Yoga for Preventive Health: A Holistic Approach

Yoga has been prevalent for over 5000 years; it originated in India and has become an essential lifestyle ingredient for achieving optimal health. The goal of this article in lifestyle modification is to increase awareness about the benefits of yoga and how its practice can reduce the overall risk of chronic diseases. Yoga has been proven to be therapeutic for enhancing immunity and support management of chronic diseases such as cardiovascular, respiratory, endocrine disorders, obesity, cancer, and metabolic syndrome. Yoga techniques called asanas, such as pranayama for breathing regulation and dhyana for meditation, boost innate immune response, interrupt inflammation, and thereby prevent the manifestation of chronic diseases. Yoga also provides symptomatic relief for chronic arthritis by increasing joint flexibility and microcirculation. Yoga and meditation regulate neurotransmitters, neuropeptides, hormones, and cytokines that mediate interactions between the central nervous system and the immune system. These techniques reduce the psychological and physiological effects of chronic stress. Serotonin, oxytocin, and melatonin released directly due to practicing yoga have been shown to better manage anxiety and fear, especially during the pandemic. We believe the current trends of chronic disease management will become more effective with the implementation of lifestyle changes using yoga.

Surgical management of septic knee arthritis with open arthrotomy and debridement-a case report

<p>Septic arthritis is an inflammatory destruction of the native joint following inoculation of pathogen. Most common organisms causing septic arthritis are <em>Staphylococcus</em> and <em>Streptococcus</em>. Large joints are commonly involved with hip and knee joint accounting for approximately 60% of the total cases. Diagnosis is usually straightforward with the patient presenting with obvious local signs and symptoms along with toxic constitutional symptoms owing to the aggressive nature of the disease. Medical management in form of intra-venous antibiotics forms the mainstay of treatment but it is often required for a prompt surgical intervention in order to provide acute relief from symptom and also to decrease the disease load so as to save the joint from irreversible damage. We have a 63-year-old male patient came presented to us with a right knee swelling and tenderness of 3 weeks duration with restricted ROM with severe toxic constitutional symptoms of 1 week duration. Patient was planned for open arthrotomy and debridement and drainage of the pus and was started on an empirical therapy of injection piperacillin and tazobactam combination for 3 weeks. Immediate relief from symptoms following arthrotomy with good range of motion at 4 weeks post-surgery. As is clear from our case, an early diagnosis of septic arthritis and starting of appropriate antibiotics along with appropriately aggressive surgical interventions in the form of open debridement is the key for treatment of septic arthritis in order to save the joint from irreversible inflammatory damage. Surgical intervention not only gives immediate symptomatic relief but also decreases the load over antibiotics and increases local blood supply subsequently helping in better healing.</p><p><strong> </strong></p>

Do NSAIDs Take Us Away From Treatment Goals in Axial Spondyloarthritis: A Story About Dysbiosis or Just a Matter of Bias?

Non-steroidal anti-inflammatory drugs (NSAIDs) remain the mainstay of treatment for spondyloarthritides (SpA), a group of entities with common clinical and pathophysiological aspects, but also with differential features. Although NSAIDs provide significant symptomatic relief, especially for joint pain and morning stiffness, their role in achieving and maintaining the treatment goals advocated by the treat to target strategy in SpA is not entirely clear. These agents can induce changes in the composition of the intestinal microbiota, also favoring an alteration of the barrier function in the gut epithelium. All of this, favored by a pre-disposing genetic background, could activate a specific type of aberrant immune response in the gut lamina propria, also known as type-3 immunity. This article offers a perspective on how NSAIDs, despite their undeniable value in the short-term SpA treatment, could hinder the achievement of medium and long-term treatment goals by compromising the barrier function of the gut mucosa and potentially altering the composition of the gut microbiota.

COMPARATIVE CLINICAL STUDY OF KUMARIKA VATI AND MEFENAMIC ACID IN UDAVARTINI YONIVYAPAD (SPASMODIC DYSMENORRHEA)

Menstruation is a normal physiological process when it is accompanied by pain is called Dysmenorrhea. It is one of the commonest gynaecological complaints. Dysmenorrhea is painful menstruation, which is the pratyatma lax- ana of Udavartini yoni vyapad i.e., spasmodic dysmenorrhea. It is a common cause of distress in women. Here the main reason for pain is the vitiation of vata dosha (apana vata), viloma/pratiloma gati leading to vedna yukta artava munchan and to manage this pratiloma vata, one needs to use drugs that have anulomana properties and vedna samak. Kumarika vati is used as vedana shamaka aushadha to give symptomatic relief. Hence the topic was selected for the study. Objectives: To compare the effect of Kumarika Vati with Mefenamic Acid in the man- agement of Udavartini Yonivyapad (Spasmodic Dysmenorrhea). Materials & Methods: 20 patients of Group A were treated with Kumarika Vati, a dose of 250mg BD 5 days before menstruation & 5 days during menstruation. 20 patients of Group B were treated with a Mefenamic Acid dose of 250mg BD for 3 days during menstruation. Result: The data of both groups were collected according to the objective and subjective parameters and analyzed using the most appropriate statistical test (repeated measures of ANOVA test and Mann –Whitney U test). The efficacy is statically significant within the group at P<0.001 and statistically insignificant between the group at P>0.05 among all the parameters. Interpretation and Conclusion: On comparison of Kumarika Vati with Mefenamic acid both have equal effectiveness in relieving the pain intensity, pain duration, site of pain, nature of pain and associated complaints. Keywords: Udavartini Yoni Vyapad, Dysmenorrhea, Kumarika Vati, Mefenamic Acid.

MANAGEMENT OF SPASTIC QUADRIPLEGIA (SARVANGGHAT) WITH VATKULANTAK RASA & SHASHTIKA SHALI PINDA SWEDA - A CASE STUDY

Background- Spastic Quadriplegia also known as spastic tetraplegia is a subset of Spastic cerebral palsy that af- fects all four limbs (both arms and legs). Spastic quadriplegia usually displays equal involvement of both upper and lower extremities with severe involvement of legs, arms and floppiness of neck. Spastic quadriplegia is gen- erally caused by brain damage either before birth, during or shortly after. In Ayurveda quadriplegia can be corre- lated with Sarvangghat which is a vatavyadhi. It is a nanatmaja vatavyadhi according to charaka. As the disease was caused by vata-kapha dosha. The treatment is mainly aimed at mitigating vata kapha dosha which helps to clear the blocked micro-channels involved in the pathology. Aim and objective- To study the effect of Vatkulan- taka rasa and Shashtika shali pinda sweda in the management of Spastic quadriplegia (Sarvangghat). Material and methods-The present case study is upon 16 years old (male patient) diagnosed case of spastic quadriplegia with complaints of difficulty in walking with stiffness for 6 years at the kayachikitsa IPD of Pt. khushilal Sharma govt. ayurvedic hospital Bhopal. He was treated with shashtika shali pind sweda & Vatkulantaka rasa. The dura- tion of the study is 21 days. The assessment was done on the basis of symptomatic relief after treatment. Observation- The Ayurvedic therapy and oral medication yielded complete symptomatic relief from pain, stiffness and improve quality of life. Conclusion- On the basis of the result obtained, it can be concluded that Shashtika shali pinda sweda and Vatku- lantaka rasa can be used as an effective treatment in the management of Spastic quadriplegia (Sarvangghat). Keywords: Sarvangghat, Spastic quadriplegia, Shashtika shali pinda sweda, Vatkulantaka rasa.

Fir (Abies Alba) extracts as symptomatic relief for covid19 discomfort

An opinion article

Therapeutic Role of Shwasa Kuthar Rasa in the Management of Tamaka Shwasa (Bronchial Asthma): A Single Group Randomized Clinical Trial

Background: Bronchial Asthma is a disease of airways that is characterized by hyper-responsiveness of the tracheobronchial tree to a variety of stimuli resulting in widespread spasmodic narrowing of the airway. According to WHO 2016, Asthma affects 235 million people worldwide, out of which 15-20 million people are from India. In India, the prevalence of self-reported asthma is 2% among women aged 15-49 years and 1% among young women aged 15-19 years as well as men aged 15-49 years as per the latest report. Prevalence of asthma is more in urban areas than rural area as due to smoke, pollution and environmental factor. In Ayurveda Bronchial Asthma has a high resemblance with Tamaka Shwasa which comes under Pranavaha Srotas. It is described in Brihatrayee as well as Laghutrayee. Acharya Charak and Sushruta has given detailed description of Tamaka Shwasa. Aim and Objectives: To study the effect of shwasa kuthar rasa in the management of (bronchial asthma) and to find out an effective Ayurvedic medicine for Tamaka Shwasa (Bronchial Asthma). Material and Methods: For this open clinical study, 10 patients of Tamak Shwasa (bronchial asthma) were registered from OPD of Kayachikitsa department and admitted in IPD of Pt. Khushilal Govt (Auto.) Ayurveda Hospital Bhopal. The patient was treated with Shwasa Kuthar Rasa. Duration of study was 30 days and follow up was done after completion of trial every week for 1 month, assessment was done on the basis of symptomatic relief and increase the range of FEV1 and FVC value after treatment. Observation: yielded symptomatic relief after treatment. The overall effect of the treatment in patient suggested that, there is 87.50 % relief in cough (Kasa), 90.01% relief in dyspnoea (Shwasakashta), 93.37% relief in chest tightness (Urashool) and 74.99% relief in wheezing (Ghurghurak) and value of FEV1 and FVC were increased up to 22.29% & 24.43% after treatment. Conclusion: On the basis of result obtained, it can be concluded that Shwasa Kuthar Rasa can be used as an effective medicine in the management of (Bronchial asthma). Key words: Tamaka Shwasa, Bronchial Asthma, Shwasa Kuthar Rasa.

Effect of Ayurvedic Interventions on Toxemia of Pregnancy (Preeclampsia) & Fetal Outcome- A Randomized Placebo-Controlled Trial

Background: Toxemia of pregnancy also known as preeclampsia is a common clinical condition affecting 8-10% pregnancies worldwide. It has adverse outcome both for mother and fetus. The management options are mainly targeted to prevent adverse outcomes associated to premature births, such as administration of antenatal corticosteroids and magnesium sulphate infusions. Aim & Objectives: The main aim of the study was to evaluate efficacy of Ayurvedic interventions in management of toxemia and in prevention of premature delivery as well as fetal hazards due to pre-eclampsia. Methods: It was an open ended, parallel group, randomized placebo controlled clinical trial with equal allocation in both the groups. Sample size was 15 in each group. Trial group was administered Gokshura Siddha Yavagu(Green gram gruel medicated with Tribulus terrestris Linn) and Dhatryavaleha (linctus prepared with Ayurveda medicines like Phyllanthus emblica L.)while control group was treated with similar looking placebo-linctus. Results: Both ayurvedic parameters-Shotha(edema), Avil mutrata (Discolored urine) & clinical features of toxemia have shown excellent relief while control group patients either show poor or no relief when assessed by USG scan and needed further treatment with induction of labor. Conclusion: This study concludes that Ayurvedic interventions in the form of Gokshura siddha Yavagu and Dhatri Avleha can provide significant symptomatic relief (p<0.0001) in toxemia of pregnancy and can also promote normal growth and development in fetus.

Laparoscopic management of a full-thickness uterine niche with subsequent pregnancy outcome

Background: Uterine niche is the consequence of impaired healing of the myometrium following a lower segment transverse caesarean section (CS). Although there is conflicting evidence on the management of these cases, laparoscopic repair is a commonly used surgical treatment modality. Objectives: To demonstrate the management and laparoscopic repair of the niche with subsequent pregnancy outcome. Materials and Methods: We report a case of a 33-year-old patient who had a significant haematoma in the niche. The haematoma resolved after conservative management however, she remained symptomatic. Therefore, she had a laparoscopic repair. The narrated surgical video article demonstrates the dissection of the uterovesical fold overlying the niche, followed by the excision of the scar tissue and its repair with laparoscopic suturing. Ultrasound and magnetic resonance imaging images of the uterus demonstrating the haematoma at the caesarean section site, the niche after resolution of the haematoma and post-repair imaging are also provided. Main outcome measures: Repair of the niche, symptomatic relief of abnormal uterine bleeding, spontaneous conception and live birth. Ultrasonographic images also demonstrate uterine wall continuity post laparoscopic repair. Results: The patient recovered uneventfully. Full-thickness of myometrium was demonstrated with post-operative imaging and confirmed at the subsequent caesarean section. Gynaecological symptoms resolved following the repair. The patient conceived spontaneously after surgery and delivered at term by caesarean section without any complications. Conclusion: Laparoscopic management of the niche should be considered where there is a complete myometrial defect or significant thinning of the myometrium, especially in symptomatic women who desire future pregnancy.

A2A Adenosine Receptor Antagonists in Neurodegenerative Diseases

Background: Alzheimer's disease (AD) is the most common form of dementia worldwide, with approximately 6 million American cases in 2020. The clinical signs of AD include cognitive dysfunction, apathy, anxiety and neuropsychiatric signs, and pathogenetic mechanisms that involve amyloid peptide-β extracellular accumulation and tau hyperphosphorylation. Unfortunately, current drugs to treat AD can provide only symptomatic relief but are not disease-modifying molecules able to revert AD progression. The endogenous modulator adenosine, through A2A receptor activation, plays a role in synaptic loss and neuroinflammation, which are crucial for cognitive impairment and memory damage. Objective: In this review, recent advances covering A2A adenosine receptor antagonists will be extensively reviewed, providing a base for the rational design of future A2A inhibitors. Method: Herein, the literature on A2A adenosine receptors and their role in synaptic plasticity and neuroinflammation as well as the effects of A2A antagonism in animal models of AD and in humans are reviewed. Furthermore, current chemical and structure-based strategies are presented. Results : Caffeine, the most widely consumed natural product stimulant and an A2A antagonist, improves human memory. Similarly, synthetic A2A receptor antagonists, as described in this review, may provide a means to fight AD. Conclusion: This review highlights the clinical potential of A2A adenosine receptor antagonists as a novel approach to treat patients with AD.