Ayurvedic Management of Parikarthika (Acute Fissure in Ano) – A Case Study

Among anorectal diseases, Parikarthika (Fissure in ano) is considered one of the most painful diseases. Now a days the incidence rate of this disease became more due to the irregular food habits as well as unproper modern life style changes. Due to this its recent occurrence in all types of age groups irrespective of gender. This case study described the effective management of acute fissure in ano which was managed with ayurvedic treatment modalities. A 23-year male patient came with symptoms of pain and burning during and after defecation and also having the presence of blood streak while passing of stool. The patient was diagnosed as acute fissure due to the presence of a cut longitudinal ulcer in lower part of anal canal at the 6 o’clock position. Ayurvedic treatment approach both internally and externally were followed. Jatyadi Ghritham Pichu application followed by a lukewarm water sitz bath was advised as external treatment. The complete improvement was found in this within 12 days of treatment. No reoccurrence was noted even after 3rd month of follow up.

Development and validation of a new algorithm model for differential diagnosis between Crohn's disease and intestinal tuberculosis: a combination of laboratory, imaging and endoscopic characteristics

Background Sometimes in clinical practice, it is a great challenge to distinguish Crohn's disease (CD) and intestinal tuberculosis (ITB), we conducted this study to identify simple and useful algorithm for distinguishing them. Methods We retrospectively reviewed the medical history of the patients who were diagnosed as ITB or CD. We firstly identified ITB patients, and then the patients diagnosed with CD were matched by age, sex, and admission time in a 1:1 ratio. Patients who admitted between May 1, 2013 and April 30, 2019 were regarded as training cohort, and patients admitted between May 1, 2019 and May 1, 2020 were regarded as validation cohort. We used multivariate analysis to identify the potential variables, and then we used R package rpart to build the classification and regression tree (CART), and validated the newly developed model. Results In total, the training cohort included 84 ITB and 84 CD patients, the validation cohort included 22 ITB and 22 CD patients. Multivariate analysis showed that, positive interferon-gamma release assays (IGRAs), ≥ 4 segments involved, longitudinal ulcer, circular ulcer, and aphthous ulcer were confirmed as independent discriminating factors. Using these parameters to build the CART model made an overall accuracy rate was 88.64%, with sensitivity, specificity, NPV, and PPV being 90.91%, 86.36%, 90.48% and 86.96%, respectively. Conclusion We developed a simple and novel algorithm model covering laboratory, imaging, and endoscopy parameters with CART to differentiate ITB and CD with good accuracy. Positive IGRAs and circular ulcer were suggestive of ITB, while ≥ 4 segments involved, longitudinal ulcer, and aphthous ulcer were suggestive of CD.

Dr the efficacy of karpoor ghrith in the management of parikartika.

Fissure in Ano ( Parikartika) is a vertical tear or an elongated longitudinal ulcer in the long axis of stratified squamous epithelium of the lower anal canal. Ancient text couldn’t give a brief idea about this condition. Mainly it has been described as complication of Bastikarma and Atisar. It is so named in which sharp cutting pain is felt in the anus. For that Modern surgical treatment of choice is again has limitations such as faecal incontinence. Hence, karpoor Ghrita having effective Vranaropan & vedanashamak, tridoshaghna property i.e. it relieves burning sensation quickly. So we modified a method of Local Application is conceived for this study.