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Int J Emerg Med 2018 16;11:49. Epub 2018 Nov 16.

4Department of Pediatric Emergency, College of Medicine, King Saud bin Abdulaziz University for Health Sciences (KSAUHS), Riyadh, Saudi Arabia.

Introduction: Pharyngitis is one of the major and commonly seen presentations in pediatric emergency departments. While it could be caused by both bacterial and viral pathogens, antibiotics are improperly prescribed regardless of the pathogen. Inappropriate usage of antibiotics has risen the concern of microbial resistance and the need for stricter guidelines. Read More

Cardiovasc Intervent Radiol 2019 Feb 14. Epub 2019 Feb 14.

Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands.

Purpose: To investigate the safety and toxicity of percutaneous hepatic perfusion with melphalan (M-PHP) with the Delcath Systems' second-generation (GEN 2) filter and compare the outcomes with historical data from studies using the first-generation filter.

Materials And Methods: A prospective, single-arm, single-center phase II study was carried out including 35 patients with unresectable, histologically confirmed liver metastases from ocular melanoma between February 2014 and June 2017. Main exclusion criteria were extrahepatic disease and age > 75 years. Read More

Eur J Case Rep Intern Med 2018 27;5(12):000987. Epub 2018 Dec 27.

Serviço de Cardiologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.

Acute non-rheumatic streptococcal myopericarditis (ANRSM) is a rare complication of an upper airway infection by streptococcus group A in developed countries. Cardiac involvement in bacterial infections must be adequately treated because it can lead to long-term complications. This case report describes recurrent ANRSM in an 18-year-old man, which illustrates how difficult and challenging the diagnosis of this disease can be. Read More

Infect Immun 2019 Feb 11. Epub 2019 Feb 11.

Department of Microbiology and Immunology, Louisiana State University Health Sciences Center - Shreveport, 1501 Kings Highway P.O. Box 33932, Shreveport, LA 71130-3932, USA

is an emerging human pathogen that causes pharyngitis and wound infections. A few studies have suggested that is able to induce its uptake into non-phagocytic epithelial cells, but the bacterial factors associated with host-cell invasion and the host-cell processes involved have yet to be studied. We investigated how two virulence factors, arcanolysin and phospholipase D, affect the ability of the bacteria to adhere to and subsequently invade Detroit 562 pharyngeal epithelial cells. Read More

Hong Kong Med J 2019 Feb 31;25(1):58-63. Epub 2019 Jan 31.

Hong Kong Sanatorium & Hospital, Hong Kong.

The Centre for Health Protection of the Department of Health has convened the Advisory Group on Antibiotic Stewardship Programme in Primary Care (the Advisory Group) to formulate guidance notes and strategies for optimising judicious use of antibiotics and enhancing the Antibiotic Stewardship Programme in Primary Care. Acute pharyngitis is one of the most common conditions among out-patients in primary care in Hong Kong. Practical recommendations on the diagnosis and antibiotic treatment of acute streptococcal pharyngitis are made by the Advisory Group based on the best available clinical evidence, local prevalence of pathogens and associated antibiotic susceptibility profiles, and common local practice. Read More

Malawi Med J 2018 06;30(2):127-131

Consultant Trauma and Orthopaedic Surgeon; Dean of Faculty of Medicine, College of Medicine, University of Malawi.

Introduction: Grisel syndrome is a non-traumatic rotary subluxation of C1 on C2 (atlantoaxial subluxation). It is a rare condition predominantly described in paediatric population with previous history of upper respiratory infections orotolaryngeal procedures. The diagnosis is established by the association of clinical and radiologic findings4,6. Read More

Int J Gen Med 2018 28;11:451-456. Epub 2018 Nov 28.

Reckitt Benckiser Healthcare International Ltd, Slough, Berkshire, UK,

Purpose: Pharyngitis is commonly caused by a self-limiting upper respiratory tract infection (URTI) and symptoms typically include sore throat. Antibiotics are often inappropriately used for the treatment of pharyngitis, which can contribute to antimicrobial resistance, therefore non-antibiotic treatments which have broad antiseptic effects may be more appropriate. Amylmetacresol (AMC) and 2,4-dichlorobenzyl alcohol (DCBA) are present in some antiseptic lozenges and have established benefits in providing symptomatic relief and some in vitro antiviral action. Read More

Eur J Pharm Biopharm 2019 Feb 10;135:36-43. Epub 2018 Dec 10.

University of Antwerp, Department of Pharmaceutical, Biomedical and Veterinary Sciences, Laboratory of Pharmaceutical Technology and Biopharmacy, Universiteitsplein 1, B-2610 Wilrijk, Belgium. Electronic address:

Tablets are increasingly explored as dosage form for oral probiotics, especially for applications such as pharyngitis and dental health. In such tablets, the dry form increases the stability and the shelf life of the product. In addition, the probiotic cells are entrapped in the tablet matrix, which protects them against the environmental factors in the human body. Read More

J Clin Microbiol 2019 Feb 30;57(2). Epub 2019 Jan 30.

Department of Pathology and Laboratory Medicine, Children's Mercy Hospital and Clinics, Kansas City, Missouri, USA

Group A (GAS) is one of the leading causes of bacterial pharyngitis. Early GAS diagnosis is critical for appropriate antibiotic administration that reduces the risk of GAS sequelae and limits spread of the infection. The Aries Group A Strep (GAS) assay (Luminex, Austin, TX) is a fully automated PCR assay for direct detection of GAS in throat swab specimens in less than 2 h with minimum hands-on time. Read More

Emerg Med Clin North Am 2019 Feb;37(1):69-80

Department of Emergency Medicine, Northwestern University, 211 East Ontario - Suite 300, Chicago, IL 60611, USA. Electronic address:

This article reviews the presentation, diagnosis, and management of common and "can't miss" infections of the oropharynx, including streptococcal pharyngitis, infectious mononucleosis, peritonsillar abscess, retropharyngeal abscess, and epiglottitis. Read More

Laryngoscope 2018 Nov 15. Epub 2018 Nov 15.

Department of Otolaryngology and Communication Enhancement, Boston, Massachusetts, U.S.A.

Objective: Pleomorphic adenoma is the most common benign salivary gland neoplasm in children. Recurrence and malignant transformation are concerns necessitating proper treatment. The goal of this research was to discuss the presentation, evaluation, and management of pediatric pleomorphic adenoma of the head and neck. Read More

Pharm Pract (Granada) 2018 Jul-Sep;16(3):1194. Epub 2018 Aug 12.

Faculty of Pharmacy & Faculty of Public Health, Lebanese University, Hadat (Lebanon).

Objectives: to assess the knowledge of both parents and community pharmacists regarding antibiotics use and resistance in pediatrics in Lebanon.

Methods: A cross-sectional study was conducted between June and August 2017 in community pharmacies. A pre-established questionnaire targeting knowledge of parents and pharmacists regarding antibiotics use/misuse was carried out. Read More

Oman Med J 2018 Nov;33(6):523-526

Radiology Department, Khoula Hospital, Muscat, Oman.

Lemierre's syndrome is a rare, life-threatening condition, which may be fatal if not properly treated. This disease refers to thrombophlebitis of the internal jugular vein, which is the result of bacterial sore throat infection (usually in the form of pharyngitis) that extends into the parapharyngeal space. However, it can result from other infective foci in the ear, nose, parotid glands, and paranasal sinuses. Read More

Turk J Med Sci 2018 Oct 31;48(5):939-944. Epub 2018 Oct 31.

Background/aim: We aimed to evaluate the efficacy of a rapid antigen test in detecting group A beta-hemolytic streptococci (GAS) in throat samples in comparison with the culture method and to compare the efficiency of matrix-assisted laser desorption/ionization-time of flight mass spectrometry (MALDI-TOF MS) and traditional methods in identifying GAS in cultures. Materials and methods: A total of 3668 throat samples from patients with a prediagnosis of tonsillopharyngitis were assessed by the QuickVue+Strep A antigen test and culture. For GAS identification from cultures, bacitracin sensitivity, PYR, and latex agglutination tests and MALDI-TOF MS were used. Read More

Circulation 2018 Oct;138(18):1920-1922

Kupat Holim Meuhedet, Jerusalem District, Israel.

Case Rep Otolaryngol 2018 27;2018:7307290. Epub 2018 Sep 27.

Department of Otorhinolaryngology, Juntendo University Faculty of Medicine, Tokyo, Japan.

Deep neck abscess is a life-threatening infection that causes laryngeal edema and upper airway occlusion. The predominant bacterial species involved in this disorder is group A streptococcus. Group G streptococcus (GGS) constitutes the normal commensal flora of the human upper airway. Read More

J Emerg Med 2018 Dec 17;55(6):841-844. Epub 2018 Oct 17.

University of California San Diego, San Diego, California.

Background: In the winter months, one often sees a large increase in the volume of patients presenting to emergency departments with acute pharyngitis. While most cases of acute pharyngitis are benign, a rare minority can be life threatening.

Case Report: We report a case of epiglottis with a concomitant peritonsillar abscess (PTA) in an adult who presented to the emergency department with a sore throat. Read More

Med Clin North Am 2018 Nov 20;102(6):1109-1120. Epub 2018 Sep 20.

Otolaryngology-Head and Neck Surgery, University of California, San Francisco, 2233 Post Street, 3rd floor, San Francisco, CA 94115, USA.

Infections of the head and neck are common and appropriately managed by primary care providers in most cases. However, some infections are associated with significant morbidity and require urgent recognition and management by specialty services. These include deep neck space infections originating in the oral cavity, pharynx, and salivary glands, as well as complicated otologic and sinonasal infection. Read More

J Infect Chemother 2018 Dec 11;24(12):969-974. Epub 2018 Oct 11.

Disease Control and Prevention Center, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan.

Purpose: Recent data suggest an association between Fusobacterium necrophorum infection and pharyngotonsillitis among adolescents and adults. However, existing reports are only from North America and Europe. We aimed to identify and compare the prevalence of F. Read More

BMJ Case Rep 2018 Oct 2;2018. Epub 2018 Oct 2.

Internal Medicine, Cooper University Hospital, Camden, New Jersey, USA.

The use of biologic drugs has expanded since its introduction in the late 1990s. With growing medical use and newer biologic drugs in development, opportunistic infections like remain important adverse effects. It carries major public health concerns, yet evidence-based clinical guidelines for more routine interval screening in patients taking immunosuppressants and exposed to tuberculosis (TB) are lacking. Read More

J Med Microbiol 2018 Nov 24;67(11):1544-1550. Epub 2018 Sep 24.

2​Department of Bacteriology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, Fukuoka 812-8582, Japan.

Purpose: The most common illness caused by Streptococcus pyogenes (Group A streptococcus; GAS) is acute pharyngitis. It has been reported that a small percentage of patients experience recurrent GAS pharyngitis after 10 days of treatment with oral amoxicillin. The aim of this study was to clarify whether recurrent GAS pharyngitis is reactivation caused by the primary strain remaining at the infection site, or if the reinfection is caused by newly acquired strains. Read More

Otolaryngol Pol 2018 Aug;72(4):42-50

Studenckie Koło Naukowe przy Klinice Otolaryngologii i Laryngologii Onkologicznej, Uniwersytet Medyczny w Łodzi.

Acute infections of the upper respiratory tract and upper gastrointestinal tract (mouth and throat) are still the most common reason for reporting to the general practitioner or ENT specialist. Despite the fact that the most common causative agent of these diseases is a virus, antibiotics are still flavored in about 60-80% of patients who report to the doctor. In consensuses such as EPOS, WHO reports and other local/ / national reports, there is a need to limit antibacterial treatment for and to replace it with symptomatic and anti-inflammatory drugs. Read More

Ann Lab Med 2019 Jan;39(1):31-35

Department of Laboratory Medicine, Gyeongsang National University College of Medicine, Jinju, Korea.

Background: The SD Bioline Strep A Ultra (SD, Yongin, Korea) is a recently developed rapid antigen detection test (RADT) for diagnosing bacterial pharyngitis caused by Group A , We evaluated the performance of SD Bioline Strep A Ultra, using the number of colony forming units and color intensity.

Methods: Three throat swabs each were taken from 343 children with pharyngitis who visited pediatric clinics. We evaluated the performance of SD Bioline Strep A Ultra and compared its positive rate with the number of colony forming units, using the Fisher exact test. Read More

Microbiol Immunol 2018 Oct;62(10):617-623

Division of Microbiology and Infectious Diseases, Graduate School of Medical and Dental Sciences, Niigata University, 2-5274 Gakkocho-dori, Chuo-ku, Niigata 951-8514, Japan.

Streptococcus pyogenes is a bacterium that causes systemic diseases such as pharyngitis and toxic shock syndrome. S. pyogenes produces molecules that inhibit the function of the human immune system, thus allowing growth and spread of the pathogen in tissues. Read More

Pediatr Emerg Care 2018 Sep;34(9):e161-e164

Division of Pediatric Emergency Medicine, Department of Pediatrics, Hamad Medical Corporation.

Neck abscesses such as retropharyngeal, peritonsilar, and lateral pharyngeal are well described, typically cause a characteristic illness, and have a known epidemiology. We present a rare occurrence of case of confluent, mixed retropharyngeal, lateral pharyngeal, and peritonsilar abscess in a 9-month-old female infant. The symptoms at presentation were very mild and not expected in association with this extensive an abscess. Read More

Int J Pediatr Otorhinolaryngol 2018 Oct 19;113:51-57. Epub 2018 Jul 19.

Department of Surgery, The University of Auckland, Auckland, New Zealand.

Introduction: Culture-independent methods, based on bacterial 16 S rRNA gene sequencing, have been used previously to investigate the adenotonsillar microbiota. However, these studies have focused on a single sampling site (usually a surface swab). We aimed to investigate potential differences in adenotonsillar microbiota according to sampling location, both on and within the adenoids and palatine tonsils. Read More

Int J Pediatr Otorhinolaryngol 2018 Oct 26;113:281-288. Epub 2018 Jul 26.

Department of Surgery, The University of Auckland, Auckland, New Zealand.

Introduction: Obstructive sleep apnea (OSA) is now a more common indication for tonsillectomy than recurrent tonsillitis (RT) [1,2]. Few studies have addressed possible differences in pathogenesis between these two conditions. Children with RT and OSA are often being treated in the community with multiple courses of antibiotics before surgery. Read More

Mikrobiyol Bul 2018 Jul;52(3):233-246

Selçuk University Faculty of Medicine, Department of Medical Microbiology, Konya, Turkey.

Streptococcus pyogenes is an important bacterial pathogen that colonizes the throat and skin of human beings and causes a wide variety of diseases ranging from mild infections like pharyngitis, tonsillitis and impetigo to severe invasive infections such streptococcal toxic shock syndrome, septicemia, and necrotizing fasciitis, and produces a wide variety of virulence factors. The aim of this study was to investigate the antibiotic resistance, virulence genes; [pyrogenic exotoxin genes (speA, C, G, H, I, J, K, L, M, smeZ and ssa), deoxyribonuclease genes (sdaB, spd3, sdc ve sdaD), protease genes (speB, spyCEP ve scpA) and inhibitor genes (mac and sic)] of S.pyogenes strains isolated from throat cultures of patients with symptomatic tonsillo-pharyngitis and typing by multiple locus variable number tandem repeat fingerprinting (MLVF) method. Read More

J Surg Case Rep 2018 Aug 7;2018(8):rjy203. Epub 2018 Aug 7.

Department of Cardiothoracic Surgery, Northern General Hospital, Herries Road, Sheffield, UK.

Descending mediastinitis is a rare, life-threatening condition caused by contiguous spread of oropharyngeal or cervical infection into the mediastinum. Infectious mononucleosis generally results in a self-limited illness characterized by fever, pharyngitis and lymphadenopathy. We present an exceptional case of an 18-year-old with infectious mononucleosis complicated by progressive bacterial superinfection and fulminant descending mediastinitis. Read More

J Med Microbiol 2018 Sep 3;67(9):1232-1242. Epub 2018 Aug 3.

1​Department of Medical Microbiology, Faculty of Medicine, University of Kelaniya, Sri Lanka.

Purpose: Respiratory tract infections are a major cause of global morbidity and mortality. Pneumonia is the ninth leading cause of mortality in Sri Lanka. Atypical pathogens cause about one-fifth of community-acquired pneumonia, while Mycoplasma pneumoniae accounts for about 50 %. Read More

Int J Parasitol Parasites Wildl 2018 Dec 30;7(3):261-267. Epub 2018 Jun 30.

Karen C. Drayer Wildlife Health Center, School of Veterinary Medicine, University of California, Davis, 1089 Veterinary Medicine Drive, Davis, CA, 95616, United States.

Avian trichomonosis is an upper digestive tract disease of birds typically caused by the protozoan parasite . In California (U.S. Read More

BMJ Case Rep 2018 Jul 30;2018. Epub 2018 Jul 30.

Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada.

We report a previously well paediatric patient with two distinct presentations of invasive group A streptococcus (GAS) infection resulting in significant morbidity. The first episode, following GAS pharyngitis, involved multiorgan dysfunction syndrome. This included cardiorespiratory and acute hepatorenal failure and purpura fulminans that eventually necessitated four-limb amputation. Read More

Infect Immun 2018 Oct 21;86(10). Epub 2018 Sep 21.

Research Programs Unit, Immunobiology, University of Helsinki, Helsinki, Finland

Pharyngeal tonsillitis is one of the most common upper respiratory tract infections, and group A streptococcus is the most important bacterial pathogen causing it. While most patients experience tonsillitis only rarely, a subset of patients suffers from recurrent or chronic tonsillitis or pharyngitis. The predisposing factors for recurring or chronic forms of this disease are not yet fully understood, but genetic predisposition has been suggested. Read More

BMJ Case Rep 2018 Jul 19;2018. Epub 2018 Jul 19.

Department of Internal Medicine, Michigan State University, Sparrow Hospital, East Lansing, Michigan, USA.

An 18-year-old woman presented to clinic with acute pharyngitis with 4/4 Centor criteria. Rapid streptococcal antigen test was negative. The patient, who was allergic to penicillin, was prescribed azithromycin. Read More

Lancet 2018 07 29;392(10142):161-174. Epub 2018 Jun 29.

Heart Institute (InCor), University of São Paulo, Institute for Investigation in Immunology, National Institute of Science and Technology, São Paulo, Brazil.

Acute rheumatic fever is caused by an autoimmune response to throat infection with Streptococcus pyogenes. Cardiac involvement during acute rheumatic fever can result in rheumatic heart disease, which can cause heart failure and premature mortality. Poverty and household overcrowding are associated with an increased prevalence of acute rheumatic fever and rheumatic heart disease, both of which remain a public health problem in many low-income countries. Read More

Front Cell Infect Microbiol 2018 3;8:211. Epub 2018 Jul 3.

Department of Biological Sciences, University of Notre Dame, Notre Dame, IN, United States.

The bacterial pathogen Group A (GAS) has been shown to induce a variety of human diseases ranging in severity from pharyngitis to toxic shock syndrome and necrotizing fasciitis. GAS produces a powerful peptide toxin known as Streptolysin S (SLS). Though long recognized as a potent cytolysin, recent evidence from our lab has shown that SLS-dependent cytotoxicity is mediated through activation of the pro-inflammatory mediators p38 MAPK and NFκB. Read More

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2018 Jul;32(13):1027-1029

Department of Otorhinolaryngology Head and Neck Surgery,the Affiliated Hospital of Qingdao University, Qingdao, 266071, China.

To investigate the pathogenic bacteria and drug sensitivity tests in patients with chronic tonsillitis.We chose a group of patients who were diagnosed chronic tonsillitis as the research object. According to age, they were divided into the children group, the adolescents group and the adults group. Read More

Vestn Otorinolaringol 2018;83(3):45-49

Urals State Medical University, Ekaterinburg, Russia, 620028; City Clinical Hospital # 40', Ekaterinburg, Russia, 620146.

The objective of the present study was the comparison of the effectiveness of the application of tonsilgon-N in the combination with the physical methods for sanitization of the palatine tonsil lagunes with that of the standard conservative treatment. A total of 60 patients having the confirmed diagnosis of sub-compensated form of chronic tonsillitis were recruited to participate in the study. All the patients were divided into two groups. Read More

Am J Clin Pathol 2018 Jun 19. Epub 2018 Jun 19.

From the Departments of Pathology and Laboratory Medicine, 1Children's Healthcare of Atlanta, Atlanta, GA.

Objectives: Group A Streptococcus (GAS) is the most common bacterial cause of pediatric acute pharyngitis, and its quick identification is important for subsequent treatment. We sought to determine whether molecular GAS-based testing can successfully replace GAS antigen testing and subsequent culture in a pediatric urgent care center.

Methods: We tested 160 patient oropharyngeal samples by a rapid antigen GAS test, the Alere i Strep A test, and throat culture in a pediatric urgent care setting and calculated basic statistical metrics. Read More

Ann Clin Microbiol Antimicrob 2018 Jun 9;17(1):26. Epub 2018 Jun 9.

The Faculty of Medicine in the Galilee, Bar Ilan University, Zefat, Israel.

Background: Antibiotics are frequently prescribed at many of the visits to primary care clinics, often for conditions for which they provide no benefit, including viral respiratory tract infections.

Objectives: The aim was to evaluate primary care visits due to infectious diseases, and to estimate antibiotic prescribing and antibiotic dispensing by pharmacies.

Methods: Diagnosis of infectious disease, antibiotic prescribing and dispensing data at the individual patient level were extracted for 2015 from Clalit Health Services' electronic medical records and linked to determine the condition for which the antimicrobial was prescribed. Read More

BMJ Case Rep 2018 Jun 6;2018. Epub 2018 Jun 6.

Pediatric Department, Hospital Vila Franca de Xira, Vila Franca de Xira, Portugal.

Lipschütz ulcers (LU) are non-sexually related genital ulcers, rarely reported. We describe a healthy 11-year-old girl, who presented with fever and a painful vulvar ulcer associated with erythematous tonsillitis. Throat swab test for Group A Streptococcus (GAS) was positive. Read More

J Drugs Dermatol 2018 Jun;17(6):632-638

Background: Long-term oral antibiotic use in acne may be associated with a variety of adverse effects including antibiotic resistance, pharyngitis, inflammatory bowel disease, and breast and colon cancer. Spironolactone may represent an effective and safe alternative to oral antibiotics for women with moderate to severe acne, however comparative studies are lacking.

Methods: Using the OptumInsight™ Clinformatics™ DataMart, we conducted a retrospective analysis of the frequency of switching to a different systemic agent within the first year of therapy among women with acne who were started on either spironolactone or an oral tetracycline-class antibiotic between 2010-2016, after controlling for age, topical retinoid, and oral contraceptive use. Read More

BMJ Case Rep 2018 May 30;2018. Epub 2018 May 30.

Radiology, Fiona Stanley Hospital, Murdoch, Australia.

Descending necrotising mediastinitis (DNM) is an uncommon clinical entity which may arise secondary to primary odontogenic or neck infection in susceptible patients. Infection may spread contiguously via the alar or 'danger' space, a potential anatomical space posterior to the true retropharyngeal space. Spread of infection to the mediastinum almost always necessitates urgent cardiothoracic surgical intervention. Read More

Cell Syst 2018 May 16;6(5):579-592.e4. Epub 2018 May 16.

Department of Pharmacology, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA; Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA; Center for Microbiome Innovation, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA. Electronic address:

Group A Streptococcus (GAS) remains one of the top 10 deadliest human pathogens worldwide despite its sensitivity to penicillin. Although the most common GAS infection is pharyngitis (strep throat), it also causes life-threatening systemic infections. A series of complex networks between host and pathogen drive invasive infections, which have not been comprehensively mapped. Read More

Homeopathy 2018 05 5;107(2):99-114. Epub 2018 Feb 5.

Department of Life Sciences, University of Westminster, London, United Kingdom.

Background: Acute upper respiratory tract infections (URTIs) and their complications are the most frequent cause of antibiotic prescribing in primary care. With multi-resistant organisms proliferating, appropriate alternative treatments to these conditions are urgently required. Homeopathy presents one solution; however, there are many methods of homeopathic prescribing. Read More