scholarly journals Clinical Efficacy of Medicinal Leech Therapy in Treating Third- and Fourth-Degree Hemorrhoids

2021 ◽  
Author(s):  
Abdul Mobeen ◽  
Ashfaque Ahmad ◽  
Mohd Aleemuddin Quamri ◽  
Abdul Nasir Ansari
Keyword(s):  
Therapeutic Option ◽  
Subjective Assessment ◽  
Medicinal Leech ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Antiinflammatory Action ◽  
Fourth Degree ◽  
Unani Medicine ◽  
Leech Therapy ◽  
Mucous Discharge

Abstract Objectives Hemorrhoids are characterized by bleeding, mucous discharge, itching, pain, and prolapse. This condition is known as bawaseer in Unani medicine, and Hirudinaria granulosa has been used for its treatment in Irsal-e Alaq, or medicinal leech therapy (MLT), for centuries. Hirudinaria granulosa with antithrombotic and antiinflammatory action is used in the treatment of chronic venous disease and hemorrhoids. The present study was aimed to investigate the efficacy of MLT in third and fourth-degree hemorrhoids. Methods A single-centre prospective, clinical trial with a pre and postanalysis design was conducted at the hospital of the National Institute of Unani Medicine. Twenty male and female patients, with a mean age of 38 years, presenting moderate symptoms assessed with the colorectal evaluation of clinical therapeutics scale (CORECTS) questionnaire were included in the study. Hirudinaria granulosa were applied around the pile mass for 15 minutes weekly, for 4 weeks. The efficacy of the treatment was measured by an objective and subjective assessment using the CORECTS. Results When analyzed by the clinician, MLT reduced the symptoms' severity score in the following domains: pain (55% improvement; p < 0.001); anorectal itching (30% improvement; p < 0.10); and bleeding (10% improvement; p < 0.7963). Significant improvement (p < 0.001) was reported in the CORECTS score in relation to pain (44.09% improvement; p < 0.001), itching (38.55% improvement; p < 0.001), swelling (44% improvement; p < 0.001), bleeding (17.28% improvement; p < 0.007), discomfort (34.01% improvement; p < 0.001), and wellbeing (32.35 %improvement; p < 0.001), giving an average overall opinion on the therapy of 4/10. Conclusion The results of the study albeit smaller in sample size show that MLT is an effective and safe therapeutic option in reducing the symptoms of 3rd and 4th degree haemorrhoids.

CHIVA strategy in chronic venous disease treatment: instructions for users

2014 ◽  
Vol 30 (3) ◽  
pp. 157-171 ◽  
Author(s):  
S Gianesini ◽  
S Occhionorelli ◽  
E Menegatti ◽  
M Zuolo ◽  
M Tessari ◽  
...  
Keyword(s):  
Clinical Data ◽  
Therapeutic Option ◽  
Cochrane Review ◽  
Recurrence Risk ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Disease Treatment ◽  
Flow Restoration

Along the years, scientific clinical data have been collected concerning the possible saphenous flow restoration without any ablation and according with the CHIVA strategy. Moreover, in 2013 a Cochrane review highlighted the smaller recurrence risk following a CHIVA strategy rather than a saphenous stripping. Nevertheless, the saphenous sparing strategy surely remains a not-so-worldwide-spread and accepted therapeutic option, also because considered not so immediate and easy to perform. Aim of this paper is to provide an easily accessible guide to an everyday use of a saphenous sparing strategy for chronic venous disease, highlighting how even apparently too complicated reflux patterns classifications can be fastly and successfully managed and exploited for a hemodynamic correction.

Optimal sizing of iliac vein stents

2017 ◽  
Vol 33 (7) ◽  
pp. 451-457 ◽  
Author(s):  
Seshadri Raju ◽  
William J Buck ◽  
William Crim ◽  
Arjun Jayaraj
Keyword(s):  
Therapeutic Option ◽  
Femoral Vein ◽  
Iliac Vein ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Initial Procedure ◽  
The Common ◽  
The Right ◽  
Vein Stenosis ◽  
Scaling Rule

Background Iliac vein stenting has emerged as a therapeutic option in chronic venous disease. The optimal stent size is unknown but should match normal caliber at a minimum. Methods Teleology: The iliac-femoral outflow caliber was measured by Duplex in healthy volunteers to determine normal caliber. Patient IVUS data: The distribution curve of IVUS planimetry data in 345 chronic venous disease limbs was analyzed: values at the right tail end of the curve should approach normal values according to distribution theory. The optimal stent size was also projected using Poiseuille equation and Young’s scaling rule. Results The optimal stent sizes in the common iliac, external iliac, and common femoral vein segments are: 16, 14, and 12 mm diameters, respectively. Conclusion Stent correction of iliac vein stenosis should aim to restore the lumen to the minimum recommended caliber during the initial procedure and later re-interventions.

Duffy antigen / receptor for chemokines correlates with inflammatory reaction in rats with venous hypertension: implication for the pathogenesis of primary chronic venous disease

VASA ◽  
2014 ◽  
Vol 43 (1) ◽  
pp. 47-54 ◽  
Author(s):  
Weibin Huang ◽  
Weiwei Qin ◽  
Lei Lv ◽  
Haoyv Deng ◽  
Hao Zhang ◽  
...  
Keyword(s):  
Mononuclear Cells ◽  
Early Stage ◽  
Antigen Receptor ◽  
Venous Hypertension ◽  
Skin Tissue ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Dependent Manner ◽  
Time Points ◽  
Duffy Antigen

Background: Duffy antigen / receptor for chemokines (DARC) possesses high affinity for several chemokine subgroups of CC and CXC. Although DARC has been shown to play a role in many inflammatory diseases, its effect on chronic venous disease (CVD) remains unidentified. We explored whether the expression of DARC in skin tissue was activated under venous hypertension as well as the relationships between DARC and inflammation. Materials and methods: The inflammation in a rat model of venous hypertension caused by a femoral arterial-venous fistula (AVF) was studied. At specified intervals the pressure in the femoral veins was recorded within 42 days. Hindlimb skin specimens were harvested at different time points. The expressions of DARC, interleukin-8 (IL-8), and monocyte chemotactic protein-1 (MCP-1) in skin tissue were examined. Mononuclear cells infiltrated in skin tissue were detected. Results: Femoral venous pressures in AVF groups increased significantly at different time points (P < 0.01). DARC was expressed in skin tissue and its expression level increased significantly in AVF groups from the 7nd day on and was enhanced in a time-dependent manner within 42 days (P < 0.05). Meanwhile, both MCP-1 and IL-8 had higher levels, accompanied by increased mononuclear cells infiltrating into skin tissue (P < 0.05). Conclusions: A rat AVF model which can maintain venous hypertension for at least 42 days is competent for researching the pathogenesis of CVD. DARC, which plays a role in the inflammation of skin tissue under venous hypertension, may become a new molecular target for diagnosis and treatment of CVD at a very early stage.

Endovenous stenting in chronic venous disease secondary to iliac vein obstruction

2019 ◽  
Vol 26 (2) ◽  
Author(s):  
Mohamed A. Taha ◽  
Tristan Lane ◽  
Joseph Shalhoub ◽  
Alun H. Davies
Keyword(s):  
Iliac Vein ◽  
Chronic Venous Disease ◽  
Venous Disease

Nédemax® Mese (Leucoselect®, Lymphaselect®, Bromelain) in the treatment of chronic venous disease: a multicenter, observational study

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Rino Albrigo ◽  
Cinzia Andreoni ◽  
Gaetano Anello ◽  
Maria G. Barboni ◽  
Elena Barzaghi ◽  
...  
Keyword(s):  
Observational Study ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Multicenter Observational Study

3D modeling of the vascular system

2016 ◽  
Vol 1 (1) ◽  
pp. 51-58 ◽  
Author(s):  
Jean François Uhl ◽  
Maxime Chahim ◽  
François Cros ◽  
Amina Ouchene ◽  
◽  
...  
Keyword(s):  
Augmented Reality ◽  
3D Modeling ◽  
Vascular System ◽  
Arterial System ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Software Products ◽  
Operative Planning ◽  
Morphological Modeling ◽  
Pre Treatment

The 3D modeling of the vascular system could be achieved in different ways: In the venous location, the morphological modeling by MSCT venography is used to image the venous system: this morphological modeling tool accurately investigates the 3D morphology of the venous network of our patients with chronic venous disease. It is also a fine educational tool for students who learn venous anatomy, the most complex of the human body. Another kind of modeling (mathematical modeling) is used to simulate the venous functions, and virtually tests the efficacy of any proposed treatments. To image the arterial system, the aim of 3D modeling is to precisely assess and quantify the arterial morphology. The use of augmented reality before an endovascular procedure allows pre-treatment simulation, assisting in pre-operative planning as well as surgical training. In the special field of liver surgery, several 3D modeling software products are available for computer simulations and training purposes and augmented reality.

Treatment Peculiarity of the Chronic Trophic Ulcers with Different Pathogenic Mechanism

2020 ◽  
Vol 62 (1) ◽  
pp. 12-16
Author(s):  
Oksana K. Melekhovets ◽  
Tetyana O. Kharchenko ◽  
Victor F. Orlovskiy ◽  
Iuirii V. Melekhovets ◽  
Alevtina S. Radko ◽  
...  
Keyword(s):  
Photodynamic Therapy ◽  
Healing Process ◽  
Modern Medicine ◽  
Lower Limbs ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Second Stage ◽  
Group 2

Introduction: Trophic ulcers of the lower extremities are an unresolved problem of modern medicine. The treatment of this pathology requires new methods that optimize care regimens and improve patients’ quality of life. Aim: The study to improve efficacy of treatment of the patients with trophic ulcers of the lower limbs with consideration to pathogenesis. M aterials and Methods: The study included 32 patients with chronic venous disease C6 (1st group) and 31 with diabetes mellitus type 2, moderate severity, compensation stage with diabetic foot syndrome II stage according to Wagner’s classification (2nd group). In addition to basic therapy in both groups photodynamic therapy was added at the first stage of the study, and at the second stage plasma rich in growth factors was prescribed. Results: At baseline evaluating of the chronic venous disease demonstrates that a total score in patient of the 1st group was 20,9 points on a modified VCSS scale; after two weeks – 15,71 points (improvement by 24.83%), and 6 weeks after–9,72 points (improvement by 53.49%). In patients with DM (2nd group) at the baseline a total score average was 13,91 points according to S(AD)SAD-1 scale; after 2 weeks – 12,29 (improvement by 11,65%), after 6 weeks – 6,39 points (improvement by 54,06%). Conclusions: The inclusion of photodynamic therapy and plasmatherapy in complex therapy in both groups led to a significant improvement of the healing process and helps to reduce the depth and area of the wound surface. However, the wound healing in patients in group 2 was slower.

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