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  • 1
    Online Resource
    Online Resource
    Homeopathic Medicines in Second Wave of COVID-19: Prognostic Factor Research
    Georg Thieme Verlag KG ; 2023
    In:  Homeopathy Vol. 112, No. 01 ( 2023-02), p. 012-021
    Details
    In: Homeopathy, Georg Thieme Verlag KG, Vol. 112, No. 01 ( 2023-02), p. 012-021
    Abstract: Background The clinical profile and course of COVID-19 evolved perilously in a second wave, leading to the use of various treatment modalities that included homeopathy. This prognostic factor research (PFR) study aimed to identify clinically useful homeopathic medicines in this second wave. Methods This was a retrospective, multi-centred observational study performed from March 2021 to May 2021 on confirmed COVID-19 cases who were either in home isolation or at COVID Care Centres in Delhi, India. The data were collected from integrated COVID Care Centres where homeopathic medicines were prescribed along with conventional treatment. Only those cases that met a set of selection criteria were considered for analysis. The likelihood ratio (LR) was calculated for the frequently occurring symptoms of the prescribed medicines. An LR of 1.3 or greater was considered meaningful. Results Out of 769 confirmed COVID-19 cases reported, 514 cases were selected for analysis, including 467 in home isolation. The most common complaints were cough, fever, myalgia, sore throat, loss of taste and/or smell, and anxiety. Most cases improved and there was no adverse reaction. Certain new symptoms, e.g., headache, dryness of mouth and conjunctivitis, were also seen. Thirty-nine medicines were prescribed, the most frequent being Bryonia alba followed by Arsenicum album, Pulsatilla nigricans, Belladonna, Gelsemium sempervirens, Hepar sulphuris, Phosphorus, Rhus toxicodendron and Mercurius solubilis. By calculating LR, the prescribing indications of these nine medicines were ascertained. Conclusion Add-on use of homeopathic medicines has shown encouraging results in the second wave of COVID-19 in integrated care facilities. Further COVID-related research is required to be undertaken on the most commonly prescribed medicines.
    Type of Medium: Online Resource
    ISSN: 1475-4916 , 1476-4245
    URL: Article
    DOI: 10.1055/s-0042-1748881
    Language: English
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2023
    detail.hit.zdb_id: 2030010-4
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  • 2
    Online Resource
    Online Resource
    Test of a Homeopathic Algorithm for COVID-19: the Importance of a Broad Perspective
    Georg Thieme Verlag KG ; 2023
    In:  Homeopathy Vol. 112, No. 01 ( 2023-02), p. 022-029
    Details
    In: Homeopathy, Georg Thieme Verlag KG, Vol. 112, No. 01 ( 2023-02), p. 022-029
    Abstract: Background Most of the symptoms of coronavirus disease 2019 (COVID-19) are covered by large repertory rubrics and hence many remedies have been proposed as “genus epidemicus”. The aim of this study was to combine the information from various data collections to prepare a COVID-19 Bayesian mini-repertory/an algorithm-based application (app) and test it. Methods In July 2021, 1,161 COVID-19 cases from 100 practitioners globally were combined. These data were used to calculate “condition-confined” likelihood ratios (LRs) for 59 symptoms of COVID-19. Out of these, 35 symptoms of the 11 medicines that had at least 20 cases each were considered. The information was entered in a spreadsheet (algorithm) to calculate combined LRs of specific combinations of symptoms. The algorithm contained the medicines Arsenicum album, Belladonna, Bryonia alba, Camphora, Gelsemium sempervirens, Hepar sulphuris, Mercurius solubilis, Nux vomica, Phosphorus, Pulsatilla and Rhus toxicodendron. To test concordance, the doctors were then invited to re-enter the symptoms of their cases into this algorithm. Results The algorithm was re-tested on 358 cases, and concordance was seen in 288 cases. On analysis of the data, bias was noticed in the Merc group, which was therefore excluded from the algorithm. The remaining 10 medicines, representing 81.8% of all cases, were included in the preparation of the next version of the homeopathic mini-repertory and app. Conclusion The Bayesian mini-repertory and app is based on qualitative clinical experiences of various doctors in COVID-19 and gives indications for specific medicines for common COVID-19 symptoms. It is freely available [English: https://hpra.co.uk/; Spanish: https://hpra.co.uk/es ] for further testing and utilization by the profession.
    Type of Medium: Online Resource
    ISSN: 1475-4916 , 1476-4245
    URL: Article
    DOI: 10.1055/s-0042-1746196
    Language: English
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2023
    detail.hit.zdb_id: 2030010-4
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  • 3
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    Online Resource
    Clinical Characteristics and Outcome of Patients with Multiple Intracranial Aneurysms from a University Hospital in Nepal
    Georg Thieme Verlag KG ; 2022
    In:  Asian Journal of Neurosurgery Vol. 17, No. 02 ( 2022-06), p. 268-273
    Details
    In: Asian Journal of Neurosurgery, Georg Thieme Verlag KG, Vol. 17, No. 02 ( 2022-06), p. 268-273
    Abstract: Objective The risk factors, management strategies, and outcomes of patients with multiple intracranial aneurysms (MIAs) are different compared with that of patients with a single aneurysm. Data are scarce regarding patients with MIAs from developing countries. The objective of this study was to describe the clinical characteristics, management strategies, and outcomes of patients treated microsurgically from Nepal. Methods The clinical records of patients confirmed to have MIAs and microsurgically clipped between July 2014 and December 2019 were retrospectively reviewed. Data on demographic and clinical characteristics, computed tomography findings, multiplicity and location of aneurysms, management strategies, and the 1-year outcome were abstracted and analyzed. Results Two hundred cerebral aneurysms were microsurgically clipped in 170 consecutive patients during the study period. Twenty-six (13.0%) patients harbored 60 aneurysms. The mean age of the patients was 58.5 (43–73) years. Smoking and hypertension were found in 20 (76.9%) and 16 (61.5%) patients, respectively. The majority of patients [17 (65.4%)] were in good grades at presentation. Twenty-one patients had two aneurysms, four had three aneurysms, and one patient had five aneurysms. The middle cerebral artery was the commonest (20) followed by distal anterior cerebral artery (14) and anterior communicating artery (13) involved in multiplicity. A single-stage surgery was performed on 17 patients. Serial clipping was performed in six patients. In three patients, a single aneurysm on the contralateral side was left untreated for various reasons. The favorable outcome was achieved in 23 (88.5%) patients whereas three (11.5%) patients had an unfavorable outcome. One patient died. Conclusion The demographic and clinical characteristics of patients in our series are comparable with those described in the published literature from other countries. With an individualized treatment strategy, an acceptable outcome can be achieved in the majority of the patients.
    Type of Medium: Online Resource
    ISSN: 1793-5482 , 2248-9614
    URL: Article
    DOI: 10.1055/s-0042-1750822
    Language: English
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2022
    detail.hit.zdb_id: 2621446-5
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  • 4
    Online Resource
    Online Resource
    Prophylactic Use of Antiepileptic Drug (Phenytoin) in Preventing Early Postoperative Seizure in Patients with Chronic Subdural Hematoma: A Randomized Control Trial
    Georg Thieme Verlag KG ; 2019
    In:  Indian Journal of Neurosurgery Vol. 08, No. 03 ( 2019-12), p. 168-178
    Details
    In: Indian Journal of Neurosurgery, Georg Thieme Verlag KG, Vol. 08, No. 03 ( 2019-12), p. 168-178
    Abstract: Introduction Antiepileptic drug (AED) therapy has been used prophylactically in various centers in patients with chronic subdural hematoma (CSDH) after surgical evacuation, although the benefit is unclear. Materials and Methods In this randomized controlled trial, patients with CSDH undergoing burr hole drainage were enrolled into two groups—one which received prophylactic phenytoin and the other without the drug use. Their clinical presentation, imaging findings and postoperative complications were analyzed. Primary objective of the study was to assess the efficacy of phenytoin in the reduction of early postoperative seizure. Results A total of 54 patients were enrolled in the study and randomized into two groups. Twenty-seven patients were assigned into the phenytoin group while another 27 patients to the “no phenytoin” group. Analysis of all patients in the no phenytoin group and those in the phenytoin group with therapeutic serum phenytoin levels were done. The incidence of postoperative seizure was 5.7%; and all patients who had seizures were in the no phenytoin group. This, however, was not statistically significant (p = 0.262). Two out of 25 patients on phenytoin (8%) developed adverse drug reactions. Conclusion Incidence of postoperative seizure in patients undergoing burr hole drainage for CSDH was low. Routine prophylactic use of AED, did not reduce seizure in early postoperative period.
    Type of Medium: Online Resource
    ISSN: 2277-954X , 2277-9167
    URL: Article
    DOI: 10.1055/s-0039-1698478
    Language: English
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2019
    detail.hit.zdb_id: 2698542-1
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