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DR THEJASWINI R
2nd year MD
DEPT OF
KAYACHIKITSA
1
NEW EMERGING
HEALTH
CHALLENGES &
AYURVEDIC
MEDICINES
Chikungunya,Dengue...
2
Contents :
*Introduction
*Present health status in India
* New Emerging health challenges
*Addressing health challenges ...
3
Introduction:
*The term wellness can refer to a variety of conditions within the body.
*Many people associate wellness t...
4
Present Health Status in India:
*In health sector, India has made enormous strides over the past decades.
*The life expe...
5
*India is presently in a state of transition — economically, demographically,
and epidemiologically — in terms of health...
6
*The unprecedented demographic changes are likely to contribute to a
substantially increased labour force.
*However, it ...
7
New Emerging HealthChallenges :
*New emerging health challenge/ issues are those, that pose either a
threat or relief fr...
8
Emerging Health Challenges
Physical environment
( air , water etc)
Socio-economic
environment
(poverty age etc)
Each of ...
9
addressing the HealthChallenges :
*Health is a determinant of development of a country and development of a
country is d...
10
The Indian healthcare spend is less than half the global average when
compared on “percent of GDP” basis.
11
The healthcare spend, when compared on the basis of public-private contribution, also depicts a
skewed picture.
As note...
12
Challenges :
* Increase in Population.
*Shifting disease burden from communicable disease to non
communicable diseases...
13
Management :
*Healthcare is at an influx of paradigm shifts in terms of changing
disease patterns, increasing dual dise...
14
Ayurveda crisis :
Ayurveda is facing an unprecedented crisis both through external as well
as internal factors.
The ex...
15
Also ,declining biodiversity as well as availability of medicinal plants,
hijacking Ayurveda for amassing wealth, absen...
16
management :
 The first action is to recognise it as a system of medicine which in no way
is inferior to modern medici...
17
*Manufacture of medicines at the local levels, with due certification can
remove the fears about the quality of Ayurved...
18
DISeaSE ASPECT :
1.Communicable diseases
2. Non-communicable diseases
3. Other HEALTH CHALLENGES
19
1. COMMUNICABLE DISEASES :
INTRODUCTION :
New emerging diseases / emerging infectious disease is one that has
appeared ...
20
BACKGROUND :
*The World Health Organization warned in its 2007 report that
infectious diseases are emerging at a rate t...
21
Factors involved in establishment of the Emergence Infectious Diseases :
At least two events have to occur :
*(1) The i...
22
Another factor that is especially important in the re-emergence of diseases is
the acquired resistance of pathogens to ...
23
An example of ,how a new infectious disease emerge :
HIV
* It is thought that humans were first infected with HIV thro...
24
Ayurvedic Perspective :
*Nature being the mother of mankind has always had soothing effect.
But in the process of learn...
25
Though we do not find a direct references for new emerging health
challenges we understand it through various concepts ...
26
1.Janapadodhwamsa rogas (Epidemic or Endemic Diseases) :
*Acharya Charaka has dedicated an entire chapter for explainin...
27
2. Aagantuja rogas (diseases of external cause) :
*While explaining various classifications of diseases, Acaharya Chara...
28
*if it is not followed by vitiation of doshas and subsequent vitiation of
dushyas in dosha-dushya-sammurchana it will f...
29
3. Oupasargika rogas (Contagious Diseases) :
*Certain group of diseases spread from one person to another by direct or
...
30
4. Graha rogas (Sporadic cases of infective nature due to
Grahabhishanga) :
*There are some groups of disease which are...
31
*They are described as living beings with contagious property, residing
in unclean places protected from sun rays. Thes...
32
5. Krimi (Micro-organisms / parasites) :
*A number of ecto-parasites and endo-parasites, minute and large ones
which li...
33
Summary :
Even though the Ancient authors have clearly not described about the
various modes infectious diseases transm...
34
Aprroach to the diagnosis and treatment of new diseaeses :
*While enumerating the topic trishothiya adhyaya in Charaka ...
35
*So a physician should try to interpret the nature of the disease in terms
of dosha , the site of its manifestation and...
36
37
CHIKUNGUNYA :
*Chikungunya is a mosquito-borne viral
disease transmitted to humans by the bite
of infected mosquitoes.
...
38
Transmission
This virus is transmitted from human to human by the
bites of infected female mosquitoes. Most commonly,
t...
39
Investigations :
*Serological tests, such as
*enzyme linked immunosorbent assays (ELISA),may confirm the presence of
Ig...
40
AYURVEDICAPPROACHTO CHIKUNGUNYA :
It can be understood with the condition, where Jwara is associated with sandhi
shoola...
41
*वात कफज ज्वर :
42
The description of Sandhiga Sannipata Jwara explained in Bhava Prakasha
can be equated with Chikungunya fever.
Sandhiga...
43
Samprapti Ghataka :
*Dosha :tridoshaja
*Dooshya : Rasa,
*Agni : Jataragni, dhatwagni
*Ama : tat janya
*Srotas :Rasavaha...
44
Ayurvedic management as per CCRAS:
The treatment modalities of Chikungunya can be categorised into :
1. symptom modifie...
45
Symptom Modifiers :
*Sl. No. Sankrit Name Botanical Name
1. Guduchi Tinospora cordifolia Willd. Miers
2. Sunti Zingiber...
46
*General health Promoters :
The agents that improve Quality Of Life (QOL),provides strength or resistance
against the d...
47
Vector control measures :
physical measures for environmental cleanliness.
* Dhoopana ( for Fumigation)
* Bhuthaghna & ...
48
*Principles for treatment :
Amapachana
In the initial stages jwara prashamana chikitsa
Kapha-vata shamana
Shotha an...
49
Formulations beneficial in Chikungunya :
In Fever and pain/jwara chikitsa :
*Amrutharishta + Punarnavasava 30ml TID
*Ve...
50
In Polyarthralgia with minimum inflammation :
*Dashamoola kashaya
*Indukantha kashaya
*Bala punarnavadi kashaya
*Karpoo...
51
In Post – Viral arthralgia / amavata hara chikitsa :
*Manjishtadi kashaya 15ml BD
*Kokilaksha kashaya + kaishora guggul...
52
53
Dengue :
* Dengue fever, also known as “break bone fever” , is a mosquito-borne infection that
causes a severe flu-like...
54
Transmission :
*The female Ae. aegypti mosquito usually
becomes infected with dengue virus when it takes
blood meal fro...
55
Clinical features :
*Dengue fever usually stats suddenly with a
rapidly climbing high fever termed as
“Saddle back” typ...
56
Investigations :
*Following tests are available for the diagnosis of dengue infection
*Haemagglutination-Inhibition (HI...
57
AYURVEDICAPPROACH TO DENGUE:
*Vikruti vishama sannipataja jwara
*Abhishangaja Jvara (Agantuja jwara)
*Dandaka jwara/ast...
58
*Vikruti vishama sannipataja jwara
59
Abhishangaja Jwara (Agantuja jwara) || cha.chi 3/114||
A type of agatuja jwara caused due to the influence of psycholog...
60
Dandaka Jwara :
अस्स्थ सस्न्द्िरुजास्तीव्र दण्डाहततक्रु ता इवा ।
क्वच त् क्षिक्प्रोदयलयो पवसिविः सववगात्रगिः॥
ज्वरश् कण...
61
Samprapti Ghataka :
*Dosha :tridoshaja
*Dooshya : Rasa,
*Agni : Jataragni, dhatwagni
*Ama : tat janya
*Srotas :Rasavaha...
62
Ayurvedic management as per CCRAS:
For Fever :
*In initial phase, Kwatha prepared of Dhamasa, Parpat, Kiratatikta, Must...
63
*Management as per AYUSH :
*Although there is no specific treatment for disease, Ayurveda stresses
to strengthen immune...
64
*Priciples for treatment :
Amapachana
Pitta Rakta shamana
Ojovardana
65
Formulations beneficial in Dengue :
Kashayas :
*Guduchyadi kashaya
*Drakshadi kwatha
*Vasa guduchyadi kwatha
Asava /Ari...
66
For prevention of haemorrhagic symptoms :
*Drakshadi kwatha
*Patolakaturohinyadi kashaya
*Sarivadi kashaya
*Vaasaguluch...
67
In recent times, papaya leaves are very effective and useful in
management of dengue fever especially in increasing pla...
68
*Chemical constituents- Papaya contains a chemical called papain,
which is commonly used as a meat tenderizer.
Papain b...
69
Caripill :
*It is the drug to treat the patient
with dengue fever in view of
platelet production.
*The drug Caripill la...
70
71
HIV / AIDS :
*AIDS is defined as an illness
characterised by
one or more indicator diseases.
*In the absence of anothe...
72
*HIV stands for Human Immuno deficiency Virus.
*HIV attacks the bodies immune system specifically the CD 4 cells
[T cel...
73
Epidemiology –
*HIV infection / AIDS is a global pandemic, with cases reported from
virtually every country.
*The estim...
74
SIGNS AND SYMPTOMS :
*Soon after the infection with HIV, some people have flu like symptoms, such
as fever, headache an...
75
*Treatment :
Combination of
*Anti Retroviral Therapy(ART) and
*Highly Active Anti Retroviral Therapy (HAART)
Is most ef...
76
Ayurvedic approach to HIV/ AIDS :
Clinical picture of AIDS, described in Ayurveda is found scattered in all
authentic t...
77
Ayurvedic Management :
Principles for treatment :
* HIV infection affects multi systems, chiefly the ojus (Immune
Syste...
78
79
Resistant Tuberculosis :
*Tuberculosis (TB) is a disease caused by bacteria that are spread from
person to person throu...
80
Causes :
*Drug-resistant TB can occur when the drugs used to treat TB are
misused or mismanaged. Examples of misuse or ...
81
Types :
*Multidrug-Resistant TB (MDR TB) : TB bacteria that is resistant to
at least isoniazid and rifampin, the two mo...
82
Treatment :
Treating and curing drug-resistant TB is complicated. Inappropriate
management can have life-threatening re...
83
Ayurvedic approach to Resistant Tuberculosis:
*The role of Ayurvedic medicines in the treatment of resistant tuberculos...
84
In addition, Ayurvedic medicines can also raise the immune status in
such patients so that the body is in a better posi...
85
86
H1N1 / Swine flu :
*Swine flu is a highly contagious respiratory disease in pigs caused by one of several swine
influen...
87
Transmission :
*Swine influenza (novel H1N1 and H3N2v) spreads from person to
person, either by inhaling the virus or b...
88
Investigation :
*Nose or throat swab. To test for swine flu a nose or throat swab is
taken. Within 15 minutes the labor...
89
*Ayurvedicapproach to Swineflu:
In general various types of flu prevailing in present days can be understood as :
1.Vat...
90
Vata Kaphaja Jwara:
The predominance of Vata and Kapha Dosha at the end of winter
and beginning of summer i.e. the Rutu...
91
*Shleshmaka jwara :
The jwara which results due to janapadodhwamsa , which is quick in spreading
and life threatening i...
92
*Abhinyasa jwara :
93
*Priciples for treatment :
Agnideepana
Kapha vata shamana
Shwasa, kapha shamana
Balavardhana
94
95
Formulations beneficial in Swine flu :
Kashayas :
*Vyaghryadi kwatha with shunthi + pippali
*Dashamoola katutrayadi kas...
96
Churnas :
*Talisadi churna
*Seetophaladi churna
Asava Arishtas:
*Amritarishta
*Vasarishta
*Kanakasava
Lehyas :
*Dasaham...
97
98
Chicken flu :
*Chicken flu / Bird flu, also called avian influenza,
is a viral infection that can also infect humans
a...
99
Transmission :
*H5N1 is a highly pathogenic virus that
results in producing avian influenza .
*But unlike human flu , H...
100
Symptoms :
*Bird flu symptoms in people can vary. Symptoms may start out as normal flu-
like symptoms.
*This can worse...
101
Ayurvedic approachto Birdflu /Chicken flu:
*As previously explained under swine flu , bird flu can also be understood ...
102
2.NON-COMMUNICABLE DISEASE
INTRODUCTION:
* Communicable diseases were the main causes of death around the
world.
*Life...
103
*Industrialization, socio-economic development, urbanization, changing age structure,
changing lifestyles has placed I...
104
Cardiovascular diseases(CVD) :
*It is the name for the group of disorders of the heart and blood vessels and
include h...
105
CANCER :
*Cancer is now a major cause of mortality throughout the world. In the
developed world, it is generally excee...
106
The incidence of cancers of the lung, colon and rectum, breast and prostate
generally increases in parallel with econo...
107
*Although rates are five times higher in industrialized countries, the burden of
disease is heavier in poorer countrie...
108
Liver cancer
*Approximately 75% of cases occur in developed countries, the rate vary over
20fold between countries. In...
109
Chronicrespiratory diseases
*Chronic respiratory diseases represent a major burden for the health systems
worldwide.
*...
110
Lifestyle Disorders :
Lifestyle diseases are defined linked with the way people live their life. This is
commonly caus...
111
2.DiabetesMellitus :
*India is currently experiencing an epidemic of Type 2 diabetes mellitus
(T2DM) and has the large...
112
*The prevalence of diabetes in the rural areas according to WHO criteria
and American Diabetes Association (ADA) crite...
113
AYURVEDA AND NCDs :
*In its own terms, expertly practiced Ayurveda can definitely yield
reliable, efficacious results ...
114
*The reason why biomedicine cannot treat chronic disease as effectively
as Ayurveda lies in its apparent lack of any k...
115
Prevention of
NCDs
Purification
of mind
Yogic
practise
Physical
Exercise
deaddiction
Destressing
Satvavajay
a
Shareera...
116
3.Other health Challenges:
Sick building syndrome :
117
Sickbuilding syndrome :
*The sick building syndrome (SBS) is used
to describe a situation in which the
occupants of a ...
118
ETIOLOGY :
*Chemical contaminants :
from both outdoor as well as indoor sources.
* Biological contaminants :
pollen, b...
119
*CLASSIFICATION :
*The health conditions associated with buildings are commonly classified
as:
*SBS or Tight building ...
120
INVESTIGATIONS :
*Evaluating the Indor Air Quality(IAQ) and identifying the contaminant by air
sampling.
*Establishing...
121
Treatment of Sick Building Syndrome :
*It is first important to make sure that there are no hazards in the building li...
122
PREVENTION AND CONTROL :
*Increasing the ventilation rates and air distribution.
*The heating, ventilation and air-con...
123
Ayurvedic approach to SBS :
*Sthapatya Veda,one of the approaches of Vedic medicine, goes deeply into the
health effec...
124
* It explains how to build:
structures that are in harmony with
the laws of Nature and the land
structures that can ...
125
*In the recent research in modern science
has now confirmed the ancient
understanding that our brain is sensitive
to o...
126
*The benefits of following Vaastu are given in the opening verse of
Vaastu Sastra written by great sage Viswakarma whi...
127
Trividha Chikitsa :
*Daiva-vyapashraya Chikitsa means the treatment based on believing on
divine power, divine remedie...
128
129
Restless leg syndrome :
*It is a neurological disorder characterised
by unpleasant sensations in the legs and an
unco...
130
Symptoms :
*Patients with RLS feel uncomfortable sensations in their legs, especially when sitting
or lying down , acc...
131
Ayurvedic apporach :
It can be considered as vata vyadhi , in which laghutva and chalatva of
vata arrggravates resulti...
132
Formulations beneficial in RLS :
*Kashayas:
*Dhanvantaram kashaya
*Vidaryadi kashaya
*Sahacharadi kashaya
*Prasaranyad...
133
Arishta :
*Balarishta
*Saraswatharishta
*Ashwagandharishta
Ghrita :
*Pachagavya ghrita
*Brahmi ghrita
Rasayana :
*Nara...
134
External therapies :
*Talam with kacchuradi churna and ksheerabala taila
*Abhyanga with prasarinyadi taila or sahachar...
135
136
Fibromyalgia:
Fibromyalgia is a chronic condition ,
characterised by non-
inflammatory pain and tenderness
in ligamen...
137
*Symptoms :
*Fibromyalgia usually presents in the
form of aches, burning sensation,
stiffness, or throbbing in any
loc...
138
Treatment :
*In general, treatments for fibromyalgia include both medication and
self-care.
*The emphasis is on minimi...
139
Ayurvedic approach :
*Fibromyalgia does not fall to a particular srotas .
*The absence of a specific evidences in the ...
140
Priciples of treatment :
*Vata shamana chikitsa
*Mana prasadana chikitsa
*Rasaprasadana chikitsa
141
Ayurvedic mangement :
*Jeevantyadi gana kashaya
*Vidaryadi kashaya
*Devedarvyadi kashaya
*Manasamitra vati
*Panchagavy...
142
Conclusion :
*Ayurveda is one of the most ancient Medical Science which sees
human being as an integral part of nature...
143
*Ayurveda define health as a state of physical, mental, intellectual and
spiritual well being.
*And its primary object...
144
*65% of population in India is reported to use Ayurvedic medicines
without prescription of doctor.
*Recent breakouts a...
145
*‘Achara rasayana’ is another unique concept in Ayurveda that implies
moral, ethical, and benevolent conduct.
*The con...
146
*Thus by implementing these principles properly in our lives, it brings
about healthy and a disease free society.
*It ...
147
References :
1.https://www.bcm.edu › ... › Emerging Infections and Biodefense
2. healthsciences.ac.in/commentry1.html
...
148
11.THE CONCEPT OF PUBLIC HEALTH IN AYURVEDA -Janmejaya Samal
12.Charaka Samhitha sutra sthana 18th chapter.
13.Charaka...
149
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New Emerging Health Challenges and Ayurvedic Management

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ayrvedic management strategy for various new emerging health issues , in terms of both communicable and non - communicable disorders.

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New Emerging Health Challenges and Ayurvedic Management

  1. 1. DR THEJASWINI R 2nd year MD DEPT OF KAYACHIKITSA 1 NEW EMERGING HEALTH CHALLENGES & AYURVEDIC MEDICINES Chikungunya,Dengue,HIV/AIDS,H1N1,SBS,Fibromyalgia,RLS, Birdflu
  2. 2. 2 Contents : *Introduction *Present health status in India * New Emerging health challenges *Addressing health challenges and its management *Ayurveda crisis and its management *Introduction to New Emerging diseases *Ayurvedic approach to New Emerging diseases : *Chikungunya *Dengue *HIV/AIDS *H1N1 *SBS *Fibromyalgia *RLS * Birdflu
  3. 3. 3 Introduction: *The term wellness can refer to a variety of conditions within the body. *Many people associate wellness to their physical health, it can also be used to describe environmental, mental, intellectual, occupational, emotional and spiritual well-being too. * These different dimensions of health will interact together to determine the quality of life.
  4. 4. 4 Present Health Status in India: *In health sector, India has made enormous strides over the past decades. *The life expectancy has crossed 67 years, infant and under-five mortality rates are declining in terms of rate of disease incidence. *Many diseases, such as polio, guinea worm disease, yaws, and tetanus have been eradicated. In spite of this progress:  The communicable diseases is expected to continue to remain a major public health problem in the coming decades posing a threat to both national and international health security.  Besides endemic diseases such as human immunodeficiency virus infection and acquired immune deficiency syndrome (HIV/AIDS), tuberculosis (TB), malaria and neglected tropical diseases, the communicable disease outbreaks will continue to challenge public health, requiring high level of readiness in terms of early detection and rapid response. *In this regard, vector-borne diseases, such as dengue are of particular concern. *Antimicrobial resistance is one of the biggest health challenges facing humanity that must be tackled with all seriousness.
  5. 5. 5 *India is presently in a state of transition — economically, demographically, and epidemiologically — in terms of health. *While the last decade has seen remarkable economic development particularly in terms of gross domestic product (GDP) growth rate, unfortunately this progress is accompanied by growing disparities between the rich and the poor. * There is strong evidence to suggest that this income inequality or disparity between the different socioeconomic classes is associated with worst health outcomes. * Widening the gap between the rich and the poor has damaging health and social consequences. *While financial inclusion and social security measures are being implemented by the Government to bridge economic inequalities. *Health sector too must ensure that health disparities between and among social and economic classes are also addressed adequately.
  6. 6. 6 *The unprecedented demographic changes are likely to contribute to a substantially increased labour force. *However, it will benefit the country only if the population is healthy. *The country at present suffers from the triple burden of disease : The unfinished agenda of infectious diseases, The challenge of non communicable diseases (NCDs) and Emergence of new pathogens causing epidemics and pandemics. *In addition, the health infrastructure is already over-stretched and needs to be strengthened to enable it confront these challenges in the twenty-first century.
  7. 7. 7 New Emerging HealthChallenges : *New emerging health challenge/ issues are those, that pose either a threat or relief from threat to the overall health of the population. *An emerging issue can be a disease or injury that has either increased incidence or prevalence in the past decade or threatens to increase in the near future. * It can be a “horizon issue” that has just begun to develop in our society and the future public health effects of which are uncertain. * It can also be an increased visibility in a long-standing health issue that continues to obstruct the public health goal of reducing death and disability.
  8. 8. 8 Emerging Health Challenges Physical environment ( air , water etc) Socio-economic environment (poverty age etc) Each of these areas evolves and affects the overall health status of the population. The emerging issues affecting health status reflect the dramatic changes in our environment and the society.
  9. 9. 9 addressing the HealthChallenges : *Health is a determinant of development of a country and development of a country is determinant of health. *Thus both needs to be addressed as a priority at global , national and local levels. *The Healthcare sector, in India, is at an inflection point and is poised for rapid growth in the medium term. *However, Indian healthcare expenditure is still amongst the lowest globally and there are significant challenges to be addressed both in terms of ‘accessibility of healthcare service and quality of patient care’.
  10. 10. 10 The Indian healthcare spend is less than half the global average when compared on “percent of GDP” basis.
  11. 11. 11 The healthcare spend, when compared on the basis of public-private contribution, also depicts a skewed picture. As noted from the comparison below, Private Sector contribution to the healthcare sector at ~75 percent is amongst the highest in the world in percentage terms. Public spending, on the other hand, is amongst the lowest in the world and is ~23 percentage points, lower than the global average.
  12. 12. 12 Challenges : * Increase in Population. *Shifting disease burden from communicable disease to non communicable diseases. *Increase in incidence of lifestyle-related diseases in urban India *At the same time, Rural India are struggling with Communicable Diseases such as tuberculosis, typhoid, dysentery etc. *Accessibility to healthcare services is extremely limited to many rural areas of the country. *Rising Literacy *In addition, existing healthcare infrastructure is unplanned and is irregularly distributed. *Further, there is a severe lack of trained doctors and nurses to service the needs of the large Indian population.
  13. 13. 13 Management : *Healthcare is at an influx of paradigm shifts in terms of changing disease patterns, increasing dual disease burden for both rural and urban India. *On the supply side there has been uneven distribution of healthcare infrastructure and resources posing various challenges to the sector. *A multi-pronged approach from key stake holders is necessary to address the issue. * Both the public and private sector need to work in tandem to make healthcare available, accessible and affordable. * India would need various solutions towards this end. *The most reliable guide to future developments in health is a careful examination of current trends in society and progress in research.
  14. 14. 14 Ayurveda crisis : Ayurveda is facing an unprecedented crisis both through external as well as internal factors. The external factors include: The rapid advancements in modern medical science ,growth of technology, stringent conditions imposed by foreign countries in the export of Ayurvedic formulations, suspicion and fear about toxicity and efficacy of its drugs, the most important of all, refusal to recognise it as a valid system. The internal factors include : absence of real gurus who used to be the storehouse of knowledge and wisdom, lack of good quality practitioners, poor quality education, virtual lack of quality research, poor quality medicines.
  15. 15. 15 Also ,declining biodiversity as well as availability of medicinal plants, hijacking Ayurveda for amassing wealth, absence of motivation in the youth to opt for a profession in Ayurveda and rejection of traditional systems by a society dazzled by globalisation and liberalisation are the other serious challenges to the very survival of Ayurveda as a healing system. * We, in India look at our own system through the eyes of the western systems of medicine and condemn traditional system of medicines as quackery. * While more and more people, especially those who belong to the low- income strata, are pushed into the vortex of chronic and newer forms of diseases and the cost of health-care is skyrocketing and our population becomes more and more unmanageable, we have nowhere else to go, except to Ayurveda and sister systems. * But the problem is that the systems are not ready to meet the challenges.
  16. 16. 16 management :  The first action is to recognise it as a system of medicine which in no way is inferior to modern medicine. * Ayurveda is a way of life practised over centuries which has contributed to health and well-being of the people. The medicines in Ayurveda are nature- based and can be considered as food. *To dismiss Ayurveda therefore on consideration that it is not evidence-based would appear somewhat ridiculous. The efficacy of the system can be proved by following its own protocols. Secondly, Ayurveda should stop imitating the modern medicine. While there could be use of modern instruments to identify and track progression of the diseases, it does not require a super- speciality hospital to treat the diseases. *A decentralised, simple and inexpensive system is the need of the hour. *Promoting cultivation of medicinal plants and their use by the population can help preserve the unique knowledge each region of this country has about them.
  17. 17. 17 *Manufacture of medicines at the local levels, with due certification can remove the fears about the quality of Ayurveda medicines. *The concept of maintaining the balance of health in Ayurveda, the tridoshas, their vitiation and correction can contribute largely to preventive health care. *India has to use Ayurveda systematically to get over the problems of coverage, outreach and funds to provide affordable and quality health care to the entire population. * Each of the factors contributing to the crisis in Ayurveda needs to be attended to, in order to revive the system.
  18. 18. 18 DISeaSE ASPECT : 1.Communicable diseases 2. Non-communicable diseases 3. Other HEALTH CHALLENGES
  19. 19. 19 1. COMMUNICABLE DISEASES : INTRODUCTION : New emerging diseases / emerging infectious disease is one that has appeared within a population for the first time, or those whose incidence or geographic range is rapidly increasing or threatens to increase in the near future. Emerging infections can be caused by: *Previously undetected or unknown infectious agents. *Known agents that have spread to new geographic locations or new populations. *Previously known agents whose role in specific diseases has previously gone unrecognized. *Re-emergence of agents whose incidence of disease had significantly declined in the past, but whose incidence of disease has reappeared. This class of diseases is known as re-emerging infectious diseases.
  20. 20. 20 BACKGROUND : *The World Health Organization warned in its 2007 report that infectious diseases are emerging at a rate that has not been seen before. *Since the 1970s, about 40 infectious diseases have been discovered, including SARS, MERS, Ebola, chikungunya, avian flu, swine flu and, most recently, Zika. *With people traveling much more frequently and far greater distances than in the past, living in more densely populated areas, and coming into closer contact with wild animals, the potential for emerging infectious diseases to spread rapidly and cause global epidemics is a major concern.
  21. 21. 21 Factors involved in establishment of the Emergence Infectious Diseases : At least two events have to occur : *(1) The infectious agent has to be introduced into a vulnerable population. *(2) The agent has to have the ability to spread readily from person-to-person and cause disease. The infection also has to be able to sustain itself within the population, that is more and more people continue to become infected. *Many emerging diseases arise when infectious agents in animals are passed to humans (referred to as zoonoses). * As the human population expands in number and into new geographical regions, the possibility that humans will come into close contact with animal species that are potential hosts of an infectious agent increases. *When that factor is combined with increase in human density and mobility, it is easy to see that this combination poses a serious threat to human health.
  22. 22. 22 Another factor that is especially important in the re-emergence of diseases is the acquired resistance of pathogens to antimicrobial medications such as antibiotics. * Both bacteria and viruses can change over time and develop a resistance to these drugs, so that drugs that were effective in controlling disease in the past are no longer useful. *Climate change is increasingly becoming a concern as a factor in the emergence of infectious diseases. As Earth's climate warms and habitats are altered, diseases can spread into new geographic areas. *One way this can occur is through mosquitoes, transmitters of many infectious diseases, as they expand their range into new regions. Examples : HIV/AIDS, severe acute respiratory syndrome (SARS), chikungunya , H1N1 influenza etc.
  23. 23. 23 An example of ,how a new infectious disease emerge : HIV * It is thought that humans were first infected with HIV through close contact with chimpanzees, perhaps through bushmeat hunting, in isolated regions of Africa. *It is likely that HIV then spread from rural regions into cities and then internationally through air travel. * Further, factors in human behaviour such as intravenous drug use, sexual transmission, and transfer of blood products before the disease was recognized, aided the rapid and extensive spread of HIV.
  24. 24. 24 Ayurvedic Perspective : *Nature being the mother of mankind has always had soothing effect. But in the process of learning for his comfort man has neglected the untoward effects on nature. Whenever man has disobeyed the nature’s law, nature has feed back with massive form of destruction. * It conveys the message that whenever an effort is made to disturb the nature, the nature will destroy the human roots. *Even the modern science has the same basis to prove it & the principles of preventive medicine are also based on it. * The concepts of micro-organisms, communicable or infectious disease is well defined and established in Ayurveda ,our acharyas were also familiar about the communicable diseases along with the mode of spread.
  25. 25. 25 Though we do not find a direct references for new emerging health challenges we understand it through various concepts given by our acharyas, such as : (2) 1.Janapadodhwamsa rogas (Epidemic or Endemic Diseases) 2. Aagantuja rogas (diseases of external cause) 3. Oupasargika rogas (Contagious Diseases) 4. Graha rogas (Sporadic cases of infective nature due to Grahabhishanga) 5. Krimi (Micro-organisms / parasites)
  26. 26. 26 1.Janapadodhwamsa rogas (Epidemic or Endemic Diseases) : *Acharya Charaka has dedicated an entire chapter for explaining epidemic disorders named as Janapadodhwamsa Vimanam, in which he has explained regarding determination of specific characteristics of epedemics. *The 4 factors Jala , Vayu, Desha and Kala , vitiation of these factors are considered to be responsible for the production of communicable diseases which can be well correlated with modern science. * Contamination and vitiation of these factors results in manifestation of epidemic diseases . * Today water borne diseases, environmental diseases, epidemiological disorders and other seasonal disorders can be correlated and understood in terms of Janapadodhwamsa Vyadhis.
  27. 27. 27 2. Aagantuja rogas (diseases of external cause) : *While explaining various classifications of diseases, Acaharya Charaka in Maharoga adhyaya has expalined regarding aagantuja rogas. *The external factors like bhoota (microbes), visha (poison), vayu (air), agni (fire), hata (injuries), kama (lust), krodha (anger), bhaya (fear /psychic) etc, association results in the manifestation of agantuja rogas however ,there is significant difference in the pathogenesis of Agantuja rogas. *Acharya Charaka explains that, here the disease is produced first and then the vitiation of doshas and dushyas occur. *So in the production of a disease even though the disease causing organism or any other agantuja hetu is capable of bringing about certain signs and symptoms of the disease initially.
  28. 28. 28 *if it is not followed by vitiation of doshas and subsequent vitiation of dushyas in dosha-dushya-sammurchana it will further not succeed in producing a fully manifested disease. *If a bhootopasarga fails to bring about subsequent vitiation of doshas and dushyas, it will not get established in the body. *This is why many diseases subside as sub clinical infections causing mild fever, malaise before entering the clinical horizon. * This description is almost equal to the modern concept of epidemic triad viz., agent, host and environment and their interaction in the development of infectious diseases.
  29. 29. 29 3. Oupasargika rogas (Contagious Diseases) : *Certain group of diseases spread from one person to another by direct or indirect contact which is termed as Oupasargika/Sankramika Rogas. *Acharya Sushruta has clearly mentioned that diseases like kushta, jwara, sosha, netrabhishyanda spread from one person to the other. * The exposure or contact can be a simple association, touch, inhalation of other’s expired air, eating together in one plate, sleeping & lying together and wearing other’s clothes etc things. *Even sexual contact with an infected woman is said to give rise so many sexual transmitted diseases. *Acharya Vagbhata explains all the diseases are transmitted through contact only, but skin and eye diseases eyes have more communicability.
  30. 30. 30 4. Graha rogas (Sporadic cases of infective nature due to Grahabhishanga) : *There are some groups of disease which are due to contact of the person with some living beings which are not seen by naked eye called as Graha (evil demons) , disease manifested by them is named as Graha Rogas. *Acharya Sushruta has given a detailed explanation regarding this concept, out of 12 chapters explained under Kumaratantra in Sushruta Uttaratantra,11 chapters have been dedicated for explation of graha rogas and its chikitsa. *Grahas is understood as ,class of evil demons supposed to capture humans & produces a variety of symptoms which is Agantuja in nature.
  31. 31. 31 *They are described as living beings with contagious property, residing in unclean places protected from sun rays. These are having ability to feed on blood & meat. * Some may be pathogenic while others are non pathogenic. *When the human beings are attacked by the evil demons, the attacked person will have evil desire and produce fever, vomiting, loose motion and other constitutional symptoms.
  32. 32. 32 5. Krimi (Micro-organisms / parasites) : *A number of ecto-parasites and endo-parasites, minute and large ones which live in various parts of the body which manifests diseases are explained in our classics . * According to Acharya Vagbhata, some of these parasites are found in blood are very minute so that can’t visible by naked eye & produces various skin diseases like kushta (leprosy etc). *Acharya Sushruta also says that all the skin diseases are associated with parasites. He also gives a description of the signs and symptoms found in a patient when infestation occur in wound etc are fever, pallor, pain, heart diseases, weakness, vertigo, anorexia & diarrhea shall be found when infestation by parasite occur. * Acharya Charaka has given three main processes for treating the krimi rogas i,e nidana parivarjana ,apakarshana and Prakriti Vighata. * This concept seems to be very similar to modern microbiology and practice of medicine.
  33. 33. 33 Summary : Even though the Ancient authors have clearly not described about the various modes infectious diseases transmission, but we can understand that some infectious diseases will spread by * Direct skin contact or use of used articles of the patient (kushta, netrabhishyanda etc), *By direct droplet infection (sosha, yakshma etc), * Through oral injestion (jwara etc), *Through sexual intercourse (upadamsa etc). In this way the concept of infectious diseases along with its causes and treatment have been highlighted in our classics.
  34. 34. 34 Aprroach to the diagnosis and treatment of new diseaeses : *While enumerating the topic trishothiya adhyaya in Charaka samhitha sutra sthana , we get reference regarding the innumerability of the disease and the approach towards it. *If a physician is not able to name a particular disease, he should not feel ashamed on that account ,because it is not always possible to name all types of diseases in definite terms. *When a dosha gets aggravated,it may cause manifold diseases depending upon the various hetu and the site of manifestation.
  35. 35. 35 *So a physician should try to interpret the nature of the disease in terms of dosha , the site of its manifestation and etiological factors and should then initiate the treatment . *Hence the new emerging diseases, prevailing in present days such as chikungunya , swineflu, chickenflu etc should be tried to understand through ayurvedic perspective ,in the virtue of the doshas, dushyas, srotas, agni(samprapti ghataka) and other entities involved in the production of the disease. *Samprapti vighatana should be thought of, and the same has to be done. *Followed by adopting appropriate dosha pratyanika as well as vyadhi pratynika chikitsa.
  36. 36. 36
  37. 37. 37 CHIKUNGUNYA : *Chikungunya is a mosquito-borne viral disease transmitted to humans by the bite of infected mosquitoes. *The term “Chikungunya” means “to become contorted” or more specifically to say “which bends up” reflecting the posture of Patient suffering from the arthritic symptoms. *This disease is almost always self limited and rarely fatal. Epidemiology *Chikungunya was first described in Tanzania, Africa in 1952. *In India a major epidemic of Chikungunya fever was reported 1963 (Kolkata), but in the year 2005 and 2006, there was a huge outbreak mainly in Andhra Pradesh, Karnataka, Maharashtra, Tamil Nadu, Kerala, Goa, Pondicherry, Madhya Pradesh, Gujarat, Rajasthan, Andaman & Nicobar, Delhi, etc.
  38. 38. 38 Transmission This virus is transmitted from human to human by the bites of infected female mosquitoes. Most commonly, the mosquitoes involved are Aedesaegypti and Aedesalbopictus, two species which can also transmit other mosquito-borne viruses, including dengue. Causitive factor : RNA virus that belongs to the alphavirus genus of the family Togaviridae. Clinical features *The incubation period of Chikungunya is 2-12 days, but usually 3-7 days. *Abrupt onset of fever(>40° C or 104° F), * frequently accompanied by joint pain(incapacitating arthralgia or arthritis, which may last for weeks to years). *Chills, rash, nausea, vomiting,fatigue ,headache, conjunctival suffusion, mild photophobia. *Most patients recover fully, but in some cases joint pain may persist for several months, or even years. Hence the virus can cause acute, subacute or chronic disease.
  39. 39. 39 Investigations : *Serological tests, such as *enzyme linked immunosorbent assays (ELISA),may confirm the presence of IgM and IgG anti-chikungunya antibodies. * Samples collected during the first week after the onset of symptoms should be tested by both serological and virological methods (RT-PCR). Treatment : *There is no specific management for Chikungunya. *The line of management usually the rest, Intravenous fluids, anti pyretic, anti inflammatory, analgesic agents. *Chloroquine Phosphate (250 mg) once daily has been tried in the patients with fever and arthritis which has demonstrated promising results.
  40. 40. 40 AYURVEDICAPPROACHTO CHIKUNGUNYA : It can be understood with the condition, where Jwara is associated with sandhi shoola. The symptoms of Vata Pitta Jwara and Vata Kapha Jwara are similar to the symptoms of Chikungunya fever to some extent. वात पित्तज ज्वर : *शिरोरुक् िववणाां भेदो दाहो रोमणाां प्रहर्वणम् । कण्ठास्य िोर्ो वमथुस्तॄष्णा मूर्च्ाव भ्र्मो अरुच िः ॥ स्वप्ननािो अततवाग् जॄमभा वातपित्त ज्वराकॄ ततिः ॥ च ३/८५॥ वात कफज ज्वर : *िीततको गौरवां तन्द्र स्तैशमत्यां िववणाां रुक् । शिरोग्रहिः प्रततश्यायिः कासिः स्वेदाप्रवतवनम् ॥ सन्द्तािो मध्यवेगश् वातश्लेष्म ज्वराकॄ ततिः ॥ च ३/८६॥
  41. 41. 41 *वात कफज ज्वर :
  42. 42. 42 The description of Sandhiga Sannipata Jwara explained in Bhava Prakasha can be equated with Chikungunya fever. Sandhigata Sannipata Jvara is characterised by fever, joint pains and swelling, sleeplessness, cough., Bhela Samhita has mentioned Sharada jvara – a seasonal fever that occurs preceding the rainy season, usually attributable to viral fevers.
  43. 43. 43 Samprapti Ghataka : *Dosha :tridoshaja *Dooshya : Rasa, *Agni : Jataragni, dhatwagni *Ama : tat janya *Srotas :Rasavaha, asthivaha *Srotodusti prakara : Sanga & vimarga gamana *Udbhava sthana : amashaya *Sanchara sthana : rasayani *Adhishtana : amashya *Vyakta sthana : sarva shareera *Sadhya asadhyata :krichra sadhya
  44. 44. 44 Ayurvedic management as per CCRAS: The treatment modalities of Chikungunya can be categorised into : 1. symptom modifiers 2. health promoters. 3. Vector control measures 1. Symptom modifiers : The agents that alleviate symptoms are categorised under symptom modifiers such as- *Jwara hara (anti pyretics) *Sotha hara (anti inflammatory) *Vedana hara (analgesics) *Kushtghna (Skin diseases) *Kandughna (anti pruritic) *Kasa hara (anti tussive) *Shwasa hara (anti dyspnoeic) *Atisara hara (anti diarrhoeal) etc.,
  45. 45. 45 Symptom Modifiers : *Sl. No. Sankrit Name Botanical Name 1. Guduchi Tinospora cordifolia Willd. Miers 2. Sunti Zingiber officinale Rosc. 3. Bhunimba Andrographis paniculata Linn. 4. Patha Cissampelos pariera Linn. 5. Tulasi Ocimum sanctum Linn. 6. Nimba Azadirachta indica A.Juss 7. Haritaki Terminalia chebula Retz. 8. Vibhitaki Terminalia belerica Roxb. 9. Amalaki Emblica officinalis Geartn. 10. Manjishta Rubia cordifolia Linn. 11. Musta Cyperus rotundus Linn. 12. Katuki Picrorrhiza Kurroa Royle ex. Benth 13. Rasna Pluchea lanceolata Oliver&Hiern 14. Guggulu Commiphora wightii (Arn.) Bhandari 15. Haridra Curcuma longa Linn. 16. Sallaki Boswelia serrata Roxb. 17. Nirgundi Vitex negundo Linn.
  46. 46. 46 *General health Promoters : The agents that improve Quality Of Life (QOL),provides strength or resistance against the disease and also facilitate early recovery are classified under General Health Promoter such as *Balya (Tonic) *Rasayana (Immunomodulator) 1.Aswagandha Witahnica somnifera 2.Amalaki Emblica offcinalis 3.Guduchi Tinospora cordifolia 4.Yastimadhu Glycyrrhiza glabra
  47. 47. 47 Vector control measures : physical measures for environmental cleanliness. * Dhoopana ( for Fumigation) * Bhuthaghna & Rakshoghna (Anti microbial agents) 1. Tulasi Ocimum sanctum 2. Nimba Azadirachta indica 3.Aparajita Clitorea terneta 4.Vacha Acorus calamus 5.Jatamansi Nardostachys jatamansi 6.Guggulu Commiophora wightii 7.Salaparni Desmodium gangeticum 8. Sala Shorea robusta
  48. 48. 48 *Principles for treatment : Amapachana In the initial stages jwara prashamana chikitsa Kapha-vata shamana Shotha and shoola shamana by adopting amavata line of treatment (post viral arthalgia)
  49. 49. 49 Formulations beneficial in Chikungunya : In Fever and pain/jwara chikitsa : *Amrutharishta + Punarnavasava 30ml TID *Vettumaran gulika with shunthi swarasa and honey 2 BD *Sudarshana choorna 1/4th tsp with 15ml Amrutharishta TID *Amruthothara kashaya 15 ml+ vettumaran gulika BD *Godanti Bhasma 200mg with honey BD *Vishama jwarantaka gulika 1 TID In nausea and vomitting : *Vilwadi gulika with honey ½ TID *Vilwadi lehya 5gms TID *Dhanwantarm gulika1TID *Water boiled with dhanyaka + shunthi + ela + guduchi
  50. 50. 50 In Polyarthralgia with minimum inflammation : *Dashamoola kashaya *Indukantha kashaya *Bala punarnavadi kashaya *Karpooradi taila *Dhanyamla dhara *Upanaha sweda In Detmetological manifestations : *Eladi choorna *Amruta rajanyadi kwatha *Avipatti choorna *Rakta chandana lepa
  51. 51. 51 In Post – Viral arthralgia / amavata hara chikitsa : *Manjishtadi kashaya 15ml BD *Kokilaksha kashaya + kaishora guggulu BD *Simhana guggulu 2 TID *Amavatari rasa 1TID *Gandhrvahastyadi kashaya 12ml BD *Karaskara Ksheera dhara - pain and burning sensation *Bhallataka rasayana Dhoopana : *Aparajita dhoopana choorna – stimulates the resistance of the patient *Sarshapa , nimba patra with saindhava and ghrita *Guggulu , vacha, sarshapa, sarjarasa
  52. 52. 52
  53. 53. 53 Dengue : * Dengue fever, also known as “break bone fever” , is a mosquito-borne infection that causes a severe flu-like illness. There are four different viruses that can cause dengue fever, all of which spread by a certain type of mosquito. *Dengue fever can vary from mild to severe; the more severe forms include dengue shock syndrome and dengue hemorrhagic fever (DHF). Epidemiology *Dengue is one of the most important emerging viral disease of humans in the world afflicting humanity in terms of morbidity and mortality. * Currently the disease is endemic in all continents except Europe. *The Epidemiology of dengue is a complex phenomenon that mainly depends upon an intricate relationship between the 3 epidemiological factors: the host (man and mosquito), the agent (virus) and the environment. *The complexity of relationship among these factors eventually determines the level of epidemology and endemicity in an area.
  54. 54. 54 Transmission : *The female Ae. aegypti mosquito usually becomes infected with dengue virus when it takes blood meal from a person during the acute febrile (viraemia) phase of dengue illness. *After an extrinsic incubation period of 8 to 10 days, the mosquito becomes infected and virus is transmitted when the infective mosquito bites and injects the saliva into the wound of the person. *There is evidence that vertical transmission of dengue virusfrom infected female mosquitoes to the next generation occurs through eggs, which is known as trans ovarian transmission. Causitive factor : *The dengue viruses are the members of the genus flavivirus. *These small (50nm) viruses contain single stranded RNA. There are four virus serotypes, which are designated as DEN-1, DEN-2, DEN-3 and DEN-4. *At present DEN1 and DEN2 serotypes are widespread in India.
  55. 55. 55 Clinical features : *Dengue fever usually stats suddenly with a rapidly climbing high fever termed as “Saddle back” type temperature. ( saddle back temperature curve – a febrile curve, where 3-5days of high temperature are followed by 3-5days of low temperature , occurring in up to 8 waves before resolution) *Retro-orbital pain ,Nausea, vomiting and loss of appetite. * Rashes develop on the feet or legs 3 to 4 days after the beginning of the fever. *Swelling and pain in muscles and joints, the joint pain in the body has given dengue fever the name that is “break bone fever”. *Thrombocytopenia (Low platelet count 100,000/mm3 or less) *Haemorrhagic manifestations like petechiae, purpura, ecchymoses,gingival bleeding,nasal bleeding,hematemesis, melena, hematuria,increased menstrual flow. *Evidence of circulatory failure manifested indirectly by all of the following: * Rapid and weak pulse * Hypotension * Cold, clammy skin and altered mental status *Frank shock is direct evidence of circulatory failure.
  56. 56. 56 Investigations : *Following tests are available for the diagnosis of dengue infection *Haemagglutination-Inhibition (HI), *Complement Fixation (CF), *Neutralization test (NT), *IgMcapture enzyme-linked immunosorbent assay (MAC-ELISA), and *Indirect IgG,ELISA. Treatment : *Bed rest is advisable during the acute phase. *Use cold sponging to keep temperature below 39oC. *Antipyretics. *Aspirin/NSAID like Ibuprofen etc should be avoided since it may cause gastritis, vomiting, acidosis and platelet dysfunction. * Oral fluid and electrolyte therapy are recommended for patientswith excessive *sweating or vomiting. Patients should be monitored in DHF endemic area until they become afebrile for one day without the use of antipyretics and after platelet and haematocrit determinations are stable. *Intravascular volume expanders (Dextran 40, plasmanate, platelet concentrates, *fresh frozen plasma, whole blood) * 7.5%sodiumbicarbonate for injection Chloral hydrate
  57. 57. 57 AYURVEDICAPPROACH TO DENGUE: *Vikruti vishama sannipataja jwara *Abhishangaja Jvara (Agantuja jwara) *Dandaka jwara/asthi sandhi gata jwara *Pittaja jwara *Rakta pitta – in haemorrhagic conditions
  58. 58. 58 *Vikruti vishama sannipataja jwara
  59. 59. 59 Abhishangaja Jwara (Agantuja jwara) || cha.chi 3/114|| A type of agatuja jwara caused due to the influence of psychological factors , toxins and evil spirits (bhuta )
  60. 60. 60 Dandaka Jwara : अस्स्थ सस्न्द्िरुजास्तीव्र दण्डाहततक्रु ता इवा । क्वच त् क्षिक्प्रोदयलयो पवसिविः सववगात्रगिः॥ ज्वरश् कण्ठरुग्युक्तिः िुनरावतवते गतिः । सन्द् ाररणा सांिोथेन सस्न्द्ििूलेन लक्षितिः॥ प्रततश्या कासवान् प्रायेणाटाडेन प्रमुर्चयते। च रां सस्न्द्िरुजािः सस्न्द्त स दण्डकज्वरिः॥ Si.Ni.pu.kh ॥
  61. 61. 61 Samprapti Ghataka : *Dosha :tridoshaja *Dooshya : Rasa, *Agni : Jataragni, dhatwagni *Ama : tat janya *Srotas :Rasavaha, asthivaha *Srotodusti prakara : Sanga & vimarga gamana *Udbhava sthana : amashaya *Sanchara sthana : rasayani *Adhishtana : amashaya *Vyakta sthana : sarva shareera *Sadhya asadhyata :krichra sadhya
  62. 62. 62 Ayurvedic management as per CCRAS: For Fever : *In initial phase, Kwatha prepared of Dhamasa, Parpat, Kiratatikta, Musta may be advised. *In case of Raktaja Jvara (Hemorrhagic condition), add Vasa, Rakta Chandana & Yashtimadhu along with sugar candy (Mishri). *Shamshamani Vati (Guduchi Ghana Vati) *Sudarshanaghana Vati *Godanti Bhasma *Amritottara Kwath *Tulsi Svarasa For Dehydration *Shadanga Paneeya *Dhanyakadi Hima (Dhaniya, Amla, Vasa, Draksha, Parpat) *Water of cardamom and clove *tender coconut water
  63. 63. 63 *Management as per AYUSH : *Although there is no specific treatment for disease, Ayurveda stresses to strengthen immune system of the body and keeping a control on hyperthermia. *Amrita (Guduchi)Tulasi(Holi basil) Shunthi(Dried ginger) *Papaya are the commonly available medicinal plants and used to prevent its complications by potentiating immune system so that disease gets controlled within a period of 4to 8 days. *Chyavanprash can be taken as an immune booster. * Amrithotharam kashayam,Amritha satva(Sat giloy) are some of the good herbal medicines advised in Dengue fever. *Water Boiled with tulasi is advised to consume throughout the day to build up immune system. * Pomegranate /black grape juice helps to increase blood count.
  64. 64. 64 *Priciples for treatment : Amapachana Pitta Rakta shamana Ojovardana
  65. 65. 65 Formulations beneficial in Dengue : Kashayas : *Guduchyadi kashaya *Drakshadi kwatha *Vasa guduchyadi kwatha Asava /Arishta: *Amritarshta *Sudarshanasava Choorna : *Talisapatradi choorna
  66. 66. 66 For prevention of haemorrhagic symptoms : *Drakshadi kwatha *Patolakaturohinyadi kashaya *Sarivadi kashaya *Vaasaguluchyadi kashaya *Chandrakala rasa *Vasa swarasa 30ml with madhu BD *Durva swarasa 15ml BD In recovery stage : *Vasarishta *Indukantha Ghirta *Vidaryadi Ghrita *Mahatikta Ghrita *Brahma rasayana
  67. 67. 67 In recent times, papaya leaves are very effective and useful in management of dengue fever especially in increasing platelet count in dengue patients with low platelet count and those who develop haemorrhagic dengue fever. Details of Papaya ( Erandakarkati): *Botanical name - Carica papaya *Family- Caricaceae *Rasa- katu, tikta *Guna- laghu, ruksha,tikshan *Virya- ushan *Vipaka- katu *Karma- kapha- vata shamaka, pachana *Useful part - leaves, fruit, seeds
  68. 68. 68 *Chemical constituents- Papaya contains a chemical called papain, which is commonly used as a meat tenderizer. Papain breaks down proteins, carbohydrates, and fats. That’s why it works as a meat tenderizer. *Dose- Seed powder= 0.5 gram. Leaves water decoction= 40-80 ml. *Uses- Papaya is used for preventing and treating gastrointestinal tract disorders, intestinal parasite infections, and as a sedative and diuretic. Action- *Papaya leaves and seeds are inhibiting haemolysis. *Papaya leaves also contain important nutrients, including vitamin A, C and E, they support the immune system
  69. 69. 69 Caripill : *It is the drug to treat the patient with dengue fever in view of platelet production. *The drug Caripill launched by micro labs, Bengaluru and the clearance was received from department of Ayush. *The Pharmacology of Caripill includes, it possesses membrane stabilizing properties and protect blood cells against stress-induced destruction. * Carica papaya rich in papain, which induces IL -6 secretions. * An increased level of IL – 6 in stem cells and leukocytes leads to the production of thrombopoietin in the liver which is major cytokine involved in megakaryopoiesis and thrombopoiesis and finally results in increased levels production of thrombocytes.
  70. 70. 70
  71. 71. 71 HIV / AIDS : *AIDS is defined as an illness characterised by one or more indicator diseases. *In the absence of another cause of immune deficiency and without laboratory evidence of HIV infection (if the patient has not been tested or the results are inconclusive), certain diseases when definitely diagnosed indicate AIDS. *Regardless of the presence of other causes of immune deficiency, if there is laboratory evidence of HIV infection, other indicator diseases that require a definitive, or in some cases only a presumptive, diagnosis also constitute a diagnosis of AIDS.
  72. 72. 72 *HIV stands for Human Immuno deficiency Virus. *HIV attacks the bodies immune system specifically the CD 4 cells [T cells], which helps the immune system fight off infections. *If left untreated , HIV reduces the no. of CD4 cells in the body, making the person more likely to get infections or infections related Cancers. *Theses opportunistic infections or cancers take advantage of very weak immune system and signal that the person has AIDS, the last stage of HIV infections. AIDS : Acquired Immuno Deficiency Syndrome . *AIDS is the final stage of HIV infection and not everyone who has HIV advances to this stage.
  73. 73. 73 Epidemiology – *HIV infection / AIDS is a global pandemic, with cases reported from virtually every country. *The estimated no. of people living with HIV i.e. the global prevalence has increased more than 4 fold since 1990. *Reflecting the combined effects of continued high rates of new HIV infection and the life prolonging impact of anti retro viral therapy. Transmission – HIV is primarily transmitted by *Sexual contact *Blood and blood products *Infected mothers to infants – intra partum, perinatally or via breast milk
  74. 74. 74 SIGNS AND SYMPTOMS : *Soon after the infection with HIV, some people have flu like symptoms, such as fever, headache and rashes. *After this earliest stage of HIV infection more severe symptoms such as chronic diarrhoea, rapid weight loss and signs of opportunistic infections. *Without treatment HIV can advance to AIDS. *During last stage of HIV infection, the risk of developing life threatening illness such as Esophagitis, Pneumonia, Meningitis, Encephalitis etc. is high. *Investigations : *ELISA *CD4/T cells count *CD4 percentage *Viral Load *Complete Blood Count
  75. 75. 75 *Treatment : Combination of *Anti Retroviral Therapy(ART) and *Highly Active Anti Retroviral Therapy (HAART) Is most effective treatment ,it reduces both the mortality and the morbidity of HIV infection, but is expensive and inaccessible in many countries.
  76. 76. 76 Ayurvedic approach to HIV/ AIDS : Clinical picture of AIDS, described in Ayurveda is found scattered in all authentic texts. *Immunity has been explained under the concept of Ojus. *Ojus is the vital substance of all dhatus and determines the capacity of the individual to combat the disease (Vyadhibala virodhitvam) and the power to the resist the virulence of disease (Vyadhi utpadaka pratibandhakatvam) causing factors in future. * Stages of AIDS resemble features of : ojo kshaya ,hatoujas, shosha, madhumeha, asadhya Pandu, rajayakshma and udanavrata prana vata in Ayurveda. *The virus invades the Rasadi sapta dhatus and causes decrement in their quality and quantity.
  77. 77. 77 Ayurvedic Management : Principles for treatment : * HIV infection affects multi systems, chiefly the ojus (Immune System). *Rasayana Chikitsa is the frontline therapy employed to treat Ojus. *Rasayana dravyas act on Agni, Dhatu and Srotas level and help in formation of prashasta dhatus maintaining a perfect equilibrium of all the doshas and dhatus. Therefore drugs with immuno-modulator and anti oxidant properties such as : * Shilajatu (Mineral pitch), *Centella asiatica (Mandukaparni), *Tinospora cordifolia (Guduchi) * Emblica officinalis (Amalaki) should be adopted.
  78. 78. 78
  79. 79. 79 Resistant Tuberculosis : *Tuberculosis (TB) is a disease caused by bacteria that are spread from person to person through the air. *TB usually affects the lungs, but it can also affect other parts of the body, such as the brain, the kidneys, or the spine. * In most cases, TB is treatable and curable; however, people with TB can die if they do not get proper treatment. *Sometimes drug-resistant TB occurs when bacteria become resistant to the drugs used to treat TB. This means that the drug can no longer kill the TB bacteria. *The TB bacteria are put into the air when a person with TB disease of the lungs or throat coughs, sneezes, speaks, or sings. People nearby may breathe in these bacteria and become infected.
  80. 80. 80 Causes : *Drug-resistant TB can occur when the drugs used to treat TB are misused or mismanaged. Examples of misuse or mismanagement include *People do not complete a full course of TB treatment *Health care providers prescribe the wrong treatment (the wrong dose or length of time) *Drugs for proper treatment are not available *Drugs are of poor quality
  81. 81. 81 Types : *Multidrug-Resistant TB (MDR TB) : TB bacteria that is resistant to at least isoniazid and rifampin, the two most potent TB drugs. *Extensively Drug-resistant TB (XDR TB) : a rare type of MDR TB that is resistant to isoniazid and rifampin, plus any fluoroquinolone and at least one of three injectable second-line drugs (i.e., amikacin, kanamycin, or capreomycin). XDR TB is resistant to the most potent TB drugs, patients are left with treatment options that are much less effective. XDR TB is of special concern for people with HIV infection or other conditions that can weaken the immune system. These people are more likely to develop TB disease once they are infected, and also have a higher risk of death once they develop TB.
  82. 82. 82 Treatment : Treating and curing drug-resistant TB is complicated. Inappropriate management can have life-threatening results. Drug-resistant TB should be managed by or in close consultation with an expert in the disease. *Fluoroquinolone antibacterial drugs administration is the main lineof treatment for resistant tuberculosis. However, safety announcement Regarding Fluoroquinolone Antibacterial Drugs use for certain uncomplicated infections because of adverse effects from these medications like sinusitis, bronchitis, and uncomplicated urinary tract infections are commonly seen.
  83. 83. 83 Ayurvedic approach to Resistant Tuberculosis: *The role of Ayurvedic medicines in the treatment of resistant tuberculosis is many- fold. *These medicines act directly on the tuberculosis bacilli and render them inactive. *These medicines also improve both the local as well as general immunity of the body, so that the weakened response of the body to the bacterial onslaught is strengthened, and the inflammatory response is inhibited or prevented altogether. *Ayurvedic medicines also help the body to repair the damage done by the tuberculosis infection. * The toxic effects of modern medicines on the liver, kidneys and other organs can be prevented or minimised, and the organs can be helped to repair themselves. *Ayurvedic medicines also help to revitalise the body and improve weight. *Ayurvedic treatment, given for about six months, can thus help to give a new lease of life to people affected with MDR and XDR tuberculosis.
  84. 84. 84 In addition, Ayurvedic medicines can also raise the immune status in such patients so that the body is in a better position to fight and control the infection. *Medicines like Tulsi, Guggulu, Haridra, Daru-Haridra, Amalaki, Pippali, Kantakari, Bruhat-Kantakari, Pushkarmool, Kushtha, Yashtimadhu, Arjuna, Abhrak-Bhasma, Shrung-Bhasma, Ras-Sindur, Malla-Sindur, Sameer-Pannag-Ras, Laghu-Malini-Vasant, Madhu- Malini-Vasant, Suvarna-Malini-Vasant and Heerak-Bhasma could be used to treat and control that tuberculosis infection. *Medicines such as Arogya-Vardhini, Sutshekhar-Ras, Suvarna- Sutshekhar-Ras, Vishwa, Laghu-Sutshekhar-Ras, Praval-Panchamrut- Ras, Punarnavadi-Qadha, Shankh-Vati, Kutki, Kalmegha, Punarnava , Deodar ,Amalaki, Chirayta, Sharpunkha and Tamra-Bhasma could be used to reduce or prevent medication toxicity arising from the utilization of modern medicines.
  85. 85. 85
  86. 86. 86 H1N1 / Swine flu : *Swine flu is a highly contagious respiratory disease in pigs caused by one of several swine influenza A viruses. * Transmission of swine influenza viruses to humans is uncommon. *However, the swine influenza virus can be transmitted to humans via contact with infected pigs or environments contaminated with swine influenza viruses. Epidemology : *In late March and early April 2009, an outbreak of H1N1 influenza A virus infection was detected in Mexico, with subsequent cases observed in many other countries including the United States. *In June 2009, the World Health Organization (WHO) raised its pandemic alert level to the highest level, phase 6, indicating widespread community transmission on at least two continents. *In 2009 outbreak of swine flu took place in various parts of India. *Government of India started screening people coming from the affected countries at airports for swine flu symptoms. * The first case of the flu in India was found on the Hyderabad airport on 13 May, when a man traveling from US to India was found H1N1 positive. * Subsequently, more confirmed cases were reported and as the rate of transmission of the flu increased in the beginning of August, with the first death due to swine flu in India in Pune.
  87. 87. 87 Transmission : *Swine influenza (novel H1N1 and H3N2v) spreads from person to person, either by inhaling the virus or by touching surfaces contaminated with the virus, then touching the mouth or nose. *Infected droplets are expelled into the air through coughing or sneezing. Symptoms : *Manifestations of H1N1 influenza are similar to those of seasonal influenza. *Patients present with symptoms of acute respiratory illness, fever, cough,sore throat, body aches,headache,chills,fatigue, diarrhoea and vomiting.
  88. 88. 88 Investigation : *Nose or throat swab. To test for swine flu a nose or throat swab is taken. Within 15 minutes the laboratory may tell if influenza type A or B is present. The specimen of the infected material from the patient's throat or nose is collected within the first 4 to 5 days of illness. *RT-PCR targeting hemagglutinin and neuraminidase genes Treatment : *Treatment is largely supportive and consists of bedrest, increased fluid consumption, cough suppressants, and antipyretics and analgesics (eg, acetaminophen, nonsteroidal anti-inflammatory drugs) for fever and myalgias. *Severe cases may require intravenous hydration and other supportive measures. Antiviral agents may also be considered for treatment or prophylaxis.
  89. 89. 89 *Ayurvedicapproach to Swineflu: In general various types of flu prevailing in present days can be understood as : 1.Vata kaphaja jwara 2.Shleshmaka jwara 3.Abhinyasaja jwara
  90. 90. 90 Vata Kaphaja Jwara: The predominance of Vata and Kapha Dosha at the end of winter and beginning of summer i.e. the Rutu sandhi kaal (transit season) lowers down the immune system of the body and makes the conditions favourable for the spread of the disease.
  91. 91. 91 *Shleshmaka jwara : The jwara which results due to janapadodhwamsa , which is quick in spreading and life threatening in nature is explained under shleshmaka jwara. *प्रादुिःर्स्न्द्तह यत् प्रायिः श्लेष्मजोिरवा भॄिम्। क्वच त् जनिदोद् ध्वांशस श्लेष्मकिः स्मृतिः॥ Si.Ni.pu.kh ॥ Lakhanas : प्रततश्यायिः शिरिःिूलां िीतकमिॊ कु त्रच त् । अङ्गमदिः कटटिृष्टोरसाां तीव्राश् वेदनािः॥ कासो ज्वरो अवसदश् काश्यं अल्िाटदनै भ्रुिम्। अत्यथव बलहातनश् शलङ्गातन श्लेष्मक ज्वरे ॥ Si.Ni.pu.kh ॥ Thus on the whole, fever resulted due to epedimic outbreak and influenza conditions can be correlated to shleshamaka jwara.
  92. 92. 92 *Abhinyasa jwara :
  93. 93. 93 *Priciples for treatment : Agnideepana Kapha vata shamana Shwasa, kapha shamana Balavardhana
  94. 94. 94
  95. 95. 95 Formulations beneficial in Swine flu : Kashayas : *Vyaghryadi kwatha with shunthi + pippali *Dashamoola katutrayadi kashaya *Pathya kustumbaradi kashaya Vatis : *Vettumaran gulika *Tribhuvana keerti rasa *Lakshmi vilasa rasa *Shwasananda gulika *Vilvadi gulika
  96. 96. 96 Churnas : *Talisadi churna *Seetophaladi churna Asava Arishtas: *Amritarishta *Vasarishta *Kanakasava Lehyas : *Dasahamula rasayna *vi;lvadi lehya *Vyaghradi lehya Dhupana : *Aparajita *Haridra+vacha+nimba twak
  97. 97. 97
  98. 98. 98 Chicken flu : *Chicken flu / Bird flu, also called avian influenza, is a viral infection that can also infect humans and other animals. *It's deadly to most birds and also to humans and to other mammals that catch the virus from birds. * Since the first human case in 1997, H5N1 has killed nearly 60% of the people who have been infected. * Currently, the virus isn't known to spread via human-to-human contact
  99. 99. 99 Transmission : *H5N1 is a highly pathogenic virus that results in producing avian influenza . *But unlike human flu , H5N1 bird flu does not spread easily from person to person. * The very few cases of human-to-human transmission have been among people with exceptionally close contact, such as a mother who caught the virus while caring for her sick infant. *Migrating water fowl, most notably wild ducks , are the natural carriers of bird flu viruses. *It's suspected that infection can spread from wild fowl to domestic poultry.
  100. 100. 100 Symptoms : *Bird flu symptoms in people can vary. Symptoms may start out as normal flu- like symptoms. *This can worsen to become a severe respiratory disease that can be fatal. Treatment : *Because of the small number of human cases, it has not been possible to conduct rigorous medical or medication treatment trials for bird flu. *World Health Organization (WHO) currently recommend antiviral drugs used in oseltamivir (Tamiflu) and zanamivir (Relenza) for the treatment and prevention of avian influenza A viruses along with supportive care. *In severe illnes hospitalization, isolation, and intensive care is suggested.
  101. 101. 101 Ayurvedic approachto Birdflu /Chicken flu: *As previously explained under swine flu , bird flu can also be understood in terms of shleshmaka jwara and the same treatment can be adopted here .
  102. 102. 102 2.NON-COMMUNICABLE DISEASE INTRODUCTION: * Communicable diseases were the main causes of death around the world. *Life expectancy was often limited by uncontrolled epidemics. After the second World War, with medical research achievements in terms of vaccination, antibiotics and improvement of life conditions, non communicable diseases(NCDs) started causing major problems in industrialized countries. *A non-communicable disease (NCD) is a medical condition or disease that is not caused by infectious agents (non-infectious or non- transmissible). *NCDs can refer to chronic diseases which last for long periods of time and progress slowly.
  103. 103. 103 *Industrialization, socio-economic development, urbanization, changing age structure, changing lifestyles has placed India at a position where it is facing a growing burden of non-communicable diseases. *In India, there is no regular system for collecting data on NCDs which can be said to be of adequate coverage or quality. Thus, most of these estimates at best may be taken as approximation only. *By 2020, it is predicted that NCDs will account for 80 percent of the global burden of disease, causing seven out of every 10 deaths in developing countries, compared with less than half today The four main types of NCDs are : *Cardiovascular diseases *Cancer, *Chronic respiratory diseases (COPD, asthma) and *Life Style Disorders – Obesity, Diabetes, .
  104. 104. 104 Cardiovascular diseases(CVD) : *It is the name for the group of disorders of the heart and blood vessels and include hypertension, coronary heart disease, cerebrovascular disease, peripheral vascular disease, heart failure, rheumatic heart disease, congenital heart disease and cardiomyopathies. * CVDs are promoted by risk factors like tobacco use, alcohol, physical inactivity and unhealthy diet. *Unfortunately, the harm caused by these risk factors affects the rise of life expectancy in developing countries *The costly and prolonged care of CVDs in low-and middle-income countries often divert the scarce family and societal resources to medical care. *Consequently, the lower socio-economic groups have greater prevalence of risk factors, higher incidence of disease and higher mortality.
  105. 105. 105 CANCER : *Cancer is now a major cause of mortality throughout the world. In the developed world, it is generally exceeded only by CVDs but developing countries are responsible for the globally increasing trend. *The incidence of cancers of the lung, colon and rectum, breast and prostate generally increases in parallel with economic development, while the incidence of stomach cancer usually declines with development. The contribution of developing countries was 53% for incidence and 56% for deaths . *From 1990 to 2000, the incidence and deaths increased by 2.4% per annum. *Between 2000 and 2020, the total number of cases of cancer in the developed world is predicted to increase by 29% whereas, in developing countries an increase by 73% is expected (largely as a result of an increase in the number of old people and as a result of urbanization and change in dietary habits).
  106. 106. 106 The incidence of cancers of the lung, colon and rectum, breast and prostate generally increases in parallel with economic development, while the incidence of stomach cancer usually declines with development. Lung cancer *This is currently the most common cancer in the world. In developed countries, smoking causes over 80% of such cancers and generally, heavy smoking increases the risk by around 30-fold making lung cancer a major problem in developing countries where the consumption of tobacco is flourishing. Breast cancer *According to the International Agency for Research on Cancer (IARC), there were over a million new cases in the world in the year 2000, making it the second most common in the world and the most common among women with 47% in developing countries.
  107. 107. 107 *Although rates are five times higher in industrialized countries, the burden of disease is heavier in poorer countries because breast cancer is highly curable if detected early and, unfortunately, about 80% of the cases are detected at advanced stages in developing countries. Colorectal cancer *Ranking at the third place, with incidence rates tenfold higher in developed than in developing countries, this type of cancer is assumed to be mainly related to dietary factors which account to up to 80% of the between-country differences in rates. Stomach cancer *20 years ago, this cancer used to be the most common in the world. At the moment, it is the fourth most common in the world but the second most common in developing countries. Substantial evidence suggests that risk is increased by high intakes of some traditionally preserved salted food and that risk is decreased by high intakes of fruit and vegetables.
  108. 108. 108 Liver cancer *Approximately 75% of cases occur in developed countries, the rate vary over 20fold between countries. In developing countries, ingestion of contaminated food is an important risk factor together with active hepatitis virus infection whereas, alcohol consumption is the main diet-related risk factor in the world. Cervical cancer *80% of the new cases and deaths are occurring in developing countries where it constitutes a major health problem. In developed countries, screening programmes and early detection have led to a noticeable decline in cervical cancer incidence and mortality, whereas, the trend is stable or increasing in low- and middle-income countries owing to their limited health care resources but also to ill-health systems generating inefficient
  109. 109. 109 Chronicrespiratory diseases *Chronic respiratory diseases represent a major burden for the health systems worldwide. *Most developing countries have no standard protocols for assessing and managing chronic non communicable respiratory diseases such as Chronic Obstructive Pulmonary Disease (COPD) and Asthma. * In these countries, the population afflicted by poverty and illiteracy, having very little (or no) access to health services, will die before the age of 40 years. *They comprise 15% of the population in Latin America, 34% in Arab world, 45% in Sub-Saharan Africa and south-east Asia. *Respiratory diseases cause 15% of the global burden of disease. Worldwide, it is estimated that 600 million people suffer from COPD and 2.5 million deaths were attributed to these diseases in 2000. * By 2020, COPD is expected to become the third most common cause of mortality in the world.
  110. 110. 110 Lifestyle Disorders : Lifestyle diseases are defined linked with the way people live their life. This is commonly caused by alcohol, drug, smoking abuse as well as lack of physical activity and unhealthy eating. It mainly includes, 1.Obesity : *Overweight and Obesity lead to adverse metabolic changes such as insulin resistance, increasing blood pressure and cholesterol. *Overweight is more prevalent among female, urban and high socioeconomic status (SES) groups (28). *The prevalence of overweight and obesity had increased slightly over the past decade in India, but in some urban and high-SES groups it reached a relatively high level. *A large multiple-site survey conducted in 10 industries in urban areas reported a high combined prevalence (BMI ≥25) of 30.9% . Another survey conducted in six major cities (Chennai, Bangalore, Hyderabad, Calcutta, Mumbai and New Delhi) showed that the combined prevalence of overweight and obesity was 30.8% and that of central obesity (waist– hip ratio ≥0.90 in men and ≥0.85 in women) was 50.3%. *Consequently, they promote CVDs, diabetes and many types of cancer. Worldwide, overweight affects 1.2 billion of which 300 million are clinically obese. *In some developed countries like USA, the prevalence reaches 60% but developing countries like Kuwait have also a very high prevalence. *More and more children are suffering from overweight and obesity. However, the most contrasting phenomenon is to find Overweight/Obesity and malnutrition side by side in low- and middle-income countries and hence contributing to the growing burden afflicting these countries.
  111. 111. 111 2.DiabetesMellitus : *India is currently experiencing an epidemic of Type 2 diabetes mellitus (T2DM) and has the largest number of diabetic patients. *It is often referred to as the diabetes capital of the world . *International Diabetes Federation (IDF) 2009 report reveals that the total number of diabetic subjects in India is 50.8 million. *In a study conducted as a part of the NCD risk factor surveillance, in different geographical locations in India, where major risk factors were studied using modified WHO STEPS approach and diabetes was diagnosed based on self-reported diabetes diagnosed by a physician. *The Prevalence of Diabetes in India Study (PODIS) was carried out in 2004, in 108 centres (49 urban and 59 rural) in different parts of India to look at the urban-rural differences in type 2 diabetes and glucose intolerance .
  112. 112. 112 *The prevalence of diabetes in the rural areas according to WHO criteria and American Diabetes Association (ADA) criteria was 2.7% and 1.9% respectively. *Compared to that, the prevalence have enormously increased in the present scenario with studies from rural Kerala and Andhra Pradesh, reporting a prevalence as high as 12.5 % and 13.2% respectively.
  113. 113. 113 AYURVEDA AND NCDs : *In its own terms, expertly practiced Ayurveda can definitely yield reliable, efficacious results whenapplied to all manner of chronic diseases. *Ayurveda begins with properties of the whole organism,starting from the whole system, and moving to smaller and smaller subsystems. * Its etiological theory must be robust. This theory is based on the concept of : ‘Tridosha’ their roles in system, Shad kriya kala - the six stages of dosha imbalance. *This is the winning point of Ayurvedic theory, allowing it to tackle chronic illness - a‘Trojan Horse’ transporting the guardians of health into the camp of disease.
  114. 114. 114 *The reason why biomedicine cannot treat chronic disease as effectively as Ayurveda lies in its apparent lack of any knowledge structures equivalent to Ayurveda‘s Tridosha and Shad kriya kala. *Ayurvedic diagnostics and approaches to treatment is concerned with the whole system, not parts in isolation. *Ayurveda never loses sight of the whole that is the whole structure of Ayurveda like dosha theory, the theory of tridosha should then be extended to include other Ayurveda fundamental concepts the 5 mahabhutas, 7 dhatus and 13 agnis *Thus the possible Ayurveda method of preventing NCDs : *Ayurveda describes about the cocepts such as pathya -apathya, dinacharya, rituchaya, sadvritta, timely shodhana , rasayana and vajikarana should be adopted
  115. 115. 115 Prevention of NCDs Purification of mind Yogic practise Physical Exercise deaddiction Destressing Satvavajay a Shareera shodhana Pure Vegetarian diet Rasayana chikitsa
  116. 116. 116 3.Other health Challenges: Sick building syndrome :
  117. 117. 117 Sickbuilding syndrome : *The sick building syndrome (SBS) is used to describe a situation in which the occupants of a building experience acute health- or comfort-related effects that seem tobe linked directly to the time spent in the building. *No specific illness or cause can be identified. *The complaints may be localized in a particular room or zone or may be widespread throughout the building. *The sick building syndrome comprises of various nonspecific symptoms that occur in the occupants of a building.
  118. 118. 118 ETIOLOGY : *Chemical contaminants : from both outdoor as well as indoor sources. * Biological contaminants : pollen, bacteria, viruses, fungus, molds, etc. * Inadequate ventilation *Electromagnetic radiation : Gadgets like microwaves, televisions and computers emit electromagnetic radiation, which ionizes the air. Extensive wiring without proper grounding. * Psychological factors: Excessive work stress or dissatisfaction, poor interpersonal relationships and poor communication are often seen to be associated with SBS. *Poor and inappropriate lighting with absence of sunlight, bad acoustics, poor ergonomics and humidity may also contribute to SBS.
  119. 119. 119 *CLASSIFICATION : *The health conditions associated with buildings are commonly classified as: *SBS or Tight building syndrome. *Building-related disease, when the symptoms of diagnosable illness are identified and attributed directly to airborne building contaminants. *Building-associated symptoms. *Signs and symptoms : *Headache, dizziness, nausea, eye, nose or throat irritation, dry cough, dry or itching skin, difficulty in concentration, fatigue, sensitivity to odours, hoarseness of voice, allergies, cold, flu-like symptoms, increased incidence of asthma attacks and personality changes.
  120. 120. 120 INVESTIGATIONS : *Evaluating the Indor Air Quality(IAQ) and identifying the contaminant by air sampling. *Establishing a cause and effect relationship between symptoms and IAQ. *Identifying the cause of the complaints so that appropriate corrective measures can be initiated. *Conducting a ‘walk-through’ inspection of the problems areas and collecting information on the following: *the Occupants, *Heating, ventilation and Air Conditioning (HVAC) Systems for pollution pathways *Possible contamination sources.
  121. 121. 121 Treatment of Sick Building Syndrome : *It is first important to make sure that there are no hazards in the building like mould or bacteria. * If there is no identifiable cause for the occupants' symptoms and signs and there is a suspicion of sick building syndrome, the first step is to make sure the air handling system is clean and functioning well. *Air filters may need to have more frequent replacement. *The HVAC system may need to have the ventilation rates increased. If there are any chemicals being stored, they must be stored in appropriately ventilated areas. *If chemicals are being used to clean, there must be good ventilation. It may be important to institute smoking restrictions.
  122. 122. 122 PREVENTION AND CONTROL : *Increasing the ventilation rates and air distribution. *The heating, ventilation and air-conditioning systems should be designed to meet ventilation standards in the local building codes. *Removal or modification of the pollutant source can be carried out by a routine maintenance of HVAC systems, replacing water-stained ceiling tiles and carpets, using stone, ceramic or hardwood flooring, proper water proofing etc. *Air cleaning can be a useful addition to control air pollution. *Education and communication are important parts of any air quality management programme so as to work more effectively and efficiently to prevent and solve the health problems. * Banning of smoking in the workplace or restricting smoking to designated well-ventilated areas away from the work stations and creating no-smoking zones with the help of laws. In some European countries, workers have a statutory right to be involved with the employer's plans for changes in the work place.
  123. 123. 123 Ayurvedic approach to SBS : *Sthapatya Veda,one of the approaches of Vedic medicine, goes deeply into the health effects of the orientation, design, proportion, and positioning of buildings. *Sthapatya Veda, is the knowledge that establishes everything in the most orderly way so that everything is completely nourished by everything else. *The word sthapana means to establish, and Veda means knowledge, Sthapatya Veda is the knowledge of how to establish life in full accord with Natural Law. *The purpose of sthapatya veda/vastu vidya is to maintain individual life in harmony with Cosmic Life, individual intelligence in tune with cosmic intelligence. *This is accomplished by using principles of architecture whereby the structuring dynamics of the building favourably influence the behavioral dynamics of the occupants.
  124. 124. 124 * It explains how to build: structures that are in harmony with the laws of Nature and the land structures that can actually improve health and happiness in those who occupy them. It is explained that people who work and live in offices or houses built under the guidelines of Sthapatya Veda, architecture will have a clear thinking ability, creative, healthier and happier, have more energy, are less stressed, and have more peace of mind.
  125. 125. 125 *In the recent research in modern science has now confirmed the ancient understanding that our brain is sensitive to orientation, position and direction in space. *The firing patterns of neurons in the thalamus of the brain are altered by the direction one is facing. When one is facing East, the brain physiology functions differently than facing North, South, or West. *The conclusion is that the power of thoughts and the quality of thoughts is influenced by the direction one is facing. *One’s sense of direction gets confused in daily life when one lives in a building with wrong orientation, resulting in potential physiological, psychological and behavioural imbalances and strain.
  126. 126. 126 *The benefits of following Vaastu are given in the opening verse of Vaastu Sastra written by great sage Viswakarma which covers all the beneficial aspects of Vaastu. *'sastrenanena sarvasya' (This science is complete in itself) *'lokasya paramam sukham' (It can bring happiness to the whole world) *'chaturvarga phala prapti' (It bestows on you all four types of benefits namely rightful living- money-fulfillment of desires and bliss) *'salokascha bhaved dhruvam' (Are all available in this world itself)
  127. 127. 127 Trividha Chikitsa : *Daiva-vyapashraya Chikitsa means the treatment based on believing on divine power, divine remedies. This includes mantra, aushadha,mani, mangala, homa etc. *Yukti-vyapashraya chikitsa – treatment in which the medicines, lifestyle, and diet are skilfully planned and administered. *Satvavajaya – to gain control over the mind of the patient and helping them to keep their mind and senses detached from the unwholesome subjects (including stress, anxiety etc). This can be correlated to the modern day psychiatry or mind medicine. This also includes patient counselling.
  128. 128. 128
  129. 129. 129 Restless leg syndrome : *It is a neurological disorder characterised by unpleasant sensations in the legs and an uncontrollable urge to move when at rest in an effort to relieve these feelings. * The most distinctive or unusal aspect of the condition is that lying down and trying to relax, activates the symptoms. *As a result , most of the people with RLS have difficulty in falling asleep and staying asleep. *More than 80% of people with RLS also experience a more common condition known as Periodic Limb Movement Disorder(PLMD). Etiology : *In most cases , the cause of RLS is idiopathic. *50% of the cases have a genetic background.
  130. 130. 130 Symptoms : *Patients with RLS feel uncomfortable sensations in their legs, especially when sitting or lying down , accompanied by an irresistible urge to move about. * These sensations usually occur deep inside the leg , between the knee and ankle. *Most of the patients find the symptoms to be less noticeable duing the day and more pronounced in the evening or at night, especially during the onset of sleep. *The symptoms of RLS vary in severity and duration from person to person. Investigations : *Complete blood count *Serum Ferritin *EMG *Nerve conduction studies Treatment : *Treating the under lying systemic cause.
  131. 131. 131 Ayurvedic apporach : It can be considered as vata vyadhi , in which laghutva and chalatva of vata arrggravates resulting in the movement of legs in this disease. Principles of treatment : *Kevala vata chikitsa *Khalli chikitsa *Ushna veerya dravya prayoga *Guru, sthira guna oushadha prayoga.
  132. 132. 132 Formulations beneficial in RLS : *Kashayas: *Dhanvantaram kashaya *Vidaryadi kashaya *Sahacharadi kashaya *Prasaranyadi kashaya *Churna : *Ashwagandha churna *Kapikacchu churna *Bala churna *Vati : *Manasamitra vati *Ekangavira rasa
  133. 133. 133 Arishta : *Balarishta *Saraswatharishta *Ashwagandharishta Ghrita : *Pachagavya ghrita *Brahmi ghrita Rasayana : *Narasimha rasayana *Brahma rasayana *Virechana karma *Mustadi raja yapana basti
  134. 134. 134 External therapies : *Talam with kacchuradi churna and ksheerabala taila *Abhyanga with prasarinyadi taila or sahacharadi taila *Patra pinda sweda *Padabhyanga with ksheerabala taila , dhanvantaram taila. *Pizhicil with sahacharadi taila . *Shiropichu with yashti taila,bala lakshadi taila
  135. 135. 135
  136. 136. 136 Fibromyalgia: Fibromyalgia is a chronic condition , characterised by non- inflammatory pain and tenderness in ligaments, muscles, and joints. It is similar to the condition of Chronic Fatigue Syndrome (CFS) but, with the added musculoskeletal pain. It is commonly associated with medically unexplained symptoms in other systems. It can occur at any age, maximum prevalence of 7% in women aged over 70years. Causes : *Low serotonin level is considered to be the most important cause for Fibromyalgia. * Apart from this, chemical changes in the brain, infections, injury, sleep disturbances, altered muscular metabolism, abnormal responses, are also believed to cause this condition.
  137. 137. 137 *Symptoms : *Fibromyalgia usually presents in the form of aches, burning sensation, stiffness, or throbbing in any location of the body. *The pain is usually severe on waking up in the morning and gradually decreases with passing of the day. *Fibromyalgia, being closely associated with CFS, including generalized fatigue, chronic headache, sleep disorder, neuronal complaints, swelling, increased sensitivity, irritable bladder, chest pain, irritable eyes, swelling in limbs, feeling of developing pelvic inflammatory disease, apart from irritable bowels, temporo-mandibular joint Syndrome, and premenstrual syndrome.
  138. 138. 138 Treatment : *In general, treatments for fibromyalgia include both medication and self-care. *The emphasis is on minimizing symptoms and improving general health. *No one treatment works for all symptoms. *Medications such as analgesics , antidepressants, anti-seizure drugs will be administered.
  139. 139. 139 Ayurvedic approach : *Fibromyalgia does not fall to a particular srotas . *The absence of a specific evidences in the anatomy of sandhi makes it very difficult to consider it as a pure organic disease. *According to Ayurvedic approach, fibromyalgia is caused by imbalance in Vata, the physiological energy generally responsible for stability and activity of nervous system. *Mana is controlled by vata , when vitiated by emotional factors like shoka, chinta etc will manifest as stress and can lead to unexplained joint pain as in fibromyalgia. *Also, rasa dhatu related lakshnas like angamarda,ati chinta, anidrata lakshanas are also seen with the association of vata is also seen in this condition.
  140. 140. 140 Priciples of treatment : *Vata shamana chikitsa *Mana prasadana chikitsa *Rasaprasadana chikitsa
  141. 141. 141 Ayurvedic mangement : *Jeevantyadi gana kashaya *Vidaryadi kashaya *Devedarvyadi kashaya *Manasamitra vati *Panchagavya ghrita *Kalyanaka ghrita *Nasya karma with ksheerabala 21 or 41 avartita taila *Mustadi raja yapana basti *Samvahana (mrudu abhyanga). *Thalam with Nimbamrutadi eranda and kachooradi churna *Shirodhara with takra+eladi gana kashaya * shirobasti with dhanwantaram taila
  142. 142. 142 Conclusion : *Ayurveda is one of the most ancient Medical Science which sees human being as an integral part of nature. *It is the science of life as it transcends the mere treatment of disease and embraces a wide array of principles and practices which deals with each individual in entirety. *It is based on universal principles and not limited to a particular ethnic group or culture- being both person-centered and intercultural. * It can be used as an integration of the existent healthcare systems as well as a template to rescue local traditional values in order to meet the needs of different populations.
  143. 143. 143 *Ayurveda define health as a state of physical, mental, intellectual and spiritual well being. *And its primary objective of health is ‘SwasthasyaSwasthyaRakshanam’ i.e to promote health and thereby preventing the ailments. *Ayurveda is ancient in its origin but its concept like oupsargikaroga (communicable diseases) and Janapadodwansa (epidemics) still holds importance in this modern era. *Certain new disease entities appearing in the course of time that has no identity can be managed through suitable drugs and procedures based on the symptom profile, taking leads from authentic literatures. *This provides us basic ideology of creating an evidence on safety and efficacy through Reverse pharmacology.
  144. 144. 144 *65% of population in India is reported to use Ayurvedic medicines without prescription of doctor. *Recent breakouts and unsatisfactory treatment makes people aware towards Ayurveda so, it is mandatory to analyse these diseases based on their symptoms and treat them according to affected doshas, srotas, agni and other entities involved in the manifestation of the disease. *However, ayurveda strongly emphasizes promoting prevention of the disease rather than cure and rehabilitation. * For this, advocating principles of health such as : Dincharya, Rutucharya ,Ratricharya, Sadvritta, *Following trayopasthambha i,e Aahar, Nidra and Brahmacharya palana should be done.
  145. 145. 145 *‘Achara rasayana’ is another unique concept in Ayurveda that implies moral, ethical, and benevolent conduct. *The concept of achar rasayana is to change our behaviors in order to reverse the disease process and stay in balance. * Truth, nonviolence, personal and public cleanliness, mental and personal hygiene, devotion, compassion, and a yogic lifestyle. *These behaviours bring about rejuvenation in the body-mind system. One who adopts such conduct gains all benefits of rasayana therapy without physically consuming any material rasayana remedy or recipe, although it can be practiced alone or in a combination with material substance rasayana therapy.
  146. 146. 146 *Thus by implementing these principles properly in our lives, it brings about healthy and a disease free society. *It not only prevents the disease in the first place but also reverses the stages of disease process. *Hence, by implementing and following these time tested ayurvedic principles one can manage the current health challenges safely and efectively.
  147. 147. 147 References : 1.https://www.bcm.edu › ... › Emerging Infections and Biodefense 2. healthsciences.ac.in/commentry1.html 3. Public Health Challenges in India: Seizing the Opportunities Jai Prakash Narain 4. ayurvedamagazine.org/ayurveda-in-crisis 5.ayurveda-foryou.com/treat/fibromyalgia.html 6.www.ayurvedalive.in/ayurvedic-approach-to-prevent-swine-flu 7. www.nhp.gov.in/ayurvedic-perspective-of-dengue-fever_mtl 8.www.ccras.com 9. Emerging Trends in Healthcare -A Journey from Bench to Bedside. 10.Emerging issues –Chapter 2
  148. 148. 148 11.THE CONCEPT OF PUBLIC HEALTH IN AYURVEDA -Janmejaya Samal 12.Charaka Samhitha sutra sthana 18th chapter. 13.Charaka Samhitha vimanan sthana 3rd chapter. 14.Charaka Samhitha sutra sthana 20th chapter. 15. Susruta Samhitha nidana sthana 5th chapter. 16. Susruta Samhitha uttara sthana 27-37 17.General Approach Towards Treatment of Chikungunya (Janapadodwampsaroga) in Ayurveda –a Review Article Dr.DhimanAmbika 18. CHIKUNGUNYA IN AYURVEDIC PERSPECTIVE AND ITS MANAGEMENT-A REVIEW ARTICLE Singh Mangal, Singh Chandan 19.CHIKUNGUNYA IN AYURVEDIC PERSPECTIVE AND ITS MANAGEMENT-A REVIEW ARTICLE Singh Mangal,Singh Chandan 20. AYURVEDIC PERSPECTIVE OF SWINE FLU (ABHINYASA JWARA)
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ayrvedic management strategy for various new emerging health issues , in terms of both communicable and non - communicable disorders.

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