Category: Public Health (Page 2 of 6)

Keep Calm and Know Your Fever (Before You Reach for That Medicine)

Growing up in the Eastern part of India, I was subject to a most peculiar cultural phenomenon known as “ThanDa lege jaabe” (ঠাণ্ডা লেগে যাবে in the vernacular, translated as: You’ll catch a cold). This odd concept, most beloved of the mothers in that region and handed down generations after generations, would teach them that any vagary of the sub-tropical weather — sun, rain, autumnal zephyrs, wet and foggy riparian winters, and everything in between — was liable to cause acute upper respiratory tract infections (uRTIs), characterized by runny nose, cough and sneeze, perhaps even progressing to pharyngitis, laryngitis or tracheobronchitis. And the most feared symptom was elevated body temperature, or fever.

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Of Serious Concern: Drug-resistant Acinetobacter baumannii in Treated Wastewater

Currently one of the most common disease-causing bacterium in the world, Acinetobacter baumannii, for sure, is a nasty bug — an emerging nosocomial (hospital-associated) pathogen, being increasingly observed in serious conditions requiring intensive care (including ventilator-associated pneumonia, sepsis, meningitis, wound infection and urinary tract infection). Unfortunately for patients, particularly immune-suppressed ones, this bug is now known to be extensively drug resistant (XDR; resistant to most antibiotics including carbapenems, with the exception of two drugs of last resort, colistin and tigecycline), with a smaller proportion resistant to even these two (known as pan-drug resistant, PDR, which are therefore virtually untreatable with the current crop of FDA-approved medications).

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Bovine Blackguards, A Profound Potboiler

Having been born and growing up in India, the land of the sacred cow, I am no stranger to this domesticated, quadrupedal ungulate of the subfamily Bovinae, genus Bos. It’s difficult not to have respect for an animal whose scientific name already proclaims it to be the boss, and I am culturally well-conditioned (‘well-done’, one might say) to accord an immediate reverence to this multi-faceted (not to mention, delectable) animal. After all, Gau-mata, or Cow the Mother, is an enduring socio-religious meme in India, stemming from simpler, more agrarian times — possibly a testament to the species’ intimate association with human history ever since it was domesticated about 10,500 years ago (archaeological and genetic evidence suggests that cows in Southeast Asia, Bos indicus, a different lineage from cows in Europe, were domesticated about 7000 years ago in the Harappan civilization).

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Sympathetic Practitioner, the Secret Weapon of Homeopathy and Other Alt-Med Modalities

ResearchBlogging.org

Last month, PLOS One published a study which held significant interest for me; as a long time sufferer from acid reflux (which is currently reasonably controlled by regular use of a PPI – Proton-pump inhibitor – class of prescription antacid), I was curious to dive into this Randomized Controlled Trial (RCT) study from Beth Israel Deaconess in Boston, in which the investigators observed that Patient-Provider Interactions Affect Symptoms in Gastroesophageal Reflux Disease (GERD) as well as dyspepsia and other acid-reflux related issues, which affect 2-4 out of every 10 people in Western world (similar statistics were observed in the Northern part of India). The name of the study medication, Acidil, wasn’t immediately familiar to me, but it turned out to be a ‘homeopathic preparation’, which – along with the placebo-controlled designed – piqued my interest further. Although the severity of GERD symptoms may fluctuate due to different reasons, it is usually not one of those self-correcting conditions in which homeopaths often claim beneficial effect. So, sufficiently interested, I delved deeper.

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Perception of Effectiveness of Homeopathy and Other Alternative Medicine Relies on Placebo Effect

The world of alternative medicine – nowadays more fashionably known as complementary and integrative medicine (CIM), replacing the erstwhile CAM (A = alternative) – encompasses a wide range of practices. Some of these practices involve physical motion of parts or whole of the body, such as massage, Yoga, and Tai Chi; if one subtracts the dollops of mysticism, especially of Eastern origin, that have come to be associated with these practices, one finds that they perform much of the same functions as any other regular exercise regimen, providing similar benefits. A few practices employ dietary supplements (vitamins, minerals, various salts, et cetera) and folk-remedies based on herbal medicine (Traditional Chinese Medicine/TCM, Ayurveda, Siddha, Unani, Amachi, and so forth) – some of which may and do contain biologically active substances, but the evidence for those being functional, safe, and effective therapeutic modalities in actual clinical situations is extremely scant, and the wide-ranging claims made by the practitioners are mostly never backed up by solid, scientific empirical methods. (Further reading: 1. Veteran ScienceBlogger Orac explains how the multi-billion dollar Supplements Industry takes their adoring clients for a ride; 2. I argue how the recent accolades for work stemming from the use of herbal medicine as a resource is not a context-less validation that herbalism works.)

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Homeopathy – that “affordable”, “cost-saving” therapy? Not really, as the numbers say.

Classical homeopathy is scientifically implausible as a therapy, because there is no substance of any medicinal value left in the functionally-infinitely diluted nostrum. Naturally, there is no hard evidence supporting the therapeutic use of homeopathy, in terms of clinical benefit to the patient. Absent such support, homeopathy-peddlers generally push affordability and low cost as homeopathy’s unique selling point (USP). A large retrospective cost-analysis study, based on nearly 45000 individual German patients, gives lie to that myth.

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Vox Media Report On Pandemrix And Narcolepsy Misses A Key Highlight, Progress By Trial

I read with a great deal of interest a report on Vox by their science and health reporter Julia Belluz (@juliaoftoronto on Twitter) on the recently publicized story of Pandemrix, an H1N1 pandemic influenza (a.k.a. “Swine Flu”) vaccine manufactured by GlaxoSmithKline (GSK), and the condition of narcolepsy (a debilitating sleep disorder) that affected a small fraction of individuals who received this vaccine.

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