Summary Rheumatoid arthritis (RA) is an autoimmune disease of unknown etiology and is mainly characterized by the progressive erosion of cartilage leading to chronic polyarthritis and joint distortion. Although the exact pathogenesis of the disease has yet not been elucidated, however, studies suggest that cellular proliferation of synoviocytes result in pannus formation which damages the cartilage and bone. Recent reports also support the role of free radicals in its pathogenesis. Apart from the conventional treatment strategies using nonsteroidal anti-inflammatory drugs, disease modifying antirheumatic drugs and glucocorticoids, newer and safer drugs are continuously being searched, as long term usage of these drugs have resulted in adverse effects. Alternative medicine provides another approach for treatment of RA and currently a number of medicinal plants are under scientific evaluation to develop a novel drug. There is a dire need to investigate the complete therapeutic potential and adverse effects, if any, of these herbals for providing newer and safer treatment options with minimum side effects. In this review we have tried to explore various Indian ancient Ayurvedic, Unani and Tibbi, as also some Chinese and Korean, herbals for their potential to treat RA.

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Creatine kinase (CK) is a key enzyme of energy metabolism, especially in muscle tissue. CK has two polypeptide chains of M and B, and three isomers, CK-BB, CK-MB and CK-MM. In some conditions like acute myocardial infarction and Neuromuscular disorders, increased CK activity is used as a part of diagnosis. CK can also be elevated in absence of neuromuscular diseases or cardiac injury, such as strenuous exercise, intramuscular injections etc.Several reports indicate elevated activity of serum CK in the maternal blood during child birth.

Background: Creatine kinase (CK) is a key enzyme of energy metabolism, especially in muscle tissue. CK has two polypeptide chains of M and B, and three isomers, CK-BB, CK-MB and CK- MM. In some conditions like acute myocardial infarction and neuromuscular disorders, increased CK activity is used as a part of diagnosis. CK can also be elevated in absence of neuromuscular diseases or cardiac injury, such as strenuous exercise, intramuscular injections etc. Several reports indicate elevated activity of serum CK in the maternal blood during child birth. This study aimed to correlate total CK and its isoenzymes activity in the cord blood with high risk pregnancies.Methods: This was a Prospective observational study conducted in the Obstetrics and Biochemistry Department of Era’s Lucknow Medical College and Hospital, Lucknow, Uttar Pradesh, India. Cord blood of 100 full term newborns was collected and serum was analyzed for total CK and its isoenzymes activity by modified IFCC method. SPSS software was used in data analysis.Results: CK-total and its isoenzymes (CK-MB, CK-BB) activities were observed higher in cases with risk as compared to those without risk. Total CK activity was observed independent while CK-MB and CK-BB were found dependent on different risk factors like pregnancy induced hypertension and fetal distress etc.Conclusions: Present study revealed that high risk pregnancies are associated with increased total CK, CK-MB as well as CK-BB activity.

To compare the outcome of patients undergoing conservative management versus ultrasound guided aspiration of small amoebic liver abscess (=<200ml). This observational prospective study was conducted on 60 patients, aged between 18 to 80 years,After confirming the diagnosis, patients were exposed to medical management or USG guided Aspiration. Patients coming for regular follow-up after completing treatment were included in the study. It was found that the majority of the patients were male (86.7%) and with mean age of the studied patients was 37.10±12.66 years. Chief complaints were pain (100%) followed by fever (85.0%) and Nausea/Vomiting (48.3%) pallor (33.3%), icterus (25.0%) and Tenderness (16.7%). Majority of patients had the right lobe of the liver affected (93.4 %) with Single abscess (94.0%). Duration of Hospital stay and time of half reduction in size was significantly higher in conservative management than the USG guided Aspiration. Reoccurrence of abscess in conservative management was in 6 (20.0%) and need of Surgical intervention was in 4 (13.3%) patients while in USG guided Aspiration group only 1 (3.3%) patient shows Reoccurrence. No mortality was observed in our study. In the present study abscess containing volume of pus (<200 cc) was treated with either conservative treatment or USG guidedAspiration. Our data suggested that the USG guided Aspiration and conservative medical management in treatment ofAmoebic liver abscess are almost equal.

Diabetes mellitus and thyroid hormone dysfunction are two common endocrinopathies seen in adult population. Insulin and thyroid hormones are intimately involved in cellular metabolism, so excess or deficit of any of them can derange the function of another. To see the prevalence of hypothyroidism in type 2 Diabetes Mellitus patients. A total of 235 patients with diagnosed Type 2 Diabetes Mellitus of either sex, aged >20 years were included in the study. Analysis of serum TSH by ELISA was done in all patients of the study. A total of 235(107 males and 128 females) Type 2 Diabetes Mellitus patients were included in the study. Hypothyroidism was seen in 48(20.4%) patients. Hyperthyroidism was seen in 17(7.2%) patients. Euthyroid patients were 170(72.3%). Out of 128 females 27(11.4%) had hypothyroidism whereas out of 107 males 21(8.9%) had hypothyroidism. We conclude that prevalence of hypothyroidism was 20.4% and seen more in female Type 2 Diabetic patients as compared with male patients.

The possible involvement of cytokines such as tumour necrosis factor-a (TNF-a), interleukin-1b (IL-1b) and interferon-g (IFN-g) that are suspected of causing pregnancy loss and miscarriage has been investigated in dams of mice subjected to hyperthermia. Thermal stress was induced by exposing mice dams at 40721C for 4 h every day during the different phases of the gestation period whereas the normothermic animals were housed at 22721C. The effect of maternal thermal stress was measured in pregnant mice at different phases of the gestation period namely, blastogenesis-implantation phase (days 0-5 postconceptionem [p.c.]), organogenesis or embryogenesis phase (days 6-15 p.c.) and fetogenesis phase (days 16-20 p.c.). Uterine examination of dams subjected to hyperthermia on days 6-15 p.c. showed maximum reduction in live fetus number, gestational index and maximum pre-and postimplantation loss in comparison with dams housed in normothermic environment and dams exposed to thermal stress between days 0-5 and 16-20 p.c. Maximum resorption rate and number of non-viable fetuses were observed in dams exposed to hyperthermia during days 6-15 p.c. Elevated levels of TNF-a and IL-1b were observed in the amniotic fluid of dams subjected to hyperthermia during days 6-15 p.c. but IFN-g levels remained unaltered. Single intraperitoneal (i.p.) administration of recombinant mouse TNF-a at a dose of 1 and 0.5 ng/ mice in dams on day 6 in normothermic condition resulted in a reduced number of live fetuses. Administration of anti-TNF-a antibody i.p. at a dose of 10 mg/dam on day 6 p.c. and subjected to thermal stress between days 6-15 p.c. increased marginally the number of fetuses but failed to attain statistical significance in comparison with days 6-15 p.c. thermally stressed dams without antibody treatment. It is concluded that the induction of TNF-a, in the amniotic fluid is associated with thermal stress during pregnancy and may be linked to the reproductive performances of dams. This study will help in understanding the mechanism of thermal injury in pregnant subjects.