Background: Osteoarthritis (OA) is by far the most common form of arthritis and is a major cause of pain and disability in the elderly. The reported prevalence of OA from a study in rural India is 5.78%. In India, OA of knee joint is more common than of hip joint. Leech therapy has been suggested and successfully practiced by Unani physicians in the management of musculoskeletal and chronic skin disease since antiquity. Objective: To assess the efficacy and safety of leech therapy in the management of knee OA on scientific parameters. Materials and Methods: The study was conducted in National Institute of Unani Medicine Hospital; Bangalore, India, Thirty patients of OA were enrolled in the trial after obtaining their informed consents. All the patients were clinically assessed and diagnosed on the basis of thorough history, clinical and radiological examination of the affected joint. Then, four leeches were applied on the affected joint for a period of approximately 30 minutes. The severity of OA and efficacy of leech therapy was assessed by Western Ontario and McMaster University (WOMAC) Score and Visual Analogue Scale (VAS) Score. Then, the results were compared with each other, employing a Paired Student's t-test. Results: The results showed significant reduction in the WOMAC and VAS scores of post-treatment group (P <0.01) as compared to pre-treatment scores. Conclusion: It is concluded that leech therapy may be used safely and effectively in the management of OA, after considering its safety and effectiveness.

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Introduction: Literature reviews world over have shown a high prevalence of musculoskeletal disorders (MSDs) among dental practitioners. Prevalence of MSD among dental practitioners in India, particularly in Karnataka, is not well documented. Aim: To determine the prevalence and distribution of MSD among dental practitioners and its correlation with working ability in South Canara district of Karnataka, India. Materials and Methods: A self-administered questionnaire was used to assess the musculoskeletal symptoms among dental practitioners. The recorded data was analyzed using Chi-square test with Statistical Package for the Social Sciences (SPSS 17). P < 0.05 was considered statistically significant. Results: Forty-nine dental practitioners participated in the study, of which 93.87% had a prevalence of at least one musculoskeletal symptom over the past 12 months. Most common areas affected by MSD in order of magnitude were back (67.34%), neck (59.18%), hand (34.69%), shoulder (32.65%), wrist (30.61%), hip/thigh (20.40%), ankle (18.36%), and knee (16.32%). Also, 39.13% practitioners attributed MSDs to cause limitations at work. Conclusions: High prevalence of MSD exists among our dental practitioners affecting the daily practice of more than one-third of them. Further studies are needed to identify the specific risk factors for MSD so as to introduce effective remedial measures.

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Objectives: To evaluate the usefulness of a selected polyherbal Unani formulation on Lequesne Algo-Functional Index (AFI) of knee Osteoarthritis (OA). Materials and Methods: Patients (n = 23) diagnosed with OA were recruited from the Nizamia General Hospital, Hyderabad to conduct a prospective, pre- and post-evaluation study. A combination of Unani herbs was given internally twice daily i.e., 3 g powder of Asgandh (1 g), Gule baboona (2 g), Bozidan (1 g), and Suranjan shireen (2 g). Topically, the paste of powdered Suranjan talkh (7 g) along with Roghane baboona (20 ml) was applied over the affected knee-joint, one-hour-twice for 40 days. The main outcome measure was to observe significant reduction in modified Lequesne AFI for knee OA after using the Unani formulations. Results: The mean Lequesne AFI Score pre- and post-test was 9.9 (1.58) and 2.05 (2.06) respectively (P < 0.0001). The mean percentage reduction of Lequense AFI score was 79.29%. Conclusion: The present study, demonstrates that the Unani herbal approach selected for this study are effective in ameliorating the severity of pain and improving knee function in patients suffering with knee OA.

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Background: Gṛdhrasi correlates with "Lumbago with Sciatica." Disease complexity suggests that integrative whole-system Āyurvēda treatment combining external and internal therapies will optimize patient care. Objectives: The aim was to evaluate the effectiveness of an integrative whole-system Āyurvēda treatment approach to the management of pain and disability in Gṛdhrasi patients. Study Design: An observational study using standard monitoring procedures. Materials and Methods: Fifty-four Gṛdhrasi patients (age range 41.53 ± 1.71 years, M: F 27:27, mean duration of illness 18.51 ± 4.36 months) receiving individualized treatments at the Integrative Healthcare Center were recruited. Subjects were assessed at the outset, and after each period of treatment using visual analog scale (VAS), straight leg-raising test (SLR), and Roland Morris disability questionnaire (RMDQ). Statistical analysis used Microsoft Excel and SPSS 16.0. Results: Following initial consultations, 16 subjects dropped out. Of the 38 remaining, 68.4% showed significant improvements in pain and disability, 18.4% were borderline non-responders, and 13.2% failed to respond to treatment. There was a statistically significant reduction in the pain (VAS) (F = 62.53, P < 0.0001) and measures of disability (RMDQ) (F = 17.14, P = 0.018). Leg-raising as assessed by SLR also improved significantly for both the legs (P < 0.001). Conclusion: The results of the current observational study are encouraging despite the small size of the group; further clinical trials using a similar integrative whole-system approach for the management of Gṛdhrasi are warranted.

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Seers of Ayurveda recorded their clinical findings from drugs of vegetable, animal, and mineral origin. Ayurvedic therapeutics contains single, simple as well as poly-herbal formulations for the management of arthritic disorders such as Āmavāta, Vātarakta , and Sandhigatavāta0. In this paper, in addition to scientifically validated pharmacological studies, information about herbs from classical as well as ethno botanical sources are compiled, analyzed, and presented. Rāsnā (Pluchea lanceolata (DC) Oliv. and Hiern), Gudūcī (Tinospora cordifolia (Thunb.) Miers), Źunthi (Zingiber officinalis Roxb), Guggulu (Commiphora mukul (Stocks) Hook), Aśvagandhā (Withania somnifera (L.) Dunal), Śatāvarī (Asparagus racemosus Willd.), Balā (Sida cordifolia L.), Erandamūla (Ricinus communis L.), Punarnavā (Boerhavia diffusa L.) are a few prominent drugs in classical Ayurvedic literature recorded for joint disorders. Plants like Azadirachta indica A. Juss (seed oil and stem bark), Cardiospermum halicacabum L.(leaf) Drynaria quercifolia (rhizome), Hemidesmus indicus (L) R.Br, Dodonaea viscosa Jacq, and Leonotis nepetifolia (L.) R.Br were found to have multiple modes of administration for arthritis in ethno medicine.

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To review the evidence on efficacy of Ayurvedic treatment taken either orally, topically, per rectum, or all routes in the management of Rheumatoid Arthritis (RA) based on published scientific literature. Systematic search of the online bibliographic database known as Digital Helpline for Ayurveda Research Articles (DHARA) was conducted to collect the data for all studies related to RA. The search has included the data from December 1945 to June 2012. A summarized and classified overview of prior research on RA in Ayurveda was generated from the collected data of published articles. Three hundred twenty five citations met our keyword search criteria. Out of these, only 127 citations were found directly relevant to RA. The trend of published articles in RA has shown that original research papers (70%) outnumbered review papers (20%) and only few surveys and position papers (2%) were found. Amongst the original research papers, 56% were clinical studies followed by 41% of preclinical studies. Most of the clinical studies were observational in nature (39%) and the rest were randomized uncontrolled trials (33%), or controlled trials (15%), and case studies (7%). It was found that clinical studies were predominant but of poor quality in terms of rigor and research design. Especially, research studies that addressed the holistic principles of Ayurveda were almost absent. However, Ayurvedic formulations were studied more than medicinal plants and external therapies.

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The term "temporomandibular disorders (TMD)" is a collective term used to describe a group of musculoskeletal conditions occurring in the temporomandibular region These conditions are characterized by pain in the muscles of mastication, the temporomandibular joint, or both. Typically, treatment of TMD is driven largely by the physical diagnosis alone, without addressing the personal or psychological impact of TMD pain or the patterns of coping used for TMD patients. Although TMD is regarded by many as a condition in which psychosocial factors influence the course of the disease, little attention has been paid to assessing how psychological or psychosocial factors influence treatment outcome and whether successful clinical outcome is associated with improved psychosocial function. In this article, we are discussing the various methods commonly used for biobehavioral assessment.

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