ABSTRACT
Rheumatoid arthritis is a chronic, progressive autoimmune arthropathy and characterized by bilateral symmetrical involvement of joints with some systemic clinical features. Treatment in allopathic medicine involves NSAIDS and steroids, which carry their own collateral burden of side effects in long term use. According to clinical features, described in Ayurveda, Vatarakta closely resembles with Rheumatoid arthritis. The study is done to find the effect of Sodhananga Achasnehapana with Guggutiktaka ghritha followed by Virechana with Nimbamrita eranda taila in Rheumatoid Arthritis. Methods: It is a simple random single case study done at Government Ayurveda College Panchakarma Hospital, Poojappura, Thiruvananthapuram. Here a case of Vatarakta (Vatakapahadikam) was treated with Sodhananga Achasnehapana with Guggutiktaka ghritha followed by Virechana with Nimbamrita eranda taila after Rukshana karma. Results: The treatment was effective in reducing the ESR, RA factor and CRP levels of the patient diagnosed with Rheumatoid arthritis. Conclusion: The case report shows that Ayurvedic treatment is potent and effective in the management of Rheumatoid arthritis. There was no adverse effect found in the treatment. Hence it can be concluded that RA can be effectively and safely treated by using the Chikitsa siddhanta mentioned in Ayurveda
ABSTRACT
The tuberculosis associated immune reconstitution inflammatory syndrome (TB-IRIS) frequently complicates the course of HIV/AIDS and HIV-TB treatment and its immunological mechanisms are poorly understood. Here, we investigated T-cells frequencies, their secreted chemokines and cytokines. In this prospective case-control study, HIV/AIDS and HIV-TB patients during treatment with highly active antiretroviral treatment (HAART) and anti-TB treatment were followed for TB-IRIS development. Age, gender and BMI-matched patients without IRIS constituted as “Controls” (non-IRIS). Activation and proliferation were assessed in CD4 and CD8 cell compartments. CCR4, CCR6 and T-reg cells were also analysed in PBMCs. Cytokines (IL-2, IL-4, IL-10, IFN-γ and TGF-β1) and chemokines (IP-10, MCP-1, MIG and RANTES) were measured in culture supernatants. Of 560 enrolled HIV/AIDS patients, TB-IRIS developed in 50 (8.9%) patients (25-paradoxical and 25-unmasking) at a median interval of 35-days (IQR, 24-78). After ART therapy, CD8+ T-cell proportion decreased in both paradoxical and unmasking-TB-IRIS as compared to non-IRIS. Simultaneously, activation of CD4+ T-cells was observed in unmasking TB-IRIS only. Similarly, CD161+ T-cells, Th17-cells and inflammatory cytokines like IFN-γ, IP-10 and MIG elevated in both TB-IRIS subgroups as compared to non-IRIS.In conclusion, during HAART treatment the dominance of pro-inflammatory cells and cytokines in TB-IRIS patients favours the development of IRIS event. On the other hand, in non-IRIS patients relative increase of anti-inflammatory cells and cytokines prevents the development of IRIS event.