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Background: Groundwater arsenic affects millions of people in about 20 countries. In West Bengal (India) and Bangladesh alone over 100 million people are exposed. The arsenic concentration in contaminated groundwater in Bangladesh was above the maximum permissible level of 0.05 mg/l as recommended by WHO for developing countries [1]. Drinking water is not the only source of poisoning. In arsenic contaminated areas, crops, vegetables, cereals, poultry, cattle, etc, also contain traces of arsenic. Chronic arsenic intoxication has been associated with several diseases such as melanosis, leuco-melanosis, hyperkeratosis, oedema, skin cancer… Cazin et al [2], have demonstrated the effect of high dilutions of arsenic compounds. They noted increased arsenic elimination from blood through urine and faeces in intoxicated rats. According to these research, the aim of Khuda Buksh studies [3-4-5] was to investigate whether high dilution Arsenicum album have any effect on arsenic accumulation in different tissues and to understand also how this high dilution could produce a protective effect on all the different organs. Methodology: Firstly, the effect of Arsenicum album 30 cH on the amount of arsenic accumulation was determined by spectrophotometric analysis in four tissues namely liver, kidney and testis in mice intoxicated by arsenic. The protective effect in chronic and acute arsenic intoxicated mice of Arsenicum Album 6cH, 30cH and 200cH has been evaluated using not only the activities of enzymatic and biomarker toxicity (aspartate amino transferase (AST), alanine amino transferase (ALT), acid phosphatase (AcP), alkaline phosphatase (AlkP), lipid peroxidation (LPO) and reduced glutathione (GSH)) but also the cytogenetical parameters (chromosome aberrations (CA), mitotic index (MI), sperm head anomaly (SHA) etc., ). Because, it is well demonstrated that these enzymes biomarkers reflect the degree of hepatotoxicity and oxidative stress caused by arsenic intoxication. Results: Compared to controls, Arsenicum album 30cH induced a significant decrease in accumulation of arsenic in 4 tissues namely liver, spleen, kidney and testis in intoxicated mice. In addition, both Arsenicum album 6cH, 30cH and 200cH reduced chromosome aberrations, sperm head abnormality frequencies and activities of acid and alkaline phosphatases, aspartate and alanine aminotransferases and lipid peroxidation, while mitotic index and activities of glutathione, catalase and succinate dehydrogenase were increased compared to controls. Conclusion: Altogether, theses results provide evidence of protective potentials of the Arsenicum album dilution against acute and chronic arsenic intoxication in mice. They also offer a new hypothesis that the mechanism of the homeopathic dilution could act through regulation of expression of certain genes. This explanation seems to be plausible because all biomarker tests are regulated by specific genetic regulatory mechanisms [6]. keywords: Arsenicum album, arsenic intoxication, enzymatic and biomarker toxicity. References: [1] WHO. WHO Guidelines for Drinking Water Quality, Vol. 2, 2nd edition. Geneva: WHO, 1996, 940–9. [2] Cazin JC, Cazin M, Gaborit JL, Chaoui A, Boiron J, Belon P, et al. A study of the effect of decimal and centesimal dilutions of arsenic on the retention and mobilization of arsenic in the rat. Hum Toxicol 1987;6:315–20. [3] Mitra K, Kundu SN, Khuda-Bukhsh AR. Efficacy of a potentized homoeopathic drug (Arsenicum Album-30) in reducing toxic effects produced by of arsenic trioxide in mice. I. On rate accumulation of arsenic in certain vital organs. Comp Ther Med 1998;6:178–84. [4] Pathikrit Banerjee. Evidences of Protective Potentials of Microdoses of Ultra-high Diluted Arsenic Trioxide in Mice Receiving Repeated Injections of Arsenic Trioxide. eCAM 2009; 1-10. [5] Pathikrit Banerjee, Comparative Efficacy of Two Microdoses of a Potentized Homeopathic Drug, Arsenicum Album, to Ameliorate Toxicity Induced by Repeated Sublethal Injections of Arsenic Trioxide in Mice. Pathobiology 2008;75:156–170. [6]/ Khuda-Bukhsh AR. Potentized homeopathic drugs act through regulation of gene expression: a hypothesis to explain their mechanism and pathways of action in vivo. Comp Ther Med 1997;5:43–6

Background: Though potentially an important limitation in the literature of randomised controlled trials (RCTs) of homeopathy, the model validity of homeopathic treatment (MVHT) has not previously been systematically investigated.Objective: As an integral part of a programme of systematic reviews, to assess MVHT of eligible RCTs of individualised homeopathic treatment.Methods: From 46 previously identified papers in the category, 31 papers (reporting a total of 32 RCTs) were eligible for systematic review and were thus the subject of the study. For each of six domains of assessment per trial, MVHT was judged independently by three randomly allocated assessors from our group, who reached a final verdict by consensus discussion as necessary.Results: Nineteen trials were judged overall as ‘acceptable’ MVHT, nine as ‘uncertain’ MVHT, and four as ‘inadequate’ MVHT.Conclusions: These results do not support concern that deficient MVHT has frequently undermined the published findings of RCTs of individualised homeopathy. However, the 13 trials with ‘uncertain’ or ‘inadequate’ MVHT will be a focus of attention in supplementary meta-analysis. New RCTs of individualised homeopathy must aim to maximise MVHT and to enable its assessment through clear reporting.

Background In endemic areas, gestational malaria is responsible for low birth weight and maternal anaemia. Quinine is the reference treatment for acute malaria in pregnant women, irrespective of term. However, quinine administration is associated with various side-effects. We evaluated the impact of the homeopathic medicine China rubra 7CH on the side-effects of quinine used as treatment for acute malaria in pregnant women in Cotonou, Benin. Methods This prospective, comparative, randomised study was carried out between June and December 2007 in the Saint Jean-Baptiste Medical Centre, Cotonou. Women were included if they were >3 months pregnant and had a clinical diagnosis of malaria confirmed by a positive thick blood smear. The study population was divided into two groups: (i) patients who presented between the 1st and 15th of each month and who received China rubra 7CH plus quinine (China group); and (ii) patients who presented from the 16th to the end of each month and who received treatment with quinine only (Standard group). The aim was to compare the frequency of side-effects of quinine in the two groups until day 6 after the start of treatment. Neither the patients nor the care givers were blinded to study treatment. Statistical comparison of the two groups was carried out with an alpha risk fixed at 5%. Results 211 women were recruited: 105 received quinine plus China rubra 7CH (China group) and 106 received quinine only (Standard group). A decrease in proportion of patients presenting with side-effects was observed in the China group from day 0 to day 6 of follow-up (53.9%–23.3%) whereas the proportion of patients with side-effects in the Standard group did not change significantly (85.9% on day 0 vs. 82.5% on day 6). Ninety-six (72.4%) patients in the China group and 103 (97.2%) in the Standard group reported at least one side-effect during follow-up (p

Background: Mammary inflammation in dairy cows is a widespread problem in dairy farming resulting in significant economic and welfare concerns. Dolisovet® (Belladonna 1dH, Calendula MT, Echinacea 1dH, Dulcamara 1cH) a homeopathic medicine, licensed in France and indicated for the restoration of mammary function in cows is presented as a 10 g tube of ointment for intramammary use. Method: A prospective, uncontrolled, observational pilot study involving the collection and analysis of data from 31 udder quarters identified as being inflamed by an automated milking system (AMS) was conducted to evaluate the effect of Dolisovet® on selected parameters of mammary inflammation. Inflamed quarters were identified when milk quality started to deteriorate, via an alert generated by the AMS, on the basis of electrical conductivity (EC). Milk yield and EC were retrieved five to seven days prior to the AMS alert, on the day of and for the following seven days. Dolisovet® was administered twice daily for two consecutive days, commencing on the day of the AMS alert. Results: A significant reduction in EC was observed 4–7 days following the first treatment. An increase in milk yield was also observed following the first treatment. Conclusion: Dolisovet® may have a beneficial therapeutic effect in the early stages of udder inflammation and for restoring udder health and function. This medicine may be an effective first line treatment for sub-clinical bovine mastitis, reducing the need for antibiotics. Randomised, controlled studies should be undertaken to further investigate this possibility.

Objective: Observational, prospective study to describe the homeopathic management of premenstrual syndrome (PMS) by a group of French physicians.Method: Women with PMS for >3 months were prescribed individualized homeopathic treatment. The intensity of 10 clinical symptoms of PMS was scored individually at inclusion and at a 3–6 month follow-up visit: absent = 0, mild = 1, moderate = 2, severe = 3. Total symptom score (range: 0–30) was calculated and compared for each patient at inclusion and at follow-up. PMS impact on daily activities (quality of life, QoL) was compared at inclusion and follow-up as: none, mild, moderate, severe, very severe.Results: Twenty-three women were prescribed homeopathic treatment only (mean age: 39.7 years). Folliculinum (87%) was the most frequently prescribed homeopathic medicine followed by Lachesis mutus (52.2%). The most common PMS symptoms (moderate or severe) at inclusion were: irritability, aggression and tension (87%), mastodynia (78.2%) and weight gain and abdominal bloating (73.9%); and the most common symptoms at follow-up were: irritability, aggression and tension (39.1%), weight gain and abdominal bloating (26.1%) and mastodynia (17.4%). Mean global score for symptom intensity was 13.7 at inclusion and 6.3 at follow-up. The mean decrease in score (7.4) was statistically significant (p < 0.0001). Twenty-one women reported that their QoL also improved significantly (91.3%; p < 0.0001).Conclusions: Homeopathic treatment was well tolerated and seemed to have a positive impact on PMS symptoms. Folliculinum was the most frequent homeopathic medicine prescribed. There appears to be scope for a properly designed, randomized, placebo-controlled trial to investigate the efficacy of individual homeopathic medicines in PMS.

International audience; BACKGROUND: Well-documented outbreaks of human toxoplasmosis infection are infrequently reported. Here, we describe a community outbreak of multivisceral toxoplasmosis that occurred in Patam, a Surinamese village near the French Guianan border. METHODS: From the end of December 2003 through the middle of January 2004, 5 adult patients in Patam, including 2 pregnant women, were initially hospitalized for multivisceral toxoplasmosis. A French-Surinamese epidemiological investigation was conducted in the village; inquiries and clinical examinations were performed, and blood and environmental samples were obtained. For all serologically confirmed cases of toxoplasmosis, molecular analysis and mouse inoculations were performed for diagnosis and genetic characterization of Toxoplasma gondii. RESULTS: The hospitalized patients, who did not have any immunodeficiencies, presented with an infectious disease with multivisceral involvement. Serological examination confirmed acute toxoplasmosis. One adult died, and a neonate and a fetus with congenital toxoplasmosis also died. During the investigation, 4 additional acute cases of toxoplasmosis were diagnosed among the 33 villagers. Only 3 inhabitants had serological evidence of previous T. gondii infection. In total, we reported 11 cases of toxoplasmosis: 8 multivisceral cases in immunocompetent adults, resulting in 1 death; 2 cases of lethal congenital toxoplasmosis in a neonate and a fetus; and 1 symptomatic case in a child. Molecular analysis demonstrated that identical isolates of only 1 atypical strain were responsible for at least 5 of the 11 cases of toxoplasmosis in the outbreak. No epidemiological sources could be linked to this severe community-wide outbreak of toxoplasmosis. CONCLUSION: This report is in agreement with the particular features of toxoplasmosis involving atypical strains that were recently described in French Guiana.

Introduction: Anxiety disorders (AD) have become the most prevalent psychiatric disorders in the general population and the number of cases coming to the primary care physician is increasing in recent years. This study aims to determine the clinical-epidemiological profile of these patients and to know the true of their management in the Primary Care setting as well as the impact of the different treatments on their short-term evolution. Materials and methods: Epidemiological survey completed by 15 investigators in the Primary Care setting who had declared to be familiarized with homeopathic drugs, with a total of 110 recruited patients followed in three scheduled visits during 60 days of follow-up. The following data were collected from patients: clinical-epidemiological data, history of AD, information on pharmacological and adjuvant treatments, assessment of the level of anxiety (Hamilton-HAM anxiety scale), the anxiety status perceived by the patient (Visual Analogue Scale - VAS) and evolution of the general state of well-being (using the Clinical Global Impression Scale - CGIC). Results: The mean age of the population studied was 42.5 years (n = 108) and 70% were female. Thirty seven percent (37%) of patients presented a first-degree family history of AD. The most frequent AD were, generalized anxiety disorder (32.7%) and panic disorder (30%). Psychological comorbidity in AD fluctuates from the initial 19% to 38.9% in the bimonthly assessment, being the most frequent association the generalized anxiety disorder with the panic disorder. The use of combination treatments was predominant over monotherapy and the most frequent combination (27.3%) was selective serotonin reuptake inhibitors (SSRI) in combination with benzodiazepine (BZD) and Sedatif-PC (SPC), the most common homeopathic treatment. Homeopathy was used by 74.5% of patients and 50% used other adjuvant treatments. Compliance was highest in the SPC group with only 1 discontinuation due to adverse effects. The administration of treatment caused an improvement in CGI-C in all groups studied that increased after 2 months follow-up. Conclusions: AD affects women more frequently than men and prevalence rates are high in midlife and in subjects with a first degree family history of AD. Psychological comorbidities among these disorders are frequent and increase with time, being generalized anxiety disorder and panic disorder the main reasons for consultation in the Primary care setting. The most frequently used pharmacological treatment is the combination of SSRI + Benzodiazepines + SPC. A quarter of the patients used other adjuvant treatments and half of them used other therapies. Overall clinical evolution was favourable for the patients under any of the treatments. SPC showed an excellent adherence to treatment due to a good safety profile and they have presented a favourable clinical evolution as a monotherapy or in combination, so Sedatif-PC could be an interesting treatment option for the patients with anxiety disorders.