Safety perception and determinants of complementary and alternative medicine usage among surgery out-patients in LAUTECH Teaching hospital, ogbomoso, Nigeria.

Objectives: The use of complementary and alternative medicine (CAM) stemmed from the search of humans for other means of relieving pain and managing diseases which has plagued its existence. CAM use is on the increase among the general population in both the developed and developing nations and also among surgical patients. There is therefore a need to ascertain the perceived adverse effects, the safety perception and the determinants of its use so as to improve the advocacy for adequate regulation. Methods: It was a cross-sectional study carried out among surgical outpatients in a tertiary hospital. One hundred and fifty patients between the ages of 18 and 85 years were recruited. An interviewer-administered questionnaire was used to collect data from each participant. Data was analyzed using SPSS version 22. Results: The lifetime prevalence of CAM use among the respondents was 76 % while the point/current prevalence was 37.3 %. The percentage of current users using CAM for surgical complaints was 30.4 %. Biological based therapy accounted for 110 (72 %) of CAM used and unbranded herbal products was responsible for more than two-third of it. Almost a third of the patients (46, 30.7 %) perceived that CAM is safe while 62 (41.3 %) were not sure of its safety. Only 15 (13.2 %) and 6 (5.3 %) have ever recorded side effects and drug interactions respectively. Older age group, income less than 10,000 Naira, positive safety perception and belief about CAM were identified as determinants of CAM usage. Conclusions: The prevalence of CAM usage among surgical outpatients was quite high and the major determinants of its use are the patient's age, safety perception and their level of income.

Exploring Possible Mechanisms of Hormesis and Homeopathy in the Light of Nanopharmacology and Ultra-High Dilutions.

Serially diluted succussed solutions of a suitable drug/toxic substance can exhibit physicochemical and biological properties even far beyond Avogadro's limit defying conventional wisdom. They can show hormesis, and homeopathy uses them as medicines. Many studies confirm that they can have an impact on gene expression different than controls. Water in the exclusion zone phase can have memory but for a short period. However, the nanoparticle as the physical substrate can hold information. Nanoparticle and exclusion zone duo as nanoparticle-exclusion zone shell can provide a prolonged memory. The Nanoparticle-Exclusion Zone Shell Model may be an important step toward explaining the nature and bioactivity of serially diluted succussed solutions used as homeopathic medicines. This model may also provide insight into the workings of hormesis. Hormesis is the primary phenomenon through which homeopathic phenomenon may have evolved exhibiting the principle of similars. Hahnemann exploited it to establish homeopathy. The nanoparticle-exclusion zone shells present in the remedy, selected on the principle of similars, can be patient-specific nanoparticles in a symptom syndrome-specific manner. They can carry the drug-specific information for safer clinical applications in an amplified form for high yielding. It suggests homeopathy is a type of nanopharmacology.

Vertigoheel induced psychosis: A patient case report.

OBJECTIVE: To describe a case of a patient who developed psychosis after ingestion of Vertigoheel for treatment of dizziness. CASE SUMMARY: A 28-year-old male with no psychiatric history presented with 5 days of worsening depression and psychosis. He denied current use of prescription medications, alcohol, or illicit substances. Approximately 2 weeks prior, while visiting family in Germany, he developed dizziness. A provider in Germany prescribed Vertigoheel, 1 tablet to be taken every hour until symptom improvement. This did not improve his dizziness but did cause him to feel as if he were "in a dream." He stopped taking the medication after 2 days but continued to feel amotivated with decreased appetite and insomnia. Several days later, he developed ego-dystonic auditory hallucinations. He returned to the United States; was admitted to an inpatient psychiatric unit for 4 days; and given olanzapine 5 mg at bedtime, lorazepam 1 mg every evening, and melatonin 6 mg every evening. He experienced gradual improvement in symptoms and was discharged with olanzapine 5 mg daily and outpatient follow-up. DISCUSSION: Vertigoheel is a homeopathic preparation containing ambra grisea, Cocculus indicus, Conium maculatum, and petroleum. Psychosis was not reported in any of the randomized controlled trials evaluating the use of Vertigoheel for treatment of vertigo. A literature search revealed no published reports of psychosis as a result of administration of any components of Vertigoheel. CONCLUSION: A possible causal relationship was observed between the homeopathic supplement Vertigoheel and an acute episode of psychosis in a young male patient with no comorbidities.

Safety assessment of homeopathic medicines: The Adonis vernalis paradox and the 'analysis trap' of using different pharmacopeias.

Regulatory agencies have to ensure the end-user safety of botanically derived homeopathic medicines prepared with diluted starting materials derived even from toxic plants. In the case of plant-derived homeopathic products, assessment must consider the particular characteristics of an extract and its component molecules, even if diluted. The identification and quantification of these molecules have a crucial role in risk assessment, as it allows complete toxicological evaluation in a regulatory perspective. Different results can be achieved using different approaches and references supported by the same regulatory framework, as different methods of preparation used, assays and test analysis performed in compliance with different referent pharmacopoeias. All these facts can introduce a bias in the safety assessment and the paradoxical outcome for homeopathic Adonis vernalis underlines the need for caution. The case also demonstrates the relevance of considering the analytical method for assessment of all herbal medicinal products or herbal supplements, with the purpose of finding the total amount of toxicants as a good approach.

Serotonin syndrome in a Parkinson disease patient after intake of an ethanol-containing homeopathic medication.

Serotonin syndrome is due to excess serotonin in the nervous system. We document a case of an elderly Parkinson disease patient who has been neurologically stable on rasagiline and escitalopram for 1 year but developed serotonin syndrome after intake of an ethanol-containing homeopathic medication. The patient presented with seizures, autonomic dysfunction and neuromuscular hyperexcitability. Maintenance medications were discontinued, hydration, sedation and respiratory support were provided with resolution of the symptoms. The combination of escitalopram and ethanol, both metabolized by the cytochrome P450 enzyme system can lead to serotonin syndrome. Our case highlights the importance of drug interactions in patients taking several medications. Additionally, the intake of medicines, may it be conventional or homeopathic medicine, without the guidance of a trained and competent physician, may lead to serious consequences for the patient.

Case series of an alternative therapy for generalised lichen planus: Four case studies.

Lichen planus (LP) is an idiopathic, cell-mediated immune disorder, accompanied by itching. Spontaneous remission occurs. Topical and systemic therapies are utilised. Four cases of generalized LP with and without mucosal involvement treated homeopathically are presented. Case 1: A 48-year-old female presented with a 7-month history of generalized itchy rash, which had been diagnosed as LP, treated unsuccessfully with topical steroids and removal of dental fillings. Examination revealed violaceous papules on upper and lower limbs, oral mucosal lesions and an irregular, erythematous, blanching, macular rash on the chest. She received homeopathic Ignatia amara at medication dilution factor (MK) potency, weekly dose and went into remission at 3 months. Patient remains in remission. Case 2: A 65-year-old female presented with a 27-year history of generalized, LP, which had been unresponsive to topical steroids. Examination showed generalized, violaceous papules, with no mucosal involvement. She received homeopathic Aurum metallicum, MK potency, weekly, and went into remission. She relapsed at 8 months after onset of therapy, following a very stressful incident, but gained remission again with Aurum metallicum after 1 month of therapy. She remains in remission. Case 3: A 38-year-old male presented with a 21-year history of generalized LP. Medical history was significant for hepatitis B and asthma. Topical steroid therapy was only partially successful. Examination revealed generalized, violaceous papules, with oral and genital involvement. He received homeopathic Lycopodium at MK potency, weekly, and remitted by 2 months. He remains in remission. Case 4: A 41-year-old male presented with a 12-year history of generalized hypertrophic LP, which had responded partially to topical steroids and ultraviolet A therapy. Medical history was significant for reduced sense of smell. Examination revealed generalized, violaceous, hypertrophic papules and nodules. He received homeopathic Carcinosinum at MK potency and remitted at 6-months. In its long-standing, generalized form, with mucosal involvement, LP may respond to individualized homeopathy. More research may clarify homeopathy's place in LP therapy.

Case Reports of Acne and Homeopathy.

BACKGROUND: Acne vulgaris is a self-limiting disorder of the pilosebaceous unit. The aesthetic aspect of the disorder may provoke depression and diminish the quality of life. A number of agents are used for acne treatment, e.g., retinoids, antibiotics, benzoic acid, azelaic acid, and hormones. These agents have side-effects, sometimes severe ones. CASE REPORTS: Presented are 2 cases of severe acne treated with individualized homeopathic medicines. Both patients were treated using the classical method of homeopathy, i.e., a single medicine based on the patient's individual characteristics was prescribed. The cases were documented photographically at onset and during the course of treatment. Both patients went into remission following treatment, and long-term follow-up suggested that the therapy remained efficacious long after cessation of treatment. No significant side effects were noted. CONCLUSIONS: Homeopathic medicines may be useful as stand-alone treatment of patients with severe acne vulgaris. A case series suggested a remission rate of more than 80% using individualized homeopathic treatment. The treatment remained efficacious long after cessation and is not accompanied by significant side-effects. It is to be hoped that this presentation will stimulate research interest into homeopathic medicines as stand-alone or adjunct treatments of acne.

Experimental neuropharmacology of Gelsemium sempervirens: Recent advances and debated issues.

Gelsemium sempervirens L. (Gelsemium) is traditionally used for its anxiolytic-like properties and its action mechanism in laboratory models are under scrutiny. Evidence from rodent models was reported suggesting the existence of a high sensitivity of central nervous system to anxiolytic power of Gelsemium extracts and Homeopathic dilutions. In vitro investigation of extremely low doses of this plant extract showed a modulation of gene expression of human neurocytes. These studies were criticized in a few commentaries, generated a debate in literature and were followed by further experimental studies from various laboratories. Toxic doses of Gelsemium cause neurological signs characterized by marked weakness and convulsions, while ultra-low doses or high Homeopathic dilutions counteract seizures induced by lithium and pilocarpine, decrease anxiety after stress and increases the anti-stress allopregnanolone hormone, through glycine receptors. Low (non-Homeopathic) doses of this plant or its alkaloids decrease neuropathic pain and c-Fos expression in mice brain and oxidative stress. Due to the complexity of the matter, several aspects deserve interpretation and the main controversial topics, with a focus on the issues of high dilution pharmacology, are discussed and clarified.

Implicaciones del positivismo como corriente filosófica en la percepción general y actual de la homeopatía / Implications of positivism as a philosophical current in the general and current perception of homeopathy

El positivismo es una corriente de pensamiento que influyó fuertemente a las sociedades occidentales durante la segunda mitad del siglo XIX y las primeras décadas del siglo XX; de acuerdo con ella, la ciencia debe dedicarse a encontrar las leyes invariables que rigen a los fenómenos naturales y sociales, ya que esto servirá como base teórica para que el ser humano domine y actúe sobre las cosas y los hechos medibles, repetibles y comprobables.Algunas ideas del positivismo, como la supuetsa inflexibilidad de la ciencia o la pretensión de reducir al conocimiento a ser una mera técnica o instrumento del progreso, siguen vigentes en nuestros días, sobre todo en ámbitos universitarios, en la cultura general y en los medios de comunicación. En este artpiculo se aborda la forma en que los postulados de la citada escuela filosófica han distorsinado la percepción que se tiene de la homeopatía, tanto en la sociedad como en los círculos científicos,s in tomar en cuenta que el método médico clínico terapéutico que configuró Samuel Hahnemann cumple con los requisitos que la verdadera ciencia exige, además de que posee un sustento doctrinario que guía sus pasos en la investigación y en la clínica.(AU)

Positivism is a school of tought that strongly influenced western societies during the scond half of the niniteenth century and the first decades of the twentieth century: according to it, science should be devoted to finding the invariable laws governing natural and social phenomena, as this will serve as a theoretical basis so that man can dominate and act on things and facts that can be measurable, repeatable and verifiable.Some ideas of positivism, as the alleged inflexibility of science or the pretension to reduce scientific knowledge to be a mere technique or instrument of progress, are still valid today, especially in university environments, in the general culture and in media communication. This article adresses the way that the postulates of the cited philosophical school have distorted the perception people have of homeopathy, both in society and in scientific circles, regardlessof the therapeutic clinical medical method that Samuel Hahnemann established meeting the requirements that true science requieres, besides having a doctrinaire support that guides their steps in research in the clinic.(AU)

Embryonic Zebrafish Model - A Well-Established Method for Rapidly Assessing the Toxicity of Homeopathic Drugs: - Toxicity Evaluation of Homeopathic Drugs Using Zebrafish Embryo Model.

OBJECTIVES: Advancements in nanotechnology have led to nanoparticle (NP) use in various fields of medicine. Although the potential of NPs is promising, the lack of documented evidence on the toxicological effects of NPs is concerning. A few studies have documented that homeopathy uses NPs. Unfortunately, very few sound scientific studies have explored the toxic effects of homeopathic drugs. Citing this lack of high-quality scientific evidence, regulatory agencies have been reluctant to endorse homeopathic treatment as an alternative or adjunct treatment. This study aimed to enhance our insight into the impact of commercially-available homeopathic drugs, to study the presence of NPs in those drugs and any deleterious effects they might have, and to determine the distribution pattern of NPs in zebrafish embryos (Danio rerio). METHODS: Homeopathic dilutions were studied using high-resolution transmission electron microscopy with selected area electron diffraction (SAED). For the toxicity assessment on Zebrafish, embryos were exposed to a test solution from 4 - 6 hours post-fertilization, and embryos/larvae were assessed up to 5 days post-fertilization (dpf) for viability and morphology. Toxicity was recorded in terms of mortality, hatching delay, phenotypic defects and metal accumulation. Around 5 dpf was found to be the optimum developmental stage for evaluation. RESULTS: The present study aimed to conclusively prove the presence of NPs in all high dilutions of homeopathic drugs. Embryonic zebrafish were exposed to three homeopathic drugs with two potencies (30CH, 200CH) during early embryogenesis. The resulting morphological and cellular responses were observed. Exposure to these potencies produced no visibly significant malformations, pericardial edema, and mortality and no necrotic and apoptotic cellular death. CONCLUSION: Our findings clearly demonstrate that no toxic effects were observed for these three homeopathic drugs at the potencies and exposure times used in this study. The embryonic zebrafish model is recommended as a well-established method for rapidly assessing the toxicity of homeopathic drugs.

Dra. Josefina Sánchez Reséndiz de Montaño. Personaje invaluable de la homeopatía mexicana / Dra. Josefina Sánchez Reséndiz de Montaño. Mexican invaluable character of homeopathy

La doctora Josefina Sánchez Reséndiz, figura sobresaliente de la medicina homeopática del siglo XX y XXI, se convirtió en el paradigma de cientos de alumnos que se forjaron en las aulas de diversas instituciones académicas de México. La entrevista que presentamos, publicada originalmente en el libro La Profesión del Médico Homeópata. Un acercamiento al pensamiento contemporáneo, editado por el Centro Homeopático Nacional en el año 2003, aborda detalladamente muchas de las problemáticas que fueron planteadas originalmente hace algunas décadas y que hoy, en el momento de la muerte de esta gran investigadora, recobran su vigencia y actualidad. (AU)

Josefina Sánchez Reséndiz MD, was an outstanding figure of homeopathic medicine of the twentieth and twenty-first century, she became the paradigm of hundreds of students that studied in the classrooms of various academic institutions in Mexico.We present an interview originally published in the book: La Profesión del Médico Homeópata. Un acercamiento al pensamiento contemporáneo, published by the Centro Homeopático Nacional in 2003, which details many problems that began decades ago. Nowadays, after this great researcher passed away, these issues regain significance. (AU)

Dra. Josefina Sánchez Reséndiz de Montaño. Personaje invaluable de la homeopatía mexicana / Dra. Josefina Sánchez Reséndiz de Montaño. Mexican invaluable character of homeopathy

La doctora Josefina Sánchez Reséndiz, figura sobresaliente de la medicina homeopática del siglo XX y XXI, se convirtió en el paradigma de cientos de alumnos que se forjaron en las aulas de diversas instituciones académicas de México. La entrevista que presentamos, publicada originalmente en el libro La Profesión del Médico Homeópata. Un acercamiento al pensamiento contemporáneo, editado por el Centro Homeopático Nacional en el año 2003, aborda detalladamente muchas de las problemáticas que fueron planteadas originalmente hace algunas décadas y que hoy, en el momento de la muerte de esta gran investigadora, recobran su vigencia y actualidad...

Josefina Sánchez Reséndiz MD, was an outstanding figure of homeopathic medicine of the twentieth and twenty-first century, she became the paradigm of hundreds of students that studied in the classrooms of various academic institutions in Mexico.We present an interview originally published in the book: La Profesión del Médico Homeópata. Un acercamiento al pensamiento contemporáneo, published by the Centro Homeopático Nacional in 2003, which details many problems that began decades ago. Nowadays, after this great researcher passed away, these issues regain significance...

Experimental evidence of stable water nanostructures in extremely dilute solutions, at standard pressure and temperature.

This paper presents the results of several experimental methods (FT-IR spectroscopy, UV-vis spectroscopy, fluorescence microscopy (FM), Atomic Force Microscopy (AFM)) evidencing structural changes induced in extremely diluted solutions (EDS), which are prepared by an iterated process of centesimal (1:100) dilution and succussion (shaking). The iteration is repeated until an extremely high dilution is reached, so that the composition of the solution becomes identical to that of the solvent--in this case water--used to prepare it. The experimental observations reveal the presence of supramolecular aggregates hundreds of nanometres in size in EDS at ambient pressure and temperature, and in the solid state. These findings confirm the hypothesis--developed thanks to previous physico-chemical investigations--that formation of water aggregates occurs in EDS. The experimental data can be analyzed and interpreted with reference to the thermodynamics of far-from-equilibrium systems and irreversible processes.

Estabilidade microbiológica de medicamentos homeopáticos veiculados em água purificada / Microbiological stability of homeopathic medicines using purified water as vehicle

Background: Homeopathic medicines are prepared in homeopathic pharmacies. This leads to freedom of prescription but requires more knowledge of the clinicians to achieve the best results. Preparations made of purified water receive a validity of 24 hours, but there are prescriptions for up to 30 days. This contradiction raises tensions among physicians, pharmacists and patients. Aims: to evaluate the increase in microbiological contamination in homeopathic medicines using purified water as vehicle compared with the microbiological stability of purified water. Contribute to the quality of homeopathic medicine and treatment. Methodology: daily microbiological analysis for one week to assess the growth of heterotrophic bacteria, Pseudomonas, yeasts and molds. The reference used was the USP 32/NF 27 and the Brazilian Pharmacopoeia 5th edition. Results: there was a higher growth of microorganisms on the medicine, compared with purified water. From the 2nd day on, this growth has been beyond the legal limits. Discussion: medicines for oral use are not sterile preparations, but they must remain stable during its shelf life. Our results indicate that contamination occurs from the earliest days of use. This shows the need to change the prescription in relation of the vehicle, to ensure hygiene and avoid potential contamination of the patient. It is necessary to prevent conflict of information between pharmacists and patients, and the contradiction of the doctor's advice, besides the potential risk of responsibility to be attributed to the pharmacy. It is necessary to promote a discussion between pharmacists and clinicians, to spread this information for those that prescribe. Conclusion: there was an increased of microbiological contamination of the medicines dispensed in purified water, which harms the quality of homeopathic medicine and homeopathic treatment.(AU)

Introdução: Medicamentos homeopáticos são manipulados em farmácias com manipulação homeopática. Isto leva a liberdade de prescrição, porém exige mais conhecimento por parte dos clínicos, para atingir os melhores resultados. Preparações em água purificada recebem validade de 24 horas, mas existem prescrições para tomar o medicamento durante 30 dias. Esta contradição gera tensões entre médicos, farmacêuticos e pacientes. Objetivos: avaliar o aumento da carga microbiana em medicamentos homeopáticos veiculados em água purificada, em comparação com a estabilidade microbiológica da água purificada. Contribuir com a qualidade do medicamento e do tratamento homeopático. Metodologia: análises microbiológicas diárias durante uma semana para avaliação do incremento de bactérias heterotróficas, Pseudomonas, bolores e leveduras. A referência utilizada foi a USP 32/NF 27 e a Farmacopeia Brasileira 5ª edição. Resultados: houve um maior crescimento de microorganismos no medicamento, quando comparado com a água purificada. Este crescimento foi além dos limites permitidos na legislação a partir do 2º dia. Discussão: os medicamentos para uso oral não são estéreis, porém devem manter-se estáveis durante seu prazo de validade. Nossos resultados indicam que a contaminação ocorre desde os primeiros dias de uso. Isto mostra a necessidade de alterar a prescrição médica em relação ao veículo, para garantir a higiene e evitar a potencial contaminação do paciente. É necessário prevenir o conflito de informações entre farmacêuticos e pacientes, e a contradição da indicação do médico, além de potencial risco da responsabilidade de medicamento contaminado recair sobre a farmácia. É necessário promover uma discussão entre farmacêuticos e clínicos, para que estas informações sejam divulgadas para a classe prescritora. Conclusões: houve aumento da carga microbiana dos medicamentos dispensados em(AU)