THE WONDERS OF METHI

Methi, Greek hay, or fenugreek, is a commodity that can be found in Indian, Turkish, and Persian cuisine, but it has also been used in Egypt, Greece, Italy and South Asia, mainly because of its many health benefits. It contains proteins, fiber, vitamin C, B6, and K, minerals like potassium, calcium, magnesiun and zink and iron alkaloids and even a compound called diosgenin, which has estrogen-like properties. It is high in dietary fiber, which aids digestion and promotes satiety. 

There are two popular varieties of fenugreek known as Kasuri Methi or Champa Methi; and Marwari Methi. Both varieties are scented and recommended for cultivation. The height of a Methi plant is approximately 2-3 feet (60-90 centimeters). It is a robust herb characterized by its green leaves, small white flowers, and pods. 

It is a nutrient-rich herb known for its numerous health benefits, including improved digestion, blood sugar control, and heart health.

Digestive Health: Methi is known to alleviate digestive issues such as indigestion, bloating, and constipation due to its high fiber content. It can also promote better nutrient absorption. It helps to cleanse the body of toxins, soothes the stomach during digestion and helps prevent constipation. There are also various components that help to calm inflammation of the digestive system by coating the walls of the stomach and intestines. It can also relieve heartburn if you drink it as a tea.

·        Grind one teaspoon of fenugreek seeds for each cup of tea you want to make.

·        Add the ground fenugreek to a tea strainer, with or without other tea, although it is recommended to combine them with others for taste.

·        Place the tea strainer in a glass and add a cup of boiling water for each teaspoon of fenugreek you have ground. Steep and let it rest for about 15 minutes.

·        Drink the tea hot (reheated) or cold, you can add sweeteners or milk for taste.

·        You can also upgrade the tea with a little nutmeg, honey, and lemon.  

 

Blood Sugar Control: The soluble fiber in methi helps slow down the absorption of sugar in the blood, making it beneficial for individuals with diabetes. Studies suggest that it can improve insulin sensitivity and regulate blood sugar levels. It is very useful for diabetics because of the galactomannan, a natural fiber in fenugreek which slows down sugar absorptions. Additionally, fenugreek contains amino acids that contribute to insulin production.

Heart Health: Methi can help lower LDL (bad) cholesterol levels and triglycerides, reducing the risk of heart disease. Its potassium content also aids in maintaining healthy blood pressure. You can crush and sprinkle some of its seeds on the food you prepare every day, helping yourself balance your cholesterol levels.

Since it contains a high amount of galactomannan and is an excellent source of potassium, fenugreek helps maintain normal blood pressure and heart rate.

Weight Management: The fiber in methi promotes a feeling of fullness, which can help reduce overall food intake and assist in weight management. If you chew a teaspoon of fenugreek seeds soaked in water each morning on an empty stomach, you can take advantage of its soluble fibers, which will expand in your stomach and suppress your appetite during the day.

Anti-Inflammatory Properties: Methi contains compounds that possess anti-inflammatory effects, which can help alleviate conditions like arthritis and asthma. 

Hormonal Balance: Fenugreek is known for its phytoestrogen content, which can help regulate hormonal imbalances, particularly in women experiencing menopausal symptoms. 

Skin and Hair Health: Methi can be used in face packs to improve skin health by reducing acne and promoting a clear complexion. It is also beneficial for hair, helping to prevent dandruff and promote hair growth. Simply soak the fenugreek seeds in coconut oil overnight, boil the solution and apply it to your hair. Leave it for about 3 hours, and repeat every day for a week.

It soothes skin infections and reduces scars. Studies have shown that fenugreek helps to treat various skin problems such as pustules, blisters, burns, eczema, and gout. Take a tablespoon of Methi seeds and grind them into powder. Mix the powder with warm water. Take a clean piece of cloth, dip it in a mixture and clean the skin with it.

Eases labour: Fenugreek is especially useful as a natural relieving drug during childbirth because it causes contractions in the uterus. It also helps to reduce labor pain, but it is important not to consume too much as this may endanger the fetus.

Breast Milk Production: Fenugreek is often recommended for breastfeeding mothers as it may help increase milk production. So it is high on the list of foods that all lactating women should eat, and studies have shown a more than 500% increase in milk production just 24-72 hours after fenugreek consumption. This is due to a high concentration of diosgenin, a compound that has been shown to have estrogen-like properties.

Eases Menstruation related discomfort: Fenugreek contains compounds called diosgenin and isoflavone, which have estrogen-like properties, and help reduce stressful symptoms of the menstrual cycle such as cramps, hot flashes, and mood swings. In addition, women are more sensitive to iron deficiency during menstruation, pregnancy, and lactation and fenugreek may help compensate for that.

Treating Anaemia:  The leaves of fenugreek are rich in Iron and thus help in blood cell formation. Apart from Iron, it is also rich in zinc, sodium, potassium and certain other trace minerals which are really good for health.

Cures Halitosis: Halitosis which is characterized by a foul smell from the mouth. This can be naturally cured with the use of fenugreek. One should take herbal tea prepared with fenugreek. The unpleasant odour occurring from the mouth can be due to several reasons; lack of nourishment, gum decay, cavity, any kind of disease, lack of personal hygiene and many more. The fenugreek tea taken regularly will help remove these accumulations from such spots where mouthwash and toothpaste can never penetrate.

Cures fever and sore throat: Fenugreek, when taken with a teaspoon of lemon and honey, can work wonders to reduce fever by nourishing the body. The soothing effect of mucilage in fenugreek also helps to relieve cough and pain from sore throat. Here are 5 foods that relieve sore throat.

 

Culinary Uses

Methi can be consumed in various forms, including fresh leaves, dried leaves, and seeds. It is commonly used in Indian cuisine to enhance the flavor of dishes like curries, parathas, and dals. 

·        A well-known flatbread called “Methi ke parathe“ is prepared using Fenugreek leaves.

·        Methi is even used as a condiment to prepare snack items.

·        Dried leaves of the fenugreek are used for flavouring meat, fish and vegetable dishes.

·        Seeds of fenugreek are also used as a cosmetic item; like in face packs, hair masks, and many more.

·        Fenugreek seeds and leaves are also used as an ingredient in herbal tea.

·        The seeds are sprouted and taken as a snack item or cooked.

·        The green leaves are used to prepare curry called ‘saag‘; or also used to cook different curry items.

 

Methi fenugreek has an antioxidant-rich composition, meaning they have relatively high amounts of flavonoids, alkaloids, saponins, and other antioxidants. This helps combat oxidative stress. The galactomannan content in Methi is believed to improve your heart health by reducing cholesterol levels. It is a rich source of protein, which can help repair tissues and build lean muscle mass. Besides, it boosts satiety and reduces hunger cravings. And it is packed with dietary fibre that aids digestion and regulates blood sugar levels. 

WHAT DO WE DO WITH ALL THIS TRASH?

 

What do we do with all this trash? With more than 7 billion people consuming, and then disposing of, "stuff" each day, usable space for trash disposal is quickly disappearing. The World Bank estimates that 3 billion people reside within urban areas, producing more than 1.3 billion metric tons of solid waste per year. By 2025 that number is expected to have ballooned to more than 2.2 billion metric tons, forcing governments to task on a garbage problem that many major cities have yet to answer.

 

It is a global problem

It is not a problem of the developing countries only. The Megacities of the world gobble up more water and energy while producing waste astronomically each year. For poor countries, inefficient waste management accelerates the rate of disease as toxins seep into waterways, leading to irreversible environmental pollution.

London churns out too much waste and only 52% goes to recycling. London’s waste disposal companies have increased the recycling rate unburdening the landfill. London’s heavy reliance on primary and secondary industries as the backbone of its economy promotes the consumption of recycled ingredients. The city is blazing the trail in creating a thriving, resilient metro that cuts down waste significantly with a circular economy along with a solid policy framework.

The 7 million perople crammed into Hong Kong's streets produce more than 13,800 metric tons of solid waste a day. That's like tossing an Empire State Building into the waste basket every 27 days. What's worse, of that waste, 3,500 tons-worth comes from scraps of uneaten food, and finding a place to store all of that garbage has proved an insurmountable task. More than 90% of waste is exported for recycling overseas, but that is simply domping poor countries with the waste created by the rich!

One New Yorker dissipates 24 times the electrical energy of a resident in Kolkata, India while spewing 15 times equal solid waste. The city runs a tight ship with aggressive recycling projects that extend outside plastics, paper, and metals to compost food waste. 

Beijing's 20 million plus people produce more than 25,000 tons of garbage a day, a number 4,300 tons beyond what the city can process. The countryside is no better; 40,000 towns and 600,000 villages across the country could not process waste and sewage, leaving more than 300 million tons of waste unprocessed each year.  Chinese government undertook a massive effort to burn trash for energy, constructing hundreds of incinerators to chip away at its trash mountains, but that resulted in large releases of harmful pollutants like dioxin and mercury into the atmosphere.

Manila area produces more than a quarter of all of the garbage in the Philippines, to the tune of nearly 9,000 tons of solid refuse a day. What's worse, only nine of the 16 cities and municipalities that make up the metro Manila area even have a plan to handle all of that waste and 83% og garbage gets collected too.  The trash that does find its way into garbage trucks coalesces into trash cities — towering trash mountains surrounded by shanty towns patrolled by Manila's poorest. Over the years Manila has played host to some of the world's most notorious garbage mountains like Smokey Mountain.

For many years Mexico City's Bordo Poniente held the dubious title of one of the largest landfills in the world. The more than 20 million people of Mexico City's metro area dumped close to 14,000 tons of garbage into the 927 acre site each day. As a result, trash gets dumped everywhere — in rivers, canals, and especially into streets, which are often impassable thanks to the mounds of refuse left behind.

With some 26.7 million people, Jakarta is also one of the world's fastest growing cities. Jakarta produces more than 6,500 tons of waste a day. Most of that waste finds its way to Jakarta's only landfill, Bantar Gebang, a 270 acre trash behemoth that receives 6,250 tons of trash from 800 garbage trucks flowing out of Jakarta each day. The trash clogs waterways during monsoon season, before being sent out into Jakarta Bay and out to sea. 

For hundreds of years the city of Cairo has operated without efficient, government-run trash collection. Instead, for the past 70 years, thousands of trash pickers known as the Zabbaleen have gone door-to-door collecting Cairo's trash for a small fee. The trash-pickers managed to recycle nearly 90 percent of all the garbage that passed through the city, a number that exceeds most Western recycling totals. 

 

The Indian Scenario

India generates 1.7 lakh tons of waste every day. Post Swach Bharat Abhiyan, 90% of the waste is collected and over 54% is processed or treated. Almost 25% of our waste is sent to the sanitary landfills. Now, to this huge man made waste we add the construction and demolition waste, which itself amounts to 15 crore tons a year. If not disposed correctly, which is often the case, it chokes our natural drainage system and cause drains to overflow and monsoon rainwater to cause floods. According to a recent estimate our cities sit atop more than 24 crore tons of legacy waste, spread across 2,400 dumpster, seeping below the surface with every rain, and infecting our groundwater. This leak into our groundwater is called leachate. This is rich in heavy metals, organic pollutants and pathogens contained in the garbage heap. Groundwater near Delhi's Bhalswa landfill has toxic levels of lead and iron and that near Nagpur's Bhandewadi landfill has zinc, copper and cadmium 200% above safe limits. 

New Delhi's tremendous growth has spurned a tremendous growth in refuse, too. The city's solid waste production increased 50 percent over five years, to 9,200 tons of trash a day in 2007, a number that was expected to double by 2024. Three of the four landfills servicing New Delhi are already past capacity, leaving the city starving for additional landfill space. If additional space isn't found these community dumps could spill over into the streets and contribute to a pollution problem that already stretches into the Yamuna river. 

 

Landfills – a necessary evil

Landfills are necessary for the proper disposal of solid waste. They reduce the amount of waste that makes it into the environment, help to prevent disease transmission, and keep communities clean. However, landfills still have significant environmental and social impact. While landfills are a societal necessity, there are practices that can reduce the reliance on landfills and decrease their effects on the biosphere.

Environmental Impact of Landfills

·         The most pressing environmental concern regarding landfills is their release of methane gas from the decomposition of organic waste. Methane is 84 times more effective at absorbing the sun’s heat than carbon dioxide, making it one of the most potent greenhouse gases and a huge contributor to climate change. 

·         Along with methane, landfills also produce carbon dioxide and water vapor, and trace amounts of oxygen, nitrogen, hydrogen, and non methane organic compounds. These gases can also contribute to climate change and create smog if left uncontrolled.  

·         The creation of landfills typically means destroying natural habitats for wildlife.

·         While landfills are required to have plastic or clay lining by federal regulation in the U.S in India these rules are openly flounted. This can result in leachate, a liquid produced by landfill sites, contaminating nearby water sources, further damaging ecosystems. 

·         Leachate can contain high levels of ammonia. When ammonia makes its way into ecosystems it is nitrified to produce nitrate. This nitrate can then cause eutrophication, or a lack of oxygen due to increased growth of plant life, in nearby water sources. Eutrophication creates “dead zones” where animals cannot survive due to lack of oxygen. Along with ammonia, leachate contains toxins such as mercury due to the presence of hazardous materials in landfills.

Social Impact of Landfills

·         Emissions from landfills pose a threat to the health of those who live and work around landfills. A study in New York found that there is a 12% increased risk of congenital malformations in children born to families that lived within a mile of a hazardous waste landfill site.

·         Chronic exposure to leachate contaminated water can cause gastroenteritis, neurological diseases and cancer. 

·         Large landfills, on average, decrease the value of the land adjacent to it. Te quality of life suffers in this region.

·         Landfills bring hazards such as odor, smoke, noise, bugs, and water supply contamination.

·         Minority and low-income areas are more likely to find themselves home to landfills and hazardous waste sites. These areas have fewer resources to oppose the placement of these facilities. This makes them an easier target for landfill placement than higher income areas.

How to avoid landfills

·         Recycle! Continuing to recycle will keep plastic and other materials out of the biosphere and put them to further use!

·         Avoid single-use plastics. Check out this article on single-use plastics and how to avoid them.

·         Compost! Landfills lack the oxygen that compostable items need to fully decompose. By putting biodegradable items into the compost instead of the trash, huge amounts of waste can avoid the landfill.

Landfills help to keep our communities clean, but they also pose serious threats to the health of our environment. Working towards living a zero waste lifestyle will help to reduce our reliance on landfills, their impact on the environment, and their impact on human health and well-being

How do we plan ideal waste management?

It has to be a multi-pronged approach. Waste management should follow the waste hierarchy:

1.      Avoid and reduce waste at the source, starting during the design and procurement phases.

2.      Repair and reuse.

3.      Sort and collect waste separating non-hazardous from hazardous waste.

4.      Recycle.

The treatment and processing system for solid waste include window composting, vermicomposting, pit composting, bio-methanation, organic waste convertors, pelletization, material recovery facilities (MRF), waste to energy plants for electricity generation etc. The ‘waste to energy’ plants are not totally safe as they emit harmful particulate matter in far higher concentration than permissible. So, such plants in Okhla in Delhi and in Jaipur and Hyderabad are not very popular with people living nearby.

So, we should have a proper plan of waste management at every step:

Planning and monitoring

Identify the different types of waste produced, evaluate and record their quantity by volume or weight. Draw up a context-based waste management plan, including sorting, collection, transport, storage, and final disposal. Assess and use local capacities like municipal landfill, informal sector, recycling companies, incineration facilities, etc.

Avoid and Reduce

Encourage procurement and programme teams to avoid and reduce waste at early stage of the project. Evaluate the relevance of each purchase. Engage with suppliers and avoid polluting or single-use items and packaging. Encourage re-usable, recycled, locally repairable and recyclable items with a long lifespan.

Repair and Reuse

Identify items that can be repaired and re-used instead of wasted. Support the necessary infrastructure, for example repair shops, tools or internal workshop. Seek spare parts for the repair process.

Sort and collect

Use separate bins and label them to sort and collect waste. Sort, collect and label hazardous waste separately to avoid any risk or contamination. Adapt the sorting to the existing local recycling opportunities (textile, paper, metals, glass, informal and formal sectors etc). Explore opportunities to mutualise collecting and storage with other actors. Bulk waste generators like malls, hotels, hostels, hospitals must compost and segregate on site. Every ward should have its own compost and segregation site and GPS tagged bins and mobile alerts should be used to track garbage collection.

Recycle

Work with local recycling companies and create employment opportunities. Consider influencing and supporting local governments and decision-makers to improve the recycling infrastructure. Recycled products like tiles, road base material, and prefabricated blocks must be popularised.

Treatment and final disposal

Identify and use legally approved local or regional disposal channels (composting, burial, sealing, controlled landfill, incineration…). Visit the site regularly. Establish partnerships (e.g., incineration in cement plants, energy recovery opportunities) and mutualize equipment like compost pits or collaborate with other actors (NGO’s, health structures, local governments, etc.). Incineration must be disintentivised to avoid contaminating the air with particulate matters.

Staff engagement and Sensitization

Raise staff awareness across all departments and involve them in avoiding waste, sorting, reusing, choosing long lifespan items, and reducing packaging.

 

The onus of mindful waste management cannot be the sole responsibility of the government. Public engagement must be strengthened by teaching waste literacy in schools and colleges, awareness campaigns by icons of the society and celebrating champions of zero waste living.

WHAT IS STOPPING YOU FROM ACHIEVING YOUR DREAMS?

Life is said to be too short, but most of us don’t feel it until we start nearing the end - only then do we really think about and regret our choices. Think about the following two questions:

1.      What was always your biggest dream?

2.      Did you realize that dream during your life?

If your answer to the second question is no, then you are wasting your precious time. Once you learn to recognize the routines and customs that cause this, you can avoid them and start to fulfill your dreams actively and consciously

In order to achieve our goals, we need to change our behavior, which leads to us becoming better versions of ourselves. Perhaps, we’re not quite ready for change because we haven’t developed the necessary success habits, haven’t eliminated unhealthy and unproductive activities, and have so many distractions that we hardly know what’s really important.

1. You think you deserve a better deal.

You want to achieve certain things in life, but you are greedy and unappreciative of what you already have, because you think you deserve better. Many, for instance, want not just to be offered a good job with a high salary and work hard to make money and increase the quality of their life, but they want to be rich, and they want it now. That’s a wrong approach.

First, you need to be grateful for what you already have. Only then will you feel some abundance and will realize that you have the power to turn it into something more? And you’ll feel the need to work for that, to give something in return and to then enjoy the fruits of your labor.

 

2. You are afraid of failure

We have a wrong perception of what failure is. Most people fear failure and it makes them not even try because of the chance of not succeeding. Because it can be easy to fail in many things, people become paralyzed with the fear of failure, and they end up never seeing their dreams come true. The truth is, failure is a precious gift. It’s an inevitable step on your way to success, and a step you’ll likely need to take more than once. Failure is proof that you’re trying, you’re doing something to get what you want, and you’re not giving up. Failure gives you the lessons and experiences you’ll need to become stronger, have more willpower, and be more focused. There is no better example than Thomas Edison who said “I have not failed. I have found 10,000 ways that won’t work!”

 

 3. Focusing on the end result

We often don’t want to wait and put in the hard work.  We want a quick result! It’s important to remember that things don’t work that way. The only thing to do is fall in love with the process and focus less on the end result. When you focus on doing what needs to be done day in and day out, you’ll get the end result you wanted. 

 

4. You are full of excuses

You often hear yourself saying:

I’m not ready;
It’s not the right time;
I’m not good enough;
I’m too old/young;
I don’t have enough money/time/experience;
Most people don’t succeed anyway, neither will I;
Maybe I’m not meant to do it;
It’s too hard;
It will take too long;
I may do it wrong;
People will laugh at me

This will make you the worst enemy of your success. Train your mind to think differently. Realize that your mind is tricky and prefers to stay in its comfort zone, doing the same old activities and tasks on autopilot, and not try anything new. That’s why it’s making up all these excuses, which can often sound quite convincing. Your job is to eliminate them, to even exaggerate them, and see how ridiculous they sound. Because if you choose the other option – if you believe them – you’ll never do anything different with your life and will never see the things you desire come true.

 

5. You are a procrastinator

Keep in mind one thing: now is the best time to do what you want, any other time is later than now. The present moment is where you create your future and the only time you can be productive and work on what you believe in. The only cure for procrastination is to start doing something immediately, without thinking and giving your mind time to come up with excuses. Without doubting your abilities and fearing failure make a small but definite step forward.

 

6. You spend too much time doing things you don’t need to do

Whether you sit every night and watch television for hours on end or spend your time in front of your computer skimming through a social network, or watching reels in your smartphone you should start taking your life more seriously. Think about the way you choose to spend most of your free time and ask yourself if it somehow helps your life move forward and helps you become better - do your actions help you create a foundation for the future you want to live? If not, you probably need to re-evaluate your routine and make changes.

 

7. You complain too much

Some people, without even knowing it, hate their lives, and they don’t stop sharing this fact with others. Do you think you’re like that? Do you complain about your boss, your salary, or your noisy neighbors? If so, you probably don’t do anything but project negative energy into your environment, and negativity doesn’t help anything, it just makes you stuck. Change the way you think, and talk to your friends about the things you love in life, not about the things that are bothering you.

 

8. You don’t feed your brain

We don’t stop growing after puberty, we stop growing when we stop learning new things. If you don’t continue to learn new things and improve your knowledge, you will degenerate and stay stagnant, just like a still lake which becomes scummy - that's what happens to your brain if you don’t keep it active and teach it new things. Thought provoking challenges help you expand your knowledge and improve your thinking, so don’t avoid them even if learning something new seems like a difficult task - you have to be a little bad at first to get better.

 

9. You aren’t inspired

Do you have a desire for something? There are many people who go to work every morning, go home, watch television and go to bed, and believe they have no passion for anything, but that's never the case. Each of us has something we enjoy doing which adds to our life, and you have to rediscover what excites you and put more of it into your life.

 

10. You expect a lot from others

Stop expecting so much. It’s a destructive behavior that brings deep disappointment in your life. You expect things to turn out in a certain way, you expect people to behave as you imagine them to, and whenever that doesn’t work out, you feel upset and lose any motivation to take action. Ditch these fantasies you live in, eliminate the scenarios you play in your head of how things should be, and accept them as they are. Create circumstances, don’t imagine them and then start expecting them to fall in place accordingly.

 

11. You have too many negative conversations with yourself

Sometimes our thoughts can ruin our day. Henry Ford said, "Whether you think you can or you think you can’t - you're right," which means that if you tell yourself that you are too exhausted to make a difference in your life, you're right because that's what you decided. However, if you tell yourself you're smart and talented enough to get promoted or start your own business, you're also right. Whatever you tell yourself will become your reality, so be aware of your thoughts and adapt them to the life you want to live.

 

12. You’re not planning for the future

While it is recommended for each of us to live in the moment, sometimes we have to look into the future and make sure we are on the path we need to be on. If you don’t have a goal or a plan of some sort, you’re like a sailor on a boat sailing the sea without a sail expecting to get to a good place, but chances are that that won’t happen. You have to create a plan of action which will help you reach your safe haven - just like choosing a destination on a GPS. Once you have a goal in mind, you’ll know which opportunities will take you to it.

 

13. You lack consistency

Lack of consistency is a big vice, because with whatever you do, you won’t see any progress if you don’t do it each day. Consistency is a trait of successful people, and it becomes a habit, like everything else. But without it, you won’t get far. It’s better to do something for 15-30 minutes every single day than to only do something once a week for hours. Stay consistent and develop that habit. 

 

14. You spend too much time with people who don’t contribute to your well-being

It is very easy to get stuck with negative people who don’t help us feel that we are better people than we think we are. Sometimes, we even call these people friends, but it's important that you know that these people are pulling you down with them. People like this are "energy vampires" because they draw the spirit of life from others and do not give anything positive in return. Instead of spending too much time with such people, identify the friends and acquaintances who make you feel proud and happy, and surround yourself with them. Robin Cook says surround yourself with ‘a circle of geniuses’.

 

15. You are addicted to your smartphone

The smartphone is one of the most useful gadgets added to our lives in recent years, but you should be aware of the time you spend on it. Think about how the use of a smartphone affects your relationship in your home environment or while you're with friends; are you locked onto the screen at dinner with your family, or are you communicating with acquaintances while you sit for a cup of coffee with a friend? If so, you are missing out on the meaningful entertainment and intimate relationship with the people you love.

 

16. You spend money on things that don’t matter

There is a big difference between "want" and "need," and certainly your parents tried to teach it to you at a young age. However, the line between these two has become very blurred in today's society, and some people fail to pay their mortgage but still manage to spend their money on non-essential products. If you stop for a moment and think about it, you’ll find that there are very few things you really need in life; water, food, a home, and love are part of that list. All other things are extra, so think about your expenses and make changes accordingly.

 

17. You don’t get enough sleep

You don’t have to be a doctor to know how important sleep is to our health. If you're awake till the early hours doing chores, you’re probably wasting your free time during the day on things that are not necessary. This is a bad habit that should be stopped because poor sleep can cause fatigue that will rob you of the desire to do the things you need to do to sustain your life. Time is our most precious asset. Use it miserly and use it purposefully. It is a precious currency with which you can buy success by spending it to your advantage.

 

18. You don’t take care of your body

Beyond the fact that adequate sleep is important for health, it is also necessary to keep the body active and maintain its health, just as you would your car. Your body is the vehicle that drives your soul, and you must help it stay healthy by eating a balanced, healthy diet and exercising, not just for weight loss, but to maintain its strength. It will affect you mentally and change your attitude toward life. Start with small changes, and if you see that you persist in them consider increasing your efforts - the more you do to keep your health, the better your life will look.

 

19. You don’t step out of your comfort zone

It’s easy to stay in a comfortable place, but if we don’t take calculated risks in life, it’ll never be able to improve enough to satisfy us. Note that there is a difference between "risk" and "calculated risk", since just any risk can lead to a negative outcome, but a calculated risk is one in which our chances of achieving a positive outcome are higher. Just think of a plan of action and go with it wholeheartedly.

 

20. You don’t love your life

Success and happiness come hand in hand, because the way to test how successful a person is, is to measure his level of happiness. Do you feel happy? If not, you may need to make a significant difference in your life. Even feelings of satisfaction or contentment aren’t indicative of a life lived to the fullest - life needs to excite you! If you don’t enjoy your life, you have to make some changes that will lead you to a better place.

 

If these 20 signs sound familiar to you, don’t be discouraged. You can change your life, but first, you have to get rid of the little voice in your head telling you it's impossible. Most of the time our biggest obstacle to success is the pattern of thoughts in our head. Change your way of thinking and speaking to yourself and gradually the way you perceive and experience life will change as well.

REMEMBERING PROF. R.P. SAHI BY HIS LECTURE ON MIDLINE SWELLINGS OF THE HEAD AND NECK

 

Prof. R.P. Sahi was our teacher in the Department of Surgery in King George’s Medical College, Lucknow. He was easily the best teacher in the campus. His baritone voice was renowned for its richness, strength and unmistakable quality, making it a defining feature of his aristocratic persona and a major factor in his enduring and universal popularity. This also made him instantly recognizable and command attention every time.

 

As an undergraduate teacher he was matchless because he could sub-divide the most complex subject into easily understandable bits, and once he taught a topic it somehow got imprinted in our brain for life. There was a method in his teaching which invariably simplified problems for even the back-benchers.

 

As a resident in his unit, I found him to be an inspiring leader and an outstanding post-graduate teacher with priceless qualities of a communicator, a disciplinarian, a conveyor of information, an evaluator, a Unit manager, a counselor, a member of many teams and groups, a decision-maker, a role-model, and a surrogate parent all rolled in one. His umbrella of benevolence was so reassuring that trainees got the best opportunity to express themselves. He understood the strengths and weaknesses of his trainees and steered them towards what would be best for them. Looking back, I can understand today how important this individualized approach was in his unit.

 

Prof. Sahi was a very sought after speaker, whether in surgical conferences or on social occasions. He was invariably our first choice for C.M.E and Conference inaugurations as well as after post dinner speeches. He somehow could palpate the mood of the gathering and say exactly what the occasion demanded. When Prof. P.C. Dubey was the Head of the Department of Surgery, Prof. Sahi was entrusted with the responsibility of resident posting and academic scheduling and the Department of Surgery was the best Department of the Medical College by miles. When I was applying for my Microsurgery training fellowship in St. Vincent’s Hospital, Melbourne, he and Prof. N.C. Misra gave me some glowing recommendations.

 

After his retirement he practiced in Krishna Medical Centre and mostly spent his time in academic pursuits. He stays in Hazratganj in his old bunglow wnd enjoys his retired life to the fullest.

 

I came across a lecture he delivered to our batch in 1978 on ‘Swellings of the Head & Neck’. He taught this vast topic in two lectures ‘Midline Swellings of the Head & Neck’ and ‘Lateral Swellings f the Head & Neck’ and this is the first lecture of this series.

  

Introduction

The deep fascia of the neck splits to envelope the Sternomastoid muscles. All swellings situated superficial to it are superficial swellings and all lying deep to it are the deep swellings.

 

Thus superficial swellings at this site are like any other site:

Skin             Epidermoid or Pilar cyst          

Fat               Lipoma

Nerve          Neurofibroma                          

Vessels        Haemangioma

 

The deep swellings of the neck for the purpose of description are sub divided into midline swellings and swellings in the lateral aspect of the neck.

 

Classification by Duration of lesion

1.      Acute: Cellulites, Ludwig’s Angina, Abscess, Carbuncle, Ac. Lymphadenitis

2.      Chronic:

A.    Cystic: Branchial cyst, Thyroglossal cyst, Cystic Hygroma, Cystic adenoma of Thyroid gland, Cold Abscess, Pharyngeal pouch

B.    Solid: Lymph nodes, Submandibular salivary gland, Thyroid tumours, Cervical Rib, Carotid body tumour, Branchogenic carcinoma, Sternomastoid Tumour

C.    Pulsatile: Aneurysm of Carotid artery / Subclavian artery, Aorta, Exophthalmic goiter.

 

Classification of Midline swellings

1.      On the face:

·        Median Angular Dermoid

·        Syncipital Meningocele

·        Fronto-nasal Meningo-encephalocele

·        Lachrymal sac swellings

·        Rhinophyma

·        Symphyseal odontomes

·        Gummata

2.      Submental region

·        Sub mental lymphadenitis

3.      Between menton and Hyoid

·        Ludwig’s Angina

·        Sublingual / Midline Neck Dermoid

·        Ranula / Plunging Ranula

·        Thyroglossal cyst

4.      Between Hyoid and Thyroid Cartilage

·        Sub Hyoid bursitis

·        Osteoma of Hyoid bone

·        Chondritis / Perichondritis

·        Chondroma of Thyroid cartilage

·        Laryngocele

·        Thyroglossal cyst

5.      Between Thyroid and Cricoid

·        Lymph node on crico-thyroid membrane

6.       Between Cricoid and Supra sternal notch

·        Thyroid gland – Goitres

7.      At Supra sternal space of Burns

·        Cold Abscess

·         Lymph nodes

·        Ectopic Thyroid

·        Supra sternal bursitis

·        Neurofibroma

·        Aneurysm of Arch of Aorta

 

Median Dermoids: Can be present at the midline either on the vault or on the floor of mouth or neck. They usually contain skin elements – sebum, hairs etc. They may scallop the skull bones and rarely have intra cranial extension through a gap in the skull. Treatment is excision and repair.

 

Fronto nasal Meningocele / Meningo-encephalocele: Meningoceles are brilliantly trans illuminent, cystic swellings, getting tense on coughing, crying or jugular pressure. Meningomyloceles have ectopic brain tissue in them and so are not trans illuminent. The inter orbital distance is widened – hypertelorism and there are cross fluctuations between it and the fontannele. CT scan demonstrates the gap in the skull and the treatment is excision, replacement of herniated contents, and repair of the bony gap by bone grafts and surgical correction of hypertelorism.

 

Lachrymal sac swellings: These are in the medial canthus of eye, usually inflammatory, and cause by blockage of naso-lachrymal duct with resultant epiphora. Treatment is initially conservative and if unsuccessful a DCR is done.

 

Rhinophyma: Sebaceous cyst adenomatosis affecting the skin of nose. There are multiple sessile nodular elevations over the nasal tip. Treatment is aesthetic rhinoplasty.

 

Gummata: These are seen in the midline in the tertiary stage of Syphilis causing erosion of skin, mucous membrane and bone. Midline structures like palate, hyoid, nasal bone, forehead etc. can be involved. VDRL test clinches the diagnosis. It is getting more and more uncommon in this antibiotic age.

 

Sub mental Lymphadenitis: May be inflammatory or neoplastic and so the entire drainage area – the tip of tongue, floor of mouth, incisors, symphyseal alveolus should be examined for focus of infection or primary tumour. Other lymph nodes should also be examined to rule out a primary Lymphoma.

 

Ranula: Myxomatous or mucoid degeneration of sublingual salivary gland. It appears as a blue-grey domed cyst in the floor of mouth, which is brilliantly trans illuminant. It has a tendency to split the mylohyoid and project in the submental region- plunging ranula. Treatment is excision by oral approach or marsupilization.

 

Sublingual dermoid: Sizable swelling filling and distorting the sublingual space, this dermoid is located within the mylohyoid muscle or the intrinsic muscles of tongue. Treatment is excision by sub mental approach.

 

Ludwig’s Angina: This is a form of cellullitis, which starts in the submandibular region and spreads to the floor of mouth. It produces a diffuse swelling beneath the jaw as well as the floor of mouth, often fixing the tongue. The unyielding deep fascia of the neck pushes the oedema up towards the glottis and down towards the mediastinum. Fatal septicemia, airway obstruction and death may result. Treatment is emergency drainage and broad spectrum anti bacterial coverage for Gram +ve, Gram –ve and anaerobes.

 

Thyroglossal cyst: These are cystic swellings mostly infrahyoid but may be suprahyoid as well and they move both with deglutition and tongue protrusion. The Thyroid develops from the foramen caecum and invaginates down as a tract called Thyroglossal tract to become the Thyroid isthmus. The cyst can occur anywhere along this tract. The cyst can become infected and form an abscess, which can be drained like any other abscess and result in the formation of a fistula. Thyroglossal fistula thus formed is never congenital, always acquired. These cysts are lined by squamous, cuboidal or columnar epithelium and may have lymphoid and thyroid tissue. They can turn malignant. Treatment of cyst and fistula is excision in toto along with the entire tract right up to the foramen caecum, taking the middle 1/3 of hyoid along with.

 

Subhyoid bursitis: Soft fluctuant swelling below the hyoid, it moves with deglutition and cannot be distinguished from Thyroglossal cyst easily.

 

Lymph node on crico thyroid membrane: A secondary deposit from a primary in the larynx, if present an endoscopic laryngeal examination and biopsy is a must. It also moves with deglutition.

 

Laryngocele: A soft, variable, unilateral or bilateral swelling, arising from the upper part of Thyroid cartilage, this is a herniation of the laryngeal mucosa through a gap in the thyrohyoid membrane. The swelling moves with deglutition and is usually seen in musicians playing wind instruments like flute and bagpipes Treatment is excision and repair.

 

Thyroid: This butterfly like endocrine gland straddles the trachea and its isthmus is situated over the 3^rd.and 4^th. tracheal rings. It moves up with deglutition and may have variable shape, size, consistency and tenderness. Lesions in Thyroid can be inflammatory, neoplastic, autoimmune and idiopathic. Lymph nodes on either sides of the neck and features of hypo and hyperthyroidism should always be examined.

 

Thus ended Prof. Sahi’s lecture on Midline Swellings of the Head & Neck. The diagram that he made on the board, every time pops up in my mind, whenever I see patients with midline head and neck swellings. This was once in a lifetime teaching, which has stayed life-long!