Clinical Complaints Research Articles

Investigation of the effect of visceral adiposity index on venous clinical severity score in patients with chronic venous insufficiency

Introduction Chronic venous insufficiency (CVI) is a common disease affecting millions worldwide. Age, obesity, female gender, sedentary life, and long-standing at work causing orthostasis have been identified as predisposing factors. Objective The visceral adiposity index (VAI) is an important indicator of abdominal obesity. Various studies in the cardiovascular field have shown that it may be more predictive than body mass index (BMI). Methods A total of 171 consecutive patients diagnosed with low-grade (C0–C3) superficial primary CVI in our clinic, between November 2021 and December 2022, were included in this prospective study. Venous Clinical Severity Score (VCSS) values were calculated. The patients were divided into two groups according to their VCSS values (Group 1: VCSS ≤6 and Group 2: VCSS >6). Results There were 110 patients in Group 1 with a median age of 42 (18–50) years. There was no difference between the groups in terms of gender, smoking, hypertension frequency, height, weight, body mass index, hemoglobin values, lymphocyte, neutrophil, mean platelet volume, urea, creatinine, high-density lipoprotein, low-density lipoprotein, triglyceride, and total cholesterol values ( p > .05). Multivariate logistic regression analysis was performed to reveal the predictive factors of high VCSS values in patients. As a result of the analysis, VAI (Odds Ratio (OR): 1.775; 95% Confidence Interval (CI): 1.389–2.269; p < .001) and CRP (OR: 2.641; 95% CI: 1.431–4.875; p = .002) values were identified as independent predictors in predicting high VCSS values. Conclusion This current study showed that high VAI values affect clinical complaints in patients with low-grade CVI. In line with our results, clinical recommendations can be made to reduce VAI values in low-stage CVI patients.

Validation of the 10-Item Unilateral Vocal Fold Paralysis-Handicap Index quality of life questionnaire.

To validate and test the reliability of the 10-Item Unilateral Vocal Fold Paralysis-Voice Handicap Index (UVFP-HI-10) quality of life (QoL) questionnaire for patients with UVFP. Prospective describe study based on perceptive surveys. We recruited 61 patients with UVFP and 53 healthy individuals comprised the control group. Both the patients and controls completed the UVFP-HI-10 questionnaire. A statistical analysis was performed to assess the internal consistency and validity of the survey. In addition, maximum phonation time (MPT) was used to objectively measure patient QoL. Internal consistency was high (α = .914) and the correlation with MPT was significant (rs = -0.722). The estimated marginal mean in the discriminant validity study was around seven times higher in the UVFP group compared to the controls. The UVFP-HI-10 cut-off value was more than 0.9 and the sensitivity and specificity were more than 0.8. The UVFP-HI-10 is a self-administered patient-reported outcome questionnaire with a high reliability and excellent criterion-based validity. This questionnaire can be used to evaluate specific clinical complaints (e.g., vocalisation, swallowing, and breathing) in terms of their impact on QoL in patients with UVFP. Thus, its use is appropriate as a basic assessment tool as part of a specific UVFP treatment protocol.

Mortality Rates Of Adult Pulmonary Tuberculosis With Malnutrition: A Case Report And Comprehensive Literature Review

Tuberculosis (TB) and malnutrition are still major public health problems in the world. These two clinical conditions can occur simultaneously and create a vicious cycle that worsens TB infection or nutritional status. This case report aims to examine the relationship between low nutritional status (malnutrition) of patients and death due to pulmonary TB. A 31 year old woman came to the pulmonary clinic of a tertiary hospital in Jakarta for her third month of drug-sensitive anti-TB drug (OAT) treatment control. Three months earlier, the patient underwent a rapid diagnostic test (RDT) to determine OAT resistance. The conclusion of her anthropometric examination was body mass index (BMI) of 15.6 kg/m2. Before being diagnosed with pulmonary TB, she always had difficulty gaining weight. During the course of disease, her weight decreased by 5 kg per month. After undergoing treatment for 6 months, the patient was declared complete after 6 months of therapy, without any improvement in nutritional status. At 1 year follow-up, the patient experienced a relapse of pulmonary TB with a BMI of 13.2 kg/m2. She died 2 months after diagnosis of relapse TB. Improvement in clinical complaints and conversion to bacteriological examination are indications of successful therapy, including improvement in nutritional status. To analyze the relationship between malnutrition and pulmonary TB and death, the authors conducted a comprehensive literature search in the journal databases PubMed, Cochrane, and Scopus, followed by analysis according to the PRISMA 2020 flowchart, for a prognostic cohort study of cases of death in pulmonary TB patients with malnutrition. There is a relationship between BMI and the risk of death in TB patients. Anthropometric measurements, especially BMI, need to be carried out during every physical examination of pulmonary TB cases.
 Keywords: Body mass index; Malnutrition; Mortality; Tuberculosis

Management of intraorbital metallic foreign body with lateral orbitotomy and c-arm guiding surgery: a challenging case

Introduction: Orbital trauma is an emergency condition that often occurs with increasing mobility and industry. An intraorbital foreign body is one of the traumas that occur in the orbit. An intraorbital foreign body is an entrapment of corpus alienum in the orbital cavity, either accompanied by orbital fracture or not accompanied by fracture. Case Report: We report a 31-year-old man who suffered ocular trauma and had a rusty hammer splinter foreign body stuck in the orbital cavity of the right intraconal region. The patient was found with an initial suspicion of IOFB, but investigations with a head CT scan could not detect the presence of IOFB. The treatment of choice for this patient is a lateral orbitotomy with C-arm fluoroscopy guiding. Panuveitis occurred in the patient's eye after the extraction of the corpus alienum was performed. Suspicion of inflammation caused by siderosis bulbi cannot been ruled out. Discussion: Suspicion of the presence of an intraorbital foreign body can be based on several clinical symptoms and patient complaints and the presence of port d' entry through the cornea, sclera, or eye adnexa. Management of intraorbital foreign body depends on the type of foreign body, its location in the orbit and the presence or absence of accompanying complications. Lateral orbitotomy with c-arm guiding in this patient successfully extracted an intraconal foreign body using the S-Stallar Wright incision technique. Avoid ocular complications due to intraorbital foreign body retention include orbital cellulitis, chronic cutaneous fistula, optic neuropathy, extraocular muscle rupture, bulbar perforation, intracranial penetration, intraorbital arteriovenous fistula, and chorioretinal atrophy. Conclusion: The management of intraorbital foreign bodies depends on the type of retained foreign body, whether inert or non-inert/toxic. So that it can prevent patients from threatening intraorbital and intraocular complications.

Современное лечение бактериального вагиноза во втором триместре беременности

Purpose: to assess the effectiveness of modern methods of treatment of patients with BV in the second trimester of pregnancy. Material and methods. The prospective comparative study included 50 patients of the second trimester of pregnancy with BV, which are divided into 2 groups. The first group received clindamycin + Lactoginal at the same time. The second group received the probiotc Lactoginal. Microscopic examination of the vaginal smear and PCR diagnostics were performed in all pregnant women. After treatment, a second study was carried out on the vaginal microflora in pregnant women. Results. According to the results of the study: according to the Amsel criterion, the recovery of patients in group 1 was 88%, in group 2 – 84%. According to the PCR study in group 1 – 80%, in group 2 – 76%. After the therapy, none of the patients noted clinical complaints. In the study groups, in 42 patients, pregnancy ended in timely delivery; caesarean section in 8 patients. Conclusion. The use of a probiotic in pregnant women with BV separately is an alternative method of treatment, favorably affects the entire period of pregnancy, as well as subsequently on delivery

Retained primary teeth: A clinical complaint not to be dismissed.

Retained primary teeth (RPT) may be an isolated finding, or one associated with other clinical complaints. In order to achieve timely and accurate diagnosis, it is helpful for paediatricians to perform thorough work-up for these patients. The article aims at providing an overview of the inborn medical causes that may be related to children with RPT, as well as their corresponding investigation and treatment modalities.

Strengthen multidisciplinary diagnosis and treatment and collaborative research on chronic cough

Chronic cough is the most common complaint in respiratory specialist clinics. The causes of chronic cough are related to respiratory system, otorhinolaryngology, gastroenterology, psychiatry and other systems. Cough hypersensitivity is the most important clinical and pathophysiological feature. Many patients with chronic cough are misdiagnosed and treated inappropriately. To improve the diagnosis and treatment of chronic cough, we should establish a multidisciplinary team and strengthen collaborative study, including cough laboratory, multidisciplinary clinic, and chronic cough ward.

Advances in clinical studies of chronic cough

Chronic cough is a common complaint in respiratory specialist clinics, with a significant impact on cough-specific quality of life and psychophysiological health. The diagnosis, treatment and management of chronic cough remains a major challenge. We summarized a series of recent advances from clinical studies in the epidemiology, diagnosis and management of chronic cough over the past year.

Bronchoscopically-visible massive central airway cancer cavitation is associated with metastatic disease, lack of actionable mutations and poor prognosis: a case series.

Cavitating lung tumors occur in approximately 10-15% of the patients, are more commonly associated with squamous histology, and are typically located in the lung parenchyma. Herein we describe an exceedingly rare series of 5 patients, 4 of whom treatment-naïve, whose tumor caused the disruption of the normal airway anatomy at the level of lobar or segmental bronchi, leading to the formation of an endoscopically-visible cavity which ended up in the lung parenchyma or even into the pleural space. Sex (3 males, 2 females), smoking habit (2 never smokers, 2 former smokers, 1 current smoker), and histology (3 adenocarcinoma, 2 squamous cell carcinoma) were heterogeneous, but the 4 patients treatment-naïve presented with metastatic disease, poor ECOG performance status, similar clinical complaints of long duration, and lack of actionable mutations. The only patient who exhibited a meaningful response to treatment had the lowest symptoms' duration, the smallest size of the cavitated mass, and the best performance status at the time of diagnosis. This series provides the first comprehensive description of a rare presentation of lung cancer characterized by similar clinical complaints, delayed diagnosis and poor prognosis.

Metallic artifact suppression with MAVRIC-SL in magnetic resonance imaging for assessing chronic pain after hip or knee arthroplasty.

To analyze the association between osteolysis at the prosthesis interfaces, as determined by magnetic resonance imaging (MRI) with multiacquisition variable-resonance image combination selective (MAVRIC-SL) sequences, and clinical severity after knee or hip arthroplasty, as well as to assess interobserver and intraobserver agreement on periprosthetic bone resorption. This was a cross-sectional study of 47 patients (49 joints) under postoperative follow-up after knee or hip arthroplasty, with chronic pain, between March 2019 and August 2020. All of the patients completed the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaire. The component interfaces were evaluated and ordered into two groups: osseointegrated and osteolytic. Nonparametric tests were used. There were significant differences between the two groups in terms of the mean WOMAC scores: total (p = 0.010); stiffness domain (p = 0.047); and function (p = 0.011) domains. There was substantial interobserver and intraobserver agreement for most analyses of the components. Periprosthetic osteolysis appears to be associated with clinical complaints of pain in the post-arthroplasty scenario, and MAVRIC-SL provides reproducible assessments. It could prove to be an important tool for orthopedists to use in the evaluation of challenging cases of chronic pain after arthroplasty.

Heart Rate Variability as a Surrogate Marker of Severe Chronic Coronary Syndrome in Patients with Obstructive Sleep Apnea.

Obstructive sleep apnea (OSA) is a known risk factor for chronic coronary syndrome (CCS). CCS and OSA are separately associated with significant changes in heart rate variability (HRV). In this proof-of-concept study, we tested whether HRV values are significantly different between OSA patients with concomitant severe CCS, and OSA patients without known CCS. The study comprised a retrospective assessment of the historical and raw polysomnography (PSG) data of 32 patients who presented to a tertiary university hospital with clinical complaints of OSA. A total of 16 patients (four females, mean age 62.94 ± 2.74 years, mean body mass index (BMI) 31.93 ± 1.65 kg/m2) with OSA (median apnea-hypopnea index (AHI) 39.1 (30.5-70.6)/h) and severe CCS were compared to 16 patients (four females, mean age 62.35 ± 2.06 years, mean BMI 32.19 ± 1.07 kg/m2) with OSA (median AHI 40 (30.6-44.5)/h) but without severe CCS. The short-long-term HRV (in msec) was calculated based on the data of a single-lead electrocardiogram (ECG) provided by one full-night PSG, using the standard deviation of the NN, normal-to-normal intervals (SDNN) and the heart rate variability triangular index (HRVI) methods, and compared between the two groups. A significant reduction (p < 0.05) in both SDNN and HRVI was found in the OSA group with CCS compared to the OSA group without CCS. Severe CCS has a significant impact on short-long-term HRV in OSA patients. Further studies in OSA patients with less-severe CCS may shed more light onto the involved mechanistic processes. If confirmed in future larger studies, this physiologic metric has the potential to provide a robust surrogate marker of severe CCS in OSA patients.

Iron depletion in “metabolic fatty liver syndromes”: a strong biological rationale with disappointing liver outcomes

Nonalcoholic fatty liver disease (NAFLD), its more rapidly progressive steatohepatitic variant [nonalcoholic steatohepatitis, (NASH)], and the recently defined metabolic dysfunction-associated fatty liver disease (MAFLD) may be collectively alluded to as “metabolic fatty liver syndromes” (MFLS). MFLS is a common clinical complaint for which no licensed drug treatment is available and a public health issue posing a heaven burden on healthcare systems. Iron plays a key role in many of the key pathogenic steps concurring in the development and progression of MFLS, notably including genetics, intestinal dysbiosis, adipositis, insulin resistance (IR), metaflammation, oxidative stress and ferroptosis, endoplasmic reticulum (ER) stress, and hepatic fibrosis (FIB). This notion raises the logical expectation that iron depletion, which can easily be implemented with venesection, might improve several aspects of MFLS. However, few published studies have globally failed to support these expectations. In conclusion, venesection in MFLS exhibits a strong biological rationale and possible metabolic benefits. However, confronted with failures in hepato-histological outcomes, data call for additional studies aimed to reconcile these inconsistencies.

Autonomic function in sporadic and familial ALS type 8

ObjectiveTo characterize and compare autonomic function in patients with sporadic (sALS) and familial ALS type 8 (fALS8). MethodsWe selected 11 patients with sALS (7 men), 14 with fALS8 (8 men) and 26 controls (15 men). All groups were gender and age-matched. For each subject, Scale for Outcomes in Parkinson's Disease for Autonomic Symptoms (SCOPA-AUT) was applied and data from heart rate variability, Quantitative Sudomotor Axon Reflex Test (QSART) and skin sympathetic response (SSR) were collected. These data were compared across groups using nonparametric tests. P-values < 0.05 were considered significant. ResultsSCOPA-AUT revealed predominant clinical complaints in thermoregulatory, pupillomotor and sexual domains in fALS8 relative to sALS as well as controls. Neurophysiological tests demonstrated significant differences in Valsalva ratio, Expiratory:Inspiratory index and RR minimum values in both ALS groups relative to controls. Sudomotor dysfunction was also observed in sALS and fALS8 groups, as shown by reduced medial forearm and foot QSART volumes and absence of SSR in lower limbs. ConclusionsDysautonomia – cardiac and sudomotor - is part of the phenotype in sALS and fALS8. The profile of autonomic symptoms, however, is different in each group. SignificancePatients with fALS8 and sALS have autonomic dysfunction involving both sympathetic and parasympathetic divisions.

What Patients Say About Their Orthopaedic Hand and Wrist Surgeons: A Qualitative Analysis of Negative Reviews on Yelp.

Background Patients often turn to online reviews as a source of information to inform their decisions regarding care. Existing literature has analyzed factors associated with positive online patient ratings among hand and wrist surgeons. However, there is limited in-depth analysis of factors associated with low patient satisfaction for hand and wrist surgeons. The focus of this study is to examine and characterize extremely negative reviews of hand and wrist surgeons on Yelp.com. Methods A search was performed using the keywords "hand surgery" on Yelp.com for eight major metropolitan areas including Washington DC, Dallas, New York, Phoenix, Los Angeles, San Francisco, Boston, and Seattle. Only single-star reviews (out of a possible 5 stars) of hand and wrist surgeons were included. The complaints in the 1-star reviews were then categorized into clinical and nonclinical categories. Result A total of 233 single-star reviews were included for analysis, which resulted in 468 total complaints. Of these complaints, 81 (18.8%) were clinically related and 351 (81.3%) were nonclinical in nature. The most common clinical complaints were for complication (24 complaints, 6%), misdiagnosis (16 complaints, 4%), unclear treatment plan (16 complaints, 4%), and uncontrolled pain (15 complaints, 3%). The most common nonclinical complaints were for physician bedside manner (93 complaints, 22%), financially related (80 complaints, 19%), unprofessional nonclinical staff (61 complaints, 14%), and wait time (46 complaints, 11%). The difference in the number of complaints for surgical and nonsurgical patients was statistically significant ( p < 0.05) for complication and uncontrolled pain. Clinical Relevance Patient satisfaction is dependent on a multitude of clinical and nonclinical factors. An awareness of online physician ratings is essential for hand and wrist surgeons to maintain and improve patient care and patient satisfaction. We believe the results of our study could be used to further improve the quality of care provided by hand and wrist surgeons.

Six Years of Complaints Issued by Patients at a Laser Treatment Center in a Plastic Surgery Hospital.

Patient complaints can provide valuable feedback regarding the objective deficiencies of medical services. There are few studies on the complaints of patients receiving photoelectric therapy, so this study aims to understand the expectations and requirements of patients by analyzing the complaints of patients receiving photoelectric therapy. The complaints of patients who underwent photoelectric therapy were retrospectively examined. Authors plan to analyze treatment items, complaint contents, appeals, time trend regarding the number of complaints, and economic compensation. Fifty-four patients were involved in the study in total, and all of them were included. According to the standardized coding classification of complaints by Reader et al., the number of clinical, management and relationship complaints were 36 (59.02%), 14 (22.95%), and 11 (18.03%), respectively. These were divided among the categories of quality (31.15%), safety (27.87%), institutional issues (22.95%), communication (8.20%), and humaneness/caring (9.84%); with the most common subcategories involving treatment (31.15%) and safety incidents (24.59%). The patients' demands involved 20 cases (32.26%) requesting a refund of their medical expenses, 16 (25.81%) issuing a warning, 15 (24.19%) requesting compensation for loss, 10 (16.13%) requiring free repair or consultation, and 1 (1.61%) demanding an apology. Eventually, financial compensation was provided to the patients in eight of the cases. At a significance level of P = 0.05, even if the number of annual complaints increased over time, the increasing trend was not significant. Patient complaints in photoelectric therapy were most commonly clinical in nature. Specifically, quality and safety concerns are the main complaints.

Development of a new universal adhesive containing CPNE7-derived peptide and its potential role in reducing postoperative sensitivity.

Post-operative sensitivity (POS) is the most common clinical dental complaint after tooth preparation and resin-based composite restoration. In our previous study, copine 7 (CPNE7) and CPNE7-derived peptide (CPNE7-DP) induced in vitro odontoblast differentiation and in vivo dentin formation. Here, we incorporated CPNE7-DP into All-Bond Universal (ABU) adhesive, developing ABU/CPNE7-DP. This study aimed to investigate the possibility of reducing POS using ABU/CPNE7-DP. We first determined the stability of CPNE7-DP under low pH. Furthermore, we evaluated its dentinal tubule penetration, in vitro odontogenic differentiation potential, in vivo tertiary dentin formation and its effects on bonding performance. CPNE7-DP was stable at pH 1.2, even lower than ABU's pH of 3.2. ABU/CPNE7-DP can penetrate dentinal tubules, stimulate odontoblast differentiation in vitro and generate tertiary dentin with tubular structure in vivo without interfering with bonding performance. Therefore, ABU/CPNE7-DP may serve as a novel bioactive adhesive for reducing POS.

A hypoarousal model of neurological post-COVID syndrome: the relation between mental fatigue, the level of central nervous activation and cognitive processing speed

BackgroundKnowledge on the nature of post-COVID neurological sequelae often manifesting as cognitive dysfunction and fatigue is still unsatisfactory.ObjectivesWe assumed that cognitive dysfunction and fatigue in post-COVID syndrome are critically linked via hypoarousal of the brain. Thus, we assessed whether tonic alertness as a neurocognitive index of arousal is reduced in these patients and how this relates to the level of central nervous activation and subjective mental fatigue as further indices of arousal.Methods40 post-COVID patients with subjective cognitive dysfunction and 40 matched healthy controls underwent a whole-report paradigm of briefly presented letter arrays. Based on report performance and computational modelling according to the theory of visual attention, the parameter visual processing speed (VPS) was quantified as a proxy of tonic alertness. Pupillary unrest was assessed as a measure of central nervous activation. The Fatigue Assessment Scale was applied to assess subjective mental fatigue using the corresponding subscale.ResultsVPS was reduced in post-COVID patients compared to controls (p = 0.005). In these patients, pupillary unrest (p = 0.029) and mental fatigue (p = 0.001) predicted VPS, explaining 34% of the variance and yielding a large effect with f2 = 0.51.ConclusionIn post-COVID patients with subjective cognitive dysfunction, hypoarousal of the brain is reflected in decreased processing speed which is explained by a reduced level of central nervous activation and a higher level of mental fatigue. In turn, reduced processing speed objectifies mental fatigue as a core subjective clinical complaint in post-COVID patients.

Oncocytic Cystic Lesions of False and True Vocal Cords: An Uncommon Occurrence

Introduction: Oncocytic cysts of the larynx are benign, uncommon, and slow-growing lesions that usually occur in elderly people, especially in those with a history of smoking and chronic irritation. These lesions cause various clinical symptoms depending on their location and size, requiring physicians to consider a wide range of symptoms. Case Presentation: Here we present two men who were referred to us because of prolonged voice hoarseness. Conclusions: Medical assessments led us to the diagnosis of oncocytic cysts in the false and true vocal cords. Both patients were followed up after removing their laryngeal cysts and have had no clinical complaints since then.

Quantitative ultrasound to assess efficacy of treatment for neck somatic dysfunctions: a feasibility study.

Neck pain is a common complaint in healthcare clinics. Although the pathogenesis of neck pain is often multifactorial, trapezius muscle dysfunction has been commonly linked to neck pain. Osteopathic manipulative treatment (OMT) has been demonstrated to be an effective treatment modality in treating trapezius muscle dysfunction and neck pain. However, there is a current lack of objective, quantitative measures to assess the effectiveness of OMT. Through previous research, ultrasound technology has been shown to be promising in its ability to quantify tissue changes both pre- and post-OMT. The objectives of this study are to evaluate the feasibility of shear wave elastography (SWE) in assessing upper trapezius muscles with pain and hypertonicity, as well as the changes in these muscles post-OMT for cervical somatic dysfunctions. After obtaining approval from the Rocky Vista University Institutional Review Board and written informed consent from participants, SWE and osteopathic assessments were performed on 22 adult participants with and without cervical spine somatic dysfunction. Participants with positive osteopathic assessments of tissue texture, asymmetry, restricted motion, and/or tenderness (TART) were treated utilizing OMT. Shear wave velocity (SWV, m/s) and shear wave velocity rate [SWVR = (SWV contraction- SWV relaxation)/ SWV relaxation] of the upper trapezius muscles with and without pain and hypertonicity, and before and after OMT, were examined utilizing a two-tailed t-test. SWV in muscle contraction and SWVR were significantly lower in muscles with pain compared to muscles without pain (p≤0.01). SWV in muscle contraction was also significantly lower in hypertonic muscles compared to normotonic muscles (p<0.01). Following OMT, SWV in muscle contraction and SWVR in muscles with pain and hypertonic increased significantly (p≤0.01). Overall TART score of all muscles with somatic dysfunction (SD) after OMT significantly decreased (p<0.01). SWV in muscle contraction and SWVR in hypertonic muscles were also significantly increased (p≤0.03), with an improvement index of 0.11 and 0.20. This study's results demonstrate the feasibility of utilizing SWE to evaluate somatic dysfunctions of the upper trapezius musculature and the efficacy of OMT for neck somatic dysfunctions.

Effect of Ayurveda Treatment in the Management of Indralupta w.s.r. Tinea Capitis: A Case Study

Hairs play an important role in making body externally beautiful, mentally enthusiastic and healthy. Hair loss is common clinical complaint due to pollution, unhealthy diet, physical or emotional stress, poor hygiene and infection. Patchy hair loss considered as Alopecia. Tinea capitis is irregular patchy hair loss due to infection. In Ayurveda hair loss considered as Indralupta. Aim: To study the concept of Ayurvedic treatment in respect to Indralupta. Material and Methods: A Female child age 10 years suffering from multiple patches of hair loss over the scalp. Itching, Redness, Slight local pain during combing scaly patches that may blister and ooze has been reported. It was treated with Ayurvedic medicine both Internal and external for a period of 2 month. Result: After 15 days associated symptoms (itching, redness, inflammation, blister) was reduced. After 1 month the patient was examined for presence of hair follicles and growth of hair over affected area. Conclusion: The given Ayurvedic treatment was successful in treating the Indralupta.