Available Online at http://www.recentscientific.com International Journal of CODEN: IJRSFP (USA) Recent Scientific International Journal of Recent Scientific Research Research Vol. 11, Issue, 01(E), pp. 37002-37005, January, 2020 ISSN: 0976-3031 DOI: 10.24327/IJRSR RESEARCH ARTICLE CYSTIC ADNEXAL SOL TREATED BY HOMOEOPATHIC MEDICINE-A CASE REPORT Dr. Milan Sengupta, and Dr Partha Pratim Pal Dr. Anjali Chatterji Regional Research Institute (H) of Kolkata, West Bengal, India DOI: http://dx.doi.org/10.24327/ijrsr.2020.1101.5039 ARTICLE INFO ABSTRACT Article History: Removal of cystic adnexal Space occupying lesion (SOL) by homeopathic treatment in postmenopausal age group is generally not considered as a dependable option as this age-group is Received 10th October, 2019 nd more vulnerable to malignancies of pelvic pathologies especially when compared to removal via Received in revised form 2 surgery. In this context, the article below is the evidence based demonstration of a successful case of November, 2019 cystic adnexal SOL of left side of a 62 years woman who was annihilated within 15 months by Accepted 26th December, 2019 th administration of a single potentized homeopathic remedy – Medorrhinum, selected on the basis of Published online 28 January, 2020 totality of symptoms through proper miasmatic and repertorial analysis and authenticated with the aid of ultrasonographic findings as well. Key Words: Adnexal SOL, Ovary, Case Analysis, Homoeopathic treatment, Medorrhinum. Copyright © Dr. Milan Sengupta, and Dr Partha Pratim Pal, 2020, this is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution and reproduction in any medium, provided the original work is properly cited. INTRODUCTION Case report An adnexal mass are growth next to the uterus, most commonly A female patient GS of 62 years age came to the clinic with arising from the ovaries, fallopian tubes, or surrounding present complaints of constant dull aching pain in left inguinal connective tissue is a common gynaecological problem 1. In region since 6 months. On examination no palpable mass over postmenopausal woman with adnexal masses, both primary and abdomen but tenderness over lower part of left iliac fossa (LIF) secondary neoplasms must be considered. The causes may be on deep palpation was elicited from the facial expression of the leiomyomas, ovarian fibromas and other lesions such as patient. Menopause occurred 15 years before and there is no diverticular abscesses 2. Menopause results in decreasing significant history of post-menopausal complications. Patient oestrogen levels, lack of menstruation and without also had H/O using oral contraceptive pills for last many years folliculogenesis the cystic activity in the ovary ceases. Hence, during the reproductive age. Patient also had chronic information from the history, physical examination, ultrasound complaints of malaise and debility especially confined to lower evaluation and selected laboratory tests (for example CA-125) extremities and mostly aggravated after walking. helps to detect the most likely cause of an adnexal mass. Past History in chronological order – cholecystectomy was Although ovarian cancer is a significant cause of mortality in done due multiple gall stone at the age of 45 years. Since then postmenopausal women, large population-based studies 3 indigestion from slight alteration in diet (mainly if it is fried demonstrate that the majority of adnexal masses are benign . and oily food stuffs and meat) occurs at times. P and both 2+1 Ultrasound is the most common initial approach for diagnosis issues were normal delivery and one H/O induced abortion in of adnexal mass with Doppler flow to rule out torsion. The between the two issues at the age of 30 yrs. standard approach in conventional modern medicine for Family History postmenopausal adnexal masses, whether they are detected manually or radiologically (ultrasound examination) is Paternal Side: father died of Cerebrovascular accident and was exploratory laparotomy. This approach has been adopted even chronic patient of Hypertension (HTN) 4 though most adnexal cystic masses in these women are benign . Maternal Side: mother had some tumour in uterus (fibroid ?? ) However, there is always a dilemma of performing extensive due to which hysterectomy was done, now alive but suffers surgery in the form of laparotomy for such a benign disease on from osteoarthritis one hand and the fear of missing the diagnosis of malignancy5. *Corresponding author: Dr. Milan Sengupta Dr. Anjali Chatterji Regional Research Institute (H) of Kolkata, West Bengal, India Dr. Milan Sengupta, and Dr Partha Pratim Pal., Cystic Adnexal Sol Treated by Homoeopathic Medicine-A Case Report Personal History: Patient was basically a housewife living Generalities – Anaemia Psora with husband. Both the daughters is married and staying Generalities – heat, vital, lack of Psora Psora + Latent Mind – concentration difficult outside Kolkata Psora+Sycosis Mind – memory: weakness of : say, for what is about to Psora Generalities Bearing in mind about the diseases in family history (CVA, Physical Generals: Thermal Reaction: chilly patient; State of HTN, Fibroid uterus, Hysterectomy, Osteoarthritis) we should Appetite: normal, feels hungry at proper intervals; Desire: for emphasis more on sycotic miasm. More significantly it is the salty things and green fruits; Intolerance: oily and fried foods, pathology of the patient i.e. cystic left adenxal SOL (possibly meat, Thirst: extreme, always feeling dryness in mouth and of ovarian origin) which says as per the literature that the most fauces, around 4-5 lts/day, Stool: Twice daily, semisolid, frequent location of sycotic manifestations is in pelvic organs satisfactory, Urine: normal frequency of micturation, clear, (pelvic inflammations such as inflammation of ovaries). And non-offensive, Perspiration: moderate only during exertion, we know that sycotic miasm means infiltration and overgrowth Sleep and Dream: sound sleep and cannot remember the of tissue. So, sycotic miasm is given more priority in the dreams precisely 7 above-mentioned case . Mental Generals: cannot focus on a particular thing for a while Reportorial analysis and very easily gets confused about trifling matters, fear of darkness and recently forgetting small things for example – Considering the above symptomatology, Kent Repertory was forgetting what to say, what to do next etc. preferred and using HOMPATH software 8, systemic repertorization was done. The repertorisation chart is given in Physical Examination: Anaemia: mild (as evident from lower Table 1. palpebral conjunctiva) Investigation: Ultrasonography of lower abdomen was done on 16.02.17 which reported – well outlined thick walled cystic SOL with echogenic debris in Left adenxal region measuring 77 x 60 mm (possibly of ovarian origin). Right ovary not visualized. After repertorisation, many medicines were competing with each other, namelyMedorrhinum, Phosphorus, Sulphur, Natrum muriaticum, Nitric acid etc. Maximum numbers of symptoms were covered by Medorrhinum (i.e. 10 out of 10). Hence, Medorrhinum was prescribed as it scored the highest of the all the drugs i.e. 20. Moreover, it is a strong anti-sycotic medicine and from above miasmatic evaluation the case preferred to start with an anti-sycotic medicine as first prescription. Further consultation of materia medica confirms the selection. Hence, finally Medorrhinum 1M, 1 dose was prescribed in sac lac pulvis with placebo for one month on 20.02.17. Follow-ups Visit Follow up Indication for Medicine with no date prescription dose No significant R improvement. Only x 1 20.03.2017 Placebo for one overall weakness seems more month. to be slightly better. Miasmatic analysis Intensity and frequency of pain around LIF R more or less status quo. x Medorrhinum 1M, Miasmatic evaluation of all the presenting symptoms was done Weakness of the limbs 1 dose with the help of “Chronic miasms in homoeopathy and their same as before. In sac lac pulvis, 2 times in last month cure with classification of their rubrics/symptoms in Dr. Kent’s OD x 1 day 2 24.04.2017 patient had acute repertory by Dr. RP Patel” showed the predominance of psoric To be taken in episodes of dyspepsia 6 empty stomach and sycotic miasm . followed by irregularity next morning with in bowel clearance. Symptoms/Rubrics Miasm placebo for rest of During that period the Abdomen – Pain – aching, dull: Inguinal region, left Psora the month. LIF tenderness was also Genitalia female – Enlarged (see swollen): Ovaries, left Sycosis increased. Extremities – weakness: lower limbs Psora Patient much improved R Stomach – desire: salt things Psora x 3 29.05.2017 this time. Pains Placebo for one Stomach – desire: fruit green Psora ameliorated to the more month. Generalities – Weakness, enervation: walking from Psora 37003 | P a g e International Journal of Recent Scientific Research Vol. 11, Issue, 01(E), pp. 37002-37005, January, 2020 extent of ORIDL +3 and overall well being was also +3 Since patient was not having any complaints for last months she stopped coming and hence discontinued Rx medicine. But the pains Medorrhinum 10M, is reappearing and 1 dose walking even for few In sac lac pulvis, meters causing severe OD x 1 day 4 21.08.2017 prostration. In between To be taken in the patient did USG by empty stomach herself on 12.08.17 next morning with when pains reappeared. placebo for rest of USG reported the same the month. cystic left adenxal SOL, but the size has decreased to 52 x 48 mm DISCUSSION There may be several cases with ovarian pathology cured by homoeopathic medicines, out of which few are documented and published. But successful cases related to homoeopathic treatment of adnexal masses which are potentially cancerous growth next to the uterus, most commonly arising from the 9 ovaries is rare. So, publishing this case report will add to the The intensity by which pool of evidence-based literature. And regarding the remedy the pain returned is not Rx Medorrhinum – a strong anti-sycotic medicine which was first 5 23.10.2017 less.