play a role in the intrinsic coagulation process [49]. The anti-inflammatory and analgesic properties of leeches are subjects of modern hirudobiochemistry and hirudopharmacology and in many aspects are associated with the blockage of amidolytic and kininogenase activities of plasma kallikrein, resulting in prevention of pain or pain relief during leech sessions [50]. Leeches may also secrete a vasodilative, histamine-like substance, which increases the inflow of blood after a leech bite and reduces local swelling [45]. Hyaluronidase, which is known as the “spreading factor,” can degrade tissue hyaluronic acid, thus facilitating the infiltration and diffusion of the remaining ingredients of leech saliva into the congested tissue. Tissue permeability, restored with the help of hyaluronidase, promotes the elimination of tissue- and circulatory-hypoxia as well as local swelling [51]. The persistent bleeding largely potentiates tissue decongestion and leads to loss of blood, relief of capillary net, decrease in venous congestion, decompression of the nerve trunks and endings, increase in lymph flow, positive changes of local hemodynamics, amelioration of hemorheology, increase of oxygen supply, improvement of tissue metabolism, and elimination of tissue ischemia [33]. In summary, hirudotherapy is a safe, easy to use, beneficial, and cost-effective treatment modality to save reattached body parts and flaps in reconstructive plastic surgery. The early recognition of flap failure and initiation of leech therapy is of paramount importance. Prophylactic treatment with antibiotics and continuous monitoring of blood parameters are necessary. Homeopathy & Ayurvedic Medicine Panda and Debnath, J Homeop Ayurv Med 2012, 1:2 DOI: 10.4172/2167-1206.1000108 Volume 1 • Issue 2 • 1000108 J Homeop Ayurv Med, an open access journal ISSN: 2167-1206 Research Article Open Access Effectiveness of Leech Therapy in Gambhira Vata-Rakta (Acute Gout): A Pilot Study Ashok Kumar Panda* and Saroj Kumar Debnath Department of Ayurveda Research, Ayurveda Regional Research Institute - A unit of CCRAS, Department of AYUSH, Government of India, Gangtok, Sikkim, India Abstract Bloodletting is a mainstay of Panchakarma therapy as per Susruta. Leech therapy has been indicated as means of bloodletting for both types of Vata-rakta where pain, burning and redness found as per Charaka chikitsa. Medical science has enormous leaps in terms of diagnosis and treatment yet there is renewed interest in leech therapy among modern as well as traditional medicine practitioners. Most of studies of leech therapy are found for plastic surgery and pain reduction in osteo- arthritis. US, FDA also approves leech therapy as tool of skin graft. Therefore, we conducted a non randomized controlled pilot study in between June 2011 to Sep 2011 to assess the efficacy of leech therapy in Gambhira Vatarakta as diagnosed as acute Gout. Twelve patients (eight male and four female) with a mean age of 47 (9) years were treated with two - four leeches for seven days with a follow up to four weeks. Another 10 patents those were not willing for leech therapy was treated with tropical Diclofenac sodium gel for 7 days as control. The mean length of blood socking is 32 (5) minute. The mean quantity of blood sucked by Individual leech per suck is 6 (2) ml. In comparison with control, leech application led to rapid relief of pain and swelling immediate after the detachment of leech. Most significant clinical improvement was noted after 14 days and slightly reduction of serum uric acid were also noted after three weeks of treatment. 90% Patient described the initial leech therapy as a painless and two patients had mild to moderate itching but no local infection was noted in treated group. Our study was limited to small sample size but it had remarkable treatment effect. Larger randomized