scholarly journals A CASE STUDY TO EVALUATE THE EFFICACY OF KAL BASTI FOLLOWED BY PANCHATIKTA KSHEER SARPI BASTI IN THE MANAGEMENT OF ASTHIMAJJAGAT VATA WITH SPECIAL REFERENCE TO HLA-B27 (ANKYLOS-ING SPONDYLITIS)

2020 ◽  
Vol 8 (8) ◽  
pp. 4291-4296
Author(s):  
Seema Bahatkar ◽  
Anita A. Patil ◽  
Kesar N. Kshirsagar
Keyword(s):  
Back Pain ◽  
Ankylosing Spondylitis ◽  
General Population ◽  
Rheumatic Disease ◽  
Strong Association ◽  
Modern Medicine ◽  
Hla B27 ◽  
Aggressive Disease ◽  
Ayurvedic Treatment

Ankylosing spondylitis belongs to group of Rheumatic disease known as spondyloarthropathies which show a strong association with genetic marker HLA-B27. Whereas the incidence of HLA-B27 is less than 1 percent in general population, it is present in more than 85% of patients with ankylosing spondylitis. In-flammatory back pain and stiffness are prominent early in the disease whereas chronic aggressive disease may produce pain and marked axial immobility and deformity. HLA-B27 is the most common findings in Ankylosing Spondylitis. In Ayurveda, no typical nomenclature has been found for the said disease but considering all sing and symptom of the patients, it can be treated as Asthimajjagata vata. No satisfactory treatment is available in modern medicine for this disorder. Various Panchakarma procedures and Ayur-vedic drugs have been proved useful for these manifestations. The patient was considered suffering from Asthimajjagat Vata (HLA-B27) and was treated with Guduchi, Dashamool and Erandmool as Niruha and Bala-guduchyadi Tail as Anuvasana for 16 days as Kal basti followed by Panchatikta ksheera sarpi Basti for 14 days (1 month) was given. Patients condition was assessed for symptoms of Asthimajjagat Vata (HLA-B27 positive). This study shows successfully managed with Ayurvedic treatment.

scholarly journals AN AYURVEDIC MANAGEMENT OF SUBCLINICAL HYPOTHYROIDISM - A CASE REPORT

2018 ◽  
Vol 6 (5) ◽  
pp. 481-486
Author(s):  
Dnyaneshwar Kantaram Jadhav
Keyword(s):  
Internal Medicine ◽  
Case Report ◽  
Weight Gain ◽  
Subclinical Hypothyroidism ◽  
Single Case ◽  
Excellent Result ◽  
Modern Medicine ◽  
Single Case Study ◽  
Ayurvedic Treatment

Ayurved is science of life. Its guide human being for living on preventive & curative both aspect. Its ancient knowledge which is still stand truth to time. There are many diseases which is not mentioned directly in Ayurveda texts is called as Anukta vikar. Subclinical hypothyroidism is one of such disease. Such disease specifically mentioned but its line of treatment described very well. The present case is 28 year old male patient was suffering from Bhaar vrudhi (weight gain) from last 2.5 years while symptoms like Drubalya (fatigue), Sheet prachiti (feeling excessive cold), Bhrama (vertigo),  Shwasakashtata (dyspnoea after walking), Katishool (backache) since last 2 years. Patient on modern medicine still he doesn’t get any satisfy relief, at the end patient decide to take Ayurvedic treatment only. For treatment patient was came to Nakshatra Ayurved Panchkarma clinic & Research center, Mumbai. Ayurvedic management include internal medicine, Rukshaya bashpa peti sweda. After 1.5 month patient got Excellent Result. All symptoms disappear, weight reduces up-to 4 kg, TSH level comes from 7.71 to 3.23. This is single case study, will Collect data of more cases for further Research.

MRI Detection of Active Sacroiliitis in First Degree Relatives of Ankylosing Spondylitis Patients with Clinical and Laboratory Correlations

2021 ◽  
Author(s):  
Haron Obaid ◽  
Stephan Milosavljevic ◽  
Udoka Okpalauwaekwe ◽  
Brenna Bath ◽  
Catherine Trask ◽  
...  
Keyword(s):  
Back Pain ◽  
Ankylosing Spondylitis ◽  
Disease Activity ◽  
Hla B27 ◽  
Physical Test ◽  
First Degree Relatives ◽  
Pain Provocation ◽  
History Of ◽  
Active Sacroiliitis

Abstract Background. Detection of ankylosing spondylitis (AS) in the preclinical stage could help prevent long term morbidity in this patients’ population. The aim of this study was to examine the prevalence of active sacroiliitis in first-degree relatives of AS patients using MRI with clinical and laboratory correlations as these patients may benefit from MRI screening and early treatment.Methods. Seventeen first-degree relatives of AS patients were recruited prospectively. AS screening questionnaires (Ankylosing Spondylitis Disease Activity Score, Bath Ankylosing Spondylitis Disease Activity Index & Visual Analogue Scale), blood tests (C-Reactive Protein, HLA-B27), and an MRI of the SIJs were taken. Two musculoskeletal radiologists interpreted the MRI scans, and two physiotherapists applied four symptom provocation tests (Gaenslen's test, posterior pelvic pain provocation test, Patrick's Faber (PF) test and palpation of the long dorsal SIJ ligament test), and two functional movement tests (active straight leg raise and Stork test). Results. Seven (41%) of the 17 participants demonstrated MRI evidence of active sacroiliitis. Of the 7 participants with active sacroiliitis, two (29%) had no history of recent low back pain (LBP), two (29%) had negative HLA-B27, and one (14%) participant had neither back pain nor positive HLA-B27. The Cohen's Kappa score for the interobserver agreement between the radiologists was 1.00 (p-value <0.0001). Despite fair to strong between therapist agreement for the physical test outcomes (Kappa 0.26 to 1.00), the physical test results per se did not have any predictive association with a positive MRI.Conclusions. MRI detected active sacroiliitis in 41% of first-degree relatives of AS patients. The lack of a history of prior LBP or positive HLA-B27 in active sacroiliitis participants might suggest that MRI screening for this high-risk population is warranted; however, further larger studies are needed to help elucidate its cost-effectiveness and long-term benefits.

scholarly journals Patient versus general population health state valuations: a case study of non-specific low back pain

2017 ◽  
Vol 26 (6) ◽  
pp. 1627-1633 ◽  
Author(s):  
J. M. van Dongen ◽  
B. van denBerg ◽  
G. E. Bekkering ◽  
M. W. van Tulder ◽  
R. W. J. G. Ostelo
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
General Population ◽  
Population Health ◽  
Health State ◽  
Low Back ◽  
Health State Valuations

scholarly journals A review of the pathogenesis of ankylosing spondylitis

2008 ◽  
Vol 24 (1) ◽  
pp. E2 ◽  
Author(s):  
Elias Dakwar ◽  
Jaypal Reddy ◽  
Fernando L. Vale ◽  
Juan S. Uribe
Keyword(s):  
Ankylosing Spondylitis ◽  
Strong Association ◽  
Critical Role ◽  
Axial Skeleton ◽  
Causative Role ◽  
Hla B27 ◽  
Pathogenic Role ◽  
The Past ◽  
New Findings

✓ Ankylosing spondylitis (AS) is a chronic, progressive inflammatory rheumatic disease involving primarily the sacroiliac joints and the axial skeleton. The main clinical features are back pain and progressive stiffness of the spine. Oligoarthritis of the hips and shoulders, enthesopathy, and anterior uveitis are common, and involvement of the heart and lungs is rare. The current understanding of the pathogenesis of this disorder is limited. Despite the strong association between human leukocyte antigen B27 (HLA-B27) and susceptibility to AS reported over the past 30 years, the exact pathogenic role of HLA-B27 in AS and other spondyloarthropathies has yet to be determined. The authors present a review of the literature pertaining to the pathogenesis of AS over the past several decades. Ankylosing spondylitis is a polygenic disorder, with HLA-B27 playing a critical causative role in its pathogenesis. Animal studies of the immunobiology of HLA-B27 have provided significant insight into the pathogenic role of HLA-B27. The search for the antigenic peptide to support the “arthritogenic peptide” hypothesis has been disappointing. Over the past decade there has been increasing interest in the critical role of the misfolding and unfolded protein response of the heavy chain HLA-B27 in the modulation of the inflammatory response. Although there have been significant new findings in the understanding of the pathogenesis of AS, the exact mechanisms have yet to be identified. There is considerable optimism that additional susceptibility genes, predisposing factors, and regulators of the inflammatory process will be identified that will provide avenues for future treatment.

scholarly journals Patient Versus General Population Health State Valuations: A Case Study Of Low Back Pain

2015 ◽  
Vol 18 (7) ◽  
pp. A686
Author(s):  
JM van Dongen ◽  
B van den Berg ◽  
GE Bekkering ◽  
MW van Tulder ◽  
RW Ostelo
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
General Population ◽  
Population Health ◽  
Health State ◽  
Low Back ◽  
Health State Valuations

scholarly journals Chronic back pain in first-degree relatives (FDRs) of patients with ankylosing spondylitis: predictive value of HLA-B27 and persistence of inflammatory back pain over time

RMD Open ◽  
2020 ◽  
Vol 6 (3) ◽  
pp. e001418
Author(s):  
Karim Doughem ◽  
Michael H Weisman ◽  
Michael M Ward ◽  
Lianne S Gensler ◽  
Mariko Ishimori ◽  
...  
Keyword(s):  
Back Pain ◽  
Ankylosing Spondylitis ◽  
High Risk ◽  
Predictive Value ◽  
Chronic Back Pain ◽  
Heel Pain ◽  
Inflammatory Back Pain ◽  
Hla B27 ◽  
First Degree Relatives ◽  
Over Time

Background/PurposeFirst-degree relatives (FDRs) of patients with ankylosing spondylitis (AS) may be at high risk of spondyloarthritis. We examined the frequency, characteristics of chronic back pain (CBP), associated features, persistence of symptoms, and HLA-B27 allele frequency in FDRs of AS patients, also comparing those FDRs with participants in NHANES 2009–2010 with CBP.Methods399 FDRs of AS probands were divided into: (1) No CBP (subjects >40 years old at study visit without CBP) (n=162); (2) NICBP (non-inflammatory CBP) (n=82), and (3) CIBP (inflammatory CBP) (n=155). White FDRs with CBP were compared with 772 participants in NHANES 2009–2010 with CBP. FDRs were invited to return for reassessment.ResultsFDRs with CIBP had earlier onset of CBP than those with NICBP (p<0.001) and had higher frequency of heel pain than those without CBP (p=0.002). HLA-B27 occurred in 57% of FDRs with CIBP vs 39.6% of those without CBP (p=0.005, OR=1.9). Of 23 patients with CIBP at baseline re-evaluated 67.04±31.02 months later, 16 (73%) still had CIBP, whereas 4 (31%) of 13 NICBP patients seen 61.23±31.84 months later remained symptomatic.ConclusionCIBP in FDRs of AS patients is HLA-B27-associated, has earlier onset and tends to persist compared to NICBP.

scholarly journals HLA-B27 is associated with reduced disease activity in axial spondyloarthritis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
James T. Rosenbaum ◽  
Michael H. Weisman ◽  
Hedley Hamilton ◽  
Cassie Shafer ◽  
Elin Aslanyan ◽  
...  
Keyword(s):  
Back Pain ◽  
Ankylosing Spondylitis ◽  
Disease Activity ◽  
Axial Spondyloarthritis ◽  
Activity Index ◽  
Disease Activity Index ◽  
Medical Decision ◽  
Hla B27 ◽  
Chi Square ◽  
The Difference

AbstractHLA-B27 is associated with increased susceptibility and disease activity of ankylosing spondylitis, but the effect of HLA-B27 on the activity of the broader category now called axial spondyloarthritis (AxSpA) is apparently the opposite. A modified Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) was used to assess disease activity among 3435 patients with spondyloarthritis (SpA) who participated in a survey designed to assess the effect of their disease and its treatment on the susceptibility and severity of Covid-19. Chi square testing was used to compare BASDAI scores between HLA-B27 positive and negative subjects. 2836 survey respondents were HLA B27 positive. The average BASDAI for the HLA-B27 negative cohort was 4.92 compared to 4.34 for the HLA-B27 positive subjects. Based on linear regression, a subject’s sex could not fully account for the differing BASDAI score in HLA-B27 negative subjects compared to those who are HLA-B27 positive. The difference between B27 positive and negative subjects was skewed by those with a BASDAI score of one or two. HLA-B27 positive subjects were more than twice as likely to have a BASDAI score of 1 compared to HLA B27 negative subjects and about 60% more likely to have a BASDAI score of 2 (p < 0.0001). HLA-B27 positive subjects have less active spondyloarthritis compared to HLA-B27 negative subjects as measured by a BASDAI score. Our data indicate that patients with mild back pain and a diagnosis of AxSpA are disproportionately HLA-B27 positive. The HLA-B27 test facilitates the diagnosis of axial spondyloarthritis such that patients from a community survey with mild back pain may be disproportionately diagnosed as having AxSpA if they are HLA-B27 positive. The test result likely introduces a cognitive bias into medical decision making and could explain our observations.

scholarly journals OP0086 THE DEGREE OF BONE MARROW EDEMA AS DETECTED BY MAGNETIC RESONANCE IMAGING IN THE SACROILIAC JOINTS AND THE SPINE SUSPICIOUS OF AXIAL SPONDYLOARTHRITIS IN THE GENERAL POPULATION IS ASSOCIATED WITH DIFFERENT FACTORS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 57-57
Author(s):  
X. Baraliakos ◽  
A. Richter ◽  
D. Feldmann ◽  
A. Ott ◽  
R. Buelow ◽  
...  
Keyword(s):  
Back Pain ◽  
General Population ◽  
Bone Marrow Edema ◽  
Population Based ◽  
Hla B27 ◽  
Sacroiliac Joints ◽  
Research Support ◽  
Population Based Study ◽  
Mri Score ◽  
Physically Demanding Work

Background:Taking advantage of a large population-based study we have recently reported that the frequency of bone marrow edema (BME) and fatty lesions (FL) in the sacroiliac joints (SIJ) and the spine of individuals <45 years detected by magnetic resonance imaging (MRI) suggestive of axial spondyloathritis (axSpA) is higher than expected.Objectives:To identify and compare factors associated with the extension of MRI lesions in the spine and the SIJ in the general population.Methods:All available spinal- (sagittal T1/T2 sequences) and SIJ- (semicoronal STIR sequences) MRIs were evaluated by two trained readers blinded to clinical data. BME (SIJ and spine) suggestive of axSpA were recorded. The extension of BME was quantified using the Berlin MRI score. Discrepancies were resolved by consensus. Degenerative lesions of the Modic type were excluded. The association of age (increase per decade), sex, HLA-B27 and hsCRP positivity, smoking (ever smoker vs. no smoker), spinal pain (yes vs. no in last 3 months), body mass index (BMI) categories (WHO definition), physically demanding job, and giving birth within the last 12 month with the severity of BME were examined. Associations between clinical factors and the Berlin MRI score were analyzed by negative binomial regression models resulting in incidence rate ratios (IRRs).Results:MRIs of 793 volunteers from the general population, mean age 37.3±6.3 years, 49.4% male, 8.9% HLA B27+, 7% CRP-positive, 56.9% with back pain in the last 3 months (28.8% with back pain NRS ≥4/10), 35.7% reported physically heavy work, 55% with BMI > 25 kg/m2, 16.2% current smokers, and 5% of females with pregnancy in the last year before MRI examination, were evaluated.For BME on SIJ-MRIs, significant associations (IRR, 95% confidence level) were found for pregnancy in the last year (3.82, 1.17-14.24), HLA-B27+ (2.42, 1.33-4.55), BMI (25-30 vs. <25; 2.09 (1.33-3.31)) and presence of back pain in the last 3 months (1.54, 1.02-2.33).For BME on spinal MRIs, significant associations were found for age per decade increase (1.45, 1.10-1.91) and physically demanding work (1.45, 1.04-2.00), while HLA-B27+ (1.32, 0.79-2.24), BMI (>30: 0.84, 0.53-1.32 (<25 reference)) and back pain in the last 3 months (1.29, 0.95-1.77) showed no association. Overall, spinal BME was more frequent than SIJ BME in the participants working at a desktop (61.5% vs. 54.4%), while smokers (66.9% vs. 63.8%) and participants with back pain in the last 3 months (62.5% vs. 56.9%) had more often SIJ BME than spinal BME, respectively.Conclusion:In this population-based study, individuals aged <45 years, HLA-B27+, women with pregnancy in the last year and presence of back pain were associated with the extent of BME in the SIJ, while age and physically demanding work were associated with the extent of BME in the spine. These data support the hypothesis of a mechanic origin of BME in the general population aged <45 years, while HLA B27 is a severity but not a susceptibility factor for BME in the SIJ.Acknowledgments:n/aDisclosure of Interests:Xenofon Baraliakos Grant/research support from: Grant/research support from: AbbVie, BMS, Celgene, Chugai, Merck, Novartis, Pfizer, UCB and Werfen, Consultant of: AbbVie, BMS, Celgene, Chugai, Merck, Novartis, Pfizer, UCB and Werfen, Speakers bureau: AbbVie, BMS, Celgene, Chugai, Merck, Novartis, Pfizer, UCB and Werfen, Adrian Richter: None declared, Daniel Feldmann: None declared, Anne Ott: None declared, Robin Buelow: None declared, Carsten Schmidt: None declared, Juergen Braun Grant/research support from: Abbvie (Abbott), Amgen, BMS, Boehringer, Celgene, Celltrion, Centocor, Chugai, Eli Lilly and Company, Medac, MSD (Schering Plough), Mundipharma, Novartis, Pfizer (Wyeth), Roche, Sanofi- Aventis, and UCB Pharma, Consultant of: Abbvie (Abbott), Amgen, BMS, Boehringer, Celgene, Celltrion, Centocor, Chugai, EBEWE Pharma, Eli Lilly and Company, Medac, MSD (Schering-Plough), Mundipharma, Novartis, Pfizer (Wyeth), Roche, Sanofi-Aventis, and UCB Pharma, Speakers bureau: Abbvie (Abbott), Amgen, BMS, Boehringer, Celgene, Celltrion, Centocor, Chugai, EBEWE Pharma, Eli Lilly and Company, Medac, MSD (Schering-Plough), Mundipharma, Novartis, Pfizer (Wyeth), Roche, Sanofi-Aventis, and UCB Pharma

scholarly journals Role of Vamana Karma (Emesis) in Jeerna Vatika Pratishyaya (Chronic Rhinosinusitis) - A Case Study

2017 ◽  
Vol 8 (3) ◽  
Author(s):  
Kunjal H Bhatt ◽  
Hemang U Raghavani ◽  
Kishor G Satani ◽  
Haridra C Dave
Keyword(s):  
Causative Factor ◽  
Modern Medicine ◽  
Sudden Onset ◽  
Vicious Cycle ◽  
Curative Therapy ◽  
First Choice ◽  
Ayurvedic Treatment

Pratishyaya (rhinosinusitis) is very difficult to treat as it happens with Sadhya Janak Nidana (sudden causative factor) also. Many times rapid and sudden onset is seen in Pratishyaya after exposure to even a weak causative factor.  If this vicious cycle of Nidana (causative factor) and Roga (disease) continues and if treatment is neglected the Roga becomes Jeerna(chronic). At this stage it becomes necessary to cure the disease with Shodhana (purification) therapy rather Shaman (curative) therapy. In this type of chronic cases we can get good results with only Vamana Karma (emesis therapy). In modern medicine conservative management is the first choice and if the disease is not managed by it, they prefer surgery to maintain the drainage and ventilation of the sinuses. Vamana Karma with or without Nasya (nasal instillation) can give complete improvement in such cases. The burden and risks of surgery can be avoided and the quality of the patient’s life can be improved with Ayurvedic treatment.

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