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Journal of Natural & Ayurvedic Medicine
ISSN: 2578-4986
MEDWIN PUBLISHERS
Commied to Create Value for Researchers
Role of Ultra-High Dilutions of Homoeopathic Medicines in Increasing Blood Oxygen Saturation
Levels in Patients under Palliative Treatment– A Case Series Study Using Pulse-Oximeter Levels
Nat Ayurvedic Med
Role of Ultra-High Dilutions of Homoeopathic Medicines in Increasing
Blood Oxygen Saturation Levels in Patients under Palliative
Treatment– A Case Series Study Using Pulse-Oximeter Levels
Advaita BN1, Arun R Nair2*, Jayakumar TK3, Gokul KK3, Gopukumar ST4
and Chandraja CV4
1Intern, Sarada Krishna Homoeopathic Medical College, India
2Department of Practice of Medicine, Sarada Krishna Homoeopathic Medical College, India
3Department of Materia Medica, Sarada Krishna Homoeopathic Medical College, India
4Research Facilitation Centre, Sarada Krishna Homoeopathic Medical College, India
*Corresponding author: Arun R Nair, Department of Practice of Medicine, Sarada Krishna Homoeopathic Medical College,
Kulasekharam, Tamilnadu, India, Email: dr.arunramagiri@gmail.com
Case Report
Volume 6 Issue 4
Received Date: September 21, 2022
Published Date: October 25, 2022
DOI: 10.23880/jonam-16000365
Abstract
Background: Oxygen is one of the most important elements that support the life. So, the demand and delivery of oxygen
should be well balanced in order to maintain homeostasis in our body. The maintenance of this homeostasis and oxygen
delivery revolves around respiratory and cardiovascular system of our body. Thus, any dysfunction or abnormal function to
these systems can leads to an imbalance in homeostasis causing hypoxemia and their complication including multi-organ
dysfunction.
Objective: To obtain an effective homoeopathic management for hypoxemia in patients under palliative care by using ultra-
high dilutions of various homoeopathic medicines and by thus improving the Quality of Life of the patient.
Methods: The methodology comprises of selection of patients from palliative care unit of Sarada Krishna Homoeopathic
Medical College, Kulasekharam, whose SpO2 level falls between 95%-80% by the help of a pulse-oximeter and after the
selection of patient appropriate ultra-high dilutions of homoeopathic medicine will be administered.
Results: From this study, it was observed that Homoeopathic treatment with oxygen therapy can improve Hypoxemia as well
as Quality of Life (using 15D-HRQoL) in hypoxemic patients under palliative care treatment.
Conclusion: With Homoeopathic intervention, we can alleviate the sufferings of Hypoxemic patients in palliative care
treatment.
Keywords: Dysfunction; Hypoxemia; Intervention; Palliative; Saturation
Introduction
Hypoxemia is a condition in which there is decrease in
partial pressure of oxygen in blood PaO2 [1]. The normal
PaO2 level is between 80-100 mmHg which corresponds to
95-100% of SpO2, which is the oxygen saturation in arterial
blood and can be assessed using a pulse-oximeter. Thus when
PaO2 level falls below 80 mmHg and SpO2 level falls below
95% it causes hypoxemia [2]. There are several mechanisms
that attributes to the development of hypoxemia, which
includes; ventilation perfusion mismatch, right to left shunt,
diffusion impairment, hypoventilation [1].
Journal of Natural & Ayurvedic Medicine
2
Arun R Nair, et al. Role of Ultra-High Dilutions of Homoeopathic Medicines in Increasing Blood
Oxygen Saturation Levels in Patients under Palliative Treatment– A Case Series Study Using Pulse-
Oximeter Levels. Nat Ayurvedic Med 2022, 6(4): 000365.
Copyright© Arun R Nair, et al.
The causes of hypoxemia include Acute Respiratory
Distress Syndrome, COPD, Asthma, Pulmonary edema,
pulmonary embolism, interstitial lung disease, atelectasis,
respiratory failure, cardiovascular diseases and anemia [3].
The common symptoms of hypoxemia include dyspnea,
coughing and wheezing, rapid heartbeat, headache, cyanosis,
feeling of confusion or disorientation [3]. Many homoeopathic
literatures have described how well homoeopathic medicines
can be used in palliative care as well as in cases of hypoxemia.
In “The collected work of Arthur Hill Grimmer” he describes
about Carbo vegetabilis as “At the end of life’s journey, when
racked with suffering and anguish, cold, pulseless, blue and
gasping for breath; wants to be fanned that more of the life
sustaining oxygen may be wafted to his air-hungry tissues,
what a comfort and power is released in the administration
of this remedy” [4].
This study is focused on signifying the role of
homoeopathy in increasing blood oxygen saturation levels
in patients under palliative care. This study will substantiate
the therapeutic value of various homoeopathic medicines
which have its effect on increasing blood oxygen saturation
and in turn help to sustain patients vitality. With the help of
pulse oximeter the values of blood oxygen saturation can be
recorded at even intervals and along with that the subjective
as well objective symptoms of the patient will be recorded.
By considering all the factors similimum is prescribed. This
will pave way for the complete analysis of the improvement
of the patient.
Materials and Methods
Sampling Method: Purposive Sampling.
Study Design: Single group, interventional study with,
before and after observation was conducted without control
group. Study was carried out at the Pain and Palliative care
specialty unit of Sarada Krishna Homoeopathic Medical
College Hospital. Data was collected according to Pre-
structured SKHMCH case record Guided by the Medical
required investigation was done for the required patients.
Cases were analysed with SpO2 levels before and after
treatment. The assessment of the SpO2 levels was done using
pulse-oximeter.
Study Setting: A sample size of 7 cases were taken
from patients under Palliative treatment, from IPD’s of
Sarada Krishna Homoeopathic Medical College Hospital,
Kulashekaram, Kanniyakumari district, Tamil Nadu, whose
oxygen saturation in arterial blood (SpO2) falls between
95%-80% particularly in patients whose SpO2 level remains
constant for at least 5 consecutive minutes. Detailed case
taking was done and recorded in accordance to the hospital’s
standardized chronic case record format. Symptom
analysis has been done and remedies were selected after
proper reportorial approach and prescription was made
by considering the patient as a whole. Follow up, analysis,
repetition, dosage was also done.
Inclusion Criteria: Subjects with SpO2 level between 95%
- 80%. Subjects under palliative treatment. All sex and age
groups.
Exclusion Criteria: Subjects with SpO2 below 80% and
above 95%. Those who are not willing for the research.
Methodology
Study was conducted in 7 subjects under Palliative
treatment, from IPD’s of Sarada Krishna Homoeopathic
Medical College, whose oxygen saturation in arterial blood
(SpO2) falls between 95%-80% particularly in patients
whose SpO2
time.
oximeter and if the SpO2 level falls between 95%-80%
and the hypoxemic state remains constant for at least 5
consecutive minutes, the patients were administered with
ultra-high dilutions of homoeopathic medicine considering
the symptoms.
For patients whose SpO2 level was between 95%-
90% they were administered with ultra-high dilutions of
homoeopathic medicine alone, whereas patients whose SpO2
level was between 89%-80% were administered with ultra-
high dilutions of homoeopathic medicine along with oxygen
therapy. After administering the medicine, the SpO2 levels
for the patient whose SpO2 level reduced to 65% or below,
they were referred to higher center and was considered drop
out of the study. The quality of life was assessed before and
after the treatment using 15D-HRQoL [5]. After administering
the ultra-high dilutions of homoeopathic medicine, the SpO2
level will be monitored continuously every 5 minutes until
the oxygen saturation of the patient becomes normal.
Statistical Analysis
The paired t test was used to compare QOL scale before
and after treatment.
Ethical Consideration
Ethical clearance was obtained from the ethical
committee of SKHMC before the commencement of the
research.
Journal of Natural & Ayurvedic Medicine
3
Arun R Nair, et al. Role of Ultra-High Dilutions of Homoeopathic Medicines in Increasing Blood
Oxygen Saturation Levels in Patients under Palliative Treatment– A Case Series Study Using Pulse-
Oximeter Levels. Nat Ayurvedic Med 2022, 6(4): 000365.
Copyright© Arun R Nair, et al.
Results
Seven cases that met with the inclusion criteria have
been considered for the study. Table 1 summarizes the
outcome of the review of these cases. The cases have been
described below.
Case
No
Gender/
Age(in years) Diagnosis
SpO2 level
before
treatment
QoL score
before
treatment
SpO2 level
after
treatment
QoL score
after
treatment
Medicine administered
1 Male/66 HCC 84% 53 94% 46 Hippozaenium Q Arsenicum
album 30
2 Female/62 CA Uterus 82% 54 92% 46 Kalium iodatum 30
3 Male/56 CA Cheek 78% 54 92% 46 Carbo vegitabilis 30
4 Male/60 CA Prostate 86% 55 91% 45 Arsenicum album 30
5 Male/50 CA Stomach 88% 55 90% 46 Apis mellifica 1X
6 Female/72 HCC 84% 55 70% 55 Amyl Nitrosum 30 Carbo
vegitabilis 30
7 Male/60 Brain tumor 80% 55 70% 55
Arsenicum album 30
Carbo vegitabilis 30
Aspidosperma Q
Table1: Clinical details of the patient considered for the study.
Case: 1
A 66 year old male patient, who has been admitted in
the IPD of SKHMCH with Hepatocellular carcinoma (forth
2 level, the initial
value was 84%, as per protocol oxygen supplementation
was given at a rate of 10-15 L/min along with ultra-high
dilutions of Hippozaenium Q followed by Arsenicum album 30
considering the totality of symptoms of the patient. After the
administration, within a period of 30 minutes the SpO2 level
was raised to 94% and the patient’s SpO2 level remained
stable after that. The 15D-HRQoL score before the treatment
was 53 and after the treatment it became 46. Patient has
other comorbidities like Hypertension, Diabetes mellitus,
Ascites and Pulmonary hypertension.
Case: 2
A 62 year old female patient, who has been admitted
in the SpO2 level, the initial value was 82%, as per protocol
oxygen supplementation was given at a rate of 10-15 L/
min along with ultra-high dilutions of Kalium iodatum 30
considering the totality of symptoms of the patient. After the
administration, within a period of 30 minutes the SpO2 level
was raised to 92% and the patient’s SpO2 level remained
stable after that. The 15D-HRQoL score before the treatment
was 54 and after the treatment it became 46. Patient has
other comorbidities like Hypertension.
Case: 3
A 56 year old male patient, who has been admitted in
in the SpO2 level, the initial value was 78%, as per protocol
oxygen supplementation was given at a rate of 10-15 L/
min along with ultra-high dilutions of Carbo vegetabilis 30
considering the totality of symptoms of the patient. After the
administration, within a period of 30 minutes the SpO2 level
was raised to 92% and the patient’s SpO2 level remained
stable after that. The 15D-HRQoL score before the treatment
was 54 and after the treatment it became 46. Patient has
other comorbidities like Hypertension.
Case: 4
A 60 year old male patient, who has been admitted in the
SpO2 level, the initial value was 86%, as per protocol oxygen
supplementation was given at a rate of 1-5 L/min along with
ultra-high dilutions of Arsenicum album 30 considering the
totality of symptoms of the patient. After the administration,
within a period of 30 minutes the SpO2 level was raised to
91% and the patient’s SpO2 level remained stable after that.
The 15D-HRQoL score before the treatment was 55 and after
the treatment it became 45.
Case: 5
A 50 year old male patient, who has been admitted in the
Journal of Natural & Ayurvedic Medicine
4
Arun R Nair, et al. Role of Ultra-High Dilutions of Homoeopathic Medicines in Increasing Blood
Oxygen Saturation Levels in Patients under Palliative Treatment– A Case Series Study Using Pulse-
Oximeter Levels. Nat Ayurvedic Med 2022, 6(4): 000365.
Copyright© Arun R Nair, et al.
SpO2 level, the initial value was 88%, as per protocol oxygen
supplementation was given at a rate of 1-5 L/min along
with ultra-high dilutions of Apis mellifica 1 X considering the
totality of symptoms of the patient. After the administration,
within a period of 30 minutes the SpO2 level was raised to
90% and the patient’s SpO2 level remained stable after that.
The 15D-HRQoL score before the treatment was 55 and after
the treatment it became 46.
Case: 6
A 72 year old female patient, who has been admitted in
the IPD of SKHMCH with Hepatocellular carcinoma showed a
2 level, the initial value was 84%, as per
protocol oxygen supplementation was given at a rate of 10-
15 L/min along with ultra-high dilutions of Amyl nitrosum 30
followed by Carbo vegetabilis 30 considering the totality of
symptoms of the patient. The patient’s blood oxygen level was
by the end of 45 minutes and thus the patient was referred
to higher centre. The patient was having other comorbidities
like Hypertension, Diabetes mellitus and Dyslipidemia.
Case: 7
A 60 year old male patient, who has been admitted in
in the SpO2 level, the initial value was 80%, as per protocol
oxygen supplementation was given at a rate of 10-15 L/min
along with ultra-high dilutions of Arsenicum album 30, Carbo
vegetabilis 30 and Aspidosperma Q considering the totality
of symptoms of the patient. The patient’s blood oxygen level
to 70% by the end of 40 minutes and thus the patient was
referred to higher centre. The patient was having other
comorbidities like COPD, Diabetes mellitus and Epilepsy.
Discussion
Hypoxemia is a medical emergency, should be treated on
the nail. Failure to initiate supporting therapy can result in
serious harm to the patient or may even lead to death. The
to have Hypoxemia and were admitted under Palliative
Care IP of Sarada Krishna Homoeopathic Medical College.
Based on the analysis from seven cases of Hypoxemia in
palliative care treatment, following observations were made
comparing with the available literature.
In a sample of 7 cases, 71.42 % (n=5) belongs to male
patient, 28.57% (n=2) are female patients. Existing cancer
incidence shows that male is more affected than females.
supports existing theories.
Based on age, 57.14 % (n=4) cases belongs to 60-69
age group, 28.57 % (n=2) cases from 50-59 age group and
14.29 % (n=1) case from age group of 70-79 years. According
Epidemiology, and End Results program, the median age of a
cancer diagnosis is 66 years. The median age at diagnosis is
61 years for breast cancer, 68 years for colorectal cancer, 70
years for lung cancer, and 66 years for prostate cancer [6].
This study supports existing data’s in prevalence of cancer
age.
In this study, most common conditions associated with
the seven (n=7) cases are 16.66% (n=3) cases have Diabetes
Mellitus, 16.66 % (n=3) cases have Hypertension, 11.11 %
(n=2) cases have Hepatocellular carcinoma, 5.55 % (n=1)
cases have Dyslipidaemia, 5.55 % (n=1) cases have Epilepsy,
5.55 % (n=1) cases have Portal Hypertension, 5.55 % (n=1)
cases have Ascites, 5.55 % (n=1) cases have COPD, 5.55 %
(n=1) cases have CA Uterus, 5.55 % (n=1) cases have CA
Prostate, 5.55 % (n=1) cases have CA stomach, 5.55 % (n=1)
cases have CA Cheek, 5.55 % (n=1) cases have Glioblastoma.
Patients having Diabetes and hypertension are at a greater
risk of developing cancer. According to a study conducted by
Hiroshi Igarashi, upheld the association between the use of
oxygen therapy, in patients with low oxygen saturation and
survival of patients with advanced cancer; he concluded that
patients with low oxygen saturation with advanced cancer
[7]. Recent years studies suggest that there is a substantial
increase in cancer incidence in Diabetes as well as in
Hypertensive patients [8].
Among the seven cases, before treatment all cases were
in moderate hypoxemic level, and after treatment 71.42
% (n=5) cases improved from moderate to mild and 28.6
% (n=2) cases became severe. The 71.42 % positive result
moderate levels of Hypoxemia. Here role of Oxygen therapy
should be discussed, because of ethical issues as well as
to experiment a patient life without oxygen support during
moderate hypoxemia.
From the study, out of the 7 cases, 42.81%(n=3) cases
were administered with Arsenicum album, 42.81 % (n=3)
cases with Carbo vegetabilis, 14.2% (n=1) cases with
Kalium iodatum 30, 14.2% (n=1) cases with Hippozaenium
Q, 14.2% (n=1) cases with Apis 1X, 14.2% (n=1) cases with
Amyl nitrosum 30, 14.2% (n=1) cases with Aspidosperma Q.
The homoeopathic medicine Phytolacca decandra, has an
alkaloid namely, phytolaccin, among the many properties,
one of them is its capability to reduce the rate of respiration.
Journal of Natural & Ayurvedic Medicine
5
Arun R Nair, et al. Role of Ultra-High Dilutions of Homoeopathic Medicines in Increasing Blood
Oxygen Saturation Levels in Patients under Palliative Treatment– A Case Series Study Using Pulse-
Oximeter Levels. Nat Ayurvedic Med 2022, 6(4): 000365.
Copyright© Arun R Nair, et al.
Therefore based on the homoeopathic principles it has the
than one medicine was used, as the most indicated remedy
didn’t work effectively. Mother tinctures were also used in
managing Hypoxemia. Interestingly, the most used potency
was lower potency and it turned out to be the most effective
one in this study.
The outcome of the study was assessed with scoring
criteria (15D-HRQoL) before and after the treatment and
in my study, it was found that the homoeopathic medicines
along with oxygen therapy are effective in the treatment of
palliative care patients having Hypoxemia. In my study out
of 7 cases, 71.42 % (n=5) showed improvement and 28.57%
(n=2) cases showed no improvement. According to a study
conducted by D L Bowton in 100 hospitalized patients; after
assessing the pulse-oximeter levels approximately for 24
hours independent of patient management, 26 out of 100
developed hypoxemia which lasted for at least 5 minutes
with an oxygen saturation (SpO2) less than 90%. After an
evaluation for 4 to 7 months, 8 (32%) patients suffering
from episodic hypoxemia died and only 7(10%) patients
without hypoxemia died(from 74 patients out of 100). Thus
the severity of hemoglobin oxygen desaturation correlated
inversely with survival time [10]. According to an article
written by Jeremy R Beitler, ventilation induced lung injury
patients through mechanisms like barotrauma, volutrauma,
atelectrauma and biotrauma. It says that prevention of VILI
can help in the attenuation of multi organ failure and can
improve survival [11].
In treatment side, the Homoeopathic remedy indication
was different in each case. So that selection of remedies are
different for different cases. Here, Repertory of Herring’s
Guiding Symptoms of our Materia Medica by Calvin B Knerr
was found effective for prescribing similimum based on
objective signs and symptoms. Most of the prescriptions
are made with the aid of Knerr Repertory. The effectiveness
of this repertory can be determined by using it for various
clinical conditions. So, from my study, we can infer that
Homoeopathic treatment with oxygen therapy can improve
Hypoxemia as well as Quality of Life (using 15D-HRQoL) in
hypoxemic patients under palliative care treatment.
Conclusion
The sample for the study consisting of seven Palliative
Care patients with Hypoxemia from inpatient department of
Sarada Krishna Homoeopathic Medical College and Hospital
and the following conclusion were obtained after statistical
analysis. It was concluded that males above 6th decades
are more vulnerable to develop various Cancer conditions.
Persons with Diabetes Mellitus and Hypertension are more
susceptible for getting cancer than others. SpO2 levels are
considerably managed through Homoeopathic medicines
and Oxygen therapy. The selection of therapeutic similimum
has been effective in improving the hypoxemic level and in
managing the case as a whole. Homoeopathic Medicines
like Arsenicum Album and Carbo vegetabilis seemed to be
the most effective. The application of Quality of Life scale
is limited in the cases of Hypoxemia. Within the limitation
before and after scale of 15D-HRQoL in statistical analysis
have shown that homoeopathic intervention was highly
appreciable with oxygen therapy. Finally, it can be concluded
that with Homoeopathic intervention, we can alleviate the
sufferings of Hypoxemic patients in palliative care treatment.
Acknowledgment
I heartfully thank the management of Sarada Krishna
Homoeopathic Medical College, Kulasekharam for their
valuable guidance, constant encouragement and providing
colleges who furnished expertise that greatly aid the research,
although they may not assent with all of the interpretations
provided in this paper. Also, I would like to thank the Central
Council for Research in Homoeopathy (CCRH), New Delhi,
for giving me this great opportunity to do the short-term
studentship research programme.
Financial Support and Sponsorship
Central Council for Research in Homoeopathy, New
Delhi, India.
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6
Arun R Nair, et al. Role of Ultra-High Dilutions of Homoeopathic Medicines in Increasing Blood
Oxygen Saturation Levels in Patients under Palliative Treatment– A Case Series Study Using Pulse-
Oximeter Levels. Nat Ayurvedic Med 2022, 6(4): 000365.
Copyright© Arun R Nair, et al.
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