Katishool, low back ache (lumbago) is the most common problem in middle and old age people hampering the normal activity. There are several reasons associated with the pain such as – neurological, metabolic, degenerative, traumatic, bad posture, restless lifestyle, etc. Gridhasi is one of the Nanatmaja Vata Vyadhi, characterised by Katishool where the site of pain starts from the Sphika (back region) and then radiates to Kati, Pristha, Uru, Janu, Jangha, Pada in order. The signs and symptoms mentioned in ayurvedic texts resembles the medical condition named sciatica. Sciatica describes leg pain that is localised in the distribu-tion of one or more lumbosacral nerve roots, typically L4-S2, with or without neurological deficit. This causes abnormality in the gait of the patient. Gridhasi being a dominant lifestyle disorder needs a proper management and Siravedhan is one of the propitious managements of Gridhasi described in Ayurveda classics. Acharya Sushruta explained the importance of Siravedhan by accepting it as Ardha Chikitsa (half of the therapeutic measure) in Shalya tantra like Basti in Kayachikitsa. Acharya Sushruta also mentioned that the diseases which are not relieved so quickly by Snehana, Lepanadi measure, in this Siravedhan do wonders by acting as an emergency management to achieve good results.

Background: Fournier’s gangrene is life threatening, necrotizing fasciitis, affecting external genetalia of male greater than female with mortality 7 to 53%. Fournier gangrene severity, LRINR and LNR scoring used to evaluate morbidity and mortality. Aim and objective of our study was to simplify a system, especially for Indian peripheral health centers which can predict mortality, morbidity.Methods: This study was conducted in department of surgery of Teerthankar Mahaveer University. Body mass index, blood urea nitrogen and patient demography used to develop the scoring system with minimum and maximum points and correlated our results.Results: Our simplified scoring system also has a direct bearing on mortality, morbidity, recovery and hospital stay. In our study 3 male and 2 females died.Conclusions: Simplified scoring and grading system will be helpful in predicting the morbidity and mortality, early surgical intervention, hospital stay, time for reconstruction.

Background and objectives: Robot-assisted minimally invasive surgeries have rapidly increased during the last decade. The objectives of the present study were to report our initial experience on robot-assisted management of urological injuries following gynecological surgeries, i.e., vesicovaginal fistula (VVF) repair and ureteric reimplantation for ureterovaginal fistula (UVF) and posthysterectomy ureteric strictures, using the da Vinci robotic system. Materials and methods:We performed robot-assisted surgeries in 12 such cases from February 2016 to September 2018. These include 7 cases of VVF repair, 2 cases of ureterovaginal fistulas and 3 cases of post-hysterectomy ureteric strictures requiring re-implantation.Results: All 7 patients who underwent VVF repair had no requirement of analgesics from 3rd day onwards and early convalescence, with only 1 having delayed recovery, The patients who underwent ureteric reimplantation for ureterovaginal fistula and ureteric strictures recovered well, with no hydroureteronephrosis or reflux of urine in any of the patients during follow-up. Conclusion:Our study concludes that, robot-assisted VVF repair and ureteric reimplantation for ureterovaginal fistula and ureteric stricture are safe and feasible and provides all the advantages of minimally invasive surgery, with additional benefit of enhanced precision, range of motion, visualization and access to pelvis and patient-related benefits of less pain, faster recovery, shorter hospital stay and early return to normal activity.