Research Design

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Research Design

• Dr. Prashant Tamboli M.D. (Hom)
• Dr. Swapna kamath M.D. (Hom)
• Dr. Shruti Palaye M.D. (Hom)
• Dr. Deepti Nathani M.D.Part 2

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Is there any need of doing research?
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Why National Papers Publishing Articles against
Homoeopathy??
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Is there a Question Mark regarding Scientificity
of Homoeopathy?
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CAN HOMOEOPATHY SURVIVE IF PROVED TO BE
UNSCIENTIFIC???
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What Is Community Expecting from Us?
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What Has Been Response of HOMOEOPATHY
COMMUNITY??
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But you may requires to do something more than
thisScientific path
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RESEARCH

• . What is Research?

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Research Definition
Common parlance Search for Knowledge
Reedman Mary Systematized effort to gain new
knowledge
Few others A movement from known to unknown
Always new Discovery ?
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D. Slesinger M. Stephenson The manipulation
of things, concept or symbols for Purpose of
Generalizing to extend, correct orverify
knowledge, Whether that knowledge aids in
construction of theory or the practice of an art
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Individualization
A P P L I C A T I O N
Case 1 Case 2 Case 3 Inf 1 Inf 2
Inf 3
Derivation Inference Hypothesis
Generalization
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Psychiatric Research What?How? Who? When?
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Psychiatric Research

• Understanding the neurobiological and genetic
  determinants of substance abuse. (EEG/ERP
  neuroimaging PET/fMRI)
• Genetic study of Autism
• Understanding Neural pathways in Fear Anxieties
• Characterization of the genes linked to bipolar
  disorder. (DNA sequencing PCR genotyping hybrid
  analysis of protein-protein interactions)
• Studying the mechanisms underlying the
  degenerative diseases of the brain such as
  Alzheimer's disease, other dementias and
  pseudo-dementia of depression.

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Homoeopathic Psychiatric Research ???
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Types of question

• What is the mental status in School children?
• What are the types of psychiatric conditions
  what are seen in Homoeopathic OPD
• What are the skills available in homoeopathic
  doctors in identifying managing these cases?

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Cont..

• Can we understand the remedy profile useful for
  the Rx. Of ADHD
• Efficacy of Homoeopathy in management of LD

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RESEARCH IN COMMUNITY
DR SWAPNA KAMATH
M.D HOM PSYCHIATRY MEDICAL OFFICER - DEP
OF PSYCHIATRY.
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EXPLORING ISSUES IN SCHOOL MENTAL HEALTH AND THE
PLACE OF HOMOEOPATHIC INTERVENTION
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Aph 4He is likewise a preserver of health if he
knows the things that derange health and cause
disease.
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BASED ON SCHOOL MENTAL HEALTH PROJECT
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CONDUCTED BY
Dr. M. L. Dhawale Memorial Homoeopathic
Institute IN COLLABORATION WITH
Muskaan Child and Adolescent Guidance Centre
Tata Institute of Social Sciences, Mumbai
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HEALTH

• A state of complete physical, mental and social
  well being.
• Mental Health
• The capacity of an individual to form a
  harmonious adjustment to his social and physical
  environment.

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MENTAL ILLNESS

• Mentally ill are unable to fulfill
• their age-appropriate social or
• productive roles and often
• become a drain on their families and
• society
• By 2020 Mental Disorders
• will be the 2nd most common
• cause of death and disability
• 20 of children need active
• mental health interventions
• 11 have significant functional
• impairment

DISGRACE DISABILITY DYSFUNCTION
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COMPONENTS OF MENTAL HEALTH
SELF ACTUALIZATION
SATISFACTION
COMPETENCE
AUTONOMY
ADJUSTMENT TO SELF AND THE WORLD
SUBJECTIVE WELL BEING
POSITIVE HEALTH
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Schools - The best place to develop mental
health programmes for children..BECAUSE

• Strongest social and educational institution for
  planned
• intervention
• Profound influence on children, their families
  and
• the community.
• Important in building or undermining self esteem
  and sense
• of competence
• Plays a crucial role in the spheres of cognitive,
  language,
• emotional, social and moral development
• Acts as a safety net, protecting children from
  hazards
• which affect their learning, development and
  psychological
• well-being.
• Effective in improving learning and wellbeing and
  in treating
• psychological disorders.

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• CHARACTERISTICS OF THE ADOLESCENT
• A Aggressive, Anaemic, Abortion
• D Dynamic, Developing, Depressed
• O Overconfident, Overindulging, Obese
• L Loud but lonely, Lack information
• E Enthusiastic, Explorative and Experimenting
• S Social, Sexual, and Spiritual
• C Courageous, Cheerful, and Concerned
• E Emotional, Eager and Emulating
• N - Nervous, Never say no to peers
• T Temperamental, Teenage pregnancy

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OBJECTIVES

• Create awareness Need
  for Mental Health.
• Evaluate Mental Health status of Adolescents
  particularly their difficulties in the spheres of
• Understand Teachers Perception and Self-role in
  spotting the nature of Mental Health difficulties
  in the Adolescent
• Plan Preventive and Therapeutic Measures-Non
  Medicinal and Homoeopathic Interventions.

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SOURCES OF DATA Students Teachers VII,
VIII, IX
Collecting data
Planning intervention
Selecting schools
Focused group discussions
METHODOLOGY
Analyzing data
Questionnaire making
STUDENTS AND TEACHERS
Administering questionnaire
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DATA COLLECTION-
22 schools of the semi-rural area of Palghar and
Boisar The 22 schools included 14 English
medium schools, 7 Marathi medium schools and 4
Hindi medium schools. 18 were SSC schools and 4
were CBSE schools.
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SAMPLING
Sample very large- 6054 Pilot study was needed
to be first undertaken which would cover
approximately 10-15 of the total
sample population ?864

• The Stratification was done on the following
  variables
• Palghar and Boisar (i.e. the area under study)
• The three Medium of Instruction viz. CBSE
  English,
• SSC English, SSC Marathi.
• Standards viz. VII, VIII. IX.
• Aided and Unaided Schools.

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SELECTION OF SCHOOLS
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Making of the Questionnaire

• Self-esteem and self-confidence
• Inter-personal relationships (with parents, peers
  and teachers)
• Emotional distress
• Perception
• Behaviour
• Substance abuse, Somatization, Suicide (SSS)

Coding of the Questionnaire
School Name Standard Division
Each student
P D S
06 B
C II
09
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ANALYSIS

• According to the parameters
• Self Esteem/Self Confidence
• IPR (Inter-Personal Relationships)
• Emotional
• Perception
• Behavioural
• According to STD VII VIII IX
• According to Schools
• According to Medium of Instruction Educational
  Board
• English CBSE English SSC
  Marathi SSC

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CONCLUSIONS FROM THE STUDENTS QUESTIONNAIRE
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Charting difference in standards
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ANALYSIS OF THE TEACHERS QUESTIONNAIRE COMMON
ISSUES/ PREVENTIVE FACTORS
ROLE OF CONCERNS TEACHERS
Lack of attention Vast syllabus Role of
middle man Poor concentration Huge class
strength Friendly attitude Talkativeness
Parental attitude Improve
Parental attitude Absentees/ill health
communication Irregular in doing Illiterate
parents Explain right/wrong Homework
Language barrier Encourage
and Laziness Private tuitions
motivate students Indiscipline Non
co-operative Build positive Class
strength /antisocial
students attitude Pressure from
family Language barrier Health/ value
teachers No extra Curricular
education/ sex Poverty/cosmopolitan
activities
education Early maturity/ sexuality
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FOCUSED GROUP DISCUSSIONS

• People from similar backgrounds or experiences
  are brought together to discuss a specific topic
  of interest.
• The topic in question is of benefit not only to
  the participants but
• also to the respondents working in a team.
• PURPOSE
• To explore the range of opinions and views on a
  topic of
• interest.
• To explore the meanings of survey findings that
  cannot be
• explained statistically.
• New ideas are generated through discussion.
• Sensitive topics can be discussed more easily by
  talking in a
• group with people who have had similar
  experiences.

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Focused Group Discussions FGDs
THEMES

• Academics
• Sexuality
• Social issues
• Behavioural

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• CONCLUSIONS FROM THE FGDs WITH TEACHERS
• IDENTIFIED THEIR ROLE
• Expectations v/s Self realization
• Need to adopt a change in their attitude
• Need to invest time/ adopt transparency in their
  behavior
• Explain the pros and cons to the students ?
  discriminate between right and wrong
• Adopt the role of a middle man
• SUGGESTIONS
• Quality education moral science and value
  education
• Train them in counseling / impart sex education
  to students
• Help the students to channelize their extra
  energy
• Hold frequent PTAs Parent- teacher Association

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NEED FOR PLANNING INTERVENTIONS
FROM THE INTERACTIONS WITH STUDENTS

• Inadequate knowledge about sex-related matters
• Discussions on issues related to sex is avoided
  at home as students dont feel comfortable.
• Much of the information about sex from friends,
  books or films
• Students considered sex as something bad and
  dirty and choose not to comment on it
• Students were uncomfortable while filling this
  section of the questionnaire
• FROM THE INTERACTIONS WITH THE TEACHERS
• Teachers asked the students not to attempt such
  type of questions
• as they were not meant for them and were too
  young for it.
• Teachers inhibited by their own values, cultural
  norms and prejudices
• uncomfortable in discussing and guiding the
  students with the right
• information
• Though aware for the need of the education
  programme they lack the
• skills and competencies in order to address
  this issue sensitively and
• sensibly.

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ROLE OF HOMOEOPATHY

• Homoeopathic study in the field of preventive
  medicine needs to be undertaken and documented
  for future reference
• Such evidence-based studies can provide a rich
  source of knowledge and information to
  homoeopathic institutions in order to plan
  homoeopathic as well as non-homoeopathic
  interventions
• Define its role in community health as indicated
  by our founder

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PHASE TWO

• PLANNING HOMOEOPATHIC INTERVENTIONS
• CURATIVE
• PREVENTIVE
• PROMOTIVE

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• The Superior doctor prevents sicknessThe
  Mediocre doctor attends to the impending
  sicknessThe Inferior doctor treats the actual
  sickness

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Descriptive Research

• Surveys Fact- finding enquiries
• No control over variables / Just reporting
• Important aspect in this is sampling
• You will get the data so that further studies can
  take place

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Analytic Research

• Use of facts to make critical evaluation of
  material
• Correlating different data
• Conversion of data ? information
• Cause effect relationship

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Quantitative Research

• Based on measurement of quantity or amount
• How many better by particular remedy / Management
  Strategy
• E.g. Animal group remedies are better indicated
  in the management of ADHD

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Qualitative Research

• About Quality of individual
• Why any particular phenomena
• Understanding motive / Purpose etc
• Why particular remedy acted or Why particular
  Management strategy was better
• E.g. Understanding the evolution of particular
  remedy
• Why mineral group of remedies acted better in DM

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Quantitative Vs. Qualitative
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QUALITATIVE RESEARCH

• Any type of research that produces findings not
  arrived at by statistical procedures or other
  means of quantification
• Where non-mathematical process of interpretation
  are used for discovering concepts, establishing
  relationships in raw data and organizing into a
  theoretical explanatory scheme

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QL R AIMS

• Understanding the meaning or nature of
  experiences of persons with problems
• Discovering the intricate details of a phenomena
  through the stages of
• Describing
• Conceptual ordering
• Building theory

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QL R HOW?

• Analyzing experiences of individuals or groups
• Analyzing interactions and communication
• Analyzing documents (texts, images, film or music)

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QL RESEARCHER ACTIONS

• Views social phenomena holistically
• Systematically reflects on who one is in the
  inquiry
• Is sensitive to ones personal biography and how
  it shapes the study
• Uses complex reasoning that is multifaceted and
  creative

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QL RESEARCHER ATTRIBUTES

• Appropriateness
• Authenticity
• Credibility
• Intuitiveness
• Receptivity
• Reciprocity
• Sensitivity

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RESEARCH IN PSYCHIATRY

• Dr. Shruti
• MD (HOM) Psychiatry
• Medical Officer Dept of Publications

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Research in Psychiatry at an individual level

• Dissertations are a prime example of research at
  an individual level
• Amongst the psychiatry PG students, several
  dissertations deal with research in different
  areas
• 1st example Determining The Nature Of
  Psychiatric Morbidity In Patients Reporting To A
  Homoeopathic Hospital In A Semi-Rural Setting

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Add why it is important

• Need to know the proportion of mental illness in
  the total patient population
• Need to know skills needed to make a psychiatric
  diagnosis
• Lack of skills lead to under/over diagnosis
• Need to know the attitude of physicians towards
  mental illness
• Labeling of patients shows lack of
  awareness/sensitivity
• PATIENT DROPOUTS!!!

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Objectives

• Proportion of psychiatric diagnoses seen in the
  screening OPD
• Proportion of psychiatric diagnoses missed by
  screening OPD physicians
• Skills needed to identify psychiatric diagnosis
  at level of screening OPD

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Add functioning structure of Screening ? Sp OPD

• Case taking is not immediate
• Need to identify and evaluate complaints of
  patient
• Need to assess what kind of management patient
  needs
• THE ANSWER?
• SCREENING OPD ? INITIAL EVALUATION OF PATIENT ?
  REFERRAL TO SPECIALTY OPD FOR CASE TAKING/FURTHER
  MANAGEMENT

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Method of Study

• To study actual screening done by doctors on the
  basis of specially formulated criteria
• To study analyze the data understand the gap
  between actual diagnosis perceived diagnosis
• To interview doctors for the knowing the
  difficulties they faced in diagnosing the cases
  the common vocabulary used in referring the cases
  
• Following are the possibilities
• Group A patients with actual physical
  complaints
• Group B patients with psychiatric complaints
• Group C patients in whom the psychiatric
  diagnosis was missed

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Data obtained

• Various demographic data was obtained with
  respect to the kind of patients that report to
  the screening OPD in RHH, Palghar
• The distribution of patients according to age,
  sex, occupation, socio-economic status and tribal
  versus non-tribal population was studied
• The distribution of patients according to the
  various clinical diagnoses was also studied

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Age wise distribution of psychiatric patients in
the screening OPD
Gender wise distribution of psychiatric patients
in the screening OPD
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Different diagnoses in psychiatric patients
coming to screening OPD
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Missed psychiatry patients referred to other
OPDs
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note of it.
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• In the analysis of the screenings, it was studied
  whether the screening physician had taken care to
  elicit all the details of the complaint from the
  patient
• The physicians observation of the patient was
  also recorded
• The above details are extremely important when it
  comes to making a psychiatric diagnosis
• It was also studied whether the screening
  physician had made any efforts to put the patient
  at ease also if the physician had made any
  efforts to elicit emotional/ psychosocial
  information which can give important clues about
  a possible psychiatric diagnosis

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Physician interviews

• The screening OPD physicians were interviewed to
  assess their psychiatric knowledge and attitude
  towards psychiatric patients
• More than 70 physicians admitted to difficulty
  in identifying psychiatric ailments
• Physicians also expressed a desire for greater
  exposure to psychiatric cases

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Add conclusions

• A significant proportion of patients reporting to
  the screening OPD report psychiatric problems in
  some form or the other almost 15
• Out of these, almost half the patients suffer
  from a missed diagnosis and are referred to
  various other OPDs
• Various skill, including a knowledge of
  psychiatry (double-edged sword) and an
  understanding of how to diagnose psychiatric
  complaints are needed
• Most important an understanding and empathetic
  attitude is needed

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From screening to OPDs

• This next study is of patients after the
  screening process is over
• Assessing The Clinical Competencies Needed For
  Managing Patients With Functional Complaints
  Allocated To Specialty Clinics Of A Homoeopathic
  Hospital
• This study deals with the patients having
  functional/somatic complaints but are posted in
  different OPDs
• Predominance of Rheumatology OPD was seen as
  these patients mainly present with
  musculoskeletal complaints
• A comparison was done of how these patients are
  handled in the Rheumatology OPD and the General
  OPD

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Objectives of study

• Understanding what kind of functional complaint
  patients present in specialty OPDs
• What kind of knowledges and attitudes are
  required to handle these kinds of patients
• Does being posted in a specialty OPD have any
  effect on the clinical outlook of these
  physicians?
• Does knowledge of functional complaints have any
  effect on the management of such patients?
• What do physicians go through while handling such
  patients?

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Study - Method

• 15 patients each from the Rheumatology and
  General OPDs were studied
• Cases having only functional complaints and
  no/minimal pathological changes were selected
• Each case was analyzed to understand how the
  physician had handled the patient of functional
  complaints
• Assessment was done on the basis of specially
  formulated criteria
• Physicians from both OPDs were interviewed to
  assess their knowledge of functional complaints
  as well as their attitude towards these patients

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Data obtained

• It was seen that functional complaints made up
  about 15-20 of the total patient load in both
  Rheumatology and General
• The ability to establish correlations between the
  onset of the patients complaints and the
  psychological factors is important in the
  management of functional complaints
• In management of patients with functional
  complaints, the general therapeutic relationship
  between patient and physician is more important
  to the healing process

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CLINICAL CORRELATIONS AND INVESTIGATIONS
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RESULTS OF PHYSICIAN INTERVIEWS

• A majority of physicians interviewed reported
  feelings of frustration and anger while dealing
  with such patients
• Physicians noticed that patients with functional
  complaints tended to be more attention seeking
  and complaining that other patients
• Knowledge about functional/somatoform complaints
  was inadequate in a majority of physicians
• Lack of knowledge left them at a loss as to how
  to manage the patient and led to building up of
  frustrations on both sides
• Physicians in the OPDs also expressed a greater
  desire for psychiatric training/exposure that
  would help them to handle such cases better

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STATEMENTS OF PHYSICIANS

• The examination is normal, but the patients are
  just going on with their complaints
• I get extremely irritated with such patients,
  more so if they are males
• They somehow know that if they exaggerate their
  complaints, they will get more attention and they
  will get medicine quicker

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Conclusions

• Physicians need knowledge of psychiatric
  complaints awareness about diagnosis
• Physicians need an understanding and empathetic
  attitude
• Commitment to developing a therapeutic
  relationship

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And thus, quoting from aphorism 3 from the
Organon The physician should clearly perceive
what is to be cured in diseases, that is to say,
in every individual case of disease (knowledge of
disease, indication),
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Research Design
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Are there any different types of studies ?

• Survey
• Case series
• Cohort
• Controlled studies

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Case Series and Case Reports
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Case series and case reports

• Either of collections of reports on the treatment
  of individual patients,
• Relatively rare condition search for case
  series
• Limitation No control group, Hence no
• statistical validity
• Use Generation of hypotheses that are
• subsequently investigated in a case
  control, cross-sectional, or cohort study
• Most of the homoeopathic studies are Case series

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Remedy profile in ADHD

• Dr. Deepti Nathani

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To correlate clinical profiles of patients
suffering from ADHD with remedial profiles

• Type of study CASE SERIES

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Objectives

• 1)to understand different clinical presentation
  of patients suffering from ADHD.
• 2) to understand evolution of ADHD and
  differentiate the clinical presentations in
  common and characteristic symptoms of ADHD.
• 3) to understand patient as a person after
  identifying the premorbid personality.
• 4) to form a portrait of disease.
• 5) to match this portrait of disease with
  portrait of remedy in materia medica and come to
  a similimum.

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Research Design

• 1) process of data collection
• Source
• OPDS of palghar, dahisar, malad
• Barvalia foundation
• .

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Method of collection of data

• Cases of ADHD which fit into the criteria as per
  the DSM IV from all the clinical centers of the
  institute.

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Inclusion criteria

• Cases of ADHD diagnosed as per criteria.
• All new screenings coming in screening OPD with
  hyperactive traits and concentration difficulties
  
• Cases of age group 3 to 12 years and cases of
  both sexes.
• All 3 subtypes of ADHD.
• Cases of ADHD with other co morbid psychiatric
  conditions

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Exclusion criteria

• Those cases of ADHD with complex associated
  diseases like uncontrollable epilepsy.

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Method of study

• Case taking with detailed information about
  clinical symptoms of ADHD and its modifying
  factors , predisposition, patient as a person
  which includes the attributes and physical
  generals including milestones ( interview with
  primary care taker)
• Interview with patient.
• School reports or teachers remarks and
  observations of the child.

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Family environment and mothers state during
pregnancy.

• Birth history
• Analysis of each factor with respect to its
  causation, expression, modifying factors and
  attribute and form a portrait of this patient
  suffering from ADHD
• Making a totality and matching this portrait to
  a materia medica picture/portrait.
• Studying the follow ups.

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Remedial profile

• Studying the remedy from different source books
  and commentators under following headings
• Ailments from
• Expressions at the level of behavior which
  include both the common as well as characteristic
  symptoms of ADHD and the remedy.

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• Expressions at the level of intellect
• Expressions at the level of emotions
• Modalities
• Cravings and aversions
• Thermals
• Sleep and dreams
• Disposition.

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Case 1

• Mast SP
• 12 and ½ years male
• 8th std student.
• Father visual merchandiser
• Mother TV actress

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Physical generals

• Milestones
• Was overweight so used to sit with support or
  fall. Teeth 5 months.
• Talking delayed ? due to effect 2 languages.
• Rest milestones were normal
• Past history
• Phimosis circumcision done, tonsillectomy at 5
  and ½ year
• Family history
• PGF ? paralytic(from 8 years)
• PGM low BP
• FATHER accident
• MOTHER endometritis and appendisectomy
• MGM AND MGF heart patients.
• SISTER dyslexic.

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• Cravings ice 3, ice cream 3, sweets 2
• Aversion non specific
• Sleep on abdomen
• Dreams of GANESHJI
• Hot patient

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Life space salient features

• Mother father inter caste love marriage
• In laws against marriage
• Family environment non conducive
• In laws not wanting the child
• Mother thought that it would improve the envt
• Husband supported his mother so she felt left out
• even during pregnancy she felt increased
  movements of the baby.
• small child used to witness conflicts daily
• Father beat mother and child was silent observer

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Got angry but didnt say anything his face would
go red, clench his fist, and bang his head

• Father met with an accident
• Severe financial stress
• Mother breadwinner
• Slowly father understood his family members
• And regained health and started working
• Initially symptoms were undiagnosed but slowly
  problems increased so teachers started
  complaining.

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• His friends used to tease him he got angry but
  hardly expressed
• Teachers used to not understand him.
• Initially he got angry, felt bad but as he grew
  he understood the situation
• Never had regrets against father
• Used to help mother at times

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• Likes new places and to discover new things.
• Creative likes drawing
• Attached to parents
• Affectionate to animals

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Obstetric history

• 1st baby got aborted
• At 7th month she had bleeding and was adviced bed
  rest as head descended.
• And she attributes it to the conflicts in
  relationships.
• 3 kg birth wt , cried after tactile stimulation
• Mother had cracked nipples so she couldnt feed
  the child

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totality

• Anger suppressed
• Aggressive
• Sensitive to teasing, criticism
• Affectionate to animals
• Craving ice, ice cream
• Hot patient
• ADHD AND LD
• Medorrhinum

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Follow ups

• with infrequent doses of medorrhinum his
  attention span and hyperactivity have improved in
  3- 4 months upto 20 percent .

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Remedy profile

• After studying 30 cases serially
• Will study in each case (Remedy) what is common.
• Accordingly remedy profile of that remedy will be
  prepared.
• This will be compared with the available
  literature
• Then by Comparing Contrasting we will know the
  remedy profile of that remedy related to ADHD

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Observational studies

• Descriptive or caseseries
• Casecontrol studies (retrospective)
• Causes and incidence of disease
• Identification of risk factors
• Cross-sectional studies, surveys (prevalence)
• Disease description
• Diagnosis and staging
• Disease processes, mechanisms
• Cohort studies (prospective)
• Causes and incidence of disease
• Natural history, prognosis
• Identification of risk factors
• Historical cohort studies

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Experimental studies

• Controlled trials
• Parallel or concurrent controls
• Randomized
• Not randomized
• Sequential controls
• Self-controlled
• Crossover
• External controls (including historical)
• Uncontrolled Trials

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Empirical or Experimental Research

• Relies on Experiences Observations
• Requires enough facts and evidences to prove or
  disprove hypothesis
• Most powerful method
• E.g. Homoeopathic medicines are not placebo

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Trials with Independent Concurrent Controls
Everything same except Rx / Procedure
Ensuring the result is because of Rx.
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The Double Blind Method
Single Blind Method
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Randomized Controlled Study

• Epitome of all research designs the strongest
  evidence for concluding causation
• There are two groups, one treatment group and one
  control group.
• Patients are randomly assigned to all groups.

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TO ASCERTAIN THE EFFECT OF HOMOEOPATHIC THERAPY
IN THE MANAGEMENT OF LEARNING DISABILITIES

• Principal Investigator
• Dr. Kumar M. Dhawale M.D.,D.P.M.,M.F. Hom (Lond)
  
• Dr. M. L. DHAWALE MEMORIAL TRUST, Mumbai
• Commencement of Project 27th Feb 2008

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OBJECTIVES

• Primary Objectives
• To assess the therapeutic efficacy of
  Homoeopathic medicines in the management of
  specific Learning Disabilities with/without
  associated hyperactivity disorder.
• Dyslexia (Reading Disorder)
• Dysgraphia (Written Expression Disorder)
• To assess the effect of Homoeopathic therapy when
  given in combination with Remedial education.
• Secondary Objectives
• To ascertain the role of homoeopathic medicines
  and to establish verified characteristic symptoms
  of medicines used in the management of various
  types of Learning Disabilities.

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Criteria

• Inclusive Criteria
• Learning Disabilities diagnosis according to
  criteria stated in ICD 10.
• Children having average IQ.
• Both sexes.
• Children in the standard 5th, 6th and 7th
• Exclusion Criteria
• Presence of any other psychiatric illness
• Disability is not directly related to any
  emotional disturbances, visual or auditory
  defect.
• Disability due to inadequate learning exposure

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Research designRandomized case control trial
Duration of Study 3 Years Enrolment
1 year 9 mnths Minimum observation period
1year Compilation, analysis and conclusion 3
months
Sample size 60 Enrolment needed 80
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Assessment result
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Research in homoeopathy

• It is the need of the time to do research
• Homoeopathic research is possible with what ever
  minimal infrastructure is available.
• Psychiatric research in homoeopathy is possible,
  its easy to perform
• Qualities required for researcher are
• Desire to do research Perseverance

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Group task

• Psychiatry OPD
• It was observed that around 15 cases are coming
  for the treatment of Dhat Syndrome
  (Prostatorrhea). It was observed that most of
  them are coming from UP/Bihar belt. There are
  many emotional reactions to it like anxiety,
  guilt, anger, fear, frustration etc. Some come
  with lot of physical complaints related with
  this. They have lot of fixed ideas about it.
• Some of them improve with the medicines some
  with just counseling. But it was not clear what
  should be the strategy of handling such cases.

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• It was found that Phos acid, Selenium, Lycopodium
  are the important remedies for the management of
  this cases apart form the constitutional
  remedies.
• Some of the physicians were also not comfortable
  to deal with such cases. Some labeled them as
  functional / physiological were not keen in
  treating such cases.

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Thank You