THE DISEASES NAMED BY THE SCIENTIST’S NAME
1. Adams – stokes attacks: Symptoms such as ORS Complex in ECG, absent pulse, vertigo, convulsion & cheynestock respiration usually as a result of heart block.
2. Addision’s disease: Chronic adreno cortical insufficiency
3. Albinism: Tyrosinase deficiency leading to little or no melanin synthesis in the skin & eyes.
4. Alzheimer’s disease: Per-Senile dementia
5. Alport’s syndrome: Hereditary nephritis
6. Argyll Robertson’s: Most important and characteristic pupillary changes in tabes dorsalis, this is characterized by miosis, eccentric pupil irregularity of the pupil due to atrophy of the iris, pigmentation of iris, light reflex is lost, Accommodation reflex is present & brisk.
7. Austin flint’s murmur: In aortic incompetence some times a functional mid – diastolic and pre systolic murmur may be heard over mitral area, called Austin flint’s murmur.
8. Bell’s palsy: LMN type of Facial nerve paralysis.
9. Bence-Jone’s Myeloma: Proteinuria occurring in multiple myeloma, also known as Plasma cell cancer.
10. Budd - chiari syndrome: Thrombosis of the hepatic vein with Hepatomegaly, ascitis and portal Hypertension.
11. Bitot’s spots: Grayish white triangular deposits on the conjunctiva due to vit A deficiency.
12. Burkit’s lymphoma: Malignant condition of lymphoid tissue involving facial bones and abdominal lymph nodes.
13. Brown – Sequard syndrome: Hemi paraplegia & hyper aesthesia but with loss of joint & muscle sence on the side of lesion and hemi anesthesia on the opposite side. (In case of unilateral spinal cord involvement)
14. Cushing’s syndrome: Hyper adrenocorticosism.
15. Conn’s syndrome: Primary Hyper aldosteronism.
16. Crohn’s disease : Regional enteritis (Type of inflammatory Bowel disease)
17. Caisson disease: A symptom complex occurring in men working under high air pressure when too suddenly released to normal atmosphere.
18. Caplan’s syndrome: Intra pulmonary nodules like rheumatoid nodule and pneumoconiosis in coal workers.
19. Carey–coombs murmur: Mid diastolic murmur observed in mitral stenosis.
20. Charcot – leydon crystals: crystal deposition arthritis associated with tertiary syphilis.
21. Curling’s ulcer: ulcer of the duodenum in a patient due to burns & Body injury.
22. Dandy Walkersyn: congenital hydrocephalus associated with Artesia of foramen of megendie.
23. Deputytran’s contracture : Permanent flexion of the fingers (especially 4th & 5th )
24. Duckett– Jones criteria: Diagnostic criteria for Rheumatic fever.
25. Down’s syndrome: Trisomy 21. One excessive chromosome in the 21st pair.
26. Edward’s syndrome: This is one of the chromosomal of abnormality trisomy 18 and trisomy E, characterized by low birth weight gross mental retardation, congenital heart disease, long & narrow skull with prominent occiput, flexion deformities & the fingers are present
27. Ehlers – Danlos syndrome: Congenital condition characterized by over elasticity & friability of skin, increased extensibility of the joint & fragility of the vessels.
28. Ewing’s tumor: Ewing’s sarcoma – neoplasm of the bone occurs 75 % in the extremities including shoulder girdle.
29. Fallot’s tetra logy: Most common form of congenital cyanotic heart disease (1) pul.stenosis 2). V.S.D 3). R.V.H 4). Dextro position of the aorta)
30. Fried riech’s ataxaia: A type of spino cerebellar degeneration.
31. Fournier’s Gangrene: Gangrene of the testis & scrotum.
32. Good pasture’s syndrome: A form of rapidly progressive Glom. Nephritis ± Hemoptysis.
33. Grave’s disease: Hyper thyroidism (Auto immune type)
34. Graham steel’s murmur: An early systolic murmur associated with pulmonic insufficiency caused by pulmonary hypertension.
35. Gullian barr syndrome: Acute infective poly neuritis
36. Hansen’s disease: Leprosy.
37. Hashimato’s thyroiditis: Hypo thyrodism due to auto immune thyroiditis.
38. Heberden’s node: Nodular growth, which affecting the distal interphalangeal joints in osteo arthritis.
39. Horner’s syndrome: Ptosis, myosis and exophthalmos due to paralysis of the cervical sympathetic nerves.
40. Huntington’s chorea: A disease of CNS (onset 30 -50 Yrs.) characterized by dementia, psychosomatic disturbances with bizarre involuntary movement characteristic of chorea.
41. Hodgkin’s lymphoma: malignant enlargement of the lymph node often cervical at the onset then generalized with hepatosplenomegally.
42. Jacksonian epilepsy: Secondarily generalized seizure.
43. Kartagener’s syndrome: Complete situs inversus associated with bronchiectasis & chronic sinusitis.
44. Kaposi’s sarcoma: Multiple areas of Neoplastic cell proliferation mainly in the skin & also in other body organ ( mainly associated with AIDS)
45. Kayser – Fleischer ring: Greenish brown discoloration of corneal margin occurring in Wilson’s disease.
46. Koch’s disease: Tuberculosis.
47. Kelly – Paterson syndrome (or) Plummer Vinson syndrome: The association of chronic iron deficiency anaemia with koilonychia, glossitis, dysphagia and splenomegaly is called Plummer Vinson syndrome.
48. Kussmaul’s respiration: Deep rapid respiration chiefly in air Hunger, Diabetic acidosis and coma.
49. K.W. Syndrome (Kilmmlstiel – Wilson syndrome): Diabetic nephropathy.
50. Marfan’s syndrome: A hereditary condition characterized by arachynodactyly, excessive length of extremities and laxness of joints.
51. Meniere’s disease: Recurrent idiopathic attack of vertigo. Nausea, vomiting, tinnitus and progressive deafness.
52. Osler’s Node: A small, raised, red, tender area present in fingers & toes due to infected emboli from the heart in infective endocarditis.
53. Osler’s disease: (Erythremia or polycythemia Vera) Increased R.B.C with splenomegally, Face is deep red rather than truly cyanotic.
54. Parkinsonism: A syndrome due to defective release of neurotransmitor dopamine in the corpus striatum.
55. Parkinson’s disease: Idiopathic Parkinsonism.
56. Patterson – Kelly syndrome: Post cricoid web due to iron deficiency anaemia producing dysphagia.
57. Paget’s disease: A Generalized skeletal disease characterized by thickening & softening of the bone as in the skull and bending of weight bearing joint.
58. Pott’s spine: T.B Spine
59. Peutz – jehers syndrome: Generalized multiple polyposis of the intestinal tract.
60. Pick’s disease: Non- Alzeimer’s degenerative dementia characterized by fronto – temporal atrophy.
61. Ramsay Hunt syndrome: Herpes zoster affecting geniculate ganglion in 7th nerve lesion, characterized by LMN type of facial palsy, loss of taste in anterior 2/3 rd of tongue, serous discharge through ear, multiple vesicles in pinna of ear and posterior tonsils.
62. Raynaud’s disease: Idiopathic paroxysmal bilateral cyanosis of the digits due to arterial contraction brought on by cold or emotion.
63. Reiter’s syndrome: A triad of urithritis, conjunctivitis and arthritis which appear on that order.
64. Reye’s syndrome: Sudden loss of consciousness or death in children following infection characterized by cerebral oedema, fatty changes in the liver and renal tubules.
65. St. Vitu’s dance (Sydenham’s chorea): this is an acute episode of involuntary movement due to a lesion in the basal ganglia associated with acute rheumatism.
66. Sheehan’s syndrome: Hypo pituitarism arising from a severe post partum circulatory collapse with resultant pituitary necrosis.
67. Shy- Drager syndrome: A type of spino cerebellar degeneration.
68. Sjogren’s syndrome: Kerato conjunctivitis sicca (or) purpuric spots on the face and bilateral parotitis seen in menopausal women.
69. Steven Johnson syndrome: Erythema multiformae exudativatum.
70. Still’s disease: Juvenile Rheumatoid Arthritis.
71. Sydenham’s chorea: childhood chorea mainly in Rheumatic fever.
72. Suzman’s sign: In coarctation of the Aorta the collateral arterial pulsations are present around the scapulae, trunk and in the axilla, this is called suzman’s sign.
73. Takayasu’s disease: pulse less disease.
74. Todd’s palsy: Temporary paralysis of the limbs after the epilepsy.
75. Turner’s syndrome: A chromosomal anomaly with chromosome count 45 including only a single X chromosome.
76. Vincent’s angina: in stomatitis Vincent’s spirochaete and fusiform bacilli are found from the ulcer and this type is known as Vincent’s angina.
77. Von reckling housen’s disease: Neuro fibromatoses.
78. Von-wille brand’s disease: Angio hemophilia or hereditary pseudo hemophilia.
79. Wilms tumor: Nephroblastoma. Common intra- abdominal malignancy in childhood.
80. Wilson’s disease: Hepto lenticular degeneration. Decreased serum ceruloplasmin and increased accumualation of copper in the body.
81. Wernicke’s Korsakoff’s psychosis: Wernicke’s encephalopathy – A syndrome charecterised by confusion and several loss of memory.
82. Walff Parkinson white syndrome: supraventricular tachycardia. ( Diagnosis made by ECG)
83. Weil’s disease: lctero – Hemorrhagica jaundice due to Leptospirosis
84. Zollinger – Ellision syndrome: Excessive acid HCL secretion (due to Gastrinoma) also with multiple ulceration in esophagus stomach, duodenum & small intestine.
Monday, 21 March 2011
Friday, 18 March 2011
HAVOC OF ALCOHOLISM
HAVOC OF ALCOHOLISM
“LIQUOR RUINS THE COUNTRY, FAMILY & LIFE”
“Alcohol is a kicker,
But it is a killer”
The term alcoholism is a confusing one and this is replaced by the current nomenclature “alcohol dependence”.
Drinking habit is gradually increasing in our society.
An alcohol addiction can be defined as one who has lost control over his drinking and has a compulsion to keep on drinking with deterioration of emotional, social and work activities.
Alcohol dependence is usually believed that drinking up to 20 units of alcohol for men and 13 units for women per week is not associated with health hazard. Definite health hazard occurs when consumption of alcohol is more than 50 units for men and 35 units for women in a week.
CAUSES FOR ADDICTION
Alcohol environment – members of a society where most of the people are alcoholics are prone to alcohol addiction.
Anxiety and depression.
Psychopathic persons.
SYMPTOMS OF ALCOHOLISM
Early symptoms – euphoria, Talkativeness
Later on – concentration is impaired and the subject becomes forgetful,
gradually power of thinking, Judgement and memory fail.
BAD EFFECTS OF CHRONIC ALCOHOLISM:
Psychological Problem :
Loss of concentration
Recent loss of memory
Delirium tremens
Dipsomania
Wernicke korsakoffs psychosis
Cardiovascular system
Alcohol is generally a peripheral vasodilatator
Daily taking one oz of French wine prevents ischemic heart disease.
Bad effects – alcoholic cardiomyopathy.
Respiratory system :
Due to chronic alcohol- in sufficient in take of food ,it produces decreased immune power ,leads for recurrent respiratory infection.
After large quantity of alcohol and heavy meal with un consciousness cause aspiration pneumonia .
Central nervous system:
Alcoholic peripheral neuropathy
Alcoholic hallucinosis
Cerebellar degeneration
Alcoholic myopathy
Hyper tropic Poly neuritis
Hepatobiliary system :
Chronic alcohol produced low immunity – amebic liver abscess
Cirrhosis
Acute and chronic gastritis
Pancreatitis
Connective tissue disorder :
Gout
Sexual:
Impotence
Management:
Admission in hospital with full with drawl of alcohol.
Adequate diet supplemented with vitamin B complex.
If with drawl leads to marked tremulousness and restlessness, large
dose of Vit.B complex I /v
Drug for with drawl systems (chlorpromazine, prochlorperazine)
Psychotherapy.
Homoeopathic management:
Nux vomica:
For anti doting bad effects of liquor such as gastric trouble,restlessness,
Bad effects of alcohol
Dipsomania
Petroleum:
Drunkard with out energy ,with out strength of will, unable to refuse wine,vomiting after the least excess in drinks , dipsomania,
Sulphuric acid :
One part with 3 parts of alcohol , 10 to 15 drops ,3 times daily for 3 or 4
weeks,has been subdue the craving for liquor ( dr. hering)
Sterculia:
The remedy for the drinking habit. It promotes the appetite and digestion, and lessens the craving for liquor.
Capsicum:
Prostration and feeble digestion of alcoholics.
Syphilinum:
Craving alcohol, in any form. Hereditary tendency to alcoholism.
Loss of memory, cannot remember names of books, persons or places.
Sensation as if going insane, as if about to be paralyzed, of apathy and indifference.
Zincum. Met:
Persons suffering from cerebral and nervous exhaustion.
Defective vitality, brain or nerve power wanting too weak to develop
exanthemata.
Quercus:
Used first by Rademacher for chronic spleen affections, spleen dropsy.
Antidotes effects of alcohol.
Takes away craving for alcoholics, give dose as below for several months.
Dropsy and lever affections.
Alcoholism, General Dipsomania:
Agar, Crot.H, Lach, Chin, Nux.Vom, Ran.B, Sulph. Acid, Sulph., Verat, Syph., Zinc, Ledum.
Ailments from Beer:
Kali. Bich, Rhus. Tox, Thuja.
Ailments form Brandy:
Carbo. Veg, Nux. Vom, Opium, Sulph.
Ailments from Wine:
Carbo .Veg, Coff, Lyco, Nat. Mur., Zinc.
“LIQUOR RUINS THE COUNTRY, FAMILY & LIFE”
“Alcohol is a kicker,
But it is a killer”
The term alcoholism is a confusing one and this is replaced by the current nomenclature “alcohol dependence”.
Drinking habit is gradually increasing in our society.
An alcohol addiction can be defined as one who has lost control over his drinking and has a compulsion to keep on drinking with deterioration of emotional, social and work activities.
Alcohol dependence is usually believed that drinking up to 20 units of alcohol for men and 13 units for women per week is not associated with health hazard. Definite health hazard occurs when consumption of alcohol is more than 50 units for men and 35 units for women in a week.
CAUSES FOR ADDICTION
Alcohol environment – members of a society where most of the people are alcoholics are prone to alcohol addiction.
Anxiety and depression.
Psychopathic persons.
SYMPTOMS OF ALCOHOLISM
Early symptoms – euphoria, Talkativeness
Later on – concentration is impaired and the subject becomes forgetful,
gradually power of thinking, Judgement and memory fail.
BAD EFFECTS OF CHRONIC ALCOHOLISM:
Psychological Problem :
Loss of concentration
Recent loss of memory
Delirium tremens
Dipsomania
Wernicke korsakoffs psychosis
Cardiovascular system
Alcohol is generally a peripheral vasodilatator
Daily taking one oz of French wine prevents ischemic heart disease.
Bad effects – alcoholic cardiomyopathy.
Respiratory system :
Due to chronic alcohol- in sufficient in take of food ,it produces decreased immune power ,leads for recurrent respiratory infection.
After large quantity of alcohol and heavy meal with un consciousness cause aspiration pneumonia .
Central nervous system:
Alcoholic peripheral neuropathy
Alcoholic hallucinosis
Cerebellar degeneration
Alcoholic myopathy
Hyper tropic Poly neuritis
Hepatobiliary system :
Chronic alcohol produced low immunity – amebic liver abscess
Cirrhosis
Acute and chronic gastritis
Pancreatitis
Connective tissue disorder :
Gout
Sexual:
Impotence
Management:
Admission in hospital with full with drawl of alcohol.
Adequate diet supplemented with vitamin B complex.
If with drawl leads to marked tremulousness and restlessness, large
dose of Vit.B complex I /v
Drug for with drawl systems (chlorpromazine, prochlorperazine)
Psychotherapy.
Homoeopathic management:
Nux vomica:
For anti doting bad effects of liquor such as gastric trouble,restlessness,
Bad effects of alcohol
Dipsomania
Petroleum:
Drunkard with out energy ,with out strength of will, unable to refuse wine,vomiting after the least excess in drinks , dipsomania,
Sulphuric acid :
One part with 3 parts of alcohol , 10 to 15 drops ,3 times daily for 3 or 4
weeks,has been subdue the craving for liquor ( dr. hering)
Sterculia:
The remedy for the drinking habit. It promotes the appetite and digestion, and lessens the craving for liquor.
Capsicum:
Prostration and feeble digestion of alcoholics.
Syphilinum:
Craving alcohol, in any form. Hereditary tendency to alcoholism.
Loss of memory, cannot remember names of books, persons or places.
Sensation as if going insane, as if about to be paralyzed, of apathy and indifference.
Zincum. Met:
Persons suffering from cerebral and nervous exhaustion.
Defective vitality, brain or nerve power wanting too weak to develop
exanthemata.
Quercus:
Used first by Rademacher for chronic spleen affections, spleen dropsy.
Antidotes effects of alcohol.
Takes away craving for alcoholics, give dose as below for several months.
Dropsy and lever affections.
Alcoholism, General Dipsomania:
Agar, Crot.H, Lach, Chin, Nux.Vom, Ran.B, Sulph. Acid, Sulph., Verat, Syph., Zinc, Ledum.
Ailments from Beer:
Kali. Bich, Rhus. Tox, Thuja.
Ailments form Brandy:
Carbo. Veg, Nux. Vom, Opium, Sulph.
Ailments from Wine:
Carbo .Veg, Coff, Lyco, Nat. Mur., Zinc.
BAD EFFECTS OF SMOKING
BAD EFFECTS OF SMOKING
“Cigarette smoking is injurious to health”
Smoking habits commonly seen in young age group
What are the diseases come due to smoking
Respiratory system
Why it is bad , nicotine causes bronchial constriction lead to early development of chronic bronchitis.
-bronchogenic carcinoma usually in old age (above 60 yrs)
- chronic bronchitis ( 30-40 yrs)
cardio vascular system:
nicotine is a vasoconstrictor , it injures the coronary vessels ,finally produces atheromatous deposition leading to ischemic heart disease . commonly in young age group.
Central nervous system:
Narrowing of cerebral vessels cause atheromatous plaque .which produces thrombosis in turn produces hemiplegia.
Others :
Peptic ulcer
Throat cancer.
Impotence
Homoeopathic management:
Destroys craving for tobacco, Cancer from smoking – Caladium.
Tobacco craving – daphne indica,
Tobacco heavy smokers- nicotine poisoning causing damage to heart, lung, and blood vessels- tabaccum.
After smoking thirst increased –ars,calad,con,phos,
Abdomen pain after smoking –bufo,
Pain in bowels, better after smoking-coloc
Addiction, nicotine –aven,calad,ign,nicot,nux.vom,tab,
Angina pectoris from tobacco –nux.vom,
Desire for smoking- calad, tab, ars, cal.p, camph, china, coca, glon, nicot, nux vom, phos, staph.
Heart, symptoms of circulation worse after smoking ¬– spongia
Hic cough during smoking – puls, sang.
Hic cough after smoking – calen, ign, puls.
Intoxicated , feeling after smoking – asc.t,
Paralysis, from abuse of nicotine – nux vom.
Smoking causes urging to stool – caladium.
“Cigarette smoking is injurious to health”
Smoking habits commonly seen in young age group
What are the diseases come due to smoking
Respiratory system
Why it is bad , nicotine causes bronchial constriction lead to early development of chronic bronchitis.
-bronchogenic carcinoma usually in old age (above 60 yrs)
- chronic bronchitis ( 30-40 yrs)
cardio vascular system:
nicotine is a vasoconstrictor , it injures the coronary vessels ,finally produces atheromatous deposition leading to ischemic heart disease . commonly in young age group.
Central nervous system:
Narrowing of cerebral vessels cause atheromatous plaque .which produces thrombosis in turn produces hemiplegia.
Others :
Peptic ulcer
Throat cancer.
Impotence
Homoeopathic management:
Destroys craving for tobacco, Cancer from smoking – Caladium.
Tobacco craving – daphne indica,
Tobacco heavy smokers- nicotine poisoning causing damage to heart, lung, and blood vessels- tabaccum.
After smoking thirst increased –ars,calad,con,phos,
Abdomen pain after smoking –bufo,
Pain in bowels, better after smoking-coloc
Addiction, nicotine –aven,calad,ign,nicot,nux.vom,tab,
Angina pectoris from tobacco –nux.vom,
Desire for smoking- calad, tab, ars, cal.p, camph, china, coca, glon, nicot, nux vom, phos, staph.
Heart, symptoms of circulation worse after smoking ¬– spongia
Hic cough during smoking – puls, sang.
Hic cough after smoking – calen, ign, puls.
Intoxicated , feeling after smoking – asc.t,
Paralysis, from abuse of nicotine – nux vom.
Smoking causes urging to stool – caladium.
Wednesday, 16 March 2011
OBESITY
OBESITY
The condition in which excess fat has accumulated in the body, mostly in the subcutaneous tissues, clinical obesity is considered to be present when a person has a Body mass index of 30 or over
Obesity is the most common nutritional disorder of recent years in western societies. Some patients may require surgical treatment to attain worth while weight reduction, drug treatments also exist.
Weight in KG
BMI = ––––––––––––––––
(Height in meters) 2
WHO Classification of over Weight
Classification BMI (KG/ M2) Associated health risk
Under weight < 18.5 Low (But risk of other clinical problems
increased)
Normal 18.5 – 24.9 Average
Over weight ≥ 25
Per obese 25 – 29.9 Increased
Obese classI 30 – 34.9 Moderately increased
Obese class II 35 – 39.9 Severely increased
Obese class III ≥40 Very Severely increased
Causes of Obesity
Simple
Endogenous - constitutional
Exogenous – Over eating lack of exercise
Other causes
Endocrine causes
a) Pituitary – Frohlich’s syndrome
Pregnancy
Climacteric both males & Females
b) Thyroid - Hypothyroidism
c) Adrenal cortex - Cushing’s Syndrome
d) Gonads - Polycystic ovaries
e) Pancreas - Islet cell tumors
f) Hypothalamus - Encephalitis
- Meningo encephalitis
- Cranio pharyngioma
- 3rd ventricle tumors
Drugs:
Anti convulsants
Anti psychotics
Anti depressants
Cortico steroids
Insulin
Types of body fat distribution
Pear type: Fat accumulates mainly around hips and thighs (Gynoid distribution) characteristics of females.
Apple type: Fat storage mainly in the abdomen (android distribution), found in both sexes.
Effects of obesity (Complications)
1. Brain - Cerebro vascular accidents (CVA), mental disturbances.
2. C.V.S. - Coronary Heart diseases (CHD)
3. Vascular - Hypertension , varicose vein, pedal edema,
4. Respiratory - Dyspnoea
5. G.I.T - Hiatus hernia, Gall stone, Constipation.
6. Joints - OA, Backache
7. Endocrine &
Metabolic - NIDDM, Hyper lipidemia, menstrual irregularities,impotence
8. Malignancy - Cancers such as ca.ovary,endometrium,cervix,breast,prostate
9. Skin - Rashes
10. Pregnancy - Perinatal mortality, per eclampsia, Gestationaldiabetes,
Caesarian sections
11. Psychic -These individuals are very unhappy. Different psychosomatic
problems may also develop.
Management:
1.Exercise.
2.Diet.
Foods to be avoided – Bread and anything made with flour, cereals, potatoes and other whole root vegetables, foods containing much sugar, all sweets and salt, fatty foods like cream, butter, fat, beans, and pork, fluids not more than 2 pints a day.
No restriction of meat, fish and fowl.
Take large amount of green leafy vegetables and fruits.
3.Psychotherapy- Motivation for weight reduction must be cultivated in the patient’s mind.
4.Surgery - Gastroplication- Jejuno ileal by pass
5.Starvation therapy- It may be helpful sometime
Homoeopathic Management
Am.Brom, Am.mur, Anti.crud, Aurnm.met, Bar.carb, Cal.carb, Capsicum, Fucus.vesi, Graph, Fer.met, Kali bich, Kali carb, Lyco, Phyto, Sulph, Thyroidinum.
Phytolacca. Berry Q (Phytoline Q) - Attended with difficulty in walking, sitting, palpitation, dyspnea on the least exertion, nausea, eructations. A great fat reducer.
Aesculentine Q- Another great fat reducer, may be alternated with phytoline.
Calotropis Q – Obesity, while flesh decreases, muscles becomes, harder and firmer
Fucus. Vesiculosis Q, 1x, if attended with indigestion and flatulence. A remedy for obesity and non-toxic goiter, obstinate constipation, thyroid enlargement in obese subjects.
The condition in which excess fat has accumulated in the body, mostly in the subcutaneous tissues, clinical obesity is considered to be present when a person has a Body mass index of 30 or over
Obesity is the most common nutritional disorder of recent years in western societies. Some patients may require surgical treatment to attain worth while weight reduction, drug treatments also exist.
Weight in KG
BMI = ––––––––––––––––
(Height in meters) 2
WHO Classification of over Weight
Classification BMI (KG/ M2) Associated health risk
Under weight < 18.5 Low (But risk of other clinical problems
increased)
Normal 18.5 – 24.9 Average
Over weight ≥ 25
Per obese 25 – 29.9 Increased
Obese classI 30 – 34.9 Moderately increased
Obese class II 35 – 39.9 Severely increased
Obese class III ≥40 Very Severely increased
Causes of Obesity
Simple
Endogenous - constitutional
Exogenous – Over eating lack of exercise
Other causes
Endocrine causes
a) Pituitary – Frohlich’s syndrome
Pregnancy
Climacteric both males & Females
b) Thyroid - Hypothyroidism
c) Adrenal cortex - Cushing’s Syndrome
d) Gonads - Polycystic ovaries
e) Pancreas - Islet cell tumors
f) Hypothalamus - Encephalitis
- Meningo encephalitis
- Cranio pharyngioma
- 3rd ventricle tumors
Drugs:
Anti convulsants
Anti psychotics
Anti depressants
Cortico steroids
Insulin
Types of body fat distribution
Pear type: Fat accumulates mainly around hips and thighs (Gynoid distribution) characteristics of females.
Apple type: Fat storage mainly in the abdomen (android distribution), found in both sexes.
Effects of obesity (Complications)
1. Brain - Cerebro vascular accidents (CVA), mental disturbances.
2. C.V.S. - Coronary Heart diseases (CHD)
3. Vascular - Hypertension , varicose vein, pedal edema,
4. Respiratory - Dyspnoea
5. G.I.T - Hiatus hernia, Gall stone, Constipation.
6. Joints - OA, Backache
7. Endocrine &
Metabolic - NIDDM, Hyper lipidemia, menstrual irregularities,impotence
8. Malignancy - Cancers such as ca.ovary,endometrium,cervix,breast,prostate
9. Skin - Rashes
10. Pregnancy - Perinatal mortality, per eclampsia, Gestationaldiabetes,
Caesarian sections
11. Psychic -These individuals are very unhappy. Different psychosomatic
problems may also develop.
Management:
1.Exercise.
2.Diet.
Foods to be avoided – Bread and anything made with flour, cereals, potatoes and other whole root vegetables, foods containing much sugar, all sweets and salt, fatty foods like cream, butter, fat, beans, and pork, fluids not more than 2 pints a day.
No restriction of meat, fish and fowl.
Take large amount of green leafy vegetables and fruits.
3.Psychotherapy- Motivation for weight reduction must be cultivated in the patient’s mind.
4.Surgery - Gastroplication- Jejuno ileal by pass
5.Starvation therapy- It may be helpful sometime
Homoeopathic Management
Am.Brom, Am.mur, Anti.crud, Aurnm.met, Bar.carb, Cal.carb, Capsicum, Fucus.vesi, Graph, Fer.met, Kali bich, Kali carb, Lyco, Phyto, Sulph, Thyroidinum.
Phytolacca. Berry Q (Phytoline Q) - Attended with difficulty in walking, sitting, palpitation, dyspnea on the least exertion, nausea, eructations. A great fat reducer.
Aesculentine Q- Another great fat reducer, may be alternated with phytoline.
Calotropis Q – Obesity, while flesh decreases, muscles becomes, harder and firmer
Fucus. Vesiculosis Q, 1x, if attended with indigestion and flatulence. A remedy for obesity and non-toxic goiter, obstinate constipation, thyroid enlargement in obese subjects.
HEALTH IMPORTANT TIPS
HEALTH IMPORTANT TIPS
Answer the phone by left ear.
Don’t take medicine with cold water.
Don’t lie down immediately after taking medicine.
Don’t have huge meals after 5 pm.
Drink more water in the morning, less at night.
Best sleeping time is from 10 pm to 5 am.
When battery is down to last bar don’t answer the phone, as the radiation is 1000 times stronger.
Answer the phone by left ear.
Don’t take medicine with cold water.
Don’t lie down immediately after taking medicine.
Don’t have huge meals after 5 pm.
Drink more water in the morning, less at night.
Best sleeping time is from 10 pm to 5 am.
When battery is down to last bar don’t answer the phone, as the radiation is 1000 times stronger.
Tuesday, 15 March 2011
“HMS” - Health Message Service
Dr. S. SABARIRAJAN, M.D., (Hom) Gen. Med.,
Reader, Dept. of Practice of Medicine.
“HMS” - Health Message Service
Acidity
Suffer from acidity? Drink water mixed with jaggery, after meals.
Anaemia
Have beet root to cure anaemia & improve your blood level.
Appetite
Lack of appetite- mix ½ tsp each of ginger juice and honey, after lunch and dinner.
Lack of hunger? Sprinkle black pepper and salt on pineapple & eat.
Begin each dinner with healthy green salad it helps cut appetite.
Autism
Watching too much TV can results in Autism.
Back ache
Wear flat- heeled shoes of offer good support to feet & legs.
Wheat grass juice is very useful for all ills, including backaches.
Lemon juice in water, up to 6 glasses / day helps easing backache.
Blood purifier
Take a tsp of powdered pomegranate skin with water early morning.
Bone strength
Calcium crunch? Chew a handful of sesame seeds for your calcium need.
Milk merits it prevents osteoporosis, BP and colon cancer in adults.
Exercise prevents osteoporosis, & controls type 2 diabetes.
Drinking calcium rich lemonade regularly strengthens bones & teeth.
Green apples are good for strong bones and teeth, also aid in vision.
Cancer
Apple reduces the risk of colon cancer, ca. prostate, and ca. lung.
Increased consumption of onions cuts risk of head and neck cancers.
Tomatoes contain lycopene which helps prevent prostate cancer.
Tomato sauce used on chips/ other food can reduce risk of prostate cancer.
Cardiac diseases
HT- have a tbsp of Neem juice mixed with mishri twice / day.
Potassium in banana regulates B.P and helps over come depression.
Garlic helps to prevent blood clots from forming, thus reducing the possibility of strokes.
Raw beets protect u against heart disease and certain cancers.
Avoid more than the recommended 5 gm/ day of salt and be healthy.
Lower your chance of heart disease by half; laugh as much as u can.
Consumption of tomatoes helps in treating high BP.
Olive oil is rich in good fat necessary for heart and immune system.
Eggs help cut heart attack/ stroke risk they prevent blood clots.
Cold
Garlic can cut by half the risk of catching a winter cold.
Prevent cold & flu-wash your hands frequently to keep viruses away.
Crush 6-7 black pepper, mix with honey and consume it.
Ginger juice and warm honey taken before sleep relieves severe cough.
Vit-C in oranges shortens the duration of your cold.
Constipation
Most fruits act as natural laxatives and regulate body’s digestive process.
Regular cabbage intake prevents constipation and aids wt loss.
Did u know? 1cup of corn provides over 18 % of the daily fiber need.
Diabetes
High blood sugar- have 1 tbsp of Neem juice daily morning, it reduce blood sugar.
Digestion
Avoid liquid calories as in shakes they’re digested much more quickly than solid calories.
Custard apple aids digestion and cures diarrhea, dysentery and vertigo.
Avoid ice- cold water along with or soon after meals it affects digestion.
Eating a banana after every meal reduces the risk of diarrhea.
Energy
Bananas are a good post exercise snack, they energize you.
Face
Chewing gum strengthens your Jaw & is good for ur facial muscles
Gum
Gum problems? Massage them with powdered carom seeds. ( Ajwain)
Hair
Carrots contain 93% of vit.A, which helps reducing hair loss.
Hair lice? Add sugar to ½ cup lemon juice, apply 4-5 hrs before hair wash.
Head ache
Head ache? Try deep breathing it releases endorphins (pain killers),
Drive headache away, apply fresh coriander juice on the fore head.
Don’t be lethargic; drink more water to avoid headache and tiredness.
Cure headache: - cut a lime in half and rub it on your forehead.
Insomnia
Suffering from insomnia? Take 2 tps of honey before bed time as it induces sleep.
Kidney stones
Grapes benefit against kidney stone, also improve blood flow.
Liver diseases
Vit-D (milk, mushroom) reduces the risk of liver diseases.
Mind
Smokers avoid cigarettes when angry stressed it adds to your anxiety.
Smile more! Being depressed affects your immune system and raised BP.
Exercise significantly reduces depression and anxiety symptoms.
Chewing gum helps release stress and improves one’s mood.
Tensed? Give a mental shrug, sigh, drop shoulders and ask- why bother
Are you stressed? Drink plenty of water it will help you to flush out toxins.
Mosquito bite
Did u know? Garlic is an effective natural mosquito repellent.
Nausea and vomiting
In nausea / vomiting, consume onion and ginger extract to feel better.
Nose
Blocked nose- prop yourself up in bet with pillows to breathe easy.
Restless due to nose congestion? Use saline drops for some rest.
Obesity
Too ill sleep can alter hormone levels and increase body wt.
Poisons
Apple seeds are mildly poisonous and have a small amount of amygdalin.
Sinusitis
Suffering from sinus? Drink plenty of water and vitamins rich fruit drinks.
Skin
Drink lemon juice every morning to make your skin glowing and healthy.
White foods such as garlic and bananas help soothe skin allergies.
Use aloe Vera a natural curative agent for / allergies/ insect bite.
Sore Throat
Place folded hand kerchief around neck over the night.
Sprain
Sprain? Apply ice to the affected area for the 1st 2 (or) 3 days.
Tooth decay
Chewing gums sweetened with xylitol reduce the risk of tooth decay.
Cheese, a rich source of calcium and protein prevents the risk of tooth decay.
Vitamins and minerals:
One egg contains over 6 Gms of protein and all 9 essential amino acids.
1 ounce of almonds a day meets 1/3 of your daily need of vit.E
Vit-C and zinc will boost your immune system and help in fighting stress.
Wounds
Honey contains antiseptic and antibacterial properties, helps wounds.
Reader, Dept. of Practice of Medicine.
“HMS” - Health Message Service
Acidity
Suffer from acidity? Drink water mixed with jaggery, after meals.
Anaemia
Have beet root to cure anaemia & improve your blood level.
Appetite
Lack of appetite- mix ½ tsp each of ginger juice and honey, after lunch and dinner.
Lack of hunger? Sprinkle black pepper and salt on pineapple & eat.
Begin each dinner with healthy green salad it helps cut appetite.
Autism
Watching too much TV can results in Autism.
Back ache
Wear flat- heeled shoes of offer good support to feet & legs.
Wheat grass juice is very useful for all ills, including backaches.
Lemon juice in water, up to 6 glasses / day helps easing backache.
Blood purifier
Take a tsp of powdered pomegranate skin with water early morning.
Bone strength
Calcium crunch? Chew a handful of sesame seeds for your calcium need.
Milk merits it prevents osteoporosis, BP and colon cancer in adults.
Exercise prevents osteoporosis, & controls type 2 diabetes.
Drinking calcium rich lemonade regularly strengthens bones & teeth.
Green apples are good for strong bones and teeth, also aid in vision.
Cancer
Apple reduces the risk of colon cancer, ca. prostate, and ca. lung.
Increased consumption of onions cuts risk of head and neck cancers.
Tomatoes contain lycopene which helps prevent prostate cancer.
Tomato sauce used on chips/ other food can reduce risk of prostate cancer.
Cardiac diseases
HT- have a tbsp of Neem juice mixed with mishri twice / day.
Potassium in banana regulates B.P and helps over come depression.
Garlic helps to prevent blood clots from forming, thus reducing the possibility of strokes.
Raw beets protect u against heart disease and certain cancers.
Avoid more than the recommended 5 gm/ day of salt and be healthy.
Lower your chance of heart disease by half; laugh as much as u can.
Consumption of tomatoes helps in treating high BP.
Olive oil is rich in good fat necessary for heart and immune system.
Eggs help cut heart attack/ stroke risk they prevent blood clots.
Cold
Garlic can cut by half the risk of catching a winter cold.
Prevent cold & flu-wash your hands frequently to keep viruses away.
Crush 6-7 black pepper, mix with honey and consume it.
Ginger juice and warm honey taken before sleep relieves severe cough.
Vit-C in oranges shortens the duration of your cold.
Constipation
Most fruits act as natural laxatives and regulate body’s digestive process.
Regular cabbage intake prevents constipation and aids wt loss.
Did u know? 1cup of corn provides over 18 % of the daily fiber need.
Diabetes
High blood sugar- have 1 tbsp of Neem juice daily morning, it reduce blood sugar.
Digestion
Avoid liquid calories as in shakes they’re digested much more quickly than solid calories.
Custard apple aids digestion and cures diarrhea, dysentery and vertigo.
Avoid ice- cold water along with or soon after meals it affects digestion.
Eating a banana after every meal reduces the risk of diarrhea.
Energy
Bananas are a good post exercise snack, they energize you.
Face
Chewing gum strengthens your Jaw & is good for ur facial muscles
Gum
Gum problems? Massage them with powdered carom seeds. ( Ajwain)
Hair
Carrots contain 93% of vit.A, which helps reducing hair loss.
Hair lice? Add sugar to ½ cup lemon juice, apply 4-5 hrs before hair wash.
Head ache
Head ache? Try deep breathing it releases endorphins (pain killers),
Drive headache away, apply fresh coriander juice on the fore head.
Don’t be lethargic; drink more water to avoid headache and tiredness.
Cure headache: - cut a lime in half and rub it on your forehead.
Insomnia
Suffering from insomnia? Take 2 tps of honey before bed time as it induces sleep.
Kidney stones
Grapes benefit against kidney stone, also improve blood flow.
Liver diseases
Vit-D (milk, mushroom) reduces the risk of liver diseases.
Mind
Smokers avoid cigarettes when angry stressed it adds to your anxiety.
Smile more! Being depressed affects your immune system and raised BP.
Exercise significantly reduces depression and anxiety symptoms.
Chewing gum helps release stress and improves one’s mood.
Tensed? Give a mental shrug, sigh, drop shoulders and ask- why bother
Are you stressed? Drink plenty of water it will help you to flush out toxins.
Mosquito bite
Did u know? Garlic is an effective natural mosquito repellent.
Nausea and vomiting
In nausea / vomiting, consume onion and ginger extract to feel better.
Nose
Blocked nose- prop yourself up in bet with pillows to breathe easy.
Restless due to nose congestion? Use saline drops for some rest.
Obesity
Too ill sleep can alter hormone levels and increase body wt.
Poisons
Apple seeds are mildly poisonous and have a small amount of amygdalin.
Sinusitis
Suffering from sinus? Drink plenty of water and vitamins rich fruit drinks.
Skin
Drink lemon juice every morning to make your skin glowing and healthy.
White foods such as garlic and bananas help soothe skin allergies.
Use aloe Vera a natural curative agent for / allergies/ insect bite.
Sore Throat
Place folded hand kerchief around neck over the night.
Sprain
Sprain? Apply ice to the affected area for the 1st 2 (or) 3 days.
Tooth decay
Chewing gums sweetened with xylitol reduce the risk of tooth decay.
Cheese, a rich source of calcium and protein prevents the risk of tooth decay.
Vitamins and minerals:
One egg contains over 6 Gms of protein and all 9 essential amino acids.
1 ounce of almonds a day meets 1/3 of your daily need of vit.E
Vit-C and zinc will boost your immune system and help in fighting stress.
Wounds
Honey contains antiseptic and antibacterial properties, helps wounds.
Arthritis
ARTHRITIS
Def:
Inflammation of the Joint’s is Called Arthritis.
Types of Arthritis:
1. Mono arthritis
2. Poly arthritis
[[
1. Acute Mono Arthritis:
Pyogenic arthritis
Gonococcal arthritis
Reactive arthritis
Juvenile chronic arthritis
Gout (or) other crystal deposition diseases
Trauma, internal derangement
Palindromic arthritis
Haemarthosis
2. Chronic Monoarthritis:
Degenerative joint disease
Tuberculosis (or) fungal infection
Incompletely treated pyogenic arthritis
Reactive arthritis
Rheumatoid Arthritis.
3. Acute Polyarthritis.
Rheumatic fever
Rheumatoid arthritis
Reactive arthritis
SLE
Syphilitic arthritis
Poncet’s
4. Chronic Poly Arthritis
Rheumatoid arthritis
Psoriatic arthritis
Ankylosing spondylitis
S.L.E
Degenerative arthritis
Hypertrophy osteoarthropathy
MONO ARTHRITIS
Four main common diagnoses need to be considered in patients who present with a single hot, painful, tender, and swollen Jt.
D/D for Mono Arthritis:
Infection
Bacterial, Viral, Fungal, Spirochaetal,
Crystal Arthropathy
Gout, Pseudo gout
Inflammatory
- Rheumatoid arthritis
- Juvenile idiopathic arthritis
- Reactive arthritis
- Psoriatic
- Inflammatory bowel disease
- Erythema Nodosum
- Plaindromic
- Plant thorn synovitis
- Paraneoplastic
Traumatic:
• Haemarthrosis
• Internal derangement
• Loose body
• Fracture
* Degenerative
• Primary osteoarthritis
• Secondary osteoarthritis
* Bone disease
• Osteomyelitis
• Osteonecrosis
* Blood disorders:
• Leukemia
• Hemophilia
• Anticoagulants
* Other:
• Villonodular synovitis
• Tumors
POLYATHRITIS
Inflammation occurs in more than one joint’s
Causes and pattern of poly arthritis
Symmetrical inflammatory
• Viral arthritis
• Rheumatoid arthritis
• Juvenile idiopathic arthritis
• SLE
A Symmetrical Panciarticular
• Psoriatic arthritis
• Reiter’s syndrome
• Enteropathic arthritis
• Ankylosing spondylitis
• Behcet’s disease
• Bacterial endocarditis
• Sarcoidosis
• Septic arthritis
Additive
• Gonococcal arthritis
Flitting
• Rheumatic fever
• Septicemia
Metabolic
• Polyarticular gout
• Pyrophosphate arthropathy
• Acromegalic arthritis
• Haemochromatosis
• Hyperlipidaemia
Osteoarthritis
Nodal osteoarthritis
Non- nodal generalized osteoarthritis
DIFFERENTIAL DIAGNOSIS OF ARTHRITIS
RHEUMATOID ARTHRITIS
Def:
A chronic inflammatory joint disease with symmetrical destructive and deforming polyarthritis, affecting small and large Jt’s with presence of circulating anti Globin antibodies
Aetiology:
The cause remain obscure, but an increasing evidence that the disease is triggered by Th1 Lymphocytes.
Predisposing factors
Genetically individuals with HLA DR4
Temperate climate
Hereditary may play a part in 5% to 10% of cases
It is commonly seen in subjects with asthenic built
In many cases H/O trauma is present.
Pathology
Swelling and congestion of synovial membrane
Infiltration of Lymphocytes, plasma cell and macrophage
Effusion of synovial fluid into the Jt space
Hypertrophy of synovial membrane
Inflammatory granulation tissue (pannus)
Spreads over the under the articular cartilage
Articular cartilage progressively eroded and destroyed
Fibrous (or) bony ankylosis may occur
Muscles adjacent to inflamed jt’s atrophy and there may be focal infiltration with lymphocytes.
C/F:
- Onset is usually gradual, sometimes acute
- Common in adults and middle aged.
- Joint pain, stiffness and symmetrical swelling of and number of peripheral joints are being swollen.
- Pain usually only on morning, but later on pain at rest and early morning stiffness are characteristic.
- Small joint’s of the fingers usually the proximal interphalangeal joint’s are involved giving a spindle appearance
- Rheumatoid nodules present in subcutaneous over bony prominences,
- In the toes usually the metatarsal phalangeal joint’s leading to broadening of the toes.
- Initially the small joint’s such as interphalangeal joint’s and metatarsophalangeal joint’s are involved, but later on the wrist, elbow, shoulder, ankle, knee, hip, temparomandibula and acromion clavicular jont’s are involved.
Hand Deformities:
- Swan neck deformities present.
- Boutonnier’s (or) buttonhole deformity present.
- Z deformity of thumb present.
Foot Deformities:
- Painful sensation as if “walking on pebbles”
- Calcanen erosion
- Backer’s cyst (or) popliteal cyst
INVESTIGATIONS:
Test for Inflammation
- Increased ESR
- C reactive protein increased
- Thrombocytosis
- Norm chromic, normocytic anemia
- Hepatic alkaline phosphate increased
Immunological Test
- Rheumatoid factor - +ve
- ANF -+ve
X ray: Show deformities, nodules, (+)
OSTEOARTHRITIS
Def:
Osteoarthritis is not a single disease, rather it is the end result of a variety of patterns of Jt failure is characterized by both degeneration of articular cartilage and simultaneous proliferation of new bone, cartilage and connective tissue .mainly affected big wt bearing Jt of the body mainly in the aged individuals
Age groups - above 60 yrs
PATHOLOGY
Micro # of subchondral bones due to repetive loading
Healing of micro#
Relative loss of original shape of bone
Creates a stress to adjacent cartilage
Proliferate changes appear at margin
(That formation - osteophytes)
Articular cartilage is lost
Underlying bone becomes hard
Cyst may form
C/F
- The common joints affected are spinal cord, hip, knee Jt.
- Gradual onset of pain at 1st intermittent and dull aching pain,
- Pain rest
- As the disease progress movement of the joint restricted initially due to pain and later on due to formation of osteophytes and remodeling of bones.
- Nocturnal aching is common due to excessive blood supply
On Examination
- Crepitus may be felt (or) heard
- Muscular wasting near the involve Jt may be present.
- Heber den’s node present (Terminal inter phalangial Jt)
- Bouchard’s Node (proximal inter phalngial Jt)
Investigation
Blood picture : Normal
Synovial fluid : Viscus in nature with low cell count
X – Ray:
- Loss of Jt space
- Formation of marginal osteophytes
- Bone remodeling and cyst may be seen.
GOUT
Def:
A Disorders in which crystals of monosodium urate, monohydrate derived from hyperuraemic body fluids giving rise to inflammatory arthritis , Tendosynovitis, Bursitis, urolithiasis and renal disease
(Normal serum uric acid level
Male –3.0 to 7.6 mg/dl Female –2.6 to 6.8mg/dl)
Age: Post pubertal in male, women after menopause
Aetiology:
Increased excretion of uric acid (75%)
- Renal failure
- Lead poisoning
- Hyper parathyroidism
- Myxoedema
- Down syndrome
- Alcohol
- Toxaemia of pregnancy
Increased Production of Uric Acid (25%)
- Increased turn over
- Increased synthesis of uric acid
C/F
Acute:
- Initially the metatarsophalangeal Jt of the great toe is involved in 70% of individuals.
- As the disease progress the ankle and wrist are involved.
- The onset is insidious with heat, redness, swelling, shiny skin and dilatation of vein over the joint.
Chronic:
- Recurrent acute attacks lead to progressive cartilage and bony erosions.
- Deposition of sodium urate in the joint produced chronic foreign body inflammatory response of the joint, this is known as “Tophi”
- Severe functional impairment with deformities may be present.
Investigations:
- Serum urate level elevated.
- Joint radiograph shows soft tissues, swelling with deposition of crystals.
RHEUMATIC ARTHRITIS
- Here big joint’s are affected one after another (fleeting type arthritis)
- Evidences of carditis are present
- ASO titer increased
TUBERCULOUS ARTHRITIS
- Single joint is involved
- Wasting of muscles above and below the involved joint is common.
- Low grade fever present
- H/o tuberculosis present
- X ray of chest may reveal tuberculosis
TRAUMATIC ARTHRITIS
- H/o trauma will be present
- Usually single joint is affected
PYOGENIC ARTHRITIS
- It is monoarticular
- The skin is red, edematous, glossy and tender with local rise of temperature
- Blood shows leucocytosis with increased polymorphs
GONORRHOEAL ARTHRITIS
- H/o exposure and urethral discharge are present
- Complement fixation test is positive
PSORIATIC ARTHRITIS
- Terminal interphalangeal joints are involved
- Nails are cracked, pitted (or) thickened.
- Psoriatic skin lesions are present
- Rheumatoid factor is negative.
HAEMOPHILIC ARTHRITIS
- H/o hemophilia is present
- Males are affected,
- Knee joint is usually affected
- Coagulation time is prolonged
REITER’S SYNDROME
- The disease is common in males,
- There is polyarthritis, non gonorrheal, urethritis and conjunctivitis,
DYSENTERIC ARTHRITIS
- Usually 3-4 weeks after an attack of acute bacillary dysentery
- Knee, elbow, wrist and finger joints are commonly affected
ARTHRITIS IN BRUCELLOSIS
- This is monoarticular, usually involving knee, hip (or) sacroiliac joints.
- Low grade pyrexia is present.
- Agglutination test is positive
HOMOEOPATHIC MANAGEMENT
(Murphy repertory)
ARTHRITIS, Inflammation
Acon kalm sep
Apis kreos saras
Bell lac.ac sulph
Bry lyco
Led merc
Sil Nat.m
Ang
Arn Nat-s
Aur phyt
Calc psor
Caust puls
Guai Rhod
Kali-c Ruta
Kali-I Rhus.tox
Def:
Inflammation of the Joint’s is Called Arthritis.
Types of Arthritis:
1. Mono arthritis
2. Poly arthritis
[[
1. Acute Mono Arthritis:
Pyogenic arthritis
Gonococcal arthritis
Reactive arthritis
Juvenile chronic arthritis
Gout (or) other crystal deposition diseases
Trauma, internal derangement
Palindromic arthritis
Haemarthosis
2. Chronic Monoarthritis:
Degenerative joint disease
Tuberculosis (or) fungal infection
Incompletely treated pyogenic arthritis
Reactive arthritis
Rheumatoid Arthritis.
3. Acute Polyarthritis.
Rheumatic fever
Rheumatoid arthritis
Reactive arthritis
SLE
Syphilitic arthritis
Poncet’s
4. Chronic Poly Arthritis
Rheumatoid arthritis
Psoriatic arthritis
Ankylosing spondylitis
S.L.E
Degenerative arthritis
Hypertrophy osteoarthropathy
MONO ARTHRITIS
Four main common diagnoses need to be considered in patients who present with a single hot, painful, tender, and swollen Jt.
D/D for Mono Arthritis:
Infection
Bacterial, Viral, Fungal, Spirochaetal,
Crystal Arthropathy
Gout, Pseudo gout
Inflammatory
- Rheumatoid arthritis
- Juvenile idiopathic arthritis
- Reactive arthritis
- Psoriatic
- Inflammatory bowel disease
- Erythema Nodosum
- Plaindromic
- Plant thorn synovitis
- Paraneoplastic
Traumatic:
• Haemarthrosis
• Internal derangement
• Loose body
• Fracture
* Degenerative
• Primary osteoarthritis
• Secondary osteoarthritis
* Bone disease
• Osteomyelitis
• Osteonecrosis
* Blood disorders:
• Leukemia
• Hemophilia
• Anticoagulants
* Other:
• Villonodular synovitis
• Tumors
POLYATHRITIS
Inflammation occurs in more than one joint’s
Causes and pattern of poly arthritis
Symmetrical inflammatory
• Viral arthritis
• Rheumatoid arthritis
• Juvenile idiopathic arthritis
• SLE
A Symmetrical Panciarticular
• Psoriatic arthritis
• Reiter’s syndrome
• Enteropathic arthritis
• Ankylosing spondylitis
• Behcet’s disease
• Bacterial endocarditis
• Sarcoidosis
• Septic arthritis
Additive
• Gonococcal arthritis
Flitting
• Rheumatic fever
• Septicemia
Metabolic
• Polyarticular gout
• Pyrophosphate arthropathy
• Acromegalic arthritis
• Haemochromatosis
• Hyperlipidaemia
Osteoarthritis
Nodal osteoarthritis
Non- nodal generalized osteoarthritis
DIFFERENTIAL DIAGNOSIS OF ARTHRITIS
RHEUMATOID ARTHRITIS
Def:
A chronic inflammatory joint disease with symmetrical destructive and deforming polyarthritis, affecting small and large Jt’s with presence of circulating anti Globin antibodies
Aetiology:
The cause remain obscure, but an increasing evidence that the disease is triggered by Th1 Lymphocytes.
Predisposing factors
Genetically individuals with HLA DR4
Temperate climate
Hereditary may play a part in 5% to 10% of cases
It is commonly seen in subjects with asthenic built
In many cases H/O trauma is present.
Pathology
Swelling and congestion of synovial membrane
Infiltration of Lymphocytes, plasma cell and macrophage
Effusion of synovial fluid into the Jt space
Hypertrophy of synovial membrane
Inflammatory granulation tissue (pannus)
Spreads over the under the articular cartilage
Articular cartilage progressively eroded and destroyed
Fibrous (or) bony ankylosis may occur
Muscles adjacent to inflamed jt’s atrophy and there may be focal infiltration with lymphocytes.
C/F:
- Onset is usually gradual, sometimes acute
- Common in adults and middle aged.
- Joint pain, stiffness and symmetrical swelling of and number of peripheral joints are being swollen.
- Pain usually only on morning, but later on pain at rest and early morning stiffness are characteristic.
- Small joint’s of the fingers usually the proximal interphalangeal joint’s are involved giving a spindle appearance
- Rheumatoid nodules present in subcutaneous over bony prominences,
- In the toes usually the metatarsal phalangeal joint’s leading to broadening of the toes.
- Initially the small joint’s such as interphalangeal joint’s and metatarsophalangeal joint’s are involved, but later on the wrist, elbow, shoulder, ankle, knee, hip, temparomandibula and acromion clavicular jont’s are involved.
Hand Deformities:
- Swan neck deformities present.
- Boutonnier’s (or) buttonhole deformity present.
- Z deformity of thumb present.
Foot Deformities:
- Painful sensation as if “walking on pebbles”
- Calcanen erosion
- Backer’s cyst (or) popliteal cyst
INVESTIGATIONS:
Test for Inflammation
- Increased ESR
- C reactive protein increased
- Thrombocytosis
- Norm chromic, normocytic anemia
- Hepatic alkaline phosphate increased
Immunological Test
- Rheumatoid factor - +ve
- ANF -+ve
X ray: Show deformities, nodules, (+)
OSTEOARTHRITIS
Def:
Osteoarthritis is not a single disease, rather it is the end result of a variety of patterns of Jt failure is characterized by both degeneration of articular cartilage and simultaneous proliferation of new bone, cartilage and connective tissue .mainly affected big wt bearing Jt of the body mainly in the aged individuals
Age groups - above 60 yrs
PATHOLOGY
Micro # of subchondral bones due to repetive loading
Healing of micro#
Relative loss of original shape of bone
Creates a stress to adjacent cartilage
Proliferate changes appear at margin
(That formation - osteophytes)
Articular cartilage is lost
Underlying bone becomes hard
Cyst may form
C/F
- The common joints affected are spinal cord, hip, knee Jt.
- Gradual onset of pain at 1st intermittent and dull aching pain,
- Pain
- As the disease progress movement of the joint restricted initially due to pain and later on due to formation of osteophytes and remodeling of bones.
- Nocturnal aching is common due to excessive blood supply
On Examination
- Crepitus may be felt (or) heard
- Muscular wasting near the involve Jt may be present.
- Heber den’s node present (Terminal inter phalangial Jt)
- Bouchard’s Node (proximal inter phalngial Jt)
Investigation
Blood picture : Normal
Synovial fluid : Viscus in nature with low cell count
X – Ray:
- Loss of Jt space
- Formation of marginal osteophytes
- Bone remodeling and cyst may be seen.
GOUT
Def:
A Disorders in which crystals of monosodium urate, monohydrate derived from hyperuraemic body fluids giving rise to inflammatory arthritis , Tendosynovitis, Bursitis, urolithiasis and renal disease
(Normal serum uric acid level
Male –3.0 to 7.6 mg/dl Female –2.6 to 6.8mg/dl)
Age: Post pubertal in male, women after menopause
Aetiology:
Increased excretion of uric acid (75%)
- Renal failure
- Lead poisoning
- Hyper parathyroidism
- Myxoedema
- Down syndrome
- Alcohol
- Toxaemia of pregnancy
Increased Production of Uric Acid (25%)
- Increased turn over
- Increased synthesis of uric acid
C/F
Acute:
- Initially the metatarsophalangeal Jt of the great toe is involved in 70% of individuals.
- As the disease progress the ankle and wrist are involved.
- The onset is insidious with heat, redness, swelling, shiny skin and dilatation of vein over the joint.
Chronic:
- Recurrent acute attacks lead to progressive cartilage and bony erosions.
- Deposition of sodium urate in the joint produced chronic foreign body inflammatory response of the joint, this is known as “Tophi”
- Severe functional impairment with deformities may be present.
Investigations:
- Serum urate level elevated.
- Joint radiograph shows soft tissues, swelling with deposition of crystals.
RHEUMATIC ARTHRITIS
- Here big joint’s are affected one after another (fleeting type arthritis)
- Evidences of carditis are present
- ASO titer increased
TUBERCULOUS ARTHRITIS
- Single joint is involved
- Wasting of muscles above and below the involved joint is common.
- Low grade fever present
- H/o tuberculosis present
- X ray of chest may reveal tuberculosis
TRAUMATIC ARTHRITIS
- H/o trauma will be present
- Usually single joint is affected
PYOGENIC ARTHRITIS
- It is monoarticular
- The skin is red, edematous, glossy and tender with local rise of temperature
- Blood shows leucocytosis with increased polymorphs
GONORRHOEAL ARTHRITIS
- H/o exposure and urethral discharge are present
- Complement fixation test is positive
PSORIATIC ARTHRITIS
- Terminal interphalangeal joints are involved
- Nails are cracked, pitted (or) thickened.
- Psoriatic skin lesions are present
- Rheumatoid factor is negative.
HAEMOPHILIC ARTHRITIS
- H/o hemophilia is present
- Males are affected,
- Knee joint is usually affected
- Coagulation time is prolonged
REITER’S SYNDROME
- The disease is common in males,
- There is polyarthritis, non gonorrheal, urethritis and conjunctivitis,
DYSENTERIC ARTHRITIS
- Usually 3-4 weeks after an attack of acute bacillary dysentery
- Knee, elbow, wrist and finger joints are commonly affected
ARTHRITIS IN BRUCELLOSIS
- This is monoarticular, usually involving knee, hip (or) sacroiliac joints.
- Low grade pyrexia is present.
- Agglutination test is positive
HOMOEOPATHIC MANAGEMENT
(Murphy repertory)
ARTHRITIS, Inflammation
Acon kalm sep
Apis kreos saras
Bell lac.ac sulph
Bry lyco
Led merc
Sil Nat.m
Ang
Arn Nat-s
Aur phyt
Calc psor
Caust puls
Guai Rhod
Kali-c Ruta
Kali-I Rhus.tox
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