Leech Therapy Research Articles

Hirudotherapy for limb ischemia in the pediatric intensive care unit: A retrospective observational cohort.

Acute limb ischemia due to microvascular malperfusion may be refractory to initial therapies. Medicinal leech therapy (hirudotherapy) has been attempted in plastic and reconstructive surgery to improve venous congestion in ischemic flaps; however, there are minimal reports related to ischemia secondary to arterial malperfusion. We evaluated a pediatric cohort from an academic intensive care unit with refractory limb ischemia in whom hirudotherapy was attempted to elucidate its use and outcomes. Institutional patient database was queried to identify pediatric patients (<18 years) who received hirudotherapy in the pediatric critical care unit and met inclusion/exclusion criteria. Patient charts were evaluated for indices including demographics, primary disease, coagulative status, vascular access, vasoactive medication dosing, bleeding, leech use, limb and mortality outcomes. Data was evaluated to identify trends or suspected impact on outcomes. Hirudotherapy was used in 7 patients for limb ischemia, 5 with congenital heart disease, and 2 others with viremic shock. Time to leech application following recognition of ischemia averaged 3 days, with duration of use averaging 3.9 days. Five patients discontinued therapy due to bleeding. Mortality rate was 57%, all secondary to multiorgan failure. In 3 surviving patients, 4 of 5 treated limbs resulted in at minimum partial amputation. Vasoactive-inotropic score tended higher prior to leech application, suggesting a vasoconstrictive pathway for arterial malperfusion. No identifiable trends appeared associated with salvaged limb or adverse effects. Blood loss predictably increased with leech application, as did total transfusion requirement. This case series establishes baseline data for use of hirudotherapy in critically ill children with acute limb ischemia caused by arterial malperfusion. Based on this retrospective cohort, we cannot recommend routine use of hirudotherapy for acute limb ischemia from arterial malperfusion in the pediatric intensive care unit. Application of leeches should be aligned with a protocol defining start and stop parameters, standardized leech utilization, and monitoring for adverse outcomes. Future study would benefit from consensus definitions of study outcomes, including perfusion recovery, tissue/limb salvage and bleeding manifestations. Additional prospective studies are needed prior to any standard or systematic recommendations for use.

Keratitis following leech therapy for periocular eczematous dermatitis: a case report

BackgroundThe medicinal leech therapy (MLT) is a kind of complementary treatment method used for various diseases. The leeches (Hirudo medicinalis) have been used for more than 2500 years by surgeons. The substances presenting in the saliva of leeches have anti-inflammatory, anticoagulant, platelet inhibitory, thrombin regulatory, analgesic, extracellular matrix degradative and antimicrobial effects. The method is cheap, easy to apply, effective and its mechanisms of action have been clarified for specific diseases. Infection particularly Aeromonas infection is the most common complication of MLT.Case presentationIn this case report, a keratitis case developing after leech therapy applied for the periocular and facial eczematous dermatitis lesions will be presented. The patient referred to our hospital with decreased vision, ocular pain, stinging, redness and lacrimation complaints. A large corneal epithelial defect with irregular margins, dying by fluorescein, involving more than inferior half of cornea and conjunctival hyperemia were seen in the right eye. No agent was determined in microbiological investigation, as the patient had used topical moxifloxacin eye drop which was commenced in another clinic before applying to us. The patient was treated with fortified vancomycin and ceftazidime, before using besifloxacin with the diagnosis of bacterial keratitis. Three weeks later epithelial defect improved completely leaving an opacity and neovascularization.ConclusionsMLT should be performed by certified physicians with sterile medicinal leeches and precautious antibiotics should be used before MLT for prevention against potential infections.

Leech therapy and adjuvant Ayurveda treatment in the management of diabetic foot ulcer with atherosclerosis

Diabetic patients are more prevalent to atherosclerosis (29.1%); however, its pathophysiology is still unclear. Such cases mostly convert into either amputation due to rapid spread or lifelong anticoagulant. Ayurveda is famed to be a tool in prevention and management of such fatal or disabling surgeries by parasurgical procedure, i.e., leech therapy, Agnikarma, etc. This study presents a case of postdiabetic atherosclerosis (male/54 years old) with a complaint of blackening of the great toe of the right lower limb and and other associated symptoms such as intermittent claudication (Garde 4), Burning in sole, occasional numbness in the foot. this case was managed by the Ayurveda para-surgical procedure (Leech therapy). The patient was a known case of DM and taking medication for it for the last 1 year, but his blood sugar level was found to be uncontrolled (HB1Ac: 9.90). The patient had surgical history of coronary artery bypass graft before 8 years. His bilateral lower limb computed tomography angiography was suggestive of diffuse atherosclerotic fibrocalcified wall plaques in abdominal aorta, iliac, femoral, and both leg arteries. Clinical examination revealed black right greater toe with line of demarcation and on palpation, feeble femoral artery and downstream non-palpable arteries. As a part of treatment, leech application along with some rejuvenating oral drugs i.e. Sanjvani vati and pippali churna was given to the patient. On 2nd week of treatment protocol, black gangrenous great- toe was amputed which afterwards become open wound(approx.2cm x 2 cm). Afterward, daily wound dressing was done with Apamarga kshar taila or Thumari taila (As per the status of the wound) after cleaning with Triphala Kwath. After completion of treatment protocol, the patient got 85-90% relief in clinical symptoms and also previously feeble arteries were felt with full volume.

Leech Application-related Upper Gastrointestinal Bleeding: A Case Report.

Leech therapy (Hirudotherapy) is a method used in the treatment of many diseases since ancient times. Although many complications have been reported following the use of this method, no systemic life-threatening bleeding has yet been described. A-43-year-old male patient was diagnosed with upper gastrointestinal bleeding following leech application that he had received for infertility one week earlier. The complications of hirudotherapy typically spontaneously improve due to the local effects of this treatment. The most frequently reported complications are local infections, and less commonly allergies and prolonged local bleeding can occur. However, in this case report, we describe a life-threatening upper gastrointestinal bleeding as a new complication. Gastrointestinal bleeding appearing a week after leech therapy does not necessarily mean that leeches caused gastrointestinal bleeding in this case. Nevertheless, considering the development time of gastrointestinal bleeding, it can be deduced that it was possibly due to hirudotherapy. Patients should be informed about alarming symptoms that can indicate complications following leech application.

Successful maintenance treatment of a patient with chronic dermatitis with leech therapy.

Successful maintenance treatment of a patient with chronic dermatitis with leech therapy.

EFFECT OF LEECH APPLICATION IN THE MANAGEMENT OF BURGER’S DISEASE:- A CASE STUDY

The inflammatory response in the arterial wall that involves the surrounding veins and nerves and results in thrombosis of the artery is known as Burger’s disease. Smoker’s disease, also known as TAO (thrombangitis obliterans), primarily affects young males between the ages of 20 and 40. Early on, it affects just one limb, but eventually, both limbs are affected. As far as the genesis of this illness is concerned, there is a strong correlation between smoking, frequent small foot injuries, poor hygiene, and altered autonomic functions. In contrast to surgical intervention, which includes lumbar sympathectomy, omentoplasty, and amputation as the only option if gangrenous stage is present, allopathic management involves conservative treatment with the use of vasodilators, pentoxifylline, and low-dose aspirin.The aforementioned procedure is expensive and has drawbacks. Although the disease is not mentioned in Ayurveda, its symptoms can be linked to strotas dushti lakshana, such as sanga and siranam granthi. Additionally, because rakta is vitiated, raktavaha strotasa dushti is also involved; therefore, leech application was planned based on these two references into account all three factors. Before using leeches and performing the scheduled leech therapy, poorva pradhan paschat karma is conducted. Leech therapy was found to be helpful with fewer problems in a total of 6 sittings.

Leech Farming: An Overview Over Leech Breeding and Multiplication.

Introduction: There are various descriptions regarding blood letting or Raktamoksha using leeches (Jaloukavacharana) in ayurvedic classics. Acharya Susruta considers Rakta as the fourth Dosha and mentions Raktamoksha as a Shodhana karma (purificatory therapy) and is indicated in many diseases with vitiation of Raktha. As a matter of time, leech therapy is becoming more popular due to its benefits but there is no known established reliable suppliers of leeches for medical needs especially for medal purpose, maintenance of leeches in adequate environment, reproduction of leeches and storage of leeches on a large scale. Materials and Methods: This study is based on analysis of classical ayurvedic texts, modern books and internet sources. Some help was also been taken from previous articles published on the same topic. All the relevant information are compiled here. Result: Parameters for successful leech farming are studied and application of these facts can improve leech farming and thus ensure increased availability of leeches for medical needs. Discussion: The increased demand of leeches and its lesser availability forms a challenge especially in extreme weather. Basically, leech farming is a research topic and also an innovative idea for ayurvedic scholars. Leech farming provides special knowledge regarding selection and breeding of leeches

Literature Review on the Effectiveness of Medicinal Leech Therapy in the Wound Healing

Literature Review on the Effectiveness of Medicinal Leech Therapy in the Wound Healing

Medicinal leech therapy and related case study: Overview in current medical field

Although complementary medicine practises have a long history, but recently focused on their potential mechanisms of action. Among the leeches, Hirudo-medicinal is has widespread therapeutic use, although other species have also been researched and investigated internationally. More than 20 known bioactive compounds are secreted by leeches (Salivary product). They have analgesic, anti-inflammatory, platelet inhibitory, anticoagulant, thrombin regulating, extracellular matrix degradative, and antibacterial activities, but with more research, the range of effects may broaden. In this instance, cultured leeches are attached to the afflicted areas and begin sucking blood after an initial, painless bite. The majority of therapeutic advantages are attributable to saliva&#39;s diverse bioactive components. The novel Ayurveda text Sushruta Samhita devoted a complete chapter on hirudino therapy In order to enable the fraternity to use both sources for the good of humanity, the current research highlights the numerous features of medicinal leech therapy from both Ayurvedic texts and contemporary science.

The Effectiveness of Leech Therapy in the Severity of Diabetic Neuropathy: A Randomized Controlled Trial

Diabetic peripheral neuropathy is one of the most common causes of disability in diabetic patients. Applying a method to achieve the highest therapeutic effect in patients is desirable. Therefore, this study aimed to evaluate the impact of leech therapy on diabetic neuropathy of lower limbs in comparison to gabapentin as a standard method. This randomized controlled parallel-group clinical trial was conducted among 40 patients with type II diabetes who were diagnosed with lower limb diabetic neuropathy and referred to specialized outpatient clinics in Babol, Mazandaran province, Iran from 23 September 2020 to 17 March 2021. The patients were randomly divided into two groups. One group was treated with leech therapy and the other group was treated with gabapentin as the standard method. The severity of neuropathy was assessed every 15 days until the 45th day. The Visual Analog Scale (VAS), Neuropathy Symptom Score (NSS), Neuropathy Disability Score (NDS), and Nerve Conduction Velocity (NCV), and Electromyography (EMG) were used for assessing the study outcomes. The repeated measure and Friedman tests were used by SPSS.V.23. The results of our study indicated that pain (P value:0.03), numbness (P value˂0.0001), and paranesthesia (P value:0.01) significantly reduced in patients undergoing leech therapy versus patients taking gabapentin on the 45th day. The total NSS (P value˂0.0001) and total NDS (P value˂0.0001) improved significantly for patients with leech therapy over 45 days compared to the patients with gabapentin. The results of our study showed that using leech therapy for patients with diabetic neuropathy was more effective in improving clinical symptoms and the functions of lower limb muscles and nerves in comparison to gabapentin. The severity and symptoms of neuropathy greatly improved for the patients treated with leech therapy versus patients taking gabapentin.

Case Reports and Experts Opinions about Current Use of Leech Therapy in Dermatology and Cosmetology

This article aimed to determine the experts’ opinion on the use of hirudotherapy in cosmetology, to supplement knowledge, and to identify factors that, in the opinion of experts, affect the effectiveness and frequency of use of this method in eliminating skin problems. The study was conducted using the expert interview method. The research tool was a categorized expert interview questionnaire using the CAWI (Computer Assisted Web Interview) technique. Hirudotherapy is one of the oldest healing methods. The mechanism of action is based on the therapeutic properties of bioactive substances isolated from leech saliva. It has been shown to have a wide range of applications in the treatment of numerous diseases in various fields of medicine, including dermatology and cosmetology. Despite its therapeutic properties and effectiveness, hirudotherapy is a rarely used tool in cosmetology. It has been found effective in the treatment of many dermatoses. The most spectacular effects have been observed in the treatment of rosacea, local inflammations, lipomas, skin scars, hard to heal wounds and contusions.

Medicinal Leech Therapy in Veterinary Medicine: A Retrospective Study.

The objective of this study was to report the clinical indications, outcomes, and complications associated with medicinal leech therapy (MLT) in dogs and cats. Medical records (2012-2016) of client-owned dogs (n = 9) and cats (n = 3) treated with MLT at one institution were retrospectively reviewed. Retrieved data included the signalment, indications, physical examination findings, laboratory results, methods of leeching, outcomes, and complications associated with MLT. Following MLT sessions, nine patients (75%) visibly showed clear improvement of the affected tissue. One patient (8%) was euthanized before complete healing owing to pulmonary parenchymal disease. Improvement or appearance of tissue following MLT was not recorded in two patients (17%). Results suggest that MLT may be a safe and effective treatment modality for venous congestion and necrosis in compromised skin flaps and wounds with success in resolving 75% of the lesions in this study. This study is suggestive of the value of MLT when more conventional treatment methods fail in dogs and cats. A data collection form was created for veterinarians to use with the goal of obtaining standardized, objective MLT data for future studies.

Study on the effect of medicinal leech therapy (Hirudo medicinalis) on full-thickness excisional wound healing in the animal model

The possible impacts of alternative and conventional medicines on wound healing are now of growing interest. This study aimed to evaluate and elucidate the wound healing activity of medicinal leech therapy in wound excision of the rat model. After a round, full-thickness excision was made in the dorsal region of the body, the animals (n = 30) were randomly divided into three equal groups: I) the treatment group (MLT), where the wounds received leech treatment; II) the positive control group (PC), where the wounds received 1% sodium phenytoin treatment; and III) the negative control group (NC), where the wounds did not receive any treatment. On days 6 and 16, wound biopsy specimens were taken, and prepared sections were stained using various methods. The contraction rate differed significantly (P < 0.05) between the NC group and the other groups. The histopathological evaluation revealed that MLT group showed an accelerated healing process and lower inflammatory response compared to other groups. In ML-treated group maturation and remodeling of collagen had occurred, while in 1% sodium phenytoin treated group, proliferation was the prominent feature. Results showed that the fibroblast was significantly lower in the NC group in comparison to other groups. The number of MNC, s, and PMN, s was significantly higher in the NC group compared to other groups (P < 0.0001). In our study, medicinal leech therapy had a higher success rate in healing for the treatment of excisional wounds in animal models.

Cost Efficiency of Leech Therapy Duration for Revascularized and Replanted Digits with Venous Congestion

Cost Efficiency of Leech Therapy Duration for Revascularized and Replanted Digits with Venous Congestion

An effective use of Ayurvedic management in case of Nail Bed Infection- A case report

Background: A Nail bed infection viz. also known as paronychia is very common condition found in people due to trauma, bacterial infection to the nail. This can be treated with systemic Anti-inflammatory and anti-biotic with Local anti-microbial ointment. In Ayurveda this condition is explained as Kunakha. This can be treated with use Leech therapy and various internal medicine and local application of various drug formulations. Objective: a. To use leech therapy in Nail bed Infection b. to apply ayurvedic treatment principle in Nail bed Infection (kunakha). Method: A case report of Nail bed infection cause due to Trauma to nail. Patient visited to ayurvedic clinic as her wound didn’t heal properly even after 45 days of conventional treatment. In Ayurvedic treatment management, 3 cycles of Raktamokshan and vrana dhoopna and Vrana ropan tail pichu were done on alternate day for 30 days. This local treatment supported with some internal medicine. Result: All this included treatment shows effective result in this patient. Conclusion: This case report concludes that Leech therapy and ayurvedic topical and internal medicine are found to be effective in case of Nail bed infection.

Protocol based pain management by Ayurveda parasurgical procedures W.S.R to musculoskeletal pain and its critical appraisal – An open labeled clinical trial

BackgroundPain has globally become an attention problem which causes discomfort by affecting the body as well as the mind. The International association of pain estimated that 1 in 5 patients experiences the pain, i.e. 30% of world population. 19.3% (180–200 million) of the total population in India suffer from chronic pain and its severity appeals early approach of patients to hospitals. Ayurveda being the oldest medical science emphasized its importance and treatment of pain with both pharmacological and non-pharmacological (Parasurgical) methods. ObjectiveTo evaluate the efficacy of non-pharmacological (para surgical) procedures in the management of pain. Materials and methodTotal 100 patients with chronic musculoskeletal pain fulfilling the inclusion criteria were recruited by assessing the site, severity and nature of pain. A special protocol was framed by incorporating Ayurveda treatment principles by using Para surgical procedures such as Agnikarma (Therapeutic burn), Jalauka (leech therapy), Alabu (Cupping therapy) and Siravyadha (Vein puncture). The parameters like VAS and VDS pertaining to pain were assessed from baseline and at various time points. Statistical analysis was performed by using Wilcoxon match paired test to assess the results. ResultsThe VAS and VDS scale were used to assess the efficacy of para-surgical procedures which was found to be significant (p < 0.0001) from baseline and at various time points. ConclusionProtocol based pain management by various para surgical procedures was found effective in the management of chronic musculoskeletal pain. The ambiguity in selection of proper parasurgical procedure for pain management is justified by following the protocol.

Jalaukavacharna (Medicinal Leech Therapy) in Dushta Vrana w. s. r. Diabetic Foot Ulcer - A Case Study

Ancient Indian medicine has a long and wide history but modern medicine has just recently emerged with focusing on their possible modes of action. Jalaukavacharna or Medicinal Leech Therapy or Hirudotherapy is an old technique of bloodletting and is being widey studied by many researchers for possible effects on numerous diseases as Dushta Vrana Ropana, inflammatory diseases, osteoarthritis, various diseases according to different Doshas etc. Detailed description of the Jalaukavacharna and Jalauka is given in Sushruta Sutra Sthana Thirteen. Researchers have described various properties of leech therapy like anti-inflammatory, analgesics, platelet inhibitory, anticoagulant etc. A 61 years old male patient with history of DMII since 10 years came to RGGPG Ayurvedic College and Hospital, Paprola, Himachal Pradesh with the complaints of wound over left foot with pustular discharge and smell accompanied by fever. After thorough debridement, leech therapy was done for 4 weeks, twice per week followed by once every week for 6 weeks. Strict limb elevation was advised along with strict diabetic management. The treatment followed may be adopted in the future for various cases.

Role of Jalauka Avacharan (Leech Therapy) in the Management of Non-Healing Ulcer: A Case Study

Non-healing ulcers are a serious health issue that affects people all over the world. They are expensive in terms of both human and material resources. Unavoidable and harmful to the lower limb, non-healing ulcers are a leading factor in non-traumatic lower limb amputations. Numerous studies have examined the potential effects of medicinal leech therapy (MLT), also known as hirudotherapy or Jalaukavcharan in Ayurveda on a variety of illnesses, including Skin disorders and inflammatory diseases, as well as various surgical ailments. Despite the lengthy history of complementary health practises, contemporary medicine has only recently focused on their potential mechanisms of action. Many bioactive compounds, including antistasin, eglins, guamerin, hirudin, saratin, and bdellins, as well as complement and carboxypeptidase inhibitors, are secreted by leeches. In addition to extracellular matrix degradative and antibacterial actions, they exhibit analgesic, anti-inflammatory, platelet inhibitory, anticoagulant, and thrombin regulating properties. However, with more research, the range of effects may broaden. The method has been shown to be affordable, efficient, simple to use, and effective. The aim of this study to evaluate the effectiveness of Jalaukavcharan to promote the healing processes in non-healing ulcer. The study was an observational single case design without control group; it was carried out in department of Shalya of Rajiv Gandhi Post Graduate Ayurvedic College, Paprola

Churg Strauss Syndrome after Leech Therapy: A Case Report

Churg Strauss Syndrome (CSS) is a necrotizing vasculitis affecting small vessels. Although there are many accompanying findings, this syndrome has distinctive clinical findings such as asthma, nasal polyposis, and hypereosinophilia. Here, we describe a case report of a 48-year-old male patient with known asthma and nasal polyposis, who applied to the emergency department with a sudden worsening of consciousness and bullous lesions on the ankle after undergoing leech therapy (hirudotherapy), accompanied by mononeuritis multiplex and other clinical findings. Clinical findings, laboratory, electromyography, lumbar puncture, radiological imaging methods, histopathological examination and transthoracic echocardiography were used to diagnose CSS. In addition, it was desired to draw attention to the fact that leech therapy may trigger hyperosinophilia in vasculitis group diseases and cause serious complications in the individual.

Role of Jaloukavacharana in Management of Raktharshas (Thrombosed Hemorrhoids)

Arsha's is one among the Astamahagada, and a commonest ano-rectal disease with a wide range of symptoms. It affects all economic groups of the population. In Ayurveda, Arsha's is a growth of Mamsa with obstructs the anal opening. Anatomically anal canal is 51/2 Angula's length. A faulty lifestyle and dietary habits along with occupational and physical stress triggers the pathology of Arsha's. Doshic involvement includes Rakta along with Mamsa dhatu at Rakthavaha Dahmanis of Guda, which forms as Mamsa Ankura. Acharya Susrutha mentioned 4 curative measures for the treatment, they are Bhesaja, Kshara karma, Agni karma, Shastra karma. Hemorrhoids are dilated rectal veins. Thrombosed piles occur where there is high venous pressure, which is associated with severe pain, which hampers their daily routine, thereby they avoid defecation which leads to hardening of stool, constipation and rectal bleeding. The treatment includes the surgical excision of the thrombosed pile mass. A case study of thrombosed pile treated with Jaloukavacharana (leech therapy) has been recorded which has reduced the mass, pain, bleeding per rectum.