Modern medical Science has offered many surgical procedures like open and closed haemorrhoidectomy, anal dilatation, Sphincterotomy etc for haemorrhoides and fissure in ano. These operative procedures are associated with unavoidable sequel of symptoms like Pain, Discharge and Inflammation etc. Role of analgesia is vital in the treatment of post-operative pain. The mode of analgesia depends on degree or level of pain which is a subjective criteria. Analgesics routinely used are NSAIDs, opioids and corticosteroids. Side effects includes like Gastritis, Gastrointestinal bleeding etc. Hence, Analgesia has to be supplemented with antacids or H2 Receptor Agonists. Here, quest for knowledge for an alternative treatment to analgesics starts. According to Sushrutacharya, these diseases like Arsha and Parikartika are termed as Chhedya, i.e., treatable by surgery and he has indicated Yashtimadhu Ghrita in Shastranipataja Vedana. Methodology- In present study, total 100 postoperative patients of haemorrhoids and fissure in ano, randomly allocated into two groups (50 in each group). In Group A (n = 50), Yashtimadhu Ghrita Gudapurana was done every day after sitz bath for 5 days. In Group B (n = 50), local application of lignocaine jelly every day after sitz bath for 5 days. Result- Yashtimadhu Ghrita as a local application is clinically as effective as lignocaine jelly in the management of post operative pain in patients of hemorrhoids and fissures in ano. Conclusion- it was concluded that Yashtimadhu Ghrita is helpful in the management of pain in the post operative patient of haemorrhoids and fissure in ano
Chronic non healing wounds represent a significant public health problem. A wound may be acute or chronic; the later could be defined as a wound that is not continuously progressing towards healing, which can be correlated with Dushtavrana. Various therapies are potentially conducive to wound healing, and according to T.I.M.E. principle of wound healing; E stands for edges of wound which is undermined due to chronicity and infection, corrected by debridement and Leech therapy is biological debridement therapy. It is a para-surgical procedure which serves debridement of the wounds by the blood sucking and oozing phenomenon. Jalaukavacharana possesses high efficacy in both Vrana Shodhana and Ropana, hence can be used for management of Dushta Vrana. Jalaukavacharana being a bio-purificatory method removes deep seated toxins, clearing Srotasa and pacifying vitiated Doṣha. Salivary gland secretions of leech have multiple actions like analgesic, anti-inflammatory and antibacterial which serve the purpose of wound healing. Keeping in mind, all the fundamentals & surgical applications of Leech therapy, a pilot study of 15 patients with chronic non healing wound was conducted. Observations were recorded on alternate days for 15 days. Within treatment analysis of the Chronic Non Healing Wound showed that T.I.M.E. principle reflected significant healing of wound after 7 days of leech therapy & supplementary protocol. The results of this pilot study in management of Chronic Non-Healing wound (Dushta Vrana) by Leech therapy (Jalauakavacharana) highlights the wound healing effects significantly.
Parikartika i.e. Fissure-in-ano is the most common disease amongst anorectal disorders characterized by severe cutting pain in anal region. Modern treatment includes local application of soothing ointments, oral analgesics and stool softeners in initial condition. Surgical management includes Lord’s dilatation, fissurectomy and lateral Sphincterotomy. But it may lead to complications like bowel incontinence and recurrence. So it is a need of hour to find an alternative and better treatment option. While managing Parikartika, two important things should be taken into consideration- to reduce pain at anal region and to heal the fissure. Keeping these aspects in mind, a pilot study was conducted using local application of Sarjarasa Malahara in the treatment of Parikartika. Methodology: Total 15 patients diagnosed as Parikartika were selected for this study. Sarjarasa Malahara was applied locally in fissure bed twice a day after sitz bath for 28 days. Result: Very encouraging result of local application of Sarjarasa Malahara was noted. Pain, bleeding, itching at anal region and spasm were significantly reduced. Considering overall effect out of 15 patients 13 patients of Parikartika were completely cured i.e. 87% (P=0.0003) and 2 patients were markedly improved i.e. 13% (P=0.0231) at the end of 28days.Conclusion: Considering all above properties of individual drugs, observations and results it can be said that Sarjarasa Malahara is effectively useful in reducing pain, inflammation, itching, spasm and bleeding per rectum and healing of fissure at anal region. Hence, it can be concluded that Sarjarasa Malahara is useful in the treatment of Parikartika.
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