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From :

Dr. AMIT MEHAROTRA

Post Graduate Student,

Post Graduate Dept. of Materia Medica.

D.B.H.P. Sabha’s Dr. B. D. Jatti Homoeopathic Medical College, Hospital & P.G. Research Centre, D. C. Compound,

Dharwad –580001.

To:

THE REGISTRAR,

Rajiv Gandhi University of Health Sciences, Karnataka,

Bangalore.

[Through, The Principal, Dr. B. D. Jatti Homoeopathic Medical College Hospital & P.G Research Centre, D. C. Compound, Dharwad – 580001]

Respected Sir,

Sub: Submission of completed proforma of Synopsis for Registration of

Subject for Dissertation

I request you to kindly register the below mentioned subject against my name for the submission of synopsis to the Rajiv Gandhi University of Health Sciences, Karnataka, Bangalore, for Partial fulfillment of M. D. (Homoeopathy).

Title of Dissertation:

A CLINICAL PROFILE OF TINEA CURIS AND ITS HOMOEOPATHIC MANAGEMENT

I am herewith enclosing the completed proforma of synopsis for registration of the subject for Dissertation.

Thanking You,

Place : Dharwad. Yours Faithfully,

Date :

(DR. AMIT MEHAROTRA)

SYNOPSIS

of

A CLINICAL PROFILE OF TINEA CURIS AND ITS HOMOEOPATHIC MANAGEMENT

Submitted to

RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,

KARNATAKA, BANGALORE.

BY

DR. AMIT MEHAROTRA

Through

D.B.H.P. Sabha’s

Dr. B. D. Jatti Homoeopathic Medical College,

Hospital & Post Graduate Research Centre, Dharwad. (Karnataka).

In partial fulfillment of requirements for the post-graduate degree of

DOCTOR OF MEDICINE (HOMOEOPATHY)

HOMOEOPATHIC MATERIA MEDICA

Under the valuable guidance of

DR. R.Y.NADAF, M.D(Hom.)

Principal, Professor & HOD, Dept. of Hom. Materia Medica,

Dr. B.D. Jatti Homoeopathic Medical College Hospital & Post Graduate Research Centre, DHARWAD.

RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, KARNATAKA, BANGALORE.

Annexure –II

REGISTRATION OF SUBJECT FOR DISSERTATION

1. / Name of the Candidate / DR. AMIT MEHAROTRA
Post Graduate Student,
Post Graduate Dept. of Homoeopathic Materia Medica,
D.B.H.P. Sabha’s Dr. B. D. Jatti Homoeopathic Medical College Hospital & P.G. Research Centre, D. C. Compound,
Dharwad – 580001. Karnataka
Permanent Address / DR. AMIT MEHAROTRA
C/O Dr. V. K. Khanna ,
19, Khun Khunji Road, Chowk,
Luckhnow - 226003 (U.P)
2 / Name of the Institution / D.B.H.P.S’s Dr. B. D. Jatti Homoeopathic Medical College Hospital & P.G. Research Centre, D. C. Compound,
Dharwad – 580001.
3 / Course of study and subject. / M.D (HOMOEOPATHY)
HOMOEOPATHIC MATERIA MEDICA
4 / Date of admission to the course. / 27-04-2010
5 / Title of the topic / A CLINICAL PROFILE OF TINEA CURIS AND ITS HOMOEOPATHIC MANAGEMENT
6. / BRIEF RESUME OF THE INTENDED WORK
6.1 / Need for the study:
1) Tinea cruris is often labeled as a Jock itch and it refers to any itching groin rashes of men. Infection often arrives from the feet (medically known as a tinea pedis) or nails (medically known as a tinea unguium) originally, spread due to scratching or using some common clothes like infected towels.
2) Tinea cruris or ringworm of the groins is an infection that occurs at groin regions because of fungi and it may form ring-like patterns onto the buttocks and is very itchy.
3) According to World Health Organization, Tinea curis represented 20% of all superficial mycosis and about 25% of population is suffering from the same.
4) The most common causative factors for tinea cruris involve are Trichophyton rubrum and Epidermophyton floccosum and to a lesser extent, Trichophyton mentagrophytes and Trichophyton verrucosum.
5) Tinea cruris is a communicable condition that gets transmitted through fomites like contaminated towels or hotels’ bedspreads, or by auto-inoculation from some reservoirs on the hands or foot
6) The rash has a scaly raised red border that spreads down the inner thighs from the groin or scrotum
7) Complications that may arise with Tinea Cruris include permanent change in the skin color of the affected area, secondary bacterial skin infections, and side effects of medications. Tinea cruris may complicate allergy and asthma and may contribute to refractory atopic disease. Patients with recurrent cellulitis may be referred to the allergist/immunologist for an immune evaluation and discovered to have tinea cruris as a predisposing factor. In some patients, gram-negative infection may complicate tinea cruris.
8) The treatments of tenia cruris is not found satisfactory by using antifungal drugs. The physicians are fascinated of using topical therapy where medicaments are used in crude form for such skin disease and suppress the same. Also due to continous use of anti fungal treatments patient have become drug resistant or suffer from severe side effects like hepatotoxicity.
9) On the other side homeopathy provide a wide range of well proved polychrest remedies. A careful case taking and judicious use of remedies can ameliorate the suffering and improve the patients quality of living.
10) On seeing the disease homeopathically, the skin reflects the earliest certain disorders taking place inside the body. Hence, the net result of suppression being, what nature wanted to throw out and there to save the internal vital organs, the human efforts drive it in and disease takes a stronger hold on vital organs.
11) So, the conclusion is that, in most of the cases internal treatment is necessary and in some cases, it is the only method of treatment for preventing its recurrence.
6.2 / Review of literature:
1) Tinea cruris is common skin infection, but many people neglect to visit a doctor. Males are affected more than female.1
2) Tinea cruris is often labeled as a Jock itch and it refers to any itching groin rashes of men. Itching in thigh skin folds and /or anal region it might be abnormally darkened or lighter skin. The condition is most active at the edges of the patches
There might be burning sensation on or around the groin
There would be flaking, peeling or cracking of the skins in the groin regions.2
3) Dermatophytes are molds that require keratin for nutrition and must live on stratum corneum, hair, or nails to survive. Human infections are cause by epidermophyton, microsporum and tricophyton spp. These differ from candidiasis in that they are rarely if ever invasive. Transmission is person to person, animal to person and rarely soil-to-person. The organ may persist indefinitely.3
4) The commonest signs and symptoms are itching in groin regions, thigh skin folds and /or anal region. There might be abnormally darkened or lighter skin. There might be burning sensation on or around the groin. The condition is most active at the edges of the patches. There would be flaking, peeling or cracking of the skins in the groin regions.4
5) Complications that may arise with Tinea Cruris include permanent change in the skin color of the affected area, secondary bacterial skin infections, and side effects of medications. Tinea cruris may complicate allergy and asthma and may contribute to refractory atopic disease. Patients with recurrent cellulitis may be referred to the allergist/immunologist for an immune evaluation and discovered to have tinea cruris as a predisposing factor. In some patients, gram-negative infection may complicate tinea cruris.5
6) Excessive moisture, warmth and sweating are the most important predisposing factors for tinea cruris.5
7) The presence of these infections is suspected from location and appearance of lesions, and diagnosis is confirmed by examination of a potassium hydroxide preparation or by culture.4
8) Dry, scaly, unhealthy; every little injury suppurates. Freckles, itching, burning; worse scratching and washing. Skin affections after local medication. Pruritus, especially from warmth, in evening, often reoccurs in spring-time, in damp weather.9
9) Many of the complaints of the skin are aggravated or worse from warmth of bed or by washing. The skin itches when warm; itches when wearing woolens. Itching when warm in bed or sweating; he scratches until the part becomes raw, and then it becomes scabby.10
10) The local affections, however, is never any thing else than a part of the general disease, but a part of it increased in one direction by the organic vital force, and transferred to a less dangerous (external) part of body, in order to allay the internal aliments. But (as he been said) by this local symptom that silences the internal disease, so far from anything being gained by vital force towards diminishing or curing the whole malady, the internal disease, on the contrary, continuous, in spite of it, gradually to increase and nature is constricted to enlarge and aggravated the local symptom always more and more, in order that it may still suffice as a substitute for the increased internal disease and may still keep it under.11
6.3 / Aims and objectives:
1.  To study clinical presentation of tinea cruris.
2.  To study the homeopathic management of tinea cruris.
3.  To study the leading homoeopathic medicines used in the treatment of tinea cruris.
7 / MATERIAL & METHODS :
7.1 / Source of data :
The subject for this study will be taken from OPD, Rural OPD and IPD of Dr. B. D. Jatti Homoeopathic Medical College Hospital Dharwad.
7.2 / Methods of collection of data.
(Including sampling procedure any)
Definition of the study subject:
Patients will be considered on the basis of clinical presentation.
Following are the inclusion criteria:
1.  All the clinically diagnosed cases of Tinea cruris
2.  Patients of all the age group and both the sexes.
Following are the exclusion criteria:
1.  Patients under immune-suppressive drugs or chronic illness will be excluded.
2.  Complication of Tinea cruris.
Study sampling design:
Prevalence rate of Tinea cruris in our hospital is 2%. Considering the 95% confidence interval at 5% permissible error, the sample size works out to be 32 cases. Since, so many cases, considering the inclusion and exclusion criteria, may not be available and since it is a time bound study, all admitted and OPD cases will be included in this study period.
Study design:
Simple random method, Hospital based time bound study.
Follow up:
Cases are followed for every 15 days for the first 3 months and then monthly once till the end of study period. Physical and laboratory examinations done periodically when ever needed.
Parameters are:
Changes in Clinical Findings like the Presenting Symptoms, Signs andinvestigations.
IMPROVED:
Regression of the signs and symptoms along with no signs of eruption of skin till the end of my study period.
NOT IMPROVED:
1)  Relief of signs and symptoms, but reoccurs within end of my study period.
2)  Relief of signs and symptoms.
3)  Regression of the erruptions but signs and symptoms not totally relieved.
DROPPED OUT:
1)  Cases who have left treatment during the study period
Statistical test:
Appropriate test will be used depending upon the data available at the end of the study.
Study period:
From November-2010 to November-2012.
7.3 / Does the study require any investigations or any intervention to be conducted on patients or other humans or animals? If so describe briefly.
Yes, the study requires investigations to be conducted on patients.
1.  Blood- Hb%, TC, DC, ESR
2.  Scrapings for microscopic study.
3.  Wood’s lamp examination.
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.  Siddharth N. Shah. API Text Book of Medicine 7th Edition, Mumbai; The Association of Physicians India; 2003.
2.  M.E. Douglass, M.D. Skin diseases. Their Description, Etiology Diagnosis and Treatment according to the law of similar. B-Jain. Publisher’s Pvt. Ltd. New Delhi 1998.
3.  Moschella & Hurley, Dermatology, Jaypee Brothers, New Delhi, India, Vol 1, 2nd Edn, 1980.
4.  Rook and Wilkinson D Setal, Text book of Dermatology, Edn 2, Blackwell Scientific Publications Co.,1985.
5.  David A. Warrell, Timothy M. Cox , John D. Firth, Edward J., Jr., M.D. Benz, Oxford Textbook of Medicine 4th edition, Oxford; Oxford Press; 2003.
6.  J. Henry Allen. Diseases and Therapeutics of the Skin. B-Jain. Publisher’s Pvt. Ltd. New Delhi 1983
7.  Rook/Wilkison/Ebling. Textbook of Dermatology. Volume-1, 5th edition, Blackwell scientific Publication
8.  Andrew’s Diseases of the skin, clinical Dermatology, 8th edition. W.B Saunders’s Company 1990.
9.  Richard Huges, The Principles and Practice of Homoeopathy. B-Jain Publishers Pvt. Ltd. New Delhi 1999.
10.  James Tyler Kent, Lectures on Materia Medica, B-Jain. Publishers Pvt. Ltd. New Delhi 1983.
11.  C.F. Samuel Hahnemann, Organon of Medicine, 6th edition, B-Jain. Publisher’s Pvt. Ltd. New Delhi 2002.
12.  http://en.wikipedia.org/wiki/Tinea_cruris
13.  http://en.healthline.org/wiki/Tinea_cruris
9 / Signature of the Candidate
10 / Remarks of the guide
11 / 11.1 Name & Designation of guide
(In block letters) / DR. R.Y.NADAF, M.D. (Hom.)
Professor & Head of Department,
Department of Homoeopathic Materia Medica, Dr. B. D. Jatti Homoeopathic Medical College & Post Graduate Research Centre, Dharwad – 580001
11.2 Signature.
11.3 Co- Guide,
if any
11.4.Signature
11.5 Head of the Department / DR. R.Y.NADAF, M.D. (Hom.)
Professor & Head of Department,
Department of Homoeopathic Materia Medica,
Dr. B. D. Jatti Homoeopathic Medical College & Post Graduate Research Centre, Dharwad – 580001
11.6 Signature
12 / 12.1 Remarks of the Chairman & Principal
12.2 Signature