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Patients with psoriasis commonly opt for homeopathic treatment. However, no study has assessed the response to homeopathic treatment by using standardized disease-specific scales, and the findings are based on clinical assessments only. The objective of this study was to evaluate the response to the individualized homeopathic treatment of psoriasis with respect to changes in disease severity and quality of life based on Psoriasis Area and Severity Index (PASI) and Psoriasis Disability Index (PDI) scales, respectively. A multicentric study was conducted using a pragmatic model. The study participants were regularly followed up for 1 year. Subsequently, participants completing the 1-year follow-up were included in a long-term assessment for further 2 years. Three monthly assessments were made by using PASI, PDI, and Visual Analog scales for patient and physician general assessment. Data were analyzed to identify treatment effects and variables affecting treatment. In total, 384 patients were enrolled, out of whom 254 participants completed 1 year of treatment. Of these, 84 participants continued treatment for an additional 12 months. A significant reduction was observed in the scores of PASI (10.96 ± 10.67 at baseline to 4.24 ± 5.10 at 12 months, p = 0.000), PDI (10.19 ± 9.11 to 3.91 ± 4.44, p = 0.000), and patient and physician global assessment scales. Regarding PASI response at 12 and 24 months, PASI 75–89 was reported in 66 and 14 participants, whereas PASI 90–100 was reported in 29 and 17 participants, respectively. Baseline severity of psoriasis considerably affected treatment response, whereas age, gender, and duration of psoriasis did not. Furthermore, the severity of psoriasis and quality of life improved considerably with regular homeopathic treatment.

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.

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.

Homeopathic medicines affect physical properties of matter which depend on the characteristic and the potency of the medicine1. These effects can be explained from two aspects: (a) classical and (b) quantum electrodynamical. Using three different sets of experiments where homeopathic medicines have affected the physical properties of matter, we have shown how the results can be interpreted from both these points of view.

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 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.

Belladonna has diverse pharmacotherapeutic properties with a shadowy history of beauty, life, and death. Alkaloids present in belladonna have anti-inflammatory, anticholinergic, antispasmodic, mydriatic, analgesic, anticonvulsant, and antimicrobial activities, which makes it widely applicable for the treatment of various diseases. However, because of its associated toxicity, the medicinal use of belladonna is debatable. Therefore, an evidence-based systematic review was planned to elucidate the pharmacotherapeutic potential of belladonna. A comprehensive literature search was performed in PubMed, MEDLINE, the Cochrane database, Embase, and ClinicalTrials.gov using the keywords "belladonna", "belladonna and clinical trials", and "safety and efficacy of belladonna". Articles published from 1965 to 2020 showing the efficacy of belladonna in diverse clinical conditions are included. The quality of evidence was generated using the GRADE approach, and 20 studies involving 2302 patients were included for the systematic review. Our analyses suggest that belladonna treatment appears to be safe and effective in various disease conditions, including acute encephalitis syndrome, urethral stent pain, myocardial ischemia injury, airway obstructions during sleep in infants, climacteric complaints, irritable bowel syndrome, and throbbing headache. However, better understanding of the dosage and the toxicity of tropane alkaloids of belladonna could make it an efficient remedy for treating diverse medical conditions.

Background Randomized placebo-controlled trials are considered to be the gold standard in clinical research and have the highest importance in the hierarchical system of evidence-based medicine. However, from the viewpoint of decision makers, due to lower external validity, practical results of efficacy research are often not in line with the huge investments made over decades. Method We conducted a narrative review. With a special focus on homeopathy, we give an overview on cohort, comparative cohort, case-control and cross-sectional study designs and explain guidelines and tools that help to improve the quality of observational studies, such as the STROBE Statement, RECORD, GRACE and ENCePP Guide. Results Within the conventional medical research field, two types of arguments have been employed in favor of observational studies. First, observational studies allow for a more generalizable and robust estimation of effects in clinical practice, and if cohorts are large enough, there is no over-estimation of effect sizes, as is often feared. We argue that observational research is needed to balance the current over-emphasis on internal validity at the expense of external validity. Thus, observational research can be considered an important research tool to describe “real-world” care settings and can assist with the design and inform the results of randomised controlled trails. Conclusions We present recommendations for designing, conducting and reporting observational studies in homeopathy and provide recommendations to complement the STROBE Statement for homeopathic observational studies.

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.

Emergence of influenza A H3N2 is alarming. Strain 2013 H3N2 has H1 subtype Haemagglutinin (HA) gene segment replaced with a H3 HA gene segment. The vulnerability of the humans to H3 may be directly proportional to the HA alterations. Therefore, we studied this strain and analyzed its sequence and structural divergence and compared it with 2009 H3N1, 2009 H1N1 and its ancestor 1968 H3N2, including 11 other strains from 1918 till 2013. Our analysis showed a maximum sequence similarity between 2013 H3N2 and 1968 H3N2. The amino acid sequence variation of 2013 H3N2 was, 15% with 1968 H3N2, 27% with 2009 H3N1, 60% with 2009 H1N1. Phylogenetic distance of 0.01709 of 2013 H3N2, 0.01118 of 2012 H3N2, 0.01422 of 1968 H3N2, from the origin explained evolution of 2013 H3N2 strain. Glycosylation analysis indicates that influenza 2013 H3N2 has been found similar to 2009 H3N1 and 1968 H3N2 with five similar sites. Antigenic analysis shows that 2013 H3N2 contains different antigenic sites explaining evolution. Comparison of RMSD and hydrogen bonds displayed minimal difference in influenza 2013 H3N2 and 1968 H3N2. Protein disorder regions were found overlapping the antigenic sites in influenza 2013 H3N2 sequences stating the destabilization of antigenic epitopes. Our analyses show the evidence of the evolution of 2013 H3N2 from 1968 H3N2 pandemic, expressing that 2013 H3N2 might be highly virulent strain, tough to be targeted by drugs potently being responsible for pandemics in near future.

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: Hyperoxaluria and calcium oxalate crystal deposition in the kidneys lead to overproduction of reactive oxygen species, resulting in the development of oxidative stress and renal injury. At the cellular levels, mitochondria and NADPH oxidase involved in reactive oxygen species production play a crucial role in the pathogenesis of hyperoxaluria-induced renal injury. Objective: The objective was to investigate the therapeutical effect of homoeopathic drug Berberis vulgaris, a potent antioxidant, upon regulation of NADPH oxidase against acute high-grade sodium oxalate-induced hyperoxaluria in rats. Materials and Methods: Hyperoxaluria was induced in male Wistar rats by administering a single dose of sodium oxalate (70 mg/kg body weight) intraperitoneally, and the treatment groups were pre-treated with homoeopathic drug Berberis vulgaris 6c (20 μl/100 g of body weight) ultra low dose for 7 days. Results: Berberis vulgaris significantly reduces hyperoxaluria-induced oxidative stress and restores antioxidant enzyme activities in kidney tissue. Histological analysis depicted that Berberis vulgaris treatment decreases renal epithelial damage and inflammation and restored normal glomerular morphology. Furthermore, immunoblotting analyses of NADPH oxidase revealed significant increased activity in the renal tissue of hyperoxaluric rats when compared to that of control rats. This has been brought back to normal by Berberis vulgaris treatment. Conclusion: Thus, our results emphasised that the Homoeopathy drug Berberis vulgaris has been effective in ameliorating sodium oxalate-induced acute hyperoxaluria in Wistar rats by modulating mitochondrial oxidative stress through the inhibition of NADPH oxidase.

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.

The concept of Prakriti is unique to Ayurveda, which is used for deciding the preventive and curative strategy to be adopted in the treatment of patients. It is the total of anatomical, physiological, and psychological domains of an individual. The diseases often manifest by susceptibility that depends upon Prakriti of individuals. COVID 19 is a new disease, where the status of the susceptibility of its victim in terms of Prakriti is not known. This study has been undertaken to determine the Prakriti of COVID 19 positive patients.The validated instrument CCRAS Prakriti assessment scale has been applied to the COVID 19 positive patients admitted between 16 May 2020 to 10 June 2020 at COVID hospital.Data of 117 patients aged 10 to 80 years have been analyzed. The ratio of male-female patients was 1.8:1. Most patients belonged to Vata-KaphaPrakriti (27%).Individuals with their Prakriti found in order of frequency were Pitta-Kapha (21%), Kapha (20%), Vata (13%), Vata-Pitta (11%), Sama (4%) and Pitta (3%).Patients with Vata-Kapha, Pitta-Kapha, and Kapha dominant Prakriti have been found more in COVID19. The treatment strategies can be accordingly decided in respect of each patient.

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.

Japanese encephalitis virus (JEV) is the main cause of viral encephalitis resulting in more than 68 000 clinical cases every year with case fatality rate as high as 30-40% for which no specific treatments are available. We have recently exhibited belladonna may be widely applicable for the treatment of various neurological disorders. Therefore, we developed a hydroalcoholic formulation of belladonna (B200) consisting of atropine and scopolamine and showed its antiviral efficacy against JEV infection. B200 treatment increases neuronal cell survival by reducing JEV induced cytopathic effects which were evident from significant reduction in necrotic cell population by flow-cytometry analysis and caspase 3 and 8 enzymatic activities. B200 treatment was found to reduce the intracellular JEV level observed by significant reduction in JEV-fluorescein isothiocyanate (FITC) expression in both neurons and microglia. Because microglia plays a crucial role in JEV pathogenesis, we further investigated the anti-JEV effects of B200 on human microglia cells and elucidated the mechanism of action by performing whole-transcriptome sequencing. Gene expression analysis revealed that B200 reduces the pro-apoptotic and inflammatory gene expression observed by significant reduction in BAD, BAX, CASP3, CASP8, IL1B, and CXCL10 and increase in IL10 responsive gene expression. Interestingly, our molecular docking analysis revealed that atropine and scopolamine interact with the His288 residue of NS3 protein, a crucial residue for RNA unwinding and ATPase activity that was further confirmed by degradation of NS3 protein. Drug likeness, ADME (absorption, distribution, metabolism, and excretion), and toxicity analysis further suggests that atropine and scopolamine both cross the blood-brain barrier, which is crucial for effective treatment of Japanese encephalitis (JE).

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.

Background We report the effects of nanoparticles in homeopathic preparations of copper salts on the electrical properties of polymer film. Previous work showed that the incorporation of metal-derived homeopathic medicines increases the dielectric constant and alternating current (AC) conductivity of an electroactive polymer film that is commonly used as a capacitor in the electronic industry.We report here the effect of dilution of one homeopathic medicine, Cuprum arsenicosum (CuAs), at 200C potency on the electrical properties of the polymer film of poly(vinylidene fluoride-co-hexafluoropropylene). Methods CuAs 200c was incorporated in the film by the solution casting method. The electrical characteristics were measured at different frequencies using an inductance, capacitance, and resistance meter. Fourier transform infrared spectroscopy (FTIR) was performed to detect phase change in the polymer film due to the incorporation of CuAs. Morphology and particle size were studied using field emission scanning electron microscopy (FESEM) and energy dispersive X-ray (EDX) spectroscopy. Results At 10 kHz frequency, both dielectric constant and AC conductivity increased approximately 18 times for the polymer film when incorporated with 2 mL CuAs at 200C potency. FTIR indicated the increase in conducting phase, while FESEM and EDX confirmed the presence of spherical CuAs particles. Conclusion The incorporation of CuAs in the electroactive polymer film enhances the conductivity and dielectric constant. We conclude that these changes arise from the change in phase of the polymer film, and because of the presence of two different metals that affects the interfacial polarization.

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.

Background: Japanese encephalitis(JE) is highly prevalent in many states of India. Belladonna 200C is widely used in the prevention and treatment of JE.The effect of Belladonna 200C in virus replication inside different tissues has not been studied. Objective: To study the effect of Belladonna 200C in virus replication inside different tissues utilising chick embryo model. Materials and Methods: Twelve-day-old fertilised eggs of Black Australorp were inoculated with JE via chorioallantoic membrane (CAM) route in different experimental sets: infection, Belladonna 200C treated and vehicle control, keeping matched blank sets. All experimental sets were incubated for 48 hours. After incubation, viable eggs were sacrificed humanly and different tissues were observed and collected for viral load determination by real-time-polymerase chain reaction (PCR). Results: The control group showed visible pocks over the CAM; brains were liquefied due to haemorrhagic liquefactive necrosis and white patches were found over the liver. However, the medicine-treated group was apparently normal; there were no visible changes in the brain and the liver was healthy like control. Real-time-PCR results showed high viral load in CAM and brain with absence of viral RNA in liver of the virus-infected group. Pre-treatment with Belladonna 200C significantly reduced the overall load (P < 0.05) in CAM and brain which correlated with the morbid pathological changes of the organs. Conclusion: Although Belladonna 200C did not completely inhibit JE viral replication in the brain, it reduced the severity of JE by diminishing the viral loads in this tissue.

Background: Chemoprofiling of homoeopathic drug/tincture (HT) represents a comprehensive approach for evaluation of quality, purity, safety and efficacy of HT. This paper reflects the chemoprofiling of Homoeopathic drug Holarrhena antidysentrica L. Objective: The objective of this study is to standardise Holarrhena antidysenterica mother tincture by taking the samples from four different sources: Dr D. P. Rastogi, CRI (H) Noida (A) and three from market (labelled as B, C and D). Materials and Methods: The authentic sample of bark of Holarrhena antidysenterica supplied by the Centre of Medicinal Plants Research in Homoeopathy, Emerald, Tamil Nadu, India was used to prepare the mother tincture (as per the Homoeopathic Pharmacopoeia of India). The solvents used throughout the study, namely, ethanol, high-pressure liquid chromatography water, cyclohexane, chloromethane and diethylamine, were of analytical grade purity (MERCK Ltd.). Physicochemical properties, ultraviolet (UV) spectroscopy and high-performance thin-layer chromatography (HPTLC) chemoprofile of raw drug and mother tinctures were standardised and compared with market samples. Results: The present study reveals the moisture content (14.40%), total ash (4.65%), alcohol (18.0%), water extractive values (16.0%), total solids (1.47%), weight/ml (0.92 g) and alcohol content (60.6%). In UV spectroscopy, λmaxvalues were observed at 228 and 278 nm in HT. HPTLC analysis of in-house HT (A) and three market samples (B, C, D) was performed by using cyclohexane: chloromethane: diethylamine (7:3:1, v/v/v) as mobile phase. Under UV light (254, 366 nm) and in the presence of visualising agent Dragendroff, bands of active constituent were observed in all the four samples. However, excess amount of active constituents were found in in-house HT (a) rather than the market samples (B, C and D). Conclusion: The present physicochemical and phytochemical data may be considered as pharmacopoeia standards for the homoeopathic drug Holarrhema antidysentrica L.

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.

Background: The objective of the study was to characterize homoeopathic nanomedicine Aurum metallicum and evaluate its biocompatibility, to explore its possible application as injectables. Metal-based homoeopathic medicine, Aurum metallicum, was chosen as a model drug and the haemocompatibility of the drug at three different potencies 6C, 30C, and 200C were studied to find the justification of the drug as an injectable candidate for clinical application. Methods: The model drug Aurum metallicum at the three potencies was characterized by dynamic light scattering (DLS), zeta potential, field emission scanning electron microscopy (FESEM), and energy dispersive X-ray analysis. Hemocompatibility of the homoeopathic medicine was performed by haemolysis assay. Red blood cell obtained from fresh human blood by centrifugation was incubated with Aurum metallicum. Haemoglobin release was measured using UV-vis spectrophotometer at 540 nm. Results: The DLS and FESEM studies show a decrease of particle size with increasing potency. The zeta potential values show a fairly constant value measured at an interval of 10 days. The haemolysis percentage for 6C, 30C, and 200C was 9.73%, 8.16%, and 0.73%, respectively. Conclusion: The nanomedicine Aurum metallicum was nontoxic at all doses of 6C, 30C, and 200C. The haemolytic percentage also shows that 200C is nonhemolytic, showing haemolysis

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.