Efficacy Of Virechana Karma In The Management Of Acne Vulgaris

A healthy and clear facial impression plays the important part for the development of the personality. Since ages, Acne vulgaris has always been one of the most burning problem of the adolescents. It affects the most prominent part of our body, the face. Among the multifactorial etiology of acne hormonal imbalance and infections are most important. Acne is a cutaneous pleomorphic disorder of the pilosebaceous unit involving abnormalities in sebum production and is characterized by both inflammatory (papules, pustules and nodules) and non-inflammatory (comedones, open and closed) lesions. Propionibacterium acnes is responsible for the development of acne vulgaris. Acne Vulgaris can be correlated with Mukhadushika or Yuvanpidika on the basis of similarity in the etiopathogenesis, symptoms, treatment and complication. In Ayurveda it is the Shalmali thorn like eruptions on the face of adolescent due to vitiation of Kapha, Vata and Shonita. Allopathic treatment includes treatment for all forms of acne as topical retinoids and benzoyl peroxide, oral antibiotics, steroids etc. But these causes serious adverse effects. So it is necessary to find out effective and safe treatment for Acne Vulgaris. Ayurveda is for it which plays important role through its principles i.e. Shodhana, Shamana and Nidanparivarjana. As described by various Acharya the Shodhanachikitsa includes Vamana, Virechana and Shiravedha. Among Shodhana, Virechana process is the safe and effective treatment, providing long lasting result for better life of patient.

A Ray Of Hope Through Ayurvedic Management In Osteoarthritis: A Case Study

Osteoarthritis (OA) is degenerative condition, increasing due to today’s life style and age related changes. It mostly affects woman. A 70 years female patient, housewife by occupation, known case of osteoarthritis since 30 years was admitted in IPD of Panchkarma department with following presenting complaints: continuous pain in both knee joints and pain in lower back and hands. On the basis of strong similarity between etiological factor, symptoms, and Doshika involvement in the etiopathology and complication, OA can be correlated with Sandhigata Vata. There is need to search a safe, effective and less-expensive treatment that can alter the course of the disease. In this condition, Ayurveda is a ray of hope to stop disease progression. Considering these points in mind, Sarvang Abhyang with Narayan Tail, Swedana, Matra vasti with Panchguna Tail was administered in patient for 10 days. After this, Sarvang Patra Pottali Swedana was given for 7 days along with oral medication like Tryodashang Gugglu 2 tablets thrice a day, Tablet Neo 2 tablets twice in day after meal. Activities which were hampered due to symptoms and after 45 days of treatment, patient can perform daily tasks easily with mild pain in some joints and complete relief in others. Ayurvedic management provides better result within limited time periods with least oral medications.

Efficacy Of Dhanyamla Sarvanga Dhara In The Management Of Obesity: An Analytical Review

Obesity consist a major nutritional health problem in developed and developing countries, which has reached epidemic proportions. It is a medical condition of excessive fat accumulation to the extent that it may have negative effect on health. Obesity are major causes of co-morbidities, including type 2 diabetes, cardiovascular disease, various cancer and other health problem like obstructive sleep apnea, osteoarthritis and depression. Obesity is most commonly caused by a combination of excessive food intake, lack of physical activity. Leptin enzyme is responsible for controlling appetite through its action on CNS, TNF alpha is also link factor between fat accumulation and metabolic disorders. The body mass index (BMI) is an internationally accepted index to estimate body weight. Taking medication like Sibutramine, Orlistat as an option for treatment of obesity can be given, because it is associated with many side effects. Bariatric surgery may be performed to reduce weight, but it is not very useful treatment. Diet, life style modification, physical activity can achieve the desired loss of body fat. In Ayurveda best treatment for Sthaulya defined by Acharyacharak and Sushruta and Vagbhatt. Dhanyamalasarvangadhara is highly effective in Vata associated with Ama and Kapha. Dhanyamla sarvanga dhara eliminates the body toxins, establishes health and tones up the joints and soft tissues. The drug will act soon as the medicine touches the skin surface. Due to Vasodilation property blood flow will increase through the area, increasing metabolism further eliminating the toxins, which will help in reducing the obesity. Dhanyamala sarvanga dhara controls the disease process and may cause long lasting relief.

Management Of Psoriasis Through Ayurveda- A Case Study

Psoriasis is one of the most common dermatologic diseases, affecting up to 1% of the world's population. It is a chronic inflammatory skin disorder clinically characterized by erythematous, sharply demarcated papules and rounded plaques, covered by silvery micaceous scale. It has poorly understood etiology and presence of 50% positive family history. Drugs used now a day are basically immunosuppressive which have severe side effects along with remission of disease as well therefore holistic approach of Ayurveda can be a better approach to such disease. Psoriasis due to its different manifestation in different types can be correlated to different types of Kustha mentioned in Ayurveda. So the case being presented here is a male patient with red demarcated patches with severe itching in armpits, groin and nipple. Material and method: The patient was administered with Virechana with Trivritaavaleha followed by Shamana drugs. Results: After Virechana there was the complete improvement in itching and redness of patches was reduced to some extent but after using Shamana drugs there was moderate reduction in all the symptoms along with mild remission. Conclusion: There is need to develop a management for psoriasis which can give benefit on a long run without any adverse effects so, Ayurvedic system of medicine could be answer to this question.

V-raf murine sarcoma viral oncogene homolog B (BRAF) mutations in hairy cell leukaemia.

Introduction: Hairy cell leukemia (HCL) is a B-cell non-Hodgkin lymphoma with distinct clinical, morphological and immunophenotypic features; however, there are many other B-cell lymphomas, which closely mimic HCL. Accurate diagnosis of HCL is important as treatment with 2-chloro-2’-deoxyadenosine (cladribine) is associated with >80% chance of complete cure. The recent description of BRAF p.V600E mutations in almost all HCL cases in various studies has not only improved the pathogenetic understanding of this entity but also increased the diagnostic accuracy of this disorder. Aim: The aim of the study was to standardize a molecular test for diagnosis of HCL and compare with standard established morphological, cytochemical and immunophenotypic parameters for HCL diagnosis. Materials and Methods: The incidence of this mutation was sought in 20 patients with either classical HCL or HCL variant (HCLv) by Sanger sequencing and allele-specifi c polymerase chain reaction. BRAF p.V600E mutation was present in all HCL cases and absent in the only HCLv case. Results: A high degree of correlation was noted between the presence of BRAF p.V600E and established diagnostic criteria in 20/20 patients with HCL/ HCLv. Our data supports the observation that this mutation is present in all cases of HCL and is absent in HCLv. Hence, detection of the BRAF p. V600E mutation can be a useful adjunct in the diagnostic algorithm.

A rapid & sensitive liquid chromatography- tandem mass spectrometry method for the quantitation of busulfan levels in plasma & application for routine therapeutic monitoring in haematopoietic stem cell transplantation.

Background & objectives: Busulfan (Bu) in combination with cyclophosphamide is widely used in myeloablative conditioning regimen prior to haematopoietic stem cell transplantation (HSCT). Its narrow therapeutic range and toxic side effects at high systemic exposure and graft rejection at low exposure emphasize the need for busulfan dose optimization using targeted dose adjustment prior to HSCT. We report here a rapid and sensitive method to quantitate busulfan plasma levels in patients receiving busulfan as part of pre-transplant conditioning. Methods: The method involves simple protein precipitation of the plasma followed by analysis using a high performance liquid chromatography (HPLC) with tandem mass spectrometry - electrospray ionization technique (LC-ESI MS/MS) in positive ionization mode and quantified using multiple reaction monitoring (MRM). Deuterated busulfan (d8-busulf`an) was used as the internal standard. Results: The method was linear for the concentration ranging from 0 to 4000 ng/ml of busulfan with a limit of detection of 2 ng/ml and limit of quantitation of 5 ng/ml. The assay was accurate for serial concentrations of Bu in plasma for five consecutive days and the CV was less than 10 per cent. Conclusion: Using this rapid and sensitive method, busulfan levels were targeted and subsequent doses adjusted at our center in 26 patients receiving high dose busulfan in combination with cyclophosphamide or fludarabine.

Fluorescence in situ hybridization patterns of BCR/ABL1 fusion in chronic myelogenous leukemia at diagnosis.

Background : Chronic myelogenous leukemia (CML) is characterised by the t(9;22)(q34;q11.2) which results in the formation of the BCR/ABL1 fusion gene. Occasionally, the t(9;22) may be associated with submicroscopic deletions of chromosomes 9 and/or 22 which appear to be associated with a worse prognosis. Three or four-way variant t(9;22) may also occur. All these changes as well as gain of the Philadelphia chromosome which represents disease progression can be detected by fluorescence in situ hybridization (FISH) analysis. FISH analysis at presentation is used to determine the number of cells with BCR/ABL1 fusion and establish whether the patterns are typical or atypical. Response to therapy can then be monitored by serial testing. Patients and Methods : The study group consisted of all patients diagnosed or suspected to have CML who had interphase FISH analysis at presentation on peripheral blood/bone marrow using a commercially available BCR/ABL1 dual colour, dual fusion probe. The study was performed at a tertiary hospital in India between 2004 and 2010. Results: There were 1076 diagnostic samples which were positive for BCR/ABL1 fusion. Typical dual fusion signals (two fusions, one red and one green, 2F1R1G) were seen in 801 cases (74 %). Atypical signal patterns were seen in 275 cases (26%). These were: 1F1R2G (4%), 1F2R1G (2.5%) and 1F1R1G (11%) representing deletions of the derivative 9 involving chromosome 9 sequences, chromosome 22 sequences, or both respectively; 3F1R1G (6.5%) usually representing gain of an additional Philadelphia chromosome and 1F2R2G (1%) representing a three- or four-way variant translocation. More than one signal pattern was seen in 1%. Conclusions: Our findings were similar to the literature with respect to the distribution of signal patterns except that we had a lower number of patients with variant translocations. While each signal pattern is typically associated with a particular abnormality, there can be more than one explanation for each pattern. Hence, metaphase FISH analysis is the "gold standard" for the interpretation of signal patterns.

EDTA and citric acid mediated phytoextraction of Zn, Cu, Pb and Cd through marigold (Tagetes erecta).

Phytoextraction is an emerging cost-effective solution for remediation of contaminated soils which involves the removal of toxins, especially heavy metals and metalloids, by the roots of the plants with subsequent transport to aerial plant organs. The aim of the present investigation is to study the effects of EDTA and citric acid on accumulation potential of marigold (Tagetes erecta) to Zn, Cu, Pb, and Cd and also to evaluate the impacts of these chelators (EDTA and citric acid) in combination with all the four heavy metals on the growth of marigold. The plants were grown in pots and treated with Zn (7.3 mg l-1), Cu (7.5 mg l-1), Pb (3.7 mg l-1) and Cd (0.2 mg l-1) alone and in combination with different doses of EDTA i.e., 10, 20 and 30 mg l-1. All the three doses of EDTA i.e., 10, 20 and 30 mg l-1 significantly increased the accumulation of Zn, Cu, Pb and Cd by roots, stems and leaves as compared to control treatments. The 30 mg l-1 concentration of citric acid showed reduced accumulation of these metals by root, stem and leaves as compared to lower doses i.e., 10 and 20 mg l-1. Among the four heavy metals, Zn accumulated in the great amount (526.34 mg kg-1 DW) followed by Cu (443.14 mg kg-1 DW), Pb (393.16 mg kg-1 DW) and Cd (333.62 mg kg-1 DW) in leaves with 30 mg l-1 EDTA treatment. The highest concentration of EDTA and citric acid (30 mg l-1) caused significant reduction in growth of marigold in terms of plant height, fresh weight of plant, total chlorophyll, carbohydrate content and protein content. Thus EDTA and citric acid efficiently increased the phytoextractability of marigold which can be used to remediate the soil contaminated with these metals.

EDTA enhances lead uptake and facilitates phytoremediation by vetiver grass.

Vetiver grass (Vetiveria zizanioides) has strong and dense root system and is a potential phytoremediator plant since it can tolerate a wide range of climatic conditions and grow well in soils contaminated with heavy metals. Soil was artificially contaminated by lead (20 mgl(-1)) during field trials. Four concentration of EDTA (Ethylene diamine tetra acetic acid-disodium salt) solution i.e. 0, 3, 5 and 10 mmol kg(-1) were added to soil prior to harvesting, to study the influence of EDTA solution on phytostabilization by vetiver grass. Results showed that the concentration of lead in roots of vetiver is significantly increased after EDTA solution (5 mmol kg(-1)) application. However, high concentration of EDTA (10 mmol kg(-1)) does not show such significant increase. The toxicity of highly contaminating metal did not affect the growth of vetiver grass significantly but a slight decrease in parameters studied was noticed. No stress symptoms were observed in vetiver plants. Results of present study reveal that vetiver could be considered as a potential phytoremediator for lead contamninated site.

Prenatal diagnosis of Glanzmann thrombasthenia.

BACKGROUND: Glanzmann thrombasthenia (GT) is an autosomal recessive disorder of platelet function, which results in major morbidity due to persistent, spontaneous, mucocutaneous bleeding and menorrhagia in women. Platelet transfusions are often needed to control the bleeding. Glanzmann thrombasthenia results from mutations in the genes located on chromosome 17q21-23, encoding the platelet glycoprotein (GP) IIb/IIIa receptor. METHODS: This report describes, for the first time in India, the prenatal diagnosis performed in a family who had a child with GT. As the molecular defect had not been identified at the time of chorionic villus sampling (CVS), prenatal diagnosis was done by linkage assessment. Haplotype analysis was performed using polymorphic markers on chromosome 17q 12-21, which included the dinucleotide repeat polymorphisms (CA)n in BRCA1 gene and locus D17S579 and (CT)n within GP IIIa intron 6, and the known restriction fragment length polymorphism (RFLP) markers Fok I (GP IIb exon 26), Taq I (GP IIIa exon 8) and Sma I (GP IIIa exon 9). The specific mutation in this family was subsequently confirmed. RESULTS: Both parents and the foetus were heterozygous for all the dinucleotide repeat polymorphisms and the affected child was homozygous. Both parents and the affected child were homozygous for Fok I RFLP. The father was heterozygous, and the mother, affected child and foetus were homozygous for Taq I and Sma I. The Fok I RFLP was identical for all the family members and hence did not provide any information for haplotype analysis (foetus not tested). CONCLUSION: The findings from dinucleotide repeat polymorphisms in BRCA1, D17S579, and GP IIIa intron 6 and the Sma I and Taq I RFLPs in GP IIIa strongly suggested that the foetus had inherited the father's mutant and the mother's normal alleles. Hence, the foetus was diagnosed to be a heterozygous carrier of GT by haplotype analysis. A private sequence alteration was later identified in the affected child in GP IIIa IVS1 (-14C --> A). The parents and foetus were heterozygous for this mutation. This confirmed the findings of the haploytpe analysis.