Role Of Panchakarma With Special Reference To Basti Chikitsa In Musculoskeletal Disorders: A Critical Review

Musculoskeletal conditions affect people of all age groups in all regions of the world. According to the Global burden disease report, musculoskeletal disorders are an increasing healthcare issue and have become the second most common cause of disability. Musculoskeletal conditions are characterized by pain, limitations in mobility, dexterity and functional ability which restrict a person’s ability to work and participate in society which in turn affects mental well being as well. According to the data by WHO 20-30% of people across the globe live with a painful musculoskeletal conditions. Pain and restricted mobility are the main features in MSD and the drugs used in contemporary medicine are analgesics, NSAIDS, DMARDS, corticosteroids etc. which are associated with long term adverse-effects. In Ayurveda Classics MSD’s can be related with the various diseases described under Vatavyadhi. Basti is the best line of treatment for treating all types of Vataja disorders. By reviewing the classical texts, it is understood that the Basti reaches in Pakawashaya and from there works on all the organs by virtue of the Virya (~potency) present in Basti dravyas. In this article an attempt has been made to explain effect of Basti chikitsa in the management of musculoskeletal disorders through analysis of various researches performed. Also various research papers available through Pub med, Google scholar, Wikipedia and websites has been compiled in this articles which can be practiced in daily basis that will lead to betterment of the patient’s conditions.

Management Of Sciatica Through Ayurveda: A Case Study

In India low back ache is one of the most common emerging diseases which are affecting day to day life of people physically as well as psychologically. Low back ache is the second most common disorder causing disability. Among its various causes the most commonly appearing one is Sciatica. Sciatica is a condition in which pain starts from low back and radiates to leg mostly unilateral but in some, it may be bilateral also. In Ayurvedic perspective its features resemble to those of Gridhrasi. In Ayurvedic classics two types of Gridhrasi have been described namely Vataja and Vata-kaphaja. The case study being presented is of a 44yr old male patient suffering from Vataja gridharsi. Basti karma is the choice of treatment in cases of Gridhrasi where as Snehana/ Snigdha svedana is choice of treatment for any Vataja disorder. So, Panchakarma therapy in this case includes Patrapindasveda, Sarvang vashpasveda and Basti therapy along with oral medication assessed on the basis of Oswestry disability index. The results indicate that the patient improved in presenting features up to 68.75% as well as day to day activities were also performed effectively by him.

A Cadaveric Study of Normal and Variant Levels of Division of Sciatic Nerve and Coupled Anomalies with Clinical Application in Surgical Interventions.

Background: Sciatic nerve, the thickest and the largest nerve of the body, is formed in the pelvis. After passing through the greater sciatic foramen, it enters the gluteal region, and subsequently the nerve passes on the back of thigh to reach the superior angle of popliteal fossa where it bifurcates into tibial and common fibular nerves. It usually divides into its terminal branches outside the pelvis; however it may rarely divide within the pelvis. In such cases, the tibial nerve and the common fibular nerve may leave the pelvis through different routes. The knowledge of different routes of exits of the sciatic nerve is of utmost importance for the surgeons and the interventionists dealing with this region as this is the site of innumerable surgical manipulations as well as nerve injuries during deep intramuscular injections in gluteal region, failed sciatic nerve block in anaesthesia and injury during posterior hip surgeries. These variations may result in non-discogenic sciatica because of the nerve compressions under other adjacent anatomic structures. Purpose of the study: This study is an attempt to analyse the course, distribution and levels of the division of sciatic nerve into tibial nerve and common fibular nerve and their clinical implications. Results: Out of the total 120 lower limbs studied, deviation from the usual described pattern was observed in four limbs. One cadaver showed bilateral variation while other two described unilateral disparity from the standard prototype. Conclusion: This knowledge of variant anatomy of division and course of sciatic nerve and its terminal branches will not only assist surgeons to take care during interventions, but also facilitate to plan accordingly during various surgical procedures and management.

Normal and variant origin and branching pattern of inferior phrenic arteries and their clinical implications: a cadaveric study.

Background: Inferior phrenic arteries, which constitute the chief arterial supply to the diaphragm, are generally the branches of abdominal aorta, however, variations in their mode of origin is not uncommon. Very less information is available regarding the functional anatomy of the inferior phrenic artery in anatomy textbooks. Methods: The present study was conducted utilizing 36 formaline-fixed cadavers between 22 years to 80 years over a period of 5 years. The frequency and anatomical pattern of the origin of the right and left inferior phrenic arteries were studied. Results: On the right side, the inferior phrenic artery arose independently from abdominal aorta in 94.4% cases and on the left side in 97.2% cases.Other sources of origin were seen in 5.55% cases. Left hepatic artery was seen as the source of origin for right inferior phrenic artery in one case while in second case left gastric artery was the source for both the right and left inferior phrenic artery. The right inferior phrenic artery is the most common source of collateral arterial supply to hepatocellular carcinoma, next to the hepatic artery. Conclusion: Knowledge of variations of inferior phrenic artery origin could be valuable during treatment of hepatic neoplasm, liver transplants, biliary tract surgery and during tanscatheter oily chemoembolisation technique.

Frequency of abnormal branching pattern of axillary artery: a cadaveric study.

Many authors suggest that abnormal branching pattern of axillary artery is very common. This compelled us to explore the axillary region of 20 formalin fixed cadavers of either sex to note the frequency of unusual branching of axillary artery over a period of five years. Axillary artery branched normally as described in various textbooks of Anatomy in thirty nine (97.5%) out of forty axillae examined. Only in one axilla (2.5%), it was observed that the second part of axillary artery branched unusually whereas on the other side it branched normally. Knowledge of such abnormal presentation of the axillary artery in the era of reconstructive surgeries is of great help to the interventionist so as to avoid any vascular catastrophe resulting in some kind of mishap. Awareness of such unusual branching pattern of axillary artery is also of great importance to vascular surgeons and radiologists dealing with this region. Embryological origin and the clinical relevance of the abnormality encountered in the branching pattern of the axillary artery in the present study have been discussed in the paper.