scholarly journals A Protocol for Treatment of Avabahuk (Frozen Shoulder) with Agnikarma and Topical Diclofenac Sodium Gel

Author(s):  
Mahesh Kumar ◽  
R. K. Shinde ◽  
Reena Jaiswal

Background:  The Avabahuk is a disease described in ancient Ayurveda and is correlated with frozen shoulder of modern science. It is mainly due to vatadosha prakopa and the treatment adopted for this are for snayu-sandhi-asthi-gata-vata. Many treatment modalities mentioned in Ayurveda for treatment of Avabahuka. The treatment modality Agnikarma, the intentional therapeutic heat burn therapy is one among them. Aim and objectives: The aim of the study is to compare efficacy of Agnikarma and topical Diclofenac sodium gel in Avabahuk (Frozen shoulder) treatment. Methodology: The sample size will decide in pilot study and the patients will randomly divided equally into 2 groups. In Group A (Interventional) the Agnikarma will be done at weekly interval for 4 weeks along with physiotherapy. In Group B (comparator group) the topical diclofenac sodium gel application for 4 weeks with physiotherapy. Results: The changes will observed and record in objective outcomes. Conclusion: Agnikarma will be effective in lowering the pain and stiffness of frozen shoulder.

Author(s):  
Praveenkumar H. Bagali ◽  
A. S. Prashanth

The unique position of man as a master mechanic of the animal kingdom is because of skilled movements of his hands and when this shoulder joints get obstructed, we call it as Apabahuka (Frozen shoulder), we do not find satisfactory management in modern medical science. Various effective treatment modalities have been mentioned which reverse the pathogenesis, Shodhana is advised initially followed by Shamana therapies. In the present study 30 patients were selected incidentally and placed randomly into two groups A and B, with 15 subjects in each group. Group A received Amapachana with Panchakola Churna, Jambeera Pinda Sweda and Nasya Karma. Group B received Amapachana with Panchakola Churna, Jambeera pinda Sweda and Nasaapana. In both the groups two months follow up was done. Both groups showed significant improvement in the signs and symptoms of Apabahuka as well as the activities of daily livings, thereby improving the quality of life of the patients. Nasya Karma and Nasaapana provided highly significant results in all the symptoms of Apabahuka. In the present study as per the clinical data, Nasaapana is found to be more effective than Nasya Karma.


2020 ◽  
Vol 8 (10) ◽  
pp. 4669-4676
Author(s):  
Maitradevi 1 ◽  
Uma Patil

Avabahuka is a disease of Amsa Sandhi (shoulder joint) and it has been described under eighty types of Vata Vyadhi by Acharya Sushruta. Being a disease of shoulder joint, which has greatest range of motion, is of vital importance to the activities of daily routine work. This disease is a hindrance in one’s productivity. Various effective treatment modalities have been mentioned in our classics regarding this disease. In order to reverse the pathogenesis, Shodhana is advised initially followed by Shamana therapies. In the present study 40 patients were selected incidentally and placed randomly into two groups- A and B, with 20 sub-jects in each group. Group- A received Nasya with Sheetala Jala and Group- B received Nasya with Ma-sha Taila followed by Rasnadi Guggulu as Shamanoushadhi for both groups A and B. In both the groups after 7th day of Nasya Karma follow up was done. Assessment was done on the bases of symptomatology. Nasya Karma provided highly significant results in all the symptoms of Avabahuka. In the present study as per the clinical data, ‘Nasya with Masha Taila is found to be more effective than Nasya with Sheetala Jala’.


2020 ◽  
Vol 11 (2) ◽  
pp. 218-227
Author(s):  
Punam Sawarkar ◽  
Manish Deshmukh ◽  
Gaurav Sawarkar ◽  
Nandini Bhojraj

Introduction- Cervical Spondylosis is now becoming a significant threat to the working population due to its progressive nature of the disease. Modern science provides various types of medical and surgical therapies for Cervical Spondylosis but it is realized that more research is needed for the treatment of Cervical Spondylosis satisfactorily.Aim - To study the efficacy of Panchtikta Ghrita Matra Vasti and Panchtikta Ghrita Marsha Nasya in Cervical Spondylosis. Material & Method- Open randomized parallel comparative clinical study, Phase 2 trial. 30 patients were randomly equal number (n=15) recruited in the study in two groups. In Group A, patients were treated with Panchtiktaghrita Matravastiand in Group B with Panchtiktaghrita Marsha Nasya. Subjective criteria for the study was Manya Shool and Manya Stambha whether objective criteria were CBC, ESR and Neck disability index (NDI). Observation & Result- With respect to the blood investigation CBC and ESR was not found significant (P<0.05). Moreover, radiological changes in X-ray also not found significantly notable. NDI score was found better in both the groups, but mean score of NDI was suggestively improved in Group B (before 45.03, after 13.06) compare to Group A (before 46.26, after 23.06). Conclusion- Both the treatment modalities i.e. Basti and Nasya was effective in Cervical Spondylosis. Panchtikta Ghrita Marsha Nasya was given good results clinically in the patients compare to Panchtikta Ghrita Matra Vasti, but significant conclusion was not calculated with small sample data. So, large population research study is recommended for further research.


2021 ◽  
Vol 10 (3) ◽  
pp. 3011-3015
Author(s):  
S Wairagade

Avabahuka is caused mainly by vitiated vata. Avabahuka is not mentioned in nanatmajvatavyadhi but acharya sushruta and other acharyas considered avabahuka as vatavyadhi. Avabahuka is a disease that affects amsa sandhi. Avabahuka is correlated with frozen shoulder of modern science. It is also known as adhesive capsulitis, or stiff shoulder where joint pain and stiffness of shoulder joint both occur. Therefore as avabahuka causes major limitations in activities of daily living casting a negative influence on the quality of life as well as long-term or even permanent disability in a few of the patients, proper treatment is needed for the problem. In ayurveda basic principle of avabahuka treatment is vata shaman chikitsa. The general line of treatment for vatavyadhi issnehana, swedana, mrudusamshodhan, basti, nasya, and so on. Snehana – swedana for the treatment of avabahuka which is generally given in vatavyadhichikitsa has gained popularity for its efficacy. Evaluation of the utility, safety, and efficacy of laghuvishagarbha tail amsabasti by amsabasti yantra along with trayodashangguggulu as compare to laghuvishagarbha tail snehana – swedana along with trayodashangguggulu in the management of avbahuka (frozen shoulder). In this study, 140 patients will be divided randomly into 2 groups (70 in each). In group a (experimental) –amsabasti of laghuvishgarbha tail and oral drug trayodashangguggulu (500 mg thrice a day) after meals with plain water will be given for 21 days and group b (control) –snehana of laghuvishgarbha tail, swedana of by plain water and oral drug trayodashangguggulu (500 mg thrice a day) after meals with plain water will be given for 21 days. Assessment of avabahuka will be recorded on day 0, on 7th day, on 14th day and on 21st day. Changes will be observed in objective outcomes. Amsa basti will be more efficacious thansnehana -swedana in the management of avabahuka.


2018 ◽  
Vol 4 (4) ◽  
pp. 519-522
Author(s):  
Jeyakumar S ◽  
Jagatheesan Alagesan ◽  
T.S. Muthukumar

Background: Frozen shoulder is disorder of the connective tissue that limits the normal Range of motion of the shoulder in diabetes, frozen shoulder is thought to be caused by changes to the collagen in the shoulder joint as a result of long term Hypoglycemia. Mobilization is a therapeutic movement of the joint. The goal is to restore normal joint motion and rhythm. The use of mobilization with movement for peripheral joints was developed by mulligan. This technique combines a sustained application of manual technique “gliding” force to the joint with concurrent physiologic motion of joint, either actively or passively. This study aims to find out the effects of mobilization with movement and end range mobilization in frozen shoulder in Type I diabetics. Materials and Methods: 30 subjects both male and female, suffering with shoulder pain and clinically diagnosed with frozen shoulder was recruited for the study and divided into two groups with 15 patients each based on convenient sampling method. Group A patients received mobilization with movement and Group B patients received end range mobilization for three weeks. The outcome measurements were SPADI, Functional hand to back scale, abduction range of motion using goniometer and VAS. Results: The mean values of all parameters showed significant differences in group A as compared to group B in terms of decreased pain, increased abduction range and other outcome measures. Conclusion: Based on the results it has been concluded that treating the type 1 diabetic patient with frozen shoulder, mobilization with movement exercise shows better results than end range mobilization in reducing pain and increase functional activities and mobility in frozen shoulder.


QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Amr Abdelaal ◽  
Mostafa Soliman ◽  
Hany Rafik ◽  
Mohamed Emam ◽  
Mohamed Mahmoud Mohamed Elsadek

Abstract Background Diabetic foot ulcers (DFUs) are the main cause of hospitalization in diabetic patients and they are considered a major worldwide health problem. Thus, there is a need to evaluate various treatment modalities. In this study we will assess the clinical efficacy of Silver nanoparticles dressing vs Standard Moist Wound Dressing (SMWD) in management of diabetic foot ulcers. Objective To compare wound outcome, limb salvage, healing time of diabetes related foot ulcers and cost effectiveness in terms of duration of hospital stay between Silver nanotechnology dressings and Standard moist wound therapy (SMWT) in management of diabetic foot ulcers. Patients and Methods This is a prospective randomized controlled study involving 34 patients with active diabetic foot ulcers, in a high volume tertiary referral vascular center. They were divided into 2 groups: 17 patients (group A) were prescribed SMWD and the other 17 patients (group B) received Silver nanoparticles wound dressing. Results Our study correlates with the study conducted by K.Suhas et al. which had observed that Silver nanoparticles wound dressing was safe and effective treatment for complex diabetic foot wounds and could lead to higher proportion of healed wounds and faster healing rates. At the end of the study, group B promised a better outcome as compared to group A. Conclusion The role of Silver nanoparticles wound dressing in healing of diabetic foot ulcers has been proposed as a novel method of manipulating the chronic wound environment in a way that it reduces bacterial burden and chronic interstitial wound fluid, increases vascularity and cytokine expression and to an extent mechanically exploiting the viscoelasticity of peri wound tissues.


QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Tarek Hussein Kamel ◽  
Amr Lotfy Farag ◽  
Dr/Sherif Hassanin Ahmed ◽  
Chresteen Talaat Samy Hanna

Abstract Background Colorectal cancer (CRC) is one of the leading causes of mortality and morbidity in the world. It is the third most common malignancy after lung & breast and the fourth leading cause of cancer-related deaths worldwide, accounting for approximately 1,400,000 new cases and about 700,000 deaths worldwide. Objectives The aim of this retrospective study is to compare the epidemiology, clinicopathologic features, different treatment modalities and outcomes regarding disease free survival (DFS), progression free survival (PFS) & overall survival (OS) of colorectal cancer disease between cases presented to Ain shams university hospital & to Luxor international hospital in 3 consecutive years. Patients and Methods The study is retrospective comparative study. Clinical oncology department in Ain Shams University Hospital and Luxor International Hospital. The data Collected from January 2013 to December 2015. This study analyzed hospital records of patients who diagnosed with colorectal cancer (CRC) and allocated into two groups: Group A: CRC patients presented to Ain-Shams University Hospital from January 2013 to December 2015, group B: CRC patients presented to Luxor International Hospital from January 2013 to December 2015. Results There was no statistically significant difference regarding age parameter in LIH when compared to ASU, but the study was consistent with higher incidence in patients who were aged more than forty- accounted about 70.5% in all CRC cases. Cases less than 40 years old, in group A were 35.2%, while in Group B were 23.5%. Even there was no statistically significant difference but it may be attributable to more westernization in Lower Egypt. Other explanation may be due to decreased low socioeconomic status and different lifestyle factors in more developing region what increase risk of colorectal cancer. Among our cases, there is no statistically significant difference regarding gender between the two hospitals. Both sexes almost were affected equally, females appeared to be at a slightly higher risk of developing CRC cancer with current prevalence 1.3:1 in ASU group, and 1.1:1 in LIH group. Conclusion The need to increase awareness about CRC in Egypt especially upper Egypt, is recommended. An awareness campaign should be performed to promote detection of CRC at its earliest and most curable stage by recognizing early symptoms and enabling early referrals for colonoscopy. Those at higher risk should be offered more intensive surveillance. Similarity of the data from different centers suggests that this is the picture of colorectal cancer typical of Egypt.


Author(s):  
Kamya Somaiya ◽  
G. D. Vishnu Vardhan ◽  
Ashish Bele

Background: Periarthritis Shoulder, also known as adhesive capsulitis, is a condition that results in tissue degeneration, thickening of the joint capsule, and a narrowing of the glenoid cavity. Diabetes mellitus is linked to many debilitating musculoskeletal disorders of the hand and shoulder. Prevalence of adhesive capsulitis or frozen shoulder is estimated to be 11-30 percent in people with diabetes. Various interventions have already been used to prevent pain and improve quality of life. Both Muscle Energy Technique and Kalternborn Mobilization Technique are thought to have a pain-relieving effect. Aim & Objective: The study's aim is to compare the effects of both techniques on pain in diabetic patients. Methods/Design: In this study experimental study, the participants will be divided into two groups: Kalternborn Mobilization Technique Group (A) and Muscle Energy Technique Group (B) based on inclusion and exclusion criteria. Both interventions include 30-45 min session which will be carried out for duration of four days. Outcome will be Pain and Quality of Life and outcome measures will be evaluated at beginning and at the end of intervention period. Result: Successful Completion of trial of Muscle Energy Technique and Kalternborn Mobilisation Technique will provide evidence for best strategy targeting Pain and quality of life in diabetic patients with Periarthritis of Shoulder. Conclusion: The study will be concluded with the significant effect of Muscle Energy Technique and Kalternborn Mobilisation Technique on Periarthritis shoulder of diabetic patients.


2018 ◽  
Vol 5 (1) ◽  
pp. 22-28 ◽  
Author(s):  
Alok Pandey ◽  
B Shrestha ◽  
K M Shrestha

BACKGROUND: Treatment of Frozen shoulder (Adhesive Capsulitis) is mainly nonoperative. Intra-articular steroid injections and physiotherapy are one of the most effective and useful treatment. Even though intra-articular steroid injections are very effective in inflammatory phase of the disease; patients are reluctant to move their affected shoulder for fear of pain. Thus, they do not follow exercise program properly resulting in poor outcomes.OBJECTIVE: If pain could be reduced, outcome of treatment can improve. Lignocaine, when combined with steroid injection, plays an important role in immediate improvement of pain and active range of motion thereby increasing the overall result. MATERIALS & METHODS: 100 patients with frozen shoulder were selected according to predetermined inclusion and exclusion criteria. After randomization by sealed envelope technique, patients were divided into Group A and Group B. Group A patients were injected with 2 ml (80 mg) of methylprednisolone and 3 ml of 1% Lignocaine, and Group B patients were injected with 2 ml (80 mg) of methylprednisolone and 3 ml of Distilled water in the affected shoulder via standard posterior approach. Then half an hour of standard shoulder range of motion (ROM) exercise regimen was performed under supervision. Pre injection and post injection pain level was scored by Visual Analogue Score (VAS) and Subjective satisfaction score (SSS). Shoulder exercises were taught and home based physiotherapy was carried out by patients themselves. They were also prescribed oral analgesics for 5 days and were followed at 1, 3, and 6 weeks. At every follow up visit, they were assessed for improvement via Constant-Murley Score (CMS).RESULTS: The mean age of this study in group A and group B was 56.46 years (SD 10.05) and 57.18 years (SD 8.87) respectively (P0.70). There were 31 male and 19 female in group A as compared to group B where there was 26 males and 24 females (P0.41). In both the groups, maximum number of patients presented at around 10 weeks. In both the groups left side dominated right side with equal frequency (33 left sides and 17 right sides) (P 1.00) and non dominant side outnumbered dominant side with near equal frequency (P 1.00). After the intervention, excellent result in SSS was observed only in group A whereas maximum patients of Group B had only fair result (42 patients). There was statistically significant difference between two groups in terms of pain; Activity of daily living (ADL) and Range of motion (ROM). Patients in group A were able to carry more weight than group B.   In CMS 1 and 6 week total, there was statistically highly significant difference between two groups. CONCLUSION: Even though steroid and physical exercises play important role in managing frozen shoulder, addition of lignocaine to steroid injection seems to be helpful. It relieves immediate pain on movement and improves exercise compliance thereby improving early outcomes. Evaluation of long term benefits of lignocaine injection needs further studies. Journal of Universal College of Medical Sciences (2017) Vol.05 No.01 Issue 15, Page: 22-28 


2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e22009-e22009 ◽  
Author(s):  
Rejin Kebudi ◽  
Samuray Tuncer ◽  
Sema Bay Buyukkapu ◽  
Serra Sencer ◽  
Omer Gorgun ◽  
...  

e22009 Background: Bilateral retinoblastomas (BRBS) comprise 25 % of all RBS. Treatment decision depends on tumor burden, potential for vision, status of the contralateral eye. As the survival rate in retinoblastoma has increased, ocular salvage and late effects has become an important issue. The aim of the study is to evaluate the demographic features, treatment modalities, and late effects in BRBS. Methods: BRBS treated in Istanbul University, Oncology Institute and Opthalmology Department between 1990-2016 were retrospectively evaluated. All patients were multidisciplinarily evaluated for chemotherapy (chemoreduction /adjuvant), local opthalmologic therapies (transpupillary thermotherapy, cryotherapy, plaque), radiotherapy, enucleation. The chemotherapy (CT) protocol used had vincristine, cisplatin, etoposide, cyclophosphamide until 2009, and vincristine, etoposide, carboplatin since then. Since 2011, intraarterial, intravitreal CT was also used. Results: 114 BRBS (228 eyes) (56 male, 58 female) with a median age of 9 months (20days-42 mo.) were evaluated. Three had extraocular disease, two trilateral RBS. Seventeen had history of retinoblastoma in their families. According to ICRB classification, there were 67 eyes in group E, 43 group D, 27 group C, 45 group B, and 19 group A. Enucleation was done in 68 (30%) eyes, mostly group E. During 1990-2000, 23/26 patients underwent enucleation, whereas 45/88 underwent enucleation after 2000. Radiotherapy was used for 30 eyes, most before 2000. Bone and soft tissue deformities and cataracts were observed in irradiated patients. Five patients had a second cancer (4 sarcomas, 1 meningioma) at a median of 11 years, four in irradiated sites. The 5 yr survival was 93.5%, 9 patients died, 4 due to second cancer. Conclusions: As the survival rate in intraocular BRBS has increased, ocular salvage and late effects have gained importance. Chemoreduction (systemic, intraarterial) and local ophtalmic therapies enable preservation of vision in most group A, B, C tumors and some D tumors. Most group E tumors require enucleation. Radiotherapy is not used in most RBS in the last decade. Intra-arterial chemotherapy is promising in maintaining ocular salvage.


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