Synopsis

of
ASSESSMENT OF HOMOEOPATHIC MEDICINE IN

THE MANAGEMENT OF

ALLERGIC RHINITIS IN CHILDREN

A project to be submitted in partial fulfillment of the requirement

For

INTERNSHIP COMPLETION TRAINING OF B.H.M.S. COURSE

OF

Dr. BHIM RAO AMBEDKAR UNIVERSITY, AGRA (U.P.)

At

BAKSON HOMOEOPATHIC MEDICAL COLLEGE & HOSPITAL,

KNOWLEDGE PARK– I, GREATER NOIDA (U. P.)

Under the guidance & supervision of

Prof. DR ASHWINI NAIR (MD HOM.)

HOD, Department of Materia Medica,PG Incharge,

at

Bakson Homoeopathic Medical College & Hospital

By Interns:-

ARSHI BHARDWAJ

SALEHA AGGRAWAL

(SESSION: 2013-2019)

PROFORMA FOR REGISTRATION OF SYNOPSIS DURING

INTERNSHIP TRAINING PROGRAM

1. NAME OF THE INTERN & PERMANENT ADDRESS :

 Saleha Aggrawal: 37 South Anarkali Ext., Delhi 51

Arshi Bhardwaj : H-5/22 Krishna Nagar Delhi-51

2. NAME OF THE INSTITUTION:

Bakson Homoeopathic Medical College and Hospital,

36-B, Knowledge Park- 1, Greater Noida, U.P

3. COURSE OF STUDY:- B.H.M.S

4. DATE OF ADMISSION TO THE COURSE & BATCH :

Date of admission - October 2013
Batch - 2013-2019
5. TITLE OF THE TOPIC :
Assessment of Homeopathic Medicines in the Management of Allergic Rhinitis in
Children.

6. INTRODUCTION :

Acute Rhinitis in children is classified in ICD-10 under item J00. Rhinitis has been
defined by the Joint Task Force Parameters on allergy, asthma and immunology as the
inflammation of the nose, characterized by nasal congestion, rhinorrhea, sneezing,
itching of the nose, and postnasal drainage. Generally, the severity of the symptoms
increase rapidly, peaks within 2-3 days after the infection and decrease soon after. The
mean duration of common cold is 7-10 days, but in a proportion of patients some
symptoms can still be present after 3 weeks. Acute respiratory infections account for
20-40% of outpatients and 12-35% of inpatients attendance in a general hospital. There
is no age or sex predilection. It may start in infants as young as 6 months or older
people.3 Usually the onset is at 12-16 years of age.5 Homeopathic Medicines are found
to be effective in variety of respiratory complaints in almost all age groups especially in
children from 6 months to 15 years. Allergic rhinitis is a global health problem that is
often treated with homeopathy. The objective of this review will be to evaluate the
effectiveness of homeopathic treatment of allergic rhinitis.

7. AIMS AND OBJECTIVES:

AIMS: To study the assessment of homoeopathic medicines in the management of

Allergic Rhinitis in children.

OBJECTIVES: To evaluate the group of homoeopathic medicine indicated during the

treatment in children.

8. REVIEW OF LITERATURE:

Definition:-
Allergic Rhinitis is an IgE mediated immunological response of nasal mucosa to air
borne allergens and is characterized by watery nasal discharge, nasal obstruction,
sneezing and itching in the nose. This may also be associated with symptoms of itching
in the eyes, palate and pharynx. 5

As allergic rhinitis has a significant genetic component, a positive family history for
atopy makes the diagnosis more likely. In fact, a greater risk of allergic rhinitis exists if
both parents are atopic than if one parent is atopic. However, the cause of allergic
rhinitis appears to be multifactorial, and a person with no family history of allergic
rhinitis can develop allergic rhinitis. 5

Etiology :-

INHALANT ALLERGENS- are often the cause. Pollen from trees and grasses, mould
spores, house dust, debris from insects or house mite are common offenders. Food
Allergy is rarely an important cause. 5

GENETIC PREDISPOSITION- plays an important part. Chances of children

developing allergy are 20% and 47% respectively, if one or both parents suffer from
allergic diathesis. 5

Clinical symptoms of Allergic Rhinitis:

There is no age or sex predilection. It may start in infants as young as 6 months or
older people. Usually the onset is at 12-16 years of age.
The cardinal symptoms of nasal allergy include paroxysmal sneezing.10-20 sneezes at a
time, nasal obstruction, watery nasal discharge and itching in the nose. 5
Two clinical types have been recognized:

SEASONAL RHINITIS
Paroxysmal Sneezing and excessive fluid and mucus secretion with Nasal obstruction or
blockage. Some may get bronchospasm. The duration and severity of symptoms may
vary with the seasons.
Tearing and redness of eyes with burning or raw sensation in throat and there is also
development of asthma symptoms (wheeze, chest tightness).

PERENNIAL RHINITIS
a) Nasal discharge (thick, viscous or purulent) with nasal congestion
b) Post nasal discharge with sneezing (less common). Loss of smell due to mucosal
oedema, postnasal drip, chronic cough and hearing impairment due to eustachian tube
blockage or fluid in the middle ear.

Signs of allergy may be seen in the nose, eyes, ears, pharynx or larynx.

1. Nasal Signs - It includes transverse nasal crease- a black line across the middle of
dorsum of nose due to constant upward rubbing of nose simulating a salute, pale
and oedematous nasal mucosa which may appear bluish.
2. Ocular Signs - includes oedema of lids, congestion and cobbler stone appearance
of the conjunctiva, dark circles under the eyes.
3. Otologic Signs - include retracted tympanic membranes as a result of eustachian
tube blockage.
4. Laryngeal Signs- It includes hoarseness of voice and oedema of vocal cords.
Complications :-

a) Recurrent Sinusitis because of obstruction to the sinus ostia.

b) Nasal polypi
c) Serous otitis media
d) Orthodontics problems and other ill-effects of prolonged mouth breathing
especially in children.
e) Bronchial asthma. Patients of nasal allergy have four times more risk of
developing bronchial asthma.

Investigations:

 Skin prick test help to identify specific allergens.

 Total and differential count. Peripheral eosinophilia may be seen but is an
inconsistent findings.
 Nasal smear shows large number of eosinophils in Allergic rhinitis.
 Radioallergosorbent test(RAST) is an in vitro test and measures specific
IgE antibody concentration in the patient's serum.

Differential Diagnosis:

Sr. Disease/Condition Differentiating Differentiating Tests

Signs/Symptoms
No.
1. Non Allergic Rhinitis Sporadic or persistent Other than the
perennial symptoms not absence of positive
resulting from IgE-mediated allergy tests, no
immunopathologic events. single, specific
differentiating
Pain/pressure, and a feature exists.
postnasal drip sensation are
common.

Presence of nasal itching

and sneezing less likely.

Nonallergic triggers such as

strong odors, perfumes,
cigarette smoke, and
weather-related changes
may be present.

Not common in children.

Onset of symptoms after
age 20 years more likely.
Acute (<2 weeks), subacute
(2 to 6 weeks).
2. Acute Sinusitis Acute disease often due to Diagnosis is usually
an infectious cause. clinical.

May present with cough,

discolored nasal mucus,
and facial pressure/pain.
Symptoms >12 weeks.
Usually diagnosed with the
aid of radiologic studies.
 One of the more common
clinical characteristics of
chronic sinusitis is the
presence of hyposmia or
anosmia.
3. Chronic Sinusitis More commonly
characterized by chronic
inflammation than a
bacterial infection,
especially in adults.

Frequently characterized as
chronic sinusitis with nasal
polyposis, and chronic
sinusitis without nasal
polyposis.

4. Viral Rhinosinusitis Acute (<2 weeks) episode Diagnosis is usually

of rhinitis presenting with clinical.
nasal congestion,
rhinorrhea, sneezing, and
varying degrees of nasal
pruritus. May present with .
a sore throat, myalgias,
headaches, discolored
mucus, and fever. More
common during the fall to
spring months.

Organon Approach: In this study, medicine will be prescribed after detailed case
taking giving importance to both physical and mental symptoms.
Allergic rhinitis can be said as the derangement of vital force expressing itself through
nose. In most of such cases it is presenting with a few symptoms. Hence, it needs to be
treated with guidelines of one sided diseases (Aphorism 172- Aphorism 184, Organon
of Medicine, fifth & sixth edition). 2
Two approaches:
1. Out of a few symptoms find the characteristic symptom and prescribe.

2. Zig-zag method: Prescription of partial similinum. After getting accessory

symtoms of the case final prescription is based on totality of symptoms.
Repertorial Approach:

From Boericke’s Materia Medica, 21 rubrics of allergic rhinitis are found, out of which
5 rubrics with least medicines are as follows:
1. Inflammation (rhinitis), Acute catarrhal: concomitants: Aching in limbs. (4)
2. Type of discharge in Rhinitis: Bland mucus: (5)
3. Type of discharge in Rhinitis: Membranous formation: (4)
4. Type of discharge in Rhinitis: Salty-tasting: (2)
5. Type of discharge in Rhinitis: unilateral (3)

Materia Medica Approach: Materia medica consists of some homoeopathic medicines

which are very effective in curing allergic conditions including rhinitis. On the basis of
symptom similarity such medicines are the most commonly and effectively used. They
are:

1) Allium cepa
2) Arsenicum album
3) Arsenicum iodatum
4) Euprasia
5) Sulphur
6) Natrum mur
7) Sabadilla
8) Tuberculinum
9) Belladonna
10) Hepar Sulph
11) Aconite Napellus
12) Aralia Racemosa
13) Pulsatilla
14) Calcarea Carb
15) Kali Bichromicum
16) Gelsemium
17) Eupatorium Perfoliatum
18) Arum Triphyllum
19) Tellurium met
20) Lycopodium

List of indicated nosodes for allergic rhinitis:

1. Bacillinum
2. Diptherio Toxinum
3. Influenzinum
4. Tuberculinum

Specific indications of medicines for allergic rhinitis:

1.Tuberculinum- Allergy to animal dander
2.Blatta Orientalis, Pothos- Allergy to dust
3.Carcinocin-Allergy to asparagus flower
4.Sulphur- Allergy to feathers
9. MATERIALS AND METHODS:

Study Setting:

A prospective study will be conducted at Bakson Homoeopathic Medical College

and Hospital, Greater Noida (U.P) with IPD, POPDs, OPD

Study Duration:-

The study will be conducted for a period of 6 months.

Number of Cases and Selection of Samples:-

A Minimum of 10 cases were selected for the study.

Random sampling methods, diagnosed & Undiagnosed cases of Allergic

Rhinitis.

Inclusion / Exclusion criteria:-

a) Inclusion Criteria:

 Children between 6 months to 15 years of age.

 Those cases which covers, having the concomitant symptoms.
 Compiling records of those patient which came for regular follow-up’s.

b) Exclusion Criteria:

 Those cases which do not cover or have any concomitant symptoms.

 Patient having severe complications.
 Case without proper follow-up’s.

Study Design:

Prospective observational study.

Selection of Tools:-

a) Case Performa: Case taking Performa was designed for study with the
approval of guide.

b) Homoeopathic Literature: Textbooks on Homoeopathic Materia Medica

& Repertory.

Data Collection:

Data will be collected by case records.

 Data Analysis:

As per the requirement of the case.

Statistical Techniques:

Appropriate statistics shall be used.

Study Procedure in Brief:

The study comprised of 10 patients especially children.The study will establish the
efficiency of Homoeopathy in treatment of Allergic Rhinitis. Cases which complicated
with other diseases is not included in study. The patients will take into the study after
questioning especial question related to study. The diagnosis as per as the clinical sign
and symptoms. The potencies will be use according to the individual case and as per the
requirement. The outcome measures will be assessed on the basis of the clinical parameter
and also by the improvement of the patient as a whole.

EXPECTED OUTCOME AND THEIR USEFULNESS :

 Study will improve the knowledge of the physician in managing the case of
Allergic Rhinitis
 Study will benefit the patients by giving cost effective and long term relief.

10. REFERENCES :

1) Davidson’s principles and practice of medicine; 22nd edition; Churchill living

stone Elsevier; pgno-1283-84.
2) Organon of Medicine by Samuel Hahnemann, Fifth & sixth edition.
3) Indian Journal of Research in Homeopathy, vol 4, April-June, 2010
4) Kumar and Clark`s Clinical medicine;17th edition; Elservier ltd; pgno-1236-38.
5) Diseases of Ear,Nose and Throat by P L Dingra
6) Harrison’s Principles of Internal Medicine; 18th edition; McGraw-Hill companies;
pgno-288-289
7) Allen H.C.; Allen’s Keynotes rearranged and classified with leading remedies of
the Materia Medica and Bowel Nosodes; 10th edition; B. Jain Publishers(P)Ltd.
8) Boericke Willam; Boericke’s New Manual of Homoeopathic Materia Medica
with Repertory; 9th editions; B. Jain Publishers (P) Ltd.

11. SIGNATURE OF THE INTERNS:

Arshi Bhardwaj

Saleha Aggrawal

12. REMARKS OF MENTOR:

13. PARTICULARS OF MENTOR

14.1) Name & Designation:-

Dr. Ashwini Nair

MD (HOM.)
HOD, Department of Materia Medica, PG Incharge

14.2) Address:- Bakson Homoeopathic Medical college and Hospital,

36-B, Knowledge park-1, Greater Noida, U.P

14.3) Signature:

14. PARTICULARS OF CO-MENTOR (if any)

15.1) Name & Designation:

15.2) Address:

15.3) Signature:

15. NAME OF THE INTERNSHIP TRAINING INCHARGE:-

Dr. Rajender
M.D.(HOM.)
Internship Incharge

Signature:

16. REMARKS OF THE PRINCIPAL / HEAD OF THE INSTITUTION:

Dr. C.P. Sharma

M.D.(HOM.)
Principal

Signature:

Seal: