Study The Utility Of Repertory Of The Homoeopathic Therapeutics Of Diarrhoea By Dr James B Bell In The Management Of Acute Watery Diarrhoea In Adults An Experimental Non-Controlled Study

1A40.Z - Acute watery diarrhoea.

Diarrhoea is an alteration in normal bowel movement, characterized by increased frequency, volume, and water content of stools. It is clinically defined as an increase in stool frequency to three or more liquid or semi-formed motions in 24 hours or more. Acute diarrhoea is defined as diarrhoea of 14 days duration or less.

Diarrhoea is loosely defined as passage of abnormally liquid or unformed stools at an increased frequency. Diarrhoea may be further defined as acute if <2 weeks, persistent if 2–4 weeks, and chronic if >4 weeks in duration.

Acute watery diarrhoea is a manifestation under "Gastrointestinal Disorders".

Causes of acute diarrhoea are mostly bacterial, viral, and parasitic infection. The route of transmission of infection is through faeco-oral route, or via eating or drinking contaminated food. Poverty and poor environmental hygiene may also contribute to infection. Acute diarrhoea may last for 7-14 days, if it occurs for more than 14days, it is called persistent diarrhoea. Diarrhoea may lead to dehydration in the body as the body tries to maintain its fluid and electrolyte balance for proper functioning but when the loss is more, the body gets dehydrated.

  |ACUTE WATERY DIARRHOEA.

Diarrhoea is an alteration in normal bowel movement, characterized by increased frequency, volume, and water content of stools. It is clinically defined as an increase in stool frequency to three or more liquid or semi-formed motions in 24 hours or more. Acute diarrhoea is defined as diarrhoea of 14 days duration or less.[2]

Diarrhoea is loosely defined as passage of abnormally liquid or unformed stools at an increased frequency. Diarrhoea may be further defined as acute if <2 weeks, persistent if 2–4 weeks, and chronic if >4 weeks in duration.[3]

OBJECTIVES.

1. To study the utility of repertory of The Homoeopathic Therapeutics of Diarrhoea by James B Bell in the management of Acute watery diarrhoea among adults.

2.  Comparison of pre and post treatment score based on pre-validated 4 point Likert scale for acute Diarrhoea.

3.  To study the rubrics related to diarrhoea from The Homoeopathic Therapeutics of Diarrhoea By James B Bell.

4. To study the etiology and pathophysiology of acute watery diarhhoea.

METHODOLOGY.

I) STUDY DESIGN: An Experimental Non-Controlled Study

2) STUDY SETTING: Cases will be collected from the OPD of the Institute.

3) STUDY POPULATION: Clinically diagnosed cases of Acute watery diarrhoea among adults.

4) DURATION OF STUDY: 18 months.

 5) METHODS OF SELECTION OF STUDY SUBJECT:

1. Inclusion Criteria:

Patients having Acute diarrhoea for less than 14days

Patients of age group 18-40 years

Patients of all genders

Patients with mild dehydration

2. Exclusion Criteria:

Suspected immunocompromised patients

Patients taking any medications that have confounding effect

Pregnant and lactating female

Patients with moderate and severe dehydration

Patients presenting with symptoms of any other diseases

3. Subject withdrawal criteria:

a. Patients who does not wish to continue the treatment.

b. Patients who do not give follow up regularly.

6) METHOD OF SELECTION OF COMPARISON OR CONTROL GROUP AND MATCHING CRITERIA: Not Applicable

7) OPERATIONAL DEFINITION:

Diarrhoea-  Diarrhoea is an alteration in normal bowel movement, characterized by increased frequency, volume, and water content of stools. It is clinically defined as an increase in stool frequency to three or more liquid or semi-formed motions in 24 hours or more. Acute diarrhoea is defined as diarrhoea of 14 days duration or less

Diarrhea is loosely defined as passage of abnormally liquid or unformed stools at an increased frequency.  Diarrhea may be further defined as acute if <2 weeks, persistent if 2–4 weeks, and chronic if >4 weeks in duration

4 Point Likert scales used to assess symptoms of acute diarrhoea.

Symptom score

0

1

3

3

|General well being

Good

Impaired

Bad

Very bad

|Stool frequency

<  2

3-5

6-8

9

|Stool consistency

Hard or normal

Somewhat loose

Runny

Watery

|Blood or mucus in stool

None

Some

Moderate

Many

|Flatulence

Absent

Mild

Moderate

Severe

|Pain intensity

Absent

Mild

Moderate

Severe

|Pain persistency

Absent

Sporadic

Prolonged with relief after defecation

Persistant

|Nausea and/or vomiting

Absent

Mild

Moderate

Severe

 3. Outcome assessment criteria

A. An overall mean total symptom score will be calculated including all subgroups which is as follows:

Unsatisfactory= 1

Satisfactory =2

Good = 3

Very Good= 4

B. Outcome Pre and Post treatment will be assessed according to  4 Point Likert scale for     acute diarrhoea

Improved

Not improved

These criteria will be assessed as per the clinical symptoms presented by the patient.

SAMPLE SIZE:  30 subjects will be selected.

DATA MANAGEMENT AND ANALYSIS PROCEDURE:

1. Framing of totality of symptoms- Will be done as per the principles of Homoeopathy.

2. Selection of remedy- Individualized Homoeopathic Medicines based on totality of symptoms.

3. The Posology- Appropriate potency will be selected based on the susceptibility of each case. Potency will be changed when required.

4. Duration of study – 18 months

5. Duration of each case –   Each case will be observed for 15 days or till improvement appeared as per decided scale.

6. Duration of follow up of each case – Every 7 days and early if required.