Scientific Research

A Prospective Case Study on Bronchial Asthma in Children & its Homoeopathic Management by LM and Centesimal Potencies

Written by Nahida Mulla

A Prospective Case Study on Bronchial Asthma in Children & its Homoeopathic Management by LM and Centesimal Potencies by Nahida M. Mulla

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

The proper administration of individualised homoeopathic medicine can help in preventing the repeated exacerbations of bronchial asthma and in improving the quality of life in children.  This paper is an attempt to study the effectiveness of individualised homoeopathic medicine by comparison of LM and centesimal potencies in the treatment of bronchial asthma.

The objectives of this study are:

  1. To assess the effectiveness of individualised homoeopathic medicine in the treatment of bronchial asthma in a paediatric age group.
  2. To compare the effectiveness of individualised homoeopathic medicine LM potency and centesimal potency in the treatment of bronchial asthma in a paediatric age group.
  3. To assess improvement in the quality of life in the patients of bronchial asthma in a 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 advantage in the management of bronchial asthma over the use of centesimal potency.

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

ABBREVIATIONS : LM – Millesimal potency ; CP – 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 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, non-standardized 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 fulfil diagnostic criteria
  4. Subjects 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 given sufficient time period to understand and analyse the outcome. At the end of the study the 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 CP 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 CP 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 & calcarean 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 are summarized in Table no-7.

Table no 7- outcome of treatment

S.No RESULT LM POTENCY Centesimal 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, the majority of the children belonged to middle and lower socioeconomic class  which is similar to the study done by Jain et al., where majority of the families were from the low socioeconomic class.[14]

Chakravarthy et al. reported that symptoms suggestive of asthma were present in 18% of children under 12 years of age. They also found that the prevalence of breathing difficulty and nocturnal cough was significantly higher among urban children in 6–12 years of age group. Children living in urban areas reported recent wheeze more often than rural children.[7]

In this study, the prevalence was more among males than females in 10–14 years of age.  Male sex is a risk factor for asthma in prepubertal children, whereas female sex is a risk factor for the persistence of asthma into adulthood.[16]

It was observed in this study that the prevalence was significantly more among those with a family history of bronchial asthma.[1],[14],[16]

In a review done by Pal et al., environmental factors, including increasing exposure to pollution, allergies, tobacco smoke, and sedentary lifestyle, were identified as risk factors for asthma.[5]  In the present study the commonest environmental trigger reported for wheezing was various inhalants. This was followed by cold exposure and exercise, irritants and infections.

A study by Vyankatesh AA et al. found the family history of asthma, history of allergy, and the presence of cough without cold a statistically significant association with asthma. These findings are in concordance with this study.[20]

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 for one symptom or organ. 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 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 centesimal 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 efficient in the treatment of bronchial asthma.

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About the author

Nahida Mulla

DR. NAHIDA M. MULLA M.D. is currently Principal, HOD repertory & PG Guide, HOD Pediatrics at A M.Shaikh Homoeopathic Medical College, Belgaum. Dr. Mulla is also a member of Karnataka State Wakf for Women"™s Development and a resource person for Continuing Medical Education. She was also a Resource person for the Re-orientation Programme for Teachers (Physiology & Biochemistry) at Government Homoeopathic Medical College Bangalore. Dr. Mulla has presented numerous scientific papers and contributes to many websites.

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