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BHARATESH HOMOEOPATHIC MEDICAL COLLEGE AND HOSPITAL POST GRADUATE RESEARCH CENTRE BELGAUM—590016 KARNATAKA Recognized by CENTRAL COUNCIL OF HOMOEOPATHY, NEW DELHI Affiliated to RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, BANGALORE SYNOPSIS M.D. (HOMOEOPATHY) “THE UTILITY OF SANGUINARIA CANADENSIS IN THE MANAGEMENT OF MIGRAINE” BY Dr. DEEPAK S. MUTAGI UNDER THE GUIDANCE DR. S. M. ANGADI MD (HOM) Professor, Guide and HOD Department of Materia Medica, 1

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Page 1: BHARATESH HOMOEOPATHIC MEDICAL · Web viewDepartment of Materia Medica, BHARATESH HOMOEOPATHIC MEDICAL COLLEGE & HOSPITAL, BELGAUM. From, Dr. DEEPAK S. MUTAGI TO, DR. S. M. ANGADI

BHARATESH HOMOEOPATHIC MEDICAL COLLEGE AND HOSPITAL POST GRADUATE RESEARCH CENTRE BELGAUM—590016

KARNATAKA

Recognized by CENTRAL COUNCIL OF HOMOEOPATHY, NEW DELHI

Affiliated to RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,

BANGALORE

SYNOPSISM.D. (HOMOEOPATHY)

“THE UTILITY OF SANGUINARIA CANADENSIS IN THE MANAGEMENT OF MIGRAINE”

BY

Dr. DEEPAK S. MUTAGI

UNDER THE GUIDANCE

DR. S. M. ANGADI MD (HOM)

Professor, Guide and HODDepartment of Materia Medica,

BHARATESH HOMOEOPATHIC MEDICAL COLLEGE & HOSPITAL, BELGAUM.

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Page 2: BHARATESH HOMOEOPATHIC MEDICAL · Web viewDepartment of Materia Medica, BHARATESH HOMOEOPATHIC MEDICAL COLLEGE & HOSPITAL, BELGAUM. From, Dr. DEEPAK S. MUTAGI TO, DR. S. M. ANGADI

From,

Dr. DEEPAK S. MUTAGI TO,

DR. S. M. ANGADI MD (HOM) Professor, Guide and HOD Department of Materia Medica, Bharateh Homoeopathic Medical College & Hospital Belgaum.

Sub: -- Application to accept my synopsis for the Dissertation

Respected Sir,

I Dr. DEEPAK S. MUTAGI would like to forward my application for the

approval of my synopsis under your guidance for the following topic, “THE

UTILITY OF SANGUINARIA CANADENSIS IN THE MANAGEMENT OF

MIGRAINE”

Hope you will approve the same.

Thanking you.

Date : 02/03/2013Place: Belgaum Yours sincerely

Dr DEEPAK S. MUTAGI

Department of Materia Medica

Bharatesh Homoeopathic Medical College

& Hospital, Belgaum.

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Page 3: BHARATESH HOMOEOPATHIC MEDICAL · Web viewDepartment of Materia Medica, BHARATESH HOMOEOPATHIC MEDICAL COLLEGE & HOSPITAL, BELGAUM. From, Dr. DEEPAK S. MUTAGI TO, DR. S. M. ANGADI

From,

DR. S. M. ANGADI MD (HOM) Professor, Guide and HOD Department of Materia Medica, Bharateh Homoeopathic Medical College & Hospital Belgaum.

To, Dr. DEEPAK S. MUTAGI

Sub: Acceptance of synopsis for the dissertation.

Dear Doctor,

I have accepted your topic, “THE UTILITY OF SANGUINARIA

CANADENSIS IN THE MANAGEMENT OF MIGRAINE” for the dissertation.

Your synopsis will be forwarded to RGUHS.

Date: 18/03/2013

Place: Belgaum.

DR. S. M. ANGADI MD (HOM)Professor, Guide and HOD

Department of Materia Medica,

Bharateh Homoeopathic Medical College

& Hospital Belgaum.

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Page 4: BHARATESH HOMOEOPATHIC MEDICAL · Web viewDepartment of Materia Medica, BHARATESH HOMOEOPATHIC MEDICAL COLLEGE & HOSPITAL, BELGAUM. From, Dr. DEEPAK S. MUTAGI TO, DR. S. M. ANGADI

RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES.BANGALORE, KARNATAKA.

ANNEXURE II

APPLICATION FOR REGISTRATAION OF SUBJECT FOR DISSERTATION

1. NAME OF THE

CANDIDATE AND

ADDRESS

Dr DEEPAK S. MUTAGI

DEPARTMENT OF MATERIA MEDICA

BHARATESH HOMOEOPATHIC

MEDICAL COLLEGE AND HOSPITAL

BELGAUM-16

2. PERMANENT

ADDRESS

Dr DEEPAK S. MUTAGI

H/NO 157/24 BHANDUR GALLI

BELGAUM

NAME OF THE

INSTITUTION

BHARATESH HOMOEOPATHIC MEDICAL

COLLEGE AND HOSPITAL, BELGAUM-16

3. COURSE OF THE

STUDY & SUBJECT

M.D.(HOM) MATERIA MEDICA

4. DATE OF ADMISSION

TO COURSE 17.10.12

5. TITLE OF THE TOPIC “THE UTILITY OF SANGUINARIA

CANADENSIS IN THE MANAGEMENT OF

MIGRAINE”

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Page 5: BHARATESH HOMOEOPATHIC MEDICAL · Web viewDepartment of Materia Medica, BHARATESH HOMOEOPATHIC MEDICAL COLLEGE & HOSPITAL, BELGAUM. From, Dr. DEEPAK S. MUTAGI TO, DR. S. M. ANGADI

6. BRIEF RESUME OF THE INTENDED WORK

6.1 NEED FOR THE STUDY

A migraine is a common type of headache that may occur with symptoms such as

nausea, vomiting, or sensitivity to light. The word derives from the Greek

word ἡμικρανία (hemikrania), "pain on one side of the head" from ἡμι- (hemi-), "half",

and κρανίον (kranion), "skull" 1.

Typically the headache is unilateral (affecting one half of the head) and pulsating

in nature, lasting from 2 to 72 hours. Migraine headaches tend to first appear between

the ages of 10 and 45. Sometimes they may begin later in life. Migraines occur more

often in women than men Migraines may run in families.

A migraine is caused by abnormal brain activity, which can be triggered by a

number of factors. However, the exact chain of events remains unclear. Today, most

medical experts believe the attack begins in the brain, and involves nerve pathways and

chemicals. The changes affect blood flow in the brain and surrounding tissues.

Initial recommended management is with simple analgesics such as ibuprofen and

acetaminophen  for the headache, an antiemetic  for the nausea, and the avoidance of

triggers. Specific agents such as triptans or ergotamines may be used by those for whom

simple analgesics are not effective. Globally, more than 10% of the population is

affected by migraine at some point in life.1

HOMOEOPATHIC VIEW POINT:

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Page 6: BHARATESH HOMOEOPATHIC MEDICAL · Web viewDepartment of Materia Medica, BHARATESH HOMOEOPATHIC MEDICAL COLLEGE & HOSPITAL, BELGAUM. From, Dr. DEEPAK S. MUTAGI TO, DR. S. M. ANGADI

There is a vast difference between the fundamental concept of disease evolution

of the so called modern medical science (Allopathy) and Homeopathy. Homeopathy

deals with the principle of individualization. It treats the man, rather than the disease.

Homoeopathy ensures much scope in treating Migraine. The properly taken

detailed case history, individualization and constitutional approach will help us in

treating Migraine permanently.

We have plenty of remedies in our Homoeopathy for Migraine, in which

Sanguinaria Canadensis is one of them. So I am intended to study Sanguinaria

Canadensis in the Management of Migraine.

6.2 HYPOTHESIS

Sanguinaria Canadensis is effective in the management of Migraine.

6.3 REVIEW OF LITERATURE

Migraine is a chronic neurological disorder characterized by recurrent moderate to

severe headaches often in association with nausea, vomiting Photophobia (increased

sensitivity to light), phonophobia (increased sensitivity to sound).

Types of Migraine

Migraine can be classified into two categories:

1) Migraine with aura: This type is known as classical migraine and is less common.

This headache is unilateral and is accompanied with nausea, vomiting, sensitivity to

light often causing momentary visual impairment, double vision, numbness, tingling,

vertigo and difficulty in speaking. Some people may have symptoms of migraine aura

without a headache. 2

2) Migraine without aura: This type is more common and is associated with a slowly

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Page 7: BHARATESH HOMOEOPATHIC MEDICAL · Web viewDepartment of Materia Medica, BHARATESH HOMOEOPATHIC MEDICAL COLLEGE & HOSPITAL, BELGAUM. From, Dr. DEEPAK S. MUTAGI TO, DR. S. M. ANGADI

increasing headache which in due course develops into a throbbing headache. This

headache is mostly unilateral and is accompanied with nausea, vomiting, and unusual

sensitiveness to light and noise. 2

Causes :

Age: Usually the Migraine is tend to appear between ages of 10- 45 years. Sometimes

they may begin later in life.

Sex: Can be seen in both sexes but Women are more prone to get Migraine than Men.3

The underlying cause of migraines is unknown however they are believed to be related

to a mix of environmental and genetic factors. Migraine attacks may be triggered by,

Psychological conditions: Mental stress, Depression, Anxiety etc.

Changes in hormone levels during a woman's menstrual cycle or with the

use of birth control pills.

Changes in sleep patterns

Exercise or other physical stress

Missed meals.

Alcohol, Smoking or exposure to smoke.

Foods:

Any processed fermented, pickled, or marinated foods, as well as foods

that contain monosodium glutamate (MSG).

Baked goods, chocolate, nuts, peanut butter, and dairy products.

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Page 8: BHARATESH HOMOEOPATHIC MEDICAL · Web viewDepartment of Materia Medica, BHARATESH HOMOEOPATHIC MEDICAL COLLEGE & HOSPITAL, BELGAUM. From, Dr. DEEPAK S. MUTAGI TO, DR. S. M. ANGADI

Foods containing tyramine, which includes red wine, aged cheese, smoked

fish, chicken livers, figs, and certain beans.

Fruits (avocado, banana, citrus fruit)

Meats containing nitrates (bacon, hot dogs, salami, cured meats).

Onions. 3

SIGNS AND SYMPTOMS

Typically the headache is unilateral (affecting one half of the head) and

pulsating in nature, lasting from 2 to 72 hours.  A migraine lasting longer than 72 hours

is termed as Status Migrainosus 1. Signs and Symptoms can be explained in 4 phases

1. The prodrome, which occurs hours or days before the headache

2. The aura, which immediately precedes the headache

3. The pain phase, also known as headache phase

4. The postdrome, the effects experienced following the end of a migraine attack.

Prodrome phase: This phase start Two hours to two days before the start of pain or the

aura. These symptoms may include: altered mood, irritability,

depression or euphoria, fatigue, craving for certain food, stiff muscles (especially in the

neck), constipation or diarrhea, and sensitivity to smells or noise. This may occur in

those with either migraine with aura or migraine without aura. 1

Aura phase: An aura is a transient focal neurological phenomenon that precedes or

accompanies the attack. They appear gradually over 5 to 20 minutes and usually subside

just before the headache begins. Symptoms include are a temporary blind spot,

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Page 9: BHARATESH HOMOEOPATHIC MEDICAL · Web viewDepartment of Materia Medica, BHARATESH HOMOEOPATHIC MEDICAL COLLEGE & HOSPITAL, BELGAUM. From, Dr. DEEPAK S. MUTAGI TO, DR. S. M. ANGADI

Blurred vision, Eye pain, Seeing stars or zigzag lines, tingling and numbness sensation

in hands, speech or language disturbances etc. 1

Pain phase: Classically the headache is unilateral, throbbing, and moderate to severe in

intensity. It usually comes on gradually. However Migraine may be Bilateral also,

Bilateral pain is particularly common in those who have migraines without an aura. The

pain usually lasts 4 to 72 hours. The frequency of attacks is variable, from a few in a

lifetime to several times in a week. The pain is frequently accompanied by nausea,

vomiting, sensitivity to light, sensitivity to sound, sensitivity to smells, fatigue and

irritability. 1

Postdrome: The effects of migraine may persist for some days after the main headache

has ended; this is called the migraine postdrome. Symptoms like, impaired thinking,

tired feeling or "hung over", gastrointestinal symptoms, mood changes, and weakness

can be observed. 1

Diagnosis:

The diagnosis of a migraine is based on signs and symptoms. MRI and CT

Scan are occasionally performed to exclude other causes of headaches. EEG may be

needed to rule out seizures.

Management: There are three main aspects of treatment:

1) Trigger avoidance.

2) Acute symptomatic control.

3) Pharmacological prevention.

Medications are more effective if used earlier in an attack. The frequent use of

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Page 10: BHARATESH HOMOEOPATHIC MEDICAL · Web viewDepartment of Materia Medica, BHARATESH HOMOEOPATHIC MEDICAL COLLEGE & HOSPITAL, BELGAUM. From, Dr. DEEPAK S. MUTAGI TO, DR. S. M. ANGADI

medications may result “ Medication Overuse Headache”, in which the headaches

become more severe and more frequent. This may occur with triptans, ergotamines, and

analgesics, especially narcotic analgesics.1

This is why Homoeopathy has more scope in treating Migraine permanently than

any other systems.

HOMOEOPATHIC MANAGEMENT

HUGHES Richard: He describes the form of migraine indicating it as a "sun-

headache," i.e., increasing in violence with the ascent of that luminary, and decreasing

as it declines. It corresponds, he says, to violent hemicrania, relieved by lying down and

by sleep, accompanied by bilious vomiting, toothache, earache, pains in the limbs,

electric shootings in the head, and shivering. 4

J H CLARK: Headache, with rheumatic pains and stiffness of limbs and neck.

- Periodical sick headache; with vomiting of bile; begins in morning,

agg- during day, lasts till evening; agg- from motion, stooping, noise, and light; only

endurable when lying still, and >> by sleep or after vomiting; esp. severe over right eye.

- Headache returns periodically.

- Heaviness in head from vertex to centre of forehead, with pressing in glabella and

buzzing in head; eyes dull. 6

FARRINGTON E. A: The circulatory disturbance is represented in the sick-headache,

and Sanguinaria has no equal in this affection. The patient suffers from rush of blood to

the head, which causes faintness and decided nausea, the nausea even continuing until

vomiting sets in. The pains, which are of a violent character, begin in the occipital

region, spread then over the head, and settle over the right eye. 5

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Page 11: BHARATESH HOMOEOPATHIC MEDICAL · Web viewDepartment of Materia Medica, BHARATESH HOMOEOPATHIC MEDICAL COLLEGE & HOSPITAL, BELGAUM. From, Dr. DEEPAK S. MUTAGI TO, DR. S. M. ANGADI

HERING C: Headache with nausea and chilliness, followed by flushes of heat,

extending from head to stomach. Headache as if forehead would burst, with chill and

burning in stomach. Headache over right eye. Headaches as if it would burst; amel-

walking in open air, agg- in temples, especially in right, in afternoon. 7

BOERICKE William: - Periodical sick headache; pain begins in occiput, spreads

upwards, and settles over eyes, especially right. Veins and temples are distended.

Worse right side, sun headache.

- Pain better lying down and sleep.

- Headaches return at climacteric; every seventh day. 8

CHOUDHURI N. M.: The headache is periodic in its nature; it returns every seventh

day.

It is a headache that begins in the morning and continues to get worse during noon and

then diminishes with the waning sun.

The headache which is bursting in nature begins at occiput and thence spreads upward

and forward and settles over the right eye. 9

NASH E: Pain beginning in occiput; spreads over the head and settles over the right

eye, with nausea and vomiting.

- Sensitive to noise and light. 10

MURPHY Robin: Periodical sick headache, pain begins in occiput, spreads upwards

or ascending from occiput to over right eye. Headaches, if he goes without food.

Headaches, better sleep, vomiting and passing copious flow of urine.

Periodical sick headache, pain begins in occiput, spreads upwards or ascending

from occiput to over right eye. Headaches, if he goes without food. Headaches, better

sleep, vomiting and passing copious flow of urine.11

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Page 12: BHARATESH HOMOEOPATHIC MEDICAL · Web viewDepartment of Materia Medica, BHARATESH HOMOEOPATHIC MEDICAL COLLEGE & HOSPITAL, BELGAUM. From, Dr. DEEPAK S. MUTAGI TO, DR. S. M. ANGADI

6.4 OBEJECTIVES OF THE STUDY

1. To study the clinical presentation of Migraine.

2. To study the role and efficacy of SANGUINARIA CANADENSIS in the treatment

of MIGRAINE.

7. MATERIALS AND METHODS

7.1 SOURCES OF DATA

The cases for study will be collected from IPD, OPD, and Peripheral clinics of

Bharatesh Homoeopathic Medical College and Hospital, Belgaum.

7.2 METHOD OF COLLECTION OF DATA (including sampling procedure, if any)

Patients will be selected on the basis of Inclusion & Exclusion criteria.

Patients are considered on the basis of the clinical presentation.

Minimum sample size will be 30. Random Sampling Procedure will be adopted.

All cases will be taken as per the Performa prepared for study.

Reference to materia medica & its corroboration to reportorial, remedial diagnosis

will be done.

All patients registered between period of 17october 2012 to 15March 2015 will be

taken for study. No new cases will be taken for study after 15 march 2015. Cases will

be studied from October 2012 to March 2015.

Follow ups will be seen weekly or fortnightly as per the requirements.

Prognosis assessment will be based on general & local improvement of the patient as

per the principles of Homoeopathy.

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Page 13: BHARATESH HOMOEOPATHIC MEDICAL · Web viewDepartment of Materia Medica, BHARATESH HOMOEOPATHIC MEDICAL COLLEGE & HOSPITAL, BELGAUM. From, Dr. DEEPAK S. MUTAGI TO, DR. S. M. ANGADI

INCLUSIVE CRITERIA

Age group: Above 10 years

Both sexes will be considered.

Patients presenting complaints of MIGRAINE will be taken up on the basis of their

clinical history and clinical findings, irrespective of their occupation and

socioeconomic status.

EXCLUSIVE CRITERIA

Cases with pathological complications.

Age: Below 10 years.

7.3 DOES THE STUDY REQUIRE ANY INVESTIGATION OR

INTERVENTION TO BE CONDUCTED ON PATIENTS IF SO PLEASE

MENTION BRIEFLY.

YES,

As per the necessity of case, the following investigations will be performed.

1. CT Scan & MRI Scan

2. EEG

7.4 HAS THE ETHICAL CLEARANCE BEEN OBTAINED FROM YOUR

INSTITUTION IN CASE OF 7.3?

Yes, ethical clearance has been obtained from the institution.

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Page 14: BHARATESH HOMOEOPATHIC MEDICAL · Web viewDepartment of Materia Medica, BHARATESH HOMOEOPATHIC MEDICAL COLLEGE & HOSPITAL, BELGAUM. From, Dr. DEEPAK S. MUTAGI TO, DR. S. M. ANGADI

LIST OF REFERENCES.

1. http://en.wikipedia.org/wiki/Migraine.

2. http://amcofh.s483.sureserver.com

3. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001728/

4. Hughes Richard, A Manual Of Pharmacodynamics, Edition 2001, 795pp

5. E. A. Farrington Farrington’s Lectures on Clinical Materia Medica

4th edition2005, New Delhi: B.Jain Publishers Pvt. Ltd. 318pp.

6. Clarke J.H, A Dictionary of Practical Materia Medica. Reprint Edition, New Delhi;

Indian Books & Periodicals Publishers, 2002;Vol-III,1080pp.

7. Hering C. The Guiding Symptoms Of Our Materia Medica vol 3 Edition,2000,

198pp

8. Boericke W, New Pocket Manual of Homoeopathic Materia Medica & Repertory.

1st Corrected/Revised/Updated edition, New Delhi; B. Jain Publishers Pvt. Ltd.,

2006; 569pp.

9. Choudhuri N. M, A Study On Materia Medica, Edition 2006, 901pp.

10. Nash E, Expanded Works Of Nash, Edition 2010, 701pp.

11. Murphy Robin, Homoeopathic Remedy Guide, Edition Nov 2001, 1536pp.

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Page 15: BHARATESH HOMOEOPATHIC MEDICAL · Web viewDepartment of Materia Medica, BHARATESH HOMOEOPATHIC MEDICAL COLLEGE & HOSPITAL, BELGAUM. From, Dr. DEEPAK S. MUTAGI TO, DR. S. M. ANGADI

9. SIGNATURE OF

CANDIDATE

10. REMARKS OF THE GUIDES

11. NAME & DESIGNATION OF11.1 GUIDE

Dr. S.M. ANGADI M.D.(HOM)

PROFESSOR, GUIDE,DEPARTMENT OF MATERIA MEDICABHARATESH HOMOEOPATHIC MEDICAL COLLEGE & HOSPITAL, DHARWAD ROAD,BELGAUM—16

11.2 SIGNATURE

11.3 CO-GUIDE (if any)

11.4 SIGNATURE

11.5 HEAD OF THE DEPT. Dr. S.M.ANGADI M.D.(HOM)

PROFESSOR,GUIDE & HOD,DEPARTMENT OF MATERIA MEDICABHARATESH HOMOEOPATHIC MEDICAL COLLEGE & HOSPITAL, DHARWAD ROAD,BELGAUM--16

11.6 SIGNATURE.

12. 12.1 REMARKS OF THE CHAIRMAN/ PRINCIPAL

12.2 SIGNATURE

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