ADENOID

               ALLERGIC RHINITIS

Allergic rhinitis is a common disorder which is characterized by spasmodic attacks of severe sneezing and nasal discharge. It affects young adults from the age of 15 onward, and also both sexes are affected.

The predisposing factors

Heredity is a main factor. If both parents are allergic, the risk of allergic rhinitis in children are high.

Hormonal factors.

Climate-humidity and atmospheric factors play an important role.

Emotional factors-psychological factors also have a role in allergic rhinitis.

Precipitating factors can also be-

1. External factors like-inhalants which can be dust, pollen, feathers, animal odor.

Food like eggs, fish, milk, citrus fruits.

Cosmetics and powders.

Irritants like fumes and smoke.

Infection like bacterial and fungal.

2. Factors within the body like -

Intestinal helminthes (worm infestations)

Tissue proteins.

Clinical features

Irritation in the nose is the starting symptoms.

Recurrent paroxysmal sneezing which exhausts the patient.

Copious watery discharge from the nose

Nasal obstruction due to venous stasis.

Anosmia (Loss of smell)-may be temporary or continuous.

Headache may be present.

Signs

Acute stage- the mucous membrane becomes pale with excessive watery secretions.

Chronic stage-the nose may appear to be normal or the mucosa is bluish or purplish due to venous stasis

Infection may occur along with it.

Polyps may be present.

Allergic salute-due to irritation to the nose with watering the patient frequently lift the tip of the nose upwards with palm. This is known as the salute sign.

Itching of the eyes, throat and ear. There may be a middle ear problem.

Asthma may be present.

CLINICAL TYPES

1. Seasonal- hay fevers due to pollen grains occur at the time of pollination.

2. perennial-affects the patient throughout the year.

Treatment

Keep away from triggering factors as mentioned above for a period of time.

Homeopathic treatment.

Since we cannot avoid some triggering factors like smoke and dust, complete cures with homeopathic medicines need a long time.

Medicines have to be changed frequently depending up the present symptoms, because symptoms' changes to the change of seasons, and also the type of predisposing factors. Once the acute symptoms' are controlled very well then the next step is to change the medicines to miasmatic level. Medicines like Ars alb, sabadilla, histamine, bromium , lemna minor, allium cepa  are used frequently to control the acute episodes. This is followed by medicines like thuja, tuberculinum, sulphur, psorium etc; as deep acting miasmatic remedies. However, as long the patient is still in the surroundings of precipitating factors, complete cure is difficult.

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     SINUSITIS

Sinusitis is the inflammation of the tissues lining the sinus. It may be acute or chronic. The most frequently infected sinus is the maxillary sinus. And frontal sinus and ethmoidal sinus are affected less frequently.

ACUTE MAXILLARY SINUSITIS

The maxillary sinus is in close relation to teeth, and it opening is slightly at a higher level. And due to this the drainage of mucous is inadequate.

Maxillary sinusitis may affect at any age group starting from 5 years of age.

The main predisposing factors are.

1-   Common cold and influenza.

2-   Nasal obstruction due to deviated nasal septum, polyp, enlarged turbinates, will obstruct the drainage of sinus and thus there is stagnation of the mucous in sinus, which results in infection.

3-   Due to allergic rhinitis, there is also blocking of the nose which affects the proper drainage from sinus.

4-   Forcible blowing through the nose forces the infection from nose to sinus.

5-   Swimming also causes maxillary sinusitis.

6-Dental infection-Infected upper molar and premolar may lead to maxillary sinusitis.

Chronic tonsillitis and adenoids may act as predisposing factors.

Atmospheric pollution, especially dust may cause sinus infection.

Causative organisms.

Bacteria or virus may cause infection.

Symptoms.

Pain may radiate to teeth, ear, and frontal sinus. Coughing, sneezing, bending forward may aggravate the pain.

Nasal discharge-initially mucoid, later become purulent and bloody. Foul smelling discharge suggests the possibility of dental infection.

Dry cough- due to postnasal discharge, there may be dry cough.

In severe infection, there is bleeding from the nose.

Along with these symptoms, there is fever malaise, chilliness and body pain.

On examination, there may be tenderness in the maxillary sinus.

CHRONIC MAXILLARY SINUSITIS

In chronic maxillary sinusitis, the pain and tenderness are absent. All other features are similar to acute infections.

There may be hyposmia (reduced ability to smell and detect odors) and cacosmia (hallucination of a disagreeable odor).

ACUTE FRONTAL SINUSITIS.             

It is less common than maxillary sinusitis.

Unlike maxillary sinusitis, dental infection won’t cause a frontal sinusitis.

But maxillary sinusitis may cause frontal sinusitis.

Signs and symptoms.

Pain- may radiate to front side of the forehead.

Pain is worse during the morning hours and better during the day.

Tenderness over the root of the nose will be present.

Along with these, there is fever, malaise, body pain, etc.

CHRONIC FRONTAL SINUSITIS.

In chronic sinusitis, the pain and tenderness may be mild or absent.

All other features same as acute frontal sinusitis.

Treatment

Homeopathic medicines are very and effective in the treatment of acute as well as chronic sinusitis. Irrespective of whether acute or chronic, and irrespective of sites homeopathic medicines help to root out the tendency. As usual, the treatment strategy is that the acute infection is controlled by medicines selected by acute simillimum and then the treatment is followed by deep acting constitutional remedies.

There is a tendency in certain patients to recur; a prolonged treatment is needed for the complete cure.

The main remedies are Kali bich, Silicia, Merc sol, Psorinum, etc.

Dr Akbar has developed a special protocol in the treatment of sinusitis. And in experience, this protocol result is very promising.

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               ACUTE TONSILLITIS

Acute inflammation of the tonsils is one of the most common conditions encountered in day to day practice. Tonsils are known as the policemen of the throat because they prevent the infection from going down.

It occurs frequently up to the age of 15 years, and both sexes are affected equally.

Predisposing factors

a) Pre existing chronic tonsillitis

b) Pre existing upper respiratory tract infection

c) Postnasal discharge due to sinusitis

d) General lowering of the resistance

e) Taking  cold drinks or foods

f). The infection may be contacted from other individuals having infection

c) Pollution and crowded ill ventilated environment

d) Embedded foreign body.

Symptoms

Raw sensation in the throat is the first symptom.

Pain in the throat aggravated by swallowing, and pain may be referred to ear.

The child may refuse to eat to eat-because of odynophagia (painful swallowing)

Voice may be thick and muffled due to thick secretion.

Fever, headache, and tachycardia.

Duration of acute tonsillitis may be 4 to 6 days.

Signs

1) Tonsil becomes congested and swollen.

2) Secretions increase and become tenacious.

3) Movements of the palate become impeded due to pain.

4) Halitosis- Foul breath may be present.

5) Jugulodiagastric lymph nodes may become enlarged and tender.

CHRONIC TONSILLITIS

It is one of the commonest chronic infections characterized by recurrent acute attacks.

Symptoms

1) Recurrent pain in the throat

2) Cough

3) Halitosis due to the cheesy material in the tonsillar crypts.

Signs

1) Appearance

  Chronic parenchymatous tonsillitis- characterized by hypertrophied tonsils.

  Chronic follicular tonsillitis- where the tonsils are normal or small and fibrotic. There may be yellowish cheesy debris. It often occurs in adult.

2) On squeezing the tonsils pus may ooze out.

3) Retension cyst: seen on the surface of the tonsils. They appear as cystic yellowish swelling containing yellow liquid.

4) Persistent enlarged jugulodigastric lymph nodes.

Complications-

Tonsillar abscess may occur in adult.

Infection may spread to ear causing acute middle ear infection.

The bacteria may invade the heart causing bacterial endocarditis, or may aggravate rheumatism, and acute inflammation of kidney-nephritis.

Treatment

General treatment

In mild case fruit juices and vitamins may help.

Tonsillectomy is the method of choice in chronic tonsillitis in modern medicine.

Homeopathic treatment.

Out of my long years of experience, it is clinically verified that homeopathic treatment is highly effective not only to control the acute infection, but also to prevent the recurrence. In majorly of the cases surgery can be avoided.

And after a few months of treatment, the patient can very well enjoy the ice cream and cold drinks and foods.

The commonly prescribed medicines for acute tonsillitis are merc sol, belladonna, aconite, hepar sulph, silica etc;

Once the acute infection is controlled next aim is to prevent recurrence, for that medicines like psorinum, tuberculinum, syphyllinum etc. are used.

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            DEVIATED NASAL SEPTUM (DNS)

Deviation of the septum occurs very frequently, but it requires treatment only if it produces symptoms.

1) Usually, it starts around puberty and fully develops by the age of 20yrs.

2) Both sexes are affected.

3) Heredity may be a cause.

4) Septum should grow at the same rate as that of face, if the septum starts growing at a rapid rate, it becomes buckled to accommodate itself. This is the common cause.

3) High arched palate- lack of descent of the palate causes buckling of the septum.

6) Congenital- abnormal intrauterine posture results from compression of nose and upper jaw.

7) Trauma may cause DNS.

Symptoms

1) Asymptomatic-only deviation of the septum but no symptoms

2) Blocking of the nose

3) Headache: It may be due to sinusitis.

4) Recurrent colds

5) Bleeding from the nose

6) Loss of smell

7) Deformity of the external nose.

Signs

1) External nose may be deformed.

2) Anterior rhinoscopy reveals the deviation of the nasal septum.

3) Posterior rhinoscopy shows no abnormality.

Complications

1) Recurrent sinusitis

2) Middle ear infection

3) Mouth breathing

4) Asthma

5) Atrophic rhinitis

Treatment

The conventional treatment is septoplasty. This is done only if the patient is suffering from recurrent or persistent symptoms.

Homeopathic treatment

Homeopathy can very well control the symptoms and complications.  Recurrence of symptoms can be controlled by homeopathic medicines. However, the deviation being a defect the septal correction can be done only through surgery. As seen from clinical experience, the septoplasty alone will not prevent the symptom recurrence. The patient may feel relived for a few months after septoplasty, but symptoms will slowly begin to reappear. Even so,  after surgery by prescribing correct homeopathic medicines the symptoms and prevention of complication can be guaranteed.

Usual medicines are ars alb, calc flour, silicia, tuberculinum, sangunaria etc. are the medicines usually prescribed.

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       EPISTAXIS

Epistaxis is the bleeding from the nose. The blood loss may range from few drops to massive loss.

Epistaxis may be due to -

Disorder from birth itself- Haemangiomas in the nose is the main cause.

Epistaxis may also due to a trauma or injury to nose or paranasal sinus, or head itself.  Here the bleeding stops within a short time.

After any operation on the nose or paranasal sinus may also cause epistaxis.

Boring or picking the nose is one of the main causes of epistaxis. There is a vulnerable area in the nose called Little’s area where the blood vessels are situated superficially (submucosally), so slightest trauma or picking results in bleeding from the nose.

Barotrauma (changes in air pressure) also causes epistaxis.

Epistaxis may also be due to inflammatory causes like.

1-nasal diphtheria –in children blood stained discharge from both nostrils in children. Presence of diphtheria bacteria- Corynebacterium diptheria in the smear confirms the diagnosis.

2-inflammation of the vestibules of the nose or a furuncle in the vestibule may cause epistaxis.

3-acute sinusitis or rhinitis also may cause epistaxis.

4-inflammation of the adenoid may cause congestion in the nose, and it may result in epistaxis.

5-chronic inflammation like chronic sinusitis, chronic rhinitis and severe case of atrophic rhinitis also causes epistaxis.

6- Rhinisporidiosis syphilis, tuberculosis, leprosy may also cause bleeding from the nose.

7-Malignancy of the maxillary sinus or ethmoidal sinus also causes bleeding from the nose. Bleeding from the nose, especially one-sided in an elderly patient should be investigated to rule out malignancy.

8-Foreign bodies - insertion of the foreign body, especially in a child is a main cause of bleeding from the nose. Blood-stained discharge from one side of the nose with a foul smell in a child should raise the suspicion of a foreign body in the nose. Removal of the foreign body may cause bleeding but only for a short duration.

9-Systemic causes like hypertension, bleeding disorders also cause epistaxis,

10-Infection may cause epistaxis. Influenza, measles, rheumatic fever, typhoid may also cause epistaxis.

11-In many cases no cause for epistaxis is detected even after thorough investigations.

Treatment

General treatment

Apply ice or cold pack on the bridge of the nose.

Pinching the nose for a while may stop bleeding, if the bleeding is from Little’s area.

Homeopathic treatment.

Homeopathic treatment is based on the cause of the disease plus considering   the mental and physical characteristics in chronic cases.

If it is due to foreign body removal of the cause is the primary aim and the bleeding if occur after the removal can be managed by medicines like Hamamelis, Arnica, etc.,

If due to infections, inflammations the basis causes are treated by medicines selected by the present symptomatology and location and site of the cause of the disease. Sometimes, the acute infection may subside and in certain patients, there is a tendency to recur the infection, like sinusitis, the constitutional medicines come into play.

The overall result is very favorable to homeopathic medicines.

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       NASAL POLYP

A nasal polyp is a fleshy growth from the edematous mucosa of the nose or the paranasal sinuses.

TYPES OF POLYPS

1. Antrochoanal it arises from the maxillary sinus and grows backwards and reaches the nasopharynx.

2. Ethmoidal- they are multiple bilateral and arise from the ethmoidal sinuses. They protrude forward.

Causes  

Antrochoanal polyps usually occur in children and young adults. Ethmoidal polyps occur at any age.

Predisposing factors-

1. Ethmoidal polyps are usually of allergic origin.

2. Infection-it may produce polyps, which are single or multiple.

4. Mixed-a combination of factors mentioned above may be responsible for polyps.

Clinical features

1. Blocking of the nose -the nose becomes blocked and is not relieved by nasal decongestion drops.

2. Allergic polyp causes sneezing.

3. Discharge-purulent discharge may be present with infection. But clear mucous discharge is from the allergic polyps.

4. Expansion of the nose. Due to increase in size of the polyp, there is an expansion of the nose.

5. Loss of smell is usual with the polyp.

6. Due to obstruction by the polyp, there will be Snoring and mouth breathing.

7. Headache, and postnasal  drip are rare.

8. Speech may be hyponasal.

Signs

1. External nose may be broadening in long standing polyps giving a frog like appearance.

2. The polyps are smooth, pearly white, pale and pulpy, and they are painless on touch.

3. Antrochoanal polyp may be seen hanging in the nasopharynx.  If it is very large, it is visible in the oral cavity as a pear shaped swelling, hanging behind the soft palate.

Investigation.

X ray paranasal sinus-the polyp can be seen as opaque mass in concerned areas.

CT paranasal sinus

Polyp has to be differentiated from turbinates. Turbinates are pink, and painful on touch, and they shrink once the allergy is over.

Rhinosporidiosis-it bleeds on touch and usually gets after bathing in ponds and rivers.

Angioma –it is single, smooth red growth, which bleeds easily.

Treatment-in modern medicine removal of the polyp-polypectomy- is the treatment of choice.

But chance of recurrence is high as seen in clinical practice.

Homeopathic treatment

Homeopathic medicine act constitutionally and hence to root out the tendency for polyp formation homeopathy has got a promising role.  Even after the surgery there is a chance of recurrence, which indicates the basic cause for the polyp is still operating within the body. This tendency can only be removed by a medicine that acts deeply in the constitution of the body. Hence homeopathy has a curative as well as the preventive role in the treatment of a polyp.

To know about the treatment

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               HOARSENESS OF VOICE

Hoarseness of voice occurs due to lesions of the vocal cord.

For hoarseness of voice to occur, the movements of the vocal cord should be affected.  There may be some mass on vocal cords, or due to tension of the vocal cords.

In hoarseness of voice the voice become rough, and unpleasant,

The voice may be muffled if there is a mass on vocal cord. In such case, the person speaks as if he has a hot potato in his mouth, which is neither being swallowed nor being spat out.

In paralysis of vocal cord, the air escapes between the paralyzed vocal cords and the voice become a breathy voice.

Causes of hoarseness of voice

Hoarseness may be congenital due to congenital cyst and tumours in the larynx.

Hoarseness may be also due to -

1-Over use or misuse of voice as in continuous speech or loud speech. This is the common cause of hoarseness. Moreover, singing in an improper manner and excessive coughing will cause hoarseness. It is due to injury of the vocal cord.

2-External injuries like contusion injuries to the larynx, or cut throat, etc.

Irradiation may damage the vocal cords.

3-Common cold may cause hoarseness. It is due to bacterial or viral infection causing laryngitis. It is the commonest cause of hoarseness.

4-Membrane formation on vocal cord in diphtheria produces hoarseness.

5-Chronic laryngitis also is the main cause of hoarseness of voice.

6-Benign tumors like cyst, chondroma, and fibroma also cause hoarseness, but rare.

7-Singer’s nodes are the common cause of hoarseness of voice. It is characterized by the formation of nodule on the edges of both vocal cords.

8-Laryngeal oedema due to -

Infection

Trauma

Allergy

Neoplasm

Laryngeal polyp causes hoarseness.

Paralysis of recurrent laryngeal nerve may cause hoarseness.

Investigations

Thyroid function test

X ray larynx

C T scan

Laryngoscopy

Treatment

General treatment

Voice rest-avoid misuse and overuse of voice.  

 Steam inhalation.

Speech therapy is also effective.

Homeopathic treatment

Along with general treatment as mentioned above, homeopathic medicines like Thuja, Calc carb, Calc flour, Arg met, Causticum etc. is the main remedies.

The treatment is based upon the cause, as well as the time of aggravation of hoarseness. And depending up on these and also the miasmatic background, the remedy is selected. And prognosis is very good, and in the majority of cases complete cures without recurrence.

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       LARYNGITIS

ACUTE LARYNGITIS

It is the commonest cause of temporary hoarseness.

Etiology

Acute laryngitis occurs at all ages.

However, in children, it may be due to following reasons.

1. Slight edema or swelling in a child may narrow the lumen of larynx or laryngeal tube.

2. The larynx is more excitable and may develop spasm easily.

3. Cough reflex of the child is weak.

4. Viral or bacterial infection may affect the larynx.

5. Exanthemata makes the larynx susceptible to infection.

6. Sinusitis, tonsillitis or bronchitis may cause inflammation of the larynx.

7. over use of voice

8. Smoke, fumes, alcohol causes irritation in the larynx.

9. Seasonal changes may affect the larynx causing laryngitis.

Symptoms

Hoarseness of voice

A feeling of rawness in the throat

Pain in severe cases

Irritating cough

Stridor

Constitutional symptoms like fever, malaise, body pain may occur.

Signs

 1) The vocal cords become congested, and color may vary from pink to red.

2) Edema may be present.

3) Mucoid discharge from the throat

4) Movements of the vocal cords may be hampered.

CHRONIC LARYNGITIS

Chronic laryngitis is a common condition which is caused by chronic irritation of the vocal cords.

Etiology

1) Occurs over the age of 20 yrs.

2) Common in males.

3) Predisposing factors like

a) Misuse or over use of voice  

b) smoking produce chronic inflammation of the larynx 

c) Atmospheric pollution by dust 

d) Chronic tonsillitis, dental sepsis and chronic paranasal and nasal infection 

e) Hawking and coughing increase laryngitis.

Symptoms of laryngitis

Hoarseness, which is worse in morning hours.

Dry irritating cough

Raw sensation in the throat

Frequent desire to clear the throat worsens the situation.

Signs

The vocal cords remain congested.

The vocal cord becomes edematous.

Secretions from the mucus glands may stick to the vocal cords.

Treatment

General treatment

Voice rest

Stop smoking

Avoid alcohol

Steam inhalation

Homeopathic treatment

Both acute as well as chronic laryngitis can be managed very well by homeopathic treatment.

Acute laryngitis being more common in children and ask to avoid icy drinks for a period and advise them for minimum voice usage.

Acute condition can be managed by medicines like Aconite, Belladona, Rhus tox, Merc sol etc.

And chronic laryngitis usually responds very well by medicines like Causticum, Thuja, Arg nit, Arg met etc.

For treatment contact Dr Akbar through www.onlinehomeocure.com

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TINNITUS

It is an auditory sensation within the ears or head in the absence of any relevant external stimulus to cause it.

It may be defined as the noise in the ear or head. It may occur without any grave illness or may be a warning sign of a serious disorder.

Tinnitus may affect only on one side or on both sides.

TYPES   1) subjective-sound like ringing, whistling or roaring is heard by the patient without the existence of such a sound, it is called tinnitus.

2) objective- tinnitus is not only heard by the patient, but also by the examiner.

Characteristics of tinnitus

1) Tinnitus may be continuous or intermittent, with long or short irregular period of absence.

2) Continuous tinnitus- is present all the time.

3) Fluctuant- tinnitus may vary in intensity. It is more noticed when the patient is alone in silence, or at night, or when he is emotionally disturbed.

4) Pitch of tinnitus may vary-it may be high or low.

 Causes of tinnitus

A) Subjective tinnitus- it includes

a) Tinnitus with deafness - any disease of the ear which can cause deafness may also produce tinnitus 

 b) All general causes of deafness

b) Tinnitus without deafness- anemia, hypertension, hypotension, carious teeth

c) Functional- emotional factors may cause tinnitus

d) Idiopathic –may cause without any cause.

B) Objective tinnitus-causes

a) Clicking temporomandibular joint 

b) Aneurism and arteriovenous shunt around the ear

c) Vascular tumour inside the head

d) Live insects in ear

e) Patulous eustachian tube

Treatment

The man aim is reassurance- that it is not at all dangerous but only a nuisance value.

Surgical treatment is not useful to the majority of the cases.

Homeopathic treatment

The complete cure for the tinnitus needs a prolong treatment. But the overall result is not hundred percent satisfactory. Patients will get marked improvement with homeopathic remedies.

The main remedies are China, Calc flour, Silica, chininum ars etc.

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                                                    VERTIGO AND MENIERE’S DISEASE

Vertigo or giddiness is the disturbance in balance and movements. Here the person feels as if he is rotating himself or his surrounding is rotating around him. In severe case, there are nausea, vomiting, and gastric disturbance.

In human being, the balance is maintained by a mechanism that situates in ear.

Causes of vertigo

Ear wax

Boils

Eustachian tube catarrh

Inflammation in middle ear

Head injuries with fracture of temporal bone

High-pitched sound

Inflammation of the labyrinth

Syphilis

Hypertension

Hypotension

Diabetes mellitus

Hypothyroidism

Hypoglycemia

Whirling movements

Heights

MENIERE’S DISEASE

Meniere’s disease is characterized by vertigo, deafness and tinnitus (noise in ear).

This occurs at an unpredictable time and at irregular intervals. Usually occur after the age of 30.

Meniere’s disease may be due to.

Reduced blood supply to the labyrinth

Emotional causes

Allergy and septic foci may cause.

Clinical features

Sudden, recurrent spells of vertigo with varying intensity, duration, and intervals.

Diarrhoea, headache and anxiety.

Homeopathic treatment.

Homeopathic  system of treatment considers all the clinical features of Meniere’s disease, as the single entity and medicines are selected according to homeopathic criteria, so instead of giving separate medicines for vertigo, deafness and tinnitus, a single remedy is selected according to the mental physical peculiarities and also the considering the modality of the disease symptoms. The medicine thus selected is the constitutional remedy which when prescribed not only cures the condition but also prevents all the chances of recurrences.

The medicines usually given are Gelseminum, Conuim mac, Bartya carb etc.

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