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Background/Objective During the coronavirus disease 2019 (COVID-19) pandemic, several homeopathic prognostic factor research (PFR) projects have been undertaken. We found two projects with comparable outcomes to assess consistency and possible flaws. Methods Two comparisons were made. (1) Outcome of a PFR data collection from the Liga Medicorum Homoeopathica Internationalis (LMHI) by about 100 doctors with 541 cases was compared with a previous analysis of 161 cases in the same database. (2) The updated LMHI database was also compared with a data collection carried out in India by four doctors with a total of 1,445 cases. Differences that resulted in conflicting outcomes (indication in one, contraindication in the other) were examined for possible causes. Results There was only a single outcome in the updated LMHI database that conflicted with the previous dataset, and this could have been due to statistical variation. The Indian data contained many cases, from few doctors, while the LMHI database had few cases per doctor, but many doctors. The overlap between the projects (individual cases entered in both) was between zero and 22%. In 72 comparisons we found six (8.3%) conflicting outcomes. Possible causes were statistical error due to small numbers of cases and/or observers, confirmation bias, and keynote prescribing if this resulted in symptoms being inadequately checked. Conclusion There was little conflict between the outcomes of the two versions of one project and between the two different PFR projects. Differences could mostly be explained by causes that can be managed. This consistency should primarily be interpreted as showing a strong overall consensus between homeopathic practitioners worldwide, but with variation of consensus between small groups of practitioners.

In course of diabetes, some 20-90% of individuals eventually develop diabetic neuropathy. Looking at the disease burden research studies in Homoeopathy were conducted and have shown positive results. These studies were not robust enough to prove the efficacy of individualized homoeopathy.To assess efficacy of individualized homoeopathic medicines in management of DDSP.A multi-centric double-blind, placebo controlled, randomised clinical trial was conducted by the Central Council for Research in Homoeopathy at six centres with a sample size of 84. Based on earlier observational studies and repertorial anamnesis of DDSP symptoms 15 homoeopathic medicines were shortlisted and validated scales were used for evaluating the outcomes post-intervention. Primary outcome measure was change in Neuropathy Total Symptom Score-6 (NTSS-6) from baseline to 12 months. Secondary outcomes included changes in peripheral nerve conduction study (NCS), World Health Organization Quality of Life BREF (WHOQOL-BREF) and Diabetic Neuropathy Examination (DNE) Score at 12 months.Data of 68 enrolled cases was considered for data analysis. Statistically significant difference (p0.014) was found in NTSS-6 post intervention in the Verum group. Positive trend was noted for Verum group as per the graph plotted for DNE score and assessment done for NCS. No significant difference was found between the groups for WHOQOL-Bref. Out of 15 pre-identified homoeopathic medicines 11 medicines were prescribed in potencies in ascending order from 6C to 1M.Further studies must be taken up with larger sample size and defined parameters for NCS to assess the effectiveness of homoeopathy.

Background Visceral leishmaniasis (VL) is a neglected tropical disease that is fatal if treatment is not given. The available chemotherapeutic options are unsatisfactory, and so complementary therapies like homeopathy might be a promising approach. Methods A nosode from a pure axenic culture of Leishmania donovani was prepared and screened for its anti-leishmanial potential both in an in-vitro and an in-vivo experimental approach. Results Leishmania donovani amastigote promastigote nosode (LdAPN 30C) exhibited significant anti-leishmanial activity against the promastigote forms of Leishmania donovani and was found to be safe. A study conducted on VL-infected mice revealed that LdAPN 30C resolved the disease by modulating the host immune response toward the Th1 type through upregulating the pro-inflammatory cytokines (IFN-γ and IL-17) and inducing nitric oxide (NO) levels in the infected macrophages. The hepatic parasite load was also found to be significantly decreased. The nosode was found to be safe, as no histological alterations in the liver or kidney were observed in the animals treated with the LdAPN 30C. Conclusion This is the first study in which an axenic culture of Leishmania donovani has been used for the preparation of a homeopathic medication. The study highlights the anti-leishmanial and immunomodulatory potential of a homeopathic nosode in experimental VL.

New effective, economical and safe antimalarial drugs are urgently needed due to the development of multi-drug-resistant strains of the parasite. Homeopathy uses ultra-diluted doses of various substances to stimulate autoregulatory and self-healing processes to cure various ailments. The aim of the study was to evaluate the in vitro and in vivo antimalarial efficacy of a homeopathic drug, Chininum sulphuricum 30C.In vitro antiplasmodial activity was screened against the P. falciparum chloroquine-sensitive (3D7) strain, and cell viability was assessed against normal human dermal fibroblasts and HepG2 cells. Suppressive, preventive and curative studies were carried out against P. berghei-infected mice in vivo.Chininum sulphuricum (30C) revealed good antiplasmodial activity in vitro, with 92.79 ± 6.93% inhibition against the 3D7 strain. The cell viability was 83.6 ± 0.6% against normal human dermal fibroblasts and 95.22 ± 5.1% against HepG2 cells. It also exhibited suppressive efficacy with 95.56% chemosuppression on day 7 with no mortality throughout the follow-up period of 28 days. It also showed preventive activity against the disease. Drug treatment was also safe to the liver and kidney function of the host as evidenced by biochemical studies.Chininum sulphuricum 30C exhibited considerable antimalarial activity along with safety to the liver and kidney function of the host.Hintergrund: Es besteht dringender Bedarf an neuen wirkungsvollen, ökonomischen und sicheren Malariamedikamenten angesichts der Entwicklung multiresistenter Stämme des Parasiten. In der Homöopathie werden hochverdünnte Dosen verschiedener Substanzen eingesetzt, um selbstregulierende und selbstheilende Prozesse zur Heilung verschiedener Leiden anzustoßen. Das Ziel dieser Studie war es, die Wirksamkeit des homöopathischen Präparats Chininum sulfuricum 30C gegen Malaria in vitro und in vivo zu beurteilen. Methoden: Die antiplasmodiale Aktivität in vitro wurde an P. falciparum, chloroquinsensitiver Stamm (3D7) getestet, und die Zellvitalität wurde bei normalen humanen Dermis-Fibroblasten sowie HepG2-Zellen untersucht. In vivo wurden suppressive, präventive und kurative Studien bei P.-berghei-infizierten Mäusen durchgeführt. Ergebnisse: Chininum sulfuricum (30C) zeigte in vitro gute antiplasmodiale Aktivitätmit 92,79 ± 6,93% Inhibition des 3D7-Stamms. Die Zellvitalität lag bei 83,6 ± 0,6% bei normalen humanen dermalen Fibroblasten bzw. 95,22 ± 5,1% bei HepG2-Zellen.Außerdem zeigte das Präparat suppressive Wirksamkeit mit 95,56% Chemosuppression an Tag 7 ohne Mortalität im gesamten Nachbeobachtungszeitraum von 28 Tagen. Auch zeigte es präventive Wirksamkeit gegen die Krankheit. Die Behandlung war dabei sicher in Bezug auf die Leber- und Nierenfunktion des Wirts, wie biochemische Studien belegen. Schlussfolgerung: Chininum sulfuricum 30C zeigte erhebliche Aktivität gegen die Malariainfektion und war dabei sicher in Bezug auf die Leber- und Nierenfunktion des Wirts.

During the past century, the amount of information about homeopathic medicines has grown dramatically. However, the recent coronavirus disease 2019 pandemic has shown that homeopathic practitioners do not use more medicines than a century ago and they seem to use less symptoms to find the proper medicine. This could be explained by the fact that the more than a hundred years old repertory was flawed from the beginning and that more information in the repertory leads the practitioner astray in an increasingly complex labyrinth of data.This can be resolved by applying modern data management techniques based on systematic collection of treatment data and statistical analysis of the data. Homeopathic practitioners should collect these data avoiding bias. This requires additional training of practitioners, which should also result in a higher scientific level of homeopathic practice and increasingly effective treatment as the database grows.

Background Acne is often treated at homeopathic clinics in India based on existing literature without using any measurable parameters and the outcomes are seldom reported, hence this study. Objective To evaluate the effects of homeopathy on the treatment of acne using specific outcome measures related to severity and disability. Methods It is an open, single-arm, non-comparative study undertaken at a clinic located in rural India using individualised homeopathy. Global Acne Grading System (GAGS) scores and Cardiff Acne Disability Index (CADI) scores were analysed at baseline and post medication at 3 and 6 months using one-way repeated measure analysis of variance (ANOVA) in Statistical Package for the Social Sciences (SPSS) version 19 to assess the outcomes of intervention. Results Eighty-four patients enrolled in the study were analysed under modified intention to treat approach. Nat-m (n = 14), Calc-s (n = 14), Sulph (n = 13), Kali-br (n = 10) and Hep-s (n = 9) were the most frequently used remedies. Significant differences were found in the severity of the disease and quality of life (QoL) from baseline to 6 months in terms of GAGS (mean difference, 15.47; standard error [SE], 0.69; 95% confidence interval [CI], 13.79–17.16; p Conclusions Acne can be effectively treated at homeopathic clinics along with improvement in QoL of patients. Increase in severity of acne was associated with worsening of QoL. Further pragmatic studies with comparative cohort is desirable.

Background Leishmaniasis is one of several neglected tropical diseases that warrant serious attention. A disease of socio-economically poor people, it demands safer and cheaper drugs that help to overcome the limitations faced by the existing anti-leishmanials. Complementary or traditional medicines might be a good option, with an added advantage that resistance may not develop against these drugs. Thus, the present investigation was performed to evaluate the anti-leishmanial efficacy of an ultra-diluted homeopathic medicine (Iodium 30c) in experimental visceral leishmaniasis (VL).Methods Compliant with strict ethical standards in animal experimentation, the study was performed in-vivo in inbred BALB/c mice which were injected intravenously with 1 × 107 promastigotes of Leishmania donovani before (therapeutic) or after (prophylactic) treatment with Iodium 30c for 30 days. In other groups of mice (n = 6 per group), amphotericin B served as positive control, infected animals as the disease control, while the naïve controls included normal animals; animals receiving only Iodium 30c or Alcohol 30c served as sham controls. The anti-leishmanial efficacy was assessed by determining the hepatic parasite load and analysing percentages of CD4+ and CD8+ T cells. Biochemical analysis and histological studies were performed to check any toxicities.Results Iodium-treated animals showed a significantly reduced parasite load (to 1503 ± 39 Leishman Donovan Units, LDU) as compared with the infected controls (4489 ± 256 LDU) (p Conclusion This original study has shown that Iodium 30c had significant impact in controlling parasite replication in experimental VL, though the effect was less than that using standard pharmaceutical treatment.

Japanese encephalitis (JE) is now a public health concern due to limitation of the available vaccine and nonexistence of specific antiviral therapy and thus demands new potential therapeutical strategies. The present study was conducted to evaluate the effect of atropine in controlling JE virus infection in chick embryo, which is already established as an ideal model for study of various host–pathogen interactions and screening of newer antiviral agents. In this experiment we pre-treated 12 day old embryos with atropine sulphate to see whether it can give protection from JE virus challenge. There were significant decrease in the viral loads in the brain, chorioallantoic membrane and amniotic fluid of the embryo in atropine sulphate pre-treated groups compared to the infection groups. Atropine sulphate pre-treated group showed significant up-regulation of interferon alpha and toll like receptor-3 mRNA, than other analogous groups. The histological changes showed significant reduction of necrosis, inflammation and other co-morbid pathology in the atropine sulphate pre-treated groups. Hence this study demonstrated the protective role of atropine in controlling the JE virus replication and its organ-tropic dissemination to brain which may pave way for a prospective therapy in the future treatment of JE.

Background: A systematic review on homoeopathic pathogenetic trials (HPTs) from 1945 to 1995 was published in 2007, and the basic question whether the effect produced by homoeopathic drugs in healthy human volunteers is equivalent to placebo or otherwise remained unanswered. There is a need to take up another review of HPTs conducted in the last two decades, to assess the changes in the methodologies adapted and to assess whether the effects produced in apparently healthy volunteers is due to homoeopathic medicines in high dilutions or not. Objective: To seek, collect, review and describe HPTs published during 1996–2018. Materials and Methods: A comprehensive literature search, both electronic and manual, was done using search terms ‘homoeopathic drug proving’ and ‘homoeopathic pathogenetic trial’ with time constraint of 1996–2018 in English language. As per the inclusion and exclusion criteria, the papers were selected for extraction of data in the predefined extraction form. Results: One hundred and forty-seven eligible records (74 peer-reviewed [PR] and 73 non-peer-reviewed [NPR]) of HPTs of 214 drugs were identified and subjected to the extraction of data. Majority of the drug proving records were contributed by the Central Council for Research in Homoeopathy which included 86 records (24 PR and 62 NPR) with the data of 24 and 63 drugs, respectively, and by Riley, one book (NPR) with data of 68 drugs. Heterogeneity was encountered in all aspects – design, conduct, participants and outcome reporting.Conclusion: This preliminary study is the basis for data recovery and for the forthcoming program of systematic review and meta-analysis, which may include the HPTs published in other languages.

Background: Hypertension (HTN) is a leading risk factor for death and disability and responsible for over 1.6 million deaths in India. Clinical case reports, observational studies and randomised controlled trials show the effects of homoeopathic medicine in HTN. Objectives: The results of this study will add to the evidence of effectiveness of individualised homoeopathic medicine in Stage I HTN. Methods: A single-blind, randomised, placebo-controlled trial was undertaken from October 2013 to March 2018. The primary outcome measure was to evaluate the change in systolic blood pressure (SBP) and diastolic blood pressure (DBP) every month for 3 months. Of 2127 patients screened, 217 patients who fitted the inclusion criteria were randomised to receive either homoeopathic Q potencies (or LM potencies) plus lifestyle modification (LSM) =116 or placebo + LSM = 101. LSM included physical activity and diet as part of the treatment regimen. Analysis was by intention to treat. Results: Repeated-measure ANOVA between the groups showed statistically significant difference (Wilk lambda 0.85, F = 12.12, df = 213,P = 0.0001), in both SBP and DBP favouring Individualised Homoeopathy (IH) along with LSM. Post hoc independent t-test showed a significant mean reduction in SBP (mean difference 7.12 mm Hg, 95% confidence interval [CI] 4.72–9.53,P = 0.0001) and DBP (mean difference 5.76 mm Hg, 95% CI: 4.18–7.23,P = 0.0001) favouring Homoeopathy plus LSM group. Sulphur (n = 24), Natrum muriaticum (n = 21), Lycopodium (n = 16), Nux vomica (n = 12) and Phosphorus (n = 10) were the most useful medicines. Conclusion: IH in LM potency along with LSM was found effective over placebo along with LSM in the patients suffering from Stage I HTN. Further trials in rigorous setting are warranted.

Background: Despite standard management, healing rate of Diabetic Foot Ulcers (DFUs) remains low, posing risk of lower extremity amputation. Objectives: This study was undertaken to evaluate if Calendula Q has added benefit over individualized homoeopathic intervention (IHI). The primary objective was to achieve complete epithelialisation within 20 weeks and secondary objective was to assess the changes in quality of life using DFU Scale-short form (DFU-SF) questionnaire. Materials and Methods: A randomised controlled pilot study with a 20-week intervention was conducted from 2014-2017. 277 cases were screened and 60 cases were enrolled and randomised to Group I: IHI + Calendula Q dressing (n= 30) and Group II: IHI + normal saline (NS) dressing (n = 30), along with standard conventional medication for glycaemic control. Results: The mean time (Group I= 12 weeks, Group II= 11 weeks) of ulcer healing in both groups showed no statistically significant difference, thus calendula Q used for dressing did not have any added benefits (p= 0.0521). Arsenicum album (n= 14, 23.3%), Lycopodium (n= 8, 13.3%), Silicea (n= 7, 11.7%), Sulphur (n= 6, 10%), Phosphorus (n= 5, 10%) and Sepia (n=5, 10%) were found to be effective medicines. Conclusion: IHI, along with wound hygiene and conventional diabetic management, proved to be effective, irrespective of whether Calendula Q or normal saline was used for wound hygiene, thus leading to early, complete epithelialisation of Wagner's first and second stages of DFUs. Further studies comparing IHI with standard care are warranted.

Background: Polar symptoms represent the most challenging rubrics in the homoeopathic repertories, despite their frequent use. Objective: The study objective was to assess the relationship between 27 polar cough symptoms, 3 non-polar cough symptoms and 30 general polar symptoms and successful response to specific homoeopathic medicines. Materials and Methods: A multi-centre, explorative, prospective, observational study was conducted at ten centres under the Central Council for Research in Homoeopathy. Two hundred and sixteen patients were enrolled with chronic cough, lasting >8 weeks. The patients were enrolled as per four underlying diagnoses of chronic upper airway cough syndrome (CUACS), gastro-oesophageal reflux disease (GERD), asthma and related syndromes, and non-asthmatic eosinophilic bronchitis (NAEB). 30 general polar symptoms, 27 polar cough symptoms and 3 non-polar cough symptoms were assessed at the baseline. During enrollment and follow-up consultations, two validated questionnaires (Leicester Cough Questionnaire chronic and EuroQuol (EQ)-5D-5L) were filled for assessing the effect of treatment. If the Physician Assessment Score was >2, the causal relationship between improvement and prescribed medicine was further assessed using Modified Naranjo Algorithm. Results: At the fourth follow-up, three medicines with >10 cases having good result were identified: Phosphorus (n = 20), Pulsatilla (n = 19) and Sulphur (n = 13). For this introductory article, we compare some results with the existing data, reflect on discrepancies between the existing data and research outcome and reflect on future use, especially in respiratory tract infections (RTIs). Conclusion: In improving the homoeopathic method and its practical use, priority should be given to polar symptoms, especially related to RTIs.

Background: Anaemia in children has significant adverse health consequences and is a major public health problem. Objective: The objective of this study is to identify efficacy of Ferrum phosphoricum 3X (FP) and Ferrum metallicum 3X (FM) in changing haemoglobin (Hb) levels in school-going children, 12–14 years of age with Iron Deficiency Anaemia (IDA). Materials and Methods: School children were screened for Hb levels using a portable haemoglobinometer at Noida, Kottayam, Guwahati and Imphal. Children with Hb levels ≤11.9 g% and ≥8 g% were investigated for IDA by measuring serum ferritin level and other parameters. Children enrolled were divided into two categories, i.e., mild (Hb 11–11.9 g%) and moderate anaemia (Hb between 8 and 10.9 g%). Children in both the groups were randomised into FP and FM groups and prescribed accordingly for 3 months. Hb levels were repeated after 3 months. Results: 2,878 children were screened and 792 (27.5%) were identified to have Hb between ≤11.9 g% and ≥8 g%. 102 (mild anaemia: FP-30; FM-29, moderate anaemia: FP-21, FM-22) were enrolled after investigations and consent. Significant increase in Hb was seen in children with moderate anaemia in FP group (9.95 ± 0.749–10.97 ± 1.51). Increase in Hb in other groups was not significant. Conclusion: Percentage of children with low iron reserves and having true IDA was

Background Signaling molecules such as cytokines and interleukins are key mediators for the immune response in responding to internal or external stimuli. Homeopathically prepared signaling molecules have been used therapeutically for about five decades. However, these types of products are not available in many countries and their usage by homoeopaths is also infrequent. The aim of this scoping review is to map the available pre-clinical and clinical data related to the therapeutic use of homeopathically prepared signaling molecules. Methods We conducted a scoping review of clinical and pre-clinical studies of therapeutically used signaling molecules that have been prepared in accordance with an officially recognized homeopathic pharmacopoeia. Articles in peer-reviewed journals reporting original clinical or pre-clinical research of homeopathically prepared signaling molecules such as interleukins, cytokines, antibodies, growth factors, neuropeptides and hormones, were eligible. Non-English language papers were excluded, unless we were able to obtain an English translation. An appraisal of eligible studies took place by rating the direction of the outcomes on a five-point scale. The quality of the papers was not systematically assessed. Results Twenty-eight eligible papers, reporting findings for four different manufacturers' products, were identified and reviewed. Seventeen papers reported pre-clinical studies, and 11 reported clinical studies (six experimental, five observational). A wide range of signaling molecules, as well as normal T-cell expressed specific nucleic acids, were used. A majority of the products (21 of 28) contained two or more signaling molecules. The most common clinical indications were psoriasis, vitiligo, rheumatoid arthritis, respiratory allergies, polycystic ovary syndrome, and herpes. The direction of the outcomes was positive in 26 papers and unclear in two papers. Conclusion This scoping review found that there is a body of evidence on the use of homeopathically prepared signaling molecules. From a homeopathy perspective, these substances appear to have therapeutic potential. Further steps to explore this potential are warranted.

Background Prognostic factor research (PFR), prevalence of symptoms and likelihood ratio (LR) play an important role in identifying prescribing indications of useful homeopathic remedies. It involves meticulous unbiased collection and analysis of data collected during clinical practice. This paper is an attempt to identify causes of bias and suggests ways to mitigate them for improving the accuracy in prescribing for better clinical outcomes and execution of randomized controlled studies. Methods A prospective, open label, observational study was performed from April 2020 to December 2020 at two COVID Health Centers. A custom-made Excel spreadsheet containing 71 fields covering a spectrum of COVID-19 symptoms was shared with doctors for regular reporting. Cases suitable for PFR were selected. LR was calculated for commonly occurring symptoms. Outlier values with LR ≥5 were identified and variance of LRs was calculated. Results Out of 1,889 treated cases of confirmed COVID-19, 1,445 cases were selected for pre-specified reasons. Nine medicines, Arsenicum album, Bryonia alba, Gelsemium sempervirens, Pulsatilla nigricans, Hepar sulphuricus, Magnesia muriaticum, Phosphorus, Nux vomica and Belladonna, were most frequently prescribed. Outlier values and large variance for Hepar sulphuricus and Magnesia muriaticum were noticed as indication of bias. Confirmation bias leading to lowering of symptom threshold, keynote prescribing, and deficiency in checking of all symptoms in each case were identified as the most important sources of bias. Conclusion Careful identification of biases and remedial steps such as training of doctors, regular monitoring of data, checking of all pre-defined symptoms, and multicenter data collection are important steps to mitigate biases.

Background Dengue is an emerging threat to public health. At present, no clear modalities are available for the prevention and management of thrombocytopenia due to dengue. This article reports the clinical outcomes of integrative homeopathic care in a hospital setting during a severe outbreak of dengue in New Delhi, India, during the period September to December 2015. Methods Based on preference, 138 patients received a homeopathic medicine along with usual care (H+UC), and 145 patients received usual care (UC) alone. Assessment of thrombocytopenia (platelet count Results There was a statistically significantly greater rise in platelet count on day 1 of follow-up in the H+UC group compared with UC alone (mean difference = 12,337; 95% confidence interval [CI], 5,421 to 19,252; p = 0.001). This trend persisted until day 5 (mean difference = 14,809; 95% CI, 1,615 to 28,004; p = 0.02). The time taken to reach a platelet count of 100,000/mm3 was nearly 2 days earlier in the H+UC group compared with UC alone (H+UC: 3.44 days ± standard error of the mean [SEM] 0.18; 95% CI, 3.08 to 3.80; UC: 5.28 days ± SEM 0.29; 95% CI, 4.71 to 5.86; p Conclusion These results suggest a positive role of adjuvant homeopathy in thrombocytopenia due to dengue. Randomized controlled trials may be conducted to obtain more insight into the comparative effectiveness of this integrative approach.

Background Based on a pluralistic approach to health care, India offers a range of medical treatment modalities to its population. In that context, the government of India aims at providing its people with wider access to homeopathy. This article provides insight into the infrastructural support put in place by the government to meet that aim. Data and Methods A literature review was carried out of recent surveys and articles to assess the morbidity trends in India and the treatment modalities being sought by patients. Extensive attempts were made to identify and access all data sources that could contribute to understanding the situation of homeopathy in public health in India. These efforts included analysis of secondary data about government wellness centres, as also a case study of one such centre. Results In India, homeopathy is well represented in public health, being a close second among the AYUSH (Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy) services. Homeopathy wellness centres comprise 31% of the total for AYUSH. Seven out of 10 diseases recognised as a national health burden are in the category of most commonly reported diseases at the homeopathy wellness centres. Academic homeopathy institutes comprise 35.8% of AYUSH colleges, the total student intakes of which are 13,658 and 32,256 respectively. Homeopathy practitioners are 37% of the AYUSH total. Homeopathy units comprise 1/19th of the number of allopathy units, yet the annual patient footfall in the former is 1/5th of the latter. Conclusion Homeopathy services, wherever available, are being used fully and thus sharing the patient load in the government-run wellness centres. There is the potential for more homeopathic practitioners to contribute importantly to health care delivery in India.

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.

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.

Aim: Assessment of group-confined likelihood ratio (GCLR) for the symptom ‘Headache’ from among 20 lesser-known remedies clinically verified by the Central Council for Research in Homoeopathy during the period 2012–2018. Materials and Methods: Analysis of data of the clinical verification study, which was a multicentric, open-label, observational clinical study conducted at 13 study sites of the council. The 50 medicines that completed the drug proving programme of the council were clinically verified in ascending potencies of 6C, 30C and 200C. Of these, 20 lesser-known medicines allowed analysis of the prevalence and LR of the symptom ‘Headache'. These 20 medicines were ordered according to the prevalence of headache, and LR >1 gave an indication what medicines were more related to headache than others. Results: The symptom ‘Headache’ was recorded in a part of the population: 4582 patients where 20 lesser-known medicines were prescribed. Of these medicines, 8 have a GCLR >1, indicating that the symptom headache could indicate these medicines out of the assessed group of 20. Only 5 had statistically significant confidence interval: Allium sativum, Formicum acidum, Gymnema sylvestre, Avena sativa and Persea americana. Among these, two medicines, Allium sativum and Formicum acidum, have significantly higher GCLR. Conclusion: Of 20 lesser-known homeopathic medicines, two could be considered for the further evaluation of the relationship with headache. These findings should be confirmed in properly organised prognostic factor research in a larger population, not restricted to specific medicines, that enables proper comparison.

Background/Objective Coronavirus disease 2019 (COVID-19) is a new disease; its clinical profile and natural history are evolving. Each well-recorded case in homeopathic practice is important for deciding the future course of action. This study aims at identifying clinically useful homeopathic remedies and their prescribing symptoms using the prognostic factor research model.Methods This was an open-label, multi-centric, observational study performed from April 2020 to July 2020 at various public health care clinics. The data were collected prospectively from clinical practice at integrated COVID-19 care facilities in India. Good-quality cases were selected using a specific set of criteria. These cases were analyzed for elucidating prognostic factors by calculating the likelihood ratio (LR) of each frequently occurring symptom. The symptoms with high LR values (>1) were considered as prescribing indications of the specific remedy.Results Out of 327 COVID-19 cases reported, 211 met the selection criteria for analysis. The most common complaints were fatigue, sore throat, dry cough, myalgia, fever, dry mouth and throat, increased thirst, headache, decreased appetite, anxiety, and altered taste. Twenty-seven remedies were prescribed and four of them—Arsenicum album, Bryonia alba, Gelsemium sempervirens, and Pulsatilla nigricans—were the most frequently used. A high LR was obtained for certain symptoms, which enabled differentiation between the remedies for a given patient.Conclusion Homeopathic medicines were associated with improvement in symptoms of COVID-19 cases. Characteristic symptoms of four frequently indicated remedies have been identified using prognostic factor research, findings that can contribute to accurate homeopathic prescribing during future controlled research in COVID-19.

Objective The aim of the study was to identify indicated homeopathic remedies based on the clinical characteristics of coronavirus disease 2019 (COVID-19) patients in India. Methods In this retrospective, cohort study, confirmed COVID-19 patients admitted at a COVID Health Centre in New Delhi between April 29 and June 17, 2020 were given conventional and homeopathic treatment. Patients were grouped into mild, moderate or severe categories of disease. Their symptomatologic profiles were analyzed to identify indicated homeopathic medicines. Results A total of 196 COVID-19 patients were admitted. One hundred and seventy-eight patients had mild symptoms; eighteen patients had moderate symptoms; no patients with severe symptoms were included as they were referred to tertiary care centers with ventilatory support. The mean age of patients with mild symptoms was significantly lower (38.6 years; standard deviation or SD ± 15.8) compared with patients in the moderate category (66.0 years; SD ± 9.09). The most important symptoms identified were fever (43.4%), cough (47.4%), sore throat (29.6%), headache (18.4%), myalgia (17.9%), fatigue (16.8%), chest discomfort (13.8%), chills (12.6%), shortness of breath (11.2%) and loss of taste (10.2%). Twenty-eight homeopathic medicines were prescribed, the most frequently indicated being Bryonia alba (33.3%), Arsenicum album (18.1%), Pulsatilla nigricans (13.8%), Nux vomica (8%), Rhus toxicodendron (7.2%) and Gelsemium sempervirens (5.8%), in 30C potency. Conclusion Data from the current study reveal that Arsenicum album, Bryonia alba, Pulsatilla nigricans, Nux vomica, Rhus toxicodendron and Gelsemium sempervirens are the most frequently indicated homeopathic medicines. A randomized controlled clinical trial based on this finding is the next step.

Background A novel pandemic disease offered the opportunity to create new, disease-specific, symptom rubrics for the homeopathic repertory. Objective The aim of this study was to discover the relationship between specific symptoms and specific medicines, especially of symptoms occurring frequently in this disease. Materials and Methods Worldwide collection of data in all possible formats by various parties was coordinated by the Liga Medicorum Homeopathica Internationalis. As the data came in, more symptoms were assessed prospectively. Frequent analysis and feedback by electronic newsletters were used to improve the quality of the data. Likelihood ratios (LRs) of symptoms were calculated. An algorithm for combining symptom LRs was programmed and published in the form of an app. The app was tested against 18 well-described successful cases from Hong Kong. Results LRs of common symptoms such as ‘Fatigue’ and ‘Headache’ provided better differentiation between medicines than did existing repertory entries, which are based only on the narrow presence or absence of symptoms. A mini-repertory for COVID-19 symptoms was published and supported by a web-based algorithm. With a choice of 20 common symptoms, this algorithm produced the same outcome as a full homeopathic analysis based upon a larger number of symptoms, including some that are traditionally considered more specific to particular medicines. Conclusion A repertory based on clinical data and LRs can differentiate between homeopathic medicines using a limited number of frequently occurring epidemic symptoms. A Bayesian computer algorithm to combine symptoms can complement a full homeopathic analysis of cases.

Background Breast cancer is the second leading cause of cancer-related deaths in women. Conventional treatment such as chemotherapy, hormonal therapy and radiotherapy has decreased the mortality rate among cancer patients but has also revealed long-term side effects. Drug resistance and toxicity to normal cells compound the problems associated with the use of modern medicines. Hence, complementary or alternative treatment options are being explored. The current study, using different homeopathic potencies of Hydrastis canadensis, was conducted to distinguish between any effects they might have on hormone-dependent and independent breast cancer. Materials and Methods The cytotoxic effect of homeopathic medicine Hydrastis on hormone-dependent (MCF 7) and hormone-independent (MDA-MB-468) breast cancer cells was assessed using viability and colony-forming assays after 48 or 72 hours of treatment. Flow cytometry-based Annexin V-PI (propidium iodide), caspase 3 and cell cycle analysis was performed following treatment of cells with mother tincture or various potencies of Hydrastis (1C, 2C, 30C, 200C). Results Different potencies of Hydrastis displayed selective cytotoxic effects against MCF 7 cells, but only marginal effects against MDA-MB-468. The maximum cytotoxicity was established in the case of 1C following 72 hours of treatment. Treatment of breast cancer cells revealed an increase in the G0/G1 cell population, along with an increase in the caspase 3 levels and induction of apoptosis. Conclusion Hydrastis may have a selective cytotoxic effect against hormone-dependent breast cancer MCF 7 cells, leading to cell cycle arrest in the G0/G1 phase, which could be the plausible reason for the induction of apoptosis. The results need to be validated in vivo.

Background During primary teething, children suffer from running nose, mild fever, diarrhoea and other mild irritations and inflammations. A public health programme, ‘Homoeopathy for the Healthy Child’, was undertaken on a pilot basis focusing on promotion of healthy teething by provision of home-based care through six pre-identified homeopathic medicines for complaints commonly observed during primary teething. This article assesses the feasibility of this programme and reports the impact of this initiative on teething profile in children and episodes of diarrhoea and upper respiratory tract infection (URTI). Materials and Methods Accredited Social Health Activists (ASHAs) were trained in child care and usage of a kit comprising six medicines, namely Calcarea phosphoricum 6X (CP), Ferrum phosphoricum 3X, Magnesium phosphoricum 6X, Belladonna 30C, Chamomilla 30C and Podophyllum 30C. Calcarea phosphoricum was given regularly to each participating child from 6 months to 1 year of age. Home-based care for diarrhoea, URTI and mild fever was provided by ASHAs using the other five medicines in the kit. Dentition pattern and diarrhoea/URTI episodes were recorded over a period of the next 12 months. Results Eleven thousand four-hundred and twenty-six children were followed up regularly. Amongst those who enrolled at 6-7 months, a larger proportion of children were approaching expected teething in successive months as compared with children enrolled at 12 months, thus indicating that teething delays, if any, were overcome during this period. Incidence of diarrhoea and URTI showed decrease in the months after enrolment. Children responded favourably to the medicines given by ASHAs at the time of diarrhoea/URTI episodes, and ASHAs expressed satisfaction with the programme. Conclusion An approach with regular use of CP and home-based care with homeopathy through health workers for common problems in teething children is acceptable to the community and enhances outreach of services to the public at large. Observations in terms of the healthy teething period may be further validated through studies of homeopathy with suitable comparator group.

COVID-19 has affected over 24 million patients with over 8 lacs deaths worldwide. Till date, no specific drug or vaccine has been proven effective for the treatment of SARS-CoV-2 patients. In a recent observational cohort study conducted at Delhi Government designated COVID hospital on 221 patients, important facts have emerged indicating the benefits of using unconventional treatment protocol (consisting of combination of homeopathic medicines, allopathic medicines & non-pharmacological interventions) in COVID-19 situation. The interdisciplinary team of doctors and scientists have found that out of 221 COVID-19 positive patients (diagnosed with RT-PCR), 169 patients were clinically classified as patients of mild category and 21 were labeled as moderate whereas 31 patients were asymptomatic. 170 patients were treated with either homeopathic medicines, allopathic medicines or the combination of both. The unconventional treatment protocol combining homeopathic medicines and allopathic systems showed rapid improvement in clinical condition. We found that fever (temperature) was reduced to normal on an average of 7.45 ± 5.19 days. The treatment outcome of this study showed better results when compared with control datasets obtained from independent studies published earlier. All the patients were discharged on an average of 9.29 ± 3.52 days. The mortality rate was zero and there were no adverse events for the patients. Apart from temperature and fever, symptoms such as cough, sore throat, myalgia, & dyspnea also improved significantly in the patients enrolled in this study. The average time for clinical improvement was significantly better than previously published clinical studies on COVID-19 patients in independent hospitals. This study indicates that the use of unconventional treatment protocol can emerge as an effective treatment option for COVID-19 patients. Despite the challenges (i.e. limited availability of high quality clinical data), we generated a machine learning model for semi-automated prediction of potential treatments (i.e. medicines, non-pharmacological interventions) that should be prescribed to the patient based on the time dependent clinical features, comorbidities, & demographic profiling. Further, efforts are underway to include additional clinical data from COVID19 patients to provide a robust and accurate machine learning based prescription system.

Objective: The primary objective of the study was to compare the effectiveness of homoeopathic treatment with standard allopathic regimen in acute ADL and secondary objective was to assess the reduction in frequency, duration and intensity of subsequent attacks, improvement of the quality of life of patients. Methods: The study was designed as a comparative randomized trial conducted from October 2012 to April 2014, on 112 patients at Regional Research Institute, Puri, Odisha. The ADL patients enrolled were randomized to receive either homoeopathic treatment or standard allopathic treatment for a period of six months. The outcome parameters used were ADL score and WHO QOL Bref. Results: 112 Patients were considered for primary outcome analysis as per the Intention to treat principle. (Homoeopathy= 55 and Allopathy= 57) and were analysed on 11th day of treatment. Both the treatments produced equal improvement in ADL scores. However, during the six months study period, the frequency, duration and intensity of attacks were better in Homoeopathy group compared to allopathy group. There was statistically significant improvement in Homoeopathy for Domain 4 of WHOQOL (P = 0.004) as compared to allopathy group. Medicines like Apismellifica (n = 23), Rhus toxicodendron (n = 20), Pulsatilla (n = 8), Arsenic album (n = 1), Bryonia alba (n = 1), Silicea (n = 1) and Hepar sulph (n = 1) were found most useful in the acute attacks. Conclusion: This study provides evidence to support the fact that individualized homoeopathy treatment is equally effective for ADL as the standard allopathy treatment in the management of ADL.

Background: Before the 20th century, research in Homeopathy was limited either for its proving in healthy human volunteers or to its clinical verification/clinical efficacy in diseased individuals. However, in recent years, there has been an increased trend in the number of pre-clinical studies aimed to evaluate the pharmacological activity produced by homeopathic medicines. The objective of this review is to make a systemic compilation of results of experimental pharmacological findings of homeopathic medicines, both in vitro and in animal models, and to present the same in a summarised form. Methods: Articles published up to March 2017 having information of in vitro and in vivo studies using homeopathic medicines were collected from the PubMed database, review articles, scientific reports, research articles, thesis, online information extracted from Medline, etc. to compile this review. The articles from the most common therapeutic areas such as antimicrobial effect, central nervous system disorders, anti-inflammatory and analgesic, anticancer, wound healing, antiasthmatic and liver toxicity and other therapeutic areas such as diabetes and malaria were included in this review. Results: This review article not only provides the scientific approaches applied in Homeopathy research but also provides evidence-based information on pharmacological effects of dilutions/potencies as well as mother tincture of different homeopathic drugs. This review article also reveals the use of improved methodology, molecular techniques and analytical part adopted in recently published research articles to understand the mechanism of action of homeopathic medicines. Conclusion: Homeopathy has substantial scope in pre-clinical research where therapeutic and biological effects of homeopathic medicines with proper mechanism of action can be traced out with the use of modern molecular techniques in in vivo and in vitro experiments.

Objectives: The objectives of the study are to evaluate the effectiveness of Homoeopathic Constitutional remedy (HC) and Homoeopathic Constitutional + Organ remedy (HCOM) in comparison to Placebo (PL) in cases of benign prostatic hyperplasia (BPH) using International Prostate Symptom Score (IPSS), ultrasonographic changes in prostate volume, post-void residual urine, uroflowmetry and in WHO Quality of Life (QOL)-BREF. Materials and Methods: A multicentric, three-armed, randomised clinical trial was conducted at five centres. Patients were enrolled following the pre-defined inclusion and exclusion criteria, randomised into three groups in 2:2:1 ratio and were followed up for 6 months. The statistical analysis was done with modified intention-to-treat principle (mITT). Results: Out of 461 patients screened, 254 patients were enrolled in the study and 241 patients were analysed as per mITT. The mean changes in IPSS and QOL due to urinary symptoms from baseline to end of study had shown a positive trend in all the three groups. However, in HC group, the changes were more prominent as compared to the other two groups. There was no difference between HC and HCOM groups and they were equally effective in terms of managing lower urinary tract symptoms due to BPH. With regard to secondary outcome, there was no difference between the groups. The psychological, social and environmental domains of WHOQOL-BREF have shown positive trend, but there was no statistically significant difference in intervention groups. Conclusion: In this study, statistical significance was found in the IPSS in all the three groups but only in HC and not in any of the objective parameters.

Objective: To evaluate the effectiveness of homoeopathic remedies in improving quality of life (QoL) of chronic urticaria (CU) patients. Methods: Setting: The study population included patients attending the Outpatient Department of State Homoeopathic Dispensary, Ahmadpur, Aligarh, Uttar Pradesh, India. CU-QoL questionnaire (CU-Q2oL) and average Urticaria Activity Score for 7 days (UAS7) questionnaires were filled questionnaires were filled at baseline and 3rd, 6th, 9th and 12th months. The study included both male and female patients clinically diagnosed with CU, screened from January 2015 to June 2016. Eighteen homoeopathic remedies were used. The individualised prescription was based on the totality of each patient's symptoms. Scores were analysed using one-way repeated measures ANOVA with SPSS version 19. Results: A total of 134 patients were screened and 70 were diagnosed with CU and enrolled in the study were analysed under modified intention-to-treat approach. Significant difference was found in baseline and 12th month CU-Q2oL score (mean difference 34.14 with standard error of 1.65, 95% confidence interval, lower bound 29.31, upper limit 38.94, P < 0.001). A one-way repeated measures ANOVA was calculated for comparing CU-Q2oL scores (F [2.45, 169.46] = 260.89, P ≤ 0.000, effect size = 0.791). Apis mellifica (n = 10), Natrum muriaticum (n = 9), Rhus toxicodendron (n = 8) and Sulphur (n = 8) were the most frequently used remedies. Conclusions: Homoeopathic medicines have potential to improve QoL of CU patients by reducing pruritus, intensity of wheals, swelling, nervousness, and improve sleep, mood and concentration. Further studies with more sample size are desirable.

Background: The comprehensive systematic review of randomised placebo-controlled trials (RCTs) in homeopathy requires examination of a study's model validity of homeopathic treatment (MVHT) as well as its risk of bias (extent of reliable evidence). Objective: To appraise MVHT in those RCTs of non-individualised homeopathy that an associated investigation had judged as ‘not at high risk of bias’. Design: Systematic review. Methods: An assessment of MVHT was ascribed to each of 26 eligible RCTs. Another 49 RCTs were ineligible due to their high risk of bias. Main outcome measures: MVHT and the prior risk of bias rating per trial were merged to obtain a single overall quality designation (‘high’, ‘moderate’, ‘low’), based on the GRADE principle of downgrading. Results: The trials were rated as ‘acceptable MVHT’ (N = 9), ‘uncertain MVHT’ (N = 10) and ‘inadequate MVHT’ (N = 7); and, previously, as ‘reliable evidence’ (N = 3) and ‘non-reliable evidence’ (N = 23). The 26 trials were designated overall as: ‘high quality’ (N = 1); ‘moderate quality’ (N = 18); ‘low quality’ (N = 7). Conclusion: Of the 26 RCTs of non-individualised homeopathy that were judged ‘not at high risk of bias’, nine have been rated ‘acceptable MVHT’. One of those nine studies was designated ‘high quality’ overall (‘acceptable MVHT’ and ‘reliable evidence’), and is thus currently the only reported RCT that represents best therapeutic practice as well as unbiased evidence in non-individualised homeopathy. As well as minimising risk of bias, new RCTs in this area must aim to maximise MVHT and clarity of reporting.

Prognostic factor research is important as it helps in refining diagnosis, taking clinical and therapeutic decisions, enhances the design and analysis of intervention trials and helps to identify targets for new interventions that aim to modify the course of a disease. Prognostic factor research in homeopathy can be done by applying Bayes' theorem. This paper considers Bayes' theorem; Likelihood Ratio, conditional probability and research in subpopulations of a condition with examples. We analysed the likelihood ratios for 11 homeopathic medicines for the symptom ‘cough’ and other upper respiratory tract symptoms, based on data from the IIPCOS2 study. This yielded useful information since several medicines, including Belladonna, had LR >1 for cough, indicating that cough is not an indication for this medicine. The implications for improving homeopathic prescribing are discussed.

The first World Integrated Medicine Forum on the regulation of homoeopathic medicinal products included 50 delegates from 25 countries to discuss the current state of regulation of homoeopathic medicinal products (HMPs). The stakeholders in attendance included government officials, manufacturers, pharmacopoeia organisations, pharmacists, and healthcare providers worldwide. The Minister of Ayurveda, Yoga, Unani, Siddha and Homoeopathy from India, who is likely the only high ranking national official in the world specifically dedicated to oversight of traditional medicines including Homoeopathy, was the keynote speaker for the meeting. The core presentations delivered information on the country-to-country variance in regulatory requirements for homoeopathic medicine manufacture and marketing. Different speakers addressed the current pharmacopeia structures in various countries, variance in premarket approval process, regulatory frameworks for homoeopathic medicines, labelling requirements, safety requirements, marketing approaches and good manufacturing practices. Debates focused on quality control testing, stability of intermediate stocks, shelf life of finished products, pre-market approval process and labelling and they shed light on regional differences in regulation. A lengthy discussion was held on the potential value of harmonisation of pharmacopoeias, manufacturing standards, safety evaluation and labelling. The group consensus was to meet again to pursue specific topics. Daily summaries of take-away points are provided at the end of each day's talk summaries. Much acclaim was won by the organisers for materialising this unique forum which proved to be an apt platform for rigorous discussions on lesser discussed, but very vital points such as regulations of HMPs, harmonisation of pharmacopeias and linking industry and regulators' sectors for unified efforts for global development of Homoeopathy.

Background: For two centuries, homoeopathic practitioners are using personal characteristics, symptoms, and diagnoses/conditions to compare the “patient picture” with the “medicine picture.” All data are considered within the context of the totality, using a so-called heuristic strategy. In prognostic factor research analyzing homoeopathic symptoms, we cannot use this context. Question: What is the essence of a homoeopathic symptom and how do we make assessment of homoeopathic symptoms applicable in daily practice? Methods: A questionnaire with seventy polar symptoms represented in Likert scales was tested in an outpatient clinic in 300 patients. Prevalence of symptoms and correlations between symptoms and between symptoms and conditions were analyzed. Outcome: The prevalence of symptoms varied widely; sometimes, prevalence was too high to give meaningful information. Theoretical considerations about heuristics can explain this variation. There is a considerable correlation between symptoms and between some symptoms and some conditions. Conclusion: The main characteristic of a homoeopathic symptom is its peculiarity, resulting in low prevalence. We can achieve this in research by using more cutoff values in our questionnaire and by guiding the filling in of the questionnaires by well-trained doctors. Correlations between symptoms and between symptoms and conditions should be monitored. Standardization of prognostic factor research is necessary to be able to generalize results.

Background: Homoeopathic drug proving being the first step in finding the pathogenetic powers of a drug is an integral part of Homoeopathic system of medicine. Objective: To elicit the pathogenetic response of Withania somnifera in homoeopathic potencies on healthy human provers. Materials and Methods: A multicentre, randomised, double-blind, placebo-controlled trial was conducted at four centres under Central Council for Research in Homoeopathy. Proving was conducted on 63 relatively healthy provers. All the provers were given 12 doses of placebo divided into 4 doses/day for 3 days during the first phase of the trial. After randomisation, 43 provers in the intervention group were given W. somnifera in 6C and 30C potencies in two phases. In the placebo group, 20 provers were administered unmedicated globules. The symptoms and signs manifested during the trial were noted down by the provers, elaborated by the proving masters and the data compilation on W. somnifera was done at proving-cum-data processing cell. Results: Out of 43 provers who were on actual drug trial, only 15 provers manifested 39 symptoms. The symptoms have been manifested predominantly in 30C potency. Among the objective findings, the drug has shown its effect on kidney, ovaries and helminthic infestation. Conclusion: The pathogenetic response elicited during this trial expands the scope of the use of W. somnifera and needs to be further validated by clinical verification study.

Background: Rauwolfia serpentina (L.) Benth. ex Kurz (Apocynaceae) (Indian snakeroot), popularly known as Sarpagandha (Sanskrit), is used for the treatment of insanity, fever, snake bites, anxiety and in neuropsychiatric conditions. The antihypertensive actions of Reserpine are a result of its ability to deplete catecholamines (amongst other monoamine neurotransmitters) from peripheral sympathetic nerve endings which are normally involved in controlling heart rate, force of cardiac contraction and peripheral vascular resistance. Objective: Comparative study of Reserpine content in R. serpentina homoeopathic mother tinctures manufactured by different pharmaceutical industries and in-house mother tinctures applying high-performance thin-layer chromatography investigative techniques to facilitate the use of correct species. Materials and Methods: The authentic samples of roots of R. serpentina were supplied by Centre of Medicinal Plants Research in Homoeopathy, Emerald, Tamil Nadu, India. Authentic plant material was used to prepare the mother tincture (as per Homoeopathic Pharmacopoeia of India). Reserpine (C33H40N2O9,M.P. 360°C, purity >99% w/w by high-performance liquid chromatography [HPLC]) was purchased from Sigma-Aldrich as a standard reference. The solvents for the study, namely, ethanol, HPLC water, toluene, ethyl acetate, diethylamine and chloroform were of analytical grade purity (MERCK Ltd.,), used throughout. Results: Five samples of mother tinctures were used for the study, in-house mother tinctures (labelled: D and E) of R. serpentina shows a higher amount of Reserpine content than the marketed samples (labelled: A, B and C). Conclusion: It may be concluded that mother tinctures prepared by authentic plants showed the excess amount of Reserpine rather than that of mother tinctures procured from the market.

Background: Homoeopathic drugs are frequently recommended in day to day life as therapeutic agents by homoeopathic practitioners. However, safety of homoeopathic drugs remains a challenge because of the high variability of chemical components involved. Aim: The objective of the present study was to investigate the acute, subacute, and chronic oral toxicity of different homoeopathic drugs (Ferrum phosphoricum 3X, Ferrum phosphoricum 6X, Calcarea phosphoricum 6X, and Magnesium phosphoricum 6X) in experimental models. Materials and Methods: In acute oral toxicity study, homoeopathic drugs were administered orally at 2000mg/kg body weight, and animals were observed for toxic symptoms till 10 days as per the OECD guidelines. For subacute and chronic toxicity study, homoeopathic drugs were administered for 28 and 180 days, respectively, as per the OECD guidelines. At the end of 28 and 180 days, the animals were sacrificed and toxicity parameters were assessed. Histopathological evaluation of different organs was also performed to assess any toxicity. Results: In acute toxicity study, no mortality was found at a dose of 2000 mg/kg which indicates that oral LD50of homoeopathic drugs were more than 2000 mg/kg. The administration of drugs at a dose of 70 mg/kg body weight for 28 and 180 days did not produce any significant change in haematological and biochemical parameters of male and female rats as compared to normal control group. No pathological changes were observed in histology of various organs of treated rats as compared to normal control animals. Conclusion: These homoeopathic drugs are safe & produce no toxicity when administered for longer duration.

In India, there is a lack of information about the adequate daily dose of vitamin D3supplementation in school children. Hence, we undertook this study to evaluate the adequacy and efficacy of different doses of vitamin D3in schoolchildren. A total of 1008 vitamin D-deficient (VDD) children, aged 6–16 years with serum 25-hydroxyvitamin D (25(OH)D) levels 3under supervision for 6 months. Of the 1008 subjects who completed the study, 938 (93 %) were compliant. Baseline and post-supplementation fasting blood and urine samples were evaluated for Ca, phosphates, alkaline phosphatase, 25(OH)D and parathormone and urine Ca:creatinine ratio. The mean age of the subjects was 11·7 (sd2·4) years, and the overall mean baseline serum 25(OH)D level was 24·3 (SD9·5)nmol/l. Post-supplementation rise in serum 25(OH)D in compliant group was maximum with 2000 IU (70·0 (SD30·0)nmol/l), followed by 1000 IU (46·8 (SD22·5)nmol/l) and 600 IU (36·5 (SD18·5)nmol/l), and serum 25(OH)D levels of ≥50nmol/l were achieved in 71·5, 81·8 and 92·9 % by groups A, B and C, respectively. Secondary hyperparathyroidism decreased from 31·7 to 8·4 % post-supplementation. Two participants developed hypercalciuria, but none developed hypercalcaemia. Children with VDD benefit maximum with the daily supplementation of 2000 IU of vitamin D3. Whether recommendations of 400 IU/d by Indian Council of Medical Research or 600 IU by Indian Academy of Pediatrics or Institute of Medicine would suffice to achieve vitamin D sufficiency in children with VDD remains debatable.

Lessons Learned Conventional medicine and homeopathy work well together. Quality of life improves with additive homeopathy in patients with non-small cell lung cancer (NSCLC). Survival improves with additive homeopathy in patients with NSCLC. Background Patients with advanced non-small cell lung cancer (NSCLC) have limited treatment options. Alongside conventional anticancer treatment, additive homeopathy might help to alleviate side effects of conventional therapy. The aim of the present study was to investigate whether additive homeopathy might influence quality of life (QoL) and survival in patients with NSCLC. Methods In this prospective, randomized, placebo-controlled, double-blind, three-arm, multicenter, phase III study, we evaluated the possible effects of additive homeopathic treatment compared with placebo in patients with stage IV NSCLC, with respect to QoL in the two randomized groups and survival time in all three groups. Treated patients visited the outpatients' centers every 9 weeks: 150 patients with stage IV NSCLC were included in the study; 98 received either individualized homeopathic remedies (n = 51) or placebo (n = 47) in a double-blinded fashion; and 52 control patients without any homeopathic treatment were observed for survival only. The constituents of the different homeopathic remedies were mainly of plant, mineral, or animal origin. The remedies were manufactured by stepwise dilution and succussion, thereby preparing stable Good Manufacturing Practice grade formulations. Results QoL as well as functional and symptom scales showed significant improvement in the homeopathy group when compared with placebo after 9 and 18 weeks of homeopathic treatment (p < .001). Median survival time was significantly longer in the homeopathy group (435 days) versus placebo (257 days; p = .010) as well as versus control (228 days; p < .001). Survival rate in the homeopathy group differed significantly from placebo (p = .020) and from control (p < .001). Conclusion QoL improved significantly in the homeopathy group compared with placebo. In addition, survival was significantly longer in the homeopathy group versus placebo and control. A higher QoL might have contributed to the prolonged survival. The study suggests that homeopathy positively influences not only QoL but also survival. Further studies including other tumor entities are warranted.

Objective: To assess the efficacy and safety of Chyawanprash in preventing SARS-CoV-2 infection among health care personnel working at COVID-19 isolation ward. Setting: A hospital designated as COVID-19 care centre in Delhi, India Participants: Apparently healthy health care workers (HCWs) of age 20 to 60 years who were RT PCR negative and asymptomatic but possibly had exposure to active cases of COVID- 19, with or without co-morbid conditions were included. Pregnant and lactating females, volunteers with malignancy, uncontrolled blood sugar, chronic renal failure, chronic heart failure, hematological disorders, and those on immunosuppressants were excluded from the study. Interventions: Chyawanprash, an Ayurvedic rasayana medicine 12 gm orally with warm water twice daily for 30 days along with standard preventive measures adopted by the institute. Primary Outcome: Incidence of COVID-19 infection confirmed by RT-PCR test. Secondary Outcomes: Evaluation of safety of the study drug through hematological & biochemical investigations and occurrence of any adverse drug reaction or adverse events; number of participants developing any other bacterial, viral or fungal infection during the study period and changes in inflammatory and immune markers. Results: At the end of study period, out of total 50 participants enrolled, two were COVID -19 positive. Incidence rate in similar population in the same study setting prior to commencing (9.71%) and after completing the study period (1.79%) was compared with incidence of COVID-19 during treatment period (1.09%). So, Chyawanprash showed protection rate of 98.91%. It was well tolerated by all the study participants, when administered for 30 days. Conclusions: The infection rate at the hospital dropped significantly following administration of Chyawanprash. As Chyawanprash shows potential of a prophylactic agent against infection by SARS-CoV-2 infection, and is safe when used in the recommended daily dosage, a randomized controlled trial to prove its prophylactic efficacy can be designed on larger sample size.

Background: \ud \ud To date, our programme of systematic reviews has assessed randomised controlled trials (RCTs) of individualised homeopathy separately for risk of bias (RoB) and for model validity of homeopathic treatment (MVHT).\ud \ud Objectives: \ud \ud The purpose of the present paper was to bring together our published RoB and MVHT findings and, using an approach based on GRADE methods, to merge the quality appraisals of these same RCTs, examining the impact on meta-analysis results.\ud \ud Design: \ud \ud Systematic review with meta-analysis.\ud \ud Methods: \ud \ud As previously, 31 papers (reporting a total of 32 RCTs) were eligible for systematic review and were the subject of study.\ud \ud Main outcome measures: \ud \ud For each trial, the separate ratings for RoB and MVHT were merged to obtain a single overall quality designation (‘high’, ‘moderate, “low”, ‘very low’), based on the GRADE principle of ‘downgrading’.\ud \ud Results: \ud \ud Merging the assessment of MVHT and RoB identified three trials of ‘high quality’, eight of ‘moderate quality’, 18 of ‘low quality’ and three of ‘very low quality’. There was no association between a trial’s MVHT and its RoB or its direction of treatment effect (P > 0.05). The three ‘high quality’ trials were those already labelled ‘reliable evidence’ based on RoB, and so no change was found in meta-analysis based on best-quality evidence: a small, statistically significant, effect favouring homeopathy.\ud \ud Conclusion: \ud \ud Accommodating MVHT in overall quality designation of RCTs has not modified our pre-existing conclusion that the medicines prescribed in individualised homeopathy may have small, specific, treatment effects.

Background and Aim: Nonerosive gastroesophageal reflux disease or nonerosive reflux disease (NERD) is characterized by troublesome reflux-related symptoms in the absence of esophageal erosions/breaks at conventional endoscopy. There are a number of medicines cited in homoeopathic literature which can be used for treatment of symptoms such as heartburn and regurgitation. A pilot study was undertaken to explore usefulness of homoeopathic medicines in treatment of NERD. Methodology: In this study, 78 patients were screened and 34 were enrolled, having symptoms of heartburn and/or regurgitation at least twice a week, having a gastroesophageal reflux disease (GERD) symptom score of more than 4. Homoeopathic medicine was prescribed on the basis of presenting symptoms. Response to treatment was assessed on GERD symptom score, visual analog scale (VAS) for heartburn, and World Health Organization quality of life-BREF (WHO-QOL) questionnaire evaluated at baseline and at end of 8 weeks of treatment . Results: Significant difference was found in pre- and post-treatment GERD symptom score (8.79 ± 2.7 vs. 0.76 ± 1.8; P = 0.001) and VAS for heartburn (47.47 ± 19.6 vs. 5.06 ± 11.8; P = 0.001). Statistically significant improvement was seen in three domains of WHO-QOL score, i.e. psychological health, social relationship, and environmental domain. Conclusion: The findings are encouraging to open avenues for further studies on reflux disease.

Background: There are diverging opinions about scientific evidence for Homoeopathy, but evidence for conventional medicine is not perfect either. In fact, proof for Homoeopathy is not inferior to conventional. However, the evidence for Homoeopathy has been downplayed by selection of trials (cherry-picking). The effect of Homoeopathy in randomized controlled trials (RCTs), however, is small due to many ineffective prescriptions. This is caused by shortcomings of our Materia Medica and Repertories. Discussion: The hegemony of the RCT is increasingly questioned; it does not provide all answers, especially not for the individual patient. The individual patient wants to know his individual prognosis: Will this medicine work for him? This is even more important than his individual diagnosis. It is possible to assess prognosis scientifically the same way as diagnosis. Prognostic research is based on daily practice; practitioners should have knowledge about statistics to fulfill their role in this process. Conclusion: The discussion in this paper elucidates that RCT has its limitations, especially for the patient whose main concern is recovery/prognosis. Drug validation is a key to improve the outcome of clinical practice in Homoeopathy.

Background: Homoeopathic drug proving is an integral part of Homoeopathic System of Medicine. It is the first step in finding out the pathogenetic powers of a drug. Objective: To elicit the pathogenetic response to Allium sativum in homoeopathic potencies on healthy human provers. Materials and Methods: A multi-center randomized, placebo-controlled, double-blind trial was conducted at two centers of the Central Council for Research in Homoeopathy (CCRH). Proving was conducted on 33 healthy provers after the pretrial medical examination. All the provers were given 12 doses of placebo divided in 4 doses/day for 3 days during the first phase of the trial. After randomization, in the intervention group (21 provers), Allium sativum (A. sativum) was proved in 6C and 30C potencies, in two phases. In the placebo group, 12 provers were administered placebo in the same manner. The symptoms manifested during the trial period were noted down by the provers and then elaborated by the proving masters. The generated data on A. sativum were then compiled and analyzed at proving-cum-data processing cell at CCRH headquarters. Results: Out of 21 provers who were on actual drug trial, only nine provers manifested symptoms. Drug was able to manifest symptoms in both the potencies, in more or less every part of the body. Conclusion: The pathogenetic response elicited during the proving trial expands the scope of use of the drug A. sativum and will benefit the research scholars and clinicians. The generated symptoms of this drug will carry more value when verified clinically.

Background: Prospective assessment of homoeopathic symptoms is different from eliciting symptoms in daily practice. In prognostic factor research, we apply symptom questionnaires with Likert scales to assess symptoms in different intensities. In former research, we tested a 5-point Likert scale, which rendered a rather high prevalence for some symptoms even the strongest intensity, not useful in daily practice. A longer, 7-point Likert scale might render more useful outcome. Objective: To study if a longer Likert scale perform better in homoeopathic prognostic factor research. Methods: A 7-point Likert scale questionnaire with 30 polar symptoms was tested on 300 patients. Responses to various domains of temperature, climate, diurnal, influence of sleep, eating and desires/aversions were elicited. The outcome was compared with the former 5-point Likert scale. Results: The mean prevalence of all symptoms in the highest intensity with the 7-point Likert scale is (much) lower than in the 5-point scale, and for some symptoms, more useful. For a few symptoms, the prevalence remained high, even in the highest intensity. Conclusion: A longer Likert scale performs better in homoeopathic prognostic factor research, but not for all symptoms. The filling out of this questionnaire by patients should be guided by homoeopathic practitioners who are properly trained in prospective assessment of homoeopathic symptoms.

Background Acute encephalitis syndrome (AES) is endemic to certain parts of India, with limited treatment options. In our initial exploratory comparative observational study of 151 patients with AES, there was significantly reduced mortality with adjunctive homeopathy compared to institutional management protocol (IMP). The present randomized placebo-controlled trial brings more statistical rigor to this research program. Methods This study was conducted at a pediatric unit from 2013 to 2015. Children aged > 6 months and ≤ 18 years and receiving IMP were randomized to receive adjunctive homeopathy (n = 325) or placebo as control (n = 323). The primary effectiveness analysis was based on Glasgow Outcome Scale (GOS). Morbidity was assessed using the Liverpool Outcome Score for Assessing Children at Follow-up. Analysis was by intention to treat. Results A total of 612 children were analyzed (Homeopathy [H] = 304; Control [C] = 308). The primary outcome, GOS, differed significantly between H and C groups. There was 14.8% death/neuro-vegetative state in the H group compared to 29.8% in the C group. Relative risk was 0.49 (95% confidence interval [CI]: 0.36 to 0.68), with absolute risk reduction of 15.0% (95% CI: 8.6 to 21.6%). Number needed to treat to prevent one additional death/neuro-vegetative state was 6.6 (95% CI: 4.6 to 11.6). Proportional-odds analysis also revealed a greater effect in the H group: odds ratio, 0.40 (95% CI: 0.27 to 0.60). The most frequently used medicines were Belladonna (n = 116), Stramonium (n = 33), Arsenicum album (n = 25), Sulfur (n = 18), Opium (n = 17), and Nux vomica (n = 10). Conclusion Adjunctive homeopathic medicines may improve clinical outcomes associated with AES. Further randomized and controlled studies, using double-blinded trial design, are recommended to discover if the current findings may be corroborated.