Category Archives: Pediatrics

Pediatrics

HEMOPHAGOCYTIC LYMPHOHISTIOCYTOSIS (HLH)

Hemophagocytic Lymphohistiocytosis (HLH) is a type of Cytokine Storm Syndrome caused due to uncontrolled proliferation of morphologically benign Macropages and Lymphocytes secreting copious amount of Inflamatory Cytokines resulting into Hyperinflamation.

PATHOPHYSIOLOGY OF HLH

CAUSES OF HLH

Mutations or Single Neuclotide Polymorphism in certain genes gives rise to HLH it can be germ-line defect or may be acquired. There are other factors as well which may cause secondary HLH(sHLH).

  • PRIMARY HLH -Primary that is without any other underlying disease in background it is termed as HLH
  • SECONDARY HLH (sHLH) – HLH secondary to some other primary underlying disease condition or Iatrogenic factors in the backgroung is termed as Secondary HLH or (sHLH)

DISEASES THAT CAUSE SECONDARY HLH (sHLH)

MALIGNANT
  • T-cell lymphoma
  • B-cell lymphoma
  • ALL – Acute Lymphocytic Leukemia, 
  • AML – Acute Myeloid Leukemia,
  • Myelodysplastic Syndrome
NON-MALIGNANT
AUTOIMMUNE
  • Juvenile Idiopathic Arthritis
  • Juvenile Kawasaki Disease
  • SLE – Systemic Lupus Erythematosus
  • Juvenile/Adult onset Still’s Disease,
  • RA- Rheumatoid Arthritis
IMMUNODEFICIENCY
  •  Severe Combined Immunodeficiency 
  • DiGeorge Syndrome
  • Wiskott – Aldrich Syndrome
  • Ataxia – Telangiectasia
  • Dyskeratosis congenita
INFECTIONS
  • EBV -Epstein Barr Virus
  • CMV -Cytomegalovirus
  • HIV – Human Immunodeficiency Virus
  • nCoV2019/SARS-CoV-2 probable
  • Certain Bacterias, Fungus and Protozoas

IATROGENIC FACTORS THAT CAUSE SECONDARY HLH (sHLH)

  • Bone Marrow Transplant
  • Organ transplantations
  • Chemotherapy
  • immunosuppressive treatment

PATHOGENESIS OF HLH

HLH is caused due to genetic mutations that may be germ-line defect or acquired

Mutation in gene responsible for decoding a proyien protein in Cytotoxic T-cells and Natural Killer cells which killes virus infected is one of the known factor causing HLH

Genes that have been identified as contributor to HLH are UNC13D, STX11, RAB27A, STXBP2, LYST, PRF1, SH2D1A, BIRC4, ITK, CD27, MAGT1 any SNP or mutation in above mentioned gene that causes decfect in ability to kill virus infected cells or damaged cells.

As the Cytotoxic T-cells and NK-cells lose their ability to kill cells infected with virus or other damaged cells, due to mutation of above mentioned genes, consequently results into uncontroled proliferation of immune system secreting excess quantity of cytokines causing excessive accumulation of Interleukine 1, Interleukine 6, Tumour Necrosis Factor-Alpha, Tumour Necrosis Factor-gamma, Plasminogen Activating Factor, Ferritin etc.

Now excess of IL1,IL6&TNF-alpha leads to fever

TNF-alpha and TNF-gamma in excessive proportion aslo leads to suppression of Heamtopoesis resulting into Cytopenia and inhibition of Lipoprotein Lipase to stimulate Triglyceride Synthesis.

Excess of Plasminogen Activating Factor and Ferritin secreted by activated macrophages leads to Hyperfibrinolysis.

SIGNS AND SYMPTOMS OF HLH

In 70% cases the onset is below one year of age.

  • Fever, nausea, vomitting, weakness, debility
  • Hepatomegaly with fatty infiltration in liver
  • Elevated Liver Enzymes
  • Icterus and rashes
  • Spleenomegaly may also show multiple small granulomas in spleen
  • Lymphomegaly may also show calcified nodes
  • Erythrocytopenia- Reduced Red blood cells
  • Leucocytopenia – Reduced White Blood Cells
  • Thrombocytopenia – Reduced Platelets
  • Reduced Serum Albumin
  • Sphingomyelinase elevated
  • Reduced Fibrinogen
  • Elevated Ferritin especially in children of above 10000 is very sensitive and specific for HLH, but no so in adults.
  • Incresase D-Dimer, CRP and ESR

DIAGNOSIS OF HLH

All patient with Hyperferritinaemia combimed with Cytopenia should be suspected for HLH and soon be considered for further investigations without wasting time.

To be clinically corelated with above mentioned sign and symptom of clinical presentation and investigations and bone marrow biopsy as mentioned below

  • Bone Marrow Aspiration and Imprint may show Hemophagocytosis, Cellular Marrow having Dimorphic Maturation with increased Histiocytes and Megakaryocytes

Other Investigations

  • CBC – reduced RBC, WBC and Platelets
  • CRP elevated
  • ESR elevated
  • D-Dimer elevated
  • Serrum Ferritin elevated
  • Liver function Test – liver enzymes elevated
  • Ultrasonography of whole abdomen – Spleen, Liver and Lymphnodes enlarged

Homeopathic Treatment and Medicines of HLH

Its a life-threatening condition and one should not waste time even in suspected cases and all patient with elevated ferritin along with cytopenia should soon be sent for bone marrow biopsy and other confirmatory supportive tests and be kept under constant medical observation.

Homeopathic prescription for HLH should be strictly derived on basis of symptom similarity basis and the potency of homeopathic medicines and repetition of doses should be as per susceptibiloty of the patient and disease symptom and severity as per homeopathic principles.

Homeopathic Medicines for HLH

Below are few homeopathic medicines that could be theraputically indicated and may proove useful in cases of HLH.

  • Aconitum Nepellus
  • Belladona
  • Arsenicum Album
  • Lycopodium
  • Cholestrinum
  • Crategus Oxyacantha
  • Cinchonna Officinalis
  • Ferrum Phosphoricum
  • Tuberculinum
  • Syphillinum
  • Natrum Muriaticum

Homeopathic medicines for HLH should be strictly dispensed under guidance and observation of homeopathic physician

AUTOIMMUNE HEMOLYTIC ANAEMIA AIHA

Autoimmune Hemolytic Anaemia (AIHA) also called Immunohemolytic Anaemia is an autoimmune condition where in there are antibodies driven against our own Red Blood Cells. Due to which there is excessive destruction of RBC reducing oxygen carrying capacity of blood.

Pathophysiology

Causes of AIHA

Autoimmune Hemolytic Anaemia (AIHA) is believed to be caused due to genetic predisposition and environmental insults on the genome. Still no specific HLA locus has been found which can be related with AIHA in other words, no Human Leucocyte Antigen association has been established yet.

It can be also be secondary to other Autoimmune diseases, Cancers and Infections as mentioned below

1) Autoimmune diseases

  • Systemic Lupus Erythematosus (SLE)
  • Rheumatoid Arthritis(RA)
  • Crohn’s Disease
  • Ulcerative Colitis
  • Scleroderma
  • Autoimmune Hepatitis
  • etc

2) Cancers

  • Chronic Lymphocytic Leukemia
  • Non-Hodgkin’s Lymphoma
  • Other Blood Cancers

3) Infections

  • Mycoplasma infections
  • Cytomegalovirus(CMV)
  • Epstein-Barr Virus
  • Human Immunodeficiency Virus (HIV)
  • Infectious Mononeucleosis
  • Viral Pneumonitis
  • Viral Hepatitis

Differentiation of AIHA

Based on optimal temperature required for reaction of autoantibody of IgG class and autologous erythrocytes AIHA can be differentiated into

  • Warm Autoimmune Hemolytic Anaemia (wAIHA)
  • Cold Autoimmune Hemolytic Anaemia, further classified into i)Cold Aglutinin Disease (CAD) and ii) Paroxysmal Cold Heamoglobinuria(PCT). These both subtypes can be acute or chronic.
  • Mixed Type
  • Atypical (DAT- negative, IgM -wAIHA)
  • Drug Induced

Classification of AIHA

Clinically AIHA can be clasified as Primary or Secondary

Primary AIHA – It is also called Idiopathic AIHA has no known underlying causative factor and presents itself with hemolysis as predominant feature and other complaints are secondary to it. This type can either be cold or warm thermal relation to reaction mention in above differentiation.

Secondary AIHA – It is usually associated with some primary underlying disease condition. This type usually shows cold thermal relation in reaction that is Cold Agglutinin Disease Category.

Pathogenesis

Autoimmune Hemolytic Anaemia characterises itself by presence of Anti-RBC autoantibodies with or without activation of Complement-Cascade causing excessive destruction of Erythrocytes(RBC).

There are many mechanisms involved in pathogenesis of AIHA. It is a complex scenario with many mechanisms involing Autoantibodies, Phagocytosis, Antibody Dependent Cell-Mediated Cytotoxity, B Lymphocutes and T Lymphocytes, T regs, Cytokines, and Complement System.

Antibody Dependent Cell-Mediated Cytotoxicity (ADCC)

Auto-antibodies are formed by both tissue and circulating self reactive B-Lymphocytes in co-ordination with T-Helper Lymphocytes.IgG sub-classes IgG1 IgG2 IgG3 and IgG4 are involved in ADCC.

Cytotoxic CD8+ T cells and NK cells opsonize the RBC’s with fc portion of IgG for attracting fc receptors on macrophages thus resulting in destruction of RBC by phagocytosis. Occurs in Spleen and lymphoid organs.

Note- Spleenectomy in most cases doesnt have much effect on the disease as in slpeen the erythrolysis is in very lesser proportion in most AIHA cases.

Activation of Final Components of Complement Cascade (Membrane Attack Complex)- DIRECT LYSIS.

IgM dependent- IgM mediated compliment activation results in direct osmotic lysis of RBC, through sequential activation of Membrane attack complex(MAC), in circulation. Also C3b opsonisation of red blood cells by compliment activation results into extracellular erythrolysis by kufper cells of liver, 10 folds more destruction of RBC if compared to ADCC. IgG1 and IgG3 are also responsible in compliment activation to some degree. Majority of erythrolysis is extravascular especially in liver by kufper cells.

SIGNS AND SYMPTOMS

Symptoms develop gradually over months with presenting symptoms usually proportionate to degree of anaemia

  • General signs of anaemia depending on degree of anaemia like weakness, lethargy, breathless, etc
  • signs of Red blood cell destruction.
  • Heamoglobinuria
  • Spherocytes in RBC morphology
  • Increased LDH
  • Spleenomegaly
  • Hepatomegaly
  • Reticulocytes in Circulation
  • Hepatoglulin
  • Jaundice which may be mild to moderate or even severe
  • Angina

DIAGNOSIS of AIHA

  • COOMB’s Test
  • DAT test
  • CBC
  • LDH

HOMEOPATHIC TREATMENT FOR AUTOIMMUNE HEMOLYTIC ANAEMIA (AIHA)

  • Ferrum Metallicum
  • Ferrum Phosphoricum
  • Calcarea Phosphoricum
  • Calcarea Flourica
  • Ruta
  • Calcarea Carbonica
  • Lycopodium
  • Cinchonna Officinalis
  • Arsenicum Album
  • Lachesis
  • Naja
  • Chelidonium Majus

ANAEMIA

Anaemia can be defined as decreased haemoglobin counts or reduced red blood cell counts or reduced oxygen carrying capacity of blood, due to “loss of” or “abnormality of” red blood cells or haemoglobin.

Normal Heamoglobin Counts

  • 6 months to 5 years of age > 11g/dl
  • 5 years to 12 years of age > 11.5g/dl
  • 12years to 16 years of age > 12g/dl
  • Adult Females (non-pregnant) > 12g/dl
  • Adult Females (pregnant) > 11gm/dl
  • Adult Males > 13g/dl

CAUSES OF ANAEMIA

  • Blood losss
  • Excessive Red Blood Cell destruction
  • Heamoglobinopathies
  • Hypovitaminosis B12
  • Hypoferremia
  • Anaemia of Chronic diseases
  • Autoimmune haemolytic anaemia
  • Inflamatory bowel diseases
  • Hypervolemia or water retention due to sodium or other salts.
  • Genetic hereditary conditions like Thalasemia
  • Certain cancers
  • Kidney diseases
  • Reduced erythropoetin production
  • Excessive RBC destruction
  • Impaired RBC production
  • Certain infections like malaria which causes RBC destruction.
  • Certain drugs which causes RBC destruction eg. Quinine causes chinchonism.
  • Bone Marrow lesions and pathologies
  • Etc.

CLASSIFICATION OF ANAEMIA

There are many types of anaemias. It can be broadly classified into 7 categories depending upon their causes

Anaemia due to

  1. Blood Loss
  2. Hemolysis
  3. Impaired or abnormal Erythropoesis
  4. Hypervolemia
  5. Chronic Diseases
  6. Nutritional deficiency

Based on RBC morphology it can be classified into 3 groups

  • Microcytic
  • Macrocytic
  • Normocytic

FEW COMMON and RARE TYPES OF ANAEMIA

  • Iron Deficiency Anaemia
  • Aplastic Anaemia
  • Megaloblastic Anaemia
  • Pernicious Anaemia
  • Sideroblastic Anaemia
  • Autoimmune Hemolytic Anaemia
  • Myelodysplastic Syndrome
  • Thalasemia
  • Fanconi Anaemia
  • Congenital Dyserythropoetic Anaemia
  • Daimond-Blacfan Anaemia
  • Myelopthisis
  • Anaemia of Prematurity
  • Erythroblastopenia or Pure Red Cell Aplasia
  • Hereditary Spherocytosis
  • Hereditary Elliptocytosis

SYMPTOMS

  • Weakness
  • Lethargy
  • In children it affects growth in general
  • Somnolence, Drowziness in day time
  • Disturbed sleep at night
  • Pallor, general pale appearance of skin, mucous membranes and eyes.
  • Dyspnoea on Exertion.
  • Reduced Immunity, tendency to catch infections and slow recovery and healing.
  • Bodyaches
  • Cyanosis in severe cases
  • Palpitations
  • Tachycardia
  • Low blood pressure
  • Chest pain
  • Depression
  • Craving for indigestible things , PICA
  • Cold clammy extremities
  • Oedematous swelling of extremities, dependent oedema
  • Angina or cardiac failure in severe cases
  • Will impact general growth and repair of all the vital organs and tissue of the body.

HOMEOPATHIC MEDICINES FOR ANAEMIA

Depending upon the cause of anaemia and general constitution of the patient, one of the following medicines may be called for duty by a homeopathic physician.

  • Ferrum Metallicum
  • Ferrum Phosphoricum
  • Cinchonna Officinalis
  • Natrum Muriatic um
  • Arsenicum Album
  • Abrotanum
  • Hamamelis Verginiana
  • Pulsatilla Nigricans
  • Janosia Ashoka
  • Crotalus Horridus
  • Lachesis
  • Acidum Phosphoricum

THALASEMIA

Thalasemia is a genetic disorder where in mutation or deletion in any genes responsible to produce globin chain of haemoglobin results in abnormal haemoglobin production.

Normal adult has Haemoglobin A (HbA). HbA is a hetrotetramer of two α globin chains and two β globin chains. In normal humans there are total 4 genes (2pairs) for production of αglobin chain and 2 genes(1 pair) for production of β globin chain. When there is defect in genes producing α globin or β globin chains of heamoglobin it results into thalasemia.

TYPES

  • Alpha Thalasemia – Abnormal or dhieficient α globin chain production
  • Beta Thalasemia – Abnormal or deficient β globin chain production.
  • Delta Thalasemia – Abnormal or defective delta chain production.
  • Thalasemia in combimation with other haemoglobinopathies like – Haemoglobin S , Haemoglobin E, Haemoglobin C, Haemoglobin D.

Of the above all types the most common types alpha and beta are discussed below.

ALPHA THALASEMIA

Alpha Thalasemia has defective α globulin chain production. Genes responsible to produce α globin chain are situated on chromosome 16. HBA1 and HBA2 genes are responsible for production of α globin chain. Both the genes are acquired from both the parents so total two HBA1 and two HBA2 genes. So, there are two genes acquired from each parent making total 4 genes or two pairs(αα/αα) responsible to produce α globin chain.

Depending upon number of gene deleted the condition is classified into 4 categories

  • α Thalasemia Silent (1 gene deletion)
  • α Thalasemia Trait (2 gene deletion)
  • HbH disease (3 gene deletion)
  • Hb Bart Syndrome (all 4 gene deletion)

Alpha Thalasemia Silent

Any one gene deletion (-α/αα), one of the two allele not received from one parent. Usually there are no sign of anaemia as the remaining three genes produce sufficient alpha globin chains. Althought they dont show symptoms they are the silent carrier and if married to person with one or more α globin making gene deletion then some of their offsprings will have symptoms, probability and severity of the disease in the offsprings will depend on number of gene deletion in the partner.

Alpha Thalasemia Trait

Any two gene deletion, it can be of two genotypes as descussed below, this type shows mild anaemia symptoms.

  1. Two gene deletion – homologous; one of the two allele not received from each parent(-α/-α).
  2. Two gene deletion- heterologous; both the alleles not received from one parent (–/αα).

HbH Disease

Three gene deletion (–/-α) No copy of gene received from one parent and only one of the two copy received from another parent. These causes very low α chain production resulting into excess proportion of β chains causing formation of unstable haemoglobin tetramer made up of 4 β globin chains, instead of two α and two β. This type of haemoglobin with all 4 globin chain of β globin is called HbH which is very unstable. These individuals shows moderate to severe anaemia and other thalasemia related symptoms.

Hb Bart Syndrome

All four gene deletion (–/– )No copy of α chain producing gene received from either of the parent. It is a fatal condition where in there are no α chains produced and results into severe fetal condition called hydrops fetalis. Death ensues soon after birth.

BETA THALASEMIA

Beta thalasemia has defective β globin chain production. For production of β globin chain there is only one gene acquired from each parent makin it total one pair(β/β) i.e total 2 genes responsible to produce β globin chain. Gene Responsible for production of β globin chain is called HBB and is located on chromosome 11.

Beta Thalasemia Minor

  1. (b/β) One gene received from a parent is altered and the one from other parent is normal.
  2. (-/β) No gene received from a parent and the gene received from another parent is normal.

Beta Thalasemia Intermedia

  1. (b/-) One copy of gene received from a parent altered and one from another parent is absent.
  2. (b/b) Genes received from both the parent are altered.

Beta Thalasemia Major

  • (-/-) No genes producing β globin chain received from either parent.

SIGNS AND SYMPTOMS

Symptoms and its severity depends upon the above mentioned severity of genotype the individual has few complaints which patient with this disease condition show are mentioned below.

  • Anaemia
  • Iron Overload
  • Bone deformities
  • Enlarged spleen
  • General growth is slow
  • Ferquent Infections
  • Cardiac complaints

DIAGNOSIS

  • Complete blood count
  • Hb Electrophoresis
  • DNA analysis.

HOMEOPATHIC TREATMENT AND INDICATED HOMEOPATHIC MEDICINES FOR THALASEMIA

  • Cinchonna Officinalis
  • Abrotanum
  • Natrum Muriaticum
  • Phosphorus
  • Calcarea Phosphorica
  • Calcarea Carbonica
  • Calcarea flourica
  • Ruta Graveolens

RICKETS

Rickets is a childhood disease mainly occuring due to vitamin D deficiency. The bones become weak and soft and are more prone to fracture and deformities.
Osteomalacia is similar condition occuring in adults.

Types of Rickets

Hypocalcemic Rickets  – This occurs due to impaired metabolism of vitamin D and calcium resulting into vitamin D deficiency and Calcium deficiency.
Hypophosphatemic Rickets – This occurs due to low serum phosphate levels.

Causes

Vitamin D Deficiency
-decreaed sun exposure
-malabsorption disease
•Chronic liver disease
•Renal tubular disease
•Neonatal hepatitis
•Limited breast feeding
•Improper diet
•Certain medications

•Certain Genetic anomalies

For Pathophysiology Also Refer This link VITAMIN D DEFICIENCY

Genes Related to Rickets-

•The most common form of disease is X-lined hypophosphatemic rickets (XLH).
•It is an autosomal form of disease.
•XLH rickets occur due to inactiving mutations in PHEX gene.
•PHEX(Phosphate regulating neutral endopeptidase) gene is expressed in bones , teeth and in mineralization and renal phosphate reabsorption.
•PHEX is involved in suppressing the response of FGF23
•FGF23(Fibroblast growth factor 23) gene signals the kidney to stop reabsorption of phosphate in to bloodstream.
•PHEX mutations lowers the tubular reabsorption of phosphate and vit D.
This contribute to bone diseases.

Signs and Symptoms

•Muscle weakness
•Bone tenderness and retarded growth
•Delayed closure of anterior frontalle
•Delayed eruption of teeth and enamel defect
•Enlargement of long bones
•Anterior curving of legs,bow legs
•Green stick fracture
•Seizures and tetany
•Improper gait, bone pain

Diagnosis

Blood tests – Serum calcium and serum phosphate show low level along with changes in shape and structure of bone’s.
Bone biopsy for confirmation.

Homoeopathic Medicine for Rickets-

Thyroidinum – Thyroid producing anaemia, muscular weakness, nervous tremor, rheumatoid arthritis. Infantile wasting rickets. Delayed union of bones, nocturnal enuresis. Oedema of legs.

Phosphorus – Dullnes of head, obstinate vertigo. Caries in teeth, drawing and tearing toothache, bleeding and grinding of teeth, gums separated from teeth. Weakness in all limbs, swelling of hand and feets, joint stiff.

Calcaria Phosphorica – Wewakness of bones,large open frontalle, headache, skull soft. Slow dentition, tearing boring pain in gums, fever during dentition,pain in molars. Rheumatic pain in shoulder and arms, paralysis of joints.

Baryta Carbonica – Suited to old people, dwarfs, scrofulous children inclined to grow fat. Glandular swelling. Chronic enlargement of tonsils. Abdomen distended and hard.

Thuja occidentalis – Scalp sensitive to touch and painful, weakness in head. Caries of teeth, crown of teeth remains sound, gums swollen. Trembling of hands and feets, cracking of joints, frozen limbs.

Silicea terra – Stiffness of nape,caries of clavicle, swelling of gland in nape,coccyx painful, tearing and shooting pain in back.Weakness of joints,cramps of arms and legs,jerk in limbs.

Kalium Iodatum – Glands swollen or atrophied. Gouty daithesis. Swelling of bones, contraction of muscles and tendons, pain after long injury.its is also very well indicated in Dropsy accompanying Rickets basically due to renal complaints impairing calcium resoption.

Conservative management for Rickets-

  • Exposure to Ultraviolet B rays
  • Increasing dietary intake of calcium
  • Phosphate and vitamin D
  • Cod liver oil
  • Halibut liver oil
  • Vit D fortified milk
  • Vit D supplements

VITAMIN D DEFICIENCY HYPOVITAMINOSIS D

CALCIUM DEFICIENCY

OSTEOPOROSIS

COUGH AND COLD -Not Only Climate But Also Doctors Making It Worse!

Cough and Cold – Not only Climate But Also Doctors Making Cough and Cold Even Worse!

Cough and Cold – As dry cold climate approaches so does dust, smog and other pollutants along with subjecting organism to unusual insults of polluted atmosphere especially in urban areas where vehicles construction activity,  crackers of festive season pollute the air so much so that majority of the population who breathes here is suffering from respiratory allergy and things become worse for Asthma patients.

In India, winter is season of fruits where many hybrid fruits come to market to which the sellers further chemically  ripen, inject sweetners, artificially colour and glisten to make it attractive and easily saleable, also many fruits like grapes have lots of pesticides and insecticides sprinkled on it.

Its seen that people have increased appetite during winter days, they feel hungry too often, so processed and packaged food like chips, choclates, soft drinks, packaged farsan, biscuits and other bakery products ,etc. comes handy. Its seen that there is huge surge in sales of all these products during cold climate of monsoon and winter, now not to forget its full of artificial colours, artificial flavours, chemical preservatives, artificial dough conditioners, artificial leavening agents, baking powders and what not, eating such thing makes the health scenerio in winter even more worse with cases of respiratory allergies shooting up even further.

It starts with mild damages to mucosa of respiratory system where the superficial mucosal epithelial lining is subjected to pollutants and the epithelial cells gets damaged and the immune system comes into role to fight out the foreign particles but because of excess quantity of allergens and excess toxicity of few of these allergens the immune system is unable to cope up which the basic primary innate immunity, so it startes to call in for more work force and immunoglobulins which makes our body a battle field causing damage even further till it fights allergen off and im this process patient has symptoms of cold, cough, malaise headache. bodyache, fever etc. In most of the cases where the dose of allergen or infectious agent is not high and immunity is strong enough or in patient, who are taking proper primary first aid care and avoiding triggering and maintaining factor of the condition, should not have complications and the bodyfight it out. Also body will form new memory against many new antigens in this process, improving one’s immunity.

But in some case where the outside organism are more virulent or the allergens are more toxic then the damage is greater. Now this damages tissue and damaged tissue becomes fertile ground for microbes like bacteria, virus, fungus etc to grow and they are ample not only in environment but also within our own body. Now with such an opportunity they start growing and making case even more difficult and severe. In cases with pre-existing allergic conditions and atopy, things get even worse causing chest congestion, breathlessness.

Patient suffers from sleepless nights due to cough, sneezing blocked nose,  irritating nose and throat malaise bodyaches and lack of energy. This causes patient to apprehend and anticipate grave condition like swine flu bird flu or Tuberculosis(TB) or severe bronchitis or asthma which drives patient to the allopathic doctor for instant relief.

Now unlike in India and other developing countries, the developed countries like USA UK and other European nations, dispensing of medicines like anti-tussives, anti-allergics, cough syrups with mix of all, antibiotics, broncho-dilators, cortico-steriods for case of uncomplicated cough and cold is strictly discouraged and the medical doctors are strictly guided not to give any of these medicines for such uncomplicated cases.As its usually a self-limiting condition and regresses on its own, medicines only weakens subject’s immunity even further, causing recurrent spells of such cough and cold every few weeks making condition persistent. But in India where almost all the doctor promotes and dispenses mix of these 4-5 harmful medicines at a time from their clinic in all cough and cold patients, regardless of wether patient’s condition requires such medicines or not, ant that is just to give symptomatic relief to patient at cost of his health. When asked to such doctors, they simply answer – “If I will not give quick relief to the patient, with help of such harmful medicines, then the doctor practicing next to me will give relief to the patient with those harmful medicines, then why shouldnt I give and retain my patient!”  . Now its role of health authorities to keep check on dispensing of such harmful cough syrup preparations and corticosteroids. So that every doctor doesnt use it in every case like what the scenerio is right now!

Knowing the well established fact that cough and cold are body’s response to fight out Antigens (foreign particles living or non living) and other external insults on body. Now suppressing it only interferes normal body functioning and weakens immunity even further and such medicines also damages other systems of body and permanently damaging one’s constitution for ever.

Medicines dispensed by allopathic doctors for cough and cold also have antihistaminics, immunosupressants. Now histamin ,we can say,  is the basic reception point of our immune system, supressing it causes less of the molecular expression signals corresponding to the antigen being sent to immune system and the organism as a whole. The result is no proper immune response being established, so patient will have no symptoms (no cough no cold pt feels good) and feel good but also no new immune memory allocation for that particular antigenis being properly developed due to supression as I explained above, so next time again when the same antigen enters our body again we will suffer from same condition. and the recurrency of cold and cold will persist almost every few weeks as we have to stay in same environment.

Most of the viral respiratory infections recover on its own and there are no medicines specific for viruses that cause cough and cold in allopathy so its not advisable to take multiple heavy allopathic medicines untill there are complications due to it.

Signs of complications:

  • Fever persisting for more than 2-3 days secondary bacterial or in immunocompromised fungal infection may be present and specific treatment is required for infection and underlying condition.
  • Pain in ear along with Cough and Cold or fever indicates that there is congestion of eustachian tube due to eustachian catarrah and may damage ear and hearing ;also infection due to this in middle ear is an unwanted complication as it may not only damage ear permanantly but can also progress retrograde into cranium and infect brain to cause meningitis which is a fatal condition.
  • Cough Cold lasting for more than 15-20days not always  but few cases turns out to be because of tuberculosis and specific TB treatment is required and not cough and cold medication
  • Blood in sputum due to violent coughing or sneezing minor capillary rupture may have occurred; now that may provide microbes an entry point for infection
  • Pain in Chest may be due to muscular fatigue due to coughing which is not a major complication but if the pain in chest is due to some other reasons like infective or inflamatory focus in the lung etc then immediate medical attention and specific treatment for tht reason is required
  • Efforts in Breathing if patient has make an effort on breathing like heaviness in breathing suffocative feeling short breaths ; in small children it is noticed by short small fast breath fan like motion of alea of nose unusual excessive movement of abdomen while breathing along with abnormal sound vibrations from chest.
  • Abnormal sounds from chest while breathing like crepitation and wheezing heard on auscultation  ; in children it is easily felt by keeping hand on chest or can be heard by keeping ear on chest.
  • Headache severe persisting after violent coughing may be due to increased intracranial pressure that may have caused damaged and may need immefiate attention
  • Any other chronic disease in in individual
  • Other coexisting infection
  • Immunocompromised Individual

So what to do, so as to get yourself a proper medical observation and yet to be sure that you will not be medicated unnecessarily, for that first of all your doctor should be experienced enough that he doesnt panic unnecessarily on listening to complaints and  should know how to treat patient without help of any unnecessary medication also he should be competent enough to estimate,  evaluate and treat condition and its complications with minimal medication, also  you need to speak to your doctor first that you are not willing to take any heavy medication and you  are ready to bear with the condition till it recovers and you have visited him just to be under proper medical observation so that no complication arise and if at all, it can be addressed and tackled soon. Now that should give your doctor comfort, confidence free hand in treating you successfully with minimal medication and that too only if required making your body less prone to side effects and also boosting your immunity.

In Homoeopathy, unlike Allopathy, we try to boost immune system by enhancing the immune response and helping organism further to develop permenant immunity, so pt initially may have mild aggravations, we call it homoeopathic aggravations, which are favourable for the case and holds good prognsosis.

There are many homoeopathic medicines that can cure the respiratory allergies and viral respiratory infections, not by suppressing, but by enhancing immune expression and developing permanant immunity against it. Homoeopathy works even faster than allopathy in such acute conditions.

Few of the good homoeopathic medicines that can be used in viral respiratory tract infection or other acute or chronic respiratory tract allergies are:

  1. Spigelia constant bland discharge from posterior nares dropping into nasopharynx and anterior portion of nose always remains dry, severe boring pain in orbits as if eyes weee pushed in, severe paraorbital sinusitis.
  2. Allium Cepa have you ever chopped onion?? Then recollect how it feels in your nose and eyes and if you have similar symptoms in cold this medicine is for you,  copious acrid nasal discharge and bland lachrymation(discharge from eyes) with photo phobia with much burning and smarting in eyes with conjunctival hyperaemia causing red suffused looks of eyes , also mild redness of eyelids,much photophobia,  nasal discharge excoriates nose and upper lip, sore raw sensation at bifurcation of trachea, frontal headache due to cold, patient feels better in open air and cold climate and his complaints becomes worse in closed room and warm climate.
  3. Euphrasia Officinalis Copious Bland nasal discharge and acrid lachrymation better in open room, much mucosal discharge from throat need to bring up too frequently which smells too offensive. Patient suffers from bursting headache due to coryza. Copious thick sticky yellowish discharg from eyes causing eye lids to agglutinate in morning ,eye discharge acrid in nature causing excoriation of surface it touches causing redness and ulceration on inner canthus of eyes , eyelids and cheeks, Blisters in eyes and ulceration in cornea with much photophobia. Good remedy for autoimmune or allergic or infective conjunctivitis accompanying cough and cold.
  4. Arsenicum Iodatum acrid fetid profuse thin watery discharge with much sneezing and redness of all mucous membranes, nasal polyps , eustachian catarrah, hypertrophy of eustachian tube causin g hearing problems and deafness, chronic nassal catarrah
  5. Ammonium Carbonicum Morning sneezing, this medicine works well in patient complaining severe violent bouts of sneezing early in the morning soon after waking up of touching feet to ground or soon after morning bath. typically suited to stout women with tendency to catch cold easily. Can’t tolerate cold climate or  cold food and drink , thirstless and doesnt like water much aversion, lympohmegaly (enlarged lymphnodes), sharp burning watery discharge that continues whale day and stops with nose block at night. slow stertorous opressed breathing. burning in throat and chest , Pneumonia , emphysema, ulcerative tonsilitis, purulent, supurative and gangreneous condition of tonsils,
  6. Spongia Tosta constant tickling and irritation in throat pt has to clear throat too frequently, stitching stinging burning pain in chest, dryness of nasal mucosa alternates with thin fluent watery discharge.
  7. Senega burning and scrapping sensation as if mucosa has abrassions bursting cough, copious thich tough tenacious mucous difficult to bring up, hacking cough, thorax feels as if shrunk and is too narrow, hoarseness of voice.
  8. Occimum Sanctum generaly used in lower potencies for hay fever , otitis media with throbbing pain due to eustachian catarrah, epistaxis with much running nose and violent sneezing, too restless cant lie in bed sits with hands on head and elbow on knee this position gives him some relief , warm drink relieves complaints.
  9. Sabadilla lachrymation with hyperaemic congestion of conjunctiva with much burning, thick tough mucous adhered within throat giving sensation as if skin is hanging within, urging patient to swallow constantly, empty swallowing pains a lot, tongue has sensation as if its burnt.
  10. Rumex Crispus mucous membranes too sensitive causing tickling sensation in pharynx going down deep to bronchus which triggers cough, pain below clavicle , cold starts with copious thin watery nasal discharg soon followed by thick stringy discharge so is with mucous discharge from throat. Urticaria accompanies with or alternates cough and cold with intense itching, early morning diarrhoea accompanies cough.

Also read for associated complaints and their medicines:

Best HOMOEOPATHIC Medicines indicated in ASTHMA

ASTHMA

Best HEADACHE Medicines in Homoeopathy

SUN STROKE HEAT STROKE

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CHICKEN POX HOMEOPATHIC MEDICINES

Chicken pox – 10 Best Homoeopathic Medicines

  1. Ranunculus Bulbosus one of the best remedy for chicken pox in all stages of disease, shingles, herpes zooster, Herpes simplex 1 and 2, pamphigous and all other skin conditions where there are vesicular eruptions with intense itching and burning
  2. Rhus Toxicodendrone can be used during initial stage of chicken pox when pt is febrile and vesicular erutions have just started appearing.
  3. Variolinum its a nosode and it is  to be administered as single dose during treatment intercurrently along with other indicated medicine.
  4. Apis Melifica indicated when vesicles start appearimg and stopped when it starts bursting and patient comolaints of violent burning and itching with stinging pain and thirstlessness aggravations in warm and ammelioration on cold.
  5. Antimonium Tartaricum indicated in vesicular stage of chicken pox till scabs starts forming.
  6. Thuja Occidentalis It is basically a psycotic remedy but has shown great effect in all sorts of viral affections it compliments other medicines and can be continued till vesicles of chicken pox starts bursting.
  7. Ledum Palustre this remedy is indicated in  in all stages of chicken pox untill scabs starts falling off.
  8. Natrum Sulphuris  It can be administered along with other homoeopathic medicines in biochemic form upto 6th trituration in all stages of
  9. Borax It is to be administered when scabs start forming and to be continued untill scabs starts falling off.
  10. Mercurius Solubilis it come into role when fever subsides and vesicles have started bursting and forming crusts , it should not be administered in fever and should not be repeated too frequently, once a day is quite often and it is to be continued once fortnight for a month even after scabs fall off.