ABSTRACT
Majority of patients visiting Ayurvedic hospitals are having ailments related to joints especially low back pain and knee joint pain. Low back ache may be due to many reasons ranges from muscular pain to complicated neurological complaints or malignancy. Disc herniation is also a major reason for low back ache in which radiculopathy might be a typical feature. In all systems of medicine many treatments exist to manage low back ache and sciatica. In Ayurveda also different treatment modalities are present ranging from simple internal medications to complex therapies like Basti (therapeutic enema), to effectively tackle such conditions. The Ayurvedic formulation, Rasna guggulu is mentioned in the treatment of Gridrasi (sciatica). To standardize any formulation its properties should be studied repeatedly in detail. Even though this formulation is comparatively a simpler one consisting of only 3 ingredients, its properties and identifying features are not widely studied. In this study pharmacognostical, organoleptic and physico-chemical characteristics of Rasna guggulu were reported. Pharmacognostical study of this drug reveals the presence of epidermal cells, starch grain, lignified stone cells, prismatic crystals, simple fiber, simple trichome, warty trichome, annular vessels and spiral vessels of Rasna along with oil globules of clarified butter. HPTLC shows 8 and 7 spots at 254nm and 366nm respectively which suggests the presence of 7 – 8 active principles in this drug. This study also can be considered to standardize the formulation, Rasna guggulu.
ABSTRACT
Cauda equina compression at the level of L4/L5 or L5/S1 level is a surgical emergency with potentially significant consequences, including motor and sensory dysfunction. The causes include disc herniation, spinal stenosis, cancer, trauma, epidural abscess. The common cause is usually a disc herniation which is most commonly due to trauma, age, connective tissue disorders and congenital disorders. Cauda equina syndrome a disorder caused by compression of the nerve roots in the cauda equina region. This can cause permanent loss of bladder and bowel control if not treated within time. The incidence of a herniated disc is about 5 to 20 cases per 1000 adults annually and is most common in people in their third to the fifth decade of life with a male to female ratio 2:1. If decompressive surgery is delayed, there can be catastrophic consequences for the patient in terms of bladder, bowel and sexual function. In the present case study, a 36 year old female patient who was diagnosed as a case of Cauda Equina compression due to an extruded L4-L5 disc refused to undergo surgery and opted for Ayurvedic treatment. She was admitted in the Kayachikitsa IPD for 45 days. She was treated with the principle of Gridrasi along with Pakwasayagata vata. Deepana pachana and Vasti or Sodhana is the main treatment choice. Rooksha and Snigdha swedas were done which also help to reduce the stiffness and pain. After the management her physical condition and quality of life improved.