What is Gangrene………

Gangrene is the death of tissue in part of the body.

Gangrene is necrosis and subsequent decay of body tissues caused by infection or thrombosis or lack of blood flow. It is usually the result of critically insufficient blood supply sometimes caused by injury and subsequent contamination with bacteria. This condition is most common in the extremities. The best of all possible treatments is revascularization (restoration of blood flow) of the affected organ, which can reverse some of the effects of necrosis and allow healing. Depending on the extent of tissue loss and location, treatment other than revascularization runs the gamut from allowing digits to auto-amputate (fall off), debridement and local care, to amputation, the removal of infected necrotic tissues.


Causes, incidence, and risk factors

Gangrene can occur when a body part loses its blood supply. This may happen from, for example, injury or infection. You have a higher risk for gangrene if you have:


• Diabetes
• Blood vessel disease (such as arteriosclerosis in your arms or legs)
• A serious injury
• Surgery
• Immunosuppression (for example, from HIV or chemotherapy)




Types of Gangrene:

Dry gangrene

Dry Gangrene begins at the distal part of the limb due to ischaemia. A typical example of dry gangrene is the toes and feet of an old patient due to arteriosclerosis. Gangrene spreads slowly upwards until it reaches the point where the blood supply is adequate to keep the tissue viable. Macroscopically, the affected part is dry, shrunken and dark black, resembling the foot of a mummy. It is black due to liberation of hemoglobin from hemolysed red blood cell which is acted upon by the hydrogendisulfide(HG) produced by the bacterias resulting in formation of black iron sulfide. The line of separation usually brings about complete separation with eventual falling off of the gangrenous tissue if it is not removed surgically.
If the blood flow is interrupted for a reason other than severe bacterial infection, the result is a dry gangrene. Persons with impaired peripheral blood flow, such as diabetics, are at greater risk of dry gangrene.
The early signs of dry gangrene are a dull ache and sensation of coldness in the area, along with pallor of the flesh. If caught early, the process can sometimes be reversed by vascular surgery. However, if necrosis sets in, the affected tissue must be removed just as with wet gangrene.

Internal gangrene

In this gangrene the tissues become white. It is located inside the body, usually after surgery or trauma. Also called "white gangrene".


Wet gangrene

Wet Gangrene Occurs in naturally moist tissue and organs such as the mouth, bowel, lung, cervix vulva, etc. Diabetic foot is another example of wet gangrene due to high sugar content in the necrosed tissue which favour the growth of bacteria. Bedsores occurring in a bed-ridden patient due to pressure sites like the sacrum, buttocks and heels are the other important clinical condition included in wet gangrene. In wet gangrene, the tissue is affected by saprogenic microorganisms (Bac.perfringes, fusiformis, putrificans, etc), becomes swollen and emits fetid smell. It develops in the tissue rich in water: Lungs, Intestine, noma(water cancer) gangrene of cheeks in children at measles. Wet gangrene usually develops rapidly due to blockage of venous and/or arterial blood flow. The affected part is stuffed with blood which favour the rapid growth of bacteria. The toxic products formed by bacteria are absorbed causing systemic manifestation of septicemia and finally death. Macroscopically the effected part is swollen edematpus, soft, putrid, rotten, dark. The part is dark due to the same mechanism as in dry gangrene.

Gas gangrene

Gas gangrene is a bacterial infection that produces gas within tissues in gangrene. It is a deadly form of gangrene usually caused by Clostridium perfringens bacteria. Due to its tendency to progress rapidly, it is considered a medical emergency. The rapid progression of gas gangrene occurs because of the tendency of expanding gas to open and separate the internal tissues, progressively exposing more and more healthy tissue to infection.
Gas gangrene is caused by exotoxin-producing clostridial species, which is mostly found in soil, and other anaerobes (e.g. Bacteroides and anaerobic streptococci). These environmental bacteria may enter the muscle through a wound and go on to proliferate in necrotic tissue and secrete powerful toxins. These toxins destroy nearby tissue, generating gas at the same time. A gas composition of 5.9% hydrogen, 3.4% carbon dioxide, 74.5% nitrogen and 16.1% oxygen was reported in one clinical case.
Gas gangrene can cause myonecrosis, gas production, and sepsis. Progression to toxemia and shock is often very rapid.

Streptococcal gangrene: Necrotizing fascitis is a flesh eating bacteria











Signs and tests:

The doctor may diagnose gangrene from a physical examination. In addition, the following tests and procedures may be performed to diagnose gangrene:
• Blood tests -- a CBC may show a high white blood cell (WBC) count
• X-rays
• CT scan for internal conditions, such as abdominal pain
• Surgical exploration to confirm (and treat) gangrene
• Microscopic examination of tissue to look for cell death
• Tissue or fluid culture from wounds to identify bacterial infection
• An arteriogram to help plan treatment for vascular disease.

Homeopathic Treatment:

Arsenicum Alb- Dry gangrene especially in old peoples; Soreness, burning & restlessness are there which is relieved by warmth. It is often indicated in gangrene of the lungs.
Other symptoms which are present are fetid diarrhea, great weakness, emaciation, and feeling of coldness and heat alternately.

Secale Cor- Secale corresponds to senile gangrene with tingling and formication. Dry gangrene of toes; the skin becomes wrinkled and dry, shriveled and cold, no sensibility, black and free from foetor; Large ecchymoses and blood blisters, which becomes gangrenous, will indicate the remedy.

Carbo Vegetabilis- Carbuncle and boils, becoming gangrenous; There is no restlessness as in Aresenic, but the parts have a livid purple look, and they are icy cold. It also suits moist gangrene in cachectic persons whose vitality is weak; the secretions are foul and there is great prostration.

Other medicines which are used in gangrenes are Arnica, Lachesis, Crotalus, Carbolic Acid, etc.

Treatment:

Gangrene requires urgent evaluation and treatment. In general, dead tissue should be removed to allow healing and prevent further infection. Depending on the area affected, the condition of the patient, and the cause of the gangrene, treatment may include:
• An emergency operation to explore or remove dead tissue
• Amputating the affected body part
• Repeated operations to remove dead tissue (debridement)
• An operation to improve blood supply to the area
• Antibiotics
• Treatment in the intensive care unit (for severely ill patients)


Complications

Complications depend on the body part affected, the extent of gangrene, its cause, and the condition of the patient. Complications may include:

• Disability from amputation or removal of dead tissue
• Prolonged wound healing or the need for reconstructive surgery, such as skin grafting

Calling your health care provider

Call your doctor immediately if:

• An area of your skin turns blue or black
• You have persistent, unexplained pain in an area
• You have persistent, unexplained fever
• A wound does not heal or there are frequent sores in an area
• There is foul-smelling discharge

Prevention:

Gangrene may be prevented if a harmful process is treated before the tissue damage is irreversible. Wounds should be treated properly and observed for signs of infection (such as spreading redness, swelling, or drainage) or failure to heal. Patients with diabetes or blood vessel disease should routinely examine their feet for any signs of injury, infection, or change in skin color and seek care as needed.


John Botrey lived for 15 years with devastating deformity and disability resulting from the tropical gangrene-like disease, Noma, known as “the face of poverty”

3 Medicines for Fissure of Anus

Graphites- Graphites is affected in person having the tendency or history of eczema; anus is extremely sore and the stool are covered with mucus; constipation with no urge; the fissures are usually caused by hard and large stool; anus are sore and it smarts after passing stool; Stool large, hard, knotty, difficult and passed with extreme pain; no desire for stool for many days, it requires long time with great straining to pass the stool; Hemorrhoids may also present with fissures.

Nitric Acid- This remedy is indicated in fissures where there is a sensation as if splinters or sticks were in the anus; Fissures are extremely painful and bleeds easily during stool; pain is so severe that the patient may break in sweat and becomes anxious; blood from fissures is dark and offensive; Patient gets some relief from cold applications.

Paeonia- Paeonia has fissures with much oozing; the anus is offensively moist and sore, smarts all the time; Burning and stinging pain lasting several hours after passing stool; Patient gets some relief while walking, must walk the floor whole night to get relief.

Other medicines used in fissures are Ratanhia, Sanguinaria Nitrate, Silicea, Platina, Krameria, Calcarea Carb, Hamamelis, Muriatic Acid, Nux Vomica, Sulphur, Carbo Veg, etc.

Anal fissures?

An anal fissure is a cut or tear occurring in the anus (the opening through which stool passes out of the body) that extends upwards into the anal canal. Fissures are a common condition of the anus and anal canal and are responsible for 6-15% of the visits to a colonic and rectal (colorectal) surgeon. They affect men and women equally and both the young and the old. Fissures usually cause pain during bowel movements that often is severe. Anal fissure is the most common cause of rectal bleeding in infancy.

Anal fissures occur in the specialized tissue that lines the anus and anal canal, called anoderm. At a line just inside the anus referred to as the anal verge or intersphincteric groove, the skin of the inner buttocks changes to anoderm. Unlike skin, anoderm has no hairs, sweat glands, or sebaceous glands and contains a larger number of somatic sensory nerves that sense light touch and pain. The abundance of nerves explains why anal fissures are so painful. The hairless, gland-less, extremely sensitive anoderm continues for the entire length of the anal canal until it meets the demarcating line for the rectum, called the dentate line.

Cause:

Anal fissures are caused by trauma to the anus and anal canal. The cause of the trauma usually is a bowel movement, and many patients can remember the exact bowel movement during which their pain began. The fissure may be caused by a hard stool (constipation) or repeated episodes of diarrhea. Occasionally, the insertion of a rectal thermometer, enema tip, endoscope, or ultrasound probe (for examining the prostate gland) can result in sufficient trauma to produce a fissure. During childbirth, trauma to the perineum (the skin between the posterior vagina and the anus) may cause a tear that extends into the anoderm.

Treatment:

General Treatment:

Changes to diet and lifestyle will help to encourage healing of a fissure. The main aim is to try and avoid constipation, so that stools are smaller and softer.

This can be achieved by eating a diet that is rich in fiber, including plenty of fruit, vegetables and wholegrain cereals such as brown rice, bread and pasta. You should also aim to drink enough water-based drinks so that your urine is no darker than pale yellow.

Taking a regular supplement of bulk-forming laxative like Fybogel or a laxative that softens the stool like lactulose syrup will help the healing process and prevent further tears. Patients are advised to avoid “sharp” foods that may not be well-digested (i.e., nuts, popcorn, and tortilla chips)

Sitting in a warm bath after bowel movements, to relax the spasm, to increase the flow of blood to the anus, and to clean the anus without rubbing the irritated anoderm may also bring some relief from the discomfort.

If your fissure has not healed despite these lifestyle changes, or if you are worried about it, you should see your doctor. If you have blood in your stool (rather than some spotting on toilet paper or in the bowel) or have recently experienced altered bowel habits or have been losing weight, another problem may be responsible for your symptoms and you should seek medical advice promptly.

Medication:

Ointments containing anesthetics, steroids, nitroglycerin, and calcium channel blocking drugs are used for treating anal fissures along with conservative management.
Injections of botulinum toxin may be effective when ointments are not effective.

Surgery:

If a fissure continues to cause pain and bleeding and does not respond to conservative medical therapy, it is considered chronic and surgery may be required. Chronic fissures heal only 10% of the time without surgery. This may involve an operation to wedge out the area of the fissure and any underlying scar tissue. During the operation, one of the anal muscles is also usually cut (internal lateral sphincterotomy) or the anus forcible dilated. While these procedures sound terrible, they reduce spasm which can interfere with healing. Surgery can usually be performed without an overnight hospital stay. Although the pain often disappears a few days after surgery, full healing requires one to two months however most patients are back to normal activity within a week or two.

Useful Link: http://en.wikipedia.org/wiki/Anal_fissure

3 Medicines for Fever

Gelsemium- Fever with absolute thirstlessness; Patient is dull, dazed, drowsy and confused minded; there is mild delirium with fever; there may be loss of muscular coordination with fever; involuntary stool and urine; trembling of limbs with heaviness, bruised and cold feeling; pulse slow, full and soft; It corresponds especially to remittent type of fever; fever brought on by warm weather; the chill is partial.

Belladonna- High temperature with excessive heat and dryness of skin; fever due to inflammatory conditions; temperature rises suddenly with active delirium; fever with severe throbbing headache; congestion of blood head and face causing redness of face, redness of eyes and headache; pain all over the body with dryness of mouth; tongue is dry, swollen and bright red; no thirst with fever; perspiration only on covered parts; the patient becomes sensitive towards motion, noise and bright light.

Rhus toxicodendron- It is effective in catarrhal fevers; fever commences with weakness of the whole body with desire to lie down; soreness and bruised sensations in the limbs; aching of limbs, bones and back; restlessness is there with fever which becomes worst when lying still; other symptom which are present with fever are loss of appetite, increased thirst, dryness of mouth, repugnance of food, etc.

Some other medicines used in fever are Aconite, Ferrum Phosphoricum, baptisia, pulsatilla, sulphur, Nux Vomica, Bryonia, Mercurius, Arsenic, Kali mur, Natrum sulph, Eupatorium Perf, Natrum mur, China, etc.

What happens with a fever

when a fever starts and your body tries to elevate its temperature, you feel chilly and may shiver to generate heat. At this point, you probably wrap yourself in your thickest blanket and turn up the heating pad. But eventually, as your body reaches its new set-point, you likely feel hot. And when your temperature finally begins to return to normal, you may sweat profusely, which is your body's way of dissipating the excess heat.

A fever usually means your body is responding to a viral or bacterial infection. Sometimes heat exhaustion, extreme sunburn or certain inflammatory conditions such as temporal arteritis — inflammation of an artery in your head — may trigger fever as well. In rare instances, a malignant tumor or some forms of kidney cancer may cause a fever.

Fever can be a side effect of some medications such as antibiotics and drugs used to treat high blood pressure or seizures. Some infants and children develop fevers after receiving routine immunizations, such as the diphtheria, tetanus and acellular pertussis (DTaP) or pneumococcal vaccines.Sometimes it's not possible to identify the cause of a fever.

How to take a temperature for fever?

Measuring an axillary (under the armpit) temperature for fever:

Axillary temperatures are not as accurate as rectal or oral measurements. Studies show that glass thermometers must be left in place for approximately 10 minutes to accurately measure an axillary temperature. An axillary temperature will read approximately 1 degree lower than a simultaneously obtained oral temperature.

Measuring fever by eardrum temperature:

Eardrum temperature measurements are not accurate in small children and should not be used in children under 3 years of age. This is especially true in infants below 3 months of age when obtaining an accurate temperature is very important.

Measuring fever by oral temperature:

Older children and adults can have their temperature taken under the tongue with their mouth closed. A standard glass and mercury thermometer should be left in place for at least three minutes. Make sure to shake down the thermometer before using it. The tip of the thermometer should be placed as far back under the tongue as possible. Oral temperatures will be inaccurate if you have had hot or cold drinks within 20 minutes of temperature measurement.

Measuring fever by rectal temperature:

Infants should have rectal temperature measurements. A standard glass and mercury thermometer should be left in place for a minimum of 3 minutes. Make sure to shake down the thermometer before using it. Appropriate care should be taken in inserting, maintaining and withdrawing the rectal thermometer. To take a rectal temperature safely, place the child prone on a firm surface. After separating the buttocks, insert a lubricated thermometer approximately 1 inch into the rectum. After at least three minutes, remove the thermometer. A rectal temperature will read approximately 1 degree higher than a simultaneously obtained oral temperature.

Measuring fever by electronic thermometer:

Electronic thermometers that are designed to be used orally or rectally are an acceptable alternative to a glass thermometer and take a temperature more quickly. They are, however, more expensive than the glass alternative. Strips that measure temperature on the forehead are not accurate and should not be used.

How to clean an oral thermometer:

Wash the thermometer with cool, soapy water and rinse it with clean water. Then, let it air-dry or wipe it dry with a clean cloth or paper towel. Be sure to wash the thermometer before and after each use.
You can use rubbing alcohol to clean an oral thermometer. If you do use alcohol, be sure to rinse off the thermometer before using it again to get rid of the alcohol taste.

3 Medicines for Earache

Aconite- It is a very useful remedy for severe pain in acute otitis; the affected part of ear becomes red, with stinging, lancinating or throbbing pains and great sensitiveness; It is effective in earaches from sudden change of temperature; it is worse at night at night; Patient is extremely restless mentally and physically; patient tosses in agony, changes his position often to get some relief.

Pulsatilla- It is a great ear remedy. It has a specific curative power in otitis externa; the ear is hot, red and swollen, and the pain is very severe darting, tearing and pulsating type which are worse at night; it is also highly effective in acute inflammation of the middle ear; it is also indicated in the problems like oozing of profuse thick yellowish discharge from the ear, deafness and a feeling as if the ears were stopped up, or if something were being forced out; there are also roaring noises with itching deep in the ear.

Plantago- It is used as homeopathic specific for earache; it works great when applied locally; earache associated with toothache; pain goes through head from one ear to the other.

There are several other medicine in Homeopathy which are used in earache and other ear related problems such as Belladonna, tellurium, hydrastis, kali sulph, ferrum phos, kali muriaticum, mag phosphorica, kali phosphoricum, chamomilla, borax, dulcamara, sanguinaria, capsicum, calcarea carb, nitric acid, kali bichromicum, aurum, baryta carb, phosphorus, mercurius, mercurius dulcis, graphites, carbo veg, carbo animalis, iodine, silicea, hepar sulph, lachesis, crotalus, conium, causticum, chenopodium, sulphur, psorinum, etc.


Home Remedies:

1) For ear aches, put 2 drops of Crisco Oil into the sore ear and it will relieve within minute.

2) Take about 2-3 cups of salt and heat it (warm not hot) in a frying pan. Place the salt in an all white tube sock. Tie off the sock and lay the ear that hurts on the sock (Do Not put the sock on your ear, because the salt granules may drop in your ear. Put under your ear as you lay watching T.V. or before bed. You want the salt to be warm enough for it to the hold the heat for awhile, if it is too hot just put a towel over the salt and sock until it is bearable to the touch of your ear.

3) Cut a piece of garlic. Wrap it with a piece of cotton ball, soak it with alcohol. Squeeze the excess alcohol and place it in the ear that aches. (Make it small enough to fit it the ear).

4) Soak half a cotton wool ball in olive oil place in the microwave (approx 20 seconds on mine) till its warm NOT hot, squeeze out excess oil so it’s damp, and then place in ear.

5) Put few drops of 3% hydrogen peroxide in painful ear and wait for 10 minutes this is good for earaches due to infections.

6) Warm onion juice and put 2-3 drops in painful ear to get relieve from earache.

7) Extracts the juice of mango leaves and warm it slightly. Put few drops in painful ear and wait for sometime.

8) Put two pieces of garlic in two teaspoonful of mustard oil and heat it till the garlic turns black. Allow it to cool and it becomes luke warm put few drops in ears.

9) Urinate in a cup, put it in an eye dropper and put few drops in painful ear.

10) Grind a few Holy basil leaves and extract some juice. Apply 2 drops inside the ear.

11) Boil 3-4 cloves of Garlic in some water. Mash them and add a pinch of salt. Wrap this poultice in a flannel or woolen cloth and place on the aching ear.

12) Infuse mullein's essential essences into olive oil and use as eardrops.

13) A warm compress-such as a towel rung out in hot water and pressed against the ear-brings the most immediate relief.

14) A hot water bottle wrapped in a towel also makes a comforting pillow for an aching ear.

15) Witch hazel is helpful in treating swimmer's ear. Make a tincture of witch hazel, goldenseal, or Oregon grape root and calendula. Apply to the outer ear. Rue can also diminish the pain and inflammation.

16) Lavender Oil Ear Rub- Take 10 drops lavender pure essential oil & 5ml or 1tsp of almond oil blend together & rub in gently to the outer ear. This oil rub can be used as need throughout the day. It is very effective in earaches.

17) Eucalyptus Oil Steam Inhalation- Take few drops of eucalyptus pure essential oil &
Add oil to a bowl of boiled water. Place towel over head inhale the steam through the nose. Repeat 3 times a day.


18) If nothing works than try this........

3 medicines for Dysmenorrhoea

Belladonna- The congestive type of dysmenorrhoea; pain started before menstrual flow with sensation of heaviness as if everything would protrude from the vulva, relieved by sitting up straight; the pains comes on suddenly and ceases suddenly; the flow is offensive and clotted; the vagina is hot and dry and the pains moves in the horizontal direction in pelvis.

Mag Phos- The pain calling for it are neuralgic and crampy preceding the flow and the greater indication for the use of this remedy is the relief from warmth and aggravation from motion; Uterine engorgements with crampy pains and membranous dysmenorrhoea indicates the remedy.

Pulsatilla- Menstrual flow is dark in color, scanty and delayed; more severe the pain the patient will get more chill; the pains gripes and double the patient up; violent pain with soreness in the region of uterus and ovaries causing patient to bend double; milk in breast during menses in young girls; pain relieved by slowly walking about.

INFO ABOUT DISEASE...................

It is estimated that between 50 and 70 percent of women endure some degree of period pain and cramping. Of those, approximately 10 per cent experience contractions so extreme that they are one-and-a-half times more powerful than labor pains. For some women the pain can be so debilitating that they are forced to take time off work or can only get through their periods by dosing themselves with painkillers.

Symptoms:

Obviously pain is the overriding symptom in dysmenorrhoea, but many women will experience other symptoms, including:
1) Nausea
2) Vomiting
3) Diarrhea/constipation
4) Fainting
5) Light-headedness
6) Feeling dizzy
7) Headaches
8) Exhaustion and lethargy

Types of Dysmenorrhoea:

A] Based on the type of pain:-

1) Congestive dysmenorrhoea- With a constant, low, dull backache.
2) Spasmodic dysmenorrhoea- Cramping pains like contractions.

B] based on the cause of dysmenorrhoea:-

1. Primary dysmenorrhoea. Primary dysmenorrhoea means that there is no specific problem or abnormality causing the pain.
2. Secondary dysmenorrhoea. Secondary dysmenorrhoea means that the pain is caused by a specific condition, such as endometriosis, fibroids or an infection, etc.

Cause:

Throughout the month your womb contracts and relaxes on a regular basis. You will probably be entirely unaware that these contractions are taking place. However, around the time of your period, they become stronger. In order to squeeze out the blood from the lining built up during your menstrual cycle, your womb has to contract. This should, theoretically, be a painless or only mildly painful occurrence, but for some women, the contractions are stronger than they need to be, causing enormous pain. Cramping can also occur and this tends to be connected with heavy periods. The greater the build-up of womb lining, the more violent the contractions needed to get rid of the engorged blood.
Another cause of painful periods can be the excess production and release of hormone-like substances called prostaglandins. Many of the prostaglandins are actually ‘healthy’, and have a beneficial effect on the body. However, two types of ‘bad’ prostaglandins, known as PGF2 Alpha and PGE2, can be increased in some women. PGF2 Alpha is a vasoconstrictor, which means that it works to reduce the blood flow to the womb muscle, and PGE2 is a highly inflammatory substance that can trigger muscle contractions and increase the sensitivity of your nerve endings to pain.

Dietary Recommendations:

It is very important that you avoid all of those foods that are high in arachidonic acid (AA). Your body produces PGE2 from AA, of which the main sources are dairy products. This means eliminating or at least reducing dairy in any form, including milk, cheese, cottage cheese yoghurt, butter and even dairy ice-cream. AA is also present in red meat and although the saturated fat content of red meat is higher than in white meats, AA is higher in chicken and turkey than in red meat.

Supplements:

Vitamin B6
Vitamin B6 is needed to help produce ‘good’ prostaglandins, so it is worth taking a good B-complex supplement. This vitamin has been shown significantly to reduce the intensity and duration of period pains.

Vitamin B1
This vitamin is very effective in helping with period pain.

Vitamin B12
Because both vitamins B1 and B6 are helpful with treating period pains, the best approach is to take a vitamin B complex. This will also give you vitamin B12, and it has been found that a combination of fish oil and B12 is actually more effective than just fish oil on its own for relieving dysmenorrhoea.

Vitamin E
Up to 70 per cent of women have found the supplementation of vitamin E to be useful in treating painful periods. The reasons for this effect are unclear, but it may be that vitamin E’s antioxidant properties help with the pain, or control the levels of prostaglandins.
Vitamin C and bioflavonoids
Bioflavonoids are helpful with period pain because they help to relax smooth muscle and reduce inflammation. Bilberry is one of the best bioflavonoids for this, but other bioflavanoids can be helpful. Include berries of any kind (including blackberries, blackcurrants, raspberries and even grapes in your diet).

Magnesium
Magnesium acts as a muscle relaxant and it has been shown to have a beneficial effect on painful periods and lower back pain, so it is worth taking as a supplement. Magnesium also has the ability to lower the ‘bad’ prostaglandins that may be causing the womb to over contract.

Zinc
This mineral is important for eliminating period pains because it is needed for the proper conversion of LA to GLA.

Essential fatty acids (EFAs)
Taking EFAs in supplement form is extremely important in the treatment of painful periods.