An Open-Label Observational Trial to Evaluate the Possible Effects of Individualized Homoeopathic Medicines in Symptomatic Nasal Polyp

Main Article Content

Aniruddha Banerjee
Birendra Prasad Srivastava
Munmun Koley
Subhranil Saha

Abstract

Introduction: Nasal polyps presenting with chronic rhino-sinusitis (CRS) is a commonly encountered condition characterized by nasal obstruction, loss of sense of smell (anosmia), postnasal drip, headache, and sleep disorders. Possibly 60-65% of the populations suffering from CRS has predisposition to nasal polyps. Homoeopathic literature claims to offer successful treatment of nasal polyps; but scarcely subjected to systematic research.


Materials and Methods: A prospective, open, non-randomized, single arm, observational trial of pre-post comparison design was conducted on 44 patients suffering from symptomatic nasal polyps. Sino-nasal outcome test (SNOT-20) and European Quality of Life (EQ-5D-5L) questionnaires were taken as the primary and secondary outcome measures respectively; assessed at baseline and after 3 months. Individualized homoeopathic medicines were prescribed on ‘totality of symptoms’. Intention to treat sample was subjected to statistical analysis. Data distribution was examined. Non-parametric Wilcoxon signed rank test and post hoc parametric paired t test were used accordingly. P values less than 0.05 were considered as statistically significant.


Results: Forty four patients were enrolled; 4 dropped out. Skiagrams revealed complete regressions of polyps in 23 (58%) cases. Statistically significant improvements were observed in both the subjective patient-rated outcomes – mean reduction of SNOT-20 scores by 19.9 [sd 15.5; 95% CI 15.5 to 24.2; P < 0.001], EQ-5D-5L questionnaire score by 0.9 [sd 2.6; 95% CI 0.1 to 1.7; P = 0.029]; and EQ-5D-5L VAS by 14.4 [sd 4.7; 95% CI 12.9 to 15.9; P < 0.001].


Conclusion: Homoeopathic medicines showed promising treatment effect in symptomatic nasal polyps. Randomized trials are warranted.

Article Details

How to Cite
1.
Banerjee A, Srivastava BP, Koley M, Saha S. An Open-Label Observational Trial to Evaluate the Possible Effects of Individualized Homoeopathic Medicines in Symptomatic Nasal Polyp. BJOHNS [Internet]. 2019Apr.30 [cited 2024May18];27(1):51-9. Available from: https://www.bjohns.in/journal3/index.php/bjohns/article/view/225
Section
Main article
Author Biographies

Aniruddha Banerjee, Bengal Homoeopathic Medical College & Hospital, Asansol 713301, West Bengal

Lecturer, Dept. Of Community Medicine

Birendra Prasad Srivastava, National Institute of Homoeopathy, Block GE, Sector III, Salt Lake, Kolkata 700106, West Bengal

Professor, Dept. of Repertory

Munmun Koley, Central Council of Homoeopathy; Village Champsara, PO Baidyabati, Hooghly 712222, West Bengal

Independent Researcher

Subhranil Saha, Central Council of Homoeopathy; 93/2/1, Shibpur Road, PO and PS Shibpur, Howrah 711102, West Bengal

Independent Researcher

References

Murphy MP, Fishman P, Short SO, Sullivan SD, Yueh B, Weymuller EA Jr. Health care utilization and cost among adults with chronic rhinosinusitis enrolled in a health maintenance organization. Otolaryngol Head Neck Surg. 2002; 127:367-76

Anand VK: Epidemiology and economic impact of rhinosinusitis. Ann Otol Rhinol Laryngol Suppl. 2004; 193:3-5

Jackson LL, Kountakis SE. Classification and management of rhinosinusitis and its complications. Otolaryngol Clin North Am. 2005; 38:1143-53

Smith TL, Batra PS, Seiden AM, Hannley M. Evidence supporting endoscopic sinus surgery in the management of adult chronic rhinosinusitis: a systematic review. Am J Rhinol. 2005; 19:537-43

Gliklich RE, Metson R. The health impact of chronic sinusitis in patients seeking otolaryngologic care. Otolaryngol Head Neck Surg. 1995; 113:104-9

Piccirillo JF. Outcomes research and obstructive sleep apnea. Laryngoscope 2000;110:16-20

National Commission on Sleep Disorders Research. Wake Up America: A National Sleep Alert. Washington, Government Printing Office, 1993

Pade J. Sinusitis. Eine ernst zu nehmende Erkrankung. HNO 2005; DOI 10.1007/s00106-005-1227-0

Pleis JR, Coles R. Summary health statistics for US adults: Nation Health Interview Survey, 1998. National Center for Health Statistics. Vital Health Stat 2002; 10: 1-113

Becker DG. Sinusitis. J Long Term Eff Med Implants. 2003; 13:175-94

Gesundheitsberichterstattung des Bundes. Available from: http://www.gbe-bund.de/ Accessed on October 13, 2017

Ray NF, Baraniuk JN, Thamer M, et al. Healthcare expenditures for sinusitis in 1996: contributions of asthma, rhinitis, and other airway disorders. J Allergy Clin Immunol. 1999; 103: 408-14

Metson R, Gliklich RE. Clinical outcome of endoscopic surgery for frontal sinusitis. Arch Otolaryngol Head Neck Surg. 1998; 124:1090-6

Goodale RL. Some causes of failure in frontal sinus surgery. Ann Otol. 1942; 51:648

Iro H, Mayr S, Wällisch C, Schick B, Wigand ME. Endoscopic sinus surgery: its subjective medium-term outcome in chronic rhinosinusitis. Rhinology. 2004; 42:200-6

Sobol SE, Wright ED, Frenkiel S. One-year outcome analysis of functional endoscopic sinus surgery for chronic sinusitis. J Otolaryngol. 1998; 27:252-7

Stammberger H, Posawetz G. Functional endoscopic sinus surgery. Eur Arch Otorhinolarngol. 1990; 247:63-76

Hessler JL, Piccinllo JF, Fang D, et al. Clinical outcomes of chronic rhinosinusitis in response to medical therapy: Results of prospective study. Am J Rhinol. 2007; 21:10-8

Robinson S, Douglas R, and wormald PJ. The relationship between atopy and chronic rhinosinusitis. Am J Rhinol. 2006; 20:625-8

Piccinllo JF, Merritt MG Jr, Richards ML. Psychometric and clinimetric validity of the 20- Item Sino-Nasal Outcome Test(SNOT-20). Otolaryngol Head Neck Surg. 2002; 126:41-7

Browne JP, Hopkins C, Slack R, Cano SJ. The Sino-Nasal Outcome Test (SNOT): can we make it more clinically meaningful? Otolaryngol Head Neck Surg. 2007; 136:736-41

The Euro-QOL group. EQ-5D-5L 2015. Available from: http://www.euroqol.org/eq- 5d-products/eq-5d-5l.html; last accessed July 18, 2015

The EuroQol Group. EuroQol – a new facility for the measurement of health-related quality of life. Health Policy. 1990;16 (3):199-208

Herdman M, Gudex C, Lloyd A, Janssen MF, Kind P, Parkin D, et al. Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L). Qual Life Res. 2011;20 (10):1727-36

Schulz KF, Altman DG, Moher D, for the CONSORT group. CONSORT 2010 statement: updated guidelines for reporting parallel group randomized trials. BMJ 2010; 340:c332

Dean ME, Coulter MK, Fisher P, Jobst K, Walach H. Reporting data on homoeopathic treatments (RedHot): a supplement to CONSORT. Homoeopathy 2007: 96(1):42-5

Mathie RT, Van Wassenhoven M, Jacobs J, Oberbaum M, Roniger H, Frye J, et al. Model validity of randomized placebo-controlled trials of individualized homoeopathic treatment. Homoeopathy 2017; 106 (4):194-202

Mathie RT, Van Wassenhoven M, Jacobs J, Oberbaum M, Frye J, Manchanda RK et al. Model validity and risk of bias in randomized placebo-controlled trials of individualized homoeopathic treatment. Complement Ther Med. 2016; 25:120-5

Saha S, Koley M, Ganguly S, Rath P, Roy Chowdhury P, Hossain SI. Developing the criteria for evaluating quality of individualization in homoeopathic clinical trial reporting a preliminary study. J Integr Med. 2014; 12(1):13-9.