ABSTRACT
INTRODUCTION AND IMPORTANCE: DFU care in India is expensive. Cost-effective integrated care approaches for diabetic wounds are a necessity. CASE PRESENTATION: A 54-year-old, type 2 diabetic male patient presented with bilateral Grade Four compound DFUs. He also had a peculiar pattern of progressive gangrenous lesions on both toes of his limbs. He was on medication for schizophrenia for 20 years. Doppler studies of both limbs revealed extensive atherosclerotic changes with no flow in the mid and very low flow in the distal left anterior tibial artery. CLINICAL DISCUSSION: Along with Ayurvedic internal medication, in-home wound care was advised. Wound cleaning (shodhana) was done with Triphala decoction, gauze packing (ropana) with Gandhak druti, and application of Jatyadi oil (snehana) was done daily. The wound inspection was done using a smartphone. Out of six wounds, one infected wound measuring (8 cm-3 cm), one tunnelling wound measuring (9 cm-3 cm), one neuro-ischemic, Grade 4 planter wound, and other non-infected wounds healed within four to ten weeks. It has been observed that all the toes with progressive ischemic black spot on the proximal interphalangeal joint had deteriorated within 20-35 days. CONCLUSION: Gandhak druti may be effective for progressive wounds. Jatyadi oil application to enhance microcirculation as a preventive therapy should be investigated. Wound dressing guidelines recommended in Ayurveda classics can be followed at diabetic wound in-home care using a smartphone. Correlative timeframe of pathophysiological signs and anatomical site of dermopathy patches can add value to the non-invasive microcirculation detection tests.
ABSTRACT
Hypertriglyceridemia is a rare disorder in childhood. Familial Chylomicronemia Syndrome (FCS) is a rare genetic disease that leads to severe hypertriglyceridemia, often associated with recurrent episodes of pancreatitis. In this syndrome, traditional lipid-lowering drugs are marginally effective. A 6-months-old infant with complaints of recurrent episodes of abdominal colic and pancreatitis, with S. Cholesterol 552 mg% and Triglycerides 6400 mg%, was treated with Ayurvedic medicines. After six months of medication, Serum Cholesterol levels were within normal limits, and within the three years of regular treatment, S. Triglycerides was under 2000 mg%. Recurrent episodes of acute abdominal colic and vomiting reduced significantly. The patient was treated for Kapha Pitta dushti in Rasa and Raktavah srotas (deformity of the Kapha Pitta humors in the tissue nourishment pathway of the first and the second tissue respectively). Laghoo Sootshekhar, Arogyavardhini, Tinospora cordifolia, Cyprus rotundus, Aegle marmelos, Berberis aristata, Vettiveria zizanioides, and Triphala were the medicines used frequently. The three years treatment was safe and effective. Cost-effectiveness was an added feature of this treatment. Clinical experience of this case shows that congenital hyperlipidemia can manage by Ayurvedic medicine.
