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Please explain what and when the procedure was performed. Has the patient been seen since surgery by the physician? What was the reason provided for not seeing the patient?There is a patient abandonment issue. The person doing the surgery should do follow up for any complication related to the procedure he/she performed. Is it because of noncompliance, schedule conflict, non-payment etc?[Edit: Per additional history provided in the Comments section. The article below addresses medical management after bariatric surgery. The physician has tried to work up surgical complications. This is the section regarding nausea and vomiting. The authors mention antiemetic unless there are other issues. I hesitate to second guess what the surgeon’s train of thought is. I do think there should be response to the patient’s communications. I understand the frustration and the cost of repeat emergency room visits. Someone here has suggested contacting the chief of surgery. Post bariatric surgery recuperation can be problematic and I hope the symptoms resolve in time.Nausea and vomitingNausea and vomiting can often be helped by antiemetic or prokinetic drugs, however, some patients have chronic functional nausea and/or vomiting that does not fit the pattern of cyclic vomiting syndrome or other gastrointestinal disorders, hence particular attention should be directed to potential psychosocial factors post bariatric surgery. Therefore, low dose antidepressant medications and psychotherapy should be addressed. On demand CT scan and Gastroscopy could be the gold standard investigations in chronic situations[39,40].]World J Gastrointest Surg. 2014 Nov 27; 6(11): 220–228.Published online 2014 Nov 27. doi: 10.4240/wjgs.v6.i11.220PMCID: PMC4241489Medical management of patients after bariatric surgery: Principles and guidelinesAbd Elrazek Mohammad Ali Abd Elrazek, Abduh Elsayed Mohamed Elbanna, and Shymaa E BilasyAuthor information ► Article notes ► Copyright and License information ►This article has been cited by other articles in PMC.Go to:AbstractObesity is a major and growing health care concern. Large epidemiologic studies that evaluated the relationship between obesity and mortality, observed that a higher body-mass index (BMI) is associated with increased rate of death from several causes, among them cardiovascular disease; which is particularly true for those with morbid obesity. Being overweight was also associated with decreased survival in several studies. Unfortunately, obese subjects are often exposed to public disapproval because of their fatness which significantly affects their psychosocial behavior. All obese patients (BMI ≥ 30 kg/m) should receive counseling on diet, lifestyle, exercise and goals for weight management. Individuals with BMI ≥ 40 kg/m and those with BMI > 35 kg/m with obesity-related comorbidities; who failed diet, exercise, and drug therapy, should be considered for bariatric surgery. In current review article, we will shed light on important medical principles that each surgeon/gastroenterologist needs to know about bariatric surgical procedure, with special concern to the early post operative period. Additionally, we will explain the common complications that usually follow bariatric surgery and elucidate medical guidelines in their management. For the first 24 h after the bariatric surgery, the postoperative priorities include pain management, leakage, nausea and vomiting, intravenous fluid management, pulmonary hygiene, and ambulation. Patients maintain a low calorie liquid diet for the first few postoperative days that is gradually changed to soft solid food diet within two or three weeks following the bariatric surgery. Later, patients should be monitored for postoperative complications. Hypertension, diabetes, dumping syndrome, gastrointestinal and psychosomatic disorders are among the most important medical conditions discussed in this review.Keywords: Obesity, Bariatric surgery, Postoperative care, Body-mass index, El bannaCore tip: Obesity is a growing health concern worldwide that impacts the life of individuals both physically and psychologically. There are several well-established health hazards associated with obesity. Additionally, obese subjects are often exposed to public disapproval because of their fatness which significantly affects their psychosocial behavior. Bariatric surgery is one of the definite solutions for obesity. In this review, we will briefly discuss the general guidelines that should be considered before bariatric surgery. Also, we discuss the protocols of patients’ postoperative care and the management of medical disorders that must be considered after bariatric surgery.Go to:INTRODUCTIONObesity is a chronic disease that impairs health-related quality of life in adolescents and children. In 2010, overweight and obesity were estimated to cause 3.4 million deaths, 3.9% of years of life loss, and 3.8% of disability-adjusted life-years worldwide. Obesity is increasing in prevalence, currently, the proportion of adults with a body-mass index (BMI) of 25 kg/m or greater is 36.9% in men and 38.0% in women worldwide[1]. Attempts to explain the large increase in obesity in the past 30 years focused on several potential contributors including increase in caloric intake, changes in the composition of diet, decrease in the levels of physical activity and changes in the gut microbiome. More than 50% of the obese individuals in the world are located in ten countries (listed in order of number of obese individuals): United States, China, India, Russia, Brazil, Mexico, Egypt, Germany, Pakistan and Indonesia. Although age-standardized rates were lower in developing than in developed countries overall, 62% of the world’s obese individuals live in developing countries. Recently, United States accounted for 13% of obese people worldwide, the prevalence of obesity was 31.7% and 33.9% among adult men and women, respectively. In Canada 21.9% of men and 20.5% of women are obese. Reported prevalence rates of obesity include: 27.5% of men and 29.8% of women in Australia, 24.5% of men and 25.4% of women in the United Kingdom, in Germany 21.9% of men and 22.5% of women, in Mexico 20.6% of men and 32.7% of women, in South Africa 13.5% of men and 42% of women, in Egypt 26.4% of men and 48.4% of women, in Saudi Arabia 30% of men and 44.4% of women and in Kuwait 43.4% of men and 58.6% of women Figure ​Figure11)[2].There are several well-established health hazards associated with obesity, e.g., nonalcoholic steatohepatitis (NASH), type 2 diabetes, heart disease, chronic kidney disease, gastroesophageal reflux disease, gastrointestinal motility disorders, sexual disorders, cerebrovascular stroke, certain cancers, osteoarthritis, depression and others[3-10]. The risk of development of such complications rises with the increase of adiposity, while weight loss can reduce the risk. Bariatric surgery could be the definitive clue in many situations[11-15]. Bariatric surgery is one of the fastest growing operative procedures performed worldwide, with an estimated > 340000 operations performed in 2011. While the absolute growth rate of bariatric surgery in Asia was 44.9% between 2005 and 2009, the numbers of procedures performed in the United States plateaued at approximately 200000 operations per year[16,17]. Starting in 2006, the Center for Medicare and Medicaid Services, United States, restricted the coverage of bariatric surgery to hospitals designated as “Centers of Excellence” by two major professional organizations[18]. Medical management and follow up of patients who have undergone bariatric surgery is a challenge due to post operative complications.GENERAL GUIDELINES FOR SURGEONS/GASTROENTEROLOGISTSA well skilled physician or a surgeon has to consider the followings:(1) as the prevalence of obesity increases so does the prevalence of the comorbidities associated with obesity. Losing weight means overcoming illness at the present, complications in future and alleviating the economic burden in the present and future;(2) Overweight; BMI between 25 and 30, technically refers to excessive body weight, whereas “obesity” BMI ≥ 30 kg/m refers excessive body fat, “Severe obesity”, BMI ≥ 35 kg/m, or “morbid obesity” refers to individuals with obesity-related comorbidities. Furthermore, severe obesity and morbid obesity groups who failed dietary and medical regimens are candidates for bariatric surgery;(3) Children obesity; refers to children with BMI > 95th percentile for their age and sex and “overweight” refers to children with BMI between the 85th and 95th percentile for their age and sex;(4) Patients undergoing a bariatric operation should have a nutritional assessment for deficiencies in macro and micronutrients, also with no contraindication for such a major operation;(5) Most of bariatric procedures are performed in women (> 80%) and approximately half of these (> 40% of all bariatric procedures) are performed in reproductive aged women, accordingly, pregnancy planning and contraception options should be discussed in details with women who will undergo bariatric procedures. Fertility improves soon after bariatric surgery, particularly in middle-aged women, who were anovulatory. Additionally, oral contraceptives may be less effective in women who have undergone malabsorptive bariatric procedure. Therefore, it is better to delay pregnancy for 6-12 mo following bariatric surgery. Risk of preeclampsia, gestational diabetes, and macrosomia significantly decrease post bariatric surgery, but the risk of intrauterine growth restriction/small infants for their gestational age may increase. Body contouring surgery is in high demand following bariatric surgery;(6) All bariatric operations are accompanied with restrictive and/or malabsorption maneuvers; less food intake and malabsorption concepts;(7) The most common types of bariatric surgeries performed worldwide are Sleeve gastrectomy (SG): This procedure involves the longitudinal excision of the stomach and thus shaping the remaining part of the stomach into a tube or a “sleeve” like structure. SG removes almost 85% of the stomach (Figure ​(Figure2);2); Roux-en-Y gastric bypass (RYGB): It reduces the size of the stomach to the size of a small pouch that is directly surgically attached to the lower part of the small intestine. In this procedure, most of the stomach and the duodenum are surgically stapled and therefore, bypassed (Figure ​(Figure3);3); The laparoscopic adjustable gastric band (AGB): This is one of the least invasive procedures, where the surgeon inserts an adjustable band around a portion of the stomach and therefore, patients feel fuller after eating smaller food portions (Figure ​(Figure4).4). Bariatric surgical procedures, particularly RYGB, plus medical therapy, are effective interventions for treating type 2 diabetes. Improvement in metabolic control is often evident within days to weeks following RYGB; and(8) Complications reported following bariatric surgery vary based upon the procedure performed. Cholilithiasis, renal stone formation and incisional hernia could be the delayed phase complications; on the other hand, bleeding, leaking, infection and pulmonary embolism could be the early phase complications following the bariatric procedure. The overall 30-d mortality for bariatric surgical procedures worldwide is less than 1%.Roux-in Y Gastrectomy, sleeve gastrectomy. and adjustable gastric band.POST OPERATIVE CARE AND FOLLOW UPEarly post operative period; (1-3) d post bariatric surgeryPatients undergoing a bariatric operation are admitted to the post-anesthesia care unit (PACU) immediately at the conclusion of the operation. Usually, on postoperative day (POD) one, we begin oral therapy in tablet or crushed-tablet and liquid form if there is a naso-gastric tube after the gastrografin leak test. A basic metabolic profile (e.g., complete blood count, electrolytes, renal function, liver function, prothrombin time and partial thromboplastin time) should be obtained every 12 h for the successive two PODs, then every 24 h for another 3 d. Oxygen is administered by nasal cannula and weaned thereafter. The likelihood that, early specific complication, will arise for a given patient is determined by the nature of the procedure, the anesthetic techniques used, and the patient’s preoperative diseases. Respiratory problems are common complication in the early postoperative period following bariatric surgery. Patients with significant comorbidities, particularly neuromuscular, pulmonary, or cardiac problems are at a higher risk for respiratory compromise, but any patient can develop hypoxemia following bariatric surgery. For prophylaxis against Deep Venous Thrombosis (DVT) following bariatric surgeries, ultrasound evaluation is recommended for all patients, D-dimer test should be applied for suspected patients with DVT, especially after long operative time, repeat ultrasound or venography may be required for those with suspected calf vein DVT and a negative initial ultrasound investigation[19,20].Late post operative monitoringAfter the PACU period, most patients are transferred to the inpatient surgical postoperative unit. For the next 24-72 h, the postoperative priorities include ruling out an anastomotic leak following laparoscopic RYGB or laparoscopic SG. If no leak is observed, patients are allowed to start a clear liquid diet and soft drinks. The postoperative care team cares for the following: control of pain, care of the wound, continuous monitoring of blood pressure, intravenous fluid management, pulmonary hygiene, and ambulation. Post-bariatric nausea and vomiting is directly correlated with the length of the surgery; it also increases in females, non-smokers, and those patients with prior history of vomiting or motion sickness. Prophylaxis with pharmacologic treatment before the development of post operative nausea and vomiting significantly reduces its incidence after surgery[21-23].After hospital dischargeDiet: Usually patients are discharged 4-6 d after surgery. Most patients are typically discharged from the hospital on a full liquid diet, patients should be taught to keep monitoring their hydration and urine output. Approximately two-three weeks after surgery, the diet is gradually changed to soft, solid foods. The average caloric intake ranges from (400) to (800) kcal/d for the first month, and thus the daily glycemic load is greatly reduced. We encourage patients to consume a diet consisting of salads, fruits, vegetables and soft protein daily.To control the epigastric pain and vomiting, patients should be taught to eat slowly, to stop eating as soon as they reach satiety and not to consume food and beverages at the same time. For most patients suffering chronic vomiting, prokinetic therapy and proton-pump inhibitors (PPIs) should be considered. Patients, who underwent SG, LAGB or RYGB, benefit from a well-planned dietary advancement. Patients should understand that the surgery has changed their body but not the environment, they have to choose healthy foods, do not skip meals and to visit the dietitian regularly in the first 12 mo after surgery. However, if food intolerance develops, patients may choose a more vegetarian-based diet. Nevertheless, fresh fruits and vegetables are usually tolerated without a problem. The daily protein intake should be between 1.0 to 1.5 g/kg ideal body weight per day[24]. The biliopancreatic diversion/duodenal switch (BPD/DS) is a malabsorptive procedure for both macro- and micronutrients. Hence, we encourage higher protein intake of 1.5 g to 2.0 g of protein/kg ideal body weight per day, making the average protein requirement per day approximately 90 g/d[25,26]. Alcohol is better prevented in the first 6-12 mo after surgery[27].Monitoring: Patients should generally have their weight and blood pressure measured weekly until the rapid weight loss phase diminishes, usually within 4-6 mo, then again at 8, 10 and 12 mo, and annually thereafter. Patients with diabetes are encouraged to check their blood glucose daily. Glycemic control typically improves rapidly following bariatric surgery. Patients maintained on antihypertensive or diabetic medications at discharge should be monitored closely for hypotension and hypoglycemia, respectively, and medications should be adjusted accordingly. We recommend that the following laboratory tests be performed at three, six, nine months and annually thereafter: (1) Complete Blood Count; (2) Electrolytes; (3) Glucose and Glucose Tolerance test; (4) Complete iron studies; (5) Vitamin B12; (6) Aminotransferases, alkaline phosphatase, bilirubin, GGT; (7) Total protein and Albumin; (8) Complete lipid profile; (9) 25-hydroxyvitamin D, parathyroid hormone; (10)Thiamine; (11) Folate; (12) Zinc; and (13) Copper.Complications following the surgical treatment of severe obesity vary based upon the procedure performed. Secondary hyperparathyroidism, Hypocalcemia, Gastric remnant distension, Stomal stenosis/Obstruction, Marginal ulcerations, Cholilithiasis, Ventral incisional hernia, Internal hernia, Hiatus Hernia, Short bowel syndrome, Renal failure, Gastric prolapse, infection, Esophagitis, Reflux, Vomiting, Hepatic abnormalities and dumping syndrome are common late-phase complications after bariatric surgery. However, the clinician should aware of complications specific for every bariatric procedure[28,29]. Before therapy, the clinician should understand that the impact of various bariatric surgeries on drug absorption and metabolism are scarce. On the other hand, RYGB and other malabsorptive procedures that significantly exclude the proximal part of the small intestine, decrease the surface area where most drug absorption occurs and may result in a reduction in systemic bioavailability[30-32].Go to:COMMON MEDICAL CONDITIONS FOLLOWING BARIATRIC SURGERYHypertensionHypertension is not always related to obesity, and dietary interventions do not assure the normalization of blood pressure. However weight loss, whether by an intensive lifestyle medical modification program or by a bariatric operation, improves obesity-linked hypertension. Patients should be monitored weekly until the blood pressure has stabilized, and patients may need to resume antihypertensive medications, but often at adjusted doses[33].DiabetesPatients with diabetes should have frequent monitoring of blood glucose in the early postoperative period and should be managed with sliding scale insulin. Many diabetic patients have a decreased need for insulin and oral hypoglycemic agents after bariatric surgery. Oral sulfonylureas and meglitinides should be discontinued postoperatively as these medications can lead to hypoglycemia after bariatric surgery. Metformin is the safest oral drug in the postoperative period, since it is not associated with dramatic fluctuations in blood glucose. RYGB is associated with durable remission of type 2 diabetes in many, but not all, severely obese diabetic adults. However those who underwent LAGB generally exhibit a slower improvement in glucose metabolism and diabetes as they lose weight in a gradual fashion[34,35].RefluxMedications for gastroesophageal reflux disease (GERD) may be discontinued after RYGB and Laparoscopic AGB, however, SG has been associated with an increased incidence of GERD in some procedures. Recurrent GERD symptoms after RYGB, particularly when accompanied by weight regain, should raise the possibility of a gastrogastric fistula between the gastric pouch and remnant, and should be investigated by an upper GI contrast study or CT scan and referred to the bariatric surgeon. Upper endoscopy is the best investigation to exclude other esophagogastroduodenal disorders. GERD may be associated with esophageal complications including esophagitis, peptic stricture, Barrett’s metaplasia, esophageal cancer and other pulmonary complications. Failure of the PPI treatment to resolve GERD-related symptoms has become one of the most common complications of GERD after bariatric surgery. Most patients who fail PPI treatment have Non Erosive Reflux Disease and without pathological reflux on pH testing. In patients with persistent heartburn despite of medical therapy, it is reasonable to recommend avoidance of specific lifestyle activities that have been identified by patients or physicians to trigger GERD-related symptoms[36-38].Nausea and vomitingNausea and vomiting can often be helped by antiemetic or prokinetic drugs, however, some patients have chronic functional nausea and/or vomiting that does not fit the pattern of cyclic vomiting syndrome or other gastrointestinal disorders, hence particular attention should be directed to potential psychosocial factors post bariatric surgery. Therefore, low dose antidepressant medications and psychotherapy should be addressed. On demand CT scan and Gastroscopy could be the gold standard investigations in chronic situations[39,40].Marginal ulcerationDue to increased risk of ulcer formation from nonsteroidal anti-inflammatory drugs (NSAIDs), these medications should be discontinued postoperatively, especially after RYGB. NSAID use is associated with an increased risk of bleeding. If analgesic or anti-inflammatory treatment is needed, the use of acetaminophen is preferred in a dose of 1-2 g/daily[41-45]. Other factors associated with increased risk of ulcer formation are smoking, alcohol, spicy food, gastrogastric fistulas, ischemia at the site of surgical anastomosis, poor tissue perfusion due to tension, presence of foreign material, such as staples and/or Helicobacter pylori infection. Diagnosis is established by upper endoscopy. According to our strategy, all patients should undergo diagnostic upper endoscopy to exclude congenital or GI diseases prior to bariatric procedures. Medical management is usually successful and surgical intervention is rarely needed[46-48].Go to:DUMPING SYNDROMEDumping syndrome or rapid gastric emptying is a group of symptoms that most likely occur following bariatric bypass. It occurs when the undigested contents of the stomach move too rapidly into the small intestine. Many patients who underwent bariatric bypass experienced postprandial hypoglycemia. However, the dumping syndrome usually occurs early (within one hour) after eating and is not associated with hypoglycemia. It is presumed to be caused by contraction of the plasma volume due to fluid shifts into the gastrointestinal tract. Dumping syndrome may result in tachycardia, abdominal pain, diaphoresis, nausea, vomiting, diarrhea, and sometimes, hypoglycemia. The late dumping syndrome is a result of the hyperglycemia and the subsequent insulin response leading to hypoglycemia that occurs around 2-3 h after a meal. Dumping syndrome is a common problem that occurs in patients who have undergone RYGB and when high levels of simple carbohydrates are ingested. Accordingly, patients who have experienced postgastric bypass bariatric surgery should avoid foods that are high in simple sugar content and replace them with a diet consisting of high fiber and protein rich food. Eating vegetables and salad is encouraged; beverages and alcohol consumption are better avoided[49].Go to:PSYCHOSOMATIC DISORDERS/DEPRESSIONMany patients usually experience enhanced self esteem and improved situational depression following weight loss. Depression often requires continued treatment, specially that, many patients with severe obesity often use food for emotional reasons. Therefore, when those patients experience a small gastric pouch postoperatively they may grieve the loss of food. Many studies documented the relationship between eating disorder and anxiety disorder, depression or schizophrenia[50,51]. Displaced emotions can result in somatization with symptoms of depression and psychosomatic disorders. It is important that clinicians recognize the psychological aspect of food loss after bariatric surgery, and reassure patients that the symptoms are related to the small gastric pouch size. Antidepressants often help to decrease the anxiety related to grieving associated with food loss, although the use of antidepressants needs to be approached with an empathetic style. Behavioral and emotive therapies are reported to be very helpful[52,53].Go to:OUTCOMEBariatric surgery remains the only effective sustained weight loss option for morbidly obese patients. The American Society for Metabolic and Bariatric Surgery estimated that in 2008 alone, about 220000 patients in the United States underwent a weight loss operation. The optimal choice for type of bariatric procedure, i.e., RYGB, SG, AGB or the selected surgical approach, i.e., open versus laparoscopic depends upon each individualized goals, i.e., weight loss, glycemic control, surgical skills, center experience, patient preferences, personalized risk assessment and other medical facilities. Laparoscopic sleeve gastrectomy is the most common bariatric procedure. However weight re-gain after long-term follow-up was reported[54-58]. Prospective studies and reviews report a general tendency for patients with metabolic disorders to improve or normalize after bariatric surgery. However weight loss is highly variable following each procedure. Recent studies have evaluated the potential impact of obesity on outcomes in organ-transplant recipients, for example bariatric surgery may be an important bridge to transplantation for morbidly obese patients with severe heart failure[59-63].Go to:RECENT ADVANCES IN BARIATRIC SURGERYA modified intestinal bypass bariatric procedure (Elbanna operation), reported a novel surgical technique designed to maintain good digestion, better satiety, and selective absorption with less medical and surgical complications (Figure ​(Figure5).5). This procedure preserves the proximal duodenum and the terminal ileum and thus preserving the anatomical biliary drainage and enterohepatic circulation[64,65].Figure 5Novel ElBanna surgical procedure.Recently, a novel bariatric technique dedicated; Modified Elbanna technique in childhood bariatric, showed promising success in pediatric surgeries (non published data).Go to:CONCLUSIONThe rising prevalence of overweight and obesity in several countries has been described as a global pandemic. Obesity can be considered like the driving force towards the pre-mature deaths. It increases the like hood for the development of diabetes, hypertension and NASH. The American Heart Association identified obesity as an independent risk factor for the development of coronary heart disease. In order to minimize post-surgical cardiovascular risk, surgical weight loss may become a more frequently utilized option to address obesity. Currently, bariatric surgery passes through a plateau phase, hence medical management and follow up of patients who have undergone bariatric surgery is a challenge.Go to:FUTURE RECOMMENDATIONSChildren obesity has become one of the most important public health problems in many industrial countries. In the United States alone, 5% of children have severe obesity. It is imperative that health care providers should identify overweight and obese children so as to start early counseling and therapy. To establish a therapeutic relationship and enhance effectiveness, the communication and interventions should be supported by the entire family, society, school, public media and primary health care. Bariatric surgery could be considered in complicated cases that failed all other options.Go to:FootnotesP- Reviewer: Amiya E, Firstenberg MS, Narciso-Schiavon JL S- Editor: Tian YL L- Editor: A E- Editor: Lu YJGo to:References1. 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The health benefits of eucalyptusLast updated Fri 5 Jan 2018By Joseph NordqvistReviewed by Debra Rose Wilson, PhD, MSN, RN, IBCLC, AHN-BC, CHTTable of contentsEucalyptus is a fast-growing evergreen tree native to Australia. As an ingredient in many products, it is used to reduce symptoms of coughs, colds, and congestion. It also features in creams and ointments aimed at relieving muscle and joint pain.The oil that comes from the eucalyptus tree is used as an antiseptic, a perfume, as an ingredient in cosmetics, as a flavoring, in dental preparations, and in industrial solvents.Chinese, Indian Ayurvedic, Greek, and other European styles of medicine have incorporated it into the treatment of a range of conditions for thousands of years.There are over 400 different species of eucalyptus. Eucalyptus globulus, also known as Blue Gum, is the main source of eucalyptus oil used globally.Leaves are steam distilled to extract the oil, which is a colorless liquid with a strong, sweet, woody scent. It contains 1,8-cineole, also known as eucalyptol.The leaves also contain flavonoids and tannins; flavonoids are plant-based antioxidants, and tannins may help to reduce inflammation.Health benefits and uses of eucalyptusEucalyptus is believed to have a number of medicinal properties, although not all of them have been confirmed by research. Below we outline some of its potential health benefits.Antimicrobial propertiesEucalyptus leaves and essential oil are commonly used in complementary medicine.Interestingly, toward the end of the 19th century, eucalyptus oil was used in most hospitals in England to clean urinary catheters. Modern research is now starting to back this practice up.In February 2016, researchers from Serbia found evidence supporting the antimicrobial action of eucalyptus.They concluded that a positive interaction between E. camaldulensis essential oil (a tree in the Eucalyptus family) and existing antibioticscould lead to the development of new treatment strategies for certain infections.They hope that this property could eventually reduce the need for antibiotics.A study published in Clinical Microbiology & Infection suggests that eucalyptus oil may have antibacterial effects on pathogenic bacteria in the upper respiratory tract, including Haemophilus influenzae, a bacteria responsible for a range of infections, and some strains of streptococcus.Colds and respiratory problemsEucalyptus features in a range of preparations to relieve symptoms of the common cold, for example, cough lozenges and inhalants.Herbal remedies recommend using fresh leaves in a gargle to relieve a sore throat, sinusitis, and bronchitis. Also, eucalyptus oil vapor appears to act as a decongestant when inhaled. It is a popular home remedy for colds and bronchitis.It may act as an expectorant for loosening phlegm and easing congestion. A number of cough medications include eucalyptus oil, including Vicks VapoRub.Researchers have called for further studies to clarify the possible therapeutic role of eucalyptus leaf extract in the treatment of respiratory tract infection.Eucalyptus and dental careThe antibacterial and antimicrobial potential of eucalyptus has been harnessed for use in some mouthwash and dental preparations.In promoting dental health, eucalyptus appears to be active in fighting bacteria that cause tooth decay and periodontitis.The use of eucalyptus extract in chewing gum may promote periodontal health, according to a study published in the Journal of Periodontology.Fungal infections and woundsThe University of Maryland Medical (UMM) Center describe how traditional Aboriginal medicines used eucalyptus to treat fungal infections and skin wounds.Insect repellentEucalyptus is an effective insect repellent and insecticide. In 1948, the United States officially registered eucalyptus oil as an insecticide and miticide, for killing mites and ticks.Oil of lemon eucalyptus is recommended by some as an insect repellant; it is effective at keeping mosquitoes away.In 2012, researchers from New Delhi, in India, found that E. globulus oil was active against the larvae and pupae of the housefly. They suggested that it could be a viable option for use in eco-friendly products to control houseflies.Pain reliefEucalyptus extract may act as a pain reliever, and research indicates that the oil may have analgesic properties. In a study published in the American Journal of Physical Medicine and Rehabilitation, scientists applied Eucalyptamint on the anterior forearm skin of 10 people.Eucalyptamint, an OTC preparation with the generic name methyl salicylate topical, is used to treat muscle and joint pain linked to strains and sprains, arthritis, bruising, and backache.The scientists concluded that "Eucalyptamint, produced significant physiologic responses that may be beneficial for pain relief and/or useful to athletes as a passive form of warm-up."Stimulating immune systemEucalyptus oil may stimulate an immune system response, say findings published in BMC Immunology.Specifically, the researchers found that Eucalyptus oil could enhance the immune system's phagocytic response to pathogens in a rat model. Phagocytosis is a process where the immune system consumes and destroys foreign particles.Other conditions that eucalyptus may help with include:Arthritis - potentially due to its anti-inflammatory propertiesA blocked noseWounds and burnsUlcersCold sores - perhaps due to its anti-inflammatory propertiesBladder diseasesDiabetes - eucalyptus might help lower blood sugarFeverFluPrecautions and side effectsAccording to the National Association for Holistic Aromatherapy (NAHA), some essential oils can be hazardous, but those that are available commercially, from reputable sources, are safe to use if handled appropriately. The NAHA say that it is important to use "pure, authentic, and genuine essential oils."Eucalyptus products can generally be used safely on the skin, as long as the oil is diluted. It should not be applied directly onto the skin until it is diluted with a carrier oil, such as olive oil.The dilution should be between 1 percent and 5 percent eucalyptus oil to between 95 percent and 99 percent carrier oil; this equates to roughly one to five drops of essential oil in an ounce of carrier oil.Eucalyptus can produce irritation and a burning sensation. It should not be used too close to the eyes.It is important to do an allergy test before using eucalyptus because it is highly allergenic. An allergy test can be done by adding the eucalyptus oil in the carrier oil and putting a drop on the arm. If there is no reaction in 24 hours, it is safe to use.Allergies can develop over time. If you have used eucalyptus oil in the past and now seem to be having an allergic reaction to it, discontinue use.It is not safe to take eucalyptus oil orally because it is poisonous.In some individuals with asthma, eucalyptus can make their condition worse. Others find that it helps to relieve their asthma symptoms.Side effects may include:DiarrheaNauseaVomitingStomach upsetSigns of eucalyptus poisoning include dizziness, feelings of suffocation, and small pupils. It is important to note that eucalyptus may interact with other medications and can impact the liver.Children are more sensitive to essential oils, so care should be taken when using eucalyptus with children. Use should be avoided during pregnancy.RELATED COVERAGEFeeling lonely may worsen cold symptomsREAD MOREFish oil may not be as healthful as you think, study findsREAD MOREAre hot drinks or ice pops better for sore throat?READ MOREWhat is the difference between cold and flu?READ MOREDo not prescribe antibiotics for common cold, doctors urgeREAD MOREWhat are the benefits of thyme?READ MOREemailCOMPLEMENTARY MEDICINE / ALTERNATIVE MEDICINERESPIRATORYAdditional informationReferencesCitationsRECOMMENDED RELATED NEWSSugar and spice and everything not so nice: Spice allergy affects foodies and cosmetic users alikeAmerican College of Allergy et al., ScienceDaily, 2012Essential oils and pregnancyMedicalXpress, 2016Parents struggle with choosing allergy medicine for their childrenMedicalXpressSpice allergy: Sugar and spice and everything not so niceMedicalXpress, 2012ADVERTISEMENTget our newsletterHealth tips, wellness advice and more.SUBSCRIBEYour privacy is important to us.Popular newsEditorial articlesAll news topicsKnowledge centerNewslettersShare our contentAbout usOur editorial teamContact usAdvertise with MNTHealthline Media UK Ltd, Brighton, UK.© 2004-2019 All rights reserved. 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Idiots think pop starz and rock stars are living deities these days. And people are taking endless selfies of themselves and idolising themselves across social media - They believe themselves to be living deities these days !Realistically ……Kumari, or Kumari Devi, or Living Goddess – Nepal is the tradition of worshipping young pre-pubescent girls as manifestations of the divine female energy or devi in Hindu religious traditions. The word Kumari is derived from the Sanskrit Kaumarya, meaning "princess".Verses in the Christian Bible tell that Jesus will come again in some fashion; various people have claimed to, in fact, be the second coming of Jesus. Others have been styled a new messiah still under the umbrella of Christianity. The Synoptic gospels (Matthew 24:4, 6, 24; Mark 13:5, 21-22; and Luke 21:3) all use the term pseudochristos for messianic pretenders.[19]Simon Magus (early 1st century), was a Samaritan, and a native of Gitta; he was considered a god in Simonianism; he "darkly hinted" that he himself was Christ, calling himself the Standing One.Dositheos the Samaritan (mid 1st century), was one of the supposed founders of Mandaeanism. After the time of Jesus, he wished to persuade the Samaritans that he himself was the Messiah prophesied by Moses.[20]Dositheus pretended to be the Christ (Messiah), applying Deuteronomy 18:15to himself, and he compares him with Theudas and Judas the Galilean.[20][21]Tanchelm of Antwerp (c. 1110), who violently opposed the sacrament and the Eucharist.Ann Lee (1736–1784), a central figure to the Shakers,[22] who thought she "embodied all the perfections of God" in female form and considered herself to be Christ’s female counterpart in 1772.[23]Bernhard Müller (c. 1799–1834) claimed to be the Lion of Judah and a prophet in possession of the Philosopher's stone.John Nichols Thom (1799–1838), who had achieved fame and followers as Sir William Courtenay and adopted the claim of Messiah after a period in a mental institute.[24]Arnold Potter (1804–1872), Latter Day Saint schismatic leader; called himself "Potter Christ"Hong Xiuquan (1814–1864), Hakka Chinese; claimed himself to be the younger brother of Jesus Christ; started the Taiping Rebellion and founded the Heavenly Kingdom of Great Peace. Committed suicide before the fall of Tianjing (Nanjing) in 1864.Mirza Husayn 'Ali Nuri, Bahá'u'lláh (1817–1892), born Shiite, adopting Bábism in 1844 (see "Bab" in Muslim messiah claimants section below). In 1863, he claimed to be the promised one of all religions, and founded the Bahá'í Faith.[25]Jacobina Mentz Maurer (1841 or 1842–1874) was a German-Brazilian womanwho lived and died in the state of Rio Grande do Sul who emerged as a messianic prophetess, a representation of God, and later declared the very reincarnation of Jesus Christ on earth by her German-speaking community called Die Muckers (or the false saints) by her enemies, Die Spotters (or the mockers). After a number of deadly confrontations with outsiders, Jacobina was shot to death together with many of her followers by the Brazilian Imperial Army.William W. Davies (1833–1906), Latter Day Saint (Mormon) schismatic leader; claimed that his infant son Arthur (born 1868) was the reincarnated Jesus Christ.Cyrus Reed Teed (October 18, 1839 – December 22, 1908, erroneously Cyrus Tweed) was a U.S. eclectic physician and alchemist turned religious leader and messiah. In 1869, claiming divine inspiration, Dr. Teed took on the name Koresh and proposed a new set of scientific and religious ideas he called Koreshanity.Abd-ru-shin (18 April 1875 – 6 December 1941), founder of the Grail Movement.[26][27][28][29]Lou de Palingboer (Louwrens Voorthuijzen)[26] (1898-1968), a dutch charismatic leader who claimed to be god and the messiah from 1950 until his death in 1968.Father Divine (George Baker) (c. 1880 –1965), an African American spiritual leader from about 1907 until his death who claimed to be God.André Matsoua (1899–1942), Congolesefounder of Amicale, proponents of which subsequently adopted him as Messiah in the late 1920s.Samael Aun Weor (1917–1977), born Víctor Manuel Gómez Rodríguez, Colombian citizen and later Mexican, was an author, lecturer and founder of the 'Universal Christian Gnostic Movement', according to him, 'the most powerful movement ever founded'. By 1972, he referenced that his death and resurrection would be occurring before 1978.[30]Ahn Sahng-hong (1918–1985), founder of the World Mission Society Church of God and worshiped by the members as the messiah.[31]Sun Myung Moon (1920–2012), founder and leader of the Unification Churchestablished in Seoul, South Korea, who considered himself the Second Coming of Christ, but not Jesus himself.[32]Although it is generally believed by Unification Church members ("Moonies") that he was the Messiah and the Second Coming of Christ and was anointed to fulfill Jesus' unfinished mission.[32]Yahweh ben Yahweh (1935–2007), born as Hulon Mitchell, Jr., a black nationalist and separatist who created the Nation of Yahweh and allegedly orchestrated the murder of dozens of persons.Laszlo Toth (1940–2012) claimed he was Jesus Christ as he battered Michelangelo's Pieta with a geologist hammer.Wayne Bent (born 1941), also known as Michael Travesser of the Lord Our Righteousness Church, also known as the "Strong City Cult", convicted December 15, 2008 of one count of criminal sexual contact of a minor and two counts of contributing to the delinquency of a minor in 2008.[33]Iesu Matayoshi (born 1944), in 1997 he established the World Economic Community Party based on his conviction that he is God and the Christ.Jung Myung Seok (born 1945), a South Korean who was a member of the Unification Church in the 1970s, before breaking off to found the dissenting group[34] now known as Providence Church in 1980.[35][36] He also considers himself the Second Coming of Christ, but not Jesus himself in 1980.[37] He believes he has come to finish the incomplete message and mission of Jesus Christ, asserting that he is the Messiah and has the responsibility to save all mankind.[38] He claims that the Christian doctrine of resurrection is false but that people can be saved through him.[39]Claude Vorilhon now known as Raël"messenger of the Elohim" (born 1946), a French professional test driver and former car journalist became founder and leader of UFO religion the Raël Movement in 1972, which teaches that life on Earth was scientifically created by a species of extraterrestrials, which they call Elohim. He claimed he met an extraterrestrial humanoid in 1973 and became the Messiah.[40] Then devoted himself to the task he said was given by his "biological father", an extraterrestrial named Yahweh.[41]José Luis de Jesús (1946–2013), founder and leader of Creciendo en Gracia sect (Growing In Grace International Ministry, Inc.), based in Miami, Florida. He claimed to be both Jesus Christ returned and the Antichrist, and exhibited a "666" tattoo on his forearm. He has referred to himself as Jesucristo Hombre, which translates to "Jesus Christ made Man".Inri Cristo (born 1948) of Indaial, Brazil, a claimant to be the second Jesus.[42]Apollo Quiboloy (born 1950), founder and leader of the Kingdom of Jesus Christ religious group, who claims that Jesus Christ is the "Almighty Father," that Quiboloy is "His Appointed Son," and that salvation is now completed. Proclaims himself as the "Appointed Son of the God" not direct to the point as the "Begotten Son of the God" in 1985.[43]David Icke (born 1952), of Great Britain, has described himself as "the son of God", and a "channel for the Christ spirit".Brian David Mitchell was born on October 18, 1953 in Salt Lake City, Utah, he believed himself the fore-ordainedangel born on earth to be the Davidic"servant" prepared by God as a type of Messiah who would restore the divinely led kingdom of Israel to the world in preparation for Christ's second coming. (Mitchell's belief in such an end-timesfigure – also known among many fundamentalist Latter Day Saints as "the One Mighty and Strong" – appeared to be based in part on a reading of the biblical book of Isaiah by the independent LDS Hebraist, Avraham Gileadi, with which Mitchell became familiar from his former participation with Stirling Allan's American Study Group.)[44][45]David Koresh (Vernon Wayne Howell) (1959–1993), leader of the Branch Davidians.Maria Devi Christos (born 1960), founder of the Great White Brotherhood.Sergey Torop (born 1961), who started to call himself "Vissarion", founder of the Church of the Last Testament and the spiritual community Ecopolis Tiberkul in Southern Siberia.Alan John Miller (born 1962), founder of Divine Truth, a new religious movement based in Australia. Alan John Miller, also known as A.J., who claims to be Jesus of Nazareth through reincarnation. Miller was formerly an elder in the Jehovah's Witnesses.David Shayler (born 1965), former MI5agent and whistleblower who declared himself the Messiah on 7 July 2007.[46]