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   Table of Contents - Current issue
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April-June 2020
Volume 14 | Issue 2
COVID-19 Special
Page Nos. 77-167

Online since Friday, May 29, 2020

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EDITORIAL  

Homoeopathy in epidemics: Bridging the gap p. 77
Anil Khurana
DOI:10.4103/ijrh.ijrh_48_20  
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ORIGINAL ARTICLES Top

Proposed checklist for standardising homoeoprophylaxis interventions p. 80
Isaac Golden
DOI:10.4103/ijrh.ijrh_18_20  
Background: Results from large homoeoprophylaxis (HP) interventions support the effectiveness of HP, but their variable methodology means that meaningful summaries of the combined data are difficult to produce. Objective: The aim of this article is to develop possible ways of standardising and improving the quality of data from HP interventions. Methods: Evidence collected from some large HP interventions is summarised. A previously suggested pre- and post-intervention checklist intended to help standardise the evidence from HP interventions is critically examined. Results: A summary of HP evidence from large interventions shows that there is a growing body of data suggesting a level of HP effectiveness between 85% and 90%. However, the type and quality of the evidence is variable. A previously developed checklist for researchers to use is modified and examples are given from actual interventions. Conclusion: There is a growing body of evidence supporting claims that HP interventions are effective. The evidence base needs to be improved in a range of ways. Requiring a standardised checklist to be completed by researchers before and after an intervention offers one method to improve the quality and consistency of evidence collected. HP has much to offer governments, health officials and citizens globally. It is safe, relatively effective, flexible, easily delivered and highly cost-effective. Yet, it is supported by very few governments. The quantity of evidence is growing, but the onus is on proponents to strengthen the quality of the evidence base supporting HP to the point where the inevitable critics of Homoeopathy are silenced.
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An online cross-sectional survey on knowledge, attitudes, practices and perspectives of homoeopathic practitioners towards COVID-19 p. 90
Divya Taneja, Anil Khurana
DOI:10.4103/ijrh.ijrh_35_20  
Background: In the light of pandemic of coronavirus disease (COVID-19), identification of level of epidemic preparedness and understanding of homoeopathic practitioners is required to utilise their services in mainstream healthcare effectively. Objective: The objective of this study was to identify knowledge, attitudes and practices of homoeopathic physicians about COVID-19. Methodology: An online cross-sectional survey was undertaken in the midst of the epidemic in India when services of homoeopathic doctors were under consideration. The ten knowledge questions were scored and analysed to identify differences with sociodemographic variables. Responses to the ten questions on attitudes and practices were analysed to identify differences in the domains, differing significantly in knowledge scores. Results: Out of 3901 responses received over 2 days, 3595 were included for analysis. Knowledge scores significantly differed with qualification (graduates – 8.60 ± 1.38, post-graduates – 8.84 ± 1.29 and other qualifications – 8.56 ± 1.31) and years of practice (<10 years – 8.57 ± 1.38 and >10 years – 8.84 ± 1.30). Gender was not identified as a variable to affect knowledge scores significantly. Attitudes and practices were also identified to be more favourable in participants with more than 10 years' experience. Conclusion: Homoeopathic physicians have largely been able to maintain a high level of currency of knowledge, purely on their own accord. Specific aspects related to patient care and practices need to be further enhanced. Practitioners affirmed that homoeopathic medicines need to be validated on a group of patients before mass treatment/prevention can be identified for which immediate access to patients is required.
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REVIEW ARTICLES Top

A review on the role of Homoeopathy in epidemics with some reflections on COVID-19 (SARS-CoV-2) p. 100
Anupriya Chaudhary, Anil Khurana
DOI:10.4103/ijrh.ijrh_34_20  
Background and Objectives: While the world is grappling with the current pandemic of COVID-19, medical fraternity and policy makers are still trying to find ways to control its spread in the absence of any definite treatment protocol. The escalating medical costs of infrastructural requirements in health care as well as development of vaccine are but a few challenges being faced. Alternative approaches to handle the situation require to be explored. This article reviews the role homoeopathy has played in controlling epidemics afflicting the mankind in the past while summarizing the scope of this approach in the current COVID-19 pandemic. Methods: A literature search was conducted using various bibliographic databases like PubMed etc, google search engines to collect all relevant research and review articles, reports, archived texts, you tube recordings, webpages etc. in English language published uptil March 2020. Results: Scientific evidence in various epidemics clearly showcase that Homoeopathy can be used both therapeutically and /or as prophylactic with success using approaches like Genus epidemicus, nosodes etc. Its greatest successes have been recorded in the prevention & treatment of flu like illnesses. Conclusion: Homoeopathy has stood the test of time over centuries as a notable approach in controlling morbidity as well as mortality in epidemics. Administration of the homoeopathic “Genus epidemicus” as a prophylactic for general public or adjuvant homoeopathic treatment in symptomatic cases can be an inexpensive, safe and feasible approach to manage and alleviate the compounding fear and panic that COVID-19 is creating across the globe. National polices & strategies to tackle the pandemic need to be revisited.
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Homoeopathy in the management of infectious diseases: Different facets of its use and implications for the future p. 110
Roja Varanasi, Debadatta Nayak
DOI:10.4103/ijrh.ijrh_40_20  
Background: Infectious diseases are a major challenge to humanity and public health at large. Objective: The aim of this study is to conduct a systematic narrative review of the clinical research evidence for homeopathy in the management of infectious diseases. Methods: A comprehensive search of major biomedical databases: Cochrane Database of Systematic Reviews, Pubmed, Core-Hom, AYUSH Research Portal) and other individual journal sites were conducted. Relevant research published between 1999 and 2019 was categorised by study type, clinical condition and causative pathogen. Results: The literature search of two decades (1999–2019) gathered 86 articles: Meta-analysis (n = 1), systematic reviews (n = 4), randomised controlled trials (n = 30), comparative cohort/observational studies (n = 16), cohort/observational studies (single arm) (n = 25), case series (n = 7) and case reports (n = 3). The review demonstrated the beneficial evidence of homeopathy in infectious diseases is large. Both controlled and uncontrolled studies reported positive results, early recovery, reduction of hospital stay, less use of antibiotics and satisfaction of patients. Prophylactic studies on dengue, chikungunya, Japanese encephalitis/acute encephalitis syndrome and leptospirosis have shown the potential role of homeopathy in preventing the disease outbreaks. Homoeopathy as an add-on treatment for these conditions has shown added benefits in reducing mortality, morbidity and sequelae. Homoeopathy has a possible and viable role as standalone and as an integrative medicine for different infectious diseases. Conclusion: Homoeopathy offers beneficial role in combating infections. Due to the heterogeneity of approaches, more studies in different research settings are warranted to add to the existing evidence and validating it for enhancing the self-healing power of the body against infections.
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A review on immunomodulatory response of homoeopathic medicines through cytokine induction as evidenced in in vivo and in vitro studies p. 122
Mohit Mathur, Anu Kapoor
DOI:10.4103/ijrh.ijrh_33_20  
Background: This review discusses the importance of inter-individual variations in Homoeopathy and role of immune modulation through cytokine induction behind these variations in symptoms. Objectives: To analyse the effects of homoeopathic drugs in modulation of cytokine synthesis to find the individualised immunological mechanisms of these drugs. Methods: The PubMed database was searched for studies which analysed effects of homoeopathic medicines on cytokine synthesis. Full texts of shortlisted studies after scrutiny of abstracts, were analysed for study design, homoeopathic medicines used, cytokines analysed and results. Results: The PubMed search yielded 21 studies. After analysis of abstracts of 21 studies, 10 were shortlisted, which included 7 in vivo and 2 in vitro studies. One study had both in vivo and in vitro interventions. Majority of in vivo studies used rat and exposure to immunological challenge before administration of homoeopathic medicine. The cytokines studied were interleukin (IL)-1α, IL-1β, interferon-gamma, tumour necrosis factor alpha, IL-2, IL-4, IL-5, IL-6, IL-10 and IL-12. The two in vitro studies evaluated effects of Saussurea lappa and Mercurius solubilis on lymphocytes and macrophage culture, respectively. Out of 10 studies analysed, 8 showed homoeopathic medicines can modulate cytokine synthesis either by increasing or decreasing the cytokine synthesis, in a statistically significant manner. Conclusion: The studies were heterogeneous regarding the antigenic challenge given to stimulate immune cells and only 50% of studies clearly mentioned random allocation of animals in groups. Though majority of studies showed that homoeopathic medicines can modulate cytokine synthesis, the mechanism of cytokine modulation remained unexplored.
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Homoeopathic nosodes, a neglected approach for epidemics: A critical review p. 129
Debadatta Nayak, Roja Varanasi
DOI:10.4103/ijrh.ijrh_46_20  
Background: Nosodes are the homoeopathic medicines prepared from diseased products of biological origin. These are commonly used in clinical practice for the prophylaxis and treatment of ailments including infectious diseases. Objective: This review aims at the usage of nosodes for the management of epidemics. Methods: The homoeopathic research literature was searched to find examples of the use of nosodes in different ways and to evaluate their role and position in homoeopathic practice with special reference to epidemic diseases. Results: Research evidence for use of the nosodes as prophylactics and for the treatment of various infectious and non-infectious diseases is emerging. Nosodes such as Meningococcinum,nosoLEP and Malaria officinalis have been used successfully in controlling meningitis, leptospirosis and malaria, respectively. The use of nosodes as isopathy is somewhat acceptable in the mainstream medicine due to its similarity to vaccination. Although it is feasible to use nosodes in a short span of time and can be administered easily, the method of preparation and the safety issues are of much concern and therefore, should be used with utmost care. The safety issues outlined by the World Health Organization should be satisfied before their application in public health. Conclusion: The challenge for the future is to refine the method of preparation and to develop a harmonised way of preparing the nosodes, which is conducive to all the homoeopathic pharmacopoeias across the globe. Nosodes prepared as per the homoeopathic principles have potential to be used as prophylactics in epidemics, but only if there is sufficient experimental evidence of its effectiveness and safety.
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Psychological implications during the outbreak of COVID-19 and its homoeopathic management p. 136
Sanjeevi Karunakara Moorthi, P Radhika, KC Muraleedharan
DOI:10.4103/ijrh.ijrh_30_20  
Background: Coronavirus disease 2019 (COVID-19) is rapidly spreading across the globe and is creating dread among all people irrespective of their socioeconomic status. To tackle the rapid spread of the disease, social distancing has been found to be the only measure. However, such distancing creates a lot of mental stress, as evident from previous studies. Objectives: The objective of the study was to assess the psychological implications during quarantine and isolation and to find the homoeopathic remedies that may be suitable. Methods: We have tried to collect the mental symptoms from the available literature and from the recent studies in China on COVID-19. Based on these, repertorisation outcome was analysed to evolve a group of medicines that can be used in the scenario. Results: Based upon the symptoms collected from the previous studies, repertorisation outcome [Figure 1] was analysed to evolve a group medicine which can be used in the scenario. The medicines Arsenic album, Calcarea carbonica, Lachesis, Ignatia andPulsatilla obtained the highest marks in the analysis. The symptoms of these medicines were collected after referring the Hering's Guiding Symptoms of Materia Medica[31] and Desktop Guide to Keynotes and Confirmatory Symptoms by Roger Morrison[32] and are presented in the paper. Conclusion: We hope that these medicines will prove to be beneficial for prescription to those suffering from the psychological impacts of COVID-19.
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DISCUSSIONS Top

Enabling use of Homoeopathy in India's preparedness for pandemic/epidemic situation like COVID-19 p. 143
Suhana Panaparambil Azis, Harleen Kaur
DOI:10.4103/ijrh.ijrh_42_20  
India reported its first positive case of COVID-19 on 30th January 2020. The alerts, the checks and the quarantines soon followed. As of 28th April 2020, India had crossed the 20,000 mark of positive cases and seen over 900 deaths. The nation is adapting and preparing fast for this rapidly spreading COVID outbreak, and new advisories superseding the previous ones as per the evolving needs are being issued by the concerned authorities on almost daily or weekly basis. The unprecedented spread of this pandemic was unforeseen, and therefore, many nations, including India, were caught off guard, and understandably so. The preparedness, policies for emergency measures in health delivery, and laws related to curfews and lockdowns had to be brought into action without much time for anticipatory planning. However, among all these arrangements, and preparedness of our nation toward the outbreak of COVID-19, the role of AYUSH has so far been minimal. The situation, however, is opening up, of late, with latest advisories and notifications roping in AYUSH professionals and students as COVID warriors for providing health support, as also for taking up evidence-based trials in selected COVID-positive cases, after due ethical and official approvals. The article reflects on why enabling the use of Homoeopathy in India's preparedness for pandemic/epidemic situations like COVID-19 is important and how this can be achieved.
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Homoeopathy in pandemic Spanish flu 1918 p. 152
Vaishali H Shinde
DOI:10.4103/ijrh.ijrh_32_20  
The mankind has been under the wrath of various H1N1 viruses tracing back to the Spanish flu (SF) in 1918 down to pandemics in 1957 H2N2, 1968 H3N2, 2009 H1N1 and COVID 19 in 2020. Despite a lot of advancements in genomic viral studies, laboratory techniques, medical advancement and treatment options in the form of antiviral and antibiotics, the threat of pandemics is hovering on mankind with a challenge at global and national level to fight against it. Homoeopathy has played a contributory role in the treatment and prevention in various epidemics in the past. In this overview, the role of homoeopathic medicines used in the treatment of Pandemic SF 1918, in reducing the mortality is highlighted.
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CONFERENCE REPORT Top

World Homoeopathy Day 2020: Connecting digitally during the adversities of COVID-19 lockdown p. 160
Deepti Singh Chalia, OP Verma, Kavita Bharti
DOI:10.4103/ijrh.ijrh_39_20  
The Central Council for Research in Homoeopathy (CCRH), with support from the Ministry of AYUSH, Government of India, organised its first Webinar on World Homoeopathy Day on 10 April 2020 to commemorate the birth anniversary of the founder of Homoeopathy, Dr Samuel Hahnemann. Considering the need of hour and utilising the advancements of digital platforms, the CCRH decided to organise this webinar focusing on the role of Homoeopathy in COVID-19, for the homoeopathic fraternity and to unite them digitally. The webinar was inaugurated by Shri. Shripad Naik, Minister of State (IC), Ministry of AYUSH; Vaidya Rajesh Kotecha, Secretary, Sh. PK Pathak, Additional Secretary; and Sh. Roshan Jaggi, Joint Secretary from the Ministry of AYUSH, also graced the occasion with their live addresses. Keynote speaker Prof. George Vithoulkas, Director, International Academy of Classical Homeopathy, Dr Robbert V Haselen, Member, Homoeopathic Pharmacopeia of United States, and Prof. Aaron To, Director, Living Homoeopathy, Hong Kong, also joined in as valued speakers. Significant deliberations were also made by Dr V. K. Gupta, Chairman, Scientific Advisory Board, CCRH, Dr Anil Khurana, Director General In-charge, CCRH; Dr Raj K Manchanda, Director, Directorate of AYUSH, Government of Delhi; Dr S R K Vidyarthi Director, Ministry of AYUSH; and Dr Subhas Singh, Director, National Institute of Homoeopathy, Kolkata. The Council humbly thanks them for their generosity and sparing their valuable time for this event at a short notice.
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