People use the flower to make medicine. Despite serious safety concerns, delphinium is used to treat intestinal worms, fluid retention, poor appetite, and trouble sleeping (insomnia). It is also used as a sedative to cause relaxation.
Delphinium Staphysagria. An important remedy in homeopathy. also called stavesacre.
Delfinium elatum L
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LEAD POISONING- A SERIOUS THREAT TO HEALTH Lead poisoning is a type of metal poisoning caused by lead in the body.The brain is the most sensitive.Symptoms may include abdominal pain, constipation, headaches, irritability, memory problems, inability to have children, and tingling in the hands and feet. It causes almost 10% of intellectual disability of otherwise unknown cause and can result in behavioral problems. Some of the effects are permanent. In severe cases anemia, seizures, coma, or deathmay occur. Lead poisoning Synonyms Plumbism, colica pictorum, saturnism, Devon colic, painter's colic An X ray demonstrating the characteristic finding of lead poisoning in humans—dense metaphyseal lines. Specialty Toxicology Symptoms Intellectual disability, abdominal pain, constipation, headaches, irritability, memory problems, inability to have children, tingling in the hands and feet Complications Anemia, seizures, coma Causes Exposure to lead via contaminated air, water, dust, food, consumer products Risk factors Being a child Diagnostic method Blood lead level Differential diagnosis Iron deficiency anemia, malabsorption, anxiety disorder, polyneuropathy Prevention Removing lead from the home, improved monitoring in the workplace, laws that ban lead in products Treatment Chelation therapy Medication Dimercaprol, edetate calcium disodium, succimer Deaths 853,000 (2013) Exposure to lead can occur by contaminated air, water, dust, food, or consumer products. Children are at greater risk as they are more likely to put objects in their mouth such as those that contain lead paint and absorb a greater proportion of the lead that they eat. Exposure at work is a common cause of lead poisoning in adults with certain occupations at particular risk.Diagnosis is typically by measurement of the blood lead level. The Centers for Disease Control (US) has set the upper limit for blood lead for adults at 10 µg/dl (10 µg/100 g) and for children at 5 µg/dl. Elevated lead may also be detected by changes in red blood cellsor dense lines in the bones of children as seen on X-ray. Lead poisoning is preventable. This includes by individual efforts such as removing lead-containing items from the home, workplace efforts such as improved ventilation and monitoring,and nationwide policies such as laws that ban lead in products such as paint and gasoline, reduce allowable levels in water or soil, and provide for cleanup of contaminated soil. The major treatments are removal of the source of lead and the use of medications that bind lead so it can be eliminated from the body, known as chelation therapy.Chelation therapy in children is recommended when blood levels are greater than 40–45 µg/dl.Medications used include dimercaprol, edetate calcium disodium, and succimer. In 2013 lead is believed to have resulted in 853,000 deaths. It occurs most commonly in the developing world.Those who are poor are at greater risk.Lead is believed to result in 0.6% of the world's disease burden. People have been mining and using lead for thousands of years. Descriptions of lead poisoning date to at least 2000 BC, while efforts to limit lead's use date back to at least the 16th century.Concerns for low levels of exposure begin in the 1970s with there being no safe threshold for lead exposure. Classification Classically, "lead poisoning" or "lead intoxication" has been defined as exposure to high levels of lead typically associated with severe health effects. Poisoning is a pattern of symptoms that occur with toxic effects from mid to high levels of exposure; toxicity is a wider spectrum of effects, including subclinical ones (those that do not cause symptoms). However, professionals often use "lead poisoning" and "lead toxicity" interchangeably, and official sources do not always restrict the use of "lead poisoning" to refer only to symptomatic effects of lead. The amount of lead in the blood and tissues, as well as the time course of exposure, determine toxicity. Lead poisoning may be acute (from intense exposure of short duration) or chronic (from repeat low-level exposure over a prolonged period), but the latter is much more common. Diagnosis and treatment of lead exposure are based on blood lead level (the amount of lead in the blood), measured in micrograms of lead per deciliter of blood (μg/dL). Urine lead levels may be used as well, though less commonly. In cases of chronic exposure lead often sequesters in the highest concentrations first in the bones, then in the kidneys. If a provider is performing a provocative excretion test, or "chelation challenge", a measurement obtained from urine rather than blood is likely to provide a more accurate representation of total lead burden to a skilled interpreter. The US Centers for Disease Control and Prevention and the World Health Organization state that a blood lead level of 10 μg/dL or above is a cause for concern; however, lead may impair development and have harmful health effects even at lower levels, and there is no known safe exposure level.Authorities such as the American Academy of Pediatrics define lead poisoning as blood lead levels higher than 10 μg/dL. Lead forms a variety of compounds and exists in the environment in various forms. Features of poisoning differ depending on whether the agent is an organic compound (one that contains carbon), or an inorganic one. Organic lead poisoning is now very rare, because countries across the world have phased out the use of organic lead compounds as gasoline additives, but such compounds are still used in industrial settings. Organic lead compounds, which cross the skin and respiratory tract easily, affect the central nervous system predominantly. Signs and symptoms Symptoms of lead poisoning. Lead poisoning can cause a variety of symptoms and signs which vary depending on the individual and the duration of lead exposure.Symptoms are nonspecific and may be subtle, and someone with elevated lead levels may have no symptoms.Symptoms usually develop over weeks to months as lead builds up in the body during a chronic exposure, but acute symptoms from brief, intense exposures also occur. Symptoms from exposure to organic lead, which is probably more toxic than inorganic lead due to its lipid solubility, occur rapidly. Poisoning by organic lead compounds has symptoms predominantly in the central nervous system, such as insomnia, delirium, cognitive deficits, tremor, hallucinations, and convulsions. Symptoms may be different in adults and children; the main symptoms in adults are headache, abdominal pain, memory loss, kidney failure, male reproductive problems, and weakness, pain, or tingling in the extremities. Early symptoms of lead poisoning in adults are commonly nonspecific and include depression, loss of appetite, intermittent abdominal pain, nausea, diarrhea, constipation, and muscle pain. Other early signs in adults include malaise, fatigue, decreased libido, and problems with sleep. An unusual taste in the mouth and personality changes are also early signs. In adults, symptoms can occur at levels above 40 μg/dL, but are more likely to occur only above 50–60 μg/dL.Symptoms begin to appear in children generally at around 60 μg/dL.However, the lead levels at which symptoms appear vary widely depending on unknown characteristics of each individual. At blood lead levels between 25 and 60 μg/dL, neuropsychiatric effects such as delayed reaction times, irritability, and difficulty concentrating, as well as slowed motor nerve conduction and headache can occur. Anemia may appear at blood lead levels higher than 50 μg/dL. In adults, abdominal colic, involving paroxysms of pain, may appear at blood lead levels greater than 80 μg/dL. Signs that occur in adults at blood lead levels exceeding 100 μg/dL include wrist drop and foot drop, and signs of encephalopathy (a condition characterized by brain swelling), such as those that accompany increased pressure within the skull, delirium, coma, seizures, and headache. In children, signs of encephalopathy such as bizarre behavior, discoordination, and apathy occur at lead levels exceeding 70 μg/dL. For both adults and children, it is rare to be asymptomatic if blood lead levels exceed 100 μg/dL. Acute poisoning In acute poisoning, typical neurological signs are pain, muscle weakness, numbness and tingling, and, rarely, symptoms associated with inflammation of the brain. Abdominal pain, nausea, vomiting, diarrhea, and constipation are other acute symptoms. Lead's effects on the mouth include astringency and a metallic taste.Gastrointestinal problems, such as constipation, diarrhea, poor appetite, or weight loss, are common in acute poisoning. Absorption of large amounts of lead over a short time can cause shock (insufficient fluid in the circulatory system) due to loss of water from the gastrointestinal tract. Hemolysis (the rupture of red blood cells) due to acute poisoning can cause anemia and hemoglobin in the urine. Damage to kidneys can cause changes in urination such as decreased urine output.People who survive acute poisoning often go on to display symptoms of chronic poisoning. Chronic poisoning Chronic poisoning usually presents with symptoms affecting multiple systems, but is associated with three main types of symptoms: gastrointestinal, neuromuscular, and neurological.Central nervous system and neuromuscular symptoms usually result from intense exposure, while gastrointestinal symptoms usually result from exposure over longer periods.Signs of chronic exposure include loss of short-term memory or concentration, depression, nausea, abdominal pain, loss of coordination, and numbness and tingling in the extremities.[unreliable medical source?] Fatigue, problems with sleep, headaches, stupor, slurred speech, and anemia are also found in chronic lead poisoning. A "lead hue" of the skin with pallor and/or lividity is another feature. A blue line along the gum with bluish black edging to the teeth, known as a Burton line, is another indication of chronic lead poisoning.Children with chronic poisoning may refuse to play or may have hyperkineticor aggressive behavior disorders.Visual disturbance may present with gradually progressing blurred vision as a result of central scotoma, caused by toxic optic neuritis. Effects on children As lead safety standards become more stringent, fewer children in the US are found to have elevated lead levels. A woman who has elevated blood lead levels during pregnancy is at greater risk of a prematurely birth or with a low birth weight. Children are more at risk for lead poisoning because their smaller bodies are in a continuous state of growth and development. Lead is absorbed at a faster rate compared to adults, which causes more physical harm than to older people. Furthermore, children, especially as they are learning to crawl and walk, are constantly on the floor and therefore more prone to ingesting and inhaling dust that is contaminated with lead. The classic signs and symptoms in children are loss of appetite, abdominal pain, vomiting, weight loss, constipation, anemia, kidney failure, irritability, lethargy, learning disabilities, and behavioral problems. Slow development of normal childhood behaviors, such as talking and use of words, and permanent intellectual disability are both commonly seen. Although less common, it is possible for fingernails to develop leukonychia striata if exposed to abnormally high lead concentrations. By organ system Lead affects every one of the body's organ systems, especially the nervous system, but also the bones and teeth, the kidneys, and the cardiovascular, immune, and reproductive systems.Hearing loss and tooth decay have been linked to lead exposure, as have cataracts. Intrauterine and neonatal lead exposure promote tooth decay. Aside from the developmental effects unique to young children, the health effects experienced by adults are similar to those in children, although the thresholds are generally higher. Kidneys Kidney damage occurs with exposure to high levels of lead, and evidence suggests that lower levels can damage kidneys as well. The toxic effect of lead causes nephropathy and may cause Fanconi syndrome, in which the proximal tubular function of the kidney is impaired. Long-term exposure at levels lower than those that cause lead nephropathy have also been reported as nephrotoxic in patients from developed countries that had chronic kidney disease or were at risk because of hypertension or diabetes mellitus.Lead poisoning inhibits excretion of the waste product urate and causes a predispositDr. Yogesh Deshpande2 Likes1 Answer
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my father's report.. age 67yrs HT on tab.amlong 5mg .. c/o fatigue , constipation, stress .. kindly give ur opinion treatment to start ,any other investigation to be done .. Hb-12, tsh -7.80 , CRP-2.5 , total cholesterol is normal , HDL - low 33Narayani Krishnamurthy1 Like12 Answers
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ORS previously included in Psychotic spectrum have been moved to the OC spectrum in DSM five. Olfactory Reference Syndrome with Suicidal Attempt Treated with Pimozide and Fluvoxamine ￼ Introduction The symptoms of Olfactory Reference Syndrome (ORS) were first described in a case series of 36 patients by Pryse-Phillips in 1971. Although published literature on the subject spans more than a century, areas of controversies persist in terms of the nosology and treatment of the disease. The core symptomatology of ORS is characterized by a preoccupation with the belief that one emits an offensive odor, which is not perceived by others. Other terms that have been used in literature to describe the disease include delusions of bromosis, hallucinations of smell, chronic olfactory paranoid syndrome, olfactory delusional syndrome, monosymptomatic hypochondriacal psychosis, olfactory delusional state, olfactory hallucinatory state, and autodysomophobia. The characterization of this syndrome has been a moving target; it appears in the DSM 5 under “Other Specified Obsessive-Compulsive Disorders” as well as under the “Glossary of Cultural Concepts of Disease,” as a variant of Taijin Kyofusho, a disease characterized by “anxiety about and avoidance of interpersonal situations, due to the thought, feeling, or conviction that one’s appearance and actions in social interactions are inadequate or offensive to others.” ORS was first categorized as an atypical somatoform disorder in the DSM-III and then as a delusional disorder in DSM-IV-TR and now under Other Specified Obsessive-Compulsive Disorders in DSM 5. The controversy surrounding its classification stems from the supposed preferential response of the condition to Selective Serotonin Reuptake Inhibitors (SSRIs) suggesting a possible associational overlap with Obsessive-Compulsive Spectrum Disorders and its very strong comorbidity with depressive disorders but, despite this preference, reports of the utility of antipsychotics such as Quetiapine, Risperidone, and Pimozide have also been reported in literature. The clinical course of ORS is chronic and debilitating for the patient and their families; although the clinical presentation may be confused with primary psychotic disorder, there is no clear evidence that this disorder leads to or is associated with schizophrenia. Pryse-Phillips, in his seminal paper, highlighted the importance of depression as the most common psychiatric comorbidity with ORS but other comorbidities have also been described in literature including bipolar disorder, personality disorders, schizophrenia, hypochondriasis, alcohol and substance use disorders, Obsessive-Compulsive Disorder (OCD), and body dysmorphic disorder. Case Report A case of a 75-year-old African American woman, widow, unemployed, and domiciled with a past medical history of hypertension, osteoarthritis, and asthma. The patient was brought to the Emergency Room by Emergency Medical Services (EMS) on account of an attempted suicide due to a 3-year history of “bad odor coming from my vagina.” The patient reported that the foul smell from her vagina was making her body “rotten.” She reported that “the smell came back recently and it is stronger.” Although she has been having the odor for the last 3 years, it has only recently gotten worse, the culmination of which resulted in her attempted suicide this time. She reported that she has seen several gynecologists who have treated her to no avail and later advised her to see a psychiatrist. She stated that there is a “devil” in her body that does not let go and she said, “I need help.” The patient has a significant impairment in social functioning evidenced by a reported avoidance of social events; she could no longer go out to the store for her basic needs; according to the patient’s son, she has also stopped going out to get groceries or to the church. She reported that she has been unable to have any romantic relationships because of her “odor.” The patient stays at home all day, showers several times daily, and has tried many vaginal products and creams but all in vain. Diagnosis At the time of initial evaluation, the patient appeared paranoid, reporting that people stayed away from her because of her smell. She also endorsed ideas of reference claiming that people around her cover their noses, stand next to windows, or look at her in “a certain way” and then talk about how much she “stinks” to each other. She endorses profound feelings of hopelessness, helplessness, and guilt and was tearful during the interview. Other symptoms reported were poor sleep, feeling less energetic, decrease in concentration, and anhedonia. She also endorsed active suicidal ideation, imagining waking up dead every morning due to her odor, and attempted to stab herself in order to “end my mystery” which led to this current admission. She also reported that she had lost up to 20 pounds in last 3 months. The patient was initially diagnosed with schizophrenia but later revised to Olfactory Reference Syndrome (ORS) in view of an extensive review of her symptoms and collateral information. Treatment The patient was admitted to the inpatient psychiatric unit and placed on 1: 1 constant observation for active suicidal ideation. Laboratory investigations including urine toxicology, liver function, urea, creatinine, electrolytes, and antinuclear antibodies, syphilis, and human immunodeficiency virus serology were all within normal limits or negative. She was started on Risperdal 2 mg PO twice daily for psychosis, Escitalopram 20 mg PO daily for depression, and Trazodone 50 mg PO HS for sleep. Neurological and gynecological consults were sought and the MRI of the brain obtained revealed no significant findings and was otherwise unremarkable. After a week, the patient’s delusions about her vaginal smell got even worse. She would not go outside of her room even for meals which were offered to her in the room because she thought that people could smell her vaginal odor. She also spent very long hours in the showers and demanded to take showers several times daily; her requests put a strain on the staff of the unit and on other patients who needed to use the same facilities. The patient’s medications were reviewed and she was started on Pimozide 1 mg PO twice daily and Fluvoxamine 25 mg PO daily based on the revision of her diagnosis to ORS. Risperdal, Citalopram, and Trazodone were discontinued. The patient made remarkable progress in the next few days. Pimozide was optimized to 2 mg PO twice daily and Fluvoxamine to 75 mg PO daily during the course of her hospitalization. She remained adherent with her medications and no side effects were noted. The patient and nursing staff agreed to a 70% symptomatic improvement in the patient’s symptoms; her affect was brighter; she was able to go outside of her room for meals and group therapy and socialize with other patients and staff. She became amenable to dissuasion regarding her previously held delusions and denied any depressive symptoms and no longer needed 1: 1 constant observation as she was no longer suicidal. She appeared future-oriented and motivated to go back home and resume her social life again. She was discharged back to her apartment and was provided with an outpatient appointment for aftercare. The team followed up with the patient patients several months after her discharge and she continued to maintain a remission of her symptoms. Discussion This patient believed that her vagina was emitting such a strong odor that she attempted to take her own life after 3 years of significant distress. Her belief was accompanied by ideas of reference; that is, she thought that other people took special notice of the odor in a negative way; she performed repetitive behaviors of multiple daily showers and use of vaginal washing soaps daily. Although not an official diagnostic criterion, our patient met the provisional criteria set by the DSM-5 Anxiety, Obsessive-Compulsive Spectrum, Posttraumatic, and Dissociative Disorders Work Group criteria for Olfactory Reference Syndrome : (A)Preoccupation exists with the belief that one emits a foul or offensive body odor, which is not perceived by others. (B)The preoccupation causes clinically significant distress (e.g., depressed mood, anxiety, and shame) or impairment in social, occupational, or other important areas of functioning. (C)The symptoms are not a symptom of schizophrenia or another psychotic disorder and are not owing to the direct physiological effects of a substance (e.g., drug abuse or medication) or a general medical condition. The comorbidity with Major Depressive Disorder in our patient is of particular significance. The importance of this comorbidity is well known and has been reported in the literature. In this case, our patient reported several symptoms suggestive of Major Depressive Disorder evidenced by her profound feeling of hopelessness and guilt; she has lost interest in everything; she reported insomnia and poor appetite with a significant amount of weight loss. All the patient’s symptoms, although rooted in the context of her perception that she was smelling, were nonetheless significant to the point that she attempted suicide. The use of Pimozide and SSRIs in the treatment of monosymptomatic hypochondriacal states has been consistently reported in the literature. The combination of these medications in the index case yielded excellent results. Although the reliability of the diagnostic criteria is not yet established and ORS is not a stand-alone diagnosis in the DSM-5, it merits consideration in patients who present with monosymptomatic hypochondriacal illnesses, as this diagnostic consideration may influence the treatment and eventually the potential course of the illness as with our patient who after three years of a distressing illness is currently in remission with proper treatment. Keywords Olfactory Reference Syndrome, suicide attempt, Pimozide, Fluvoxamine Author : Jegede, et al.Dr. Saleem Pallisserikuzhiyil9 Likes9 Answers
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WHAT IS RESTLESS LEGS SYNDROME? Restless legs syndrome (RLS) is a cause of insomnia (trouble sleeping) for many people. Restless legs syndrome is aching, twitching, tingling, burning, or prickling feelings in the lower leg muscles when you lie in bed. You have a strong urge to move your legs. This may also happen when you are sitting. Moving your legs or getting up and standing or walking may make your legs feel better, but not for long. True restless legs syndrome is different from night-time leg cramps or occasional sudden jerks of leg muscles at night. WHAT IS THE CAUSE? The exact cause of RLS is not known. It tends to run in families. It is more common after middle age and occurs more often in women than in men. Many people with RLS can remember having what they called growing pains in their legs during childhood. It may be that a nerve malfunction is involved. RLS has also been linked with alcohol dependence, smoking, too much caffeine (usually from drinking coffee), rheumatoid arthritis, anemia, and diabetes. Use of some medicines may make symptoms worse. The problem may get worse when you are not active for a long period of time. For example, it might get worse when you have been lying in bed, sitting in a theater, working at a desk, or riding in a car for a long time. WHAT ARE THE SYMPTOMS? Symptoms include: Strong urges to move your legs Aching, twitching, tingling, burning, prickling in the lower legs when you are lying down or sitting Relief from the symptoms when you move, especially if you get up and walk The symptoms start or get worse in the evening or at night. Leg cramps and occasional, sudden jerking of legs or arms are not symptoms of restless legs syndrome. A day of heavy exercise can lead to a tight cramp in your calf (sometimes called a charley horse). Stretching and jiggling the calf muscle helps the cramp ease off and usually you can go back to sleep without having a relapse. Many people also have an occasional night jerk where their arm, leg, or half their body twitches once as they are falling asleep. This may wake you up, but it is not serious. Almost always you can go back to sleep without a second occurrence. During sleep it is not unusual to have uncontrolled movements of your arms or legs. This is called periodic limb movements of sleep, or PLMS. Usually, you are not aware of these movements and you sleep through them. By themselves, they usually are not bothersome to the sleeper, although they may disturb a bed partner. People can have RLS or PLMS or both. Treatment of PLMS alone usually is not needed. HOW IS IT DIAGNOSED? The diagnosis of RLS is based on your medical history. Your healthcare provider will examine you and may order blood tests or other tests to check for an underlying medical problem, such as anemia, rheumatoid arthritis, or diabetes. HOW IS IT TREATED? Studies have found that over half of the people who have RLS describe their problems as mild or minor. If your symptoms are mild, you may not need medical treatment. Here are some things you can do that may help relieve your symptoms: Stretch or massage the leg muscles before going to sleep. Practice relaxation methods. Wear long socks to bed. Sometimes elastic compression socks up over the calf are helpful. Ask your provider about these socks. Use a covered hot water bottle or cold moist cloths on painful areas before you go to sleep. Take a warm bath before bedtime. If these steps do not help, your healthcare provider may prescribe medicine to relieve the symptoms and help you sleep better. Quite a few medicines have been tried as treatments. Some are helpful but none are a cure. Drugs that may be recommended are: Levodopa, a drug normally used for Parkinson’s disease Pramipexole and ropinirole Low-dose narcotic medicines or benzodiazepines, such as Valium Getting more iron if you are iron deficient sometimes helps ease the symptoms. If you have RLS every day and the usual treatments don’t help, the RLS is called refractory. Medicines that may be prescribed in this case include gabapentin and cabergoline. These are much more expensive medicines. HOW CAN I TAKE CARE OF MYSELF? Follow your healthcare provider's advice for relief of your RLS symptoms. You may need to: Avoid or cut back on caffeine (coffee, tea, cocoa, cola). Avoid or cut back on alcohol. Improve your general health by eating a healthy diet and exercising regularly. For many people who have RLS, it is a great relief just to learn that there are other RLS sufferers like themselves and that they are not alone. Also, it is good news to hear that RLS does not keep getting worse or become disabling. It does not lead to other diseases. If nondrug treatments work well enough, then not taking a drug for RLS is generally wise.Kirti Yadav15 Likes8 Answers
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MANDRAX( METHAQUALONE)::Originally a product if Indian science Mandrax is also called Quaalude,Indes,buttons,press outs,andquas,quacks,soaps and sopes.This was developed by biochemical researchers in India in the early 1950's.Originially this was made to use as a sedative but its highly addictive and powerful sedative effect giving 'Kick',this drug became very popular among the roadsiders and in the prisons.The originally prepared in form of tablets and sold as tablets,Mandrax allegedly gives its abusers a 'rush' or 'kick' or feeling of euphoria.Physical and mental dependency can be developed rapidly with Mandrax and the often causes severe withdrawl symptoms,when one attempt to abstain from it.Its addictive nature,derived form its active ingredient METHAQUALONE.This can cause serious emotional problems,depression,epilepsy and delirium.Interestingly the Mandrax was initially prescribed for Insomnia or used as a sedative and muscle relaxant.After use for aound 10 years it was withdrawn from the market and almost banned in India,however some illegally manufactured stock is smuggled in few countries,produced form outside the India.Dose 150-300 mgm only can producea sensual euphoric state of mind and profound relaxed intimate mood.According to the National Institute of Drug Abuse(NIDA),mandrax is particularly dangerous when consumed with alcohol.Its dose of 2 Gms can cause COMA AND CONVULSIONS AND 8 Gms produce death as it is a fatal dose.This was in use in India from 50-70.Still this is a popular drug in South Africa and some parts of Europe.It is produced in Pakistan,Kenya,zambia and South Africa.This is still smuggled to India in some border states.This is totally banned in India and can be brought under Indian Narcotic Act and Prohibited drug.Dr. Suryakant Bheda3 Likes7 Answers