Therapeutic efficacy of Antimonium arsenicosum in the acute presentation of obstructive pulmonary disease (OPD) in children

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1 arsenicosum in the acute presentation of obstructive pulmonary disease (OPD) in children Dr Ivan Nestorov Sofia, Bulgaria

2 Acute obstructive pulmonary disease (OPD) Why OPD? OPD is seen in several common or rarer pediatric pathologies: acute bronchiolitis, asthma, foreign objects in the bronchi, etc. Several studies reported that OPD is becoming more common as an upper respiratory tract pediatric pathology. The socioeconomic impact of this syndrome is becoming more important.

3 Acute obstructive pulmonary disease (OPD) KEY SYMPTOMS ARE: Cough, nighttime cough Respiratory distress Wheezing Tachypnea Fluttering of the nostrils using accessory respiratory muscles Sleep disorders and Effort intolerance

4 Acute obstructive pulmonary disease (OPD) PHYSIOPATHOLOGY: Muscle spasm Edema of the mucous membrane and Hypersecretion Note! The younger the patient, the greater the role of hypersecretion and edema in the pathogenesis of OPD.

5 Acute obstructive pulmonary disease (OPD) TREATMENT? A. General measures B. Respiratory physiotherapy C. Medicines Methylated xanthines (methylxantines) used to be the standard treatment, not used as much today. Mucolytic-fluidifying agent uncontrolled bronchial hypertension. Bronchial dilator inhaler / ß-2 adrenergic agonists with a short term action / - efficacy is only validated in older children. Steroids their efficacy on the viral load is still being debated; however they slow down the apoptosis of neutrophils

6 Acute obstructive pulmonary disease (OPD) Treatment options remain open! Is homeopathy the relevant therapeutic approach? In our Materia Medica are there some well-targeted medicines? My answer is: ANTIMONIUM ARSENICOSUM evaluation of its therapeutic efficacy in in the of acute OPD in children.

7 MATERIALS AND METHODS Clinical, observational, retrospective study based on 647 patients with OPD, evaluation criteria: sex boys, girls age 3-12 months; 1-3 years; 3-7 years; 7-11 years; years OPD severity Silverman RDS Score OPD nosology bronchiolitis in the first year of life; phenotypes A/ occasional obstructive bronchitis /; phenotypes B /bronchial asthma/; Neither A nor B phenotypes /intermittent wheezing/ Location: Pediatric medical center, private practice, Sofia, Bulgaria Period:

8 PROTOCOL evaluate severity and results at day 0 and day 3 Severity is quantified by the adapted Silverman RDS score The medicine is chosen based on the principle of similitude and the physiopathological approach Treatment: At D0, 3 pellets in 15C each 3 hours, space out the takes according to improvement. After 72 hours, at D3 we evaluate the result.

9 INCLUSION CRITERIA All acute OPD cases, clinically validated, regardless of: Sex The episode or evolution stage Etiology or nosology Long term treatment conventional or homeopathic EXCLUSION CRITERIA Children who received steroids, bronchial dilator inhaler or any acute/symptomatic medicine at the time of the consultation D0 Newborns 0-3 months Children with severe respiratory distress Silverman RDS score > 3

10 Total Nr of clinical cases = 647 RESULTS Clinical cases by age ranges 45% 55% 12% 39% 9% 18% 22% male female 3-12 m 1-3y 3-7y 7-11y 11-18y

11 Clinical cases split by gravity Silverman score RESULTS Clinical cases split by nosology 26% 12% 22% 14% 16% 62% 48% 0-1 points 1-2 points 2-3 points infants' bronchiolitis phenotyle A phenotype B phenotype nona nonb

12 Number of cases Nr of cases % of improvement th International CEDH Conference - June 24-26, 2016 Clinical improvement by sex on Day RESULTS Clinical improvement by age on Day-3 80% 70% 60% % 40% % 70% % % % 0 male Total number female Nr of cases with improvement 0 0% 3-12m 1-3y 3-7y 7-11y 11-18y Total Nr of cases Nr of cases with clinical improvement % of cases with improvement

13 Nr of cases % of improvement Nr of cases % of improvement 450 5th International CEDH Conference - June 24-26, 2016 Clinical improvement for severity at Day-3 RESULTS 80% 350 Clinical improvement for nosology at Day-3 80% % % % 50% % 50% % 30% % 30% % % 50 10% 50 10% 0 0% 0-1 point 1-2 point 2-3 point Total Nr of cases Nr of cases with clinical improvement % of cases with improvement 0 bronchiolitis phenotype A phenotype B phenotype nona nonb Total Nr of cases Nr of cases with clinical improvement % of cases with improvement 0%

14 DISCUSSION AND CONCLUSION Results showed that Antimonium arsenicosum improves the course of acute OPD in children The younger the child, the higher the clinical efficacy of the homeopathic medicine, it is thus a very good alternative, even as first line treatment in newborns and toddlers. In my opinion it is also quite relevant to use it as a «sentinel» medicine There is always the question of the dosage «playing» with the dilutions sensitive type or looking for the physiological effect at the different stages of the disease?! The study showed the reliability of our MatMeds, as well as the clinical efficacy of our homeopathic medicines prescription via the pathophysiological approach.

15 «It is not important for the pathogenic picture of a medicine to be toxic or clinical, the essential thing is for it to be clinically validate». Constantin Herring

16 Thank you for your patience! 5th International CEDH Conference - June 24-26, 2016