DYSPEPSIA

MULTI-DIMENSIONAL APPROACH  TO  DYSPEPSIA. SAY NO TO PROTON PUMB INHIBITORS

Dyspepsia, also known as indigestion or upset stomach, is a term that describes discomfort or pain in the upper abdomen. It is not a disease. Various conditions cause dyspepsia. It can be caused due to various medications, stressed lifestyle and spicy foods. The main symptom is usually pain or discomfort in the upper tummy (abdomen). In addition, other symptoms that may develop include Bloating, Belching, Quickly feeling full after eating, Feeling sick (nausea) & Being sick (vomiting). Hyperacidity is also called Acid Dyspepsia, which is one of the most common problem. Hyperacidity is a medical condition in which the stomach secretes a lot of acids.

Causes of Dyspepsia

Indigestion is usually related to lifestyle and what we eat and drink. It may also be caused by infection or some other digestive conditions.
Some common causes include:
Life Style factors - Eating too much, Eating too rapidly, Consuming fatty or greasy foods, Consuming spicy foods, Consuming too much caffeine, Consuming too much alcohol, Consuming too much chocolate, Consuming too many fizzy drinks, Emotional trauma, moderate to intense exercise immediately after eating.
Functional dyspepsia - a type of indigestion that may undermine the stomach's ability to accept and digest food and then pass that food on to the small intestine.
Gallstones
Gastritis (inflammation of the stomach)
Hiatus hernia
Infection, especially with bacteria known as Helicobacter pylori
Nervousness
Obesity - caused by more pressure inside the abdomen
Pancreatitis (inflammation of the pancreas)
Peptic ulcers
Smoking
Some medications like Antiinflammatory medicines are the most common culprits. These are medicines that many people take for arthritis, muscular pains, sprains, period pains, etc. For example: aspirin, ibuprofen,and diclofenac but there are others. Antiinflammatory medicines sometimes affect the lining of the stomach and allow acid to cause inflammation and ulcers.
Various other medicines sometimes cause dyspepsia, or make dyspepsia worse. They include: digoxin, antibiotics, steroids, iron, calcium antagonists, nitrates, theophyllines and bisphosphonates.such as antibiotics and NSAIDs (non-steroidal anti-inflammatory drugs)
Stomach cancer

Clinical manifestations of Dyspepsia
Most people with indigestion feel pain and discomfort in the stomach or chest area. The sensation generally appears soon after consuming food or drink. In some cases symptoms may appear some time after a meal. Some people feel full during a meal, even if they have not eaten much. Heartburn and indigestion are two separate conditions.
Heartburn is a burning feeling behind the breastbone, usually after eating.
The Common symptoms are Nausea, Belching, Feeling bloated (very full)
In very rare cases indigestion may be a symptom of stomach cancer.
Mild indigestion is rarely anything to worry about. if symptoms continue for more than two weeks. Consult a physician immediately if pain is severe, and symptoms like
Loss of appetite or weight loss, Vomiting, Black stools, Jaundice (yellow coloring of eyes and skin), Chest pain, Shortness of breath, Sweating, Chest pain radiation to the jaw, arm or neck.

Investigations

Majority of patients indigestion is mild and does not occur very often. In such cases no treatment from a doctor is required. People who experience indigestion regularly consult a good physician.
Blood test - if the patient has any symptoms of anemia then blood test is needed.
Endoscopy - patients who have not responded to treatment, or those with certain signs and symptoms, may be advised to have their abdomen examined in more detail like endoscopy is advised.
Tests to diagnose Helicobacter pylori infection - this may include a urea breath test, a stool antigen test, and a blood test. Peptic ulcers are often cause by this bacterium.
Liver function test  if the patient may have a biliary condition, which affects the bile
ducts in the liver. This involves a blood test that determines how the liver is working.
X-rays - usually an upper-gastrointestinal and small bowel series. X-rays are taken of the esophagus,stomach and small intestine.
Abdominal ultrasound - high-frequency sound waves make images that show movement, structure and blood flow.
Abdominal CT (computed tomography) scan.

Management
In modern medicine, Proton pump inhibitors like omeprazole, lansoprazole, pantoprazole, rabeprazole, esomeprazole, dexlansoprazole rank among the top 10 prescribed classes of drugs and are commonly used to treat acid reflux, indigestion, and peptic ulcers. Although generally assumed to be safe, recent studies have shown that they have numerous side effects, from an altered gut environment and impaired nutrient absorption to an increased risk for cardiovascular events, kidney disease, and dementia.

Lifestyle changes

For all types of dyspepsia, the National Institute for Health and Care Excellence (NICE) recommends the following lifestyle changes like Make sure you eat regular meals, Lose weight if you are obese, If you are a smoker, consider giving up, Don't drink too much alcohol.
Changing the way you eat may help your symptoms. Steps you can take include: Allow enough time for meals, Chew food carefully and completely, Avoid arguments during meals, Avoid excitement or exercise right after a meal, Relax and get rest if indigestion is caused by stress.
Posture - Lying down or bending forward a lot during the day encourages reflux. Sitting hunched or wearing tight belts may put extra pressure on the stomach, which may make any reflux worse.
Bedtime - If symptoms recur most nights, the following may help:
Go to bed with an empty, dry stomach. To do this, don't eat in the last three hours before bedtime and don't drink in the last two hours before bedtime. If you are able, try raising the head of the bed by 10  20 cms (for example, with books or bricks under the bed's legs). This helps gravity to keep acid from refluxing into the oesophagus. If you do this, do not use additional pillows, because this may increase abdominal pressure.
Spices and condiments such as pepper, mustard must be avoided.
Vinegar or pickles, which make food more palatable and lead to overeating, must be avoided.
Alcohol, tobacco, strong tea and coffee must be avoided. Highly seasoned meats, pulses, potato, rice, cheese, refined, processed, stale and tinned foods should all be avoided.

Home Remedies:
For instance, drinking a glass of water at the first sign of indigestion can give you much relief. Water helps dilute stomach acids thus giving you relief from bloating and burning.
Apple cider vinegar is often used to kick start a slow stomach and settle indigestion due to its antibiotic properties. Add one tablespoon apple cider vinegar to a cup of water. Mix in one teaspoon honey. Drink this solution two to three times a day for quick relief.
Fennel seeds can be really helpful for indigestion caused by very spicy or fatty food. Fennelseeds contain oil that can help reduce nausea and control flatulence.
Ginger stimulates digestive juices and the flow of enzymes that help you digest your food. This makes ginger an effective remedy for indigestion from overeating.
Baking soda - Indigestion often happens due to high levels of stomach acids. Baking soda is one of the most simple and effective treatments for indigestion because it acts like an antacid. Stir one half teaspoon of baking soda into half a glass of water. Drinking this solution will neutralize the acid in your stomach and give your relief from bloating.
Coriander is an effective spice to treat indigestion. Add some roasted coriander seeds to half a glass of buttermilk and drink it twice a day.
Drinking herbal tea after eating a heavy meal can greatly reduce indigestion. Dip your favorite herbal tea bag into a hot cup of water and cover it for five minutes. Drink it while it is still warm. You can try herbal tea containing mint, raspberry and blackberry for instant relief. Peppermint or chamomile tea can also calm your stomach, especially after overeating.

HOMOEOPATHIC MANAGEMENT

Homoeopathy is a remarkable resource for those dealing with digestive disorders. Homeopathic constitutional treatment based on the individual case is the most suitable and would aim to heal the underlying physical or emotional crisis causing digestive disorders. The unique physical, emotional and mental expression of illness is characteristic and is used to channel the course of Homoeopathic treatment. The remedies work by stimulating bodys natural ability to heal itself, acting as a catalyst for healing. Homoeopathy can be of assistance in retrieving normal motility and treating any psychological issues related to IBS. Homeopathic remedies can help rebuild mind, body and spirit as well as personal relationships for a balanced lifestyle. Homeopathy will reinforce and tone the bodys systems. Homeopathic remedies can help deal with anxiety, depression, and stress along with digestive problems. It will attend to nutritional problems and help the patient develop a healthier body image.

Some Homoeopathic remedies for Dyspepsia are

Indicated Remedies
Indications

Arsenicum album
This remedy may be indicated if a person feels anxious, restless yet exhausted, and is worse from the smell and sight of food. Burning pain is felt in the stomach and esophagus, which often is relieved by warmth and sitting up. Vomiting and diarrhea are possible. Upsets from spoiled food or from eating too much fruit often respond to this remedy.

Bryonia
When this remedy is indicated, the stomach feels heavy, with rising acid and a bitter or sour taste. Pain and nausea are worse from motion of any kind. The person may have a dry mouth and be thirsty for long drinks, which may increase discomfort. Bryonia is strongly suggested if a person is grumpy and wants to stay completely still and not be touched or talked to.

Carbo vegetabilis
Sour belching bringing only small relief, burning pain in the stomach and abdomen, and flatulence after eating may be seen when this remedy is needed. The person feels cold and faint, with a strong desire for fresh or moving air. Digestion may be slow and incomplete, with nausea or cramping.

Colocynthis
Cutting, cramping pain in the stomach and abdomen, with relief from hard pressure or from doubling over, indicates a need for this remedy. A bitter taste in the mouth, a feeling that the intestines are about to burst, or a sensation that stones are grinding together in the abdomen may be present. Indigestion may be worse when the person feels upset, especially after suppressing anger.

Lycopodium
This remedy is indicated for many digestive troubles. The persons appetite may be ravenous, but eating even a small amount can cause a feeling of fullness and bloating. Rumbling gas may form in the abdomen, pressing upward and making breathing difficult. The person often has a strong desire for sweets, is sleepy after meals, and feels worst in the late afternoon and evening.

Natrum carbonicum
This remedy can be helpful to mild people who have trouble digesting and assimilating many foods and have to stay on restricted diets. Indigestion, heartburn, and ulcers can occur if offending foods are eaten. Milk or dairy products can lead to flatulence or sputtery diarrhea that leaves an empty feeling in the stomach. Cravings for potatoes and sweets are common; also milk, but it makes these people sick, so they have usually learned to avoid it.

Natrum phosphoricum
A sour taste in the mouth, an acid or burning sensation in the stomach, sour vomiting, regurgitated bits of food, and a yellow coating on the tongue are all indications for this remedy. The person may have problems after consuming dairy products or too much sugar. Another indication for Natrum phos is a craving for fried eggs.

Nux vomica
This remedy is often useful for indigestion, and is especially suited to those who overindulge in stimulants, food, and alcohol. Chilliness, irritability, and sensitivity to odors, sound, and light are often seen. Pain and weight can be felt in the stomach, with cramps or constricting pains. The person often feels an urge to vomit or move the bowels (which may make the person feel better, but is rarely successful).

Phosphorus
Burning pain in the stomach that feels better from eating ice cream or other cold, refreshing foods suggests a need for this remedy. The person is usually thirsty for cold drinks, but often feels nauseous or vomits once liquids warm up in the stomach. People needing Phosphorus may have a tendency toward easy bleeding and sometimes develop stomach ulcers.

Pulsatilla
Indigestion that is worse from eating rich and fatty foods, with a feeling of a lump or pulsation in the stomach, suggests a need for this remedy. Discomfort often is worse from warmth, especially in a stuffy room, and the person may feel better from gentle walking in open air. A bitter taste in the mouth can take the pleasure out of eating. A person who needs Pulsatilla usually does not feel thirsty and may be tearful and emotional.

SCARE OF BALD HEAD? HAIR LOSS – A COMMON PROBLEM WITH HOLISTIC APPROCH

Homoeopathy is considered as one of the very best alternative system for treating hair loss. Hair loss can affect scalp or entire body. It can be the result of heredity, hormonal changes, medical conditions or medications. Anyone like men, women and children can experience hair loss. Baldness typically refers to excessive hair loss from scalp. Hereditary hair loss with age is the most common cause of baldness. Some people prefer to let their baldness run its course untreated and unhidden. 

Causes

Most people normally shed 50 to 100 hairs a day. This usually doesn't cause noticeable thinning of scalp hair because new hair is growing in at the same time. Hair loss occurs when this cycle of hair growth and shedding is disrupted or when the hair follicle is destroyed and replaced with scar tissue.

The exact cause of hair loss may not be fully understood, but it's usually related to one or more of the following factors: Family history (heredity), Hormonal changes, Medical conditions, Medications

Family history - The most common cause of hair loss is a hereditary condition called male-pattern baldness or female-pattern baldness. It usually occurs gradually and in predictable patterns — a receding hairline and bald spots in men and thinning hair in women. Heredity also affects the age at which begin to lose hair, the rate of hair loss and the extent of baldness. Pattern baldness is most common in men and can begin as early as puberty. This type of hair loss may involve both hair thinning and miniaturization (hair becomes soft, fine and short).

Hormonal changes and medical conditions - A variety of conditions can cause hair loss, including: Hormonal changes and imbalances can cause temporary hair loss. This could be due to pregnancy, childbirth or the onset of menopause. Hormone levels are also affected by the thyroid gland, so thyroid problems may cause hair loss.

Patchy hair loss - This type of nonscarring hair loss is called alopecia areata. It occurs when the body's immune system attacks hair follicles — causing sudden hair loss that leaves smooth, roundish bald patches on the skin.

Scalp infections - Infections, such as ringworm, can invade the hair and skin of your scalp, leading to scaly patches and hair loss. Once infections are treated, hair generally grows back.

Other skin disorders - Diseases that cause scarring alopecia may result in permanent loss at the scarred areas. These conditions include lichen planus, some types of lupus and sarcoidosis.

Hair-pulling disorder - This condition, also called trichotillomania, causes people to have an irresistible urge to pull out their hair, whether it's from the scalp, the eyebrows or other areas of the body.

Medications - Hair loss can be caused by drugs used for cancer, arthritis, depression, heart problems, high blood pressure and birth control. Intake of too much vitamin A may cause hair loss as well.

Hair loss can also result from Radiation therapy to the head. The hair may not grow back the same as it was before.

Many people experience a general thinning of hair several months after a physical or emotional shock. This type of hair loss is temporary. Examples of trigger events include sudden or excessive weight loss, a high fever, surgery, or a death in the family.

Certain hairstyles and treatments. Excessive hairstyling or hairstyles that pull your hair tight, such as pigtails or cornrows, can cause traction alopecia. Hot oil hair treatments and permanents can cause inflammation of hair follicles that leads to hair loss. If scarring occurs, hair loss could be permanent.

Clinical Manifestations

Hair loss can appear in many different ways, depending on what's causing it. It can come on suddenly or gradually. Some types of hair loss are temporary, and others are permanent.

Signs and symptoms of hair loss may include:

Gradual thinning on top of head. This is the most common type of hair loss, affecting both men and women as they age. In men, hair often begins to recede from the forehead in a line that resembles the letter M. Women typically retain the hairline on the forehead but have a broadening of the part in their hair.

Circular or patchy bald spots. Some people experience smooth, coin-sized bald spots. This type of hair loss usually affects just the scalp, but it sometimes also occurs in beards or eyebrows. In some cases, your skin may become itchy or painful before the hair falls out.

Sudden loosening of hair. A physical or emotional shock can cause hair to loosen. Handfuls of hair may come out when combing or washing your hair or even after gentle tugging. This type of hair loss usually causes overall hair thinning and not bald patches.

Full-body hair loss. Some conditions and medical treatments, such as chemotherapy for cancer, can result in the loss of hair all over your body. The hair usually grows back.

Patches of scaling that spread over the scalp. This is a sign of ringworm. It may be accompanied by broken hair, redness, swelling and, at times, oozing.

Diagnosis

Diagnosis made with help of physical exam, medical history, and family history and with some tests.

Blood test - This may help uncover medical conditions related to hair loss, such as thyroid disease.

Pull test - gently pulls several dozen hairs to see how many come out. This helps determine the stage of the shedding process.

Scalp biopsy - scrapes samples from the skin or from a few hairs plucked from the scalp to examine the hair roots. This can help determine whether an infection is causing hair loss.

Light microscopy - Microscopy helps uncover possible disorders of the hair shaft and to examine hairs trimmed at their bases.

MANAGEMENT

These tips may help avoid preventable types of hair loss:

·         Eat a nutritionally balanced diet.

·         Avoid tight hairstyles, such as braids, buns or ponytails.

·         Avoid compulsively twisting, rubbing or pulling your hair.

·         Treat your hair gently when washing and brushing. A wide-toothed comb may help prevent pulling out hair.

·         Avoid harsh treatments such as hot rollers, curling irons, hot oil treatments and permanents.

·         A good daily multivitamin containing zinc, vitamin B, folate, iron, and calcium is a reasonable choice, although there is no good evidence that vitamins have any meaningful benefit in alopecia. Newer studies suggest that vitamin D may be somewhat helpful and worth considering. Specific vitamin and mineral deficiencies like iron or vitamin B12 may be diagnosed by blood tests and treated.

·         Multiple vitamins, including biotin, have been promoted for hair growth, but solid scientific studies for many of these claims are lacking. 

Home remedies

·         Onion Juice for hair growth - This remedy is regarded as one of most effective and oldest ones. The reason behind is that it contains sulphur that boosts collagen production in the tissues and helps in the re-growth of hair. Don’t let its strong smell keep you away from using it, because it goes off just after one rinse. To try this remedy, cut a few slices of onion and squeeze out its juice (either by mashing it or grating it) and apply it on your scalp for about 10-15 minutes. Let it work its magic and then rinse it off with a mild shampoo.

·         Coconut Milk - it is rich in iron, potassium and essential fats, take coconut milk from a fresh coconut, to it add half a squeeze of lemon, 4 drops of essential lavender oil. Mix it thoroughly and apply it on your scalp, leave it on for 4-5 hours and then rinse it off.”

·         Apple Cider Vinegar – This vinegar gently cleanses the scalp and maintains the pH balance of the hair thereby accelerating hair growth.  Start for making a diluted solution by mixing 75ml of it in one litre of water for a larger batch or 15 ml of it to a cup of warm filtered water for a smaller batch.

·         Egg Mask – This home remedy is used all over the world for quick and natural hair growth. As we know, eggs contain high levels of proteins which help in the formation of new hair. It is also rich in sulphur, zinc, iron, selenium, phosphorous and iodine.
For the egg mask, separate one egg white in a bowl and add one teaspoon of olive oil ( you can also use grape seed oil or lavender oil )and honey. Make a paste of it and apply it all over your hair and scalp for about 20 minutes. Rinse it off with cool water and some shampoo.  

·         Fenugreek– This herb is also an age-old remedy for hair growth problems. It contains proteins and nicotinic acid; protein-enriched diets have been known to encourage stimulation of hair growth. Add a tablespoon of this herb and water in a grinder till a smooth paste it formed. Add a little coconut oil (or milk) to it and apply on your hair and scalp for half an hour. Wash it off with a mild shampoo.

·         Green tea, as you know is super rich in antioxidants and that helps in boosting hair growth and preventing hair loss. Apply warm green tea (from the used tea bags) over your scalp and leave it for an hour. Wash it off with cool water.

·         Indian Gooseberry (amla) – This magical fruit is a powerhouse of nutrients. It’s rich in Vitamin C and that accelerates hair growth. All you need to do is, mix 2 teaspoons of amla powder or juice with equal amounts of lime juice and let it dry. Rinse it off with some warm water. It will also prevent hair pigmentation.

HOMOEOPATHIC MANAGEMENT

            Homoeopathic mode of treatment has good scope and can aid regrowth of hair. Homoeopathic medicines stimulate the hair roots to promote regrowth. The medicines used in Homoeopathy to aid hair regrowth are all of natural origin and therefore, safe for use among persons of all age groups. The main advantage of opting for Homoeopathic medicines for hair regrowth is the absence of any related toxic side effects. Hair-loss is again just an indicator that there is something not well in our body. The hairs may fall due to a local infection or due to a systemic disorder or deficiency. The treatment also varies accordingly. The following homoeopathic medicines are often found indicated in cases of hair fall: Alum, Ars, Bar-c, Carbo-veg, Flour-ac, Graph, Lyco, Nat-m, Nit-ac, Phos-ac, Phos, Selen, Sep, Syph, Thallium, Vinca.

Medicine	Indication
Fluoricum Acidum	It is considered excellent for hair loss, especially alopecia areata, where the patient loses hair from spots on the scalp. It is also adept at dealing with the resulting hair fall after a period of sickness, hair breakage, hair fall caused by syphilis, and hair gets tangled a lot. It is recommended by a lot of homeopathic doctors.
Phosphorus	It is a medicine that is capable of curing a wide array of diseases. While it is popular for treating alopecia, it is also used to heal issues of the gastrointestinal tract, blood, nervous tissue, and bones.
Calcarea Carbonica	Calcarea Carb, has been found to be one of the best homeopathic medicines for hair regrowth. It is often prescribed to patients for whom hair loss is accompanied by intense itching and sweating of the scalp.
Vinca Minor	Vinca Minor is efficient in treating alopecia when it is accompanied by dandruff. It is also used to treat abnormal hair growth i.e. when the hair grows out like white wool.
Silicea	It is hard to believe that this deep acting remedy is inert before it undergoes potentization. It is used to treat a wide range of diseases. Homeopaths commonly prescribe Silicea for baldness accompanied with pain. It also treats skin conditions like eczema, which may sometimes cause dandruff.
Baryta Carbonica	This homeopathic cure is administered to young people suffering from premature baldness. It is generally used to treat timid people who are experiencing baldness along with throat complaints and issues such as tonsillitis.
Lycopodium Clavatum	This is one of the best homeopathic medicines for preventing a number of hair-related problems. Lycopodium is a wonderful remedy for hair loss, premature graying of the hair, and even baldness. It is prepared from club moss (fungus), which is potentized for its usage. This homeopathic medicine also tackles premature balding.
Psorinum	Psorinum is the best treatment for hair loss that is caused due to dandruff. Dandruff is a common result of skin conditions like psoriasis and eczema. Psorinum tackles the root of the cause, reducing hair fall and dandruff at the same time.
Mezereum	This is another medicine that efficiently deals with conditions of the skin such as rashes, lesions, and psoriasis. It tackles hair fall in people who have crusty scalps and infected scalps with pus. It is also ideal for encouraging hair growth.
Kali Sulphuricum	When the dandruff is yellow in color, Kali Sulphuricum is a good treatment to resort to. It promises great results and is often prescribed by homeopaths to patients who complain of dandruff and hair loss together.
Natrum Muriaticum	The interesting thing about Natrum Muriaticum is that it is made from common salt through potentization. It is used to treat a myriad of issues and is perfect for treating post childbirth hair fall. It is also prescribed for hair fall in women suffering from anemia.
Pulsatilla Pratensis	This is administered to women suffering from post-delivery hair loss. The people to whom this medicine is prescribed often report a lack of thirst and a desire for breathing in fresh air. It is also administered to women who have trouble in digesting fatty food.

DIABETES MELLITUS HOLISTIC APPROCH TO ITS COMMON COMPLICATIONS

 Homoeopathy is considered as one of the very best alternative system for treating Diabetes Mellitus & its complications. Diabetes mellitus (DM), commonly referred to as diabetes, is a group of metabolic disorders in which there are high blood sugar levels over a prolonged period. Symptoms of high blood sugar include frequent urination, increased thirst, and increased hunger. If left untreated, diabetes can cause many complications. Acute complications can include diabetic ketoacidosis, hyperosmolar hyperglycemic state, or death. Serious long-term complications include cardiovascular disease, stroke, chronic kidney disease, foot ulcers, and damage to the eyes.
Diabetes is due to either the pancreas not producing enough insulin or the cells of the body not responding properly to the insulin produced. There are three main types of diabetes mellitus:
Type 1 DM results from the pancreas's failure to produce enough insulin. This form was previously referred to as "insulin-dependent diabetes mellitus" (IDDM) or "juvenile diabetes". The cause is unknown.
Type 2 DM begins with insulin resistance, a condition in which cells fail to respond to insulin properly. As the disease progresses a lack of insulin may also develop. This form was previously referred to as "non insulin-dependent diabetes mellitus" (NIDDM) or "adult-onset diabetes". The most common cause is excessive body weight and not enough exercise.
Gestational diabetes is the third main form and occurs when pregnant women without a previous history of diabetes develop high blood sugar levels.
In this article we discuss briefly about complications of Diabetes mellitus and its treatments & preventions.
The complications of diabetes mellitus are far less common and less severe in people who have well-controlled blood sugar levels. Chronic complications occur due to a mix of microangiopathy, macrovascular disease and immune dysfunction in the form of autoimmune disease or poor immune response, most of which are difficult to manage. Microangipoathy can affect all vital organs, kidneys, heart and brain, as well as eyes, nerves, lungs and locally gums and feet. Macrovascular problems can lead to cardiovascular disease including erectile dysfunction. Female infertility may be due to endocrine dysfunction with impaired signalling on a molecular level. Other health problems compound the chronic complications of diabetes such as smoking, obesity, high blood pressure, elevated cholesterol levels, and lack of regular exercise which are accessible to management as they are modifiable. Non-modifiable risk factors of diabetic complications are type of diabetes, age of onset, and genetic factors, both protective and predisposing have been found.
ACUTE COMPLICATIONS OF DIABETES MELLITUS
Acute complications include hypoglycemia and hyperglycemia, diabetic coma and nonketotic hyperosmolar coma.
Diabetic ketoacidosis
Ketoacidosis is much more common in type 1 diabetes than type 2. Diabetic ketoacidosis is an acute and dangerous complication that is always a medical emergency and requires prompt medical attention. Low insulin levels cause the liver to turn fatty acid to ketone for fuel (i.e., ketosis); ketone bodies are intermediate substrates in that metabolic sequence. This is normal when periodic, but can become a serious problem if sustained. Elevated levels of ketone bodies in the blood decrease the blood's pH, leading to this condition. On presentation at hospital, the patient is typically dehydrated and breathing rapidly and deeply. Abdominal pain is common and may be severe. The level of consciousness is typically normal until late in the process, when lethargy may progress to coma. Ketoacidosis can easily become severe enough to cause hypotension, shock, and death. Urine analysis will reveal significant levels of ketone bodies (which have exceeded their renal threshold blood levels to appear in the urine, often before other overt symptoms). Prompt, proper treatment usually results in full recovery, though death can result from inadequate or delayed treatment, or from complications (e.g., brain edema)
Hyperglycemia hyperosmolar state
This is more common in type 2 diabetes than type 1. Nonketotic hyperosmolar coma  is an acute complication sharing many symptoms with diabetic ketoacidosis, but an entirely different origin and different treatment. A person with very high (usually considered to be above 300 mg/dl) blood glucose levels, water is osmotically drawn out of cells into the blood and the kidneys eventually begin to dump glucose into the urine. This results in loss of water and an increase in blood osmolarity. If fluid is not replaced (by mouth or intravenously), the osmotic effect of high glucose levels, combined with the loss of water, will eventually lead to dehydration. The body's cells become progressively dehydrated as water is taken from them and excreted. Electrolyte imbalances are also common and are always dangerous. Urgent medical treatment is necessary, commonly beginning with fluid volume replacement. Lethargy may ultimately progress to a coma.
Hypoglycemia
Hypoglycemia is low blood glucose (blood sugar). It is possible for blood glucose to drop, especially if person taking insulin or a diabetic drugs (those make your body produce insulin throughout the day). With these medications, if person eat less than usual or were more active, then blood glucose may dip too much. Other possible causes of hypoglycemia include certain medications (aspirin, for example, lowers the blood glucose level if you take a dose of more than 81mg) and too much alcohol (alcohol keeps the liver from releasing glucose).
The signs and symptoms of low blood glucose are easy to recognize: Rapid heartbeat, Sweating, Whiteness of skin, Anxiety, Numbness in fingers, toes, and lips, Sleepiness, Confusion, Headache, Slurred speech. Mild cases of hypoglycemia can be treated by drinking orange juice or eating a glucose tabletthose will quickly raise your blood glucose level. In severe cases, an injection of glucagon (a hormone with effects largely opposite to those of insulin) or an intravenous infusion of dextrose is used for treatment, but usually only if the person is unconscious. In any given incident, glucagon will only work once as it uses stored liver glycogen as a glucose source; in the absence of such stores, glucagon is largely ineffective. In hospitals, intravenous dextrose is often used.
Diabetic coma
Diabetic coma is a medical emergency in which a person with diabetes mellitus is comatose (unconscious) because of one of the acute complications of diabetes:  Severe diabetic hypoglycemia, Diabetic ketoacidosis advanced enough to result in unconsciousness from a combination of severe hyperglycemia, dehydration and shock, and exhaustion, Hyperosmolar nonketotic coma in which extreme hyperglycemia and dehydration alone are sufficient to cause unconsciousness.
CHRONIC COMPLICATIONS OF DIABETES MELLITUS
Long-term complications of diabetes develop gradually. The longer diabetes  and the less controlled blood sugar  the higher the risk of complications. Eventually, diabetes complications may be disabling or even life-threatening. Possible complications include: Microangiopathy & Macrovascular disease
Cardiovascular disease. Diabetes dramatically increases the risk of various cardiovascular problems, including coronary artery disease with chest pain (angina), heart attack, stroke and narrowing of arteries (atherosclerosis). Diabetic cardiomyopathy, damage to the heart muscle, leading to impaired relaxation and filling of the heart with blood (diastolic dysfunction) and eventually heart failure; this condition can occur independent of damage done to the blood vessels over time from high levels of blood glucose
Nerve damage (neuropathy). Excess sugar can injure the walls of the tiny blood vessels (capillaries) that nourish your nerves, especially in your legs. This can cause tingling, numbness, burning or pain that usually begins at the tips of the toes or fingers and gradually spreads upward. Left untreated, you could lose all sense of feeling in the affected limbs. Damage to the nerves related to digestion can cause problems with nausea, vomiting, diarrhea or constipation.
Erectile Dysfunction: Estimates of the prevalence of erectile dysfunction in men with diabetes range from 20 to 85 percent when defined as consistent inability to have an erection firm enough for sexual intercourse. Among men with erectile dysfunction, those with diabetes are likely to have experienced the problem as much as 10 to 15 years earlier than men without diabetes
Kidney damage (nephropathy). The kidneys contain millions of tiny blood vessel clusters (glomeruli) that filter waste from your blood. Diabetes can damage this delicate filtering system. Severe damage can lead to kidney failure or irreversible end-stage kidney disease, which may require dialysis or a kidney transplant.
Eye damage (retinopathy). Diabetes can damage the blood vessels of the retina (diabetic retinopathy), potentially leading to blindness. Diabetes also increases the risk of other serious vision conditions, such as cataracts and glaucoma.
Foot damage. Nerve damage in the feet or poor blood flow to the feet increases the risk of various foot complications. Left untreated, cuts and blisters can develop serious infections, which often heal poorly. These infections may ultimately require toe, foot or leg amputation.
Skin conditions. Diabetes may leave more susceptible to skin problems, including bacterial and fungal infections.
Hearing impairment. Hearing problems are more common in people with diabetes.
Alzheimer's disease. Type 2 diabetes may increase the risk of Alzheimer's disease. The poorer your blood sugar control, the greater the risk appears to be. Although there are theories as to how these disorders might be connected, none has yet been proved.
Abnormal immune responses The immune response is impaired in individuals with diabetes mellitus. Cellular studies have shown that hyperglycemia both reduces the function of immune cells and increases inflammation.
Respiratory infections such as pneumonia and influenza are more common among individuals with diabetes. Lung function is altered by vascular disease and inflammation, which leads to an increase in susceptibility to respiratory agents. Restrictive lung disease is known to be associated with diabetes. Lung restriction in diabetes could result from chronic low-grade tissue inflammation, microangiopathy, and/or accumulation of advanced glycation end products. In fact the presence restrictive lung defect in association with diabetes has been shown even in presence of obstructive lung diseases like asthma and COPD in diabetic patients.
Lipohypertrophy may be caused by insulin therapy. Repeated insulin injections at the same site, or near to, causes an accumulation of extra subcutaneous fat and may present as a large lump under the skin. It may be unsightly, mildly painful, and may change the timing or completeness of insulin action.
Complications of gestational diabetes
Most women who have gestational diabetes deliver healthy babies. However, untreated or uncontrolled blood sugar levels can cause problems for mother and baby.
Complications in baby can occur as a result of gestational diabetes, including:
Excess growth. Extra glucose can cross the placenta, which triggers your baby's pancreas to make extra insulin. This can cause baby to grow too large (macrosomia). Very large babies are more likely to require a C-section birth.
Low blood sugar. Sometimes babies of mothers with gestational diabetes develop low blood sugar (hypoglycemia) shortly after birth because their own insulin production is high. Prompt feedings and sometimes an intravenous glucose solution can return the baby's blood sugar level to normal.
Type 2 diabetes later in life. Babies of mothers who have gestational diabetes have a higher risk of developing obesity and type 2 diabetes later in life.
Death. Untreated gestational diabetes can result in a baby's death either before or shortly after birth.
Complications in the mother can also occur as a result of gestational diabetes, including:
Preeclampsia.This condition is characterized by high blood pressure, excess protein in the urine, and swelling in the legs and feet. Preeclampsia can lead to serious or even life-threatening complications for both mother and baby.
Subsequent gestational diabetes. Once you've had gestational diabetes in one pregnancy, more likely to have it again with the next pregnancy. Also more likely to develop diabetes  typically type 2 diabetes  as get older.

Diagnosis & Prognosis
Glycated hemoglobin (HbA1C) test. This blood test indicates your average blood sugar level for the past two to three months. It measures the percentage of blood sugar attached to hemoglobin, the oxygen-carrying protein in red blood cells. The higher blood sugar levels, the more hemoglobin  have with sugar attached. An A1C level of 6.5 percent or higher on two separate tests indicates that you have diabetes. An A1C between 5.7 and 6.4 percent indicates prediabetes. Below 5.7 is considered normal. This test is useful for diagnosis and also prognosis of treatment undergone

MANAGEMENT
Prevention is the optimal approach to managing the microvascular complications of diabetes. The two main approaches to preventing retinopathy and nephropathy are intensive glycemic control and aggressive control of hypertension. Intensive glycemic control has been the most effective approach to preventing neuropathic complications of diabetes.
Diet and exercise play a key role in controlling blood sugar levels and reducing your weight, blood pressure and cholesterol levels, in turn preventing any further kidney damage. Steps may include:
Exercising regularly, if possible for 30 minutes a day.
Eating at least five portions of fruit and vegetables a day.
Increasing the amount of starchy carbohydrates in diet.
Choosing to eat carbohydrates that release energy slowly such as porridge oats, brown rice and pasta, lentils and beans and avoiding those that release energy quickly such as white bread and white rice.
Reducing the amount of sugar, fat and salt in your diet.
Stop smoking.
Cutting down on alcohol.
Monitoring and controlling your blood sugar levels if you have diabetes.
Limit the amount of foods containing high levels of protein, sodium, potassium or phosphate.
The following measures are advisable in diabetes patients:
Tighten up your blood sugar control.
Blood pressure lowering if high.
Stop smoking.
Exercise.
Lipid lowering treatment.
HOMOEOPATHIC MANAGEMENT
Diabetic mellitus is supposed to be a constitutional disease, so treatment also should be constitutional to prevent there complications. Normal levels can be absolutely attained and maintained if Homoeopathic treatment is started earlier. In Homoeopathy, medicines are highly individualized to the patient and this will help, Homoeopathic constitutional treatment for diabetes controls side effects of the disease. Homoeopathy considers life style, diet habits, other physical symptoms along with clinical history of diabetes in order to control the sugar levels as well prevent diabetic complications like heart diseases, diabetic kidney disease, diabetic neuropathy and retinopathy etc. Following remedies are quite helpful to treat the symptoms and condition related to complications.
Medicine
Indication

Arsenicum Album
Agitation tendency to move from one place to another, great anxiety, prostration, useful in diabetic neuropathy there ardour and/or numbness in limbs.

Lycopodium Clavatum
Diabetes. Anger during disease. Lost of self confidence. The right side conditions works well and thus improve the liver and kidney functioning as conditions Neuropathy above all of the autonomic nervous system where there is constipation due to inactivity of the rectum. Impotence. Intense desire for sweets.

Phosphorus
Tuberculinic patient, tall, slender, with strait chest or nervous and weak people. Works efficiently in the liver and kidney improving the hypercholesterinemia. It is also a large drug bleeding anywhere body by avoiding significantly the cerebral vascular event. Albumin in urine. Depression and high stress. Retinopathy.

Phosphoricum acidum
Diabetic neurosis. Weak and thin with presence of urine sugar. Polyuria. Diarrhea or constipation. Impotence. Depression. Weakness of memory. Inability to concentrate.

Lacticum Acidum
Diabetes. Presence of blood sugar. Thirst. Voracious hunger. Abundant urine. Rheumatic pain.

China officinalis
Weakness for loss of fluids. Bleeding. Tympanites. The expulsions of gases do not produce improvement. Loss of vision. Ringing in the ears. Canine hunger. Extreme sensitivity to touch in diabetic neuropathy.

Nitricum acidum
Diabetic nervous, irritable. Strong smell like horse urine. Skin cracks and fissures. Ulcers by arterial insufficiency. Weakness. Condylomas and warts.

Aceticum acidum
Very weakened patient which thins quickly. With edema or anasarca.

Ignatia
Diabetic with marked signs of sadness and the silent penalty provision. Want to be alone. Profound sighs. Weakness in the mouth of the stomach. Empty feeling in the stomach. Bipolarity. Shock disorders. In neuropathy acts on the spinal marrow and affects both motor nerve as sensitive. Tremor by penalties or scares or by parasites. Hysteria.

Natrum sulphuricum:
Useful in diabetic neuropathy that affects the autonomic nervous system. Diarrhea aggravated by the morning of begin to move. Borborigmos on the right side of the abdomen in the ileocecal region. Productive cough aggravated by wet time.

Thuja
Diabetes in patients with sycosis. Polyneuritis with great pain. Polyps. Warts. In the mental area with special illusions: believes that his body and limbs are glass. Thinks he has a live animal inside abdomen. It is obsessive.

Lachesis Trig
 Loquacious, diabetic patients with circulatory problems. Diabetes in menopause. Diabetic Gangrene. Useful in the brain vessel event. Upper digestive tube (bowel) hemorrhages. Retinal hemorrhages. Varicose ulcers, diabetic gangrene and treatment of cerebral vascular event.

ANAEMIA A SILENT KILLER AMONG MIDDLE AGED WOMEN WITH HOMOEOPATHIC APPROACH

ANAEMIA  A SILENT KILLER AMONG MIDDLE AGED WOMEN WITH HOMOEOPATHIC APPROACH

Anaemia is a condition where the number of healthy red blood cells (RBCs) in the blood is lower than normal. RBCs transport oxygen throughout the body, so a shortage of these cells can be serious. WHO defines anaemia as a condition in which the Haemoglobin (Hb) content of blood is lower than normal as a result of deficiency of one or more essential nutrients, regardless of the cause of such deficiencies. Anaemia is the most common nutritional deficiency disorder in the world.  In Anaemia a silent killer among women in India: Present scenario, by Kawaljit Kaur in the European Journal of Zoological Research, 2014, the author states that India has among the highest number of cases of anaemia in the world with an estimated 50 percent of the population affected. Iron-deficiency anaemia is the most common type of anaemia. Women in the childbearing years are particularly susceptible to iron deficiency anaemia because of the blood loss from menstruation and the increased blood supply demands during pregnancy. It's estimated that at least 2 out of every 10 women in India have iron-poor blood. There are many types of anaemia, but in this article we discussing about iron deficiency anaemia which is common among all type of anaemias.

Causes of Anaemia
According to the American Society of Haematology, iron deficiency is the most common cause of anaemia. There are many reasons for person might become deficient in iron. These include: Inadequate iron intake, Pregnancy or blood loss due to menstruation, certain medical conditions can cause internal bleeding & inability to absorb iron.

Iron deficiency may also be aggravated by poor nutritional status, especially when it is associated with deficiencies in folic acid, vitamin A or B12, as is often the case in populations living in developing countries. A diet that is monotonous, but rich in substances (phytates) inhibiting iron absorption so that dietary iron cannot be utilised by the body. In India, the prevalence of anaemia is high because of low dietary intake, poor iron (less than 20 mg /day) and folic acid intake (less than 70 micrograms/day); poor bio-availability of iron (3-4 percent only) in phytate fibre- rich Indian diet; and chronic blood loss due to infection such as malaria and hookworm infestations. The low dietary intake of iron and folic acid coupled with poor bioavailability of iron is the major factor responsible for very high prevalence of anaemia in the country. s. In the adolescent phase of women  due to menstruation, the requirement of iron increases. Every month about 40 ml. blood is lost with approximately 0.6 mg of iron. This increased requirement for iron is not met due to discriminatory social beliefs and food restrictions. According to WHO, women of childbearing age need to absorb 2-3 times the amount of iron required by men or older women.

Clinical Presentation

The symptoms of iron deficiency anaemia can be very mild at first.The symptoms of moderate to severe iron deficiency anaemia include: general fatigue, weakness, pale skin, shortness of breath, dizziness, strange cravings to eat items that arent food, such as dirt, ice, or clay, a tingling or crawling feeling in the legs, tongue swelling or soreness, cold hands and feet, fast or irregular heartbeat, brittle nails and headaches

Diagnosis
Although the history and physical examination can lead to the recognition of the condition and help establish the etiology, iron deficiency anaemia is primarily a laboratory diagnosis.
Useful tests include a complete blood count (CBC); a peripheral smear; serum iron, total iron-binding capacity (TIBC), and serum ferritin.
Other laboratory tests (eg, stool testing, incubated osmotic fragility testing, measurement of lead in tissue, and bone marrow aspiration) are useful for establishing the etiology of iron deficiency anemia and for excluding other diseases
If bloodwork indicates iron deficiency anemia, then following additional tests can perform to identify an underlying cause, such as:
Endoscopy -  check for bleeding from a hiatal hernia, an ulcer or the stomach with the aid of endoscopy
Colonoscopy. To rule out lower intestinal sources of bleeding.
Ultrasound. Women may also have a pelvic ultrasound to look for the cause of excess menstrual bleeding, such as uterine fibroids.

MANAGEMENT

Home natural remedies
In the treatment of nutrition related anaemia, combinations of nutrient rich foods play a very important role in absorption of iron. For e.g. Iron from corn is better absorbed when eaten with fish or meat, whereas milk inhibits iron absorption. Vitamin C increases iron absorption by a factor of 4. Being a powerful reducing antioxidant agent; it changes ferric iron to better absorbed ferrous form of iron.

Beetroot and Amla: Beets are extremely important in curing anaemia. Beets contain potassium, phosphorous, calcium, sulphur, iodine, iron, copper, carbohydrate proteins, fat, Vitamin B1, B2 niacin,B6 Vitamin P and Vitamin C (that helps absorption). In fact Vitamin C is regarded as the most potent enhancer of iron absorption and vitamin C alone will often increase body iron stores. Thus, the juice of Red beets and amla(that is packed with Vitamin C) strengthen the body's power to regenerate and re-activate the red blood cells and supplies the body with fresh oxygen.

Banana and Honey: Bananas are particularly beneficial as they also contain besides easily assimilable iron, folic acid and B12, all of which are extremely useful in the treatment of anaemia. Drizzle honey over the bananas as it is rich in copper which helps in iron absorption.

Jaggery and Ginger: Regular intake of jaggery in any form with any food will help combat anaemia. A person can obtain 3% of iron of daily value from 10grams of jaggery. Regular intake of jaggery with ginger juice helps in better absorption of iron.

Fenugreek: The leaves of fenugreek help in blood formation, cooked leaves can be taken to prevent anemia. The seeds of fenugreek are also a valuable cure for anaemia being rich in iron. Also the fat soluble chlorophyll molecule is similar to the haemoglobin molecule and is efficiently absorbed from the gastrointestinal tract providing all the structural elements for hemoglobin.

Spinach A diet rich in green leafy vegetables like spinach is one of the best home cures for anaemia. Spinach is rich in iron  as well as vitamin B12 and folic acid, energy boosting nutrients that the body needs to recover from anaemia

Pomegranate is rich in iron and other minerals, such as calcium and magnesium. It also contains vitamin C, which helps improve the bodys absorption of iron. This results in more red blood cells and an increase in the hemoglobin level.

Dates are a rich source of iron as well as vitamin C that plays an important role in the bodys absorption of iron. Soak two dates in a cup of milk overnight. The next morning, eat the dates and drink the milk on an empty stomach.

Blackstrap Molasses: Blackstrap Molasses is a great source of iron, about 5 tablespoons of black strap molasses contain 95 percent of your daily allowance of iron. Try to eat foods high in Vitamin C alongside blackstrap molasses- cabbage, broccoli, citrus fruits are all good choices. In addition to these, include raisins, dried apricots, mangoes, brewer's yeast, dried beans, lean meats and shell fish to enhance your iron levels. Sesame seeds are also great for treating anaemia due to their high iron content. One fourth cup of sesame seeds provides almost 30 percent of the daily iron requirement.

However, there are also several foods and beverages that inhibit iron absorption including coffee, tea, egg yolks and foods high in phytates such as wheat bran. Antacids and over use of calcium supplements also decrease iron absorption. These items should be restricted for individuals with iron deficiency. Foods rich in calcium should be avoided when taking iron rich foods, as they inhibit iron absorption.

HOMOEOPATHIC MANAGEMENT

Homoeopathy is one of the most popular holistic systems of medicine. The selection of remedy is based upon the theory of individualization and symptoms similarity by using holistic approach. This is the only way through which a state of complete health can be regained by removing all the sign and symptoms from which the patient is suffering. The aim of homoeopathy is not only to treat anaemia but to address its underlying cause and individual susceptibility. Caring for blood count is essential for life since whole life / health relies on it. With clear-cut causes like accidental bleeding, heavy menstruation, pregnancy, poor nutrition, the person can be treated accordingly with the prescribed essential supplements in the form of foods / tablets / tonics / injections and in case of critical condition blood transfusion may be a must. No one can deny this principle. But using supplements (in the form of tablets / tonics / Injections) continuously without regular nutritious food to maintain blood counts / haemoglobin is not acceptable. In general, 50 per cent of anaemic patients can be cured with diet alone, 30 per cent may need supplements and medicines and 20 per cent may need blood transfusion and medicines.
Even though well substituted, if the cell activity is not capable of absorbing the same, the substitute will go waste and the cell will continue to be less active or diseased. Actually, everyone needs stimulation for good activity. Homoeopathic medicines can tackle the complaint or disease without persistent usage by treating the root cause.Anaemia is an ongoing process of chronic fatigue. Complaints will creep up with time when not attended properly. So it is better to analyse the cause and treat the condition right to the requirement. To distinguish from other ways,

Medicine
Indication

Aletris Farinosa
Great tonic for woman not only increase blood but also weakness , Tired dull, heavy,confused feeling. Debility of females from protracted illness; no organic disease. Power and energy of mind and body are weakened.

Calcarea carbonica
Almost any of the deeper acting constitutional remedies may be of use in anaemic anddebilitated conditions, and especially are the Calcareas useful.

Ferrum phosphoricum
People who generally feel weak and tired because of the loss of iron from the body or poor absorption proved to be an effective remedy for those who are suffering from these situations.

Calcarea Phosphoricum
It is a good remedy for treating the anemia. It is helpful in giving the strength to the bones and helpful in curing the debility and weakness which is generally developed by the loss of iron from the
body. Also this medication helpful in improving the texture of the skin and it very effective remedy for those children who have deficiency of minerals and suffering from weak bone.

Helonias
It is very beneficial homeopathic remedy for anaemia and cholorsis. It is generally effective for women having anemia which occurred from the long period of hemorrhage by indolence or luxury, or like worn out with hard work.

Phosphorus
When the predominant symptom is that of weakness, exhaustion or prostration, Phosphorus is one of the best homeopathic medicines for anaemia. There is increased thirst and that too for cold water. The patient is usually thin, wiry and tall in stature. There is great weakness of the nervous system. There is increased restlesness and one cannot tolerate any noise, strong odor or light.

Calcarea flour
It is very beneficial homeopathic remedy for those having iron deficiency anaemia. It is helpful in boosting up the energy and also helps in higher absorption of iron in the blood. It also helps in lowering the symptoms of anemia which is better in forming the haemoglobin.

Kali phosphoricum
It is also good homeopathic remedy in curing the iron deficiency anaemia. It helps by providing the strength to the nerves and also helps in providing the relief from the vertigo and headache.

Natrum muriaticum
It is an effective homeopathic remedy in curing the anemia. It is good for those who has exhaustion following loss of blood, which is generally occurred by the aggravated by heat, in case of chronic
because of physical and emotional disorder.

Cinchona
It is good homeopathic remedy in treating the anemia. It is effective for those who are having anemia because of blood loss, blue colour around eyes, night blindness and debility from the exhausting discharges.

 Arsenicum
It is an effective homeopathic remedies for treating anemia. This remedy is for those pernicious anemia, debility from overtaxing, muscular tissues by prolong exertion and extreme restlessness.

Pulsatilla
It is beneficial homeopathic remedy for treating the anemia. It is Effective for those women having chloro-anaemic women which always complain of feeling chilly.

Natrum muriaticum
This is one of our best remedies in anemic conditions. There is paleness, and, in spite of the fact that the patient eats well, there is emaciation. There are attacks of throbbing headache and dyspnoea, especially on going up stairs, constipation and depression of spirits, and consolation aggravates. With these symptoms there is much palpitation, fluttering and intermittent action of the heart.

Nitric acid
When there is an irresistible desire to eat chalk, paper, earth or any such indigestible things, Nit-acid is one of the best homeopathic medicines for anaemia. There are often cuts at the corners of the mouth. Aphthae or ulcers in the mouth are also seen quite frequently.

Cinchona
In cases where the cause is blood loss, Cinchona is one of the best homeopathic medicine for anaemia. The blood loss may be due to increased menstrual flow as happens in some females or due to worms as occurs in some children. Even when the blood loss has happened in some acute cases like injury, Cinchona is very useful. One feels weak and tired. There are frequent 0.headaches. Periodicity of the pains is a characteristic of this medicine.