Wednesday, 23 January 2019

DR.BHARAT ROKADE




HISTORICAL ASPECTS OF FISTULA-IN-ANO.
Brief reference to Fistula-in-ano was mentioned in the Code of Hammurabi even
as early as 12th century BC.
Hippocrates (400-365 BC) thought that the trauma and abscess were the causes of
fistula. He advised early drainage of an abscess even open while still unripe to prevent
fistula formation. Various forms of treatment were used in fistula. The non-operative
procedures of ligation using horse hair and raw lint was given as the method of choice in
the majority of cases. If ligation failed then surgical procedure of cutting down on the
tract was directed. The wound is to be allowed to heal by granulations from the bottom.
The use of the syringe and caustic substances are advocated to distend the tract.
Celsus (25 BC-50? AD) performed the ligature after having accomplished a total
excision of the superficial plane and the only incision which is interrupted in its central
part is performed by following a probe. He pointed out the dangers of incising to a high
internal opening and used a tent in such cases. The modern fistulotomy in 2 stages and
fistulectomy are repetitions of Celsus’s treatment.
Heliodorus (c. 1st century AD) and Antyllos (c. 150 AD) in Rome performed the
incision by following a flat probe.
Galen (130-200 AD) treated fistulas with drainage and chemical cauterisation.
Leonidas of Alexandria (c. 200AD) and Aetios of Amida (502-575 AD) performed the
incision after previous ligature and pulling with a folded probe.
Paul of Aegina (625-690 AD) used a bent bistoury and left the Hippocratic
ligature for fearful patients.

KSHARSUTRA

Dr. Bharat Rokade.


Fistulogram and
Ksharsutra Application

Monday, 22 August 2016

My new syllabus for IV/I batch




Dr. Bharat Rokade


Part A
Marma: Nirukti, types, description and importance.  Target –Clinical application of concepts of marma.·  Preferable targets- Study of relevance of marma in the light of current anatomical· and surgical knowledge. 

Kshara and Kshara Karma: i. Nirukti, Pradhanyata, Guna, Dosha, Karma, Prakara, Yogya, Ayogya, Procedure, Upadrava and Chikitsa. ii. Kshara nirmana vidhi, knowledge of Kshara Varti, Taila and Pichu. iii. Kshara Sutra – Preparation, Indications, Contraindications and Method of application, Complications and their Management.  Target – Capability to identify and practice the use of kshara, kshara sutra in· common clinical conditions.  Preferable targets – Broader knowledge of current trends and ongoing researches in· kshara application.

Bandha Vidhi – Prayojana, Dravya, Indications, Contraindications, Prakara, Upadrava, Pichu, Plota, Kavalika and Vikeshika.  Target- Hands on experience of techniques of bandaging.·  Preferable targets - New generation of bandaging and splintage tools.·

Diagnostic techniques – X-ray, Imaging techniques, Ultrasonography, CAT Scan, MRI, Biopsy / Cytological study.  Target- Knowledge of proper indications for optimum investigational tools and their· interpretation.  Preferable targets - Capability to work independently in the field of diagnostic· techniques.



B part
Shat Kriyakala in surgical practice.  Target- Clinical utility of the concepts.·  Preferable targets - Applied aspects of Kriyakalas in the light of current concepts of· pathogenesis.

Vranashotha - Inflammation ii. Vidhradi - Abscess iii. Pidika - Boils iv. Nadi Vrana - Sinus / Fistulae v. Vrana Granthi - Keloid / Hypertrophic scar 

 Marmagata - Shock vii. Kotha – Gangrene and Principles of Amputation. viii. Granthi - Cyst ix. Arbuda - Tumour  Target-Clinical application of the concepts.·  Preferable targets - Hands on experience of management of different conditions.·

Diseases of esophagus: Aetiopathogenesis, Classification, Clinical features, Diagnosis, Complications and Management of Congenital anomalies, Oesophagitis, Varices, Ulcer and Tumours.  Target - Clinical utility of the concepts.·  Preferable targets - Hands on experience of management of different conditions.
·
Diseases of Rectum and Anal Canal – Aetiopathogenesis, Classification, Clinical features, Diagnosis, Complications and Management of Congenital disorders, Arshas - Haemorrhoids, Parikartika - Fissure-in-ano, Bhagandara - Fistula-in-ano, Guda Vidradi - Anorectal abscesses, Gudabhramsa - Rectal prolapse, Sanniruddaguda - Anal stricture, Incontinence, Rectal Polyp and Tumours.  Target - Clinical utility of the concepts.·  Preferable targets - Hands on experience of management of different conditions.·

Diseases of Kidney and Ureters - Aetiopathogenesis, Classification, Clinical features, Diagnosis, Complications and Management of Congenital anomalies, Polycystic kidney, Injuries, Perinephric abscess, Calculus and Neoplasms.  Target - Clinical utility of the concepts.·  Preferable targets - Hands on experience of management of different conditions.· Diseases of Urinary bladder – Aetiopathogenesis, Classification, Clinical features, Diagnosis, Complications and Management of Congenital anomalies, Injuries, Ashmari - Vesical Calculus, Cystitis and Neoplasms.  Target - Clinical utility of the concepts.·  Preferable targets - Hands on experience of management of different conditions.· Mutraghata and Mutrakrichra - Aetiopathogenesis, Classification, Clinical features, Diagnosis, Complications and Management. Retention of urine.  Target - Clinical utility of the concepts.·  Preferable targets - Hands on experience of management of different conditions.· 


Friday, 5 August 2016

my syllabus

UG
Ist term:  
           Paper I : Part A :Shat-kriya kala.
           Paper II :Part A:Vrana shotha & Vidradhi- Derivation, Nidana , Samprapti,types,Sthana,symptoms & complications,Ama-Pachyman-Pakwa Avastha,Sadhyasadhyatva,treatment of Vranashotha & Vidradhi.Seven Upakramas.Antar vidradhi.
          Paper I: Part A: Aushadhi vidhi.

IInd term:
          Paper II: Part B :Oesophagus-Vrana (Ulcer), Sannirodha (Obstruction), Shotha(Inflammation),Raktasrava(haemorrhage) & Arbuda(Tumors)-causes ,symptoms & treatment.
         Part A:Mansa vikara-Mansa shotha (myositis), Mansa dushti, Mansa arbuda (tumor) ,Mansa granthi ,etc. Shleepada (Filaria)-according to sites-causes,symptoms & treatment.
        Paper I:Part B:Role of Shalyashastra in medical jurisprudence. Duty of surgeon.
        Paper II: Part B: Medhra vikara (penile disorders)-causes,symptoms & treatment of vrana(ulcer),Niruddha prakasha (phymosis), Parivartika(paraphymosis) ,Avapatika (Tear of prepuce),Arbuda (carcinoma),Arsha(polyps),Upadansha(chancre), Puyameha(gonorrhoea),Phiranga(syphilis)./

IIIrd term:
       Paper II:Part B: Pittashshaya vikar(Gall bladder disorders)-shotha(inflammation), Ashmari(Gall stones),Kamala(Jaundice) & Arbuda-causes,symptoms &treatment.
      Paper II: Part A: Marmaghata-causes & treatment(Vital injury).
                                 Types of bandages.
      Paper I :Part A: Kshara vichara.
      Paper II : Part A: Manya Vikara-Manya stambha, Manya granthi,Pashana gardhabha-causes,symptoms & treatment.  


PG  (Prelim)
·       Vrana bandha
·       Ksharakarma
·       Shastra sadhya Vyadhi.


PG (Specialisation)
Paper I
·       Marmaghata
·       Kshara parichaya
·       Vruddhi vikara
·       Shleepada
·       Visarpa
Paper II
·       Gall bladder
·       Urinary bladder
·       Ureter
·       Mootra praseka sandhana (Urethroplasty)
Paper III
·       Oesophagus
Paper IV
·       Shalyatantra pracheena samhita



              




Ksharsutra preparation & Application

@ Department of Shalyatantra,
BVDUCOA-Pune.


vidradhi bhedan karma


Agnikarma procedure