AYURVEDIC MANAGEMENT OF GRAHANI ROGA- CASE REPORT

Grahani Roga is a disease of Annavaha Srotas caused due to the formation of Ama due to Mandagni. Elimination of Vidagadha or Apakva anna through the Guda is known as Grahani Roga. Acharya Charaka has mentioned that the improperly digested food due to Mandagni when moved either in Urdhwa or Adho-Marga leads to Grahani Roga. Acharya Sushruta and Madhavakara have mentioned that patients of Atisara, during the stage of Agnimandya, if taken virudhha ahara, may lead to Grahani Roga. Muhur Baddha Muhur drava mala pravritti (altered bowel habit), Shleshma mala pravritti (mucous in stool) are the main symptoms of this disease. The symptoms of Grahani resemble most irritable bowel syndrome (IBS) symptoms. So, we can correlate the Grahani roga with IBS. A diagnosed case of Grahani (IBS) is discussed here who was treated with Bilwavaleha, Sanjeevani Churna, Arogyavardhini vati, Brahmi vati, Manasamitravatakam and Hingwashtak churna. Keywords: Grahani roga, IBS, Agnimandya, Case report

Intestinal microbiota fingerprint in subjects with Irritable Bowel Syndrome responders to a low FODMAP diet

Irritable Bowel Syndrome (IBS) is a functional gastrointestinal disorder characterized by abdominal pain and altered bowel habit. IBS patients report that FODMAP (Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols) diet induce...

Irritable bowel syndrome

Irritable bowel syndrome (IBS) is a functional bowel disorder that commonly presents in primary care and has an array of symptoms including abdominal discomfort and altered bowel habit. There may be an overlap of symptoms with other gastrointestinal disorders, leading to difficulty or delay in diagnosis. The condition can produce a variety of troublesome physical and psychological sequelae causing significant impact on an individual’s quality of life. The aim of this article is to highlight the ways in which IBS can present to the General Practitioner and guide the approach to investigation, diagnosis and management in primary care.

Colorectal Cancer in Different Age Groups in a Tertiary Hospital in Nepal

Introduction: Some studies have suggested that colorectal cancer at a younger age had distinct biological characteristics: different clinical presentations, more advanced stage at time of diagnosis and poorly differentiated carcinoma. The aim of the study is to analyze clinical and histopathological differences between younger (≤40 years of age) and older (>40 years of age) colorectal cancer patients.Methods: A cross-sectional analysis was conducted amongst the colorectal cancer patients who visited Bir Hospital between July 2015 and April 2017. All colonoscopically diagnosed and histopathologically proven cases of colon cancer were included. Chi-square test and independent t – test was performed to analyze the difference between clinical presentations and histopathological findings among two groups of patients and p value of <0.05 was considered as significant.Results: Thirty younger patients and thirty older patients were enrolled without any differences in gender proportion. There were no statistical differences between clinical presentation and histological grade and type in younger and older patients. The younger patients had more complaints of altered bowel habit (p <0.001) while older patients mostly presented with per rectal bleeding (p< 0.008).Conclusions: In this study, colorectal cancer at younger ages showed similar characteristics to those of older patients except altered bowel habit was more common in younger patients while per rectal bleeding was more common in older patients. Although colorectal cancer incidence increases with age, younger patients with altered bowel habits, weight loss, anemia and anorexia should also be given due medical attention and undergo evaluation promptly. Keywords: carcinoma; colon; per rectal bleeding; younger group. [PubMed]

Clinico-demographic Characteristics of Colorectal Carcinoma in Bangladeshi Patients

Background: Colorectal carcinoma is one of the most common human malignancies worldwide. Objectives: The purpose of the present study was to see the clinico-demographic Characteristics of colorectal carcinoma. Methodology: This cross sectional study was carried out in the Department of Pathology at Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh during the period of November 2009 to July 2010. Patients with colorectal carcinoma from all ages and both sexes were included in the study. Detailed clinical information was obtained by taking history from patient's attendant’s statement. Fresh unfixed specimens were obtained after surgical resection. Result: A total of 50 cases of colorectal adenocarcinoma from all ages and both sexes were included in the study. The mean age of the 50 cases was 47±14.8 years. Per rectal bleeding was the most common clinical presentation of colorectal carcinoma which was 20(40.0%) cases followed by abdominal pain, altered bowel habit, generalized weakness, anorexia and pallor and p/r bleeding and abdominal pain which were 8(16.0%) cases, 7(14.0%) cases, 6(12.0%) cases and 6(12.0%) cases respectively. Conclusion: In conclusion middle age male patients are the most vulnerable for colorectal carcinoma with common presenting features of per rectal bleeding, abdominal pain and altered bowel habit. Journal of Current and Advance Medical Research 2016;3(1):22-25

Colonic adenocarcinoma with coexisting tuberculosis: an unusual presentation

Tuberculosis affecting the colon is an uncommon extra-pulmonary form of the disease, and its association with malignancy is highly unusual. A 66-year man presented with lower gastrointestinal bleeding altered bowel habit and significant weight loss. On examination, he had ulcer infiltrative growth in the descending colon, with friable mucosa, bleeds easily on touch. With the diagnosis of carcinoma of the descending colon, he underwent left hemicolectomy. The histopathological examination revealed carcinoma colon with coexisting tuberculosis. The aetiological association between the tuberculosis and colon cancer is a matter of debate. However, the treating surgeon should be aware of this association, to avoid confusion and delay in the management.Bangladesh Journal of Medical Science Vol.15(1) 2016 p.131-134

Update on Orofacial Granulomatosis

Orofacial granulomatosis (OFG) is a condition manifesting clinically with chronic swelling of the mouth and/or face, notably with swelling of the lips and oral mucosa, a full-thickness, erythematous gingivitis and mucosal ulceration of various clinical types.1 Some patients may also present with neurological findings, for example facial palsy. Biopsy of affected tissue shows lymphoedema, with or without granulomatous inflammation. The oral lesions in OFG are histologically indistinguishable from the oral lesions in Crohn's disease (CD) and other systemic granulomatous disorders. It is a condition which may respond to the exclusion of certain food-related chemicals from the diet in up to 60% of patients and, as such, is distinct from gastrointestinal CD.2 CD is a relapsing systemic inflammatory disease which predominantly affects the gut, and patients suffering from this disease frequently present with abdominal pain, fever and altered bowel habit.3 A proportion of patients with clinical OFG (without other systemic disease) may have asymptomatic gastrointestinal involvement or go on to develop gut CD2,4 suggesting an association between the two diseases. It is estimated that 1% of CD sufferers may have a diagnosis of OFG, but the majority of patients in specialist OFG clinics do not have gut symptoms.2

Primary rectal melanoma - a case report

The most common site for malignant melanoma is skin, then eye and third is anorectal region. Primary anorectal malignant melanoma is still very uncommon. It is usually very aggressive and presents with altered bowel habit and rectal bleeding. Proctoscopy shows non-pigmented or lightly pigmented polypoid lesion. Histopathology is confirmatory. Early radical excision is mandatory. A 56 year-old female was presented with malignant melanoma of the lower third of rectum. We report this case for its rarity.