Fat necrosis as a differential diagnosis for recurrence in a treated case of breast cancer: A case report

Fat necrosis is a benign inflammatory process that can involve adipose tissue that most frequently affects peri-menopausal women. It can mimic breast cancer clinically or radiologically. The incidence of breast fat necrosis overall is roughly 0.6%, representing 2.75% of all benign lesions. Fat necrosis presents in 0.8% of breast tumors and 1–9% of breast reduction surgery cases. Most at risk are middle-aged women, with an average age of 50 years, and women with pendulous breasts. Traumatic Fat Necrosis is an important differential diagnosis to be kept in mind in Carcinoma Breast patients who are treated with surgery and adjuvant radiation therapy. We present a case where radiation is followed by a large non-healing ulcer in a known case of breast carcinoma patient.

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.

Formulation and Efficacy of Plaksha (Ficus lacor) Ointment in the Management of Non-Healing Ulcer

Chronic infected wound or non healing ulcer is commonly encountered problem faced in surgico-clinical cases. Wound healing property is most important pharmacological activity of Plaksh or Ficus lacor described by acharya Charaka and Bhavprakash, in an ancient compendia. A male patient aged 55 years, having non healing ulcer on right leg medially above the ankle joint due to trauma, reported to OPD. Wound was irregular with hyper keratinized edges, purulent discharge with foul smell, itching, redness and inflammation. Wound was cleaned with normal saline aseptically and ‘malhar’ or ointment which was prepared by using stem bark of Ficus lacor, was applied locally every day, for thirty days followed by alternate day for next fifteen days. ‘Malhar’ or ointment was prepared as per the formulation mentioned in ‘Ras tarangini’, an ancient compendia. Vitamin C, B complex and Zinc supplement was given orally. After forty five days, wound healed with healthy granulation tissue, purulent discharge and foul smell was totally absent .Bark contains phytochemicals like tannins, polyphenols caffiec acid. It possesses antioxident, anti-inflammatory, antibacterial, astringent activities. Caffeic acid have regulatory mechanism on glucose metabolism in diabetes.

NK/T cell Lymphoma as a Rare Cause of an Oronasal Fistula

NK/T cell lymphoma is one of the most unique and rare forms of extranodal non-Hodgkin’s lymphoma, mostly derived from natural killer cell lineages and occasionally cytotoxic T cell lines. Due to the non-specific presentation of NK/T cell lymphoma such as nasal obstruction, nasal discharge, and epistaxis, diagnosis is often an issue and can be misleading. Oronasal fistula following a non-healing ulcer on the soft palate, can be one of the clinical presentations of NK/T cell lymphoma. Here, we are reporting a rare case of NK/T cell lymphoma in a 32-year-old gentleman who presented with an oronasal fistula post tissue biopsy for a non-healing ulcer over the soft palate. The tissue biopsy of the soft palate mass was revealed as NK/T cell lymphoma and was staged as Stage1b after computed tomographic imaging revealed a local tumour invasion without sign of nodal involvement and no metastasis. The patient eventually started with the SMILE Protocol and responded well up to the date. The ulcer healed but the fistula persisted. Primary closure was planned by the oromaxillofacial surgery team after completion of chemotherapy.

Management of Non-Healing Ulcer by the Use of Crushed Raw Papaya along with Leeching: A Case Study

The incidence of non-healing ulcer is 1-2 percent in developed countries. In Indian community its prevalence reported in year 2004 was 4.8 per 1000 populations. It may increase many folds in future because of increase in number of old persons, diabetes mellitus and vascular diseases A male patient aged 63yrs. came to surgery OPD Majeedia Unani Hospital, Jamia Hamdard, New Delhi, in October 2019, with the complain of ulcer on antero-medial aspect of right foot. The ulcer was painful and movement was limited on affected side. After required investigations and local examination of wound, treatment was started by local application of meshed papaya and combination of oral Unani drugs formulations along with leech therapy as described in texts of Unani System of Medicine. It was observed that Unani treatment of non-healing ulcer with papaya and leech therapy is an option to avoid amputation and its complications. The ulcer completely healed without any locomotor disturbances. Recovery was very fast and the condition of leg totally resolved without any complications and side effects. Keywords: Non-healing ulcer, Unani medicine, leech therapy, Qurooh-e-Aseeratul Indemal.

Clinical effect of Apamarga Kshara Taila and adjuvant drugs in the management of Diabetic wound – A Case Report.

Diabetic foot ulcer is a serious devastating complication of diabetes mellitus (DM) when it involves deep tissues and bone which may require amputations. In this case report a 70 year old male patient presented with non healing ulcer of sized (3.5 *3.2) cm2 at dorsum of the left foot since last 4 years. The ulcer was on the dorsum having most movable part in daily activity so it was reluctant to meal by all means of conventional management. So patient consultant to Ayurveda OPD and he was treated with local dressing of Apamarga Kshara Taila till wound healing for 50days. Along with local dressing patient prescribed with Haritaki Churna 5gm at night with luke warm water and Punarnavashtak Kwatha 40ml twice in a day on empty stomach for 50 days. Inj. wosulin 12 units thrice in day and Inj. basalog 14 units at nigh were continued simultaneously as prescribed by diabetologist during the treatment. Complete wound healing was achieved within 50days with unit healing time 4.46 day/cm2. This single case report showed wound healing potential of Ayurvedic medicine in diabetic wound.

AEGLE MARMELOS (BAEL PATRA): AN AYURVEDIC PLANT WITH ETHNOMEDICINAL VALUE

Aegle marmelos is considered as the most sacred or holy plant which is grown by the sides of Hindu temples. This plant is dedicated to Lord Shiva and is also believed that Lord Shiva resides under the Bael tree. Besides this, the plant is associated with a great medicinal value whose medicinal description is also mentioned in the ancient treatise like Vedas, Puranas, Charaka Samhita and Brihat Samhita and has also been portrayed in the paintings of Ajanta caves. Every part of the Bael plant is used to treat various diseases. In Ayurveda, the plant is used in Panchang form to treat diarrhea, dysentery and ulcer. In folklore, the plant parts are used to treat diabetes, skin diseases and typhoid, wound healing, ulcer, stomachache, jaundice, high BP, malaria, cancer and other diseases. The fruit of the plant is edible and carries great medicinal value because of the presence of vitamins, minerals and various antioxidants. The pulp of the fruit is aromatic, sweet, pale orange and resinous. The unripe fruit pulp of the plant is used to prepare murabba, pudding and juice. The plant is associated with ethnomedicinal uses and possesses various therapeutic and pharmacological properties including antioxidant, anti-diabetic, antihistamine, radio protective, antiulcer, anticancer, cardio-protective, antidiarrheal, antibacterial, antimicrobial, hepatoprotective, anti-inflammatory and antiviral. In this review article, attempts have been made to summarize the phytochemistry, ethnomedicinal, Ayurvedic and pharmacological view of the Bael plant.