Thursday 30 December 2021

SCIATICA - EVER SUFFERED AN AGONY - INTERVENTION WITH HOMOEOPATHY

 ABSTRACT

 Ever suffered a gnawing pain called sciatica? Sciatica pain is pretty clear cut, piercing or shooting pain in the lower back, which radiates down buttocks and legs. It is more common in men than women. Homoeopathy is considered as one of the very best alternative system for treating Sciatica pain. This article provides an overview of the aetiology, diagnosis, and appropriate general & homoeopathic management of this gnawing pain.

INTRODUCTION

Sciatica is not a disorder itself but is a general term used to describe the pain that occurs when nerve roots in the lumbosacral spine (low back) become compressed (pinched), irritated, or inflamed, often from a herniated disc or other narrowing of the spinal canal. Sciatica may be accompanied by numbness/tingling and muscle weakness. The sciatic nerve is the longest and thickest (almost finger-width) nerve in the body. True injury to the sciatic nerve “sciatica” is actually rare, but the term “sciatica” is commonly used to describe any pain that originates in the lower back and radiates down the leg. 

AETIOLOGY

Sciatica occurs when the sciatic nerve becomes pinched, usually by herniated lumbar disc, Lumbar spinal stenosis, Lumbar degenerative disc disease, general degenerative changes in vertebrae or discs, Spondylolisthesis, Muscle spasm and/or inflammation of the lumbar and/or pelvic muscles, Sacroiliac joint dysfunction

Rarely, tumors, blood clots, or other conditions in the lower spine may cause sciatica.

RISK FACTORS

Risk factors for sciatica include:

· Age. Age-related changes in the spine, such as herniated disks and bone spurs, are the most common causes of sciatica.

· Obesity. By increasing the stress on spine, excess body weight can contribute to the spinal changes that trigger sciatica.

· Occupation. A job that requires to twist back, carry heavy loads or drive a motor vehicle for long periods might play a role in sciatica, but there's no conclusive evidence of this link.

· Prolonged sitting. People who sit for prolonged periods or have a sedentary lifestyle are more likely to develop sciatica than active people are.

· Diabetes. This condition, which affects the way body uses blood sugar, increases risk of nerve damage.

· Smoking, Mental health issues, such as depression, Tall height in older age groups (50 to 60 years), Vitamin B 12 deficiency

CLINICAL MANIFESTATIONS

The symptoms of sciatica are commonly felt along the path of the large sciatic nerve. Sciatica is often characterized by one or more of the following features:

· Pain. Sciatica pain is typically felt like a constant burning sensation or a shooting pain starting in the lower back or buttock and radiating down the front or back of the thigh and leg and/or feet.

· Numbness. Sciatica pain may be accompanied by numbness in the back of the leg. Sometimes, tingling and/or weakness may also be present.

· One-sided symptoms. Sciatica typically affects one leg. The condition often results in a feeling of heaviness in the affected leg. Rarely, both legs may be affected together.

· Posture induced symptoms. Sciatica symptoms may feel worse while sitting, trying to stand up, bending the spine forward, twisting the spine, lying down, and/or while coughing. The symptoms may be relieved by walking or applying a heat pack over the rear pelvic region.

Certain symptoms of sciatica may indicate a serious medical condition, such as cauda equina syndrome, infection, or spinal tumors. These symptoms may include, but are not limited to: Progressive neurological symptoms, such as leg weakness, Symptoms in both legs, Bowel and/or bladder dysfunction, Sexual dysfunction

Types of Sciatica

Depending on the duration of symptoms and if one or both legs are affected, sciatica can be of different types:

Acute sciatica. Acute sciatica is a recent onset, 4 to 8-week duration of sciatic nerve pain. The pain may be self-managed and may not typically require medical treatment

Chronic sciatica. Chronic sciatica is persistent sciatic nerve pain that lasts for more than 8 weeks and usually does not subside with self-management. Depending on the cause, chronic sciatica may require nonsurgical or surgical treatment.

Alternating sciatica. Alternating sciatica is sciatic nerve pain that affects both legs alternately. This type of sciatica is rare and may result from degenerative problems in the sacroiliac joint

Bilateral sciatica. Bilateral sciatica occurs in both legs together. This type of sciatica is rare and may occur due to degenerative changes in the vertebrae and/or the disc at several spinal levels, or from serious conditions such as cauda equina syndrome.

DIAGNOSIS

A diagnosis of the underlying cause of sciatica is essential in formulating an effective treatment plan and managing sciatica pain.

Physical Examination and Medical History - The goal of conducting a physical exam and review of medical history is to identify the pain pattern in the patient’s leg.

Straight leg raise (SLR) test. This test includes the patient lying on his/her back and lifting one leg at a time with the other leg flat or bent at the knee. A pain encountered while lifting the affected leg usually indicates sciatica.

Slump test. This test includes the patient seated upright with hands behind the back. The patient bends (slumps) forward at the hip. The neck is bent down with the chin touching the chest and one knee is extended to a degree possible. If pain occurs in this position, sciatica may be present.

Medical imaging tests like Magnetic resonance imaging (MRI) & Discogram helps in diagnosing underlying cause

GENERAL MANAGEMENT

Sciatica treatment may include both nonsurgical and surgical methods. Typically, nonsurgical methods are tried first. Surgery may be indicated when the underlying cause is severe and/or progressive neurological deficits such as leg weakness occurs.

Massage Therapy

Certain forms of massage therapy, such as deep tissue massage, may have benefits for pain relief. The benefits of massage therapy include:

· Improving blood circulation, which in turn creates a better healing response in the body

· Relaxing tight muscles, which may be contributing to the pain

· Releasing endorphins, which are hormones in the body that function as natural pain relievers

Physical Therapy

The goals of physical therapy and exercises for sciatica include:

· Strengthen the spine and muscles of the lower back, abdomen, buttocks, and hip.

· Increase core strength

· Stretch tight and inflexible muscles, such as hamstrings

· Encourage the exchange of fluids and nutrients in the body by light aerobic exercises such as walking, swimming, or pool therapy

Hot and cold compresses

· A hot pack on your lower back and spine area can help to relax the tense muscles and improves the circulation. Either use a steamed towel or simply sit in a tub of warm water for 15-20 minutes. Do this twice a day and will be able to feel the pain ease away sooner than normal.

· Ice packs on the affected area for 10-15 minutes helps in decreasing the swelling around the nerve and also numbs the pain.

Chiropractic care

The core of chiropractic care are spinal adjustments. Manipulation of the spine frees restricted movement and helps to restore misaligned vertebral bodies to their proper position in the spinal column. Spinal manipulations help to calm the agitated and inflamed nerves, and in turn relax the muscle spasm. Ideally, spinal manipulations are not painful and are definitely effective.

YOGA

Yoga can help strengthen and stabilize core muscles, increase flexibility in hip and spine, and reduce lower back pain and sciatica

While yoga can be complex and difficult to perform, here are some easy and effective yoga stretches that can do at home using a yoga mat or a thick towel.

· Child’s Pose (Balasana)

· Half Moon Pose (Ardha Chandrasana)

· Downward-Facing Dog

· Locust Pose (Salabhasana)

· Cobra Pose (Bhujangasana)

· Knees-to-Chest Pose/Wind-Relieving Pose (Pawanmuktasana)

· Reclined Pigeon Pose (Supta Kapotasana)

· Bridge Pose (Setu Bandha Sarvangasana) 

· Legs-Up-the-Wall pose (Viparita Karani)

 

 

 

HOMOEOPATHIC MANAGEMENT

Homeopathy is an effective option to treat sciatica. The medicines given below indicate the therapeutic affinity but this is not a complete and definite guide to the treatment of this condition. Homoeopathy medicines are effective in treating. It is true that this method takes a longer time, but it is also the best one because not only the haemorroids are cured but also the patient.

Indicated Remedies

Indications

Aesculus

Pain in the very low back (the sacral or sacroiliac areas) that feels worse when standing up from a sitting position, and worse from stooping, may be eased with this remedy. Aesculus is especially indicated for people with low back pain who also have a tendency toward venous congestion and hemorrhoids.

Arnica montana

This remedy relieves lower back aches and stiffness from overexertion or minor trauma.

Bryonia

This remedy is indicated when back pain is worse from even the slightest motion. Changing position, coughing, turning, or walking may bring on sharp, excruciating pain. This remedy can be helpful for back pain after injury and backaches during illness.

Calcarea carbonica

This is often useful for low back pain and muscle weakness, especially in a person who is chilly, flabby or overweight, and easily tired by exertion. Chronic low back pain and muscle weakness may lead to inflammation and soreness that are aggravated by dampness and cold.

Calcarea phosphorica

Stiffness and soreness of the spinal muscles and joints, especially in the neck and upper back, may be relieved by this remedy. The person feels worse from drafts and cold, as well as from exertion. Aching in the bones and feelings of weariness and dissatisfaction are often seen in people who need this remedy.

Natrum muriaticum

Back pain that improves from lying on something hard or pressing a hard object (such as a block or book) against the painful area suggests a need for this remedy. The person often seems reserved or formal, but has strong emotions that are kept from others. Back pain from suppressed emotions, especially hurt or anger, may respond to Natrum muriaticum.

Nux vomica

This remedy is indicated for muscle cramps or constricting pains in the back. Discomfort is made worse by cold and relieved by warmth. Pain usually is worse night, and the person may have to sit up in bed to turn over. Backache is also worse during constipation, and the pain is aggravated when the person feels the urge to move the bowels.

Rhus toxicodendron

This remedy can be useful for pain in the neck and shoulders as well as the lower back, when the pain is worse on initial movement and improves with continued motion. Even though in pain, the person finds it hard to lie down or stay still for very long, and often restlessly paces about. Aching and stiffness are aggravated in cold damp weather and relieved by warm applications, baths or showers, and massage.

Sulphur

This remedy is often indicated when a person with back pain has a slouching posture. The back is weak and the person feels much worse from standing up for any length of time. Pain is also worse from stooping. Warmth may aggravate the pain and inflammation

Hypericum perforatum

 

This homeopathic remedy relieves lower back pain with sharp throbbing pain.

 

Ruta graveolens

This is used to relieve lower back pain caused or worsened by staying immobile.

Cimicifuga

Severe aching and stiffness in the upper back and neck, as well as the lower back—with pains that extend down the thighs or across the hips — may be eased with this remedy. It is often helpful for back pain during menstrual periods, with cramping, heaviness, and soreness. A person who needs this remedy typically is talkative and energetic, becoming agitated or depressed when ill.

CONCLUSION

Homoeopathy treats the person as a whole. It means that homoeopathic treatment focuses on the patient as a person, as well as his pathological condition. The homoeopathic medicines are selected after a full individualizing examination and case-analysis, which includes the medical history of the patient, physical and mental constitution etc. A miasmatic tendency (predisposition/susceptibility) is also often taken into account for the treatment of chronic conditions. It is true that this method takes a longer time, but it is also the best one because not only the haemorroids are cured but also the patient.

Deep-acting medicines are required to treat the constitution and bring about lasting relief.

Sunday 24 October 2021

HAIR FALL LOSING ELEGANCY AND PERSONALITY?? – HOMOEOPATHIC HAIR CARE

 Abstract 

 

Homoeopathy is considered as one of the very best alternative system for treating hair loss. Hair loss can affect scalp or entire body. It can be the result of heredity, hormonal changes, medical conditions or medications. Anyone like men, women and children can experience hair loss. Baldness typically refers to excessive hair loss from scalp. Hereditary hair loss with age is the most common cause of baldness. Some people prefer to let their baldness run its course untreated and unhidden. 

Introduction

 

Hair is almost like a social status for both men and women, and also children. It is society’s expectation that you will have a head of hair! Hair states ones personality and adds additional beauty. Hair is a statement about yourself, how you have your hair. Women who desire to be beautiful almost always start with their hair. There’s nothing more stunning than long, shiny, healthy hair! Elegant and versatile, long hair gives women many options when it comes to styling and creating new looks. Even though the hair is a dead tissue, it suffers from numerous hazards mirroring hair problems. Everyone who desire to be beautiful and takes hair care should understand the basics of hair.

Most people normally shed 50 to 100 hairs a day. This usually doesn't cause noticeable thinning of scalp hair because new hair is growing in at the same time. Hair loss occurs when this cycle of hair growth and shedding is disrupted or when the hair follicle is destroyed and replaced with scar tissue.Hair loss can appear in many different ways, depending on what's causing it. It can come on suddenly or gradually. Some types of hair loss are temporary, and others are permanent.

Causes of Alopecia

The exact cause of hair loss may not be fully understood, but it's usually related to one or more of the following factors: Family history (heredity), Hormonal changes, Medical conditions, Medications

Family history - The most common cause of hair loss is a hereditary condition called male-pattern baldness or female-pattern baldness. It usually occurs gradually and in predictable patterns — a receding hairline and bald spots in men and thinning hair in women. Heredity also affects the age at which begin to lose hair, the rate of hair loss and the extent of baldness. Pattern baldness is most common in men and can begin as early as puberty. This type of hair loss may involve both hair thinning and miniaturization (hair becomes soft, fine and short).

Hormonal changes and medical conditions - A variety of conditions can cause hair loss, including: Hormonal changes and imbalances can cause temporary hair loss. This could be due to pregnancy, childbirth or the onset of menopause. Hormone levels are also affected by the thyroid gland, so thyroid problems may cause hair loss.

Patchy hair loss - This type of nonscarring hair loss is called alopecia areata. It occurs when the body's immune system attacks hair follicles — causing sudden hair loss that leaves smooth, roundish bald patches on the skin.

Scalp infections - Infections, such as ringworm, can invade the hair and skin of your scalp, leading to scaly patches and hair loss. Once infections are treated, hair generally grows back.

Other skin disorders - Diseases that cause scarring alopecia may result in permanent loss at the scarred areas. These conditions include lichen planus, some types of lupus and sarcoidosis.

Hair-pulling disorder - This condition, also called trichotillomania, causes people to have an irresistible urge to pull out their hair, whether it's from the scalp, the eyebrows or other areas of the body.

Medications - Hair loss can be caused by drugs used for cancer, arthritis, depression, heart problems, high blood pressure and birth control. Intake of too much vitamin A may cause hair loss as well.

Hair loss can also result from Radiation therapy to the head. The hair may not grow back the same as it was before.

Many people experience a general thinning of hair several months after a physical or emotional shock. This type of hair loss is temporary. Examples of trigger events include sudden or excessive weight loss, a high fever, surgery, or a death in the family.

Certain hairstyles and treatments. Excessive hairstyling or hairstyles that pull your hair tight, such as pigtails or cornrows, can cause traction alopecia. Hot oil hair treatments and permanents can cause inflammation of hair follicles that leads to hair loss. If scarring occurs, hair loss could be permanent.

Clinical Presentation

 

Hair loss can appear in many different ways, depending on what's causing it. It can come on suddenly or gradually. Some types of hair loss are temporary, and others are permanent.

Signs and symptoms of hair loss may include:

Gradual thinning on top of head. This is the most common type of hair loss, affecting both men and women as they age. In men, hair often begins to recede from the forehead in a line that resembles the letter M. Women typically retain the hairline on the forehead but have a broadening of the part in their hair.

Circular or patchy bald spots. Some people experience smooth, coin-sized bald spots. This type of hair loss usually affects just the scalp, but it sometimes also occurs in beards or eyebrows. In some cases, your skin may become itchy or painful before the hair falls out.

Sudden loosening of hair. A physical or emotional shock can cause hair to loosen. Handfuls of hair may come out when combing or washing your hair or even after gentle tugging. This type of hair loss usually causes overall hair thinning and not bald patches.

Full-body hair loss. Some conditions and medical treatments, such as chemotherapy for cancer, can result in the loss of hair all over your body. The hair usually grows back.

Patches of scaling that spread over the scalp. This is a sign of ringworm. It may be accompanied by broken hair, redness, swelling and, at times, oozing.

Diagnosis

Diagnosis made with help of physical exam, medical history, and family history and with some tests.

Blood test - This may help uncover medical conditions related to hair loss, such as thyroid disease.

Pull test - gently pulls several dozen hairs to see how many come out. This helps determine the stage of the shedding process.

Scalp biopsy - scrapes samples from the skin or from a few hairs plucked from the scalp to examine the hair roots. This can help determine whether an infection is causing hair loss.

Light microscopy - Microscopy helps uncover possible disorders of the hair shaft and to examine hairs trimmed at their bases.

MANAGEMENT

These tips may help avoid preventable types of hair loss:

· Eat a nutritionally balanced diet.

· Avoid tight hairstyles, such as braids, buns or ponytails.

· Avoid compulsively twisting, rubbing or pulling your hair.

· Treat your hair gently when washing and brushing. A wide-toothed comb may help prevent pulling out hair.

· Avoid harsh treatments such as hot rollers, curling irons, hot oil treatments and permanents.

· A good daily multivitamin containing zinc, vitamin B, folate, iron, and calcium is a reasonable choice, although there is no good evidence that vitamins have any meaningful benefit in alopecia. Newer studies suggest that vitamin D may be somewhat helpful and worth considering. Specific vitamin and mineral deficiencies like iron or vitamin B12 may be diagnosed by blood tests and treated.

· Multiple vitamins, including biotin, have been promoted for hair growth, but solid scientific studies for many of these claims are lacking. 

Home natural remedies

 

· Onion Juice for hair growth - This remedy is regarded as one of most effective and oldest ones. The reason behind is that it contains sulphur that boosts collagen production in the tissues and helps in the re-growth of hair. Don’t let its strong smell keep you away from using it, because it goes off just after one rinse. To try this remedy, cut a few slices of onion and squeeze out its juice (either by mashing it or grating it) and apply it on your scalp for about 10-15 minutes. Let it work its magic and then rinse it off with a mild shampoo.

· Coconut Milk - it is rich in iron, potassium and essential fats, take coconut milk from a fresh coconut, to it add half a squeeze of lemon, 4 drops of essential lavender oil. Mix it thoroughly and apply it on your scalp, leave it on for 4-5 hours and then rinse it off.”

· Apple Cider Vinegar – This vinegar gently cleanses the scalp and maintains the pH balance of the hair thereby accelerating hair growth.  Start for making a diluted solution by mixing 75ml of it in one litre of water for a larger batch or 15 ml of it to a cup of warm filtered water for a smaller batch.

· Egg Mask – This home remedy is used all over the world for quick and natural hair growth. As we know, eggs contain high levels of proteins which help in the formation of new hair. It is also rich in sulphur, zinc, iron, selenium, phosphorous and iodine.
For the egg mask, separate one egg white in a bowl and add one teaspoon of olive oil ( you can also use grape seed oil or lavender oil )and honey. Make a paste of it and apply it all over your hair and scalp for about 20 minutes. Rinse it off with cool water and some shampoo.  

· Fenugreek– This herb is also an age-old remedy for hair growth problems. It contains proteins and nicotinic acid; protein-enriched diets have been known to encourage stimulation of hair growth. Add a tablespoon of this herb and water in a grinder till a smooth paste it formed. Add a little coconut oil (or milk) to it and apply on your hair and scalp for half an hour. Wash it off with a mild shampoo.

· Green tea, as you know is super rich in antioxidants and that helps in boosting hair growth and preventing hair loss. Apply warm green tea (from the used tea bags) over your scalp and leave it for an hour. Wash it off with cool water.

· Indian Gooseberry (amla) – This magical fruit is a powerhouse of nutrients. It’s rich in Vitamin C and that accelerates hair growth. All you need to do is, mix 2 teaspoons of amla powder or juice with equal amounts of lime juice and let it dry. Rinse it off with some warm water. It will also prevent hair pigmentation.

 

HOMOEOPATHIC MANAGEMENT

   Homoeopathic mode of treatment has good scope and can aid regrowth of hair. Homoeopathic medicines stimulate the hair roots to promote regrowth. The medicines used in Homoeopathy to aid hair regrowth are all of natural origin and therefore, safe for use among persons of all age groups. Hair-loss is again just an indicator that there is something not well in our body. The hairs may fall due to a local infection or due to a systemic disorder or deficiency. The treatment also varies accordingly. The following homoeopathic medicines are often found indicated in cases of hair fall:

Medicine

Indication

Arsenic album

alopecia due to use of metallic arsenic, scalp itches intolerable. Circular patches of bare spots, hair fall in debilitated persons. Patients is mentally restless and very anxious about his/her health or hairfall. Sensitive to cold in general and cold drinks. Fastidious temperament.

Fluoricum Acidum

 

It is considered excellent for hair loss, especially alopecia areata, where the patient loses hair from spots on the scalp. It is also adept at dealing with the resulting hair fall after a period of sickness, hair breakage, hair fall caused by syphilis, and hair gets tangled a lot. It is recommended by a lot of homeopathic doctors.

Phosphorus

 

It is a medicine that is capable of curing a wide array of diseases. While it is popular for treating alopecia, it is also used to heal issues of the gastrointestinal tract, blood, nervous tissue, and bones.

Calcarea Carbonica

 

Calcarea Carb, has been found to be one of the best homeopathic medicines for hair regrowth. It is often prescribed to patients for whom hair loss is accompanied by intense itching and sweating of the scalp.

Vinca Minor

 

Vinca Minor is efficient in treating alopecia when it is accompanied by dandruff. It is also used to treat abnormal hair growth i.e. when the hair grows out like white wool.

Silicea

 

It is hard to believe that this deep acting remedy is inert before it undergoes potentization. It is used to treat a wide range of diseases. Homeopaths commonly prescribe Silicea for baldness accompanied with pain. It also treats skin conditions like eczema, which may sometimes cause dandruff.

Baryta Carbonica

 

This homeopathic cure is administered to young people suffering from premature baldness. It is generally used to treat timid people who are experiencing baldness along with throat complaints and issues such as tonsillitis.

Lycopodium Clavatum

 

This is one of the best homeopathic medicines for preventing a number of hair-related problems. Lycopodium is a wonderful remedy for hair loss, premature graying of the hair, and even baldness. It is prepared from club moss (fungus), which is potentized for its usage. This homeopathic medicine also tackles premature balding.

Psorinum

 

Psorinum is the best treatment for hair loss that is caused due to dandruff. Dandruff is a common result of skin conditions like psoriasis and eczema. Psorinum tackles the root of the cause, reducing hair fall and dandruff at the same time.

Mezereum

 

This is another medicine that efficiently deals with conditions of the skin such as rashes, lesions, and psoriasis. It tackles hair fall in people who have crusty scalps and infected scalps with pus. It is also ideal for encouraging hair growth.

Kali Sulphuricum

 

When the dandruff is yellow in color, Kali Sulphuricum is a good treatment to resort to. It promises great results and is often prescribed by homeopaths to patients who complain of dandruff and hair loss together.

Mercurius solubilis

falling of hair due to syphilis. Alopecia with eruptions on scalp; discharge from eruptions is fetid and accompanied by burning pains in scalp. Patient has profuse perspiration, excessive thirst and salivation.

Natrum Muriaticum

 

The interesting thing about Natrum Muriaticum is that it is made from common salt through potentization. It is used to treat a myriad of issues and is perfect for treating post childbirth hair fall. It is also prescribed for hair fall in women suffering from anemia.

Pulsatilla Pratensis

 

This is administered to women suffering from post-delivery hair loss. The people to whom this medicine is prescribed often report a lack of thirst and a desire for breathing in fresh air. It is also administered to women who have trouble in digesting fatty food.

Selenium

falling of hair from whole head leaving the scalp smooth and hairless (alopecia universalis). Falling of hair from eyebrows and face giving a strange appearance.

Vinca minor

 bald spots with itching of the skin, oozing moisture, matting hair together. Irresistible desire to scratch. Hair-loss, sharp and well defined, circumscribed patches which leave the scalp smooth and white or gray hair may grow on the bald spots like white wool.

Wiesbaden 

the hair grows rapidly and become darker by the use of this remedy. Arnica and Cantharis are also known to promote hair growth.

 

Conclusion

The aim of homoeopathy is not only to treat hair loss but to address its underlying cause and individual susceptibility. As far as therapeutic medication is concerned, several well-proved remedies are available for homoeopathic treatment of hair loss that can be selected on the basis of cause, location, modalities and extension of the hair loss. Hair-loss is again just an indicator that there is something not well in your body. The hairs may fall due to a local infection or due to a systemic disorder or deficiency. The treatment also varies accordingly. The main advantage of opting for Homoeopathic medicines for hair regrowth is the absence of any related toxic side effects.For individualized remedy selection and treatment, the patient should consult a qualified homoeopathic doctor in person. Homoeopathy has to treat the cause and the person a a whole, after due individualization of every patient.


 

 

 


BOERHAVIA DIFFUSA MOTHER TINCTURE IN THE MANAGEMENT OF ESSENTIAL HYPERTENSION

  RETROSPECTIVE CASE ANALYSIS ON THE EFFECTIVENESS OF BOERHAVIA DIFFUSA MOTHER TINCTURE IN THE MANAGEMENT OF ESSENTIAL HYPERTENSION ABSTRACT...