Mahesh Bhattacharyya Homeopathic Medical College and Hospital

Allium sativum L. (Garlic) is a fragrant herb and tuber-derived spice that is one of the most sought-after botanicals, used as a culinary and ethnomedicine for a variety of diseases around the world. An array of pharmacological attributes such as antioxidant, hypoglycemic, anti-inflammatory, antihyperlipidemic, anticancer, antimicrobial, and hepatoprotective activities of this species have been established by previous studies. A. sativum houses many sulfur-containing phytochemical compounds such as allicin, diallyl disulfide (DADS), vinyldithiins, ajoenes ( E -ajoene, Z -ajoene), diallyl trisulfide (DATS), micronutrient selenium (Se) etc. Organosulfur compounds are correlated with modulations in its antioxidant properties. The garlic compounds have also been recorded as promising immune-boosters or act as potent immunostimulants. A. sativum helps to treat cardiovascular ailments, neoplastic growth, rheumatism, diabetes, intestinal worms, flatulence, colic, dysentery, liver diseases, facial paralysis, tuberculosis, bronchitis, high blood pressure, and several other diseases. The present review aims to comprehensively enumerate the ethnobotanical and pharmacological aspects of A. sativum with notes on its phytochemistry, ethnopharmacology, toxicological aspects, and clinical studies from the retrieved literature from the last decade with notes on recent breakthroughs and bottlenecks. Future directions related to garlic research is also discussed.

BACKGROUND: The development of an effective vaccine against visceral leishmaniasis (VL) caused by Leishmania donovani is an essential aim for controlling the disease. Use of the right adjuvant is of fundamental importance in vaccine formulations for generation of effective cell-mediated immune response. Earlier we reported the protective efficacy of cationic liposome-associated L. donovani promastigote antigens (LAg) against experimental VL. The aim of the present study was to compare the effectiveness of two very promising adjuvants, Bacille Calmette-Guerin (BCG) and Monophosphoryl lipid A (MPL) plus trehalose dicorynomycolate (TDM) with cationic liposomes, in combination with LAg, to confer protection against murine VL. RESULTS: All the three formulations afforded significant protection against L. donovani in both the visceral organs, liver and spleen. Although comparable level of protection was observed in BCG+LAg and MPL-TDM+LAg immunized mice, highest level of protection was exhibited by the liposomal LAg immunized group. Significant increase in anti-LAg IgG levels were detected in both MPL-TDM+LAg and liposomal LAg immunized animals with higher levels of IgG2a than IgG1. But BCG+LAg failed to induce any antibody response. As an index of cell-mediated immunity DTH responses were measured and significant response was observed in mice vaccinated with all the three different formulations. However, highest responses were observed with liposomal vaccine immunization. Comparative evaluation of IFN-gamma and IL-4 responses in immunized mice revealed that MPL-TDM+LAg group produced the highest level of IFN-gamma but lowest IL-4 level, while BCG+LAg demonstrated generation of suboptimum levels of both IFN-gamma and IL-4 response. Elicitation of moderate levels of prechallenge IFN-gamma along with optimum IL-4 corresponds with successful vaccination with liposomal LAg. CONCLUSION: This comparative study reveals greater effectiveness of the liposomal vaccine for protection against progressive VL in BALB/c. Again, evaluation of the immune responses by vaccination emphasizes the need of stimulation of potent cellular immunity based on both Th1 and Th2 cell responses to confer protection against VL.

OBJECTIVES: To understand reasons for lost-to-follow-up (LTFU) from a community-based antiretroviral therapy program in Uganda. STUDY DESIGN: Retrospective cohort of patients LTFU between May 31, 2001, to May 31, 2010, was examined. A representative sample of 579 patients traced to ascertain their outcomes. METHODS: Mixed methods were used. Using "stopped care" as the hazard and "self-transferred" as the comparator, we examined using Cox proportional multivariable model risk factors for stopping care. RESULTS: Overall, 2933 of 3954 (74.0%) patients were LTFU. Of 579 of 2933 (19%) patients sampled for tracing, 32 (5.5%) were untraceable, 66(11.4 %) were dead, and 481 (83.0%) found alive. Of those found alive, 232 (40.0%) stopped care, 249 (43.0%) self-transferred, whereas 61 (12.7%) returned to care at Reach Out Mbuya HIV/AIDS Initiative. In adjusted hazards ratios, born-again religion, originating from outside Kampala, resident in Kampala for <5 years but >1 year, having school-age children who were out of school, non-HIV disclosure, CD4 counts >250 cells per cubic millimeter and pre-antiretroviral therapy were associated with increased risk of stopping care. Qualitative interviews revealed return to a normal life as a key reason for LTFU. Of 61 patients who returned to care, their median CD4 count at LTFU was higher than on return into care (401/mm³ vs. 205/mm³, P < 0.0001). CONCLUSIONS: Many patients become LTFU during the course of years, necessitating the need for effective mechanisms to identify those in need of close monitoring. Efforts should be made to improve referrals and mechanisms to track patients who transfer to different facilities. Additionally, tracing of patients who become LTFU is required to convince them to return.

More than a half-century has passed since it was discovered that phytohormone cytokinin (CK) is essential to drive cytokinesis and proliferation in plant tissue culture. Thereafter, cytokinin has emerged as the primary regulator of the plant cell cycle and numerous developmental processes. Lately, a growing body of evidence suggests that cytokinin has a role in mitigating both abiotic and biotic stress. Cytokinin is essential to defend plants against excessive light exposure and a unique kind of abiotic stress generated by an altered photoperiod. Secondly, cytokinin also exhibits multi-stress resilience under changing environments. Furthermore, cytokinin homeostasis is also affected by several forms of stress. Therefore, the diverse roles of cytokinin in reaction to stress, as well as its interactions with other hormones, are discussed in detail. When it comes to agriculture, understanding the functioning processes of cytokinins under changing environmental conditions can assist in utilizing the phytohormone, to increase productivity. Through this review, we briefly describe the biological role of cytokinin in enhancing the performance of plants growth under abiotic challenges as well as the probable mechanisms underpinning cytokinin-induced stress tolerance. In addition, the article lays forth a strategy for using biotechnological tools to modify genes in the cytokinin pathway to engineer abiotic stress tolerance in plants. The information presented here will assist in better understanding the function of cytokinin in plants and their effective investigation in the cropping system.

BACKGROUND: Iron-deficiency anemia is considered to be a major health problem in India. This can complicate a normal pregnancy resulting in poor maternal and fetal outcomes. Iron-folic-acid (IFA) supplementation to antenatal and postnatal mothers given through the National Health Mission (NHM) serves as a major tool to combat this problem. AIM: This study aimed to assess compliance to IFA supplement and associated factors among antenatal mothers in a district of West Bengal, India. METHODS: A cross-sectional observational study was conducted among 208 pregnant mothers attending different subcenters, using multistage sampling technique. Data were collected on their demographic, obstetric profile, compliance to IFA tablets, and knowledge on various health care-related factors through direct interviews. Data were analyzed using SPSS 22.0 (licensed) considering the confidence interval to be 95%. RESULTS: Compliance rate was 81.74%. The most common cause of noncompliance was forgetfulness (73.7%). On multivariate regression analysis, age, history of deworming, and education became the significant predictors for noncompliance to IFA. CONCLUSIONS: Compliance to IFA supplementation was better than the national average, although deworming and education can lead to a better outcome. Health workers played a pivotal role for the success of this national program.

Selenium, an essential micronutrient, is associated with antioxidant functions, physiological defence mechanisms against different diseases including several types of cancers. Search for new selenium compounds with more chemopreventive activities and lesser toxicities are in progress. In the present study, the antioxidative roles of a synthetic organoselenium compound, diphenylmethyl selenocyanate, were evaluated against 7,12-dimethylbenz(a)anthracene (DMBA)/croton oil-induced two-stage mouse skin carcinogenesis model. The compound was administered orally in carcinogen-induced mice in two different non-toxic doses: 2 mg/kg body weight and 3 mg/kg body weight. Significant inhibition in the incidence of papilloma formation (58-80%) as well as in the cumulative number of papilloma per papilloma-bearing mouse were observed in the treated groups as compared with the carcinogen control group. The compound was also found to significantly upregulate different phase II detoxifying enzymes in liver cytosol such as glutathione-S-transferase (P<0.01), catalase (P<0.01) and superoxide dismutase (SOD) (P<0.01) when measured after 15 days and also after 12 weeks of first DMBA treatment. Lipid peroxidation measured as the thiobarbituric acid reactive substances in liver microsomes was significantly inhibited (P<0.05) in a dose-dependent manner by diphenylmethyl selenocyanate. Thus the compound exerts its chemopreventive activity by reducing papilloma formation during chemically induced carcinogenesis, which in turn, may be through modulating the level of lipid peroxidation and phase II detoxifying enzyme system at the doses evaluated.

We studied the effects of the local anesthetics, procaine and benzocaine, on the action potential and force of canine ventricular muscle and Purkinje fibers. In ventricular muscle, procaine often shifted the plateau to a more positive value and increased the force of contraction, whereas benzocaine shortened the action potential and decreased contractile force. In Purkinje fibers, both local anesthetics reduced contractile force and decreased the duration of the action potential markedly. In ventricular muscle fibers norepinephrine potentiated the positive inotropic effect of procaine and changed the effects of benzocaine from a negative to a positive inotropic effect. The potentiating effect of procaine on contraction was eliminated by propranolol. In the presence of norepinephrine (and the absence of propranolol), in Purkinje fibers both anesthetics decreased force but less than in the absence of norepinephrine. In the presence of tetrodotoxin (TTX) and norepinephrine, procaine and benzocaine increased contractile force of muscle fibers. Under the same conditions in Purkinje fibers, procaine increased contractile force and benzocaine decreased it (but less than in the absence of TTX). Administration of veratridine increased contractile force in both ventricular muscle and Purkinje fibers: under these conditions, both local anesthetics decreased contractile force in both tissues. We conclude that: (1) the positive inotropic effects of procaine and benzocaine are mediated through an adrenergic mechanism; (2) the negative inotropic effect is at least in part mediated through a reduction of sodium influx; and (3) the negative inotropic effect is more pronounced in Purkinje fibers because of a larger steady state sodium influx during the plateau.

<ns4:p> <ns4:bold>Background:</ns4:bold> The study’s aim is to examine adolescent girls’ attitudes toward the continuation or discontinuation of female genital mutilation (FGM) in association with their demographics in seven different countries in Africa. </ns4:p> <ns4:p> <ns4:bold>Methods:</ns4:bold> Data from the women’s survey of the Demographic and Health Surveys (DHS) conducted by the respective ministries (of Health and Family Welfare) in Egypt, Guinea, Kenya, Mali, Niger, Senegal and Sierra Leone were used. Adolescent girls (15–19 years) were included in the current analysis: Egypt (N=636), Guinea (N=1994), Kenya (N= 1767), Mali (N=2791), Niger (N=1835), Senegal (N=3604), Sierra Leone (N=1237). </ns4:p> <ns4:p> <ns4:bold>Results:</ns4:bold> Prevalence of supporting the continuation of FGM among adolescent girls was in Egypt 58%, Guinea 63%, Kenya 16%, Mali 72%, Niger 3%, Senegal 23%, and Sierra Leone 52%. Being Muslim and having low economic status were significantly associated with supporting the continuation of FGM in five of the participating countries. Girls having no education or only primary education in Guinea, Kenya, Mali and Sierra Leone exhibited a higher likelihood of supporting FGM than girls with secondary or higher education. In Egypt, Niger and Senegal there was no association between education and supporting FGM. The girls who stated that they had no exposure to media showed the higher likelihood of supporting FGM in Guinea, Kenya, and Senegal than those with exposure to media. </ns4:p> <ns4:p> <ns4:bold>Conclusions:</ns4:bold> The current study argues that increasing media coverage and education, and reducing poverty are of importance for shifting adolescent girls’ attitudes in favor of discontinuation of FGM. </ns4:p>

BACKGROUND: Visceral leishmaniasis (VL), is a parasitic disease that causes serious medical consequences if treatment is delayed. Despite a decline in the number of VL cases in the Indian subcontinent, the commencement of the disease in newer areas continues to be a major concern. Although serological diagnosis mainly by immunochromatographic tests has been found to be effective, a test of cure in different phases of treatment is still desired. Even though a good prophylactic response has been obtained in murine models by a number of vaccine candidates, few have been proposed for human use. METHODS: In this study, nine antigenic components (31, 34, 36, 45, 51, 63, 72, 91 and 97 kDa) of Leishmania promastigote membrane antigens (LAg), were electroeluted and evaluated through ELISA to diagnose and distinguish active VL from one month cured and six months post-treatment patients. Further, to investigate the immunogenicity of electroeluted proteins, human PBMCs of cured VL patients were stimulated with 31, 34, 51, 63, 72 and 91 kDa proteins. RESULTS: We found that 34 and 51 kDa proteins show 100% sensitivity and specificity with healthy controls and other diseases. After six months post-treatment, antibodies to 72 and 91 kDa antigens show a significant decline to almost normal levels. This suggests that 34 and 51 kDa proteins are efficient in diagnosis, whereas 72 and 91 kDa proteins may be used to monitor treatment outcome. In another assay, 51 and 63 kDa proteins demonstrated maximum ability to upregulate IFN-γ and IL-12 with minimum induction of IL-10 and TGF-β. The results indicating that 51 and 63 kDa proteins could be strong candidates for human immunization against VL. In contrast, 34 and 91 kDa proteins demonstrated a reverse profile and may not be a good vaccine candidate. CONCLUSIONS: The preliminary data obtained in this study proposes the potential of some of the antigens in Leishmania diagnosis and for test of cure. Additionally, some antigens demonstrated good immunoprophylactic cytokine production through T cell-mediated immune response, suggesting future vaccine candidates for VL. However, further studies are necessary to explore these antigens in diagnosis and to access the long-term immune response.

UNLABELLED: Few homeopathic complexes seemed to produce significant effects in osteoarthritis; still, individualized homeopathy remained untested. We evaluated the feasibility of conducting an efficacy trial of individualized homeopathy in osteoarthritis. A prospective, parallel-arm, double-blind, randomized, placebo-controlled pilot study was conducted from January to October 2014 involving 60 patients (homeopathy, n = 30; placebo, n = 30) who were suffering from acute painful episodes of knee osteoarthritis and visiting the outpatient clinic of Mahesh Bhattacharyya Homeopathic Medical College and Hospital, West Bengal, India. Statistically significant reduction was achieved in 3 visual analog scales (measuring pain, stiffness, and loss of function) and Osteoarthritis Research Society International scores in both groups over 2 weeks (P < .05); however, group differences were not significant (P > .05). Overall, homeopathy did not appear to be superior to placebo; still, further rigorous evaluation in this design involving a larger sample size seems feasible in future. TRIAL REGISTRATION: Clinical Trials Registry, India (CTRI/2014/05/004589).

Background: Hypertension is the most common cardiovascular disorder posing a major public health challenge to the population. Homoeopathy, although widely used in hypertension, is assumed to have nothing but placebo effects and its specific clinical effects are frequently ascribed as implausible. Aims: To evaluate whether individualized homoeopathy can produce any significant effect different from placebo in essential hypertension by comparing the lowering of blood pressure between groups. Settings and Design: A prospective, double-blind, randomized, placebo-controlled, parallel-arm clinical trial was conducted at the Outpatient Clinic of the Mahesh Bhattacharyya Homoeopathy Medical College and Hospital, West Bengal. Material and Methods: Out of 233 hypertensives assessed for eligibility, 150 were enrolled and randomized (verum/homoeopathy 70, control/placebo 80). A total of 18 dropped out and 132 were regular (verum 64, control 68). The outcome measures were assessed after three months and six months. Statistical Analysis: The intention-to-treat population was subjected to statistical analysis. Group differences were tested using the χ2 test and independent t test. Repeated measure (ANOVA) was performed to compare the data of two groups obtained longitudinally at baseline, three months and six months. Results: The baseline data were not significantly different between the groups. After six months, mean Systolic Blood Pressure (SBP) reduction was 26.6 mm Hg (95% CI 21.5, 31.7) in the homoeopathy group and SBP increased by 3.6 mm Hg (95% CI -8.7, 1.5) in the placebo group. Similarly, the mean Diastolic Blood Pressure (SBP) in the homoeopathy group reduced by 11.8 mm Hg (95% CI 9.2, 14.4) and increased by 1.6 mm Hg (95% CI -3.6, 0.4) in the placebo group. Repeated measures ANOVA also showed significant difference (P=0.0001) between the groups. Natrum muriaticum, Calcarea carbonica, Sulphur, Thuja occidentalis, Nitric acid and Medorrhinum were frequently prescribed. Conclusion: Individualized homoeopathy produced a significantly different hypotensive effect than placebo.

Homeopathy research has focused on chronic conditions; however, the extent to which current homeopathic care is compliant with the Chronic Care Model (CCM) has been sparsely shown. As the Bengali Patient-Assessed Chronic Illness Care (PACIC)-20 was not available, the English questionnaire was translated and evaluated in a government homeopathic hospital in West Bengal, India. The translation was done in six steps, and approved by an expert committee. Face validity was tested by 15 people for comprehension. Test/retest reliability (reproducibility) was tested on 30 patients with chronic conditions. Internal consistency was tested in 377 patients suffering from various chronic conditions. The questionnaire showed acceptable test/retest reliability [intraclass correlation coefficient (ICC) 0.57-0.75; positive to strong positive correlations; p < 0.0001] for all domains and the total score, strong internal consistency (Cronbach's α = 0.86 overall and 0.65-0.82 for individual subscales), and large responsiveness (1.11). The overall mean score percentage seemed to be moderate at 69.5 ± 8.8%. Gender and presence of chronic conditions did not seem to vary significantly with PACIC-20 subscale scores (p > 0.05); however, monthly household income had a significant influence (p < 0.05) on the subscales except for "delivery system or practice design." Overall, chronic illness care appeared to be quite promising and CCM-compliant. The psychometric properties of the Bengali PACIC-20 were satisfactory, rendering it a valid and reliable instrument for assessing chronic illness care among the patients attending a homeopathic hospital.

OBJECTIVE: We examined the cost of lost productivity due to erectile dysfunction (ED) and employer benefit exclusion of penile prosthesis implantation (PPI) among men with employer-sponsored health insurance. METHODS: A decision-analytic model was developed using administrative claims data, US Bureau of Labor Statistics, and published literature. The economic impact of ED productivity loss and PPi benefit exclusion was reported in2019USD. RESULTS: Men with ED had an additional 282.7 hours/ year of work impairment compared to men without ED, resulting in annual incremental costs of $7270. US employers excluding PPi benefits could lose $9.3billion/year of work due to additional work impairment from ED. CONCLUSIONS: Productivity loss due to ED and PPI benefit exclusion have considerable economic impacts on men with ED and their employers. continuous advocacy for benefit exclusion removal is needed to ensure appropriate patient access.

Documentation of prescriptions and clinical outcomes in routine homeopathic practice is a prerequisite for conducting targeted research in homeopathy. Six homeopathic physicians participated in methodical data collection over a 3-month period in 6 outpatient departments of Mahesh Bhattacharyya Homeopathic Medical College and Hospital, West Bengal, India. A specifically designed Microsoft Excel spreadsheet enabled recording of consecutive appointments-date, patient identity, medical condition/complaint, whether chronic/acute, new/follow-up case, patient-assessed outcome (7-point Likert-type scale: -3 to +3), prescribed homeopathic medication, and whether other medication/s being taken for the condition. Spreadsheets were submitted monthly for data synthesis and analysis. A total of 1972 patients' follow-up generated data of 2905 appointments, of which 2272 (78.2%) were positive, 183 (6.3%) negative, and 450 (15.5%) showed no change. Strongly positive outcomes (scores of +2/+3) were recorded in osteoarthritis, piles, cough, dysfunctional uterine bleeding, chronic suppurative otitis media, and conjunctivitis. This systematic recording short-listed promising areas of future homeopathic research.

High prevalence of undiagnosed cases of diabetes mellitus and poor knowledge, awareness, and practice has increased premature death, costly complications, and financial burden. A cross-sectional survey was conducted in November 2014 on 273 diabetics and 355 nondiabetics in 3 government homeopathic hospitals in West Bengal, India. A self-administered questionnaire assessing knowledge, awareness, and practice related to diabetes was used. A total of 17.5% to 29.3% of the participants were aware of the normal blood sugar level. Lack of insulin, frequent urination, hypertension, and poor wound healing were identified most frequently as the cause, symptom, association, and complications. A total of 35.5% to 46.5% said that diabetes was preventable; 14.1% to 31.9% knew that diabetes was controllable rather than curable. Consumption of planned diet, avoiding sugar, and testing blood sugar were the most frequently identified components of healthy lifestyle, diabetic diet, and diagnostic domain. Diabetics had higher knowledge and awareness than nondiabetics (P < .0001); still the latter need to be made aware and knowledgeable to curtail the ever-increasing burden of diabetes.

This paper measures the degree of inequality in child mortality rates across districts in India using data from the 1981, 1991 and 2001 Indian population censuses. Results show that child mortality is more concentrated in less developed districts in all three census years. Furthermore, between 1981 and 2001, the inequality in child mortality seems to have increased to the advantage of the more developed districts. In the decomposition analysis, it is found that while a more equitable distribution of medical facilities and safe drinking water across districts has contributed to reducing inequality in child mortality between 1981 and 1991, different levels of structural change among districts have been responsible for a very large part of the inequality in child mortality to the advantage of the more developed districts in all three census years. The paper concludes with some brief comments on the policy implications of the findings.

Angioleiomyoma is a benign tumour composed of smooth muscle and vascular tissue. Because of the paucity of smooth muscles in the hand other than tunica media of the blood vessels, its occurrence is quite rare in the hand and only few cases are reported in the English literature. We present the case of a 49-year-old man with benign painless swelling on the dorsum of hand. Differential diagnosis of ganglion cyst and tendon sheath tumour were considered. However, excision biopsy revealed angioleiomyoma. At 2-year follow-up, the patient remained asymptomatic with no evidence of recurrence.

The American Patient Activation Measure-22 questionnaire (PAM-22) quantifies the knowledge, skills, and confidence essential to manage own health and health care. It is a central concept in chronic illness care models, but studied sparsely in homeopathic hospitals. PAM-22 was translated into Bengali and a cross-sectional study was undertaken in chronically ill 417 patients visiting the outpatient clinic of Mahesh Bhattacharyya Homeopathic Medical College and Hospital, India. Response rate was 90.41%. Data were analyzed using Rasch rating scale model with Winsteps. Activation score was 54.7 ± 8.04 or 62.13% of maximum score. PAM scores differed significantly by age, education, income, and health status (P < .05). The items had good data quality fit statistics and good range of difficulty. The construct unidimensionality was confirmed by good model fits for Rasch model and principal component analysis of residuals found no meaning structure. The questionnaire showed acceptable psychometrics. Patient activation was moderate and needs to be improved.

An integrated form of the governing equations in terms of pseudopotential higher-order nonlinear and dispersive effects is obtained by applying the reductive perturbation method for ion-acoustic solitary waves in a collisionless unmagnetized multicomponent plasma having warm ions and two-component nonisothermal electrons. The present method is advantageous because instead of solving an inhomogeneous second-order differential equation at each order, as in the standard procedure, we solve a first-order inhomogeneous equation at each order except at the lowest. The expressions of both Mach number and width of the solitary wave are obtained as a function of the amplitude of the wave for third-order nonlinear and dispersive effects. The variations of potential, width, and Mach number against soliton amplitude are shown graphically, taking into consideration the nonisothermality of two-component electrons in the plasma.

Peripheral blood lymphocytes from 11 patients with ovarian carcinoma were incubated several times with autologous tumor extract as well as phytohemagglutinin (PHA) at different concentrations. Lymphocytes from 10 normal, healthy, age-matched females were also studied similarly. Tritiated thymidine incorporation into DNA of transformed lymphocytes was measured. No significant response was obtained with lymphocytes from ovarian cancer patients or normal individuals in the presence of tumor extracts. Of 6 tumor extracts tested, 5 did not have any cytotoxic effect on autologous or on homologous normal healthy lymphocytes. Hence, with this test system employed, no evidence for a cell-mediated immunity to autologous tumor in ovarian cancer patients was observed. PHA, on the other hand, induced vigorous blastogenic response in several ovarian cancer patient's lymphocytes, as well as in all normal healthy lymphocytes, indicating no inherent defect in the T-lymphocyte system of ovarian cancer patients. Only 2 of the patients, when tested for delayed hypersensitivity reaction against a battery of recall antigens and keyhole limpet hematocyanin, were completely anergic. None of the patients responded when skin tested with their own tumor extracts.