May 2011|Vol 8|Issue 5

   
 
Case
 
   
A Case of Subserous Fibroid alongwith Tubo-Ovarian mass
 

 

Dr. Kunal Paul,Post graduate trainee,National Institute of Homoeopathy, Kolkata presents a case of subserous fibroid along with tubo ovarian mass treated under the supervision of lecturer, Dr. Subhash Chaudhary and the reader, Dr. Gitashree Pal. Dr. Kunal Paul can be contacted at Department of Practice of Medicine, National Institute of Homoeopathy,Block-GE. Sector-III, Salt Lake, Kolkata-700106. West Bengal.

 
 
 

       A female aged 35 years attended NIH outdoor clinic and presented constant lower abdominal pain more on the left side and severe low back pain for last 7 years along with burning urination, all of which had got aggravated of late.

H/o Present illness
Patient was suffering from lower abdominal pain which was gradual in onset but persistent for last 7 years along with constant low back pain. She was also having burning urination more or less persistent for last 2 years. She has taken homoeopathic treatment locally without much relief.

Past History
· Typhoid at the age of 13 years.

· Appendicectomy done at the age of 17 years.

Family History
· Premature menopause in both of her sisters at the age of 35 and 37 years respectively.

· Mother living - Joint pain.

· Father living - Breathing trouble.

Personal History

· No addiction. P 0+0.

· Menopause at the age of 35 years.

Homoeopathic Generals

· Appetite : Average,

· Desire : Bitter, extra salt in her food

· Intolerance : Milk causes nausea and wheat product produces acidity and flatulence

· Thermal : Hot patient, sun heat always causes headache

· Tongue : Moist no coating

· Thirst : Average

· Stool : Hard

· Urine : Burning urination specially at the closure of it

· Sweat : Profuse, feels better after sweating, stains white

· Sleep : Good

· Dreams : No particular dreams

· General sensations: burning sensation over palms, soles and vertex, of recent origin.

Mental Generals

Weeping disposition, weeping while telling her symptoms, aggravation from consolation and irritability. She was grieved that she did not have a child.

Investigations
Patient came with previous whole abdomen ultrasonography report dated 09.05.2008
“Right adnexa shows an ovoid thick-walled Cyst with a septation measuring about 3.3× 2.2 cm. Another thick-walled Cystic SOL measuring about 3.7×2.2 cm. is seen in the POD on left side-? bilateral cystic SOL- ?bilateral cystic ovaries. A hypoechoic ovoid SOL measuring about 6.5×4.2 cm. is seen in the left adnexa. ? pedunculated subserous myoma.”

(Refer the Plate Before)

 

First Prescription                      18.06.2009
On the basis of marked physical generals like desire for extra salt, bitter food, intolerance milk and bread, sun headache, burning urination at the closure of it, hard stool and mentals like weeping disposition, consolation aggravation, Natrum Muriaticum 200, 2 doses was prescribed


Follow Up 1                               16.07.2009
Except for the symptom of burning urination all the generals remained the same. Pain abdomen persisted and low back pain
was reduced. Placebo was prescribed for one month.

12.08.2009: Much aggravation of all symptoms including burning palms, soles and vertex and burning while urination. These, with the patient’s pelvic pathology, desire for salt, increased thirst, profuse sweat, Medorrhinum 200, 2 doses was prescribed.

15.10.2009: Patient was on placebo as she was better last month. Again there was reappearance of all previous symptoms, so Medorrhinum 1M, 1 dose was prescribed.

21.01.2010: Patient was continuing on placebo. Patient’s abdominal pain and low back pain got reduced and also burning
with urination was much less. Now again for the features like hard stool, persistent desire in respect of food like bitter and salt, sun headache, and also the mental generals Natrum muriaticum 1M, 1 dose was prescribed.

28.03.2010: Patient appeared much improved. Constipation improved. Frequency and intensity of headache also reduced. Pain abdomen was still less. Mentally patient appeared less anxious.Placebo was prescribed.

01.07.2010: Patient received some acute remedies for cough cold etc. in the mean time. Apart from this patient was on placebo. Now her abdominal pain again increased, back pain increased, constipation appeared and her desire for bitter and extra salt persisted. Again Natrum muriaticum 10M, single dose was prescribed. Patient was asked to come with a lower abdominal ultrasonography on her next visit.

14.09.2010: Patient was better in all her mental symptoms and physical generals including the lower abdominal pain. Lower abdominal ultrasonography as on 05.09.2010 showed:
“SOL - 47×29mm, right adnexal mixed echoic SOL, solid in nature. Impression: Right sided TO Mass”. No subserous fibroid was seen.

Rx
Placebo was given

05.10.2010: Patient came back with burning while urination, burning palms and soles and her extreme desire for cold foods and drinks. Even with this approach of winter she could not tolerate any covering. Considering the inherent sycotic trait of her case and all the indications, Medorrhinum 1M, one dose was prescribed.

03.03.2011: Patient having no lower abdominal pain and backache. Her physical generals like those of sun headache,
constipation, burning urination, burning palms, soles and vertex were no more. Lower abdominal ultrasonography (3rd USG) as on 03.03.2011 showed: “No TO Mass now seen”.

(Refer the Plate After)

Comments:
In this case the menstrual disturbances (amenorrhoea) was not considered a problem by the patient as two of her sisters also experienced ‘premature menopause’ at about her age. But she was extremely happy at the improvement of her distressing symptom of pain. During the course of her treatment she was not taking any hormonal medicines or other medicines prescribed by modern medicine. The fact that improvement occurred not just in her symptoms but was also evident from the sequential improvement in the pathology as seen on ultrasonography must be considered as an achievement for homoeopathy. The case shows the extreme efficacy of homoeopathic treatment even in cases with organic pathology.