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Project on Sub clinical hypothyroidism

 

A single blind randomized control trial of two year duration, was undertaken at OPD of NHMC & H and INMAS, Delhi, India, under DHAP in May 2004. The objectives of the study were- to evaluate the efficacy of Homoeopathic treatment in cases of Subclinical Hypothyroidism (SCH) in children and to study the progression of Sub clinical hypothyroidism to overt hypothyroidism. 98 consented subjects of age group 6-18 years were randomized into homoeopathic treatment and control groups and were followed up for 18 months. Homoeopathic medicines were prescribed to the treatment group on the constitutional totality. Project completed in May 2006.



PRINCIPAL INVESTIGATORS
    1. Dr. V.K. Khanna, Principal, NHMC & hospital
    2. Brig. Dr. R.K. Marwaha, Jt. Director, INMAS

CO – INVESTIGATORS
  1. Dr. Archana Narang, M.O.(T)

RESULTS & ANALYSIS (2004-2006)

At baseline, age, free thyroxine, free triiodothyronine, serum TSH concentrations were similar in the 2 groups. Out of 98 subjects in both the groups, 59 (60%) subjects were asymptomatic and 39(40%) had thyroid specific symptoms. Most common thyroid related complaints were tiredness, lethargy in 34 (34.6%) subjects followed by hairfall in 24 (24.5%) and weight gain in 24 (24.5%) subjects. Thyroid gland was palpable in 32 (32.5%) subjects.

Table No.1: Goiter grading Goiter grading%age


INTERNS: Bharti Wadhwa and Rohit Dubey

Thyroid gland not palpable/small palpable67.5%
Grade 1 & 2 thyroid gland32.5%


DATA OF PATIENTS ENROLLED FOR PROJECT FROM MAY 04 – DEC 04
  • Total no. of cases taken = 50
  • Dropouts = 10
  • Medicine given = Homoeopathic
  • No. of cases progressed to Overt Hypothyroidism= 0
  • No. of Sub clinical Cases with TSH>10= Nil
  • No.of Subclinical cases with TSH<10= 09
  • No. of cases in which TSH has come within Normal Limits= 31
Data of Control Cases after 18months follow up
  • Total no. of cases taken = 48
  • No. of dropouts= 08
  • Medicine given = placebo
  • No. of cases progressed to Overt Hypothyroidism= 08
  • No. of Sub clinical Cases with TSH>10= 11
  • No.of Subclinical cases with TSH<10= 14
  • No. of cases in which TSH has come within normal limits within a year= 07

Project on Autoimmune Thyroiditis (AIT) (2008-2011)

Thyroid dysfunction is common among school children. It manifests as euthyroid autoimmune thyroiditis (AIT), subclinical hypothyroidism (SCH) or overt hypothyroidism (OH). In natural course, thyroid dysfunction progresses either to to SCH or OH. In conventional treatment, lifelong replacement therapy is the only available option for OH and there is no treatment protocol for SCH/AIT cases. There is a window of opportunity for homeopathic intervention in cases of SCH/AIT cases that have not yet progressed to OH. This study was carried out to evaluate the homoeopathic intervention in SCH/AIT cases using randomized control study with blind assessment design. 5059 school children, aged 6 18 years were screened by thyroid function tests (serum FT3, FT4 and TSH, anti TPO ab) and 613 were found to have thyroid dysfunctions. Of these parents of 194 children gave written informed consent. These were sub divided into Group A- SCH with +ve antiTPOab (n=38); Group B- AIT euthyroid (n=47) and Group C- SCH with -ve antiTPOab (n=109). These were further randomized using random allocation software into verum and control groups. Homoeopathic remedies were prescribed on the individualised constitutional totality to the verum groups and controls were given only placebo without blinding. 162 subjects completed the follow up of 18 months (2008-11).


PRINCIPAL INVESTIGATORS

Dr. V.K. Chauhan, Principal, SHMC & hospital

Maj.Gen.R.K.Marwaha Dr. R.K. Marwaha, INMAS


CO-INVESTIGATORS

Dr. R.K. Manchanda, Deputy Director (Homeopathy),
Directorate of ISM & Homoeopathy

Dr.Archana Narang, Medical Officer (Teaching)

SRF's
Dr.Saurav Arora

Dr.Latika Nagpal


Results and Analysis
Mean age, FT4, TSH, antiTPOab, gland grade and ultrasonographic findings in verum and control groups were statistically comparable in all the three sub-groups (p>0.05). The laboratory assessments were blinded. Post treatment comparision of serum TSH levels in Group A and C revealed that TSH returned to within normal limits in 85.94% and 64.29% in verum and control groups respectively (p< 0.006). None of the subjects progressed to OH in verum group whereas it was 08/76 (10.5%) in control group. Comparision of antiTPOab titres in Group A and B revealed that 70.27% subjects in verum group had antiTPOab titres < 34 IU/ml in comparison to 27.02% in control group (p<0.05). There was no significant change in FT4 levels in Group A and B, but in Group C; there was significant increase in FT4 levels.(p < 0.003)


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