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Resumo Quase 90% dos casos de coccigodínia podem ser tratados por meio de tratamento clínico conservador; os 10% restantesprecisam de outras modalidades invasivas para o alívio da dor, como o bloqueio do gânglio ímpar (BGI) ou ablação por radiofrequência (ARF) do gânglio ímpar. Com o objetivo de avaliara eficácia do BGI e ARF do gânglio ímpar no controle da dor em pacientes com coccigodínia, foi realizada uma pesquisa sistemática no PubMed, MEDLINE eGoogle Scholar, a fim de identificar estudos que relatam o alívio da dor, em termos de Escala Visual Analógica (EVA) ou dos seus homólogos, após o BGI ou ARFem pacientes com coccigodínia por 2 autores diferentes, de acordo com as diretrizes PRISMA. Foram definidos sete estudos com um total de 189 pacientes (104 no grupo BGI e 85 no grupo ARF). No grupo BGI, a média da pontuação EVA melhorou de 7,83 no início do estudo para 3,11 no acompanhamento de curto prazo, 3,55 no acompanhamento de médio prazo e 4,71 no acompanhamento de longo prazo. No grupo ARF, amédia da pontuação EVA melhorou de 6,92 no início do estudo, 4,25 no acompanhamento de curto prazo e 4,04 no acompanhamento de longo prazo. No grupo BGI foram relatadas 13,92% de falhas (11/79) e complicações de 2,88% (3/104), enquanto que no grupo ARF foram relatadas 14,08% de falhas (10/71) e nenhuma complicação (0%). A taxa total de êxito foi > 85% em qualquer uma das modalidades. O BGI e ARF do gânglio ímpar fornecem um método confiável e provavelmente excelente no controle da dor, em pacientes com coccigo- dínia que não respondem ao tratamento médico conservador. No entanto, deve ser estabelecido um limite entre os que responderam, os que não responderam e aqueles não respondedores tardios, sendo necessários estudos mais amplos com acompanhamento mais longo (> 1 ano).

The Government of India, on directions from the Supreme Court in 2002 and advice from the National Water Development Agency (NWDA), proposed an estimated US$120 billion National River Linking Project (NRLP) which envisages linking 37 Himalayan and Peninsular rivers (Figure 1; NCIWRD 1999). Doing this will form a gigantic South Asian water grid which will annually handle 178×109 m3/yr of interbasin water transfer; build 12,500 km of canals; generate 34 gigawatts of hydropower; add 35 million hectares (Mha) to India’s irrigated areas; and generate inland navigation benefits (IWMI 2003; NWDA 2006; Gupta and van der Zaag 2007).

Virtual water trade has been promoted as a tool to address national and regional water scarcity. In the context of international (food) trade, this concept has been applied with a view to optimize the flow of commodities considering the water endowments of nations. The concept states that water-rich countries should produce and export water intensive commodities (which indirectly carry embedded water needed for producing them) to water-scarce countries, thereby enabling the water-scarce countries to divert their precious water resources to alternative, higher productivity uses. While progress has been made on quantifying virtual water flows between countries, there exists little information on virtual water trade within large countries like India. This report quantifies and critically analyzes inter-state virtual water flows in India in the context of a large inter-basin transfer plan of the Government of India. Our analysis shows that the existing pattern of inter-state virtual water trade is exacerbating scarcities in already water scarce states and that rather than being dictated by water endowments, virtual water flows are influenced by other factors such as "per capita gross cropped area" and "access to secured markets". We therefore argue that in order to have a comprehensive understanding of virtual water trade, non-water factors of production need to be taken into consideration.

AB Provision of irrigation has been thought to be crucial in improving the livelihoods of millions of tribals in Central belt of India, who are locked in perpetual poverty. Green Revolution Technology, which has been at the heart of Indiaٳ agricultural development, has more or less bypassed the tribal population. For one, irrigation infrastructure is inadequate in the tribal regions and again when irrigation infrastructure is made available, the tribals do not seem to make adequate use of them. Creating demand for irrigation among the tribal farmers seems to be most important challenge. It is in this backdrop that we undertook our case study in a tribal dominated block of Gujarat. Unlike the other tribal dominated areas Jharkhand and Chattisgarh), the tribals in our study area were third generation farmers and therefore they faced no cognitive barriers in adopting irrigated agriculture. They are also as skilled a farmer as any other, which is reflected by the fact that there are no discernable yield differences between a tribal and a non-tribal farmer. We studied four canal irrigation schemes, which have been all turned over to the farmers at the behest of AKRSP (I)ٳ intervention. All these four schemes are tribal dominated, some of them are completely so, others have a handful of non-tribal population. The schemes we studied were Pingot RBMC, Baldeva LBMC, Pingot LBMC and Issar Minor Irrigation scheme. Our results confirm that irrigated agriculture has brought about tremendous benefits to a tribal farmer in the form of yield increases, higher cropping intensity, lower out migration and higher wage rates within the village. The trajectory of change for a typical tribal farming has been from cultivating local paddy in Kharif and migrating in Rabi and summer to cultivating hybrid paddy in kharif and irrigated groundnut or moong in summer. Irrigated agriculture has become central to their livelihoods and this in part explains why Participatory Irrigation Management (PIM) has been more or less successful here. However, the non-tribal farmers have benefited more from PIM than tribal farmers, because they shifted to very lucrative sugarcane farming. The non-tribals (Patels) have also played a significant role in these irrigation co-operatives in that they have provided the much needed ܤemonstration effectݠof profitability of irrigated agriculture. AKRSP (I)ٳ role as facilitator of PIM in Pingot RBMC and Baldeva LBMC has been acclaimed nationally. But we propose that the success of these two schemes lies in the creation of Pingot LBMC society, where tribal farmers came forward on their own and formed irrigation society to take over management of the canal system. The very fact that an all-tribal farmer group could successfully replicate PIM experiment in Gujarat that was started with Pingot RBMC and Baldeva LBMC is a proof enough for the success of PIM as a whole. We also propose that in the long term, the sustainability of PIM will depend on the overall profitability of irrigated agriculture and therefore efforts should be made to make farming a more profitable venture for the tribal farmers. Encouraging them to shift to highly lucrative crops such as sugarcane and orchard crops could perhaps make irrigated agriculture more profitable in future.