PCOS is caused due to Hyperandrogenism and has strong germ line and/or acquired genetic anomaly, Strongly associated with heriditary as clustering of members with condition in same family Is very commonly seen.
Lifestyle, lack of exercise proper sleep and dietary irregularities contribute to Polycystic ovarian Syndrome, it is observed that most of the symptoms of Polycystic Ovarian Syndrome are ammeliorated only by regular exercise and diet.
Polycystic Ovaries (PCOS) berfore treatment Dr SHAH Homoeopathy – Dr DEEPAN P SHAHPolycystic Ovaries(PCOS) cured After Treatment – Dr SHAH’s Homoeopathy – Dr DEEAN P SHAH
PCOS is characterised by
Oligovulation /anovulation and or polycystic ovary.
Hyperandrogenism
Exclusion of all other causative factors of hyperandrogenism.
Sign and Symptoms of PCOS
Polycystic ovaries, strings of follicles peripherally located in ovaries detected by USG.
Oligovulation or Anovulation
Various types of Menstrual disorders but mostly Oligomenorrhoea less than 9/annum or Amenorrhoea.
Hyperandrogenism, excessive androgens , especially ovarian testosterone
Reduced sensitivity to insulin
Hirsuitism excessive hair growth in females especially on beard upperlips abdomen chest and back
Central obesity
Eevated Homocystien levels
Acne on face neck back and upper chest
Infertility
Dark velvety thickening of skin especially on neck and other extensor surfaces.
Pathogenesis of PCOS
It is caused due to increase in ovarian androgens especially testosterone due to one or more of the following reasons with combination of genetic factors.
Insulin resistence causing Hyperinsulinaemia which disturbs Hypothalamo-Pitutary-Ovarian Axis causing increase in GnRH which causes increase in LH:FSH ratio which increases ovarian androgen, reduces follicular maturity and SHBG binding giving rise to Polycystic Ovarian Syndrome.
Also insulin in presence of its cognate receptors in presence of cAMP via P13k increases activity of 17α-Hydroxylase which is responsible for Androgen precursor synthesis so hyperinsulinaemia contributes in pathogenesis of Polycystic Ovarian Syndrome.
It is observed that insulin resistance and obesity is strongly associated in pathogenesis of Polycystic Ovarian Syndrome.
FMR1gene Subtype is associated with Poly Cystic Ovarian Syndrome.
Chronic inflamation, certain inflamatory mediators and oxygen radicals are also associated with Polycystic Ovarian Syndrome.
Diagnosis of PCOS
1)Ultra Sonography(USG) findings in Polycystic Ovarian Syndrome.
Strings of ovarian follicles peripherally arranged in ovaries more than 25 in number most of them arrest in growth at 5-7mm and no dominant follicle reaching preovulatory size of above 16mm. It appears like “string of pearls” on USG.
Hypothyroidism is insufficiency of thyroid hormone required for normal growth and functioning of the body.
THYROID HORMONE AND ITS PHYSIOLOGY
Thyroid Hormones are produced in body only by thyroid glands , its a butterfly shaped glands situated in neck each lobe on either side of trachea connected with isthemus on midline behind hyoid bone.
T3 or tri-iodothyronine or liothyronine and T4 or thyroxine are active thyroid hormones partially composed of Iodine, so iodine is required for production of T3 and T4.
Hypothalamus releases Thyrotropin Releasing Hormone(TRH) which stimulates Pitutary glands to secret Thyroid Stimulating Hormone(TSH) which stimulates thyroid glands to produce thyroglobulin which is precursor of thyroid hormones, the residue of thyroglobulin is protien tyrosin which undergoes iodination with help of thyroperoxidase forming thyroid hormone.(1 molecule of thyroglobulin has 100-120 residual tyrosin of which only 20 undergoes iodination with help of thyroperoxidase in follicular colloid and rusultant formation of upto 10 thyroid hormone molecule from 1 thyroglobulin molecule.)Hypothalamo-pitutary-thyroid axis regulates levels of thyroid hormone in blood, increased level of T3 and T4 inhibibits TSH and TRH. Thus regulating proper balance of blood level of thyroid hormone.
T4 is converted into T3 with help of Deiodinases , these Deiodinases are Selenium based compounds, So sufficient selenium is required for production of T3 , its then converted into T1a (iodothyronamine)and T0a (thyronamine) by decarboxylation and deiodination.
In blood almost 99.97% thyroxine is bound to Thyroxine binding globulin only free thyroxine is biologically active.
Thyroid hormones helps in protien, fat and carbohydrate metabolism and stimulates vitamin metabolism. It is essential for proper development and differentiation of cells, it influences almost each and every cell bt binding with thyroid hormone receptor on neucleus of cells and it activates gene to express cell specific protiens to neucleus of the body and on cell membrane it attaches to integrin αvβ3 stimulating sodium-hydrogen anti-porter and activating processes like cell growth and formation of blood vessels. it also helps in maturation of neurons and bone growth, it promotes catecholeamines sensitivity.
Regulation of thyroid hormone levels is influenced by many different physiological and pathological stimulus.
HYPOTHYROIDISM MAY BE CAUSED DUE TO
Defective Thyroid Gland itself , functioning inadequately, its called Primary Hypothyroidism. It is caused due to Iodine Deficiency, autoimmune Thyroiditis like Hashimato’s Thyroiditis where auto antibodies are driven against Thyroglobulin, Thyroxine peroxidase, TSH receptors which infilterate thyroid glands, post partum thyroiditis, subacute lymphocytic thyroiditis, subacute granulomatous thyroiditis, certain medications , radio-iodine procedure, thyroidectomy.
Lack of sufficient stimulus by Thyroid stimulating Hormone (TSH), which is secreted from pitutary glands, it is called Secondary Hypothyroidism.
Inadequate Thyroid Releasing Hormone(TRH), which is secreted from Hypothalamus, its called Tertiary Hypothyroidism.
A person can suffer from one or above all three types of causes of hypothyroidism.
Central Hypothyroidism, any hypothyroidism which can be classified under Secondary or Tertiary cause is termed as Central Hypothyroidism, their causes are any lesions compressing the pitutary, injury to pitutarty due to surger or other reasons , pitutary irradiation, certain drugs influencing pitutary, vascular disorders affecting pitutary, intracranial heamorrhages, certain autoimmune diseases like lymphocytic hypophysitis, certain infiltrative diseases, infection and congenital disorders.
SIGNS AND SYMPTOMS OF HYPOTHYROIDISM
Fatigue , patient gets tired easily, frequently complaints of aching sensation in limbs and very occasionaly complaints of sensation of trembling of limbs
Somnolence, sleepy feeling throughout the day and Insomnia, cant get proper sleep at night
Weakness and lethargy, pt complaints of general weakness and lack of interest to do any physical activity.
Coldness, cold feet and hands , slightly lower body temperature, cant tolerate cold climate.
Dry thick and coarse skin
Hoarseness in voice
Tendency to catch cold easily
Lack of concerntration and weak memory
Depression, lack of interest , gloomy and melancholic.
Delayed cycles with initial heavy flow and later very scanty flow.
Oedematous swelling of limbs and face
Myxedema
Hearing deteriorates
Slow Pulse Rate
Carpel Tunnel Syndrome
Delayed Tendon Relaxation Reflexes.
DIAGNOSIS OF HYPOTHYROIDISM
Blood test
T4 and TSH levels helps diagnose the condition
Low T4 and elevated TSH suggests Hypothyroidism
Low T4 and normal/low TSH suggests Hypothyroidism of central origin.
Normal T4 and elevated TSH suggests Subclinical Hypothyroidism.
T3 levels are just extra parameter and should not be considered primary parameter, according to current guidelines T4 and TSH levels are considered first and T3 is used for extra guidance.
In many cases, patient shows signs and symptoms of hypothyroidism but their FT3 FT4 and TSH levels are absolutely normal in such cases antithyroglobulin and anti TPO antibodies test should be done to rule out Hashimoto’s Thyroiditis.
HOMEOPATHIC MEDICINES FOR HYPOTHYROIDISM
Based on symptoms and condition.
THYROIDINUM
Thyroidinum is a polcrest remedy with a wide sphere of action. Thyroidinum is a sarcode prepared from dried thyroid gland of the sheep or calf. It influences all the other systems of the body. Thyroidinum is used to treat various symptoms of hypothyroidism. Hypothyroidism is usually causex due to deficiency of tbyroid hormone. Patient usually presents with general and muscular weakness, easy fatigue, mood changes, obesity, digestive disturbances. Tendency for obesity. Very good remedy for menstrual disorders like menorrhagia, metrorrhagia, amenorrhoea. Arrested mental and physical development. Fatigue, marked weakness, poor concentration.
IODIUM
Iodum is generally known as iodine, a non metallic trace element required by our body. Iodine has multiple functions in our body. Deficiency of iodine in human body leads to several symptoms. Iodum is a very useful remedy in case of thyroid disorders. Patient usually presents with dry skin, hair loss,, feeble muscles, puffed up face and swollen tbyroid glands. Mental and physical lethargy, weight gain. Severe exhaustion and fatigue. Ravenous hunger, eats well yet losses flesh all the time. Anxiety with increased palpitations. Great debility, slightest effort endures perspiration.
CALCAREA CARBONICA
Calcarea carb is usually suited to fair, fat, flabby persons who are always chilly and cannot tolerate cold air. Calcarea carb is Very well indicated in hypothyroidism. Excessive sweatinv on head is a leading symptom for its use in hypothyroidism patients. Feels overworked or exhausted. Forgetful, confused, misplaced and expresses herself wrongly. Women with hypothyroidism have too early, too profuse menses with vertigo. Recomended in obese patients. Pecularities in eating like craving for boiled egg. Desire for indigestible things. Presents with constipation, first part of stool hard followed by soft stools.
BROMIUM
Bromium is a deep acting remdy indicated in case of Hypothyroidism. Suited to people with flax hair, light blue eyes, fajr individuals. Tendency to cause induration and enlargement of glands. Patient is very anxious, apprehensive with great depression of spirits. Glandular swelling, stony hardnesd of glands. All glands are affected thyroid, parotid, submaxillary, ublingual etc. The thyroid gland may bulge at one side and may be so hard as to restrict the movement. Presents with emaciation, general weakness and perspiration. Limbs are weak and tremble with growing prostration. Presents with chronic fatigue syndrome. Another important symptom of bromium is its indication of respiratory ailments especially in asthama in sailors as they go ashore.
SELENIUM
Selenium is one of the indicated remedy in case of hypothyroidism. Presents with marked mental and physical weakness.Great fatigue from which he seems unable to recuperate from rest. Sudden weakness in hot weather. Dry hacking cough with weak feeling in chet. Weak spine as if paralysed. He is sleepless till midnight, awakens early and always at the same hour. Severe hairfall. Constipation with inactivity of rectum.
APOCYANUM CANABINUM
Apocyanum cannabinum is an efficient remedy in case of hypothyroidism. Useful in dropsies. General dropsies with or without disease. Swelling of every part of body. Presents with great weakness. Low spirited, nervous. The skin feels husky and rough. Great proatration. Presents with great oppression about epigatrium with difficult breathing. Gasping for breath. In females metrorrhagia with paroxysmal flow.
BUFO RANA
Bufo is usually suited to feeble minded children and prematurely senile people. Bufo is a deep acting antisporic remedy. Main sphere of action is on glands, skin, CNS, mind. Useful in hypothyroidism. Patient is usually sad , restless, feeble minded, idiotic childish, impatient child. Inclination to bite. Presents with marked swelling of body. In female the menses are too early and too copious with clots. Weak memory, desires solitude.
“Hormesis is a term used to describe any phenomenon in a cell or the whole organism that exhibits a biphasic response to exposure to increasing amounts of substance or condition”. from wikipedia.
Within the hormetic zone there is generally a favorable biological response to low exposures to toxins and other stressors. ~from wikipedia
Any substance or condition showing Hormesis thus has the opposite effect in small doses as in large doses.
In toxicology, hormesis is a dose response phenomenon characterized by a low dose stimulation, high dose inhibition, resulting in either a J-shaped or an inverted U-shaped dose response. Such environmental factors that would seem to produce positive responses have also been termed “eustress”. ~ from wikipedia.
This is exactly what homoeopathic principle of similia similibus curenture is. Thus theory of Hormesis proves Homoeopathic Principle of Similia Similibus Curenture.
Non of the single Homoeopathic medicines can be patented and almost all available elements and naturally occuring substances are already mentioned in homoeopathic materia medica and are efficiently used as as per principle of Similia Similibus Curentur or say homoeopathic doctorine of same cures same or say Hormesis or hormetic effect , its one and the same.
The scientific community is outright rejecting similia similibus curentur and accepting the theory of Hormesis, where as its exactly one and the same with two different names.
They say they reject homoeopathy because homoeopathy uses only high dilution, its their lack of knowledge or misconception or delibrate misrepresentation of facts, they should not forget that homoeopthic system of medicine not only use high dilutes but also uses crude form and various different concentration of substance and we dilute it in various ways and methods to get various degrees of concerntration of the substance, we have various different scales for diluting a substance, and we have various degrees of dilutions straight from crude till very high ultra dilutions.
Wikipedia have misrepresented the fact about Homoeopathy intheir page about Hormesis, that in homoeopathy typically uses high potency. Also the page about homoeopathy terms Homoeopathic principle of same cure same as unscientific now again that contradicts with their article about hormesis where they claim this principle to be scientific.
Homoeopathy uses dilutions in varying degrees as per requirement and symptoms of patient, straight from crude substance to ultra high dilutes.
So to delibrately misrepresent the facts and to systematically demolish almost 400yrs old system of medicine, just to bring up the same principle of Similia Similibus Curenture with new name is nothing but old wine in new bottle and its a malicious act and conspiracy done just to get homoeopathic medicines and its principles patented so that few with wasted interests can make money out of it.
Dengue is a disease caused by virus which is spread by Aedes mosquitoes which are usually white striped /dotted. They breed in clean water and usually bite during early morning and evening. Few cases have been reported where it has been spreaded by blood of infected person comming in contact of mucous membrane of healthcare worker.
The incubation period is 4-15 days. i.e the symptoms will appear after 4-15 days after being bitten by the infected mosquito.
There are 4 types of dengue viruses (Type 1 and type 3 are less severe compared to type 3 and type 4), so it is possible to be infected by dengue multiple times in a life time since at a time your body develops immunity only against the type you are infected with.
It is also known as “dandy fever” or “breakbone fever” as it causes severe joint pain and muscle pain.
Symptoms of Dengue
High fever with chills, headache (typically located behind the eyes), Joint pain , muscle pain, extreme pain in the lower back ,rashes, loss of appetite, extreme weakness, Thrombocytopenia (drop in platelets)
Often due to similarity of symptoms, it is difficult to distinguish between dengue and other diseases such as chikungunya, malaria , typhoid and influenza etc.
Dengue Fever can be classified in two types Uncomplicated Dengue Fever and Heamorrhagic Dengue Fever which may result into Dengue Heamorrhagic Shock and is a medical emergence and required immediate hospitalisation preferebly in an intensive care unit. Dengue Fever lasts for 5-7 days then there is a phase of udden drop in platelets for 2-3 days as its supposed that the antibodies driven against dengue virus also damages platelets and also there is suporession of bone marrow due to infection so the production of new platelets is arrested to certain extent for some period which causes severe fall in platelets , these 2-3 days post fever are very critical as patient seems to be out of fever but platelets falls drastically within, the fall is severe bringing platelets down to sub 10k levels within a day or two and may progress into condition called Dengue Heamorrhagic Shock if there is external or internal heamorrhage as a result of damaged capillaries due to virus and extreme thrombocytopenia due to some ort of antibody driven immune response and suppressed marrow by virus.
A feeling of fatigue may last for weeks.
Diagnosis of Dengue
Drop in plateles count starts after 2-3 days from 1st day of fever and after last day of fever there severe drop causing thrombocytopenia.
LDH level may rise upto 1500 due to mild damages to liver.
In most cases where pt doesnt have any other disease condition in body the WBC starts increases only after 2-3 days from 1st day of fever when platelets starts falling
The Diagnosis can be confirmed by a blood test – Dengue NS1 antigen test, its positive only during first 2-5days of infection then indirect antibody test are used Dengue IgG and Dengue IgM if both these antibody are postive it indicates that person is infected second time with dengue virus. Every subsequent infection is more complicated then previous.
Treatment/Management of Dengue
There is no specific allopathic medicine available.
In homoeopathy certain medicines like Eupatorium Perfoliatum, Lachesis, Phosphorus are frequently used.
Treatment is based on symptomatic management of the patient
Drinking plenty of liquids – water , fruit juices, coconut water, Oral Rehydration Solution etc. and avoiding solid food or keeping it to minimum. atleast 3-4 liters of fluids should be consumed throughout the day, monitoring urine output and calculating fluid inpit is to output ratio and monitoring blood pressure.
Take enough rest.
Can take Paracetamol for reducing fever, Avoid other NSAIDS, avoid Aspirin for headache.
Its claimed that Papaya leaf juice/extract, Giloi, Kiwi fruit & dragon fruit helps in increasing platelet count but its role remains uncertain as per highly controled studies.
If platelets fall below 10000 and if there is active bleeding external or internal, then Single Donor Platelets transfussion is required, otherwise platelets transfusion should b avoided as its observed that in many cases platelets transfussion has complicated the case.
If patient develops any kind of active bleeding or there is sudden drop in blood pressure or any symptoms of neurological origin its a medical emergency and can be fatal patient needs to b shifted to hospital with Intensive Care Unit and Blood Bank facility as it can lead to Dengue Heamorrhagic Shock and death.
Frequently it is accomoanied by malaria and it is a medical emergency as in such case platelets fall even faster and also there is loss of RBC due to malaria.
Many other conditions like autoimmune anaemia(Pernicious anaemia) and heamolytic conditions complicates the case and is a medical emergency as patient may require blood concerntrates and plateles transfussion.
Any other co-existing infection and ailments should be treated with its specific medication if required.
Though fall in platelets is thought to b due to immune response still use of corticosteroids is contradicted as its observed that it complicates the case.
If Menstrual bleeding appear during dengue there is no need to interfere or stop bleeding with help of medicines till the bleeding is not beyond average and vitals of patients are normal. wait for it to subside on its own and if it is prolonged beyond its normal course or there are other complications or vitals of patient are not normal it needs to be intervened.
Pt is considered out of risk if he has no fever for more than 4 days and also his platelets stops falling and increases 1.5 times of last reading and if there are no other comolications and his vital are normal.
Patient will feel weak for weeks after dengue and some patient will also have abdominal discomfort and loss of appetite and very mild swelling of extremities on dependent parts especially aroud ankle joint , it subsides on its own and if persists longer it may require medical attention.
Pt will require nutritious diet , enough of sleep for recovery after dengue. rest is recomended atleast for a week after dengue.
Prevention of Dengue
To avoid dengue protect yourself from the mosquitoes spreading them.
Keep your house and surroundings free of stagnant water where the Aedes mosquitoes generally breed.
Use mosquito repellent, use mosquito net while sleeping .
Wear full clothes.
We cant survive few minutes without Breathing, And the very basic and most essential substance of our survival Air is now not breathable due to air pollution created by population explosion, deforestation, industrialisation and civic development.
Recently in past decade with global surge in pollution levels as much as 20-40 times beyond acceptable limits; for certain extremely toxic pollutants in most cities; with Delhi as worlds most polluted megacity , with visibility not more than few feets, this is not only causing road accident pile-ups but also we have seen surge in deaths due to pollution, reduced life-span and poor quality of life due to ill health caused due to surge in Allergic Respiratory diseases , Allergic Skin diseases , Various Autoimmune diseases, Cancers , Hormonal Imbalances, PCOD and the list goes on.
But as we know trees are our best friends, so here they come for our rescue, luckily there are certain indoor plants which can efficiently takle situation and can bring down pollution and increase oxygen in the air thus making air more breathable effectively at our home.
According to study done at IIT-Kanpur, following 3 plants that require low and occasional sunlight and can efficiently absorb pollutants and release sufficient oxygen are and can grow almost in any region are easily availabe in India as well.
Areca Palm also called Butterfly Palm, Botanical name Dypsis Lutes, it can survive indoor in low and required sunlight once in couple of months.Check the link for details of plant and its image https://en.m.wikipedia.org/wiki/Dypsis_lutescens
Mother In Law Tug Plant also called Snake Plant, Botanical name Sansevieria Trifasciata, it can survive indoor in low and required sunlight once in couple of months. Check the link for details of plant and its image https://en.m.wikipedia.org/wiki/Sansevieria_trifasciata
If 3 Erica Palm and 3 Snake Plant each 3 feet tall are planted in house supplimented with couple of short 3-6feet Money Plant creepers releases good quantity of oxygen and efficiently absorbs pollutants for a house of around 600 sqft with 4-5 members.
Alopecia Areata is a systemic autoimmune disorder where autoantibodies are driven against anagen hair follicle.
Alopecia Areata Before treatment at Dr SHAH’s HomoeopathyAlopecia Areata After treatment at Dr SHAH’s Homoeopathy by Dr Deepan P Shah
PATHOHENESIS AND GENETICS OF ALOPECIA AREATA
Its thought to be systemic autoimmune disorder affecting anagen hairfollicle.Its T-cell mediated inflamatory non scarring condition. T-cell mediates inflamatory response around hair follicle which damages hair follicle.
Endogenous retinoids metabolic disorder plays a major role in its pathogenesis.
Atleast 129 various SNP are associated with this disease in genome.
Atleast 4 regions in genome are found to have these genes
Genes associated with this disease have functions of controlling the activation and proliferation of regulatory T cells, cytotoxic T-Lymphocyte-Associated Antigen 4, InterLeukin-2, InterLeukin-2 receptor A, and Eos, and HLA.
PRDX5 and STX17 genes expressed in the hair follicle are associated with Alopecia Areata.
It shares genetic risk with autoimmune conditions like Diabetes Mellitus Type 1, Rheumatoid Arthritis and may accompany each other.It may be the only manifestation of Celiac disease.
Cases with congenital Alopecia Areata are also noted.It has strong hereditary association.Its a non contagious disease.
SYMPTOMS AND CLASSIFICATION OF ALOPECIA AREATA
It presents itself with small well demarcated bald patches with seemingly healthy skin below, with no scarring on skin. It can affect any region that has hair but it usually involves , scalp and beard. The patches are usually circular but it can present in any shape and extent. The hairs on the border of bald patches are very easy to pluck off compared to other regions.
CLASSIFICATION OF ALOPECIA AREATA
Diffuse Alopecia Areata
the baldness is diffused over whole scalp rather than in patches.
Alopecia Monolocularis
bald patch is located only in one spot
Alopecia Areata Multilocularis
many bald spots
Ophiasis
hairloss at margins of hairline in waveforms
Alopecia Areata Barbae
disease is limited only in beard region
Alopecia Areata Totalis
complete hairloss of scalp
Alopecia Areata Universalis
all hair of each and every region are lost.
DIAGNOSIS OF ALOPECIA AREATA
Trichoscopy shows evenly distributed hyperkeratotic plugs called yellow plugs, small shoots of hairs like exclamation marks, and destroyed hair follicles in follicular openings called black dots.
Biopsy
HOMEOPATHIC MEDICINES FOR ALOPECIA AREATA
SULPHUR
Sulphur is a general antisporic remedy. It is usually suited to lean, stoop shouldered patients. Sulphur is very well indicated remedy in case of Alopecia areata. Acting upon the external head, the itching is indescribable, constant itching worse from warmth of bed. Erruptions in general on the scalp. Severe loss of hair in patches. Dandruff with itense itching. Humid offensive erruptions with thick pus, yellow crust dry up into honey like scabs. Hair become dry, lustureless and fall off. Sulphur is a widely used remedy for almost every kind of itch.
LYCOPODIUM CLAVATUM
Lycopodium has a very deep and broad sphere of action. It is a remedy prepared from club moss. Lycopodium is useful in case of alopecia areata. Frequently used remedy in case of hair loss, premature greying of hair, premature baldness. Patient usually presents with patchy hair loss. Itching in the scalp due to dandruff or erruptions which are thick indurated. Complaints are usually worse from warmth and better by cold applications. Extremely sensitive patient with deep furrows on forehead.
KALIUM BICHROMICUM
Kali bichromicum is prepared by the potentisation of salt potassium bicarbonate. Kali bichromicum is a wonerful deep acting remedy having effects on multiple system of body. Patient usually presents with hairfall in spots. Dandruff with severe itching. Dandruff is yellowish in colour with formation of scabs. Scalp is infected with severe itching. Kali bichromicum helps in regeneration of hair growth.
PHOSPHOROUS
Phosphorous is well suited to young people who grow rapidly and are inclined to stoop. Phosporous indication in alopecia areata is very valuable. Phosphoorous works well in cases where falling of hair occurs in large bunches, leaving marked patches. Dandruff with sevre itching of scalp. Dry scalp and scaliness of scalp. Dry painful heat of scalp compellinh one to uncover head. Clammy perspiration on head only. Phosphorous helps in case of traction alopecia. There is receding hair line. Hairfall from forehead is prominent. Hence Phosphorous is very well indicated in frontal baldness too.
THUJA OCCIDENTALIS
Thuja is one of the indicated remedy in case of Alopecia areata. Patient usually complains of diffuse hair loss along with dandruff on scalp. Dandruff is generally thick and whitish in color with intolerable itching. Patchy hair loss. Handfull of hair come out while combing or washing hair. Single bald spots progress to form multiple spots. Hence thuja is very good remedy in such cases.
CALCAREA CARBONICUM
Calcarea carbonicum is the chief representative of calcium compounds. Great Hahnemanian antiporic. Chief action is centered in vegetative sphere. Calcarea carbonicum is one of the frequently used remedy for hairloss. Usually associated with intense itching of scalp. Marked feature is excessive perspiration of scalp or head which is so intense even wets the pillow. Head feels hot. Scratches head on waking. Hair falls in bunches. Scabs on the scalp. Painful sensitive roots of hair. Dandruff with milky crusts causes intense itching. Boils on scalp which tend to suppurate.
PULSATILLA NIGRICANS
Pulsatilla is pre eminently a female remedy especially suited to mild, gentle, yielding disposition. Very useful remedy in case of Alopecia areata. Hairfall in patches on combing hair. Purulent pustules on scalp with pain in the scalp. Itching on scalp mostly on temples and bwhind the ears. Dandruff white scaly with severe itching. Fetid and frequently cold perspiration on scalp with intense itching.
ARSENIC ALBUM
Arsenic album is a profoundly acting remedy on every organ and tissue. Arsennic album is one of the frequently indicated remedy for alopecia areata which usually appears as circular bald patches along with itching and burning of scalp. Sensitive scalp which it hes intolerably. The scalp is so sensitive that the patient cannot brush hair, seems as kfthe touch of comb or brush when rubbing over scalpwent into the brain. Circular patches of bald spots, rough, dirty, sensitive covered with dry scales. Hair greying at an early age, with severe hairfall.
Alopecia Areata Before Homeopathic TreatmentAlopecia Areata During Homeopathic TreatmentAlopecia Areata After Homeopathic Treatment
Killer’s Aggravation – Homoeopathic Medicines Can Kill You
Killer’s Aggravation and Homoeopathic Medicines
Now a days we frequently see people buying homoeopathic medicines over the counter without doctors prescription, consodering it to be safe and can be consumed by anyone. Its surprising to see that even parent are buying these medicines for their new born kids.
Most of these medicines are patented mix of multiple medicines which is against homoeopathic principles, as homoeopathic medicines are meant to be taken only one medicine at a time.
Also they are proved by using very low standards of drug provings that too completely contradicting principles of homoeopathy as homoeopathy strictly doesnt allow use of multiple medicine at a time.
If it is single medicine one is consuming it doesnt allow frequent repetition of dose in same potency with exceptions, its a very highly skilled to decide at which potency and how many repetition does a patient require as it varies from person to person in similar conditions, most of the times only one dose is administered to cure the conditions, more of it only complicates the case most of the time.
One should be aware that homoeopathic medicines are effective only if they match the constitution and symptoms of the patient or else it may not act at all and the disease may keep on progressing making it worse on the other hand if the medicinines that are not selected by process for repertorisation for indivudualisation ans similimum dosing and if taken too frequently unhomoeopathically then it produces a new artificial morbid condition in the body which can be so severe so as to cause gross pathological change in the body which may be irreversible damaging the body permenantly.
Its a myth that HOMOEOPATHIC MEDICINES does not have side effects!
The fact is , Its HOMOEOPATHY that does not have side effects! But HOMOEOPATHIC MEDICINES if not taken in accordance with HOMOEOPATHIC PRINCIPLES as mentioned in HOMOEOPATHIC ORGANONof medicine then the recipient may have severe aggravations.
As mentioned in KENT’s 12 observations the very first point says “Prolonged aggravation with final decline of patient” also termed as KILLER’s Aggravation by practitioners , a FATAL CONDITIONwhich we not too frequently encounter and is difficult to handle.
So be careful before self medicating or giving medicines to your kids, always consult a registered homoeopathic consultant first.
ANKYLOSING SPONDYLITIS (AS) / MARIE’s Disease / BEKTEREV’s Disease is a Chronic Autoimmune or Autoinflamatory systemic disease which predominantly affects joints and bones of Spine and Pelvis
It falls under AXIAL SPONDYLOARTHRITIS Category.
CAUSES OF ANKYLOSING SPONDYLITIS
Causes are obscure, though Genetics Environmental Factors and Lifestyle in combination are believed to be involved in causation of Ankylosing Spondylitis (AS)
It falls under Sero-negative Systemic Rheumatic disease where its believed to be mediated by Autoimmune or Autoinflamatory response.
Human Leucocyte Antigen HLA B27 subtypes B2701and B2759are class I antigen encoded by B locus of Major Histocompatibility Complex (MHC) on Chromosome 6 and presents antigenic peptides (derived from self and non self antigens ) to T cells. HLA B27 is strongly associated with Ankylosing Spondylitis as 90% of patient showing symptoms of Ankylosing Spondylitis has a genotype presenting it. and 2% of all having genotype expressing HLA B27 contracts Ankylosing Spondylosis.
PATHOGENESIS OF ANKYLOSING SPONDYLITIS
Pathogenesis of AS is still not clear and many factors associated with the pathophysiology directly or indirectly have been identified
Human Leucocyte Antigen (HLA B27 subtypes B2701and B2759) are class I antigen encoded by B locus of Major Histocompatibility Complex (MHC) on Chromosome 6 and presents antigenic peptides (derived from self and non self antigens ) to T cells. HLA B27 is strongly associated with Ankylosing Spondylitis as 90% of patient showing symptoms of Ankylosing Spondylitis has a genotype presenting it. and 2% of all having genotype expressing HLA B27 contracts Ankylosing Spondylosis.Now this association with HLA B27 suggests possible link with CD8 T cells though not proven to involve self antigen it might also be due to reactive arthritis following infection and the antigen might be derived from intracellular microorganism; HLA B27 has many unusual varied properties also it has ability to interact with CD4 so possible association of CD4 in AS is also a probability.
Tumour Necrosis Factor α (TNF α) is found to b implicated in Ankylosing Spondylitis
Interleukine 1 (IL 1) is also associated in pathogenesis of Ankylosing Spondylitis
Anti-Neutrophil Cytoplasmic Antibodies (ANCAs) are associated with Ankylosing Spondylitis but is not indicator of severity of disease
Autoantibodies Specific to Ankylosing Spondylitis have not been identified
PTGER4 gene codes for prostaglandin EP4 receptor(EP4). which is associated with bone remodeling and deposition and is highly expressed in those sites of vertebral coloumn which are involved in Ankylosing Spondylitis . Single Neucleotide Polymorphism (SNP) of A/G variant rs10440635a close to the PTGER4 gene on human chromosome 5 possibly influences excessive production of EP4 which causes excessive bone remodelling and deposition in Ankylosing Spondylosis; though this type of SNP and its association with increased rate of Ankylosing Spondylosis is found only in few ethnic groups
All these and other unknown factors contribute in pathogenesis of Ankylosing Spondylitis which typically results in Annulus Fibrosus Disci Intervertebralis (fibrous ring) of intervertebral disc to OSSIFY which results in the formation of marginal SYNDESMOPHYTES between adjoining vertebrae giving rise to BAMBOO SPINEtype appearance of spine
SYMPTOMS AND DIAGNOSIS OF ANKYLOSING SPONDYLITIS
Genetic Testing For Ankylosing Spondylitis
HLA B27 is a non specific test For Ankylosing Spondylitis
As although 90% of those who have AS are HLA B27positive(50% in african-americans and 80% in mediterrenean)
But it has seen in many ethnic group ;esp north scandivanian;that Only 2 % of total HLA B27 positive have AS
Blood Test for Ankylosing Spondylitis
There are no specific Blood Tests Available for AS except for general inflamatory indicators like ESR and CRPwhich are elevated and tend to increase further on acute episode
Radiological Investigation For Ankylosing Spondylitis
There are no specific Blood Tests Available for AS So its diagnosed based on typical radiological changes but it takes 8-10 years for the disease to become evident enough to establish diagnosis neither CT or MRI can evaluate the disease in early stages
Typical radiological features are:-
Axial Spondyloarthritis
Early Xray changes include erosion and sclerosis of sacroilliac joints
in later stage that erosion increases resulting in pseudo-widening of joint space and Bony Ankylosis
squaring of vertebrae with spine ossification with fibrous band running longitudinally called syndesmophyte giving a bamboo spine appearance
Now in case where there are no evident radiological signs it becomes difficult to establish diagnosis as there are no specific blood tests for AS. In such cases clinical features signs symptoms and other non specific blood tests are conducted to evaluate the probability of AS; they are :
Chronic backache with insidious onset before age of 40yrs which has peculiar modalities- Aggravates on rest ;at night and Ameliorates on moderate movement ;exercise ; after getting up from bed in morning
History of inflamatory arthritis or tendinitis
Family history of axial Spondylosis
Positive HLA B27
Responds well to NSAIDs
Elevated ESR and CRP
Other accompaning conditions like IBS Uveitis psoriasis
Schober’s test is a clinical performed during physical exam which is measure of flexion of lumbar spine.
BATH ANKYLOSING SPONDYLITIS DISEASE ACTIVITY INDEX
BASDAIindex score is an index which is based on multiple clinical radiological genetic and blood parameters which helps in establishing stage and diagnosis and determine type of management and treatment required
BATH ANKYLOSING SPONDYLITIS FUNCTIONAL INDEX
BASFIindex to acess functional impairment
GAIT
HUNCHED POSTURE is a severe complication of AS resulting due to complete spinal fusion leading to increased spinal KYPHOSIS which results into forwar and downward shift of Center of Mass to compensate it the knee flexes and ankle dorsiflexes.Their gait has a cautious pattern as they have reduced shock absorbing ability and cant see horizon.
INDICATED HOMEOPATHIC MEDICINES FOR ANKYLOSING SPONDYLITIS
RHUS TOX
Rhus tox is the most common homoeopathic medicine which is very valuable in case of Ankylosing spondylitis, and is useful in various kinds of pains. Rhus tox affects the multiple systems of the body indcluding spine, joints, extremities, skin and mucus membrrane. Patient usually presents with stiffness of back associated with restlessness, is the key indication of this remedy. Pains are aggravated after a period of inactivity. There is marked stiffness, lameness, and pain in the lumbosacral area of back and hips to thighs. Rheumatic pains spread over a large surface area at the nape of neck, back, loins extremities. The small of back aches while sitting. Painfull stiffness on rising from seat. We are led to think of this remedy where we find an irresistible desire to move or change the position constantly. After
resting for a while, when he wakes up and takes a first move, a painful stiffness is felt.
CIMICIFUGA RACEMOSA
Cimicifuga racemosa is one of the indicated remedy for ankylosing spondylitis where there is marked stiffness in the neck area. The patient usually presents with excessive stiffness in the neck with severe pain. The neck muscles feel retracted, neck stiffness is worsened by cold air. The muscular and crampy pains are primilarily are of neurotic origin, occuring nearly in every part of the body. Pains of Cimicifuga are like that of electric shock, which come and go suddenly. Violent lightening type of pain in posterior spinal sclerosis, stiff neck from cold air. Sensitiveness of spine especially in cervical and upper dorsal region. Severe aching pain in lumbar and sacral region.
KALMIA LATIFOLIA
Kalmia is a great rheumatic remedy. Dr Hering introduced Kalmia into homeopathic practice, he himself and his friends being the first provers. Kalmia is one of tbe efficient remedy in ankylosing spondylosis cases where pain and stiffness are marked in lower back,lumbosacral region and neck area. The pains are accompanied with heat and burning in affected area. Pain is attended with excessive stiffness in neck. The pain from neck often radiates down the arms or scapula. Violent pains in the upper dorsal vertebrae. Constant pain in spine. Sensation as if spinal column would break with an anterior convexity and feeling of paralysis in saccrum.
GUAIACUM
Guaiacum is one of the Hahnemans antisporics, is one of the beat known remedies in rheumatism, gout, ankylosing spondylitis. There is Pressure on the vertebrae of the neck. Stiffness in the back, extending from neck to small of back and saccrum, intolearable on slightest motion. Indicated when there are contractive pains between the scapulae. Stiffness from neck may extend to shoulder blades and its painful. All pains are aggravated from motion and heat and relieved during rest.
KALI CARBONICUM
Kali carbonicum is very useful in deep seated diseases lime Ankylosing spondylosis. Kali carb patient presents with severe back pain with stiffness. Small of back feels weak. There is marked Stiffeness and paralytic feeling in the back. Marked indication of kali carb is severe backache during pregnancy and after miscarriage. Burning in the spine. Lumbago with sudden, sharp pains extending up and down of back to thighs. Weakness caused by all potassium salts is more pronounced in this typical salt of potassium
group. Sharp stitching, stabbing pain felt in various parts of the body. Severe backache must lie down for relief.
AESCULUS HIPPOCASTANUM
Aesculus is one of the indicated remedy in ankylosing spondylitis. The main feature of Aesculus is matked pain in lumbosacral area of the back and hips with extreme stiffness. Pain from back radiates to thighs. Lameness in neck. Aching pain between the ahoulder blades, region of spine feels weak. Backache affecting saccrum and hips worse walking or stooping. When walking feet turn under. Rising from seat seems difficult, has to make repeated efforts. Severe pain in lumbosacral region making movement impossible.
SILICEA
Silicea is a very valuable remedy in case of spondylitis. The action of silicea is slow. In the proving it takes long time to develop symptoms. It is therefore suited to complaints which develop slowly. Presents with ankylosing spondylitis with stiffness in nape of neck with severe headache. Coccyx painful as after a long carriage ride. Weakness and paralytic stiffness in back, loins and nape of neck. Swelling and distortion of spine.Aching, shooting, burning and throbbing pain in lumbosacral region with contussive pain between shoulder blades.
COLOCYNTH
Colocynth has a long lasting action on the spine and nerves. The main feature of colocynth is severe pain in the back which finally settes down on the upper part of thigh and buttock. Pain usually confines to small spot making the patient limp and finally becomes so severe that he can neither stand nor walk. Severe burning pain along the saccrum, cramps in hip. Feels better by doubling up, hard pressure and warmth.
CONIUM MACULATUM
Conium maculatum is deep acting antisporic remedy, its action disturbs almost all the tissues of the body. Very well indicated in ankylosing spondylitis of back, weakness is the most striking feature with dorsal pains. Effects of bruises and shocks to spine. After injuries especially in lumbar region. Severe rheumatic pains. The pains are relievex by putting feet on chair. Pain between the shoulder blades. Dull aching pain in lumbar and sacral region.
CALCAREA PHOSPHORICUM
Calcarea phos is a great tissue remedy, though it resembles calcarea carb in many aspects but has its own characteristic symptoms. The spher of phosphate of lime includes all bone diseases whether due to some inherited dyscrasia or defective nutrition in osseous and other structures. It is.a bone salt.without this element no bone is formed, hence it is a valuable remedy. Patient usually presents with weakness of spine, there is curvature of spine towards left , lumbar vertebrae bent towards left. Soreness in sacro iliac symphysis. Rheumatic pains from draught of air with stiffness of neck and back.
Arthritis is a term derived from “ARTHRON” means Joint and “ITIS” means Inflamation
Inflamation of joint and surrounding tissue is called ARTHRITIS
Its a general term used to describe pain swelling of joint and its surrounding tissue.
When one joint is involved its called Monoarthritis and when more than one joints are involved its called Polyarthritis
Different types of arthritis have different causative factors like
Mechanical
Immunological
Metabolical
Spetic
Genetics
Lifestyle and Evironmental factors
Though each factor has contribution in certain degree in every type of arthritis; Still it can broadly be classified into 4 major category based on the predominant factor responsible for their Pathophysiolohy/Pathogenesis :
Mechanically mediated type
Immunological mediated type
Metabolical mediated type
Spetic
With Genetics Lifestyle and Environment as Contributory factors in each type.
Further various major subtypes are described in detail in following link:
HOMOEOPATHIC MEDICINES and MANAGEMENT OF ARTHRITIS
Homoeopathic Arthritis Management depends on individualisation of the patient based on present symptoms, past history, family history and constitution of the patient.
In arthritis cases it is necessary to take into account the following points (with constant search for underlying miasm and constitution type):
When it started, that is since how long its been there.
How was the onset when it appeared first time.
Wether the complaints had incidious progression or it was sudden.
Which joint is involved, wether its single joint or multiple, wether its bilateral and symetrical or diagonal.
Particulars like which part was affected first, which side it started first and how much time it took for progression to other side or other joints, sequence in which joints were involved.
How and when it gets triggered, aggravation pattern morning stiffness , aggravation on rest/ motion, relation to climate winter/monsoon/summer, relation to heat and cold, aggravation to any particular type of food.
Wether its constant or intermittant.
The joint is warmer than rest of the body or not.
Wether there is swelling around the joint or not.
Nodes or nodosities on or around any joints. or any other signs of disfigurement.
Movement or other disability in joint.
Patient has fever or not or h/o fever before or during the episode of joint pain started.
Presence of any concomittants or accompanying symptoms and wether those symptoms are of Psychotic, Syphilitic or Psoric nature.
Wether he has any other systemic complaint especially any other autoimmune or metabolic disorder.
History of injury, surgery especially affecting neurons or musculoskeletal structure.
Nature of work the patient does , postural habits, structural anomalies disfigurements.
Diet sleep and exercise routine water intake should also be noted carefully.
It is important to note family history of patient wether first degree relative had any autoimmune or metabolic disorder.
Wether patient was or is under any long term medication.
A careful history of all communicable ailments should be recorded in sequence as they had been contracted by patient, as it helps us evaluate when and how was the vital force deranged in past and wether the present condition is manifestation of some past ailment, that is any deep seated miasm, also it helps to establish wether its some inherited genetic condition or its acquired condition also it helps differentiate between
Vector borne conditions like post viral arthralgia/arthritis and Group A streptococcal borne post pharyngitis systemic autoimmune condition AND
Other Systemic autoimmune conditions like Rheumatoid Arthritis SLE psoriatic arthritis.
These basic question will lead you towards a broader vision in the case and will let you reach upto some conclusion that under what category of arthritis it should be classified and will lead you towards some understanding of miasm and constitution.
As I have mentioned in my other arthritis articles that basically I divide all types of arthritis into four major categories based on their pathogenesis.
Mechanical
Immunological
Metabolic
Septic
After being diagnosed and classified the disease condition from one of the above group we can go further on how to manage each type of case.
Immunologically mediated
Once established that its an immune mediated arthritis its necessary to rule out any damage to other organs like heart, liver, kidney, pancreas, eyes etc, as in most cases autoimmune arthritis is found to involve other system and organs or it is a part of broader systemic autoimmune condition and it is all the more necessary to find out miasmatic background, constitution and individualising symptoms, as such types of arthritis are deep seated having its own sets of aggravating and ammeliorating factors, furthermore its also observed that mental stress and emotional fluctuations have much impact on intensity and frequency of aggravations in almost all types of immunologically mediated arthritis, so its of utmost importance to take proper account of patient’s mental emotional past and present including likes and dislikes aversion and cravings, which helps us to individualise the case.
Once the we have derived constitution , miasmatic background and individuslised the case then comes medicine selection process,
I strongly recomend to go by constitution of patient in immunologically mediated arthritis rather than going theraputic remedy selection.
and it should be kept in mind that the selection procedure of medicine should correspond to degree of mental PQRS , degree of systemic PQRS and degree of musculo-skelatal symptoms of the person in disease should match the degree of pathogenic action on various sphere of the specific medicine.
Though during acute exacerbations of disease it becomes necessary many a times to administer short acting acute medicines theraputically where the new symptoms desnt fall into sphere of the constitutional medicine thats been administered.
Many a times only a single dose of similimum medicine selected may suffice to cure the case but all patients are not the same each has a different constitution and miasmatic background and severity of ailment and other external inimical factors, so in many cases it may take series of medicines one by one as per case demands during progression of treatment before the case is cured. It all depends upon how well the physician is able to find out the similimum and type of case and its requirement.
Mechanical
Under mechanical type of arthritis falls osteoarthritis and other types of arthritis caused due to mechanical injuries in such types the case is usually tale tale and shows basic picture of mechanical wear n tear which might be due to poor constitution inherited or might be acquired later on due to external inimical reasons.
In such cases it is necessary to consider that basically the constitution is lacking the capability to repair regenerate and maintain proper quality of joint cartilage and underlying bone and has tendency towards chronic sub-acute inflamation. in such cases it is important to take complete history of patient and family with details of gestational period and individulisation based on Peculiars should be derived forindividualised remedy selection for complete annihilation of condition; if not done so the patient might find relief for time being but the symptoms might keep relapsing with time again and again.
In many cases the repair and regeneration mechanisms are sufficient but mechanical wear and tear are in greater proportion and on regular basis so damage tends to accumulate, in such cases there is not much need to go deep into deriving constitution and treatment approach should aim towards elimination of maintaining cause that is excessive mechanical wear and tear and suppliment with nutritious diet and rest to affected part and symptomatic homoeopathic medicines based on theraputics will also work well.
Metabolic
Again this type of arthritis is a deep seated genetic in nature and they might accompany other metabolic syndromes and requires a careful case taking to get a broader picture of the person in disease, all aother systems and organs should be evaluated to understand sphere of disease pathology its extent and severity so it helps us to select the most similimum homoeopathic remedy.
The approach in such cases again remains constitutional , miasmatic and remedy should be selected only after proper individualisation of case and repertorisation.
Septic
In septic arthritis pt needs to be administered short acting acute remedies theraputically with support of deep acting constitutional remedy which can be administered intermittently or after the acute symptoms are ammeliorated to rearrange the deranged vital force.
Commonly Used Homoeopathic Medicines for Arthritis and its symptoms and indications:
RHUS TOXICODENDRON Usefull in almost all types of joint and musculoskeletal complaints where the symptom call for the medicine like stiffness of joints aggravatedon rest and ammeleorated on motion in any ailment involving musculoskeletal system, rheumatic joint affections, sprain and injury on joints etc
ARNICA MONTANA blunt injury and trauma, sore lame bruised sensation with swelling concussion and contusion call for this remedy
ACTEA SPICATA Pain stiffness and swelling of small joints especially of hands , good remedy for post viral arthralgia like in chickengyunya where small joints are involved
BRYONIA ALBA Stiffness and pain with hot swelling, redness of joints with stitching and tearing pain aggravation on least motion every spot is painful on slightest pressure
LEDUM PALUSTURE Gouty arthritis involving small joints of extremities, hot swollen joints with throbbing pain, gouty nodosities, pain in ball of great toe, podagra, swollen ankles and painful soles, aggravation on warmth of bed , rheumatism starting from lower extremities and ascending upwards. right side more involved compared to left.
HYPERICUM PERFOLIATUM Degenerative changes of joints involving nerves, sciatica, coccygodynia, cervical and lumbarspondylosis with nerve compression, tingling burning and numb sensation with lancinating pain calls for the remedy, darting pain of shoulders , cramps in calf muscles, pain in tips of toes and fingers, sensation of pressure along the ulnar side if arm.
PLANTAGO MAJOR helps relieve bony snd neuralgic pain in arthritis
BELLIS PERENIS Soreness lameness of joints and muscles, rheumatic joint affections, sciatica where pain radiates down the anterior portion of thigh, sensation as if elastic band is tied around wrist feeling of contration of wrist joint, Railway spine, sprain and bruises of joints and muscles, good remedy where varicose veins complicate case of arthritis or both are coexisting in any patient.
ACTEA RACEMOSA Rheumatism affecting intercostal region back and neck, cervical spondylosis caising nerve compression and electric shock like shooting pain comes suddenly reaches peak and goes suddenly, stiffness and pain in tendo-achilles. sensation of heaviness in lower extremities, heavy aching tensive pain with twitching and jerking of limbs.
APIS MELIFICA swelling of joint with synovitis and synovial effusion, spetic arthritis, red hot swollen joint , pain on sloghtest pressure or motion, gout , rheumatoid arthritis , post viral arthritis and arthralgia
CALCAREA CARBONICA osteoarthritis, degenarative changes in any joint , osteomalacia or osteoporosis causing joint degeneration, open sutures and fontanale in children, rickets , kyphosis and other loss of normal curvatures of spine, pigeon chest, fractures injuries of bones and joints
COLCHICUM Gouty arthritis , increased Serum Uric acid and tophus formation in joints. typical pain in great toe aggravated at night, sudden gripping cutting pain with much burning comes at night waking patient up from sleep
CALCAREA PHOSPHORICA osteoarthritis due to calcium deficiency , musculoskeletal complaints of old age, developmental musculoskeletal anomaly of growing children, fractures injuries of bones and joints.
BELLADONNA red hot inflamed joint with much pain and swelling
ACONITUM NAPELLUS Acute onset of pain and swelling , can be used in first 24hours or first stage of any acute inflamatory condition with severe mental restlessness fear fright and anxiety.
CALCAREA FLOURICA
NATRUM SULPH a very good remedy for gouty diathesis.
Caused due to mechanical stress and covert low grade inflamatory process.
Due to excessive mechanical stress there is increased in demand from factors responsible for repair mechanism. Initially this repair mechanism repairs as it normally should but then it becomes insufficient to repair with same mechanism so it starts compensatory mechanism where in, it tries to maintain structural aspect but at cost of quality of structural components which again due to its inferior quality gets damaged soon further due to prolonged regular mechanical stress these damages gets accumulated even further and now even compensatory mechanism fails to keep up with the amount of damage that’s been done , this starts erosion of the cartilage and the underlying bone and there is general degeneration of joint.
WHAT ARE THE RISK AND CAUSATIVE FACTORS FACTORS OF OSTEOARTHRITIS?
Mechanical injury like trauma causing damage to joint or any of its component useful in maintaining strenght structure gait and support to joint.
Mechanical stress due to different length of either legs
Mechanical stress due to neurological muscular disorder of muscles supporting that particular joint
Those who never had habit of running or jogging during their childhood or young age if suddenly starts running in excess on later age, or running along with an injury cuases severe mechanical wear and tear injury to joint.
Abnormal body gait and habitual abnormal postures
Genetics and hereditary
Hormone levels especially sex hormones
Metabolic syndrome and obesity( debated as its not the weight thats causing mechanical damage but rather its fats thats responsible to cause metabolic disorder contributing to osteorthritis)
Diet and Lifestyle
Prolonged regular mechanical stress and insufficient self repair causing accumulation of damages and later resulting into prolonged inflamation causes osteoarthritis.
Prevailing condition in body like Osteoporosis, metabolic disorders, autoimmune diseases, joint infections, congenital joint anomaly, certain syndromes like marfan syndrome, elher danlos syndrome, inflamatory diseases like lyme’s disease perthe’s disease
PATHOGENESIS OF OSTEOARTHRITIS
Chondrocytes are responsible to maintain elastic and tensile strength of cartilage by producing collagen and extracellular matrix which maintains hydration by compressive force driving water out and hydrostatic and osmotic pressure drawing water in.
Constant damage to cartilage puts extra load on chondrocytes ;if they aren’t able to repair the damage by producing sufficient collagen and extracellular matrix ; then they start producing different type of collagen just to maintain the structure as far as possible but then this collagen has a different character of retaining more water then the former which spoils the elastic and tensile strength of cartilage as a whole. This further damages the cartilage to the point where it starts disintegrating and shedding off in synovial space which puts extra load on synovium to clear it off for which synoviocytes triggers inflamatory response and synovitis and general mild inflamatory process in joint which gets prolonged due to constant mehanical stress and accumulated damages and finally inflamatory products accumulates damaging joint even further eroding cartillage and bone causing fibrillations and also reduced bone mineral density at site is observed (causation is in debate); finally there is general degeneration of joint leading to pain inflamation and loss of regular function of the affected joint.
WHAT ARE SYMPTOMS OF OSTEOARTHRITIS?
Low grade inflamation and degeneration causes pain due to which there may be loss of range of movement of a joint along its axis in varing degrees from mild to severe.
This loss of ability of movement further causes dysuse atrophy of muscles related to that particular joint and due to degenerative changes the joint becomes wider which gives typical lean muscle and wide joint looks, like in the Heberden’s Nodes and Bouchard’s Nodes in fingers
Osteoarthritis particularly involves weight bearing joint and joints more prone to mechanical stress like knee joint; lumbar spine cervical spine hip joint joints of fingers and less commonly other joints like ankle joint shoulder joint etc
It may present in one joint or in multiple joints at a time.
Exertion and motion aggravates the complaints and rest ameliorates the complaints.
Morning stiffness of affected joint is present in majority cases though not a specific symptom.
Aggravation in cold climate, high humidity, low atmospheric pressure is seen in many cases tough not consistent every-time.
Crepitation on movement or pressure are observed in affected joint.
Surrounding muscle spasms and when vertebral bodies are affected the spinal nerve corresponding to it may get compressed leading to spasms paraesthesia myalgia and cramps to correrponding musscle the affected nerve supplies.
Joint effusion, especially of knee joint are see not too infrequently.
DIAGNOSIS OF OSTEOARTHRITIS
In most cases sufficient clinical evidence supports the diagnosis but an X ray is required not only to reconfirm diagnosis but also to evaluate to amount of damage within as pain and other clinical symptoms are not indicator of the amount of damage within; in many cases we may also need to exclude other conditions for which further related investigations should be done.
HOMOEOPATHIC MANAGEMENT OF OSTEOARTHRITIS
Once its established that the patient is suffering from osteoarthritis the homoeopathic management of the case will be as follows
As per my classification criteria Osteoarthritis falls under Mechanically mediated type of arthritis
Under mechanical type of arthritis falls osteoarthritis and other types of arthritis caused due to mechanical injuries in such types the case is usually tale tale and shows basic picture of mechanical wear n tear which might be due to poor constitution inherited or might be acquired later on due to external inimical reasons.
In such cases it is necessary to consider that basically the constitution is lacking the capability to repair regenerate and maintain proper quality of joint cartilage and underlying bone and has tendency towards chronic sub-acute inflamation. in such cases it is important to take complete history of patient and family with details of gestational period and individulisation based on Peculiars should be derived forindividualised remedy selection for complete annihilation of condition; if not done so the patient might find relief for time being but the symptoms might keep relapsing with time again and again.
In many cases the repair and regeneration mechanisms are sufficient but mechanical wear and tear are in greater proportion and on regular basis so damage tends to accumulate, in such cases there is not much need to go deep into deriving constitution and treatment approach should aim towards elimination of maintaining cause that is excessive mechanical wear and tear and suppliment with nutritious diet and rest to affected part and symptomatic homoeopathic medicines based on theraputics will also work well.
Homoeopathic Medicines for Arthritis with its symptoms and indications:
RHUS TOXICODENDRONusfull in almost all types of joint and musculoskeletal complaints where the symptom call for the medicine like stiffness of joints aggravatedon rest and ammeleorated on motion in any ailment involving musculoskeletal system, rheumatic joint affections, sprain and injury on joints etc
ARNICA MONTANA blunt injury and trauma, sore lame bruised sensation with swelling concussion and contusion call for this remedy
ACTEA SPICATA pain stiffness and swelling of small joints especially of hands , good remedy for post viral arthralgia like in chickengyunya where small joints are involved
BRYONIA stiffness and pain with hot swelling, redness of joints with stitching and tearing pain aggravation on least motion every spot is painful on slightest pressure
LEDUM PALgouty arthritis involving small joints of extremities, hot swollen joints with throbbing pain, gouty nodosities, pain in ball of great toe, podagra, swollen ankles and painful soles, aggravation on warmth of bed , rheumatism starting from lower extremities and ascending upwards. right side more involved compared to left.
HYPERICUM PERFOLIATUM degenerative changes of joints involving nerves, sciatica, coccygodynia, cervical and lumbarspondylosis with nerve compression, tingling burning and numb sensation with lancinating pain calls for the remedy, darting pain of shoulders , cramps in calf muscles, pain in tips of toes and fingers, sensation of pressure along the ulnar side if arm.
PLANTAGO MAJOR helps relieve bony snd neuralgic pain in arthritis
BELLIS PERENIS soreness lameness of joints and muscles, rheumatic joint affections, sciatica where pain radiates down the anterior portion of thigh, sensation as if elastic band is tied around wrist feeling of contration of wrist joint, Railway spine, sprain and bruises of joints and muscles, good remedy where varicose veins complicate case of arthritis or both are coexisting in any patient.
ACTEA RACEMOSA Rheumatism affecting intercostal region back and neck, cervical spondylosis caising nerve compression and electric shock like shooting pain comes suddenly reaches peak and goes suddenly, stiffness and pain in tendo-achilles. sensation of heaviness in lower extremities, heavy aching tensive pain with twitching and jerking of limbs.
APIS MELIFICA swelling of joint with synovitis and synovial effusion, spetic arthritis, red hot swollen joint , pain on sloghtest pressure or motion, gout , rheumatoid arthritis , post viral arthritis and arthralgia
CALCAREA CARBONICA osteoarthritis, degenarative changes in any joint , osteomalacia or osteoporosis causing joint degeneration, open sutures and fontanale in children, rickets , kyphosis and other loss of normal curvatures of spine, pigeon chest, fractures injuries of bones and joints
CALCAREA PHOSPHORICA osteoarthritis due to calcium deficiency , musculoskeletal complaints of old age, developmental musculoskeletal anomaly of growing children, fractures injuries of bones and joints.
BELLADONNA red hot inflamed joint with much pain and swelling
ACONITUM NAPELLUSAcute onset of pain and swelling , can be used in first 24hours or first stage of any acute inflamatory condition with severe mental restlessness fear fright and anxiety.
For understanding of arthritis in general, its case-taking and homoeopathic management visit following link
