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 

Hunner's ulcers, simply put are painful ulcers in your urinary bladder. These ulcers are inextricably linked to another disorder called the painful bladder syndrome or intestinal cystitis. They occur in 10 to 15 percent of people with interstitia cystitis. These, in fact, are red patches or lesions on the bladder wall which can stiffen tissue and cause reduced bladder capacity. Hunner s ulcers bleed, ooze pus and can be of different sizes. The ulcers in the bladder can be extremely painful and uncomfortable.

These are called Hunner s ulcers because they were first described by Dr. Guy LeRoy Hunner, a Johns Hopkins gynecologist, in 1915. Since Hunner s ulcers are seen only in people with intestinal cystitis, it s important to know more about this painful life-altering bladder disorder before we can even understand how to deal with them.

Interstitial cystitis (IC)
IC is also called painful bladder syndrome. Another important thing to know about IC is that it strikes more women than men. IC is a chronic disorder and there s no cure for it. It causes recurring bouts of pain and pressure in the urinary bladder and the pelvic area. This is often accompanied by an urgent and frequent need to urinate. Sufferers may have to rush to the  loo  as much as 40, 50, or 60 times a day.

Diagnosis
Hunner's ulcers can only be accurately diagnosed by doing a cytoscopy which involves inserting a fibre-optic tube through the urethra to look at the bladder wall closely. During this procedure, a tissue sample from the bladder wall is usually also taken to rule out bladder cancer. Cytoscopy is usually done with hydrodistention under local anesthesia. This involves filling the bladder with a liquid for stretching it to provide a closer view of the bladder wall. Usually, a urologist performs this surgery along with a gynaecologist. IC and also Hunner s ulcers are both a diagnosis of exclusion. This means that they re diagnosed only after a number of other conditions have been ruled out.

Hence, the urologist will first take your thorough medical history, followed by a physical exam and a pelvic exam for women patients and perform tests for ruling out infection, and other disorders like bladder stones and cancer, kidney disease, multiple sclerosis, endometriosis, sexually transmitted diseases amongst others. Only after these tests are inconclusive or uncertain and if there is blood in urine, will the urologist go for cystoscopy.

Treatment
There's no cure for IC, but Hunner s ulcers can be cured by burning them off the bladder wall. Called fulguration, the process uses electricity or laser to burn the ulcers on the bladder wall. Resection is also used in which skin from around the Hunner s ulcer is cut for removing both the ulcer and the inflamed tissue around it. The problem is that ulcers may recur in the same location.
So, managing IC becomes critical. Your doctor can try to treat the patient with one treatment or with a combination of treatment depending on the condition of the patient.

Pain medicines are the first line of treatment to manage Hunner s ulcers and IC both, and many patients do go in for this. Patients also find relief by modifying their diet to remove foods and drinks like caffeinated beverages- tea, coffee, colas etc. Sodas, artificial sugars and fruit juices, especially Cranberry juice can trigger intense pain and discomfort, so these are usually contraindicated. Another important aspect is patient education about normal bladder function and tips on self-care and behavioural modifications like stress control to manage Hunner s ulcers.

Hunner's Ulcer In Urinary Bladder - How They Can Be Treated?

In modern day societies of intense stress and work pressure, the average diet mostly comprises of street foods, packaged fast foods and processed foods. Such stress and overexposure to a lot of toxins (present in the processed food, fast foods, and street foods) disable the liver from performing its primary function of cleansing the toxic materials through the skin, the respiratory and the digestive system. Besides, this overexposure to toxins also disrupts bile formation, which hinders the absorption of necessary nutrients, resulting in a severe disruption in health. Also, liver is responsible for the proper functioning of the eyes, the brain, the kidneys and the joints in the body. Thereby, it is necessary to include these 7 foods in your diet which help to detoxify your liver from the excessive toxins and allow it to function properly.

    Avocado: Avocados contain a rich amount of the antioxidant glutathione, which helps the liver to fight against the toxins.
    Garlic: Garlic contains a rich amount of selenium and allicin, which helps to cleanse the liver. A little amount of garlic helps in the activating liver enzymes which in turn helps to eliminate the toxins from the body.
    Green tea: Green tea contains a rich amount of the plant antioxidant known as Catechin, which help the liver to function properly. It also helps to protect the liver from the toxins.
    Beets and Carrots: Beets and carrots contain a rich amount of beta - carotenes and plant flavonoids which help to regulate the overall function of the liver.
    Turmeric: A little amount of turmeric in your daily meal helps in the cleansing the liver by helping the enzymes to get rid of the toxic carcinogens.
    Green Vegetables: Green Vegetables like spinach, bitter gourd and chicory contains a rich amount of detoxifying components, which helps in the neutralization of heavy metals which in turn regulates the cleansing ability of the liver. Green vegetables also help in the simulation of the flow of bile.
    Grape Fruit: Grape fruit contains a rich amount of vitamin C and antioxidants which initiates the cleansing process of the liver. Grape fruit also help in the formation of enzymes that destroys toxins like carcinogens.

Cleanse Your Liver - 7 Natural Foods that Will Help You 

Psoriasis is the condition in which the infected skin cells multiply 10 times faster than the normal rate. During this disease, the normal skin tends to get covered by a layer of dead skin cells, not allowing the skin to breathe. People who suffer from psoriasis face an increased likelihood of contracting other serious medical conditions such as cardiovascular diseases, diabetes, and psoriatic arthritis.

Psoriasis can erupt just about anywhere on the body, but it most often occurs on the scalp, chest, back, elbows, knuckles, and knees. If you have a mild case, the patches may hardly be noticeable. The worst cases produce unsightly patches almost everywhere.

Psoriasis can also affect fingernails and toenails, making them appear pitted and discolored. It can even cause significant joint pain, a condition known as psoriatic arthritis. 

Most people who develop psoriasis are initially diagnosed in their teens, twenties, or thirties. The disease follows a very unpredictable course. That first flare-up may also be the last. Or it may signal the start of a lifetime of flare-ups that come and go for no apparent reason. Fortunately, when the lesions disappear, they leave no scars. 

Here's a list of following unsafe health conditions created by psoriasis:

Cancer: People experiencing psoriasis are subjected to an increased risk of contracting certain cancers like lymphoma. A study discovered that people diagnosed with psoriasis have an increased likelihood of 40% to contract cancer than the general population. The reason for this particular risk hasn't been yet understood.
Kidney disease: According to a 2013 study, published in the British Medical journal people with psoriasis have an increased risk of encountering kidney disorders. Severe and mild psoriasis increases the likelihood of kidney diseases by 58% and 36% respectively.
Obesity: People suffering from mild psoriasis are 30% likelier to be obese than those who are not. For people diagnosed with severe psoriasis the chances increase by 80%.
Diabetes and high cholesterol: High levels of triglycerides, total cholesterol and lipoprotein are present in patients with psoriasis, and these patients are 28% likelier to have high cholesterol compared to the general masses. According to a recent study, people with the condition have a 46% increased chance of suffering from Type 2 diabetes.
Peptic ulcers and mood disorders: In some cases, peptic ulcers are also linked with psoriasis. The reason for this is attributed to inflammation. Psoriasis also leads to mood disorders like depression due to the pain and anxiety arising from the condition.

Psoriasis: Vulnerability to Health Conditions

Hearing has a deep impact on your life. It determines the kind of life you are going to lead. It has been found by various studies and surveys that hearing aids drastically improve the quality of life you lead. It is the much needed relief to a life, burdened by the stress and strains of living with hearing impairment. The hearing aids are not just instruments. This is a way to live a life of dignity. According to the Evaluation of the Social and Economic Costs of Hearing Impairment report, hearing loss leads to socio and economic stress in ones  life in major continents like Europe, Australia and the United States.

A research conducted by the National Council on Aging found that over 2,000 people living with hearing impairment or loss experienced positive changes in their respective lives after using hearing aids. They experienced improvements in social, emotional, psychological and physical spheres of life. Furthermore, a US study claims that nine in ten people using hearing aid say that their life has changed for the better after using the aids. It can also be said that hearing aid users lead a better life than non-users of these aids.

How these aids better your life?
Hearing aids gift you a life of expressions and dignity. They can connect you to the rest of the world and empower you to maintain your individualism. You are empowered to make your point in front of others and understand their perspectives too. Here s what a hearing aid can do for you:

Users of hearing aids have a better life as they have improved cognitive functioning. The family members claim that the users of these aids become more interactive. They are lesser of an introvert than the non-users.

It improves the social life of user. He or she can participate in group activities and their family and other ties or relationships go smooth. There is no communication gap.
Hearing aids build up your confidence. You regain your lost dignity and faith on your abilities. Hearing loss kicks you to a life of loneliness, alienation and leaves you with low confidence levels.
It helps you in having better psychological functioning. It keeps you away from psychological problems like depression, personality disorders and over-all absurd behavioural changes.
It improves the understanding in closer or personal relationships. The warmth in a relationship is regained or bettered with effective communication.

Hearing Aids - How Can They Improve Quality of Life?

So your folks have always been advising, Early to bed, early to rise, makes a person healthy, wealthy and wise? But, it is so not you. You realise that waking up early has its perks but cannot bring yourself to do it? You must have categorised yourself as nocturnal and left things at that.

Fact is, getting up early morning not only makes you more productive it also makes you less stressful. It is better to start your day on a calm note than rushing to get ready and leave for work. Give your body time to get out of sleep before you begin your daily grind. 

1) Sleep is first: Deadline is an excuse. Make it a point to sleep at an assigned hour and waking up at a particular time.
2) Break the cycle: You sleep late, you wake up late and the cycle continues. Break this by forcing yourself to sleep at a particular time. Use simple ways such as having a warm glass of milk before bed, exercising, etc to make yourself fall asleep.
3) Be patient: It is ok to fail. The trick is to keep trying. Your body is used to a certain sleeping pattern and it will take a few days before it can accept a new one.
4) Start small: Take baby steps. On the first day, sleep 15 minutes earlier than your regular time and wake up 15 minutes earlier. Increment it till you reach your goal time. 

Struggling to become a morning person?   Here are 4 tips to ditch your  Snooze  button.

Don't wait any longer, manage your Yaws online with a Lybrate doctor today

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