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 

Myth: COPD is an incurable chronic lung disease mainly affecting the aged people (above 60 years).
Fact: There is no denying the fact that COPD is indeed a chronic disorder that severely affects the lungs and its functioning. However, with timely diagnosis and treatment, the condition and the deleterious consequences can be managed and controlled significantly. Since COPD triggers breathing problems (the airflow from the lungs gets obstructed), the use of bronchodilators, oxygen therapy or corticosteroids can be highly beneficial. Though COPD is rare among young adults, the condition can affect people in their late 30's or early 40's as well.

Myth: COPD only affects people who smoke.
Fact: Smoking is one of the triggers for COPD, but the condition can also affect people who have never smoked in their lifetime. Factors such as neonatal chronic lung disease or prolonged exposure to substances that cause lung irritation and damage (toxic industrial fumes and chemicals) can play a pivotal role in triggering COPD. COPD can also be a genetic predisposition.

Myth: People with COPD should avoid exercise and physical activities.



Fact: Mild to moderate exercise (especially breathing exercise) are indeed helpful and go a long way in the effective management of COPD. Exercising regularly (for 20-30 minutes or as the doctor recommended) help to lower the blood pressure and improve the circulation that provides fruitful results for people with breathing problems. However, doctors do advise people with shortness of breath to avoid strenuous exercise.

Myth: COPD only affects the lungs.
Fact: With time and left unmanaged and untreated, COPD acts as a catalyst making a person more susceptible to heart ailments. In some cases, the condition can also trigger depression and anxiety.

Myth: In the case of COPD, giving up on smoking will not produce any positive results.
Fact: Giving up on smoking may not help to reverse the damage that has already been caused by COPD. However, quitting smoking along with proper medications and lifestyle changes does help to control the condition better. In some instances, there were also significant improvements in the associated symptoms (such as shortness of breath, fatigue, wheezing, a chronic cough).

Myth: COPD is another name for Asthma.
Fact: Many people confuse COPD with Asthma. Though some symptoms may appear identical (such as wheezing, shortness of breath), the conditions are different and so are their treatments. In case you have a concern or query you can always consult an expert & get answers to your questions.

COPD - Are You Aware Of These Myths & Facts?

Infertility is a condition wherein a woman does not get pregnant in spite of having unprotected intercourse over a period of a year or even more. An abnormal menstrual cycle that is either too short or too long, irregular or even scanty can be an indication of a lack of ovulation, which in turn, is another factor behind female infertility.

Causes

Ovulation disorders are characterized by either a lack of ovulation or irregular and infrequent ovulation. These are a major cause of infertility. This may be due to defects in the regulation of the reproductive hormones by the pituitary gland or the hypothalamus (brain center responsible for producing some of the most essential hormones required by the body). Malfunctioning of the ovary is another cause in itself. Polycystic Ovarian Syndrome, premature failure of the ovaries (a condition wherein a woman s ovaries fail to function properly even before she is 40 years old), hypothalamic dysfunction (a dysfunction of the hypothalamus) and excessive production of prolactin (a hormone that stimulates milk production among women after childbirth) by the pituitary gland are some of the factors responsible for the occurrence of such a disorder.

Damaged fallopian tubes do not allow the sperms to fuse properly with the egg. They might also prevent the fertilized egg from entering into the uterus. This condition may be caused due to pelvic inflammatory diseases (a group of infections of the reproductive organs in women), an infection in the fallopian tubes or the uterus caused due to various Sexually Transmitted Diseases, any abdominal surgery or surgery of the pelvic region and pelvic tuberculosis.

Endometriosis, wherein the tissue that usually grows in the uterus, starts growing outside it, is another factor responsible for infertility.

Several cervical or uterine disorders, such as tumors, inflammation within the uterus, uterine abnormalities, a cervical narrowing or the inability of the cervix to produce mucous for the sperm to travel to the uterus, are likely to impact fertility by obstructing implantation or enhancing the chances of miscarriage.

Treatments

Fertility drugs can be used to regulate and induce ovulation. But they carry with them certain risks and therefore you should consult your physician prior to consumption. Few examples of these drugs are Clomiphene Citrate, Gonadotropins, Metformin, Letrozole and Bromocriptine.

Surgical procedures can be recommended to correct reproductive abnormalities and restore fertility. A laparoscopic surgery or a tubal ligation reversal surgery (a surgery that unites one s fallopian tubes again in order to enable the woman to have a baby) can be advised by the doctor.

Reproductive assistance by Intrauterine insemination (a process that involves putting sperms inside a woman s uterus in order to help her conceive) and Assisted reproductive technology (consisting of IVF and surrogacy).

Infertility - 4 Causes Behind It

A lot of things can be done to cope with the initial stages of dementia. A person goes through a wide range of emotions such as fear, denial, frustration, and anger, post the diagnosis. Here is a list of tips that will help a patient with dementia to cope better:

Physical health: For a dementia patient, it is very important to take care of one s health. A good diet along with regular exercise and adequate rest is a prerequisite to manage this disorder.
Regular check-ups: Regular medical check-ups with the doctor are necessary in this condition. Depression and other mental health problems should be discussed with a professional.
Quit alcohol: Alcohol might give momentary pleasure from the misery, but it has long-standing implications. It reacts with the medicine and creates additional health and memory-related complications.
Allocate time for difficult tasks: With time, it can become difficult to perform even the simplest of tasks. The patient should accordingly schedule the time to perform the tasks which may be difficult to carry out. Adequate breaks should be taken while performing a task to avoid getting fatigued.
Redefine work: If a patient is suffering from dementia is still working, it should be ensured that the work is more manageable from a desk. Planning an early retirement may be a good idea in order to cope with dementia.
Be organised: Keeping track of things can get difficult with time. It, therefore, makes sense to organise all belongings systematically. Putting labels on doors and drawers also help.
Continue pursuing your hobbies: Amidst the difficulty and the depression, it is a good idea to continue doing things that are fun. While such activities might require some assistance from the doctor and family members, this helps the patient to be cheerful and healthy.
Maintain notes: Since dementia is involved with forgetfulness, it makes sense to maintain a diary and keep records of phone numbers, people, appointments, etc.
Communication channel: Maintaining a direct communication channel with family, friends, and relatives is a good idea. Sharing feelings will go a long way in maintaining relations with loved ones.
Support group: Joining a dementia support group can be highly beneficial for the patient. It will not only give the patient company but also make sure that the patient gets a lot of useful information about the disorder. It also helps in keeping the morale up.
Getting ready for the future: Things need to be meticulously planned well in advance to ensure that when the disease progresses, the patient has enough people to look after him. Things such as medical arrangements, financial assets, and property details should be carefully handed over as per the patient's wish. This will ensure a smooth run of the patients  life when they can no longer take care of themselves.

Dementia - Easy Tips To Help You Cope With It!

Every smoker knows smoking is not good, yet the addiction stays. This addiction can lead to a variety of problems that can damage their body in  at times, irreparable ways. The tar in cigarettes is particularly damaging. It can lead to reduction in oxygen consumption and replenishment in the body and makes open or more susceptible to diseases such as emphysema and bronchitis. However the biggest killer is 'nicotine. There are ways to offset nicotine intake.

Adopt these methods to detox your body of nicotine.
 
1) Drink lots of water -  Having a lot of water helps. Lime water, chamomile or green tea help a lot in flushing out the nicotine that has accumulated your body for over the years.

2) Take diet rich in nutrients and fibres - Nicotine addiction and if you quit, smoking withdrawal may lead to unbalanced diet and weight gain. So, ensure that you consume enough fibre for regular bowel movement to clean out your system. Berries, grapes, mangoes and a variety of antioxidants are a must have.

3) Avoid these foods - There are certain foods you should consider avoiding. For instance, alcohol. Also, avoid soda, caffeine and fried foods as well.

4) Exercise - Strengthen the capacity of your lungs through deep breathing and other cardio-strength training exercises.

5) Make 'No Smoke' a Goal - The only long term help in detoxifying your body from nicotine is to remain smoke free. While your determination plays the most important role here, some people can leave it without many hassles, while others witness severe withdrawal symptoms. You can also opt for a nicotine patch or gum to help you with it.

If you have any further questions on issues related to smoking or other general health queries, click on 'consult.

From Lybrate: If you found this tip useful, please thank the doctor by clicking on the heart icon below. Also, spread good health by sharing this tip with your loved ones over WhatsApp, Facebook and other media.

Can't Stop Smoking? Atleast Follow This Advice.

A migraine often causes throbbing pain at one side of the head accompanied by sensitivity to sound and light, nausea and vomiting. The pain can last from a few hours to few days. Some warning signs of the pain take over include tingling of the leg or face, flashes of light and blind spots. Medication can help in avoiding the pain or manage it considerably.

Diagnosis:
Detection of a migraine is fairly easy for a medical professional. If a patient has a family history of a migraine, a doctor can prescribe the following to lock in on the diagnosis:

Blood tests: Through blood tests, a doctor tries to understand any possible problems in the blood vessels, spinal cord or presence of other toxins in the system
Magnetic Resonance Imaging: Better known as MRI, this is a process of capturing the detailed image of the blood vessels and the brain. It readily detects any possible problems related to a migraine.
Computerized tomography: More commonly known as CT scan, this is a process of capturing an image through a line of x-rays to detect any possible problems related to a migraine.
Lumbar puncture: This test is prescribed in extreme cases when a doctor suspects that there is a possible chance of bleeding in the brain.
What are the treatment options available?
There are two kinds of medications available- preventive medication and pain relieving medication. The treatment strategy is decided based on the frequency of the headaches and other health factors.



Some pain reliever medication includes triptan, ergots, opioid, glucocorticoids, anti-nausea medications etc. These medicines constrict the blood vessels and block the pathways of the pain in the brain cells. While some medicines are required to be consumed immediately after the symptoms starts, some should be taken regularly to avoid the pain in the first place. These pain relievers have side effects and should be consumed after prior discussion with a doctor.



Preventive medication, on the other hand, is only suggested by a doctor when a patient suffers from a migraine twice or more in a month, the pain lasts for more than 12 hours and the pain relievers do not work. Some of the common group of medicines that are suggested for these set of patients include cardiovascular drugs, anti-seizure drugs, anti-depressants etc.

Alternative medicine approach:
Alternative medicines are often witnessed to fetch positive results for migraine patients:

Acupuncture: this form of treatment involves inserting thin needles into the skin at various points to give relief from pain
Cognitive behavioral therapy: This is a form of treatment which focuses on perceiving pain with behavioral changes.
Biofeedback: This is a relaxation technique that teaches to control physical responses such as pain, stress, muscle contraction etc.
In case you have a concern or query you can always consult an expert & get answers to your questions!

Migraine - Treatment Options Available!

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