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AYUSHDHARA ◽  
2021 ◽  
pp. 3473-3481
Author(s):  
Vijay Chaudhary ◽  
Ankita Agrawal

In present time, lifestyle disorders are rapidly rising in our society. Over consumption of food, alcohol and fructose sweetened soft drinks in combination with a sedentary lifestyle has resulted in increased prevalence of visceral obesity, metabolic syndrome and gout in all socioeconomic groups of society including the lower socioeconomic status. Gout is one of the major life style disorders. The clinical manifestation and textual references of gout may be attributed with 'Vatarakta', also known as Vatashonita. Vata and Rakta are the Dosha and Dushya respectively which are primarily involved in the pathology of Vatarakta. Virudhaahar and Vihara aggravate Vata dosha and Rakta dhatu. Provocated Vata gets Aavrut with vitiated Rakta dhatu leading to the beginning of pathophysiological cascade of Vatarakta. The patients for this study were diagnosed based on Ayurvedic and modern parameters. Clinical signs and symptoms described in classical texts were considered for the diagnosis of Vatarakta, whereas serum uric acid was considered as investigation based diagnostic tool. Total 15 patients were registered in trial. The selected patients were given the trial drug i.e., Amrita guggulu one gram and Guduchi kwath 50ml twice a day with plain water after food. Out of 15 registered patients, 1 dropout from the trial, 4 patients (28.57%) showed marked improvement, 7 patients i.e., 50% showed moderate improvement and 3 patients 21.43% showed mild improvement. None of patient in present clinical trial remained unimproved or deteriorated during the clinical trials. In the present study, none of the patient reported any adverse effect to the trial drug during study and follow up period.


2021 ◽  
Vol 9 (11) ◽  
pp. 2713-2722
Author(s):  
Sushil Kumar Jangid ◽  
Sunita Kumari Bijarniya

Ayurveda is not only the science of life but also the philosophy of life. Srotasa which represent the internal transport system includes a series of channels through which Rasa-Raktaadi Dhatu is propelled to all parts of the body. The concept of Pranavaha Srotodushti & its explanation matches entirely with the pathogenesis mechanism symptoms of Asthma. Taking this aspect in the mind, the clinical study was planned to establishment of the func- tional utility of Srotomoola in the management of the disease Tamaka Shwasa. AIM & OBJECTIVES: To estab- lish the role and function utility of Srotomoola. To study the aetiopathogenesis and treatment of Pranavaha- Pradoshaja Vikara. To assess the efficacy of Shwashar Yoga, Hridya Yoga, and Deepaniya Yoga. MATERIALS AND METHODS: For the clinical study 30 clinically diagnosed patients of Tamaka Shwasa (Bronchial Asthma) were registered for present clinical. They were treated in three groups randomly each containing 10 patients with- in the age group of 20-70 years. Group 1 has been treated with Shwashar Yoga 5gm three times a day for 2 months. Group 2 have given Hridya Yoga 5gm three times a day for 2 months. Group 3 have given Deepaniya Yoga 5gm three times a day for 2 months. 30 clinically diagnosed patients of Tamaka Shwasa (Bronchial Asthma) were registered for the present clinical study in 3 divided groups. RESULTS: After the complete intervention the overall improvement in the patient of group I was found to be 77.27%, in Group II was found to be 63.64% and in group III was found to be 31.50% which was a mild improvement symptomatically but statistically it was highly significant. DISCUSSION AND CONCLUSION: It was observed that most drug ingredients in Shwashar Yoga, Hridya Yoga, Deepaniya Yoga have Laghu, Ruksha, Tikshna Guna, Tikta, Katu Rasa, Katu & Madhura Vipaka & Kapha Vatashamaka Prabha- va. Considering these factors, the selected drugs as well comprises Kapha Vatashamaka action, moreover, should contain a strong affinity to perform on Pranavaha Srotas. It shows signs of Srotoshodhaka properties which may assist to eliminate sluggish Dosha in the Srotas. Keywords: Srotasa, Srotomoola, Tamaka Shwasa, Kapha Vatashamaka.


Author(s):  
E Noyes ◽  
A Rajput ◽  
A Rajput

Background: There is no biological marker of progression in early Parkinson Disease (PD). Upper limb (UL) tremor is the most common motor symptom at onset. The significance of lower limb (LL) tremor remains unknown. We report on longitudinally followed autopsy-verified PD tremor onset cases. Methods: A chart review of longitudinally followed autopsy-verified PD cases was performed. Age and mode of onset were recorded at initial evaluation. Prognosis was measured by change in Hoehn and Yahr scale while on levodopa (LD). Results: Fourty-nine patients were included. Thirty-eight cases had upper limb (UL), four lower limb (LL), and seven upper and lower limb (ULL) onset tremor. UL had 86.8% response to LD, LL 50% and ULL 85.7%. Sub-analysis of UL responders found 20% mild improvement, 53.3% moderate and 26.7% marked. ULL had moderate response in 83.3% and marked in 16.7%. LL responders only had mild improvement with LD. Conclusions: Tremor onset is most common in UL, followed by ULL and then LL. LL onset tremor cases have an inferior response to LD when compared to UL and ULL cases.


2021 ◽  
Vol 14 (11) ◽  
pp. e244968
Author(s):  
Christon Grant ◽  
Varun Chalasani ◽  
Jeffrey M Uchin ◽  
Adam Dore

Few cases of programmed death-ligand 1 inhibitor-induced scleroderma have been reported and their clinical features remain unpublished. Optimal management is, therefore, unknown and an autoantibody association has yet to be identified. We present the case of a female in her 60s who developed skin thickening after starting atezolizumab for metastatic non-small cell lung cancer. Skin biopsy 7 months after symptom onset showed histological changes consistent with scleroderma. Anti-PM/SCL-75 antibody was positive. Atezolizumab was discontinued and treatment was started with mycophenolate mofetil. After 5 months, she experienced mild improvement in skin thickening. Earlier identification of this complication may limit morbidity in this disease process, which otherwise has limited treatment options. In suspected cases, obtaining scleroderma-associated autoantibodies may help with earlier diagnosis.


2021 ◽  
pp. 105-107
Author(s):  
Michelle F. Devine ◽  
Divyanshu Dubey ◽  
Sean J. Pittock

A 44-year-old man sought care for new right-sided tinnitus and sensorineural hearing loss. He was treated with high-dose oral prednisone and acyclovir. Later, mild, intermittent dizziness developed, which progressed to constant, moderate dizziness and was exacerbated by sudden head movements. He participated in vestibular rehabilitation with only mild improvement. Within 5 months of tinnitus onset, horizontal binocular diplopia also developed. Examination showed spontaneous left-beating torsional nystagmus in primary gaze, down-beating nystagmus with leftward gaze, and right-beating torsional nystagmus in rightward gaze. Head impulse testing to the right produced a catch-up saccade. Dix-Hallpike maneuver in both positions led to leftward torsional nystagmus followed by down-beating nystagmus. He had full range of eye motion. There was evidence of asymmetric hearing loss on the right and moderate gait unsteadiness; he was able to complete only a few steps in tandem. Neurologic examination findings were otherwise normal. Oculomotor testing demonstrated abnormalities supportive of a central nervous system disorder. These included excessive square-wave jerks, impaired smooth pursuit, and direction-changing nystagmus. Results of cerebrospinal fluid studies included a normal opening pressure, pleocytosis, and increased protein concentration. Serum and cerebrospinal fluid paraneoplastic evaluations showed a unique immunofluorescence staining pattern on rodent brain tissue by patient immunoglobulin G, which was later confirmed to be immunoglobulin G antibodies to kelch like family member 11. Whole-body positron emission tomography showed a single anterior mediastinal mass, which was then resected. The patient was diagnosed with a paraneoplastic anti-kelch like family member 11 rhombencephalitis with an extratesticular seminoma. After removal of the mediastinal mass, intravenous methylprednisolone was started. The patient had symptom stabilization but no clinical improvement. Cyclophosphamide was added to the weekly pulse-dose intravenous corticosteroids. He had mild improvement in vertigo and gait imbalance. For symptomatic management of the vertigo, he received baclofen, citalopram, and vestibular rehabilitation. He continued to have slow improvement. After approximately 1 year of cyclophosphamide treatment, his gait normalized and nystagmus diminished, although he had persistent neurologic deficits including spontaneous down-beating nystagmus and a few intermittent square-wave jerks. The intravenous methylprednisolone infusions were tapered, with continued examination stability. After stable symptoms and examination findings, cyclophosphamide was discontinued. After discontinuation of cyclophosphamide, new central sensorineural hearing loss developed suddenly in his left ear. This improved with additional intravenous methylprednisolone treatment. Mycophenolate mofetil was also started, and corticosteroids were tapered. Repeated positron emission tomography of the body showed no recurrence of seminoma. Symptoms and audiography findings were stable after 10 months, so the patient elected to discontinue immunosuppression again and has remained stable. Kelch like family member 11 autoimmunity is a distinct paraneoplastic syndrome associated with encephalitis and testicular germ cell tumors (including seminoma).


2021 ◽  
Vol 9 (10) ◽  
pp. 2353-2361
Author(s):  
Shwetambika Shwetambika ◽  
Ananta. S. Desai ◽  
Shaila Borannavar

Polycystic ovarian syndrome is one of the most common endocrine disorders affecting women in their reproduc- tive age group and the most common cause of anovulatory infertility. It is characterized by the presence of men- strual irregularities, infertility, hirsutism, acne, hair loss, insulin resistance, hyperandrogenemia, central obesity and dyslipidemia with a higher risk of developing Diabetes mellitus, endometrial hyperplasia and cardiovascular diseases. It is important to treat these patients early to help them, deal with emotional stress caused by hirsutism, infertility, obesity that is often overlooked with PCOS. So early diagnosis and proper management can help socie- ty to control PCOS so that women can live a healthy, active life and avoid long term complications such as meta- bolic syndrome and cardiovascular disease. The present study has been done to evaluate the effect of Vamana karma with Madanapala Varti and Madanaphala Avalehya yoga in PCOS. Methodology: 40 patients suffering from PCOS. Group A-Vamana karma with MadanaphalaVarti Yoga, Group B - Vamana karma with Madan- aphalaAvalehyaYoga. Result And Conclusion. The test shows that the treatment is not significant in Group A when compared to Group B. Group A overall result is 28.87% and Group B overall result is 32.37%. Both groups showed mild improvement in features of PCOS both clinically and statistically. Keywords: PCOS, Artavakshaya, Vamankarma, Madanaphalavarti and MadanaphalaAvalehya yoga.


2021 ◽  
Vol 07 (10) ◽  
Author(s):  
Dr. Harsha Radhakrishnan ◽  

Tamaka Shwasa is one of the chronic disorders of Pranavaha srotos which occurs by Pratiloma gati of Vata due to obstructed Kapha. Tamaka Shwasa is often correlated with Bronchial Asthma in modern medicine. Asthma is a disease of airways that is characterised by increased responsiveness of the tracheobronchial tree to a variety of stimuli. Keeping these points in view, the clinical study entitled as “Role of Amritadi Kwath in Tamaka Shwasa (Bronchial Asthma)” was been selected. For this 27 patients of Tamaka Shwasa were randomly selected on the basis of inclusion and exclusion criteria from Kayachikitsa O.P.D of Rishikul Campus, UAU, Haridwar. The drug chosen was Amritadi Kwath (with Pippali churna as Anupan) from Chakradatta which was given in a dose of 40 ml twice daily for 45 days. Assessment was done at the interval of 7 days during this period, along with a follow up of 15 days after the completion of trial on the basis of subjective and objective parameters. Appropriate statistical tests were used for obtaining the results. The effect of trial was considered on the basis of percentage relief in the above parameters. Maximum improvement were noted in Sleshma vimokshante labhate sukham (92.31%), Kapha nishtivana (88.46%) and Ushnabhinanditi (84.91%). In overall response, marked improvement was found in 56% patients, moderate improvement in 28% patients, mild improvement in 8% patients and no change in 8% patients. As per the data collected, Amritadi Kwath when given in Tamaka Shwasa was effective in relieving the symptoms in the patients.


2021 ◽  
Vol 26 (Supplement_1) ◽  
pp. e69-e71
Author(s):  
Felicia Paluck ◽  
Inbal Kestenbom ◽  
Gidon Test ◽  
Olivia Ostrow ◽  
Brooke Brimmer

Abstract Primary Subject area Emergency Medicine - Paediatric Background Fever is a common presentation among children coming to the Emergency Department (ED) and a urinary tract infection (UTI) often needs to be excluded. Sterile techniques, like catheterization, are invasive, can be traumatizing to children, and are time consuming to complete. A two-step approach has been shown to reduce the catheterization rate in febrile, young children without unintended consequences. Objectives Our aim was to implement a two-step approach for UTI screening in febrile children 6-24 months in order to decrease unnecessary urine catheterizations by 50% without impacting ED length of stay (LOS) or return visits (RVs). Design/Methods After engaging key stakeholders and a nursing champion, we created a process map to understand the current urine collection process in our ED, and areas for targeted improvement. Using the model for improvement, we adopted a 2-step pathway for a suspected UTI in children 6-24 months as our change idea. The pathway involved identifying children who met inclusion criteria for UTI screening, followed by urine bag application and urinalysis (UA) if clinically indicated. Only if the UA was positive, a second urine sample was collected via catheterization, for repeat UA and culture. Through multiple PDSA cycles, our pathway was implemented in the ED along with concurrent staff education. The outcome measure was the rate of ED urine catheterizations. Process measures included the total number of urine cultures sent to microbiology and percent positivity. The balancing measures included ED LOS and RVs. Results Since project initiation in July 2019, the ED catheterization rate decreased from 73% to 53% (Figure 1) and the number of urine cultures sent to Microbiology decreased by 23%. The number of urine cultures sent to Microbiology decreased by 23% with a mild improvement in the positivity rate by 2% (Figure 2). There was no significant change in RVs. There was a slight 10-min increase in ED LOS, most likely confounded by the COVID pandemic. Conclusion Using improvement methodology, we successfully decreased the number of unnecessary catheterizations in children and the number of urine cultures sent to microbiology. Further refinements to our intervention are ongoing and include optimizing urine screening equipment in patient rooms, poster reminders, re-education for providers, and introducing a parent resource explaining the 2-step pathway. This improvement work is also being spread to the paediatric wards and can easily be adopted by other paediatric centres. It has also been adapted by the Choosing Wisely hospital campaign.


Author(s):  
Sudhir Kumar Pani ◽  
B. B. Khuntia ◽  
Sudarshan Behera

Cerebral palsy is a non-progressive disorder, which arising in early stages of development of child. There are many etiology factors like antenatal, natal and postnatal factors responsible for causing cerebral palsy but exact cause is still unknown. Spasticity is the main feature of cerebral palsy(). Classification of CP is too broad on the basis of physiological and topographic etc. Symptoms of spastic cerebral palsy can be corelated with Jadhata in Ayurveda. In Jadata, there is tightness of muscles occurs. Improvement can be got in children with ayurvedic treatment. Aim- To improve the quality of life of child suffered from spastic CP. Place and duration of study- Study was done in Parul Ayurved Hospital, Vadodara, Gujarat. Method- In this case study, Samavardhan ghrita() orally, snehana() with bala taila() and svedan () with dashmmola kwath () was given to child for 31 days. Results- mild improvement in spasticity and achievement of milestones have observed. Patient got discharged from IPD of hospital due to COVID 19 pandemic. Conclusion- Hence, through Ayurveda treatment, improvement in symptoms of spastic cerebral palsy can achieve and quality of life of child can increase spontaneously.


Author(s):  
Fadhilah Hani Ishak ◽  
Abdul Hanif Khan Yusof Khan ◽  
Mohd Naim Mohd Yaakob ◽  
Mohd Fandi Al Khafiz Kamis ◽  
Anna Misyail Abdul Rashid ◽  
...  

Abstract Background Trigeminal neuralgia (TN) commonly affects individuals aged more than 50 years and is mostly primary owing to trigeminal nerve neurovascular compression. We report a case of secondary TN attributed to a giant intracavernous aneurysm compressing the trigeminal nerve. Case presentation A 74-year-old female presented with classic TN symptoms, which were initially refractory to medical treatment. Imaging including MRI brain, MR angiography, and cerebral angiogram revealed a giant intracavernous aneurysm measuring 1.7 cm × 2.8 cm, inducing mass effect on the left Meckel's cave. Aneurysm embolization was challenging due to the difficult cannulation of the distal portion of the aneurysm. The patient opted for conservative management with mild improvement of symptoms. Conclusions Intracavernous aneurysm rarely present with isolated trigeminal neuralgia. This case report emphasizes that the assessment of the intracranial vasculature should be considered as part of the diagnostic imaging work-up for patients presenting with TN


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