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Discussions on 8th february 2017

Dr.Anitha:
PATIENT : 34 YEAR'S OLD FEMALE
C/O PRIMARY INFERTILITY
MARITAL LIFE : 4 YEAR'S
History:
Two years ago she had white discharge (purulent)
Given ayurveda TX for a month
and got relief from the condition.

USG:
PCOD  rt ovary
HSG:
Left tube removed due to previous ectopic (tubal) pregnancy.
Right tube blocked with hydrosalphingitis .

Medical Hx:
Underwent medication for hydrosalphingitis ..after 6 month's HSG  shown patent right tube.
Still she is under going medication
For infertility..
Tx
pushpadhanwa ras
Shatavari
Shiva gutika
Ashokarista
Bright yoga Raj guggulu..

Etc....
But still she is not getting any result...
Allopathic  doctors advising them for IVF
But they are not interested.
Still wanted to continue the Ayu medication...
Any suggestions...for mor e TX options ...

yeligeti swetha:
Dr.Anitha u will start shodhana therapy to the patient.intially u give yoga vasthi pattern with suitable kashayas..And yoni prakshalana.

Dr.kamal:
Swati madam...

Kaishora guggulu
Manjistadhi kashayam

External...

Eladi or yastimadhu taila application

Nalpamaradhi or eladhi soap

Avoid inner wear.. And tight dressing.. Night time any loose wears like lungi etc...

Avoid curd brinjal pickles sour items nonveg...

vijayalakshmi:
From Dr.ganesh
what about H/o husband and do a C&s of vaginal smear and semen
If possitive then treat that with proper sapthadhatu yukta yogaraja guggulu.
And advice proper ratricharya. and if ratricharya is defective advice 20 ml of drakshasava.

Vinaya Ballakur:
Mam what is saptadhatuyukta yograj guggulu?
Drakshasava for improper ratricharya. Please can you explain? Thanks🙏

Pavani Bingi:
S...we do....Stem extract of Cissus can b taken in the form of tablet or capsule with 500 mg dosage for 2 months as adjuvant for healing bone realated issues....

Payal K:
Dr Anitha...I would suggest basti upakrama yoga basti for her with dashmoolerandadi niruha and phalagruta + shatavari ghruta matrabasti .
Even if husband's reports are normal in my clinic I prefer giving medicines to both. Shatavari + ashwagandha + gokshur + trivanga for husband.
For wife since there is pcos, history of salpingitis etc , you can give her Chandra Prabha, trivanga bhasma, shankhavati, gokshur, ashwagandha, shatavari.
Phalagruta yoniPicchu is advisable and also you can start her suvarna bhasma & loha bhasma in rasayana kala to help ovulation.
Monitor her ovulation

We have got 2 pregnancy positive cases in last 6 months . One at age 34 and second conceived at age 39

Kindly contact me personally if u want details of procuring rasa preparations which are very helpful in infertility

Also check for agni, malapravrutti etc in her and thyroid levels

Dr Jaya Sambhus:
Sir pz share indications of tankan bhasma 🙏🙏

:

Discussions on 6th february 2016

Dr.ravndr:
Wounds are vrana{ below 3 weeks}
Ulcer are dustha vrana { chronicity more then 3 weeks.. untreated or infected one}

{Cause:Either nija or agantuja }

Vrana and bhagna are two different phenominas.  Moreover bhagna may be  with Vrana / without Vrana. Intervention is different.

त्वङ्मांससिरास्नाय्वस्थिसन्धिकोष्टमर्माणीत्यष्टौ व्रणवस्तूनि । अत्र सर्वव्रण सन्निवेशः । सुसू.22.3 व्रणनस्तूनि व्रणाधिष्टानानि। व्रण सन्निवेशो  व्रणावसानं।। (ड)

The other matter in discussion about Paaka.

This Word is used at places, one as posted above ..... Mukha Paaka, etc and other at pooyotpatti by dhaatu please in dushta vrana or vidradhi.

,# not please, but paaka.

Vinaya Ballakur:
I usually give Brihat vat chintamani if patient can afford it or ekangveer ras if patient cannot afford.
Sahacharadi kashayam, mustadi marma kashayam,gandharvahastadi  kashayam, rasnaerandadi kashayam are all effective and you may choose one or two of the above depending on suitability to the patient.
Ashwagandha may be good as a rasayan.

A long term internal oil will be useful like gandha thailam or dhanvantharam thailam

Trayodashanga guggulu relieves pain and inflammation

Kati vasti with murivenna and sahacharadi thailam initially for ten days.

Later with nourishing oils like dhanvantaram kuzhampu and bala ashwagandhadi  thailam

Dr.suresh Jakotia:
Marta vasti with Kseera Bala tail.

vijayalakshmi:
thank you vd surender sharmaji and vd saraswathi ji for your valuable sugeestion for fungal infection. Tankana bhasma with coconut oil has worked in one application. I had a patient with fungal infection in the groin , he had sever pricking sensation he was applying antifungal cream with some steroid since since six months with no relief. when he came to me as I have read your suggestion, I asked him to apply tankan with coconut oil even to my astonishment with one application he got relief from pricking sensation and pain. before this I have never used tankan bhasma in fungal infections.🙏👍

:
🙏🍀🌷
Thank Q very much vd. Vijayalakshmi ji....
Tankan Bhasma is one of my favourite drug.... I need 2-3 kg per month.
🙏🍀🌷

Vd.Saraswathi Sharma. K:
But yet to use kuchla as widely and as confidently as you do. Hopefully will be doing that too soon

Swathi Tumma:
Thanku for the information vaidyas
I too have been using tankan bhasmam with coconut oil in many fungal cases and got good relief but in one case i dint get response
Sharing the photograph here need our vaidyas guidence in this

:
🙏🍀🌷
Use Shuddha Kuchla,  without any hesitation SAS..  it is one of the best drug of Ayurveda...
Thanks for ur kind words SAS.
🙏🍀🌷

Ayurveda jobs Febraury 2017

Discussions on 5th feb 2017

Dr.ravndr:
@ vrana, gaatra visheernane.....discontinuety of outer layer part or organ is vrana.

I strongly believe and practice only by this definition. Many Vds follow this principle and give yoni pichu, varti, prakshaalanam, etc.

Vinaya Ballakur:
@ Ravinder sir.
I agree with you
व्रण गात्र विचूर्णने   व्रणयतीति व्रणः
Implies damage to tissues as seen in erosion and ulcer.
Practically too vrana ropana measures like ghrithas  are used.

But there is one aspect here.
In Susruta' s Vrana description  he categorically states that a vrana is never healed 100%. There is always a scar even  with the best wound management.
Coming to mukhapaka, ulcers or erosions they would be healed without leaving scar .

If gatra vichurnane  is interpreted as breech in external/ cutaneous tissue then a scar is invariably left after healing. If it is internal environment , maybe there is complete healing.

Nevertheless , we can try to apply  shashti upakramas  ( one or more of it ) in all kinds of wounds , ulcers and erosions. Kavala / Gandusha , prakshalana taila, ghrita appln. all are included in Susruta' s Shashthi Upakramas for Vranas. Depending on situation we need to apply it and not get restricted .

Raghavendra Rao.S:
Is damage of the tissues of twak and kalaabhaaga is one and same?

Vinaya Ballakur:
Tvak  or rasa, rakta, mamsa and medas  disrupted in cutaneous vrana.... Asthi in fractures...
Kalabhaagaas in internal injuries or in surgical wounds..

Vd.Saraswathi Sharma. K:
Vrana gaatra vichurnane is what I remember. Any discontinuity in any living tissue and any injury or swelling or anything that can cause scar tissue or leave a scar is vrana as per definition. This is not just my interpretation but it was in the text books I read. So I believe erosions and any damage to any tissue bahya or abhyantara can be classified as vrana. Pl correct if I'm wrong but quote sources so we can get clarity

Vinaya Ballakur:
But going by the vrana gatra vichurnane, any condition that fulfils breach or damage of tissues can be classified under Vrana and managed within the upakramas.

Dr.ravndr:
In fact, erosion is not an erosion. It is only a misnomer and merely an inflammation. For this, vrana shophaghna ekaadashopakrama out of shashti are sufficient. Mostly they are aclinical and called as ectropion. Clinically, disruption of vasculature in most outer layer or epithelium of CX. Therefore, erosion here is vrana. But as it involved superficial layer (Rasa dhaatu), there is less incidence of scarring (vrana vasthu). However, it is not untrue that it's chronicity leads to increased connective tissue and in turn results hypertrophy.

Until unless we recognise these changes in that simple cx erosion, how can we get positive results and again how many vds could able to speculate this and treating the cases?

Vrana shopha (aamaavastha),
Pachyamaana shopha (sarakta),
Pakva shopha (sapooya)

Deeper (gambheera) and more dhaatu-aartava in that part of organ are involved, the fibro-nectin in between cell to cell is replaced by connective tissue or vrana vasthu. Connective tissue formation is more prevalent in deeper tissue than epithelium.

Every body organ is a sapta dhaatu swaroopam with a principle of 'vyapadeeyasthu bhooyasaah'.

Vinaya Ballakur:
What is erosion then? How to understand it in Ayurveda? What is the management for it from outside the shashthi upakramas. Please explain

Dr.ravndr:
I reiterate erosion of various states with vrana and without.

One phase requires shophaghna and for other vrana shodhana and ropana.

Vinaya Ballakur:
Shopha is the purvarupas of vrana.

Dr.ravndr:
Undoubtedly in case of nija but not agantuka. Shopha may follow agantuka vrana.

Vd.Saraswathi Sharma. K:
There are more than one niruktis for each sabda since a single definition may not convey all its functions or characters. So ruling out anything just because it's not in accordance to one nirukti is not proper I believe. Also shasthi upakramas are guidelines. Not all are indicated in all types of vranas. So can't rule out on that basis as well since susruta himself suggests only few of the upakramas in various conditions

Dr.ravndr:
60 for 3 states of vrana. Before, during and after.

Vd.Saraswathi Sharma. K:
In bhagnas and internal ulcerations how healing occurs? Is the tissue normal as before? No vrana vaastu?

Vinaya Ballakur:
Bhagnas never come completely to pre bhagna state.
Ulcers are different from wounds . They heal completely most of the times

Dr.ravndr:
Few senior people of PSR compared cervical erosion with KARNIKA YONI VYAAPAT.

Vaata and kapha in onset.

vijayalakshmi:
How can wounds and ulcers are differentiated according to ayurveda?

Dr.Naveen Kumar kandagatla M. S. Shalya tantra:
Wounds are vrana{ below 3 weeks}
Ulcer are dustha vrana { chronicity more then 3 weeks.. untreated or infected one}

{Cause:Either nija or agantuja }

Raghavendra Rao.S:
Vrana and bhagna are two different phenominas.  Moreover bhagna may be  with Vrana / without Vrana. Intervention is different.

Before entering into chikitsa clarity is required about the vyaapti of the terms and the samprapti.

vijayalakshmi:
वृणोति स्माद्रूढे अपि व्रणवस्तु न नश्यति । आदेह धारणात्तस्माद्व्रण इत्युच्यते बुधैः ।। सु.सू.21.40

त्वङ्मांससिरास्नाय्वस्थिसन्धिकोष्टमर्माणीत्यष्टौ व्रणवस्तूनि । अत्र सर्वव्रण सन्निवेशः । सुसू.22.3 व्रणनस्तूनि व्रणाधिष्टानानि। व्रण सन्निवेशो  व्रणावसानं।। (ड)

आस्यपाक, मेढ्रपाक, गुद पाक has been explained in charaka samhita in pittaja nanatmaja roga

generally speaking wherever विदरण is present it can be considered as vrana. when we go more technically for academic purpose and we think there is no technical terms specific to many samprapthi and diseases in ayurveda , to be more specific in this aspect we should consider erosions as 'paaka' where both internal and external treatment are equally important. and vrana that which start s from twak

because sushruta only tellsतत्र आद्यैकवस्तु सन्निवेशी त्वग्भेदीव्रणः सूपचरः, शेषाः स्वयमवदीर्यमाणा दुरुपचाराः । सु.सू.22.s

those which starts from twak  is vrana which can be treated easily  shasti upakramas are followed easily ( plan of treatmen can be made in a systemic way)

शेषा इति मांसाध्यधिष्टानाः। स्वयमवदीर्यमाणा इति आलेपस्रावणादिभिर्विना त्वयमेव पक्वा पश्चाद्भइन्ना इत्यर्थः ।। (ड)

since the healing process is different the technical term also varies in terms of medical treatment and surgical treatment. otherwise dd of infectious and non infectious internal ulcers and erosions will be difficult according to ayurveda academiclly

Vinaya Ballakur:
Vd. Vijayalakshmi mam, very much appreciate your  knowledge  of the granthas.
But why be conservative with respect to vrana definition. Any breach in tissues in internal or external environment can and will respond to vrana chikitsa. It is up to us to decide it depending on affected dosha. The applicative aspects in granthas  go beyond text book definitions although they derive strength from fundamental concepts.

Paka is a pitta condition and we are aware it can lead to vrana. Ghrita is the best vrana ropana agent and it is also paka shamana.
I remember your excellent yukti of advising kshaya treatment for cervical spondylosis.
Why restrict our thinking based on 'vrana vastu na nashyati' .
It is definitely tvakadi that susruta is referring to in this gatra there is no doubt about it . But damage to tissues is seen in internal epithelial lining too.
🙏

Dr Ravi Kumar Sivva:
S...we do....Stem extract of Cissus can b taken in the form of tablet or capsule with 500 mg dosage for 2 months as adjuvant for healing bone realated issues....

vijayalakshmi:
This is Dr.ganesh

37 yr old female
C/o Secondary infertility
USG : bilateral PCOD
*Since six month's she is having heavy menstruation along with heavy clots
*And having white discharge  ( curdy type) since two month's
Took allopathic treatment for white discharge and got good relief ..

Two things basic question wheather kaseesadi can be used or not ? is this is addressed?
There is no definite answer if no why? if yes why?.
Use this or that or XXX. This can be got from theraputic guide of companies.
And person to whom was asked why selection of kaseesadi taila has not answed it.
can admin moniter it?

Swati Totla:
1. Back pain at left waist
2. Left leg pain and not able to walk with left leg
3. For the last one month this problem is there
4. If sleep on tummy side waist and leg pain
Pain Symptoms :
1.Back pain started 2 years back.
2.Around 6 months back again back pain started for a period of month.
3.Now Pain is from left lower back to foot.(while walking,standind,sitting) until back a point in a nerve is not touched.

Suggested surgery. Need all expert opinions and suggestions

Dr.kamal:
Madam...
Lumbaton
Reosteo
Rasna erandadhi and sahacharadhi mix

Local abhyanga with visagarbha and murivenna mix
Kati vasti with same oil
Matra basti with sahacharadhi

Discussions on 4th february 2017

Vd Saraswathi Sharma K:
Good evening. Need your guidance in diagnosing a case. Pt presented with pain in both knee joints severe in lt knee, increasing since 1 year. Now severe since few days, radiating upwards and downwards. Lt hip joint too pain + but started only recently. O/E no obvious deformity. Unable to extend leg beyond 45 degrees though no problem with flexion. Local raise of temp+. No erythema. No swelling. No tenderness. Tightening of the muscles in the subpatellar region feeling like a thick, flat cord. What are all the different possibilities. How to confirm or exclude them. Pl guide

Female, 50+, no dm,htn. Agricultural labourer

@Saraswati
Vayaha vata
Vikruti vata
Sthana -sandhi (vata in kapha background.)
Agni Kosta ??
Treat dhatukshaya janya vata and asti vriddhi chikitsa
Sandhivata + Gridhrasi like treatment.
Vatahara-snigdha tikta rasa pradhana.mooda vata hara
Steps
1.Langhanam + Tikta rasa
2. Kashayam -vatahara
3.Snehanam (likeguggulu tiktaka ghrutam )
I like to prescribe
Sahacharadi kashayam
Panchtikta ghruta guggulu
Vatagajankush ras
Ksheerbala capsules.initially for 7 days.
Lepam With vatahara grihadhoomadi lepa )

Subhadra S:
Seems  muscular spasm in lumbo sacral region,   kativasti and local patrapinda swedam in low back and knee joints might help her along with internal medication.

Vijaya Rani:
Pancha guna vardhamana tailam is available ,if it which phorma ?

Plz let me know about this Drs

Vinaya Ballakur:
I also think similarly.
Nutritional levels should also be checked.

Dr.Vishwanath Dixit:
Vaidyas does mixing sodium benzoate in Ayurvedic preparation laden with vitamin c .... (this combination) is said to be  cancerous. For e.g. packed Amla juice is bad.
2)Have also come across opinion that sodium benzoate causes psychotropic excitement in kids.
3)Are there any research papers or studies conducted?Vaidyas kindly voice your views & opinions.

Dr Ravi Kumar Sivva:
S....Sodium benzoate do hav the foresaid illeffects if added more than 5000 ppm......Natural Vit C is also a preservative with short shell life.... Many of the tablets coming now are coated with Vit C without the addition of Sodium benzoate...

Vinaya Ballakur:
In some cases we only have to go by dosha assessment. We may not be able to name the disease. Charaka himself was of the opinion that all diseases cannot be named and need not be named. Tridosha assessment is enough

Dr.Anitha:
Hai
Here I have a case to discuss..

37 yr old female
C/o Secondary infertility
USG : bilateral PCOD
*Since six month's she is having heavy menstruation along with heavy clots
*And having white discharge  ( curdy type) since two month's
Took allopathic treatment for white discharge and got good relief ..
But now suffering from heavy menstruation and severe itching on pubic area...

OBS..HX ...
G2P1A1

GYN Hx....
5 day/30
Regular..

P/v...severe erosion of cervix

Papsmear test    :  Negative.

Iam have given 1)Ashokarista
                            2) Steptovit
Two month's
She got relief from heavy clots .
But stil continuing with heavy menstruation...with mild clots.

For white discharge i advised tripahala kashaya for wash..but it was of no use..she got relief after   
Taking allopathic tx ..
Now she got relief from white discharge ..
My question is ....can I advise her kaseesadi tailom for pichu now?

Sorry a small correction ..it was STYPLON  i have given....not STeptovit...

Dr.ravndr:
Kasisadi Taila  ingredients:

12 grams of each of

Kasisa – Ferrous sulphate

Saindhava – Rock salt

Krishna – Piper longum

Shunti – Ginger – Zingiber officinalis

Kushta – Saussurea lappa

Langali – Gloriosa superba

Shilabhid – Shilajatu – Asphaltum

Ashvamara

Danti – Baliospermum montanum

Jantughna – Embelia ribes

Chitraka – Plumbago zeylanica

Talaka – Haratala – Orpiment – Aresnic tri sulphide

Kunati – Manashila – Realgar – Arsenis sulphide

Svarnakshiri – Argemone mexicana

Snuhi Paya – Latex of Euphorbia neriifolia

Arka Paya – Latex of Calotropis procera

Taila – Oil of sesamum indicum – 768 ml

Gomutra – Cow urine – 3.072 liters

Reference: Bhaishaj Ratnavali Arsharogadhikara 111-113

Expiry date: 3 years from the date of manufacture. Once you open the seal, it is better to use it within an year.


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Justification of corrosive kaasisaadi thaila in erosion of cervix requested.

Doctor people usually describes karya kaarana sambandha in-between cx erosion and sweta pradara. As per Susrita school of thought, erosion is VRANA and should be again classified into V P K..........Etc. So also it's discharges too.

Sweta pradara is said only as K...Vyaadhi, truly it's not.

Vinaya Ballakur:
Thanks Sir, Susruta school of thought so nicely clarified by you. We must remember Shodhana  + Ropana principle here and in many other applicable places like mukhapaka etc. 🙏🙏🙏

Will triphaladi thaila  pichu or thikthaka ghritham pichu be a better option?

Dr.ravndr:
Thus, vrana sraava here is upadravaja. It's adhistaana is vrana, not Rasa/rakta dhaatu to cause doshaja pradara.

Yoni (vyaapat) sraava of various origin should be ruled out from doshaja pradara.

That's why all yoni gata sraava better described into yoni vyaapat janyam and dhaatu-aartava vyaapat janyam.

Ya, if it is judged to be vranopadravajam, .... triphalaadi, jaatyaadi or any ropana thaila/ghrita shall be advised and may be left over. If dusta vrana, kaasisaadi too can be used but mootraavega kaala maatram follow by prakshaalanam.

Yoni sraava without vrana or any other y. vyaapat shall be managed according to pradara chikitsa

Aamayika prayoga including PK treatments carries significance in these.

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