All posts by Dr Deepan

Dr DEEPAN P SHAH MD(HOMOEOPATHY) SPECIALISED HOMEOPATHIC PHYSICIAN AND SURGEON
HOMEOPATHIC TREATMENT, Infectious diseases

DENGUE

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DENGUE

Dengue is a disease caused by virus which is spread by Aedes mosquitoes which are usually white striped /dotted. They breed in clean water and usually bite during early morning and evening. Few cases have been reported where it has been spreaded by blood of infected person comming in contact of mucous membrane of healthcare worker.

The incubation period is 4-15 days. i.e the symptoms will appear after 4-15 days after being bitten by the infected mosquito.

There are 4 types of dengue viruses (Type 1 and type 3 are less severe compared to type 3 and type 4), so it is possible to be infected by dengue multiple times in a life time since at a time your body develops immunity only against the type you are infected with.

It is also known as “dandy fever” or “breakbone fever” as it causes severe joint pain and muscle pain.

Symptoms of Dengue

High fever with chills, headache (typically located behind the eyes), Joint pain , muscle pain, extreme pain in the lower back ,rashes, loss of appetite, extreme weakness, Thrombocytopenia (drop in platelets)

Often due to similarity of symptoms, it is difficult to distinguish between dengue and other diseases such as chikungunya, malaria , typhoid and influenza etc.

Dengue Fever can be classified in two types Uncomplicated Dengue Fever and Heamorrhagic Dengue Fever which may result into Dengue Heamorrhagic Shock and is a medical emergence and required immediate hospitalisation preferebly in an intensive care unit. Dengue Fever lasts for 5-7 days then there is a phase of udden drop in platelets for 2-3 days as its supposed that the antibodies driven against dengue virus also damages platelets and also there is suporession of bone marrow due to infection so the production of new platelets is arrested to certain extent for some period which causes severe fall in platelets , these 2-3 days post fever are very critical as patient seems to be out of fever but platelets falls drastically within,  the fall is severe bringing platelets down to sub 10k levels within a day or two and may progress into condition called Dengue Heamorrhagic Shock if there is external or internal heamorrhage as a result of damaged capillaries due to virus and extreme thrombocytopenia due to some ort of antibody driven immune response and suppressed marrow by virus.

A feeling of fatigue may last for weeks.

Diagnosis of Dengue

Drop in plateles count starts after 2-3 days from 1st day of fever and after last day of fever there severe drop causing thrombocytopenia.

LDH level may rise upto 1500 due to mild damages to liver.

In most cases where pt doesnt have any other disease condition in body the WBC starts increases only after 2-3 days from 1st day of fever when platelets starts falling

The Diagnosis can be confirmed by a blood test – Dengue NS1 antigen test, its positive only during first 2-5days of infection then indirect antibody test are used Dengue IgG and Dengue IgM if both these antibody are postive it indicates that person is infected second time with dengue virus. Every subsequent infection is more complicated then previous.

Treatment/Management of Dengue

There is no specific allopathic medicine available.

In homoeopathy certain medicines like Eupatorium Perfoliatum, Lachesis, Phosphorus are frequently used.

Treatment is based on symptomatic management of the patient

Drinking plenty of liquids – water , fruit juices, coconut water, Oral Rehydration Solution etc. and avoiding solid food or keeping it to minimum. atleast 3-4 liters of fluids should be consumed throughout the day, monitoring urine output and calculating fluid inpit is to output ratio and monitoring blood pressure.

Take enough rest.

Can take Paracetamol for reducing fever, Avoid other NSAIDS, avoid Aspirin for headache.

Its claimed that Papaya leaf juice/extract, Giloi, Kiwi fruit & dragon fruit helps in increasing platelet count but its role remains uncertain as per highly controled studies.

If platelets fall below 10000 and if there is active bleeding external or internal, then  Single Donor Platelets transfussion is required, otherwise platelets transfusion should b avoided as its observed that in many cases platelets transfussion has complicated the case.

If patient develops any kind of active bleeding or there is sudden drop in blood pressure or any symptoms of neurological origin its a medical emergency and can be fatal patient needs to b shifted to hospital with Intensive Care Unit and Blood Bank facility as it can lead to Dengue Heamorrhagic Shock and death.

Frequently it is accomoanied by malaria and it is a medical emergency as in such case platelets fall even faster and also there is loss of RBC due to malaria.

Many other conditions like autoimmune anaemia(Pernicious anaemia) and heamolytic conditions complicates the case and is a medical emergency as patient may require blood concerntrates and plateles transfussion.

Any other co-existing infection and ailments should be treated with its specific medication if required.

Though fall in platelets is thought to b due to immune response still use of corticosteroids is contradicted as its observed that it complicates the case.

If Menstrual bleeding appear during dengue there is no need to interfere or stop bleeding with help of medicines till the bleeding is not beyond average and vitals of patients are normal. wait for it to subside on its own and if it is prolonged beyond its normal course or there are other complications or vitals of patient are not normal it needs to be intervened.

Pt is considered out of risk if he has no fever for more than 4 days and also his platelets stops falling and increases 1.5 times of last reading and if there are no other comolications and his vital are normal.

Patient will feel weak for weeks after dengue and some patient will also have abdominal discomfort and loss of appetite and very mild swelling of extremities on dependent parts especially aroud ankle joint , it subsides on its own and if persists longer it may require medical attention.

Pt will require nutritious diet , enough of sleep for recovery after dengue. rest is recomended atleast for a week after dengue.

Prevention of Dengue

To avoid dengue protect yourself from the mosquitoes spreading them.
Keep your house and surroundings free of stagnant water where the Aedes mosquitoes generally breed.
Use mosquito repellent, use mosquito net while sleeping .
Wear full clothes.

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Air Purifying Indoor Plants

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AIR PURIFYING INDOOR PLANTS

We cant survive few minutes without Breathing, And the very basic and most essential substance of our survival Air is now not breathable due to air pollution created by population explosion, deforestation, industrialisation and civic development.

Recently in past decade with global surge in pollution levels as much as 20-40 times beyond acceptable limits; for certain extremely toxic pollutants in most cities; with Delhi as worlds most polluted megacity , with visibility not more than few feets, this is not only causing road accident pile-ups but also we have seen surge in deaths due to pollution, reduced life-span and poor quality of life due to ill health caused due to surge in Allergic Respiratory diseases , Allergic Skin diseases , Various Autoimmune diseases, Cancers , Hormonal Imbalances, PCOD and the list goes on.

But as we know trees are our best friends, so here they come for our rescue, luckily there are certain indoor plants which can efficiently takle situation and can bring down pollution and increase oxygen in the air thus making air more breathable effectively at our home.

According to study done at IIT-Kanpur, following 3 plants that require low and occasional sunlight and can efficiently absorb pollutants and release sufficient oxygen are and can grow almost in any region are easily availabe in India as well.

Money Plant, botanical name Epipremnum Aureum, its a creeper that can survive in low sunlight. Check the link for details of plant and its image  https://en.m.wikipedia.org/wiki/Epipremnum_aureum

Areca Palm also called Butterfly Palm, Botanical name Dypsis Lutes, it can survive indoor in low and required sunlight once in couple of months.Check the link for details of plant and its image  https://en.m.wikipedia.org/wiki/Dypsis_lutescens

Mother In Law Tug Plant also called Snake Plant, Botanical name Sansevieria Trifasciata, it can survive indoor in low and required sunlight once in couple of months. Check the link for details of plant and its image  https://en.m.wikipedia.org/wiki/Sansevieria_trifasciata

If 3 Erica Palm and 3 Snake Plant each 3 feet tall are planted in house supplimented with couple of short 3-6feet Money Plant creepers releases good quantity of oxygen and efficiently absorbs pollutants for a house of around 600 sqft with 4-5 members.

Dermatology, HOMEOPATHIC TREATMENT, Trichology

ALOPECIA AREATA

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Alopecia Areata is a systemic autoimmune disorder where autoantibodies are driven against anagen hair follicle.

Alopecia Areata Before treatment at Dr SHAH's Homoeopathy
Alopecia Areata Before treatment at Dr SHAH’s Homoeopathy
Alopecia Areata After treatment at Dr SHAH's Homoeopathy by Dr Deepan P Shah
Alopecia Areata After treatment at Dr SHAH’s Homoeopathy by Dr Deepan P Shah

PATHOHENESIS AND GENETICS OF ALOPECIA AREATA

Its thought to be systemic autoimmune disorder affecting anagen hairfollicle.Its T-cell mediated inflamatory non scarring condition. T-cell mediates inflamatory response around hair follicle which damages hair follicle.

Endogenous retinoids metabolic  disorder plays a major role in its pathogenesis.

Atleast 129 various SNP  are associated with this disease in genome.

Atleast 4 regions in genome are found to have these genes

Genes associated with this disease have functions of controlling the activation and proliferation of regulatory T cells, cytotoxic T-Lymphocyte-Associated Antigen 4, InterLeukin-2, InterLeukin-2 receptor A, and Eos, and HLA.

PRDX5 and STX17 genes expressed in the hair follicle are associated with Alopecia Areata.

It shares genetic risk with autoimmune conditions like Diabetes Mellitus Type 1, Rheumatoid Arthritis and may accompany each other.It may be the only manifestation of Celiac disease.

Cases with congenital Alopecia Areata are also noted.It has strong hereditary association.Its a non contagious disease.

SYMPTOMS AND CLASSIFICATION OF ALOPECIA AREATA

It presents itself with small well demarcated bald patches with seemingly healthy skin below, with no scarring on skin. It can affect any region that has hair but it usually involves , scalp and beard. The patches are usually circular but it can present in any shape and extent. The hairs on the border of bald patches are very easy to pluck off compared to other regions.

CLASSIFICATION OF ALOPECIA AREATA

  • Diffuse Alopecia Areata

    the baldness is diffused over whole scalp rather than in patches.

  • Alopecia Monolocularis

    bald patch is located only in one spot

  • Alopecia Areata Multilocularis

    many bald spots

  • Ophiasis

    hairloss at margins of hairline in waveforms

  • Alopecia Areata Barbae

    disease is limited only in beard region

  • Alopecia Areata Totalis

    complete hairloss of scalp

  • Alopecia Areata Universalis

    all hair of each and every region are lost.

DIAGNOSIS OF ALOPECIA AREATA

Trichoscopy shows evenly distributed hyperkeratotic plugs called yellow plugs, small shoots of hairs like exclamation marks, and destroyed hair follicles in follicular openings called black dots.

Biopsy

HOMEOPATHIC MEDICINES FOR ALOPECIA AREATA

SULPHUR

Sulphur is a general antisporic remedy. It is usually suited to lean, stoop shouldered patients. Sulphur is very well indicated remedy in case of Alopecia areata. Acting upon the external head, the itching is indescribable, constant itching worse from warmth of bed. Erruptions in general on the scalp. Severe loss of hair in patches. Dandruff with itense itching. Humid offensive erruptions with thick pus, yellow crust dry up into honey like scabs. Hair become dry, lustureless and fall off. Sulphur is a widely used remedy for almost every kind of itch.

LYCOPODIUM CLAVATUM

Lycopodium has a very deep and broad sphere of action. It is a remedy prepared from club moss. Lycopodium is useful in case of alopecia areata. Frequently used remedy in case of hair loss, premature greying of hair, premature baldness. Patient usually presents with patchy hair loss. Itching in the scalp due to dandruff or erruptions which are thick indurated. Complaints are usually worse from warmth and better by cold applications. Extremely sensitive patient with deep furrows on forehead.

KALIUM BICHROMICUM

Kali bichromicum is prepared by the potentisation of salt potassium bicarbonate. Kali bichromicum is a wonerful deep acting remedy having effects on multiple system of body. Patient usually presents with hairfall in spots. Dandruff with severe itching. Dandruff is yellowish in colour with formation of scabs. Scalp is infected with severe itching. Kali bichromicum helps in regeneration of hair growth.

PHOSPHOROUS

Phosphorous is well suited to young people who grow rapidly and are inclined to stoop. Phosporous indication in alopecia areata is very valuable. Phosphoorous works well in cases where falling of hair occurs in large bunches, leaving marked patches. Dandruff with sevre itching of scalp. Dry scalp and scaliness of scalp. Dry painful heat of scalp compellinh one to uncover head. Clammy perspiration on head only. Phosphorous helps in case of traction alopecia. There is receding hair line. Hairfall from forehead is prominent. Hence Phosphorous is very well indicated in frontal baldness too.

THUJA OCCIDENTALIS

Thuja is one of the indicated remedy in case of Alopecia areata. Patient usually complains of diffuse hair loss along with dandruff on scalp. Dandruff is generally thick and whitish in color with intolerable itching. Patchy hair loss. Handfull of hair come out while combing or washing hair. Single bald spots progress to form multiple spots. Hence thuja is very good remedy in such cases.

CALCAREA CARBONICUM

Calcarea carbonicum is the chief representative of calcium compounds. Great Hahnemanian antiporic. Chief action is centered in vegetative sphere. Calcarea carbonicum is one of the frequently used remedy for hairloss. Usually associated with intense itching of scalp. Marked feature is excessive perspiration of scalp or head which is so intense even wets the pillow. Head feels hot. Scratches head on waking. Hair falls in bunches. Scabs on the scalp. Painful sensitive roots of hair. Dandruff with milky crusts causes intense itching. Boils on scalp which tend to suppurate.

PULSATILLA NIGRICANS

Pulsatilla is pre eminently a female remedy especially suited to mild, gentle, yielding disposition. Very useful remedy in case of Alopecia areata. Hairfall in patches on combing hair. Purulent pustules on scalp with pain in the scalp. Itching on scalp mostly on temples and bwhind the ears. Dandruff white scaly with severe itching. Fetid and frequently cold perspiration on scalp with intense itching.

ARSENIC ALBUM

Arsenic album is a profoundly acting remedy on every organ and tissue. Arsennic album is one of the frequently indicated remedy for alopecia areata which usually appears as circular bald patches along with itching and burning of scalp. Sensitive scalp which it hes intolerably. The scalp is so sensitive that the patient cannot brush hair, seems as kfthe touch of comb or brush when rubbing over scalpwent into the brain. Circular patches of bald spots, rough, dirty, sensitive covered with dry scales. Hair greying at an early age, with severe hairfall.

 

 

Alopecia Areata Before Homeopathic Treatment
Alopecia Areata Before Homeopathic Treatment
Alopecia Areata During Homeopathic Treatment
Alopecia Areata During Homeopathic Treatment
Alopecia Areata After Homeopathic Treatment
Alopecia Areata After Homeopathic Treatment
HOMEOPATHIC TREATMENT

THE KILLER’s AGGRAVATION -Homoeopathic Medicines Can Kill You!

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Killer’s Aggravation – Homoeopathic Medicines Can Kill You

Killer’s Aggravation and Homoeopathic Medicines

Now a days we frequently see people buying homoeopathic medicines over the counter without doctors prescription, consodering it to be safe and can be consumed by anyone. Its surprising to see that even parent are buying these medicines for their new born kids.

Most of these medicines are patented mix of multiple medicines which is against homoeopathic principles, as homoeopathic medicines are meant to be taken only one medicine at a time.

Also they are proved by using very low standards of drug provings that too completely contradicting principles of homoeopathy as homoeopathy strictly doesnt allow use of multiple medicine at a time.

If it is single medicine one is consuming it doesnt allow frequent repetition of dose in same potency with exceptions, its a very highly skilled to decide at which potency and how many repetition does a patient require as it varies from person to person in similar conditions, most of the times only one dose is administered to cure the conditions, more of it only complicates the case most of the time.

One should be aware that homoeopathic medicines are effective only if they match the constitution and symptoms of the patient or else it may not act at all and the disease may keep on progressing making it worse on the other hand if the medicinines that are not selected by process for repertorisation for  indivudualisation ans similimum dosing and if taken too frequently unhomoeopathically then it produces a new artificial morbid condition in the body which can be so severe so as to cause gross pathological change in the body which may be irreversible damaging the body permenantly.

Its a myth that HOMOEOPATHIC MEDICINES does not have side effects!

The fact is , Its HOMOEOPATHY  that does not have side effects! But HOMOEOPATHIC MEDICINES if not taken in accordance with HOMOEOPATHIC PRINCIPLES as mentioned in HOMOEOPATHIC ORGANON of medicine then the recipient may have severe aggravations.

As mentioned in KENT’s 12 observations the very first point says “Prolonged aggravation with final decline of patient” also termed as KILLER’s Aggravation by practitioners , a FATAL CONDITION which we not too frequently encounter and is difficult to handle.

So be careful before self medicating or giving medicines to your kids, always consult a registered homoeopathic consultant first.

Genetic Disorders, HOMEOPATHIC TREATMENT, Orthopedic, Rheumatology

ANKYLOSING SPONDYLITIS

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ANKYLOSING SPONDYLITIS (AS) / MARIE’s Disease / BEKTEREV’s Disease is a Chronic Autoimmune or Autoinflamatory systemic disease which predominantly affects joints and bones of Spine and Pelvis

It falls under AXIAL SPONDYLOARTHRITIS Category.

CAUSES OF ANKYLOSING SPONDYLITIS

Causes are obscure, though Genetics Environmental Factors and Lifestyle in combination are believed to be involved in causation of Ankylosing Spondylitis (AS)

It falls under Sero-negative Systemic Rheumatic  disease where its believed to be mediated by Autoimmune or Autoinflamatory response.

Human Leucocyte Antigen HLA B27 subtypes B2701and B2759  are class I antigen encoded by B locus of Major Histocompatibility Complex (MHC) on Chromosome 6 and presents antigenic peptides (derived from self and non self antigens ) to T cells. HLA B27 is strongly associated  with Ankylosing Spondylitis as 90% of patient showing symptoms of Ankylosing Spondylitis has a genotype presenting it. and 2% of all having genotype expressing HLA B27 contracts Ankylosing Spondylosis.

PATHOGENESIS OF ANKYLOSING SPONDYLITIS

Pathogenesis of AS is still not clear and many factors associated with the pathophysiology directly or indirectly  have been identified

  • Human Leucocyte Antigen (HLA B27 subtypes B2701and B2759)  are class I antigen encoded by B locus of Major Histocompatibility Complex (MHC) on Chromosome 6 and presents antigenic peptides (derived from self and non self antigens ) to T cells. HLA B27 is strongly associated  with Ankylosing Spondylitis as 90% of patient showing symptoms of Ankylosing Spondylitis has a genotype presenting it. and 2% of all having genotype expressing HLA B27 contracts Ankylosing Spondylosis.Now this association with HLA B27 suggests possible link with  CD8 T cells though not proven to involve self antigen it might also be due to reactive arthritis following infection and the antigen might be derived from intracellular microorganism; HLA B27 has many unusual varied properties also it has ability to interact with CD4 so possible association of CD4 in AS is also a probability.
  • Tumour Necrosis Factor α   (TNF α) is found to b implicated in Ankylosing Spondylitis
  • Interleukine 1 (IL 1) is also associated in pathogenesis of Ankylosing Spondylitis
  • Anti-Neutrophil Cytoplasmic Antibodies (ANCAs) are associated with Ankylosing Spondylitis but is not indicator of severity of disease
  • Autoantibodies Specific to Ankylosing Spondylitis have not been identified
  • PTGER4 gene codes for prostaglandin EP4 receptor(EP4). which is associated with bone remodeling and deposition and is highly expressed in those sites of vertebral coloumn which are involved in Ankylosing Spondylitis . Single Neucleotide Polymorphism (SNP) of A/G variant rs10440635a close to the PTGER4 gene on human chromosome 5  possibly influences excessive production of EP4  which causes excessive bone remodelling and deposition in Ankylosing Spondylosis ; though this type of SNP and its association with increased rate of Ankylosing Spondylosis is found only in few ethnic groups

All these and other unknown factors contribute in pathogenesis of Ankylosing Spondylitis which typically results in Annulus Fibrosus Disci Intervertebralis (fibrous ring) of intervertebral disc to OSSIFY which results in the formation of marginal SYNDESMOPHYTES between adjoining vertebrae giving rise to BAMBOO SPINE type appearance of spine

SYMPTOMS AND DIAGNOSIS OF ANKYLOSING SPONDYLITIS

Genetic Testing For Ankylosing Spondylitis

HLA B27 is a non specific test For Ankylosing Spondylitis

As although 90% of those who have AS are HLA B27positive(50% in african-americans and 80% in mediterrenean)

But it has seen in many ethnic group ;esp north scandivanian;that Only 2 % of total HLA B27 positive have AS

Blood Test for Ankylosing Spondylitis

There are no specific Blood Tests Available for AS except for general inflamatory indicators like ESR and CRP which are elevated and tend to increase further on acute episode

Radiological Investigation For Ankylosing Spondylitis

There are no specific Blood Tests Available for AS So its diagnosed based on typical radiological changes but it takes 8-10 years for the disease to become evident enough to establish diagnosis neither CT or MRI can evaluate the disease in early stages

Typical radiological features are:-

  • Axial Spondyloarthritis
  • Early Xray changes include erosion and sclerosis of sacroilliac joints
  • in later stage that erosion increases resulting in pseudo-widening of joint space and Bony Ankylosis
  • squaring of vertebrae with spine ossification with fibrous band running longitudinally called syndesmophyte giving a bamboo spine appearance

Now in case where there are no evident radiological signs it becomes difficult to establish diagnosis as there are no specific blood tests for AS. In such cases clinical features signs symptoms and other non specific blood tests are conducted to evaluate the probability of AS; they are :

  1. Chronic backache with insidious onset before age of 40yrs which has peculiar modalities- Aggravates on rest ;at night and Ameliorates on moderate movement ;exercise ; after getting up from bed in morning
  2. History of inflamatory arthritis or tendinitis
  3. Family history of axial Spondylosis
  4. Positive HLA B27
  5. Responds well to NSAIDs
  6. Elevated ESR and CRP
  7. Other accompaning conditions like IBS Uveitis psoriasis
  8. Schober’s test is a clinical performed during physical exam which is measure of flexion of lumbar spine.

BATH ANKYLOSING SPONDYLITIS DISEASE ACTIVITY INDEX

BASDAI index score is an index which is based on multiple clinical radiological genetic and blood parameters which helps in establishing stage and diagnosis and determine type of management and treatment required

BATH ANKYLOSING SPONDYLITIS FUNCTIONAL INDEX

BASFI index to acess functional impairment

 

GAIT

HUNCHED POSTURE is a severe complication of AS resulting due to complete spinal fusion leading to increased spinal KYPHOSIS which results into forwar and downward shift of Center of Mass to compensate it the knee flexes and ankle dorsiflexes.Their gait has a cautious pattern as they have reduced shock absorbing ability and cant see horizon.

INDICATED HOMEOPATHIC MEDICINES FOR ANKYLOSING SPONDYLITIS

RHUS TOX

Rhus tox is the most common homoeopathic medicine which is very valuable in case of Ankylosing spondylitis, and is useful in various kinds of pains. Rhus tox affects the multiple systems of the body indcluding spine, joints, extremities, skin and mucus membrrane. Patient usually presents with stiffness of back associated with restlessness, is the key indication of this remedy. Pains are aggravated after a period of inactivity. There is marked stiffness, lameness, and pain in the lumbosacral area of back and hips to thighs. Rheumatic pains spread over a large surface area at the nape of neck, back, loins extremities. The small of back aches while sitting. Painfull stiffness on rising from seat. We are led to think of this remedy where we find an irresistible desire to move or change the position constantly. After
resting for a while, when he wakes up and takes a first move, a painful stiffness is felt.

CIMICIFUGA RACEMOSA

Cimicifuga racemosa is one of the indicated remedy for ankylosing spondylitis where there is marked stiffness in the neck area. The patient usually presents with excessive stiffness in the neck with severe pain. The neck muscles feel retracted, neck stiffness is worsened by cold air. The muscular and crampy pains are primilarily are of neurotic origin, occuring nearly in every part of the body. Pains of Cimicifuga are like that of electric shock, which come and go suddenly. Violent lightening type of pain in posterior spinal sclerosis, stiff neck from cold air. Sensitiveness of spine especially in cervical and upper dorsal region. Severe aching pain in lumbar and sacral region.

KALMIA LATIFOLIA

Kalmia is a great rheumatic remedy. Dr Hering introduced Kalmia into homeopathic practice, he himself and his friends being the first provers. Kalmia is one of tbe efficient remedy in ankylosing spondylosis cases where pain and stiffness are marked in lower back,lumbosacral region and neck area. The pains are accompanied with heat and burning in affected area. Pain is attended with excessive stiffness in neck. The pain from neck often radiates down the arms or scapula. Violent pains in the upper dorsal vertebrae. Constant pain in spine. Sensation as if spinal column would break with an anterior convexity and feeling of paralysis in saccrum.

GUAIACUM

Guaiacum is one of the Hahnemans antisporics, is one of the beat known remedies in rheumatism, gout, ankylosing spondylitis. There is Pressure on the vertebrae of the neck. Stiffness in the back, extending from neck to small of back and saccrum, intolearable on slightest motion. Indicated when there are contractive pains between the scapulae. Stiffness from neck may extend to shoulder blades and its painful. All pains are aggravated from motion and heat and relieved during rest.

KALI CARBONICUM

Kali carbonicum is very useful in deep seated diseases lime Ankylosing spondylosis. Kali carb patient presents with severe back pain with stiffness. Small of back feels weak. There is marked Stiffeness and paralytic feeling in the back. Marked indication of kali carb is severe backache during pregnancy and after miscarriage. Burning in the spine. Lumbago with sudden, sharp pains extending up and down of back to thighs. Weakness caused by all potassium salts is more pronounced in this typical salt of potassium
group. Sharp stitching, stabbing pain felt in various parts of the body. Severe backache must lie down for relief.

AESCULUS HIPPOCASTANUM

Aesculus is one of the indicated remedy in ankylosing spondylitis. The main feature of Aesculus is matked pain in lumbosacral area of the back and hips with extreme stiffness. Pain from back radiates to thighs. Lameness in neck. Aching pain between the ahoulder blades, region of spine feels weak. Backache affecting saccrum and hips worse walking or stooping. When walking feet turn under. Rising from seat seems difficult, has to make repeated efforts. Severe pain in lumbosacral region making movement impossible.

SILICEA

Silicea is a very valuable remedy in case of spondylitis. The action of silicea is slow. In the proving it takes long time to develop symptoms. It is therefore suited to complaints which develop slowly. Presents with ankylosing spondylitis with stiffness in nape of neck with severe headache. Coccyx painful as after a long carriage ride. Weakness and paralytic stiffness in back, loins and nape of neck. Swelling and distortion of spine.Aching, shooting, burning and throbbing pain in lumbosacral region with contussive pain between shoulder blades.

COLOCYNTH

Colocynth has a long lasting action on the spine and nerves. The main feature of colocynth is severe pain in the back which finally settes down on the upper part of thigh and buttock. Pain usually confines to small spot making the patient limp and finally becomes so severe that he can neither stand nor walk. Severe burning pain along the saccrum, cramps in hip. Feels better by doubling up, hard pressure and warmth.

CONIUM MACULATUM

Conium maculatum is deep acting antisporic remedy, its action disturbs almost all the tissues of the body. Very well indicated in ankylosing spondylitis of back, weakness is the most striking feature with dorsal pains. Effects of bruises and shocks to spine. After injuries especially in lumbar region. Severe rheumatic pains. The pains are relievex by putting feet on chair. Pain between the shoulder blades. Dull aching pain in lumbar and sacral region.

CALCAREA PHOSPHORICUM

Calcarea phos is a great tissue remedy, though it resembles calcarea carb in many aspects but has its own characteristic symptoms. The spher of phosphate of lime includes all bone diseases whether due to some inherited dyscrasia or defective nutrition in osseous and other structures. It is.a bone salt.without this element no bone is formed, hence it is a valuable remedy. Patient usually presents with weakness of spine, there is curvature of spine towards left , lumbar vertebrae bent towards left. Soreness in sacro iliac symphysis. Rheumatic pains from draught of air with stiffness of neck and back.

HOMEOPATHIC TREATMENT, Orthopedic, Rheumatology

ARTHRITIS

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Arthritis is a term derived from “ARTHRON” means Joint and “ITIS” means Inflamation

Inflamation of joint and surrounding tissue is called ARTHRITIS

Its a general term used to describe pain swelling of joint and its surrounding tissue.

When one joint is involved its called Monoarthritis and when more than one joints are involved its called Polyarthritis

Different types of arthritis have different causative factors like

  • Mechanical
  • Immunological
  • Metabolical
  • Spetic
  • Genetics
  • Lifestyle and Evironmental factors

Though each factor has contribution in certain degree in every type of arthritis; Still it can broadly be classified into 4 major category based on the predominant factor responsible for their Pathophysiolohy/Pathogenesis :

  • Mechanically mediated type
  • Immunological mediated type
  • Metabolical mediated type
  • Spetic

With Genetics Lifestyle and Environment as Contributory factors in each type.

Further various major subtypes are described in detail in following link:

1)OSTEOARTHRITIS
2)RHEUMATOID ARTHRITIS
3)GOUT
4)ANKYLOSINS SPONDYLOSIS

HOMOEOPATHIC MEDICINES and MANAGEMENT OF ARTHRITIS

Homoeopathic Arthritis Management depends on individualisation of the patient based on present symptoms, past history, family history and constitution of the patient.

In arthritis cases it is necessary to take into account the following points (with constant search for underlying miasm and constitution type):

  • When it started, that is since how long its been there.
  • How was the onset when it appeared first time.
  • Wether the complaints had incidious progression or it was sudden.
  • Which joint is involved, wether its single joint or multiple, wether its bilateral and symetrical or diagonal.
  • Particulars like which part was affected first, which side it started first and how much time it took for progression to other side or other joints, sequence in which joints were involved.
  • How and when it gets triggered, aggravation pattern morning stiffness , aggravation on rest/ motion, relation to climate winter/monsoon/summer, relation to heat and cold, aggravation to any particular type of food.
  • Wether its constant or intermittant.
  • The joint is warmer than rest of the body or not.
  • Wether there is swelling around the joint or not.
  • Nodes or nodosities on or around any joints. or any other signs of disfigurement.
  • Movement or other disability in joint.
  • Patient has fever or not or h/o fever before or during the episode of joint pain started.
  • Presence of any concomittants or accompanying symptoms and wether those symptoms are of Psychotic, Syphilitic or Psoric nature.
  • Wether he has any other systemic complaint especially any other autoimmune or metabolic disorder.
  • History of injury, surgery especially affecting neurons or musculoskeletal structure.
  • Nature of work the patient does , postural habits, structural anomalies disfigurements.
  • Diet sleep and exercise routine water intake should also be noted carefully.
  • It is important to note family history of patient wether first degree relative had any autoimmune or metabolic disorder.
  • Wether patient was or is under any long term medication.

A careful history of all communicable ailments should be recorded in sequence as they had been contracted by patient, as it helps us evaluate when and how was the vital force deranged in past and wether the present condition is manifestation of some past ailment, that is any deep seated miasm, also it helps to establish wether its some inherited genetic condition or its acquired condition also it helps differentiate  between

  1. Vector borne conditions like post viral arthralgia/arthritis  and Group A streptococcal borne post pharyngitis systemic autoimmune condition AND
  2. Other Systemic autoimmune conditions like Rheumatoid Arthritis SLE psoriatic arthritis.

These basic question will lead you towards a broader vision in the case and will let you reach upto some conclusion that under what category of arthritis it should be classified and will lead you towards some understanding of miasm and constitution.

As I have mentioned in my other arthritis articles that basically I divide all types of arthritis into four major categories based on their pathogenesis.

  1. Mechanical
  2. Immunological
  3. Metabolic
  4. Septic

After being diagnosed and classified the disease condition from one of the above group we can go further on how to manage each type of case.

Immunologically mediated

Once established that its an immune mediated arthritis its necessary to rule out any damage to other organs like heart, liver, kidney, pancreas, eyes etc, as in most cases autoimmune arthritis is found to involve other system and organs or it is a part of broader systemic autoimmune condition and it is all the more necessary to find out miasmatic background, constitution and individualising symptoms, as such types of arthritis are deep seated having its own sets of aggravating and ammeliorating factors, furthermore its also observed that mental stress and emotional fluctuations have much impact on intensity and frequency of aggravations in almost all types of immunologically mediated arthritis, so its of utmost importance to take proper account of patient’s mental emotional past and present including likes and dislikes aversion and cravings, which helps us to individualise the case.

Once the we have derived constitution , miasmatic background and individuslised the case then comes medicine selection process,

I strongly recomend to go by constitution of patient in immunologically mediated arthritis rather than going theraputic remedy selection.

and it should be kept in mind that the selection procedure of medicine should correspond to degree of mental PQRS , degree of systemic PQRS and degree of musculo-skelatal symptoms of the person in disease should match the degree of pathogenic action on various sphere of the specific medicine.

Though during acute exacerbations of disease it becomes necessary many a times to administer short acting acute medicines theraputically where the new symptoms desnt fall into sphere of the constitutional medicine thats been administered.

Many a times only a single dose of similimum medicine selected may suffice to cure the case  but all patients are not the same each has a different constitution and miasmatic background and severity of ailment and other  external inimical factors, so in many cases it may take series of medicines one by one as per case demands during progression of treatment before the case is cured. It all depends upon how well the physician is able to find out the similimum and type of case and its requirement.

Mechanical

Under mechanical type of arthritis falls osteoarthritis and other types of arthritis caused due to mechanical injuries in such types the case is usually tale tale and shows basic picture of mechanical wear n tear which might be due to poor constitution inherited or might be acquired later on due to external inimical reasons.

In such cases it is necessary to consider that basically the constitution is lacking the capability to repair regenerate and maintain proper quality of joint cartilage and underlying bone and has tendency towards chronic sub-acute inflamation. in such cases it is important to take complete history of patient and family with details of gestational period and individulisation based on Peculiars should be derived forindividualised  remedy selection for complete annihilation of condition;  if not done so the patient might find relief for time being but the symptoms might keep relapsing with time again and again.

In many cases the repair and regeneration mechanisms are sufficient but mechanical wear and tear are in greater proportion and on regular basis so damage tends to accumulate, in such cases there is not much need to go deep into deriving constitution and treatment approach should aim towards elimination of maintaining cause that is excessive mechanical wear and tear and suppliment with nutritious diet and rest to affected part and symptomatic homoeopathic medicines based on theraputics will also work well.

Metabolic

Again this type of arthritis is a deep seated genetic in nature and they might accompany other metabolic syndromes and requires a careful case taking to get a broader picture of the person in disease, all aother systems and organs should be evaluated to understand sphere of disease pathology its extent and severity so it helps us to select the most similimum homoeopathic remedy.

The approach in such cases again remains constitutional , miasmatic and remedy should be selected only after proper individualisation of case and repertorisation.

Septic

In septic arthritis pt needs to be administered short acting acute remedies theraputically with support of deep acting constitutional remedy which can be administered intermittently or after the acute symptoms are ammeliorated to rearrange the deranged vital force.

Commonly Used Homoeopathic Medicines for Arthritis and its symptoms and indications:

RHUS TOXICODENDRON Usefull in almost all types of joint and musculoskeletal complaints where the symptom call for the medicine like stiffness of joints aggravatedon rest and ammeleorated on motion in any ailment involving musculoskeletal system,  rheumatic joint affections, sprain and injury on joints etc

ARNICA MONTANA blunt injury and trauma, sore lame bruised sensation with swelling concussion and contusion call for this remedy

ACTEA SPICATA Pain stiffness and swelling of small joints especially of hands , good remedy for post viral arthralgia like in chickengyunya where small joints are involved

BRYONIA ALBA Stiffness and pain with hot swelling, redness of joints with stitching and tearing pain aggravation on least motion every spot is painful on slightest pressure

LEDUM PALUSTURE Gouty arthritis involving small joints of extremities, hot swollen joints with throbbing pain, gouty nodosities, pain in ball of great toe, podagra, swollen ankles and painful soles, aggravation on warmth of bed , rheumatism starting from lower extremities and ascending upwards. right side more involved compared to left.

HYPERICUM PERFOLIATUM  Degenerative changes of joints involving nerves, sciatica, coccygodynia, cervical and lumbarspondylosis with nerve compression, tingling burning and numb sensation with lancinating pain calls for the remedy, darting pain of shoulders , cramps in calf muscles, pain in tips of toes and fingers, sensation of pressure along the ulnar side if arm.

PLANTAGO MAJOR helps relieve bony snd neuralgic pain in arthritis

BELLIS PERENIS Soreness lameness of joints and muscles, rheumatic joint affections, sciatica where pain radiates down the anterior portion of thigh, sensation as if elastic band is tied around wrist feeling of contration of wrist joint, Railway spine,  sprain and bruises of joints and muscles, good remedy where varicose veins complicate case of arthritis or both are coexisting in any patient.

ACTEA RACEMOSA Rheumatism affecting intercostal region back and neck, cervical spondylosis caising nerve compression and electric shock like shooting pain comes suddenly reaches peak and goes suddenly, stiffness and pain in tendo-achilles. sensation of heaviness in lower extremities, heavy aching tensive pain with twitching and jerking of limbs.

APIS MELIFICA swelling of joint with synovitis and synovial effusion, spetic arthritis, red hot swollen joint , pain on sloghtest pressure or motion, gout , rheumatoid arthritis , post viral arthritis and arthralgia

CALCAREA CARBONICA osteoarthritis, degenarative changes in any joint , osteomalacia or osteoporosis causing joint degeneration, open sutures and fontanale in children, rickets , kyphosis and other loss of normal curvatures of spine, pigeon chest, fractures injuries of bones and joints

COLCHICUM Gouty arthritis , increased Serum Uric acid and tophus formation in joints. typical pain in great toe aggravated at night, sudden gripping cutting pain with much burning comes at night waking patient up from sleep

CALCAREA PHOSPHORICA osteoarthritis due to calcium deficiency , musculoskeletal complaints of old age, developmental musculoskeletal anomaly of growing children, fractures injuries of bones and joints.

BELLADONNA red hot inflamed joint with much pain and swelling

ACONITUM NAPELLUS Acute onset of pain and swelling , can be used in first 24hours or first stage of any acute inflamatory condition with severe mental restlessness fear fright and anxiety.

CALCAREA FLOURICA

NATRUM SULPH a very good remedy for gouty diathesis.

SILICEA

PHOSPHORUS

PHOSPHORIC ACID

TUBERCULINUM

MEDHORRHINUM

SYPHILLINUM

RUTA GRAVEOLANS

GULTHERIA PROCUMBENS

THUJA OCCIDENTALIS

HEKLA LAVA

HOMEOPATHIC TREATMENT, Orthopedic

OSTEOARTHRITIS

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Osteoarthritis is a degenerative joint disease.

Caused due to mechanical stress and covert low grade inflamatory process.

Due to excessive mechanical stress there is increased in demand from factors responsible for repair mechanism. Initially this repair mechanism repairs as it normally should but then it becomes insufficient to repair with same mechanism so it starts compensatory mechanism where in, it tries to maintain structural aspect but at cost of quality of structural components which again due to its inferior quality gets damaged soon further due to prolonged regular mechanical stress these damages gets accumulated even further and now even compensatory mechanism fails to keep up with the amount of damage that’s been done , this starts erosion of the cartilage and the underlying bone and there is general degeneration of joint.

WHAT ARE THE RISK AND CAUSATIVE FACTORS FACTORS OF OSTEOARTHRITIS?

  • Mechanical injury like trauma causing damage to joint or any of its component useful in maintaining strenght structure gait and support to joint.
  • Mechanical stress due to different length of either legs
  • Mechanical stress due to neurological muscular disorder of muscles supporting that particular joint
  • Those who never had habit of running or jogging during their childhood or young age if suddenly starts running in excess on later age, or running along with an injury cuases severe mechanical wear and tear injury to joint.
  • Abnormal body gait and habitual abnormal postures
  • Genetics and hereditary
  • Hormone levels especially sex hormones
  • Metabolic syndrome and obesity( debated as its not the weight thats causing mechanical damage but rather its fats thats responsible to cause metabolic disorder contributing to osteorthritis)
  • Diet and Lifestyle
  • Prolonged regular mechanical stress and insufficient self repair causing accumulation of damages and later resulting into prolonged inflamation causes osteoarthritis.
  • Prevailing condition in body like Osteoporosis, metabolic disorders, autoimmune diseases, joint infections, congenital joint anomaly, certain syndromes like marfan syndrome, elher danlos syndrome, inflamatory diseases like lyme’s disease perthe’s disease

PATHOGENESIS OF OSTEOARTHRITIS

Chondrocytes are responsible to maintain elastic and tensile strength of cartilage by producing collagen and extracellular matrix which maintains hydration by compressive force driving water out and hydrostatic and osmotic pressure drawing water in.

Constant damage to cartilage puts extra load on chondrocytes ;if they aren’t able to repair the damage by producing sufficient collagen and extracellular matrix ; then they start producing different type of collagen just to maintain the structure as far as possible but then this collagen has a different character of retaining more water then the former which spoils the elastic and tensile strength of cartilage as a whole. This further damages the cartilage to the point where it starts disintegrating and shedding off in synovial space which puts extra load on synovium to clear it off for which synoviocytes triggers inflamatory response and synovitis and general mild inflamatory process in joint which gets prolonged due to constant mehanical stress and accumulated damages and finally inflamatory products accumulates damaging joint even further eroding cartillage and bone causing fibrillations and also reduced bone mineral density at site is observed (causation is in debate); finally there is general degeneration of joint leading to pain inflamation and loss of regular function of the affected joint.

WHAT ARE SYMPTOMS OF OSTEOARTHRITIS?

  • Low grade inflamation and degeneration causes pain due to which there may be loss of range of movement of a joint along its axis in varing degrees from mild to severe.
  • This loss of ability of movement further causes dysuse atrophy of muscles related to that particular joint and due to degenerative changes the joint becomes wider which gives typical lean muscle and wide joint looks, like in the Heberden’s Nodes and Bouchard’s Nodes in fingers
  • Osteoarthritis particularly involves weight bearing joint and joints more prone to mechanical stress like knee joint; lumbar spine cervical spine hip joint joints of fingers and less commonly other joints like ankle joint shoulder joint etc
  • It may present in one joint or in multiple joints at a time.
  • Exertion and motion aggravates the complaints and rest ameliorates the complaints.
  • Morning stiffness of affected joint is present in majority cases  though not a specific symptom.
  • Aggravation in cold climate, high humidity,  low atmospheric pressure is seen in many cases tough not consistent every-time.
  • Crepitation on movement or pressure are observed in affected joint.
  • Surrounding muscle spasms and when vertebral bodies are affected the spinal nerve corresponding to it may get compressed leading to spasms paraesthesia myalgia and cramps to correrponding musscle the affected nerve supplies.
  • Joint effusion, especially of knee joint are see not too infrequently.

DIAGNOSIS OF OSTEOARTHRITIS

In most cases sufficient clinical evidence supports the diagnosis but an X ray is required not only to reconfirm diagnosis but also to evaluate to amount of damage within as pain and other clinical symptoms are not indicator of the amount of damage within; in many cases we may also need to exclude other conditions for which further related investigations should be done.

HOMOEOPATHIC MANAGEMENT OF OSTEOARTHRITIS

Once its established that the patient is suffering from osteoarthritis the homoeopathic management of the case will be as follows

As per my classification criteria Osteoarthritis falls under Mechanically mediated type of arthritis

Under mechanical type of arthritis falls osteoarthritis and other types of arthritis caused due to mechanical injuries in such types the case is usually tale tale and shows basic picture of mechanical wear n tear which might be due to poor constitution inherited or might be acquired later on due to external inimical reasons.

In such cases it is necessary to consider that basically the constitution is lacking the capability to repair regenerate and maintain proper quality of joint cartilage and underlying bone and has tendency towards chronic sub-acute inflamation. in such cases it is important to take complete history of patient and family with details of gestational period and individulisation based on Peculiars should be derived forindividualised  remedy selection for complete annihilation of condition;  if not done so the patient might find relief for time being but the symptoms might keep relapsing with time again and again.

In many cases the repair and regeneration mechanisms are sufficient but mechanical wear and tear are in greater proportion and on regular basis so damage tends to accumulate, in such cases there is not much need to go deep into deriving constitution and treatment approach should aim towards elimination of maintaining cause that is excessive mechanical wear and tear and suppliment with nutritious diet and rest to affected part and symptomatic homoeopathic medicines based on theraputics will also work well.

Homoeopathic Medicines for Arthritis with its symptoms and indications:

  • RHUS TOXICODENDRON usfull in almost all types of joint and musculoskeletal complaints where the symptom call for the medicine like stiffness of joints aggravatedon rest and ammeleorated on motion in any ailment involving musculoskeletal system,  rheumatic joint affections, sprain and injury on joints etc
  • ARNICA MONTANA blunt injury and trauma, sore lame bruised sensation with swelling concussion and contusion call for this remedy
  • ACTEA SPICATA pain stiffness and swelling of small joints especially of hands , good remedy for post viral arthralgia like in chickengyunya where small joints are involved
  • BRYONIA stiffness and pain with hot swelling, redness of joints with stitching and tearing pain aggravation on least motion every spot is painful on slightest pressure
  • LEDUM PAL gouty arthritis involving small joints of extremities, hot swollen joints with throbbing pain, gouty nodosities, pain in ball of great toe, podagra, swollen ankles and painful soles, aggravation on warmth of bed , rheumatism starting from lower extremities and ascending upwards. right side more involved compared to left.
  • HYPERICUM PERFOLIATUM degenerative changes of joints involving nerves, sciatica, coccygodynia, cervical and lumbarspondylosis with nerve compression, tingling burning and numb sensation with lancinating pain calls for the remedy, darting pain of shoulders , cramps in calf muscles, pain in tips of toes and fingers, sensation of pressure along the ulnar side if arm.
  • PLANTAGO MAJOR helps relieve bony snd neuralgic pain in arthritis
  • BELLIS PERENIS soreness lameness of joints and muscles, rheumatic joint affections, sciatica where pain radiates down the anterior portion of thigh, sensation as if elastic band is tied around wrist feeling of contration of wrist joint, Railway spine,  sprain and bruises of joints and muscles, good remedy where varicose veins complicate case of arthritis or both are coexisting in any patient.
  • ACTEA RACEMOSA Rheumatism affecting intercostal region back and neck, cervical spondylosis caising nerve compression and electric shock like shooting pain comes suddenly reaches peak and goes suddenly, stiffness and pain in tendo-achilles. sensation of heaviness in lower extremities, heavy aching tensive pain with twitching and jerking of limbs.
  • APIS MELIFICA swelling of joint with synovitis and synovial effusion, spetic arthritis, red hot swollen joint , pain on sloghtest pressure or motion, gout , rheumatoid arthritis , post viral arthritis and arthralgia
  • CALCAREA CARBONICA osteoarthritis, degenarative changes in any joint , osteomalacia or osteoporosis causing joint degeneration, open sutures and fontanale in children, rickets , kyphosis and other loss of normal curvatures of spine, pigeon chest, fractures injuries of bones and joints
  • CALCAREA PHOSPHORICA osteoarthritis due to calcium deficiency , musculoskeletal complaints of old age, developmental musculoskeletal anomaly of growing children, fractures injuries of bones and joints.
  • BELLADONNA red hot inflamed joint with much pain and swelling
  • ACONITUM NAPELLUS Acute onset of pain and swelling , can be used in first 24hours or first stage of any acute inflamatory condition with severe mental restlessness fear fright and anxiety.

For understanding of arthritis in general, its case-taking and homoeopathic management   visit following link

http://atomictherapy.org/homoeopathic-arthritis-management/

Gastroentrology, HOMEOPATHIC TREATMENT

ACHLORHYDRIA or HYPOCHLORHYDRIA

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WHAT IS ACHLORHYDRIA OR HPOCHLORHDRIA?

Achlorhydria or hypochlorhydria is a condition where stomach and other digestive organs stops or has reduced secretion respectively of hydrochloric acid

CAUSES OF HYPOCHLORHYDRIA / ACHLORHYDRIA

It usually is secondary to a primary condition like  bacterial overgrowth like helicobacter pylori etc which neutralizes HCl; Gastro-intestinal Metaplasia; Atrophic Gastristis; Reducing Basal Metabolic Rate (BMR); autoimmune conditions where there are autoantibodies formed against gastric parietal cells that produces Gastric Acid ; frequent long-term use of antacids like H2 receptor antagonist or Proton pump inhibitors; mucolipidosis type IV, procedures like Gastric Bypass  Duodenal switch RNY; Islet Cells tumors like  VIPomas ( Vasoactive intestinal peptides) and Somatostatinomas; Pellagra(niacin deficiency), Pernicious anemia, deficiency of mineral and electrolytes required to produce sufficient Gastric acid like sodium chloride potassium zinc iodine etc.

So its a vicious cycle where pre-existing condition causes achlorhydria and achlorhydria further aggravates that primary cause.

SIGNS AND SYMPTOMS OF ACHLORHYDRIA OR HPOCHLORHDRIA

So along with symptoms of primary disease it will also show Gastro-Oesophageal Reflux Disease, anorexia, Early satiety while eating , weight loss, abdominal discomfort , sensation of fullness and distention of abdomen, frequent diarrhea and constipation, iron deficiency anemia due to lack of HCl, pernicious nemia due to lack of Vit B12 and many other deficiencies like that of vitamin B complex, vitamin k, vitamin C and other micronutrients minerals like magnesium sodium chloride potassium zinc etc; causes many neuro-muscular disorders like general weakness esp. lower limbs with myalgia paraesthesia ataxia and gait disorders ;also psychological disorders like weak memory, mood disorders personality disorders, hallucinations etc. these patients are prone to infection of Vibrio Vulnificus and other usually uncommon infections of organisms found in food ( more commonly from seafood); all these complaints and many other collectively may prove fatal.

DIAGNOSIS OF ACHLORHYDRIA OR HYPOCHLORHDRIA

  • Oesophageal pH monitoring giving 24-hour profile of gastric acid Secretion
  • Gastric pH at endoscopy
  • Extreme low levels of pepsinogen A(PgA) < 17ug/l in blood serum and  high serum Gastrin Level >500-1000pg/ml supports the diagnosis
  • Heidelberg test is an alternate test.
  • Many other tests like Serum iron, serum calcium, Vit B12, Vit D, Thaimin, CBC tests for various forms of anemia elevation in serum folate level s/o small bowel bacterial growth etc  can help to exclude associated conditions.
  • Once achlorhydria is confirmed a hydrogen breath test should be conducted to exclude bacterial overgrowth.
Dermatology, HOMEOPATHIC TREATMENT

ACNE

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Acne or Pimples is a chronic skin disorder affecting pilosebaceous units caused due to clogged skin’s hair follicles by dead skin, excess sebum, dust and pollution.

It is also called Acne Vulgaris

SYMPTOMATIC CHARACTERISTICS OF ACNE/PIMPLES

It is characterised by oily skin, comedons, black-heads, white-heads, pimples and scarring and pigmentation.

It usually presents itself in region dense with sebeceous glands, like on face, chest and back.

Strong Genetic and Heredity association is found in 80% cases. During puberty surge in hormones triggers Acne in both sexes. Diet, cleanliness, medication, infections, pollution environmental factors ,sunlight exposure, stress, smoking and other lifestyle factor seems to contribute in not all but many cases in varing degrees. propionibacterium acnes a commonly found on skin which frequently outgrows in number and contribute to acne in most of the cases.

CATEGORISATION METHODOLOGY TO JUDGE SEVERITY OF ACNE/PIMPLES

Acne are categorised based on severity and there are various methods to do this Cook’s photographic scale of 0-8 grades, Leed’s scale of 0-10 with 2 modified versions of 0-11 and 0-12 and  Pillsburry’s scale of 1-4 grades. A scale of mild, moderate and severe is commonly used which easily helps to quickly decide line of treatment.

Mild form has only clogged hair follicle called comedones also known as black-head(open mouth comedone) and white-head(closed mouth comedone) and very occasional pimples are found on trunk .

Moderate form has pappules and pustules forming on clogged hair follicles called pimples are found on face and trunk.

Severe form has cysts and nodules its termed severe nodular acne and is present extensively on face and trunk.

PATHOGENESIS OF ACNE/PIMPLES

Acne is a chronic skin disorder affecting pilosebaceous units caused due to clogged skin’s hair follicles due to

  • Excess sebum production under influence of androgen
  • Excess keratin deposition in hair follicle
  • Infection and colonization of the hair follicle by Propionibacterium acnes
  • Local activation of inflamatory mediators.

Dihydroxytestosterone and increased amount DHEA-S of secreted during adrenarche leads to excessive Sebum production prevents dead cells and debri  to clear itself from hairfollicle causing an initial keratin and debri clog within and form microcomedon, excessive skin cell proliferation also contributes in development of clog its further complicated by colonisation of Propionibacterium Acnes which forms a slimy biofilm within the hair folicle and helps forming a comedone.

If comedone is superficial the melanin pigments gets exposed giving it dark colour so its called blackhead also called open comedone.

If the comedone is deep within the hair follicle, unexposed, it is called whitehead also called closed comedone.

Many of the comedones further progress into papules, pustules and nodules, also it may affect deeper tissue and form deep tissue nodule.

HOMEOPATHIC TREATMENT WITH INDICATED HOMEOPATHIC MEDICINES FOR ACNE/PIMPLES

KALIUM BROMATICUM

Kali bromaticum is one of the most indicated remedy in case of Acne. In Kali bromaticum pimples usually begins in the teenage. Reddish pustules on the face causing grooves. Pimples usually have a depressed centre. Face is usually flushed, yellowish, cahetic look with pimples on face. In females the acne are worse prior to the menstrual period and during the time of menstruation. Exhausted look of face, lifeless and expressionless. Inflammation and great redness of face due to pimples.

JUGLANS REGIA

It was said that in the golden age, when men lived on acorns, God lived upon walnuts and hence the name Juglans (Jupitars nut). Juglans regia stimulates the body’s defense mechanism and acts on various skin problems like pimples, eczema etc. Juglans regia is a very beneficial remedy in case of Acne. Indicated comedone of face. Reddish hard painful swelling of cheeks due to pimples. Acne filled with pus. Sharply defined depressed dark red erruptions, pus is seen through the thin skin.

CALCAREA SULPHURICA

Calcarea sulph is a Schussler’s connected tissue salt and most of the indications for its use are derived from his clinical experience. It has been extensively used for acne treatment based upon the biochemic theory. Very valuable remedy in case of pimoles. pimples with pustules on the face. Pale and sick looking face. Severe erruptions on face with itching. Pain in the erruptions after exposure to cold. Cold sweat on face. Useful in severe cystic acne. Lesions usually persists in one place for weeks and do not heal quickly. Yellow creamy pus drains for a long time. Unhealthy skin with yellowish scabs. Pimples on face, near hairline.

MERCURIUS SOLUBILIS

Mercurius solubilis is a powerful remedy which acts on every organ and tissue of the body.Very useful remedy in cases of acne. Earthy, puffy, dirty looking face, with constantly perspiring skin. A big pimple is surrounded by multiple smaller ones. Itchy erruptions, yellowish brown or greenish discharge from pustular pimples, often streaked with blood. Worse from extremes of temperature. Yellowish scabs with purulent pustules. Severe Burning of pimples.

ECHINECEA ANGUSTIFOLIA

Acne is by far the most commonest skin condition. Although prevalent among teens, a number of old people are also struggling with this condition. Echinecea angustifolia is the most effective remedy in case of acne. Echinecea angustifolia plant has its roots from daisy family. It makes the subcutaneous and superficial blood vessel walls stronger. This makes the skin more resistant and less penetrable from either the bacteria or free radicles that promote the development of acne. Echinecia helps to lower the inflammation levels due to its antibacterial properties. Echinecea angustifolia enhances good circulation and hence the skin will be clear and free from dead skin cells that clog the pores. It helps to accelerate the body’s natural defense mechanisms of flushing out the toxins.

AZADERECHTA INDICA

Azaderechta indica has been used since decades as a traditional medicine in treatment of Acne. Azaderchta indica is known commonly as Neem. It is aaociated to Meliaceae family. Azaderchta indica detoxifies the body and acts as a blood purifier. Every part of Neem is useful with number of medicinal properties. It has been used since ancient times to treat many skin problems. It has a soothing effect on irritating skin. Very useful in acne. It acts as a nutritive tonic to skin. The antebacterial properties help to reduce the risk of infections. Azaderachta indica reudces the inflammations and puffiness of acne. Purifies blood thus gives radiance to skin. Pimples with severe redness, pus and tendency to form scars. Painful to touch.

BERBERIS AQUIFOLIUM

Berberis aquifolium has a marked action on the skin producing pimples, dry, rough and scaly erruptions. Acne is the most common and psychologically distressing skin disorder which is very well managed by Berberis aquifolia, it clears acne and hence clears the skin. It also helps to erase scars on skin. Berberis aquifolia is one of the recommended medicine for its cleansing effect and helps in lightening of complexion.

PULSATILLA NIGRICANS

Pulsatilla nigricans is a very effective remedy for acne during puberty. Especially indicated in young girls. Young girls usually suffer from various hormonal changes which lead to formation of pimples. Acne is worse during time of or around the time of menses, eating rich and fatty food. Especially indicated around time of puberty or when pimples breaks out near menstrual periods.

HEPAR SULPHUR

Hepar sulphur is one of the indicated remedies in acne. Usefull in acne in case of adolescents with unhealthy skin. Yellowish complexion. Great sensitiveness to slightest touch. Useful in pimples that are pustular in nature. The pus may be blood stained at times. The pimples are extremely painful. Tendency to form boils or abscess.

SILICEA

Acne like boils on face especially on cheeks. Slow healing acne which leave pitting scars. Silicea face is waxy, tired, anaemic. Pustular and vesicular erruptions spread over the face. Erruptions and crusts peel off with no healing. Useful in cases of pimples with offensive pus formation. Indicated in treating all types of skin problems. Pimples on forehead and cheeks. Silicea is usually chilly with increased sweating of palms and soles.

ACNE BEFORE HOMEOPATHIC TREATMENT AT Dr SHAH's HOMOEOPATHY
ACNE BEFORE HOMEOPATHIC TREATMENT AT Dr SHAH’s HOMOEOPATHY
ACNE CURED AFTER HOMEOPATHIC TREATMENT AT Dr SHAH's HOMOEOPATHY
ACNE CURED AFTER HOMEOPATHIC TREATMENT AT Dr SHAH’s HOMOEOPATHY
CASE OF ACNE AFTER HOMEOPATHIC TREATMENT AT Dr SHAH's HOMOEOPATHY
CASE OF ACNE AFTER HOMEOPATHIC TREATMENT AT Dr SHAH’s HOMOEOPATHY
HOMEOPATHIC TREATMENT, Orthopedic, Rheumatology

SCIATICA

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Nerve fibres originating from L4-S3 unites in front of piriformis muscle to form the widest single nerve in human body called the SCIATIC NERVE. Myalgia Paraesthesia in the corresponding region of supply of the Sciatic Nerve is termed as SCIATICA.

This symptom can be due to compression of /injury to /pathology of Sciatic Nerve or its nerve fibre origin.

Compression/Injury/ Pathology can be due to trauma / mechanical wear and tear / pathological changes around sciatic nerve or at origin of its fibres at lumbar and sacral region.

COMMON CAUSES OF SCIATICA

  • Lumbar Spondylosis
  • Spinal Stenosis
  • Spinal Disc Herniation
  • Degenerated Vertebra
  • Sciatic Nerve Surrounding Muscle Spasms
  • Sciatic Nerve Surrounding Tissue Inflamation
  • Deep Tissue Abscess Around Sciatic Nerve
  • Fetal Weight During Pregnancy
  • Piriformis Syndrome
  • Tumours in and around Sciatic Nerve
  • Injury During Surgical Procedures

MANAGEMENT OF SCIATICA

Patients presenting with pain along nerve path; should be tested for straight leg raise test

Further imaging tests CT, MRI, MRneurography helps to find out exact cause

Person should also be tested for any deficiency of Calcium through Bone Mineral Density ; Vitamin D levels where sciatica is due to bony degeneration or osteoarthritis of lumbar spine or osteoporosis in general.

Vitamin B12 levels should also be tested

In patients with sciatica due to spinal complaints originated from mechanical reasons

Secure lower back(lumbosacral region) and give it proper rest; mild exercises not involving lumbo-sacral region; helps by not involving lower back but still maintaining healthy equilibrium of body thus helping faster recovery.

Spinal manipulation helps to an extent in disc related pain which is contraindicated in progressive neurological deficits

Patients with sciatica due to non mechanical spinal reason / secondary to tumour / some other pathology like inflamation or abscess around; should be treated first for primary reason.

Homoeopathic Medicines for Sciatica with Indications

MAGNESIA PHOSPHORICA

Magnesium phosphoricum is a great antipsoric remedy. Mag phos is a constituent of nerves, muscles, bones, spine, brain, blood corpuscles. It helps to create white fibres of muscles amd nerves. The deficiency of this salt allows the fibres to contract causing spasms, cramps and other nervous phenomenon. Magnesium phosphoricum is thought of in all maladies having origin in nerve cells and in muscle tissue. Mag phos is very well indicated in Sciatica. It is suited to tall, dark, neurotic, exhausted people. Used for neuralgic pains, having spasmodic effects and have great influence on nerves and muscles. The pains are very violent and may affect any nerve. Pain localises itself in a nerve and become worse especially in case of sciatic nerve. Pains come in paroxysms. The patient feels better in warm place where neuralgias are better. There are times when a nerve in which there is a considerable pain becomes sensitive to pressure. Stiffnness, numbness along the route of nerve from prolong exertion. Rest relieves most of the complaints.

RHUS TOXICODENDRON

Rhus tox is a frequently indicated remedy in rheumatic affections, and neuralgias. Rhus tox affects the fibrous tissue markedly joints, tendons, sheaths, producing pain and stiffness. Rhus tox is very useful in Sciatica. Pains usually spread over a large surface area along the route of nerve, stiffeness of limbs with paralysis. Presents with tingling in feet. Affections of nerves and spinal cord give rise to paretic effects. Symptoms appear on the eft side and go from left to right. Patient is very restless., cannot rest in one position. Complaints come on from cold damp weather aspecially to cold. Pains that run through Rhus tox are aching, tearing with numbness and paralytic weakness of limbs with loss of sensation. Presents with low back ace with stiffnness, aggravatiom on resting after excercise.

CALCAREA CARBONICA

Calcarea carb is chief representative of calcium compound. Calcium metabolism is active during childhood and becomes defective in middle age. Calcarea patient can be described as fair, fat and flabby with tendency to gain weight. Calcarea carb has main action on the vegetative sphere with impaired nitrition being the keynote of its action. Calcarea carb has marked indication in case of sciatica, where there is severe pain in the lower back, lumbar spine to the buttock and down the back of leg. Excruciating pain with burning sensation. Presents with numbness tingling sensation in affected leg or foot. Associated with Weakness of extremities.

BELLIS PERENIS

Bellis is known commonly as Wound wort, therfore like Arnica it is great traumatic remedy. Very well indicated in Sciatica. There is results of injurie to nerves with intense soreness and intolerance of cold bathing. Severe pain at the lowet back, radiatinv downwards, pains may vary widely from a mild ache to sharp burning sensation, can feel like a jolt or electric shock. Worse when you cough sneeze or due to prolong sitting aggravates the complaints. Sore bruised feeling in the pelvic region.

HYPERICUM PERFORATUM

Hypericum perforatum is an excellent remedy for injury to parts rich in sentient nerves. Indicated in traumatic neuralgiaand neuritis.Spasms after injury.
Hypericum perforatum is considered when the sciatic pain is attended with tingling, burning and numbness in affected limb. The spine is very sensitive to touch. Walking or stooping is impossible from intense pain in back and lower limb. Aching pain in left sciatic nerve after prolonged sitting. Violent pains and inability to walk or stoop after a fall on coccyx. Excessive painfullness is the guiding symptom, associated with cramps in calves.

ARNICA MONTANA

Arnica montana is frequently indicated remedy in case of sciatica. Patient usually presents with excessive soreness of lower limbs. Severe neuralgias with low backache and pain radiating from back through thigh to foot. Numbness and soreness after over exertion. Cannot walk erect on account of bruised pain in pelvic region. Limbs ache as if beaten. Numbness in feet. Sore lame bruised feeling all over the body, bed feels hard. Slightest tough is unbearable. Arnica is usually suited to cases when an injury however remote seems to have caused the trouble. Extreme restlessnes, patient constantly changes his position.

CALCAREA PHOSPHORICA

The sphere of action of phospahte of lime includes all neuralgic affections and bone diseases whether due to some dyscrasia or defective nutrition. Calcarea phos is One of the most important tissue remedies. Very well indicated in case of sciatica. The back pains are worse from cold stormy weather. Severe pain in the back and along the route of sciatic nerve from straining, tearing, shooting, and aching in the spine. Soreness in the sacroiliac symphysis. Pain in the lumbar region and sacrum extending to the feet.

PLANTAGO MAJOR

Plantago usually affects the nerves causing nerves causing neuralgias. Patient usually presents with sharp cutting type of pain. Numbness in the affected parts. Trembling of limbs. Severe pain in the back extenxing to feet. Sharp shifting type of pains. Very useful remedy in case of sciatica.

COLOCYNTHS

Colocynth has a long lasting action on the nerve especially the scoatic nerve. The principle feature of colocynth is its severe tearing, neuralgic pains, pains are so severe that the patient is unable to remain still. The sciatic pains ae better feom hard pressure. Neuralgic pains are cutting, clamping, gnawing type followed by numbness and lumbar ache which is relieved by pressure. Severe pain in the back extending downwards, sensation as if heavy weight in the lumbo dorsal region lying on left side. Along with sciatica there is agonising pain in abdomen causing patient to bnd double with restlessness. Sciatic pains extend from lumbar region to limbs. Tensive lancination in lumbar region and hips especially while lying on the back. Pain while walking as if psoas muscles were too short, on stooping it caeses but commences again while walking. Usually Left sided sciatica, pain along the course of left sciatic nerve. Pain in low back radiates to toes.

GNAPHALLIUM

Gnaphalium is an indicated medicine in sciatica, when the pain in the sciatic nerve is attended with numbness. Useful in cases of sciatica where pain is confined to calves and feet. There is intense pain in the nerve accompanied by cramps alternating with numbness. Intense pain along the route of sciatic nerve. Lumbago with numbness of parts and weight or heaviness in pelvis.

ACONITUM NAPELLUS

The rapidity of action of aconite determines its symptomatology. Aconite is one of the indicated remedy in sciatica. Symptoms are acute, violent and painful. They appear suddenly and remain for a short while as if a big stormwhich soon blows over. Neuralgic pains are very intense. Pain in the back. Sensation of burning, numbness, tingling, crawling semsation alon the route of nerve. Parts remain sore and numb after pains. Physical and mental restlessness with state of fear, anguish.

BELLADONA

Belladona is very useful remedy in sciatica. Where the pains are sudden and violent with redness and heat of affected parts. Belladona acts on the nerve centres producing twitching, pains, jerks and spasms in limbs. Invluntary limping. Trembling of limbs. The lower part of the back feels as if broken. Sensation of heaviness in the buttocks and thigh. The sciatic pain is worse from heat and relieved from bending backwards and by rest. Symptoms of belladona that is pain and suffering come on suddenly pass a regular course amd subside suddenly.

SILICEA

Silicea is one the indicated remedy in sciatica. Presents with neurasthenic states and increased susceptibility to nervous stimuli. Sciatic pains usually start in thr back hips and run through the course of sciatic nerve through back of legs and feet. Severe cramps in calves and soles. Weak spine. Severe pain in coccyx.

BRYONIA ALBA

Bryonia is most effective medicine for sciatica that gets worse from walking. The slightest motion may worsen sciatica., in such cases lying down absolutely still provides some relief to the patient. Heaviness in the Affected hip or leg. The general character of pain here is stitching type of pain, pains greatly aggravated by slight motion and better by rest. Usually adapted to nervous dry, alender people. Pain in small of back which becomes worse by stooping. Scaitica better by lying on painful side.