scholarly journals MANAGEMENT OF HYPERURICEMIA(GOUT) THROUGH AYURVEDA: A CASE STUDY

2021 ◽  
Vol 9 (7) ◽  
pp. 1571-1574
Author(s):  
Nabaruna Bose ◽  
Shyamanta Kalita
Keyword(s):  
Uric Acid ◽  
Fast Food ◽  
Dietary Habits ◽  
Serum Uric Acid Level ◽  
Gouty Arthritis ◽  
Metatarsophalangeal Joint ◽  
Burning Sensation ◽  
Food Culture ◽  
First Metatarsophalangeal Joint ◽  
The Right

The rapid modernization in India, fast-food culture, stressful and speedy life is causing several lifestyle disorders. Gout is a metabolic disease that most often affects middle-aged to elderly men and post-menopausal women. It results from an increased body pool of urate with hyperuricemia. It is typically characterized by episodic acute arthritis or chronic arthritis caused by deposition of monosodium urate crystals in joints and connective tissue tophi and the risk for deposition in kidney interstitium or uric acid nephrolithiasis. Vatarakta (gouty arthritis) is a chronic disease in which derangement of metabolism, occurs due to indulgence in unwholesome dietary habits and lifestyle. Vatarakta is caused by vitiated Vata and Rakta simultaneously. Initially vitiated Vata obstructs the path of vitiated Rakta and then gets obstructed by Rakta itself. It can be correlated with Gouty Arthritis due to their similarity in the clinical presentation. It is characterised by severe pain, tenderness, inflammation and burning sensation in the affected joints. A 34-year-old male patient came to Kayachikitsa OPD of Government Ayurvedic College and Hospital, Guwahati presenting with complaints of pain and swelling in the right first metatarsophalangeal joint, burning sensation of both the sole, right ankle joint pain and swelling along with pain in the right elbow from last 4 months. The patient was subjected to both panchakarma therapy and oral medication and at the end of the treatment Serum Uric acid level came down from 8.6mg/dl to 5.4mg/dl. Keywords: Gout, Vatarakta, Ksheera basti, Amritadi guggulu, Kokilaksha Kasaya.

scholarly journals Correlation between Ultrasound Findings of Uric Acid Precipitate in MTP I and Acute Gout Flare in Gouty Arthritis

2020 ◽  
Vol 31 (1) ◽  
pp. 33
Author(s):  
Elys SUSANTI ◽  
Muhammad Ilyas ◽  
Nurlaily Idris ◽  
Andi Alfian Zainuddin ◽  
Bachtiar Murtala ◽  
...  
Keyword(s):  
Uric Acid ◽  
Serum Uric Acid Level ◽  
Gouty Arthritis ◽  
Metatarsophalangeal Joint ◽  
Acute Gout ◽  
Chi Square ◽  
Cross Sectional ◽  
Exact Test ◽  
Chi Square Test ◽  
Gout Flare

<p>Acute gout flare is the most common manifestation of gouty arthritis that intermittently occurs with severe pain in the joints due to interactions between monosodium urate crystals (MSU) and the surrounding tissues. The most common predilection is the metatarsophalangeal joint (the 1st MTP). Ultrasound examination is a modality that can be used to visualize MSU crystal precipitates in and around joints. This study aimed to determine the correlation between the findings of the MSU crystal precipitate on the 1st MTP using ultrasound with the occurrence of acute gout flare in gout patients. This study was an analytical observational study with a cross-sectional method. The samples were 41 patients with a history of previous acute flares and in the intercritical phase when participating in the study. Examinations of ultrasound on the 1st MTP and random serum uric acid level were performed. Evaluations were carried out on both of the 1st MTPs to assess the shape of the MSU crystalline precipitate, namely Double Contour Sign (DCS), aggregate, and tophus. Each sample was evaluated within five days to assess the presence or absence of an acute flare. The diagnostic tests used were the Chi-Square Test and the Fischer Exact Test with a significance value of p &lt;0.05. The results showed the images of DCS were seen in 20 samples with 9 (45%) samples experiencing acute flare (p &lt;0.05), while in 21 samples where no DCS were found, all did not experience any flare. Findings of aggregate and tophus were rarely found, 7.3% and 4.9%, respectively. In this study, the finding of DCS precipitates using ultrasound has a significant correlation to the emergence of acute flare and is a significant form of precipitate findings in this study, whereas aggregate and tophus precipitates are difficult to determine.</p>

scholarly journals LESCH-NYHAN SYNDROME – late diagnosis of rare disease: clinical case

2021 ◽  
Keyword(s):  
Uric Acid ◽  
Motor Development ◽  
Clinical Case ◽  
Muscle Tone ◽  
Genetic Disorder ◽  
Gouty Arthritis ◽  
Metatarsophalangeal Joint ◽  
Uric Acid Concentration ◽  
Moderate Degree ◽  
First Metatarsophalangeal Joint

Background. Lesch-Nyhan syndrome is inherent X-linked recessive genetic disorder with decreased activity of hypoxanthine-guanine phosphoribosyltransferase (HGPRT). The disease is characterized by presence of the classical triad: hyperuricemia, neurological and behavioral changes. In the article we present a clinical case of Lesch-Nyhan syndrome first diagnosed only at 16 years old despite the fact that the clinical clues were already found at the patient`s early age. Case presentation. An 18-year-old Caucasian man was admitted to the rheumatology department because of gouty arthritis. In neonatal period he was diagnosed with mild intrauterine growth restriction by hypoplastic type. Uric acid crystals were found in our patient`s urine at 6-month-old. In the first year of life, delayed motor development was noted together with permanent neurological changes which were referred to rickets. During school years, severe dysgraphia, dyslexia, dysarthria, logoneurosis warranted observation by a speech therapist. At his 12 he had been diagnosed with nephrocalcinosis, at 14 – with chronic kidney disease and symptomatic arterial hypertension. The family history was remarkable for gout in grandmother and great-grandmother, chronic pyelonephritis – in mother, urate nephropathy – in both brothers. In physical examination hyperemia and edema of the left first metatarsophalangeal joint, left ankle defiguration, funnel chest, gynecomastia, tophi on the ears were noted. On examination, some neurological disorders and mild cognitive impairment were found. In investigations hyperuricemia, arthritis of the first metatarsophalangeal joint, diffuse changes in the renal parenchyma with impaired renal excretory function were detected. Despite the clues in patient`s anamnesis, objective examination and additional investigation, as well as the presence of a family anamnesis suggesting the hereditary nature of hyperuricemia, the diagnosis of HGPRT deficiency was not made until the age of 16 years. Conclusion. The presence of Lesch-Nyhan syndrome can be assumed with the progression of muscle tone impairment and movement disorders in a child after the first six months of life in combination with high plasma uric acid concentration and its increased urinary excretion. Difficulties in the syndrome diagnosis are associated not only with a rare occurrence, but with a slight or moderate degree of central nervous system impairment that is often related by doctors to rickets or delivery trauma, as well as low accessibility of molecular genetic testing.

Correlation analysis of the x-ray and functional parameters from the results of chevron (Austin) osteotomy for hallux valgus

2020 ◽  
pp. 54-63
Author(s):  
Ruslan Khairutdinov ◽  
Timur Minasov ◽  
Ekaterina Yakupova ◽  
Elvina Mukhametzyanova
Keyword(s):  
Hallux Valgus ◽  
Rating Scale ◽  
Metatarsophalangeal Joint ◽  
Valgus Deformity ◽  
First Metatarsophalangeal Joint ◽  
Chevron Osteotomy ◽  
Hallux Valgus Deformity ◽  
Valgus Angle ◽  
The Right ◽  
Bone Structures

Hallux valgus is characterized by the appearance and growth of a painful “lump” in the region of the first metatarsophalangeal joint, the development of forefoot corns, and inability to choose the right shoes, which leads to a significant decrease in the quality of life of these patients. Corrective osteotomies that preserve the metatarsophalangeal joint, for example Austin (Chevron) osteotomy, are usually used for hallux valgus deformity of the I, II degrees. Radiography with the study of the hallux valgus angle (HVA), the intermetatarsal angle (IMA), the distal metatarsal articular angle (DMAA) is a research method that shows the true correlation between bone structures. The correlation between the radiological and functional indicators of osteotomy allows us to determine possible recommendations for indications for surgical treatment of Hallux valgus. Correlation shows that the largest correction of hallux valgus in older patients occurs due to a small adjustment of the angle of DMMA and HVA. IMA had the best correction after Austin osteotomy among patients of a younger age, then the HVA, and the DMMA had minimum correction according to the AOFAS rating scale (Kitaoka). The revealed correlations allow us to determine the correct tactics for the treatment of hallux valgus by identifying the benefits of Austin osteotomy.

Management of Gouty Arthritis with special reference to Vatarakta - A Case Report

2017 ◽  
Vol 2 (4) ◽  
Author(s):  
V. Balendu Krishnan ◽  
Prashanth A. S.
Keyword(s):  
Uric Acid ◽  
Case Report ◽  
Serum Uric Acid ◽  
Serum Uric Acid Level ◽  
Gouty Arthritis ◽  
Treatment Protocol ◽  
Joint Inflammation ◽  
High Serum ◽  
Common Disease ◽  
Disease Condition

Gouty Arthritis has now become a common disease condition which we deal in Ayurveda, but a proper treatment protocol is not followed in many cases. The case reported here was as a result of improper diet and lack of exercise which resulted in an increase serum uric acid level and joint inflammation. The treatment was given at IPD level diagnosing it as Gambhira Vatarakta with valid Chikitsa Siddhanta. This case report provides us a guidelines that even a chronic gouty arthritis with a very high serum uric acid can be treated as per Vataraktha Chikitsa Siddhanta in Ayurveda.

scholarly journals The impact of functional excess of footwear on the foot shape of 7-year-old girls and boys

PeerJ ◽  
2021 ◽  
Vol 9 ◽  
pp. e11277
Author(s):  
Ewa Puszczalowska-Lizis ◽  
Aleksandra Lukasiewicz ◽  
Sabina Lizis ◽  
Jaroslaw Omorczyk
Keyword(s):  
Regression Analysis ◽  
Hallux Valgus ◽  
Metatarsophalangeal Joint ◽  
Rank Test ◽  
Chi Square ◽  
First Metatarsophalangeal Joint ◽  
Longitudinal Arch ◽  
Transverse Arch ◽  
The Right ◽  
The Impact

Background Properly fitted shoes can support the development of growing feet and prevent problems and pathologies, not only in childhood, but also in adulthood. This points to the need to conduct research on the impact of shoe fitting on the structure of the foot in order to raise awareness and importance of this problem, to enable proper decisions regarding the purchase and use of shoes. The aim of this study was to analyze indoor footwear fit and its impact on foot structure in 7-year-old schoolchildren. Methods The CQ-ST podoscope and the Clevermess device were used for measurements. The analysis was carried out using the Mann Whitney U test, Wilcoxon signed-rank test, Chi-square test, regression analysis. Results About 40% of girls and boys had shoes that were incorrectly fitted in length, while as many as 74% of girls and 66% of boys wore shoes that were incorrectly fitted in width. Regression analysis demonstrated a statistically significant influence of the footwear length on longitudinal arch of the right and left foot and the transverse arch of the right foot. In boys, the length of the shoes shows associations with the right and left hallux valgus angle. Conclusion A significant percentage of the studied 7-year-olds, regardless of gender, wears inappropriately fitted shoes. In both sexes, the length of the footwear influenced the longitudinal arch of the right and left foot and the transverse arch of the right foot. Due to the deformity of the first metatarsophalangeal joint, the boys with hallux valgus require footwear which is wider and therefore their shoes need to be bigger in size.

Development and Reliability of a Measurement Device for Flexion Force of the First Metatarsophalangeal Joint

2003 ◽  
Vol 19 (3) ◽  
pp. 271-278 ◽  
Author(s):  
Jaap Swanenburg ◽  
Karel H. Stappaerts ◽  
Bart Tirez ◽  
Daniel Uebelhart ◽  
Geert Aufdemkampe
Keyword(s):  
Hallux Valgus ◽  
Weight Bearing ◽  
Metatarsophalangeal Joint ◽  
Measurement Device ◽  
Good Reliability ◽  
First Metatarsophalangeal Joint ◽  
Healthy Female ◽  
The Right ◽  
Leg Dominance ◽  
Flexion Force

The purpose of this study was to present a method for repeated measurement of flexion force of the hallux in the metatarsophalangeal joint. The reliability of this measurement device was also examined. This device is suitable for situations where weight-bearing is contraindicated or when it is not possible for patients to bear load on their toes, such as hallux valgus patients. Since most such patients are female, the participants in this study were 24 healthy female volunteers. Age, weight, height, and leg dominance were determined for each. Muscle strength was measured using a device with a built-in MicroFET dynamometer. The result for the left hallux was ICC(3,1).89 (95% CI .77–.95). The result for the right hallux was ICC(3,1).94 (95% CI .87–.97). In the Bland and Altman plots, the reliability again appeared to be sufficient. The Pearson product-moment correlations gave poor results for the association between body weight, height, age, and mean force of the four trails. The test results indicate good reliability of the measurement device as used in this study. The advantage of this testing device is that it makes it easier to standardize measurements as opposed to the MicroFET used as a hand-held dynamometer. Also, patients can be tested in a nonload situation, which makes it possible to test hallux valgus at any time, and therefore it is possible to monitor variations in progression (or regression).

First Metatarsophalangeal Joint Arthrodesis for the Treatment of Tophaceous Gouty Arthritis

Orthopedics ◽  
2014 ◽  
Vol 37 (2) ◽  
pp. e141-e147 ◽  
Author(s):  
Yong Sang Kim ◽  
Eui Hyun Park ◽  
Ho Jin Lee ◽  
Yong Gon Koh
Keyword(s):  
Gouty Arthritis ◽  
Metatarsophalangeal Joint ◽  
First Metatarsophalangeal Joint

Efficacy of Ayurvedic treatment protocol in gouty arthritis – a clinical study

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Aswathi Rajan Vaprath Kuniyil ◽  
Devipriya Soman ◽  
Mahesh C. Kundagol ◽  
James Chacko
Keyword(s):  
Uric Acid ◽  
Serum Uric Acid ◽  
Uric Acid Level ◽  
Acid Level ◽  
Serum Uric Acid Level ◽  
Gouty Arthritis ◽  
Treatment Protocol ◽  
Therapeutic Interventions ◽  
Tinospora Cordifolia ◽  
Rank Test

Abstract Objectives Gout is an inflammatory response to the Monosodium urate crystals formed secondary to hyperuricaemia. The prevalence of gout has increased in recent years. The current conventional medical management aims at symptomatic management. In Ayurveda, gouty arthritis has similarity to Vata-Pittadhika Vatarakta, owing to its comparable aetiology and clinical features and treatment was planned accordingly. The present study is designed to evaluate the combined effect of Ayurvedic formulations and therapy in reducing the signs and symptoms and uric acid level in Gouty Arthritis. Methods The study was a single group pre–post test design. The patients diagnosed on the basis of ACR EULAR Gout classification 2015 criteria. They were given Guduchi Siddha Ksheeravasthi (Therapeutic enema), Guduchi (Tinospora cordifolia) Kashaya (diluted decoction) and Punarnava Guggulu. Assessment of pain was done by Visual Analogue Scale and serum uric acid level was assessed on day 1 and on 31st day. Also, the change in symptoms were analyzed before and after the treatment. This study has been registered in the clinical trial registry-India. Results The obtained data were evaluated using paired t-test and Wilcoxon signed rank test. A significant improvement (p=0.0001) was observed in VAS scale (98.77%), serum uric acid levels (57.81%), subjective parameters. Moreover, erythrocyte sedimentation rate was observed to be normal level as compared to baseline of the therapy also with an enhancement of hemoglobin (Hb) levels. Conclusions Thus, the present study revealed that Ayurvedic therapeutic interventions can play a major role in the management of gouty arthritis.

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