Abstract: Sinusitis is defined as an inflammation of nasal mucosa and paranasal sinuses for at least 12 weeks which may cause nasal blockage or congestion, mucous discharge, facial pain or pressure, and/or impaired smell. Several factors have been found to contribute to the disease, namely, insufficient ciliary motility, allergy, asthma, bacterial infection, and more rarely, morphological anomalies, immune deficiencies. Various studies have demonstrated the beneficial effect of homoeopathic treatment in cases of sinusitis. Homoeopathic approach as per the totality of symptoms has given significant results in this area as well as a few commonly therapeutically indicated medicines also have given good results.
Keywords: sinusitis, methodology, case series, homoeopathy.
Abbreviations: sinonasal outcomes test (SNOT-22), outpatient department (OPD), paranasal sinuses (PNS), thrice a day (TDS)
Background:
When a person has a cold or a blocked nose, the sinus opening also gets blocked. The mucus, thus, remains in the sinus cavity, leaving the rest of the lining dry. As mucus accumulates, it may lead to swelling and pus in the neighbouring areas of eyes and brain.[1,2]
METHODOLOGY:
Study design:–A randomised open labelled clinical study.
Brief of procedure –
OUTCOME ASSESSMENT:
According to the scores obtained from the SNOT-22 scoring method, following formula was applied after calculating before and after scores.
| Marked improvement | Moderate improvement | Mild improvement | Not significant | Status quo |
| 75%-100% | 50%-74% | 25%-49% | <25% | 0% |
Outcome Assessment table
ANALYSIS AND EVALUATION: On the basis of inclusion/exclusion criteria because of predefined homoeopathic medicine.
SINUSITIS CASE SERIES:
Five cases of sinusitis treated with single predefined homoeopathic biochemic medicine are presented.Sinusitis was assessed using SNOT 22 (sino nasal outcome tool) score.[3]
Case 1:
A 36 years old married male patient, came to OPD (OPD reg.no. 10521;dated – 16/11/18) with complaints of sneezing with watery nasal discharge since 6 months. Patient was apparentely well 6 months back then gradually he started developing complaints of coryza, nasal discharge, redness of eyes and itching in the nose, with heaviness in the forehead and abdomen.
| Location | Sensation | Modalities | Concomitants |
| Sneezing in morning with nasal obstruction and watery nasal discharge.Redness of eyes. | Itching in the nose. | Aggravation – in summers | Heaviness in forehead.Sour eructation with mild pain in abdomen aggravated by pressure. |
PRESENTING COMPLAINTS:
CHARACTERISTIC PHYSICAL GENERALS:
- Thermal reaction(relation to heat and cold): hot patient
- Desires/craving:- salty food
- Aversion/dislikes:- sweets
- Thirst:- thirstlessness, without desire to drink.
- Tongue :- coated tongue.
PAST HISTORY: operated for sinusitis 5 years back, at the age of 25 years.
FAMILY HISTORY: father – asthmatic
LABORATORY INVESTIGATIONS: X-Ray PNS (16/11/18):– Revealed frontal and maxillary sinusitis.
PRESCRIPTION: Date: 16/11/18
Natrum muriaticum 6X/ 4 tablets / TDS/ for 07 days
ADVISE :(supportive dietary advice and accessory measures for management.)
- Take steam inhalation.
- Avoid cold and sour food from the diet.
FOLLOW UP:
| DATE | SYMPTOMATOLOGY | PRESCRIPTION |
| 24/11/18 09/12/18 17/12/18 24/12/18 02/1/19 16/1/19 | Sneezing in morning present. Watery nasal discharge reduced. Redness of eyes slightly reduced. Sneezing in morning gets reduced. Slight relief in nasal discharges. Itching inside the nose. Itching in the nose reduced. Redness of the eyes becomes normal. Nasal discharges present. Sneezing in morning present but reduced. Nasal discharges reduced. No Pain in abdomen. Relief in Sneezing and nasal discharges. Redness and Itching in nose, eyes becomes normal. Relief in all the complaints. X-Ray findings- Normal Skiagram PNS | Natrum muriaticum 6X / TDS / 14 Days. Natrum muriaticum 6x / TDS / 7 days Rubrum 30 / TDS / 7 days. Rubrum 30 / TDS / 7days. Rubrum 30 / TDS / 14days. Rubrum 30 / TDS / 7days. |
Result – Marked Improvement
Pre Score – 90
Post Score – 50
Case 2:
A 28 years old married male patient, came to our OPD (OPD reg.no.10974;dated – 17/11/18) with complaints of watery nasal discharges, sneezing, and cough without expectoration since 8 months. Patient was apparently healthy 8 months back. Before that, he suffered from pneumonia and took allopathic medicine, after which he suffered from coryza for which also he took allopathic medicines giving relief in coryza but cough started.
PRESENTING COMPLAINTS:
| Location | Sensation | Modalities | Concomitants |
| Sneezing with watery nasal discharges, Cough without expectoration. | Itching inside the nose. | Aggravation- By dust, in winters, in morning and evening. Amelioration – in summers. | Burning in throat. |
CHARACTERISTIC PHYSICAL GENERALS:
- Thermal reaction(relation to heat and cold): hot patient.
- Desires/craving:- salty food
- Intolerance to:- sunlight
- Thirst:- drinks 3-4 litres of water a day, in every 15 minutes interval.
- Tongue :- mapped.
FAMILY HISTORY: Father – asthmatic
LABORATORY INVESTIGATIONS: X Ray PNS (17/11/18):- Revealed frontal and maxillary sinusitis.
PRESCRIPTION:
Date: 17/11/18
Natrum muriaticum 6X /4 tablets/ TDS/ For 7 days
ADVISE (Supportive dietary advise and accessory measures for management.)
- Avoid cold and sour food from the diet.
- Take steam inhalation.
FOLLOW UP:
| DATE | SYMPTOMATOLOGY | PRESCRIPTION |
| 23/11/18 09/12/18 17/12/18 24/12/18 02/1/19 10/1/19 | Sneezing present. Slight relief in cough. Pain in facial region slightly decreases. Frequency of sneezing reduced. Watery nasal discharge becomes reduced. Facial pain present but mild. Nasal discharges stopped. Facial pain becomes mild. Slight relief in nasal obstruction. Relief in sneezing also. Cough relieved. Watery nasal discharges stopped. Nasal obstruction becomes reduced. No sneezing. Nasal discharges absent. X-Ray findings-Normal Skiagram PNS | Natrum muriaticum 6X / TDS / 7 Days Rubrum 30 / TDS / 14 Days Natrum muriaticum 6X / TDS / 7 days Placebo 30 / TDS / 7 days. Placebo 30 / TDS / 7 days. Placebo 30 / TDS / 7 days. |
Result – Marked improvement
SNOT Pre Score – 85
SNOT Post Score – 50
Case 3:
A 55 years old married male patient, came to our OPD ( reg.no.12501;on– 04/01/19) with complaints of watery nasal discharges, throat pain and sneezing. Patient was apparently healthy 6 months back.That time he suffered from recurrent headache and took allopathic medicines and after that he suffered from coryza for which he also took allopathic medicines which gives relief in coryza but dyspnoea and cough started.
PRESENTING COMPLAINTS:
| Location | Sensation | Modalities | Concomitants |
| Sneezing, watery nasal discharges, and throat pain | Itching inside the nose. | Aggravation – By dust, in winters, in morning and evening. | Pain in abdomen and Headache. |
CHARACTERISTIC PHYSICAL GENERALS:
- Thermal reaction(relation to heat and cold): hot patient
- Desires/craving:- salty food
- Intolerance to:- cold air
- Tongue :- white coated.
FAMILY HISTORY: Father – asthmatic
LABORATORY INVESTIGATIONS: X Ray PNS (4/1/19):- Revealed left maxillary sinusitis.
PRESCRIPTION:
Date: 04/01/19
Natrum muriaticum 6X/ 4 tablets/ TDS/ For 7 days
ADVISE (Supportive dietary advise and accessory measures for management.)
- Avoid cold and Sour food from the diet.
- Take Steam inhalation.
FOLLOW UP:
| DATE | SYMPTOMATOLOGY | PRESCRIPTION |
| 11/01/19 20/01/19 28/01/19 05/02/19 13/02/19 20/02 /19 | Nasal obstruction present. Slight relief in dyspnoea. Headache slightly decreased. Relief in dyspnoea. Nasal obstruction reduced. Headache present but mild. Dyspnoea relieved. Slight reduction in nasal obstruction. Nasal discharges stopped. Headache and abdominal pain becomes mild. Slight relief in nasal obstruction. Dyspnoea relieved. Nasal obstruction becomes reduced. No Dyspnoea. Nasal discharges absent. X-ray Findings- Normal Skiagram PNS | Natrum muriaticum 6X / TDS / 7 Days Natrum muriaticum 6X / TDS / 7 Days Natrum muriaticum 6X / TDS / 7 days Placebo 30 / TDS / 7 days. Placebo 30 / TDS / 7 days. Placebo 30 / TDS / 7 days. |
Result – Marked improvement
SNOT Pre Score – 45
SNOT Post Score – 20
Case 4:
A 35 years old married female patient, came to our OPD (OPD reg.no. 11614;dated – 4/2/19) with complaints of sneezing,with watery nasal discharge and headache since 6 months. Patient was apparentely well 1 year back. At that time, she suffered from allergic bronchitis for which he took allopathic medicines which was recovered at that time but now he suffered from other symptoms.
| Location | Sensation | Modalities | Concomitants |
| Sneezing with watery nasal discharge. | Lethargic feeling. | Aggravation- in morning. Amelioration- in daytime. | Constipation – stool not completely evacuated. Buzzing in the ears. |
PRESENTING COMPLAINTS:
CHARACTERISTIC PHYSICAL GENERALS:
- Thermal reaction(relation to heat and cold): hot patient
- Desires/craving:- salty food and sweets.
- Intolerance to:- warm food.
- Perspiration:- profuse, yellow, foul swelling.
- Tongue: white coated
FAMILY HISTORY: Mother died of tuberculosis.
LABORATORY INVESTIGATIONS: X-Ray PNS (4/2/19):- Revealed left maxillary sinusitis PRESCRIPTION:
Date: 04/2/19
Natrum muriaticum 6X/ TDS/for 07 days
ADVISE :(Supportive dietary advise and accessory measures for management.)
- Avoid cold and sour food.
- Take steam inhalation
FOLLOW UP:
| DATE | SYMPTOMATOLOGY | PRESCRIPTION |
| 11/2/19 18/2/19 25/2/19 5/3/19 12/3/19 19/3/19 | Sneezing present. Watery nasal discharge slightly reduced. Constipation, present. Heaviness in the head reduced. Stool passes out without much straining. Nasal discharges reduced. Drowsiness relieved. Staus quo. Headache relieved. Relief in constipation. Watery nasal discharges not present. Sneezing also relieved. Relief in the general conditions of the patient. X-Ray findings- Normal Skiagram PNS | Natrum muriaticum 6X / TDS / 7 days. Rubrum 30 /TDS / 7days Rubrum 30 /TDS / 14 days Natrum muriaticum 6X /TDS/7days. Rubrum / TDS / 7 days. Rubrum 30 / TDS / 7 days |
Result – Marked improvement
Pre Score – 60 , Post Score –30
Case 5:
A 32 years old married female patient, came to our OPD (OPD reg.no.11958;dated – 15/2/19) with complaints of nasal obstruction, sneezing with watery nasal discharge since 7 months. Patient was apparentely well 7 months back. At that time, she only suffered from coryza for which she took allopathic medicines due to which coryza suppressed but urticaria appears on whole body with itching and recurrence of coryza was also there.
PRESENTING COMPLAINTS:
| Location | Sensation | Modalities | Concomitants |
| Nasal obstruction along with sneezing and watery nasal discharge since 7 months.Pain in forehead.Heaviness on face. | Itching in the nose.Throbbing pain in forehead. | Aggravation- In morning, at the time of farming. | Burning in throat, sour eructation.Urination by Sneezing.Backache.Aggravation- by bending forward, motion. |
CHARACTERISTIC PHYSICAL GENERALS:
- Thermal reaction (relation to heat and cold): hot patient
- Desires/craving:- sour things
- Aversion/dislikes:-tomato
- Intolerance to:- hot food
- Tongue in the middle of tongue.:- white coated
- Stool (character and frequency):- hard stool with much straining.
FAMILY HISTORY: Father- hypertensive
MENSTRUAL HISTORY:- Early menses.Dark red, itching during menses.Leucorrhoea, foul smelling.
Obstetric history: G2P2A0
LABORATORY INVESTIGATIONS: X-Ray PNS(15/2/19) – Revealed left maxillary sinusitis.
PRESCRIPTION:
Date: 15/2/19
Natrum muriaticum 6X/ TDS/ 07 Days
ADVISE:- Avoid taking cold, sour and extra salt in the diet.
FOLLOW UP:
| DATE | SYMPTOMATOLOGY | PRESCRIPTION |
| 22/2/19 2/3/19 16/3/19 23/3/19 30/3/19 8/4/19 | Itching inside the nose present but sneezing reduced. Watery nasal discharge present. Itching with thick nasal discharges slightly reduced, but nasal obstruction present. Relief in hard, straining stool as well. Status quo. Itching reduced. Nasal obstruction reduced. Slight heaviness feeling on the face. Relief in heaviness on face. Nasal disharges absent. Headache present with nasal obstruction. Nasal obstruction relieved. Headache also relieved. X-Ray findings- Normal Skiagram PNS | Natrum muriaticum 6X / TDS/ 7days Rubrum 30 / TDS/14days Natrum muriaticum 6X / TDS/ 7days Rubrum 30 / TDS/ 7days Natrum muriaticum 6X / TDS/ 14 days Rubrum 30 / TDS/ 7days |
Result – Marked improvement
Pre Score – 55
Post Score –20
Conclusion:
Natrum muriaticum assumes the natural homoeopathic remedy for sinus infections when sneezing, fluent nasal discharge, with pressure in the nose accompanies with sinus inflammation.[4,5,6]
In this study 34 cases were taken by random allocation sampling methods. Paired sample t-test result, to assess the effect of homoeopathic medicine on sinusitis post treatment compared to pre treatment by SNOT – 22 score analysis. Lower score indicates sinusitis improved by Natrum muriaticum.
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ABOUT THE AUTHORS:
Dr ANUPAM KUMAR,
Ph.D., M.D. (Hom.)
PROFESSOR,
Homoeopathy University, Jaipur.
Dr GITANJALI MATHUR,
M.D. (Part II), Homoeopathic Philosophy,
Homoeopathy University, Jaipur.
