All posts by Dr Deepan

Dr DEEPAN P SHAH MD(HOMOEOPATHY) SPECIALISED HOMEOPATHIC PHYSICIAN AND SURGEON

HOMEOPATHIC TREATMENT, Orthopedic, Rheumatology

TRIGGER FINGER

December 7, 2018 Dr Deepan 6 Comments

TRIGGER FINGER or TRIGGER THUMB is a condition where in joints of one or more of the digits(finger/thumb) gets stucked up/locked up at certain postion which is difficult to move and moving it with force may cause popping or clicking sound with pain.

Though it can present in any sex and at any age, it is more commonly found in females around age of 50-60 yrs.

CAUSES OF TRIGGER FINGER/THUMB

Its is also termed as digital Stenosing Tenosynovitis, although there is no predominant inflamation to Tendosynovium but inflamation is found in Tendon Sheath. And also its not comfirmed that inflamatory process has any primary role in its development

Though exact cause behind trigger finger/thumb is not known but the risk factors that tend to increase the incidence of this condition are identified

Over straining and over use of hand and fingers espescially activities involving prolonged forceful flexion of digits(fingers/thumb) may be occupational or habbitual routine activities.
Frequent injuries – occupational, accidental or even injuries of planned surgery of hand especially ofter surgery for carpel tunnel syndrome
Systemic connective tissue disorders
Autoimmune diseases especially Rheumatoid Arthritis
Hypothyroidism
Renal Disease
DeQuervain’s Diseases
Amyloidosis
Diabetes Mellitus and Other Metabolic disorders.

SYMPTOMS OF TRIGGER FINGER/THUMB

Though it may involve any digit(thumb/finger) Index finger and Thumb are more frequently involved. One or more digits may be involved.
Patient presents with stucked up digit at certain position. It may be at any level from flexed to extended position usually found at semiflexed position.
This locking up may be persistent for a prolonged period of time or may be momentary and recurrent.
Aggravations are more commonly experienced at night, especially while holding heavy article with hand or while gripping or applying pressure with fingers or hand.
On moving and or forcefully unlocking the stucked finger is bit painful and causes clicking and popping sound
In severe cases the finger may be persistently locked for prolonged period of time with constant pain which may also extent to whole hand and wrist.

DIAGNOSIS OF TRIGGER FINGER/THUMB

Diagnosis of trigger finger/thumb is based on clinical symptomatology of the patient where in inflamation or involvement of tendon sheath of flexors is confirmed and excluding probability of other condition like

Tumour
Sprain of digit
Osteoarthritis of metacarpo-phalangeal joint
Fracture
Tendon Entrapment post-trauma
Extensor Apparatus Injury
Game Keeper’s Thumb
Sesamoid anomaly
Dupuytren’s Contracture
Focal Dystonia

An injection of lidnocaine in tendon sheath of flexors reduced the pain then it confirms diagnosis Trigger Finger/thumb.

HOMEOPATHIC TREATMENT FOR TRIGGER THUMB

Treatment of trigger finger/thumb is dependent on combination of modalities of physiotherapy, splinting and medication.

HOMEOPATHIC MEDICINES FOR TRIGGER THUMB/FINGER

CALCAREA FLOURICA
SILICEA
THIOSINAMINUM
RHUS TOXICODENDRON
ACTEA SPICATA
THUJA OCCIDENTALIS
AGARICUS MUSCARIOUS
ARNICA MONTANA
BRYONIA ALBA
CIMICIFUGA RACEMOSA

HOMEOPATHIC TREATMENT, Infectious diseases, Nephrology, Opthalmology, Orthopedic, Rheumatology, Urology

REACTIVE ARTHRITIS

December 2, 2018 Dr Deepan 8 Comments

Reactive Arthritis was also called Reiter’s Arthritis is RF-negative and HLA-B27 Linked Imflamatory oligoarthritis typical with Enthesitis, accompanied with Inflamatory occular and/or inflamatory genitourinary and other systemic manifestation usually post gastrointestinal or genitourinary infection.

During world war one and two many cases emerged with the Triad of Symptoms viz. Inflamation of Joints, Inflamation of eyes and Inflamation of Uretha. Which drew attention of medical community due to common presentation in many giving it some syndrome like picture. On further investigations it was found out that most of them were exposed to urogenital or Gastro-intestinal infection 1-4 weeks prior to onset of this Triad of Symptoms. This was initially termed as “Fessenger-Leroy-Reiter’s Syndrome” or simply “Reiter’s Syndrome”. But as the physician Hans Conard Julius Reiter was involved in attrocities and war crimes with Hitler, so his name was removed and later renamed and termed as “Reactive Arthritis”.

EPIDEMIOLOGY OF REACTIVE ARTHRITIS

AGE – It more frequently affects age group of 20-40 years.
SEX – It is more common in Males then in Females.
ETHNICITY – Due to its association with HLA-B27 it is frequently found in white race compared to dark race as comparatively HLA-B27 occurs more commonly in white population.
RISK FACTOR – Person with HIV positive status are more prone to develop reactive arthritis.

SIGNS AND SYMPTOMS OF REACTIVE ARTHRITIS

The onset of symptoms of Reactive Arthritis typically starts 4-35 days after an initial infection of gastro-intestinal system or genito-urinary system.

TRIAD OF REACTIVE ARTHRITIS

Reactive arthritis in most of the cases presents where patient cant – SEE, PEE, climb the TREE! due to following Classical Triad of Symptoms of reactive arthritis

i) OLIGOARTHRITIS

Oligoarthritis involving less than five joints. It may frequently involve knee and sacroilliac joint as well. May present itself in additive pattern where it starts with one joint and add another joints subsequently or it may be migratory in pattern where the set of inflamed joints keep changing by addition and simultaneous substraction of joints involved.

ii) NON-GONOCOCCAL GENITOURINARY INFLAMATION

Inflamation of genitourinary system classically presents itself at the onset of the disease. Not always but in many its typically after initial sexual exposure. It presents as frequent burning micturation, uritheritis, prostatitis, balanitis in men and salpingitis, vulvitis and vaginitis in women.

iii) OCCULAR INFLAMATION

Occular Inflamation may present itself as mild conjunctivitis or uveitis in 75% of cases with gastrointestinal origin and 50% of cases with urogenital involvement. patients have intermittent irritation in eyes with blurred vision typically commences at onset of disease.

OTHER SYMPTOMS

Few patients also presents with peculiar symptom which is specific to reactive arthritis, its Keratoderma Blenorrhagica which are small hard nodule commonly appear on soles occasionally on palms and rarely on other parts of body subcutaneous nodules are not incluced. Even in absence of above mentioned triad of symptom the presence of Keratoderma Blenorrhagica is diagnostic for reactive arthritis.
In reactive arthritis; typical to HLA B27 related immunological reactions; involves Entheses that is where skeletal muscles attaches with bones through tendons, where it causes Enthesitis and tendon inflamation especially the tendo-achilles and also fascia in particular Plantar Tendinitis.
Occasionally patients also suffer from dactilitis giving finger sausage-like apperance “sausage finger” due to inflamation.
Mucocutaneous involvement presents as ulcerative or non ulcerative stomatitis, apthous ulcers and geographic tongue are also seen as presentation of this disease
Cardiac involvement causing pericarditis and aortic regurgitation in cases which do no recover soon or if its recurring or progressive.
Gastrointestinal manifestation like pain and cramps with frequent semiformed stools with mucous and insome cases blood due to inflamation and ulcceration in gastrointestinal tract.

Most of the cases of Reactive Arthritis recover within six months, in many cases it keeps comming back time and again and in few it becomes chronic and progressive which may increase risk of severe complications.

COMPLICATIONS OF REACTIVE ARTHRITIS

In chronic progressive and recurring cases the patient may develop following complications

Ankylosing Spondylosis
Disabling Arthritis
Aortitis
Aortic Regugitation
Conduction defects of Heart
Pericarditis
Amyloid deposits
Immunoglobulin A Nephropathy

CAUSE OF REACTIVE ARTHRITIS

Reactive Arthritis is is HLA B27 linked inflamatory arthritis and enthesitis preceeded by a spell of infection either of genito-urinary system or gastro-intestinal system by following commonly involved organisms

GENITO-URINARY INFECTIONS ASSOCIATED WITH REACTIVE ARTHRITIS

Chlamydia Trachomatis
Ureaplasma Urealyticum

GASTRO-INTESTINAL INFECTIONS ASSOCIATED WITH REACTIVE ARTHRITIS

Salmonella Spp.
Shigella Spp.
Campylobacter Spp.
Yersinia Spp.

4-35 days after the spell of urethritis or food poisoning by above mentioned organisms the symptoms of reactive arthritis sets in, where the synovial fluid has negative culture ans is free from infection and but the HLA B27 linked inflamation is thought to be triggered due to

Autoimmune reaction due to cross reactivity of micro-organism antigen with joint tissue or
Micro-organism antigenic components that may have settled in joint tissue.

DIAGNOSIS OF REACTIVE ARTHRITIS

Clinically the Reactive Arthritis can be diagnosed with help of Sensitivity and Specificity Guidlines laid down by American College of Rheumatology, for clinical diagnosis with given set of presenting symptom, its as follows

Arthritis > 1 month with Urethritis and/or cervicitis has sensitivity of 84.3% and specificity of 98.2%.
Arthritis > 1 month with Urethritis or Cervicitis or bilateral Conjunctivitis has Sensitivity of 85.5% Specificity of 96.4%.
Arthritis, Urethritis and Conjunctivitis has Sensitivity of 50.8% and sensitivity of 98.8%.
Arthritis > 1 month, Conjunctivitis and Urethritis has Sensitivity 48.2% and Specificity of 98.2%.

Patients falling in above criteria or those showing just Keratoderma Blenorrhagica without any other symptoms and other suspected cases can be sent for following test for further evaluation.

HLA B27 testing
Urine routine and culture
STOOL Routine and culture
Throat swab culture
Cervix and Urethral swab culture
Erythrocytes Sedimentation Rate
C-Reactive Protein Test

HOMEOPATHIC TREATMENT FOR REACTIVE ARTHRITIS

Being an immune mediated systemic reaction that too the one that is triggered with different causative agents and even to same agents different individuals will respond differently.

Though they may have same set of general symptoms like the classical triad of reactive arthritis but intensity of each of the symptom of triad will differ in each individual,

Now this is where the homeopathic individualisation process starts. In Homeopathy we believe that though majority of human genome is the same but the minor variations in gene and the epigenome make the whole lot of difference in various characteristerics of each individual, similarly their immune reaction also varies, so every person should have individualised medicine.

Homeopathic Treatment is based on symptom similarity and individualisation of case based on peculiar symptoms based on which the case is individualised and medicine is selected.

Alternatively as per Homeopathic principle of Genus Epidemicus or pathology based symptomatology there can be disease specific homeopathic medicine derived from common symptomatic representation of a disease condition in a group of population.

Now this can not be the most similimum homeopathic prescription but roughly it can hit the disease condition within an indivudual though not accurate but will yeild some results in most of the cases.

To yield best homeopathic results there can be no generalised common approach for all cases.

But still if we have to attempt common standardised pathology based approach then to give some guidelines on homeopathic approach towards cases of reactive arthritis I have attempted following rough guidelines which may help to give some vision in approach towards such cases.

Its seen that in few case it begins after gastro-intestinal infection and in some case post genito-urinary infection. So this will further guide determining “morbid cause” behind the disease directing us in homoeopathic similimum medicine selection.

Now reactive Arthritis shows a triad of symptom in most of the cases. So this triad helps us to reach to group of medicines with such combination of symptoms.

Intensity, occurance of symptoms and its sequence in triad differs in each individuals. For example

In some person urogenital symptoms may be more severe compared to occular symptoms or arthritis symptoms, where as in others arthritis and ocular symptoms would be more severe than urogenital symptoms.
Some may not have occurence of conjunctivitis
In some all three triad occur at a time where as in some patients it may occur gradually one after another in different sequence.

All this helps us find out the “seat of disease” in an individual and its degree of affinity towards various organs which can be related to homeopathic medicines during selection process.

Further arthritis may show different pattern like

progressive
migratory
additive
symetry
predominantly involved joint
sequence of joint involvement
number of joints involved
severity
intensity
type of sensation and other symptoms

Also similarly symptoms of occular involvement and urogenital involvement should be take in to account in absolute detail. This further helps refine and classify the patient and the respective medicines to be repertorised.

Which other systems and organs are involved like mucous membranes, skin, heart, kidney etc and what type of pathology they are showing like tissue destruction or just inflamation and functional disturbance or tissue lysis with regenerated and degenerative changes this will help to decide what “type of miasm” is underlying wether its psoric, syphillitic or psychotic type pathology.

Certain symptom are very “peculiar” for the disease and occurs in few individuals like Keratoderma Blenorrhagica eruption, now location of this eruption will further help individualise the case.

Enthesitis – Inflamation of tendo-achilles and plantar fascitis is “very specific” to the disease but does not occur in all individuals, so if plantar fascitis or inflamation of tendo-achilles if occurs in someine with this disease then it helps further in individualisation of during homeopathic medicine selection.

Other than this the general health and family background should be noted to derive constitutional types and association of HLA B27 in 75% of this individual further helps in individualisation and homeopathic medicine selection.

COMMONLY USED HOMEOPATHIC MEDICINES FOR REACTIVE ARTHRITIS

PHOSPHORUS
ARSENICUM ALBUM
RHUS TOXICODENDRON
BRYONIA ALBA
LEDUM PALUSTURE
THUJA OCCIDENTALIS
ANTIMONIUM CRUDUM
ARGENTUM NITRICUM
BORAX
MERCURIOUS SOLUBILIS
PULSATILLA NIGRICANS

HOMEOPATHIC TREATMENT, Orthopedic, Rheumatology

FROZEN SHOULDER HOMEOPATHIC TREATMENT

November 25, 2018 Dr Deepan Leave a comment

Frozen Shoulder also called Adhesive Capsulitis of shoulder joint is painful stiffness limiting range of motion of shoulder joint caused due to inflammation related pathophysiology in capsule of shoulder joint.

CAUSES AND RISK FACTORS OF FROZEN SHOULDER

CAUSE OF FROZEN SHOULDER

Exact cause of Frozen Shoulder remains unclear but there are many factors that increases the risk and lead to frozen shoulder

RISK FACTORS FOR FROZEN SHOULDER

GENDER

Frozen shoulder is more common in females than in males

AGE

Person above 40yrs of age are more prone to this condition

INJURIES

Injury to shoulder joint involving any of its companent especially gleno-humeral joint capsule or rotator cuff.
Sports persons typically develop calcifications of tendons around shoulder joint and also in joint structures due to repeated injury and result of prolonged inflamation such persons are at high risk of developing frozen shoulder.

REDUCED MOBILITY

Injuries to arm and neck may indirectly affect shoulder joint, due lack of motion in general of that region as a whole and changes pattern of gait and movements of that region.
Immobility or reduced mobility post surgerr with general debility and delayed recovery.
Immobility post stroke.

MUSCULO-SKELETAL DEFECTS

Certain congenital structural anomaly of Musculoskeletal framework which has influence on movement, gait and weight distribution pattern on shoulder joint in abnormal pattern, which may put the person at risk of develooing Frozen Shoulder.
Kyphosis or Scoliosis or other congenital or acquired spinal anomaly especially those above thoracic spinal level may increase risk of frozen shoulder.
Patients with cervical spondylosis are at risk of developing frozen shoulder.

RHUEMATIC DISORDERS

OTHER SYSTEMIC DISEASES

Rheumatoid Arthritis
Systemic Lupus Erythematosus
Ankylosing Spondylosis
Diabetes Mellitus
Gout
Cardiovascular disorders
Tonic Seizures in epileptic patients or in Parkinsonism
Thyroid Disorders like Hyper or Hypothyroidism

SYMPTOMS OF FROZEN SHOULDER

Pain in affected shoulder aggravates on movement
Loss of rang in motion of affected shoulder joint

Frozen Shoulder is divided into 3 stages

1) Freezing Stage

In Freezing Stage there is pain in joint which aggravates on motion and he range of motion gradually starts decreasing.

2) Frozen Stage

In Frozen Stage the pain is not much as compared to freezing stage but the range of motion is completely diminished so much so that patient can barely move the joint or cant move at all.

3) Thawing Stage

In Thawing Stage pain subsides and range of motion gradually starts improving and complete recovery is established in few weeks.

If it is acted upon quickly in freezing stage with intervention of physiotherapy and proper medication the progress of the disease is arrested and soon resolves completely.

DIAGNOSIS OF FROZEN SHOULDER

On clinical presentation of symptoms of the patient frozen shoulder can be diagnosed and radiological tests like X-rays, CT scan and MRI may be suggested inrequired cases to find out extent, severity of pathological condition within and also to rule out any other pathological condition within or around shoulder joint.

If along with shoulder joint if there are other joints involved simultaneously or frequently different joints in past then it becomes necessary to rule out other underlying systemic conditions like Rheumatoid Arthritis, Gout, Ankylosing Spondylosis, Systemic Lupus Erythematosus etc and for that your doctor may suggest blood tests like RA factor, ESR, CRP, ANA, S.uric acid and HLA B27 (where there is severe spinal involvement along with shoulder). Vitamin D should also be checked wether its in optimal range for better recovery.

TREATMENT OF FROZEN SHOULDER

Treatment of frozen shoulder is based on combination of both Physiotherapy and Medicines.

Physiotherapy plays a major role in cases of frozen shoulder. Physiotherapist takes support of certain modalities, recomends certain exercises and manual physical intervention where in he may exert mild force or pressure along and within the axis of movement of shoulder joint and try to open up the freezed shoulder and gradually retain its laxity and mobility.

Pain may temporarily increase during and after physical intenvention but with regular recomended exercise and medicines it finally subsides and joint regains its complete range of axis of movement subsequently.

HOMEOPATHIC MEDICINES FOR FROZEN SHOULDER

If the frozen shoulder is without any underlying condition specific medicines will work well but if it is secondary to some underlying condition like autoimmune diseases or metabolic disorders or Infections or some other systemic or acute or chronic complaints then constitutional trearment along with initial acute specific remedy may be required.

List of Common Homeopathic Remedies Used in Frozen shoulder

Calcarea Flourica
Silicea
Calcarea Phosphorica
Thiosinaminum
Rhus Toxicodendron
Bryonia Alba
Arnica Montana
Plantago Major
Belladonna
Ledum Palusture

HOMEOPATHIC TREATMENT, Neurology, Orthopedic, Rheumatology

LUMBAR SPONDYLOSIS

November 18, 2018 Dr Deepan 2 Comments

Degenerative changes in vertebral bodies and intervertebral disc at the level of L1 to S1 in vertebral cloumn affecting lumbar region of spine is called Lumbar Spondylosis.

It is characterised by degenerative changes of Lumbar vertebral bodies like osteophyte lippings and spur formation, degeneration of intervertebral disc, narrowing of intervertebral space, Intervertebral disc bulging, intervertebral disc herniation.

It can also be called Osteoarthritis of Lumbar Spine.

CAUSES OF LUMBAR SPONDYLOSIS

Lumbar Spondylosis may be caused due to many factors that can be broadly classified into Mechanical, Congenital or Acquired Anatomic anomalies, Metabolic, Immunologic, Genetic, Nutritional, Ageing and Septic reasons.

Most common of all are ageing and mechanical reasons like excessive wear and tear due to wrong postural habbits, type of work like driving for long duration regularly, sitting for long hours, lifting weights or working with bent posture etc. that exerts much pressure on lumbar spine on regular basis so as to not giving much time to recover again and resulting into accumulation of wear and tear finally damaging the spine and causing lumbar spondylosis.

Metabolic problems like Hyperuricemia/Gout where high level of uric acid in blood damages lumbar spine also this uric acid may get crystalised to form monosodium urate monohydrate and settle in the intervertebral joints and damage them.

Immunologically mediated chronic inflamation in lumbar spine like in Rheumatoid Arthritis, Chickenguniya, Systemic Lupus Erythematosus etc.

Genetic Complaints like Ankylosing Spondylosis etc

Vitamin D deficiency causes reduced calcium assimilation resulting into reduced bone mineral density causing weak bones easy to damage. Insufficient nutrition compared to requirement, which prevents repair work of regular wear and tear of lumbar spine, due to which damages tend to get accumulated resulting into lumbar spondylosis.

Congenital or acquired Anatomical anomalies in musculoskeletal framework that may cause abnormal posture or abnormal weight distribution which results into pressure on spine in wrong fashion gradually facilitates development of Lumbar spondylosis.

Septic Conditions of spine like Tuberculosis of spine may result into lumbar spondylosis due to tissue lysis as result of infection.

SIGNS AND SYMPTOMS OF LUMBAR SPONDYLOSIS

Pain and Stiffness in lower back or Lumbar Region.
Sciatica due to compression of nerve roots of sciatic nerve.
Pain stinging pain in lumbar spine
Pain radiating from lumbar spine to lower limbs
Paraesthesia in lower back genitals or lower limbs
Cramps calfs, thighs and other muscle and muscle groups of lower limbs
Difficulty in walking and maintaining posture and balance.
Lack of control on urinary spincter or anal spincter resulting into either retention of urine or bowel or involuntary expulsion of urine and bowel
Sexual debility Tabes Dorsalis

COMPLICATIONS OF LUMBAR SPONDYLOSIS

Myelopathy – When there is damage to spinal cord it causes Myelopathy.

Raduclopathy – compression of nerve near nerve root where it emerges out of spinal cord.

Vertebrobasilar insufficiency – Vertebral artery insufficiency due to its occulusion while it passes through vertebral foremen sue to degenerative changes for lumbar spine causes vertebrobasilar insufficiency leading to death of condrocytes of intervertebral disc and osteophytes starts accumulating and depositing.

DIAGNOSIS OF LUMBAR SPONDYLOSIS

Clinical symptoms if indicate towards Lumbar spondylosis it can be then confirmed with X ray.
MRI and CT scan gives us better imaging which helps judge and evaluate the extent of damage and condition
Myelograph is dye injected while Xray and CTscan this gives detailed shadow to understand even better
Electromyography helps evaluate nerve involvement in spondylosis.

HOMEOPATHIC MEDICINES FOR LUMBAR SPONDYLOSIS

HYPERICUM PERFOLIATUM
CALCAREA CARBONICA
GNAPHALLIUM
CALCAREA PHOSPHORICA
MAGNESIA PHOSPHORICA
ARNICA MONTANA
NATRUM SULPHURICUM
RHUS TOXICODENDRON
SILICEA
MEDHORRINUM

HOMEOPATHIC TREATMENT, Neurology, Orthopedic, Rheumatology

CERVICAL SPONDYLOSIS

November 11, 2018 Dr Deepan Leave a comment

Our spine is classified into cervical, thoracic, lumbar and sacral regions.

Cervical Spondylosis is condition where in vertebra and intervertebral discs of cervical region undergoes degeneration.

It is characterised by thinning of intervertebral discs, reduced intervertebral space, osteophyte lipping, spurs formations, herniation of intervertebral disc, nerve compression etc.

It can also be called osteoarthritis of cervical spine.

CAUSES OF CERVICAL SPONDYLOSIS

This degeneration can be due to various mechanical, immunological, infective, metabolic, genetic, nutritional and age related reasons.

It can be due to one or combination of than one ot the above reasons. Most of the cases are due to ageing and mechanical wear and tear related to abnormal physical exertion and postural habbits.

It is commonly seen in people assuming wrong posture for long hours like lying down with head placed on huge pillow or watching mobile phones or reading books with tilted head for long hours, staying on computer workstation with an arm stretched on mouse or key board for long transfers weight on neck.

When such postural habbits are prolonged for few hours to days its starts inflamatory process in cervival spine and if still prolonged for months to years the prolonged inflamation and mechanical wear and tear results into degeneration of spine.

Many genetic and immune mediated conditions like Rheumatoid arthritis, Ankylosing spondylosis, Systemic Lupus Erythematosus, Psoriatic Arthritis etc may result into prolonged chronic inflamation of spine ingeneral and gradual degeneration of cervical spine as well resulting into cervical spondylosis.

Metabolic reasons like hyperuricemia may result into deposition of monosodium urate monohydrate crystals into joint spaces in cervical spine resulting into subsequent erosion and degeneration of spine causing cervical spndylosis.

Certain infections in spine like tuberculosis results into degeneration of spine and spondylosis and when it affects cervical region on spine it causes cervical spondylosis.

With ageing there is depletion of anabolic hormones and other factors required for quick repair process which results into slow repair process compared to daily wear and tear and damages tends to accumulate and gradually resulting into erosion and degeneration of spine.

Nutritional deficiencies arised due to lower intake compared to requirement, resulting into lower calcium vitamin D and many other nutrients which not only slows down the repair process to built up damages but also gives rise to low bone mineral density resulting into erosion and degeneration of vertebral bodies.

SIGNS AND SYMPTOMS OF CERVICAL SPONDYLOSIS

In initial stages it starts with occasional stiffness and pain in neck lasting few minutes to hours after exertion gradually it starts persisting with pain on extreme range of axis of movement of neck then later even on smaller axis or range of motion of neck patient starts feeling stiffness or pain or discomfort in neck

If not taken care the nerves originating from cervical plexus which emerge out from cervical spine they start getting compressed causing myalgia paraesthesia in neck which may radiate to shoulder and extend upto arm and upto tip of fingers.

In severe cases of cervical spondylosis patient may also experience vertigo nausea vomitting complete loss of balance with pain in neck and gastric derangement as concomittant symptoms

COMPLICATIONS OF CERVICAL SPONDYLOSIS

CERVICAL SPONDYLOTIC MYELOPATHY (CSM) – It is caused due injury to spinal cord due to cervical spondylosis.

CERVICAL SPONDYLOTIC RADICULOPATHY – In this the nerve gets pinched and compressed near the nerve root shortly after it leaves spinal cord.

VERTIBROBASILAR INSUFFICIENCY – When vertebral artery which is passing through vertebral formen gets occluded and deprives chondrocytes of intervertebral disc from circulation as a result the die and weaken intervertebral disc and osteophytes starts settling in.

DIAGNOSIS OF CERVICAL SPONDYLOSIS

Cervical Compression Test – When the neck is tilted laterally and applied downward pressure patient feels pain on ipsilateral side in neck or shoulder , its not conclusive but indicative and qualifies case for further radiological investigations

Lhermitte’s Sign – Electrict Shock like pain on flexion of neck

These patients general show reduced range of motion of n

Based on clinical symptoms patient may be sent for X ray for ascertaining the diagnosis.

MRI and CT Scan helps to further find out extent and severity of damage to spine.

Myelography is done with dye injection in spinal cord during CT or X ray for more detailed radiological imaging

Electromyography and Nerve Conduction Test helps to find out involvement of nerve and nerve damage and extent of nerve injury.

TREATMENT FOR CERVICAL SPONDYLOSIS

Guidlines to patients on maintaining correct posture, avoid jerk and strain to secure neck is of utmost importance in management of cervical spondylosis patients.

Proper calcium intake sufficient exposure to sunlight for vitamin D. Increased protein, vitamin B12 and iron intake.

Exercise like pranayam and walk helps stimulate hormone secretion and thus facilitating absorption and assimilation of nutrients required for repair and rebuilding the worn and damaged tissues and to increase bone mineral density.

Mild gentle exercise of neck helps increase local blood flow and keep tissue supple and stimulate its growth and strenght but if not done under proper guidance of qualified physiotherapist it may further injure the already damaged tissue. So if proper qualified physiotherapist is not available to guide its safer bet not to exercise neck region involving cervical spine on your own and giving it complete rest and let it recover on its own while still continueing with walk and pranayam regularly.

HOMEOPATHIC MEDICINES FOR CERVICAL SPONDYLOSIS

CIMICIFUGA RACEMOSA / ACTEA RACEMOSA

RHUS TOXICODENDRONE

ARNICA MONTANA

PLANTAGO MAJOR

HYPERICUM PERFOLIATUM

TUBERCULINUM

BELLADONNA

CALCAREA PHOSPHORICA

BELLIS PERENIS

SILICEA

MEDHORRINUM

HOMEOPATHIC TREATMENT, Infectious diseases

SWINE FLU H1N1

October 3, 2018 Dr Deepan Leave a comment

Swine flu is an infection caused by swine flu influenza virus which is common throughout the population worldwide. The disease affects the respiratory tract of pigs and is transmitted to humans.

THE SWINE FLU VIRUS

The influenza virus is a negative sense RNA virus of the family Orthomyxoviridae with three genera Influenza A, B, C.

Swine influenza is known to be caused by Influenza A subtypes. H1N1, H1N2, H3N1 H3N2. In pigs Influenza A virus are divided into subtypes based on 2proteins on surface of virus the haemagglutinin(H) and the neuraminidase (N). There are various types of subtypes of H and N.
Every year new strains of virus evade host defenses.
Another characteristic of type A influenza is that the virus has segmented genome with eight single stranded RNA segments. When the host cell is infected with more than one influenza virus, the genes have the opportunity to get ressorted and produce a different strain altogether. The antigenic shift is responsible for pandemic of influenza which has been observed in the past. Virus acquires the ability to not only infect but spread within the human host.

Influenza B viruses are only known to infect human and seals causing influenza

Influenza C virus infect both human and pigs and does not infect birds.

HISTORY OF SWINE FLU

Swine origin influenza A H1N1 virus was first recognised in the border area of Mexico and United states in April 2009 and during the span of 2 months and was spread with travellers wordlwide resulting in 1st influenza pandemic since 1968. Around mid 20th century identification of influenza sub types became possible allowing accurate diagnosis of transmission to humans. In 2010 the World Health Organisation declared Swine flu pandemic officially.
The term pandemic means that an infection has spread to many countries around the world causing widespread human suffering. This pandemic has become a worldwide concern. A new strain of Swine flu was detected in 2011, it did not affect a large number of people. In 2015-2016 a large outbreak of swine flu killed a huge number of people. Another outbreak 2017 affecting various people at different places and most recent is 2018 outbreak

The influenza virus is a negative sense RNA virus of the family Orthomyxoviridae with three genera Influenza A, B, C.

Influenza B viruses are only known to infect human and seals causing influenza

Influenza C virus infect both human and pigs and does not infect birds.

EPIDEMOLOGY AND HISTORY OF SWINE FLU VIRUS INFECTION OUTBREAKS

HISTORY

Influenza A outbreaks occur almost every year although their extent and severity vary.
In the last century, influenza virus caused 3 pandemics, the 1918 spanish flu, 1957 Asian flu, 1968 Hong kong flu. The out breaks differ in extent of spread.
The H1N1 strain responsible for current outbreak of swine origin influenza was first recognised at Mexico and US in 2009, and during a very short spam Swine flu became the 1st pandemic of 21st century. The outbreak has been pandemic in true sense involving more than 170 countries spread all over continents.
As per WHO there is a high risk of overall transmission of Swine flu globally.

SWINE FLU TRANSMISSION

As Swine flu is a viral disease it usully spreads from person to person by inhalation or ingestion of droplets containing virus from affected people who sneeze or cough leading to contamination of air with millions of virus in air.

CLINICAL REPRESENTATION OF SWINE FLU.

Signs and symptoms are similar to seasonal influenza virus or similar to other viral respiratory illness.
A common element of swine flu is upper respiratory symptoms. The patient presents with severe cold, stuffy or running nose combined with head congestion along with watery eyes associated with itching. Sore throat.
Severe bodyache, includes muscle weakness. Feeling of general malaise or weakness are very common with overall discomfort. The patient usually feels so weak that it hampers his daily activities. Presents with continous drowsiness.
In some cases of swine flu, gastrointestinal symptoms like stomach ache, cramps, nausea, vomiting and diarrhoea occur.

PREVENTION

Patients affected with swine flu should take necesary precautions.
Stay at home if you are sick.
Maintain distance from people so that you do not pass the infection to others.
Always wear a well fitted masks in public places.
Cover your mouth and nose while coughing and sneezing.
Wash your hands with soap. Make sure you wash your hand for atleast 15 sec. Use an alcohol based gels or foam sanitizers.
Use disposable tissues
Take proper rest.
Necesary preventive measures in people who are travelling or residing in areas where a swine flu outbreak have occured
Avoid close contact with people who have been affected with swine flu.
Always cover your mouth while coughing or sneezing.
Wash hands frequently as chances of infection through contact.
Maintiain proper hygeine.
Practice a healthy lifestyle habits such as nutritious diet, proper sleep, excercise.
Drink plenty of fluids.

DIAGNOSIS OF SWINE FLU

Swine flu is diagnosed based on the clinical representation of patient. Diagnosis can be made if the person has recently travelled to an area where there is Swine flu outbreak in humans.
If you residing in locality where there is epidemic of Swine flu, or if you come in contact with the influenza virus and symptoms of flu appears.
First thing you need to do is Rapid Influenza Diagnostic Test.. It is a blood test which detects whether the flu is of type A or type B. If type A turns to be positive then you should further go for PCR test for confirmation of subtype. It is advisable to straight away go with PCR in high risk group and in epidemic prone areas.

HOMEOPATHIC TREATMENT, Neurology, Psychiatry

INSOMNIA – Sleep Management Schedule – Get Rid Of Sleeping Pills

September 12, 2018 Dr Deepan Leave a comment

Sleep Management schedule is designed to help insomnia patients who have difficulty in falling asleep or difficulty in maintaining state of sleep. It helps to avoid sleeping pills and to tapper down the dose of sleeping pills and stop it completely in those who are already on sleeping pills. In complicated cases Homeopathic remedies may be required in conjunction with this sleep management schedule as a supportive measure.

FOLLOW THE FOLLOWING SLEEP MANAGEMENT GUIDELINES FOR 2-10 DAYS AND RESTORE YOUR SLEEP CYCLE WITHOUT ANY MEDICINES!

SLEEP MANAGEMENT SCHEDULE

We only need to fix the time of waking up and let the body decide the sleeping time then!
Set an alarm 15 minutes earlier than your usual time at which you wake up every morning, regardless of what time you had went to sleep at night.
Step out of bed as soon as you wake up in morning.
Morning walk is beneficial, if you do not have time in morning, make it in evening before sunset.
Have nutritious breakfast in morning.
Have curds after Lunch.
Do not sleep in day time, regardless of wether you have slept at night or not.
Do not miss evening snacks.
Stop all stimulants and caffeinated drinks after 5pm.
Dinner should be not too heavy nor too light, just filling.
Dinner should be taken ideally 1 hour before desired time to sleep after which one can go for a stroll outside for 10-15minutes.
Make sure all the meals you have throughout the day are not spicy, oily or made up of maida or bakery products.
Have a mix of papaya and pineapple 200gms approx after meals. Pineapple helps balance out serotonine levels and this induce sleep and papaya helps to mellow down the hyperacidity forming tendency of pineapple also both of them are rich in fibres. Pineapple has soluble and insoluble fibres and papaya has lots of soluble fibres so mixing both gives you blend of both soluble and insoluble fibres thus helping digestion as well, giving lighter feeling to stomach throughout the night.
One should not lie down atleast 1 hour after any meal.
Consume 2 liters of water throughout the day and stop water intake 1 hour prior to desired time to sleep.
Stop watching bright screens like television, mobile and laptop screens or listening to loud music atleast 2 hours prior to desired time to sleep.
Make sure you have bed and room exclusively meant for sleeping, the room should be completely silent and dark if not then change to thicker curtains to prevent outside light entering your room and thicker window glass to prevent outside noise entering your bedroom.
We spend 1/3rd of our life sleeping on bed, so make sure its absolutely comfortable, your pillow, mattress, bedsheet etc. change them to new if you find them uncomfortable.
Don’t do any activity like reading, writting listening music etc on bed excpet sleeping, bed should be used exclusively to sleep, during the course of sleep management, so that by the end of this course the brain gets trained to feel sleepy soon, on the touch and feel of bed.
Do not enter bed untill you are feeling too sleepy.
Even after entering bed if you are not able to fall asleep then try keeping all your neck shoulder and facial muscles relaxed while attempting to sleep.
Do not try too hard to fall asleep, rather get out of the bed and involve yourself into small activity which doesn’t consume much of time eg. reading a small news papper article is recomended but not the novel. Enter bed again soon after you start feeling sleepy.
Certain fragrances are known to help induce sleep, I recomend lavender oil. Mix lavender oil with coconut oil in ratio of 1:10 and then can be applied on scalp, or alternatively, lavender oil can be applied on handkerchief and placed near or beneath head while sleeping as its known to calm mind and induce sleep.
A cup of warm milk before bed with very little quantity of jaifal and turmeric boiled in it, helps to induce sleep.
Get your Serum Vitamin B12 and Iron levels tested and start suppliments if the levels are depleted.

Usually results are expected within 2-10 days but in cases those who are not finding results and your sleep cycle is not restored then along with above sleep management schedule you can go for homeopathic supportive medicines under advise of registered homeopathic practitioner.

COMMONLY USED HOMEOPATHIC MEDICINES FOR INSOMNIA

PASSIFLORA INCARNATA
KALIUM PHOSPHORICUM
FERRUM PHOSPHORICUM
NUX MOSCHATA
COFFEA CRUDA

HOMEOPATHIC TREATMENT, Infectious diseases, Nephrology, Urology

URINARY TRACT INFECTION

September 12, 2018 Dr Deepan Leave a comment

Urinary Tract Infection is an infection in any part of the urinary system i.e kidney, ureters, bladder and urethra.

Infection of the urinary tract is a very common and distressing condition.

Acute infections of urinary tract can be anatomically subdivided into two general catagories.
Lower urinary tract infection
Upper urinary tract infection

Infections at these sites may occur together or independently and may be asymptomatic or may present with clinical symptoms.

When there are recurrent infections it can be classified as relapses or reinfections. Most relapses are thought to result from unresolved prior infections.

CAUSES OF URINARY TRACT INFECTIONS

Many different micro organisms can infect the urinary tract, most common agents are the gram negative bacilli.

Ecoli causes approximately 80% of acute infections in patients and other organisms are proteus, klebsiella, enterobacter, pseudomonas, chalamydia etc.

PATHOGENESIS of URINARY TRACT INFECTION

Adhesion of bacteria is the first step in the pathogenesis of Urinary tract infectiion.

The entry of uropathogens into the urinary tract is usually from periurethral colonisation of females or often from prepucial colonisation of uncircumcised males. About 75% of organisms is distal urethra are a mixture of lactobacilli, streptococci, staphylococci, while remaining 25% are anaerobic. When the host defenses are weakened urtheral colonisation and mucosal adhesion of bacteria occurs.

Usually in a normal healthy individual a series of non specific and specific mechanisms prevent this process.

The non specific mechanisms are the flushing effect of urine, normal vaginal flora and tamm horsfall glycoprotein which complexes with bacteria and are eliminated through urine.

Circulating IgG and IgM in upper urinary tract act as specific immunological mechanisms.

Secretory IgA in the upper and lower urinary tract particularly the urethra provide a barrier to ascent of infection. In addition to humoral defence, cellular response also plays a role in preventing ascent of infection.

FACTORS INVOLVED IN THE PATHOGENESIS OF URINARY TRACT INFECTION

HOT SUMMER CLIMATE

There is lots of water loss from the body surface through pirspiration in form of sweat which causes depletion, it sufficient water is not consumed thos might lead to change in ph level of urine making it acrid which may excoriate the inner linning of urinary tract thus making it more sussceptible to infections.

LOW WATER INTAKE

Low water intake causes increase in concerntration of metanolites in urine making it more corrosive in nature to inner linning of urinary system thus damaging it and giving opportunity yo organsims to infect and colonise in urinary system.

DIABETES

High sugar levels are associated with infections as they not only reduce immunity but also provide with instant and easy source energy for micro-organosms to multiply and grow

IMMUNOCOMPROMISED INDIVIDUALS

Immunocompromised imdividuals especially those on therapy with drugs known to suppress immunity, individuals with Human Immunodeficiency Virus Infection, Diabetics and other immunodeficiency disease conditions provide easy breeding ground for opportunistic micro-organisms to infect immunocompromised tissue of urinary system.

PRE-EXISTING GENITAL INFECTIONS

Pre-existing genital infection may fimd route from genitals to urinary tract and may infect it as well which is more common in females also in females ots seen that skin infecyions of vulva may traverse intonthe urinaty system and may infect it.

FEMALE ANATOMY

Female are more prone to the development of Urinary tract infection. Women have a shorter urethra, wbich shortens the distance that bacteria must travel into the urinary tract. Gram negative enteric organisms risiding near anal region colonise the periurethral region and cause infections.

USE OF BIRTH CONTROL DEVICES

Women who use diaphragm as a birth control have a high risk of urinary tract infections.

MENOPAUSE

After menopause there is decline in the oestrogen level causes changes in urinary tract and that make a women more vulnerable to infections.

SEXUAL ACTIVITY

Sexually active women tend to have more tendency to have urinary tract infections, as the act facilitates the entry of introital bacteria into the bladder.

BLOCKAGES IN URINARY TRACT

Any impediment to free flow of urine as with renal calculi, strictures,, tumors, prostatic hypertrophy favour the development of Urinary tract infections.

URINARY TRACT ABNORMALITIES

Babies born with urinary tract abnormalities that hinder the flow of urine to leave the body normally or cause urine to back flow urine up in urethra have a increased risk of Urinary tract infection.

CATHETHER USE

Use of catheters have a high risk of urinary tract infections. This may include in patients who are hospitalised, amd im some cases it also advised on daily basis especially in patients with urethral stricture, patients who are having neurological abnormalities, paraylsed patients which make it difficult to control their ability to urinate.

CLINICAL FEATURES OF URINARY TRACT INFECTION

The clinical features depend on whether the infection is on upper tract or lower tract.

CYSTITIS OR URETHRITIS

Infection in bladder is common in women during thier reproductive years. Patient with cystitis or urethritis may be asymtomatic or may present with frequency, urgency, suprapubic pain and dysuria, nocturia, urge incontinence, a sensation of incomplete bladder emptying may accompany lower urinary tarct infection.
The urine may have offensive odour and haematuria occurs in 30% of cases. On physical examination usually reveals mild suprapubic or urethral tenderness.

PROSTATITIS AND SEMINAL VESICULITIS

The usual symptoms of prostatic infection are frequency, dysuria, perineal or groin pain, difficulty in voiding urine and painful ejaculation. Relapsing urinary tract infections are associated with above symptoms in men are suggestive of chronic bacterila prostatitis.

ACUTE PYELONEPHRITIS

Emphysematous pyelonephritis is a particularly severe form of upper urinary tract infection.

Symptoms of acute pyelonephritis include fever with chills, nausea, vomiting and diarrhoea.

Physical examination reveals tachycardia, myalgia, renal angle tenderness. Most patients have significant leucocytosis and bacteria detectable in gram stained urine.

CHRONIC PYELONEPHRITIS

Chronic pyelonephritis is known to develop as a result of infection and vesicoureteric reflex. It is a form of upper urinary tract infection. Many patients remain asymtomatic for a long time and present with symptoms later.

ROLE OF HOMOEOPATHY IN TREATMENT OF URINARY TRACT INFECTION

Homoeopathy plays a very significant role in the management of Urinary tract infections. In homoepathy we adopt a holistic approach to Urinary tract infection with a detailed case analysis and individualisation of each patient.

FEW INDICATED HOMOEOPATHIC REMEDIES

CANTHARIS

Cantharis has main sphere of action on the genito urinary system.Indicated in case of urinary tract infection. Cantharis patient has intolerable urging and tenesmus. Frequent urge to pass urine. This is one of the important symptom which points towards cantharis. There is intense burning and cutting pain during urination. Severe back pain, violent paroxysms of cutting burning pain in whole renal region. Urine scalds and is passed drop by drop.

STAPHYSAGRIA

Staphysagria is more commonly indicated in Urinary tract infections in female. Suited to women who are newly married and have ineffectual desire to urinate, as a result of sexual activity.,often known as honeymoon cystitis. Presents with burning in urethra while urinating. Feeling of pressure on the bladder with sensation as if undone completely. Sensation as if drop of urine is rolling continously along urethra. Prostatic enlargements which cause infections in urinary tract can also be very well managed with Staphysagria.

BENZOIC ACID

Benzoic acid is indicated remed in urinary tract infections, when there is a very strong smell in urine, the odour is as if that from horse urine. Another strong symptom that indicates Benzoic acid is intense pain in urethra. Also indicated in cystitis. The complaints of benzoic acid are changeable. When the urine is scanty or light he suffers from backache and pain in joints. When the urine is copious and plenty and urine is full of deposits he feels better. Presents with alternate light and heavy urine.

APIS MELLIFICA

Apis mellifica acts on the urinary system and presents with burning at the end of urination. The urine may be scanty,despite scanty urine the patient has constant urge to urinate. Urine is dark coloured or muddy. Presents with burning and soreness when urinating. A great anasarca appears and the face is swollen with bags under eyes. Great agony in voiding urine. Unconcious flow of urine.

SARSAPARILLA

Sarsaparilla acts through the ganglionic system upon the genitourinary system . Its is one of the indicated remedies in irinary tract infection when urine is either too often or too copious pale and scanty. There is much pain at the conclusion of passing urine, which is almost unbearable. Patient has to wake up two to three times at night to pass urine. Pain in the bladder region or lower abdomen extends to back.

BERBERIS VULGARIS

Berberis vulgaris has affinity towards the genito urinary system. Berberis is indicated in urinary tract infections. Cystitis with twings of cutting pain or burning sensation that extends towards the urethra and its opening may indicate the need for this remedy. There is no desire to urinate. After emptying the bladder the patient feels some urine is left inside, undone sensation. There are irregularities of urine, with copius discharges. There is Changeability of urine like benzoic acid.

LYCOPODIUM

Lycopodium is one of the indicated remedy in urinary tract infection. A marked feature or one of the prominent feature of lycopodium is polyuria during night must arise at night and pass large quantity of urine.,altough day time urine is normal. Painful urge to urinate, but has to strain to pass urine. Pain is felt at the back before passing urine. Flow of urine is slow and with feeble stream. The urine is often muddy with brick dust or with red sand deposits.

SULPHUR

Sulphur has a important role in urinary tract infection. The patient has unsual desire to pass urine at night. The most characteristic symptom that indicates the use of sulphur is great burning sensation while passing urine. Frequent micturation, enuresis. Mucus and pus in urine, parts sore over which it passses. Has sudden call to urinate must hurry. The urine scalds the urethra while passing urine and smartine is so intense that it lasts for a long time after urination.

CLEMATIS ERECTA

Clematis has main sphere of action on the genito urinary tract. Its is very effective for urine infections in patients who have suffered from sexually transmitted disease. Slow inflammation of urethra will infilterate and urethra feels like a large whip cord, painful on pressure. Patient cannot emtpty bladder completely. He has undone sensation, when he appears to have finished urinating, it wil keep dribbling often. Presents with frequent scanty urination.

PREVENTIVE MEASURES IN URINARY TRACT INFECTION

Some useful steps to reduce your risk of Urinary tract infections

Stay hydrated, drink plenty of liquids. Drinking enough water helps to dilute your
urine and hence ensures that you will urinate more frequently allowing the bacteria to be flushed from your urinary tract.

Urinate frequently, do not hold urine when you need to urinate. Holding urine when you need to evacuate can help the bacteria present that may develop into infectiions.

Emtpty your bladder soon after intercourse and drink enough water to flush out the bacterias.

Maintain good hygeine. Keep genital area clean, after urinating and bowel movement always clean the area from front to back by doing so it wil prevent bacteria in anal region from spreading to vagina and urethra.

Avoid using scented feminine products and use of douches, diaphragms which can cause irritation and infections which contribute to bacterial growths leading to urinary tract infections.

Wear comfortable cotton undergarments as other fabrics can trap moisture creating a potential breeding for bacteria. Avoid tight clothing.

HOMEOPATHIC TREATMENT

LIFESTYLE DISEASES AND HOMEOPATHY

September 7, 2018 Dr Deepan Leave a comment

LIFESTYLE DISEASES OR DISORDERS

Lifestyle Diseases and Role of Homeopathy.

Firstly let us understand what lifestyle means,

Lifestyle means a pattern of individual practices and personal behavioral choices or in a more simpler way we can describe lifestyle as “the way people live”, i.e day to day habits of an individual.

What Are Lifestyle Diseases or Disorders?

The diseases which primarily arises from the abnormal lifestyle of a person are grouped under the term lifestyle diseases or disorders.

Adopting an unhealthy lifestyle pattern leads to increase in both physical and mental diseases.

Lifestyle diseases too have become an epidemic and causes much greater public threat than any other epidemic.

It is seen that almost every 2nd individual suffer from some kind of lifestyle diseases.

Unfortunately, these lifestyle diseases are no longer restricted to people in their forties and fifties but has affecting the young adult zone and children as well.

Incidence And Causes Of Lifestyle Disorders

It is in practice that more than 30% of Indians over 30 years of age or even below 30 are suffering from one or more lifestyle diseases.

In our day to day life it is seen that, there are always deadlines, office or work pressure, family pressure, due dates and many other priorities. Thus due to this continous busy schedule and tension our mind and body are exhausted and we do not usually get the requied rest.

The risk of developing lifestyle disorder depends on various factors including the kind of work one does, the environment where the person lives, the type of food he consumes and various unavoidable stressful situations.

The World health organisation identifies following as major risk factors for developing lifestyle disorders.

Improper Diet
Stress
Lack of Physical Activity
Disturbed Biological Clock
Alcoholism
Smoking

IMPACT OF TECHNOLOGY ON HEALTH

Present or current scenario of technological advancements, globalisation, consumerism, substance abuse, disturbed family life, stress, competative working pattern have a severe impact on the health of an individual.

When we consider each of the lifestyle diseases in our daily practice we see a huge number of population are restricted to thier gadgets (cell phones, laptops, computers) and hence are always in their comfort zone. They are usually unaware about how harmful the use of technology is and how it is having a negative impact on their daily life. They are only aware of its adverse effects when their body starts showing the symptoms.

Let us see how some of the factors which are affecting health.

Prolonged use of laptops, cellphones, computers, continous watching of televison, may lead to spondylosis causing neck pain along with pain in the spine, trapezitis, tendinitis, trigger thumb, carpel tunnel syndrome, sciatica, strain on eyes, along with headache, fatigue, exhaustion, etc.

Prolong standing or wrong sitting posture gives strain on the backbone and causes chronic back pain. Also sitting for long induces continuous pressure on posterior aspect of thighs and hips which are largest muscle group of our body and almost centrally located this obliterates blood vessel on a very significant region of body thus disturbing the blood flow and circulatory pressure and pattern giving rise to engorged vessels in ano-rectal region and coccyxgodynia due to pressure on tissue and lack of circulation causing damage around coccyx. Not only this the circulatory disturbance of this scale due to pressure on significantly large part of body for prolonged period of time also gives rise to low tissue perfussion of blood in the dependent part that are compressed due to pressure in sitting posture, so then there is compensatory increase blood pressure to make sufficient tissue perfussion of blood where ever the blood vessels are compressed due to seated posture and mechanical pressure compression, this leads to high blood pressure.

Radiations generated by cellphones, and heat generated by laptop have adverse effect on the fertility.

People working against the biological clock, working continously on computers causing insomnia, and gastric disturbances.

Not to mention the addiction and psychological stress prosuced sue to social sites and unhealth mind again leads to unhealthy body.

SOME COMMON TYPES OF LIFESTYLE DISORDERS

It is usually seen that the onset of lifestyle disorders is insidious, it may take years to develop one.

But once these disorders are detected there has to be a total vigilance in the way of life along with proper medication and treatment for the same.

In present generation Stress tops the chart of causation of many diseases like obesity, diabetes, hypertension, cancers, etc.

Not that stress was never present in our ancestors in the past, but it was combated with stress busters like spending time with family and friends, excercising, meditation, etc., in present generation mankind had distanced self from all this stress busters and are more influenced by technology.

Few Common Lifestyle Disorders Are

INSULIN RESISTANCE and METABOLIC SYNDROME

Imbalance in energy utilisation and storage, as a result of disturbances in multiple physiological functioning, especially insulin resistance considered as a major contributing factor which results into metabolic syndrome which presents itself with collection of signs like Hyperglycemia, Central Obesity Hypertension, Dyslipidemia – High Triglycerides and Low HDL.

Lifestyle factors like Stress, disturbed chronobiology, improper diet, frequent consumption of sugar sweetened beverages, alcoholism substance abuse or psychotropic and certain other longterm medications, sedendary life, and definately genetics play major role in development of metabolic syndrome.

OBESITY
Indis has been ranked as second higest nation to have huge number of obese individuals. Obesity is a very fatal condition which makes an individual more vulnerable to lifestyle disorders. Obesity is one of the important disorder caused due to sedentary lifestyle, unhealthy eating habits, reduced physical activity, stressful life etc.

DIABETES MELLITUS

Diabetes mellitus is a metabolic disorder. It is a complex condition in which the blood sugar levels are raised for a long period of time either because of inadequacy of insulin production or lack of body cell responses to insulin. Diabetes is also a result of age, stress, sedentary lifestyle, obesity etc.

HYPERTENSION

Hypertension is a term used for a condition of body in which the blood pressure is higher than the normal. Its one of the common lifestyle disorder. Various causes related to hypertension mainly stress, sedentary lifestyle, increased salt intake.

Basically Hypertension in most of the cases is a compensatory mechanism of the body which is brought in place by body to counter reduced tissue perfussion of blood caused due to obesity lack of exercise and wrong postures where circulation is obliterated of a larger area due to pressure for long period like sitting in almost same posture for long or lying in almost same posture for long; Or in posture where dependent parts are not moved for longer period of time causing difficulty in circulation due gravity like standing for prolonged period or hanging limbs for prolonged period of time.

Salt restriction, regular excercise, proper diet, decrease stress help to manage hypertension.

CARDIOVASCULAR DISEASES

Any abnormality or irregularity which affects the heart muscles and blood vessel walls can be refered to as heart disease. Elevated level of cholestrol and triglycerides are major markers for heart diseases.
There is a huge number of population in India who suffer from cardiovascular diseases. Again it is one of the lifestyle disorder sedentary habits, stress, increased level of cholestrol, improper diet are some of the reasons for cardiovascular diseases.

CARCINOMAS

Due to stressfull lifestyle we lead, there is decrease in immunity of our body, WBC’s loose thier power to fight the viruses that enter our body. Ther may be an irregular cell growth which can be concluded as carcinoma when diagnosed appropriately.

RESPIRATORY DISEASES

In present practice we notice a huge number of population suffering from reccurent respiratory tract infections. It may be worsend due to continous influence to body to abnoxious agents, may be occupational harmful chemical exposures, prolong use of antihistamines anticold cough medicines, habit of smoking has a very severe impact on health which leads to various repiratory diseases.

AUTOIMMUNE COMPLAINTS

Due to sedentary lifetsyle, decreased physical activity, obesity and improper diet many other causes leads to various joint complaints like arthritis,rheumatoid arthitis, gout etc.

DEPRESSION and ANXIETY

Stress and anxiety trigger a number of lifestyle disorders. Continous worry stress, family tensions, work pressure, health concerns, unemployment, love failures have a direct impact on the mental or emotional health of the person. Continous stress worry leads to anxiety neurosis and depression.

Along with the above mentioned lifestyle disorders there are various other diseases which directly or indirectly have an impact on the health of an individual due to lifestyle.

ROLE OF HOMOEOPATHY IN LIFESTYLE DISEASES OR DISORDERS.

Homoeopathy plays a very significant role in the management of lifestyle disorders.

Lifestyle disorders are a threat to the socio economic aspect of nation globally and appropriate actions for their management are the need for the moment.

Management of lifestyle diseases include proper diagnosis and treatment for the same.

Homoeopathy has a major role to play in the management of present day lifestyle diseases.

Homoepathy medicines strengthens the immunity of the body to fight against pathogens. They act on much deeper level both at physical and emotional health.

Homeopathy is a complete system of medicine discovered by a German physician Dr Samuel Hahneman.

Dr Hahneman highlights the importance of healthy lifestyle. He advises to remove all influences which hinder cure.
According to him hinderances to the cure of chronic diseases are exccesive hardships, laboring, grief, hunger, poverty, sudden death of loved ones etc. He advised to avoid sedentary life that interferes with health.

In case of lifestyle disorders Homoepathic management include a detailed individualised study of the patient. A constitutional medicine is selected based on individualised approach. A holistic approach towards each case really helps to give wonderful results.

PREVENTION OF LIFESTYLE DISORDER

A healthy lifestyle should be adopted to combat life style disorders.

Health rests on three pillars

DIET
EXERCISE
REST

If any one of above three is disturbed the health will fall

PROPER DIET

There is a well known proverb in ayurveda that says

” If your diet is not proper, no medicines will work

And

If your diet is proper then no medicines will be required.”

Diet rich in fiber and nutients, fresh fruits, vegetables should be a regular part of meal.
Avoid skipping meals.,junk food, fatty food, aerated drinks as they do no good but just harm the body in many ways.

ADEQUATE EXERCISE

Exercise helps improve circulation and secrete ample of anabolic hormones thus wash off metabolites and other harmful substances from body.

The root cause of most of the lifestyle disorders is obesity. It is really importamt to maintain a ideal body weight. Regular exercise, brisk walk, yoga help to comabat many diseases

REST TO MIND AND BODY

Stress Management

Proper hormone flow depends much on balanced mind as its optimal balance is dependent on a very delicate Hypothalamo-Pitutary-Hormonal Axis. Which is much dependent on psychological wellbeing and vice-a-versa.

Proper guidance and counselling to combat stress. Involve in recreational activities which help to relieve stress. Practice yoga, music therapy, maintain a balance between work and family., proper balanced food with adequate sleep.

Adequate Sleep

Most of the hormones and other repair mediators within body are secreted most abaundantly during and deeper the sleep better the repair work in body.

Continous and undisturbed sleep of 7 to 8 hours helps to solve many health issues.

HOMEOPATHIC TREATMENT, Orthopedic

GANGLION CYST cured with Homeopathy

August 26, 2018 Dr Deepan 6 Comments

Ganglion Cyst also called Synovial Cyst is a soft but firm cystic overgrowth usually found near joints and tendon sheaths.

APPEARANCE OF GANGLION CYST AND ITS AMBIGUOUS NOMENCLATURE

SIZE AND SHAPE OF GANGLION CYST

It is somewhat round in shape well-demarcated margins and can grow upto 5cm in size. The average size is 2cm.

CONSISTENCY OF GANGLION CYST

Most of them have consistency that is seemingly hard but its fluid filled within so its best described as “Soft but Firm”. It is so, because though fluid filled the firm character is derived due to the wall of the cyst which is thin but tough and firm due to high tensile strenght of the wall and also it actually divides or breakes-off shoots at various points into many thin films which runs randomly into the depth of the cyst and each film of wall intermingling and interlacing with each other and forming a mesh work just like a complex knotty intermingled bunch of thread, this also turns larger cyst into collection of multiple small cysts within.

Due to this the term Ganglion was derived which actually meant “Knot Beneath Skin”.

It does have a larger cystic space within but rest of it is much of multiple very small cysts giving it hard and firmer character. the firmer the cyst more of the wall meshwork within. Softer Ganglion are more of fluid within and lesser wall meshwork.

LOCATIONS OF GANGLION CYST

They appear near almost any joints and tendon sheaths wether hands, feets, within knee joint near cruciate ligaments or hoffa’s infrapatellar fat pad, near shoulder joint where larger cysts apposing or adjoining each other have known to compress nerve within, acromioclavicular joint within gastroncemous muscle, biceps tendon, peroneal nerve sheath, it can rarely be intraosseous, it is also seen in popleteal artery from from within tunica adventia layer of the artery and such condition is not common but is termed as Cystic Adventitial Disease.

The most common site of it appearance is wrist joint, along the Extensor Carpi Radialis Brevis especially when it passes over wrist joint on dorsal aspect.It is also commonly found on fingers mostly near joints

They also appear on feet almost 40% lumps found on feet turn out to be Ganglion cyst but there are very rare chance of them appearing on soles and heels the reason may be because there is constant tapping of that region with floor and that was the old treatment to treat ganglion cyst that is to tap it with thick book like Bibble, that why it was also called “Bibble Cyst” in ancient times.

Ganglion cyst is a misnomer used since ancient times, remaining unchanged till date, making it ambiguous term which is not at all related in anyways to the neuronal ganglion or ganglion cell.

CAUSES OF GANGLION CYST

Herniation Hypothesis

Althought the exact cause of Ganglion Cyst is unknown but Herniation Hypothesis is being widely accepted. Herniation Hypothesis states that probable cause is thought to be due to weakened joint capsule which leads to distention and out-pouching.

The dye injected in joints space can enter the cyst but not vice a versa. This shows that though the joint space is some what continious in someways with cyst but with a Check-Valve Mechanism to prevent the cyst fluid entering into joint space. This oneway flow causes further bulging and herniation.

This hypothesis is supported by the fact that

The fluid within the cyst is Mucinous which resembles to synovial fluid
The microscopic anatomy of cyst resembles to that of tenosynovial tissue.
The dye experiment that shows that Joint Space and Cyst are continuous but with unidirectional flow towards cyst

Other probable mechanisms and causes of Ganglion Cyst

Joint stress leads to split in joint capsule that surrounds the joint, as a result the synovial fluid leaks into the tissue and create thicker cystic fluid with cyst wall
They may occur when the connective tissue breaks down around a joint. They tend to attach to an underlying joint capsule or tendon sheath.
Degenerative conditions of synovial joint post trauma or inflamation causes damage to proportion that body’s process of healing with primary patent intention becomes insufficient and body starts healing with secondary intention with compensatory mechanisms activated giving rise to abnormal joint capsule composition and malformed joint capsule linning making it more vulnerable and thus facilitating further damage over and over again and giving rise to ganglion.
Excessive Hyaluronic acid secretion by fibroblasts
Excessive proliferation of parenchymal cells
Myxoid degeneration of fibroid tissues and liquifaction.

Occupation plays an imoprtant role in development of ganglion, occupations where workers overuse certain joints, example wrist have a tendency to develop ganglion.

SYMPTOMS OF GANGLION CYST

Most of the ganglion cause some pain usually following acute repeatative trauma but about 30 to 35 % are without symptoms except for their appearance.

If pain is present, it is usually chronic and is made worse by continous movement of joint.

The swelling may appear over time or when the cyst is connected to a tendon or nerve there is sense of weakness and numbness in the affected finger.
Stiffness and spasms of joints may occur.

DIAGNOSIS OF GANGLION CYST

Ganglion cyst can be diagnosed easily based on the appearance and location of the cyst.

A routine X-ray or ultrasound can help to rule out other serious outcomes.
X-ray wil be usually normal unless there are changes related to arthritis.

HOMOEOPATHIC APPROACH IN CASE OF GANGLION CYST

As from above we see Ganglion cyst is disease condition that triggered due to degeneration there is overgrowth but its triggered as a secondary compensatory mechamism where the tissue is degenerated and not the regular one

So this condition falls primarily under Syphylitic condition with Sychotic secondary processes.

In such patients its of much importance to evaluate general constitution and find out any other degenerative condition that also shows simultaneous regenerative as features within itself.

If such conditions are found or any other constitutional or miasmatic deep seated conditions are found at more than one site (which is usually found in such cases on very thorough case taking) then they need to be evauated with their totality and constitutional or miasmatic treatment should be given.

There are many cases where its an isolated condition with no other strong miasmatic or constutional features supporting of that can be linked to th ganglion cyst in such cases initially starting theraputically yeilds some results and also helps vital principle to express new symptoms which then will help get the constitution properly during second prescription

It is difficult to cure the condition with theraputically indicated medicine alone. It does resolve the visible cyst to nonpalpable level but it will resurface again and again soon after the action duration of the given theraputic is over. And to anihilate ot from roots it will require a deep acting constitutional medicine sooner or later.

INDICATED REMEDIES IN GANGLION CYST

CALCAREA FLOUR

Calcarea flour is indicated in hard, stony glands, ganglions, and enlargement of joints. Calcarea flour is very well indicated in ganglion or encysted tumours at the back of the wrist. The patient usually experienes pain while moving the joint. Calcrea flour disperses bony growth, exostosis after injury. The patient presents with general stiffness of joints with numbness of affected part. The patient is sensitive to cold, to change in weather.

CALCAREA CARB

This remedy has great affinity towards glands, bone and skin. Impaired nutrition being the keynote of its action. Cacarea is indicated in case of ganglion of wrist. Presents with sharp, stitching pain as if parts are wrenched or sprained. Patient presents with weakness of extremities and swelling of joints. Well suited in arthritic nososities. Patient is worse from exertion both mental or physical. Complaints Worse from cold in every form and better by dry weather.

RUTA GRAVEOLENS

Ruta is know for its sphere of action on periosteum and cartilages. It is seen that Ruta has tendency to form deposits in periosteum, tendons and joints especially wrist. Ruta is one of the indicated remedy in ganglion of wrist. Bones of wrist and back of hand are painful as if bruised. Pain while lifting heavy weight. Numbness and tingling in hand after exertion. Feeling of intense lassitude, weakness and despair. Ruta is well suited to mechanical injuries of bones and periosteum which may be one of the causative factor for ganglion.

BENZOIC ACID

Benzoic acid has affinity towards all the joints especially wrist, knees and there is cracking on motion. Benzoic acid is indicated in gouty or rheumatic diathesis engrafted on a syhilitic patient. Indicated in ganglion with swelling of wrist. There are Gouty deposits on both the wrists. Paralytic pains, pain on movement of joints. Patient is usually sad, weak, debilitated and inclined to dwell on unpleasant things.

SILICEA

Silicea has affinity towards diseases pf bones, caries and necrosis. Indicated in case of ganglion cyst on wrist. Patient presents with stitching type of pain with numbnesss in fingers. Tonic spasms of hand when writing. Profuse sweat of hand with ganglion on back of the hand. Weakness rigidity and want of flexibility in fingers. Usually the complaints develop slowly. Silicea is Adapted to nervous, irritable, sanguine temperament, dry pale skin. Very oversensitive both mentally and physically.

SULPHUR

Sulphur is a deep acting antipsoric remedy. Its action is centrifugal that is from within outwards. Sulphur is indicated in case of ganglion and rheumatic complaints. Ganglion on back of wrist. Sprained pain and stiffness of wrist, worse in the morning. Presents with Paralytic weakness of hands and arms. Rigidity and wrenching pain in joints. Trembling of hands when strained. Sulphur patient is usually quick tempered, lean with stoop shoulder.

ONE OF OUR CASES OF GANGLION CYST CURED WITH HOMEOPATHIC MEDICINES WITHOUT ANY SURGERY

BEFORE HOMEOPATHIC TREATMENT

GANGLION CYST ON THUMB, BEFORE TREATMENT

AFTER HOMEOPATHIC TREATMENT