medicinal are there with significant result [15]. Some traditional healers of Sikkim have been practicing leech therapy in acute gout also [16]. But no clinical studies available on leech therapy in acute gout except some review. 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. Citation: Panda AK, Debnath SK (2012) Effectiveness of Leech Therapy in Gambhira Vata-Rakta (Acute Gout): A Pilot Study. J Homeop Ayurv Med 1:108. doi:10.4172/2167-1206.1000108 Page 2 of 4 Volume 1 • Issue 2 • 1000108 J Homeop Ayurv Med, an open access journal ISSN: 2167-1206 Patients and Methods We recruited 22 patients of acute gout from the OPD of our Institute by preset exclusion and inclusion criteria. An informed consent was obtained from all participants in the study and all patients were informed about 2-4 leech application. The patients were male and nonpregnant women in between the age of 18-60 years were included in the study based on the American College of Rheumatology 1980 classification criteria [17]. The major exclusion criteria were treatment with anticoagulants, haemorrhagic disorders, treated with western medication and preexisting arterial insufficiency. The patients were treated with two - four leeches in the affected area for seven days with a follow up to four weeks. Leech (Hirudo medicinalis) was used for the treatment after identified by local zoologist and conformed from literature [18]. The leech were attached, monitored and detach as per the published recommendations [19]. Eligible patients also had at least 1 CBC, blood chemistry, and urinalysis performed within 1 year prior to trial, the results of which revealed no abnormalities that would contraindicate treatment with either study medication. Efficacy & Safety Evaluation The primary outcome (0-7 days) was measured by pain intensity in the index joint by Visual analogous scale (VAS) i.e. 0= no pain & 10= extremely painful on D0, immediately after therapy for 7 days daily with a fellow up for 28 days. The secondary outcome i.e. tenderness (0–3-point scale), and swelling (0–3-point scale) are also assessed. The patient’s and investigator’s global assessments of response to therapy (0 = excellent; 4 = poor) and the investigator’s assessments of study joint tenderness (0 = no pain; 3 = patient states there is pain, winces, and then withdraws), swelling (0 = none; 3 = bulging beyond the joint margins), and erythema (present, absent, or not assessable) were conducted on day0, immediately after therapy for 7 days daily with a fellow up for 28 days. The patients were advised for visit if problem arise in between. The serum uric acid was measured on D0, D1, D4, D8, D14, D21 and D28. The outcome of safety measured by patient’s and investigator’s global response to treatment with any adverse effect was observed during the therapy and observed period. Observations and Results Total 22 patients were recruited in the study and man patient 14 (64%) are dominant in the study with more educated people 16 (73%) are attracted to this Ayurveda therapy (Table 1). All the patients have the classical symptoms of acute gout but elevated uric acid observed in only 10 (83.33%) in leech therapy group and 7 (70%) in control group. Presence of trophy is very less in both the groups. Polyarticular joint pain was found in maximum patients. The most affected joint was great toes in both the groups (Table 2). We attached the leech by griping in dry gauze to the site or by placing a drop of glucose on desired site. We noticed that some time leech migrate from one site to another. 90% Patient described the initial leech therapy as a painless. The mean feeding time was 32(5) minute. The mean quantity of blood sucked by Individual leech per suck is 6(2) ml. Three patients had mild to moderate itching and Bleeding from the site of application was seen in 2 patients and was easily managed with compressive dressings. No other complications or infections were noted. The mean changes in primary outcome i.e. Pain (VAS) was significantly reduced immediate after the leech therapy and completely disappear in 28 days, whereas