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Case Presentation Keshav Rai 20240827 101612 0000

Ch jkk

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33 views29 pages

Case Presentation Keshav Rai 20240827 101612 0000

Ch jkk

Uploaded by

itspradeep347
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Case PRESENTATION

KUSTHA ROGA

KESHAV RAI
BAMS2nd Prof. Schoolar
PREMILINARY DATA OF PATIENT
Name: XYZ
o Age 37 Years
o Sex: Female
• Religion: Hindu

• Socio economic status: Middle class


• Marital status: Married
• Education status: 9th Standard
• Occupation: Peon (Aaya) in school.
PRADHAN VEDANA

C/O Sputhna in both hasta pradesha associated with


sotha, daha, srava yukta pidakas and kandu since 3 years.
ANUBANDHA VEDANA

• Stabhdhata in hasta pradesha when srava dries up


VEDANA VRUTTANTA

• Patient is suffering from pidakas, all over the body associated


with kandu on and off since 3 years and subside on medication.
The pidakas develop any where in the body and subsides on
medication. 3 months back when she resumed her work after
which rashes appeared with sputhana in both hasta pradesha
associated with shotha, and srava yukta pidakas with kandu
since 3 years.
• Presently the patient has severe lesions in her both hand and
itching all over the body with healed marks of previous lesions.
Rashes appeared extensor surface of b/l hand and left palm with
severe itching and it spreads to right palm and b/l foot region
due to severe itching all fingers became oedematous and
multiple fluid filled lesions appeared on the palms which burst
open, oozing clear fluid which was foul smelling because of the
swelling of the fingers patient is unable to do closing and
opening of the fist.
After the lesion bursted it was associated with
burning sensation and pricking type of pain.

For the above complaints she got admitted to


SKAMCH & RC
POORVA VYADHI VRUTTANΤΑ
• Nothing contributory.

Patient is not a k/c/o Diabetes Mellitus, Hypertension,


Tuberculosis, Asthma
TREATMENT HISTORY
IN SAPTHAGIRI HOSPITAL (12/12/16 to 24/12/16 )
1) Inj. Avil 0-0-1 (IM)
2) Inj. Betnisol 1-0-1 (IV)
3) Clonate lotion (E/A) @ night

Advice on discharge
1) Tab Teczine 0-0-1
2) Sper lotion (morning)
3) Clonate lotion (night)
VYAKTIKA VRUTTΑΝΤΑ
• Diet : Mixed (non veg 2 to 3 times in a month)
• Appetite : Moderate
• Bowel : once per day (constipated)
• Bladder : 4 to 5 times/day (Occasionally burning 1 to 2
times/night.
Micturation)
• Sleep : Disturbed
• Habit : Tea / coffee 3-4 times/day
Rajo vruttanta
• Menarche - @ 15 years of age
• Cycle - Irregular till age of 26, later said to be regular
GENERAL PHYSICAL EXAMINATION

• General Condition: Fair.


• Built : Moderately built.
• Nourishment : Moderately Nourished.
• Pallor : Absent.
• Oedema : Present over both hands
• Nails : Pitting
• Cyanosis : Absent.
• Icterus : Absent.
• Lymphadenopathy: Absent.
• Pulse:78 bpm.
• BP :120/80 mmHg.
OR/R :18/minute.
• Tongue : Coated.
• Height : 1.55 m
• Weight: 57.5 Kgs
• BMI : 23.95
INTEGUMENTARY EXAMINATION

Skin Colour - Normal skin colour


Lesio - Secondary
Character - Size: Small
Colour: Dark black
Shape -: Asymmetrical
Individual Lesion
Extensor surface - Papule
Palm, Soles - Flake Scales present
Nature - Dry Flake
Itching - Present
Discharge - Absent (present when new lesion occur)
Distribution of lesion - Symmetrical extensor surface
On exposed body parts
Superficial sensation of lesion - Normal
Candle grease sign - Positive
Auspitz sign - Positive
Koebner phenomenon - Positive
DASHAVIDHA PARIKSHA

1) प्रकृ तिः -: Vata Pittaja.


2) सारतः -: Madhyama.
3) संहनतः -: Madhyama.
4) प्रमाणतःःःः -: Height - 1.55 m
- : Weight - 57.5 kgs.
5) सात्म्यतः -: Madhyama.
6) सत्वतः -: Madhyama
7) आहर शक्ति -: अभ्यवहरण शक्ति
– Avara
-: जरण शक्ति – Avara
8) व्यायाम शक्ति -: Avara
9) वयः -: Madhyama
10) विकृ ति -: Pravara
NIDANA PANCHAKA

NIDANA: Viruddhahara, mandagni, ati vyayama after


snigdha bhojana, snana after bhojana in the night everyday,
chinta, shoka, uses of acidic solution for cleaning in school

SAMPRAPTI GHATAKA:

• Dosha : Tridosha

Dushya: Twak, Mamsa, Rakta, Lasika.

• Srotas : Rasa, Rakta, Annavaha


Sroto dusti: Sanga
Agni : Jathragni
Ama : Jathragni
Udbhava sthana : Twak, Mamsa, Rakta, Lashika
Sanchara sthana : Sarvasarira
Vyakta sthana : Twak, Mamsa
Roga marga : Bahya
Vyadhi Svabhava: Chirakari.
Sadhya asadhyata: Krichra sadhya.
SAMPRAPTI
Nidana sevana
↓
Tridosha prakopa
↓
Spreaded in triyak gata shiras
↓
Twak, Rakta, Mamsa, Lasika
↓
Dosha-Dushyas takes sthanshanshraya in Twak
↓
Leads to mandaloutpatti
↓
Kustha
Kustha
↓
Viruddhopkrama or Nidana sevana
↓
Causes Flaring up of lesions
↓
Resulting to Vaipadika
POORVAROOPA
ROOPA

Sputhna in both hasta pradesha associated with sotha, daha,


srava yukta pidakas and kandu.

UPASAYA: Aushadha sevana.


ANUPSAYA: Nidana sevana.
PROPOSED LINE OF TREATMENT
• Snehapana with mahatiktaka ghrita
• Sarvanga abhyanga with Marichadi taila
• Virechana with Trivrut, Danti & Triphala with souveeraka
• Manjisthadi kwatha
• Tandula lepa
• Unmatta taila for external application
• Dhattura beeja kalka lepa
• Kanaka bindu arista with krutmala kwatha
• Tab - Arogya vardhini
• Tab - Gandhak rasayana
• Mustadi churna for Shotha
• Bhallataka rasayan
• Tuvarak rasayan (Ah.Chi.19/53)
• Tuvaraka taila 10 ml for internal purpose kostha suddhi
PATHYA & APATHYA

• Laghu aahara, tikta rasa pradhana, ghruta, bhallatak, triphala, nimba,


purana dhanya, jangala
Mamsa, mudga, patola,

• Viruddhara (amla, payo, dadhi, anupa mamsa, matsya, guda, tila)

• Laghu vyayama, Siddhartha snana, abhyanga

• Divaswapna, mala-mutra vega dharana.

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