FIRST AID IS THE BEST AID – AN GENERAL & HOMEOPATHIC APPROACH

First aid is the provision of initial care for an illness or injury. It is usually performed by non-expert, but trained personnel to a sick or injured person until definitive medical treatment can be accessed. Certain self-limiting illnesses or minor injuries may not require further medical care past the first aid intervention. It generally consists of a series of simple and in some cases, potentially life-saving techniques that an individual can be trained to perform with minimal equipment. Any layperson can be trained to administer first aid, which can be carried out using minimal equipments. Basic training in first aid skills should be taught in school, in work places and, in general, be learnt by all, as it is mandatory to our modern and stressful life.

BLEEDING:

First aid

·        Apply direct pressure, using a sterile dressing or a clean cloth; apply direct pressure on the wound for at least 10 minutes. If the dressing becomes soaked with blood, do not pull the dressing from the wound; instead, place another clean dressing on top of the existing cloth.

·        Elevate the injured area if you don’t suspect a broken bone. This helps slow down the bleeding.

·        If bleeding doesn’t stop, use pressure points, maintain direct pressure over the wound and also apply pressure to a pressure point above the wound for the arm. Apply pressure to upper arm, with a leg wound; apply pressure where the groin and leg meet.

·        Seek emergency medical treatment and advice.

·        Homoeo. Medicine:- Hamamaelis, Millefolium, Crotalus Horridus, Ipecac,

BROKEN BONES:-

Symptoms / Sign’s – limb/ joint area may be deformed, difficult or painful to move, sensitive to the touch, discolored, or cold; or have acute swelling or no feeling.

First aid

·        The utmost care and gentleness must be exercised in handling a broken limb or spine it is imperative to avoid any movement of the broken fragments, or any forward bending of the spine, lest further damage accrue to muscles, Nerves, blood vessels, or the spinal cord. It is far better to do nothing until expert help arrives than to do the wrong thing, first aid implies firm gentle traction and some form of support that will prevent any movement of the jagged ends of the fragments during transport to hospital.

·        Seek emergency medical treatment and advice.

·        Homoeo. Medicine:-  Symphytum, Calc.phos , Arnica mont, Ruta, Bryonia

SEIZURES:-

Symptoms / sign’s – Rigid body, clenched fists and jaw, twitching in limbs or face, eyes rolling back in head. Excessive salivation possibly, unconsciousness.

 First aid

·        Do not restrain the person

·        Lay the person on a soft or padded surface during the convulsion to avoid self – injury.

·        If the person begins to vomit, turn his or her head to the side to prevent choking.

·        Try to prevent Tongue Biting (use mouth gag)

·        Seek emergency medical treatment and advice.

·        Homoeo. Medicine:-  Cuprum met, Plumbum. Met, Cicuta, Nuxvomica, Bufo.

CHOKING

Choking is the mechanical obstruction of the flow of air from the environment into the lungs. Choking prevents breathing, and can be partial or complete, with partial choking allowing some, although inadequate, flow of air into the lungs.

   First aid

·        Wrap you arms around the victim from behind tip the victim slightly forward.

·        Make a fist with one hand; grasp the fist with your other hand.

·        Position your fist between the victim’s navel and rib cage.

·        Thrust your fist upward quickly and forcefully. Use an inward and upward motion, as if you are trying to lift the person off the ground.

·        Repeat thrusts as necessary until object pops out and the airway is clear.

·        Seek emergency medical treatment and advice.

DROWNING

Drowning is the process of experiencing respiratory impairment from submersion/immersion in liquid.

  First aid

·        Get the person out of the water, summoning help if needed.

·        Begin resuscitation as soon as possible if the person is not breathing.

·        If the person is breathing, lay him or her down in the recovery position (stomach down, head turned to side) and keep him or her warm with blankets until medical help arrives.

·        Seek emergency medical treatment and advice

FROST BITE

Symptoms / sign’s – Skin that is somewhat numb and white may blister or peel when rewarmed (mild frostbite), skin that is cold, hard, white or grayish and numb, may turn blue or purple, or swell and blister when rewarmed (severe frost bite)  

    First aid

·        Find a warm area quickly.

·        Never rub frostbitten skin.

·        Use very warm water ( 100 to 105⁰ F) to rewarm frostbitten skin quickly; immerse in a tub or basin or apply compresses. Rewarming can be painful, if immersion is not an option, remove clothing from frostbitten areas and cover with blankets.

·        Frostbitten skin burns easily so do not rewarm too close to dry heat or a campfire, or with a heating pad. If you can’t get to a warm area, use your body to rewarm; put frostbitten hands under armpits. Rewarm toes with warm hands cover face with hands to warm nose and cheeks.

·        Drink warm liquids (coffee, tea, and broth, cocoa) don’t drink alcoholic beverages, which promote heat loss.

·        Seek emergency medical treatment and advice

·        Homoeo. Medicine:-  Agaricus, Petroleum, Pulsatilla, Silicea, Zincum.

RESCUE BREATHING

     If a person is not breathing but has a pulse;

First aid

·        Tilt the victim’s head back to open the airway

·        Check for breathing position your ear over the victim’s mouth. Listen for breathing while looking at chest for rise and fall of breathing

·        Pinch the victim’s nostrils closed and seal your mouth tightly over the victim’s mouth

·        Give two slow breaths the victim’s chest should rise and fall as you breathe into the mouth. If it does not, reposition the victim’s head and try two more slow breaths. If the chest still does not rise, follow the procedure for choking followed by two slow breaths.

Cardio-Pulmonary Resuscitation(CPR)

         If a person has no pulse and is not breathing, proceed with CPR.  

First aid

·        Get on your knees next to the victim

·        For an adult, place one hand on top of the other, with the heel of the bottom hand on the victim’s breast bone (locate the area where bottom ribs meet in the center of the chest, then move up ½ – 1 inch). For a child, place the heel of one hand on the breastbone.

·        For a child compress chest 5 times to a depth of 1 inch; for an adult compress chest 15 times to a depth of 2 inches. Don’t lift your hand(s) off chest between compressions, lock elbow(s) during compressions and keep shoulders directly over hand(s),

·        Lift and tilt victim’s head, pinch the nose and breathe in to mouth, give a child 1 slow breath; give an adult 2 slow breaths; and watch for chest to rise.

·        Repeat cycle of compressions and breaths (15 :2 for an adult, 5 : 1 for a child) for one minute, recheck pulse and breathing, if the victim is still not breathing and has no pulse, call the emergency number for help

·        Continue giving CPR until victim has a pulse or until paramedics arrive.

·        Seek emergency medical treatment and advice

HYPERTHERMIA

Symptoms / sign’s –

Heat Exhaustion: Increased thirst, weakness, mental or physical disorientation, nausea,    profuse sweating, cold or clammy skin, visual disturbances.

Heat stroke:  confusion, bizarre behavior, strong and rapid pulse, extreme fatigue, rapid heartbeat, loss of consciousness, body temperature over 104⁰ F, lack of sweating with dry, red skin.

First aid

·        As soon as you notice any symptoms of hyperthermia, rest in a cool, shaded area with feet elevated.

·        Remove excess clothing.

·        Splash skin with cool or tepid water, or apply cool towels or sheets to skin.

·        If possible, move to an air – conditioned setting.

·        Drink lots of cool water, fruit juices or sports drinks.

·        Seek emergency medical treatment and advice

·        Homoeo. Medicine: - Pyrogenum, Belladonna, Swertia chirata Q, Millefolium, Aconite, Ars.alb, Gelsemium.

HYPOTHERMIA

Symptoms / sign’s  Shivering, numbness in hands and feel, confusion, sleepiness, physical exhaustion, slurred speech, memory lapses, slow and shallow breathing, slow and weak heart beat, cool, pale skin, fingers, toes and lips may be slightly blue, cessation of shivering with diminished alertness or loss of consciousness, slow pulse and breathing ( Severe hypothermia).

First aid

·        Move to a warm, sheltered area.

·        Use blankets or skin to skin contact (ie. torso to torso) to raise body temperature or to keep warm.

·        In cases of very mild hypothermia, a warm bath can help restore body temperature.

·        Remove any wet clothes and replace with dry clothes or blankets, keep the head covered.

·        Drink hot tea, broth, or water and avoid alcohol, altogether.

·        Seek emergency medical treatment and advice

HEART ATTACK

Symptoms / sign’s Chest pain; the victim may describe it as pressure, a feeling of tightness in the chest, aching, crushing, fullness or tightness, constricting or heavy pain. The pain may be located in the center of the chest although it is not uncommon for the pain to radiate to one or both shoulders or arms or to the neck, jaw or back, in addition to pain, victims may experience sweating, Nausea, or shortness of breath.

First aid

·        Comfort and reassure the victim.

·        Have the victim stop whatever they were doing and sit or lie in a comfortable position.

·        Seek emergency medical treatment and advice

·        If the victims become unconscious, be prepared to perform CPR.

·        Homoeo. Medicine: - Latrodetus mactans, Amylnitrosum, Aconite, Cactus, Spigelia.  

STROKE:

Symptoms / sign’s Weakness and Numbness of the face, arm or leg, often an one side of the body only. Dizziness, confusion, headache, ringing in the ears. A change of mood. Difficulty in speaking, unconsciousness, pupils of uneven size. Difficulty in breathing and swallowing, loss of bowel and bladder control.

First aid

·        Have the victim stop what ever they were doing and sit or lie in a comfortable position.

·        Seek emergency medical treatment and advice

·        Homoeo. Medicine: - Opium, Nuxvomica, Arnica, Baryta carb, Belladonna, Laurocerasus.

INSECT BITES

Symptoms / sign’s of allergic Reaction: Pain, swelling of the throat, redness or discoloration at the site of the bite, itching, hives, decreased consciousness and difficult or Noisy breathing.

First aid

·        If a stinger remains in the victim, you may try to remove it carefully with a tweezers or by scraping with the edge of a credit card, be careful not to squeeze the stinger as this will inject more venom.

·        Once a stinger has been removed, the wound should be washed well with soap and water, cold compresses will help relieve pain and swelling. The stung area should be kept lower than the heart to slow circulation of the venom.

·        Seek emergency medical treatment and advice

·        Homoeo. Medicine: - Apis mell. Kali. Perm, Ledumpal, Lachesis, Amm.Carb

·        For external  - Arnica Q, Apis.mell Q, Cedron Q

INSULIN REACTION(Hypoglycemia):

This condition occurs when there is too much insulin in the body. This condition rapidly reduces the level of sugar in the blood and brain cells suffer. Insulin reaction can be caused by taking too much medication, by falling to eat, by heavy exercise, by emotional factors.

Symptoms / sign’s Fast breathing, fast pulse, dizziness, weakness, change in the level of consciousness, vision difficulties, sweating, headache, numb hands or feet, and hunger.

First aid

·        A person in insulin shock needs sugar, quickly! If the person is conscious, give sugar in any form; candy, fruit juice or a soft drink.

·        Seek emergency medical treatment and advice

·        Homoeo. Medicine: - For hypothermia - Graphites, Iodum, Kali. Carb, Lycopodium, Phosphorus, Silicea, Sulphur.

BURNS

I^st degree burns are the least severe. They are characterized by redness or discoloration, mild swelling and pain, over exposure to the sun is a common cause  of first degree burns.

2^nd degree – Burns are more serious, they are deeper than first degree burns, look red or mottled and have blisters. They may also involve loss of fluids through the damaged skin, 2^nd degree burns are usually the most painful because nerve ending are usually intact, despite severe tissue damage. 

3^rd degree – Burns are the deepest, they may look white or charred, extend through all skin layers. Victims of 3^rd degree burns may have severe pain / no pain at all, if the nerve endings are destroyed.

First aid

·        1^st degree – Flush with cool running water, apply moist dressings and bandage loosely.

·        2^nd degree – Apply dry dressings and bandage loosely do not use water as if may increase risk of shock.

·        3^rd degree – Same treatment as second degree, in all case Seek emergency medical treatment and advice

·        Homoeo. Medicine: - Cantharis, Urtica urens, Pic.acid,

o       For external Cantharis Q, Urtica urens Q

NOSE BLEEDS:

First aid

·        If you get a nose bleed, Sit down and lean slightly forward. Keeping your head above your heart will make your nose bleed less. Lean forward so the blood will drain out of your nose instead of down the back of your throat. If you lean back, you may swallow the blood. This can cause nausea, vomiting and diarrhea, use your thumb and index finger to squeeze together the sold portion of your nose. This area is located between the end of your nose and the hard, bony ridge that forms the bridge of your nose. Keep holding your nose until the bleeding stops. Don’t let go for at least 5 minutes. If it’s still bleeding, hold it again for 10 minutes straight, you can also place a cold compress or an ice pach across the bridge of your nose. Once the bleeding stops, don’t do anything that may make it start again, such as bending over or blowing your nose.

·        Seek emergency medical treatment and advice

·        Homoeo. Medicine: - Ammoniun. Carb, Arnica, Crotalus horridus, Ferr.phos, Hamamaelis, Ipecac, Millefolium. For external, Drench the cotton with Hamamaelis Q and smell it

SPRAINS:

Symptoms / sign’s Pain, tenderness, swelling, bruising and an inability, to move the injured part.

First aid

·        Using ice packs, ice slush baths or ice massages can decrease the swelling, pain bruising and muscle spasms.

·        Wrapping the ankle may be the best way to avoid swelling and bruising.

·        Seek emergency medical treatment and advice

·        Homoeo. Medicine: - Arnica, Bryonia, Rhustox, Ledumpal, Carbo. Ani,

For External Arnica Q, Ruta Q, Bellis per Q.

COMMON FIRST AID HOMEOPATHIC REMEDIES

Arnica – This is the No. 1 remedy for all cases of injury as it also deals with shock. It removes the blood back into the vessels as well. Give Arnica first in every First Aid situation.

Aconite – Fright is the keynote of this homeopathic remedy when there is great anxiety and sudden emotions. It is for any complaint that comes on suddenly after exposure to cold dry windy conditions.

Apis – This is for bee stings and insect bites where there is a lot of swelling, heat, redness and stinging pains. It is > cold applications and < heat. It is also an emergency measure for anaphylactic shock to give on the way to the hospital

Argentum Nitricum – Fear and anxiety before an event, flying and ordeals of every kind. There is distension of the stomach, burping, palpitations, diarrhoea especially after sweet things.

Arsenicum Album – for food poisoning with diarrhoea and vomiting. Feel cold and fearful – frightened to be left alone. < 11.00pm – 1.00am. Complaints after exposure to wet and damp.

Belladonna – Fever with great heat which follows Aconite well. Red, hot, skin, dilated pupils, throbbing pains. < light, noise and jarring. Throbbing headaches and mild sunstroke. > bending backwards, sitting or standing erect. Sudden and violent onset of conditions.

Bellis Perenis – Specific for bruising of soft tissue like the breast and internal organs. Ailments after a blow. Good for internal bruising after a hysterectomy. It is also called the Gardeners friend as it works well for aches after gardening.

Bryonia – A dry remedy. Dry fever, dry cough < for any movement, company or talking. Dry lips, thirst, irritable. Bursting headache < any movement. Must stay still. Red swollen, shiny joints, frozen shoulder, tennis elbow, sciatica A stitching pain > pressure. Appendix symptoms which develop slowly – specific. < heat > cold.

Calendula – the healing remedy. Use the tincture as an antiseptic. For all infections and inflammations where flesh is torn. It prevents pus formation. Beware that there is no infection inside the wound or the skin will close up and keep it in! This homeopathic remedy can be bought as a cream and useful for children’s cuts and scrapes.

Cantharis – bad burns and scalds with blistering. Stops the pain.

Carbo Veg – Air hunger, wants to be fanned but is chilly. Bluish colour. After near drowning or electric shock and patient is cold, blue and lifeless. Indigestion with a lot ofwind.

Causticum – Also for burns. Take a 30C potency and the pain goes in about 7 mins.

Chamomilla – great sensitivity to pain. Teething in babies. Very irritable.

China – Any illness when a patient is weak after the loss of vital fluids e.g. vomiting, haemorrhage, sweating, diarrhoea. Distension of abdomen, flatulence, burping and discomfort. Oversensitivity.

Cocculus – For sea sickness and travel sickness. Nausea, dizziness < motion > sitting still or lying on side

Colocynthus – for colic in babies which is > doubling up > hard pressure. Also menstrual colic.

Eupatorium Perforlatum – Flu, fever with great thirst, aching, bone pain, bruised and aching muscles in back, chest and limbs. Scanty sweat. Restless, chilly, nausea. Weakness. < cold air < 7 -9am < motion. Sick headache, nausea at the sight of food. > vomiting.

Gelsemium – Also for flu but no thirst. Comes on over a couple of days. Nerves affected. Heaviness in limbs. Face a dusky red colour with heavy droopy eyelids. Muscles won’t do as they are told.

Hepar Sulphuris – Eruptions, boils, whitlows by nails, Ailments that are made worse by a draft of air. Abscesses, sensitive to touch. Sore throats, earache that has yellow thick discharge. Pain that is splinter like.

Hypericum – is the homeopathic remedy for injuries that are rich in nerves, like fingers, toes. Specific for injury to the coccyx. Use the tincture or cream for very painful cuts, grazes and burns. Also use tincture as an antiseptic as it prevents tetanus.

Ignatia – Emotional and mental stress with grief, worry and disappointment. Characteristic signing. Moody. Illness after a loss or shock. < tobacco smoke. Anger and then suppressed tears or emotions after a loss. Globus hysterica ( lump in throat)

Ipecac – Colic with nausea. Giddiness, vomiting. Profuse saliva. Any complaint where there is strong nausea. No thirst.

Ledum – Puncture wounds, which are cold to touch, wounds from rusty nails, bites, needles, wasp stings. It prevents post injury infections. (Aches and pains that are > ice)

Magnesium Phosphate – Bad cramping pains which are > heat > pressure and doubling up. Especially period pains.

Mercurius – pus, bad breath, offensive profuse sweat. Excessive saliva. Thick yellow discharges. < warmth and < cold. Sore throats, ear pains. throat infection after the pus has formed.

Nux Vom – Hangovers. Illness after too much rich food > fresh air < indoors. Chilly and irritable. Fever when every movement causes shivering even when wrapped up. Piles.

Phosphorus – After effects of anaesthetics particularly after injections for dental treatment. Jet lag. Dry irritating cough. Loss of voice. Craves ice cream and ice cold drinks. > for sleep.

Pulsatilla – Earache. Weepiness, clinging dependant, whining. Craves attention. Crave fresh air, like the windows open. > walking in fresh air. Very changeable. No thirst. Cough > vinegar

Rhus Tox – Aches and pains which are < first movement > on continued movement. < damp < rest < cold > warmth. Restless. Often stops the irritation inchicken pox.

Ruta Grav – Strains, tendons, ligaments and cartilage. Bone injuries, dislocations and eyestrain. < with motion < lying on painful side. < cold > warmth

Sulphur – > open air. Boils, inflammations, a hot person, burning pains, offensive discharges.

Silicea – splinters, promotes rejection of thorns, glass etc. Boils, abscesses. MUST NOT BE USED if patient has anything artificial in body like new hip joint, pacemaker as it may cause rejection.

Rescue Remedy (It is a Bach Flower Remedy and not Homeopathy Remedy) – Loss, shock, fright, upset.

FREQUENT NASAL TROUBLES?? THINK OF DEVIATED NASAL SEPTUM – GENERAL AND HOMOEOPATHIC APPROACH

Nasal septum deviation or deviated nasal septum (DNS) is a common physical disorder of the nose, involving a displacement of the nasal septum. The nasal septum is the wall that separates the left and right nostrils. A centered septum allows air to flow equally through each nostril. In a deviated nasal septum the wall is not centered. A deviated septum is a condition in which the nasal septum is significantly off center, or crooked, making breathing difficult. Most people have some sort of imbalance in the size of their breathing passages. In fact, estimates indicate that 80% of people, most unknowingly, have some sort of misalignment to their nasal septum. Only the more severe imbalances cause significant breathing problems.

Aetiology and Risk factors:

A deviated septum occurs when your nasal septum — the thin wall that separates your right and left nasal passages — is displaced to one side.

A deviated septum can be caused by:

·        A condition present at birth. In some cases, a deviated septum occurs during fetal development and is apparent at birth.

·        Injury to the nose. A deviated septum can also be the result of an injury that causes the nasal septum to be moved out of position. In infants, such an injury may occur during childbirth. In children and adults, a wide array of accidents may lead to a nose injury and deviated septum — from tripping on a step to colliding with another person on the sidewalk. Trauma to the nose most commonly occurs during contact sports, active play or roughhousing, or automobile accidents.

The normal aging process may affect nasal structures, worsening a deviated septum over time. Also, changes in the amount of swelling of nasal tissues, because of developing rhinitis or rhinosinusitis, can accentuate the narrowing of a nasal passage from a deviated septum, resulting in nasal obstruction.

For some people, a deviated septum is present at birth — occurring during fetal development or due to injury during childbirth. After birth, a deviated septum is most commonly caused by an injury that moves your nasal septum out of place. Risk factors include:

·              Playing contact sports

·              Not wearing your seat belt while riding in a motorized vehicle

Clinical Features:

·        The most common symptom of a deviated septum is nasal congestion, with one side of the nose being more congested than the other. Due to this affected person may suffer from difficulty in  breathing.

·        Obstruction of one or both nostrils. This obstruction can make it difficult to breathe through the nostril or nostrils. This may be more noticeable when you have a cold (upper respiratory tract infection) or allergies that can cause your nasal passages to swell and narrow.

·        Recurrent  sinus infections is one of the effect  of a deviated septum. Affected person may get  frequent nosebleeds, pain in the sinus areas due to Sinusitis, headaches ,postnasal drip,  snoring during sleep.

·        Headache  -  Sinusital headache secondary to obstruction to drainage of sinuses. Neurological headache when septum touches a sensitive part on the lateral wall of the nose.

·        Nose bleeding - Little area the deviated side of the septum is exposed to atmospheric directly predisposing to drying and crusting of mucosa and tendency to pick the nose.

·        A deviated septum may also cause sleep apnea, a condition in which a person stops breathing during sleep.

·        Again due to which a person doesn’t get enough deep sleep due to which  suffers from symptoms like fatigue, improper digestion, hyperacidity etc. 

·        Deformity of external nose.

·        Secondary hypertrophy of turbinate.

·        Frequent or recurring sinus infections

·        Recurrent rhinitis i.e. nose.

Complications:

·        Recurrent sinusitis due to obstruction to drainage of sinus.

·        Middle ear infection due to forcible blockening of nose or recurrent upper respiratory infection.

·        Mouth breathing causing infection of pharynx, larynx, trachebronchial tree.

·        Asthma: DNS acts as trigger for bronchospasm.

·        Atrophic rhinitis on the root side of nose.

Prevention

You may be able to prevent the injuries to your nose that can cause deviated septum with these precautions:

·  Wear a helmet when playing contact sports, such as football and hockey.

·  Wear a seat belt when riding in a motorized vehicle

Homoeopathic Management

Homoeopathy has a great & valuable role in treating the effects of Deviated Nasal Septum by enhancing or improving one’s Immune Power. So in spite of having the Deviated septum a person will be symptom free. Treatment should be directed towards symptomatic history like blockening of nose, recurrent upper respiratory tract infection, sinusitis, epistaxis, headache, middle ear infection, spurs, thickening.

Allium cepa - Sneezing, especially when entering a warm room. Copious, watery and extremely acrid discharge. Feeling of a lump at root of nose. Hay-fever. [Sabad.; Sil.; Psor.]. Fluent coryza with headache, cough, and hoarseness. Polypus. Catarrhal headache, mostly in forehead; worse in warm room towards evening. < evening, warm room. > open air, cold room.

Arsenic Album - Coryza with thin, watery, excoriating discharge. Nose feels stopped up. Sneezing withoutrelief. Hay-fever and coryza; worse in open air; better indoors. Burning and bleeding from nose. Headaches relieves by cold, other symptoms worse.< wet weather, after midnight; from cold, cold drinks, or food. Seashore. Right side. > from heat; from head elevated; warm drinks.

Arum Triphyllum - Acridity is the keynote of the kind of action characteristic of Arum. Soreness of nostrils. Acrid, excoriating discharge,producing raw sores. Nose obstructed; must breathe through mouth. Boring in the nose. Coryza; discharge blood-streaked, watery. Nose completely stopped, with fluent, acrid discharge. Hay-fever, with pain over root of nose. Large scabs high up on right side of nose. Face feels chapped, as if from cold wind; feels hot. Constant picking at nose until it bleeds. Headache from too warm clothing, from hot coffee. < northwest wind, lying down.

Arundo - A remedy for catarrhal states & Hay-fever. Hay-fever begins with burning and itching of palate and conjunctiva. Annoying itching in the nostrils and roof of the mouth. Coryza; loss of smell. Sneezing, itching of nostrils.

Aurum Mettalicum - Indicated for Ulcerated, painful, swollen, obstructed nose. Inflammation of nose; caries; fetid discharge, purulent, bloody. Boring pains in nose; worse at night. Putrid smell from nose. Sensitive smell. Horrible odor from nose and mouth. Knobby tip of nose. < in cold weather when getting cold. Many complaints come on only in winter; from sunset to sunrise

 

Euphrasia: Patient is better in open air. Catarrhal affections of mucous membranes especially of eyes and nose. Profuse acrid lachrymation and bland coryza; worse, evening. Hawking up of offensive mucus. < in evening, indoors, warmth; south winds; from light.

 

Ferrum Phos - Useful medicine for first stage of colds in the head. Predisposition to colds. Epistaxis; bright red blood. The typical Ferr.phos subject is nervous, sensitive, anemic with the false plethora and easy flushing of Ferrum. Indicted in pale, anaemic subjects, with violent local congestions. Haemorrhages are bright from any orifice. < at night and 4 to 6 p.m.; touch, jar, motion, right side. > by cold applications.

Kali Iod - The profuse, watery, acrid coryza that the drug produces serves as a sure guiding symptom, especially when associated with pain in frontal sinus. Violent headache in which pain intense over eyes and root of nose. Nose is red, swollen. Tip of nose red; profuse, acrid, hot, watery, thin discharge. Ozaena, with perforated septum. Sneezing. Nasal catarrh, involving frontal sinus. Stuffiness and dryness of nose, without discharge. Profuse, cool, greenish, unirritating discharges. < warm clothing, warm room, at night, damp weather. > motion, open air.

Merc Sol - Useful for Cold & Coryza in which there is much sneezing, in sunshine. Coryza; acrid discharge, but too thick to run down the lip; worse, warm room. Nostrils raw, ulcerated; nasal bones swollen. Yellow-green, fetid, pus like discharge. Pain and swelling of nasal bones, and caries, with greenish fetid ulceration. Nosebleed < at night. Copious discharge of corroding mucus. < at night, wet, damp weather, lying on right side, perspiring; warm room and warm bed.

Natrum Mur - Useful for violent, fluent coryza, lasting from one to three days, then changing into stoppage of nose, making breathing difficult. Discharge thin and watery, like raw white of egg. Violent sneezing coryza. Infallible for stopping a cold commencing with sneezing. Loss of smell and taste. Internal soreness of nose. Dryness. Frontal sinus inflammation. < noise, music, warm room, lying down about 10 a. m;, at seashore, mental exertion, consolation, heat, talking. > by open air, cold bathing, going without regular meals, lying on right side; pressure against back, tight clothing.

 

Nux Vomica - Indicated for stuffing up of nose < at night especially. Also useful for Stuffy colds, snuffles, after exposure to dry, cold atmosphere; worse, in warm room. Coryza is fluent in daytime; stuffed up at night and outdoors; or alternates between nostrils. Bleeding in morning. Acrid discharge, but with stuffed up feeling. Frontal headache, with desire to press the head against something.< morning, mental exertion, after eating, touch, spices, stimulants, narcotics, dry weather, cold.> from a nap, if allowed to finish it; in evening, while at rest, in damp, wet weather, strong pressure.

 

Silicea - There is Itching at point of nose. Dry, hard crusts form, bleeding when loosened. Nasal bones sensitive. Sneezing in morning. Obstructed and loss of smell. Perforation of septum. Headache in which pain begins at occiput, and spreads over head and settles over eyes. Silica patient is cold, chilly, hugs the fire, wants plenty warm clothing, hates drafts, hands and feet cold, worse in winter. Great sensitiveness to taking cold.< new moon, in morning, from washing, during menses, uncovering, lying down, damp, lying on, left side, cold.> warmth, wrapping up head, summer; in wet or humid weather.

 

Syphilinum - Indicated for Caries of nasal bones, hard palate and septum, with perforation; ozaena.< at night, sundown to sunrise, seashore, in summer.> inland and mountains, during day, moving about slowly.

BPH ( Benign prostatic hyperplasia) – NON SURGICAL MANAGEMENT

Benign prostatic hyperplasia (BPH), also called benign enlargement of the prostate (BEP), adenofibromyomatous hyperplasia and benign prostatic hypertrophy, prostate gland enlargement can cause bothersome urinary symptoms. Prostate problems are common in men 50 and older. Benign prostatic hyperplasia is nonmalignant (noncancerous) enlargement of the prostate gland. Untreated prostate gland enlargement can block the flow of urine out of the bladder and can cause bladder, urinary tract or kidney problems.

The prostate is a small organ about the size of a walnut. It lies below the bladder (where urine is stored) and surrounds the urethra (the tube that carries urine from the bladder). The prostate makes a fluid that helps to nourish sperm as part of the semen (ejaculatory fluid).

Causes and Risk Factors of BPH

·      Aging - Prostate gland enlargement rarely causes signs and symptoms in men younger than 40. By 55, about 1 in 4 men have some signs and symptoms. By 75, about half of men report some symptoms.

·      Family history. Having a blood relative such as a father or brother with prostate problems means more likely to have problems as well

·      Excessive DHT: DHT (dihydrotestosterone), a substance that is the result of a conversion of testosterone by an enzyme called 5-alpha reductase. BPH is an “androgen-dependent disease,” which means it is influenced by the male hormone (androgen) testosterone. The prostate will not grow unless it is “directed” to do so by testosterone, which is made mainly by the testes

·      Elevated estradiol: It’s natural for men to have some of the female hormone estrogen (in the form of estradiol). When estradiol levels are too high, however, and the ratio is out of balance, men can experience fatigue, increased body fat, loss of libido and an enlarged prostate. An imbalance between estrogen and testosterone increases DHT activity, and thus encourages prostate cells to grow.

·      Overweight/Obesity: Being overweight, especially around the midsection, raises the risk of excessive prostate growth. The link between obesity and BPH may be related to the reduced testosterone levels seen in the obese. Also, a drop in testosterone means there’s an accompanying rise in estrogen levels, which can increase the activity of DHT and thus prostate growth.

·      Diabetes mellitus : Having diabetes increases the risk of developing BPH, perhaps significantly. The diabetes-BPH link may also be related to the damage that diabetes does to blood vessels. If the vessels that service the prostate are damaged, an enlarged prostate may be the result. 

·      High “Bad” Cholesterol : Those who had higher levels of the notorious “bad” cholesterol, low-density lipoprotein (LDL), were more likely to develop BPH than men who had normal LDL levels. (Parsons 2008) When the researchers divided the men into three groups (high, medium, low), those with “high” LDL levels were four times more likely to have BPH than those in the “low” group.

·      High blood pressure: Although no one is exactly sure how high blood pressure may trigger or worsen BPH, researchers have found a link between hypertension and BPH. 

·      Sedentary lifestyle: A lack of exercise may increase your chances of developing BPH, possibly because exercise helps fight obesity, type 2 diabetes, insulin resistance, and other risk factors associated with BPH.

Clinical Features:

Symptoms are classified as storage or voiding

·      Storage symptoms include urinary frequency, urgency, urgency incontinence, and voiding at night (nocturia).

·       Voiding symptoms include urinary stream hesitancy (needing to wait for the stream to begin), intermittency (when the stream starts and stops intermittently), straining to void, and dribbling. Pain and dysuria are usually not present. 

·      Urinary frequency - The need to urinate frequently during the day or night (nocturia), usually voiding only small amounts of urine with each episode

·      Urinary urgency - The sudden, urgent need to urinate, owing to the sensation of imminent loss of urine without control

·      Hesitancy - Difficulty initiating the urinary stream; interrupted, weak stream

·      Incomplete bladder emptying - The feeling of persistent residual urine, regardless of the frequency of urination

·      Straining - The need strain or push (Valsalva maneuver) to initiate and maintain urination in order to more fully evacuate the bladder

·      Decreased force of stream - The subjective loss of force of the urinary stream over time

·      Dribbling - The loss of small amounts of urine due to a poor urinary stream

·      Physical examination over the suprapubic area for signs of bladder distention and a neurological examination for sensory and motor deficits.

·      The digital rectal examination (DRE) is an integral part of the evaluation in men with presumed BPH. During this portion of the examination, prostate size and contour can be assessed, nodules can be evaluated, and areas suggestive of malignancy can be detected. Findings suggestive of Benign Prostatic Hyperplasia are Symmetric prostatic enlargement, Smooth and Firm but elastic 

Lab Tests Used to Diagnose BPH

Several tests help the physician identify the problem and decide treatment to be needed. The tests vary from patient to patient, but the following are the most commonly used tests to diagnose BPH and other problems in the urinary tract:

·        Digital rectal exam

·        Prostate specific antigen test (PSA test):- PSA stands for Prostate Specific Antigen and is a protein enzyme made in your prostate gland

·        Rectal ultrasound 

·        Urine flow study

·        Cystoscopy.

Risk Analysis and PSA Range - Normal: 0-4 ng/ml, Slightly Elevated: 4-10 ng/ml, Moderately Elevated: 10-20 ng/ml, Highly Elevated: 20+ ng/ml.

Complications

Complications related to bladder outlet obstruction secondary to BPH include the following: Urinary retention, Renal insufficiency, Recurrent urinary tract infections, Gross hematuria, Bladder calculi, Renal failure or uremia (rare).

Management:

Lifestyle changes and Natural remedies

Making some lifestyle changes can often help control the symptoms of an enlarged prostate and prevent your condition from worsening. Try these measures:

·        Limit beverages in the evening. Don't drink anything for an hour or two before bedtime to help you avoid wake-up trips to the bathroom at night.

·        Don't drink too much caffeine or alcohol. These can increase urine production, irritate your bladder and worsen your symptoms.

·        Limit decongestants or antihistamines. These drugs tighten the band of muscles around your urethra that control urine flow, which makes it harder to urinate.

·        Go when you feel the urge. Try to urinate when you first feel the urge. Waiting too long to urinate may overstretch the bladder muscle and cause damage.

·        Schedule bathroom visits. Try to urinate at regular times to "retrain" the bladder. This can be done every four to six hours during the day and can be especially useful if you have severe frequency and urgency.

·        Stay active. Inactivity causes you to retain urine. Even a small amount of exercise can help reduce urinary problems caused by an enlarged prostate.

·        Urinate — and then urinate again a few moments later. This is known as double voiding.

·        Keep warm. Colder temperatures can cause urine retention and increase your urgency to urinate.

·        Increase intake of fruits, vegetables and whole grains, soy, and green tea, foods rich in omega 3 oils (cold-water fish – salmon, sardines, mackerel) and in zinc (raw pumpkin seeds for omega-3 and zinc)

·        reduce foods high in fat and cholesterol (butter and margarine, beef and
whole milk), sweet foods, and refined carbohydrates (white bread and white-flour pasta)

Some of the herbal treatments that have been suggested as helpful for reducing enlarged prostate symptoms include:

·        Saw palmetto extract, made from the ripe berries of the saw palmetto shrub

·        Beta-sitosterol extracts, made from several plants, such as certain grasses and trees

·        Pygeum, an oil made from the bark of an African prune tree

·        Ryegrass extract, made from ryegrass pollen

·        Stinging nettle extract, made from the root of the stinging nettle plant

Homoeopathic Management

Homoeopathy considers the person as a whole, and takes account of the physical and psychological characteristics of the patient. It involves a detailed case history, which serves as ray of hope to both the patient- i.e., the one who is abused, as well as the offender. The patient has an opportunity to be heard and understood from her own perspective .After careful case taking and analyzing the case, the homeopathic physician decides on the remedy which suits the patient’s needs. The remedy is chosen depending upon the patient’s characteristic traits and symptoms. This list of remedies is meant for use with the guidance of a qualified homoeopath.

An clinical trail has been conducted in 220 men’s (aged 30-90 years) suffering from BPH in odisha india. This study compared homeopathic treatment strategies using constitutional medicines (CM) or organopathic medicines(OM) alone or in combination(BCOM) in patients suffering from BPH. The study result shows treatment response was highest with BCOM (38.24%) compared to OM (31.62%) and CM (30.15%).

Apis mellifica: Stinging pain during urination that is worse when the final drops are passing is a strong indication for this remedy. Discomfort may also involve the bladder. The prostate area is swollen and very sensitive to touch. The person may feel worse from heat and from being in warm rooms, with improvement from being out in open air or from cool bathing.

Causticum: Urine loss when the person coughs or sneezes often indicates a need for this remedy. Once urine has started passing, the person may feel pressure or pulsation extending from the prostate to the bladder. Causticum is also indicated when sexual pleasure during orgasm is absent or diminished.

Chimaphilla umbellata: This remedy is often helpful when the prostate is enlarged, with urine retention and frequent urging. The person may have the feeling that a ball is lodged in the pelvic floor, or experience pressure, swelling, and soreness that are worse when sitting down.

Clematis: This remedy is often indicated when swelling of the prostate seems to have narrowed or tightened the urinary passage. Urine usually emerges slowly, in drops instead of a stream, with dribbling afterward.

Conium :

This remedy is useful in chronic hypertrophy of the prostate with difficulty in voiding urine, it stops and starts and there is an accompanying catarrh of the bladder. The suitability of conium to the complaints of the aged should be considered. Depressed, timid  with weak memory.

Lycopodium: This remedy may be helpful if urine is slow to emerge, with pressure felt in the prostate both during and after urination. The prostate is enlarged, and impotence may also be a problem. People who need this remedy often suffer from digestive problems with gas and bloating, and have an energy slump in the late afternoon.

Pulsatilla: Prostate problems with discomfort after urination and pains that extend to the pelvis or into the bladder (often worse when the man is lying on his back) suggest a need for this remedy. There may also be a bland, thick, yellow discharge from the penis. Pulsatilla is usually suited to emotional individuals who want a lot of affection and feel best in open air.

Sabal serrulata: A frequent urge to urinate at night, with difficulty passing urine, and a feeling of coldness in the sexual organs, suggest a need for this remedy. It is sometimes also used in lower potencies for urinary incontinence in older men. This remedy is made from saw palmetto which is also used as an herbal extract for similar prostate problems.

Staphysagria: This remedy may be indicated if a man feels burning pain in his urinary passage even when urine is not flowing, and urine retention is troublesome. Men who are likely to respond to Staphysagria are often sentimental and romantic, and may also have problems with impotence (most often caused by shyness).

Thuja: When the prostate is enlarged, and the person has a frequent urge to urinate, with cutting or burning pain felt near the bladder neck, this remedy may bring relief. After urine passes, a dribbling sensation may be felt. A forked or divided urine stream is sometimes seen when this remedy is needed.