What is Anasarca –

What is Anasarca –

Anasarca, or extreme generalized edema, is a medical condition characterized by widespread swelling of the skin due to effusion of fluid into the extracellular space. It is usually caused by liver failure (cirrhosis of the liver), renal failure/disease, right-sided heart failure, as well as severe malnutrition/protein deficiency. The increase in salt and water retention caused by low cardiac output can also result in anasarca as a long term maladaptive response. It can also be created from the administration of exogenous intravenous fluid. Certain plant-derived anticancer chemotherapeutic agents, such as docetaxel, cause anasarca through a poorly understood capillary leak syndrome.

In Hb Barts, the high oxygen affinity results in poor oxygen delivery to peripheral tissues, resulting in anasarca.

Ayurvedic View on Anasarca -

In case of anasarca there is not much to say except that it is a gross kaphaja vikar which arises primarily due to an increased parthivo jalaja distribution in the whole body. This may be due to a drastic change in the prakruti of the individual largely.

                Its primary cause may be associated with capillary level anomalies.

What is Pulmonary Oedema –

What is Pulmonary Oedema –

Pulmonary edema is fluid accumulation in the tissue and air spaces of the lungs leading to impaired gas exchange which may cause respiratory failure.

It is due to either failure of the left ventricle of the heart to remove blood adequately from the pulmonary circulation (cardiogenic pulmonary edema), or an injury to the lung parenchyma or vasculature of the lung (noncardiogenic pulmonary edema).

Discussion

The most common symptom of pulmonary edema is presents with difficulty in breathing, but may include other symptoms such as coughing up blood ( seen as pink, frothy sputum), excessive sweating, anxiety, and pale skin, orthopnea (inability to lie down flat due to breathlessness) and/or paroxysmal nocturnal dyspnea (episodes of severe sudden breathlessness at night).

These are common presenting symptoms of chronic pulmonary edema due to left ventricular failure. The development of pulmonary edema may be associated with symptoms and signs of "fluid overload"; this is a non-specific term to describe the manifestations of left ventricular failure on the rest of the body and includes peripheral edema (swelling of the legs, in general, of the "pitting" variety, wherein the skin is slow to return to normal when pressed upon), raised jugular venous pressure and hepatomegaly, where the liver is enlarged and may be tender or even pulsatile. Other signs include end-inspiratory crackles (sounds heard at the end of a deep breath) on auscultation and the presence of a third heart sound.

As, the prakruti shift towards parthiv which is else parthivo jalaja. The tissue becomes hygroscopic and also finds a lot of akash element providing space for jal accumulation as fibrosis ensues. The lung tissue which retains water possibly due to impaired drainage across the capillary channels and hygroscopic character which consequently results in oedema. The important point to be noted is –

Loss of heat symbolic of reduced pitta and also shows up in reduced drainage as along with it pulmonary dosha balance is symbolic of a dried state which is shown up as fibrosed tissue. We must remember that as the heart is cycles the blood with each pulse, the same cycles across the pulmonary channels. This shift reduces the pulmonary partial pressure and affects exchanges and also increases cardiac load which in turn leads to pulmonary oedema in a cyclic change.

What is Cardiac Oedema? –

What is Cardiac Oedema? –

Abstract -

A condition when there is an abnormal accumulation of fluid in cardiac tissues due to high venous and capillary pressures as in case of congestive heart failure (CHF), it is called as cardiac oedema.

Cardiac edema is a buildup of fluid in the interstitial tissues and cavities of the body as a result of congestive heart failure, and presents as fatigue or weakness, irregular heartbeat, shortness of breath and weight gain caused by fluid retention and often can be confusing with other conditions and hence needs an urgent attention of a physician.

The part of the heart that is affected by the oedema defines which part of the body gets affected.

Lower left chamber of the heart, or the left ventricle – pulmonary oedema -  blood is not pumped out to the body as fast as it returns to the lungs.

In case of cardiac tissue, the prakruti shift towards parthivo-jalaja may be seen as fibrosed myocardial tissue which retains water possibly due to impaired drainage across the capillary channels, hence resulting in oedema. The important point to be noted –

Loss of heat symbolic of reduced pitta and also shows up in reduced cardiac output as along with it cardiac vata balance is impaired. We must remember that the heart is capable of functioning upto 6 times its capacity and hence much of it may not be realized until a major part of it is compromised.

Increase of jal symbolic of increasing kapha and slow cardiac output.

Cardiac oedema is less noticeable though in the cardiac muscles and shows more often as pulmonary congestion or peripheral oedema.

GENERALISED VIEW ON OEDEMA

A condition when there is an abnormal accumulation of fluid in the interstitium, located beneath the skin and in the cavities of the body, which may cause severe pain has been called as oedema. Its common manifestation is a swelling wherein the amount of interstitial fluid can be determined by the balance of fluid homeostasis; and the increased secretion of fluid into the interstitium. It has been broadly classified as - Cutaneous oedema or "pitting oedema" & Non-Pitting Oedema.
Grading of edema
Absent Absent
Grade + Mild: Both feet / ankles
Grade ++ Moderate: Both feet,
plus lower legs,
hands or lower arms
Grade +++ Severe: Generalised
bilateral pitting edema,
including both feet,
legs, arms and face
A low plasma oncotic pressure is widely cited for the edema of nephrotic syndrome, most physicians note that the edema may occur before proteinuria is noticed or fall in plasma protein level is noticed. In accordance with the ayurvedic view it is important to understand the sheathed environment where oedema occurs. The environment is mainly lipoproteinous in the sense of it being surrounded and made up of lipoprotein. Proteins in the Ayurvedic context may be interpreted as (Prithvi+Agni+Akash). It may be considered that Vata and Jal due to induction of microvascular injuries take the place of Akash and combine with Prithvi to create a stiff and lesioned site with rubour; in progressive state Prithvi is reduced and Agni is replaced with Jal component which is increased. In this condition prakruti tends to shift towards parthivo-jalaja which will retain water and hence impair drainage across the channels, thereby causing oedema. The classic point here to be noted stands along three factors –
Loss of heat symbolic of reduced pitta
Increase of jal symbolic of increasing kapha
Reduced pain symbolic of sedative property of shleshma which prevents vata prasar which again points towards increasing kapha and hence water retention presenting as oedema.
I SHALL BE AVAILABLE FOR CALLS ON FACEBOOK TOMORROW BETWEEN 4PM & 6 PM INDIAN TIME FOR DISCUSSIONS ON THIS ABSTRACT.
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LECTURE ON GENERALISED VIEW ON OEDEMA

LECTURE SERIES STARTING JUNE 2017.....................

Planning to start a lecture series on a weekly basis starting June 2017, on oedema an ayurvedic perspective from a prakrutik stand point, which will cover following organ systems -
1) Generalised perspective on Oedema
2) What is Cardiac Oedema?
3) What is Pulmonary Oedema?
4) What is the relevance of Oedema to anasarca?
5) Cerebral Oedema
6) Trauma and oedema at the site of trauma?
7) Importance of tissue based microoedema
8) Basic principle of management of Oedema in Ayurveda
9) How is drainage different from medicinal reduction of oedema and what stands better and where?
10) Conclusionary Q&A based on readers feedback

Those interested are requested to share their e-mail addresses so they can be sent abstracts directly. Detailed versions shall be provided on paid basis and may be purchased online soon from the facebook store once the lecture is delivered.

NEWS ON UTERINE TRANSPLANT

The news of two successful uterus transplants (ut) at Pune, goes a long way in Indian medical history.

Many of you may question its relevance to an Ayurvedic blog and why this discussion here.

Ayurveda is world over known to be the first science to pioneer plastic surgery and cosmetic surgery. Transplants are in a way an extension of the science.

The observations made after and before the procedure in restoring microvasculature and environment follow Ayurvedic principles of prakrui which is very natural.

The provision for hydration through blood supply is for a kaphaj environment which promotes growth and tissue proliferation, reduces atrophy and necrotization and also helps in assimilation of the transplant into the body's own system. It is in a lay man's term just like farming of paddy where you transplant a shoot from one place to another and there again you have to have a bed ready and then in a short course restore hydration for the crop to grow and restore.

The beauty of Ayurved lies in these comparatives which can be drawn from natural acts and processes that happen or we perform in support of nature.

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JANU BASTI

जीवनशैली की गलत आदतें, ऑफिस में लगातार लंबे समय तक बैठकर काम करना, जरूरत से ज्यादा वजन उठाना या बिल्कुल काम न करने से घुटनों में दर्द की दिक्कत बढ़ती है।

आयुर्वेद में प्रयोग होने वाली जानुबस्ति थैरेपी फायदेमंद है जो जोड़ के अंदर तक असर कर दर्द में राहत देती है। इसमें महा नारायण, विषगर्भ, बला आदि औषधियुक्त तेलों का इस्तेमाल होता है।

जानते हैं जानुबस्ति की विधि व लाभ के बारे में-
लाभ: इससे घुटने का दर्द, सूजन व जकडऩ दूर होने से हल्कापन आता है। औषधियुक्त तेल के सेंक से घुटने की मांसपेशियों, हड्डी व नसों को पोषण मिलता है। जोड़ लचीला होने से रक्तसंचार बढ़ता है। ऐसे होता इलाज रोगी को पीठ के बल लिटा दिया जाता है। इसके बाद घुटने पर उड़द की दाल के आटे से बनी पीठी (गुथा हुआ आटा) से एक रिंग बना देते हैं।

चिकित्सक की देखरेख में इस रिंग के अंदर सहने योग्य औषधियुक्त गुनगुना तेल डालते हैं। रिंग के अंदर से तेल धीरे-धीरे बाहर निकलता रहता है और ऊपर से गुनगुने तेल को डालते रहते हैं। कितनी सिटिंग: एक सिटिंग के दौरान इस प्रक्रिया में लगभग 35-40 मिनट का समय लगता है। जरूरत के अनुसार विशेषज्ञ 5-7 या इससे ज्यादा सिटिंग के लिए मरीज को बुला सकते हैं।

ध्यान रखें: थैरेपी के तुरंत बाद स्नान न करें। साथ ही इसके बाद कुछ देर एसी में न बैठें।

KATI BASTI

कमरदर्द से हम सभी कभी न कभी परेशान जरूर होते हैं। उठने-बैठने के गलत पॉश्चर से यह समस्या और भी बढ़ जाती है। ऎसे में आयुर्वेदिक उपचार से रोगी को राहत पहुंचाई जा सकती है।

प्रमुख कारण
गलत आदतें कमरदर्द का प्रमुख कारण हैं जैसे-कम्प्यूटर के आगे या ऑफिस में लगातार बैठकर काम करना, उठने-बैठने व चलने का गलत तरीका, हçaयां कमजोर होना, शारीरिक श्रम न करना या ज्यादा करना और अत्यधिक तनाव जैसे कारणों से मांसपेशियों में खिंचाव आ जाता है व नसों की ताकत कम हो जाती है। जब यह प्रक्रिया लगातार चलती है तो कमर के निचले हिस्से में दर्द व पैर सुन्न हो जाते हैं। कई बार दर्द एड़ी तक चला जाता है और स्थिति बिगड़ जाती है।

दवाओं से जब आराम नहीं मिलता तो डॉक्टर ऑपरेशन की सलाह देते हैं। कमरदर्द के अधिकतर मामलों में स्लिप डिस्क इसकी वजह बन जाता है। ऎसे में कटि बस्ति थैरेपी फायदेमंद होती है। साथ ही आयुर्वेदिक औषधियों, योग और नियमित व्यायाम के अभ्यास से रोगी को आराम मिलता है।

उपचार की विधि
पेट के बल लेटे रोगी की पीठ पर उड़द के आटे की बनी हुई पीठी से एक रिंग बना दी जाती है। विशेषज्ञ द्वारा इस रिंग में औषधि युक्तगर्म तेल सहने लायक स्थिति में धीर-धीरे डाला जाता है। एक सिटिंग 40-45 मिनट की होती है व जरूरत के अनुसार 5-7 या ज्यादा सिटिंग विशेषज्ञ की राय से दी जाती हंै।

इसके लाभ
जड़ी-बूटियों से बने हुए गर्म तेल एवं औषधियों के गुण कमर की मांसपेशियों के सूक्ष्म ऊत्तकों में समा जाते हैं, जिससे कमर की मांसपेशियों की जकड़न व सूजन दूर होती है। खून का दौरा बढ़ता है, मांसपेशियों, हçaयों एवं नसों को पोषण मिलने से इनमें मजबूती आती है और तनाव दूर होकर दर्द में राहत मिलती है।