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Monday, July 12, 2010

AYURVEDA
Ayurveda is grounded in a metaphysics of the "five great elements ; Prithvi-earth, Aap-water, Tej-fire, Vaayu-air, and Akash-ether—all of which compose the Universe, including the human body. Chyle or plasma (called rasa dhatu), blood (rakta dhatu), flesh (mamsa dhatu), fat (medha dhatu),bone (asthi dhatu),marrow (majja dhatu), and semen or female reproductive tissue (shukra dhatu) are held to be the seven primary constituent elements –Saptadhatu of the body.  Ayurveda deals elaborately with measures of healthful living during the entire span of life and its various phases. Ayurveda stresses a balance of three elemental energies or humors: Vata (air & space – "wind"), Pitta (fire & water – "bile") and Kapha (water & earth – "phlegm").  According to Ayurveda, these three regulatory principles—Doshas (literally that which deteriorates)—are important for health, because when they are in balanced state, the body is healthy, and when imbalanced, the body has diseases. Ayurveda holds that each human possesses a unique combination of Doshas. In ayurveda, the human body perceives attributes of experiences as 20 Guna (meaning qualities).  Surgery and surgical instruments are employed.  It is believed that building a healthy metabolic system, attaining good digestion and proper excretion leads to vitality.  Ayurveda also focuses on exercise, yoga , meditation, and massage.  Thus, body, mind, and spirit/consciousness need to be addressed both individually and in unison for health to ensue.
"Because every embodied individual is composed of a body, a mind and a spirit, the ancient Rishis of India who developed the Science of Life organized their wisdom into three bodies of knowledge: Ayurveda, which deals mainly with the physical body; Yoga, which deals mainly with spirit; and Tantra, which is mainly concerned with the mind. The philosophy of all three is identical; their manifestations differ because of their differing emphases. Ayurveda is most concerned with the physical basis of life, concentrating on its harmony of mind and spirit. Yoga controls body and mind to enable them to harmonize with spirit, and Tantra seeks to use the mind to balance the demands of body and spirit."

The proper function of channels (srotas) that transport fluids from one point to another within the body is seen as vital, and the lack of healthysrotas may lead to disease and insanity.  Sushruta identifies that blockages of these channels may lead to rheumatism, epilepsy, paralysis, and convulsions as fluids and channels are diverted from their ideal locations.  Sweating is used as a means to open up the channels and dilute the Doshas causing the blockages and harming a patient. A number of ways to take steam bathing and other steam related cures are recommended so that toxins are released.
In 1970, the Indian Medical Central Council Act which aims to standardize qualifications for AYURVEDA and provide accredited institutions for its study and research was passed by the Parliament of India.  In India, over 100 colleges offer degrees in traditional Ayurvedic medicine.  The Indian government supports research and teaching in Ayurveda through many channels at both the national and state levels, and helps institutionalize traditional medicine so that it can be studied in major towns and cities.  The state-sponsored Central Council for Research in Ayurveda and Siddha (CCRAS) is the premier institution for promotion of traditional medicine in India.  The studies conducted by this institution encompass clinical, drug, literary, and family welfare research. To fight biopiracy and unethical patents, the Government of India  in 2001, set up the Traditional Knowledge Digital Library as repository of 1200 formulations of various systems of Indian medicine, such as Ayurveda, Unani and Siddha. The library also has 50 traditional Ayurveda books digitized and available online.
Some ayurvedic products, mainly herbs used for phytotherapy, have been tested with promising results. Studies suggest that TURMERIC and its derivative CURCUMIN are antioxidants. TINSPORA CORDIFOLIA has been tested.  Among the medhya rasayanas (intellect rejuvenation), two varieties of SALVIA have been tested in small trials; one trial provided evidence that SALVIA LAVANDULIFOLIA (Spanish sage) may improve word recall in young adults, and another provided evidence that SALVIA OFFICINALIS (Common sage) may improve symptoms in Alzheimer’s patients. In some cases, Ayurvedic medicine may provide clues to therapeutic compounds. For example, derivatives of snake venom have various therapeutic properties.  Many plants used as RASAYANA (rejuvenation) medications are potent antioxidants. NEEM appears to have beneficial pharmacological properties. Cardamom and cinnamon stimulate digestive enzymes that break down polymeric macromolecules in the human body.  Research suggests that TERMINALIA  ARJUNA is useful in alleviating the of angina pectoris and in treating heart failure and coronary artery disease.  T. ARJUNA may also be useful in treating hypercholesterolemia.

Safety of Ayurvedic medicines:
The use of toxic herbs and of toxic metals and minerals as ingredients in traditional ayurvedic treatments is a major safety concern. Rasa shastra, the practice of adding metals, minerals or gems to herbs, is a source of toxic heavy metals such as lead, mercury, and arsenic. Adverse reactions to herbs due to their pharmacology are described in traditional ayurvedic texts.
Traditionally the toxicity of these materials are believed to be reduced through purification processes such as samskaras or shodhanas (for metals), which is similar to the Chinese pao zhi. The ayurvedic technique is more complex and may involve prayers as well as physical pharmacy techniques.

BASIC PRINCIPLE OF AYURVEDA:
The basic principle of ayurveda is thridoshas (three basic constituents of human body) are vata, pitta, and kapha.  The selection of ayurvedic medicines and treatments will be based on these three elements.  The predominance one of these suggest the PRAKRUTI(NATURE) of the individual.

VATA------Any movement in the body, macro or micro movements, nerve impulses, finger, hand movements, eyelid movements, talking, sensation etc all come under the vata dosha functions.
PITTA------Macro and micro digestion, metabolism, catabolism, anabolism etc.
KAPHA----Binding, keeping cells together, giving shape, providing lubrication etc.
In body without vata there is no pain, without pitta there is no burning sensation, and without kapha there is no swelling.
So, one has to look into the predominance of doshas among these three in particular illness and patient symptoms.  Then the medicine has to be decided.  For e.g. if a person is having joint pain with swelling (which means there is aggravation of vata and kapha) the medicines should be selected which will reduce vata and kapha.  The nadeepareeksha  (ayurvedic way of assessing the nadee i.e. pulse) is having a very important role in deciding the doshas apart from patient symptoms.  (One has to see the subdoshas and dhatus also).
SANTHIGIRI offers a unique system of treatment which combines Ayurveda and Siddha, the two systems of Indian medicinal systems. 
Santhigiri produces a variety of 700 plus Ayurveda and Siddha medicines both classical and proprietary.  The method of preparation is strictly according to the texts of Ayurveda and Siddha.
An extremely expert surgeon will pray for a minute before surgery as prayer (of God or positive energy etc) improves and imparts the positive energy in any work that we do.  This spirituality has been given an importance in sathigiri by praying Navajyothishri karunakara guru who is the founder of santhigiri.  The specific prayers are chanted while cultivating and collecting the raw materials, preparation and packing of medicines, prescription, and handing over of medicines to patients and also during the panchakarma treatments, so that the medicine should be enhanced in terms of positive energy through this spirituality.  This makes santhigiri distinct from other ayurvedic institutions.
Santhigiri has some special treatments in the form of massages, kizhi, vasti and an unique combined medicine systems of Ayurveda and Siddha.

AYURVEDIC APPROACH OF TREATING SOME DISEASES
OSTEOARTHRITIS:  In degenerative disorders like Osteoarthritis the allopathic approach is to give pain killers, external ointments and some calcium supplements, or else surgery if conservative treatments fails.  In ayurveda this is because of imbalance of Vata dosha.  The Osteoarthritis is treated strengthening the muscles in and around the joints by treatments like njavara kizhi, dhara, oil bandages and specific internal medications to. Also the effort is made to improve the synovial fluid by treatments and medicines.
Ayurvedic treatments packages:
Abhyanga swedanam for 3 days
Elakizhi for 7 days.
Njavara kizhi 7 days
Dhara 7 days
Oil Bandage
Janu Vasti and Yoga Vasti.
The treatments are decided on the symptoms, dosha predominance and prakruti of patients along with the internal medications.
SPONDYLOSIS:  In spondylosis and slip disc the allopathic treatment is taking pain killers, traction, use of braces (neck belt), or surgery in advanced cases.  But in ayurveda, there are lot of treatments available for the better management of spondylosis.  First the stiffness of the muscles is releaved by some muscle relaxing massages, and then the muscles are strengthened by different types of kizhi treatments.  The greeva/katee vasti (making the oil to stay behind the neck/low back for about 20 to 30 minutes by ayurvedic treatment procedure) and vasti (medicated enema) are very beneficial in spondylosis as ayurveda catogerises spondylosis as one among the disorders caused by Vata vitiation.  Once the muscles around the neck and paraspinal muscles are strengthened, the pressure on the intervertebral discs is minimized and the possible nerve compression is minimized which will help in relieving the symptoms.  There are some medicines should be taken after these ayurvedic treatments to strengthen the muscles and nourish the body and vertebral column.

Ayurvedic treatments packages:
Nasyam for 7 days.
Greeva/Kati vasti for 7 days.
Elakizhi/Njavara kizhi 7 days.

PSORIASIS:  Psoriasis is worst of skin diseases.  It makes one’s life miserable. Santhigiri offers a very good line of treatment as psoriasis is considered as a disease which is having a link with our past life, which the ayurvedic texts explain.  Psoriasis effects from the gene level.  In allopathy the steroids are used as treatment measures.  Ayurveda advises a particular life style for psoriasis effected patients, how should they live, what to eat and what not to eat, balance of body and mind etc. The body is purified with internal medicines and also by panchakarma treatments.
Santhigiri follows a special takradhara treatement and njavara lepa treatments along with other classical vamana, virechana, and swedana chikitsa for psoriasis which are very useful and giving very good results in effected patients. These treatments are done for 7 to 14 days and with a 6 month or 1 year interval.
DIABETES MELLITUS:  According to Ayurveda diabetes mellitus is of three types i.e. Sadhya (curable), Yapya (manageable), and Asadhya (non curable).  In allopathy, eventhough the blood sugar level is controlled, the patients may have the secondary symptoms such as tiredness, burning sensation, uneasiness, loss of libido etc which are considered as “must compromise symptoms if you want to control blood glucose level.”  But by Santhigiri’s special treatment methods, the diabetic patients can control their diabetes without these secondary symptoms eventhough they have diabetes from many years.  The ayurvedic medicines act at the basic constituent level of body.  As diabetes is a metabolic disorder, the ayurvedic medicines will correct the metabolism i.e. pitta according to ayurveda.  There are so many patients who are diagnosed at very early stage and are controlling their diabetes through ayurvedic medicines.  Also the antidiabetic medicines of santhigiri will help to regain the loss of strength, libido, and to overcome the tiredness, tingling sensation, constipation etc in patients who are taking the allopathic medicines.
Massage and Steam bath is very useful in diabetes as it increase the blood circulation and stimulates the fat metabolism.
Santhigiri gives a special Vaitarana vasti for 8 to 16 days along with other internal medications in the management of diabetes.
IMMUNITY ENHANCING TREATMENTS AND MEDICINES:   Ayurveda focuses on immunity and has many treatments and medications to improve one’s own immunity level or body resistance power. The diseases like ALLERGY, ALLERGIC SINUSITIS, AND SOME FEVERS etc are immunity related. One can improve the immunity power by following the different regimens, seasonal treatments, and diets. 
Santhigiri has different packages for different seasons like monsoon rejuvenation packages which include ABHYANGA SWEDANAM, KIZHI, SHIRODHARA, PIZHICHIL ETC for 7 to 14 days.
STRESS AND SLEEP DISORDERS:  In allopathy, the stress and sleep disorders are treated with anti anxiety and sleeping pills which can cause addiction over a long term use.  But, ayurveda have far better approach and treatments and medicines.  The massages will increase the blood circulation and relax the body.  The treatments like shriodhara and shirovast will relax the mind.  The stress and sleep disorders are coming under the imbalance of VATA-PITTA.  The treatment packages and medicines given here are having the qualities of balancing this VATA-PITTA.
Treatment packages:
Relaxation massage with steam bath 3 to 7 days.
Shirodhara  for 7 to 14 days.

HYPERTENSION AND HYPERCHOLESTEROLEMIA:  According to ayurveda, hypertension is because of PITTA imbalance and hypercholesterolemia is because of PITTA-KAPHA imbalance. In gross these two are metabolic disorders.  Santhigiri has some unique medicines like Hridayashanthi, Triphala choornam, Maruthan pattai choornam etc along with ayurvedic treatments like Steam bath, shirodhara, etc.  In the same way, obesity also comes under the metabolic disorders for which udwartanam, steam bath along with kashaya vasti  and some special internal medications are given which have a proven effect.


SPECIAL MEDICINES OF SANTHIGIRI
HRIDAYASHANTHI:  Hridayashanthi is an ayurvedic medicine for protection of heart.  It contains kharjura, draksha, ….., triphala, arjuna, sarpagandha etc almost eighteen ingredients including fuits and herbs.  Hridayashanthi controls LDL, VLDL(bad) cholesterol, maintain HDL i.e good cholesterol.  It removes fat deposition in the inner walls of arteries and blood vessels and prevents atherosclerosis.  Also reduces hypertension and insomnia.  In menopause it is helpful to control frustration, sleeplessness, hypertension, and mood swinging.  Fast food habits are more prone to heart problems.  It is also recommended as general tonic now a days as it contains nutritious ingredients like grapes, dates etc.
KADALEEKALPA RASAYANAM:  Effective ayurvedic medicine for complete healthcare of females from puberty to menopause.  It corrects Disfunctional Uterine Bleeding (DUB), leucorrhea, burning micturition, hormonal imbalances and infertility.  It strengthens uterus, cavities, controls excessive bleeding and pain.  It contains dffective and nutritious ingredients and it hlepls to improve the body complexion and health.
ANTIDIABETICS:  JUMBOLENE CAPSULES, PANCHAMRIDWEEKA RASAM, MENI NOKKI CHOORNAM, KOUSHALAMOHINI.  These controls fatigue, general and nervous debility, copious urination, voracious hunger, pain in joints, excess thirst etc.  It protects vital organs, hearts, liver, kidneys and eyes.
ANTI RHEUMATICS:  ARTIBAN FORTE CAPSULES, AMUKKURA LEHYAM, KARPOORADI THAILAM, DIFFERENT TYPES OF KASHAYA PREPARATIONS. These will reduce the swelling and pain, help to restore mobility of the joints, corrects neuralgia and muscle pain, removes uric acid deposited in the joints, strengthen bone and joints.
TIPPILI RASAYANAM, SOLANUM SYRUP, SOLANUM FORTE CAPSULE:  These will help in controlling asthma, allergic bronchitis, cough, and breathing problems.  The Tippili Rasayana will act as immune modulator and prevents infections.  They strengthen the respiratory system and correct breathing problems, also liquefies and expels the mucus.
UDARASUDHA, INJI RASAYANM, REGAS CAPSULES:  These correct the bowel movements, regulates assimilation and absorption, relieves urinary obstructions.  Effective medicines for constipation, dyspepsia, flatulence, loss of appetite.
AMUKKURA LEHYAM:  Ideal health restorative tonic.  Enriched with milk, honey, palm jiggery, ghee and corrects loss of weight and mal nutrition and increases breast mil.  It is most effective in male sexual problems-loss of libido, oligospermia, impotency, premature ejaculation, general weakness, fatigue, rheumatism and degenerative diseases.
KUMKUMADI LEPAM:  Best recommended for acne, blackheads, black spots, blemishes and dry skin.
KARUNAI LEHYAM, ENDOPILE CAPSULES, AND CHIRAVILWADI KASHAYAM:  Relieve constipation, prevents irritation, arrests bleeding per ano, and helps to shrink pile mass.  It controls bleeding and nonbleeding piles.
PANCHAJEERAKA GUDAM:  Traditional ayurvedic preparation which gives ideal body complexion for female.  It adds beauty health and structure in females.  It restores energy, vitality, and vigour.  In post natal, it promotes health to mother and baby.
NEELIBHRINGADI KERAM AND KESHAPUSHPAM:  Traditional ayurvedic medicine to promote hair growth.  It prevents premature graying and adds darkness to hair.
STROBILANTHUS OIL:  It is the body massage oil.  It impoves blood circulation and tone up the skin.  Best recommended oil for relaxation massages.
HRIDAYARENJINI LEPAM:  A pain reliever ointment used as external application.  A rare formula of ayurvedic ingredients to protect from head ache, cold, back ache, stiffness, joint pains, muscular pains, sprain and spasms.  It can be mixed with hot water and used for inhalation purpose.  It has bo burning sesation and can be applied for children as well as elders.  It is best recommended for low back ache during pregnancy.  It is also effective for sports injuries and dislocations etc.
KURUNJI KUZHUMBU:  It is a traditional ayurvedic medicine for mothers after delivery, used in post natal care, helps to restore health and symmetry of the body after delivery.
SANTHIGIRI HERBAL SOAPS, CHARMA SHUDDHI AND CHARMA MAHIMA:  Contains ayurvedic ingredients to protect from skin diseases and body odors.  These will improve the skin complexion and beauty and also gives good fragrance.

AYURVEDIC TREATMENTS OF SANTHIGIRI
PANCHKARMA (THE 5 MAJOR AYURVEDIC BODY CLEANING THERAPIES)
The role of Panchakarma is to clean the body (it never means that your body is unclean) by various detoxifying procedures, which will help in free radical scavenging and will restore the immunity of the body.  The procedures reduce the dryness inside the body, clears up various channels so that all the organs should receive proper nourishment / blood supply and function up to its best.
Be it be stone or other obstruction in urinary tract or atherosclerotic changes inside the arteries, lymphatic blockage, muscular dystrophy or atrophy, Breathing difficulties, musculoskeletal disorders like arthritis, Habitual constipation, obesity, osteoporosis, marrow compression, infertility, metabolic disorders, hormonal disturbances, different types of anemia etc.
Santhigiri practices these panchakarmas as mentioned in the Vedic texts and the inventions and modifications by the grace of NAVAJYOTHISRI KARUNAKARA GURU
While we are healthy, as by the judicious application of Panchakarma will never let the ailments to proliferate as ailments always challenge and reduce the immunity and only challenged and reduced immunity can let the disease/s to manifest in our biology.
PURVAKARMA: PRE-PURIFICATION MEASURES FOR PANCHAKARMA
Before the actual operation of purification begins, there is a need to prepare the body in prescribed methods to encourage the body to let go of the toxins. The two procedures are Snehana and Swedana (general body massage with medicated steam bath). Snehana is the oil massage. Oil is applied to the entire body with a particular type of massage which helps the toxins to move towards the gastrointestinaltract.  Ayurvedic oil massage also makes the superficial and deep tissues soft and supple, thus helping to remove stress and to nourish the nervous system.  Snehan is given daily for three to seven days, as indicated.  Swedana is sudation or sweating and is given every day immediately following the snehana.  An herbal concoction may be added to the steam to further loosen the toxins from the individual.  Swedana liquefies the toxins and increases the movement of toxins into the gastrointestinal tract.
PANCHAKARMA /CLEANSING THERAPIES
Pradhana Karma: Main Purification measures of Panchakarma
VAMANAM: THERAPEUTIC EMESIS THERAPY:  When there is congestion in the lungs causing repeated attacks of bronchitis, colds, cough or asthma, the Ayurvedic treatment is therapeutic vomiting so to eliminate the kapha causing the excess mucus also the aggravated Kapha is eliminated.  This is also useful in some of the skin diseases like psoriasis etc.
VIRECHANAM: THERAPEUTIC PURGATION THERAPY:  When excess bile, pitta, is secreted and accumulated in the gall bladder, liver and small intestines, it tends to result in rashes, skin inflammation, acne, chronic attacks of fever, biliary vomiting, nausea and jaundice.  Ayurvedic literature suggests in these conditions the administration of therapeutic purgation or a therapeutic laxative is recommended.
NASYAM: NASAL ADMINISTRATION:  An Ayurvedic Sutra says, the nose is the gateway to the brain and it is also the doorway to consciousness.  The nasal administration of medication is called NASYAM.  An excess of bodily Humors accumulated in the sinus, throat, nose or a head area is eliminated by means of the nearest possible opening, the nose.  The NASYA therapy sometimes acts as a stimulant.
VASTI : MEDICATED ENEMA THERAPY:   Vata's predominant site is the colon. Ayurvedic Vasti involves the introduction into the rectum of herbal concoctions of sesame oil, and certain herbal preparations in a liquid medium.  Vasti, is the most effective treatment of vata disorders, although many enemas over a prescribed period of time are usually required.  It relieves constipation, distention, chronic fever, cold, sexual disorders, kidney stones, heart pain, backache, sciatica and other pains in the joints.  Many other vata disorders such as arthritis, rheumatism, gout, muscle spasms and headaches may also be treated with Vasti.  This therapy is divided in two main types, i.e. Anuvasana Basti or medicated oil enemas and Niruha Basti or medicated enema of decoctions and medicated oils.

OTHER MISCELLANEOUS THERAPIES OF SANTHIGIRI AYURVEDA AND SIDDHA VAIDYASALA:
SHIRODHARA:   Prescribed herbal oils, medicated milk, buttermilk etc are poured on the forehead in a special method.  It is recommended in anxiety, depression, hypertension, insomnia etc.
KATIVASTI:   The oil is made to stay on the low back with the help of flour wall.  It is indicated in different backaches.
JANUVASTI:   Useful in arthritis of knee joint.  It is the variant of kativasti.  This is done on the knee joints.
NADISWEDA:   Useful in pain disorders of different sites.
ELAKIZHI:  Herbal leaves and herbal powders are applied to the whole body in bowls with hot medicated oils.  It makes body strong and sturdy with well developed musculature, removes sluggishness of excessive sleep, stiffness of joints, improves complexion, and increases appetite.  Useful in neurological ailments and in the management of different pains.
NJAVARA KIZHI:   The whole body or any part is made to perspire by the application of certain medical pudding tied up in cotton bag.  Good for joint pain, arthritic conditions, muscle weakness and certain skin diseases.  Useful in neurological ailments.
AKSHI-TARPANAM:  Useful in the ailments of eyes.
SHIROVASTI:   Certain lukewarm herbal oil are poured into a leather cap fitted on the head for 15 to 40 minutes. The treatment is highly effective for facial paralysis, severe headaches, migraine, epilepsy, lack of memory, sleep disturbances etc. Useful in hair fall and other diseases of skull.
UTTARA VASTI:   Useful in genitourinary diseases and infertility of female.
PIZHICHIL:   In this treatment, lukewarm herbal oils are poured all over the body in a special rhythmic way.  This is good for nervous disorders, efficacious in fractures, dislocation of joints, joint pain, and stiffness of limbs.
UDVARTANAM:   It is a medicated Ubtan to be applied over the skin for fair and glowing skin. This is a typical head & body massage with herbal powder for about 30-40 minutes. This is best treatment to relieve central obesity & helps in maintaining the figure according to desirable body proportion.
GREEVA VASTI:   Herbal paste ring made of black gram flour is applied over the shoulder – neck region in it Fresh herbal decoctions/medicated oils are poured, in this process specially prepared warm medicated oil is kept on the cervical region for 20 to 30 minutes. It provides good relief in chronic cervical spondylitis, spondylosis, and stretch in neck region, giddiness and vertigo.
UROVASTI:   Like kativasti, herbal medicated oil / ghrita (clarified butter for 20 minutes and it is good for vessel blockage of heart, angina pectoris, asthma etc.
AKSHI TARPAN:   This is a process where herbal medicated clarified butter is formed over eyes. Fresh black gram flour paste is applied around the eyes (as a type of bike / skiing spectacles this process is done with different herbal medication in certain eye diseases, refractive errors and to improve eye sight. This 3 months treatment package is also good for under eye circles and eye beauty.
MUKHA- ABHYANGA:   Beauty care treatment take care of pimples, wrinkles, sagging of the skin and falling of hairs by head massage, facial massage application of certain herbal / gold/ silver face gels and or / face packs.
AVAGAHAM:  This is a process of tub bath & tub medicated milk, 100% Ayurvedic perfumes, flowers and herbs are added to give a relaxing, expressing bath to achieve glowing of skin & add to beauty to all parts of body.


 DR.USHAKIRAN

5 comments:

  1. Namaste, don't You have any paper, magazin or mail-informations.

    Danielle
    e-mail: vivance99@gmail.com

    ReplyDelete
  2. I had ayurvedic treatment at santhigiri last fornight. Really a very good treatment. Herbal fragrance every where and spirituality every where. Really satisfied experience and treatment.

    ReplyDelete
  3. dear venkataramani,

    thanks for the comments. please follow the post treatment care inorder to get the maximum benefits of the treatment that u have done.

    get well soon....

    ReplyDelete
  4. Nice Blog, I think ayurvedic products is great helpful for our body and there is no harmful for our body and i recommended patanjali ayurvedic products online is more helpful for our basic life.

    ReplyDelete
  5. I went for spospondylis they charged 40k.no use.. Waste of ttim and money

    ReplyDelete