All posts by Dr Deepan

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

PREMATURE GREYING OF HAIR

There was a time when premature greying of hair happend to only older people. Premature greying of hair has become a cause of concern for younger generation. Its not uncommon anymore to see people in thier early 20’s with a mop of grey hair on thier head. Premature greying of hair has become an important concern in present day and thousands of people both men and women alike are seeking medication for the same. Premature greying of hair can have a negative effect on appearance, confidence and social acceptance of the affected individual.

HOW AND WHY EXACTLY DOES GREYING OF HAIR OCCURS?

The root of every hair strand under the scalp is surrounded by a hair tissue called hair follicle which contains pigment cells. These cells produce the chemical called melanin that gives hair strand its colour.

When a person grows older the melanin production reduces making the strand greyish or white.

WHAT CAUSES PRE MATURE GREYING OF HAIR?

It is usually a complex multifactoral process.

Genetic factor: is one of the most common reasons for having grey hair at an early age.

Stress: Person under prolonged stress anxiety tension can be one of the cause of greying at an early age.

Dietary deficiencies: Deficiency of vitaminB, zinc, copper. These nutrients assist the metabolic process involved
in giving hair its natural colour.

Smoking damages the melanin producing cells melanocytes causing greying of hair.

Thyroid disorder: An underactive or overactive thyroid can affect the melanin production of hair.

HOMEOPATHIC APPROACH IN PREMATURE GREYING OF HAIRS

It is important to find the underlying cause for greying of hair.
Once this is done,the condition is best attended by Homeopathy.
With effective counselling,diet and regimen followed by a homeopathic medicine really helps.

HOMEOPATHIC REMEDIES INDICATED IN PREMATURE GREYING OF HAIRS

PHOSPORIC ACID
LYCOPODIUM
NATRUM MUR
PHOSPHORUS
SILICEA
VINCA MINOR

PREMATURE GREYING OF HAIR THERAPEUTICS :

EMBELICA OFFICINALIS or AMLAKI

Since ages Amla is known to benefit health of hair. Amla is rich source of Vitamin C, Iron, Calcium and has lots Fibres. In ayurveda it is well proven that amlaki helps reduce greying of hair Similarly in Homeopathy the tincture prepared from amla that is Embelica Officinalis Q also called Amlaki Q is proven to be too beneficial in cases of premature greying of hairs.

PHOSPHORIC ACID

Phosphoric acid is one of the indicated remedies for the treatment of premature greying of hair resulting from grief and depression. There is thining and falling out of hair. The patient is indifferent to all affairs of life.Phosphoric acid helps to restore the pigmentation of hair that are destroyed by effects of grief.

NATRUM MURIATICUM

Natrum muriaticum is indicated in treatment of premature greying of hair mainly in weak and anaemic person. Natrum Mur helps to improve general health of the patient and raise immunity to combat greying of hair. Natrum patients have severe headache which gets worse in the heat of sun.

SILICEA

Silicea is very useful in treating grey hair when the digestive power and absorption of nutrients is weak. Deficiency of nutrients lead to greying of hair. Silicea helps to improve the proper absorption of nutrients and hence prevent greying of hair.

PHOSPHOROUS

Phosphorous is indicated in treatment of grey hair. It prevents further greying of hair. The patient presents with hairfall and dandruff, itchy dry scalp. Desires icy cold drinks.

VINCA MINOR

Indicated in case of greying of hair. Helps to prevent greying of hair. Indicated when hair falls in spots, vinca helps to restore natural pigment of hair.

LYCOPODIUM

Indicated in case of premature greying of hair. Lycopodium halts the process of greying of hair when de pigmentation of hair occurs in spots. Indicated in patients whose hair problems are associated with gastric disturbances.

THYROIDINUM

Indicated in premature greying of hair along with thyroid disorders. Helps in arresting the process of greying of hair.

CALCAREA CARBONICA

Indicated in greying of hair presents with severe hair loss, sweating of scalp followed by intense itching.

DIETARY ADVICE FOR CASES OF PREMATURE GREYING OF HAIR

  • Increase your intake of fruits rich in vitamin C.
  • Amla since ages is known to aid in cases of premature greying of hair, it is recomended to consume atleast one amla everyday and when off season on can purchase dried amla powder. Amla Hair oil for external application on hair and scalp is also known to prevent greying of hairs.
  • Make sure your diet contains sufficient amount of green leafy vegetables
  • Adding almonds and other nuts rich in vitamin E can help reduce greying of hair.
  • Walnuts contain biotin that helps strengthen hair, reduces occurance of premature grey hair.

OCD OBSESSIVE COMPULSIVE DISORDER

OCD- Obsessive Compulsive Disorder is a type of Mental health disorder which involves unwanted distressing obssesive thoughts and repeatative compulsive mental or physical acts.

FACTS ABOUT OCD ..!!

It can begin at an early age between 7 to 12.

It is the 4th most common Mental Illness after Phobias, Depression, Substance Abuse.

Obsessive Compulsive Disorder is more common in boys than girls in childhood but into later stages women are more affected than men.

It has a significant impact on social life.

PROBABLE CAUSES OF OBSESSIVE COMPULSIVE DISORDER OCD

Dysregulation of serotonin leads to symptoms of Obsessive Compulsive disorder

35% of 1st degree relative suffer from Obsessive Compulsive Disorder.

Genetically monozygotic twins are more prone to Obsessive Compulsive Disorder

Depression or anxiety may be one of the probable causes.

DIAGNOSTIC CRITERIA OF OBSESSIVE COMPULSIVE DISORDER OCD

Usually OCD is diagnosed by identifying the situations causing obsessions and compulsions.

COMMON OBSESSIONS INCLUDES.

  • Excessive, persistent thoughts,
  • Impulses or images experienced at some time of disturbance causes anxiety and distress.
  • Obsessions like fear of contamination from dirt or germs.
  • Perfectionism including concerns about exactness, needing to remember things and has fear of losing things.
  • Religious obssesions including concerns about offending God.

COMMON COMPULSIONS INCLUDES.

  • Repeatative behavior like washing hands many times in a row.
  • Repeatative checking on a locked door, light switch, counting, praying.
  • They do a task in a specific order everytime.

HOMEOPATHIC APPROACH IN OBSESSIVE COMPULSIVE DISORDER OCD

Homeopathic medicines are selected on the basis of detailed case analysis and individualised approach in each case.

Homeopathic treatment along with proper counselling and advise and reassurance have definately a positive impact on the patient.

INDICATED HOMEOPATHIC MEDICINES FOR OCD -Homeopathic Theraputics For OCD

ARSENIC ALBUM

Arsenic album is indicated in case of Obssesive compulsive disorder where the patient has persistent thoughts of death, fear of germs, robbers. Repeated washing of hands because of fear of illness. Persistent fear of death, thinks that there is no use of taking any medication or treatment. Very fastidious, wants everything neat and clean. There is extreme restlessness and anxiety.

CALCAREA CARBONICA

Calcarea carb is indicated in case of Obssessive compulsive disorder. They have common fear of going insane, fear of heights ,fear of ghosts, spirits, natural disasters. They are very organised, pleasant and hard working. They are very obssesed with cleanliness. Extreme anxiety, slugishness lack of confidence.

NATRUM MURIATICUM

Natrum muriaticum is indicated in patients of obsessive compulsive disorder who are obessed with idea that the thieves may strike and have the habit of repeatedly checking the locks of doors. They are so obsessed that they have dreams of thieves in the house and wake up to check the doors again.

CARCINOSIN

Carcinosin is indicated in patients who are very much fastidious, concerned about cleanliness. They always follow a specific pattern in placing things. They are always well dressed neat and tidy. They want everything in a proper colour combination too. They want perfection in every work they do.

SYPHILLINUM

Syphillinum is one of the indicated remedy for patients with obsesive compulsive disorder, who have a compulsive habit of washing hands repeatedly. They have fear of contamination.

MEDORRHINUM

Medorrhinum is indicated in case of Obssesive compulsive disorder. Patient feels that germs are present on each and every object. So they have a habit of washing hands at every short intervals. Fear of dark. Anticipation anxiety is usually present.

OPIUM

Opium is indicated in case of obssesive compulsive disorder. The patient has a history of narcotics. Yielding disposition. They do not process grief well. Fear of contamination., frightful dreams, fancies. Delirious talking. Sleepy but cannot sleep. Depression. Painlessness with sluggishness.

SILICEA

Silicea is indicated in case of obsessive compulsive disorder. Silicea is a very mild yielding patient. They have persistent thoughts of pins, also called as pin mania. They have fear of pins but have habit of collecting and counting pins. They have fixed thoughts and ideas. They are Fearful and anxious.

SOCIAL ANXIETY DISORDER

Social Anxiety Disorder and Homeopathic treatment approach with Homeopathic Theraputics.

Anxiety is a general term for certain disorders that cause nervousness, fear,
apprehension and worrying.

Anxiety is closely related to an individuls needs and motives. So if the essential needs linked with affections, security, self esteem, achievement and freedom are not satisfactorily gratified, it may give rise to feeling of excessive anxiety.

WHAT IS SOCIAL ANXIETY DISORDER?

Social Anxiety Disorder is the most common anxiety disorder.
it is also known as Social Phobia.
Social Phobia is a irrational fear that produces a concious aboidance of feared subject, activity and situation.

INCIDENCE OF SOCIAL ANXIETY DISORDER

Social Anxiety Disorder is known to appear at an early age in most of the cases, developed by the age of 11 and in some cases by age of 20.

It is a serious mental health disorder in India with an incidence of 2.79%.

WHAT CAUSES SOCIAL ANXIETY DISORDER?

It is usually seen that there is greater risk of having social phobia if there is a positive family history.

The development of social anxiety disorder may occur from humiliating or embarassing social experience can be a trigger to social phobia.

CLINICAL PRESENTATION OF SOCIAL ANXIETY DISORDER

A person with Social Anxiety Disorder is afraid that he or she will make mistakes, look bad and will be embarrased or humiliated infront of others.

The fear may be worse by lack of social skills or experience in social situations.

They suffer from distorted thinking including false beliefs about social situations and negative opinion of others.

Social anxiety disorder negatively interferes with the persons normal daily routine including school, work, social activities.

These patients presents with physiological symptoms such as excessive sweating, difficult breathing, palpitations.

Blushing and shyness is also exhibited by most of the individuals.

Social Anxiety shows a high degree of co occurance with other psychiatric disorders.

SOCIAL ANXIETY DISORDER HOMEOPATHIC TREATMENT APPROACH AND HOMEOPATHIC MEDICINES 

Rate of anxiety disorder is increasing with change in lifestyle where people are subjected to various stress.

Mental or pyschiatric diseases are more troublesome to a patient in comparision with physical disorders.

Homeopathy not only reduces anxiety but also makes the individual feel better in other areas of functioning as well.

INDICATED HOMEOPATHIC REMEDIES WITH THERAPUTICS FOR SOCIAL ANXIETY DISORDER

ACONITE

Aconite is one of the most indicated medicine for Social anxiety disorder. The patient presents with social anxiety, palpitations, trembling, nervousness. Fear appearing in public. They avoid going in social events, crossing streets full of people.

ARSENIC ALBUM

Arsenic album is indicated in Social anxiety disorder. Presents with anticipation, anxiety, dread appearing in public. Social anxiety with depression. Presents with symptoms of indigestion and dirrhoea along with anxiety. They are very restless and fastidious. Great fear of death. And anxiety about health.

ARGENTUM NITRICUM

Argentum nitricum is indicated remedy in case of social phobia where the patient presents with grear anticipatory anxiety. Dread appearing in public, fear, anxiety, anticiaption before appearing a public event. Lack of confidence, examination and stage fear.

AMBRA GRESIA

Ambra gresia is indicated in case of social anxiety disorder. Patients have intense fear of appearing in public. They feel embarrassed. They havr fear and cannot perform any activity infront of others. Presents with blushing, nervousness and palpitation.

CALCAREA CARBONICA

Calcarea carbonica is one of the indicated remedy for social anxiety disorder. They are very mild, yielding ,lack of confidence, highly dependable. Their thoughts are confused when tired which adds to anxiety. Unknown fear, confused thoughts. Extremely chilly, slightest cold goes right through them. Presents with physical complaints like increased perspiration, palpitation.

IGNATIA AMARA

Ignatia is indicated in social anxiety. Very sensitive, mild and anxious person. Anxiousness due to grief, loss of loved one, disappointments, stressfull emotional experience, frequent mood swings. Presents with extreme anxiety, mood swings, lack of confidence , fear appearing in public, facing social gathering. They burst unexpectedly into tears and laughter.

NATRUM MURIATICUM

Indicated in case of social anxiety disorder. They are peronally aloof but have a social conscience and desire to help others. Even when lonely they tend to stay away from social situations, lack of confidence. Easily offended, constant brooding.

GELSEMIUM SEMPERVIRENS

Gelsemium patient suffer from performance anxiety.,exam fear.,stage fear. Any exertion leads to trembling of muscles, trembling of hands, knock knee. They have persistent anxiety, anxiousness to appear in a social gathering. Present with diarrhoea before an occasion.

LYCOPODIUM

Lycopodium is indicated in Social anxiety disorder. Usually lycopodium patient lacks self confidence and is fearful appearing in public and speaking in public, stage fear, very coward. The person as intense anxiety with nervous breakdown. There is stammering and confusion of thoughts.

SILICEA

Indicated in case of social anxiety disorder. Silicea patient is very mild, yielding, sensitive. Anxiety nervousness when appearing a social gathering and events where they require public interaction, they anticipate failure in such situations.

PYOGENIC GRANULOMA

What is Pyogenic Granuloma?

PYOGENIC GRANULOMA also called GRANULOMA TELANGIECTATICUM or LOBULAR CAPILLARY HEAMANGIOMA is relatively a common benign vascular lesion of skin and mucosa and appears as an overgrowth of tissue.

It is usually a small, round, bloody red in color.

They are also known as Lobular capillary haemangioma or granuloma telangiectaticum.

They grow rapidly at first and then remain a constant size, they rarely exceed 1cm in diameter.

What causes Pyogenic Granuloma?

The following factors have a possible role in their development

Some cases develop at the site of a recent minor injury, such as a pin prick.

Staphylococcus aureus is frequently present in the lesion.

Hormonal changes in the body during pregnancy can also be the cause of Pyogenic Granuloma.

Certain drugs and medications are known to cause pyogenic granuloma

SIGNS AND SYMPTOMS

The appearance of Pyogenic Granuloma is usually a small red, round, oozing and bleeding bump.

Younger lesions bleed easily because they are rich in blood vessels. These lesions can be painful.

The lesions arise on various regions of the body such as eyelids, face, tongue, lips, arms, hands and feet.

EYELID: The condition gives rise to reddish pink vascular bumps over the eyelid and is said to be caused due to a rich blood supply from conjunctiva.

TONGUE: These growths arise on lateral side of the tongue, it may arise due to trauma from dentures.

LIP: Arises as a solitary growth on the lip.Growth generally appears on the lower lip.

FINGERS:The growths are common on hands and fingers.

FACE: Growths arising on face are generally multiple in number and looks like small red or reddish purple lumps

FEET: These bumps arise in the nail bed of a toe with an accompanying ingrown toe nail.

DIAGNOSIS

Pyogenic Granuloma can be diagnosed based on its appearance.

HOMEOPATHIC MANAGEMENT

Commonly Used Homeopathic Medicines for Pyogenic Granuloma

SYPHILLINUM

Syphillinum is mostly indicated in case of pyogenic granuloma, where the patient presents with abnormal growths with pain. Indicated in case of chronic erruptions. Suited to person with pale and fine textured skin, who are slender. Presents with marked prostration and debility.

HEPAR SULPH

Hepar sulph is indicated in pyogenic granuloma. Specially suited to lymphatic and phlegmatic individuals. Excessive sensitiveness of parts is a leading indication. Chilly sensation. Indicated in csae of vascular lesions of the skin, they are bright red in colour which tend to bleed.

SILICEA

Silicea is mainly indicated in cases like pyogenic granulomas. Patient presents with vascular lesions of the skin where the suppurations continue and wound refuse to heal. Discharge is thin bloody. The lesion are benign and granulomatous.

THUJA OCCIDENTALIS

Thuja is indicated in case pyogenic granuloma as it is used in bleeding growths, spongy tumours, warts. Thuja has main action on the skin. The lesions have tendency to bleed easily and presents with pain. Complaints worse at night.very sensitive to touch.

RUTA GRAVEOLENS

Ruta is indicated in case of pyogenic granuloma. The patient presents with small rounded vascular lesions which tend to bleed easily. Very anxious and low spirited with mental dejection. Presents with neuralgia, burning stinging pain.

CALCAREA FLOURICA

Indicated in case of pyogenic granuloma. Vascular lesions which tend to bleed and are painful. Indicated in abnormal grwoths. There is great depressio . Sensitiveness to cold. Mostly indicated in blood tumors.

Homeopathic Approach in case of Pyogenic Granuloma

In Homeopthy we not only consider the signs and symptoms of the patient but treat the patient holistically, based on individualisation.

Similarly considering the symptoms-similarity, individuality and total of the patient, below is an example of one of our cases of pyogenic granuloma at Dr SHAH’s HOMOEOPATHY this case responded well to homeopathic medicine Syphillinum and got completely resolved with selected potency of 200C of the said remedy.

pyogenic granuloma
Pyogenic Granuloma Before treatment
Pyogenic Granuloma
During Homeopathic treatment Pyogenic Granuloma becoming dark and dry
PYOGENIC GRANULOMA
DURING HOMEOPATHIC TREATMENT  PYOGENIC GRANULOMA BECOMING DARKER DRIER AND SHRINKING IN SIZE
DURING TREATMENT – SEE THE LARGE FRAGMENT OF PYOGENIC GRANULOMA HAS GOT DETACHED AND HAS INTERMINGLED IN HAIR NEAR INDEX FINGER
Pyogenic Granuloma
During Homeopathic Treatment at Dr Shah’s Homeopathy
Pyogenic Granuloma resolved after detaching and shrinking completely now only a small dark spot can be seen at the site.
Pyogenic Granuloma
Pyogenic Granuloma- After Treatment – Cured completely after Homeopathic Treatment By Dr DEEPAN P SHAH at Dr Shah’s Homoeopathy.

ORAL MUCOCELE cured with Homeopathy

What is Oral Mucocele?

Oral Mucocele is a cyst formed due to collection of salivary gland secretion.

It is pearly translucent occasionally with bluish discoloration usually measuring from 1-8mm in diameter. The deeper cysts may appear as a nodule and may not have translucent pearly appearance as in superficial cyst.

It appears on lower lip on sides.

When it appears on floor of mouth below tongue its termed as ranulla.

They are painless most of the time.

It usually lasts for few days to years.

It may frequently rupture and reappear again at same site.

It may also cause ulcerations.

Oral Mucocele
Oral Mucous retention cyst
Oral Mucocele, Mucous Retention Cyst, Mucous Extravasation Phemenon
Oral Mucocele, Mucous Retention Cyst, Mucous Extravasation Phemenon

Oral Mucocele results from

  • Ruptured Salivary Gland Duct this results into mucous extravasation phenomenon.
  • Obstructed Salivary Gland Duct this results into mucous retention cyst.

Rupture or Obstruction can be due to

  • Infection that can potentially obstruct or damage the salivary gland and its duct.  which can be due to many factors most common being poor oral and dental hygiene.
  • Injury on lower lip which can damage salivary gland duct may result innto oral mucocele tje most common form of injury is due to bitting lips by one own teeth.
  • Tumours that may obliterate obstruct or rupture or damage salivary glands and its ducts in any form may result in to mucocele in oral mucosa

HOMEOPATHIC TREATMENT FOR ORAL MUCOCELE

The underlying cause needs to be evaluated, exclude the probability of infection, malignancy. Patient needs to be guided for proper oral hyegiene, any habbit like bitting teeth should be avoided.

Following are the common Homeopathic  medicines used in treatment of Oral Mucocele

  • Silicea
  • Thuja
  • Variolinum
  • Calcarea flourica
  • Mercurious Solubilis
  • Syphyllinum
  • Antimonium Tartaricum
  • Antimonium Crudum
  • Apis Mellifica
  • Ranunculus bulbosus

Selection from the above medicines should be strictly done as per symptom similarity basis under consultation of homeopathic practitioner.

NIPAH VIRUS HOMEOPATHY Controversy – Does Homoeopathy Really Have Prevention or Cure For Nipah Virus Infection?

Nipah Virus Homeopathy Controversy – Does Homeopathy Really Have Prevention or Cure For Nipah Virus Infection?

Nipah Virus Homeopathy controversy has been gaining momentum since few days with many claiming that the claims of homeopathy are false, so whats the truth is lets have the deeper understanding about it.

Nipah Virus outbreak in state of Kerala first noted on 19th of May 2018 and since then the government authorities are on alert and to contain the infection and avert the potential epidemic about 230 doubted cases have being tested of which total 18 have turned out positive of which 16 have already lost their life. which shows that mortality rate of current outbreak is very high compared to average of all past outbreaks one can say almost 100% fatality rate of the current outbreak

THE NIPAH VIRUS HOMEOPATHY CONTROVERSY

Homoeopaths have come out with the medicines that can be indicated or applied in subjects of Nipah Virus Infection after proper homeopathic evaluation. To which believers of orthodox wide spread conventional mode of treatment, the allopathy, have come up with a very rebellious mood as usual claiming that homoeopathy cant work in Nipah Virus Infection and rebuting our claims even without giving a thought find out its practicality.

Homeopathy has since long came in for the disposal of mankind whenever there were epidemics and outbreaks of disease and allopathy had failed.

EXPLANATION – WHETHER HOMEOPATHY HAS MEDICINE FOR NIPAH VIRUS INFECTION OR NOT

Now the question arises right now is of the current outbreak of Nipah Virus Infection and its homeopathic treatment whether homeopathy has medicines for prevention and/or cure of Nipah Virus Infection or not.

Homoeopathy is based on principle of  “likes cure likes” its called the principle of similars ( just like vaccines ) ; where as the Allopathy is based on dissimilar sufferings and so aptly the name allopathy to this system was given non other than by the Founder of Homeopathy Dr Samuel Christian Fredrich Hahnemann and since that time Allopath’s opposition to this system Homeopathy is continuing.

In homeopathy we do not treat “the disease” but we treat “the person in disease” – Various Disease causing agents have different type of virulence, each which very specific set of characters, now our immune system responds in various ways to various antigens and also its very much subjective in various individuals. So in homeopathy we first take into consideration the type of response of immune system and what it has to express and how its responding to this antigenic stimulus as it is the one which is going to fight out the disease.

So in homeopathy we do not have name of the disease and its medicine but we have the set of symptoms that our immune system is expressing and its matching remedies. So its based completely on symptom similarity principle with which homeopathy since ages have cured many so-called incurable conditions because we believe in treating the Person in Disease by understanding what its immune system is expressing and trusting and strengthening it so that it can drive out the antigen with its dynamic, intelligent, automatic, autocratic, powerful nature of force which has helped life forms to evolve from unicellular to various life forms so different from each other and with different abilities.

In Homeopathy rather than hitting the virus or the antigen directly with noxious agents and damaging the system even further we simply trust the unquestionable power and ability of our immune system and try to strengthen it by stimulating it so that it can drive the virus out so homeopathy shows better success rate in treating viral conditions compared to allopathic mode of treatment.

Now in Nipah Virus Infection in past outbreaks we have seen that there are IgG and IgM antibodies against Nipah Virus have been formed in individuals that have survived the infection. so the immune sytem of many is strong enough to fight out the virus and survive.

CONCLUSION TO THE CONTROVERSY OF NIPAH VIRUS HOMEOPATHY

So homeopathy has a role in the Nipah Virus Infection disease and homoeopathic medicines if selected as per symptoms of patients affected by the disease and principle of organon of medicines should help the Nipah Virus Infected subjects to recover from the infection completely and also prevent the condition as mention in principle of Genus Epidemicus.

Journalists and critics should responsibly first understand homeopathy and its principles which are quite different than allopathy before jumping up on conclusion that homeopathy has no solution, similarly homeopathic doctor or association should be very careful mentioning indicated medicines and should not make any unproven claims of sure cure or sure prevention and should be very clear that the medicines are only indicated as per homeopathic principles.

So health authorities with unprejudiced and unpolitically motivated mind should come forward and consider the goods of the homeopathic system of medicines which the homeopathic system has delivered since ages and should apply in the preventive medicine for nipah virus and treatment of Nipah Virus Infection to confirm and perfect the homeopathic  community claims, Especially when where allopathy is absolutely failing!

ALSO READ

https://atomictherapy.org/nipah-virus/

NEUROFIBROMATOSIS (NF)

NEUROFIBROMATOSIS (NF)

Neurofibromatosis is syndrome of Phakomatosis or Neuro-Occulo-Cutaneous type of Autosomal Dominant Genetic Anomaly. It can be hereditary germline change or acquired during early developmental stage, affecting structures of embryonic ectoderm, where in, there is mutation or rarely somatic mosaicsism(RASopathy) of NF1 gene or its alleles, present on Chromosome 17 and is responsible for synthesis of protein neurofibromin which regulates cell proloferation and differentiation which hampers tumour suppressor activity giving rise to tumours of nervous system.

TYPES OF NEUROFIBROMATOSIS

  1. NEUROFIBROMATOSIS TYPE 1. 

    It is considered to be syndrome falling under category RASopathies. It affects supporting structures of Peripheral Nervous System. This type rarely show any severe complication other than cosmetic and compression complaints.

  2. NEUROFIBROMATOSIS TYPE 2.  

    Involves Schwaan cell of Cranial nerves especially of Vestibulocochlear nerve that is 8th cranial nerve or CN VIII causing bilateral acoustic Schwannoma causing hearing loss. It shows many complications of cranial nerves and brain stem. It can be disabling and life threatening. Severeity varies in different individuals depending on the way in which the disease assumes its course in different individual.

  3. SCHWANNOMATOSIS.   

    In this type Schwann cell tumours are found in Peripheral and Spinal nerves. It can be very painful and disabling.

SYMPTOMS OF NEUROFIBROMATOSIS

  • Multiple upto six or more “cafe au lait” spots more than 5mm in diameter is one of the diagnostic sign which are also present in Mc Cune Albright Syndrome.
  • Freckles generalised dispersed throughout body increasing simultaneously with neurofibromas.
  • Excessive folds of skin especially in underarm region with freckles.
  • More than one overgrowths in iris of eye.
  • More than one Neurofibroma.
  • Spinal growth and curvature anomalies.
  • During early stages of development in children it may show Learning and Behavioral problems
Cafe au Lait spots and neurofibroma in patient with Neurofibromatosis. 1)Neurofibroma marked in Green Circles 2)Cafe au Lait spots marked in Red Circles
Cafe au Lait spots and neurofibroma in patient with NF
1)Neurofibroma marked in Green Circles
2)Cafe au Lait spots marked in Red Circles
Neurofibromatosis patient with classical presentation of Cafe au Lait Spot, Neurofibromas and extensive freckles on back.
1)Café au Lait spot – dark brown spot marked in green circle
2) Neurofibroma – nodules marked in red circles
3)Freckles – Extensively scattered, small dark dots like pigmentation throughout the back
Above three are common findings in patients with Neurofibromatosis.
Plexiform Neurofibroma on eyelids in patient with neurofibromatosis
Plexiform Neurofibroma of eyelids
Cafe au Lait spots and neurofibroma in patient with Neurofibromatosis. 1)Neurofibroma in Red Circle 2) Cafe au Lait Spot in Green circle
Cafe au Lait spots and neurofibroma in case of NF.
1)Neurofibroma in Red Circle
2)Cafe au Lait Spot in Green circle

DIAGNOSIS OF NEUROFIBROMATOSIS

  • HISTOLOGY helps to confirm neurofibroma
  • SLIT-LAMP TEST
  • GENETIC TESTING helps confirm the diagnosis.
  • EEG, MRI, CT SCAN AND MRI helps us to assess tumour and its influence on surrounding tissue
  • Sphenoidal dysplasia on imaging, is one of the major finding in diagnosis  of NS1

HOMEOPATHIC MEDICINES FOR NEUROFIBROMATOSIS

  • THUJA
  • HYPERICUM
  • SILICEA
  • MEDHORRINUM
  • CONIUM MACULATUM
  • COCCULUS
  • BELLADONNA
  • CALCAREA FLOURICA
  • CALCAREA CARBONICA
  • GELSEMIUM SEMPERVIRENS
  • RUTA GRAVEOLENS
  • SYMPHYTUM
  • CALCAREA PHOSHORICA

SUN STROKE HEAT STROKE

Sun Stroke or Heat Stroke is a fatal condition caused due to exposure to excessive heat of Sun

Its also called Non Exertional Heat Stroke (NEHS).

And Exertional Heat Stroke (EHS) is the condition where it is caused due to excessive physical exercise.

As the summer approaches, so does the increase in number of sun stroke or heat stroke cases. In summer of 2015 more than 2500 people died in India. Many of them were from metro cities having best medical facilities. Many more world wide are losing their life to this fatal avoidable medical emergency.

RISK FACTORS of SUN STROKE or HEAT STROKE

  • Summer season
  • Heat waves
  • Humid Climate
  • Eecessive physical exertion
  • Pre-existing acute infection in body
  • Heart diseases
  • Skin ailments
  • Allergies
  • Autoimmune conditions
  • Beta-blockers
  • Diuretics
  • Alcohol
  • Drug Abuse
  • Smoking
  • Diabetes
  • Hypothyroidism
  • Other Chronic Diseases
  • Children and Elderly subjects

It is a medical emergency and requires immediate medical attention, the sooner its detected the better the prognosis and lesser the long term consequenses, yes heat stroke does lead to consequences even after patient recovers from convalscence  which was best understood after 1995 Chicago heat wave, when 50% died within a year, and many has disabilities and impairment making them disabled and dependent.

SIGNS and SYMPTOMS of SUN STROKE or HEAT STROKE

  • Hyperthermia, Increased body temperature usually above 105°F or 40.6°C
  • Headache
  • Dullness
  • Diziness
  • Disorientation
  • Confussion
  • No Perspiration/ but in Exertional Heat Stroke patient has much perspiration.
  • Dry red skin / damp skin if not exposed to heat of sun for prolonged hours and or was in humid climate.
  • Symptoms might not be much evident if patient is in sleep.
  • The disease soon progress to show severe sypmtoms like unconsciousness, seizures(usually in children).
  • Rhabadomylosis
  • Organ failure, kidney and heart in particular
  • And death ensues.

It is important to judge the condition earliest but its also difficult as initially patient doesnt realise that its a sun stroke and carries on with the mild discomfort he is experiencing and soon symptoms starts progressing.

So its necessary to educate people about its causes, how to prevent it, occurence of symptoms and what to do at first if doubted.

PREVENTION of SUN STROKE or HEAT STROKE

Dont’s to prevent Sun stroke or heat stroke avoid following things

  • Exposure to heat for long
  • Excessive exercise or exertion especially in hot climate especially military personals, athletes, fire fighters and other straineous activity workers in hot climate needs to take extra precautions.
  • Sitting in car without aircondition it frequently happens when car is parked. Even when out side temperature is around 20-21°C the temperature inside car can reach upto 49°C , without the aircondition and when parked even with slight window open.
  • Leaving behind children and elderly in parked car.
  • If the climate is too hot and humid and you are with children dont neglect or forget the fact that they are more prone to the condition comparatively, and u may subject them to it and this happens too frequently which is why its now commonly termed by laymen as “Neglected Baby Syndrome” a non medical term famous tailored by laymen which discribes the situation and not the disease.
  • Avoid stimulants, smoking, alcohol and drugs in hot climates.
  • In acute infection or other acute illness avoid being in hot humid climate for too long.
  • In chronic ailments especially metabolic disorders or allergies or autoimmune conditions avoid prolonged exposure to heat or exertion.
  • If you are on beta-blockers or other diuretics, then avoid exertion or heat exposure.
  • Avoid heat exposure or exertion in heart or kidney disease.

Do’s to prevent Sun Stroke or Heat Stroke

  • Drink ample of water in short intervals of time even if u are not feeling thirsty, in hot climate, also note excess of water in electrolyte imbalanve may be counterproductive and dangerous.
  • Keep sipping commercially available isotonic sports drink.
  • Maintain you urine colour light, dark urine colour shows signs of lack of water, urine colour is better indicator than the feeling of thirst.
  • Eat lots of salads and be more on liquids if you in hot climate.
  • Wear loose, white, thin, clothing a cap or hat with ample ventilating holes and large brim helps protect from heat.
  • Keep searching shades and cool places and halt for a while if u are walking in hot summer sun.
  • Keep body dry keep wiping body sweat.
  • Block direct heat of Sun.
  • Know the causes, prevention, signs and symptoms and first aid of Sun Stroke or Heat Stroke

TREATMENT of SUN STROKE or HEAT STROKE

Patient should be first taken under proper medical observation as soon as possible when ever available.

  • First and foremost aim is to bring down body temperature and to hydrate the patient.
  • Mechanical means to cool the patient as soon as possible can be applied.
  • Remove all clothes of patient and wipe off all sweat and make his body dry.
  • Cool and dry climate should be provided airconditioned room preferably or highly ventilated cool dry climate.
  • Avoid cold wet cloth wraps generaly on whole body. It might act as insulation and prevent heat to escape out from the body. Instead use cold packs only on head, neck, torso and groins, let rest of the body be open.
  • Bathing the patient in cold water is a good idea. Immertion in too cold water water is also a good idea. Both of these were previously opposed, due to the doubts of vasoconstriction of superficial blood vessels, preventing heat to escaping out of body. However more practical evidence and study have proved it to be useful.
  • Hydration of patient should be done simultaneous. Excess of water in presence of electrolyte imbalance can make case worse, so isotonic sports drinks comercially available are good option.
  • Intravenous fluid infussion whenever required, keeping in chk the electrolyte imbalance and accordingly infusing the indicated IV Fluid.
  • CRP and other measures in complicated cases in hospital setup.

HOMOEOPATHIC MEDICINES for SUN STROKE or HEAT STROKE

General guidelines for Homoeopathic medicine section for sun stroke or heat stroke

While Selecting Homeopathic medicines for Sunstroke or Heat Stroke one needs to first understand that Heat Stroke is a fast progressive acute condition.It is caused due to excessive heat causing disturbed thermo-regulation of the body, with loss of water from body altering electrolytes and enzymatic processes of cellular respiration.

So one need to be very careful about related aspects that can not be neglected which are as follows:

  • Medicines needs to be fast and deep acting with more affinity towards CNS Heart and circulatory system along with urinary system.
  • Such cases demands frequent repetition of doses.
  • Type of thirst pattern of medicine and that in patient with sunstroke are of utmost importnce.
  • Skin symptoms with characteristic appearance and texture cant be neglected.
  • Also make note of the characteristics of patient’s tongue appearance and try to match with remedy
  • Characteristics of Urine and Urinary system needs to be evaluated with much attention.
  • Fever and headache pattern and other concomittants during fever like general condition, delirium level of consciousness etc are important.
  • Pulse pattern needs to be observed.
  • Neupsychiatric condition evaluation is must.
  • Acessesment of all other organs especially heart and kidney is necessary to rule out complications.

Such cases needs to be managed under highly trained medical staff.

Homoeopathic medicines can be administered along with regular medical supportive management.

Following are some Homoeopathic Medicines for Sun Stroke along with their indications.

Strictly to be taken under guidance and observation of qualified homoeopathic doctor and medical staff.

ACONITUM NAPELLUS

Fever and Headache Acute violent sudden onset of acute heavy pulsating headache with sensation as if head floating in boiling water. Acute onset of violent fever with fear, fright and anxiety especially fear of death with mental restlessness. Complaints caused due to dry climate and extremes of heat or cold. Much indicated in very first stage of sunstroke, the sooner you give better the results. This remedy is indicated only in functional disturbances there is no evidence of aconite being useful where there are gross pathological changes also its effect is very short without any periodicity.

Thirst – intense thirst, drinks and vomits and declares himself that he will die.

Tongue -Dry red constricted tongue with white coating and tingling on the tip of tongue.

Urine – scanty, red, hot, painful.

GLONOINUM

A theraputically specific remedy for sunstroke in homoeopathic materia medica, which can be applied in general with much benefits in most of the cases of sun stroke.

Headache and Fever –Surge of blood to the head and heart. Aggravation due to exposure to heat of fire or heat of sun. Sensation of pulsation throughout the body. Throbbing headache with diziness and confusion,  cannot recognise localities. Head heavy but cannot lay it on pillow as he cant bear any heat around head and also it aggravates throbbing rush of blood to head, visual disturbances during headache sees everything half light half dark with visions of sparkling light.

NATRUM MURIATICUM

A known remedy for sun stroke and complaints due to heat of sun better given in biochemic form especial in children and female of pre-pubertal and early pubertal age affected with sun stroke effects in early stages. Throbbing blinding headache with sensation as if thousands of little hammers were knocking.

Thirst -unquinchable thirst for cold drinks, desires salt.

Tongue -Mapped tongue frothy coated tongue with cracked lips with numb sensation.

Skin – Greasy and Earthy texture , Blistering redness with much burning due to sun burns with dry sensation.

Urine – pain in urethra after passing urine, involuntary urination.

BELLADONNA

Headache and Fever-Very well indicated when there is severe headache with throbbing heat especially in forehead and temples with vertigo and  high grade fever and difficukty in breathing

Tongue – Dry, Swollen glazzy and Painful with red edges, Strawberry like appearance of tongue due to elevated buds and papillae of tongue,dry throat.

Thirst –Great thirst for cold water with nausea and vomitting and spasm of stomach, but thirstless during fever.

Urine –Scanty dark turbid with phosphates.

Skin – Dry, Hot, Swollen, Smooth.

GELSEMIUM SEMPERVIRENS

Headache anf fever –Indicated in both initial and later stages of Sun Stroke. Fever with delirium diziness, disorientation, confusion, trembling, tremors, in seizures due to sun stroke. Face is heavy flushed besotted during fever.

Thirst: Thirstless with heaviness in stomach

Tongue: Numb with thick yellowish coating feels paralysed.

Urine: Dysuria with tremulousness

Specific Biochemic Twelve tissue remedies can be given for electrolyte imbalance in all cases in general

 

Also Read

http://atomictherapy.org/headache/

GALL BLADDER STONE Cured with Homeopathy

Gall Bladder Stone or Cholelithiasis is a condition where cholesterol monohydrate stone starts coagulating and neucleate together to form stone in gall bladder.

  • Ecxess of Cholestrol can be eliminated from body only through Liver, either as free cholestrol in bile or as bile salts.
  • Cholestrol is water insoluble.
  • Bile salt and lecithin when co-secreted and are mixed with this cholestrol to make it soluble, then can easily be eliminated.

But when,

  1. This cholestrol is in excess beyond saturation limit of the bile – lecithin -cholestrol solution saturation.
  2. Or if the character or quantity of bile salt and lecithin alters.
  3. Or if there are any other physiological or structural anomaly of hepatobilliary aparatus to cause stasis of bile.
  4. Or there are some other metabolic anomalies.
  5. Or if there is presence of some other metabolites or micro-precipatates of protein or salts like calcium salts that promotes cholestrol crystalisation.

Then this excess cholestrol which was no further able to mix in bile salt and lecithin due to oversaturation starts forming dispersed cholestrol monohydrate crystals, which later agregates and coagulate to neucleate and form Cholelithiasis or Gall Stone or Gall Bladder stone.

So for such formation following three conditions are required.

  • Supersaturation of Bile with Cholestrol.
  • Kinetically favourable conditions for neucleation of dispersed cholestrol crystals.
  • Cholestrol crystals should stay in bile long enough so as to aggregate and form stone.

An its very difficuly to judge or find out any of the risk factors, except genetic and familial predesposition and is found more in men compared to women.

GALL BLADDER STONE CURED WITH HOMEOPATHIC MEDICINES by Dr DEEPAN P SHAH at Dr SHAH's Homeopathy
CASE A – GALL BLADDER STONE CURED WITH HOMEOPATHIC MEDICINES by Dr DEEPAN P SHAH -MD(Homoeopathy) at Dr SHAH’s Homeopathy -BEFORE TREATMENT
GALL BLADDER STONE CURED WITH HOMEOPATHIC MEDICINES by Dr DEEPAN P SHAH at Dr SHAH's Homeopathy -page 1 of report
CASE A – GALL BLADDER STONE CURED WITH HOMEOPATHIC MEDICINES by Dr DEEPAN P SHAH at Dr SHAH’s Homeopathy page-1 of reoprt AFTER TREATMENT
GALL BLADDER STONE CURED WITH HOMEOPATHIC MEDICINES by Dr DEEPAN P SHAH at Dr SHAH's Homeopathy page-2 of reoprt AFTER TREATMENT
GALL BLADDER STONE CURED WITH HOMEOPATHIC MEDICINES by Dr DEEPAN P SHAH at Dr SHAH’s Homeopathy page-2 of reoprt AFTER TREATMENT
Gall Bladder Stone USG report Before treatment
CASE B – Gall Bladder Stone USG report – Before treatment
Gall Bladder Stone Cured with Homeopathic medicines USG report -After Treatment
CASE B – Gall Bladder Stone Cured With Homeopathic medicines USG report -After treatment

SYMPTOMS of GALL BLADDER STONES

Gall bladder Stones affect 10-20% of population in developed countries.

Upto 80% of Patients will never develop any symptom throughout their life and are called Silent Cases of Gall Bladder Stone and remainder 20 % become symptomatic at the rate of 1-3% per year.

Though most of the patient frequently present with non specific general mild complaints like eructations, GERD, unsatisfactory bowel clearance.

A few patients also present with prolonged mild discomfort in right hypochondrium and lumbar region with occasionall in epigastric region, with sensation as if weight or stone was lodged in the site of discomfort which aggravates on  false stepping or jumping , unsatisfactory bowel clearance and other mild digestive derangements.

When Acute Symptom appear they are very severe and may be life threatening  which needs immediate medical attention as in most of the cases it sets in whenever there are complications like

  • Cholecystitis- Inflamation of gall bladder due to infection or adhering of stone to bladder wall or severe statis and obstruction of downstream of bile due to blockage created by lodging of stone in bile tree, usually such blockages are created by very smallstones which can easily enter cystic and common bile ducts.
  • Inflamation of bile tree.
  • Pancreatitis is a very severe and life threatening condition may also present along secondary infection.
  • Gall Stone illeus when large stone enters adjoining loop of small intestine.
  • Empyema, collection of puss in pleural cavity due to secondary infections
  • Perforations
  • Fistulae

Patient with acute symptoms has severe excruciating spasmodic colicky pain in abdomen more pronounced in right hypochondriac region epigastric and umbilical region.

Fever  with rigor and chills and it is indicative of secondary infection

DIAGNOSIS of GALL BLADDER STONES

Ultra Sonography is the most common prescribed test.

MRI in cases where unable to detect by USG or accidental finding.

CT Scan in cases where unable to detect by USG or accidental finding.

X rays not specific; very occasionally shadow is visualised in accidental findings, after which the patient is sent for USG for confirmation and proper evaluation of size and severity.

Serum Lipase and Serum Amylase activity with Ultra Sonography of pancreas need to be monitored frequently in cases with acute complaints to rule out pancreas involvement which can be life threatening.

MORPHOLOGY of GALL BLADDER STONE

Gall Bladder Stone consists 50-100% cholestrol.

More the cholestrol more pale yellow colour of stone, Exclusive Cholestrol stones are complete pale yellow in colour.

More the proportion of Calcarea Carbonate and Phosphate, more the stone has Greyish-white to black discoloration from pale yellow.

BEST HOMEOPATHIC MEDICINES  for GALL BLADDER STONES

CALCAREA FLOURICA

Calcarea flourica is a powerful tissue remedy. Calcarea flourica is a combination of lime and flouric acid. It is a naturally occuring mineral in the body. Calcarea flourica is very useful remedy in the treatment of gallstones. Usually patient presents with prolonged mild discomfort in the right hypochondrium and lumbar region. Gastric derangements, weakness, loss of appetite. Vomiting of undigested food. Indigestion, fatigue and brain fag. Presents with paroxysms of lancinating paind in the right hypochondrium awaking him about midnight with aggravation lying on painful side. Sensation of dull weight and discomfort in the right hypochondrium. Sensitive to cold, to drafts and changes in weather.

FEL TAURI

Fel tauri is remedy used since ancient time. Fel tauri is a very efficient remedy for gallstones. Fel tauri increases the duodenal secretions, emulsifies fats and increases the peristaltic action of intestine. Liquifies bile and acts as a purgative. Presents with disordered digestion, diarrhoea, obstruction of bile ducts. Eructations and pain in the epigastrium. Gurgling in stomach and epigastric region. Pain in the right hypochondrium with sensation of heaviness. Fel tauri liquifies bile and helps in expulsion of biliary calculi.

CHOLESTRINUM

Choleatrinum is considered as a specific remedy for gallstones. It helps to relieve pain at once. Useful in obstinate hepativ engorgements, obstinate gall stones. Pain in the right hypochondriac region. Sensation of heavines in the abxomen. Gastric derangements. Reflux of gastric contents with pain in the epigatrium.

SILICEA

Silicea is a deep acting remedy indicated in case of gallstones. Silicea disturbs tbe stomach, causes hiccoughs. Severe pain in abdomen relieved by heat, distension of abdomen with flatulence and rumbling. Tightness accross the abdomen. Disturbed by pressure of clothes and worse after eating. Constipation from inability of rectum to expel faeces. Great straining at stool. Constant urge but cannot expel requiring mechanical aid. Hardness and distension of the region of liver with throbbing pain. Gastric derangements causes hicoughs, nausea, vomiting, disturbs the liver. Silicea is usually very sensitive to extremes of heat and cold.

CARBO VEGETABILIS

Carbo vegetabilis is a very effective remedy in patients suffering from gallstones. When Carbo vegetabilis is indicated the patient will be below par, the digestion will be slow and imperfect. Heaviness and fullness sensation. Sensation of weight in the abdomen. All gone sensation not relieved by eating, but after a few mouthfuls there is a sense of repletion. There is great distension of abdomen which is temporarily releieved by belching. Burning in the stomach extending to back and along the spine. Cramping pain forcing patient to bend double.

CARDUS MARIANUS

The action of Cardus marianus is centered on the liver, gall bladder, portal system causing apin, soreness. Pain in the region of liver. Swelling of gall bladder with painful tenderness.Sensation of fullness and soreness. Constipation with hard stool, difficult knotty, alternates with diarrhoea. Poor appetite. Nausea retching and vomiting sensation. Inflammation of gall bladder, pain in the upper abdomen in the region of gall bladder which is accompanied by nausea and vomiting.

CHELIDONIUM MAJUS

Chelidonium majus is one of the most indicated medicine for gallstone. Effective medicine for gall stones and jaundice when there is obstruction of bile ducts.Useful when gallstone colic is shooting, stabbing, tearing and lancinating type extending to back. Colic with constriction as by a string across abdomen. Most important symptom of Chelidonium is constant pain under the right shoulder blade. Suffers from hepatic or gastric symptoms. The tongue is coated thick and yellowish with imprints of teeth. Alternate diarrhoea and constipation. All symptoms are usually right sided.

CALCAREA CARBONICA

Calcarea carbonica is one of the indicated remedy in gallstone. Calcarea carbonica is usually suited to fair, fat, flabby constitution. Shooting pain around the liver with discomfort after wearing tight clothing. Sensitive to slightest pressure. Liver region painful when stooping. Presents with severe gall stone colic. Weak digestion. Milk disagrees. Feeling of tumefaction and fullness. Loss of appetite. No desire for food. Constipation. Frequent nausea ezpecially in morning. Cramps in stomach at night. Pains generally shooting or tensive, pressive type with swelling and induration of hepatic region.

CRATEGUS OXYACNTHA

Crategus oxyacantha is a excellent heart tonic and also useful in gallstone colic. Acts a a tonic for heart muscles that have becomw weakened due to reduced blood supply to heart as a result of deposits of cholestrol in arteries. Crategus is a very useful remedy in dissolving cholestrol deposits in arteries. Colic with severe pain in the hypochondrium with sensation of heaviness. Presents with difficulty in breathing with slight exertion. Dyspepsia and nervous prostration. Cold extremities.

COLOCYNTHIS

Colocynthis is indicated in case of choleliathiasis. Colocynth is a ideal remedy when gall stone pain is of a cutting shooting nature and better by bending double or by applying pressure. Worse by cold. Presents with pain in right hypochondriac region with sensation of fullness of abdomen. Colocynth is usually a acjte useful in gall stone colic. Neuralgias with sense of restlessness. Sharp shooting and lightening type of pain.

Also read

ABDOMINAL PAIN Homeopathic Medicines

SLE SYSTEMIC LUPUS ERYTHEMATOSUS

SLE or Systemic Lupus Erythematosus or sometime only called Lupus is a chronic systemic autoimmune condition with genetics, nutrition and environment playing a major role in its onset and evolution, its a condition which greatly reduces life expectancy and also causes complications in pregnancy. It falls under disabling disease conditions category though much less than10% cases develops disabilities.

TYPES of SLE

  • Acute Cutaneous Lupus
  • Sub-Acute Cutaneous Lupus Erthematosus
  • Chronic Cutaneous Lupus also called Discoid Lupus Erthematosus
  • Neonatal Lupus Erythematosus
  • Drug Induced Lupus Erythematosus

EPIDEMIOLOGY of SLE

Lupus was the most google searched topic in healthcare related topics in 2017! Now that is something to be added in Epidemiology section!  😀 hehehe!

Female are affected more with SLE than male, female of child bearing age are affected more with female to male ratio of about 9:1.

African, Caribean and chinese ethnic groups are more prone to this condition.

SIGNS and SYMPTOMS of SLE

GENERAL

Undifferentiating symptoms which are common to other diseases as well.

  • Fever
  • Fatigue
  • Malaise
  • Joint pain
  • Muscle pain
  • Bodyache
  • Sleep disturbances
  • Psychiatric Disorders
  • Poor physical fittness
  • Anaemia of chronic disease
  • Raynaud’s Phenomenon

SKIN

Majority of cases shows skin manifestation of the condition

  • Though the rashes and lesion on skin may vary, the classic sign of SLE on skin is butterfly rashes on face, also called Mallar Rashes and is seen in almost half of the cases with skin lesions.
  • If it is Acute type there might not be scaling of skin, not well demarcated distinct edge compared to othe types.
  • If it is Subacute type rashes shows scaling of skin with distinct edges.
  • And in Chronic type rashes shows thick distinct thick scaling with very well demarcated edges.
  • Increased Hairfall is also one of the complaints.
  • Ulcers in mucous membranes esp of nose and mouth.

MUSCULOSKELETAL

It affects Small joints especially of fingers and wrist and it very closely mimicks rheumatoid arthritis and psoriatic arthritis making it clinically difficult in making differential diagnosis.

But it is less destructive and disabling compared to other two conditions, only less than 10% cases of SLE will develop deformities and even fewer will have disabilities.

It not only mimicks Rheumatoid Arthritis but it also seems to have very close relation to rheumatoid arthritis.

It significantly increases risks of fractures and also it is associated with facilitation of Osteoarticular Tuberculosis.

HEAMOTOLOGICAL

  • Anaemia of chronic disease with low Red Blood cell count
  • Low White Blood Cell count
  • Anti phospholipid antibody syndrome is a condition where anti-phospholipid antibodies increases Partial Thromboplastin time causing tendency to heamorrhages and it is frequently found positive in patient with SLE and its coexisting is termed as Lupus Anticoagulant Positive.
  • Patients with SLE frequently show positive results for Anti Cardiolipin Antibodies as well, and patients with these antibodies sometimes shows false positive results for Syphillis.

CIRCULATORY SYSTEM AND HEART

  • Artheroscelerosis – Thickening and deposition of cholestrol plaque in blood-vessel walls which may also give rise to Ischemic Myocardial diseases like Myocardial Infarction.
  • Vasculitis – Inflamation of blood-vessels in some cases
  • Endocarditis – Inflamation of inner linning of heart, when due to SLE its termed as Libman-Sacks Endocarditis
  • Pericarditis – inflamation of outer layers and and surrounding tissues.
  • Myocarditis – Inflamation of cardiac muscles.
  • It may also cause inflamation of Mitral and Tricuspid valves of heart.

LUNGS

  • Pleurisy – Inflamation of pleura.
  • Pneumonitis – Inflamation of lungs.
  • Interstitial Lung Disease
  • Pulmonary Embolism
  • Pulmonary Heamorrhage
  • All these complications and chronic inflamatory processes causes Shrinking Lung Syndrome where there is reduction in lung volume.

REPRODUCTIVE

30 % of pregnancy has comolications like

  • Fetal Death
  • Spontaneous Abortion
  • Still Birth

Prognosis is worse in those who get aggravations in SLE duringbpregnancy.

Neonatal Lupus Erythematosus

Child born to mother with SLE shows symptoms of Discoid Lupus Erythematosus with

  • Heart block
  • Splenomegaly – Enlargement of Spleen
  • Hepatomegaly – Enlargement of Liver
  • Neonatal SLE is self limiting condition and in most cases recovers on its own.

RENAL (Kidney)

  • Painless Heamaturia – Blood in urine.
  • Painless Proteinuria – Protein in urine.
  • Lupus Nephritis leading to terminal Renal failure.
  • Histologically it shows its classical appearance of Membranous Glomerulonephritis with Wire-Loop  Abnormailities due to deposition of Immune Complexes in Basement Membrane.

NEUROPSYCHIATRIC (NP-SLE)

If any Neuro-Psychiatric is caused dur to SLE its called NPSLE Neuro-Psychiatric Systemic Lupus Erythematosus

There are atleast 12  Central Nervous System related and 7 Peripheral Nervous System relate manifestation of SLE that are being observed in patients with SLE.

Central Nervous System(85-90% of all NPSLE)

  1. Headache
  2. Anxiety Disorder
  3. Mood Disorder
  4. Acute Confusional state
  5. Psychosis
  6. Movement Disorder
  7. Cognitive Dysfunction
  8. Seizure Disorder
  9. Myelopathy
  10. Aseptic Meningitis
  11. Cerebrovascular diseases
  12. Demyelinating Syndrome

Peripheral Nervous System(10-15% of all NPSLE)

  1. Acute Inflamatory Demyelinating Polyradiculoneuropathy
  2. Autonimic Disorder
  3. Mononeuropathy
  4. Myasthenia Gravis
  5. Cranial Neuropathy
  6. Plexopathy
  7. Polyneuropathy

DIAGNOSIS of SLE

SLE is considered amongst one of the prototype disease as its very difficult to  differentiate from many other autoimmune conditions as they share in common majority of signs and symptoms making  its diagnosis very difficult, It much depends on clinical picture of the disease and investigations after that there are many criterias based on clinical symptoms coupled with laboratory tests based on which a person can arrive at some conclusion though not absolutely sensitive and specific to confirm diagnosis in every case but fair enough.

LABORATORY TESTS

ANA detection by direct  or indirect immunoflorescence

ANA test detects many different subtypes of ANA related to many other autoimmune conditions as well with many overlapping eachother of which

  • Anti- Double Strand DNA Antibodies most specific of all present in almost 70% cases of SLE with only 0.5% non-SLE cases has t in them.
  • Anti-Smith DNA Antibodies present in most of the cases of SLE and not frequently found in non-SLE person.
  • Anti- Histone Antibodies present in Drug Induced SLE
  • Anti- U1 RNP antibodies – non specific also appears in other conditions like Systemic Sclerosis
  • Anti- Ro or SS-A and  Anti- La or SS-B – non specific for SLE but more Specific to Sjogrene syndrome, but its present in many of the cases of neonatal lupus with heart involvement in particular.

Other Tests

Anti-ENA Test

Lupus Cell Test – It was used in past as it used to show positive in 50-70% SLE cases but was not specific to SLE and used to be present in many cases of many other conditions like RA Scleroderma etc.

DIAGNOSTIC CRITERIA OF AMERICAN COLLEGE OF RHEUMATOLOGY.

Its a stringent criteria developed by American College of Rheumatology, so that non of non-SLE cases should filter in, so many of the SLE cases are also filtered out.

The criteria is that if any patient shows any of the four symptoms out of eleven simultaneously or serially in more than one occasion than he is considered to be positive for SLE.

  1. Mallar Rash/ Butterfly rash on cheeks; Sensitivity of 57% and Specificity of 96%.
  2. Discoid Rash; Sensitivity of 18% and Specificity of 99%.
  3. Serositis, Inflamation of serous membranes around heart (more specific) and lungs(more sensitive); Sensitivity of 56% and Specificity of 86%.
  4. Mucosal Ulcers of oral cavity and nasopharynx; sensitivity of 27% and specificity of 96%.
  5. Arthritis, non-erosive with more than two joints involved with tenderness swelling and effusion; Sensitivity of 86% and Specificity of 37%.
  6. Photosensitivity, Ligh causes aggravation in skin rashes or other Lupus related complaints; Senitivity of 43%and Specificity of 96%.
  7. Non Drug Induce : Hemolytic Anaemia, Leucopenia, Lymphopenia, Thrombocytopenia; Sensitivity of 59% and Specificity of 89%.
  8. More than 0.5g of total protein in urine in a day or cellular cast seen in urine under microscope; Sensitivity 51% and Specificity of 94%.
  9. Anti- Nuclear Antibody positive; Sensitivity of 99% and specificity of 49%.
  10. Positive Anti- Smith, Anti- Double Strand DNA, Positive Anti- Phospholipid Antibody, False Fositive Serological test for Syphillis; Sensitivity 85% and Specificity of 93%; Presence of Anti- ssDNA in 70% of cases.
  11. Neurological disorder Seizure or psychosis; Sensitivity of 20% and Specificity of 98%

This is a very stringent criteria used for research purpose if we go through we may falsely conclude negative diagnosis and miss out on diagnosing many patients who are suffering from SLE

Aslo it misses out on certain factors like antiphospholipid anti bodies which has strong association with SLE  there are many cases who are anti phospholipid antibody positive but are not fitting in above ACR criteria but still they are having SLE.

So more practicle approach widely used is through the Recursive Partitioning which has two classification trees

The Simplest Classification Tree – If patient has any immunological disorder with positive anti- Smith antibody, anti- DNA antibody, false positive serology test for Syphillis, presence of Lupus cells or Mallar rash/butterfly rash, then the person is diagnosed as positive for SLE; specificity of 92% and sensitivity of 92%.

Full Classification Tree : It uses six criterias; sensitivity of 97% and specificity of 95%

HOMOEOPATHIC MEDICINES FOR SLE

I have seen homoeopathy work wonders in SLE especially in cases with NPSLE because then the disease becomes very expressive about itself,  it shows itself not only on skin and joints but also on Neuropsychiatric sphere which show various symptoms typically different in each individual and this is what is required in homeopathic medicine selection, that the body is expressing itself in mental sphere which makes remedy selection easier.

Always a proper case taking needs to be done in deep seated chronic autoimmune conditions like this and a deep acting polycrest remedy should be selected after proper repertorisation as per each individual constitution and constitutional treatment is the only permanant solution for such conditions.

Still some theraputic indications are given which can be helpful guide and can be used as per the symptomatology in course of disease if indicated intercurrently or during acute excerbations of disease showing following symptom.

  • BELLADONNA

    – Typically suited in Mallar rash or Bitterfly rash of Syetemic Lupus Erythemotosua with symptoms of Neuro-Psychiatric SLE (NPSLE) where CNS involvement is markedly noted also suits in PNS symptoms of NPSLC

  • MERCURIOUS SOLUBILIS

    Whenever in case of lupus there are oral and/or naso-pharyngeal ulceration this remedy is very well suited

  • BORAX

    Again this is best suited in mucosal ulceration but in this remedy the ulceration are more marked in oral mucosa than in nasopharynx.

  • SYPHYLLINUM

    A nosode a dose can be given intercurrent as anti miasmatic of the cases that shows syphillitic miasma in the background also useful in cases showing painless red mallar rash or butterfly rash with much thickening and exfoliation especially like in Chronic Lupus Erythemotosus, also suited well in ulcerations of oral and nasopharyngeal mucosa.

  • CINCHONNA OFFICINALIS

    In cases with signs of hemolytic anaemia wether due to disease ot allopathic medicines, it will work wonders in both the cases.

  • FERRUM PHOSPHORICUM

    Where the patient has febrile condition due to disease with malaise, fatigue, Hairloss and aneamia duw to lupus or its medicines, can also be givem in low potencies in biochemic form along with other medicines

  • FERRUM METALLICUM

    Red acute rash typically in acute lupus erythematosus with involvement of oral mucosa, also in later chronic stages when there is are signs of anaemia of chronic disease of hemolytic anaemia

  • RHUS TOXICODENDRON 

    Works wonders in cases of lupus where it not only acts on skin but also wonderfully acts on the joints and musculoskelwtal complaints the disease shows.

  • HYOCYAMUS 

    In patients with symptoms of NPSLE.

  • ACONITE NAPELLUS

    in acute violent spells of relaopse and aggravations with symptoms of NPSLE like mental restlessness and has fear fright and anxiety in general and fear of death in particular.

  • RHUS VENENTA