A case study illustrating the use of an integrated approach to treat secondary Anal Fistula Post I&D of Perianal Abscess

Background:Anal fistula is a long-term disease characterized by a tubular structure with one end opening in the anorectal canal and the other end opening on the surface of the perineum or perianal skin with chronic pus drainage.It is linked to Bhagandar in Ayurveda,and in Sushruta Samhita,Acharya has mentioned 5 forms of Bhagandar.The boil in the present case was Shukla,sthira i.e.hard and firm,with Picchila strava and Kandu resembling the features of Parisraavi bhagandar.Aim and objective:The current case was diagnosed as Parisravi bhagandar,which resembles trans-sphincteric or intersphincteric fistula in modern ano.In Ayurveda,the management of Parisraavi Bhagandar,Shastra,kshara,and Agnikarma is advised and the use of Ksharasutra,which contributes to complete cutting and healing of the track without reoccurrence,similarly Modern surgeon depends on surgery i.e radical excision of the track,ligation with Seton,and use of chemical irritants like urethane,silver nitrates,etc.A cutting seton(tight)gently slices the confined muscle to close the fistula with the least interruption to continence.This operation is especially advised when a one-stage fistulotomy poses a considerable risk of incontinence.Material and methods:The method performed here was Core Partial Fistulectomy followed by Ksharasutra application till complete healing of the wound.Discussion and conclusion:This case study provides the successful management of Parisraavi Bhagandara(high anal,trans-sphincteric fistula in ano)in 61-year-old male patient with an integrated surgical&Ayurvedic management approach.

铁苋菜叶提取物抑制大鼠实验性心肌缺血的生物化学和组织病理学研究(英文)

目的:研究富含类黄酮的热带铁苋菜叶的甲醇提取物抗心肌缺血的作用。方法:用异丙肾上腺素诱导大鼠心肌缺血。成年Wistar白化大鼠经热带铁苋菜提取物(100和200mg/kg大鼠体质量,口服)30d预处理后连续2d注射异丙肾上腺素(85mg/kg大鼠体质量,皮下注射)。第2次注射异丙肾上腺素后12h,肌肉注射氯胺酮(24mg/kg大鼠体质量)处死大鼠。检测血浆总胆固醇、三酰甘油、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、极低密度脂蛋白胆固醇、游离脂肪酸、磷脂质以及心肌脂质、肝脏脂质的含量,以衡量热带铁苋菜提取物的抗心肌缺血作用,同时观察大鼠心脏组织的组织病理学变化。结果:与模型组大鼠相比,所有热带铁苋菜提取物给药组(100和200mg/kg)大鼠的血浆脂质水平改善,且与正常组相比无明显变化。模型组大鼠心脏组织病理学结果显示心肌纤维缺失,广泛性心内膜下坏死,炎症细胞浸润,心肌细胞明显水肿,空泡变性。而经200mg/kg热带铁苋菜提取物预处理的大鼠心脏组织观察到较完整的心肌结构,心肌纤维可见,没有炎症细胞浸润、细胞水肿和坏死现象。结论:本研究的生化指标及组织学结果表明热带铁苋菜可抑制异丙肾上腺素诱导的大鼠心肌缺血。