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   Table of Contents - Current issue
Coverpage
April-June 2019
Volume 13 | Issue 2
Page Nos. 69-136

Online since Thursday, June 27, 2019

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EDITORIAL  

Improving validity and reliability of homoeopathy p. 69
Raj Kumar Manchanda
DOI:10.4103/ijrh.ijrh_45_19  
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ORIGINAL ARTICLES Top

Retrospective estimation of prevalence and likelihood ratio of general symptoms of 29 less frequently prescribed homoeopathic medicines by clinical verification p. 72
Raj K Manchanda, Parthasarathi Chakraborty, Munmun Koley, Dinesh Singh, Pramodji Singh, Ojit Singh, Varanasi Gayatri Prasad, Jai Prakash Singh, Surinder Singh Nain, Prasant Kumar Pradhan, Sunil S Ramteke, Ramesh Bawaskar, Lipi Pushpa Debata, Subhranil Saha, Chaturbhuja Nayak, Lex Rutten
DOI:10.4103/ijrh.ijrh_64_18  
Context: Scientific assessment of proving symptoms or already recorded symptoms in patients refers to Clinical Verification (CV). There are serious shortcomings of existing methods of CV, mostly arising from qualitative observations made on absolute occurrence of symptoms instead of relative ones. This problem can be resolved by the use of the Likelihood Ratio (LR). Aim: This study aims to estimate the prevalence and LRs of general symptoms of 29 less frequently prescribed homoeopathic medicines. Methods: The study was multicentric, open and observational. Patients were enrolled as per pre-specified eligibility criteria. Alongside, presenting complaints and general symptoms were taken into account during prescription. Medicines were prescribed in centesimal potencies. LR calculation of general symptoms was based on clinician-rated outcomes as 'improved' and 'not improved' of presenting complaints and was divided into three sections: (1) when the prevalence of a symptom was available from literature, LR was calculated by assessing the prevalence of that symptom in the responder sample, (2) in the absence of so, calculation was restricted to mean prevalence data from study sample ('confined LR') and (3) 'confined LRs' were not calculated for symptoms whose prevalence were not recorded for at least five medicines and were kept for estimation in future. Results: Of 166 general symptoms of 29 medicines, LRs and confined LRs >1.5 were elicited for 6 and 49 symptoms, respectively. Conclusion: In spite of considerable caveats, it is the first insight into prevalence and LRs of general symptoms of less frequently prescribed homoeopathic medicines. Further research is warranted.
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The role of homoeopathic treatment in women suffering from post-caesarean backache: An open observational clinical trial p. 81
Arunava Nath, Mahadeb De, Subhas Singh, Nivedita Kundu, James Michael, Satarupa Sadhukhan, Deepak Kumar, Munmun Koley, Subhranil Saha
DOI:10.4103/ijrh.ijrh_14_19  
Context: An open observational trial was carried out at National Institute of Homoeopathy, India, to assess the possible effects of individualised Homoeopathy in individuals suffering from post-caesarean backache. Aim: The aim of the study was to find the role of homoeopathic treatment in individuals suffering from post-caesarean backache. Methods: Fifty subjects were enrolled. The Short-Form McGill Pain Questionnaire (SF-MPQ) and Oswestry Low Back Pain Disability Questionnaire (ODQ) were used as the outcome measures, assessed at baseline and after 3 months of treatment. Medicines prescribed followed homoeopathic principles. Non-parametric Wilcoxon signed rank test was applied to compare the dependent observations. P < 0.05 two-tailed was considered statistically significant. Results: Five subjects dropped out and 45 completed the trial. Intention-to-treat sample (n = 50) was analysed. There were statistically significant reductions in pain rating index percentage score (median 83.3 (IQR 66.7 to 100) vs. median 66.7 (IQR 33.3 to 71.1), P < 0.001); visual analogue scale score (median 7.0 (IQR 6.0 to 8.0) vs. median 6.0 (IQR 4.8 to 7.0), P < 0.001); present pain index score (median 3.0 (IQR 2.0 to 3.0) vs. median 2.0 (IQR 2.0 to 3.0), P = 0.019) and ODQ% score (median 44.0 (IQR 39.5 to 50.0) vs. median 39.0 (IQR 31.9 to 44.0), P < 0.001) over 3 months of treatment. Natrum muriaticum (n = 11, 22%); Staphysagria (n = 8, 16%); Bryonia alba and Rhus toxicodendron (n = 6 each, 12%) and Pulsatilla nigricans (n = 4, 8%) were prescribed frequently. Conclusion: Indicated homoeopathic medicines reduced SF-MPQ and ODQ scores. Further randomised trials are warranted with enhanced methodological rigour.
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Pharmacognostic and physicochemical study of Urtica urens L.: A drug used in Homoeopathy p. 91
Satish Patel, Bibaswan Biswas, K Rambabu, Shyaga Jhansi, Ramchander Potu, EN Sundaram, Renu Arya
DOI:10.4103/ijrh.ijrh_50_18  
Background: Urtica urens L. (Family Urticaceae), known as annual nettle, dwarf nettle, small nettle, dog nettle or burning nettle, is used in the treatment of arthritis, uric acid diseases, benign prostatic hyperplasia and burn. In Homoeopathy, the whole plant is used for the treatment of gout, uric acid diathesis, joint pain, lithiasis, urticaria and agalactia and burns. Objective: The objectives of the present study were to investigate morpho-anatomical, powder and physicochemical standards of the whole plant of Urtica urens for authentication and identification of raw drug. Materials and Methods: The current study includes macroscopical and microscopical study of root, stem, leaf and powder and physicochemical studies of whole plant powder and mother tincture of Urtica urens. Results: The taproot is rounded, thick and brown; leaves are long petiolate, elliptic to broadly ovate; stem 0.5–1 cm thick, rounded and branched. Qualitative and quantitative microscopic studies showed the distinguishing characters of root stem and leaf. In physicochemical studies of the drug, extractive values in alcohol and water were ≤7.52 and ≤13.88% w/w, respectively; loss on drying, total, acid insoluble and water-soluble ash were found to be ≤11.75, ≤24.55, ≤3.59 and ≤6.89% w/w, respectively. In mother tincture, weight per millilitre, alcohol content, total solids, pH and λmax were found to be ≥0.97 g, 47% v/v–52% v/v, ≤1.88% w/v, 7.93 and 266, 279 nm, respectively. Conclusion: The data presented in this communication may be used as diagnostic characters for identification and authentication of raw drug so as to ensure purity, quality and efficacy of homoeopathic drug Urtica urens.
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Evaluation of antibacterial and antioxidant potential of some homoeopathic mother tinctures p. 100
Tayyeba Rehman, Saeed Ahmad
DOI:10.4103/ijrh.ijrh_44_17  
Objectives: In homoeopathic system of medicine, mother tinctures are prescribed for several diseases especially for septic conditions and cure of many illnesses. This study was done to evaluate the antibacterial and antioxidant potential of ten commonly used homoeopathic mother tinctures. Materials and Methods: Ten prepared mother tinctures were tested against five clinically important human pathogenic bacteria (Salmonella typhi [S.T], Escherichia coli [E.C], Bacillus subtilis [B.S], Staphylococcus aureus [S.A], and Pseudomonas aeruginosa [P.A]) by broth micro-dilution method with ciprofloxacin as positive control. Antioxidant activity was estimated by 2,2-diphenyl 1-picryl hydrazyl (DPPH) inhibition assay. Ascorbic acid was taken as positive standard in antioxidant activity. Results: All mother tinctures showed more or less antibacterial activity. Cinchona officinalis had maximum activity (89% inhibition) against Salmonella typhi than all the tested mother tinctures. Pulsatilla nigricans showed the highest inhibition of DPPH (85%) among other tested plant mother tinctures. Conclusion: This study reveals that the above-tested mother tincture has antibacterial and antioxidant potential against the particular microorganism and 2,2- diphenyl 1-picrylhydrazyl (DPHH), respectively.
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Attenuation of Complete Freund's Adjuvant-induced arthritis by different dilutions of Eupatorium perfoliatum and Crotalus horridus and their safety evaluation p. 107
Surender Singh, Ritu Karwasra, Prerna Kalra, Debadatta Nayak, Anil K Khurana, Raj K Manchanda
DOI:10.4103/ijrh.ijrh_23_19  
Objective: The aim of this study was to investigate, the inhibitory effect of the homoeopathic drugs – Eupatorium perfoliatum and Crotalus horridus in experimental models of inflammation and Complete Freund's Adjuvant (CFA)-induced arthritis with evaluation of their safety aspects by acute and subacute toxicity studies. Materials and Methods: Animals were divided into eight groups (n = 6). Eupatorium perfoliatum and Crotalus horridus in different dilutions (6CH, 12CH, 30CH and 200CH) were administered orally, daily during the study period of 21 days, and their effect on joint dysfunction was evaluated by measuring joint diameter in CFA-induced arthritis model. In addition, inflammatory profiles of these homoeopathic drugs were screened in carrageenan-induced paw oedema model. Acute and subacute studies were carried out according to Organization for Economic Cooperation and Development 425, 407 guidelines. The subacute toxicity study was carried out for a duration of 28 days, and all the animals were observed for behavioural abnormalities. At the end of 28th day, animals were sacrificed to carry out the biochemical, haematological and histopathological estimations. Results: Findings of the study revealed that on CFA administration, there is a significant (P < 0.01) increase in joint diameter in all the tested animals. Maximum increase in joint diameter was observed on day 3 in all the treatment groups. Eupatorium perfoliatum 200CH showed significant decrease in joint diameter on day 21. In carrageenan study, the homoeopathic drugs produced a significant reduction in paw oedema at 5-h post-carrageenan administration. Study noted that the anti-inflammatory activity of Eupatorium perfoliatum was found to be superior to Crotalus horridus. Conclusion: Study inferred that Eupatorium perfoliatum and Crotalus horridus are safe at dilutions 6CH, 12CH, 30CH and 200CH and effective in minimising inflammation and arthritis in CFA-induced model.
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RESEARCH PROTOCOL Top

Protocol for efficacy of individualised homoeopathic medicine in cases of wrist ganglion: A prospective, parallel arm, randomised, double-blind, placebo-controlled trial p. 118
Central Council for Research in Homoeopathy
DOI:10.4103/ijrh.ijrh_3_18  
Background and Objectives: Wrist ganglia are benign soft-tissue tumours of controversial pathogenesis. Most of them are asymptomatic besides swelling but may be associated with pain, interference with activities and an increase in size. Non-surgical management options are not much effective, and surgical excision may invite complications as well as longer recovery period. Homoeopathic treatment remains a very effective measure, but the documentation of it is not adequate. This protocol is designed to evaluate the effect of individualised homoeopathic medicines in cases of wrist ganglion. Materials and Methods: The study will be a prospective, parallel arm, randomised, double-blind, placebo-controlled trial. Participants (n = 154) will be allocated to individualised homoeopathic medicine group or placebo group by block randomisation. Enrolment will be done for 6 months, and every enrolled participant will be followed up for 8 months. Primary outcome measure will be changes in ganglion size at 8th month. Secondary outcome measures will be changes in pain visual analog scale score and patient-rated wrist evaluation score at every month till 8th month. Discussion: The study may help in generating evidences which may be helpful to validate the effectiveness of individualised homoeopathic medicine in the wrist ganglion.
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CASE REPORT Top

Case of lumbar spondylosis treated with Homoeopathic medicine Calcarea fluorica p. 125
Ranjit Sonny
DOI:10.4103/ijrh.ijrh_56_17  
Chronic Low Back Pain (CLBP) is one of the most common problems with which people of all age groups report to physicians. It is a very troublesome complaint affecting day-to-day life, leading to decreased productivity. Amongst all the causes, lumbar spondylosis is one of the major causes of CLBP. Lumbar spondylosis commonly affects middle to later age groups. This case report describes patient with symptoms of recurrent pain in low back for the last 10 years. X-ray of the lumbosacral (L.S.) spine showed features of osteophyte confirming the diagnosis of lumbar spondylosis. After careful case-taking, homoeopathic medicine Calcarea fluorica in different potencies was prescribed as per homoeopathic principles with ever-increasing improvement. Pain in the low back gradually diminished. Ultimately, the patient got rid of all the symptoms with general improvement. After that, he was on placebo for 5 months. X-ray of the L.S spine done after treatment revealed no feature of lumbar spondylosis along with remission of osteophyte.
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RESEARCH UPDATES Top

Research Highlights p. 131
Daisy Katarmal
DOI:10.4103/ijrh.ijrh_38_19  
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BOOK REVIEW Top

Book review: Prognostic factor research in Homoeopathy p. 135
Laxmikanta Nanda
DOI:10.4103/ijrh.ijrh_44_19  
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