Hima Bindu Ponnam

Hypertriglyceridemia is an independent risk factor of coronary heart disease (as established through various previously conducted studies) and it's rising incidence is creating a need for the immediate attention of it's management. Instead of focusing on the controversies involving the toxicity caused due to the long-term use of statin therapy in conventional mode of treatment, opting for a safer alternative system of treatment seems important. Five cases of diagnosed HTG, with triglyceride levels above 200 were treated with homoeopathic medicine - Fucus vesiculosus, in mother tincture form. The primary outcome measure was to evaluate the reduction in the blood triglyceride levels. All the five cases showed a reduction in triglyceride levels to normal range within 4 months of starting the treatment with the Fucus vesiculosus mother tincture. Also, it was observed that the borderline cholesterol levels and high LDL levels in 2 cases were found to reduce to normal. Treatment involving Fucus vesiculosus in cases diagnosed with HTG showed significant reduction in triglyceride levels along with other parameters of lipid profile. Further authentication of results with significant sample sizes may be taken up.

Background The novel coronavirus disease 2019 (COVID-19) pandemic has created immense panic globally with its advent in December 2019 and now showing readvent with its camouflage of different dangerous mutant strains. Its psychological repercussions on the community are very disastrous and immeasurable. At this juncture, the most vulnerable group are the patients of Noncommunicable diseases (NCDs) who are the most sufferers due to the impact caused by the anxiety and fear of COVID-19 apart from its high rate of infectivity. In this context, an online survey to assess the levels of anxiety and fear of COVID-19 in patients with lifestyle diseases has been taken up. Methods This was an online cross-sectional survey using the Fear of COVID-19 Scale (FCV-19S) to assess the levels of anxiety and fear in patients with NCDs. The survey was made available for both genders and an age group of 30 years and above in India. Results and Discussion A total of 627 participants participated in this online survey. The Indian residents with NCDS )Noncommunicable diseases) were found to suffer from significantly increased levels of anxiety and fear of COVID-19 and almost 60.4% of the participants were found to acquire these lifestyle diseases as diabetes and hypertension during this recent COVID-19 times. Conclusion This survey shows the real-time psychological impact of COVID-19 which has a disastrous effect upon the community especially on the patients with NCDs who are the most vulnerable group. The study findings corroborate with the recent studies conducted on NCDs.

Background: Psychological fragility caused to human life has been the largest aftermath of the pandemic posing a raised public health concern globally. This psychological impact is identified as Post-Traumatic Stress Disorder (PTSD) which was the most commonly diagnosed psychological disorder during this pandemic. These cases, if left untreated and unidentified may take a devastating transformation into psychotic disorders and cause gross damage to the individual and the community by disrupting human relations. Aims: Keeping in view the beneficial role of homoeopathy in dealing with psychological disorders based on its philosophy and previous studies, a clinical case series of 10 PTSD cases successfully treated with homoeopathy during this pandemic is presented here. Methods: 10 cases of PTSD consulted during the first wave of the pandemic diagnosed based on the clinical picture analogous to PTSD cluster symptomatology from the Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5) and objectively through Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) were treated with homoeopathic intervention. Homoeopathic medicine was prescribed based on the totality of each case through repertorization and in consultation with the sourcebooks of Homoeopathic Materia Medica (HMM). The cases were followed monthly for clinical improvement and every three months using the CAPS-5 score. The outcome was assessed after six months clinically and objectively through the CAPS-5 score. At the end of one year, further, to assess the causal attribution of clinical outcomes to homoeopathic intervention, a validated MONARCH (Modified Naranjo Criteria for Homoeopathy) tool was utilized. Results: The 10 diagnosed PTSD cases showed marked improvement assessed after one year of homoeopathic treatment. Significant improvement was found in the clinical picture affirmed through the CAPS-5 score and MONARCH tool. Conclusion: Homoeopathic medicines showed a significantly beneficial role in the management of PTSD during the pandemic in the presented 10 cases. Further validation through well-designed clinical trials is warranted.

Objective During the early part of the COVID-19 pandemic, non-pharmacologic interventions were the strategies for the prevention of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The Ministry of Ayush, Govt. of India, had advised Arsenicum album 30C, as a prophylactic to prevent COVID-19. This study was undertaken to evaluate the protective efficacy and safety of the Arsenicum album 30C. Methods We conducted a prospective, multicentre, cluster-randomized, parallel arm, community-based, open-label study involving apparently healthy individuals residing in containment areas of 7 cities of India. Clusters are defined as the population residing in the containment areas, who are under restriction for movement. 42 clusters were randomly assigned at 2:1 to the Arsenicum album 30C group (30 clusters) or to the control group (12 clusters, which received no specific therapy). The medicine was given twice daily for 7 days. The primary outcome was the incidence of COVID-19, as per the case definition notified by the National Centre for Disease Control, Government of India, during three weeks follow-up period. Results The analysis included 32186 individuals residing in 42 clusters (containment areas). A total of 22693 individuals of 30 clusters received Arsenicum album 30C and 9493 individuals of 12 clusters were observed in the control group. Results were similar in the medicine and control groups for age, gender, and comorbidity. The overall protective effect of the Arsenicum album 30C was 80.22% (95% confidence interval [CI], 71.16 to 86.44; 40 cases per 22693 [6.04 per 10000 person-weeks] in the Arsenicum album 30C group vs. 84 cases per 9493 [29.78 per 10000 person-weeks] in the control group). The protective effect of the Arsenicum album 30C against laboratory-confirmed COVID-19 was 68.22% (95% [CI], 49.64 to 80; 32 cases per 22693 [4.83 per 10000 person-weeks] in the Arsenicum album 30C group vs. 42 cases per 9493 [14.93 per 10000 person-weeks] in the control group). Adverse effects observed in both groups were mild and resolved without medication and sequelae. Conclusion Homeopathic medicine Arsenicum album 30C was associated with a decrease in the incidence and provided some protection against COVID-19 as compared to non-treatment. Further, randomized, double-blind, placebo-controlled trials may be conducted to validate the results of this 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.

Introduction: Plantar psoriasis is a variant of psoriasis and accounts for 3–4% of total cases of psoriasis. Psoriasis, an autoimmune and chronic inflammatory disease of the skin, can leave the patient in agony with its distressing infection episodes. The homoeopathic system of medicine offers a wide range of medicines that can have a beneficial role in managing cases of psoriasis as depicted in the previous studies. Case summary: A distinct case of plantar psoriasis treated with homoeopathic remedies of ultra-high dilution has been presented here. The evidence-based illustrations were done before and after the treatment and the periodical objective assessment of the lesions with psoriasis area and severity index (PASI) calculation to ascertain the prognosis. The causal attribution of outcome to the treatment was evaluated using Modified Naranjo Criteria for Homoeopathy (MONARCH) tool. Marked improvement was found in the psoriatic lesions evidenced photographically and the PASI scores showed significant reduction affirming the same. The MONARCH score (+9) suggested that the clinical improvement was likely attributable to the homoeopathic treatment. This evidence-based case report suggests a beneficial role of homoeopathy in the treatment of plantar psoriasis

The substantive acquired experience from the research studies conducted by the WHO for reaching international control over OPVs helps to combat the existing threat of MPXV and future emerging diseases. All countries worldwide[9,10] have issued separate guidelines based on the standard operating procedures opined by the WHO and are striving for implementation to effectively combat the MPXV

Background Urinary tract infections (UTIs) comprise a troublesome array of symptomatology accounting for disruption in the quality of life of an individual to a significant extent. Increasing prevalence of the drug-resistant microbes in UTIs poses a major concern for treatment to the medical fraternity. Homoeopathy offers a safe and effective treatment option for treating a broad spectrum of multidrug-resistant diseases. Patient Profile Two patients presented with acute UTI for homoeopathic consultation. The conventional treatment options taken with rigorous antibiotic medications could not stop the frequent relapses and prolonged suffering. Indicated homoeopathic medicine was prescribed for the cases based on the characteristic symptoms. The improvement was assessed symptomatically and by urine culture reports. The outcome has been further verified through outcome in relation to impact on daily living (ORIDL). Result Homoeopathic medicine showed marked improvement in both cases by not only alleviating the symptoms of infection subjectively but also resolving the Escherichia coli (E. coli) bacterial infection confirmed through objective evidence of urine culture report. Conclusion Homoeopathic medicine found to be effective in relieving the acute UTI caused by antibiotic-resistant E. coli.

Background After the declaration of COVID-19 as a pandemic by the World Health Organisation, the physical medical consultations became almost impossible. Telemedicine (TM) health care delivery (HCD) seemed to be the only means to handle the crisis and served as a boon in the management of mild to moderate COVID-19 cases. The telemedicine practice (TMP) spread worldwide in no time, and the same was adopted even in homoeopathic consultations. Objective The aim of this study is to highlight the TM practice globally and its adoption in homoeopathy concerning notified guidelines by the Central Council of Homoeopathy, erstwhile National Commission for Homoeopathy, Ministry of AYUSH (Ayurveda, Yoga and Naturopathy, Unani, Sow-Rigpa, Siddha and Homoeopathy), Government of India. Conclusion TMP has become a necessity for easy access to essential and universal health care and to treat remotely located patients. The publication of these guidelines for homoeopathic consultations is timely to strengthen and encourage its usage in public HCD. There is a need to periodically evaluate its optimal integration in digital health care in the future.

Background & Objectives: Post-COVID psychological fragility caused to human life has been the largest aftermath of the pandemic posing a raised public health concern globally. This psychological impact is identified as Post-Traumatic Stress Disorder (PTSD) which was the most commonly diagnosed psychological disorder during this pandemic. These cases, if left untreated and unidentified may take a devastating transformation into psychotic disorders and may cause gross damage to the individual and the community by disrupting human relations. Keeping in view the beneficial role of Homoeopathy in dealing with psychological disorders based on its philosophy and previous studies, a clinical case series of 10 PTSD cases successfully treated with Homoeopathy during this pandemic are presented here. Method: 10 cases of PTSD consulted during this ongoing pandemic diagnosed based on the clinical picture analogous to PTSD cluster symptomatology from Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5) and objectively through validated Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) were treated with Homoeopathic intervention. Homeopathic medicine was prescribed based on the totality of each case through repertorization and after consultation with the sourcebooks of Homoeopathic Materia Medica (HMM). The cases were followed every month for clinical improvement and assessed every three months using the CAPS-5 score. The outcome was assessed after six months clinically and objectively through the CAPS-5 score. At the end of one year, further to assess the casual attribution of clinical outcome to homeopathic intervention, validated MONARCH (Modified Naranjo Criteria for Homoeopathy) tool was utilized. Results: The 10 diagnosed PTSD cases showed marked improvement assessed after one year of Homoeopathic treatment. Significant improvement was found in the clinical picture affirmed through CAPS-5 score and MONARCH tool. Conclusion: Homoeopathic medicines showed a significantly beneficial role in the management of PTSD during the pandemic in the presented 10 cases. Further validation through well-designed clinical trials is warranted.

A Hindi article on Telemedicine Health Care Delivery in India: A Boon during pandemic

The devastating COVID-19 pandemic has completely changed the scenario of health care at a rapid pace with upcoming challenges18. In order to serve the needs of the community in regards to their psychological manifestations during the pandemic, the field of psychiatry should raise to the level of advanced technology as video�conferencing and telemedicine for ensuring mental health to make easily accessible to the public19, 20. An integration of Tele-psychology and Tele-counselling should be a part of the routine health care services for easy access and must create awareness among people about mental disorders. It further would help to remove the myths and taboos about psychological disorders. Previously many online-based psychological counselling was taken up through social networking platforms21 with positive outcomes. Keeping in view the present need for psychological counselling during the pandemic – authenticated psychological organizations with public-private collaborative partnerships should focus on a global vision by promoting specific training for psychologists and psychotherapists as developing the basic skills in managing the effects of a pandemic and emergency situations and also sensitizing patients to online therapeutic rapport providing standard operating procedures (SOPs)22. Psychiatrists, psychologists from the public, private sectors, and non-governmental organizations should all associate with each other and start affiliating to community clubs, local societies, etc. to cater to the pandemic mitigation plans as envisaged by WHO and the Health and Family Welfare Ministry of our Government. Thus, the integration of psychotherapy in the essential health services of the pandemic would further strengthen the roots of mental health care delivery of our country and also nurtures an easy accessibility for every citizen enriching the future health care vision of India.

In India, Ministry of Health and Family Welfare (MOHFW) laid its clear TMHCD guidelines in March 2020 in which the standard operating procedures for TMHCD for its effective implementation in the management of the crisis situation aroused during this pandemic3 . The medical professionals stretched themselves to the fullest extent delivering health care remotely helping the public in an integrated manner. Apart from the pandemic disaster, the pre-existing co-morbid conditions and the anxiety, fear component among the public is also of major concern which was not possible to handle through physical consultations owing to the COVID-19 appropriate behavioural guidelines. AYUSH (Ayurveda, Yoga, Unani, Siddha, Sow-Rigpa, Homoeopathy) health care system plays a major role in public health care of India as a reflection of Indian culture and heritage also has released specific standard operating procedures for TMHCD in the respective systems of medicine separately to ensure the delivery of TMHCD in a qualitative manner4, 5 .

The vision of India emerging as a global leader in digital health was planned through NITI AAYOG during 2018-19 and has been launched by Shri Narendra Modi, prime minister of India on 15th August 2020 in the form of National Digital Health Mission (NDHM) to further revolutionize the health sector of India in the field of advanced technology8. In this context, the TMHCD would evolve as a global integrative health care delivery strategy with its various aspects as ease in access, time & cost-effectiveness, multidisciplinary integration and many more advantages9. Though TMHCD is not the solution for all health care problems but especially it was found to be an effective solution for rapid action in response to the COVID-19 pandemic combating the deadly virus10, 11. Further, TMHCD initiative calls for a proper global research agenda to be evaluated for its effective implementation in future.

The various reasons for PTSD during COVID-19 times can be summarized as below: 1. Shock due to quarantine/isolation. 2. Mental trauma due to severe illness and hospitalization. 3. Morbid fear of contracting infection and new strains. 4. Visualizing the death of near and dear. 5. Financial burden due to loss of job/income. 6. Stress and shock due to continuous watching daily news updates. 7. Domestic violence/Sexual abuse due to caught back at unknown places and staying at home. 8. Imaginary fear of adverse reactions from new vaccines. 9. Social isolation stigma from the community. 10.Morbid Fear about future

Introduction Prodigious restrictions and safety measures have been adopted by the government to control the spread of wildfire coronavirus disease 2019 (COVID-19) pandemic in India. However, the effective implementation of these measures depends upon the knowledge, attitudes, and practices (KAP) of the people. In this context, a cross-sectional online survey of a sample of Indian residents for assessing their KAP toward COVID-19 has been taken up during the verge of lockdown restrictions. Methods A self-developed online KAP questionnaire consisted of 21 questions related to clinical treatment and prevention aspects of COVID-19 including the safety measures completed by the participants. Assessments on their attitudes and practices toward COVID-19 included the confidence of people to overcome this pandemic and adapting safety measures such as wearing mask while going out in recent days. Results and Discussion A sample of 1,043 participants participated in this online survey. The overall correct rate of the knowledge questionnaire was 90%. More than half of the respondents (53.3%) had confidence that India can win the battle against COVID-19. All the participants believed that Ayurveda, Yoga, Unani, Siddha, and Homoeopathy (AYUSH) systems of medicine that are the rich heritage of India would be helpful in combating the viral illness (95.4%). Nearly all the participants (99%) wore masks when going out in recent days. In multiple logistic regression analyses, the COVID-19 knowledge score was significantly associated with a lower likelihood of negative attitudes and preventive practices toward COVID-19. Conclusion The Indian residents showed good knowledge toward COVID-19 and this in turn helped them to hold optimistic attitudes and have appropriate practices toward COVID-19. More community-based health education program strategies if aimed would help further. The limitation of sample representativeness restricts to generalize the findings to population of rural areas with low socioeconomic status.

Background: Despite standard management, healing rate of Diabetic Foot Ulcers (DFUs) remains low, posing risk of lower extremity amputation. Objectives: This study was undertaken to evaluate if Calendula Q has added benefit over individualized homoeopathic intervention (IHI). The primary objective was to achieve complete epithelialisation within 20 weeks and secondary objective was to assess the changes in quality of life using DFU Scale-short form (DFU-SF) questionnaire. Materials and Methods: A randomised controlled pilot study with a 20-week intervention was conducted from 2014-2017. 277 cases were screened and 60 cases were enrolled and randomised to Group I: IHI + Calendula Q dressing (n= 30) and Group II: IHI + normal saline (NS) dressing (n = 30), along with standard conventional medication for glycaemic control. Results: The mean time (Group I= 12 weeks, Group II= 11 weeks) of ulcer healing in both groups showed no statistically significant difference, thus calendula Q used for dressing did not have any added benefits (p= 0.0521). Arsenicum album (n= 14, 23.3%), Lycopodium (n= 8, 13.3%), Silicea (n= 7, 11.7%), Sulphur (n= 6, 10%), Phosphorus (n= 5, 10%) and Sepia (n=5, 10%) were found to be effective medicines. Conclusion: IHI, along with wound hygiene and conventional diabetic management, proved to be effective, irrespective of whether Calendula Q or normal saline was used for wound hygiene, thus leading to early, complete epithelialisation of Wagner’s first and second stages of DFUs. Further studies comparing IHI with standard care are warranted.

Background: Homoeopathic medicines are known to be effective in alleviating pain and other troublesome symptoms of patients suffering from cervical spondylosis. Objective: The primary objective was to evaluate the effectiveness of predefined homoeopathic medicines in the pain management of cervical spondylosis using the Cervical Spondylosis Pain Management Scale (CSPMS). Methods: A prospective, doubleblind randomised placebo-controlled multicentric clinical trial was conducted from April 2012 to May 2013. Results: Sixty-seven cases were enrolled in the Homoeopathy group and 69 in the placebo group. One hundred and thirty-four cases that completed the follow-ups were analysed. The improvement in pain was 56.18% in the Homoeopathy group and 46.45% in the placebo group, as per CSPMS. The mean improvement between the groups was not significant: 60.36% in the Homoeopathy group and 48.66% in the placebo group. The mean score of quality of life, assessed using the ‘Patient’s Global Impression of Change Scale,’ was 2.29 ± 1.90 quality of life in the Homoeopathy group and 2.93 ± 2.28 in the placebo group. There was 27.95% more improvement in the Homoeopathy group, as compared to the placebo group. Among the most used medicines were Rhus toxicodendron (n = 19) 28.8%, Calcarea carbonica (n = 7) 10.6%, Kalmia latifolia (n = 7) 10.6% and Paris quadrifolia (n = 8) 12.1%. Conclusion: Homoeopathic medicines are effective in management of acute pain due to cervical spondylosis.

Diabteic Foot Ulcer (DFU) is one of the most serious and costliest complications of diabetes. Every 30 seconds a lower limb is lost with this condition by UNWHO. Homoeopathy is the safest, economical and efficient treatment approach for this condition.

AYUSH for Immunity Weekly News Bulletin released by Ministry of AYUSH, Govt. of India

Fear of an infection is posing a major threat in the current coronavirus disease 2019 (COVID-19) crisis. Although nothing novel but still when we see historically over the times, fear of infection in any pandemic crisis remains the same even after the advent of modern medical advancements. This morbid fear of risk of infection has more traumatic effect psychologically than reality of succumbing to an infection and its recovery. Nevertheless, the cause of the fear and its management is very important in this COVID-19 crisis situation. Homoeopathy system of medicine offers a safe, palatable, economical and an eco-friendly management solution to tackle this morbid fear. Homoeopathy is being used by the public since a very long time and people continue to experience its overall health benefits with utmost trust and diligence. Two cases of morbid fear of COVID-19 infection treated homoeopathically with positive outcome are presented here.

“I envisage that the best viable solution in the current COVID-19 would be to adopt lifestyle modifications, using these age-old AYUSH medicines and make them a part of our daily life-enhancing our internal immune powers to fight the disease effectively.

Background and Objectives Diabetic foot is a condition especially vulnerable to amputation because of frequent complications of peripheral neuropathy, infection and peripheral arterial disease. Diabetic foot problems are a major cause of hospitalisation and prolonged hospital stays, constituting 20% of those entering hospitals. If treatment is delayed or improper treatment is given, it leads to infection, gangrene and amputation. Homoeopathic literature reveals that Silicea is a useful medicine for ulcers, but there is dearth of systematic research in this area. This article is an effort to provide detailed information of potentised Silicea in reference to diabetic foot ulcer (DFU). Method A prospective observational study was conducted by Central Council for Research in Homoeopathy at its Extension Clinical Research Unit, Hyderabad, from 2005 to 2009. From the study, cases where Silicea (n = 22) was indicated and prescribed were taken for retrospective analysis. Results The analysis showed usefulness of Silicea in treating DFU. The baseline symptom score of DFU and sugar values were statistically analysed before and after treatment. The mean symptom scores at the baseline (8.41 ± 3.03) and at the end of treatment (0.27 ± 0.70) were found to be statistically significant (p = 0.001). Conclusion The result of the role of Silicea in ulcer healing was found to be positive and encouraging. Further, to validate the effect of Silicea, randomised controlled trials can be undertaken.

Background: Polycystic ovarian syndrome (PCOS) is an emerging health problem in young females characterized by ovarian dysfunction and hyperandrogenism. Existing information indicates a positive role of homoeopathy but more rigorous studies are desirable. This protocol has been developed to undertake a pilot study to evaluate the efficacy of homoeopathic intervention using established diagnostic criteria.Methods/Design: It will be a multi‑centric, randomized, placebo controlled pilot study with a 6‑month intervention and follow up period. Minimum 60 cases fulfilling the eligibility criteria will be enrolled and randomized to receive either the homoeopathic intervention or the identical placebo. Both the arms follow lifestyle modification for weight reduction. Primary endpoint will be the establishment of regular menstrual cycle along with improvement in either ultrasonology or hirsutism/acne. Secondary endpoints will be to compare the changes in total and individual domain scores of PCOS questionnaire at monthly interval and the changes in ultrasound of polycystic ovaries. For the primary outcome and each of the secondary outcomes, both per protocol and modified intention to treat analysis will be done.Discussion: This pilot study has been planned considering the varied presentation of PCOS as per international diagnostic criteria and accordingly the composite endpoints have been kept for evaluation. The outcome of this pilot study will help in planning a definite study.Trial registration: CTRI/2013/09/003983 [Registered on: 16/09/2013]

Background: Polycystic ovarian syndrome (PCOS) is an emerging health problem in young females characterized by ovarian dysfunction and hyperandrogenism. Existing information indicates a positive role of homoeopathy but more rigorous studies are desirable. This protocol has been developed to undertake a pilot study to evaluate the efficacy of homoeopathic intervention using established diagnostic criteria. Methods/Design: It will be a multi-centric, randomized, placebo controlled pilot study with a 6-month intervention and follow up period. Minimum 60 cases fulfilling the eligibility criteria will be enrolled and randomized to receive either the homoeopathic intervention or the identical placebo. Both the arms follow lifestyle modification for weight reduction. Primary endpoint will be the establishment of regular menstrual cycle along with improvement in either ultrasonology or hirsutism/acne. Secondary endpoints will be to compare the changes in total and individual domain scores of PCOS questionnaire at monthly interval and the changes in ultrasound of polycystic ovaries. For the primary outcome and each of the secondary outcomes, both per protocol and modified intention to treat analysis will be done.

Adenomyosis is a common pathological condition of the uterus where its diagnosis and treatment remain still a challenge to the treating physicians. Even though termed as benign, its clinical presentation of heavy, painful menstrual bleeding, infertility and hindrance to a women's quality of life makes it significant cause for treatment. The adenomyosis condition with significant symptoms is dealt with surgically in the conventional system of medicine by way of hysterectomy, uterine artery embolisation or endometrial ablation. These surgical interventions can be prevented with homoeopathic system of medicine. A case of adenomyosis in a 41-year-old female who presented with continuous heavy bleeding and severe pelvic pain was successfully treated with homoeopathy medicine, Conium maculatum, which is commonly called as poison hemlock. The medicine prescribed on totality alleviated not only symptoms of the patient but also resolved adenomyosis completely.