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Article: Integrative management of diabetic foot ulcers - A case series.

Shindhe, Pradeep S / Kale, Ajay Pandurang / Killedar, Ramesh S

Journal of Ayurveda and integrative medicine

2023 Volume 14, Issue 5, Page(s) 100770

Abstract: Diabetic foot ulcer (DFU) is a serious complication of diabetes mellitus and a cause of significant morbidity, mortality and healthcare expenditure. Treatment of DFU includes multimodal approach like surgical debridement, infection control, vascular ... ...

Abstract	Diabetic foot ulcer (DFU) is a serious complication of diabetes mellitus and a cause of significant morbidity, mortality and healthcare expenditure. Treatment of DFU includes multimodal approach like surgical debridement, infection control, vascular assessment, dressing etc. Multidisciplinary approach towards foot care is becoming a mainstay of therapy, and even with this comprehensive approach, there is still room for improvement in DFU outcomes. Integrative management includes the adoption of various systems of treatment with standard treatment for better outcomes. In the present case series, six cases of DFU were managed with the integration of Ayurveda and allopathic treatments. The cases were managed according to the standard diabetic foot ulcer management principles like surgical debridement, insulin therapy, along with incorporation of Ayurveda procedures like Vimlapana, Prakshalana, Bandhana etc. Standard assessment of ulcers at different time points was done using the Bates- Jensen Ulcer assessment tool. All the six DFU healed with minimal scar formation and in less time, lowering the risk of further amputation. Promising results were obtained in all six cases by adopting integrated Ayurveda and allopathic treatments, which indicates the potential benefits of alternative systems of medicine.
Language	English
Publishing date	2023-09-06
Publishing country	United States
Document type	Case Reports
ISSN	0975-9476
ISSN	0975-9476
DOI	10.1016/j.jaim.2023.100770
Database	MEDical Literature Analysis and Retrieval System OnLINE

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

Mishra, Vibhuti / Shindhe, Pradeep S / Killedar, Ramesh S

Journal of Ayurveda and integrative medicine

2022 Volume 13, Issue 4, Page(s) 100665

Abstract: Background: Pain 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% ( ... ...

Abstract	Background: Pain 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. Objective: To evaluate the efficacy of non-pharmacological (para surgical) procedures in the management of pain. Materials and method: Total 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. Results: The 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. Conclusion: Protocol 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.
Language	English
Publishing date	2022-11-24
Publishing country	United States
Document type	Journal Article
ISSN	0975-9476
ISSN	0975-9476
DOI	10.1016/j.jaim.2022.100665
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Integrative management of diabetic foot ulcers – A case series

Shindhe, Pradeep S. / Kale, Ajay Pandurang / Killedar, Ramesh S.

Journal of Ayurveda and Integrative Medicine. 2023 Sept., Oct., v. 14, no. 5 p.100770-

2023

Abstract	Diabetic foot ulcer (DFU) is a serious complication of diabetes mellitus and a cause of significant morbidity, mortality and healthcare expenditure. Treatment of DFU includes multimodal approach like surgical debridement, infection control, vascular assessment, dressing etc. Multidisciplinary approach towards foot care is becoming a mainstay of therapy, and even with this comprehensive approach, there is still room for improvement in DFU outcomes. Integrative management includes the adoption of various systems of treatment with standard treatment for better outcomes. In the present case series, six cases of DFU were managed with the integration of Ayurveda and allopathic treatments. The cases were managed according to the standard diabetic foot ulcer management principles like surgical debridement, insulin therapy, along with incorporation of Ayurveda procedures like Vimlapana, Prakshalana, Bandhana etc. Standard assessment of ulcers at different time points was done using the Bates- Jensen Ulcer assessment tool. All the six DFU healed with minimal scar formation and in less time, lowering the risk of further amputation. Promising results were obtained in all six cases by adopting integrated Ayurveda and allopathic treatments, which indicates the potential benefits of alternative systems of medicine.
Keywords	Ayurvedic medicine ; amputation ; debridement ; diabetic foot ; disease control ; health care costs ; insulin replacement therapy ; mortality ; risk ; Diabetic foot ulcer (DFU) ; Integrative management ; Bates- jensen ulcer assessment tool ; Vrana Ropana ; Vrana Shodhana
Language	English
Dates of publication	2023-09
Publishing place	Elsevier B.V.
Document type	Article ; Online
Note	Pre-press version ; Use and reproduction
ISSN	0975-9476
DOI	10.1016/j.jaim.2023.100770
Database	NAL-Catalogue (AGRICOLA)

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Article ; Online: Efficacy of Jatyadi, Madhughrita and honey tulle in wound management: a three-arm randomized controlled clinical trial

Prasannan, Dhrushnu / Shindhe, Pradeep S. / Jadar, Prashant G. / Killedar, Ramesh S. / Priyanka K.

Journal of Ayurveda and Integrative Medicine. 2023 May, June, v. 14, no. 3 p.100719-

2023

Abstract: Ayurveda underlines the significance of wounds and wound healing. Acharya Susruta has highlighted the need for shastiupakramas in the management of the wound. Even with a multitude of therapeutic concepts and formulations in Ayurveda, wound management ... ...

Abstract	Ayurveda underlines the significance of wounds and wound healing. Acharya Susruta has highlighted the need for shastiupakramas in the management of the wound. Even with a multitude of therapeutic concepts and formulations in Ayurveda, wound management has yet to gain acceptance. To evaluate the effect of Jatyadi tulle, Madhughrita tulle, and honey tulle in the management of Shuddhavrana (clean wound). A three-arm randomized, parallel group, active-controlled, open-label clinical trial. Randomization was done through online random number generator software to allocate 45 patients treatment into three groups. Trial groups were treated with Jatyadi tulle (JT), Madhughrita tulle (MG), and control group was treated with Honey tulle (HT) for 10 days, and assessment was done on the 5th and 10th day. The wound was assessed using the Bates Jensen wound assessment tool, and the efficacy of the dressing material was assessed using the Worcestershire tissue viability team dressing assessment form. The study outcomes were early wound healing and clinical cure. Within-group results were assessed using the Wilcoxon matched pairs test, and between-group results were assessed by Kruskal-Wallis ANOVA and Mann-Whitney U test. Significant results were obtained within-group (p value < 0.05) from day 0 and at various time points. The results between groups were found to be comparable; JT and MG were found to be significant in ease of application, removal, and patient comfort. No adverse drug events were identified throughout the study. JT and MG tulle have shown significant results in the management of shuddhavrana.
Keywords	Ayurvedic medicine ; clinical trials ; computer software ; drugs ; honey ; patients ; viability ; wound treatment ; Vrana ; Wound healing ; Jatyadi tulle ; Honey tulle ; Madhughrita tulle
Language	English
Dates of publication	2023-05
Publishing place	Elsevier B.V.
Document type	Article ; Online
Note	Use and reproduction
ISSN	0975-9476
DOI	10.1016/j.jaim.2023.100719
Database	NAL-Catalogue (AGRICOLA)

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Article: An integrated management (Ayurveda and Modern medicine) of accidental burn injury: A case study.

Shindhe, Pradeep S / K, Priyanka / Killedar, Ramesh S / Prasannan, Dhrushnu / A, Kirthi

Journal of Ayurveda and integrative medicine

2023 Volume 14, Issue 2, Page(s) 100691

Abstract: Burn injuries are frequent, horrifying, and life-threatening conditions that are still challenging to cure. Complications like scarring, keloid formation, and contractures are the main challenges for the treating surgeon. The Ayurvedic classics explain ... ...

Abstract	Burn injuries are frequent, horrifying, and life-threatening conditions that are still challenging to cure. Complications like scarring, keloid formation, and contractures are the main challenges for the treating surgeon. The Ayurvedic classics explain different treatment modalities for the management of burn wounds, like oral medicines, topical applications prepared with herbal medicines, ghee, oil, and typical wound dressing techniques like Patraadaana (wound covering with medicinal leaves), and fumigation therapy, etc. Here we report a case of accidental burn injury with a TBSA of 27% First degree (superficial) and 15% second degree (deep partial-thickness) burns with complaints of fever and burning sensation at the burn site. On the basis of the symptoms listed in the classical texts of Ayurveda, the case was diagnosed as Pramadadagdha (accidental burn). To properly manage the burn wound, an integrated therapy strategy was designed. Ropanaghrita (medicated ghee) was applied locally, followed by the application of Tinospora cordifolia leaves to cover the wound, fumigation therapy, and oral medications to hasten wound healing and reduce infection. In the first seven days, modern medicine was used as emergency care in addition to Ayurvedic management. Within 60 days of receiving treatment, the burn wound had entirely healed, and the patient was able to resume her regular work activities. In the current situation, the combined strategy produced encouraging burn management outcomes.
Language	English
Publishing date	2023-02-24
Publishing country	United States
Document type	Case Reports
ISSN	0975-9476
ISSN	0975-9476
DOI	10.1016/j.jaim.2023.100691
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Efficacy of Jatyadi, Madhughrita and honey tulle in wound management: a three-arm randomized controlled clinical trial.

Prasannan, Dhrushnu / Shindhe, Pradeep S / Jadar, Prashant G / Killedar, Ramesh S / Priyanka K

Journal of Ayurveda and integrative medicine

2023 Volume 14, Issue 3, Page(s) 100719

Abstract: Background: Ayurveda underlines the significance of wounds and wound healing. Acharya Susruta has highlighted the need for shastiupakramas in the management of the wound. Even with a multitude of therapeutic concepts and formulations in Ayurveda, wound ... ...

Abstract	Background: Ayurveda underlines the significance of wounds and wound healing. Acharya Susruta has highlighted the need for shastiupakramas in the management of the wound. Even with a multitude of therapeutic concepts and formulations in Ayurveda, wound management has yet to gain acceptance. Objective: To evaluate the effect of Jatyadi tulle, Madhughrita tulle, and honey tulle in the management of Shuddhavrana (clean wound). Materials and methods: A three-arm randomized, parallel group, active-controlled, open-label clinical trial. Randomization was done through online random number generator software to allocate 45 patients treatment into three groups. Trial groups were treated with Jatyadi tulle (JT), Madhughrita tulle (MG), and control group was treated with Honey tulle (HT) for 10 days, and assessment was done on the 5th and 10th day. The wound was assessed using the Bates Jensen wound assessment tool, and the efficacy of the dressing material was assessed using the Worcestershire tissue viability team dressing assessment form. The study outcomes were early wound healing and clinical cure. Results: Within-group results were assessed using the Wilcoxon matched pairs test, and between-group results were assessed by Kruskal-Wallis ANOVA and Mann-Whitney U test. Significant results were obtained within-group (p value < 0.05) from day 0 and at various time points. The results between groups were found to be comparable; JT and MG were found to be significant in ease of application, removal, and patient comfort. No adverse drug events were identified throughout the study. Conclusion: JT and MG tulle have shown significant results in the management of shuddhavrana.
Language	English
Publishing date	2023-06-02
Publishing country	United States
Document type	Journal Article
ISSN	0975-9476
ISSN	0975-9476
DOI	10.1016/j.jaim.2023.100719
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Ayurveda management of Nicolau syndrome W.S.R to Kotha – a case report

Killedar, Ramesh S / Gupta, Shivay / Shindhe, Pradeep

Journal of Ayurveda and integrative medicine. 2021 Jan., Mar., v. 12, no. 1

2021

Abstract: Administration of intramuscular, intraarterial or subcutaneous injection of particular drugs ends up into a rare entity known as Nicolau syndrome (NS). The viscous nature of these drugs sometimes triggers acute vasospasm and even arterial embolism. There ...

Abstract	Administration of intramuscular, intraarterial or subcutaneous injection of particular drugs ends up into a rare entity known as Nicolau syndrome (NS). The viscous nature of these drugs sometimes triggers acute vasospasm and even arterial embolism. There is no consensus on treatment of NS so far. Phasic treatments depend on the extent of the necrotic lesion and ranges from medication to surgical debridement. Here we report a case of 60 year female known case of Knee Osteoarthritis who was dependent on Diclofenac injection IM for relief of pain. She presented with complaints of fever with chills, rigors, discoloration of skin at the gluteal region right side, later turned into necrosis of skin and adipose tissue, pus formation and associated with loss of appetite, dryness of mouth, pedal oedema. The case was diagnosed as NS according to contemporary science and Kotha (Gangrene) as per Ayurveda. The case was treated successfully with Chedana karma (Surgical debridement) followed by Vrana shodhana (making free from undesirable healing factors), Ropana (Closure of wound) and oral medications.
Keywords	Ayurvedic medicine ; adipose tissue ; anorexia ; buttocks ; case studies ; debridement ; diclofenac ; discoloration ; edema ; embolism ; females ; fever ; gangrene ; mouth ; osteoarthritis ; pain ; subcutaneous injection
Language	English
Dates of publication	2021-01
Size	p. 165-168.
Publishing place	Elsevier B.V.
Document type	Article
Note	NAL-AP-2-clean
ISSN	0975-9476
DOI	10.1016/j.jaim.2020.07.004
Database	NAL-Catalogue (AGRICOLA)

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Article: Ayurveda management of Nicolau syndrome W.S.R to Kotha - a case report.

Killedar, Ramesh S / Gupta, Shivay / Shindhe, Pradeep

Journal of Ayurveda and integrative medicine

2020 Volume 12, Issue 1, Page(s) 165–168

Abstract	Administration of intramuscular, intraarterial or subcutaneous injection of particular drugs ends up into a rare entity known as Nicolau syndrome (NS). The viscous nature of these drugs sometimes triggers acute vasospasm and even arterial embolism. There is no consensus on treatment of NS so far. Phasic treatments depend on the extent of the necrotic lesion and ranges from medication to surgical debridement. Here we report a case of 60 year female known case of Knee Osteoarthritis who was dependent on Diclofenac injection IM for relief of pain. She presented with complaints of fever with chills, rigors, discoloration of skin at the gluteal region right side, later turned into necrosis of skin and adipose tissue, pus formation and associated with loss of appetite, dryness of mouth, pedal oedema. The case was diagnosed as NS according to contemporary science and Kotha (Gangrene) as per Ayurveda. The case was treated successfully with Chedana karma (Surgical debridement) followed by Vrana shodhana (making free from undesirable healing factors), Ropana (Closure of wound) and oral medications.
Language	English
Publishing date	2020-09-04
Publishing country	United States
Document type	Case Reports
ISSN	0975-9476
ISSN	0975-9476
DOI	10.1016/j.jaim.2020.07.004
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Wound healing efficacy of novel ayurveda formulation- Pentabark Kashaya: In wistar rats using excision wound model- an in vivo study.

Madiwalar, Manjula B / Pradeep S, Shindhe / Hiremath, Rudramma Rachayya / Killedar, Ramesh S

Journal of Ayurveda and integrative medicine

2022 Volume 13, Issue 3, Page(s) 100602

Abstract: Background: Wound healing plays a major concern in the field of surgery as it requires uneventful healing. Management aims towards prevention of infection and to accelerate healing. Acharya Sushruta has given more emphasis on Vrana (wound) and its ... ...

Abstract	Background: Wound healing plays a major concern in the field of surgery as it requires uneventful healing. Management aims towards prevention of infection and to accelerate healing. Acharya Sushruta has given more emphasis on Vrana (wound) and its chikitsa (treatment). Many antiseptic agents which prevent infection are widely used but have no role in accelerating the healing process and are cytotoxic, deleterious to wound healing. In this regard an innovative polyherbomineral formulation Pentabark Kashaya (PK)was formulated to assess acute dermal toxicity and woundhealing activity. Objective: To explore the wound healing efficacy of novel Ayurveda Formulation i.e Pentabark Kashaya in Wistar rats using the excision wound model. Materials and method: Acute dermal toxicity study was carried out on five female Wistar rats by following the OECD guideline 434 and signs of toxicity were assessed for the period of 14 days. Wound healing activitywas assessed on the excision wound model. 18 male Wistar rats were procured for the study and divided into three groups (n = 6 in each group). The test group was treated with application of PK, standard group with Povidone iodine solution 5% and control group with distilled water. The parameters assessed were epithelialization period, wound contraction rate, wound closure day and swab test for microbial load for the period of 21 days. Statistical analysis was done by using one way ANOVA and Tukeys HSD to assess changes in between three groups at each time point. Results: No signs of acute dermal toxicity were seen, which proved that PK is safe for application. Significant results were seen in the parameters of wound healing like period of epithelialization and wound closure day. Percentage of wound contraction rate was increased in test group when compared to other groups. Histopathology of skin showed marked changes in re-epithelialization, dermal fibroblast, dermal fibrocytes in test group when compared to control group. Conclusion: PK is safe for application and it is effective in wound healing. Clinical trial registration no: Not applicable.
Language	English
Publishing date	2022-07-21
Publishing country	United States
Document type	Journal Article
ISSN	0975-9476
ISSN	0975-9476
DOI	10.1016/j.jaim.2022.100602
Database	MEDical Literature Analysis and Retrieval System OnLINE

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