A Comparative Study To Determine Bells Diarrhoea And Boericke Repertory Effectiveness in Acute Gastroenterities

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.