An Encounter With Hivaids Patient-magicq

AN ENCOUNTER WITH HIV/AIDS PATIENT It was during September/October, 1990 when I read heart-rending articles on AIDS patients of Kamatipura, Bombay. This made me curious to .e across some AIDS afflicted persons. Later news about AIDS victims appeared in local newspapers. As some of the patients were residing in and around Chandigarh and Punjab, I tried to contact them personally by visiting their places and through post until on 4th May, 1992 at about 5 p.m. when an AIDS patient was brought to me in a critical condition. Frankly speaking, although I was keen to treat HIV/AIDS patients but when I was informed by the attendant, younger brother of the victim about the disease (prior to my .ing face to face with the patient) I developed fear psychosis and hesitation for a while. Somehow, I reconciled and prepared myself to examine the patient. The patient seemed seriously ill. He was laid down on a bench with his head o the lap of his brother. I thoroughly inspected the patient. He was in a state of stupor and remained thus throughout the physical examination and my interrogation with the attendant except when he asked for water and when I tried to remove his undergarments for physical examination of his genitals, the patient did not allow me to do so. I too did not insist too much. On the basis of PGIMER, Chandigarh OPDs cards, reports, narration by the attendant and Physical Examination of the patient, I noted the following things: 1. Name : M.S. Age – 25 years, married 2. Occupation : Truck Driver, he happened to go to Bombay where He (might have) frequented Kamatipura, the den of prostitution and contracted Syphilis (information gathered from brother) through sexual intercourse. 3. Constitution : Wrecked, lean and thin built. 4. Skin : Pale hue of the skin of the face. The skin of the trunk, extremities and back was full of reddish brown popular rash. On the left upper arm, right thigh and on the abdomen bluish purple colour circumscribed spots of purpura haemorrhagica were also seen. 5. Body Temperature : 100 degrees Fahrenheit 6. General Condition : Excessive prostration. The patient remained in a propped position and in a state of semi-unconsciousness. 7. Respiratory Condition : Patient was coughing often, with the feeling of soreness in the chest but without any expectoration. 8. Mouth : Dry and thickly brownish coated tongue. 9. Thirst : Patient took tumbler full of water twice at about half an hour interval. 10. Lymphatic System : Left cervical lymph nodes were enlarged. 11. Past History : On the basis of prescription note made on 26.10.91 by a doctor (Ex-Professor and Head of Medicine, Rajindra Hospital, Patiala). i) The patient was a daily drinker for 15 years. ii) Spontaneous bleeding from gums for 3-4 months. iii) Epistaxis 4 months iv) Ecchymosis v) C/O Easy fatigability vi) Reduced appetite 12. Family History : Not of special keeping in view with the nature of the disease. 13. Treatment Taken : Allopathic from various practitioners and PGIMER Chandigarh on different cards stipulating the dates. 20.11.91 Thrombocytopenia Leukocytosis Anaemia 27.11.91 ? ITP with sessile type of condyloma acuminata + Recurrent Herpesprogenitalis. ? ITP Leukaemia Lesions on trunk, face acneform, lesions are steroid induced taken for his ITP Oral lesions part of ITP. Lesion over pubic region healed folliculitis purpuric lesion HIV report negative (ELISA) 19.2.92 Lymphoma ? Hodkins disease 10.3.92 A case of thrombocytopenia ANF + On Steroids Receiving Wysolone 60 mg. OD. Present C/O Fever x 7 days Cough No other local symptoms. 4.5.92 Immunothrombocytopenia HIV +ve Fever with cough Lymph nodes left cervical region enlarged Throat multiple small ulcers. Lab Investigations 24.10.91 Private Lab at Sunam, Punjab Hb 5.8 gm% TLC 13700/cmm & DLC P62 L34 E2 M0 B0 Serum Bilirubin 0.4 mg% 26.10.91 Private Lab at Patiala i) Hb 6.0 gm% TLC 6100/cmm DLC P62, L33, M3, E2, B0 Platelet count 52000/cmm Prothrombin Time 16 sec. Control 16 sec. Index 100% ii) Hb 7.5% TLC 20400/cmm DLC P83, L15, EO M2 Platelet count 38000/cmm 7.11.91 Private Lab at Patiala Hb 7.5 gm/dl TLC 20,400/cmm DLC P83, L15, M0 E2 Bo Platelet Count 38000/cmm 26.11.91 PGIMER, Chandigarh Department of Haematology i) Report of Bone marrow Aspirate/Trephine Interrogation: Although aspirate is a particulate, a few Megakaryocytes thrombocytopenia. A report aspirate with Trephine is advised at a later date ii) PFNA Hb 8.4% Retic 0.5% Platelets 5000 TLC – 16000/cmm DLC P75 L15 My 3 MM1 Ratio 2m RBC/100 WBC Mild Anisopoikilocytosis with Micro, Macro Ovalocytes, mildly hypochromic Platelets reduced on smear 5.12.91 Haematology Clinic Platelets/cmm < 5000 30.12.91 Department of Immunopathology, PGIMER, Chandigarh HIV test is negative both by ELISA and Western BLOT Sd/- 30.12.91 Haematology Clinic Hb 10.4% gm% TLC 11700/cmm Mid January, 92 Department of Immunopathology, PGIMER, Chandigarh HIV-I is positive by ELISA with fresh sample taken during mid January. To be treated at positive. Sd/- 5.2.92 Department of Medical Microbiology, PGIMER, Chandigarh V.D.R.L. Test Nonreactive Sd/- 12.2.92 Department of Immunopathology ( Pathology) AIDS Surveillance Center, PGIMER, Chandigarh HIV test: By ELISA Negative Sd/- N.B. It does not rule out the possibility of HIV but at the same time western BLOT was not conducted, which was a must since It is the only confirmatory test, further mid January, 92 sample was declared HIV positive by ELISA. On the basis of PGIMER OPDs findings and clinical investigations, the case was repertorised for the following symptoms :- Medicamentum abuse Dry mouth with thirst skin discoloration Anemia Cough dry, soreness in chest coughing while fever-heat in general weakness Syphilitic history. Ars. Album, Sulphur and Nitric Acid were the three medicines covering all the symptoms. Patient was given medicines keeping inn view the cause of the present state of the patient and chronicity of the disease R/ Sulphur 1M 3 doses 1 hourly Ars. Album 1M 9 doses (SOS) 1-3 hourly Plo 21 doses TDS Sd/- N.B. While I was busy in repertorising the case, the attendant as well other ac.panying persons of his village wanted me to be hurry in issuing the medicines to the patient so that they could reach their home at Sunam(Punjab) well in time before mid-night. They all were reluctant to night stay at Chandigarh. The patient was given one dose of Sulphur 1M at the clinic and the rest two doses were to be given after an hour interval while enroute to his home. In case there was increase in the temperature after the first dose of Sulphur 1 M or otherwise, Ars. Album 1M, SOS was to be given as per instructions. They all left the clinic at about 6 p.m. Nobody turned up to report the condition of the patient even after a week or 10 days time. I therefore, realised my folly in not .pelling the attendant for making the patient stay at Chandigarh as long as he needed constant observation. I had almost lost the hope of turning up of the patient or the attendant when on 20th June the attendant of the patient turned up at my residence around noon and accounted for the events pertaining to the patients condition thus:- After leaving my clinic, when enroute home of the patient the temperature rose high (around 104 degrees Fahrenheit). The patient became anxious, restless and started speaking (O God I am dying). He was offered water which he took in a small amount first at Banoor then at Rajpura and next at Patiala (The patient might have not been given any medicine) After reaching home at Sunam, one dose of Ars. Album 1M was given which relieved the patient of his anxiety and restlessness but temperature remained between 102-104 degrees Fahrenheit throughout the night as well as the next morning (I cant say whether Ars. Album 1M was further repeated or not but I have no mention in my case file. I might have either forgotten to ask or to note the same). Next day they called a local allopathic physician to examine the patient, who not only gave Sporidex, wysolone and crocine 6 hourly 5-6 times but also warned the family against the so called harmful effects of the homeopathic medicines. Thenceforth homoeopathic medicines were stopped. On 6th May there was no temperature and the patient was alright for about 10 days. Patient started taking 2-3 chapati and some juicy fruits daily. Then again he got temperature (between 100 to 103 degrees Fahrenheit). This time besides above noted allopathic medicines, injections of Vetenisol and Cal. Sandose + one bottle of Dextrose were also administered I.V. resulting in .ing down of the body temp. to 100 degrees Fahrenheit. Patient was alright for another 7 days. Thereafter, he started bleeding from gums. It was checked with the help of Allopathic drugs but it did not sttop .pletely. On 14th June the patient went to see his in-laws in another village, there he developed 102-103 degrees Fever temperature. Either there itself or after his .ing home, he was given usual course of steroids and antipyretic drugs. Meanwhile, his maternal uncle visited the patient, who not only cleared all doubts about the alleged harmful effects of homoeopathic medicines but also insisted on taking them (at least along with the allopathic drugs). Thus the patient started taking medicines of both the systems together. He was alright on 15,16,17 June. On 18th June, patient passed two loose motions in the morning and another at 3 p.m. which were stopped by giving antipurgatives. On 19th June at about 7 p.m. patient .plained of headache, pain in the abdomen and legs. The body temperature rose to 99 degrees Fahrenheit to 100 degrees Fahrenheit. He was given both the types of medicines and the temperature did not shoot. The attendant turned up on 20th June to report and to fetch more medicines. According to him: In the morning temperature was 100 degrees Fahrenheit. Bleeding from the gums continued. Pain in the whole body remained. Patient passed 3 motions in the morning. The first one was loose and subsequent two were normal. Left cervical lymph nodes got enlarged during fever and when there was no fever these would be.e invisible. Reddish brown discoloration of the skin of the body was no more. Bluish purple spots (purpurea haemorrhagica) were no more on the upper left arm and abdomen but appeared on the back. Since the patient was getting the temperature often along with haemorrhages, following prescription was made this time. R/ 1. Ars. Album 1M, 6 doses (SOS) 3-4 hourly. 2. Ars. Album 10 M, 6 doses (SOS) 2-4 hourly (when the temperature does not .e down by No.1. 3. Acid Nitric 10M 3 doses (SOS) 4 hourly when the temperature does not .e down by No.2. 4. Ars. Album 50M 6 doses (SOS) 4 hourly when the temperature does not .e down by No.3. 5. Acid Nit. 50M 3 doses (SOS) 4 hourly when temperature still does not .e down by No.4. N.B.: The attendant was instructed not to give allopathic drugs in the first and second instance but if homoeopathic medicine did not work only then the former could be tried. No PLO was given this time as there were already sufficient PLO left with the patient. The attendant revisited me on 29th June and reported: on 20th June evening, no rise of temperature On 21st June morning at 7 p.m. 100 degrees Fahrenheit Ars. Album 1M As the temperature continued throughout the evening and night, the patient was given 3 doses of Allopathic drugs. On 22nd June Morning Temperature 100 degrees Fahrenheit, Day time 102 degrees Fahrenheit Evening at about 7 p.m. 100 degrees Fahrenheit. At Night below 100 degrees Fahrenheit. On 23rd June: Morning at 8 A.M. 99 degrees Fahrenheit N.B. Forenoon 11 A.M. 98 degrees Fahrenheit Evening 7-8 P.M. 100 degrees Fahrenheit Night 9 to 9:30 P.M. 102 degrees Fahrenheit N.B. Although I did not mention the names of medicines of any kind in my case file but there could not have been almost low-grade temperature without giving medicines. On 24th June, 1992: Morning 100 degrees Fahrenheit Ars. Album 50 M Forenoon at 11 A.M. 102 degrees Fahrenheit Ars. Album 50 M Afternoon at 11 A.M. 102 degrees Fahrenheit Ars. Album 50 M Afternoon 1.30 p.m. 102 degrees Fahrenheit inj. of allo. drugs Evening 6 p.m. 102 degrees Fahrenheit Tab Steroid and Antiypyretic given. 25th June, 92 No rise of temperature still the patient was given above mentioned drugs. N.B.: The patient was given allopathic medicines, might be as per instructions of the attending physician or as a precautionary/preventive measure. 26th June, 92 Morning, Forenoon, Noon temperature 100 degrees Fahrenheit Afternoon at 3 P.M. Nitric Acid 50 M At 6 P.M. Inj. allopathic drugs. At midnight 1 dose of allopathic drugs. 27th June, 92 Morning 100 degrees Fahrenheit Allopathic medicines Noon 100 degrees Fahrenheit Plo Afternoon 100 degrees Fahrenheit Evening 7.30 P.M. 100 degrees Fahrenheit Ars. Album 50M Night 9.30 P.M. 100 degrees Fahrenheit Ars. Album 50M Night 11.30 P.M. 100 degrees Fahrenheit Allopathic Medicine 28th June, 92 Morning 6 A.M. Normal Allopathic medicines Forenoon 10.30 Normal Plo Afternoon 100 degrees Fahrenheit Allopathic drugs Evening normal Night normal On 29th June, 92 the attendant further reported: Morning Normal Body temperature The patient felt pain all over the body during fever and desired the body to be pressed lightly. Mouthful: Bleeding from the gums in the morning daily. Thereafter no bleeding. Temperature during last one week i.e. from 20th June to 28th June did not go beyond 102 degrees Fahrenheit with the use of different potencies of homoeopathic medicines as well as allopathic drugs which otherwise would go up and above 104 degrees Fahrenheit Cervical lymph nodes prominent during fever. Since the patient was still getting fever off and on and he was also having bleeding in sufficient quantity from his mouth(gums) owing to low platelet count (thrombocytopenia), I presumed bleeding resulted in weakness, which further resulted in rise of body temperature quite often. It was therefore imperative to stop the bleeding first so that the rise of the temperature could be stopped and thus use of immunosuppressive allopathic drugs could be stopped. Keeping in view this fact in the mind, I made the following considerations for the selection of another suitable remedy. The following symptoms were taken into account and repertorisation was done as per Kent and Kerr repertories. Blood, Anemia: Pernicious, in Constitutional breakdown by gonorrhoea, syphilis, alcoholic etc. Tendency to haemorrhage from gums, mucous membrane and skin, blood non-coagulable. Knerr Page. 820. Blood, Leukemia (Leucocytemia) Constitution broken down by gonorrhoea, syphilis, alcohol, etc. Knerr Page. 822. Fever, blood: Haemorrhagic symptoms or tendency to putrescence Knerr Page 1091. Fever, continued: haemorrhagic: oozing of dark thin blood from capillaries, Kent Page. 1060. The .mon medicine was found to be Crotalus horidus (basically an antihaemorrhagic medicine and the cognate of Lachesis. Lachesis is presently being considered and developed as an effective medicine for AIDS patients by Researchers in the U.S.A) The medicine was given in 30 potency, nearly 21 doses to be taken as SOS, BD, TDS or QIDS. Since I was over-confident, I had instructed the attendant to give only this medicine to the patient for fever as well as for bleeding from the mouth. The attendant contacted me on phone on 5.7.92 and informed that temperature was now rising to 103-104 degrees Fahrenheit and would not .e down merely by giving homoeopathic medicines. He did not speak about bleeding from mouth. I too could not ask him about this. Therefore I presume that the patient might have been given the usual course of steroids and antipyretic drugs, in order to bring the temperature down. Although I had asked the attendant to .e to Chandigarh for Change of medicine but he did not turn up. Later on I received a letter describing the same thing as was narrated by him on the Phone. I sent a letter advising him to .e for the same medicine which was able to contain the temperature to some extent or some n! ew medicine could also have been looked into but there was 相关的主题文章: