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Bhagandara (~anal fistula) is a challenging surgical condition due to its high recurrence rate and anal incontinence. Acharya sushruta has explained surgical and para-surgical techniques for its management. Ksharasutra therapy is a time-tested para-surgical modality for Bhagandara with least recurrence (3.33%). Modified conventional technique of application of Ksharasutra is aimed to eliminate infected source and facilitate healing in short duration. A 30-year-old male patient presented with recurrent painful swelling with intermittent pus discharge from the base of the scrotum for one and half years. He underwent incision and drainage twice in the last six months. Magnetic resonance imaging revealed an anterior fistulous tract representing as St. James Type 1 Fistula, which varied from clinical features. He was treated with Modified Conventional Kshara Sutra Therapy (MC-KST) and whole length of fistulous tract was healed completely within five weeks. Anal fistula with scrotal extension is considered a complex manifestation to manage. In MC-KST method, tract was intercepted nearer to sphincter and infected crypto-glandular lesion was eradicated by Ksharasutra. The study concluded that MC-KST is one option to manage anal fistula with scrotal extension to preserve normal perineal structures.

Introduction: As per Ayurveda, suppression or forceful creation of natural urges always results in diseases, including anorectal disorders such as piles, fistula, fissure, and other diseases. Bowel and bladder habits come under the umbrella of “Vegadharana,” i.e., suppression of natural urges. In the present scenario, maximum people suppress natural urges and indulge in erroneous lifestyle and suffer from a variety of disorders. Hence, a case–control survey study was conducted in healthy and patients suffering from anorectal disorders. Aim: The aim is to study the effect of bowel and bladder habits in anorectal disorders. Methodology: The study comprised 110 subjects suffering from anorectal disorders (study group) and 110 healthy subjects (control group). Detailed history was obtained using a specially designed questionnaire. The data collected was computed in MicroSoft Excel Sheet and analyzed using Chi-square test and interpreted accordingly with the help of the percentage. Results: Subjects in the study group suppressed defecation urge (Purisha Vegadharana) comparatively more (P

Chronic wounds are becoming challenge for scientific community due to their economical and psychological burden. Contemporary science tried hard to cop up with this difficult situation by the use of tissue engineering, cell-based therapy, plasma therapy along with various dressings, and surgical procedures, but the results are not very promising. Wounds are described under the heading of Vrana in Ayurveda along with various herbs and herbomineral preparations for their management. Gojihva (Launaea nudicaulis [L.] Hook.f.) is an herb mentioned to be useful in various diseases as well as for wounds. It is also practiced ethnomedicinally for wound management in various countries. A 60-year-old male having non-healing wound on his dorsal surface of the forearm for the past 45 days was treated with dressing of Gojihva kwatha (~ decoction) for 28 days. Bates–Jensen Wound Assessment Tool (BWAT), wound tracing and digital photography was used to asses wound healing on every week. BWAT score was 52 before treatment and 13 after the treatment. The surface area was 42.9 cm2 before treatment and nil after treatment. The wound was completely healed in 28 days without any complications.

Microalbuminuria is one initial diagnostic marker of progressive Diabetic Nephropathy (DN). Urine Albumin Excretion (UAE) between 30 and 300 mg/24 h is found in Stage 2 DN. In Ayurveda, no description is found, which can be directly correlated with DN, but Nidana and Samprapti of Prameha can be correlated for its manifestation. In this case, a 56-year-old male patient visited to Shalya Tantra OPD with complaints of type 2 diabetes and 135 mg UAE in 24 h with estimated Glomerular Filtration Rate (eGFR) of 77 ml/min/1.73 m2. This case report was aimed to evaluate the effect of Ayurveda formulations (Gokshuradi guggulu, Haritakyadi kwatha, Bhumyamalaki churna, and Gokshura churna) with Pathya ahara (Plant-based diet) in the management of microalbuminuria in DN Stage 2. This formulation was given for one month and Pathya ahara advised for two months. UAE significantly decreased and came to normoalbuminuria state. eGFR increased up to 87 ml/min/1.73 m2. The present study suggested that using Ayurveda formulations with Pathya ahara is effective in the management of microalbuminuria in DN Stage 2.

Management of anal fistula is always a big challenge for surgeons due to recurrence and associated anal incontinence. In spite of various advancements, failure rate is high even after surgery. Ksarasutra therapy is accepted as a successful modality with high cure rate in the management of anal fistula. In this case, a 45-year-old, hypertensive, and diabetic male patient visited to Shalya tantra outpatient department with complaints of intermittent pus discharge from the peri-anal region for seven months. On local examination, an external opening covered with hyper-granulation and pus discharge was observed nearer to the base of scrotum at approximately eight cm away from the anterior anal verge. On palpation, a thick fibrous cord-like structure was felt extending from the anal canal to the base of scrotum. On per rectal examination (P/R) examination, a tender point was felt at the 12'o clock position just above the dentate line. Magnetic resonance imaging revealed a trans-sphincteric anal fistula with internal opening at the 12 o' clock position and was managed by Modified Conventional Ksarasutra technique. The tract was completely healed within five weeks. No fecal incontinence was reported by the patient, nor signs of recurrence were observed after six months of follow-up.

Vata kantaka (~plantar fasciitis) is mentioned as one of Nanatmaja vatavyadhi (~disease caused by Vata dosha). It is manifested due to constant exposure on uneven surface or walking over an irregular surface for long period. Patients suffering from Vata kantaka usually complain of pain at the heel that gradually increases when a patient starts walking in the morning. One in ten people suffers from plantar fasciitis in their lifetime and conventional treatment has limitations in providing satisfactory relief. A 35-year-old male patient visited Asthi-sandhi-marma roga Outpatient Department with plantar fasciitis in left foot. Seven sittings of iontophoresis with Murivenna kwatha (~decoction of Murivenna formulation) were done on alternate day and rolling plantar exercise daily for 10 min. Satisfactory relief in pain score was found after the seventh sitting. Visual Analog Scale was reduced from 8 to 1 and Maryland foot score was increased from 45 to 96 by the end of the seventh sitting. No recurrence was reported during the follow-up of four months. Murivenna kwatha possesses Vatadosha (~functional units of body) pacifying properties, Shulahara (~analgesic), and Shophahara (~anti-inflammatory). Iontophoresis possibly enhances transdermal absorption of Murivenna kwatha. This iontophoresis in combination with Murivenna kwatha rendered significant relief from pain in the management of plantar fasciitis.