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SYNOPSIS

OF

“Understanding role of miasmatic analysis in treatment


of ADHD and studying evolving remedy profiles- A
Descriptive Study”

A Dissertation to Be Submitted in Partial Fulfilment of


the Requirement
For The Award of the Degree of

DOCTOR OF MEDICINE IN HOMOEOPATHY M.D.(Hom.)

PAEDIATRICS

MAHARASHTRA UNIVERSITY OF HEALTH SCIENCES,


NASHIK

1) TITLE “Efficacy of integrated individualised homoeopathic similimum with


psychological counselling in treatment of ADHD in paediatric age group
3-10 years against the standard psychological counselling: a randomized
control trial”

2) INTRODUCTION Attention-deficit/hyperactivity disorder (ADHD) is the most common


neurobehavioral disorder of childhood, among the most prevalent
chronic health conditions affecting school-aged children, and one of the
most extensively studied neuro developmental disorders of childhood.
ADHD is characterized by inattention, including increased distractibility
and difficulty sustaining attention; poor impulse control and decreased
self-inhibitory capacity; and motor overactivity and motor restlessness.[1]

ADHD is an extremely common conditions experienced by individuals in


Paediatric age group worldwide. It is a major chronic behavioural
disorder due to its

 Prevalence all around the world


 Impact on overall development of child
 Impact on performance and productivity.

Children who are diagnosed with ADHD are also likely to have conditions
like Oppositional defiant disorder (ODD), Disruptive mood

dysregulation disorder, Conduct disorder, Learning disabilities,


Substance use disorders, Anxiety disorders, Mood disorders, Tic

disorder or Tourette syndrome as compared to children without


developmental disorders.

Detailed case receiving of the child including emphasis to behaviour


and/or gestures during case taking, along with mother’s /caretaker’s
history is considered to prescribe along with other factors. Majority of
the cases in ADHD present with common behaviour complaints. Hence it
becomes extremely important for the physician to find characteristics in
behaviour pattern for that individual child. The holistic approach of
homeopathy will be beneficial in such cases.

By miasmatic children is meant those born afflicted with one or more of


the chronic miasms of Hahnemann. Also, it became evident that a great
many people express symptoms of combinations, of the three. Since the
Law of Similars is the law of cure, homoeopathy is capable of curing the
chronic miasms if handled by wise, able prescriber and if environment
and care are favourable. Hence the possibility in the present time of
curing miasmatic children.[2]

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?

3.3) OTHER RESEARCH How are miasms relevant in treatment of ADHD?


QUESTION 2

4.1) PRIMARY Null Hypothesis: Homeopathic medicines have insignificant changes


HYPOTHESIS when used in cases of ADHD

Alternative Hypothesis: Homeopathic medicines when added to


management of ADHD along with behavioural therapy bring significant
changes in impulsivity, attention and hyperactivity.

4.2) OTHER NA

HYPOTHESIS 1

4.3) OTHER Not Applicable


HYPOTHESIS 2

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]

Most common allergies of the upper respiratory tract in children are-

 Allergic Rhinitis (hay fever) which affects the nose and the eyes.

 Allergic Sinusitis, Nasopharyngitis, Pharyngitis, Tonsillitis and


Laryngitis.

Out of which Allergic Rhinitis remains the major cause of Upper


respiratory tract allergies in children.

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]

It was found that the largest group of patients comprised children of 3-7


years of age, and most children visited the outpatient clinic in the period
March-May. The most common main disorder, according to ICD-10, was
acute nasopharyngitis (J00) and vasomotor and allergic rhinitis (J30). [6]

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

A careful history, including an assessment of the home, school and/or


daycareenvironments is needed to identify potential irritants and
allergens.

Major allergens and irritants[11]

Indoor allergens

 House dust mites

 Animal dander (dogs, cats)

 Cockroaches

 Molds

Outdoor allergens

 Pollens

 Trees (early to late spring)

 Grass (late spring to early summer)


 Ragweed (late summer)

 Molds

Irritants

 Cigarette smoke

 Wood burning stoves

 Emissions from paints, lacquers, glues

Other common trigger factors include:

1. Cold draft of air.

2. Changes in climate (such as temperature, humidity, and


barometric pressure).

3. Strong smells (such as perfume, cooking smells, flowers, and


chemical odors)

4. Highly allergenic foods such as nuts, fish and seafood,etc.

Inheritance has a major influence on allergies. Inheritance determines


whether or not a person makes IgE in response to everyday substances.
Although it is unlikely that there’s a single gene behind allergies in all
allergic individuals, you are still more likely to have allergies if other
members of your family have them.[12]

Pathophysiology

Although all people are constantly exposed to environmental allergens, it


is only those patients with the innate ability to become sensitized that
develop symptoms. In these sensitive individuals, repeated exposure to
aeroallergens causes B cell activation and maturation into plasma cells,
which produce specific IgE antibodies.[13]

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.

Early and late phase reactions

The immune system's response to allergen exposure can be divided into


two phases.[14]

 The first is immediate hypersensitivity or the early phase reaction,


which occurs within 15 minutes of exposure to the allergen.
During the early phase reaction chemical mediators released by
mast cells including histamine, prostaglandins, leukotriene and
thromboxane produce local tissue responses characteristic of an
allergic reaction. In the respiratory tract for example, these
include sneezing, oedema and mucus secretion, with
vasodilatation in the nose, leading to nasal blockage, and
bronchoconstriction in the lung, leading to wheezing[14]

 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

Allergic rhinitis is a major cause of morbidity in children. It is the cause,


coexisting disorder or predisposing factor in many cases of serous otitis,
chronic sinusitis, increased susceptibility to upper and lower respiratory
infections and orthodontic disorders such as overbite and maldeveloped
dental arch.[15]

The most common symptoms are:

 Itchy, runny or congested nose, sneezing


 Irritable airways, coughing, tight chest, wheezing, shortness of
breath
 Itching, watering and congestion of both eyes
 Itchy skin, rashes, wheals
 Congestion sinuses and headache
 Disturbed sleep
 Poor concentration
 Symptoms worse indoors in bed or in the early morning.

Treatment

Allergen-specific immunotherapy (AIT) has disease-modifying effects and


can induce immune tolerance to allergens.However, patient adherence
to treatment with AIT seems to be quite low, mostly due to the fact that
treatment with AIT is relatively time-demanding and, moreover, due to
patients not receiving adequate information and education about the
treatment before it starts.[16]

Most antihistaminic are histamine H1 blocking agents and exert their


action by competing with H1 receptors. These do not prevent release of
histamine but have varying degrees of anticholinergic and
antiserotogenic activity.[17]

Homeopathic Approach
The Homoeopathic Approach will be in the following ways:

Constitutional Remedies: For e.g.

 Natrum Muriaticum- Violent paroxysmal sneezing in the morning


(allergic to house dust and house dust mites)[18]
 Pulsatilla –Very useful in hay fever. The management of hay fever
requires considerable study because you have to deal with
troublesome imaginations of patient.[19]

Acute Remedies: For e.g.

 Allium Cepa- Colds of spring, hay fever of August, epidemics of


spasmodic cough in autumn.[20]
 Sabadilla –Fluent coryza; discharge is worse from the odour of
flowers, even thinking of flowers.[21]
Rare/ Specific Remedies: For e.g.

 Wyethia helenoides- Excellent remedy in pharyngitis, especially


the follicular form.[22]
 Ambrosia artemisiaefolia- Symptoms of coryza and hay fever
whilst observing the pollen of this plant ragweed.[23]

Anti Miasmatic Remedies: For e.g.

 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]

Recent/On-going Research Relevant to Present Study

Dated-July 2001- “Paediatric Allergic Rhinitis and Comorbid Disorders” [26]

Dated-March 11 2011- “The Atopic March from Skin to the Airways” [27]

Dated-2013 Editorial- “Allergic Situation in India: What is being done?” [28]


Present Knowledge Gap for the Stated Problem

As there is no specific research done related to this topic, therefore there


is no availability of any specific data as proof for management of upper
respiratory tract allergies in children by homoeopathic medicines. Thus, I
have chosen this topic to fill this knowledge gap on the specified topic.

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.

6.3) OTHER Not applicable.


OBJECTIVES 2

7) METHODOLOGY 1) STUDY DESIGN


i) Descriptive study in my research period, cases of various strata
will be studied, and the effectiveness of homoeopathic medicines will
be concluded.
ii) According to inclusive criteria the group of 30 cases will be drawn
on the basis of actual complaint.

2) STUDY SETTING (LOCATION OF STUDY)


i) Paediatric OPD/IPD of Homoeopathic Medical College
ii) Others
a. Patients will be selected on the basis of inclusion and exclusion
criteria, history and findings.
b. History and interview will be taken as proforma prepared for the
topic.

3) STUDY POPULATION
Patients who fulfil the requisite criteria laid down along with written
informed consent.
4) SAMPLE SIZE (ADEQUATE FOR THE STUDY)

A minimum of 30 standard cases will be recorded from Study settings


mentioned above considering patient as a whole who complaints of URT
allergies assessed objectively.

5) SAMPLING TECHNIQUE
Non-randomized sampling will be done.

6) DURATION OF STUDY: 18 months

7) METHOD OF SELECTION OF STUDY SUBJECTS


INCLUSION CRITERIA:

 All the diagnosed cases of Upper Respiratory Tract Allergies i.e.


Allergic Rhinitis, Allergic Sinusitis, Nasopharyngitis, Pharyngitis,
Tonsillitis and Laryngitis.
 Patients of age group from 5-18 years.
 Patients from various socio-economic status & both sexes will be
considered for study.
EXCLUSION CRITERIA:
 Children below 5 years and above 18 years.
 Children with irreversible or severe pathologies.
 Immunocompromised children.
 Any other condition requiring emergency or surgical intervention.

SUBJECT WITHDRAWAL CRITERIA:

 Cases with irregular follow up.


 Patient who are not co-operative.
 Patients who do not give consent.

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.

11) METHOD FOR DATA COLLECTION:


 Informed consent of the patient will be taken. A questionnaire
will be used to record the name, age, sex, detailed history of
complaints, family history, past history and associated
complaints.
 Then each patient will undergo detailed general, physical, local
and systemic examinations.
 The diagnosis will be made on clinical grounds and relevant
investigations will be done to rule out or rule in the diagnosis
whenever necessary.
 The diagnosis will be made on criteria fulfilling the diagnosis of
URT allergies.

12) DATA MANAGEMENT AND ANALYSIS PROCEDURE:


 The Case Records andfindings would be analysed to research
standards and data managed accordingly.

13) DATA ANALYSIS PLAN AND METHODS:

The data is collected by observing the action of Homeopathic


Medicineson children with symptoms of URT allergiesover a period of 18
months in age group of 5-18 years, in both sexes.

-Constitutional remedy will be given on the basis of similarity of the


symptoms.

-Acute prescription and dosage will be given when required.

-Potency and dosage will be based on severity of Allergy.

-Questionnaires for assessing the cause and intensity and frequency


of attacks will be usedin each case.

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

9) TIMELINE/GANTT Study will be completed in 18 months.


CHART
ANNEXURE ‘A’

CASE RECORD PROFORMA

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-

Mother’s history during pregnancy-

Mental Generals-

General examination-

Systemic examination-

Diagnosis-

Miasmatic Diagnosis-
Prescription-

Investigation- Depending upon case taking

Follow-Up (FORTNIGHTLY DONE TILL THE TREATMENT CONTINUES):


Abbreviations

URT:Upper Respiratory Tract

%: Percentage

ICD: International Classification of Diseases

Etc – et cetera

IgE: Immunoglobulin E Antibody

S/S: Signs and Symptoms

AIT: Allergen-Specific Immunotherapy

H1: Antihistamines

E.g.: For example

OPD: Out Patient Department

IPD: In Patient Department

Dr: Doctor
ANNEXURE ‘B’

PATIENT INFORMATION SHEET

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’

INFORMED CONSENT FORM

I ____________________________________exercising my free power of choice, hereby


give my consent to be included as a subject in the clinical trial. I have read and understood
the ‘Patient’s Information Sheet’ I have received a copy of signed and informed consent
form and ‘Patient’s Information Sheet’. I have been explained about URT Allergiesand the
objectives of this trial.

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.

I voluntarily consent to participate in this study.

Sign of patient: Sign of the Research Student:

Name of the Patient: Name:

Date: Designation:

Place: Reg. No. :


रुग्ण माहिती पत्रक आणिसंमती फॉर्म:

रुग्णालयाचे नाव __________________________________ आणि माझ्या स्थानिक भाषेत


प्रत्यक्ष पर्यवेक्षणाखाली होणारी होम्योपैथीक उपचारांमुळे मी_______________________
अधोरे खित केले जाते.

मी प्रशासनास होमिओपॅथिक औषधे दे खील मान्य करतो.मला माझ्या उपचारांदरम्यान


अतिरिक्त तपासणीबद्दल सांगितले गेले आहे .मी रोगनिदान आणि उपचार यासाठी
फोटोग्राफीचा वापर करण्यास सहमत आहे .मी याद्वारे प्रमाणित केले आहे की मी उपरोक्त
नामित उपचार आवश्यक आहे म्हणन
ू च होमिओपॅथिक उपचारांसाठी प्रामाणिकपणे वाचलेले
आणि पर्ण
ू पणे समजन
ू घेतले आहे आणि वरील कारणांमळ
ु े मला या भाषेमध्ये फायदे आणि
संभाव्य पर्यायी पर्याय आणि माझ्या जबाबदार्या स्पष्ट केल्या आहे त. .

मी दे खील असे प्रमाणित करतो की, प्राप्त झालेल्या प्राप्त झालेल्या परिणामांबद्दल कोणतीही
हमी किंवा हमी दिली जात नाही.

तारीख:

स्वाक्षरी: __________

साक्षीदार आणि अनामिकतेचे स्वाक्षरी: ______________

डॉक्टर आणि डॉक्टरांचे स्वाक्षरी: ______________


GUIDE ACCEPTANCE LETTER

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

I accept the assignment to guide the above student as desired.

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.

You have been allotted “STUDY OF HOMEOPATHIC MANAGEMENT IN UPPER


RESPIRATORY TRACT ALLERGIES WITH ITS MIASMATIC APPROACH IN AGE GROUP OF 5-18
YEARS”the topic for dissertation. You are informed to get prior appointment for receiving
instruction from time to time in relation to your dissertation.

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.

Department Department of Paediatrics

Name of the Guide & DR. V. S. PARASHARM.D. (Hom.)

College Name DKMM Homoeopathic Medical College & Hospital


Aurangabad, Maharashtra.

Contact Number of Guide +91- 9422211671

Through Proper Channel only


To,
The Registrar,
MUHS, Nashik- 422 004
Subject: Submission of Title & Synopsis of Dissertation
Respected Sir/Madam,
I DR. RHUTU SHAHregistered for M.D. (Hom)PAEDIATRICin the 2017-18 batch under the
guidance of DR. V. S. PARASHAR,M.D. (Hom), DKMM Homoeopathic Medical College &
Hospital Aurangabad, Maharashtra.
I am due to appear for M.D. (Hom)PAEDIATRICS in Year 2018-2019
I am submitting herewith Title & Synopsis of Dissertation as mentioned below &
assuggested by my aforesaid Guide.
Title of Synopsis

“STUDY OF HOMEOPATHIC MANAGEMENT IN UPPER RESPIRATORY TRACT ALLERGIES


WITH ITS MIASMATIC APPROACH IN AGE GROUP OF 5-18 YEARS”

Kindly accept and register my Title of Synopsis.

DR. RHUTU SHAH


(Candidate Name & Signature)
The qualification of the teacher is recognized by the Central Council.

DR. V. S. PARASHAR Dr. V. S. PARASHAR


(Guide Name & Signature) (HOD Name & Signature with Dept. Seal)

DR.RAJESH PATNI
(Signature & Seal of Dean of College)
APPENDIX’B’
REPORT OF ETHICS COMMITTEE
Department :PAEDIATRIC

Candidate admitted year :2017-18

Course and Subject :M.D.(HOM.)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

Sub.: Topic & Synopsis of Dissertation for A.Y.2017-18


Sir,
With reference to above cited subject & reference, I am to inform you that, Topic of
Synopsis and Dissertation selected by the following M.D. (Hom.) students admitted for
Academic Year 2017-18 have cross checked by the undersigned. It is ensured that, the Title
selected by the student is not repeated for last three batches i.e. 2014-15, 2015-16 and
2016-17. If there is any repetitions observed by the expert committee appointed by the
University, such type of topic may be rejected & there will be no objection by the college.
Sr.No Subject for M.D. Name of the Students Title &Synopsis of Dissertation
Admitted

1 PAEDIATRIC DR. RHUTU SHAH “STUDY OF HOMEOPATHIC MANAGEMENT


IN UPPER RESPIRATORY TRACT ALLERGIES
WITH ITS MIASMATIC APPROACH IN AGE
GROUP OF 5-18 YEARS”

Thanking you,

Yours faithfully

Dean/Principal
(Seal of College)