Efficacy of Homoeopathic medicines in the treatment of Chronic tonsillitis in paediatric age group -a prospective study

Dr Fasna T

ABSTRACT
Background:
Respiratory tract infections are very common in children when there is climatic change especially during winter season, under developed immunity, poor hygiene and sanitary conditions, overcrowding, low socio economic status1. Tonsillitis is one of the most common infections in children between 5-15 years.

Methodology:
A hospital based prospective study conducted in the department of Paediatrics, Gov Homoeopathic medical college, Bangalore during the year 2018 December to 2019 December.

30 children between 5-15 years attending in our Paediatric department were included in this study. This clinical study was undertaken with an aim to find out the efficacy of Homoeopathic medicines in the treatment of Chronic tonsillitis. Treatment outcome were assessed based on Assessment criteria and Vas scale for assessing the pain severity.

Result:
The overall response with the Homoeopathic medicines was significant. Total 13 patients got recovered, 12 cases improved, 3cases were not showing much improvement and 2 cases dropped out. In 30% cases Calc carb  was the indicated medicine, 23.3% cases Calc iod ,20% cases Calc phos, 6.6% cases Hepar sulph, Belladonna ,Phytolacca, 3.3% cases Calc sulph, Lycopodium, Sepia ,Tuberculinum, was given.

Conclusion:
Study suggests that Homoeopathic medicines are effective in the treatment of chronic tonsillitis, not only in bringing down the intensity of pain but also helped to reduce the recurrence. 

Key words:Homoeopathy,  chronic tonsillitis, Paediatric.

INTRODUCTION:

Palatine tonsil constitutes the major part of waldeyers ring. It is a collection of lymphoid tissue that is located in the lateral wall of oropharynx.

 The immunological role of Tonsils is to induce secretary immunity and production of immunoglobulin. As Tonsils are situated at opening of Pharynx it may get infected frequently and may leads to Chronic tonsillitis.Tonsils are more active between 4-10 years of age with a decrease after puberty.2

Chronic Tonsillitis is defined as inflammation of the tonsils caused by several types of bacteria or viruses. Children very often suffer from tonsillitis although it is seldom observed below the age of 2 years.3The symptoms may include chronic sore throat, halitosis, foreign body sensation, history of foul smelling or foul tasting cheesy lumps. Many children there are chances of airway obstruction due to tonsillar hypertrophy include mouth breathing, nasal obstruction, hypo nasal speech ,hyposmia, decreased appetite, poor school performance and snoring etc.2Due to these all reasons Adeno tonsillectomy is now one of the common surgical procedure in children under 15 years.

Repeated occurrences of inflamed tonsils may have a significant impact on a patients quality of life .

Fortunately, fatality is very low but rate of complication is still on the rise despite of improvement in healthcare facilities.1

In Homoeopathy we are considering susceptibility as a basic tendency of living organism which is going to decide the well-being of a person. Susceptibility and immunity are interdependent; when Tonsils are removed it may affect susceptibility of that person.4

Homeopathy plays an important role in treating the cases of Tonsillitis and preventing recurrence with restoration of health.

PATIENTS AND METHODS:
This study was carried out in the Paediatric department of Government homoeopathic medical college; Bangalore.30 patients with chronic tonsillitis during the period from December 2018 to December 2019 were seen and examined.

The diagnosis of chronic tonsillitis was based on the presence of following criteria’s

  • Enlarged   tonsils.
  • History  of fever.
  • Atleast 3-4 episodes of tonsillitis in a year.
  • Sore throat.
  • Tender and enlarged cervical lymph nodes.
  • +/- halitosis.

Outcome measure was based on change in symptomatology.

Assessment of pain was done based on visual analogue scale.

Patient was asked to point to the position on the line between the faces to indicate how much pain they are currently feeling. The far left end indicate no pain and far right end indicate worst pastedGraphic.png  

Figure -1

RESULT: 

Out of 30 patients 14 were males And 16 were females.

                                                                                   pastedGraphic_1.png

  Figure 2

 Among  30  cases 13 patients were recovered , 12 patients were  showing improvement,3 patient showed no relief and 2 patients dropped out during the study .

Assessment according to the symptoms

Table-1

Outcome to treatment No.of cases Percentage
Recovered 13 46.5%
Improved 12 42.8%
Not improved 3(2 patient dropped out) 10.7%
Total 28 100%

Table-2

Remedies Prescription frequency in chronic tonsillitis (%) Prescription frequency in all children
Calcarea carb                30                 9
Calcarea iod              23.3                 7
Calcarea phos                20                 6
Hepar sulph               6.6                 2
Belladonna               6.6                 2
Phytolacca              6.6                 2
Calcarea sulph              3.3                 1
Lycopodium              3.3                 1
Sepia              3.3                 1
Tuberculinum            3.3               1

In 30% cases  Calc carb200 was the indicated medicine, 23.3% cases Calc iod 200,  20% cases Calc phos200, 6.6%cases Hepar sulph200, Belladonna200, Phytolacca200 ,3.3% cases Calc sulph200, Lycopodium200, sepia200, Tuberculinum1M  was  given.

DISCUSSION AND OBSERVATION:
Tonsillitis is one of the most common ENT disorders which bring a child for seeking relief to the doctor. One study conducted in Norwegian children and Turkish children estimated that prevalence of recurrent tonsillitis is 11.7% and 12.1% respectively.5

Major observations:
The majority of the Chronic tonsillitis cases came to opd were during the month of June and December. Major clinical features were recurrent attack of sore throat (100%)  ,hypertrophy of tonsils(100%), difficulty in swallowing (97%), enlarged lymph nodes(66%) and pain while swallowing(90%). In 70 % of the cases there was a strong family history. Around 15 cases children were advised to do surgery and we could prevent that. 

Calcarea group was showing marked action in Tonsillis cases . Whenever calcarea carb was prescribed ,Belladonna has given as acute for atleast for 2 follow up .It was showing that calcarea carb was acting slowly even if it was indicated .Hepar sulph and Belladonna has got more action when the pain was so much marked. In my study except hypertrophy of tonsils all other symptoms were showing marked improvement within one year. Marked reduction in the size of tonsils has seen in only few cases.

Homoeopathy is a system of medicine based on the law, similia  similibus curantur. According to the basic principles of Homoeopathy where the individual as a whole considered important than the disease itself. Homoeopathic medicines enhance the resistance of body to fight against the bacteria and viruses and it gives no chance for recurrence of disease from external influences.

With the help of Homoeopathic medicine  we could prevent recurrent attack of upper respiratory tract infections too  by enhancing immunity.  

CONCLUSION:
Recurrent or chronic tonsillitis is currently a global health issue which can severely impair an individual’s quality of life. The research shows that homoeopathic medicines has significant role in treating Chronic tonsillitis patients in paediatric age group. The patients whom surgical intervention is advised were prevented.

ACKNOWLEDGEMENTS:
I am thankful to Dr Usha.s (HOD, Department  of paediatrics ),Dr Muddassir mulla(Lecturer, Department of paediatrics ) for their constant encouragement to do this research. And  i am also thankful to the teaching and non teaching staffs ,P.G s ,Interns ,Students and my Colleagues for their support.

CONFLICT OF INTEREST: None.

CONSENT: Parents of the subjects were explained about the research and consent and assent were obtained. 

ETHICAL APPROVAL: obtained from the institutional ethical committee.

REFERENCE:
1)Surapaneni H, Sisodia SS. Incidence of ear, nose and throat disorders in children: a study in a teaching hospital in Telangana. International Journal of Otorhinolaryngology and Head and Neck Surgery. 2016;2(1):26-29.Available at  https://www.ijorl.com/index.php/ijorl/article/view/87

2)Kliegman, Behrman, Jenson and Stanton. Nelson Text book Of  Paediatrics.18the/ .vol 2:1756

3)Abu baker Muhammad, Mc kimmjudy, Anwarul  azim md, Majumder,Haque mainul, chronic tonsillitis and biofilms:a brief overview of treatment modalities.journal of information research.2018;11:329-337. Available at

http://pubmed.ncbi.nlm.nih.gov/30233227-chronic -tonsillitis -biofilms-a-brief-overview-of-treatment-modalities/

4)Close Stuart, m.d, The genius of homoeopathy,B.jain publishers pvt.ltd, page no 86.

5)kvestad.E,kvarner .k.j,Roysamb.E,Tambs k,Harris JR,Magnus .p,Heritability of recurrent tonsillitis.Arch otolaryngol Head neck surg .may 2005;131(5);383-7.Available at https://jamanetwork.com/journals/jamaotolaryngology/article-abstract/649025.

Dr Fasna.T
PG Scholar, Department of Paediatrics
Government Homoeopathic medical college, Bangalore

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