Homoeopathic Management of Cystic and Bulky Ovaries: A Case Report

Background: Ovarian excrescencies are fluid-filled structures that may be simple or complex. They're common findings generally discovered incidentally on physical examination or imaging. Ovarian excrescencies can cause complications, including rupture, haemorrhage, and torsion, which are considered gynaecological emergencies. thus, it's essential to instantly diagnose and treat them to avoid high morbidity and mortality. In cases involving simple excrescencies exceeding 5 cm in periphery and complex cysts, surgical removal of the mass is constantly advised to save feasible ovarian tissue. With homoeopathic approach the treatment lasted for nearly 4 months with gradational reduction in pain intensity and sonographically no sensible abnormality was noted after treatment. In this case study a 32-time-old lady came to my clinic with A 32 time aged women came to our clinic with burning pain the right ovarian region since 1 time along with fullness of the hypogastrium for last 8 months. Method: After detailed case-taking and repertorization at first arsenicum album 0/1 was specified, after which case began to improve in the subsequent visits and after that she was given medicines as per the totality of the case from time to time till she came symptom free on his last visit. Results: The casual association of clinical outcome to the homoeopathic treatment was estimated using Modified Naranjo Criteria for Homoeopathy( MONARCH) tool. Significant improvement was set up in the bulky and cystic ovaries as evidenced radiologically. The MONARCH score( 9) suggested that the clinical improvement was likely attributable to the homoeopathic treatment. Conclusion: This current case report implies the efficacy of homoeopathic remedies in the treatment of bulky ovaries. However, it is essential to emphasize the necessity for additional clinical trials to substantiate these findings and delve into uncharted territories.

post-menopausal women with any type of cyst should undergo thorough follow-up and treatment due to an elevated risk for malignancy [4,5] .Non-neoplastic enlargement of the ovary commonly stems from the accumulation of fluid within the functional unit of the ovary.Causes encompass follicular cysts, corpus luteum cysts, theca lutein and granulose lutein cysts, polycystic ovarian syndrome, and endometrial cysts (chocolate cysts).All of these, with the exception of the last one, are functional cysts of the ovary and are broadly denoted as a cystic ovary [6] .The true prevalence of ovarian cysts is still yet to be known, as many patients are seen to be asymptomatic and undiagnosed, and the prevalence varies according to the geography and ethnicity.An adnexal lesion was 7.8% common in 335 asymptomatic women aged 24 to 40 who were included in a random sample. [7]During the physical examination, the position, size, consistency, shape (regular or irregular), degree of tenderness, and mobility of the ovaries should all be ascertained by palpating them during the bimanual exam.Because of this, the pelvic examination's capacity to diagnose ovarian cysts is restricted.Factors such as pelvic anatomy, provider experience, and patient body habitus can all affect how difficult it is to palpate the ovaries. [8]On the other hand, problems including pelvic pain, cyst rupture, blood loss, and ovarian torsion brought on by ovarian cysts need to be treated right away. [9]Cyst size greater than 10 cm, ascites, papillary excrescences or solid components, irregularity, and high color are findings that increase the suspicion for malignancy.In the field of homeopathy, there have been notable case reports [12][13][14][15][16] and a case series [17] that compellingly demonstrate the efficacy of homeopathic remedies in the management of ovarian cysts.One noteworthy case report [12]   , authored by Kumari P, underscores the successful treatment of an ovarian cyst patient using the homeopathic medicine Conium maculatum.A case study [13] by Chakma et al. describes how homeopathy is used to treat ovarian cysts.The article emphasizes the administration of several medications, such as Lycopodium clavatum, Arsenicum album, and Natrum muriaticum, but in the end, Pulsatilla Nigricans is identified as the similimum that resulted in the case's cure.The purpose of the current case report is to assess the efficacy of homeopathic remedies chosen in this particular context to treat ovarian cysts based on the complete set of symptoms.

CASE REPORT:
A 32 year aged women came to our clinic with burning pain the right ovarian region and scanty menses since 1 year along with fullness of the hypogastrium for last 8 months.
History of present complaints: patient had consulted a allopathic physician with no such significant improvement.

Past history: chicken pox Intra-uterine history: hyperemesis Graviderum
Family history: Grand mother: bronchial asthma and mother: T2DM Clinical diagnosis: On general survey there was Yellowish discolouration of the tongue.and otherwise the general survey did not reveal any other abnormalities and Examination of the gastro-intestinal system and cardiovascular system was also normal.On detailed case taking menses was found to be irregular onset of the cycle being late and discharge is scanty.

Generalities:
Regarding the generalities patient has got desire for fatty food, lukewarm food, sour, milk and there was a general aggravation from the sour food.Appetite of the patient is below normal, Thirst is moderate about 2-3 litres per day with dry mouth, and there is Sour taste in mouth, perspiration occurs only over the face, sleep is unrefreshing, and thermally the patient is hot, and patient has got desire for open air, and regarding the Mental generals patient whenever angry is ameliorated from consolation, weeping disposition, and there is anxiety when alone.The miasmatic evaluation of the symptoms of this case was done and the predominant miasm was found to be Psoric.Considering the above-mentioned characteristic symptoms, Kent's Repertory was preferred and using HOMPATH software, systemic repertorization was done.The Repertorization chart is given in

DISCUSSION OF THE CASE:
In this specific case the case complained of burning pain in the right ovarian region along with scanty menses was advised to undergo a ultrasound of whole abdomen which revealed the " bulky and cystic ovaries ".Considering the entire case, along with characteristic physical and mental symptoms, and consulting our authentic Materia Medica, ( 18,19) the final choice for this remedy for this case was Arsenicum album 0/1, 30 doses, twice daily for 15 days, administered on 06/06/2023.Followed by which there was a marked improvement in all the symptoms especially regarding the chief complaints.The details of the follow-up is mentioned in table-1.The case demonstrated effective management, as evidenced by imaging radiology conducted before [Figure -A] and after the treatment [Figure -C].The Modified Naranjo Criteria [20] were applied to establish the casual relationship between the homoeopathic medicine and the changes in the patient's symptoms and signs [Table -2].The criteria were enhancement in other symptoms(+1), enhancement in the primary symptom(+2), clinical enhancement that happed within a reasonable quantum of time after taking drug, and overall well-being (+2).likewise, as reported by transvaginal sonography of the uterus(+2), there was an objective enhancement in the pathological condition of the case and no other factor that could have contributed to the enhancement(+1).Grounded on the result, the overall score is 9.

CONCLUSION:
This case report highlights the effectiveness of homoeopathy in the management of conditions like "bulky and cystic ovaries".The positive outcomes observed in this case suggest that homeopathy can be a valuable therapeutic option.However, further studies and clinical interventions with homeopathic medicines are necessary to establish their efficacy in similar conditions.Overall, this case report supports the use of individualized homeopathic treatment and emphasizes the need for more research to explore the potential benefits of homeopathic medicines in the treatment of bulky and cystic ovaries and other similar diseases.

CONFLICTS OF INTEREST: None
CONSENT OF THE PATIENT: Obtained from Patient, to circulate this clinical information and display images on a scientific database, and the patient was also assured of the confidentiality of the same.
Anger ameliorated from consolation Weeping disposition Anxiety when alone Physical general Menses scanty Desire for fatty food, lukewarm food, sour, milk general aggravation from the sour food Sour taste in mouth Unrefreshing sleep Desire for open air Appetite decreased Perspiration only on the face Particular Burning pain the right ovarian region Fullness of the hypogastrium.Dryness of tongue and mouth.Yellowish discolouration of the tongue.TOTALITY OF SYMPTOMS: • Anger ameliorated from consolation • Weeping disposition • Anxiety when alone • Menses scanty • Desire for fatty food, lukewarm food, sour, milk • general aggravation from the sour food • Sour taste in mouth • Unrefreshing sleep • Desire for open air • Appetite decreased • Perspiration only on the face • Burning pain the right ovarian region • Fullness of the hypogastrium.• Dryness of tongue and mouth.• Yellowish discolouration of the tongue.