title: A clinical trial for evaluation of leech application in the management of Vicarcikā (Eczema).
abstract: BACKGROUND
  Skin diseases are among the most common health problems worldwide and are associated with a considerable burden. Eczema is such a skin ailment which cause psychological, social and financial burden on the patient and their families. Management of eczema with antibiotics, antihistamines, steroids etc., are available but even after their use relapses, recurrences and other complications are very common.
  
  
  OBJECTIVE
  The aim of this study was to assess the efficacy of leech application in the management of vicarcikā (Eczema) with standard clinical parameters viz. Eczema Area and Severity Index (EASI) score, SCORing of Atopic Dermatitis (SCORAD) Index and Dermatology Life Quality Index (DLQI).
  
  
  METHODS
  An open labeled clinical trial study without control group was conducted with 27 patients having the classical symptoms of vicarcikā (Eczema), selected as per the inclusion and exclusion criteria from outpatient department and inpatient department sections of Shalya Department, S.V. Ayurvedic Hospital, Tirupati. Minimum four sittings of leech application were carried out with 7 days interval. Pre- and post-treatment evaluation of the patient was done with Eczema Area and Severity Index (EASI) score, SCORing of Atopic Dermatitis (SCORAD) Index and Dermatology Life Quality Index (DLQI).
  
  
  METHODS
  Analysis of the data was done with Student's paired t-test.
  
  
  RESULTS
  The total EASI score showed considerable reduction up to 54.45% (P < 0.01) and the SCORAD Index significantly reduced by 55% (P < 0.01). The life quality of the patient calculated by DLQI improved significantly by 62.36% (P < 0.01).
  
  
  CONCLUSIONS
  Leech application gives significant relief for the symptoms of eczema. The life quality of the patient also improved significantly after leech therapy. No adverse reactions were reported during the entire course of study.
authors.affiliation: Department of Salya, Santhigiri Ayurvedic College, Palakkad, Kerala, India.
authors.forename: K M Pratap
authors.initials: KM
authors.lastname: Shankar
authors.affiliation: Department of Śalya, S.V. Ayurvedic College, Tirupati, India.
authors.forename: S Dattatreya
authors.initials: SD
authors.lastname: Rao
authors.affiliation: Department of Statistics and Mathematics, Acharya NG Ranga Agricultural University, Guntur, Andhra Pradesh, India.
authors.forename: Shaik Nafeez
authors.initials: SN
authors.lastname: Umar
authors.affiliation: Department of Basic Principles, JSS Ayurveda Medical College, Mysore, Karnataka, India.
authors.forename: V
authors.initials: V
authors.lastname: Gopalakrishnaiah
keywords: Dermatology Life Quality Index; Eczema Area and Severity Index score; Scoring of Atopic Dermatitis Index; eczema; leech application