A prospective case study on Bronchial Asthma in Children

September 16, 2021 admin Research in Homoeopathy 0

Dr NAHIDA M. MULLA MD. (HOM), MACH

Bronchial asthma affects people of all ages but most often starts early in life, causing high morbidity and constant burden on health system. Bronchial asthma results in episodes of disturbed sleep, restriction of activities, school absenteeism, learning disabilities thus leading to multilevel effects in children.

Homoeopathic medicines are used to stimulate defence mechanism of body including immune system, and can modify hypersensitive nature of immune system of an asthmatic person.

This can be possible by proper administration of Individualised Homoeopathic medicine which helps in preventing the repeated exacerbations of bronchial asthma and helps in improving the quality of life in children. This study is proposed to assess the effectiveness of LM potency and centesimal potency in management of bronchial asthma in paediatric age group. On the basis of above observations, this is a sincere attempt to study the effectiveness of Individualised Homoeopathic medicine by comparison of LM and centesimal potency in the treatment of Bronchial asthma.

The objectives of this study are:
1. To assess the effectiveness of Individualised Homoeopathic medicines in the treatment of Bronchial asthma in paediatric age group.

2. To compare the effectiveness of Individualised Homoeopathic medicine between LM potency and centesimal potency in the treatment of Bronchial asthma in paediatric age group.

3.To assess improvement in the quality of life in the subjects of Bronchial asthma in paediatric age group.

The following methodology is adopted;

1: Type of research: A Prospective case study

2: Sampling design: Simple random sampling.

3: Selection criteria: Based on the inclusion and exclusion criteria, history and clinical symptoms.

The treatment is based on interpretation of clinical signs and symptoms

CONCLUSION: After the results were statistically analysed it showed that medicines of 50 millesimal potency have a significant role in the management of bronchial asthma over the usage of centesimal potency.

KEYWORDS: Bronchial asthma , Homoeopathy, LM potency, centesimal potency.

ABBREVIATIONS : LM – Millesimal potency ; CM – centesimal potency

INTRODUCTION:
Bronchial asthma is an important health issue mainly in developing countries like India.[1] Apart from being the leading cause of hospitalization for children, it is one of the most important chronic conditions causing elementary school absenteeism. It has also increased the number of preventable hospital emergency visits and admissions.[2],[3] The global strategy for asthma management and prevention guidelines define asthma as “a chronic inflammatory disorder of airways associated with increased airway hyper-responsiveness, recurrent episodes of wheezing, breathlessness, chest tightness, and coughing.”[4]

Since 1970, the prevalence of bronchial asthma has increased continuously, and now, it affects an estimated 4%–7% of people worldwide.]

It is estimated that 14% of children in the world experience asthma symptoms.[6] The prevalence has been seen more in urban than in rural areas.[7] When segregated by gender and age, asthma is seen more in boys in the age group of 12–14 years and more in girls in the age group of 14–16 years.[8] India accounted for 277 disability-adjusted life years lost per 100,000 population and 57,000 deaths in the year 2004.[9]

Bronchial asthma is often under-diagnosed and undertreated during the childhood, which may lead to severe psychosocial disturbances in the family.[10] The diagnosis of asthma is dependent on the clinical presentation of bronchospasm, variable airway narrowing, bronchial hyper-responsiveness, airway inflammation, and response to inhaled bronchodilators or corticosteroids.

In the past 10 years, the proportion of Indian school children suffering from bronchial asthma has increased to more than double.[11] The increase in the prevalence of bronchial asthma in children may have serious implications in their adult life, as 40% of children with trivial wheeze and 70%–90% of those with troublesome asthma continue to have symptoms in mid-adult life.[12] It is also shown that male sex, a positive family history of atopic disorders and the presence of smokers in the family are significant factors that influence the development of asthma.[1] This problem is increasing in urban areas as a result of increase in environmental smoke and air pollution. In India, the obstacles to asthma care are the costs of care and medications, the socioeconomic disparity within the country, use of multiple languages, cultural issues, and the common use of alternative remedies.[13] The magnitude of the problem of asthma has not been defined with certainty although numerous epidemiological studies have been carried out worldwide. Indeed, the prevalence studies of asthma lack consistency, possibly because of the ill-defined diagnostic criteria, nonstandardized study protocols, and different methodologies.[5]

MATERIALS AND METHODS:

Type of research:A Prospective case study

Sampling design: Probability method of simple random sampling procedure for subjects who presented with clinical signs of Bronchial asthma.

Selection criteria: 60 cases were selected from the OPD, IPD and school camps of A M Shaikh Homoeopathic Medical College and Hospital, Belagavi, on the basis of inclusion and exclusion criteria, history and symptoms.

Inclusion criteria:

  1. Subject of age group between 3-18 years
  2. Subject of all genders.
  3. Subjects who is fulfilling diagnostic criteria.
  4. Subjects those who are willing to participate and parents willing to sign written informed consent and assent taken from the subjects.

Exclusion Criteria:

  1. Subjects with co-morbid conditions like GERD, Sinusitis, Allergic rhinitis, Otitis media, Bronchitis, Foreign body obstructions
  2. Subjects with Acute severe asthma, and Status asthmaticus.
  3. Subjects on any other medication and any Surgical interventions.
  4. Subjects complicated with other Organic and psychiatric diseases.

RESULTS
The study was conducted between October 2019 to July 2021 and all the cases were sufficiently given time period to understand and analyse the outcome. At the end of the study following data is observed which is placed in tabular form.

1) Age Incidence: Statistical study was done to identify the age group with highest incidence as shown in Table No.1.

Table No. 1 – Age Incidence

Sl.No. Age in years No.of Subjects Percentage
1. 5 – 8 18  30.00
2. 9 – 11 20 33.33
3. 12 – 14 22 36.66
  Total 60 100%

Out of sixty cases studied, maximum prevalence was noted in the age group

between 12-14 years (36.66%). Followed by a near distribution in the

age groups of 9-11 years (33.33%) & 5 – 8 years (30.00%).

2)  Sex Incidence: Statistical study was done to identify the sex incidence with highest incidence as shown in Table No.2

Table No. 2 –Sex Incidence

Sl.No. Sex of subjects No. of Subjects Percentage
1. Male 34 61.6%
2. Female 26 38.3%
  Total 60 100 %


As shown in table above, 61.6% of the subjects (34) were males and 38.3% of the subjects (26) were females.

3)Incidence of Presenting Complaints: In the statistical study of 60 cases, each subject is presenting with one or more complaints, the presenting complaints are shown in table no.-3.

Table No. 3 – Incidence of Presenting Complaints

Sl.No. Symptoms No. of Subjects Percentage
1 Difficulty in breathing 12 20%
2 Wheezing 24 40%
3 Cough 24 40%

Out of 60 cases studied,12 cases (20%) had difficulty in breathing, 24 cases

(40%) had wheezing, 24 cases (40%) had cough,

4) Subjects with family history: Statistical study was done to identify the family history of asthma in the subjects is shown in the table no-4.

Table 4: Distribution of cases according to family h/o asthma

Family h/o asthma cases percentage
With Family h/o 48 80 %
No family h/o 12 20%
total 60 100%

In above table with family h/o asthma have 48 cases i.e. 80% , no family h/o asthma have 12 cases i.e. 20%.

5) Remedies used: A statistical analysis was done to identify the remedies that were used during the course of treatment of subjects is shown in table no. 5.

Table 5: The following  constitutional remedies were found useful.

Sl.no Remedies No. Of cases receiving CM potency No. Of cases receiving LM potency Percentage
1. Kali carbonicum 6 7 21.6 %
2. Arsenic album 6 5 18.3%
3. Pulsatilla 4 5 15%
4. Tarentula hispanica 4 4 13.33%
5. Phosphorus 4 3 11.6%
6. Sepia 2 3 8.3%
7. Calcarea carbonicum 2 2 6.66%
8. Ammonium carbonicum 2 1 5%
  TOTAL 30 30 100%

Out of 60 cases 8 remedies were used as constitutional remedies. In CM potency Arsenic album & Kali carbonicum was prescribed to  6  cases,  followed by Pulsatilla, phosphorus & tarentula

hispanica, was prescribed to 4 cases each, followed by ammonium carbonium, sepia & calcarea

carbonicum was prescribed for 2  cases each.

In LM potency Kali carbonicum was prescribes to 7 cases, arsenic album and pulstailla to 5 cases each. Tarantula hispanica to 4 cases. Phosphorus and sepia to 3 cases each. Calcarea carbonicum to 2 cases and ammonium carbonicum to 1 patient.

6) Potency used: The following potencies are used in the study in table no-6 .

Table no. 6 – potencies used

Sl.no Potency No. of patients
1. Centesimal 30
2.        0/1    (LM) 12
3.        0/2 (LM) 18
   Total 60

7)Result of Treatment: In the statistical study of 60 cases the results of the

Treatment is summarized in Table no-7.

Table no 7- outcome of treatment

S.No RESULT LM POTENCY CM POTENCY
1 IMPROVED 24 20
2 NOT IMPROVED 6

 

 10
  TOTAL 30 30
  PECENTAGE 80% 66.6 %

As shown in the table LM potency was prescribed for 30 patients out of which 24 patients improved (80%). Centesimal potency was prescribed to 30 patients out of which 20 patients improved (66.6%).

DISCUSSION
In this study various observations were made to assess the susceptibility of children in acquiring  bronchial asthma. Susceptibility is assessed considering age, sex, intensity of symptoms, habit, environment, temperament and constitution. Various factors responsible for bronchial asthma like socioeconomic status, locality, vaccination, overcrowding, hygienic measures, nutrition, health awareness and seeking treatment were observed during this study. Study also shows positive treatment response with homoeopathic medicines in early treatment of bronchial asthma.

In homoeopathy the patient is treated rather than the disease. In acute illness, the patient changes from the normal are taken into account. Homoeopathic remedies are prescribed holistically rather than one part.  The homoeopathic system of Medicine with its unique Similia principle and with its Individualistic approach helps to overcome the acute deviation from health, helps to decrease the duration of acute phenomenon and prevents the hospitalization.

From the study it was found that after the use of homoeopathic medicines there was statistical improvement in cases of bronchial asthma.

CONCLUSION
This study which was conducted on 60 subjects of paediatric age group concentrated mainly on utilization of 50 millesimal scale remedies by comparing them to the regular usage of centesimal scale in the practice of treating bronchial asthma.

Wheezing & cough which were the most common symptom in this study responded well to the medicines of 0/1 potency and also the subjects showed increased general wellness.

The above study revealed the significant effect of individualized homoeopathic medicines in treatment and management of bronchial asthma. Hence, it may be concluded that 50 millesimal drugs are well efficient in the treatment of bronchial asthma.

LIST OF REFERENCES

  1. Kumar GS, Roy G, Subitha L, Sahu SK. Prevalence of bronchial asthma and its associated factors among school children in urban Puducherry, India. J Nat Sci Biol Med 2014;5:59-62
  2. Reid J, Marciniuk DD, Cockcroft DW. Asthma management in the emergency department. Can Respir J 2000;7:255-60.
  3. Gürkan F, Ece A, Haspolat K, Derman O, Bosnak M. Predictors for multiple hospital admissions in children with asthma. Can Respir J 2000;7:163-6.
  4. Masoli M, Fabian D, Holt S, Beasley R; Global Initiative for Asthma (GINA) Program. The global burden of asthma: Executive summary of the GINA dissemination committee report. Allergy 2004;59:469-78
  5. Pal R, Dahal S, Pal S. Prevalence of bronchial asthma in Indian children. Indian J Community Med 2009;34:310-6.
    [PUBMED]  [Full text]
  6. Global Burden of Diseases Study. Global Asthma Report. Global Burden of Diseases Study; 2014.
  7. Chakravarthy S, Singh RB, Swaminathan S, Venkatesan P. Prevalence of asthma in urban and rural children in Tamil Nadu. Natl Med J India 2002;15:260-3.
  8. Gupta MK, Sharma BS, Chandel R. Prevalence of asthma in urban school children in Jaipur, India. Pediatr Res 2011;70:517
  9. Agrawal S. South Asia Network for Chronic Disease. Factsheet on Asthma in India. New Delhi, India: 2010. Available from: http://www.sancd.org/uploads/pdf/Asthma_factsheet.pdf. [Last accessed on 2012 Oct 20]
  10. von Mutius E. The burden of childhood asthma. Arch Dis Child 2000;82 Suppl 2:II2-5.
  11. Pal R, Barua A. Prevalence of childhood bronchial asthma in India. Ann Trop Med Public Health 2008;1:73-5
  12. Horak E, Lanigan A, Roberts M, Welsh L, Wilson J, Carlin JB, et al.Longitudinal study of childhood wheezy bronchitis and asthma: Outcome at age 42. BMJ 2003;326:422-3.
  13. Singh RB. Proceedings of the 58thAnnual Meeting of the American Academy of Allergy, Asthma and Immunology. Symposium: International Conference on Health Care Delivery for Asthma. Asthma in India. New York, NY; 2002.
  14. Jain A, Vinod Bhat H, Acharya D. Prevalence of bronchial asthma in rural Indian children: A cross sectional study from South India. Indian J Pediatr 2010;77:31-5.
  15. Awasthi S, Kalra E, Roy S, Awasthi S. Prevalence and risk factors of asthma and wheeze in school-going children in Lucknow, North India. Indian Pediatr 2004;41:1205-10
  16. Qureshi UA, Bilques S, Ul Haq I, Khan MS, Qurieshi MA, Qureshi UA, et al.Epidemiology of bronchial asthma in school children (10-16 years) in Srinagar. Lung India 2016;33:167-73.
  17. Paramesh H. Epidemiology of asthma in India. Indian J Pediatr 2002;69:309-12
  18. Prasad R, Verma SK, Ojha S, Srivastava VK. A quistionnaire based study of bronchial asthma in rural children of Lucknow. Indian J Allergy Asthma Immunol 2007;21:15-8
  19. Sharma SK, Banga A. Prevalence and risk factors for wheezing in children from rural areas of North India. Allergy Asthma Proc 2007;28:647-53.
  20. Vyankatesh AA, Bharat PS, Kush A. Prevalence of Asthma in School going Children of Semi-Urban Area in the State of Madhya Pradesh. Int J Med. Public Health 2016;71:37-40

Dr. NAHIDA M. MULLA MD. (HOM), MACH
PROFESSOR, HOD & PG GUIDE, DEPARTMENT OF PAEDIATRICS
A M SHAIKH HOMOEOPATHIC MEDICAL COLLEGE, BELGAUM -590010
E mail:drnahida.mulla@gmail.com
Mobile: 9448814660 / 8660646492

Be the first to comment

Leave a Reply

Your email address will not be published.


*