Paper Title
EFFICACY OF 50 MILLESIMAL POTENCY VIS-À-VIS A CENTESIMAL POTENCY OF HOMOEOPATHIC MEDICINES IN CASES OF HYPOTHYROIDISM WITH RESPECT TO ZULEWSKY’S CLINICAL SCORE– RANDOMISED TRIAL

Abstract
The rate of patients suffering from hypothyroidism has been increasing recently worldwide. Hypothyroidism causes an enormous degree of health loss and economic loss to the country due to high medical costs and loss of productive manpower. Life becomes threatening for them as the pathological conditions of hypothyroidism cause activity limitation, thus decreasing the quality of life. In the absence of a curative solution for hypothyroidism, there is a need for a study to evaluate the effectiveness of homoeopathic medicine for the management of hypothyroidism. A randomized trial was conducted to evaluate the effectiveness of homoeopathic medicine in hypothyroidism using centesimal and millesimal scales. The millesimal scale of potency is a very recent approach in potency selection, and not many people know about its real efficacy in hypothyroidism. To determine which potency is best suited for thyroid disorders and other chronic conditions, this topic was selected for the study. After screening hypothyroidism patients based on the inclusion and exclusion criteria, the eligible participants were randomly allotted into centesimal and millesimal groups. A standardized case recording format was prepared to document the profiles of the patients. The diagnosis of hypothyroidism was performed by estimating serum TSH levels and T4, and symptomatic evaluation was conducted according to Zulewsky’s clinical score. After analysis and evaluation, the remedy was selected with the help of materia medica. It was observed that, although all age groups of the study population were affected by hypothyroidism, the age group of 20 to 30 years was the most affected. Females were more affected by hypothyroidism than males. Total number of 82 patients were enrolled, from December 2019 to May 2022, out ofwhich50patientswererandomlyallocatedtocentesimalandmillesimalgroup;voluntary informed consent was taken before starting of study. Ethical clearance wasobtained from the institutional ethical Committee, homoeopathy university beforeconducting a trial on them. Total 12 patients were dropped out during washout period,so12newpatientswereenrolledagainforthestudy.Studywasconductedforayear1 year with 6 months of follow-up done on monthly basis. The inclusion criteria forselection of patients were age group 10-60, patients were selected from both genderwhereas exclusion criteria were pregnant ladies, lactating females, females takingcontraceptive pills, congenital hypothyroidism. In millesimal group individualizedhomoeopathic medicines were given upto 0/6 after following thorough standardizedcase taking andevaluation onZulewsky’sclinical score and to the value of TSHlevel. Whereas in centesimal group, individualized homoeopathic medicines weregiven. The results thus obtained were assessed on the basis of zulewski’s clinical score andtheestimationofTSHlevel.AccordingtochangeinvalueofserumTSHlevel patients were categorized into five group-; as in marked improvement-TSH levelreduced 50% from baseline, marked improvement-TSH level reduced 25-50% frombaseline, mild improvement- TSH level reduced up to 25% from baseline, Status quo-nochangeinTSHleveland worse– increasein TSHlevelfrom baseline. Thedatawasanalyzedtakingtwovariables-zulweski’sclinicalscoreforhypothyroidism and estimation of serum TSH. The data analysis basically includedtwo types of comparison. For comparison before treatment and after treatment score –paired t- test was used. And for comparison millesimal group and centesimal groupindependent t – test was used. After statistical analysis a significant decrease in TSHlevel(meandifference=3.1240,t=9.061to3.85,p=0.000)incentesimalgroup.Also, in millesimal group significant decrease in TSH level was observed (meandifference 2.216; post treatment to 3.171, p=0.000; pretreatment). The significant difference was found in ZCHS values in both the groups towards pre and posttreatment.(meandifference2.194to1.760incentesimalgroupandmean3.171to 2.216 whereas mean difference 2.491 to 2.184 in millesimal group). A statisticallysignificant difference was found between pre-treatment and post-treatment levels ofTSH and ZCSH levels in Centesimal as well as Millesimal potencies. There was nosignificantdifference (p>0.05)observedinmillesimalandcentesimalpotencies. The results thus obtained suggested that age group 20-30 were commonly affectedwith hypothyroidism. In millesimal group 44% of patients belonged to 20-30 agegroup followed by 40% inage group and 80% in 40-50 age group. In centesimalgroup48%belongsto20-30agegroupfollowedby32%inagegroup30-40and12 % in 40-50 age group. The commonly affected gender was found to be female ascomparedtomaleinboththegroup.(Incentesimalgroup20patientswerefemaleas compare to male patient were 5 and in millesimal group 22 patients were female incompareto 3 patients weremale. The common symptoms of hypothyroidism present in centesimal group were weightgain followed by constipation and dry skin and signs were delayed ankle reflex.Inmillesimal group the commonest symptoms were dry skin (76%) cases followed byhoarseness (58%) and in diminished sweating in44% of cases. In millesimal groupoutofthe25cases,3casesshowedmarkedimprovementinmillesimalwhereas1case showedmarkedimprovementincentesimalgroup.Theresultsof the studysubstantiated the usefulness of millesimal in comparison to medicine in the cases of hypothyroidism.