PROPHYLAXIS IN HOMOEOPATHY Dr' Sanil Kumar' M' C

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PROPHYLAXIS IN HOMOEOPATHYDr. Sanil Kumar. M. C
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• Levels of prevention
• Objective To intercept or oppose the disease
  process in man or community.
• 5 levels of prevention
• 1. Health promotion
• 2. Specific promotion
• 3. Early diagnosis and treatment
• 4. Disability limitation
• 5. Rehabilitation

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Primordial and primary prevention

• Mother
• Child

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Primordial prevention

• Mother
• Health education regarding reproductive health,
  ANC, safe delivery, PP care, contraception
• Nutritional programmes for mothers, eg. ICDS
• Promotion of participation of fathers and family
  in MCH
• Female literacy, employment, poverty alleviation
  for overall improvement

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Primary prevention

• Mother
• Anaemia, Child care, Immunization, Hygeine
• Promotion of rest, diet, hygeine during pregnancy
• Follow-up in postpartum period to prevent
  complications

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Primordial prevention

• Child
• Nutritional Intervention Programme, such as
  Anganvadi, Education of Mothers regarding child
  care
• Environmental sanitation to prevent infections
  like diarrhoea.
• Clean water provision.
• No open defecation and provision of sanitary
  latrines
• Food hygeine

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Primary prevention

• Child
• Ensuring breast-feeding promotion
• Growth monitoring
• Promotion of baby-friendly hospitals

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Primary intervention levels

• Mother
• Contraception
• TT immunization
• Maintaining balanced diet to prevent
  complications as result of malnutrition
• Iron prophylaxis
• Antenatal care
• Provision of birth kits to mother
• Food fortification and enrichment
• Safe delivery by trained birth attendants
• Social Welfare Programmes on women and children

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Primary intervention levels

• Child
• Care of newborn and immunization
• Exclusive breast-feeding till 6 months of age
• Introduction of complementary foods at 6 months
  of age
• Growth monitoring well baby clinics, prevention
  of nutritional blindness
• Iron and Vitamin A prophylaxis
• ORS to prevent dehydration
• School health services
• Ratifying rights of the child with National
  Policy on children
• Health check-ups

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Secondary prevention levels

• Mother
• Treatment of anaemia during pregnancy
• Urine examination for albumin and sugar during
  ANC
• Hb examination, BP, TORCH, VDRL tests during
  pregnancy
• High risk screening in pregnancy
• Emergency care during pregnancy
• Detection of high risk during labour (e.g.
  obstructed labour) and treating properly
• Treatment of infirtility
• Early detection and treatment of pelvic infection
  and STDs

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Secondary prevention levels

• Child
• Calculation of Apgar scores of he baby
• Screening baby for congenital abnormality
• Early detection and control of malnutrition
• Early detection and control of ARI
• Nutrition Intervention programme such as ICDS
• Appropriate rehydration of diarrheal patients
• Early detection and treatment for anemia, rickets
• Parental screening for congenital anomalies

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Tertiary prevention levels

• Mother
• Child adoption for infertile couples
• To do corrective surgeries for vesico-vaginal
  fistula and recto-vaginal fistula, cystocele,
  rectocele or prolapse uterus

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Tertiary prevention

• Child
• To correct congenital malfunction. E.g., cleft
  lip defect
• Disability limitation in polio rehabilitation in
  polio, congenital cataract/nutritional blindness
  rehabilitation
• Congenital deafness-rehabilitation
• To do corrective surgeries in rickets deformities
• Rehabilitation of mentally retarded children and
  children with Cerebral Palsy
• Occupational therapy, physiothearpy, prosthetics,
  speech therapy, training and education,
  vocational guidance, child placements.

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• Health Promotion
• - not directed at any particular disease but
  intended to improve the general health and
  well-being of the individual and the community.

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• The components of health promotion are
• Adequate nutrition
• Provision of sanitary environment
• Personal hygiene
• Health education
• Marriage counselling
• Sex education
• Physical education
• Periodic health screening
• Improvement of the standard of living of people
• Genetic counselling etc

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• 2. Specific protection
• Current measures available in allopathic science
• 1. Specific immunizations
• 2. Use of specific nutrients
• 3. Protection against occupational hazards
• 4. Protection against accidents
• 5. Protection from carcinogen
• 6. Avoidance of allergen

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• Homoeopathic view of specific protection
• - supports all measures except immunization
  where Homoeopathy has its own views and scope.
• - Immunization by Homoeopathic preventive
  medicine

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• Different methods
• 1. Specific prophylaxis.
• a. By specific medicine
• b. By Genus epidemicus
• 2. General prophylaxis.
• a. By anti-miasmatic constitutional
  treatment (especially of children)
• b. By anti-miasmatic constitutional
  treatment (especially of pregnant mother)

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• Specific prophylaxis.
• (a) Special prophylaxis by specific medicine

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• (b) Specific prophylaxis by genus epidemicus
• genus epidemicus can only be obtained after the
  break out of an epidemic disease in the
  community. That is the main defect of using it as
  a preventive.

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• 2. General prophylaxis
• (a). General prophylaxis by anti-miasmatic
  treatment advocated by Dr. Winter and Dr.
  Gastier of Thoissey.
• (b) General prophylaxis by constitutional
  treatment especially of pregnant mother by Dr.
  Fearson

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• An example for a programme on health promotion
  which is the first level of Prevention.
• Jyothirgamaya is a school health programme
  conducted by Department of Homoeopathy,
  Government of Kerala.

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• General outline
• Create an awareness about Jyothirgamaya among the
  headmasters during their district level meeting
  and distribute the brochure.
• Criteria for selecting schools. (3 from a
  district selected by DMO, 1 school control
  group). Total no of students not to exceed 500.
• Programme briefed at PTA meetings every year.

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• 4. Awareness class at PTA meeting by DMO. Consent
  obtained from School PTA and HM.
• 5. Collect list of name, class and division, of
  all high school students.
• 6. Maintenance of the registration book by the
  convener.
• 7. Introduction of case sheets.
• JG 1A The check list
• JG 1 B Sociogram for students
• JG 2A For parents review
• JG 2B for parents with problem children
• JG 2C parents review
• JG 3 teachers review
• JG4 Proper case record for students
• JG 5 Assess socio-economic status of
  student s family

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• 8. Administration of JG 1 format to students (15
  20 minutes)
• 9. Parent form (JG 2A) filled within 2 days
  returned in sealed covers.
• 10. Administration of JG 3 for teachers.
• 11. Administration of JG 4 format of case record
• 12. Group discussion on the filled case records
  among them.
• 13. Prepare for the interview with the students.

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• 14. After personal interrogation, a sociogram
  form (JG 1B) given to students.
• 15. Serious behavioral problems if detected in
  students (JG 2B) personal interrogation.
• 16. After case taking, analysis and
  repertorisation of the case.
• 17. Potency and dose.( High potency, 1 dose)
• 18. Follow-up of cases
• 19. Administration of JG 2 C Review from parents
  through students after 2 days.

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• 20. Students with serious ailments who are on
  life supporting measures should be excluded from
  the project. Similarly children with other
  chronic ailments included in study.
• 21. Diet and regimen
• 22. Transmission of data In soft copy, excel
  format
• Preliminary data within 20 days of completion of
  Phase 1
• Details of Phase II within 20 days of completion
• Details of phase III activities within 20 days of
  completion
• Details of specific cases after one month of
  phase III
• Diagnosed case pf ADHS, Conduct disorders, ODD
  etc, reported to Director fro future strategy
• Provisional diagnosis in psychological basis and
  miasmatic diagnosis.

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• 23. Every doctor attending this programme should
  follow professional ethics and dedicate
  themselves to make this project successful.

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• Homoeopathic Special prophylaxis programme by
  genus epidemicus in the State of Kerala is
  controlled and monitored by an organization
  called RAECH

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RAECHRapid Action Epidemic Control Cell -
Homoeopathy
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• RAECH is a state level organization that acts
  under the Homoeopathic Department to control
  epidemics.
• The cell is to be under the direct control and
  supervision of Directorate of Homoeopathy.
• It has to function by coalescing the Homoeopathic
  Educational Institutions and organizations of
  general practitioners as well as Medical
  Officer's in Homoeopathy with the health care
  delivery institutions under the Department of
  Homoeopathy.

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High Power Committee

• Director of Homoeopathy
• Controller and Principal of Government
  Homoeopathic Medical College.
• Deputy Director of Homoeopathy
• Project coordinator

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ORGANIZATION
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MODUS OPERANDI
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The advisory body at State Level - State Level
Expert Group (SLEG) of RAECH
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• This body is constituted with the
• Deputy Director of Homoeopathy.
• Three experts from the Homoeopathic Profession
  (nominated by the HPC)
• The HOD of the Community Medicine of Government
  Homoeopathic Medical College, Thiruvananthapuram

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• One representative each nominated by
• The Kerala Government Homoeopathic Medical
  Officers Association (KGHMOA),
• The organization of Government Homoeopathic
  Medical Officers Kerala (OGHMOK),
• The Institution of Homoeopathic Kerala (IHK),
• The Indian Homoeopathic Medical Association
  (IHMA).
• The members of the Technical Core Group (TCG) of
  the Directorate of Homoeopathy

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• SLEG is the official body to declare the
  preventive medicine, its dose and duration during
  an out break of an epidemic anywhere in the
  state.

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The District Level Executive body District Level
Raech (DLR).

• It consists of
• District Medical Officer (Homoeo) as its
  Chairperson,
• The Supdt / Senior Chief Medical Officer
• of the district
• The Senior Supdt of DMO's Office as its
  members.

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District level expert groups - DLEG.

• This body is equivalent to SLEG at the
• District level.
• The duty of the DLEG is to find out preventive
  medicine during an epidemic. To take all
  necessary initiative to swing into action when a
  report about the out break of any epidemics comes
  under its Jurisdiction.

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DLEG consists of

• District Medical Officer
• Senior Chief Medical Officer
• HOD of Community Medicine
• Members from all organisations
• Medical Officers of the affected area

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• It is this body which is immediately responsible
  for implementing all the preventive activities
  such as
• Distribution of preventive medicine, organizing
  of medical / preventive camps,
• Giving public awareness about the Homoeopathic
  Prophylactics and
• Imparting instructions regarding the use of
  medicine, diet and regimen, hygienic measure etc.

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Trained Reserve Group (TRG)

• One doctor from each organisation in
• Thaluk level.
• Medical officers from the region.

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• To visit the affected area
• To take case in the prescribed format
• Report to DLEG
• Organize preventive medical camps
• To take part in feed back study

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RECENT STUDIES ON EFFICACY OF HOMOEOPATHIC
PROPHYLAXIS
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CHIKUNGUNYA FEVER EPIDEMIC 2006-STUDY REPORT

• Total persons surveyed 2000
• Excluded 376
• Included 1624

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CHIKUNGUNYA FEVER EPIDEMIC 2006-STUDY REPORT

• Treatment Group
• Total no. of persons consumed prophylaxis
  1061
• Total No. persons who where affected with fever
  189
• No. of Persons in which the prophylaxis was
  effective 872
• Percentage of Efficacy 82.19
• Control Group
• Total No. of person who havent consume
  prophylaxis 563
• Total No. of Persons affected with fever 413
• No. of persons protected naturally (without
  prophylaxis) 150
• of cases protected naturally (without
  prophylaxis) 26.64

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CHIKUNGUNYA FEVER EPIDEMIC 2006-STUDY REPORT
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CHIKUNGUNYA FEVER EPIDEMIC 2006-STUDY REPORT

• Statistical Analysis
• Fever affected Fever not affected
• Prophylaxis consumed
  189 872
• Prophylaxis not consumed 413 150
• Chi square test value 486.44
• P value lt0.0001
• The study is highly significant.

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RAECH Its Strength

• Effective collaboration with Dept. of
  Homoeopathy, Academic institutions and
  professional organizations.
• Common platform or public and private
  participation (PPP)
• A large network of Govt. dispensaries and
  Hospitals.

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RAECH Its Limits

• Lack of expertise manpower.
• Lack of adequate infrastructure.
• Lack of adequate fund.

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THANK YOU