Search

Introduction: This study aimed at examining the feasibility issues of comparing individualized homeopathic medicines (IHMs) with identical-looking placebos for treating knee osteoarthritis (OA)., Methods: Forty eligible patients participated in this double-blind, randomized (1:1), placebo-controlled feasibility trial in the outpatient clinics of a homeopathic hospital in West Bengal, India. Either IHMs or identical-looking placebos were administered, along with mutually agreed-upon concomitant care guidelines. The Knee Injury and Osteoarthritis Outcome Score (KOOS) was the primary outcome measure, along with derived Western Ontario and McMaster Universities Arthritis Index (WOMAC) scores from KOOS. The EQ-5D-5L questionnaire and Visual Analog Scale (VAS) were the secondary outcomes. All were measured at baseline and after 2 months. Group differences and effect sizes (Cohen's d ) were estimated using an intention-to-treat approach. p -Values less than 0.05 (two-tailed) were considered statistically significant., Results: Enrolment/screening and trial retention rates were 43% and 85% respectively. Recruitment was difficult owing to the coronavirus disease 2019 (COVID-19) lockdown. Group differences were statistically significant, favoring IHMs against placebos in all the KOOS sub-scales: symptoms ( p  < 0.001), pain ( p  = 0.002), activities of daily living ( p  < 0.001), sports or recreation ( p  = 0.016), and quality of life ( p  = 0.002). Derived WOMAC scores from KOOS favored IHMs against placebos: stiffness ( p  < 0.001) and pain ( p  < 0.001). The EQ-5D-5L questionnaire score ( p  < 0.001) and EQ-5D-5L VAS scores ( p  < 0.001) also yielded significant results, favoring IHMs over placebos. All the effect sizes ranged from moderate to large. Sulphur was the most frequently prescribed homeopathic medication. Neither group reported any harm or serious adverse events., Conclusion: Although recruitment was sub-optimal due to prevailing COVID-19 conditions during the trial, the action of IHMs was found to be superior to that of placebos in the treatment of knee OA. Larger and more definitive studies, with independent replications, are warranted in order to substantiate the findings., Trial Registration: CTRI/2021/02/031453., Competing Interests: None declared., (Faculty of Homeopathy. This article is published by Thieme.)

Urban forests face multiple human-mediated pressures leading to compromised ecosystem structure and functioning. Therefore, understanding ecosystem structure in response to ongoing pressures is crucial for sustaining ecological integrity and human well-being. We aim to assess the disturbance and its effects on the vegetation structure of urban forests in Chandigarh using a combination of remote sensing techniques and vegetation surveys. The disturbance was evaluated as a change in NDVI (Normalised Difference Vegetation Index) from 2001 to 2021 by applying the BFAST (Breaks For Additive Season and Trend) algorithm to the MODIS satellite imagery data. A vegetation survey was conducted to compare the species composition, taxonomic and phylogenetic diversity as measures of forest vegetational structure. While signals of disturbance were evident, the changes in vegetation structure were not well established from our study. Further, this analysis indicated no significant differences in vegetation composition due to disturbance (F 1,12  = 0.91, p = 0.575). However, the phylogenetic diversity was substantially lower for disturbed plots than undisturbed plots, though the taxonomic diversity was similar among the disturbed and undisturbed plots. Our results confirmed that disturbance effects are more prominent on the phylogenetic than taxonomic diversity. These findings can be considered early signals of disturbance and its impact on the vegetation structure of urban forests and contribute to the knowledge base on urban ecosystems. Our study has implications for facilitating evidence-based decision-making and the development of sustainable management strategies for urban forest ecosystems., (© 2024. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Background: Methadone take-home doses for opioid dependence treatment are strictly regulated due to diversion and overdose concerns, so patients must visit the clinic daily for dispensing. This was also done in India until the COVID-19 pandemic, when lockdown restriction compelled take- home dispensing of methadone. This study examined experience of patients who received take- home methadone during COVID-19 pandemic in India., Methods: Observational, cross-sectional design. We contacted all consenting methadone centres in India during the lockdown and selected those that provided take-home doses for the study. Patients who received daily methadone before the lockdown and take-home doses after were interviewed using a study-specific questionnaire., Results: The study had 210 participants. Take-home methadone was dispensed for 2.5 days on average in each dispensing. When taking methadone at home, 3.3% split their dose 25% took less than the prescribed dose to save it for a rainy days, and 3.3% reported an overdose episode. Adherence improved in 58.6% participants after take-home methadone. Participants perceived many benefits from take-home methadone such as reduced hospital visits and travel time to collect methadone, improvement in work, and financial savings. About 54.3% participants reported storing their take-home doses safely, and 1.9% reported that their family consumed methadone by mistake., Conclusions: Take-home methadone was found to be beneficial to most participants in terms of time saved and improved productivity. Preconceived concerns of providing take-home methadone in terms of its overdose, diversion, or accidental ingestion by others are not commonly seen when individuals are provided take-home doses of methadone., (Copyright © 2024 Elsevier B.V. All rights reserved.)

In recent years, South Asian economies have observed rapid urbanization along with expanding informal economy that poses a serious threat to environmental quality. This study examines the impact of urbanization and informal economy on the ecological footprint of selected South Asian countries. Results indicate that urbanization and informal economy increase the environmental degradation in South Asia and the estimates are statistically significant in the long run. In the short run, urbanization positively affects the ecological footprint in Bangladesh, Pakistan, Sri Lanka, and Nepal except India, while the informal economy also enhances environmental degradation for all the selected countries except Bangladesh. Most surprisingly, the interaction term of urbanization and informal economy has a negative impact on ecological footprint, and the coefficient is statistically significant as well. To combat the environmental issues in South Asia, detailed policy recommendations have been suggested at the end., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

This study examines the impact of foreign direct investment (FDI) on environmental degradation by keeping in view the role of institutional quality (IQ) in the South Asian region. Second-generational unit root test is used to address the issue of cross-sectional dependency. Mixed order of integration enabled us to use panel autoregressive distributed lag (ARDL) method to investigate short-run and long-run association. Moreover, this study also employs Granger causality test to explore causalities among the selected variables. Empirical results reveal that FDI has a positive and statistically significant effect on environmental degradation. Institutional quality is measured as rule of law has insignificant impact on ecological footprint both in short run as well as long run. However, government stability decreases environmental degradation while corruption enhances environmental hazards tremendously. This study also supports environmental Kuznets curve (EKC) for the South Asian countries. This study emphasized the role of political institutions in environmental degradation. South Asian countries must focus on the implementation of environmental laws and regulations by improving the quality of institutions to achieve the goal of sustainable development.

This study aims to investigate the effect of economic globalization and technological changes on the environmental degradation of the South Asian countries over the time span of 1975-2017. Westerlund (Oxf Bull Econ Stat 69:709-748, 2007) cointegration test is employed to estimate the presence of long-run relationship between globalization, technological changes, and environmental degradation. To determine the validity of the Environmental Kuznets Curve, this study employs panel autoregressive distributional lag (ARDL) model. Empirical findings of this study yield the inverted U-shaped association between globalization, technological changes, and environmental degradation which validate that EKC holds in the South Asian countries. The results indicate that the measures of globalization such as FDI, trade openness, and KOF index have positive and statistically significant effect on ecological footprint. However, technological changes measured as patents registered by residents have an insignificant impact on environmental quality. This study infers that the globalization has increased environmental degradation through unsustainable economic development in South Asian countries. These countries should shift to renewable energy resources to protect the environment and mitigate greenhouse gas emissions.

Bronchial asthma is an important public health problem in India with significant morbidity. Several international guidelines for diagnosis and management of asthma are available, however there is a need for country-specific guidelines due to vast differences in availability and affordability of health-care facilities across the globe. The Indian Chest Society (ICS) and the National College of Chest Physicians (NCCP) of India have collaborated to develop evidence-based guidelines with an aim to assist physicians at all levels of health-care in diagnosis and management of asthma in a scientific manner. Besides a systematic review of the literature, Indian studies were specifically analysed to arrive at simple and practical recommendations. The evidence is presented under these five headings: (1) definitions, epidemiology and impact, (2) diagnosis, (3) pharmacologic management of stable disease, (4) management of acute exacerbations, and (5) non-pharmacologic management and special situations. The modified grade system was used for classifying the quality of evidence as 1, 2, 3, or usual practice point (UPP). The strength of recommendation was graded as A or B depending upon the level of evidence.

Is discrimination based on caste equivalent to racism? This paper explores the complex relationship between genetic, race and caste. It also discusses the debate over the exclusion of a discussion of caste-based discrimination at the 2001 World Conference against Racism, Racial Discrimination, Xenophobia and Related Intolerance held in Durban, South Africa.