A Case of Allergic Bronchitis

                                       

                                      A Case of Allergic Bronchitis

© 2013 Dr Vandana Patni 

Presented By

Dr Vandana Patni

A 14 year old girl presented with recurrent attacks of bronchitis with allergic rhinitis. Nose obstructed especially at night. Dry cough at night which wakes her. Attacks of difficult respiration which are further aggravated by walking and ameliorated by bending head forward. Wheezing during expiration. Asthmatic attacks precipitated by cold drinks and strong odors. Feels better by sitting. Have multiple freckles on the face.

All these complaints are occurring once or twice a month from childhood. Taking anti-allergic tablets and inhalers continuously but whenever she has an asthmatic attack, she has to take some antispasmodic drugs for bronchial spasm and sometimes rush for nebulization.

May 16, 2013

13 rubrics are chosen and repertorized in Radar.

Rubrics selected

NOSE - OBSTRUCTION

NOSE - OBSTRUCTION - night

NOSE - SMELL - acute

FACE - FRECKLES

RESPIRATION - DIFFICULT

RESPIRATION - DIFFICULT - bending - head - forward - amel.

RESPIRATION - DIFFICULT - walking

RESPIRATION - WHEEZING - expiration, during

COUGH - DRY

COUGH - NIGHT

COUGH - NIGHT - waking from the cough

GENERALS - FOOD and DRINKS - cold drink, cold water - agg.

GENERALS - SITTING - amel.

Medicines chart

Sep 13/31, Calc 11/25, Puls 11/24, Kali Carb 11/23, Sil 11/22.

Prescription:-

Sepia 200   3 Doses prescribed to take half hourly. Sac lac twice a day for a week.

May 23, 2013

Chest clear. Asthmatic respiration relieved. No cough. No obstruction of nose.

Prescription:-

Sac Lac for fifteen days.

June 8, 2013

No symptom and sign is detected. No complaint.

Prescription:-

Sac Lac for fifteen days.

June 29, 2013

Mild difficulty of respiration and nasal obstruction reported after exposure to dust. But symptoms are very mild as comparison to earlier attacks.

Prescription:-

Sepia 200  3 doses prescribed again with Sac Lac for fifteen days.

July 20, 2013

All the complaints were relieved on same day on june 29. No further nasal or respiratory symptoms.

Prescription:-

Sac Lac prescribed and advised to consult after a month.

August 20, 2013

No complaint.

Prescription:-

Sac Lac for fifteen days.

September 6, 2013

No complaint.

Since May 16, 2013 only one mild attack occurred on June 29. Earlier, attacks was occurring once or twice a month.

Prescription:-

Medicines discontinued and advised to contact on any discomfort.  

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Online Consultation Available

Dr Vandana Patni

Dr R S Mann

Consultant Homeopathic Physician

Contact: 9897271337

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A Case of Asthmatic Respiration

Copyright © 2010 Dr R S Mann

A Case of Asthmatic Respiration

Presented By
Dr R. S. Mann

A Male 40 yrs of age, suffering from asthmatic respiration since many years. Asthmatic attacks periodically; as every month but no specific season of occurrence. Aggravation, Evening, when head becomes cold, and  by dust. Patient told that he must lie down with head high otherwise he is unable to breath. Patient has emphasized that he can only sleep with very thick pillow.  In rainy weather asthmatic problems somewhat increases.

Walking aggravates. Patient lives on hilly area so he feels very discomfort in his daily routine, cause everyday he has to walk kilometers to fulfill his various needs.

Earlier patient has received Sulph, Phos, Ars Alb for his complaints without much relief.

His characteristic clinical feature is – “difficult respiration ameliorated by lying on head high.”

May 19, 2010

 Eupatorium Perf 30   TDS for a week.

Jun 4, 2010

One attack of dyspnoea on May 25, 2010 for 6 – 7 hours. 

Sac. Lac. for two weeks.

June 22, 2010

Mild discomfort, like heaviness in chest.

No attack of dyspnoea.

Eupatorium Perf 30 TDS for a week with Sac. Lac. for three weeks.

July 24, 2010

No attack of dyspnoea, not any discomfort. Quite well.

Sac. Lac. For a month.

August 23, 2010

Not any discomfort or difficulty in respiration.

Sac. Lac. For two weeks.

September 9, 2010

Completely well.

Sac. Lac. For a month.

October 16, 2010

No signs and symptoms of any kind of asthmatic respiration.

Sac. Lac. For two weeks and advised to discontinue medicine. And was directed to contact if anytime he get his asthma back in between, or asked to report after 6 months.

April 4, 2011

Reported he is well.

Bronchitis

Bronchitis

Bronchitis generally refers to an acute inflammation of the air passages within your lungs. It occurs when your trachea (windpipe) and the large and small bronchi (airways) in your lungs become inflamed because of infection or other causes.

• The thin mucous lining of these airways can become irritated and swollen.
• The cells that make up this lining may leak fluids in response to the inflammation.
• Coughing is a reflex that works to clear secretions from your lungs. Often the discomfort of a severe cough leads you to seek medical treatment.
• Both adults and children can get bronchitis. Symptoms are similar for both.
• Infants usually get bronchiolitis, which involves the smaller airways and causes symptoms similar to asthma.
  

Bronchitis Causes

Bronchitis occurs most often during the cold and flu season, usually coupled with an upper respiratory infection.

• Several viruses cause bronchitis, including influenza A and B, which we commonly call "the flu."
• A number of bacteria are known to cause bronchitis, such as Mycoplasma pneumoniae, which causes so–called walking pneumonia.
  
• Bronchitis also can occur when you inhale irritating fumes or dusts. Chemical solvents and smoke, including tobacco smoke, have been linked to acute bronchitis.
• People at increased risk both of getting bronchitis and of having more severe symptoms include the elderly, those with weakened immune systems, smokers, and anyone with repeated exposure to lung irritants.
  

Bronchitis Symptoms

Acute bronchitis most commonly occurs after an upper respiratory infection such as the common cold or a sinus infection. Therefore, you may see symptoms such as fever with chills, muscle aches, nasal congestion, and sore throat.

• Cough is a common symptom of bronchitis. The cough may be dry or may produce phlegm. Significant phlegm production suggests that your lower respiratory tract and the lung itself may be infected and you may have pneumonia.
• The cough may last for more than two weeks. Continued forceful coughing may make your chest and abdominal muscles sore. Cough can be severe enough at times to injure the chest wall or even cause you to pass out.
  
• Wheezing may occur because of the inflammation of your airways. This may leave you short of breath.

When to consult your physician

Although most cases of bronchitis clear up on their own, some people may have complications that their doctor can ease.

• Severe coughing that interferes with rest can be reduced with prescription cough medications.
• Wheezing may respond to an inhaler (which has brochodilatordrugs) which dilates your airways.
• If fever continues beyond four to five days, see your doctor for a physical examination to rule out pneumonia.
  
• See a doctor if you have coughing up blood, rust–colored sputum, or an increased amount of green phlegm.
• If you experience difficulty breathing with or without wheezing ,go to a hospital's emergency department for evaluation and treatment.
  

Exams and Tests

Doctors diagnose bronchitis generally on the basis of your symptoms and a physical examination.

• Usually you will need no blood tests.
• If the doctor suspects you have pneumonia, you may have a chest x–ray.
  
• It may need to measure oxygen saturation (how well oxygen is reaching blood cells) using a sensor placed on a finger.
• Sometimes it needs to examine of phlegm cough up to look for bacteria.
  

Bronchitis Treatment

Self–Care at Home

• By far the majority of bronchitis cases stem from viral infections. This means that most cases of bronchitis are short–term and require nothing more than treatment of symptoms to relieve discomfort.
• Antibiotics will not cure a viral illness.

A.Experts in infectious diseases have been warning for years that overuse of antibiotics is allowing many bacteria to become resistant to the antibiotics available.
B.Doctors often prescribe antibiotics because they feel pressured by people's expectations to receive them. This expectation has been fueled by both misinformation in the media and marketing by drug companies. Don't expect to receive a prescription for an antibiotic if your infection is caused by a virus.

• Acetaminophen ,aspirin or ibuprofen will help with fever and muscle aches.
• Drinking fluids is very important because fever causes the body to lose fluid faster. Lung secretions will be thinner and thus easier to clear when you are well hydrated.
• A cool mist vaporizer or humidifier can help decrease bronchial irritation.
• An over–the–counter cough suppressant may be helpful to ease symptoms.
  

Medical Treatment

Treatment of bronchitis can differ depending on the suspected cause.

A. Medications to help suppress the cough or loosen and clear secretions may be helpful. If you have severe coughing spells that you cannot control, you need prescription for cough suppressants. In some cases only the stronger cough suppressants can stop a vicious cycle of coughing leading to more irritation of the bronchial tubes, which in turn causes more coughing.
B. Bronchodilator inhalers will help open airways and decrease wheezing.
C.Though antibiotics play a limited role in treating bronchitis, they become necessary in some situations if suspicion of a bacterial infection or in people with chronic lung problems.

Homeopathic Treatment

Homeopathy has very effective treatment of Bronchitis. There are more then 150 medicines for Bronchitis. In cases of children and Acute cases of Bronchitis homeopathy cure immediately. Old cases take a long time to cure. Homeopathic medicines are prescribed on basis of Individuality of a patients,his symptom complex, triggering factors, personality traits, modalities of weather and temperature changes, family history,person's mental make up and reaction pattern.

Prevention

A. Stop smoking.
B. Avoid exposure to irritants.Exposure at workplace must be prevented.
C. The dangers of passive smoke are well known. Children should be prevented from passive smoke.
D.Avoiding long exposure to air pollution from heavy traffic may help prevent bronchitis.

Sinusitis

Sinusitis: Sinus Infections

© Dr Vandana Patni 2008

Sinus infection, or sinusitis, is an inflammation of the sinuses and nasal passages. A sinus infection can cause a headache or pressure in the eyes, nose, cheek area, or on one side of the head. A person with a sinus infection may also have a cough, a fever, bad breath, and nasal congestion with thick nasal secretions. Sinusitis is categorized as acute (sudden onset) or chronic (long term, the most common type).
Structure of the sinuses (also called para-nasal sinuses): The human skull contains four major pairs of hollow air–filled–cavities called sinuses. These are connected to the space between the nostrils and the nasal passage. Sinuses help insulate the skull, reduce its weight, and allow the voice to resonate within it. The four major pairs of sinuses are the:

1. Frontal sinuses (in the forehead,under eyebrow)

2. Maxillary sinuses (behind the cheek bones)

3. Ethmoid sinuses (between the eyes)

4. Sphenoid sinuses (behind the eyes)

The sinuses provide defenses against bacteria (germs). If a disruption occurs that affects the normal host defenses inside the sinuses, those defenses may allow bacteria, which are normally present in the nasal passages, to enter any of the sinuses. Once the bacteria get entry ,they stick to the lining cells and cause a sinus infection.

Acute sinusitis usually lasts less than eight weeks or occurs no more than three times per year with each episode lasting no longer than 10 days. Successful treatment counteracts damage done to the mucous lining of the sinuses and surrounding bone of the skull.

Chronic sinusitis lasts longer than eight weeks or occurs more than four times per year with symptoms usually lasting more than twenty days.

The sinuses are covered with a mucus layer and cells that contain little hairs on their surfaces called cilia. These help trap and propel bacteria and pollutants outward. Para-nasal sinuses are connected to nasal cavities.

Causes of Sinus Infection

Acute sinusitis usually follows a viral infection in the upper respiratory tract, but allergens (allergy–causing substances) and pollutants may also trigger acute sinusitis. A viral infection causes damage to the cells of the sinus lining, which leads to inflammation. The lining thickens with fluid that obstructs the nasal passage. This passage connects to the sinuses. The obstruction disrupts the process that removes bacteria normally present in the nasal passages, and the bacteria begin to multiply and invade the lining of the sinus. This causes the symptoms of sinus infection. Allergens and pollutants produce a similar effect.

Bacteria that normally cause acute sinusitis are Streptococcus pneumoniae, Haemophilus influenza, and Moraxella catarrhalis. These microorganisms, along with Staphylococcus aureus and anaerobes (bacteria that live without oxygen), are involved in chronic sinusitis.

Fungi are also becoming an increasing cause of chronic sinusitis, especially in people with diseases that weaken the immune system, such as AIDS, leukemia, and diabetes.


Symptoms of Sinus Infection

Signs and symptoms of sinus infections depend upon which sinuses are affected and whether the sinus infection is acute or chronic.

Acute sinusitis:

A. Ethmoid sinusitis (behind the eyes)

• Nasal congestion with discharge or postnasal drip (mucus drips down the throat behind the nose)
• Pain or pressure around the inner corner of the eye or down one side of the nose
• Headache in the temple or surrounding the eye
• Pain or pressure symptoms worse when coughing, straining, or lying on the back and better when the head is upright
• Fever

B. Maxillary sinusitis (behind the cheek bones)

• Pain across the cheekbone, under or around the eye, or around the upper teet
• Pain or pressure on one side or both
• Tender, red, or swollen cheekbone
• Pain and pressure symptoms worse with the head upright and bending forward and better when reclining
• Nasal discharge or postnasal drip
• Fever

C. Frontal sinusitis (behind forehead, one or both sides)

• Severe headaches in the forehead
• Fever
• Pain worse when reclining and better with the head upright
• Nasal discharge or postnasal drip

D. Sphenoid sinusitis (behind the eyes)

• Deep headache with pain behind and on top of the head, across the forehead, and behind the eye
• Fever
• Pain worse when lying on the back or bending forward
• Double vision or vision disturbances if pressure extends into the brain
• Nasal discharge or postnasal drip

Chronic sinusitis:

A. Ethmoid sinusitis

• Chronic nasal discharge, obstruction, and low–grade discomfort across the bridge of the nose
• Pain worse in the late morning or when wearing glasses
• Chronic sore throat and bad breath
• Usually recurs in other sinuses

B. Maxillary sinusitis

• Discomfort or pressure below the eye
• Chronic toothache
• Pain possibly worse with colds, flu, or allergies
• Increased discomfort throughout the day with increased cough at night

C.Frontal sinusitis

• Persistent, low–grade headache in the forehead
• History of trauma or damage to the sinus area

D.Sphenoid sinusitis

• Low–grade general headache common

Exams and Tests

The diagnosis of a sinus infection is usually made based on a thorough medical history assessment and a physical examination. Adequately distinguishing sinusitis from a simple upper respiratory infection or a common cold is important.

Sinusitis is often caused by bacteria and viruses .Upper respiratory infections and colds are viral illnesses. Proper diagnosis of these potentially similar conditions prevents confusion as to which medications should be given. Over treating viral infections with antibiotics can be dangerous.

A. X-Ray PNS(Para Nasal Sinuses) may be helpful in diagnosis of sinus infections.But it is not con formative among bacterial or viral cause of sinusitis and sometimes X-Ray study may miss the infection.

B. CT scan: In most cases, diagnosing acute sinusitis requires no tests. When testing is needed, the CT scan can clearly depict all of the para-nasal sinuses, the nasal passages, and the surrounding structures.
Mucosal thickening can occur in people without symptoms of sinusitis. Therefore, CT scan findings must be correlated with a person's symptoms and physical examination findings to diagnose a sinus infection.

C. Ultrasound: Another noninvasive diagnostic tool is ultrasound. The procedure is fast, reliable, and less expensive than a CT scan. However, the results are not as detailed as those from a CT scan. 

D. Nasopharyngoscopy: Direct viewing of Nasal and pharyngeal cavity.

E.Culture and Sensitivity : Doctor may drain the affected sinus to test for organisms. This is a more invasive test than those already mentioned. During this procedure, a doctor inserts a needle into the sinus through skin (or gum) and bone in an attempt to withdraw fluid, which can be sent to the lab for culture. Any present bacteria can be identified . Usually this procedure does not needs.
Sinus Infection Treatment

Self–Care

A.Promote drainage

• Drink plenty of water and hydrating beverages. Hot tea is often recommended.
• Inhale steam two to four times per day by leaning over a bowl of boiling hot water (not while the water is on the stove) or using a steam vaporizer with a towel over the head and bowl to prevent the escape of the steam. Inhale the steam for about 10 minutes

B.Relieve pain: Pain medication such as ibuprofen , aspirin, and acetaminophen ( reduce pain and inflammation. These medications help to open the airways by reducing swelling.

Medical Treatment

The main goals in treating a sinus infection or sinusitis involve reducing the swelling or inflammation in the nasal passages and sinuses, eliminating the infection, promoting drainage from the sinuses.

Medications

1.Decongestants -help to reduce airway obstruction and are important in the initial treatment to alleviate symptoms.
2.Nasal sprays -work fastly—within one to three minutes. However, these agents should not be used for more than three days because they become less effective and developed dependency on it.
3. Oral Decongestants
Both nasal and oral decongestants have side effects, including general stimulation causing increased heart rate and blood pressure, insomnia, nervousness, anxiety, tremor, dry mouth, blurry vision, and headache. They may also cause an inability to urinate. Therefore, persons with a history of cardiac disease, high blood pressure, anxiety, or urinary problems should consult a physician before using decongestants.
4. Antibiotics: Broad spectrum antibiotics may be necessary for Bacterial infection.
5.Anti-allergic drugs may be prescribed to you.
6.Steroids: Intra-nasal steroids may be needed in cases of recurrent attacks of acute or chronic sinusitis.

Surgery

Surgery may be needed to remove complications of sinusitis and to remove obstruction

A.The surgery is performed endoscopically using the same fiberoptic nasopharyngoscope used to make the diagnosis.
B. During the surgery, nasal polyps can also be removed, and a crooked nasal septum can be straightened, leading to improved airflow.

Homeopathic Treatment

Homeopathy is well known for cases of Sinusitis,Allergy and recurrent infections. Homeopathy cures permanently Acute,Chronic and Allergic sinusitis. Old patients needs long term therapy to cure permanently. Homeopathy has more then 150 medicines for Allergy,Acute and Chronic Sinusitis. Children and young age persons are more vulnerable to infections of nasal cavity and sinuses. Homeopathy medicines are prescribed on basis of individuality of patient, modalities, symptoms, temperament, personality traits, mental attitudes and behavior patterns.