SHATAPONAK BHAGANDARA (FISTULA IN ANO WITH MULTIPLE OPENINGS)

A 55 year old male attended the OPD of Shalya tantra department, S.V.N.H.T Ayurved College, Rahuri (Maharashtra) with the complaints of difficulty in sitting and walking due to severe pain, pus discharge, itching, intermittent bleeding and swelling in perianal region and on and off mild fever. On physical examination multiple external openings were found around the anus. On probing multiple openings were connected internally with external opening located at 60 clock position. Fistulogram was advised. Fistulogram revealed that low anal fistula with multiple openings. Finally patient was diagnosed as Shataponak Bhagandara[1] which correlates with fistula in Ano with multiple openings in modern surgical practice. After surgical profile of the patient; he had been posted for the Ayurvedic minimally invasive procedure i.e., Ksharasutra. Ksharsutra procedure was done under spinal anesthesia and subsequent change of the thread was done on weekly basis for 10 weeks. Brief description about the disease Bhagandara and Kshrasutra preparation and its application is also important.[2] Studies also reported the comparative efficacy of the different kinds of Ksharasutra.[3] Ksharsutra procedure not only prevents further complications of the condition but also cures the condition[4]

INNOVATION OF KSHARAPLOTA (MEDICATED GAUZE) IN THE MANAGEMENT OF VRANA (ULCER)

Indians have paid enough attention to discover the therapeutically effects of plants and herbs as medicinal agents in many diseases. Plants contain Alkaloids and various other chemical substances which form the base for many medical preparations. Most of the drugs used are derived from the natural world through the experiments of earlier civilization. Ksharaplota (medicated gauze) is an innovative concept used for management of infected and chronic wounds and ulcers. This Ksharaplota (medicated gauze) was prepared with the help of Snuhikshira (latex of Euphorbia neriifolia Linn.), Apamargakshara (ash of Achyranthes aspera L.) and Haridra (Curcuma longa L.). Single coating of the above drugs are given to the Plota (gauze). It can be used to heal wounds and ulcers. This Ksharaplota is prepared similarly with basic concept of Ksharasutra preparation. There are number of dressing materials given by Sushruta e.g. Pichu (cloth), Kawalika, Plota (gauze) and Vikeshika or Varti (wick). Among that we selected Plota as a dressing material which can be used as for deep and broader wounds and ulcers. In the present study preparation of Ksharaplota, advantages, indications, disadvantages, sterilization, storage, standardization were observed for simple and safest parasurgical practice

ROLE OF AGNIKARMA WITH ELECTRIC CAUTERY IN CHARMAKILA W. S. R. TO WART- A CASE DISCUSSION

Agnikarma Chikitsa was at peak level in Sushruta period but its use was declined gradually in modern era due to lack of availability of instruments and also the therapy was not easily acceptable by patient so in the present case study discussion we have made attempt on the disease Charmakila with the help of electric cauterization which is nothing but advanced version of ancient Agnikarma therapy. In present case study observation, efficacy of electric cauterization therapy shows minimum invasive parasurgical method in Charmakila (wart). One patient was treated on OPD basis in a minor OT of Ayurved college hospital Rahuri. Treatment was well tolerated by patient without complication during the therapy and post operative period. Hence, use of electric cautery as an Agnikarmas Dahanaupakarana in Charmakila is a best option with minimum trauma, easily acceptable by patient and surgeon in their fast day-to-day life

ROLE OF AGNIKARMA IN THE MANAGEMENT OF TRIGGER FINGER

Although in ancient times, Agnikarma practice has been very less but the last ten years have seen a remarkable rise in the efficiency of Agnikarma practice. This has been possible due to a combination of valuable researches and conferences carried out all over the globe. And thats the reason why most of the Ayurvedic Shalya Tantra practitioners use Agnikarma as a healing mechanism for most of the human diseases. Although modern surgical procedures are effective for curing diseases but the complications that arise out of such procedures are equally fatal and deadly. However in recent times it has been observed that such diseases can be cured by Agnikarma without undertaking any surgical procedure hence Agnikarma is proved to be a boon for curing such diseases. Trigger finger, a disease is commonly seen in professions which involve frequent movement of fingers e.g. surgeons, typist, barbour, soldiers, farmer etc. As the reference of Acharya Sushruta suggests the disease trigger finger can be correlated with Snaya Asthi Sandhi Aashrita Vikara. So the patient should be kept under Agnikarma therapy upto a satisfactory level of relief from pain and hence in this study a case of trigger finger was treated by Agnikarma for a period of 30 days. In this period 4 sittings was administered at intervals of 7 days giving a complete relief from symptoms. After completion of Agnikarma, the patient was followed up and observed for recurrence for 3 months

A NOVEL METHOD FOR VRANA SHODHANA & ROPANA USING KSHARAJALA

Indians have paid enough attention to discover the therapeutic effects of plants and herbs as medicinal agents in many diseases. Plants contain Alkaloids and various other chemical substances which form the base for many medical preparations. Most of the drugs used are derived from the natural world through the experiments of earlier civilization. Ksharajala is an innovative concept used for management of Infected & chronic Wounds and ulcers. This Ksharajala was prepared with the help of Apamargakshara & distilled water in 1:100 proportion. It can be used in number of open wounds & ulcers. This Ksharajala is prepared similar to the Hima kalpana preparation. There are number of dressing materials given by Sushruta e.g. Pichu, Kawalika, Plota and Vikeshika or Varti, Kashaya, Kwatha, Rasakriya, Swarasa, Lepa and Hima. Ksaharajala as a dressing material which can be used as for deep & broader wounds & ulcers. In the present study preparation of Ksharajala, advantages, indications, disadvantages, sterilization, storage, standardization were observed for simple & safest parasurgical practice

NOTABLE MODIFICATIONS OF SUSHRUT SAMHITA BY DALHANA ON KSHARAPAKAVIDHI ADHAYAYA

Ksharapakavidhi Adhyaya is one of the important chapters described in Sushrut Samhita sutrastana. Kshara (caustics) are superior and potential to achieve Chedana (excision), Bhedana (incision), Lekhana (scraping), because of their power to alleviate all the three Doshas. Acharya Vaghbhata and Sushruta advocated its importance in several diseases where surgery is difficult and futile. The commentary on Sushrut Samhita which is available in complete form is Nibhandha Sangraha by Dalhana. Acharaya Dalhana commented on Sushruta quotations gave further modifications on the quotations. Now a days the world recognizes the pioneering nature of Sushruta Kshara Karma Chikitsa and hence modern science also accepts Kshara as an alkali and uses it in various infected wounds. The present review describes the historical perspective of Kshara Karma as described in Ayurveda by Acharya Sushruta and Dalhana

EFFECT OF COUNSELING FOR CONSTIPATION IN PRIMARY SCHOOL CHILDREN: A SURVEY STUDY

Constipation is a very common problem which affects large number of school going population of children. The most of the gastroenterologist, pediatricians and proctologist encounter with this problem routinely. Socio-economic factors play significant role towards the prevalence of disease. The dietary habits & life style pattern also leads constipation in children. This article presented a survey study based on primary school children suffered with constipation. The study revealed causes of constipation mainly associated with social & daily routine activities. The 83% of affected students were found to have bad dietary habits. The 56 % of affected children were found to possess lack of outdoor sports activity. Counseling to students, teachers and parents help to change their diet pattern and living habits in natural way. The present study also suggests guideline or rules to be adopted for curing problem of constipation in primary school children

ROLE OF AGNIKARMA THERAPY IN THE MANAGEMENT OF KADARA (CORN): A CASE REPORT

Kadara (corn) is initially painless in condition but with its progress, it may become painful. In modern science, corn is being treated by using anti inflammatory drugs, corn cap, saliciylic acid and excision. Even today there is no satisfactory and permanent treatment available for corn because of its high recurrence tendency. According to Ayurveda, ˜Kadara can be correlated with the condition of corn. Aacharya Sushrut has advised Agnikarma (cauterization) for Kadara. Hence, in this study corn (Kadara) was treated by Agnikarma with Panchadhatu Shalaka (instrument made of 5 metals) in a systematic manner for a duration of 15 days with intervals of 5 days in 3 sittings. Here, we have applied two types of Agnikarma. i.e. Pratisaran (flat type of cauterization) and Bindu (dotted type of cauterization) which were used in combination with application of Tilatailam (sesame oil) for better results. This combination therapy provided cured management, which is observed in the present case study. The patient was followed upto 6 months for observation of recurrence

ROLE OF VIRECHAN KARMA BEFORE KSHARASUTRA PROCEDURE IN THE MANAGEMENT OF BHAGANDARA W.S.R. TO FISTULA IN ANO

Since ages, Bhagandara is the challenge for surgeon. But from three decades Ksharasutra procedure was practised and used with great success without recurrences but it takes long duration to heal. In Ksharasutra procedure patient have pain, foreing body sensation, discomfort and tightness in anal region etc., So to overcome such crucial problems clinical study is required. In ancient ayurvedic texts Bhagandara is Virechan Yogya Vyadhi and advocated Virechan Karma in Bhagandara Chikitsa. So we decided to give Panchtikta Ghrita for Snehan followed Virechan by Aragvadha Hima after that Ksharasutra procedure is done. The present study has been carried out to study the clinical efficacy of Virechan Karma before Ksharasutra procedure in the management of Bhagandara w.s.r.to fistula in ano. A pilot study was conducted, 2 patients selected randomaly and divided into two same group. Group A will be treated with Virechan Karma before Ksharasutra procedure and Group B will be treated with Ksharasutra only. The clinical assessment will be done on the basis of grading criteria. Virechan Karma before Ksharasutra procedure showed better results in reducing pain, itching, burning sensation, pus discharge, unit cutting time and helps in healing of the tract

VARIOUS ASPECT OF ETHICAL MEDICAL PRACTICE: A REVIEW BASED ON AYURVEDA SCIENCE

Patients always seek for the quality treatment from his/her doctor. The basic tool of good medical practice involves professional competence, healthy relationships with patients and conductance of good ethical practice. The regulatory agencies composed “Code of Ethics and Professional Conduct†which is updated time to time. The guideline for Ayurvedic practice protect right of doctors as well as patient. The guideline of Ayurveda practice included information regarding how to practice with in confined regimen of standard protocol, it is very essential for a medical practitioner to follow ethical behavior since medical practice directly dealt with the health of human being. There are many ethical issue related to the medical profession adapted universally. Ayurveda the traditional science of Indian medical system also prescribed ethical code for the medical practice but yet to be recognized; thus there is a need to look at the ethical conductance of ayurveda practice to maintain quality of Ayurveda profession.