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Monday, 25 November 2013

Pulmonary vascular disease: Pulmonary edema- In conventional & Herbal medicine perspective

Pulmonary vascular disease is defined as a condition of blood flow to the lung’s artery is blocked suddenly due to a blood clot somewhere in the body, including pulmonary embolism, chronic thromboembolic disease, pulmonary arterial hypertension, pulmonary veno-occlusive disease, pulmonary arteriovenous malformations, pulmonary edema, etc.
Pulmonary edema
Pulmonary edema is defined as a condition of fluid accumulation in the air spaces and parenchyma of the lungs of that can lead to difficult of breathing and respiratory failure.
VI. Treatments
A. In conventional medicine perspective
Treatment of Pulmonary edema is depending to the unlined causes of the diseases. In most cases, the disease is caused by congestive heart failure. According to A.D.A.M. Medical Encyclopedia, most cases of Pulmonary edema are almost always treated in the emergency room or hospital, sometimes in an intensive care unit (ICU), including Oxygen is given through a face mask or tiny plastic tubes are placed in the nose and a breathing tube may be placed into the windpipe (trachea) so you can be connected to a breathing machine (ventilator). The unlined causes of the disease should be diagnosis quickly and treated accordingly. Certain medications may be prescribed such as diuretics to remove excess fluids from the body and medicines to strengthen the heart muscle, control the heartbeat, or relieve pressure on the heart(62).
B. In Herbal medicine perspective
1. Sea buckthorn
Sea buckthorn (Hippophaë rhamnoides L.) is a rich source of flavonols, especially isorhamnetin. Most prospective cohort studies have indicated some degree of inverse association between flavonoid intake and coronary heart disease.
2. Astragalus
Astragalus (Astragalus onobrychis), also known as Huang Qi in traditional Chinese medicine, is a genus of small shrubs, belonging to the legume family Fabaceae. The herb has been used in traditional herbal medicine in boosting and stimulating the immune system, as a diuretic, to treat shortness of breath, general weakness, and lack of appetite, colds, flu, stomach ulcers, diabetes, etc.
a. Congestive heart failure
In a study of Sixty-two in-patients with CHF (congestive heart failure), whose heart function belonged to NYHA grade II-IV with Astragalus Injection (AI),conducted by Huazhong University of Science and Technology, posted in PubMed(63), researchers found that astragalus Injection could improve the immune function of CHF patients, and can be taken as an important auxiliary treatment for CHF.
b. Atherosclerosis
Extract of Astragalus, Radix Codonopsis and Cortex Lycii, reduces the risk of Atherosclerosis by suppressing the low-density lipoprotein (LDL) oxidation and inhibiting vascular smooth muscle cell migration, according to the study of “Suppression of low-density lipoprotein oxidation, vascular smooth muscle cell proliferation and migration by a herbal extract of Radix Astragali, Radix Codonopsis and Cortex Lycii” by Chan JY, Koon JC, Leung PC, Che CT, Fung KP., posted in PubMed(64).
c. Heart diseases
One optimal dose of DHEA or Astragalus can reduce the condition of heart disease? according to the study of “Organ representation areas of different internal organs localized on the eyebrows & eyelids by the Bi-Digital O-Ring Test electromagnetic resonance phenomenon between 2 identical molecules–Part I: Detection of increased markers for cancer & heart disease from white hairs on the eyebrows and marked decrease in the markers after taking one optimal dose of DHEA” by Omura Y., posted in PubMed(65)
d. Hypertension
flavonoid (TF), extracted from the seed of Astragalus have shown the properties of lowering blood pressure in both in both renal hypertensive rats (RHR) and spontaneously hypertensive rats (SHR) according to the study of “Antihypertensive effect of total flavonoid fraction of Astragalus complanatus in hypertensive rats” by Li JX, Xue B, Chai Q, Liu ZX, Zhao AP, Chen LB., posted in PubMed(66)
3. Bromelain
Bromelain, a proteolytic enzymes found in pineapples (Ananas comosus) has been used in traditional medicine as inflammatory agent and to treat pains, strains, and muscle aches and pains and ease back pain and chronic joint pain, skin diseases, etc.
a. Bromelain in cardiovascular diseases
In the review out of Out of 223 papers retrieved, 6 papers met the inclusion criteria(Randomised controlled trials (RCTs), human studies, animal studies and experimental studies related to bromelain for CVDs. Data extraction and analysis: The quality assessment of all the selected studies was conducted by the authors. Data from 3 animal trials and 3 human trials were included in the review. Data collected included: type of trial, drug dosage, duration, outcome measures, characteristics of bromelain used, significance of results and conclusion), bromelain could be used for treating acute thrombophlebitis, as it decreases aggregation of blood platelets, has a cardio-protective effect, ameliorates rejection-induced arterial wall remodelling, prevents thrombin-induced human platelet aggregation as well as reduces thrombus formation, according to the study of “A review of the use of bromelain in cardiovascular diseases” by Ley CM, Tsiami A, Ni Q, Robinson N., posted in PubMed(67)
b. Renal diseases
Bromelain proteolytic enzymes has improved proteinuria and urinary TGF-beta 1 excretion, as well as the severity of tubulointerstitial fibrosis without signs of toxicity, according to the study of “The effect of oral protease administration in the rat remnant kidney model” Sebeková K, Dämmrich J, Krivosíková Z, Heidland A.” by posted in PubMed(68).
4. Garlic
Garlic (Allium sativum) is a species in the onion genus, belonging to family Amaryllidaceae, native to central Asia. It has been used popularly in traditional and Chinese medicine in treating common cold and flu to the Plague, blood pressure cholesterol levels, natural antibiotic, etc.
a. Blood pressure
In the assessment of garlic extract and its effect of hypertension. found that Aged garlic extract was generally well tolerated and acceptability of trial treatment was high (92%) and aged garlic extract is superior to placebo in lowering systolic blood pressure similarly to current first line medications in patients with treated but uncontrolled hypertension, according to “Aged garlicextract lowers blood pressure in patients with treated but uncontrolled hypertension: a randomised controlled trial” by Ried K, Frank OR, Stocks NP.(69)
b. Atherosclerosis
In the demonstration of aged garlic extract therapy with supplements (AGE+S) and theirs effect on cardiovascular diseases found that CAC progression was significantly lower and TR significantly higher in the AGE+S compared to the placebo group after adjustment of cardiovascular risk factors (p<0.05). Total cholesterol, LDL-C, homocysteine, IgG and IgM autoantibodies to MDA-LDL and apoB-immune complexes were decreased, whereas HDL, OxPL/apoB, and Lp (a) were significantly increased in AGE+S to placebo and concluded that AGE+S is associated with a favorable improvement in oxidative biomarkers, vascular function, and reduced progression of atherosclerosis., according to “Aged garlicextract supplemented with B vitamins, folic acid and L-arginine retards the progression of subclinical atherosclerosis: a randomized clinical trial” by Budoff MJ, Ahmadi N, Gul KM, Liu ST, Flores FR, Tiano J, Takasu J, Miller E, Tsimikas S.(70).
c. . Cardiovascular diseases
In the review of the experimental and clinical studies confirm that the ancient experience with beneficial effects of garlic holds validity even in prevention of cardiovascular disorders and other metabolic ills, indicated that Garlic-derived organic polysulfides are converted by erythrocytes into hydrogen sulfide which relaxes vascular smooth muscle, induces vasodilation of blood vessels, and significantly reduces blood pressure. There are data on potential ability of garlic to inhibit the rate of progression of coronary calcification. Garlic as a dietary component appears to hold promise to reduce the risk of cardiovascular disease (Fig. 2, Ref. 46), according to “Garlic (Allium sativum L.) and cardiovascular diseases” by Ginter E, Simko V.(71)

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Sources
(a) http://www.ncbi.nlm.nih.gov/pubmed/19739476 
(62) http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001195/
(63) http://www.ncbi.nlm.nih.gov/pubmed/16968106 
(63) http://www.ncbi.nlm.nih.gov/pubmed/12800417
(64) http://www.ncbi.nlm.nih.gov/pubmed/21513503
(65) http://www.ncbi.nlm.nih.gov/pubmed/19301629
(66) http://www.ncbi.nlm.nih.gov/pubmed/16201455
(67) http://www.ncbi.nlm.nih.gov/pubmed/21749819
(68) http://www.ncbi.nlm.nih.gov/pubmed/10639701
(69) http://www.ncbi.nlm.nih.gov/pubmed/20594781
(70) http://www.ncbi.nlm.nih.gov/pubmed/19573556
(71) http://www.ncbi.nlm.nih.gov/pubmed/21033626