It is a common notion among people in India that herbal or Ayurvedic products are safe and do not produce any adverse effect. This is not true since Ayurveda has evaded many adverse effects which occur by combination of herbs. This axiom is potentiated by our report that occurs in the form of skin rashes. A 20-year-old South Indian female of Pittakapha prakṛti (constitution) after beginning therapy with Aragvādādi kaṣāyam (ARK) (poly-herbal formulation) and Syrup Talekt (poly-herbal patent formulation) for the treatment of recurrent incidence of abscess. Rash disappeared after stopping the suspected drug and treatment with Vibhītakī kaṣāyam (decoction of Terminilia bellarica) and Śatadhauta ghṛtam. Possible and probable (score 6) were the causality according to WHO-Uppsala Monitoring Centre and Naranjo's Adverse Drug Reaction Probability Scale and grouped under type-B reaction. To the best of our knowledge, this is the first case of skin rashes which seen after administration of ARK and Syrup Talekt. This report highlights the need of implementation of pharmacovigilance center in the hospital level and additional research in the field of skin toxicity of ARK and Syrup Talekt.
Abscess; Aragwadadi kashaya; Ayurveda; skin rashes; Talekt
This is the era of fast foods. Irregularity in food timing, improper diet, and mental stress coupled with a sedentary life disturb the digestive system resulting in increased incidence of hemorrhoids. In the present report, we present two cases of intero-external hemorrhoids. Case 1: A 30-year old young male approached with intero-external hemorrhoid at 11 O’clock position as a primary. Case 2: A 41-year-old female visited with second degree intero-external hemorrhoid at 11 O’clock position. Hemorrhoids present in these patients can be considered as Kaphaja Arṣa. These cases were diagnosed by per rectal digital and proctoscopic examinations by ayurvedic proctologists. In both cases, application of Jīmūtaka Lepa was done under local anesthesia administered using lignocaine 2% with adrenaline. This was followed by manual anal dilatation. Jīmūtaka Lepa was applied to the internal hemorrhoids (Arṣa). Changes were observed in the form of edema, ulcer in 3-4 days and sloughing out of the pile mass up to 5-7 days. Subsequently fibrosis of hemorrhoidal masses started after 7 days. Jīmūtaka Lepa shows a significant effect in obliterating the hemorrhoidal mass within a month of application. The patients were followed-up regularly with proctoscopic examination in each visit and did not reveal any evidence of recurrence of the hemorrhoids.
Arṣa; hemorrhoids; Jīmūtaka; Lepa; Luffa echinata
Anal fistula (bhagandara) is a chronic inflammatory condition, a tubular structure opening in the ano-rectal canal at one end and surface of perineum/peri-anal skin on the other end. Typically, fistula has two openings, one internal and other external associated with chronic on/off pus discharge on/off pain, pruritis and sometimes passing of stool from external opening. This affects predominantly male patients due to various etiologies viz., repeated peri-anal infections, Crohn's disease, HIV infection, etc., Complex and atypical variety is encountered in very few patients, which require special treatment for cure. The condition poses difficulty for a surgeon in treating due to issues like patient hesitation, trouble in preparing kṣārasūtra, natural and routine infection with urine, stool etc., and dearth of surgical experts and technique. We would like to report a complex and atypical, single case of anterior, low anal fistula with tract reaching to median raphe of scrotum, which was managed successfully by limited application of kṣārasūtra.
Anal fistula; avagāha sveda; bhagandara; Goodsall's rule; kṣārasūtra
A 62-year-old, male patient radiologically diagnosed as a case of avascular necrosis of femur head with grade 4, presented the following chief complaints. Pain in the left hip joint radiating to thigh (anterior part), of grade ‘9’ on “visual analog scale (VAS)” associated with swelling in bilateral feet and decreased range of movements in the hip joint. This presentation was correlated with Asthi-majjagata vāta (musculo-skeletal disorder) and treated accordingly. Initially, patient had been administered dīpana and pācana followed by nityavirecana (therapeutic purgation). Further Saghrita kṣīrabasti (medicated enema prepared with milk and ghee) was administered in kalābasti schedule (16 in number). This resulted with relief of pain to grade “3” on “VAS” and complete resolution of pedal edema and improvement in range of movement of hip joint.
Asthi-majjagata vata; avascular necrosis of head of femur; Saghrita ksheerabasti
Three cases of molluscum contagiosum (MC) approached our outpatient Department of Dermatology complaining of umbilicated, skin-colored, firm, painless papules over the neck and face. All of them were immune competent. The medical, social, and family history was insignificant. The lesions were, numerous and recurrent. However, MC in healthy people is a self-limiting disease, but it will take about 18 months to resolve by its own. Hence, the treatment becomes necessary to accelerate the healing process, preventing its spread and for cosmetic reasons. Most of the contemporary treatment methods such as cryotherapy, curettage, and topical application of caustic agents are effective but produce local side-effects such as erythema, tenderness, itching, burning sensation, and pain. The present study reports the efficacy of external application of Pratisaraṇīya Kṇāra (the type of Alkali used for smearing over the affected area) and Bilvādi Agada tablet orally in three cases, which yielded encouraging results.
Ajagallikā; Bilvādi Agada; molluscum contagiosum; Pratisaraniya kshara
A female aged 30 years, consulted the Govt. Ayurveda Hospital, Perinthalmanna with complaints of left side of the body totally paralysed along with severe shivering of the right hand and head and the patient was bedridden for 1½ years. She was diagnosed earlier with spontaneous pontine hematoma (on 10th Nov 2007) and had undergone midline sub occipital craniectomy (on 13th Nov 2007) as an emergency treatment. She developed neurotrophic ulcer in the right eye with lagophthalmos post-surgery. The patient showed no improvement to treatment but further developed stromal abscess and hence paramedian tarsorraphy (4th Jan 2008) was done. The deficits in the right eye led to diminution of vision of that eye after Allopathy treatment. The patient sought Ayurvedic treatment for a better prognosis. The patient was under Ayurvedic treatment from 5th Mar 2009 to 24th Nov 2009. During that period Ayurvedic treatment such as abhyaṅga (oil massage), patra poṭṭalī sveda (use of poultices) and mṛdu virecana (purgation) was also done. After a period of 8 months of internal medication and treatment, the shivering of the right hand and head resolved. She could move the left leg and left hand and started walking without support. There was gradual loss of vision during the course of Ayurvedic treatment. At present, the patient is able to move around and do household works on her own.
Ayurveda; case report; pontine haemorrhage
Venous ulcers (stasis ulcers, varicose ulcers) are the wounds occurring due to inappropriate functioning of venous valves, usually of the legs. It is one of the most serious chronic venous insufficiency complications. The overall incidence rate is 0.76% in men and 1.42% in women. When a venous valve gets damaged, it prevents the backflow of blood, which causes pressure in the veins that leads to hypertension and, in turn, venous ulcers. These are mostly along the medial distal leg, which is often very painful, can bleed, and get infected. Treating varicose ulcers is a difficult task to the physician and a nightmare to the suffering patients, though a good number of the treatment principles are mentioned and practiced in allied sciences. In Ayurveda, this condition is considered as duṣṭa vraṇa. It can be managed with the specific s’odhana therapy. So, the same treatment protocol was used to treat the case discussed here, i.e. with Nitya virecana and by Basti karma. The wound was successfully treated and, therefore, is discussed in detail.
Basti karma; Dustha vrana; Nitya virechana; varicose ulcer
Sadyo Vamana is a type of purificatory measure mentioned in Ayurveda, which to expel the pus and morbid factors present in a dental abscess without opening it. However, Sadyo Vamana's role in fever and pus filled dental abscess has not been reported so far. I report a case of dental abscess with fever. A 24-year-old male patient with a pus filled dental abscess. His fever and dental abscess didn’t respond to antibiotic and analgesic treatment for 10 days. The patient was given Sadyo Vamana (instant therapeutic emesis) to expel the accumulated pus in dental abscess without opening it. The patient got complete relief from fever and dental abscess after Sadyo Vamana. The patient not gave internal medication.
Danta arbuda; dental abscess; instant therapeutic emesis; Sadyo Vamana
A 55-year-old female presented at Department of Pañcakarma with diagnosis of progressive supranuclear palsy (PSP). For assessing disability, progressive supranuclear palsy rating scale (PSPRS) was used and balance was assessed by using Tetrax Interactive Balance System (IBS) posturography. Āyurvedic treatment was given along with Pañcakarma and balance exercises for 3 months. As part of Āyurvedic treatment, first Virecana karma was done with classical method and then Mātrā basti, Śirobasti, and other palliative treatment was given for 3 months. Amanatidine was not continued during Virecana karma but started thereafter. On comparison with pre-intervention scores, there was a significant improvement in the patient post-treatment. The features which mainly showed improvement were: Eye movements, spontaneous episodes of laughing, dysphagia, dysarthria, double vision, and neck rigidity. Balance showed significant improvement and there was a remarkable decrease in the postural sway. This case study may present new possibilities for treatment of neurodegenerative diseases by Āyurveda.
Āyurveda; Basti; Pañcakarma; progressive supranuclear palsy; Śirobasti; Virecana
Dashanga Lepa is a polyherbal preparation of Ayurveda, used to treat many skin ailments and rheumatoid arthritis. However, its toxicological property has not been reported so far. We report a rare case of cutaneous adverse reaction in the form of skin rash following the application of Dashanga Lepa. A 42-year-old female patient with a Pittakaphalaprakruthi (constitution) developed skin rashes, soon after the application of Dashanga Lepa over the applied area, which disappeared after stopping the suspected drug and starting treatment with Shatadhauta ghritha. The patient was again treated with the same formulation after a span of a month, which led to the reappearance of a similar type of rash. The temporal relationship, positive dechallenge, and rechallenge are strong associations between the event and formulation. No such reaction was noticed by any other patient with the suspected medicine.
Ayurveda; cutaneous adverse reaction; Dashanga Lepa; rheumatoid arthritis; skin rash
A case of stricture of membranous urethra was treated with medicated oil used as Uttara Basti (administration of medicated oil through urethra) once daily for seven consecutive days. The treatment was repeated at a monthly interval for two months. The patient obtained remarkable improvement in his condition. This case highlights the fact that it is possible to treat the cases of urethral stricture with Uttara Basti.
urethral stricture; Uttara Basti