The kidneys are the purifiers of the body; they help in removing the waste from the body through the urine. In those suffering from kidney diseases, the function of the kidney is affected, and so their ability to clear out waste from the body is reduced and completely lost gradually. However, waste continues to form, and therefore, such patients have to undergo dialysis, where the blood is purified through an external device.

The frequency and duration of the dialysis would depend on how effectively the kidneys are still functioning and how much waste has been formed from the time of the previous dialysis session. The person s overall body mass index (BMI) and the water weight gained are also considered.

Once it is decided that a person s kidneys are damaged and dialysis is required, the person has to prepare for a long-term process. The following outlines what to expect before, during, and after the dialysis sessions. 

Before the session: 

Since most people prefer to get it done at a dialysis centre, it is preferable to plan for it, three treatments a week on an average, with each session lasting about 4 to 4 hours.

During the session: 

The blood flows through the dialysis device, which acts as an artificial kidney. The sequence of events are as follows:
The Weight is checked
Vital signs, including heart rate, blood pressure, breathing and pulse are checked.
The access areas are washed, and needles are used to connect these areas to the dialysis machine. Anesthesia may be used in the beginning to reduce the pain in this area.
The same access areas are used for each session, and over a period of time, buttonholes are formed which is like a small tunnel.
Though the session would last about 3 to 4 days, normal activities can be done, including reading, working on a laptop, watching television, or even sleeping.
Once the dialysis session is complete, the tube will be removed and a dressing is placed over the site.
After the session

The same site is used each time for the dialysis, so for the first couple of sessions, there could be discomfort. There could also be nausea, diarrhoea, cramping, and headaches.
The treatment needs to be adjusted based on symptoms, so please let the doctor know if you experience any symptoms.

Call the doctor if you are facing the following:

Bleeding from the access site
Inflammatory signs around the site
Persistent fever of over 104 degrees
Numbness or weakness in the arms
Confusion, drowsiness, or cognition problems
Though initially uncomfortable, once you get into the dialysis schedule, you will notice the difference of how cleansed you will feel after each session.

Undergoing Dialysis - What To Expect From It?

Psoriasis is a chronic dermatosis characterised by an unpredictable course of remissionn & relapse. It is an non-infectious skin disaease chracterised by scaly, silvery patches mainly on the scalp and extensior surface of the body. Its exact cause is unkown. In ayurveda, it is closely resembles with ekakushta. The features of ekakushta explains in ayurveda classics resembles with the symptoms of psoriasis. Psoriasis is the challenge for modern science. There is no definite treatment for psoriasis in modern science till today. The drug available in the market use to treat psoriasis are not very effective and have local and systemic effects.

In ayurveda, vata pitta and kapha dosha is the main contributory factor for the disease. Due to vitiation of three dosha, the disease manifest and main line of treatment for psoriasis is panchkarma and internal medicine. It is considering the best approach for skin disorder in ayurveda. A case report of 42-year old male, presented with well demarcated red scaly, silvery patches mainly on both legs, hands, scalp, chest and back with itching, and also nail and joint involvement has been presented in this article.

Etiology of Psoriasis: 

Unknown but many factors have been associated-

Genetic: may be autosomal dominant

Triggers: physical trauma ,infection and drugs.

Biochemical change: like increase level of arachidonic acid and Cgmp.

Immunological factors: helper T cells PLAY A KEY ROLE.

Epidemiology: 

Roughly, 1% of population is affected. Can occur at any age and affected both sex. Most patients as worse in winters.around 7 million people are affected in developed country.

Histopathogenesis:

Increased epidermal cell proliferation.

Retention of nuclei in stratum corneum.

Proliferation of fibroblast.

Dilated and tortous capillary loops.

Shortened epidermal turnover time from normal of 60 to 10 days.

Clinical features: Usually chronic indolent lesions which persist for month. Lesions are mildly papule or plaque.erthematous plaque lesions with characteristic slivery, large, loose scales. The patients of psoriasis may also suffer from depression and low self-esteem.

In a patients with psoriasis always check for nail and joint involvement.

Nail: 10 to 15% of the patients have nail involvement. Pitting, nail plate thickening, subungual debris, discolouration of nail plate and oil spot seen in the nails.

Joints: 10% patients have joint involvement.

Sites: Scalp, pressor points & extensor. Sometimes generalised.

Chronic recurrent psoriasis is difficult to treat. Modern science treat with PUVA and corticosteroids but these drugs having local and systemic side effects like liver and kidney failure etc. So, it is the time to find out the effective and safe treatment for Psoriasis. Medicines which are used in ayurveda are safe and practised since many years. A huge numbers of drugs are prescribed in ayurveda for the treatment of kushta.

Case details: A 42-year old male patient, hindu brahman by religion, presented on 10 april 2016 with well demarcated raised red scaly, silvery patches on chest, back and both legs and hands. He complained of itching all over the body and on scraping, white powder like substances fall down and leaves a bleedy surface. On history, patients had complaints since 20 years and diagnosis of psoriasis by allopathic physician. Since 20 years he has been taking allopathy and homoepathy patients from various practioners of U.P and delhi. He is brahman and lives in well known temple of delhi and visit homes of peoples for religious ceremony. He is afraid that if the disease is spreading continously, then he is unable to work as priest because people neglect him due to disease. The disease is spreading all over his body and also involves nail and joint. Destruction of nail plates of hand and legs was also developed. For this, patients took allopathic treatment for such a long time but do not get relief.

The patients visit our clinic for the first time. He told use that his problem not solves since 20 years and spreading continuously. So, he is unable to trust us. So, we first give him counselling because reassurance and emotional support are invaluable. Physical and mental rest enhance the effects of the treatment. It is also important to tell him that the disease is not contagious and is benign.

SYMPTOMS OF THE PATIENTS :

Itching all over body

Silvery patches, especially, on legs ,chest ,back but now spreading in his hand and scalp.

Destruction on nail plates

Swelling and pain in left middle fingers and flexor deformity in proximal interphalangeal joint

Swelling in right middle metatarso phangeal joint and pain

Some blood test of the patients were done like CBC, LFT, KFT, SR, URIC ACID to assess outcome.

His general health was good and both physical and all blood test were within the normal limts.we advise patients for panchkarma and oral medication but patients refuse for panchkarma so we start his oral or internal medication. 

Investigation Done :

CBC(Complete Blood Count)

LFT(Liver Function Test)

KFT(Kidney function Test)

Sr. Uric Acid

Investigation was done to rule out any other pathology. Investigation were within normal limit.

Internal Medication :

Medication are given into two phase. In First Phase, we are given panchsakara churna - one spoon two times daily for anulomana and pachan, Panchnimba churna- one spoon two times daily with luke water, panchtikta ghrita gugulu - two tab two times daily, and one oil for local application containing jyotishmati,bakuchi, and chakramad for five days. We told patient to apply the oil firstly only on legs for 5 days. Patient taking the same for 5 days and come on 5th day, we see the fabulous result, the rashes which are developed within 4 to 5 months just disappear and other rashes are also subsiding.

After 5 days, in second phase, we continue the same treatment and also added haridra khand - one spoon two times daily, gugulu tiktam kashaya - three spoon two times daily (one hour before food for 15 days). The patient came back on 20th day, with great result, the rashes were almost 60 % subsiding and pain and swelling in finger and ankle also reduce to great extent. Now, patient is not taking any pain killer for pain. Patient also get improvement in nails of legs.

We prescribe the same medicine for one month that time and ask him to do some physiotherapy additional for finger deformity. After that patient came with 70 to 75 % relief in symptoms and patients also tell that during the treatment, he will not develop any additional rashes.

During the treatment, we also told the patients to follow some dietary changes and live according to the rules of Ayurveda.

Result: Psoriasis is a disease with unkown etiology and triggered by many factors. In modern science, treatment of psoriasis is a challenge. They do not have any safe and proper medicine for psoriasis. But, ayurveda treatment gives satisfactory results as well as the quality life to the patients. Ayurveda removes toxin out of the body and corrects the formation of aama. Ayurveda gives the prevention as well as the treatment. So, by following the dietary and lifestyle change we prevent the reoccurrence of the disease.

Ayurveda For Psoriasis 

Vitiligo is a disease that causes the loss of skin shading and colour in patches. The degree and rate of colour loss from vitiligo cannot be determined. It can influence any part of the skin on your body. It might also influence one s hair, inside of the mouth and even the eyes. 


Ordinarily, the shade of one s hair, skin and eyes is measured by melanin. Vitiligo happens when the cells that create melanin quit working or die. Vitiligo influences individuals of all skin types; however, it might be more common in individuals with a darker skin. The condition is not contagious or life threatening.


Numerous medicines may be used to restore the skin shading or level out the skin tone. A few medicines might have some serious side effects on some people. So your specialist may propose that you first try to improve your skin by applying self-tanning products or make-up. Here are some of the top ways to treat vitiligo:


Medicines 
Creams that control aggravation: A topical corticosteroid may cause the skin to return to its natural shade (repigment), especially if you begin utilising it right at the start of the disease. 
A type of vitamin D: Topical calcipotriene (Dovonex) is a cream that can be used with corticosteroids. Possible reactions include dry skin, rash and itching. 
Medicines that influence the immune system: Treatments containing tacrolimus or pimecrolimus (calcineurin inhibitors) might be compelling for individuals with little ranges of depigmentation, particularly on the face and neck.
Therapies
Light therapy: This uses a narrow band of UVB light. You may get treatment in a specialist s office up to three times each week. 
Laser treatment: This technique brings the shading back to the patches of light skin by treating them with an excimer laser, which utilises a particular wavelength of UVB light. 
Depigmentation: A solution with monobenzone is connected to the unaffected zones of the skin. This progressively lightens the skin so that it blends with the affected areas.
Surgery
Skin grafting: In this system, your specialist removes little segments of your ordinary, pigmented skin and joins them to regions that have lost colour. 
Rankle grafting: In this system, your specialist makes blisters on your pigmented skin with suction. He or she then removes the highest points of the blisters and transplants them to a range of stained skin. 
Micropigmentation: In this method, your specialist utilises an extraordinary surgical instrument to embed colour into your skin. 
Other treatments
Shield your skin from the sun and UV light. In case that you have vitiligo, especially in case you have light skin, use a wide range of waterproof sunscreen with an SPF of not less than 30. 
Abstain from tattoos that are not associated with treating your vitiligo. 
Make-up concealers may enhance the appearance of the skin and help you feel better about yourself, particularly if your vitiligo patches are on uncovered skin.


4 Top Ways You Get Vitiligo Treated

Most women get accustomed to and know the pattern of their menstrual cramps. So, when something out of this pattern happens, they know it is not normal. There are various reasons for pelvic pains not associated with menses. The following are some common causes and it is always advisable to seek medical help, which will help in right diagnosis, early intervention and reduced complications.

1. Ectopic pregnancy: If a fertilized egg has planted itself outside of the uterus or the womb, it is referred to as ectopic pregnancy. The fallopian tube is the most common place for ectopic pregnancies. There is associated pelvic pain, which is unilateral, sharp, and gradually worsens. There would also be associated bleeding which is darker than the regular bleeding. This again should be confirmed on an ultrasound and then the ectopic pregnancy removed.

2. Endometriosis: The inner thick layer of the uterus could be infected leading to severe pelvic pain, especially in women who are in their 30s, who are not able to conceive. This is often ignored, considering it as normal and it continues to progress and could even result in infertility.

3. Pelvic inflammatory disease (PID): Infections like gonorrhea or chlamydia travel up from the genital tract and reach the uterus. Infection along the entire reproductive tract can lead to severe pain. In most cases, if identified early, a course of antibiotics is all that is required to control this infection. Left untreated, it can even cause infertility.

4. Ovarian cysts: Another common cause of pelvic pain, they are quite often asymptomatic, except for occasional pelvic pain. They also disappear with no medical intervention. Sometimes, however, it may get infected or rupture and can cause severe pain. This can is an indication for medical intervention. Ultrasound may be required for diagnosis and treatment may include surgical removal.

5. Uterine fibroids: The fibroids are noncancerous growths, which can grow to a considerable size and fall short of blood supply. This may cause them to burst, which can be very painful.

6. Miscarriage: Most miscarriages occur before 13 weeks of pregnancy and the usual accompanying symptoms of bleeding are severe pelvic cramps. If you are pregnant and notice bleeding with pelvic pain, it is advisable to immediately visit a doctor. Diagnosis may require an ultrasound to confirm the miscarriage. If medications are not sufficient to remove the remnants, then a dilation and curettage may be required.

7. Non-gynecological causes: Appendicitis, urinary tract infections, hernia, lower spinal problems, irritable bowel syndrome can also cause pelvic pain. The cause should be identified and managed accordingly.

Unfortunately, most women continue to experience and suffer with chronic pelvic pain without a cause identified. A thorough internal examination can help identify the problem and treat the issue.

How to Deal with Pelvic Pain other than Menstrual Cramps

Nasal allergies are very common and as a result, not taken seriously by most people. In most cases you patiently withstand the coughing and sneezing, which might last for an entire day and in the process might inadvertently damage your health by choosing to ignore it for the time being. Here are some of the commonly experienced nasal allergies and what you should do to get relief from them.

1. Runny or stuffy nose: The best option is to just avoid allergy triggers. For example, if pollen is your allergen, then avoid going out during the times pollen count when it is reported to be high. Or, if animals make you sneeze, then make sure to have your hands washed and clothes changed after playing with them. Do not over use decongestant sprays at all. If these symptoms persist for more than half a week, then it's time to seek your doctor's advice.
1. Uncontrollable Sneezing: Again, the best option is to avoid; but in many cases, it becomes difficult for you to avoid the allergen. In those cases, try antihistamine. If that doesn't work, then you can also go for a nasal steroid spray, but again, make sure to not overuse it.
2. Post Nasal Drip: Usually, you unconsciously swallow your mucus. But, if the mucus quantity increases, it becomes thicker and results in post-nasal drip. It isn't much common, but you can practically feel the mucus dripping into your throat from the back of the nose. It can result in a lumpy feeling in the throat and can cause irritation. You can try drinking more fluids and using a nasal spray to reduce the mucus quantity. If that doesn't work, then it's time to seek advice from your doctor.
3. Eyes that itch: Watery eyes that itch are annoying companions of nose allergy and though they might not be a serious hazard for the eyes, you cannot ignore them. Try wearing sunglasses when you go out into a reportedly high-pollen-count weather. It might be a better option to forego contact lenses; they can escalate the entire eye-itching problem. If it becomes too itchy, you can place a cold washcloth over your eyes.

Testing an Allergy
Allergy testing is commonly done by by skin prick test, in order to diagnose the allergens. Once, the allergens are diagnosed, immunotherapy can be started, which will help in improving the symptoms of and in many cases, it provides complete cure.

Allergic Issues of the Nose

Hiatal hernia takes place when the upper portion of the stomach pushes itself through an opening in the diaphragm, into the chest cavity. The diaphragm is a wall of thin muscles, which separates the chest cavity and the abdomen. In most cases, a small hiatal hernia doesn't cause problems and you may never know you have a hiatal hernia unless your doctor discovers it when checking for another condition.

But a large hiatal hernia can allow food and acid to back up into your oesophagus, leading to heartburn. Self-care measures or medications can usually relieve these symptoms, although a very large hiatal hernia sometimes requires surgery.

Causes

Hiatal hernia is primarily or most commonly caused due to the increase in pressure in the abdominal cavity. Sometimes, a lot of pressure may be felt around the stomach accompanied by coughing, vomiting, strain during bowel movements. For people born with an abnormal hiatus, the chance of getting hiatal hernia is more.

The two common types of hiatal hernia are:

 Sliding hiatal hernia, which occurs during the sliding out of the stomach and oesophagus into and out of the chest through the hiatus. This type of hiatal hernia is less intense and has no symptoms.
 Fixed hiatal hernia or paraoesophageal hernia is an uncommon type of hernia where a part of the stomach pushes through the diaphragm and stays there.

Symptoms

Usually, no symptoms are experienced during hiatal hernia. Some symptoms are experienced that happen due to stomach acids, bile or air, which enters the oesophagus. Some common symptoms include:

 Heartburns which become worse when a person lies down
 Chest pain, better called epigastric pain
 Problem in swallowing food
 Belching

Tests for diagnosis

Several tests can be carried out for the diagnosis of hiatal hernia. They include:

 Barium x-ray, where a person is made to drink a liquid filled with barium before the x-ray. The x-ray provides a clear image of the upper digestive tract region and the location of the stomach can be seen. If it is protruded out, hiatal hernia is signified.
 Endoscopy is another test for detection of hiatal hernia. A thin tube slides down the throat, which reaches up to the oesophagus and stomach. This will determine whether the stomach is pushing through the diaphragm or not.

Treatment

Medicines, which are used to cure a hiatal hernia may include antacids for neutralizing stomach acid, h2 receptor blockers to lower acid production and proton pump inhibitors. Sometimes fundoplication surgery is required for the treatment of hiatal hernia, although it is rare. Some common surgical techniques are rebuilding of oesophageal muscles or a surgery to put the stomach back in its actual place. Laparoscopic surgery methods are used. Hiatal hernia may reoccur even after surgery; so general precautions should be taken. You should:

 Exercise regularly and maintain a healthy weight
 Avoid lifting heavy objects and ask for help
 Avoid any kind of strain on the abdominal muscles

Hiatal hernia is a disorder, which is more common among people over the age of fifty. Necessary precautions and treatment should be adopted in case of hiatal hernia.


All About Hiatal Hernia

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