Darunak or commonly known as dandruff, is a disorder that affects the scalp. Dandruff causes white, dry flakes of dead skin cells to shed from the scalp. Although dandruff rarely causes baldness and hair loss, the itchiness of this condition may most certainly be a cause of concern. If white flakes persist for a long time, the person may experience symptoms of seborrhea, psoriasis, or eczema. According to Ayurveda, Darunak is a Vatakapha predominant tridoshaj disease. According to Acharya  Sushrut , Madhav  and Yogratnakar , Darunak have symptoms like Itching, White scales like structures, Dryness in the scalp. Along with aforesaid symptoms of Acharya Vagbhatta also considered Hair loss and Numbness of scalp. The Adhisthan (place of origin) of this disease is the keshbhumi (Scalp). 

Over time, proponents of Ayurveda have conducted various researches on this disease, trying to find out an effective solution when it comes to dandruff related problems. 

Prolonged Treatment for Wet or Oily dandruff: 

The scalp skin produces sebum (Kapha), which is an oily substance. This sebum helps in keeping your scalp and hair hydrated. It is a natural process, without which your hair may turn dry and frizzy. However, when this sebum (kapha) is over produced due to certain reasons, you may suffer from problems of the scalp. Over production of sebum (kapha) causes oily scales to appear on the scalp, which may cause severe itching and may also result in infection. Therefore, wet dandruff requires prolonged treatment, whereas it is easier to treat dry dandruff. 

Impurity in the blood: 

According to Ayurvedic system of medicine, dry dandruff is caused because of  Vata Pradhan Kapha dosha . On the other hand, wet dandruff is caused because of  Kapha Pradhan Vata dosha . As per Acharya Videha Pitta and Kapha are involved in causing darunak i.e. Dandruff. The vitiation of Vata and Pitta in the body leads to vitiation of Raktadhatu(blood) thus giving rise to impurities in the blood. This in turn leads to poor nourishment of the scalp. In such cases, detoxification of blood is also required to get rid of dandruff. 

Ayurvedic View

Ayurveda places the problem of dandruff in the category of Shudra Roga, which appears due to an imbalance of all three doshas (Ayurvedic humor). The primary doshas involved are Kapha and Vata.Kapha is an Ayurvedic humor which symbolizes Softness, Stickiness, provides nourishment & lubrication. Vata is dry and rough in nature. In an aggravated state, both doshas as per their predominance cause the production of specific impurities in scalp, which are dry and sticky in nature. These impurities accumulate in the deep tissues of the scalp and contaminate them. Contamination of the deep tissues and aggravated Vata-Kapha Dosha causes itching and flaky patches on the scalp. Due to these factors, the scalp sheds larger than normal amounts of dead epidermal cells, which leads to the problem of dandruff. 

The Ayurvedic line of treatment is to generally pacify Kapha and Vata through herbal medicines, as well as a tailor-made diet and lifestyle plan. Also, special herbs are administered to cleanse the body of accumulated digestive impurities. 

The Ayurvedic system of treatment for wet or oily dandruff, in particular, is briefly mentioned here: 

According to Ayurveda, dandruff could be caused due to prolonged intake of cold water, Excessive usage of foods that taste salty, Chronic Rhinitis,  Irregular Sleeping Habits, Excessive Exposure to UV of sun, Suppressing Natural Urges, Excessive consumption of alcohol, Excessive sweating , Improper maintenance of Hair and using very less or no hair oil for massaging Head and Scalp.
Ayurveda suggests both topical and internal medicines for the treatment of wet or oily dandruff. The topical medicines are intended to manage dandruff and also provide relief from itching and infection, if any. The internal medicines are intended to detox the blood and also improve immunity, nourish the skin and thereby help in improving the quality of hair.
If dandruff is caused due to psoriasis and eczema, then there are exclusive medicines to combat the infection, detox the body and nourish the skin and hair.
Ayurveda suggests that foods like coconut, Indian gooseberry ( Amla), Raisins etc. help in preventing dandruff.
In addition to these, Ayurveda also suggests various home remedies for effective management of both wet and dry dandruff, like washing your hair with decoction prepared with Neem Leaves or Take powder of Mustard seeds and licorice, make them into paste by adding milk to it and leave it on head for 20min and wash later with water.
Taking Panchkarama detoxification procedures like Nasyam, Raktamokshnam, Shirobasti, Abhyanga Swedanam under the guidance of expert can also play very important role in the management of both the types of dandruff. 
Accumulated hair and dandruff scales can be made returned to the healthy scalp from unclean combs and brushes. This may irritate the scalp and causes flare of dandruff again. Combs and brushes are the tools for the care of your hair; they should be properly made and well cared to accomplish this purpose. Neem wood combs can work wonder but they should also be regularly cleaned and changed every six months. It can be easily deduced that wet dandruff can be effectively managed and treated by undergoing treatment under Ayurvedic system of medicines. 
However, you should avail such treatment under the supervision of an experienced doctor specialised in Ayurvedic medical science.

Dandruff (Oily & Wet) and its Management With Ayurveda 

The metatarsal and tarsal bones form two different types of arches at the bottom of the foot. These are known as the transverse and longitudinal arches. These arches act as springs and help support the body. The arch of a foot influences the person s posture as well. Longitudinal arches can be further categorized as a medial arch, lateral arch, and fundamental longitudinal arch. The amount a person s foot arches, can also determines the type of injuries the person is susceptible to.

Low Arch
A person with minimal foot arch is also said to be flat-footed. Up to 20% of people across the world are flat-footed. Low arches make feet very flexible and also increase the risk of making the foot roll inwards. People with low arched feet have a high risk of heel pain, plantar fasciitis, heel spurs, bunions and arch pain. It can also increase the risk of medial knee problems. Arch support and rearfoot posting can help align the foot and control over-pronation.

Medium Arch
This is an example of a biomechanically efficient foot. It can be described as a defined arch and a moderately flexible foot. The most common foot problems such people are susceptible to are metatarsalgia and heel pain. This is triggered by wearing improper footwear. People with a medium arch in their feet should ensure that they wear footwear that fits them properly. The right footwear for a person with a medium arch has extra cushioning, good support and it absorbs shock well. This can help prevent injuries and align the body properly.

High Arch
A high arch is defined as a well-defined arch that sits higher from the ground than the average foot. This type of an arch makes the foot very rigid and puts extra pressure on the forefoot and rear foot. This can affect up to 20% of the worldwide population. People with high arches have a very little surface area to absorb impact while walking or running. This can make them very susceptible to heel pain, pain in the forefoot and plantar fasciitis. It can also increase the risk of calluses, arch strain, heel pain syndrome, and claw toes. The good news is that it can be treated. Wearing shoes with the right arch support, good cushioning, and metatarsal pads to provide forefoot relief can help disperse the shock and help you prevent injuries.


Arches Of Foot And Its Effect On Body!

Hypothyroidism is a condition in which the thyroid gland is not producing the thyroid hormones adequately. This is a fairly common condition.

What is thyroid gland?

The thyroid gland is a small butterfly-shaped gland located just below Adam s apple. It encircles the windpipe or the trachea. It is about 4 cms in height and weighs about 18 gms. This gland is responsible for the secretion of thyroid hormones. Hormones are chemicals produced by special glands like thyroid, adrenals, ovaries etc. They act as messengers and are carried by the blood to the various target organs.

What are the hormones produced by thyroid gland and what do they do?

The thyroid hormones are of two types   T3 (Tri iodo thyronine) and T4 (Thyroxine). These hormones are mainly responsible for the body s metabolism - a process in which food is converted into energy in the cells. They influence growth and development and regulate various bodily functions which are mentioned below:

Heartbeat
Body temperature
Breathing
Body weight
Metabolism of fat
Menstrual cycles in females
Functioning of Nervous system
Digestion
Burning calories etc.
What is Hypothyroidism?

Inadequate production of hormones by the thyroid gland is termed as hypothyroidism. This is also called Underactive thyroid state. Hypothyroidism can make the body s development to slow down and reduces metabolism rates.

What are the causes of Hypothyroidism?

Hypothyroidism can be caused by a number of factors:

Hashimoto's thyroiditis: This is the commonest cause. This is an autoimmune disorder (normally body s defence system fight against external infections. In autoimmune disorder the defence system attacks the healthy cells of the body by mistake). In Hashimoto s thyroiditis the immune system/defence system produces antibodies that attack the thyroid gland and destroy it.
Iodine deficiency in diet. For the production of thyroid hormones iodine is very important. The body does not produce iodine normally, so it needs to be supplemented from outside. Iodine is mainly present in the food we eat. It is mainly present in shellfish, salt-water fish, eggs, dairy products. If a person does not eat iodine rich foods, he may end up with iodine deficiency leading to hypothyroidism. Currently, this causative factor is on the decline due to government initiative of table salt with iodine.
Surgery: Surgery to remove thyroid gland (for e.g. thyroid cancer treatment, overactive thyroid etc.)
Radiation to the neck (to treat cancer in the neck area): The thyroid gland cells are damaged due to the radiation.
Treatment with radioactive iodine: This treatment is used for managing hyperthyroidism/overactive thyroid, where the thyroid gland produces excessive thyroid hormones. One of the treatment modalities is by radioactive iodine. Sometimes this radiotherapy destroys normal functioning cells which lead to hypothyroidism.
Certain medicines: Certain medicines used to treat heart conditions, cancer, psychiatric conditions etc.   for e.g. amiodarone, lithium, interleukin-2, interferon-alpha.
Pregnancy: Pregnancy (the reason is unclear but it has been noticed that the thyroid may get inflamed after delivery   this is called Postpartum thyroiditis.
Damage to the pituitary gland: Pituitary gland is a gland which is present in the brain. It produces a hormone called TSH (Thyroxine-Stimulating hormone).The TSH tells the thyroid gland how much thyroid hormone it should make. If the levels of thyroid hormone in the blood are low, then the TSH will stimulate the thyroid gland to produce more Thyroid hormone.
Hypothalamus disorders: This is an organ in the brain. This produces a hormone called TRH (Thyrotropin Releasing Hormone) which acts on the Pituitary gland to secrete TSH. So any disorder of Pituitary gland will indirectly effect the production and secretion of Thyroid hormones. These are very rare disorders.
Congenital thyroid defects: Some babies are born with thyroid problems. This is due to the thyroid not being developed normally during pregnancy. Sometimes the thyroid gland does not function normal. This can be identified by screening for thyroid disorders in the first week after delivery. This is usually by a blood test using a small drop of blood from the baby s heel.
What are the different types of hypothyroidism?

One classification is based on whether the defect is with the thyroid gland or not:

Primary hypothyroidism: The problem is in the thyroid gland itself and thus there is reduced production /secretion of thyroid hormones.
Secondary hypothyroidism: Here the problem is with the Pituitary gland or the Hypothalamus. This results in abnormal production of TSH or TRH, which indirectly leads to less production and secretion of thyroid hormones.
Another classification is based on the symptoms and levels of the thyroid hormones and TSH:

Overt hypothyroidism: Here the patient is having the symptoms. Further the T3/T4 are low and TSH is high
Subclinical hypothyroidism: Here patient may or may not have symptoms. The T3/T4 levels are normal but TSH is high. In this situation the patient is at an increased risk of developing overt hypothyroidism in the future especially if he has Thyroid peroxidase antibodies on testing.
Who are at risk of developing Hypothyroidism?

Women have a higher risk of suffering from hypothyroidism than men.
Older people are at increased risk.
People suffering from other autoimmune diseases like Coeliac disease, Type-1 Diabetes Mellitus, Vitiligo, Pernicious anemia, Multiple sclerosis, Rheumatoid arthritis, Addison s disease etc.
People with psychiatric conditions such as bipolar disorder
People with Chromosomal abnormalities like Down syndrome, Turners syndrome also have a high risk of suffering from hypothyroidism.
What are the symptoms of hypothyroidism?

Symptoms vary from person to person. They may also mimic other conditions and hence be difficult to diagnose. Symptoms may also develop very slowly over a span of moths-years. Some of the characteristic symptoms of this disease are:

Depression
Constipation
Hair loss
Dry hair
Dryness of the skin
Tiredness
Body pains
Fluid retention in the body
Irregular menstrual cycle
Increased sensitivity to cold
Reduced heart rate
Increase in size of the thyroid gland   called Goitre. This is due to constant stimulation of the thyroid gland by TSH.
Weight gain
Carpal tunnel syndrome
Hoarse voice
Infertility
Loss of libido/sex drive
Confusion or memory problems especially in the elderly
What are the symptoms to look for in a baby if you suspect hypothyroidism?

Infants suffering from congenital hypothyroidism may show no symptoms or exhibit signs of excessive drowsiness, cold hands, cold feet, constipation, hoarse cry, poor growth or absent growth, poor appetite, bloating of abdomen, puffiness of face, swollen tongue, persistent jaundice.

How to diagnose hypothyroidism?

Blood tests:

TSH: This hormone is made in the pituitary gland and it stimulates the thyroid gland to produce thyroxine. If the thyroxine levels are low in the blood, the pituitary gland produces and secretes more TSH into the blood to act on the thyroid gland to produce more thyroxine. A raised TSH level indicates hypothyroidism. Other tests are not usually necessary unless a rare cause of hypothyroidism.
T4: A low level of thyroxine indicates hypothyroidism.
T3: these levels are generally not needed to diagnose hypothyroidism
Anti-Thyroid peroxidase antibodies (anti-TPO antibodies) or Anti- thyroglobulin antibodies are present in 90-95% of patient with autoimmune thyroiditis.
Other blood tests include Creatinine Kinase, Serum Lipids, Complete blood picture etc.
Ultrasound of the neck is done if the patient presents with a thyroid swelling.
What is the treatment of hypothyroidism?

Overt hypothyroidism is treated by synthetic Thyroxin hormone which should be taken every day on an empty stomach at least 30   45 minutes before breakfast. The treatment is continued for the rest of the patient s life. Regular thyroid function tests are done once every 8 weeks-12 weeks to adjust the dose of the thyroxine in the initial period of diagnosis. Once the thyroxine dose is stabilised, the tests can be done even once a year. This treatment is quite effective.

Sub-clinical hypothyroidism is only treated if the patient is a woman and is contemplating pregnancy, in patients with symptoms or if the TSH is quite high.

What are the side-effects of thyroxine medication?

There are few side effects if any. Most people tolerate these medications quite well. An important consideration before starting medication is to check if the patient has chest pain/angina. These people are started on the least available dose. If these patients are started on a higher dose they notice a worsening of their angina pains.

Side effects mainly occur if the thyroxine dose is high which leads to hyperthyroidism. The symptoms of this could be palpitations 9increased heart beat), weight loss, profuse sweating, anxiety, irritability etc.

There are some tablets which increase with thyroxine tablets. These include carbamazepine, iron supplements, calcium supplements, rifampicin, phenytoin, warfarin etc.

What are the complications of hypothyroidism?

If untreated hypothyroidism can lead to:

heart problems like heart attack due to increased levels of bad cholesterol like LDL, or heart failure due to fluid retention
obesity
infertility
joint pains
depression
A pregnant woman with hypothyroidism is at increased risk of giving birth to a baby with congenital hypothyroidism, also known as cretinism. Further, the woman may have pregnancy related complications like pre-eclampsia, premature delivery, low birth weight baby, anemia, post-partum haemorrhage (bleeding after delivery) etc.
Myxoedema is another complication where the patient has extremely low levels of thyroid hormone. The body temperature drops drastically making the person lose consciousness or go into a coma.
References:

2013 ETA Guideline: Management of Subclinical Hypothyroidism; European Thyroid Association (Nov 2013)
Management of primary hypothyroidism: statement by the British Thyroid Association Executive Committee; British Thyroid Association (2015)
The diagnosis and management of primary hypothyroidism; Royal College of Physicians and others (June 2011)
Suh S, Kim DK; Subclinical Hypothyroidism and Cardiovascular Disease. Endocrinology Metabolism (Seoul). 2015 Aug 4.
UK Guidelines for the Use of Thyroid Function Tests; British Thyroid Association (2006)
Gaitonde DY, Rowley KD, Sweeney LB; Hypothyroidism: an update. American Family Physician. 2012 Aug 1 86(3):244-51.
Bindra A, Braunstein GD; Thyroiditis. American Family Physician. 2006 May 15 73(10):1769-76.
Wilson GR, Curry RW Jr; Subclinical thyroid disease. American Family Physician. 2005 Oct 15 72(8):1517-24.
British National Formulary; NICE Evidence Services (UK access only)
Baumgartner C, Blum MR, Rodondi N; Subclinical hypothyroidism: summary of evidence in 2014. Swiss Medical Weekly. 2014 Dec 23 144:w14058. doi: 10.4414/smw.2014.14058. eCollection 2014.

Know Everything About Hypothyroidism

Corns and calluses are areas of stumpy skin caused by friction or pressure. They usually hurt when you wear shoes or walk.
Calluses generally develop on your feet or hands, and most of the time, don t require treatment.
Corns have a hard or soft inner core. Soft corns are mostly found between the toes, while hard corns form on the top of the toes. Corns that are caused by ill-fitting shoes often reduce on wearing the right shoes.
Causes-
Repeated friction or pressure causes corns and calluses on areas of skin. The pressure leads to the death of the skin, which develops a protective, hard surface. Soft corns develop in a similar fashion. Corns and calluses are not formed due to viruses and are not harmful. They can be formed due to:
Regular usage of any object that puts strain on the hands, such as sports equipment (badminton racquet) or tools (hammer or gardening hoe), usually leads to calluses on the hands.
Pressure from wearing the wrong footwear usually leads to corns and calluses on the feet. Calluses can also form by walking barefoot.
Abnormal structures on the foot, such as hammertoe or bone spurs, can cause calluses and corns.
Repeated pressure from playing certain sports can also cause calluses on the feet.
Symptoms-
Corns and calluses on the feet are easy to spot. A callus is thick, hard and dry, and may appear yellowish or grey in colour. When touched, it will feel bumpy and more insensitive than the skin around it. A hard corn is thick and firm, while soft corns look like an exposed sore. The hard corn may have a grey centre with a light yellow ring around it.
Corns and calluses don t hurt, but it does become painful when you are wearing shoes or walking. Fitting your feet into shoes gets more difficult due to them. Touching or squeezing the corn or callus can also be painful.
Treatment-
Corns and calluses don t require treatment normally, but if they hurt, here s what you can do:
Wearing well-fitting shoes that are roomy with deep and wide toe boxes (the area covering the toe).
Protective paddings, such as moleskin, toe separator, toe sleeves, etc., can alleviate pain.
Soaking the corn or callus in hot water, and then gently wear down the dead skin by using a pumice stone.
Salicylic acid can be used to soften the corn or callus.


All about Calluses and Corns

An often painful condition usually involving the bowel, ovaries or the tissue lining the pelvis, endometriosis is characterized by the abnormal growth of the endometrial tissue beyond the premises of your uterus or your pelvic region. The endometrium, in fact, functions perfectly normal with each menstrual cycle, but because of it being displaced, it cannot exit the body and consequently gets trapped.

Besides causing severe pain and distress, endometriosis can also adversely affect fertility. When the ovaries get involved, certain cysts known as endometriomas tend to develop which often result in the formation of scar tissues and adhesions.

Complications associated with it

Infertility: Impaired fertility is the most common kind of complication arising from endometriosis, with approximately one-third to one-half women having problems with pregnancy. During endometriosis, the fallopian tube gets obstructed, thereby restricting the union of the egg and sperm.
Ovarian cancer: Women with endometriosis are more likely to suffer from ovarian cancer. Moreover, they are also more susceptible to acquiring endometriosis related adenocarcinoma, which is another variant of cancer, but a comparatively rarer phenomenon.
How best to treat it?

Depending upon how severe your symptoms are, endometriosis can be treated via the use of medications or through the advent of surgery.

Pain medications: Certain medications, including pain relievers and anti-inflammatory drugs, are particularly useful in providing relief to painful menstrual cramps.
Hormone therapy: Undergoing hormonal therapy can help ward off or reduce the pain of endometriosis, but it should be kept in mind that it is only a temporary fix and that symptoms might reoccur. Hormonal therapies include:
Hormonal contraceptives
Medroxyprogesterone
Gonadotropin-releasing hormone (Gn-RH) agonists and antagonists
Danazol
Conservative surgery: This can either be done through laparoscopy or, in more extensive cases, through traditional abdominal surgery.
Assisted reproductive techniques: These include in-vitro fertilization, and are sometimes more preferable over conservative surgery.
Hysterectomy: This is usually done in more severe cases of endometriosis whereby ovaries are also removed with uterus and cervix

Complications and Treatment of Endometriosis

A head louse is an insect that lives on the human scalp and feeds on human blood. The female louse lays eggs in the head and makes sure the eggs are attached to the hair shaft. It takes around eight days for the egg to hatch. The louse takes another 11 days to mature into an adult louse.

Causes:
The primary cause of head louse is poor personal hygiene. Other causes due to which a person can be infected by lice are:
1. Using combs and towels that are infested.
2. Coming in contact with another person who has this condition.
3. Sharing the bed with a person who is affected by lice.

Symptoms:
When a person is affected by this condition then the following symptoms are observed:
1. The saliva of the lice causes an allergic reaction in the scalp which leads to constant itching. It can occur in various places such as ears, scalp and the neck. It may not occur initially, but it tends to occur after a few weeks.
2. Constant scratching can lead to formation of small red bumps on the skin. A bacterial infection usually occurs from constant itching.
3. It may lead to symptoms of dandruff in the scalp.
4. Presence of various insects in the scalp.

Prevention of Lice:
Lice can be prevented by using medicated shampoos and conditioners to wash the hair. The shampoos are usually based on a chemical called pyrethrin. This compound is toxic for lice and helps in getting rid of it.

You can also opt for the following lifestyle changes to prevent lice:
1. You should avoid sharing your hairbrush with others.
2. In case you have long hair, tie it in buns or ponytails.
3. Add tea tree oil to your shampoo before using it.
4. Keep the scalp clean to prevent infestations.
5. Avoid sharing pillows and clothes.

Causes, Symptoms and Prevention of Lice

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