sexta-feira, 9 de outubro de 2015

A CASE OF URTICARIA

BY
Dr Rupal Karwa MD (Hom) Nagpur
A lady of 28 yrs old presented with eruptions all over the body especially trunk & thighs. Eruption was pink-red colored around 2mm-6mm in size with slight elevation. The rash was very itchy with <touch, >rubbing. Only change was in diet, as she was fasting so she had meals only once a day for about a month.
 
Past History- Not specific          
 
 Menstrual History- cycle of 28 days with a regular average bleeding. Discharge is bright red colored.
 
Obstetric History- full term one male child delivered by caesarean section.
 
Physical Generals
Appetite - decreased, takes meal only once a day.
Thirst – increased.
Sweat – on covered parts.
Stool – constipated.
Urine—normal.
Thermals—chilly.
Sleep—disturbed due to itching.
Mental generals—she gets easily angry and is highly irritable. Does not wish talk with anybody.
                                                                                       
General examination--
Weight- 54 kg.
Height—5 ft.
B.P—120/70 mm of Hg.
Pulse—78/min
CVS –NAD
Abdomen—NAD
Respiration –difficult after midnight (3 a.m)
 
TOTALITY OF SYMPTOMS
·         urticaria
·         Reddish rash all over the body.
·         itching
·         burning
·         complaints aggravate after scratching 
·         Difficult respiration
·         Midnight aggravation.
·         difficulty in respiration at 3 am

FIRST PRESCRIPTION
On 10/2/10
Rx
Belladonna 200 BD on empty stomach
Placebo for 8 days TDS.

FOLLOW UP—
On 19/2/10
Rash disappeared partially.
Appetite increased.
Breathlessness during night <3 a.m.
Prescription
Rx
Kalium carbonicum 200 BD on empty  stomach.
Placebo for 15 days TDS.
 
FOLLOW UP-
On  5/3/10
Rash disappeared completely.
No burning, no itching.
Breathlessness relieved.
Sleep improved.
 
FOLLOW UP-  
Placebo for 8 days,

DISCUSSION-
The drug is based on totality  and prescribed on psoric plethora  which has benefited the patient. till now there is no recurrence.

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