To explore the role of miasms in homoeopathic management of grade-I and grade-II hemorrhoids in age group 25-60 years- A prospective case series study.

INTRODUCTION

Hemorrhoids or piles is a anorectal disease associated with sedentary lifestyle. It commonly occurs due to varicosities of hemorrhoidal veins. Internal hemorrhoids and external hemorrhoids are two types of hemorrhoids. Hemorrhoids are more commonly observed in the adult population. Adults from age group 45 to 60 are more prone to suffer hence in this study a wide range is targeted to see the predominant age group likely to suffer and aim of this study is to acknowledge the prevalence depending upon gradation of hemorrhoids.

It is necessary to study homoeopathic management of hemorrhoids as other schools of medicine treating this condition with medication, topical ointments and surgery which only suppress or palliate the disease state, that later on followed by relapse or worse disease manifestation or often leading to recurrence with more severe symptom and many patients suffer from post operative complications .

In homoeopathy we believe that to treat disease, root cause should be removed. Dr. Hahnemann explains in aphorism 80 that the psora, is the only real fundamental cause of various diseases like nervous debility, hysteria, hypochondriasis, mania, melancholia, epilepsy, convulsions, gout, hemorrhoids, cancer, deafness, cataract etc.

Although remarkable cure is noticed in hemorrhoids cases, research evidences are too much compromised regarding susceptibility, miasm, posology in such cases hence the present study is aimed at investigating the role of miasms in homoeopathic management of grade I and grade II hemorrhoids as a conservative treatment method.

 AIM AND OBJECTIVE

 PRIMARY OBJECTIVE

To explore the role of miasm in homoeopathic management of grade I and grade II hemorrhoids.

 OTHER OBJECTIVE

1.To study the susceptibility in cases of grade I and grade II hemorrhoids.

2.To understand the importance of posology in cases of grade I and grade II hemorrhoids.

 METHODOLOGY

 1.STUDY DESIGN A Prospective case series study.

 2.STUDY SETTING

a. Cases are collected from OPD and IPD of homoeopathic medical college.

b. Peripheral OPDs run by the homoeopathic medical college.

c. Medical camps conducted by the institute.

 3.STUDY POPULATION

Patients from various socioeconomic status, suffering from grade I and grade II hemorrhoids in the age group 25 to 60 years.

 4.DURATION OF STUDY

18 months during the MD course . Follow up will be done as per the requirement of a case and severity of symptoms.

 5.METHOD OF SELECTION OF STUDY SUBJECT

INCLUSION CRITERIA

1. Patients suffering from grade I and grade II hemorrhoids presenting with any of the symptoms bleeding, pain, tenesmus, heaviness, pruritus, mucus discharge from anorectal region.

2. Diagnosed cases of hemorrhoids taking treatment from other system of medicine but feeling no relief and now willing to take homoeopathic treatment.

3. Age group 25 to 60 years.

4. Patients from various socioeconomic status.

5. Patients with Hb count more than 8 gm per dl.

6. Patients with signed written consent

 EXCLUSION CRITERIA

1. Patients suffering from grade III and grade IV hemorrhoids.

2. Age group less than 25 years and more than 60 years.

3. Patients with associated comorbidities like fissures, fistula, anal stricture and other systemic disorders like known bleeding disorders, diabetes mellitus and hypertension.

4. Patients with Hb count less than 8 gm per dl.

5. Pregnant females.

 SUBJECT WITHDRAWL CRITERIA

1. Cases with irregular follow ups.

2. Patient who are on Parallel treatment for the same/other Disease.

3. Patient who are not following protocol.

4. Disease progressing even after receiving treatment for more than 6 months, such patients will be excluded.

5. Patients with Hb count less than 8 gm per dl.

 6.OPERATIONAL DEFINITION

Hemorrhoid is a swollen and painful area located at or near the anus.

Miasm means the fundamental cause of disease.

 7.SPECIFICATION OF INSTRUMENT AND RELATED MEASUREMENT

Visual analogue scale is used to measure the severity of hemorrhoid symptoms before and after treatment.

Improved is complete relief of signs and symptoms and general well being of the patient.

Not improved is no relief of complaints after sufficient period of treatment.

 SAMPLE SIZE

Minimum 30 cases

 SAMPLING TECHNIQUE

Simple random sampling.

 DATA MANAGEMENT AND ANALYSIS PROCEDURE

1.Data for case taking will be collected from patient, patients attendants, physicians observations and examination finding.

2.Symptoms of the case will be repertorized using synthesis repertory from RADAR software.

3.Depend upon totality of symptoms, homoeopathic similimum will be given

4.Pre and post symptom severity score will be maintained in case record form and excel sheet.

5.The analysis of the collected data will be done as per appropriate statistical test to assess the effectiveness of homoeopathic intervention.