Bharatesh Homoeopathic Medicalcollege & Hospital, POST GRADUATE RESEARCH CENTRE

Bharatesh Homoeopathic Medicalcollege & Hospital, POST GRADUATE RESEARCH CENTRE

BharAtesh Homoeopathic MedicalCollege & Hospital, POST GRADUATE RESEARCH CENTRE, BeLgaum-590016.

Karnataka.

Recognised by

CENTRAL COUNCIL OF HOMOEOPATHY, NEW DELHI.

Affiliated to

RAJIVGANDHIUNIVERSITY OF HEALTH SCIENCES, BANGALORE.

SYNOPSIS

M.D. (HOMOEOPATHY)

“THE UTILITY OF MURIATIC ACID IN THE MANAGEMENT OF HAEMORRHOIDS”

By

DR.SUSHANT C. KULKARNI

DR.S.M. ANGADI MD (HOM)

Professor, Guide

DEPARTMENT OF HOMOEOPATHIC MATERIA MEDICA

BHARATESH HOMOEOPATHIC MEDICALCOLLEGE & HOSPITAL,

BELGAUM.

From,

Dr. KULKARNI SUSHANT CHANDRAKANT

To,

DR.S.M. ANGADI

H.O.D;P.G. Guide

Department of Materia Medica

Bharatesh Homoeopathic Medical College & Hospital,

Belgaum.

Sub: Application to accept my synopsis for the dissertation

Respected Sir,

I, Dr. KULKARNI SUSHANT CHANDRAKANT,

Would like to forward my application for the approval of my synopsis under your guidance for the following topic, “THE UTILITY OF MURIATIC ACID IN THE MANAGEMENT OF HAEMORRHOIDS.”

Hope you will approve the same.

Thanking you.

Date: 24/10/2009

Place: Belgaum. Yours Sincerely

Dr. KULKARNI SUSHANT CHANDRAKANT

Department of Materia Medica

Bharatesh Homoeopathic MedicalCollege Hospital, Belgaum.

From:

DR. S. M. ANGADI M.D (HOM)

H. O. D; Guide

Department of Materia Medica,

Bharatesh Homoeopathic Medical College & Hospital,

Belgaum.

To,

Dr. KULKARNI SUSHANT CHANDRAKANT

Sub: Acceptance of synopsis for the dissertation.

Dear Doctor,

I have accepted your topic,“THE utilityOF MURIATIC ACID IN THEMANAGEMENT OF HAEMORRHOIDS.”

For the dissertation.

Your synopsis will be forwarded to RGUHS.

Date: 24/10/2009

Place: Belgaum.

DR. S. M. ANGADI M.D (HOM)

Professor, Guide

Department of Materia Medica,

Bharatesh Homoeopathic MedicalCollege

& Hospital, Belgaum.

RAJIVGANDHIUNIVERSITY OF HEALTH SCIENCES,

KARNATAKA, BANGALORE.

Annexure II

APPLICATION FOR REGISTRATION OF SUBJECT FOR

DISSERTATION

11
1
1. / NAME OF CANDIDATE & ADDRESS / Dr. KULKARNI SUSHANT CHANDRAKANT
Post Graduate Student,
BharAtesh Homoeopathic MedicalCollege & Hospital,
Belguam.
PERMANENT ADDRESS
Dr. KULKARNI SUSHANT CHANDRAKANT
144, BEHINDLAXMITEMPLE, MAHADEV GALLI, A/P:HINDALAGA TAL/DIST: BELGAUM, KARNATAKA.
2.
2. / NAME OF INSTITUTION / BharAtesh HomOeopathic MedicalCollege & Hospital, Dharwad Road,
Belgaum (Karnataka).
3.
3. / COURSE OF STUDY & SUBJECT / doctor of medicine (HOMOEOPATHY)
MATERIA MEDICA
4.
4. / DATE OF ADMISSION TO COURSE / 25-02-2009
5.
5. / TITLE OF THE TOPIC. / “the utility OF MURIATIC ACID IN THEMANAGEMENT OF HAEMORRHOIDS.”
6. / Brief Resume of the intended Work
6.1 Need for the Study
. Haemorrhoids is one such disease which challenges the modern treatment namely local medication and surgical removal. A considerable part of population suffers from this disease with bleeding, pain, itching, prolapse or altered bowel habits. This causes extreme inconvenience which hurdles and hinders the patient’s daily routine with great mental agony and anxiety.
Symptomatic haemorrhoids affect more than 1 million individual in modern civilization per year. The prevalence of haemorrhoidal diseases is not selective for age or sex. However age is known to have a deleterious effect on the anal canal. The prevalence of haemorrhoidal diseases is less in underdeveloped countries. Over two thirds of all healthy people reporting for physical examinations have haemorrhoids. Unfortunately a haemorrhoidal condition only tends to get worse over the years, never better.
In Homoeopathy judicious prescribing of medicine can cure the condition or in some cases can prevent the surgeries. There are many remedies which attract many homoeopaths for treatment of haemorrhoids and Muriatic Acid is one of the remedy which can play an important role in treatment of haemorrhoids.
Many remedies from acid group have been proved efficient in treatment of condition arising from inflammation of mucus membrane and also other diseases of rectum and anal canal. Muriatic Acid is a remedy which is seen to be efficient in many diseases of rectum and anal canal. So there is a need to study role of Muriatic Acid in treatment of haemorrhoids.
6.2 Review of Literature
Haemorrhoids or piles are dilated vein occurring in relation to anus or these can be called as symptomatic enlarged vascular cushions of anal canal.1
Symptoms of Haemorrhoids: The most common symptom of internal haemorrhoids is painless bright red blood covering the stool, on toilet paper, or in the toilet bowl. Other symptoms are mucus discharge, prolapse accompanied with pain.2
However, an internal haemorrhoid may protrude through the anus outside the body, becoming irritated and painful. This is known as a protruding haemorrhoid.Symptoms of external haemorrhoids may include painful swelling or a hard lump around the anus that results when a blood clot forms.3
In addition, excessive straining, rubbing, or cleaning around the anus may cause irritation with bleeding and/or itching, which may produce a vicious cycle of symptoms. Draining mucus may also cause itching.
Causes of Haemorrhoids: It is a known fact that constipation and prolonged straining at stool are main causes of piles but there are some other important aspects too.
Low fiber diet causing small caliber stool and straining during defecation.
Sitting for prolonged period at closet.
Hypertension mainly in portal vein.
Anal sex without proper use of lubricants stresses anus.
Obesity.
Sedentary life style.
Constipation as well as chronic diarrhea.
Pregnancy causes hypertension and increases strain during bowel movements.
Increased use of alcohol and caffeine.
Lack of erect posture.
Familial tendency.
Higher socio-economic status.
Colon malignancy.
Hepatic disease.
Spinal cord injury.
Loss of rectal muscle tone.
Rectal surgery.
Episiotomy.
Ageing – weakened support structures.2, 3, 4.
Types of haemorrhoids:1) Internal haemorrhoids – when the superior haemorrhoidal venous plexus is involved, the condition is designated as internal haemorrhoids. Occur inside the rectum. Not painful. May bleed when irritated.
2) External haemorrhoids – when the inferior haemorrhoidal venous plexus is involved, the condition is called as external haemorrhoids. Occur outside of anal verge (distal end of anal canal) sometimes painful.Swelling and irritation present. Itching present. Prone to thrombosis, if the veins rupture a blood clot is formed.3.
Gradation of Hemorrhoids-
Grade I - Hemorrhoids project into the anal canal and often bleed but do not prolapse.
Grade II - Hemorrhoids may protrude beyond the anal verge with straining or defecating but reduce spontaneously when straining ceases.
Grade III - Hemorrhoids protrude spontaneously or with straining and require manual reduction
Grade IV - Hemorrhoids chronically prolapsed and cannot be reduced. They usually contain both internal and external components and may present malignancy.2, 3.
Prevention of Hemorrhoids/Piles–
Drinking more fluids in routine.Eating more dietary fibers.Practicing better posture.Reducing bowel movement strain and time.Avoid wearing tight under clothes.Washing the anus with cool water and soap may reduce swelling and increase blood supply for quick healing.Exercises.Using squat toilets may help.10,11.
Dr.J H Clarke has explained Muriatic Acid as,”Piles like a bunch of grapes which look purple and burn when touched. Prolapse of rectum, whilst straining to pass water. Urination involuntary or difficult; there is straining and dribbling, and the straining causes the rectum to prolapse; it may also cause involuntary stool. This may be due to local conditions, or it may be a consequence of a low state of health. 5.
Dr.W Boericke says that Muriatic Acid has a tendency to involuntary evacuations while urinating. Haemorrhoids most sensitive to all touch; even sheet of toilet paper is painful. Anal itching and prolapsus ani while urinating. Haemorrhoids duringpregnancy; bluish, hot with violent stitches. 6.
Dr.WM H Burt has given Muriatic Acid as “Varices of the anus, which are exceedingly sore to the touch; much prostration. Largely protruding piles; bluish, and extremely sensitive and painful. If the anus be very sensitive, either with or without haemorrhoids, Muriatic acid is sure to be the right remedy. Exceeding tenderness of the anus; she can not bear the least touch, not even of the clothes. Can not bear the slightest touch upon the anus, which often itches violently, and is not relieved by scratching.7.
Dr.C Hering under Muriatic Acid explains as Haemorrhoids: swollen, blue; painful to touch; appear suddenly in children; protruding, reddish blue, burning; too sore to bear least touch, even sheet is uncomfortable. Anal orifice surrounded by a thick, round swelling, which is separated into three unequal parts, one being as large as a hen's egg, the other two about as large
as nutmegs; swelling bluish red, hard, hot, shining, very sensitive to touch; sore pain, itching, severe stitches, paroxysmal, making her cry out; cannot sit and can turn around only with great difficulty. Inflamed hemorrhoids after labor.8.
Dr.J T Kent explains about Muriatic Acid as; Large, dark, purple haemorrhoids, extremely sensitive to touchInflammation of the pile tumors, hot and pulsating; must lie with limbs wide apart.Bleeding piles.Burning and cutting during stool. Burning after stool, ameliorated by warm applications, aggravated from bathing with cool water. Excoriation of anus.9
6.3 AIMS AND OBJECTIVE OF THE STUDY
  • To study the clinical presentation ofhaemorrhoids.
  • To study the drug profile of Muriatic Acid in general.
  • To study the utility of Muriatic Acid in the treatment of haemorrhoids.

7. / MATERIAL & METHODS:
7.1 SOURCES OF DATA:
The cases for the study will be collected from OPD, Rural and regular camp visits of Bharatesh Homoeopathic Medical College & Hospital, Dharwad Road, Belgaum.
7.2 METHOD OF COLLECTION OF DATA(INCLUDING SAMPLING PROCEDURE, IF ANY)
  • Patients will be considered on inclusion and exclusion criteria.
  • Patients are considered on the basis of clinical presentations.
  • Minimum Sample size will be 30. Simple random sampling procedure will be adopted.
  • All cases will be taken as per the Performa prepared for the study.
  • All patients registered between periods of July 2009 to November2010 will be selected. No new cases will be taken for study after November 2010. All cases shall be followed up for period of 2-6 months.
  • Follow up will be seen weekly or fortnightly as per requirement. Physical, radiological & laboratory examinations done periodically whenever needed.
Prognosis: Assessment will be based on the general and local improvement of the patients.
Recovered,
Improved,
Not improved.
Inclusion criteria:
  • Patients suffering from haemorrhoids on the basis of clinical history and findings.
  • Patients above age of 30, of both sexes, irrespective of their occupation will be considered.
Exclusion criteria
  • Cases which need surgical intervention.
  • Cases with complication of haemorrhoids.
  • Haemorrhoids which are symptomatic of some other conditions like CA rectum and pregnancy.

7.3 Does the study require any investigation or intervention
to be conducted on the patients or other Human or
Animals? If so describe briefly.
The diagnosis of the cases will be done on eliciting case history and clinical findings, other required investigations are :
  1. Blood examination - routine and microscopic
  2. Detail proctoscopy

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. Shah Siddharath H., API Text book of Medicine. 7th edition revised reprint Mumbai; the Association of Physicians India, 2006 573pp.
  2. R.C.G. Russel, N .S. Williams, C. J. K. Bulstrode, Baily and love short practice of surgery, 23rd edition, London; Oxford press 2003 ;1128pp.
  3. Chatterji B P Short textbook of Surgery, vol 2 second edition, Culcutta,
Sen J N, New central book agency 1981,258-26pp
  1. Kasper D L, Fauci A S Longo D L, Braunwald E, Hauser S C, Jameson J L Harrisons principles of internal medicine, vol 2 16th edition, The Mcgrow-Hill companies Inc USA, 2005, 1801pp.
  2. Clarke J H, Adictionary of practical materiamedica, vol 2, New Delhi, reprintedition B Jain publishers (p) ltd, 1997, 508pp.
  3. Boericke William, Pocket manual of Homoeopathic materia medica and repertory, reprint edition, New Delhi; B Jain publishers (p) ltd, 2006; 449pp.
  4. Burt WM H, Physiological materia medica, reprint edition New Delhi, B Jain publishers (p)ltd, 2002; 164pp.
  5. Hering C, The guiding symptoms of our materia medica, vol 7, reprint edition
B Jain publishers (p) ltd, New Delhi, 2000, 506pp.
  1. Kent J T, Lectures on homoeopathic marteria medica, third edition, B Jain publishers (p)ltd, New Delhi, 2000, 697-698pp
  2. en.wikipedia.org/wiki/hemorrhoids
  3. quickcare.org/gast/hemorrhoids

9 / SIGNATURE OF THE CANDIDATE
10 / REMARKS OF THE GUIDE
11 / NAME AND DESIGNATION OF
(IN BLOCK LETTERS)
11.1 GUIDE / DR. S. M.ANGADIM.D.
H.O.D., GUIDE
DEPARTMENT OF MARERIA MEDICA BHARATESH HOMOEOPATHIC MEDICALCOLLEGE,
BELGAUM – 16.
11.2SIGNATURE
11.3CO-GUIDE (IF ANY)
11.4SIGNATURE
11.5 HEAD OF THE DEPARTMENT / DR. ANGADI S. M. M.D.
PROFESSOR, H.O.D.
DEPARTMENT OF MARERIA MEDICA BHARATESH HOMOEOPATHIC MEDICALCOLLEGE,
BELGAUM – 16.
SIGNATURE
12 / 12.1REMARK OF THE
CHAIRMAN AND PRINCIPAL
12.2SIGNATURE