Pyoderma gangrenosum healing with marham-e-raal: A case study

Glossary definitions and references:

Scientific and Ayurvedic Glossary list for “Pyoderma gangrenosum healing with marham-e-raal: A case study”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.

1) Ulcer:
An ulcer refers to open sores or lesions that are often painful and difficult to heal. In the case of Pyoderma Gangrenosum, multiple ulcers were found on the patient's lower limbs with burning pain and serosanguinous discharge, forming due to an autoimmune disease and complicating healing processes.

2) Disease:
The term 'disease' denotes a pathological condition affecting the body. Pyoderma Gangrenosum, discussed in the article, is described as a rapidly progressing and destructive skin disease, often linked to other systemic illnesses like inflammatory bowel disease or autoimmune conditions.

3) Blood:
The word 'blood' plays a critical role in the diagnosis and treatment of Pyoderma Gangrenosum. Unani medicine uses formulations like Majoon-e-Ushba, known for its blood-purification properties, to treat the disease. Blood tests, including Hb levels and ESR, were part of the patient evaluation.

4) Medicine:
Medicine refers to substances or drugs used for treating diseases. The article explains the use of Unani medicine, including Marham-e-raal and various oral formulations, as a treatment for Pyoderma Gangrenosum, showing promising results where modern treatments, like high-dose steroids, have failed.

5) Pain:
Pain was a significant symptom for the patient with Pyoderma Gangrenosum, described as severe burning pain around the ulcers. Traditional treatments sometimes worsened the condition, whereas the Unani approach aimed at not only healing the ulcers but also alleviating the severe discomfort experienced by the patient.

6) Hindi (Himdi):
'Hindi' in the context of Unani medicine refers to ingredients like Kaat hindi (Acacia catechu) and Raal hindi (Vateria indica), which are used for their therapeutic properties. These ingredients have anti-inflammatory and blood-purifying effects and play a role in treating chronic ulcers like those in Pyoderma Gangrenosum.

7) Swelling:
Swelling is often associated with inflammation and infections. In the patient's case, the Pyoderma Gangrenosum initially presented as blister-like swellings, which burst and evolved into painful ulcers. Management of swelling is a part of the comprehensive treatment approach in Unani medicine.

8) Neem:
Neem (Azadirachta indica) is highlighted for its antimicrobial, anti-inflammatory, and blood-purifying properties. In treating Pyoderma Gangrenosum, neem leaves were used in decoctions to clean the wound area before applying the Unani ointment Marham-e-raal, contributing to infection control and healing.

9) Drug:
A drug is any substance used to treat, prevent, or diagnose a disease. In the study, both modern (like corticosteroids) and Unani drugs (like Majoon-e-Ushba and Marham-e-raal) were utilized. Unani drugs offered a natural alternative aimed at improving immune response and wound healing in Pyoderma Gangrenosum.

10) Withania somnifera:
Withania somnifera, also known as Ashwagandha, is an immunomodulatory herb used in Unani medicine. In this case study, a decoction of Withania somnifera was given orally to manage Pyoderma Gangrenosum, leveraging its anti-inflammatory and blood-purifying properties to aid in the healing process.

11) Acacia catechu:
Acacia catechu, referred to as Kaat hindi in Unani medicine, is known for its anti-pruritic and astringent properties. Its powder form, when applied topically, exhibits haemostatic activity and helps in wound healing. This was part of the treatment regimen for managing the patient's non-healing ulcers.

12) Tuberculosis:
Tuberculosis was part of the patient's medical history; he had pulmonary tuberculosis 30 years prior to the diagnosis of Pyoderma Gangrenosum. This historical detail was essential to rule out any connections or confounding factors in understanding and treating his current condition.

13) Science (Scientific):
Scientific rigor is evident in the article through detailed case studies, laboratory investigations, and treatment methodologies. The efficacy and safety of the Unani treatment for Pyoderma Gangrenosum are suggested to be further evaluated through clinical trials and robust scientific evidence.

14) Banafsha:
Banafsha, also known as Viola odorata, is an important component in Unani medicine due to its anti-inflammatory properties. In the study, it was used in a decoction along with other herbs to enhance the immune response and aid in healing the ulcers associated with Pyoderma Gangrenosum.

15) Hygiene (Hygienic):
Maintaining hygiene was crucial in the patient's treatment plan. He was instructed to keep personal hygiene, change costumes daily, and perform intermittent movements of the knee and ankle joints to prevent arthrosis, all contributing to the overall management and healing of Pyoderma Gangrenosum.

16) Powder:
Powder forms of various ingredients, such as alum (Zaaj abyaz), were used in the treatment to clean and purify the wounds. Alum's astringent and wound-healing properties helped dry out the ulcers and promote healthy granulation, playing a vital role in treating Pyoderma Gangrenosum.

17) Sugar:
Blood sugar levels were one of the routine investigations conducted to rule out diabetes mellitus in the patient. The patient's random blood sugar level was within normal limits (118 mg/dl), ensuring that diabetes was not a complicating factor in the treatment for Pyoderma Gangrenosum.

18) Azadirachta indica:
Azadirachta indica, commonly known as neem, was used for its antimicrobial and healing properties. Neem leaves were used to prepare a decoction for cleaning the ulcerated area, contributing to infection control and promoting wound healing in the treatment of Pyoderma Gangrenosum.

19) Burning sensation:
Burning sensation was a significant and distressing symptom experienced by the patient with Pyoderma Gangrenosum. The use of Unani medicine, including Marham-e-raal, effectively alleviated this symptom, providing relief from the intense pain and discomfort associated with the condition.

20) Antibiotic (Antibacterial):
Anti-bacterial properties were crucial in managing the ulcers in Pyoderma Gangrenosum. Ingredients like neem and other components in the Unani formulations possess strong antibacterial activities, which help in controlling infection and promoting healing of the chronic, non-healing ulcers.

21) Purification:
Purification, particularly blood purification, is a key concept in Unani medicine. The formulation Majoon-e-Ushba, known for its blood-purifying properties, was used in the treatment to cleanse the patient's blood, thereby improving immune response and aiding in the healing of Pyoderma Gangrenosum.

22) Discussion:
The discussion section in the article highlights the rarity of Pyoderma Gangrenosum, its association with systemic diseases, treatment challenges, and the promising results of Unani medicine. It also calls for further scientific studies to validate and understand the treatment's efficacy and safety.

23) Sprinkling:
Sprinkling refers to the method used to apply medicinal powders directly onto ulcers or wounds. In this study, the application of powders, such as alum (Zaaj abyaz), played a role in the local treatment, helping to dry the wound and promote granulation in Pyoderma Gangrenosum management.

24) Inference:
Inference in the context of the article refers to the conclusions drawn from the case study on the efficacy of Unani medicine for treating Pyoderma Gangrenosum. It suggests that Marham-e-raal and other Unani formulations show promising results and warrants further scientific investigation.

25) Vomiting:
[see source text or glossary: Vomiting]

26) Mustard:
In modern medicine, local therapies for Pyoderma Gangrenosum include topical and intralesional corticosteroids, topical 5-aminosalicylic acid, benzoyl peroxide, and topical nitrogen mustard. These treatments aim to manage the disease locally, though not always resulting in complete healing or preventing recurrence.

27) Kerala:
One of the co-authors, Sahibole Suhail Yunus, is affiliated with the Markaz Unani Medical College in Kozhikode, Kerala. This indicates that the study involved contributions from various geographical regions, underlining the collaborative nature of the research in Unani medicine.

28) Nausea:
Nausea is mentioned in the patient’s medical presentation as a symptom that he did not experience, which helped differentiate and diagnose his condition. The absence of symptoms like nausea, vomiting, and fever supported the diagnosis of Pyoderma Gangrenosum rather than other systemic illnesses.

29) Nature:
Nature refers to the inherent characteristics of the ulcers and the disease. The ulcers in Pyoderma Gangrenosum are described as aggressive, with violaceous margins and severe burning pain. Unani treatment tailored to these natural attributes provided holistic care and alleviation of the symptoms.

30) India:
India is the country where the study was conducted and where Unani medicine practices are deeply rooted. The case study involved various institutes in India, including HRUMC & H in Sambhal, Moradabad, and the National Institute of Unani Medicine in Bangalore, showcasing the practice’s regional relevance.

31) Ayus (Ayush):
'Ayush' refers to the systems of traditional medicine practiced in India, including Ayurveda, Yoga, Unani, Siddha, and Homeopathy. The journal AYUSHDHARA publishes research in these fields, here presenting a case study on the treatment of Pyoderma Gangrenosum using traditional Unani formulations.

32) Fever:
Fever was one of the symptoms not present in the patient with Pyoderma Gangrenosum, aiding in ruling out other infections or systemic illnesses. The absence of febrile symptoms helped focus the diagnosis and treatment on the specific autoimmune and chronic aspects of Pyoderma Gangrenosum.

33) Anger (Angry):
[see source text or glossary: Angry]

34) Alam (Alaṁ):
Saiyad Shah Alam, another co-author, contributes his expertise as the HOD of Ilmul Jarahat (Surgery) at the National Institute of Unani Medicine, Bengaluru. His academic and medical input were pivotal in evaluating the case of Pyoderma Gangrenosum and administering the Unani treatment.

35) Sah:
Saiyad Shah Alam is mentioned within the context of his role in the National Institute of Unani Medicine. This highlights the collaborative nature across multiple experts in Unani medicine, supporting the treatment and case study of Pyoderma Gangrenosum presented in the article.

36) Diet:
The patient's diet consisted of vegetarian meals, which is an important consideration in Unani medicine for overall health and treatment response. The diet was noted as good, meaning nutritious and balanced, indirectly aiding the immune response and the healing process of Pyoderma Gangrenosum.