Effectiveness of Eupatorium perfoliatum 30C in Prevention of Dengue Fever and Acute Febrile Illness during 2017 Dengue Outbreak in Urban Slums of Delhi: A Prospective, Open-Label, Community-Based, Parallel Cohort Study.

OBJECTIVE: This study was undertaken to assess the effectiveness of Eupatorium perfoliatum (EP) 30C on the incidence of dengue fever and acute febrile illness (AFI) during the 2017 dengue outbreak. METHODS: We conducted a prospective, open-label, community-based parallel cohort study involving apparently healthy individuals residing in 06 urban slums (JJ colony) of Delhi. The participants were enrolled in two cohorts - the medicine cohort (MC) and the control cohort (CC). Participants in MC were given weekly one dose of EP 30C for 10 weeks along with Information, Education and Communication (IEC) material regarding dengue. Participants in the CC were provided with the IEC material only. The primary outcome measure was the incidence of dengue fever as per case definitions notified in the national guidelines for clinical management of dengue fever by the Government of India during the 10 weeks follow-up period. The secondary outcome measures were the incidence of AFI and the hospitalization of confirmed dengue cases. RESULTS: The analysis included 40,769 participants residing in 06 slum clusters of Delhi out of which 28,321 participants were in MC and 12,448 participants were in CC. The incidence of laboratory-confirmed dengue in the MC was 2.57 per 10,000 person-weeks (95% confidence interval [CI], 2.02-3.22) in comparison with 7.55 per 10,000 person-weeks (95% CI, 6.12-9.21) in the CC. The incidence of AFI in the MC was 19.66 per 10,000 person-weeks (95% CI, 18.07-21.36) in comparison with 40.96 per 10,000 person-weeks (95% CI, 37.48-44.67) in the CC. The overall protective effect of EP against laboratory-confirmed dengue was 65.77% (95% CI, 53.37-74.87; p = 0.0001) and against AFI was 52.58% (95% CI, 46.37-58.07; p = 0.0001). Hospitalization reported in the MC was nil as against 4.35% in the CC. No dengue-related case fatalities were reported from either cohort. None of the participants from the MC reported any adverse events owing to the prophylactic intervention. CONCLUSION: The study concludes that EP 30C was able to prevent dengue significantly. Randomized controlled trials are needed to confirm or refute our findings.Das Ziel dieser Studie war die Beurteilung der Wirksamkeit von Eupatorium perfoliatum (EP) 30C auf die Inzidenz von Dengue-Fieber und akuter fiebriger Erkrankung (AFE) während des Dengue-Ausbruchs 2017.Wir führten eine prospektive, unverblindete, Bevölkerungs-Parallelgruppen-Kohortenstudie mit augenscheinlich gesunden Bewohnern von 6 städtischen Slums (JJ-Kolonie) in Delhi durch. Die Teilnehmer wurden in 2 Kohorten aufgenommen, einer Medizinkohorte (MK) und einer Kontrollkohorte (KK). Die Teilnehmer in der MK erhielten 10 Wochen lang wöchentlich eine Dosis EP 30C und dazu Aufklärungsmaterialien über Dengue. Die Teilnehmer in der KK erhielten nur die Aufklärungsmaterialien. Die primäre Zielgröße war die Dengue-Fieber-Inzidenz laut der in den nationalen Leitlinien für das klinische Management des Dengue-Fiebers von der indischen Regierung bekannt gegebenen Falldefinition in dem zehnwöchigen Beobachtungszeitraum. Die sekundären Zielgrößen waren die Inzidenz von AFE und die Anzahl hospitalisierter bestätigter Dengue-Fälle.In die Analyse wurden 40,769 Bewohner von 6 Slum-Clustern in Delhi einbezogen, davon wurden 28,321 Teilnehmer in die MK aufgenommen und 12,448 Teilnehmer in die KK. Die Inzidenz von im Labor bestätigter Dengue betrug in der MK 2,57 pro 10,000 Personen/Woche (95%-Konfidenzintervall [KI]: 2,02­3,22), verglichen mit 7,55 pro 10,000 Personen/Woche (95%-KI: 6,12­9,21) in der KK. Die Inzidenz von AFI betrug in der MK 19,66 pro 10,000 Personen/Woche (95%-Konfidenzintervall [KI]: 18,07­21,36), verglichen mit 40,96 pro 10,000 Personen/Woche (95%-KI: 37,48­44,67) in der KK. Der Schutzeffekt (SE) von EP betrug gegen im Labor bestätigte Dengue 65,77% (95%-KI: 53,37­74,87; p = 0,0001) und gegen AFI 52,58% (95%-KI: 46,37­58,07; p = 0,0001). Die Hospitalisierungsrate war in der MK gleich Null versus 4,35% in der KK. In keiner Kohorte waren Dengue-bedingte Todesfälle zu verzeichnen. Bei keinem der Teilnehmer in der MK traten jegliche unerwünschten Ereignisse infolge der prophylaktischen Maßnahme auf.Die Studie gelangt zu dem Schluss, dass Eupatorium perfoliatum 30C in signifikantem Maße Dengue vorbeugen konnte. Randomisierte kontrollierte Studien sind erforderlich, um unsere Ergebnisse zu bestätigen bzw. zu widerlegen.

Could Homeopathy Become An Alternative Therapy In Dengue Fever? An example Of 10 Case Studies.

Background:Dengue fever is one of the most rampant epidemics in India of late and any therapy that may help limit the sickness and hospital admissions is worth considering. In India complementary and alternative medicine physicians are medically trained and hence have a role to play in delivery of public health. Case Series:We present a retrospective case series of 10 Indian patients who were diagnosed with dengue fever and treated exclusively with homeopathic remedies at Bangalore, India. This case series demonstrates with evidence of laboratory reports that even when the platelets dropped considerably there was good result without resorting to any other means. Conclusions:A need for further, larger studies is indicated by this evidence, to precisely define the role of homeopathy in treating dengue fever. This study also emphasises the importance of individualised treatment during an epidemic for favourable results with homeopathy. Abbreviations:DF: dengue fever, NS1: non-structural protein 1 antigen, IgG: immunoglobulin G, IgM: immunoglobulin M, +ve: positive, -ve: negative, WBC: white blood cells, RBC: red blood cells, ESR: erythrocyte sedimentation rate.

Effectiveness of Pooled Platelet Transfusion in Concordant and Discordant Groups among Dengue Patients.

INTRODUCTION: Dengue affects more than 50 million people per year and is one of the most common causes of severe thrombocytopaenia. Thrombocytopaenia is a common complication of dengue and other viral fevers apart from malaria, typhoid, leptospirosis, leukaemia and megaloblastic anaemia. A platelet count of <20,000/µl is characteristically seen in dengue haemorrhagic fever and dengue fever. It results from immune complex mediated platelet destruction or bone marrow suppression. Severe thrombocytopaenia <10,000/µl is one of the indications for prophylactic platelet transfusion therapy to prevent haemorrhage. AIM: To evaluate the effectiveness of transfusion of ABO compatible and ABO incompatible pooled platelet units in severe thrombocytopaenia cases. MATERIALS AND METHODS: In this study ABO compatible and incompatible pooled platelet units were transfused to serologically confirmed dengue cases having thrombocytopaenia with or without bleeding manifestations. Each of the adult patients received 4-6 units of pooled platelet concentrates prepared from random donor whole blood suspended in plasma for severe thrombocytopaenia. Pre and post transfusion platelet counts were compared. Children aged less than 12 years, pregnant women and patients with splenomegaly those on ayurvedic and homeopathic therapy, recipients of packed red cells on the same day of platelet transfusion and recipients of multiple platelet transfusions within 24 hours were excluded from the study. RESULTS: The median post transfusion platelet increments (PPI) and corrected count increments (CCI) at 4hour post transfusion were 25,000/µL (5,000-80,000/µL) and 18,000/µL (range 8,000/µL- 47,500/µL) respectively among the responders. Median PPI and CCI at 24 hours were 45,000/µL and 28,863/µL among the responders. The median CCI at 4 hour post transfusion among the non-responders was 850/µL and at 24hours was 1,425/µL. At 24 hours responders showed significantly higher PPI as compared to non responders. The average platelets transfused were 4units in case of responders and 8 units in case of non-responders. CONCLUSION: ABO identical and compatible pooled platelet transfusions were more successful in increasing the post transfusion platelet counts as compared to ABO incompatible pooled platelets.

Experiência de Macaé/RJ com homeopatia e dengue, 2007-2012 / Homeopathy and dengue: Macaé, Rio de Janeiro, Brazil, 2007-2012

No Brasil, a primeira epidemia documentada clínica e laboratorialmente foi em 1981-1982 e desde então vem ocorrendo no Brasil de maneira continuada, intercalando-se com a ocorrência de epidemias, geralmente associadas com a introdução de novos sorotipos. Em Macaé, RJ, ocorreram epidemias em 2002, 2007 e 2010. A Secretaria Municipal de Saúde de Macaé vem implementando mecanismos para o efetivo enfrentamento da dengue através de uma política de saúde baseada na intersetorialidade e a partir de 2007 se agregou ao plano de contingência a utilização de medicamento homeopático. No presente artigo são apresentados os resultados da aplicação profilática de medicamentos homeopáticos, assim como os critérios de escolha dos mesmos entre os anos 2007 e 2012. A utilização da homeopatia foi implantada facilmente, com um custo de financiamento condizente às condições socioeconômicas e culturais do país e contou com grande adesão da população...

The first documented dengue epidemic took place in Brazil in 1981-1982; from that time onwards dengue became endemic, with periodic epidemic outbreaks associated with the introduction of new serotypes. In Macaé, Rio de Janeiro, epidemic outbreaks occurred in 2002, 2007 and 2010. The Municipal Health Secretary consequently established an ongoing multi-sector policy for control of dengue, which began to include homeopathy starting 2007. The present article analyzes the results of prophylactic application of homeopathic medicines and the criteria to choose them from 2007 to 2012. Homeopathy was easily implemented, with low cost and was massively accepted by the local population...

Experiência de Macaé/RJ com homeopatia e dengue, 2007-2012 / Homeopathy and dengue: Macaé, Rio de Janeiro, Brazil, 2007-2012

No Brasil, a primeira epidemia documentada clínica e laboratorialmente foi em 1981-1982 e desde então vem ocorrendo no Brasil de maneira continuada, intercalando-se com a ocorrência de epidemias, geralmente associadas com a introdução de novos sorotipos. Em Macaé, RJ, ocorreram epidemias em 2002, 2007 e 2010. A Secretaria Municipal de Saúde de Macaé vem implementando mecanismos para o efetivo enfrentamento da dengue através de uma política de saúde baseada na intersetorialidade e a partir de 2007 se agregou ao plano de contingência a utilização de medicamento homeopático. No presente artigo são apresentados os resultados da aplicação profilática de medicamentos homeopáticos, assim como os critérios de escolha dos mesmos entre os anos 2007 e 2012. A utilização da homeopatia foi implantada facilmente, com um custo de financiamento condizente às condições socioeconômicas e culturais do país e contou com grande adesão da população. (AU)

The first documented dengue epidemic took place in Brazil in 1981-1982; from that time onwards dengue became endemic, with periodic epidemic outbreaks associated with the introduction of new serotypes. In Macaé, Rio de Janeiro, epidemic outbreaks occurred in 2002, 2007 and 2010. The Municipal Health Secretary consequently established an ongoing multi-sector policy for control of dengue, which began to include homeopathy starting 2007. The present article analyzes the results of prophylactic application of homeopathic medicines and the criteria to choose them from 2007 to 2012. Homeopathy was easily implemented, with low cost and was massively accepted by the local population. (AU)

Expresión de genes de IFN g y TNF a en tejidos de fallecidos por dengue / Expression of IFN g and TNF a genes in tissues from dengue fatal cases

INTRODUCCIÓN: el dengue es considerada la enfermedad viral transmitida por artrópodos de mayor importancia en el humano a nivel global, con un estimado de 100 millones de infecciones anuales y más de 20 000 muertes. La patogénesis de la enfermedad grave por dengue no está totalmente esclarecida. Sin embargo, existen estudios que la asocian con infecciones secuenciales por diferentes serotipos virales, activación de células T de memoria e hiperproducción de citocinas. OBJETIVOS: determinar la expresión cualitativa de genes de las citoquinas IFNγ y TNFα en tejidos de bazo e hígado de casos fatales por dengue 3 o dengue 4 mediante la detección de ARNm y comprobar su papel en la patogénesis de la enfermedad. MÉTODOS: El estudio se realizó a través de un método de retro-transcripción y reacción en cadena de la polimerasa (RT-PCR) con el uso de cebadores específicos. RESULTADOS: la expresión de IFNγ predominó a la de TNFα, y fue más evidente en los tejidos de bazo que del hígado. CONCLUSIONES: los resultados obtenidos apoyan el papel patogénico del patrón de respuesta Th1 en el dengue grave y constituye el primer estudio realizado de este tipo en la infección por dengue.

INTRODUCTION: dengue is considered to be the most important arthropod-borne human disease worldwide, with an estimated 100 million new cases per year and more than 20 000 deaths. The pathogenesis of severe dengue is not fully understood. However, certain studies have associated it with sequential infections by different viral serotypes, memory T cell activation and cytokine hyperproduction. OBJECTIVES: determine the qualitative expression of genes of cytokines IFNγ and TNFα in spleen and liver tissues from dengue 3 and 4 fatal cases, detecting RNAm and verifying their role in the pathogenesis of the disease. METHODS: the study was conducted by retrotranscription and polymerase chain reaction (RT-PCR) using specific primers. RESULTS: expression of IFNγ predominated over that of TNFα, and was more evident in spleen than in liver tissues. CONCLUSIONS: results support the pathogenic role of the Th1 response pattern in severe dengue. This is the first study of its type about dengue infection.

A homeopatia na prevenção e tratamento da dengue: uma revisão / Homeopathic medicines in the treatment and prevention of dengue: a review

A dengue é uma importante doença tropical, com um número estimado de 50 a 100 milhões de casos a cada ano. Atualmente, não se dispõe de tratamentos específicos nem de uma vacina para a prevenção da doença, mas os praticantes da medicina homeopática sugerem que formulações homeopáticas sejam úteis como medidas profiláticas e terapêuticas para a dengue. Trata-se de uma revisão da literatura que busca identificar e sumarizar os estudos que investigaram medicamentos homeopáticos para o tratamento e a prevenção da dengue. Realizou-se busca sistemática de publicações científicas nas seguintes bases de dados: PubMed, LILACS, Scopus, ISI Web of Science, The Cochrane Library, PsycInfo e SciELO, utilizando os termos "dengue" e "homeopatia" em inglês, português e espanhol. Foi identificado um único ensaio clínico aleatorizado controlado duplo-cego, além de dois ensaios de comunidade. Entretanto, tais estudos não evidenciaram a eficácia terapêutica ou profilática das formulações homeopáticas. Conclusões: Até o momento, pela falta de ensaios clínicos randomizados, duplo-cegos e controlados bem conduzidos e em número suficiente não há evidências claras da utilidade dos medicamentos homeopáticos para o tratamento e a prevenção da dengue. Assim, as medidas usuais e já bem conhecidas empregadas na prevenção primária da doença não devem ser substituídas por formulações homeopáticas.

Dengue is an important tropical disease with an estimated number of 50 to 100 million cases per year. Currently, there are no specific treatments or a vaccine available for the control of dengue disease, but homeopathic practitioners suggest that homeopathic formulations are useful to prevent and treat symptoms of dengue. To present a review of literature that seeks to identify and summarize all studies that had investigated the utility of the homeopathic medicines in the treatment and prevention of dengue. We conducted a systematic search of published scientific articles in the following databases: PubMed, LILACS, Scopus, ISI Web of Science, The Cochrane Library, PsycInfo and SciELO, employing English, Portuguese and Spanish language. The search terms used were "dengue" and "homeopathy". It was found only one randomized controlled double-blind clinical trial and two trials of community. However, these studies do not provided reliable evidences of therapeutic or prophylactic efficacy of homeopathic formulations. To date, due to the lack of randomized, double-blind controlled and well conducted studies in sufficient numbers, there are no clear evidences of the usefulness of homeopathic medicines for the treatment and prevention of dengue. Thus, the usual measures and well known employed in the primary prevention of disease should not be replaced by homeopathic formulations. .

Perspectiva del manejo homeopático de las enfermedades tropicales / Perspective of homeopathic management of tropical diseases

Se calcula que cerca de 2700 millones de personas en el mundo viven en condiciones de pobreza y más de 1000 millones de personas se encuentran afectadas por una o varias enfermedades tropicales desatendidas. Las poblaciones más vulnerables son aquellas que viven en condiciones socioeconómicas de pobreza, las comunidades indígenas y los afrodescendientes. La OMS ha encaminado estrategias de integración en salud, que abarquen la problemática global de estas comunidades y en un marco de inclusión resalta los aportes que las Medicinas Tradicionales y Complementarias pueden proporcionar en la atención primaria de las enfermedades. La homeopatía, ha contribuido a través de la historia al control y tratamiento de las enfermedades epidémicas e incursiona en la investigación científica dando a conocer su utilidad en los distintos ámbitos de manejo de las Enfermedades Tropicales. Objetivo: Identificar las perspectivas del uso de la homeopatía como sistema médico complejo en el manejo de las enfermedades tropicales. Metodología: abordaje de tipo descriptivo, se realizó la búsqueda de la literatura disponible en diferentes bases de datos indexadas usando términos MeSH y palabras clave de interés. Resultados: Se encontró un total de 734 artículos en las bases de datos seleccionadas, estos artículos fueron distribuidos así: 558 para Malaria, 46 para Enfermedad de Chagas, 61 para Leishmaniasis, 64 para Dengue y 8 para Chikungunya. Del total de artículos se seleccionaron 24 que cumplieron con el criterio de selección y fueron clasificados como sigue: 6 en Malaria, 8 en Enfermedad de Chagas, 3 en Leishmaniasis, 5 en Dengue y 2 en Chikungunya. Conclusiones: La homeopatía ha presentado avances en términos de investigación y plantea tratamientos encaminados al uso de medicamentos constitucionales, del Genio epidémico y Nosodes para el manejo de las Enfermedades Tropicales con fines preventivos y de forma coadyuvante con la Medicina Convencional

O uso de medicamentos em saúde coletiva: aspectos sobre a dengue e a gripe A / The use of medicines in public health: aspects of dengue and influenza A

O autor debate alguns aspectos sobre a epidemia de dengue e gripe A no Brasil, sobretudo a orientação terapêutica do Ministério da Saúde e o uso do Paracetamol, e faz propostas alternativas em função de trabalhos realizados na região de Rio Preto/SP.