Efficacy of Ayurvedic Medicines and Leech Therapy on Psoriasis, Complicated by Recurrent Cellulitis: A Case Report

Cellulitis and Psoriasis are common bacterial skin infections. Psoriasis affects 1-3 percent of the world's population. According to Ayurveda, it is a curable disease, and leech therapy, a bloodletting method is considered the effective method in the treatment of psoriasis and cellulitis with no side effects. To evaluate the efficacy of leech therapy, Ayurvedic medicine, and lifestyle modification in the management of psoriasis complicated by recurrent cellulitis and other co-morbidities. This is a case report of a known diabetic and obese 39-year-old female patient. An Ayurvedic management plan and dietary modifications with leech application were administered to the patient. Leech application was done in five sessions with regular follow-ups. Leech therapy showed outstanding results in producing symptomatic relief for patients. It has helped the patient in reducing the condition of Psoriasis and Cellulitis with no common steroid therapy complications like weight gain and hyperglycemia. In this study, leech therapy showed excellent results in producing symptomatic relief for the patient. Leech therapy has a considerable anti-psoriatic and anticellulite impact without causing any toxicity or side effects.

Raktamokshana- Ancient Blood Letting Technique: A Review

Ayurveda is a science that focuses on both well-being and disease treatment. Many surgical and para-surgical procedures have been described by Acharya Sushruta for the management of various diseases; among these, Raktamokshana is popularly used for the management of various pathologies occurring due to Rakta Dushti (blood-borne disorders). It is derived from two words i.e., ‘Rakta’ which means blood & ‘Mokshana’ which means leave. Hence, Raktamokshana means to let the vitiated blood out. It is one of the five purification therapies by Acharya Sushruta. There are two ways to do Raktamokshana i.e., Shastra Visravana (using sharp instruments) and Anushastra Visravana (without using sharp instruments). Furthermore, it is said that Siravedha is ‘Chikitsaardha’ i.e., half of the treatment described in Shalya Tantra is similar to a well-performed Basti karma (Therapeutic Medicated Enema) advocated in Kaya-Chikitsa. However, there are relatively limited recommendations or use of Raktamokshana in clinical practices nowadays which may be due to fear associated with the procedure, lack of skillfulness, and unawareness about the efficacy of Raktamokshana in various diseases. This review article is specifically intended to assemble the usefulness of numerous modes of Raktamokshana based on Ayurvedic parameters with its detailed procedure

Leech infestation: Our experience at Government Medical College, Rajouri

Leech invasion into a bodily cavity or orifice is known as hirudiniasis. This article’s objective is to explain an uncommon cause of epistaxis brought on by a leech infestation in the nasal cavity, nasopharynx, or oropharynx in the hilly Rajouri district of Jammu and Kashmir, as well as how to manage it. This retrospective case series consisted of seven cases. All the cases present with unilateral epistaxis. Anterior rhinoscopy with or without endoscope reveal smooth, grayish-black mobile leech inside nasal cavity, nasopharynx, or oropharynx which was removed by suction or forcep.

Role of Leech Application with Ayurvedic Medication in the Management of Non-Healing Wound

Wound is breaking in the continuity of any bodily tissue due to external action, by cut, bruise, or hematoma. From the time of Vedas wound and its management is one of the challenging task with which health science is dealing. A chronic wound is the wound that does not heal in an orderly set of stages and in a predictable amount of time or wounds that do not heal within three months are often considered chronic. There are many factors involve in healing of any wound. All factors should present at correct time to heal any wound but absence of any factors leads to delayed wound healing or non-healing wound. Modern science has explained in wound healing it involves Multiple cell actions and extracellular matrix and soluble mediators such as growth factors and cytokines. According to science wound dressings are conventionally only applied to shield the wound from external contamination so they don’t have any involvement in wound healing. In advanced era technology related to wound healing is developing rapidly. In Ayurveda Acharya Sushruta described various therapies for wound management i.e., Shashti Upakrama. One of them is Jalaukavacharan, leech application on the wound site. As leech contains various chemicals in their saliva, this chemical helps in reducing the blockage in the capillaries and improves micro- circulation. Here is a case study of patient suffering from non-healing wound treated with leech application.

Effectiveness of Panchavalkala Pralepa and Jalaukavacharana in Reducing Duration for Regression of Vranashopha w.s.r. to Cellulitis: A Randomized Controlled Trial

Acharya Sushruta was well aware about importance of Vranashopha (stages of abscess formation), Vrana (wound) and their management in surgical practice, along with its unfavourable and untreated complications. The Vranashopha is described as earlier phase of Vrana. Sushruta has mentioned detail description of inflammatory swelling under the heading of Vranashopha. Among the all-available treatment modalities for Vranashopha (Cellulitis), the Jalaukavacharana and Jalaukavacharana with Panchavalkala Pralepa is found to be more effective by considering its feasibility, adoptability, cost-effectiveness and curative results. Sushruta has mentioned Lepa for local application in the treatment of Vranashopha. Methodology: In this present study, Jalaukavacharana, which is one of the proven therapy for treatment of Vranashopha was compared with easily available drug Jalaukavacharana with Panchavalkala Pralepa, by its local application directly on Vranashopha, to find out its effectiveness. A total 70 patients were randomly selected and divided in two groups. Jalaukavacharana and Jalaukavacharana with Panchavalkala Pralepa was done in group A and group B respectively for once for 5 days and observations are noted on 1st, 3rd, 5th, 10th and 15th day and the result was assessed thoroughly on the basis of observation according to the specially designed proforma. Result: Jalaukavacharana with Panchavalkala Pralepa was found to be more effective in all the four criteria, low cost therapy and easily available throughout the year. Conclusion: it was concluded that Jalaukavacharana with Panchavalkala Pralepa shown significant improvement in reducing pain, swelling, redness, local temperature and healing of wound at affected site without any side effect. Hence, it can be concluded that this Pralepa is useful in the treatment of Vranashopha (Cellulitis).

The repellent effect of tea tree oil emulsion on leeches / 药学学报

Leech bites usually lead to more bleeding, and dermal tissue is damaged to form lifelong scars. If leeches enter the body cavity, it will be more dangerous. Therefore, there is an urgent need to develop effective repellents. In this study, oil in water (O/W) emulsion of tea tree oil was prepared with tea tree oil as the main ingredient, and konjac glucomannan (KGM), ethyl cellulose (EC) as the main excipients. The filter-paper ring method and repellent test in water were used to evaluate the repellent effects on leeches. The animal experiments were approved by the Ethics Committee of Academy of Military Medical Sciences and were conducted in accordance with relevant guidelines and regulations. The activities of acetylcholinesterase (AchE), glutathione S-transferase (GST) and carboxylesterase (CarE) in vivo were measured to clarify the repellent mechanisms. The results showed that a uniform and stable tea tree oil emulsion was successfully prepared, which has excellent hydrophilicity and can effectively repel leeches. The tea tree oil emulsion has a good repellent effect on leeches, which can avoid the volatilization of tea tree oil and prolong the effective repelling time. The novel formulation of tea tree oil provides a new idea for repelling effects with long time and high efficiency based on similar essential oil.

Evaluation of selected plant extracts for in vitro anti-marine leech (Zeylanicobdella arugamensis) activity

@#The aqueous extracts of thirty-four (34) tropical plants were tested in vitro for potential anti-marine leech (Zeylanicobdella arugamensis) activity. The anti-leech activity was determined by exposing 8 adult leeches (Z. arugamensis) (9.3 ± 1.5 mm, aged 15 days) to 20 μl of plant extract (0.5 g/ml) for 5 min in a 24-well plate. After 5 min of exposure, the leeches were rinsed and transferred into seawater, to enable them to revive from the effect of the extract. Leech movements were observed from time to time and the numbers of paralyzed or dead leeches were recorded at 5, 20, 30 and 240 min. The efficacy of the plant extract in killing the adult Z. arugamensis during the 5 min exposure is reflected on the anti-leech property of the extract. The anti-leech property of positive plant extracts was also determined at different exposure time (1, 3, 5 min) and dilutions (1/2 (0.25 g/ml), 1/5 (0.1 g/ml) and 1/10 (0.05 g/ml). The extracts of 4 plants (Melastoma malabathricum, Piper betle, Tetracera indica and Etlingera coccinea) demonstrated anti-leech activity. The effects of M. malabathricum, P. betle and E. coccinea extracts on the leeches were very rapid causing death as early as a few seconds upon exposure. However, all four positive plant extracts were found not effective in killing the leeches at 1/10 dilution (0.05 g/ml). A Scanning Electron Microscopy examination on leeches exposed to the positive plant extracts exhibited effects such as protruding proboscis and shrunken or swollen bodies.

Management of herpes zoster in Ayurveda through medicinal leeches and other composite Ayurveda Treatment

Herpes zoster commonly known as shingle's caused by varicella zoster virus (VZV). Recent studies have shown that exosomes play important role in pathogenesis as well as spread of herpes. Leeches when applied over affected part of herpes sucks the blood and there by interferes with extracellular communication through these exosomes and their by showing pain reduction, reduction in burning and arrest progression of disease. This technique is cost effective and easy to apply. In Ayurveda herpes can be correlated with Pittaj visarpa. Principle of treatment is Raktmokshan (~Bloodletting) and Pradeha (~Local application of medicines). Bloodletting with Jalauka (~Medicinal Leeches) is specifically indicated in management of Pitta dominant disorder. A 65-year-old female known case of Type 2 Diabetes (DM) and presented in Casualty of Government Ayurved College, Nagpur (GACN). We treated her Herpes zoster on the basic principles of management of Pittaj Visarpa. Management of Type 2 DM was continued as per modern medicine consultant. Rapid decrease in pain severity was observed after the 1st setting of leech therapy according to Zoster Specific Brief Pain Inventory (ZBPI) Questionnaire. After each seating pain reduction was observed. Repeated application of Jalauka along with internal medications gave complete relief. Ayurveda pain management in herpes zoster by leech therapy gives innovative easy, better and cost effective treatment. Adaptive trials are necessary to explore further practical applicability of Ayurveda and modern treatment together. Future research on effect of leech application on exosomes is necessary.

Effect of Irsale Alaq (leech therapy) in thrombosed pile mass: a case study

Among all the diseases of gastrointestinal disordershaemorrhoidis the commonest and troublesome disease. Haemorrhoids are dilated veins within the anal canal. The condition becomes worse after thrombosis and strangulation of the pile mass. Urgent surgical intervention is required in all the cases. Patient strucks in serious woe and seeks urgent surgical attention. Leeches can be used as a successful tool in this situation for the purpose of bloodletting as accumulation of morbid humor is the main cause of haemorrhoid in Unani system of medicine. In present case study,a patient of thrombosed pile mass was cured by Irsale Alaq(leech therapy)

The inhibitory effect of leech extract on human retinoblastoma cells / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To evaluate the effect of leech extract on human retinoblastoma WERI-RB-1 cells.<p>METHODS: WERI-RB-1 cells with different concentrations of leech extracts(0.02, 0.04, 0.08 and 0.16U/mL)were cultured in vitro for 0, 24, 48 and 72h. The optimal drug intervention concentration and time were selected by CCK-8 method for subsequent experiments. WERI-RB-1 cells cultured <i>in vitro</i> were divided into control group(normal culture medium)and experimental group(culture medium containing leech extract). Flow cytometry was used to detect the effects of drugs on cell cycle and cell apoptosis, and Transwell invasion assay was used to detect the effects of drugs on cell invasion abilit. <p>RESUITS: According to the detection results of CCK-8 method, the optimal intervention conditions were 0.04 and 0.08U/mL leech extract for 48h. The cells in the leech extract intervention were mainly blocked at G2/M stage, and the positive cell rates in the 0.04 and 0.08U/mL groups were(12.59±5.36)% and(14.79±4.12)%, respectively, which were significantly higher than those in the control group \〖(3.00±2.32)%, <i>P</i><0.01\〗. The apoptosis rate of the cells in the 0.04 and 0.08U/mL groups was(37.91±3.44)% and(33.05±2.25)%, respectively, which were significantly higher than that in the control group \〖(4.64±2.56)%, <i>P</i><0.01\〗. The results of Transwell invasion assay showed that the number of cells under the Transwell chamber in the experimental group was significantly than that in the control group, indicating that the leech extract could inhibit cell invasion.<p>CONCLUSION: The leech extract can inhibit the proliferation and invasion of human retinoblastoma cells and induce cell apoptosis <i>in vitro</i>.

An Ayurvedic Multimodular Treatment Of Alopecia Totalis (khalitya) W.r.t Panchakarma: A Case Report

Alopecia areata is characterized by circumscribed non-scarring loss of hair in single or multiple patches over the scalp or body hair. Histopathology shows perifollicular and intrafollicular inflammatory cells infiltrate composed mainly of lymphocytes, described as swarm of bees’ appearance. The characteristic lesion is an asymptomatic, smooth bald patch with normal skin within the patch. Fine regular pitting of nails and tachynochia is a common association. When the hair loss involves the entire scalp it is known as alopecia totalis. Khalitya in Ayurveda is a disease in which Pitta combining with Vata and getting into the pores of hairs (hair follicles) cause fall of hair, and then Kapha along with Rakta obstructs the pores of those hairs and makes it impossible for other hair to grow. As it does not destroy the hair follicles the potential for the re-growth is maintained for many years. However growth in alopecia totalis and universalis is limited. Material and Methods: The present clinical study is a case report on the efficacy of Shamana (pacification) medication along with Vamana (therapeutic emesis), Virechana (therapeutic purgation), Basti (therapeutic Enema) and Nasya (therapeutic nasal medication) and Raktamokshan (therapeutic bloodletting) in the management of a patient diagnosed as Alopecia totalis. Results: There was significant re-growth of the hair of the scalp. SALT Score improved from 97.76 to 2. Discussion: The collected data from this study suggests that Ayurvedic Shodhana (Purification) treatment along with Shamana medications can provide an efficient result for managing Alopecia totalis.

Ayurvedic management of Ulcerative Keratitis – A case report

Ulcerative Keratitis is a sight-threatening corneal infection. It is one of the most common global causes ofirreversible blindness due to corneal diseases. This case report highlights the potential of Ayurvedicmanagement in nonresponding ulcerative keratitis. A 20 year old boy came to the outpatient departmentwith redness, discharge, photophobia and defective vision in the right eye since 4 months following aforeign body injury. He was treated at leading ophthalmic hospital for keratitis but due to poor responsewas suggested keratoplasty and the patient had opted for Ayurvedic treatment. He was initially treated inthe OPD and since he started responding well to treatment, he was admitted in the hospital. He underwent Jaloukavacharana, Snehapana, Virechana, Nasya, Anjana, Tarpana and Putapaka. He wascompletely relieved of pain, redness, discharge, photophobia. His BCVA was hand movements at the timeof the first visit and it improved to 6/24 at the time of discharge. Ayurveda has an important role to playin infective eye diseases which needs to be explored scientifically.© 2018 Transdisciplinary University, Bangalore and World Ayurveda Foundation. Publishing Services byElsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Indralupta (alopecia Areata): A Case Successfully Treated With Jalukavcharana (leech Therapy)

Hair disorders cause negative impact towards the individual and his/her quality of life. Indralupta is a Kshudraroga characterized by loss of hair. It can be correlate with alopecia areata, which is having chief complaint of hair loss on body especially on scalp without any clinical inflammatory signs. Raktamokshana is a technical term employed to denote a para-surgical procedure to expel out the vitiated blood from selected areas of the body, by specific methods. Ayurveda classical text propounds practical guidelines for bloodletting and claims it as most effective therapy in half of the body ailments. Jalaukavacharna Karma (Leech therapy) is considered as the ideal method to expel out the vitiated blood safely, quickly, and effectively. Here a case of Indralupta (alopecia areata) successfully treated with Ayurveda Raktamokshana treatment is recorded.

Unusual vaginal bleeding due to a leech bite in a girl from a tropical area: a case report

Abstract This study describes the isolation of a leech following the presentation of unusual vaginal bleeding. Vaginal bleeding in children due to a leech bite is very rare. This is the first report of severe bleeding in a virgin 14-year-old girl from Mashhad, Iran due to the presence of a leech in the vagina.

Serotonin induces or inhibits neuritic regeneration of leech CNS neurons depending on neuronal identity

Recovery of motor function after central nervous system (CNS) injury is dependent on the regeneration capacity of the nervous system, which is a multifactorial process influenced, among other things, by the role of neuromodulators such as serotonin. The neurotransmitter serotonin can promote neuronal regeneration but there are also reports of it causing restriction, so it is important to clarify these divergent findings in order to understand the direct scope and side effects of potential pharmacological treatments. We evaluated the effect of serotonin on the extent of neuritic outgrowth and morphology of three different neuronal types in the leech Haementeria officinalis during their regeneration in vitro: Retzius interneurons (Rz), annulus erector (AE) motoneurons, and anterolateral number 1 (AL1) CNS neurons. Neurons were isolated and cultured in L15 medium, with or without serotonin. Growth parameters were registered and quantified, and observed differences were analyzed. The addition of serotonin was found to induce AL1 neurons to increase their average growth dramatically by 8.3-fold (P=0.02; n=5), and to have no clear effect on AE motoneurons (P=0.44; n=5). For Rz interneurons, which normally do not regenerate their neurites, the addition of concanavaline-A causes substantial growth, which serotonin was found to inhibit on average by 98% (P=0.02; n=5). The number of primary neurites and their branches were also affected. These results reveal that depending on the neuronal type, serotonin can promote, inhibit, or have no effect on neuronal regeneration. This suggests that after CNS injury, non-specific pharmacological treatments affecting serotonin may have different effects on different neuronal populations.

Construction of engineered Streptococcus zooepidemicus for the production of hyaluronic acid ligosaccharide / 生物工程学报

Hyaluronic acid (HA) is widely used in many fields, such as medicine, cosmetics and food. The bioactivity of HA depends on its molecular weight (Mw). Owing to the important physiological activities and special physiological functions, HA oligosaccharides have important application prospects in medicine fields. Streptococcus zooepidemicus has wide applications in commercial production of HA, due to its short fermentation cycle and strong production intensity. In order to efficiently synthesize HA oligosaccharides and solve the dissolved oxygen in the fermentation process, in this study, we overexpressed HA synthase (HasA) and introduced and optimized the leech hyaluronidase LHAase in Streptococcus zooepidemicus WSH-24. As a result, HA oligosaccharides were efficiently produced with improved dissolved oxygen. After 24 h, HA oligosaccharides production intensity reached to 294.2 mg/(L·h), and the concentration accumulated to 0.97 g/L in flask cultures, which was 1.82 times of the wild strain. Impressively, HA oligosaccharides were increased to 7.06 g/L in 3 L fermentor. The constructed Streptococcus zooepidemicus strain for producing HA oligosaccharides would have broad application prospects.

Attai Vidal (leech Therapy) In Siddha System Of Medicine And Their Current Concept In Therapeutic Application - A Review

The Siddha system of medicine is an unique traditional system of medicine practiced in Tamil speaking countries particularly India. In Siddha system of medicine the diseases were treated through internal and external medicine. In external medicine, the leech therapy is one which is used to treat various non-surgical and surgical cases. The leeches have been used for therapeutic purposes since their beginning of civilisation. Ancient Indian, Egyptian, Greek and Arab physicians were used the leeches for wide range of diseases such as inflammatory condition, skin diseases, respiratory disorders, eye diseases, cardiac diseases, urinary and reproductive diseases and dental diseases. The leeches are also used as one of the bloodletting methods in Unani, Ayurveda, and Modern science for various clinical conditions. Recently, researches on leech saliva revealed the presence nearly 100 biologically active compounds such as Hirudin, vasodilators, hyaluronidase, anaesthetics, fibrinases, antibacterial, collagenase etc. The above mentioned pharmacological compounds are injected into human body while sucking of the blood and are responsible for the anaesthetic, anti-inflammatory, anticoagulant and analgesic effect of leech application. In current scenario, the leech therapy is used for various diseases including life threatening diseases such as cardiovascular diseases, cancer, etc. in different system of medicine including modern medicine. Leech therapy is used in plastic and microsurgery as a protective tool against vascular congestion in modern medicine. The Scientific studies on leech saliva were proven and support the leech application in Siddha system of medicine.

Cloning of Guamerin gene in Whitmania pigra and its spatio-temporal expression analysis after ingestion / 中国中药杂志

The present study cloned wpGuamerin gene from a non-bloodsucking leech (Whitmania pigra), and the bioinformatics analysis of the sequence was performed. Additionally, the effects of feeding duration on the expression profile of the wp Guamerin gene were explored. The results showed that its sequence consisted of 295 nucleotides encoding a peptide of 83 amino acids(Genbank: KX768545), and its relative molecular weight is 9 145.95 Da. wp Guamerin does not encode proteins with a signal peptide, belonging to the hydrophilic protein. Its secondary structure is mainly composed of α-helix, extending chain, folding and random curl. Its similarity with other blood-sucking leeches ranges from 29% to 65%. The results revealed that wpGuamerin mRNA was detected higher expression in muscle than in salivary glands of Wh. pigra, and did not expressed in ingluvies and intestine. Its expression in muscle and salivary glands showed a single peak curve after feeding and the peak was observed in the 1st and 3rd after feeding, respectively. In summary, wp Guamerin in Wh. pigra is a small molecule polypeptide protein and is different from the Guamerin in blood-sucking leeches. wpGuamerin does not express in the digestive tract of Wh. pigra, and mainly express in muscle. Feeding behavior would stimulate the expression of wpGuamerin gene in muscle and salivary glands, but not in digestive tract.

Effect of leech on lipid metabolism and liver in hyperlipidemia rats / 中国中药杂志

To explore the effect of leech on lipid metabolism and liver function in hyperlipidemia rats and the possible mechanism, biochemical analyzer was used to examine the regulation of leech on levels of serum triglycerides(TG), total cholesterol(TC), low-density lipoprotein cholesterol(LDL-C), and high-density lipoprotein cholesterol(HDL-C). The levels of ALT and AST in serum were detected by ELISA. The proteins expression of ACAT-2, Fas and HMGCR in liver tissue was detected by Western blot. The weight of body and liver were weighed, and liver index was calculated. Oil red O staining was used to observe the lipid accumulation in liver tissue of rats by light Microscope. The results showed that leech could decrease the levels of TC, LDL-C obviously, and increase HDL-C, decrease the levels of ALT, AST and the liver index, down-regulate the proteins expression of ACAT-2, Fas and HMGCR. And oil red O staining indicated that the lipid accumulation was less in the liver tissue of the rats intervented by leech. These data indicated that leech may affect the expression of ACAT-2, Fas and HMGCR in liver tissue to reduce the synthesis of cholesterol and fatty acid, and promote the cholesterol transforming, then regulate lipid metabolism to decrease the levels of serum lipid, and reduce lipid accumulation in liver tissue and ease liver injury of rats, then slowing down the process of nonalcoholic fatty liver disease(NAFLD) in hyperlipidemia rats.

Comparison of Statistical Analysis of Biological Assays of Anticoagulation Activity of Leeches between European and Chinese Pharmacopeias / 中国药学杂志

OBJECTIVE: To compare two biological standardization calculation methods for evaluating the anticoagulation activity of different leeches in the same measure. METHODS: Heparin was used as the reference substance. The APTT values of W. pigra, H. nipponica and P. manillensis were used as the anticoagulant activity evaluation potency. The slope ratio model of European Pharmacopoeia 7.0 and the parallel reaction model of Ch.P 2015 were used to calculate the activity and the results were compared. RESULTS: The logarithm dose response curves of three kinds of leeches displayed linear relationship. Both of biological standardization statistical methods could be used for the calculation. The slope ratio model complete randomized design(0, 3, 3) of European Pharmacopoeia 7.0 was suitable to calculate the activity potency of different leeches, but the parallel reaction model of Chinese Pharmacopoeia 2015 was only suitable for P. manillensis. CONCLUSION: Taking the anticoagulation potency of heparin sodium as the reference, the slope ratio model complete randomized design(0, 3, 3) of European Pharmacopoeia 7.0 can be used as a standard method to evaluate the anticoagulation activity of different leeches.