Cerebral Vasospasm in Patients over 80 Years Treated by Coil Embolization for Ruptured Cerebral Aneurysms

Object. The effect on clinical outcomes of symptomatic vasospasm after aneurysmal subarachnoid hemorrhage (SAH) in patients over 80 years who underwent coil embolization was evaluated.Methods. Forty-four cases were reviewed and divided into two groups according to patient age: Group A, 79 years or younger, and Group B, 80 or older. Patient characteristics, prevalence of symptomatic vasospasm, modified Rankin Scale (mRS) scores at discharge and frequency of symptomatic vasospasm in patients with mRS scores of 3–6 were analyzed.Results. Thirty-two (73%) of the 44 cases were categorized as Group A and 12 (27%) as Group B. Group B had a significantly higher prevalence of symptomatic vasospasm compared to Group A(P=0.0040). mRS scores at discharge were significantly higher in Group B than in Group A(P=0.0494). Among cases with mRS scores of 3–6, there was a significantly higher frequency of symptomatic vasospasm in Group B than in Group A(P=0.0223).Conclusions. In our cohort of aneurysmal SAH patients treated by coil embolization, patients over 80 years of age were more likely to suffer symptomatic vasospasm, which significantly correlated with worse clinical outcomes, than those 79 years and under.

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P–098 Use of Dimethylxanthine Theophylline in surgical retrieved sperms that do not recover motility after thawing

Human Reproduction ◽

10.1093/humrep/deab130.097 ◽

2021 ◽

Vol 36 (Supplement_1) ◽

Author(s):

N Calza ◽

P M Ciotti ◽

M L Tranquillo ◽

L Notarangelo ◽

S Zuffa ◽

...

Keyword(s):

Pregnancy Rate ◽

Clinical Outcomes ◽

Sperm Motility ◽

Polarization Microscopy ◽

Age Group ◽

Miscarriage Rate ◽

Group A ◽

Viable Sperm ◽

Recovery Group ◽

Group B

Abstract Study question Can the use of Theophylline recover motility of frozen surgically retrieved sperms in case of absence of motility after thawing? Summary answer Theophylline allows to recover motility of thawed surgically retrieved sperms. The utilization of sperms with or without pharmacological activation gives comparable clinical outcomes. What is known already Testicular sperm motility is usually poor. A method is needed to detect viable sperm for ICSI when motility is totally absent after freezing/thawing. Hypo-osmotic swelling test, mechanical touch technique, laser-assisted immotile sperm selection, birefringence-polarization microscopy and exposure to pharmacological stimulation are techniques used for this purpose. Among pharmacological agents Dimethylxanthine Theophylline is a phosphodiesterase inibitor that improves sperm motility by promoting an increase in intracellular cyclic AMP levels. Few studies report that it is efficient for recovery of sperm motility in cases of thawed testicular and retrograde ejaculation samples improving reproductive outcomes. Study design, size, duration Retrospective analysis of sixty frozen surgical sperm cycles (45 patients) utilized from February 2018 to November 2020. After thawing, samples were divided in two Groups according to motility recovery. Group A: presence of motility, Group B: absence of motility. Group B was treated with Theophilline and motility was re-assessed after incubation. Activated sperms were utilized for ICSI when available. Sperm motility recovery, fertilization, pregnancy rate/transfer, implantation and miscarriage rate were evaluated in both Groups. Participants/materials, setting, methods Surgical specimens were treated and concentrated in SpermRinse™ Medium (Vitrolife) and then cryopreservated in nitrogen vapor in TEST Yolk Buffer (Irvine Scientific). After thawing, only samples with no motility recovery were treated with a brief incubation in Theophylline (GM501 SpermMobil, Gynemed) and washed in Polyvinylpyrrolidone (ICSITM Vitrolife) before injection. ICSI was performed in all cases approximately 4–5 hours after sperm thawing. After fertilization check, transfer was scheduled in day 2. Main results and the role of chance Women’s age Group A (34,39±2,29 M±SD) and group B (35,87±4,34 M±SD) and men’s age Group A (37,31±5,12 M±SD) and group B (40,89±8.15 M±SD) were not significantly different (P= .328 and P=.218) respectively. Group A: 13/60 cycles (21.7%) (9 patients). Pre freezing and post thawing total motility percentage were 34.0±19.0 (M±SD) and 13.5±15.6 (M±SD) respectively (39.8% recovery). Group B: 47/60 cycles (78.3%) (36 patients). Pre freezing total motility percentage was 5.3±8.5 (M±SD) and no motility was recovered post thawing (0%). After treatment with Theophylline total motility was 1.8±1.8 (M±SD) (33.5% recovery). Motile sperms were utilized in all cases except from two in the Group B. Number of injected oocytes was 2.8±1.1 (M±SD) in Group A and 4.3±3.1 (M±SD) in Group B (P=.004) respectively. Fertilisation rate (63.1% and 45.4%, P=.066), Number of embryos transferred (1.8±0.7 M±SD and 1.6±0.7 M±SD, P=.271), Pregnancy rate/Transfer (54.5% and 37.1%, P=.502), Implantation rate (30.0% and 27.8%, P=.919) and Miscarriage rate (33.3% and 30.7%, P=.675) were not statistically significant between Group A and B respectively. In the two cases of group B injected with immotile sperm, fertilization rate was 0% (0/3) and 50% (2/4). Limitations, reasons for caution A larger study is needed to investigate the recovery of sperms motility (and/or their activation) and clinical outcomes, in particular referring to the origin of sampling (epididymal aspirate and testicular tissue) and type of azoospermia (obstructive and non-obstructive). Wider implications of the findings: Theophylline is an effective tool for sperm motility recovery after thawing allowing to inject viable sperm and facilitating laboratory handling. Trial registration number Not applicable

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Endovascular Treatment of Large and Giant Carotid Aneurysms with Flow-Diverter Stents Alone or in Combination with Coils: A Multicenter Experience and Long-Term Follow-up

Operative Neurosurgery ◽

10.1093/ons/opx032 ◽

2017 ◽

Vol 13 (4) ◽

pp. 492-502 ◽

Cited By ~ 14

Author(s):

Simone Peschillo ◽

Alessandro Caporlingua ◽

Maria Chiara Resta ◽

Jo Peter Paul Peluso ◽

Nicola Burdi ◽

...

Keyword(s):

Endovascular Treatment ◽

Coil Embolization ◽

Aneurysmal Subarachnoid Hemorrhage ◽

Neurological Complications ◽

Flow Diverter ◽

Flow Diversion ◽

Group A ◽

Group B ◽

Carotid Aneurysms ◽

Favorable Neurological Outcome

Abstract BACKGROUND: Although flow diverters (FDs) have been widely accepted by neurointerventionists, their safety has yet to be fully defined. Stratification by aneurysm size and location is essential for correct evaluation of treatment outcomes and risks of flow diversion. OBJECTIVE: To compare neurological and anatomic outcomes and evaluate the risk of complications after endovascular treatment of large or giant internal carotid artery (ICA) aneurysms with FD/FDs alone or together with coil embolization. METHODS: We reviewed all patients with large or giant, ruptured or unruptured ICA aneurysms who underwent endovascular treatment with flow diversion alone (group A) or with concomitant coiling (group B) in 4 international institutions between 2010 and 2015. Anatomic outcome was evaluated using the Byrne scale on digital subtraction angiography and/or angioMRI and/or angioCT scans 3, 6, 12, and 24 months postoperatively. RESULTS: We collected 44 patients with large or giant ICA aneurysms. Four patients (9%) presented with aneurysmal subarachnoid hemorrhage (SAH). FD/FDs were used alone in 26 patients and in combination with coil embolization in the 18 remaining patients. The mortality rate due to procedure-related and/or neurological complications was 2.2%. Twelve months after the procedure, 88.6% (n = 39) of patients had a favorable neurological outcome. One year after the procedure, the aneurysm was completely occluded in 72.7% of patients: 61.5% (16/18) in group A and 88.9% (16/26) in group B. CONCLUSION: Clinical outcomes and rates of intraoperative and postoperative complications did not differ significantly between the groups. Better anatomic results using FD/FDs combined with coils were documented 6 months after the procedure; this option seems to provide a higher aneurysm occlusion rate and reduce the need for retreatment.

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Prospective analysis of aneurysm treatment in a series of 103 consecutive patients when endovascular embolization is considered the first option

Journal of Neurosurgery ◽

10.3171/jns.2000.93.2.0175 ◽

2000 ◽

Vol 93 (2) ◽

pp. 175-182 ◽

Cited By ~ 99

Author(s):

Christian Raftopoulos ◽

Pierre Mathurin ◽

Dutcho Boscherini ◽

Rudolf F. Billa ◽

Michel Van Boven ◽

...

Keyword(s):

Coil Embolization ◽

Clinical Status ◽

Cerebral Aneurysms ◽

Endovascular Embolization ◽

Surgical Clipping ◽

Anterior Circulation ◽

Content Type ◽

Group A ◽

Group B ◽

Fine Print

Object. The aim of this study was to evaluate prospectively the results of treating cerebral aneurysms with coil embolization (CE) or with surgical clipping when CE was considered the first option.Methods. Whenever an aneurysm was to be treated, CE was first considered by our neurovascular team. Surgical clipping was reserved for cases excluded from CE or cases in which CE failed. The study consisted of 103 consecutive patients with 132 aneurysms, of which 127 were treated. Coil embolization was performed using Guglielmi detachable coils, and surgery was performed using Zeppelin clips. Three groups were defined: Group A consisted of 64 aneurysms that were treated by CE (neck/sac ratio < 1:3); Group B, 63 aneurysms that were surgically clipped; and Group C, 12 aneurysms that failed to be satisfactorily (≥ 95%) embolized and were subsequently clipped. The percentages of residual aneurysm were 31.2% in Group A, 1.6% in Group B, and 0% in Group C. The percentages of patients with poor Glasgow Outcome Scale (GOS) scores (GOS Scores 1–3) were 13.3% in Group A, 6.1% in Group B, and 8.3% in Group C. The percentages of poor outcome (GOS Scores 1–3) in patients with good clinical status before treatment were 10.7% in Group A, 0% in Group B, and 8.3% in Group C.Conclusions. Even with preselection, CE remains associated with a significant number of treatment failures and poor outcomes, even in patients with good preoperative clinical status. Surgical clipping can offer better results than CE, even for more complex aneurysms of the anterior circulation, especially for those involving the middle cerebral artery cases. However, because CE can be effective and causes less stress and invasiveness for the patient, it should be considered first in aneurysms strictly selected by a neurovascular team.

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Echocardiographic Evaluation of Cardiac Remodeling After Surgical Closure of Ventricular Septal Defect in Different Age Group

Journal of National Institute of Neurosciences Bangladesh ◽

10.3329/jninb.v2i2.34097 ◽

2017 ◽

Vol 2 (2) ◽

pp. 69-74

Author(s):

Mohammad Aminullah ◽

Fahmida Akter Rima ◽

Asraful Hoque ◽

Mokhlesur Rahman Sazal ◽

Prodip Biswas ◽

...

Keyword(s):

Ventricular Septal Defect ◽

Ejection Fraction ◽

Cardiac Remodeling ◽

Septal Defect ◽

Left Ventricular ◽

Age Group ◽

Surgical Closure ◽

Group A ◽

Group B ◽

Fractional Shortening

Background: Cardiac remodeling is important issue after surgical closure of ventricular septal defect.Objective: The purpose of the present study was to evaluate cardiac remodeling by echocardiography by measuring the ejection fraction, fractional shortening, left ventricular internal diameter during diastole (LVIDd) and left ventricular internal diameter during systole (LVIDs) after surgical closure of ventricular septal defect in different age group. Methodology: This prospective cohort studies was conducted in the Department of Cardiac Surgery at National Institute of Cardiovascular Disease (NICVD), Dhaka. Patient with surgical closure of VSD were enrolled into this study purposively and were divided into 3 groups according to the age. In group A (n=10), patients were within the age group of 2.0 to 6.0 years; age of group B (n=8) patients were 6.1-18.0 years and the group C (n=6) aged range was 18.1-42.0 years. Echocardiographic variables such as ejection fraction, fractional shortening, LVIDd, LVIDs were taken preoperatively and at 1st and 3rd month of postoperative values. Result: A total number of 24 patients was recruited for this study. The mean ages of all groups were 12.60±12.09. After 1 month ejection fraction were decreased by 5.97%, 6.71% and 5.66% in group A, group B and group C respectively. After 3 months ejection fraction were increased by 6.13%, 5.13% and 5.14% in group A, group B and group C respectively. After 1 month fractional shortening were decreased by 13.55%, 9.30% and 9.09% in group A, group B and group C respectively. After 3 months fractional shortening were increased by 7.23%, 7.35% and 4.55% in group A, group B and group C respectively. After 1 month LVIDd were increased by 1.97%, 1.91% and 1.32% in group A, group B and group C respectively. After 3 months LVIDd were decreased by 10.84%, 9.89% and 7.34% in group A, group B and group C respectively. After 1 month LVIDs were increased by 2.19%, 2.86% and 1.98% in group A, group B and group C respectively. After 3 months LVIDs were decreased by 11.68%, 10.97% and 8.87% in group A, group B and group C respectively.Conclusion: Cardiac remodeling occurred after surgical closure of ventricular septal defect and remodeling were more significant in younger age group. Journal of National Institute of Neurosciences Bangladesh, 2016;2(2):69-74

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Effects of stent generation on clinical outcomes after acute myocardial infarction compared between prediabetes and diabetes patients

Scientific Reports ◽

10.1038/s41598-021-88593-x ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Yong Hoon Kim ◽

Ae-Young Her ◽

Myung Ho Jeong ◽

Byeong-Keuk Kim ◽

Sung-Jin Hong ◽

...

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Clinical Outcomes ◽

Secondary Outcome ◽

Drug Eluting Stent ◽

Diabetes Group ◽

Repeat Revascularization ◽

Group A ◽

Group B ◽

Diabetes Patients

AbstractWe investigated the effects of stent generation on 2-year clinical outcomes between prediabetes and diabetes patients after acute myocardial infarction (AMI). A total of 13,895 AMI patients were classified into normoglycemia (group A: 3673), prediabetes (group B: 5205), and diabetes (group C: 5017). Thereafter, all three groups were further divided into first-generation (1G)-drug-eluting stent (DES) and second-generation (2G)-DES groups. Patient-oriented composite outcomes (POCOs) defined as all-cause death, recurrent myocardial infarction (Re-MI), and any repeat revascularization were the primary outcome. Stent thrombosis (ST) was the secondary outcome. In both prediabetes and diabetes groups, the cumulative incidences of POCOs, any repeat revascularization, and ST were higher in the 1G-DES than that in the 2G-DES. In the diabetes group, all-cause death and cardiac death rates were higher in the 1G-DES than that in the 2G-DES. In both stent generations, the cumulative incidence of POCOs was similar between the prediabetes and diabetes groups. However, in the 2G-DES group, the cumulative incidences of Re-MI and all-cause death or MI were significantly higher in the diabetes group than that in the prediabetes group. To conclude, 2G-DES was more effective than 1G-DES in reducing the primary and secondary outcomes for both prediabetes and diabetes groups.

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The Role of Obesity in Predicting the Clinical Outcomes of COVID-19

Obesity Facts ◽

10.1159/000517180 ◽

2021 ◽

pp. 1-9

Author(s):

Serdar Sahin ◽

Havva Sezer ◽

Ebru Cicek ◽

Yeliz Yagız Ozogul ◽

Murat Yildirim ◽

...

Keyword(s):

Clinical Outcomes ◽

Health Care Providers ◽

Study Groups ◽

Normal Weight ◽

Overweight And Obesity ◽

Care Providers ◽

Significant Difference ◽

Group A ◽

Group B ◽

Group D

Introduction: The aim of this was to describe the predictors of mortality related to COVID-19 infection and to evaluate the association between overweight, obesity, and clinical outcomes of COVID-19. Methods: We included the patients >18 years of age, with at least one positive SARS-CoV-2 reverse transcriptase-polymerase chain reaction. Patients were grouped according to body mass index values as normal weight <25 kg/m2 (Group A), overweight from 25 to <30 kg/m2 (Group B), Class I obesity 30 to <35 kg/m2 (Group C), and ≥35 kg/m2 (Group D). Mortality, clinical outcomes, laboratory parameters, and comorbidities were compared among 4 groups. Results: There was no significant difference among study groups in terms of mortality. Noninvasive mechanical ventilation requirement was higher in group B and D than group A, while it was higher in Group D than Group C (Group B vs. Group A [p = 0.017], Group D vs. Group A [p = 0.001], and Group D vs. Group C [p = 0.016]). Lung involvement was less common in Group A, and presence of hypoxia was more common in Group D (Group B vs. Group A [p = 0.025], Group D vs. Group A [p < 0.001], Group D vs. Group B [p = 0.006], and Group D vs. Group C [p = 0.014]). The hospitalization rate was lower in Group A than in the other groups; in addition, patients in Group D have the highest rate of hospitalization (Group B vs. Group A [p < 0.001], Group C vs. Group A [p < 0.001], Group D vs. Group A [p < 0.001], Group D vs. Group B [p < 0.001], and Group D vs. Group C [p = 0.010]). Conclusion: COVID-19 patients with overweight and obesity presented with more severe clinical findings. Health-care providers should take into account that people living with overweight and obesity are at higher risk for COVID-19 and its complications.

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Outcome of endovascular treatment within and beyond 6 h without perfusion software

Scientific Reports ◽

10.1038/s41598-021-84857-8 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Zhen Jing ◽

Hao Li ◽

Shengming Huang ◽

Min Guan ◽

Yongxin Li ◽

...

Keyword(s):

Ischemic Stroke ◽

Endovascular Treatment ◽

General Anesthesia ◽

Acute Ischemic Stroke ◽

Clinical Outcomes ◽

Symptom Onset ◽

Anterior Circulation ◽

Vessel Occlusion ◽

Group A ◽

Group B

AbstractEndovascular treatment (EVT) has been accepted as the standard of care for patients with acute ischemic stroke. The aim of the present study was to compare clinical outcomes of patients who received EVT within and beyond 6 h from symptom onset to groin puncture without perfusion software in Guangdong district, China. Between March 2017 and May 2018, acute ischemic stroke patients who received EVT from 6 comprehensive stroke centers, were enrolled into the registry study. In this subgroup study, we included all patients who had acute proximal large vessel occlusion in the anterior circulation. The demographic, clinical and neuroimaging data were collected from each center. A total of 192 patients were included in this subgroup study. They were divided into two groups: group A (n = 125), within 6 h; group B (n = 67), 6–24 h from symptom onset to groin puncture. There were no substantial differences between these two groups in terms of 90 days favorable outcome (modified Rankin scale [mRS] ≤ 2, P = 0.051) and mortality (P = 0.083), and the risk of symptomatic intracranial hemorrhage at 24 h (P = 0.425). The NIHSS (median 16, IQR12-20, group A; median 12, IQR8-18, group B; P = 0.009) and ASPECTS (median 10, IQR8-10, group A; median 9, IQR8-10, group B; P = 0.034) at baseline were higher in group A. The anesthesia method (general anesthesia, 21.3%, group A vs. 1.5% group B, P = 0.001) were also statistically different between the two groups. The NIHSS and ASPECTS were higher, and general anesthesia was also more widely used in group A. Clinical outcomes were not significantly different within 6 h versus 6–24 h from symptom onset to groin puncture in this real world study.

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RANDOMIZED COMPARATIVE STUDY OF ONDANSETRON AND COMBINATION OF ONDANSETRON AND DEXAMETHASONE, AS A PROPHYLAXIS OF POST-OPERATIVE NAUSEAAND VOMITING IN ADULTS UNDERGOING ELECTIVE LAPAROSCOPIC SURGERIES

10.36106/ijsr/3207561 ◽

2021 ◽

pp. 48-49

Author(s):

Rumani Ruku ◽

Jasmeen Chowdhary

Keyword(s):

Laparoscopic Surgery ◽

Surgical Care ◽

Demographic Variables ◽

Nausea And Vomiting ◽

Age Group ◽

Patient Response ◽

High Incidence ◽

Group A ◽

Group B ◽

Post Operative Nausea

Background: Post-operative nausea and vomiting (PONV) is quite associated with laparoscopic surgery. In-spite of advances in surgery and post surgical care, nausea and vomiting still has a high incidence. This study was planned to explore the efcacy of a combination therapy of ondansetron with dexamethasone against PONVand compare the results with the efcacy of ondensetron-only. Method:Arandomized clinical trial study was conducted in the Department of Anesthesia, GMC Jammu, over a period of 6 months, on 50 patients in the age group of 18-50 years, of either gender, undergoing laparoscopic surgeries under general anesthesia. Patients were divided into two groups of 25 each: Group A received 4 mg of Ondansetron intravenously, while Group B received 4 mg of Ondansetron and 8 mg of Dexamethasone intravenously, soon after intubation. Results: The demographic variables of two groups were similar. While 19 (76%) patients showed post-operative nausea in Group A, while in Group B, only 8 (32%) patients experienced nausea, which was very signicant. Similarly, 11 (44%) patients showed post-operative vomiting in GroupAand only 2 (8%) complained of vomiting. 24% patients did not complain about any kind of nausea or vomiting in GroupA. Mild nausea was observedin60%patientsinGroupA,while amongonly32%patientsingroupB.Nocomplications of anykindwereobservedduringthisstudy. Conclusion: Ondensetron and dexamethasone, administered intravenously, after intubation, in laparoscopic surgery, is safe and has a better patient response in preventing post-operative nausea and vomiting.

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Correlation between angiographic transit times and neurological status on admission in patients with aneurysmal subarachnoid hemorrhage

Journal of Neurosurgery ◽

10.3171/2015.4.jns15134 ◽

2016 ◽

Vol 124 (4) ◽

pp. 1093-1099 ◽

Cited By ~ 9

Author(s):

Alexander Ivanov ◽

Andreas Linninger ◽

Chih-Yang Hsu ◽

Sepideh Amin-Hanjani ◽

Victor A. Aletich ◽

...

Keyword(s):

Subarachnoid Hemorrhage ◽

Cerebral Artery ◽

Aneurysmal Subarachnoid Hemorrhage ◽

Clinical Information ◽

Control Group ◽

Angiography Suite ◽

Transit Times ◽

Significant Difference ◽

Group A ◽

Group B

OBJECT The use of digital subtraction angiography (DSA) for semiquantitative cerebral blood flow(CBF) assessment is a new technique. The aim of this study was to determine whether patients with aneurysmal subarachnoid hemorrhage (aSAH) with higher Hunt and Hess grades also had higher angiographic contrast transit times (TTs) than patients with lower grades. METHODS A cohort of 30 patients with aSAH and 10 patients without aSAH was included. Relevant clinical information was collected. A method to measure DSA TTs by color-coding reconstructions from DSA contrast-intensity images was applied. Regions of interest (ROIs) were chosen over major cerebral vessels. The estimated TTs included time-to-peak from 0% to 100% (TTP0–100), TTP from 25% to 100% (TTP25–100), and TT from 100% to 10% (TT100–10) contrast intensities. Statistical analysis was used to compare TTs between Group A (Hunt and Hess Grade I-II), Group B (Hunt and Hess Grade III-IV), and the control group. The correlation coefficient was calculated between different ROIs in aSAH groups. RESULTS There was no difference in demographic factors between Group A (n = 10), Group B (n = 20), and the control group (n = 10). There was a strong correlation in all TTs between ROIs in the middle cerebral artery (M1, M2) and anterior cerebral artery (A1, A2). There was a statistically significant difference between Groups A and B in all TT parameters for ROIs. TT100–10 values in the control group were significantly lower than the values in Group B. CONCLUSIONS The DSA TTs showed significant correlation with Hunt and Hess grades. TT delays appear to be independent of increased intracranial pressure and may be an indicator of decreased CBF in patients with a higher Hunt and Hess grade. This method may serve as an indirect technique to assess relative CBF in the angiography suite.

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A CLINICAL EVALUATION OF MATRA BASTI AND KATI BASTI WITH DHANWANTARAM TAILA IN THE MANAGEMENT OF GRIDHRASI

International Journal of Ayurveda and Pharma Research ◽

10.47070/ijapr.v9i4.1910 ◽

2021 ◽

pp. 17-31

Author(s):

N. Haritha ◽

Rashmi. R ◽

Nighil Gigi ◽

Binu.M.B

Keyword(s):

Clinical Evaluation ◽

Combined Treatment ◽

Signs And Symptoms ◽

Age Group ◽

Group A ◽

Group B

Gridhrasi comes under 80 types of Nanatmaja Vatavyadhi. The cardinal signs and symptoms of Gridhrasi are Ruk (pain), Toda (pricking sensation), Spandana (twitching) in the Sphik, Kati, Uru, Janu, Jangha and Pada in order and Sakthikshepa Nigraha i.e., restricted lifting of the leg associated with Gourava, Aruchi. Kati Basti is widely being practiced throughout country as Bahyaupakrama which has both Snehana and Swedana effects. Matra Basti is Snehana procedure which does Vataanulomana, Vatashamana. Objectives: To evaluate the efficacy of Matrabasti and Katibasti with Dhanvantaram Taila in the management of Gridhrasi. Materials and Methods: Patients presenting with the classical features of Gridhrasi and between the age group of 16 to 50 years irrespective of sex were selected and allotted in Group A, B and C with 15 patients in each group. Group A was administered with Matra basti with Dhanwantram Taila and Group B with Kati basti with Dhanwantram Taila and Group C with both Matra basti and Kati basti with Dhanwantram Taila for 9 days. Results: In combined treatment of Kati Basti and Matra Basti in Group C there was tremendous response in relieving Ruk (73%), Toda (46%), Spandana (60%), Supti (80%), Gourava (73%), Aruchi (66%), Sparshasahyata (73.3%) SLR (60%). In Group A, patients subjected to Matra Basti was effective in relieving Ruk (26.7%), Toda (13.3%), Spandana (26.7%), Supti (66.7%), Gourava (46.7%), Aruchi (53.3%), Sparshasahyata (13.3%) SLR (6.7%). In Group B patients subjected to Kati Basti was effective in relieving Ruk (6.7%), Toda (0%), Spandana (0%), Supti (40%), Gourava (20%), Aruchi (0%), Sparshasahyata (20%) SLR (0%). Conclusion: On the basis of the results of this study, it can be clearly concluded that combined treatment of Matrabasti and Kati basti with Dhanwantaram taila provided significant relief in the signs and symptoms of Gridhrasi than individually performed Matra basti and Kati basti with Dhanwantaram taila.

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