No abstract

We propose that the modified "cross and push" technique is a feasible, safe, and more accurate option over the standard technique for sampling strictures of the biliary tree.

Gridhrasi (Sciatica) is a disorder in which low back pain is found, that spreads through the hip, to the back of the thigh and down the inside of the leg. Mechanical low back pain (LBP) remains the second most common symptom related reason for seeing a physician. 85% of total population will experience an episode of mechanical LBP at some point during their lifetime. Fortunately, the LBP resolves for the vast majority within 2-4 weeks. There are many causes for low back pain, however true sciatica is a symptom of inflammation or compression of the sciatica nerve. The sciatica nerve carries impulses between nerve roots in the lower back and the muscles and nerve of the buttocks, thighs and lower legs. Compression of a nerve root often occurs as a result of damage to one of the discs between the vertebrae. In some cases, sciatic pain radiate from other nerves in the body. This is called referred pain. Pain associated with sciatica often is severe, sharp and shooting. It may be accompanied by other symptom, such as numbness, tingling, weakness and sensitivity to touch. There is only conservative treatment giving short term relief in pain or surgical intervention with side effect. But these are not successful and therefore those who are suffering from this are always in search of result oriented remedy. Walking distance and SLR test were taken for assessment parameter, VAS score was adopted for pain. Before treatment patient was not able to walk even 4 to 5 steps due to severe pain, was brought on stretcher and his SLR was 30° of right side. After 22 days of treatment he was able to walk up to 500 meters without any difficulty, SLR was changed to 60° and patient had got 80 % relief in pain. This case report showed that Ayurvedic protocol is potent and safe in the treatment of Gridhrasi.

Gridhrasi is a Shula Pradhana Vata Nanatmaja Vyadhi which is characterized by the Kramat Shula in the Prushtha Bhaaga of Sphik, Kati, Uru, Jaanu Jangha and Pada Pradesha. It is corelated with Sciatica based on the aetiology and symptomatology. This disease is mainly caused due the improper postures and the nature of the work. The main challenge is the management of pain. In Modern Science this condition is managed by the administration of Analgesics and in the later conditions Surgery will be advised with no definite relief. Shodhana, Siravyadha, Basti, Agni Karma are the treatment modalities have been mentioned in the classics. Here the study is conducted to evaluate the efficacy of Siravyadha in the management of the Shula in Gridhrasi with a successful outcome.