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Transcript
BHARATESH HOMOEOPATHIC MEDICAL COLLEGE &
HOSPITAL, POST GRADUATE RESEARCH CENTRE
BELGAUM-590016, KARNATAKA
Recognised by
CENTRAL COUNCIL OF HOMOEOPATHY, NEW DELHI
Affiliated to
RAJIV GANDHI UNIVERSITY OF HEAITH SCIENCES, BANGALORE
SYNOPSIS
M.D. (HOMOEOPATHY)
“A STUDY OF TINEA CORPORIS &ITS CONSTITUTIONAL
APPROACH”
By
DR.TAIMIMKOUSAR.M.KHADAKWALE
Under the Guidance of
DR.M.N.SHAIKH MD (HOM)
Professor, HOD & P. G. Guide,
DEPARTMENT OF HOMOEOPATHIC MATERIA MEDICA
BHARATESH HOMOEOPATHIC MADICAL COLLEGE &
HOSPITAL
From,
Dr. TAIMIMKOUSAR
To,
DR. M.N.SHAIKH M.D (HOM)
Professor, H.O.D & P.G. Guide,
Department of Organon Of Medicine & Homeopathic Philosophy
Bharatesh Homoeopathic Medical College & Hospital,
Belgaum.
Sub: Application to my synopsis for the dissertation
Respected Sir,
I Dr. TAIMIMKOUSAR, would like to forward my application for the
approval of my synopsis under your Guidance for the following topics, “A STUDY
OF TINEA CORPORIS & ITS CONSTITUTIONAL APPROACH ” Hope you
will approve the same
Thanking you.
Date:
Place: Belgaum.
Yours Sincerely
Dr.TAIMIM KOUSAR
Department of Organon of
Medicine &Homoeopathic Philosophy
Bharatesh Homoeopathic medical
College and hospital
From,
DR. M.N.SHAIKH M.D (HOM)
Professor, H.O.D & P.G. Guide,
Department of Organon Of Medicine & Homeopathic Philosophy
Bharatesh Homoeopathic Medical College & Hospital,
Belgaum.
To,
Dr. TAIMIM KOUSAR
Sub: Acceptance of synopsis for the dissertation
Dear Doctor,
I have accepted your topic, “A STUDY OF TINEA CORPORIS & ITS
CONSTITUTIONAL APPROACH ”For the dissertation.
Your synopsis will forward to RGUHS.
Date:
Place: Belgaum
DR. M.N.SHAIKH M.D (HOM)
Professor, H.O.D & P.G. Guide,
Department of Organon Of Medicine &
Homeopathic Philosophy
Bharatesh Homoeopathic Medical College &
Hospital, Belgaum.
RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,
KARNATAKA, BANGALORE
ANNEXURE II
APPLICATION FOR THE REGISTRATION OF SUBJECT FOR
DISSERTATION
1.
NAME OF THE
CANDIDATE &
ADDRESS
DR.TAIMIMKOUSAR.M.KHADAKWALE
POST GRADUATE STUDENT ,
BHARATESH HOMOEOPATHIC
MEDICAL COLLEGE AND HOSPITAL,
BELGUAM
PERMANENT ADDRESS
DR.TAIMIMKOUSAR.M.KHADAKWALE
c/o AFZAL HUSSAINS.A.SHAIKH.
PLOT NO:53 SECTOR NO:2
SHIVABASAVANAGAR
BELGAUM-590016
2.
NAME OF
INSTITUTION
BHARATESH HOMOEOPATHIC
MEDICAL COLLEGE AND HOSPITAL,
DHARWAD ROAD BELGUAM
(KARNATAKA).
3.
COURSE OF STUDY
AND SUBJECT
DOCTOR OF MEDICINE
(HOMOEOPATHY)
ORGANON OF MEDICINE
&HOMEOPATHYIC PHILOSOPHY
4.
DATE OF ADMISSION 31-10-2011
TO COURSE
5.
TITLE OF THE TOPIC “A STUDY OF TINEA CORPORIS & ITS
CONSTITUTIONAL APPROACH ”
6.
BRIEF RESUME OF THE INTENDED WORK
6.1 NEED FOR THE STUDY
Tinea Corporis is seen world wide is the most common in the tropical region,
any dermatophyte can potentially cause tinea corporis but T Rabrum is the most
common pathogen world wide follow by T Mentagrophyte.
Sites of predilection are the neck upper and lower extremities and trunk it can
be caused by any dermatophytes. This form of ringworm is characterized by one or
more circular, sharply circum scribed slightly erythematous, dry scaly usually
hypopigmented Patches. The modern system of medicines makes the usage of external
application like ointments, fungicides etc, which leads to suppression or palliation. So
the disease tends to recur often and becomes a chronic disease. The disease is usually
chronic and the course extends over months to years eczematisation and lichenification
may become the complicating features of chronic cases half hearted treatment is
demoralizing and results in chronicity.
As Homeopathy is a system of medicine which work on inspiration the humoral
or the immune mechanism of the body from its latent or overt reaction ,it is there by the
best form of medicine to treat skin diseases here the cure is obtained by constitutional
treatment .
The sum total of the individual characteristics in the three planes –emotional,
intellectual & physical-depicts the constitution. This some total is the resultant of the
environmental factor, right from the time of conception, acting on the hereditary plan of
organization as determined genes. Therefore individual illness cured if only we can
clearly understand the constitution. A systemic study on scientific line is needed to
conclude on the effect of homoeopathy medicine in the treatment of tinea corporis
hence study is under taken.
Hypothesis: Constitutional approach to Tinea Corporis may be effective.
6.2 REVIEW OF LITERATURE
Tinea corporis is the commonest clinical variety of dermatophyte infection in
India. It is distributed world wide.(1) It is most common in tropical regions. Tinea
corporis manifests itself as Marked itching, vesicles pustules or scaling; these vary
from case to case depending upon the virulence of the fungus and sensitivity of the
individual.(2)
The disease is usually chronic and the extent over month to year eczematisation
and linchenification may become complication features of chronic cases.(3) Hugein his
manual of Therapeutic say that Herpss circinnatus (ring worm of the surface) is usually
treated and with fair success by sepia, but that when the proving of Tellurium produced
so similar an eruption, he (Dr. Hunges) followed Dr.Metcalf in prescribing it instead of
sepia for this disorder and has never failed to cure in speedily there by. Hence, it appear
that there is a wide scope for proper management and treatment of tinea corporis in
homoeopathy. The modern system of medicine adopts the usage of antifungal or
fungicides, externally or internally. But the side effects of this treatment out weight
benefits and is only a palliation.(6)
PREDISPOSING FACTOR
1. Tinea corposis may be transmitted by direct contact with other infected individuals
or by infected animals1. Transmission of infection by clothing furniture or any other
sites in the same patients.(2)
2. Risk factors for infection include exposure to infected animals persons soil, athlete,
veterinarians, animal handlers .(3)
3. In addition certain systemic disease may predispose to infection including
cashing’s syndrome, D.M.atropy and most immuno deficiency syndromes .(4)
PATHOGENESIS :
Dermatophytes grow only on the keratinised layers of the skin and its
appendages and do not ordinarily penetrate the living tissues. Fungal products may be
responsible for inciting local inflammation. Hypersensitivity to fungus antigens may
play a role in pathogenesis and is probably responsible for the sterile vesicular lesions
some times seen in distant from the ring worm.(2)
The organism responsible for tinea corporis invades the stratum corneum,
possible aided by warm moist occlusive conditions and resides in it. After about 1-3
weeks of incubation it starts spreading centrifugally.(4) Serum inhibitory factor may be
responsible for limiting this infection. Chronicity and further spread of infection.
Dermatophytes unlike most other fungi produce keratinases (Enzymes that break down
Keratin) which allow for invasion of the fungi into kerotinized tissue. Mannans in the
cell walls of dermatophytes have immuno inhibitory effects. The severity of clinical
disease is affected by several host factors, sebum has an inhibitory effect on
dermatophytes, and the level of disease activity may be related to the number and
activity of sebaceous glands, and increased susceptibility may be inherited or related to
the competency of the immune system.(3)
COMPLICATION: Half hearted treatment is demoralizing and results in
chronicity: (3,4)
1) eczematisation 2) lichenification.
DIAGNOSIS: Laboratory findings for the correct diagnosis tinea corporis the
spreading ringworm with active erythumotous border-specimens for KOH examination
should be obtained from the actively spreading border of the lesion.(1) Microscopic
examination of skin scrapings for fungi is essential in dermatologic. Fungal eruptions
may closely resemble dermatitis. Microscopy of potassium hydroxide-cleared skin
scrapings called a KOh exam takes only a few minutes and is simple principle doing
it.(3,4)
Thus in homeopathy, constitutional is defined as physical and mental makeup of
individual. Constitution is a phenomenon i.e. I has antecedents; it evolves over period
of times and unfold in itself by constant interaction with the environment.
Constitutional presiding is a holistic approach of homoeopathic treatment where
prescription is not based on isolated systems, but on the characteristics , unearthed by
proper, in depth case taking ;this information is then matched to a single remedy.(5)
J.Compton Burnett Quotes: I seek to show that the so called diseases of the
skin are for the most part diseases of the constitutions of the persons, and not diseases
of theirs. Many cutaneous manifestations be taken in a certain sense, constitutional
power organism has the power to determine its diseases to the periphery to its outside.
It is a smaller evil to have it outside on the skin than to have it inside in a given organ.
The trichophyton is not the disease itself but its organic scavenger cure the internal
disease, and this scavenger dies.(6)
Chatterji.TP: Defines constitution as “It is the inherited qualities cum
environment, having genetic background.(7)
Constitutions types according to Dr. Hahnemann : After years of patient
observation Hahnemann saw that a superficial symptom resemblance between drugsymptoms and disease-symptoms was sometimes insufficient to show the true specific
correspondence eventually he tracked down the underlying constitutional dyscrasiae to
the 3 miasms” and he named them, syphilis, sycosis and psora.(8)
Thomas. P. Paschero, tells us: “Homoeopathy views the constitution as a
pathogenic dynamism which the individual inherits and modifies during his life, in
three distinct directions. Inflammation, destruction of tissue, or its proliferation. These
dynamic morbid tendencies were called by Hahnemann ‘miasms’ a term comparable to
‘diathesis’ dyscrasia terrain; or constitution and he gave them the names, psora,
syphilis, and sycosis.(9)
J.H. Allen say: Sycosis as well as pseudo psora we see them in the vegetable
parasitical pest as seen in tinea. We see the animal parasite in the psoric and
pseudopsoric; probably no skin disease show such a special form of sycotic expression
as we find in Tinea barbae, Tinea tonsuraus, Tinea vesicular and similar diseases of the
face, scalp and other part of the body, when they are suppressed, they develop for their
sycotic difficulties of a sycotic nature.(10)
Some of the constitutional remedies used for Tinea Corporalis are:(11)
SULPHUR: skin dry scaly unhealthy; every little injury suppurate, Itching ,burning ;
worse scratching and washing .pimple eruption ;worse scratching and watching pimple
eruption pustules. rhagades, hang nail, excoriation especially in folds .feeling of bands
around bone skin affection after local medication pruritus especially from warmth in
evening often recur in spring time in dame weather.
SEPIA : Ringworm like eruption every spring. Urticaria on going in open air; better in
warm room hyperidrosis and bromidrosis. sweat on feet ,worse on toes ; intolerable
odor lentigo in young women. ichthyosis with offensive odor of skin. itching is not
relive by scratching worse in bends of elbow and knee.
TELLURIUM : Itching of hands and feet herpetic spots ring shape lesion of offensive
odour from affected part barber itch stinging in skin fetid exhalation offensive foot
sweat eczema back of ear and occiput, circular patch of eczema worse at night ,cold
whether, from friction.
6.3 AIMS AND OBJECTIVE OF THE STUDY :

To study the clinical presentation of tinea corporis.

To study the efficacy of Homoeopathic medicines in treatment of tinea corporis.

To study the miasmatic interpretation of tinea corporis to assess the predominant
miasm.
7.
MATERIAL & METHODS :
7.1 SOURCES OF DATA :
The cases of the study will be collected from OPD. Rural and Regular camp
visits of Bharatesh Homoeopathic Medical College & Hospital Road, Belgaum.
7.2 METHODS OF COLLECTION OG DATA (INCLUDING SAMPLE
PROCEDURE, IF ANY)
 Patients will be considered on including and exclusion criteria.
 Patients are considered on the basis of clinical presentations.
 Minimum sample size will be 30. Sample random sampling will be adopted.
 All cases will be taken as per the Performa for the study.
 > All patients registered between periods of November 2011 to July 2013
will be
selected. No new cases will be taken for study after July 2013. All cases shall be
followed up for period of 2-6 months.
 Follow up will be seen weekly or fortnightly as per requirement. Physical,
radiological & laboratory examinations done periodically whenever needed.
Prognosis: Assessment will be based on the general and local improvement of the
Patients.

Recovered.

Improved.

Not improved.
Inclusion criteria:
 Patient suffering from TINEA CORPORALIS on the basis of clinical history and
finding.
 Patients of all age groups and both the sexes will be considered.
Exclusion criteria:
 Cases with complication of TINEA CORPOLIS.
 Complication-LICEANIFICATION &ECZEMITIZATION.
 Patient
secondary
should be excluded.
to
DM;
HTN;
complication
of
DM
(Gangrene)
7.3 DOES THE STUDY REQUIRE ANY INVESTIGATION OR
INTERVENTION TO BE CONDUCTED ON THE PATIENTS OR OTHER
HUMAN OR ANIMALS? IF SO DESCRIEB BRIEFLY.
The diagnosis of the cases will be done on eliciting cases history and clinical
findings, other required investigation is,
1) Microscopic- fungus under the microscopic in skin scraping.
2) Culture- skin scarping can be cultured on a suitable medium.
7.4 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. Ananth Narayan R. Jayaram Paniker C.K., Textbook of Microbiology. 7th Edition.
Chennai: orient Longman Pvt Ltd; 2005. Pg no 606.
2. Jean Bolognia, Joseph L. Jari 220, Ronald. P. Roipini. Dermatology volume 1, 1st
ed. London: Mos by ; 2003.pg no 1174-1185.
3. Thomas .B. Fitzpatrick, Arthur z. Eisen, Irwin M. Freed burg, F. Frank austen
Dermatology in General 2nd. Vol, 4th ed. New York : Mc Graw Hill ; 1993.pg no
2212-2217.
4. Aggarwal BN. Govind Srivastava. Practice of Dermatology 10th ed. New Delhi:
Satish Kumar Jain For C.B.S;2005 pg no 167.
5. Kent
JT.
Lectures
on
Homoeopathy
philosophy.NewDelhi-1005.
B.Jain
publisher(p)Ltd;1999. Pg no 120
6. Burnett JC. Ringworm. New Delhi : Indian Books and periodicals ; .pg no 129.
7. Chatterji TP. Fundamentals of Homoeopathy and valuable Hints for practice. 4th
ed. New Delhi : New Delhi : B.Jain publishers (P) Ltd ; 1993.pg no 77-79.
8. Hahnemann S. Organon of Medicine. Reprinted : New Delhi : B.Jain publishers (P)
Ltd ; 1997.pg no35.
9. Ortega PS. Notes on the miasms. Ist English ed. New Delhi National Homoeopathic
pharmacy ; 1980.pg no 44.
10. Allen JH. The chronic miasms psora pseudo psora and sycosis Reprinted ed. New
Delhi : Mayur Jain Indian Book and periodicals ; 2004. Pg no 267.
11. Boericke W. Pocket book manual of homoeopathic materia medica and repertory.
Reprinted New Delhi: B.Jain Publisher(p)Ltd;1980.pg no520,580,635.
12. http//WWW.aocd.org/skin/dermatological disease/dermatitis.
9
SIGNATURE OF THE
CANDIDATE
10
REMARKS OF THE GUIDE
11
NAME OF THE
DESIGNATION OF
(IN BLOCK LETTERS)
11.1 GUIDE
DR. M.N.SHAIKH.M.D.(HOM)
PROFESSOR, H.O.D & P.G.GUIDE
DEPARTMENT OF ORGANON OF
MEDICINE AND HOMOEOPTHY
PHILOSOPHY,
BHARATESH HOMOEOPATHIC
MEDICAL COLLEGE,
BELGAUM- 16
11.2 SIGNATURE
11.3 CO-GUIDE (IF ANY)
11.4 SIGNATURE
11.5 HEAD OF THE
DEPARTMENT
12.
SIGNATURE
12.1 REMARKS OF THE
CHAIRMAN AND
PRINCIPAL
12.2 SIGNATURE
DR. M.N.SHAIKH. M.D.(HOM)
PROFESSOR, H.O.D, GUIDE
DEPARTMENT OF ORGANON OF
MEDICINE AND HOMOEOPTHY
PHILOSOPHY,
BHARATESH HOMOEOPATHIC
MEDICAL COLLEGE,
BELGAUM- 16