An integrative approach for management of post-traumatic dorsal foot wounds - A case report.

Crush injuries to the foot have become increasingly prevalent in contemporary settings, primarily arising from incidents such as the impact of large objects falling onto the foot or involvement in traffic accidents. The complexity of treating these injuries is compounded by the intricate anatomy of the foot. In specific scenarios, the implementation of an integrated management approach could prove advantageous. In this report, we depict the case of a 23-year-old male who visited the Shalya OPD with a wound on his left foot caused by trauma. The wound covered the medial portion of the foot, involving the dorsal area, and measured roughly 20 cm by 9 cm and was unable to walk. We successfully managed the case by adopting an integrative approach. The Ayurvedic treatment included Panchavalkala kashaya for wound irrigation, as well as oral administration of Amalaki rasayana, Triphala guggulu, Shatavari churna and Ashwagandha churna. Jatyadi taila was topically applied. For the first seven days, in addition to these ayurvedic medications, we also employed analgesics and antibiotics to treat infection and pain. To accomplish early closure, we employed a split-thickness skin graft after sufficient granulation tissue had appeared. The wound was completely healed within three months and the patient was able to walk freely without any support. The combined approach yielded a promising result in this case.

AYURAKSHA, a prophylactic Ayurvedic immunity boosting kit reducing positivity percentage of IgG COVID-19 among frontline Indian Delhi police personnel: A non-randomized controlled intervention trial.

Objective: The world continues to face the COVID-19 crisis, and efforts are underway to integrate traditional medicine interventions for its effective management. The study aimed to determine the efficacy of the "AYURAKSHA" kit in terms of post-interventional percentage of COVID-19 IgG positivity, immunity levels, and quality of life (QoL) against COVID-19. Method: This was a non-randomized controlled, prospective intervention trial, done after the distribution of 80,000 AYURAKSHA kits (constituent of Sanshamani Vati, AYUSH Kadha, and Anu Taila) among Delhi police participants in India. Among 47,827 participants, the trial group (n = 101) was evaluated with the positivity percentage of IgG COVID-19 and Immune Status Questionnaire (ISQ) scores as a primary outcome and the WHO Quality of Life Brief Version (QOL BREF) scores along with hematological parameters as a secondary outcome in comparison to the control group (n = 71). Results: The data showed that the percentage of COVID-19 IgG positivity was significantly lower in the trial group (17.5 %) as compared to the control group (39.4 %, p = 0.003), indicating the lower risk (55.6%) of COVID-19 infection in the trial group. The decreased incidence (5.05%) and reduced mortality percentage (0.44%) of COVID-19 among Delhi police officers during peak times of the pandemic also corroborate our findings. The ISQ score and WHO-QOL BREF tool analysis showed the improved scores in the trial group when compared with the controls. Furthermore, no dysregulated blood profile and no increase in inflammation markers like C-reactive protein, erythrocyte sedimentation rate, Interleukin-6 (IL-6) were observed in the trial group. However, significantly enhanced (p = 0.027) IL-6 levels and random blood sugar levels were found in the control group (p = 0.032), compared to a trial group (p = 0.165) post-intervention. Importantly, the control group showed more significant (p = 0.0001) decline in lymphocyte subsets CD3+ (% change = 21.04), CD4+ (% change = 20.34) and CD8+ (% change = 21.54) levels than in trial group, confirming more severity of COVID-19 infection in the control group. Conclusion: The AYURAKSHA kit is associated with reduced COVID-19 positivity and with a better quality of life among the trial group. Hence, the study encourages in-depth research and future integration of traditional medicines for the prevention of the COVID-19 pandemic. Clinical trial registration: http://ctri.nic.in/, identifier: CTRI/2020/05/025171.

Pharmacodynamic appraisal of wound-healing herbs of Sushruta Samhita.

Background: In Sushruta Samhita, various medicinal plants as single and compound formulations having Vrana-Shodhana (wound cleansing) and Vrana-Ropana (wound healing) potential are enumerated. There are no published data available on these wound-healing medicinal plants of Sushruta Samhita. The effectivee management of wound is necessary in the immunocompromised and chronic wounds patients as they take more time to heal. Aim: To review and systematically analyze wound-healing medicinal plants and their modus-operandi on the basis of pharmacodynamics attributes, i.e., Rasa (taste), Veerya (potency), and Vipaka (biotransformation) in the various stages of healing. Materials and methods: Review of Sushruta Samhita was done to gather wound-healing medicinal plants; pharmacodynamics attributes were gatherd from various Nighantus to understand their role in wound healing. The contemporary information about wound-healing mechanism was gathered from PubMed to interpitate the rational use of plants in the various stages of wound healing. Results: The study suggests that 43 medicinal plants have Vrana-Shodhana activity, 48 have Vrana-Ropana and 62 have both Vrana-Shodhana and Vrana-Ropana potential. Medicinal plants with Vrana-Shodhana category are having predominance of Katu (pungent), Tikta (bitter) and Kashaya (astriengent) Rasa. Plants under Vrana-Ropana are having Madhura, Kashaya Rasa (sweet taste), Madhura Vipaka (sweet biotransform) and Sheeta Veerya (cold potency). Conclusion: Plants having Tikta, Kashaya Rasa, Katu Vipaka, and Sheeta Veerya may be useful in the inflammatory stage, plants having Madhura, Kashaya Rasa and Sheeta Veerya may be useful in the prolifiratory stage and plants having Madhura Rasa, Sheeta Veerya, and Madhura Vipaka may be useful in the remodeling stage. The present review will help to give the directions to the researchers for the development of effective wound-healing medicines for wounds.

IFTAK technique: An advanced Ksharsutra technique for management of fistula in ano.

Fistula in ano is mostnotorious disease among all the ano-rectal disorders since antiquity. Over the past few decades, various techniques are being evaluated in terms to prevent its recurrence and complications, but despite more than two millennia of efforts, fistula in ano still remains a perplexing surgical disease. The sign and symptoms of fistula in ano resembles with Bhagandara described in Ayurveda classics. For the management of this painful disease many treatment modalities are enumerated in Ayurveda classics and Ksharsutra therapy is one among them which is proved to be gold standard. Though Ksharsutra therapy is big revolution in the field of fistula in ano, but it has some disadvantages like it is time consuming process, severe post-procedural pain, big scar mark. So, in present era IFTAK is emerging as an advanced innovative technique for the management of fistula in ano along with betterment in the consequences of conventional method of Ksharsutra therapy. In the present case report, IFTAK (Interception of Fistulous tract and application of Ksharsutra) technique is used in trans sphincteric fistula in ano which showed a great potential in management by minimizing the duration of treatment, mild post procedural pain and minimum scar mark.