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ENDOMETRIOSIS is a painful disorder ,in which abnormal growth of the endometrium outside Of uterine lining .commonly involves ovaries,fallopian tubes and tissue lining of pelvis. The area of endometriosis bleed each month ,resulting in inflammation and scaring .
SIGNS AND SYMPTOMS -Pain and infertility are common symptoms ,although 20-25% of womens are asymptomatic. PELVIC PAIN A major symptom of endometriosis is recurring pelvic pain ,pain can range from mild –severe Cramping or stabbing ,pain that occurs on both sides of pelvis, lower back,rectal area and even down the legs. INFERTILITY About a third of women with infertilityn have endometriosis,among women with endometriosis About 40% are infertile.
OTHER SYMPTOMS Diarrhoea or constipation,chronic fatigue,nausea, vomiting,headache,low grade fever,heavy and or Irregular periods and hypoglycemia. ENDOMETRIOSIS is unreleated to ENDOMETRIAL CANCER.
RISK FACTORS ENDOMETRIOSIS is a heritable condition that is influenced by both genetic and environmental factors Daughters or sisters of women with endometriosis are at high risk of developing endometriosis themselves. -More often endometriosis found on the ovaries, fallopian tubes and ligaments -Less common in sites of vagina,cervix,vulva,bowel,bladder and rectum. -Rarely in parts such as lungs ,brain and skin.
HOMEO INDICATIONS CIMICIFUGA AND XANTHOXYLUM:Endometriosis with dysmenorrhoea PULSATILLA,SABINA AND SEPIA:Endometriosis with pelvic pain SEPIA AND PLATINA:Endometriosis with painful intercourse(dysperunia) AMMON.MUR,LACHESIS AND NUX.VOMICA:Endometriosis with rectal complaints NATRUM.MUR AND SEPIA:Endometriosis with urinary complaints.

ENDOMETRIOSIS is a painful disorder ,in which abnormal growth of the endometrium outside Of uterine lining .commonly involves ovaries,fallopian tubes and tissue lining of pelvis. The area of endometriosis bleed each month ,resulting in inflammation and scaring .
SIGNS AND SYMPTOMS -Pain and infertility are common symptoms ,although 20-25% of womens are asymptomatic. PELVIC PAIN A major symptom of endometriosis is recurring pelvic pain ,pain can range from mild –severe Cramping or stabbing ,pain that occurs on both sides of pelvis, lower back,rectal area and even down the legs. INFERTILITY About a third of women with infertilityn have endometriosis,among women with endometriosis About 40% are infertile.
OTHER SYMPTOMS Diarrhoea or constipation,chronic fatigue,nausea, vomiting,headache,low grade fever,heavy and or Irregular periods and hypoglycemia. ENDOMETRIOSIS is unreleated to ENDOMETRIAL CANCER.
RISK FACTORS ENDOMETRIOSIS is a heritable condition that is influenced by both genetic and environmental factors Daughters or sisters of women with endometriosis are at high risk of developing endometriosis themselves. -More often endometriosis found on the ovaries, fallopian tubes and ligaments -Less common in sites of vagina,cervix,vulva,bowel,bladder and rectum. -Rarely in parts such as lungs ,brain and skin.
HOMEO INDICATIONS CIMICIFUGA AND XANTHOXYLUM:Endometriosis with dysmenorrhoea PULSATILLA,SABINA AND SEPIA:Endometriosis with pelvic pain SEPIA AND PLATINA:Endometriosis with painful intercourse(dysperunia) AMMON.MUR,LACHESIS AND NUX.VOMICA:Endometriosis with rectal complaints NATRUM.MUR AND SEPIA:Endometriosis with urinary complaints.

VITILIGO

VITILIGO VITILIGO is an acquired condition in which circumscribed depigmented patches develop ,it affects 1% of World population Unlike albinism where melanocytes are present but the production of melanin is abnormal. VITILIGO involves focal area of melanocyte loss,there may be positive family history and associated with Autoimmune disease,diabetes ,thyroid and adrenal disorders. Pernicious anaemia ,trauma and sun burn may precipitate the appearance of vitiligo SEGMENTAL VITILIGO is restricted to one part of the body ,but not necessarily dermatome ,generalized Vitiligo involves hands,wrist, knee, neck as well as the area around the body orifices,hair of the scalp And beard may also depigmented. The patches of depigmentation are sharply defined and in Caucasians(white skin of European origin)may be surrounded by light brown CAFÉ AU LAIT hyperpigmentation. Some spotty perifollicular pigment may be seen with in the depigmented patches and is sometimes the 1 st sign of repigmentatioin . Sensation in the depigmented patches is normal (compare to tuberculoid leprosy)the cause is unpredictable but most patches remain static or enlarged ,few repigmented spontaneously. HOMEOPATHIC TREATMENT:ARSENIC SULFURATUM FLAVUM,CARCINOSIN,HYDROCOTYL, KALI CARB,NITRIC ACID,NAT MUR,PHOS ,SILICEA AND SYPHILINUM.

UTERINE FIBROID

UTERINE FIBROID FIBROIDS OF UTERUS ALSO KNOWN AS UTERINE LEIOMYOMAS OR FIBROIDS are benign smooth muscle tumors of the uterus. -Mostly fibroids are asymptomatic ,while some women experience painful and heavy bleeding. -If fibroids are large enough ,they may pressure on bladder causing frequent urination. -Fibroids run in families and appear to be partly determined by hormone levels. -Risk factors includes OBESITY. SIGNS AND SYMPTOMS -Abdomen pain with heavy bleeding leads to anaemia. -Depends on location of fibroid ,women may experience pain during intercourse. -During pregnancy ,fibroids may cause mis carriage , bleeding and premature labour. -Abdomen grows larger mimicking the appearance of pregnancy. REED’S SYNDROME Uterine fibroids with cutaneous leiomyomata and renal cell carcinoma. LOCATION AND CLASSIFICATION INTRA MURAL FIBROID -Located on muscular wall of uterus -Mostly fibroids are lagre and asymptomatic – They expand inwards causing distortion and elongation of uterine cavity. SUB SEROSAL FIBROID -Located on surface of uterus . -They can grow outwards from the surface and remains attached by a small piece Called PEDUNCULATED FIBROID ,they detach from uterus to become PARASITIC LEIOMYOMA. SUB MUCOSAL FIBROID -Located in the muscle beneath the endometrium of the uterus, even a small lesion in this location May lead to bleeding and infertility. CERVICAL FIBROID -Located in the wall of the cervix(neck of the uterus ) -Rarely fibroids are found in the supporting structures (round ligament, broad ligament or utero sacral ligament) FIBROIDS may be single or multiple ,secondary changes may develop with in the fibroid are hemorrhage,necrosis,calcification and cystic changes. EXTRA UTERINE FIBROIDS OF UTERINE ORIGIN -FIBROIDS of uterine origin located in other parts of the body ,sometimes also called PARASITIC MYOMAS,extremely rare ,they may be identical or metastasizing leiomyoma. The majority of fibroids remain asymptomatic (75%) Menorrhagia(30%)is the classical symptom of symptomatic fibroid Metrorrhagia or irregular bleeding may be due to -ulceration of submucous fibroid -torn vessels from the sloughing base of a polyp -associated endometrial carcinoma Dysmenorrhoea -cogestive associated with endometriosis or pelvic congestion -spasmodic associated with extrusion of polyp Infertility (30%)may be major compliant Pain in lower abdomen Abdominal swellings(lump)

URTICARIA

URTICARIA URTICARIA also known as HIVES.It is a skin rash with red ,rised,itchy bumps.they may also burn or sting Rash lasts for few days but do not leave a scar ,the condition frequently recurs and lasts more than 6 weeks. URTICARIA frequently occur following an infection or as result of an allergic reaction such as to -Medication (aspirin,buprofen,penicillin,clorimezole, vaccine and antidiabetic drugs etc), -Insect bite , -Food(shell fish, nut, egg,wheat and soy), -Infections or environmental agents, -Psychological stress -Cold temperature etc SIGNS AND SYMPTOMS -WELTS(raised area surrounded by a red base) -ANGIOEDEMA(allergic or non allergic) -Individual hives that are painful ,last more than 24 hours or leave a bruise as they heal more likely To be a more serious condition called URTICARIAL VASCULITIS. -Hives carried by stroking the skin are due to a benign condition called DERMATOGRAPHIC URTICARIA. HOMEOPATHIC TREATMENT:APIS,ARSALB,DULC,NAT MUR,RHUSTOX AND URTICA URENS

URINARY INCONTINENCE

URINARY INCONTINENCE URINARY INCONTINENCE is defined as any leakage of urine.it may occur with normal urinary tract e.g.in association with poor cognitiojn or poor mobility or transiently during an acute illness or hospitalization Especially in older people.Diuretics (medication ,alcohol or caffeine)may worsen incontinence The pattern of micturition is important in defining the incontinence ,and the patients should be encouraged to keep a voiding diary,including the estimated volume voided,frequency of voiding, Precipitating factors and associated features, e.g. URGENC. Examination includes an assement of cognitive function and mobility ,and of perineal sensation and anal Spincter tone since the innervations is from the same sacral nerve roots that supply the bladder and urethral spincture. A general neurological assessment is required to detect disorders such as multiple sclerosis that may affect the nervous supply for the bladder ,and the lumbar spine should be inspected for features of Spina bifida occulta. Rectal examination is needed to assess the prostate in men and to exclude faecal impaction as a cause of incontinence. Genital examination should identify phimosis and paraphimosis in men ,and vaginal mucosal atrophy, And cystoceles or rectoceles in women. STRESS INCONTINENCE In stress incontinence leakage occurs because passive bladder pressure exceeds the urethral pressure ,due to either poor pelvic floor support or a weak urethral spincture . This is very common in women and most often seen following childbirth ,and it is rare in men and then usually follows surgery to the prostate Urine leaks when the abdominal pressure rises,e.g. when coughing or snezzing.In women ,perinal inspection may reveal leakage of urine ,when the patient coughs and sometimes also a proplase URGE INCONTINENCE In urge incontinence leakage usually occurs because of DETRUSOR OVER ACTIVITY producing an increased bladder pressure which over comes the urethral sphicture (motor urgency)urgency with or with out incontinence may also be driven by hypersensitive bladder(sensory urgency)resulting from UTI or BLADDER STONES. CONTINUAL INCONTINENCE This suggests the presence of a fistula ,usually between the bladder and vagina(vesicovaginal )or the ureter and vagina (uretero vaginal).This is most common following gynaecological surgery but is also seen in patiemnts with gynaecological malignancy or following radiotherapy The parts of the world where obstetrics services are scarce prolonged obstructed labour can be a common cause of vesicovaginal fistulae.Continual incontinence may also be seen in infants with Congenital ectopic ureters,occasionally stress incontinence is so severe that the patient leaks continuously OVER FLOW INCONTINENCE This occurs when the bladder becomes chronically over destended.It is most commonly seen in men with BENIGN PROSTATIC PLASIA or BLADDER NECK OBSTRUCTION ,but may occur in either sex as a result of failure ofr the DETRUSOR MUSCLE(ATONIC BLADDER). The later state may be idiopathic but more commonly is the result of damage to the pelvic nerves , Either from surgery(hysterectomy or rectal excision),trauma or infection ,or from compression of the cauda equine from disc proplase ,trauma or tumour. POST-MICTURITION DRIBBLE This is very common in men ,even in the relatively young .it is due to a small amount of urine becoming Trapped in the U-BEND of the bulbar urethra ,which leaks out when the patient moves.it is more pronounced if associated with a urethral diverticulum or urethral stricture .it may occurs in females with urthral diverticulum and may mimic stress incontinence. INCONTINENCE IN OLD AGE PREVALENCE:urinary incontinence after 15%of women and 10%of men aged over 65 years CAUSES:Incontinence may be transient due to an acute confusional state ,urinary infection ,medication (such as diuretics)faecal impaction or restricted mobility and these should be treated before embarking On further specific investigations DETRUSOR OVER ACTIVITY:established incontinence in old age is most commonly due to detrusor over- activity which may be caused by damage to central inhibitory centres or local detrusor muscle aqbnormalities CATHETERISATION :poor manual dexterity or cognitive impairment may necessitate the help of a carer to assist with intermittent catheterization.

TONSILITIS

TONSILITIS TONSILITIS is one of the most common infection encounterd in everyday ACUTE TONSILITIS occurs frequently up to age of 15 years ,both sex are equally affected . ENDOGENOUS FACTORS: pre –existing upper respiratory tract infection , post nasal discharge due to tonsillitis general lowering of the resistance EXOGENOUS FACTORS Ingestion of cold drinks or cold foods may directly cause infection or lower the resistance by Vasoconstriction Contagion :the infection may be contracted from other individuals having infection CAUSATIVE ORGANISMS usual respiratory gram positive cocci like streptococci,staphylococcus, Pneumococcus and diptheroid organisms are responsible .of these ,haemolytic streptococcus Has special predilection for the tonsils.it may be a viral infection. PATHOLOGICAL TYPES ACUTE PARENCHYMATOUS TONSILITIS :The tonsils are enlarged and congested ACUTE FOLLICULAR TONSILITIS:The crypts are studded with pus and stand out as multiple Yellow spots on the red congested tonsils. Raw sensation in the throat is often the first symptom Pain in the throat occurs which is aggravated by swallowing .it may be reffered to the ears Refusal to eat:children may not complain about pain in throat ,but may refuse to eat because of ODYNOPHAGIA Voice may be thick and muffled due to thick secretions and impeded movements of the palate Tonsils become congested and swollen Secretions increased and become tenacious Halitosis :offensive breath may be present SEPTIC FOCUS IN CHRONIC TONSILITIS may produce effects on distant organs of the body by acting as septic focus due to bacteraemia ,or because of allergic reaction to bacteria and products of inflammation .

TINNITUS

TINNITUS TINNITUS is a noise in the ear or head .TINNITUS may occur with a benign disease , or it may be a warning signal of a serious disorder which needs to be diagnosed by through investigations TINNITUS is one of the most difficult symptoms to treat,it may be persists even after the aliments causing it has been cured TINNITUS may be unilateral or bilateral ,it may be classified as SUBJECTIVE TINNITUS :When a sound like ringing ,whistling or roaring is heard by the patients without The existence of such a sound it is called TINNITUS.This is an auditory hallucination ,is reserved for those conditions where an individual hears voices and sentences due to functional disturbances OBJECTIVE TINNITUS is heard not only by the patients, but also by the examiner INTERMITTENT :tinnitus may be continous or intermittent ,with long or short irregular intervals of Absence of tinnitus CONTINUOUS tinnitus is present all the time FLUCTUANT tinnitus may vary in intensity .it is more marked when the patients is emotionally protruded or when he is in a quiet atmosphere ,as at night PITCH of tinnitus may be high or low ,sometimes the pitch may vary SUBJECTIVE TINNITUS TINNITUS WITH DEAFNESS LOCAL :any disease of theear which can cause deafness may also produce tinnitus GENERAL :all the general causes of deafness may also be responsible for tinnitus TINNITUS WITHOUT DEAFNESS TINNITUS may occur without deafness in conditions llike anaemia,hypertension ,hypotension and carious teeth or impacted wisdom tooth. FUNCTIONAL :Emotional factors may cause tinnitus,but tinnitus itself may lead to anxiety and depression OBJECVTIVE TINNITUS Clicking temporomandibular joint,aneurysm and arteriovenous shunt around the ear,intracranial vascular tumours,live insects in the ear,clonic contractions of the palatal or tympanic muscles and patulous Eustachian tube.

SINUSITIS

SINUSITIS Sinusitis is an infection of the paranasal sinuses that may be bacterial ,mainly streptococcus pneumonia And haemophilus influenza or occasionally fungal. Most commonly associated with an upper respiratory tract infection and can occur with severe asthma SYMPTOMS Include frontal headache ,purulent rhinorrhoea,facial pain with tenderness and fever. It can be confused with a variety of other conditions such as migraine,trigeminal neuralgia and Cranial arteritis. ACUTE SINUSITIS –Lasting between 1 week-1 month RECURRENT ACUTE SINUSITIS – More than 4 episodes of acute sinusirtis per year SUB ACUTE SINUSITIS – Lasting between 1-3 months CHRONIC SINUSITIS-Lasting more than 3 months HOMEOPATHIC TREATMENT:ARS ALB,BELL,KALI BICH,MERC SOL, PULS AND SIL.

SCIATICA

SCIATICA SCIATICA is a medical condition in which pain going down the leg from the low back , Along the sciatic nerve pathway associated with weakness and numbness of the affected leg. CAUSES -SPINAL DISC HERNIATION pressing on one of the lumbar or sacral nerve roots is the most frequent Cause of sciatica ,it occurs during heavy lifting. -SPINAL STENOSIS is a condition in which the spinal canal ,the space the spinal cord runs through Narrow and compress the spinal cord ,this narrowing because of bony spurs ,spondylolisthesis, Inflammation or herniated disc. -PERIFORMIS SYNDROME it contributes up to 8% of low back or buttock pain,the sciatic nerve runs through the periformis muscle ,when the muscle shortens or spasms due to trauma or over use,this Cause compression of sciatic nerve. PERIFORMIS SYNDROME has colloquially been referred to as “WALLET SCIATICA” since wallet carried in a rear hip pocket compress the buttock muscle and sciatic Nerve ,when it bearer sits down. -PREGNANCY Sciatica may occur during latger stages of pregnancy as a result of the weight of the fetfus pressing On the sciatic nerve during sitting or during leg spasm. -OTHERS Sciatica can also be caused by tumor impinging on the spinal cord or the nerve root . Trauma to the spine , such as from a car accident or hard fall on to the heel or buttock leads to SCIATICA. HOMEOPATHIC TREATMENT: 1.AMMONIUM MUR:Chronic backache extends to heel,difficulty in straightening the knee withlimping gait. 2.BELLIS PER:Indicated in case of tail bone injury,nerve pain during pregnancy. 3.CAL.FLUOR:Degenerative changes after trauma to spine 4.CICUTA:Sciatica after serious trauma and muscle spasm. 5.COLOCYNTH:Left sided sciatica, >from pressure and warmth. 6.CHAMOMILLA:Sharp and tearing pains radiating to buttocks and heel with numbness. 7.PHYTOLACCA :Shooting pain towards the thigh and legs with unbearable stiffness of lumbar vertebrae. 8.RHUSTOX:Sciatica after lifting heavy weights and over exertion.

Complication of RA

RHEUMATOID ARTHRITIS

RHEUMATOID ARTHRITIS Chronic symmetrical polyarthritis .It is a systemic disorder characterised by chronic inflammatory synovitis of mainly peripheral joints. It is a significant causes of disability and mortality and carrier a high socio economic cost Women before the menopause are affected 3 times more often than men. Majority of patients complains of pain and stiffness of small joints of hands and feet . Periodic painful swelling of the joints with stiffness and deformity (e.g ulnar deviation of the hand ,flexon deformity etc)may occur Wrists, elbows,shoulders,knees and ankles are also affected with carpel tunnel syndrome. Pain worse in the morning ,joint usually warm and tender with swelling .There is limitation Of movement and muscle wasting and muscle spasm may present .Deformity develops as the disease progress. Other presentations like seronegative limited synovitis and palindromic rheumatis is unusual. COMPLICATIONS : Septic arthritis,amyloidosis and tenosynovitis. RHEUMATOID ARTHRITIS :EARLY PHASE Slight demineralization ,joint effusion,pericapsular swelling and marginal erosion LATE PHASE :Massive destruction ,sub luxation and fibrous ankylosis STILL’S DISEASE is juvenile rheumatoid arthritis with splenomegaly and lymphadenopathy. HOMEOPATHIC TREATMENT: ARNICA:Chronic arthritis,sore bruised feeling BRYONIA:Inflammation of joint with stiffness ,from pressure and rest. CAUSTICUM:Deformity developed in the joints with stiffness,continous motion. RUTA:Tendons are deeply affected,arthritis after overuse from repeated wear and tear.

PSORIASIS

PSORIASIS PSORIASIS is a non infectious chronic inflammatory disease of the skin ,characterized by well defined Erythematous plaques with silvery scales . PSORIASIS may start at any age but is unusual before the age of 5 and the oldest recorded onset was In a patient aged 107. FACTORS CAUSING FLARE UP OF PSORIASIS TRAUMA :when the condition is erupting ,lesions appear in area of skin damage such as scratches or Surgical wounds (KOBNER PHENOMENON) INFECTIONS: beta haemolytic streptococcal throat infections often preced guttate psoriasis. SUNLIGHT :rarely UVR may worsen psoriasis DRUGS:Antimalarial, beta adrenoreceptors antagonists (BETA BLOCKERS) and lithium May worsen psoriasis. EMOTIONS:Anxiewty precipitates some exacerbation TYPES OF PSORIASIS STABLE PLAQUE PSORIASIS:Scalp (60%)patients with psoriasis,well demarcated easily palpable Area ,in palms its difficult to recognize as individual plaques may be poorly demarcated. GUTTATE PSORIASIS:Mostly commonly seen in childrens and adolescents and may follow Streptococcal sore throat ,lesions are droplet shaped ,majority will develop plaque psoriasis Later in life. ERYTHRODERMIC PSORIASIS :Skin become universally red with hypo or hyperthermia. PUSTULAR PSORIASIS:Generalised rare but very serious onset ,sudden with large no of small Pustules erupting on red base ,with swinging pyrexia coinciding with new pustules ,primarily Affects palms and soles.

POST PREGANANCY COMPLICATIONS

POST PREGANANCY COMPLICATIONS 1.POST PARTUM HAEMORRHAGE The amount of bleeding from the genital tract following birth of the baby up to the end of puerperium which adversely affects the general condition of the patient rise in pulse rate with fall of blood pressure. The average blood loss is 500ml,1000ml and 1500ml respectively. PRIMARY –TRUE POST PARTUM HAEMORRHAGE bleeding occurs before expulsion of placenta. SECONDARY-DELAYED OR LATE PUERPERAL HAEMORRHAGE bleeding occurs beyond 24 hours and with In puerperium . 2.RETAINED PLACENTA The placenta is said to be retained when it is not expelled out even 30 minutes after the birth of the baby. 3.PUERPERAL SEPSIS An infection of the genital tract which occurs as a complication of delivery is termed as PUERPERAL SEPSIS Puerperal sepsis is commonly due to -1.endometitis ,2.endomyometritis,3.endoparametritis combination of 3 is called as PELVIC CELLULITIS. Micro organisms responsible for puerperal sepsis are-STREPTOCOCCUS HAEMOLYTICUS GROUP A (Toxic shock syndrome,caesarean section wound) STREPTOCOCCUS HAEMOLYTICUS GROUP B in Neonatal deaths due to septicaemia ,respiratory diseases and meningitis. 4.PUERPERAL PYREXIA Arise of temperature reaching 100 degree F or more on 2 seperarte occasions at 24 hours apart ,with in first 10 days following delivery is called PUERPERAL PYREXIA. CAUSES-Puerperal sepsis,urinary tract infection(cystitis,pyelo nephritis),mastitis,pulmonary infection,septic pelvic thrombophlebitis etc 5.SUBINVOLUTION When the involution is impaired or retarded it is called subinvolution.UTERUS is the most common organ affected in suninvolution CAUSES –Grand multiparity,hydramnios,maternal ill health,caesarean section,proplase of uterus and uterine fibroids etc SIGNS AND SYMPTOMS –Abnormal lochial discharge,irregular or excessive uterine bleeding ,irregular cramps with rise of temperature. 6.URINARY COMPLICATIONS -Retention of urine -Incontinence of urine -Suppression of urine 7.BREAST COMPLICATIONS -Breast engorgement -Cracked and retracted nipple -Acute mastitis -Breast abscess 8.PUERPERAL VENOUS THROMBOSIS Thrombosis of the leg veins,and pelvic veins is one of the common and important complications in puerperium 9.PULMONARY EMBOLISM Pulmonary embolism is the leading cause of maternal deaths. 10.PSYCHIATRIC DISORDERS DURING PUERPERIUM In the first 3 months after delivery ,incidence of maternal illness is high,incidence about 15-20% Sleep deprivation,massive post partum withdrawal,contribute to the risk.

PILES OR HEMORRHOIDS

PILES OR HEMORRHOIDS Vascular structure in the anal canal ,they become disease when swollen or inflamed Signs and symptoms of haemorrhoids depends on type INTERNAL HEMORREHOIDS :Painless , bright red rectal bleeding when defecating EXTERNAL HEMORRHOIDS:Painful and swelling in the aera of anus CAUSES -Irregular bowel habits(constipation or diarrhea) -Nutritional factors(low fiber diet) -lack of exercise -Increased intraabdominal pressure (prolonged straining,ascitis,pregnancy) Other factors believed to increased risk include obesity, prolonged sitting,chronic cough, And pelvic floor dysfunction. During pregnancy pressure from the fetuson the abdomen and hormonal changes causes the Hemorrhoidal vessels to enlarge. GRADES OF INTERNAL HEMORRHOIDS GRADE 1-No prolapse ,just prominent blood vessels GRADE 2-Prolapse ,but spontaneous reduction GRADE 3-Prolapse ,and require manual reduction GRADE 4-Prolapse with inability to be manually reduced PREVENTION -Avoid straining while attempting to defecate -Avoid constipation and diarrhoeaeither by eating high fibre diet and drinking plenty of fluids Or by taking fibre supplements. HOMEOPATHIC TREATMENT HAMAMELIS :Bleeding piles RATANIAH:Piles with burning sensation COLLINSONIA:Piles with constipation AESCULUS HIP:Piles with shooting pain NUX VOMICA AND PULSATILLA :Blind piles SEPIA AND KALI CARB:Piles after child birth SILICEA:Piles with anal fistula MERC SOL:Piles with chronic diarrhoea LYCOPODIUM:Piles with rectal prolapsed AMMONIUM CARB:Piles during menses LACHESIS:Piles protrude during cough and sneeze BARYTA CARB:Piles protrude during urination.

PCOS

PCOS POLY CYSTIC OVARIAN SYNDROME is a set of symptoms due to elevated androgens(male hormones)in female SIGNS AND SYMPOTOMS -PCOS includes irregular or no menstrual periods or heavy periods ,excess body and facial hair ,acne,pelvic pain,difficulty getting pregnancy and patches of thick darker velvety skin. -Associated conditions include type 2 diabetes ,obesity ,obstructive sleep apnea,heart disease,mood disorder and endometrial cancer. -PCOS is due to a combination of genetic and environmental factors -RISK FACTORS includes obesity,lack of physical exercise and family history of PCOS -Treatment may involves lifestyle changes,such as weight loss and exercise -PCOS is the most common endocrine disorder among women between the ages of 18-44 -Most common cause of infertility is PCOS. SIGNS AND SYMPTOMS -MENSTRUAL DISORDERS :PCOS mostly produce oilgomenorrhoea (fewer than 9 menstrual periods in a year)or amenorrhoea(no menstruation for 3-4 consecutive months) even it may produce hypermenorrhoea(heavy and prolonged menstrual periods). -INFERTILITY : results directly from chronic anovulation -HIGH LEVELS OF MASCULINIZING HORMONE known as hyperandrogenism,the most common signs are acne and hirsutism(male patternof hair groeth on chin and chest) – ANDROGENIC ALOPECIA(Hair thinning or diffuse hair loss) -METABOLIC SYNDROME tendency towards central obesity associated with insulin resistance.

OLIGOMENORRHOEA

OLIGOMENORRHOEA: Menstrual bleeding occurring more than 35 days a part and which remains constant at the frequent is called OLIGOMENORRHOEA. CAUSES -Age-related-During adolescence and preceding menopause -Weight-related-obesity. -Stress and exercise related -Endocrine disorders-PCOS,HYPERPROLACTINAEMIA,HYPERTHYRIDISM -Androgen producing tumours-ovarian,adrenal. -Tubercular endometritis-late cases. -Drugs:phenothiazines,crimetidine and methyldopa. HOMEOPATHY TREATMENT PULSATILLA,SEPIA,ALETRIS FARINOSA,HELONIAS,CONIUM,ACTEA RACEMOSA,VIBURNUM OPULUS,BELLADONA ,IGNATIA,HYOSCYAMUS,VALERIANA AND OOPHRINUM.

NASAL OBSTRUCTION

NASAL OBSTRUCTION can be temporary or permanent ;intermittent or persistent;unilateral or bilateral PHYSIOLOGICAL CYCLIC:one nostril functions more than the other in cyclic phase in normal persons POSTURAL :While lying down on one side ,the nostril on the lower side gradually gets blocked ,while the upper nostril gradually opens due to naso –pulmonary reflexes REFLEX:If thenose is exposed to cold air ,the nose gets partially obstructed reflexly to provide better air Conditioning of the inhaled air and to warm it .Exposing the head and feel to chill or cold water also causes reflex nasal obstruction PATHOLOGICAL CONGENITAL:Chonal atresia and atresia of anterior nares may occur .congenital deviation of the nasal septum is uncommon OBSTRUCTION :Deviated nasal septum is a common cause on the side opposite to the deviation ,compensatory hypertrophy of the turbinates may produce obstruction Adenoids in children are a common cause of mouth breathing TRAUMATIC :Birth trauma may deviate the septum ,but it is easily corrected by manipulating the nose External injuries may cause fracture ,dislocation of the nasal septum or septal haematoma Foreign bodies obstructed the nose by their physical presence and secondary infection INFECTION :All types of rhinitis and sinusitis causes obstruction .chronic hypertrophic rhinitis With hypertrophic turbinates is a common cause of obstruction.common cold often produces temporary Obstruction Septal abscess blocks the nose on both sides NON INFLAMMATORY RHINITIS :Allergic rhinitis ,vasomotor rhinitis MISCELLANEOUS :Nasal polyps,rhinitis medicamentosa NEOPLASMS in the nose,paranasal sinuses and nasopharynx produce unilateral nasal obstruction ,but later these may obstruct the other side also. Malignant neoplasms may be associated with blood stained discharge GENERAL CAUSES:Hypotensive drugs may produce nasal obstruction,hypothyroidism,using snuff ,smoking and alcoholism COMMON CAUSES OF NASAL OBSTRUCTION IN CHILDREN:Adenoids,rhinitis and foreign bodies. IN ADULT:Deviated nasal septum,hypertrophic turbinates,nasal allergy or vasomotor rhinitis,polyps,sinusitis and rhinitis medicamentosa IN ELDERLY:Hypotensive drugs,rhinitis medicamentosa ,malignancy in the nose,paranasal sinuses And nasopharynx should be ruled out if there is unilateral obstruction with blood stained discharge and sinusitis CAUSES OF UNILATERAL NASAL OBSTRUCTION Congenital :choanal atresia Infections:sinusitis and rhinosporidiosis Neoplasms Miscellaneous :deviated nasal septum,hypertrophic inferior turbinate ,antrochonal polyp,foreign body , rhinolith and synechia.

MUSCULAR DYSTROPHIES

MUSCULAR DYSTROPHIES This is a group of inherited disorders characterized by progressive degeneration of groups of muscles,sometimes with involvement of the heart muscle or conducting tissue and other parts of the nervous system. MYOTONIC DYSTROPHY Autosomal dominant; expanded triplet repeat chromosome 19q, Age of onset-occurs at any age Muscles affected –face(including ptosis),sternomastoids,distal limb,and generalized later. Other features-myotonia,cognitive dulling,cardiac conduction abnormalities,lens opacities ,frontal balding and hypoganadism. PROXIMAL MYOTONIC MYOPATHY(PROMM;DM2) Autosomal dominant;quadruplet repeat expansion in zn finger protein 9 gene chromosome 3q Age of onset-adult Muscles affected-proximal,especially thigh ,sometimes muscle hypertrophy. Other features-As for DM 1 but cognition not affected,muscle pain. DUCHENNE X-linked;deletion in dystorphin gene Age of onset-first 5 years Muscles affected-proximal and limb girdle Other features- pseudohypertrophy of clves,cardiomyopathy. BECKER X-linked ;deletions in dystrophin gene Age of onset-late childhood/early adult Muscles affected-proximal and limb girdle Other features –pseudohypertrophy of calves,cardiomyopathy LIMB GIRDLE Autosomal dominant (type-1),autosomal recessive (type-2),many mutations on different chromosomes Age of onset-childhood/early adult Muscles affected-limb girdle Other features-some have calf hypertrophy ,some have cardiac conduction abnormalities. FACIOSCAPULOHUMERAL(FSH) Autosomal dominant; tandem repeat deletion chromosome 4q Age of onset-7-30 years Muscles affected –face and upper limb ,girdle. Other features –pain in shoulder girdle common. OCULOPHARYNGEAL Autosomal dominant and recessive;triplet repeat expansion in PABP2 gene chromosome 14q Age of onset-30-50 years Muscles affected-ptosis,external opthalmoplegia, dysphagia,tongue weakness Others features-mild lower limb weakness EMERY-DREIFUSS X-linked recessive;mutation in emerin gene Age of onset-4-5 years Muscles affected-humero-peroneal,proximal limb girdle later Others features-contractures develop early ,cardiac involvement leads to sudden death Clinical features Onset is often in childhood ,although some patients especially those with myotonic dystrophy, may present as adults. Wasting and weakness are usually symmetrical,there is no fasciculation and no sensory loss,except in myotonic dystrophy. Differential diagnosis is based on the age at onset ,the distribution of affected muscles and the pattern of inheritance Myotonic dystrophy may be diagnosed clinically by the distribution of muscle weakness and other features including myotonia, many dystrophies include cardiomyopathy amongst their clinical features.

MIGRAINE

MIGRAINE as a traid of paroxysmal headache,nausea or vomiting and an aura of focal neurological events (usually visual) MIGRAINE WITH AURA –CLASSICAL MIGRAINE MIGRAINE WITH OUT AURA –COMMON MIGRAINE CLASSICAL MIGRAINE starts with malaise and irritability followed by AURA of focal neurological event And then severe throbbing ,hemicranial headache with photophobia and vomiting during headache patient prefers quite and darkroom to sleep and may persists for several; days. True weakness is distinctly unusual in migraine, so hemiplegic migraine should be diagnosed with Extreme caution. In some patients the focal events may occur by them selves (MIGRAINE EQUIVALENT) In some patients the symptoms of aura do not resolve leaving more permanent neurological disturbance (COMPLICATED MIGRA) AETIOLOGY OF MIGRAINE is largely unknown .ther is often a family history suggesting a genetic Predisposition .in women migraine attacks at certain points in their menstrual cycle hint at Hormonal influences ,contraceptive pills exacerbate migraine in many patients. HOMEO TREATMENT: BELLADONA:Magraine with intense throbbing ,pulsating headache. GLONINE:Congestive headache after sun exposure SPIGELIA:Indicated in case of LEFT SIDED MIGRAINE. IRIS VER:RIGHT SIDED MIGRAINE with intense nausea,vomiting and acidity. SANGUNARIA:RIGHT SIDED MIGRAINE ,started from morning till sunse,works well in case of women during menopause. NUX VOMICA:Migraine with gastric troubles. NAT.CARB:Migraine from sun,shooting pain in the forehead. NAT.MUR:Migraine attacks

MENIERE’S DISEASE

MENIERE’S DISEASE MEINERE’S DISEASE is characterized by a triad of symptoms consisting of VERTIGO,DEAFNESS AND TINNITUS which occurs at irregular and unpredictable intervals MEINERE was a French physician who described in 1861.There is ENDOLYMPHATIC HYDROPS characterized by increased tension of the endolymph Usually it occurs over the age of 30 years ,both sexes are equally affected ,bujt slightly more common in males VASOSPASM:Reduced blood supply to the labyrinth due to vasospasm is the most likely cause ENDOLYMPHATIC HYDROPS:There is increased tension of endolymph in the labyrinth ,due to reduced Absorption of endolymph secondary to reduced blood supply .Water and salt retension in the body Is sometimes considered to be the cause. EMOTIONAL FACTORS may cause giddiness ,but they may also be secondary to giddiness ,patients may lose confidence and become emotionally liable SYMPATHETIC SYSTEM OVERACTIVITY may cause vasospasm HORMONAL DISTURBANCES may cause water and electrolyte disturbances in the endolymph VITAMIN B COMPLEX DEFICIENCY is not an established cause ALLERGY AND SEPTIC FOCI may be responsible for MENIERE’S DISEASE. GIDDINESS The patient gets recurrent attacks of giddiness of sudden onset in spells of varying intensity duration and intervals .it may range from mild dizziness or imbalance to severe vertigo which is usually rotator in character. DEAFNESS sensori-neural deafness is always present and its intensity may fluctuate . it may increase with each attack .the patient may have distorted sounds (DIPLACUSIS)and may have intolerance to loud Sounds because of the phenomenon of recruitment TINNITUS may be continuous or may be present only during attacks . it may be more on the affected side .sometimes deafness and tinnitus increase before the attack (AURA) NAUSEA AND VOMITING may occur if giddiness is severe PERSPIRATION ,GASTRIC UPSET AND DIARRHOEA are due to vagal stimulation ,and severe giddiness may be accompanied by these symptoms .The patient may look pale and the blood pressure may drop FULLNESS often patients complain about fullness in the affected ear HEADACHE is often present ,migraine may affect some cases ANXIETY always accompanies giddiness NYSTAGMUS During an acute attack ,horizontal nystagmus may be present.

MASTITIS

Incidence of mastitis is 2-5% in lactating and less than 1% in non-lactating women.The common organisms involved are staphylococcus aureus,s.epidermidis and streptococci viridians. MASTITIS is inflammation of the breast usually associated with breast feeding There are 2 differeny types of mastitis depending upon the site of infection 1.Infection that involves the breast parenchymal tissues leading to cellulitis ,the lacteal system remains unaffected. 2.Infection gains access through the lactiferous duct leading to development of primary mammary adenitis,the source of organisms is the infants nose and throat. Non-infective mastitis may be due to milk stasis.feeding from the affected breast solves the problem In superficial cellutitis,the onset is acute during first 2-4 weeks postpartum.However,acute mastitis may occur even several weeks after the delivery. SIGNS AND SYMPTOMS -LACTATING MASTITIS usually affects only one breast and symptoms can develop quickly -Breast tenderness and warmth to touch. -Swelling of breast -Skin redness often in wedge shaped -Fever of 101degree /F -Pain or burning sensation continuously or while breast feeding -General malaise and headache. HOMEOPATHIC TREATMENT BELLADONA:Initial stages of inflammation,breast red, swollen with throbbing pain. PHYTOLACCA:Grade -1 medicine for mastitis ,breast swollen,painful with soreness.stitching and shooting pain with cracked nipples.PAIN FROM BREAST RADIATES TO WHOLE BODY WHILE NURSING. CROTON TIG:Effective medicine for mastitis.breast is hard, swollen,inflamed .PAIN FROM BREAST RADIATES TO THE BACK WHILE NURSING THE BABY. BRYONIA:Stony hardness of breast,hot swollen ,highly painful ,patient need to support the breast with the hand.pain >from rest. SILICEA AND HEPAR SULPH:Very effective in treating suppurative condition ,helps in the drainage of pus without any surgical intervention.pus discharge with intense pain ,sensitive to touch.

MALE FERTILITY

MALE FERTILITY is inability of male to cause pregnancy in fertile female. -Male is directly responsible in about 30-40% -Female is about 40-55% -Both r responsible in about 10% of cases -It is also emphasized that the relative subfertility of one partner may sometimes be counter Balanced by the high fertility of other. FAULTS IN THE MALE DEFECTIVE SPERMATOGENESIS: -CONGENITAL :Undesended testes,kartagener syndrome and hypospadias -THERMAL FACTOR:Scrotal temperature is raised in condition such as varicocele -INFECTION:Mumps orchitis after puberty may permanently damage spermatogenesis,Sperm quality is adversely affected by chronic systemic illness likeBRONCHIECTASIS,bacterial or viral infection of seminal Vesicles or prostate depress the sperm count -GENERAL FACTORS :Chronic debilitating diseases,malnutrition,heavy smoking reduce spermatogenesis. Alcohol inhibits spermatogenesis either by suppressing leydig cell synthesis of testosterone or by suppersing gonadotropin levels. -ENDOCRINE:Testicular failure due to gonadotropin deficiency (kallmann’s syndrome),FSH raised in idiopathic testicular failure with sperm cell hypoplasia(sertoli-cell-only-syndrome),hyperprolactinaemia Is associated with impotency. -GENETIC :Azospermic male is KLINEFELTERS SYNDROME. -IATROGENIC:Radiations,cytotoxic drugs,beta blockers,antihypertensive,anticonvulsant and antidepressant drugs are likely to hinder spermatogenesis. -IMMUNOLOGICAL FACTORS:Antibodies against spermatozoa surface antigen may be the cause of infertility, this results in clumping of the spertmatozoa after ejaculation OBSTRUCTION OF THE EFFERENT DUCT SYSTEM :The efferent ducts may be obstructed by infection like Tubercular ,gonococcal or by surgical trauma(herniopathy)following vasectomy. In YOUNGS SYNDROME there is epididymal obstruction and bronchiectasis. FAILURE TO DEPOSIT SPERM HIGH IN THE VAGINA(COITAL PROBLEMS) -Erictile dysfunction,ejaculatory defect-permature,retrograde or absence of ejaculation. SPERM ABNORMALITY -Loss of sperm motility(ASTHENOZOOSPERMIA),abnormal sperm morphology (round headed sperm, Teratozoospermia)are the important factors ERROR IN SEMINAL FLUID -Unusually high or low volume of ejaculate, -Low fructose content, -High prostaglandin content, -Undue viscosity. MAN TO BECOME FATHER MUST FOCUS ON FOLLOWING MAINTAIN HEALTHY BMI(BODY MASS INDEX) -Increased BMI leads to decreased sperm production and sperm motility. REGULAR EXERCISE FOR MINIMUM 30 MINUTES FOR HEALTHY REPRODUCTIVE LIFE -Exercise helps in increasing sperm count and sperm motility MUST FOCUS ON THIS FOODS SALMON FISH rich of omega 3 fatty acids and protein helps in regulating prostaglandins to boost up fertility ,It also contains selenium and vitamin D,helps in increasing blood flow to reproductive organs. SUN FLOWER SEEDS rich of vitamin E which helps in boosts up male fertility,improves sperm count and motility WAL NUTS contains omega 3 fatty acids which maintains the semen health and increase vitality of sperm PINEAPPLE useful for chronic smokers whose semen quality is poor,pine apple will helps to increase the quality of semen. ASHWAGANDHA(GINSENG)Helps in increasing the level of testosterone and helps in treating ERECTILE DYSFUCTION. CARROT Beta carotene an antioxidant helps in maintain the health of sperm and aids mobility of sperm helping to reach the egg. DARK CHOCLATE contains amino acids and arginine which improves sperm count and quality. MUST AND SHOULD AVOID RICH DIARY PRODUCTS contains estrogenwhich lowers the sperm count FATTY ,FRIED FOODS,AND PROCESSED MEAT LOWERS THE SPERM COUNT.

LIGAMENT TEAR

A ligament is a tough fibrous band of connective tissue that connects one bone to other bones . Ligamental tear is also called as a SPRAIN. VARIOUS LOCATIONS OF LIGAMENTAL TEAR Arm,Shoulder,wrist,knee,heel,fingers,cuboid,neck, Calf,thigh,breast,abdomen,popliteal,goin and trapezoid etc Sprain commonly occur in ANKLE ,about 25000 people sprain an ankle every day. Thumb and wrist sprains are also more common in sports people. Ligament tear mostly seen in athelets like foot ball players,soccer,basket ball etc Depends on the type of sport,location of sprain will vary. GRADES OF TEAR GRADE I :very mild tear with little instability at joint. GRADE II :more serious but still incomplete tear,with some looseness in the joint GRADE III :ruptured ligament or complete torn,its impossible to put weight on the joint or use the affected limb. Some of the 1st grade remedies used in case of ligamental tear are ARNICA( injury,fall ,blow or trauma )RHUSTOX,RUTA,BRYONIA,SYMPHYTUM,CALCAREA CARB,APIS MEL etc.

HAIRFALL

Alopecia means nothing more than loss of hair and is a sign rather than diagnosis. There are many causes and patterns.
CLASSIFICATION : LOCALISED (non scaring) :tinea capitis,alopecia areata,androgenetic alopecia, Traumatic and syphilis. DIFFUSED (non scaring) :Hypothyroidism,hyperthyroidism,hypopituitarism,diabetes, Hiv,nutritional deficiency,liver diseases and post partum etc LOCALISED(scaring) :idiopathic,discoid lupus erythematous,herpes zoster,tinea capitis. DIFFUSED(scaring):radiotherapy,folliculitis decalvans,lichen planus pilaris. ALOPECIA AREATA:Sudden loss of hair in patchy fashion may be due to anxiety or sudden shock It may show a marked tendency of recurrence. RINGWORM:It causes bald patches having scanty ,small,thin hairs.fungal spores are found in affected hair USE OF CURLERS:It may be responsible for baldness in corresponding areas .later on there may be scaring and permanent loss of hair. HOMEO TREATMENT FOR HAIRFALL FLUORIC ACID:Hairfall after sickness ,hair breakageand hair gets tangled a lot. PHOSPHROUS:Alopecia with gastrointestinal disorders CALCAREA CARB:Hairfall with itching and sweating of scalp,helps in regrowth of hair. VINCA MINOR:Hairfall with dandruff,used to treat abnormal hair growth. SILICEA:Baldness accompanied with pain BARYTA CARB:Premature baldness in timid people with tonsillitis.

FISTULA

A FISTULA is an abnormal connection between 2 hallow spaces (2 epithelial surfaces) Such as blood vessels,intestines,or other hallow organs. -FISTULAS are usually caused by injury or surgery,but they can also results from an Infection or inflammation. ANAL FISTULA is a chronic abnormal communication between the epithelial surface of the Anal canal . ANAL FISTULA is a narrow tunnel with its internal opening in the anal canal and its external opening Is the skin near the anus -ANAL FISTULA is commonly seen in people with history of anal abscess where it do not heel properly SIGNS AND SYMPTOMS
-Skin maceration
-Pus ,serious fluid and rarely feces discharge can be bloody or purulent
-Pruritis ani-itching -Depending on presence and severity of infection –pain,swelling,tenderness,fever,unpleasant odor, Thick discharge, which keeps the part always wet. HOMEO INDICATION
GRAPHITES 200:Fistula with sticky discharge along with itching. HEPAR SULPH 200:Used in case of fistula as ANTIBIOTIC. CAL.SULPH 200:Fistula with offensive and yellowish discharge. SILICEA 6X:Fistula with frequent tendency of pus formation CALC FLUOR 6X:Used to heel the blind tract. THUJA 1M:Used to heel chronic infection ,should take once in aweek

ENDOMETRIOSIS

ENDOMETRIOSIS is a painful disorder ,in which abnormal growth of the endometrium outside Of uterine lining .commonly involves ovaries,fallopian tubes and tissue lining of pelvis. The area of endometriosis bleed each month ,resulting in inflammation and scaring .
SIGNS AND SYMPTOMS -Pain and infertility are common symptoms ,although 20-25% of womens are asymptomatic. PELVIC PAIN A major symptom of endometriosis is recurring pelvic pain ,pain can range from mild –severe Cramping or stabbing ,pain that occurs on both sides of pelvis, lower back,rectal area and even down the legs. INFERTILITY About a third of women with infertilityn have endometriosis,among women with endometriosis About 40% are infertile.
OTHER SYMPTOMS Diarrhoea or constipation,chronic fatigue,nausea, vomiting,headache,low grade fever,heavy and or Irregular periods and hypoglycemia. ENDOMETRIOSIS is unreleated to ENDOMETRIAL CANCER.
RISK FACTORS ENDOMETRIOSIS is a heritable condition that is influenced by both genetic and environmental factors Daughters or sisters of women with endometriosis are at high risk of developing endometriosis themselves. -More often endometriosis found on the ovaries, fallopian tubes and ligaments -Less common in sites of vagina,cervix,vulva,bowel,bladder and rectum. -Rarely in parts such as lungs ,brain and skin.
HOMEO INDICATIONS CIMICIFUGA AND XANTHOXYLUM:Endometriosis with dysmenorrhoea PULSATILLA,SABINA AND SEPIA:Endometriosis with pelvic pain SEPIA AND PLATINA:Endometriosis with painful intercourse(dysperunia) AMMON.MUR,LACHESIS AND NUX.VOMICA:Endometriosis with rectal complaints NATRUM.MUR AND SEPIA:Endometriosis with urinary complaints.

DYSPHAGIA

EVERY DIFFICULTY MUST BE REMOVED FOR EASY MOVING DYSPHAGIA si defined as difficulty in swallowing .It may coexist with heart burn or vominting but should be distinguished from both globus sensation(in which anxious people feel a lump in the throat without organic cause)and odynophagia (pain while swallowing, usually from gastroesophagial reflux or candidiasis) DYSPHAGIA has oropharyngeal disorders results from neuromuscular dysfunction affecting the initiation Of swallowing by the pharynx and upper oesophageal spincture (e.g. bulbar or pseudobulbar palsy and myasthenia gravis) Patients with oropharyngeal dysphagia have difficulty initiating swallowing and develop choking,nasal regurgitation or tracheal aspiration.Drooling ,dysarthria,hoarseness and cranial nerve or other neurological signs may be present. Oesophageal causes include structural disease(benign or malignant strictures)and dysmobility of the Oesophagus .Patients with oesophageal disease complain of food ‘sticking’after swallowing ,although The level at which this is felt correlates poorly with the true site of obstruction .swallowing of liquids is Normal until strictures become extreme. BENIGN STRICTURE(peptic,fibrous rings) MALIGNANT STRICTURE(carcinoma of the oesophagus,carcinoma of stomach and extrinsic compression) HOMEO INCATIONS
Lachesis and hyoscymus-Difficulty in swallowing liquids Alumina and kalicarb-Difficulty in swallowing solids Baptisia and baryta carb-inability to swallow solids Belladona and cactus-patient has to drink water to swallow food.

ANAL FISSURE

INTAKE WILL REFLECT YOU OUT………………….. ANAL FISSURE is a break or tear in the skin of the anal canal ANAL FISSURE may be noticed by bright red anal bleeding on toilet paper and Under garments or sometimes in toile. If acute they are painful after defecation If its chronic ,pain intensity is often less -Untreated fissure develop a hood like skin tag (SENTINEL PILES) which covers the fissure and cause discomfort and pain. CAUSES -Most anal fissures are caused by stretching of anal mucous membrane beyond its Capability -Superficial fissure ,they will self heal with in a couple of weeks -Most common cause of non healing fissures is spasming of internal anal spincture muscles which results in impaired blood supply to the anal mucosa. -other common causes like child birth trauma in women,anal sex,corhns disease,ulcerative colitis etc PREVENTION -Avoid straining when defecating includes treating and preventing constipation by eating food rich in Dietary fiber. -In infants frequent diaper change can prevent anal fissure as constipation can be a cause, making Sure the infant is drinking enough fluids (i.e breastmilk ,proper ratio in mixing formulae)is beneficial. CRACKY LIPS WILL HAVE CRACKY ANUS HOMEO WILL HELP YOU IN CLEARING YOUR ANAL CRACKS NITRIC ACID ONE OF THE INDICATED REMEDY IN ANAL FISSURE. Splincter like pains,stiching and tearing in nature,hard stool with bright red bleeding. Cutting and tearing sensation in anus.
RATANIA
Its top grade medicine in case of ANAL FISSURES Long lasting pain in the rectum with burning after passing stool