Clinical efficacy of Jalaukavacharana (leech application) in Gluteal Hematoma...

[Full title: Clinical efficacy of Jalaukavacharana (leech application) in Gluteal Hematoma -A Case Study]

ISSN: 2456-3110 CASE REPORT July-Aug 2018 Journal of Ayurveda and Integrated Medical Sciences | July - Aug 2018 | Vol. 3 | Issue 4 187 Clinical efficacy of Jalaukavacharana (leech application) in Gluteal Hematoma ---- A Case Study Dr. Sinjid R, 1 Dr. Gopikrishna BJ. 2 1 Post Graduate Scholar, 2 Professor & HOD, Dept. of Shalya Tantra, Sri Dharmasthala Manjunatheshwara College of Ayurveda and Hospital, Hassan, Karnataka, INDIA. I NTRODUCTION The most common cause of a hematoma is injury or trauma to blood vessels. This can happen as a result of any damage to blood vessels that can disrupt the integrity of the blood vessel wall [1] Even minimal damage to a small blood vessel can result in a hematoma. For example Subungual hematoma can simply occur from minor trauma to the nail or from a light stroke against an object [2] Hematomas can be seen under the skin or nails as purplish bruises of different sizes. Hematomas can also happen deep inside the body where they may not be visible. Hematomas may sometimes form a mass or lump that can be felt. Sometimes hematomas are named based on their location. Address for correspondence: Dr. Sinjid R. Post Graduate Scholar, Dept. of Shalya Tantra, Sri Dharmasthala Manjunatheshwara College of Ayurveda and Hospital, Hassan, Karnataka, India. E-mail: sinjid 93@gmail.com Submission Date : 12/07/2018 Accepted Date: 15/08/2018 Access this article online Quick Response Code Website: www.jaims.in DOI: 10.21760/jaims.v 3 i 4.13309 Subdural hematoma: Hematoma between the brain tissue and the inside lining of the brain. Spinal epidural hematoma: Hematoma between spinal vertebrae and the outside lining of the spinal cord. Intracranial epidural hematoma : Hematoma between the skull and the outside lining of the brain. Subungual hematoma: Hematoma under the nail. Intra-abdominal, peritoneal, or retroperitoneal hematoma: Hematoma inside the abdominal cavity. Ear or aural hematoma: Hematoma between the ear cartilage and overlying skin. Splenic hematoma: Hematoma within the spleen. Hepatic hematoma: Hematoma within the liver. C ASE S TUDY Presenting complaint A male patient of 32 years came to our OPD with complaints of severe pain and tenderness of left gluteal region associated with difficulty in sitting since 2 days. A B S T R A C T Hematoma is generally defined as a collection of blood outside of blood vessels. Most commonly, hematomas are caused by an injury to the wall of a blood vessel, prompting blood to seep out of the blood vessel into the surrounding tissues. A hematoma can result from an injury to an artery, vein, or small capillary. A patient with 12 x 12 cm Hematoma of left gluteal region associated with severe pain and local tenderness was taken for Jalaukavacharana (leech therapy) as primary line of management. Key words: Gluteal hematoma, Jalaukavacharana, Leech therapy.

Dr. Sinjid R. et.al. Clinical efficacy of Jalaukavacharana in Gluteal Hematoma - A Case Study ISSN: 2456-3110 CASE REPORT July-Aug 2018 Journal of Ayurveda and Integrated Medical Sciences | July - Aug 2018 | Vol. 3 | Issue 4 188 History of present illness Patient was apparently healthy before 2 days. Then while driving tractor he fell down hitting the left gluteal region. Immediately he developed severe pain, tenderness and reddish discoloration of the area. For the above complaints he took analgesic medications for 2 days, but he didn’t got any relief. So he came to our hospital for further management Past History No H/O - HTN, DM, H/o Trauma - Fell down hitting the left gluteal region Personal History Appetite - Good Sleep - Reduced Bowel - Normal Micturition - Normal Habits Non smoker Non alcoholic Examinations BP - 130/80 mm of Hg on supine position Pulse - 78/min regular Temp. - 98.6°f Systemic CNS - conscious oriented RS - NVBS CVS - S 1, S 2 normal, No added sounds P/A - soft & normal Local examination Inspection - Gluteal region Hematoma of left gluteal region 12 x 12 cm Palpation Induration associated with tenderness of left gluteal region Temperature raised Blood investigations Hb - 12.8 gm/dl TLC - 4,800/cumm RBC count - 4.43 millions/cmm PCV/Hematocrit - 34.7% MCV - 79.8 fL MCHC - 33.6 gm/dl MCH - 26.9 picogram Platelet Count - 2.91 Lakh/cmm Bleeding Time - 02 min 05 sec Clotting Time - 05 min 20 sec Blood Sugar Random - 98 mg/dl HbsAg - Non reactive HIV 1 (Antibodies) - Non Reactive HIV 2 (Antibodies) - Non Reactive M ETHODOLOGY After proper investigation, leech therapy was planned as a first line treatment. Written consent was taken. 3 leeches were applied over gluteal hematoma for 45 minutes. O BSERVATIONS Before Treatment

Dr. Sinjid R. et.al. Clinical efficacy of Jalaukavacharana in Gluteal Hematoma - A Case Study ISSN: 2456-3110 CASE REPORT July-Aug 2018 Journal of Ayurveda and Integrated Medical Sciences | July - Aug 2018 | Vol. 3 | Issue 4 189 During Treatment - Day 1 During Treatment - Day 3 During Treatment - Day 6 During Treatment - Day 9 During Treatment - Day 12 O BSERVATIONS Symptoms were taken into consideration under grading system according to their severity. Variables BT Day 1 Day 3 Day 6 Day 9 Day 12 Pain +++ +++ ++ ++ + - Tenderness +++ +++ ++ ++ + - Burning Sensation ++ ++ ++ + - - Bleeding - - _ - - - Local Temp. ++ ++ + - - - Redness +++ +++ +++ ++ + - Difficulty in sitting +++ +++ +++ ++ + - Size of hematoma 12 x 12 cm 12 x 12 cm 8 x 8 cm 6 x 5 cm 1 x 1 cm - BT = Before treatment, No symptom = - , Mild = +, Moderate = ++, Severe = +++ R ESULT As soon as the leech application was started, patient got relieved of pain and tenderness. His agony and discomfort level was also reduced. After second sitting, induration and redness was also reduced.

Dr. Sinjid R. et.al. Clinical efficacy of Jalaukavacharana in Gluteal Hematoma - A Case Study ISSN: 2456-3110 CASE REPORT July-Aug 2018 Journal of Ayurveda and Integrated Medical Sciences | July - Aug 2018 | Vol. 3 | Issue 4 190 After Jalaukavacharana , patient was completely relieved and satisfied with the treatment. DISCUSSION Due to the qualities of its anticoagulant, vasodilator, thrombolytic, anti-inflammatory substances, leeches has been proved as medically effective [3] Through their sucking effect, leeches stimulate circulation of cells at risk of necrosis and maintain oxygenation of the tissue. They therefore promote restoration of capillary anastomosis [4] They accelerate the hematoma decongestion process. CONCLUSION The present study proves the effectiveness of Jalaukavacharana in treatment of Hematoma. REFERENCES 1 https://www.rxlist.com/hematoma/drugscondition.htm 2 https://www.rxlist.com/hematoma/drugscondition.htm 3 https://s 3.amazonaws.com/academia.edu.documents/ 36092240/IRJPS_11_3345.pdf?AWSAccessKeyId=AKIAI WOWYYGZ 2 Y 53 UL 3 A&Expires=1530014300&Signature =BMlGWJ 3 wsksKsvIU%2 Bcee 0 CTeO 1 Y%3 D&responsecontentdisposition=inline%3 B%20 filename%3 DAn_Overview_o n_Hirudotherapy_Leech_thera.pdf 4 K.R. Srikantha Murthy, Illustrated Susruta Samhita, Vol 1, Chaukamba Orientalia, Varanasi, 2001;p.78 ******************************* How to cite this article: Dr. Sinjid R, Dr. Gopikrishna BJ. Clinical efficacy of Jalaukavacharana (leech application) in Gluteal Hematoma - A Case Study. J Ayurveda Integr Med Sci 2018;4:187-190. http://dx.doi.org/10.21760/jaims.v 3 i 4.13309 Source of Support: Nil, Conflict of Interest: None declared.

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Jalaukavacharana, Severe pain, Present study, Leech application, Past history, Leech therapy, Gluteal region, Case study, Local tenderness, Local examination, Analgesic medication, Clotting time, Pain and tenderness, Written consent, Hematoma, Blood investigation, Bleeding time, Subdural hematoma, Before treatment, Blood vessel, Presenting complaint, Key-word, Blood vessel wall.