The case was cured by Dr. Girish Gupta, MD (Hom), PhD Chief Consultant Physician at GAURANG CLINIC AND CENTRE FOR HOMOEOPATHIC RESEARCH, Lucknow, India.
Present Complaints:
A 26-year-old unmarried girl Miss. SS (S-14363; B/L OC-99) reported on 28.1.20 for treatment of bilateral multicystic ovaries-endometrioma with recurrent mild to moderate left lower abdominal pain.
Past history:
She had h/o raised CA 125 level which was 89.45 U/mL on 24.4.19. She underwent laparoscopic surgery for left sided complex haemorrhagic/ endometriotic cyst in May 2019. She also had bilateral hydrosalpinx in June 2019.
Menstrual history:
Her menses were regular adequate lasting 5 days.
Treatment history:
Endoreg, Drotin DS
Family history:
Father is diabetic and mother is suffering from hypertension and pain in multiple joints.
Initial investigations:
CA 125 (29.1.2020): 137.98 U/mL
Ultrasonography (27.1.2020):
Both ovaries are bulky, globular measuring 51 x 39 mm on right and 49 x 36 mm on left and show multiple cysts with low level internal echoes. An encysted loculated collection measuring 50 x 36 x 16 mm (vol. 16 cc) is seen adjacent to uterine fundus.
Life Space:
She was in a relationship since many years. She wanted to marry him but her family members opposed it because the boy was of other caste. She tried her level best to convince her parents but things could not be materialized. Later both separated in 2018. She used to suppress her anger on parents to avoid making them feel sad. She became very pessimistic towards life.
Rubrics for Repertorisation:
|
Sn. |
Rubrics |
Sn. |
Rubrics |
|
|
1. |
Ailments from disappointed love |
7. |
Persistent thoughts | |
|
2. |
Anger easily |
8. |
Pessimist | |
|
3. |
Ailments from suppressed anger |
9. |
Fear of dark | |
|
4. |
Desire for company |
10. |
Fear of rats | |
|
5. |
Sadness |
11. |
Anticipatory anxiety | |
|
6. |
Offended easily |
12. |
Desire for spicy food |
Repertorisation table:
Result of Repertorisation:
| Remedies |
Nat mur |
Lyco |
Nux vom |
Ars alb |
| Totality |
19 |
19 |
18 |
17 |
| Symptoms covered |
11/12 |
8/12 |
9/12 |
9/12 |
Medicine selected:
Natrum muriaticum
Justification of Prescription:
Ailments from disappointed love, sadness, persistent thoughts pessimistic nature and anticipatory anxiety favoured the selection of Natrum muriaticum.
Date-wise Follow-up:
January 28, 2020: Natrum mur. 30 single dose once a week followed by placebo for 4 weeks.
February 28, 2020: Pain in abdomen reduced. Same prescription was repeated for 4 weeks. Out of curiosity patient got ultrasonography repeated without our advice.
Follow up-1 investigations:
Ultrasonography (27.2.2020):
Both ovaries are enlarged measuring 39 x 28 x 41 mm (24.4 cc) on right, 41 x 33 x 39 mm (28.7 cc) on left and reveal hypoechoic, septate cysts in stroma measuring 30 x 25 mm on right and 37 x 26 x 41 mm (21 cc) on left respectively. A loculated collection measuring 38 x 8 x 36 mm (5.8 cc) is noted anterior to uterine fundus and body. (Better than before dated 27.1.2020)
May 3, 2020: Patient better. Same prescription was repeated for another 8 weeks. Ultrasonography was repeated.
Follow up-2 investigations:
CA 125 (30.4.2020): 51.5 U/mL (Reduced compared to report dated 29.1.2020)
Ultrasonography (2.5.2020):
Both ovaries are bulky, globular measuring 48 x 25 mm on right and 55 x 29 mm on left. Both ovaries show multiple cysts with low level internal echoes measuring 7-22 mm in right and 14-34 mm in left ovary respectively.
July 5, 2020: Patient clinically asymptomatic.
Final investigations:
CA 125 (5.7.2020): 24.10 U/mL (Normal)
Ultrasonography (3.7.2020):
No significant sonological abnormality.
Duration of treatment: 6 months.
Comparative chart of CA 125 reports at a glance:
|
CA 125 (U/mL) |
||
|
29.1.2020 |
30.4.2020 |
5.7.2020 |
|
137.98 (initial) |
51.50 (reduced) |
24.10 (normal) |
Comparative chart of ultrasonography reports at a glance:
|
Ultrasonography reports |
||||
|
Legends |
27.1.2020 |
27.2.2020 |
2.5.2020 |
3.7.2020 |
| Shape of Ovary | Bulky, globular | Enlarged | Bulky, globular | Normal |
| Size of Ovary | Right: 51 x 39 mm
Left: 49 x 36 mm |
Right: 39 x 28 x 41 mm (24.4 cc)
Left: 41 x 33 x 39 mm (28.7 cc) |
Right: 48 x 25 mm
Left: 55 x 29 mm |
Right: 41 x 25 mm
Left: 48 x 30 mm |
| Cyst |
– |
Right: 30 x 25 mm
Left: 37 x 26 x 41 mm (21 cc) |
Right: 7-22 mm
Left: 14-34 mm |
No significant sonological abnormality |
| Collection | Encysted loculated collection: 50 x 36 x 16 mm (vol. 16 cc) adjacent to uterine fundus | Loculated collection: 38 x 8 x 36 mm (5.8 cc) anterior to uterine fundus and body |
– |
– |
| Status |
– |
Improved |
Improved |
Cured |
Inference:
This case shows the effectiveness of individualized homoeopathic medicine in the treatment of bilateral multicystic ovaries prescribed on holistic basis. The message by reporting this case is to inculcate confidence in homoeopathic physicians to have firm belief in homoeopathic philosophy i.e. “treat the person in disease”.