Saturday 30 November 2013

Vertigo - The Do's and Do not's list

Vertigo is defined as a condition of dizziness of feeling of spinning, or swaying when one is stationary. Dizziness is a general, non-specific term to indicate a sense of disorientation. Some researchers suggested that vertigo is a subtype of dizziness and refers to an erroneous perception of self- or object-motion or an unpleasant distortion of static gravitational orientation that is a result of a mismatch between vestibular, visual, and somatosensory systems, affecting approximately 20-30% of the general population(1) and about two to three times higher in women than in men.
Preventions
A. The Do's and Do not's list 
1. Unhealthy diet
Unhealthy diet with high in saturated and trans fat and less fruits and vegetables can increase the risk of cholesterol building up in the arteries and nutrients deficiency of that can lead to insufficient blood flow to the back of the brain.

2.  Avoid damage to the head
From a neurotologic perspective, approximately 21.9% of head injured workers were determined to have recognizable evidence of cochleovestibular dysfunction. Olfactory dysfunction as a physical finding post-head injury compares favourably with the presence of post-traumatic benign positional paroxysmal vertigo (BPPV) and its atypical variants in 11.2% of head injured workers(17)

3. Relaxation
In the study of VERTIGO AND PSYCHOLOGICAL DISTURBANCES  Timothy C. Hain, MD, showed that Psychological abnormalities are common in the general population, even more common in those who are ill, and are certainly also common in individuals with vertigo. In a recent study by Garcia et al in Portugal, out of 43 patients, a large number of psychological abnormalities were diagnosed by the SCL-90 (a standard psychological test) including
a. Somatization     41.9%
b. Hostility     20.9%
c. Interpersonal sensitivity     18.6%
d. Anxiety     23.3%
e. Phobic anxiety     20.9%
f. OCD (obsessive compulsive disorder)     53.5%
g. Depression     30.2%
h. Paranoid traits     11.6%
i. Psychotic traits     2.3%(18)

4. Fruits and vegetables
Fruits and vegetables contain high amount of antioxidants and overprotective nutrients of which can enhance the immune system in fighting against firming of free radicals causes of degenerative diseases and viral and bacteria causes of infection and inflammation and decrease the chronic diseases causes of vertigo.

5. Moderate exercise
Excessive exercise can decrease the immune function in fighting against disease, moderate exercise not only enhances the blood circulation to increase oxygen to the back of the brain but also promotes the immune function fighting against inflammation and weaken immune system causes of vertigo.

6. Smoking
Smoking can reduce the lung function in oxygen absorption, thus reducing the risk of oxygen deficiency causes of vertigo.

7. Excessive alcohol drinking
Alcoholism can weaken the immune system and increase the risk of inflammatory causes of vertigo.

8. Etc.
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Sources
(1) http://www.ncbi.nlm.nih.gov/pubmed/22377855
(17) http://www.ncbi.nlm.nih.gov/pubmed/10445080
(18) http://www.dizziness-and-balance.com/disorders/psych/psych.htm 

Vertigo - Diagnosis and Diseases associated with Vertigo

Vertigo is defined as a condition of dizziness of feeling of spinning, or swaying when one is stationary. Dizziness is a general, non-specific term to indicate a sense of disorientation. Some researchers suggested that vertigo is a subtype of dizziness and refers to an erroneous perception of self- or object-motion or an unpleasant distortion of static gravitational orientation that is a result of a mismatch between vestibular, visual, and somatosensory systems, affecting approximately 20-30% of the general population(1) and about two to three times higher in women than in men.
Diagnosis and Diseases Associated to
Diagnosis and Diseases associated with Vertigo
Diagnosis
Dr. Della-Morte D, Rundek T. at the University of Miami, indicated that differential diagnosis between vascular vertigo and other causes of vertigo can result in misclassification due to the overlapping of symptoms. Careful medical history, physical examination, neuroimaging and ear, nose, and throat studies may help to distinguish vascular vertigo from other causes.(1)
1. Positive Dix-Hallpike test.
In the study of Twelve patients from the derivation set and six patients from the validation set had DHT + BPPV. Binomial logistic regression analysis selected a "duration of dizziness ≤15 seconds" and "onset when turning over in bed" as independent predictors of DHT + BPPV with an odds ratio (95% confidence interval) of 4.36 (1.18-16.19) and 10.17 (2.49-41.63), respectively. Affirmative answers to both questions yielded a likelihood ratio of 6.81 (5.11-9.10) for diagnosis of DHT + BPPV, while negative answers to both had a likelihood ratio of 0.19 (0.08-0.47).(15)

2. Electronystagmography versus videonystagmography
In the study to assess the value of electronystagmography (ENG) and videonystagmography (VNG) for diagnosing vertigo of various origin, scientists at the Medical University of Łódź, showed that In all patients with vertigo due to vestibular neuritis, barotrauma and kinetosis, significant CP, the important sign of peripheral site of vestibular lesion was identified both in ENG and VNG. None of the patients with central origin disorders showed CP in VNG; in the majority of cases DP was observed. However, in ENG we found CP in 5 patients with central origin disorders. There were no essential differences between ENG and VNG in measurements of FRQ and SPV except for higher values in VNG in controls and patients with mixed vertigo(16)

3. CT scan
CT scan  if a brain injury is suspected to be the cause of vertigo or your doctor would like to rule out the tumors or cancer causes of vertigo.

4. Etc.

In the study to the DISCUSSION ON VERTIGO, the team wrote that Vertigo associated with
1. acute, non-perforative otitis media
2. chronic otitis media
3. labyrinthine fistula
4. otosclerosis,
5. post-suppurative adhesions
6. peripheral nerve deafness,
7. gun deafness;
8. with rhinitis,  
9. ethmoiditis, 
10. sinusitis, 
11. nasal polypi, 
12. postnasal catarrh and 
13. dental infections.-Influence of general health on recurrent vertigo and vice versa (3)

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Sources
(1) http://www.ncbi.nlm.nih.gov/pubmed/22377855
(3) http://www.ncbi.nlm.nih.gov/pubmed/19987027
(15) http://www.ncbi.nlm.nih.gov/pubmed/22162937 

(16) http://www.ncbi.nlm.nih.gov/pubmed/22219058


Vertigo - The Risk Factors

Vertigo is defined as a condition of dizziness of feeling of spinning, or swaying when one is stationary. Dizziness is a general, non-specific term to indicate a sense of disorientation. Some researchers suggested that vertigo is a subtype of dizziness and refers to an erroneous perception of self- or object-motion or an unpleasant distortion of static gravitational orientation that is a result of a mismatch between vestibular, visual, and somatosensory systems, affecting approximately 20-30% of the general population(1) and about two to three times higher in women than in men.
Risk Factors
1. Endolymphatic hydrops 
In the study to assess the results of treatment for a first episode of benign paroxysmal positional vertigo (BPPV) and risk factors for recurrence at the Kobe University Graduate School of Medicine, showed that  endolymphatic hydrops is a risk factor for recurrence of BPPV and that prevention of recurrent BPPV is important for control of endolymphatic hydrops(10)

2. Vascular risk factors
Vascular risk factors predispose to vertebrobasilar ischemia. Cervical osteophytes can impinge on the vertebral artery causing mechanical occlusion during head turning. Presentation with vertigo in such instances is a common finding(11)


3. Otitis media history
Researchers found that having an otitis media history or eustachian tube dysfunction determined with the nine-step inflation/deflation tympanometric test before diving, or difficulty in clearing ears during diving could be important risk factors for AV in sport SCUBA divers (p <.05)(12).

4. Gender
If you are women, you at  two to three times higher risk to develop Vertigo

5. Vestibular neuritis (VN) is a condition of an ear disorder that involves irritation and inflammation. The recurrence rate of vertigo due to any cause in patients with vestibular neuritis (VN) was about 26.0(13)

6. Heredity
Genetic loci and clinical features of familial episodic ataxias have been defined in linkage disequilibrium studies with mutations in neuronal genes KCNA1 and CACNA1A. Migrainous vertigo is a clinical disorder with a high comorbidity within families much more common in females with overlapping features with episodic ataxia and migraine. Bilateral vestibular hypofunction is a heterogeneous clinical group defined by episodes of vertigo leading to progressive loss of vestibular function which also can include migraine. Meniere's disease is a clinical syndrome characterized by spontaneous episodes of recurrent vertigo, sensorineural hearing loss, tinnitus and aural fullness and familial Meniere's disease in around 10-20% of cases.(14)

7. Etc. 
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Sources
(1) http://www.ncbi.nlm.nih.gov/pubmed/22377855
(10) http://www.ncbi.nlm.nih.gov/pubmed/19128712
(10) http://www.ncbi.nlm.nih.gov/pubmed/17986375
(11) http://www.ncbi.nlm.nih.gov/pubmed/19300597 
(12) http://www.ncbi.nlm.nih.gov/pubmed/14670144
(13) http://www.ncbi.nlm.nih.gov/pubmed/21728751
(14) http://www.ncbi.nlm.nih.gov/pubmed/22379397 

Vertigo - The Causes

Vertigo is defined as a condition of dizziness of feeling of spinning, or swaying when one is stationary. Dizziness is a general, non-specific term to indicate a sense of disorientation. Some researchers suggested that vertigo is a subtype of dizziness and refers to an erroneous perception of self- or object-motion or an unpleasant distortion of static gravitational orientation that is a result of a mismatch between vestibular, visual, and somatosensory systems, affecting approximately 20-30% of the general population(1) and about two to three times higher in women than in men.

The Causes
1. DR. Karatas M. at the Baskent University, Medical School, Adana Research Center in a study of Central vertigo and dizziness: epidemiology, differential diagnosis, and common causes indicated that central causes are responsible for almost one-fourth of the dizziness experience by patients. The patient's history, neurologic examination, and imaging studies are usually the key to differentiation of peripheral and central causes of vertigo. The most common central causes of dizziness and vertigo are  
a. cerebrovascular disorders related to the vertebrobasilar circulation,  
b. migraine, 
c. multiple sclerosis, 
d. tumors of the posterior fossa, 
e. neurodegenerative disorders, 
f.  some drugs, and 
g. psychiatric disorders.(4)


2. Stroke
Stroke accounts for 3-7% among all causes of vertigo. The blood perfusion to the inner ear, brainstem, and cerebellum arise from the vertebrobasilar system. Vertigo, nausea, and vomiting, along with nystagmus, represent symptoms of stroke in posterior fossa due to arterial occlusion or rupture of the vertebrobasilar system. However, the spectrum of signs and symptoms as a manifestation of stroke associated with dizziness and vertigo may be variable depending on the affected vascular territories(1)

3. Meniere's disease
Meniere's disease is a clinical syndrome characterized by spontaneous episodes of recurrent vertigo, sensorineural hearing loss, tinnitus and aural fullness and familial Meniere's disease in around 10-20% of cases. An international collaborative effort to define the clinical phenotype and recruiting patients with migrainous vertigo and Meniere's disease is ongoing for genome-wide association studies(5).

4. Diabetes
Some researchers at the GENyO Pfizer-Universidad de Granada suggested that suggest that type 1 diabetes mellitus is associated with cupular and free-floating deposits in the semicircular canals. The patients with type 1 diabetes mellitus with a longer duration of disease have an increased probability of suffering from benign paroxysmal positional vertigo(6).

5. Head trauma
It is well known that head trauma may cause hearing loss, which can be either conductive or sensorineural. Benign paroxysmal positional vertigo and olfactory dysfunction due to head trauma are also well known(7).

6. Syphilis
Syphilis is a chronic, systemic and sexually transmitted infectious disease affecting most of the organs in the body. A young African man presented with vertigo, unsteadiness of gait and a skin rash suggestive of secondary syphilis. Diagnosis was confirmed on serology and was treated with two shots of long-acting penicillin, following which his symptoms settled(8).

7. Benign positional vertigo (BPV) 
Benign positional vertigo (BPV) is the most common cause of episodic vertigo. It results from activation of semicircular canal receptors by the movement of calcium carbonate particles (otoconia) which dislodge from the otolith membranes. During changes in head position, the otoconia either float freely within the semicircular canal duct (canalithiasis) or adhere to and move with the cupula of the canal (cupulolithiasis). BPV from canalithiasis evokes brief spells of vertigo lasting seconds and can be diagnosed at the bedside by provoking paroxysmal vertigo and nystagmus on tilting the head in the plane of the affected canal. The nystagmus has a unique rotational axis perpendicular to the affected canal(9)
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Sources
(1) http://www.ncbi.nlm.nih.gov/pubmed/22377855
(4) http://www.ncbi.nlm.nih.gov/pubmed/19008741
(5) http://www.ncbi.nlm.nih.gov/pubmed/22379397
(6) http://www.ncbi.nlm.nih.gov/pubmed/21572081
(7) http://www.ncbi.nlm.nih.gov/pubmed/20162029
(8) http://www.ncbi.nlm.nih.gov/pubmed/17052426
(9) http://www.ncbi.nlm.nih.gov/pubmed/22060084

Vertigo - The Symptoms

Vertigo is defined as a condition of dizziness of feeling of spinning, or swaying when one is stationary. Dizziness is a general, non-specific term to indicate a sense of disorientation. Some researchers suggested that vertigo is a subtype of dizziness and refers to an erroneous perception of self- or object-motion or an unpleasant distortion of static gravitational orientation that is a result of a mismatch between vestibular, visual, and somatosensory systems, affecting approximately 20-30% of the general population(1) and about two to three times higher in women than in men.

II. Symptoms
A. Eidelman D. in the study of "Fatigue on rest" and associated symptoms (headache, vertigo, blurred vision, nausea, tension and irritability) due to locally asymptomatic, unerupted, impacted teeth" showed that
1. "Fatigue on Rest",
2. headache,  
3. vertigo and the feeling of loss of balance,
4. blurred vision,
5. nausea,
6. tension and
7.  irritability
were found to be prevalent amongst patients who had  locally asymptomatic, unerupted impacted teeth. A comparative pressure sign was developed, which, when positive, confirmed the relationship between the impacted teeth and the medical symptoms. Removal of the impactions resulted in the alleviation of the symptoms. Stress and psychogenic factors are considered as trigger mechanisms, rather than as basic causes of the symptoms(2).

B. Other symptoms
Other researchers indicated that Destructive lesions of labyrinth, or of vestibular tracks, partial or complete.-Heterogeneous stimulations of the paired intact vestibular-end organs.-The hypersensitive labyrinth.-Clinical manifestations of vertigo, associated with nausea, headache, 
8. visual disturbances,
9. nystagmus, 
10. diplopia, 
11. staggering gait,
12. vasomotor and cardio-vascular symptoms, 
13. pallor, flushing,  
14. sweating
15. dyspnoea, 
16. fainting, 
17. vomiting and 
18. diarrhoea.
19. Etc.(3)


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Sources
(1) http://www.ncbi.nlm.nih.gov/pubmed/22377855
(2) http://www.ncbi.nlm.nih.gov/pubmed/459987
(3) http://www.ncbi.nlm.nih.gov/pubmed/19987027

Shingles Treatments In the Traditional Chinese medicine perspective

Shingles also known as herpes zoster or zona is defined as a viral disease with condition of a painful, blistering skin rash on one side of the body of  that can continue to be painful even after the rash have long disappeared(1), as a result of varicella-zoster viral causes of a nerve and skin inflammation.
C. In Traditional Chinese perspective (55)
C.1. Herbal treatment
Depending to the differentiation, some traditional Chinese medicine practitioner define shingles as  a result of Stagnated Heat in the Liver meridian bright red with distended pain, Damp/Heat in Spleen meridian and Chronic Blood Stasis
C.1. 1. Stagnated Heat in the Liver meridian bright red with distended pain with treatments of Herbal Formula: Huang Lian Jie Du Tang + Xi Jiao Di Huang Tang
1. Huang Lian Jie Du Tang (clear heat and damp-heat in all three burners), ingredients include
a. Huang Lian (coptis, Coptidis Rhizoma), 9g
b. Huang Qin (scutellaria, Scutellariae Radix) 6g
c.  Huang Bai (phellodendron, Phellodendri Cortex) 6g
d. Zhi Zi (gardenia, Gardeniae Fructus) 9 g

2.  Xi Jiao Di Huang Tang (clears Heat/Fire toxin, cools blood, nourish Yin, moves Blood Stasis, stops bleeding)
a. Xi Jiao (cornu rhinoceri) 3g
b. Sheng Di Huang (radix rehmanniae glutinosae) 24g
c. Shao Yao (radix paeoniae) 9g
d. Mu Dan Pi (cortex moutan radicis) 6g
 
C.1.2. Damp/Heat in Spleen meridian with Herbal Formula Chu Shi Wei Ling Tang
1. Functions
Eliminate Dampness by Combining Calm the Stomach and Five
2. Ingredients
a Fang Feng (saposhnikovia root) 3g
b.  Zhi Zi (cape jasmine fruit)  3g
c. Zhu Ling (polyporus) 3g
d. Hua Shi  (talcum) 3g
e. Mu Tong  (akebia caulis) 3g
f. Deng Xin Cao (juncus pith 3g
g. Ze Xie (water plantain) 3g
h. Hou Po (magnolia bar 3g
i. Cang Zhu (atractylodes rhizome) 3g
j. Chen Pi (tangerine peel) 3g
k. Decoction Rou Gui (cinnamon bark) 0.9g

C.1. 3. Chronic Blood Stasis (Last stage of shingles)with Herbal Formula Tao Hong Si Wu Tang
1. functions
Blood deficiency with mild Blood stagnation in the lower jiao, Tonifies and regulates qi and blood, gently moves stagnant blood and warms the uterus.
2. Ingredients
a. Chuan Xiong (Sichuan lovage root) 3g
b. Tao Ren (peach kernel) 6g
c. Hong Hua (safflower flower) 3g
d. Shu Di Huang (cooked rehmannia root) 6g
e. Dang Gui (Chinese angelica root) 6g
f. Bai Shao  (white peony root) 6g

C.2. Cupping theory
Traditional Chinese medicine (TCM) cupping therapy has been applied as a formal modality in hospitals throughout China and elsewhere in the world, Dr. Cao H, and the research team at University of Western Sydney indicated that numerous RCTs on cupping therapy have been conducted and published during the past decades showed that cupping has potential effect in the treatment of herpes zoster and other specific conditions. However, further rigorously designed trials on its use for other conditions are warranted.(56).
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Sources
(1) http://www.ncbi.nlm.nih.gov/pubmed/16936604
(54) http://theworldmostpopularherbs.blogspot.ca/2011/10/world-most-popular-herbs-health.html 
(55) http://www.chinesemedicinecure.com/Shingles-Herpes-Zoster
 

Shingles Treatments In the Herbal medicine perspective

Shingles also known as herpes zoster or zona is defined as a viral disease with condition of a painful, blistering skin rash on one side of the body of  that can continue to be painful even after the rash have long disappeared(1), as a result of varicella-zoster viral causes of a nerve and skin inflammation.
B. In herbal medicine perspective
The aims of herbal treatment is to enhace the self defense of the immune system
B.1.  Alfalfa is a flowering plant in the genus Medicago, belonging to the family Fabaceae, It has been cultivated all over the world as hay for cattle feeding. The leaves, sprouts, and seeds to make medicine has been used in traditional medicine over 15010 years to treat high cholesterol, asthma, osteoarthritis, rheumatoid arthritis, diabetes, enhance digestive system, bleeding disorder, kidney and urinary tract infection, etc. North Americal aboriginal has used Alfalfa seed as food, such as making bread and mush.
1. Antioxidant
In a study of measurements of pH, water holding capacity, color, oxymyoglobin content, TBARS and oxidation-reduction potential in evaluating the effects of a dietary protein-xanthophylls (PX) concentrate of alfalfa to turkey diets conducted by University of Life Sciences in Lublin, Skromna 8, 20-704 Lublin, Poland.(a), researchers found that TBARS and oxidation-reduction potential values suggested that the inclusion of the concentrate to turkey diets acts as an antioxidant in the raw meat.

2. Disease of autoimmune
In a study of five groups of 12-week-old female mice were per oral treated with vehicle (control), lyophilized AS (550 mg wt/kg BW), ASEA (ASEA, 25 mg/kg BW), coumestrol (CUM, 0.075 mg/kg BW) and tamoxifen (TAM, 0.375 mg/kg BW) as the positive control, conducted by Institute of Microbiology and Biochemistry, College of Life Science, National Taiwan University, Taipei, Taiwan (b), researchers found that alhalfa decreased the disease severity, increased survival and life span of the autoimmune-prone MRL-lpr/lpr mice, suggesting a potential of ASEA in the treatment of autoimmune diseases.

3. Anti-inflammatory activity
In a study of anti-inflammatory effects may be used for inflammatory disorders by examining alfalfa sprout ethyl acetate extract (ASEA) in ,ice coducted by College of Life Science, National Taiwan University, Taipei, Taiwan, Republic of China.(c), researchers found that significantly higher survival rates than the control group and suggests that ASEA supplementation can suppress the production of pro-inflammatory cytokines and alleviate acute inflammatory hazards.

B.2. Black Cohosh is a herbaceous perennial plant, genus Actaea, belonging to the family Ranunculaceae, native to eastern North America. The herb has been used in traditional medicine as analgesic, sedative, diuretic, emmenagogue anti-inflammatory agent and to treat rheumatism, symptoms of menopause, uterine cramps and muscle pain, etc.. Native Americans have used the root of the herb to treat snake bite.
a. Antioxidants
Polyphenols in Black cohosh may be considered as an antioxidant which help to fight against the forming of free radicals cause of DNA damage and guarding our body against foreign invasion such as bacteria and virus, according to the study of "Black cohosh (Cimicifuga racemosa L.) protects against menadione-induced DNA damage through scavenging of reactive oxygen species: bioassay-directed isolation and characterization of active principles" by Burdette JE, Chen SN, Lu ZZ, Xu H, White BE, Fabricant DS, Liu J, Fong HH, Farnsworth NR, Constantinou AI, Van Breemen RB, Pezzuto JM, Bolton JL., posted in PubMed(41)

b.2. Anti-inflammation
Cimicifuga racemosa (Actaea racemosa, black cohosh)have exerted inflammatory activity by inhibiting nitric oxide production by reducing iNOS expression without affecting activity of the enzyme, according to the study of "Inhibition of inducible nitric oxide synthesis by Cimicifuga racemosa (Actaea racemosa, black cohosh) extracts in LPS-stimulated RAW 264.7 macrophages" by Schmid D, Gruber M, Woehs F, Prinz S, Etzlstorfer B, Prucker C, Fuzzati N, Kopp B, Moeslinger T., posted in PubMed(42)

B.3. Chamomile is also known as camomile, common name of many species daisy-like plants in the family Asteraceae. The herb has been used in traditional medicine as antispasmodic and anti-inflammatory constituents and to treat menstrual cramps and sleep disorders, reduce cramping and spastic pain in the bowels, relieve excessive gas and bloating in the intestine, etc.
a. Anxiety
Matricaria recutita (chamomile) extract therapy has exerted the modest anxiolytic activity in patients with mild to moderate generalized anxiety disorder, according to the study of "A randomized, double-blind, placebo-controlled trial of oral Matricaria recutita (chamomile) extract therapy for generalized anxiety disorder" by Amsterdam JD, Li Y, Soeller I, Rockwell K, Mao JJ, Shults J.(43)

b. Anti-inflammatory effects
Chamomile has demonstrated the inhibition of NO production and iNOS gene expression by inhibiting RelA/p65 activation and supports the utilization of chamomile as an effective anti-inflammatory agent, according to the study of "Chamomile: an anti-inflammatory agent inhibits inducible nitric oxide synthase expression by blocking RelA/p65 activity' by Bhaskaran N, Shukla S, Srivastava JK, Gupta S.(44)

c. Immunomodulatory effect
Extracts of Silene (Silene nocturna), Black seed (Nigella sativa) and Chamomile (Matricaria chamomilla) have exerted significantly (P < 0.01) restored their resistance against lethal infection with the predominately granulocyte-dependant Candida albicans, according to the study of "Evaluation of immunomodulatory effect of three herbal plants growing in Egypt" by Ghonime M, Eldomany R, Abdelaziz A, Soliman H.(45)

B.4. Grapefruit seed extract (GSE) is a liquid extracted from the seeds, pulp, and white membranes of grapefruit. The herb has been used in traditional medicine as an anti bacterial, viral, fungal, parasites and to enhance immune system, protect against colds and flu and malignant disease.
a. Antimicrobial activity
In the determination of antibacterial and antifungal activity of ethanolic extract of grapefruit (Citrus paradisi Macf., Rutaceae) seed and pulp found that ethanolic extract exibited the strongest antimicrobial effect against Salmonella enteritidis (MIC 2.06%, m/V). Other tested bacteria and yeasts were sensitive to extract concentrations ranging from 4.13% to 16.50% (m/V), according to "Antimicrobial activity of grapefruit seed and pulp ethanolic extract" by Cvetnić Z, Vladimir-Knezević S.(46)

b. Antioxidant activity
In analyzing the antioxidant activity of Citrus paradisi (grapefruit) seeds glyceric extract dissolved in ethanol and in aqueous media found that grapefruit seeds glyceric extract utilized as aqueous solutions demonstrated antioxidant properties better than those displayed by alcoholic solutions. according to "Antioxidant activity of Citrus paradisi seeds glyceric extract" by Giamperi L, Fraternale D, Bucchini A, Ricci D.(47)

B.5.  Shiitake mushroom is an edible mushroom, genus Lentinula, belonging to family Marasmiaceae, native to East Asia and widely cultivated for consumption for its health benefits and commercial purpose in many Asian countries. The herb has been used in traditional medicine as blood tonic agent and to strengthen immune system, treat colds, measles, bronchial inflammations, etc.
a. Immune system
Shiitake mushroom enhances the immune system in fighting against infection and disease. influenza, viruses and irregular cells growth due to it anti-tumor polysaccharide lentinan, according to "Immunoregulatory effects of the antitumor polysaccharide lentinan on Th1/Th2 balance in patients with digestive cancers" by Yoshino S, Tabata T, Hazama S, Iizuka N, Yamamoto K, Hirayama M, Tangoku A, Oka M.(48)

b. Cholesterol
It also enhances the ration levels of blood cholesterol due to its active compound eritadenine, according to "Eritadenine-induced alterations of plasma lipoprotein lipid concentrations and phosphatidylcholine molecular species profile in rats fed cholesterol-free and cholesterol-enriched diets" by Shimada Y, Morita T, Sugiyama K.(49)

c. Free radicals
Shiitake mushroom contains high levels of antioxidants such as L-ergothioneine, that helps to
reduce the risk of oxidative cause of mutation in cell division and alternation, according to"Ergothioneine; antioxidant potential, physiological function and role in disease" by Cheah IK, Halliwell B.(50)

d. Liver diseases
Extracts of the mycelium of shiitake mushrooms not only protect the liver but also recover from liver fibrosis, according to "Effects and mechanisms of Acremoniumterricola milleretal mycelium on liver fibrosis induced by carbon tetrachloride in rats" by Tian XP, Yin YY, Li X.(51)

B.6. Ginseng Asia is also known as Panax ginseng. Since it has been grown in the cold places in the Asian, Asian ginseng is considered as yang promoting, according to traditional Chinese medicine.
The herb has been used in traditional and Chinese medicine to promote yang and to improve cardiac function, short of breath, blood pressure. Panax ginseng can generates fluids and reduce thirst, to treat anxiety, insomnia, dizziness/headache, forgetfulness, impotence, diabetes, bleeding in the vagina not during period, etc.
a. Antioxidant activity
In the evaluation of the extraction conditions of polysaccharides from the rhizomes of Panax japonicus C.A. Meyer and its antioxidant effect found that antioxidant activity exhibited Panax japonicus polysaccharides (PJP) had a good potential for antioxidant, according to "Optimization of polysaccharides from Panax japonicus C.A. Meyer by RSM and its anti-oxidant activity" by Wang R, Chen P, Jia F, Tang J, Ma F.(52)

b.  Immunological activities
In the study of Water-soluble ginseng oligosaccharides (designated as WGOS) with a degree of polymerization ranging from 2 to 10 were obtained from warm-water extract of Panax ginseng roots, found that WGOS were potent B and T-cell stimulators and WGOS-1 has the highest immunostimulating effect on lymphocyte proliferation among those purified fractions. It is hoped that the WGOS will be developed into functional food or medicine, according to "Structural characterization and immunological activities of the water-soluble oligosaccharides isolated from the Panax ginseng roots" by Wan D, Jiao L, Yang H, Liu S.(53)

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Sources
(1) http://www.ncbi.nlm.nih.gov/pubmed/16936604
(41) http://www.ncbi.nlm.nih.gov/pubmed/16562825 
(42) http://www.ncbi.nlm.nih.gov/pubmed/19703353 
(43) http://www.ncbi.nlm.nih.gov/pubmed/19593179 
(44) http://www.ncbi.nlm.nih.gov/pubmed/21042790 
(45) http://www.ncbi.nlm.nih.gov/pubmed/20507215 
(46) http://www.ncbi.nlm.nih.gov/pubmed/15610620 
(47) http://www.ncbi.nlm.nih.gov/pubmed/15030930 
(48) http://www.ncbi.nlm.nih.gov/pubmed/11205205
(49) http://www.ncbi.nlm.nih.gov/pubmed/12834276
(50) http://www.ncbi.nlm.nih.gov/pubmed/22001064
(51) http://www.ncbi.nlm.nih.gov/pubmed/21598420 
(52) http://www.ncbi.nlm.nih.gov/pubmed/22214823 
(53) http://www.ncbi.nlm.nih.gov/pubmed/22183124 
(54) http://theworldmostpopularherbs.blogspot.ca/2011/10/world-most-popular-herbs-health.html