pain in control group was poorly reduced and reappeared after the cessation of application of Diclofenac gel in the affected area (Table 3). The secondary outcomes were also assessed by the patient’s and investigators global assessment to response to the therapy, tenderness, swelling and noting erythema in leech and control groups. Leech group was responded well even after the cessation of treatment but control group had reappeared the symptoms after the cessation of treatment (Table 4,5). The primary and secondary endpoints were also compared in trial and control group and significant response was observed in trial group compared to control group (Table 6). Discussion A seven days course of leech therapy was effective in relieving pain, tender, swelling, erythema in acute gout and the effect was intact up to 28 days of observed period. These types of pain relieving effect was also observed in other randomized control studies in the treatment of Osteoarthritis and epicondylitis [20,21]. The saliva of leeches contains a variety of substances such as hirudin, hyaluronidase, histamine-like vasodilators, collagenase, inhibitors of kallikrein and superoxide production, and poorly characterised anaesthetic and analgesic compounds [22,23]. Therefore, a regional analgesic and antiphlogistic effect by these substances enforced by hyaluronidase as well as counter-irritation might be possible. Leeches might be considered as an additional option in the therapeutic approach to acute Gout. Our study was limited to small sample size but it has remarkable treatment effect. Larger randomized control trial should be undertaken to study the safety and efficacy of leech therapy in acute gout. Variables Test group Control Group Total No of patients 12 10 22 Percentage of Male 8(66.66%) 6(60%) 14(64%) Mean age in Years 47(9) 50(10) Percentage of Educated person (above matric) 9(75%) 7(70%) 16(73%) Duration of diseases 8.1(6.2) 7.3(4.5) 7.9(4.9) Monoarticular joint pain 5 4 09 Polyarticular 7 6 13 Metatarsophalangeal (foot) 3 3 6 Ankle 2 2 4 Knee 1 1 2 Great toe proximal interphalangeal joint 6 4 10 Others 0 0 0 Table 1: Patient’s demographic variables of studied 22 patients. Clinical variables Test group Control group Pain in Joint 12 10 Swelling of the joints 12 10 Joints of limited mobility 12 12 Redness of Joint 11 10 Elevated uric acid 10 07 Presence of Trophy 03 02 Table 2: Clinical variables of studied 22 patients. Group Baseline Day1 Day4 Day8 Day14 Day21 Day28 Leech 3: Mean changes in the primary outcome (Pain Score-VAS) in different duration of treatment in Studied & Control group. 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 3 of 4 Volume 1 • Issue 2 • 1000108 J Homeop Ayurv Med, an open access journal ISSN: 2167-1206 References 1. Garrison FH (1929) An introduction to the history of medicine with medical chronology, suggestions for study and bibliographic data. (4thedn), W.B. Saunders Company, Philadelphia. 2. Davis AB, Appel T (1979) Bloodletting instruments in the National Museum of History and Technology. 3. Seigworth GR (1980) Bloodletting over the centuries. N Y State J Med 80: 2022-2028. 4. Whitaker IS, Rao J, Izadi D, Butler PE (2004) Historical Article: Hirudo medicinalis: ancient origins of, and trends in the use of medicinal leeches throughout history. Br J Oral Maxillofac Surg 42: 133-137. 5. Abdelgabar AM, Bhowmick BK (2003) The return of the leech. Int J Clin Pract 57: 103-105. 6. Eldor A, Orevi M, Rigbi M (1996) The role of the leech in medical therapeutics. Blood Rev 10: 201-209. 7. Whitaker IS, Izadi D, Oliver DW, Monteath G, Butler PE (2004) Hirudo Medicinalis and the plastic surgeon. Br J Plast Surg 57: 348-353. 8. Mumcuoglu KY, Pidhorz C, Cohen R, Ofek A, Lipton HA (2007) The use of the medicinal leech, Hirudo medicinalis, in the reconstructive plastic surgery. The Internet Journal of Plastic Surgery 4: 12. 9. http://www.news24.com/World/News/Thumbs-up-for-leech-therapy-20050824 10. Michalsen A, Klotz S, Lüdtke R, Moebus S, Spahn G, et al. (2003) Effectiveness of leech therapy in osteoarthritis of the knee: