Charmadala: Virudhaahar Janya Kushtha - A Case Study

In the midst of movement and chaos of life, we forget to pay heed to our health and as a result of which susceptibility to various allergens is increasing day by day. Allergens can be dust, smoke, fumes, pollen and even food. A person can either be allergic to certain allergen right from his birth or can acquire hypersensitivity in later stage of his life. Food allergy is quite common in present era and is affecting the lives of many people. Although there are a number of manifestations of food allergy like nausea, vomiting, diarrhoea, headache etc, most commonly seen are skin manifestations like blisters, itching, redness, burning sensation, oozing, discolouration etc. Acharyas have also mentioned Virudhaahar as one of the most prominent cause of Kushtha. Virudhaahar is any food that causes sensitivity reactions in a person. In contemporary sciences, there are no such permanent cures for hypersensitivity induced skin diseases. But in Ayurveda, through Shodhana and Shamana, these can be treated effectively and occurrence can also be avoided to some extent. This case report is of 38 yrs old male who visited our OPD with itching, oozing, blisters with intense burning sensation in palms and redness and itching in groin areas. The disease was diagnosed here as Charmdala. The treatment protocol opted was Virechan and Shamana. The patient was assessed every 7 days for a month and showed significant relief. This case thus proves that Ayurveda has the potential for curing Virudhaahar janya Kushtha which is often unresponsive to the contemporary treatment protocol.

Til Tail (Sesamum Indicum): A Hidden Cause Behind Tamaka Shwasa (Bronchial Asthma): A Literary Review

Respiratory problems are very common due to the devastating pollution, irritants and infections. Asthma is one of the chronic inflammatory respiratory illnesses throughout the world and is characterized by breathlessness, chest tightness, wheeze and coughing. It occurs as a result of hypersensitivity reaction mainly due to allergens. These allergies mostly can be from the food. Like other allergies, sesame allergy is quite common yet unknown but it’s prevalence has been continuously increasing in recent years. A lot of modern researches proved Sesame as a food allergen causing airway inflammation and IgE mediated airway hyper responsiveness and finally causes asthma. In Ayurveda, asthma is well correlated as Tamaka shwasa. In classical texts of Ayurveda like Charaka Samhita and Sushrut Samhita similar etiological factors are described for Shwasa roga, in addition to that dietary factors (Aharaj Nidan) are also mentioned such as Nishpava, Masha, Til tail, Pinyak, Pishti, Aam ksheer etc. which vitiates the Doshas and finally causes Tamaka shwasa. This review article mainly focuses the role of Til tail (Sesamum indicum) in the etiopathogenesis of Tamaka shwasa and also, for better understanding of textual facts and may be used as an effective key to control the mortality and morbidity related to it.

A Conceptual Study on the Role of Vasa Bhavit Haridra Churnam in Vataja Kasa (Dry Cough) w.s.r. to Allergic Bronchitis: A Review

In the present era of COVID -19, management of respiratory disorders is becoming a challenge to the world. Ayurveda, the science of life, provides a lot of hope in the present condition by assuring better results in the field of prevention and management of respiratory diseases. Cough carries out an essential protective function for the respiratory tract and lungs. Kasa (cough) is one of the commonest complaints in day-to-day life and it is also a symptom of various diseases of the respiratory system. In Ayurveda, Acharyas have explained Kasa in detail. They have described five types of Kasa. Among the various respiratory diseases, Vataja Kasa (dry cough) has been selected here. In the contemporary science, it can be correlated to Allergic Bronchitis, which is one of the common problems throughout the world. In the present study Vasa Bhavit Haridra Churnam (VBHC) has been selected from Siddh Bhaisajya Manimala and further details regarding the ingredients were collected from various text books, PubMed, research articles, previous works done etc. As per the data collected, Allergic Bronchitis when treated with Vasa Bhavit Haridra Churnam will be effective in relieving the symptoms. Ayurveda has a vital role to play in the field of respiratory ailments.

Ayurvedic Management of Hepatitis

Hepatitis is inflammation of liver parenchyma mostly caused by viruses and other factors. It’s a non-specific prodromal illness characterized by headache, myalgia, arthralgia, nausea, anorexia, dark urine, yellow discoloration of skin, mucosa, sclera and other tissues etc. Methodology: A diagnosed case of hepatitis, 37yrs old female patient, admitted in at Government Ayurvedic college & Hospital, Kadam Kaun, Patna, Having IPD No.1006, RN.7178. Based on symptoms, supported by blood investigation reports and Ayurvedic parameters, the condition diagnosed as Yakritsotha. Oral medicines given: Aryogyavardhini Vati, Punarnava Mandur, Shallaki, Syp. Kalmegh, Kasis Bhasm, Liv 52 HB, Phaltrikadi Kwatha, cap. Stresscom along with Pathya apathya ahara vihara were prescribed. Result: There was drastic decrease in all the symptoms. The effect of treatment was monitored during the follow up with routine blood examinations. The bilirubin level decreased from initial 6.2mg/dl to 1.0mg/dl. Discussion: This article is a discussion about a case of Hepatitis which was successfully treated by Ayurvedic line of treatment. The signs and symptoms, causes, pathos-physiology of Hepatitis, along with its co-relation in Ayurveda as Yakritsotha, its line of treatment and possible the mode of action of drugs were the main points of consideration. Conclusion: Use of medicines such as Aryogyavardhini Vati, Punarnava Mandur, Shallaki, Syp. Kalmegh, Kasis Bhasm, Liv 52 HB, Phaltrikadi Kwatha, cap. Stresscom along with Pathya apathy ahara vihara showed good result without any complication in the present study.

Utility of thromboelastography versus routine coagulation tests for assessment of hypocoagulable state in patients undergoing cardiac bypass surgery

Introduction: Peri-operative monitoring of coagulation is important to diagnose potential cause of hemorrhage, to manage coagulopathy and guide treatment with blood products in patients undergoing cardiac surgery with cardiopulmonary bypass. This study was done to evaluate usefulness of Thromboelastography (TEG) and routine coagulation tests (RCT) in assessing hemostatic changes and predicting postoperative bleeding in patients undergoing cardiac surgery with cardiopulmonary bypass. Methods: Fifty adult patients undergoing cardiac surgery with cardiopulmonary bypass were enrolled in this prospective study. Preoperative and post-operative samples were collected for routine coagulation tests and TEG. Regression analysis and test of significance using Pearson's correlation coefficient was performed to assess correlation between routine coagulation tests and corresponding TEG parameters .Regression analysis was done to study relation between blood loss at 24 hours and various coagulation parameters. Results: The Routine coagulation test i.e. PT, INR, APTT showed no significant correlation with corresponding TEG parameters in pre-operative samples. However platelet count significantly correlated (p = 0.004) with MA values in postoperative samples. A significant correlation (p = 0.001) was seen between fibrinogen levels and alpha angles as well as with MA in both baseline preoperative and postoperative samples. TEG parameters R time and MA in postoperative samples were the only parameters that predicted bleeders with fair accuracy. Conclusion: Though the techniques of RCT and TEG are different, a few RCT e.g. platelet count and fibrinogen correlated with corresponding TEG parameters i.e. MA and Alpha angle. TEG parameters (R time and MA in postoperative samples) were able to predict blood loss better than RCT.

Regulation of N-Myristoyltransferase by the Calpain and Caspase Systems.

N-myristoyltransferase (NMT) is an essential eukaryotic enzyme which catalyzes the transfer of the myristoyl group to the terminal glycine residue of a number of proteins including those involved in signal transduction and apoptotic pathways. In higher eukaryotes, two isoforms of NMT have been identified (NMT1 and NMT2) which share about 76% amino acid sequence identity in humans. Protein-protein interactions of NMTs reveal that m-calpain interacts with NMT1 whereas caspase-3 interacts with NMT2. These findings reveal differential interactions of both isoforms of NMT with various signaling molecules. This minireview provides an overview of the regulation of N-myristoyltransferase by calpain and caspase systems.

Comparison of spoligotyping, mycobacterial interspersed repetitive units typing and IS6110-RFLP in a study of genotypic diversity of Mycobacterium tuberculosis in Delhi, North India

The aim of the present study was to compare polymerase chain reaction (PCR)-based methods - spoligotyping and mycobacterial interspersed repetitive units (MIRU) typing - with the gold-standard IS6110 restriction fragment length polymorphism (RFLP) analysis in 101 isolates of Mycobacterium tuberculosis to determine the genetic diversity of M. tuberculosis clinical isolates from Delhi, North India. Spoligotyping resulted in 49 patterns (14 clusters); the largest cluster was composed of Spoligotype International Types (SITs)26 [Central-Asian (CAS)1-Delhi lineage], followed by SIT11 [East-African-Indian (EAI) 3-Indian lineage]. A large number of isolates (75 percent) belonged to genotypic lineages, such as CAS, EAI and Manu, with a high specificity for the Indian subcontinent, emphasising the complex diversity of the phylogenetically coherent M. tuberculosis in North India. MIRU typing, using 11 discriminatory loci, was able to distinguish between all but two strains based on individual patterns. IS6110-RFLP analysis (n = 80 strains) resulted in 67 unique isolates and four clusters containing 13 strains. MIRUs discriminated all 13 strains, whereas spoligotyping discriminated 11 strains. Our results validate the use of PCR-based molecular typing of M. tuberculosis using repetitive elements in Indian isolates and demonstrate the usefulness of MIRUs for discriminating low-IS6110-copy isolates, which accounted for more than one-fifth of the strains in the present study.

A simple method to differentiate between Mycobacterium tuberculosis and non-tuberculous mycobacteria directly on clinical specimens.

We report the applicability of testing susceptibility to paranitrobenzoic acid (PNB) directly on clinical samples as a rapid screening assay, to detect M. tuberculosis and differentiate it from non-tuberculous mycobacteria (NTM). One hundred smear positive sputum samples from patients with pulmonary tuberculosis attending the Department of Respiratory Medicine at VP Chest Institute, Delhi, were cultured on Löwenstein Jensen medium with and without 0.5 mg/ml paranitrobenzoic acid. Serial concentrations of known cultures of H37Rv, M. fortuitum, M. scrofulaceum and M. avium were used as controls in the study. After 3 weeks of incubation, growth was observed on all the drug free Löwenstein Jensen slants but none of the slants containing PNB, which inhibited the growth of M. tuberculosis. The cultures were further confirmed to be M. tuberculosis by niacin, nitrate and catalase tests. Direct susceptibility to PNB was thus found to be a simple, cheap and technically feasible method of preliminary identification of M. tuberculosis and its effective differentiation from NTM, which may be adapted for use at Level II laboratories, especially in developing countries.

Genotype analysis of human Mycobacterium avium isolates from India.

BACKGROUND & OBJECTIVE: Mycobacterium avium has emerged as a major opportunistic pathogen, infecting nearly 50 per cent of HIV/AIDS patients in the western world. There is no report from India regarding the typing profile of M. avium, a potential pathogen, the present study was undertaken to assess the genotypic diversity of Indian M. avium isolates of human origin. METHODS: A total of 65 biochemically identified M. avium isolates from sputum samples of patients with chronic pulmonary illness were subjected to IS1245 based restriction fragment length polymorphism (RFLP) and polymerase chain reaction (PCR) typing. RESULTS: IS1245 insertion sequence based RFLP demonstrated polymorphism in 84.6 per cent isolates, while 15.4 per cent isolates did not hybridize on Southern blot and therefore were RFLP negative. Among the 55 RFLP positive isolates, 8 showed 1-3 bands, 19 had bands ranging between 4-9, and 28 isolates had >10 bands each. Although the isolates could be clubbed on the basis of number of bands, the banding profile was highly polymorphic. Among the 55 isolates typeable by RFLP, four clusters and 40 unique types of polymorphism were observed. Application of IS1245 based PCR typing on the same isolates showed that 87.7 per cent isolates were typeable. Interestingly the 10 isolates that were not typeable by IS1245 RFLP were typeable by IS1245 based PCR typing. Among the 57 PCR typed isolates a cluster of 14 isolates with identical 3-banded pattern was observed. Notably, 5 of the ten IS1245 RFLP negative isolates were within this cluster. INTERPRETATION & CONCLUSION: Our results demonstrated that M. avium isolates from India were highly polymorphic with remarkable genetic diversity and heterogeneous RFLP profile. We observed that 47 per cent (n=27) isolates had RFLP profile suggestive of bird and animal origin indicating a strong association with the environment. By applying two typing methods based on IS1245 on the isolates 100 per cent typeability could be achieved.