More often than not, PCOD and PCOS are used interchangeably, but while they can co-exist, they are not the same. PCOD is just a part/sign of the syndrome PCOS.
PCOD – Polycystic Ovarian Disease
PCOS – Polycystic Ovarian Syndrome
The only evident difference between the two is Disease and Syndrome but these two
terms are self-explanatory for us to understand the difference. While PCOD is a medical
condition in which the ovaries produce immature eggs in large numbers that become cysts
eventually. Whereas PCOS is a syndrome i.e. combination of Disease conditions of females
in their reproductive age consisting of a combination of hormonal imbalance and metabolic
disorders leading to various signs and symptoms.

NOMENCLATURE

The disorder was first known as Stein Leventhal Syndrome (after its founder) after which it
was called PCOD and today as we understand that the disorder is so much more than
multiple cysts in the ovary we now use the term PCOS as it encompasses the various
aspects of the disorder.

PREVALENCE

Worldwide: 4 to 20% of women
India: 3.7 to 22.5%

DIAGNOSTIC CRITERIA ESHRE or The ROTTERDAM CRITERIA (2003)

● Oligo/anovulation
● Hyperandrogenism (Clinical/Chemical)
● Polycystic ovaries (USG) [PCOD]
The presence of any 2 of the 3 conditions given is sufficient to diagnose PCOS.

1. Oligo/Anovulation: Normal cycle: 24-35 days
   Cyclic menses at normal intervals cannot be regarded as proof of ovulation, 15-40%
   females are eumenorrheic despite oligo/anovulation.
2. Hyperandrogenism:
   ● Clinical – Acne Hirsutism
   Androgenic alopecia
   (All are effects of androgens on pilosebaceous units i.e. sebaceous gland, erector
   pili muscle, hair follicle)
   HIRSUTISM can be assessed using the Modified Ferriman-Gallwey score.
   ● Chemical – Elevated levels of Testosterone
   Androstenedione
   DHEA & DHEA-S
   DHEA-S is a traditional marker for adrenal androgen excess because:
   ● It is derived exclusively from adrenal
   ● Relatively high concentration
   ● Stable across the day & menstrual cycle.
   DHEA-S may also be misleading because:
   ● It may also be elevated in tumors.
   ● It may lack sensitivity and specificity to identify the adrenal cause.
3. Polycystic ovaries:
   As per rotterdam criteria
   ● >=12 follicles
   ● Cysts 2-9 mm diameter.
   The volume and architecture of the ovary are not considered.
   Females using oral contraceptive pills may show polycystic ovaries in ultrasound.
   False positive ultrasound: Hyperprolactinemia
   Hypothalamic amenorrhea
   Normal pubertal development

OTHER FEATURES OF PCOS

OBESITY –

● Visceral fat > Subcutaneous fat
● Increased intra-abdominal obesity
● Increased waist-hip ratio
● Obesity is a risk factor and not an essential factor.

INSULIN RESISTANCE –

● 50 to 75% of females with PCOS have insulin resistance
● IR causes increased insulin which further leads to increased ovarian androgen, increased LH, and decreased hepatic SHBG all of which lead to Hyperandrogenism.
● Test – OGTT

ABNORMAL GONADOTROPIN SECRETION –

● High LH
● Low/ normal FSH
● High LH: FSH

DYSLIPIDEMIA –

● High HDL
● High Triglycerides (associated with IR)
● High LDL Normal lipid profile can also be seen in PCOS females

INVESTIGATIONS

1. USG – number of cysts >=12
   Size 2-9mm diameter
2. Serum values
   Luteinizing hormone – raised
   Follicular stimulating hormone – lower/normal
   LH: FSH – raised
   Testosterone – raised
   DHEA-S – raised
   Oestrone – raised
3. Other tests to be done
   TSH
   Prolactin
   Fasting lipid profile
   2-hour Oral glucose tolerance test

Lifestyle Management

1. Diet
2. Weight management
3. Exercise
4. Stress management
5. Sleep schedule

Drug Indication Side effects
Oral contraceptive pills
(First line of treatment)
Not trying to conceive Insulin resistance
Cardiac issues
Clomiphene citrate Anovulation Multiple pregnancies
Hot flashes
Metformin Insulin resistance
Diabetes mellitus
GIT complaints

Homeopathic Treatment Of PCOS

Various Homeopathic medicines indicated in cases of PCOS such as:

• Sepia
• Natrum muriaticum
• Calcarea carbonica
• Pulsatilla nigricans
• Kali carbonicum

Prescription varies from patient to patient as different patients suffering from PCOS show
a different picture that not everyone exhibits all symptoms of the syndrome, therefore,
prescription can be made based on the prominent symptoms seen in that patient for instance
HIRSUTISM – Sepia officinalis, Oleum jecoris
Acne – Sulphur, Silicea, Kali Brom
OBESITY – Calcarea carb, Graphites, Ammonium carb
Ovarian cyst – APIs mel, Thuja, Iodum, Conium mac

We must understand that while PCOS is a complex disease manifested in the form of
various disease conditions in the female body, a syndrome of such magnitude does not just
appear in a day, it is important to peel the layers and reach the core behind the massive
complex that appears as a consequence. Knowing the cause, be it hereditary, sedentary
lifestyle, stress, etc. Helps us find the right remedy for that given case of PCOS.

Case Report:

Patient Miss XYZ, aged 27 years, a primary teacher by profession came to the clinic as she
suffered from Irregular menses for the past 3 years, she was always a scholar during her
schooling and therefore she and her parents had very high expectations from her. The Father of
the patient wanted her to be a Chartered accountant but she wanted to be a lawyer, but due
to family pressure she was bound to pursue commerce, but despite all her efforts she
couldn’t clear her CA finals as her heart was not in it. She loved her father dearly but her
failed attempts made her feel she failed her father and being a scholar throughout school

she felt like a failure when she couldn’t clear her CA exams. This feeling lurked in the patient
even after the patient started her career as a teacher, which led to her abnormal menses,
and on getting a USG done polycystic ovaries were also seen. The patient took allopathic
treatment for 1.5 years and Homoeopathic treatment for 6 months, but had no relief. After
the patient’s anamnesis, it was found that too high expectations from parents and oneself were the core of the patient’s problem, and therefore Carcinosinum 200 was prescribed, which gradually improved the patient and did not require repetition The patient started having
regular cycles of 26 days and the patient was observed for the next 4 months.

COMPLICATIONS OF PCOS

1. Endometrial hyperplasia/carcinoma – due to constant estrogen stimulation.

2. Infertility

3. Metabolic syndrome/ Syndrome “X”

● Increased waist circumference

● Hypertension (>= 130/85 mmHg)

● Raised Triglycerides (>=150 mg/dl)

● Low HDL (< 50 mg/dl)

● High Fasting glucose (>=100 mg/dl) or known case of Diabetes.

4. Cardiovascular diseases

5. Type 2 Diabetes

It is important to understand that PCOS is not just a gynecological disease, rather it is a
complex issue that hampers the quality of life of a female as it causes weight gain,
acne, facial hair, and hair fall which leads to body shaming & lack of self-confidence. Irregularities
in menses hamper the routine as the patient is always concerned about her menses
approaching. Infertility from PCOS takes a mental toll on the patient and the entire family.

This is a serious condition that must be treated with caution and appropriate treatment.

It takes the right amount of time to reverse PCOS and allow patients to live normal and healthy
life.

Eczema is a prevalent skin condition that is long-lasting, not contagious and is characterized by dry skin, red scaly patches in one area, intense itchiness, and skin discomfort. This condition can also be referred to as atopic eczema, neurodermatitis, or atopic dermatitis. It affects a proportion of 20% of children and 10% of the adult population in India and ranks as the 15th most common non-fatal disease worldwide and is the leading skin disease in terms of disability-adjusted life years (DALYs).

The skin eruptions linked with eczema are recognizable due to the presence of small raised bumps, the formation of crusts and scales, and fluid-filled blisters on reddened and swollen skin. Though, in darker skin, it might be tough to recognize the redness. When the eruptions or scales persist for long periods, the skin might thicken resulting in a condition called lichenification.

The causes of eczema are linked to a genetic variation that affects the skin’s capacity to offer protection. Due to a weakened barrier function, the skin becomes less capable of retaining moisture and safeguarding against bacteria, irritants, allergens, and environmental factors such as tobacco smoke. Other causes include the excessive presence of Staphylococcus aureus bacteria on the skin.

Types of Eczema

S.no	Types	Indications
1.	Atopic Dermatitis –	This type of eczema leads to dryness, inflammation, and itching in the affected area. It usually affects young children and can happen to people of any age.
2.	Contact Dermatitis –	Also known as allergic contact dermatitis, is caused by environmental factors.
3.	Neurodermatitis or  –      Discoid Eczema	This form affects small patches of skin. It makes them itchy and scaly.
4.	Dyshidrotic Eczema –	The skin can become dry and a person may experience a burning sensation, rashes and blisters with this form of eczema.
5.	Nummular Eczema –	This condition results in the development of circular lesions throughout the entire body, with a particular prominence on the arms and legs.
6.	Seborrheic Dermatitis –	A type of eczema that causes inflammation specifically on the scalp.
7.	Stasis Dermatitis –	A condition characterized by changes in skin coloration on the legs that resemble varicose veins.

The American Academy of Dermatology states that the clinical diagnosis of eczema is determined by examining skin signs, identifying the location of the skin lesions, noting any related clinical findings, and determining if there is a history of atopy in the individual or their family. It is crucial to seek advice from a dermatologist, as each variant of this disease has its characteristic triggers and treatment requirements.

Treatment of eczema usually involves oral antibiotics, corticosteroids, and topical medications such as creams, gels, or ointments, which are applied directly to the affected skin to alleviate itching and reduce redness and swelling. It can be managed with lukewarm baths using a mild soap and applying moisturizer every day on the skin and by wearing cotton or soft fabrics clothes.

Homeopathic Management Of Eczema

Homeopathy is a holistic system of treatment that is safe, effective and involves the use of highly diluted substances to treat a variety of skin conditions, including eczema.

Homeopathic remedies for eczema are based on the principle of “like cures like,” meaning that a substance that causes similar symptoms in a healthy person is used to treat those symptoms in a sick person.

Homeopathy can help the body to move towards a healthier state and improve eczema by balancing the immune system. The chances of improvement are high because the body is capable of regulating itself.

The healing process follows Hering’s law of cure, where the deepest level symptoms are the first to improve, followed by the less severe ones.

If treatment is successful, the overall health of an individual will improve before eczema improves, starting with the face and trunk, and lastly, the extremities. According to the Homeopathic concept of disease, eczema is linked to the Psoric miasm, typically seen in individuals who have a sensitive, weak, and reactive personalities. They often have a tendency to develop chronic skin problems, which can be aggravated by stress, anxiety, and emotional imbalances.

In Previous studies, it was found that Graphites 30C shows good improvement in all symptoms of this problem. In another study most frequently prescribed homeopathic medicines were Calcarea carbonicum, Tuberculinum, and Medorrhinum.

Homeopathic Therapeutics

• Sulphur: Used when the skin is dry, scaly, and itchy, with a burning sensation.
• Graphites: Useful for treating dry, cracked, and scaly skin.
• Arsenicum album: It is recommended for itchy, burning, and painful eczema that is aggravated at night.
• Petroleum: Helps to relieve eczema with cracks that bleed, especially on the hands, fingers, and feet.
• Natrum muriaticum: It is used for eczema that is triggered by emotional stress and has a tendency to form blisters.

Conclusion

Homeopathy aims to stimulate the body’s natural healing process and improve the patient’s overall health and can provide a long-term solution to eczema, promoting overall well-being and improving patients’ quality of life. To accurately determine the effectiveness of homeopathic treatment for eczema, it is necessary to conduct larger studies using various study designs and larger groups of participants.

Hypothyroidism is the most common Thyroid disorder in India. It is an endocrine disorder that
occurs as a result of an underactive thyroid. The gland fails to produce enough thyroid hormones
per the body’s requirements leading to raised Thyroid stimulating hormone (TSH).

PATHOPHYSIOLOGY OF THYROID

“All acidity and indigestion diseases begin in the gut”

Hippocrates

What Hippocrates, the father of modern medicine said 2400 years ago gold sequin ground event today. Millions of people worldwide have various gastric issues-Acidity being one of them.

We hear & use the term ‘Acidity’ very casually day in & out, but what does it really stand for?

Acid means anything with a ph level between 0-7. But that is not the case with our stomachs. Our stomach requires a very acidic pH of 1.5-2.5 to maintain digestive health this acidic pH is mainly determined by HCl (Hydrochloric acid). Disturbance in the production of HCl may lead to various symptoms that are conjointly referred to as acidity.

CLINICAL PRESENTATION

The term Acidity encompasses the following common symptoms.

• Heartburn
• Nausea & vomiting
• Sour eructation
• Regurgitations
• Bloated abdomen
• Associated headaches
• Belching and flatus
• Hiccups
• Dysphagia
• Weight loss

CAUSATIVE FACTORS

• Lifestyle: A sedentary lifestyle is one of the significant causes of acidity.
  • Lack of exercise lack of sleep/disturbed sleeping pattern overweight
  • Unhealthy diet habits
• Chronic Stress – According to the American Journal of Gastroenterology, people with chronic stress & anxiety had more severe acid reflux symptoms than those without pressure.

Impact of Stress

• Increased sensitivity to the slightest increase in acid levels
  • Production of prostaglandins depleted (Prostaglandins protect the stomach from the effect of acid)

• Smoking
  • Nicotine relaxes LES (lower esophageal sphincter) causing regurgitation & acid reflux. Reduced salivation-saliva contains acid-neutralizing bicarbonates Increased acids erection in the stomach
  • Damage dysphagia alining
• GERD –  Gastroesophageal Reflux Disease
• Peptic Ulcers
• Hiatus Hernia
• Lactose intolerance
• Medication
  • NSAID Seg :- ibuprofen, aspirin etc
  • Corticosteroids
  • Iron supplements
  • Anti-anxiety and Antidepressants
  • Antibiotics

MANAGEMENT

Exercise- Decrease obesity

Reduce stress by production of Endorphins

Sleep – Durations of Sleep (6-8 hours) and a fixed sleeping schedule help keep the circadian rhythm synced.

• Eat slowly and chew well
  • Do not get to bed immediately after meals.Slow walking after meals.adequate water intakeConsume meals at regular intervalsIncrease consumption of antioxidants & raw foodsAvoid Carbonated drinksFried, spicy, and junk foodsProcessed foodsCaffeineSmoking and alcohol
  • Citrus fruits during an acute attack of acidity

• Medicinal

ANTACIDS	H2RECEPTORBLOCKERS	PROTON PUMP INHIBITORS(PPI)
Neutralize/counteract acid production	Decrease gastric acid secretion	Stop sal most all acid production

Side effects of Antacids

COMMON HOMOEOPATHIC MEDICINES PRESCRIBED IN CASE OF ACIDITY:

Carbo Vegetabilis

• Weak digestion-simplest food disagrees.
  • Excessive flatulence – Upper part of AbdomenCannot wears tight clothing around the waist ever recovered from Typhoid. Loud rancid eructation; gives only temporary relief.
  • Desire to be constantly fanned.

  Lycopodium

• Excessive flatulence – Lower abdomen
  • Bloating loud fermentation gurglingEverything tastes our – eructation, heartburn, water brash & vomiting. Constant feeling of satiety, few mouthfuls fill up to the throat. Desire for hot food & drinks, which provide relief.Right side affection
  • Most complaints occur between  4-8 pm.

Phosphorus

• Vomiting of food & water as soon as it becomes a swarming stomach (useful in cases of gastric ulcers)Regurgitation of ingestion.
• Burning: Causing desire for cold food & drinks, juicy fresh foods, and ice cream which relieve the burning.
• Hemorrhagic tendency – Causing bleeding along with vomiting
  • Nausea on putting hands in warm water.

 Robinia

• A remedy for Hyper chlorhydria.
• Pronounced acidity is the keynote that is compared to a frontal headache.
• Acidity sour eructation profuse vomiting of intensely sour greenish fluid.
• Nocturnal burning pains in the stomach
• Too rapid digestion of albumin & slow digestion of starch.
• Acidity in Children
• Incarcerated flatus with colic
• Frequent repetition of this medicine for a long duration is seen as beneficial in acidity

Other Common Homoeopathic Drugs are:

Pulsatilla Arsenic album Antim crud

Calcarea Carb Natrum Carb Nux

Vomica Sulphur

Kali carb etc.

A vast proportion of our population suffers from acidity and the majority of them resort to antacid pills which generally become a habit that when taken in the long term hampers normal HCL production. In this regard, a thorough homeopathic treatment for acidity not only is free from side effects but provides a cure without being dependent on a pill for the rest of your life.

Homeopathic treatment is based on the individuality of the case considering its symptom anthology dealing with the root cause in that particular case.

For instance:

A case of Dyspepsia:

Name: XYZ

Age: 29 Years

Gender: Male

Showed common symptoms of heartburn, regurgitation, and bilious vomiting in the morning on waking with a severe headache.

On thorough case taking it was discovered that the patient was a lawyer who was working at a corporate job and freelancing at the same time, which demanded him to work late at night to finish his freelancing work, for that he was dependent on stimulants like coffee to keep him active and awake in the late night hours.

Here we see that the patient is:

A workaholic leading a sedentary life Dependent on stimulants Night watching / lack of sleep.

The common symptoms Seen in this case could have misguided & confused us, but knowing the patient as a whole guided us toward Nox vomica.

HOMEOPATHIC MEDICINES PRESCRIBED IN CASES OF ACIDITY:

• Dr. Goel’s Homeopathic Vegetab help in treating indigestion and acidity problem in human being.
• Vegetab pills help you digest food. They are found naturally in the body.

 Visit www.homeonest.com to buy a Vegetab pill or call 7060202088

Homeonest India Pvt. Ltd.

Influenza (flu) and the common cold are both contagious respiratory illnesses, but they are caused by
different viruses. Flu is caused by influenza viruses only, whereas the common cold can be caused by a
number of different viruses, including rhinoviruses, parainfluenza, and seasonal coronaviruses.
Illnesses like flu/influenza have their own impact on public health as it imposes threat for epidemic outbreaks,
which spreads rapidly and widely, affecting many individuals in a population, especially high-risk
individuals such as the elderly and pregnant women. Vaccines, anti-viral medications, and antibiotics are
the standard conventional treatments for these diseases. The use of homeopathy for epidemic diseases dates
to the time of Hahnemann, who recommended Belladonna for scarlet fever.
Interestingly homeopathy was invented in the same year as Jenner first practiced vaccination (1796).
Homeopathy first rose to prominence in the 19th century due to its success in treating epidemic diseases
such as cholera, yellow fever, and typhus. Various strategies have been used by homeopaths to treat
epidemic diseases, including individualization, combination remedies, and genus epidemics.
The flu pandemics in the 20th century caused considerably high mortality: the H1N1 Spanish flu (1918–
1919) claimed 50–100 million victims, the H2N2 Asian flu (1957) 1 million, and the H3N2 Hong Kong flu
(1968) around 700 thousand.
From the history of influenza epidemics and pandemics, it is apparent that outbreaks occur somewhere in
the world in most years.
As homeopathic treatment for individual persons based on the unique principle of individualization, Maste
Samuel Hahnemann has advised in his Organon of Medicine “§100, 101, 102” to observe carefully each
epidemic disease as a phenomenon of unique character’ that must be distinguished from the previous
outbreaks. To gather the picture of the disease, the ‘totality of characteristic signs and symptoms’, he
suggested observing several cases to formulate a ‘Genus epidemics (GE)’ for that particular epidemic.
Vaccines, anti-viral medications, and antibiotics have been the gold standard for conventional treatments.
Administration of the specific GE, derived after careful assessment of the characteristic picture of the
disease across regions, and treatment of symptomatic cases with adjuvant individualized Homoeopathy, can
be the most viable, safe, inexpensive, and effective approach to managing disease outbreaks globally

Mode of transmission

Cold or flu/influenza usually gets transmitted through droplet infection.

Clinical features and Complications

Influenza/ Flu can cause mild to severe symptoms. Flu usually has an abrupt onset of symptoms or with 1 or
2 days of the incubation period
Flu could have any of the following symptoms:
1. Fever or feverish feeling /chills
2. Cough, hoarseness, or sore throat
3. Shortness of breath or chest pain
4. Runny or stuffy nose
5. Sneezing
6. Earache
7. Muscle, body, or joint aches
8. Headaches
9. Fatigue (tiredness)
10. Loss of appetite
11. In some cases vomiting and diarrhea, which is more common in children than adults.
The symptomatology of influenza infections can however range from afebrile respiratory illnesses similar
to the common cold, to diseases in which systemic signs and symptoms predominate with relatively little
respiratory tract infection symptoms.
Colds generally are not associated with any effect, but flu can have associated complications such as
lower respiratory tract bacterial infection that may or may not require hospitalization

Diagnosis

The majority of Influenza cases are diagnosed based on clinical symptoms and there is no need for any laboratory
tests, however under some conditions certain laboratory confirmation using available tests such as nucleic
acid tests (e.g., PCR) or rapid diagnostic tests might be needed.

Treatment General Management:

1. Cold or Flu symptoms in individuals who are not in a high-risk group usually lessen
within 3-5 days even without medical intervention.
2. The symptomatic patients are advised to stay at home to minimize the risk of infecting others
in the community.
3. Stay hydrated and maintain a healthy, nutritious diet.
4. They should monitor themselves to detect if their conditions deteriorate and seek medical
attention.

Therapeutic Homoeopathic interventions:

As per individualized symptomatology, there are various medicines in our materia medica that help
lessens flu symptoms with minimum complications and shorten the duration and severity of illness
in case of recurrent infection. A few of these are named below.
1. Bryonia alba: Coryza with shooting and aching in the forehead. The swelling of the tip of the nose
feels as if it would ulcerate when touched. Mucous membranes are all dry.
2. Rhus Toxicodendron: Sneezing and coryza from getting wet. Tip of nose red, sore and
ulcerated. Nosebleed on stooping.
3. Aconite: Smell acutely sensitive. Pain at root of nose. Coryza much sneezing. Mucous
membrane dry, nose stopped up, dry or with but scanty watery coryza.
4. Belladonna: Imaginary odors. Tingling in the tip of the nose. Bleeding of nose, with a red face.
Coryza; mucus mixed with blood.
5. Pulsatilla: Coryza and stoppage of right nostril, pressing pain at root of nose. Loss of
smell. Large green fetid scales on the nose. Stoppage in the evening. Yellow mucus; is abundant
in the morning. Bad smells, as of old catarrh.
6. Hepar sulphur: Soreness of nostrils, with catarrhal troubles. Sneezes every time he goes
into a cold, dry wind, with running from the nose, later, thick, offensive discharge.
7. Phosphorus: Fan-like motion of nostrils. Bleeding, epistaxis instead of menses. Oversensitive smell. Foul imaginary odors. Chronic catarrh.
8. Allium cepa: Sneezing, especially when entering a warm room. Copious, watery, and
extremely acrid discharge. The feeling of a lump at the root of the nose. Fluent coryza with
headache, cough, and hoarseness.
9. Euphrasia officinalis: Profuse, fluent coryza, with violent cough and abundant
expectoration.
10. Natrum muriaticum: Violent, fluent coryza, lasting from one to three days, then
changing into stoppage of nose, making breathing difficult. Discharge thin and
watery, like the raw white of an egg.
11. Quillaja Saponaria: It produces and cures symptoms of acute catarrh, sneezing, and
sore throat. Most effective at the beginning of coryza.

Indigestion or dyspepsia is a common gastrointestinal problem that comes to the physician. Indigestion is a common word that is loosely used by laymen and physicians as some kind of gastrointestinal tract upset. Sometimes the word dyspepsia is used in place of indigestion. The overall prevalence of ranges from 11.5 to 14.7%. About 30 % population in the West experience dyspepsia at some time or another. While the health care financial burden of dyspepsia ranges up to 18 billion U.S Dollars in the united states, apart from social burdens like missed jobs and reduced work efficiency.

Indigestion is usually presenting with symptoms like postprandial nausea and occasionally emesis; upper abdominal bloating, epigastric pain, fullness, or discomfort; belching and flatulence; and, less commonly, a bad taste in the mouth, a coated tongue, fatigue, somnolence, retrosternal burning or headache. Functional dyspepsia is characterized by epigastric pain that lasts for 1 month with no organic disease found on endoscopy, which constitutes about 70% of patients with dyspepsia in which no identifiable risk factor has been found (organic, systemic, or metabolic).

The most common cause of indigestion is gastroesophageal reflux disease and functional dyspepsia. Other causes are the result of organic illness. The risk of developing indigestion is increased with excessive consumption of alcohol, NSAID use, emotional stress that includes anxiety and depression, smoking, too much caffeine, obesity, etc.

1. Upper gastrointestinal disorders Peptic ulcer diseaseOesophageal spasm Acute gastritis Non-ulcer dyspepsiaGallstone irritable bowel syndrome	2. Other gastrointestinal disorders pancreatic disease (cancer, chronic pancreatitis)hepatic disease (hepatic metastases colonic carcinoma
3. Renal disease renal failure hypercalcemia	4. Drugs NSAIDsIron and potassium supplements CorticosteroidsDigoxin

Clinical evaluation

A thorough history and physical examination are to be conducted on every patient presenting with chronic indigestion. One should look for alarm symptoms. While doing the investigation, an algorithm is to be followed as given below.

1. Odynophagia or dysphagia	2. Jaundice
3. Unexplained weight loss	4. Palpable mass or adenopathy
5. Recurrent vomiting	6. Family history of gastroesophageal malignancy
7. Occult or gross gastrointestinal bleeding

Table-1 Alarm symptoms when treating a patient with dyspepsia

Differential diagnosis

A patient who has symptoms of dyspepsia and has not gone to any investigation is termed uninvestigated dyspepsia. The investigated patients have five 5 major differential diagnosis that includes, gastroesophageal reflux (with or without esophagitis), medications, functional dyspepsia, chronic peptic ulcer disease (PUD), and malignancy. While the minority of the patient is diagnosed with pancreatic or hepatobiliary tract disease, motility disorders, infiltrative diseases of the stomach (e.g., eosinophilic gastritis, Crohn’s disease, sarcoidosis), celiac disease, intestinal angina, small intestine bacterial overgrowth (SIBO), irritable bowel syndrome (IBS), metabolic disturbances (e.g., hypercalcemia, heavy metal), diabetic radiculopathy, hernia, and abdominal wall pain.

General management

• For mild indigestion, careful evaluation and reassurance are required.
• Drugs especially NSAIDs which cause indigestion should be stopped or narrowed down intake.
• Persons with GERD should limit the consumption of alcohol, caffeine, and smoking, avoid heavy meals before bedtime, and raise the head end of the bed.

Homeopathic management

According to the homeopathic concept of diseases, indigestion may be regarded as indisposition when it occurs due to some fault in diet and regimen. Indigestion is improved by some changes in diet and regimen.

Indigestion is to be considered a pseudo-chronic disease when to continues exposure to avoidable noxious influences i.e., NSAIDs, coffee, smoking, etc. This condition can be helped by an improved mode of living.

While the other conditions arise as natural chronic diseases which should be treated with appropriate anti-psoric remedies.

Few homeopathic medicines for indigestion with their indication

Nux vomica: Gastric complaint in sedentary person, after coffee, tobacco, alcoholic drinks, overeating; eructation sour, bitter. Pressure in the stomach one or two hours after eating.

Carbo vegetabilis: Indigestion after excessive drinking. Flatulence abdomen feels distended eructation gives temporary relief. Eructation, heaviness, fullness, and sleepiness.

Bryonia: Complaints in hot summer weather; from cold drinks or ice. Pressure as from stone at the pit of stomach; relieved by eructation. Nausea and faintness on rising.

Abies nigra: Dyspeptic complaints of old people. Pain in the stomach after eating. Total loss of appetite in the morning.

Pulsatilla: Eructation with a taste of food, remains after a long time. Heartburn. Dyspepsia great tightness after every meal; must lose clothing. All gone sensation in tea drinkers.

Antimonium crudum: Gastric complaints from over-eating; stomach weak digestion easily disturbed. Complaints after bread, pastry, acids, vinegar, in hot weather. Belching testing of ingesta. Bloating after eating.

Lycopodium: Excessive accumulation of flatulence especially in the lower abdomen; constant sensation of satiety, even after a few mouthfuls fill up to the throat and he feels bloated.

Alumina: Chronic eructation for years; worse in the evening. Heartburn; feels constricted. Eat small morsels of food.

Anacardium: weak digestion with fullness and distention. Empty feeling in my stomach. Eating relieves dyspepsia.

Rubrics are useful in cases of indigestion-

                Kent’s repertory

                Stomach; eructations

                Stomach; indigestion

                Abdomen; distension

                Abdomen; distention, eating after

                Stomach; heartburn

Boger’s Boenninghausen’s characteristics and repertory

                Eructation

                Waterbrash and heartburn

                Stomach; epigastrium, pain, aggravates Eating after

VEGE-TAB is a homeopathy medicine, it helps with indigestion and acidity problems. If you are facing any issue related to indigestion then you can try this remedy. It is totally safe and free from side effects.

Introduction

Acne is also known as a pimple in layman’s terms.

Acne Vulgaris is one of the most common skin disorders – if not common, it has been evident in 70% of the population at some stage during their adolescence, occurs mainly due to occlusion of the sebaceous gland which may be due to hair, sebum, and dirt including bacteria and dead skin cells.

It’s a chronic inflammatory disease of the pilosebaceous unit. 

Open pores when gets blocked usually present as open comedones (blackhead) and closed come dome (white head).

About 80% of people ages 11 to 30 will have some or the other mild form of acne, and most people are affected by it at some point in their lives.

Area affected mostly includes the face, arms, chest, and upper back.

Pathophysiology of acne

Acne occurs due to the involvement of the sebaceous gland, as well as the pro-inflammatory activity of the cutaneous microbiome.

• The pathophysiology involves three actors, hyper seborrhoea, abnormal follicular keratinization, and Propionibacterium acnes proliferation in the pilosebaceous unit. 
• As a result of their interaction, the cutaneous microenvironment changes and leads to inflammatory reactions of the host that foster acne lesion progression.
• It involves different factors resulting in inflammation and the formation of different types of acne lesions. 
• These factors include the quantitative and qualitative alteration of the sebum during puberty, called dysmenorrhoea, triggered by internal factors such as hormonal or genetic factors, and external factors such as comedogenic cosmetics, aggressive detergents or drugs, which may stimulate mechanisms involved in the pathophysiologies of acne. 
• The impact of stress and diet on dysmenorrhoea remains to be elucidated. Sebum production is induced by different receptors expressed by the sebaceous gland. In addition to the well-described histamine receptor activated by histamines, the hormonal DHT receptor, activated by androgens, and the neuromodulator receptor, mainly substance P and corticotrophin-releasing hormone (CRH) receptor which are mainly activated by stress.
• Therefore, increased sebum excretion, alteration of lipid composition, and the oxidant/antioxidant ratio characteristic of the skin surface lipids are major concurrent events associated with the development of acne.  If sebum interferes with the process of follicular keratinization in the pilosebaceous unit, pore blockage may occur, contributing to lesion formation and acne.
  • Extreme caloric restriction dramatically decreases the sebum excretion rate and these changes can be reversed when a normal diet is resumed. Various studies have demonstrated that increased consumption of dietary fat or carbohydrate increases sebum production and modifications to the type of carbohydrate can also alter sebum composition. o Typical western diet, comprised of milk and hyperglycaemic foods, may have potentiating effects on serum insulin and insulin-like growth factor-I (IGF-I) levels, thereby promoting the development of acne.
• There is an association between the local overproduction of active androgens and acne.
  • Acne patients produced higher rates of testosterone and 5α-dihydrotestosterone (5α-DHT) in their skin than healthy individuals. High testosterone levels have been implicated with enhanced sebaceous gland activity in humans and consequently with diseases marked by hyper seborrhea, such as Acne vulgaris. However, only a few patients with androgenic disorders exhibit hyperandrogenemia, an observation that indicates the predominance of peripheral tissue events for the occurrence of clinical signs.
• Dehydroepiandrosterone (DHEA) has been also shown to regulate sebum production, especially in postmenopausal women. Consequently, several researchers have suggested the use of DHEA as an anti-aging agent. However, in in vitro experiments DHEA has been shown to have no direct effect on the biological activity of human sebocytes
• Inflammation is regarded as a key component of the pathogenesis of acne.
• An increase in IL-1 activity occurs before the hyperproliferation around uninvolved follicles and this triggers the activation of the keratinocytes

Therefore, we can sum up the factors that can cause acne and/or make it worse:

• Fluctuating hormone levels around the time of a woman’s period.
• Picking at acne sores.
• Clothing and headgear, like hats and sports helmets.
• Air pollution and certain weather conditions, especially high humidity.
• Using oily or greasy personal care products (like heavy lotions, creams, or hair pomades and waxes) or working in an area where you routinely come in contact with grease (such as working at a restaurant where there are greasy food surfaces and frying oil).
• Stress, which increases the hormone cortisol, can also cause acne to flare.
• Certain medications.
• Genetics.

Clinical features

• It is largely a hormonal condition that’s driven by androgen hormones, which typically become active during the teenage and young adult years. Many people continue struggling with acne into their 20s, 30s, and beyond. Some even develop acne for the first time as adults.
• The most common spots of acne are over the face, forehead, chest, shoulders, and upper back. Oil glands are all over your body, but those are the places where there are the most. Female patients may more frequently develop lesions on the lower third of the face, especially on the chin and jawline.
• Acne lesions range from comedones to papules and pustules, cysts, and/or nodules. In one study of post-adolescent acne, 85% of patients had mostly come donal acne with two subtypes identified as persistent and late-onset acne. Persistent acne, which is defined as acne that persists beyond adolescence into adulthood, accounts for 80% of cases in adult female patients. Late-onset acne is defined as acne that begins after the age of 25 years.
• This problem in women can occur at any age and with varying degrees of severity. Women with signs of hyperandrogenism such as hirsutism or menstrual irregularities and those with true late-onset acne should be further evaluated for an underlying endocrine disorder such as PCOS.
• For most of those affected, the disorder is annoying and may be troublesome, but is not of enormous significance because it is limited in extent and only lasts a few months or at the most a year. For the unfortunate few, the condition is a disaster, as it is disfiguring, disabling and persistent, with wave after wave of new lesions.
• It improves in the summertime and sun exposure seems to improve the condition of many patients. However, the heat does not produce improvement and, indeed, can make it much worse
• Too much sebum in a follicle can cause a hardened plug to form, which can then lead to various forms of acne.

Different forms of acne include:

• Blackheads: Open pores on the skin filled with excess oil, dead skin, and hair. They get clogged by the dirt that causes them to appear as dark spots.
• Whiteheads: Bumps that remain closed by oil and dead skin.
• Papules: Small red or pink bumps initially that may become inflamed later.
• Pustules: Pimples filled with pus and can cause scarring if plucked or scratches. They look like whiteheads surrounded by red rings.
• Nodular: large and painful solid pimples that are deep in the skin.
• Cystic lesions: Pus-filled pimples that can cause scars.

Grading of acne based on the severity

• Grade 1 (mild): mostly whiteheads and blackheads, with a few papules and pustules.
• Grade 2 (moderate, or pustular acne): multiple papules and pustules, mostly on your face.
• Grade 3 (moderately severe, or nodulocystic acne): numerous papules and pustules, along with occasionally inflamed nodules. Your back and chest may also be affected.
• Grade 4 (severe nodulocystic acne): numerous large, painful, and inflamed pustules and nodules.

Differential Diagnosis

• Warts
• Acne Rosacea
• Seborrheic dermatitis

General Management

The best way to treat acne depends on how severe it is. 

• Dietetic and social restrictions are typical, as is more frequent washing.
• Treatment may be aimed at: 
  • Reducing the bacterial population of the hair follicles to cut down the hydrolysis of lipids (antimicrobial agents). Encouraging the shedding of the follicular horny plugs to free the obstruction (comedolytic agents). reducing the rate of sebum production, either directly by acting on the sebaceous glands or indirectly by inhibiting the effects of androgens on the sebaceous glands (anti-androgens).
  • Reducing the damaging effects of acne inflammation on the skin with anti-inflammatory agents.
• Patients with acne are often depressed and may need sympathetic counseling and support. 
• There is no evidence that particular foodstuffs have any deleterious effect or that washing vigorously will help remove lesions. These and other myths should be dispelled and replaced with a straightforward explanation of the nature of the disorder, its natural history, and treatment.

Homeopathic Management

As Master Samuel Hahnemann said in his Organon of Medicine, 6^th Edition, §173 “The only diseases that seem to have but few symptoms, and on that account to be less amenable to cure, are those which may be termed one-sided, because they display only one or two principal symptoms which obscure almost all the others. They belong chiefly to the class of chronic diseases”.

Acne, being an outward manifestation of internal malady has to be treated from its root cause, therefore it is necessary to administer proper similimum in order to achieve cure.

Based on individualization, there are various medicines in our materia medica that not only reduce the current symptoms of acne but also help in reducing the intensity and severity of acne lesions.

• Antim crudum.
• Hepar sulphuricum.
• Silicea.
• Kalium bromatum
• Kalium carbonicum
• Asteria rubens
• Calcarea silicatum
• Belladonna
• Sulphur
• Graphitis
• Dulcamara
• Pulsatilla
• Merc solubilis, etc

Introduction

Master Samuel Hahnemann was the first who began a thorough investigation into the pathogenetic effect and therapeutic uses of biochemic medicines. It was his proof of lime, salt, potash, and silica that prepared the way for the rest of the tissue remedy. It was Dr. Wilhelm Schuessler of Germany, who uses these suggestions and give the idea to make a new system. In 1873 with the publication of his article “Abridged Homoeopathic therapeutics” this new system come to light.  Soon after C. Hering published his work “Twelve tissue remedies”. But Dr. Schussler later denies any connection with homeopathy and insists that his method is not based on homeopathic law, but upon physiologic-chemical processes that take place within the organism.

Concept of tissue remedy

The main idea on which biochemic therapeutics is based is the physiological fact that both the structure and vitality of the organs of the body are dependent upon certain necessary quantities and proper apportionment of its organic constituents.

Inorganic constituents of cells

The main inorganic material of nerve cells is magnesium phos, kali phos, natrum, and ferrum. Muscle cells contain the same with the addition of kali mur. Connective tissue cells have for their specific substance silica, while elastic tissue has Calcarea fluor. In bone cells, we have Calcarea fluor and magnesia phos. And large proportion of calcarea phos. Cartilage and mucus cells have their specific inorganic material natrum mur.

Concept of health disease and cure according to biochemic system of medicine

Health is considered a state of normal cell metamorphosis; as the normal functioning of the body there is a building of new cells and the destruction of old ones, and the elimination of useless material occurs. This whole process is done by digestion of food and drinks which recompense the blood for the loss, it sustains by furnishing nutritive material to the tissues. Under this condition, there is a building of new cells and the destruction of old ones. 

The disease is the result of a disturbance of the molecular motion of one of the inorganic tissue salts. The cure consists of the restoration of the equilibrium of the molecular motion by furnishing a minimal dose of the same inorganic substance.

Every normal cell has the faculty of absorbing or rejecting certain substances. This property is diminished or suspended when the cell has suffered a loss in one of its salts as a consequence of any irritation. As soon as this deficiency is made good by a supply of a homogeneous material from the immediate nutritive soil, the equilibrium is re-established. But if the supply is not offered spontaneously, it is to be assumed that the needful salt is lacking in quantity, or, on the other hand, that the diseased cells have suffered a physical alteration besides, which precludes the entrance of the required tissue salt. In such a case the salt must be offered in a more diluted state, that is, a higher trituration.

If the altered cells regain their integrity by recovering their loss, they can again perform their normal functions and bring about the removal by chemical processes of morbid products, exudations, etc. The biochemical therapeutics aids nature in her efforts to cure by supplying the natural remedies lacking in certain parts, that is, the inorganic cell salts, and in this way corrects abnormal states of physiological chemistry.

Dose, or quantity of tissue salt required to re-establish normal cell equilibrium

Administration of medicine

Biochemic remedies are administered in minimal doses. Usual useful doses are 5^th, 6^th, 7^th, 8^th decimal trituration. The most frequently used is the 6^th decimal trituration.

Biochemic medicine may be administered dry on the tongue or dissolved in a spoonful of water.

Frequency of doses

In acute cases, a dose every hour or two; in severe, painful affections, a dose every ten to fifteen minutes; in chronic affections, one to four doses daily.

The uses of twelve Biochemic medicine with indications

1. Calcarea fluorica

A disturbance of equilibrium of these molecules results in prolapse, dilation, and relaxed condition of elastic fibers. It is used for prolapsed organs, varicose veins, hemorrhoids, and vascular tumors. Hard swelling and bone derangement often call for Calc. Fluor.

• Calcium phosphorica

The inability of the body to assimilate and utilize this salt results in difficult dentition at a young age, slow development, and general debility. It is the best tonic after exhausting illness and is employed in T.B. cases, bone diseases, emaciation, anemia, painful and difficult menses, and for conditions of puberty.

• Calcium sulphurica

The sphere of this remedy comes under the healing of suppurative tissue. Used for mattery discharges, abscesses, boils, ulcers, blood disorders, rheumatism, etc.

• Ferrum phosphoricum

It is used for ailments arising from disturbed or sluggish circulation. Used in fever and inflammations. An ideal remedy for pain accompanied by heat, redness, throbbing pulse, and congestion. Good for colds, diarrhea, hemorrhages, rheumatism, nose bleed, simple catarrh, bed-wetting, etc.

• Kali muriaticum

Used in all ailments accompanied by grey or white coating of tongue, thick white discharge and expectorations, skin diseases, colitis, dysentery, etc. ailments characterized by exudations, infiltrations, swellings, and the later stages of acute illness.

• Kali phosphoricum

The supreme remedy for nervous disorders and nervous debility. For lack of nervous energy, brain fatigue, neurasthenia, insomnia, lack of confidence, irritability, hysteria, melancholy, gloominess, tearfulness (with Nat. Mur.), nervous headaches, pain in the limbs, offensive ulcers, and offensive discharges.

• Kali sulphuricum

Indicated when the tongue is yellow-coated. In the last stage of cold and cough when expectoration is easy. Skin is oily, peels easily, and has yellow or greenish discharge. The person is worse in a heated atmosphere and towards evening. Useful in catarrhal condition, and leucorrhea when discharge is yellow.

• Magnesia phosphorica

The ailments are relieved by the application of heat. A chief remedy for spasmodic conditions: ailments accompanied by sharp, shooting, stabbing pains. Ailments which it has been employed with success are flatulence, colic, St. Vitus’s Dance, neuralgia, neurasthenia, palpitation, toothache, writer’s cramp, etc. a fine remedy for tummy pains of babies. A few tablets of Mag. Phos. Dissolved in hot water, and taken in sips, will usually relieve distressing flatulence.

• Natrum muriaticum

It is the first remedy to think of for anemia and malnutrition. Used for headaches, indigestion, vomiting, thin catarrh, cold with watery discharge, watery blisters, constipation, mental anxiety, and disorders due to mal-assimilation.

1. Natrum phosphoricum

The biochemic anta-acid. Used for all disorders due to acidity and acid condition of the body. Used for acid dyspepsia, sour risings, acid diarrhea, rheumatic disorders, nervous troubles, and worms. A sure guide for indication is the thick yellow-coated tongue. Good for children who have acidity from eating too many sweets and cakes.

1. Natrum sulphuricum

A great remedy for the liver and kidneys. Usually indicated in people who are worse in damp weather. It is used in all liver troubles, biliousness, sick headache, migraine, vomiting of bile, bitter taste in the mouth, diarrhea, influenza, intermittent fever, gravel, poor kidney function, dropsy, etc.

1. Silica

This remedy is used to promote the formulation of pus and suppuration. Used for abscesses and for boils that will not discharge. Has produced wonderful results in the more advanced diseases of the nervous system, forms of paralysis, spasms, rheumatic pains in the limbs, etc. it is also advised for those who lack self-confidence and courage and have an inferiority complex.

Homeonest Calcigen Tablets are the best homeopathic medicine that improves energy balance due to chromium. The risk of developing osteoporosis increases as people grow older, and women may lose bone mass quickly However, the Homeonest Calcigen Tablets product aids in the treatment of calcium deficiency.

What is Cholesterol?

Cholesterol is a lipophilic molecule that is essential for the normal functioning of cells as well as for successful cellular homeostasis. Cholesterol functions as a precursor molecule in the synthesis of vitamin D, steroid hormones (e.g., cortisol and aldosterone and adrenal androgens), and sex hormones (e.g., testosterone, estrogens, and progesterone).  While cholesterol is central to many healthy cell functions, it also can harm the body if it is allowed to reach abnormal blood concentrations. Interestingly, when LDL-cholesterol levels are too high, the condition is referred to as hypercholesterolemia.

Hypercholesterolemia (high LDL-cholesterol) is one of the major modifiable risk factors, contributing to the formation of atherosclerotic plaques. That causes an increased risk of Cerebrovascular diseases, Coronary artery disease, aortic aneurysms, and peripheral arterial diseases.

It observed that nearly three fourth of the Indian population is suffering from some or other kind of dyslipidemia, where hypercholesterolemia accounts for 13.9%, hypertriglyceridemia affects 29.5%, low level of HDL-C in 72.3% and high LDL-C in 11.8%.

India has seen a rapid increase in the prevalence of cerebrovascular diseases, accounting for around 24% of all deaths, aged 25–69 years. Cerebrovascular diseases tend to occur at a younger age in Indians, with 10% of all heart attacks in people. Below 40 years and more than 50% of cardiovascular deaths in people below 70 years of age. The age-standardized estimates for disability-adjusted life-years (DALYs) lost due to coronary artery diseases are three times higher in India than in developed countries.

Several factors can lead to increased LDL levels. Some of these factors include genetics, diet, stress, sedentary lifestyle, medications, and other disorders such as nephrotic syndrome and hypothyroidism.

While considering the clinical presentation, on clinical examination, look for absent pulses, bruits, arcus senilis (younger than 50 years of age), tendon xanthoma, xanthelasma, and aortic stenosis are all stigmata of very high cholesterol levels as in familial hypercholesterolemia.

How it Manage?

High cholesterol levels can be managed with a healthy diet and lifestyle modifications with the possible addition of lipid-lowering medications, or a combination of both. Patients with mild hyperlipidemia should consume a low-fat and low-carbohydrate diet and perform moderate to high-intensity physical activity (30 minutes per day for 5 to 6 days/ week), avoid tobacco, smoking, and alcohol, lower blood pressure and lose weight (if you are overweight or obese) all have proven to be very advantageous in regards to lowering vascular disease risk. Therefore, theoretically, a lifestyle change alone may be sufficient to lower elevated LDL cholesterol levels, without the use of any cholesterol-lowering medications, such as statins.  

The Dean Ornish–style diet is also recommended to reduce cholesterol levels which include a vegetarian diet consisting of fruits, vegetables, soybean products, nonfat milk, and yogurt with no oils or animal products.

How Homeopathic control Cholesterol?

Homeopathy is a rapidly growing holistic system of treatment being practiced by using natural substances such as plants and minerals to correct psychophysiological factors all over the world. Its strength lies in its evident effectiveness as it takes a holistic approach toward the sick individual through the promotion of inner balance at mental, emotional, spiritual, and physical levels.

The goal of homeopathy is to reduce high cholesterol levels to prevent coronary heart disease by assisting the body in healing the underlying illness. Homeopathic treatment can help to lower LDL cholesterol levels and can increase HDL cholesterol. 

There are studies that show the promising result of homeopathic medicines in reducing the triglyceride level, in long follow-ups. Another case report shows the lipid-lowering property of homeopathic medicine (namely Fucus vesiculosus). Another study shows the lipid-lowering property of homeopathy medicine (namely  Syzygium jambolanum), in diabetic rats.

Classification of disease according to Organon of medicine and selection of medicine

According to the Homoeopathic concept of diseases, high cholesterol levels can be considered a pseudo-chronic disease. If a person continues to take an unhealthy diet (eating too much-saturated fat or trans fats. (Aphorism 77) or it can be considered as Psoric miasmatic disease when due to genetic factors i.e. Familial hypercholesterolemia.

Conclusion

Hypercholesteremia is associated with many diseases, including arterial thrombotic disease i.e. coronary artery disease. Reducing the value of cholesterol can lead to improved morbidity and mortality. Homoeopathy shows better disease outcomes in many diseases and also shows a lipid-lowering property. Further, it is concluded that a research study with a robust design is to be conducted to show the better outcome of homeopathic medicines in controlling cholesterol levels.

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