Bharatesh Homoeopathic
BHARATESH HOMOEOPATHIC
MEDICAL COLLEGE & HOSPITAL,
POST GRADUATE RESEARCH
CENTRE, BELGAUM-590016.
KARNATAKA.
Recognized by
CENTRAL COUNCIL OF HOMOEOPATHY, NEW DELHI.
Affiliated to
RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, BANGALORE.
SYNOPSIS
M.D (HOMOEOPATHY)
THE EFFICACY OF PHOSPHORUS IN THE MANAGEMENT OF “EPISTAXIS”
By
Dr. SAURABH PAL
Dr. S.M. ANGADI
M.D (HOM)
Professor, Guide and HOD,
Department of Materia Medica,
BHARATESH HOMOEOPATHIC MEDICAL COLLEGE & HOSPITAL,
BELGAUM.
From,
Dr. SAURABH PAL
To,
Dr. S.M. ANGADI
M.D. (HOM)
Professor, Guide & HOD,
Department of Materia Medica,
Bharatesh Homoeopathic Medical College & Hospital,
Belgaum.
Sub:-Application to accept my synopsis for the dissertation.
Respected Sir,
I Dr. Saurabh Pal, would like to forward my application for the approval of
my synopsis under your guidance for the following topic THE EFFICACY OF
PHOSPHORUS IN THE MANAGEMENT OF “EPISTAXIS”.
Hope you will approve the same.
Thanking you.
Date: 24-10-2009
Place: Belgaum
Yours sincerely
Dr. SAURABH PAL
Department of Materia Medica,
Bharatesh Homoeopathic Medical College
& Hospital, Belgaum.
From,
Dr. S.M ANGADI
M.D. (HOM)
Professor, Guide &HOD,
Department of Materia Medica,
Bharatesh Homoeopathic Medical College & Hospital,
Belgaum.
To,
Dr. SAURABH PAL
Sub: Acceptance of synopsis for the dissertation.
Dear Doctor,
I have accepted your topic THE EEFICACY OF PHOSPHORUS IN
THE MANAGEMENT OF “EPISTAXSIS” for the dissertation. Your synopsis will
be forwarded to the Rajiv Gandhi University Of Health Sciences, Bangalore.
Date: 24-10-2009
Place: Belgaum
Dr. S.M.ANGADI
Professor, Guide HOD,
Department of Materia Medica,
Bharatesh Homoeopathic Medical College & Hospital,
Belgaum.
RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,
KARNATAKA, BANGALORE.
ANNEXURE II
APPLICATION FOR REGISTRATION OF SUBJECTS FOR
DISSERTATION
1. / NAME OF THE CANDIDATE & THE ADDRESS / DR. SAURABH PALDEPARTMENT OF MATERIA MEDICA,
BHARATESH HOMOEOPATHIC
MEDICAL COLLEGE & HOSPITAL,
BELGAUM.-16
PERMANENT ADDRESS / DR. SAURABH PAL.
S/O V.R.PAL
STREET NO.4, DAMODAR PURAM,
OLD CHANDMARI, SUBHASH NAGAR
BAREILLY.- 243001
U.P.
2. / NAME OF THE INSTITUTION / BHARATESH HOMOEOPATHIC
MEDICAL COLLEGE & HOSPITAL,
BELGAUM.-16
3. / COURSE OF THE STUDY AND SUBJECT. / M.D. (HOM) MATERIA MEDICA
4. / DATE OF ADMISSION TO COURSE / 17-03-2009
5. / TITLE OF THE TOPIC / THE EFFICACY OF PHOSPHORUS
IN THE MANAGEMENT OF “EPISTAXIS”
6. / BRIEF RESUME OF INTENDED WORK:
6.1 NEED FOR STUDY:
Epistaxis has been referred to as the albatross of Otolaryngology
and is considered to be a significant and furious problem. It cannot only affect
the haemodynamics but may cause great anxiety to the patients and their
relatives.
Epistaxis is a very common complaint found in different age groups. This is of
concern because it leads to physical and psychological impact on ones health.
Homoeopathic approach to Epistaxis will provide an effective measure to deal
with it, because of its subjective; individualistic concept. Diseases like epistaxis
can be better managed by Homoeopathic medicines because of sufficient no. of
medicines to control almost every type of Epistaxis. A very well known and
effective medicine Phosphorus can be useful to deal with Epistaxis for its
pathogenetic (hence curative) qualities covering different varieties of
Epistaxis. Indications of Phosphorus in Hemorrhagic diathesis and its quality of
polycrest drug can be a sound basis for its use in epistaxis.
Therefore it is decided to carryout a study with cases to understand the efficacy
of homeopathic medicines and especially of Phosphorus for Epistaxis.
6.2 REVIEW OF LITERATURE
· Bleeding from inside the nose is called Epistaxis. Bleeding from the nose
may occur as a result of a variety of causes ranging from insignificant
trauma to malignancy , and the blood loss may vary from a few drops to a
massive loss of many litres .1
· From the two types of Epistaxis: Anterior and Posterior epistaxis,
anterior epistaxis is more common than posterior epistaxis. Anterior
epistaxis mainly occurs in children and young adults, while the posterior
epistaxis occurs after the age of 40 years.2
· Aetiology of epistaxis are classified as (1) Local and (2) general. Local
causes include trauma, acute infection, ulceration, separation of crusts and
heridetary hemorrhagic telangiectasia. General causes include hypertension,
venous congestion of the head and neck, bleeding diseases and leukaemia.3
· Nosebleeds are due to the rupture of a blood vessel within the richly
perfused nasal mucosa. Rupture may be spontaneous or initiated by trauma.
Nosebleeds are reported in up to 60% of the population with peak incidences
in those under the age of ten and over the age of 50 and appears to occur in
males more than females. An increase in blood pressure (e.g. due to general
hypertension) tends to increase the duration of spontaenous epistaxis..
Anticoagulant medication and disorders of blood clotting can promote and
prolong bleeding. Spontaneous epistaxis is more common in the elderly as
the nasal mucosa (lining) becomes dry and thin and blood pressure tends to
be higher. The elderly are also more prone to prolonged nose bleeds as their
blood vessels are less able to constrict and control the
bleeding.8
· The nose has several physiologic functions. One of these is to serve as a
conduct for inspired and expired air. Another function of the nose is
Olfaction. Olfaction is the medical word for smell. The vast majority of nose
bleeds occur in the anterior (front) part of the nose from the nasal septum.
This area is richly endowed with blood vessels (Kiesselbach's plexus). This
region is also known as Little's area. Bleeding further back in the nose is
known as a posterior bleed and is usually due to rupture of the
sphenopalatine artery or one of its branches. Posterior bleeds are often
prolonged and difficult to control. They can be associated with bleeding from
both nostrils and with a greater flow of blood into the mouth.9
· Kent says that the action of phosphorus on the nose as follows, there is
painful dryness of nose ; constant sneezing and running from the nose of
bloody water with stopped up conditions of the nose. Nostrils filled with
green mucous ; a copious nasal discharge of greenish yellow , blood
streaked mucus worse in morning . Frequent flowing of blood from the
nose; copious haemorrhage from the nose of bright red blood; nose is very
sensitive to touch . Phosphorus specially cured bleeding polypi.4
· W. Boericke puts forth that Bleeding epistaxis instead of menses.
Oversensitiveness Periostitis of nasal bones; foul imaginary odour.
It is indicated in chronic catarrh, with small haemorrhages, the handkerchief
is always bloody. The nasal polyps bleeds very easily with a bright red
blood.5
· Dr. Burt states that Phosphorus is indicated in the following ”Swelling of
nose, painful to touch”.”Soreness of the Scheiderian & mucus membrane,
with bloody scabs on the margin of nostrils”.” Ulcerated nostrils with
swollen nasal bones”.“Internal inflammation of nose, dry sensation and slow
bleeding of nose”. “Profuse long lasting nose bleeding”. There is polypus of
nose; which bleeds easily, the nose has fatty arteries.6
· According Dr. Carroll Dunham Phosphorus has a marked action on nose
when nose is rubbed it bleeds easily . Haemorrhages are easily produced
from mucus surfaces, from wounds and ulcers of the nose, the bleeding
frequently occurs spontaneously. This probably suggested its use in fungus
haematodes. The discharge from the nose is often streaked with blood; the
nose is obstructed by clots.7
6.3 OBJECTIVES OF STUDY
Keeping in view the increasing incidences and limited scope of old schools of
medicines it is decided to carry-out a study regarding
‘Efficacy of Phosphorus in the management of Epistaxis’.
. The objectives of this study are:
Ø To study the clinical spectrum of Epistaxis.
Ø To establish the efficacy of Phosphorus in curing and preventing the incidences of Epistaxis
7. / MATERIAL AND METHODS:
7.1 SOURCE OF DATA
The cases for the study will be selected from the OPD, IPD, peripheral
clinics and regular camp visits of Bharatesh homoeopathic Medical College and
Hospital, Belgaum.
7.2 METHOD OF COLLECTION OF DATA ( INCLUDING SAMPLING
PROCEDURE IF ANY)
a) Patients will be selected on the basis of inclusion and exclusion criteria.
b) Minimum sample size will be 30. Simple random sampling procedure will
be adopted.
c) All cases will be taken as per the Performa prepared for the study.
d) All patients registered between the period of July 2009 to November 2010
will be selected for the study. No new cases will be taken after November
2010. All cases shall be followed up for period of 2-6 months.
e) Prognosis – Assessment will be based on the general and local
improvement of the patient as per principles of Homoeopathy.
Inclusion criteria:
· Age between 1-65 yrs is considered for case study
· Both sexes will be considered.
· Cases are taken irrespective of socio-economic and religion status.
· Patients presenting complaints of Epistaxis will be taken up on the
basis of their clinical history and clinical findings.
Exclusion criteria:
· Infants.
· Cases which need surgical intervention.
Results:
· Recovered
· Improved
· Not Improved
7.3 DOES THE STUDY REQUIRE ANY INVESTIGATIONS OR INTERVENTIONS TO BE CONDUCTED ON THE PATIENT OR HUMANS OR ANIMALS? IF SO, PLEASE MENTION BRIEFLY.
· Complete Haematological investigations with Bleeding
Time & Clotting Time, Platelet count.
· X-Ray’s
· Additional investigations if needed.
7.4 HAS ETHICAL CLEARANCE BEEN OBTAINED FROM YOUR INSTITUTION IN CASE OF 7.3?
Yes ethical clearance has been obtained from the institution.
8. / LIST OF REFERENCES
1. A Short Text Book Of E.N.T. Diseases For
Students And Practitioners, By Krishnakant B .Bhargava, Sameer K
Bhargava and Tilak M Shah., Usha Publication,4th edition 1997,pg no.225
2. Diseases of Ear, Nose And Throat, By P.L Dhingra,3rd edition 2004,
Published by Elsevier India Pvt Ltd, New Delhi, pg no.218
3. Price’s Text Book Of The Practice Of Medicine , By R .F. McNab
Jones, Edited by Sir Ronald Bodley Scott.12th edition, 1982. Oxford
Medical Publications, pg no.839.
4. Lectures on Homoeopathic Materia Medica ,by James Tyler Kent,
2002, B. Jain Publishers. pg. no 827)
5. New Manual Of Homoeopathic Materia Medica& Repertory by W.
Boericke., edition 2002,B.Jain.Publishers.pvt.ltd,New Delhi,
pg.no.495.
6. Physiological Materia Medica By WM .H .Burt., M.D, B .Jain
Publisher. Pvt. ltd. New Delhi, 3rd edition, edition 1996, pg.no 707.
7. Lectures on Materia Medica, By Carroll Dunham, M.D, 5th edition,
2004, B.Jain. Publisher’s .pvt. Ltd, New Delhi, pg.no.342.
8. en.wikipedia.org/wiki/Epistaxis.
9. health.ucsd.edu/specialties/surgery/.../nasal/physiology.htm
9. / SIGNATURE OF CANDIDATE
10. / REMARKS OF THE GUIDE
11. / NAME AND DESIGNATION OF
11.1 GUIDE / Dr. S.M.ANGADI
PROFESSOR, GUIDE & HOD,
DEPARTMENT OF MATERIA MEDICA,
BHARATESH HOMOEOPATHIC
MEDICAL COLLEGE & HOSPITAL,
DHARWAR ROAD, BELGAUM.
11.2 SIGNATURE
11.3 CO-GUIDE (IF ANY)
11.4 SIGNATURE
11.5 HEAD OF THE
DEPARTMENT / Dr. S.M.ANGADI
PROFESSOR,GUIDE & HOD,
DEPARTMENT OF MATERIA MEDICA,
BHARATESH HOMOEOPATHIC
MEDICAL COLLEGE & HOSPITAL,
DHARWAR ROAD, BELGAUM.
11.6 SIGNATURE
12. / 12.1 REMARKS OF
CHAIRMAN
AND PRINCIPAL
12.2 SIGNATURE