N_diseases – Dr Sanjeev Chawla

Diseases Starting with N

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Nasal Polyps

Definition:
A polyp is a swelling of the lining (mucosa) of the nose and the para-nasal sinuses. Polyps generally occur due to long-standing inflammation of the lining of the nose and of the sinuses surrounding the nasal cavity (para-nasal sinuses).
Symptoms:
Polyps look like small grapes deep inside the nasal cavity and can appear singly or in clusters. They are collections of inflammatory cells, fluid and tissue.
Common symptoms associated with polyps are:
Nose-block forcing an individual to breathe through the mouth
Runny nose and sneezing
Reduced sense of smell and taste, etc.
Homeopathic treatment:
Homeopathic treatment is targeted towards the root cause of the illness and hence the disease is treated from the core. Homeopathy believes in treating the patient and not just the disease.
Suggestion about homeopathic treatment:
Homeopathy is strongly recommended for management of nasal polyps, especially when they are small in size. Timely administered homeopathy medicines help avoid surgery and its inherent complications. Moreover, it is very common for the condition to recur even after surgery. Homeopathy also has preventive role to offer, by which chance of recurrence is minimized.

Neuritis

Neurofibromatosis

Definition:
Neurofibromatosis, also called as von Recklinghausen’s disease, is a genetically inherited disease of nerve tissue. It causes tumors to grow on nerves (neurofibromas) that lie on or under the skin anywhere in the body. It affects the development and growth of nerve cell tissues. The tumors are usually benign (non cancerous). Even so, in some cases they can be disfiguring. They tend to grow in many numbers and varying size, over the period of years.
Types of Neurofibromatosis:
There are two types of neurofibromatosis:-
NF1- It is most common type of neurofibromatosis. It is caused by the mutation of the chromosome 17 affecting 1 in every 2,500-4,000 births. It mainly affects peripheral nerves associated with café-au-lait spots on the skin. Café-au-lait spots are light brown in color like coffee in milk. It is also known as von Recklinghausen disease.
NF2- It is rare type of neurofibromatosis. It is caused by the mutation of the chromosome 22 affecting 1 in every 25,000. It mainly affects VIII cranial nerve (auditory-vestibular nerve) which passes information from inner ear to the brain. It causes hearing loss, ringing in ear and problem with balance.
Causes:
Neurofibromatosis is a genetically inherited disease. If either parent has neurofibromatosis, then there are 50% chance of having the disease in their children.
Neurofibromatosis also appears in families with no previous history of the condition. It results from change (mutation) in the genetic material of the sperm or egg during the time of conception.

Signs and Symptoms:
Café-au-lait spots: These are light brown in color like coffee in milk. If there are six or more Café-au-lait spots on the body then the chances of neurofibromatosis may be suspected. Such spots would precede tumors in any part of the body, not at the place of the spots.
Neurofibromas: These are generally benign tumors which grow on nerves that lie on or under the skin anywhere in the body. They appear as lumps under the skin. It is likely to increase in size and number as the child gets older. Tumors are soft in nature.
Lisch nodules: It is very small spots of brown color which appear in the iris of the eye. It generally has no symptoms.
Acoustic neuroma: It is the most common type of the brain tumor which generally develop on the VIII cranial nerve (auditory-vestibular nerve) which passes information from inner ear to the brain. It is also known as vestibular schwannoma. When these tumor grow in size it causes- hearing loss, ringing in ear and problem with balance, facial weakness, facial numbness, vertigo.
Freckles: These are small light brown spot on the skin which becomes more pronounced after sun exposure. In neurofibromatosis cases these freckles are found on uncommon places such as groin region, under breast and armpits.

Diagnosis:
Diagnosis is mainly done by physical examination and enquiring about the family history of neurofibromatosis. One should have at least two of the following signs and symptoms to diagnose with neurofibromatosis.
Café-au-lait spots- six or more Café-au-lait spots on the body of 5mm or more in size.
Neurofibroma- appearance of two or more Neurofibromas.
Family history of neurofibromatosis.
Freckles on groin region, under breast and armpits
Lisch nodules – At least two Lisch nodules on the iris
Certain skeletal deformities such as scoliosis (forward bending of the spine)
Optic glioma-a tumor on the optic nerve
MRI and X- ray are done for the screening of tumor and skeletal abnormalities. In NF2 – audiometry test for hearing loss.
Treatments:
Most of the time it does not need treatment but if the tumors are painful, disfiguring, growing and compressing the adjacent tissues may need treatment.
Surgery: Large tumor may be removed surgically. Chances of growth of tumor at the same place, after the surgery, are very high. The doctor may remove a tumor and also treat bone abnormalities by surgical means.
Radiation: Radiotherapy is used to shrink tumors.
Chemotherapy: Some drugs are useful in treating tumors.
Counseling – Some patient and family members may experience emotional or psychological issues (sadness, shock, anger, frustration, embarrassment etc.) as a result of neurofibromatosis. They become isolated and withdraw themselves from the society. They may have emotional setback about their appearance.
Family counseling and genetic counseling may help people with neurofibromatosis to be comfortable with themselves and their family members.
Homeopathic approach for Neurofibromatosis:
At Life Force we have treated several cases of Neurofibromatosis. We have observed that this disease cannot be cured with homeopathy. In a few cases we have observed that the growth in size and number remains under control, using homeopathy; which takes many years of treatment. However, we do not have a huge study. We usually do not recommend homeopathy for Neurofibromatosis.

Non-Healing Ulcers

Definition:
Any Non-healing wound or ulcer on skin that has been present for 3-4 weeks duration, without healing is called Non-healing ulcer.
Causes:
Some of the major causes are listed under:
Vascular congestion
Infection (mostly due to resistant bacteria)
Poor nutritional
Diabetes mellitus
Some systemic disease such as SLE (Systemic Lupus)
Unknown causes

Types of Non-Healing Ulcers
There are a few types of Non-healing ulcers:
Pressure ulcers
Venous stasis ulcer
Diabetic Ulcer
Arterial ulcer
Pyoderma gangrenosum
Marjolin’s ulcer
Pressure Ulcers:
Pressure ulcers are formed when skin and tissue are compressed leading to decrease in circulation and oxygen to the area, causing tissue damage, which results in formation of ulcers. Most often found on lower limbs especially heels and buttocks. These are commonly found in people confined to bed or wheelchair, inability to shift positions, poor nutrition, etc.

Venous Stasis ulcer:
Venous stasis ulcers account for 70 to 80 percent of all lower extremity ulcers.Varicose veins, sustained venous hypertension, due to chronic venous insufficiency lead to damage of valves in the legs. This results in tissue swelling, increase in pressure, and formation of venous ulcers. These ulcers are most often found on medial side of ankle, mostly around the maleoli and calf. Pitting oedema is often present and may predate the ulcer.
Management involves assessment of blood flow to the extremity, wound management, compression stockings and/or wraps.
Diabetic Ulcer:
These ulcers result from damage to peripheral nerves due to diabetes. They are most commonly found on bottom of the foot or on the foot.
Arterial ulcer:
These ulcers are due to reduced arterial blood supply to lower limbs. Most common causes are atherosclerosis and peripheral vascular disease. Arterial ulcers develop on the distal extremities and are sharply demarcated and painful with little granulation tissue. Mainly occur on toes, heels, and bony prominences of foot. The toenails thicken and become opaque and maybe lost, Gangrene may set in. Onset can be precipitated by trauma. Management involves assessment of blood flow to the extremity, wound management.
Pyoderma gangrenosum:
These are small ulcers that begin as painful, pus-filled sores that unite into a non-bacterial sore within days. These are usually found on the exterior surfaces of the legs or the face.Pyoderma gangrenosum is an immune-mediated, inflammatory condition commonly associated with inflammatory bowel disease and immuno-deficient states.
Marjolin’s ulcer:
This entity was first described in 1828 by Marjolin, who diagnosed Non-healing ulcers developing in burn scars. Later, Dupuytren found these ulcers to be malignant in nature. Today, the term Marjolin’s ulcer is used to describe a cancer arising from any site of chronic inflammation.
Marjolin’s ulcers occur most often on the extremities and in wounds that have been present for 30 years or more.
Diagnosis:
Diagnosis of Non-healing ulcers is based on physical examination and specific tests such as Biopsy, Magnetic resonance imaging of Non-healing pressure ulcers, Doppler flow-metry of leg arteries or Doppler Ultra-sonography of the lower limb venous system.
Self help for Non-healing ulcers:
Avoid walking barefoot. Wearing compression stockings, skin care (Keep legs and feet clean and dry, lubricate dry skin), avoid cuts, cracks, abrasions. Leg elevation and calf exercise are recommended. Patients are encouraged to decrease their risk factors (e.g., smoking, tobacco, etc.) and to manage co-existing conditions such as diabetes, blood pressure, cholesterol.
Conventional Treatment:
Topical antibacterial agents, Antiseptics, Antibiotics, Skin grafting, Reconstructive surgery, angioplasty, amputation, Hyperbaric oxygen (HBO) therapy.
Diabetic ulcers have a high incidence of infection, which further slows the healing process. Cleansing and semi-permeable foam dressing is recommended along with diabetes control. Venous ulcers are also susceptible to infection. Venous eczema is seen in severe cases.
In Marjolin’s ulcer, wide excision followed by skin grafting is recommended. Elective lymph node dissection has been suggested because of the high rate of metastasis. Finally, amputation may be recommended for recurrent disease, or when a Marjolin’s ulcer is associated with underlying osteomyelitis (ulcerated bone).
Non healing ulcer generally does not respond to conventional therapies in few weeks of treatment.
Homeopathic treatment for Non-healing ulcers
Homeopathy has very good medicines for treating non- healing ulcers.
Homeopathic remedies directly enhance the inherent healing capacity and treat by addressing the underlying causes as described above. All cases are assessed individually and treated according to the underlying etiology.

Nutritional Anemia

Anemia is the most common of all blood disorders. The term anemia (derived from Greek) means a deficiency of blood.
Anemia results from reduced red blood cell production in the bone marrow. Hemoglobin is the oxygen carrying protein in blood. It is a major component of all red blood cells and gives them their red color. This protein picks up oxygen from the lungs, carries it throughout the body and delivers it to all your cells. In addition, hemoglobin also picks up some of the carbon dioxide produced by the cells and transports it to the lungs from where it is exhaled out.
Cells need oxygen for their basic functions and to keep them alive. Hence, without enough red blood cells to transport oxygen to your cells and carbon dioxide away from your cells, it is like literally suffocating every tissue and organ system in the body.
Symptoms of Nutritional Anemia
Symptoms of anemia are usually very vague and hence, it goes undetected in many people. People tend to ignore these symptoms until they become quite disturbing. Thus, it is necessary to know some of the often ignored symptoms:
Tiredness
Pallor (pale appearance)
Rapid heart beats (sensations of pounding heartbeats)
Headache
Dizziness
Shortness of breath
Loss of sex drive
Nervousness
Depression
Poor concentration
Weak memory
Easy bruising of body parts
Slow healing of wounds
Worsening of symptoms of other diseases
Angina – heart pain from insufficient oxygen
Claudication – cramped pains in muscles being used.
Pica – the consumption of non-food items like wax, dirt, paper, grass or hair is often a symptom of anemia.
Must see your physician when?:
You feel tired for more than five days
You are unable to perform routine activities
There is persistent exhaustion with even minimal exertion
The skin appears pale, and there is fatigue plus breathlessness on moderate exertion.
Your tongue appears, smooth, shiny and very clean always
There is yellowish (jaundiced) appearance of the skin.
Your wounds don’t heal soon or when there is presence of bluish-green discolorations under the skin.
Causes of Nutritional anemia:
Causes of anemia can be broadly grouped in to the following categories:
Insufficient production of red blood cells or hemoglobin
Starvation/poverty
Deficient dietary intake of iron, Vitamin B12 and folic acid impairs the bone marrow functions.
Conditions like cancer, chronic illnesses, allergic reactions to prescribed medications, toxic substances, etc.
Inherited defects like Thalessemias and sickle cell disease which cause faulty red blood cell structure thus, hastening red blood cell destruction.
Complete failure of the bone marrow in producing red blood cells is called aplastic anemia
Increased destruction of red blood cells.
Increased destruction of red blood cells means they are destroyed before their normal life span is completed. A normal red blood cell lives for approximately 120 days. Many conditions increase their destruction.
Infectious conditions like malaria Rh-incompatibility in a pregnant mother.
Loss of blood
Increased loss of blood when menstruating Silent duodenal or gastric ulcers (common in immuno-compromised, elderly and diabetics)
Cancers of the intestines
Any disorder which impairs the coagulability of blood (hemophilia)
Some of the most common causes of nutritional anemia are:
Iron deficiency
Vitamin B12 Folic acid deficiencies (these usually occur together)
Thyroid disorders
Lead toxicities
Infectious diseases like malaria
Alcoholism
Vitamin E and B6 deficiencies.
Premature born infants.
Medications which
Prevent iron absorption from the gut e.g. ‘proton pump inhibitors’ in treating acidity, tetracycline etc.
Cause chronic, mild bleeding from the gut e.g. NSAIDs (ibuprofen, naproxen used widely as pain-killers).
Aspirin is another widely used medication known to cause mild to moderate bleeding from the gut.
Hydrocortisones and valproic acid are drugs which cause folic acid deficiencies.
Vitamin B12 deficiency can be caused by drugs like amoxicillin (antibiotic), and phenytoin (anti-convulsive).
Risk factors fro nutritional anemia:
Ones chances of developing anemia increase particularly if they are:
Menstruating and having heavy bleeding or excessively long periods (monthly blood loss depletes iron)
Pregnant
Lactating
Athletes (especially endurance athletes)
An alcoholic
Vegetarians or vegans
Using nonprescription drugs and natural remedies whose side-effects are less known.
Habituated to having tea in excess (tannin in tea causes decreased absorption of iron).
Diagnosis of Nutritional anemia:
Anemia is diagnosed through blood check ups and clinical examination. Your physician can diagnose anemia when told of your symptoms. A simple blood test called “complete blood count (CBC)” maybe advised by your physician. This provides an idea of the hemoglobin count. Other tests required of anemic patients are:
Blood Smear: study the structure of red blood cells with a microscope after preparing a slide smear.
Serum iron, iron binding capacity and Serum ferritin: to detect iron deficiency.
Reticulocyte count: Reticulocytes are immature red blood cells. Their raised levels in the blood indicate an increased destruction of red blood cells.
Serum Vitamin B12 and folic acid: Measured to rule out their deficiencies.
Hemoglobin electrophoresis: to rule out disorders in which hemoglobin structure is abnormal.
Coombs test: to find antibodies for red cells
Red cell fragility: done to know how easily the cells get destroyed.
Bone marrow biopsy: any abnormalities in cells which produce the red blood cells can be identified by studying a sample of bone marrow.
Treatment for Nutritional anemia:
Conventional treatments emphasize on:
Lifestyle changes and
Medications.
Lifestyle changes
Some life style changes can help you remain healthy without having to depend upon too many medications.
Diet for Nutritional Anemia
A balanced and nutritious diet can go a long way in reversing anemia.
Red meats, egg yolks, clams & liver are some of the richest sources of iron.
However, there is hope for vegetarians too. Dietary iron is obtained from:
Spinach and other dark leafy vegetables
Dried beans
Parsley (herb) is one of the richest source of iron among plants
Nuts, seeds
Dried fruits (apricots, peaches, raisins, and prunes)
Fortified cereals
Fortified soy products
Brewers yeast
Cooking in iron pots and pans can also increase the amounts of iron consumed.
Vitamin C can enhance iron absorption in the body. So, a diet rich in vitamin C consisting of fresh fruits and vegetables (amla, guavas, limes, oranges, tomatoes, cabbages, etc.) should be maintained as well.
Exercises in moderation can improve blood circulation. However, an excess is additional stress which can be harmful in severe anemia. So, discuss with your physician before starting any regimen.
Medications
For the treatment of anemia, prescription drugs as well as over the counter medications are available. Still, it is better to seek medical advice before starting any supplementary regimen.
The most common prescription medications are:
Folic acid supplements
Vitamin B12 injections
Iron supplements
Intake of iron supplements can cause toxicity in some persons. A rare genetic disorder called hemochromatosis causes increased absorption of iron leading to an overload. This condition is as dangerous as having too little iron in the body. Since men lose less iron compared to women, hemochromatosis is more prevalent in men. The condition is also common in persons from Northern Europe.
Homeopathic Treatment for Nutritional anemia:
In addition to the supplements with iron and other components, homeopathic medications work wonders for cases of Nutritional anemia by treating the cause such as problems with absorption and assimilation of food. The medicines increase iron absorption and its assimilation. The medications act without any side-effects. Homeopathy is strongly suggested for Nutritional anemia.