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Banerjee A, Ganguly S, Saha S, Bhattacharyya P, Naskar S, Mukherjee D, Ghosh S, Maji P, Saha S, Shaikh AR, Ghosh P, Chatterjee C, Koley M, Mukherjee SK. Individualized homeopathic medicines in preventing the progression from pre-diabetes to diabetes: A double-blind, randomized, placebo-controlled, parallel-arm trial. Explore (NY) 2024:S1550-8307(24)00058-2. [PMID: 38631987 DOI: 10.1016/j.explore.2024.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Revised: 03/15/2024] [Accepted: 03/28/2024] [Indexed: 04/19/2024]
Abstract
CONTEXT Pre-diabetes is a significant public health problem worldwide. India has a very high rate of progression from pre-diabetes to diabetes, 75-78 per thousand persons per year. OBJECTIVE To study the efficacy of individualized homeopathic medicinal products (HMPs) against placebos in preventing the progression from pre-diabetes to diabetes. DESIGN Six-month, double-blind, randomized (1:1), two parallel arms, placebo-controlled trial. SETTING Outpatient departments of D. N. De Homoeopathic Medical College and Hospital, Kolkata, West Bengal, India. PATIENTS Sixty participants with pre-diabetes. INTERVENTIONS Verum: HMPs plus yoga therapy (YT; n = 30); control: identical-looking placebos plus YT (n = 30). MAIN OUTCOME MEASURES The primary efficacy endpoint was the proportion of participants progressing from pre-diabetes to diabetes, measured after three and six months. Secondary outcomes comprised of fasting blood glucose (FBS), oral glucose tolerance test (OGTT), glycated hemoglobin percentage (HbA1c%), lipid profile, liver enzymes (alanine transaminase, aspartate transaminase), urea and creatinine, and Measure Yourself Medical Outcome Profile version 2 (MYMOP-2); all measured after 3 and 6 months. RESULTS The proportion of participants converted from pre-diabetics to diabetics (n/N; n = diabetics, N = prediabetics) was significantly less in the verum group than control: HbA1C% (month 3: verum - 2/30 versus control - 11/30, p = 0.003; month 6: 3/30 vs. 2/30, p = 0.008), OGTT (month 3: 0/30 vs. 8/30, p = 0.015; month 6: 0/30 vs. 1/30, p = 0.008), but not according to FBS (month 3: 1/30 vs. 1/30, p = 0.779; month 6: 1/30 vs. 3/30, p = 0.469). Several secondary outcomes also revealed significant improvements in the verum group than in placebo: HbA1C% (p < 0.001), OGTT (p = 0.001), serum ALT (p = 0.031), creatinine (p = 0.012), and MYMOP-2 profile scores (p < 0.001). Sulphur, Bryonia alba, and Thuja occidentalis were the most frequently indicated medicines. Thus, HMPs outperformed placebos by successfully preventing the progression of pre-diabetes to diabetes. TRIAL REGISTRATION Clinical Trials Registry - India CTRI/2022/04/042,026; UTN: U1111-1277-0021.
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Affiliation(s)
- Aryabrata Banerjee
- Dept. of Organon of Medicine and Homoeopathic Philosophy, D. N. De Homoeopathic Medical College and Hospital, Govt. of West Bengal, 12, Gobinda Khatick Road, Kolkata 700046, West Bengal, India.
| | - Subhasish Ganguly
- Dept. of Organon of Medicine and Homoeopathic Philosophy, D. N. De Homoeopathic Medical College and Hospital, Govt. of West Bengal, 12, Gobinda Khatick Road, Tangra, Kolkata 700046, West Bengal, India
| | - Sangita Saha
- Dept. of Organon of Medicine and Homoeopathic Philosophy, D. N. De Homoeopathic Medical College and Hospital, Govt. of West Bengal, 12, Gobinda Khatick Road, Tangra, Kolkata 700046, West Bengal, India
| | - Pulakendu Bhattacharyya
- Dept. of Organon of Medicine and Homoeopathic Philosophy, D. N. De Homoeopathic Medical College and Hospital, Govt. of West Bengal, 12, Gobinda Khatick Road, Tangra, Kolkata 700046, West Bengal, India
| | - Satyajit Naskar
- Dept. of Organon of Medicine and Homoeopathic Philosophy, D. N. De Homoeopathic Medical College and Hospital, Govt. of West Bengal, 12, Gobinda Khatick Road, Tangra, Kolkata 700046, West Bengal, India
| | - Debraj Mukherjee
- Dept. of Yoga and Physiotherapy, D. N. De Homoeopathic Medical College and Hospital, Govt. of West Bengal, 12, Gobinda Khatick Road, Tangra, Kolkata 700046, West Bengal, India
| | - Shuvadip Ghosh
- Dept. of Organon of Medicine & Homoeopathic Philosophy, D. N. De Homoeopathic Medical College and Hospital, Govt. of West Bengal, 12, Gobinda Khatick Road, Tangra, Kolkata 700046, West Bengal, India
| | - Prosenjit Maji
- Dept. of Organon of Medicine & Homoeopathic Philosophy, D. N. De Homoeopathic Medical College and Hospital, Govt. of West Bengal, 12, Gobinda Khatick Road, Tangra, Kolkata 700046, West Bengal, India
| | - Subhranil Saha
- Lecturer, Dept. of Repertory, D. N. De Homoeopathic Medical College and Hospital, Kolkata, Govt. of West Bengal, 12, Gobinda Khatick Road, Tangra, Kolkata 700046, West Bengal, India
| | - Abdur Rahaman Shaikh
- Dept. of Practice of Medicine, D. N. De Homoeopathic Medical College and Hospital, Govt. of West Bengal, 12, Gobinda Khatick Road, Tangra, Kolkata 700046, West Bengal, India
| | - Priyanka Ghosh
- Dept. of Organon of Medicine and Homoeopathic Philosophy, D. N. De Homoeopathic Medical College and Hospital, Govt. of West Bengal, 12, Gobinda Khatick Road, Tangra, Kolkata 700046, West Bengal, India
| | - Chandrima Chatterjee
- Dept. of Materia Medica, D. N. De Homoeopathic Medical College and Hospital, Govt. of West Bengal, 12, Gobinda Khatick Road, Tangra, Kolkata 700046, West Bengal, India
| | - Munmun Koley
- Dept. of Homoeopathy, East Bishnupur State Homoeopathic Dispensary, Chandi Daulatabad Block Primary Health Centre, South 24 Parganas, West Bengal, under Department of Health & Family Welfare, Govt. of West Bengal, India
| | - Shyamal Kumar Mukherjee
- Dept. of Community Medicine, D. N. De Homoeopathic Medical College and Hospital, Govt. of West Bengal, 12, Gobinda Khatick Road, Tangra, Kolkata 700046, West Bengal, India
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Ghosh P, Ganguly S, Mukherjee SK, Dutta S, Shaikh AR, Ali SS, Singh NK, Bhattacharya P, Koley M, Saha S. Individualized Homeopathic Medicines in Treatment of Hyperuricemia: Evaluation by Double-Blind, Randomized, Placebo-Controlled Trial. HOMEOPATHY 2022; 112:85-96. [PMID: 36122588 DOI: 10.1055/s-0042-1751272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Hyperuricemia (HU) is a major health issue in India and across the globe. It increases the disease burden and hampers quality of life. This study was aimed at exploring the effects of individualized homeopathic medicines (IHMs) against placebo in the treatment of HU. METHODS This double-blind, randomized, placebo-controlled trial was conducted on 60 patients suffering from HU in the outpatient department of D. N. De Homoeopathic Medical College and Hospital, Kolkata. Each patient received either IHMs or identical-looking placebos, along with advice on dietary modifications irrespective of codes. Serum uric acid (SUA) level was the primary outcome measure; the HU quality of life questionnaire (HUQLQ) and the Measure Yourself Medical Outcome Profile version 2 (MYMOP-2) were the secondary outcomes; all measured at baseline, and every month, up to 3 months. Group differences were examined by two-way (split-half) repeated-measures analysis of variance after adjusting for baseline differences. Significance level was set at p ≤0.05, two-tailed. RESULTS The intention-to-treat sample (n = 58) was analyzed. Between-group differences in SUA levels (F 1, 56 = 13.833, p <0.001), HUQLQ scores (F 1, 56 = 32.982, p <0.001) and MYMOP-2 profile scores (F 1, 56 = 23.873, p <0.001) were statistically significant, favoring IHMs against placebos, with medium to large effect sizes. Calcarea carbonica and Pulsatilla nigricans were the most frequently prescribed medicines. No serious adverse events were reported from either of the groups. CONCLUSION IHMs showed significantly better results than placebos in reducing SUA levels and improving quality of life in patients suffering from HU. TRIAL REGISTRATION CTRI/2019/10/021503; UTN: U1111-1241-1431.
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Affiliation(s)
- Priyanka Ghosh
- Department of Organon of Medicine and Homoeopathic Philosophy, D. N. De Homoeopathic Medical College and Hospital; affiliated to The West Bengal University of Health Sciences, Govt. of West Bengal, Kolkata, West Bengal, India
| | - Subhasish Ganguly
- Department of Organon of Medicine and Homoeopathic Philosophy, D. N. De Homoeopathic Medical College and Hospital; affiliated to The West Bengal University of Health Sciences, Govt. of West Bengal, Kolkata, West Bengal, India
| | - Shyamal Kumar Mukherjee
- Department of Community Medicine, D. N. De Homoeopathic Medical College and Hospital; affiliated to The West Bengal University of Health Sciences, Govt. of West Bengal, Kolkata, West Bengal, India
| | - Souvik Dutta
- Department of Organon of Medicine and Homoeopathic Philosophy, D. N. De Homoeopathic Medical College and Hospital; affiliated to The West Bengal University of Health Sciences, Govt. of West Bengal, Kolkata, West Bengal, India
| | - Abdur Rahaman Shaikh
- Department of Practice of Medicine, D. N. De Homoeopathic Medical College and Hospital; affiliated to The West Bengal University of Health Sciences, Govt. of West Bengal, Kolkata, West Bengal, India
| | - Sk Swaif Ali
- Department of Practice of Medicine, Mahesh Bhattacharya Homoeopathic Medical College and Hospital, Howrah, Govt. of West Bengal; affiliated to The West Bengal University of Health Sciences, Govt. of West Bengal, Howrah, West Bengal, India
| | - Navin Kumar Singh
- Department of Repertory, The Calcutta Homoeopathic Medical College and Hospital; affiliated to The West Bengal University of Health Sciences, Govt. of West Bengal, Kolkata, West Bengal, India
| | - Pulakendu Bhattacharya
- Department of Organon of Medicine and Homoeopathic Philosophy, D. N. De Homoeopathic Medical College and Hospital; affiliated to The West Bengal University of Health Sciences, Govt. of West Bengal, Kolkata, West Bengal, India
| | - Munmun Koley
- Department of Homoeopathy, East Bishnupur State Homoeopathic Dispensary, Chandi Daulatabad Block Primary Health Centre, West Bengal, under Department of Health & Family Welfare, Govt. of West Bengal, West Bengal, India
| | - Subhranil Saha
- Department of Repertory, D. N. De Homoeopathic Medical College and Hospital; affiliated to The West Bengal University of Health Sciences, Govt. of West Bengal, Kolkata, West Bengal, India
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Dutta S, Ganguly S, Mukherjee SK, Ghosh P, Hazra P, Roy AS, Shaikh AR, Ali SS, Sadhukhan S, Koley M, Saha S. Efficacy of individualized homeopathic medicines in intervening the progression of pre-hypertension to hypertension: A double-blind, randomized, placebo-controlled trial. Explore (NY) 2021; 18:279-286. [PMID: 34147344 DOI: 10.1016/j.explore.2021.05.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 05/27/2021] [Accepted: 05/28/2021] [Indexed: 11/04/2022]
Abstract
CONTEXT Pre-hypertension remains a significant public health challenge and appropriate intervention is required to stop its progression to hypertension and/or cardiovascular diseases. OBJECTIVE To study the effects of individualized homeopathic medicines (IH) against placebo in intervening with the progression of pre-hypertension to hypertension. DESIGN Double-blind, randomized, two parallel arms, placebo-controlled trial. SETTING Outpatient departments of D. N. De Homoeopathic Medical College and Hospital, Kolkata, West Bengal, India. PATIENTS Ninety-two patients suffering from pre-hypertension; randomized to receive either IH (n = 46) or identical-looking placebo (n = 46). INTERVENTIONS IH or placebo in the mutual context of lifestyle modification (LSM) advices including dietary approaches to stop hypertension (DASH) and brisk exercises. MAIN OUTCOME MEASURES Primary - systolic and diastolic blood pressure (SBP and DBP); secondary - Measure Yourself Medical Outcome Profile version 2.0 (MYMOP-2) scores; all measured at baseline, and every month, up to 3 months. RESULTS After 3 months of intervention, the number of patients having progression from pre-hypertension to hypertension between groups were similar without any significant differences in between (all P>0.05). Reduction in BP and MYMOP-2 scores were non-significantly higher (all P>0.05) in the IH group than placebo with small effect sizes. Lycopodium clavatum, Thuja occidentalis and Natrum muriaticum were the most frequently prescribed medicines. No harms or serious adverse events were reported from either group. Thus, there was a small, but non-significant direction of effect favoring homeopathy, which ultimately rendered the trial as inconclusive. [Trial registration: CTRI/2018/10/016,026; UTN: U1111-1221-8251].
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Affiliation(s)
- Souvik Dutta
- Dept. of Organon of Medicine and Homoeopathic Philosophy, D. N. De Homoeopathic Medical College and Hospital, Kolkata, West Bengal, affiliated to The West Bengal University of Health Sciences, Govt. of West Bengal, India.
| | - Subhasish Ganguly
- Dept. of Organon of Medicine and Homoeopathic Philosophy, D. N. De Homoeopathic Medical College and Hospital, Kolkata, West Bengal, affiliated to The West Bengal University of Health Sciences, Govt. of West Bengal, India
| | - Shyamal Kumar Mukherjee
- Principal and Administrator D. N. De Homoeopathic Medical College and Hospital, Kolkata, West Bengal, affiliated to The West Bengal University of Health Sciences, Govt. of West Bengal, India
| | - Priyanka Ghosh
- Dept. of Organon of Medicine and Homoeopathic Philosophy, D. N. De Homoeopathic Medical College and Hospital, Kolkata, West Bengal, affiliated to The West Bengal University of Health Sciences, Govt. of West Bengal, India
| | - Pallavi Hazra
- Dept. of Organon of Medicine and Homoeopathic Philosophy, D. N. De Homoeopathic Medical College and Hospital, Kolkata, West Bengal, affiliated to The West Bengal University of Health Sciences, Govt. of West Bengal, India
| | - Aniket Singha Roy
- Dept. of Organon of Medicine and Homoeopathic Philosophy, D. N. De Homoeopathic Medical College and Hospital, Kolkata, West Bengal, affiliated to The West Bengal University of Health Sciences, Govt. of West Bengal, India
| | - Abdur Rahaman Shaikh
- Dept. of Practice of Medicine, D. N. De Homoeopathic Medical College and Hospital, Kolkata, West Bengal, affiliated to The West Bengal University of Health Sciences, Govt. of West Bengal, India
| | - Sk Swaif Ali
- Dept. of Practice of Medicine, Mahesh Bhattacharyya Homoeopathic Medical College and Hospital, Howrah, Govt. of West Bengal, affiliated to The West Bengal University of Health Sciences, Govt. of West Bengal, India
| | - Satarupa Sadhukhan
- Dept. of Organon of Medicine and Homoeopathic Philosophy, National Institute of Homoeopathy, Block GE, Sector III, Salt Lake, Kolkata 700106, West Bengal, India; affiliated to The West Bengal University of Health Sciences, Govt. of West Bengal, India
| | - Munmun Koley
- Dept. of Organon of Medicine and Homoeopathic Philosophy, State National Homoeopathic Medical College and Hospital, Lucknow, Govt. of Uttar Pradesh, affiliated to Dr. Bhimrao Ramji Ambedkar University, Agra, Govt. of Uttar Pradesh), India
| | - Subhranil Saha
- Dept. of Repertory, D. N. De Homoeopathic Medical College and Hospital, Kolkata, West Bengal, affiliated to The West Bengal University of Health Sciences, Govt. of West Bengal, India
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Dey S, Shaikh AR, Saha S, Agrawal E, Gautam AK, Karuppusamy A, Sadhukhan S, Dutta S, Ali SS, Basu A, Koley M, Saha S. Efficacy of Individualized Homeopathic Medicines in the Treatment of Atopic Dermatitis in Adults: A Double-Blind, Randomized, Placebo-Controlled, Preliminary Trial. Complement Med Res 2021; 29:17-26. [PMID: 33857943 DOI: 10.1159/000516026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 03/19/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Individualized homeopathy (IH) in atopic dermatitis (AD) remained under-researched. OBJECTIVE We aimed at evaluating efficacy of IH in AD. METHODS A double-blind, randomized, placebo-controlled, short-term, preliminary trial was conducted in an Indian homeopathy hospital. Patients were randomized to either IH (n = 30) or identical-looking placebo (n = 30) using computerized randomization and allocation. Outcomes were patient-oriented scoring of AD (PO-SCORAD; primary end point), Dermatological Life Quality Index (DLQI) score, and AD burden score for adults (ADBSA; secondary end points), measured monthly for 3 months. An intention-to-treat sample was analyzed after adjusting baseline differences. RESULTS On PO-SCORAD, improvement was higher in IH against placebo, but nonsignificant statistically (pmonth 1 = 0.433, pmonth 2 = 0.442, pmonth 3 = 0.229). Secondary outcomes were also nonsignificant - both DLQI and ADBSA (p > 0.05). Four adverse events (diarrhea, injury, common cold) were recorded. CONCLUSIONS There was a small, but nonsignificant direction of effect towards homeopathy, which renders the trial inconclusive. A properly powered robust trial is indicated.
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Affiliation(s)
- Samit Dey
- Department of Repertory, D.N. De Homoeopathic Medical College and Hospital, Government of West Bengal (affiliated to the West Bengal University of Health Sciences, Government of West Bengal), Kolkata, India
| | - Abdur Rahaman Shaikh
- D.N. De Homoeopathic Medical College and Hospital, Government of West Bengal (affiliated to the West Bengal University of Health Sciences, Government of West Bengal), Kolkata, India
| | - Sangita Saha
- Department of Organon of Medicine and Homoeopathic Philosophy, Calcutta Homoeopathic Medical College and Hospital (affiliated to the West Bengal University of Health Sciences, Government of West Bengal), Kolkata, India
| | - Ekta Agrawal
- Department. of Repertory, National Institute of Homoeopathy, Ministry of AYUSH, Government of India (affiliated to the West Bengal University of Health Sciences, Government of West Bengal), Kolkata, India
| | - Ashish Kumar Gautam
- Department. of Repertory, National Institute of Homoeopathy, Ministry of AYUSH, Government of India (affiliated to the West Bengal University of Health Sciences, Government of West Bengal), Kolkata, India
| | - Avaranjika Karuppusamy
- Department of Materia Medica, National Institute of Homoeopathy, Ministry of AYUSH, Government of India (affiliated to the West Bengal University of Health Sciences, Government of West Bengal), Kolkata, India
| | - Satarupa Sadhukhan
- Department of Organon of Medicine and Homoeopathic Philosophy, National Institute of Homoeopathy, Ministry of AYUSH, Government of India (affiliated to the West Bengal University of Health Sciences, Government of West Bengal), Kolkata, India
| | - Souvik Dutta
- Department of Organon of Medicine and Homoeopathic Philosophy, D.N. De Homoeopathic Medical College and Hospital, Government of West Bengal (affiliated to the West Bengal University of Health Sciences, Government of West Bengal), Kolkata, India
| | - Sk Swaif Ali
- Mahesh Bhattacharyya Homoeopathic Medical College and Hospital, Government of West Bengal (affiliated to the West Bengal University of Health Sciences, Government of West Bengal), Howrah, India
| | - Anamika Basu
- Mahesh Bhattacharyya Homoeopathic Medical College and Hospital, Government of West Bengal (affiliated to the West Bengal University of Health Sciences, Government of West Bengal), Howrah, India
| | - Munmun Koley
- Department of Organon of Medicine and Homoeopathic Philosophy, State National Homoeopathic Medical College and Hospital, Lucknow, India
| | - Subhranil Saha
- Department of Organon of Medicine and Homoeopathic Philosophy, D.N. De Homoeopathic Medical College and Hospital, Government of West Bengal (affiliated to the West Bengal University of Health Sciences, Government of West Bengal), Kolkata, India,
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Dey S, Hashmi S, Saha S, Mandal M, Shaikh AR, Agrawal E, Ghosh P, Sehrawat N, Koley M, Saha S. A Randomized, Double-Blind, Placebo-Controlled, Pilot Trial of Individualized Homeopathic Medicines for Cutaneous Warts. HOMEOPATHY 2021; 110:149-159. [PMID: 33761570 DOI: 10.1055/s-0040-1722232] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Though frequently used in practice, research studies have shown inconclusive benefits of homeopathy in the treatment of warts. We aimed to assess the feasibility of a future definitive trial, with preliminary assessment of differences between effects of individualized homeopathic (IH) medicines and placebos in treatment of cutaneous warts. METHODS A double-blind, randomized, placebo-controlled trial (n = 60) was conducted at the dermatology outpatient department of D.N. De Homoeopathic Medical College and Hospital, West Bengal. Patients were randomized to receive either IH (n = 30) or identical-looking placebo (n = 30). Primary outcome measures were numbers and sizes of the warts; secondary outcome was the Dermatology Life Quality Index (DLQI) questionnaire measured at baseline, and every month up to 3 months. Group differences and effect sizes were calculated on the intention-to-treat sample. RESULTS Attrition rate was 11.6% (IH, 3; placebo, 4). Intra-group changes were significantly greater (all p < 0.05, Friedman tests) in IH than placebo. Inter-group differences were statistically non-significant (all p > 0.05, Mann-Whitney U tests) with small effect sizes-both in the primary outcomes (number of warts after 3 months: IH median [inter-quartile range; IQR] 1 [1, 3] vs. placebo 1 [1, 2]; p = 0.741; size of warts after 3 months: IH 5.6 mm [2.6, 40.2] vs. placebo 6.3 [0.8, 16.7]; p = 0.515) and in the secondary outcomes (DLQI total after 3 months: IH 4.5 [2, 6.2] vs. placebo 4.5 [2.5, 8]; p = 0.935). Thuja occidentalis (28.3%), Natrum muriaticum (10%) and Sulphur (8.3%) were the most frequently prescribed medicines. No harms, homeopathic aggravations, or serious adverse events were reported. CONCLUSION As regards efficacy, the preliminary study was inconclusive, with a statistically non-significant direction of effect favoring homeopathy. The trial succeeded in showing that an adequately powered definitive trial is both feasible and warranted. TRIAL REGISTRATION CTRI/2019/10/021659; UTN: U1111-1241-7340.
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Affiliation(s)
- Samit Dey
- Department of Repertory, D.N. De Homoeopathic Medical College and Hospital, Govt. of West Bengal, Tangra, Kolkata, West Bengal, India
| | - Shifa Hashmi
- D.N. De Homoeopathic Medical College and Hospital, Govt. of West Bengal, Tangra, Kolkata, West Bengal, India
| | - Sangita Saha
- Department of Organon of Medicine and Homoeopathic Philosophy, The Calcutta Homoeopathic Medical College and Hospital, Kolkata, West Bengal, India
| | - Mahakas Mandal
- Department of Practice of Medicine, The Calcutta Homoeopathic Medical College and Hospital, Kolkata, West Bengal, India
| | - Abdur Rahaman Shaikh
- D.N. De Homoeopathic Medical College and Hospital, Govt. of West Bengal, Tangra, Kolkata, West Bengal, India
| | - Ekta Agrawal
- Department of Repertory, National Institute of Homoeopathy, Ministry of AYUSH, Govt. of India, Kolkata, West Bengal, India
| | - Priyanka Ghosh
- Department of Organon of Medicine and Homoeopathic Philosophy, D.N. De Homoeopathic Medical College and Hospital, Govt. of West Bengal, Tangra, Kolkata, West Bengal, India
| | - Nisha Sehrawat
- Department of Pediatrics, National Institute of Homoeopathy, Ministry of AYUSH, Govt. of India, Salt Lake, Kolkata, West Bengal, India
| | - Munmun Koley
- Department of Organon of Medicine and Homoeopathic Philosophy, State National Homoeopathic Medical College and Hospital, Lucknow, Uttar Pradesh.,Independent Researcher; Champsara, Baidyabati, Hooghly, West Bengal, India
| | - Subhranil Saha
- Department of Repertory, D.N. De Homoeopathic Medical College and Hospital, Govt. of West Bengal, Tangra, Kolkata, West Bengal, India.,Independent Researcher, Shibpur, Howrah, West Bengal, India
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Abstract
BACKGROUND Choledochotomy followed by T-tube has long been a standard surgical treatment for choledocholithiasis. It is still a preferred choice in many hospitals where minimal invasive procedures are not feasible. The use of T-tube is not without complications. To avoid the complications associated with T-tube, we have performed primary closure of the common bile duct (CBD) after exploration. This pilot study assesses the safety of primary closure of CBD, which would help form a basis for implementation on a wider scale. OBJECTIVE To compare the clinical results of primary closure with T-tube drainage after open choledochotomy and assess the safety of primary closure for future application on a greater mass. PATIENTS AND METHODS This comparative study was conducted at surgical unit IV Liaquat University of Medical and Health Sciences, Jamshoro, from January 2007 to December 2007. Thirty-five patients were included in the study of which 16 patients underwent primary closure. RESULTS Thirty-five patients were included in the study. The mean age of patients who had primary closure done (n = 16) was 46.0 +/-16.8 and there were two (12.5%) males and 14 (87.5%) females. After primary closure of the CBD, bile leakage was noted in one patient (6.3%), which subsided without any biliary peritonitis as compared to the T-tube group in which two patients (10.5%) had bile leakage. Postoperative jaundice was seen in one patient (5.3%) who had a T-tube because of a blockage of CBD. Not a single patient had a retained stone in both groups as well as no recurrence of CBD stones. The postoperative hospital stay after primary closure was 5.56 +/-1.1 days as compared to after T-tube drainage which was 13.6 +/-2.3 days. The total cost of treatment in patients who underwent primary closure was USD194.5 +/-41.5 but after T-tube drainage it was USD548.6 +/-88.5. The median follow up duration for both groups was 6 months. CONCLUSION Primary CBD closure is a safe and cost effective alternative to routine T-tube drainage after open choledochotomy.
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Affiliation(s)
- M Ambreen
- Department of Surgery, Liaquat University of Medical and Health Sciences, Jamshoro, Sindh, Pakistan.
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Dreixler JC, Shenoy S, Shaikh AR, Roth S. Protein Kinase C Delta and Epsilon Subtypes and Ischemic Preconditioning. J Neurosurg Anesthesiol 2006. [DOI: 10.1097/00008506-200610000-00091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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