RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, KARNATAKA BANGALORE.

ANNEXURE-II

APPLICATION FOR REGISTRATION OF SUBJECT FOR DISSERTATION.

1 / NAME OF THE CANDIDATE AND ADDRESS / DR. MONIKA KATTI
PRESENT ADDRESS
A.M. SHAIKH HOMOEOPATHIC MEDICAL COLLEGE, HOSPITAL AND PG RESEARCH CENTRE,
NEHRU NAGAR,
BELGAUM-10.
PERMANENT ADDRESS
C/o JAYARAMAPPA,
INFRONT OF OLD GOVT HOSPITAL STREET,
POST- HOLEHONNUR,
TALUK- BHADRAWATI,
DISTRICT- SHIMOGA,
KARNATAKA.
2 / NAME OF THE INSTITUTION / A.M. SHAIKH HOMOEOPATHIC MEDICAL COLLEGE, HOSPITAL AND PG RESEARCH CENTRE,
NEHRU NAGAR,
BELGAUM-10.
3 / COURSE OF STUDY AND SUBJECT / M.D. (HOM)
ORGANON AND HOMOEOPATHIC PHILOSOPHY
4 / DATE OF ADMISSION / 30-06-2009
5 / TITLE OF THE TOPIC / “SIGNIFICANCE OF STUDY OF KENT’S TWELVE OBSERVATIONS IN MAKING SECOND PRESCRIPTION”
6 / BRIEF RESUME OF THE INTENDED WORK
6.1 NEED FOR THE STUDY
The greatest problem faced by the homoeopathic physician, after selecting a similimum and administering it to the patient is how to regulate further prescription. Once the remedy is given, the patient will come back in due course of time with some changes in his morbid condition namely, disappearance of symptoms, aggravation of symptoms, amelioration of symptoms or change in the direction of symptoms.
But obviously these changes themselves will guide the physician to assess the prognosis of the case. Procuring signs and symptoms are the most important indication for selecting a remedy, hence any change in the direction of symptoms will be the important criteria for making a second prescription.
Inability to regulate the administration of further prescription will often spoil the cases. Thus it is very imperative that a through analysis be done of all the changes that occur after the first prescription has been made.
Dr. J.T. Kent after much watchfulness, long waiting, analyzing and interpreting the changes that occur after a remedy has been given, has enumerated all his observations along with its implications in his masterpiece “Lectures on Homoeopathic Philosophy”. Lecture XXXV “Prognosis After Observing the Action of the Remedy”.
Though we realize that these 12 observations proposed by Kent play a vital role in making a second prescription common Homoeopathic practitioners often fail to observe these minute changes and commit mistakes in making further prescription. These problems usually crop up in clinical practice due to failure in rightly interpreting the changes.
In the modern context, it is very important to look at these changes in the state of disease with a scientific view. There is a need to throw some light on understanding the depth of the Twelve observations proposed by Kent. When these observations are made simple to understand and given a scientific touch, then both a routine practitioner and an expert practitioner shall incorporate these in their clinical practice.
HYPOTHESIS
Null Hypothesis – Kent’s twelve observations are not valid in the present understanding of making a second prescription.
6.2 REVIEW OF LITERATURE
·  After a prescription has been made the physician commences to make observations. The whole future of the patient may depend upon the conclusions that the physician arrives at from these observations for his action depends very much upon his observations, and upon his action depends the good of the patient.
If the homoeopathic physician is not an accurate observer, his observations are indefinite; and if his observations are indefinite, his prescribing is indefinite.
Now, if a medicine is acting it commences immediately to affect changes in the patient and these changes are shown by signs and symptoms.
The remedy is known to act by the changing of the symptoms. The disappearance of the symptoms, the increase of symptoms, the amelioration of symptoms, the order of symptoms, are all changes from the remedy and these changes are to be studied.
1)  First Observation- A prolonged aggravation and final decline of the patient.
2)  Second Observation- Long aggravation, but final and slow improvement.
3)  Third Observation- Aggravation is quick, short and strong with rapid improvement of the patient.
4)  Fourth Observation- No aggravation with recovery of the patient.
5)  Fifth Observation- The amelioration comes first and the aggravation comes afterwards.
6)  Sixth Observation- Too short relief of symptoms.
7)  Seventh Observation- Full time amelioration of the symptoms yet no special relief of the patient.
8)  Eight Observation- Some patients prove every remedy they get.
9)  Ninth Observation- Action of medicines upon provers.
10) Tenth Observation- New symptoms appear after the remedy.
11) Eleventh Observation- Old symptoms are observed to re-appear.
12) Twelfth Observation- Symptoms take the wrong directions. 1
·  …..he may have the keen perception of the import of the symptoms after the remedy has been carefully selected and administered. After the administration of the similimum some action should result. It is upon the development and interpretation of the action of the remedy or the reaction of the vital energy to the remedy, that successful prescribing very largely depends.
When the remedy acts the symptoms will change, in either character or degree. There may be a disappearance of symptoms, amelioration of the symptoms or increase of the symptoms, and these changes are the manifest action of the remedy on the vital energy or vital force; and it is these manifestations we must study.
We must also observe how the aggravation or amelioration occurs and the duration of these periods. In this connection we must always bear in mind that it is the patient’s welfare we are seeking, and it is for us to determine whether he is improving or declining. 2
·  After we have selected what we believe to be the indicated remedy and administered it in proper potency and dosage, it is our duty to observe the patient carefully in order that we may correctly note and intelligently interpret the changes that occur, for upon these changes in the patient’s conditions, as revealed by the symptoms depend our subsequent action in the further treatment of the case.
The action of the remedy is shown by changes in the symptoms of the patient. Upon the character of those changes depends our further course of action. A remedy shows its action, 1. by producing new symptoms; 2. by the disappearance of symptoms; 3. by the increase or aggravation of symptoms; 4. by the amelioration of symptoms; 5. by a change in the order and direction of symptoms.
The management of the remedy in regard to potency and dosage is almost as important as the selection of the remedy itself. 3
·  What happens after the administration of a remedy in Homoeopathic practice is one of the most absorbing and intricate aspects of Homoeopathic therapeutics. The fine changes in the symptomatology after a remedy is administered are easily missed unless the physician is quite alert. A correct interpretation of these changes enables him to arrive at certain conclusions about the further outcome of the case. These changes also help him to judge the accuracy of his prescription, regulate the administration of the remedy and effect appropriate changes in the prescription from time to time. 4
·  The other new or increased symptoms, or, on the contrary, the diminution of the original ones without any addition of new ones, will soon dispel all doubts from the mind of the attentively observing and investigating practitioner with regard to the aggravation or amelioration. 5
·  In our daily practice we encounter a lot of dilemmas. The complaints disappear in one system only to appear in another. Comprehending or not comprehending the follows-ups properly might be a key in determining success or failure.
Follow-up of a case and not only good prescribing for a case is what distinguishes one as a good ‘similimum’ prescriber. Understanding of what is more important and what is less important in the symptoms that follow is what makes a good prescirber. 6
6.3 OBJECTIVES OF THE STUDY
·  To analyse and interpret changes in the pattern of condition after the first prescription is made.
·  To assess the role of miasm in understanding the changes after the first prescription is made.
7. / MATERIAL AND METHODS
7.1 SOURCES OF DATA
The subject for this study will be taken from the OPD, IPD, Village camps and satellite OPDs of A.M. Shaikh Homoeopathic Medical College, Hospital and PG Research Centre, Belgaum
7.2 METHOD OF COLLECTION OF DATA
(Including sampling procedure, if any)
·  Study design- Prospective study of randomized clinical trial.
·  Sample size- Minimum 30 in number.
·  Participant subject- Both men and women of all age.
·  Selection criteria- On the basis of inclusion and exclusion criteria.
·  Sampling method- Simple randomized prospective procedure will be adopted with subjects willing to take treatment at above specialized clinic.
·  Duration of study- All patients registered between the periods of 01/12/2009 to 30/03/2011 will be selected for the study. No new case will be taken after 30/4/2011 and only follow-up will be continued till 30/11/2011.
·  Follow up- Follow up of cases will be done for a minimum of 9 months to assess the prognoses. Cases will be reviewed every month except in cases where medical emergencies are called for; such cases will be attended in between whenever necessary.
FOLLOWING ARE THE INCLUSION AND EXCLUSION CRITERIA
INCLUSION CRITERIA
·  The cases of duration of at least 3 years.
·  The case should have occurred due to miasmatic causes.
EXCLUSION CRITERIA
·  Subject undergoing active treatment from other non-homoeopathic and un-homoeopathic line of treatment.
·  Cases that come under the purview of poisoning, accidental trauma like fractures etc.
RESULT CRITERIA
·  Recovered
·  Improved
·  Not improved
7.3 DOES THE STUDY REQUIRE ANY INVESTIGATIONS OR INTERVENTIONS TO BE CONDUCTED ON PATIENTS.
Relevant investigations shall be carried out as per the type and requirement of the case.
7.4 HAS THE ETHICAL CLEARANCE BEEN OBTAINED FROM YOUR INSTITUTION IN CASE OF 7.3
Yes the ethical clearance has been obtained from the institution.
8. / LIST OF REFERENCES
1.  Kent J.T., Lectures on Homoeopathic Philosophy, New Delhi, B. Jain Publishers Pvt. Ltd., Reprint Edition – 1997, 224-234 pp
2.  Robert Herbert. A., The Principles and Art of Cure by Homoeopathy, Student Edition, New Delhi, B. Jain Publishers Pvt. Ltd., Reprint Edition- 2004-2005, 124, 125pp.
3.  Close Stuart, The Genius of Homoeopathy Lectures and Essays on Homoeopathic Philosophy, New Delhi, Indian Books and Periodicals Publishers, Reprint Edition- 2008, 205, 206 pp.
4.  Dhawale M.L. Principles & Practice of Homoeopathy Part-I, Mumbai, Dr. M.L.
Dhawale Memorial Trust, Reprint Edition- 2008, 261 pp.
5.  Hahnemann Samuel, Organon of Medicine, 6th Edition, Translated by William Boericke, New Delhi, B. Jain Publishers Pvt. Ltd, Reprint Edition- 1997, 278 pp.
6.  Vijaykar Prafull, Predictive Homoeopathy, Part-I, Theory of Suppression, Mumbai, Mrs. Preeti Vijaykar, Forth Edition-2002, 51, 63pp.
9. / SIGNATURE OF CANDIDATE
10. / REMARKS OF THE GUIDE
11. / NAME AND DESIGNATION OF
11.1 GUIDE / DR. SANTAN MATHEW D’SOUZA, MD(HOM)
PROFESSOR, HOD AND GUIDE DEPARTMENT OF ORGANON AND HOMOEOPATHIC PHILOSOPHY, A.M. SHAIKH HOMOEOPATHIC MEDICAL COLLEGE, HOSPITAL AND PG RESEARCH CENTRE, NEHRU NAGAR,
BELGAUM-10.
11.2 SIGNATURE
11.3 CO-GUIDE (If any) / ------
11.4 SIGNATURE / ------
11.5 HEAD OF DEPARTMENT / DR. SANTAN MATHEW D’SOUZA, MD(HOM)
PROFESSOR, HOD AND GUIDE DEPARTMENT OF ORGANON AND HOMOEOPATHIC PHILOSOPHY, A.M. SHAIKH HOMOEOPATHIC MEDICAL COLLEGE, HOSPITAL AND PG RESEARCH CENTRE, NEHRU NAGAR,
BELGAUM-10.
11.6 SIGNATURE
12. / 12.1 REMARKS OF CHAIRMAN AND PRINCIPAL
12.2 SIGNATURE

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