CERVICAL POLYP TREATED WITH INDIVIDUALIZED HOMOEOPATHIC MEDICINE – CASE REPORT

CERVICAL POLYP TREATED WITH INDIVIDUALIZED HOMOEOPATHIC MEDICINE - CASE REPORT

S. Kadam *, P. Lamba, D. B. Sharma, P. A. Chaphekar and P. Aphale

Department of Homoeopathic Materia Medica , Dr. D. Y. Patil Homoeopathic Medical College & Research Centre, Pimpri, Pune, Maharashtra, Dr. D. Y. Patil Vidyapeeth, Pimpri, Pune, Maharashtra, India.

ABSTRACT: A known case of a cervical polyp of a 26-year-old woman presented in the Outdoor-patient Department of Dr. D. Y. Patil Homoeopathic Medical College and Research Centre with complaints of abnormal bleeding in between periods, pain after coition, and profuse white discharge. USG reports confirmed the diagnosis of the cervical polyp. After a detailed history taking of the patient and considering a complete totality of symptoms, Natrum Muriaticum 30C, a single individualized homeopathic medicine, was prescribed to the patient, and it proved effective in the treatment of cervical polyp. The patient slowly showed improvement in physical symptoms, followed by mental symptoms. Modified Naranjo Criteria were used, and regular follow-ups were taken to assess the case. This case demonstrates the usefulness of homeopathic medicines in psychosomatic diseases wherein the psychological cause is the main cause of the disease in the patient. Also, this case shows the effectiveness of Homoeopathic remedies in the treatment of cervical polyps. It can be looked at as an alternative method of treatment with further research on the same.

Keywords: Natrum muriaticum, Homoeopathy, Cervical polyp, Case report

INTRODUCTION: Cervical polyps are excess non-cancerous growths arising from end cervical tissue that protrudes in the cervical canal and are the most common condition in gynecological practice ². to 5 % of women are at risk of developing cervical polyp ¹. The etiology of cervical polyps is not clearly understood. Risk factors that contribute to the development of polyps are chronic inflammation due to recurrent infection, hormonal disturbances, past history of pregnancy, and endometrial hyperplasia.

Presenting symptoms of polyp is intermenstrual bleeding, abnormal discharge from the vagina, post coition bleeding, painful menses, and heavy bleeding during menses. Many of the patients remain asymptomatic ^{1, 8}.

If left untreated, there are 0.2% to 1.5% chances of malignancy. Other common complications are infertility, bleeding, and recurrence ^{1, 3}. In modern medicine, there is no medicinal treatment for polyps; the main line of treatment is the surgical removal of polyps ¹⁰.

The present case report supports the earlier studies conducted on cervical polyps, which were treated with homeopathy ⁴. This case is presented for the further scope of homeopathy in managing cases of cervical polyp and to be considered as an alternative method of treatment in such cases.

Patient Information: This is a known case of a cervical polyp of a 26-year-old married woman pre-diagnosed by gynecologists who came to the Outdoor Patient Department on 28/09/21 with complaints of abnormal bleeding post menses for 2 months. Profuse white discharge before menses irritating the parts. Pain after coition. Other associated complaints were heavy flow during menses, <at night. Throbbing headache, which was worse in the morning. Frequent episodes of headache since complaints.

Past History: H/o urticaria 10yrs back treated with homoeopathy. H/o hematuria 6 months back. Took allopathic treatment for same.

Family History: Father–Diabetes Mellitus for 2 years.

Personal History: Appetite - Adequate.

Desire: She has a habit of eating bit of salty food.

Sleep: Disturbed due to irregular routine sleep after 2- 3.00 am.

Menstrual History:

Age of Menarche: 13 years.

L.M.P: 06/09/21.

Menses: Regular.

Duration and Cycle: 8-10 days / 28days

Bleeding: Heavy flow since 2 months (3-4 pads/day).

Clots: Intermittent clots.

Complaints during Menses: Cramps during menses ++ with low back pain. Sometimes, it is associated with nausea and vomiting. Takes Tab. Meftal Spas on the first day of menses. Leucorrhea before menses.

Obstetric History -P0: No major past Gynecological history. H/O repeated vaginal infection.

Mental Symptoms: She belongs to a middle-class family working in an IT company. When enquired about her nature according to her, she becomes easily angry. Angry, especially when consoled. Cannot tolerate any consolation. Cries when alone thinking of past events. She gets very irritable, especially after menses and coition. There has been emotional turmoil in the patient since she got married and shifted to Pune from Mumbai. She is not able to adapt to the culture of her current place, and constant minor health issues make her much more irritable. According to her, she has gone through many adverse events in the past that she was not willing to reveal.

Clinical Findings: P/A – Soft. Mild tenderness in the lower abdomen. P/S – Erosion on the anterior lip of the cervix with polyp protruding the cervix. White discharge +++. Redness of vulva +

Laboratory Investigations: CBC (04/08/21): Hb – 13.4%; WBC – 8,500; Platelet – 339 10^3/ul

Glucose Random: 81mg/dl; T3 – 129 ng/dl, T4 – 7.88 microgram/dl, TSH – 3.38 uIU /mL

USG Abdomen and Pelvis: Refer to Fig. 1.

Uterus Normal: ET- 5MM. Cervix shows a7 x 6 mm hyperechoic lesion with a vascular pedicle suggestive of the polyp.

Diagnosis: Cervical Polyp.

FIG. 1: ULTRASONOGRAPHY ABDO-PELVIS (BEFORE TREATMENT)

FIG. 2: ULTRASONOGRAPHY ABDO-PELVIS (AFTER TREATMENT)

Therapeutic Intervention:

Totality of Symptoms: The symptoms arrived in totality were as follows-

• Ailments from anger+++
• Irritable after coition++
• Irritable after menses ++
• Weeps when alone.
• Desire salty food.
• Sleepless till 2 am.
• White discharge acrid, excoriating.
• White discharge <after menses.
• Abnormal bleeding post-menses
• Profuse bleeding during menses<night.
• Pain during coition.
• Pulsating headache <before menses.

MATERIALS AND METHODS: Repertorisation – Repertorisation of the case was done by using Hompath Zomeo Basic Lan version 1.0 software, in which a complete repertory was used. Natrum Muriaticum scored the highest, scoring of 35 and covered all 13 symptoms.

FIG. 3: REPERTORISATION TABLE: REPERTORISATION OF CASE USING HOMPATH ZOMEO SOFTWARE

Prescription: Natrum muriaticum 30C, twice a day (B.D.) was given for 5 days and Sac Lac thrice a day (T.D.S) for 15 days on Day 1 of the visit – 28/09/2021. The patient was asked to follow up after 15 days.

TABLE 1: REMEDY DIFFERENTIATION ^{5, 9, 7}

TABLE 2: FOLLOW-UP VISITS WITH DETAILED SYMPTOMS, USG REPORT, AND TREATMENT

TABLE 3: RESPONSE OF PATIENT ASSESSED WITH MODIFIED NARANJO CRITERIA (MAXIMUM SCORE= +13 AND MINIMUM SCORE= -6)²

RESULT AND DISCUSSION:

The above case report demonstrates the effectiveness of individualized homeopathic medicine in the treatment of cervical polyps. The patient was advised for Polypectomy. The patient responded to a single homeopathic remedy effectively, and a permanent cure was achieved. Based on the chronic totality of symptoms, the patient was prescribed Natrum Muriaticum 30C. The remedies taken for differentiation were Sepia and Calcarea Carbonicum as seen in Table 1. In this case, the mental symptoms of the patient were much marked wherein Irritability after Menses and Weeping When Alone were covered only by Natrum Muriaticum. Also, sleeplessness, which was most marked in the patient, was not covered by Sepia and Calcarea Carbonicum.

In Fig. 3 Natrum Muriaticum has covered all the symptoms and scored 35 marks. Other remedies were Sepia, which scored 29 marks and Calcarea Carbonicum, which scored 27 marks. Natrum Muriaticum was given as the constitutional remedy best suited to the patient's constitution.Natrum Muriaticum is indicated in cases of psychic causes of illness, where there are ill effects of anger. The first dose of Natrum Muriaticum. 30C showed improvement in the general aspect of the patient. She could sleep well, and her menses were less profuse than before. Sac lac was prescribed to the patient in 1st follow-up in order not to disturb the action of the medicine. In 2^nd follow-up, pain after coition was much better, and no other significant changes were noted.

In 3^rd and 4^th follow-ups, the patient noticed old symptoms that appeared after taking medicine with occasional intermenstrual bleeding. According to the Principles of Homoeopathy, there was an appearance of old symptoms, meaning the remedy selected was correct ⁶. Natrum Muriaticum was prescribed in the higher potencies, that is in 200 C potency, followed by 1M. Mentally, the patient was much better there was no irritability and the patient had started engaging herself in her hobby of dancing and other daily activities. In 5th follow-up, intermenstrual bleeding was better. No new eruptions on genitals since 15 days, no pain after coition. On 1^st day of menses, there was heavy flow followed by normal flow for the rest four days. On examination, as the polyp was not felt, the patient was advised to do repeat Ultrasonography. Results of post-treatment USG are mentioned in Fig. 2 and Table 2. In 6^th follow-up, the patient had no intermenstrual bleeding and so Sac lac was prescribed, and in 7^th follow-up, the patient was asked to follow up when needed. Table 3 consists of the Naranjo Criteria Score, which assessed the patient’s response to treatment. There was a score of +11 which indicates good improvement in the patient, and no adverse effects were seen in the patient during treatment ². The consistent follow-up revealed that the patient had improved not only in the physical aspect but also in her mental symptoms. This itself shows the compatibility of single individualized medicines in treating such cases with no need for surgical interventions.

CONCLUSION: In the Homoeopathic system of medicine, only disease is not treated, but the patient is treated as a whole; both the patient's mental and physical aspects are considered. With this, I conclude that this case has shown how a holistic method of treatment has given encouraging results in treating cervical polyps, as evident in USG results. So with further research, homeopathy can be thought of as an alternative treatment in such cases.

ACKNOWLEDGEMENT: I am thankful to Dr. D. Y. Patil, Homeopathic Medical College, and Research Centre and faculties for guiding us and for the opportunity to conduct various research and publish articles in reputed Journals.

Informed Consent: Informed consent was taken from the patient on 1^st visit.

Source of Funding: Nil

CONFLICTS OF INTEREST: No conflict of interest.

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    How to cite this article:

    Kadam S, Lamba P, Sharma DB, Chaphekar PA and Aphale P: Cervical polyp treated with individualized homoeopathic medicine - case report. Int J Pharm Sci & Res 2023; 14(11): 5526-31. doi: 10.13040/IJPSR.0975-8232.14(11).5526-31.

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