when it comes to managing and treating those affected by autism. The earlier an autistic person resorts to Ayurveda, the more effective it is.

Ayurvedic drink recipe for treating the symptoms of autism: (should be taken daily)

1. 1/3 cup of yogurt
2. 3/4 cup of water
3. Cumin
4. Coriander
5. Ginger

Or

1. Diluted Fresh Pomegranate Juice

Ayurveda in Curbing Aggression:
Autism includes heightened aggression and aversion from social interaction due to a neurological condition that impairs the functioning of the brain. Not all autistic patients are violent towards others, but may express their frustration by self-harm and emotional outbursts. One can curb these emotional outbursts by taking herbal supplements. An Ayurvedic herb called Brahmi (Bacopa monnieri) which is known for its, anti-anxiety, neuroprotection and antioxidant properties can help considerably.

Regular massages using sandalwood, rose, lavender and gotu kola oils are also very calming and relieving, because it stimulates the blood flow and neuronal responses. Massage also helps in increasing eye contact and social relatedness, less stereotypical behavior and improved sleep.

Ayurvedic Herbs for Autism:

1. Brahmi; Scientifically known as Bacopa monnieri, Brahmi is an important herb that delays the process of forgetting and improves memory. Not only does Brahmi improve memory, but also increases the grasping power, intellect and speech and also corrects the abnormality of emotions, personality and mood of an autistic individual. It also helps in performing complex tasks such as comprehension, reasoning and learning.
2. Ashwagandha: Scientifically known as Withania somnifera, Ashwagandha has high affinity for gamma aminobutyric acid (GABA) receptors. Low GABA activity is related to cognitive impairment.
3. Shankhapushpi: Scientifically known as Convolvulus pluricaulis, Shankhapushpi is very effective in improving learning and memory and is highly effective in treating insanity and epilepsy. 
4. Centella asiatica: This Ayurvedic herb is used as a medication for insanity, speech disorders and epilepsy, making it a very useful drug for treating autism. If you wish to discuss about any specific problem, you can consult an Ayurveda.

Headaches and migraines can vary drastically depending on their duration, specific symptoms and the person they are affecting. The more you know about your specific type of headache or migraine, the better prepared you will be to treat them—and possibly even prevent them. The two types of migraine are- 

1. Migraine without aura: The majority of migraine sufferers have Migraine without Aura. 
2. Migraine with aura: Migraine with Aura refers to a range of neurological disturbances that occur before the headache begins, usually lasting about 20-60 minutes.

Symptoms of migraine vary and also depend on the type of migraine. A migraine has four stages: prodrome, aura, headache and postdrome. But it is not necessary that all the migraine sufferers experience all the four stages.

Prodrome: The signs of this begin to appear a day or two days before the headache starts. The signs include depression, constipation, food cravings, irritability, uncontrollable yawning, neck stiffness and hyperactivity.

Migraine Aura: Auras are a range of symptoms of the central nervous system. These might occur much before or during the migraine, but most people get a migraine without an aura. Auras usually begin gradually and increase in intensity. They last for an hour or even longer and are 

• Visual: Seeing bright spots, various shapes, experiencing vision loss, and flashes of light
• Sensory: Present in the form of touch sensations like feeling of pins and needles in the arms and legs
• Motor: Usually related with the movement problems like the limb weakness
• Verbal: It is related with the speech problems

Headache: In case of a migraine attack one might experience:

• Pain on both sides or one side of the head
• Pain is throbbing in nature
• Vomiting and nausea
• Sensitivity to smells, sound and light
• Vision is blurred
• Fainting and lightheadedness

Postdrome: This is the final phase of the migraine. During this phase one might feel fatigued, though some people feel euphoric.

Red flags that the patient may be having underlying serious disorder not migraine

1. Onset of headaches >50 years 
2. Thunderclap headache - subarachnoid haemorrhage 
3. Neurological symptoms or signs 
4. Meningism 
5. Immunosuppression or malignancy 
6. Red eye and haloes around lights - acute angle closure glaucoma 
7. Worsening symptoms 
8. Symptoms of temporal arteritis

These patients require CT scan / MRI or CSF examination. Most Migraine patients do not need these tests. 

Diagnosis of Migraine: Usually migraines go undiagnosed and thus are untreated. In case you experience the symptoms regularly then talk to the doctor, who evaluates the symptoms and can start a treatment. You can also be referred to a neurologist who is trained to treat the migraines and other conditions. During the appointment the neurologist usually asks about the family history of headaches and migraines along with your symptoms and medical history.

The doctor might advise for some tests like:

1. Blood Tests: These reveal problems with the blood vessel like an infection in the spinal cord and brain.
2. CT scan: Used to diagnose the infections, tumors, brain damage, and bleeding that cause the migraines.
3. MRI: This helps to diagnose the tumors bleeding infections, neurological conditions, and strokes.
4. Lumbar Puncture: For analyzing infections and neurological damages. In lumbar puncture a thin needle is inserted between the two vertebrae to remove a sample of the cerebrospinal fluid for analysis.

Treatments

Migraine treatments can help stop symptoms and prevent future attacks.

Many medications have been designed to treat migraines. Some drugs often used to treat other conditions also may help relieve or prevent migraines. Medications used to combat migraines fall into two broad categories:

• Pain-relieving medications. Also known as acute or abortive treatment, these types of drugs are taken during migraine attacks and are designed to stop symptoms.
• Preventive medications. These types of drugs are taken regularly, often on a daily basis, to reduce the severity or frequency of migraines.

Your treatment strategy depends on the frequency and severity of your headaches, the degree of disability your headaches cause, and your other medical conditions.

Some medications aren't recommended if you're pregnant or breast-feeding. Some medications aren't given to children. Your doctor can help find the right medication for you. If you wish to discuss about any specific problem, you can consult a Neurologist.

Best Ways To Beat Allergies With Ayurveda​

Good afternoon, I am Dr Lata Bhat, a developmental Pediatrician in Delhi. We take care of developmental disorders in children like Autism, Hyperactivity, ADHD, learning and physical disability. Today I will talk about Autism.

Autism is a spectrum disorder that means there is a wide range of presentations.

Why did I choose to speak on this topic? The incidents are alarmingly high. It is a sort of epidemic and if not addressed, it can lead to a disaster.

The cause is Genetic. If one child has got Autism then the siblings also have the maximum chance to suffer from the same disease.

How does it affect the children?

Autism affects the communication of the child. It affects the speech, language as well as the non- verbal communications. Communication is the exchange of thoughts, ideas between the two or more people. Speech is delayed.

How do the parents or a care taker suspect the child?

Initially, the norms of the communication come first and then the speech.