A Patient with Intracerebral Hemorrhage Improved by Korean Medical Treatment including Pyung-Hyung Acupuncture: A Case Report

Objective: This study examined the effectiveness of Pyung-Hyung acupuncture and herbal medicine for a hemiplegic patient diagnosed with intracerebral hemorrhage.Methods: The patient was treated with Pyung-Hyung acupuncture and herbal medicine for one month. Intracerebral hemorrhage symptoms were evaluated using the Korean version of the Modified Barthel Index (K-MBI), the Manual Muscle Test (MMT), and brain CT images.Results: Following Pyung-Hyung acupuncture and herbal medicine, K-MBI, MMT, and brain CT image results improved.Conclusion: This case showed that Pyung-Hyung acupuncture and herbal medicine effectively treated intracerebral hemorrhage with hemiplegia.

Effects of Individualized Gait Rehabilitation Robotics for Gait Training on Hemiplegic Patients: Before-After Study in The Same Person

Background : Lower-limb exoskeleton robots are being widely used in gait rehabilitation training for stroke patients. However, most of the current rehabilitation robots are guided by predestined gait trajectories, which are often different from the actual gait trajectories of specific patients. One solution is to train patients using individualized gait trajectories generated from the physical parameters of patients. Hence, we aimed to explore the effect of individual gaits on energy consumption situation during gait rehabilitation training for hemiplegic patient with low-limb exoskeleton robot.Methods : 9 unilateral-hemiplegic patients were recruited. On the first day of the experiment, the 9 patients were guided by a low-limb exoskeleton robot, walking on a flat ground for 15 minutes in general gait trajectory, which was gained by CGA (clinical gait analysis) method.On the other day, the same 9 patients wore the identical robot and walked on the same flat ground for 15 minutes in individualized gait trajectory. The main physiological parameters including heart rate (HR) and peripheral capillary oxygen saturation (SpO2) were acquired via cardiotachometer and oximeter before and after the walking training. The energy consumption situation was indicated by the variation of the value of HR and SpO2 after walking training compared to before.Results : Between-group comparison shows that the individualized gait trajectory training results in lower increase in HR levels and decrease in SpO2 levels in experimenters compared to general gait trajectory training. Difference has statistical significance(p<0.05).Conclusions : Using individualized gait guidance in rehabilitation walking training can significantly improve energy efficiency for hemiplegic patient with stroke.Trial registration: Registered on 29 July 2021 at Chinese Clinical Trial Registry (ChiCTR2100049310). https://www.chictr.org.cn/edit.aspx?pid=130960\&htm=4

Role of 5% Tankana bhasma in Gomutra Arka as a Chemical Debridement agent in the Management of Pressure Ulcer - A Case Report

Background and Objective: Pressure ulcers regarded as preventable but occur in approximately 5% of all hospitalized patients (range of 3% to 12 % in published literature). It is more common in paraplegic patients. Only after the complete debridement of slough in grade 3 and grade 4 pressure sores the healing progresses and the infection can be controlled. A chemical solution of 5%Tankana in Gomutra Arka was reviewed in the management of a case of pressure ulcer. Presentation of Case: A 26 year old male hemiplegic patient presented with a wound in the sacral region which was diagnosed as a Grade 4 pressure ulcer measuring 12x13 cm. Manual Debridement of ulcer was associated with bleeding. Methodology: There after the solution of 5% Tankana in Gomutra Arka was applied upon the wound by soaking a gauge with the above solution. A regular passive movement of the lower part of the body was done to prevent further development of new Ulcer. Result: After 3 days of dressing 90 % or slough was reduced, discharge from the ulcer reduced and progression of infection had stopped. Discussion: Pressure ulcers impose an economic burden on the patient and common problem amongst bed ridden patients. Grade 4 pressure ulcers have a poor prognosis. Manual slough removal is usually associated with bleeding. Chemical debridement not only helps us in avoiding instances of bleeding but also is more effective in its reach and action. Conclusion: In this case 5% Tankana bhasma in Gomutra Arka was found to be very effective in slough removal which in turn reduced the total duration of management. Use of Chemical debriding agents in a grade 4 ulcer had hastened the process of slough removal and improves the overall rate of recovery. Mixture of Tankana and Gomutra Arka seemed to complement each other’s action on Vrana Shodhana.

A case report on necrotizing fasciitis in a hemiplegic patient following an intra-muscular injection

Necrotizing fasciitis (NF) can be defined as a surgical emergency causing the necrosis of the skin, subcutaneous fat, and superficial fascia. It spreads along the fascial planes with or without the presence of cellulitis. It is characterized by the destruction of tissue, systemic toxicity, and may even lead to morbidity and mortality. Higher rates of prevalence were observed in the obese, diabetic, alcoholic, patients with peripheral vascular diseases and immunocompromised populations. There are no definite diagnostic criteria for NF and the laboratory findings may lead to misdiagnosis as cellulitis or abscess. It is usually developed from an injury to the skin, which may occur during trauma, IV drug use, drug administration (via injection), skin infections, ulcer, insect bites, visceral-cutaneous fistulas, surgical complications, percutaneous catheter insertion, abscesses and can even have idiopathic causes. Early diagnosis of the condition, surgical debridement, and optimal antibiotic therapy leads to the improvement in the condition and desired outcomes in the patient. The present study is focused on the successful treatment of necrotizing fasciitis in a hypertensive and hemiplegic patient, following an IM injection of an analgesic, which caused an ulcer and rapidly progressed, leading to necrosis of the affected regions.