scholarly journals SYSTEMATIC REVIEW ON UNDERSTANDING AND MANAGEMENT OF VATARAKTA: A REVIEW ARTICLE

2021 ◽  
Vol 9 (10) ◽  
pp. 2404-2410
Author(s):  
Vaibhavi Bhavar ◽  
Atal Bihari Trivedi
Keyword(s):  
Fast Food ◽  
Metabolic Disorders ◽  
Severe Disease ◽  
Gouty Arthritis ◽  
Modern Science ◽  
Monosodium Urate ◽  
Disease Symptoms ◽  
Ayurvedic Treatment ◽  
The One ◽  
Urate Crystals

BACKGROUND: In today’s modern period, the lifestyle of people has changed, food habits also has changed, it is going more towards sedimentary lifestyle. People nowadays preferred to have instant, junk, and spicy fast food than a normal healthy diet. Hence nowadays more and more people are developing so many metabolic disorders due to inactive, sluggish, seated lifestyles. Among so many metabolic disorders gout is the one that commonly occurs in today’s modern manner of living. Purine metabolism causes hyperuricemia and deposition of monosodium urate crystals in joints. In Ayurveda, Vatarakta shows so much resemblance with gouty arthritis. Vatarakta is mainly an Avaranajanya Vata Pradhan Tridoshaja Vyadhi where Rakta is main Dushya.Vatarakta is more distressing. Due to the desk-bound lifestyle, many people are affected constantly by this severe disease. Currently, in modern science NSAIDS, allopurinol, colchicine, the corticosteroid is being used to treat gout. But these drugs have many adverse effects and disadvantages Panchkarma induced Shodhana and Shamana is not only an important component of Ayurvedic treatment but also the elemental basis of Ayurvedic treatment. Different procedures like Swedana, Va- mana, Virechana, Basti, Raktamokshana focuses on purification which detoxifies the patient's body and thus helps in correcting metabolism at the molecular level. Hence the Panchkarma is a quirky approach in the management of Vatarakta. Shamana refers to all the Ayurvedic procedures and protocols that reduce suppress and eliminate thedisease. Shamana Chikitsa is planned to make the patient recover and feel healthier by suppressing the disease symptoms. Hence while the inherent disease might still be present the patient going through Shamana Chikitsa can control the symptoms. Keywords: Ayurveda, Cataract, Vata, Rakta, Gouty arthritis.

Management of Vatarakta w.s.r. to Gout through Panchakarma

2018 ◽  
Vol 3 (4) ◽  
Author(s):  
Dr. Chandramohan Arya ◽  
Dr.Sanjay Gupta
Keyword(s):  
Metabolic Disorders ◽  
Molecular Level ◽  
Modern Science ◽  
Monosodium Urate ◽  
Monosodium Urate Crystals ◽  
Predominant Symptom ◽  
Essential Components ◽  
Unique Approach ◽  
Ayurvedic Treatment ◽  
Urate Crystals

Vatarakta is more distressing and common metabolic disorder prevalent in present era. It is Vatapradhana Tridoshaja Vatavyadhi where Rakta is main Dushya. Vata is a predominant Dosha in Vatarakta, when it is excessively aggravated with vitiated Rakta is called Vatarakta. Vatarakta is correlated with gout in modern science. Gout is an abnormality of purine metabolism causes hyperuricemia and deposition of monosodium urate crystals in joints. Pain is predominant symptom of gout, which disturbs day-today life of the patients. The Panchakarma is not only a important component of Ayurvedic treatment but it is also forms the fundamental basis of Ayurveda therapy. The different procedures like Swedana, Vamana, Virechana, Basti, Sirovirechana, Raktamokshana focus on the purification which detoxifies the human body, i.e. the correction of the metabolism at molecular level. These detoxification procedures are essential components of the management in various metabolic disorders. So Panchakarma is an unique approach in the management of Vatarakta.

Biostatistical Analysis and Possible Forecasting of Relationship Between Uric Acid and Specific Laboratory Tests in Cases of Gouty Arthritis

2017 ◽  
Vol 68 (6) ◽  
pp. 1234-1241
Author(s):  
Adina Octavia Duse ◽  
Delia Berceanu Vaduva ◽  
Mirela Nicolov ◽  
Cristina Trandafirescu ◽  
Marcel Berceanu Vaduva ◽  
...  
Keyword(s):  
Uric Acid ◽  
Laboratory Tests ◽  
Gouty Arthritis ◽  
Main Diagnosis ◽  
Monosodium Urate ◽  
Glutamate Pyruvate ◽  
Metatarsophalangeal Joints ◽  
The Relationship ◽  
Biostatistical Analysis ◽  
Urate Crystals

Acute gouty arthritis represents an inflammatory response to microcrystals of monosodium urate that precipitate in joint tissues from supersaturated body fluids or are shed from preexisting articular deposits [1]. Gout is a metabolic disease characterized by recurrent episodes of arthritis associated with the presence of monosodium urate crystals in the tissue or synovial fluid during the attack.These forms of crystal-induced arthritis usually affect peripheral joints, including knee, ankle, wrist, and metacarpophalangeal and metatarsophalangeal joints. All of them may be associated with other inflammatory, endocrine diseases [2]. The present study was done to highlight the relationship between increased levels of uric acid and specific laboratory tests in order to possible forecast development of further disease in patients with gouty arthrithis.The present study was done on 34 patients hospitalized in Felix Hospital of Rehabilitation in 2015-2016, with age between 44 and 74, having the main diagnosis of gouty arthritis.We studied the following laboratory tests:urea and other related analysis, like uric acid, creatinine, cholesterol, glutamate pyruvate transaminase and glutamate oxalate transaminase.

scholarly journals Hyperuricemia and Gout – Ins and Out

2020 ◽  
Vol 15 (2) ◽  
pp. 227-234
Author(s):  
Md Abdur Razzak ◽  
Quazi Audry Arafat Rahman ◽  
Fahtiha Nasreen
Keyword(s):  
Gouty Arthritis ◽  
Polarized Light ◽  
Acute Gout ◽  
Women Patients ◽  
Monosodium Urate ◽  
Tophaceous Gout ◽  
First Metatarsal ◽  
Birefringent Crystals ◽  
Inflammatory Drugs ◽  
Urate Crystals

Gout is a condition characterized by the deposition of monosodium urate crystals in the joints or soft tissue. The four phases of gout include asymptomatic hyperuricemia, acute gouty arthritis, intercritical gout and chronic tophaceous gout. The peak incidence occurs in patients 30 to 50 years old, and the condition is much more common in men than in women. Patients with asymptomatic hyperuricemia do not require treatment, but efforts should be made to lower their urate levels by encouraging them to make changes in diet or lifestyle. Acute gout most commonly affects the first metatarsal joint of the foot, but other joints are also commonly involved. Definitive diagnosis requires joint aspiration with demonstration of birefringent crystals in the synovial fluid under a polarized light microscope. Treatment includes nonsteroidal anti-inflammatory drugs (NSAIDs), colchicine, corticosteroids and analgesics. In patients without complications, NSAID therapy is preferred. JAFMC Bangladesh. Vol 15, No 2 (December) 2019: 227-234

Treatment of acute gout

2016 ◽  
Author(s):  
Puja Khanna
Keyword(s):  
Inflammatory Arthritis ◽  
Adult Population ◽  
Gouty Arthritis ◽  
Acute Gout ◽  
Monosodium Urate ◽  
Epidemiological Evidence ◽  
Acute Gouty Arthritis ◽  
Over Time ◽  
Underlying Inflammation ◽  
Urate Crystals

Acute gout is a common inflammatory arthritis in the adult population. Epidemiological evidence suggests that the prevalence of gout is steadily on the rise due to longevity, coexisting comorbidities, and iatrogenic causes contributing to hyperuricaemia. Acute gout usually presents as a self-limiting flare of synovitis that occurs due to deposition of monosodium urate crystals. The frequency of flares generally increases over time in patients who continue to have hyperuricaemia and their risk factors for acute gout attacks have not been adequately addressed. Effective treatment of acute gouty arthritis is primary focused on pain which is the primary symptom but must target both the pain and underlying inflammation. Acute gout is frequently treated with non-steroidal anti-inflammatory agents, colchicine, and corticosteroids. This chapter reviews the available therapies for management of acute gout and ones that have shown promising results.

scholarly journals Tu-Teng-Cao Extract Alleviates Monosodium Urate-Induced Acute Gouty Arthritis in Rats by Inhibiting Uric Acid and Inflammation

2020 ◽  
Vol 2020 ◽  
pp. 1-13
Author(s):  
Rongmei Yao ◽  
Zihan Geng ◽  
Xin Mao ◽  
Yanyan Bao ◽  
Shanshan Guo ◽  
...  
Keyword(s):  
Uric Acid ◽  
Gouty Arthritis ◽  
Histological Evaluation ◽  
Therapeutic Effects ◽  
Monosodium Urate ◽  
Cell Degeneration ◽  
Acute Gouty Arthritis ◽  
Monosodium Urate Crystals ◽  
Potassium Oxonate ◽  
Urate Crystals

Gouty arthritis is an inflammatory joint disease closely related to hyperuricemia. It is characterized by deposition of monosodium urate crystals in the joints, resulting in an intense inflammatory process and pain. Control of hyperuricemia and anti-inflammation treatments are the main therapeutic approaches. However, the commonly used drugs for inhibiting uric acid and acute gouty arthritis have obvious gastrointestinal and renal toxicity; thus, there is an urgency to develop new alternative therapeutic drugs. An extract of Tu-Teng-Cao (TTC), a compound drug used in traditional Chinese medicine, has been widely applied to the clinical treatment of arthritis. In this study, we investigated the therapeutic effects of TTC on gouty arthritis. In this study, an animal model of acute gouty arthritis with hyperuricemia was established using potassium oxonate and monosodium urate crystals. After treatment with TTC, the results showed obvious therapeutic effects on the rat model of acute gouty arthritis. The treatment significantly attenuated the degree of ankle swelling, inflammation, and dysfunction index, and the levels of proinflammatory cytokines. In addition, TTC has significant antihyperuricemia activity in rats with hyperuricemia induced by potassium oxonate. Histological evaluation showed that TTC relieved pathological damage in rats with acute gouty arthritis induced by monosodium urate crystals. All the groups treated with TTC showed improvement in cartilage degeneration, cell degeneration, synovial hyperplasia, and inflammatory cell invasion in the ankle joint of rats. TTC significantly alleviated swelling, inflammation, and bleeding of the renal corpuscle and convoluted tubules of rats. The results of this study suggest that TTC is capable of treating gouty arthritis and decreasing ankle injury through the control of uric acid and inflammation.

scholarly journals Effects of Modified Simiao Decoction on IL-1βand TNFαSecretion in Monocytic THP-1 Cells with Monosodium Urate Crystals-Induced Inflammation

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Ya-Fei Liu ◽  
Sheng-Hao Tu ◽  
Zhe Chen ◽  
Yu Wang ◽  
Yong-Hong Hu ◽  
...  
Keyword(s):  
Gouty Arthritis ◽  
Underlying Mechanism ◽  
Monosodium Urate ◽  
Future Studies ◽  
Treatment Groups ◽  
Chinese Herbal Formula ◽  
Chinese Herbal ◽  
Control Serum ◽  
Msu Crystals ◽  
Urate Crystals

Simiao pill, a Chinese herbal formula containing four herbs, has been used in the treatment of gouty arthritis for many years. The aim of this study was to explore the effects of modified Simiao decoction (MSD) on IL-1βand TNFαsecretion in monocytic THP-1 cells with monosodium urate (MSU) crystals-induced inflammation. The MSU crystals-induced inflammation model in THP-1 cells was successfully established by the stimulation of phorbol 12-myristate 13-acetate (PMA) and MSU crystals. Then, the MSD-derived serum or control serum extracted from rat was administered to different treatment groups. The morphology of MSU crystals and THP-1 cells was observed. IL-1βand TNFαprotein expression in supernatant of THP-1 cells were determined by ELISA. Our data demonstrated that MSU crystals induced time-dependent increase of IL-1βand TNFα. Moreover, MSD significantly decreased IL-1βrelease in THP-1 cells with MSU crystals-induced inflammation. These results suggest that MSD is promising in the treatment of MSU crystals-induced inflammation in THP-1 cells. MSD may act as an anti-IL-1 agent in treating gout. The underlying mechanism may be related to NALP3 inflammasome which needs to be validated in future studies.

Crystals of monosodium urate monohydrate enhance lipopolysaccharide-induced release of interleukin 1β by mononuclear cells through a caspase 1-mediated process

2008 ◽  
Vol 68 (2) ◽  
pp. 273-278 ◽  
Author(s):  
E J Giamarellos-Bourboulis ◽  
M Mouktaroudi ◽  
E Bodar ◽  
J van der Ven ◽  
B-J Kullberg ◽  
...  
Keyword(s):  
Mononuclear Cells ◽  
Gouty Arthritis ◽  
Underlying Mechanism ◽  
Monosodium Urate ◽  
Peripheral Blood Mononuclear ◽  
Caspase 1 ◽  
Pyrin Domain ◽  
Factor Α ◽  
Msu Crystals ◽  
Urate Crystals

Objective:Recent studies suggest that crystals of monosodium urate (MSU), deposited in joints of patients with acute gouty arthritis, activate the NACHT domain, leucine-rich repeat and pyrin domain-containing protein (NALP)3 inflammasome. In the present study we have investigated whether production of proinflammatory cytokines by crystals was exacerbated during costimulation with Toll-like receptor (TLR) ligands.Methods:Mononuclear cells of 22 healthy donors were stimulated by various concentrations of MSU crystals in the absence or presence of lipopolysaccharide (LPS), Pam3Cys and flagellin. Production of tumour necrosis factor α (TNFα), interleukin (IL)1β and IL6, as well as the intracellular concentrations of proIL1β were measured by ELISA. mRNA transcripts of TNFα and IL1β were assessed by real-time PCR. Stimulation experiments were also performed with peripheral blood mononuclear cells (PBMCs) of one patient carrying a NALP3 mutation.Results:MSU induced a moderate release of IL1β and IL6, but not of TNFα. Urate crystals amplified IL1β production stimulated by the TLR4 ligand LPS, while no synergy was apparent for IL6 production. In addition, no synergy between urate crystals and Pam3Cys (TLR2 ligand) or flagellin (TLR5 ligand) was apparent. The synergy between urate crystals and LPS was directed at the level of the NALP3 inflammasome, as it was present only when active IL1β was measured, but not at the level of IL1 mRNA or proIL1β. The synergy between LPS and MSU crystals ceased to exist in the presence of a caspase 1 inhibitor.Conclusions:MSU crystals act in synergy with LPS for the induction of enhanced release of IL1β. Increased cleavage of proIL1β by urate-activated caspase 1 is proposed as the underlying mechanism.

scholarly journals Acute presentation of spinal gouty arthritis: A case report and review of literature

2019 ◽  
Vol 10 ◽  
pp. 232
Author(s):  
Asad S. Akhter ◽  
Ahmed Mohyeldin ◽  
Andrew J. Grossbach
Keyword(s):  
Spinal Surgery ◽  
Gouty Arthritis ◽  
Review Of Literature ◽  
Monosodium Urate ◽  
Decompressive Laminectomy ◽  
Acute Presentation ◽  
Fourth Decade ◽  
The Us ◽  
Laminectomy And Fusion ◽  
Urate Crystals

Background: Gout is an inflammatory arthritis that results from faulty purine metabolism, affecting approximately 4% of adults in the US, and predominately affects people in the fourth decade of life. Further, spinal gout is rarely the first presentation of gout, especially in younger individuals. Case Description: A 26-year-old male came to the emergency room with acute lower extremity numbness and weakness. The MR demonstrated an enhancing epidural lesion at T6–T8 in the mid-thoracic spine. He subsequently underwent a decompressive laminectomy and fusion at levels T6–T9, resulting in full recovery 1 year later. The pathology demonstrated needle-like monosodium urate crystals consistent with the diagnosis of spinal gouty arthritis. Conclusion: Gout rarely initially presents in a young adult in the spine. Here, we reviewed the case of spinal gout in a 26-year-old male who successfully underwent spinal surgery.

scholarly journals Images in clinical medicine: gouty arthritis with osteomyelitis

2018 ◽  
Vol 12 (4) ◽  
pp. 270-272 ◽  
Author(s):  
Rosa Scipioni ◽  
Luciano Frate ◽  
Valentino Di Tomasso ◽  
Michele Saltarelli ◽  
Francesco Carubbi ◽  
...  
Keyword(s):  
Clinical Medicine ◽  
Gouty Arthritis ◽  
Monosodium Urate ◽  
Joint Function ◽  
Tophaceous Gout ◽  
Function Impairment ◽  
History Of ◽  
Acute Attacks ◽  
Gout Tophi ◽  
Urate Crystals

Gout is one of the most common inflammatory arthropathies, characterized by the deposition of monosodium urate crystals in the synovial membrane, articular cartilage and periarticular tissues and leading to inflammation. The natural history of articular gout is typically composed of four periods: asymptomatic hyperuricemia, episodes of acute attacks of gout (acute gouty arthritis) with asymptomatic intervals (intercritical gout), and chronic tophaceous gout. Tophi develop in 12-35% of gouty patients without adequate control of uricemia. Initially, they do not cause significant complaints or function limitation of the nearby joints. However, if they become larger, joint instability and movement range limitation, joint function impairment and bone erosions and infection at the sites of their penetration can develop.We report a case of a poorly controlled polyarticular tophaceous gout complicated by osteomyelitis.

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