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.

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.

Abstracts of the online research-to-practice conference with international participation “Current infectious diseases in the practice of a family doctor. Algorithms for diagnosis, treatment, observation” (April 8–9, 2021)

No abstract

Aplikasi M-Learning Pada Dongle Melalui Nilai-Nilai Islam

This purpose of study analyzed mobile learning application using by Dangle tool through Islamic values for students of English department at Faculty of Teacher Training and Education in University of Muhammadiyah Sumatera Utara. Research method conducted descriptive qualitative. Population conducted of 136 students 4th semester of English department in 2019/2020 academic year in University of Muhammadiyah Sumatera Utara. Sample of 32 students taken Curriculum Design Material subject of English department at Faculty of Teacher Training and Education. The technique of collecting data used observation and documentation during the learning process. Data collection method carried out using by the spiral model of Kemmis and Mc and Taggart, these were; Action planning, treatment / observation of action, reflection and revision. The results of study showed the students can use the dongle properly and enthusiastically used it in the class of assignment presentation. M-learning application of dongle tool should be carried out in all classes in University of Muhammadiyah Sumatera Utara to advance learning technology.

Effect of Guhong injection combined with atorvastatin on angina pectoris of coronary heart disease and its influence on Hemorheology and oxidative stress

Objective: To explore the effect of Guhong injection combined with atorvastatin on CHD patients with angina pectoris and its influence on hemorheology and oxidative stress.Methods: 80 CHD patients with angina pectoris admitted to our hospital from December 2018 to December 2019 were randomly divided into the observation group (40 cases) and the control group (40 cases) by use of the random number table. The patients in the control group were treated with atorvastatin, while those in the observation group were treated with Guhong injection on the basis of the control group. The course of treatment was 2 weeks for each group. The treatment effect, the frequency of angina pectoris seizure and its duration before and after treatment, the changes of hemorheology indexes and oxidative stress and the occurrence of adverse reactions were compared between the two groups.Results: the total effective rate of the observation group (92.50%) was higher than that of the control group (70.00%) (p < .05). The frequency of angina pectoris seizure and its duration in these two groups after treatment were lower than those before treatment (Observation group: t = 25.588, 23.009; Control group: t = 16.587, 16.263; p < .05); After treatment, the frequency of angina pectoris seizure and its duration in the observation group were lower than those in the control group (t = 15.191, 9.425; p < .05). In the observation group, the hemorheology indexes after treatment were lower than those before treatment (t = 6.742, 15.224, 6.983, 23.537, p < .05); the hemorheology indexes after treatment in the observation group were lower than those in the control group (t = 5.201, 13.913, 5.539, 13.745; p < .05). In the observation group, the level of serum SOD after treatment was higher than that before treatment, while the levels of LPO and MDA after treatment were lower than those before treatment (t = 10.839, 6.924, 8.466; p < .05); the level of serum SOD after treatment in the observation group was higher than that in the control group, while the levels of LPO and MDA after treatment in the observation group were lower than those in the control group (t = 6.171, 6.432, 5.394; p < .05). The incidence of adverse reactions in the observation group was lower than that in the control group (p < .05).Conclusions: Guhong injection combined with atorvastatin has an obvious clinical effect on CHD patients with angina pectoris, and it can improve hemorheology indexes and oxidative stress reaction with fewer adverse reactions.

ROLE OF VIRECHANA KARMA (THERAPEUTIC PURGATION) IN PSORIASIS: A CLINICAL STUDY

Background: The skin or the integument is the external organ that protects against mechanical trauma, UV light and infections. The prevalence of skin diseases in India is 10 to 12% of the total population with psoriasis being the major contributor, in India it ranges from 0.44% to 2.8%. In Ayurveda all skin diseases come under the concept of Kushta. Psoriasis has a high resemblance with Ekkushta, which is the type of Kshudrakushta (less severe form of the Kushta). Skin diseases considered as Pitta Doshaja and Rakta Dhatu Pradoshaja Vikara. Acharya Charaka stated that Virechana is the great treatment for Pitta predominance diseases. Aim: To study the role of Virechana Karma in the management of Ekkushta (Psoriasis). Material and Methods: A single group of 5 diagnosed patients of Ekkushta (Psoriasis) were registered at the Kayachikitsa OPD of Pt. Khushilal Sharma Govt. (Auto.) Ayurvede Hospital Bhopal. The patients were treated with Virechana Karma. Duration of study is 21 days and follow up after completion of trial every week for 1 month. Assessment was done on the basis of symptomatic relief after treatment. Observation: The overall effect of the Virechana Karma in all patients suggested that, complete cure was not in any patient. One patient was mild improved, one patient was markedly improved and three patients were moderately improved. None of patients remained unchanged. Conclusion On the basis of this clinical trial it can be concluded that Virechana Karma works effectively in the management of psoriasis.

Maintenance acne therapy: prophylactic efficacy of fixed combination of adapalene and benzoyl peroxide

Acne is a chronic disease and even reliable therapies do not completely ensure absence of relapses. Acne relapses have a negative psychological impact on patients, as they feel unable to control the disease and achieve complete and long-lasting recovery. Supportive therapy is necessary to prolong the remission of acne achieved with initial successful treatment and to minimize the risk of relapse. According to the literature sources, the most justified as a maintenance therapy is the use of topical retinoids, which have been shown to be effective in the prevention of exacerbations of acne. In the present study 54 patients were involved who after the active therapy used a fixed combination of adapalene 0.1% / BPO 2.5% as maintenance treatment. Only 1 patient (2.9%) with moderate acne and 2 patients (5.8%) with severe acne had a relapse within 6 months of maintenance therapy. The absence of adverse events during the course of treatment was recorded, as well as high adherence of patients to the treatment. During the period of post-treatment observation (6 months after maintenance therapy), among the patients without exacerbations during maintenance therapy, a relapse occurred in 2 (7.1%) patients of group 1 (n = 28) and 2 (8.7%) patients of group 2 (n = 23). The obtained data indicates that maintenance therapy with Effezel® gel can extend the achieved effectiveness of the treatment and prevent the development of relapses.

Usual or unusual presentations of Dirofilaria repens in two sibling dogs: a case report

This study describes two different manifestations of Dirofilaria repens infection in sibling dogs with microfilaremia. Dog 1, asymptomatic, harbored a gravid female of D. repens on the parietal layer of tunica vaginalis of one testicle and showed a marked circulating eosinophilia (3.3·103/μL). Both testicles were normal in shape and size without any gross lesions. Dog 2 had a pyotraumatic dermatitis. The cases were confirmed by PCR and sequencing. The sequences obtained showed 100% identity with those of D. repens isolated from human scrotum in Croatia. The treatment with moxidectin 2.5% and imidacloprid 10%/kg was effective in eliminating microfilariae after just one application, as demonstrated by negative modified Knott’s tests and PCR analyses of blood samples. This status was maintained during the post-treatment observation period. The classical localization of D. repens in dogs is in subcutaneous tissues, within nodules or free; however, it can also occur with some frequency in testicles, as described in humans. The infection can be associated with circulating eosinophilia or pyotraumatic dermatitis, as reported in this study. Thus, in endemic areas, it is advisable to carefully inspect the removed testicles at neutering since parasite localization can take place without any macroscopic changes. Moreover, in the case of circulating eosinophilia or pyotraumatic dermatitis, investigations should include modified Knott’s test and PCR to ensure that D. repens is not the cause of these alterations. Rapid and sensitive tests for the early detection of infected animals would help to prevent or limit the spread of this zoonosis.

CLINICAL ASSESSMENT OF BASTI KARMA AND RASARAJ RASA IN THE MANAGEMENT OF GRIDHRASI (SCIATICA)

Background: Sciatica is the most common disorder which affects the quality of life of individual. Sciatica is the set of symptoms which is caused by a pinching and /or irritation of one of the three lowest nerve roots that make up the giant sciatic nerve and causing a low back pain and leg pain. Prevalence of sciatica ranges from 2% to 40% worldwide. In Ayurveda sciatica has a high resemblance with Gridhrasi, which comes under Samanyaja Vikara and Nanatmaja Vatavikara. Aim & Objectives: To study the effect of Dashmooladi Niruha Basti with Rasaraj Rasa in the management of Gridhrasi (Sciatica) and to find out an effective Ayurvedic management for Gridhrasi (Sciatica). Material and Methods: An open clinical study with Dasmooladi Niruha Basti with Rasaraj Rasa was done in 10 patients of Gridhrasi (sciatica). 10 clini-cally diagnosed patients of Gridhrasi (sciatica), registered at the Kayachikitsa OPD of Pt. Khushilal Sharma Govt. Ayurvedic Hospital Bhopal. The patients were treated with Dasmooladi Niruha Basti along with Rasaraj Rasa. Duration of study is 30 days. Assessment was done on the basis of symptomatic relief and change in the degree of SLR test after treatment. Observation: Dasmooladi Niruha Basti and Rasaraj Rasa yielded symptomatic relief and increased the degree of SLR test after treatment. The overall effect of the treatment in all patients suggested that, complete cure was not in any patient. Three patients were markedly improved, and seven patients were moderately improved. None of patients remained unchanged. Conclu-sion: On the basis of result obtained, it can be concluded that Dasmooladi Niruha Basti and Rasaraj Rasa can be used as an effective treatment in the management of Gridhrasi (sciatica).

109. Preexisting Resistance and Week 48 Virologic Outcomes After Switching to B/F/TAF in African American Adults with HIV

Background The BRAAVE 2020 study is evaluating the safety and efficacy of switching to bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF) among virologically suppressed Black adults with HIV. At Week (W) 24, 0.6% (2/328) on B/F/TAF vs 1.8% (3/165) who stayed on their baseline 3 drug regimen (SBR) had HIV-1 RNA ≥ 50 c/mL demonstrating noninferiority of B/F/TAF. Here, resistance analyses and virologic outcomes at W48 are described. Methods Enrollment criteria permitted prior treatment failure, except on an INSTI-containing regimen, and allowed documented resistance to NNRTIs, PIs and/or NRTIs, except for K65R/E/N, ≥ 3 thymidine analog mutations (TAMs), or T69-insertions; primary INSTI resistance (-R) was excluded. Preexisting drug resistance was assessed with historical genotypes and proviral DNA genotyping. B/F/TAF outcomes were determined by last on-treatment HIV-1 RNA through W48. Results Altogether, 495 participants enrolled (B/F/TAF n=330, SBR n=165). Preexisting primary NRTI-R, NNRTI-R, and PI-R substitutions were observed in 14% (70/495), 21% (102/495), and 13% (62/495), respectively. M184V/I and TAMs were detected in 10% (51/495) and 7% (34/495), respectively. Primary INSTI-R was detected post-randomization in 2% (11/495); all continued on study and were included in efficacy analyses. At W24, 163 in the SBR group switched to B/F/TAF (SBR to B/F/TAF). W48 outcomes were determined for 489 participants who had ≥ 1 post-switch HIV-1 RNA measurement: 99% (324/327) in the B/F/TAF and 100% (162/162) in the SBR to B/F/TAF groups had HIV-1 RNA &lt; 50 copies/mL at their last study visit, including 100% (68/68) with NRTI-R (50 of whom had archived M184V/I and post-switch data), and 100% (11/11) with INSTI-R (Table). No participant had treatment emergent resistance to study drugs. Table. BRAAVE 2020 Preexisting Resistance and Virologic Suppression at Week 48 (Last On-treatment Observation Carried Forward Analysis) Conclusion Preexisting resistance was common among virologically suppressed Black adults in BRAAVE 2020, notably M184V/I, TAMs, and NNRTI-R. High rates of virologic suppression were maintained through 48 weeks of B/F/TAF treatment and there were no failures with de novo resistance, indicating that B/F/TAF is an effective treatment option for virologically suppressed people with HIV with or without preexisting resistance to NNRTIs, PIs, or non-tenofovir NRTIs. Disclosures Kristen Andreatta, MSc, Gilead Sciences (Employee, Shareholder) Michelle L. D’Antoni, PhD, Gilead Sciences (Employee, Shareholder) Silvia Chang, Masters, Gilead Sciences (Employee, Shareholder) Aiyappa Parvangada, MS Computational Biology, Gilead Sciences (Employee) Christiana Blair, MS, Gilead Sciences (Employee, Shareholder) Sean E. Collins, MD, MS, Gilead Sciences (Employee) Kirsten L. White, PhD, Gilead Sciences, Inc. (Employee, Shareholder)