Gridhrasi - A Case presentation

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Information about Gridhrasi - A Case presentation

Published on January 14, 2016

Author: MaanasAjay

Source: slideshare.net

1. CASE PRESENTATION By Dr. Maanas. A 15‘ year PG scholar Guided by Dr. Rajarajeshwari N M Associate Professor Dept of samhita samskruta and siddhanta

2. Efifia ififiififiw « Name: Lakshmamma « Age: 55 ~/ Sex: Female ~/ Occupation: Farmer [worker] « Address: Signahalli, Hassan ~/ PH. NO: 8453266593 « IPD- 004104-2014 / OPD- 023862-2014 ~/ D. O.A- 30-06-2014 ~/ D. O.D- 09-07-2014

3. CHIEF l: lIl1I'I. II| I'IT ~/ Pain in the lower back region radiating to the posterior aspect of Left leg since 3 months. / The pain has increased from 15 days.

4. IISSIIBIIITEII ClIHP| .IIII'| TS J Unable to walk properly due to pain since 15 days. J Pulling type of pain in left calf and thigh region.

5. tifififilw 8% t§5?? §E§Ea'1a“W llflifififi Patient was apparently normal 3 months back. She developed pain in lower back region , which started gradually radiating to posterior aspect of left leg within two days and was not able to do her occupational work. She consulted an doctor who prescribed her with medications and rest. The treatment gave her temporary relief. but pain recurred which was continuous in nature and used to aggravate after strenuous work. She came to a stage were she was unable to do her household work also. 1 5days back she came to know about our hospital and started taking medications for the same which gave her relief, so for further improvement she got admitted in our hospital.

6. Film MSWW N0 I-I/ C DIX/ J; no 1‘ N No surgical liistory

7. FlIl1|I. Y IIISTIIIIY ~/ Nothing Significant

8. §E%§%ii%§%i E*§%$? §fi? AAHARA: MIXED DIET. Morning-Dosa, rice items Afternoon-Ragi Mudde, curd and buttermilk, Night rice curd, non veg once in a week VIHARA: FARM WORKER she sits in same position for almost 5-6 hr since 30 yr, controls her thirst and urge to micturate. APPETITE: Decreased appetite, but takes food regularly BOWELS: Since 3 months Hard, straining l/ IICTURITION: Normal SLEEP: DISTURBED since 5 yr, DUE TO PAIN since 3 months HABITS : NIL

9. Gynecological history Menarche : l5yr Menopause : 50yr Disturbed sleep since then Obstetric history : P3A0L3D0

10. EEWEESQE, §§§@i“i'iis“iE5.i7'§: 'E@i% B. P-130/80 mm Hg PR-78/Min R. R-20/Min Height -5ft Zinches Weight - 48kg Edema/1ymphadenopathy/ pa1lor/ icterus/ clubbing / cyanosis - absent

11. SYSTEMIC EIIIINIHIITIIIII « RS - NVBS « CVS - S1 S2 heard « P/ A - Soft, non tender « CNS-Conscious and well oriented

12. Musculo-skeletal system 6) Gait - limping with support <9 Upper limb - Normal Lower limb - Stiffness: Stiffness in the calf and thigh region. Redness and Warmth / Weakness / Swelling / Deformity : Absent é> Examination of spine - Inspection : No visible deformity Palpation : Tendemess - L5 S1 S2 region Movements : Cervical/ Thoracic : NAD Lumbar : Flexion Restricted Lateral flexion Lt-Not possible Rt — Restricted Extension- restricted

13. « SLRT-Positive at 30 degree w LASEGUES SIGN- Positive

14. IIIIIESTIIIIITIIIIIS J Hb: l1gm°/ o J E. S.R :20 mm/ hr J Platelets: 3.31 lakhs/ CMM J FBS: 82 mg/ dl J Blood urea: 15 mg/ dl J Urine sugar: absent

15. SSW §T%§§i“i% J NADI-78/ min J JHIVA-Alipta J MALA-Twice/ day J MUTRA- 4-5 times/ day J SHABDA-Prakrita J SPARSHA-Sama sheetoshna J DRIK — Gati- Vikruta J AKRITI- Madhyama

16. Efigilfi iii J PRAKRITL Vata - Pitta J VIKRITI- Hetu- Long hours of sitting and working, lifting heavy weight, vegadharana, Nidrahaani Dosha- Vata Dooshya- Asthi, Sandhi, Mamsa Prakriti - Mridu A Desha — Bhumi -Anupa Sadharana ‘Stilt Filfiliifiiifi r 5 Atura — Kati, Vama sakthi Kala — Ritu- Varsha ritu Kriyakaala- Vyakta avastha Bala —Rogi - Avara ; Roga - Madhyama

17. IIIISIIII IIIIIIIII PIIIIIIISIIII l3lIIIT. . J SARA r Madhyama J SAMHANANA r Madhyama J SATVA r Madhyama J SATMYA r Madhyama J AHARA SHAKTI r Abhyavaharana Shakti— Madhyama , Jarana Shakti- Madhyama J VYAYAMA SHAKTI r Avara J VAYAH r Madhyama J PRAMANA I Madhyama

18. lg Efigrigiélfilitifi J Nidana - Long hours of sitting and working, lifting heavy weight, vegadharana, Nidrahaani J Purvarupa — Purvarupa not elicited. J Rupa - Low back pain, radiating pain from Left buttock region to posterior side of the leg, difficult to walk, pain aggravating while walking and while turning from one side to other on lying down. J Upashaya — Resting in supine position with legs fl J Anupashaya - walking, bending, working.

19. ,‘ »x [1 VATA PRAKO PA NIDANA ~ DHATU KSHAYA t , KHA _, - . VAIGUNYA IN KATI VAYAH DOSHA - DUSHYA SAMMURCCHANA SIRA, SNAYU *5 GRIDHRASI AFFECTED

20. Vfizlillfll l’i’1M’. LM3MlEll1%M11ll. VATAJA VATA-KAPHAJA _ GRIDHASI GRIDHRASI URUSTMIBHA - KHALLI J PADA, JANGHA, J STAMBHA J STAMBHA J RUKINURU URU&URU MOOLA PEEDA SHOTHA, AYASA, MARDANAVAT J TODA AROCHAKA ANGAMARDA ‘ v’ SPANDATE NIUHUHU TANDRA GURU I WA / DEHA VAKRATA TANDRA ARUCHI, STAIMITYA, SUPTI

21. Wfilfili QENESEESSPS q‘ -. ._‘_~IVT. —.r. , . ,fi. ,- " . - at’ ‘I.71&}~. ri: ‘1&i*-O‘1&, ‘- : ..: .Q"‘i. ... ..J; --_Ji-“~.1LL. LJi.

22. OP basis Treatment <9 Sahacharadi Kashaya 3tsf BD <9 Rasna Guggulu 2 TID <9 Hingvashtak Churna ‘/2 tsf TID * 1 week

23. TIIEIITPIEIIT 30-S-2014 T0 S-T-2014

24. 1%'rEb’c<“FR‘l§l tEfififlfifiIfiuGF{| ® ? rmw wT H Ia. 1=, L.? (,/ Q6 fit. Qc/ Lek I El. oafiailfigqfi

25. LOW BACK ACHE RADIATING TO LT Leg +++ O1_O7_1 4 APPETITE — GOOD BOWEL-REGULAR SLEEP- DISTURBED STIFFNESS- PRESENT <9 Kati Basti with Dhanwantara taila <9 Sarvanga Abhyanga (Dhanwantara Taila) + Bashpa Sweda <> Matra Basti with Pancha Tiktaka Ghrita 80ml <9 Katilepa with Jadamayadi Churna + Dhanwantara Taila <9 Rasna Guggulu 2-O-2 <> Physiotherapy

26. PAIN — REDUCED O2_O7_1 4 APPETITE — GOOD BOWEL-REGULAR SLEEP- DISTURBED STIFFNESS- PRESENT <> Kati Basti with Dhanwantara Taila <9 Sarvanga Abhyanga with Dhanwantara Taila + Patra Pinda Sweda <9 Matra Basti with Pancha Tiktaka Ghrita <> Katilepa with Jadamayadi Churna + Dhanwantara Taila é> Rasna Guggulu 2-0-2 <9 Physiotherapy

27. PAIN - REDUCED APPETITE — GOOD i 03-07-14 . ... w.. -m. ... ... . SLEEP— DISTURBED STIFFNESS- PRESENT <9 Ksheera vaitarana Basti- Guda Paka 30ml, Chincha Rasa 50ml, saindhava Lavana-l2gm, PTG-40ml, Ksheera 200ml <9 Kati basti with Dhanwantara taila <9 Sarvanga Abhyanga + Patra pinda sweda <9 Matra Basti with Pancha Tiktaka Ghrita <9 Katilepa with Jadamayadi Churna + Dhanwantara Taila <9 Rasna Guggulu 2-0-2 <9 Physiotherapy

28. Pain reduced, No pain while getting up from bed 04 O 7 1 4 APPETITE — GOOD - - BOWEL-REGULAR SLEEP- DISTURBED STIFFNESS- PRESENT <9 Ksheera vaitarana Basti <9 Kati basti with Dhanwantara taila <9 Sarvanga Abhyanga (Dhanwantara Taila) + Patra pinda sweda <9 Matra Basti with Pancha Tiktaka Ghrita 80ml <9 Katilepa with Jadamayadi Churna + Dhanwantara Taila <9 Rasna Guggulu 2-0-2 <9 Physiotherapy

29. Pain reducedl Able to walk O5_O7_14 APPETITE — GOOD BOWEL-REGULAR SLEEP- DISTURBED STIFFNESS- PRESENT <9 Kati basti with Dhanwantara taila <9 Sarvanga Abhyanga (Dhanwantara Taila) + Patra pinda sweda <9 Ksheera vaitarana Basti <9 Matra Basti with Pancha Tiktaka Ghrita 80ml <9 Katilepa with Jadamayadi Churna + Dhanwantara Taila <9 Rasna Guggulu 2-0-2 <9 Physiotherapy

30. PAIN REDUCED, PERSISTS ON WALKING O6_O7_ 1 4 APPETITE — Goon BOWEL-REGULAR SLEEP- DISTURBED STIFFNESS- PRESENT <9 Kati Basti with Dhanwantara taila <9 Sarvanga Abhyanga (Dhanwantara Taila) + Patra pinda sweda <9 Ksheera vaitarana Basti <9 Katilepa with Jadamayadi Churna + Dhanwantara Taila <9 Rasna Guggulu 2-0-2 <9 Physiotherapy

31. C/ O PAIN WHILE WALKING O7_O7_1 4 APPETITE — Goon BOWEL-REGULAR SLEEP- DISTURBED STIFFNESS- PRESENT <9 Kati Basti with Dhanwantara taila <9 Sarvanga Abhyanga (Dhanwantara Taila) + Patra pinda sweda <9 Ksheera vaitarana Basti <9 Matra Basti with Pancha Tiktaka Ghrita 80ml <9 Katilepa with Jadamayadi Churna + Dhanwantara Taila <9 Rasna Guggulu 2-0-2 <9 Physiotherapy

32. O/ E PAIN ON PRESSURE. PAIN REDUCED O8_O7_1 4 APPETITE — Goon BOWEL-REGULAR SLEEP- DISTURBED STIFFNESS- PRESENT <9 Kati basti with Dhanwantara taila <9 Sarvanga Abhyanga (Dhanwantara Taila) + Patra pinda sweda <9 Matra Basti with Pancha Tiktaka Ghrita <9 Katilepa with Jadamayadi Churna + Dhanwantara Taila <9 Rasna Guggulu 2-0-2 <9 Physiotherapy

33. Treatment Chart - M W flflflllllflllfl + EIIIIIII -Ilflflllllflfl Basti chart 01/07 02/07 03/07 04/07 05/07 06/07 07/07 08/07

34. DISCHARGE ADVISE <9 Rasna Guggulu 2-2-2 <9 Sahacharadi Kashaya 4tsf-4tsf-4tsf <9 Dhanwantara Taila (E/ A) REVIEW AFTER 15 DAYS

35. i Pathya J <9 Sarpi, Swadu, amla, lavana rasa ahaara, Godhuma, Masha, Shali, Kulattha, Mamsa rasa, Gramya - audaka, mamsa, Dadim, Jambir, Draksha, etc. Daily Abhyanga Apathya <9 Tikta, Katu, Kashaya Rasa Ahaara atisevana, late night food, Chinta, Vegadharana, Shrama- Especially Bharadhwa, Anashana etc.

36. PROGNOSIS ACCORDING TO PATIENTS SATISFACTION SCALE No C/ O Pain Only O/ E Pain +ve at 30 ° +ve at 70° LASEGUES SIGN APPETI'I'E Good Can sleep Better

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