Naturopathy is a traditional health care science having its own concepts of health and healing rooting through nature.It is a non-pharmacological system of health care which derives its disease causing and health keep...Naturopathy is a traditional health care science having its own concepts of health and healing rooting through nature.It is a non-pharmacological system of health care which derives its disease causing and health keeping principles from fundamental natural elements(Panchamahabhutas)viz.Prithvi,Jala,Vayu,Agni,and Akash.The imbalance among these five elements individually or in respect to others creates disease and in turn also forms the basis of healing if such imbalances are corrected.This paper reviews the simple concepts of naturopathy referring to health and disease and contextualises them to the on-going pandemic which has affected the entire world.An extensive manual and digital search of the relevant literature was done related to naturopathy in order to compile the review.This review is important from the perspectives that in the current pandemic the cure is still not evident from any corner of the world and from any system of medicine.Therefore such simple health keeping strategies from naturopathy seem to be of much relevance.展开更多
Background:Asthma is a major non-communicable disease affecting both children and adult populations,characterized by inflammation and narrowing of airways.Hydrotherapy is a naturopathy treatment modality effectively u...Background:Asthma is a major non-communicable disease affecting both children and adult populations,characterized by inflammation and narrowing of airways.Hydrotherapy is a naturopathy treatment modality effectively used to manage bronchial asthma.This case series presents the immediate effect of one such hydrotherapy treatment hot fomentation on pulmonary function in bronchial asthma.Case presentation:Three women who had chief complaints of wheezing,sneeze and breathlessness due to chronic bronchial asthma.Hot fomentation over the inter-scapular region was given to the patient for a duration of 20 minutes.Pulmonary function test was performed using Recorders&Medicine Systems Pvt Ltd.Helios 401 before and immediately after the intervention to assess the efficacy of hot fomentation.Result:When compared to baseline,the pulmonary function’s parameters,such as forced vital capacity,forced expiratory volume in the first second,forced expiratory volume in the first second/forced vital capacity ratio,forced expiratory flow(25–75%)and peak expiratory flow showed significant improvement immediately after the fomentation.Conclusion:After 20 minutes of hot fomentation,significant improvement in pulmonary function was observed.Hot fomentation over the interscapular region,could thus be used to improve clinical outcomes in the management of bronchial asthma by improving pulmonary function and relieving acute symptoms.展开更多
<strong>Introduction:</strong><span><span><span style="font-family:""><span style="font-family:Verdana;"> Breast cancer remains a public health problem due ...<strong>Introduction:</strong><span><span><span style="font-family:""><span style="font-family:Verdana;"> Breast cancer remains a public health problem due to its sever</span><span style="font-family:Verdana;">ity and because it is the leading cause of death from cancer</span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">s</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> in women </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">worldwide as well as in Cameroon. Our objective was to study the diagnostic and </span><span style="font-family:Verdana;">therapeutic options that patients followed for breast cancer choose in</span><span style="font-family:Verdana;"> Yaound</span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">e</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">. </span><b><span style="font-family:Verdana;">Method:</span></b><span style="font-family:Verdana;"> This was an analytical cross-sectional study with prospective data collection among patients followed for breast cancer at two referral hospitals in Yaound</span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">e</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> from February 1, 2019 to August 31, 2019. Data collected were recorded and analyzed using R application version 3.5.0.</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">,</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> p values < 0.05 w</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">ere</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> considered to be statistically significant. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> A total of 105 patients were </span><span style="font-family:Verdana;">recruited, including 104 women and 1 man. The median age was 46 years</span><span style="font-family:Verdana;"> with extremes of 25 and 77 years. Most patients (71%) had a monthly income </span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">of </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">less than 175 USD. Patients in this study had opted for: contemporary</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> medi</span><span style="font-family:Verdana;">cine (49.5%), therapeutic abstention (38.1%), naturopathy (1.9%), </span><span style="font-family:Verdana;">self-me</span><span style="font-family:Verdana;">dication (9.5%) and traditional medicine (1%). The factors significantly associ</span><span style="font-family:Verdana;">ated with the choice of contemporary medicine as a first diagnostic option</span><span style="font-family:Verdana;"> were monthly income above 175 USD (OR = 0.37, 95% CI: 0.15 - 0.89, p = 0.028), good level of education (OR = 0.37, 95% CI: 0.16 - 0.82, p = 0.034) and </span><span style="font-family:Verdana;">good knowledge about breast cancer (OR = 0.28, 95% CI: 0.08 - 0.89, p = </span><span style="font-family:Verdana;">0.005). The majority of patients (65.7%) sought contemporary medicine as</span> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">the </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">first therapeutic option after a diagnosis of breast cancer was confirmed,</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> while about a third </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">of them </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">had chosen alternative treatment options including na</span><span style="font-family:Verdana;">turopathy (15.2%), traditional medicine (9.5%), religious practices (4.8%), </span><span style="font-family:Verdana;">thera</span><span><span style="font-family:Verdana;">peutic abstention (2.9%) and self-medication (1.9%). </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> The firs</span></span><span style="font-family:Verdana;">t diagnostic and therapeutic choices of breast cancer patients in </span><span style="font-family:Verdana;">our setting are </span><span style="font-family:Verdana;">numerous and intricate, including contemporary medicine, therapeutic ab</span><span style="font-family:Verdana;">stention, self-medication, traditional medicine, naturopathy and religious </span><span style="font-family:Verdana;">practices. There is a need to promote breast cancer awareness in our population.</span></span></span></span>展开更多
Though the cancer is a multifactorial disease,where various types of cancers exhibit varying mechanisms,pathways,genetic and cellular defects,the study of tumor micro-environment confirms that upregulated glycolysis a...Though the cancer is a multifactorial disease,where various types of cancers exhibit varying mechanisms,pathways,genetic and cellular defects,the study of tumor micro-environment confirms that upregulated glycolysis and hypoxia are the part and parcel of almost every cancer subtypes.Therefore,targeting them with nutritional ketosis and hyper-oxygenation therapies could create an unfavourable environment for cancers to thrive.The aim of this review is to study the significance of these interventions in the integrative cancer treatment.Extensive search has been carried out through the online scientific database like PubMed and other medical journals with the search words,‘cancer metabolism’,‘tumor micro environment’,‘hypoxia and tumor’,‘ketosis and cancer treatment’,‘hyperbaric oxygen therapy and cancer’and‘ozone therapy and cancer’.All biomolecule studies,preclinical and clinical studies,received as search results are reviewed.In addition,a nutritional book,named‘Healing with Whole Foods:Asian Traditions and Modern Nutrition’by Paul Pitchford is also referred.These studies recommend the use of various therapeutic approaches like ketogenic diet,ketone supplementation,hyperbaric oxygen therapy and intravenous ozone therapy,individually or in combination with standard therapies,based on its antitumor effects,safety,tolerability,its ability to potentiate the radio and chemo therapy,while decreasing its side effects and its efficiency to improve the quality of life.Rewardingly,when combined,the synergistic action of nutritional ketosis and hyperoxygenation therapies elicited profound,supra additive anti-cancer effects.As per present studies,these therapies are safe to include in an Integrative cancer treatment,though large clinical trials are needed to systematize its clinical usage.展开更多
Meal timing plays a crucial role for cardiometabolic health,given the circadian regulation of cardiometabolic function.However,to the best of our knowledge,no concept of meal timing exists in traditional European medi...Meal timing plays a crucial role for cardiometabolic health,given the circadian regulation of cardiometabolic function.However,to the best of our knowledge,no concept of meal timing exists in traditional European medicine(TEM).Therefore,in this narrative review,we aim to define the optimal time slot for energy intake and optimal energy distribution throughout the day in a context of TEM and explore further implications.By reviewing literature published between 2002 and 2022,we found that optimal timing for energy intake may be between 06:00 and 09:00,12:00 and 14:00,and between 15:00 and18:00,with high energy breakfast,medium energy lunch and low energy dinner and possibly further adjustments according to one’s chronotype and genetics.Also,timing and distribution of energy intake may serve as a novel therapeutic strategy to optimize coction,a concept describing digestion and metabolism in TEM.展开更多
Objective: To assess the knowledge, attitude, perception and practice of Ayurveda, yoga, Unani, Siddha, homeopathy and naturopathy (AYUSH) among allopathic doctors and interns and determine their opin- ion regardin...Objective: To assess the knowledge, attitude, perception and practice of Ayurveda, yoga, Unani, Siddha, homeopathy and naturopathy (AYUSH) among allopathic doctors and interns and determine their opin- ion regarding integration of AYUSH education within the allopathic curriculum. Methods: This prospective, cross sectional study was conducted in a tertiary care teaching Hospital, New Delhi, India, from March 2016 to March 2017. A survey of 500 aUopathic doctors and 150 interns was performed using a structured questionnaire. Results: A majority of doctors (95.2%) were aware of the term AYUSH and had knowledge of yoga (70.6%), homeopathy (55.6%), Ayurveda (50.3%), Siddha (47.8%), naturopathy (32.9%) and Unani (28.9%). Most of the participants (63.0%) felt that therapies under AYUSH are effective. A majority (84.0%) of the doctors were of the view that more research is required in the field of AYUSH. While homeopathy (44.0%) was the most common system used by doctors for themselves, yoga was the therapy most commonly (60.0%) recommended to patients. Nearly half of the doctors (46.7%) recommended AYUSH to their patients, mainly for chronic illness (74.0%). A majority (77.5%) of the respondents agreed that students of allopathic med- icine should be familiarized with AYUSH. The modes of incorporation of AYUSH into the medical curriculum most commonly suggested by respondents were optional courses (54.5%) and introductory lectures (42.3%). Conclusion: Doctors and interns ofallopathic medicine are aware of AYUSH systems. They use it for them- selves and recommend it to patients. They believe that familiarization of Bachelor of Medicine and Bachelor of Surgery students with AYUSH therapies and their integration with allopathic medicine may help in improving patient care.展开更多
Scholars have argued that theoretical insights of critical medical anthropology should be applied to the analysis of complementary and alternative medicine in order to develop more critically engaged integrative medic...Scholars have argued that theoretical insights of critical medical anthropology should be applied to the analysis of complementary and alternative medicine in order to develop more critically engaged integrative medicine. In this essay we focus on nature cure in the context of India's contemporary epidemiological transition as an example of why engaged integrative medicine is important for public health, and how the institutionalization of nature cure treatment in India provides a critical framework for the development of programs focused on holistic treatment and prevention. After providing an overview of the epidemiological transition in contemporary India, we develop this argument through an examination of illustrative cases in a clinic that operates within the structure of India's Central Council for Research on Yoga and Naturopathy. Based on a review of recent history and contemporary practice we describe how a system of medicine that makes use exclusively of air, earth, sunlight, water and food has been institutionalized and professionalized in India. Whereas biomedical treatment for chronic non- communicable diseases is focused on the problem of curing individual diseases, nature cure establishes a regimen of personalized public healthcare for the integrated management of symptoms. We argue that nature cure is based on an ecological understanding of health, thus providing treatment that reflects a broad appreciation for the risk factors that characterize India's current crises of public health.展开更多
文摘Naturopathy is a traditional health care science having its own concepts of health and healing rooting through nature.It is a non-pharmacological system of health care which derives its disease causing and health keeping principles from fundamental natural elements(Panchamahabhutas)viz.Prithvi,Jala,Vayu,Agni,and Akash.The imbalance among these five elements individually or in respect to others creates disease and in turn also forms the basis of healing if such imbalances are corrected.This paper reviews the simple concepts of naturopathy referring to health and disease and contextualises them to the on-going pandemic which has affected the entire world.An extensive manual and digital search of the relevant literature was done related to naturopathy in order to compile the review.This review is important from the perspectives that in the current pandemic the cure is still not evident from any corner of the world and from any system of medicine.Therefore such simple health keeping strategies from naturopathy seem to be of much relevance.
文摘Background:Asthma is a major non-communicable disease affecting both children and adult populations,characterized by inflammation and narrowing of airways.Hydrotherapy is a naturopathy treatment modality effectively used to manage bronchial asthma.This case series presents the immediate effect of one such hydrotherapy treatment hot fomentation on pulmonary function in bronchial asthma.Case presentation:Three women who had chief complaints of wheezing,sneeze and breathlessness due to chronic bronchial asthma.Hot fomentation over the inter-scapular region was given to the patient for a duration of 20 minutes.Pulmonary function test was performed using Recorders&Medicine Systems Pvt Ltd.Helios 401 before and immediately after the intervention to assess the efficacy of hot fomentation.Result:When compared to baseline,the pulmonary function’s parameters,such as forced vital capacity,forced expiratory volume in the first second,forced expiratory volume in the first second/forced vital capacity ratio,forced expiratory flow(25–75%)and peak expiratory flow showed significant improvement immediately after the fomentation.Conclusion:After 20 minutes of hot fomentation,significant improvement in pulmonary function was observed.Hot fomentation over the interscapular region,could thus be used to improve clinical outcomes in the management of bronchial asthma by improving pulmonary function and relieving acute symptoms.
文摘<strong>Introduction:</strong><span><span><span style="font-family:""><span style="font-family:Verdana;"> Breast cancer remains a public health problem due to its sever</span><span style="font-family:Verdana;">ity and because it is the leading cause of death from cancer</span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">s</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> in women </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">worldwide as well as in Cameroon. Our objective was to study the diagnostic and </span><span style="font-family:Verdana;">therapeutic options that patients followed for breast cancer choose in</span><span style="font-family:Verdana;"> Yaound</span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">e</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">. </span><b><span style="font-family:Verdana;">Method:</span></b><span style="font-family:Verdana;"> This was an analytical cross-sectional study with prospective data collection among patients followed for breast cancer at two referral hospitals in Yaound</span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">e</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> from February 1, 2019 to August 31, 2019. Data collected were recorded and analyzed using R application version 3.5.0.</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">,</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> p values < 0.05 w</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">ere</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> considered to be statistically significant. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> A total of 105 patients were </span><span style="font-family:Verdana;">recruited, including 104 women and 1 man. The median age was 46 years</span><span style="font-family:Verdana;"> with extremes of 25 and 77 years. Most patients (71%) had a monthly income </span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">of </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">less than 175 USD. Patients in this study had opted for: contemporary</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> medi</span><span style="font-family:Verdana;">cine (49.5%), therapeutic abstention (38.1%), naturopathy (1.9%), </span><span style="font-family:Verdana;">self-me</span><span style="font-family:Verdana;">dication (9.5%) and traditional medicine (1%). The factors significantly associ</span><span style="font-family:Verdana;">ated with the choice of contemporary medicine as a first diagnostic option</span><span style="font-family:Verdana;"> were monthly income above 175 USD (OR = 0.37, 95% CI: 0.15 - 0.89, p = 0.028), good level of education (OR = 0.37, 95% CI: 0.16 - 0.82, p = 0.034) and </span><span style="font-family:Verdana;">good knowledge about breast cancer (OR = 0.28, 95% CI: 0.08 - 0.89, p = </span><span style="font-family:Verdana;">0.005). The majority of patients (65.7%) sought contemporary medicine as</span> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">the </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">first therapeutic option after a diagnosis of breast cancer was confirmed,</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> while about a third </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">of them </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">had chosen alternative treatment options including na</span><span style="font-family:Verdana;">turopathy (15.2%), traditional medicine (9.5%), religious practices (4.8%), </span><span style="font-family:Verdana;">thera</span><span><span style="font-family:Verdana;">peutic abstention (2.9%) and self-medication (1.9%). </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> The firs</span></span><span style="font-family:Verdana;">t diagnostic and therapeutic choices of breast cancer patients in </span><span style="font-family:Verdana;">our setting are </span><span style="font-family:Verdana;">numerous and intricate, including contemporary medicine, therapeutic ab</span><span style="font-family:Verdana;">stention, self-medication, traditional medicine, naturopathy and religious </span><span style="font-family:Verdana;">practices. There is a need to promote breast cancer awareness in our population.</span></span></span></span>
文摘Though the cancer is a multifactorial disease,where various types of cancers exhibit varying mechanisms,pathways,genetic and cellular defects,the study of tumor micro-environment confirms that upregulated glycolysis and hypoxia are the part and parcel of almost every cancer subtypes.Therefore,targeting them with nutritional ketosis and hyper-oxygenation therapies could create an unfavourable environment for cancers to thrive.The aim of this review is to study the significance of these interventions in the integrative cancer treatment.Extensive search has been carried out through the online scientific database like PubMed and other medical journals with the search words,‘cancer metabolism’,‘tumor micro environment’,‘hypoxia and tumor’,‘ketosis and cancer treatment’,‘hyperbaric oxygen therapy and cancer’and‘ozone therapy and cancer’.All biomolecule studies,preclinical and clinical studies,received as search results are reviewed.In addition,a nutritional book,named‘Healing with Whole Foods:Asian Traditions and Modern Nutrition’by Paul Pitchford is also referred.These studies recommend the use of various therapeutic approaches like ketogenic diet,ketone supplementation,hyperbaric oxygen therapy and intravenous ozone therapy,individually or in combination with standard therapies,based on its antitumor effects,safety,tolerability,its ability to potentiate the radio and chemo therapy,while decreasing its side effects and its efficiency to improve the quality of life.Rewardingly,when combined,the synergistic action of nutritional ketosis and hyperoxygenation therapies elicited profound,supra additive anti-cancer effects.As per present studies,these therapies are safe to include in an Integrative cancer treatment,though large clinical trials are needed to systematize its clinical usage.
文摘Meal timing plays a crucial role for cardiometabolic health,given the circadian regulation of cardiometabolic function.However,to the best of our knowledge,no concept of meal timing exists in traditional European medicine(TEM).Therefore,in this narrative review,we aim to define the optimal time slot for energy intake and optimal energy distribution throughout the day in a context of TEM and explore further implications.By reviewing literature published between 2002 and 2022,we found that optimal timing for energy intake may be between 06:00 and 09:00,12:00 and 14:00,and between 15:00 and18:00,with high energy breakfast,medium energy lunch and low energy dinner and possibly further adjustments according to one’s chronotype and genetics.Also,timing and distribution of energy intake may serve as a novel therapeutic strategy to optimize coction,a concept describing digestion and metabolism in TEM.
文摘Objective: To assess the knowledge, attitude, perception and practice of Ayurveda, yoga, Unani, Siddha, homeopathy and naturopathy (AYUSH) among allopathic doctors and interns and determine their opin- ion regarding integration of AYUSH education within the allopathic curriculum. Methods: This prospective, cross sectional study was conducted in a tertiary care teaching Hospital, New Delhi, India, from March 2016 to March 2017. A survey of 500 aUopathic doctors and 150 interns was performed using a structured questionnaire. Results: A majority of doctors (95.2%) were aware of the term AYUSH and had knowledge of yoga (70.6%), homeopathy (55.6%), Ayurveda (50.3%), Siddha (47.8%), naturopathy (32.9%) and Unani (28.9%). Most of the participants (63.0%) felt that therapies under AYUSH are effective. A majority (84.0%) of the doctors were of the view that more research is required in the field of AYUSH. While homeopathy (44.0%) was the most common system used by doctors for themselves, yoga was the therapy most commonly (60.0%) recommended to patients. Nearly half of the doctors (46.7%) recommended AYUSH to their patients, mainly for chronic illness (74.0%). A majority (77.5%) of the respondents agreed that students of allopathic med- icine should be familiarized with AYUSH. The modes of incorporation of AYUSH into the medical curriculum most commonly suggested by respondents were optional courses (54.5%) and introductory lectures (42.3%). Conclusion: Doctors and interns ofallopathic medicine are aware of AYUSH systems. They use it for them- selves and recommend it to patients. They believe that familiarization of Bachelor of Medicine and Bachelor of Surgery students with AYUSH therapies and their integration with allopathic medicine may help in improving patient care.
文摘Scholars have argued that theoretical insights of critical medical anthropology should be applied to the analysis of complementary and alternative medicine in order to develop more critically engaged integrative medicine. In this essay we focus on nature cure in the context of India's contemporary epidemiological transition as an example of why engaged integrative medicine is important for public health, and how the institutionalization of nature cure treatment in India provides a critical framework for the development of programs focused on holistic treatment and prevention. After providing an overview of the epidemiological transition in contemporary India, we develop this argument through an examination of illustrative cases in a clinic that operates within the structure of India's Central Council for Research on Yoga and Naturopathy. Based on a review of recent history and contemporary practice we describe how a system of medicine that makes use exclusively of air, earth, sunlight, water and food has been institutionalized and professionalized in India. Whereas biomedical treatment for chronic non- communicable diseases is focused on the problem of curing individual diseases, nature cure establishes a regimen of personalized public healthcare for the integrated management of symptoms. We argue that nature cure is based on an ecological understanding of health, thus providing treatment that reflects a broad appreciation for the risk factors that characterize India's current crises of public health.