The discontinuation or a break in the continuity of the covering epithelium of skin or mucous membrane is called as ulcer. The healing of the ulcer is a physiological response of the body. When a person does not maintain the proper treatment regimen, hygiene, along with indulgence of Ahita Ahara, Ahita Vihara and contaminated with various micro-organisms and developed a Dusta Vrana or non healing ulcer. Sushruta has described six types of Dusta Vrana. Bed sore can be co-related with Dusta Vrana. A single case of Dusta Vrana (bed sore) was successfully treated with local application of Yastimadhu Siddha Taila in Govt. Ayurvedic College and Hospital, Guwahati. Thus it has been observed that Yastimadhu Siddha Taila is a very effective drug in the management of Dusta Vrana

Binod Kalita

Dr. Surajit Das

English

Journal of Ayurveda and Integrated Medical Sciences (JAIMS)

   ISSN: 2456-3110                                                             CASE REPORT Sep-Oct 2017  Journal of Ayurveda and Integrated Medical Sciences | Sep - Oct 2017 | Vol. 2 | Issue 5 211  Role of Yastimadhu Siddha Taila in the management of Dusta Vrana (bed sore) -  A Case Study Surajit Das,1 Binod Kalita2 1Post Graduate Scholar, 2Assistant Professor, Dept. of Shalya Tantra, Govt. Ayurvedic College and Hospital, Guwahati, Assam, India.                  INTRODUCTION The wound healing is the physiological response of the body.[1] When a person does not maintain the proper treatment regimen, hygiene, along with his indulgence Ahita Ahara, Ahita Vihara, then the Doshas and Dushyas get vitiated along with  various contamination of the wound with different micro-organisims.[2] The healing process of the wound gets impaired after contaminated with micro organism and developed a non-healing ulcer or Dusta Vrana.[3] In Ayurvedic system of medicine, Dusta Vrana can be co-related with bed sore. A pressure ulcer also known as bed  sores  and  decubitus ulcer  is  a  localized  area of  Address for correspondence:  Dr. Surajit Das Post Graduate Scholar, Dept. of Shalya Tantra, Govt. Ayurvedic College and Hospital, Guwahati, Assam, India. E-mail: dr.surajitdas15@gmail.com   Submission Date : 13/08/2017 Accepted Date: 15/10/2017 Access this article online Quick Response Code Website: www.jaims.in  DOI: 10.21760/jaims.v2i05.10282 tissue necrosis that developed when soft tissue is compressed between a bony prominence and an external surface. Pressure ulcer occur due to pressure applied on soft tissues resulting in completely or partially obstruction and capillary collapse and impedes the neutrients to body tissue. Pressure ulcer formation are accelerated in the presence of friction, shear forces and moister. Pressure ulcer most commonly develop in individuals who are unable to move, such as bedridden, confined to a wheel chair.The most common site are the skin overlying the sacrum, coccyx, heels, hips, elbows, knees, ankles, back of shoulders, back of the cranium.[4] This kind of Dusta Vrana or non healing ulcer is a surgical challenge for surgeons in their day to day practice. Acharya Sushruta has been described sixty treatment modalities in Dvi-Vrananiya  Chikitsa Adhaya.[5] Out of them Taila preparation is one which has been   mentioned for Vrana Shodhana and Ropana.[6] So in this study Yastimadhu Siddha Taila has been applied in the management of a case of Dusta Vrana vs Bed sore.[7],[8] Lakshana of Dusta Vrana Sushruta has explained the signs and symptoms of Dusta Vrana as follows - Ati Samvritta, Ativivrito, Ati A B S T R A C T  The discontinuation or a break in the continuity of the covering epithelium of skin or mucous membrane is called as ulcer. The healing of the ulcer is a physiological response of the body. When a person does not maintain the proper treatment regimen, hygiene, along with indulgence of Ahita Ahara, Ahita Vihara and contaminated with various micro-organisms and developed a Dusta Vrana or non healing ulcer. Sushruta has described six types of Dusta Vrana. Bed sore can be co-related with Dusta Vrana. A single case of Dusta Vrana (bed sore) was successfully treated with local application of  Yastimadhu Siddha Taila  in Govt. Ayurvedic College and Hospital, Guwahati. Thus it has been observed that Yastimadhu Siddha Taila is a very effective drug in the management of Dusta Vrana.  Key words: Dusta Vrana, Bed Sore, Yastimadhu Siddha Taila. Surajit Das et.al. Role of Yastimadhu Siddha Taila in the management of Dusta Vrana  ISSN: 2456-3110                                                             CASE REPORT Sep-Oct 2017  Journal of Ayurveda and Integrated Medical Sciences | Sep - Oct 2017 | Vol. 2 | Issue 5 212  Kathina, Ati Mridu, Utsanni, Avasanni, Ati Shita, Ati Ushna, Krishna Varna, Rakta Varna, Shukla Varna, Puti Puyamamsha Shira-Snayu, Purna Putipuya Snayu Unmarga Utsanga, Manajnya Adarshama, Gandha, Ativedana, Daha, Paka, Roga Kandu, Shopha, Pidaka Upadasat, Dusta Shonita Shraba, Digrakala Anuvandhi.[9],[10] Type of study - Single case observational study.  Study center - Govt. Ayurvedic College, Guwahati. MATERIALS AND METHODS In this study Yastimadhu Siddha Taila was used for local application for the management of Dusta Vrana (Bed sore).. Contents of Yastimadhu Siddha Taila[11] 1. Yastimadhu Kalka 2. Yastimadhu Kwatha 3. Murchita Tila Taila A Case Report Name: X. Age: 20year, Hospital No.= 616/16, Date of Admission : 12-10-2016. The patient was asymptomatic three months back.  One day the patient was got alleged road traffic accident and injured over cervical and thoracic regions. After that patient was operated for spinal injury  but later he was unable to walk due to loss of  motor function and sensation of both the lower limbs. After one month, the patient had developed a bed sore or compress ulcer over sacral region. The size of the ulcer was 7cms. Patient was treated in local hospital for two months but there was no any improvement observed. There was no history of Hypertension, Diabetes millitus and all other vital records were within normal  limit and the patient was known case of paraplegia.  So, the patient came to Govt. Ayurvedic College Hospital for better management of the ulcer.  Local examination  ▪ The ulcer was over Sacral region. ▪ Size of the ulcer: About 7x6x1 cm3 ▪ Foul smell with swelling along with discharge ▪ The floor of the ulcer was covered with blackish discolouration of tissue.  Treatment plan The wound was irrigated with normal saline daily and after proper debridement unhealthy dead tissue, the Yastimadhu Siddha Taila was applied locally and the wound was covered with sterile gauze.  Antibiotic was administered for the first seven days to prevention the nesocomial infections and the wound was completely healed after 50 days.  Figure 1: Dusta Vrana on 1st day  Figure 2: Dusta Vrana on 2nd day  Figure 3: Dusta Vrana on 7th day Surajit Das et.al. Role of Yastimadhu Siddha Taila in the management of Dusta Vrana  ISSN: 2456-3110                                                             CASE REPORT Sep-Oct 2017  Journal of Ayurveda and Integrated Medical Sciences | Sep - Oct 2017 | Vol. 2 | Issue 5 213   Figure 4: Dusta Vrana on 25th day  Figure 5: Dusta Vrana on 50th  day RESULT The clinical features of Dusta Vrana were improved within the first week of the trial study. The wound was healed completely after 50 days leaving minimal scar.  DISCUSSION Effect of Yastimadhu Siddha Taila on Vrana Ropana A the end of the ten days slough was completely removed and floor was covered with healthy granulation tissue. This may be due to Shodhana property of the Yastimathu Siddha Taila. ▪ Effect on Vrana Srava: No discharges were present at the end of the  treatment.  ▪ Effect on Vrana Gandha: The unpleasant smell was present at the beginning of treatment. But after ten days of treatment the smell was totally  reduced. ▪ Effect on Vrana Akriti: At the end of the fifty days the Vrana was completely healed with minimal scar.  So, the Yastimadhu Siddha Taila has been very efficacious for Vrana Shodhana and Vrana Ropana Karma.  CONCLUSION The Yastimadhu Siddha Taila has properties like Lekhana, Sodhana, Soshana, Stambhana, Sandhaniya, Ropana and Varnya, Vedanahara. Thus it helps in Shodhana and Ropana of Dusta Vrana.   REFERENCES 1. Schwartz’s Principles of Surgery, by F.Charles Brunicarde. Tenth Edition 2015, Page:241.  Publisher by: Mc Grow- Hill Education . Publication 1969. 2. Dr. Keval Krishna Thakral (Translator), Sushruta Samhita, Nivandha Sangraha Vyakhya by Shri Dalhan Acharya and Nyaychandrika Vyakhya by Acharya Gayadas, Vol-I, Edition2 016, Publication 2016;p.265. 3. Schwartz’s Principles of Surgery, by F.Charles Brunicarde. Tenth Edition 2015, Page:225.  Publisher by: Mc Grow- Hill Education . Publication 1969. 4. Schwartz’s Principles of Surgery, by F.Charles Brunicarde. Tenth Edition 2015, Page:260, 261.  Publisher by: Mc Grow- Hill Education . Publication 1969. 5. Dr. Keval Krishna Thakral (Translator), Sushruta Samhita, Nivandha Sangraha Vyakhya by Shri Dalhan Acharya and Nyaychandrika Vyakhya by AcharyaGayadas,Vol-II,Edition2016, Publication 2014. Page no 168, 169. Sloka No Su. Chi. 1/8. 6. Dr. Keval Krishna Thakral (Translator), Sushruta Samhita, Nivandha Sangraha Vyakhya by Shri Dalhan Acharya and Nyaychandrika Vyakhya by AcharyaGayadas,Vol-II,Edition2016, Publication 2014. Page no 181. Sloka No Su. Chi. 1/57. 7. Sri Dalhan Acharya, Sushruta Samhita of Susruta, with the Nigandha Sangraha Commentary, Edited by Vaidya Jabavi Trikamji Acharaya, Edition 2012, Su.Su. 37/22-26, Page-162. 8. Sri Dalhan Acharya, Sushruta Samhita of Susruta, with the Nigandha Sangraha Commentary, Edited by Vaidya Jabavi Trikamji Acharaya, Edition 2012, Su.Su. 38/35, Page-167. 9. Sri Dalhan Acharya, Sushruta Samhita of Susruta, with the Nigandha sangraha commentary, edited by Vaidya Surajit Das et.al. Role of Yastimadhu Siddha Taila in the management of Dusta Vrana  ISSN: 2456-3110                                                             CASE REPORT Sep-Oct 2017  Journal of Ayurveda and Integrated Medical Sciences | Sep - Oct 2017 | Vol. 2 | Issue 5 214  Jabavi Trikamji Acharaya, Edition 2012,  Sloka No Su.Su. 22/7 .Page-108. 10. Dr. Keval Krishna Thakral (Translator), Sushruta Samhita, Nivandha Sangraha Vyakhya by Shri Dalhan Acharya and Nyaychandrika Vyakhya by Acharya Gayadas, Vol- I, Edition-2016, SlokaNo. Su.Su.22/7. Page: 265. 11. Acharya Sharangadhar, Sarangadhar Samhita (Madhyam Khanda 9/7), Edited with Pandit Parasuram Shastry and Vidyasagar, Publisher- Choukhamba Orientelia, Varanasi, Edition 2008.     ******************************* How to cite this article: Surajit Das, Binod Kalita. Role of Yastimadhu Siddha Taila in the management of Dusta Vrana (bed sore) -  A Case Study. J Ayurveda Integr Med Sci 2017;5:211-214. http://dx.doi.org/10.21760/jaims.v2i05.10282  Source of Support: Nil, Conflict of Interest: None declared. 

Role of Yastimadhu Siddha Taila in the management of Dusta Vrana (bed sore) - A Case Study

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Role of Yastimadhu Siddha Taila in the management of Dusta Vrana (bed sore) - A Case Study

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