Abstract : The aim of this study was to evaluate and compare the efficacy and safety of three third-line treatment modalities for urgency urinary incontinence (UUI) refractory to pharmacotherapy: sacral neuromodulation (SNM), implantable tibial nerve neuromodulation (iTNM), and intradetrusor injection of botulinum toxin type. The purpose of this literature review is to summarize the current state of knowledge regarding available third-line treatments for urgent urinary incontinence. A literature review of studies published between 2017 and 2026 was conducted, including randomized controlled trials, systematic reviews, and meta-analyses. The primary outcomes assessed were reduction in incontinence episodes, urinary frequency, quality of life, and incidence of adverse events. All three treatment modalities demonstrated significant efficacy in reducing UUI symptoms. Toxin botulin showed the highest short-term effectiveness; however, it was associated with a higher risk of adverse events, particularly urinary retention and urinary tract infections. SNM provided a durable and stable therapeutic effect, although it requires a more invasive procedure. Implantable tibial nerve neuromodulation was associated with a favorable safety profile and lower invasiveness, but its efficacy may be slightly lower and long-term data remain limited. SNM, implantable tibial nerve neuromodulation, and BoNT-A are all effective third-line treatment options for refractory UUI. Treatment selection should be individualized based on efficacy, safety profile, and patient preferences..
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Abstract : Cancer-related pain remains one of the most distressing symptoms for oncology patients, and despite pharmacologic advances, a large proportion experience suboptimal relief or intolerable side effects from opioids and NSAIDs. Integrating evidence-based Ayurvedic formulations with standard care may offer a safer, multimodal approach to pain and symptom control. This paper proposes a scientific and regulatory framework for integrating selected Ayurvedic products in oncology pain and palliative medicine within evidence-based and ethical boundaries. A multidisciplinary clinical integration model was developed aligning with National Medical Commission, AYUSH, and Drugs and Cosmetics Act standards. Ayurvedic products were selected based on published data, pharmacologic mechanisms, and Good Manufacturing Practice compliance. Specific botanicals—Boswellia serrata, Curcuma longa, Withania somnifera, and Cannabis sativa leaf extract—demonstrated analgesic, anti-inflammatory, adaptogenic, and neuroprotective properties. Standardized Cannabis leaf tincture, rich in THC and CBD, acted via CB1 and CB2 receptors to modulate nociceptive signaling and reduce opioid load. Curcumin showed COX-2 inhibition, neuroprotective effects, and tumor-modulating activity, while hemp seed oil provided nutritional and anti-inflammatory support. Integrative oncology using standardized Ayurvedic formulations may complement conventional pain management, improving quality of life, reducing opioid dependence, and addressing fatigue, cachexia, and neuropathic pain. Proper regulatory compliance, patient monitoring, and multidisciplinary collaboration are essential for safe clinical application. Further clinical trials are warranted to validate efficacy and develop standardized integrative protocols for cancer pain and palliative care in India and globally..
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Abstract :

Abstract

Background:

Chikun guniya virus infection frequently results in long-lasting complications such as chronic arthritis, myalgia, fatigue, and neuropathic pain. Conventional management is largely symptomatic and fails to prevent chronic sequelae.

Objective:

To evaluate the role of individualized homeopathic immunomodulation in the management of post-Chikun guniya complications in a rural population.

Methods:

This observational study was conducted at Anand Hospital & Research Centre, Ghodegaon, Maharashtra. Patients presenting with persistent post-Chikun guniya symptoms were treated with individualized homeopathic remedies based on the principle of similia similibus curentur (“like cures like”). No admission or injections were required. Patients were assessed for reduction in pain, stiffness, mobility, and overall quality of life.

Results:

Marked improvement was observed within minutes to days of treatment in pain relief, reduction of stiffness, and restoration of mobility. Long-term follow-up demonstrated prevention of chronic arthritis and improved immune resilience. No adverse effects were reported.

Conclusion:

Immunomodulation through homoeopathic treatment represents a rational and effective strategy to combat post-Chikun guniya complications. By restoring immune homeostasis in line with the natural law of cure, homeopathy provides a safe, sustainable, and community-acceptable approach for post-viral syndrome management.

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Introduction

Chikun guniya virus (CHIKV), a mosquito-borne alpha virus, has re-emerged as a significant public health challenge in India. While the acute febrile illness resolves within 7–10 days, up to 60% of patients suffer from persistent complications such as chronic arthritis, joint stiffness, fatigue, neuropathic pain, and depression. These sequelae are attributed not to ongoing viral replication but to immune dysregulation and post-viral inflammation.

Conventional medicine often provides only short-term symptomatic relief with NSAIDs, corticosteroids, or physiotherapy. However, these measures fail to correct the underlying immune imbalance and thus cannot prevent chronicity.

In this situation, immunomodulation is a logical way to address post-viral syndromes. Homeopathy, based on the natural law of cure called similia similibus curentur, offers personalized medicines that help the body’s immune system regain balance.

This study presents the clinical outcomes of using homeopathic immunomodulation in the treatment of post-Chikun guniya complications in a rural Maharashtra population.

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Methods

Study Site: Anand Hospital & Research Centre, Ghodegaon, Taluka Newasa, Dist. Ahilyanagar.

Study Design: Prospective observational study.

Participants: Patients aged 15–70 years with persistent symptoms after confirmed or clinically suspected Chikun guniya infection.

Exclusion: Patients with other rheumatologic or autoimmune diseases.

Intervention: Individualized homeopathic remedies selected based on the totality of symptoms, with emphasis on musculoskeletal, neurological, and constitutional presentation.

Follow-up: Patients were assessed at intervals of 1 day, 1 week, and 1 month for pain relief, joint mobility, fatigue, and recurrence.

Outcome Measures: Rapidity of relief, degree of functional recovery, long-term prevention of chronic sequelae, and safety profile.

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Results

Immediate Relief: Patients reported significant reduction in stiffness and pain within minutes to hours after remedy administration in acute cases.

Functional Recovery: Within 1–3 days, most patients regained near-normal mobility.

Long-term Benefits: Follow-up over 3–6 months showed sustained relief, no relapse into chronic arthritis, and improved general well-being.

Safety: No adverse effects were recorded.

Community Acceptance: Patients expressed high satisfaction, particularly appreciating the no admission, no injection approach.

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Discussion

The persistence of post-Chikun guniya complications is linked to immune dysregulation, particularly aberrant T-cell activation, cytokine storms, and autoimmune phenomena. This highlights the need for a therapeutic approach that restores immune homeostasis rather than suppresses it.

Immunomodulation is therefore the most rational and effective way to combat post-Chikun guniya syndrome.

Homoeopathy uses the law of cure, similia similibus curentur, to support the body’s natural defenses, adjust the immune response, and help repair tissues. In this study, clinical experience showed that homeopathic remedies can act as natural immunomodulators, providing quick relief and helping prevent long-term issues.

This aligns with emerging biomedical evidence that post-viral syndromes require immune recalibration rather than simple symptomatic treatment. Furthermore, the community-based, low-cost, and non-invasive nature of this intervention makes it highly suitable for rural and resource-limited settings.

For a demonstration, see  https://www.youtube.com/watch?v=2CF-_rw5BGg&t=315s

Conclusion

Homoeopathic immunomodulation offers a safe, rational, and effective strategy for the management of post-Chikun guniya complications. By addressing the root cause — immune dysregulation — it prevents chronic sequelae and restores quality of life. This study highlights the potential of integrating homeopathy into public health strategies for viral post-syndromes.

 

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Abstract : Diabetes mellitus (DM) being a chronic disease is associated with a wide range of both microvascular and macro vascular complications. Hearing loss is one such complication which is often over looked despite its impact on quality of life. Hence this study aimed to estimate the prevalence of sensorineural hearing loss (SNHL) and to determine the factors influencing its occurrence in patients with Type 2 Diabetes mellitus attending a tertiary hospital, Hyderabad. A hospital based cross-sectional study conducted over a period of one year from January 2024 to December 2024 in a tertiary care hospital, Hyderabad. A total of 180 patients with type 2 Diabetes mellitus attending the hospital were included in this study after excluding those with congenital hearing loss, non-diabetic and with SNHL due to other non-diabetic causes. A semi-structured questionnaire is used for taking detailed history, then ear, nose and throat examination followed by pure tone audiometry and measurement of glycosylated hemoglobin (HbA1c) levels. Data was collected and entered in MS Excel and analyzed by using SPSS software version 22. Out of 180 patients, 60% of them are males and 40% are females. The prevalence of SNHL among 180 patients was found to be 68.9%. Increasing age and, longer duration of diabetes and poor glycemic control had significant association with severity of SNHL with p value <0.05. This study showed 68.9% prevalence of SNHL among patients with type 2 diabetes mellitus. This study findings highlighted the need for routine auditory screening, especially in elderly diabetic patients and those with poor glycemic control..
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Abstract : Purtscher-like retinopathy is a rare occlusive microvasculopathy typically associated with systemic conditions such as acute pancreatitis, renal failure, and autoimmune disorders. Visual prognosis is generally poor. A 43-year-old male was admitted to the hospital, following a week-long episode of excessive alcohol consumption. His medical history included two prior episodes of acute pancreatitis and a history of alcohol dependence. Upon admission, he was diagnosed with alcoholic liver disease, acute alcoholic pancreatitis, secondary thrombocytopenia, and visual disturbances. The patient’s visual acuity was significantly reduced: right eye (OD): 0.2 sc. and left eye (OS): 0.2 sc. A refraction assessment was performed, revealing no significant refractive errors. Intraocular pressure was measured at 12 mmHg (OD) and 13 mmHg (OS). Ophthalmoscopic examination revealed optic discs with well-defined margins, segmental narrowing of retinal vessels, and cotton wool spots within the macula and peripheral retina bilaterally. Optical Coherence Tomography (OCT) confirmed macular edema, while angio-OCT demonstrated ischemic retinal areas in both eyes. Based on these findings, the patient was diagnosed with Purtscher-like retinopathy. The patient was managed with supportive care for pancreatitis and alcohol cessation, without the use of corticosteroids or anti-VEGF agents. At follow-up, the patient demonstrated significant visual improvement. His visual acuity improved to OD: 0.8, OS: 0.9 - representing a gain of over six Snellen lines, and intraocular pressures were recorded at 15 mmHg (OD) and 17 mmHg (OS). This case highlights an atypically rapid and significant visual recovery in Purtscher-like retinopathy secondary to acute alcoholic pancreatitis..
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