Effectiveness of Homeopathic Medicines as Add-on to Institutional Management Protocol for Acute Encephalitis Syndrome in Children: an Open-Label Randomized Placebo-Controlled Trial

2020 ◽  
Author(s):  
Praveen Oberai ◽  
Roja Varanasi ◽  
Maya Padmanabhan ◽  
Alok Upadhyaya ◽  
Supriya Singh ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Open Label ◽  
Institutional Management ◽  
Acute Encephalitis Syndrome ◽  
Acute Encephalitis ◽  
Management Protocol

Effectiveness of Homeopathic Medicines as Add-on to Institutional Management Protocol for Acute Encephalitis Syndrome in Children: An Open-Label Randomized Placebo-Controlled Trial

Homeopathy ◽  
2018 ◽  
Vol 107 (03) ◽  
pp. 161-171 ◽  
Author(s):  
Praveen Oberai ◽  
Maya Padmanabhan ◽  
Alok Upadhyaya ◽  
Supriya Singh ◽  
Samarendra Singh ◽  
...  
Keyword(s):  
Absolute Risk ◽  
Controlled Trial ◽  
Vegetative State ◽  
Treatment Options ◽  
Number Needed To Treat ◽  
Open Label ◽  
Institutional Management ◽  
Acute Encephalitis Syndrome ◽  
Acute Encephalitis ◽  
Management Protocol

Background Acute encephalitis syndrome (AES) is endemic to certain parts of India, with limited treatment options. In our initial exploratory comparative observational study of 151 patients with AES, there was significantly reduced mortality with adjunctive homeopathy compared to institutional management protocol (IMP). The present randomized placebo-controlled trial brings more statistical rigor to this research program. Methods This study was conducted at a pediatric unit from 2013 to 2015. Children aged > 6 months and ≤ 18 years and receiving IMP were randomized to receive adjunctive homeopathy (n = 325) or placebo as control (n = 323). The primary effectiveness analysis was based on Glasgow Outcome Scale (GOS). Morbidity was assessed using the Liverpool Outcome Score for Assessing Children at Follow-up. Analysis was by intention to treat. Results A total of 612 children were analyzed (Homeopathy [H] = 304; Control [C] = 308). The primary outcome, GOS, differed significantly between H and C groups. There was 14.8% death/neuro-vegetative state in the H group compared to 29.8% in the C group. Relative risk was 0.49 (95% confidence interval [CI]: 0.36 to 0.68), with absolute risk reduction of 15.0% (95% CI: 8.6 to 21.6%). Number needed to treat to prevent one additional death/neuro-vegetative state was 6.6 (95% CI: 4.6 to 11.6). Proportional-odds analysis also revealed a greater effect in the H group: odds ratio, 0.40 (95% CI: 0.27 to 0.60). The most frequently used medicines were Belladonna (n = 116), Stramonium (n = 33), Arsenicum album (n = 25), Sulfur (n = 18), Opium (n = 17), and Nux vomica (n = 10). Conclusion Adjunctive homeopathic medicines may improve clinical outcomes associated with AES. Further randomized and controlled studies, using double-blinded trial design, are recommended to discover if the current findings may be corroborated.

scholarly journals Analysis of outcome of acute encephalitis syndrome after inclusion of coverage against scrub typhus

2018 ◽  
Vol 6 (1) ◽  
pp. 10
Author(s):  
Ruchi Jha ◽  
Anil Kumar Jaiswal
Keyword(s):  
Scrub Typhus ◽  
Controlled Trial ◽  
Case Fatality ◽  
Standard Operating Procedure ◽  
Acute Encephalitis Syndrome ◽  
Acute Encephalitis ◽  
Number Of Patients ◽  
Management Of Complications ◽  
Significant Difference ◽  
Before And After

Background: Acute encephalitis syndrome (AES) has emerged as a major epidemic in Bihar and is associated with high mortality. Owing to the increasing burden of disease and its associated morbidity and mortality, studies were undertaken to evaluate specific etiology of AES. Some studies suggested emergence of scrub typhus as a major cause of AES accounting for about 25% of the cases1. A Standard Operating Procedure (SOP) was developed for treatment of AES cases in Bihar which included addition of Injection Azithromycin (@ 10 mg/kg for 7 to 10 days in case of suspected mycoplasma/rickettsial infection. The objective of the study is to compare the outcome of AES before and after the inclusion of coverage against rickettsial infection.Methods: It is a randomized controlled trial conducted in the Department of Pediatrics, Patna Medical College and Hospital, Patna from January 2016 to August 2018.Results: Total number of patients enrolled in both the groups were 127 and 88 respectively. No significant difference were seen in the baseline socio- demographic characteristics of the two groups. Case Fatality Rate in the 1st group (without inclusion of Azithromycin) was 39.3% while in the 2nd Group (with Azithromycin) was 12.5%.Conclusions: Due to the emergence of scrub typhus as a major etiological factor for AES, inclusion of coverage against it along with measures like widespread immunization against Japanese Encephalitis and prompt management of complications and euglycemia, can result in steady decline in the death rates due to AES.

scholarly journals Role of oral Minocycline in acute encephalitis syndrome in India – a randomized controlled trial

2015 ◽  
Vol 16 (1) ◽  
Author(s):  
Rashmi Kumar ◽  
Anirban Basu ◽  
Subrata Sinha ◽  
Manoj Das ◽  
Piyush Tripathi ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Randomized Controlled ◽  
Acute Encephalitis Syndrome ◽  
Acute Encephalitis

Impact of Temperature on Injection-Related Pain Caused by Subcutaneous Administration of Ustekinumab: A Three-arm Crossover Open-label Randomized Controlled Trial

2017 ◽  
Vol 1 (3) ◽  
pp. 117-127
Author(s):  
Yasaman Mansouri ◽  
Yasmin Amir ◽  
Michelle Min ◽  
Raveena Khanna ◽  
Ruiqi Huang ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Subcutaneous Administration ◽  
Open Label ◽  
Post Dose ◽  
Subcutaneous Injections ◽  
Pain Scores ◽  
Observational Cohort ◽  
Vas Scores ◽  
Pre Treatment ◽  
To Receive

Background: Adherence to subcutaneous biologic agents for the treatment of psoriasis can be negatively influenced by injection pain.Objective: To explore the differences in injection site pain when patients are pre-treated with heat or cold, versus no pre-treatment prior to administration of a subcutaneous biologic agent.Methods: In an observational cohort study, patients receiving subcutaneous injections of ustekinumab were randomly assigned to receive pretreatment with ice, heat, or no intervention over three visits. Post-dose, patients rated pain on a 100 mm visual analogue scale (VAS).Results: There was an increase in the VAS score for both heat (2.51, P=0.30) and ice (3.33, P=0.16), compared to no intervention. No differences were found between the two intervention groups (-0.83, P=0.73). On average, females had the same VAS scores with ice compared to that of no intervention (-0.12, P=0.97) and a non–significant decrease of 3.29 points (P=0.38) with heat. Males had increased pain scores by 5.65 points (P=0.07) with ice and by 6.39 points (P=0.04) with heat.Limitations: Pain is a subjective measurement and objective quantification is difficult.Conclusions: On average, neither heat nor cold application reliably reduced pain. Our results do not support the application of heat or cold prior to ustekinumab injection.

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