Rajiv Gandhi University of Health Sciences s313
RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES
KARNATAKA, BANGALORE
ANNEXURE – II
APPLICATION FOR REGISTRATION OF SUBJECT FOR DISSERTATION
1. / Name of the Candidate andAddress / Dr. APARNA
P.G. STUDENT,
DEPARTMENT OF MATERIA MEDICA,
H.K.E’S HOMOEOPATHIC MEDICAL
COLLEGE & HOSPITAL, SEDAM ROAD,
GULBARGA – 585105.
2. / Name of the institution / H.K.E’S HOMOEOPATHIC MEDICAL
COLLEGE & HOSPITAL, SEDAM ROAD,
GULBARGA – 585105.
3. / Course of study and
Subject / M.D. (HOMOEO) MATERIA MEDICA.
4. / Date of admission to
the course / 10-10-2012
5. / Title of the topic / “A Clinical Study on Efficacy of Homoeopathic Remedies in the Management and Treatment of Osteoarthritis.”
6. / Brief resume of the
Intended work
6.1 / Need for the study / The incidence of Osteoarthritis is increasing day by day due to the changed life style, less physical work, obesity are the common factors causing Osteoarthritis.
There is a steady rise in prevalence from age 30 such that by 65, 80% of people have radiographic evidence of OA, though only 25-30% is symptomatic. The knee and hip are the principal large joints involved; affecting 10-25% of those aged over 65 years. Even in joints less frequently targeted by OA, such as the elbow, glenohumeral joint or ankle, OA remains the most common cause of arthritis because it is far more prevalent than inflammatory arthropathies. The joint distribution of OA in men and women is similar; in older individuals, hip OA is more common in men, while OA of interphalangeal joints and the thumb base is more common in women. Similarly, radiographic evidence of knee OA, and especially of symptomatic knee OA, is more common in women than in men.
Obesity is a risk factor for both knee and hand OA. For those in the highest quintile for body mass index at baseline examination, the relative risk for developing knee OA in the ensuing 36 years was 1.5 for men and 2.1 for women. For severe knee OA, the relative risk rises to 1.9 for men and 3.2 for women, suggesting that obesity plays an even larger role in the etiology of the most serious cases of knee OA. Obese subjects who have not yet developed OA can reduce their risk: A weight loss of only 5 kg was associated with a 50% reduction in the odds of developing symptomatic knee OA.
Other system of medicine, there is no long lasting relief, only they are treated with symptomatic pain killers, which produce more adverse effect than the disease.
In spite of improving hygienic conditions and advancement in medical field, the incidence of osteo-arthritis is increasing in developing countries like India. The reasons may include immune suppressive drugs, obesity, mal-nutrition, lack of exercises, unhealthy food intake, as well as immune suppressive and auto-immune diseases.
Even though many books mention cure about osteoarthritis, but the systemic study has not been conducted yet. Homoeopathy offers best treatment for the same. With homoeopathic medicines, the immune power of the patient is going to be raised thus the patient, not only recovers from disease but also improves generally as a whole.
Homeopathy is one of the most popular holistic systems of medicine. The selection of remedy is based upon the theory of individualization and symptoms similarity by using holistic approach. This is the only way through which a state of complete health can be regained by removing all the signs and symptoms from which the patient is suffering. The aim of homeopathy is not only to treat osteoarthritis but to address its underlying cause and individual susceptibility. As far as therapeutic medication is concerned, several well-proved remedies are available for osteoarthritis which can be selected on the basis of cause, location, sensation, modalities and extension of the complaints.
Homoeopathic remedies have the ability to arrest the process of degeneration and prevent further damage. The symptoms of pain and inflammation can also be relieved by Homoeopathic Medicines in most of the cases.
In Homoeopathic literature we find many cases of Osteoarthritis cured by Homoeopathic pioneers but no systematic study has been done, hence this study of “A Clinical Study on Efficacy of Homoeopathic Remedies in the Management and Treatment of Osteoarthritis” has been undertaken.
6.2 / Review of literature / 1) Osteoarthritis (OA), also erroneously called degenerative joint disease, represents failure of the diarthrodial (movable, synovial-lined) joint. In idiopathic (Primary) Osteoarthritis the most common form of the disease, has no predisposing factor is apparent. Secondary Osteoarthritis is pathologically indistinguishable from idiopathic Osteoarthritis but is attributable to an underlying cause.
Ref.No.1
2) Osteoarthritis is a disorder of diarthrodial joints characterized clinically by pain and functional limitations, radio-graphically by osteophytes and joint space and narrowing, histo-pathologically by alternations by cartilage integrity. Although the etiology of the disorder is still not clearly understood, Osteoarthritis has been shown to be family disorders with cartilage as a target organ in which biochemical factors play a central role and with risk factors such as age, weight and occupation also a major importance.
Ref.No.2
3) Rheumatic Gout must, I think still retain this name in preference to the rheumatoid arthritis, the chronic rheumatic arthritis or Osteoarthritis, the arthritis deforms and the nodular rheumatism which have been suggested in sub situation. The name is familiar to all, it well expresses the phenomena and relationship of the disease and we shall not be led as try by it’s as to its pathology and treatment.
Ref.No.3
4) Aetiology: Normal synovial joints may be regarded as being in a state of equilibrium between the mechanical properties of the articular cartilage and the mechanical stresses imposed upon this tissue. If the load supplied to the joints rise abnormally or the same loads are applied through unusually small areas, (i.e., the joint becomes abnormally incongruous) this equilibrium will be disturbed.
Ref.No.4
5) Bryonia Alb it is one of our most important remedies in Osteoarthritis. The joints are much swollen and reddened. Streaks of red extending up and down the limb. They are sensitive to touch and are especially painful during motion.
Ref.No.5
6) Ledum Pal is a useful in Osteoarthritis. The symptoms are sore and painful on stepping; drawing pains worse from warmth, pressure and motion. It is used when the patient come from Allopathic hands.
Ref.No.6
7) Osteoarthritis is among the common musculoskeletal disease which affecting the human beings making it an important cause of disability. According to World Health Organization (WHO) Osteoarthritis is the second commonest musculoskeletal problem in the world population (30%) after back-pain (50%). The reported prevalence of Osteoarthritis from a study in rural India is 5.78%. Indians are said to have increased Knee Osteoarthritis as compare to western people, while Hip Osteoarthritis is comparatively uncommon in India.
Ref.No.7
8) Osteoarthritis (also known as degenerative arthritis, degenerative joint disease), is a group of diseases and mechanical abnormalities involving degradation of joints, including articular cartilages and the subchondral bone next to it. Clinical manifestations of osteoarthritis (OA) may include joint pain, tenderness, stiffness, creaking, locking of joints, and sometimes local inflammation. The patient increasingly experiences pain upon weight bearing, including walking and standing. As a result of decreased movement because of the pain, regional muscles may atrophy, and ligaments may become more lax. Osteoarthritis is the most common form of arthritis, and the leading cause of chronic disability. It is estimated that about 80% of the population will have radiographic evidence of OA by age 65, although only 60% of those will show symptoms.
Calc.fluor: Ganglia or encysted tumors at the back of the wrist. Gouty enlargements of the joints of the fingers. Exostoses on fingers. Chronic synovitis of knee-joint. A powerful tissue remedy for hard, stony glands, varicose and enlarged veins, and malnutrition of bones.
Rhus tox: Hot, painful swelling of joints. Pains tearing in tendons, ligaments, and fasciae. Rheumatic pains spread over a large surface at nape of neck, loins, and extremities; better motion. Soreness of condyles of bones. Limbs stiff paralyzed. The cold fresh air is not tolerated; it makes the skin painful. Pain along ulnar nerve. Tearing down thighs. Sciatica; worse, cold, damp weather, at night. Numbness and formication, after overwork and exposure. Tenderness about knee-joint. Loss of power in forearm and fingers; crawling sensation in the tips of fingers. Tingling in feet.
Ref.No.8
9) Osteoarthritis is a degenerative joint disease, which is sometimes also called degenerative arthrosis or osteoarthrosis. It is the most common form of arthritis mostly in obese and middle age. Menopausal women suffer more than others due to hormonal changes, especially the oestrogen deficiency, followed by the rapid reduction in bone mineral density. But it occurs more or less frequently in both sexes. The degenerative form due to age is present in almost everyone by the age 70. Modification in diet, reduction of weight in the overweight patients and a few tone-up exercises help considerable along with the medication.
Arnica montana: Osteoarthritis due to injury; arthritic pain with fear of being touched; Feels bed on which he lies too hard; extreme coldness of forearm.
Belladonna: Shiny, swollen joints of first stage inflammation; shooting pain shifting pain shifting rapidly; affected joint is with heat, redness, throbbing and burning pain; arthritic affection with subcutaneous red streak.
Ref.No.9
10) Osteoarthritis is termed as inflammation of the joint which is often associated with pain, stiffness and limitation of movement of affected joint. There are various forms of arthritis like osteoarthritis, rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis; gout etc. pain is the most common feature of osteoarthritis. Joints, muscles, ligament, cartilage and tendons are mainly affected in this kind of disorder.
Ledum pal. – Remarkable remedy helpful in treatment of osteoarthritis, gout and rheumatism which is of ascending nature, better by cold application, there is deposition of chalk stones in finger joints, wrists and toes. Irritable patient with desire to be alone. Pain may be caused by alcoholism, insect stings, and punctured wound. Pain worse by warm applications.
Benzoic acid -pains in uraemic and lithaemic constitutions. When the urine is scanty the patient suffer more whereas it is heavily laden with deposits and is copious, the pains are relieved. The urine in such a state of a hoarse. Checking of these deposits aggravates the pain. The urine contains uric acid forming the red deposits. The pain cease on catching cold and the inflammation of tongue and stomach starts. In the latter case the patient vomits everything he eats. The suppressed pains go to the stomach.
Ref.No.10
11) Osteoarthritis is an inflammation of the joints, involving breakdown of the cartilage at the ends of bones.A constitutional remedy, chosen to closely fit the individual, may help on deeper levels.
Apis mellifica:This remedy can be helpful in acute conditions with redness, tenderness, and swelling. Joints feel hot and have stinging pain. The hands and knees are often affected. Warmth can aggravate the symptoms and cool applications bring relief.
Calcarea carbonica:This remedy is often useful for arthritis in a person who is chilly, flabby or overweight, and easily tired by exertion. Inflammation and soreness are worse from cold and dampness, and weakness or cramping in the extremities are often seen. Problems often focus on the knees whenCalcarea is needed.
Kali carbonicum:If the joints have begun to get thickened or deformed, and discomfort is worse from cold and dampness, this remedy may help to bring relief. People who need this remedy are often dutiful and conservative, and tend to feel anxiety in the stomach.
Ref.No.11
12) Homoeopathic remedies are prescribed by symptoms rather than conditions, as each case of a particular illness can manifest differently in different people. However, to make it quicker to find the symptoms related to Osteoarthritis, the symptoms experienced by a previous visitor to our homeopathic remedy finder have been grouped, by them, under the name of Osteoarthritis. There may be symptoms not related to Osteoarthritis, and this may not be an exhaustive list of symptoms.
Ref.No.12
6.3 / Objective of the study / 1. To study the Homoeopathic management
of Osteoarthritis.
2. To evolve the group of remedies commonly indicated in the treatment of Osteoarthritis.
7. / Materials and methods
7.1 / Sources of data / Subject will be collected from
H.K.E’S Homoeopathic medical college and hospital Gulbarga. IPD OPD’s.
7.2 / Method of collection of data including sampling procedure if any / 1. By interrogation of individual case.
2. By physical examination of the patient.
3. By laboratory Investigations.
4. Sampling size - 30 cases are to be studied.
5. Sampling procedure:
a) Samples collected using simple random sampling technique.
b) Statistical data analyzed by X2 square test (chi square test).
6. Inclusive criteria fixed for the study:
Osteoarthritis cases between age group of 40 and above of both sexes with Hip and Knee joints are taken for study.
7. Exclusive criteria fixed for the study:
All other degenerative joint diseases and secondary Osteoarthritis for Ex: Trauma, Congenital, Metabolic, Endocrine, Calcium deposition diseases and other bone and joint diseases.
8. Duration of the study:
01-05-2013 to 30-04-2015
7.3 / Does the study require
any investigations or intervention to be conducted on patients or other humans or animals? If so, please describe briefly / The diagnosis is usually clear from history and physical examination. The investigation wherever necessary, viz.,
Blood: T.C., D.C., E.S.R, RA Factor and ASO Titre etc.,
Urine: Alb., Sugar, Microscopic.
X-Ray
7.4 / Whether ethical clearance has been obtained from your institution in case of 7.3 / Yes, ethical clearance has been obtained from our institution.
8. / List of references / 1. Kenneth D.Brandt Harrison’s Principles of Internal Medicine 16th Edition Volume-II Editors Dennis L.Kasper MD & others Published by Mc. Graw-Hill Medical Publishing Division New York. Page No.2036.
2. CECIL Text Book of Medicine 21st Edition Volume-II, Editors Goldman Lee M.D. and J.Claude Bennett M.D. Published by A Harcourt Publishers International Company. Page No. 1550.
3. Richard Hughes-The Principles and Practice of Homoeopathy New Delhi, B.Jain Publishers Pvt. Ltd., New Delhi, Re-print Edition 2001. Page No. 298.
4. Charles V.Mann & R.C.G. Russel Bailey and Love’s short Practice of Surgery. 21st Edition Published by Nick Dunton oxford University Press New York. Page No. 402.
5. Carroll Dunham, M.D. “Lectures on Materia Medica” B.Jain Publishers (P) Ltd. New Delhi. Page No.113, 114.
6. Dewey W.A. M.D. “Practical Homoeopathic Therapeutics” Published by B.Jain Publishers Pvt.Ltd., New Delhi. Page No. 313-321.
7. API Text Book of Medicine 8th Edition, 2008 Chief Editor: Shah Siddharth N. Published by Physicians Association of Mumbai India. Page No.279.
8. Homoeopathy for All Monthly Magazine Volume.11, No.01 (121) January 15 (2010). Author Dr.Swapan Paul BHMS, MD (Hom.) Page No.13, 18, 19, 20.
9. Homoeopathy for All Monthly Magazine Volume.13, No.12 (156) December 15 (2012). Author Dr.R.Valavan, Page No.41, 42.
10. http://hpathy.com/cause-symptoms-treatment/osteoarthritis/
11. http://www.truestarhealth.com/Notes/2246008.html
12. http://abchomeopathy.com/c.php/103
9. / Signature of candidate
10 / Remarks of the guide
11 / Name and designation of
( in block letters)
11.1 / Guide / Dr. RAJESHWARI.K
M.D.(Homoeo)
Prof. & H.O.D
Department of Materia Medica
H.K.E’S Homoeopathic Medical College & Hospital, Gulbarga.
11.2 / Signature
11.3 / Co-Guide (if any)
11.4 / Signature
11.5 / Head of the department / Dr. RAJESHWARI. K
M.D. (Homoeo)
Prof. & H.O.D
Department of Materia Medica,
H.K.E’s Homoeopathic Medical College & Hospital, Gulbarga.
11.6 / Signature
12 / 12.1 / Remarks of the chairman and Principal
12.2 / Signature
1