In homeopathy there r so many medicine which will work ...like bella , bry , gels ‹ stress Glonoinum -throbing pain Spigelia -throbing pain Lach -congestive headache K.p- intelectual work, over work or mental exertion Coffeea cruda -sleeplessness , over active thoughts Sil- forhead affection Sangunaria Nux vom N.m Iris versicolor etc... Here in this case i think N.M , Nux Vom or china somewhere covers the totality...
रोगी सूर्यावृत से पीड़ित है। चिकित्सा संबंधी योग,,,, रोगी को सुबह गर्म जलेबी खिलाएं सूर्य उदय से पूर्व। तगर 50 ग्राम जटामांसी 25 ग्राम लेकर दोनों का पाउडर बनाकर 5 ग्राम सुबह-शाम खाने से पहले दें। निश्चित रूप से लाभ होगा। योग परिक्षित है। पिछले 40 वर्ष से प्रयोग कर रहा हूं।
Dear Dr. Surya Mehra , Advice for the case. Tab. Shirah Shuladi Vajra Ras . Shadbindu tail Pratimarsh Nashyam. Jelebi with warm milk early in the morning.
Investigations as suggested by dr. Batt will help to confirm or rule out the possible differential diagnosis as suggested by dr. Mohanty.
Virechana Pathyadi khada Shirashoola vajra rasa Rasnadi lepa on forehead
X-ray pns, vision check up, blood pressure, and rule out anxiety
Cephagrain tablet and nasal drop can be advised.
D/D Cluster headache Migraine
Thinking too much... needs counselling calmness symphony music lime juice pineapple with black pepper sprouts kalijeeri alkaline diet beetroot coriander juice awla.. pomegranates cucumber dates figs apricots carrots raisins... All this for digestion sweet potato for pancreas peach
Ask abt headache doctor is it from eye to frontal head means its Badiaga covers or directly from frontal means Natrum Mur 1M will help
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A 24-year-old man developed unilateral supraorbital pain, lacrimation, conjunctival hyperemia, nasal congestion, proptosis, and painful eye movements. The pain intensity varied over the course of each day and disappeared after 1 month. He had multiple attacks responsive to prednisone that were separated by months over the ensuing 6 years. Neuroimaging revealed an enlarged extraocular muscle. Plz, suggest the line of treatment.Dr. Kabir Khatri1 Like13 Answers
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Female Pt of age 24years C/O Migraine on the right side , including pain in the eyes and temporal region.. No history of Dental or medical problems CT is completely normal.. What should be the next treatment plan..Pls guide me doctorsDr. Kavin Prasad Bds ,Pg Dip In Fc Ortho3 Likes12 Answers
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### 30 years old lady presents with severe headache since 6 months. Other examination findings are WNL. NECT Head report is also normal. CT PNS report is as follows. Further management ???Dr. Shofique Anowar0 Like6 Answers
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Sinusitis-Management and Prevention -------------------------------------------------------- by Dr Sunil. Sinusitis is infl ammation of the mucous membranes lining one or more of the paranasal sinuses. The various presentations are as folllows: ● Acute sinusitis: infection lasting less than 30 days, with complete resolution of symptoms ● Subacute infection: lasts from 30 to 90 days, with complete resolution of symptoms ● Recurrent acute infection: episodes of acute infection lasting less than 30 days, with resolution of symptoms, which recur at intervals of at least 10 days apart ● Chronic sinusitis: infl ammation lasting more than 90 days, with persistent upper respiratory symptoms ● Acute bacterial sinusitis superimposed on chronic sinusitis: new symptoms that occur in patients with residual symptoms from prior infection(s). With treatment, the new symptoms resolve but the residual ones do not. PHYSICAL FINDINGS AND CLINICAL PRESENTATION ● Patients often give a history of a recent upper respiratory illness with some improvement, then a relapse. ● Mucopurulent secretions in the nasal passage ● Purulent nasal and postnasal discharge lasting more than 7 to 10 days ● Facial tightness, pressure, or pain ● Nasal obstruction ● Headache ● Decreased sense of smell ● Purulent pharyngeal secretions, brought up with cough, often worse at night ● Erythema, swelling, and tenderness over the infected sinus in a small proportion of patients ● Diagnosis cannot be excluded by the absence of such findings. ● These fi ndings are not common, and do not correlate with number of positive sinus aspirates. ● Intermittent low-grade fever in about one half of adults with acute bacterial sinusitis ● Toothache is a common complaint when the maxillary sinus is involved. ● Periorbital cellulitis and excessive tearing with ethmoid sinusitis ● Orbital extension of infection: chemosis, proptosis, impaired extraocular movements. Characteristics of acute sinusitis in children with upper respiratory tract infections: ● Persistence of symptoms ● Cough ● Bad breath ● Symptoms of chronic sinusitis (may or may not be present) ● Nasal or postnasal discharge ● Fever ● Facial pain or pressure ● Headache ● Nosocomial sinusitis is typically seen in patients with nasogastric tubes or nasotracheal intubation. CAUSE ● Each of the four paranasal sinuses is connected to the nasal cavity by narrow tubes (ostia), 1 to 3 mm in diameter; these drain directly into the nose through the turbinates. The sinuses are lined with a ciliated mucous membrane (mucoperiosteum). ● Acute viral infection ● Infection with the common cold or infl uenza ● Mucosal edema and sinus infl ammation ● Decreased drainage of thick secretions, obstruction of the sinus ostia ● Subsequent entrapment of bacteria a. Multiplication of bacteria b. Secondary bacterial infection Other predisposing factors ● Tumors ● Polyps ● Foreign bodies ● Congenital choanal atresia ● Other entities that cause obstruction of sinus drainage ● Allergies ● Asthma ● Dental infections lead to maxillary sinusitis. ● Viruses recovered alone or in combination with bacteria (in 16% of cases): ● Rhinovirus ● Coronavirus ● Adenovirus ● Parainfluenza virus ● Respiratory syncytial virus ● The principal bacterial pathogens in sinusitis are Streptococcus pneumoniae, nontypeable Haemophilus influenzae, and Moraxella catarrhalis. ● In the remainder of cases, fi ndings include Streptococcus pyogenes, Staphylococcus aureus, alpha-hemolytic streptococci, and mixed anaerobic infections (Peptostreptococcus, Fusobacterium, Bacteroides, Prevotella). Infection is polymicrobial in about one third of cases. ● Anaerobic infections seen more often in cases of chronic sinusitis and in cases associated with dental infection; anaerobes are unlikely pathogens in sinusitis in children. ● Fungal pathogens are isolated with increasing frequency in immunocompromised patients but remain uncommon pathogens in the paranasal sinuses. Fungal pathogens include Aspergillus, Pseudallescheria, Sporothrix, phaeohyphomycoses, Zygomycetes. ● Nosocomial infections occur in patients with nasogastric tubes, nasotracheal intubation, cystic fi brosis, or those who are immunocompromised. ● S. aureus ● Pseudomonas aeruginosa ● Klebsiella pneumoniae ● Enterobacter spp. ● Proteus mirabilis Organisms typically isolated in chronic sinusitis: ● S. aureus ● S. pneumoniae ● H. infl uenzae ● P. aeruginosa ● Anaerobes DIFFERENTIAL DIAGNOSIS ● Migraine headache ● Cluster headache ● Dental infection ● Trigeminal neuralgia WORKUP ● Water’s projection: sinus radiograph ● CT scan ● Much more sensitive than plain radiographs in detecting acute changes and disease in the sinuses ● Recommended for patients requiring surgical intervention, including sinus aspiration; it is a useful adjunct to guide therapy. ● Transillumination ● Used for diagnosis of frontal and maxillary sinusitis ● Place transilluminator in the mouth or against cheek to assess maxillary sinuses, and under the medial aspect of the supraorbital ridge to assess frontal sinuses. ● Absence of light transmission indicates that sinus is filled with fluid. ● Dullness (decreased light transmission) is less helpful in diagnosing infection. ● Endoscopy ● Used to visualize secretions coming from the ostia of infected sinuses ● Culture collection via endoscopy often contaminated by nasal flora; not nearly as good as sinus puncture ● Sinus puncture ● Gold standard for collecting sinus cultures ● Generally reserved for treatment failures, suspected intracranial extension, nosocomial sinusitis. TREATMENT Nonpharmacologic therapy ● Sinus drainage ● Nasal vasoconstrictors, such as phenylephrine nose drops, 0.25% or 0.5% ● Topical decongestants should not be used for more than a few days because of the risk of rebound congestion. ● Systemic decongestants ● Nasal or systemic corticosteroids, such as nasal beclomethasone, short-course oral prednisone ● Nasal irrigation, with hypertonic or normal saline (saline may act as a mild vasoconstrictor of nasal blood fl ow) ● Use of antihistamines has no proved benefi t, and the drying effect on the mucous membranes may cause crusting, which blocks the ostia, thus interfering with sinus drainage. ● Analgesics, antipyretics. Antimicrobial therapy ● Most cases of acute sinusitis have a viral cause and will resolve within 2 weeks without antibiotics. ● Current treatment recommendations favor symptomatic treatment for those with mild symptoms. ● Antibiotics should be reserved for those with moderate to severe symptoms who meet the criteria for diagnosis of bacterial sinusitis. ● Antibiotic therapy is usually empirical, targeting the common pathogens. ● First-line antibiotics include amoxicillin, TMP-SMZ. ● Second-line antibiotics include clarithromycin, azithromycin, amoxicillin-clavulanate, cefuroxime axetil, loracarbef, ciprofloxacin, levofloxacin. ● For patients with uncomplicated acute sinusitis, the less expensive first-line agents appear to be as effective as the costlier second-line agents. Surgery ● Surgical drainage indicated ● If intracranial or orbital complications suspected ● For many cases of frontal and sphenoid sinusitis ● For chronic sinusitis recalcitrant to medical therapy ● Surgical débridement imperative for treatment of fungal sinusitis Regards Dr SunilDr. Sunil Kumar5 Likes3 Answers
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30 year old lady with recurrent headaches, more in the evening. headache more on left side for last 4 months. no sinus tenderness. CT normal. what could be the other causes and how to manageDr. Anirudh Mishra1 Like40 Answers