Background and Introduction
Otitis media is inflammation of the middle ear. It occurs in the area between the tympanic membrane and the inner ear, including a duct known as the eustachian tube. It is one of the two categories of ear inflammation that can underlie what is commonly called an earache, the other being otitis externa. Diseases other than ear infections can also cause ear pain, including cancers of any structure that shares nerve supply with the ear and shingles which can lead to herpes zoster oticus. Acute otitis media is a very common illness in infants and toddlers. When physicians are faced with a crying, fretful child who seems to have a sore ear their first reaction is almost certainly to diagnose acute otitis media. This is often reinforced by the thought that otitis media is a difficult diagnosis to exclude. In children with an upper respiratory tract infection eustachian tube function and oedema commonly give rise to negative pressure in the middle ear or the production of non-infected exudate, or both. The other main otological cause is myringitis, which is thought to be due to a viral infection and gives rise to a red ear without a middle ear exudate. Children with an upper respiratory tract infection commonly also have pain referred to the ear from a sore throat. In addition, teething is a well known cause of fretfulness in infants and is often associated with otalgia. When the middle ear becomes acutely infected, pressure builds up behind the eardrum, frequently causing intense pain. A major risk factor for developing otitis media is Eustachian tube dysfunction, which leads to the ineffective clearing of bacteria from the middle ear. Children younger than seven are much more prone to otitis media due to shorter Eustachian tubes, which are at a more horizontal angle than in the adult ear. Acute otitis media is usually diagnosed via visualization of the tympanic membrane in combination with the appropriate clinical history.
Acute bacterial otitis media can cause pain that leads to sleepless nights for both children and parents, can cause eardrum perforations, not all of which heal, and can spread to cause mastoiditis and/or meningitis, brain abscess, and even cause death if a severe infection goes untreated. Children with recurrent episodes of acute otitis media and those suffering from otitis media with effusion or chronic otitis media, have higher risks of developing conductive and sensorineural hearing loss. In acute disease, a well chosen homeopathic remedy usually acts quickly, sometimes within minutes, or within a few hours. Therefore, if one succeeds to find the right remedy, it is not unrealistic to postulate a time limit of few hours for a considerable amelioration. The major problem in the homeopathic treatment of Acute Otitis Media is the usually very acute onset of symptoms. Because of the intolerable pain patients are brought to the doctor very quickly. This leaves little space for an accurate observation of the changes the patient goes through, and thus often makes it necessary to choose a remedy on the basis of only a few symptoms. Secondly whether the risk of complications with homeopathic treatment differs from that of conventional treatment. Also of further interest was the spectrum of homeopathic remedies and the cost effectiveness of homeopathy as compared to conventional treatment.
Homoeopathy is a system of medicine that treats the entire pattern of physical, emotional, and mental characteristics of an individual. Hence to treat acute disease in children also needs an approach based on cardinal principles of Homoeopathy. This study has been planed to understand the importance and necessity of Homoeopathy in the treatment of acute otitis media in children. Homeopathy has been used historically to treat acute otitis media, but there have been no much methodologically rigorous trials to determine whether there is really a positive treatment effect.
Aims and Objectives of the study
- To ascertain the efficacy of Homoeopathic remedies in the treatment of acute Otitis media with intense Otalgia in children.
- To evolve an understanding of Homoeopathic remedies from the source books in the treatment of acute otitis media with intense otalgia in children.
In order to study efficacy of homoeopathy in the treatment of acute otits media with intense otalgia in children a special emphasis was given to the individualisation of every case. Here also it is necessary to consider constitution, temperament mental generals, physical generals, particulars, diathesis, past history, family history, indisposition and susceptibility of every child. The selection of the homeopathic remedy requires 5 to 10 minutes more time than conventional medicine. Overwhelmed by an unceasing flood of children cases, I struggled to find the similumum with tools that were inadequate to the task. In acute otitis media, the symptoms take a quick evolutionary course and it is easy for the physician to ascertain the complete picture of the disease. According to Hahnemann, the totality of symptoms in a case means a group of related symptoms not expressing the disease so much as expressing the individual who suffers.
Research Methodology
a) Research question and hypothesis
Hypothesis: Null Hypothesis
Research question: Homoeopathic remedies are not beneficial in the management of otalgia with acute otitis media in children as compared to conventional therapy.
b) Study setting: Clinical study with randomized single blind drug evaluation method of research was carried out.
c) Study duration: The diagnosed cases of acute otitis media with otilgia were considered and followed up completely till relief/cure for a period of minimum one week in an individual case. And total duration of research was of minimum one year.
d) Study design (Type of Study): A prospective study based on simple randomized clinical trial was designed.
e) Sample size and selection of sample: Sample Size: Small sample of 60 cases formed the basis of research. Selection of sample: The simple random sampling procedure was adopted on the basis of inclusion and exclusion criteria. Children of various age group from 0 to 15, both sexes, and socio-economic classes were considered.
f) Inclusion / Exclusion Criteria: Inclusion Criteria: Children with acute complaints of both sexes, within age group of 0 to 15 of different socio economic classes, different life style & places, different habits which exhibits signs and symptoms indicative of acute otits media & otalgia were considered.
Exclusion Criteria: Patients suffering with complications of otitis media & those suffering with other systemic diseases were not considered.
g) Selection of tools: The tools were selected as per guidelines prescribed for standard research projects and all rules were followed while selection of tools required for the study. Theoretical study was thoroughly studied from various books, websites, journals, software’s, etc.
h) Data collection: Clinical data was collected through history taking of approached cases in a standard case record. The history in relation to preliminary, present, past, family, personal, mental, other general as well as particular history was noted. And also clinical data includes physical examination including local examination.
i) Statistical techniques: The data obtained from the observations after treatment was statistically analysed and interpreted for drawing the statistical inference with the tables.
j) Data analysis: The related theoretical and clinical data from different sources was collected and analysed to research standard as per different methods of analysis and type of data.
k) Outcome Assessment Criteria: It was mainly based on presence or absence of signs & symptoms. And for assessment of result following indices were considered:
- Cured: i.e. complete disappearance of signs and symptoms.
- Uncured: i.e. no much improvement of signs and symptoms.
l) Expected Outcome & It’s Usefulness: The available Homoeopathic literature of Homoeopathic remedies give details of its pathogenesis and action in the cases of acute otitis media & otalgia in children. This systematic study has once again proved its usefulness in greater depth.
Discussion
In Homoeopathy we only stimulate the patient to cure himself. Our medicine provides only the stimulus and only the right stimulus will help to stimulate. The children of age group 0 to 15 years possesses low immunity and hence they are highly susceptible for diseases including acute otitis media. Normal susceptibility is essential for the maintenance of continued health and deviation from normal susceptibility leads to development of disease. Hence restoration of normal susceptibility is the basis of cure. All the physiological and pathological functions depend on the basic quality of life. Any change in the normal susceptibility will interfere with the capacity of pre-determined response and this interference will be reflected in a chain response which ultimately leads to a loss of balance as evidence by the development of acute otits media. It is therefore necessary to understand the level of susceptibility in a child before proceeding with the treatment.
In acute disease, a well chosen homeopathic remedy usually acts quickly, sometimes within minutes, or within a few hours. Therefore, if one succeeds to find the right remedy, it is not unrealistic to postulate a time limit of few hours for a considerable amelioration. The major problem in the homeopathic treatment of Acute Otitis Media is the usually very acute onset of symptoms. Because of the intolerable pain patients are brought to the doctor very quickly, this makes difficult for an accurate observation of the changes the patient goes through, and thus often makes it necessary to choose a remedy on the basis of only a few symptoms. Proper hygienic and dietetic measures must be taken before administration of remedial drugs which are used as specific stimuli to rouse the vital force to react against the morbific agents and overcome their noxious influences. The instinctive desires of the body with regard to food and drink should be allowed to be satisfied by the physician and the patient’s attendants. These bodily instincts crave for things that would give palliative relief. The temperature of the room and heat or coolness of bed covering must also be adjusted according to the patient’s wish and comfort. Lastly it has been noted that, consideration of all the above information is mandatory while treating the acute otitis media in children and then only it becomes right homoeopathic approach towards the same.
However, with this study, we are able to demonstrate that homoeopathy may provide a good alternative to the conventional treatment of otitis media. But homoeopathy can be successfully applied in most cases at least, thus avoiding those forms of medication which have a large number of known adverse side effects. Under homoeopathic treatment, therapy is shorter and improvement is more favorable. This contrasts with the popular concept that homoeopathy is particularly slow in acting.
Observations
On the basis of the results achieved in this study the following information has been gathered and put into frequency distribution tables for further analysis as below:
| Age Of Patients In Years | Frequency Of Cases Distribution | Percentage % |
| 00- 03 | 22 | 36.66% |
| 03 – 06 | 20 | 33.33% |
| 06 – 09 | 12 | 20.00% |
| 09 – 12 | 04 | 06.66% |
| 12 – 15 | 02 | 03.33% |
Thus it can be seen that lower age group children are more attacked by the acute otitis media. A similar analysis of the study for sex distribution reveals an almost equal distribution between both sexes. This again coincides with the general prevalence of acute disease in the world over as elaborated in the literature.
| Sex | Frequency Of Cases Distribution |
Percentage%
|
| Male | 35 | 58.33% |
| Female | 25 | 41.66% |
The 60 clinical cases and their response to the indicated remedy can be summarized as follows:
| Response To Treatment | Frequency Of Cases | Percentage % |
| Cured | 56 | 93.33% |
| Uncured | 04 | 06.66% |
On the basis of the totality of symptoms acute otitis media in children shows the following frequency on the corresponding indicated remedies. A review of the remedy indicated and used through the study shows the following:
| Remedy | Frequency |
| Pulsatilla | 11 |
| Belladonna | 10 |
| Sulphur | 05 |
| Phosphorus | 03 |
| Calcium carb. | 03 |
| Ferrum phos | 02 |
| Bryonia | 02 |
| Mercurius sol. | 02 |
| Lycopodium | 02 |
| Aconite nap. | 02 |
| Chamomilla | 02 |
| Silicea | 02 |
| Capsicum | 01 |
| Kali bich. | 01 |
| Apis mel | 01 |
| Rhus tox. | 01 |
| China | 01 |
| Arsenicum alb. | 01 |
| Hepar sulph. | 01 |
| Nux vom | 01 |
| Aurum met | 01 |
| Lachesis | 01z |
| Kalium-mur. | 01 |
| Natrum-mur. | 01 |
| Conium | 01 |
| Kalium-carb. | 01 |
It can be seen through the above table that Pulsatilla and Belladonna were the most frequently indicated remedies in the acute otitis media in children.
A further study of the 60 clinical cases with regards to the duration of treatment and the time period for which follow up was carried out shows the following:
It was observed that within a week most of the cases responded to homeopathic medicines.
Result
The clinical study of efficacy of homoeopathy in Treatment of Acute otitis Media with Intense otalgia in children as seen through the study of 60 clinical cases shows the
following results in the table below.
The table-X shows that 56 cases recovered and its percentage is 93.33 %. There were no drop outs from the study. And 04 cases not recovered and its percentage is 06.66 %. Thus we may conclude that homeopathy works instantly in all acute otitis media of infants and children aged 0-15 years. The acute otitis media are more prevalent in younger kids as they are highly susceptible with anatomical drawbacks and an equal prevalence of acute otitis media in both sexes. The efficiency of homeopathy in the treatment of acute otitis media with intense otalgia in children is excellent and shows high success rate of fifty six out of sixty patients responding successfully to the treatment with no signs of recurrence in near future. There were no complications in the 60 patients seen in this study.
Conclusion
After going through the observations and results it is concluded that the acute otitits media in children can be treated successfully by Homoeopathy. All that is required in the treatment of acute otitis media in children is quick selection of right remedy and right dose for the instant relief of otalgia is in order to cure otitis media rationally. In children, the disease forces are more pronounced and clear than those in adults.
From the review of literature on acute otitis media in children, remedies were studied. And the application of above knowledge helped me a lot in order to achieve my aim of in Efficacy of Homoeopathy in Treatment of Acute Otitis Media with Intense Otalgia in Children.
Summary
The results suggest that there is a positive treatment effect of homeopathy in acute otitis media in children and that a larger study is further justified. My research has various sections which has been formed to make it easy to understand and to work on it further more. The aims and objectives which I had planned in the beginning of my study have been achieved.
| DURATION OF TREATMENT & FOLLOW U3P (IN DAYS) | FREQUENCY OF CASES |
Percentage
%
|
| 1 -04 | 03 | 05.00% |
| 1-05 | 09 | 15.00% |
| 1-06 | 13 | 21.66% |
| 1-07 | 09 | 15.00% |
| 1 – 08 | 08 | 13.33% |
| 1 – 09 | 06 | 10.00% |
| 1-10 | 05 | 08.33% |
| 1-11 | 03 | 05.00% |
| More than 12 days | 04 | 06.66% |
The later part which mainly relates to my clinical work which consists of 60 clinical cases of acute otitis media in children which are arranged in a very ideal way. In the case taking of patient the main intention was kept in receiving the case easefully and it was not just taking the case for the purpose of this study alone. Such results are possible only with the tools of homoeopathy as it is the rational science. The work of my research is based on a topic which in it self is a common and important one.
It is essential to first study the normality before proceeding to comprehend the abnormal. This work in the child domain needs an approach to acute otitis media that leads to further reduction in the use of conventional therapy without making children suffer unnecessarily.
Bibliography
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Allen, H C 1999, Allen’s Keynotes, 9thedn, BJain Publishers, New Delhi.
Allen, T F 2004, Boenninghausen’s Therapeutic Pocket Book, 1stedn, BJain Publishers,New Delhi.
Betarrnan, R E 2011, Nelson Textbook of Pediatrics, 19th edition, W.B. Saunders Company, London.
Bhargava, K B 2002, A short textbook of ENT diseases, 6thedn, Usha Publications, Mumbai.
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Boger, C M 2007, A Synoptic key to the Materia Medica, 1thedn, BJain Publishers, New Delhi.
Clarke, J 2003, A Dictionary of Practical Materia Medica, 1thedn, BJain Publishers, New Delhi.
Clarke, J H 2006, The Bedside Prescriber, 3rdedn, BJain Publishers, New Delhi.
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Background and Introduction
Otitis media is inflammation of the middle ear. It occurs in the area between the tympanic membrane and the inner ear, including a duct known as the eustachian tube. It is one of the two categories of ear inflammation that can underlie what is commonly called an earache, the other being otitis externa. Diseases other than ear infections can also cause ear pain, including cancers of any structure that shares nerve supply with the ear and shingles which can lead to herpes zoster oticus. Acute otitis media is a very common illness in infants and toddlers. When physicians are faced with a crying, fretful child who seems to have a sore ear their first reaction is almost certainly to diagnose acute otitis media. This is often reinforced by the thought that otitis media is a difficult diagnosis to exclude. In children with an upper respiratory tract infection eustachian tube function and oedema commonly give rise to negative pressure in the middle ear or the production of non-infected exudate, or both. The other main otological cause is myringitis, which is thought to be due to a viral infection and gives rise to a red ear without a middle ear exudate. Children with an upper respiratory tract infection commonly also have pain referred to the ear from a sore throat. In addition, teething is a well known cause of fretfulness in infants and is often associated with otalgia. When the middle ear becomes acutely infected, pressure builds up behind the eardrum, frequently causing intense pain. A major risk factor for developing otitis media is Eustachian tube dysfunction, which leads to the ineffective clearing of bacteria from the middle ear. Children younger than seven are much more prone to otitis media due to shorter Eustachian tubes, which are at a more horizontal angle than in the adult ear. Acute otitis media is usually diagnosed via visualization of the tympanic membrane in combination with the appropriate clinical history.
Acute bacterial otitis media can cause pain that leads to sleepless nights for both children and parents, can cause eardrum perforations, not all of which heal, and can spread to cause mastoiditis and/or meningitis, brain abscess, and even cause death if a severe infection goes untreated. Children with recurrent episodes of acute otitis media and those suffering from otitis media with effusion or chronic otitis media, have higher risks of developing conductive and sensorineural hearing loss. In acute disease, a well chosen homeopathic remedy usually acts quickly, sometimes within minutes, or within a few hours. Therefore, if one succeeds to find the right remedy, it is not unrealistic to postulate a time limit of few hours for a considerable amelioration. The major problem in the homeopathic treatment of Acute Otitis Media is the usually very acute onset of symptoms. Because of the intolerable pain patients are brought to the doctor very quickly. This leaves little space for an accurate observation of the changes the patient goes through, and thus often makes it necessary to choose a remedy on the basis of only a few symptoms. Secondly whether the risk of complications with homeopathic treatment differs from that of conventional treatment. Also of further interest was the spectrum of homeopathic remedies and the cost effectiveness of homeopathy as compared to conventional treatment.
Homoeopathy is a system of medicine that treats the entire pattern of physical, emotional, and mental characteristics of an individual. Hence to treat acute disease in children also needs an approach based on cardinal principles of Homoeopathy. This study has been planed to understand the importance and necessity of Homoeopathy in the treatment of acute otitis media in children. Homeopathy has been used historically to treat acute otitis media, but there have been no much methodologically rigorous trials to determine whether there is really a positive treatment effect.
Aims and Objectives of the study
- To ascertain the efficacy of Homoeopathic remedies in the treatment of acute Otitis media with intense Otalgia in children.
- To evolve an understanding of Homoeopathic remedies from the source books in the treatment of acute otitis media with intense otalgia in children.
In order to study efficacy of homoeopathy in the treatment of acute otits media with intense otalgia in children a special emphasis was given to the individualisation of every case. Here also it is necessary to consider constitution, temperament mental generals, physical generals, particulars, diathesis, past history, family history, indisposition and susceptibility of every child. The selection of the homeopathic remedy requires 5 to 10 minutes more time than conventional medicine. Overwhelmed by an unceasing flood of children cases, I struggled to find the similumum with tools that were inadequate to the task. In acute otitis media, the symptoms take a quick evolutionary course and it is easy for the physician to ascertain the complete picture of the disease. According to Hahnemann, the totality of symptoms in a case means a group of related symptoms not expressing the disease so much as expressing the individual who suffers.
Research Methodology
a) Research question and hypothesis
Hypothesis: Null Hypothesis
Research question: Homoeopathic remedies are not beneficial in the management of otalgia with acute otitis media in children as compared to conventional therapy.
b) Study setting: Clinical study with randomized single blind drug evaluation method of research was carried out.
c) Study duration: The diagnosed cases of acute otitis media with otilgia were considered and followed up completely till relief/cure for a period of minimum one week in an individual case. And total duration of research was of minimum one year.
d) Study design (Type of Study): A prospective study based on simple randomized clinical trial was designed.
e) Sample size and selection of sample: Sample Size: Small sample of 60 cases formed the basis of research. Selection of sample: The simple random sampling procedure was adopted on the basis of inclusion and exclusion criteria. Children of various age group from 0 to 15, both sexes, and socio-economic classes were considered.
f) Inclusion / Exclusion Criteria: Inclusion Criteria: Children with acute complaints of both sexes, within age group of 0 to 15 of different socio economic classes, different life style & places, different habits which exhibits signs and symptoms indicative of acute otits media & otalgia were considered.
Exclusion Criteria: Patients suffering with complications of otitis media & those suffering with other systemic diseases were not considered.
g) Selection of tools: The tools were selected as per guidelines prescribed for standard research projects and all rules were followed while selection of tools required for the study. Theoretical study was thoroughly studied from various books, websites, journals, software’s, etc.
h) Data collection: Clinical data was collected through history taking of approached cases in a standard case record. The history in relation to preliminary, present, past, family, personal, mental, other general as well as particular history was noted. And also clinical data includes physical examination including local examination.
i) Statistical techniques: The data obtained from the observations after treatment was statistically analysed and interpreted for drawing the statistical inference with the tables.
j) Data analysis: The related theoretical and clinical data from different sources was collected and analysed to research standard as per different methods of analysis and type of data.
k) Outcome Assessment Criteria: It was mainly based on presence or absence of signs & symptoms. And for assessment of result following indices were considered:
- Cured: i.e. complete disappearance of signs and symptoms.
- Uncured: i.e. no much improvement of signs and symptoms.
l) Expected Outcome & It’s Usefulness: The available Homoeopathic literature of Homoeopathic remedies give details of its pathogenesis and action in the cases of acute otitis media & otalgia in children. This systematic study has once again proved its usefulness in greater depth.
Discussion
In Homoeopathy we only stimulate the patient to cure himself. Our medicine provides only the stimulus and only the right stimulus will help to stimulate. The children of age group 0 to 15 years possesses low immunity and hence they are highly susceptible for diseases including acute otitis media. Normal susceptibility is essential for the maintenance of continued health and deviation from normal susceptibility leads to development of disease. Hence restoration of normal susceptibility is the basis of cure. All the physiological and pathological functions depend on the basic quality of life. Any change in the normal susceptibility will interfere with the capacity of pre-determined response and this interference will be reflected in a chain response which ultimately leads to a loss of balance as evidence by the development of acute otits media. It is therefore necessary to understand the level of susceptibility in a child before proceeding with the treatment.
In acute disease, a well chosen homeopathic remedy usually acts quickly, sometimes within minutes, or within a few hours. Therefore, if one succeeds to find the right remedy, it is not unrealistic to postulate a time limit of few hours for a considerable amelioration. The major problem in the homeopathic treatment of Acute Otitis Media is the usually very acute onset of symptoms. Because of the intolerable pain patients are brought to the doctor very quickly, this makes difficult for an accurate observation of the changes the patient goes through, and thus often makes it necessary to choose a remedy on the basis of only a few symptoms. Proper hygienic and dietetic measures must be taken before administration of remedial drugs which are used as specific stimuli to rouse the vital force to react against the morbific agents and overcome their noxious influences. The instinctive desires of the body with regard to food and drink should be allowed to be satisfied by the physician and the patient’s attendants. These bodily instincts crave for things that would give palliative relief. The temperature of the room and heat or coolness of bed covering must also be adjusted according to the patient’s wish and comfort. Lastly it has been noted that, consideration of all the above information is mandatory while treating the acute otitis media in children and then only it becomes right homoeopathic approach towards the same.
However, with this study, we are able to demonstrate that homoeopathy may provide a good alternative to the conventional treatment of otitis media. But homoeopathy can be successfully applied in most cases at least, thus avoiding those forms of medication which have a large number of known adverse side effects. Under homoeopathic treatment, therapy is shorter and improvement is more favorable. This contrasts with the popular concept that homoeopathy is particularly slow in acting.
Observations
On the basis of the results achieved in this study the following information has been gathered and put into frequency distribution tables for further analysis as below:
| Age Of Patients In Years | Frequency Of Cases Distribution | Percentage % |
| 00- 03 | 22 | 36.66% |
| 03 – 06 | 20 | 33.33% |
| 06 – 09 | 12 | 20.00% |
| 09 – 12 | 04 | 06.66% |
| 12 – 15 | 02 | 03.33% |
Thus it can be seen that lower age group children are more attacked by the acute otitis media. A similar analysis of the study for sex distribution reveals an almost equal distribution between both sexes. This again coincides with the general prevalence of acute disease in the world over as elaborated in the literature.
| Sex | Frequency Of Cases Distribution |
Percentage%
|
| Male | 35 | 58.33% |
| Female | 25 | 41.66% |
The 60 clinical cases and their response to the indicated remedy can be summarized as follows:
| Response To Treatment | Frequency Of Cases | Percentage % |
| Cured | 56 | 93.33% |
| Uncured | 04 | 06.66% |
On the basis of the totality of symptoms acute otitis media in children shows the following frequency on the corresponding indicated remedies. A review of the remedy indicated and used through the study shows the following:
| Remedy | Frequency |
| Pulsatilla | 11 |
| Belladonna | 10 |
| Sulphur | 05 |
| Phosphorus | 03 |
| Calcium carb. | 03 |
| Ferrum phos | 02 |
| Bryonia | 02 |
| Mercurius sol. | 02 |
| Lycopodium | 02 |
| Aconite nap. | 02 |
| Chamomilla | 02 |
| Silicea | 02 |
| Capsicum | 01 |
| Kali bich. | 01 |
| Apis mel | 01 |
| Rhus tox. | 01 |
| China | 01 |
| Arsenicum alb. | 01 |
| Hepar sulph. | 01 |
| Nux vom | 01 |
| Aurum met | 01 |
| Lachesis | 01z |
| Kalium-mur. | 01 |
| Natrum-mur. | 01 |
| Conium | 01 |
| Kalium-carb. | 01 |
It can be seen through the above table that Pulsatilla and Belladonna were the most frequently indicated remedies in the acute otitis media in children.
A further study of the 60 clinical cases with regards to the duration of treatment and the time period for which follow up was carried out shows the following:
It was observed that within a week most of the cases responded to homeopathic medicines.
Result
The clinical study of efficacy of homoeopathy in Treatment of Acute otitis Media with Intense otalgia in children as seen through the study of 60 clinical cases shows the
following results in the table below.
The table-X shows that 56 cases recovered and its percentage is 93.33 %. There were no drop outs from the study. And 04 cases not recovered and its percentage is 06.66 %. Thus we may conclude that homeopathy works instantly in all acute otitis media of infants and children aged 0-15 years. The acute otitis media are more prevalent in younger kids as they are highly susceptible with anatomical drawbacks and an equal prevalence of acute otitis media in both sexes. The efficiency of homeopathy in the treatment of acute otitis media with intense otalgia in children is excellent and shows high success rate of fifty six out of sixty patients responding successfully to the treatment with no signs of recurrence in near future. There were no complications in the 60 patients seen in this study.
Conclusion
After going through the observations and results it is concluded that the acute otitits media in children can be treated successfully by Homoeopathy. All that is required in the treatment of acute otitis media in children is quick selection of right remedy and right dose for the instant relief of otalgia is in order to cure otitis media rationally. In children, the disease forces are more pronounced and clear than those in adults.
From the review of literature on acute otitis media in children, remedies were studied. And the application of above knowledge helped me a lot in order to achieve my aim of in Efficacy of Homoeopathy in Treatment of Acute Otitis Media with Intense Otalgia in Children.
Summary
The results suggest that there is a positive treatment effect of homeopathy in acute otitis media in children and that a larger study is further justified. My research has various sections which has been formed to make it easy to understand and to work on it further more. The aims and objectives which I had planned in the beginning of my study have been achieved.
| DURATION OF TREATMENT & FOLLOW U3P (IN DAYS) | FREQUENCY OF CASES |
Percentage
%
|
| 1 -04 | 03 | 05.00% |
| 1-05 | 09 | 15.00% |
| 1-06 | 13 | 21.66% |
| 1-07 | 09 | 15.00% |
| 1 – 08 | 08 | 13.33% |
| 1 – 09 | 06 | 10.00% |
| 1-10 | 05 | 08.33% |
| 1-11 | 03 | 05.00% |
| More than 12 days | 04 | 06.66% |
The later part which mainly relates to my clinical work which consists of 60 clinical cases of acute otitis media in children which are arranged in a very ideal way. In the case taking of patient the main intention was kept in receiving the case easefully and it was not just taking the case for the purpose of this study alone. Such results are possible only with the tools of homoeopathy as it is the rational science. The work of my research is based on a topic which in it self is a common and important one.
It is essential to first study the normality before proceeding to comprehend the abnormal. This work in the child domain needs an approach to acute otitis media that leads to further reduction in the use of conventional therapy without making children suffer unnecessarily.
Bibliography
Allen, T F 1997, Encyclopedia of pure Materia Medica, 1thedn, BJain Publishers, New Delhi.
Allen, H C 1999, Allen’s Keynotes, 9thedn, BJain Publishers, New Delhi.
Allen, T F 2004, Boenninghausen’s Therapeutic Pocket Book, 1stedn, BJain Publishers,New Delhi.
Betarrnan, R E 2011, Nelson Textbook of Pediatrics, 19th edition, W.B. Saunders Company, London.
Bhargava, K B 2002, A short textbook of ENT diseases, 6thedn, Usha Publications, Mumbai.
BJain 2002, Homoeopathic case history booklet, 1stedn, BJain Publishers,New Delhi.
Boericke, G 2001, A compend of the principles of Homoeopathy for student in medicine, 1stedn, BJain Publishers,New Delhi.
Boerieke, W 2004, Pocket Manual of Homoeopathic Materia & Repertory, 1thedn, BJain Publishers,New Delhi.
Boerieke, W 2005, Homoeopathic Medical Repertory, 2ndedn, BJain Publishers,New Delhi.
Boger, C M 2004, Boenninghausens Characteristic Materia Medica & Repertory, 1stedn, BJain Publishers,New Delhi.
Boger, C M 2007, A Synoptic key to the Materia Medica, 1thedn, BJain Publishers, New Delhi.
Clarke, J 2003, A Dictionary of Practical Materia Medica, 1thedn, BJain Publishers, New Delhi.
Clarke, J H 2006, The Bedside Prescriber, 3rdedn, BJain Publishers, New Delhi.
Dhawale, M L 2000, Principle & Practice of Homoeopathy, 3rdedn, Institute of Clinical Research Mumbai, Mumbai.
Dudgeon, R E, 2010, The Lesser Writings of Samuel Hahnemann, 1stedn, BJain Publishers, New Delhi.
Dunham, C 2004, Lectures on Materia Medica, BJain Publishers, New Delhi.
Farrington, E A 1995, Lesser Writings with Therapeutic Hints, 1stedn, BJain Publishers, New Delhi.
Farrington, E A 2003, Comparative Materia Medica, BJain Publishers, New Delhi.
Farrington, E A 2004, Clinical Materia Medica, 1stedn, BJain Publishers, New Delhi.
Ghai, O P, Paul, V K et al 2004, Ghai Essential Pediatrics, 6thedn, CBS Publishers, New Delhi.
Herscu, P 2005, The Homoeopathic Treatment of Children, 1stedn, BJain Publishers,New Delhi.
Hahnemann, S 2004, Organon of Medicine, 6thedn, BJain Publishers,New Delhi.
Hahnemann, S 2010, Materia Medica Pura, BJain Publishers, New Delhi.
Hering, C 1997, Guiding symptoms of our Materia Medica, 1thedn, BJain Publishers, New Delhi.
Humaranwala, P 2005, Temperament types a study, 2ndedn, Nina Foundation , Mumbai.
ICR (Pediatric Team) 1999, Pediatrics in Homeopathy, an Approach, 1stedn, Mumbai.
Kamthan, P S 1993, Therapeutic Guide to common disease of intants children & Adult , 1stedn, BJain Publishers,New Delhi.
Kent, J T 2004, Kents lectures on Materia Medica, 1thedn, BJain Publishers, New Delhi.
Kent, J T 2004, Lectures on Homoeopathic Philosophy, 1stedn, BJain Publishers, New Delhi.
Kent, J T 2006, Kent’s Repertory, 1stedn, BJain Publishers,New Delhi.
Lilienthal, S 2000, Homoeopathic Therapeutics, 1stedn, published on 2000 by B. Jain at New Delhi.
Nash, E H 2004, How to take case & to find the simillimum, BJain Publishers, New Delhi.
Rauc, S 1993, Diseases of Children, 1stedn, BJain Publishers,New Delhi.
Roberts, H A 2005, The Principles & Art of Cure, 3rdedn, BJain Publishers, New Delhi.
Sankaran, R1992, The Science of Healing, 1stedn, BJain Publishers, New Delhi.
Santwani, M T 1994, Common Ailments of children & their Homoeopathic Treatment, 1stedn, BJain Publishers, New Delhi.
Sarkar, B K 2006, Organon of Medicine, 1stedn, published on 2006 by Birla at New Delhi.
Stuart, C 1999, Genius of Homoeopathy, 1stedn, BJain Publishers, New Delhi.
Tyler, M L 2010, Homoeopathic Drug Pictures, BJain Publishers, New Delhi.
Vijakar, P 2005, Predictive Homoeopathy, 4thedn, Preeti Publishers, Mumbai.
William, B 1998, The twelve tissue remedies of Schussler, 1stedn, BJain Publishers, New Delhi.
Background and Introduction
Otitis media is inflammation of the middle ear. It occurs in the area between the tympanic membrane and the inner ear, including a duct known as the eustachian tube. It is one of the two categories of ear inflammation that can underlie what is commonly called an earache, the other being otitis externa. Diseases other than ear infections can also cause ear pain, including cancers of any structure that shares nerve supply with the ear and shingles which can lead to herpes zoster oticus. Acute otitis media is a very common illness in infants and toddlers. When physicians are faced with a crying, fretful child who seems to have a sore ear their first reaction is almost certainly to diagnose acute otitis media. This is often reinforced by the thought that otitis media is a difficult diagnosis to exclude. In children with an upper respiratory tract infection eustachian tube function and oedema commonly give rise to negative pressure in the middle ear or the production of non-infected exudate, or both. The other main otological cause is myringitis, which is thought to be due to a viral infection and gives rise to a red ear without a middle ear exudate. Children with an upper respiratory tract infection commonly also have pain referred to the ear from a sore throat. In addition, teething is a well known cause of fretfulness in infants and is often associated with otalgia. When the middle ear becomes acutely infected, pressure builds up behind the eardrum, frequently causing intense pain. A major risk factor for developing otitis media is Eustachian tube dysfunction, which leads to the ineffective clearing of bacteria from the middle ear. Children younger than seven are much more prone to otitis media due to shorter Eustachian tubes, which are at a more horizontal angle than in the adult ear. Acute otitis media is usually diagnosed via visualization of the tympanic membrane in combination with the appropriate clinical history.
Acute bacterial otitis media can cause pain that leads to sleepless nights for both children and parents, can cause eardrum perforations, not all of which heal, and can spread to cause mastoiditis and/or meningitis, brain abscess, and even cause death if a severe infection goes untreated. Children with recurrent episodes of acute otitis media and those suffering from otitis media with effusion or chronic otitis media, have higher risks of developing conductive and sensorineural hearing loss. In acute disease, a well chosen homeopathic remedy usually acts quickly, sometimes within minutes, or within a few hours. Therefore, if one succeeds to find the right remedy, it is not unrealistic to postulate a time limit of few hours for a considerable amelioration. The major problem in the homeopathic treatment of Acute Otitis Media is the usually very acute onset of symptoms. Because of the intolerable pain patients are brought to the doctor very quickly. This leaves little space for an accurate observation of the changes the patient goes through, and thus often makes it necessary to choose a remedy on the basis of only a few symptoms. Secondly whether the risk of complications with homeopathic treatment differs from that of conventional treatment. Also of further interest was the spectrum of homeopathic remedies and the cost effectiveness of homeopathy as compared to conventional treatment.
Homoeopathy is a system of medicine that treats the entire pattern of physical, emotional, and mental characteristics of an individual. Hence to treat acute disease in children also needs an approach based on cardinal principles of Homoeopathy. This study has been planed to understand the importance and necessity of Homoeopathy in the treatment of acute otitis media in children. Homeopathy has been used historically to treat acute otitis media, but there have been no much methodologically rigorous trials to determine whether there is really a positive treatment effect.
Aims and Objectives of the study
- To ascertain the efficacy of Homoeopathic remedies in the treatment of acute Otitis media with intense Otalgia in children.
- To evolve an understanding of Homoeopathic remedies from the source books in the treatment of acute otitis media with intense otalgia in children.
In order to study efficacy of homoeopathy in the treatment of acute otits media with intense otalgia in children a special emphasis was given to the individualisation of every case. Here also it is necessary to consider constitution, temperament mental generals, physical generals, particulars, diathesis, past history, family history, indisposition and susceptibility of every child. The selection of the homeopathic remedy requires 5 to 10 minutes more time than conventional medicine. Overwhelmed by an unceasing flood of children cases, I struggled to find the similumum with tools that were inadequate to the task. In acute otitis media, the symptoms take a quick evolutionary course and it is easy for the physician to ascertain the complete picture of the disease. According to Hahnemann, the totality of symptoms in a case means a group of related symptoms not expressing the disease so much as expressing the individual who suffers.
Research Methodology
a) Research question and hypothesis
Hypothesis: Null Hypothesis
Research question: Homoeopathic remedies are not beneficial in the management of otalgia with acute otitis media in children as compared to conventional therapy.
b) Study setting: Clinical study with randomized single blind drug evaluation method of research was carried out.
c) Study duration: The diagnosed cases of acute otitis media with otilgia were considered and followed up completely till relief/cure for a period of minimum one week in an individual case. And total duration of research was of minimum one year.
d) Study design (Type of Study): A prospective study based on simple randomized clinical trial was designed.
e) Sample size and selection of sample: Sample Size: Small sample of 60 cases formed the basis of research. Selection of sample: The simple random sampling procedure was adopted on the basis of inclusion and exclusion criteria. Children of various age group from 0 to 15, both sexes, and socio-economic classes were considered.
f) Inclusion / Exclusion Criteria: Inclusion Criteria: Children with acute complaints of both sexes, within age group of 0 to 15 of different socio economic classes, different life style & places, different habits which exhibits signs and symptoms indicative of acute otits media & otalgia were considered.
Exclusion Criteria: Patients suffering with complications of otitis media & those suffering with other systemic diseases were not considered.
g) Selection of tools: The tools were selected as per guidelines prescribed for standard research projects and all rules were followed while selection of tools required for the study. Theoretical study was thoroughly studied from various books, websites, journals, software’s, etc.
h) Data collection: Clinical data was collected through history taking of approached cases in a standard case record. The history in relation to preliminary, present, past, family, personal, mental, other general as well as particular history was noted. And also clinical data includes physical examination including local examination.
i) Statistical techniques: The data obtained from the observations after treatment was statistically analysed and interpreted for drawing the statistical inference with the tables.
j) Data analysis: The related theoretical and clinical data from different sources was collected and analysed to research standard as per different methods of analysis and type of data.
k) Outcome Assessment Criteria: It was mainly based on presence or absence of signs & symptoms. And for assessment of result following indices were considered:
- Cured: i.e. complete disappearance of signs and symptoms.
- Uncured: i.e. no much improvement of signs and symptoms.
l) Expected Outcome & It’s Usefulness: The available Homoeopathic literature of Homoeopathic remedies give details of its pathogenesis and action in the cases of acute otitis media & otalgia in children. This systematic study has once again proved its usefulness in greater depth.
Discussion
In Homoeopathy we only stimulate the patient to cure himself. Our medicine provides only the stimulus and only the right stimulus will help to stimulate. The children of age group 0 to 15 years possesses low immunity and hence they are highly susceptible for diseases including acute otitis media. Normal susceptibility is essential for the maintenance of continued health and deviation from normal susceptibility leads to development of disease. Hence restoration of normal susceptibility is the basis of cure. All the physiological and pathological functions depend on the basic quality of life. Any change in the normal susceptibility will interfere with the capacity of pre-determined response and this interference will be reflected in a chain response which ultimately leads to a loss of balance as evidence by the development of acute otits media. It is therefore necessary to understand the level of susceptibility in a child before proceeding with the treatment.
In acute disease, a well chosen homeopathic remedy usually acts quickly, sometimes within minutes, or within a few hours. Therefore, if one succeeds to find the right remedy, it is not unrealistic to postulate a time limit of few hours for a considerable amelioration. The major problem in the homeopathic treatment of Acute Otitis Media is the usually very acute onset of symptoms. Because of the intolerable pain patients are brought to the doctor very quickly, this makes difficult for an accurate observation of the changes the patient goes through, and thus often makes it necessary to choose a remedy on the basis of only a few symptoms. Proper hygienic and dietetic measures must be taken before administration of remedial drugs which are used as specific stimuli to rouse the vital force to react against the morbific agents and overcome their noxious influences. The instinctive desires of the body with regard to food and drink should be allowed to be satisfied by the physician and the patient’s attendants. These bodily instincts crave for things that would give palliative relief. The temperature of the room and heat or coolness of bed covering must also be adjusted according to the patient’s wish and comfort. Lastly it has been noted that, consideration of all the above information is mandatory while treating the acute otitis media in children and then only it becomes right homoeopathic approach towards the same.
However, with this study, we are able to demonstrate that homoeopathy may provide a good alternative to the conventional treatment of otitis media. But homoeopathy can be successfully applied in most cases at least, thus avoiding those forms of medication which have a large number of known adverse side effects. Under homoeopathic treatment, therapy is shorter and improvement is more favorable. This contrasts with the popular concept that homoeopathy is particularly slow in acting.
Observations
On the basis of the results achieved in this study the following information has been gathered and put into frequency distribution tables for further analysis as below:
| Age Of Patients In Years | Frequency Of Cases Distribution | Percentage % |
| 00- 03 | 22 | 36.66% |
| 03 – 06 | 20 | 33.33% |
| 06 – 09 | 12 | 20.00% |
| 09 – 12 | 04 | 06.66% |
| 12 – 15 | 02 | 03.33% |
Thus it can be seen that lower age group children are more attacked by the acute otitis media. A similar analysis of the study for sex distribution reveals an almost equal distribution between both sexes. This again coincides with the general prevalence of acute disease in the world over as elaborated in the literature.
| Sex | Frequency Of Cases Distribution |
Percentage%
|
| Male | 35 | 58.33% |
| Female | 25 | 41.66% |
The 60 clinical cases and their response to the indicated remedy can be summarized as follows:
| Response To Treatment | Frequency Of Cases | Percentage % |
| Cured | 56 | 93.33% |
| Uncured | 04 | 06.66% |
On the basis of the totality of symptoms acute otitis media in children shows the following frequency on the corresponding indicated remedies. A review of the remedy indicated and used through the study shows the following:
| Remedy | Frequency |
| Pulsatilla | 11 |
| Belladonna | 10 |
| Sulphur | 05 |
| Phosphorus | 03 |
| Calcium carb. | 03 |
| Ferrum phos | 02 |
| Bryonia | 02 |
| Mercurius sol. | 02 |
| Lycopodium | 02 |
| Aconite nap. | 02 |
| Chamomilla | 02 |
| Silicea | 02 |
| Capsicum | 01 |
| Kali bich. | 01 |
| Apis mel | 01 |
| Rhus tox. | 01 |
| China | 01 |
| Arsenicum alb. | 01 |
| Hepar sulph. | 01 |
| Nux vom | 01 |
| Aurum met | 01 |
| Lachesis | 01z |
| Kalium-mur. | 01 |
| Natrum-mur. | 01 |
| Conium | 01 |
| Kalium-carb. | 01 |
It can be seen through the above table that Pulsatilla and Belladonna were the most frequently indicated remedies in the acute otitis media in children.
A further study of the 60 clinical cases with regards to the duration of treatment and the time period for which follow up was carried out shows the following:
It was observed that within a week most of the cases responded to homeopathic medicines.
Result
The clinical study of efficacy of homoeopathy in Treatment of Acute otitis Media with Intense otalgia in children as seen through the study of 60 clinical cases shows the
following results in the table below.
The table-X shows that 56 cases recovered and its percentage is 93.33 %. There were no drop outs from the study. And 04 cases not recovered and its percentage is 06.66 %. Thus we may conclude that homeopathy works instantly in all acute otitis media of infants and children aged 0-15 years. The acute otitis media are more prevalent in younger kids as they are highly susceptible with anatomical drawbacks and an equal prevalence of acute otitis media in both sexes. The efficiency of homeopathy in the treatment of acute otitis media with intense otalgia in children is excellent and shows high success rate of fifty six out of sixty patients responding successfully to the treatment with no signs of recurrence in near future. There were no complications in the 60 patients seen in this study.
Conclusion
After going through the observations and results it is concluded that the acute otitits media in children can be treated successfully by Homoeopathy. All that is required in the treatment of acute otitis media in children is quick selection of right remedy and right dose for the instant relief of otalgia is in order to cure otitis media rationally. In children, the disease forces are more pronounced and clear than those in adults.
From the review of literature on acute otitis media in children, remedies were studied. And the application of above knowledge helped me a lot in order to achieve my aim of in Efficacy of Homoeopathy in Treatment of Acute Otitis Media with Intense Otalgia in Children.
Summary
The results suggest that there is a positive treatment effect of homeopathy in acute otitis media in children and that a larger study is further justified. My research has various sections which has been formed to make it easy to understand and to work on it further more. The aims and objectives which I had planned in the beginning of my study have been achieved.
| DURATION OF TREATMENT & FOLLOW U3P (IN DAYS) | FREQUENCY OF CASES |
Percentage
%
|
| 1 -04 | 03 | 05.00% |
| 1-05 | 09 | 15.00% |
| 1-06 | 13 | 21.66% |
| 1-07 | 09 | 15.00% |
| 1 – 08 | 08 | 13.33% |
| 1 – 09 | 06 | 10.00% |
| 1-10 | 05 | 08.33% |
| 1-11 | 03 | 05.00% |
| More than 12 days | 04 | 06.66% |
The later part which mainly relates to my clinical work which consists of 60 clinical cases of acute otitis media in children which are arranged in a very ideal way. In the case taking of patient the main intention was kept in receiving the case easefully and it was not just taking the case for the purpose of this study alone. Such results are possible only with the tools of homoeopathy as it is the rational science. The work of my research is based on a topic which in it self is a common and important one.
It is essential to first study the normality before proceeding to comprehend the abnormal. This work in the child domain needs an approach to acute otitis media that leads to further reduction in the use of conventional therapy without making children suffer unnecessarily.
Bibliography
Allen, T F 1997, Encyclopedia of pure Materia Medica, 1thedn, BJain Publishers, New Delhi.
Allen, H C 1999, Allen’s Keynotes, 9thedn, BJain Publishers, New Delhi.
Allen, T F 2004, Boenninghausen’s Therapeutic Pocket Book, 1stedn, BJain Publishers,New Delhi.
Betarrnan, R E 2011, Nelson Textbook of Pediatrics, 19th edition, W.B. Saunders Company, London.
Bhargava, K B 2002, A short textbook of ENT diseases, 6thedn, Usha Publications, Mumbai.
BJain 2002, Homoeopathic case history booklet, 1stedn, BJain Publishers,New Delhi.
Boericke, G 2001, A compend of the principles of Homoeopathy for student in medicine, 1stedn, BJain Publishers,New Delhi.
Boerieke, W 2004, Pocket Manual of Homoeopathic Materia & Repertory, 1thedn, BJain Publishers,New Delhi.
Boerieke, W 2005, Homoeopathic Medical Repertory, 2ndedn, BJain Publishers,New Delhi.
Boger, C M 2004, Boenninghausens Characteristic Materia Medica & Repertory, 1stedn, BJain Publishers,New Delhi.
Boger, C M 2007, A Synoptic key to the Materia Medica, 1thedn, BJain Publishers, New Delhi.
Clarke, J 2003, A Dictionary of Practical Materia Medica, 1thedn, BJain Publishers, New Delhi.
Clarke, J H 2006, The Bedside Prescriber, 3rdedn, BJain Publishers, New Delhi.
Dhawale, M L 2000, Principle & Practice of Homoeopathy, 3rdedn, Institute of Clinical Research Mumbai, Mumbai.
Dudgeon, R E, 2010, The Lesser Writings of Samuel Hahnemann, 1stedn, BJain Publishers, New Delhi.
Dunham, C 2004, Lectures on Materia Medica, BJain Publishers, New Delhi.
Farrington, E A 1995, Lesser Writings with Therapeutic Hints, 1stedn, BJain Publishers, New Delhi.
Farrington, E A 2003, Comparative Materia Medica, BJain Publishers, New Delhi.
Farrington, E A 2004, Clinical Materia Medica, 1stedn, BJain Publishers, New Delhi.
Ghai, O P, Paul, V K et al 2004, Ghai Essential Pediatrics, 6thedn, CBS Publishers, New Delhi.
Herscu, P 2005, The Homoeopathic Treatment of Children, 1stedn, BJain Publishers,New Delhi.
Hahnemann, S 2004, Organon of Medicine, 6thedn, BJain Publishers,New Delhi.
Hahnemann, S 2010, Materia Medica Pura, BJain Publishers, New Delhi.
Hering, C 1997, Guiding symptoms of our Materia Medica, 1thedn, BJain Publishers, New Delhi.
Humaranwala, P 2005, Temperament types a study, 2ndedn, Nina Foundation , Mumbai.
ICR (Pediatric Team) 1999, Pediatrics in Homeopathy, an Approach, 1stedn, Mumbai.
Kamthan, P S 1993, Therapeutic Guide to common disease of intants children & Adult , 1stedn, BJain Publishers,New Delhi.
Kent, J T 2004, Kents lectures on Materia Medica, 1thedn, BJain Publishers, New Delhi.
Kent, J T 2004, Lectures on Homoeopathic Philosophy, 1stedn, BJain Publishers, New Delhi.
Kent, J T 2006, Kent’s Repertory, 1stedn, BJain Publishers,New Delhi.
Lilienthal, S 2000, Homoeopathic Therapeutics, 1stedn, published on 2000 by B. Jain at New Delhi.
Nash, E H 2004, How to take case & to find the simillimum, BJain Publishers, New Delhi.
Rauc, S 1993, Diseases of Children, 1stedn, BJain Publishers,New Delhi.
Roberts, H A 2005, The Principles & Art of Cure, 3rdedn, BJain Publishers, New Delhi.
Sankaran, R1992, The Science of Healing, 1stedn, BJain Publishers, New Delhi.
Santwani, M T 1994, Common Ailments of children & their Homoeopathic Treatment, 1stedn, BJain Publishers, New Delhi.
Sarkar, B K 2006, Organon of Medicine, 1stedn, published on 2006 by Birla at New Delhi.
Stuart, C 1999, Genius of Homoeopathy, 1stedn, BJain Publishers, New Delhi.
Tyler, M L 2010, Homoeopathic Drug Pictures, BJain Publishers, New Delhi.
Vijakar, P 2005, Predictive Homoeopathy, 4thedn, Preeti Publishers, Mumbai.
William, B 1998, The twelve tissue remedies of Schussler, 1stedn, BJain Publishers, New Delhi.
Background and Introduction
Otitis media is inflammation of the middle ear. It occurs in the area between the tympanic membrane and the inner ear, including a duct known as the eustachian tube. It is one of the two categories of ear inflammation that can underlie what is commonly called an earache, the other being otitis externa. Diseases other than ear infections can also cause ear pain, including cancers of any structure that shares nerve supply with the ear and shingles which can lead to herpes zoster oticus. Acute otitis media is a very common illness in infants and toddlers. When physicians are faced with a crying, fretful child who seems to have a sore ear their first reaction is almost certainly to diagnose acute otitis media. This is often reinforced by the thought that otitis media is a difficult diagnosis to exclude. In children with an upper respiratory tract infection eustachian tube function and oedema commonly give rise to negative pressure in the middle ear or the production of non-infected exudate, or both. The other main otological cause is myringitis, which is thought to be due to a viral infection and gives rise to a red ear without a middle ear exudate. Children with an upper respiratory tract infection commonly also have pain referred to the ear from a sore throat. In addition, teething is a well known cause of fretfulness in infants and is often associated with otalgia. When the middle ear becomes acutely infected, pressure builds up behind the eardrum, frequently causing intense pain. A major risk factor for developing otitis media is Eustachian tube dysfunction, which leads to the ineffective clearing of bacteria from the middle ear. Children younger than seven are much more prone to otitis media due to shorter Eustachian tubes, which are at a more horizontal angle than in the adult ear. Acute otitis media is usually diagnosed via visualization of the tympanic membrane in combination with the appropriate clinical history.
Acute bacterial otitis media can cause pain that leads to sleepless nights for both children and parents, can cause eardrum perforations, not all of which heal, and can spread to cause mastoiditis and/or meningitis, brain abscess, and even cause death if a severe infection goes untreated. Children with recurrent episodes of acute otitis media and those suffering from otitis media with effusion or chronic otitis media, have higher risks of developing conductive and sensorineural hearing loss. In acute disease, a well chosen homeopathic remedy usually acts quickly, sometimes within minutes, or within a few hours. Therefore, if one succeeds to find the right remedy, it is not unrealistic to postulate a time limit of few hours for a considerable amelioration. The major problem in the homeopathic treatment of Acute Otitis Media is the usually very acute onset of symptoms. Because of the intolerable pain patients are brought to the doctor very quickly. This leaves little space for an accurate observation of the changes the patient goes through, and thus often makes it necessary to choose a remedy on the basis of only a few symptoms. Secondly whether the risk of complications with homeopathic treatment differs from that of conventional treatment. Also of further interest was the spectrum of homeopathic remedies and the cost effectiveness of homeopathy as compared to conventional treatment.
Homoeopathy is a system of medicine that treats the entire pattern of physical, emotional, and mental characteristics of an individual. Hence to treat acute disease in children also needs an approach based on cardinal principles of Homoeopathy. This study has been planed to understand the importance and necessity of Homoeopathy in the treatment of acute otitis media in children. Homeopathy has been used historically to treat acute otitis media, but there have been no much methodologically rigorous trials to determine whether there is really a positive treatment effect.
Aims and Objectives of the study
- To ascertain the efficacy of Homoeopathic remedies in the treatment of acute Otitis media with intense Otalgia in children.
- To evolve an understanding of Homoeopathic remedies from the source books in the treatment of acute otitis media with intense otalgia in children.
In order to study efficacy of homoeopathy in the treatment of acute otits media with intense otalgia in children a special emphasis was given to the individualisation of every case. Here also it is necessary to consider constitution, temperament mental generals, physical generals, particulars, diathesis, past history, family history, indisposition and susceptibility of every child. The selection of the homeopathic remedy requires 5 to 10 minutes more time than conventional medicine. Overwhelmed by an unceasing flood of children cases, I struggled to find the similumum with tools that were inadequate to the task. In acute otitis media, the symptoms take a quick evolutionary course and it is easy for the physician to ascertain the complete picture of the disease. According to Hahnemann, the totality of symptoms in a case means a group of related symptoms not expressing the disease so much as expressing the individual who suffers.
Research Methodology
a) Research question and hypothesis
Hypothesis: Null Hypothesis
Research question: Homoeopathic remedies are not beneficial in the management of otalgia with acute otitis media in children as compared to conventional therapy.
b) Study setting: Clinical study with randomized single blind drug evaluation method of research was carried out.
c) Study duration: The diagnosed cases of acute otitis media with otilgia were considered and followed up completely till relief/cure for a period of minimum one week in an individual case. And total duration of research was of minimum one year.
d) Study design (Type of Study): A prospective study based on simple randomized clinical trial was designed.
e) Sample size and selection of sample: Sample Size: Small sample of 60 cases formed the basis of research. Selection of sample: The simple random sampling procedure was adopted on the basis of inclusion and exclusion criteria. Children of various age group from 0 to 15, both sexes, and socio-economic classes were considered.
f) Inclusion / Exclusion Criteria: Inclusion Criteria: Children with acute complaints of both sexes, within age group of 0 to 15 of different socio economic classes, different life style & places, different habits which exhibits signs and symptoms indicative of acute otits media & otalgia were considered.
Exclusion Criteria: Patients suffering with complications of otitis media & those suffering with other systemic diseases were not considered.
g) Selection of tools: The tools were selected as per guidelines prescribed for standard research projects and all rules were followed while selection of tools required for the study. Theoretical study was thoroughly studied from various books, websites, journals, software’s, etc.
h) Data collection: Clinical data was collected through history taking of approached cases in a standard case record. The history in relation to preliminary, present, past, family, personal, mental, other general as well as particular history was noted. And also clinical data includes physical examination including local examination.
i) Statistical techniques: The data obtained from the observations after treatment was statistically analysed and interpreted for drawing the statistical inference with the tables.
j) Data analysis: The related theoretical and clinical data from different sources was collected and analysed to research standard as per different methods of analysis and type of data.
k) Outcome Assessment Criteria: It was mainly based on presence or absence of signs & symptoms. And for assessment of result following indices were considered:
- Cured: i.e. complete disappearance of signs and symptoms.
- Uncured: i.e. no much improvement of signs and symptoms.
l) Expected Outcome & It’s Usefulness: The available Homoeopathic literature of Homoeopathic remedies give details of its pathogenesis and action in the cases of acute otitis media & otalgia in children. This systematic study has once again proved its usefulness in greater depth.
Discussion
In Homoeopathy we only stimulate the patient to cure himself. Our medicine provides only the stimulus and only the right stimulus will help to stimulate. The children of age group 0 to 15 years possesses low immunity and hence they are highly susceptible for diseases including acute otitis media. Normal susceptibility is essential for the maintenance of continued health and deviation from normal susceptibility leads to development of disease. Hence restoration of normal susceptibility is the basis of cure. All the physiological and pathological functions depend on the basic quality of life. Any change in the normal susceptibility will interfere with the capacity of pre-determined response and this interference will be reflected in a chain response which ultimately leads to a loss of balance as evidence by the development of acute otits media. It is therefore necessary to understand the level of susceptibility in a child before proceeding with the treatment.
In acute disease, a well chosen homeopathic remedy usually acts quickly, sometimes within minutes, or within a few hours. Therefore, if one succeeds to find the right remedy, it is not unrealistic to postulate a time limit of few hours for a considerable amelioration. The major problem in the homeopathic treatment of Acute Otitis Media is the usually very acute onset of symptoms. Because of the intolerable pain patients are brought to the doctor very quickly, this makes difficult for an accurate observation of the changes the patient goes through, and thus often makes it necessary to choose a remedy on the basis of only a few symptoms. Proper hygienic and dietetic measures must be taken before administration of remedial drugs which are used as specific stimuli to rouse the vital force to react against the morbific agents and overcome their noxious influences. The instinctive desires of the body with regard to food and drink should be allowed to be satisfied by the physician and the patient’s attendants. These bodily instincts crave for things that would give palliative relief. The temperature of the room and heat or coolness of bed covering must also be adjusted according to the patient’s wish and comfort. Lastly it has been noted that, consideration of all the above information is mandatory while treating the acute otitis media in children and then only it becomes right homoeopathic approach towards the same.
However, with this study, we are able to demonstrate that homoeopathy may provide a good alternative to the conventional treatment of otitis media. But homoeopathy can be successfully applied in most cases at least, thus avoiding those forms of medication which have a large number of known adverse side effects. Under homoeopathic treatment, therapy is shorter and improvement is more favorable. This contrasts with the popular concept that homoeopathy is particularly slow in acting.
Observations
On the basis of the results achieved in this study the following information has been gathered and put into frequency distribution tables for further analysis as below:
| Age Of Patients In Years | Frequency Of Cases Distribution | Percentage % |
| 00- 03 | 22 | 36.66% |
| 03 – 06 | 20 | 33.33% |
| 06 – 09 | 12 | 20.00% |
| 09 – 12 | 04 | 06.66% |
| 12 – 15 | 02 | 03.33% |
Thus it can be seen that lower age group children are more attacked by the acute otitis media. A similar analysis of the study for sex distribution reveals an almost equal distribution between both sexes. This again coincides with the general prevalence of acute disease in the world over as elaborated in the literature.
| Sex | Frequency Of Cases Distribution |
Percentage%
|
| Male | 35 | 58.33% |
| Female | 25 | 41.66% |
The 60 clinical cases and their response to the indicated remedy can be summarized as follows:
| Response To Treatment | Frequency Of Cases | Percentage % |
| Cured | 56 | 93.33% |
| Uncured | 04 | 06.66% |
On the basis of the totality of symptoms acute otitis media in children shows the following frequency on the corresponding indicated remedies. A review of the remedy indicated and used through the study shows the following:
| Remedy | Frequency |
| Pulsatilla | 11 |
| Belladonna | 10 |
| Sulphur | 05 |
| Phosphorus | 03 |
| Calcium carb. | 03 |
| Ferrum phos | 02 |
| Bryonia | 02 |
| Mercurius sol. | 02 |
| Lycopodium | 02 |
| Aconite nap. | 02 |
| Chamomilla | 02 |
| Silicea | 02 |
| Capsicum | 01 |
| Kali bich. | 01 |
| Apis mel | 01 |
| Rhus tox. | 01 |
| China | 01 |
| Arsenicum alb. | 01 |
| Hepar sulph. | 01 |
| Nux vom | 01 |
| Aurum met | 01 |
| Lachesis | 01z |
| Kalium-mur. | 01 |
| Natrum-mur. | 01 |
| Conium | 01 |
| Kalium-carb. | 01 |
It can be seen through the above table that Pulsatilla and Belladonna were the most frequently indicated remedies in the acute otitis media in children.
A further study of the 60 clinical cases with regards to the duration of treatment and the time period for which follow up was carried out shows the following:
It was observed that within a week most of the cases responded to homeopathic medicines.
Result
The clinical study of efficacy of homoeopathy in Treatment of Acute otitis Media with Intense otalgia in children as seen through the study of 60 clinical cases shows the
following results in the table below.
The table-X shows that 56 cases recovered and its percentage is 93.33 %. There were no drop outs from the study. And 04 cases not recovered and its percentage is 06.66 %. Thus we may conclude that homeopathy works instantly in all acute otitis media of infants and children aged 0-15 years. The acute otitis media are more prevalent in younger kids as they are highly susceptible with anatomical drawbacks and an equal prevalence of acute otitis media in both sexes. The efficiency of homeopathy in the treatment of acute otitis media with intense otalgia in children is excellent and shows high success rate of fifty six out of sixty patients responding successfully to the treatment with no signs of recurrence in near future. There were no complications in the 60 patients seen in this study.
Conclusion
After going through the observations and results it is concluded that the acute otitits media in children can be treated successfully by Homoeopathy. All that is required in the treatment of acute otitis media in children is quick selection of right remedy and right dose for the instant relief of otalgia is in order to cure otitis media rationally. In children, the disease forces are more pronounced and clear than those in adults.
From the review of literature on acute otitis media in children, remedies were studied. And the application of above knowledge helped me a lot in order to achieve my aim of in Efficacy of Homoeopathy in Treatment of Acute Otitis Media with Intense Otalgia in Children.
Summary
The results suggest that there is a positive treatment effect of homeopathy in acute otitis media in children and that a larger study is further justified. My research has various sections which has been formed to make it easy to understand and to work on it further more. The aims and objectives which I had planned in the beginning of my study have been achieved.
| DURATION OF TREATMENT & FOLLOW U3P (IN DAYS) | FREQUENCY OF CASES |
Percentage
%
|
| 1 -04 | 03 | 05.00% |
| 1-05 | 09 | 15.00% |
| 1-06 | 13 | 21.66% |
| 1-07 | 09 | 15.00% |
| 1 – 08 | 08 | 13.33% |
| 1 – 09 | 06 | 10.00% |
| 1-10 | 05 | 08.33% |
| 1-11 | 03 | 05.00% |
| More than 12 days | 04 | 06.66% |
The later part which mainly relates to my clinical work which consists of 60 clinical cases of acute otitis media in children which are arranged in a very ideal way. In the case taking of patient the main intention was kept in receiving the case easefully and it was not just taking the case for the purpose of this study alone. Such results are possible only with the tools of homoeopathy as it is the rational science. The work of my research is based on a topic which in it self is a common and important one.
It is essential to first study the normality before proceeding to comprehend the abnormal. This work in the child domain needs an approach to acute otitis media that leads to further reduction in the use of conventional therapy without making children suffer unnecessarily.
Bibliography
Allen, T F 1997, Encyclopedia of pure Materia Medica, 1thedn, BJain Publishers, New Delhi.
Allen, H C 1999, Allen’s Keynotes, 9thedn, BJain Publishers, New Delhi.
Allen, T F 2004, Boenninghausen’s Therapeutic Pocket Book, 1stedn, BJain Publishers,New Delhi.
Betarrnan, R E 2011, Nelson Textbook of Pediatrics, 19th edition, W.B. Saunders Company, London.
Bhargava, K B 2002, A short textbook of ENT diseases, 6thedn, Usha Publications, Mumbai.
BJain 2002, Homoeopathic case history booklet, 1stedn, BJain Publishers,New Delhi.
Boericke, G 2001, A compend of the principles of Homoeopathy for student in medicine, 1stedn, BJain Publishers,New Delhi.
Boerieke, W 2004, Pocket Manual of Homoeopathic Materia & Repertory, 1thedn, BJain Publishers,New Delhi.
Boerieke, W 2005, Homoeopathic Medical Repertory, 2ndedn, BJain Publishers,New Delhi.
Boger, C M 2004, Boenninghausens Characteristic Materia Medica & Repertory, 1stedn, BJain Publishers,New Delhi.
Boger, C M 2007, A Synoptic key to the Materia Medica, 1thedn, BJain Publishers, New Delhi.
Clarke, J 2003, A Dictionary of Practical Materia Medica, 1thedn, BJain Publishers, New Delhi.
Clarke, J H 2006, The Bedside Prescriber, 3rdedn, BJain Publishers, New Delhi.
Dhawale, M L 2000, Principle & Practice of Homoeopathy, 3rdedn, Institute of Clinical Research Mumbai, Mumbai.
Dudgeon, R E, 2010, The Lesser Writings of Samuel Hahnemann, 1stedn, BJain Publishers, New Delhi.
Dunham, C 2004, Lectures on Materia Medica, BJain Publishers, New Delhi.
Farrington, E A 1995, Lesser Writings with Therapeutic Hints, 1stedn, BJain Publishers, New Delhi.
Farrington, E A 2003, Comparative Materia Medica, BJain Publishers, New Delhi.
Farrington, E A 2004, Clinical Materia Medica, 1stedn, BJain Publishers, New Delhi.
Ghai, O P, Paul, V K et al 2004, Ghai Essential Pediatrics, 6thedn, CBS Publishers, New Delhi.
Herscu, P 2005, The Homoeopathic Treatment of Children, 1stedn, BJain Publishers,New Delhi.
Hahnemann, S 2004, Organon of Medicine, 6thedn, BJain Publishers,New Delhi.
Hahnemann, S 2010, Materia Medica Pura, BJain Publishers, New Delhi.
Hering, C 1997, Guiding symptoms of our Materia Medica, 1thedn, BJain Publishers, New Delhi.
Humaranwala, P 2005, Temperament types a study, 2ndedn, Nina Foundation , Mumbai.
ICR (Pediatric Team) 1999, Pediatrics in Homeopathy, an Approach, 1stedn, Mumbai.
Kamthan, P S 1993, Therapeutic Guide to common disease of intants children & Adult , 1stedn, BJain Publishers,New Delhi.
Kent, J T 2004, Kents lectures on Materia Medica, 1thedn, BJain Publishers, New Delhi.
Kent, J T 2004, Lectures on Homoeopathic Philosophy, 1stedn, BJain Publishers, New Delhi.
Kent, J T 2006, Kent’s Repertory, 1stedn, BJain Publishers,New Delhi.
Lilienthal, S 2000, Homoeopathic Therapeutics, 1stedn, published on 2000 by B. Jain at New Delhi.
Nash, E H 2004, How to take case & to find the simillimum, BJain Publishers, New Delhi.
Rauc, S 1993, Diseases of Children, 1stedn, BJain Publishers,New Delhi.
Roberts, H A 2005, The Principles & Art of Cure, 3rdedn, BJain Publishers, New Delhi.
Sankaran, R1992, The Science of Healing, 1stedn, BJain Publishers, New Delhi.
Santwani, M T 1994, Common Ailments of children & their Homoeopathic Treatment, 1stedn, BJain Publishers, New Delhi.
Sarkar, B K 2006, Organon of Medicine, 1stedn, published on 2006 by Birla at New Delhi.
Stuart, C 1999, Genius of Homoeopathy, 1stedn, BJain Publishers, New Delhi.
Tyler, M L 2010, Homoeopathic Drug Pictures, BJain Publishers, New Delhi.
Vijakar, P 2005, Predictive Homoeopathy, 4thedn, Preeti Publishers, Mumbai.
William, B 1998, The twelve tissue remedies of Schussler, 1stedn, BJain Publishers, New Delhi.
Background and Introduction
Otitis media is inflammation of the middle ear. It occurs in the area between the tympanic membrane and the inner ear, including a duct known as the eustachian tube. It is one of the two categories of ear inflammation that can underlie what is commonly called an earache, the other being otitis externa. Diseases other than ear infections can also cause ear pain, including cancers of any structure that shares nerve supply with the ear and shingles which can lead to herpes zoster oticus. Acute otitis media is a very common illness in infants and toddlers. When physicians are faced with a crying, fretful child who seems to have a sore ear their first reaction is almost certainly to diagnose acute otitis media. This is often reinforced by the thought that otitis media is a difficult diagnosis to exclude. In children with an upper respiratory tract infection eustachian tube function and oedema commonly give rise to negative pressure in the middle ear or the production of non-infected exudate, or both. The other main otological cause is myringitis, which is thought to be due to a viral infection and gives rise to a red ear without a middle ear exudate. Children with an upper respiratory tract infection commonly also have pain referred to the ear from a sore throat. In addition, teething is a well known cause of fretfulness in infants and is often associated with otalgia. When the middle ear becomes acutely infected, pressure builds up behind the eardrum, frequently causing intense pain. A major risk factor for developing otitis media is Eustachian tube dysfunction, which leads to the ineffective clearing of bacteria from the middle ear. Children younger than seven are much more prone to otitis media due to shorter Eustachian tubes, which are at a more horizontal angle than in the adult ear. Acute otitis media is usually diagnosed via visualization of the tympanic membrane in combination with the appropriate clinical history.
Acute bacterial otitis media can cause pain that leads to sleepless nights for both children and parents, can cause eardrum perforations, not all of which heal, and can spread to cause mastoiditis and/or meningitis, brain abscess, and even cause death if a severe infection goes untreated. Children with recurrent episodes of acute otitis media and those suffering from otitis media with effusion or chronic otitis media, have higher risks of developing conductive and sensorineural hearing loss. In acute disease, a well chosen homeopathic remedy usually acts quickly, sometimes within minutes, or within a few hours. Therefore, if one succeeds to find the right remedy, it is not unrealistic to postulate a time limit of few hours for a considerable amelioration. The major problem in the homeopathic treatment of Acute Otitis Media is the usually very acute onset of symptoms. Because of the intolerable pain patients are brought to the doctor very quickly. This leaves little space for an accurate observation of the changes the patient goes through, and thus often makes it necessary to choose a remedy on the basis of only a few symptoms. Secondly whether the risk of complications with homeopathic treatment differs from that of conventional treatment. Also of further interest was the spectrum of homeopathic remedies and the cost effectiveness of homeopathy as compared to conventional treatment.
Homoeopathy is a system of medicine that treats the entire pattern of physical, emotional, and mental characteristics of an individual. Hence to treat acute disease in children also needs an approach based on cardinal principles of Homoeopathy. This study has been planed to understand the importance and necessity of Homoeopathy in the treatment of acute otitis media in children. Homeopathy has been used historically to treat acute otitis media, but there have been no much methodologically rigorous trials to determine whether there is really a positive treatment effect.
Aims and Objectives of the study
- To ascertain the efficacy of Homoeopathic remedies in the treatment of acute Otitis media with intense Otalgia in children.
- To evolve an understanding of Homoeopathic remedies from the source books in the treatment of acute otitis media with intense otalgia in children.
In order to study efficacy of homoeopathy in the treatment of acute otits media with intense otalgia in children a special emphasis was given to the individualisation of every case. Here also it is necessary to consider constitution, temperament mental generals, physical generals, particulars, diathesis, past history, family history, indisposition and susceptibility of every child. The selection of the homeopathic remedy requires 5 to 10 minutes more time than conventional medicine. Overwhelmed by an unceasing flood of children cases, I struggled to find the similumum with tools that were inadequate to the task. In acute otitis media, the symptoms take a quick evolutionary course and it is easy for the physician to ascertain the complete picture of the disease. According to Hahnemann, the totality of symptoms in a case means a group of related symptoms not expressing the disease so much as expressing the individual who suffers.
Research Methodology
a) Research question and hypothesis
Hypothesis: Null Hypothesis
Research question: Homoeopathic remedies are not beneficial in the management of otalgia with acute otitis media in children as compared to conventional therapy.
b) Study setting: Clinical study with randomized single blind drug evaluation method of research was carried out.
c) Study duration: The diagnosed cases of acute otitis media with otilgia were considered and followed up completely till relief/cure for a period of minimum one week in an individual case. And total duration of research was of minimum one year.
d) Study design (Type of Study): A prospective study based on simple randomized clinical trial was designed.
e) Sample size and selection of sample: Sample Size: Small sample of 60 cases formed the basis of research. Selection of sample: The simple random sampling procedure was adopted on the basis of inclusion and exclusion criteria. Children of various age group from 0 to 15, both sexes, and socio-economic classes were considered.
f) Inclusion / Exclusion Criteria: Inclusion Criteria: Children with acute complaints of both sexes, within age group of 0 to 15 of different socio economic classes, different life style & places, different habits which exhibits signs and symptoms indicative of acute otits media & otalgia were considered.
Exclusion Criteria: Patients suffering with complications of otitis media & those suffering with other systemic diseases were not considered.
g) Selection of tools: The tools were selected as per guidelines prescribed for standard research projects and all rules were followed while selection of tools required for the study. Theoretical study was thoroughly studied from various books, websites, journals, software’s, etc.
h) Data collection: Clinical data was collected through history taking of approached cases in a standard case record. The history in relation to preliminary, present, past, family, personal, mental, other general as well as particular history was noted. And also clinical data includes physical examination including local examination.
i) Statistical techniques: The data obtained from the observations after treatment was statistically analysed and interpreted for drawing the statistical inference with the tables.
j) Data analysis: The related theoretical and clinical data from different sources was collected and analysed to research standard as per different methods of analysis and type of data.
k) Outcome Assessment Criteria: It was mainly based on presence or absence of signs & symptoms. And for assessment of result following indices were considered:
- Cured: i.e. complete disappearance of signs and symptoms.
- Uncured: i.e. no much improvement of signs and symptoms.
l) Expected Outcome & It’s Usefulness: The available Homoeopathic literature of Homoeopathic remedies give details of its pathogenesis and action in the cases of acute otitis media & otalgia in children. This systematic study has once again proved its usefulness in greater depth.
Discussion
In Homoeopathy we only stimulate the patient to cure himself. Our medicine provides only the stimulus and only the right stimulus will help to stimulate. The children of age group 0 to 15 years possesses low immunity and hence they are highly susceptible for diseases including acute otitis media. Normal susceptibility is essential for the maintenance of continued health and deviation from normal susceptibility leads to development of disease. Hence restoration of normal susceptibility is the basis of cure. All the physiological and pathological functions depend on the basic quality of life. Any change in the normal susceptibility will interfere with the capacity of pre-determined response and this interference will be reflected in a chain response which ultimately leads to a loss of balance as evidence by the development of acute otits media. It is therefore necessary to understand the level of susceptibility in a child before proceeding with the treatment.
In acute disease, a well chosen homeopathic remedy usually acts quickly, sometimes within minutes, or within a few hours. Therefore, if one succeeds to find the right remedy, it is not unrealistic to postulate a time limit of few hours for a considerable amelioration. The major problem in the homeopathic treatment of Acute Otitis Media is the usually very acute onset of symptoms. Because of the intolerable pain patients are brought to the doctor very quickly, this makes difficult for an accurate observation of the changes the patient goes through, and thus often makes it necessary to choose a remedy on the basis of only a few symptoms. Proper hygienic and dietetic measures must be taken before administration of remedial drugs which are used as specific stimuli to rouse the vital force to react against the morbific agents and overcome their noxious influences. The instinctive desires of the body with regard to food and drink should be allowed to be satisfied by the physician and the patient’s attendants. These bodily instincts crave for things that would give palliative relief. The temperature of the room and heat or coolness of bed covering must also be adjusted according to the patient’s wish and comfort. Lastly it has been noted that, consideration of all the above information is mandatory while treating the acute otitis media in children and then only it becomes right homoeopathic approach towards the same.
However, with this study, we are able to demonstrate that homoeopathy may provide a good alternative to the conventional treatment of otitis media. But homoeopathy can be successfully applied in most cases at least, thus avoiding those forms of medication which have a large number of known adverse side effects. Under homoeopathic treatment, therapy is shorter and improvement is more favorable. This contrasts with the popular concept that homoeopathy is particularly slow in acting.
Observations
On the basis of the results achieved in this study the following information has been gathered and put into frequency distribution tables for further analysis as below:
| Age Of Patients In Years | Frequency Of Cases Distribution | Percentage % |
| 00- 03 | 22 | 36.66% |
| 03 – 06 | 20 | 33.33% |
| 06 – 09 | 12 | 20.00% |
| 09 – 12 | 04 | 06.66% |
| 12 – 15 | 02 | 03.33% |
Thus it can be seen that lower age group children are more attacked by the acute otitis media. A similar analysis of the study for sex distribution reveals an almost equal distribution between both sexes. This again coincides with the general prevalence of acute disease in the world over as elaborated in the literature.
| Sex | Frequency Of Cases Distribution |
Percentage%
|
| Male | 35 | 58.33% |
| Female | 25 | 41.66% |
The 60 clinical cases and their response to the indicated remedy can be summarized as follows:
| Response To Treatment | Frequency Of Cases | Percentage % |
| Cured | 56 | 93.33% |
| Uncured | 04 | 06.66% |
On the basis of the totality of symptoms acute otitis media in children shows the following frequency on the corresponding indicated remedies. A review of the remedy indicated and used through the study shows the following:
| Remedy | Frequency |
| Pulsatilla | 11 |
| Belladonna | 10 |
| Sulphur | 05 |
| Phosphorus | 03 |
| Calcium carb. | 03 |
| Ferrum phos | 02 |
| Bryonia | 02 |
| Mercurius sol. | 02 |
| Lycopodium | 02 |
| Aconite nap. | 02 |
| Chamomilla | 02 |
| Silicea | 02 |
| Capsicum | 01 |
| Kali bich. | 01 |
| Apis mel | 01 |
| Rhus tox. | 01 |
| China | 01 |
| Arsenicum alb. | 01 |
| Hepar sulph. | 01 |
| Nux vom | 01 |
| Aurum met | 01 |
| Lachesis | 01z |
| Kalium-mur. | 01 |
| Natrum-mur. | 01 |
| Conium | 01 |
| Kalium-carb. | 01 |
It can be seen through the above table that Pulsatilla and Belladonna were the most frequently indicated remedies in the acute otitis media in children.
A further study of the 60 clinical cases with regards to the duration of treatment and the time period for which follow up was carried out shows the following:
It was observed that within a week most of the cases responded to homeopathic medicines.
Result
The clinical study of efficacy of homoeopathy in Treatment of Acute otitis Media with Intense otalgia in children as seen through the study of 60 clinical cases shows the
following results in the table below.
The table-X shows that 56 cases recovered and its percentage is 93.33 %. There were no drop outs from the study. And 04 cases not recovered and its percentage is 06.66 %. Thus we may conclude that homeopathy works instantly in all acute otitis media of infants and children aged 0-15 years. The acute otitis media are more prevalent in younger kids as they are highly susceptible with anatomical drawbacks and an equal prevalence of acute otitis media in both sexes. The efficiency of homeopathy in the treatment of acute otitis media with intense otalgia in children is excellent and shows high success rate of fifty six out of sixty patients responding successfully to the treatment with no signs of recurrence in near future. There were no complications in the 60 patients seen in this study.
Conclusion
After going through the observations and results it is concluded that the acute otitits media in children can be treated successfully by Homoeopathy. All that is required in the treatment of acute otitis media in children is quick selection of right remedy and right dose for the instant relief of otalgia is in order to cure otitis media rationally. In children, the disease forces are more pronounced and clear than those in adults.
From the review of literature on acute otitis media in children, remedies were studied. And the application of above knowledge helped me a lot in order to achieve my aim of in Efficacy of Homoeopathy in Treatment of Acute Otitis Media with Intense Otalgia in Children.
Summary
The results suggest that there is a positive treatment effect of homeopathy in acute otitis media in children and that a larger study is further justified. My research has various sections which has been formed to make it easy to understand and to work on it further more. The aims and objectives which I had planned in the beginning of my study have been achieved.
| DURATION OF TREATMENT & FOLLOW U3P (IN DAYS) | FREQUENCY OF CASES |
Percentage
%
|
| 1 -04 | 03 | 05.00% |
| 1-05 | 09 | 15.00% |
| 1-06 | 13 | 21.66% |
| 1-07 | 09 | 15.00% |
| 1 – 08 | 08 | 13.33% |
| 1 – 09 | 06 | 10.00% |
| 1-10 | 05 | 08.33% |
| 1-11 | 03 | 05.00% |
| More than 12 days | 04 | 06.66% |
The later part which mainly relates to my clinical work which consists of 60 clinical cases of acute otitis media in children which are arranged in a very ideal way. In the case taking of patient the main intention was kept in receiving the case easefully and it was not just taking the case for the purpose of this study alone. Such results are possible only with the tools of homoeopathy as it is the rational science. The work of my research is based on a topic which in it self is a common and important one.
It is essential to first study the normality before proceeding to comprehend the abnormal. This work in the child domain needs an approach to acute otitis media that leads to further reduction in the use of conventional therapy without making children suffer unnecessarily.
Bibliography
Allen, T F 1997, Encyclopedia of pure Materia Medica, 1thedn, BJain Publishers, New Delhi.
Allen, H C 1999, Allen’s Keynotes, 9thedn, BJain Publishers, New Delhi.
Allen, T F 2004, Boenninghausen’s Therapeutic Pocket Book, 1stedn, BJain Publishers,New Delhi.
Betarrnan, R E 2011, Nelson Textbook of Pediatrics, 19th edition, W.B. Saunders Company, London.
Bhargava, K B 2002, A short textbook of ENT diseases, 6thedn, Usha Publications, Mumbai.
BJain 2002, Homoeopathic case history booklet, 1stedn, BJain Publishers,New Delhi.
Boericke, G 2001, A compend of the principles of Homoeopathy for student in medicine, 1stedn, BJain Publishers,New Delhi.
Boerieke, W 2004, Pocket Manual of Homoeopathic Materia & Repertory, 1thedn, BJain Publishers,New Delhi.
Boerieke, W 2005, Homoeopathic Medical Repertory, 2ndedn, BJain Publishers,New Delhi.
Boger, C M 2004, Boenninghausens Characteristic Materia Medica & Repertory, 1stedn, BJain Publishers,New Delhi.
Boger, C M 2007, A Synoptic key to the Materia Medica, 1thedn, BJain Publishers, New Delhi.
Clarke, J 2003, A Dictionary of Practical Materia Medica, 1thedn, BJain Publishers, New Delhi.
Clarke, J H 2006, The Bedside Prescriber, 3rdedn, BJain Publishers, New Delhi.
Dhawale, M L 2000, Principle & Practice of Homoeopathy, 3rdedn, Institute of Clinical Research Mumbai, Mumbai.
Dudgeon, R E, 2010, The Lesser Writings of Samuel Hahnemann, 1stedn, BJain Publishers, New Delhi.
Dunham, C 2004, Lectures on Materia Medica, BJain Publishers, New Delhi.
Farrington, E A 1995, Lesser Writings with Therapeutic Hints, 1stedn, BJain Publishers, New Delhi.
Farrington, E A 2003, Comparative Materia Medica, BJain Publishers, New Delhi.
Farrington, E A 2004, Clinical Materia Medica, 1stedn, BJain Publishers, New Delhi.
Ghai, O P, Paul, V K et al 2004, Ghai Essential Pediatrics, 6thedn, CBS Publishers, New Delhi.
Herscu, P 2005, The Homoeopathic Treatment of Children, 1stedn, BJain Publishers,New Delhi.
Hahnemann, S 2004, Organon of Medicine, 6thedn, BJain Publishers,New Delhi.
Hahnemann, S 2010, Materia Medica Pura, BJain Publishers, New Delhi.
Hering, C 1997, Guiding symptoms of our Materia Medica, 1thedn, BJain Publishers, New Delhi.
Humaranwala, P 2005, Temperament types a study, 2ndedn, Nina Foundation , Mumbai.
ICR (Pediatric Team) 1999, Pediatrics in Homeopathy, an Approach, 1stedn, Mumbai.
Kamthan, P S 1993, Therapeutic Guide to common disease of intants children & Adult , 1stedn, BJain Publishers,New Delhi.
Kent, J T 2004, Kents lectures on Materia Medica, 1thedn, BJain Publishers, New Delhi.
Kent, J T 2004, Lectures on Homoeopathic Philosophy, 1stedn, BJain Publishers, New Delhi.
Kent, J T 2006, Kent’s Repertory, 1stedn, BJain Publishers,New Delhi.
Lilienthal, S 2000, Homoeopathic Therapeutics, 1stedn, published on 2000 by B. Jain at New Delhi.
Nash, E H 2004, How to take case & to find the simillimum, BJain Publishers, New Delhi.
Rauc, S 1993, Diseases of Children, 1stedn, BJain Publishers,New Delhi.
Roberts, H A 2005, The Principles & Art of Cure, 3rdedn, BJain Publishers, New Delhi.
Sankaran, R1992, The Science of Healing, 1stedn, BJain Publishers, New Delhi.
Santwani, M T 1994, Common Ailments of children & their Homoeopathic Treatment, 1stedn, BJain Publishers, New Delhi.
Sarkar, B K 2006, Organon of Medicine, 1stedn, published on 2006 by Birla at New Delhi.
Stuart, C 1999, Genius of Homoeopathy, 1stedn, BJain Publishers, New Delhi.
Tyler, M L 2010, Homoeopathic Drug Pictures, BJain Publishers, New Delhi.
Vijakar, P 2005, Predictive Homoeopathy, 4thedn, Preeti Publishers, Mumbai.
William, B 1998, The twelve tissue remedies of Schussler, 1stedn, BJain Publishers, New Delhi.
