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A Case of Huge Pleural Effusion Cured with Homoeopathy

A Case of Huge Pleural Effusion Cured with Homoeopathy

© Dr. Rajneesh Kumar Sharma MD (Homoeopathy)

For well formatted article with images and evidences of cure, pl. see attached pdf file....

A case of Pleural effusion with cardiomegaly cured with Homoeopathy...

Definition

A PLEURAL EFFUSION is an abnormal, excessive collection of this fluid (Sycosis/ Pseudopsora). Excessive amounts of such fluid can impair breathing by limiting the expansion of the lungs during respiration.

Types of Effusions

1.     TRANSUDATIVE PLEURAL EFFUSIONS

A fluid substance passed through a membrane or extruded from a tissue is of high fluidity and has a low content of protein, cells, or solid materials derived from cells is called transudative fluid. This effusion is caused by increased pressure (Psora), or low protein content in the blood vessels (Syphilis). A transudate is a clear fluid, similar to blood serum. It reflects a systemic disturbance of entire body. (Pseudopsora)

Causes of Transudates

·       Atelectasis (Psora/ Syphilis)

·       Early Cirrhosis (Psora/ Syphilis/ Sycosis)

·       Congestive heart failure (Psora/ Sycosis)

·       Hypoalbuminemia (Psora/ Syphilis)

·       Nephrotic syndrome (Psora/ Sycosis/ Syphilis)

·       Peritoneal dialysis (Causa occasionalis)

2.     EXUDATIVE EFFUSIONS

A fluid rich in protein and cellular elements that oozes out of blood vessels due to inflammation is called exudative effusion (Pseudopsora/ Sycosis). It is caused by blocked blood vessels, inflammation, lung injury, and drug reactions (Psora/ Sycosis). It often is a cloudy fluid, containing cells and much protein, signifying underlying pleuropulmonary disease (Pseudopsora/ Sycosis).

Causes of Exudates

·       Asbestos exposure (Causa occasionalis)

·       Atelectasis (Psora/ Syphilis)

·       Haemothorax Infection (bacteria, viruses, fungi, tuberculosis, or parasites) (Pseudopsora/ Sycosis).

·       Pulmonary embolism (Causa occasionalis/ Psora/ Sycosis)

·       Uremia (Psora/ Sycosis/ Syphilis)

Types of fluids

Four types of fluids can accumulate in the pleural space-

1.     Serous fluid (hydrothorax): A hydrothorax is a condition that results from serous fluid accumulating in the pleural cavity. This specific condition can be related to cirrhosis with ascites in which ascitic fluid leaks into the pleural cavity. (Sycosis)

2.     Blood (haemothorax): is a condition that results from blood accumulating in the pleural cavity. (Pseudopsora/ Sycosis)

3.     Chyle (chylothorax): chyle is a milky bodily fluid consisting of lymph and emulsified fats, or free fatty acids (FFAs). It is formed in the small intestine during digestion of fatty foods. It results from lymphatic fluid (chyle) accumulating in the pleural cavity. (Psora)

4.     Pus (pyothorax or empyema): is an accumulation of pus in the pleural cavity. (Pseudopsora/ Sycosis/ Syphilis)

Pathophysiology

It is explained by increased pleural fluid formation or decreased pleural fluid absorption (Psora/ Sycosis). Increased pleural fluid formation can result from elevation of hydrostatic pressure & decreased osmotic pressure (Psora/ Sycosis). It leads to increased capillary permeability and passage of fluid through openings in the diaphragm (Psora). Hence production increases and absorption decreases (Psora). Lymphatic obstruction may also cause effusion (Sycosis). Pleural effusions produce a restrictive ventilatory defect and also decrease the total lung capacity and vital capacity. (Psora)

CLINICAL MANIFESTATION

Pleuritic chest pain indicates inflammation of the parietal pleura (Psora/ Pseudopsora). Chest pain, usually a sharp pain, is worse with cough or deep breaths. Cough, fever, rapid breathing, shortness of breath etc. may accompany it (Psora).

DIAGNOSTIC EVALUATION

Physical examination can reveal the presence of an effusion by dull or flat note on percussion and diminished or absent breath sounds on auscultation.

Pleural fluid analysis

Thoracentesis

Chest Radiography: The posteroanterior and lateral chest radiographs are still the most important initial tools in diagnosing a pleural effusion.

Ultrasound is useful both as a diagnostic tool and as an aid in performing thoracentesis. It assist in identifying pleural fluid loculations.

Computed Tomography: It helps distinguish anatomic compartments more clearly. This modality is useful as well in distinguishing empyema.

Normal Chest X Ray P A View

Treatment

Aims:

·       To remove the fluid

·       Prevent fluid from building up again

·       Treating the cause of the fluid buildup

Therapeutic thoracentesis

It may be done if the fluid collection is large and causing chest pressure, shortness of breath, or other breathing problems, such as low oxygen levels. Removing the fluid allows the lung to expand, making breathing easier.

In some cases, Surgery may be needed.

Comfortable position

To maintain a comfortable position, usually elevated headboard is used.

Oxygen level

To supply oxygen.

Nutrition level

To maintain nutrition supply if intake less than body requirement related to inability to ingest adequate nutrients.

Body fluid level

To maintain body fluid volume lost due to drainage, by oral/ i. v. method.

Possible Complications

A lung that is surrounded by excess fluid for a long time may be damaged. Pleural fluid that becomes infected may turn into an abscess, called an empyema. Pneumothorax can be a complication of the thoracentesis procedure.

References

 Chapter 22. Pleural Effusions, Excluding Hemothorax CURRENT Diagnosis & Treatment in Pulmonary Medicine

Chapter 117. Thoracentesis Principles and Practice of Hospital Medicine

Dullness and diminished vibrations—pleural effusion or pleural thickening" border="0" height="86" width="50"> The Chest: Chest Wall, Pulmonary, and Cardiovascular Systems; The Breasts > Dullness and diminished vibrations—pleural effusion or pleural thickening DeGowin’s Diagnostic Examination, 10e

Pleural Effusion Chapter 263. Disorders of the Pleura and Mediastinum > Pleural Effusion Harrison's Online

Pleural Effusion Chapter 107. Basic Chest Radiography (CXR) > Pleural Effusion Principles and Practice of Hospital Medicine

BENIGN PLEURAL EFFUSIONS Occupational Lung Diseases > BENIGN PLEURAL EFFUSIONS CURRENT Diagnosis & Treatment: Occupational & Environmental Medicine, 5e

Postoperative Pleural Effusion & Pneumothorax Chapter 5. Postoperative Complications > Postoperative Pleural Effusion & Pneumothorax CURRENT Diagnosis & Treatment: Surgery, 13e

Exercise 4-13. Pleural Effusion Chapter 4. Radiology of the Chest > Exercise 4-13. Pleural Effusion Basic Radiology, 2e

Pleural Effusions Chapter 13. Pulmonary Pathology > Pleural Effusions Pathology: The Big Picture

Pleural Effusion Chest Wall, Lung, Mediastinum, and Pleura > Pleural Effusion Schwartz's Principles of Surgery

The Case study

Mrs. Ritu, F 42 developed shortness of breath, complete anorexia, cough and weakness for last one month. The symptoms grown worse and worse day by day and she became unable to lie down in bed for shortness of breath and cough which aggravated after midnight and she was so panic as in agony. The only comfortable position was to sit up. Usually, cough had two paroxysms. She was obliged to sit up in bed or keep herself in half sitting position. She developed extreme aversion to food, even smell of food causing her nausea.

On examination, she was found to be hypertensive, asthmatic, non-diabetic, pale, anemic and too weak even unable to walk.

Haemogram, LFT, KFT, Electrolytes, Lipid profile, CK MB etc. all were within normal range.

ECG revealed cardiomegaly with LVH.

Echocardiography revealed cardiac overload, reduced left ventricular efficiency with mild PR.

Chest X ray PA view showed marked cardiomegaly with pulmonary congestion with bilateral pleural effusion, more on right side.

HRCT Thorax revealed almost same findings as in chest x ray.

On further case taking, she revealed history of menorrhagia due to adenomyosis uteri for last 3 years, bleeding piles due to constipation and hard stools.

Mild albuminuria, borderline diabetes mellitus, hyper loaded kidneys with elevated blood creatinine level and anemia.

 

X Ray Chest PA View dated 03-01-2015

 

X Ray Chest PA View dated 20-01-2015

 

HRCT Thorax dated 21-01-2015

X Ray Chest PA View dated 19-02-2015

 

Complete resolution of effusion and restoration of normal cardiac size with normal findings in blood and urine exams.

Evaluation and repertorization

Prescription

On looking at a glance, Asclp. Tub seems to be similimum, but modalities were so marked Kali nitricum was found to be most suitable.

RESPIRATION - ASTHMATIC - night - midnight - after - sitting up in bed - must sit up- KALI-N.

A single dose of Kali nitricum was given on 03rd January 2015 in morning. There was mild aggravation that night.

Since second night, improvement in general condition started but dyspnea and cough was increased. Surprisingly, there was sense of wellbeing along with aggravation in particulars.

X ray and HRCT scan were done on 20 and 21 January respectively. Both were showing slight worsening in conditions at pathological levels. The only supporting symptom was a feeling of better health all the time. Night agony was also better in spite of dyspnea and cough. Appetite was much better now.

By the end of 20th day, she was miraculously better and all the symptoms gone except some weakness.

The last scan was done on 03rd January 2015 and there was no sign of disease. No fluid, no cardiomegaly and no pulmonary congestion.

A complete cure of gross pathological changes with a single dose of the similimum remedy!

 

 

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Comment by Dr Nikhil Kambli on March 16, 2015 at 1:49am

this is a good case of use of modality in treatment .. 

could you also post the reports of the patient. scans etc..

also what is the state of the kidneys now??? 

and finally what was the diagnosis. as you have mentioned the cardiomegaly and pleural effusion along with renal affection ? so were these cardiac symptoms complications of pre exsisting renal disease, as the pleural effusion being bilat the cause of which appears to be systemic in origin. the pleural effusion and cardiomegaly might be a part of serious underlying disorder.so investigate it carefully and take opinion of supportive MD medicine. they might be just pathological symptoms of the "disease" or complications. 

this is a great case of use of homoeopathy, kindly preserve such cases with records scans etc , also comparative studies with previous findings where it is mentioned on reports as compared to so and so date..it has decreased... great work.

we really require hospital and institute support if we want to make progress.. we also require support of good people related to medicine, and we should be able to prove ourselves in a SYSTEMATIC way again and again..

Comment by Dr Rajneesh Kumar Sharma MD(Hom) on March 14, 2015 at 1:35am

Thanks  Sayed Sir... Regards

Comment by Dr. Sayed Tahir Hassan on March 14, 2015 at 12:31am

Thanks for posting this case!
We should start to use homeopathy more and more even in casualty. This case is another example that a good hospital setup will help us get more of such cases.

Comment by Dr Rajneesh Kumar Sharma MD(Hom) on March 12, 2015 at 11:31pm

Welcome Dr. Aparna.

Comment by Dr Aparna Singh on March 12, 2015 at 12:57pm

Kali nit is an unusual medicine, I have never used it.. thanks for this case

Comment by Dr Rajneesh Kumar Sharma MD(Hom) on March 10, 2015 at 8:55am

Kali nitricum 200 c potency.

Comment by Dr Aparna Singh on March 10, 2015 at 7:03am

hi ,
KALI N was used in 30, 200 1M or LM,
you have said single dose was used.... but have not mentioned potency

Comment by Dr Rajneesh Kumar Sharma MD(Hom) on March 9, 2015 at 11:27pm

Dear Debby, Such a gross pathological change must take much more time to resolve. Often, it needs to be removed mechanically. Very often it needs repeatition of doses. But this is a single dose miracle. Regards

Comment by Debby Bruck on March 9, 2015 at 9:45pm

Would you say the extent of cure was unusual? Would you expect such a case to resolve so completely in this amount of time and is there any reason to think the symptoms would return?

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