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Rhinitis in children Jacqueline M Mardon. A collaborative model retrospective review 47 children referred by ENT allergic or non-specific rhinitis ineffective.

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Presentation on theme: "Rhinitis in children Jacqueline M Mardon. A collaborative model retrospective review 47 children referred by ENT allergic or non-specific rhinitis ineffective."— Presentation transcript:

1 Rhinitis in children Jacqueline M Mardon

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3 A collaborative model retrospective review 47 children referred by ENT allergic or non-specific rhinitis ineffective conventional therapy assessed by homeopathic practitioner treated with homeopathy ± isopathy follow-up and outcomes retrospective review 47 children referred by ENT allergic or non-specific rhinitis ineffective conventional therapy assessed by homeopathic practitioner treated with homeopathy ± isopathy follow-up and outcomes

4 The integrity of the child What is rhinitis and what is it an expression of in the child’s being? What is the significance? (different levels this can be approached) What is rhinitis and what is it an expression of in the child’s being? What is the significance? (different levels this can be approached)

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7 A very visible manifestation: flowing, sticky lurid green, yellow, clear burny blood Face full, tender, squeaky, stuffed- up Unseen pain, itch - nose rub, palate scratch A very visible manifestation: flowing, sticky lurid green, yellow, clear burny blood Face full, tender, squeaky, stuffed- up Unseen pain, itch - nose rub, palate scratch

8 Eyes water, stick, searing tears Ears fuzzy, bubble Skin prickles and flakes Hard to breathe - the night is not peaceful, disturbed with grunts, snorts and gasps Eyes water, stick, searing tears Ears fuzzy, bubble Skin prickles and flakes Hard to breathe - the night is not peaceful, disturbed with grunts, snorts and gasps

9  An assault to the dignity of the young individual and their integrity  Affects concentration, distorts the face. Hard to gaze outwardly.  There may be shame, mute misery  Can experience being shunned, bullied  An assault to the dignity of the young individual and their integrity  Affects concentration, distorts the face. Hard to gaze outwardly.  There may be shame, mute misery  Can experience being shunned, bullied

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11 Conventional approaches  History, examination ± investigation (skin prick tests, RAST)  Associated asthma, eczema, foods?  Treatment nasal corticosteroids, anti-histamines  History, examination ± investigation (skin prick tests, RAST)  Associated asthma, eczema, foods?  Treatment nasal corticosteroids, anti-histamines

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13 Self-help approaches  Allergen avoidance/reduction  Saline nasal washes  Light impulse probes?  Allergen avoidance/reduction  Saline nasal washes  Light impulse probes?

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15 Homeopathic “holistic” approach  The child first and always  Welcome the family  Symptoms  Maternal history, birth  Early life, breathing, feeding and weaning  FHx Onset allergy - eczema,asthma, rashes, food  The child first and always  Welcome the family  Symptoms  Maternal history, birth  Early life, breathing, feeding and weaning  FHx Onset allergy - eczema,asthma, rashes, food

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17 Homeopathic “holistic” approach (2)  Movement  Physical, social and emotional development  Sleeping  Day rhythms  Temperature Observations; significance of ages  Movement  Physical, social and emotional development  Sleeping  Day rhythms  Temperature Observations; significance of ages

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19 Review of cases(1)  47 children: 18 girls, 29 boys  Age range: years  47 children: 18 girls, 29 boys  Age range: years

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21 Review of cases (2) ENT referral/diagnosis  Non-specific rhinitis - 8 children  Allergic rhinitis/multiple allergies - 37  Other - 2 children  Non-specific rhinitis - 8 children  Allergic rhinitis/multiple allergies - 37  Other - 2 children

22 Review of cases (3) other medical problems/Hx A hetereogeneous group Congenital heart disease Tonsils, adenoids Cleft lip and palate Nasal intubations/feeding, surgery Grommet insertions, ear problems A hetereogeneous group Congenital heart disease Tonsils, adenoids Cleft lip and palate Nasal intubations/feeding, surgery Grommet insertions, ear problems

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24 Review of cases (4) medical hx cont  Asthma (11 children)  Eczema (13 children), 5 with both  “ALLERGY MARCH”  Urticaria/rashes  Food allergies: milk protein, fish, egg, dairy  Chest and respiratory tract infections - multiple antibiotics  Asthma (11 children)  Eczema (13 children), 5 with both  “ALLERGY MARCH”  Urticaria/rashes  Food allergies: milk protein, fish, egg, dairy  Chest and respiratory tract infections - multiple antibiotics

25 Review of cases (5)  Allergy tests  RAST - 2 children  Skin prick tests - 39 children (9 negative results; 30 positive for one or more allergen)  Allergy tests  RAST - 2 children  Skin prick tests - 39 children (9 negative results; 30 positive for one or more allergen)

26 Review of cases (6) Family history  Siblings with congenital heart disease (2)  30 children with family hx of atopy  Siblings with congenital heart disease (2)  30 children with family hx of atopy

27 Review of cases (7) Maternal hx/birth 33 children recorded details 7 Caesarean Section births 5 births by Forceps delivery - SCBU with bruising to head/face in 2 babies Individual experiences eg “stuck”, purple large baby with excess mucus, lasted several months 33 children recorded details 7 Caesarean Section births 5 births by Forceps delivery - SCBU with bruising to head/face in 2 babies Individual experiences eg “stuck”, purple large baby with excess mucus, lasted several months

28 Review of cases (8) Conventional medication: - one child parents declined nasal spray - one child spray effective but parents concerned re side-effects - In most cases the tx (steroids,antihistamines) ineffective or limited effect - Also bronchoinhalers and antibiotics Conventional medication: - one child parents declined nasal spray - one child spray effective but parents concerned re side-effects - In most cases the tx (steroids,antihistamines) ineffective or limited effect - Also bronchoinhalers and antibiotics

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30 Review of cases (9)  Previous homeopathy - one patient visited homeopath in Pakistan; another previous patient GHH

31 Review of cases (10) Homeopathy/Isopathy Tx  Many different remedies, first consultation and beyond  No treatment (1)  Single (constitutional) remedy (17)  Single (local)remedy (1)  Miasmatic nosode and constitutional (3)  Isopathy and constitutional (23)  Many different remedies, first consultation and beyond  No treatment (1)  Single (constitutional) remedy (17)  Single (local)remedy (1)  Miasmatic nosode and constitutional (3)  Isopathy and constitutional (23)

32 Review of cases (11) Follow-up  11 children attended one appointment only- 1 was planned  Further ENT assessment/treatment? (10/46 is DNA rate of 21.7%) 36 children attended at least one follow- up (range 1 to 14 months from first seen - patient-led!)  11 children attended one appointment only- 1 was planned  Further ENT assessment/treatment? (10/46 is DNA rate of 21.7%) 36 children attended at least one follow- up (range 1 to 14 months from first seen - patient-led!)

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34 Review of cases (12)- Outcome  Reduction/cessation conventional Tx  No response at follow-up - 5 children (1 did not like powders): 5/36 (14%)  Partial response - 9/39 (25%)  Good response with significant improvement - 22/36 (61%)  31/36 children (86%) of those seen more than once have either partial or good response - some follow-up and Tx ongoing  Reduction/cessation conventional Tx  No response at follow-up - 5 children (1 did not like powders): 5/36 (14%)  Partial response - 9/39 (25%)  Good response with significant improvement - 22/36 (61%)  31/36 children (86%) of those seen more than once have either partial or good response - some follow-up and Tx ongoing

35 Review of cases (13) Discussion  Rhinitis is a symptom - complexity of individual’s history and circumstances  Many of these children had heavy load of interventions and Tx  Allergies on many levels  Can treating early in holistic way affect longer-term outcome?  Rhinitis is a symptom - complexity of individual’s history and circumstances  Many of these children had heavy load of interventions and Tx  Allergies on many levels  Can treating early in holistic way affect longer-term outcome?

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37 Collaborative model  Child at centre  Family  General Practitioner  Specialists - ENT surgeon, Homeopathic/holistic practitioner  Community/environment  Child at centre  Family  General Practitioner  Specialists - ENT surgeon, Homeopathic/holistic practitioner  Community/environment

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39 Thanks  Mr HA Sadiq ENT Surgeon, Royal Hospital for Sick Children, Glasgow  Elaine Hamilton, Nadja Gunneburg, Kamal Ohri, Bridie O’Dowd, Robert Leckridge  Linda and administrative staff  Betty and pharmacy staff  Mr HA Sadiq ENT Surgeon, Royal Hospital for Sick Children, Glasgow  Elaine Hamilton, Nadja Gunneburg, Kamal Ohri, Bridie O’Dowd, Robert Leckridge  Linda and administrative staff  Betty and pharmacy staff


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