A Case Study of Left Testicular Torsion treated by Orchidectomy

Testicular torsion is a surgical emergency which requires early surgical intervention. A delay in surgery may end up in gangrene of the testes. Orchidopexy is the surgery of choice if a surgeon is unable to do manual detorsion of the testis. Torsion is usually anticlockwise in case of left testis and clockwise in case of right testis. The case report shown here is a case of left testicular torsion where the patient reported to opd after 1 day of the torsion. Exploratory surgery of scrotum was performed under general anesthesia. As early necrosis of the left testis had happened already, orchidectomy was performed for left testis and right testis was anchored to the scrotal wall. Photographs of the testis were captured with the written consent of patient

A critical study on Burn Injury (Dagda Vrana) with special reference to Sushruta Samhita

Burns are global public health problem, accounting for an estimated death 180000 annually and the estimated annual burn incidence in India is approximately 6 -7 million. In Ayurveda, burn injury has been dealt in the name of Dagdha Vrana. The concept of Dagdha Vrana was found in different treatises, In Sushruta Samhita details regarding classification, clinical features and detailed management according to types are described. In Ayurveda, therapeutic burns also have been described. This article compiles with classification, clinical features and treatment of burns injury and Dagda Vrana with special reference to Sushruta Samhita

A clinical trial to evaluate the efficacy of Katupila Arka in post operative fistulotomy wound

Post-operative fistulotomy wound is a surgically created wound for the better healing of fistulous tract. It is considered as the standard treatment modality for fistula in ano and is the most widely performed procedure. The healing of the fistulotomy wound is a challenging task as the chances of infection is more because of its contaminated nature. This can be related to Vrana in Ayurveda and can be managed. There is a need for drugs which have Vrana Shodhaka and Vrana Ropaka properties. Katupila (Securinega leucopyrus (Wild.) Muell) has all the above said properties due to the presence of various phytochemical agents. It’s having a broad spectrum anti-microbial activity. References from a previous work done on Katupila Kalka indicate that, it is effective for the management of diabetic wound. Keeping the practical difficulty in the preparation of Kalka on daily basis, Arka Kalpana is adopted as an alternate method here. Katupila Arka showed marked ulcer regression during the course of treatment than Povidone Iodine which could be attributed to Vrana Shodana and Ropana property. It renders Shodhana (Cleansing/ Purification) action by virtue of its Kashaya and Tikta Rasas, Laghu, Ruksha, Tikshna Gunas, Ushna Veerya and Katu Vipaka. Ropana (Tissue healing / Regeneration) by virtue of its Kashaya and Madhura Anurasa and overall, by Prabhava. Tannins, Flavonoids, Phenol, Saponins and Alkaloids are present in the trial drug which enhances the wound healing property

A randomized, controlled clinical study to evaluate the role of Sarjarasa Apamarga Ksharasutra in the management of Bhagandara w.s.r to fistula-in-ano

Fistula-in-ano is one of the most common ailments pertaining to ano-rectal region, is prevalent all over the world and its occurance is 8.6 cases per 100,000 population.[1] The main cause known for fistula-in-ano is crypto glandular infection of anal crypts. In Ayurveda, according to similar clinical features the disease Bhagandara can be correlated with fistula in ano. Presently Ksharasutra therapy is found most approaching and attractive treatment modality among para-surgical procedures for fistula in ano. Guggulu Apamarga Ksharasutra which is widely used, having good binding nature and anti-inflammatory effect, But the main complaints reported by the patients are pain and discomfort during and after Ksharasutra procedure. So, instead of Guggulu, Sarjarasa was taken which is having binding property, Vedanasthapaka, Vrana Ropana and Vrana Shodhana Guna, for the Ksharasutra preparation.[2] A total of 30 subjects were taken, Trial group treated with Sarjarasa Apamarga Ksharasutra and control group treated with Guggulu Apamarga Ksharasutra. The study shows Sarjarasa Apamarga Ksharasutra had high efficacy in subjective parameters like pain and burning sensation compared to Guggulu Apamarga Ksharasutra. There were no complications like necrosis, stenosis, anal incontinence after application of Sarjarasa Apamarga Ksharasutra

A randomised controlled clinical study to evaluate the role of Nirvapana Upakrama with Durva ointment in the management of Pittaja Dushta Vrana with special reference to fissure-in-ano

Introduction: Fissure-in-ano is an ulcer in the longitudinal axis of lower anal canal. It is having prevalence of about 17.91%. By seeing the signs and symptoms we can consider it as one among the six varieties of Dushta Vrana i.e., Pittaja Dustavrana. Due to busy life schedules people don’t prefer hospitalization and other operative procedures. So, there is a need to find out a new and simpler medicament which enables easy and better storage, preservation and mode of application. Here an attempt was made to study the effect of Nirvapana Upakrama in the management of fissure in ano is taken. This Upakrama is used for the treatment of Vrana accompanied with Daha, Paka, Jwara and having Pitta Kopa and Raktena Abhibhuta. Since fissure is having the similar symptoms this treatment can be adopted for the management of the same. Methodology: A randomized controlled clinical study was conducted over 30 subjects in two groups.  Fifteen subjects were advised to apply Diltiazem gel and 15 subjects were advised to apply Durva ointment twice daily for a period of 14 days. Results: Rapid reduction in pain, burning sensation and length of ulcer was observed in the subjects who were given Durva ointment. Discussion: Durva ointment having Madura Rasa, Snigdha Guna and Sheeta Virya does Vatapitta Shamana and pacifies vitiated Rakta. Kashaya rasa of Durva does Vrana Ropana and Rakta Sthambana which amplifies in ulcer healing and relaxation of the sphincter

Sushruta - A True Pioneer in the field of Plastic Surgery

Plastic and reconstructive surgery is a branch of surgery that specializes in restoring form and function to damaged or missing tissues and skin. Plastic surgery consists of reconstructive surgery and cosmetic surgery / aesthetic surgery. It is a specialty which adapts surgical principles and thought processes to the unique needs of each individual patient by remolding, reshaping and manipulating bone, cartilage and all soft tissues. Plastic surgery is one among the branches of surgery that has seen peak surge of procedures conducted across the globe post-pandemic period wherein aesthetic and reconstructive surgeries being the major ones.  According to the global statistics as per ISAPS, the most commonly performed plastic surgeries are breast augmentation, liposuction, eyelid surgery, rhinoplasty and abdominoplasty.  Defective healing of the wound either leading to hypertrophied scar or keloid formation and various approaches for closure of large wounds and has always been a surgical challenge from ancient period. Acharya Sushruta had laid down the principles of plastic surgery centuries ago which are quite relevant even in the present era of advanced plastic surgery

A clinical study to evaluate the role of Kshara Karma in oral mucocele with Teekshna Pratisaraniya Apamarga Kshara

Introduction: Mucoceles are the most common benign lesions of the oral cavity developing as a result of retention or extravasation of mucus from the minor salivary glands. There are various treatment modalities which include excision, laser ablation, cryosurgery, sclerotherapy, micro marsupialization, and intra-lesional injection of sclerosing agent or corticosteroid. Although surgery is widely used, it has several disadvantages such as bleeding, lip disfigurement and damage to adjacent ducts with further development of satellite lesions. Kshara being an Anusastra possessing Chedana, Bhedana, Lekhana, Pachana, Vilayana, Shodhana, Ropana, Shoshana and Stambhana Karmas will address all the difficulties faced during conventional ways of treatments. The current study was undertaken to introduce, validate and standardise novel, minimally invasive, para surgical approach towards the treatment of oral mucocele. Methodology: Teekshna Pratisaraniya Apamarga Kshara was prepared. Clinical study was conducted on 30 subjects diagnosed with oral mucocele. Ksharakarma was done. For statistical analysis of parametric values, Repeated period ANOVA test within the group and for non-parametric values, Friedman’s Test within the group were used. Result: The comprehensive analysis of all the results reveals that, all the parameters showed significant change both statistically and clinically with no side effects or complication. Discussion: Ksharakarma on oral mucocele acts by tissue necrosis, gradual sloughing off followed by healing of remnant ulcer with epithelialisation, which was found to be an effective, minimally invasive, para surgical management of oral mucocele without any complications

Clinical trial to evaluate the efficacy of Sandhaniya Cast in Ankle Sprain

Ankle is the most common site for acute musculoskeletal injuries and sprains. Acute ankle trauma is responsible for 10-30% of sports related injuries in young athletes. Ankle sprain is characterized by pain, swelling with or without deformity. According to the Modern science the treatment modalities adopted for the ankle sprain are ankle brace, below knee cast and ankle strap. Inadequate treatment of ankle sprain can lead to chronic problems such as decreased range of motion, pain and joint instability. Acharya Sushruta advocates Alepa with Asthisandhaniya Dravyas for the management of Bhagna. These dravyas when used in the form of Lepa have the properties of Sandhaniya, Shophahara and Vedanasthapaka action. It is a need of hour to bring up new innovative, readily available, patient friendly and time saving techniques which possess the same effect. Hence this study is taken up to bring the Manjistadi Lepa in the modified form as Sandhaniya cast. Such kind of medicated casts weren’t in use till date which makes it unique. This would not only help in immobilization like any other ankle brace or ankle binder, but also reduces localized edema and pain due to its Vedanasthapaka and Shophahara properties and also accelerates the healing

Application of Katupila Rasakriya for Vrana Shodhana in Venous Ulcer : A Case Study

Katupila (Seccurinega leucopyrus (Wild.) Muell) is a dessert climate plant widely known in Sri Lanka as a traditional folk remedy for treating / addressing acute, chronic, and non-healing wounds. Majority of the chronic leg ulcers arises from venous ulcers, which occurs due to abnormal venous hypertension in the lower third of the leg, ankle and dorsum of foot. The study aims to explore the potential benefits of Katupila Rasakriya for Vrana Shodhana in venous ulcer. It is a case report of a 54 year old male patient who presented with the chief complains of a non-healing ulcer above right lateral malleolus since 2 months. Associated with pain, burning sensation, seropurulent discharge with unpleasant odour. He was examined and diagnosed as venous ulcer. The wound was dressed with Katupila Rasakriya twice for a period of 14 days. Significant healing in wound was observed within 2 weeks of treatment. Healing of Venous ulcers are a major clinical challenge. In spite of the fact that the healing of vrana is a natural process, it should be protected against Dosha Dushti, and micro-organisms which may delay the healing process. Thus, before initiating Ropana, It is important to focus on making a Vrana Sudha. In the present study, Katupila Rasakriya demonstrated promising results in the better management of venous ulcer. Further clinical study is needed to evaluate the effectiveness in larger sample

Agnikarma with Kshoudra for pain management in De Quervain’s Tenosynovitis - A Single Case Study

De Quervain’s disease, also called gamer’s thumb or mother’s thumb, is a common pathological condition of the wrist. It is commonly known as de quervain’s tenosynovitis a repetitive use of wrist and thumb lead to an inflammation of the Abductor Pollicis Longus and Extensor Pollicis Brevies tendon and all the layers of their associated tendon sheath. The overall incidence of De Quervain’s tenosynovitis is 0.9/1000 person. As per Ayurvedic parameters this condition can be correlated to Snayugata Vikara, which usually presents with Sthambha, Shula, and Kriyavasakthi. According to Ayurveda, Snayugata Vata - Snehana, Upanaha, Agnikarma, and Bandha are the treatments advised. Agnikarma with “Kshoudragudasnehacha” is mentioned is Sandhiasthsirasnayugatavikara. Kshoudra is mentioned as Dahanopakarana for Sira-Snayu-Asthi Sandhi because of penetration to the deeper structures. Till date splinting, systemic anti-inflammatories and corticosteroid injection are the most frequently utilized non-surgical treatment options and if these processes are ineffective, the tendon sheath of the 1st dorsal compartment is surgically released. This study includes a case study of a gentle man of 34 years who gradually developed pain over base of right thumb and wrist joint since 1 month. Agnikarma with Kshoudra was performed in 4 sittings, with a gap of 7 days and assessment was done with subjective and objective parameters. The therapeutic effects of Agnikarma with Kshoudra resulted in relief of pain and muscle spasm, acceleration of healing, promotion of resolution of inflammation and painless range of movement of joint. Kshoudra Agnikarma is cost effective, easy to perform with better aesthetic outcome