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Background India is home to one in 14 of all chronic hepatitis B virus (HBV) cases, meaning that it is important to develop HBV interventions that are applicable in the Indian context. Vaccination is the foremost tool for interrupting the HBV infection cycle. HBV vaccination was not included in India’s government-sponsored expanded immunisation program until 2011, and many children born earlier remain unvaccinated. This study sought to observe the impact of the HOPE Initiative’s school-based intervention to increase vaccination coverage by increasing HBV awareness among students in Lucknow, Uttar Pradesh. Methods At 430 schools in the administrative areas within and surrounding Lucknow, students viewed an educational documentary film on HBV and completed two questionnaires, one immediately before the screening and the other six weeks later. Both questionnaires asked the same 14 questions, which were organized into five domains: knowledge of the magnitude of the problem of HBV; knowledge of modes of HBV transmission; knowledge of consequences of HBV infection; awareness of HBV; and attitudes regarding HBV. The baseline questionnaire also asked students whether they had been vaccinated against HBV. At two-year follow-up, researchers measured vaccination levels at a subset of 30 intervention schools and six non-intervention schools to further assess the impact of the intervention. Results Baseline questionnaires were completed by 11,250 students, and post-intervention questionnaires, by 9698 students. Scores for knowledge about the magnitude of the HBV problem improved from 41% at baseline to 74% at follow-up, and scores for knowledge about modes of transmission, from 38% to 75% (p

Anemia is a serious health problem in Indian school children. High prevalence of anemia has been reported in nonpregnant adolescent girls. An investigation was initiated to study the effect of two non-iron-containing Ayurvedic preparations-Sootshekhar Rasa plus Sitopaladi Churna-in improving nutritional anemia among adolescent students.This was a single-blinded, randomized, controlled study.The study setting was Dehradun district, North India.The subjects comprised a total of 1646 boys and girls, aged 11-18 years, attending school in Dehradun district.As per World Health Organization guidelines, a total of 1322 adolescent anemic students were randomly divided into 5 groups. Students of group I (control) received starch. Group II, III, and IV students received Sootshekhar Rasa (SR) plus Sitopaladi Churna (SC) in various combinations, namely, SR 125 mg + SC 500 mg daily, SR 250 mg + SC 400 mg daily, and SR 250 mg + SC 400 mg weekly, respectively. Group V student were given iron and folic acid tablet. All the students received treatment for 90 days and were followed up for the next 180 days.The outcome measure was to evaluate the effect of Sootshekhar Rasa plus Sitopaladi Churna in improving nutritional anemia.The overall prevalence of anemia was found to be 81.3%. At baseline, the mean hemoglobin (Hb) was 97.4 +/- 13.2 g/L and ranged from 96.4 +/- 0.8 g/L to 98.3 +/- 0.8 g/L in various groups. At end of follow-up (day 270), a significant increase in Hb levels from baseline was observed in all treatment groups; however, the Hb gain (6.9 +/- 0.6 g/L) in group III and group V (3.64 +/- 0.56 g/L) differed significantly from the control group. A total of 155 students dropped out of the study due to various reasons not related to treatment. No adverse side-effect of Ayurvedic medication was noted in any student.We conclude that a daily dose of Sootshekhar Rasa (250 mg) plus Sitopaladi Churna (400 mg) can produce sustainable improvement of nutritional anemia in adolescent students.

A 47 year old diabetic male patient was diagnosed and treated for high risk AML-M3 at Tata Memorial Hospital (BJ 17572), Mumbai in September 1995. His bone marrow aspiration cytology indicated 96% promyelocytes with abnormal forms, absence of lymphocytic series and myeloperoxide test 100% positive. Initially treated with ATRA, he achieved hematological remission on day 60, but cytogenetically the disease persisted. The patient received induction and consolidated chemotherapy with Daunorubicin and Cytarabine combination from 12.01.96 to 14.05.96, following which he achieved remission. However, his disease relapsed in February 97. The patient was given two cycles of chemotherapy with Idarubicine and Etoposide, after which he achieved remission. His disease again relapsed in December 97. The patient then refused more chemotherapy and volunteered for a pilot Ayurvedic study conducted by the Central Council for Research in Ayurveda and Siddha, New Delhi. The patient was treated with a proprietary Ayurvedic medicine Navajeevan, Kamadudha Rasa and Keharuba Pisti for one year. For the subsequent 5 years the patient received three months of intermittent Ayurvedic treatment every year. The patient achieved complete disease remission with the alternative treatment without any adverse side effects. The patient has so far completed 13 years of survival after the start of Ayurvedic therapy.

KEYWORDS Environmental carcinogenic agents; epidemiology; vegetables and fruits; molecular targeted agents ABSTRACT Cancer is a major cause of mortality and morbidity worldwide. The majority of cancers are reported to be caused by environmental carcinogenic agents, occupational environment and dietary habits. Dietary habits are one of the major contributory factors for the genesis of cancer. The optimal way of dealing with any disease is by prevention, this is particularly relevant for cancer. Despite decade of basis and clinical research and trial of promising new therapy, overall cancer survival has only improved marginally. Molecular targeted agents are currently being studied in all treatment settings including chemoprevention, which is defined as the use of natural or synthetic agents to interrupt the process of carcinogenesis and to prevent or delay tumor growth. Epidemiological and experimental studies have indicated that dietary fat has an influence on carcinogenesis process. However, it has been observed that individuals who consume relatively large amounts of vegetables and fruits are at decrease risk of cancer of many organs. Several epidemiological studies suggest that consumption of cruciferous vegetables may be particularly effective in reducing cancer risk. Glucosinolates in crucifers are converted to isothiocyanates by plant myrosinase and gastrointestinal microflora, these are potent inducer of phase II proteins and is effective to block chemical carcinogenesis in animal models. Some dietary constituents are reported to act as naturally occurring cancer prevention agents and may explain some of the differences in cancer incidence seen in populations with varying dietary intake. Long term supplementation of the diet with folate, seems to lower the risk of colorectal cancer. Curcumin in the spice turmeric, genistein in soya, and catechins in tea have tumor-suppressing properties in rodent models of carcinogenesis. Although the results of clinical interventions trials of β-carotene to prevent lung cancer, and of dietary augmentation with fiber or fruits and vegetables to reduce the occurrence of colonic polyps have so far been negative, a structured path for the development of diet-derived constituents as cancer chemoprevention is emerging. By applying chemoprevention approaches from the use of single nutrients to multiple dietary constituents and functional foods, the scope of future cancer prevention strategies will be broadened. A new paradigm for diet, nutrient and cancer prevention can be developed using a multidisciplinary approach that includes lifestyle and environmental changes, dietary modification and physical activities consciousness to reduce the burden of cancer.

Cancer remains the major cause of mortality and morbidity worldwide. Despite the billions of dollars spent on research each year, recent statistics indicate that overall cancer incidence has not changed significantly in the last half-century. Although modern science has made major strides in understanding cancer and its molecular basis, the knowledge about how to prevent or treat cancer still lags behind. Environmental carcinogenic agents, occupational environments, and dietary habits have been found to be associated with the majority of cancers. Age-adjusted cancer incidence in the Western world is much higher than that of the Eastern world. It is now believed that dietary habits could be one of the major contributing factors in the genesis of cancer. The optimal way to deal with any disease is by prevention, and this is particularly relevant for cancer. It has been observed that individuals consuming relatively large amounts of vegetables and fruits are at a decreased risk of cancer of many organs. Ayurveda, a traditional Indian medicine system, has been successful since ancient times at using natural drugs to prevent or suppress a variety of tumors using various lines of treatment. Ayurvedic texts emphasize ahara, proper diet, as vital for promoting health and well-being. Although this traditional medicine has been around for thousands of years, the scientific community has recently started to pay attention to it. Following Ayurvedic principles a new paradigm for food-based cancer prevention and management can be developed to reduce the burden of this malignant disease.

Dear Editor: Chatterjee and Biswas have presented three interesting cancer cases treated with homeopathic medicines. Their article has provided some concrete evidence that homeopathic medicines work for cancer. This homeopathic approach was first advocated by Dr. Ashim Chatterjee in Kolkata. However, there are some important issues that require attention and discussion. I became associated with this alternative cancer therapy in 1997 when my family accepted the help of Dr. Chatterjee for the treatment of my 70-year-old father-in-law (late Mr. Brojen Das, King of Channel), after the conventional cancer therapy failed to produce any desired response. There was a tremendous clinical improvement in Mr. Das after the start of the alternative treatment, which everyone believed may be due to this therapy. Before coming to the conclusion that homeopathy actually works for cancer, Dr. Chatterjee did research for over 20–25 years with many important homeopathic mother tinctures viz. Psorinum, Chelidonium majus, Carduus marianus, Hydrastic canadensis, Aconite, Belladonna, Thuja occidentalis, etc. However, he obtained very good anti-cancer response when he combined snake venom–derived homeopathic medicines like Crotalus horridus, Lachesis, and Naja in his anti-cancer therapy. Dr. Chatterjee’s idea of treating cancer was simple: use medicine that can strengthen liver and kidney function, reduce pain, and most importantly, stop malignant cells from growing and spreading. His idea really made sense; potential use of snake venom as medicine has been known to humans for centuries. I was associated with Dr. Chatterjee and this alternative therapy for almost three years. After my last major publication on Psorinum therapy, many homeopathic doctors reported that they tried this approach in numerous cancer patients but failed to get any response. Now, the recent publication of more success stories with this alternative therapy may encourage more homeopaths from India and abroad to try this homeopathic approach for cancer treatment. I am sure that many will not obtain any desired results. This is an important issue that needs proper attention and understanding. The homeopathic approach to treat cancer patients in Critical Cancer Management Research Centre & Clinic (CCMRCC) is very different and cannot usually be found in conventional homeopathic textbooks. The central theme of homeopathy, ‘‘like cure like’’ in a very tiny dilution, is not followed. The specific ailment versus specific medicine concept is followed, instead of the concept of specific patient versus specific medicine. Moreover, the homeopaths in India have very little knowledge about conventional medicine and oncology, in particular. They generally don’t understand the concept of teamwork and prefer to work independently. Very few are actually associated with conventional healthcare systems. The cancer patients who generally seek the help of an alternative clinician are mostly in their advanced stages of malignancy. Management of such terminally ill patients is only possible in conventional set-ups/hospitals. So I wish to suggest that in future publications on Psorinum therapy, some warning should also be incorporated that this is a new experimental approach with homeopathy, and if any homeopaths wish to try this in patients, they should first contact CCMRCC to be properly informed and trained. I am also informed by Dr. Chatterjee that the homeopathic medicine Psorinum that is used in CCMRCC is prepared using a special technique and is somewhat different from the commercially available medicine. Any hypothesis or idea requires replication of results by peers to be accepted globally. Since the prescriptions are not always based on similarity, replication of this method may be difficult. So it would be a good idea to establish protocols for the method that can be widely tested. I hope the authors will agree that complete regression of cancer with this homeopathic approach is observed in very few patients. In most situations, there is partial response, mild response, or no response at all. So what to do in a situation where there is no response? A protocol should provide information on what should be done in each situation. Only then will it be possible to integrate this alternative approach into conventional care. Moreover, an official website should be developed where all such information is posted.