Efficacy of single sitting Jalaukavacharana in Dushta Vrana (Diabetic Foot Ulcer) on selected inflammatory Bio-markers (TNF-ALFA, IL-6) -An open label clinical trial

Chronic wounds (diabetic foot ulcer) are one of the major concern in surgery from ancient times because of various factors are associated with the wound becoming non-healing. Acharya Sushruta has dedicated many chapters with dealing of chronic wounds, may be because he was well aware of treating the chronic wounds is troublesome. Incidence rate in India, the occurrence of chronic wounds is estimated at 4.5 per 1000 population1

Contemporary science has well described the pathophysiology and stages involved in the wound healing i.e. haemostasis, inflammation, proliferation, and remodeling2. The wound to become chronic, it means it has arrested in some step of wound healing. The recent articles have shown different inflammatory mediators have major role in delayed wound healing. In Diabetic foot ulcer TNF-𝛼 has shown prolonged expression as proinflammatory cytokine which has elevated or prolonged the inflammation in the wound3. Similarly IL-6 is the proinflammatory cytokine which was seen significantly high in diabetic patients with foot ulcer may be fundamental in the development of the ulcer4.

                    Jaloukavcharana is one of the method of blood letting mentioned in Ayurveda, Acharya Sushruta includes jalouka in anushastra (Accesory sharp instrument) and indicated in the symptoms like taapa, shotha , daha shows  pitta dosha pradhanta5 and as per studies they have  anticoagulant, analgesic, antiinflammatory, platelet inhibitory and thrombin regulatory functions as well as antimicrobial effects and extra cellular matrix degradative effects6. In a patient of diabetic foot there will be gross inflammation so we want see is there any effect of Jaloukavcharana in reducing in the proinflammatory cytokine (TNF-𝛼 and IL-6) in diabetic foot ulcers.