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   Table of Contents - Current issue
Coverpage
July-September 2019
Volume 13 | Issue 3
Page Nos. 137-205

Online since Friday, October 4, 2019

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EDITORIAL  

Homoeopathy research – Building up the evidence p. 137
Anil Khurana
DOI:10.4103/ijrh.ijrh_73_19  
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ORIGINAL ARTICLES Top

Lycopodium clavatum for the management of urolithiasis: A randomised double blind placebo controlled trial p. 139
Rupali Bhalerao, Praveen Oberai, Pritha Mehra, Yogendra Rai, Gurudev Choubey, Amulya Ratna Sahoo, AK Majumder, Mahesh Sah, AK Gupta, AK Tyagi, VA Siddiqui, Arvind Kumar, Raj K Manchanda
DOI:10.4103/ijrh.ijrh_30_19  
Background: Urolithiasis is the most common disease of urinary tract found worldwide. There are several approaches for the treatment of urolithiasis that include the use of various synthetic and natural drugs and/or surgery in the conventional system of medicine. Objective: This study was taken up to evaluate the efficacy of Lycopodium clavatum in the management of urolithiasis. Materials and Methods: A multicentric, randomised, double-blind, placebo-controlled trial was conducted. Patients having symptomatology like Lycopodium clavatum were enrolled after screening and repertorisation as per the inclusion and exclusion criteria. During acute renal colic, despite group allocation, the patients were either prescribed the indicated homoeopathic medicines or conventional medicine. The analysis was carried out with an intention-to-treat approach, and missing values were handled using Last Observation Carry Forward method. Results: There was no statistical significance between the groups (P = 0.31) in reference to the number of cases in which stones expelled during the trial. The mean size of single stone expelled was 9.4 ± 4.9 and 13.9 ± 2.2 in Verum and Placebo groups, respectively (P= 0.12). There was also no significant difference in the mean size of mean size of multiple stones; in Verum group (10.1 ± 5.3) and Placebo group (16.1 ± 9.1) (P = 0.11). For assessment of pain and dysuria, Visual Analogue Scale was used, and a statistically significant difference was found between the groups (P = 0.039) for pain, and positive trend for Homoeopathy was noted for dysuria. A verified symptom syndrome of Lycopodium clavatum has been observed. Conclusion: Future studies with pragmatic study design and individualistic Homoeopathy can be undertaken to assess the effectiveness of treatment in urolithiasis.
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Antimicrobial activity of different homoeopathic drugs and their potencies against 'Aspergillus niger' In vitro p. 150
Suneel Prajapati, Mahima Sharma, Arun Kumar, Pankaj Gupta, Binit Dwivedi, Bhopal Singh Arya, Renu Arya, Debadatta Nayak
DOI:10.4103/ijrh.ijrh_46_18  
Background: Homoeopathic remedies are widely used all over the world for different disease conditions. Approximately 70% are derived from the plant; however, their preclinical evaluation is still a major concern. Objective: This study was undertaken with an aim to explore the antimicrobial effect of different homoeopathic drugs and its potencies against the Aspergillus niger. Materials and Methods: Fifteen homoeopathic mother tinctures (Θ) and their potencies (3x, 6x, 12x) were tested for their biological activity against the human pathogenic fungi A. niger using disc diffusion method according to clinical and laboratory standard (CLSIM44-A) with slight modifications. The diameter of zone of inhibition was measured and compared with vehicle control (Alcohol 90%). The experiment was performed twice to check the reproducibility. Results: The marked antifungal activity was observed with Θ of Zingiber officinale; the growth of A. niger was inhibited and showed maximum zone of inhibition up to 15.4 ± 2.88 mm followed by Holarrhena antidysenterica (13.2 ± 1.09) and Terminalia chebula (10.6 ± 1.14). Different potencies (3x, 6x and 12x) were also exhibited significant zone of inhibition, especially Allium cepa 6x (10.4 ± 0.89), Caesalpinia bonducella 6x and 12x (12.8 ± 0.54 and 10.4 ± 1.14, respectively), Eucalyptus globulus 12x (11.3 ± 1.94), Ruta graveolens 12x (15.0 ± 2.23), Thuja occidentalis 6x (10.8 ± 0.83), and Zingiber officinale 3x and 6x (13.0 ± 2.73 and 11.4 ± 2.30, respectively) as compared to control. Conclusion: The findings of study concluded that Θ and potencies can effectively inhibit the growth of A. niger in vitro. This study paves the way for development of homoeopathic antifungal treatments. However, further investigations are required to get more information about the mechanistic approach, their mode of action and in vivo evaluation.
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REVIEW ARTICLE Top

A review on animal-based homoeopathic drugs and their applications in biomedicine Highly accessed article p. 159
Bibaswan Biswas, EN Sundaram, Shyaga Jhansi, Satish Patel, Anil Khurana, Raj K Manchanda
DOI:10.4103/ijrh.ijrh_20_19  
Homoeopathy is one of the most well-practiced medical systems in the world. In Homoeopathy, like all other natural sources, animal and their secretions have been widely used. However, unlike other natural sources of homoeopathic drugs, for example, plants and chemicals, the collection and preparation of animal-based drugs are extremely challenging, especially for drugs from exotic animals. Considering the challenges, we envision that a review regarding the animal-based therapeutics, used in Homoeopathy, may be useful. Our review, consistently has found that the discoveries of the modern biomedicine agree with the reports from the homoeopathic literature. In many cases, the recent biomedical and medicinal chemistry research aptly justifies the findings of the old homoeopathic literature. Even though there are many animal-based homoeopathic drugs, this review will focus only on those drugs which are included in Essential Drugs List of Homoeopathy. We believe this article will not only be beneficial towards homoeopathic community but also may provide needed information regarding homoeopathic findings for future biomedical research.
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RESEARCH PROTOCOL Top

A study protocol on comparative randomised controlled trial of Homoeopathy -vs- allopathy in acute otitis media and its recurrence in Children p. 177
Central Council for Research in Homoeopathy
DOI:10.4103/ijrh.ijrh_57_19  
Background: Acute otitis media (AOM) is one of the most common acute infections in children, and injudicious prescription of antibiotics may lead to increase of antibiotic-resistant cases. Homoeopathic treatment may provide a safer and more effective treatment. Objective: Earlier, a pilot study conducted by the Central Council for Research in Homoeopathy (CCRH) on eighty patients at a single centre showed non-inferiority results. This study shall be undertaken to substantiate the earlier findings. Methods: This will be an open-label, non-inferiority, randomised controlled (parallel arm) trial to be conducted on children in the age group of 2–12 years, suffering from AOM. The trial will include 240 children; each participant shall be randomly selected to receive either individualised homoeopathic medicine or symptomatic allopathic medicine. In case a child does not have ≥50% improvement with assigned treatment on day 3, he/she shall be given antibiotics. Children shall be treated/followed up for a period of 1 year to check recurrence, if any, in both the groups. The primary outcomes are changes in the Tympanic Membrane Examination Scale and Acute Otitis Media-Severity of Symptoms scale, time to improvement in pain through the Facial Pain Scale-Revised between the groups and recurrence (number of episodes, intensity and duration) of AOM between the groups at 1 year. Discussion: The study will consolidate the findings observed during a pilot study conducted by the CCRH at Jaipur, India. It is proposed to compare the role of individualised homoeopathy over allopathy in the treatment of AOM and to assess its role in controlling the recurrence.
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CASE REPORT Top

Resolution of vocal cord nodules with individualised homoeopathic treatment p. 184
Suraia Parveen, Ranita Nath
DOI:10.4103/ijrh.ijrh_5_19  
Vocal Cord Nodules (VCNs) are localised benign, superficial growths on the medial surface of the true vocal folds resulting primarily from voice abuse, overuse or misuse and clinically manifested by progressive hoarseness of voice, with increased effort required to produce the voice, vocal fatigue and discomfort or pain in the throat. Conventional treatment methods include conservative voice therapy and surgical intervention. Both treatment methods are required for the resolution of VCNs with improvement of clinical symptoms. Here, a 44-year-old male teacher presented with a history of progressive hoarseness with vocal fatigue, discomfort in the throat during talking and bilateral VCNs since 8 months. There was no improvement after voice rest and voice therapy interventions for 5 months and he was finally advised for surgery, which he denied. He was, instead, successfully treated by individualised homoeopathic single medicine Hepar sulphuricum (30C, 200C and 1M) selected on holistic approach. Over the period of 5 months of homoeopathic treatment, the patient's presenting symptoms of VCNs were improved and with resolution of it. This case report suggests that homoeopathic intervention may be the treatment for the resolution of VCNs with its presenting symptoms.
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DISCUSSION Top

Proving non-conventional methods: A paradigmatic paradox p. 192
Lex A. L. B. Rutten
DOI:10.4103/ijrh.ijrh_64_19  
Originally, it was thought that Evidence-Based Medicine (EBM) would supplant decision-making based on intuition or plausibility. Later, it appeared that the gold standard in EBM, the Randomised Controlled Trial (RCT), was not as 'hard' a reference point as had been supposed, and an assessment of credibility was needed. After some decades, 'credible' RCT-centred EBM has led to the dismissal of therapies deemed to be implausible, such as Homoeopathy. Nevertheless, such therapies remain widely appreciated by patients who use them alongside conventional medicine. Nearly two hundred RCTs of Homoeopathy showed no difference in efficacy between Homoeopathy and comparable conventional trials. There is no proof that conventional trials are of better quality and there is no proof of harm by Homoeopathy. However, selective analysis of evidence shows statistically insignificant results, then interpreted as unscientific 'confirmation' of the hypothesis that Homoeopathy is a placebo. As a result, the use of Homoeopathy instead of antibiotics in acute respiratory tract infections has been discouraged, despite the absence of evidence of the efficacy of antibiotics for this indication and an established risk of harm. Complex statistical interpretations of RCT evidence lead to impractical and even harmful advice. Credible proof is actually based on many subjective (often continuous) variables. As an endpoint for EBM, Bayesian probabilities, based on more than RCT evidence, would provide a more practical and personalised type of advice for patients, and would develop the diagnostic process into a prognostic framework, offering alternatives if one particular solution was to fail.
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RESEARCH UPDATES Top

Research Highlights (June–July 2019) p. 204
Meenakshi Bhatia
DOI:10.4103/ijrh.ijrh_62_19  
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