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Management of herpes zoster in Ayurveda through medicinal leeches and other composite Ayurveda Treatment.

ABSTRACT: Herpes zoster commonly known as shingle's caused by varicella zoster virus (VZV). Recent studies have shown that exosomes play important role in pathogenesis as well as spread of herpes. Leeches when applied over affected part of herpes sucks the blood and there by interferes with extracellular communication through these exosomes and their by showing pain reduction, reduction in burning and arrest progression of disease. This technique is cost effective and easy to apply. In Ayurveda herpes can be correlated with Pittaj visarpa. Principle of treatment is Raktmokshan (~Bloodletting) and Pradeha (~Local application of medicines). Bloodletting with Jalauka (~Medicinal Leeches) is specifically indicated in management of Pitta dominant disorder. A 65-year-old female known case of Type 2 Diabetes (DM) and presented in Casualty of Government Ayurved College, Nagpur (GACN). We treated her Herpes zoster on the basic principles of management of Pittaj Visarpa. Management of Type 2 DM was continued as per modern medicine consultant. Rapid decrease in pain severity was observed after the 1st setting of leech therapy according to Zoster Specific Brief Pain Inventory (ZBPI) Questionnaire. After each seating pain reduction was observed. Repeated application of Jalauka along with internal medications gave complete relief. Ayurveda pain management in herpes zoster by leech therapy gives innovative easy, better and cost effective treatment. Adaptive trials are necessary to explore further practical applicability of Ayurveda and modern treatment together. Future research on effect of leech application on exosomes is necessary.

SUBMITTER: Nakanekar A

PROVIDER: S-EPMC7527853 | biostudies-literature | 2020 Jul - Sep

REPOSITORIES: biostudies-literature

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Management of herpes zoster in Ayurveda through medicinal leeches and other composite Ayurveda Treatment.

Nakanekar Amit A Khobarkar Punam P Dhotkar Sanjana S

Journal of Ayurveda and integrative medicine 20200701 3

Herpes zoster commonly known as shingle's caused by varicella zoster virus (VZV). Recent studies have shown that exosomes play important role in pathogenesis as well as spread of herpes. Leeches when applied over affected part of herpes sucks the blood and there by interferes with extracellular communication through these exosomes and their by showing pain reduction, reduction in burning and arrest progression of disease. This technique is cost effective and easy to apply. In Ayurveda herpes can ...[more]

PMID: 32798195

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Project description:IntroductionRisk of herpes zoster (HZ) is increased with Janus kinase inhibitor use. We evaluated clinical study data relating to HZ management in patients with rheumatoid arthritis (RA) or psoriatic arthritis (PsA) receiving tofacitinib.MethodsThis post hoc analysis included data from 21 RA and 3 PsA clinical studies; data were pooled for tofacitinib doses. Outcomes of HZ events (serious and non-serious) and tofacitinib treatment changes were evaluated in response to first and second HZ events. Median time to resolution was stratified by dermatomal involvement, history of HZ prior to tofacitinib, changes to tofacitinib treatment, anti-viral and corticosteroid use, and tofacitinib dose.ResultsSeven hundred eighty-three (11.1%, N = 7061) patients with RA experienced ≥ 1 HZ event, 63 (8.0%) of whom had ≥ 2 HZ events. In patients with PsA, 36 (4.6%, N = 783) experienced ≥ 1 HZ event, 1 (2.8%) of whom had ≥ 2 HZ events. For most HZ events, tofacitinib treatment was unchanged or temporarily discontinued. The majority of patients received anti-viral treatment, most within 3 days of onset. Post-herpetic neuralgia developed in 6.9% and 3.2% of patients with RA with first and second events, respectively, and in 2.8% of patients with PsA with a first event. Most first and second events resolved (RA: 97.6% and 96.8%, respectively; PsA: 94.4% and 100%, respectively). Median time to resolution was 22.0 days for first and 15.0 days for second events for RA and 20.5 days for first and 11.0 days for second events (n = 1) for PsA. Time to resolution of first events for RA and PsA was generally numerically shorter for patients with single dermatomal HZ, history of HZ, or anti-viral use versus those without.ConclusionAmong patients receiving tofacitinib, recurrent events were more common in patients with RA versus PsA; HZ duration was shorter for repeat events.Trial registrationNCT01262118, NCT01484561, NCT00147498, NCT00413660, NCT00550446, NCT00603512, NCT00687193, NCT01164579, NCT00976599, NCT01059864, NCT01359150, NCT02147587, NCT00960440, NCT00847613, NCT00814307, NCT00856544, NCT00853385, NCT01039688, NCT02187055, NCT00413699, NCT00661661, NCT01877668, NCT01882439, NCT01976364.

Project description:Juvenile Spondyloarthropathies are the inflammatory arthritis before the age of 16 years and are characterized by the involvement of both synovium and enthesis leading to spinal and oligoarticular peripheral arthritis, principally in genetically predisposed (HLA-B27) individuals. These arthropathies are having poorer chance of remission with conventional treatment in comparison to other juvenile arthritis; with less than 20% going into remission within five years of diagnosis. This paper is a retrospective observational study of this condition in one patient receiving Ayurvedic treatment in Paediatric Unit of Ch. Brahm Prakash Ayurved Charak Sansthan. A 15 years adolescent boy with the complaints of inability to stand and walk due to pain and swelling in large joints of body; was carried to Balroga OPD by parents. On the basis of history, physical examination and investigations, the condition is diagnosed Aamavata as per ayurvedic approach and juvenile spondyloarthropathy as per modern medical science. This case is managed on the principle of treatment of Aamavata with administration of Ajamodadi churnam and Mishreya ark as deepana-pachana drugs followed by administration of Simhnad Guggulu and Lakshadi Guggulu with Maharasnadi kashayam and Dashmoolaristam for 3 months. Rheumayoga gold was also given from 4th week onward for 3 months. Panchkarma in the form of Baluka swedana and Kshara basti was also administered for 2 weeks after one month of oral medication. This treatment results in complete remission of all the signs and symptoms including pain and swelling of joints. The case is followed up for next three years without any relapse or progression in the disease. The case study infers that early intervention of Ayurvedic treatment in juvenile spondyloarthropathies may result in complete remission as well as may prevent progression of the disease. The case study provides a good hope for the management of this ailment as well as new ray for research.

Project description:IntroductionImmunocompromised patients are at increased risk for herpes zoster (HZ)-associated complications. Despite standard therapy with systemic antiviral drugs and analgesics, complications are frequently encountered, including generalization of lesions or persistent neuropathic pain, so-called post-herpetic neuralgia (PHN). Given the scarcity of literature and awareness of therapeutic options to improve patient outcomes, especially for vulnerable patient groups, here we describe a strategy based on early intensification of treatment with a varicella zoster virus-specific hyperimmunoglobulin (VZV-IgG), which is approved in the adjuvant treatment of HZ.MethodsFor this case series, we selected four cases of HZ in patients with impaired immunity due to hemato-oncologic disease or immunosuppressive treatment who presented with either existing generalized lesions and/or severe pain or with other risk factors for a complicated HZ course such as PHN. They were considered to be representative examples of different patient profiles eligible for intensification of treatment by the addition of VZV-IgG to virostatic therapy.Case reportAll patients showed a rapid response to combined treatment with VZV-IgG and a virostatic agent. In two patients who had generalized lesions, the formation of new lesions ceased 1 day after VZV-IgG infusion. One patient, with mantle cell lymphoma, achieved complete healing of the lesions 9 days after diagnosis of HZ, a rare occurrence compared to similar cases or cohorts. A patient with HZ in the cervical region showed a good response after a single dose of VZV-IgG. None of the patients developed post-zoster-related complications. Combination therapy of a virostatic agent and VZV-IgG was well tolerated in these four cases.ConclusionThis case series demonstrates highly satisfactory treatment effectiveness and tolerability for VZV-IgG in the adjuvant treatment of immunocompromised HZ patients and supports early intensification of HZ therapy in patients at high risk of severe disease progression.

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Management of herpes zoster in Ayurveda through medicinal leeches and other composite Ayurveda Treatment.

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Management of herpes zoster in Ayurveda through medicinal leeches and other composite Ayurveda Treatment.

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