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Monday, June 30, 2008

Diseases of External Ear

As we have learned the anatomy of external ear in the previous post ,now we will check important high yield facts about external ear diseases.

we divide the topic into:

  1. congenital disorders
  2. traumatic
  3. inflammatory
  4. neoplastic.

congenital disorders:

auricle/pinna:

bat ear(lop ear) :"lop"-to hang down loosely

  • Definition: The external ear stands away from the head at a greater angle (Normal angle of the auricle to the median plane averages 25 degrees in boys and 18 degrees in girls). Lop ears are usually larger than normal ears.
  • concha is large
  • poorly developed antihelix & scapha.both these feature clearly seen in this picture.
  • Associates anomalies: Commonly associated with the following:
  1. Ehlers-Danlos syndrome: Unusual facies, lop ears, hyperextensible joints, hip dislocation, inguinal hernia with autosomal recessive inheritance.
  2. Towns-Brocks syndrome: Lop ears, imperforate anus, hypoplastic kidney, ventricular septal defect, limb anomalies with autosomal dominant inheritance.

otopl_1b

  • treatment - by surgical correction -Bat ear correction or otoplasty, is a plastic surgery procedure designed to pull the ears closer to the head. Otoplasty involves reshaping, remodeling, and reforming the outer ear.

anotia:

  • complete absence of pinna
  • part of "First arch syndrome"

Macrotia:

  • Definition: Macrotia means large ears.
  • The auricle is usually very large but well shaped without other ear malformations.
  • The most exaggerated portion is the scaphoid fossa.

microtia:

  • Microtia means small ears

1_29.sized

  • associated anomalies :
DIAGNOSIS MINIMAL CRITERIA
microtia

Isolated microtia

Hemifacial microsomia

Unilateral microtia

Goldenhar syndrome

Unilateral microtia, small malformed mandible

Oculo-auriculo-vertebral dysplasia

Unilateral microtia, small malformed mandible, epibulbar dermoids, anomalies of the cervical spine

note:

  • microtia-anotia is an essential component of isoretinoin embryopathy,
  • important manifestation of thalidomide embryopathy, and
  • can be part of the fetal alcohol syndrome and
  • maternal diabetes embryopathy.
  • Microtia-anotia occurs with a number of single gene disorders, such as Treacher-Collins syndrome, or chromosomal syndromes, such as trisomy 18.
  • Rubella and other intrauterine infections
  • Trisomy 21: Mean ear length and measured: expected ear length ratios are significantly lower in 75% of fetuses with trisomy 21
  • Retinoic acid embryopathy



preauricular appendages:

  • Definition: tags of skin with or without a cartilaginous base frequently located in the line drawn from tragus to angle of mouth.
  • are often associated with microtia, melotia( Definition: Ear located on the cheek.) or oblique facial features

preauricular pit or sinuses:

  • due to a failure in the fusion of the primitive ear hillocks, or to a defective closure of the first branchial cleft
  • characteristically located in or just in front of the anterior crus of the helix.

preauricular pit

  • The pits often discharge a cheesy substance, which consists of desquamated keratin debris.

Low-set ears

Definition: An ear that is set below an arbitrary line drawn between the lateral canthus of the eye and the occipital protruberance is considered low-set.

low set ears

Associated anomalies: Commonly associated with the following

  • Noonan syndrome: webbing of the neck, pectus excavatum, cryptorchidism, pulmonary stenosis. Ears are low-set with or without abnormal auricles. 25% have mental retardation. Koretzy et al. described an unusual type of pulmonary valvular dysplasia which showed a familial tendency with either affected parent and offspring or affected sibs. Other features were retarded growth, abnormal facies (triangular face, hypertelorism, low-set ears and ptosis of the eyelids)
  • Pena Shokeir phenotype: Neurogenic arthrogryposis, pulmonary hypoplasia, hypertelorism with low-set malformed ears. 30% are stillborn. Majority of those liveborn die within the first month of life[15].
  • Trisomy 18:Clenched hand, short sternum, low arch dermal ridge patterning on fingertips and low-set malformed auricles. Only 5% to 10% survive the first year as severely mentally defective individuals.

Synotia

  • Definition: In Agnathia-Synotia-Microstomia, the ears are very close to each other due to absence or hypoplasia of the mandible.
  • The external ears assume a horizontal position with the lobules located near the midline.

synotia

  • "Bow-tie" ear due to failure of migration in Agnathia-Synotia-Microstomia

External auditory canal:

atresia:

when occurs alone when in association with microtia
due to failure of canalisation of ectodermal corethat fills the dorsal part of first branchial cleft associated with abnormailities of middle ear ,inner ear
outer meatus-filled with fibrous tissue or bone total atresia
deep meatus-normal

collaural fistula:

  • has two openings, the lower one situated in the neck between the angle of the mandible and the sternomastoid muscle, the upper in the floor of the external auditory canal or intertragal notch.

collaural fistula

The lower opening of the collaural fistula is outlined with a blue circle .

traumatic :

auricle:

hematoma of auricle :

hematoma cauliflower ear

  • collection of blood b/w auricular cartilage & perichondrium.
  • this blood may clot & organise into "cauliflower ear"
  • treatment -
  1. aspiration of hematoma & pressure dressing.
  2. if aspiration fails -incision & drainage
  3. prophylactic antibiotics.

{note: do as fast as possible since due to hematoma ,the vascular supply of cartilage is cut-off ,therefore it would cause avascular necrosis of cartilage.}

laceration:

  • cut in the pinna
  • treatment: as fast as possible by stiching
  1. perichondrium - absorbable suture use
  2. skin - non-absorbable suture
  3. broad spectrum antibiotics

avulsion of pinna:

avulsion

  • The blood supply to the auricle is excellent and its metabolic demands are relatively low; therefore, primary reattachment is frequently successful, even with a tenuous pedicle.
  • treatment :Management of these injuries consists of an early meticulous reimplantation, with minimal debridement and the use of low-dose heparin sodium to prevent thrombosis, appropriate antibiotic coverage to prevent infection, and multiple stab incisions to relieve venous congestion while revascularization is taking place.

keloid :

  • excessive scar at site of piercing

Keloid_2

  • usual sites-lobule or helix

{note-Hypertrophic scars remain within the confines of the wound and flatten spontaneously over one or more years. By contrast, keloids not only persist but frequently extend beyond the site of the original injury. Keloids occur more commonly in blacks than in whites and develop more frequently in the second and third decades of life.}

  • treatment:
  1. surgical excision causes recurrence.
  2. to prevent recurrence-
  • pre & post-operative radiation with total dose of 600-800 rad delivered in 4 divided doses
  • local injection of steroid after excision.

ear canal:

minor lacerations major lacerations
from Q-tip injury gun shot wounds,accidents
heal without sequelae stenosis of ear canal is common problem

ear drum:traumatic rupture

  • trauma due to hair pin ,match stick
  • sudden change in pressure- slap , forceful valsava procedure
  • fracture of temporal bone

treatment: minor injury-heal by themselves

if it doesn't heal-tympanoplasty.

inflammatory disorders:

pinna:

PERICHONDRITIS RELAPSING POLYCHONDRITIS
infection secondary to laceration ,hematoma ,surgical incision or extension of infection from ear canal autoimmune in origin
pseudomonas is important cause.others-Staphylococcus aureus, and Streptococcus pyogenes does not involve any bacteria
symptoms-red ,hot ,painful pinna & stiff same & other cartilages like tracheal ,nasal septum ,coastal cartilages also involved.
later abscess may form no
treatment-early stage:systemic antibiotics like fluoroquinolones-ciprofloxacin are drug of choice Treatment is with oral corticosteroids.
if an abscess is present, surgical incision and drainage often are necessary.

{note:in both these conditions lobule is unaffected thus differentiating from cellulitis.}

chondrodermatitis nodularis chronica helicis:

  • small benign painful nodules on free border of helix

chondrodermatitis nodularis

  • most authorities believe it is caused by prolonged and excessive pressure.check this on emedicine
  • treatment:surgical excision of underlying cartilage.

{note:The most important medicolegal pitfall associated with CNH may be the misdiagnosis of a true malignancy as CNH, thereby resulting in failure to perform a biopsy and to treat it as a malignancy.}

this is for today,in the next post we will deal with otitis externa & other miscellaneous conditions & tumors affecting external ear.


46 comments:

Anonymous said...

Thank you

Anonymous said...

good job....:-)

NFS said...

Thank you , very helpful

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Anonymous said...

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copper westmoreland said...

I am very happy today to share this amazing testimony on how Dr JOE the herbal doctor was able to cure me from my HIV Virus with his herbal medicine. I have been a HIV patient for almost 9 years now and have tried different methods of treatment to ensure that I am cured of this terrible disease, but none worked for me, so I had to leave everything to God to handle as I was a Christian who had faith that one day God would intervene in my life, yet I felt so sad and desperate as I was losing almost everything due to my illness, A few months ago while I was surfing the internet I saw different recommendation about Dr JOE on how he have been using his herbal Medicine to treat and cure people, these people advice we contact Dr JOE for any problem that would help immediately, I contacted Dr JOE and I told him how I got his contact and also about my disease, after some time Dr JOE told me to have faith that he would prepare for me a medication of herbal herbs, he told me I would take this medicine for a few weeks and also asked my home for home address so as possible for him to submit the drug for me, so my good friends after all the process and everything Dr JOE actually sent me the medicine, I took it as I was directed by Dr. JOE, after a few weeks passed, while on Dr JOE medication I began to experience changes in my body, I had to call my doctor at the hospital for some blood test after test my hospital doctor told me that I was no longer with the Hiv virus and my blood is pretty good, I can not even believe this, Friends well today i am Hiv Free and i want everyone to know that there is a cure for Hiv for those who will contact Dr JOE after reading my testimony, you can kindly contact Dr JOE on his email (drjoehome@gmail.com) or call him or whatsapp on +2348155730398, God bless you all ….

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Lizah Purity said...

I want to share my testimony on how i get cure of my HERPES GENITAL with
the help of Doctor idahosa, i have being suffering for this disease for a
very long time now.i have try several means to get rid of of the (HERPES)
disease for the last five years and had constant pain, especially in my
knees. During the first year,I had faith in God that i would be healed
someday.This disease started circulate all over my body and i have been
taking treatment from my doctor, few weeks ago i came on search on the
internet if i could get any information concerning the prevention of this
disease, on my search i saw a testimony of someone who has been healed from
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address of this man and advise we should contact him for any sickness that
he would be of help, so i wrote to Dr idahosa telling him about my (HERPES
Virus) he told me not to worry that i was going to be cured!! hmm i never
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man few weeks later i started experiencing changes all over me as the
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TINA PHILIPA said...

I am very much happy to share to every viewers that is reading this,I want to inform the whole public of how I got help for my herpes, I wanted this since 6 months ago, I have also taken treatment from some doctor,few weeks back I came on the net to see if I will be able to get any information as to cure my herpes, on my search I saw various testimony of people who was helped by a great man called Dr Akhigbe and without any hesitation, I contacted him, I wrote to him and and he guided me, I asked him for solutions and he started the remedies for me and indeed 3 weeks after I started using the medicine, I was completely happy as it worked for me.I went to the hospital for check up and indeed I was declared negative from my disease, and I also waited again for two weeks and went back to another hospital for check up to be fully sure and to my great surprise I was still declared negative, and I decided to share this great opportunity to those people out there fighting this sickness, You can contact him now for your medicine to cure your diseases, contact his Email; drrealakhigbe@gmail.com or Whatsapp +2348142454860. website. hpps:drrealakhigbe.weebly.com

Dr Akhigbe also cure diseases like..
HIV
Herpes
Cancer
Chronic Disease
Asthma
Als
Heart Disease
Diabetes
Kidney Disease
Lupus
Epilepsy
Stroke
Eczema
Eating Disorder
Back Pain. etc
contact him for your solution

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roland lisa said...


I am from UNITED STATES i was diagnosed with HIV/AIDS for over 12 years which made loose my job and my relationship with my fiance after he discovered that i was having HIV, he departed from me i tried all my best to make him stays with me, but neglected me until a friend of mine on Facebook from Singapore told me Great healer, who will restore my life back with his powerful healing spell, he sent me the email address to contact and i quickly contacted him, and he said my condition can solved, that he will treat the disease immediately only if i can accept trust him and accept his terms and condition, i Agreed because i was so much in need of help by all means, so i did all he want from me and surprisingly on Sunday last week He sent me a text, that i should hurry up to the hospital for a checkup, which i truly did, i confirm from my doctor that i am now ( HIV NEGATIVE) my eyes filled with tears and joy, crying heavily because truly the disease deprived me of many things from my life, This is a Miracle, Please do not en-devour to email dr.losaherbalhome@gmail.com or whatsapp Dr LOSA on +2349056464736 for healings Thanks
stay blessed......
HE ALSO HAVE THIS CURE
{1}HIV And AIDS
{2}Diabetes
{3}Epilepsy
{4} Blood Cancer
{5} HPV
{6} ALS
{7} Hepatitis B
{8} COPD (Chronic Obstructive Pulmonary Disease)
{9} IF YOU NEED YOUR EX LOVER BACK TO LOVE YOU AGAIN.
https://drlosaherbslhome.wordpress.com

Carlos Benita said...

I am a 51 year old female that just found out I have Motor Neuron Disease Parkinson's about a year and half, but I have been having signs of it for years, tremors, depression, body weakness. ECT. I honestly don't think my doctor was reading the signs because of my gender and age. A few years ago I had my shoulder lock up on me and I was sent to a P.T since x-rays didn't show any physical damage. My shaking was getting worse and I began falling. Only when my speech became so bad that it brought concern to my dentist was Parkinson's even considered. He phoned my doctor with his concerns about my shaking and balance problems. By this time I was forgoing shots in the back of my neck for back and neck pain to which once again I was sent to a P.T (although x-rays showed no damage) I was told I had a few spurs which were most likely causing the pain. Here I was feeling like my whole body was falling apart and doctor could not find anything wrong, maybe in was all in my head? My doctor even seemed annoyed with me and things just kept progressing and I just kept it to myself, why bother going through testing and them finding nothing? Well, it was after my second P.T called my doctor about the weakness in my legs and arms, by this time I have developed a gait in my walk and I fell more frequently. Only then did my doctor send me to a specialist and it was found that I had Parkinson's, and that I have had it for awhile. I think because I was a woman that my signs and symptoms weren't taken seriously and therefor left untreated for so long,I was taking pramipexole dihydrochloride three times daily, I Was on carbidopa levodopa but only lasted 90 minutes then wore off.I found that none of the current medications worked effective for me.I got tired of using those medication so I decided to apply natural herbs formula that was prescribed to me by my second P.T, i purchase the herbal formula from totalcureherbsfoundation. com, There has been huge progression ever since I start the treatment plan which will last for 15 weeks usage.all the symptoms and sign has begin to disappear .

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John Williams said...

Herpes Finally Gone, thanks to Dr. Utu for his Herbal Treatment.
I had a sudden onset of cold sores and a new one was appearing each day. I was on primary immunosuppressant I noticed my body just can't fight the virus on its own. After five days of treatment and no success I suspected herpes I went for test and it was confirmed. God was my strength I met a doctor for treatment. He gave me Dr Utu's contact. I contacted him immediately, This medication was far amazing that within 24-48 hrs the blisters were crusting over. The swelling and redness was decreasing as well. I was on four weeks herpes medication which I completed before going for test. I went for herpes test and then again back to my doctor who confirmed me herpes negative it was really like a dream. What a relief! Feel Free to contact Dr Utu Email:- drutuherbalcure@gmail.com OR WhatsApp :- +2347032718477

LARRY SCOTT said...

I am Larry Scott, I contracted HIV in 2009 I was told by my doctor that there’s no possible cure for HIV. I started taking my ARV’s, My CD4 is 77 and viral load is 112,450. I saw a website of Dr.Ehi, also I saw a lot of testimonials about him on how he uses herbal medicine to cure HIV. I contacted him and told him my problems, He sent me the herbal medicine and I took it for 21 days after then I went for check-up and I was cured. The medicine has NO SIDE EFFECT, there’s no special diet when taking the medicine.  is really a great man contact him now. { Ehicareherbalhome@gmail.com } m the great herbal mercy add him on whatsapp on +2348117827382 thanks once again dr Ehi you are the best I have ever seen  

Erica Max said...

Do you still Struggle with Cold Sores, unexpected Outbreak and Herpes Virus? then you don't have to keep waiting for treatment when the is a herbal medicine that cure this virus. I was searching online for Herbal Cure for Herpes Virus when I saw a testimony online about Dr. Akintunde and how he cured a lady of HSV1 with his.
natural herbal medicine and tested Negative and in less than a month she was cured of this virus. So it took me time to believe that this was true, because my family Doctor tried all his best to get rid of this virus in my body system but yet no cure and I suffered from outbreak and Cold Sores always. I had to contact Dr. Akintunde after I have access his website and i had faith in God that I was going to be fine and free of this virus one day. Finally I contacted Dr. Akintunde on his WhatsApp number that I saw on the testimony post online, and after our conversation the Doctor only promise me that I was going to be cured and free of this virus after taking his natural herbal medicine because I was tired of my situation with this virus it was so distracting to my life and whole family. Later Dr. Akintunde send some Herbal medicine to me through UPS courier service, with instructions on how to used this medicine, to my biggest surprise first week of taking my herbal medication I saw great improvement and I still think that it's a dream but this is real, I now test Negative of this virus today and my blood pressure well regulated now, my family doctor after my test was extremely surprise to see my test result change to HSV1 Negative and no more symptoms, cold sores, sores throat and outbreak again. I wish to tell everyone about this, mostly if you have this virus then do yourself good to contact Dr. Akintunde and see what the Lord can do through this Herbal Doctor's medicine in less than a month. 100% free from herpes Virus. I and my family say "thank you" Sir, for helping my life. You are a blessing to this generation and God will reward you richly

Email: drakintundehomecare@gmail.com

WhatsApp number: +234 703 524 5593

Nora Gurun said...

HSV1 & HSV2 Negative.
Saying that, herpes virus is not curable is because you have not seen the right person to help you get rid of the virus. I testify because it's only someone who have experience this virus that konws what it means to be in this situation. After my marriage to Loe my hubby, i noticed one day that I had sudden Cold Sores in my genital part. I went for test and the doctor confirmed me being HSV2 positive.
I felt my life and happiness with my hubby was finished. But to my greatest surprise my husband had contacted this virus and was later confirm HSV1 positive. I started noticing symptoms like sore throat, fever blister weakness of the body, runny nose, cough and finally the was a serious Outbreak. So I started looking for a means to control our situation because the phamacytical drugs and the pains was too much for I and my hubby. I was looking for remedy online and different website when i saw a testimony about Dr. Akintunde and the herbal medicine that helped Erica to get rid of HSV2, I remembered my doctor told me the is no cure to this virus, I had to contact Dr. Akintunde on his WhatsApp number and told him about us and the virus, he promised to cure this virus with his herbal medicine. And he prepared four bottles of the herbal medicine and send to me through UPS delivery with instructions on how to take it. And only first week of my start, I noticed the outbreak and all the symptoms was off so, I told Dr. Akintunde about it and he said the medicine will eradicate the virus and boots my immune when i complete my medication. After I took the medicine I went back for retest and my doctor was surprised with my new status HSV2 negative my hubby also was cured. Thanks to Dr. Akintunde I am proud to say you safe our life and we remain greatful and we support your mission on humanity Sir, Do you experience such too?
Tell Dr. Akin your health problem and be sure of total cure with his natural roots and herbs. Like Erica did testify to me I also testify for everyone who need help to be free from this inconveniencing virus. All the best.
Dr. Akintunde email and WhatsApp number below.
Via email:-
drakintundehomecare@gmail.com

WhatsApp number:. +2347035245593

DAVID ALLEN said...

ARE YOU AWARE THAT MODERN NATURAL HERBAL MEDICINES OF THIS GENERATION NOW PERMANENTLY CURE DRUG RESISTANT DISEASES LIKE; HSV/HERPES, CANCERS, HIV/AIDS FOREVER WITHOUT A POSSIBLE COME BACK OR AFTER EFFECTS?
It wonderfully worked for me;
At first I was a bit skeptical about this Natural cure for herpes and other similar medicines. Discovering people with similar symptoms who are treated and cured by Dr Utu both on medias and in social medias on daily basis motivated me, so I contacted him for help!
At first, I was a bit curious about this possible cure, but! I don't want to be left out without giving it a trial, so I contacted him as well.
Some hours later he replied me, then he asked me some private questions, of which I honestly answered, I told him how I have lived and suffered with this disease and how much I will do anything to get rid of it. He assured me of total cure after taking his herbal medicines. It was even more easier than I expected. Also I never even imagined to get my parcels within five working days, but to my greatest surprise my parcels was brought to my doorstep by the end of the second day. I collected the parcel which I followed all the instructions as he had directed. Just as I was told "four weeks medication " my medicine finished in four weeks exactly. From week one of my medication I started noticing positive change in health. and in week two I could tell much more differences and I was so eager to even testify of life again in me.
I patiently continue medication till the last bottle which was then week four. I was the first person the next day in the clinic for lab test. Not even a particle of herpes was found in my system when I collected my result. Knowing I'm now herpes negative at this point I proceeded to inform my doctor, he doubted me, that day he gave me a month appointment to be closely monitored. It's my health so I waited more six Months and again i went for 'lab test' in a different clinical lab.
This time the result was still the same as the previous one. Also since this year I have been living my normal life and am still herpes free no symptoms and even till now no cold sore or outbreak. As a result of this herbal cure in my life and my family at large, I can boast of doctors today who through me, now uses African Traditional Roots and Herbs to TREAT AND CURE patients that are, CANCERS, HERPES, PARALYSIS, and HIV successfully today. Many are still ignorant of this I know.
Contact Dr Utu directly today on; "drutuherbalcure@gmail.com" to free yourself from emotional stress and become healthy again

DAVID ALLEN said...

ARE YOU AWARE THAT MODERN NATURAL HERBAL MEDICINES OF THIS GENERATION NOW PERMANENTLY CURE DRUG RESISTANT DISEASES LIKE; HSV/HERPES, CANCERS, HIV/AIDS FOREVER WITHOUT A POSSIBLE COME BACK OR AFTER EFFECTS?
It wonderfully worked for me;
At first I was a bit skeptical about this Natural cure for herpes and other similar medicines. Discovering people with similar symptoms who are treated and cured by Dr Utu both on medias and in social medias on daily basis motivated me, so I contacted him for help!
At first, I was a bit curious about this possible cure, but! I don't want to be left out without giving it a trial, so I contacted him as well.
Some hours later he replied me, then he asked me some private questions, of which I honestly answered, I told him how I have lived and suffered with this disease and how much I will do anything to get rid of it. He assured me of total cure after taking his herbal medicines. It was even more easier than I expected. Also I never even imagined to get my parcels within five working days, but to my greatest surprise my parcels was brought to my doorstep by the end of the second day. I collected the parcel which I followed all the instructions as he had directed. Just as I was told "four weeks medication " my medicine finished in four weeks exactly. From week one of my medication I started noticing positive change in health. and in week two I could tell much more differences and I was so eager to even testify of life again in me.
I patiently continue medication till the last bottle which was then week four. I was the first person the next day in the clinic for lab test. Not even a particle of herpes was found in my system when I collected my result. Knowing I'm now herpes negative at this point I proceeded to inform my doctor, he doubted me, that day he gave me a month appointment to be closely monitored. It's my health so I waited more six Months and again i went for 'lab test' in a different clinical lab.
This time the result was still the same as the previous one. Also since this year I have been living my normal life and am still herpes free no symptoms and even till now no cold sore or outbreak. As a result of this herbal cure in my life and my family at large, I can boast of doctors today who through me, now uses African Traditional Roots and Herbs to TREAT AND CURE patients that are, CANCERS, HERPES, PARALYSIS, and HIV successfully today. Many are still ignorant of this I know.
Contact Dr Utu directly today on; "drutuherbalcure@gmail.com" to free yourself from emotional stress and become healthy again

John kim said...

How can I explain this to the world that there is a man who can cure HERPES, I was diagnosed for the past 1 year I have being into HERPES since 1 year, so I decide to look for help in the internet then I found a post write about this great man called DR. Yakubu , people say good thing about him that this man have cured, a lot of people in the internet, him has power's to cure HSV1 AND HSV2 I don’t believe that there is a cure for Herpes Simplex Virus because though there is no cure for herpes that what I have in mind HERPES had no cure well , my HERPES is negative through the using of herbal cured of DR yakubu , I contacted this man for help because of what i see in the internet. if you need his cured just email him now on dr.yakubuherbalhealingclinic@gmail.com , thank you DR. i will never stop shearing you testimony DR. Yakubu . him Can as well CURE THE FOLLOWING DISEASE:-1, HIV/AIDS, 2, Diseases of the hear 3, Malignant tumors 4. Cardiovascular diseases 5. Diabetes mellifluous 6.Influenza and pneumonia 7.Alzheimer's disease 8. hsv1 - hsv2. If you need LOVE SPELL. E.T.C contact him dr.yakubuherbalhealingclinic@gmail.com or you whatsapp him on +2348057353647...
Dr.yakubu 하나님은 내 삶을 회복시켜 주신 것에 대한 축복을 계속할 것입니다. 나는 사람들에게 증거를 계속 나눌 것입니다.

Angelina Keffi said...

There is a safe & effective Natural Herbal Medicine. For Total Cure Call    +2349010754824,  or email him   drrealakhigbe@gmail.com       For an Appointment with (Dr.) AKHIGBE contact him. Treatment with Natural Herbal Cure. For:Dengue Fever, Malaria. Painful or Irregular Menstruation. HIV/Aids. Diabetics. Vaginal Infections. Vaginal Discharge. Itching Of the Private Part. Breast Infection. Discharge from Breast. Breast Pain & Itching. Lower Abdominal Pain. No Periods or Periods Suddenly Stop. Women Sexual Problems. High Blood Pressure Chronic Disease. Pain during Sex inside the Pelvis. Pain during Urination. Pelvic Inflammatory Disease, (PID). Dripping Of Sperm from the Vagina As Well As for Low sperm count. Parkinson disease. Lupus.  Cancer.  Tuberculosis.  Zero sperm count. Bacteria Diarrhea.Herpatitis A&B, Rabies. Asthma.  Quick Ejaculation. Gallstone,  Premature Ejaculation. Herpes. Joint Pain. Stroke. Weak Erection.  Erysipelas, Thyroid, Discharge from Penis. HPV.  Hepatitis A and B. STD. Staphylococcus + Gonorrhea + Syphilis. Heart Disease.  Pile-Hemorrhoid.rheumatism, thyroid, Autism, Penis enlargement,  Waist & Back Pain.  Male Infertility and Female Infertility. Etc. Take Action Now. contact him & Order for your Natural Herbal Medicine:  +2349010754824  and email him    drrealakhigbe@gmail.com    Note For an Appointment with (Dr.) AKHIGBE.I suffered in Cancer for a year and three months dieing in pain and full of heart break. One day I was searching through the internet and I came across a testimony herpes cure by doctor Akhigbe. So I contact him to try my luck, we talk and he send me the medicine through courier service and with instructions on how to be drinking it.To my greatest surprise drinking the herbal medicine within three weeks I got the changes and I was cure totally. I don't really know how it happen but there is power in Dr Akhigbe herbal medicine. He is a good herbalist doctor.

Meyer Becker said...

Health wise, I feel like a child dancing in the rain ever since I got cured of hepatitis. I was diagnosed of HEPATITIS B and I was told it has no cure at the hospital, but I was given several antiviral medications to slow the virus’s ability to damage liver. But after sometime the medicine wasn't working and I became very sick with different symptoms like: vomiting, fatigue, dark urine, swollen stomach and so on. I went back to the hospital and I was told it has become chronic with liver problem, and out of frustration I went online to search for something new to try, and I came across Dr. IYABIYE's recommendation, I gave it a try hence it's a herbal medicine. And behold, I was cured after the treatment. I have to wait for months then went back to the hospital and still I was tested negative. You too will be cured. Contact: (Whatsapp: +2348072229413 or +2348158577300) iyabiyehealinghome@gmail.com

Amanda Bella said...

I Want To Appreciate Dr.OYAGU for hs great deeds, I Was Diagnosed With type 2 Herpes Virus Last year,And Was Look For Solution To Be Cured Luckily I Saw Testimonies On How Dr.OYAGU Cure Herpes Virus I Decided To Contact Dr.OYAGU I Contacted Him He Prepared A Herbal Medicine Portion And Sent It To Me,I Started The Herbal Medicine For My Health.He Gave Me Step By Step Instructions On How To Apply It, When I Applied It As Instructed, I Was Cured Of This Deadly Herpes Within 2 weeks, I Am Now Herpes Negative.My Brother And Sister I No That There Are So Many People That Have There Same Herpes Virus Please contact Dr OYAGU To Help You Too,And Help Me To Thank Dr.OYAGU For Cure Me, I’m Cured By Dr. OYAGU Herbal Medicine,His Contact Email:oyaguspellcaster@gmail.com

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Suntran Matthew said...

I am here to give my testimony about Dr Ebhota who helped me.. i want to inform the public how i was cured from (HERPES SIMPLEX VIRUS) by salami, i visited different hospital but they gave me list of drugs like Famvir, Zovirax, and Valtrex which is very expensive to treat the symptoms and never cured me. I was browsing through the Internet searching for remedy on HERPES and i saw comment of people talking about how Dr Ehbota cured them. when i contacted him he gave me hope and send a Herbal medicine to me that i took for just 2 weeks and it seriously worked for me, my HERPES result came out negative. I am so happy as i am sharing this testimony. My advice to you all who thinks that there is no cure for herpes that is Not true just contact him and get cure from Dr Ebhota healing herbal cure of all kinds of sickness you may have like
(1) CANCER,
(2) DIABETES,
(3) HIV&AIDS,
(4) URINARY TRACT INFECTION,
(5) CANCER,
(6) IMPOTENCE,
(7) BARENESS/INFERTILITY
(8) DIARRHEA
(9) ASTHMA
(10)SIMPLEX HERPES AND GENITAL
(11)COLD SORE
HERPES. he also cure my friend from cervical cancer Email: drebhotasoultion@gmail.com or whatsapp him on +2348089535482

Celina Gomez said...

i'm Celina Gomez from Canada, i have been cured from genital herpes with herbalist Aziza herbal medicine.
i have been infected with Genital herpes for 1 year now , i have done so many medical treatment from different hospital still
not cured.
On a very good day , i decide  to make a research on my computer on how to get rid of my Genital herpes,i found a post of Sarah Wilson on how she was  cured from herpes with HERBALIST Aziza herbal remedy.
The Herbalist email was there as well drazizaspellhome@gmail.com +2348160802189. i contacted him for my Genital herpes infection.
he needed few of my information and also send me his medicine through FedEx courier service.
i received it after 3 working  days of shipment,i drink the  herbal medicine the same way Dr Aziza instructed.
but now my Genital herpes is gone totally without any side effect or harm, may God Almighty continuing to bless him abundantly .
you can contact him on mail/ whats-app dr.azizaspellhome@gmail.com +2348160802189 or follow him on Instagram @herbalist_Aziza 
you can as well contact me for more information celinagomez784@gmail.com

Unknown said...

Living with Herpes for the past six years,it has been hell to me and I have
tried all possible means to get cure but all to no avail, luckily for me
one day as i was browsing through the Internet searching for remedy on
Herpes, and i saw comment of people talking about how Doctor BIYA cured
them,so I contacted him base on the testimonies i have been seeing about
him on the internet,Lo and behold friends,that was the end used
omen(Herpes) now i'm free no more matters that touches the heart. Dr words
is just not enough to express what you have done for me,thanks to you....
You are indeed a light to those living with Herpes virus and may you remain
bless for your good work... Dr Biya have cure for any types of diseases,
Herpes HIV DIABETES CANCER Asthma STROKE INFERTILITY HEPATITIS B HEART
DISEASE and you will be also cured Gmail: drbiyajatto@gmail.com WhatsApp
+2348111856507 The almighty God shall continue to bless you Dr Biya.

Albert said...

I have been suffering from (HERPES SIMPLEX VIRUS) disease for the past four years and had constant pain, especially in my knees. During the first year, I had faith in God that i would be healed someday. This disease started circulating all over my body and I have been taking treatment from my doctor, few weeks ago I came on search on the internet if I could get any information concerning the prevention of this disease, on my search I saw a testimony of someone who has been healed from (Hepatitis B and Cancer) by this Man Dr VOKE and she gave the email address of this man and advise we should contact him for any sickness that he would be of help, so I wrote to Dr. VOKE telling him about my (HERPES Virus) he told me not to worry that I was going to be cured!! hmm I never believed it,, well after all the procedures and remedy given to me by this man few weeks later I started experiencing changes all over me as the Dr assured me that I have cured, after some time I went to my doctor to confirmed if I have be finally healed behold it was TRUE, So friends my advice is if you have such sickness or any other at all you can email Dr voke on doctorvoke@gmail.com
contact Dr VOKE today for your problem to be solve for you just as my problem have been solved for me also, via Email doctorvoke@gmail.com


E-mail: doctorvoke@gmail.com


chloe said...

I just experience the wonders of Dr ovia herbs. God will continue to bless you Dr ovia more abundantly for the good work you are doing in peoples life by curing them from different type of diseases. I will keep on testifying about your good work. I was living with diabetes type 1      6 months ago and my doctor told me that there is no cure. I did not believe him and i keep my faith up hoping that one day i will be cured from this horrible disease. One day i saw a post on diabetes forum about a herbal doctor called Dr ovia on how he cure people from diseases with his root and herbs and i quickly contact Dr ovia  on his email and explain my problem to him and he told me not to worry that he is going to cure me and truly he prepared the herbal medicine and send it to me through UPS and gave me instructions on how to take it. After three weeks of taken the herbal medicine , i went to my doctor for checkup and my  diabetes result show Negative and my doctor told me that there is no trace of diabetes in my body and the diabetes is completely gone You can also be cured from any type of diseases by contacting Dr ovia on his email: droviaherbalhome@gmail.com or WhatsApp him on +2348117923986You can follow his page droviaherbalhome

patrice said...

BEST NATURAL TREATMENT FOR ITCHY SHINGLES earning that you have ITCHY SHINGLES can be one of the most difficult experiences you go through in life. You may feel scared, sad or even angry – this is OK, and a completely natural part of coping with something that can be life changing.
It will probably take a while for the news to sink in.

My name is Patrice Davis  and i am from the United States.

I remember spending so much money buying drugs from hospitals hoping that i will be cured from ITCHY SHINGLES, but all to no avail. I contacted so many  doctors and they prescribe medicine for me which they indeed tried their best but was unable to provide for me a possible cure, luckily i saw a comment about a herbal doctor, (Dr. Idedia) online.

I then contacted him (Dr. Idedia) through his email, After much chat and enquiry with the doctor, i decide to take a leap of faith because i have nothing to loose.

To my greatest surprise, Dr. Idedia prepare a medicine and  send me a Herbal Medicine through FEDEX courier Service, and he gave me guidelines on how am to take it. I followed all procedures as instructed, and after 2 weeks of taking it i was free from ITCHY SHINGLES  his medicine is legit and it is real.

I just want to encourage all individuals out there living with ITCHY SHINGLES , Genital Herpes, HSV1&2, HIV/AIDS/ HPV, COPD, CANCER, Hepatitis b, Lupus, PCOS, Kindney failure, Lung cancer and alot more. That there is still a huge chance that you can get cure only with the help of dr idedia. kindly contact him via email: dr.idediatraditionalhealinghome@gmail.com or whatsapp +2349074505296. 

Ose White said...


FINALLY FREE FROM HERPES VIRUS
I thought my life had nothing to offer anymore because life became meaningless to me because I had Herpes virus, the symptoms became very severe and bold and made my family run from and abandoned me so they won't get infected. I gave up everything, my hope, dreams,vision and job because the doctor told me there's no cure. I consumed so many drugs but they never cured me but hid the symptoms inside me making it worse. I was doing some research online someday when I came across testimonies of some people of how Dr Oseremen cured them from Herpes, I never believed at first and thought it was a joke but later decided to contact him on the details provided and when I messaged him we talked and he sent me his herbal medicine and told me to go for a test after two weeks. Within 7 days of medication the symptoms disappeared and when I went for a test Lo and behold I was NEGATIVE by the Doctor Who tested me earlier. Thank you Dr Oseremen because I forever owe you my life and I'll keep on telling the world about you. If you are going through same situation worry no more and contact dr.Oseremenvadi@gmail.com or WhatsApp him via +2349056394313 he is good too to cure all type of disease and virus.1 HIV cure
2 cancer
3 diabetes
4 hepatitis
5 herpes.
You can contact if you are having any problem...

james Benson said...

I GOT CURED FROM HERPES VIRUS I was diagnosed of HERPES virus and i have tried all I can to get cured but all to no avail,,until I saw a post in a health forum about a herbalist man who prepare herbal medications to cure all kind of diseases including #HERPES virus,at first I doubted if it was real but decided to give it a try,when I contacted this herbalist via his email and he prepared a #HERPES herbal cure and sent it to me via DHL delivery company service, when I received this herbal medicine, he gave me step by direction on how to apply it,after applying the way I was instructed,I was totally cured of this deadly disease called HERPES, all thanks to Dr OGODO Email this great herbal doctor via his email Ogodoherbalhomesolution@gmail.com
You can also WhatsApp him on +2349044680467
HE CAN ALSO CURE SICKNESS LIKE
{1}HIV/AIDS
{2}DIABETES
{3}EPILEPSY
{4} BLOOD CANCER
{5} HPV
{6} ALS
{7} HEPATITIS
{8}LOVE SPELL
{9} SICKLE AND ANEMIA
Only DR OGODO Can Help You I Love You Father.

Unknown said...

[ ] I'm here to testify about the great work Dr Osebor did for me. I have been suffering from (HERPES) disease for the past 5 years and had constant pain, especially in my knees. During the first year,I had faith in God that i would be healed someday.This disease started circulating all over my body and i have been taking treatment from my doctor, few weeks ago I came across a testimony of one lady on the internet testifying about a Man called Dr Osebor on how he cured her from HIV Virus. And she also gave the email address of this man and advise anybody to contact Dr Osebor for help for any kind of sickness that he would be of help, so I emailed him on ( oseborwinbacktemple@gmail.com ) telling him about my (HERPES Virus) he told me not to worry that i was going to be cured!! Well i never believed it,, well after all the procedures and remedy given to me by this man few weeks later i started experiencing changes all over me as Dr Osebor assured me that i will be cured,after some time i went to my doctor to confirmed if i have be finally healed behold it was TRUE, So 
- [ ] friends my advise is if you have such sickness or any other at all you can contact Dr Osebor via email. { oseborwinbacktemple@gmail.com }or call or what sapp him on( +2348073245515 )
- [ ] DR osebor CAN AS WELL CURE THE FOLLOWING DISEASE:-
- [ ]  HIV/AIDS
- [ ]  HERPES
- [ ] CANCER
- [ ] ALS
- [ ] cancer 
- [ ] Diabetes
eye problem etc.

cosmetic surgery said...
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cosmetic surgery said...
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