Revisiting and recreating plastic surgery concepts of Acharya Sushruta through Torn Ear Lobulue Repair vis-à-vis Karnasandhana w.s.r. to Lobuloplasty - A Single Case Study

Plastic surgery is one of the oldest forms of surgery which was expounded to the world by Ayurveda through Acharya Sushruta in his treatise Sushruta Samhita. Reconstructive plastic surgical procedures were performed in ancient India. The plastic surgery of ear (Otoplasty) and Nose (Rhinoplasty) are described in the Sushruta Sutrastana 16th chapter. First methods are described for piercing the ear lobes of an infant which is still a wide spread practice in India. Often these ear lobes; due to the use of heavy Ornaments; gets considerably expanded - split and tear as time passes. Sushruta has described 15 methods of joining these cup-up ear lobes through basic concepts of plastic surgery under the broad heading of Karnasandana. For correcting ear lobe tear, people demand good cosmetically appealing surgery which comes with minimal scar formation. All these types of Sandana Karma with due consideration to its finest details were explained in detail, represent the school of surgery of Acharya Sushruta, who made significant contribution to the principles and techniques of plastic surgery which are surprisingly applicable even in todays modern surgical era. It highlights the status and sophistication of ancient Indian surgery. Here, A brief review on a patient suffering from split ear lobules, was operated on the lines of Karnasandhana as described by Acharya Sushruta,which can be compared with Lobuloplasty, is detailed below

COMPREHENSIVE REVIEW ON PARIKARTIKA (FISSURE-IN-ANO)

The health of an individual depends solely on his diet and life style. Diet plays very important role in Parikartika which is evident by references. The earliest reference of Parikartika is available from Sushrutha Samhitha (1500 B.C). Description about Parikartika is also available in all Bruhatrayees and later classics. Parikartika is referred in Brihatrayees not as an independent disease but as a complication of Bastikarma and Virechana (vyapath). Fissure-in-ano is very commonly encountered in current day to day practice. About 30-40% of the population suffer from proctologic pathologies at least once in their life. Anal fissure comprises of 10-15% of anorectal disorders and is characterized by excruciating pain during and after defecation, bleeding per anus with spasm of anal sphincter. Parikartika is characterized by Kartanavat and Chedanavat shoola in Guda. Similarly Fissure-in-ano is also characterized by sharp cutting pain in anal region. In Parikartika, Teevra shoola, Piccha-asra are seen, similarly severe pain and slimy blood discharge are seen in Fissure-in-ano. Parikartika is treated with internal medications and local applications formulated by using Madhura, Sheeta, Snigdha dravyas. Local therapies in the form of Anuvasana basti, Picchabasti, Madhura, Kashaya dravya Siddha basti taila poorana, Lepa, Pichu dharana are given prime importance in the management. Sentinel Piles is a sequel of chronic fissure-in-ano. In Ayurvedic text no specific description available as a sequel of Parikartika but lots of references available with help of that we can compare Sentinel Piles with Ayurvedic pathogenesis. In Ayurvedic text information available on Shushkarsh, Bahyarsh, Vataj, Janmottar-kalaj Arsha can be correlated with Sentinel Piles.

A single case report on management of Bilateral Epididymal Cyst - A successful Ayurvedic Surgical Approach

Cysts are the fluid filled sacs. It can occur anywhere in the body. Epidydimal cyst occurs in male commonly in the middle age group. When it is small in size, there is no need of any treatment. If the size is large the ultimate treatment is the surgery that is excision of sac. If left untreated it may cause abscess and even destroy the epididymis which can lead to infertility. Here we report a case of bilateral Epididymal cyst in a 63 year old man who was admitted and underwent the Chedana Karma for the removal of the cyst/Kaphaja Granthi. He was successfully managed with regular wound care and dressings and patient had complete relief from his complaints. Detailed case history is presented below

A Single case study of Pilonidal Sinus managed through Ayurvedic Surgical Treatment Vis-à-vis through Chedhana Karma (Wide Excision)

Pilonidal sinus is a very common anorectal problem that more often arises in the hair follicles of natal cleft of the sacrococcygeal area. It is due to penetration of hair through the skin into subcutaneous tissue.it forms unhealthy granulation tissue in the deeper plane.it is of infective origin and occurs in sacral region between the buttocks, umbilicus, axilla. It is common in hair dressers (seen in interdigital clefts), jeep drivers. More commonly seen in between age group of 20-40 years. It is common in males and mostly affects hairy men. Incidence of pilonidal disease is about 26 per 100,000 population. Pilonidal disease occurs predominantly in males, at a ratio of about 3-4:1. When the causes, pathology, clinical symptoms and the examination are taken under consideration and when we read Shalyaja Nadi Vrana mentioned by Acharya Sushruta we can corelate this disease with Pilonidal Sinus.  Treatment of Nadi Vrana is Chedana Karma or with the usage of Kshara Karma. Similarly in contemporary science procedure of wide excision is gold standard for the management of Pilonidal Sinus, which was already mentioned by Acharya Sushruta under the treatment of ‘Nadi Vrana’. We can proudly say that Pilonidal sinus can be completely managed by principles of Ayurveda. Here we report a case of Pilonidal Sinus in 35 year male patient, who had been operated 8 years back for Pilonidal Sinus. Now, he has presented with recurrence of same complaints with sinus at natal cleft region associated with the pain, discharge, swelling since one month