RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES



BHARATESH HOMOEOPATHIC MEDICAL COLLEGE &

HOSPITAL

POST GRADUATE RESEARCH CENTRE,

BELGAUM-590016.

KARNATAKA.

Recognized by

CENTRAL COUNCIL OF HOMOEOPATHY, NEW DELHI.

Affiliated to

RAJIV GANDHI UNIVERSITY OF HEATLH SCIENCES, BANGALORE

SYNOPSIS

M.D (HOMOEOPATHY)

“REPERTORIAL STUDY AND CLINICAL PRESENTATION OF ALLERGIC BRONCHIAL ASTHMA”

By

Dr. SUNILKUMAR. K

DR. P.A. CHOWDHARY MD (HOM)

PROFESSOR AND GUIDE,

DEPARTMENT OF REPERTORY, BHARATESH HOMOEOPATHIC MEDICAL COLLEGE AND HOSPITAL. BELGAUM

From:

Dr. SUNILKUMAR.K

To,

DR. P.A. CHOWDHARY MD (HOM)

Professor and guide,

Department of Repertory,

Bharatesh Homoeopathic Medical

College & Hospital. Belgaum.

Sub: Application to accept my synopsis for the dissertation.

Respected Madam,

I Dr. Sunilkumar. K would like to forward my application for the approval of my synopsis under your guidance of the following topic.

“REPERTORIAL STUDY AND CLINICAL PRESENTATION OF ALLERGIC BRONCHIAL ASTHMA”

Hope you will approve the same.

Date: 10-10-2009

Place: Belgaum Yours sincerely,

Dr. Sunilkumar. K

Department of repertory

Bharatesh homoeopathic college & hospital, Belgaum.

From:

DR. P.A. CHOWDHARY MD (HOM)

professor and guide,

Department of Repertory,

Bharatesh Homoeopathic Medical

College & Hospital. Belgaum.

To:

Dr. SUNILKUMAR. K

Sub: acceptance of synopsis for the dissertation.

Dear Doctor,

I have accepted your topic, “REPERTORIAL STUDY AND CLINICALPRESENTATION OF ALLERGIC BRONCHIAL ASTHMA”

For the dissertation.

Your synopsis will be forwarded to RGUHS.

Date: 10-10-2009

Place: Belgaum

DR. P.A. CHOWDHARY MD (HOM)

professor and guide,

Department of Repertory, Bharatesh Homoeopathic Medical College & Hospital. Belgaum.

RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES

KARNATAKA, BANGALORE

ANNEXURE –II

APPLICATION FOR REGISTRATION OF SUBJECT FOR DESSERTATION

DISSERTATION

| | | |

| | | |

|1 |NAME OF THE CANDIDATE |Dr. SUNILKUMAR K |

| |AND ADDRESS | |

| | |PRESENT ADDRESS: |

| | |BHARATESH HOMOEOPATHIC MEDICAL COLLEGE & HOSPITALS AND RESEARCH CENTRE.. |

| | |BELGAUM, KARNATAKA -590016 |

| | | |

| | |PERMANENT ADDRESS: |

| | |S/o. VIRUPAKSHAPPA SAJJAN |

| | |PAN MOHALLA, |

| | |Po: RANGAN PETH, |

| | |Tq: SHORAPUR |

| | |Dt: GULBARGA-585220 |

| | | |

|2 |NAME OF THE INSTITUTION |BHARATESH HOMOEOPATHIC MEDICAL COLLEGE & HOSPITALS AND RESEARCH CENTRE.. |

| | |BELGAUM, KARNATAKA -590016 |

| | | |

|3 |COURSE OF STUDY AND |DOCTOR OF MEDICINE |

| |SUBJECT |(HOMOEOPATHY) REPERTORY |

| | | |

|4 |DATE OF ADMISSION |20-03-2009 |

| | | |

|5 |TITLE OF THE TOPIC |REPERTORIAL STUDY AND CLINICAL PRESENTATION OF ALLERGIC BRONCHIAL ASTHMA |

| | |

|6 |BRIEF RESUME OF THE INTENDED WORK: |

| | |

| |6.1 NEED FOR THE STUDY : |

| | |

| |Allergic Bronchial Asthma is a very common disease with immense social impact. The prevalence of allergic bronchial |

| |asthma is rising in many parts of the world, In India prevalence of Allergic Bronchial Asthma has been found to be |

| |around 6% in majority of surveys. However, it has been reported to vary from 2 to 17 % in different study populations. |

| |This is unclear whether due to actual increase incidence or merely to the fact that the size of the overall population |

| |is growing. It is estimated that nearly 5 to 10% population suffer from it. |

| | |

| |Allergic Bronchial Asthma occurs at all ages but predominantly in early life. About one-half of cases develop before |

| |age 10, and another third occur before age of 40. In childhood, there is a 2:1 male/female preponderance, but the sex |

| |ratio of equalizes by age 30. It affects all type of socio-economic people, specially who works at mines, industry’s, |

| |A.C chambers, stays at over crowding places etc. |

| | |

| |The data collected from the Centers for Disease Control and Prevention suggest that 10 to 11 million persons had acute |

| |attacks in 1998, which resulted in 13.9 million out patients visits, 2 million requests for urgent care, and 4,23,000 |

| |hospitalizations, with a total cost >$6 billion. The impact of the disease appears to fall more heavily on minorities |

| |and inner-cities of developing countries. |

| | |

| |In such a common clinical condition it is necessary to understand the fundamental cause, maintaing cause, socio-economic|

| |status, susceptibility to receive and to react the stimuli, the true cause is in the patient himself, so it is necessary|

| |to treat individuals not the disease. |

| | |

| |Homoeopathy posses a better scope in treating Allergic Bronchial Asthma, Homoeopathic treatment became less expensive |

| |compare to other system of medicine and it completely cure the disease, gives better future to the patient. So I would |

| |like to study this topic. |

| | |

| | |

| | |

| |6.2 REVIEW OF THE LITERATURE : |

| | |

| |The word ‘Asthma’ is derived from Greek "( ( ( ( (" and signifies panting or to breath with open mouth. 1 |

| |The word ‘Allergy’ is derived from Greek language, “Allos” means other and ‘Ergon’ means work i.e altered work. |

| | |

| |Allergic Bronchial Asthma is defined as a chronic inflammatory disease of airways that is characterized by increased |

| |responsiveness of the tracheobronchial tree to multiplicity of stimuli, Followed by rise in IgE antibodies when they |

| |come in contact with allergens. It is manifested physiologically by a widespread narrowing of the air passages, which |

| |may be relieved spontaneously or a result of therapy, and clinically by a paroxysms of dyspnea, cough, and wheezing. 2 |

| | |

| | |

| |Traditionally asthma is divided into two types: Atopic and Nonatopic |

| |ATOPIC ASTHMA: Patient with atopic asthma form IgE antibodies when they come in contact with common allergens. Atopic |

| |asthma usually starts at an early age and is provoked by allergens in addition to other triggers. Atopic individuals |

| |usually have allergic ailments of skin, nose and eyes. In their families, allergic diseases are more common. Skin |

| |tests to common allergens are positive and serum IgE levels are increased. Atopic asthma is also called extrinsic or |

| |early onset asthma. |

| |NONATOPIC ASTHMA: This is usually provoked by allergens. In patients with nonatopic asthma family history of allergic |

| |diseases is uncommon. It starts in adult age. Skin tests to allergens are usually negative. It is also called |

| |intrinsic or late onset asthma. 3 |

| | |

| |Inducers and triggers of Allergic Bronchial Asthma |

| |INDUCERS: After birth, several factors interest to result in the clinical manifestations of asthma. Factors called |

| |inducers actually ‘switch on’ the asthma following which symptoms may be present for weeks, months or years. |

| | |

| | |

| | |

| | |

| |Infections |

| |Cigarette smoke |

| |Allergens |

| |(a) Aero –allergens: Dust, mite allergens, tree pollens, feathers, paint, smoke, animal dander, moulds. |

| |(b) Ingestants –Milk, eggs, nuts, chocolates, fish, shell-fish, strawberries etc. |

| | |

| |TRIGGERS : |

| |Night or early morning |

| |Exercise (especially running) |

| |Cold air, fog |

| |Viral respiratory tract infection |

| |Allergens (e.g. house dust, mite, cat fur) 4 |

| | |

| |Asthma is not a uniform disease but a dynamic clinical syndrome with a variety of features. Typical symptoms include |

| |recurrent episodes wheezing, chest tightness, breathlessness and cough. Common precipitants include exercise, |

| |particularly in cold weather, exposure to airborne allergens or pollutants, and viral upper respiratory tract infections|

| |(beware the cold that ‘goes to the chest’ or takes more than 10 days to clear). |

| | |

| |Asthma being worse in the early morning. Particularly when asthma is poorly controlled, symptoms such as cough and |

| |wheeze disturb sleep and have led to the use of the term ‘nocturnal asthma’. Cough may be the dominant symptom in some |

| |patients and the lack of wheeze or breathlessness may lead to a delay in reaching the diagnosis of so-called |

| |‘cough-variant asthma’. 5 |

| | |

| | |

| | |

| | |

| | |

| | |

| |Some Rubrics found in KENT repertory are |

| |Section: Cough |

| |Rubric: Asthmatic, Page No:782 |

| |Rubric: Night, Page No:780 |

| |Sub Rubric: Waking from the cough, Mid night, Page No:780 & 781 6 |

| | |

| |Some Rubrics found in BBCR are |

| |Section: Respiration |

| |Rubric: Asthma |

| |Sub Rubric: Attack during, bronchial, Page No: 690 |

| |Sub Rubric: Panting, gasping, Page No: 693 |

| |Section: Cough |

| |Rubric: Asthmatic Wheeze, Page No: 705 7 |

| | |

| |Some Rubrics found in CLARKE CLINICAL REPERTORY are |

| |Section: Clinical |

| |Rubric: Asthma |

| |Sub Rubric: Anger from, bronchial, dry, humid, Page No:39 8 |

| | |

| |Asthma has inconvenient red flag that precedes it in many pediatric cases Atopic Dermatitis. Approximately half of the |

| |babies diagnosed with atopic dermatitis go on to develop asthma. This tendency can be described as an allergic cascade |

| |over the immune system, Allergies, Asthma, Atopic dermatitis, Anaphylaxis, Allergic rhinitis and Acid reflux. Research |

| |has definitely shown a correlation.” 9 |

| | |

| |Allergic Bronchial Asthma is a chronic, dynamic disease. It needs administration of remedy as the guidelines prescribed|

| |by Dr.Hahnemann to treat the chronic diseases. Since the Allergic Bronchial asthma shows the genetic trait it falls |

| |mostly on Sycotic miasm having psoric expressions as acute exacerbations like wheeze, sneeze the itching. Some mixed |

| |miasmatic expression also seen in little cases. |

| | |

| |Psora: Hypersensitivity of the tracheobronchial tree to any allergen indicates psora as the basic cause. |

| |Sycosis: History of Bronchial asthma in the family, both paternal and maternal side is suggestive of hereditary sycosis|

| |as the basic cause. |

| |Syco-Syphilis: History of syphilitic miasmatic state in the family with symptoms of latent syphilis and developed |

| |sycosis in the patient suggestive of syco-syphilis. |

| |Mixed miasmatic state: In some cases a combination of all the above mentioned factors may be present making the state |

| |much more complicated and difficult to diagnose and also to treat. 10 |

| |Physicians typically diagnose asthma by looking for the classic symptoms: episodic problems with breathing that include |

| |wheezing, coughing, and shortness of breath. When symptoms alone fail to establish a diagnosis of asthma, doctors may |

| |use spirometry, a test that measures airflow. By comparing a patient’s normal airflow, airflow during an attack, and |

| |airflow after the application of asthma medication, doctors determine whether the medicine improves the patient’s |

| |breathing problems. If asthma medication helps, doctors usually diagnose the condition as asthma. 11 |

| |The truth is that both the parents and the doctor are helpless. The only saving grace is the inhaler on which the |

| |patient is put forcibly to avoid the attack and wait patiently until the child grows out of it. The parents who are |

| |dejected need to be here reassured, that allergy and asthma is completely curable if treated with correct homoeopathy. |

| |12 |

| | |

| |6.3 OBJECTIVES OF THE STUDY: |

| |1. To study the clinical presentation of Allergic Bronchial Asthma. |

| |2. To study the management of Allergic Bronchial Asthma through holistic approach. |

| |3. To individualise the case of Allergic Bronchial Asthma. |

| |4. To prevent the complications of Allergic Bronchial Asthma. |

| |5. Counseling and Advice to change the life style. |

| | |

| | |

| |MATERIAL AND METHODS: |

| |7.1 SOURCE OF DATA: |

| |The subject for the study will be taken from the OPD / IPD village health camps of Bharatesh homoeopathic medical |

| |college and hospital, Belgaum. |

| | |

| |7.2 METHOD OF COLLECTION OF DATA : (including sampling procedure if any) |

| |Inclusion criteria: |

| |Patients of Age group 1 to 40, of both sex. |

| |All diagnosed cases of Allergic Bronchial Asthma. |

| |All type of socio-economic status patients. |

| | |

| |Exclusion criteria: |

| |Patients of Age group above 40. |

| |Allergic Bronchial Asthma complicated with other systemic disorders. |

| | |

| |Result criteria: |

| |Partially improved |

| |Improved |

| |Not improved |

| | |

| |Patients will be selected on the basis of inclusion and exclusion criteria, history, clinical finding. Detailed case |

| |history by interview as per the proforma prepared for the topic will be taken. On the basis of homeopathic totality, |

| |treatment will be started. |

| | |

| |Sample size will be minimum 30 in number. No particular sampling procedure shall be adopted. |

| | |

| | |

| | |

| | |

| | |

| |7.3 DOES THE STUDY REQUIRE ANY INVESTIGATION OR INTERVENTION TO BE CONDUCTED ON PATIENTS OR OTHER HUMANS OR ANIMALS? IF|

| |SO, PLEASE MENTION BRIEFLY. |

| |YES, the study requires following investigation. |

| |Blood examination: |

| |CBC |

| |ESR |

| |AEC |

| |Special investigations: (As an when it is required) |

| |Sputum examination. |

| |X-ray chest. |

| |IgE |

| | |

| |7.4 HAS ETHICAL CLEARENCE BEEN OBTAINED FROM YOUR INSTITUTION IN CASE OF 7.3 |

| |Yes, ethical clearance has been obtained from the institution. |

| | |

| | |

| |LIST OF REFERENCES: |

| | |

| |Mills. PRACTICE OF MEDICINE, New Delhi, Re-print Edition 1989, B.Jain Publishers (P) Ltd. 362 pp. |

| | |

| |Dennis L.Kasper, HARRISON’S PRINCIPLES OF INTERNAL MEDICINE, Vol:2, USA,16th Edition, McGraw Hill Inc., Copyright 2005, |

| |1508pp. |

| | |

| |Siddharth N.Shah’s API TEXTBOOK OF MEDICINE, Mumbai, 7th Edition Revised Reprint, publisher The Association of Physician|

| |of India, 2006, 291pp. |

| | |

| | |

| | |

| | |

| | |

| |Golwalla’s MEDICINE FOR STUDENTS, Mumbai, 22nd Edition, published by Dr.Aspi F.Golwalla. 114pp. |

| | |

| |Davidson Stanely’s DAVIDSON’S PRINCIPLES & PRACTICE OF MEDICINE, Edinburgh (UK), 20th Edition Reprint, Churchill |

| |Linvingston Publishers, 2006. 671pp. |

| | |

| |Dr.J.T.Kent. REPERTORY OF THE HOMOEOPATHIC MATERIA MEDICA, New Delhi, 6th American Edition Reprint, B-Jain Publishers, |

| |2006, 2007. 780 & 781pp. |

| | |

| |Dr.C.M.Boger BOENNIGHAUSEN’S CHARACTERISTICS MATERIA MEDICA AND REPERTORY, New Delhi, Reprint Edition, B-Jain Publishers|

| |1998. 705pp. |

| | |

| |J.H.Clarke. A CLINICAL REPERTORY TO THE DICTIONARY OF MATERIA MEDICA, New Delhi, Reprint Edition, B-Jain Publishers |

| |1987. 39pp. |

| | |

| |Dr.Beena Thomas, Bronchial asthma & its homoeopathic management, Continued Medical INFORMATION (CMI), Vol, 2 no,ii, |

| |2009. 11pp |

| | |

| |Dr.Tapan kumar pradhan. Miasmatic Expression in Bronchial Asthma, SIMILIUMUM IN BRONCHIAL ASTHMA, HOMEO TIMES, 2009, |

| |20pp. |

| | |

| |. assessed on 03/10/2009. |

| | |

| |cureasthma.co.in cureasthma.co.in assessed on 05/10/2009 |

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|8. | |

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|9 |SIGNATURE OF CANDIDATE | |

|10 |REMARK OF GUIDE | |

|11. |NAME AND DESIGNATION OF |DR. P.A. CHOWDHARY MD (HOM) |

| | |PROFESSOR AND GUIDE, |

| |11.1 GUIDE |DEPARTMENT OF REPERTORY, BHARATESH HOMOEOPATHIC MEDICAL |

| | |COLLEGE AND HOSPITAL. BELGAUM |

| |11.2 SIGNATURE | |

| |11.3 CO-GUIDE | |

| |(If any) | |

| |11.4 SIGNATURE | |

| |11.5 HEAD OF THE DEPARTEMNT |Dr. D.H. AJGAONKAR MD (HOM) |

| | |PROFESSOR, GUIDE AND HOD, |

| | |DEPARTMENT OF REPERTORY, |

| | |BHARATESH HOMOEOPATHIC MEDICAL COLLEGE AND HOSPITAL. BELGAUM|

| | | |

| |11.6 SIGNATURE | |

| |12.1 REMARKS OF THE CHAIRMAN & | |

| |PRINCIPAL | |

| |12.2 SIGNATURE | |

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