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