“To evaluate the role of homoeopathic medicines as add‑on therapy in patients with rheumatoid arthritis on NSAIDs: A retrospective study”
By: Tapas K. Kundu1, Afroz F. Shaikh2, Sindhu M. Jacob
Department Of Organon Of Medicine And Homoeopathic Philosophy
TITLE AND AUTHOR
- The title of the journal accurately explains the complete article.
- The article is on the significant topic and derives concrete conclusions and sets a base for further research as well.
- The research adds up to the existing literature and encourages other homoeopathic practitioners to come up with similar presentation of their cases as well. Rheumatoid Arthritis is a very common problem these days. Such research is very much needed for the patient welfare and advancement of homoeopathy.
PRESENTATION AND ABSTRACT
- The abstract of the article is very well laid out.
- The keyword selection is apt for the journal article. The keywords selected are, ‘Deformity’, ‘Homoeopathy’, ‘Disease Activity Score’, ‘Analgesics’, ‘Rheumatoid arthritis’.
- The author starts by briefing us about the conventional management of Rheumatoid Arthritis (RA) which includes administration of Non- Steroidal Anti- Inflammatory Drugs (NSAIDs), disease modifying anti‑rheumatic drugs (DMARDs) like Methotrixate and anti-tumor necrosis factor α monoclonal antibody (anti‑TNFά). Gastric ulcers, bleeding and perforation are the most commonly known adverse reactions found associated with excessive consumption of NSAIDs.
- Finally, Author concludes the abstract by general as well as specific details i.e. The homoeopathic system of medicine improves the general well-being, that is, Quality of Life (QoL) in addition to reducing the pain and disability.
➢ The article complies with the laid down instructions for the authors of the journal that is mentioned at. https://www.ijrh.org/contributors.asp The instructions for the clinical trials have also been followed.
- The length of the paper is suitable. All the concepts and headings are explained in the proper word limit.
- The paper is written in a clear and easily understandable style.
- The research paper does have a logical construction.
- The topic of the article is relevant and appropriate for the journal IJRJ (Indian Journal of Research in Homoeopathy).
- The introduction of the article is very thoughtfully presented by the author as he only mentions and explains the literature part which is relevant for the journal article.
- In this study, the patients with RA receiving homoeopathic medicine were analyzed for QoL, disease activity score (DAS), erythrocyte sedimentation rate (ESR), morning stiffness/pain and frequency of analgesics as outcome measures.
MATERIAL AND METHODS
- Ten cases of RA (age 32-60 years) under homoeopathic treatment were evaluated from the single private homoeopathic out-patient clinic.
- Author retrospectively analyzed to investigate the efficacy of homoeopathic medicines in patients with RA.
➢ Cases were pre-diagnosed cases of RA and confirmed clinically by presence of at least four clinical signs or symptoms.
- Patients tested sero-positive for RA, patients who took homeopathic medicine for 3 months or more were included in the study.
CLINICAL FINDINGS AND DIAGNOSTIC ASSESSMENT
- ESR tested at 3 months of duration. Each individual patient was assessed for DAS set by ACR. Joint count is one of the components to measure DAS and includes swelling, tenderness, pain on motion, limited motion and deformity.
- It also depicts how author not only considered the reports, clinical parameters and outcomes but also stressed on the overall improvement of the patient which is one of the core principles of Homoeopathy.
THERAPEUTIC INTERVENTION, FOLLOW-UP AND OUTCOME
- The homoeopathic medicines were selected as per the law of similia and prescribed singly at one occasion. The analysis was done as per Kentian school of philosophy, that is mental general, physical general and characteristic particular. Detailed case taking, its recording and interpretation of the symptoms were the steps followed for repertorization. The symptoms were classified and evaluated to erect the totality. The repertorial results were analyzed and importance given to the essence of the patient considering life space situation, predominant mental/emotional state (diagnosis of the person as a whole) for final selection of medicine. Placebo was continued with improvement in general condition of the patient.
- Individualized homoeopathic prescription was given in pills. The potency of the medicine during subsequent consultations was raised based on the progress of the case or the medicine was changed in cases where no change in the symptoms observed following Gibson–Miller remedy relationship.
- Author starts by explaining the severity and complexity of the case, proceeding towards explaining the homoeopathic basis of selection of remedy and cure through the right choice of remedies in the case. The discussion part of the journal is flawlessly explained by the author.
- Arsenic album, Belladonna, Calcarea carb, Lachesis, Pulsatilla, Causticum, Nux vomica, Silicea, Cocculus, Sulphur, Sepia, Aurum metallicum were used as constitutional similimum given singly at one occasion depending upon the totality of symptoms.
- Author mentions how homoeopathic constitutional similimum improves the QoL of patients with RA by reducing intensity of pain, limiting disability and reduces the disease activity.
- Author statistically shows the improvement in general and disease condition limits the need of analgesics and DMARDs in RA.
- Conclusion could have been more elaborate.
- Author has chosen appropriate and relevant references.
Emilius Kreussler 1865,obstinate rheumatism three remedies veratrum alb carbo veg phos are best all have chilliness of body and intolerable heat of single parts esp head,pains of phos and veratrum are tearing nature but that of carbo veg sting burn nature.
acute rheumatic fevers Aconite best if metastasis to organs esp heart then Arsenic.
rheumatic pains SHIFT on motion then spigelia crocus valeriana asafoe cina be compared.
Pulsa is specific muscle inflammatory rheumatism then with high fever there is thirst also.
cocculus ignatia nux have stiff body never cure shift nature pains.
Rhus tox and pulsa rarely constipated have diarrhea or normal stools.
lay homeopaths bryonia worse by motion and Rhus Tox better by motion best general drainers.
Homeopaths thinking is Rheumatism is not disease but irritation of brain causes metabolic disturbances and by products of bad digestion is rheumatism.treat mind first not body.