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RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES
BANGALORE, KARNATAKA,
ANNEXURE-II
APPLICATION FOR REGISTRATION OF SUBJECT FOR DISSERTATION
DR RAMASHEELA J. R
1.
NAME OF THE CANDIDATE &
DEPARTMENT OF PAEDIATRICS,
ADDRESS
FATHER MULLER HOMOEOPATHIC
MEDICALCOLLEGE AND HOSPITAL,
UNIVERSITY ROAD,DERALAKATTE,
MANGALORE-575018
KARNATAKA.
PERMANENT ADDRESS
DR RAMASHEELA J. R
D/O RAMANAYAKA J.
KUMARA RAMA KRUPA
8TH MAIN . P L D BANK ROAD.
K.R. EXTENSION
MADHUGIRI – 572132, TUMKUR (D)
KARNATAKA
2.
NAME OF THE INSTITUTION
FATHER MULLER HOMOEOPATHIC
MEDICAL COLLEGE AND HOSPITAL,
DERALAKATTE, MANGALORE.
3.
4.
COURSE OF THE STUDY &
M .D.(HOM)
SUBJECT
HOMOEOPATHIC PEDIATRICS
DATE OF ADMISSION TO THE
COURSE
5.
11.10.2012
TITLE OF THE TOPIC
“A CLINICAL STUDY TO EVALUATE THE EFFICACY OF
HOMOEOPATHIC MEDICINES IN CASES OF PAEDIATRIC
EOSINOPHILIA”
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6.
BRIEF RESUME OF THE INTENDED WORK
6.1 NEED FOR STUDY:
Eosinophilia is one of the commonest clinical conditions which we get to see
very often in Pediatric Age Group. Many times child will be brought to the doctor
with the complaints of recurrent respiratory infections, itching etc.. when it is
undiagnosed the condition treated symptomatically. The term Eosinophilia refers to
condition in which abnormally high amounts of Eosinophils are found in either the
blood or in body tissues. It is due to many causes, Very common causes include
allergic reactions parasitic infestations and other systemic infections. It is becoming
one of the major cause to cause ill health in the school going children leading to poor
performance in academics. In cases of allergic respiratory conditions& parasitic
infestation indirectly causes nutritional deprivation. Many paediatric eosinophilic
cases are managed by administrating corticosteroids in inhaled form, topical
treatment, pills, and injections and also with antihistamines like cetirizine leads to
drug reaction in chronic administration and also gives only temporary relief in
allopathy. According to modern medicine there is no cure of allergic disorders and
only it can be only managed. Homoeopathy being a therapeutic system in holistic
approach in such cases it removes the basic cause or root of the cause... At least five
minimum numbers of cases out of thirty cases in OPD is due to allergic reaction. In
order to manage eosinophilia or hypersensitivity reactions in children efficiently
physicians must understand common and uncommon causes for or eosinophilia
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symptoms, pathology immune reactions of the body signs & symptoms treatment
management in these cases.
During the period of 1981-82 in a survey of 21 schools in four villages of
North Arcot Ambedkar Dist of Tamilnadu among the population of 4282 children it is
detected 92 with respiratory eosinophil count greater than1000/cumm, with worm
infestation, 37 with pulmonary eosinophilia, 14 with wheezing, cough, 6 with respond
to diethyl carbamazine and 17 others following deworming required further therapy
for eosinophilia4.
Epidemiology of pulmonary eosinohilia in Rural South India prospective study
1981 -86 subject with eosinophilia more than or equal to 2000/cumm and this study
found that pulmonary eosinophilia either or alone with worm infestation was a major
cause of morbidity in the rural population4.
In keeping all the above mentioned points above we need to do research work
on eosinophilia cases in paediatric age group and to know the effectiveness of
homoeopathic medicines.
6.2 REVIEW OF THE LITERATURE:
Eosinophilia is a condition in which eosinophil count in the peripheral blood
exceeds 0.45*109/L. or 450/µl eosinophils are a type of white blood cells produced in
the bone marrow and normally found in the blood stream and gut lining and hundreds
times more abundant in tissues. They survive longer than neutrophils. Increased
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production of eosinophils in the bone marrow and normally found in the blood stream
and gut lining and hundred times more abundant in tissues than in the blood. The
immune system recognizes and kills pathogens and tumor cells to protect the host.
The immune system is composed of two major subdivisions, the innate or nonspecific immune system and the adaptive or specific immune system. Innate immunity
that is constitutively present and is immediately mobilized upon infection acts as the
first line of defense against invading organisms.
It is non-specific and reacts equally well to a variety of organisms. While the
adaptive immune system acts as a second line of defense, responding specifically and
generating immunological memory. Both innate immunity and adaptive immunity
have humoral response and cell-mediated responses. In the innate immune system,
humoral responses involve cytokines, complement system, coagulation system,
lysozymes and other secreted substances; cell-mediated responses involve a wide
number of cell types, including phagocytes (neutrophils, monocytes/macrophages, and
dendritic cells), natural killer cells (NK cells), basophils, mast cells and eosinophils.
In the adaptive or specific immune system, humoral responses (also called antibody
responses) and cell-mediated responses are carried out by B cells and T cells,
respectively.
PROPERTIES OF EOSINOPHIOPHILIA
Eosinophils are bone marrow derived granulocytes that are abundant in
inflammatory infiltrates of late phase reactions and contribute too many of the
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pathologic processes in allergic diseases.
Eosinophils release granule proteins that are toxic to parasitic organisms and
antigens may injure the normal tissues.
Eosinophils can kill microorganisms by antibody –dependent cell mediated
cytotoxicity (ADCC) with the use of FcERI and perhaps FcR. DURING THIS
PROCESS eosinophils bind to micro-organisms coated with IgE antibody and their
granule contents are released on to microorganisms.
The granule content of eosinophil include lysosome hydrolase found in the
other grnulocytesas well as eosinophil-specific proteins that are particularly toxic to
helminthic organisms, including major basic protein and eosinophil cationic protein.
These 2 cationic and polypeptides have known enzymatic activities and toxic to
bacteria helminthes and normal tissue1.
CLASSIFICATION :
INTRINSIC: The problem inside the eosinophils
EXTRINSIC : The problem outside the eosinophils
AETIOLOGY :

ALLERGIC DISORDERS : Asthma, hay fever, urticaria, allergic rhinitis, food
allergy

IMMUNOLOGIC DISORDERS: Hyper IgE syndrome, wiskott Aldrich
syndrome, graft versus host disease, severe congenital neutropenia.
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
SKIN DISORDERS: Pemphigoid, scabies

PARASITIC
INFESTATION:
Ascariasis,
filiariasis,
echinococcosis,
toxocariasis, amoebiasis, malaria, aspergillosis, toxoplasmosis enterobiasis.,

HEMATOLOGICAL
DISORDERS:
Eosinophilic
leukaemia,
acute
mylogenous leukaemia, Hodgkin’s disease, T-cell lymphoma.

FAMILIAL EOSINOPHILIA : Sometimes eosinophilia is genetic.

IRRADIATION : Post irradiation of abdomen,

INFECTIOUS DISEASES : Bacterial : (TB), leprosy, syphilis, Fungal,
protozoan, viral, arthropod.

OTHERS: Vasculitis, RA, IBS, scleroderma, eosinophilic esophagitis,
eosinophilic lung disease, sarcoidosis, hypersensitivity drug reactions.
GRADES ACCORDING TO ABSOLUTE NUMBER IN CICULATING BLOOD :
Mild Eosinophilia : 400 -500/ cumm
Moderate Eosinophilia : 1500-5000/cumm
Severe eosinophilia : Greater than 5000/cumm
CLINICAL FEATURES :
Worldwide the most common cause of eosinophilia is parasitic infestation &
this remains as an important cause of eosinophilia. The most common 4 causes of
eosinophilia documented in an Italian series of nearly 2000 patients were

Atopy including asthma 79.9%

Parasites 8.2%
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
Hematological Neoplasm 2.4%

Allergic/Atopic skin disease 2.1%.10
Certain features which are associated with eosinophilia are listed below
 Skin allergy
 Cough & frequent cold attack with throat irritation
 Muscle weakness
 Weight loss
 Lymph node enlargement
 Night sweats
 Fever.
GENERAL CONSIDERATIONS TO APPROACH PATENT WITH EOSINOPHILIA:
Given the diversity of medical conditions that may be associated with
increased blood Eosinophilia, the evaluation of such patients must include diverse
medical conditions that may contribute to Eosinophilia. Levels of blood Eosinophilia
are labile, and absolute thresholds for various clinical conditions cannot be
definitively established. In the setting of asthma, eosinophils level are usually less
than 1500/ cumm. In the setting of Churg-Strauss Syndrome (often with asthma),
however, blood eosinophils are greater than 1500/ cumm. However, sustained
elevated levels of blood Eosinophilia should prompt ongoing pursuit of an etiology
for the Eosinophilia and monitoring for organ associated damage.
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HOMOEOPATHIC APPROACH :
Homoeopathy is a holistic system of medicine which is based on law of
similar Homoeopathy “Miasms” are the fundamental cause of sickness. He says
in homoeopathy is the most popular holistic systems of medicine. This is the only way
through which a state of health can be regained.
The aim of homoeopathy is not only to treat eosinophilia but to address its
underlying cause and individual susceptibility. As far as therapeutic medication is
concerned, several remedies are available to treat eosinophilia that can be selected on
the basis of cause, sensation, and modalities of the complaints. Homoeopathic
medicines stimulate the immune power to act against the disease. So homeopathy acts
well in cases of eosinophilia.
There is a special mention about allergic disease in homoeopathy literature
under the heading Idiosinchracy. According our system individual that becomes sick
first. The objective of treatment should be the improvement of the constitution and
also by constitutional approach we can prevent the recurrence of the complaints.
MAIN REMEDIES IN THE CASES OF EOSINOPHILIA:
Some
of
the
remedies
which
are commonly used in treating the
eosinophilia are
Arsalb, acon, allium cepa, cina, bry, Cal carb, Drosera, Cina, Echinacea, phos, Nat-m,
Puls
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6.3 OBJECTIVE OF THE STUDY:
1. To assess the effectiveness of homoeopathic medicines in eosinophilia
2. To evaluate the various factors of eosinophilia
3. To study the various apertures of homoeopathy in eosinophilia
7.
MATERIALS AND METHODS
7.1 SOURCE OF DATA:
The subjects will be selected from OPD, IPD, peripheral centers, and village
camps of Father Muller Homoeopathic Medical College, Mangalore.
7.2 METHOD OF COLLECTION OF DATA:
A sample of minimum of 30 cases will be selected purposive sampling method
as per the inclusion criteria and will be followed for a minimum period of 4-6 months
duration. Every case will be analyzed with reference from Materia Medica, Repertory,
and therapeutics whenever required.
The potency selection and repetition of the doses will be done according to the
demand of the case, with consideration of potency selection criteria such as Acute or
Chronic, Susceptibility, Vitality and Suppression (if any), changes in structural and
functional level and the degree of correspondence to the remedies selected.
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INCLUSION CRITERIA:
1. Children between the age group of 2 to 14years of both sexes will be included
2. Diagnostic criteria is mainly based on clinical presentation, eosinophil
value or absolute eosinophil count
EXCLUSION CRITERIA:
1. Children below2yrs and above14 years of age of both sexes are excluded
2. Children with ADHD, autism, are excluded.
3. Children with chromosomal and congenital abnormalities are excluded.
RESEARCH HYPOTHESIS:
Homoeopathic medicines are effective in the treatment of eosinophilia in
pediatric age group.
NULL HYPOTHESIS:
There is no significant improvement among the cases of eosinophilia in
pediatric age group after homoeopathic treatment...
PLAN FOR DATA ANALYSIS:
The collected data will be analyzed by paired ‘t’ test and data will be
presented in the form of mean standard deviation, the frequency and percentage.
7.3 Does the study require any investigations to be conducted on patients, or
other humans (or animals)? If so please describe briefly.
The diagnosis of eosinophilia is mainly established on the basis of clinical
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presentation and lab investigations. To confirm the enuresis following investigations
should be done. CBC DC TC AEC
7.4 Has ethical clearance been obtained from your institution in case of 7.3?
Yes, enclosed.
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8.
LIST OF REFERENCES:
1.
Abbas K abdul , Litchman H.Andrew , Cellular and Molecular immunology . 5th
edition. Pg 444,437, 314, 449, 204,254
2.
Thomas jones .Mackie & james elvins McCartney, Practical Medical
Microbiology. 14th edition.
3.
http://en.wikipedia.org/wiki/eosinophilia Accessed on 16-10-2013
4.
www.ncbi.nlm.nih.gov.pubmed.eosinophilia Accessed on 16-10-2013
5.
http://www.aaaai.org . Accessed on 16-10-2013
6.
www.mdhil.com.Accessed on 16-10-2013
7.
http://www.homeopathy world community.com Accessed on 16-10-2023
8.
Kumar Vinay, Abbas K Abdul, Fausto Nelson, Robins & Cotran, pathologic
basis of disease 8th edition ,pg 72, 200,395, 780, 632, 704
9.
Kindt J.Thomas , Osborne A. Barbara, Goldslay A. Richard , Kuby ,
immunology 6th edition . pg 383, 37, 38.
10. http://.icid.salisbury.nhs.uk/Clinical
Management/Haemotology/Pages/Eosinophilia-c...on 2-6-2013.
11. Robert , owen, Ian, Paediatric Hemotology and oncology 3rd edition. Pg 235,
236, 242, 606 607..
12. Denis & Robert, Blood diseases of infancy & Childhood 6th edition.
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9.
SIGNATURE OF THE
CANDIDATE
10.
REMARKS OF THE GUIDE
11.
11.1 NAME AND
DR.GURUPRASAD. M N
DESIGNATION OF THE
B. H.M S, MD (HOM)
GUIDE (IN BLOCK LETTERS)
PROFESSOR, DEPT. OF MATERIA MEDICA
FATHER MULLER HOMOEOPATHIC
MEDICAL COLLEGE & HOSPITAL,
DERALAKATTE, MANGALORE.
11.2 SIGNATURE
11.3 CO-GUIDE (IF ANY)
11.4 SIGNATURE
11.5 HEAD OF THE
DR.JYOSHNA S.B.H.M.S,M.D (HOM),
DEPARTMENT
PROFESSOR,DEPT OFPEDIATRICS,
FATHER MULLER HOMOEOPATHIC
MEDICAL COLLEGE& HOSPITAL,
DERALAKATTE, MANGALORE.
11.6 SIGNATURE
12.
12.1 REMARKS OF THE
CHAIRMAN & PRINCIPAL
12.2 SIGNATURE
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