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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.

ObjectiveThe 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.MethodThis 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).ResultsThe 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.ConclusionThe 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 registrationhttp://ctri.nic.in/, identifier: CTRI/2020/05/025171.

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.

Objective: To explore Rasayana herbs ascribed in Ayurveda classics and their contemporary appraisal for Rasayana potential. Data Source: Classical Ayurvedic review of Rasayana herbs were done from three distinguished Ayurveda classics (Charaka Samhita, Sushruta Samhita and Ashtang Hridaya) known as Brithattrayi. The contemporary review of those classical herbs was done from PubMed and other reputed databases. Review Methods: The classical Ayurveda review was done manually from Charaka Samhita, Sushruta Samhita and Ashtanga Hridaya. The single herbs mentioned in specifically dedicated Rasayana chapters of these classics (Charaka Chikitsa 1, Sushruta Chikitsa 27, 28, Ashtanga Hridaya Uttarsthana 39) were gathered. The botanical identity of the herbs were taken from “The plant list.org”. The contemporary review of those classical herbs mentioned as Rasayana in Ayurveda classics were done from PubMed and other databases. The searching key was Latin name of drug/herb+Rasayana activity. Results: Total 39 herbs were enumerated in Brihattrayi, among them 21 are in Charaka Samhita, 12 in Sushruta Samhita and 21 are from Ashtanga Hridaya, few of them are Bhallataka, Mandukaparni, Guduchi, Varahikanda, Soma, Tuvaraka, Vacha and Bhringaraja. Most of the herbs mentioned as Rasayana are evaluated scientifically for their antioxidant, immunomodulatory and nootropic potential. These reported activities of herbs support their Rasayana property. Conclusion: These studies indicate that daily damage of cells leads to early ageing and occurrence of many diseases. Rasayana herbs through their anti-oxidant, immunomodulatory and nootropic potential protect the damage which contribute towards health and longevity.

Introduction: Fistula in ano is one of the challenging diseases due to the lack of ideal treatment modalities and its high rate of recurrence. Fistulas with multiple openings are very difficult to manage considering the preservation of sphincter muscles. Modern science has developed many techniques in this area but mostly all were failures and resulted in complications like anal incontinence. Ksharasutra therapy is accepted worldwide as the ideal treatment modality of fistula in ano by its simultaneous cutting and healing property. Main Clinical Findings and Diagnosis: In this case, a 37 year old male patient presented with complaints of swelling over the right perianal area and intermittent pus discharge from that swelling for 1 year. On local examination, there were two external openings at 10 and 11'O clock position 4 cm away from the anal verge and a sentinel tag at 6'O clock position. Per rectal examination revealed induration and tenderness at 11'O clock above the dentate line. Intervention: It was managed by a new sphincter saving technique, modified conventional Ksharasutra therapy to fasten the recovery period and minimize the postsurgical pain. Conclusion: Fistula was completely healed by 5 weeks. No complications reported from the patient and no recurrence was happened after 6 months of follow up.

Introduction: Lower urinary tract symptoms (LUTS) are highly prevalent in men and the incidence increases with aging. The pathophysiology of LUTS is multifactorial and is characterized by voiding and storage symptoms. Acharya Sushruta described 12 types of Mutraghata along with its management in the form of single drug or compound formulations. Clinical Finding & Diagnosis: This is a case of LUTS secondary to benign prostatic hyperplasia; the patient was a known case of urosepsis, obstructive uropathy, and presented with LUTS with a Foley urethral catheter in situ for refractory urinary retention. Interventions: Despite the poor prognosis of the complicated LUTS, conservative treatment was given as per the management principles of urinary disorders in Ayurveda which showed a great potential in the management of complicated LUTS. Conclusion: The bothersome urinary symptoms of the patient were improved along with improvement in the quality of life and better compliance was observed by the patient.

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 < 0.0001). Maximum subjects in both groups (98.1% and 99.1%, respectively) had the evacuation of bowel within 1 hr of waking up. Further, maximum subjects had the habit of bowel evacuation after drinking water/tea/after breakfast, i.e., 64.5% and 60% in the study and control groups, respectively. A statistically significant number of subjects (45.5%) in the study group evacuated bowels 2–4 times in a day and 5.5% evacuated once in 2 days; it showed that subjects were constipated (P < 0.005). Maximum subjects in the study group had late waking-up and sleeping habits. The difference was statistically significant, with P = 0.04. Conclusion: Subjects with anorectal disorders (piles, fistula, and fissure) had the habit of suppression of defecation urge and also showed strong association between bowel and bladder habits and anorectal disorders. The waking-up and sleeping habits also showed statistically significant effect in causation of anorectal disorders.