Dr. B. Saunders Mr. N. de Villiers

Dr. K.S. Peck Dr. J.R. Torline

M.Tech.

The aim of this study was to determine the efficacy of the combination of Nigersan® 4X, Citrokehl® 10X/30X/200X and Recarcin® 4X in the treatment of symptoms experienced with endometriosis. Endometriosis is a gynaecological disorder, where functioning endometrial tissue is present outside the uterine cavity. Symptoms are often associated with severe pain and/or infertility. The aetiology is unknown and there is no cure for endometriosis. This was a double blind study in which a placebo group was compared to an experimental group. Twenty five females with pre-diagnosed endometriosis were analysed over a twelve week period. The participants were randomly divided into two groups, one receiving Nigersan® 4X, Citrokehl® 10X/30X/200X and Recarcin® 4X and the other placebo. This was a subjective study with reference to the participant’s perception of their condition before, during and at the end of the study. Participants were asked to record the following on a daily basis: menstruation, pelvic pain, backache, nausea, vomiting and diarrhoea. The participants were then also asked to rate the following on a monthly basis: energy levels, general wellbeing, dysmenorrhea, pelvic pain, menstrual clotting, menstrual flow, menstrual colour and dyspareunia. All forms and questionairres were then collected at four week intervals and analysed for comparison. The data was statistically analysed using the Analysis of Variance technique and Chi-squared statistics. Results revealed a significant decrease in the average number of days of backache and pelvic pain within the placebo group while the experimental group indicated a significant improvement in energy levels and general wellbeing. Therefore it is concluded that Nigersan® 4X, Citrokehl® 10X/30X/200X and Recarcin® 4X did not significantly alleviate symptoms associated with endometriosis. / Dr. N. Wolf Dr. S. Sarawan

Dissertation submitted in partial compliance with the requirements for the Master’s Degree in Technology: Homoeopathy, Durban University of Technology, 2011. / Hypertension is a serious problem in South Africa, affecting 18.8 percent of women (South African Demographic and Health Survey, 2003), prompting investigation into treatment. In total, approximately 6.1 million people suffer from Hypertension in South Africa. AIM The purpose of this double-blind study was to evaluate the efficacy of the Homoeopathicsimillimum and a Homoeopathic complex (Aurummetallicum6CH, Lachesismuta6CH, Natrummuriaticum6CH, and Veratrum album 6CH) in the treatment of Primary Hypertension in adult females. METHODOLOGY A minimum of 30 patients were recruited and were selected on the basis of specified inclusion and exclusion criteria, and randomly divided into two equal groups by the research supervisor, with the first group receiving the Homoeopathic simillimum andthe second group receiving the Homoeopathic complex.The initial consultation took place at the Durban University of Technology or at the Umlazi Medical Centre after obtaining informed consent from the patients (Appendix D).A detailed case history was taken, followed by a complete physical examination, including blood pressure readings and cardiovascular system examinations. Follow up consultations occurred weekly for a period of four weeks to record blood pressure readings, any changes in the general health and well being of the participants, in order to prescribe more medicines if needed. A mercury sphygmomanometer and a Littmann Classic 2 stethoscope were the tools of measurement and was used according to the method outlined by Bates (2007), which states that an accurate measurement of blood pressure is dependent on the appropriate cuff size of the sphygmomanometer and whether the type of gauge used needs to be calibrated or not. SPSS version 18 was used to analyse the data. A p value <0.05 was considered as statistically significant. Repeated measures ANOVA tests were done to compare the blood pressures over time between the treatment groups. Specific remedies used at each time point were described by treatment group. Potencies of the remedies were compared within each remedy between the treatment groups using Pearson’s chi square tests. RESULTS Within each of the two treatment groups there was a highly significant decrease in systolic blood pressure over time (p<0.001). This means that both treatments were effective at lowering systolic blood pressure. Within each of the two treatment groups there was a highly significant decrease in diastolic blood pressure over time (p=0.001 and p<0.001 respectively). This means that both treatments were effective at lowering diastolic blood pressure. Systolic and diastolic blood pressures at five time points were compared between the two treatment groups using repeated measures ANOVA. There was an overall significant change over time in both groups (p<0.001), but the change over time was not different according to treatment groups (p=0.355). The decrease in systolic blood pressure over time was nearly identical in the two groups as the profiles are almost parallel. Therefore in terms of systolic blood pressure there was no statistical evidence for one treatment being more beneficial than the other. There was an overall significant change over time in both groups (p<0.001) but the change over time was not different according to treatment groups (p=0.187). The decrease in diastolic blood pressure over time was almost the same rate in both groups as the profiles are almost parallel. Therefore in terms of diastolic blood pressure there was no statistical evidence for one treatment being more beneficial than the other. CONCLUSION The results of the study led to the conclusion that both the simillimum and complex treatments were effective at reducing blood pressure over time, but there was no evidence that one treatment was more beneficial than the other, since the rates of change over time in systolic and diastolic blood pressure were similar in both treatment groups.

Background: The homeopathic preparation, Traumeel S, has been used as a valuable alternative to conventional non-steroidal anti-inflammatory drugs (NSAIDS) for over 30 years. This antihomotoxic, anti-phlogistic drug has been widely used by sportsmen and women in the treatment of lesions and inflammatory processes which result from exercise-induced skeletal muscle microtrauma. Although numerous randomised, double-blind placebo-controlled trials have confirmed the efficacy of Traumeel S as an anti-inflammatory agent, there are few in vivo studies which have specifically investigated the mechanism by which Traumeel S is effective in reducing inflammatory response to exercise-induced muscle cell damage. Aim: To establish whether the administration of Traumeel S during the five days before participation and three days following participation, significantly attenuates the systemic markers of the inflammatory response, following a 90-minute downhill running trial. Method: Twenty-four healthy athletes (14 men and 10 women), aged 20-50 years, were recruited for this study. Following baseline laboratory testing and familiarisation with the treadmill as well as a field test, subjects were matched according to gender, BMI, training age, training status, peak performance and foot strike patterns and randomised into Traumeel (TRS) and Control (PLAC) groups in a placebo-controlled, double-blind design. One Traumeel S or Placebo tablet was ingested three times per day for five days prior to and three days following a 90-minute exercise trial on a downhill (-6% gradient) at 75% V02 max- Blood samples were collected prior to the 90-minute trial (PRE), immediately after the trial (IPE) and 24 hours (24 PE), 48 hours (48 PE) and 72 hours (72 PE) following the trial. Each subject was also requested to complete a training record prior to the trial and keep a record of the daily symptoms of delayed onset muscle soreness (DOMS) both at rest (general pain) and during walking (daily living). Full blood counts (FBC), serum creatine kinase (CK), lactate dehydrogenase (LDH) and Cortisol concentrations were measured using standard haematological laboratory procedures and serum C-Reactive Protein (CRP) was determined by immunoturbidimetric assay. Sandwich ELISA's were used to determine myeloperoxidase (MPO) and plasma interleukin-6 (IL-6) concentrations. All results obtained were adjusted for changes in plasma volume as calculated from the red blood cell indices. Results: Mean ± SD characteristics of the gender-matched subjects in the experimental (TRS) and placebo-control (PLAC) groups did not differ significantly in terms of BMI, age, % body fat, FVC, FEVi, training age and status, foot strike pattern or peak running performance, maximal Heart Rate, VE, V02peak> RER, RPE during the maximal exercise test (p > 0.05). This indicated that the randomised pairs were well matched. The 90-minute downhill running protocol resulted in significant elevations in total circulating white blood cell count (WBC), neutrophil, CK, LDH, Cortisol, CPR, MPO and IL-6 concentrations (p < 0.001). When comparing the TRS and PLAC groups, mean ± SD total and differential WBC count, neutrophil count, CK, LDH, Cortisol, CPR, MPO and IL-6 concentrations did not differ (p > 0.05) over the 5 time points. At 24 PE, MPO concentrations were significantly higher in the TRS group than in the PLAC group (p = 0.03). The lower mean ± SD post-trial DOMS scores reported by the TRS group were not significantly different from those reported by the PLAC group (p > 0.05). Conclusion: Although the findings of this study did not identify differences in circulating CK, LDH, Cortisol, CPR and IL-6 concentrations between the TRS and PLAC groups, the elevated MPO concentration at 24 PE did provide preliminary novel evidence of enhanced activation of neutrophil oxidative burst activity following exercise-induced muscle damage which is hypothesized to accelerate the recovery process. / Thesis (M.Med.Sc.)-University of KwaZulu-Natal, 2008.

M.Tech. / The most susceptible and vulnerable segment of society to HIV/AIDS infection is the population sector aged between twenty and forty years old. This threatens to impact negatively on South Africa’s economic, social and human development (Whiteside and Sunter, 2001). The aim of this descriptive pilot study is to elicit a homoeopathic symptom picture of HIV positive Black females living in Gauteng, and also to compare this symptom picture to existing HIV proving pictures. Ten HIV positive Black females living in Gauteng were interviewed from a homoeopathic perspective. The participants were aged between twenty-two and forty years, and were in the asymptomatic carrier phase or the AIDS related complex (ARC) phase of HIV infection. None of the participants were receiving antiretroviral treatment. The researcher utilized a set questionnaire to conduct the interviews with. Each interview was compared to one another to determine the common themes and trends emerging from the case histories. These common features were utilized to produce a unique homoeopathic symptom picture of HIV infection in Black females. This symptom picture was compared to the existing HIV proving pictures of Stallick’s and Norland’s AIDS nosodes and Chappell’s PC1. The symptom picture was repertorised using the Cara Pro computerized repertory programme to determine possible constitutional and genus epidemicus treatment options for HIV infection as well as to evaluate the miasmatic presentation of HIV. This study indicates that the HIV proving pictures of the AIDS nosodes and PC1 closely match the unique homoeopathic symptom picture derived from this study. Possible genus epidemicus treatment options include Iodium and PC1. A wide variety of constitutional prescription options materialized from this research. This study also supports the idea that HIV/AIDS is a miasm in its own right, and is represented by aspects of the psoric, sycotic, syphilitic, tuburculinic and cancer miasms. This work is dedicated to the memory of Bongi, a fun-loving, sincere and courageous woman, and to all the HIV/AIDS sufferers in South Africa. / Dr. J. Roohani Dr. K.S Peck Dr. T.A Blake

M.Tech. / The worldwide dissemination of Human Immunodeficiency Virus (HIV) over the past four decades has entered our consciousness as one of the most catastrophic examples of the emergence, transmission and propagation of a virus (Department of Health, 2000; Stebbing et al., 2004). Globally, an estimated 40.3 million people are living with the virus. In 2005 alone, the World Health Organisation estimated that there were close to five million new HIV infections worldwide (UNAIDS/WHO, 2005). Southern Africa is experiencing an HIV/AIDS epidemic of shattering dimensions and, unfortunately, shows little evidence of possible future declines in HIV prevalence. It remains by far the worst-affected region, with 25.8 million people infected at the end of 2005. Of these infected, only one in ten Africans were receiving anti-retroviral treatment (ART) in mid-2005 (Dorrington et al., 2001; UNAIDS/WHO, 2005). Since South Africa carries the biggest global burden of HIV, it is difficult to provide and sustain treatment for all individuals infected with HIV (Department of Health, 2004b). Previous research on the efficacy of homoeopathic treatment in HIV has been done by Brewitt et al (1999) and Da Silva et al (2005) with beneficial results. The aim of this study was to determine the effect of homoeopathic growth factors (HoGF’s) on CD4 cell count, measurements such as weight and body mass index (BMI), symptoms associated with HIV/AIDS, and quality of life of participants living with HIV. The research was conducted on a sample of twenty five participants (n=25) drawn from a population of persons from eighteen to sixty years of age. Twenty two participants (n=22) completed the research. Participants were recruited from the Inkanyezi ARV Clinic, situated in an informal settlement in Orange Farm, south of Johannesburg, South Africa. The recruited participants were requested to read and sign the Participant Information and Consent form (Appendix A) providing them with the necessary information regarding the research. The duration of the clinical trial was thirteen weeks. Analysis of CD4 cell count, measurements of weight and body mass index (BMI) and symptoms associated with HIV/AIDS were conducted at day 1, week 5, week 9 and week 13. A quality of life questionnaire was conducted and analysed at day 1 and week 13. The HoGF medication was administered to each participant, who received sufficient medication until the next follow up consultation. This allowed the researcher to monitor patient compliance. One tablet was given three times a day, for a thirteen-week period. The participants were instructed to suck or chew the pleasant tasting, white tablet. The statistical models such as the repeated measures ANOVA analysis test, the non-parametric Wilcoxon test and the McNemar test were used to statistically analyse the data. The resultant analyses of the data have provided the following conclusions. HoGF treatment did not improve overall immune function of the participants, as there was a decrease in the average CD4 cell count of the HIV infected adults over the 13 week period. HoGF was effective in increasing immune functionality of the major symptomatic group but did not show improved immune functionality in the asymptomatic or minor symptomatic groups. There was, however, an overall decrease in the occurrence of the common symptoms of HIV seen in the entire sample group and HoGF intervention stabilised weight and BMI over the trial period. HoGF treatment also demonstrated an improvement in the quality of life of the participants. There were no reported signs of adverse side effects while on HoGF treatment. The results of this study are expected to initiate further research in the area of homoeopathy and HIV/AIDS. It is recommended that future studies include a control group with placebo for inter-group comparisons. This HoGF treatment can therefore be seen as a possible complementary treatment option for treating the common symptoms associated with HIV/AIDS in the absence of ART, and maintaining wellness in HIV patients. / Dr. R. Razlog Dr. M. Da Silva

M.Tech. / Since its discovery in 1983, millions of people worldwide have been infected with the human immunodeficiency virus (HIV). HIV is a singlestranded retrovirus belonging to the Lentivirinae subfamily of retroviruses and is responsible for the acquired immune deficiency syndrome (AIDS) (Haslett et al, 2002). The infection results in a wide range of clinical manifestations related to defective cell-mediated immunity (Beers and Berkow, 1999). At the end of the twentieth century, over 21 million individuals worldwide had died from AIDS, over 34 million were living with the HIV infection, and over 95% of HIV-infected persons resided in developing nations (Klatt, 2005). At present, 40 million people worldwide are infected with HIV/AIDS of which more than 26 million reside in Africa (Treatment Access, 2005). Sutherlandia frutescens, a medicinal plant from South Africa has documented anti-cancer and antiviral activity. One of the active compounds of this plant is L-canavanine, a cytokine-inducible nitric oxide synthase (iNOS) inhibitor (Van Wyk and Gericke, 2000). In minute doses, the iNOS inhibitor may stimulate nitric oxide (NO) release to counteract retrovirus replication. This study aimed to ascertain the effect of Sutherlandia frutescens 200CH on CD4 cell counts and symptomatology in persons infected with HIV. Study parameters involved recording of vital signs, symptomatology and CD4 analysis at three separate consultations over a ten-week period. All information was collected and collated for statistical or descriptive analysis. The research study was carried out on a random sample size of twenty-six participants, between the age of seventeen and fifty years over a period of ten weeks. Participants included both genders and had been previously diagnosed HIV-positive. Persons using antiretroviral treatment or falling into Category C as specified in the Centres for Disease Control Classification (Appendix B), were excluded from the sample group. Participants acted as own controls for the study with the use of a CD4 analysis baseline reading at the first consultation. Participants were then assessed at mid-term (week 5) and final consultations (week 10) during the study. Sutherlandia frutescens 200CH, in granule form, was taken sublingually once a day for two weeks, with participants then taking no medication for three weeks until the mid-term consultation. The treatment regimen was repeated in the second half of the study. Physical examinations to assess vital signs and opportunistic infections, completion of a health status questionnaire and report-back sessions were conducted at all consultations to determine a general symptomatic picture of research participants. Blood samples taken at all consultations were analysed for CD45+ white cell count, CD4 percentage of lymphocytes and absolute CD4 cell count. The McNemar test and a One Factor Repeated Measure (ANOVA) test were used to give statistical results and to form a profile analysis. Analysed results show that treatment with Sutherlandia frutescens 200CH significantly improves several common signs and symptoms experienced by HIV positive people, including oral candidiasis, fever and skin rashes; a number of other pathologies showed improvement, but not to a statistically significant level. The analysis of CD4 cell counts demonstrated a significant decrease of absolute CD4 cell counts during the course of the study, even in the presence of a stable CD4 percentage. Statistical analysis also indicated a lack of consistency in change of CD4 percentage and absolute CD4 between participants, as well as a lack of correlation between change of CD4 percentage and absolute CD4 changes. As NO was not tested directly no assumption can be made as to how these results might have been influenced. Further research into the use of Sutherlandia frutescens in the treatment of HIV is none the less to be recommended given its reported large number of medicinal properties and its extensive use as an herbal supplement in HIV treatment in South Africa.

M. Tech / HIV/AIDS is currently one of the most devastating conditions affecting the health of millions throughout the world. In South Africa it is estimated that 4,74 million individuals between 15-49 years are infected with HIV despite the intensive HIV prevention programs that are in place. KwaZulu Natal (KZN) province of South Africa has the highest HIV prevalence in the country (Statistics South Africa, 1996; South African DOH, 2001). Only in August 2003, the South African government announced that it would provide anti-aids drugs free of charge in the public sector. Previously this was unavailable to most HIV-infected South Africans. However despite the governments plan to roll out the provision of ARVs, there are mammoth logistical and human capacity challenges confronting the implementation of a treatment program of this magnitude. Furthermore due to the rapid spread of HIV/AIDS, the high cost of treatment and the association of symptomatic treatment with emergence of drug resistance, many patients with HIV/AIDS are seeking help from alternative systems of medicine. With the worldwide sales of homoeopathic products in 1997 estimated to be $1.5 billion, homoeopathy is growing and becoming an important aspect of healthcare. However in South Africa homoeopathy is relatively new and there seems to be a limited awareness of homoeopathy amongst the public and healthcare authorities. For this reason the Technikon Witwatersrand’s’ (TWR), Department of Homoeopathy has instituted a 3 Phase HIV/AIDS Research strategy in order to identify alternative remedies and support structures that could be useful in controlling the HIV/AIDS pandemic. This study aims to achieve phase one of the TWR’s 3 phase strategy. This study initiated the collection of basic data on the extent homoeopaths are treating HIV/AIDS, the current approaches utilised by the homoeopaths in KwaZulu Natal in the treatment of HIV/AIDS and the need for additional training for homoeopaths with regards to HIV/AIDS. The study was carried out by using the survey method and the measuring tool was a self-administered questionnaire as well as an interview. The study population (n = 59) comprised only registered homoeopathic practitioners of KwaZulu-Natal (KZN). The study was completed in four stages. Stage 1 comprised mailing a covering letter together with the questionnaire and self addressed stamped return envelope. Stage 2 and 3 involved the mailing of reminder letters to the study population. Stage 4 which was only carried out when the data from the questionnaire was analyses consisted of either a face to face or telephonic interview of practitioners. The data was analysed by means of descriptive statistics using the SPSS version 11.0 statistical program. The Mann-Whitney test, Kruskal-Wallis Test (non-parametric ANOVA) and Dunn’s Multiple Comparison Test which was used as a post-test to the Kruskal-Wallis and the Spearman Rank Correlation were used to test the association between various factors in the questionnaire. On analysing the results it can be seen that the demographics of practitioners who treat HIV-positive patients have been influenced by the political-legal and training history of Homoeopathy in South Africa. The majority of respondents in this survey are graduates of Durban Institute of Technology are White and have had less than ten years experience. It has been found that locality of the practice, race of the practitioner and the number of years in practice has an influence on the number of HIV-positive patients that the practitioner treats. Homoeopaths who practice in rural areas rather than urban, treat larger numbers of HIV-positive patients. Black homoeopaths see more HIV-positive patients than white homoeopaths. The longer a practitioner was in practice the more HIV-positive patients are seen. Homoeopathic simplex was the most frequently used treatment for HIV/AIDS patients. This was followed by vitamin supplementation and the use of homoeopathic complex. In addition, it was found that more than 90% of the respondents felt the need for further training with regards to HIV/AIDS. Specific topics that should be addressed were evaluated. This study raised many areas of concern with regards to the treatment of HIV/AIDS using homoeopathy and strongly highlights the need for more information and further research. / Professor A. N. Smith Dr. N. Wolf