Beruflich Dokumente
Kultur Dokumente
OF
PAEDIATRICS
Children who are diagnosed with ADHD are also likely to have conditions
like Oppositional defiant disorder (ODD), Disruptive mood
The life of a man starts while he is still in the uterus, where he can
experience emotions both painful and pleasant which will ultimately
condition his state of mind.[3]
3.1) PRIMARY Does Homoeopathy along with behavioural therapy bring significant
RESEARCH changes in children diagnosed with ADHD as compared to management
QUESTION with only behavioural therapy?
3.2) OTHER RESEARCH If yes, then what are the common remedy profiles that emerge out in the
QUESTION 1 study?
4.2) OTHER NA
HYPOTHESIS 1
5) REVIEW OF
Definition
LITERATURE
Allergy is a hypersensitivity disorder of the immune system of the human
body. Allergic reactions occur when a person’s immune system reacts
abnormally to normally harmless substances, present in the
environment. A substance that causes a reaction is called an allergen.
Allergy is formally called type I (or immediate) hypersensitivity and is one
of four or more forms of hypersensitivity.[4]
Allergic Rhinitis (hay fever) which affects the nose and the eyes.
Epidemiology
Establishing a reliable estimate of the prevalence of allergic rhinitis is
difficult; prevalence estimates range from as low as 4% to more than
40%. Epidemiology studies suggest the prevalence of allergic rhinitis in
the United States and around the world is increasing. The cause of this
increase is unknown; however, contributing factors may include higher
concentrations of airborne pollution, rising dust mite populations, less
ventilation in homes and offices, dietary factors, and the trend toward
more sedentary lifestyles.[5]
Occurrence in India
The burden of allergic diseases in India has been on an uprising trend in
terms of prevalence as well as severity. These allergic diseases comprise
of asthma, rhinitis, anaphylaxis, drug, food and insect allergy, eczema
[7]
and urticaria and angioedema. Approximately 20% to 30 % of total
population suffers from at least one of these allergic diseases in India. A
study carried, over 30 years ago in Delhi reported around 10% allergic
rhinitis and 1% asthma in 1964. [8] Thereafter later studies have reported
that 20% to 30% of the population suffer from allergic rhinitis and that
15% develop asthma.[9][10]
Aetiology
Indoor allergens
Cockroaches
Molds
Outdoor allergens
Pollens
Molds
Irritants
Cigarette smoke
Pathophysiology
The IgE binds to specific receptors on the surface of basophils and mast
cells. When cell bound specific IgE is cross-linked by the sensitizing
allergen, the cells release or generate chemical mediators which produce
the allergic symptoms. Activated mast cells release preformed histamine
and generate newly synthesized leukotrienes, prostaglandins, kinins, and
other compounds. The end result of this mediator release is an
immediate hypersensitivity reaction with itching, sneezing, and
congestion due to increased vascular permeability, vasodilatation, and
increased mucus production. The vascular leakage of plasma proteins
contributes to both rhinorrhoea and nasal congestion.
The second or late phase reaction, occurs 4-6 hours after the
disappearance of the first phase symptoms and can last for days
or even weeks. During the late phase reaction in the lung, cellular
infiltration, fibrin deposition and tissue destruction resulting from
the sustained allergic response lead to increased bronchial
reactivity, oedema and further inflammatory cell recruitment.
These observations suggest that IgE is instrumental in the
immune system's response to allergens by its ability to trigger
mast cell mediator release, leading directly to both the early and
late phase reactions.[14]
Allergen
IgE-antibody
Mast cell/Basophil
Mediators
Inflammation
s/s of Disease
Diagnosis
Treatment
Homeopathic Approach
The Homoeopathic Approach will be in the following ways:
Medorrhinum
Tuberculinum
Psorinum
Miasmatic Understanding
Each miasm has its own general characters but we frequently find
combinations in-patients; it is for the Homeopath to recognize these
inherent tendencies. The recognition of such traits in-patients before
they become parents, would remove constitutional encumbrances in
future offspring.[24]
Dr Kent further adds that, “When you see the image of Psora, Sycosis or
Syphilis then you are ready to proceed with what may be called
individualization, because these are the most general, and from these we
go into particulars and then into comparison. This is the classical way to
proceed, and when it is followed the physician becomes wise and
intelligent and can apply the Materia Medica with wonderful precision.
Such was Hahnemann's method.”[25]
Dated-March 11 2011- “The Atopic March from Skin to the Airways” [27]
6.1) PRIMARY To study the utility of Homoeopathic medicines in cases of URT allergies
OBJECTIVES in age group of 5-18 years.
6.2) OTHER To study the role of Miasms in management of URT allergies in children
OBJECTIVES 1 aged 5-18 years.
3) STUDY POPULATION
Patients who fulfil the requisite criteria laid down along with written
informed consent.
4) SAMPLE SIZE (ADEQUATE FOR THE STUDY)
5) SAMPLING TECHNIQUE
Non-randomized sampling will be done.
8) OPERATIONAL DEFINITIONS
It will depend on the case history of patients.
9) METHOD OF MEASUREMENTS:
Methods of measuring the effectiveness of homeopathy in management
of URT allergies in paediatric age group include simple grading of
symptoms, based on clinical examination and case taking. Grading is a
subjective method, which involves determining the symptoms, as told by
patient, his/her attendant, evaluating the overall severity.
10) STUDY INSTRUMENTS/DATA COLLECTION TOOL
Detailed case recording of suffering from patients and his
attending relatives.
RADAR OPUS software for repertorisation will be used.
Clinical observation, Physical examination and Laboratory
investigation if required.
Improvement Score Format.
The outcome of result will be assessed on cured, mild improved,
moderate improved and not improved.
Appropriate reference books like Homoeopathic Materia Media,
various Homeopathic Journals, Paediatric books, Research articles
and websites will be considered.
8) REFERENCE STYLE 1. Nelson textbook of pediatrics- 21st Edition- Chapter 49- Attention
Deficit Hyperactivity Dissorder
(VANCOUVER)
2. http://www.homeoint.org/hompath/articles/3109.html
3. The State of Mind that affects Foetus- Dr.Farokh Master
4. http://medind.nic.in/iae/t13/i1/iaet13i1p7.pdf
5. https://www.ncbi.nlm.nih.gov/pubmed/10748945
6. http://www.icd10data.com/ICD10CM/Codes/J00-J99/J30-
J39/J30-/J30.9
7. http://medind.nic.in/iae/t13/i1/iaet13i1p7.pdf
8. Viswanathan R. Definition, incidence, aetiology and natural
history of asthma. Indian J Chest Dis 1964;6:108-24.
9. Anonymous. All India Coordinated Project on Aeroallergens and
Human Health Report. Ministry of Environment and Forests, New
Delhi; 2000.
10. Chhabra SK, Gupta CK, Chhabra P, Rajpal S. Prevalence of
bronchial asthma in schoolchildren in Delhi. J Asthma
1998;35:291-6.
11.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2805592/table/t
7-pch06555/
12.http://www.cityallergy.com/13-the-process-of-an-allergic-
reaction/
13.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2846743/
14.http://www.worldallergy.org/professional/allergic_diseases_cent
er/ige/-->IgE in Clinical Allergy and Allergic diagnosis-Early and
late phase reactions.
15.(Hannuksela A, Vaananen A. Predisposing factors for malocclusion
in 7-year-old children with special reference to atopic
diseases. Am J Orthod Dentofacial Orthop. 1987;92:299–
303. [PubMed])
16.https://www.ncbi.nlm.nih.gov/pubmed/28243068
17. Ghai essential Paediatrics- 6h Edition- Chp.29-Rational Drug
Therapy- 29.11.-Antihistaminics
18. Clinical Observations of Children’s Remedies- third edition-
Farokh J. Master- Natrum Muriaticum.
19. Lectures on Homeopathic Materia Medica- James Tyler Kent-
Pulsatilla
20. Homeopathic Remedy Guide by Robin Murphy- Allium Cepa
21. Materia Medica of Homeopathic Medicines- Phatak- Sabadilla
22. Pocket Manual of Homeopathic Materia Medica Boericke-
Wyethia Helenoides
23. A Dictionary of Practical Materia Medica- JH Clarke- Ambrosia
artemisiaefolia
24. Dr. Farokh Master Tubercular Miasms Tuberculins- Preface
25. Lectures on Homeopathic Philosophy by Dr.J.T.Kent- Chapter X
26.https://www.ncbi.nlm.nih.gov/pubmed/11449201
27.https://www.ncbi.nlm.nih.gov/pubmed/22427479
28.http://medind.nic.in/iae/t13/i1/iaet13i1p7.pdf
Preliminary Data:
Name-
Age-
Sex-
Address-
Contact number-
OPD Number-
Physician In-charge-
Chief complaint-
Associated complaints-
Physical Generals-
Appetite-
Thirst-
Likes-
Dislikes-
Stool-
Urine-
Perspiration-
Thermals-
Physical factors-
Sleep-
Dreams-
Family History-
Past History-
Birth Details-
Ante-natal
Natal
Post-natal
Immunisation History-
Developmental Milestones-
Mental Generals-
General examination-
Systemic examination-
Diagnosis-
Miasmatic Diagnosis-
Prescription-
%: Percentage
Etc – et cetera
H1: Antihistamines
Dr: Doctor
ANNEXURE ‘B’
Dear patient I am glad to inform you that I Post graduate student have undertaken a Post
graduate research project. In the research project the subject will be“STUDY OF
HOMEOPATHIC MANAGEMENT IN UPPER RESPIRATORY TRACT ALLERGIES WITH ITS
MIASMATIC APPROACH IN AGE GROUP OF 5-18 YEARS”.During this project a minimum of
30 cases (patients) will be treated by giving Homoeopathic medicines for their complaints.
Through this information sheet you are informed about the following important features of
this research project:-
1. The sole aim of the researcher is to restore the sick to health and cure.
2. Your consent about voluntary participation in the project is the most important
prerequisite. Hence you are requested to fill the “Informed consent form”. It is
attached with this sheet. You have the right to opt out of the project at any time
without having to give any reason for doing so.
3. One of the main objectives of this study is to treat patients and observe the
effects and to find out the success rate.
4. Cases fitting into case definition will be included in this study.
5. You are requested to give detail, true information about your complaints and
other required information. Your name and address will be kept confidential.
6. Medicines used in this study are prepared by standard Pharmacy; manufactured
by following the norms of standard Homoeopathic Pharmacopoeia.
7. The Project will be started after being sanctioned by the properly formed “Ethical
Committee”.
8. Drug used in this study is not harmful to human beings.
9. You are requested to come regularly or as asked by the physician for the follow-
up.
10. Required and appropriate investigations will be done from time to time. You are
requested to cooperate.
11. The study duration will be of 18 months.
12. You will be informed about alternative treatments available and their risks and
benefits.
13. No major life threatening complications will occur with these medicines.
I thank you very much for your consent and participation in this research project.
Yours sincerely,
PG Student
ANNEXURE ‘C’
I agree to participate and co-operate fully. I agree to undergo clinical examination and any
investigation required.
I agree that my medical records may be disclosed to the appropriate authorities keeping my
name and address confidential.
I am aware of my right to opt out of the trial at any time during the course of trial without
having to give the reason for doing so.
Date: Designation:
मी दे खील असे प्रमाणित करतो की, प्राप्त झालेल्या प्राप्त झालेल्या परिणामांबद्दल कोणतीही
हमी किंवा हमी दिली जात नाही.
तारीख:
स्वाक्षरी: __________
From,
Department of Paediatrics,
D.K.M.M.H.M.C.
Aurangabad.
Subject: Acceptance to serve as Guide for M. D. (HOM) P.G. course for year 2017-2018
Dear Sir,
I am thankful to you for assigning following P.G. student for guidance in dissertation
work. The name of studentDR. RHUTU SHAH
Yours Sincerely,
DR. V. S. PARASHAR
M.D.(Hom.)
P. G. Guide
ALLOTMENT OF TOPIC BY THE GUIDE
To,
DR. V. S. PARASHAR,
DEPT OF PAEDIATRICS,
D.K.M.M.H.M.C.
AURANGABAD
With reference to your application hereby give my consent to accept you as my P.G.
studentand guide you for M.D. (Hom.) in the subject of “PAEDIATRIC” from DKMM
HOMOEOPATHIC MEDICAL COLLEGE, AURANGABAD, MAHARASHTRA affiliated to
MAHARASHTRA UNIVERSITY OF HEALTH SCIENCES, NASHIK.
DR. V. S. PARASHAR
M.D.(Hom.)
P. G. Guide
APPENDIX’A’
Name of the P.G. College DKMM Homoeopathic Medical College & Hospital
Aurangabad, Maharashtra.
DR.RAJESH PATNI
(Signature & Seal of Dean of College)
APPENDIX’B’
REPORT OF ETHICS COMMITTEE
Department :PAEDIATRIC
College Name & Address :DKMM Homoeopathic Medical College &Hospital Aurangabad,
Maharashtra
Date: ………………
To,
DR. RHUTU SHAH
DKMM HMC
Guru Ganesh Nagar,Pahadsingpura,
Behind Bibi-Ka Makbara,
Aurangabad -431001
Subject: Research Proposal of entitled “STUDY OF HOMEOPATHIC MANAGEMENT IN UPPER
RESPIRATORY TRACT ALLERGIES WITH ITS MIASMATIC APPROACH IN AGE GROUP OF 5-18
YEARS”
Dear Student,
The above mentioned research proposal of Title& Synopsis of Dissertation was discussed in
the Ethics Committee meeting held on (Date)………………………. at our College.
Ethics Committee has unanimously approved your Title & Synopsis of Dissertation.
This work will be done under the guidance and supervision of your guide DR. V. S.
PARASHAR.
(Signature)
(Name)
Chairperson, Ethics Committee
DKMM Homoeopathic Medical College & Hospital Aurangabad, Maharashtra
APPENDIX’C’
To,
The Registrar,
Maharashtra University of Health Sciences,
Mhasrul, Vani-Dindori Road,
Nashik-422004
Thanking you,
Yours faithfully
Dean/Principal
(Seal of College)