There were no clinical or laboratory evidence for other autoimmune or systemic illnesses. of cows urine) with the concept of (nonpitting edema) and got significant result in both subjective and objective parameters. (purgation) with (Retz.) and (extract of cows urine), is one of the remedies to treat (diagnosis):such as uses with 20 g + 30 ml with as [Table 2] and with and to painful joints were given during the course of admission. During menstruation, the treatment was discontinued. Table 2 Course and duration of during admission up to the reduction of (swelling) Open in a separate window Results Data based on clinical presentation were collected before, during and after treatment and are presented in the tabular form. Subjective parameters Buergers test are the subjective parameters [Table 3] and pain in multiple joint, stiffness in multiple joints, tenderness in multiple joints, swelling [Table 4 and Figures ?Figures1,1, ?,2],2], deformity in multiple joints, seizures episodes, Homans sign, Moses sign and peripheral pulses. Table 3 Subjective parameters before, during, and after the treatment Open in a separate window Table 4 Measurement of both upper and lower limbs in centimeters Open in a separate window Open in a separate window Figure 1 Color Doppler of left lower limb on June 24, 2013 (during treatment) Open in a separate window Figure 2 Color Doppler of left lower limb on July 23, 2014 (after treatment) Objective parameters (i) Hematological investigations [Table 1] such as cardiolipin antibody-IgG, cardiolipin antibody-IgM, APC, homocysteine, antinuclear antibody, erythrocyte sedimentation rate; (ii) prothrombin time international normalized ratio (PT-INR) periodical monitoring [Table 5]; and (iii) radiological findings that are color doppler evaluation of the left lower limb vessels [Table 6 and Figures ?Figures33C5] are the objective parameters. IMR-1 Table 5 Monthly monitoring of prothrombin time-international normalized ratio (confirmed by coagulometer) Open in a separate window Table 6 Radiological findings: Color Doppler evaluation of left IMR-1 lower limb vessels Open in a separate window Open in a separate window Figure 3 Edema of lower limb before the treatment Open in a separate window Figure 5 Color Doppler of left lower limb on February 26, 2013 (before IMPG1 antibody treatment) Open in a separate window Figure 4 Edema of lower limb after the treatment Discussion Antiphospholipid antibody syndrome The term APLA syndrome denotes the clinical association between APLAs and a syndrome of hypercoagulability.[5,6] It is an autoimmune disease characterized by the presence of thromboembolic complications and pregnancy morbidity in the presence of persistently increased titers of APLAs.[7] The most commonly detected subgroups of APLAs are lupus anticoagulant, aCL, and anti-beta-2-glycoprotein 1 antibodies. Lupus anticoagulant antibodies are associated with thromboembolic events rather than clinical bleeding. APLAs can interfere with both pro- and anti-coagulant pathways Probable mode of action might have acted to prevent further thrombosis along with recanalization of thrombosed veins without any thromboembolism [Figure 3]. Studies have showed that and are not yet proven; further studies are needed to find the efficacy of in resolving, preventing further thrombus formation and recanalization of thrombosed vein without a history of any embolism. Future treatment planning Treatment will be continued by monitoring PT-INR every month and are planning to conduct MR venogram to rule out the presence of thrombus. Conclusion Though APS is an autoimmune condition with limited treatment options, if properly treated as per the basic principles of Ayurveda under the light of promising results can be obtained which gives a hope for its further approach without any IMR-1 adverse effects. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest..
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