NEED FOR THE STUDY: Acute Gastroenteritis
is the condition where there is inflammation and irritation into the stomach
and intestine which cause symptoms such as abdominal cramps, nausea, vomiting,
and diarrhea. These can be due to viral, bacterial, parasitic or fungi
infection which leads to Gastroenteritis. Nowadays,
Acute Gastroenteritis is considered to be the most problematic disease among
the population, which increase the mortality and morbidity of the patients. The
Centers for Disease Control and Prevention (CDC) estimate, there are more than
350 million cases of acute gastroenteritis in the united states annually and 48
million of these cases are caused by food-borne bacteria. Traveler’s diarrhea
affects more than half of people travelling from developed countries to
developing countries. In adult and pediatric patients, the prevalence of Clostridium difficle is increasing.
Contact precautions, public health education are necessary goals in decreasing
the prevalence of Clostridium difficle. (1)
According
to WORLD HEALTH ORGANISATION (WHO)
stats that: Diarrheal disease is the third leading cause of death in children
1-59 months of age. It is both preventable and treatable. Each year diarrhea
kills around 443832 children under 5 and an additional 50851 children aged 5 to
9 years. Globally, there are nearly 1.7 billion cases of childhood diarrheal
disease every year. Diarrhea is the leading cause of malnutrition in children
under 5 years old. (2) According
to a 2019 study, ROTAVIRUS causes an estimated 11.37 million cases of Acute
gastroenteritis (AGE) in children under five years old in India each year.
Rotavirus can also cause an estimated 122000-153000 deaths and 457000-884000
hospitalizations in children under five each year. In October 2022, the CDC
found that acute diarrhea had a higher prevalence among people aged 18-44
(10.2%) and 5-17 (3.3%) than among the people aged 0-4 (7.8%). (5) Boericke
repertory and Bell’s diarrhea repertory is the repertory which can be used in
the case of gastroenteritis, due to their construction of repertory. Boericke
repertory has well-arranged rubric for the symptoms of gastroenteritis, in the
format of occurrence, type, during, after, associated symptoms etc. Boericke
repertory is the clinical repertory. While
Bell’s diarrhea repertory has well-arranged rubrics related to the diarrhea in
every aspect related location, sensation, modalities and concomitant. Bell’s
diarrhea repertory is the regional repertory.
Therefore, need for
study these repertories for Acute gastroenteritis, is to know the effectiveness
of Boericke’s repertory and Bell’s diarrhea in cases of Acute Gastroenteritis
as a comparative study. ACUTE GASTROENTERITIS
DEFINITION
·
Acute gastroenteritis presents as profuse
diarrhea with associated nausea, vomiting with or without abdominal
discomfort.
·
By Definition “diarrhea means passage of 3 or
more loose or watery motion per 24 hrs. resulting
in excessive loss of fluid and
electrolytes in stool”.
·
When associated with fever and vomiting it is termed “acute gastroenteritis”.
·
WHO/UNICEF definition of acute diarrhea –
acute diarrhea is an attack of sudden onset,
which lasts usually for 3- 7 days but may last up to 10 – 14 days, caused by infection
of the bowel. (4) Factors that increase the susceptibility to the disease: (10) ·
Young age ·
Immune deficiency ·
Measles ·
Lack of breastfeeding ·
Ingestion of contaminated food and water ·
Poor hygiene ·
Ignorance ·
Overcrowding
·
Poverty CLINICAL MANIFESTATIONS ·
Diarrhea ·
Cramps ·
Emesis ·
Fever ·
Malaise
·
Seizures INVESTIGATIONS Laboratory
studies to identify the pathogen are not required as most of the episodes are self-limiting. Only when the child is
not responding to the standard treatment a stool
culture is indicated. Stool specimen should be
examined for mucus, blood and leucocytes, the presence of which indicates
colitis. In cases of severe dehydration,
serum electrolytes, BUN, serum creatinin should be done to assess the kidney function and to plan the fluid therapy MANAGEMENT (3) (12)
Management of dehydration remains
the cornerstone of therapy of diarrhea according
to the severity of dehydration. OBJECTIVE OF
THE STUDY : 1.
To show the effectiveness of Bell’s diarrhea
repertory and Boericke’s repertory in Acute Gastroenteritis.
2.
To do a comparative study of Boericke’s
repertory (Clinical repertory) and Bell’s diarrhea repertory (Regional
repertory) in Acute Gastroenteritis. material and methods
: SOURCES OF
DATA : ·
PROJECT SITE
– 1.
OPD & IPD of C. D. Pachchigar
College of Homoeopathic Medicine & Hospital; Near Navjivan Circle, Udhana
Magdalla Road, Surat. 395001
2.
Peripheral OPDs MATERIALS : ·
Case Performa prepared for C. D. Pachchigar
General Hospital - OPD Performa ·
Boericke’s repertory ·
Bell’s diarrhea repertory ·
Materia medica of homoeopathic
medicines by Dr. William Boericke. ·
Homoeopathic computerized
software: CARA PRO.V.4.5, and other homoeopathic software.
·
All literature of Homeopathy and
Allied science which required for my study. METHOD
OF COLLECTION OF
DATA :
·
STUDY DESIGN – Prospective Analytical Study
·
STUDY POPULATION – 100 cases of Gastroenteritis, which will be
treated with the help of Bell’s diarrhoea and Boericke’s repertory.
·
SAMPLE SIZE – 30 CASES
·
SAMPLING TECHNIQUES - Simple Random Sampling
·
STUDY DURATION – 9 months
·
SELECTION CRITERIA
Inclusion
Criteria
1.
Both sex
2.
All age groups predominant
3.
Cases of Acute Gastroenteritis
Exclusion
Criteria
1.
Patient suffering from any
Congenital Anomalies.
2.
Cases with advance pathological
condition.
Withdrawal
Criteria
1.
Patient with irregular follow up.
2.
Who left the treatment
·
Patient will be selected on basis
of Inclusion & Exclusion Criteria, history & clinical findings.
·
Case taking will be done
according to guidelines given in Aphorisms 83-104 by
Dr. Hahnemann.
·
Repertorization will be done by
using Bell’s diarrhea and Boericke’s Repertory.
·
Remedy will be selected on the
basis of repertorial result obtained by using Bell’s diarrhea and Boericke’s
Repertory and differentiated from different Materia Medica.
·
The remedies will be used in
various potencies as per the requirement of the case.
·
The remedies will be repeated as
per the requirement of the case.
·
The follow-up of case will be
taken as per the requirement.
Response
will be analyzed according to following 3 Criteria _
1.
SIGNIFICANT IMPROVEMENT – Sense
of wellbeing with no presenting complaints and no relapse of the symptoms for
more than 3 months
2.
IMPROVEMENT – Patient relieved
from presenting complaints with decrease in intensity.
3.
NO IMPROVEMENT – Patient who
didn’t get relief in spite of giving medicine at regular intervals.
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