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Inflammation of knee joint is called knee arthritis. Among various forms of knee arthritis common is degenerative type of knee osteoarthritis It is the major cause of loco motor disability in old age people particularly among women. Analgesics and Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) are the current available pharmaceutical management of knee osteoarthritis which are associated with adverse side effects. Thus, there is need of research in traditional system of medicines for cost effective and long-term management of knee OA. Degenerative Knee osteo arthritis is almost similar to the Sandhivata describes in Ayuveda with respect to aetiology, pathology and clinical features. With the use of medicines Ayurveda also employs the prospective of Panchakarma in the various therapeutic measures, which is a kind of Shodhan Chikitsa. Panchakarma provides various therapeutic benefits as detoxification, improved circulation, spasm and pain relief. Hence objective of this review article is to describe the efficacy of Panchakarma in knee-arthritis with taking consideration of disease mentioned in Ayurvedic classics as Sandhivata

Background: The prevalence of hypothyroidism is reported in 4%–5% of population in the developed world, while in Indian population it is reported in around one in ten adults. Aims & Objectives: This study was conducted to determine the prevalence of hypothyroidism in Indian patients with T2DM and hypertension. Material and methods: In this cross-sectional observational study, amongst adults who were aged 18 years and above and diagnosed T2DM, HTN, and T2DM + HTN who resided in the field practice areas of the Urban Health Training Centre of the Department of Community Medicine, Integral institute of medical sciences and research, Lucknow, India. The results were summarized by descriptive statistics. Results: Out of 300 persons questioned, 159 (53.0%) were females and 141 (47.0%) were males. It was found that the mean age of the overall population was 53.1±11.3 years, mean and standard deviation of thyroid function and glycemic indicators test, observed that the levels of fT3, fT4, TSH, and glycemic indicators like FPG, PPG and HbA1c were identical. Conclusion: Subclinical hypothyroid subjects should be regularly screened for HTN. Elderly patients had higher proportion of thyroid dysfunction.

Introduction: Diabetes and hypertension are among the most common non-communicable diseases affecting our population. They are the important risk factors for cardiovascular morbidity and mortality. Objective: The study was performed to estimate the association of hypertension and dyslipidaemia with increasing body weight and obesity in Type II diabetics. Methods: This one year cross sectional study was conducted by enrolling 677 diabetics subjects from rural health training centre of integral institute of medical sciences, Lucknow, India. MS excel was used for data analysis. Descriptive statistics were used for number and percentages and associations were estimated using chi-square test. Results: Most of the subjects belonged to overweight category (36.91%) followed by obese (32.3%). Majority of subjects (38.4%), were within 40 – 50 years of age in which most of them belonged to overweight category (39.2%) followed by obese (31.5%). Out of total study subjects, 62% were males and 38% were females. Means of HbA1C, lipid parameters, blood pressure were found significantly associated with dyslipidemia and hypertension Conclusion: Association of hypertension and dyslipidemia in obese diabetics signifies that these patients may be at a higher risk of developing cardiovascular diseases and a precise action or self-care management is required.

Background Comorbidities such as undernutrition and parasitic infections are widespread in India and other tuberculosis (TB)-endemic countries. This study examines how these conditions as well as food supplementation and parasite treatment might alter immune responses to Mycobacterium tuberculosis (Mtb) infection and risk of progression to TB disease. Methods This is a 5-year prospective clinical trial at Jawaharlal Institute of Post Graduate Medical Education and Research in Puducherry, Tamil Nadu, India. We aim to enroll 760 household contacts (HHC) of adults with active TB in order to identify 120 who are followed prospectively for 2 years: Thirty QuantiFERON-TB Gold Plus (QFT-Plus) positive HHCs ≥ 18 years of age in four proposed groups: (1) undernourished (body mass index [BMI] 2); (2) participants with a BMI ≥ 18.5 kg/m2 who have a parasitic infection (3) undernourished participants with a parasitic infection and (4) controls—participants with BMI ≥ 18.5 kg/m2 and without parasitic infection. We assess immune response at baseline and after food supplementation (for participants with BMI 2) and parasite treatment (for participants with parasites). Detailed nutritional assessments, anthropometry, and parasite testing through polymerase chain reaction (PCR) and microscopy are performed. In addition, at serial time points, these samples will be further analyzed using flow cytometry and whole blood transcriptomics to elucidate the immune mechanisms involved in disease progression. Conclusions This study will help determine whether undernutrition and parasite infection are associated with gene signatures that predict risk of TB and whether providing nutritional supplementation and/or treating parasitic infections improves immune response towards this infection. This study transcends individual level care and presents the opportunity to benefit the population at large by analyzing factors that affect disease progression potentially reducing the overall burden of people who progress to TB disease. Trial registration ClinicalTrials.gov; NCT03598842; Registered on July 26, 2018; https://clinicaltrials.gov/ct2/show/NCT03598842

OBJECTIVE: The aim of the study was to assess the impact of non-surgical periodontal therapy (NSPT) on periodontal clinical parameters, spirometric indices, and salivary MMP-8 levels in patients with chronic obstructive pulmonary disease (COPD) with concurrence of chronic periodontitis (CP) compared with systemically healthy CP. MATERIAL AND METHODS: In this prospective clinico-biochemical study, a total of 75 patients belonging to various socioeconomic strata were randomly divided into cases, that is, COPD patients as per the Global Initiative for Obstructive Lung Disease (GOLD) criteria with concurrence of CP [at least ≥ 20 teeth with ≥ 2 tooth sites having pocket probing depth (PPD) or clinical attachment loss (CAL) ≥ 4mm and bleeding on probing (BOP)] and controls (systemically healthy CP). Both groups underwent NSPT and were evaluated for plaque index (PI), gingival index (GI), PPD, CAL, and BOP and spirometry (FEV(1)/forced vital capacity (FVC)) values at baseline, 3, 6, and 12 months and for salivary MMP-8 levels at baseline and 3 months. RESULTS: Statistical results showed that cases (COPD with CP; n = 37) were significantly older (mean age 56.16 ± 9.01 years), ex-smokers (48.6%) with male preponderance (78.4%), and belonged to the upper middle class (40.5%) as compared to controls (systemically healthy CP; n = 38). After NSPT, significant improvement in mean PI, GI, PPD, CAL, and BOP was observed in both groups at 3, 6, and 12 months with better results in controls. FEV(1)/FVC was significantly improved (P < .001) in cases with insignificant change in controls at 12 months. After 3 months, MMP-8 levels were significantly reduced in cases (P = .002) and controls (P < .001). CONCLUSION: The present study provided substantial evidence that COPD patients have poorer periodontal health as compared to systemically healthy counterparts. Further, these patients showed improvement in FEV1/FVC, however, with higher salivary MMP-8 levels despite NSPT at the end of the study, indicating a possible role of systemic inflammatory overburden of pulmonary disease.

In the rapidly changing and modernizing era, human population is becoming vulnerable to many disorders related with altered lifestyle and food habits. Vatarakta is one such metabolic disorder. It is disease caused due to margavarana of aggravated Vata by vitiated Rakta or morbid Kapha and Medas. Etiological factors of Vatarakta are responsible for aggravation of Vata dosha and Rakta dushti. It also has rasayana, pain relieving and anti inflammatory properties which renders it quite effective for those suffering from the disease. The presentation of Vatarakta along with its etiopathogenesis is quite similar to gouty arthritis in modern medicine. Patoladi kwath is a combination of tridosha shamak, Raktasodhak (blood purifier) and also Vatashamak drugs. This decoction helps in Vatarakta to alleviate the features of aggravated doshas and remove blockage in srotas thereby causing Vayu shaman. The management of Vatarakta is a challenge as it is a disease of severe morbidity, chronicity and incurable to certain extent with associated complications . With certain lifestyle modifications alongwith pathya ahara(right diet) and certain Ayurvedic modalities it can be cured and prevented.

Asthma is a respiratory disorder accounts for ~339 million cases per annum. The initial diagnosis of asthma relies on the symptomatic identification of characters, such as wheeze, shortness of breath, chest tightness, and cough. The presence of two or more of these symptoms may be considered as indicative of asthma. The asthma-diagnostic also involves spirometry test before and after inhaling a bronchodilator like albuterol. Because asthma pathophysiology involves participation of immune system, the cytokines play an important role. The review discusses various molecules that are or may be used as biomarkers for the asthma diagnosis.

Background Tuberculosis (TB) is the major cause of death in Human Immunodeficiency Virus (HIV)-infected individuals. However, diagnosis of TB in HIV remains challenging particularly when HIV infection is advanced. Several gene signatures and serum protein biomarkers have been identified that distinguish active TB from latent infection. Our study was designed to assess if gene expression signatures and cytokine levels would distinguish active TB in advanced HIV. Methods We conducted a case-control study of whole blood RNA-Seq and plasma cytokine/chemokine analysis in HIV-infected with CD4+ T cell count of ≤ 100 cells/μl, with and without active TB. Next, the overlap of the differentially expressed genes (DEG) with the published signatures was performed and then receiver operator characteristic (ROC) analysis was done on small gene discriminators to determine their performance in distinguishing TB in advanced HIV. ELISA was performed on plasma to evaluate cytokine and chemokine levels. Results Hierarchical clustering of the transcriptional profiles showed that, in general, HIV-infected individuals with TB (TB-HIV) clustered separately from those without TB. IPA indicated that the TB-HIV signature was characterized by an increase in inflammatory signaling pathways. Analysis of overlaps between DEG in our data set with published TB signatures revealed that significant overlap was seen with one TB signature and one TB-IRIS signature. ROC analysis revealed that transcript levels of FcGR1A (AUC = 0.85) and BATF2 (AUC = 0.82), previously reported as consistent single gene classifiers of active TB irrespective of HIV status, performed successfully even in advanced HIV. Plasma protein levels of IFNγ, a stimulator of FcGR1A and BATF2, and CXCL10, also up-regulated by IFNγ, accurately classified active TB (AUC = 0.98 and 0.91, respectively) in advanced HIV. Neither of these genes nor proteins distinguished between TB and TB-IRIS. Conclusions Gene expression of FcGR1A and BATF2, and plasma protein levels of IFNγ and CXCL10 have the potential to independently detect TB in advanced HIV. However, since other lung diseases were not included in this study, these final candidates need to be validated as specific to TB in the advanced HIV population with TB. Electronic supplementary material The online version of this article (10.1186/s12879-018-3127-4) contains supplementary material, which is available to authorized users.

Background: Neonatal sepsis is a continuing problem causing significant burden on health care, especially in developing world. As blood culture has low sensitivity in diagnosis of neonatal sepsis, strong clinical suspicion along with combination of different laboratory tests is required. The data available for extensively studied acute phase reactant, procalcitonin (PCT) remains controversial. This study was done to assess role of PCT alone and in combination with different tests for diagnosing neonatal sepsis.Methods: Blood samples of 275 neonates (>35 weeks of gestation) admitted to NICU, with suspicion of neonatal sepsis were collected for bacterial culture, serum procalcitonin level and sepsis screen (CRP, mESR, I/T ratio, Total Leucocyte Count, Absolute Neutrophil Count).Results: Blood culture was positive in 30.5% of enrolled neonates. At a cut-off value of 0.5 ng/ml the sensitivity, specificity, PPV, NPV of serum PCT in neonatal sepsis cases was 73.8%, 47.1%, 48%, 80.4% respectively. Serum PCT was found raised in 60 (48.8%) clinically suspected cases of neonatal sepsis where sepsis screen and blood culture both were negative, also it was not raised in 17 (32.7%) of clinically suspected cases of septicemia where both blood culture and sepsis screen were positive. Amongst other individual tests, CRP was found to have best sensitivity (79.7%) and NPV (85%) followed by PCT (73.8% and 80.4%) while best specificity was found for I/T ratio (93.7%) followed by mESR (89%) for diagnosis of neonatal sepsis with positive blood culture. Best NPV was seen for combination of PCT+CRP+I/T ratio (95.6%) for the suspected cases of neonatal sepsis.Conclusions: Thus, we conclude that serum PCT can play a useful role when combined with other test markers but may not find its way as a sole diagnostic marker for diagnosing neonatal sepsis in term/near term babies.

Liquid hydrocarbons derived from petroleum are widely used in household and industry. Many hydrocarbons in kerosene, such as hexane, naphthalene, octane and phenanthrene, are toxic to humans. Pulmonary toxicity is the major cause of morbidity and mortality followed by central nervous-system and cardiovascular complications.1 As kerosene is a mixture of chemicals, there is no definitive absorption, distribution, metabolism and excretion. The major route of exposure is by inhalation of liquid (aspiration). Kerosene vapours may be mildly irritating to the respiratory system and spray applications of kerosene may provoke signs of pulmonary irritation such as coughing and dyspnoea. Kerosene aspiration leads to inflammation and loss of surfactant. Secondary effects in the lungs include pneumothorax, pneumatocele or bronchopleural fistula. Here, we are presenting a case of pyopneumothorax after kerosene consumption.