A Case Study: Management of Ankylosing Spondylitis in Ayurveda
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Abstract:
Ankylosing spondylitis (AS) is chronic inflammatory disorders of unknown cause that primarily affects the axial skeleton (Predominantly sacroiliac joints and spine) peripheral joints and of extra articular structures may also be involved in an asymmetrical pattern. The disease usually begins in the second or third decade; the male to female prevalence is approximately 3:1. Patients having AS, more than 95% of them are positive HLA-B27. Use of NSAIDS are the first line of management and they effectively relieve the symptoms. Few Ayurvedic medicines found to be effective in the management of AS. Here, a case study of AS managed by Ayurvedic treatment approaches is presented. A patient 21yrs male came to OPD of Kayachikitsa i.e., Room No. 9 of GACH, Patna. He complaint of pain in B/L ankle left>right, also B/L knee joint pain as well as low back pain for 6 months. He was diagnosed on the basis of its signs and symptoms of AS with HLAB27 positive. He was managed by Ayurvedic medicines like Panchatikta Ghruta Gugglu, Ekangveer ras, Tab. Shallaki, Cap. Stresscom, Jrumax oil, Vaishwanar churna, Laxarid for 7 months and relief in his signs and symptoms.Keywords:
Back Pain
Objective To discuss the value of CR and CT to diagnose early ankylosing spondylitis. Methods Clinical data and the signs of CR and CT of eighteen cases which were diagnosed as early ankylosing spondylitis were analyzed. Results Both CR and CT imaging could show the diseased region, morphous change, and the extent of diseased joint. CT imaging could show the tiny change of diseased articular facet. Conclusion CR plain is the first choice to diagnose early ankylosing spondylitis. As doubtful case, CR combination with CT scan can raise the accuracy rate of diagnosis to early ankylosing spondylitis.
Spondylitis
Facet (psychology)
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Ankylosing spondylitis is apparently rare among Japanese and it is known that this disease is commoner in males than in females. The male to female ratio among general ankylosing spondylitis is 4.5:1. The cardiac conduction abnormalities, aortic insufficiency and mitral insufficiency are sometimes associated with this disease. We analysed the influence of sex on the development of these cardiac complications using 95 reported cases of ankylosing spondylitis including our case. Among the ankylosing spondylitis patients who were accompanied with cardiac complication, 99% were male. This frequency is significantly high compared with that found in general ankylosing spondylitis (p less than 0.0001). The cardiac complication associated with this disease seems to be characteristic for males. This sex difference is useful for differential diagnosis from various diseases which accompany these cardiac complications. The mechanism of sex influence on the cardiac complication of ankylosing spondylitis was also discussed.
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The article is devoted to the study of the assessment of the clinical and functional features of the course of ankylosing spondylitis in patients who have undergone COVID-19. The patients were divided into two groups: the first group of patients with ankylosing spondylitis who had undergone COVID-19, the second group of patients with ankylosing spondylitis who did not undergo COVID-19. All patients underwent in-depth clinical, laboratory and radiological examinations as well as testing using various scales. The clinical course of ankylosing spondylitis in patients who had undergone COVID-19 was characterized by a more pronounced disease activity, a high intensity of pain syndrome and more pronounced impairments in functional activity.
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Objective:To explore the role of Platelet parameters(PLT、MPV) in activity ankylosing spondylitis,Discusses the mechanism and clinical value.Methods:by the whole blood cells analyser and immunology detection methods,detected the Venous blood platelets parameter(PLT、MPV)and CRP of 53 cases activity ankylosing spondylitis and 39 cases Health group,And do statistical analysis.Results:the CRP and PLT of activity ankylosing spondylitis are Significantly higher than health group,MPV significantly smaller than healthy group(P =0.000,P0.05),there is positively correlated between PLT and CRP(r=0.421,P0.05),MPV and CRP(r=-0.325,P0.05),negative correlation exists.Conclusion:Platelet parameters(PLT,MPV)have relations with the activity ankylosing spondylitis disease,Can be used as a reaction index condition monitoring.And as the same important role of CRP.
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Mean platelet volume
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Outcome measurement in spondylarthritis, particularly
ankylosing spondylitis (AS) has been a rapidly growing
field over the last decade, with enormous progress being
made in patient-reported outcomes, clinical assessments,
physical measurements and composite scoring of disease
state, and response to treatment. Many of these advances
arose out of need, when anti–tumor necrosis factor therapies
were found to have a role in the treatment of AS
patients and therefore required appropriate clinical assessment.
The Assessment of SpondyloArthritis international
Society (ASAS) was first formed in 1995 as a group of
clinicians and methodologists with a shared interest in
outcome measurement in AS patients, and has grown to
incorporate early diagnosis, classification, development
and validation of outcome measures, and evaluation of
therapeutic modalities.
The instruments reviewed here include those recommended
in the ASAS core sets for clinical record keeping
(in daily clinical practice) and for clinical research, as over
time these have been extensively validated and implemented
across different clinical settings. The core sets
describe those health-related domains that should be
measured in AS patients in different settings, and recommend
appropriate instruments that can be used for that
domain. Additional measures included are the AS Quality
of Life scale and the Health Assessment Questionnaire for
the Spondylarthropathies, which cover health domains
not included in the original core sets but have been shown
to be important to AS patients through the World Health
Organization International Classification of Functioning,
Disability and Health projects (1). Finally, the AS Disease
Activity Score has also been presented, as an alternative to
the Bath Ankylosing Spondylitis Disease Activity Index,
as one of the newest measures constructed to assess disease
activity.
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Plantar pressure
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The Oswestry Disability Index is considered the gold standard in the evaluation of disability in patients with chronic mechanical back pain. The aim of this study was to assess the applicability of Oswestry Disability Index in patients with ankylosing spondylitis and its relationship with disease assessment parameters for ankylosing spondylitis.A total of 100 patients diagnosed with ankylosing spondylitis were included in the study group. The control group consisted of 50 individuals with nonspecific low back pain. The Oswestry Disability Index and Bath Ankylosing Spondylitis Disease Activity Index were applied to both groups. In addition, the Visual Analog Scale, the Ankylosing Spondylitis Disease Activity Score C-Reactive Protein, the Ankylosing Spondylitis Disease Activity Score-the Erythrocyte Sedimentation Rate, the Bath Ankylosing Spondylitis Functional Index, Bath Ankylosing Spondylitis Metrology Index, and the Ankylosing Spondylitis Quality of Life scales were applied in the study group. the Erythrocyte Sedimentation Rate, C-Reactive Protein levels, and HLA-B27 analysis were noted as laboratory markers in ankylosing spondylitis patients.The scores of Oswestry Disability Index had a significant correlation with scores of Bath Ankylosing Spondylitis Disease Activity Index in ankylosing spondylitis patients (r=0.543) and in the control group (r=0.401). There was a significant correlation between the scores of Oswestry Disability Index and the Bath Ankylosing Spondylitis Functional Index (r=0.544), Bath Ankylosing Spondylitis Metrology Index (r=0.317), the Ankylosing Spondylitis Quality of Life (r=0.723), the Ankylosing Spondylitis Disease Activity Score-the Erythrocyte Sedimentation Rate (r=0.501), the Ankylosing Spondylitis Disease Activity Score C-Reactive Protein (r=0.530), Visual Analog Scale-Rest (r=0.476), and Visual Analog Scale-Activity (r=0.441) values in patients with ankylosing spondylitis.Evaluation of Oswestry Disability Index in conjunction with Bath Ankylosing Spondylitis Disease Activity Index may warn the physician to interpret high Bath Ankylosing Spondylitis Disease Activity Index scores in the context of mechanical pain. Therefore, the use of Oswestry Disability Index in patients with ankylosing spondylitis will be beneficial.
Erythrocyte sedimentation rate
Oswestry Disability Index
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Objectives: This study aims to investigate the association of serum fetuin-A levels with disease activation and clinical parameters in ankylosing spondylitis (AS) patients. Patients and methods: Forty-seven AS patients (30 males, 17 females; mean age 39.7±11.1 years; range 20 to 69 years) and 30 healthy controls (14 males, 16 females; mean age 42.0±11.5 years; range 19 to 63 years) were included in the study. Erythrocyte sedimentation rate, C-reactive protein, Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis Functional Index, Bath Ankylosing Spondylitis Radiology Index, and Bath Ankylosing Spondylitis Metrology Index were used in the assessment of AS. Serum fetuin-A levels were measured using ELISA. Results: Mean serum fetuin-A values in AS patients (984±203 ng/mL) were significantly lower compared to controls (1156±218 ng/mL) (p=0.001). While a statistically significant negative correlation was detected in AS patients between fetuin-A values and C-reactive protein (p=0.009, r=-0.377), no significant correlation was detected between erythrocyte sedimentation rate, Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis Metrology Index, Bath Ankylosing Spondylitis Functional Index or Bath Ankylosing Spondylitis Radiology Index parameters and fetuin-A. Conclusion: Serum fetuin-A levels in AS patients were lower than the control group. However, further research is required to establish the role of serum fetuin-A levels as a surrogate marker of disease activity.
Erythrocyte sedimentation rate
Fetuin
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Etiology
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