Colocolic intussusception in children: A case series and literature review

Background Colocolic intussusceptions is a rare subtype of intussusception mostly caused by juvenile polyps. The treatment of colocolic intussusception caused by other pathologic lead points remains poorly understood. Methods A systematic literature review between January 2000 and June 2021 was performed to characterize the comprehensive treatment of colocolic intussusception in children. This report also included 10 patients admitted to our center between 2010 and 2020 not previously reported in the literature. Results We identified 27 patients in 20 studies in addition to 10 patients from our center for a total of 37 patients (median age, 4.0 years; 54.1% male). The lead point was identified in 33 patients (33/37, 89.2%). The most common lead point was juvenile polyps (16/33, 48.5%). A therapeutic enema was performed in 12 patients with colocolic intussusception caused by juvenile polyps and was successful in 8 patients (8/12, 66.7%). Colonoscopic polypectomy was subsequently performed in 7 patients and was successful in 6 patients (6/7, 85.7%). The other patient had undergone laparoscopic exploration, and no abnormality was found. Subsequently, the patient underwent open surgery. The patients with colocolic intussusception caused by other pathologic lead points almost underwent surgical treatment (14/17, 82.4%), including 12 open surgeries and 2 laparoscopic surgeries. Conclusion A therapeutic enema followed by colonoscopic polypectomy is feasible to treat colocolic intussusception caused by juvenile polyps unless the patient has bowel perforation; however, open surgery is sometimes needed. For patients with colocolic intussusception caused by other pathologic lead points, open surgery may be preferable to laparoscopic surgery.

A REVIEW ON CLINICAL IMPORTANCE OF PANCHAKARMA IN VRANA SHASTI UPAKRAMAS

Panchakarma is a fundamental part of Ayurveda. It is chiefly constituted of especially deliberate five procedures for detoxification of the body. These include Vamana (emesis therapy), Virechana (purgation therapy), Basti (therapeutic enema), Nasya (errhine therapy) and Raktamokshana (bloodletting therapy). Acharya Sushruta father of surgery mainly deals with Chaladanta in Sushruta Samhita. Shalya Tantra. It is carried out with the help of different surgical apparatuses like Yantra, Shastra and Anushastra. Panchakarma is not only a sohana (bio- purificatory) process but involves a wide range of therapeutics such as samana(therapeutic) brahmana (rejuvenat- ing), Ropana (healing), lekhana (scraping), prasamak (soothing). Acharya susruta explained widely Vranasasti- upakram as with applications in the practice of Shalya Tantra i.e, Ayurvedic discipline of surgery. Numerous tex- tual references are available where the procedures of Panchakarma and up karmas have been adopted as an im- portant measure to Vrana Ropana along with the institution of surgical mediation directly or partially. Keywords: Panchakarma, Vrana, Vrana Swastiuakram, Shalya Tantra, Rakta-Mokshana.

MATRA BASTI THE PANACEA: A NARRATIVE REVIEW

In Panchakarma, Basti is one of the important therapies. Basti Chikitsa (therapeutic enema) is a natural method to detoxify the body and putting the vivacity into the millions of processes proceeding in the body i.e. it has the power to change the biological rhythm of the body and encourages self-healing. The impuri-ties which are entangled with the body are scraped by the Basti Karma and shown the path of egress to them. It is a holistic treatment with natural things to bring the body back into its natural and homoeostatic state. Basti Chikitsa is considered to be a prime treatment modality among the Panchakarma in Ayurveda. It has not only curative aspects but also preventive and promotive aspects. This Basti treatment also relieves stress from the body and mind to improve the quality of life. Matra Basti is a therapy where least dose of oil/unctuous substance is used. It is preceded by abhyanga (therapeutic oil massage) and Swedana (suda-tion). Human is the king of the castle (body) so he has to make the decisions how to convert it into more beautiful and healthy state along with its prevention from the rust of impurities.