HEMIC

Cleft lip is a ______ Disease?
ঠোট কাটা, এটা কী ধরনের ডিজঅর্ডার?

কোনটি সঠিক উত্তর? এবং এর সঠিক চিকিৎসা কী?

কোন কোন হোমিওপ্যাথিক ঔষধের লক্ষণ?

এই হাড়ের নাম কী?
What is the name of this bone?

কোন কোন ঔষধের লক্ষণ?
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Clinical Case -
Atopic Dermatitis in a Woman of 60
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Dr. Apoorva Sishtla shares a case of atopic dermatitis in a woman of 60. Ailments from bad news and anger were among symptoms leading to the simillimum.

This case report outlines the successful treatment of a 60-year-old female presenting with a recurrent eruption at the back of her forearm. She had eruptions on calves and legs and pain at feet and toes for 2.5 months with inflammation and itching.



Eczema, Atopic Dermatitis, Atopic Eczema, Homoeopathy, Eruptions, Itch, Apis Mellifica, Apis

Report

Mrs. R is a 60-year-old female residing in Hyderabad. She holds a PhD in microbiology and has worked at that the past. She is currently a housewife. She is married and has two children. Her religious affiliation is Hindu.

:

eruptions at back of forearm since 2.5 months
eruptions on calves and legs since 2.5 months
pain at feet and toes since 2.5 months

Macular eruptions first started on forearms when she was in America, visiting her son. Before the complaint started, she was sitting outside in the garden where she thinks she was bit by something on the arm, although she was not sure and there was no bite mark.

Macular raised eruptions of the size of 1cm or less, some coalesced together, red coloured eruptions, first starting out on arms and then starting out at Calves and Legs.

There is burning pain +2 at the eruptions, which is mildly sensitive to touch of clothes. No certain time of aggravation. Eruptions better with ice, bathing.

Discomfort of the eruptions aggravated with heat of sun, warm application Heat of sun produces tingling on the skin, leading to itching.

Itch +2 On and off – Itch is not continuous, occurs spontaneously with only one episode of violent itching sensation at evening time. No scratching or bleeding at the eruptions. No specific differentiation with the aspect of perspiration.

Pain and sensitivity in feet – Patient felt tensed sensation and stiffness in feet. There was mild inflammation on the feet and mild redness. Patient was feeling difficulty in walking long distances. Standing for long was painful due to the inflammation and stiffness. Pain in left foot is more than compared to right foot.

HISTORY
Hypertension ( Since 7 years)

HISTORY
Mother: Diabetes Mellitus, hypertension Father: Apparently healthy

HISTORY
Nothing Specific

HISTORY
Tubectomy

HISTORY
Soap Detergent in the past gave Contact dermatitis

HISTORY
G2 P2 L2 A1

HISTORY
Menopause attained at the age of 43.

HISTORY -
APPETITE – 2/day, Doesn’t feel very hungry these days, eats little quantities, Vegetarian diet.
THIRST – 2-2.5L per day, moderate quantities at long intervals, doesn’t crave any cold or hot water
DESIRES – Nothing Specific
AVERSION –Nothing Specific
DISAGREE –Oily food, Fried Food
SLEEP – Refreshed, DREAMS –Doesn’t remember
THERMALS – Towards Hot; Fan –Needed, Bath- Cold water, Blanket – seasonal

ELIMINATIONS -

PERSPIRATION – On face, mouth and armpits. Not offensive.
URINE –4 -5 5imes per day, no burning or pain, pale yellow color, not offensive, satisfactory.
STOOL –1 time per day, satisfactory, not offensive. No pain or burning.

SPACE INVESTIGATION -
The patient was visiting her son in the USA. He was married 3 years back but now the marriage is not in an amicable state, and her son was going through a divorce. This news deeply affected her. Shet is a very cheerful, sensitive lady who has faced many hardships in her life. She is easily distressed by bad news and easily gets anxious.

The situation also included overseas financial settlements and property settlements which led to arguments between the parties and she mentioned being mentally drained and vexed with frustration. Her discomfort and anger on the issue was evident.

EXAMINATION -

BUILD – Moderately built, Overweight
NOURISHMENT –Well nourished
TEMPERATURE –Afebrile
BP –130/90 mm Hg
CYANOSIS – None
ICTERUS – None
PALLOR –None
OEDEMA –None
EYES AND EARS –no deformities, no inflammation, no abnormal discharges.
THROAT –No congestion, no inflammation of tonsils
TONGUE –White coating present
SKIN – Dry

EXAMINATION -

RESPIRATORY SYSTEM
RR – 18 per minute, No added sounds, No wheeze or crackles.

CARDIOVASCULAR SYSTEM
Pulse 80 bpm, BP 130/90mmhg. NO murmur or pericardial rub

LOCOMOTOR SYSTEM
No deformities or limited range of movements

CENTRAL NERVOUS SYSTEM
Well oriented time, space and place. Conscious. Power and Balance – NORMAL

GASTROINTESTINAL SYSTEM
Inspection- no swellings, no redness, Fat filled Abdomen, no visible external pulsation. Palpation – No Organomegaly, No tenderness. Auscultation – Bowel sounds heard

INTEGUMENTARY SYSTEM
Arm and forearm – Macular red raised eruptions, inflammation present. No wheal formation, No oedema, redness present, no tenderness, no blisters and no discharge, skin is dry. Size 1cm or Less.

Calves and Legs -Macular red raised eruptions, coalition of macular eruptions leading to bigger eruptions, inflammation present. No oedema, redness present, no tenderness, no blisters and no discharge, skin is dry.

Size 1 to 1.5cm eruptions

AND EVALUATION
TOTALITY -

A/F Insect Bite
Suppressed anger
Ailments from bad news
Burning +2 Pain at eruption
Burning pain better by cold application
Burning pain increased with heat of sun
Increased sensitivity of skin
Inflammation on Left foot with stiffness
Appetite reduced
Thermal – Hot

, POSOLOGY AND REPETITION -
The disease condition in this case showed a gradual progress. The patient shows sensitivity at the mental level with prominent dispositional and mental symptomatology, so the sensitivity is high. The pathology is structurally reversible and the miasm is psoro-sycosis.

Hence, the susceptibility of the patient is moderate to high. So, 200 potency was selected and was repeated.

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FIRST PRESCRIPTION - 18thrd SEPTEMBER 2023
Due to the ‘supposed’ insect bite, the causation of insect bite was given first priority and was prescribed LEDUM PAL 200.

LEDUM PAL 200 BD x 2 days.
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FIRST FOLLOW UP : 27th SEPTEMBER 2023

The 1st prescription brought amelioration of symptoms, but the amelioration was short and the complaint came back on again.
The burning and itching reduced by 60% for a few days, but again it has come back to the original state, the amelioration was short lived. Proper analysis and repertorisation was made again towards the case using Kent’s Repertory

APIS MELLIFICA 200 BD X 2 days.
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FOLLOW UP on 3rd OCTOBER 2023

Complaints better by 50%
Eruptions itch absent, Burning reduced by 50%. Patient says her energies feel better.

Pain in left foot reduced, tightness reduced 20 % in foot
PRESCRIPTION

▪ Sac Lac dose OD
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FOLLOWUP 9 OCT 2023

a) Red eruption completely reduced on arms and legs, no more raised eruptions
b) No Burning or itching
c) Left foot swelling is better, mild pain 10 % left. Able to walk well.
PRESCRIPTION

▪ APIS MELLIFICA 200 1 DOSE OD

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FOLLOW UP ON 19th OCTOBER

No eruptions on the body. No itch. No Burning or sensitivity of skin. Left foot swelling reduced completely and now has no problem standing for longer

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FOLLOW UP
28TH NOVEMBER 2023
No new eruptions.
All previous complaints are completely reduced without any aggravations or any recurrence of symptoms.
No Rx prescribed.
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FOLLOW UP 10TH JANUARY 2023
Had a phone call with patient, she is healthy.
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একজন রোগী চর্মরোগের কষ্ট নিয়ে এসেছে- তার কষ্টের বর্ণনা তুলে ধরা হলো -

স্যার, আমি অনেক মাস ধরে এই চর্মরোগে খুব কষ্ট পাচ্ছি। বিশেষ করে রাতে চুলকানি এত বেশি হয় যে সহ্য করতে পারি না। অনেক সময় এত চুলকাই যে ত্বক লাল হয়ে যায়, পরে জ্বালাপোড়া শুরু হয়।

আমার ত্বক খুব শুষ্ক আর খসখসে হয়ে গেছে। কিছু জায়গায় ফেটে যায়, আর সাবান বা ডিটারজেন্ট লাগলে অনেক ব্যথা করে। গরমে সমস্যা আরও বেড়ে যায়। রাতে বিছানায় গেলে চুলকানি এত বাড়ে যে ঠিকমতো ঘুমাতে পারি না।

শরীরে সবসময় যেন গরম গরম লাগে। বেশি কাপড় বা গরম পরিবেশ একদম সহ্য করতে পারি না। এতে অস্বস্তি আরও বেড়ে যায়।

শরীর দুর্বল লাগে, খুব সহজেই ক্লান্ত হয়ে যাই। আবার ছোট ছোট বিষয়েও খুব বিরক্ত লাগে, মেজাজ খিটখিটে হয়ে গেছে।

অনেক রকম ক্রিম আর ওষুধ ব্যবহার করেছি। কিছুদিন একটু ভালো লাগে, কিন্তু পরে আবার আগের মতো হয়ে যায়। এই কারণে আমি হোমিওপ্যাথিক চিকিৎসার জন্য আপনার কাছে এসেছি।

আপনি কোন ঔষধ নির্বাচন করবেন?

#কুইজঃ র/ক্তে জলীয় পদার্থের পরিমান কতটুকু?
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#হেমিক

What is the largest vein in the body?
দেহের সবচেয়ে বড় ভেইন কোনটি?