scholarly journals Efficacy of Langhana with Saptamushtika Yusha in the Treatment of Aama in Aamavata with special reference to Rheumatoid Arthritis

2020 ◽  
Vol 11 (1) ◽  
pp. 108-112
Author(s):  
Jasminbegam Momin ◽  
Gogate V E
Keyword(s):  
Rheumatoid Arthritis ◽  
Fast Food ◽  
Dietary Habits ◽  
Salt Intake ◽  
Signs And Symptoms ◽  
Autoimmune Disorder ◽  
Unknown Etiology ◽  
Treatment Protocols ◽  
American College Of Rheumatology ◽  
The Common

In developing societies, the nutritional patterns collectively termed the ‘western diet’ including high fat and cholesterol, high protein, high sugar and excess salt intake as well as frequent consumption of processed and fast food promote obesity, cardiovascular diseases and metabolic syndrome which are now recognized as due to chronic inflammatory processes in body. According to the ancient Acharyas, above mentioned dietary habits are the common hetus responsible for the Agnidushti and development of diseases like Aamavata. The common signs and symptoms of Aamavata have similarities with Rheumatoid Arthritis which is an autoimmune disorder of unknown etiology. Aamavata has been a challenging problem to the medical field. Various treatment protocols are applied in this disease with partial success. The ancient Acharyas have mentioned the Langhana along with its different possible ways as a first Upakrama for the treatment of Aamavata. In present clinical study, five patients of clinically proven Aamavata were treated with Laghu Aahara Rupi Langhana by using Saptamushtika Yusha for seven days. All clinical Nidanadi Ayurvediya parameters and American College of Rheumatology guidelines for Rheumatoid Arthritis were followed. The assessment of symptoms was done with the help of Disease Activity Score (DAS). Erythrocyte Sedimentation Rate (ESR) which is increased in most of the chronic inflammatory conditions was also investigated. It was observed that there was a marked reduction in ESR along with the considerable relief in signs and symptoms of patient. The results are encouraging and indicate the efficacy of Langhana with Saptamushtika Yusha over Aamavata.

Rheumatoid Arthritis: Etiology and Pathogenesis

2014 ◽  
Author(s):  
Gary S. Firestein ◽  
Anna-Karin H. Ekwall
Keyword(s):  
Rheumatoid Arthritis ◽  
Intracellular Signaling ◽  
Cartilage Damage ◽  
Signs And Symptoms ◽  
American College Of Rheumatology ◽  
European League Against Rheumatism ◽  
Citrullinated Proteins ◽  
Definition Of

Rheumatoid arthritis (RA) is among the most common forms of chronic inflammatory arthritis. It affects approximately 1% of adults and is two to three times more prevalent in women than in men. There are no specific laboratory tests for RA; diagnosis depends on a constellation of signs and symptoms that can be supported by serology and radiographs. The disease evolves over many years as a consequence of repeated environmental stress causing inflammation and immune activation followed by a breakdown of tolerance in individuals with a specific genetic background. This review describes the definition of RA; its etiology, including genetics, infections, the role of smoking and citrullination of proteins, and epigenetic mechanisms; and its pathogenesis, including synovial histopathology, bone and cartilage damage, adaptive and innate immunity, and the role of cytokines and intracellular signaling. Tables include the 1987 American Rheumatism Association criteria for the classification of RA and the 2010 American College of Rheumatology/European League Against Rheumatism classification for RA. Figures show citrullinated proteins in airway cells, a section of a proliferative synovium from a patient with a classic RA, and scalloped regions of erosion at the junction between a proliferative inflamed rheumatoid synovium and the bone. This review contains 3 highly rendered figures, 2 tables, and 71 references.

scholarly journals Roles of Genes in the Susceptibility to and Severity of Rheumatoid Arthritis - A Review

1970 ◽  
Vol 13 (1) ◽  
pp. 51-54
Author(s):  
Abul Khair Ahmedullah ◽  
Shamim Ahmed ◽  
MD Ariful Islam
Keyword(s):  
Rheumatoid Arthritis ◽  
Genetic Factors ◽  
Human Leukocyte ◽  
Drug Efficacy ◽  
Autoimmune Disorder ◽  
Individual Variability ◽  
Unknown Etiology ◽  
Entire Genome ◽  
Gene Effects ◽  
Leukocyte Antigen

Rheumatoid arthritis (RA) is a chronic heterogeneous autoimmune disorder of unknown etiology. Genetic factors play an important role in susceptibility to RA as the heritability of RA is between 50% and 60%, with the human leukocyte antigen (HLA) locus accounting for at least 30% of overall genetic risk. It is conceivable that there is more than one susceptible gene(s) operative in RA, and an interaction of the relevant genes may predispose the offspring to develop the disease under certain conditions .Outside the major histocompatibility complex (MHC) region, some additional risk loci have been identified and validated including PTPN22, STAT4, PADI4, CTLA4 and others Genetic factors are also important in RA pharmacotherapy due to the gene-dependent activity of enzymes involved in the pharmacokinetics and/or pharmacodynamics of RA medications. Indeed, there is great variability in drug efficacy as well as adverse events associated with any anti-rheumatic therapy and genetics is thought to contribute significantly to this inter-individual variability in response. The ability to screen the entire genome for association to complex diseases has great potential for identifying gene effects. DOI: http://dx.doi.org/10.3329/jom.v13i1.10048 JOM 2012; 13(1): 51-54

scholarly journals CLINICAL EVALUATION OF VAITARANA BASTI ALONG WITH DHANWANTARA TAILA MATRA BASTI IN AMAVATA: A CASE SERIES

2020 ◽  
Vol 11 (6) ◽  
pp. 12-15
Author(s):  
Sheetal G Lodha ◽  
Ruchika S Karade
Keyword(s):  
Rheumatoid Arthritis ◽  
Connective Tissue ◽  
Rheumatoid Factor ◽  
Morning Stiffness ◽  
Dominant Role ◽  
Case Series ◽  
Signs And Symptoms ◽  
The Other ◽  
Knee Joints ◽  
The Common

Amavata is one of the common and most crippling joint disorders. It is a chronic, degenerative disease of the connective tissue mainly involving the joints. The clinical features of Amavata such as pain, swelling and stiffness of joints, fever and general disability are very much close to the Rheumatological disorder called rheumatoid arthritis. Ama associated with aggravated vata plays a dominant role in the pathogenesis of Amavata. According to its pathophysiology, one should treat the morbid doshas involve in are kapha and vata simultaneously. In the present study, four clinically diagnosed cases of Amavata with swelling of knee joints and morning stiffness , pain in multiple joints, raised rheumatoid factor and anti CCP factor are treated with Vaitarana basti along with Dhanwantara taila Matra basti on same day and changes are observed in subjective and objective criteria. Significant improvement is observed in reducing signs and symptoms of Amavata and in rheumatoid arthritis factor and anti CCP. Vaitarana basti eradicate Ama and kapha dosha as the drugs of Vaitarana basti having Ama pachaka, vatakapha shamaka and Anulomaka properties. On the other hand, Matra basti of Dhanwantara taila pacifies the vatadosha and reduced the pain and swelling. It also acts as neuroprotective, analgesic, anti-inflammatory, anti-arthritic and anti-paralytic. The combination of Vaitarana basti and Dhanwantara taila Matra basti can be an effective treatment for Amavata.

scholarly journals Filgotinib in combination with methotrexate or as monotherapy versus methotrexate monotherapy in patients with active rheumatoid arthritis and limited or no prior exposure to methotrexate: the phase 3, randomised controlled FINCH 3 trial

2021 ◽  
pp. annrheumdis-2020-219213
Author(s):  
René Westhovens ◽  
William F C Rigby ◽  
Désirée van der Heijde ◽  
Daniel W T Ching ◽  
William Stohl ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Primary Endpoint ◽  
Active Rheumatoid Arthritis ◽  
Health Assessment ◽  
Signs And Symptoms ◽  
Janus Kinase ◽  
Phase 3 ◽  
Double Blind ◽  
Acr20 Response ◽  
American College Of Rheumatology

ObjectivesTo investigate efficacy and safety of the Janus kinase-1 inhibitor filgotinib in patients with active rheumatoid arthritis (RA) with limited or no prior methotrexate (MTX) exposure.MethodsThis 52-week, phase 3, multicentre, double-blind clinical trial (NCT02886728) evaluated once-daily oral filgotinib in 1252 patients with RA randomised 2:1:1:2 to filgotinib 200 mg with MTX (FIL200 +MTX), filgotinib 100 mg with MTX (FIL100 +MTX), filgotinib 200 mg monotherapy (FIL200), or MTX. The primary endpoint was proportion achieving 20% improvement in American College of Rheumatology criteria (ACR20) at week 24.ResultsThe primary endpoint was achieved by 81% of patients receiving FIL200+ MTX versus 71% receiving MTX (p<0.001). A significantly greater proportion treated with FIL100+ MTX compared with MTX achieved an ACR20 response (80%, p=0.017) at week 24. Significant improvement in Health Assessment Questionnaire-Disability Index was seen at week 24; least-squares mean change from baseline was −1.0 and −0.94 with FIL200+MTX and FIL100+MTX, respectively, versus −0.81 with MTX (p<0.001, p=0.008, respectively). Significantly higher proportions receiving FIL200+MTX (54%) and FIL100+MTX (43%) achieved DAS28(CRP) <2.6 versus MTX (29%) (p<0.001 for both) at week 24. Hierarchical testing stopped for comparison of ACR20 for FIL200 monotherapy (78%) versus MTX (71%) at week 24 (p=0.058). Adverse event rates through week 52 were comparable between all treatments.ConclusionsFIL200+MTX and FIL100+MTX both significantly improved signs and symptoms and physical function in patients with active RA and limited or no prior MTX exposure; FIL200 monotherapy did not have a superior ACR20 response rate versus MTX. Filgotinib was well tolerated, with acceptable safety compared with MTX.

scholarly journals Faulty Dietary Habits vis-à-vis Acne Vulgaris: An Epidemiological Study

2015 ◽  
Vol 6 (3) ◽  
Author(s):  
Talekar Manisha ◽  
Mandal Sisir Kumar ◽  
Deshmukh Prashant Nareshrao ◽  
Vaish Gaurav
Keyword(s):  
Glycemic Index ◽  
Dairy Products ◽  
Dietary Habits ◽  
Acne Vulgaris ◽  
Signs And Symptoms ◽  
Survey Study ◽  
Junk Food ◽  
Common Skin ◽  
The Common ◽  
High Glycemic Index

Background: In day to day life, person consumes an incompatible diet and faulty food habits which leads to most of the diseases. Yuvanapidaka (Acne vulgaris) is one of the common skin disease which is affected by faulty dietary intake.Aims and Objective: To conduct a survey study on faulty dietary habits in Acne vulgaris patients and to find out cause-effect relationship between them.Materials and Methods: Total 210 patients having signs and symptoms of Acne vulgaris were selected from NIA O.P.D., I.P.D., various camps in Jaipur & certain junk food outlets. Patients were screened on the basis of specially prepared questionnaires.Results: On survey study, 100% patients were consuming Junk food & dairy products & incompatible diet. Maximum no. of patients was taking high glycemic index diets which play an important role in aggravation of acne.Conclusion: Maximum prevalence of faulty dietary habits was found in patients. So it was concluded that dairy products, incompatible diets, high glycemic index diet, junk foods which is responsible for formation of acne vulgaris. 

scholarly journals A randomised phase II study evaluating the efficacy and safety of subcutaneously administered ustekinumab and guselkumab in patients with active rheumatoid arthritis despite treatment with methotrexate

2017 ◽  
Vol 76 (5) ◽  
pp. 831-839 ◽  
Author(s):  
Josef S Smolen ◽  
Sandeep K Agarwal ◽  
Elena Ilivanova ◽  
Xie Lillian Xu ◽  
Ye Miao ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Active Rheumatoid Arthritis ◽  
Phase Ii Study ◽  
Signs And Symptoms ◽  
Common Type ◽  
Efficacy And Safety ◽  
Treatment Groups ◽  
American College Of Rheumatology ◽  
Registration Number ◽  
To Receive

ObjectiveInterleukin (IL)-12 and IL-23 have been implicated in the pathogenesis of rheumatoid arthritis (RA). The safety and efficacy of ustekinumab, a human monoclonal anti-IL-12/23 p40 antibody, and guselkumab, a human monoclonal anti-IL-23 antibody, were evaluated in adults with active RA despite methotrexate (MTX) therapy.MethodsPatients were randomly assigned (1:1:1:1:1) to receive placebo at weeks 0, 4 and every 8 weeks (n=55), ustekinumab 90 mg at weeks 0, 4 and every 8 weeks (n=55), ustekinumab 90 mg at weeks 0, 4 and every 12 weeks (n=55), guselkumab 50 mg at weeks 0, 4 and every 8 weeks (n=55), or guselkumab 200 mg at weeks 0, 4 and every 8 weeks (n=54) through week 28; all patients continued a stable dose of MTX (10–25 mg/week). The primary end point was the proportion of patients with at least a 20% improvement in the American College of Rheumatology criteria (ACR 20) at week 28. Safety was monitored through week 48.ResultsAt week 28, there were no statistically significant differences in the proportions of patients achieving an ACR 20 response between the combined ustekinumab group (53.6%) or the combined guselkumab group (41.3%) compared with placebo (40.0%) (p=0.101 and p=0.877, respectively). Through week 48, the proportions of patients with at least one adverse event (AE) were comparable among the treatment groups. Infections were the most common type of AE.ConclusionsTreatment with ustekinumab or guselkumab did not significantly reduce the signs and symptoms of RA. No new safety findings were observed with either treatment.Trial registration numberNCT01645280.

The eye

2013 ◽  
pp. 177-184
Author(s):  
Harry Petrushkin ◽  
Duncan Rogers ◽  
Miles Stanford
Keyword(s):  
Rheumatoid Arthritis ◽  
Juvenile Idiopathic Arthritis ◽  
Lupus Erythematosus ◽  
Signs And Symptoms ◽  
Systemic Lupus ◽  
Treatment Regimes ◽  
Ocular Discomfort ◽  
The Common ◽  
Sudden Blindness ◽  
Rheumatological Diseases

The ophthalmologist has a large part to play in the management of many rheumatological diseases. These diseases can cause a number of symptoms from mild ocular discomfort to sudden blindness. In addition, many rheumatological diseases have helpful ophthalmic signs, which can aid diagnosis. This chapter has been written to help rheumatologists identify these signs and symptoms. We have started by summarizing the common pathology found in patients with rheumatological diseases (dry eye syndromes, conjunctivitis, episcleritis, scleritis, uveitis, and optic neuropathy). This has been arranged working backwards from the front of the eye towards the retina and optic nerve. The rheumatological conditions that give rise to ophthalmic signs (giant cell arteritis, systemic lupus erythematosus, polyarteritis nodosa, Wegner’s granulomatosis, systemic sclerosis, rheumatoid arthritis, seronegative arthropathies, sarcoidosis, and Behçet’s disease) have then been summarized, including a section of paediatric conditions (juvenile idiopathic arthritis, spondyloarthropathies, and multisystemic illness). Finally, treatment regimes and recent guidelines have been covered for the screening of uveitis in juvenile idiopathic arthritis and the management of patients taking hydroxychloroquine. We hope that both rheumatologists in training and consultants find this chapter a useful clinical aid, and that it encourages them to look closely for subtle signs that will help improve the management of their patients.

Safety and Efficacy of Subcutaneous Golimumab in Patients with Active Rheumatoid Arthritis despite Methotrexate Therapy: Final 5-year Results of the GO-FORWARD Trial

2015 ◽  
Vol 43 (2) ◽  
pp. 298-306 ◽  
Author(s):  
Edward C. Keystone ◽  
Mark C. Genovese ◽  
Stephen Hall ◽  
Sang-Cheol Bae ◽  
Chenglong Han ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Active Rheumatoid Arthritis ◽  
Signs And Symptoms ◽  
Joint Disease ◽  
Inadequate Response ◽  
Safety And Efficacy ◽  
American College Of Rheumatology ◽  
Increased Risk ◽  
Group 2 ◽  
Group 1

Objective.To evaluate the safety and efficacy of golimumab (GOL), a human antitumor necrosis factor antibody, in patients with active rheumatoid arthritis (RA) despite methotrexate (MTX) therapy through 5 years in the GO-FORWARD trial.Methods.Patients with active RA despite MTX therapy were randomly assigned to receive placebo + MTX (Group 1), GOL 100 mg + placebo (Group 2), GOL 50 mg + MTX (Group 3), or GOL 100 mg + MTX (Group 4). Patients in groups 1, 2, and 3 with inadequate response could enter early escape at Week 16 to GOL 50 mg + MTX or GOL 100 mg + MTX, and all remaining Group 1 patients crossed over to GOL 50 mg + MTX at Week 24. The blind was maintained through the 52-week database lock, after which treatment adjustments were permitted. Adverse events (AE) were monitored through Week 268. Efficacy was evaluated using the American College of Rheumatology (ACR) 20/50/70 responses and a 28-joint Disease Activity Score using C-reactive protein (DAS28-CRP). Response rates at Week 256 were analyzed by an intent-to-treat analysis.Results.A total of 444 patients were randomized, and 313 received GOL through Week 252; 301 patients completed the safety followup through Week 268. Infections were the most common type of AE; 172 patients (39.6%) had ≥ 1 serious AE. No unexpected safety signals were observed. At Week 256, ACR20/50/70 responses were achieved by 63.1%, 40.8%, and 24.1%, respectively, of all randomized patients. About 78% of all patients achieved a good or moderate DAS28-CRP response.Conclusion.Improvements in the signs and symptoms of RA were maintained through 5 years. AE through 5 years were consistent with earlier reports of the GO-FORWARD trial; no apparent increased risk was observed over time.

A Prospective Study Comparing Celecoxib with Naproxen in Children with Juvenile Rheumatoid Arthritis

2009 ◽  
Vol 36 (1) ◽  
pp. 174-182 ◽  
Author(s):  
IVAN FOELDVARI ◽  
ILONA S. SZER ◽  
LAWRENCE S. ZEMEL ◽  
DANIEL J. LOVELL ◽  
EDWARD H. GIANNINI ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Juvenile Rheumatoid Arthritis ◽  
Response Rate ◽  
Signs And Symptoms ◽  
Total Daily Dose ◽  
Target Dose ◽  
Double Blind ◽  
American College Of Rheumatology ◽  
The Difference ◽  
Improvement Criterion

ObjectiveTo compare the efficacy and safety of celecoxib and naproxen in children with juvenile rheumatoid arthritis (JRA).MethodsIn this multicenter, randomized, double-blind, noninferiority study, subjects with JRA were randomized to receive a target dose of celecoxib 3 mg/kg bid or 6 mg/kg bid, or a target dose of naproxen 7.5 mg/kg bid for 12 weeks (maximum allowed dose = 600 mg total daily dose). The primary efficacy measure was the percentage of responders at Week 12 attaining the American College of Rheumatology pediatric 30% improvement criterion (ACR Pediatric-30).ResultsBoth celecoxib doses were at least as effective as naproxen at Week 12 [ACR Pediatric-30 treatment differences: celecoxib 3 mg/kg bid – naproxen = 1.36% (95% CI –13.08 to 15.80); celecoxib 6 mg/kg bid – naproxen = 13.02% (95% CI –0.22 to 26.25)]. Celecoxib 6 mg/kg bid had a numerically higher response rate than celecoxib 3 mg/kg bid at all postrandomization visits and a numerically higher response rate than naproxen 7.5 mg/kg bid at Weeks 4, 8, and 12. Improvement in each ACR Pediatric-30 core set measure was comparable to or numerically higher for celecoxib 6 mg/kg bid than naproxen or celecoxib 3 mg/kg bid. Adverse event rates were similar for all treatment groups, except that gastrointestinal adverse events were more common in the naproxen group, although the difference was not statistically significant.ConclusionCelecoxib 3 mg/kg bid and 6 mg/kg bid were at least as effective as naproxen 7.5 mg/kg bid in treating the signs and symptoms of JRA over 12 weeks. All treatments were generally well tolerated.

Relationship between Eating Patterns and Body Composition among Young Females in Qatar

2020 ◽  
Author(s):  
Fatma Elsayed ◽  
Aram Alhammadi ◽  
Alanood Alahmad ◽  
Zahra Babiker ◽  
Abdelhamid Kerkadi
Keyword(s):  
Body Composition ◽  
Dietary Patterns ◽  
Fast Food ◽  
Dietary Habits ◽  
Communicable Disease ◽  
Normal Weight ◽  
Female Students ◽  
Eating Patterns ◽  
Young Females ◽  
Significant Difference

The prevalence of obesity has been increased in Qatar, with the transition from healthy to unhealthy dietary habits. Behavioral factors that are associated with obesity are, long-term imbalanced energy intake, high screen time, skipping breakfast and physical inactivity. Changes in body composition and percent body fat (PBF) increase the risk of non-communicable disease. This study is the first study conducted in Qatar to investigate the relationship between dietary patterns and body composition among young females at Qatar University. This cross-sectional study consisted of 766 healthy female students Qatari and non-Qatari aged from 18-26 years randomly selected from different colleges at Qatar University. A validate questionnaire was used in order to collect data about healthy and unhealthy dietary patterns. Anthropometric measurements involved body weight, height, waist-to-height ratio (WHtR), waist circumference (WC), body mass index (BMI) and body composition using “Seca285”, “Seca203” and “InbodyBiospace 720”. Dietary patterns were identified by using factor loading. Linear regression was used to estimate confidence intervals and regression coefficient. More than half of the participants had a normal weight (65.1%), whereas 22.8 % and 12.0% were overweight and obese, respectively. Fat mass, BMI and PBF were slightly increased with age, but there was no significant difference. Factor analysis identified two dietary patterns: unhealthy patterns and healthy patterns. The frequent intake of vegetables and fruits was significant among high PBF female students (p=0.045 and p=0.001, respectively). The frequent intake of fast food was higher for overweight female students but there was no significant difference (p=0.289), whereas, the frequent intake of sweetened beverages was associated with higher significant rate of normal weight among female students (p = 0.009). No significant relation was found between dietary patterns, BMI and PBF. In conclusion, body composition is not significantly associated with healthy and unhealthy eating patterns among young females.

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