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Alternative treatments

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http://en.wikipedia.org/w/index.php?title=Flu_treatment&diff=51190390&oldid=51085999 is thinly veiled advertising for linksynergy links, but also well documented (I didn't check the pubmed links). Not sure how to rv - would like to keep what's relevant there. Comments? - unsigned

I deleted it along with your addition. Perhaps you (and others) would like to use this talk space to (for this article) agree on good sources on alternative treatments, then agree on good quotes from those sources, then we can add those quotes and sources to this article. WAS 4.250 18:00, 2 May 2006 (UTC)[reply]

OK how about this, I have copied the important info on the page, it is great information and I think it would be useful.

"

Alternative medications that are most likely to help us during a severe pandemic

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Garlic (allicin) - Very effective antiviral. Best if fresh (raw) and crushed. Must be consumed within 1 hour of crushing. Dosage is initially 2 to 3 cloves per day but later reduce until no body odour occurs. No toxic effects noted. (Pubmed PMID 9049657)

Vitamin C - Boosts the immune system and is an antiviral by blocking the enzyme neuraminadase. Viruses need neuraminadase to reproduce. There are anecdotal stories of people taking large amounts of Vitamin C (children ½) surviving the Spanish Flu. Research shows that it may reduce the production of cytokines TNF-a and IL-6. A study on 470 people involved giving the test group 1000 mg hourly for 6 hours and then 1000 mg 3 times daily after reporting flu symptoms. Symptoms decreased by 85%. (Pubmed PMID 10543583, 634178, 16169205, 12876306)

Green Tea (possible Tamiflu/Relenza alternative)- Very effective antiviral. Also decreases the production of the cytokine (catechins) TNF-a. Inhibits neuraminidase. May have antiviral activity that is equal to other antivirals such as Tamiflu ( Pubmed PMID 16137775 )

St Johns Wort (Hypericum) - Very effective antiviral. Also decreases the production of the cytokine IL-6. Hypericum is an extract from St John’s Wort. There have been some very successful field trials in commercial flocks infected with H5N1 in Vietnam. (Pubmed PMID 7857513, 11518071, 11362353, 7857513, 11518071)

Vitamin E - Immune booster. Also decreases the production of the cytokine TNF-a. (Pubmed PMID 155882360, 10929076) Experiments involved using mice. Very suitable for immune compromised people, especially the elderly. Effects enhanced when taken with Vitamin C. Apple Juice - Antiviral. Fresh apple juice including the pulp and skin has greater antiviral activity than heated commercial apple juice. More research is needed. Effectiveness on H5N1 is unknown (Pubmed PMID 32832, 12452634)

Resveratrol - Antiviral. In addition to inhibiting neuraminidase, Resveratrol also sends a message to cells to stop manufacturing viruses. This is a proven antiviral found naturally in red wine, peanuts, mulberries, Japanese Knottwood root (richest source), raisins and red grapes. Resveratrol supplements are relatively inexpensive, are more stable than wine and is available in liquid form for absorption in the mouth. No toxic effects noted. (Pubmed PMID 1583880, 12817628, 15985724)

Scuttellaria (Skullcap)- Antiviral. A herb used as a tea. It has no side effects and is also a mild tranquilliser. Research suggests neuraminidase, which is a substance needed by the H5N1 Bird Flu virus to reproduce, may be inhibited..

Cranberry Juice - Early research shows that it may be an antiviral, making viruses less able to invade or multiply. Effectiveness on H5N1 is unknown (Pubmed PMID15781126)

Cat’s Claw (Uncaria tomentosa)- Decreases the production of the cytokine TNF-a. Also boosts immune system. The number of white blood cells was significantly increased during treatment. No toxicity was noted. Active constituents can be found in the leaves, bark, vine, and roots. Water extraction from bark used. Children and pregnant women are to avoid. Has a potentially damaging effect on the DNA of proliferating cells (cancers, foetuses, growing children)

Curcumin (Tumeric Spice) - Decreases the production of the cytokine TNF-a. This is the yellow compound in turmeric spice. Research shows that this may be very good for preventing a cytokine storm although this is not proven (www.pdrhealth. com/drug_info/cur_0087), (enzy.com/abstracts/display1961) Must be taken with food or gastritis or peptic ulcers may occur. Pregnant women and feeding mothers should avoid this. The medicinal properties of curcurnin cannot be utilised when used alone due to rapid metabolism in the liver and intestinal wall. When combined with Piperine found in black pepper the absorption is increased with no adverse effects.(www.pdrhealth.com/drug_info/pip_0322) Obtainable from health stores in tablets, liquid, capsules already combined with piperine. Dosage is 500mg to 4000mg daily.

Astragalus root (Astragali Radix) - Boosts immune system (Pubmed PMID15588652) Tea tree Steam Inhalation - Reduces the cytokine TNF-a. Add 2 drops of tea tree oil in a bowl of steaming water. Cover head with a towel and inhale for 5 to 10 minutes. Relieves congestion and fights infection. Its effectiveness is unknown. (Pubmed PMID 11131302)

== The following substances may be best to avoid during a H5N1 pandemic ==


Elderberry juice (Sambucal) - Increases production of cytokines TNF-a and IL-6. This substance is very effective against the common flu but may not be desirable for the H5N1 Bird Flu virus. Increases in these cytokines may trigger a lethal cytokine storm. (Isr Med Journal2002 Nov;4:944-6)

Micro Algae (Chlorella and Spirulina) - Increases production of cytokine TNF-a (Pubmed PMID 11731916)

Honey - Increases production of cytokines TNF-a and IL-6 (Pubmed PMID12824009)

Chocolate - Increases production of cytokines TNF-a and IL-6 (Pubmed PMID 12885154, PMID 10917928)

Echinacea - Increases production of cytokines TNF-a and IL-6. Although it is often used for normal flu, research shows that it may increase the chance of cytokine storms for H5N1 (Pubmed PMID 15556647, 9568541)

Kimchi - Increases production of cytokines TNF-a and IL-6 (Pubmed PMID15630182)

Dairy products & Bananas - These foods increase mucous production.


References: http://www.bird-flu-influenza.com/relenza-tamiflu-alternatives-folk-medicines-antivirals.htm http://www.ncbi.nlm.nih.gov/entrez/ (search using Pubmed ID number listed after each food)

Comments

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First grouping them into two groups is biased (not NPOV); so listing alphabetically is more appropriate for wikipedia. Second, since this can get very very controversial, quotes with actual online sources would be very helpful. And let's not include anything wikipedia doesn't have an article on (so make an article if it should be included. How about making the subsection title Food and herbs? WAS 4.250 14:46, 18 May 2006 (UTC)[reply]

Mercifully, I did not look at this Talk page before starting a new section on nutritional and herbal remedies. If you set yourself the task of reviewing all the evidence (or lack thereof) for every possible herb mentioned, the swine flu outbreak will be over long before the page is deemed ready, and even then some people will delete it anyway (for those who do that sort of thing, "who can possibly read all those references?" is a perfectly good justification!) Just add good, well-sourced content whenever you have it, regardless of what it is about.
As a general strategy, I think it is best to pull out reviews about herbal remedies, see which ones the authors actually claim human data to support their use, then research those and see what you can find out from PubMed. Then go back to the reviews and double check their references, since PubMed isn't perfect (e.g. it seems to think lactacystin is a synonym for N-acetylcysteine, while missing some articles using NAC or N-acetyl L-cysteine with that search term). Don't be surprised whether a remedy turns out to have an interesting depth of support or is advocated only by one small pilot study. Mike Serfas (talk) 14:31, 13 June 2009 (UTC)[reply]

Working area, add to and modify until ready to add to article

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Food and herbs

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Suggested treatment for head cold, sore throat, strep throat, cold sore, outer ear infection

Possible treatment for chest cold, pneumonia (including From bird flu), middle ear infection, skin infections from cuts


People "catch" colds, sore throats, strep throat streptococcus bacteria), cold sores, and outer ear infections due to invasion by bacteria or viruses. Then people experience fevers, swollen tissue, and congestive symptoms thought to be caused by the viral or bacterial infection. The following model of bacterial and viral infections suggests that many of the symptoms experienced during these infections are generated by the body itself. The body may be responding to invasion by increasing the temperature of the infected tissues. People may get fevers and swelling (inflammation) of the tissues during bacteria or viral infections because their bodies may be trying to slow down the bacteria or viruses, which are often not able to easily replicate in temperatures very much higher than 98.6 degrees. The reason humans are vulnerable to specific viruses and bacteria is because those bacteria and viruses thrive at the normal internal temperatures of the body, and cannot survive and replicate in temperatures much higher or much lower than 98.6 degrees Fahrenheit. The production of fever and heating of affected tissues might be one of the ways the body has evolved to defend against and combat infections. This might only help the body fight infection moderately well. The spot heat the body generates that inflames (heats and swells) its infected tissues is not very hot. The temperature in fevers, a general heat, can only get as high as 106 degrees or so without endangering the body, a temperature which may be ineffective for killing viruses and bacteria. That heat level may only slow viral or bacterial infection. More localized heat often inflames tissues (like nasal passages in head colds) and causes symptoms like swelling--like in colds (stuffy nose, congestion). Given the possibility that the body heats up its tissues in a partially effective bid to slow down infection, a treatment that could apply spot heat of much greater magnitude and specificity to the areas of infection, without damaging the body's tissues, could potentially do very well what the body can only do fairly well: significantly slow or kill a viral or bacterial infection with heat. People have had this idea before. Treating colds with steam heat is a folk remedy that has existed for a long time. One product ("Rhinotherm" from Israel) that has been on the market claims to cure head colds with spot heat to nasal passages, but has had mixed reviews. It has been evaluated in at least two research studies to be ineffective in shortening the length of colds, or stopping their symptoms (Forstall, G., Macknin, M., Yen-Lieberman, B., and Medendrop, S. 1994. Effect of inhaling heated vapor on symptoms of the common cold. JAMA, April 13, 271(14), 1109-1111; Hendley, J., Abbot, R., Beasley, P., Gwaltney, J. Jr. 1994. Effect of inhalation of hot humidified air on experimental rhinovirus infection. JAMA, April 13, 271(14) 1112-1113). The device shoots hot blasts of steam up the nostrils at 47 degrees Celsius (about 117 degrees Fahrenheit), which raises the internal temperature of the nose to 43 degrees Celsius (about 109 degrees Fahrenheit). Theoretically, this product should kill or severely debilitate the virus's ability to survive and replicate, if the (rhino)virus that causes head colds is truly vulnerable to heat. Instead, the steam treatment used in these studies had no curative effect on head colds.


Possible etiology of upper and lower respiratory infections and throat infections

    Treatment of head colds using the product

above to provide spot heat in the nasal passages should work, according the theory of viral/bacterial susceptibility to heat. One possible reason it may not work the way it is used may be from a special vulnerability of the tissues in the nasal passages (and the throat and chest) to a quick temperature change. The second major supposition to this theory is that a quick temperature change may weaken the tissues susceptible to viral and bacterial infection and cause or exacerbate an active infection. The heat treatment described in the above articles may be successful in weakening the rhinovirus involved, but at the same time, it could be hurting the upper/lower respiratory tissues equally as much. During a head cold, the internal temperature of the nasal tissues are likely between room temperature (from breathing through them) and body temperature (98.6% degrees). The temperature may be slightly higher than body temperature in the nostril(s) that is congested at the moment and not drawing in room temperature air and being inflamed by the body to slow infection

(usually at least one nasal passage during a

cold is completely stuffed up). To be suddenly bathed in heat of 117 degrees or higher, especially in the nostril that is clear and closer to room temperature, may render the already vulnerable tissues even weaker. This could allow a virus to maintain its foothold in the tissues, even if it is similarly weakened by the heat treatment. This is likely what happened in the two studies.

The Rhinotherm deliveres a constant stream of

heat and water vapor at 47 degrees Celsius (117 degrees Fahrenheit). It does not gradually warm up the tissues slowly, but immediately bathes the nasal passages with 117 degree heat. If the subjects nasal passages were exposed to that great a temperature change immediately, about 30 degrees, their tissue may have been weakened and in poorer shape to fight off infection, even if the viruses were also weakened. Some of these treatment have shown efficacy in treating colds. Both of the above unsuccessful studies were attempted replications of three earlier studies that showed positive effects of steam treatment (Tyrell, D., Barrow, I., and Author, J. 1989. Local hyperthermia benefits natural and experiment common colds. British Medical Journal, 298:1280-1283; Yerushalmi, A., and Lwoff, A. 1980. Traitement du coryza infectieux et des rhinites persistantes allergiques par la thermotherapie. CR Seances Sci D., 291:957-959; Ophir, D., Ellad, Y. 1987. Effects of steam inhalation on nasal patency and nasal symptoms in patients with the common cold. American Journal of Otolaryngology, 8:149-153). If the steam treatment in these positive studies started initiated a more gradual warming up of the nasal passages (and a more gradual cooling down afterward), it would account for the disparity in findings with the two more recent studies, which found no positive effect of hot steam treatment on colds. Accordingly, had the two recent studies been done with a gradual warming up and down of the nasal passages before and after the treatment, they might have found consistently positive effects of hot air inhalation in the treatment of head colds (if as supposed, viral/bacterial infections of this type are truly vulnerable to heat, and if tissues really are sensitive to a quick & large temperature change). Also, with a gradual warming (and gradual cooling down after) of the heat treatment to protect the tissues in the nasal passages, a higher temperature might be able to be used than with the Rhinotherm (more than 117 degrees), which could render the treatments more effective.

The subjects in the study also inhaled through the nose, and exhaled through the mouth, which may not be as effective as as exhaling also through the nose (which may keep the nasal passages at a more even temperature). Lowering the temperature slowly of the heat device after treatment and avoiding breathing through the nose for 5 minutes after the treatment is over may be important to avoid a quick temperature change also, as the steam from the device can evaporate and chill the nasal passages if they are still wet when breathing in room temperature air. Lastly, in the two recent studies, the heat treatment was used for one hour or one-half hour.

It is likely that extended treatment weakens the

tissues as much as a large, quick temperature change is hypothesized to do in this treatment model. In the model presented below the heat treatment is suggested to be used for a maximum of five minutes for every eight hour period.

 The suggestion that a quick temperature change

leaves nose, throat, and lung tissues vulnerable to viral/bacterial infection may give insight into the etiology of head colds, sore throats, strep throat, chest colds, and pneumonia. If a sudden temperature change does weaken tissues actively fighting off an infection (the failed heat treatment cited above), perhaps exposure to a sudden temperature change also causes the initial vulnerability to the virus/bacteria and contributes to the subsequent infection. The bacteria and viruses that cause head colds, sore and strep throats, etc. are often present around and in people who do not develop active infection. Susceptibility to developing an infection is known to be increased with a higher amount of virus/bacteria present (being around people who are sick with these infections), and when the immune system is weakened. But these risk factors account for only about 30-50% of new infections. These factors may not account for all of the variation in susceptibility. Perhaps the largest still unknown factor that contributes to infection is a quick exposure to temperature change of tissues vulnerable to these infections.


Observations on the development of colds, throat

 infections, and lung infections (pneumonia,

chest cold)

Tissues that are susceptible to viral and bacterial infection- nasal passages, the throat, and the lungs -seem to be weakened by exposure to a very fast temperature change of (hypothesized) 10 degrees or more (10 degrees for nasal passages, and about 20 degrees, for chest exposure or throat exposure). When people go from inside heat to outside cold, or from inside cold (like with air conditioning) to outside heat and vice versa, and they breathe through their nose immediately (or have their chest or throat exposed very quickly to a severe temperature change), it seems to stress and weaken cells in those areas and make the people more susceptible to infection. Catching a "head" cold is a good example. When a person goes through a temperature change of more than 10 degrees and breathes through his/her nose continually, even after her/his nasal passages begin to inflame and swell (stuff up), s/he might be at a significant risk of catching a head cold. The same is true to a degree for throat and chest exposure. If a person is exposed suddenly to a temperature change (hot or cold) of 20 degrees (hypothesized, could be 5 degrees greater or smaller) or more on his/her chest (like with an open jacket) or his/her throat, s/he may be more susceptible to a lower respiratory infection (chest cold, pneumonia), a sore throat, or a strep throat infection. If people become susceptible to throat and respiratory (lower and upper) infections due to a quick temperature change in vulnerable tissues, any heat treatment of already weakened and vulnerable tissue would have to avoid causing a fast temperature change that could further weaken the tissue and negate the benefits of the heat treatment. The treatment described above for head colds (Rhinotherm) used heat that is instant and creates the type of temperature change that may have caused the vulnerability to the infection in the first place.


Ideal heat treatment

If the heat is slowly (a gradual buildup for about 1 minute to peak temp) applied to the area that is infected and inflamed, and the tissues are subsequently not weakened, the viral/bacterial infection could likely then be slowed or killed by the heat under this theory. When the tissues are not weakened by the onset of a quick temperature change, heat treatment could have very positive effects in slowing and killing these infections. The heat the body generates to swell and heat up its tissues is not nearly as hot as the temperature that can be generated and locally supplied by mechanical means. This more localized and intense heat may be more efficient than the body's own defenses. Even if all the viruses are not killed immediately, the heat treatment seems to signal to the body to stop heating up the tissues itself. The spot heat is more localized and more intense than the body's own efforts to heat up the tissues. The inflammation in the throat, nose, and lungs may stop in part because the body realizes that it doesn't need to heat up the tissues, and/or the weakening/killing of the bacteria/viruses leaves the temperature increase unnecessary. Because the swelling in the affected areas is immediately lowered during and after the heat treatments (congestion clears, inflammation almost stops completely for a little while), it is likely the body just realizes its own heat treatment isn't needed. The bacteria or viruses are subjected to higher temperatures in an artificial heat treatment than the body's own defenses can produce. So the heat treatment is treating the symptoms at the same time it is treating the infection. It slows or kills viruses or bacteria much more quickly than the body's own heat response, and signals to the body to discontinue it's own heat and subsequent inflammation response for a while.

    The timing of this type of heat treatment

would be important. It should not be too long, too frequent or too hot, in order to avoid stressing the tissues. It should be done frequently enough that it catches the viruses/bacteria in all phases of their protected (inactive) and vulnerable (active) cycles in the body. Using these criteria, the effectiveness of localized heat and elevated temperatures, and the need to avoid overstressing the infected and vulnerable tissues, it is suggested that the duration of this type of heat treatment should be no longer than 5 minutes every 8 hours. The degree of heat should be modulatable by the person to be the hottest s/he can comfortably (and safely) endure for the period (perhaps as high or somewhat higher than in the above device 117 degrees Fahrenheit). The heat should start at room or body temperature and slowly, over one minute, be increased to the hottest comfortable temperature.

The person may need to breathe and exhale

through the nose exclusively during the treatment of head colds or the mouth for throat infections to better stabilize temperature. Exhaling through the nose in treatment of head colds may help keep the internal temperature of the nasal passages from getting too hot (the exhaled air will be closer to body temperature than the inhaled air from the heat device). Because viruses can cycle into periods where they are protected/dormant, the heat treatment should be used every 8 hours for 4 cycles to catch the infection in all phases of its active-inactive cycle. More frequent applications might (and have seemed to) irritate and weaken the tissues without aiding the treatment. The best device for delivery of the heat would blow hot air in a directed stream (so it could be applied to the nasal passages or the throat), would have an easily adjusted temperature from at least 98.6 degrees to the hottest comfortable temperature (130 degrees?), and would have a small amount of moisture/water vapor. A small amount of humidity would help keep the nasal passages and throat from getting too dry from the heat, while avoiding leaving the tissues wet and susceptible to a quick temperature change when the heat is taken away and the moisture evaporates. The product mentioned above (Rhinotherm) that shoots hot blasts of steam into the nostrils would not be the ideal mechanism. Its temperature needs to be adjustable, the delivery end may not be made to work to deliver the heat stream both into the mouth (for sore throat and strep throat infections) and on throat itself at the same time, and the steam may contain too much moisture. On the other end of the spectrum, a hot air hair dryer would not have even a small amount of water vapor, so it wouldnnot be ideal. Other than this, a hair dryer does blow air in a stream that can be directed to be breathed in by the nasal passages, and on the throat. It can be held away from the vulnerable area at first, then slowly brought forward to incrementally increase the temperature. The best delivery device would have a flexible delivery end that would blow hot air in a directed stream but over a large enough area to include the outside of the throat and the mouth together (for throat infections), have a variable temperature dial like on an oven, have a range of 70 degrees to 130? degrees, a mild amount of water vapor, and a 5 minute timer.

A head cold would be treated through the nasal passages; chest cold/pneumonia through the nasal passages or mouth with possible simultaneous dry heat on the chest and/or back; a sore throat and strep throat with heat on the throat and through the nasal passages or the mouth at the same time (to heat up the inner and outer portions of the throat). Only pneumonia or a chest cold would require a separate heat source on the chest (like a heating pad) in addition to the hot air stream during treatment. For sore and strep throat the hot air can be angled to bathe the throat and be breathed in through the mouth or nose simultaneously to warm the internal portion of the throat. The heat source can be blown directly into the outer ear for ear infections.


Prevention of head colds

Using this model of tissue vulnerability, the key to relieving or avoiding head colds would be to avoid breathing through the nose temporarily when going from a colder place to a warmer place or a warmer place to a colder place. Breathing in through the nose immediately during any temperature change of 10 degrees or more could be a main contributor toward developing a head cold.

Under this theoryl, the cells that make up the

nasal passages (and other body sites that are vulnerable to viral/bacterial infection of this sort) may be very sensitive to a fast temperature change. They seem to become vulnerable to viruses and bacteria when air that is different by 10 degrees or more is breathed in without the nasal passages first getting a chance to adjust their internal temperature. So when the air a person is breathing goes through the temperature change, the person would have to breathe through his/her mouth for 30-45 seconds until the nasal passages have adjusted it's internal temperature closer to the temperature in the air. When someone breathes through his/her nose too quickly, it will stuff up (the body will heat it up and make the tissues swell). If the person stops breathing through his/her nose immediately, the nose may unstuff, as the nasal passages have a chance to recover/adjust. For some reason, breathing through the mouth when the nose begins to stuff up seems to almost always stop the nose from stuffing up completely and developing into a cold, even when it becomes congested for reasons other than a quick temperature change. When the legs or feet get exposed to cold, the nose can temporarily become congested (for an unknown reason), even if the nasal passages are not breathing in during a quick temperature change. If a person avoids breathing through the nose, the sniffles may clear up around 45 seconds after s/he leaves the cool draft or breeze. This can also happen if s/he has too much clothing on and is overheated in a hot room, and his/her nose begins to stuff up. If s/he avoids breathing through his/her nose while it is stuffed, the nose may unstuff and s/he usually will not develop a head cold.


Treatment of head colds

    If a stuffed nose does develop into a cold,

a treatment with heat can potentially end the symptoms. The person can use some kind of hot air blower, like a hair dryer (for the nasal passages, slightly moist heat is better to keep from overdrying them). The hot air blower would be turned on to a low level, placed a comfortable distance from the nose, beneath it. The dittance the hot air blower is held away can regulate the heat delivered, so the blower should be held far enough away at first that only a mild heat reaches the nasal passages. After turning it on the person should avoid putting his/her sinuses through too quick a temperature change. The person should breathe through the mouth for at least 30 seconds to avoid further weakening the tissues in the nasal passage. After the person tentatively starts breathing through the nose after 30 seconds of the passages getting slowly heated up (and stopping for a little while if his/her nose starts to stuff up), the heat source can be brought gradually closer. The temperature can be gradually raised (as the heat source gets closer) until the naeal passages have adjusted to the highest comfortable temperature. Even a comfortable temperature will be more than hot enough for treatment. Increasing thedtemperature any higher than comfortable isn't safe for your tissues, and will actuall weaken the tissues and keep them vulnerable to infection. The hot air blower dryer should be below the nose, blowing up into it. The time should be limited to 5 minutes per treatment (1 minute gradual warming, 4 minutes full heat). The heat level possibly needed for effective treatment is too high to breathe in longer than 5 minutes, and the treatment may actually loses effectiveness when continued any longer (as the tissues may weaken). The person should then gradually lower the heat source over 1 minute back to room temperature to avoid a quick temperature change. After the temperature of the air going into the nose is back down to normal, the person should breathe through his/her mouth for a couple of minutes. This is a very important step. The tissues of his/her nasal passages (or throat, or lungs depending upon the location of the treatment) are very sensitive right after a heat treatment. After a couple of minutes, the person can then breathe through his/her nose or his/her mouth, as long as the air temperature is warm. The person needs to stay in a warm place, the warmer the better and not go outside (into cold air, or into a large temperature change) for at least 30 minutes whill the tissues are still sensitive from the heat treatment. The person should also avoid eating or drinking anything cold for 30 minutes, as this could irritate the tissues.

The real benefit of the treatment is that many of the symptoms associated with the virus/bacterial infection will be immediately relieved. In the case of a head cold, the throbbing, sensitivity, and stuffiness will leave the person's nose and nasal passages and it will feel close to normal for a couple hours, as long as she remembers to breathe through his/her mouth when s/he next encounters a temperature change of 10 degrees or more, or when s/he get the sniffles (start to stuff up). Staying in a warm area with no cold drafts lengthens the immediate relief, possibly until the second heat treatment. The person should repeat the heat treatment no more often than every 8 hours as necessary. It seems to kill the next generation of viruses or bacteria when done every 8 hours, but more frequently than once every 8 hours seems to hurt the tissues more than help. It should work equally well for all types of cold viruses, as they all seem to have the same effects and modes of operation, differing only by incubation period- the amount of time before full symptoms are present (Tyrrell, D., Cohen, S., and Schlarb, J. 1993. Signs and symptoms in common colds. Epidemiology and Infection, 111(1), 143-156).

After the second treatment, the person is often nearly symptom free (the sooner treatment is initiated after exposure to the temperature change, the quicker the recovery). Heat treatments of this type seem to work for head colds, sore throats, strep throats (a very serious infection), cold sores and outer ear infections (the techniques to treat these will be explained later). It is hypothesized to possibly work in combating viral/bacterial infection with chest colds, pneumonia, and other lower respiratory infections. Treatment of the early symptoms of these infections (when the nose starts to stuff for an hour; the throat starts to feel sore or scratchy; or the outer ear first begins to feel sensitive to touch) can reduce recovery time from the need for 6 treatments over 2 days to just one treatment. Cutting the infection symptoms off just as they get started can help prevent even moderate symptoms, as well as the fatigue and energy drain that accompanies a full infection. The reason for almost immediate results from the heat treatment may be that many of the symptoms of bacterial/viral infections may be brought on by the body to help fight the infection. When using a mechanical heat source, in a manner that is many times more efficient (higher temperatures, more localized) than a fever or tissue inflammation, it may signal to the body to immediately stop its own attempts to heat the infected/affected area. This effect is more pronounced when used in the early stages of the infection, as the heat treatment may both signal the body to stop the inflammation and it may kill and slow down the viruses/bacteria before the body has been weakened and fatigued.


Prevention of sore and strep throat

Some types of sore and strep throat (streptococcus bacteria) may be preventable to some degree by having the throat protected from a large temperature change. Going outside into cold with a coat that doesn't cover the throat might leave a person vulnerable to infection. Overwrapping the throat with scarfs can backfire by causing the skin over the throat to sweat. If the person then takes off the scarf and goes out into the cold with a sweaty throat for just a brief period, the evaporation of the sweat could chill the throat, leaving it vulnerable. The best course could then be to have the throat covered adequately by a coat with a high collar or with one scarf, but not so hot that it sweats.


Treatment of (some types of) sore throat

With a sore throat (actual feelings of soreness at the front of the throat), have the person hold the hot air source (dry heat is best for the outside of the throat, as moist heat will make the throat cold from evaporation after the heat is taken away) away from the throat to give the tissues a chance to adjust to the temperature change and increased heat. After 30-45 seconds, the person can bring the hot air source as close to the throat as comfortable. Then the hot air can blow it on the throat for another 4 minutes. After the 5 minutes are up, the heat source should be slowly withdrawn to allow the tissues to adjust to the temperature change. A scarf or high-neck clothing can be put over the throat now. After ending the heat treatment, the person should avoid going outside or through a large temperature change for the next 20-30 minutes (including avoiding cold drafts or drinking cold beverages). When s/he does, s/he should cover his/her throat with a high-necked coat or a scarf to keep its temperature at an even leve.. S/he should repeat this treatment no more than once every 8 hours.


Treatment of strep throat

With strep (streptococcus bacteria) throat (it often begins with a deep scratchiness in the back of the throat), have the person turn on the hot air source and hold it far enough away from the throat to give the tissues a chance to adjust to the temperature change. The hot air source can then slowly be brought toward the throat until it is at the highest comfortable temperature. Have the hot air source angled upward to blow up the nose or mouth while heating the throat. It may be more important than with a sore throat to have the treatment be breathed in as well as having it on the outside of the neck, because the heat may not get to the back of the throat as well if it is not breathed in. A moist heat is best to breathe in here, because the throat often feels very dry and scratchy. If a dry heat is used, the person should swallow often, or have a warm/hot beverage available to sip on. After 30-45 seconds (the person should breath through his/her mouth at first) the person can bring the hot air source as close to the throat and nose as comfortable. Then it can be blown on the throat and up the nose (with breathing) for another 4 minutes, before being slowly taken away. If a person uses a moist heat, the throat should be dried off immediately after the treatment, and if possible, a scarf should be put around the neck for 30 minutes. After the heat treatment is done, the person should avoid going outside or through a large temperature change (stay in a very warm place with no cold drafts) for the next 20-30 minutes (and avoid drinking anything cold for the same amount of time). When s/he does, s/he should cover his/her throat with a high-necked coat or a scarf to keep its temperature at an even level, and have another scarf double-layered over his/her mouth and nose to warm the air coming in.

At this time (and anytime during the infection,

treated or not) the throat is sensitive to cold drafts, to cold breathed in, and to cold beverages and food. The person should repeat this treatment only once every 8 hours.


Treatment of outer ear infections and prevention of middle ear infections (otitis media)

Heat treatment can help relieve and prevent the pain and inflammation of outer ear infections (it may also help with middle ear infections). The procedure for administering the heat treatment is: gradual warming up of the ear canal (the hot air blower should be angled to blow into the ear canal) with the hot air blower until the maximum comfortable heat is reached; treatment for 5 minutes only; only one treatment every 8 hours; and avoidance of cold air or a large temperature change for (at least) thirty minutes after the treatment. The person should tip his/her head so it is angled with the infected ear pointing down to the ground (or at an angle to the ground) during the treatment. This keeps any fluid in the outer ear canal from pushing back up into the middle ear during the treatment. Then the person can turn on the hot air (dry heat is best for the ear, to dry up any fluids contributing to the infection), blowing it up in the ear and keeping it far enough away from the ear at first to make the temperature change of the ear canal slow. After 30-45 seconds the hot air source can be brought as close to the ear as is comfortable. The tissue of the ear canal during an outer ear infection is very sensitive, so the temperature should be comfortable, and not feel overl hot. After the heat is stabilized, the treatment should go on for 4 more minutes. Then the heat source should be slowly removed, allowing time for the tissues to adjust to the temperature change. This should be repeated at need only once every 8 hours. The person should avoid going out into the cold for at least a half hour after treatment, and should wear earmuffs until the infection and all signs of it are gone if it is winter outside. The tissues of the ear are very sensitive to cold right after treatment, and exposure to cold in a sensitive stage of healing can be as painful and last as long as the original infection.

This heat treatment should relieve the inflammation of an outer ear infection and dry up any liquid that is contributing to the infection in the ear canal. If done with a slow temperature change, the heat treatment often immediately relieves most of the painful symptoms of an outer ear infection. If done early, when the ear canal first starts to itch and the ear itself becomes sensitive to touch, it may help prevent an outer ear infection from spreading to the middle ear. A good preventative measure for preventing middle and outer ear infection is to repeat the same hot air treatment- blowing hot air into the ear canal with the side of the head tilted down for only 30 seconds immediately after taking a shower, a swim, or after immersing the ears in water. A 30-second treatment should dry up any liquid in the ear that contributes to chronic ear infections in people who have recurrent problems.

A person should be able to dry both ears with a

30-second mild burst of heat every time s/he immerses them in water without hardening the wax in the ears, or without the ear canals becoming too sensitive. When using this treatment for prevention, a person should always be careful to keep the temperature comfortable, the side of the head tilted down (to keep from blowing the water up further into the ear canal) and the times conservative (no more than one minute if no infection symptoms are present, only once every 8 hours as necessary). This should prevent any outer or middle ear infections that come from water in the outer ear canal getting into the middle ear. The treatment dries some of the water in the ear canal, likely slows or kills (damages) any bacteria in the water in the ear, and seems to prevent inflammation.

It is extremely important in these treatments to gradually warm up the tissues before application of full heat. The sensitive and weakened tissues become weaker when put through a fast temperature change. People also cannot handle treatment more often than once every 8 hours, and a maximum of 5 minutes per (because of the moderately high heat levels used). The heat should only be increased to the degree comfortable, and lessened when uncomfortable. The tissues should also be protected from a large temperature change or exposure to any cold for at least 30 minutes after treatment. Tissue exposed to cold too quickly after a treatment can feel as bad as if the cold or infection had been allowed to run its course untreated. The longer the vulnerable tissue is sheltered from the cold, the longer the symptoms will decrease and the formerly inflamed area will feel almost like normal (especially if kept in a warmer than normal area until the next treatment).

    Scarfs and hats help to keep the temperature

level more stable and warm. When the throat infection, ear infection, chest cold or sinus cold has already happened, these keep the throat, head (nasal passages), and chest more comfortable and keep irritation of these tissues down. But if a person sweats in them, s/he needs to dry off his/her throat or head when s/he takes them off, or only take them off in a hot place. Otherwise the sweat will evaporate and chill his/her head and throat. A pair of earmuffs will help the ear maintain a stable temperature during recovery from an ear infection. After a treatment, it is immensely helpful to use a hat or scarf to keep the temperature consistent and warm (still protecting against sweat evaporation) on/in the treated area. The tissues are very sensitive after treatment and during recovery. Without protection, the temperature change occurring when going out into the cold (or into the air conditioning) has a damaging effect, and recovery from the symptoms of a cold or infection is slower.


Treatment of cold sores (herpes blisters)

The heat treatment can be applied to different infections or inflammations on the skin that are caused by the body's reaction to an infection. Cold sores, cuts, and any other conditions where the body causes swelling in an attempt to heat up the tissue to kill an infection can benefit (except where heat will damage the skin, like infections from burns). Skin tissue is also quite amenable to heat treatment, as it is tougher and less sensitive to temperature change or drying out than internal tissue like the nasal passages, throat, or the outer ear (heat treatment could be used in areas where sensitivity is not important but resistance to infection is). Oral herpes (usually herpes simplex 1) lesions may be treated by localized heat directed on the blister. The blister must not be directly on an area too sensitive for the heat treatment. The procedure for administering the heat treatment consists of a gradual warming up of the lesion with the hot air blower until the maximum comfortable heat is reached; treatment for 5 minutes only; only one treatment every 8 hours; avoidance of cold air or a large temperature change for (at least) thirty minutes after the treatment. To keep the skin from drying out during the treatment, moisturizing ointment or lotion can be liberally applied on the lesion or blister. A large amount of ointment should be used, and it should be layered on instead of rubbed in, so a layer of ointment completely covers the lesion during the treatment. The heat treatment should be applied before the ointment is fully absorbed, to keep the skin cells from drying out during the treatment. This should keep the skin cells from being irritated or damaged. Drying the cells out by not using moisturizer during treatment would make them susceptible to further infection, and to exacerbation of the current infection. This treatment has been used on cold sores (usually herpes simplex 1). Treatment during the initial stages of the infection may reduce what would have been a full scale blowup over the course of a couple weeks with much pain and inflammation to 4 to 7 days of mild symptoms and little discomfort. The herpes simplex #1 blisters will develop and leave quicker, and be less painful and sensitive to cold and touch. The full course of infection may last only 4-7 days instead of weeks if the treatment is used when the first signs of a blister appear (itchiness, irritation, a red bump on the skin where past blisters have appeared). The heat treatment likely both slows down the herpes virus, and halts the inflammation response of the body. The treatment only needs to be used once or twice, until the pain from the sore leaves. If the lesion is caught early, the later pain from the sore may only be minimal. Moderate to strong heat only should be used. Too much heat will only make the tissue vulnerable to the recurrent viral infection, not speed up healing. This treatment seems to best shorten the flareup and stop the pain and sensitivity. It does not keep the lesions from forming, just stops debilitating effects of the full infection and the pain and sensitivity. During the heat treatment, the area of infection should be kept moisturized. This might speed healing, and retard symptoms of pain and inflammation. Any touching (or scratching) of the area or application of ointment to the area should be done with tissue or cloth. Touching the area of infection with hands can spread the infection to other parts of the body and to other people, as well as exacerbate symptoms, as fingers are often full of opportunistic germs that can make the area more susceptible to the virus flareup. Also, when prodromal symptoms of dryness and itching are present, moisturizing with any liquid handy and a brief heat application, along with avoiding touching the area with fingers, may prevent lesions from forming at all.


Chest colds, pneumonia (proposed)

Heat treatment may also work for chest colds and pneumonia. If used for chest colds or pneumonia, the heat used could be steam to keep the air moist (steam will help loosen mucus in the chest if that's needed, and avoid exacerbating a dry cough), or hot air. The person should prepare the lungs for the temperature change by breathing through the nose for 45 seconds. Then the person can start breathing a little bit of steam or hot air through the mouth, gradually increasing the temperature for at least 1 minute (after 30 seconds the person can breath the heat through their nasal passages). After a 5 minute treatment with steam or hot air, the person can gradually decrease the temperature (amount) breathed in. As soon as possible, the person should breath throught the nose for at least 3 to 5 minutes, even during coughing. This will keep the air going into his/her lungs warm for a period of time that the lungs are vulnerable after treatment. The temperature of the room should be elevated, and drafts soould be avoided.

The hotter and more stable the temperature in

the room is, the better. A heating pad can be kept on the chest and/or back for as long as is comfortable (making sure to wipe off any sweat immediately when it is taken off).

    During chest colds and pneumonia it is

important to stay in for a full day or a number of days out of the cold, and to avoid any large temperature changes. Chest colds and pneumonia stay with people for a long period (weeks sometimes) because a person going outside or into a large temperature change must breathe through his/her nose or his/her mouth. If the person immediately breathes through his/her nose immediately, it could stuff up and s/he may get a head cold (sinus infection). If the person breathes through his/her mouth, s/he may make his/her lungs more vulnerable and prolong or intensify the infection (chest cold) by exposing the lungs to a fast temperature change, and to cold air. Staying inside a warm place with no cold air pockets is best while symptoms still are present. This could partly explain (in addition to a weakened immune system) why people often get head colds that follow up chest colds. People unconsciously will breathe through their nose to warm the air to the lungs immediately when going outside. If they don't, they exacerbate their chest cold. The best solution is to double layer a scarf over the mouth and nose to warm the breath, and especially to stay inside and avoid the cold and large temperature changes until the chest cold/pneumonia is completely over. The heat treatments should be able to speed the process and lower the symptoms significantly. Bronchitis may or may not be helped by the heat treatment. The treatment may help if the irritation from bronchitis causes a vulnerability to getting a chest cold, or pneumonia. If used to treat a person with bronchitis and pneumonia/chest cold, the heat used should have enough water vapor, like steam, to avoid exacerbating the dry coughing from bronchitis.


Prevention and early treatment

Prevention is the most effective use of the heat treatment for these types of viral and bacterial infection. If the symptoms are full blown before implementation, three to six treatments (1-2 days) of one treatment every 8 hours could be necessary to fully relieve symptoms (exposure to the cold during this time, even sometimes by drinking cold liquids, may delay full recovery of symptoms by a day). If initiated when symptoms of an infection first appear, one treatment is often enough to stop the symptoms (and the infection), even if the infection would eventually have been severe without treatment (like with strep throat).

The key to prevention of viral and bacterial infections, in this model, is to avoid exposing sensitive areas like the nasal passages, throat, or chest to quick temperature changes. The key to ending the infections is with heat treatment to slow or kill viruses (or bacteria) and counteract the symptoms stemming from the body's reaction to it, and with introducing and withdrawing that heat slowly. Perhaps because of the sensitivity of the tissues to temperature change, heat treatments with this aim in the past have not been successful. Products that shoot steam up the nostrils fail because the fast temperature change (from intake of steam, and from not delaying breathing through the nose for 1 minute after treatment ends) may have weakened the tissues in the nasal passages, negating any benefit from decreased viral activity. Also, exposure to cold was not likely delayed for a half hour while the tissues were still sensitive from the treatment. The sensitivity to temperature change is possibly the missing element in the treatment of viruses and bacteria by heat, as well as some of the vulnerability to them in the first place.

    This sensitivity to a fast temperature

change and to cold for 1/2 hour after treatment also explains anecdotal accounts of spas and steamrooms curing symptoms from different viral respiratory infections. The temperature change into spas and steamrooms would have to be slow, and the temperature change coming out of them would have to be slow, with much delayed exposure to cold afterward (at least 1/2 hour) while the tissues were sensitive after the high temperature treatment. If by chance these circumstances came about, the person would likely have been relieved of his/her symptoms, and recommended the therapy to others. However, if the next person who tried this unthinkingly experienced a very quick temperature change when going in or coming out of the spa or steamroom, or was exposed to cold too soon after the heat treatment, s/he would not have benefitted and would not have know why.

    Spas, steamrooms, and even the everyday

shower can be used as aides in treating the infection by bathing the body in heat. These can be effective as long as the temperature change of the infected part of the body into these places is slow enough (about 1 minute); the temperature change coming out of the shower, steamroom, or whirlpool is slow; the person puts on clothes quickly enough that s/he doesn't feel chilled and doesn't encounter cold air pockets or drafts; the person stays warm and indoors (if in winter) for at least 1/2 hour afterward while the tissues are sensitive (this includes not drinking or eating anything cold if the person has a throat or upper respiratory infection). In these situations, a steamroom could be the ideal heat treatment (except for an ear infection) if it wasn't inconvenient to go to every 8 hours. When done safely, all of these can feel good.

Effectiveness

This treatment has worked for the viral and bacterial infections indicated. This treatment has had no effectiveness in treating nasal congestion identical to head colds but caused by allergies and hay fever, even in people who've successfully used the treatment for viral and bacterial infections. It has done nothing for the congestion and symptoms of hay fever and allergies, which may provide evidence that the effectiveness of the treatments may not be due to the placebo effect. The reasons given for the effectiveness of these heat treatments are just speculations, some having lead to the treatment's development and some used in an attempt to explain the seemingly successful applicability of the treatment. They do not necessarily fully or accurately explain the process behind the methods' success. This hot air treatment has been used for treatment and prevention (when symptoms first start) of head colds, sore throat, strep throat, outer ear infections, minor cuts, and cold sores (the mild form of herpes). It is only hypothesized for pneumonia, chest cold, and major cuts. The principle is the same, and the implications for possible quick and effective treatment of pneumonia, as works for head colds and throat infections, may suggest further exploration for this treatment.


A hair dryer may be good enough to use with sore throats, ear infections, and skin infections when there is not much problem or need to prevent against tissue drying out. With head colds, strep throat, and chest colds a machine should ideally be used that generates mild water vapor with the heat (or steam) that shoots gently up the nostrils. It would have to be room temperature at first, gradually building up to it's peak temperature at the end of 1 minute, with temperature control in case someone needs a slower buildup. Then the machine should maintain peak temperature for 4 minutes. After 4 minutes, the machine should, over 1 minute time, gradually lower temperature back to room temperature. A dry heat has been ok for head colds. If a dry heat is used with sore/strep throat, hot liquid could be drank intermittently during the 5 minutes to keep the tissues of the throat moist (or frequent swallowing may be enough). Steam may be best for chest colds and congestion. —Preceding unsigned comment added by Mdwickimd (talkcontribs) 00:05, 2 October 2007 (UTC)[reply]

How much exercise is okay for an flu patient with muscular aches?

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I wonder if we could find more info on myalgia (muscular aches) and its treatment? Acetaminophen is mentioned, but I'm also wondering about how must rest is actually in order? I personally find that exercise is very helpful if I have blocked sinuses (especially if I also do Jala neti sinus cleansing). But when the sinusitis sufferer also has aches all over due to a viral infection, is it more important to rest? Or is very, very gentle exercise a good thing? --Singkong2005 talk 04:12, 24 September 2006 (UTC)[reply]

"Plenty of rest" is recommended for flu. The best indicator of what "plenty of rest" means is your own body. Pay attention to signals from your body and take seriously the need to rest. WAS 4.250 12:40, 24 September 2006 (UTC)[reply]
Animal studies suggest that strenuous exercise leads to a worsened course of infection. See PMID 18616997, PMID 18579649, PMID 11770987. However, there is some indication that moderate exercise might actually be beneficial in animals (See PMID 17201075, PMID 15922557) and in the human response to vaccine (See PMID 15149789, PMID 15944076). None of this data gives us solid advice regarding human survival and recovery following swine flu infection. In the absence of other data, we might generally assume that evolution should have endowed humans with some sense (including bodily aches and pains) for when exercise is good or bad - yet in everyday uninfected life some of us don't always act in our own best interest on this point. Mike Serfas (talk) 14:11, 13 June 2009 (UTC)[reply]

Proposed move → Influenza treatment

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Part of an effort to expand 'flu titles where appropriate.--ZayZayEM 03:35, 13 September 2007 (UTC)[reply]

Agree I think that correct terminology rather than contractions are more appropriate in article titles, although 'flu' could be used where appropriate in the text. BTW, you're doing a great job tackling the flu (whoops, I mean influenza) articles -- they are a mess. —G716 <T·C> 04:38, 13 September 2007 (UTC)[reply]

Viferon

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Viferon is a suppository of (non-pegylated[1]) interferon alpha-2b, ascorbic acid (vitamin C), and tocopherol (vitamin E) which was reported in a study of 101 patients to be approximately as effective against influenza as arbidol. It is sold in Russia for $4-$9 per suppository depending on dose.[2][3] A similar product sold in the U.S., Pegasys, is not labeled for influenza treatment.[4]

This product only has a single trial of 100 patients, published in Antibiotiki i khimioterapii͡a (Antibiotics and chemoterapy) - this is just too obscure to include in this article. Tim Vickers (talk) 16:48, 14 June 2009 (UTC)[reply]

I've located a second reference.PMID 18318133 Bear in mind that various similar drugs are already approved for several other viral diseases, and this drug is presently being sold by online pharmacies for use against influenza. I have already used a fairly loose standard of notability (which I think it consistent with Wikipedia guidelines) in the "Kan Jang" section. I think in general that any treatment people have heard of should be covered here, and if the evidence is weak we simply tell them that. Mike Serfas (talk) 23:13, 14 June 2009 (UTC)[reply]
No, this is dredging the bottom of the barrel Mike. This article needs to abide by WP:MEDRS and reflect the view of the subject presented in high-quality secondary sources, such as PMID 11130232. If you wish to write an article about Influenza treatment (alternative medicine) then please do so, but the article is rapidly becoming very unbalanced with what can only be described as junk treatments. We can't just list every nostrum that people have ever tested on influenza. Tim Vickers (talk) 01:32, 15 June 2009 (UTC)[reply]
Recombinant interferon alpha proteins aren't actually alternative medicine. There are many countries where people are buying these drugs even as we speak. Besides, it doesn't seem that alternative medicine actually raises many objections on Wikipedia. Once all the information about blood and serum transfusions, arbidol, and vitamins and herbal treatments etc. was removed from 2009 flu pandemic, a prescription that "chicken noodle soup is good for the soul" was added to replace them - in reduced form, this is still present in the current version a month later. So what is needed isn't really an article about alternative medicine, but rather an article Influenza treatment (non-U.S.) Since Wikipedia usually tries to maintain a global perspective I'd hoped it wouldn't literally be necessary to create such an article.
It is my position that an article on influenza treatment should cover (at least) everything that is actually being sold in some country as an influenza treatment, regardless of whether a particular person believes in it. If Wikipedia can have separate articles for the life histories of every character in each new video game on the market, shouldn't we at least fully survey the medical topics?
I do agree that the sections on Tamiflu and other specific antiflu drugs need to be greatly expanded, but this isn't my fault. Despite all the news about swine flu, this article did not change from May 3 to June 13 when I began editing. I see no reason to omit perfectly good information simply because no one wants to work on some other section. Besides, I imagined I'd get around to expanding that section if I ran out of new treatments to mention. Mike Serfas (talk) 02:36, 15 June 2009 (UTC)[reply]
The new interferon section looks much better, if you deal with a broad class of treatments without focusing on one brand-name product it removes most of the problem with balance. Tim Vickers (talk) 16:56, 15 June 2009 (UTC)[reply]

References

  1. ^ "Russia through the prism of the world biopharmaceutical market" (PDF).
  2. ^ Gatich RZ, Kolobukhina LV, Vasil'ev AN, Isaeva EI, Burtseva EI, Orlova TG, Voronina FV, Kol'tsov VD, Malinovskaia VV. "Viferon suppositories in the treatment of influenza in adults (article in Russian)". PMID 18942420. {{cite web}}: Missing or empty |url= (help)CS1 maint: multiple names: authors list (link)
  3. ^ "Market reference for price and composition".
  4. ^ "Pegasys market reference".

Added Green Tea to Alternative Treatments

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I was easily able to locate Pubmed published studies that provide strong evidence of the efficacy of green tea in both reducing duration and severity of influenza infections. Due to it's well established reputation of enhancing immune function, I saw fit to add it to this article. LiamSP (talk) 04:53, 8 September 2012 (UTC)[reply]