Acute urinary retention following frequent administration of Guggulu Tiktakam Kwatha and its management - a case report

Abstract

A 72-year-old male patient, a diagnosed case of infective spondylodiscitis, was admitted in our hospital for severe pain in the right hip and lower back (in the lumbo-sacral region) in a non-ambulatory mode. Considering the criticality, we administered Kwatha in a Muhurmuhu (frequent administration) schedule. The initial medicines reduced pain, but not the elevated C-reactive protein (CRP). To reduce this elevated CRP, we administered Amruthotharam Kwatha and Guggulu Tiktakam Kwatha (GTK) in the dosage of 30 ml every 2 h for eight times. CRP started reducing, but we encountered an acute urinary retention as an adverse drug reaction. Naranjo Adverse Drug Reaction Probability Scale recording gave a score of eight, which shows that the AE could be probably due to administration of Guggulu Tiktakam Kwatha (GTK) in Muhurmuhu schedule. When the patient did not void urine for more than 6 hours, we did Marma therapy on left Mootthira Kala Marma. The patient voided urine within half an hour of Marma therapy. Clinically, after the medications, pain reduced considerably, CRP came to normal, and the patient came to an ambulatory mode. This case report shows that medicines like GTK should cautiously be administered, as it may complicate. This case report also focusses light on the fact that Marma therapy could be a possible mode of tackling acute conditions.

Keywords: Adverse effect; Ayurveda; C-Reactive protein; Guggulu Tiktakam Kwatha; Intensive ayurveda care; Marma therapy.

Fig. 1

Showing the left Moothira-kala Marma (in circle).

Fig. 2

The probable mode of adverse event in administration of high dose of GTK.