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The term pollution means the introduction of harmful and unwanted contaminants into our environment. Due to the borderless nature of our atmosphere and oceans, contamination at a small level can have a huge impact that to in places which are nearby and one of the best examples of this is crop stubble burning in Punjab and Haryana which is a major contributor to Delhi smog. Pollution is a slow poison and is deleterious to the life of all beings, including plants, animals, and humans. With the rise in the pollution levels, no one can escape the harmful effects of the same on health. Though pollution poses a great threat to everyone, it is the children who are most affected, let us read on to know the reasons

Why are children more susceptible to pollution?

The lung function, immune system, and metabolic systems in children are not fully developed and functional which makes it difficult for the body to fight these pollutants.
Children breathe in more air per kilogram of their body weight than adults, so they take in more pollutants per breath.
Children are not only more active but also have a faster breathing rate than that of adults. This means that they take in more environmental toxins and at a much faster rate.
Understanding the effects of pollution on children s health

Exposure of pregnant women to polluted air is strongly associated with premature birth, low birth weight, and intrauterine growth retardation. Low birth weight babies and premature infants are more prone to developmental delays and other disorders.
Exposure to certain pollutants like carbon monoxide and ozone are linked with septal and valvular defects in the heart of a child.
There is a strong association between particulate pollution and symptoms like wheezing and bronchitis in both adults and children. This is the main reason why there is an increased prevalence of Asthma in children in urban areas. Research has shown that a high level of pollutants in air cause deficits in lung function growth.
The immune system which protects the body from infections and germs is not fully developed in children. Pollutants are known to cause suppression of immunity in small children making them more prone to infections.
Children need sufficient Vitamin D for strong and healthy bones. Vitamin D is known as the sunshine vitamin and is synthesized in the body on exposure to UVB rays of the sun. Increased particulate components in the air reduce the amount of UVB radiation reaching the ground level. More than 60% of children are Vitamin D deficient and require supplements orally.
The exhaust of gasoline and diesel is known to emit carcinogens which are thought to play a role in the development of leukemia (blood cancer) in children.
The nervous system is a target for many environmental pollutants. Exposure to these pollutants can lead to neurological deficits and delays in development. Some of these effects are irreversible and long-lasting.
Unfortunately, with urbanization and increased population, the levels of particulate pollutants in the air are increasing at an alarming rate. The problem of pollution needs to be addressed immediately, until then it is best to keep the children indoor and take necessary precautions and keep children safe from exposure to the pollutants.

Pulmonary tuberculosis was a fatal disease in the past in India. On average, 95% of the deaths occur in third world countries, especially the developing ones, due to tuberculosis. In India, the deaths account to 50% out of the 95%. Such is the scenario that everyone is apprehensive if they have a prolonged cough and cold. As sputum with blood is one sign that the person is suffering from tuberculosis, steps must be taken promptly and at a swift pace to streamline things for quick care.

Tuberculosis is an air-borne disease and it can easily travel through the air when the affected person is in contact. In tuberculosis, specific bacteria called mycobacterium tuberculosis affects the lungs. On average, 10% of such infections progress into acute disease and kill the affected individuals.

The symptoms of tuberculosis are seen more in patients suffering from AIDS as their immunity is often compromised. Early detection can be made possible through a chest X-Ray, microscopic examination, and the nature of the fluids. In case you are suffering from a prolonged cough and cold, you must go for a tuberculin skin test or blood test to find out more about the problem.

Why is it important to eat a proper diet during pulmonary tuberculosis?
Malnutrition and pulmonary tuberculosis are interrelated. If you are eating right and inducting all healthy meals in your daily lifestyle, it will build your immunity and help fight against grave diseases. When you have pulmonary tuberculosis, the desire or craving for the food will disappear and eventually, your body will wither off. You will lose mass by losing muscles.

So, eating healthily can only help you stay strong to defeat pulmonary tuberculosis. Those who are suffering from tuberculosis face challenges with nutrients in their body. They are deprived of essential micro-nutrients and they have severe deficiencies of zinc, Vitamin A, D, C & E, selenium, iron and copper.

A protein- and vitamin-rich diet can boost the immunity of the body and prevent deadly diseases from wreaking havoc in the body. So, if you are wondering about food, here are a few items that you can eat and few that you can avoid when you have pulmonary tuberculosis.

Food to eat -

Kale and spinach are instant sources of high iron and Vitamin B, which will help you power up your immune system.
Whole grains like wheat, bread and cereals are a must-have during this time-tested period.
Carrots, peppers, tomatoes, blueberries, and cherries are rich anti-oxidants and they can boost your immune system by flushing out the oxidants from the body, which are tantamount to poison.
Vegetable oil (not butter) could be a green go during pulmonary tuberculosis.
Food to avoid -

Greasy food like beef, chicken, and mutton must be avoided. They can increase the cholesterol level in the body and compromise on the power of immunity.
Avoid margarine and butter. One should not eat cake, pastries, and other food with hydrogenated oil.
Keep an eye on your regular diet, work to build strong immunity, and always stay healthy.

The body s reacts to anything suspicious by developing an allergic reaction. Some of the common substances inducing this reaction include certain food substances, pollen, insect bites and certain metals. This body recognises these suspicious substances as antigens and produces what is known as antibodies. These produce various allergic reactions in the body ranging from something as minor as a skin rash to something drastically fatal as respiratory distress and even death.

Features:

Angioedema is one of the most severe forms of allergic reactions.
Translated literally as swelling of the blood vessels, angioedema causes swelling of the blood vessels in the underlying layers and this can lead to the formation of giant hives.
The hives or rashes are extremely itchy, reddish, and can vary in shape (oval or circular). The hives also are warm and painful when touched.
Angioedema usually affects the skin but can have more severe effects like blocking the airway and leading to respiratory distress
Causes: Angioedema is usually caused by one of the following:

Insect bites or stings
People with allergies to foods like peanuts, eggs, milk, shellfish, chocolates, tree nuts, etc.
Pollen, animal dander, latex, poison ivy, and other common allergens
Medicines like penicillin, aspirin, ibuprofen, and some anti-hypertensives
Autoimmune skin disorders like lupus
Reaction to incompatible blood transfusions
Weather conditions like extremes of cold, heat, or pressure
Infections like hepatitis, cytomegalovirus infections, Epstein-Barr infections, etc.
Conditions like leukaemia and thyroid disorders
Extreme emotional stress
Genetic angioedema, inherited from parents by children, which can last forever
Risk factors: Though hives usually develop without any warning signs, the following are some risk factors for developing angioedema.

Previous history of allergies
Predisposition to develop allergic reactions (overactive immune system)
Genetic history of allergies, especially of angioedema
Diagnosis:

In first-time patients, a detailed history with deep dive into similar instances in the past will be done
A physical exam to check for missed hives (like the back) is then done
Allergy testing may also be required to test if a person has a high predisposition to allergies
Blood testing to check for eosinophils, which is usually high in patients with allergies, is done.
Allergy testing to identify the triggering agent may be done if the trigger is not known. This will help in preventing further attacks.
If genetic angioedema is suspected, C1 esterase inhibitor test and complement particles are also checked.
Treatment:
Non-medical treatment including loose clothing, cool compresses, and copiously moisturizing to reduce dryness and itching. This is usually sufficient in the majority of the cases.
Medical: Antihistamines like cetirizine and loratadine are the next line of treatment. Very severe cases may require steroids like prednisone.

Diwali is the celebration of lights. However, it has also become associated with noise, smoke and pollution. This can be credited to a large number of firecrackers, which are burst as part of Diwali celebrations. Pollution affects not only your skin but also your internal health and can lead to a number of health problems such as:

Respiratory problems
Smoke is a common byproduct of every firecracker. These suspended particles in the air, when inhaled, can lead to a number of respiratory problems. In some cases, this floating particulate matter may also contain heavy metal oxides and salts that can get deposited in the lungs and cause irreversible damage. Asthmatic patients often see a sudden spike in respiratory attacks around Diwali.

To deal with respiratory issues during Diwali, wear face masks to limit the inhalation of noxious fumes. Those who are suffering already from respiratory concerns should get themselves examined after Diwali to be on the safe side.

Digestive problems
While bursting crackers, a small residue of particulate matter is often left behind on your fingers. Since bursting crackers and enjoying sweetmeats go hand in hand on Diwali, there is a high chance of ingesting these chemicals. Even washing your hands may not get rid of all the chemical traces. This can lead to indigestion and a number of other digestive problems.
Take care to wash your hands thoroughly with soap before you touch any food item. You can use a sanitizer as well for extra protection. If you experience any gastric discomfort, visit a physician without delay.

Hearing problems
Pollution is not measured only by the levels of particulate matter in the air. Excessive noise that goes over the permissible decibel level leads to noise pollution. This can be in the form of noise emitted by firecrackers, loudspeakers etc. Noise pollution can lead to temporary deafness and damage the ear as well. It can also lead to sleeping problems, high blood pressure and permanent hearing loss.
To avoid noise-related problems, use ear plugs and keep your doors and windows closed. Heart patients should, especially get themselves checked by a doctor after Diwali or if a problem suddenly arises during festivities.

Skin problems
Many children and adults suffer from skin irritations and eczema during Diwali. This is largely due to pollutants in the air and chemical residue left on the skin. To keep skin problems at bay, drinks lots of water, use moisturiser, avoid fried food, cover your face with a cloth while burning crackers and wash your face afterwards thoroughly. For those already suffering from skin worries, consult your doctor for guidance.

The best way to limit your exposure to harmful chemicals and pollutants during Diwali is by celebrating an eco-friendly Diwali and saying no to crackers . Additionally, try to stay indoors in the evening when crackers are being burnt and close all the windows and doors. Wearing a mask can also help prevent the inhalation of poisonous gases. This is especially necessary for people suffering from asthma and other such respiratory illnesses. Air pollutants do not clear away immediately and are present in the air for many days after Diwali as well. Hence, try staying indoors and keep the windows of your car rolled up for the next few days after Diwali as well.

Most of us experience or suffer from some or the other side effects of air pollution in our lives. However, with the consistent surge in the level of air pollution, the air quality has taken a plunge. The smog and particulates in the air cause multiple health problems.

So is there a way we can protect ourselves and our loved ones against this pollution?

Yes! Just by adopting these basic methods one can easily combat the ill effects of air pollution.

Always cover your face with a handkerchief or mask. Tying a handkerchief on your face to cover your nostrils can provide some protection; although it is minimal. Respiratory masks, such as N-95 and P 100 provide advanced protection against air pollution.

Use an air purifier inside the room as they help filter out suspended particulates which can cause breathing trouble, coughing, wheezing, sneezingand even trigger asthma attacks. Although they are slightly expensive, you can still consider them as a long term investment for the protection of your health.



It is advisable to avoid areas with heavy traffic as the pollution level is high in such areas. Try and avoid using two-wheelers and autos, if not possible, two wheeler riders should wear proper mask and glasses, in order to protect their eyes.

Keeping plants in your home is always advisable as they are the natural air purifiers, because they absorb carbon dioxide and also bring down the level of other poisonous gases.

It is also advisable to clean the filters of your AC frequently, so that the air that is being circulated is clean and free of dust particles.

Avoid smoking at this point of time, as at this point of time it is not just a health hazard, but also an environmental hazard.

Consume foods, which are easy to digest and support your lungs in withstanding the effects of air pollution especially those foods which are rich in beta-carotene, vitamin A and C.

Asthma patients, should keep their inhalers and medication close-by. It is very important to safeguard against asthma attacks triggered by pollutants.

Hello!

Main Dr. Praveen Sharma, Gastroenterologist. Aaj hum hepatitis ke bare me baat krenge. Iska mtlb hai liver me inflammation. Is se liver me swelling hoti hai. Hmare India me 5/100 patients ko ye problem hai. Iske causes hai hepatitis - A, B, C, D & E. Overweight, drugs and alcohol consume krne valon ko ye disease hoti hai. Jo unnecessary medicines lete hain, unhe bhi ye problem hoti hai. Kya hepatitis and jaudice ek hain? Nhi, ye ek jaise nhi hain.

Jayatar logon ko iske symptoms nhi aate quki ye bimari dheere dheere chalti hai or achanak bade roop me samene aati hai. Isko diagnose krane pe is disease ka pta chalta hai. Other symptoms hai loss of appetite, stomach pain, weight loss and pillia. Isko diagnose krne ke lia hum liver functuin ka test bhi krate hain. Hepatitis - A, B, C & D ke tests bhi available hain. Inko kaise prevent kia ja skta hai? Isko prevent krne ka sabse easy way hai ki khana khane se pehle hand-wash kren. Boiled water peena chaiye.

Hepatitis - B & C ka vaccination available hai jo chote se bade bachon ko dia jata hai. Alcohol consumption bhi apko khtm krna chaiye. Aaj kal iska main cause hai motapa. Ultrasound krne me pta chalta hai ki fatty liver ka problem hai or jab aap liver test krayen to hepatitis hota hai. Isko prevent krne ke lia apko regular exercise krni chaiye. Fried foods and sweets avoid kren. Isko aap easily prevent kar skte hain.

Thank You.

The consumption of tobacco by humans began many years ago and has taken many forms ranging from rolled tobacco leaves and pipes to cigarettes. Smoking is a habit that is easy to start, but is difficult to quit. Smoking has both short term effects such as bad breath, tooth and gum loss, premature ageing and weakened immune system and long term effects that impair the respiratory system and cardiovascular system.

Smoking can cause and worsen diseases like cancer of lungs, throat, mouth, kidneys and blood and other chronic obstructive pulmonary diseases. Smokers also have a higher risk of conditions such as dementia, cataract, pulmonary fibrosis, psoriasis, osteoporosis and optic neuropathy. Smoking can also affect fertility, cause erectile disorders and speed up the onset of menopause.

It is said that a smoker s life expectancy is 10 years less than that of a non-smoker. There are three main components of cigarette smoke that can harm the body.

Nicotine: Nicotine is what makes cigarettes addictive and make smoking a habit. In the beginning, it may stimulate the brain but in the long run, your body can begin to crave for nicotine. If this craving is not fulfilled, it can cause irritability, restlessness, headaches and shortened attention span.
Tar: Tar in cigarettes contains many harmful chemicals and is deposited in the lungs. From here it enters the blood vessels and is carried to other parts of the body. In many ways, tar is akin to a poison.
Carbon monoxide: Carbon monoxide affects the blood s capacity to transport oxygen from the heart to the rest of the body. In the case of pregnant women, carbon monoxide can also reduce the amount of oxygen available to the growing foetus and hence cause complications in pregnancy. Children born to smokers are also said to have an increased risk of suffering from congenital defects and conditions like asthma.
The good news is that quitting it is possible and its benefits can be experienced right away. Within the first 72 hours of quitting, the bronchial tubes begin to open up and breathing becomes easier. If you stop smoking before the age of 50, you can reduce your risk of dying from smoking related complications by 50%. The most important part of quitting nicotine is your own determination and willpower. Nicotine replacement therapy in the form of gums, patches, lozenges and inhalers can also help deal with nicotine withdrawal symptoms and make the process easier.

The consumption of tobacco by humans began many years ago and has taken many forms ranging from rolled tobacco leaves and pipes to cigarettes. Smoking is a habit that is easy to start, but is difficult to quit. Smoking has both short term effects such as bad breath, tooth and gum loss, premature ageing and weakened immune system and long term effects that impair the respiratory system and cardiovascular system.

Smoking can cause and worsen diseases like cancer of lungs, throat, mouth, kidneys and blood and other chronic obstructive pulmonary diseases. Smokers also have a higher risk of conditions such as dementia, cataract, pulmonary fibrosis, psoriasis, osteoporosis and optic neuropathy. Smoking can also affect fertility, cause erectile disorders and speed up the onset of menopause.

It is said that a smoker s life expectancy is 10 years less than that of a non-smoker. There are three main components of cigarette smoke that can harm the body.

Nicotine: Nicotine is what makes cigarettes addictive and make smoking a habit. In the beginning, it may stimulate the brain but in the long run, your body can begin to crave for nicotine. If this craving is not fulfilled, it can cause irritability, restlessness, headaches and shortened attention span.
Tar: Tar in cigarettes contains many harmful chemicals and is deposited in the lungs. From here it enters the blood vessels and is carried to other parts of the body. In many ways, tar is akin to a poison.
Carbon monoxide: Carbon monoxide affects the blood s capacity to transport oxygen from the heart to the rest of the body. In the case of pregnant women, carbon monoxide can also reduce the amount of oxygen available to the growing foetus and hence cause complications in pregnancy. Children born to smokers are also said to have an increased risk of suffering from congenital defects and conditions like asthma.
The good news is that quitting it is possible and its benefits can be experienced right away. Within the first 72 hours of quitting, the bronchial tubes begin to open up and breathing becomes easier. If you stop smoking before the age of 50, you can reduce your risk of dying from smoking related complications by 50%. The most important part of quitting nicotine is your own determination and willpower. Nicotine replacement therapy in the form of gums, patches, lozenges and inhalers can also help deal with nicotine withdrawal symptoms and make the process easier.

Diagnosis of Visarpa in clinical practice is very controversial. Visarpa is an extreme form of viral and spread in similar to that of cobra venom. If not attended properly readily inflict as death. Hence Visarpa is known as extreme form of atyayika roga.

Visarpa is an infectious disease caused by Nita group (Harpes group) of viruses this classification made according to afflicting chemical, physical, and serological criteria. Herpes simplex 1, Herpes simplex 2, Herpes zoster, Vericella zoster, Vericella, Cytomogalo virus and secondary infection to streptococcus pyogenes (Hemolytic streptococci of group A) 80 types of streptococcus pyogenes are have been recognized so far. Parisarpana is due to these infections having lot of similarities in clinical condition of Visarpa. Visarpa is caused by chardi vega dharana janya udavartha and also caused due to wounds fractures, crush injuries, cutting of immature part affliction by banda and fall the deranged and vitiated vatadi doshas get aggravated and there by afflicted the twak mamsa and rakta speedily gives rise to a sort of shifting elevated shotha marked by the characteristic symptoms any of them involved in the samprapthi this swelling tends to extend all over the body. This disease is called Visarpa from the fact of extending or shifting character.


Clinical features:

Vatika Visarpana: The patient has same type of constitutional features as in vataja fever, inflammation, twitching, pins and needles, tearing sensation pain on movement, horripilation (Ah. Ni. 13/47).
Giddiness, davathu (burning sensation in eyes), thirst, pricking pain, malaise, cramps, tremors, fever, tamaksvasa, kasa, pain in bones and joints and their dislocation, shivering, anorexia, indigestion, cloudiness of the eyes, lacrimation and a feeling as if ants are crawling over the body.
The space through which the Visarpa spreads becomes grayish or pinkish in colour and oedematous. The space become excessively affected with pricking pain, breaking pain, colic pain, expansion, contraction and tingling and throbbing sensation if not treated, space become accumulated with instantaneous cracking, pustules which are small in size and pink/grayish in colour and secretion of liquid which is thin, transparent small quantity.
Arrest of voiding of flatus, urine and stool.
The patient feels comfortable with ingredients having opposite attribute to vata.
Paittika Visarpam :

The pittaja Visarpa is rapidly spreading in character, deep red in color and the patient presents with constitutional features of pittaja fever (Ah.Ni 13/48)

The discolouration of the affected part will be haridra, harita, nila, krisnam, etc., with sravam. The space, in which this spreads, becomes coppery, green, yellow, blue, black, or red coloured. The space becomes full of pustules, which are excessively swollen and associated with excessive burning sensation and breaking pain. The exudates from these pustules have the colours like those of pustules. The pustules get suppurated very quickly. Factors described to cause pitta Visarpa are not homologatory to such a patient.


Kaphaja Visarpa: The kaphaja Visarpa patient presents with the same constitutional feature as in care of kaphaja jvara.There is numbness, stiffness, heaviness and less pain the body. The space, in which Visarpa spreads, becomes oedematous, pale yellow, not very red and unctuous. The pustules in this space get suppurated very late, they become chronic, they appear in large number, the skin over these pustules get covered with sticky material and these pustule are either white or pale yellow in colour. When there is eruption of these pustules then exudates which is white, slimy, fibrous, dense, knotty and unctuous. After the eruption of these pustules, the space is covered with ulcer which is deep seated, stable, surrounded by the capillary network, unctuous and covered with many skin scabs. The ulcer continues to stay for long time.The upper part of the body (urdhva bhagam) becomes afflicted with the ulcer of the above mentioned symptoms, because the upper part of the body is the abode of kapha


Sannipatika Visarpa:

The sannipatika type of visarpa is caused by the all-etiological factors, the signs and symptoms described in respect of each of the vatadi verities Visarpa. It pervades all the dhatus (tvak, lasika, rakta, mamsa). It spreads instantaneously and is incurable in nature.


Agni Visarpa:

In this type vata and pitta simultaneously aggravated because of their respective causative factor, gain strength from each other and spread over the body along with burning sensation, which is called agneya visarpa. Fever, vomiting, attacks of swooning diarrhea, thirst, dizziness, splitting pain in regional glands, diminished digestive power, respiratory distress and anorexia, the patient feels as if the whole body is covered with burning charcoal, all those sites where the Visarpa spreads, get quickly studded with blister as after with thermal burn and appears blackish, bluish or reddish like an extinguished charcoal.

On account of fast spreading tendency, it quickly pervades into the vital areas (marmas) as result of which vata becomes overwhelmingly powerful and gives rise to pain all over the body, loss of consciousness, sleeplessness, dyspnoea and hiccough. The patient who has reached this stage does not find any relief by any measures. He remains restless and attempts to lie down on the ground or sit or adopt any other posture resulting in extreme agony, mental confusion and bodily inactivity and finally results in death.

Kardama Visarpa:

The disease generally spread in slow speed in the amasaya and gets localized there. The space, in which this type of Visarpa spreads, becomes as if studded with eruption of red, yellow and pale yellow colour. The space looks muddy, black, dirty and unctuous and it is excessively hot, heavy with dull pain, oedema and deep-seated suppuration. These eruptions are free from exudations and become sloughy very quickly. The skin and muscle tissue over these eruption are shriveled, sticky and suppurated. The pain over this space is less and it appears gradually. By rubbing, these eruptions get cracked and when pressed sticky and purified muscle tissue comes out of these eruptions. In the space at the bottom of this eruption (after taking out the slough), one can visualize vessels and ligaments and smells like cadaveric as emitted from this space. The patient loses consciousness and memory.


Granthi Visarpa:

It is one of the Visarpa involving vata and kapha as main vitiated dosa. Intake of sthira, guru, kathina, madhura, sita, snigdha, abishyandi, Lack of exercise, Habitually avoiding administration of elimination therapy (panchkarma therapies) at the appropriate time. The channels of circulation of vayu get obstructed by the aggravated kapha (which causes further aggravation of vata). Both these vitiated dosas get excessively aggravated and vitiate dusyas giving rise to Visarpa.

Aggravatd vata, in turn, causes splitting of cough into several parts gradually giving rise to a series of granthis (grandular enlargements) in the abodes of kapha (ura: pradesa). These enlarged glands get suppurated very slowly and is difficult to cure.

In a person having excess of blood (aggravated vata and kapha) vitiate the blood giving rise to a series of glandular enlargements located in vessel, ligaments (or nerves), muscles and skin. These enlarged glands are extremely painful; some of them might be big in size and shape and some are red in colour.


Complication of Visarpa:

All types of Visarpa usually have following complications: fever, diarrhea, vomiting, tearing of the skin, muscle fatigue, anorexia, and indigestion.

Based on dosa dominance: (C.Ci.21/42):

Single dosa involvement: vatika, pittaja, kaphaja, Visarpa types are curable.

Double dosa involvement; agniVisarpa (vatapittaja) and kardamaVisarpa (kaphapittaja) can be alleviated by the habitual use of general therapeutic measures (to counteract the respective etiological factors) only when the vital organs (like heart) are not afflicted and there is no softening of vessels, ligaments and muscle tissue. If not properly treated. Any one of these two may cause instant death like snake poison.

Granthi Visarpa is treatable only when it is without any complications otherwise difficult to treat.

Three dosas involvement: Sannipatika type of Visarpa is incurable because it pervades all the tissue elements, it spreads instantaneously and its treatment involves mutually contractor therapeutic measures.

Differential Diagnosis:

Positive and complete findings are the tools to arrive at a definite diagnosis, to estimate the prognosis and to adopt appropriate line of treatment for the disease. Studying the various stages of the disease and the consequential changes can make a correct diagnosis.

Seven dhatus and tridosa are involved in the pathogenesis of Visarpa and kustha (a group of obstinate skin diseases). In spite of the identify of these seven elements there is difference between these two diseases in as much as Visarpa is characterized by its spreading nature, and kustha by its chronic condition. Visarpa should also be differentiated from diseases in which rakta, lasika, tvak, mamsa are vitiated i.e. from kushtan, vidhradhi, visphota, apaci.

Other:

When are aggravated pitta together with rakta spreads within the skin, it causes red swelling which known as Visarpa
When the aggravated pitta is located in tvak (skin) and rakta, this will also causes red swelling which known as pidika (vesicle).
When the aggravated pita gets dried up in combination with rakta, this causes skin diseases like tilaka (black moles), vyanga (red moles) and nilika (blue moles) (C.su. 18/23-25).
In Visarpa inflammation is without swelling (annunat sotha) while arbuda, granthi, vidhadhi have swelling (sotha).
In Visarpa clinical diagnosis is based on dosa dominance and morphological feature therefore they should be differentiated from kushtha with similar dosa dominance.
Nita group of viruses with Visarpa:

Visarpa is an inflammatory disease some types of Visarpa are due to the Nita group of virus classified made according to affecting chemical, physical and serological criteria.

Herpes simplex 1
Herpes simplex 2
Herpes zoster,
Vericella zoster
Vericella
Cytomogalo virus are comes under this group
It is having particle size 100-200 nucleic acid DNA, type of symmetry cubic number of cap so meters 162 sensitive, Family-Herpes viridae, genomic type DSDNA

Vericella zoster, herpes simplex 1 Herpes simplex 2 are concerned with skin eruption system.

Cytomegalovirus and epsein barr virus are concerned with hematopoietic disorder.

And also some of the Visarpa are due streptococcus pyogenes (hemolytic streptococci of group A). These streptococci pyogenes (Hemolytic streptococci of Group A) are I. Gram positive cocci, these are spherical or oval in shape, 0.5 to 1.0 in diameter, arranged in chains. They are important human photogenes, causing pyogenic infections with a characteristic tendency to spread. These may be sub divided into types based on the protein (MTR) antigens present on the cell surface. About 80 types of streptocci pyogenes have been recognised so far.

Even though the parisarpana is due to sara and chala guna of vata property any our acharyas are not enumerate the vataja Chikitsa, instead of that they explained the krimihara Chikitsa. Visahara Chikitsa. It indicates that the parisarpana is may be due to microbial infection spreding. The nature of spreading and the cliniical present of Nita group of virus and streptococcal pyeogene (group A,B,C) and Visarpa are one the same.

Visarpa is an infection disease which spreads from place to place quickly involving the raktha twacha mamsa snayu and lasika, having painful Visarpa on the twacha leads on to suppurating tumors, gangrene and multilation of the body. It has been identified with several discuss like erysipelas, cellulities, herpes zoster, moist gangrene, eczema erpitivum, chicken pox, herpes labials, herpes simplex, acute myeloid leukemia, acute lymphoid leukemia, carcinoma of stomach. Some kind of dermatitis etc., by modern scholors.

Herpes simplex

Herpes simplex occurs naturally only in man. There are two types of herpes simplex virus, herpes simplex virus 2. There are different modes of visaprana or prisarpana are seen herpes simplex are transmission occurs by close contact and may be venereal in genital herpes after contact, the virus probably enters the tissue through defects in the skin and mucus membranes. There is then phase of local multiplication with cell to cell spread and local lymph nodes are involved. The virus can also travel along with the nerve fibers and may be able to reach CNS in man. In general primary infections are localized. The avakasho Visarpa anusarpayatin of vataja Visarpa shows as that of typical herpes lesion, they are thin walled humiliated vesicles that rapidly becomes pustules and scabs and heal without scaring. In the vataja Visarpa davahuhu indicates the morbidity presenting chakshuradi indrayas like commonest site herpes simplex is the eyes, face on the cheeks, chin, around the mouth or on the forehead. Lesions may also appear on the buttocks as napkin rash an occupational variety of cutanious herpes is the herpetic whitlow.

Eczema herpectium is a generalized eruption caused by herpes infection in children suffering from eczema. Vagbhata Visarpa mainly straps from the affected area with wide spread ulceration. A clinically indistinguishable picture in also produced by vaccine virus infection both designated kaposis karicelliform eruption.

Herpes virus simiae (B virus)

Herpes virus simiae infects monkey in the same manner that herpes simplex infexts in man, herpes virus simiae is similar to herpes simplex properties. The disease in man is usually fatal. The rare patients who survive have serious neurological sequelae.

Vericella Zoster virus

Mode of spread: Very rapidly whole body is sprinkled with live charcol

In pathology of agni Visarpa aggravated the vata and pitta simultaneous aggreavated with each other. These doshas shows effect in all over the body within a short period of time along with burning sensation. The incubation period of V-Z virus is 14-16 days, prodromal symptoms are minimal. These include mild favour malaise and impaired appetite as that of agni Visarpa. These rashes appear on the first day.


Management:

Samanya Chikitsa with clinical interpretation:-

Chikitsa sutra : - Langanam ullekanam shaste tikta nam cha sevanam ||(cha, chi)

Langana:-

One who fit for the langana, langana pachana, dashava sechanaand accourding to ama which is particular stana, rogabala, rogibala and also as per the doshas. The different langana therapies are to be adopted. Langana causes vata vruddi, jataragni vardana, amarpachana in the Visarpa patient. The adoption of different types of langana reduces the jwara, swayathu, angamardu etc lakshanas of Visarpa and by the langana therapy, avakasho Visarpa anusarpati have the lakshanas like svayathu, paka, kleda are also reduces. Langan is a therapy which has the natural auto ammune power enhancing property in the body which helps in fight aginest the Nita group of virus (herpes viruses) and streptococci pyogenes infection which reduces the symptoms up to som extents.


Langana Tiktakam Cha Sevanam

Compounds with a tikta rasa pradana may reflexly increases the flow of gastric juice in the stomach acts as ama pacana and also having the Visarpa hara property. So our acharya highlighted the lagana Chikista with tikta dravya is ideal one. The drugs having the properties like langana-Visarpahara tikta rasa pradanya are to selected. E.g guduchi, musta, patola, nimbi, ushira, kirata tikta, nishi and katuki. In the purvarupa and amavasta of the Visarpa. These dravyas can be adopted as a front the treatment along with the peya mandadi ahara dravyas which are used for langana as well as the kwatadi oushadis.


Langana Rukshana

Other acharyas also enlighten about langana rukshana. In the purvaropa Chikitsa langana followed by rukshana or rukshana rupi langana chikitsa should be carried out so, the drugs having the properties like langana rukshana Visarpa hara are to be selected example, trivruth, musta, nimba, patola, kiratatikta, chandana, amalaki, usheera, lodra, draksha, shunti, katuki.

Ullekana chikitsa in Visarpa:-


Ullekanam iti vamanam (chakrapani)

The ama which is present in pithastana and kaphastana vamana should be conducted. If Visarpa is caused by rather kapha or pitha or both kapha and pitha. Then vamana should be conducted. Kardama Visarpa should be treated by quickly by administration of vamana.


Sneha pana:

1) Mahatiktaka ghruta, 2) Trayamana ghruta


Vamana yogas:

Madana, maduka, nimba, vatsaka patra kwata,
Madana patola, pippali, nimba should be made into kwata and used.
Vamanopaka dravya:

nimba, musta, patola kwata (C.S)
Patoladi phanta (A.S)
In pitha pradana Visarpa after the vamana virechana should be administer.

Virechana:

In both dosha dushta Visarpa and initial stage virechana should be selected

Sneha pana:

The medicated ghruta for sneha parartha should be administered which are having purgation property, otherwise which causes the paka of the twak, mamsa, rakta. After ama pachana sneha pana should be administered with tikta rasa pradana ghrutas.

1. Triphala ghruta 2. Traya mana ghruta

The virechana yogas:

Trivruth, draksha, triphala, trayamana (A.S)

Trivruth churna should be boiled by adding ghruta or ksheera and administered with warm water or mrudvika swarasa. Similarly boiled with trayamana (C.S) in kardama Visarpa for producing virechana should be made to drink trivruth churna along with either ghruta ksheera draksha rasa or ushna jala. If pitha is aggravated greatly should drink milk boiled with trayamana.


Mode of action of virechana in Visarpa:

The main action of Visarpa dravya is adobaga hara. The vitiated pitha dosha is alleviated and expelled out through the mechanism of virechana so, the disease process is arrested. The virechana dravya spreads through the body at cellular level due to its pharmacological action. Ushna and theekshna properties of virechana drugs produces chetana of dosha durshya sambanda, which are already soften due to snehamsha of shodananga snehapana. Thus, liquid doshas are dragged towards to koshta due to the predominance of pruthvi and jalamahabhoota present in virechana kalpa.


Rakta mokshana in Visarpa:

Rakta mokshana should be administered as a front line treatment because of rakta dusti is the main factor of pathogenesis in Visarpa. According to predominance of doshas associated with rakta, different methods of rakta mokshana should be conducted. If dushta rakta associated with vata then avasechana should be done with the shrunga yantra. If dushta rakta is associated with kapha alabu karma should be administered. If Rakta dusti with is assocated with pitha jalauka charana should be administered. Rakta mokshana acts as auto immune enhancing property. So, develop the resistance against the Nita group of virus and strepto coccus pyogenes. Jaluka is having haparin which climes to exert some anti inflammatory activity and wound healing property.


Tiktanam cha sevanam:

Tikta dravya having the dosha prashamana, thrushna prashamana sheeta ruksha lagu and vidagda pitha hara property. So, recipies which are dominant of tikta dravya pecifies the vitiation of rakta and pitha, which are the main causative factor for Visarpa. The role of ama is cause in Visarpa is most important. Due to the deepana pachana rukshana langana property of tikta dravya are acts as avapachana in Visarpa. tikta dravya which acts as samprapti vigatana with the property of tawk in mamsa sthira karana which gives stability immunity and also increases brachaka pitta. If we administered the virechana and other shodana therapies from the tikta dravya. Visarpa is mainly due to Nita group of virus and strepto coccus pyogenes. The Use of tikta dravya by internally and externally which acts against these microbes due to the krimi hara property. Due to the vishagna property of tikta dravya acts as the anti dote for virus and toxins produced by these infetion.


Shamana Yogas:

Kasisadi ghruta for external application tid.
Balaguduchyadi kashaya (anubhutha yoga) 15 ml. bid, before food. (In clinically experienced that balguduchyadi kashaya 15 ml per every one hour once Visarpa in initial stage relived that symptoms and lesions. Within 3 days).
Panchatikta guggulu ghruta without ballataka 10 ml with milk twice a day after food.
Triphala churna 1 tea spoon with hot water at bed time.
Kustagna vati (anubhutha yoga): 1 tablet bid after food.
Some special clinical case presentation:

Case 1

Patient name kousar bai w/o panduranga aged 34 years, complaining of blisters, shopha, vrana, shula, Kunapa Gandhi, jwara, daha, kandu, srava, avkasho visarpa anusarpayathi lakshanas in the vrana since 3 days , these lakshanas are transferred through the while paper collection in garbage. This case simmilor to previous one. Vikruthi taha pariksha shows due to herpes virus similes (B virus).

In this condition kapha, vatha dosha dusti takes place, rasa, raktha, mamsa, thwak, lasikadi dhatus, mamsa vaha srotas, rasa vaha srotas, lasika vaha srotas are involved. This shows the sroto dusthi lakshanas are sanga, vimarga gamana and athi pravruthi. There are no abnormalities seen in the mala and general examination. Laboratory investigations done. Due to these lakshanas as per our acharya this disease can be diagnosed as agni Visarpa. Through the modern perspective which is originated from the Herpes simplex B virus or Herpes simile. It is one of the daruna, kasta sadya vyadi.

Case 2

Patient name govinda aged 32 years complaining of blisters as a avakasho visarpa anusarpa yathi with full of water, pain, daha over the neck, unable to flex the neck & unable to sit properly, since 8 days. She undergone allopathic & fockler treatment but not relived. There family members concluded that he daid within 3 days. This condition is diagnosed as vericella pittaja visarpa.

Case 3

Patient name hruthik aged 4 years complaining of blisters as a avakasho visarpa anusarpa yathi with full of water, pain, daha over the pennies since 2 days. This condition is diagnosed as Herpes genitals Vataja Visarpa.

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