An Ayurvedic treatment protocol in the management of Vataja Prathishyaya w.s.r. to Allergic Rhinitis - A Case Report

Introduction: Prathishyaya is one among 31 Nasagatha Roga explained by Sushrutha Acharya. Vata and Kapha are said to be the predominant Doshas involved in the manifestation of this condition. Vataja prathishyaya is one among 5 types of Prathishyaya. It is a common disorder characterized by Anaddha Pihita Nasa, Tanusrava, Shosha in Gala Taalu and Oshta, pain in Shankapradesha and Swaropaghatha. It is correlated to allergic rhinitis. This is a disorder in which there are episodes of nasal congestion, watery nasal discharge sneezing and redness and itching in eyes and nose. Allergic Rhinitis is due to an immediate hypersensitivity reaction to nasal mucosa. According to ayurvedic perspective allergy is scientifically explained under Asatmyaja Vyadhi and is mainly caused due hereditary factor, Viruddhahara, Dushivisha & Ritu Sandhi. This is the case report of 20 years old male patient complaints of continuous episodes of sneezing, running nose, itching in eyes and nose since 3 years. Materials and Methods: The subject who approached Shalakya Tantra OPD of Government Ayurveda Medical College, Bengaluru with symptoms of episodes of sneezing, running nose, itching in eyes and nose since 3 years was systematically reviewed and treatment modalities like Nirgundi Taila Nasya and internally Guda Maricha yoga is advised. Results: The subject showed marked improvement symptomatically and marked changes are seen in haematological investigations. Discussion: Vataja Prathishyaya is affecting the Urdhwajatru especially Nasa and hampering the lifestyle of the patient. It is mainly vata and kaphaja vyadhi.  Nasya and Abhyantara yoga advised are Vata - Kaphara in nature, having anti-inflammatory and antiallergic property hence it has shown marked improvement

A single case study to evaluate the applicability of Ayurveda treatment protocol in Otalgia w.s.r. to Kaphaja Karnashoola

Background: Otalgia or ear ache is a symptom which will hamper the daily activities of individual, and a cause of unease or discomfort. Even today there is no specific permanent remedy to this condition in advance modern medical system despite of some Otogesics which will only mask the pain. The common over the Counter medicines available on medical stores are having side effects on continuous usage. So there is a need for safe Ayurvedic medicine which can act better like modern analgesics but fewer side effects. Methodology: In this Case study, Agastya Haritaki Avaleha, Dashamoola Katutraya Kashaya and Capsule Grab, internally and Haridradi Karnadhoopana and Anu Taila Nasya as Sthanika Chikitsa were tried on patient of otalgia with ASOM (Kaphaja Karnashoola) Patient was treated in 2 stages. Observations: It was observed in the present study that in stage 1 there was 50% improvement as compared to stage 2 which showed better results in reducing the symptoms of Otalgia with ASOM. Re-occurrence of symptoms were merely less in stage 2 as compared to stage 1 Conclusion: There is a false assumption that Ayurvedic medicines are slow acting and allopathic medicines are desperately used for pain management and acute conditions. But this study throwing a light to substantiate that, Ayurvedic medicines are potent enough to manage acute otalgia also, just like Otogesics in Modern Medical Science. The study revealed that the re-occurrence rate of symptoms was very less in patients who used Agastya Haritaki Avaleha, Dashamoola Katutraya Kashaya and grab along with Haridradi Karnadhoopana and Anu Taila

Ayurvedic understanding and management of Trigeminal Neuralgia w.s.r. to Anantavaata - A Case Study

Trigeminal Neuralgia is one of the painful disorders involving fifth cranial nerve, causes severe unilateral pain over regions supplied by the branches of trigeminal nerve associated with tempero mandibular joint stiffness. Trigeminal neuralgia nearly can be correlated to Anantavaata, one of the 11 types of Shirorogas explained by Acharya Sushruta and is Vaatapradhaana Tridoshaja Vyadhi. Present study is conducted to know the efficacy of ayurvedic line of management in TN. A female patient of age 46 years, diagnosed with Trigeminal Neuralgia was treated with allopathy medications. But did not get satisfactory results. Hence patient approached our hospital and got Vaatahara and Brihmana line of management involving Nasya with Karpasasthyaadi Taila for 7 days, Shiropichu and Karnapoorana with Ksheerabala Taila, Gandoosha with Murchita Tila Taila and oral medications. Patient’s complaints were assessed before and after treatment with VAS pain scale and verbal descriptor scale for TMJ stiffness After Follow up patient had got relieved with the complaints and got satisfactory results with ayurvedic line of management

Changes in the gastric enteric nervous system and muscle: A case report on two patients with diabetic gastroparesis

<p>Abstract</p> <p>Background</p> <p>The pathophysiological basis of diabetic gastroparesis is poorly understood, in large part due to the almost complete lack of data on neuropathological and molecular changes in the stomachs of patients. Experimental models indicate various lesions affecting the vagus, muscle, enteric neurons, interstitial cells of Cajal (ICC) or other cellular components. The aim of this study was to use modern analytical methods to determine morphological and molecular changes in the gastric wall in patients with diabetic gastroparesis.</p> <p>Methods</p> <p>Full thickness gastric biopsies were obtained laparoscopically from two gastroparetic patients undergoing surgical intervention and from disease-free areas of control subjects undergoing other forms of gastric surgery. Samples were processed for histological and immunohistochemical examination.</p> <p>Results</p> <p>Although both patients had severe refractory symptoms with malnutrition, requiring the placement of a gastric stimulator, one of them had no significant abnormalities as compared with controls. This patient had an abrupt onset of symptoms with a relatively short duration of diabetes that was well controlled. By contrast, the other patient had long standing brittle and poorly controlled diabetes with numerous episodes of diabetic ketoacidosis and frequent hypoglycemic episodes. Histological examination in this patient revealed increased fibrosis in the muscle layers as well as significantly fewer nerve fibers and myenteric neurons as assessed by PGP9.5 staining. Further, significant reduction was seen in staining for neuronal nitric oxide synthase, heme oxygenase-2, tyrosine hydroxylase as well as for c-KIT.</p> <p>Conclusion</p> <p>We conclude that poor metabolic control is associated with significant pathological changes in the gastric wall that affect all major components including muscle, neurons and ICC. Severe symptoms can occur in the absence of these changes, however and may reflect vagal, central or hormonal influences. Gastroparesis is therefore likely to be a heterogeneous disorder. Careful molecular and pathological analysis may allow more precise phenotypic differentiation and shed insight into the underlying mechanisms as well as identify novel therapeutic targets.</p

Real-time three-dimensional transthoracic echocardiography in daily practice: initial experience

<p>Abstract</p> <p>Aim of the work</p> <p>To evaluate the feasibility and possible additional value of transthoracic real-time three-dimensional echocardiography (RT3D-TTE) for the assessment of cardiac structures as compared to 2D-TTE.</p> <p>Methods</p> <p>320 patients (mean age 45 ± 8.4 years, 75% males) underwent 2D-TTE and RT3D-TTE using 3DQ-Q lab software for offline analysis. Volume quantification and functional assessment was performed in 90 patients for left ventricle and in 20 patients for right ventricle. Assessment of native (112 patients) and prosthetic (30 patients) valves morphology and functions was performed. RT3D-TTE was performed for evaluation of septal defects in 30 patients and intracardiac masses in 52 patients.</p> <p>Results</p> <p>RT3D-TTE assessment of left ventricle was feasible and reproducible in 86% of patients while for right ventricle, it was (55%). RT3D-TTE could define the surface anatomy of mitral valve optimally (100%), while for aortic and tricuspid was (88% and 81% respectively). Valve area could be planimetered in 100% for the mitral and in 80% for the aortic. RT3D-TTE provided a comprehensive anatomical and functional evaluation of prosthetic valves. RT3D-TTE enface visualization of septal defects allowed optimal assessment of shape, size, area and number of defects and evaluated the outcome post device closure. RT3D-TTE allowed looking inside the intracardiac masses through multiple sectioning, valuable anatomical delineation and volume calculation.</p> <p>Conclusion</p> <p>Our initial experience showed that the use of RT3D-TTE in the assessment of cardiac patients is feasible and allowed detailed anatomical and functional assessment of many cardiac disorders.</p

Identification of Potent EGFR Inhibitors from TCM Database@Taiwan

Overexpression of epidermal growth factor receptor (EGFR) has been associated with cancer. Targeted inhibition of the EGFR pathway has been shown to limit proliferation of cancerous cells. Hence, we employed Traditional Chinese Medicine Database (TCM Database@Taiwan) (http://tcm.cmu.edu.tw) to identify potential EGFR inhibitor. Multiple Linear Regression (MLR), Support Vector Machine (SVM), Comparative Molecular Field Analysis (CoMFA), and Comparative Molecular Similarities Indices Analysis (CoMSIA) models were generated using a training set of EGFR ligands of known inhibitory activities. The top four TCM candidates based on DockScore were 2-O-caffeoyl tartaric acid, Emitine, Rosmaricine, and 2-O-feruloyl tartaric acid, and all had higher binding affinities than the control Iressa®. The TCM candidates had interactions with Asp855, Lys716, and Lys728, all which are residues of the protein kinase binding site. Validated MLR (r² = 0.7858) and SVM (r² = 0.8754) models predicted good bioactivity for the TCM candidates. In addition, the TCM candidates contoured well to the 3D-Quantitative Structure-Activity Relationship (3D-QSAR) map derived from the CoMFA (q² = 0.721, r² = 0.986) and CoMSIA (q² = 0.662, r² = 0.988) models. The steric field, hydrophobic field, and H-bond of the 3D-QSAR map were well matched by each TCM candidate. Molecular docking indicated that all TCM candidates formed H-bonds within the EGFR protein kinase domain. Based on the different structures, H-bonds were formed at either Asp855 or Lys716/Lys728. The compounds remained stable throughout molecular dynamics (MD) simulation. Based on the results of this study, 2-O-caffeoyl tartaric acid, Emitine, Rosmaricine, and 2-O-feruloyl tartaric acid are suggested to be potential EGFR inhibitors.National Science Council of Taiwan (NSC 99-2221-E-039-013-)Committee on Chinese Medicine and Pharmacy (CCMP100-RD-030)China Medical University (CMU98-TCM)China Medical University (CMU99-TCM)China Medical University (CMU99-S-02)China Medical University (CMU99-ASIA-25)China Medical University (CMU99-ASIA-26)China Medical University (CMU99-ASIA-27)China Medical University (CMU99-ASIA-28)Asia UniversityTaiwan Department of Health. Clinical Trial and Research Center of Excellence (DOH100-TD-B-111-004)Taiwan Department of Health. Cancer Research Center of Excellence (DOH100-TD-C-111-005

Brain Research to Ameliorate Impaired Neurodevelopment - Home-based Intervention Trial (BRAIN-HIT)

<p>Abstract</p> <p>Background</p> <p>This randomized controlled trial aims to evaluate the effects of an early developmental intervention program on the development of young children in low- and low-middle-income countries who are at risk for neurodevelopmental disability because of birth asphyxia. A group of children without perinatal complications are evaluated in the same protocol to compare the effects of early developmental intervention in healthy infants in the same communities. Birth asphyxia is the leading specific cause of neonatal mortality in low- and low-middle-income countries and is also the main cause of neonatal and long-term morbidity including mental retardation, cerebral palsy, and other neurodevelopmental disorders. Mortality and morbidity from birth asphyxia disproportionately affect more infants in low- and low-middle-income countries, particularly those from the lowest socioeconomic groups. There is evidence that relatively inexpensive programs of early developmental intervention, delivered during home visit by parent trainers, are capable of improving neurodevelopment in infants following brain insult due to birth asphyxia.</p> <p>Methods/Design</p> <p>This trial is a block-randomized controlled trial that has enrolled 174 children with birth asphyxia and 257 without perinatal complications, comparing early developmental intervention plus health and safety counseling to the control intervention receiving health and safety counseling only, in sites in India, Pakistan, and Zambia. The interventions are delivered in home visits every two weeks by parent trainers from 2 weeks after birth until age 36 months. The primary outcome of the trial is cognitive development, and secondary outcomes include social-emotional and motor development. Child, parent, and family characteristics and number of home visits completed are evaluated as moderating factors.</p> <p>Discussion</p> <p>The trial is supervised by a trial steering committee, and an independent data monitoring committee monitors the trial. Findings from this trial have the potential to inform about strategies for reducing neurodevelopmental disabilities in at-risk young children in low and middle income countries.</p> <p>Trial Registration</p> <p>Clinicaltrials.gov NCT00639184</p