Individualized Homeopathic Medicines in the Management of Symptomatic Adenotonsillar Hypertrophy in Children: A Prospective Observational Study.

BACKGROUND: Globally, adenotonsillar hypertrophy (ATH) is one of the most prevalent upper respiratory tract disorders of children, with associated troublesome symptoms such as sleep apnea and cognitive disturbances. In this study, we evaluated the potential role of individualized homeopathic medicines in the management of symptomatic ATH in children. METHODS: A multicenter prospective observational study was conducted at five institutes under the Central Council for Research in Homoeopathy, India. Primary and secondary outcomes (symptom score for adenoids, other symptoms of ATH, Mallampati score, tonsillar size, Sleep-Related Breathing Disorder of the Paediatric Sleep Questionnaire [SRBD-PSQ]) were assessed through standardized questionnaires at baseline and at 3, 6, 9 and 12 months. Radiological investigations for assessing the adenoid/nasopharyngeal (A/N) ratio were carried out at baseline, 6 and 12 months. All analyses were carried out using an intention-to-treat approach. RESULTS: A total of 340 children were screened and 202 children suffering from ATH were enrolled and followed up monthly for 12 months. Each patient received individualized homeopathic treatment based on the totality of symptoms. Statistically significant reductions in adenoid symptom score, Mallampati score (including tonsillar size), SRBD-PSQ sleep quality assessment and A/N ratio were found over time up to 12 months (p < 0.001). Homeopathic medicines frequently indicated were Calcarea carbonicum, Phosphorus, Silicea, Sulphur, Calcarea phosphoricum, Pulsatilla, Lycopodium and Tuberculinum. No serious adverse events were recorded during the study period. CONCLUSION: This study suggests that homeopathic medicines may play a beneficial role in the management of symptomatic ATH in children. Well-designed comparative trials are warranted.

Enduring Efficacy and Clinical Outcomes of Combined Palliative Chemotherapy With Gefitinib, Methotrexate, and Cyclophosphamide in Advanced Oral Cancer: A 3.5-Year Case Study of Carcinoma in the Buccal Mucosa and Hard Palate.

This case report outlines the diagnostic and treatment experience of a 50-year-old male diagnosed with moderately differentiated squamous cell carcinoma (SCC) in the right lower alveolus. It underscores the challenges of oral squamous cell carcinoma (OSCC) diagnosis and management, emphasizing the need for comprehensive multidisciplinary approaches. The patient's initial presentation with persistent mandibular pain highlighted the complexities of diagnosing oral and maxillofacial pathologies. A detailed clinical examination revealed unique ulceroproliferative growth, showcasing the importance of meticulous clinical assessment. Histopathological confirmation solidified the diagnosis. Treatment involved surgery, adjuvant radiotherapy, and concurrent chemotherapy. Post-chemotherapy, the patient responded positively, underlining treatment efficacy. Transitioning to oral chemotherapy demonstrated adaptability. Vigilant follow-up, exemplified by detecting non-healing ulcers and erosions, is crucial for early intervention. This case informs oral squamous cell carcinoma management. Integrated therapy's success underscores the value of combining surgery, chemotherapy, and radiotherapy. The patient's response to gefitinib, cyclophosphamide, and methotrexate suggests promise for targeted therapies. Patient-centered care, interdisciplinary collaboration, and adaptability are vital. This case report illustrates oral squamous cell carcinoma eradication through multidimensional treatment. The patient's journey highlights accurate diagnosis, adaptable therapy, and vigilant follow-up. It informs the field and fosters further research and innovation.

Low-Dose Abiraterone in Metastatic Prostate Cancer: Is It Practice Changing? Facts and Facets.

PURPOSE: It is projected that approximately 50,000 new cases of prostate cancer will be diagnosed in 2020 in India. Survival has improved because of the development of effective drugs such as abiraterone acetate, but universal accessibility to treatment is not always possible because of cost constraints in lower- and middle-income countries. Recently, the National Comprehensive Cancer Network (NCCN) has included low-dose abiraterone (250 mg/day) with food as an alternative treatment option to full-dose abiraterone (1,000 mg/day) fasting. METHODS: The Science and Cost Cancer Consortium conducted a survey to evaluate the use of abiraterone in India and the opinions of medical oncologists about using low-dose treatment. Modeling was used to estimate potential financial benefits to individual patients and to estimate overall costs of health care in India if low-dose abiraterone is prescribed. RESULTS: Of 251 Indian medical oncologists who were invited to participate in the survey, 125 provided their e-mail address and received the survey; 118 responded (47% of the total). Of these, 25% were not aware of the recent NCCN recommendation, 55% were already prescribing low-dose abiraterone when resources were limited, 7% had already changed their practice, and 29% agreed to switch to a universal practice of using low-dose abiraterone with food; 9% of practitioners would not use low-dose abiraterone. Estimated mean per patient savings was US$3,640, with annual savings of US$182 million in India. CONCLUSION: Use of lower-dose abiraterone would increase access to treatment in India and globally and lead to large cost savings.

Efectos del tratamiento homeopático individualizado en la hipertensión esencial de estadio I: ensayo aleatorizado, simple ciego, controlado con placebo / Effects of Homeopathic Treatment Individualized in Hypertension Stage I Essential: Randomized Trial, Single Blind, Placebo controlled

Fundamentos: la hipertensión arterial es el cuarto principal factor de riesgo de muerte e incapacidad, así como el responsable de más de 1.6 millones de fallecimientos en la India. Los informes de casos clínicos, los estudios observacionales y los ECA evidencian los efectos de los medicamentos homeopáticos en la hipertensión. Objetivos: los resultados de este estudio se añaden a la evidencia de la eficacia del uso de los medicamentos homeopáticos individualizados en la hipertensión de estadio I. Materiales y métodos: Se ha realizado un ensayo aleatorizado, simple ciego y controlado por placebo entre octubre de 2013 y marzo de 2018. El parámetro primario fue evaluar los cambios en la presión sistólica (PS) y la presión diastólica (PD) mensualmente durante tres meses. 217 pacientes de los 2,127 pacientes examinados cumplieron los criterios de selección y fueron aleatorizados para recibir un medicamento en potencias Q (o potencias LM) más indicaciones para la modificación del estilo de vida (MEV) (116 pacientes) o bien placebo + MEV (101 pacientes). La modificación del estilo de vida incluyó actividad física y dieta como parte de la pauta terapéutica. El análisis fue de intención de tratamiento. Resultados: Las mediciones ANOVA repetidas entre los grupos mostraron una diferencia estadística significativa (Lambda de Wilks 0.85, F=12.12, dF=213, P=0.0001) tanto en la PS como en la PD a favor de la Homeopatía individualizada. La prueba t independiente post hoc mostró una reducción media significativa de la PS [diferencia media 7.12 mmHg, IC del 95%; CI 4.72 a 9.53, P=0.0001] y un descenso medio de la PD [diferencia media 5.76 mmHg, IC del 95%: 4.18 a 7.23, P=0.0001] a favor del grupo con Homeopatía más MEV. Los medicamentos más utilizados fueron: Sulphur (n=24), Natrium muriaticum (n=21), Lycopodium (n=16), Nux vomica (n=12) y Phosphorus (n=10). Conclusiones: Se ha constatado que la Homeopatía individualizada junto con la MEV fue más eficaz que el placebo junto con la MEV en los pacientes que sufren hipertensión en estadio I. Se precisan más ensayos en un marco estricto. (AU)

Background: Hypertension (HTN) is a leading risk factor for death and disability and responsible for over 1.6 million deaths in India. Clinical case reports, observational studies and randomised controlled trials show the effects of homoeopathic medicine in HTN. Objectives: The results of this study will add to the evidence of effectiveness of individualised homoeopathic medicine in Stage I HTN. Methods: A single-blind, randomised, placebocontrolled trial was undertaken from October 2013 to March 2018. The primary outcome measure was to evaluate the change in systolic blood pressure (SBP) and diastolic blood pressure (DBP) every month for 3 months. Of 2,127 patients screened, 217 patients who fitted the inclusion criteria were randomised to receive either homoeopathic Q potencies (or LM potencies) plus lifestyle modification (LSM)=116 or placebo + LSM=101. LSM included physical activity and diet as part of the treatment regimen. Analysis was by intention to treat. Results: Repeated-measure ANOVA between the groups showed statistically significant difference (Wilk lambda 0.85, F=12.12, df=213, P=0.0001), in both SBP and DBP favouring Individualised Homoeopathy (IH) along with LSM. Post hoc independent t-test showed a significant mean reduction in SBP (mean difference 7.12 mmHg, 95% confidence interval [CI] 4.72-9.53, P=0.0001) and DBP (mean difference 5.76 mmHg, 95% CI: 4.18-7.23, P=0.0001) favouring Homoeopathy plus LSM group. Sulphur (n=24), Natrum muriaticum (n=21), Lycopodium (n=16), Nux vomica (n=12) and Phosphorus (n=10) were the most useful medicines. Conclusion: IH in LM potency along with LSM was found effective over placebo along with LSM in the patients suffering from Stage I HTN. Further trials in rigorous setting are warranted. (AU)