Vātaśonita

वातशोणित ;
Vātaśonita is the disease produced by vitiated vāta dośa and rakta which impede the gati of each other causing the disease. This disease is also renamed as ādhyaroga i.e. mainly affluent people are affected by the disease as said by Chakrapāni.1 Very detailed aetiological factors had been mentioned in Caraka Samhita which were in practice during that very time and now has become either out dated or localized to very remote places in India, like pinyaka (in ancient time, the residue of oil seeds were eaten after oil had been extracted), madya like arnāl, sauvir, sukta, surā, āsava like alcoholic beverages which were in use which have been replaced by refine alcoholic drinks like beer, wine etc. Again during old time horse, camel and yāna (carts) were used for travelling which may be co related with travelling means of modern era. The disease is predominant among the people who in general are not habitual to physical activity rather they have more sedentary lifestyle. People of pitta prakriti (pitta constitution) are prone to develop vātaśonita, sukumāratwa (delicate personality) is the characteristic feature of pitta prakriti.
Each of the three dośa, which are physiological entity can be subdivided into three types depending on the mode of action which each of the three execute in the normal and pathological stages, a) normal physiological activities of the body are dhātu dośa (normal dośa), b) abnormal physiological activities of dośa in the body- (vitiated dośa) and c) by products of abnormal physiology will be the mala dośa (waste product) only which have anatomical entity and are removable from the body. All normal micro and macro movemental activities in the body are dhātu vāta, all the activities responsible for heat production and regulation are dhātu pitta and all the synthesis or productive activities of the body are dhātu kapha. Dośa (normal physiological activities) are very essential for the body so in that context they are called as dhātu, but when they are prone to vitiation they are called as dośa. All abnormal movemental (macro and micro) activities in the body are caused by vitiated vāta dośa, abnormality in heat production and regulation in the body are caused by vitiated pitta dośa and abnormal synthesis in the body are caused by vitiated kapha dośa and by products of abnormal activities (pathological activities) are mala dośa, they tarnish (malini karnat) the body so called mala.
In case of vāta śonita there should be abnormality in movemental activity (vāta dośa) as well as abnormality of rakta. Due to metabolic disturbances (dhātwāgni vaishamya) there is overproduction of metabolites like uric acid, calcium pyrophosphate, etc. High concentration of these metabolites in blood should be considered as raktaduśti, high concentration of uric acid and other metabolites in blood slows the propulgation of blood in capillaries and hence there is stagnation of it near the joints and dependent parts of the body. Uric acid escapes and enters into the joints and other tissues from the stagnated hyperuricemic blood, and the same time there may be reduced excretion of uric acid through kidneys, these all disturbed movemental activities are considered as vāta duśti and over production of uric acid during metabolism of nucleoproteins and through de novo pathway may be considered as agniduśti. It is observed that patients suffering from vātaśonita also have visamāgni (disturbed digestive capability), it is a rule that if the jatharāgni (digestive capability) is disturbed the other types of agnī (metabolism) will also be disturbed. It is the beauty of Ayurvedic science that has mentioned all and very different etiological factors responsible for a) agni vaisamya b) dośa prakopa and c) dhātu dushti directly or indirectly.
Inflammation of joints may also occur by some other metabolites like calcium pyrophosphate crystal deposition which is also a by product and resultant of agni dushti (disturbed metabolism).

Prof. Dr. Satyendra Narayan Ojha ,
MD (KC), Ph.D.
Director , Yashawant ayurveda college , Post graduate teaching and research center ,
Kodoli ,Panhala , Kolhapur.. 

drsnojha@rediffmail. com   

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Obesity

Some Basics –

“Let thy FOOD be thy Medicine
Let thy medicine be thy food”
-Hippocrates

“Eat to live and not live to eat”

“Health is made or marred in the Kitchen ”

Now a days , menstrual abnormalities incidence have gone high,
we see only two types of young girls- one very lean with zero figure and others maximum in no a very Obese.

Obesity –
Obesity is a condition wherein the body weight is 20% or more above the ideal body weight.
Excessive accumulation of adipose tissue in relation to lean body mass.

Causes-
1. Overeating- and Fast food
This leads to excessive consumption of energy, which is stored in the body as fat. Consumption of high fat diet leads to increased triglycerides levels. Excess of Carbohydrate and Protein in food,which are not utilized,are stored as fat.

2. Physucal inactivity-
Lack of adequate exercise leads to a decreased energy requirements.Thus ,an imbalance between the energy intake and energy expenditure occurs.

3. Emotional disturbance-
During anxiety, frustration,tension or insecurity some people tend to overeat to allay their tension. Thus, they see food as a model of comfort resulting in overeating.

4. Heredity-
Studies indicate that if both parents are obese,there is an 80% chance of the child also becoming obese.

In postmenopausal women, estrogen levels are decreased, leading to the deposition of fat in abdominal region,thereby contributing to abdominal obesity.

MANAGEMENT OF OBESITY:

Behaviour modification together with diet and exercise help in prevention and treatment of obesity.
*Diet:
Do’s-
● High fibre foods like whole wheat flour, bajra,jowar, oatmeal etc
● Pulses,especially whole pulses and Sprouts.
●Use Skimmed milk
●More of Vegetables in raw or cooked form such as leafy vegetables, cabbage, gourds etc.
● Fruits like apple,Papaya,Orange,Sweetlime,guava,peach etc
● 8_10 glasses of water per day.
●Cut down on fruits like banana, chikoo,mango,custard apple and Vegetables like potatoes, sweet potatoes, yam etc.

Don’t-
● cut off sugar.
●Avoid refined products such as Maida,white bread,khari ,pasta etc.
● Reduce Consumption of Chocolates, Pastries,aereated drinks.
●Reduce /stop smoking,alcohol,tobacco chewing.

*Behaviour Modification
●Eat slowly -savour each bite.
● Regular meal pattern with frequent intervals
● Never skip meal
● Eat wisely and learn to say ‘No’ to temptation.

*Exercise-

Aim to increase your physical activity at least thirty minutes per day.

Exercise is excellent to burn calories out and improve both mental and physical health.

Dr.Rupali Mahadik

MD Streerog
Amrutwel Women’s Clinic
Kharghar

Neoplasm of the Lung

Neoplasm of the Lung ;
The incidence of lung cancer peaks between ages 55 and 65 years. Lung cancer accounts for 29% of all cancer deaths (31% in men, 26% in women). Lung cancer is responsible for more deaths in the United States each year than breast cancer, colon cancer, and prostate cancer combined; more women die each year of lung cancer than of breast cancer.

Aetiology
Most lung cancers are caused by carcinogens and tumor promoters inhaled via cigarette smoking etc.

Clinical Features
Although 5–15% of patients with lung cancer are identified while they are asymptomatic, usually as a result of a routine chest radiograph or through the use of screening CT scans.
Most patients present Central or endobronchial growth of the primary tumor which may cause cough, hemoptysis, wheeze and stridor, dyspnea, and postobstructive pneumonitis (fever and productive cough).
Peripheral growth of the primary tumor may cause pain from pleural or chest wall involvement, dyspnea on a restrictive basis, and symptoms of lung abscess resulting from tumor cavitation.
Regional spread of tumor in the thorax (by contiguous growth or by metastasis to regional lymph nodes) may cause tracheal obstruction, esophageal compression with dysphagia, recurrent laryngeal nerve paralysis with hoarseness, phrenic nerve paralysis with elevation of the hemidiaphragm and dyspnea, and sympathetic nerve paralysis with Horner’s syndrome (enophthalmos, ptosis, miosis, and ipsilateral loss of sweating).
Malignant pleural effusion often leads to dyspnea.
Pancoast’s (or superior sulcus tumor) syndrome results from local extension of a tumor growing in the apex of the lung with involvement of the eighth cervical and first and second thoracic nerves, with shoulder pain that characteristically radiates in the ulnar distribution of the arm, often with radiologic destruction of the first and second ribs. Often Horner’syndrome and Pancoast’s syndrome coexist.
Other problems of regional spread include superior vena cava syndrome from vascular obstruction; pericardial and cardiac extension with resultant tamponade, arrhythmia, or cardiac failure; lymphatic obstruction with resultant pleural effusion; and lymphangitic spread through the lungs with hypoxemia and dyspnea.
Common clinical problems related to metastatic lung cancer include:-
Brain metastases with headache, nausea, and neurologic deficits;
Bone metastases with pain and pathologic fractures;
Bone marrow invasion with cytopenias or leukoerythroblastosis;
Liver metastases causing liver dysfunction, biliary obstruction, anorexia, and pain;
Lymph node metastases in the supraclavicular region and occasionally in the axilla and groin;
Spinal cord compression syndromes from epidural or bone metastases.
Adrenal metastases are common but rarely cause adrenal insufficiency

Investigation:
Chest x-ray
CT scan of chest and abdomen
CT or MRI scan of brain and radionuclide scan of bone if any finding suggests the presence of tumor metastasis in these organs
Tumor tissue can be obtained by a bronchial or transbronchial biopsy during fiberoptic bronchoscopy; by node biopsy during mediastinoscopy; from the operative specimen at the time of definitive surgical resection; by percutaneous biopsy of an enlarged lymph node, soft tissue mass, lytic bone lesion, bone marrow, or pleural lesion; by fine-needle aspiration of thoracic or extrathoracic tumor masses using CT guidance; or from an adequate cell block obtained from a malignant pleural effusion.

Ayurved treatment by Panchkarma: (Purificative Procedure) especially Vaman is very useful. Associated therapy with following procedures may also be helpful.
Ura- basti
Lepa

Internal Medicine may be used:
Pushkarmula, (Inula racemosa), janjabilsami
Bharangi, (Clerodendron serratum)
Ashwagandha kshar (Withania somnifera), Winter cherry
Haridra, (Curcuma longa), Turmeric
Daruharidra, (Berberis species), Indian berberry
Bhallataka, (Semecarpus anacardium) Marking nut
Vansha, (Bambusa arundinacia), Bamboo manna
Shirish, (Albizzia lebbeck)
Pippali, (Piper longum), long pepper
Tulasi, (Ocimun sanctum), Holy basil
Brihat panchmula: It is group of 5 herbal drugs viz; Bilwa,{(Aegle marmelos), Bengal Quince}, Gambhari, {(Gmelina arborea)}, Patala, (Stereospermum suaveolans), Agnimantha, (Premna integrifolia), Syonaka, (Oroxylum indicum).

Prof. Dr. Satyendra Narayan Ojha ,
MD (KC), Ph.D.
Director , Yashawant ayurveda college , Post graduate teaching and research center ,
Kodoli ,Panhala , Kolhapur.. 

drsnojha@rediffmail. com   

SKIN CANCER

SKIN CANCER

Clinical Characteristics:
There are four types of cutaneous melanoma. In three of these—superficial spreading melanoma, lentigo maligna melanoma, and acral lentiginous melanoma—the lesion has a period of superficial (so called radial) growth during which it increases in size but does not penetrate deeply. It is during this period that the melanoma is most capable of being cured by surgical excision. The fourth type— nodular melanoma —does not have a recognizable radial growth phase and usually presents as a deeply invasive lesion, capable of early metastasis.
When tumors begin to penetrate deeply into the skin, they are in the so-called vertical growth phase. Melanomas with a radial growth phase are characterized by irregular and sometimes notched borders, variation in pigment pattern, and variation in color. An increase in size or change in color is noted by the patient in 70% of early lesions.
Bleeding, ulceration, and pain are late signs and are of little help in early recognition. Superficial spreading melanoma is the most frequent variant observed in the white population.
The back is the most common site for melanoma in men. In women, the back and the lower leg (from knee to ankle) are common sites.

Nodular melanomas are dark brown-black to blue-black nodules. Lentigo maligna melanoma is usually confined to chronically sun-damaged, sun-exposed sites (face, neck, back of hands) in older individuals. Acral lentiginous melanoma occurs on the palms, soles, nail beds, and mucous membranes.

While this type occurs in whites, it is most frequent (along with nodular melanoma) in blacks and East Asians.

A fifth type of melanoma, the desmoplastic melanoma, is recognized. This tumor type is associated with a fibrotic response to the tumor, neural invasion, and a higher tendency to local recurrence.

Occasionally, melanomas can be amelanotic, in which case the diagnosis is established histologically after biopsy of a new or changing skin nodule or because of a suspicion of a basal cell carcinoma. Sites appear to be the forearm and leg (excluding feet), while unfavorable sites include scalp, hands, feet, and mucous membranes.
In general, women with stage I or II disease have a better survival than men, perhaps in part because of earlier diagnosis; women frequently have melanomas on the lower leg, where self-recognition is more likely and prognosis is better.

Lymphadenectomy may control early regional disease. Liver, lung, bone, and brain are common sites of hematogenous spread, but unusual sites, such as the anterior chamber of the eye, may also be involved.

Biopsy: The recommended technique is an excisional biopsy, as that facilitates pathologic assessment of the lesion, permits accurate measurement of thickness if the lesion is melanoma, and constitutes treatment if the lesion is benign.
For large lesions or lesions on anatomic sites where excisional biopsy may not be feasible (such as the face, hands, or feet), an incisional biopsy through the most nodular or darkest area of the lesion is acceptable; this should include the vertical growth phase of the primary tumor, if present. Incisional biopsy does not appear to facilitate the spread of melanoma.

In ayurveda one can opt for Panchkarma: (Purificative Procedure) such as:
Vaman
Virechan
2. Associated therapy
Lepa
Snehan especially various abhyanga
3. Internal Medicine
Manjistha, (Rubia cordifolia), Indian madder
Haridra, (Curcuma longa), Turmeric
Daruharidra, (Berberis species), Indian berberry
Bakuchi, (Psoralea corylifolia), Malaya tea
Chakramarda, (Cassia tora), Fetid cassia
Nimba, (Azadirachta indica), Neem tree..

Prof. Dr. Satyendra Narayan Ojha ,
MD (KC), Ph.D.
Director , Yashawant ayurveda college , Post graduate teaching and research center ,
Kodoli ,Panhala , Kolhapur..
 drsnojha@rediffmail. com   -