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  • THE HEADACHE

    Definition of the headache. Headache means the feeling of the pain or discomfort localized within the area over the eyebrows and up to the cervical-occipital area. The most frequent causes of the headache are considered: The intracranial infections: the meningitis, meningoencephalitis, thrombosis of sinuses of the dura mater, and also postherpetic neuralgia. The diseases of vessels: the subarachnoid hemorrhages, transient disturbances of the cerebral circulation, strokes, chronic failure of the cerebral circulation, hypertension, atherosclerosis, vasculitis, and collagenosis. The blood diseases: leukosis, polycythemia, syndrome of the increased blood viscosity. The injuries: the acute craniocerebral trauma, post-traumatic brain disease. The high intracranial pressure: the volume processes (the tumor, hematoma, or abscess), brain edema of different genesis. The low intracranial pressure: after punctures in the hypotension. The hypercapnia: the respiratory failure, sleeps apnea the sleep. The endocrine disorders: hypothyroidism, premenstrual syndrome, etc. The diseases of the eyes, ears, teeth, salivary glands, nasal sinuses, temporal-mandibular joint, cervical spine, bones of the skull, and main arteries of the head. The intoxications with: alcohol, carbon monoxide, nitroglycerin, antibacterial drugs (Rifampicin, Ethionamide, Cycloserine), Indomethacin, Biphenyl, Carbamazepine, and antidepressants. The pathogenesis of the headache. The mechanical, temperature, chemical factors take part in its formation. The most aggressive are the endogenous pain substances biogenic amines (histamine, serotonin), polypeptides (bradykinin), and ions of Na+ K+, and also prostaglandins. The specific mediator of the pain is the substance P. The substance P take the first place in mediation and modulation of the pain at the segmental and suprasegmental levels. Pathogenetic Classification of the Headaches . The following types of headaches: vascular tension liquor dynamic neuralgic mixed psychalgia The tension headache. Occurs in the tension or compression of muscles of the scalp and masseters. Intensifying of the neuromuscular excitation occurs in the sympathetic-adrenal activation appearing on the background of emotional stress. In development of the tension headache also the significant role is played by the segmental reflex mechanisms. The tension headache (TH). Is an independent nosological form. It is the most widespread form of the primary headache, which is manifested by the long bilateral gripped pain of moderate intensity, which often is associated with the tension of the pericranial muscles. There are the incidental (several times a month) and chronic (more than 15 times a month, including daily) pressing headache. The pain occurs at any time of day or night, lasts from several hours to several days. The diagnostic criteria of TH . The duration of the headache not less than 30 minutes; specific character of the headache (the feeling of head compression wrap, a bandage — 'neurasthenic helmet’); its low intensity. The pain is diffuse, bilateral, doesn’t increase during the physical load. The throbbing pain isn’t typical. The pressing headache is accompanied by nonsystemic dizziness, general weakness, and increased sensitivity to any stimuli. The nausea, vomiting, and vegetative disorders are not typical. The pain decreases or disappears after rest and psychological relaxation. The neuralgic pain (NP). It is the prosopalgia (the facial pain). The paroxysmal attacks of the pain occur; they last several seconds or minutes and appear one after another with small intervals. The pain is resembled to a blow of electric current (like a lightning). The trigger: zones or pain spots, which irritation provokes the paroxysm, are characteristic for the neuralgic pain. At the moment of the paroxysm the patient fades; he (she) is afraid once again to open the mouth, blink eyes, avoiding movements with the head. The combined headache. Occurs in the combined influence of two or more mechanisms. This case is most often observed. The psychogenic mechanism of the headache. Psychalgia becomes perceptible dysfunction of the central antinociceptive system owing to disturbance of the exchange c monoamines and endogenic opiates that leads to disturbances of the antinociceptive system. The clinical classification of the headache . The migraine. The tension headache. The cluster headache and chronic paroxysmal hemicranias. The primary headache of other genesis. The pain because of the injury of the head or neck. The headache because of a lesion of vessels of the brain and neck. The headache connected with the non-vascular intracranial disorders. The headache connected with the use of certain substances or their cancelation. The headache due to non-cerebral infections. The headache because of disturbance of the homeostasis. The head or facial pain due to the pathology of the skull, neck, eyes, ears, nose, nasal sinuses, teeth, mouth, or other facial or cranial structures. The headache because of the mental diseases. The cranial neuralgias and central causes of the facial pain. Other headaches, cranial neuralgias, the central and primary facial pain. First three forms are primary headaches. The primary headache . Is an independent nosological form, which includes the migraine, cluster headache, the chronic paroxysmal hemi-cephalgia, and the tension headache. In the secondary headache . Headache is the syndrome and need to prescribe the treatment of the main disease, which caused the pain. The treatment of the headache. The elimination of causes of the headaches. The vasomotor cephalgias - prescribe alpha- or beta-blockers (Pyroxan, Regelin, Sermion, Inderal, Atenolol, Propranolol), antagonists of calcium (Stugeron, Sibelium, Nimotop, Cinnarizine), and belloid preparation. In the venous cephalgias venotonics (Detralex, Phlebodia. Lysine escinat, Troxevasin, Anavenol) are used; in the intracranial hypertension they prescribe osmotic diuretics (Mannitol, Glycerol), saluretics (Furosemide, Hydrochlorothiazide), potassium-sparing diuretics (Verospiron, Diakarb, etc.). The dehydrational agents often are combined with venotonics. The treatment of the hypotension. Provides staying in bed. increased consumption of the salt, and drinking of much fluid. The pressing headache needs the reflex methods of the treatment (massage of the neck area, physiotherapeutic methods of influence), carrying out the psychotherapy, prescription of antidepressants, muscle relaxants (Mydocalm, Sirdalud, Baclofen, Myolastan). In the neuralgic pain preparations of Carbamazepine (Finlepsin, Carbamazepine), Gabapentin, Lamotrigine are prescribed. In the psychogenic headache they use the psychotherapeutic methods, tranquilizers, and antidepressants. THE MIGRAINE. Is the paroxysmal headache of the throbbing character, which occurs most often in one half of the head; rarer it may be bilateral, on intensity varies from moderate to sharp. The migraine attacks often are followed by the anorexia, sometimes nausea and vomiting. The headache duration on average fluctuates from 4 to 72 hours. From 12—15 % of population suffer from the migraine. The genetic predisposition to this pathology is traced mainly on the mother’s side. The etiology of migraine. Food rich in tyramine (cheese, red wine, cocoa, chocolate, smoked products, citrus, or nuts). Irregular meal, especially starvation. Psycho-emotional factors (emotional stress, depression, shock, frustration, and strong noise). Physical factors (intense work, physical load); meteor conditions (cold, wind, and drafts). Use of the hormonal contraceptives; menses. Clinical factors (high BP or temperature, toothache, and allergy) and so on. The pathogenesis of migraine. The significant role is played by the hereditary inferiority of the vegetovascular regulation in the form of instability of the tone of extra- and intracranial vessels. Disturbance of exchange of such biologically active agents as serotonin, catecholamines and estrogens, prostaglandins, kinins, histamine, substance-P, and vascular active peptides (vasointestinal peptide, calcitonin gene relating peptide). The most popular is the trigeminal-vascular theory: the activation of the trigeminal nerve leads to the release of potent vasodilator from its nerve endings; it causes the decrease in the vascular tone with further development of the aseptic neurogenic inflammation, in which there is the increase in permeability of the vascular wall, its swelling, and also inflammation of the dura mater and meninges of the brain. The aseptic inflammation provokes exaltation of afferent fibers of the trigeminal nerve, which anatomic features cause occurrence of the pain in a half of the head with the most frequent localization in the frontal-temporal-parietal area. Classification of migraine. There is the migraine without the aura (simple migraine) ; migraine with the aura (the associated migraine). The migraine with the aura is divided into: ophthalmic (classical). migraine with the prolonged aura. family hemiplegic migraine. Basilar. migraine with the aura without pain. migraine with the acute beginning of the aura. Ophthalmoplegic. Retinal. Children’s periodic syndromes, which may precede the migraine or are associated with it (the benign paroxysmal dizziness, alternating hemiplegia). The status migrainous and migrainous infarct of the brain belong to the complicated forms of the migraine. The clinical Picture of migraine attack. In most cases the migraine occurs without the aura. At the same time the headache attack and vomiting is observed. Quite often the attack is preceded by the prodromal stage, which is characterized by change of mood, nervousness, irritability, apathy, addiction to concrete food, especially sweet, frequent yawning, and depression of working capacity. This period lasts for several hours and is replaced by the headache, which is localized in the frontal-temporal-parietal area of one half of the head, has the throbbing character, gradually accrues with accession of vomiting at the pain height, and also with the photophobia and phonophobia. The migraine headache often increases at any physical activity, coughing, sneezing, climb the stairs, with the head tilts down, or in other situations promoting the high intracranial pressure. Some patients have the vegetative disturbances: the dyspnea, sweating, pain in the epigastric area, diarrhea, frequent urination, orthostatic hypotension, and dizziness. During an attack the patient tries to squeeze the head (makes a dressing with a towel), or goes to bed in the dark room. The “Aura” before the migraine attack. The retinal migraine is manifested by the transient blindness on one or both eyes in combination with the headache (the discirculation in the system of branches of the central artery of the retina of the eye). In the hemiplegic migraine the transient mono- or hemiparesis with the hemiparesthesia or hemihypesthesia are formed. The ophthalmoplegic migraine is the migraine, at which the headache is combined with the oculomotor disturbances, unilateral ptosis, or diplopia. In the basilar migraine the headache is followed by the tinnitus, dysarthria, and ataxia, paresthesia in the extremities, bilateral visual disorders, and dizziness. A short-term disturbance of consciousness is possible. Complications of the migraine. The status migrainous is the severe complication of the migraine. These are the migraine paroxysms occurring one after another, or one severe and long attack with repeated vomiting and possible development of the brain infarct. The migrainous infarct is characterized by the presence of the focal neurologic symptoms depending on localization. Diagnostics criteria of M. For the diagnostics of the migraine without the aura in the history that to be not less than 5 migraine attacks corresponding to the following criteria: the duration of the paroxysm is from 4 to 72 hours; mainly unilateral localization of the headache (alternating is possible: on the left, on the right); the throbbing nature of the headache, which increases at exercise stress; existence at least one of the attack symptoms nausea, vomiting, photophobia, and phonophobia. The treatment of the M. attack. The modem preparations (used for the treatment of an attack) are the selective agonists of serotonin (Sumatriptan, Zolmitriptan, Rizatriptan), Sumatriptan (Imitrex, imigran) is used orally 50—100 mg, or subcutaneously — 6 ml (if necessary, the dose is injected repeatedly in 2 hours), or in the form of the transdermal Migraine Patch (NP 101 — Zelrix). Zolmitriptan (Zornig), as a rule, is used at the beginning of the migraine attack, the optimal dose is 2.5—5 mg. In milder attacks they use acetylsalicylic acid and its derivatives in combination with caffeine-benzoate of sodium, non steroid anti-inflammatory drugs (Diclofenac potassium, Naproxen). The status migrainous. necessary to hospitalize the patient. Prescribe: Tramadol (tramal) 50—100 ml IV or Aspisol in a dose of 1000 mg IV in Bolus; Butorphanol (Morada, Stadol) 1 mg IV; Torecan, Neuleptil, Navoban, and Haloperidol (in the repeated vomiting); Seduxen — 0.5 % solution of 2—4 ml in 20 ml of 40 % solution of glucose is introduced IV; corticosteroids (Prednisone, Dexametha- zone — 8—12 mg per day), Furosemide, Dihydroergotamine; neuroleptics (Aminazine); Metoclopramide; antihistamines (Dimedrol, Suprastin, calcium gluconate) venotonics; The hemodilution due to dehydration.

  • MECHANICAL ASPHYXIA : Forensic Medical Examination

    In mechanical asphyxia the air-passages are blocked mechanically. In intravital development of Mechanical Asphyxia there are 2 periods lasting 5-7 minutes and known as pre-asphyxial period and asphyxial period. The preasphixyal period is a delay of breath. It is not asphyxia. A person without any harm to his/her health can delay breath during 10-15 seconds, but if the obstacle is not removed the next period develops. The asphyxial period has 5 stages: Stage of inspiratory dyspnea; Stage of expiratory dyspnea; Stage of relative rest (terminal pause); Stage of terminal breath; Terminal Stage. The duration of each stage can be from 1 to 3-5 minutes. In the beginning dyspnea has inspiratory character. In the clinical aspect, it is expressed by enhanced deep inspiration at which the organism tries to compensate lack of oxygen. Thus, the thorax sharply extends, which complicates transition of blood in arteries. Blood overfills the right half of heart and passes in venous system. Then the expiratory dyspnoea develops featured by expiration movements, increase of muscular weakness, cyanosis and swelling of the face; complete loss of consciousness, convulsions, involuntary discharge of faeces, urine and seminal fluid develop. In Stage III a short respiratory standstill due to depression of functions of the respiratory centre. Stage IV appears at the 4th or 5th minute when deep breath and pauses develop. Terminal breath is caused by depression of functions of the respiratory centre and weak stimulation of the spinal cord centres. Stage V (terminal) is complete respiratory standstill. Heart can function within 5- 30 minutes. Classification of Mechanical Asphyxia I. Asphyxia by compression: a.) Strangulation Asphyxia: Hanging; Ligature Strangulation; Strangulation by hands (extremities). b) Compressive Asphyxia External compression of the chest and abdomen interfering with respiratory movements. External compression of the chest External compression of the abdomen II. Asphyxia by closure: a) Obstructive Asphyxia: Closure of the external respiratory orifices, as in Smothering. Closure of the airways by the impaction of foreign bodies in the larynx or pharynx, as in Choking. b) Aspirative Asphyxia: By loose substances, by fluid, by blood, by vomitive masses, etc. Drowning III. Insufficiency of oxygen in the inspired air (in enclosed places, trapping in a disused refrigerator or trunk. It can happen at a placement of child or only his head in a plastic bag. Common (general) Asphyxial Signs External: Livores mortis is well developed. The face is often cyanosed and purple, and sometimes swollen and oedematous. The eyes are prominent, the conjunctivae are congested and the pupils are dilated. Petechial haemorrhages in the conjunctiva. They are most marked where for mechanical reasons, capillary congestion is most prominent. Their distribution lies above the level of obstruction. They appear commonly as a rash-like shower in the scalp, eyebrows and face in hanging and strangulation, and in the zone above the level of compression in traumatic asphyxia. They are produced by simple mechanical obstruction to the venous return of blood from the paits, resulting in acute rise in venous pressure and over-distension and rupture of thin-walled peripheral venules and capillaries, especially in lax unsupported tissues, such as the eyelids, forehead, and skin behind the ears, circumoral skin, conjunctivae and sclerae. Involuntary defecation, urination, discharge of seminal fluid, pushing mucus plug from the cervix — valuable but non-permanent signs. Internal: Dark liquid blood in the heart and large venous vessels. Venous congestion of inner organs. The large veins are full of blood. The postmortem fluidity of the blood is due to presence of fibrinolysins. Under certain conditions, the fibrinolysin may be so active that fibrin is destroyed as rapidly as it is produced, and post-mortem clots never develop in the vessels. In other cases, thrombi are formed, but they undergo lysis. Spleen anaemia. Overflow by blood of the right part of the heart and at the system of superior vena cava. Petechial sub-epicardial and subpleural haemorrhages. These are often referred to as Tardieu spots, after the French Police Surgeon who described them in 1866. Acute alveolar emphysema. SEPARATE KINDS OF A MECHANICAL ASPHYXIA Hanging Hanging is the form of asphyxia which is caused by suspension of the body by a ligature, which encircles the neck, the constricting force being the weight of the body. Ligature Mark The most important and specific sign of death from hanging is the Ligature Mark in the neck. It is imprint of a loop on the skin of the neck. The ligature produces a groove in the tissues, which is pale in colour, but it later becomes yellowish or yellow- brown, hard and parchment-like due to the drying of the slightly abraded skin. It is oblique, does not completely encircle the neck; usually seen at high up of the neck between the chin and larynx. In the typical case of a fixed loop, the mark is seen on both sides of the neck, and is directed obliquely upwards towards the position of the knot over the back of the neck. In partial hanging when the body leans forward, a horizontal ligature mark may be seen. The ligature mark usually encircles the entire neck, except for the place where the knot was located. The mark is situated above the level of thyroid cartilage. The width of the groove is about, or slightly less than width of the ligature. Ligature Strangulation Ligature Strangulation is that form of mechanical asphyxia, which is caused from constriction of the neck by a ligature or a part of other flexible object by their tension, a force of extraneous or own human arms or any mechanisms. At ligature strangulation on a corps we found the general (common) asphyxial signs and ligature mark. The ligature mark is situated at the level of thyroid cartilage or below, is almost horizontal, and encircles the neck completely. The mark may be absent on the any area due to the presence of clothing or long hair between the ligature and the skin. The character of the mark depends upon the nature of ligature but is also affected by the number of turns round the neck and length of time it remains applied. The pattern of the ligature may be imprinted on neck as a pressure abrasion (mirror image phenomenon) or bruise. If the ligature has gone round the skin more than once, corresponding number of marks, one above the other and close to each other are seen. In such cases, there may be evidence of skin bruising if it is caught between the rounds of ligature. There is always some damage to skin underneath the ligature. A careful search of the neck may reveal minute fibres or any other material from the ligature. The ligature should be examined for presence of blood, hair, or suspicious substances. Strangulation by Hand (Hands, Extremities) Asphyxia produced by compression of the neck by human hands is called Strangulation by hands, or extremities (syn.: Throttling, Manual Strangulation). The bruises are produced by the tips or the pads of the fingers. Their shape may be oval or round and of the size of the digits, but continued bleeding into the contused area usually increases the size. A grip from right hand from the front produces a thumb impression on the right side of the victim's neck, which is usually under the lower jaw over the cornu of thyroid. Several finger-marks are seen on the left side of the neck obliquely downwards and outwards, and one below the other, but sometimes are grouped together and cannot be distinguished separately. In a grip from behind the victim, the pressure is applied all round the neck, but some areas of bruising are more prominent due to the pressure of the fingertips. When both hands are used to compress the throat, the thumb-mark of one hand and the finger-marks of other hand are usually found on either side of the throat. Sometimes, both thumb-marks are found on one side and several finger-marks on the opposite side. A grip from both hands, one being applied to the front and the other to the back, produces bruises on the front and back of the neck. Due to the shifting of the grip, and sometimes the frank struggle of victim, bruises may be seen in a completely haphazard manner. If the fingertips are pressed deeply, the pressure of the nails produce crescentic marks on the skin. If a soft material is kept between the hand and throat, bruising may not be seen. Marks of struggle are similar to those found in strangulation. External Compression of the Chest and/or Abdominal Walls External compression of the chest and/or abdominal walls (Compressive Asphyxia) is a form of asphyxia resulting from external pressure on the chest, abdomen, or back, which prevents normal respiratory movements. Post-mortem signs In addition to signs of asphyxia, and mud or other foreign material on clothing as the case may be, there are three characteristic features: "ecchymosed mask", pulmonary carmine-red oedema, and line of demarcation. The mechanism of Compressive Asphyxia is as follows: The face and neck of the victim are deeply cyanosed-almost black, the eyes blood-shot, and numerous petechiae are found over scalp, face, neck, and shoulders ("ecchymosed mask") because compression of the chest displaces blood from the superior vena cava and subclavian veins into the veins and capillaries of the head and neck. No valves are present in superior vena cava because backpressure is normally not present in the venous system above the level of heart. Valves in subclavian veins prevent spread of the hydrostatic force set up in the blood column to the veins of upper limbs. The valveless veins and capillaries of the head and neck are therefore considerably engorged and the hydrostatic pressure in them rises so rapidly as to burst their walls. The level of compression is indicated by a well-defined line of demarcation between the discoloured upper portion of body and the lower normally coloured part. The tissue of the lungs on section is oedematous, shining, of carmine-red colour. In mild cases of traumatic asphyxia, injury to the lungs may be in the form of traumatic emphysema wherein the air in the lungs is forcibly redistributed producing small bullae along the edges of the lung. Depending on the mechanism of trauma, other injuries may be found in various other parts of the body (e.g., fracture of the ribs, which are usually bilateral, multiple). The cause of death is asphyxia, but not injury in this case. Obstruction of the Airways Smothering Smothering is a form of asphyxia which is caused by closing the external respiratory orifices either by the hand or by other means, or by blocking up the cavities of the nose and mouth by the introduction of a foreign substance, such as mud, paper, cloth, etc. Choking Choking is a form of asphyxia caused by an obstruction within the air-passages by a foreign object. Drowning Drowning is a form of asphyxial death in which access of air to the lungs is prevented by submersion of the body in fluid medium (typically the entire body). The liquid is most commonly water but drowning can occur in any liquid, e.g., beer, wine, gasoline, bitumen, dye, paint or some other chemical solution. It is necessary to distinguish 4 main types of drowning in water: aspirate, spastic (asphyxial),reflex (syncopal), mixed. Diagnostic Signs Foam in the airways: Externally a fine white froth or foam is seen exuding from the mouth and nostrils (Krushevsky's sign). The froth is sometimes tinged with blood producing a pinkish colour. If the foam is wiped away then pressure on the chest wall will cause more to exude from the nostrils and mouth. It is persistent and resists submersion for several days (up to a week in winter). The foam is also found in the trachea and main bronchi. The foam is a mixture of water, air, mucus and surfactant whipped up by respiratory efforts. Thus it is a vital phenomenon and indicates that the victim was alive at the time of submersion. Similar foam is found with severe pulmonary oedema from any cause such as drug overdose, congestive cardiac failure and head injuries. Emphysema aquosum ("emphyseme hydro-aerique"): The lungs in fresh water drowning are voluminous, bulky, ballooned, may completely cover the heart, and bulge out of the chest when the sternum is removed. They retain their shape and often show impressions of ribs upon them. Their surface is pale and they pit on pressure. On sectioning there is a flow of watery material. The appearances reflect active inspiration of air and water and cannot be reproduced by the passive flooding of the lungs with water. However the appearances are not generally distinguishable from pulmonary oedema. Contrary to expectations lung weights in fresh water drowning are not statistically different from lung weights in salt water drowning. The average lung weight is approximately 700 g with a standard deviation of approximately 200 g so that in a minority of cases the lungs are "dry". Larger ecchymoses are sometimes seen in the interlobar surfaces of the lower lobes (Rasskazov-Lucomsky-Paultauf's haemorrhages). Haemorrhages are the result of tears in the alveolar walls and this is the explanation for the occasional blood tinging of foam in the airways. Subpleural bullae, which may be haemorrhagic, are occasionally found. The lungs in salt water drowning are heavy and more markedly waterlogged. After the body has been in water for a few hours, these changes gradually disappear, and the difference in appearance of the lung in salt water drowning and fresh water drowning becomes far less clear. Tardieu spots are seldom seen. Water in stomach and intestine: The stomach often contains water that has been swallowed during the struggle for life. This may be salty or fresh, clean or dirty, and may even contain algae, weeds, mud or sand, varying according to the medium in which drowning has taken place. This is of value provided the deceased did not drink this water immediately before submersion and the body is not putrefied. This water, by peristaltic movement, may enter the small intestine and provide absolute proof of death from drowning, subject to the limitations mentioned above. In dead bodies thrown in wafer, it is not possible for water to get beyond the cardiac sphincter and into the stomach and intestine. However, when putrefaction sets in, cardiac and pyloric sphincters may relax and allow water with its contaminants to get into stomach and small intestine. This observation therefore has no significance in a putrefied body. Other signs: Edema of the gallbladder's bed, of the brain, increased transudation of liquid in serous cavities is marked. In the bladder the large volume of urine is marked. The microscopic appearance varies from being suggestive of drowning to entirely normal. Aspiration of large quantities of water results in over distension of the pulmonary alveoli (emphysema aquosum) the alveolar septae are thinned and stretched with narrowing and compression of the capillaries. The appearances resemble pulmonary emphysema.

  • 7 AUTHENTIC CHINESE STREET FOODS IN BEIJING

    Chinese foods are famous for their multiform colors, aromatic flavor, and unique excellent taste. Their daily meal consisting of fresh vegetables, fruits, grains, and meat. Traditional chinese foods are rice, noodles, and dumpling. Most of the foreigners loves Chinese cuisine. They spent their vacation in china, enjoying traditional Chinese foods. Food is an important part of daily life and most of them loves street foods. Its not bad to eat food from streets. Just go on and explore your life with no limits. Beijing is famous for Beijing signature noodles - Zha jiang mian Beijing roast duck - Peking duck BEIJING ZHA JIANG NOODLES - ZHA JIANG MIAN Chinese name : 闸江面 Ingredients : Plain noodles Sliced vegetables include cucumber, beansprouts, celery, radish, soybeans, carrot and cabbage Beijing Zha jiang noodle sauce made with pork chunks Location : Hutong alleyway street Eaten for Lunch Plain noodles, fresh vegetables and zha jiang sauce serves seperately. First mix the vegetables to plane noodles and then mix whole with zhajiang sauce. This secret sauze gives the dish backbone essential flavor. At the time of mixing, we can experience fantastic fragrance. BEIJING ROAST DUCK - PEKING DUCK Chinese name : 北京烤鸭 Ingredients : Sliced whole duck Served along with cucumber, melon, radish and pineapple. Sauce include Hawthorn made with chilli, Traditional sweet bean paste, and a fruit dip made with apples and smoked chillies. Pancakes Location : Old Beijing Hutong alleyway street. Eaten for Dinner Crispy thin skin of duck is sliced and served with vegetables and sauce. Also some pancakes also provides to wrap the sliced duck and vegetables. Eat this wrap with sauces. It had a massive juicy flavor. Also flavor had actually a slight sweet wasabi mustard like flavor to the sweet bean paste. FRIED PANCAKE - JIANBING Chinese name : 炸煎饼 Ingredients : Wheat flour pancakes, 2 eggs, sweet bean paste, green onion, cilantro, lettuce Hoisin and chilli paste Wonton chips. Location : Hutong alleyway street, Beixinqiao subway station Eaten for breakfast Jianbing is the Chinese crepes which are made up of soft pancakes. The wanton chips inside the pancakes makes it more crispy.The two eggs gives it strength and fresh flavors from green onion and coriander makes it a comfort dish. SIMPLE MILLET PORRIDGE - MIAN CHA PORRIDGE Chinese name : 面茶 Ingredients : Millets flour Sesame paste White and black sesame seeds. Location : Hutong alleyway street, Eaten for breakfast Mian cha is a thick porridge made from millet and rice flour, with salty sesame butter and rich in flavor. Overall taste is salty. BEIJING ORGAN PITA SOUP : LUZHU HUOSHAO Chinese name : 卤煮火烧 Ingredients : Soaked pita bread Smoky tofu Chopped intestines and lungs Rich organ broth. Location : Hutong alleyway street Eaten for both lunch and breakfast. The rich organ broth in luzhu huoshao has a great salty flavor. Eventhough it doesn't contains meat, the flavor is even better than meat. The intestines in soup is very chewy. Pita bread bread soaked in the broth made it softer and no more harder. CHINESE DUMPLINGS : JIAO ZI Chinese name : 饺子 Ingredients : Dumplings and meat fillings Eaten for lunch Dumplings consist of grounded meat and chopped vegetables wrapped in a thin dough sheet. When we take a bite and the taste of the mixture had enriched with flavor. BBQ SQUID Chinese name : 铁板鱿鱼 Ingredients : Grilled squid Eaten for Dinner BBQ squids are more familiar food in china. It had an ultimate flavor. They are salty, sweet, little bit tangy, Spicy and juicy. Flavor on BBQ dish is got deepened.

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