WhatsApp Discussion Series: 24 - Discussion on Cerebral Thrombosis by Prof. S. N. Ojha, Prof. Ramakant Sharma 'Chulet', Dr. D. C. Katoch, Dr. Amit Nakanekar, Dr. Amol Jadhav & Others

[14/08 21:17] Amol Jadhav Dr.: 

What should be our approach towards...

Headache with cranial nerve palsies....

Please guide...

[14/08 21:31] satyendra ojha sir: 

Nervous System Disorders » 

Neurological Disorders

Headache

What is a headache?

A headache is pain or discomfort in the head or face area. Headaches vary greatly in terms of pain location, pain intensity, and how frequently they occur. As a result of this variation, several categories of headache have been created by the International Headache Society (IHS) to more precisely define specific types of headaches.

What aches when you have a headache ?

There are several areas in the head that can hurt when you have a headache, including the following:

a network of nerves that extends over the scalp certain nerves in the face, mouth, and throat muscles of the head blood vessels found along the surface and at the base of the brain (these contain delicate nerve fibers)

The bones of the skull and tissues of the brain itself do not hurt because they do not have pain-sensitive nerve fibers.

What causes a headache?

Headaches may be caused by a number of conditions, such as disorders of the neck, eyes, brain, jaw, or teeth. Headaches with an underlying medical condition are classified as secondary headaches because they are related to the condition. An example of this would be a headache due to neck injury or sinus infection.

Other headaches are classified as primary because the headache itself is the main medical problem, although underlying non-medical causes, such as muscle tension or foods, may be identified. Other contributing factors may include medications, dehydration, or changing levels of hormones. These factors that influence headaches are sometimes called headache triggers.

What are some of the different types of primary headaches?

migraines

This type of headache is distinguished by the fact that symptoms other than pain occur as part of the headache. Nausea and vomiting, light headedness, sensitivity to light (photophobia), and other visual symptoms typically occur.

Migraines are also unique in that they have distinct phases. Not all individuals experience each phase, however. The phases of a migraine headache may include:premonition phase - a change in mood or behavior that may occur hours or days before the headache.aura phase - a group of visual, sensory, or motor symptoms that immediately precede the headache. Examples include hallucinations, numbness, changes in speech, and muscle weakness.headache phase - period during the actual headache. Throbbing pain on one or both sides of the head. Sensitivity to light and motion are common, as are depression, fatigue, and anxiety.headache resolution phase - pain lessens during this phase, but may be replaced with fatigue, irritability, and difficulty concentrating. Some individuals feel refreshed after an attack, while others do not.tension headaches

Tension headaches are the most common type of headache. Stress and muscle tension are often factors in tension-type headaches. While symptoms may differ, the following are common symptoms of a tension-type headache:slow onset of the headachehead usually hurts on both sidespain is dull or feels like a band or vice around the headpain may involve the back (posterior) part of the head or neckpain is mild to moderate, but not severe

Tension type headaches typically do not cause nausea, vomiting, or sensitivity to light (photophobia).cluster headaches

Cluster headaches usually occur in a series that may last weeks or months, and the headache series may return every year or two. While people often experience symptoms differently, the following are the most common symptoms of a cluster headache:severe pain on one side of the head, usually behind one eye the eye that is affected may have a droopy lid, small pupil, or redness and swelling of the eyelid runny nose or congestion swelling of the forehead

What are the most serious symptoms of a headache?

Headache symptoms depend upon the type of headache. The frequency of headaches and the intensity of the symptoms may vary as well. Symptoms that may suggest a more serious headache include any of the following:

headaches that start early in the morning pain that is worsened by strain, such as a cough or a sneeze vomiting without nausea sudden onset of pain and the "worst headache" ever headache that is becoming more severe or continuous personality changes changes in vision weakness in the arms or legs seizures or epilepsy

The symptoms of a headache may resemble other conditions or medical problems. Always consult your physician for a diagnosis.

How are headaches diagnosed ?

The full extent of the problem may not be understood immediately, but may be revealed with a comprehensive medical evaluation and diagnostic testing. The diagnosis of a headache is made with a careful history, physical examination and diagnostic tests.

Questions commonly asked during the exam may include, but are not limited to, the following:

When do headaches occur ? What is the location of the headache ? What do the headaches feel like ? How long do the headaches last ? Have there been changes in behavior or personality ? Do changes in position or sitting up cause the headache ? Do you have trouble sleeping ? Do you have a history of stress ? Is there a history of head injury ?

If the history is consistent with migraine or tension-type headaches and the neurological exam is normal, no further diagnostic testing may be necessary. However, if it is not a primary type headache, then other tests may be needed to determine the cause.

Tests used to determine the cause of a headache may include:

blood tests - various blood chemistry and other laboratory tests may be run to check for underlying conditions.sinus x-rays - a diagnostic imaging procedure to evaluate for congestion or other problems that may be corrected.magnetic resonance imaging (MRI)- a diagnostic procedure that uses a combination of large magnets, radio frequencies, and a computer to produce detailed images of organs and structures within the body.computed tomography scan (Also called a CT or CAT scan) - a diagnostic imaging procedure that uses a combination of x-rays and computer technology to produce cross-sectional images (often called slices), both horizontally and vertically, of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general x-rays.

Treatment for headaches:

Specific treatment for headaches will be determined by your physician based on:

your age, overall health, and medical history type of headaches severity and frequency of the headaches your tolerance for specific medications, procedures, or therapies your opinion or preference

The ultimate goal of treatment is to stop headaches from occurring. Adequate headache management depends on the accurate identification of the type of headache and may include:

avoiding known triggers, such as certain foods and beverages, lack of sleep, and fasting changing eating habits exercise resting in a quiet, dark environment medications, as recommended by your physician stress management

Migraine headaches may require specific medication management including:

abortive medications - medications, prescribed by your physician, that act on specific receptors in nerves and blood vessels in the head to stop a headache in progress.rescue medications - medications purchased over-the-counter, such as analgesics (pain relievers), to stop the headache.preventive medications - medications, prescribed by your physician, that are taken daily to reduce the onset of severe migraine headaches.

Some headaches may require immediate medical attention including hospitalization for observation, diagnostic testing, or even surgery. Treatment is individualized depending on the underlying condition causing the headache. Full recovery depends on the type of headache and other medical problems that may be present.

[14/08 21:56] Katoch sir: 

Impirical treatment of such headache could be done with Nadi Balya  (Kupilu, Ashwagandha, Suvarn) Yog and Nasya, Shirobasti with palliative remedies like Godanti Bhasma+ Pipplamool Churna. In worse cases Tamra Yoga can be added.

[14/08 21:57] Amol Jadhav Dr. Ay. Pth: 

Respected Ojha sir...

I always respect your spontaneous guidance...

To know any headache...

We are supposed to know neurology...i admit it...

A few days back I came across a patient

With headache...

On MR venography...

MD physician easily ruled out cause of

His headache...

That was

Cerebral venous thrombosis...

In such conditions...

How a definite approach can be taken by an Ayurveda physician. ???

[14/08 21:57] Pawan rajyan AP: 

Whats want to convey sir

[14/08 22:01] Katoch sir: 

What can not be inferred that can/should be treated with Sannipattik Shirashool chikitsa of Ayurveda.

[14/08 22:17] Anup baishya Dr Ay Pith: 

Marmabhighata(siro marma)caused ardita bankya etc disorder.its also a kind of margaabarodhajanya vatavyadhi.abhyantar marmaghata due to margaabrodha causes vatavaha srota abarodha leads to cranial nerve palsy.

[14/08 22:21] pawan madan Dr: 

There are about tens of causes of pain in shiras.

We need to find whats the possible/exact hetu.

Thats why I asked about the clinical presentation of that patient.

And even not only laxanas.....history ia most important to know even if it is due to thrombosis.

Then it will comfortable to chalk out treatment plan.

Knowing the MRI report only will be fine to make a treatment as per allopathic principles.

[14/08 22:32] Amol Jadhav Dr. Ay. Pth: 

Patient was with c/o

Sever headache

Sever neck pain

Dizziness...

Which was not responding to any pain relieving therapy.

[14/08 22:34] ‪+91 98903 12002‬: 

Cerebral venous thrombosis is ruled out or is it d diagnosis.

[14/08 22:37] Amol Jadhav Dr. Ay. Pth:

 Ruled out

[14/08 22:38] pawan madan Dr:

 ...is headache daily?

...which part ..back or sides?

...from how much period

...if continous...then how it started...at once or slowly?

...what are aggravation factors?

...male or female

...age....occupation

...mental.sthiti

...state of emotional.lability

And so many other question to know.....

[14/08 22:41] ‪+91 98903 12002‬: 

MRI report ?

[14/08 22:50] Amol Jadhav Dr. Ay. Pth:   

51 year male

Employee of indian assurance company...

His is a chief officer

Resident of kolhapur...

Yes it was a continuous headache

Pain was in his occipital area

Radiating to neck

He started with mild neck pain...

Consulted with  local GP

Received some pain killers

But didn't have the relief...

He referred him to orthopedic

There he received traction

But

Nothing was improved

Then somebody told him to go to MD medicine...

Then rest of the history was

MR venography...

Then

Anti coagulation therapy by

Tab Warf 7 mg

We are observing his PT INR

recent INR # 1.74

[14/08 22:51] Tapan Vaidya ADI AP: 

सुश्रुत महाराज कहते है

द्वे पाद मध्ये पृथु संन्निवेशे..(आगे नही याद)

अत: अगर नस्य और रक्तमो़ण के उपरान्त यदि पादाभ्यंग पाद संवाहन इत्यादिको भी चिकीत्सामें शामिल कीया जाय तो कंइ अद्भूत परिणाम मेरे सीनीयर्सने लिये हैं।

मेरे आॉंखों की और मेरे घूँटों की तकलिफोंमें सीर्फ जूतों को मेडीकली बनवाने से ही तीन दिनमें उपशम प्राप्त हुआ हैं।

अत: शीरोरोग के लिये पादाभ्यंग संवाहन एक नयी दिशा प्रदान कर सकते हैं।

[14/08 22:51] ‪+91 98903 12002‬: 

Why anticoagulants when venous thrombosis is ruled out

[14/08 22:52] Amol Jadhav Dr. Ay. Pth: 

Standard protocols

[14/08 22:53] ‪+91 98903 12002‬: 

That means its d diagnosis .. Its not ruled out..

[14/08 22:58] ‪+91 98903 12002‬: 

सरत्व गुणक्षय रुक्षत्ववृद्धी... रक्ते पित्तदूषणात्.. वा वायुना मार्गावरोधात्

[14/08 22:58] satyendra ojha sir: 

Think ; कफानुबंधि रक्तपित्त is reason of thrombosis.. so , apply katu rasaatmaka dravya , utpala or kamal or plasha kshaara , paaraawat shakrit , darbha..

[14/08 22:58] satyendra ojha sir: 

Dr Amol 

[14/08 22:59] jay govind ukinada Dr Ay pith:

 

[14/08 23:00] satyendra ojha sir: 

Without kapha rakta is not thrombosed..

[14/08 23:02] pawan madan Dr:

 ...fir anticoagulant to chal hi rahaa hai....

...thats more easy, proven and comfortable

[14/08 23:02] Amol Jadhav Dr. Ay. Pth: 

Please elaborate

Various routes of administration

And Yogas as well

[14/08 23:03] Dr Akash Meshram AP: 

Venous thrombosis will give giddiness and numbness. ..if it's not adhmaan should be ruled out

[14/08 23:04] satyendra ojha sir: 

Oral route kamal kshaara.. for nasya vacha tail ..

[14/08 23:04] satyendra ojha sir: 

Dr Pawan Madan , then , leave the ayurveda..

[14/08 23:05] Dr Akash Meshram AP: 

Mostly indigestion causes occipital headache if certainly cervical screening is clear

[14/08 23:09] satyendra ojha sir: 

It's cerebral venous thrombosis.. think accordingly.. no diversion..

[14/08 23:15] Amol Jadhav Dr. Ay. Pth: 

Pt was further investigate d for

Sr. Vit B12

And

Sr. Homocysteine

[14/08 23:15] satyendra ojha sir: 

Okay.. send the reports..

[14/08 23:17] jay govind ukinada Dr Ay pith: 

Even if the cause is Vitb12 deficiency/hyperhomocystinaemia both thrombolytic drugs and correction of the defects should be performed simultaneously

[14/08 23:18] jay govind ukinada Dr Ay pith: 

Vit k inhibitors..

[14/08 23:24] jay govind ukinada Dr Ay pith: 

Homocystine shows very high value. Hence adding abundant green leaves/ folic acid along with drugs suggested for thrombolysis should be followed.

Hyperhomocystinaemia is one of the big culprit for Stroke/MI/early thrombosis in younger age group.

Its always better to test homocystine at around 30's if there is family history of stroke/MI.

[14/08 23:25] satyendra ojha sir: 

Dr Jayagovind ji.. 

[14/08 23:25] ‪+91 98235 94378‬: 

Thrombosis =› styaan kapha in rakta,

[14/08 23:25] ‪+91 98235 94378‬: ?

[14/08 23:25] satyendra ojha sir: I love it..

[14/08 23:26] satyendra ojha sir: 

Dr Prathamesh, refer ch.soo. 24 & ch.chi 4..

[14/08 23:27] ‪+91 98235 94378‬: Thnks sir

[14/08 23:31] Amol Jadhav Dr. Ay. Pth: 

Initially i was trying to interpret

How both the values are raised high but

When just went through

Initial order sheet...

Pt was received

Tab hosit XT

As well as

A point of NS WITH inj optineuron...

Hence

Vit B 12 values were too raised...

[15/08 11:34] Katoch sir: 

Thrombosis is intravascular phenomenon whereas Raktapitta is vimargaman (extravascular)of Rakta . Pl explain how thrombosis could be equted to Kaphanubandhi Raktapitta or Styaan Kapha. In simple terms thrombosis is solidification of blood, Raktapitta does not reveal that meaning.

[15/08 12:30] satyendra ojha sir: 

Dr Katoch Sir ! Thrombosis is the process of a blood clot, also known as a thrombus, forming in a blood vessel. This clot can block or obstruct blood flow in the affected area, as well as cause serious complications if the clot moves to a crucial part of the circulatory system, such as the brain or the lungs.

It is normal for the body to produce clotting factors like platelets and fibrin when a blood vessel is injured, to prevent an excessive loss of blood from the body. If this effect is over productive it can obstruct the flow of blood and form an embolus that moves around the blood stream.

bleeding/vessel wall injury is initial factor in the formation of thrombosis. This is the reason why acharya charak mentions......

कफाद्दुष्टं पिच्छिलं तन्तुमद्घनम् ( च.सू.2 4/21), 

कटुको रसो शोणितसंघातं भिन्नत्ति..( च.सू.2 6/42-4 ) 

कफानुबन्धे रुधिरे सपित्ते कण्ठागते स्यात् ग्रठिते प्रयोगः ।

युक्तस्य युक्तया मधुसर्पिषोश्र्च क्षारस्य चैवोत्पलनालजस्य..(च.चि.4/93). 

चिरस्रावि मांसपेशीप्रभं च श्लेष्मदुष्टम् । सु.सू.1 4/21.. 

all these references show the role of kapha in रक्तं स्त्यायति ( घनं ) भवति ..

। parthivaansha vriddhi at place of vascular injury cease the bleeding, after cessation of bleeding, at due course of time , vaata comes in action to maintain patency of vessel, ie natural phenomenon.. the disruption in this mechanism leading to grathit rakta formation and in turn srotorodha and related pathology.. katu  is vaayu , agni mahaabhoota predominant rasa. Hence , useful to dissolute clot/lysis of clot/fibrinolysis/thrombolysis. Similarly, kshaara works in dissolution of clot.

[15/08 12:39] satyendra ojha sir: 

Whether it's minor or major bleeding, it is caused due to रक्तयुक्तं पित्तं.. only in case of increased resistance to blood flow, the rupture of vessel is cause of bleeding, then only ,  there is role of vaata.. in one condition, when vessel wall is thin , there may be rupture of blood vessels and easy bruising occurs as in Cushing syndrome, here , we can see the role of raktavaha srotasa dushti.. the mobilisation of glycogenic aminacid from vascular wall make it weak .

[15/08 12:42] Pawan rajyan AP: 

[15/08 12:48] satyendra ojha sir: 

Increased resistance to blood flow is commonly caused by atherosclerosis in which the role of kapha and saama meda is very clear.. atheroma is common site for ulceration, fissure and plaque formation , ie due to vitiated pitta predominantly  , but vitiated vaata also may be a reason..

[15/08 12:57] pawan madan Dr:

 

Sir...only a small doubt..

Kapha anubandhi raktapitta me grathit rakta results in clot.

Kya is stage me ekdeshiya clot formation and anya deshiya bleeding ....aise symptoms hote hain kyaa?

[15/08 12:58] satyendra ojha sir: 

I don't think so..

[15/08 12:59] satyendra ojha sir: 

Whenever There is bleeding, clotting factors come in action..

[15/08 12:59] satyendra ojha sir: 

It's deficiency of clotting factors leading to bleeding diathesis..

[15/08 13:00] Sanjay Lungareg Dr: 

मेरी अल्प बुद्धि से।

No doubt Thrombosis is intravascular phenomenon whereas Raktapitta is extravascular.

When this रक्तपित्त comes in contact with different दोष then extravascular nature of रक्तपित्त converted into intravascular phenomenon and can be identified on the basis of intravascular sign of blood mixed with different दोष।

*तत्र दोषानुगमनं सिरास्त्र इव लक्षयेत्।* अ ह्र नि ३/१६

*तत्र - तस्मिन् रक्तपित्ते, दोषानुगमन-वातपित्तश्लेष्मणामनुबन्ध, सिरास्र इव -सिराव्यधविध्युक्तम्- वाताच्छायावारुण रुक्ष इत्यादिग्रन्थनिर्दिष्टेन लक्षणान्यत्वात् लक्षित, लक्षयेत।*

बाकी सब आचार्य ओझा जी ने स्पष्ट कर दिया है।

[15/08 13:00] satyendra ojha sir: 

And that deficiency is doshaja..

[15/08 13:00] pawan madan Dr: Ji sir...

That wud mean kapha anubandhi raktapitta ek aisi stage hai jisme actually us samay koi bleeding nahi ho rahi.

[15/08 13:02] satyendra ojha sir: 

Ji , nishchita rupa , tabhi to rakta grathit ho payega..

[15/08 13:03] satyendra ojha sir: 

Bleeding ke hote rahane par grathita avashthaa kaise milegi..

[15/08 13:04] pawan madan Dr: 

That means there can be some stages or types of raktapitta in which there is *virtually absence of clinically evident sym of bleeding* (intravascular raktapitta)...?

[15/08 13:04] satyendra ojha sir: 

Bleeding hote rahane ko hi Raktapitta kahate hai..

[15/08 13:06] satyendra ojha sir: 

Dr Pawan Madan ji, please.. it should be understood that at due course of time only , the clinical features manifest..

[15/08 13:18] satyendra ojha sir: 

Dr Sanjay lungare ji...

[15/08 13:25] Katoch sir: Thanks to Ayurvedic principles.

[15/08 13:33] Katoch sir: 

Means Thrombosis is the result of Raktapitta with kapha dosha implication and it is intravascular bleeding getting solidified. What an explanation !

[15/08 13:39] Katoch sir: 

Anything can be explained in anyway.

[15/08 13:40] Shastri BSRNL AP: 

When raktapitta originated from kapha stahana like amashaya,  vurah etc it will show kapha dusti nature

*Urdhvagam kapaha samsrustam*

Treatment may have similar nature -  kaphaja raktapitta -  thrombosis but diseases need not to be same time

 please क्षमाप्रार्थी

[15/08 13:43] satyendra ojha sir: 

The role of katu rasa in dissolution of clot helps to understand grathit rakta..

[15/08 13:44] Katoch sir: 100% right.

[15/08 13:44] Dr Surendra A. Soni: 

Respected Ojha Sir

Please review this as I ve observed carotid artery thrombosis due to overnight journey in AC Sleeper coach where AC wind were directly on cervical area resulting in hemiparesis. Another my patient who used to work in well known Ice cream factory developed Bud chiary syndrome who routine used to visit cold storage in his duty hours. This may be a type of thrombus formation except you and Lungare Sir are mentioning.

[15/08 13:48] satyendra ojha sir: 

The differentiation between kaphaja Raktapitta and kaphaanubandhe rakte sapitte is also very much needed..

[15/08 13:50] satyendra ojha sir: 

Dr Surendra Soni, sheeta is one cause of vitiated vaata and kapha.. the change in theological force is also found one cause of  thrombosis..

[15/08 13:53] Dr Surendra A. Soni: 

yes Sir

Sheet acted as pradhanika hetu in said cases.

Should be taken as achaya prakopa.

[15/08 13:53] satyendra ojha sir: 

The thrombus formation at site of bifurcation of artery is commonly seen..

[15/08 13:55] satyendra ojha sir: 

The role of parawata shakrit , utpala kshaara in grathita rakta indicate the whole process of thrombosis in terms of Ayurveda perspective..

[15/08 13:56] satyendra ojha sir: 

Darbha ( not durvaa ) works as anticoagulant..

[15/08 13:57] satyendra ojha sir: 

Samprapti chikitsa interrelationship is also here to interpret the same..

[15/08 14:08] Dr Surendra A. Soni: 

[15/08 14:16] Shastri BSRNL AP:

  

In kaphaja Raktapitta घनत्व शीत गुण  of kapha is involved

where as in thrombosis  vata with ruksha guna also involved - it seems

 

[15/08 14:23] pawan madan Dr: 

Very interesting discussion.

Thank U all ...

That also means in a patient of raktapitta when there is a stage like kapha anubandh qhen there is possible thrombus formation.....

.....drungs like paravata shakrit and darbha can be used as anticoagulant action for the time being???

.....and when used they will not cause/increase the pathogenesis of Raktapitta in that patient??

[15/08 14:32] satyendra ojha sir: 

युक्तस्य युक्तया means very cautious use of kshaara dravya.. we know the side effects, complications, and contraindications of thrombolytic drugs.. in certain existing conditions, these drugs are not used.. low molecular weight heparin is option.

The approach of acharya charak can be understood..

[15/08 14:35] satyendra ojha sir: 

INR study at regular intervals in anticoagulant therapy is mandatory.. otherwise, either bleeding or thrombosis may happen at higher or lower doses..

[15/08 15:42] pawan madan Dr: Jee sir...

[15/08 15:43] Chulet Sir Nia: 

The role of parawata shakrit , utpala kshaara in grathita rakta indicate the whole process of thrombosis in terms of Ayurveda perspective..----

There is a major difference between paravat sakrit and utpalnaal kshar . Parawat shakrit is always ushna by gun & veerya where as Utpal naak  kshar is sheet in veerya and gun ,which has acquired ushna gun and tekshnataa during the ksharpaak procedure only therefore useful for long term use without complications . In parawat shakrit we have found that lower doses  100 mg  is  more effective then higher dose 200 mg .

[15/08 16:06] Chulet Sir Nia: 

Yes dr Ojha this is युक्तस्य रोगी रोग परीक्षणानन्तर निश्चितीकृतस्य,युक्त्या अप्रत्यक्षेण ,अन्य औषधिमिश्रीकरणेन न्यूनीकृत  क्षार प्रभावस्य अपि ksharasy yuktyaa प्रयोग: अपेक्षित: आतुर बल प्राण रक्षार्थम् ---अल्पस्यापि महार्थत्वम् प्रभूतस्याल्पकर्मताम् कुर्यात् संयोगविश्लेष ----युक्तिभि: 

in which yukti it self is a yukti and samyog vishlesh etc are also separate yukti , one or more can b used to control and correlate the Aushadh Bal in accordance to dosh Bal ,Rog Bal ,rogibal coz,--बलाधिष्ठानमारोग्यम्  यदर्थोयम् क्रियाक्रम:

[15/08 16:08] Dr Surendra A. Soni:

 

[15/08 16:09] satyendra ojha sir: Guruji.. 

[15/08 16:11] Chulet Sir Nia: 

राधे राधे , ग्रुप में बात करने से आनन्द आने लगा है

वादे वादे ज़ायते तत्वबोध:

[15/08 16:15] satyendra ojha sir: 

In people admitted to hospital, thrombosis is a major cause for complications and occasionally death. In the UK, for instance, the Parliamentary Health Select Committee heard in 2005 that the annual rate of death due to thrombosis was 25,000, with at least 50% of these being hospital-acquired.[20] Hence thromboprophylaxis (prevention of thrombosis) is increasingly emphasized. In patients admitted for surgery, graded compression stockings are widely used, and in severe illness, prolonged immobility and in all orthopedic surgery, professional guidelines recommend low molecular weight heparin(LMWH) administration, mechanical calf compression or (if all else is contraindicated and the patient has recently suffered deep vein thrombosis) the insertion of a vena cava filter.[21][22] In patients with medical rather than surgical illness, LMWH too is known to prevent thrombosis,[22][23] and in the United Kingdom the Chief Medical Officer has issued guidance to the effect that preventative measures should be used in medical patients, in anticipation of formal guidelines.[24]

[15/08 16:22] pawan madan Dr: 

Jee sir...

Isiliye shayad grathitha kaphanubandh jo gale.me.hona bataaya gyaa hai, ke liye paravat shrita ka praavdhaan kiyaa gyaa hai.

[15/08 16:26] Chulet Sir Nia:

yes sir its wonderfull kalpana , achary selected kamalnaal for ksharkalpana to balance sheet and ush gun in a drug

[15/08 16:30] satyendra ojha sir: 

कण्ठागते......क्षारस्य...।। Dr Pawan Madan ji..

[15/08 16:32] satyendra ojha sir: 

सक्षौद्रं ग्रथिते रक्ते लिह्यात् पारावतं शकृत् . च.चि.4/71

[15/08 16:32] Amit Naknekar Dr. AP: 

what are other dd other than grathit raktpitaa fr thrombosis

[15/08 16:33] Amit Naknekar Dr. AP: Dhamani pratichay ?

[15/08 16:33] satyendra ojha sir: No..

[15/08 16:34] Amit Naknekar Dr. AP: 

So there are no other possibilities other than grathit raktpitta ?

[15/08 16:34] satyendra ojha sir: Yes..

[15/08 16:34] Amit Naknekar Dr. AP: 

thrombosis during dm ?

[15/08 16:35] satyendra ojha sir: 

In every aspect

[15/08 16:35] satyendra ojha sir: The same

[15/08 16:36] Amit Naknekar Dr. AP: 

sir why not dhamani pratichay

[15/08 16:36] Amit Naknekar Dr. AP: 

why not santarpanotha sira avrodh ?

[15/08 16:37] satyendra ojha sir: 

It's upalepana of dhamani by saama meda , maansa and kapha..

[15/08 16:37] Dr Surendra A. Soni: 

Perfect

[15/08 16:38] Amit Naknekar Dr. AP: 

If thrombosis along with dyslipidemia ?

[15/08 16:38] satyendra ojha sir: 

It also may occur with apatarpanottha nidaana like tear phenomena..

[15/08 16:38] satyendra ojha sir: 

Dr Amit.. first , you need to understand genesis of thrombosis..

[15/08 16:39] Amit Naknekar Dr. AP: 

yes sir that u have described in your previous post

[15/08 16:40] satyendra ojha sir: 

No , it's brief description.. please, go through text..

[15/08 16:40] Amit Naknekar Dr. AP: 

I am jst trying to clear my concepts little bit becoz u r giving excellant references so i thought thoda aur puch lu..

[15/08 16:41] Amit Naknekar Dr. AP: 

Yes i will again go through detail in textbook

[15/08 16:41] satyendra ojha sir: 

It's okay , you are welcome.. but , little bit self explanatory approach should be developed..

[15/08 16:42] Amit Naknekar Dr. AP: 

Your referencing method also develops some lateral thinking sir this is d only reason

[15/08 16:43] Amit Naknekar Dr. AP: 

i have also gone through your work on paravat shakrut on the same contest some time ago u have explained i dont remember exactly on which group

[15/08 16:44] satyendra ojha sir: 

Curr Opin Pulm Med. 2003 Sep;9(5):378-84.

Dyslipidemia, statins, and venous thromboembolism: a potential risk factor and a potential treatment.

Ray JG1.

Author information

Abstract

The optimal drug for the prevention of venous thromboembolism is one that is efficacious, associated with minimal bleeding risk, and easy to administer. Statins fulfill the latter two criteria, but their efficacy remains unproved. By examining the association between dyslipidemia and venous thromboembolism, as well as the evidence that statins might prevent venous thromboembolism, there may be a new rationale for the use of this class of drugs. There may be a common link between arterial and venous thrombosis. Dyslipidemia may be one of the many systemic factors associated not only with arterial thrombosis, but with venous thromboembolism as well. This may occur through the effects of circulating lipid molecules on the vascular endothelium, platelet function, and coagulation factors. By impeding these mechanisms, statins may be protective against venous thrombosis, but epidemiologic studies are few in number, and no randomized clinical trials have been conducted. Better epidemiologic evidence is required to establish whether dyslipidemia is a risk factor for venous thromboembolism. If future observational studies can demonstrate that statins are associated with a lower risk of venous thromboembolism, then consideration should be given to conducting a randomized clinical trial comparing statins with placebo for the prevention of venous thromboembolism. Until then, the efficacy of statins for the prevention or treatment of venous thromboembolism remains uncertain.

[15/08 16:44] satyendra ojha sir: 

Dr Amit 

[15/08 16:44] Amit Naknekar Dr. AP:

 yes sir thanx 

[15/08 16:54] satyendra ojha sir: 

ABHISYANDI AAHAR: Fast food can also be defined as any food that contributes little or no nutrient value to the diet, but instead provides excess calories and fat. Some of these foods that are of little nutritional value and often high in fat, sugar, and calories. Common foods include salted snack foods, gum, candy, sweet desserts, fried fast food, and carbonated beverages.

GURU, PISHTANNA, VISTAMBI AAHAR : Trans Fatty Acids render plasma lipid profile even more atherogenic than saturated fatty acids by not only elevating LDL cholesterol but also by decreasing HDL cholesterol. It includes

Deep fried fast food

Cake mixes

Cereal and energy bars

Chips, Crackers, Whipped toppings

Packed cookies and candy

Packed doughnuts, pies and cake..

SNIGDHA AAHAR : Dietary fat has long been implicated as a driver of insulin resistance. Large quantities of saturated, monounsaturated, and polyunsaturated (omega-6) fats all appear to be harmful. Being insensitive to insulin is still positively correlated with fat intake, and negatively correlated with dietary fiber intake, but both these factors are also correlated with excess body weight.

[15/08 16:57] satyendra ojha sir: 

Snigdha - kapha - medaadi - Dyslipidaemia, DM ,  atherosclerosis , metabolic syndrome......

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Above discussion held on 'Ayurveda Peetha" (initiated by Prof. S.N. Ojha) a Famous Whatsapp group of  well known Vaidyas from all over the India. 

Compiled & edited by

Dr. Surendra A. Soni

M.D.,PhD (KC)

Associate Professor

Dept. of Kaya-chikitsa

Govt. Ayurveda College

Vadodara Gujarat, India.

EMAIL: surendraasoni@gmail.com

Mobile No. +91 9408441150