Efficacy of individualized homeopathic medicines in treatment of post-stroke hemiparesis: A randomized trial.

BACKGROUND: Hemiparesis is a serious motor impairment following stroke and affecting around 65% of stroke patients. This trial attempts to study the efficacy of individualized homeopathic medicines (IHMs) in comparison with identical-looking placebos in treatment of post-stroke hemiparesis (PSH) in the mutual context of standard physiotherapy (SP). METHODS: A 3-months, open-label, randomized, placebo-controlled trial (n = 60) was conducted at the Organon of Medicine outpatient departments of National Institute of Homoeopathy, West Bengal, India. Patients were randomized to receive IHMs plus SP (n = 30) or identical-looking placebos plus SP (n = 30). Primary outcome measure was Medical Research Council (MRC) muscle strength grading scale; secondary outcomes were Stroke Impact Scale (SIS) version 2.0, Modified Ashworth Scale (MAS), and stroke recovery 0-100 visual analogue scale (VAS) scores; all measured at baseline and 3 months after intervention. Group differences and effect sizes (Cohen's d) were calculated on intention-to-treat sample. RESULTS: Although overall improvements were higher in the IHMs group than placebos with small to medium effect sizes, the group differences were statistically non-significant (all P>0.05, unpaired t-tests). Improvement in SIS physical problems was significantly higher in IHMs than placebos (mean difference 2.0, 95% confidence interval 0.3 to 3.8, P = 0.025, unpaired t-test). Causticum, Lachesis mutus, and Nux vomica were the most frequently prescribed medicines. No harms, unintended effects, homeopathic aggravations or any serious adverse events were reported from either group. CONCLUSION: There was a small, but non-significant direction of effect favoring homeopathy against placebos in treatment of post-stroke hemiparesis. TRIAL REGISTRATION: CTRI/2018/10/016196; UTN: U1111-1221-7664.

Ethnobotanical study of endemic and non-endemic medicinal plants used by indigenous people in environs of Gullele botanical garden Addis Ababa, central Ethiopia: A major focus on Asteraceae family.

Gullele Botanical Garden (GBG) in Addis Ababa, Ethiopia is a joint venture of Addis Ababa government and the university. The garden has been built mainly to conserve the endemic plants and to advance the research on the endemic and non-endemic plants collected from different part of Ethiopia. Many traditional healers from the environs of GBG and different subcities of Addis Ababa depend on the garden for their practice of traditional medicine but there is no systematic documentation of the traditional medicinal knowledge of these healers. The main objective of the present study is to comprehensively document the ethnobotanical and ethnomedicinal information from the traditional healers of different ethnic and cultural groups depending on GBG and to create a database of the endemic plants used by these healers. The ethnobotanical and ethnomedicinal data obtained from 60 traditional healers have been analyzed both qualitatively and quantitatively. A total of 81 medicinal plants belonging to 47 families have been identified. Majority of the plants used belonged to Asteraceae (12) family. The most frequently used plant form and plant parts are herbs and leaves. The major method adopted by the healers for preparation and administration of traditional medicine is crushing and topical, respectively. Skin and general diseases are the most important ailments treated by the healers. The three most cited plants used to treat diseases are Echinops kebericho Mesfin (60), Hagenia abyssinica (Bruce) J.F.Gmel (60) and Laggera tomentosa (A.Rich.) Sch.Bip. ex Oliv. & Hiern (58). The present study is the first systematic, qualitative, and quantitative ethnobotanical analysis and documentation done on the use of the medicinal plants from GBG for traditional medicine. In addition, our study reveals that E. kebericho is endemic and endangered plant and is highly used in traditional medicine. Therefore, GBG authorities should take steps for the propagation and restoration of this plant. Further it is suggested that the pharmacological properties of the roots and leaves of E. kebericho should be compared to find the possibility of use of leaves in place of roots for the preparation of traditional medicine which would help in conserving this endemic plant of Ethiopia.

Ecological health assessment of a coastal ecosystem: Case study of the largest brackish water lagoon of Asia.

This study focuses on the ecological health assessment of Chilika, a shallow lagoon present in east coast of India, through nutrient stoichiometry and trophic state index (TSI). Multivariate statistical analysis such as ANOVA, Pearson's correlation, Principal Component Analysis (PCA), and Discriminant Analysis (DA) were employed for data interpretation. Nutrient stoichiometry revealed that the Chilika Lagoon experiences phosphorus limitation with regard to nitrogen and silicate (N:P:Si = 16:1:16) throughout the study period. As per the computed TSI values, the southern sector (SS), central sector (CS), and outer channel (OC) were assigned with a mesotrophic status, whereas the northern sector (NS) was assigned with the eutrophic status. From PCA, total nitrogen was found to be negatively correlated with salinity and positively correlated with silicate, thus indicating that the major source of nitrogen in the lagoon was freshwater ingress by rivers with high silicate content. DA indicated that it was successful in discriminating the groups as predicted.

Spatial distribution and potential biological risk of some metals in relation to granulometric content in core sediments from Chilika Lake, India.

The article presents first systematic report on the concentration of selected major elements [iron (Fe) and manganese (Mn)] and minor elements [zinc (Zn), copper (Cu), chromium (Cr), lead (Pb), nickel (Ni), and cobalt (Co)] from the core sediment of Chilika Lake, India. The analyzed samples revealed higher content of Pb than the background levels in the entire study area. The extent of contamination from minor and major elements is expressed by assessing (i) the metal enrichments in the sediment through the calculations of anthropogenic factor (AF), pollution load index (PLI), Enrichment factor (EF), and geoaccumulation index (Igeo) and (ii) potential biological risks by the use of sediment quality guidelines like effect range median (ERM) and effect range low (ERL) benchmarks. The estimated indices indicated that sediment is enriched with Pb, Ni, Cr, Cu and Co. The enrichment of these elements seems to be due to the fine granulometric characteristics of the sediment with Fe and Mn oxyhydroxides being the main metal carriers and fishing boats using low grade paints, fuel, and fishing technology using lead beads fixed to fishing nets. Trace element input to the Chilika lake needs to be monitored with due emphasis on Cr and Pb contaminations since the ERM and ERL benchmarks indicated potential biological risk with these metals.

Developing the criteria for evaluating quality of individualization in homeopathic clinical trial reporting: a preliminary study.

OBJECTIVE: This study describes the development of a preliminary version of an instrument that attempts to assess the quality of reports of individualized homeopathic prescriptions in clinical trials and observational studies. METHODS: A multidisciplinary panel of 15 judges produced an initial version of the instrument through iterative Delphi rounds and pilot-tested the instrument on five clinical trials. Later they assessed, under blind conditions, the individualization quality of 40 randomly-selected research reports. The final version of the instrument included six criteria. These items were scored consistently by all the raters regardless of background. RESULTS: The instrument appeared to have adequate face and content validity, acceptable internal consistency or reliability (Cronbach's α 0.606 - 0.725), significant discriminant validity (F = 398.7; P < 0.000 1), moderate interrater reliability (Fleiss κ 0.533), agreeable test-retest reliability (Cohen's κ 0.765 - 0.934), moderate sensitivity (0.4; 95% confidence interval 0.253-0.566), and high specificity (1.0; 95% confidence interval 0.891-1.000). CONCLUSION: The initial data suggest that this instrument may be a promising systematic tool amendable for further development.

Developing the criteria for evaluating quality of individualization in homeopathic clinical trial reporting: a preliminary study / 中西医结合学报

This study describes the development of a preliminary version of an instrument that attempts to assess the quality of reports of individualized homeopathic prescriptions in clinical trials and observational studies.

Application of sequential leaching, risk indices and multivariate statistics to evaluate heavy metal contamination of estuarine sediments: Dhamara Estuary, East Coast of India.

In the present study, concentration of some selected trace metals (Fe, Mn, Ni, Co, Pb, Zn, Cu, Cr and Cd) are measured in Brahmani, Baitarani river complex along with Dhamara estuary and its near shore. Chemical partitioning has been made to establish association of metals into different geochemical phases. The exchangeable fraction is having high environmental risk among non-lithogeneous phases due to greater potential for mobility into pore water. The metals with highest bio-availability being Cd, Zn and Cr. The metals like Mn, Zn, Cd and Cu represent an appreciable portion in carbonate phase. Fe-Mn oxides act as efficient scavenger for most of the metals playing a prime role in controlling their fate and transport. Among non-lithogeneous phases apart from reducible, Cr showed a significant enrichment in organic phase. Risk assessment code values indicate that all metals except Fe fall under medium-risk zone. In estuarine zone Cd, Zn, Pb and Cr are released to 32.43, 26.10, 21.81 and 20 %, respectively, indicating their significant bio-availability pose high ecological risk. A quantitative approach has been made through the use of different risk indices like enrichment factor, geo-accumulation index and pollution load index. Factor analysis indicates that in riverine zone, Fe-Mn oxides/hydroxides seem to play an important role in scavenging metals, in estuarine zone, organic precipitation and adsorption to the fine silt and clay particles while in coastal zone, co-precipitation with Fe could be the mechanism for the same. Canonical discriminant function indicates that it is highly successful in discriminating the groups as predicted.

Study of geochemical association of some trace metals in the sediments of Chilika lake: a multivariate statistical approach.

In order to establish the natural processes and geochemical factors responsible for enrichment of trace metal ions (Cu, Co, Ni, Zn and Cr) with respect to textural parameters (sand, silt and clay weight percentages) along with depth, multivariate statistical approach has been carried out for sediments in different water zones of Chilika lake, the largest brackish water lagoon in Asia. The rotated varimax factor results reveal that Cobalt enrichment is controlled by both textural parameters as well as adsorption mechanism. In fresh and saline water region, textural parameters and in mixed water, adsorption phenomenon predominates. Zn in fresh water is related to clay, whereas it is in adsorbed state in mixed water. Cu in fresh water sediments is in absorbed state and in mixed water it is related to depth and Co concentration. Cr does not show any specific association in fresh water, but in both mixed and saline water it is associated with clay minerals. Although both textural parameters and adsorption mechanism play an important role for the enrichment of trace metal ions in these lagoonal sediments, their relative importance varies with specific metal ions as well as the water quality. Sequential extraction technique was used to characterize the various forms of metals in the < 63 micro size sediments of Chilika lake. The concentrations determined indicated selective accumulation of the various metals in the different phases with spatial variability in different water zones. Slightly higher availability of Co and Zn near Balugaon township in exchangeable phase may be related to anthropogenic activities. Among the non-lithogenous (NL) phases, reducible phase associated with higher concentration of Ni, Cu and Cr. Organic bound Zn and Co contributed highest percentages among NL fractions. Residual fraction contributed more than 50% in most of the cases, reflected the predominance of physical weathering, high erosion rate along the drainage basin.