Conceptual Study on Management of Surgical Complications of Prameha w.s.r to Diabetes and Its Management by Acharya Sushruta

Abstract

Prameha is characterized by copious flow of cloudy or turbid urine and as a sequel pidakas will be formed which are again with all the tridosha vitiation. 1 The disease prameha may be correlated to diabetes depending upon the similar characteristics of these two entities. Diabetes mellitus is recognized as a syndrome characterized by chronic hyperglycemia due to relative deficiency of insulin or resistance or both. The common surgical complications are – macro vascular changes, micro vascular changes, diabetic neuropathy, and infection in glucose-laden tissue. Most common are carbuncles, diabetic foot, necrotizing fasciitis, and atherosclerosis. Acharya Sushruta has described 10 prameha pidakas which are considered to be the complications of diabetes. Understanding the pathology and breaking the pathology by time would help to prevent the establishment of such complications and thus reducing the morbidity and mortality. Application of concepts of Ayurveda such as – Following pathya ahara vihara periodically, usage of shodhana therapies . Raktamokshana in order to improve the blood circulation as well as removal of impurities through blood. Lekhana basti s can be adopted in the prevention and management of vascular related complications, which would decrease the risk of gangrene formation as well as cardiac complications. In case of established cases of diabetic ulcers – use of topical application of Shodhana Dravyas like Gomutra Arka, Guggulu Tiktaka Ghrita , and Ropana Dravyas . The Shodhana therapies would help the diagnosed cases to eliminate the toxins and thus prevent and manage the complications like atherosclerosis and other complications. Local foot care, ulcer care, improvement of blood circulation would prevent gangrene formation and thus reduce the chances of amputation.