OSTEOARTHRITIS AND HOMEOPATHIC MANAGEMENT

                                                                    OSTEOARTHRITIS

DEFINITION:-

               Osteoarthritis is a degenerative condition that occurs in old age and affects the weight-bearing joints such as hip, knee, ankle, inter vertebral and shoulder joints.

AETIOLOGY OR CAUSES:-

The disease is more commonly affects at after 40 years of age. Main causes are

-          Obesity.

-          Age - on old age above 40 years of aged people.

-          Both sexes equally affect.

-          Trauma or injury.

-          Chondrocalcinosis.

-          Systemic lupus erythematosus.

-          Gout.

-          Rheumatoid arthritis.

PATHOLOGY BEHIND OSTEOARTHRITIS:-

               The primary affection occurs in the joint cartilage. The central part of the joint cartilage is affected early followed by the peripheral parts. This is followed by hypertrophy of the peripheral part of the concerned bones which presents as osteophytes projecting out of the bones or lying as loose bodies inside the joint space. Repeated effusions occur in the affected joints especially after minor trauma or twists. The movement of the affected joint is limited initially due to pain and muscular spasm and later due to capsular fibrosis, osteopyte formation and bony deformity.

SYMPTOMS:-

-          Pain.

-          Swelling.

-          Stiffness.

-          Stiffness and pain are worst in the morning or at initiation of movement but are relived on rest or continuation of movement.

-          Pain is greater at the time of getting up from bed or from sitting position.

-          Restricted movements due to stiffness.

-          The weight bearing bigger joints are mostly affected.

EXAMINATION:-

-          The joint is swollen.

-          On palpitation grunting or crepitations can be heard. On bending the joint while keeping the palm over it, a crackling feeling is felt (crepitations) underneath the palm.

INVESTIGATIONS:-

-          Radio-logical signs:

a.       Marked prominence of Tibial tuberosity.

b.      Reduction of joint space with destruction of articular cartilage.

c.       Presence of osteophytes.

TREATMENT:-

1.       Physiotherapy is useful.

2.       Use of analgesics in severe pain.

3.       Surgery.

HOMEOPATHIC REMEDIES:

BRYONIA ALBUM:-

                This is one of the best remedy for Osteoarthritis. Knee joint is stiff and painful, hot swelling of feet, pain worse at least movement and better by rest. Every spot is painful on least touch. Dryness all over the body, chilly patient, business minded, money minded person. Painful stiffness on nape of the neck. Restricted movements.

CALCAREA CARB:-

                The patients are obese, fat, fair and flabby. These remedy will act well on bones, rheumatoid pain after exposure to wet, cold knees cramps on calf muscle, swelling of joints esp. on knee joint, sweats on hands, weakness of extremities, stiffness of knee joint, chilly patient, desires for sweets and eggs, insecurity.

DULCAMARA:-

                  Paralysis of single part, stiff neck, stiffness around the neck and shoulders, after getting cold and wet, pain in shin bones, perspiration on palms, rheumatism alternates with diarrhea, rheumatic complaints after acute skin eruptions, all complaints get worse at damp weather. Swelling of knee joint with stiffness, chilly patient.

FER RUM PHOS:-

                 Its one of the best remedy for fever, stiff neck, stiffness on knee joints, articular rheumatism, rheumatic pain  of the shoulder and pain extends to chest and wrist, hands swollen and palms feels hot, restless and sleeplessness, pain worse at motion, and better by cold applications.

GUAIACUM OFFICINALE:-

                   Stiff neck and shoulders, contractive pain in between scapulae, stitching between scapulae and occiput, rheumatic pain in shoulders, hands, knees, immovable stiffness, joints are swollen, painful and intolerance of pressure, can bear no heat, stinging pain in limbs, ankle pain extends up the leg, cause lameness, worse from heat, motion, cold wet weather and better by pressure.

KALMIA:-

                    It’s a rheumatic remedy, deltoid rheumatism especially right side, pain from hip to knee and then legs, pains affects large part of the limbs especially all joints, and pass through quickly, weakness, prickling, numbness and sense of coldness in limbs, pains along ulnar nerve and index finger, joints red, hot and swollen, tingling and numbness of left arm, sleeplessness wakes up very early morning.

LEDUM PAL:-

                    The ledum rheumatism starts on feet and travels upwards, swollen, hot and pale in joints, throbbing in right shoulder, cracking in joints worse by heat of the bed, soles painful, can hardly step on them, easy spraining of ankle. Better by putting feet in cold water, worse at night and warmth of bed.

RHUS TOXICUM:-

                    It is the wonderful remedy for rheumatism and arthritis, chilly patient, extreme restless, hot, painful swelling of joints, pains tearing in tendons, ligaments, rheumatic pain more on nape of neck, loins and extremities, better by motion, limbs stiff paralyzed, tenderness about knee joint, loss of power in forearm and fingers, crawling sensation in the tip of the finger. Tingling in feet.

SILICEA:-

                   It is one of the best immunizer in homeopathy, its good remedy for bone diseases, ill effects from vaccination, cramps in calves and soles,  loss of power in legs,  in growing nails in toes, icy cold and sweaty feet, pain in knee as if tightly bounded, pain beneath toes and soles, sore soles, offensive perspiration on soles and palms, chilly patient. 

Some of other drugs are aconite, apis, arnica, lyco, caustic um  colocynth, kali carb, iodum, kali iod, Natrum Mur, Natrum sulph, sepia and sulphur. 

CHRONIC PANCREATITIS AND HOMEOPATHIC REMEDIES

                                                           CHRONIC PANCREATITIS

DEFINITION:-

             Chronic pancreatitis is a state of pancreatic insufficiency and inflammatory caused by atrophy and fibrosis of the pancreatic tissue.

AETIOLOGY OR CAUSES:-

            The disease is more common in male past middle age.

-          Chronic alcoholism is the main cause.

-          Recurrent attacks of acute or sub acute pancreatitis.

-          Obstruction to the main pancreatic duct due to gall stone, papilloma or stricture.

-          Chronic inflammation of billary tract.

-          Leaking of chronic duodenal ulcer.

-          Poly-cystic disease of pancreas.

-          Hyperparathyroidism.

PATHOLOGY:-

           There is atrophy of the acinar elements with extensive fibrosis and at times. Calcification inside the gland. The exocrine apparatus is affected first producing digestive disturbances or features of malabsorption.the islet tissue are affected somewhat later resulting in diabetes mellitus. The end result is failure of both exocrine and endocrine functions of pancreas.

SYMPTOMS:-

-          Recurrent attacks of upper abdominal pain lasting for a day or two.

-          Pain is more on epigastrium, radiates to the back and relived on leaning forward.

-          Pain got more by taking alcohol or a heavy meal.

-          Chronic diarrhea.

-          Which are bulky, foul and fatty stools.

-          Loss of weight.

-          Mid ascites.

DIAGNOSIS:-

-          Plain X-ray abdomen shows calcification inside the pancreas.

-          Ultra sonography swollen pancreas and gall stones may be.

-          CT scan.

TREATMENT:-

-          Surgery is indicated only when pain is recurrent and some obstruction is suspected.

-          Ranitidine (150 mg twice daily) may be help ful.

DIET:-

-          Avoid alcohol.

-          Avoid diet which is rich in fat.

HOMEOPATHIC REMEDIES:-

ARSENIC ALBUM:-

             A profoundly  acting remedy on liver, pancreas. Burning pains, its chilly patient, thirst less, restless, fear of incurable disease. Nausea, retching, vomiting, after eating or drinking. Craves milk, liver, spleen, pancreas enlarged and painfull.fatty degeneration, cyanosis.

BELLADONNA:-

            Heat, redness, throbbing and burning pains, no thirst, anxiety or fear, suddenness of attacks and onset. Sensitive to least contact, strawberry tongue, swollen tongue and painful, extreme sensitive to bed clothes and touch, distension of abdomen, low grade fever, restless, chilly patient.

CONIUM:-

        It’s a wonderful medicine for any glandular affections, weakness of body, mind, trembling and pailpitation.severe aching in and around of liver region, great debility. Knife like pain in whole abdomen, distension of abdomen, chilly patient, thirst less.

IODUM PU-RUM:-

       Hungry with much thirsty, better after eating, pain in empty stomach, great debility even slight work leads sweating, desires cold air, inflammation of pancreas. Chronic congestive headache in old age person, cutting pain in abdomen, pancreatic disease, pain in bones at night.

IRIS VERSICOLOR:-

       Burning of whole elementary canal, good remedy for any pancreatic problem, vomiting, sour billary and blood. Nausea, profuse flow of saliva, deficient appetite. Periodical night diarrhea, with pain and greenish discharge. Shifting pain is main in iris.

PHOSPHOROUS:-

      Clairvoyance, fearfulness, fear of dark, fear of thunderstorm, vomiting, water is thrown up as soon as it gets warm in the stomach.post operative vomiting, pain in stomach reduced after cold water, Ice, ice creams. Burning pain in stomach, large yellow spots on abdomen, pancreatic disease. Lascivious dreams.

SPONGIA TOSTA:-

     Anxiety and fear, bursting type of headache, tongue is dry and brown, full of vesicles, cant bear tight cloths around abdomen, excessive thirst, great hunger, awakes in a fright, and feels as if suffocating.

Some of other drugs in homeopathy for acute pancreatitis are atropinum purum sulphuricum, baryta muraticum, kali iodum, and mercurious solliblis.

ACUTE PANCREATITIS AND HOMEOPATHIC MANAGEMENT

                                                            ACUTE PANCREATITIS

DEFINITION:-

              Acute pancreatitis is an acute inflammatory disease of the pancreas caused by auto digestion of the pancreatic tissue by its own enzymes.

AETIOLOGY:-

-          Alcoholic bout, fatty foods or trauma incurred during surgical operation may initiate inflammatory process.

-          Any obstruction at sphincter of oddi due to imp action of a gall stone.

-          Obesity, hyperparathyroidism and heredity are also known predisposing factors.

-          Its more common in middle aged fatty ladies.

-          A virus of mumps or infective hepatitis or some blood borne infection.

PATHOLOGY BEHIND PANCREATITIS:-

              There is necrosis of the pancreatic tissue. The pancreas along with areas of the peritoneum show varying grades of oedema and leucocytic infiltration (oedematous pancreatitis).in more severe cases there is collection of a hemorrhagic exudates. There is exudation of hemorrhagic often bile stains fluid into the lesser sac of peritoneum, over the peritoneum itself, or over the mesentry.fatty necrosis also occurs and produces whitish patches(due to the action of pancreatic lipase)spread all over the pancreas, peritoneum and mesentry.suppurative changes are rare. Absorption of the products of tissue digestion may cause severe toxaemia and features of shock.

SYMPTOMS:-

The main symptoms are

-          Abdominal pain.

-          Vomiting.

-          Shock.

-          Patient is seized with severe agonizing pain across the epigastrium radiating to the back.

-          Patient is restless and rolls in bed.

-          Cold, clammy skin, rapid or thread pulse.

-          Hypo-tension and low grade fever.

EXAMINATION:-

         Tenderness and rigidity may be felt in the upper part of abdomen due to peritoneal irritation. A patch of bluish discolouration of the skin around the umbilicus (Cullen’s sign) or in the loin (grey-turner’s sign) may sometimes be noticeable.

INVESTIGATIONS:-

-          Serum amylase > 100 W.units.

-          Leucocytosis – polymorpho nuclear leucocytosis.

-          Plain X-ray – gas in abdomen.

-          Ultra sonography, CT-scan shows (swollen pancreas, gall stones, may be).

COMPLICATIONS:-

-          Pancreatic abscess, pancreatic ascites.

-          Jaundice.

-          Gastro intestinal hemorrhage, paralytic ileus.

-          Peripheral circulatory failure, hyperglycemia, hypocalcaemia.

-          Portal vein thrombosis.

-          Acute renal failure.

ALLOPATHIC TREATMENT:-

-          Pethidine hydrochloride (100 mg intra muscular) is ideal for immediate relief in pain and may repeat.

-          Dehydration and electrolyte imbalance should be corrected by appropriate intra venous transfusions.

-          Atropine sulphate (1 mg intra-muscularly) to decrease pancreatic secretion.

-          A continues suction of gastric contents is done through nasal tube to relives distension and prevent vomiting.

HOMEOPATHIC TREATMENT:-

ARSENIC ALBUM:-

             A profoundly  acting remedy on liver, pancreas. Burning pains, its chilly patient, thirstless, restless, fear of incurable disease. Nausea, retching, vomiting, after eating or drinking. Craves milk, liver, spleen, pancreas enlarged and painfull.fatty degeneration, cyanosis.

BELLADONNA:-

            Heat, redness, throbbing  and burning pains, no thirst, anxiety or fear, suddenness of attacks and onset. Sensitive to least contact, strawberry tongue, swollen tongue and painful, extreme sensitive to bed clothes and touch, distension of abdomen, low grade fever, restless, chilly patient.

CONIUM:-

        It’s a wonderful medicine for any glandular affections, weakness of body, mind, trembling and pailpitation.severe aching in and around of liver region, great debility. Knife like pain in whole abdomen, distension of abdomen, chilly patient, thirst less.

IODUM PURUM:-

       Hungry with much thirsty, better after eating, pain in empty stomach, great debility even slight work leads sweating, desires cold air, inflammation of pancreas. Chronic congestive headache in old age person, cutting pain in abdomen, pancreatic disease, pain in bones at night.

IRIS VERSICOLOR:-

       Burning of whole elementary canal, good remedy for any pancreatic problem, vomiting, sour billary and blood. Nausea, profuse flow of saliva, deficient appetite. Periodical night diarrhea, with pain and greenish discharge. Shifting pain is main in iris.

PHOSPHOROUS:-

      Clairvoyance, fearfulness, fear of dark, fear of thunderstorm, vomiting, water is thrown up as soon as it gets warm in the stomach.post operative vomiting, pain in stomach reduced after cold water, Ice, ice creams. Burning pain in stomach, large yellow spots on abdomen, pancreatic disease. lascivious dreams.

SPONGIA TOSTA:-

     Anxiety and fear, bursting type of headache, tongue is dry and brown, full of vesicles, cant bear tight cloths around abdomen, excessive thirst, great hunger, awakes  in a fright, and feels as if suffocating.

Some of other drugs in homeopathy for acute pancreatitis are atropinum purum sulphuricum, baryta muraticum, kali iodum, and mercurious solliblis.

URTICARIA AND HOMEOPATHIC MANAGEMENT

                                                              URTICARIA

                           Urticaria is a condition characterized by sudden and transient (recurrent) eruption of a number of circumscribed, smooth, raised, pinkish and itchy wheals over the skin surface. A wheal consists of a localized collection of serum underneath the dermis and is caused by transient increase in permeability of local capillaries. It has a pale, dome shaped oedematous centre and zone of erythema around it.

AETIOLOGY OR CAUSES:-

-           Contact with certain plants, chemicals,drugs or sting of insects.

-          Unusual susceptibility to sun rays.

-          Ingestion of certain allergic foods(eg.Shell,fish,prawn,strawberries,eggs,banana,curd,brinjal,fish).

-          Allergic to certain drugs like pencillin,sulpha groups of drugs, aspirin

-          House dust, pollen and perfumes.

-          Presence of any parasitic infections like filariasis, trichiniasis.

TYPES:-

Depends on etiological agents Urticaria may be of two types.

a.       Allergic Urticaria.

b.      Non-allergic Urticaria.

ALLERGIC URTICARIA:-

                  Allergic Urticaria is caused by hypersensitive reaction to a foreign protein resulting in release of histamine and other vasodilators substances. These cause dilatation of skin capillaries and increase permeability of their walls. Consequently serum leaks out of the capillaries and accumulates inside the layers of the skin. Its very common in any age groups.

NON-ALLERGIC URTICARIA:-

                   An attack of Urticaria may be precipitated by exercise; trauma or an emotional conflict.urticaria following a hot bath is a common example. There may be an indirect release of histamine from the mast cells in all such cases.

SYMPTOMS:-

-          Itching leads rashes.

-          The rashes may fade away quickly or persist for days or months depending on the nature and period of contact with the allergen

-          Burning and pricking on kin is a classical symptom.

-          Mild fever, malaise and headache.

-          Massive oedematous swellings over the skin or inside the mucous membranes, eyelids, lips, external genitalia, extrimities, tongue and larynx are likely to be involved.

DIET:-

-          Avoid fish, prawn, brinjal,eggs and citreous fruits.

-          Avoid sulpha group of drugs.

-          Take fruits and freshy vegetables’.

TREATMENT:-

-          Chlorpheniramine maleate  2ml intra muscular injection.

-          Occasionally cetrizine or avil tablet but directed by your physician.

HOMEOPATHIC REMEDIES:-

1.       ACONITE:-

        Red, hot, swollen, dry, burning. Rash like measles, Chilliness and formication down back. Onset is sudden and goes sudden. Low grade fever, burning sensation on skin, Fears the future, a crowd, crossing the street. Great restless.

2.       ANTIMONIUM CRUDUM:-

       Cannot bear heat of sun.These patients are very much food lovers, chilly patient, obese person, aching, worse in vertex, on ascending, from bathing, from disordered

Stomach, especially from eating candy or drinking acid wines. Desire for acids, pickles. Urticaria; measle-like eruption.dry skin, Scaly with burning and itching, worse at night.

3.       ARSENIC ALBUM:-

    Fears, of death, of being left alone. Despair drives him from place to place. Swollen, pale, yellow, cachectic, sunken, cold, and covered with sweat. Swollen, oedematous, constricted, burning, unable to swallow. Craves acids and coffee. Urticaria, with burning and restlessness.Restless,avarice,fastidious due to fear of disease, chilly patient.

4.       BELLADONNA:-

     Belladonna stands for violence of attack and suddenness of onset. Delirium; frightful images; furious; rages, bites, strikes; desire to escape. Eyes feel swollen and protruding, staring, brilliant; conjunctiva red; dry, burn; photophobia; shooting in eyes. Eyelids swollen. Strawberry tongue. Tongue swollen and painful.Dry and hot; swollen, sensitive; burns scarlet, smooth. Glands swollen, tender, red

5.       CALCAREA CARB:-

    The patient is obese,fat,fair,flabby,chilly patients,desires sweets and eggs,insecurity,anticipatory anxiety, Scratches head on waking. Itching of lids, swollen, scurfy. Swelling of upper lip. Small wounds do not heal readily.

6.       HEPAR SULPH:-

   Anguish in the evening and night, with thoughts of suicide. Hasty speech, eyes are red and inflamed, eyelids are swollen, itching on skin leads rashes, Unhealthy skin; every little injury suppurates. Chronic and recurring Urticaria. Cannot bear to be uncovered; wants to be wrapped up warmly.

7.       LYCOPODIUM:-

One of the best remedy for Urticaria, hot patient,cowardice,food lovers, Hurried when eating. Eyes half open during sleep. Dryness of throat, without thirst. Desire for sweet things. Violent itching; fissured eruptions.

8.       SEPIA:-

It is great washer women remedy, Indifferent to those loved best. Weeps when telling symptoms. Ptosis, ciliary irritation. Swelling and cracking of lower lip. Urticaria on going in open air; better in warm room. Ringworm-like eruption every spring. Itching; not relieved by scratching; worse in bends of elbows and knees. Sweat on feet, worse on toes; intolerable odor.

9.       SULPHUR:-

Its is very good remedy for all skin disease, aversion to bathing, hot patient,therotical speech. Very forgetful. Childish peevishness in grown people. Dry, scaly, unhealthy; every little injury suppurates. Itching, burning; worse scratching and washing. Skin affections after local medication.Pruritus, especially from warmth, is evening, often recurs in Spring-time, in damp weather.

Some of other drugs are bryonia,causticum,conium,dulcamara,silicea,acid phos,mezerium,petroleum,pulsatilla,rhus toxi,veratrum album.

CHRONIC BRONCHITIS AND HOMEOPATHIC TREATMENT

                                                            CHRONIC BRONCHITIS

DEFINITION:- 

                Chronic Bronchitis is a longstanding inflammatory disease of the tracheobronchial tree which is often associated with emphysema. Clinically it is defines as a condition associated with a history of productive cough for most days during three consecutive months in two successive years or more.

AETIOLOGY (or) CAUSES:-

        Males are more commonly affected in middle aged or elderly peoples. Presence of chronic disease of lungs or the heart or acute bronchitis will favours the incidence of chronic bronchitis.

-          Chronic irritation of the bronchial mucosa (dust, smoke, fumes and fog).

-          Climacteric changes mainly winter season.

-          Cigarette smokers.

-          Bacterial infections.

-          Exposure to damp weather, foggy or chilly weather.

PATHOLOGY:-

          There is chronic inflammation of the bronchial tree. The bronchial glands are hypertrophies secreting lot of mucus inside the bronchial lumen. The bronchial mucousa is oedematous due to congestion and collection of exudates. The lumen of the lower respiratory  tract is narrowed resulting in chronic airway obstruction. The goblet cells present inside the bronchioles proliferate and are over distended with mucus. This contributes to airway obstruction, Air can be inhaled during inspiration with the help of accessory muscles of respiration but expiration becomes difficult. This results in prolonged expiration and expiratory dyspnoea.Air remains trapped inside the lung alveoli which get ruptured.

The disease passes through 3 stages.

-          During the first stage the sputum is mucoid and white in co lour.

-          During the second stage infection supervenes and sputum becomes mucopurulent or yellow in co lour.

-          Third stage is that of chronic obstructive bronchitis associates with significant airway obstruction. This is crippling stage of the disease which persists and leads to death from respiratory failure with or without cor pulmonale.

SYMPTOMS:-

-          Cough with expectoration.

-          Cough leads to vomiting.

-          The sputum is scanty or copious, thin or thick, white or yellow.

-          Sputum with blood.

-          Dyspnoea is more on late hours of night or early morning.

-          Low grade fever.

  EXAMINATION:-

                The breath sounds are vesicular in character with prolonged expiration.Rhonchi (both sonorous and sibilant) are heard all over the chest bilaterally and symmetrically.Crepitations are present all over the chest. Presence of unusually coarse crepitations at one of the lung bases, signifies develops of bronchiectatic changes.

  INVESTIGATIONS:-

-          Pulmonary function tests -  The forced expiratory volume is reduced, the forced vital capacity is also reduced. The residual volume of the lungs is increased due to distension of alveoli and trapping of air inside them. The PaO2 falls and PaCO2 rises leading to respiratory acidosis.

-          Mild leucocytosis with increased polymorpho nuclear cell count.

-          X-ray.

   COMPLICATIONS:-

-          Emphysema and chronic cor pulmonale.

-          Bronchiectatic changes.

-          Bronchopneumonia and pneumonia.

   TREATMENT:-

-          Stop smoking.

-           Avoidance of dusty and smoke laden atmosphere.

-          Mechanical ventilation.

-          Tablets like salbutamol,terbutaline

-          Erythromycin, azhithromycin, ampicillin 2 times in a day.

  HOMEOPATHIC TREATMENT:-

1.       ACONITE:-

               Dry cough, worse at night, every inspirational seems to increase the cough, sleep disturbed due to cough which almost awakes him, onset will be sudden, chilly pt.

2.       ARSENIC UM ALBUM:-

                For any dryness, when due to some organic trouble, particularly of the heart, or with emphysema, the cough is violent and dry, with shortness of the breath and suffocative spells, worse at night.raipid emaciation and debility, restlessness,anguish and fear of death.

3.       BRYONIA:-

                 The cough is dry in  night, compelling one to spring up and assume and erect posture at once, patient dreads motion, cannot sit up as it causes nausea, the lips are dry and cracked, chilly pt.

4.       CALCAREA CARB:-

                  Secondary bronchitis, cough caused by sensation of plug, which moved up and down in the throat, cough is dry especially at night,violent,first dry, afterwards with profuse salty expectoration, with pain as if something had been torn loose from the larynx with rattling in the chest.

5.       KALI BICH:-

                 When there is an expectoration of tough, string mucus, irritability, chilly patient, anxiety about health.

6.       LYCOPODIUM:- 

                 The patient is quite emaciated, cough with excessive accumulation of mucus, the cough sounds loose, but the expectoration is easy. cough worse from 4-8 pm on alternate days, from exertion, when lying down on left side, from eating and drinking cold things, in the wind or in the warm room.

7.       SENEGA:-

                

                Particularly in old people, when there is an enormous accumulation of phlegm, with a loose rattling cough, tendency to diarrhea, chest is painful and sore.

8.       SEPIA:-

                       Particularly when reflex in women with some uterine trouble or from some stomach disease, cough at every evening, not ceasing until he coughs loose a little sputum, spasmodic dry cough from tickling in the chest.

9.       SULPHUR:-

                 This is our best remedy for cases of long standing profuse secretion of mucus. Cough with expectoration.

Some of other drugs are pulsatilla,arg nit, Kali sulph,carb veg etc.

HYPERTHYROIDISM AND HOMEOPATHIC MANAGEMENT

                                                               HYPERTHYROIDISM

Hyperthyroidism ( state of hyperfunctioning of the thyroid gland) is a clinical state produced by excessive secretion of either tri-iodothyronine(T3) alone or T3 and T4(thyroxine) combined.

The vast majority of the cases hyperthyroidism are of the primary type i.e, Grave’s disease(nearly 75% of cases).Others are a multinodular goiter or an autonomously functioning solitary nodules.

Primary  Hyperthyroidism or Grave’s disease:-

                 Grave’s disease is the commonest type of hyperthyroidism. It occurs in younger group of patients and much more common in females.There is diffuse enlargement of the thyroid gland with increased vasculature and increased blood circulation.

Aetiology or Causes:-

1.       Auto immune disorder.

2.       Stress.

3.       Grave’s disease.

4.       Sub acute thyroiditis.

5.        Some sedentary life cycle.

Symptoms:-

1.       General symptoms:-

a. Loss of weight.

b. Weakness and wasting of the proximal group of muscles in arms and legs.

c.  Nervousness,Irritability,easy fatigue.

d.  Insomia,excessive sweating.

e.  Palpitation.

f.   decreased tolerate to heat.

g.  Tremors of the outstretched hands and fingers.

 2.  Goitre.

3.  Exopthalmos 

                       The eyeballs are unusually prominent and protruded.The look is staring,diplopia or visual   difficulty,excessive lacrymation and gritty sensation in the eyes.

4. Dermatopathy:-

          Localised thickening of skin due to mucin like deposits may occur in the legs (Pre-tibial myxoedema).clubbing of fingers and toes.

Examination:-

-           The facial expression with prominent eyeballs,a staring look with red,congested eyes and diffusely enlarged thyroid gland.

-          The hands are warm and sweating.

-          The pulse rate remains persistently high.

-          Fine tremors of fingers are detected when the patient is asked to stretch his hands and fan out the fingers.

Investigations:-

-          Thyroid hormone test.

 Diet:

-          Avoid  foods high in iodine.

-          Avoid smoking,drinking,tea,coffe,chocolates.

-          Vitamin d from eggs and mushroom.

-          Green leaf vegetables and cabbage,cauli flower.

Treatment :-

-          Anti thyroid drugs like eltroxine and thyroxine but dose should follow by given physician.

-          Surgery.

Homeopathic treatment:- 

1.       Thyroidinum:-

          It is very good remedy for hyperthyroidinum,eyes are protruded,goitre,tongue thick coated,irritability,melancholy,anxiety about chest is constricted,palpitation from least exertion,tachycardia,excessive obesity,  anaemia, emaciation, muscular weakness, sweating,

headache, nervous tremor of face and limbs, tingling sensations.

2.       Kali carb:-

           Irritability,anxiety about health,tachycardia,palpitation,full of fear and imaginations,menses early,profuse or to late,pain in tip of the toe and finger,chilly patient,expressive,anger also violent,family oriented persons.

3.       Natrum muraticum:-

             Emaciation most notable in neck.constrictive feeling all over the body,headache got increase after exposure to sun,desires salt,wants to be alone,consolation aggravates,irritable, menses irregular,dryness in vagina,heart pulsation shakes body,tachycardia,dreams of robbers,hot patient.

4.       Lycopus:-

            Protrusion, pressing, outward, with tumultuous action of heart.palpitation from nervous irritation,increased in pulse rate,headache from nervous.good remedy for hyperthyroidism,irregular menses.

5.       Ferum sulph:-

             Severe vertigo; with diarrhea,taste of salt  with smarting of throat,loss of appetite,aversion to meat.hot patient,mentally they are very strong and maintain punctuality in all manners,headache frequent between periods, paralysis of lower limbs.

6.       Calc phos:-

             Lean,thin constitution,hurried in everything,tremors of limbs, forgetful,menses too early,excessive and bright in young girls,likes travelling,insecurity,pain in joints and bones, tachycardia,chilly pt,hoarseness,nymphomania.

7.       Iodum:-

            It is excellent remedy for glandular diseases,anxiety when quiet,forgetful,fear of people,melancholy,pain in eyes,violent lacrymation,goiter with sensation of constriction.menses irregular,pain in mammary gland,palpitation from least exertion,heart feels squeezed, tachycardia,

8.       Sulphur iodatum:-

            Tongue is thick,swollen throat,boils on neck,good remedy for hyperthyroidism.

Some other drugs are calc carb,lycopodium,acid flour,conium,pulsatilla,platina,thuja

HYPOTHYROIDISM AND HOMEOPATHIC MANAGEMENT

                                                                       HYPOTHYROIDISM

The condition characterized by under section of the thyroid hormones  i.e. t3 and t4 levels are in normal and increased level of thyroids stimulating hormones level. In adults, the condition manifests most commonly as “myxoedema”.

                     The term myxoedema literally signifies a non-pitting type of oedema due to deposition of mucous like material underneath the skin.

                    Hypothyroidism in children is either congenital or acquired. The congenital type known as cretinism occurs in infants.The acquired type known as juvenile myxoedema occurs in grown up children.

Aetiology:-

                   This is usually due to acquired causes. It is more common in middle aged women approaching menopause.

A.      Primary atrophy of the thyroid  gland.

B.      Auto immune disorder.

C.      Atrophy secondary to other diseases of the thyroid.

D.      Atrophy secondary to pituitary or hypothalamic disease.

E.       Stress.

F.       Iodine deficiency.

Symptoms:-

              There is 3 types of symptoms they are a. mental,b.physical,c.metabolic symptoms.

A.      A. Mental symptoms:-

-          Loss of memory, patient  is mentally dull and depressed.

-          Delusions and hallucinations.

-          Irritability.

B.      Physical symptoms:-

-          The patient feels unusually tired and weak.

-          Slowness of all physical activities.

-          The voice is slow,monotonus and husky. In an advanced case,the voice may be hoarse and croaky.Hoarseness is partly due to enlargement of the tongue and swelling of the lips.

-          Vague pain in muscles and joints particularly the knee joints,may be stiff and swollen.

C.      Metabolic symptoms:-

-          The BMR is reduced to about 30%.

-          Constipation and anorexia (loss of appetite).

-          Unusually sensitive to cold and remain in warm places.

-          Increased in weight due to the presence of non-pitting oedema.

-          Menstrual abnormalities (irregular).particularly menorrhagia(menu – lot so many times).

        -      Infertility occurs as a rule and impotency in males .

        -      Hair fall on eyebrows and scalp.

Examination:-

       The face is broad and looks bloated with puffy eyelids, thick lips and broad nose. The skin is rough, dry and lusterless. Hair is thin, brittle tends to fall out especially on eye brows. The patient looks pale due to anaemia.

       A non-pitting oedema is present in legs and hands. Patient have short and broad neck, the pulse is slow.

Investigations:-

      The level of T4 is low and that of TSH is raised confirms hypothyroidism.

-          In doubtful cases thyroid function test should done.

         Treatment:-

           The treatment consists of substitution theraphy with L-thyroxine. In the event of over dose case, the patient complaints of palpitation, sweating,diarrhea and pain  in heart.

          Diet to avoid:-

-          Raddish.spanish,cauliflower and cabbage.

-          Avoid coffee, smoking.

          Homeopathic treatment:-

                   Homeopathy has very good acting medicines on hypothyroidism condition.

                                   Natrum muraticum.

                                    Iodum.

                                  Thyroidinum.

                                  Calcarea iod.

                                  Calcarea carb.

                                  Calc phos.

                                  Lycopus.

.                                Kali carb.