Difficulty In Closure Research Articles

Safety and efficacy of a modified endoscopic full-thickness resection technique for gastric submucosal tumors: a case series.

Endoscopic full-thickness resection (EFTR) has proven effective and economical for patients with gastric submucosal tumors (SMTs). However, the poor operative field of view, the risk of massive hemorrhage, and the difficulties in defect closure have limited its widespread application. Herein, we described a modified EFTR technique developed to simplify the dissection and defect closure procedures using common and economical endoscopic accessories. Forty-two patients who underwent the modified EFTR for gastric SMTs in the Shenzhen Guangming District People's Hospital were enrolled in the case series. Following a cross incision to expose the intraluminal surface the tumors were captured by suction through a transparent cap and the roots were ligated using a loop. The tumors and part of the suction tissue were removed along the ligated root. A tension-relieving closure was performed by clipping the raised plica in four quadrants outside the ligated root. Patient demographics, tumor characteristics, and therapeutic outcomes were evaluated retrospectively. All tumors had an R0 resection. The median procedure time was 51.8min (IQR 34.25 min). No severe perioperative adverse events occurred. No residual lesion or recurrence was reported during the follow-up period of 9.84 months (IQR 5.0 months). The safety and practicability of Modified-EFTR could allow for wide clinical application in patients with micro-gastric SMTs.

Repair of a “long and narrow” skin defect of the upper extremity with a modified design of a compound SCIP flap: a series of 12 cases

BackgroundLarge skin lesions of the upper extremity tend to be ‘‘long and narrow’’ in shape, and the currently used repair and reconstruction protocols still have some drawbacks, including difficulty in closure of the donor area, poor cosmetic appearance of the donor and recipient areas, and low flap survival rates. The ilioinguinal flap has been more widely used for repair and reconstruction of various complex conditions. In order to improve the versatility of the flap design and to achieve better aesthetic results, we report a study on the improved design of Compound SCIP flap for repairing "long and narrow" large skin defects of the upper extremity by using a modified design of the ilioinguinal flap for the procurement of perforating blood vessels and flap excision.MethodsFrom April 2005 to August 2015, a total of 12 patients underwent this modified design procedure, in which the anterior branch of the fourth lumbar artery or the posterior intercostal artery was selected to provide blood supply for the perforator flap together with the superficial branch of the superficial iliac artery to meet the blood supply needs of the flap for the one-time repair of a large "long and narrow" skin defect in the upper limb. Patient demographics, flap characteristics, and associated complications were retrospectively analyzed.Results3 females and 9 males were included in this study, the mean age of the patients was 31.7 years (range, 22–44 years), the mean follow-up period was 15.3 ± 5.6 months (range, 7–24 months), and all patients had complete closure of the defect site and donor area, and all flaps survived.ConclusionsThe Compound SCIP flap presents some advantages in repairing 'long and narrow' skin defects in the upper limb. While ensuring the survival rate of the elongated ilioinguinal flap, it amplifies the benefits of the ilioinguinal flap and enhances skin utilization. This can serve as a beneficial choice for repairing 'long and narrow' skin defects in the upper limb.

Ardita and its Ayurvedic Management - A True Story

Ardita is a disease with functional disturbances affecting the Uthamanga (head) and stands close with the symptoms of Bell's palsy. It is narrated as one among the Asheeti Vata Vikaras. It is a condition that develops due to Vata and Kapha Dusti. The present case study was conducted with an objective to find out the effective Ayurvedic management in Bell’s palsy. This report is on a case study of a 29 years old male patient who approached to Kayachikitsa OPD presenting with symptoms of deviation of mouth towards on left side, unable to chew from right side, difficulty in complete closure of right eye, since 1 day. After relevant examinations and screening it was diagnosed as Bell's palsy. This disease though self-resolving some cases remain partially recovered and some may be left with major facial dysfunction. So, the patient was admitted in Sri Kalabyraveshwara Swamy Ayurvedic Medical College and Hospital for 10 days and this condition was managed through Panchkarama & palliative treatment. The patient was treated with Mukhabhyanga, Panasa Patra Sweda for 10 days and Nasya Karma for 8 consecutive days. There was no side effect observed during and after the treatment. The patient got complete relief in all symptoms without any residual weakness or deformity within two weeks which is much early than the self-resolving period of 6 months.

Evolution of weak, homogeneous turbulence with rotation and stratification

This article concerns the time-evolution, spectral structure and scaling of weak turbulence subject to rotation and stable stratification. The flow is expressed as a combination of particular solutions, referred to as modes, of the linearised governing equations without viscosity or diffusion. Modes are of two types: oscillatory ones which represent inertial-gravity waves and time-independent ones that express a non-propagating (NP) component of the flow. The presence of the NP component, which plays an active role in the dynamics apart from in the case of pure rotation, renders wave-turbulence analysis problematic because the NP mode is non-dispersive. Equations are derived for the time evolution of the modal amplitudes, evolution which is due to nonlinearity and visco-diffusion. Subsequent analysis assumes that one or other (or both) of the Rossby and Froude numbers is small (weak turbulence). Given this assumption, the NP component is found to evolve independently of the wave one and a numerical scheme, similar to, though significantly different from classical direct numerical simulation, is used to determine its time evolution. The treatment of the wave component assumes its amplitude is large compared with the NP one, otherwise there are seemingly intractable difficulties of closure in the analysis. Given this further assumption, the wave component decouples from the NP one. Evolution equations for the wave spectra are derived using wave-turbulence analysis and are integrated numerically. As might be expected, these equations indicate that nonlinear coupling of wave modes is dominated by resonances. Results are given for both the NP and wave components.

A novel twin-grasper assisted mucosal inverted closure technique for closing large artificial gastric mucosal defects

BackgroundLarge artificial gastric mucosal defects are always left unclosed for natural healing due to technique difficulties in closure. This study aims to evaluate the feasibility and safety of a new Twin-grasper Assisted Mucosal Inverted Closure (TAMIC) technique in closing large artificial gastric mucosal defects.MethodsEndoscopic submucosal dissection (ESD) was performed in fifteen pigs to create large gastric mucosal defects. The mucosal defects were then either left unclosed or closed with metallic clips using TAMIC technique. Successful closure rate and the wound outcomes were assessed.ResultsTwo mucosal defects with size of about 4.0 cm were left unclosed and healed two months after surgery. Thirteen large gastric mucosal defects were created by ESD with a medium size of 5.9 cm and were successfully closed with the TAMIC technique (100%), even in a mucosal defect with a width up to 8.5 cm. The mean closure time was 59.0 min. Wounds in eight stomachs remained completely closed 1 week after surgery (61.5%), while closure in the other five stomachs had partial wound dehiscence (38.5%). Four weeks later, all the closed defects healed well and 61.5% of the wounds still remained completely closed during healing. There was no delayed perforation or bleeding after surgery. In addition, there was less granulation in the submucosal layer of the closed wound sites than those under natural healing.ConclusionsThe present study suggests that TAMIC is feasible and safe in closing large artificial gastric mucosal defects and could improve mucosal recovery compared to natural healing process.

Ultra-processed food consumption is associated with variations in daily routines in elementary schoolchildren during the COVID-19 pandemic in Chile.

To assess the association between child ultra-processed food (UPF) consumption and home-school learning environment characteristics during school closures due to the COVID-19 pandemic in schoolchildren with low- and middle income in Chile. Cross-sectional. UPF consumption was collected using the Nova screener. We apply the structured days hypothesis (SDH) to assess home-school learning environment characteristics with three constructs that summarised school preparedness for online teaching and learning, school closure difficulties for caregivers and child routine. We explored associations between child UPF consumption and home-school environment characteristics using multivariate linear regression analyses after controlling for child demographic and school characteristics. Low- and middle-income neighbourhoods in southeastern Santiago, Chile. Children from the Food Environment Chilean Cohort (n 428, 8-10 years old). Based on the Nova score, child mean consumption of UPF was 4·3 (sd 1·9) groups. We found a statistically significant negative association between child routine for eating, play and study and child UPF consumption when we adjusted for child sociodemographic (model 1: β = -0·19, (95 % CI -0·40, 0·02)) and school characteristics (model 2: β = -0·20, (95 % CI -0·41, 0·00)). Associations between school preparedness for online teaching or school closure difficulties and UPF were not statistically significant. Variations in child routines during the COVID-19 pandemic were negatively associated with UPF intake in schoolchildren with low- and middle income. Our findings are consistent with the SDH, suggesting the school environment helps regulate eating behaviours. Future research should evaluate what happens when children return to in-person classes at school.

A modified exposed endoscopic full-thickness resection: Traction-assisted resection while defect closing.

Exposed endoscopic full-thickness resection (Eo-EFTR) has proven effective and economical for patients with gastric submucosal tumors (SMTs), showing great prospects. However, the poor operative field of view, the risk of tumors falling into the peritoneal cavity, especially the difficulties in defect closure, have limited its widespread application. Herein, we described a modified traction-assisted Eo-EFTR technique aimed at simplifying both the dissection and defect closure procedures. Nineteen patients who underwent the modified Eo-EFTR for gastric SMTs in the Chinese People's Liberation Army General Hospital were enrolled in the study. Following a 2/3 circumferential full-thickness incision, a clip with dental floss was anchored to the resected part of the tumor surface. With the dental floss traction, the gastric defect was reshaped into a V shape, which facilitated the deployment of clips to close the defect. The defect closure and tumor dissection procedures were then performed alternately. Patients' demographics, tumor characteristics, and therapeutic outcomes were evaluated retrospectively. All tumors had an R0 resection. The median procedure time was 43 min (range 28-89 min). No severe perioperative adverse events occurred. Two patients experienced transient fever, and three patients complained of mild abdominal pain on the first day after the operation. All patients recovered on the next day with conservative management. No residual lesion or recurrence was reported during the follow-up period of 30.1 months. The safety and practicability of the modified technique might allow for wide clinical applications of Eo-EFTR in gastric SMTs.

The Adjustable Cranial Plate: A Novel Implant Designed to Eliminate the Need for Cranioplasty Surgery Following a Hemicraniectomy Operation

Decompressive hemicraniectomy (DHC) is performed to relieve life-threatening intracranial pressure elevations. After swelling abates, a cranioplasty is performed for mechanical integrity and cosmesis. Cranioplasty is costly with high complication rates. Prior attempts to obviate second-stage cranioplasty have been unsuccessful. The Adjustable Cranial Plate (ACP) is designed for implantation during DHC to afford maximal volumetric expansion with later repositioning without requiring a second major operation. The ACP has a mobile section held by a tripod fixation mechanism. Centrally located gears adjust the implant between the up and down positions. Cadaveric ACP implantation was performed. Virtual DHC and ACP placement were done using imaging data from 94 patients who had previously undergone DHC to corroborate our cadaveric results. Imaging analysis methods were used to calculate volumes of cranial expansion. The ACP implantation and adjustment procedures are feasible in cadaveric testing without wound closure difficulties. Results of the cadaveric study showed total volumetric expansion achieved was 222 cm3. Results of the virtual DHC procedure showed the volume of cranial expansion achieved by removing a standardized bone flap was 132 cm3 (range, 89-171 cm3). Applied to virtual craniectomy patients, the total volume of expansion achieved with the ACP implantation operation was 222 cm3 (range, 181-263 cm3). ACP implantation during DHC is technically feasible. It achieves a volume of cranial expansion that will accommodate that observed following survivable hemicraniectomy operations. Moving the implant from the up to the down position can easily be performed as a simple outpatient or inpatient bedside procedure, thuspotentially eliminating second-stage cranioplasty procedures.

Prevention and management of stoma-related complications after surgery for low rectal cancer

The related technology of enterostomy is a professional skill that colorectal surgeons need to master, and it is clinically important to prevent the occurrence of enterostomy-related complications of low rectal cancer. The early complications of enterostomy include stoma retraction, stoma ischemic necrosis, stoma edema and peripheral dermatitis, and the long-term complications include parastomal hernia, stenosis and stoma prolapse. In addition, the rare or easily neglected stoma cancer, difficulty of stoma closure and following social psychological disorders should also be paid attention to by surgeons. Effective reduction of enterostomy complications can lead to better quality of life for patients, which is the best interpretation of the concept of "patient-centered ness" by colorectal surgeons.

Endoscopic resection for gastric submucosal tumors: Japanese multicenter retrospective study.

Limited information is available on the efficacy and safety of endoscopic resection (ER) of gastric submucosal tumors (SMTs) in Japanese endoscopic practice where ER for gastric tumors is extremely popular. We conducted this study to elucidate the current scenario of ER for gastric SMTs in Japanese endoscopic practice. Patients (from 12 institutions) with gastric SMTs who underwent ER were enrolled from the first case until August 2020. We enrolled 117 patients with 118 lesions. The number of patients who underwent ER increased over the years. The mean endoscopic tumor size was 20 ± 7.2 (8-40) mm. The growth type was primarily intraluminal (90%). The mean resection and wound closure times were 58 ± 38 (range, 12-254) min and 31 ± 41 (range, 3-330) min, respectively. Complete ER was achieved for 117 (99%) lesions. Full-thickness resection rate was 44%; however, only 12 (10%) patients required abdominal paracentesis for decompression. Endoscopic treatments were completed in 115 (97%) lesions, while three lesions required conversions to laparoscopic surgery due to luminal collapse, uncontrolled bleeding, and difficulty in defect closure. Gastrointestinal stromal tumors were the most common pathology (74%). No recurrence was observed during the mean follow-up period of 4.3 ± 2.9 years. The 5-year overall survival rate was 98.9% (95% confidence interval 97.8-100%). Performance of ER for gastric SMTs is increasing in Japan. The technique seems feasible in Japanese endoscopic practice, warranting further validation in a prospective study.

10-Year Experience with the Modified Pectoralis Major Flap: The Use of the Deltopectoral Flap to Reduce Skin Tension.

Purpose: Pectoralis major myocutaneous flap has been the work horse flap for head and neck reconstruction. However, due to the bulky nature of the pedicle it is not uncommon to struggle to achieve tension free closure of the neck skin incision. This case series presents a modified pectoralis major flap technique to overcome the difficulty of tight closure or the need to graft the residual cutaneous defect. Method: This 10-year study includes 73 patients who underwent modified pectoralis major flap reconstruction for complex laryngo-pharyngeal defects following resection of tumours involving larynx, hypopharynx oropharynx and cervical oesophagus. The modified technique involves accommodating a deltopectoral fasciocutaneous flap which rotates over the pedicle to insert into the neck incision providing extra tissue to achieve a tension free closure. Results: 73 patients underwent the procedure, 80% were male. Mean age of patients was 62.8years. Larynx was the most common site and the average size of the tumour was 34.8mm. 13 patients developed minor complications such as wound dehiscence out of which 10 were managed conservatively, 3 patients required additional reconstructive procedures. 13 patients developed pharyngocutaneous fistula and 6 developed Neopharyngeal stenosis. 51 patients achieved good swallowing and 55 developed intelligible speech following recovery. Conclusion: We recommend the use of this technique as an effective method to achieve tension free neck incision closure and improved cosmetic results especially in centres which do not have free flap facility readily available.

Reverse-traction skin-stretching device for primary closure of large skin defects.

The tension in the skin margin of a wound is the major determinant for wound healing. The difficulty of primary closure for large skin defects due to excessive wound tension has long been a clinical challenge. In this study, we designed and fabricated a reverse-traction skin-stretching device (RT-SSD) to relieve the skin tension of a large skin defect and thereby allow primary wound closure. The novel RT-SSD designed in this study drives the fixing device fixed on the skin edge of the wound by rotating the pulling device, thus exerting a reverse tensile force on both sides of the wound, causing creep and stress relaxation, thus reducing the skin tension. Through the tension analyses; microcirculation detection; clinical scores; and a series of histological staining in vivo, it is verified that intraoperative application of RT-SSD can stretch and straighten collagen and fragment elastin, thus effectively reducing skin tension of large skin defect of miniature pigs. In addition, its special linear and planar traction protects the subcutaneous microcirculation of the wound site. The evaluation of wound healing confirmed that RT-SSD had negligible negative impact on wounds, reduced the incidence of complications, and promoted the healing of large skin defects. Therefore, this study provides a new safe and effective device for the primary closure of large skin defects.

Factors Influencing Suture Difficulty of T-tube Fixation and Closure in Laparoscopic Common Bile Duct Exploration.

Suture under the laparoscopy was considered as one of the most difficult and time-consuming tasks in laparoscopic common bile duct (CBD) exploration. Difficult suturing can lead to prolonged suturing time and decreased suturing quality. The aim of this study was to identify preoperative factors associated with the difficulty of T-tube suture following laparoscopic bile duct exploration. Retrospective analysis of consecutive patients who experienced successful laparoscopic CBD exploration with T-tube drainage were collected. Perioperative outcomes and short-term and long-term complications were recorded. Associations of the average suture time per stitch with preoperative demographic data and laboratory tests in patients were analyzed. A total of 106 cases (46 males and 60 females) were included in this study. The average suture time per stitch was between 3 and 7.5 minutes with a median of 4.5 minutes (4, 5). There were no biliary leakage and other T-tube-related complications in all patients during follow-up. Spearman correlation analysis revealed that biliary tract reoperation (r=0.384, P<0.0001) and a higher body mass index (r=0.486, P<0.0001) were positively correlated with the average suture time per stitch, while there was no association between the average suture time per stitch and other preoperative demographic data and preoperative blood parameters, including CBD diameter, age, sex, operative time, preoperative white cell count, alanine transaminase, total bilirubin, and gamma-glutamyl transpeptidase. We have identified 2 preoperative variables (biliary tract reoperation and a higher body mass index) that were positively associated with the suture difficulty under laparoscopy. An adequately powered prospective multicentre study is needed to validate our findings.

Effect of residual cofferdam at the diversion tunnel inlet on the index of river closure and the dumped materials: A Case study

The cofferdam built at the inlet of the diversion tunnel may be left due to incomplete blasting demolition, which affects the river closure. Several indexes have been used to evaluate the difficulty of river closure, but all indexes suffer from their limitations in use. Thus, it is more useful to combination multiple indexes to analyze the impact of residual cofferdam. Taking the river closure project of a Hydropower Station in southwest China as an example, the influence of the residual cofferdam heights on the river closure was studied by experiments. The discharge of river closure is 590 m 3 /s and 758 m 3 /s. In this paper, the results of studies on a 1:50 scale hydraulic model based on the Froude similitude relationships are presented. The test results show that the discharge capacity of the diversion tunnel is reduced by 27.2% at most when this height is more than 2 m. The residual height mainly affects the maximum of stream energy with unit width, which increase by more than 50% at most compare to Non-existent residual cofferdam. However, the final drop, max-velocity along the gap axis, the local scour of riverbed and the flow pattern of the gap are basically not affected. In addition, with the height increase, the bank collapse is intensified, and the amount of dumped material with medium size increases, especially when it reaches 4 m, the large or Extra-large size stones begin to be dumped. Based on the comprehensive evaluation of multiple indexes and the type of dumped material, it is shown that the residual cofferdam height more than a certain value, the value is 2 m for the case study, will significantly increase the river closure difficult.

Styloid Process Is the Robust Landmark for Identification of the Facial Nerve during Parotid Surgery

Objective: To identify the facial nerve trunk (FNT) very easily. quickly and accurately considering the styloid process as the robust anatomically consistent landmark during parotid surgery. Patients and Methods: This prospective study was conducted between January 2010 to December 2022 at a Tertiary care hospital. It included 130 patients: 84 (65%) males and 46 (35%) females with a mean age of 43.52 ± 15.63 years. Patients presented with pleomorphic adenoma (90), chronic sialectasis (05), parotid cyst (03), parotid sinus (01), mucoepidermoid carcinoma (28), adenoid cystic carcinoma (02) and squamous cell carcinoma (01) were subjected to superficial parotidectomy and total parotidectomy. The outcome was evaluated regarding the clinical success of facial nerve function that considered the location of the styloid process in the triangle technique for identification of the FNT during parotid surgery. Results: All 130 patients underwent superficial and total parotidectomy. The facial nerve trunk was successfully identified as the location of the styloid process in the triangle technique in all the patients with no intra-operative complications. Operative time ranged from 50 to 180 minutes with a mean time 90.70 ± 15.68 minutes. Dysfunction of the angle of the mouth due to the deficit of the marginal mandibular nerve (MMN) was noted in 5 patients (3.8%), 02 had difficulty in eye closure (1.5%). No patient reported surgical site infection, skin flap necrosis and hematoma in this series. Conclusion: Styloid process is the prominent robust landmark in the triangle technique for the identification of facial nerve trunk with relative ease, safety and accuracy in the parotid surgical procedure. This can be a very useful method to locate the FNT and minimize facial nerve injury during parotid surgery.

Transcatheter closure of Abernethy Malformation associated with interrupted inferior caval vein and other systemic venous anomalies - ERRATUM.

Abernethy malformation is a rare entity. We report a 5-year-old boy presenting with severe pulmonary hypertension in whom Abernethy malformation and inferior caval vein interruption were diagnosed by CT angiography. In addition, the iliac veins were thrombosed with multiple venous collateral drainage. This abnormal venous anatomy caused difficulty in device closure of the Abernethy malformation, which was successfully closed using a vascular plug.

Cesarean myomectomy: a case report and review of the\xa0literature

BackgroundRoutine myomectomy at the time of cesarean section has been condemned in the past due to fear of uncontrolled hemorrhage and peripartum hysterectomy. It is still a topic of debate worldwide. However, in recent years, many case studies of cesarean myomectomy have been published validating its safety without any significant complications.Case presentationWe describe the case of a 27-year-old gravida 2 para 1 live birth 1 North Indian woman with one previous lower segment caesarean section (LSCS) at 35 weeks with labor pains and scar tenderness. Her recent ultrasound (USG) report suggested a single live intrauterine pregnancy with an intramural fibroid of 8.6 × 6.5 cm located in the left anterolateral wall of the lower uterine segment. The patient was taken up for emergency cesarean section along with successful removal of the myoma, which was bulging into the incision line, causing difficulty in closure of the uterine wound. Prophylactically, oxytocin infusion, bilateral ligation of uterine arteries, and injection vasopressin (diluted) was administered to decrease the blood loss. The patient was discharged after 7 days without any complications.ConclusionsRoutine myomectomy at the time of cesarean section is not a standard procedure and is not accepted worldwide. However, it may be considered a safe option in carefully selected cases in the hands of an experienced obstetrician with appropriate hemostatic technique. Large multicenter randomized controlled trials should be conducted to evaluate the best practice guidelines for cesarean myomectomy.

Capsular Management of the Hip During Arthroscopic Acetabular Chondral Resurfacing: Pearls, Pitfalls, and Optimal Surgical Technique

Treatment of hip joint chondral damage is a well-recognized aspect of the arthroscopic management of femoroacetabular impingement syndrome. Hip chondral resurfacing has evolved from microfracture to different forms of cartilage grafting, all with variable long-term outcomes. Recent literature has focused on techniques using different cartilage sources (native and synthetic products) that are available for clinicians to choose from during hip arthroscopy. None of the published reports on cartilage grafts have commented on hip joint capsular management as part of the procedure. This is likely because of the increased difficulty of capsular closure in the dry arthroscopic environment required for graft stabilization. However, potential iatrogenic hip instability induced by an unrepaired interportal capsulotomy can be detrimental to the existing joint architecture and possibly to the cartilage graft. This article presents a step-by-step approach, including tips and pearls, for capsular closure during arthroscopic acetabular chondral resurfacing with BioCartilage (Arthrex, Naples, FL). This method is a safe and reproducible way to close the joint capsule during chondral resurfacing in patients undergoing hip preservation that can potentially enhance the chances of a successful outcome.

Peritoneal flap mesh hernioplasty: A reliable option for difficulty in closure of complex ventral hernia: A case report

Peritoneal flap mesh hernioplasty is a technique to deal with complex ventral hernias in which primary closure of the defect is not attainable. We are here presenting a case report of a 50-year-old gentleman with huge complex ventral hernia with loss of domain. The patient also had overlying ulcerated and blackish colored skin. Botulinum toxin was infiltrated into the muscles of anterior abdominal wall and was followed by peritoneal flap mesh hernioplasty after one month. The final outcome was complete closure of the midline with a healthy skin with no evidence of abdominal compartment syndrome. There was no evidence of early recurrence on follow up.&#x0D; Owing to the favorable outcome in this case, suitability of peritoneal flap mesh hernioplasty technique in treatment of complex ventral hernia could be explored further where closure of the primary defect is difficult.

MANAGEMENT OF ARDITA THROUGH PANCHAKARMA AND PALLATIVE CARE - A CASE STUDY

Ardita is a condition that develops due to excessive aggravation of Vata and causes distortion of face, con-sidered as one among the eighty Vata Nanatmaja Vyadhi in Ayurveda. Bell’s palsy, the paralysis of facial nerve also affects the movement of facial muscles and shows similar symptoms, hence, can be correlated with the disease. A 39 years old Hindu male patient approached to Kayachikitsa OPD (Out Patient Depart-ment) who was suffering from complaints of deviation of lips towards right side, difficulty in closure of eyes and speech x 20 days. He was clinically diagnosed as Ardita (Bell’s palsy) and managed through Pan-chakarama &amp; Palliative treatment. The patient got complete relief in all symptoms with appreciable chang-es. Aim: to manage the Ardita through Panchakarma and Palliative treatment. Methodology: In the present study both Panchakarma and Palliative management were selected for the management of Ardita in 39 years old married male patient for 7 days and follow up treatment was also recommended. Results: The patient improved on 8th day as the symptoms were almost recovered. Conclusion: Ardita can be managed by giving comprehensive management of Panchakarma and palliative treatment which reflects that it is good remedy for this Vata Vyadhi.