Anal Route Research Articles

Single-operator single-balloon enteroscopy is safe and effective: A 6-year retrospective study.

Single-balloon enteroscopy (SBE) is an effective tool for the detection of small intestine lesions. Because itis conventionally performed by two operators, the efficacy of single-operator SBE method has not yet been elucidated. We aimed to evaluate the diagnostic yield, total enteroscopy rate, procedure time, and complications of single-operator SBE for small intestinal disease. This was a single-center, retrospective study including consecutive patients who underwent single-operator SBE for suspicious small intestinal disorders or required therapeutic interventions between December 2014 and January 2019. The SBE procedures were performed by four endoscopists. Diagnostic yield, total enteroscopy rate, procedure time, incubation depth, and complications were analyzed, and stratification analysis was performed. Altogether 922 patients with 1422 SBE procedures were included for analysis, among whom 250, 172, and 500 patients underwent SBE via the oral route, the anal route and a combined route, respectively. The overall diagnostic yield was 78.52% (724/922). And 253 patients achieved total enteroscopy, with a total enteroscopy rate of 56.10%. The average procedure time for the oral and anal routes were 69.28 ± 14.72 min and 64.95 ± 13.87 min, respectively. While the incubation depth was 389.95 ± 131.42 cm and 191.81 ± 83.67 cm, respectively. Jejunal perforation was observed in one patient, which was managed by endoclips. Stratification analysis showed that the diagnostic yield and total enteroscopy rate significantly increased with operation experience together with decreased procedure time. Single-operator SBE is effective and safe for the detection of small intestinal lesions, and is easy to master.

Role of Vitamin B17 against Colitis Bearing Female Mice Induced Variations in Some Blood Parameters

Colorectal cancer is also the third most common cause of cancer-related death, and in the US, it ranks as the third most prevalent kind of cancer. The cells that produce mucus to lubricate the colon and rectum can be the source of colorectal cancer. Natural substances known as phytochemicals contain anti-oxidant, anti-inflammatory, and anti-tumor properties. These properties may be crucial for the treatment of a number of debilitating illnesses. The extract of vitamin B17, or amygdalin, is made from the kernels of apricots. Nitrilosides are naturally occurring compounds that contain cyanide. Natural substances called amygdalin have been utilized in traditional Chinese medicine to treat a wide range of illnesses. Its various pharmacological qualities include anti-inflammatory, antioxidant, antitussive, anti-asthmatic, and anti-ulcer effects. findings, When colitis mice were given acetic acid injections via the anal route, they had diarrhoea, obvious rectal bleeding, and weight loss.serum ALT, AST, and ALP values were higher in the colitis group than in the control and vitamin B17 groups. Conversely, there was a notable drop in the colitis group's blood albumin and total protein levels when compared to the control and vitamin B17 groups. In contrast, as compared to the colitis group, vitamin B17 therapy for colitis resulted in a substantial decrease in the levels of ALT, AST, and ALP and an increase in the levels of albumin and total proteins. Serum urea and creatinine levels were higher in the colitis group in comparison to the vitamin B17 and control groups. However, there is a significant decrease in serum urea and creatinine levels in treated colitis with vitamin B17 group when compared with the colitis group. Compared to the vitamin B17 and control groups, the colitis group had higher blood levels of potassium and sodium ions. On the other hand, compared to the colitis group, the treated colitis with vitamin B17 group had significantly lower blood levels of potassium and sodium ions. When compared to the control and vitamin B17 groups, the colitis group's RBC levels and HB% were considerably lower; however, vitamin B17 therapy for colitis regulates and improves these alterations. In contrast to the control and vitamin B17 groups, the colitis group's WBC and platelet counts considerably increased. Conversely, the colitis group's WBC and platelet counts fell when treated with vitamin B17.

The anal pore route is efficient to infect Amblyomma spp. ticks with Rickettsia rickettsii and allows the assessment of the role played by infection control targets.

Adult Amblyomma sculptum and Amblyomma aureolatum ticks are partially refractory to Rickettsia rickettsii when fed on infected hosts, hindering the functional characterization of potentially protective targets in the bacterial acquisition. In the current study, we used the anal pore route to infect adult A. sculptum and A. aureolatum ticks with R. rickettsii and to assess the effects of the knockdown of microplusin in infection control. The anal pore route was efficient to infect both species, resulting in a prevalence of around 100% of infected ticks. Higher loads of R. rickettsii were detected in microplusin-silenced A. aureolatum in relation to the control, as previously obtained when microplusin-silenced ticks were fed on R. rickettsii-infected rabbits. This is the first report showing R. rickettsii infection through the anal pore in Amblyomma ticks, highlighting this route as a powerful tool to assess the role played by additional targets in the control of pathogens.

Classical and Modern Review on Sneha Kalpana w.s.r to Ghrita Kalpana

Ayurvedic dosage forms hold a unique place in pharmaceutics and therapeutics. Sneha Kalpana is a group of products of medicated Taila and ghee. It is an Ayurvedic preparation of oleaginous medicine that is prepared with the use of Kalka (herbal paste of different parts of plants), Kwatha (specifically prepared decoction in accordance with Ayurvedic principles) or Drava Dravya (any other liquid such as milk, juices etc.) With suitable Sneha as base taken in specific proportion, both the ingredients are mixed and heated under a specific temperature to meet the desired therapeutic requirement. In the modern terminology, Sneha can be correlated with Lipids. Materials and Methods: Literature related to Sneha Kalpana and Lipids have been referred from various Ayurvedic texts, modern medical books, research papers and journals. Properties of Sneha Dravya, Sneha sources, phases of Sneha Kalpana, effect of Sneha Paka on therapeutics, Sneha dose, Anupana, shelf-life, lipids and their types have been explained and compiled from different sources. Conclusion: Sneha Kalpana is used to extract fat soluble active principles from drugs and also to increase permeability of drugs so that they can be absorbed easily through the cell membrane. It is the only dosage form that can be administered through all routes of body, viz., Nasya (nasal route), Tarpan (ocular route), Karnapooran (auditory route), Snehapan (oral route), Abhyanga (topical route), Basti (vaginal, urethral, anal route). In the Modern era, various dosage forms can be developed as novel drug delivery system (NDDS) utilizing the concept of Sneha Kalpana (Lipids) to increase the bio availability of drugs to show maximum therapeutic effect.

AN EXPLORATORY STUDY ABOUT AROHANA ANUVASANA BASTI MATRA FROM CLASSICS: A REVIEW

Panchakarma is a unique treatment modality with five specially designed procedures, vamana, virechana, asthapana vasti, anuvasana vasti and nasya where the body is purified internally through the nearest possible pathway. Out of these shodhana therapies, vasti is the most important constituent of panchakarma due to its multidimensional properties. The administration of either medicated oil (anuvasana) or herbal decoction (niruha) through the anal route with the help of vastiyanthra is generally termed vasti karma. Anuvasana vasti mainly contains sneha (unctuous substances) and does not produce any side effects. It can be done daily after taking food, hence the name anuvasana. According to Sushruta and Kashyapa, anuvasana is classified into three types, sneha vasti, anuvasana vasti and matra vasti based on the sneha matra used. It is indicated when Kapha and Pitta dosha are diminished when there is Vata prakopa and the pathology is localized in the pelvic region associated with malabandha. Arohana matra of anuvasana vasti mentioned in classics is studied in detail here.

Motorized spiral enteroscopy in clinical practice: Benefits and results in a single-center cohort study of 204 procedures

ObjectivesThe aim of this paper relies on our clinical experience in a single center with an evaluation of feasibility, clinical benefits, and safety in daily practice based on diagnosis and therapeutic yield using a newly designed Motorized Spiral Enteroscope (MSE) marked by Olympus. MethodAll examinations were conducted in the usual endoscopy suite with patients in the left lateral position with deep propofol sedation monitored by an anesthesiologist (bolus 2 ​mg/kg then 0.5 ​mg/kg on demand with mean total dose 300 ​mg (225.6–386 ​mg). For the anal route, MSE was performed on the X-ray table in order to monitor colonic passage and ileocecal intubation. Inflation was carried out with CO2 used. ResultsFrom June 2019 to July 2022, 204 procedures have been carried out. 188 patients were involved as repeated MSE was required due to multiple bleeding (male 111, 57.1%, female 87, 46.2%). In all cases, we considered a successful MSE when the enteroscope was deeply inserted in the ileum and achieved diagnosis or therapeutic indications as an endpoint (195 patients, 95.5%). Diagnostic yield was achieved in 134 procedures (65.7%).Time to deep insertion was 11:36 ​± ​05.05 ​min, and the total procedure time was 22:07 ​± ​07:25 ​min. Minor mucosal damage occurred in 59 patients (28.9%). ConclusionsIn our 204 procedures MSE is a safe and useful new tool in routine clinical practice with an overall benefit for our patients.

A Unique Case of Foreign Body Acquired by Stabbing and Retained for 7 Years in the Sigmoid Colon

The ingestion of foreign bodies is a common cause for presentation in the emergency department by pediatric, adult, or elderly psychiatric patients. Swallowed foreign bodies sometimes represent a great challenge for surgeons due to the obstruction or perforation of the digestive tube’s upper or lower segments. Occasionally, the foreign bodies detected in the lower parts of the digestive tube (colon and rectum) could be introduced through the anal route with the risk of perforation of the rectum or sigmoid colon. In this report, we describe a unique case of a foreign body located in the sigmoid colon, where it arrived due to backstabbing and was retained for 7 years without acute symptoms. The 43-year-old male patient came to the emergency department with pain in the left iliac fossa. Before his presentation, a computerized tomography (CT) scan examination had suggested a foreign body. A surgical approach was decided. The surgery started as an exploratory laparoscopy and was converted to a xiphoid-pubic incision to extract the foreign body (a piece of glass about 8 cm long) through a sigmoid colotomy followed by a double-layer sigmoidorrhaphy. The postoperative evolution of the patient was uneventful. As far as we know, this is the first case of a patient with a foreign glass body positioned in the sigmoid colon that got there by stabbing and not by ingestion or introduced per anum. In conclusion, we suggest that aggressive behavior and abdominal wall penetration by different sharp objects should be considered when foreign bodies are detected in the abdomen.

Various Types of Basti Karma and their Therapeutic Indications: An Ayurveda Review

The various detoxifying techniques recommended by Ayurveda are Vaman, Virechan, Basti, Nasya and Raktamokshana. These all comes under the heading of Panchkarma procedure. Amongst them the Basti Karma is one of the important detoxification measures in which drug is transported through the anal route in the form of medicinal oil or herbal concoction. Enemas are frequently administered to clean the lower bowel in modern medicine as a last option for treating constipation when all other treatments have failed. Instead of this, Basti Karma, which is mentioned in classical Ayurvedic texts, has a wider therapeutic effect on almost all body tissues and has curative, preventive, health-promoting and rejuvenative effects. There are different types of Basti Karma proposed by Ayurveda philosopher which utilizes for various therapeutic purposes. Present article described various types of Basti Karma and their therapeutic indications along with general overview of this ancient technique.

Gastrointestinal Bleeding in a Child: Is It a Meckel Diverticulum?

A 2-year-9-month-old boy with multiple episodes of melena and hematochezia with unclear cause was admitted to our hospital. Laboratory tests showed iron deficiency anemia (hemoglobin of 5 g/dL) and positive fecal occult blood test. Single-operator double-balloon enteroscopy (DBE) through the anal route was performed and revealed multiple patchy mucosal eminence consisted of ectopic gastric pit and loss of villi observed by electronic stain in the distal jejunum, approximately 2 m from the ileocecal valve. The bowel cavity was deformed like a maze in the distal jejunum. There are several mucosal bridging structures and focal stricture, making it difficult to determine the direction of the lumen. Two irregular deep ulcers were found near the stricture (A [a–f] and Video 1). Emission computer tomography Tc99m pertechnetate scan showed multiple areas of radioisotope uptake in the middle and lower abdomen. At laparotomy, a 46-cm-long cyst was noted on the mesentery aspect that protruded alongside from the distal jejunum (B [a–c]). Resection of 58 cm of the jejunum was performed including the cyst. Pathology showed a duplication cyst located on the mesenteric aspect with ectopic gastric mucosa (C). The postoperative diagnosis was a duplication cyst of the jejunum. The patient was discharged 14 days after surgery and remained symptom-free thereafter. Intestinal duplication cysts are rare congenital malformations that can appear anywhere in the gastrointestinal tract. The preoperative diagnosis of a duplication cyst is difficult and can be easily misdiagnosed as Meckel diverticulum. Duplication cysts usually locate on the mesenteric aspect as in our case, in contrast to Meckel diverticulum that localizes on the antimesenteric aspect. In our case, the deformed intestine was found approximately 2 m from the ileocecal valve, which was not common in Meckel diverticulum. To the best of our knowledge, this is the first reported tubular type of jejunal duplication cyst case with an DBE video. DBE can be a useful tool for the diagnosis of intestinal duplication in young children. Watch the Video, Supplementary Digital Content 1, https://links.lww.com/AJG/C853. (Informed consent was obtained from the patient to publish these images.)

Ethnopharmacological Study and Antibacterial Activities of Some Plants Used in Traditional Medicine for the Treatment of Diarrheal Diseases in Gabon

The purpose of this work was to develop ethnopharmacological and biological studies of plants used in traditional medicine for the treatment of diarrheal diseases. This study results in scientific data that validates the uses of these plants in traditional medicine. Firstly, ethnopharmacological surveys were conducted with a few traditional healers from the provinces of Estuaire, Haut Ogooué and Woleu-Ntem in Gabon. Next, ethnobotanical data such as percentage of families, species, routes of administration, methods of preparation, parts used and number of plant names were analyzed and summarized. Finally, the antibacterial activities of some plants have been evaluated by diffusion and microdilution methods. Thirty-four (34) traditional healers were interviewed. A total of 90 plant species were identified during this study. They belong to 44 families, the most represented were Leguminoseae (13.33%), Apocynaceae (7.78%), Annonaceae (5.55%), Euphorbiaceae (4.44%) and Anacardiaceae (4.44%). Trees were used more (44.44%) than shrubs (32.22%), herbaceous plants (16.67%) and lianas (6.67%). The drug administration was mainly oral (84.62%) and by the anal route. Decoction and maceration were the two most used methods of preparation. Among identified plants, twenty-seven (27) plant extracts were subjected to microbiological analyzes. Plant extracts tested were active on Gram-negative and Gram-positive bacteria. Cola nitida extracts gave the best antibacterial activity against Enterococcus faecalis 103907 CIP. This study identified 90 antidiarrheal plant species and clearly shows the antimicrobial potential of several medicinal species.

Comparison of oral and anal inoculation of Enteromyxum leei into olive flounder Paralichthys olivaceus

Enteromyxum leei causes emaciation disease in fish, resulting in economic losses in the aquaculture industry. To develop control methods against E. leei infection, efficient and stable experimental infection of the parasite should be established. To determine the optimal experimental infection of E. leei, we carried out oral and anal inoculation into the olive flounder with different doses of parasite. A total of 90 fish were inoculated with approximately 500 primary cells of E. leei/μL through the oral and anal routes with volumes of 20, 50, and 100 μL. The oral inoculation group showed a higher prevalence, heavier infection intensity, and a greater decrease in relative condition factor than the anal inoculation group. However, there was no significant association between the indicators of parasite infection and the inoculation dose. The mortality in the anal inoculation group was higher than that in the oral inoculation. Dead fish showed rectal hernia and abdominal distension with ascites, and Edwardsiella piscicida was isolated from their kidneys and ascites. Statistical analysis revealed a significant relationship between mortality and E. piscicida infection. Based on the results, we suggest that oral inoculation is more efficient and safer than anal inoculation. In addition, the effect of a bacterial infection should be considered when diagnosing the mortality of cultured olive flounder infected by E. leei.

A clinical study to evaluate the effect of Guduchyadi Ksheerabasti in Hyperuricemia

Background: Hyperuricemia affects approximately 5.9% of men and 2.0% of women and around 12% of overall population. Vatarakta is correlated with hyperuricemia is a acute/chronic inflammatory condition of joint takes place predominantly where serum uric acid is raised beyond 6.8 mg/dL. Aims and Objectives: Assessment of Guduchyadi Ksheera Basti in the management of Hyperuricemia. Methodology: The 23 patients of either sex belonging to age between 20-70 years having signs and symptoms of Hyperuricemia and confirmatory haematological investigations, were selected and after local massage and fomentation, were administered Ksheera Basti through anal route for a period of 8 days (Kala Basti Schedule) Niruha and Anuvasana given on the same day. Results were statistically analysed by using paired ‘t’ test and Wilcoxon signed rank test. Observations and Results: Ksheera Basti provided statistically highly Significant effect (p<0.001) in improving in almost all the cardinal symptoms of Hyperuricemia. It also provided statistically highly significant results in improving all the given parameter in Visual Analogue Scale (VAS), Numerical rating scale (NRS), Verbal Rating Scale (VRS), status of serum uric acid, Bodily pain assessment, due to nourishing, rejuvenating, anti-inflammatory, immunomodulatory and analgesic properties of ingredients. Conclusion: Guduchyadi Ksheera Basti yields good clinical improvement in pacifying Vatadhika, Pittadhika Vatarakta.

Ileoileal Intussusception Caused by Ileal Neuroendocrine Carcinoma

A 62-year-old man presented with intermittent hematochezia and nonradiating right lower-quadrant pain for 2 weeks. He had a history of atrial fibrillation under warfarin prophylaxis and end-stage renal disease on hemodialysis. Esophagogastroduodenoscopy and colonoscopy did not show identifiable bleeding source. Abdominal computed tomography angiography showed the target sign in the ileum (Figure A). Double-balloon enteroscopy was performed via the oral route followed by the anal route, where 1 nonobstructing 2-cm polypoid tumor was found at midileum (Figure B).

Ethno-botanical Survey and Chemical Study of Medicinal Plants Traditionally used to Treat Anemia in Yakoma Territory (Nord Ubangi), Democratic Republic of the Congo

Aims of the Study: To identify plant species traditionally used to treat anemia in Yakoma territory and to evaluate their chemical composition.
 Place and Duration: Yakoma Territory (survey) and University of Kinshasa (Phytochemical study), from August and October 2019.
 Methods: Ethnobotanical survey according to the "snowball" sampling technique among traditional healers (based on the free consent of the respondents), chemical analyses of plant materials (chemical screening, TLC, phytomarkers content, minerals composition) according to standard methods. ED-XRF was used for mineral analysis. Microsoft Excel version 2010, Origin version 8.5 Pro and IBM SPSS statistics version 20 software packages were used for data processing and analysis.
 Results and Discussion: The survey showed that 18 plant species are traditionally used by Ngbandi traditional healers to treat anemia in Yakoma territory. They belong to 16 families and 17 genera. The most used organs are the leaves (68.4%) and the roots (10.5%). Decoction and infusion are the most used mode of preparation (33.3% each), followed by cooking (22.2%) and maceration (11.1%). The oral route (77.8%) is the most used mode of administration followed by the enema (16.7%) and the anal route (5.6%). Morphological types consist of herbs and trees (33.3% each) and shrubs and lianas (16.7% each). The biotope types consist of forest plants (44.4%), cultivated plants/Crops (38.9%), marshy ground plants (11.1%) and ruderal plants (5.6%). These plants belonging to five biological types: erected therophytes (44.4%), mesophanerophytes (27.8%), microphanerophytes and climbing phanerophytes (11.1% each) and lianescent phanerophytes (5.56%). These anti-anemic plant species are mostly Pantropical and Afro-tropical (39% of species each) followed by Guineo-Congolese (17% of species) and American (5%). Chemical analysis revealed the presence of alkaloids, anthocyanins, flavonoids, anthraquinones and terpenoids and various minerals including iron, zinc, copper, calcium, magnesium and manganese.
 Conclusion: In the current state of knowledge, the survey of anemic plants from this part of the Democratic Republic of the Congo is reported for the first time.

The case of spontaneous stoma closure in patient with loop ileostomy.

IntroductionAn ileostomy is a mean to empty the contents of the bowel via ileum rather than usual anal route to prevent distal anastomotic leak. It is considered a controlled entero-cutaneous (EC) fistula which prevents contamination of peritoneal cavity, protecting the peri-stomal skin from effluent and excoriation. Spontaneous closure of ileostomy is a very rare phenomenon. Thus, we hereby report a case of spontaneous closure of ileostomy.Case presentationAn 18-years male presented with complaints of pain abdomen, vomiting for 6 days. Chest X-ray showed free air under the right dome of diaphragm suggestive of pneumo-peritoneum. So explorative laparotomy with primary repair of ileal perforation with diversion loop ileostomy (2 ft proximal to ileocecal junction) was performed. Over the months stoma retracted and eventually spontaneous closure of stoma took place after 4 months of surgery.DiscussionRetraction of stoma depends on multiple factors. Firstly, on patient's general condition, if he/she is malnourished/obese/immunocompromised then retraction occurs due to poor healing of wound. Secondly, it results from inadequate mobilization of bowel. Separation of stoma with muco-cutaneous fascial planes leads to gradual retraction of stoma which is primary mechanism of spontaneous closure of stoma.ConclusionTo summarize, gradual retraction of stoma (complication of an ileostomy) and healing of EC fistula has to be correlated to know the complex mechanism of spontaneous closure of an ileostomy.

Matra Basti-Mode of Action-A Conceptual Study

The five-bio cleansing/detoxifying procedures (Panchakarma procedures/ Samshodhan Chikitsa) advocated in Ayurveda are Vaman(Therapeutic emesis), Virechan(Therapeutic Purgation), Basti (Medicated Enema), Nasya (Infiltration of medications through nostrils), and Raktamokshana(Bloodletting by different methods). The therapeutic oil or herbal decoction is administered through the anal route in Basti Karma. Ayurveda considers Basti Chikitsa to be one of the most important Panchakarma treatments. It contains both therapeutic and preventative as well as promotional properties. This Basti therapy also helps to relieve tension in the body and mind, hence improving one's quality of life. The rectum is used to administer herbal decoctions and therapeutic oils to thecolon. It is not a localised or symptomatic treatment, despite the fact that it directly affects the colon. Vatahara, Shulahara, Shothahara, Srotoshodhaka, Yogavahi, Agnideepaka, and Rasayanaare some of the roles that Basti Dravyascan play. Matra Bastiis an oil/unctuous substance-free therapy. Abhyanga (therapeutic oil massage) and Swedanaare performed before to it (sudation). Human is the king of the castle (body) so he has to make the decisions how to convert it into more beautiful and healthy state along with its prevention from the rust of impurities.The current article summarises the ayurvedic perspective on Matra bastiand its mode of action.

A Review Article on dose of Matra Basti

Panchakarmapresents a unique approach of Ayurvedawith specially designed five procedureof internal purification of the body through the nearest possible route. These are Vamana, Virechana, Basti, Nasyaand Raktamokshana. Ayurvedaconsiders BastiChikitsato be one of the most important Panchakarmatreatment. The therapeutic oil or herbal decoction is administered through the anal route in BastiKarma. MatraBastiis one among the SnehaBasti. It is termed so because the dose ofSnehaused in it is small when compared to the dose of SnehaBasti. MatraBastithat, there is norestriction of food or regimen while administering MatraBasti. It can be administeredcontinuouslyinallseasons. The term Matra Bastiis popular because of its dose only, because Snehais administered in the Hraswamatra. Here this article has made to know the different dose of Matra Bastias per different Achaya

Unusual Case of Foreign Body Ingestion in a Child: A Case Report

Foreign body ingestion is a common problem in pediatric age group patients throughout the world. Radiographic findings revealed multiple foreign bodies throughout abdomen. Foreign objects attach frequently at the esophageal anatomic narrowing. They must be taken out immediately because they can cause an obstruction, mucosal erosion or perforation. Endoscopy is the criterion standard for removal of foreign bodies from the esophagus. Here, we report an interesting case of a multiple stones ingested by a female child. The child presented with complaints of distension of abdomen, vomiting and pain all over abdomen. The foreign bodies were found as hard black stones after removing them through anal route.

MANAGEMENT OF GUD BHRANSHA WITH KASISADI TAIL - A CASE STUDY

Gud Bhransha is a protrusion of mucous membrane of the Rectum from outside the anal verge with membrane or without membrane. It can be partial or complete. This condition is common in children and elderly patients. There are two types of treatment of rectal prolapse are conservative and surgical. The type of treatment of rectal prolapse depends on the severity of the disease. A clinical study was conducted on the patient of Gudbhransh with an elderly patient disease to evaluate the contraction effect of the Kasisadi tail which is traditionally practised in rural areas of Igatpuri, Maharashtra, India based on a survey. The aim and objective of this study were to evaluate the contraction effect of the Kasisadi tail over prolapsed rectal mucosa. Which was successfully treated by conserva- tive Ayurvedic management Gudbhransh is treated in line with the treatment of Ayurveda as a complication of Atisar by the Kasisadi tail by anal route for correction of prolapse locally. The case result confirms that rectal prolapse can be managed effectively with Ayurvedic treatment in a short duration of time. Keywords: Kasisadi Tail, Gudbhransh, Rectal prolapse, Atisar

Efficacy of Mahanarayana Taila Matra Basti in Primary Insomnia (Anidra)-An Analytical Review

We all live in 21st century; this era is an age of industrialization and fast life. This fast life has destroyed healthy life style which has created various lifestyle disorders. Insomnia is one of those deadly disorders. Nowadays increasing number of patients with various forms of sleep pattern abnormalities is seen attending the outpatients, among this insomnia is important one. Insomnia disorder is defined as a subjective perception or complaint of inadequate or poor quality sleep due to a number of factors such as difficulty in falling asleep, waking up frequently during the night with difficulty in returning to sleep, waking up too early in the morning or un refreshing sleep. In Ayurveda it can be corelated with Anidra and Nidranasha. People with Vata and Pitta Prakriti are more susceptible to develop insomnia [1]. Asvapna is categorized in to 80 Nanatmaja Vata diseases [2]. Anidra is a disease, which is having cardinal symptoms like Jrumbha, Angamarda, Tandra, Shiroroga, Shirogaurava, Akshigaurava, Jadya, Glani, Bhrama, Apakti and Vataroga occur due to sleeplessness [1]. Allopathic treatments show temporary relief in curing of this disease and produce massive side effects. Ayurveda has a very good approach towards the treatment of insomnia by both internal and external medications. Panchakarma therapy is designed to eliminate the vitiated Doshas through the nearest route. Mahanarayana Taila when administered through anal route in the form of Matra Basti, it gives soothing effect to the mind and initiate good sleep. After reviewing the recent findings from literature we aim to discuss efficacy of therapy in management of insomnia.