Principles Of Treatment Research Articles

Secondary Preventive Management of Kitibha Kushta (Plaque Psoriasis) - A case study

Levels of prevention has been a wide idea concept which includes all the aspects related to health and disease like preventive, curative, promotive and rehabilitative measures. Applicability of this concept in Ayurveda has elaborative understanding in a more simplified manner. Despite leading to both physical and psychological issues, the importance given to skin diseases is always the least. Changing food habits and lifestyle is being the major reason in the current era for increased prevalence of skin diseases especially in young adults. In a way to cope up with fast living culture, people are compromising with their health and well being which needs immediate attention and action. Early diagnosis and complete treatment is the basis of Kushta Chikitsa (treatment of skin diseases) and the same has been highlighted as a secondary preventive measure. One such case is being discussed here which is diagnosed initially and treated as per Ayurveda chikitasa siddhtanta (Ayurvedic treatment principle), considering Dosha (bio-forces of body), Agni(metabolism), Bala (Strength), Ritu (season) etc giving complete relief and self confidence of the patient. This not only prevents the further occurrence of complications due to chronicity but also brings back the faith in Ayurveda treatment modalities. It is high time to make the young minds realize the importance of healthy living, which otherwise can impair the health status of the nation, dragging back its growth and development.

Antibacterial Therapy and Prevention of Infectious Endocarditis in Modern Conditions

The problem of infectious endocarditis (IE) still retains its importance due to high mortality rates and the development of severe complications. Modern IE is a polyethological disease, the occurrence and development of which can be caused by pathogens that make up an extremely extensive list, which is updated almost annually. At the same time, serious obstacles standing in the way of effective antimicrobial therapy are both the increasing resistance of IE pathogens to antibiotics and the increasing etiological role of infectious agents that were previously very rare. This article presents the basic principles of treatment and prevention of IE, taking into account the latest recommendations of the experts of the European Society of Cardiology in 2023.

Berberine-Loaded PVCL-PVA-PEG Self-Assembled Micelles for the Treatment of Liver Fibrosis.

Liver fibrosis is a necessary pathological process in many chronic liver diseases. Studies have shown that the progression of chronic liver disease can be slowed by rational intervention in hepatic fibrosis. Berberine (BBR), a natural extract of Phellodendron amurense, inhibits the development of liver fibrosis through several mechanisms. However, the clinical application of BBR is limited due to its low solubility. Drug delivery systems have been developed to improve the solubility of hydrophobic drugs and increase their efficacy in treating the liver fibrosis. In this study, a biocompatible nanomicelle was constructed by thin-film dispersion method using polyvinyl caprolactam-polyvinyl acetate-polyethylene glycol graft copolymer (PVCL-PVA-PEG) as a carrier to encapsulate BBR (PVCL-PVA-PEG/BBR-MCs) to improve the solubility of BBR and reduce the systemic side effects. The ability to inhibit HSC-T6 cell activation of PVCL-PVA-PEG/BBR-MCs was evaluated in vitro. The anti-hepatic fibrosis effects of PVCL-PVA-PEG/BBR-MCs were investigated in vivo. PVCL-PVA-PEG/BBR-MCs have a uniform spherical shape with a mean particle size of 60.04 ± 0.027 nm and a potential of 1.49 ± 0.32 mV. It had an encapsulation efficiency of 98.52% ± 0.70 and drug loading content of 6.16% ± 0.04. Compared to free BBR, PVCL-PVA-PEG/BBR-MCs significantly inhibited HSC-T6 cell activation and TGF-β1-induced HSC-T6 cell migration in vitro. In vivo biodistribution experiments showed significantly improved hepatic distribution of PVCL-PVA-PEG/DiD-MCs compared to free DiD, suggesting that PVCL-PVA-PEG micelles enhance the ability of BBR to enter the liver and improve therapeutic efficacy. After treatment, PVCL-PVA-PEG/BBR-MCs significantly improved fibrotic liver structure and reduced collagen deposition in comparison to the CCl4-treated group; the treatment outcome was more effective than that of the free BBR group. Our results demonstrate the advantages of encapsulating BBR in PVCL-PVA-PEG micelles and highlight the potential of PVCL-PVA-PEG/BBR-MCs as a therapeutic strategy for the treatment of liver fibrosis.

Application of temporomandibular joint prosthesis in oral and maxillofacial surgery: strategic thinking and prospects.

The temporomandibular joint (TMJ) is the critical functional unit in the human stomatognathic system. Damage of the TMJ causes orofacial dysfunction and secondary jaw deformities, leading to seriously decreased quality of life in patients. The TMJ prosthetic replacement is an important treatment method for severe joint destruction because of its remarkable advantages compared with other methods. In recent years, this technique has gradually attracted wide attention in China, but it has not been popularized on a large scale in our country because of several limitations. Thus, in this study, the clinical experience of patients with TMJ prosthetic replacement in clinical units was summarized, and the treatment principles, treatment processes, and technical advantages were systematically discussed, aiming to promote the popularization and application of TMJ prosthetic replacement in China.

Eurasian Association of Cardiology (EAC)/ Russian society of somnologists (RSS) guidelines for the diagnosis and treatment of obstructive sleep apnea in patients with cardiovascular diseases (2024)

The aim of this guideline is to assist physicians in the management of patients with cardiovascular pathology and obstructive sleep-disordered breathing. The article consists data on diagnostic tactics for patients with possible sleep-breathing disorders, describes the basic principles of obstructive sleep apnea treatment, and substantiates the clinical significance of obstructive sleep apnea therapy initiating in the management of patients with cardiovascular diseases.

A novel smartphone application for bladder cancer management (BCM App): Design, development, and usability evaluation

BACKGROUND: Providing clinical guidelines to clinicians using innovative technologies seems practical and useful. This study aimed to design, develop, and evaluate a smartphone application to assist urologists in managing bladder cancer (BCM App). MATERIALS AND METHODS: The study was conducted in three phases, following the user-centered design model, at the urology clinic of Khorshid Hospital (Isfahan, Iran) in 2021. Components and functionalities for BCM App were specified in three focus group sessions with urologists and urology residents using clinical guidelines. Adopting the Delphi technique, the participants completed a questionnaire addressing issues including educating and informing clinicians, performing clinical calculations, representing graphical information, and recording patient information. A conceptual model for the app was designed, and the final product was developed. The usability of the BCM App was evaluated using the think-aloud technique by usability experts and end-users. RESULTS: The app’s components were categorized into three groups: Patient evaluation, disease staging and management, and patient follow-up. The app’s main components included “bladder cancer classification,” “disease grading and staging,” “management based on the disease stages,” “principles of intravesical treatment,” and “classifying follow-ups by disease stages.” Moreover, the most prominent app’s functionalities were “using staging and grading table,” “using American Urological Association risk stratification,” “calculating disease stages,” “calculating patient’s follow-up,” and “recording patient information.” The usability evaluation results revealed that the BCM App was at a “highly acceptable” level. CONCLUSION: To design and develop a smartphone app for managing bladder cancer, the involvement of urologists is crucial. Apart from assisting urologists in effectively managing bladder cancer, the proposed app has the potential to enhance residents’ knowledge and streamline their access to evidence.

Rational treatment of acute rhinosinusitis in the context of increasing antibiotic resistance.

Acute rhinosinusitis is one of the most common diseases in the population, both in primary and specialist otolaryngological care. It is also responsible for a disturbingly high percentage of prescribed antibiotic therapy, regardless of the etiology of the disease. Despite the fact that acute viral and acute postviral rhinosinusitis dominate among the phenotypes of acute rhinosinusitis, and the development of acute bacterial rhinosinusitis occurs in only 0.5-2% of all cases in adults and 5-10% in children, antibiotics still remain an important element of treatment, despite alarming data on the growing antibiotic resistance and the adverse effect of antibiotics on the human microbiome, leading to dysbiosis. The discovery of antibiotics was one of the greatest achievements of modern medicine, but their inappropriate use leads to the gradual increase in the phenomenon of antibiotic resistance, considered one of the most serious public health problems, recognized by the WHO as one of the 10 greatest threats to human health in the 21<sup>st</sup> century. The unjustified use of antibiotics in outpatient care is the key to the growth of this problem, in parallel with the lack of patient compliance. The COVID pandemic has intensified this unfavourable trend. That is why the knowledge of antibiotic stewardship is so important. According to the guidelines, in the therapy of acute rhinosinusitis, symptomatic and anti-inflammatory treatment dominates, and antibiotic therapy has very strictly defined and limited indications. The latest guidelines also recommend herbal medicines, including BNO 1016, in the treatment of acute viral and postviral rhinosinusitis. Available studies indicate that it has a beneficial effect not only on shortening the duration of the disease and reducing symptoms, but also reduces the need for antibiotic treatment in acute rhinosinusitis. Complications of acute rhinosinusitis are relatively rare and are not related to taking antibiotics.

Underexplored Areas of Photobiomodulation in Oral Oncology: An Expert Analysis.

Objective: This study aimed to review the current body of literature on underexplored areas of photobiomodulation (PBM) for preventing and/or treating oral adverse events. Background: Recent studies suggest that PBM may offer potential benefits in managing cancer-related toxicities other than oral mucositis. Nevertheless, further research to establish conclusive evidence is still missing. Methods: A panel of specialists conducted a narrative review to evaluate the evidence on PBM therapy for oral mucositis, xerostomia, dysgeusia, dysphagia, and trismus/fibrosis. Each topic was reviewed by two specialists who discussed treatment rationale, summarized current evidence, evaluated risk/benefit ratio, and identified future research directions. Results: The current evidence suggests promising outcomes in nonroutine uses of PBM for xerostomia, dysgeusia, odynophagia, oral mucositis (extraoral PBM and the pediatric population), and trismus/fibrosis. However, the primary studies are often small and may have biases that require further evaluation, particularly regarding treatment safety. Conclusion: Despite the overall positive impression of PBM therapy for oral adverse events of cancer treatment, robust evidence from large multicentered studies is necessary to support its widespread clinical use.

Innovative surgical treatment approaches for endothelial dysfunction : Descemet stripping only (DSO) and endothelial cell injection

Currently, due to arising number of patients Germany and many other countries experience alarge deficit of donor eyes for posterior lamellar keratoplasty procedures in the treatment of corneal endothelial diseases. To address this unmet need there is an ongoing investigation of treatment modalities which do not rely on donor tissue or enable clinicians to treat more patient eyes per donor eye. The authors introduce apromising approach for both treatment principles. First, the technique of Descemet stripping only (DSO) is detailed, in which acentral part of the Descemet's membrane including the endothelium is surgically removed without replacement with donor tissue. This then allows endothelial cells from the periphery of the cornea to migrate into the central area and can reduce corneal opacification and swelling. As arepresentative technique of the second group, the authors introduce endothelial cell injection, in which human corneal endothelial cells are cultivated in vitro and then, after removal of the diseased endothelium, injected into the anterior chamber of the recipient's eye to form anew and healthy endothelium. This is supported by injection of Rho kinase inhibitors and aface-down positioning of the patient after surgery. It is postulated that endothelial cell injection could possibly enable clinicians to treat up to 300 patient eyes with the tissue generated from 1 donor eye. Whether and how these novel approaches will become established in Europe remains to be seen.

Research Progress of Printing and Dyeing Wastewater Treatment

In the textile industry, printing and dyeing technology, as an essential technical basis, produces a lot of printing and dyeing wastewater (PDW) that jeopardizes the ecological environment and human health. PDW generally has the characteristics of large discharge, high chromaticity, strong toxicity, strong alkalinity, complex componentization, poor biodegradability, large fluctuations in water quality and quality, and high content of organic pollutants, belonging to the type of industrial wastewater that is difficult to manage. In this paper, the current research progress of PDW treatment technology from the aspects of physical technology, chemical technology, and biological technology are reviewed. In addition, measures to reduce the damage caused by printing and dyeing wastewater from three perspectives: treatment principle, processes, advantages, and disadvantages are discussed, which provides a reference point for the treatment of printing and dyeing wastewater. It is worth noting that the article reviews the ABS system, which is gaining attention as an emerging technology under biological technology. The purpose of this paper is to provide a reference basis for the selection and application of technology, and then promote the innovation and development of printing and dyeing wastewater treatment technology.

Morphological rationale for surgical treatment of patients with true splenic artery aneurysm

Aim. To study the morphological features of the wall structure of the splenic artery aneurysm in order to identify the safest and most effective method of surgical treatment.Materials and methods. From 2020 to 2023, 43 patients underwent surgery for true splenic artery aneurysm. Interventions involved laparoscopic clipping of aneurysm branches, laparoscopic resection of aneurysm, laparoscopic splenectomy, and resection of giant splenic artery aneurysm. A clinical and morphological study of 16 slides of splenic artery aneurysm was performed. The aneurysm wall and the adjacent wall of the splenic artery without macroscopic signs of lumen dilatation for 1 cm from the aneurysmal dilatation were examined.Results. Microscopic study revealed fragments of loose, edematous wall of large elastic arteries with atherosclerosis, atheromatosis and calcification. Atherosclerotic plaques were observed in the intima; calcium deposits were detected in 81.25% of slides, and defects in elastic fibers – in all slides. The elastic membrane was thinned or had a discontinuous structure. Morphological changes in the wall of the splenic artery persisted up to 1.0 ± 0.2 cm proximal and distal to the aneurysm.Conclusion. Taking into account the revealed features of the morphological structure of the aneurysm, the formation of an end-to-end vascular anastomosis of the splenic artery, clipping or suturing of the aneurysm neck pose a significant risk of aneurysm recurrence. Laparoscopic clipping of splenic artery aneurysm branches at a distance of >1.5 cm from the edges of the aneurysm becomes the operation of choice for patients in this category.

Management Strategies for Children and Adolescents with Diabetes Mellitus

The principles of treatment for diabetes in children and adolescents cannot simply be derived from care routinely provided to adults with diabetes. The major consideration is that the epidemiology, pathophysiology, developmental considerations, and response to treatment of pediatric diabetes are often different from those of adult diabetes. Second, recommended treatments for children and adolescents with type 1 diabetes (T1DM), type 2 diabetes (T2DM), and other pediatric conditions such as monogenic diabetes (neonatal diabetes and MODY [maturity-onset diabetes of the young]) also differ. HbA1c goals in T1DM and T2DM must be individualized and reassessed over time. A HbA1c < 7% is appropriate for many children and adolescents with T1DM. In a case with hypoglycemia, hypoglycemic unawareness, lack of access to analog insulins, advanced insulin delivery technology and/or continuous glucose monitoring, a less stringent HbA1c < 7.5% will be required. A reasonable HbA1c goal for T2DM is < 7%. If possible, a strict HbA1c target of < 6.5% can be implemented. Metformin is the first-line treatment of choice in T2DM. In a case with ketosis or HbA1c > 8.5%, insulin will be required with once daily basal insulin (0.25~0.5 IU/kg). If the glycemic goal is not attained, the addition of a second agent is considered in adult patients but might not be applicable or safe in pediatric cases. Therefore, the efficacy and safety of these drugs used in adult patients, including glucagon-like peptide-1 receptor agonists and sodium glucose cotransporter 2 inhibitors, should be evaluated in pediatric patients worldwide.

A PHARMACOECONOMIC EVALUATION OF TYPE 2 DIABETES DRUGS IN CENTRAL PHARMACIES IN SİVAS PROVINCE

Type 2 diabetes is characterized by insulin resistance in tissues such as the liver, muscle, and fat, resulting from detectable damage to pancreatic beta cells. The disease is also related to genetics, environmental factors, and lifestyle. In our country, 22.6% of the health budget is allocated to treating diabetes and its complications. Due to the increasing incidence of patients with type 2 diabetes, effective and rational treatments to reduce the burden of the disease on the healthcare budget have become an important issue for both payers and policymakers. In this study, prescriptions of 391 Type-2 diabetic patients were analyzed from pharmacies selected by mass sampling method in Sivas center, and the pharmacoeconomic suitability of these drugs was investigated, taking into account chronic complications related to diabetes. According to the data obtained, the drugs prescribed to diabetic patients with chronic diseases were found to be appropriate. However, when all diabetic patients were examined, it was determined that the prescribed amount of insulin preparations was high and not pharmaceutically appropriate. It was revealed that the cost of type 2 diabetes medications for 391 patients was 77,852,79 TRY, and the prescription price was 199.11 TRY.

PBA2, a novel inhibitor of the β-catenin/CBP pathway, eradicates chronic myeloid leukemia including BCR-ABL T315I mutation

BackgroundBCR-ABL is a constitutively active tyrosine kinase that stimulates multiple downstream signaling pathways to promote the survival and proliferation of chronic myeloid leukemia (CML) cells. The clinical application of specific BCR-ABL tyrosine kinase inhibitors (TKIs) has led to significantly improved prognosis and overall survival in CML patients compared to previous treatment regimens. However, direct targeting of BCR-ABL does not eradicate CML cells expressing T315I-mutated BCR-ABL. Our previous study revealed that inhibiting CREB binding protein (CBP) is efficacious in activating β-catenin/p300 signaling, promoting cell differentiation and inducing p53/p21-dependent senescence regardless of BCR-ABL mutation status. We hypothesize that the specific inhibition of CBP may represent a novel strategy to promote β-catenin/p300-mediated differentiation and suppress cancer cell proliferation for treating CML patients.MethodsThe anticancer efficacy of PBA2, a novel CBP inhibitor, in CML cells expressing wild-type or T315I-mutated BCR-ABL was investigated in vitro and in vivo. Cell differentiation was determined by the nitroblue tetrazolium (NBT) reduction assay. The extent of cellular senescence was assessed by senescence-associated β-galactosidase (SA-β-Gal) activity. Cytotoxicity was measured by MTS assay. RNA interference was performed to evaluate the cell proliferation effects of CBP knockdown. The interaction of β-catenin and CBP/p300 was examined by co-immunoprecipitation assay.ResultsPBA2 exhibited significantly higher anticancer effects than imatinib in CML cells harboring either wild-type or T315I-mutated BCR-ABL both in vitro and in vivo. Mechanistically, PBA2 reduced CBP expression and promoted β-catenin-p300 interaction to induce cell differentiation and senescence.ConclusionOur data supported the rational treatment of CML by inhibiting the β-catenin/CBP pathway regardless of BCR-ABL mutation status.

Predictive model of prognosis index for invasive micropapillary carcinoma of the breast based on machine learning: a SEER population-based study

BackgroundInvasive micropapillary carcinoma (IMPC) is a rare subtype of breast cancer. Its epidemiological features, treatment principles, and prognostic factors remain controversial.ObjectiveThis study aimed to develop an improved machine learning-based model to predict the prognosis of patients with invasive micropapillary carcinoma.MethodsA total of 1123 patients diagnosed with IMPC after surgery between 1998 and 2019 were identified from the Surveillance, Epidemiology, and End Results (SEER) database for survival analysis. Univariate and multivariate analyses were performed to explore independent prognostic factors for the overall and disease-specific survival of patients with IMPC. Five machine learning algorithms were developed to predict the 5-year survival of these patients.ResultsCox regression analysis indicated that patients aged > 65 years had a significantly worse prognosis than those younger in age, while unmarried patients had a better prognosis than married patients. Patients diagnosed between 2001 and 2005 had a significant risk reduction of mortality compared with other periods. The XGBoost model outperformed the other models with a precision of 0.818 and an area under the curve of 0.863.ConclusionsA machine learning model for IMPC in patients with breast cancer was developed to estimate the 5-year OS. The XGBoost model had a promising performance and can help clinicians determine the early prognosis of patients with IMPC; therefore, the model can improve clinical outcomes by influencing management strategies and patient health care decisions.

Takayasu arteritis: the patient at the interdisciplinary crossroads

The article is devoted to a rare, serious disease - Takayasu arteritis. Due to the predominant involvement of the cardiovascular system, patients with this disease are more often seen by a cardiologist, but only inhibition of immune inflammation, which underlies the pathogenesis, can radically change the natural course of the disease. The article provides information on the etiology and pathogenesis of Takayasu arteritis, risk factors, clinical picture, diagnostic methods, classification, principles of medical and surgical treatment. The theoretical material is illustrated with a clinical case (authors’ own observation). The article will be of interest to cardiologists, rheumatologists, internists, and family medicine doctors

Changes in the levels of cytokines IL-1β, IL-4, IL-8, and IL-10 in dental orthopedic fixed prosthetics

Despite significant advances in materials science, introduction of new methods and principles of prosthetic treatment into the practice of dentists, complications after prosthetics with fixed structures are encountered. The result of dental prosthetics of patients with defects of hard tissues of teeth depends not only on the chosen construction and materials from which they are made, but is closely connected with the functional activity of the immune system. Cytokines are an important factor of mucosal immunity. The cytokine system represents one of the key components of mucosal immunity. It regulates normal physiological functions, restoration of haemostasis in the interaction of physical, chemical and biological factors on the body and participates in the pathogenesis of allergic, autoimmune, and autoinflammatory processes. The aim of the study is to compare the content of IL-1â, IL-8, IL-10, and IL-4 in unstimulated saliva and gingival fluid in patients during adaptation to metal-ceramic and oxide ceramic tooth-supported constructions. In the period from 2021-2024, we examined 3 groups of patients aged 46±2 years: group 1 – comparison group, patients without dental constructions in the oral cavity (25 people); group 2 – patients treated with tooth-supported metal-ceramic (MC) crowns (25 people); and group 3 – patients treated with tooth-supported zirconium dioxide (ZrO2) crowns (25 people). On the basis of IL-1â, IL-8, IL-10, and IL-4 we concluded that the mucosal immunity of oral mucous membranes is less affected by the structures made of oxide ceramics compared to the crowns made of metal-ceramics. Similar patterns of changes in the levels of IL-1â, IL-8, and IL-4 in saliva and gingival fluid in patients who underwent dental rehabilitation were found, which allows us to use only saliva in order to eliminate the complexity and specificity of gingival fluid sampling. Also, changes in cytokine indices in saliva and gingival fluid at different stages of prosthodontics reflect the level of reaction of oral mucosal immunity, which can serve as a criterion of the quality of the performed dental treatment.

RELATIONSHIP OF OHA’S TREATMENT RATIONALITY WITH THERAPY TARGETS ACHIEVEMENT IN TYPE II DIABETES MELLITUS PATIENTS

Diabetes mellitus (DM) is the most common condition in Central Java. Irrational use of drugs can cause various problems, including increased disease morbidity and mortality rates, wasted health costs, and the emergence of undesirable effects. Therefore, this study was necessary to assess the rationality of the treatment. The aim was to describe the rationality of OHAs treatment and to achieve therapy targets, and to understand the relationship between OHA treatment rationality and therapy target achievement in patients with type 2 diabetes mellitus at primary health care in Wirosari District, Grobogan Regency. An analytical observational study used a cross-sectional design, purposive sampling, and chi-square test to establish relationships between variables. The rationale for treating OHAs in patients with type 2 diabetes mellitus at primary health care in Wirosari District, Grobogan Regency, is 47.67% rational and 52.33% irrational. Among the samples, 26.7% reached the therapeutic target, whereas 73.3% did not. The rationality of treating OHAs and achieving therapeutic targets was interconnected (p=0.014). Keywords: HbA1C, rational treatment, therapeutic target, type 2 diabetes mellitus

Modern surgical strategies in pediatric neuroblastoma: Evolving approaches and treatment principles.

Neuroblastoma, the most common extracranial solid tumor in children under the age of 5, has been described as early as the 19th century, and its complexity has continued to intrigue researchers, as well as medical and surgical specialists. At one end of the phenotypic spectrum, neuroblastoma is self-limiting with minimal to no intervention required, while on the opposite end exists the challenge of refractory disease despite aggressive management and toxic systemic treatments. The goal of this review is to describe a comprehensive surgical perspective and contemporary approach to neuroblastoma.

Ayurvedic Management of Endometriosis w.s.r. to Vatiki Yoni Vyapada

Endometriosis is a chronic, often painful condition in which tissue similar to the lining of the uterus grows outside the uterine cavity. Affecting approximately 10% of women of reproductive age, endometriosis can lead to severe pelvic pain, infertility, and other systemic symptoms. Despite its prevalence, the condition remains under-diagnosed and poorly understood, largely due to the complexity of its symptoms and variability in individual presentations. The treatment involves hormonal therapy and surgical interventions, but these may not always solve the underlying issue or may have significant side effects. This article explores Ayurvedic management of endometriosis by adopting the treatment principles of Vataja yonivyapada due to similarities of symptoms. A holistic approach is used by focusing on Vatanulomana by Shamana chikitsa and Shodhana and Sthanika chikitsa in the form of Nabhi purana with Eranda taila and Mruttika alepa. This is a case report of a 34 year old unmarried female patient suffering from endometriosis and having complaint of severe pain during menses. She was totally dependent on analgesics injections and oral painkiller during her menses since 2 years. The objective of present treatment included management of the symptoms by Ayurvedic intervention by formation of Shudha artava dhatu and balancing the Gati of Vata dosha and also improvement of the quality of life which was hampered during menses. After the treatment her dependency on the painkillers was gradually reduced.