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BHARATESH HOMOEOPATHIC MEDICAL COLLEGE & HOSPITAL,
POST-GRADUATE RESEARCH CENTRE, BELGAUM-590016,
KARNATAKA,
RECOGNISED BY
CENTRAL COUNCIL OF HOMOEOPATHY, NEW DELHI
AFFILIATED TO
RAJIV GANDHI UNIVERSITY OF HEAITH SCIENCES,
BANGALORE
SYNOPSISM.D. (HOMOEOPATHY)
“UTILITY OF SYNTHESIS REPERTORY IN ALLERGIC
BRONCHIAL ASTHMA”
BY
DR.POMANNA LAMANI.
UNDER THE GUIDANCE OF
DR. SHAILA.M. UDACHANKAR MD (HOM)
PROFESSOR & PG GUIDE
DEPARTMENT OF REPERTORY
BHARATESH HOMOEOPATHIC MADICAL COLLEGE AND
HOSPITAL, BELGAUM.
FROM,
DR. POMANNA LAMANI,
TO,
DR. S.M.UDACHANKAR. M.D(HOM)
PROF. & P.G. GuideDepartment of Repertory, Bharatesh Homoeopathic Medical College & Hospital,Belgaum.
Sub: Application to my synopsis for the dissertation
Respected Madam,
I, Dr. POMANNA LAMANI, Would like to forward my application for the
approval of my synopsis under your Guidance for the following topic, “UTILITY OF
SYNTHESIS REPERTORY IN ALLRGIC BRONCHIAL ASTHMA”. Hope you will
approve the same.
Thanking you.
Date:
Place: Belgaum.
Your sincerely.
Dr. POMANNA LAMANI.
Department of Repertory,
Bharatesh Homoeopathic Medical
College & Hospital, Belgaum.
FROM,
DR. S.M. UDACHANKAR M.D (HOM)
PROF. & P.G. Guide
Department of Repertory
Bharatesh Homoeopathic Medical
College & Hospital, Belgaum.
To,
Dr. POMANNA LAMANI.
Sub: Acceptance of synopsis for the dissertation
Dear Doctor,
I have accepted your topic, “UTILITY OF SYNTHESIS REPERTORY IN
ALLERGIC BRONCHIAL ASTHMA” For the dissertation.
Your synopsis will forward to RGUHS.
Date:
Place: Belgaum
DR. S.M.UDACHANKAR.M.D(HOM)
Professor & P.G, Guide,
Department of Repertory,
Bharatesh Homoeopathic Medical
College & Hospital,
RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCS,
BANGALORE, KARNATAKA.
ANNEXUREII
APPLICATION FOR REGISTRATION OF SUBJECT FORDISSERTATION
1. NAME OF THE
CANDIDATE AND
ADDRESS (IN BLOCK
LETTERS )
DR. POMANNA .LAMANI.
PG STUDENT DEPARTMENT OF
REPERTORY BHARATESH
HOMEOPATHIC MEDICAL
COLLEGE AND HOSPITAL ,
BELGAUM
PERMANENT ADDRESS DR. POMANNA.LAMANI.
# H.NO. 95.BANJARA COLONY
GOKUL ROAD HUBLI,
DIST,DHARWAD.
2. NAME OF INSTITUTION BHARATESH HOMOEOPATHIC
MEDICAL COLLEGE & HOSPITAL,
BELGAUM, KARNATAKA.
3. COURSE OF STUDY &
SUBJECT
M.D. (HOMOEOPATHY)
DEPARTMENT OF REPERTORY.
DATE OF ADMISSION TO
COURSE
31 /10/2011.
5. TITLE OF THE TOPIC “UTILITY OF SYNTHESIS
REPERTORY IN ALLERGIC
BRONCHIAL ASTHMA”
6. BRIEF RESUME OF INTENDED WORK:
6.1 NEED FOR 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 the
surveys.
However, it has been reported to vary from 2 to17% 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 3rd 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 at mines, industry’s, A.C chambers, stays at
over crowding place etc.
In such a common clinical condition it is necessary to understand the fundamental
cause, maintaining cause, socioeconomic status, suscptability 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 helps a better scope in treating Allergic Bronchial Asthma.
Null Hypothesis: The management of Allergic Bronchial asthma in Synthesis repertory does
not have significant role in the assessment.
Honourable Dr Hahnemann has provided us a unique and well proven scientific
theory to care for those suffering from such illnesses. Dr Hahnemann has the answer to these
all. He has given us the information, how to deal with the various stages of sickness; Acute &
chronic and with its subdivisions. With this science of holistic healing namely Homoeopathy,
we have been successful not only to relieve
Since the existing treatment types are helpful only to some extent, and since most
medicines have side effects, there is need for study of the efficacy of Homoeopathic medicines
in such a disorder. Our Homoeopathic medicines are not only economically feasible but also
have no any side effects, besides they can control & treat acute episodes of asthma effectively.
The present day study taken by me “Study of asthma with miasmatic approach” is an earnest
attempt to study the efficacy of Homoeopathic medicines in this condition
6.2 REVIEW OF LITERATURE
DEFINATION The word ‘Asthma’ is derived from Greek it signifies panting or to breath
with open mouth.2
The word ‘Allergy’ is derived from Greek language, “Allos” means other and
‘Ergon’ work i.e altered work.
Allergic Bronchial Asthma is a chronic inflammatory disease of airways that is
characterised by increased responsiveness of the tracheobronchial tree to multiplicity of
stimuli, followed by rise in IgE antibodies when they come in contact with allergens.1
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
dysnea, cough and wheezing.
Traditionally asthma is divided into two types: Atopic and Nonatopic.
ATOPIC ASTHMA: Patient with atopic asthma from IgE antibodies when they come in
contact with common allergens. Atopic asthma usually start at an early age and is age and
is provoked by allergens in addition to other triggers.2
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
serum IgE levels are increased. It is also called extrinsic or early onset asthma.
NON ATOPIC 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 negative. It is also called late onset asthma.3
ETIOLOGY
Allergic bronchial asthma is interplay between hereditary and environmental
factors.
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 and moulds.
b) Ingestants : Millk, eggs, nuts, chocolates, fish, shell-fish ,
strawberries etc.
TRIGGERS :
1. Night or early morning.
2. Exercise (especially running)
3. Cold air, fog.
4. Viral respiratory tract infection.
5. Allergens (e.g.house dust, mite, cat fur.)
PATHOLOGY4:
The pathology of asthma has been revealed through a bronchial biopsy of asthmatic
died patient.
Inflammation of bronchial alveoli leads to the hyper stimulation
Infiltration of Esinophils with activated T Lymphocytes.
Thickening of the basement membrane due to subepithelial deposition of collagen.
Airways walls are attached to the lumen, and leading to the deposition of mucoid in
the bronchiols, that give the narrowing of the air ways.
Esinophilic deposition the air ways gives rise to hyper secreation of mucus
glycoproteins secreted from the goblates cells. These pathological air ways do not
extend to lung paranchyma.
The involvement of airways are patchy that should investigate by doing Bronchoscophy.3
CLINICALFEATURES
Wheezing with cough.
Dyspneoa.
Patient reports with difficult in breathing.
Patient feels their Lungs is filled with air.
Difficulty in breathing worse in the night4
SUSCEPTABILITY:
In Allergic bronchial asthma the susceptibility play a greater rule in the patients , allergic
bronchial asthma is starts from the external stimuli to the air ways here the susceptibility is
more in the patient.5
MIASMATIC BACKGROUND 5 :
Asthma has inconvenient red flag that precedes it in many paediatric cases Atopic
dermatitis Approximately half of the babies diagnosed with atopic dermatitis go on to
developed asthma. This tendency can be described as an allergic cascade over the immune
system, Allergies, Asthma, Atopic dermatitis, Anaphylaxis , Allergic rhinitis and Acid reflux.6
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 maism having
psoric expressions as acute exacerbations like wheeze, sneeze the itching. some mixed
miasmatic expression also seen in little cases.7
In psora
Hypersensitivity of the tracheobronchial tree to any allergen indicates psora as the
basic cause. The symptoms starts from the basic cause allergic reaction on skin and airways
and othere external stimulants.8
In Sycotic
History of Bronchial asthma in the family, both paternal and maternal side is
suggestive of hereditary sycosis as the basic cause. Asthma itself a genetic predispositions to
the susceptible individuals so it is miasmatically sycotic because there is narrowing and bigger
size of the bronchials.
In Syphilis
History of syphilitic state in the family with the symptoms of latent syphilis and
developed the allergic bronchial asthma.9
MANAGEMENT
HOMOEOPATHIC MANAGEMENT:
Honourable Dr Hahnemann has provided us a unique and well proven scientific
theory to care for those suffering from such illnesses. Dr Hahnemann has the answer to these
all. He has given us the information, how to deal with the various stages of sickness; Acute &
chronic and with its subdivisions. With this science of holistic healing namely Homoeopathy,
we have been successful not only to relieve the symptoms but also the cause & thereby
restoring your inner harmony and health
According to homoeopathic philosophy, diseases is not caused by a single factor.
Homoeopathy believes that every disease in depth, is depends upon the etiological factors and
local manifestations and stress factors so homoeopathy play a good rule in treating allergic
bronchial asthma such as follows.10
THERAPUTICS DRUGS.
Pulsatilla, Aconite. Ars,alb. Bell. Anti,tart . Sabadilla . Sticta . Calc, carb .Chamomilla.
Ipecacuhna . Stanum, met. Spongia . sulp .
Natrum, sulp. Sambucus . Tub . Medorrhinum . Sepia. Phosphorus .
ARSENICUM ALBUM.
Asthmatic, difficulty in breathing .patient feels that something is causing me to feel
saffocation. Arsenic patient wants breath so he/she gets up and sit. Restlessness with cough
want to drinks water with frequently. Weakness, burning in chest with cyanosis, sensation of
dust in lungs, aggravation in midnight, cold, lying down. amelioration by.
BRYONIA ALBA.
Difficulty in respiration soreness in larynx and trahcea horseness worse in the night, frequent
desire to take long breath, irritation in upper respiratory track. respiration worse in every
movements, better by rest, Heaviness beneath the sternum extending to right side.
PHOSPHORUS.
Horseness worse in the evening Rt side chest pain ,
Pt larynx feels very painful, asthmatic worse in the open air , ice creams, cold food, cold
room, asthma worse in lying on left side and better by lying on RT side,
NATRUM SULP.
Dypsneoa during damp weather must hold the chest during coughing, humid asthma and also
Sellars asthma. Constant desire to take long breath. Aggravation in the 4 to 5 am.
Asthma alternate with diabetes. Children asthma.11
SOME RUBRICS ARE FOUND IN FOLLOWING REPERTORY.
Synthesis repertory,
Chapter, respiration. Rubric, asthma. Subrubric, allergic, 177.
Chapter, respiration . Rubric, asthma . subrubric, bronchial,178.
Chapter ,respiration . Rubric , asthma . subrubric, bronchial . in children, 180.
Chapter, respiration, Rubric , asthma. Subrubric, morning agg.
Chapter, respiration, Rubric , asthma. Subrubric, evening,agg .
Chapter, respiration, Rubric , asthma. Subrubric, night, agg .
Chapter, respiration, Rubric , asthma. Subrubric, cold ,agg.
Chapter ,respiration . Rubric , asthma . subrubric, bronchial, night ,agg.
Chapter , cough. Rubric , evening agg.
Chapter , cough. Rubric , evening .ameliorate.
Chapter , cough. Rubric, morning agg.
Chapter, nose .Rubric, sneezing, subrubric, morning agg.
Chapter ,generalities .Rubric Asthma.
Chapter, generalities. Rubric. history of personal , subrubric, asthma.12
Kent’s Repertory,
Chapter, respiration, rubric, asthma. Subrubric, bronchial.
Chapter, respiration, rubric, asthma, subrubric, allergic.
Chapter, cough, rubric , morning agg,
Chapter, cough. rubric. Cough , subrubric ,cold application ,agg.
Chapter. Cough, rubric, sitting up. Subrubric . ameliorates.
Chapter,nose. Rubric. Sneezing.subrubric. morning agg.
Chapter, generality. Rubric. Asthma.
Chapter, chest, rubric, pain, subrubric morning agg.
Chapter, chest, rubric, pain, subrubric, evening agg.
Chapter, respiration, rubric. difficulty in breathing. Subrubric ,morning agg.
Chapter, respiration, rubric. difficulty in breathing. Subrubric stretching arm better.13
6.3 AIMS AND OBJECTIVES
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 complication of Allergic Bronchial Asthma.
5. To cure the Allergic Bronchial Asthma with the help of synthesis repertory by expert
system of Vithoulkas method.
6. Counseling and Advices to change the life style.
7. MATERIALS AND METHODS
7.1 SOURCE OF DATA:
The subjects for the study will be selected from the OPD, Peripheral and regular
camp visit of Bharatesh Homoeopathic Medical College and Hospital, Belgaum.
7.2 MTHODS OF COLLECTING DATA (including sampling procedure, if any)
Patient will be selected randomly on the basis of inclusion and exclusion criteria for the
study.
Minimum sample size will be 30 cases.
All patients registered between periods of March 2012 to July 2013, will be selected.
No new case will be taken for the study after July 2013.
Duration of study 6 months.
Follow ups will be seen weekly or fortnightly as per requirements.
Prognosis - Assessment will be on the general and local improvement of the subjects.
INCLUSION CRITERIA:
Patient of all ages above 10 to 25.of both sex.
All diagnosed cases of Allergic Bronchial Asthma.
All type of socio-economic status patients
Exclusion Criteria:
Patient of age above 25 years.
Patient age below 10 years
Allergic bronchial asthma is complicated with other systemic disease.
RESULT CRITERIA:
RECOVERED.
IMPROVED.
NOT IMPROVED.
7.3. DOES THE STUDY REQUIRE ANY INVESTIGATION TO BE CONDUCTED
ON THE PATIENTS OR OTHER HUMANA OR ANIMAL? IF SO, PLESE MENTION
BRIEFLY.
Yes,
BLOOD EXAMINATION :
*CBC
*ESR
*AEC
SPECIAL INVESTIGATIONS: (As when it is required)
*Sputum examination.
*X-rays chest PA view.
* IgE.
7.4 HAS ETHICAL CLEARANCE BEEN OBTAINED FROM YOUR INSTITUTION
IN CASE OF 7.3?
Yes, ethical clearance has been obtained from the institution
8. LIST OF REFERENCES:
1. Harrison TR. Harrison’s Principles of Internal Medicine. 16th edition. published in New
Delhi: Churchill livingstone. Elsevier; 2006. 2046, 2308 pp.
2. O’Callaghan C. Oxford Medicine; 2nd edition. published in New Delhi: Churchill
livingstone. Elsevier; 2004. 241 pp.
3. Siddharth NS. API Text Book of Medicine.7TH Edition. Mumbai: The Association of
India; 2003. 1155 pp.
4. Clark K. Clinical Medicine. 6th edition. Published in New Delhi: Elsevier Saunders;
2005. 568 pp.
5. Robbins KC. Basic Pathology. 7th edition. Published in New Delhi: Elsevier Saunders;
2003. 774 pp.
6. Kumar P. Homoeo Era. Vol. 1 Issue 4. Manglore: Published by E.S.J Prabhu Kiran.
May 2010. 16 pp.
7. Mehta K. Miasms the devious Intrigue. Published in Mumbai: by Mind Technologies;
2008. 7 pp.
8. Hahnemann S. Organon of Medicine. 6th Edition. Reprint edition. published in New
Delhi: Indian Books & Periodicals Publishers; 2007. 185 pp.
9. Banerjea SK. Miasmatic Diagnosis. 1st Edition. Reprint edition. Published in New
Delhi: B. Jain Publishers ( P ) ltd; 2004. 94 pp.
10. Muzumdar KP. Textbook of Homoeopathic therapeutics. 2nd Edition. Published in
West Bengal: by New Central Book Agency ( P ) ltd; 2006. 146 pp.
11. Kent JT. Repertory of the Homoeopathic Materia Medica. Reprint edition. New Delhi:
Indian Books & Periodicals Publishers; 2009. 953 pp.
12. Schryones F. Synthesis Repertory. Version 9.
13. Vithoulkas view of expert system (Ves).
9. SIGNATURE OF CANDIDATE
10. REMARKS OF THE GUIDE
11. NAME &DESIGNATION OF (IN BLOCK LETTERS) 11.1 GUIDE
DR. S.M.UDACHANKAR.M.D (HOM) PROF,HOD & P.G GUIDE,DEPT. OF REPERTORY ,BHARATESH HOMOEOPATHIC MEDICAL COLLEGE & HOSPITAL, BELGAUM-590016
11.2 SIGNATURE
11.3 CO-GUIDE
11.4 SIGNATURE
11.5 HEAD OF THE DEPARTMENT
DR.P.A.CHOWDHARY.M.D (HOM),
PROF & P.G.GUIDE, DPT OF REPERTORY BHARATESH HOMOEOPATHIC MEDICAL COLLEGE & HOSPITAL,BELGAUM.
11.6 SIGNATURE
12. 12.1REMARK OF THE CHAIRMAN/PRINCIPAL
12.2SIGNATURE