TREATMENT OF A COMBINATION OF DIABETIC POLYNEUROPATHY WITH TYPE 2 DIABETES AND GOUT

The purpose of the work. To show the expediency of using a complex DPN therapy with thio-gammoy-600 in combination with TPP, B12-ankerman and febuxostat. Materials and research methods. The study involved 28 male patients suffering from DM2 aged 56-77 years, with an av-erage age of 64.6±0.7 years. The initial values of average fasting blood glucose were 7.8 ± 1.52 mmol/l, glycosylated hemoglobin 7.4 ± 0.13%. Two groups were identified: group 1 (main) – 14 people and group 2 (control) - 16 people. In group 2, basic DPN therapy was used (thiogamma 600 mg/day for 4 months). For the first 14 days, the drug was administered intravenously, and then administered orally. In group 1, in addition to basic DPN therapy, B12-ankerman and febuxostat (adenuric) – 80 mg/day were received. TPP was carried out on a portable device TPP-03 for 15 minutes daily. This treatment regimen was used for 4 months. The assessment of the quality of life (QL) was carried out using the MOS SF-36 questionnaire. Results and their discussion. Four months after the start of therapy, more pronounced changes were observed in patients of the first group. The total score of the NSS scale in this group increased by 28.9%, and in group 2 - by 18.8%. The positive effect of therapy with adenuric and TES on the course of DPN shows that the use of this treatment will naturally lead to an improve-ment in the quality of life of patients, the dynamics of which was studied according to the results of the SF-36 questionnaire.

A Clinical Study of Maltyadi Tail in the Management of Darunak W.R.S. To Dandruff

Darunak is a Vata –Kaphaj Vyadhi. Sushruta mentioned it under Kshudra roga. Chakradatta has mentioned application of Maltyadi Tail (Jaati, Karveer, Chitrak, Karanj, base oil- Tila Tail) in the treatment of Darunak. Aggravation of Kapha and Vata in Darunak causes, itching, falling of hair, loss of sensation, dryness and small cracks of the skin of the scalp. Several factors increase the risk of developing dandruff, including a person’s age, the weather, stress levels, fungus, medical conditions, and choice of hair products. Oiling is the best way to get a healthy scalp. Aim and objective: To evaluate efficacy of Maltyadi Tail in the management of Darunak w.s.r to dandruff. Materials and Methods: In this clinical study total 46 Patients of Darunak were registered out of which 3 patients left the treatment; remaining 43 patients were divided into 2 groups. 23 patients were treated in group A (test drug- Maltyadi Tail) and 20 patients were treated in group B (control drug- Tila Tail) for 30 days. The effect of therapy was assessed on the basis of changes in grading score. Result: In clinical study, All the cardinal and associate symptoms except Raag, Daah, Ruja were statistically significant improved after the complete course of test drug (Maltyadi Tail). Effect of Group A reduced Kesha Bhoomi Rookshta by 92.68%, Kandu by 100%, Keshbhoomi Prapatan by 92.68% and Keshchyuti by 87.50% which was statistically highly significant. Conclusion: The study revealed that test drug (Maltyadi tail) is more effective in Darunak /dandruff compare to control drug (Tila Tail).

Factors affecting rehabilitation of infants with Central Coordination Disorders during a three-month-long observation

Background Central coordination disorders (CCD) encompass various abnormalities observed in infants but early therapy may have an impact on their condition. The aim was to seek factors that may affect the early results of therapy of infants with CCD. Methods We analyzed the outcomes of a three-month period of rehabilitation of infants living with CCD. Children were treated at Non-public Specialist Healthcare Institution Medi-Reh in Kalisz in the period from 1 Jan 2014 to 31 Nov 2019. In our retrospective study results of three-month therapy of infants, aged 1 to 6 months, with CCD were analysed regards to the effectiveness and the potential impact of different factors. Therapy and assessment of children were conducted with the use of the Vojta method, which was performed during the first visit (WW) and the follow-up visit (after 3 months- 1WK). The analysis of the influence of various factors on the effect of therapy included: mother's age at the time of delivery, duration of breastfeeding, child APGAR, gestational age in which the child was born, sex of the child, birth weight, age of the child at WW, type of delivery, craniosacral therapy as an additive treatment. Results Based on the examination results from 66 medical records it was demonstrated that after active period of the therapy, improvement was observed in 54 (81.81%) (p=0.48) children (condition during WW versus 1WK among the group). The sole factor impacting improvement after 3 months was the age of the child at WW, when the child started therapy. This factor significantly (p=0.002) increased the chance of achieving improvement - by 3.2 times (OR= 3,2; CI= 95). No statistically significant differences were shown for the other studied factors. Conclusions Prompt implementation of rehabilitation in children with CCD provides a better chance of improving their motor function. The rehabilitation should be started as soon as possible after the diagnosis is constituted.

The phenomenon of pseudoprogression in cancer immunotherapy: is everything so unambiguous?

When evaluating the effect of therapy for malignant neoplasms with inhibitors of CTLA-4, PD-1 and PD-L1, the phenomenon of pseudoprogression may occur. Pseudoprogression is an increase in the volume of tumor tissue due to immunocompetent cells (lymphocytes, macrophages) mobilized into the tumor focus under the action of immunotherapy. As the antitumor effect of lymphocytes and macrophages is realized, the tumor decreases or disappears over time. Pseudoprogression occurs with varying frequency in various types of cancer. It may also matter which immune checkpoint inhibitors is used to treat a solid tumor or lymphoproliferative disease. Currently, several immune-related response-evaluation criteria have been developed, which can help diagnose the phenomenon of pseudoprogression. But, unfortunately, none of these criteria clearly distinguish pseudoprogression from true tumor progression. In the case of an erroneous judgment about the effect of treatment, immunotherapy ends, and the patient may not get a chance for long-term remission. Using two clinical examples (immunotherapy for metastatic kidney cancer and recurrent Hodgkin lymphoma), the authors discuss the pitfalls of evaluating the effectiveness of treatment with checkpoint inhibitors.

Use of Homeopathic Arnica montana 30cH for Postoperative Analgesia in Female Dogs Undergoing Elective Ovariohysterectomy

Background Ovariohysterectomy (OH) is one of the most frequent elective surgical procedures in routine veterinary practice. Arnica montana is a well-known medicine in phytotherapy, with proven analgesic, anti-inflammatory, antiseptic, healing, antioxidant and immunomodulatory activity. However, there is still a shortage of studies on the action and effects of the homeopathic formulation of the medicine on animals. The aim of this study was to evaluate analgesia with Arnica montana 30cH during the postoperative period after elective OH. Methods Thirty healthy female dogs, aged 1 to 3 years, weighing 7 to 14 kg, were selected at the Veterinary Hospital in Campo Mourão, Paraná, Brazil. The dogs underwent the surgical procedure with an anaesthetic protocol and analgesia that had the aim of maintaining the patient's wellbeing. After the procedure, they were randomly divided into three groups of 10. One group received Arnica montana 30cH; another received 5% hydroalcoholic solution; and the third group, 0.9% NaCl saline solution. All animals received four drops of the respective solution sublingually and under blinded conditions, every 10 minutes for 1 hour, after the inhalational anaesthetic had been withdrawn. The Glasgow Composite Measure Pain Scale was used to analyse the effect of therapy. Analysis of variance (ANOVA) followed by the Tukey test was used to evaluate the test data. Statistical differences were deemed significant when p ≤0.05. Results The Arnica montana 30cH group maintained analgesia on average for 17.8 ± 3.6 hours, whilst the hydroalcoholic solution group did so for 5.1 ± 1.2 hours and the saline solution group for 4.1 ± 0.9 hours (p ≤0.05). Conclusion These data demonstrate that Arnica montana 30cH presented a more significant analgesic effect than the control groups, thus indicating its potential for postoperative analgesia in dogs undergoing OH.

A Clinical Study to Evaluate the Efficacy of Asthapana Basti and Uttar Basti in Asrigdara w.s.r to Abnormal Uterine Bleeding

Regular periods are necessary to maintain good health of women. Any abnormality in Rituchakra leads to excessive and irregular uterine bleeding which is known as Asrigdara which can be correlated to Abnormal Uterine bleeding. In Ayurvedic text, many preparations are described to treat Asrigdara. Samshodhan therapy is mainstay in the management of Artava related disorders of which Basti is supreme to manage Asrigdara. In conventional science, Hormonal therapy is given but chances of recurrence of the disease are high. This study was planned to provide simple, safe, non- hormonal drug for the patients of Asrigdara. Total 40 patients fulfilling the inclusion criteria were selected randomly from Dept. of Stree roga and Prasuti tantra O.P.D.and I.P.D. The total effect of drug was evaluated on the basis of signs and symptoms after completion of therapy. Overall effect of therapy shows in group-I 6 (60%) patients were markedly improved, 11 (61.11%) were partially improved and 1 (5.6%) was not improved and group II- 6 (33.33%) patients were cured, 9 (50%) were markedly improved, 2 (11.1%) were partially improved, and 1 (5.6%) was unimproved. Thus, Basti Chikitsa manifested promising results for the management of Asrigdara, although hormonal pill manifested better cycle but for shorter duration.

Expression of interferon-stimulated genes in patients with rheumatoid arthritis on anti-B-cell therapy (preliminary results)

Objective: to evaluate the expression of interferon-stimulated genes (ISG) – interferon (IFN) signature – in patients with rheumatoid arthritis (RA) and its dynamics during anti-B-cell therapy.Patients and methods.We examined 20 patients with RA who received two infusions of the biosimilar rituximab (RTM) Acellbia® in a total dose of 1200 mg. Five genes were selected to evaluate IFN signature: IFI44L, MX1, IFIT1, RSAD2, EPSTI1. The expression of IFI44L and IFIT1 could not be determined for technical reasons, and further analysis included three genes – MX1, EPSTI1, RSAD2. IFN signature was calculated as the average value of the expression of three selected genes (IFN-score).Results and discussion. The initial expression level of MX1 was 11.48 (5.45–19.38), EPSTI1 – 12.83 (5.62–19.64), RSAD2 – 5.16 (2.73–10.4) and IFN-score –10.3 (5.18–17.12), in patients with RA it was statistically significantly higher than in healthy donors: 1.26 (0.73–1.6); 1.06 (0.81–1.48); 0.93 (0.72–1.19) and 1.09 (0.92–1.42), respectively (p<0.05). The IFN-score was high in 15 (75%) patients, low in 5 (15%). The use of RTM was accompanied by a statistically significant decrease in disease activity and the level of acute phase parameters (ESR, CRP) after 12 and 24 weeks of therapy (p<0.05). In the group as a whole, as well as in patients with a moderate effect of therapy or its absence, by the 24th week of treatment, an increase in the expression of RSAD2 (p<0.05) and a tendency to an increase in the IFN-score level (p=0.06) were observed.Conclusion. In patients with RA, an increased expression of ISH was found compared to healthy donors. An increase in the expression of RSAD2 and IFN-score is observed both in patients with a satisfactory effect of RTM and with no effect. The obtained results can be important for predicting the course of the disease and personalizing therapy.

A CLINICAL STUDY TO EVALUATE THE EFFECT OF DADRUGHNA PATRA TAILA IN DADRU KUSHTA

Introduction: All the skin diseases in Ayurveda have been classified under the broad heading, “Kushta”. Dadru is one among Kushta. It involves the clinical features like kandu, raga, pidaka, utsannamandala. Dadru kushta mostly simulates with ‘Dermatophytosis’ commonly referred to as ringworm which is highly contagious. In this study an effort has been made to evaluate the Dadrughna karma (Antifungal activity) of the oil prepared from Dadrughna (Cassia alata Linn) leaves. Materials and methods: In the present study, action of Dadrughna (Cassia alata Linn) patra taila on Dadru kushta was evaluated in 32 subjects who were treated with Dadrughna patra taila as an external application twice a day for 30 days and follow up was done on 45th day. Assessment was done for subjective parameter-itching and objective parameters-distribution of lesion, severity of inflammation, extent of lesion. Results: The effect of therapy was assessed before treatment, 15th day, 30th day of treatment and follow up was done on 45th day. The results were statistically analyzed; it showed significant changes in subjective parameter-itching (p<0.001) and Objective parameters- distribution of lesion (p <0.001), severity of inflammation (p<0.001), extent of lesion (p <0.001). Discussion and conclusion: The external application of Dadrughna patra taila applied for 30 days has helped in reduction of itching, distribution of lesion, extent of inflammation and severity of inflammation where the taila was found more effective in reducing itching when compared to other symptoms KEY WORDS: Dadru kushta, Dermatophytosis, Dadrughna (Cassia alata Linn), Dadrughna patra taila

CLINICAL STUDY TO EVALUATE THE EFFICACY OF YAVAKSHARA PRATISARANA IN THE MANAGEMENT OF TUNDIKERI (CHRONIC TONSILLITIS)

Introduction: The symptoms of Tundikeri resembles with Chronic Tonsillitis. This disease is more frequent in young and middle aged adults. If not treated in time, chronic tonsillitis may lead to Middle ear infection, Rheumatic fever, Nephritis, Rheumatic heart disease and many other systemic complications.Looking into above facts there is a need of treatment which can prevent complications of the disease as well as reduces the recurrence effectively. In this study an effort has been made to evaluate the efficacy of Yavakshara pratisarana in Tundikeri (Chronic Tonsillitis). Materials and methods: The present study was an open labelled, single arm, clinical study in Tundikeri (Chronic Tonsillitis) (n=30) selected using convenience sampling technique with pre and post design conducted in a tertiary Ayurveda healthcare centre attached to a teaching institute, situated at the district headquarters in South India. 31 patients fulfilling the inclusion criteria suffering from Tundikeri w s r to Chronic Tonsillitis were selected with the intervention of Yavakshara pratisarana in single sitting. Results: The effect of therapy was assessed before and after treatment, the results were statistically analyzed; it showed significant changes in subjective parameters like Katina shopha,Mandaruk ,Galaragata,Galoparodha ,Halitosis,Enlarged Jugulodigastric lymph nodes, and Objective parameter- ESR Conclusion: Yavakshara pratisarana has shown better efficacy in subjective parameters likeKatinashopha,Mandaruk,Galaragata,Galoparodha,Halitosis,EnlargedJugulodaigastric lymph nodes , and Objective parameter like- ESR KEY WORDS: Tundikeri, Yava kshara, Pratisarana.

A Clinical Study on Sleshmala Yonivyapad through Anubhoota Yoga the ‘Patrangadi Yoga’

Sleshmala yonivyapad is one of the most common and burning problem faced by the women all around the globe. The symptoms are vaginal white discharge, itching, foul smell mild pain in vagina. On the bases of chief complaints and review of the disease the shlesmala yonivyapat is compared with Trichomonas vaginalis. There are many treatments prescribed for this problem but they are not free from side effects and with reoccurrence. Hence selection of an appropriate treatment is very essential. Study design: In the present study, 30 patients fulfilling criteria of sleshmala yonivyapat were selected under single group. Patients were given Patrangadi churna 4gms thrice a day with ushnodaka internally after food for 7 days and Yoniprakshalana with Patrangadi kashaya for 7days. This study was carried out for 21 days. The signs and symptoms were observed before and after treatment and were compared. Subjective parameters: Picchila shweta srava, Dourgandya, Kandu and Alpavedana. Objective parameters: Profuse thick creamy discharge, Red and swollen vulva with evidence of pruritis like scratch marks and wet mount showing Trichomonas vaginalis positive. Result: In the present study total 11 subjects showed complete relief, 17 subjects showed moderate relief and 2 subjects showed partial relief after treatment. And 11 subjects showed complete relief, 7 subjects showed moderate relief, 7 subjects showed partial relief and 5 subjects showed no relief after follow up. The total effect of therapy provided statistically highly significant result (p<0.001) in both subjective and objective parameters. Paired ‘t’ test is applied. Thus the study showed the effectiveness of Patrangadi churna internally as well as Patrangadi kashaya yoniprakshalana in alleviating symptoms of sleshmala yonivyapad. Key words: Sleshmala yonivyapad, Patrangadi yoga, Trichomonas vaginalis.