Hand-foot-mouth disease is a viral disease that occurs mostly in children, but sometimes affects adults as well. It is most often caused by Coxsackie virus A16 or Enterovirus 71. Other strains of these viruses can also be an etiological factor for the development of the disease. It usually starts with an increase in body temperature and fatigue. Subsequently, papulo-vesicular rashes appear on the oral mucosa, palms and soles. Over time, some of them form small erosions or ulcers. Although rare, few weeks after an infection has passed, nail changes can be seen. Some are associated with falling off the nail plate, others with onychom?d?sis or the development of a bacterial and/or fungal infection. In this report, we present a clinical case of a 22-year-old woman who in the month of September 2022 had hand-foot-mouth disease and two months later developed nail changes associated with a change in the integrity and color of the nail plate.

Objective: In this case study, an Ayurvedic medical approach called Kshara Sutra treatment is used to treat a chronic transsphincteric fistula in a 45-year-old male patient after three unsuccessful surgical operations. Methods: The patient has been experiencing peri-anal pain and discharge on and off for six years. An extensive diagnostic examination, which included an MRI fistulogram, revealed a transphincteric fistula with several external openings on the left buttock and one internal hole at 6 o’clock. Following methylene blue infiltration confirmation of the interior orifice, Kshara Sutra herapy was applied. Results: The patient responded well to Kshara Sutra therapy, showing significant improvement in pain and discharge as well as no significant side effects. At the conclusion of the therapeutic time, the fistula was seen to have fully resolved, and the patient has since been symptom-free. Conclusions: This instance highlights the Kshara Sutra therapy’s potential efficacy in treating persistent transphincteric fistulas, especially when other treatments have failed. It is necessary to conduct more study to confirm these conclusions and examine the wider Applications of this therapy for the treatment of fistulas.

Background: Spermicides are substances that can kill spermatozoa. Spermicide circulating in the community contains Nonoxynol9 which, if used for a long time, can irritate the vaginal mucosa and penis. Indonesia has a variety of plants that have the potential to act as anti-fertility, including Sapindus rarak, Centella asiatica, and Azadirachta indica. Objective: This study aim to evaluate extract Sapindus rarak, Centella asiatica, and Azadirachta indica. and mixing of third etract to motility and viability of spermatozoa Guinea pigs. Methods: The sample of this research was 15 guinea pig spermatozoa, 3-4 months old male guinea pigs taken from the cauda epididymis and vas deferens. Guinea pigs were divided into 5 group treatments with each group treatment incubated for 1, 10, and 30 minutes and repeated each for 5 times. The treatments in this study is control, 200 µl of spermatozoa suspension + 50 µl of Sapindus rarak fruit pulp extract 0.9%; 200 µl of spermatozoa suspension + 50 µl of gotu kola extract 0.9%; 200 µl of spermatozoa suspension + 50 µl of 0.9% neem seed extract; 200 µl of spermatozoa suspension + 50 µl of the third mixture extract 0.9%. This study used a completely randomized design (CRD). The observations in this study were the motility of guinea pig spermatozoa categories a + b and the viability of guinea pig spermatozoa using a microscope. The data obtained were analyzed statistically using One Way ANOVA. The results of this study indicated that the administration of extract Sapindus rarak, Centella asiatica, and Azadirachta indica and a mixture of the three extracts had a significant effect (P < 0.05) on the motility of guinea pig spermatozoa categories a + b and viability of guinea pig spermatozoa. Conclution: This study concludes that the mixture of the three extracts has more potential in reducing the motility of spermatozoa categories a + b and the viability of guinea pig spermatozoa compared to single extracts. The mixture of the three extracts may contribute for reduce quality of sperm.