[ VOLUME 5 I ISSUE 3 I JULY– SEPT 2018] E ISSN 2348 –1269, PRINT ISSN 2349-5138

594 IJRAR- International Journal of Research and Analytical Reviews Research Paper

Clinical Evaluation Sulphur and Psorinum in treatment of Recurrent URTI

Dr. Ragini Raut* HOD, Forensic Medline &Toxicology Department, Bharati Vidyapeeth (Deemed to be) University,

Pune, India.

Received: May 12, 2018 Accepted: June 25, 2018

ABSTRACT A study of treatment of recurrent Upper Respiratory Tract Infections (URTIs) with Sulphur and Psorinum was carried out. This study consists of detailed cases with before and after comparison of data of 112 patients collected during 2016-2017.The number of attacks of the URTIs during the 12 months period before the date of commencement of the homoeopathic treatment (Control value) and 12 months period following the date of commencement of treatment (Treatment value) were compared. The study was carried out as part of a research project at a private Homoeopathic Medical College and Post-Graduate Institute. The results of the study indicates Statistically significant decrease in the number of episodes after paired T test application As scores of both no. of Episodes and Sensitivity shows significant differences at p < 0.001 level. (By Paired t Test and Chi-square Test) Hence, it goes to state that Psorinum and Sulphur helps in treatment of Recurrent URTI.

Keywords: Recurrent, URTI,Sulphur,Psorinum.

INTRODUCTION URTIs are the most common infectious illness in general population. URTI are the leading reasons for people missing work, school and visit to Physicians. Epidemiology – Most common human disease and affects people all over the Globe. In 2015, 17.2 billion cases of upper respiratory infections occurred. As of 2014, Upper respiratory infections caused about 3,000 deaths down from 4,000 in 19902 . URTI are loosely divided by the areas they affect, primarily affecting the nose (acute Coryza), the throat (Pharyngitis), and the sinuses (sinusitis), larynx (laryngitis), tonsils (tonsillitis), Adenoids.6

Signs & symptoms – Acute upper respiratory tract infections include rhinitis, Pharyngitis, tonsillitis& laryngitis often referred as a common cold, and their complication: sinusitis, ear infection & bronchitis. Sore throat is present in about 40% of the cases. Cough in about 50%. Symptoms commonly include cough, sore throat, runny nose, nasal congestion, headache, low grade fever, facial pressure & sneezing. 6

Symptoms are mostly due to the body's immune response to the infection rather than to tissue destruction6

Primary method of prevention is by hand washing is especially encouraged during the cold seasons (fall and winter) or handling others with the infection; reducing contact with people who may have the infection (people may carry and spread the virus a few days before they have symptoms and a few days after their symptoms have resolved);proper cleaning of common objects that are touched by individuals who may be infectious such as, telephones, refrigerator door, computers, stair railings, door handles, etc.;covering mouth and nose when coughing or sneezing3. No cure exists. These infections have been with humanity since Antiquity (ancient time). Normally an adult can expect two to three colds a year and a child can expect about four to six colds a year. 1 So adults visiting with recurrent Upper Respiratory Tract infections more than 3 to 4 episodes, in pediatrics more than 4 to 6 episodes per year affect overall health of individual. 1

Progression – Symptoms may begin within 16 hrs of exposure and typically peak two to four days after onset. Usually resolve in seven to ten days but may last up to three weeks in 35-40 % of the cases.6 Transmission- Airborne, droplets (aerosols), direct contact, and fomites (contaminated objects)6

Weather – Prolonged exposure to cold weather such as rain or winter conditions. This may occur due to cold induced changes in the respiratory system, decrease immune response.6

Other factors - Poor immune function, insufficient sleep, malnutrition. Prevention – Hand washing, isolation, vaccination, probiotics, wearing face masks. Zinc supplements may help to reduce the prevalence. Routine vitamin C supplements do not reduce the risk or severity. 3

Prognosis – Sinusitis occur in 8% and an ear infection in 30 % of cases as complications.6

Society & Culture - Economic impact. Antibiotic resistance. School days are missed annually. Workdays missed by employees, the total economic impact. This accounts for 40% of time lost from work. 1

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Illness under this heading, recur frequently & even though they are not actually fatal they remain lingering for many years because of which patient is really afraid of some serious illness but that cannot be documented & treated easily. Relapsing conditions are more painful than an illness that causes suffering at once. Modern medicine has achieved success in controlling these diseases but no solution has been found for preventing relapses or removing tendencies of the individuals. So this research study is taken “To reduce recurrence of URTI, by using Psorinum or Sulphur “with the 1) primary objective to ascertain the therapeutic usefulness of Sulpur and Psorinum in treatment of Recurrent Upper Respiratory Tract Infections. 2) Secondary objective, To increase tolerance of individual towards stimuli without suffering. (Stimuli-Sensitive to: Weather changes, Drafts, Strong Smell, Dust, Cold Food) Patients were assessed under following headings- 1. Recurrence of episodes of URTI, before and after treatment 2. To increase tolerance of individual towards stimuli without suffering.

Prescribing indications of the medicines used in the study Two remedies were selected on the basis of following indications- Indications: Both selected remedies are Great Antipsoric, Deep acting, one is Hot other is Chilly. Sulphur 5

Complaints that relapse. It is often of great use in beginning the treatment of chronic disease & in finishing acute once or when reaction is deficient, when the carefully selected remedy fails to act. Psorinum Eradicates tendency.4

Often gives immunity from cold-catching. 4

Is cold medicine. 4 Lack of reaction.5 When there is lack of reaction in chronic diseases, when well related remedies fail to relive or to permanently improve, also when sulphur seems indicated but fails to relive.5 No new medicine administered to the patients in this study. Medicines used as per guide lines given in Homoeopathic Pharmacopoeia of India.

Material and methods Methodology used- Single group prospective clinical study Case Definition - Patients suffering from Recurrent Upper Respiratory Tract infections where

adults gets more than 3 to 4 episodes and in pediatrics more than 4 to 6 episodes per year, of both sex and age group between 2 to 60 yrs.

Inclusion – Patients fulfilling the case definition included in study. Exclusion- 1. The patients not fulfilling the case definition. 2. Patients who require emergency medical intervention. 3. Female patients who is pregnant/lactating mother. 4. If known case of - Patients having major psychological or major neurological problems.

HIV infected patients /AIDS. Malignancy. Alcoholic, chain smoker, Anemic.

Drug Dose- One dose of medicine in powder form. Acute episodes will be managed with well indicated remedy. Psorinum or Sulphur will be prescribed after acute episode

Potency – 1M Route of administration- Oral. Repetition -As per requirement of the case.

Analysis of data is processed under following headings Total No. of Patients Gender Age Family History

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596 IJRAR- International Journal of Research and Analytical Reviews Research Paper

Various Recurrent URTI in the study Sensitivity to Various Stimulus

Table N0.1.Total No. of Patients No. of patients

Screened No. of patients

Recruited No. of patients

Completed No. of Drop out

patients

156 126 112 14

Table No.2 Gender Analysis Total Cases Male Female

112 47 (41.96) % 65 (58.03) %

Table No.3 Recurrent URTI in different Age Group Age Group No of Patients

Adult [18-60] 98 ( 87.5 %)

Pediatric [2-17] 14 (12.5 %)

Total 112

Table No.4 Family History of Recurrent URTI Hereditary Factors %

Patients with Family History 78 ( 69.64%)

patients with No Family History 34 ( 30.35 % )

Total 112

Table No.5 Recurrent URTI in the study (Figure-1)

Type of URTI No of patients

Allergic Rhinitis 61 ( 54.46 %)

Pharyngitis 18 ( 16.07 %)

Tonsillitis 20 ( 17.8 %)

Sinusitis 13 ( 11.60 % )

Total Cases 112

Figure -1

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Research Paper IJRAR- International Journal of Research and Analytical Reviews 597

Table No.6 Sensitivity to various Stimuli (Figure-2) Precipitating Factors Total %

Sensitive to Cold Food 55 49.10 %

Sensitive to Cold Drafts 74 66.07 %

Sensitive to change of weather 95 84.82 %

Sensitive to Dust 71 63.39 % Sensitive to Strong Smell 44 39.28 %

Figure -2

Observation and Results Table No.7 Patients Response – Sensitivity to Cold Food

Sensitivity No of patients

Before Treatment 55

After Treatment 7 (12.72%)

Improved 48 (87.27%)

Table No.8 Patients Response – Sensitivity to Drafts

Sensitivity No of patients

Before Treatment 74

After Treatment 18 (24.32%)

Improved 56 (75.67%)

Table No.9 Patients Response – Sensitivity to Weather Changes

Sensitivity No of patients

Before Treatment 95

After Treatment 23 (24.21%)

Improved 72 (75.78%)

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Table No.10 Patients Response – Sensitivity to Dust Sensitivity No of patients

Before Treatment 71

After Treatment 17 (23.94 %)

Improved 54 (76.05 %)

Table No.11 Patients Response – Sensitivity to Dust Sensitivity No of patients

Before Treatment 4444444444444444 44

After Treatment 08 (18.18 %)

Improved 36 (81.81%)

Table No.12 Response to Treatment Improvement Indices

Criteria to assess response to treatment Response No. of Patients

%

Improvement in both, number of episodes and sensitivity towards stimuli

Best 82 73.21%

Improvement in only number of episodes but no improvement in the sensitivity towards stimuli

Good 14 12.5%

No improvement in number of episodes, and sensitivity towards stimuli

Poor 16 14.2%

Total 112

Discussion It has been observed that hyper-response to the stimuli stopped after reduction in sensitivity of

individuals by administration of Psorinum or Sulphur. This resulted in reduction of no. of episodes and Recurrence of URTI. 61 cases of Recurrent Allergic Rhinitis treated with Psorinum ( 38) or Sulphur (23) after reduction

in sensitivity to stimuli 59 improved & 2 cases not improved. 18 cases of Recurrent Pharyngitis treated with Psorinum (8) or Sulphur (10) after reduction in

sensitivity to stimuli 14 improved & 4 cases not improved. 20 cases of Recurrent Tonsillitis treated with Psorinum (13) or Sulphur (7) after reduction in

sensitivity to stimuli 18 improved & 2 cases not improved. 13 cases of Recurrent Sinusitis treated with Psorinum (4) or Sulphur (9) after reduction in

sensitivity to stimuli 5 improved & 8 cases not improved

Conclusion The results of the study indicate statistically significant decrease in the number of episodes after paired T test application. As scores of both no. of Episodes and Sensitivity shows significant differences at p < 0.001 level. (By Paired t Test and Chi-square Test) Hence, it goes to state that Psorinum and Sulphur helps in treatment of Recurrent URTI.

Summary Table No. 13 Sensitivity to various Stimuli (Figure – 3)

Precipitating Factors Before Treatment

After Treatment %

Not Improved Improved Sensitive to Cold Food 55 11 44 80%

Sensitive to Cold Drafts 74 18 56 75.67%

Sensitive to change of 95 23 72 75.78%

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weather

Sensitive to Dust 71 17 54 76.05%

Sensitive to Strong Smell 44 08 36 81.81%

Figure -3

Table No.14 Number of Episodes (Figure-4) Before Treatment After Treatment

Average Mean 8.89 2.28

Approximate Difference 4.59

Figure -4

Statistically significant decrease in the number of episodes after paired T test application Recurrent URTI in the study

Table No. 14 Before And After Treatment (Figure -5) Type of URTI Before Treatment After Treatment

Not Improved Improved

Allergic Rhinitis 61 ( 54.46 %) 02 59

Pharyngitis 18 ( 16.07 %) 04 14

Tonsillitis 20 ( 17.8 %) 02 18

Sinusitis 13( 11.60 % ) 08 05

Total Cases 112 16 96

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Figure -5

Table No. 15 Sulphur and Psorinum Used in Study (Figure- 6)

Total cases Psorinum used in No. of cases Sulphur used in No. of cases

112 65 (58.03) % 47 (41.96) %

Figure -6

Acknowledgement I am indeed thankful to my patients for their complete faith and have enthusiastically participated in my research work. My humble thanks to my Guide- Prof. Dr. G.K. Oberoi and Prof. Dr. A.B.Jadhav, Principal Bharati Vidyapeeth (Deemed to be) University Homoeopathic Medical College – Pune for their immense support.

References - 1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3215607/ 2. .https://en.wikipedia.org/wiki/Upper_respiratory_tract_infection 3. https://www.medicinenet.com/upper_respiratory_infection/article.htm#can_an_upper_respiratory_infection

_be_prevented 4. Pocket manual of Homeopathic Materia Medica and Repertory By William Boericke, M.D, Ninth edition ,B.Jain

Publishers PVT.LTD.New Delhi-110055 5. Materia Medica of Homeopathic medicines, Second Edition, By Dr.S.R. Phatak , B.Jain Publishers (P) Ltd. 6. A short textbook of E.N.T.Diseases, K.B.Bhargava & T.M.Shah second edition, 6 th print.