PARAKERATINIZED ODONTOGENIC KERATOCYST: A CASE REPORT WITH 8 YEARS FOLLOW-UP

OKC (odontogenic keratocyst) of parakeratinized variant is a benign developmental cyst in jaw, aggressive in nature, and is considered a mystery for surgeons in terms of its management. Though they are benign in nature they have a unique tendency to recur after conservative treatment. Therefore most appropriate management still remains controversial. Treatment modalities advocated ranges from conservative approach of enucleation to most radical form of resection. Here is a case of Parakeratinized odontogenic keratocyst in which treatment was done by enucleation with peripheral ostectomy along with chemical cauterization through CarnoyÂ’s solution. The patient was kept under follow up without any signs of recurrence for past 8 years.

STHANIK CHIKITSA (LOCAL THERAPIES) IN STRI ROGA: CRITICAL REVIEW

Ayurveda is one of the oldest systems of health gives a detail description of Stree Roga. Women combat with quite common gynecological problems like white discharge, itching at vulva, foul smelling vaginal discharge, burning micturition etc. Sthanik Chikitsa has given excellent results in these problems. Sthanik Chikitsa preferably includes Yonidhawan (Douching per vaginum), Yoni-Pichu (Tampooning per vaginum), Yoni Dhoopan (Fumigation of vagina), Yoni-Varti (Vaginal suppository), Yoni-Lepana (Vaginal painting), Uttarbasti (Medicated oil or decoction is pushed into the uterine cavity through vagina), Agnikarma (Cauterization) and Ksharakarma (Chemical cauterization) etc. In the present study all these local therapies are revised through ancient Samhitas, and these therapies are reviewed with their meanings, indications, procedures, application site and probable mode of actions. It is my sincere and optimistic effort to encourage most of the Ayurveda physician towards Sthanik Chikitsa in the management of Stree Rogas. Keywords: Sthanikchikitsa, Local therapies, Stree Roga.

Epistaxis: comparison of chemical cautery with topical vasoconstrictor in adult anterior epistaxis

Background: To compare efficacy of 75% silver nitrate chemical cautery as opposed to topical vasoconstrictor spray (xylometazoline 0.1%) in adult anterior epistaxis.Methods: This randomized controlled trial study was carried out at SMHS Hospital Srinagar from Jan 2019 to Dec 2019. 110 subjects that presented to ENT & HNS emergency with epistaxis and fulfilled the inclusion criteria were selected. Subjects were randomly distributed into two groups. Group-A individuals were treated by cauterization with 75% silver nitrate and Group-B individuals were treated with topical vasoconstrictor spray (xylometazoline 0.1%). All the subjects were reviewed at 1 month and success was determined in terms of control of epistaxis from same side of nose.Results: The mean age of the cohort was 48.5yrs (age range, 17-59). There were total 60 (54.4%) males and 50 (45.4%) females among the cases. Both the groups were comparable as regards the age, sex, duration and frequency of epistaxis. 91.2% cases in Group-A (silver nitrate cautery) and 73.5% cases in Group-B (xylometazoline spray 0.1%) had no further epistaxis at one-month follow-up (p=0.014).Conclusions: Chemical cauterization with silver nitrate is a feasible and safe technique for the treatment of adult anterior epistaxis and is more effective than topical vasoconstrictor spray.

Retrospective Clinical Study on Epistaxis

Background: Epistaxis is bleeding through nose. It is most common emergency situation in ENT that is disastrous to the patient and troublesome to treat for doctors. It is seen that 60% population experiences epistaxis in their life time and only 6% went to take consultation. The study aims to evaluate incidence, etiology, provoking factors and cost effective management. Subjects and Methods: A 3 years retrospective study between September 2015 to August 2018 carried out in Anugarah Narayan Magadh Medical College & Hospital, Gaya on 98 admitted epistaxis patients. Results: Total 11,667 patients came in ENT department among them 2,723 patients with nasal complain. Incidence was0.84% among all cases and 3.6% among nasal problems. No obvious cause seen in 34 cases (34.23%) then cardiovascular cause in 32 cases (32.65%) then infection in19.32% and lastly by trauma in 5.68%. Maximum patients in 40-50 years age group 36% and minimum in 70-80 years 1%. Most patients belong to urban76 cases (77.27%) and middle age 36 cases (36.36%). Males are more prone 57 cases (57.95%) with ratio 1.39:1. Mostly in January-March months 45 cases (46.59%). Most patients came with unilateral epistaxis 86 cases (87.5%). About 26cases (26.14%)came with single episode whom urgent treatment required. Well managed with Nonsurgical method to 85 patients (86.73%) by anterior nasal packing (ANP) in 43 cases (43.87%) and chemical cauterization to 19 cases(19.30%) while surgical treatment given to 13 patients (13.26%).Some required electrocauterization 16 cases (16.32%) with bipolar. Mean hospital stay length 3.2 days. Blood transfusion required in 7cases (7.14%). Conclusion: Cost effectively anterior nasal packing is best conservative indirect method and electrocauterization is very effective direct method.

A Case Report on removal of Filiform Warts using Siddha Kaalaani Kalimpu

Background: Cutaneous warts are the benign epithelial proliferative lesions caused by human papilloma virus infection. Warts are successfully treated with Siddha drugs having chemical cauterization mechanism. We report a case on filiform warts treated effectively using Kaalaani kalimpu. Cases: One filiform warts on face was treated with three doses of Kaalaani kalimpu cream application, followed by application of Kaya thirumeni ennai. In three application, the warts fall off and Kaya thirumeni ennai effectively healsthe ulcer without scar. Conclusion: Kaalaani kalimpu is effective in removal of filiform warts, but further investigations in controlled studies should be carried out to create evidence.

To evaluate the effect of Arka Pratisaraneeya Kshara in the management of Kadara w.s.r. to Corn

Kadara is a Kshudraroga which is characterized by hard thickened type swelling, largely confined to the Pada but also seen in Hastha. The disease Kadara is not a life threatening condition, but makes the life of the sufferer miserable. Aetiological factors include injury due to the thorn prick, stone, cut, friction, pressure or wearing ill-fitting and tight shoes. The disease Kadara described in Ayurveda and Corn in western medical textbooks have absolute similarity in their manifestation. The management of corn is done by application of salicylic acid, corn caps, and invasive procedures like cryotherapy, laser, chemical cauterization, electric cauterization and surgical excision. But the results by these procedures are not satisfactory and there are more chance of recurrence. Kshara is indicated in management of Kadara. Kshara Karma is unique procedure used since ancient time which best among Shastra and Anushastra due to its comprehensive multi-faceted effects. Hence the present study was undertaken for evaluation of efficacy of Arkapratisaraneeya Kshara obtained was compared with the results of Agnikarma using Panchalohashalaka which is a standard and established study.

Chemical cauterization of peristomal granulomas with 50% trichloroacetic acid

Objetive: This study deals with the treatment of granulomas, one of the possible complications of the stomies, which are characterized as focal lesions, whose formation occurs due to the presence of aggressive agents to the tissues from the increase of the degree of cellularity and other tissue elements, generating annoyance and anxiety to patients. This study aims to describe the clinical results of the treatment of peristomal granulomas with the use of 50% trichloroacetic acid (TCA). Methods: This is a case series study, carried out by professionals in a referral center for the treatment of individuals with an ostomy in the city of Porto Alegre, state of Rio Grande do Sul. Results: The study sample consisted of 13 patients who underwent follow-up for treatment of peristomal granulomas with TCA. Data collection was performed during nursing consultations, based on the observation and photographic record of the granulomas, with subsequent evolution in the individual charts. Conclusion: It was concluded from this study that the regular treatment with TCA resulted in regression of the granulomas until their total disappearance, being this acid able to be considered, therefore, a potential therapeutic option; however, it is recommended to carry out further studies on its use in stomatherapy, seeking the use of more robust clinical research methodologies and with bias control.