CHRONIC RENAL FAILURE

Chronic renal failure is a gradual and progressive loss of the ability of the kidneys to excrete wastes, concentrated urine and conserve electrolytes.

CAUSE

Chronic renal failure is slowly progressive failure of kidney function. It can range from mild dysfunction to severe kidney failure.

Chronic renal failure usually occurs over a number of years as the internal structures of the kidneys are slowly damaged. In the early stage there may be no symptoms.

causes are:-

Diabetes and hypertension

Glomerulonephritis of any type

Polycystic kidney

Alport syndrome

Reflux nephropathy

Obstructive uropathy

Kidney stones

Infections

Analgesic nephropathy

SYMPTOMS

Nausea, Vomiting, General ill feeling, Fatigue, Headache, Frequent hiccough, Generalized itching, Need to urinate at night, Cramps, Seizures.

SIGNS

Blood pressure may be high; with mild or severe hypertension. A neurological examination may show polyneuropathy. Abnormal heart and lung sounds may be heard with a stethoscope. A urine analysis may show protein or other abnormalities.

Creatinine levels progressively increased.

BUN is progressively increased.

Creatinine clearance progressively decreased.

 Potassium may elevate.

COMPLICATIONS:-

Congestive heart failure.

Hypertension. 

Anemia

Liver failure.

Seizures.

Skin dryness, itching.

HOMOEOPATHIC MEDICINES:-

Betula alba, Borago off, Cucurbita pepo, Equsitum arvenses, Erodium cicutarium, Hypericum pilosella, Hyndrangea, Sarsaparilla, Solidago virga, Taraxacum off, Uva ursi, Vitis vinifera, Zea mays, Apis mel, Berb vulg, Brachyglottis, Cantharis, Kali chlor, Merc cor, Phosphorus, terebianth.

CASE

This is the case of a man (Mr. Gopal) aged 46 years. He was a known case of C.R.F. He was under allopathic treatment since last two years. His s. urea level was 90 and s. creatinine Level was 4.1.His urea and creatinine was progressively increasing. No improvement since last six months. He has nausea, weakness, cramps, swelling in legs, appetite decreased. On 25/09/08 He was prescribed following medicines. R-1, R-18, UREA 200, MERC SOL 200, PLB MET200, KALI CHLOR 200, APIS30, PYROGENUM 1M and he called after fifteen days.

On 08/10/08 He was advised for urine C/E, HB, TLC, DLC, ESR, S. UREA.

S.  UREA                   60.35

S. CREAT                   1.32

Hb                               13

TLC                             7600

ESR                             10

ALBUMIN                 ++++

PUS CELLS               15-20

EPITH CELLS           ++

RBC                            2-4

BECT.                         +

MUCUS                      PRESENT

0n 11/10/08 repeated same medicines for fifteen days.

On 18/10/08 advised for URINE C/E

ALBUMIN                 ++

RBC                            2-4

WBC                           8-10

EPITH CELLS             +

CAST GRANULAR    +

BACT                          +

On 27/10/08 prescribed following medicines. R-1, R-18, UREA 200, and KALI CHLOR 200

He was called after fifteen days.

On 13/11/08 he reported with no nausea, no weakness, general health improved. Repeated medicines as 27/10/08 and R-64

Hb                              13.9

PUS CELLS               2-3

RBC                           8-10

MUCUS                     PRESENT

UREA                         36.6

CREATININE           1

ESR                            5

On 08/12/08 repeated medicines and advised for Hb TLC DLC ESR UREA CREATININE URINE C/E

He was called after two months.

Patient reported on 18/05/ 09

Hb                               13.8

TLC                             7100

ESR                             8

UREA                         34

CREATININE           0.9

ALBUMIN                 TRACE

PUS CELLS               1-2

EPITH CELLS           +

RBC                            NIL

BACT                         +

He was CURED

Dr. G. S. Bhatnagar

D.H.M.S.  B.H.M.S.

Research officer

Sewa Mandir

Mobile 9829978284

E-Mail: sewamandir@usa.net, drgsbhatnagar@gmail.com  

POST TUBECTOMY BLUE AND PELVIC INFLAMMATORY DISEASE

Mrs. K.V.  40 yrs.  female    hindu   married    non-vegetarian    Nursing Staff

Diagnosis – Post Tubectomy Melancholy, Pelvic Inflammatory Disease, Anal fissure, Colitis, Obesity.

Patient came with complain that since 15 yrs. after tubectomy she suffered episodes of sudden sinking and faintness with vertigo, blurred vision and heaviness in head. It may occur any time but more often during scanty menses. She felt better if menses flow was good. Head pain before menses better during flow, after eructation or flatus. Desire to lie down as always felt tired with aversion to work. Every thing seems gloomy.

Leucorrhea – thin yellowish discharge with pain in hypogastrium. Menses regular for three days, very scanty since 15 yrs. Pain uterus one day before and on first day of menses, better by pressure, lying on abdomen. Had two male issues.

Patient got tubectomy done 15 yrs. back, which got infected and suppurated. She was reoperated and pus was drained under cover of antibiotics. She stated that her all troubles started after operation.

Abdomen distended with hollow tone on percussion, better after eating. Burning anus after stool due to fissure.

USG showed Liver enlarged and Pelvic inflammatory disease.

Patient feels dull and sad. Short tempered becomes abusive. Get emotional hurt easily. Memory poor for numbers. Concentration decreased, could not do things in an organized way if got more than two works to do at a time.

Averse milk and salad, likes meat and oily food. Sun and heat aggravate. Perspiration more on face and body, stains yellow on cloths.

Patient’s mother got depression and hysteric convulsions after hysterectomy, father has IHD and hypertension, of four sisters two are said to be mentally dull and one has been diagnosed malignant  tumor in brain. Uncles have mental sickness.

Patient was obese, weight 86 kg., height 5’ 1 ½”. Prominent vaccine marks. Brown spots on both cheeks. Blood pressure 120/80.

12/03/10     R_x  1. Pulsatilla         200    two doses at 10 minutes interval

                         2. L. S.               30     one tablet twice a day for 15 days

26/03/10  Vertigo was relieved but there was an aggravation for about a week as patient felt increased flatulence and eructation, weariness and restless sleep for two nights after Pulsatilla but after that things were improved. Now, sleep is sound, vertigo did not occur after 18^th as menses appeared with a good flow. Anal fissure healed as there was no burning.

                     R_x  1. P.L.             200    two doses at 10 minute interval

                           2. L. S.            30     one tablet twice a day for 15 days

12/04/10 Much better but feeling recurrence of pains from two days. Menses is due on 16^th or 18^th.

B. P. - 106/80.

                      R_x  1. Pulsatilla         200     two doses at 10 minute interval

                            2. L. S.               30      one tablet twice a day for 10 days

14/05/10 Head pain since two days - before menses, pain uterus before menses and Itching and eruption pudenda before menses. Menses appeared today. Weight 84 kg.

                       R_x  1. Pulsatilla         1M     two doses at 10 minute interval

                             2. L. S.                30     one tablet twice a day for 10 days

                             3. Silicea              30     4 doses four hourly on next day if pains do not subside after pulsatilla.

Patient took Silicea doses on next day. Thereafter  pains and eruptions disappeared and never  appeared again till this date. Her work efficiency has improved and she now gets neither vertigo nor fainting.


Dr. M. K. Tyagi
D.H.M.S., Dip. N.I.H.Research Officer
Sewa Mandir
Mobile" 09829157926
Email: 1.sewamandir@usa.net, 2.manju_mkt2003@yahoo.co.in

E. COLI (DIARRHEA) INFECTION

 What is an E. coli Infection?

Escherichia coli bacteria, commonly called E. coli has certain types which can cause food borne illness. Most strains of E. coli are harmless and found widely in nature, including the intestinal tracts of humans and warm-blooded animals, some mammals, raw milk, unchlorinated water. Disease-causing strains, however, are a frequent cause of both intestinal and urinary-genital tract infections.  One type causes travelers' diarrhea. The worst type of E. coli (Enterohemorragic E. coli) causes bloody diarrhea, and can sometimes cause kidney failure which may, sometime lead to death. These problems are most likely to occur in children and in adults with weak immune systems. This type produces one or more related, powerful toxins which can severely damage the lining of the intestines. Other types can also cause human disease.

Normally, urine is sterile. It is usually free of bacteria, viruses, and fungi but does contain fluids, salts, and waste products. An infection occurs when tiny organisms, usually bacteria from the digestive tract, cling to the opening of the urethra and begin to multiply. The urethra is the tube that carries urine from the bladder to outside the body. Most urinary infections arise from Escherichia coli (E. coli), normally lives in the colon.

In many cases, bacteria first travel to the urethra. When bacteria multiply, an infection can occur. An infection limited to the urethra is called urethritis. If bacteria move to the bladder and multiply, a bladder infection, called cystitis, results. If the infection is not treated promptly, bacteria may then travel further up the ureters to multiply and infect the kidneys. A kidney infection is called pyelonephritis.

Types of E-coli poisoning food includes:

·         Escherichia coli O157:H7 (enterovirulent  E. coli - EEC)/ Enterohemorrhagic Escherichia coli (EHEC)Infection

·         Enterotoxigenic Escherichia coli (ETEC) caused traveler’s diarrhea because they commonly contaminate food and water in developing countries.  

·         Enteropathogenic E. coli (EPEC) are associated with persistent diarrhea (lasting 2 weeks or more), are more common in developing countries where they can be transmitted by contaminated water or contact with infected animals.

Transmission of E. Coli -

E. coli bacteria and its toxins are transmitted to human via:

• Raw or undercooked food or hamburgers
• Salami, (Salami is originally an Italian preparation made by peasants by processing meat to preserve it for long time.)
• Sprouts
• Lettuce
• Unpasteurized milk, apple juice, and apple cider -  an unfiltered, unsweetened, non-alcoholic drink made from apples. It is opalescent, or opaque, due to the fine apple particles in suspension, and may be tangier than conventional filtered apple juice, depending on the apples used.
• Contaminated well water.
• Contaminated swimming pools.

Symptoms of E. Coli Infection

Symptoms of E. Coli infection usually begin 2 to 5 days after exposure. The symptoms may last for 8 days. Some common symptoms of infection with E. coli are:

• Nausea
• Severe abdominal cramps
• Watery or very bloody diarrhea
• Fatigue
• Low grade fever

Diagnosis of E. Coli Infection -                                                                   

Stool OR Urine test to see if it was infected with E. coli.

Treatment of E. Coli Infections

In most infected individuals, symptoms of E. coli infection last about 5 to 14 days and resolve without any long-term problem.  Antibiotics are not helpful. It is believed that these medications rather, increase the risk of developing post-diarrheal hemolytic uremic syndrome (D+HUS).  Therefore, good supportive care such as increased fluid and electrolyte (salts) intake and nutrition i.e., easy to digest food is necessary to check E. coli symptoms. 

Homoeopathic Medicines –  

Health care experts recommend against taking anti-diarrheal medicines but homoeopathy has many effective medicines for prompt relief from the infection. They need supervision of physician for their indications and repetition. The most commonly indicated homoeopathic medicines in E. coli infection are –

Mercurius solubilis,  Mecurius corrosivus, Arsenicum alb., Nux vomica, Rhus tox., Phosphorus, Colocynthes, Aloe soc., Trombidium, Natrum sulph., Rheum, Ipecac., Rhus tox., varatrum alb., Croton tig., Gambogia, Hydrastis, Podophylum, Apis mel., Nitric acid, Cantharis, Sepia, Aethusa etc.

  

Probiotics -

Probiotics are defined as ‘mono- or mixed cultures of live micro-organisms which, when applied to animal or man, beneficially affect the host by improving the properties of the indigenous microflora. Yogurt is an excellent source to build the good bacteria in intestine, make sure that it got a good culture.

Among the effects claimed for probiotics are beneficial immuno-modulation, reduction of serum cholesterol, improved lactose digestion and protection against colon cancer. 

Complications of E. coli

One of the most serious complications of an E. coli infection is Hemolytic uremic syndrome. Hemolytic uremic syndrome is characterized by destruction of red blood cells, damage to the lining of blood vessel walls and in severe cases, kidney failure.

A properly selected homoeopathic medicine can revert the situation. Solidago, Hydrocyanic acid, Cantharis, Apis mel., Baptisia t. may be indicated.

Treatment for those who develop HUS ranges from mild to very intensive.  Children may need to be hospitalized for about two weeks (range 3 days to 3 months), and adults longer, as their courses tends to be more severe.  Diarrhea with HUS need supportive therapy, including meticulous attention to fluid and electrolyte balance, is the cornerstone of survival. 

Preventing E. coli Infection -


Anything ingested by a person can be a vehicle for infection. E. coli are now so widely disseminated that a wide variety of foods can be contaminated.  Direct animal-to-person and person-to-person transmission is not uncommon.  Following steps can be taken to prevent E. coli infection -

1.       Practice meticulous personal hygiene.  This is true not only for family members and guests, but for any member of the food supply chain. 

•      Eat only thoroughly cooked food products.
•      Wash fruits and vegetables thoroughly specially if one takes them uncooked/raw.
•      Avoid unpasteurized juices.
•      Drink only pasteurized milk and chlorinated water.
•      Avoid swallowing lake or pool water while swimming.
•      The persons with diarrhea, especially children should wash their hands carefully with soap after bowel movements to reduce the risk of spreading infection, and person should take gloves while changing soiled diaper of baby or wash hands thoroughly after changing it. E. coli diarrhea initially is non-bloody, but still very infectious.

2.       E. coli bacteria can survive on surfaces as work station, utensils etc. for weeks and only a few are sufficient to cause illness. 

3.       Be careful to avoid cross contamination when preparing and cooking food.  The work stations and the utensils used during meal preparation should be thoroughly cleaned. 

4.       Do not allow children to share bath water with anyone who has any signs of diarrhea.   

5.       After touching a pet or farm animals merely cleaning the hands may not be adequate, it needs more thorough washing and cleaning!

6.       Keep toddlers in diapers and away of all bodies of water. Wear disposable gloves when changing the diapers of any child with any type of diarrhea. 

7.       Avoid drinking and even playing in any non-chlorinated water. 

Food Industry Prevention

Irradiation is the most practical and effective way of sterilizing foods.  Even though the word “irradiation” creates fear of radiation exposure, irradiated food does not become radioactive; it is safe and the taste or form of the food does not change. 

To control or eliminate any infection public education and awareness is very necessary.


Dr. M. K. Tyagi
D.H.M.S., Dip. N.I.H.Research Officer
Sewa Mandir
Mobile" 09829157926
Email: 1.sewamandir@usa.net, 2.manju_mkt2003@yahoo.co.in

CARPAL TUNNEL SYNDROME

Sign and symptoms of (CST) are caused by compression of the median nerve travelling through the carpal tunnel. Carpal Tunnel Syndrome affects the hands in motor and sensory disturbance of the median nerve.

This condition affects causing pain, paresthesia, and sometimes weakness in the median nerve distribution. Those diagnosed with Carpal Tunnel Syndrome may experience pain, numbness and tingling sensations in the arm, which may extend to the shoulder and neck area; these feelings are more at night due to various sleeping positions. Carpal Tunnel Syndrome, a disabling overuse injury to the hand is one of the most frequent work injuries reported by the medical profession

Symptoms

Patients that have been diagnosed with CTS experience numbness, tingling, or burning sensations in the thumb and fingers, particularly the index and middle fingers. Individuals also experience pain in the hands or wrists and some report to have lost gripping strength. Pain also develops in the arm and shoulder and swelling of the hand, which increases at night

Causes

Most cases of CTS are of unknown causes, or idiopathic. Carpal Tunnel Syndrome can be associated with any condition that causes pressure on the median nerve at the wrist. Some common conditions that can lead to CTS include obesity, hypothyroidism, arthritis, diabetes, and trauma. Other causes of this condition include intrinsic factors that exert pressure within the tunnel, and extrinsic factors which include benign tumors such as lipomas, ganglion, and vascular malformation.

CST with other diseases Examples include:- Rheumatoid arthritis, pregnancy, inflammation such as inflammatory arthritis, Colles' fracture, amyloidosis, hypothyroidism, diabetes mellitus, acromegaly, and use of corticosteroids and estrogens. Previous injuries, Tumors such as a ganglion or a lipoma, Acromegaly, a disorder of growth hormones, Obesity.

Diagnosis

Clinical assessment by history taking and physical examination can support a diagnosis of CTS.

Phalen's maneuver is performed by flexing the wrist gently as far as possible, then holding this position and awaiting symptoms. A positive test is one that results in numbness in the median nerve distribution when holding the wrist in acute flexion position within 60 seconds. The quicker the numbness starts, the more advanced the condition. Phalen’s sign is defined as pain and/or paresthesias in the median-innervated fingers with one minute of wrist flexion. Tinel's sign, electromyography, Durkan test.

HOMOEOPATHIC TREATMENT: -

Following homoeopathic medicines are useful – Boswellia, Calcarea cab, Calcarea phos, Causticum, Curcuma longa, Formica rufa, Ginkgobiloba, Guaicum, Lachesis, Lycopodium, Medorrhinum, Natrum mur, Nux vom, Pulsatilla, Rhus tox, Ruta g, Viola odorata.

CASE

This is the case of a lady (Mrs. Anj.) aged 45 years with pain in right wrist, numbness. Pain aggravated night, work ameliorated by pressure, rest. Pain up to shoulder weakness in hand, she lost her gripping strength. This was diagnosed as a carpal tunnel syndrome.

Following medicines given on 27/04/10 for fifteen days. Rhus tox 1M weekly, Ruta gr,30  TDS, Viola odorata Q, Lachesis 30 TDS, Kreosotum 200.

Patient reported with no pain, no numbness and she regaining her gripping strength.

Patient was cured. She was given some P.L. doses. 

Dr. G. S. Bhatnagar

D.H.M.S.  B.H.M.S.

Research officer

Sewa Mandir

Mobile 9829978284

E-Mail: sewamandir@usa.net, drgsbhatnagar@gmail.com

Oscillococcinum – Clinical Experience

 OSCILLOCOCCINUM a nosode prepared from Duck liver was first introduced by Dr. J. Roy (1925).   However, there was paucity of data on its efficacy because very few clinical experiences have been published though lately Drs. Julian, Murphy and Schroyens have came out with improved data.  In fact it has remained a lesser known remedy.

            The present authors came across the suggestion of Dr. Colin B. Lesell in his book “Homoeopathy for Physician” for use of Oscillococcinum – 200 in common cold.  The nosode was procured from Nelson & Company England. For the last many years the nosode Oscillococcinum-200 Three times Daily for two days has been prescribed for common cold with very promising results, to several hundred outdoor patients of Sewa Mandir Foundation, Ajmer. In most of cases Oscillococcinum-200 alone could do yeoman work and did not require any other remedy.  

             Looking to results in common cold we were encouraged to see its efficacy in other diseases and it was found that Oscillococcinum-200 given in a weekly dose has acted as a prophylactic against the recurrent attacks of allergic rhinitis and chronic catarrh. 

             

It is admitted that homoeopathy is based on totality of symptoms and individualization but in some very common ailments like common cold some medicine work as a snap shot remedy.

            It is hoped that fellow homoeopaths will come forward to test exciting potential of Oscillococcinum in cold and related ailments and publish their results for confirmation.

Collin B. Lessel           ---      1986 Homoeopathy for Physicians.
B. Jain publishers. New Delhi.

                              

Dr. Khursheed Ahmed, M.Sc. Ph.D.
Dr. Mukesh Kumar Tyagi, DHMS, Dip. N.I.H.

Sewa Mandir
Mobile" 09829157926
Email: 1.sewamandir@usa.net, 2.manju_mkt2003@yahoo.co.in

GALLBLADDER STONES

(CHOLELITHIASIS)

Definitions

Presence of stones in the gallbladder is referred to as cholelithiasis. If gallstones migrate into the ducts of the biliary tract the condition is referred to as choledocholithiasis.  Gall stone are crystalline concretions formed within the gall bladder by accretion of bilecomponents. Presence of gallstones in the gallbladder may lead to acute cholecystitis, an inflammatory condition. Presence of gallstones in other parts of the biliary tract can cause obstruction of the bile ducts. The large yellowish calculus is probably composed largely of cholesterol, while the greenish to brownish color of the other stones suggests these are composed of bile pigments.

Gallstones can be divided into the following types:

Cholesterol stones: They vary in color from light yellow to dark green or brown and are oval 2 to 3 cm in length often having a tiny dark central spot.

Pigment stones: Pigment stones are small, dark stones made of bilirubin and calcium salts that are found in bile.        

Mixed stones: Mixed gallstones common constituents are calcium carbonate, palmitate phosphate, bilirubin, and other bile pigments.

Signs and symptoms

Gallstones may be asymptomatic. These gallstones are called "silent stones". A characteristic symptom of gallstones is a intense pain in the upper right side of the abdomen, often accompanied by nausea and vomiting, that steadily increases. Pain almost always happen at night belching, gas and indigestion.

Pathophysiology

Cholesterol gallstones develop when bile contains too much cholesterol and not enough bile salts. Besides a high concentration of cholesterol, two other factors seem to be important in causing gallstones. The first is how often and how well the gallbladder contracts; incomplete and infrequent emptying of the gallbladder may cause the bile to become over concentrated and contribute to gallstone formation. The second factor is the presence of proteins in the liver and bile that either promote or inhibit cholesterol crystallization into gallstones. In addition, increased levels of the hormone estrogen as a result of pregnancy, hormone therapy or the use of combined (estrogen-containing) forms of hormonal contraceptives, may increase cholesterol levels in bile and also decrease gallbladder movement, resulting in gallstone formation.

Diagnosis                                                                                                                       

A positive Murphy's sign(a painful spot just below right ribs on abdomen) is a common finding on physical examination.

Gallstone can visualized in the gallbladder by ultrasound image.

Homoeopathic medicines

Carduus mar, Chelidonium, Cholesterinum, Colocynthis, Olea europa, Mentha piperita, Ginkgo biloba, Ammi visnaga, Gentiana lutea, Tilia europea.

                                                                                          

CASE

This is the case of a man [Mr. k. k.] aged 53 years. He came with severe pain in epigastric region and right side of abdomen,nausea, vomiting, distention, burning urination with pain in right renal region. Symptoms were aggravated by eating after fatty food. He was advised for USG abdomen.

USG: - 6 mm CALCULUS SEEN IN THE UPPER CALYX OF RIGHT KIDNEY AND MULTIPLE SMALL CALCULI IN GALLBLDDER this is the case of Cholelithiasis and Nephrolithiasis.

He was prescribed following medicines on 05/03/10

A) BERBERIS VULGERIS Q

B) CALCARIA CARB 10M/2

C) CATHERIS 30

D) CHOLISTRINUM 3X

He was called after fifteen days.

On 22/03/10 abdomen pain was better, no nausea, no vomiting. No burning in urine.

He was given same medicines for three months.

On 10/06/10 he had no pain abdomen, no nausea, no other symptoms. He was advised for USG abdomen.

USG: - NO CALCULUS SEEN IN GALLBLADDER, 5.4 mm CALCULUS IN RIGHT KIDNEY.

He was repeated medicines for kidney stones.

A) BERBERIS VULGERIS Q

B) CANTHERIS 30

C) TRIBULUS TERRESTRIS Q

Dr. G. S. Bhatnagar

D.H.M.S.  B.H.M.S.

Research officer

Sewa Mandir

Mobile 9829978284

E-Mail: sewamandir@usa.net, drgsbhatnagar@gmail.com