A Case Report on Ayurvedic Management of Dushta Vrana

Dushta vrana is a commonly encountered problem in day-to-day practice. Contemporary progress in the field of surgery has reduced the incidence of wound infection to a great extent along with the use of antibiotics. But still the management of ulcer encounters many glitches. This case study discusses about a 58-year-old male patient who presented with a chronic non healing ulcer in the anterior aspect of the left ankle joint associated with pain, burning sensation, foul smelling and inflammation with no history of varicose veins. Patient was treated with Karaskara ksheera kashaya dhara followed by dressing with Jathyadi ghrta. Punarnavadi kashayam and Guggulupanchapala choornam was given internally for a period of 35days. Virechana with Avipathy Choornam was given once during the whole course of the treatment. Raktamokshana was done twice as Jaloukavacharana. In order to enhance the speedy recovery, traditional use of Kupeelu was considered. A highly potent drug among the Upavisha which is well known for properties like Vranahara, Soolahara, Kushtahara, Sothaghna etc. which augments the peripheral blood circulation, reduces pain, burning sensation and inflammation. The wound healed within a period of 35 days and got complete relief from pain, burning sensation and swelling. Thus, the patient was successfully treated with no complications.

Microcirculatory bed in reperfused flaps: modern possibilities for the correction of hemodynamic disorders (part III)

The paper presents an analysis of the literature data concerning the autoregulation of tissue blood flow in free axial flaps. Autoregulation of microcirculation is an extremely important physiological phenomenon that ensures the stability of peripheral blood circulation and adequate metabolism in organs and tissues, regardless of fluctuations in systolic blood pressure in the range of 80-160 mm Hg. The types of sludge and their origin are described. Technologies of elimination of erythrocyte aggregates (sludge) by using dextrans of different molecular weights and pentoxifylline are discussed. Controlling the duration of primary ischemia, maintaining adequate perfusion pressure in the replants of the limbs and in free flaps, as well as reducing the peripheral vascular resistance in them, will make it possible to level the disturbances in the autoregulation of microcirculation in the reperfused tissues, ensuring the stability of capillary pressure.

Risk factors for pegylated liposomal doxorubicin-induced moderate to severe hand-foot syndrome in breast cancer patients: assessment of baseline clinical parameters

Background Hand-foot syndrome (HFS) is a side effect of skin related to pegylated liposomal doxorubicin (PLD) application. Moderate to severe hand-foot syndrome (MSHFS) might have a serious impact on patients’ quality of life and treatment. However, information on risk factors for the development of MSHFS is still limited. To analyze the risk factors for PLD-induced MSHFS in breast cancer patients and constructed a logistic regression prediction model. Methods We conducted a retrospective analysis of breast cancer patients who were treated with a PLD regimen in the Tumor Hospital of Harbin Medical University from January 2017 to August 2019. A total of 26 factors were collected from electronic medical records. Patients were divided into MSHFS (HFS > grade 1) and NMHFS (HFS ≤ grade 1) groups according to the NCI classification. Statistical analysis of these factors and the construction of a logistic regression prediction model based on risk factors. Results A total of 44.7% (206/461) of patients developed MSHFS. The BMI, dose intensity, and baseline Alanine aminotransferase (ALT) and Aspartate aminotransferase (AST) levels in the MSHFS group, as well as good peripheral blood circulation, excessive sweat excretion, history of gallstones, and tumour- and HER2-positive percentages, were all higher than those in the NMHFS group (P < 0.05). The model for predicting the occurrence of MSHFS was P = 1/1 + exp. (11.138–0.110*BMI-0.234*dose intensity-0.018*baseline ALT+ 0.025*baseline AST-1.225*gallstone history-0.681* peripheral blood circulation-1.073*sweat excretion-0.364*with or without tumor-0.680*HER-2). The accuracy of the model was 72.5%, AUC = 0.791, and Hosmer-Lemeshow fit test P = 0.114 > 0.05. Conclusions Nearly half of the patients developed MSHFS. The constructed prediction model may be valuable for predicting the occurrence of MSHFS in patients.

The Effect of Dry Carbon Dioxide Bathing on Peripheral Blood Circulation Measured by Thermal Imaging among Patients with Risk Factors of PAD

Peripheral artery disease (PAD) is becoming a serious health problem of present times. It appears crucial to explore therapies that might help to restore blood flow or increase tissue oxygenation. The most effective methods of detecting early-stage changes in blood circulation in the extremities need to be identified. The aim of this study was to identify the effect of carbon dioxide (CO2) bathing on peripheral blood circulation measured by thermal imaging among patients with risk factors of PAD and ankle–brachial index (ABI) in the normal range or ABI indicating some or moderate arterial disease (ABI > 0.5). The correlation between surface temperature change and PAD-relevant characteristics was also examined. Forty-six patients who were over 65 years old who had a minimum of two additional PAD risk factors were recruited. A series of ten dry CO2 baths was performed. Thermal images were taken before and after the intervention. The CO2 therapy caused a significant change in the body surface temperature of many body areas. Numerous moderate correlations between temperature change and health-related characteristics were identified. Therefore, patients with PAD risk factors could benefit from CO2 therapy. Improvements in blood flow change the body surface temperature, and these changes could be successfully detected by thermal imaging.

Individual mechanisms underlying peripheral nerve damage when exposed to metallic mercury

Introduction. There is a lack of knowledge of the pathophysiological mechanisms that form peripheral nerve disorders in mercury lesions of professional origin. The study aims to reveal the mechanisms underlying peripheral nerve damage in the long-term post-contact period of chronic mercury intoxication (CMI). Materials and methods. Fifty-one people had the diagnosis of a long-term period of CMI. The post-contact period was 8.5±2.6 years. The authors compared the results with a control group of 26 healthy men who had no contact with toxic substances. Stimulating electroneuromyography was performed. We studied the body systems that could contribute to the formation of disorders in the peripheral nerves. Changes in peripheral hemodynamics were studied using reovasography. The content of autoantibodies, neuron-specific enolase, serotonin, histamine, catecholamines (epinephrine, dopamine), metanephrine, and neurotrophin-3 was reviewed. The content of ceruloplasmin, secondary products of lipid peroxidation processes, reduced glutathione, the activity of superoxide dismutase and the content of nitric oxide levels were determined. Results. The study established pathogenetic structural links of peripheral nerve disorders. The autoimmune process's role was to increase the range of antibodies to the MAG protein and increase the level of antibodies to DNA. Violations of elastic-tonic properties of peripheral vessels could be associated with the functional state of motor axons. The increased content of neurotransmitters is related to the state of peripheral blood circulation; the most pronounced changes were on the legs, which could contribute to the occurrence and maintenance of vasoconstriction. The role of oxidative stress in the formation of demyelinating disorders in patients' peripheral nerves in the long-term period of CRI is possible. Conclusion. Neuroimmunological processes has an essential role in the development of peripheral nerve demyelination was shown, which consists in an increase in the content of antibodies to the MAG protein expressed on Schwann cells of peripheral nerves and in an increase in the level of antibodies to DNA involved in the formation of demyelinating changes when exposed to metallic mercury. The revealed pathological changes in the state of the peripheral blood circulation, characterized by a violation of the vessels' elastic-tonic properties, leading to demyelination of motor axons in patients in the long-term period of CMI. The increased content of neurotransmitters in the examined is of great importance in the state of peripheral circulation. Pronounced changes in blood circulation are established on the lower extremities, which may be associated with the predominance of α-adrenergic receptors in the arterial bed and may contribute to the occurrence and maintenance of vasoconstriction in the legs. The relationship between changes in indicators of oxidative stress, consisting of a decrease in the value of superoxide dismutase and reduced glutathione, and the formation of demyelinating disorders of peripheral nerves in patients in the long-term period of CMI has been proved.

Pengaruh Therapeutic Exercise Walking terhadap Sirkulasi Darah Perifer pada Pasien Diabetes Melitus Tipe 2 di Kelurahan Gebang Kecamatan Patrang Kabupaten Jember. (The Effect of Therapeutic Exercise Walking on Pheripheral Blood Circulation in Patients wit

Pathological change experienced by patients with type 2 diabetes mellitus is impaired peripheralblood circulation, especially in the lower limbs and feet. Peripheral blood circulation can be examinedby measuring Ankle Brachial Index (ABI). Therapeutic exercise walking is one of physical activitieswhich can improve blood circulation. This research goal was to analyze the effect of therapeuticexercise walking on peripheral blood circulation in patients with type 2 diabetes mellitus. Theresearch design was randomized control group pretest-posttest design. The sample size was 15respondents as control group and 15 respondents as treatment group. Data was analyzed by usingdependent t-test and independent t-test with significant level of 0.05. This result showed a significantincrease of ABI after therapeutic exercise walking in the treatment group (p= 0.001). However therewas a significant decrease of ABI between pretest and posttest in control group (p=0.010).Independent t-test indicated a significant difference of ABI between treatment group and controlgroup (p=0.000). So, it can be concluded that there is an influence of therapeutic exercise walking onthe peripheral blood circulation in patients with type 2 diabetes mellitus. Nurses should applytherapeutic exercise walking to improve peripheral blood circulation in patients with type 2 diabetesmellitus.Keywords: type 2 diabetes mellitus, therapeutic exercise walking, ankle brachial index