Acute exacerbation of bronchial asthma with infective focus treated with holistic Ayurveda approach: A case report.

While there are numerous published clinical trials investigating the efficacy of Ayurveda in managing bronchial asthma, a paucity of published case reports, case series, or randomized controlled trials (RCTs) concerning Basti (medicated enema) therapy in conjunction with Dhumapana (fumigation therapy) exists on PubMed.This scarcity of data hinders the comprehensive evaluation of this specific Ayurvedic approach for asthma management. A 69-year-old female patient with a known case of bronchial asthma and hypertension presented with complaints of breathlessness on and off for 3 years, cough, urgency of micturition, constipation for 7 days, and fever for 3 days. The patient was treated according to the treatment principles of Tamakshwas (bronchial asthma) and Jwara (fever). Basti, Dhumapana, and oral Ayurvedic formulations were administered. Significant improvements in symptoms, the mMRC dyspnea scale, and the pulmonary function test were observed. This case provides new insight into clinical diagnosis and management through gut modulation in respiratory diseases and vice versa.

Complete resolution of lumbar disc sequestration with Ayurveda management: A case report.

Lumbar disc herniation (LDH) is the most common spinal disorder among which disc sequestration is a severe type where the herniated disc fragment migrates and is completely separated from the parent disc. A 46-year-old female patient with severe lower back pain radiating to right lower limb, disability, and numbness in the affected extremity came to Panchakarma O.P.D of our hospital. She was a chronic case of disc sequestration where her symptoms were severely aggravated after a sudden jolt felt on her lower back while traveling on a motorcycle. The patient's Oswestry disability index (ODI) score was 90 % which indicates a bed-bound condition and even Schobar's test indicated a severe reduction in lumbar flexion capability. MRI showed postero-central herniation with disc sequestration at L5-S1 caused compression on the subarachnoid space and traversing S1 nerve roots. She was treated according to Ayurveda treatment principles and underwent Panchakarma like medicated enema (Basti) and fomentation of a lumbosacral region with oil (Kati Basti). She also received different oral medications on successive follow-ups. After 6 months of Ayurveda treatment, the patient showed remission in lower back pain (LBP), radiculopathy, and numbness. Her ODI score was reduced to 6 %. The MRI repeated post-treatment showed complete interval resolution of disc sequestration and no neurological compression was observed.

Effect of Matra Basti of Eranda Taila in non-progress of labor and neonatal outcome by umbilical cord blood study - A case report.

Every pregnant woman expects a natural, safe and uncomplicated delivery. The outcome of pregnancy i.e. childbirth is a natural but at the same time very complex process. The time taken for normal labor in primigravida is 12h-14 h and latent phase of labor is expected not to exceed more than 8 h. Thus, any intervention that augments and eases labor is well accepted for mother and fetus. Apana Vayu is having pivotal role in regulating the process of labor. A woman, aged 27 years, primigravida with full term pregnancy and pain in lower abdomen for 7 h visited Rajiv Gandhi Govt. Post Graduate Ayurvedic College & Hospital, Paprola. She was given a soap water enema and kept under a close observation for 2 days. There was neither significant progress of labor nor the pain subsided with afore mentioned management. On the third day, she was given Matra Basti of Eranda Taila. This showed the therapeutic effect on progress of labor and ultimately safe delivery of baby. To evaluate any kind of fetal distress, APGAR score of neonate and umbilical cord arterial blood was collected for determination of pH value. Present case suggests an example to manage delayed labor with Eranda Taila Matra Basti without any altered fetal parameters and fetal distress.

The clinical evaluation of Basti along with Rasayana on symptoms of post-COVID-19 syndrome: an open-labeled proof of concept pragmatic study-a study protocol.

BACKGROUND: Post-COVID-19 syndrome is a result of triggering various immune pathways and metabolic disturbances. Basti is an important per rectal Ayurveda-based treatment having multi-targeted actions. Basti and Rasayana treatment modulate immune responses by regulating pro-inflammatory cytokines, immune globulins, and functional properties of T cell. We propose to study the clinical evaluation of Basti along with Rasayana (rejuvenation therapy) on symptoms of post-COVID 19 syndrome. METHODS AND ANALYSIS: We designed a prospective, open-labeled proof of concept pragmatic study. The study duration is 18 months, and the intervention period are 35 days from the day of enrollment of the patients. The patients will be treated on the basis of Ayurvedic classification of Santarpanottha (over nutrition) symptoms and Apatarpanottha (lack of nutrition) symptoms. The Santarpanottha group will be treated within 3-5 days of oral Guggulu Tiktak Kashayam followed by 8 days of Yog Basti treatment and then 21 days of Rasayana therapy with Brahma Rasayan. The Apatarpanottha group will be treated within 3-5 days of oral Laghumalini Vasant, followed by 8 days of Yog Basti treatment and then 21 days of Kalyanak Ghrit. The outcome measures of this study will be to evaluate the changes in fatigue severity scale, MMRC dyspnea chest pain scale, pain score assessed by VAS scale, smell and taste scale, WOMAC scale, Hamilton depression scale, Hamilton anxiety scale, Insomnia Severity Index, change in Cough Severity Index, facial aging scale, dizziness scale, Pittsburgh Sleep Severity Quality Index, functional status scale, and heart palpitation scale. All adverse events will be monitored at each time throughout the study visit time. A total of 24 participants will be recruited to demonstrate with 95% confidence interval and 80% power. DISCUSSION: Ayurveda treats Santarpanottha (originated from over nutrition) symptoms and Apatarpanottha (symptoms originated from undernutrition) symptoms differently; hence, inspite of the same disease or symptom management, changes depend upon the type of the origin. This pragmatic clinical study is developed on the fundamental grounds of Ayurveda. ETHICS AND DISSEMINATION: Ethics approval was obtained through the Institutional Ethics Committees of Government Ayurved College and Hospital on 23 July 2021. TRIAL REGISTRATION: The trial is prospectively registered with the Clinical Trial Registry of India on 17 August 2021 [CTRI/2021/08/035732] after the Institutional Ethics Committee approval [GACN/PGS/Synopsis/800/2021 Date 23/7/2021].

Ayurvedic management of idiopathic small fibre neuropathy- A case report.

Small fibre neuropathy (SFN) is a subgroup of peripheral neuropathy which is characterized by a disorder of the thin myelinated A-δ and unmyelinated C-fibres. With a prevalence of 52.95 per 100,000 population per year, the reported etiology of SFN has remained unclear in 23-93% of investigated patients and hence termed idiopathic small fibre neuropathy (iSFN). Pain is the most common symptom which is often described as burning. Conventional pain management is the only treatment option for iSFN, which is only modestly effective and associated with adverse events which lead to reduced drug compliance. It also affects the overall quality of life. This case report discusses the effect of Ayurvedic interventions in the management of iSFN. The patient was a 37-year-old male, who presented with severe pain, burning, and tingling sensation of B/L lower limbs and hands with decreased sleep for 5 years (visual analogue scale (VAS) was 10 and neuropathic pain scale (NPS) score was 39). Considering the signs and symptoms, the disease was diagnosed under the Vata Vyadhi (disease/syndrome caused by Vata Dosha) spectrum. The treatment included an initial OPD-based Shamana (treatment that pacifies the aggravated doshas) treatment with Drakshadi Kwatha, Sundibaladwaya Ksheera Kwatha, Kalyanaka Gritha, and Ashwagandhadi Churna. As the symptoms persisted, Shodhana (treatment in which aggravated doshas are expelled from the body) treatment was adopted which included Mridu (mild) Shodhana, Nasya (medicine administered through nasal route) and Basti (administration of medicine through the procto-colonic route). The intervention resulted in significant clinical improvement as evidenced by the reduction in VAS and NPS scores to zero and five respectively. The patient's quality of life also showed significant improvement. This case report signifies the pivotal role of Ayurvedic intervention in the management of iSFN and encourages further research in this area. Integrative therapeutic approaches can be developed which may offer a promising strategy for managing iSFN and improving patient outcomes.

Ayurveda management of large endometrioma - A case report.

Endometriosis is an unusual feature of retrograde menstruation that affects nearly every woman of reproductive age. Endometrioma, a severe form of endometriosis, is a common cause of infertility. Surgery is the recommended treatment for large endometrioma, which most women prefer to avoid. A 23-year-old unmarried patient had right side rapidly enlarging endometrioma measuring 6.9 × 5 cm with acute intermittent abdominal pain diagnosed as udavarta yonivyapada. Yoga basti (eight medicated enemas) and Kuberaksha vati were the primary treatments. Yoga basti is the treatment of choice for pain, inflammation and all the pelvic diseases related to fertility caused by vata aggravation. Alleviation of pain avoided the surgery. After discontinuation of medicines, the endometrioma size increased to 10.3 × 5.5 cm The second Yoga basti was administered before wedding. The patient conceived within four months after the marriage and had a full-term normal delivery with no acute pain episodes. The endometrioma size was reduced by 2 cm within one year and further reduced to 7.6 × 5.2 cm in the first trimester. Ayurvedic conservative treatment for endometriosis can manage pain and may also prevent retrograde menstruation. It can be a minimally invasive alternative prior to surgical removal, that has long-term beneficiary effects. As a seasonal regimen, yoga basti can also help fertile women with primary and secondary dysmenorrhea enhance the quality of life.

Conservative management of acute prolapsed inter-vertebral disc with ayurveda: A case report.

Acute prolapsed inter-vertebral disc (IVDP) is a painful condition that requires immediate treatment by conservative or surgical management. Though majority of patients show remission in symptoms with conservative treatment, regression of herniated disc with non-surgical management has been rarely reported. A 46 years old female patient with acute and severe low back pain, disability and radiating pain towards right lower extremity came to our hospital. Oswestry Disability Index (ODI) score of the patient was 94% indicating bed-ridden condition. MRI of lumbar spine showed diffuse posterior disc bulge between fourth and fifth lumbar vertebra indenting right traversing nerve root and inferior displacement of extruded disc along the body of fifth lumbar vertebra. She was treated according to treatment explained in Ayurveda. She received oral medications, application of medicated oils, fomentation and medicated enema (Basti). After treatment of seven and half months, the patient showed good remission in pain, stiffness and radiculopathy. ODI score reduced to 9% that indicates minimal disability. Follow up MRI showed non significant compression of the nerve root and gross reduction in the inferior displacement of extruded disc. Acute IVDP can be successfully conserved using Ayurveda treatment. The Panchakarma procedures and medicines used in the treatment need further evaluation.

Traumatic Optic Neuropathy (TON) and Ayurveda - A case report.

The vision loss in the Traumatic Optic Neuropathy is the impact of deformational forces. This occurs due to direct or indirect injuries during trauma to skull. The use of high dose corticosteroids is the primary line of treatment in such injuries still remains a matter of debate. Traumatic Optic Neuropathy is yet an unexplored topic of study in Ayurveda. The Traumatic Optic Neuropathy can be correlated with Abhighatajanya Vataprakopaj Drishtinash. The treatment principles of Vataprakopaj Vyadhi are Snehan (massage), Swedan (sudation), Basti (enema) and Nasya (oleation through nasal route). A 50 year old male patient came to outpatient department suffered from motorcycle accident and had a forehead trauma followed by loss of vision in both eyes after 5 days and diagnosed as Traumatic Optic Neuropathy. An electrophysiological assessment showed absence of waveform in Visual Evoked Potential (VEP). According to Ayurveda patient was diagnosed primarily as Abhighatajanya Vataprakopaj Drishtinash and started to follow the protocol of Vataprakopaj Vyadhi. Patient received Ayurvedic formulations in morning, after meal and at night for 12 months and a course of Yapan Basti (medicated decoction enema) followed by Netratarpan (eye satiation), Nasya and Abhyanga (body and foot massage). Patient showed an improvement in the visual quality from no perception of light to perception of light and rays in right eye in 9 month. Patient had improvement in P100 latencies of right eye in VEP report and subjective improvement in quality of vision to perceive the images and objects. Application of Ayurvedic principles and Panchakarma therapy resulted in improvement of the case. An early management of Traumatic Optic Neuropathy with Ayurvedic treatment can have a significant impact on the clinical/visual outcome in terms of recovery in damaged optic nerve fibers.

Effects of medicated enema and nasal drops using Triphaladi oil in the management of obesity - A pilot study.

An open label, randomized, comparative, interventional pilot study was done to assess the effect of Lekhana Basti (medicated enema) and Rechana Nasya Karma (Errhine therapy) in the management of Sthoulya with special reference to obesity. In the study 30 clinically diagnosed patient of either sex were randomly divided into two groups. In Basti group, Lekhana Basti in Karma Basti manner was given for 30 days. Anuvasana Basti (enema with Triphaladi Taila) in the dose of 120 mL and Asthapana Basti (enema with Triphaladi decoction etc.) in the dose of approximately 960 mL was given. In Nasya group, Rechananasya on alternate days was given with Triphaladi (oil) in the dose of 0.5 mL per nostril for total 28 days. The patients were assessed on objective criteria such as such as weight, chest circumference, mid-arm circumference, mid-thigh circumference, triceps skin fold thickness, sub-scapular skin fold thickness, abdominal skin fold thickness, waist-hip ratio and lipid profile. It was observed that Basti group was a better intervention in providing relief, however there intergroup standard deviation was low on most of the variable expect the lipid profile. The results suggest that the Nasya Karma may be developed as a better practical approach in obesity management.

Effect of Brihatyadi Yapana Basti and Shivalingi (Bryonia laciniosa Linn.) seed powder in the management of female infertility (Vandhyatva) due to anovulatory factor: An open-labelled randomized clinical trial.

BACK GROUND: Infertility is a global problem that has impact on quality of life, especially through the negative psycho-social consequences. One-third of infertile population attending infertility clinics are reported with anovulation. According to Acharya Sushruta, among four essential factors required for conception, Beeja (ovum) is the core stone of the female reproductive process and conception can not be achieved in its absence, despite of other factors. AIMS AND OBJECTIVES: To evaluate and compare the efficacy of Brihatyadi Yapana Basti (therapeutic enema) and Shivalingi (Bryonia laciniosa Linn) seed powder in the management of female infertility w.s.r to the anovulatory factor. MATERIALS AND METHODS: Total 30 female patients suffering from infertility due to anovulation confirmed by trans vaginal sonography were enrolled in the present study and randomly divided in two groups i.e., in group A (n = 15), Brihatyadi Yapana Basti (400 ml) was administered for 15 days after menstruation for 2 consecutive cycles. In group B (n = 15) Shivalingi seed powder was administered in dose of 3 gms twice in a day with cow milk on empty stomach for 2 months with 2 months followup. The efficacy of the therapy was assessed on the basis of follicular study by trans-vaginal sonography (TVS) on the 12th , 14th, 16th and 18th days of menstrual cycle and/or on the basis of conception achieved. The obtained data was analyzed for statistical significance using Student's t-test. RESULT: In the Brihatyadi Yapana Basti group, ovulation was found in 80% of the patients and conception rate was 26.66% and in the Shivalingi seed powder oral group, ovulation was found in 64.28% patients and conception was not reported. CONCLUSION: It was concluded that Brihatyadi Yapana Basti is more effective in follicular growth, ovulation and also achieving conception than that of Shivalingi seed powder orally.

Management of hypothyroidism by Kshara Basti (therapeutic enema)- A case report.

Hypothyroidism is emerging as a common health concern in India as well as worldwide. An autoimmune cause accounts for approximately 90% of adult hypothyroidism mostly due to Hashimoto's disease. This autoimmunity goes parallel with the theory of Ama (intermediatory product) in Ayurveda. A case of a 27-year-old female patient, presenting with pain in multiple joints, deformity in the right little finger, morning stiffness lasting for more than 3 h, reduced appetite, constipation, and lethargy, diagnosed with Amavata (rheumatoid arthritis), was subclinically diagnosed with hypothyroidism and treated with Deepana (stimulates digestion), Pachana (promots digestion) and Koshtha Shuddhi (mild purgation) for 5 days followed by Kshara Basti (therapeutic enema) for 5 days. Reduction in serum- thyroid-stimulating hormone (S. TSH) (31.1 mIU/ml to 16.6 mIU/ml) along with relief in clinical manifestations of the disease was the outcome. Koshtha Shuddhi followed by Kshara Basti has its efficacy in hypothyroidism, as it not only improved signs and symptoms but S.TSH level was reduced significantly. This case report proposes an innovative treatment modality for the management of hypothyroidism, which needs to be validated through a well-planned study on a large sample size.

Panchakarma in autoimmune pancreatitis: A single-case study.

Autoimmune pancreatitis (AIP) is the pancreatic manifestation of a systemic fibro-inflammatory disorder. AIP is a unique form of pancreatitis in which autoimmune mechanisms are suspected to be involved in the pathogenesis. AIP is a rare disorder, its exact cause is unknown, but it is thought to be caused by the body's immune system attacking the pancreas and it responds to steroid therapy only. In Ayurveda, although there is no synonym for AIP, but has a resemblance in clinical features of Grahani Dosha (derangement of duodenum and intestine). The cause of Grahani Dosha is Mandagni (hypofunctioning of Agni) and Panchakarma therapy increases Agni. As per Charaka Samhita, treatment for Grahani Dosha amongst the Panchakarma therapy is Virechana (therapeutic purgation) and Basti (medicated enema). The present case report is of a 30-year-old female, diagnosed as case of AIP with multisystem involvement with increased level of immunoglobulin G (IgG), glycosylated heamoglobin (HbA1c), cholesterol, triglycerides, low-density lipoprotein (LDL) and body mass index (BMI). The patient was on anticholinergic agents, antacids, levothyroxine, multivitamin along with iron and antihistamine drugs since 1 year, but with not much relief. Patient was treated with classical Virechana and Madhutailika Basti. It was observed after the completion of therapy, that there was decrease in IgG, HbA1c, S. cholesterol, S. triglyceride, low density lipoprotein (LDL) and body mass index (BMI). This shows that Virechana and Basti play a significant role in patient with AIP associated with other disorders.

Ayurvedic management of chronic constipation in Hirschsprung disease - A case study.

Hirschsprung disease (HSCR) or congenital intestinal aganglionosis is characterized by complete absence of neuronal ganglion cells from a portion of the intestinal tract, most commonly in the large intestine. The main sign or symptom of HSCR is constipation usually appearing shortly after birth. This constipation is chronic in nature and usually not relieved with laxatives. The present case is of a patient having HSCR which was successfully managed with Ayurvedic treatment. A four year old boy with complaint of severe constipation, abdominal pain, abdominal distension and occasional vomiting was treated with Panchakarma procedures and Ayurvedic oral drugs. The Ayurvedic diagnosis of the case was Pakvasayagata vata. Shashtikashali pinda swedana (sudation with medicated cooked bolus of rice) and Matra basti (enema with medicated oil) with Ashwagandha taila (Ayurvedic medicated oil) was given for first 16 days. From the 2nd month of treatment, Matra basti was administered daily for 3 months in the dose of 25 ml. In 5th and 6th month Matra basti was administered on alternate days in the dose of 25 ml. From the 7th month Matra basti was administered once weekly in the dose of 25 ml. In 14th month Shashtikashali pinda swedana and Erandmooladi yapna basti (medicated enema) was given for 16 days. Eight scales based Medical outcome study (MOS) - 36 item short form - health surveys was periodically assessed for outcome which shows good improvement. Experience of this case showed that HSCR may satisfactory be managed with Ayurvedic treatment.

A clinical study on the effect of Triphaladi Kala Basti with Arjuna Punarnavadi Ghanavati in the management of essential hypertension.

INTRODUCTION: Hypertension, one of the grave conditions, accounts for 6% of deaths worldwide. In 2010 increased blood pressure was the cause of an estimated 9.4 million deaths. According to Ayurveda, systemic arterial hypertension can be considered as Tridoshaja condition with predominance of Vata and Pitta along with invovment of Rasa, Rakta and Meda. Basti Karma a medicated enema procedure is the best treatment for vitiated Vata Dosha and it regulates the movement of Vata Dosha. OBJECTIVES: The present study was conducted to evaluate effect of Triphaladi Kala Basti procedure given along with Arjuna Punarnavadi Ghanavati in the management of essential hypertension. MATERIALS AND METHODS: Fifteen patients who were diagnosed cases of essential hypertension as per the 7th JNC and World Health Organization criteria for diagnosis of hypertension were treated with Triphaladi Basti followed by oral administration of Arjuna Punarnavadi Ghanavati. RESULTS: Administration of Basti and Arjuna Punarnavadi Ghanavati were effective in reducing both systolic and diastolic blood pressure level which was highly significant (P < 0.001). CONCLUSION: Triphaladi Kala Basti procedure along with oral administration of Arjuna Punarnavadi Ghanavati is moderatly effective in management of systemic arterial hypertension.

Effect of panchakarma and Ayurvedic treatment in postpartum rheumatoid arthritis (amavata): A case study.

Dream of a mother is to get involved actively in upbringing of child, which is impeded if she is suffering from painful condition like rheumatoid arthritis (RA) in postpartum phase. It causes physical incapacity and psychological trauma as well. Present case is a patient who developed RA one month after full term delivery by caesarean section. In view of symptoms, she was diagnosed as case of amavata. She received Ayurvedic treatment - Simhanada guggulu, Pratapalankeshwara rasa, Dashamoola katutraya kashaya and combination of Swarnabhupati rasa, Tapyadi loha, Mahavatavidhvansa, Chopachini (Smilax china), Shunthi (Zinziber officinale) and Guduchi (Tinospora cordifolia) for four months and course of kala basti (medicated enema) along with application of medicated oil (Vishagharbha taila abhyanga) and sudation (bashpa sweda) for ten days. Complete remission was seen after treatment for four months. The patient was free from oral analgesics. RA test titer that was 160 international units per milliliter (IU/ml) before treatment showed marked reduction (28.12 IU/ml) after 75 days of treatment and later dropped in normal range (6.1 IU/ml). Normal milestones were seen in the child receiving breast feeding. Application of Ayurvedic principles showed excellent results in this case where modern medical management options were limited due to lactation.

Comparative study of Anuvasana Basti with constant and escalating dose as an alternative to Snehapana in Purvakarma of Vamana and Virechana.

BACKGROUND: Snehapana is the essential step prior to Vamana and Virechana (therapeutic vomiting and purgation). But it was found that 10-15% patients are reluctant towards Snehapana hence may deprive the benefits of Shodhana. These inconveniences made us think about effective alternative to counter drawbacks of Snehapana. On the basis of literature review and pilot study, it was confirmed that, Anuvasana Basti can be administered as an alternative for Snehapana. OBJECTIVE: To evaluate samyak snigdha lakshana achieved by administration of Anuvasana Basti and to evaluate outcomes of Vamana and Virechana. MATERIALS AND METHODS: Specially designed basti pouches were used according to doses. In group A, constant dose of processed sesame oil (120 ml) and rock salt (500 mg) was used. In group B, the dose was escalating started with 120 ml and 500 mg with 25 ml and 100 mg increase in sesame oil and rock salt respectively for maximum seven days. RESULTS: Patients from group B showed better results than group A i.e. 29 patients showed symptoms of proper oleation. Mridu koshtha required minimum dose and duration for getting proper symptoms of oleation. Outcome of Vamana and Virechana were also very promising. CONCLUSIONS: Hence it can be concluded that Anuvasana Basti in escalating dose can be used as an alternative for Snehapana.

Management of premature contractions with Shatavaryadi Ksheerapaka Basti - A Case Report.

Premature contraction of the uterus is the very first sign of premature labour, which is followed by progressive changes in cervix such as effacement and dilatation. Four or more uterine contractions with or without pain per hour is a major biophysical predictor of preterm labour. According to the WHO statistics, every year, an estimated 15 million babies are born preterm and this number is rising. Although tocolytic agents are used to suppress premature contractions and prevent preterm labour, it is not proven to be efficacious in preventing preterm birth or reducing neonatal mortality or morbidity. As per Ayurveda, AkalaPrasava (preterm labour) results due to the malfunctioning of ApanaVata (a type of Vata Dosha which is responsible for the excretory action). Basti (medicated enema therapy) is considered the best for managing the deranged ApanaVata. Basti is also indicated in GarbhiniParicharya (routine antenatal care) after completion of seven months of pregnancy. In this present case study, ShatavaryadiKsheerapakaBasti (medicated enema prepared along with milk) was administered in a 28 year old second gravida patient of 33 weeks gestation with premature contractions, wherein isoxsuprine hydrochloride proved to be ineffective. Per-rectal Basti with 450 ml Shatavaryadi Ksheerapaka administered for 2 consecutive days was found to be effective in preventing the uterine contractions and further advancement to preterm labour. The drugs in ShatavaryadiKsheerapakaBasti possess antioxytocic and vasodilating properties which may effectively curtailed the progress of premature contractions.

Management of internal bleeding piles by ligation and plication followed by Matra Basti - A case report.

Arsha (hemorrhoids) is engorgement of the hemorrhoidal venous plexus, characterized by bleeding per rectum, constipation, pain in ano, prolapse and discharge per anum. It is a primary disease, with impaired digestion as the underlying pathogenesis. It is manifested due to improper diet, prolonged standing and faulty habits of defecation causing derangement of Tridosha, mainly VataDosha. Vitiated Dosha localizes in Houstan's Valve, rectal arteries, fascia and vitiates Skin, muscles, adipose tissue and blood due to AnnavahaSrotodushti (vitiation of gastrointestinal tract). A 45-year-old male patient came to the OPD of Dr. Sarvepalli Radhakrishnan Rajasthan Ayurved University hospital, Jodhpur, Rajasthan, with complaints of prolapsing pile mass during defecation, pain per anum with erosion and bleeding per anum while passing stool. On proctoscopy, pile masses were seen at 11 and 3 O'clock positions and few erosions were seen near the 3 O'clock pile mass. The case was diagnosed as "Raktarsha"- later stage of 2nd degree internal hemorrhoids at 11 and 3 O'clock positions, deeply situated, projecting one and caused by Pitta and RaktaDosha; with bleeding tendency. Ligation of pile mass by surgical linen barbour thread number 20 on 11 O'clock positions and plication by absorbable chromic catgut on 3 O'clock positions of internal hemorrhoid were done under local anesthesia followed by Matra Basti (therapeutic oil enema) with Jatyadi oil. The pile mass and per rectal bleeding resolved in 10 days and the patient got relief from all the symptoms within 4 weeks. No complications were reported after the procedure. The patient was followed up regularly from the registered date onward till 3 months and proctoscopic examination did not revealed any evidence of recurrence of the hemorrhoids.

Ayurvedic management of spondyloepiphyseal dysplasia tarda, a rare hereditary disorder.

Spondyloepiphyseal dysplasia tarda (SEDT) is a rare genetic disease in which patient suffers from short stature, short trunk and neck with disproportionately long arms, coxa vara, skeletal features such as barrel shaped chest, kyphosis, scoliosis and early arthropathy. Only limited medical and surgical management is available in modern medicine. A 15 years old male suffering from SEDT and diagnosed as Vata vyadhi was treated with Panchakarma therapy and selected Ayurvedic oral medicines. Ayurvedic treatment was directed to ameliorate the orthopaedic clinical conditions in this case. Panchakarma procedures such as Shalishastika pinda svedana for a month and Mustadi yapana basti for 16 days were given along with oral Ayurvedic medicines. Same Panchakarma procedures were repeated after an interval of 2 months. A combination of Ayurvedic oral medicines such as Trayodashanga guggulu-500 mg twice a day, Dashmool kvatha (decoction of roots of 10 herbs) 40 ml twice a day, Eranda paka 10 g twice a day, Shiva gutika-500 mg twice a day and Dashmoolarista-20 ml (with equal water) twice a day were prescribed. Eight scales based Medical outcome study (MOS) - 36 item short form - health surveys was assessed for outcome which shows good improvement. Kyphosis, scoliosis and pain were moderately reduced. Clinical experience of this case indicates that Ayurvedic herbs along with Panchakarma can play a major role in the management of hereditary disorder SEDT.

Ayurvedic approach for management of ankylosing spondylitis: A case report.

Ankylosing spondylitis (AS) is a rheumatic disease with various skeletal and extra skeletal manifestations. No satisfactory treatment is available in modern medicine for this disorder. Various Panchakarma procedures and Ayurvedic drugs have been proved useful for these manifestations. We present a case of AS, which was treated for two months with a combination of Panchakarma procedures and Ayurvedic drugs. Ayurvedic treatments, in this case, were directed toward alleviating symptoms and to reduce severe disability. The patient was considered suffering from Asthimajja gata vata (∼Vata disorder involving bone and bone marrow) and was treated with Shalishastika Pinda Svedana (sudation with medicated cooked bolus of rice) for one month and Mustadi Yapana Basti (enema with medicated milk) with Anuvasana (enema with Asvagandha oil) in 30 days schedule along with oral Ayurvedic drugs for two months. Pratimarsha nasya (nasal drops) with Anu Taila (oil) for one month was given after completion of Basti procedure. Patient's condition was assessed for symptoms of Asthimajja gata vata and core sets of Assessment of Spondylo Arthritis International Society showed substantial improvement. This study shows the cases of AS may be successfully managed with Ayurvedic treatment.