🔘 APASMARA ROGA

APASMARA ROGA:-

👉🏻 Defination:-

• स्मृतेरपगमं प्राहुरपस्मारं भिषग्विदः|

तमःप्रवेशं बीभत्सचेष्टं धीसत्त्वसम्प्लवात्||

- The expert physicians call apasmara as 'going away of memory' characterized by black-outs (feeling of entering into darkness) and revolting movements caused by conglomeration of the intellect and the mind.

👉🏻 Nidana:-

•विभ्रान्तबहुदोषाणामहिताशुचिभोजनात् |

रजस्तमोभ्यां विहते सत्त्वे दोषावृते हृदि ||

चिन्ताकामभयक्रोधशोकोद्वेगादिभिस्तथा|

मनस्यभिहते नॄणामपस्मारः प्रवर्तते||

✓ Apasmara occurs in those persons, in whom:-

- The doshas are excessively aggravated and have spread to other sites (vibhranta) due to (habitual) intake of improper/harmful and impure/contaminated food.

- In whom, the sattva is suppressed by rajas and tamas.

- The heart is obscured by aggravated doshas.

- Mind is distressed or annihilated by worry, passion, fright, anger, grief, anxiety etc. 

👉🏻 Purvaroopa:-

• Premonitory symptoms of apasmara include:-

- contraction of eyebrows

,erratic and constant movement of eyes, auditory hallucinations, excessive salivation, and nasal discharge. 

- There is frequent accompaniment of anorexia, indigestion, and general disinclination towards food.

- Chest congestion, distension of the lower abdomen accompanied with gurgling sound, weakness, cracking pain in bones and malaise, unconsciousness, a feeling of despondency or depression, fainting and giddiness, and frequent dreams of scenes of intoxication, dancing, murdering, aching, shivering and falling.

👉🏻 Samprapti:-

- Due to nidana sevana doshas located in the vessels afflict the heart. Thus person suffers due to bewildered mind.

- He visualizes non-existent forms, falls down, his tongue, eyes and eyebrows become tremulous, saliva discharges from his mouth, his hands and legs are extended / bent.

- When the surge of doshas is over, he wakes up as if he is getting up from sleep.

👉🏻 Samanya lakshana:-

- Apasmara is characterized by occasional loss of consciousness associated with aberrant activities and behavior, due to perversion of memory, intellect and other psychic faculties.

 

👉🏻 Types:-

1.Vataja

2.Pittaja

3.Kaphaja

4.Sannipataja

👉🏻 Vishesha lakshana:-

1) Vataja Apasmara:-

• Vatika apasmara is characterized by:-

- Trembling, grinding of teeth, frothing from the mouth, and gasping. 

- The patient gets visual hallucinations of objects which are rough, reddish brown or black in color. 

2) Pittaja Apasmara:-

• Paittika apasmara is characterized by:-

- Yellowish froth, body, face and eyes. 

- He gets visual hallucinations of yellow or blood-red objects. He has thirst, hot sensation (sensation of heat), and sees fire all over his surroundings.

3) Kaphaja Apasmara:-

• Tridoshaja apasmara is characterized by:-

- Manifestation of all of above features at the same time. 

- This type of apasmara is incurable. 

👉🏻 Sadhyasadhyata:-

- The apasmara, which occurs in emaciated person and in chronic stage, is incurable. 

👉🏻 Diagnosis as per frequency of seizures:-

- The vitiated doshas lead to paroxysms of apasmara once in fifteen days, twelve days or a month. 

- The paroxysm may occur even after a shorter period.

👉🏻 Management:-

- Strong elimination and alleviation therapies are effective in alleviating and curing apasmara.

- When extrinsic causative factors are involved, then mantras etc., are considered useful.

🔘 ANATOMY OF FEMALE REPRODUCTIVE ORGANS

ANATOMY OF FEMALE REPRODUCTIVE ORGANS

👉🏻 Overview:-

- The female reproductive system is designed to

carry out several functions.

- 4 is the normal pH of the vagina.

- 40 weeks is the normal gestation period.

- 400 oocytes released between menarche and

menopause.

- 400,000 oocytes present at puberty.

- 28 days in a normal menstrual cycle.

- 280 days (from last normal menstrual period) in a

normal gestation period.

💫 External genital organs:-

1.Mons pubis

2.Labia majora

3.Labia minore

4.Clitoris

5.Vestibule

6.Urethral opening

7.Vaginal orifice and Hymen

8.Bartholin's glands

9.Skene's gland

10.Vestibular bulbs

 1.Mons pubis:-

- It is the pad of subcutaneous adipose connective tissue lying in front of the pubis that is covered with hair at puberty.

 2.Labia Majora:-

- Has two folds of adipose tissue that border each side of the vagina.

- The labia majora enclose and protect the other external reproductive organs.

- It contain sebaceous glands, sweet glands, and hair follicles.

- After puberty, the labia majora are covered

with hair.

 3.Labia Minora:-

- The labia minora are smaller folds (forchette) of

skin that lie inside the labia majora.

- Contains no hair follicles or sweat glands.

- The folds contain connective tissues numerous

sebaceous gland, erectile muscle fibers and

numerous vessels and nerve endings.

- Anteriorly, they are divided to enclosed the clitoris

and unite with each other in front-prepause and

behind- frenulum.

- The lower portion fuses known as fourchette.

 4.Clitoris:-

- It is small cylindrical erectile body.

- Measuring about 1.5 to 2cm.

- Situated in the most anterior part of the vulva, the two labia minora meet at the clitoris.

- The clitoris is covered by a fold of skin, called the prepuce, richly supplied with nerves.

- The clitoris is very sensitive to stimulation and can become erect.

 5.Vestibule:-

- It is a tringular space bounded ant by clitoris, post.

by fourchette and on either side by labium minus.

- It encloses:-

• Urethral opening

• Vaginal orifice and hymen,

• Bartholin's ducts opening

• Skene's glands

 6.Urethral opening:-

- Situated in midline just infront of the vaginal orifice.

- About 1-1.5 cm below the pubic arch.

- The paraurethral ducts open either on the posterior

wall of urethral orifice or direct into the vestibule.

 7.Vaginal Orifice and Hymen:-

- Lies in the posterior end of the vestibule.

- It incompletely enclosed by a septum of mucous membrane called hymen.

- The membrane varies in shape but is usually circular or crescentie in virgins.

- Hymen Located just inside the vaginal Opening.

- It is usually ruptured at the consummation of

marriage.

 8.Bartholin's glands:-

- There are two bartholin's glands One on each side.

- They are pea sized and yellowish in colour and lined

by cuboidal epithelium.

- Each gland has a duet which measures about 2

cm and open into vestibular outside Close to the

posterior end of the vestibular bulb.

- During sexual excitement it secretes abundant alkaline mucus which helps in lubrication.

 9.Skene's gland:-

- The largest paraurethral gland.

- Homologous to the prostate in the male.

- The two skene's ducts may open in the vestibule on

either side of externa urethral meatus.

 10.Vestibular bulb:-

- These are bilateral elongated masses of erectile

tissuses situated beneth the mucous mambrane of

vestibule 

- Each bulb lies on either side in vaginal orifice.

- They are likely to be injured during childbirth with

brisk haemorrhage

👉🏻 Blood supply:-

• Arterles:-

- Branch of Internal pudendal artery

- Branch of femoral artery

• Veins:-

- Internal pudendal vein

- Vesicle or vaginal venous plexus

- Long saphenous vein

👉🏻 Nerve supply:-

- Bilateral somatic nerve

- Posteroinferior part:-Pudental branch from posterior cutaneoys nerve

- Anterosuperior part:-Cutaneous branch from ilioinguinal Genital branch from genitofemoral nerve

- Between 2 groups the vulva - Pudental nerve

👉🏻 Lymphatic:-

- Superficial inguinal nodes

- Intermediate group of inguinal lymph nodes

- External and internal illiac lymph nodes

💫 Internal Genital organs:-

1.Vagina

2.Uterus

3.Fallopian tube

4.Ovaries

 1.Vagina:-

✓ Introduction:-

- Vagina:- Birth canal

- It is fibro-musculo membranous sheath connects the external Genital organs to uterus.

- About 4 to 5 inches long in an adult women.

- It is the passageway for sperm to the egg and for Menstrual bleeding.

- Organ for copulation and forms the birth canal of parturition.

✓ Structures:-

- Posterior wall of vagina is 9 cm long

- Anterior wall is only 7 cm length

- The upper end of the vagina is known as the vault

- Pink in appearance

- PH 4-5 acidic due to Doderlein'bacilli which produce lactic acid from glycogen present in exfoliated cells.

• Layers:-

1.Mucous coat -no secreting glands

2.Submucous layer

3.muscular layer inner circular n outer longitudinal

muscles

4.Fibrous coat

✓ Fornics of Vagina:-

- Formed at the top of vagina due to projection of the

uterine cervix

- Four fornlcs are there:-

One anterior - front of cervix most shallow

One posterior - behind, deeper

Two lateral - either side of cervix

✓ Relations of vagina:-

• Anterior to the vagina - lie the bladder and the

urethra which are closely connected to the anterior

vaginal wall

• Posterior to the vagina - lie the pouch of douglas,

the rectum and the perineal body, each occupying

one third of the posterior vaginal wall

• Laterally on the upper two third are the pelvic

fascia and the ureters, which pass beside the cervix

• Superior to the vagina - lies the utreus

• Inferior to the vagina - lies the externalgenitalia

✓ Blood Supply:-

• Arterles:-

- cervico vaginal branch of uterine artery

- vaginal artery anterior division of internaliliac and Internal pudendal

• Veins:-

- Internal iliac vein

- Internal pudendal vein

- Lymphatic Internal illac group

- Superficial inguinal group

✓ Nerve supply:-

- Sympathetic and parasympathetic from the pelvic

plexus

- Lower part is supplied by the pudendal nerve

 2.Uterus:-

✓ Introduction:-

- The uterus is a thick-walled, muscular, hollow pyriform organ

- Located in the middle of the pelvis, behind the bladder, and in front of the rectum. The

uterus is anchored in position by several ligaments.

- The uterus consists:-

a.Body(Corpus)

b.Isthumus

c.Cervix

- The cervix is the lower part of the uterus, which protrudes into the upper part of the vagina. 

- It can be seen during a pelvic examination Like the vagina, the cervix is lined with a mucous membrane, but the mucous membrane of the cervix is smooth.

- Sperm can enter and menstrual blood can exit the uterus through a channel in the cervix (cervical canal).

- The cervical canal is usually narrow, but during labor, the canal widens to let the baby through

- The cervix is usually a good barrier against bacteria,

except around the time an egg is released by the

ovaries (ovulation), during the menstrual period, or

during labor.

✓ Functions:-

- The main function of the uterus is to sustain a developing fetus.

- It prepare for this possibility for each month

- At termination of pregnancy it expels the uterine

contents.

√ Relations:-

- Anterior - the uterovesical pouch and the bladder

- Posterior - the rectouterine pouch of the douglas

- Laterally-the broad ligament, the uterine tubes

- Superior - the intestine

- Inferior - the vagina

✓ Measurement and parts:-

- Measures 8cm long, 5cm wide, 1.25cm thick

- Weight 50-80gms

- Parts:-

1.The body or corpus

2.Isthumus

3.Cervix

- Secreation:- 

• The endometrial:- Scanty and watery

• Cervix:- Alkaline,thick,rich in mucoprotein, fructose and sodium chloride

✓ Layers:-

- ENDOMETRIUM: inner lining of uterus, nourishes

developing embryo, built up each month for pregnancy, if not,shed during menstruation

- MYOMETRIUM: smooth muscular, supports fetus,

contracts at birth and to shed the endometrium

during menstruation.

- PERIMETRIUM: The perimetrium is a serous

membrane that lines the outside of the uterus.

✓ Arteries:-uterine artery-branch of internal iliac

artery

✓ Veins :- Internal liac vein

✓ Lymphatic:- Deep and Superficial lymph vessels

✓ Nerve supply:- Parasympathetic and sympathetic

 3.Fallopian tube or oviducts:-

✓ Introduction:-

- The two fallopian tubes, which are about 4 to 5inches (about 10 cm) long, extend from the upper edges of the uterus toward the ovaries.

✓ Function:-

- Transport of the gametes

- To facilitate fertilization and survival of zygote

through its secretion

✓ Relations:-

- Anterior, Posteriorand Superior - the peritoneal

cavity and intestine

- Laterally - the sidewall of pelvis

- Inferior - the broad ligament and the ovaries

- Medial - the uterus lies between the uterine tubes

Structure 1) Serous 2 muscular, mucous

✓ Parts:-

1.The intestinal/intramural

2.The isthumus

3.The ampulla

4.The infundibulum

✓ Artery:- Uterine and ovary

✓ Veins:- Ovarian vein

✓ Lymphatic:- Along with the ovarian vessels to para aortic nodes

✓ Nerve supply:- Uterine and ovarian nerves

 4.Ovaries:-

✓ Introduction:-

- Paired sex glands in female which are concerned for:-

1)Germ cell maturation, storage, its release

2)Steroidogenesis

- Each gland is oval shape and pinkish grey in colour

and surface is scarred during reproductive peroid.

- Measure-3cm length, 2cm breadth, 1cm thickness

✓ Relations:-

- Ovaries are intraperitoneal structures

- In nullipara, its lies in ovarian fossa

• Anterior - the broad ligaments

• Posterior - the intestine

• Laterally the infundibulopelvic ligaments and side

walls of the pelvis

• Superior to the ovaries lie the uterine tube

• Inferior to the ovaries lies the ovarian ligaments

- Two ends - Tubal and Uterine

- Two borders- Mesovarium anterior and Free posterior

- Two surfaces. Medial and lateral

✓ Structure:-

- The ovary is covered by a single layer of cubical cell known as germinal epithelium.

- Medulla

- Cortex

• Medulla:-

- supporting framework

- Made of fibrous tissue

- Has ovarian blood vessels

- Lymphatics and nerve travels through it

- there is small collection of cells called hilus cells

• Cortex:-

- It consits of stromal cell which are thickened

benetath the germinal epithelium to form tunica albugenia

- Functioning part of the ovum

- Contains ovarian follicals in different stage

✓ Artery:-ovarian and abdominal aorta

✓ Venous:- ovarian vein

✓ Lymphatic:- Along the ovarian vessels to para aortic nodes

√ Nerve supply:- ovarian nerves from T10 segment

🔘 Hydro Therapy

Hydrotherapy 

(Elemental force = Water)

👉🏻Significance of water

-Water is a universal solvent

-Available universally in abundance and is -cheap

-Non-toxic and non-irritating

-Rapidly absorbs and holds good deal of heat, releases it easily

-without cooling too quickly

-Stores energy

-Can be converted from liquid to vapor or solid

-Touches every part of body surface

👉🏻Thalasso Therapy - 

Use of sea water,beach sand, sea weeds, sea mud for treatment.

👉🏻2 RULES

Mode of Action

-Always Cold AFTER Hot

-Hot water should be BEARABLE

Hot water-(98-104 F)(37-40°C)

Muscle - relaxation - Increased blood circulation

Cold water - (55-65F /13-18°C)

Tissue decongestion - Tissue flushed with

fresh blood.

👉🏻Reflexology of Hydrotherapy

-Region of Circulation    & Correlating Body parts

1. Head, chest, pelvic 

region -  Skin of feet and hand      

2.Kidney - Skin of lower breast bone.

3. Blood vessels of head      - Skin of face

4.Mucous membrane of 

nose - Skin of base of neck.

5.Abdominal organs and 

internal organs  - Skin of spinal region.

6.Genitourinary 

organs  - Skin of thighs, lower back & buttock

7.Prostate and 

uterus  - Skin of lower inner thighs.

💫 Hydrotherapy - 7 application methods

Application methods

1. Heating compress

2. Foementation

3. Full sheet pack (For      relaxation and detox)

4. Ice pack (For calming inflammation/easing pain)

5. Alternating sitz bath/local immersion

6. Neutral bath (For anxiety reduction/pain relief)

7. Steam Bath ( For breathing problems/sinus congestion)

👉🏻 Heating Compress

- Requirements: 

Cotton sheet/Towel, Plastic sheet, Safety pins, Cold water

- Indications: 

Painful joints, mastitis, sore throat, back ache, tight chest from bronchitis.

- Procedure:

Squeeze out cotton sheet in cold water so that it does not drip

Keep over painful area then cover with plastic sheet

Secure with safety pins.

Remove after cold cotton sheet becomes warm.

👉🏻Foementation

-Requirements: 

Cotton sheet, Blanket, very hot water, woolen towels.

-Indications:

Pain, congestion especially muscle spasm & tension,

lumbago, neuralgia, dysmenorrhoea, renal colic.

-Contra-Indications: Cancer, heart disease, diabetes, circulatory problems

of legs, haemorrhage, sensitive skin.

- Procedure:

Soak woollen towel in very hot water (more water retained better, foementation)

Keep on painful area between layers of dry towel

Change every 5 minutes. Apply 3 to 4 times

When sweating begins, apply cold towel to forehead. After foementation, rub area with cold damp towel and rest for 1/2 to 1 hour.

👉🏻Full Sheet Wet Pack

- Requirements: 

2 Cotton sheets, 2 Blankets, very hot water, woolen

towels.

 - Contra-Indications: 

Severe anaemia, debility, skin conditions.

- Procedure:

Have warm water bath and without drying body cover with Cold Wet Sheet

Wrap with one blanket covering full body

Fit second blanket over first one tightly

 Lie down by supporting neck with pillow

Keep hot water bottle under feet.

For maximum benefit, apply for 3 hours.

👉🏻 Ice Pack

- Requirements: 

Woollen sheet, towels, ice, safety pins, plastic,

bandage.

- Indications:

Sprains, injuries, bursitis, swellings, bites,

haemorrhoids

- Contra-Indications:

Acute bladder problems, 

acute asthma, 

abdominal application.

- Procedure:

Crush ice into towel and fold and secure with pin

Cover painful area with pack and cover with plastic

Leave in place for 1/2 hour

Repeat process after 1 hour if necessary

👉🏻Alternating hot and cold application

- Requirements: Cotton sheet, 2 Blankets, Three towels, hot & cold water.

- Indications:

Chronic pains, enhances immunity, promotes healing.

 - Contraindications: Haemorrhage, colic & spasm, chronic heart disease,

acute bladder, kidney infection.

- Procedure:

 Lie down between two blankets

Cover body with sheet

Then place one layer hot towel and one layer cold towel

Remove old hot towel and keep new hot towel for 2 minutes.

Immediately keep new cold towel

Cover with blanket until cold towel is warmed

Repeat same steps on back.

👉🏻 Neutral Bath

Pack temperature = Body temperature

Keep for 1/2 hour

Indicated in agitation, anxiety, and nervousness

Contraindications - Serious cardiac disease and skin conditions.

👉🏻Steam Bath

Local steam bath (Steam inhalation, Immersion Bath, Sauna Bath)

Full body steam bath (Sitting posture, lying posture)

Indicated in quick elimination of toxins, enhance vital power.

💫 Hydrotherapy -18 bathing methods :-

👉🏻Depending on Temperature

1. Neutral

2.Hot

3.Cold

4. Alternate

👉🏻Using Additional Substances:-

1. Oil Bath

2. Oat meal Bath

3. Mustard Bath

4. Moor Bath

5. Simple Detox bath

6. Epsum Salt bath

👉🏻Depending on Area :-

1. Sitz Bath

2. Spinal Bath

3. Hip Bath (Full and Shallow)

4. Foot Bath

5.Head Bath

6.Trunk Bath

7.Cold Friction Bath

8.Full Bath

🔘 DOWRY DEATH

*DOWRY DEATH:-* 

👉🏻 Introduction:-

- Dowry or Dahej is the money, goods, or estate that a woman brings to her husband in marriage.

- The practice of giving Dowry is very common in the Indian and South Asian cultures.

👉🏻 The Function of Dowry:-

- The family of the bride gives the groom and/or his family dowry to ensure that their daughter will be well taken care of.

- Dowry is a form of assurance that the bride will be well treated. If not, it can be revoked.

- In the event that the husband dies, the wife will be financially stable through inheritance of the dowry she paid.

👉🏻 The History of Dowry:-

- We can date the history of Dowry as far back as 1700 BC when the Code of Hammurabi was written.

- This code stated that in the death of her husband or through divorce, the wife would receive back the Dowry that she paid to him.

👉🏻 Ancient Dowry:-

- The initial role of dowry was to financially provide for the bride because she was moving into a joint family with the groom.

- Women were not allowed to work and earn a living outside of the home, so dowry was suppose to serve as her income and her contribution to the home.

👉🏻 A Twist on Dowry:-

- As times have changed, Dowry is now considered a way for a groom and his family to extort money and gifts from the bride and her family.

- Families often go broke because they are unable to supply the Dowry to the groom.

- Majority of these women come from poor to middle class homes in which their parents save for years in order to provide Dowry to the groom.

👉🏻 Dowry death:-

- Dowry death is a death of young women either by murder or suside as a resort of inability to provide more dowry to her husband and his family.

- The most common form of dowry death is ' bride burning' in which the bride is doused with gasoline or kerosene and set on fire. This is usually done by the groom or his family.

👉🏻 Dowry death statistics:-

- According to Indian National crime records bureau (NCRB) there were approximately 6787 reported dowry deaths in india in 2005.

- The NCRB also reported that there were 2276 female susides related to dowry in 2006 which amounts to 6 deaths per day.

👉🏻 Religious Influences:-

- Hinduism is the predominant religion in India.Giving of Dowry is a tradition and ritual observed in Hindu

marriages incanged marriages in are a common cultural practice.

- The Hindu religion states that mariage is a sacred

relationship and consist of dharma(obligatory

duty) and samskara (sacrament).

👉🏻 The Dowry Prohibition Act, 1961:-

- In July 1961, Indian officials created The Dowry Prohibition Act which prohibits the demand, receipt. or payment of dowry in marriage.

- In this act, any gifts viewed as a precondition for marriage were punishable and illegal Punishment for receiving or giving dowry is imprisonment up to 6 years and/or a fine of 5000 Rupees or the amount of dowry which was paid (whichever is more).

👉🏻 Indian Penal Code Section 304B:-

- In 1986, this penal code was inserted into the Dowry Prohibition Act stating it a woman is burned to death or dies due tofunnatural) bodily injuries within seven years of her marriage this case will be investigated as dowry death.

- If it is proven that these women were tortured or harassed soon before her death groom and his family would be considered suspects and/or implicated in the cause of her death(deemed

dowy death)

- Punishment can range from seven years to life.

👉🏻Dowry in India now a days:-

- Despite the Dowry Prohibition Act and Indian Penal Code(304b) dowry and dowry death are still occurring in India.

- Although dowry death maybe investigated convictions are slim to none.

- The accused party states that their beloved bride" is dead as a result of a kitchen fire.

👉🏻 Gender Inequality:-

- Indian Brides and their families are the ones who suffer from the Dowry system.

- As a result of inability to provide (more) Dowry, they are often killed, harassed, tortured or commit suicide.

- The extremely poor to middle class are affected by the Dowry system.

- The groom and his family benefit from receiving Dowry and may kill the bride in order to remaity and receive dowry from another bricoland her family).

👉🏻 Preventions:-

- Women Organizations, legal amendments, media support, special police cells for women and protest are all ways people are trying to end the Dowry system in India.

- Despite their attempts dowry still continues to be a social norm in the Indian society, thus dowry deaths

continue to rise.

👉🏻 Anti-dowry organizations:-

- Azad foundation

- Bharatiya grameen mahila sangh

- ICRW (International center for Research on women)

- Lawyers collective

- Angala

- Aasra

🔘 UNMADA ROGA

*UNMADA ROGA:-* 

👉🏻 Defination:-

• समुद्भ्रमं बुद्धिमनःस्मृतीनामुन्मादमागन्तुनिजोत्थमाहुः|

- Unmada refers to excessive affliction of intellect, mind and memory

👉🏻 Types:-

1.Vataja

2.Pittaja

3.Kaphaja

4.Sannipataja

5.Agantuja

👉🏻 Nidana:-

• विरुद्धदुष्टाशुचिभोजनानि प्रधर्षणं देवगुरुद्विजानाम्|

उन्मादहेतुर्भयहर्षपूर्वो मनोऽभिघातो विषमाश्च चेष्टाः|

- Food with incompatible, contaminated and unclean properties.

- Possession by spirits like gods, teachers and brahmanas

- Mental trauma due to recurrent exposure to fear or exhilaration and adopting difficult posture.

👉🏻 Purvaroopa:-

- Emptiness in head

- Congestion in eyes

- Noises in ears

- Hard breathing in excess

- Excessive salivation in the mouth

- Absence of inclination for food, anorexia and indigestion

- Spasm in cardiac region

- Meditation, fatigue, unconsciousness and anxiety in improper situations

- Continuous horripilation

- Frequent pyrexia

- Pain in the upper part of the body

- Manifestation of symptoms of facial paralysis resulting in movement in one half of the face.

- Frequent appearance of the following in dreams

Inauspicious objects that are wandering, moving and unstable.

👉🏻 Samprapti:-

- By nidana sevana the doshas get vitiated in the person possessing low level of sattva guna in turn vitiate hridaya, which is the seat of intellect. There from the channels carrying mental factors quickly delude the mind of the person and causes Unmada.

👉🏻 Samanya lakshana:-

- Perverted intellect, psychic agitation, restlessness in eyes, impatience, incoherent speech and feeling of emptiness in hridaya. 

- Thus, the person with deranged mind does not know pleasures, pain, ethics and eternal duties and does not get peace anywhere. 

- Therefore, he lets the mind wander here and there due to loss of memory, intellect and perceptions

👉🏻 Vishesha Lakhana:-

 *1. Vataja Unmada:-* 

• The distinctive features of vatika type of unmada are as follows:

- Constant wandering

Sudden spasm of eyes, eyebrows, lips, jaws, and irregular movements of shoulder, fore-arms and legs.

- Continuous, irrelevant and incoherent speech.

- Frothing from the mouth.

- Frequent smiling,laughing, dancing, singing and playing musical instruments in inappropriate situations.

- Loudly imitating the sounds of lute, flute, conch, samya and tala.

- Riding phantom vehicles.

- Adoration of self by false ornaments.

- Craving for food articles that are not available;

Disgust and hatred for food articles that are readily available.

- Emaciation and roughness.

 *2.Pittaja Unmada:-* 

- Intolerance, anger and excitement at inappropriate occasions.

- Inflicting injury on self or on others by weapons, brickbats, whips, sticks and fist.

- Running around

- Desire for shade, cold water and food having cooling effect.

- Prolonged anguish

- Ferocious eyes with coppery, green or yellow color

 *3.Kaphaja Unmada:-* 

- Prefers to live at one place

- Meek and mum, prefers not to speak

- Excessive salivation and nasal secretions

- Disinclination for food

- Prefers loneliness

- Frightening appearance

- Aversion for cleanliness

- Always drowsy

- Edematous face

- White and timid eyes full of dirt

 *4.Sannipataja Unmada:-* 

- In the unmada caused by the combined vitiation of all the three doshas, all the symptoms mentioned above are simultaneously manifested. 

- This type of unmada is considered to be incurable.

 *👉🏻 Agantuja Unmada:-* 

√ Nidana:-

- Possession by the gods, sages, gandharvas, pishachas, yakshas, rakshasas  and pitru

- Unmethodical performance of spiritual rituals and vows etc

- The deeds of past life  

√ Purvaroopa:-

- Desire for inflicting injury upon the gods, cows, Brahmins and ascetics.

- Anger and liking for mischievous work

Disliking attitude

- Impairment of Ojas Color complexion and physical strength and

Abuse and incitement by the gods.

√ Lakshana:-

- Untimely, uncertain and uncalled for manifestations

- Superhuman strength, valor, manliness, enthusiasm, power of understanding and retention, memory, spirituality, logical and scientific knowledge and power of speech.

- Celestial beings invisibly and swiftly enter into the body of a person by their own supernatural effect without affecting the body of the individual. 

- This simulates with as image enter the mirror and sunlight enters the sun-stone.

√ Chikitsa:-

- Incantation of mantras,

Wearing of gems and jewels according to astrological indications.

- Performance of auspicious and religious rites and sacrifices, oblations

Taking a vow, performing religious duties, penance, fasting, blessings, obeisance and pilgrimage.

👉🏻 Sadhyasadhyata:-

- Of the above varieties of unmadas, he who strikes at others or himself, without hesitation raising his hands with wrath and agitation should be considered as incurable.

- He who has tearful eyes, hemorrhage from penis, wounded tongue, running nose, a bruised skin, uninteractable hands, constantly groaning, deranged complexion, excessive thirst and foul smell should be known as maddened by a violent type of spirits (grahas) and should not be treated.

🔘 Methanol Poisoning

METHANOL POISONING

👉🏻Introduction :-

Methanol is a nondrinking type of alcohol (also known as wood alcohol and

methyl alcohol) which is mostly used to create fuel, solvents and antifreeze. A colorless

liquid, it is volatile, flammable, and unlike ethanol, poisonous for human consumption.

This denatured spirit is used in hospitals & clinics to disinfect skin before surgery &

dressing process or before giving injections. It is also used in varnish, paint removal.

👉🏻Absorption & Metabolism:-

It is rapidly absorbed through the stomach & intestines & also through the lungs

& skin. through its action resembles that of Ethyl alcohol to greater extent, It is

metabolized more slowly & with repeated dose tends to accumulate in the blood.

80mg/100ml of blood is dangerous level. It does not completely disappear from the blood

fro 3 to 4 Days.

👉🏻Action:-

It Causes C.N.S. depression. It is less respiratory depressant than ethyl alcohol.

Its late effects are very dangerous, which includes optic nerve atrophy.

👉🏻Excretion:-

About 80% is excreted unchanged from the lungs & about 3% is excreted

unchaged in the urine.

👉🏻Signs and symptoms :-

💫 In small doses -

- Dizziness (vertigo)

- Headache

- Nausea & Vomitting

- Abdominal pain

💫 In Moderate doses -

- Tachy cardia

- Drowsiness

- Mydriasis (dilation of the pupil

💫 In High doses -

-Metabolic Acidosis

- Convulsions

- Retinal Oedema

- COMA

- Respiratory failure and death

👉🏻Fatal Dose:- 

60 ml to 140 ml.

To produce blindness - 15 ml

👉🏻Fatal Period:-

Usually between 24 - 36 hours.

 However

as in the 4th or 5th Day.

many cases, death occurs as late

👉🏻TREATMENT:-

The patient must be hospitalized & kept under close observation even after

several days of recovery. 

An ophthalic review should be ensured.

A)- According to Ayurved - 

In Ayurveda, use of different Medicinal Madya according

to Dosha is a main treatment.

B)- According to Modern

 - Patient should be admitted in ICU department &

following treatment should be administered.

1. To stop further absorption of methyl alcohol, stomach wash with 5%

bicarbonate solution in warm water should be given & after stomach wash 1/2 litre

solution is left in stomach.

2. To reduce acidosis, administer 2gm of sodabicarb in 250 ml DW slowly. If it

is no possible to give orally then 50 gm of Sodium bicarbonate in 1 litre of 5% dextrose

& 10-15 units of insulin should be administered through intravenous line.

3. Ethyl alcohol is a Specific antidote of Methyl alcohol.

4. Haemodialysis - In severe poisoning of methyl alcohol haemodialysis is a

effective treatment to remove toxic content.

5. Oxygen supply, artificial respiration & other symphomatic treatment should

be prescribed whenever necessary.

👉🏻Autopsy Findings:-

- Cyanosis (Specially in thorax region) is prominently seen.

- The blood is fluid & dark in colour, Coagulation of blood after death is not seen.

- The inflammation of brain & lungs are seen.

- The mucosal membrane of gastrointestinal tract is congested.

- The degenerative changes in liver & kidney are seen.

- Retinal oedema is found.

- The internal organs are preserved in saturated solution of salt.

👉🏻Medico-Legal Importance:-

Accidental Poisoning:-

 The poisoning is mostly accidental. 

-It is mixed in the from of

French polish, varnish, denatured spirit in country liquor to gain some profit.

-This liquor is called as Khopadi in Maharashtra.

🔘 Samskara In Children

TO BE CONTINUED...... 

💫 KARNAVEDHANAM

 ( Ear Piercing) :

Karnavedhana is one of the important samskaaras with medical and socio-cultural relevance.

In addition to the cosmetic value (Karnaabhushana), it was believed that Karnavedhana protects the baby from untoward health complications like Grahas.

However , this is not medically proven. 

👉🏻 Time of Karnavedhana -

According to Sushrut and Astang Hrudaya, Karnavedhana has to be done in 6th,7th or 8th month of age, in the sisira ritu on an auspicious day, in the morning.

According to Gruhya Sutra, Karnavedhana has to be done on the 3rd or 5th month.

👉🏻 Pre Operative Measures -

After Poojaadikarmas and enchantment of mantra.

The baby is seated on the mother’s lap.

Made happy with sweet words and desired toys etc.

Then the ear is punctured.  

👉🏻 Procedure -

The right ear should be punctured first in case of a male child and left ear in a female child.

The physician holding the puncturing needle with his right hand and the ear lobe with the other.

The site of the puncture should be the middle of the ear lobe , slightly towards the cheek , where the maximum translucency from the light source.

This spot is marked by the Colour of laksha rasa. 

The puncturing should be done with a single and straight stroke; it should neither high up , sideward nor downward.

If the ear lobe is thicker, Aara Sastra should be used.

👉🏻 Inference -

By puncturing the correct site, there will not be severe pain , bleeding and immediate inflammatory reaction, local rise of temperature, swelling and redness.

 

👉🏻 Post Operative Measures -

A cotton thread soaked in oil should be drawn through the puncture and the site bathed with unprocessed oil.

On each 3rd day the thread should be replaced with thicker ones for widening of the puncture.

Daily fomentation , massage , bathing with oil and nourishing foods should be adopted repeatedly.

👉🏻 Precaution -

The puncture should be at the correct site , be neither high up , sideward nor downward, since siras known by the names kaalika, marmari and rakta are situated there. 

👉🏻 Complications -

Following are the complications produced by injury to the siras.

Kaalika – Jwara, daaha, sopha,ruk.

Marmari – Jwara, ruk, granthi.

Lohitika – Manyaagraham, apataanakam, sirograha, karnasula.

💫 PHALAPRAASANAM

 (Feeding fruits/fruit juices to baby) :

Acharya Kashyapa is the only one who has explained phalapraasana.

Up to 6 months of age ,  the child is fed exclusively with breast milk.

There after, prior to the introduction of solid food, so as to make the GI Tract accustomed to it, liquid food is given.

Among them, fruit juices are considered ideal.

Besides, fruits are best sources of vitamin C and fibrous material.

The baby who is accustomed to madhura rasa alone will experience difficulty to adjust with the rasas like katu, tikta, etc. 

At this stage, Phalapraasana helps the baby to adapt with other rasas through madhura amla rasa of fruits. 

Kashyapa considers dental eruption as the endpoint of phalapraasana.

Initially , central incisors erupt during 6-7th month.

Eruption of teeth is indicative of GIT maturity to digest, absorb and assimilate nutrients 

💫 ANNAPRAASANA

( Feeding Ceremony) :

It is related to feeding of solid food for the first time to the baby.

After teeth eruption, the child should be gradually taken away from breastfeed.

At the same time , the child should be given ksheera(goat milk) alongwith laghu and brimhana aahara.

👉🏻 Time of Annapraasana -

According to Kashyapa, 10th month is the appropriate time for Annapraasana.

According to Astanga Samgraha, Vagabhata and Sushruta opines 6th month to be the time for Annapraasana.

👉🏻 Procedure -

Annapraasana should be done in an auspicious day in prajaapatya constellation after fulfilling the following conditions :

Worshiping Gods and Brahmins by cereals with meat and donations.

Reciting mantras.

Smearing the site with cow dung, spreading darbha.

Decorating with fragnances and garlands and signs of swastika in 4 places.

Preparing all the articles for making toys.

 

Next, the physician gets seated facing east and the child facing west.

After igniting fire, a delicious diet comprising of cereals and drinks made from meats of laavaka, kapinjala, tittiri, charanaayudha should be first offered as oblations to fire alongwith enchantment of mantras.

After oblations, the remaining food made soft by mashing, is given to the child(3/5th times) in a quantity equal to that of a thumb(angushta maatra).

👉🏻 Paschat Karma -

After feeding , the baby should be cleaned.

🔘 Samskara In Children

Samsakara

The important cultural events in an individual’s life from birth to death are grouped under the term ‘samskaaras’. 

The  number of samskaaras varies in different communities. 

The customary samskaaras are 16 in number which were put forward by Maharshi Dayananda.

All the samskaaras are not medically important; rather they posses much of a socio-cultural dimension. 

Only the medically important ones are dealt by the ancient medical scholars.

💫 NAAMAKARANA SAMSKAARA

(Naming Ceremony) :

👉🏻 Time of Naamakarana -

According to Ashtanga samgraha naamakarana can be done either on the 10th or 12th day. Kasyapasamhita and Ashtanga Hridayam mentions 10th day as appropriate for naamakarana. 

👉🏻 Preparation of the baby -

Mother and the baby having taken bath in water mixed with aromatic drugs, wearing light and clean cloth and ornaments should worship deity and receive blessings from braahmanas. 

Then the baby is made to sit over a pad of clothes with the head towards east or north.

There after, the father of the baby should utter that the child is offering salutation to the diety and braahmanas. 

Having said so, the child should be given two names.

👉🏻 Characters of names -

Out of the two names, one is based on the constellation present at the time of birth and the other should be a popular name for day to day use. The popular name should begin with ‘ghosha’ alphabets and end with ‘antastha’ alphabets.

There should not be a letter with vridddhi or parvam. 

The name should not be newly established. It should be similar to that of the preceding generation. 

The name should be denotable with baby’s star or devotee.

💫 NISHKRAAMANA SAMSKAARA

(Outing Ceremony) :

It is the ceremony of taking the baby out of the Kumaaraagaara. 

This samskara enables the baby to acclimatize with the external environment.

👉🏻 Time of Nishkraamana -

Kasyapa and Vagbhata considers 4th month as the appropriate time for niskraamana karma.

👉🏻 Preparation of baby -

The baby having bathed, adorned and worn new clothes and possessing the rakshoghna oushadhas like siddhaartaka, madhu, ghrita and gorochana on his body, should be brought out.

👉🏻 Nishkraamana vidhi -

The baby along with the mother should be taken out of the Kumaaraagaara and made to enter the temple. 

After worshiping the burning fire, braahmana, God Vishnu, skanda and receiving their blessing should re-enter their own house. 

Having entered, the physicians should chant mantras for offering prayer.

It is for the first time during Nishkraamanakarma that the child is exposed to some sort of ‘external environmental’ stimuli, mainly visual and auditory. This karma helps the physician to confirm the proper functioning of the sense organs especially the eye and the ear.

According to modern view, macular fixation and pupillary adjustment is attained during the same 4th month. 

During the early weeks eye movement and coordination may not be perfect. 

However, proper coordination should be achieved by 3-6 months.

💫 UPAVESANAM SAMSKAARA

(Sitting Ceremony) :

Upavesana is a ceremony of making the baby sit without support in a proposed manner to ensure the activity, growth and development of the baby.

👉🏻 Time of Upavesana -

Kasyapasamhita says upavesana at the age of 6th month. 

Ashtanga Samgraha mentions the same at 5th month.

👉🏻 Preparation of child -

The baby should be bathed, adorned and dressed in intact cloths. 

Before the ceremony, worshiping of gods and satisfying the beaahmanas by diets and donations has to be performed.

The site where baby is to be seated has to be smeared with cowdung. 

Toys used by the baby are to be placed nearby.

The baby should be made to sit for a muhurta(48 min.) at a time facing eastwards in the middle of site. 

After completion of a muhurta, the child should be carefully lifted up. 

The whole procedure has to be repeated everyday.

👉🏻 Precautions -

The duration of sitting should not be too long.

The child should always be assisted and never left alone.

This need not be performed while the baby is ill.

👉🏻 Complications of prolonged sitting -

Fixing

Weakness of hip

Hunch back

Tiredness

Fever

Retention of feces,urine and flatus develop due to sitting for longer duration.

👉🏻 Complications of early sitting -

If the baby is made to sit prior to the prescribed age, vitiation of vaata occurs which leads to fever, pain, hardness of body parts and even arrest of further growth and development.

 

TO BE CONTINUED....

🔘 Menstrual Cycle

Menstrual Cycle 

👉 DEFINITION OF MENSTRUATION :- 

- Menstruation is the visible menifestation of cyclic physiological  uterine bleeding due to shedding of the endometrium .

👉 Duration of Menstruation :- 4-5 days 

👉 Blood loos amount :- 30-80 Ml 

👉 COMPONENTS :- 

1) Dark altered blood 

2) Mucus 

3) Vaginal epithelial cells 

4) Fragment of endometrium 

5) Prostaglandin 

6) Enzymes 

7) Bacteria 

👉 ENDOMETRIAL CYCLE :- 

- 1st day of bleeding is considered as 1st day of cycle .

4-Phases :- 

1) Stage of regeneration 

2) Stage of proliferation 

3) Secretary phase 

4) Menstrual phase 

1) Stage of regeneration :- 

- it's starts even before ceases of Menstruation & it's completed 2 days after end of Menstruation .

- the cubical epithelium , glands , vessels regenarate from the basal zone .

- Thickness is 2 MM

2) Stage of proliferation ( follicular stage ) :- 

- it extends from 5th to 6th day to 14th day .

- The proliferative changes occur due to rise in level of ovarian estrogen .

- thickness is 3-4 mm 

3) Secretary phase ( Luteal phase ) :- 

- It's begins on day 15 & ceases 5-6 day prior to Menstruation .

- changes due to combined effect of estrogen & progesterone liberated from the corpus luteum after ovulation .

- Thickness is 6-8 mm 

- prominent corkscrew - shaped glands & increase vascularity .

- Endometrial glands increase in size & exceeds thickness of endometrium .

- They secret thick viscous fluid containing glycogen .

- Blood vessels undergo armed spiralling . 

4) Menstrual phase :- 

- It's essential degeneration & casting of an endometrium prepare for a pregnancy .

- The flow stops as result of combined effect of prolonged vascontriction , mayometrial contraction & local aggregation of platelets with fibrin deposition them .

- If no embryo , the corpus luteum begins to disintegrate .

- progesterone level drop , uterine lining detaches , Menstruation can begin .

- Tissue , blood , unfertilized egg all discharge .

- It can take 3-7 days .

👉 OVARIAN CYCLE :- 

- Development & maturation of follicle ovulation & formation of corpus luteum & it's degeneration constitute an ovarian cycle .

4 phase :- 

1) recruitment of group of follicle .

2) selection of dominant follicle & maturation .

3) ovulation 

4) corpus luteum 

1) Recruitment of group of follicle :- 

- It's presumed that about 20 antral follicle proceed & develop in each cycle .

- The intial recruitment & growthof primordial follicle are not under control of any hormone after certain stage 2-5 mm in size the growth & differentiation of follicle are the control of FSH .

- The follicle are rescued by FSH at this stage they undergo atresia .

2) Selection of dominant follicle & maturation :- 

- one with highest antral concentration of estrogen.

- Androgen - estrogen  low 

- maximum receptor of FSH 

- fully mature grfian follicle just prior to ovulation means about 20 mm.

3) Ovulation :- 

- The follicular wall near the ovulation surface becomes thin .

- The stigma develops as a conical projection with penetrate the outer surface layer of ovary & persists for while 0.5 to 2 min as a thin membrane .

- The cumulus escapes out of the folical by a slow oozing process about 1-2 min.

- The stigma is soon closed by plug of plasma .

- ovulation occurs :- 

1) 10-12 hrs after LH peak 

2) 34-36 hrs after onset of LH surge 

3) 24-36 hrs after oestradiol peak 

- The combined LH / FSH mid-cycle surge is responsible for the final stage of Menstruation .

4) Corpus luteum :- 

- After ovulation the rupture grafian follicle develops into corpus luteum .

4 phases :- 

1) Proliferation 

2) Vascularization 

3) Maturation 

4) Regression 

1) Proliferation :- 

- the colour of corpus luteum at this stage is graish yellow colour .

2) Vascularization :- 

- Withing 24 hrs of rupture of follicle , small capillaries grow into granulosa layer 

3) Maturation :-

- By 4th luteal cell have attained the maximum size , thickness is 1-2 cm & yellowish in colour. 

4) Regression :- 

- on the day 22-23 of cycle , regression is occour

🔘 NUTRITION IN CHILDREN

NUTRITION IN CHILDREN:-

👉🏻 Normal requirements of nutrients for newborn infant and children:-

- The infants show a dramatic rate of growth in the 1st year of life. 

- It continues further, though at a comparatively lower level, after the age of 1 year upto the adolescence. 

- During this stage of growth there occurs marked

developmental change in the organ structure and function. Owing to their higher metabolic rates and nutrient turnover rates, as compared to adults,

failure to provide adequate mutrients during this period adversely effects the growth and development of the child.

👉🏻 Satmya and Asatmya aahaara (compatible and incompatible diet):-

- Since infancy and childhood is the age of maximum growth and development, the most saatmya aahaara at this age is those having Madhura

rasa, Snigdha guna and Bramhana karma.

- Contrarily, this age group being a kapha predominant one the aahaara having above mentioned properties can lead to diseases in the child. 

- This paediatric age group generally presents

with kapha-vaata diseases.

- The diet has a major role to play in causation of

such diseases. Such food items in present day include:-

1.Fast foods

2.Chocolates, biscuits etc

3.Fried items eg chips etc.

- Such dietary items cause maximum kapha-vaata predominant diseases in the children. 

- So all such stuffs has to be avoided from the diet of the child.

- While classifying the dravyas acharyas mentioned 3 classes:-

1.Shamana

2.Kopana

3.Swasthahit.

- The dravyas coming under the swasthavritta group

comprises the saatmya or the hita-aahaara while the others are the asatmya aahaara.

👉🏻 Examples:-

- Some examples quoted in the classics are as follows:-

1.Asaatmya aahaara:-

- This group includes the 18 types of virudhha or

incompatible food stuffs that lead to many diseases.

2.Saatmya aahaara:-

- Those foods which are free from the 18 incompatibilities as mentioned above and thus do not produce diseases on consumption falls under this group, especially on the basis of guru-laghu guna virudhha.

- Those foods which are not so guru are satm

ya for the child as Saali,shashtika, godhuma etc.

👉🏻 Common food sources:-

√ Proteins:-

- Animal origin:- Milk, meat, egg, cheese, fish etc.

- Vegetable sources:- Pulses, cereals, beans, nuts, oil seed cakes

√ Fats:-

- Animal fats:- Ghee, butter, milk, cheese, eggsz fat of fish and meat etc.

- Vegetable fats:- Ground nut, mustard, sesame, coconut etc.

√ Carbohydrates:-

- Cereals, roots, tubers, fruits, sugars

√ Vitamins:-

• Vitamin A:-

- Animal liver, eros, butter, cheese, whole milk etc.

- Green leafy vegetables, papaya, mango, pumpkin etc.

• Vitamin D:-

- Sunlight

- Only in foods of animal origin liver, cee yolk, butter and cheese,

• Vitamin E:-

- Vegetable oils, cotton sced, sunflower veed, ese yolk and butter,

• Vitamin K:-

- Fresh green vegetables, cow's milk, fruits

• Thiamine:-

- Whole grain cereals, wheat, gram, yeast, pulues, sound nut

• Riboflavine:-

- Milk, egg, livet, kidney and green leafy vegetables

• Niacin:-

- Liver, kidney, mcat, poultry, fish, legumes, ground nut

• Vitamin B6:-

- Milk, liver, meat, egg yolk, fish, whole grain cereals, legumes and vegetables

• Pantothenic acid:-

- All foods contribute to dietary intake

• Folate:-

- Leafy vegetables

- Liver, mear, cs, fruits

• Vitamin B12:-

- Liver, kidney, meat, fish, eggs, milk, cheese.

• Vitamin C:-

- Fresh fruits. green leafy vegetables,

- Germinating pulses

√ Minerals:-

• Calcium:-

- Milk and milk products

- Eggs and fish

- Millet, ragi

• Phosphorus:-

- All vegetable foods

• Sodium:-

- Added in food as sodium chloride

• Iron:-

- Liver, meat, poultry and fish (haem iron)

- Green leafy vegetables, legumes, nuts, oil seeds (non haem iron)

• Iodine:-

- Sea foods

- Cod liver oil