From,
Dr.KhangembamGopeshwar Singh
To,
Dr.(Mrs)M.N.Shaikh M.D.(Hom)
HOD, Professor PG Guide
Department of Organon of Medicine &
Homoeopathic Philosophy
Bharatesh Homoeopathic Medical College,
Hospital & PG Research Centre, Belgaum
Subject: - Request for a application of to accept my synopsis for the dissertation
Respected Madam,
With due respect, I Dr.KhangembamGopeshwar Singh would like to forward my application for the approval of my synopsis under your kind perusal and guidance the topic
“A Constitutional approach in the management of Menopausal Syndrome”
I am sure you will accept & approve the same.
Thanking you.
Your faithfully,
Date: -15-03-2013
Place:-Belgaum (Dr.Kh.Gopeshwar Singh)
Department of Organon of Medicine & Homoeopathic Philosophy
Bharatesh Homoeopathic Medical College,Hospital & PG Research Centre, Belgaum
From,
Dr.(Mrs)M.N.Shaikh M.D.(Hom)
HOD, Professor PG Guide
Department of OrganonofMedicine
Homoeopathic Philosophy
Bharatesh Homoeopathic Medical College,
Hospital & PG Research Centre, Belgaum
To,
Dr.KhangembamGopeshwar Singh
Dear Doctor,
After thorough study of your synopsis. I have accepted your topic
“A Constitutional approach in the management of Menopausal Syndrome” for the dissertation.
I assure, your synopsis will be forwarded to RGUHS.
Date: - 15-03-2013
Place:-Belgaum Dr. (Mrs.) M.N.Shaikh M.D.(Hom)
HOD, Professor PG Guide
Department of OrganonOf Medicine
& Homoeopathic Philosophy
Bharatesh Homoeopathic Medical College,
Hospital & PG Research Centre, Belgaum
RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, BANGALORE
ANNEXURE –II
APPLICATION FOR REGISTRATION OF SUBJECT FOR DISSERTATION
1. / NAME OF THE CANDIDATE AND ADDRESS / DR.KHANGEMBAM GOPESHWAR SINGHBHARATESH HOMOEOPATHIC MEDICAL COLLEGE, HOSPITAL AND POST GRADUATION RESEARCH CENTRE,BELGAUM-590016
KARNATAKASTATE.
PERMANENT ADDRESS / CHINGTHAM MANING (KHONGJOM)
B.P.O. SAPAM, P.O. WANGJING
PIN – 7 9 5 1 4 8
THOUBAL DISTRCT
MANIPUR SATE
2. / NAME OF THE INSTITUTE / BHARATESH HOMOEOPATHIC MEDICALCOLLEGE,HOSPITAL AND POST GRADUATION RESEARCH CENTRE,BELGAUM-590016
KARNATAKA STATE.
3. / COURSE OF THE STUDY & SUBJECT / DOCTOR OF MEDICINE (HOMOEOPATHY)
ORGANON OF MEDICINE AND HOMOEOPATHIC PHILOSOPHY
4. / DATE OF ADMISSION TO THE COURSE / 15/ 02 / 2012
5. / TITLE OF THE TOPIC / “A Constitutional approach in the management of Menopausal Syndrome”
6. / BRIEF RESUME OF INTENDED WORK:
6.1 NEED FOR STUDY:
The simplest definition of menopause is “that is when there is complete cessation of menstrual periods.” In most cases, very much more. The mystery and magic of menopause has to do with the fact that it can be very variable among women as to just when it happens, how it behaves, and how long it lasts time it lasts. As women age, their health becomes a multidimensional issue influenced by factors such as career, changes in home life, diet and physical activity, the economy, society and the environment. These changes, together with the natural processes of ageing and the environment. These changes, together with the natural process of ageing and the hormonal changes in the reproductive system, affect the well being of women. The complex, interrelated nature of the process often makes it difficult to distinguish between the symptoms of ageing or those resulting from the loss of ovarian functions, and the factors arising out of socio-environmental conditions. It was only in the last decade that the menopausal syndrome was identify and the acknowledged as an issue that affected some women and become a matter of concern to health care providers.
Menopause begins for most women between the ages of 35 to 58 years. That’s a 23 year time span and even then it marks the end of menstruation but not the beginning or the end of symptoms. Natural menopause occurs in 25% of women by the age 47, in 25% by the age 50, and 25% by the age 55. The leaves 25% that may occur before age 35 and after age 58.
Menopausal syndrome is usually a very gradual process. Early indication can include hot and cold flushes, episodic weakness, emotional disturbances (especially a feeling of depression), excessive or scanty menstrual bleeding and short or prolong bleeding, and the time between periods that range from a weak or so too many months. Symptom may precede changes in bleeding by several years and may reoccur with decreasing frequency and severity years after all bleeding stops.
Homoeopathy is the safest treatment before, during, and after menopause because it stimulates the natural hormonal balance without the use of harmful drugs. Constitutional Homoeopathic treatment is best during the transitional period of menopause in order to balance hormonal levels and cure the many accompanying symptoms. We cannot address the complex of the symptoms is separate from the whole individual, for this reason to true classical Homoeopathy prescribes is
highly recommended for the treatment of menopause. Homoeopathy, as a holistic form of medicine, has been used for close to 200 years to treat women with hot flushes and other menopausal symptoms. Each person is treated as an individual. The correctly chosen Homoeopathic remedy can work quickly for premenopausal symptoms. Constitutional remedies can be reassuring and helpful for both physical and emotional aspect of menopause. Though menopause is a normal physiological change, yet we find majority of females undergo a myriad of symptoms in varying intensity, which can be termed as a “Menopausal syndrome”.
It is not uncommon for a woman to have heavy menopausal bleeding resulting in serious blood loss or to have various physical and the psychological problems. The conventional system of medicine recommends hysterectomy or Hormone Replace Therapy treatment in dealing these symptoms. Yet both these treatment are not bereft of various after effects like increased risk of breast cancers, systemic diseases and hormonal imbalances. In such condition where the manifestations are individualistic, homoeopathic as a holistic science is the safest treatment, wherein all the constitutional symptoms i.e. symptoms at the physical, mental, social and the environmental are taken into consideration thus transiting the menopausal age in a gracile way.
The present study, “A constitutional approach in the management of Menopausal Syndrome”, is an earnest attempt to study this inevitable condition based on a Constitutional approach.
Null Hypothesis: constitutional approach does not have a significant role in the management of Menopausal Syndrome”
6.2 Review of Literature
Definition:
At the thirty-fifth to the fifty-eight years, menstruation disappears permanently and this change marks what is known as the natural menopause, climacteric or change of life. The changes is sometimes abrupt, sometime very gradual, being preceded by irregularities in menstruation and it is not frequently it is not infrequently associated with psychical and physical disturbances of a serious character1.
Aetiology:
Menopausal symptoms are caused by the lack of oestrogen. The female hormone. It is the increasing shortage of progesterone (Corpus luteum hormone) which accounts for major disturbances. In some cases the first climacteric afflictions such as hot flushes & mood swings are likewise attributed to the onset of changes in the hormonal balance. The shortage of hormones affects the hormonal cycles because of the failure functions in the feedback mechanisms.
The exhaustion of the ovaries is due to the reduced reactivity of the gonadotrophins release by the pituitary gland as well as to a decrease in the follicles numbers which are the responsible for the ovulation.
The age at which menopause is reached varies with geographical, racial, nutritional and other factors. It does not depend on the age of menarche, marital status and parity, use of hormonal contraceptive, smoking or occupation2.
Clinical Features :
- Amenorrhoea
- Hot flushes
- Insomnia
- Vaginal and urinary changes
- Cardio vascular changes
- Osteoporosis
- Psychological3
BanerjeaSubratakumar, puts forth his views of miasmatic diagnosis of menopausal syndrome, wherein he says various disturbances from imbalance of the hormonal system, particularly around puberty and the menopause are due to a sycotic base. Climacteric flush is syco-tubercular in sycosis, purities vulvae may occur with voluptuous itching, a result of an imbalance in the acidic pH of the vaginal fluid. 5
Karow, opines that as a rule of the homoeopathic treatment for menopausal complaints will be constitutional. An experienced Homoeopath can easily differentiate between especial climacteric type of women, as for instance the Sepia – The Pulsatilla – The Cimicifuga – and the Sanguinariapatients. 6
Kent J.T. says Lachesis is laid down as a remedy for the climacteric period. Now if you will study the cases of many women at the climacteric period you will find that many of them have the flushes of heat and urgings in the head and the great circulatory disturbances that are found under Lachesis. This is also true of the complaints, the headache etc. that comes in women at the climacteric period and at the menstrual period. Sabina is indicated during the climacteric period, when the woman is run down by over work and much child bearing.7
Borriecke mentions the followings remedies for menopause
Menopause – Climacteric period; change of life ; Remedies in general.
Acon; Agar ; Alet ; Amyl ; Aquil ; Arg. N.; Bell.; Bellis.; Bor.ac.; Cact.; Calc.ars.; Calc.c.; Carbo.v.; Caul.;Cim.; Cocc.; Coff.; Con.; Cycl.; err.; Gels.; Glon.; Graph.; Helon.; Ign.; Jabor.; Kahbr.; Kali c.; Kreos. ; Lach.; Mag.c.; Mancin.; Murex.; Nux m.; Nux.v.; Oophor.; Plumb.; Puls.; Sang.; Semperv.T.; Sep.; Sul.; Sul.ac.; Ther.; Ustil.; Val.; Vipera.; Viscum.; Zinc.v.8
6.3 OBJECTIVES OF THE SYUDY:
1) To study the clinical presentation (individualistic) of menopausal syndrome.
2) To study the constitutional approach in the treatment of menopause.
3) To study the miasmatic cleavage of menopausal syndrome.
4) To compile the treatment of menopausal syndrome from various sources in homoeopathic
literature.
MATERIAL AND METHODS:
7.1 SOURCE OF DATA:
The subjects for this study will be taken from the Bharatesh Homoeopathic Medical college and Hospital - O.P.D. / I.P.D / VILLAGE HEALH CAMPS.
7.2 METHODS of Collection of Data (including sampling procedure, if any)
- Subjects will beselected for the study based on inclusion and exclusion criteria, developed for this paarticular study.
- Detailed case history by interview as per the proform prepared for the topic will be taken.
- Treatment will be based on Homoeopathic principles.
- All the cases will be taken from 14th December 2012 to 30th March 2013.
- Every case will be followed for a period of minimum 6 months.
- Sample size will be minimum 30 in number; no particular sampling procedure shall be adopted.
Inclusion Criteria:
- All the subjects in the age groups of 35 to 58 years, irrespective of their occupation and socio-economic background will be included in the study.
- The subjects on active hormonal therapy like HRT and on immunosuppressive drugs will be excluded from the study.
- The subjects with artificial menopause, due to total hysterectomy, radiation etc. will be excluded from the study.
Yes, the diagnosis of the case will be done on symptoms and history of patient and ultrasonography finding, routine blood examination and other routine investigation will be done as per the requirement.
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:
- Howell WH. A textbook of physiology for medical students and physicians. 12th edition. Phileadephia, London: W.B. Saundars Company; 1934
- Menon Krishana MK, Rao B. et al. Postgraduate obstetrics and gynecology.4th edition. Madars: Orient Longgman; 1989.
- Berek, Jonathan S. Novak’s Gynaecology. 12th edition. USA: Williams and Wilkins;1996
- Harris R. Lady’s manual of Homoeopathic treatment. New Delhi: B.Jain Publishers (P) Ltd; 1998.
- Banerjea S. Miasmatic Diagnosis.Newdelhi: B.Jain Publishers (P) Ltd; 1998
- KaroW.Homoeopathy in women’s diseases. Culcutta: Hahnemann Publishing Co.(P) Ltd; 1965.
- Kent JT. Lectures on Homoeopathic MateriaMedica. Reprint edition. New Delhi: B.Jain Publishers (P) Ltd; 2000.
- Boericke W. Pocket manual of Homoeopathic MateriaMedica & Repertory. Reprint edition. New delhi: B.Jain Publishers (P) Ltd; 2001.
9 / SIGNATURE OF THE CANDIDATE
10. / REMARKS OF THE GUIDE
11. / NAME AND DESIGNATION OF
11.1 GUIDE / Dr. (Mrs.) M.N.SHAIKH M.D.(HOM)
HOD, PROF. & PG GUIDE
DEPT.OF ORGANON OF MEDICINE AND PHILOSOPHY
BHARATESH HOMOEOPATHIC MEDICALCOLLEGE,HOSPITAL AND POST GRADUATION RESEARCH CENTRE,
BELGAUM-590016
KARNATAKA STATE.
11.2 SIGNATURE
11.3 CO-GUIDE
11.4 SIGNATURE
11.5 HEAD OF DEPARTMENT / Dr. (Mrs.) M.N.SHAIKH M.D.(HOM)
HOD, PROF. & PG GUIDE
DEPT.OF ORGANON OF MEDICINE AND PHILOSOPHY
BHARATESH HOMOEOPATHIC MEDICALCOLLEGE,HOSPITAL AND POST GRADUATION RESEARCH CENTRE,
BELGAUM-590016
KARNATAKASTATE.
11.6 SIGNATURE
12 / 12.1 REMARKSOFTHE CHAIRMAN/PRINCIPAL
12.2 SIGNATURE