Medicine prescription practices of homeopathic undergraduate students in West Bengal, India / 中西医结合学报

To our knowledge, prescription of homeopathic medicines by homeopathic undergraduate students has not been studied before though it may possess serious implications. We aimed to determine the practice and attitudes of prescription by homeopathic undergraduate students.

A survey exploring research perception of homeopathic undergraduate students in West Bengal, India

Background: Prioritizing undergraduate research is emphasized to develop critical analytical skills and thinking, independent writing, future clinical practice, enhanced employability, and improved research productivity. Despite far reaching consequences, research perception of homeopathic undergraduate students has barely been investigated to date. Poor participation of homeopathic undergraduates in research is reflected by a single MEDLINE indexed publication with adequate students’ contribution in the last decade. We aimed to assess their knowledge and attitude towards research and to identify barriers towards successful conduct of research. Methods: Institutional cross-sectional survey was carried out during August-September, 2013 in the four Government undergraduate homeopathic schools in West Bengal, India involving 902 participants. A semi-structured questionnaire was developed for the purpose depending on earlier studies on medical undergraduates. 364 completed responses were analyzed in the end. Results: Study sample mostly spanned 18-25 years of age group (94%), belonged to urban families (44.8%), with no gender differences (almost 1:1) and no physicians in family (73.1%). Maximum complete responses were obtained from 3rd year students (61.5%) and students of Calcutta Homeopathic Medical College and Hospital (51.2%). In spite of willingness to participate and keeping a positive attitude towards research, current involvement, training, knowledge and awareness remained quite unsatisfactory. Lack of infrastructure was identified as the chief barrier towards research. Conclusion: Undergraduates had a positive attitude towards homeopathic research, but need a realistic understanding of the research process. Opportunities for research skill development are underdeveloped.

Introdução: Estimular a pesquisa no nível de graduação é considerado um recurso importante para o desenvolvimento da capacidade de análise e pensamento críticos, redação independente, prática clínica futura, melhorar as possibilidades de inserção no mercado de trabalho e a produtividade em pesquisa. Apesar dessas consequências de amplo alcance, a percepção sobre pesquisa de estudantes de graduação em homeopatia tem sido raramente investigada. A escassa participação em pesquisas de estudantes de graduação em homeopatia é evidenciado pelo achado de um único trabalho indexado em MedLine com expressiva participação de estudantes nos últimos 10 anos. O nosso objetivo consistiu em avaliar o conhecimento e atitude em relação à pesquisa e identificar as barreiras que impedem o sucesso na realização de pesquisas. Métodos: Um estudo transversal foi realizado entre agosto e setembro de 2013 nas quatro faculdades públicas de homeopatia na Bengala Ocidental, Índia, com um total de 902 participantes. Um questionário semiestruturado foi desenvolvido especificamente para este estudo baseado nos resultados de estudos anteriores realizados com estudantes de medicina. Um total de 364 questionários completos foi incluído na análise. Resultados: A maioria dos participantes tinha entre 18 e 25 anos de idade (94%), residia em áreas urbanas (44.8%) e não incluía médicos na família (73,1%). A amostra apresentou homogeneidade em relação ao sexo (quase 1:1). O maior número de questionários completos correspondeu a estudantes do 3o ano (61,5%) e da Faculdade e Hospital Homeopático de Calcutá (51,2%) [...] Conclusão: Os estudantes manifestaram atitude positiva em relação à pesquisa em homeopatia, porém precisam adquirir uma compreensão mais realista do processo de pesquisa. As oportunidades para desenvolvimento de competências de pesquisa são muito escassas.

Qualitative systematic review of homeopathic outcome studies in patients with HIV/AIDS

Background and aims: Systematic reviews of high-quality randomized controlled trials (RCTs) are crucial in evidence-based medicine (EBM). The aim of the present review was to investigate whether there is enough evidence on the efficacy of homeopathy in individuals with HIV/AIDS based on clinical trials. Methods: The present is a criteria-based systematic review of cumulative research, and assessment of the methodological quality of published studies. The quality of the trials was evaluated using a list of validated and predefined criteria, and their outcomes were interpreted based on their quality. The main outcome measure was the methodological quality of the studies in terms of the threats to external, internal, construct, and statistical conclusion validity. Results: Among the 6 clinical outcome studies located, 3 were open-label, non-randomized, non-controlled trials, 2 were RCTs, and one was a single-set replication study. The trials were too few in number, and did not exhibit very high quality. The results showed a positive trend regardless of the quality of the trials, or the variety of homeopathic treatment used. The results of the present review may be complicated by publication bias. Conclusion: The currently available evidences do not suffice to infer definitive conclusions. Therefore, further evaluation of homeopathic treatment by means of appropriate RCTs with high methodological quality is required.

As revisões sistemáticas de estudos randomizados controlados (RCTs) são essenciais na medicina baseada em evidências (MBE). O objetivo deste estudo foi estabelecer se há evidência suficiente a favor da eficácia da homeopatia em pacientes com HIV/AIDS a partir de ensaios clínicos. Trata-se de uma revisão sistemática da pesquisa acumulada baseada em critérios, com avaliação daqualidade metodológica dos estudos publicados. A qualidade dos estudos foi avaliada medianteuma lista de critérios validados e predefinidos e os resultados foram interpretados a partir de suaqualidade. O desfecho principal analisado foi a qualidade metodológica dos estudos nos termos das ameaças a sua validade externa, interna, de construto e conclusão estatística.Dos 6 estudos clínicos informando resultados que foram localizados, 3 eram ensaios abertos, não randomizados e não controlados, 2 eram RCTs e um era um estudo de replicação com um único grupo. O número de ensaios clínicos localizados foi muito pequeno e de qualidade não muito alta. Os resultadosapontaram uma tendência positiva independentemente da qualidade dos ensaios e do tipo de tratamento homeopático utilizado. Os resultados desta revisão podem sofrer de viés depublicação. As evidências disponíveis atualmente são insuficientes para conclusões definitivas.Portanto, o tratamento homeopático ainda precisa de maior avaliação, através de RCTs adequados e de alta qualidade metodológica.

Las revisiones sistemáticas de estudios controlados aleatorizados(ECC) son esenciales en la medicina basada en evidencia (MBE). El objetivo de este estudio fue evaluar si hay evidenciasuficiente a favor de la eficacia de la homeopatía en pacientes con VIH/SIDA a partir de ensayosclínicos. Se trata de una revisión sistemática basada en criterios de la investigación acumulada,con evaluación de la calidad metodológica de los estudios publicados. La calidad de los estudiosfue evaluada mediante una lista de criterios validados y predefinidos ylos resultados fueron interpretados a partir de su calidad .El principal resultado medido fue la calidad metodológica de los estudios expresa como amenazas a su validez externa, interna, de constructo y conclusiónestadística. De los 6 estudios clínicos de resultados localizados, 3 eran ensayos abiertos, no aleatorizados y no controlados, 2 eran ECC y uno un estudio de replicación con un único grupo. El número de estudios clínicos localizados fue muy bajo y su calidad no muy alta. Los resultados indican una tendencia positiva independiente de la calidad de los estudios y el tipo de tratamiento homeopático efectuado. Los resultados de esta revisión pueden adolecer de sesgo de publicación. La evidencia actualmente disponible no permite inferir conclusiones definitivas. El tratamiento homeopático necesita mayor evaluación mediante ECC adecuados y de alta calidad metodológica.

Acute lower respiratory tract infection among under- fives in urban eastern India--an appraisal of risk factors.

200 under-fives children diagnosed as having ALRTI in pediatric OPD and indoor ward were sampled using standard case definition, and bodyweight was noted for each. All relevant factors of ALRTI were studied using pre-designed and pre-tested proforma. 90 (45%) were underweight and 143 (71.5%) had >5 episodes of ALRTI. Socio-economic status was inversely related to the percentage having >5 ALRTI episodes. 93.0% of children whose parents were up to primary education level suffered from >5 episodes of ALRTI as compared to 55.3% whose parents had higher literacy levels (Z=7.0, P<0.05). Odds ratio for absence of exclusive breastfeeding (14.1), absence of measles vaccination (6.1), attached kitchen (6.9) were very high.

A medico-social appraisal of commercial sex workers in a metropolitan city from eastern India.

This cross-sectional study of 146 commercial sex workers (CSWs) selected by stratified sampling, in a red light area of Kolkata, showed that 25.3% were teenagers and 37.0% were forced into the profession due to poverty. White discharge was present in 42.5% of the CSWs. Only 65.1% had the proper knowledge of the causes of disease, but 49.3% preferred to go to "quacks" for treatment, while 42.5% preferred traditional medicine. Knowledge of the prevention of sexually transmitted infections by condom use was correct in 44.2% of the CSWs, but 17.8% used condoms regularly. One fourth of the CSWs having 5 or more clients per day used condoms regularly.

Life events as risk factors for myocardial infarction: a pilot case-control study in Kolkata, India.

This case-control study was conducted in the Cardiology Department of Medical College, Kolkata, India, during 2000-2001, to explore the link between stressful life events and subsequent myocardial infarction (MI). One hundred consecutive confirmed MI patients were selected as a case group. One hundred age-, sex- and income-matched controls were selected from visitors other than relatives who attended these patients. The subjects were interviewed and asked to rate 61 life events with a number between 0 and 20. They also noted which of these they had experienced in the last one year. The main exposure variables included life events as per E.S. Paykel, smoking, alcohol consumption, chewing of tobacco, marital status, literacy, employment, and monthly per-capita income. The results showed that an MI patient was likely to experience 4.16 stressful life events, which were twice as much as the control group (2.24). The total stress score was the highest for serious personal illness followed by illness of family members and unemployment for the MI patients. For the controls, conflict between husband and wife, death of friends, and personal illness had the highest total stress score. The mean stress score for the MI patients was 35.5 compared to 17.35 among the controls. The MI subjects were more likely to have experienced stressful life events than the controls.