Some aspects of Giardiasis with homoeopathic mode of treatment

This is a small-intestinal disease due to infestation caused by Giardia lamblia, a flagellate that is found worldwide. Cyst causes infection. It is an important cause of traveller’s diarrhea worldwide usually occurring on return from travel. Prevalence is high throughout the tropics. Many individuals excreting giardia cysts are asymptomatic and hence carriers. Symptoms are produced within 1-2 weeks of ingestion of cysts.

Pathogenesis-The organism colonizes & multiplies within the small-intestine and may remain there without causing any detrimental effects to the host. Otherwise it causes alteration in mucosal architecture. The changes in villous architecture may vary from mild partial villous atrophy to rarely subtotal villous atrophy. The mechanism of producing diarrhea & intestinal malabsorption is ill understood.

Age- Children are mostly affected though adults are not immune to it.

Clinical Features- Children often produce symptoms whereas adults may be asymptomatic. Symptoms are produced within 1-2 weeks of ingestion of cysts. These include diarrhea, often watery in the early stage, nausea, anorexia, abdominal discomfort, distension and pain. Stools gradually become paler and frothy, with the characteristic features of steatorrhoea. There is gradual emaciation which is marked even in previously healthy individuals.

Complications-
(1) Malabsorption syndrome in severe cases.
(2) Growth retardation in children due to chronic giardiasis.

Laboratory Investigations-

(1) Stool examination-It may show both cysts and trophozoites. But as the parasite may be excreted at irregular intervals, a negative result does not exclude the diagnosis. Stool examination aids in the diagnosis of giardiasis in 80-85% of patients.

(2) Indirect immunofluorescence (IFA) /ELISA- Detection of circulating antibody to G. lamblia can be done.

(3) Invasive method- An alternative method is upper endoscopy with biopsies of the mucosa of the jejunum and aspirate of the duodenum to detect the presence of the parasite in them if other procedures fail to confirm the diagnosis of giardiasis.

Control and prevention- Eradication is difficult because of the substantial human reservoir of asymptomatic cases and remote hope of vaccine development. Improved standards of personal hygiene and water quality are to be maintained. Standard of water quality may be improved by using different types of water purifiers.

Treatment- Homoepathy can be effectively used for its remedy. If flatulence or abdominal discomfort predominate, China ( Cinchona Officinalis) 6 & Carbo.veg (Carbo Vegetabilis) 6 should be alternatively used each 6 times daily for seven days or until the disease is controlled . Aloes 30 should be used six times daily in diarrhea for at least seven days or till the persistence of diarrhea.

Labels- China ( Cinchona Officinalis), Carbo.veg (Carbo Vegetabilis), Aloe, Biopsy, Prevalence,Villous, Atrophy, Water purifier, Cyst, Duodenum, ELISA, Endoscopy, Invasive, Small-intestine, Diagnosis, Giardia lamblia, Abdominal, Method, Infestation, Flagellate, Mucosa, Pathogenesis, Reservoir ,Growth retardation, Indirect immunofluorescence (IFA), Jejunum, Malabsorption syndrome, Diarrhea, Parasite, Flatulence, Steatorrhoea, Stool, Trophozoite.

IN SHORT-Giardiasis is a small-intestinal disease caused by Giardia lamblia & may be asymptomatic or is manifested diarrhea, often watery in the early stage, nausea, anorexia, abdominal discomfort, distension and pain. Treatment is as mentioned above.

But in every case a doctor should be consulted.

Some aspects of Chickenpox with homoeopathic mode of treatment

Chicken pox is an acute, highly infectious disease of childhood caused by varicella zoster virus (VZV) which is a DNA virus belonging to the family of herpesvirus. VZV infects only humans and produces two distinct diseases in man- varicella ( chicken pox) and herpes zoster ( shingles) among which chicken pox is the primary infection occurring usually in the childhood. Chicken pox is the primary infection in the non-immune host. It almost never occurs twice in the same individual. The virus then remains latent in the dorsal root and cranial nerve ganglia for the rest of the life. If immunity is impaired which occurs in elderly persons, the virus replicates and migrates along the sensory nerves to the skin or eye causing the lesions of zoster. There are no animal reservoirs of varicella.

Age- Chicken pox is the disease of childhood. But it can occur at any age and adult chicken pox which is more common in some tropical areas for reasons not understood is much more serious.

Source of infection -The source of infection is a chicken pox or herpes zoster patient. Infectivity is maximum during the initial stages of the disease when the virus is present abundantly in the upper respiratory tract. Infectivity diminishes with the progress of the disease and the scabs are practically non- infectious.

Route of entry-The portal of entry of the virus is the upper respiratory tract.

Incubation Period- 7-23 days, average 2 weeks.

Onset-Acute.

Clinical Features- There are malaise, headache, weakness, fever and prodromal rash. In children the prodromal illness is mild and so the disease is usually noticed only when the skin lesions appear. In adults, however, prodromal fever and malaise with respiratory symptoms lasting 2-3 days are common features. True rash usually appears on the first day of the disease and is vesicular in nature. The rash is centripetal in distribution, affecting mainly the trunk along with face & scalp and sparing the distal parts of the limbs. Moreover, the rash is very superficial and does not involve the deeper layers of the skin. With each fresh crops of rash temperature rises. The vesicles are unilocular and not umbilicated. Fever subsides as soon as new lesions cease to appear. Eventually the pustules crust and heal without scarring. The illness tends to be more severe in older children and can be debilitating in adults. One of the most characteristic features of the rash is pleomorphism and so all stages of the rash that is papules, vesicles and crusts may be seen simultaneously at one time in the same area.

Laboratory Investigations- Laboratory diagnosis is seldom required because of clear-cut clinical signs. Confirmation of the diagnosis is possible by examining the direct scraping of the skin lesion under a microscope, viral cultures or a rising antibody level in convalescing blood samples.

Complications-
Secondary bacterial infection usually due to staphylococci or streptococci may occur.
Varicella pneumonia- It is an important complication that usually 1-6 days after skin eruption. Varicella pneumonia is found mainly in adults where it usually becomes fatal. Besides these, CNS ( Central nervous system) involvement occurs in rare cases. The immunocompromised are susceptible to disseminated infection with multi-organ involvement.

Prevention-Recently a vaccine has been introduced in some countries. The vaccine is effective in preventing chickenpox in a number of cases & is recommended for use between the ages of twelve and eighteen months. In the rest of the cases the severity of a chickenpox infection is lessened by the vaccine.

Prognosis- Chicken pox requires no treatment in healthy children and infection results in life-long immunity. But the disease may be fatal in the immunodeficient or the immunosuppressed. If the primary infection occurs during pregnancy, the virus may cross the placenta with subsequent infection of the foetus. Primary infection of the mother near term may lead to neonatal varicella.

Treatment- Rhus.t ( Rhus toxicodendron) 30 is very effective to cope with skin lesions & should be used six times daily for one week or till the lesions heal & then should be stopped. Dulc (Dulcamara) & Merc.s ( Mercurius –Hydrargyrum ) be also used especially for high temperature.

Labels- Microscope, Infection, Centripetal, Laboratory Investigations, Laboratory diagnosis, Chicken pox, DNA virus, Dulc (Dulcamara), Immunocompromised, Immunodeficient, Immunosuppressed, Lesion, Merc।s ( Mercurius –Hydrargyrum ), Microscope, Pleomorphism, Varicella pneumonia, Foetus, Neonatal varicella, CNS ( Central nervous system), Pleomorphism,Pustule, Rash, Multi-organ, Staphylococci, Streptococci, Incubation Period, Prevention, Complications,Clinical Features.

IN SHORT- Chicken pox is an acute, highly infectious viral disease of childhood which begins with malaise, headache, weakness, fever and a characteristic type of rash appearing mainly the trunk with pleomorphism. Treatment is as mentioned above.

But in every case a doctor should be consulted।

Some aspects of Chalazion with homoeopathic mode of treatment

A chalazion is a chronic granuloma of one or more than one meibomian glands.

Pathology- A low grade infection, entering through a duct of the meibomian gland, causes infiltration of the wall of the duct with leucocytes along with proliferation of the epithelium of the duct. The duct, thus, becomes obstructed and the meibomian secretion accumulates within the gland. The retained secretion causes irritation resulting in infiltration of the surrounding tissues with inflammatory cells and consequently formation of a granuloma. Much of the glandular tissue is thus ultimately replaced by granulation tissue which undergoes hyaline degeneration forming a jelly-like mass.

Histology- A chalazion consists of sebaceous material in the centre surrounded by giant cells, epitheloid cells and lymphocytes.

Associated Conditions- It may be associated with blepharitis, rosacea or seborrhoeic dermatitis. Chronic chalazion may be associated with hypercholesterolemia.

Age- A chalazion is more common in adults than in children.

Presentation- Presentation is usually at any age with a gradually enlarging painless nodule (swelling).

Symptoms- Depending on the size of the chalazion, there may be a sense of heaviness in the lid and mild irritation. Occasionally an upper lid chalazion may press on the cornea inducing astigmatism and consequently blurred vision.

Signs-
(1) A single or multiple roundish, firm swellings of variable size within the substance of the lid in the tarsal plate, a little distance away from the lid margin.
(2) It is painless or there is initial tenderness followed by little or no tenderness.
(3) The swelling is fixed to the tarsus, with the skin freely moving over it.
(4) On everting the lid, the conjunctiva over it is found to be engorged and velvety in colour.
(5) The regional lymph glands are not palpable.

Course-
(1) A very small chalazion may undergo resolution.
(2) A chalazion may remain as it is.
(3) A chalazion may gradually increase in size over weeks or months and then may remain stationary & may even slowly regress.
(4) A chalazion may burst either on the skin surface or on the conjunctival surface, with granulation tissue protruding.
(5) A chalazion may be secondarily infected leading to the formation of an internal hordeolum.
(6) A chalazion may affect a meibomian duct or may protrude through a meibomian duct when the nodule is found to develop at the lid margin and is called a marginal chalazion.

(7) There may be calcification of a chalazion.

(8) A chalazion may recur.

Treatment-
(1) Lid hygiene should be promoted.
(2) Diabetes mellitus should be excluded by necessary laboratory investigations.
(3) Hypercholesterolemia should be excluded by necessary laboratory investigations
(4) Refractive errors, if any, should be corrected with proper glasses (spectacles) or contact lenses.
(5) Recurrent chalazia, especially in old people should arouse the suspicion of malignancy.
(6) Hot compresses may be applied, especially if there is pain or tenderness.
(7) Of the homeoepathic medicines, Conium 200 twice in the morning at an interval of three hours and Staph (Staphysagria) 200 twice in the evening also at an interval of three hours should be used for at least one month. If not recovered, the same dose schedule should be continued for another month and then stopped. Kali Iod 200 may also be tried.

Labels-Astigmatism, Blepharitis, Chalazion, Conium, Cornea, Homeoepathic medicine, Resolution, Kali Iod, Gland, Granuloma, Hypercholesterolemia, Internal Hordeolum, Lymph gland, Malignancy, Meibomian, Staph (Staphysagria), Treatment, Vision, Hygiene, Refractive errors, Glass, Spectacles, Contact lenses, Diabetes mellitus, Rosacea, Seborrhoeic dermatitis, Hyaline degeneration, Sebaceous, Giant cell, Epitheloid cell, Lymphocyte.

IN SHORT- Chalazion is manifested as a painless single or multiple firm swellings of variable size within the substance of the eyelid, a little distance away from the lid margin. Treatment is followed as mentioned above.

But in every case a doctor should be consulted.

Some aspects of Internal Hordeolum with homoepathic mode of treatment-

It is the suppurative inflammation of a meibomian gland of exactly same nature as stye but is comparatively rare. It is often called a suppurative chalazion and sometimes may be due to secondary infection of a chalazion.

Causative agent- Staphylococcus.

Symptoms-They are same as for stye but are more severe.

Signs-
(1) A tender, painful swelling within the substance of the lid in the tarsal plate, a little distance away from the lid margin.
(2) The point of maximum tenderness is away from the lid margin.
(3) If the lesion enlarges, the pus points on the tarsal conjunctiva and not on the root of an eyelash. It rarely points on the skin.

Treatment-
(1) Lid hygiene should be properly maintained.
(2) Blood sugar should be controlled in case of diabetes mellitus.
(3) General health of the patient should be improved with good nutrition and vitamins.
(4) Refractive errors, if any, should be corrected with suitable glasses (spectacles) or contact lenses।

(5) Hot compresses may be applied.
(6) Homoeopathy plays a good role in its treatment. Of the different medicines, Hepar Sulph (Hepar Sulphuris Calcareum) 30 should be given six times daily for a week if there is intense pain. Silicea 30 may also be used & should be given six times daily for a week if the pain is stitching in nature.

Labels-Blood sugar, Chalazion, Conjunctiva, Contact lens, Diabetes mellitus, Hepar Sulph (Hepar Sulphuris Calcareum), Eyelash, Glass, Health, Homoeopathy, Refractive errors, Spectacle, Hygiene, Internal Hordeolum, Nutrition, Patient., Pus, Silicea, Skin, Vitamin.

IN SHORT- Internal Hordeolum is manifested as a tender, painful swelling within the substance of the lid a little distance away from the lid margin. Treatment is followed as mentioned above.

But in every case, a doctor should be consulted.

Some aspects of External Hordeolum or Stye with homoeopathic mode of treatment -

External hordeolum or stye is a focal, acute inflammation of the follicle of an eyelash including the glands of Zeis or Moll, usually ending in suppuration.

Causative agent- Staphylococcus.

Associated Conditions- It may be associated with blepharitis, rosacea or seborrhoeic dermatitis.

Associated factors- It may be associated with uncorrected errors of refraction as well as some metabolic factors like diabetes mellitus, debility & excessive intake of carbohydrate.

Age- It may occur at any age, but more common in adults than in children.

Symptoms- Acute pain in the lid margin with a sense of heaviness & heat.

Signs-
(1) A single or multiple swellings at the margin of the affected lid pointing anteriorly through the skin.
(2) Marked tenderness at the point of inflammation on the lid margin.
(3) Swelling, redness & marked oedema of the affected lid as a whole.
(4) Congestion of the neighbouring conjunctiva which may be chemotic.
(5) Enlargement of the corresponding pre-auricular lymph glands.
(6) Finally appearance of a white pus point on the lid margin at the base of a cilium which indicates suppuration.

Course- If not treated, the pus point may burst outside & consequently the pain and swelling subsides.

Complications- Usually none but very rarely the inflammation may spread producing cellulitis of the orbital tissue.

Treatment-
(1) Lid hygiene should be properly maintained.
(2) Blood sugar should be controlled in case of diabetes mellitus.
(3) Refractive errors, if any, should be corrected with proper glasses (spectacles) or contact lens.
(4) General health of the patient should be improved with good nutrition and vitamins.
(5) Hot fomentation should be applied on the lid to hasten suppuration.
(6) If the pus points on the skin of the lid, the pus should be drained by pulling out the affected eyelash.
(7) Homoeopathy plays a good role in its treatment. Of the different medicines, constitutional medicine is Graph (Graphites) 200 for fair, fatty, flabby patients. General medicine is Staphysagria 200 twice daily. If there is severe pain, Hepar Sulph (Hepar Sulphuris Calcareum) 30 should be added with it till the pain persists in a dose of four times daily. If there is stitching pain, Silicea 200 should be added with the general medicine till the persistence of the pain. General medicine should be continued till the subsidence of stye and also for another two weeks.

Labels- Homoeopathy, Diabetes mellitus, Nutrition, Vitamins, Refractive errors, Glasses, Spectacles, Blepharitis, Rosacea, Seborrhoeic dermatitis, Swelling, Oedema, Lymph gland, Inflammation, Suppuration, Blood sugar, Health, Eyelash, Pus, Conjunctiva, Treatment, Staphylococcus, External Hordeolum, Stye, Graphites, Silicea, Hepar Sulph, Staphysagria.

IN SHORT- Stye is manifested as a single or multiple swellings at the margin of the eyelid with marked tenderness along with swelling, redness & oedema of the affected lid as a whole. Treatment is followed as mentioned above.

But in every case a doctor should be consulted.

Some aspects of Whooping Cough with homoeopathic mode of treatment-

Whooping Cough is a type of catarrh of the entire respiratory tract which produces paroxysmal cough and a typical stridor or ‘whoop’ caused by Bordetella pertussis, a gram negative, coccobacillus. Though Bordetella pertussis is the main causative agent, a few cases, milder in nature may be caused by Bordetella parapertussis, the incidence of cases varying in different countries. Very rarely, the disease may be caused by Bordetella bronchiseptica. A whooping cough like clinical picture may also be caused by some other respiratory pathogens like adenoviruses and Mycoplasma pneumoniae. Whooping Cough is one of the most infectious of bacterial diseases and the non-immune contacts seldom escape the disease. One characteristic feature of whooping cough is that the infection is limited to the respiratory tract and the bacilli do not invade the bloodstream.

Host & reservoir of infection-Humans are both the natural hosts and reservoirs of infection.

Age- It is a disease of childhood occurring common between 1-5 years of age. However, no age is exempt.

Sex- The disease is relatively commoner in the female than in the male at any age.

Spread of infection- Infection is transmitted by droplets and fomites contaminated with oropharyngeal secretions.

Source of infection- Source of infection is a patient in the early stage of the disease. In adolescents and adults the disease is often atypical with the presentation of bronchitis who then serves as a source of infection to infants and children. Chronic carriers are not known.

Incubation Period- 7-14 days.

Pathology- It produces a local infection. The organism is not invasive. It multiplies on the surface epithelium of the respiratory tract and causes inflammation and necrosis of the mucosa which in turn may invite secondary bacterial invasion. The whole respiratory tract starting from nasopharynx down to bronchi is thus involved in a necrotizing inflammation along with inflammation of the peribronchial and tracheobronchial lymphoid tissue. As the disease progresses, inflammation of the lung produces a diffuse bronchopneumonia with desquamation of the alveolar epithelium. The stickiness of exudates causes obstruction of bronchioles and atelectasis.

Onset- Insidious.

Clinical Features- The disease usually lasts 6-8 weeks. The course of the disease is protracted and may be divided into three stages- each lasting approximately two weeks-

(1) The catarrhal stage- Clinical diagnosis at this stage is difficult. It has an insidious onset with malaise, anorexia, mucoid rhinorrhoea, conjunctivitis and a dry irritating cough. This is the stage of maximum infectivity.

(2) The paroxysmal stage-It is so called because of the characteristic paroxysms of coughing. It begins about a week later. The cough increases in intensity and comes on in distinctive bouts. The cough is more prominent at night and is increased on crying and during feeding. The characteristic feature of paroxysms of cough is that there is no apparent inspiration in between them which ends in a crowing inspiratory sound, the classic inspiratory whoop. Children under 6 months usually do not produce whoop. During this stage, there is no fever unless complicated by some other infection. These paroxysms usually terminate in vomiting. Conjunctival suffusion and petechiae and ulceration of the frenulum of the tongue may also be seen.

(3) Convalescent stage- During this stage, cough becomes less frequent and sputum is less tenacious.

Complications- The paroxysmal stage is mainly associated with complications. Bronchitis, lobar pneumonia, atelectasis, rectal prolapse etc. Cerebral anoxia may occur, especially in younger children. The respiratory complications are self-limited, the atelectasis resolving spontaneously but the neurological complications may result in permanent sequelae like epilepsy, paralysis, retardation, blindness or deafness. Bronchiectasis may be a late sequel.

Laboratory Investigations- The initial diagnosis of whooping cough is usually based on the symptoms. The following may be done-

(1) Blood examination -Blood examination shows high W.B.C count. Total count is also high with about 90% lymphocytes. No immature lymphocytes are present.

(2) Culture of the organism- The most accurate method of diagnosis of whooping cough is to culture the organisms obtained from swabbing mucus out of the nasopharynx. Unfortunately the organism is delicate. So it is unusual to get a positive culture in whooping cough. In other words, if a swab is negative, the patient can still have whooping cough.

(3) Serological Tests- Serological diagnosis is generally of no use. ELISA may be used for demonstration of specific secretory IgA antibody in nasopharyngeal secretions in culture negative cases. A better and more modern way of detecting the organism is by detecting its unique DNA pattern by means of polymerase chain reaction (PCR).

Control and prevention- Maternal antibodies do not seem to give protection against the disease. Affected individuals should be isolated to prevent contact with others. But this is seldom practicable, as infectivity is highest in the earliest stage of the disease when clinical diagnosis is difficult. Active immunization with triple antigen comprising of pertussis vaccine in combination with diphtheria and tetanus toxoid is recommended for consecutive three months starting at three months of age of the infant.

Treatment- Of the different medicines, Bell (Belladonna) 6, Dros (Drosera) 6 and Aralia (Aralia Racemosa) 6 are some of the medicines used most frequently. Each of them is administered three times daily, giving a gap of at least one hour between two different medicines. The medicines should be continued for at least one week or till cough persists. Then gradually the medicines should be stopped. If there is associated chest congestion, Ant.t (Antimonium Tartaricum ) 6 should be used thrice daily along with the above medicines.

Labels- Epilepsy, Bronchitis, Lobar pneumonia, Atelectasis, Rectal prolapse, Paralysis, Ulcer, Rhinorrhoea, Conjunctivitis, Retardation, Blindness, Deafness Polymerase chain reaction (PCR), Tetanus toxoid, Diphtheria, ELISA.etc.

Some aspects of Mumps with homoeopathic mode of treatment

Mumps is an acute, highly infectious disease of childhood caused by mumps virus, a RNA virus belonging to the family of paramyxoviruses which has a predilection for glandular and nervous tissues. The virus is antigenically stable and only one serotype exists. Humans are the only natural hosts. No human carriers or animal reservoirs exist. One attack confers lasting immunity and so second attacks are not seen. Introduction of aggressive immunization has dramatically reduced the incidence of the disease in the developed countries.

Age- Although no age is exempt, it is primarily a disease of childhood and young adults it is uncommon before 2 years of age. It often occurs as epidemics in children of 5-15 years as well as in young people living in groups as in army camps.

Spread of infection- This infection spreads by direct contact, airborne droplets or fomites contaminated with saliva and possibly also with urine.

Source of infection- The source of infection is a patient in the late incubation or early clinical stage of illness. The peak infectivity is about a day or two before the clinical manifestation of parotitis and subsides rapidly thereafter.

Incubation Period- Long and is about 12-25 days, average being 18 days.

Clinical Features- The prodromal symptoms are non-specific and include fever, malaise, headache and anorexia usually followed by severe pain over the parotid gland with its swelling. Sometimes parotid gland swelling may be the first clinical manifestation of the illness. Parotid swelling is unilateral to start with but may become bilateral. There is stiffness of jaw, inability to open the mouth. Dryness of the mouth with foul smell is also present. There is local pain and tenderness over the parotid gland region. There is also tenderness over the posterior ramus of the mandible. The swelling of the soft tissue may proceed downwards. The enlarged parotid glands obscure the angle of the mandible and may elevate the ear lobe. The parotitis is non-suppurative and usually resolves within a week. Rarely only the submandibular gland involvement may occur.

Complications- The most commonest complication is orchitis. It is usually unilateral but may also be bilateral when it may cause sterility due to testicular atrophy. Other less common complications are arthritis, oophoritis, nephritis, pancreatitis, thyroiditis and myocarditis. Besides these, central nervous system involvement is very often seen; it may cause ‘aseptic meningitis’ as well as meningoencephalitis in some cases. But both of these usually resolve without sequelae. A portion of patients with central nervous system involvement involvement may not show any evidence of parotid gland involvement.

Laboratory Investigations- A typical case of mumps does not need any laboratory investigation for confirmation. Laboratory investigations are needed for atypical cases.

(1) Blood Examination- Some non-specific findings may be present in the blood. The WBC may be low with lymphocytes predominating. ESR and CRP may be normal or slightly elevated. Serum amylase levels may be elevated even without pancreatic involvement.

(2) Virus Isolation - Virus can be isolated in cell culture from saliva, throat swab, urine and CSF and virus identification can be performed by neutralization or inhibition of haemadsorption by specific sera.

(3) Serologic test- Positive serologic test for serum mumps IgM antibody or four-fold rise between acute- and convalescent-phase titers in serum mumps IgG antibody level may help in the establishment of the diagnosis of the disease.

(4) Reverse transcription polymerase chain reaction (RT- PCR) Test - Detection of viral RNA by this test is also helpful for confirmation of the diagnosis.

Prophylaxis- Active immunization with a live attenuated mumps virus vaccine given as a single dose can prevent the disease in children over the age of 1 year, below which age the vaccine is not recommended as it may be inhibited by maternally acquired antibodies. The vaccine is not to be given to immunosuppressed individuals or to those with severe febrile illness and also during pregnancy.

Treatment- Homoepathy plays a vital role in the treatment of mumps. Isolation of the patient and proper maintenance of oral hygiene are the first things to be borne in mind. Of the medicines, Bell ( Belladonna) 200 and Rhus.tox (Rhus Toxicodendron) 200 are to be taken alternatively at an interval of three hours between the two medicines three times daily. This should be continued for one week. Then at least for the next two weeks, both the two medicines should be continued two times daily with the gap between them increasing to not less than four hours. If there is associated throat pain, Phytolacca 200 should be added along with four times daily till the pain persists. If temperature is present, Ferrum.Phos 6x should also be given three times daily along with the main medicines.

Labels-Anorexia, Fever, Headache, Immunization, Virus, Ferrum.Phos, Bell ( Belladonna), Reverse transcription polymerase chain reaction (RT- PCR) Test, Attenuated, Isolation, Rhus.tox (Rhus Toxicodendron), Medicine, Swelling, Temperature, Serologic test, IgM, IgG, Acute, Convalescent, Antibody, Arthritis, Oophoritis, Nephritis, Pancreatitis, Thyroiditis, Myocarditis.

IN SHORT-Mumps is an acute, highly infectious viral disease of childhood which begins with non-specific symptoms like fever, malaise, headache & anorexia and is soon followed by severe pain over the parotid gland with its swelling. The parotitis is non-suppurative and usually resolves within a week. The disease may be associated with several complications the most important of which is orchitis. Prevention is done with active immunization with a live attenuated mumps virus vaccine. Treatment is as mentioned above.

But in every case a doctor should be consulted।

Some aspects of Measles with homoeopathic mode of treatment -

Measles is an acute, highly infectious disease of childhood occurring worldwide and is caused by measles virus, a RNA virus belonging to the family of paramyxoviruses. The virus is antigenically uniform. Humans are the only natural hosts. One attack confers solid immunity and second attacks are uncommon. Introduction of aggressive immunization has dramatically reduced the incidence of the disease in the developed countries but it is still now a very common disease of childhood in the developing countries. Although it is a relatively mild disease in the healthy child, it carries a high mortality in the malnourished as well as in those with other diseases. In the nonimmune, infection almost always causes clinical manifestation.

Age- Peak incidence is in young children between 1-5 years of age. It is rare in first six months of life due to the presence of maternal antibody.

Season- Epidemics occur mostly in late winter and early spring, with a peak in April.

Spread of infection- This infection spreads by droplet during the prodromal stage and in early eruptive stage. Infectivity is maximum at the prodrome and diminishes rapidly with the appearance of rash. It starts from 3 days prior to the onset of symptoms and lasts until the rash desquamates.

Pathogenesis-The virus enters the body through the respiratory tract or the conjunctiva and multiplies locally as well as in the adjoining lymph nodes. The virus spreads to the reticuloendothelial system via blood where it multiplies and then a secondary viraemia carries the virus to the epithelial surfaces including the skin, mouth, respiratory tract and conjunctiva.

Incubation Period- 8-14 days.

Clinical Features- The course of the disease is divided into two distinct phases-

(1) The infectious pre-eruptive and catarrhal stage-
This is the stage of viraemia and viral dissemination and lasts for about 4 days. There are sudden onset of malaise, acute fever, rhinorrhoea, cough, conjunctivitis, photophobia and hoarseness of voice. The cough is hacking and occasionally painful. After 3-4 days of prodromal illness, the rash which is a characteristic of the next stage appears and a day or two before the onset of rash, the pathognomonic Koplik’s spots develop. Koplik’s spots are tiny whitish irregular spots against a reddish background characteristically around the opening of the parotid duct opposite the second molar teeth. Koplik’s spots may occasionally develop on the conjunctiva and the intestinal mucosa. On the 3rd day the temperature usually comes down to a low level and is so known as day of remission.

(2) The non-infectious eruptive or exanthematous stage- This stage is characterized by the appearance of a maculopapular rash which appears usually on the 4th day and initially occurs on the face, mainly on the forehead and behind the ears at the junction of skin and hair. It then spreads rapidly to involve whole of the body, including palms and soles. Initially they are discrete, pink in colour, blanch on pressure but later it become confluent and patchy, particularly on the face and neck. It fades in about a week in the same sequence, leaving behind a brownish discolouration of skin and areas of desquamation. The rash represents an immune reaction between T lymphocytes and cells in which viral replication is going on. During this stage, there is again a high rise of temperature with puffiness of face, headache, cough, photophobia and myalgia. Lymph nodes may also enlarge.

Complications- Although most patients recover uneventfully, a few may develop complications which are due to secondary bacterial infection or to the virus itself and are found in those who are malnourished or have other diseases. Complications include bacterial pneumonia, bronchitis, otitis media and gastroenteritis. Rarely the virus may cause fatal giant cell pneumonia. Less common complications are myocarditis, hepatitis and encephalomyelitis. A rare late complication is subacute sclerosing panencephalitis. Protracted diarrhea may also occur as a complication in children in poor countries. Maternal measles may cause spontaneous abortion and premature delivery.

Laboratory Investigations-

(1) Blood examination -Blood examination shows leucopenia or normal count. Leucocytosis may be seen with secondary bacterial infection.

(2) Immunofluorescence-Detection of measles virus antigen by immunofluorescence in multinucleated giant cells which may be demonstrated in Giemsa stained smears of nasal secretions may be used to confirm the diagnosis. This is very simple and may be used a diagnostic test even before the appearance of rash.

(3) Serological tests- Serological tests like complement fixation test( CFT), haemagglutination inhibition test etc may also be used to confirm the diagnosis. High titre measles antibody if can be demonstrated in CSF is diagnostic of subacute sclerosing panencephalitis, a rare and late complication of measles.

(4) Virus culture- Virus culture may also be used to confirm the diagnosis.

Prophylaxis-Normal human gammaglobulin administered within 5 days of exposure can prevent or modify the disease. This is particularly valuable in previously unimmunized children below the age of 3 years, children with immunodeficiency, during pregnancy and others at special risk. Active unimmunization may be done with single antigen measles vaccine or with combined vaccine, MMR.

Treatment- Bry. ( Bryonia) 30, Kalibich. (Kali bichromicum) 6 or 30, Puls. (Pulsatilla) 30 etc are some of the medicines used most frequently. The dose administered and the frequency maintained depends on the state of condition and the severity of the disease. Bryonia is the prime medicine. It is especially useful in fever with dry cough as well as in fever with internal heat. If there is associated cough, Kalibi is to be added. If there is any abdominal distress or diarrhoea, Pulsatilla should be used in addition to Bryonia.

Labels-Abortion, Antibody , CFT, Epidemics, Gammaglobulin, Giemsa Stain, Haemagglutination, Inhibition Test, Immunodeficiency, Immunofluorescence, Serological Test, Viraemia, Bry. ( Bryonia), Kalibich. (Kali bichromicum) , Puls. (Pulsatilla), Sclerosing panencephalitis, CCF , Otitis media, Gastroenteritis, Peumonia, Bronchitis, Giant Cell, Myocarditis, Hepatitis, Encephalomyelitis.

IN SHORT-Measles, an acute, highly infectious disease of childhood is caused by measles virus, a RNA virus & begins with sudden onset of malaise, acute fever, rhinorrhoea, cough, conjunctivitis, photophobia and hoarseness of voice. The disease is characterized by the appearance of the pathognomonic Koplik’s spots which is soon followed by the appearance of a maculopapular rash. The disease may be associated with some complications which are due to secondary bacterial infection or to the virus itself. Prevention may be done with active unimmunization with single antigen measles vaccine or with combined vaccine, MMR. Treatment is as mentioned above.

But in every case a doctor should be consulted.

Some aspects of Influenza with homoeopathic mode of treatment -

Influenza is an acute infectious disease of the respiratory tract which occurs in sporadic, epidemic and pandemic forms. It is caused by the Influenza virus which is a RNA virus and belongs to the family of Orthomyxovirus and has the unique ability to undergo antigenic variation. The route of entry is the respiratory tract. Though the disease is generally confined to the respiratory tract, very rarely it may spread to some other organs. The virus is classified into three serotypes, A, B and C, based on the antigenic nature of the ribonucleoprotein antigen. Influenza B is associated with localized outbreaks of milder nature such as in camps, whereas Influenza A is the cause of worldwide pandemics and epidemics. Influenza C rarely produces disease in humans. Influenza also occurs in animals and birds in nature. But isolates from nonhuman hosts belong to type A. Influenza viruses belonging to B and C types are exclusively human viruses and have not been found to be associated with infection in animals and birds. The unique ability of the virus to cause epidemics and pandemics is due to the frequent antigenic variations in it. Major shifts in the antigenic structure of influenza A form the essential conditions for pandemics. On the other hand, minor shifts in the virus results in less severe epidemics. A major reservoir of influenza virus is believed to exist in animals and birds and the source of infection is usually a clinical case or a sub-clinical case.

Spread of infection- Spread is mainly by droplet infection but fomites and direct contact may also be the cause.

Incubation Period-1-3 days.

Onset- Sudden.

Clinical Features- Most of the cases are sub-clinical. The disease varies in severity from a mild coryza to fulminating and rapidly fatal pneumonia. There is high rise of temperature all on a sudden with shivering and generalized aching in the limbs. This is associated with severe headache, soreness of the throat and a persistent dry cough that may last for several weeks. Abdominal pain and vomiting may also occur, especially in type B infection in children. There may be mild conjunctivitis and nasal congestion may or may not be present. During acute stage of the disease there may be flushing of the face and the pulse shows tachycardia. But all these symptoms usually disappear within a few days, an uncomplicated case usually resolving within 2-7 days, except asthenia which persists for several days or weeks.

Complications- Secondary bacterial infection, particularly with Strep.pneumonia and H. influenza is often found. The most important one is pneumonia which is rarer and is caused by Staph.aureus or very rarely by the virus itself. Cardiac complications like congestive cardiac failure (CCF) or myocarditis and postinfectious encephalomyelitis may also rarely occur after infection with this virus.

Prophylaxis- Protection by influenza vaccine is not always successful and is of short duration, lasting for about a year. The major problem is the frequent change in its antigenic make up. Hence new vaccines are to be prepared each time to cover each change in antigenicity of the virus which is a great hindrance to the fight against an outbreak of influenza at the very beginning.

Treatment- Besides bed rest, the following homeoeoathic medicines may be used-
Bry (Bryonia) 30, Bell ( Belladonna) 6, Rhus tox ( Rhus Toxicodendron) 30, Eup.perf (Eupatorium Perfoliatum) 6 or 30 should be used separately one after another at an interval of usually ½ to 1 hour several times in a day depending on severity and nature of the condition. Bryonia is especially useful in fever with pain stitching and or tearing in nature as well as in fever with dry cough. Belladonna is particularly useful in a high feverish state with mild or no signs of toxaemia. It may also be used effectively when there is distension of superficial blood vessels. Rhus tox 30 acts better in chill with dry cough and or restlessness. It is particularly useful when the bowels are loose. Eupatorium Perfoliatum is particularly useful in fever with much frontal ache but without thirst during chill and also in bone pains. For high fever, Ferrum Phos 6x should be used repeatedly in between the above four medicines. If there is any chest congestion, Antim. tart ( Antimonium tartaricum) 6 may be used several times depending on severity of the condition. Lach. ( Lachesis) may be tried in presence of hot flushes and hot perspiration.

Labels-Antim. tart ( Antimonium tartaricum), CCF, Encephalomyelitis, Eup.perf (Eupatorium Perfoliatum), Lach. ( Lachesis), Myocarditis, Pandemic, RNA., Sporadic, Staph.aureus, Ferrum Phos, Chill, Toxaemia, Bry (Bryonia) , Bell ( Belladonna) , Rhus tox ( Rhus Toxicodendron) , Chest, Congestion, Blood vessel, Strep.pneumonia, H. influenza, Orthomyxovirus, Serotype, Epidemic, Ribonucleoprotein, Antigen.

IN SHORT-Influenza is an acute infectious disease of the respiratory tract caused by the Influenza virus which is manifested by a sudden high rise of temperature with shivering and generalized aching in the limbs & is also associated with severe headache, soreness of the throat and a persistent dry cough that may last for several weeks. It may be complicated by secondary ingection. Protection by influenza vaccine is not of much value due to the frequent change in its antigenic make up. Treatment is as mentioned above.

But in every case a doctor should be consulted.

Some aspects of Herpes Zoster infection ( shingles) with homoeopathic mode of treatment-

This infection usually represents the re-emergence of varicella zoster virus (VZV) from posterior nerve roots in the spinal cord or cranial nerves into the skin, the original infection having been acquired in an attack of chicken pox many years previously usually in the childhood. VZV is a DNA virus that infects only humans and produces two distinct diseases in man- varicella ( chicken pox) and herpes zoster ( shingles) among which chicken pox is the primary infection occurring usually in the childhood. Chicken pox is the primary infection in the non-immune host. It almost never occurs twice in the same individual. The virus then remains latent in the dorsal root and cranial nerve ganglia for the rest of the life. If immunity is impaired which occurs in elderly persons, the virus replicates and migrates along the sensory nerves to the skin or eye causing the lesions of zoster. Shingles is never the direct result of a primary infection. Patients with chicken pox or shingles are infective, the virus being spread from fresh skin lesions by direct contact or airborne transmission and causing chicken pox in susceptible individuals.The disease affects individuals in their middle years or old age. Factors causing re-emergence of the virus are often ill understood and probably may represent changes in the immune state of the host.
In the cranial nerves herpes zoster has a predilection for the fifth and seventh nerve.

Age- Old age, being common after the age of fifty years.

Incubation Period- About two weeks.

Clinical Features- It produces an identical skin lesion to chicken pox, although classically it is unilateral and restricted to a sensory nerve (dermatomal) distribution, thus respecting the midline. But inflammatory oedema may cross the midline, giving the erroneous impression of bilaterality. General symptoms include fever, malaise, swelling of lymph nodes etc, which may precede the development of pain. The first specific symptom is pain in the segmental distribution of the nerves involved and is burning or shooting or cutting in character associated with hyperaesthesia or hyperalgesia over the affected cutaneous segments. Within a few days this is followed by appearance of erythema initially and later on vesicles containing clear fluid and papules or bullous lesions. These eruptions are distributed over the cutaneous segments of the affected nerves. The vesicular eruption is accompanied with much swelling and tenderness. The lesions vary in distribution, density and severity. They may be small, discrete and scattered or large, confluent and deep with haemorrhagic bullae. In course of time the vesicles are dried up leaving behind permanent scars on the skin. Unusual site of involvement such as sacral nerve disease may give rise to visceral changes which may lead to, for example, bladder dysfunction.

Clinical variants-

(1) Zoster of the limbs and trunk-This is the usual type where the posterior root ganglia of the spinal nerves are involved.

(2) Geniculate zoster- This is herpes zoster of the geniculate ganglion causing facial palsy identical to Bell’s palsy with herpetic vesicles on the external auditory meatus, pinna and sometimes on the soft palate. Deafness may also be there.

(3) Ophthalmic zoster- This involves the ophthalmic division of the fifth cranial nerve. There may be keratitis, anterior uveitis, conjunctivitis, scleritis, episcleritis, acute retinal necrosis. There may be cranial nerve palsies of which third nerve palsy is the most common but palsies of fourth, sixth and seventh cranial nerves, though uncommon, may occur.

(4) Generalised zoster- In rare cases there may be scattered eruptions all over the body.

Complications- These are secondary infection, very rarely purpura and necrosis in the affected segment and postherpetic neuralgia.
Postherpetic neuralgia - Postherpetic neuralgia is intractable pain in the zone of the previous eruption after the subsidence of the vesicles. It occurs in some 10% of patients who are often elderly. It is a burning, continuous pain responding poorly to any treatment and depression is almost always associated with.

Treatment- There are lots of medicines for herpes zoster. A few of them are described below-
Dolich ( Dolichos puriens ) may be used in case of intense itching. It is particularly useful in postherpetic neuralgia. Croton tig (Croton tiglium) 6 or 30 potency is useful especially in pustular eruptions on face where there is intense itching but scratching is painful. It is also useful in herpes with eye symptoms. Semperv.t (Sempervivum Tectorum) is also recommended for herpes zoster. But Cantharis 6 may be recommended as the drug of choice if there is burning sensation with or without itching. And in general Rhus.tox ( Rhus Toxicodendron) 30 should be used. Locally cantharis ointment or lotion may be used.

Labels-Croton tig (Croton tiglium), Dolich ( Dolichos puriens ), Keratitis, Postherpetic neuralgia, Purpura, Rhus.tox ( Rhus Toxicodendron), Semperv.t (Sempervivum Tectorum), Cantharis, Ointment, Lotion, Conjunctivitis, Scleritis, Episcleritis, Retinal necrosis, Uveitis, Geniculate ganglion, External auditory meatus, Pinna, Soft palate, Segment, Facial palsy, Purpura, Hyperaesthesia, Hyperalgesia .

IN SHORT- Herpes Zoster is a viral disease usually occurring in old man due to the re-emergence of varicella zoster virus (VZV) from posterior nerve roots in the spinal cord or cranial nerves into the skin. It usually occurs in persons who had chicken pox several years earlier. General symptoms include fever, malaise, swelling of lymph nodes etc followed by pain burning or shooting or cutting in character restricted to a sensory nerve (dermatomal) distribution and associated with hyperaesthesia or hyperalgesia over the affected cutaneous segments. Within a few days this is followed by appearance of skin eruptions which are usually unilateral and confined to the area supplied by a single sensory ganglion. The commonest sites are the areas innervated by spinal cord segments from third thoracic to second lumber and the trigeminal nerve, particularly its ophthalmic branch. The eruptions heal in about two weeks but pain and paresthesia of the affected area may persist for weeks or months. Of the complications, postherpetic neuralgia is very important. Treatment is as mentioned.

But in every case a doctor should be consulted. Signs including swelling of the eyelid, conjunctivitis or blistering at the site of the nose should seek the attention of an ophthalmologist.