Thursday, April 28, 2011

JAUNDICE

        Jaundice is a yellow discoloration of the skin, mucous membranes, and the whites of the eyes caused by hyperbilirubinemia (increased levels of bilirubin in the blood). This hyperbilirubinemia subsequently causes increased levels of bilirubin in the extracellular fluids. Jaundice is a sign of an underlying disease process. The term "icterus" is sometimes incorrectly used to refer to jaundice that is noted in the sclera of the eyes, however its more common and more correct meaning is entirely synonymous with jaundice.
Causes
      Jaundice may be caused by several different disease processes.
Pre-hepatic (before bile is made in the liver)
       Jaundice in these cases is caused by rapid increase in the breakdown and destruction of the red blood cells (hemolysis), overwhelming the liver's ability to adequately remove the increased levels of bilirubin from the blood.
Examples of conditions with increased breakdown of red blood cells include:
*       Malaria,
*       Sickle cell crisis,
*       Spherocytosis,
*       Thalassemia,
*       Drugs or other toxins, and
*       Autoimmune disorders.
         Jaundice in these cases is caused by the liver's inability to properly metabolize and excrete bilirubin. Examples include:
*       Hepatitis (commonly viral or alcohol related),
*       Cirrhosis,
*       Drugs or other toxins,
*       Crigler-Najjar syndrome,
*       Gilbert's syndrome, and
*       Cancer.
Post-hepatic (after bile has been made in the liver)
        Jaundice in these cases, also termed obstructive jaundice, is caused by conditions which interrupt the normal drainage of conjugated bilirubin in the form of bile from the liver into the intestines.
Causes of obstructive jaundice include:
*       Gallstones in the bile ducts,
*       Cancer (pancreatic and gallbladder/bile duct carcinoma),
*       Strictures of the bile ducts,
*       Cholangitis,
*       Congenital malformations,
*       Pancreatitis,
*       Parasites,
*       Pregnancy, and
*       Newborn jaundice.
Jaundice in newborn babies can be caused by several different conditions.
The following are some common causes of newborn jaundice:
Physiological Jaundice
         This form of jaundice is usually evident on the second or third day of life. It is the most common cause of newborn jaundice.
Maternal-fetal blood group incompatibility (Rh, ABO)

Signs and symptoms

         Often symptomatic of certain diseases such as hepatitis Yellowing of the eyes sclera and cornea form the external covering of the eye
          Head ache, weakness, loss of appetite, pain abdomen, constipation, urine yellow, anemia, light colored stool.

CASE
          This is the case of a girl [pari] aged five years old. She came to me with her parents. She had pain abdomen, head ache, weakness, constipation, loss of appetite, fever, urine yellow. She has Yellowing of eyes. She was advised for HB, TLC, DLC, ESR and LFT

         On 22/01/11 her report was [HB-12.2, TLC-11500, ESR-17, BILI T-7.8, BILI. D. -6.8, BILI. I.-1, SGPT-655 SGOT-384, ALKL PHOS-1023
She was prescribed R-7, R-1, Natrum Sulf, iris v, chinonthus for 20 days.

        On14/02/11 her parents reported that she is much better. She have no fever, no nausea, no pain abdomen but urine still yellow. Prescribed medicines for fifteen days and advised for LFT.
  
       She came on12/03/11 with report of LFT [BILI T - 0.7, BILI D - 0.3, BILI I- 0.4, SGPT - 33, SGOT- 45, ALKALI  PHOS-478, TLC- 9200] No symptoms of jaundice. She 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

Tuesday, April 19, 2011

Be Resistant to Bacteria


Before further writing, I would like to ask you one simple question. Would you like to die? No. Then would you like to be killed by someone by any mean? No!  Strange? Can anybody tell me any sane organism, leave aside a man who would like to die or being killed. Even a non-living resists any change in its state.  Do you disagree? Everyone has desire to live/ exist, it is called “JIJEEVISA” in hindi. Then why we human being expect from bacteria, viruses, parasites etc. and any other living being who harm us in one or other way that they should enjoy their killing by man through antibiotics and other chemical or natural drugs and other means. What is harm to us is an effort to live for them and same is true to us when we kill them. Therefore, it is mutual when we defend ourselves and they do the same. This we can understand in this way – if you are attacked you resist and successfully conquer the attack. Then you make safety arrangements and preparation to avoid, face and conquer any future attack. It is the same bacteria are doing when attacked by antibiotics and similarly mosquitoes are doing to the threat we human being are posing to their existences. So what is sense in crying for occurrence of Superbug.
Antibiotic resistance and superbugsThere is a type of drug resistance due to which a microorganism is able to survive exposure to an antibiotic. This occurs due to evolutionary changes (genetic mutation) in Genes which can be transferred between bacteria in a horizontal manner by processes of conjugation, transduction or transformation. Thus a gene for antibiotic resistance evolved via natural selection against threat to existence. As resistance to certain antibiotic becomes common, there arises need for new and stronger antibiotic. After certain period of time bacteria develop resistance to the new drug also. If a bacterium carries several resistance genes, it is called multi-resistant or, informally, superbug or super bacterium. It is resistant to all known drugs! And in spite of continuous research there is decline in number new approved antibiotics.
Why the Resistance Develops – There are certain interesting observations why bacteria become resistant to an antibiotic.
1. The antibiotics are use widely both inside and outside of medicine eg. Antibiotics are often used in rearing animals as cows, pigs, chickens, fish, etc., for human food and this use leads to the creation of resistant strains of bacteria. The meat, milk, and eggs produced from those animals can be the source of superbugs. So the antibiotics as growth promoters in animal feeds should be prohibited.
 2. Antibiotics are sold over the counter without a prescription are misused and over used.
3. Household use of anti-bacterial in soaps and other products should be discouraged as they are not effective in controlling infection, although it does not directly contribute to resistance.
4. Some people insist on antibiotics and physicians simply prescribe them as they feel they do not have time to explain that they are not at all required,
5. Physicians either do not know when to prescribe antibiotics or the fear medical legal consequences.
6. People believe that antibiotics are effective for every disease condition for example in common cold  antibiotics have no role yet people take these and are often prescribed.  
7. Many people do not complete the prescribed course of antibiotics of the fact that they feel better and discontinue (depending on the country this figure vary from 10% to 44% ).
8. Less amount antibiotic than the optimum concentrations required in a critically ill patient increases the frequency of antibiotic resistance organisms. While taking antibiotics doses less than those recommended may increase rates of resistance, shortening the course of antibiotics may actually decrease rates of resistance.
9. Poor hand hygiene by hospital staff has been associated with the spread of resistant organisms
How Superbugs were created There are innumerable varieties of microorganisms and man is affected by many. All are prone to develop resistance to the antibiotics/drugs used against them.
Development of resistance in bacteria is not a new phenomenon. It was first noticed in 1947 in Staphylococcus aureus against Penicillin, just four years after the use of penicillin started at mass scale! So quick were the mutation or to say instinct to survive.    
A new antibiotic Methicillin had chosen, but due to its side effects on kidney has been replaced by Oxacillin. In 1961 in Britain, Methicillin-resistant Staphylococcus aureus (MRSA – also resistant to Oxacillin) was first detected and is now "quite common" in hospitals. In the United Kingdom MRSA was responsible for 4% of fatal sepsis cases in 1991and 37% of fatal cases in 1999 (the rise was due to resistance).
Vancomycin  was the next effective agent at that time. But vancomycin intermediate Staphylococcus aureus (VISA), appeared in the late 1990s. Identified first in Japan in 1996 and strains have been found in hospitals in England, France and the United States. The first Vancomycin-resistant Staphylococcus aureus (VRSA) appeared in the United States in 2002, it was completely resistant to Vancomycin.
Presently more than 50% of all Staphylococuss aureus infections in the United States are resistant to methicillin, tetracycline, penicillin and erythromycin.
new class of antibiotics Oxazolidones was developed in 1990s and the Linezolid was found effective against MRSA but Linezolid-resistant Staphylococcus aureus was reported in 2003.
Community-acquired MRSA (CA-MRSA, another one is Hospital –acquired MRSA which spreads through hospitals) has spread as an epidemic. It is the cause of rapidly progressive fatal diseases including severe sepsis and necrotizing fasciitis known as Flesh Eating Disease and necrotizing pneumonia. 
This type of resistance development is true for all organisms so stronger and strongest antibiotics were developed but no one is born to submit to killer.
What then?
Why you are sick but your brother is not or why your brother is sick and you are not? Though sharing so many things you seldom fall sick with your brother or other family member or friend or share their sickness. What is the difference? Yes, in the medical world the difference is talked as Susceptibility that is ability to be affected to fall sick and/or defense mechanism that is to remain protected from a sickness. Susceptibility decides whether a person will take sickening influence of agents/circumstances or not and defense mechanism make certain whether the influence would be fight out to retain the state of health. The delicate equilibrium of the two is essential to maintain the state of health.  If defense fails, the person gets sickness which is manifested through signs and symptoms.  However, the modern medicine at large does not recognize role of the person who is sick. It only recognizes the infecting (so called causative) agent and tries to hit, hit and hit it out with stronger and stronger medicines.  
Look at the common experience of medical practice in the following example
A patient who has a staphylococcal infection of lungs, his defense system come in play and he gets fever, cough, chill, weakness etc., and X –ray shows an abscess in lung, on testing increased white blood cell count, anti-staphylococcus antibodies in blood and staphylococcus growth in culture of sputum sensitive to certain antibiotics is found. When the patient is given one of the antibiotic, fever decreases, patient gains strength and sputum improves. This is the case when the patient’s defense system is strong enough to bring back the equilibrium to a healthy state. But in case defense mechanism is not strong enough the patient does not improves in spite of antibiotic and after a time lapse “Pleural reaction” occurs with pain and effusion. The patient is said to get “complication” and culture of fluid from the pleural space shows growth of a new bacteria Proteus, which is sensitive to fewer antibiotics than was the staphylococcus.  This occurred is due to the new level of susceptibility has established.
The second antibiotic given, patient improves as pain decreases a little. But nothing has been done to improve susceptibility. The antibiotic further weakens the defense system hence susceptibility level changes. Then effusion increases and this time a Bacillus pyocyanaeus is found in the drained fluid, which is insensitive to all known antibiotics. The allopathic physician then considers surgical drainage or lobectomy (surgical removal of a lobe of lung) because the case is very serious and may die in any event.
At that stage equally common is that allopathic physicians talk about systemic weakness but they could not understand how to deal with it whence all the tonics and vitamins refuse to work.  
Here we see that microorganism is not the basic problem but the weakness in defense mechanism of the patient which has further weakened during the whole course of treatment from antibiotics as stronger and stronger antibiotics are required to treat subsequent infection while susceptibility is further increased to be more grievously affected at deeper level of existence. If a well selected Homoeopathic medicine is given one could observe reversal of the process and symptoms and equilibrium of the patient’s susceptibility and defense mechanism re-established so it washes away the infection and the person recovers to his state of health.
Therefore the cause of disease basically lie with susceptibility conversely ability to resist adverse influences of environment may it be Biological, Physical, Chemical, Dynamic as exposure to various radiation energies cosmic or otherwise, due to various social and interpersonal interactions and stress and strains of day to day life and the most important one personal desires, expectations, ambitions, achievements and failures, satisfactions and discontentment etc.. Under all these interaction if a person keeps a sound physical, mental and spiritual balance he remains healthy. Wherever this delicate equilibrium is disturbed disease (dis - ease) creeps in the system and person falls sick.
Next to yoga (which is less a therapy and more a way to live), Homoeopathy is the first medical system which teaches and preaches to treat the person who is sick and not disease or one or the other part of the body, as in reality human body is not an assembled machine nor is the life merely a physicochemical phenomena. It is dynamics of body, mind and spirit (homoeopathy terms it as vital force of vital principle). It has been evidenced in last 200 years that after taking homoeopathic treatment for any reason, the person remained in better state of health.
With the recent discoveries modern medicine has been travelling from body through organs, tissues and cells has reached to molecular medicine and heading towards the energy medicine which homoeopathy has already reached. Therefore, to conclude –  
In production of sickness or disease two definite factors are recognized – one host and number two is agent/agents. The second factor may be from external or from internal environment of the host. It may affect individually or with other factors to cause a disease. Another important thing recognized is that the second factors can not affect host, the first factor unconditionally. The host has ability to deal with the influences of environment. It is only when the susceptibility to a particular type of influence is high and the defense system is at low, the host falls sick. Though the role of host is accepted by the modern medicine but it has, so far failed to appreciate its role specially, in recovery from disease. It has failed to develop the medicines to boost the defense and lower the susceptibility. Contrary to this homoeopathy believes in “Treat the sick and not the disease”, achieves long lasting cures by boosting the defense and lowering the susceptibility so that the person remains in equilibrium with the environment and becomes resistant to bacteria.

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

Monday, April 11, 2011

Hypersensitivity Reaction

Hypersensitivity (also called hypersensitivity reaction) refers to undesirable reactions produced by the normal immune system. These reactions may be damaging, uncomfortable, or occasionally fatal. Hypersensitivity reactions require a pre-sensitized (immune) state of the host.

Mrs. R. D.           36 yrs  female    hindu     housewife        vegetarian
Diagnosis – Hyper-sensitivity reaction (Total Eosinophil Count varied between normal to 830), Leucorrhea.

Patient has an allergic reaction from June 2010. She regularly gets sneezing from dust, cold and cold air. Sneezing occurs with itching and watery discharge from nose. She feels worst attacks in morning. Simultaneously there is itching in eyes with redness and watering. She feels chilly during attack and this chill begins in nose!
Leucorrhea thin and white aggravates 10 days before menses. Menses regular with lumber back pain two days before menses and ameliorate as flow starts.
Heels cracked more in summer, better in winters.
She sweats profusely in palms and soles which is offensive. She has no sweat on body. She craves curd and salt. Can not digest fried foods. Gets dreams frightful of ghost, ½ burnt charred bodies, missing train and left alone and away from family. Becomes violent and angry on contradiction.
She had history of taking calcium for long as diagnosed osteoporotic.
Father has Hypertension and osteoporosis.
She is obese and fair. Weight – 70 kg. height – 5’ 4”.
29/10/10   
Rx   
  1. Calcarea phosphoric    1M    two doses to be taken at 10 minutes interval.
   2. Phytum                         30    two pills thrice daily for 15 days
   3. P. L.                           200    two pills once a day for 15 days
12/02/11    She got no allergic reaction after the dose of calcarea phos. Her periods are painless and leucorrhea disappeared. She has swelling and tension in finger tips and toes worse by cold and exertion.      Rx   
  1. Calcarea phosphoric    1M    two doses to be taken at 10 minutes interval.
  2. Phytum                          30    two pills thrice daily for 15 days.
   3. P. L.                            200    two pills once a day for 15 days.

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