Abstract –Trichomoniasis is among the most common sexually transmitted infection caused by Trichomonas vaginalis parasite. In this case study homoeopathic management has proven its efficacy in such common sexually transmitted disease.
Key words- Trichomoniasis, trichomonas vaginalis, cervical smear.
Abbreviations – WHO- world health organisation, BD- twice a day, CNS- central nervous system, CVS- cardiovascular system, LMP- last menstrual period, OPD – outpatient department, Sac. Lac. – Saccharum lactis (placebo).
Introduction-
Trichomoniasis is among the most common sexually transmitted infections. The WHO has estimated that 160 million cases of infection are acquired annually worldwide. Infection rates are similar in male and female but most of the time it’s treated as common urinary tract infection without any investigation with modern medicines. These type of patients unlikely visit homoeopaths for such cases. So, this case study has proven efficacy of homoeopathy in sexually transmitted infection and a wide unexplored area of infectious diseases should be focussed with limited investigation and marvelous homoeopathic medicines. [01]
Transmission usually occurs via direct, skin-to-skin contact with an infected individual, most often through vaginal intercourse. The estimates for North America alone are between 5 and 8 million new infections each year, with an estimated rate of asymptomatic cases as high as 50%. [02]
Case study
24 years old young, unmarried, working female came in OPD on 12/06/2021 with complaints of irregular menses, backache, and pain during micturition, frequent urination and bleeding in urine from last 6 months.
Pain like pulling sensation, spasms and which was coming suddenly, goes upwards to lower abdomen from pelvis and disappears suddenly.
Pain aggravates by standing and ameliorates by sitting and pressure on the part. During this pain patient gets black in mind.
Physical generals:
Appetite– Irregular, 2 fasts in a week. Appetite increased at evening.
Desire- No particular desire.
Thirst– Thirst scanty before, now use to drink as much liquids as she can- 8-10 glasses / day.
Stool– Regular, loose stool after eating green chilies.
Urine– Itching ++, discharge on under garments.
Menses –Menarche at the age of 15 years (std-10th)
Duration- 2 days. Quantity- scanty +, no clots, color- bright red.
Before and during menses – no complaints.
After menses- mild pain in pelvis.
Last menstrual period – 12/05/2021
Menses was irregular before 2 years, so patient took allopathic treatment for that.
Mind-
Her work gets affected from pain. She was brought up by her uncle. She was sent there for education. She felt, “it was a worst decision of my parents”. She lost her valuable 4 years away from home. She felt, “god always does this unfair with her only”! She felt suffocated and perspiration occurred over whole body during this situation. Her heartbeats got faster and her body and hands used to tremble. During this situation – “I feel can’t weep or can’t express my emotions and gets trembling. I try to control this.”
She was very irritable and gets anger very easily when she felt opposition and hurt from others. She told, “Anger is worst part of my life”. She used to raise her voice loud, got spasms in body involuntary weeping during anger and trembling in body. When she raised her voice, she suffered from pain in throat. She was quarrelsome in nature, after anger, she pleased everyone and felt nobody should get hurt from her side. She felt happy when her closed ones become happy.
She had fear of losing relations, friends. She added that at present, she had no fear in life because she lost everything which she had in childhood. She lost very important moments of her life and was trying to give as much time to herself as she could. Again, she felt feel regret about that time that someone could make her parents realise about her situations.
Dreams- of snakes, black and brown color snakes are creeping in backyard.
Family history-
Maternal grandfather- diabetes mellitus – 2.
Personal h/o-
In a relationship with her boyfriend. History of 2-3 times physical relations.
Past h/o-
Recurrent urinary tract infections.
Investigations-
Urine routine and microscopic examination
Diagnosis
A classical way to diagnose is wet vaginal swab during speculum examination of female. The parasites are usually colonised in vaginal canal. The motility of this parasites and its appearance is useful for exact diagnosis. But in this case study it’s an example that expert pathologist has inspected the parasites from urine sample. It’s a new direction for others to evaluate a disease beyond common urinary tract infection as nonspecific urinary tract infection with trichomonas vaginalis infestation. [03]
Final diagnosis – Non-specific urinary tract infection with trichomonas vaginalis infestation (ICD – A59.01) [04]
Investigations –
Treatment before urine analysis report:-
Treatment after urine analysis report :-
Case analysis –
Analysis and evaluation of symptoms –
| SR.NO | CHAPTER | SYMPTOMS | WILL | INT | MEM | DREAM | P.G | P.P | AGG | AMEL | CONCO | COM | UNCO |
| 1 | MIND | Absent mind during pain ++ | 1 | 1 | 1 | ||||||||
| 2 | MIND | Anger easily ++ | 1 | 1 | |||||||||
| 3 | MIND | Anger with trembling of body ++ | 1 | 1 | |||||||||
| 4 | MIND | Fear of losing relations ++ | 1 | 1 | |||||||||
| 5 | MIND | Dreams of snakes + | 1 | 1 | |||||||||
| 6 | MIND | Anger aggravation from rudeness ++ | 1 | 1 | |||||||||
| 7 | GEN. AGG | Pain aggravation by standing | 1 | 1 | 1 | ||||||||
| 8 | GEN. AMEL | Pain ameliorates by pressure | 1 | 1 | 1 | ||||||||
| 9 | GEN. AMEL | Pain ameliorates by sitting | 1 | 1 | 1 | ||||||||
| 10 | GEN. FEMALE | Backache during menses | 1 | 1 | |||||||||
| 11 | GEN. FEMALE | Menses scanty and irregular | 1 | 1 | |||||||||
| 12 | URINARY ORGANS | Burning pain during urination | 1 | 1 | |||||||||
| 13 | FEMALE | Itching on genitals ++ | 1 | 1 | |||||||||
| 14 | URINARY | Bleeding in urine | 1 | 1 | |||||||||
| 15 | URINARY | Urination frequent | 1 | 1 | |||||||||
| TOTAL | 5 | 1 | 1 | 8 | 3 | 2 | 1 | 6 | 7 |
Rubrics for repertorisation-
- Mind anger, trembling with.
- Mind, Rudeness ailment aggravation from.
- Generalities, pain pressure ameliorates.
- Generalities, pain standing aggravates.
- Generalities, parasites, ailment from.
- Female menses scanty.
- Female itching vagina
- Urethra burning smarting micturition during. [05]
Repertorial sheet
[05]
Remedy selection and potency –
Remedy selected was Staphysagria 1M BD for 2 days
Sac. Lac 5 pills two times a day for 15 days.
Selection of remedy –
Remedy was selected on bases of result of repertorisation and final decision was made after reading material medica disseizes of the genitourinary tract , ill effects of anger, sexual sins indicates Staphysagria’s urinary symptoms – cystitis in newly married women, burning micturition. [06]
Mind symptoms – violent outburst of passion, morbidly sensitive to less harmful words, great indignation about the things done by others, want of self-control. [07]
Trembling in anger, voice lost during anger, anger – things threw away, ailments from rudeness of others, fear self-control of losing – soul of remedies. [09]
Staphysagria covered sphere of action, mental general and particular symptoms of the case. It’s widely used remedy in cases of cystitis under chapter. [08]
Selection of potency – as per guidelines from Organon of Medicine 6th edition, higher potency was selected on the basis of strong mental characteristics in the case. [10]
Follow up
| SR. NO | DATE | COMPLAINTS | TREATMNET | REASON |
| 1 | 29/06/2021 | Skin eruptions, dark, circular on nape of neck before a week and disappeared – it was an old complaint. Itching white discharge – burning micturition, frequency same like before – 3-4 days. Patient felt better from last 5 days. Better in micturition from 7 days. Now she felt happy, irritability is less. | Staphysagria 1 m BD for 2 days. Sac lac 5 pills BD for 30 days. | Significant action of medicines no change. [10] |
| 2 | 13/07/2021 | LMP- 10/07/22021, 3rd day of menses. Oral apthae, before menses backache and weakness. No skin eruptions on neck, leucorrhoea – 2-3 days before menses. Itching on genitals better from last 3 days. Pain reduced – now single episode in last 15 days! Blank during pain was not noticed. Physical generals no change. Dreams – no particular. | Staphysagria 1 m BD for 2 days. Sac lac 5 pills BD for 30 days. | New complains appeared with changes in menstrual characteristics but complains are better so no change in medicine and potency. [10] |
| 3 | 21/09/2021 | Urine report s/o – T. VAGINALIS ABSCENT, ALBUMIN ABSCENT! Itching, occasionally. Thirst increased. White discharge + | Staphysagria 1 m BD for 2 days. Sac lac 5 pills BD for 30 days. | Significant response of remedy. Lab investigation is improved significantly. [10] |
| 4 | 26/11/2021 | LMP- 12/11/2021, occasionally burning- watery discharge. Other symptoms are better. Anger is very less. Control my emotions. No itching. No pain. Desire for sweets. | Staphysagria 1 m bd for 2 days. Sac. Lac 5 pills BD for 30 days. | Significant change in mental characteristics. Improvement in all level. [10] |
Conclusion:
Homoeopathic medicine has proven its efficacy in sexually transmitted disease like Trichomoniasis. Infection rates are very high in sexually active people and investigation criteria is very difficult in countries like India. [03]
Conventional medicines suggested wet vaginal swab is an only tool for diagnosis. But learning from this case study is this diagnosis can be done by an expert pathologist from urine examination also. Still this is an open area with wide possibilities for further research with this non-conventional diagnostic method for Trichomoniasis infection by urine analysis. Such a case can motivate young fellows for further trials to prove a scientific role of homoeopathic medicines in this type of common infectious cases. [02]
References:
- Trichomonas vaginalis. Available from – https://en.wikipedia.org/wiki/Trichomonas vaginalis. [ accessed 08th January 2021]
- BMC infectious diseases. Available from https://bmcinfectdis.biomedcentral.com/articles[accessed 08th January 2021]
- Chakraborty P. A textbook of microbiology published by New central book agency ltd, 1995, 5th reprint.
- The web’s free 2022 ICD-10. Available from- https://www.icd10data.com [accessed 08th January 2021]
- Complete dynamics 2020 homoeopathic repertory software.
- Boericke W. Pocket manual of homoeopathic materia medica and repertory, MD 21st edition
- Phatak SR. Materia medica of homoeopathic medicines, 2nd revised & enlarged edition-1999.
- Lilienthal S. Homoeopathic therapeutics.
- The soul of remedies by Rajan Sankaran published by Homoeopathic medical publishers 1997, reprinted edition.
- Organon of medicine 6th edition by Dr. S. Hahnemann
About author-
Dr. Rahul V. Sutariya, MD (Hom),
Assi. Professor department of materia medica,
A.J.S.H.M.C, Mehsana, Gujarat.
E mail- [email protected]
