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Rhinitis in children

Rhinitis in children. Jacqueline M Mardon. 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.

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Rhinitis in children

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  1. Rhinitis in children Jacqueline M Mardon

  2. 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

  3. 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)

  4. 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

  5. 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

  6. 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

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

  8. Self-help approaches • Allergen avoidance/reduction • Saline nasal washes • Light impulse probes?

  9. 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

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

  11. Review of cases(1) • 47 children: 18 girls, 29 boys • Age range: 1 - 16 years

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

  13. 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

  14. 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

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

  16. Review of cases (6)Family history • Siblings with congenital heart disease (2) • 30 children with family hx of atopy

  17. 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

  18. 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

  19. Review of cases (9) • Previous homeopathy - one patient visited homeopath in Pakistan; another previous patient GHH

  20. 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)

  21. 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!)

  22. 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

  23. 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?

  24. Collaborative model • Child at centre • Family • General Practitioner • Specialists - ENT surgeon, Homeopathic/holistic practitioner • Community/environment

  25. 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

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