RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,
KARNATAKA, BANGALORE.
ANNEXURE II
APPLICATION FOR REGISTRATION OF SUBJECT FOR
DISSERTATION
1. / Name of the candidate & address / DR. INDIRA .A. JOSHIPRESENT ADDRESS:
BHARTESH HOMOEOPATHIC MEDICAL COLLAGE AND HOSPITAL, DHARWAD ROAD, BELGAUM -16
PERMANENT ADDRESS:
C/O DR M.S. KULKARNI PLOT NO 154 GURUPRASAD COLONY, MANDOLI ROAD AT POST UDYMBAG BELGAUM
2. /
Name of the institution
/ BHARTESH HOMOEOPATHIC MEDICAL COLLEGE AND HOSPITAL, DHARWAD ROAD, BELGAUM3. / Course of the study & subject / M.D. (HOMOEOPATHY)
REPERTORY
4. / Date of admission to Course / 01-06-2009
5. / Title of the topic / UTILITY OF KENTS REPERTORY IN THE MANAGEMENT OF VASOMOTOR RHINITIS
6 / Brief resume of the intended work:
6.1 Need for the study
Vasomotor Rhinitis “VMR” (synonyms–Intrinsic Rhinitis, Non-allergic rhinitis) is a very common condition that occurs in children as well as adults. The name describes the condition; rhinitis is inflammation of the nose; vasomotor indicates that the normal nerve reflex (“motor”) and hormone regulation of the blood vessels (‘vas”) of the nose is imperfect. Due to which the nose becomes overly reactive and overly sensitive to the emotions, long time use of decongestant sprays, environmental changes (extremes of heat and cold), irritant odors (pollution or smoke), alcoholic beverages, hot or cold, spicy food, drug side effects especially hypotensive drugs, oral contraceptives etc. in the absence of allergens and infections, and characterized by rhinorrhoea, nasal congestion and nasal blockage, this condition masquerades as an allergy, “but it is not”. In fact it is only diagnosed after an allergy has been thoroughly ruled out as a cause. The autonomic nervous system which is under the control of hypothalamus is unstable in vasomotor rhinitis.
The present treatment for VMR is, nasal sprays/pills to reduce nasal inflammation and runny nose, decongestant pills/sprays to reduce nasal congestion, antihistamine pills/sprays to block histamine release and SMR (sub mucosal turbinectomy) as a surgical relief which is not permanent, there are chances of relapse.
Homoeopathy has a significant role in the treatment of VMR, our aim is, “ to restore the sick to cure”, the properly taken detailed case history, concept of susceptibility, individualization and constitutional approach helps us in treating such non allergic condition. Homoeopathic remedies act in a smooth manner, conserving the bodily resources and leading to quick and uneventful convalescence; the tendency to relapse is also checked effectively. Our remedies when given, they stimulate the natural defense mechanism of the body and help the sick to restore back to health.
The present study of Utility of Kents Repertory in the management of Vasomotor Rhinitis is an effort in this direct, to study the role of Homoeopathy as a holistic science in the management of VMR. Since VMR is a condition which also has a lot of mental and emotional triggers along with the exciting internal and external milieu in the environment; it can be substantiated that Kents Repertory
allows the domain of the totalistic approach in the management of VMR. Thus the utility of Kents Repertory is taken up in the management of Vasomotor Rhinitis in this study.
6.2 REVIEW OF LITERATURE
It is a non-allergic rhinitis but clinically simulating nasal allergy with symptoms of nasal obstruction, rhinorrhoea and sneezing. The condition usually persists throughout the year 1
Pathogenesis: Nasal mucosa has rich blood supply. Its vasculature is similar to the erectile tissue in having venous sinusoids or “lakes” which are surrounded by fibers of smooth muscle which act as sphincters and control the filling or emptying of these sinusoids. Sympathetic stimulation causes vasoconstriction and shrinkage of mucosa, while parasympathetic stimulation causes vasodilatation and engorgement. Over activity of parasympathetic system also causes excessive secretion from the nasal glands.
Autonomic system is under the control of hypothalamus and therefore emotions play a great role in VMR. Autonomic system is unstable in cases of VMR. Nasal mucosa is also hyper reactive and responds to several non-specific stimuli,
e.g. change in temperature, humidity, blasts of air, small amounts of dust or smoke 1
Predisposing factors:
1. Hereditary
2. Infection : A preceding history of infection(bacterial or viral)
3. Septal deviation: Makes the obstruction symptoms worse.
4. Psychological and emotional factors: Anxiety, grief, tension etc.
5. Endocrine influences: At puberty, during menstruation, pregnancy.
6. Drugs: Hypotensive drugs, oral contraceptive pills cause nasal edema which leads to nasal blockage.
7. Overuse of local applicants.
8. Hypothyroidism: Causes a reduced activity of the sympathetic system resulting in to nasal block 2
Clinical presentation:
1. paroxysmal sneezing
2. Excessive rhinorrhoea: Profuse and watery
3. Nasal obstruction: alternates from side to side usually more marked at night.
4. Post nasal discharge 1
Differential diagnosis: Allergy, Infection, Foreign body, adenoids in children 2
Complications: Long standing cases of VMR may develop nasal polyp, hypertrophic rhinitis, and sinusitis 1
In the 6th edition Hahnemann explains in aphorism 4: He is likewise a preserver of health if he knows the things that derange health and cause disease, and how to remove them from persons in health 3
There are persons who are sensitive, not merely to one or few things, but to all things; oversensitive to taste, to light, and a great many other things. This is a constitutional state; the patient is born with it 4
Miasmatic background:
Psoric nose: olfactory disturbances of functional origin, sensation of dryness and blocking of nostrils, psoric colds begin with sneezing, redness and heat, thin watery discharges < in the morning, during sleep, oversensitive to irritant odors 5
Tubercular nose has a recurrent tendency to catch colds and have periodic and recurrent attacks with various allergic manifestations 5
Hahnemann says: More absolutely necessary in the cure of the chronic diseases is the giving up of whisky and brandy, weakness and diminution of the vital warmth are the inevitable consequences of their use, states which ought to be removed as far as possible from the chronic patient by every true physician 6
J. T. Kent under ars alb in his materia medica explains: The Arsenicum patient is always taking cold in the nose, always sneezing from every change of weather, and is worse in cold, damp weather; always freezing, chilled through. Arsenicum is the remedy for old catarrhal troubles of the nose where the nostrils bleed easily, always chilly and tired, restless, full of anxiety in the night and troublesome dreams 7
J. T. Kent under nux vomica in his material medica explains: Striking over sensitiveness, irritable, oversensitive to noise, light, medicines, least current of air. Tendency to take cold; gets coryza. Colds settle in the nose, throat, chest and ears. Takes cold from the least provocation; much stuffing up of the nose in the house at night; nose feels completely filled up, particularly out of doors, but fluent in doors; thin watery discharge during the day. Sneezing caused by itching in the nose 7
Some related rubrics, to the symptoms of VMR found in Kents Repertory
· Section: Mind
Rubric: Fear
Sub rubric: Cold, of taking 8
· Section: Nose
Rubric: Coryza
Sub rubric: Chronic, long-continued 8
· Section: Nose
Rubric: Coryza
Sub rubric: agg. in cold 8
· Section: Nose
Rubric: Sneezing
Sub rubric: Frequent 8
· Section: Generalities
Rubric: Cold in general agg
Sub rubric: Air, agg 8
· Section: Generalities
Rubric: Food
Sub rubric: beer agg 8
· Section: Generalities
Rubric: Food
Sub rubric: Cold food, agg 8
· Section: Generalities
Rubric: Food
Sub rubric: Rich agg 8
6.3 OBJECTIVES OF THE STUDY
§ To study the individual clinical presentation of Vasomotor Rhinitis.
§ To analyze the miasmatic background of Vasomotor Rhinitis.
§ To study the philosophical background of Kents Repertory and its utility in the management of VMR.
7 / MATERIAL AND METHODS
7.1 SOURCES OF DATA
The subject for this study will be taken from OPD, IPD, and Peripheral OPD’S
of Bhartesh Homoeopathic Medical College & Hospital, Belgaum.
7.2 METHOD OF COLLECTION OF DATA (including sampling procedure, if any)
Following is the inclusion criteria fixed for the study
§ Patients of both the sexes and age group between 13-65 years. The subjects will be selected irrespective of their occupational and socio-economic status and based on clinical presentation.
§ All cases registered between the periods July 2009 to July 2011 shall be taken for the study. Every case will be followed for a period of minimum 6 months.
§ Sample size will be minimum 30 in number. No particular sampling procedure shall be adopted.
Following is the exclusion criteria fixed for the study
§ The immunocompramised individuals.
§ VMR associated with sinusitis, nasal polyps, with extended chest infections. (Pneumonia, Tuberculosis, Chronic bronchitis, Allergic bronchitis, Allergic bronchial asthma, COPD, Bronchiectasis.)
§ Any gross pathological changes, irreversible pathological changes with complications.
Result Criteria
· Recovered· Improved
· Not improved
7.3 Does the study require any investigation or interventions to be conducted on patients or other humans or animals? If so, please describe briefly.
The diagnosis of the cases will be done on eliciting the detailed case history and clinical findings, therefore no specific investigations are required, however CBC and absolute eosinophil count, if needed, will be done as per the requirement of the case.
7.3 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. Dhingra P.L. Diseases of the Ear Nose and Throat. 3rd Edition, New Delhi, Elsevier, a division of Reed Elsevier India Private Limited, 2004, 208pp2. Prabhat Divya Diseases of ENT, 1st Edition, Mumbai: Prabhat Publishers,
2001, 160pp, 161pp, 162pp
3. Hahnemann Samuel. Organon of Medicine, 6th Edition, New Delhi, B. Jain
publishers Pvt. Ltd, 1996, 93pp
4. Kent James Tyler A.M.M.D. Lectures on Homoeopathic Philosophy, Reprint
Edition, New Delhi, B. Jain Publishers (p) Ltd, 1993, 192pp
5. Dr. Banerjea Subrata Kumar Miasmatic Diagnosis Practical tips with clinical comparisons, Reprint Edition, New Delhi, B. Jain Publishers (p) Ltd, 2007, 36-37pp
6. Dr. Hahnemann Samuel The Chronic Diseases Their Peculiar Nature and Homoeopathic cure, Reprint Edition, New Delhi, B. Jain Publishers (p) Ltd, 2008, 127-128 pp
7. Kent James Tyler A.M.M.D. Lectures on Homoeopathic Materia Medica
Reprint Edition, New Delhi, B. Jain Publishers (p) Ltd, 1997, 158pp, 803pp, 806pp
8. Kent J.T. Repertory of the Homoeopathic Materia-Medica, Reprint Edition,
New Delhi, B. Jain Publishers (p) Ltd, 1999, 43pp, 326pp, 351pp, 1348pp,
1362-1363pp
9 / SIGNATURE OF CANDIDATE
10 / REMARK OF GUIDE
11 / NAME AND DESIGNATION OF (in block letters)
11.1 GUIDE / DR. P.A. CHOWDHARY M.D.
PROFESSOR &GUIDE
DEPARTMENT OF REPERTORY,
BHARTESH HOMOEOPATHIC MEDICAL COLLEGE,
BELGAUM-10
11.2 SIGNATURE
11.3 CO-GUIDE
(If any) / ------
11.4 SIGNATURE / ------
11.5 HEAD OF THE DEPARTEMNT / DR. D.H. AJGAONKAR M.D.
PROFESSOR, HOD & GUIDE
DEPARTMENT OF REPERTORY,
BHARTESH HOMOEOPATHIC MEDICAL COLLEGE,
BELGAUM-10
11.6 SIGNATURE
12.1 REMARKS OF THE CHAIRMAN &
PRINCIPAL
12.2 SIGNATURE
BHARTESH HOMOEOPATHIC MEDICAL COLLEGE & HOSPITAL
POST GRADUATE RESEARCH CENTRE
BELGAUM-590016
KARANATAKA
Recognized By
CENTRAL COUNCIL OF HOMOEOPARHY, NEW DELHI
Affiliated to
RAJIV GANDHI UNUVERSITY OF HEALTH SCIENCES, BANGALORE
SYNOPSIS
M.D. (HOMOEOPATHY)
“UTILITY OF KENTS REPERTORY IN THE MANAGEMENT OF VASOMOTOR RHINITIS”
By
DR. INDIRA .A. JOSHI
DR. P.A. CHOWDHARY M.D. (HOM)
PROFESSOR GUIDE
DEPARTMENT OF REPERTORY,
BHARTESH HOMOEOPATHIC MEDICAL COLLEGE & HOSPITAL BELGAUM
From:
DR. INDIRA .A. JOSHI
To,
DR. P.A. CHOWDHARY M.D. (HOM)
Professor & Guide
Department Of Repertory,
Bhartesh Homoeopathic Medical College &
Hospital Belgaum
Sub: Application to accept my synopsis for the dissertation.
Respected Madam,
I the undersigned DR. INDIRA .A. JOSHI, would like to forward my application for the approval of my synopsis under your guidance for the following topic, “UTILITY OF KENTS REPERTORY IN THE MANAGEMENT OF VASOMOTOR RHINITIS”
Hope you will approve the same.
Date: 31.10. 2009
Place: Belgaum
Yours sincerely,
DR. INDIRA .A. JOSHI
Department Of Repertory,
Bhartesh Homoeopathic Medical College
& Hospital, Belgaum
From:
DR. P.A. CHOWDHARY M.D. (HOM)
Professor & Guide
Department Of Repertory,
Bhartesh Homoeopathic Medical College & Hospital
Belgaum.
To,
DR. INDIRA .A. JOSHI
Sub: Acceptance of synopsis for the dissertation.
Dear Doctor,
I have accepted your topic, “UTILITY OF KENTS REPERTORY IN THE MANAGEMENT OF VASOMOTOR RHINITIS”
For the dissertation.
Your synopsis will be forwarded to RGUHS.
Date: 31.10.2009
Place: Belgaum.
DR. P.A. CHOWDHARY M.D. (HOM)
Professor & Guide
Department Of Repertory,
Bhartesh Homoeopathic Medical College &
Hospital, Belgaum.