Single Clinical Study Research Articles

Pre-operative collapsed disc is a negative prognostic factor of back-pain outcome in trans-foraminal endoscopic discectomy. A single cohort clinical study

PurposeTrans-foraminal endoscopic discectomy (TELD) is an alternative surgical technique for lumbar disc herniation (LDH). Compared with microscope-assisted open discectomy, TELD is expected to result in less postoperative low back pain (LBP) and has a lower likelihood of complications. However, some clinical analysis report patients still had persistent LBP at follow-up. Several studies have identified different known risk factors for LBP after TELD, including the preoperative presence of disc height loss and “microinstability” of the lumbar spine, which can be detrimental to a patient's successful outcome. MethodsWe conducted a retrospective review of a cohort of 86 patients with symptomatic LDH who underwent TELD surgery in a single Neurosurgery Unit from 2021 to 2023 and subjected themselves to a clinical and radiological follow-up program up to one year, focusing on the presence of collapsed disc (Group A) and the presence of normal intersomatic height (Group B) at the site of lumbar herniation. ResultsThe two groups demonstrated no significant differences in the pain and disability scales at the preoperative and postoperative phases, both after surgery and during follow-up. However, at the 1-year clinical evaluation, patients who had signs of a collapsed disc before surgery experienced less recovery on the ODI scale compared to the other group ConclusionOur study showed that the presence of severe intervertebral disc height loss, accompanied by pre-operative signs of a collapsed disc at the site of the LDH, may serve as a predictor of poor postoperative pain recovery.

Tofacitinib for ulcerative colitis: A promising treatment option

A single center retrospective clinical study revealed the efficacy and safety of tofacitinib in the treatment of ulcerative colitis (UC). This study has clinical reference value but also has some limitations. Previous studies, including this clinical trial, have shown that tofacitinib could be a promising treatment option for UC, but further clinical research is required to prove this point.

Glutathione as a skin-lightening agent and in melasma: asystematic review.

Hyperpigmentary disorders, including melasma, are challenging to treat. Glutathione has anti-melanogenic and antioxidant properties, which led to its use as a skin-lightening agent. Our objective was to review the published evidence and literature on the efficacy and safety of glutathione as a skin-lightening agent and in the treatment of melasma. A literature search was done in the PubMed, Embase, and Cochrane library databases using the search terms "glutathione as a skin-lightening agent" and "glutathione in melasma" for the past 10 years. The level of evidence, strength of recommendation, and risk of bias assessment were evaluated. Among various forms of topical glutathione, glutathione 0.5% was significantly more effective compared to glutathione 0.1% and placebo. For glutathione alone versus glutathione plus microneedling, more improvement was seen. Five randomized controlled trials and a single open-arm clinical study on oral glutathione at doses of 250 mg once a day, 250 mg twice a day, and 500 mg once a day showed a significant reduction in the melanin index compared to placebo. The combination of topical 2% glutathione plus oral glutathione was superior to monotherapy alone. There was only one placebo-controlled study on intravenous (IV) glutathione [6/16 (37.5%) vs. 3 (18.7%), (p0.054)]. The risk of bias assessment showed that almost an equal number of studies have low and high risk of bias. Topical versus oral glutathione both provide moderately efficacious skin-lightening outcomes that are localized versus generalized and have minimal versus substantial adverse effects, but they are unsustainable, with variable costs. IV glutathione is contraindicated due to lack of efficacy and side effects. It may work more as an antioxidant in melasma.

Laparoscopic Surgery for Superior Mesenteric Artery Syndrome.

Superior mesenteric artery syndrome (SMAS) is a rare condition, for which laparoscopic surgery was successfully performed safely and with long-term efficacy. This single center retrospective clinical study comprised 66 patients with SMAS, surgically treated between January 2010 and January 2020, who were allocated to three different surgical groups according to their medical history and symptoms (Laparoscopic duodenojejunostomy, n = 35; Gastrojejunostomy, n = 16; Duodenojejunostomy plus gastrojejunostomy, n = 15). Patient demographics, surgical data and postoperative outcomes were retrieved from the medical records. All operations were successfully completed laparoscopically, and with a median follow-up of 65 months, the overall symptom score was significantly reduced from 32 to 8 (p < 0.0001) and the BMI was increased from 17.2 kg/m2 to 21.8 kg/m2 (p < 0.0001). When conservative measures failed in the treatment of SMAS, laparoscopic surgery proved to be a safe and effective method. The specific surgical technique was selected according to the history and symptoms of each individual patient. To our knowledge, this study represents the largest number of laparoscopic procedures at a single center for the treatment of superior mesenteric artery syndrome.

A single arm phase 2 clinical trial of YIV-906 with neoadjuvant concurrent chemo-radiation therapy in patients with locally advanced rectal cancer.

Pre-operative chemoradiation for rectal cancer is often associated with severe gastrointestinal (GI) toxicity which can interrupt, delay, and/or lead to termination of treatment. In this study, we evaluated whether the addition of YIV-906, a novel herbal medicine proven to reduce GI toxicity associated with chemotherapy could also reduce GI side effects during standard pre-operative capecitabine and pelvic radiation therapy (RT) in the neoadjuvant setting for the treatment of locally advanced rectal cancer. This single arm clinical study enrolled 24 patients between Dec 23, 2014-Sep 17, 2018 at Smilow Cancer Hospital, a comprehensive cancer center at Yale New Haven Hospital. All patients were age ≥18 years, Eastern Cooperative Oncology Group 0-1 and with histologically confirmed T3-T4 and N0-N2, M0 adenocarcinoma of the rectum. Median follow-up was 61.9 months. All patients received concurrent pelvic external beam RT (50.4 Gy in 28 fractions), YIV-906 (taken orally 800 mg twice daily on days 1-4 of RT each week), and oral capecitabine delivered in a neo-adjuvant fashion, followed by definitive surgery. Toxicity was assessed weekly during radiation and until acute symptoms resolved and then at 28 days, 4 months, 7 months and 10 months. Toxicities were graded in accordance with Common Terminology Criteria for Adverse Events (CTCAE) version 4.0. At the time of surgery, 4 patients (16.7%) had a complete or near-complete response. At a median follow-up of 61.9 months, the mean overall survival (OS) of our patient cohort was 74.9 months [95% confidence interval (CI): 67.3-82.5]. The estimated 5-year OS was 82.0%. We observed 0% acute grade 4 toxicities, and only two cases of acute grade 3 diarrhea (8.3%). The addition of YIV-906 to capecitabine based chemoradiation for locally advanced rectal cancer led to reduced rates of GI toxicity compared to historical controls, in particular grade 3 or greater diarrhea. These findings suggest YIV-906 should be evaluated in a randomized clinical trial to further assess potential reductions in the toxicity profile of chemoradiation for GI cancers.

A clinical study of Digestive Health Capsules in the management of Grahani Roga with special reference to Irritable Bowel Syndrome

Background: Clinical manifestation of Grahani Roga is similar to irritable bowel syndrome (IBS). IBS is not a life-threatening condition but it can significantly impact the quality of life. The prevalence of IBS varies from 12% to 15% in India. It is 3 times more common in women and people of working age. Due to the wide spectrum of disease, much prevalence in society and lack of effective medicines, the disease has been chosen for the trial. Digestive Health Capsules manufactured by Bombay Hemp Company is used in patients suffering from Grahani Roga (IBS). Aim: The aim of this study was to study the safety and efficacy of Digestive Health Capsules in the management of Grahani Roga (IBS). Materials and Methods: Forty clinically diagnosed patients of Grahani Roga (IBS) were selected and administered Digestive Health Capsules - 1 capsule twice a day with water after meal for 8 weeks. Study Design: It was an open labeled, single center, single arm clinical study. Results: The result was highly significant for all the subjective and objective parameters. Conclusion: Digestive Health Capsules can be used as safe and effective drug of choice in patients suffering from Grahani Roga (Irritable Bowel Syndrome).

Paclitaxel and cisplatin/carboplatin plus tislelizumab in young patients with cervical cancer preserve fertility: Phase II prospective, single arm clinical study.

e17513 Background: Cervical function damage after fertility-sparing surgery has a lower pregnancy success rate. Chemotherapy (chemo) mainly plays an auxiliary role in the treatment of cervical cancer (CC), but its efficacy is limited. Recently, immunotherapy has shown remarkable progress in treatment of CC, potentially provide new treatment options for pts of childbearing age who require preservation of fertility. Herein, we conducted this study to evaluate the efficacy and safety of chemo plus tislelizumab (TIS) in young pts with CC who required fertility preservation. Methods: In this single arm, phase II trial, pts with histologically confirmed invasive, FIGO2018 stage IB1-IB3 or IIIC1r (localized cervical lesions) CC, and having fertility needs were enrolled. Eligible pts received 4 cycles chemo (175 mg/m2 paclitaxel + 70 mg/m2 cisplatin/AUC 5-6 carboplatin, Q3W) + TIS (200 mg, Q3W), followed by surgery-diagnostic cervical conization and sentinel lymph node (SLN) biopsy (IIIC1r stage with pelvic lymph node [PLN] systematic dissection)-upon achieving a radiographic complete response (CR). After surgery, pts will undergo 2-cycle chemo plus TIS therapy, if PLNs achieve a pathological complete response (pCR), regardless of the pCR status of localized cervical lesion. If the first cervical conization did not result in a pCR for localized cervical lesion only, a second conization was performed after 2-cycle chemo + TIS. Upon achieving pCR in both the cervical local disease and PLN, maintenance therapy (MT) with TIS will be continued for 1 year. Primary endpoint is pCR (SLN/PLNs + cervical conization) after surgery. The key secondary endpoints included clinical response to 4 cycles chemo + TIS, pregnancy rate, fertility rate, and treatment-emergent adverse events (TEAEs). Results: Between March 2022 and January 2024, 7 pts (mean age 31 years, range 27-38) were enrolled, with 2 pts (28.6%) having stage IIIC1r disease. All 7 pts received chemo plus TIS therapy; of these, 5 (71.4%) pts completed 4 cycles The objective response was achieved in 5 pts, with all complete response. Amenorrhea was observed in 3 of 5 pts (60%), with 2 recovering normal menstruation after chemo cessation, and 1 had finished the last chemo+TIS for 3 weeks and had not yet returned. During 4 cycles chemo + TIS therapy (n=7), the most common TEAEs of any grade were rash (71.4%), alanine aminotransferase increased (57.1%), neutrophil count decreased (57.1%), and white blood cell count decreased (57.1%). At data cutoff (median follow-up, 9 months, range 3.5-17), 1 pt experienced disease progression during MT, and 1 pt got pregnancy 3 months after completed MT. Conclusions: Chemo plus TIS could mediate tumor regression and eliminate micro-metastases with a tolerable safety profile, potentially allowing for fertility preservation in many pts for which this was not thought to be an option. Clinical trial information: ChiCTR2300067495.

Functional outcomes of femoral diaphyseal fractures using titanium elastic nail: A retrospective study

Background: Femoral Diaphyseal is common fracture in pediatrics. The Titanium Elastic Nail is designed to stabilized the long bone fracture in children where the implant flexibility is paramount and medullary canal is narrow. This study evaluates the functional outcome and complications of using elastic nail. Materials and Methods: This was a single centric, retrospective and clinical investigation study. The study was consisting of thirty-eight children (29 boys, 9 girls) aged group of 9-15 years who underwent femoral diaphyseal fracture treatment in Gautemala between March 2018 to June 2019 were recruited. The patient outcome was analyzed by physical examination, radiographs, VAS and ASA score by one year follow up. Results: The result showed better outcomes in all the patients with decline in the VAS score. All patients were available for the follow up of one year. The bone union was achieved in mean time of 7.1 weeks. The study reveal that no mechanical failure related to nail, bend or corrosion was seen in the patients. Finally, all the patient’s bone healed with time without any adverse effect and severe complications. Conclusion: The elastic nailing fixation is an efficient method for treating long bone fracture in children’s.

A clinical study of Sidharthakadi Lepa in management of Yuvanpidika (Acne Vulgaris)

Introduction: Acne is a distressing condition that affects the majority of adolescents and harms beauty of the face so person may suffer with inferiority complex, anxiety, isolation etc. Due to wide spectrum of disease, much prevalence in the society and lack of effective medicine, this is the main cause of the global shift toward Ayurveda and Herbal skin care. The present study was conducted to evaluate the effect of Sidharthakadi Lepa in management of Yuvanpidika. Methodology: Single arm open randomized clinical study was conducted on 40 clinically diagnosed patients with Acne Vulgaris for Sidharthakadi Lepa in the Postgraduate Institute of Ayurveda, DSRRAU, Jodhpur. Study evaluates their role in management of Pidika (Prescence of Acne), Kandu (Itching), Vedana (Pain), Daha (Burning sensation) and Srava (Discharge) Results: Result of the study depicts that Lepa has significantly helps in reducing the Acne vulgaris. Conclusion: Out of 40 patients selected for the study, a greater number of young adults &amp; 11 patients were male and 29 were female. It showed the high rate of occurrence and consciousness of this condition in females. Sidharthakadi Lepa is more effective in Vata and Kapha Prakrithi individuals.

A CLINICAL STUDY TO EVALUATE THE EFFICACY OF DARUHARIDRA-NIMBA MALHAR (LOCALLY) ALONG WITH PANCHASAMCHURNA-VATI (INTERNALLY) IN THE MANAGEMENT OF ABHYANTAR GUDARSHA W.S.R. TO GRADE II INTERNAL HAEMORRHOIDS.

Haemorrhoid is one of the prime important diseases of ano rectal disorder. In Ayurveda, it can be co- related with Gudarsha. In modern science, haemorrhoids are managed by lifestyle-diet modification, topical preparations, internal medicines and surgical procedures like Sclerotherapy, rubber band ligation, Laser therapy, Haemorrhoidectomy etc. with varied prognosis and complications. Acharya Sushruta has mentioned four different treatment modalities for management of Arsha (Haemorrhoids). Further, Bheshaja Chikitsa (Palliative medicine) is used for conservative management of Grade II Internal Haemorrhoids effectively. Hence, to establish a palliative treatment for Abhyantar Gudarsha, the open single arm clinical study had been carried on 50 patients. These patients were treated with specific regimen- Daruharidra-Nimba Malhar (Locally) at anal region twice daily for 15 days along with Panchasamchurna-Vati (Internally)) for 28 days. Therapeutic efficacy of the regimen was evaluated by assessing the parameters such as Pain, Bleeding per rectum, Constipation, Colour and Size of pile pedicle before, during and after the treatment.The present clinical study revealed that, the prescribed combination therapy proved effective in reducing symptoms of Abhyantar Gudarsha such as pain, per rectal bleeding, constipation, colour and size of pile pedicle in desired 28 days.

A COMBINED STUDY OF GIRIKARNI PHALADI NASYA AND NETIKARMA IN MANAGEMENT OF ARDHAVABHEDAKA (MIGRAINE)

Introduction: Migraine is one of the most common neurovascular disabling disorders. Migraine can be defined as a paroxysmal affection having a sudden onset accompanied by usually unilateral severe headache. In Ayurve-da, migraine is described as Ardhavabhedaka, which is a significant health issue among people of the age group 30-50 years. According to WHO, migraine is the third most common disease in the world, with an estimated global prevalence of 14.7%. Chronic migraine affects about 2% of the world's population. Female and male ratio 3:1. It is a widespread chronic and intermittently disabling disorder characterised by recurrent headaches with or without aura. Neti Karma and Nasya, one of the five types of Shodhana therapy, is the most effective Chikitsa for treating Urdhvajatrugata Roga (Eye, ENT and head diseases). Methodology: A single arm open randomised clinical study was conducted on 40 clinically diagnosed patients with Ardhavabhedaka (Migraine) for the proce-dure (Nasya karma and Neti karma) in the Postgraduate Institute of Ayurved, DSRRAU, Jodhpur. The study evaluates their role in the management of Shirahshoola (Headache), Shirobhrama (Confusion), Phonophobia (Sensitivity of sound), Shirajala (Pulsating vessels), Netra hani (Loss of Vision), Anorexia (Aruchi). Result: The result of the study depicts that Nasya karma and Neti karma have significantly helped reduce the Ardhavabhedaka (Migraine). Conclusion: The study concluded that Nasya and Neti karma have a role in man-aging Migraines, giving internal medication dosages, increasing their level of physical and mental alertness, and preventing complications. Both therapies are effective in Vata &amp; Vata-Kapha disease. Results should be validat-ed in larger sample sizes and multicentric models to establish it as a well-known treatment.

An Open Label Single Arm Clinical Study to Evaluate the Efficacy of Vamana Karma with Nimba Kashaya Yoga in Sheetapitta WSR O Urticaria

An Open Label Single Arm Clinical Study to Evaluate the Efficacy of Vamana Karma with Nimba Kashaya Yoga in Sheetapitta WSR O Urticaria

CLINICAL STUDY OF YOGASANA AND PATHYAAHARA IN MANAGEMENT OF MADHUMEHA (DIABETES MELLITUS-2)

Introduction: About 422 million people worldwide, most of whom reside in low and middle-income nations, have diabetes (metabolic lifestyle disorder), according to the World Health Organisation, contributing to 1.5 mil-lion deaths annually. Aahara (diet) and Yoga asanas are essential for controlling and preventing lifestyle disor-ders. Thus, this study assessed how yoga techniques and the Aahara contribute to managing diabetes mellitus. Methodology: A single arm open randomised clinical study was conducted on 30 clinically diagnosed patients with diabetes mellitus 2 for Yoga asanas (Mandukasana, Kurmasana, Vakrasana, and Ardhamatsyendrasana) and Ayurvedic Aahara plan in the Postgraduate Institute of Ayurved, DSRRAU, Jodhpur. The study evaluates their role in the management of Prabhoot Mutrata (Polyuria), Avila Mutrata (Urine turbidity), Pipasadhikya (Polydipsia), Kshuda Adhikya (Polyphagia), Sweda Adhikya (The excessive sweating) The, Dourbalya The (Weakness The/Tiredness The), The Alasya (The Laziness) The, Atinidra (Excessive sleep), Karpada Daha (Burning sensation in hands and feet) and blood sugar level (i.e. FBS and PPBS, HbA1c). Result: The result of the study depicts that Yoga asanas and Ayurvedic Aahara have significantly helped in reducing the Prabhoot Mutrata, Avila Mutrata, Pipasadhikya, Kshuda Adhikya, Sweda Adhikya, Dourbalya, Alasya, Atinidra, Karpada Daha and blood sugar level. Conclusion: The study concluded that Yoga therapy and the Aahara plan have a role in managing diabetes mellitus by lowering medication dosages, increasing physical and mental alertness, and preventing complications. Results should be validated in larger sample sizes and multicentric models to es-tablish it as a well-known treatment.

An open label single arm clinical study of Dashamooladi Yamaka Pratimarsha Nasya and Prasaranyadi Kashaya in Apabahuka (Frozen Shoulder)

Background: Apabahuka is a Vata Vyadhi which affects Amsa Sandhi and causes Amsa Bandha Shoshana. Prakupita Vata causes Kshaya of Shleshaka Kapha and Sira Sankochana leading to Bahupraspanditahara. Nasya and Uttarbhaktika Snehapana are the indicated Chikitsakrama for Apabahuka. Dashamooladi Yamaka Pratimarsha Nasya and Prasaranyadi Kashaya are the indicated Chikitsa Yoga for Apabahuka in Vatavyadhichikitsa. Hence this study is intended to evaluate the same. Objective: To clinically evaluate the combined effectiveness of Dashamooladi Yamaka Pratimarsha Nasya and Prasaranyadi Kashaya in Apabahuka (Frozen Shoulder). Methodology: 36 subjects were administered with Dashamooladi Yamaka Pratimarsha Nasya 2 Bindu in each nostril after food morning and night and Prasaranyadi Kashaya 16ml 3 times a day on before food for a period of 14 days. Subjective and objective parameters were assessed by Constant Murley score. Results: Statistically significant (P &lt; 0.05) improvement was observed in subjective parameters such as Amsasandhi Shoola, Bahupraspanditahara. With objective parameters like range of movement of shoulder significant change was observed. Conclusion: Dashamooladi Yamaka in the form of Pratimarsha Nasya and Prasaranyadi Kashaya orally together were found effective in the management of Apabahuka.

TO EVALUATE THE EFFICACY OF MUDGA MASURA ADAKI YUSHA AS PATHYA IN PANDU ROGA W.S.R TO IRON DEFICIENCY ANAEMIA – A CLINICAL STUDY

Background &amp;Objective: Pandu Roga is a Pitta Pradhana Tridosha Vikara associated with Rasa and Raktha Vaha Srotas. It is characterized by Pandu Varnata, Arohana Ayasa, Dourbalya, Bhrama, and Hrudaya Spandhana. Anaemia is the most prevalent Nutritional deficiency disorder in the world, it affects all age groups but the most vulnerable are preschool age children, pregnant women and non-pregnant woman of childbearing age. Anaemia is a condition where haemoglobin concentration of the individuals falls below the lower limit of the normal range for the age and sex of the individual. Its common clinical features include pallor, exertional dyspnoea, tiredness, and giddiness, and can be correlated with Pandu Roga. Methods: An Interventional Single Arm Clinical Study conducted in 30 subjects for a period of 30 days. Clinical features and Hematological pa-rameters were documented before and after the treatment. Observations were analyzed and findings were evalu-ated by using Software stigma STAT-3 and statistical analysis done by Wilcoxon signed rank test and paired t test. Results: The study shows that Mudga Masura Adaki Yusha have significant effect in clinical features and Haematological parameters significantly. The results obtained were found to be statistically significant at p&lt;0.001 except for Blood picture and RBC shows p=1.000 and p=0.161 respectively. Conclusion: Mudga Masura Adaki Yusha has significant effect in Pandu Roga.

Association between celiac disease and fibromyalgia and their severity: a cross-sectional study.

Fibromyalgia (FMS) is a common musculoskeletal disorder with many causes. People with fibromyalgia often have the same symptoms as people with celiac disease (CD). Demonstration of the coordination and frequency of FMS and CD is important for effective treatment. This is a single center cross-sectional clinical study. The study included 60 patients who were diagnosed with CD by the Gastroenterology Clinic based on American College of Gastroenterology (ACG) criteria. Patients were also asked to complete the Widespread Pain Index (WPI), Symptom Severity Scale (SSS), and Fibromyalgia Impact Questionnaire (FIQ) to diagnose fibromyalgia and assess its severity. The results were used to analyze the frequency of concomitance and relationship between the two diseases. The relationship between the clinical types of CD and the presence of fibromyalgia was insignificant. Analysis of the relationship between the pathologic typing of biopsy and fibromyalgia frequency was insignificant. Those with antibodies more frequently met criteria for fibromyalgia (P = 0.04, P = 0.04, respectively). Presence of clinical extraintestinal manifestations in patients with CD should lead clinicians to consider FMS as a possible diagnosis. This points to the importance for clinicians in all subspecialties to be aware of the various symptoms and diseases associated with FMS.

An Open Label Single Arm Clinical Study on Dashamooladi Yamaka Pratimarsha Nasya and Ashtavargam Kashaya in Vishwachi (Cervical Radiculopathy)

Background: Vishwachi is one among the 80 Vatavyadhi. Lakshana of Vishwachi are Bahu Cheshtapaharana, Bahu Karma Kshaya, Stambha, Ruja, Toda, Spandana, Tandra, Gourava and Arochaka. Cervical radiculopathy is a condition similar to Vishwachi, which results from compression of cervical nerve roots. This leads to neck pain radiating along the distribution of the affected nerve root, numbness, altered reflexes and weakness in the muscles of arm. Objectives: To evaluate the combined effectiveness of Dashamooladi Yamaka Pratimarsha Nasya and Ashtavargam Kashaya in Vishwachi (Cervical Radiculopathy). Materials and methods: 30 subjects fulfilling the inclusion criteria were administered with Dashamooladi Yamaka Pratimarsha Nasya in the dose of 2 Bindu twice daily after food and Ashtavargam Kashaya, 15ml thrice daily after food, for 14 days. Ruja, Toda, Spandana, Sthambha, Tandra, Gourava, Arochaka, Bahukarmakshya, Bahucheshtapaharana and Spurling test were assessed on 1 st day, 7th day and 15th day. Data were analyzed using appropriate statistical tests. Results and conclusion: Statistically significant (P &lt; 0.05) improvement was observed in symptoms such as Bahu Karmakshaya, Bahu Cheshtapaharana, Ruja, Toda, Spandana and range of cervical movement. Dashamooladi Yamaka Pratimarsha Nasya and Ashtavargam Kashaya were found to be effective in the management of Vishwachi.

An open label single arm clinical study to evaluate the combined effectiveness of Navakashaya and Vidangadi Lepa in Vicharchika (Dermatitis)

Background: Vicharchika is one among the Kshudra Kushta with predominance of Kapha Dosha and it is characterized by, Kandu (Itching), Bahu Srava (Excessive exudation), Shyava Varna (Greyish black discolouration) and Pidaka (Papule). Vicharchika is similar to Dermatitis (Eczema). Dermatitis is a heterogenous group of disorders that share similarities in clinical appearance and histopathologic findings, but may have different etiologies. Objectives: To evaluate the combined effectiveness of Navakashaya and Vidangadi Lepa in the management of Vicharchika (Dermatitis). Methods: Among 34 registered subjects, 30 of them completed the course of treatment. They were administered with Navakashaya internally and Vidangadi Lepa application externally for a period of 30 days. Ordinal data was analyzed with Friedman’s test followed by Wilcoxon signed rank test as post-hoc and Nominal data was analyzed with Cochran Q test followed by McNemar test as post-hoc. Continuous data was analyzed by Repeated Measures ANOVA and after applying bonferroni correction with Paired t test as post-hoc. Results: There was statistically significant improvement in the subjective and objective parameters of Vicharchika (Dermatitis). Conclusion: Navakashaya and Vidangadi Lepa are effective in the management of Vicharchika (Dermatitis).

Brain Abscess: A Comparison of Surgical Outcomes between Conventional Burr Hole Aspiration and Endoscope-assisted Evacuation.

Brain abscess is a major health problem with a significant morbidity and mortality rate. The objective of this study was to compare the surgical efficacy between endoscope-assisted evacuations of brain abscess with a single burr hole aspiration procedure in a tertiary health care center. This single center non-randomized clinical study was conducted in our Department of Neurosurgery during the period of July 2020 to December 2021. Patients under 30 years of age of both genders presented with brain abscess were enrolled in this study. Patients were treated with two different techniques and divided into 2 groups: conventional burr hole aspiration group and endoscope-assisted evacuation group. Thirty patients were enrolled for this study. The mean age was 13.0 ± 6.3 years in burr hole group and is 13.1 ± 6.4 years in endoscope-assisted group. This study showed ≥75.0% evacuation of brain abscess at 1st post-operative day in 13 (92.9%) patients in endoscope-assisted group and 5 (33.3%) patients in burr hole group. This study showed mortality rate of 6.7% in both the groups. Mean residual volume at 30th post-operative day was 0.75 ml in endoscope-assisted group and 1.75 ml in burr hole aspiration group. No patients treated with required endoscope-assisted evacuation required a repeated surgery, whereas 5 patients (33.3%) of patients treated with conventional burr hole required it. This study showed that endoscope-assisted procedure has better rate of abscess evacuation, less chance of residual and repeated surgeries than conventional burr hole.

Effect of Dashmoola Siddha Ksheera Janu Basti and Jatamayadi Upanaha in Sandhigatavata (Osteoarthritis) - A Case Study

Sandhigatavata is one of the Vata Vyadhi characterized by the symptoms as Sandhi Shoola and Sandhi Sphot. Most middle-aged and older adults experience degenerative joint disorders with symptoms such as swelling, pain on flexion and extension. Symptoms of Sandhigatavata exhibit apparent similarity with that of osteoarthritis, a degenerative disorder that occurs when articular cartilage wears down and the failure of diarthrodial joint. A Single clinical case study was conducted to evaluate the effectiveness of Dashmoola Ksheera Janu Basti and Jatamayadi Upanaha in Janu Sandhigatavata. Dashmoola Siddha Khseera was freshly prepared, used in Sthanik Janu Basti and Jatamayadi Upanaha applied externally over the affected knee joints of the patient for 1-2 hrs daily, for 21 days. After the treatment, the patient experienced significant relief and observed visible reduction in predominant symptoms.