EFFECT OF SIGRUBEEJAARKA NASYA IN CHRONIC SINUSITIS - A CLINICAL STUDY

Chronic sinusitis, defined as an inflammatory process that involves the paranasal sinuses and persists for 12 weeks or longer. The conventional treatment is either conservative or surgical. Since this ailment is of a chronic nature, simple conservative management will not be sufficient for a cure. Even though the surgery is effective, there is chance of recurrence and morbidity. The clinical picture of chronic sinusitis shows the predominance of Kaphavata dosha in Jatrurdhwa. Sigru is a single drug having Thikshna ushna guna and Vatakaphahara properties and is included in Sirovirechana group. Arkaprakasa written by Ravana illustrates a large number of Arkas (distillates) which is found to be very effective and harmless and Sigrubeeja Arka nasya indicated in Siroroga was selected for the study. Methods: The study design was interventional pre and post evaluation without control and sample size fixed as 30 patients. The data collection was done with case proforma, symptomatic scoring using VAS scale, Nasal Signs and Symptoms Score (NSSS), and X-ray PNS. Selected patients were subjected to Nasyakarma with Sigrubeeja arka for a period of 7 days. Assessments were done prior to the commencement of intervention and on 15th, 30th, 60th day of follow up. Statistical analysis was done using Wilcoxon Signed Rank test. Result: Change in outcome variables like headache, nasal obstruction, nasal discharge, loss of smell, and postnasal drip, showed significant results. Conclusion: Sigrubeejaarka was found to be effective in chronic sinusitis

EFFECT OF NIRGUNDI (VITEX NEGUNDO LINN.) PATRA ARKA AS ASCHOTHANA (EYE DROPS) IN CATARACT-A CLINICAL STUDY

Purpose: Age-related cataract is one of the leading causes of blindness and avoidable visual impairment in the world. There is no time-tested, FDA-approved, or clinically proven medical treatment exists till date to delay, prevent, or reverse the progression of senile cataract. Nirgundi (Vitex negundo) is a Chakshushya single drug mentioned in Ayurvedic classics. Various animal experimental study and invitro studies in recent years using flavonoids extracted from leaves of Vitex negundo on selenite induced cataract models proved to be beneficial in arresting the progression of cataract. Hence a clinical study with Vitex negundo eye drops in the form of Arka was planned with primary objective to assess the effect of Nirgundi patra arka as Aschotana (eye drops) in pre senile cataract. Methods: The study design was interventional pre and post evaluation without control. Patients were advised to instill Nirgundi patra arka two drops thrice daily i.e. 6 am, 12 pm and 6pm for a period of 6months. Log mar visual acuity score and contrast sensitivity score were recorded before treatment, 3rd month of treatment, after treatment, 9th month (1st follow up) and 12th month (2nd follow up). Slit lamp photographs were recorded before treatment and 12th month. Study and follow up were done in 31 eyes. Result: The intervention is statistically significant while considering visual acuity and contrast sensitivity. All the 27 cases of nuclear cataract responded to the intervention, while only 83.3% of posterior sub capsular cataract and 60% of cortical cataract showed response. But the change was not significant statistically. Conclusion: The intervention was effective in improving visual acuity and contrast sensitivity in all types of pre senile cataract. Clinical assessment revealed the study was effective in preventing the progression of pathogenesis in early stage of nuclear cataract

The bradykinin-forming cascade in anaphylaxis and ACE-inhibitor induced angioedema/airway obstruction

Anaphylaxis is a potentially life-threatening multi-system allergic reaction to a biological trigger resulting in the release of potent inflammatory mediators from mast cells and basophils and causing symptoms in at least two organ systems that generally include skin, lungs, heart, or gastrointestinal tract in any combination. One exception is profound hypotension as an isolated symptom. There are two types of triggers of anaphylaxis: immunologic and non-Immunologic. Immunologic anaphylaxis is initiated when a foreign antigen directly binds to IgE expressed on mast cells or basophils and induces the release of histamine and other inflammatory substances resulting in vasodilation, vascular leakage, decreased peripheral vascular resistance, and heart muscle depression. If left untreated, death by shock (profound hypotension) or asphyxiation (airway obstruction) can occur. The non-immunologic pathway, on the other hand, can be initiated in many ways. A foreign substance can directly bind to receptors of mast cells and basophils leading to degranulation. There can be immune complex activation of the classical complement cascade with the release of anaphylatoxins C3a and C5a with subsequent recruitment of mast cells and basophils. Finally, hyperosmolar contrast agents can cause blood cell lysis, enzyme release, and complement activation, resulting in anaphylactoid (anaphylactic-like) symptoms. In this report we emphasize the recruitment of the bradykinin-forming cascade in mast cell dependent anaphylactic reactions as a potential mediator of severe hypotension, or airway compromise (asthma, laryngeal edema). We also consider airway obstruction due to inhibition of angiotensin converting enzyme with a diminished rate of endogenous bradykinin metabolism, leading not only to laryngeal edema, but massive tongue swelling with aspiration of secretions

Effect of Navajivana Rasa with Pathyashadangam Kashaya Ghanasatwa in Classical Migraine - An Open Label Single Arm Pilot Study

Migraine is the second most common cause of primary headache and as per GBD 2015; migraine was ranked third highest cause of disability worldwide. Migraine with aura is an episodic headache associated with certain features such as sensitivity to light, sound or movement; nausea, vomiting and various fully reversible neurological symptoms. The aim of study was to assess the effect of Navajivana rasa with Pathyashadangam kashaya ghanasatwa in Classical Migraine. The formulations were combined and made into a dispensable form of hard gelatin capsules. Selected participants were given with two 500mg capsules twice daily after food for 2 months and were observed during 1 month of follow up. Symptomatic features were assessed before treatment, after 2 months of medication & after follow up. The MIDAS score for the assessment of disability was assessed before and after 3 months of study period. The results showed that, the study drug was effective in relieving the sign & symptoms of classical migraine and in improving the quality of life

EFFECT OF MRIDWEEKADI KASHAYA SEKA IN RETINAL HAEMORRHAGES ASSOCIATED WITH NON-PROLIFERATIVE DIABETIC RETINOPATHY – A CLINICAL STUDY

Diabetic retinopathy (DR) is a leading cause of acquired vision loss in middle-aged and elderly people globally. In modern science, other than the meticulous control of diabetes there is no proven non-invasive management for the prevention or cure of Diabetic retinopathy. In this study, mild to moderate Non-proliferative diabetic retinopathy (NPDR) with retinal haemorrhages is considered as a Timira (symptomatically) and as Abhishyanda (considering etiopathogenesis) with Kapha-pitta predominance. Mridweekadi kashaya, predominantly Kapha Pitta samana, was selected for the study to be used as Seka. Method: The study design was Interventional- pre and post evaluation without control, sample size fixed as 30 eyes. Mridweekadi kashaya was used as Seka for 21 days, twice daily. Fundus photographs were taken prior to commencement of Seka, on the 22nd day and then on 30th and 60th day after completion of the procedure. Change in extent of retinal hemorrhages were assessed as visualized in Fundus photographs and direct ophthalmoscopy. Change in visual acuity was assessed by LogMar Visual acuity chart and change in contrast sensitivity by Pelli-Robson contrast sensitivity chart consecutively, prior to the treatment, on the 10th day, 22nd day and then on 30th and 60th day after completion of procedure. Statistical analysis was done using Wilcoxon signed rank test and Paired t test according to the variable. Result: Control in retinal haemorrhages associated with NPDR and improvement in visual acuity and contrast sensitivity. Conclusion: Mridweekadi kashaya seka is effective in controlling retinal haemorrhages associated with NPDR

Oxidative stress sensitizes retinal pigmented epithelial (RPE) cells to complement-mediated injury in a natural antibody-, lectin pathway-, and phospholipid epitope-dependent manner.

International audienceUncontrolled activation of the alternative complement pathway (AP) is thought to be associated with age-related macular degeneration. Previously, we have shown that in retinal pigmented epithelial (RPE) monolayers, oxidative stress reduced complement inhibition on the cell surface, resulting in sublytic complement activation and loss of transepithelial resistance (TER), but the potential ligand and pathway involved are unknown. ARPE-19 cells were grown as monolayers on transwell plates, and sublytic complement activation was induced with H2O2 and normal human serum. TER deteriorated rapidly in H2O2-exposed monolayers upon adding normal human serum. Although the effect required AP activation, AP was not sufficient, because elimination of MASP, but not C1q, prevented TER reduction. Reconstitution experiments to unravel essential components of the lectin pathway (LP) showed that both ficolin and mannan-binding lectin can activate the LP through natural IgM antibodies (IgM-C2) that recognize phospholipid cell surface modifications on oxidatively stressed RPE cells. The same epitopes were found on human primary embryonic RPE monolayers. Likewise, mouse laser-induced choroidal neovascularization, an injury that involves LP activation, could be increased in antibody-deficient rag1(-/-) mice using the phospholipid-specific IgM-C2. In summary, using a combination of depletion and reconstitution strategies, we have shown that the LP is required to initiate the complement cascade following natural antibody recognition of neoepitopes, which is then further amplified by the AP. LP activation is triggered by IgM bound to phospholipids. Taken together, we have defined novel mechanisms of complement activation in oxidatively stressed RPE, linking molecular events involved in age-related macular degeneration, including the presence of natural antibodies and neoepitopes