Integrative Approach in the Management of Janusandhivata w.s.r. to Osteoarthritis

Janusandhivata is a Vataj disorder in which Vata resides in Janu sandhi (Vimarga gaman) and produces various signs and symptoms according to its Gunas. In modern sciences Janusandhivata is correlated with osteoarthritis. In the present study integrative measures like allopathy medicines, Ayurvedic medicines and Karmas, yoga, naturopathy and exercises are studied for the effective relief of symptoms of Janu sandhigata vata i.e., OA. Integrative measures are studied to provide effective and fast relief to the patient. Modern treatment provides instant relief while on the other hand Ayurveda heals by curing the disease from root and is considered Apunarbhav chikitsa which means it prevents recurrence of the disease. Other measures aid in achieving the ultimate goal of cure from the disease.

A Comparative Clinical Study To Evaluate The Efficacy Of Greevabasti With Prasarini Taila And Nasya Karma With Parinitakeriksheera Taila As Pradhana Karma In Greevasandigatavata W.s.r. To Cervical Spondylosis

The digitalization of the world has influenced people to have access on all the things through technologies like use of computers, mobiles etc and excess use of this has caused various problems and one among them is usage of these gadgets in improper position which is the causative factor for Greeva Sandhigatavata and shows Sandhi Shoola, Sandhi Shotha, Vatapoorna Druti Sparsha and Prasarana Akunchana Vedana which can be correlated to Cervical Spondylosis which also shows similar symptoms like pain in the neck, stiffness, radiating pain and tenderness. So the study was carried on 10 patients, 5 patients in each group to evaluate the efficacy of Greevabasti with Prasarini Taila in Group A and Nasya Karma with Parinitakeriksheera Taila in Greeva Sandigatavata w.s.r. to cervical spondylosis as Pradhana karma after Poorava Karma of Snehana and Swedana in both the groups. The study revealed that Sandhishoola (joint pain) and Sandhishotha (joint Swelling) where highly significant statistically and Sandhisthabdhata was significant statistically in Group A, and in Group B Sandhi Sthabdhata shown highly significant results.

Clinical Efficacy Of Udvartana With Lekhana Basti In Hypercholesterolemia

Now a day, due to increase in industrialized population include a sedentary lifestyle and a diet characterized by the excessive consumption of saturated fats, trans fatty acids and cholesterol which tends to increase blood cholesterol levels. Raised total cholesterol is a major cause of disease burden in both the developed and developing world as a risk factor for Ischemic heart disease and stroke. In Ayurveda, this condition can be considered under Santarpanotthavyadhi. Due to Santarpanothanidanas there will be increase in the Pichilla and Snehagunas which in turn causes Ama, if further same nidanas are continued leads to Madhuratara of Ama and Annarasa causes the circulation of increased Medaie: Shareera Anukraman Atisnehan Medo Janayati. To combat this condition Acharyas have mentioned about VatagnaAnnapana, Ruksha- Ushna i.e., Ruksha Udvartana, Lekhana Basti etc lines of treatment. Hence this study was taken up to see the efficacy of the treatment protocol mentioned for the better management. It was an open label clinical study done on 10 patients. Patients were subjected to Sarvanga Udvartana with Kolakulatthadichurna and Lekhanabasti for a period of fifteen days. In the present study, the effect of the treatment has shown statistically Highly Significant (p<0.01) results on Serum Cholesterol and LDL. As the study was conducted to know the combined effect of Bahyaupakrama along with the Lekhanabasti, the usefulness of individual Upakrama found limited. So probably administration of these upakramas in single dimension one after the other along with proper diet and physical exercise in frequent intervals may yield good results.

A Comparative Clinical Study To Evaluate The Efficacy Of Janubasti Followed By Patrapinda Sweda And Janubasti Followed By Atasi Upanaha Sweda In Janu Sandhigata Vata W.s.r To Osteoarthritis Of Knee Joint

Janu Sandhigata Vata is a common Vata predominant disorder mainly caused in Vriddhavastha. It is a degenerative articular disorder caused in geriatric age group and its correlates with Osteoarthritis of knee joint. Being commonest form of articular disorders, Osteoarthritis poses a huge hindrance in day to day activities of the sufferer like walking, dressing and bathing etc. Due to Vriddaavasta, Uttarothara Dhatuposhana gets reduced and finally makes the person lame. Hence this study was conducted on 10 patients for 7 days to evaluate the efficacy of Janubasti with Moorchita Tila Taila followed by Patrapinda Sweda in Group A and Janubasti with Moorchita Tila Taila followed by Atasi Upanaha Sweda in Group B. The study reports significant relief in subjective parameters like Vatapurna Dritisparsha (joint crepitations), Sandhi Shoola (joint pain) and Prasarana akunchana pravriti sa vedana (pain during flexion and extension of joint) Sandhi Shotha (joint swelling) is completely relieved after the study. Assessment of results was done on the subjective parameters which showed highly significant changes in Vatapurna Drithisparsha, Sandhi Shotha and Prasarana Akunchana Vedana, and significant improvement in Sandhi Shoola in Group A. In group B Vatapurna Drithisparsha, Sandhi Shotha and Sandhi Shoola showed highly significant changes and Prasarana Akunchana Vedana showed significant changes.

A Clinical Study On Erandamula Ksheera Basti In The Management Of Vataja Gridhrasi W.s.r To Sciatica

Now a day抯 large number of population are suffering from low backache because of lifestyle modification, irregular sitting posture and house hold works. Low backache is a common symptom involving the muscles, nerves and vertebral column. Sciatica refers to pain that radiates along the path of Sciatic nerve. It resembles disease 揋ridhrasi� in Ayurveda. Radiating pain is the predominant symptom with stiffness, which will hamper the daily activity of an individual. The purpose of the study is to evaluate the efficacy of Erandamula Ksheera Basti in Vataja Gridhrasi. A total 10 patients of Vataja Gridhrasi were administered Erandamula Ksheera Basti in Yoga Basti pattern for 8 days. Vataja Gridhrasi lakshanas and SLR Positive were taken as assessment parameters, which showed significant results. Hence, Erandamula Ksheera Basti has better effect on patients of Vataja Gridhrasi.

A Clinical Study To Evaluate The Efficacy Of Panasa Patra Sweda As Poorva Karma For Nasya In Ardita W.s.r To Facial Palsy

Arditha is explained as one among the Vatananathmaja vyadhi by Acharya Charaka. Acharya sushrutha has considered as only Mukha ardha while Acharya Charaka has included Sharira ardha in Arditha.Facial nerve paralysis is the condition which presents with the deviation of half of the face and associated with the impairment of motor and sensory functions of the affected side of the face. Facial paralysis can be placed under the wide spectrum of Arditha vyadhi. In recent years, life time prevalence is about 6.4 to 20 per 1000, which increases with age, and predominantly seen in Females. Contemporary science adopts the treatment wherein chances of reoccurrence are possible. Both Acharya Charaka and Sushrutha as mentioned Nasya and Swedana as the prime line of treatment modalities in Ardita. Aims and objectives of the present study is to evaluate the efficacy of Panasa patra sweda followed by Nasya karma in Ardita. 10 patients fulfilling the inclusion and exclusion criteria were selected for Panasa patra sweda as Poorva karma and Nasya for 7 days with Ksheera bala taila 101. It was observed that Maximum patient in the study given statistically significant relief in almost all Parameters. The results of the present clinical study has given (p<0.001) which shown statistically highly significant.

Effective Management Of Vrasana Kacchu - Case Report

Skin is an organ which represents some inner abnormalities and stress conditions within one抯 body. Skin is just like a mirror reflection and manifesting various type of inner abnormality or diseased condition. Now a day抯, skin infections are more common in a persons who is having altered life style, lack of physical exercise, unhygienic condition, mental stress, irregular food habits. In Ayurveda, major skin diseases have been classified under the heading of Kustha. Acharya Sushrutha explained Vrsanakacchu under Kshudrarogas, while explaining the Nidanas, he opines that due to lack of hygiene there will be Mala sanchaya in the Vrshana leads to Kandu, Kshipraspota and Sravayukthavyadhi called Vrsanakacchu. In modern science this condition is termed as 揟inea Cruris, but in this present case, symptoms are seen in other places also, so in this condition can also be considered as 揟inea corporis" Inspite of all the advancement in treatment the results in contemporary science are not much beneficial. Here, a case report of 24 years female who approached to OPD of SKAMC,H & RC with chief complaints of dryness, blackish discoloration along with itching and peeling off of the greyish skin in the groin region, upper back, and above the umbilicus since 1 year, was treated with initial line of Bahirparimarjana chikitsa followed by Shodhana chikitsa.

Role Of Panchakarma In Myasthenia Gravis– A Case Study

Myasthenia Gravis (MG) is a long-term neuromuscular disease that leads to varying degrees of skeletal muscle weakness. The underlying defect is a decrease in the number of available acetylcholine receptors (AChRs) at neuromuscular junctions due to an antibody mediated autoimmune attack. The most commonly affected muscles are those of the eyes, face and swallowing. The cause of this disease can be understood in view of Upahata Dhatu Ushma, Srotas and Marutha respectively. The present observation was conducted with an objective to find out the efficacy of Ayurvedic management in Myasthenia gravis. Here is a case of 50years old Hindu female who was diagnosed as myasthenia gravis (MG) reported with complaining of slurred speech, low pitch of voice, difficulty to open the mouth and to swallow food and weakness in the both upper limbs since 4months was registered in OPD of SKAMCH&RC, Bengaluru. Considering the signs and symptoms patient was treated on the line of Ardita Vata chikitsa, Sarvanga Abhyanga with Moorchita tila taila, Nasya with Yashtimadhu taila, Gandusha with Erimedadi taila, Jihwa nirlekhana with Vacha churna were done. Treatment shows significant improvement in the symptoms without any side effects.

A prospective open-label randomized comparative study in Alzheimer’s disease between two commonly used drugs in coastal Indian population.

Background: Currently, therapy for Alzheimer’s disease (AD) is only symptomatic. Only two classes of drugs are approved by the United States Food and Drug Administration. Our study aimed at comparing effi cacy and safety of memantine and donepezil in moderate to severe AD patients. Methods: Totally, 22 patients with moderate to severe AD were randomized into the 2 arms of the study. The study was divided into an initial 4 weeks for determination of onset of effi cacy and subsequent 28 weeks of the treatment phase. Onset of effi cacy and response was defi ned as >20% and >50% reduction in the mean total score of functional dementia scale (FDS) and clinical global impression scale (CGIS) from baseline to the study end, respectively. Results: Onset of effi cacy on FDS and CGIS was 16.7% (mean-time 61.25 days) and 80% (mean-time 36 days) with memantine and donepezil, respectively. Response was 89.3% and 40% with memantine and Donepezil, respectively. Total reduction in FDS and CGIS score of from baseline to the study end was 39.50, 40.00, and 25.60, 27.20 with memantine and donepezil, respectively. Tolerability was 86.33% and 20% with memantine and donepezil, respectively. Anorexia, muscle cramps, constipation, headache, and insomnia, were the common side-effects and self-limiting. Safety was 100% in both groups. Conclusions: Onset of effi cacy was faster with donepezil seen at 2 weeks. Response, improvement in CGIS, FDS, and tolerability were better seen with memantine at 40 weeks. Thus, in similar clinical settings, memantine can be preferred.

Clinical manifestation and prevalence of peripheral neuropathy and nerve dysfunction in patients with chronic kidney disease.

Background: Chronic Kidney Disease (CKD) is recognized as a major health problem. Prevalence of CKD is rising continuously; mostly CKD is affecting the elderly aged population and/or patients with diabetes and hypertension. Present study was aimed to explore clinical manifestation and evaluate the prevalence of peripheral neuropathy and peripheral nerve dysfunction in CKD patients attending our hospital with reference to the severity and duration of the CKD. Methods: The present cross sectional study was conducted in 74 patients affected with chronic kidney disease, of different age groups at the medical wards of King George Hospital, Visakhapatnam. The presence of peripheral nerve dysfunction was assessed by nerve dysfunction clinically (motor or sensory symptoms and signs) and electrophysiological nerve conduction studies. Results: Out of 74 patients, 65% of study population was suffering from chronic kidney disease with peripheral nerve dysfunction. The peripheral nerves dysfunction was more prevalent in elder age (>65 years) subjects when compared to subjects with age <65 years. Moreover, the results shown that the rate of prevalence of peripheral nerves dysfunction was observed higher in subjects with longer duration of CKD. Male subjects were affected more when creatinine clearance is <15 ml/minute. Both sexes were affected equally when creatinine clearance is between 30-59 ml/minute. Conclusion: This study enlightens the prevalence and clinical presentation of peripheral nerve dysfunction in patients with CKD. The CKD was found to cause peripheral neuropathy including overt and subclinical neuropathy, of which distal symmetrical sensory motor neuropathy was common in CKD. The prevalence of peripheral neuropathy was directly proportional to duration and severity of CKD.

Clinical, biochemical & cytomorphologic study on Hashimoto’s thyroiditis.

Background & objectives: Despite, the extensive salt iodization programmes implemented in India, the prevalence of goiter has not reduced much in our country. The most frequent cause of hypothyroidism and goiter in iodine sufficient areas is Hashimoto’s thyroiditis (HT). This study records the clinical presentation, biochemical status, ultrasonographic picture and cytological appearance of this disease in a coastal endemic zone for goiter. Methods: Case records of patients with cytological diagnosis of HT were studied in detail, with reference to their symptoms, presence of goiter, thyroid function status, antibody levels and ultrasound picture. Detailed cytological study was conducted in selected patients. Results: A total of 144 patients with cytological proven HT/lymphocytic thyroiditis were studied. Ninety per cent of the patients were females and most of them presented within five years of onset of symptoms. Sixty eight per cent patients had diffuse goiter, 69 per cent were clinically euthyroid and 46 per cent were biochemically mildly hypothyroid. Antibody levels were elevated in 92.3 per cent cases. In majority of patients the sonographic picture showed heterogeneous echotexture with increased vascularity. Cytological changes were characteristic. Interpretation & conclusions: our study showed predominance of females in the study population in 21-40 yr age group with diffuse goiter. We suggest that in an endemic zone for goiter, all women of the child bearing age should be screened for HT.

Focal reactive soft tissue Lesion of gingiva: a diagnostic dilemma

There are different types of focal overgrowths which may occur on the gingiva. These growths of gingiva are common and often result from underlying systemic disease, drug induced, local iatrogenic factors and dental plaque. Many of these enlargements are considered to be reactive rather than neoplastic in nature. These reactive lesions are more common in the oral cavity because of the frequency with which the tissues are injured. Clinically differentiating one from the other as specific entity is sometimes difficult. This case report describes one such reactive growth of the gingiva that is not implicated with any underlying systemic disease or drug induced. Clinical, radiographic, histologic characteristic along with the differential diagnosis, treatment and prognosis are discussed with the importance of the proper communication with the patient as she was more anxious about the possibility of the lesion being a carcinoma.

A Study of Clinical Profile and Outcome in Acute Viral Hepatitis E.

Introduction: Hepatitis E is the most common cause of acute viral hepatitis in the adult population in India. Acute viral hepatitis E (HEV) is generally mild and self-limiting and resolves within six weeks, with no chronic sequelae. Pregnant women are at increased risk with the risk increasing as the pregnancy progresses near term. Methods: We performed a prospective study of 100 patients who presented to Dept. of Medicine, Civil Hospital, Ahmedabad with jaundice (IgM anti-HEV positive) during 2011-2012 and data were analyzed for the clinical profile and outcome of HEV. Results: The most common age group affected was 21-30 years with overall M:F ratio of 3.4:1. Most common presenting symptom was jaundice (100%) followed by nausea/ vomiting (87%). On presentation, serum bilirubin level was elevated in 89% patients with SGPT raised in 86%. PT was prolonged in 39% patients. Anemia (Hb < 7) was seen in 17% while 9% of patients had renal involvement. Hepatic encephalopathy was seen in 15%. In this study, 12 women were pregnant in whom IUD occurred in 66% with maternal mortality in 33%. Overall mortality was 7%. Conclusion: We found that majority of cases were cured with supportive treatment while risk of mortality and morbidity was more in pregnant women.

Chronic subdural empyema and cranial vault osteomyelitis due to Salmonella paratyphi A.

Intracranial infections, especially subdural empyema, due to salmonella are rare. Subdural empyema caused by Salmonella paratyphi A has been documented only once earlier in the literature. Hence, we report a case of subdural empyema and osteomyelitis of cranial vault due to S. paratyphi A. A 42- year-old male presented with headache and purulent discharge from right parietal burr hole wound site. Patient gave a history of head injury two years ago. He underwent burr hole evacuation of chronic subdural haematoma, excision of outer membrane and right parietal craniectomy. The cultures grew S. paratyphi A. Recovery was uneventful following surgical intervention and antibiotic therapy.

Molecular mechanics studies of homopolymeric and mixed sequence Py.Pu*Pu triple helices.

DNA triple helices containing two purine strands and one pyrimidine strand (C.G*G and T.A*A) have been studied, using model building followed by energy minimisation, for different orientations of the third strand resulting from variation in the hydrogen bonding between the Watson-Crick duplex and the third strand and the glycosidic torsion angle in the third strand. Our results show that in the C.G*G case the structure with a parallel orientation of the third strand, resulting from Hoogsteen hydrogen bonds between the third strand and the Watson-Crick duplex, is energetically the most favourable while in the T.A*A case the antiparallel orientation of the third strand, resulting from reverse Hoogsteen hydrogen bonds, is energetically the most favourable. These studies when extended to the mixed sequence triplexes, in which the second strand is a mixture of G and A, correspondingly the third strand is a mixture of G and A/T, show that though the parallel orientation is still energetically more favourable, the antiparallel orientation becomes energetically comparable with an increasing number of thymines in the third strand. Structurally, for the mixed triplexes containing G and T in the third strand, it is seen that the basepair non-isomorphism between the C.G*G and the T.A*T triplets can be overcome with some changes in the base pair parameters without much distortion of either the backbone or the hydrogen bonds.

Effect of low fluoride dentifrices on microhardness of sound enamel. In vitro study.

The present study was undertaken to evaluate the effect of dentifrices containing low fluoride concentrations on microhardness of sound enamel in 50 healthy young premolar teeth. They were divided into five different groups according to the concentrations of fluoride in dentifrice used. The Vickers hardness of enamel was measured using a Zwick microhardness tester under 1000 g load and a Vickers indenter before and after the application of fluoride dentifrices. The results of the present study suggest that low fluoride concentration dentifrices are as effective as the higher concentrations in increasing the hardness of enamel.