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ADHD (Attention Deficit Hyperactivity Disorder) is a topic that concerns and interests me, esp. since I have quite a few children who come to me for homeopathic treatment as referrals from a school counsellor. Very often, I find that the counsellor herself does not believe that these kids have ADHD but just regular behavioural issues. To prevent these kids from being put onto ADHD medication, this wise counsellor refers them for homeopathy.

Unfortunately, the schools seem to be putting the parents under a lot of pressure to have these kids seen by a psychiatrist and then put onto medication for ADHD. Initially, one of the psychiatrists even argued with the school about holding off on medication as far as possible. However, his present stand seems to be to put the kids on medication. As he tells the parents, “If your child does not have ADHD, the drugs won’t work and then you can stop medication.” From all my reading, I do not think that this is what will happen. Even if the child does not have ADHD, these drugs will show an initial improvement in the symptoms of restlessness, lack of focus and concentration, etc. These drugs will work on anyone and have some kind of initial beneficial result. Why else would the US armed forces be giving these to their cadets? It is not possible that their cadets all have ADHD!

It is sad that schools nowadays lack teachers who can cope with different children. For the sake of ease and convenience of the teachers and the school, children are being put onto medication unnecessarily so that they comply. Pharmaceutical companies promote medication in their own interests and advise doctors accordingly. It would be truly disheartening to believe that a huge number of doctors are hand-in-glove with the companies and hence medicate children. It is possible that doctors, either from being too busy or from trust in the companies, remain ignorant about the ill-effects of these drugs and the absence of any long-term benefit despite a myriad studies and experience with their patients.

In such a scenario, widespread awareness is the need of the day.

Here is an article which strikes the right chord –

http://www.naturalnews.com/023334_child_children_brain.html

Sometimes, I find such articles an exaggeration but this one seems to be spot on. Get aware.

Acetaminophen, also known as Paracetamol, is a commonly used drug in modern medicine, which has been considered ‘safe’ even for children in normal dosage. New studies are raising some questions about its safety and long-term ill-effects.

In the last 30 years there has been a dramatic rise in the incidence of childhood asthma and this has perplexed doctors, scientists and researchers alike.
This increase in incidence was noticed soon after doctors stopped using Aspirin (because it was causing Reye’s Syndrome in children) regularly and started using Acetaminophen instead.

An initial paper published in 1998 suggested the use of acetaminophen to be causing increased asthma in children. Over time, more than 20 studies have reached the same conclusion, with data of over 200,000 children being analysed.

In November 2011, Dr. John T. McBride, a pediatrician at Akron Children’s Hospital in Ohio, published a paper in the journal Pediatrics arguing that the evidence for a link between acetaminophen and asthma is now strong enough. He now explains how acetaminophen might provoke or worsen asthma. Researchers found that even a single dose of acetaminophen can reduce the body’s levels of glutathione, a peptide that helps repair oxidative damage that can drive inflammation in the airways. Acetaminophen causes increased bronchial constriction and wheezing.

This association linking acetaminophen with asthma is consistent across age, geography and culture. Studies also found an increased risk of asthma in children whose mothers who took acetaminophen during pregnancy. A big analysis in 2008 found that children who had taken acetaminophen for a fever during the first year of life had a 50 percent greater risk of developing asthma symptoms, compared with children who had not taken the drug. The risk rose with increasing use — children who had taken acetaminophen at least once a month had a threefold increase in the risk of asthma symptoms.

This leads us to question the use of this drug. Are parents unknowingly, in their haste to quell even mild fevers, pushing their children towards a chronic disease like asthma? Parents do it unknowingly. Doctors often do it despite knowing. Are pharma incentives worth turning a blind eye to the welfare of patients?

I hope this study and all the preceding ones will not be pooh-poohed by the Pharma companies who will come up with some other study (sponsored by themselves and hence baised) refuting these.

May knowledge and awareness prevail.

References:

http://pediatrics.aappublications.org/content/early/2011/11/04/peds.2011-1106.abstract?rss=1


http://www.nytimes.com/2011/12/20/health/evidence-mounts-linking-acetaminophen-and-asthma.html

http://chestjournal.chestpubs.org/content/127/2/604.full

http://edition.cnn.com/2010/HEALTH/08/13/acetaminophen.may.double.asthma.risk/index.html

http://debbybruck.hubpages.com/hub/Fosamax-Drug-Effects-Causing-Severe-Femur-Fractures-Brittle-Bones

Ever since drugs to combat osteoporosis started being prescribed, I began to wonder whether they would not be interfering with the normal bone health regulation cycle. Healthy bone is, at all times, being built and remodelled; old bone cells being killed within the body. Osteoblasts are the bone building cells and osteoclasts are the cells that take away old cells, unhealthy cells and hence help to remodel bone tissue. As age progresses, the bone building activity reduces, hence the breakdown of bone cells takes on a predominant role.

Drugs for osteoporosis inhibit the activity of osteoclasts. Common sense then tells me that under the influence of these drugs, healthy bone remodelling will not occur as it should. Old bone cells, unhealthy bone cells will not get destroyed as they should. Could this even lead to an increase in bone cancers? If there is a major reduction in osteoclastic activity, bone might then get too dense and rigid, lacking the amount of elasticity that it needs; this can then make the bones hard and brittle, thus increasing the risk of fractures after even slight trauma.

Studies are now showing that the osteoporosis drugs ARE in fact, leading to more brittle bones and more fractures. The excessive calcium deposits are leading to eye problems, heart ailments and embolic stroke.

To read more details, please click on this link

http://debbybruck.hubpages.com/hub/Fosamax-Drug-Effects-Causing-Severe-Femur-Fractures-Brittle-Bones

Last year, in November 13, 2010, the prestigious Journal of Rheumatology published an article with the following heading:

“Homeopathy has clinical benefits in rheumatoid arthritis patients that are attributable to the consultation process but not the homeopathic remedy”.

http://rheumatology.oxfordjournals.org/content/early/2010/11/08/rheumatology.keq234.abstract

World famous Greek homeopath, George Vithoulkas responded with an answer to Rheumatology Journal but they refused to publish it.

The article was then sent to another peer review journal “HOMEOPATHY” and here is the answer for those who are interested in defending homeopathy and understanding the truth.

http://www.sciencedirect.com/science/article/pii/S1475491611000555

Now, the answer to Rheumatology Journal by Prof. Vithoulkas is available through the website of the International Academy of Classical Homeopathy.

http://www.vithoulkas.com/images/stories/Articles/letter_to_the_editor_homeopathy_rheumatology.pdf

I had put up this fantastic article as one of my health resources and to my dismay I found that the original article has been removed from the internet. The author has been hounded and no wonder!

My tech-savvy husband showed me the website waybackmachine.org from which I could find a cached copy of the article.
So here it is, uploaded as a pdf.
Dr. Andrew Moulden’s Interview – What You Were Never Told About Vaccines _ vactruth

All parents need to read this and take informed decisions about vaccination.

More and more people, even those in their 30s, are being tested for cholesterol levels and are prescribed some form of cholesterol-lowering drugs. Doctors are happy to prescribe these expensive medications to their patients but (knowingly or unknowingly) no mention is made of their dangerous side-effects, esp., when one considers that these drugs are meant to be taken long-term, if not for a lifetime.

One important fact is missed/ignored – statistics can easily be used to manipulate studies and figures to show misleading results. A report might say that a medicine slashes the risk of, say, heart attacks, by 50%. Such a statement fails to tell you the whole truth. If only 2 people in a group of 100, actually fit the risk profile, then a drug that prevents heart attack in 1 of those 2 people, is considered to have a 50% success rate in the whole group of 100 people, but then, 98 of the group were not at risk anyway. Hence, in this scenario, a drug that cuts the rate by 50% prevents just 1 heart attack when taken by all 100 people. Researchers prefer to use the term “Numbers Needed to Treat” (NNT). It shows how many people must take a drug for one person to benefit. The ideal NNT is 1, where everyone has improved with treatment and no-one has with control. The higher the NNT, the less effective is the treatment.

Hence, for people taking statins, it is necessary that they weigh the possible side effects against the possibility (not certainly) of any benefit.

As published in Business Week,

Lipitor and other cholesterol-lowering statins, when used in people who have had a heart attack or who have signs of heart disease — have an NNT of 16-23. In clinical trials with 5 years of treatment, 1 in 16-23 people is spared a coronary event. To prevent an actual death, the NNT is 48.

Lipitor and other cholesterol-lowering statins, when used in patients without heart disease, but who have risk factors like high blood pressure — have an NNT of 70-250, which means that 1 person in 70-250 is spared a heart attack or a stroke.

Lipitor and other cholesterol-lowering statins, when used in patients without heart disease, but who have risk factors like high blood pressure — have an NNT of 500+ to prevent death or serious medical conditions.

Zetia, which lowers cholesterol — has an NNT of 1000+ which means that, of over 1000 patients who take Zetia, heart disease is prevented in only 1.

Astonishing, isn’t it!!! For all those on cholesterol-lowering medication, have your doctors given you these figures or have you only received assurances? With such a poor benefit record, is it worth having the possibility of deadly side effects?

Some of the side-effects known to occur with cholesterol-lowering drugs are:

  • Common side-effects include headache, nausea, vomiting, diarrhoea/constipation, rash and muscle pain.
  • Memory loss and amnesia, along with less severe cases of forgetfulness, confusion, difficulty concentrating, or other cognitive symptoms that are simply chalked up to the gradual erosion of the body and mind by the aging process, when they are in fact attributable to cholesterol-lowering statin drugs.
  • Depression.
  • Polyneuropathy.
  • Muscle pain, muscle cramps, unusual tiredness.
  • Rhabdomyolysis — a fatal condition involving the destruction of muscle tissue that was responsible for the recall of the lethal statin Baycol.
  • Congestive heart failure.
  • Coenzyme Q10 (CoQ10) and carnitine deficiency.
  • Inflammation and rupture of tendons and ligaments.
  • Interference with the production of endorphins.
  • Liver and kidney dysfunction.

Here are some links giving details of these side-effects:

http://www.cholesterol-and-health.com/Statin-Drugs-Side-Effects.html

http://www.medindia.net/news/Statins-can-also-Exert-Detrimental-Effects-on-Brain-Cells-60245-1.htm

http://www.spacedoc.net/statins_brain_cell_damage.html

http://www.brainbequick.com/brain-fog.html

http://www.spacedoc.net/stopping_statins.html

http://www.medicinenet.com/statins/page2.htm#toce

References:
http://www.businessweek.com/magazine/content/08_04/b4068052095204.htm

http://www.medicine.ox.ac.uk/bandolier/booth/glossary/NNT.html

At a time when the whole world is concerned about the recent earthquake and tsunami in Japan and the nuclear repercussions, this article and the comments that follow will be of interest to all.
Though the Japanese and American governments are downplaying the situation, possibly with the idea of not creating mass panic, it is always better to be prepared for any eventuality.

http://hpathy.com/homeopathy-papers/overview-of-reactor-problems-in-japan-homeopathic-remedies-and-nutrients-for-radiation-symptoms/

Several readers inquired about the possibilities of homeopathic use for the problems of progressing age. This article is an attempt to answer those queries.

Aging is inevitable for all of us who will be lucky enough to get there. Aging with grace, dignity and good health is one of the blessings of life. Good health comprises physical and mental well-being. Homeopathy is a system of medicine that can help to maintain good health for as long as we live.

However much we want to be free of health problems, our aging years bring with them some sort of ailment or disability. There could be physical problems like pain and stiffness of the joints, weakening brittle bones, vertigo, trembling, debility and gait disturbances, diminishing bladder control, sleeplessness, recurrent respiratory infections, complications of chronic conditions like heart disease, diabetes, etc. Aging could affect our mental sphere bringing on depression, decline in our cognitive functions, memory, etc.

Often I come across patients who are overwhelmed by the name of a diagnosis given to them. This brings on anxiety and often depression at the thought of a ‘big and unknown’ illness. My advice to them would be not to get scared of the ‘disease term’ used; ask your doctor to explain what the condition is all about and what the common terminology is for it. Patients have every right to ask their doctors for details. Many patients have come to me, worried that they have “vertigo”. They say that they had suffered from dizziness, in Gujarati called ‘chakkar’, but the doctor said they had vertigo. And this gets them worried. It is a big relief for them to know that vertigo is the medical term for dizziness. This is just a small example, this happens commonly with many other ailments.

Many a time, we see senior citizens being diagnosed with a chronic disease condition and then put on long-term medication that brings on its own share of side-effects, adding to the ill-health and suffering that the patient has to put up with. Homoeopathy is ideal for such situations – the remedies, in their correct potency and dosage are safe from side-effects (because they are not chemical drugs but potentized electromagnetic energy forms of the remedy substance), they are easy to take and are cheaper than conventional medicine treatments. Homoeopathic remedies, for all chronic conditions, are chosen with due emphasis on the individual patient and not the disease name. When remedies are chosen in this manner, they work to stimulate the immune system of the patient, making all the body systems run optimally. The body’s own healing mechanism is given a boost and the process of cure is begun. It is important to realize that ailments that have existed for many years will not go away in a few months. Patience is essential. However, some kind of improvement should certainly be visible in about 3 – 4 months. In cases where cure is not possible, homoeopathic remedies serve to give relief and keep the patient as comfortable as possible. The progress of chronic degenerative illnesses can be slowed down by homoeopathy, if the patient is beyond the reach of cure.

Our senior citizens often suffer from acute health problems like coughs, colds, digestive disturbances, etc., that are triggered by environmental conditions, due to a weakened immunity. Strong chemical drugs may help to contain the infection but bring on diarrhoea and weakness that stays with them a long time. Homoeopathic remedies are effective even in acute conditions and work rapidly to eliminate the problem without the addition of side-effects. In such acute conditions, the homoeopath does not need to know the life history of the patient; details about the acute problem itself – details about the origin, duration and progress are enough to aid the homoeopath to select a suitable remedy. A well-selected remedy can deal with an acute problem very rapidly, within minutes to hours. The patient is left free of the problem and with good vitality.

To conclude, a senior citizen, with the help of homoeopathy, has very good chances of staying relatively healthy, avoiding unnecessary hospitalization and enjoying the retirement years in the best way possible.

After several queries, I have decided to write about the twenty most effective remedies that are regularly used for infants and children in homoeopathic practice. These are not ‘constitutional’ remedies (remedies for eradicating long-term problems or inherited tendencies) but those that are commonly used for acute problems and which every household with young children should stock.

This article is not meant to encourage home-prescribing, but to build up awareness about the great potential that homoeopathy has to solve most problems that children encounter; safely and gently, without the use of strong chemical drugs like antibiotics.

Nowadays, we see a lot of children in our practice that come with health problems that could easily have been avoided, had homoeopathy been resorted to in the first place. Instead, anxious parents, unknowingly, often compel their doctors to prescribe strong medicines like antibiotics even for routine coughs, colds and fevers. This way, the body’s own immunity does not adequately learn how to fight infections and hence the next rounds of infection come sooner and sooner. This leads to a vicious circle of infections and antibiotics with the child’s immunity taking a battering. As the child’s immunity continues to suffer, the child becomes more and more disposed to developing more serious infections and conditions like ear infections, chronic otitis media, tonsillitis, bronchitis and even bronchial asthma. Chronic ailments like skin allergies and eczema also become more common. These are usually considered as new ailments and never linked to the actual immunity lowering cause.

With correct homoeopathic prescribing, all the acute coughs, colds, fevers and even the more serious conditions like ear infections, chronic otitis media, tonsillitis, bronchitis and bronchial asthma can be treated well. Homoeopathic remedies stimulate the immune system to function optimally and, over time, the immunity improves and children’s own bodies are able to fight off most infections without the need for any medication. For such immunity-improving treatment, detailed constitutional therapy is essential – this requires a detailed case taking and proper case management. However, the list given below contains remedies often used for acute problems, from which, even at odd hours of the day or night, your homoeopath can choose the suitable remedy based on the symptoms present. Such a kit kept at home can be handy and valuable.

1. ACONITE
This is a remedy useful for the congestive stage of inflammation before localization takes place. Ailments arise from exposure to dry cold air, drafts of cold air especially when overheated. Ailments come on suddenly with intense symptoms. High fevers where the face is red or red and pale alternately. There is great thirst for large quantities of cold water, lot of restlessness and tossing about. Teething children may develop convulsions. Cough is dry, hoarse and croupy, more on expiration.

2. AETHUSA CYNAPIUM
Suited to children during dentition who develop complaints in hot summer weather, children who cannot tolerate milk. Milk is vomited in large curds as soon as it is taken, vomiting leads to intense weakness and drowsiness. The child sleeps and then wakes up hungry and crying, drinks milks again and the cycle repeats. The child’s face bears and expression of pain and anxiety.

3. ANTIMONIUM TART
Children with cough where there seems to be a large collection of mucus but nothing comes up. Child is clingy and wants to be carried but won’t let anyone else touch him. Vomiting that is followed by drowsiness and great weakness. Tongue is coated pasty, thick and white. Great inclination to sleep with nearly all complaints. Useful for children at birth who are pale, breathless and gasping; prevents asphyxia neonatorum. Most ailments seem to come on in damp weather or from living in damp rooms.

4. ARNICA MONTANA
Very useful for the falls and bumps that children get as a routine part of growing up. Prevents serious repercussions of head injuries and is known to absorb bleeding that has occurred into the brain after a head injury. Also useful for the bad effects of injuries received a long time ago. Useful also for mechanical blunt injuries that result in stupor from concussion with involuntary passage of stools and urine. Injuries bring on a sore, lame, bruised feeling, as if beaten. Whole body is oversensitive. Everything on which he lies feels very hard, keeps moving from place to place in search of a soft spot.
* Do not use Arnica ointment on any open wounds.

5. ARSENICUM ALBUM
For the start of colds with intense sneezing, watery nasal discharge and thirst for sips of cold water frequently. Fevers with restlessness where children want to be carried rapidly. Also useful for tummy upsets that result from cold food or drink or from eating bad meat. Nausea at the smell or sight of food, diarrhoea after eating or drinking, watery stools with great weakness.

6. BELLADONNA
Suited to children with great liability to catch colds; sensitive to drafts of air especially when uncovering the head or after a hair cut, tonsillitis after exposure to cold winds. Sudden onset of ailments with redness of face or eyes with most complaints. Tongue has a strawberry red appearance. Pulse is full and bounding, congestive headaches worse from slight noise, light, jar, movement; better by tight bandaging or pressure. Useful for convulsions during teething, with fever where the head is hot and the feet are cold. For children who get delirious with fever.

7. CALENDULA
One of the best antiseptic remedies in homoeopathy. Very useful for open wounds to promote healthy healing of tissue and prevent excessive pus formation. Useful as oral medicine as well as application of Calendula ointment on the wounds. Also for use post-surgically to promote rapid healing.

8. CHAMOMILLA
Useful for children – newborn and during the teething period. Ailments from cold, anger, dentition. Child is exceedingly irritable and fretful, quiet only when being carried. Impatient and demanding, rejecting the thing when given. Whining and moaning constantly. Intense pains (eg., ear pains) with great oversensitivity, one cheek red and hot, the other pale and cold. Great aversion to wind especially about the ears. Diarrhoea of teething infants where the stools are green, watery, like chopped eggs and spinach, hot and very offensive.

9. CINA
For complaints of children who are very irritable and cross, want to be carried but carrying gives no relief. They do not want to be touched and cannot bear anyone coming close. Constantly digging and boring at the nose. Worm complaints with startling and screaming during sleep and grinding of teeth.

10. COLOCYNTH
Very useful for abdominal colic. Agonising pains making the child bend double. Great restlessness, twisting and turning about for relief. Pains are better by hard pressure. Irritable and impatient, throwing things out of his hands.

11. FERRUM PHOS
Very useful for inflammatory conditions and fevers especially the first stages. Easy flushing of the face, less intense symptoms than of Aconite and Belladonna. Pulse is soft and flowing. Often useful in fevers of children when there are no other symptoms to guide to a suitable remedy.

12. IPECACUANHA
Also known as Ipecac, it is a very useful remedy for coughs of children that are dry, spasmodic and asthmatic. Breathlessness with wheezing. Cough that often results in gagging, retching and vomiting of white frothy phlegm. Most complaints are accompanied by nausea with profuse saliva and vomiting; vomiting without relief. Tongue is clean or slightly coated.

13. JALAPA
For the colic and diarrhoea of children where the children are good all day long but scream and are very restless and troublesome at night.

14. KALI MUR
A useful remedy to cut short colds right at the beginning, also useful for sub-acute inflammatory states. Stuffy colds with ear involvement. Greyish-white slimy coating of the tongue.

15. PODOPHYLLUM
Diarrhoea of children during teething and in hot weather, worse from eating and worse while being bathed or washed. Stools are profuse, painless, of varying colour, often yellow, watery and very offensive.

16. PULSATILLA
Commonly used for colds with yellow discharges, stuffed up noses where the symptoms are changing often. Most symptoms are better in open air and worse indoors. Absence of thirst with most complaints and indigestion from eating rich food. Tendency to styes and agglutination of eyes with yellow sticky discharges on waking.

17. RHEUM
Suitable for children, especially during dentition. Sour smell of the whole body, child smells sour even after washing. Children cry and toss about all night. Impatient, desires many things and cries, dislikes even favourite playthings. Constant sweat of scalp keeping the hair always wet.

18. RHUS TOX
For coughs and colds after getting wet that result in muscle pains and flu-like symptoms. Corners of the mouth are ulcerated with fever blisters around the mouth. Very useful for sprains and strains where symptoms are worse on initial movement and better by walking or continued motion.

19. SAMBUCUS NIGRA
For dry colds of infants where the nose is dry and completely blocked, preventing breathing and nursing. The child awakens suddenly, nearly suffocated and gasps for breath. Difficulty in breathing out. Suffocative coughs with crying children.

20. SENNA
Very useful in intestinal colics where the child seems full of wind. Clinically used most often for third-month-colic of infants.

Besides these twenty, many other remedies may be suitable to a given case, based on symptoms that individual children present. These are just some guidelines and I reiterate once more that it is best to consult your homoeopath for proper remedy selection and dosage, this will give safe, gentle and speedy results.

Leptospirosis is an infectious disease caused by the spirochaete Leptospira, which is transmitted to humans from the infected urine of rats. Once affected, a patient may develop high fever, chills, severe headache, muscle pains, vomiting, abdominal pain, diarrhoea, jaundice, redness of eyes and rash. Complications include kidney damage, meningitis, liver failure and respiratory illness.

Cuba goes through a yearly cycle of Leptospirosis epidemic, especially after the hurricanes flood the countryside and water pollution reaches its height. Many people are left homeless, flooded out and under the stress of a disaster situation.

Cuba, being considered an outcast by the USA, has had to become self-reliant in terms of production of medicines, health care programmes, etc. This is advantageous because research is no longer hampered by the all-powerful lobby of pharmaceutical companies and hence, Cuba has been able to search for the most effective and inexpensive ways of dealing with widespread health problems.

Until 2007, the Finlay Institute distributed its own allopathic vaccine against leptospirosis; however, the yearly high incidence of the disease, almost to epidemic proportions continued.

In October-November 2007, three provinces of the eastern region of Cuba were affected by heavy rainfalls causing flooding of big areas and damage to sanitary and health systems. The risk of leptospirosis infection reached extremely high levels with about 2 million people exposed to potentially contaminated water. This time, not having enough vaccine stock to vaccinate all the at-risk population, the Finlay Institute prepared a homoeopathic remedy to be used as a preventive – leptospirosis nosode 200 CH, using 4 circulating strains. Coordination with the public health infrastructure allowed the administration of 2 doses of the nosode, at 9 days’ interval, to about 2.4 million people. About 92% of the total population from the at-risk areas were administered the doses. Another dose in the 10M potency was given after hurricane Ike hit the island. This programme cost US $200,000, much less than what the cost of the regular vaccine would have been which was around US $3,000,000.

Even after the allopathic vaccination, the usual expectancy of infection is several thousand, including some deaths. Careful research conducted showed that after the homeopathic prophylaxis the incidence of leptospirosis dropped to almost zero, just 10 cases were reported and no deaths occured even after three major hurricane hits. The rest of the country which had not received the homeopathic prophylaxis, showed the expected incidence of leptospirosis.

This application of homoeopathy in such a large population with such dramatic results and scientifically documented as it has been, is tremendously encouraging and shows how homoeopathy can be used effectively, cheaply and within an existing health care structure, if the administration really wants to achieve good health without any financial influence.

Sources and references:

http://www.homeopathyeurope.org/news-and-press/news/stunning-cuban-experiences-on-leptospirosis

http://www.medicalnewstoday.com/articles/197128.php

http://www.facultyofhomeopathy.org/media/press_releases/leptospirosis_infection_in_Cuban_population.html

http://www.thefreelibrary.com/Homeopathy+prevents+Leptospira+epidemic.-a0231544963

Journal Spectrum of Homeopathy, No. 1, 2010. Narayana Publishers.