Efficacy and safety of a polyherbal formulation in hemorrhoids.

Background: The medical management of hemorrhoids should include an integrated approach. This integrated approach can be achieved by polyherbal formulations containing anti-inflammatory, styptics, analgesics, and laxative effect which reduce inflammation, pain, and bleeding, and increase gastro-intestinal motility and soften stools. One such polyherbal kit is “Arshkeyt™, a 7 day kit,” which consists of oral tablets and powder along with topical cream. Objective: Efficacy and safety of Arshkeyt™, a 7 day kit, a marketed polyherbal formulation was evaluated in comparison with conventional therapy practiced in surgery outpatient departments. Materials and Methods: Patients (n = 90) with hemorrhoids were randomly allocated to receive either Arshkeyt™ or standard therapy (combination of oral Isabgul powder and 2% lidocaine gel) for 14 days. Assessment on the basis of rectal symptoms and proctoscopic examination was done on day 0, 7, and 14 to derive a “composite score” which ranged from 0 to 25 by a blinded evaluator. The primary endpoint was number of patients achieving composite score 0 at the end of therapy (day 14). Inter-group analysis was done using Chi-square test. Results: On day 14, the composite score of 0 was achieved in 15 patients of Arshkeyt™ group versus 6 patients receiving standard therapy. The symptoms and signs which showed significant improvement in Arshkeyt™ group compared to standard treatment group were the tenesmus (visual analog score) score (P = 0.047), anal sphincter spasm (P = 0.0495) and a decrease in the grade of hemorrhoids (P = 0.0205) on day 14. Arshkeyt™ was also more beneficial in case of bleeding hemorrhoids as compared to nonbleeding hemorrhoids (P < 0.05). The incidence of adverse drug reactions in both groups was comparable and no patient required any treatment for the same. Conclusion: “Arshkeyt™, a 7 day kit,” was effective in the treatment of hemorrhoids and had a good safety profile.

The Effect of Intraurethral 2% Lidocaine Gel as Topical Urethral Anesthetic During Cystoscopy / 대한비뇨기과학회지

Despite current practice there is no evidence to demonstrate the efficacy of intraurethral 2% lidocaine gel as an anesthetic for rigid cystoscopy. To evaluate the usefulness of lidocaine on decreasing pain associated with cystoscopy, we performed a randomized controlled study comparing 2% lidocaine gel with a plain water based lubricant. Pain was recorded on a visual analogue scale by the patient and by the physician. Physician perception of pain experienced by the patient was compared with the actual pain experienced. We found decrease in pain perception in men following lidocaine gel instillation with a 5 or 10 minute dwell time compared to instillation of the plain lubricant.