MANAGEMENT OF PERINEAL AND PERIANAL WARTS THROUGH AYURVEDA: A CASE REPORT

Warts are the commonest benign, viral condition found in day to day practice and it is more common in young females. In Ayurveda warts may be compared with Charmakeel. As per Acharya Sushruta Agnikarma has been described as superior para-surgical procedures among all the measures used in Ayurveda, as the disease treated by it usually did not relapse. In present case report 33 years old female patient visited in Outpatient department (OPD) of Shalya Tantra having complaints of numerous growths in perineal and peri-anal region with itching and occasional pain since 6 months. The swelling was gradually increasing in size with local itching and discomfort. So the case was diagnosed as external genital warts and Chedana (excision) of the warts with cautery was planned. Orally two tablets (500mg each) Triphala Guggulu thrice in a day with luke warm water was advised for one month. Daily cleaning with Panchavalakal Kwath and dressing with Thumari Taila was performed till complete healing of the post-operative wound. Within 3 weeks wound was healed completely. Follow-up was done up to 10 months and patient had no any complaints or recurrence of warts. This case demonstrates that warts can be managed through Ayurveda without any complications, no recurrence and cost-effectively

GUGGULU BASED KAHARASUTRA IN THE TREATMENT OF BHAGANDARA (FISTULA-IN-ANO): CASE REPORT

A standard Ksharasutra is practiced in treatment of Bhagandar (fistula-in-ano) with high success rate and minimum recurrence rate. In previous research it was noted that Pittaj prakruti patients sometime might cause more perianal irritation due to Apamarga Ksharasutra. So in this study Guggulu based Ksharasutra was prepared by Apamarga Kshara (Ash of Achyranthes aspera Linn.), Guggulu (Commiphora mukul) and turmeric powder (Curcuma longa Linn.). This Ksharasutra was prepared as per the API guidelines and preserved in air tight tube. A patient of Pittaj predominant Prakruti with fistula-in-ano having two external opening at 6 and 7 o clock position of anus was treated with application of Ksharasutra. The Guggulu based Ksharasutra was applied in these two opening under spinal anesthesia. Then Ksharasutra was changed by weekly interval under local xylocaine jelly 2%. The length of thread was measured weekly and noted in the case to assess the unit cutting time (UCT). The unit cutting time (UCT) of first thread was 7.5 days/cm and second one had UCT 6.8 days/cm. During the treatment patient was doing his job regularly without hampering the quality of life. After 2 months patient was free from all symptoms of fistula with normal scar and without any complications. This case study demonstrated the utility of Guggulu based Kaharasutra in multiple fistula-in ano

Ayurvedic Management of Mootraghata (Benign Prostate Hyperplasia) – A Systemic Review

Lower urinary tract symptoms (LUTSs) are quite common in aging males and these affect the quality of life of an individual. From out of various etiologies of LUTS, benign prostate hyperplasia (BPH) has a high prevalence itself. Similarly, in ancient times, Acharya’s described various types of Mootraghata with their various etiological factors. Ayurveda clinicians and postgraduate institutes are being conducted researches or clinical trials with various modalities in the management of Mootraghata. Many of the researches done on Mootraghata remain in the library in the form of gray literature. Evidence-based medicine is the key to conscientious, explicit, and judicious use of currently available medicines for the best result of individual patient care. The research that was published in research journals can be summarized to know the treatment modalities in the management of BPH. In the review, the clinical studies/trials from the year January 2001 to 2021 are included in the study. For that purpose, the data mining was done through search engines, that is, Google Scholar, Ayush Research Portal, Dhara, AYU, Ayu-Care, J-Gate, J-Aim, Google, PubMed, Sci-Hub, and Shodhganga. In this review total, 50 studies have been collected from the available online search engine, out of 50 studies, 30 studies are having clinical intervention while 20 are review articles. Based on this review, the presented review article provides information on BPH and its treatment by herbal medicine, prognosis, and limitations of conservative treatment, and uses of parameters to the assessment of BPH

Agnikarma with Adjuvant Drug in the Management of Frozen Shoulder (Avabahuka) – A Case Report

Agnikarma is superior to all parasurgical interventions narrated by father of surgery. Avabahuka can be correlated with frozen shoulder that affects routine activity by painful shoulder and restricted shoulder joint movements. This case report is an evidence to support alternative therapy in the management of frozen shoulder. A 50-year-old female presented with a 1 year history of gradual onset of painful restricted movements of the right shoulder, radiating pain from the right shoulder to elbow joint. The patient was diagnosed as a case of frozen shoulder and was treated with four sittings of Bindu Dagdha Agnikarma with Pachadhatu Shalaka along with orally Dashmooladi kwatha 50 ml at evening with empty stomach once daily and Haritaki Churna 3 g with lukewarm water at bed time for 28 days. After completion of the treatment, the patient got relieved from pain and restricted shoulder joint movement along with improvement in complete abduction, flexion, extension, adduction, and external rotation. Promising role of Agnikarma and adjuvant medicines is supposed to subside Vata Kapha dominant Sthanika Shotha (localized swelling) and as a result of this, it may have improved the shoulder joint movements

Management of Low Anal Fistula by Chedana and Ksharkarma A Case Study and Review of Literature

Introduction:-Bhagandara is considered under the Ashta Mahaarogas (Eight grave disorders).The prevalence rate of fistula-in-ano has been accepted as second highest after piles in ano-rectal disorders. Sushruta has given equal emphasis to surgical as well as parasurgical measures for the management of bhagandara, he advocated chedana (fistulectomy) of fistulous tract followed by ksharkarma. Aim: To evaluate the efficacy of chedana (fistulectomy) with ksharakarma in management of low anal fistula. Material & Methods: A 43 years old male patient visited OPD with throbbing pain in ano, swelling and fever with chills. On examination external opening was seen at 11 o’clock approximately 4 cm from anal verge with abscess. TRUS (Transrectal Ultrasonography) was done to confirm the diagnosis. Patient had history of surgery before 2 years for drainage of perianal abscess. So, it was diagnosed as a case of perianal abscess with intersphicteric low anal fistula. Chedana (fistulectomy) followed by teekshna Apamarga kshara application under spinal anesthesia (Xylocaine 2% with adrenaline) was done. Observation And Results: The wound was assessed weekly and it was observed that in first week pain was reduced completely. On second week healthy granulation was observed without any discharge. The wound healed completely within one and half month with minimal scar formation and normal skin coloration. Conclusion: This single case study concluded that chedana (fistulectomy) with ksharkarma is one of the option for management of low anal fistula. &nbsp

Efficacy of Lakshadi Plaster and Laksha Guggulu in the Management of Bhagna (Stable Colle’s Fracture)

The application of lakshadi plaster in the cases of Bhagna (fracture) is an innovative idea in the form of Herbal plaster. In this case report single case was presented having the fracture of forearm i.e.  colles' fracture. Laksha is a good bone healing so for the healing purpose internal Laksh Guggulu was given 1gm three times for one month. The final observation has shown that the Lakshadi Plaster achieve the aim of immobilization as effective as the POP (Plaster of Paris) without any complications. Internal Laksha Guggulu helps in early bone healing without any Calcium and Vitamins prescriptio

The role of Apamarga Kshara in the treatment of Arsha

As per the available treatment modalities of Arsha, the Kshara karma modality is the best one, taking into the consideration its convenience, easy adoptability, cost-effectiveness and curative results. Under this parasurgical procedure, various forms of external kshara application are used in treating the Arsha. These are Ksharasutra Ligation (KSL), ksharpatan, etc. KSL is a surgical procedure, while ksharapatan vidhi is local application and seems to be effective with an easy procedure. Several studies of ksharapatan had been conducted; so the time has come to specify the study of ksharapatan, e.g., according to degree of pile mass and different symptoms and signs. In this present study, apamarga (Achyranthus aspera Linn.) kshara, one among the best qualitative ksharas, was locally applied directly on the different sizes, shapes and degrees of Arsha, to find out its effectiveness with or without any untoward effect. A total of 30 patients were treated by local application of Apamarga kshara. The ksharapatan was done every day, for 7 days in 3 g dose, and the result was assessed thoroughly on the basis of observation according to the specially designed proforma. Apamarga kshara was prepared as per the standard method described in Ayurvedic texts. Patients suffering from Arsha were selected by simple random sampling method, with the complaints of bleeding per rectum, Vedana, Srava, kandu and prolapse. Lastly, it was concluded that ksharapatan had shown significant improvement in 1st and 2nd degree of pile masses without any side effect

A Comparative Clinical Study of Kanchanar Guggulu and Varuna Shigru Guggulu along with Bala Taila Matra Basti in the Management of Mootraghata w.s.r. to Benign Prostatic Hyperplasia

Background: Benign prostatic hyperplasia (BPH) is a benign enlargement of prostate gland commonly found in elderly men (50% found above 40 year of age) and responsible for major affecting factor for quality of life. The overall incidence rate of BPH is 15/1000 men per year. The present treatment modalities have their own complication and limitations. Hence, here is a need to approach a treatment aspect which can minimize the complication along with major relief effect. According to Ayurveda, considering Vata dosha (ApanaVata) as a main culprit for BPH/Mootraghata, line of treatment was planned to evaluate and compare the clinical efficacy of Kanchanar Guggulu and Varuna Shigru Guggulu, along with Matra basti of Bala Taila svata-kaphahar, mutrakrichahara, Lekhan, and shothahara along with oral medication. Materials and Methods: The patients having signs and symptoms of Mootraghata/BPH were registered and allocated into two groups by computer generated randomization method. Patients were treated with Kanchanar Guggulu orally (1 g thrice a day) in Group A (n = 40) and (1 g thrice a day) Group B (n = 41) for 21 days. Matra basti with 60 ml Bala Taila once a day was given in both groups for 21 days. Results: The result was drawn using appropriate statistical testes in objective as well subjective parameters and also to compare efficacy of both group treatment modalities. The trial drug depicted highly significant results in international prostate symptoms score (IPSS) symptoms, average urine flow rate and prostate size, and post-void residual urine (PVRU) in Group A, whereas Group B possessed highly significant effect on all the mentioned IPSS symptoms with improvement in the QOL, but significant changes were observed in PVRU. Conclusion: Final study concluded that Kanchanar Guggulu and Varuna Shigru Guggulu orally along with Bala Taila Matra bastiis safe and effective in the management of Mootraghata (BPH)

Role of Ksharasutra suturing along with adjuvant therapy in the management of Parikartika (Chronic fissure-in-ano)

In Ayurvedic classics Parikartika has been depicted as complication of vamana, virechana, Atisara, etc.  Parikartika can be correlated to fissure-in-ano in modern parlance a common disease among ano-rectal disorders. The main objective of this study was to evaluate the role of Ksharasutra suturing in chronic fissure-in-ano.  In this study, total 50 patients of chronic fissure-in-ano aged between 18-60 years of either sex were selected for Ksharasutra suturing (KSS) which performed under spinal anesthesia. The Ksharasutra suturing was done once and after slough out of Ksharasutra wound was treated with Jatyadi taila and adjuvant drugs for four weeks. The study showed encouraging results with Ksharasutra Suturing in Parikartika without untoward effect.&nbsp

Management of Mootraghata (Benign Prostatic Hyperplesia) with herbal remedies- A pilot study

Mootraghata (Benign Prostatic Hyperplesia i.e. BPH) is a senile disorder affects above 40 years of age, having symptoms like retention, incomplete voiding, dribbling, hesitancy, incontinence of urine, etc. Conservative treatment and surgical interventions for BPH with modern medicines are not free from side effects. So in this age group, there is a need for safer alternative method of management. Total 10 patients having signs and symptoms of mootraghata / BPH were selected from OPD and IPD of Shalya Tantra. In this regard, herbal drug Kanchanar Guggulu (500 mg TID orally), and Dhanyaka Gokshura Ghrita matra basti (60 ml OD) tried in this study.  The treatment was given for 21 days and assessed as per gradation adopted. Finally study has concluded that Kanchanar Guggulu & Dhanyaka Gokshura Ghrita matra basti is effective in symptomatic relief in mootraghat