Schwabe News Volume 5 | Issue 3-6 | March – June 2014
Homoeopathy can be a supportive therapy in pulmonary tuberculosis: a randomized, double blind, placebo controlled clinical trial
Multi drug resistant-tuberculosis (MDR-TB) [resistant to Isoniazid and Rifampicin] is a major global public health problem. In India the incidence is rising in spite of implementation of Revised National Tuberculosis Control Program. Standard MDR-TB drugs are second generation antibiotics taken for 24–27 months. The present study was undertaken to evaluate the efficacy of add on homoeopathic intervention to the standard MDR-TB regimen (SR). It was a randomized, double blind, placebo controlled study conducted from 2003 to 2008. 120 diagnosed MDR-TB patients (both culture positive and negative) were enrolled and randomized to receive Standard Regimen + individualized homoeopathic medicine (SR + H) or Standard Regimen + identical placebo (SR + P). The medicines have been used in infrequent doses. The outcome measures were sputum conversion, changes in chest X-ray (CXR), haemoglobin, erythrocyte sedimentation rate (ESR), weight gain, and clinical improvement.
There was an improvement in all the outcome measures as per intention to treat (ITT) and per protocol (PP) analyses. ITT analyses revealed sputum culture conversion from positive to negative in 23 (38.3%) in SR + H; 23 (38.3%) patients in SR + P group; (p = 0.269) and 27 (55.1); 21 (42.8%), p = 0.225 as PP analyses. The mean weight gain in SR + H group was 2.4 ± 4.9 and in SR + P was 0.8 ± 4.4; [p = 0.071], reduction in ESR in SR + H was −8.7 ± 13.2; SR + P was 3.9 ± 15.4 [p = 0.068]. The mean increase in hemoglobin was by 0.6 ± 1.7 in SR + H & 0.3 ± 2.3 [p = 0.440] in SR + P group at 95% confidence interval. Statistically significant improvement was seen in CXR in 37 (61.7%) in SR + H and 20 (33.3%) patients in SR + P group (p = 0.002). Subgroup analyses of culture positive patients showed statistically significant improvement in CXR (p = 0.0005), weight gain (p = 0.026), increase in hemoglobin (p = 0.017) and reduction in ESR (p = 0.025) with add on homoeopathy. The cure rate was 11.4% more in SR + H group as compared to placebo group. Change in sputum culture conversion, was not statistically significant. Researchers finally concluded that add on homoeopathy in addition to standard therapy appears to improve outcome in MDR-TB. They have also suggested that larger scale studies using a standardized homoeopathic treatment regime should be conducted.
- Kusum S. Chand, Raj K. Manchanda, Renu Mittal, Sudhir Batra, Jayant N. Banavaliker, Indra De, Homeopathy, Volume 103, Issue 2 , Pages 97-107, April 2014
Homoeopathic medicines as add-on therapy in patients with rheumatoid arthritis on NSAIDs: A retrospective study
Many patients of rheumatoid arthritis have to depend on allopathic medicines including steroids and many analgesics with side-effects. This paper establishes higher benefit if homoeopathic medicine is complemented. For information, homoeopathy has been managing rheumatoid arthritis in satisfactory level. Conventional management of Rhematiod Arthritis (RA) includes administration of Non- Steroidal Anti- Inflammatory Drugs (NSAIDs), disease modifying anti-rheumatic drugs (DMARDs) like Methotrixate and anti-tumor necrosis factor α monoclonal antibody (anti-TNFά). Gastric ulcers, bleeding and perforation are the most common known adverse reactions found associated with excessive consumption of NSAIDs. The homoeopathic system of medicine improves the general well being, that is, Quality of Life (QoL) in addition to reducing the pain and disability. Objective of this study was to evaluate the patients with RA receiving homoeopathic medicines with respect to QoL, Disease Activity Score (DAS), Erythrocyte Sedimentation Rate (ESR), morning stiffness/pain and frequency of analgesics after homoeopathic intervention. This was a retrospective analysis of the role of homoeopathic medicines in RA. Patients diagnosed as sero-positive for RA antigen receiving homoeopathic medicines were analysed for DAS, QoL, frequency of analgesics, ESR and pain/morning stiffness. Ten cases testing sero-positive for RA with at least four clinical signs were evaluated from single homoeopathic Out-Patient Department (OPD) from February 2009 and February 2011. Cases were analysed to find out the role of homoeopathic constitutional similimum in people with RA. Changes in DAS, ESR, pain/morning stiffness and QoL were considered as outcome measure. According to the results, homoeopathic constitutional medicines reduce the intensity of pain in patients with RA (t = 4.3733, P < 0.01) along with reduction in consumption of NSAIDs (t = 2.4, P < 0.05). The DAS reduced in all 10 patients (t = 2.67, P < 0.01). The QoL was also found to improve under homoeopathic medication (t = 4.044, P < 0.01) and no further deterioration joint/disability was observed in any of the 10 patients. Mean ESR improved to 19.5 from 38.1 (t = 2.235, P < 0.05). Out of 10, 3 (30%) patients were found to be sero-negative after homoeopathic constitutional similimum. Researchers have finally concluded that homoeopathic constitutional similimum improves the QoL of patients with RA by reducing intensity of pain, limiting disability and reducing disease activity, thus causing improvement in general and disease condition in particular. It also limits the need of analgesics and DMARDs in RA.
- Tapas K Kundu, Afroz F Shaikh, Sindhu M Jacob, To evaluate the role of homoeopathic medicines as add-on therapy in patients with rheumatoid arthritis on NSAIDs: A retrospective study, Indian Journal of Research in Homoeopathy, Volume 8, Issue, 1, Page : 24-30
Pathogenetic trials and their reproducibility: Results from a pilot pathogenetic trial
Homoeopathic Pathogenetic Trials (HPTs) are a pillar of homoeopathy, a key source of the symptoms characteristic of a particular homoeopathic medicine. Homoeopaths choose homoeopathic medicines by comparing these remedy pictures with the symptoms the patient is presenting. Thus, recognition of these symptom sets underpins the clinical practice of homoeopathy. A study was conducted to test whether HPTs generate consistent and recognisable sets of symptoms in consecutive trials. Practising homoeopaths, blinded to the homoeopathic medicine under investigation, were given the set of symptoms generated during an unpublished HPT and asked to identify the homoeopathic medicine used. Ozone, prepared by homoeopathic method to the ultramolecular dilution of 30c (10−60 dilution), was chosen at random from twenty potential medicines. Seven practising homoeopaths were asked to make three guesses as to the identity of the remedy. Initially from the full list of possible remedies (N = 2372). Two of the seven homoeopaths guessed the identity of the remedy correctly (p < 0.0001). Subsequently, when their choice of possible medicines was restricted to a list of 20, the same two homoeopaths selected the correct medicine, however none of the other practising homoeopaths did so (p = 0.2). The selection of the correct homoeopathic medicine from the unrestricted list (N = 2372 medicines) by two homoeopaths is noteworthy given that the homoeopathic medicine used during the HPT was diluted well beyond Avogadro’s number and would not be expected to produce any detectable or recognisable symptomatology. Possible reasons why the remaining five homoeopaths did not guess correctly are discussed. The results show that practising homoeopaths may be able to correctly identify a homoeopathic medicine from the set of symptoms generated during an HPT. This suggests that such symptom pictures generated by taking an ultramolecular homoeopathic medicine are recognisable and specific to the substance taken. Since identification of the remedy was based on past HPT information held in the materia medica, this demonstrates that HPT-generated symptom pictures are reproducible, thus validating the HPT methodology. These promising preliminary findings warrant replication; possible improvements to the trial design to be incorporated in future studies were identified.
- Jeremy Sherr, Tina Quirk, Alexander L. Tournier, Do homoeopathic pathogenetic trials generate recognisable and reproducible symptom pictures?: Results from a pilot pathogenetic trial of Ozone 30c, Homeopathy, Volume 103, Issue 2, April 2014, Pages 108–112
A survey exploring research perception of homoeopathic undergraduate students in West Bengal, India
Prioritizing undergraduate research is emphasized to develop critical analytical skills and thinking, independent writing, future clinical practice, enhanced employability, and improved research productivity. Despite far reaching consequences, research perception of homoeopathic undergraduate students has barely been investigated to date. Poor participation of homoeopathic undergraduates in research is reflected by a single MEDLINE indexed publication with adequate students’ contribution in the last decade. The authors have aimed to assess their knowledge and attitude towards research and to identify barriers towards successful conduct of research. Institutional cross-sectional survey was carried out during August-September, 2013 in the four Government undergraduate homoeopathic colleges in West Bengal, India involving 902 participants. A semi-structured questionnaire was developed for the purpose depending on earlier studies on medical undergraduates. 364 completed responses were analyzed in the end. Study sample mostly spanned 18-25 years of age group (94%), belonged to urban families (44.8%), with no gender differences (almost 1:1) and no physicians in family (73.1%). Maximum complete responses were obtained from 3rd year students (61.5%) and students of Calcutta Homoeopathic Medical College and Hospital (51.2%). In spite of willingness to participate and keeping a positive attitude towards research, current involvement, training, knowledge and awareness remained quite unsatisfactory. Lack of infrastructure was identified as the chief barrier towards research. The authors have concluded that undergraduates had a positive attitude towards homoeopathic research, but need a realistic understanding of the research process. Opportunities for research skill development are underdeveloped.
- Malay Mundle, Subhranil Saha, Munmun Koley, Jogendra Singh Arya, Gurudev Choubey, Sangita Saha, Aloke Ghosh, Subhasish Ganguly, Shubhamoy Ghosh, A survey exploring research perception of homeopathic undergraduate students in West Bengal, India, International Journal of High Dilution Resarch;Mar2014, Vol. 13 Issue 46, p28
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