रोगी वात व्याधि से ग्रस्त है। चिकित्सा संबंधी योग,,, बृहत वात चिंतामणि रस स्वर्ण युक्त 1 एकांग वीर रस 2 रत्ती शहद में मिलाकर सुबह-शाम सेवन कराएं महानारायण तैल की मालिश करें, बालुका पोटली स्वेदन कराएं महारास्नादि क्वाथ 25 ग्राम सुबह-शाम खाने के बाद दें योग परिक्षित है पिछले 40 वर्ष से प्रयोग कर रहा हूं।
gvn local snehan n swedan with vathar oils like mahaanrayan tailm, mahamash tailm.. orally gvn ekangveer ras, tryodanshang guggle,panchamrit loh guggle,or as age factor can b added lakshadi guggle..locally apply turmaric+maithi dana +kachur churn lep ,advise to mild execrise, avoid pillow,heavy work..
Uttarbhouktika snehapana shamana sneha is helpful as age is 68 years Or plan first brumhana nasya such as ksheerabala 101 Shamana- sahacharadi kashaya 3 tsf tid KSheerabala 101 capscule 2 tid before food Mahavishgarbha tails local application followed by patrapinda sweda
Adv. Shoulder exercises. Avoid using pillows at night. Sleep on flat bed. Rx Snehan and Sweden with Mahavishgarbh tail. Baluka swed. Tab.Singhnad guggul...2 bid Tab.Sallaki...2.bid Maharasnadi kwath...10.ml.bid Review after 15 days.
shivachar pachan churna das moolarist kwath tds mahayog raj gugloo massage with castar iol maha mass oil mahavishgarbha oil mahanarayanoil mhanarayan oil jatoon tail
Lateral to the ac joint bony sclerotic changes have been seen with reduced glenohumeral space and restricted shoulder movement suggestive of avabahuka.
Trayodashaag guggulu Pravaal panchamrit rasa Ajmodadi churna Avipittikar churna Arogyavardhani vati Tab rumalaya fort Mahanrayan tail massage
Trayodashang Guggulu Rumalaya Forte Tab Shallaki Tab Maharasnadiquath Mahanarayan tail Softly Application on Affected Area.
Trayodasang guggulu Bhrihat vaat chintamani rasa Mahanarayan tail for local application Rumalaya tab Dasmoolarishth
Bry 30 (3) dose bd... C. F 12x 4 pills 5 days tds...
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65 year old male presented with multiple tiny punched out ulcers since 3 months. Post Transcutaneous electrical nerve stimulation therapy for Diabetic peripheral neuropathy with cellulitis over left lower limb which is associated with pain redness and increased peripheral warmth. His sugars and BP are under control. Any advices my dear respected colleaguesDr. Anudeep Puvvula7 Likes21 Answers
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Comments on X-ray ,D/D and treatment. A male aged 58 years having cough, severe pain chest right referring to back, weakness since 45 days. He is chronic smoker. Suggest Investigations to reach the diagnosis.Dr. Arjun Singh Shekhawat4 Likes34 Answers
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*Ankylosing spondylitis* ☝ *All about*☝ or AS, is a form of arthritis that primarily affects the spine, although other joints can become involved. It causes inflammation of the spinal joints (vertebrae) that can lead to severe, chronic pain and discomfort. The disease leads to calcification of the spine’s ligaments and discs and causes these soft structures to harden and fuse together with the joints and vertebral bodies. The spine becomes hard, brittle and susceptible to fracture. In some people, AS can also affect the shoulders, ribs, hips, knees, and feet. It can also affect areas where the tendons and ligaments attach to the bones. Sometimes it can affect the eyes, bowel, and very rarely, the heart and lungs. Pathophysiology There are no single agents that have been associated with the causation of ankylosing spondylitis. There seems to be a complex interaction between raised serum levels of IgA (Immunoglobulin A) and acute phase reactants of inflammation, the body’s immune system and the HLA-B27 gene. A typical histological finding is called Enthesitis. Enthesis is the insertion of a tendon, ligament, capsule, or fascia into bone. Typically in ankylosing spondylitis, this enthesis is inflamed at the vertebrae. Studies show that the entheseal ﬁbrocartilage is the major target of the immune system and inflammation in ankylosing spondylitis. Enthesitis was originally considered as the hallmark of ankylosing spondylitis. In addition, there is seen to be mild and destructive synovitis or inflammation of the synovium that forms a cushion in the joints. The myxoid subchondral bone marrow is also affected. As the disease progresses it destroys the nearby articular tissues or joint tissues. The original and new cartilages are replaced by bone through fusion. This causes fusion or joining up of the joint bones and stiffness and immobility. This is the hallmark symptom in the spine in ankylosing spondylitis. Causes The cause of ankylosing spondylitis is unknown. The disorder does tend to run in families, so genetics probably play a role. If your parents or siblings have ankylosing spondylitis, you are 10 to 20 times more likely to be diagnosed with the disease than someone with no family history. The main gene associated with the risk of AS is called HLA-B27. Scientists recently discovered two more genes (IL23Rand ERAP1) that, along with HLA-B27, make it more likely you will get AS. Other immune system-related genes associated with ankylosing spondylitis include endoplasmic reticulum aminopeptidase 1 (ERAP1), interleukin 1 alpha (IL1A), and interleukin 23 receptors (IL23R). However, it is not clear how these gene variations affect a person’s risk of developing AS. Risk factors Men are as much as 3 times likelier to develop AS than women The biggest risk factor for developing a severe form of AS is smoking Age: Onset generally occurs in late adolescence or early adulthood Family history Clinical manifestations Constant pain and stiffness in the low back, buttocks, and hips that continue for more than three months Pain in ligaments and tendons Eye inflammation such as redness and pain occurs in some people with spondylitis You may also experience pain in the large joints such as the hips and shoulders. Early morning stiffness Loss of appetite Low-grade fever Weight loss Fatigue Anaemia or low iron Because ankylosing spondylitis involves inflammation, other parts of your body can be affected as well. Patients may also experience: Inflammation of the bowels Mild eye inflammation Heart valve inflammation Achilles tendonitis Complications Ankylosing spondylitis can cause an overgrowth of the bones, which may lead to the abnormal joining of bones, called “bony fusion.” Fusion affecting bones of the neck, back, or hips may impair a person’s ability to perform routine activities Heart problems. Ankylosing spondylitis can cause problems with your aorta, the largest artery in your body. The inflamed aorta can enlarge to the point that it distorts the shape of the aortic valve in the heart, which impairs its function. Eye inflammation like uveitis Compression fractures in bones of people with AS A hunched posture. A curled forward, chin-to-chest stance can occur if the spine fuses together in a hunched forward position. Cauda equina syndrome. This rare condition involves extreme pressure and swelling of the nerves at the end of the spinal cord. In this condition, one or more intervertebral discs or disc spaces become infected. Diagnosis and Test A medical history A patient will be asked to describe: When and how the joint pain or other symptoms first occurred If pain improves or worsens with exercise If joint pain has changed in severity or location If any treatment has provided pain relief A physical exam A doctor will ask you for details about the pain and the history of your symptoms. Images of your bones and joints X-ray. An X-ray of your spine and any painful joints will show erosion. The erosion may not be detected if the disease is in the early stages. An MRI study may also be done, but the results are often difficult to interpret. An MRI provides more-detailed images of bones and soft tissues. MRI scans can reveal evidence of ankylosing spondylitis earlier in the disease process but are much more expensive. CAT scans (CT scans), and ultrasound can provide more accurate and detailed images, helping doctors identify earlier changes in the joints. These medical imaging techniques are more expensive and time-consuming than x-rays, so they are only done if needed. Blood tests C-Reactive protein (CRP). A high CRP level indicates an inflammatory condition, including infection. For this reason, a high CRP level does not automatically mean a patient has ankylosing spondylitis. In addition to using this test for diagnosis, doctors often monitor CRP levels to gauge a patients’ response to treatment. Erythrocyte sedimentation rate (ESR). Similar to CRP as an indicator of inflammation, this test is not specific for ankylosing spondylitis and by itself does not diagnose a patient, but it can support the diagnosis. It is also used to see how active the condition is. HLA-B27 gene. A positive test for this gene can help to confirm a suspected case of ankylosing spondylitis, but this test is not required for diagnosis when a patient has several obvious symptoms, or when sacroiliitis can be seen on an x-ray. Treatment and medications Exercise: Exercise and stretching may help painful, stiff joints. It should be done carefully and increased gradually. Diet: A healthy diet is good for everyone and may be very helpful if you have AS. Keeping a healthy weight reduces stress on painful joints. Omega-3 fatty acids, found in cold-water fish (such as tuna and salmon), flax seeds, and walnuts, might help. This is still being studied. Medicines: Several types of medicines are used to treat AS. Nonsteroidal anti-inflammatory drugs (NSAIDs). Aspirin, ibuprofen, and naproxen are examples of NSAIDs. These strong drugs are similar to the cortisone made by your body. They fight pain and swelling. Disease-modifying antirheumatic drugs (DMARDs). These drugs work in different ways to reduce pain and swelling in AS. Biologic agents. These are newer types of medicine. They block proteins involved with pain and swelling. Examples: adalimumab (Humira), adalimumab-atto (Amjevita), a biosimilar to Humira, certolizumab pegol (Cimzia), etanercept (Enbrel), etanercept-szzs (Erelzi), a biosimilar to Enbrel, golimumab (Simponi Aria, Simponi), infliximab (Remicade), and infliximab-dyyb (Inflectra), a biosimilar to Remicade, and secukinimab (Cosentyx) have been FDA-approved for treating ankylosing spondylitis. Surgery: If AS causes joint damage that makes daily activities difficult, joint replacement may be an option. The knee and hip are the joints most often replaced. In very rare cases, your doctor may suggest surgery to straighten the spin. There are three types of spine surgery that may be used to treat ankylosing spondylitis. Only a surgeon can decide which surgery, if any, is appropriate. Osteotomy of the spine. Spinal fusion instrumentation. Spinal decompression. Prevention and Cure It is not known how you can prevent ankylosing spondylitis because no one knows what causes it in the first place. However, if you have the disease, you can focus on preventing disability by staying active, eating healthy, and maintaining a normal body weight. Stay active. Exercise can help ease the pain, maintain flexibility and improve your posture. Apply heat and cold. Heat applied to stiff joints and tight muscles can ease pain and stiffness. Try heating pads and hot baths and showers. Ice on inflamed areas can help reduce swelling. Don’t smoke. If you smoke, quit. Smoking is generally bad for your health, but it creates additional problems for people with ankylosing spondylitis, including further hampering breathing. Practice good posture. Practising standing straight in front of a mirror can help you avoid some of the problems associated with ankylosing spondylitis.Dr. Shailendra Kawtikwar12 Likes18 Answers
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A 63 years old male patient, suffered from injury on back which was ignored by family for 20 days. At present pt.is admitted in hospital since 15 days. Pt.is unable to recognise family members at present. Please suggest treatment for wound healing.Dr. Pushpa Sharma6 Likes28 Answers
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This is a case of abdominal preg P4+0+0+4 at 36 wks preg. She was admitted with chronic pain abd with chr anaemia. On pv examn cx could not be felt and post fx was thinned out with fetal head embedded in the post fx . Usg report did not mention intra or extra uterine gestation . Since pt was in pain laparotomy was done. A live baby but with multiple facial conj anomaly was delivered. Baby survived for 2 hrs. As seen in the photo, the placenta was located to the right of uterus and was supplied by omental vessels which were ligated with satisfactory hemostasis.Pt survived . Sharing my experience to my colleagesDr. Chhani Leivang15 Likes24 Answers