Wednesday 29 June 2016

PSORIASIS

INTRODUCTION

The skin is one of the five sensitive organs which is responsible for touch sensation; therefore, it plays a great role in physical and mental wellbeing of any individual. The unbroken skin is the nature’s dressing over the body. It acts as an effective barrier against the entry of diseases and its damage results in whole host problems.

Psoriasis is one of the most common dermatologic diseases, affecting about 2% of the world population. The rate of psoriasis varies according to age, gender, region and ethnicity. A combination of environmental and genetic factors is thought to be responsible for these differences. It usually occurs before the age of 40, most commonly between the ages of 15 and 25 years; affects equally in men and women. The aetiology of psoriasis is still poorly understood, but there is clearly a genetic predisposition. It has been found in large surveys that one third of patients have a positive family history. Evidence has accumulated and clearly indicating a role of T- cells in the patho- physiology of psoriasis.

Psoriasis can be a very persistent complaint. It does not kill but it is responsible for great deal of unhappiness feeling of depression. Hence, psychological aspect of psoriasis is most important in the etiopathogenesis and management of psoriasis.

DEFINITION

Psoriasis is a non-infectious chronic relapsing inflammatory skin disease characterized by well-defined dry scaly erythematous patches and covered with adherent silvery white scales. The eruption is usually symmetrical and most commonly affects extensor surfaces of elbows, knees, scalp, nails and the sacral regions. Psychological stress is emphasized as one of the major triggering factor in the exacerbation of the disease.

CLASSIFICATION
Clinically psoriasis can be classified as:

  •   Plaque psoriasis
                  Involving palms & feet       Scalp involvement       Nail involvement
  • Guttate psoriasis
  • Flexural psoriasis
  • Pustular psoriasis
  • Erythrodermic psoriasis

PLAQUE PSORIASIS: Also called as psoriasis Vulgaris is the most common form of Psoriasis. It is presented with dry, slightly elevated, red patches called as plaques that are covered by a layer of silvery white scales.   


When plaques are localised in the palms of the hands and soles of the feet are called as PALMO-PLANTAR Psoriasis.

The lesions effecting the scalp dermis, may spread to the ears, forehead, and the back of the neck may or may not be presenting with the hair loss, without the involvement of the rest of the body surface is called as scalp psoriasis.

50% of the patients suffering from the psoriasis presents with the changes in the nails which include, severe thickening of the nail, shallow or deep holes (pits) in the nails, discoloration of the nail either yellow or brown, separation of the nail from the bed.




GUTTATE PSORIASIS: 
This presents as small reddish dots simulates the rain drop like lesion. Typically seen in the upperbody, legs, and arms, but also can occur in any other part of the body.








FLEXURAL PSORIASIS:This type of psoriasis appears in the skin folds which are smooth, red patches devoid of scales as seen in plaque psoriasis. It may appear in the genitals, under the breasts, and in the armpits. 





PUSTULAR PSORIASIS: This appears as small, white, fluid filled blisters (pustules) surrounded by swollen, reddish skin. It can occur anywhere in the body and may result in the fluid imbalances and infection associated with the raise in temperature.






ERYTHRODERMIC PSORIASIS:This covers the entire body; skin appears bright red with extensive fine scaling. It may be a quite painful conditionassociated with severe itching. There may be requirement of hospitalisation in case of protein and fluid loss, and decrease in body temperature.
One of the complications of the illness is the development of the Arthropathy in about 5% of the psoriatic patients. Symptoms may simulate the presentation of rheumatoid arthritis. The tests for rheumatoid arthritis will be negative and rheumatoid nodules will be absent.

Modern medical science treats psoriasis with PUVA and corticosteroids. But these therapies give serious side effects like liver and kidney toxicity, bone marrow depletion etc. Hence it is the need of time to find out an alternate safe and effective treatment for Psoriasis.

TREATMENT IN AYURVEDA

Psoriasis is one of the most common dermatologic diseases and still stands as a challenge to different medical systems. Many research works have been done on psoriasis in Ayurveda and modern medical science but no drug has yet been claimed to cure psoriasis completely. Psoriasis can be better managed by the following Ayurvedic principles:  


Ø  NidanaParivarjana(Avoiding the cause factor)
Ø  Shodhana Therapy(Purification Therapy)
Ø  ShamanaChikitsa(Pacification Treatment)


In Ayurveda, Psoriasis can be correlated with‘Ekakustha’ due to very much similarity in their symptoms. The unique treatment modality of Ayurveda provides long lasting results and a better life to patients through its three basic principles of treatment.

PANCHAKARMA – The purificationtherapy is a unique type of treatment for various chronic, auto-immune, hormonal, degenerative disorders etc, where other sorts of treatments have no satisfactory answer as well equally beneficial for the promotion and preservation of health. In addition, the “Shamana” (internal medicines)& External Application (Lepan) of drugs is administered after taking the proper course of “Shodhana” (Panchakarma) then it provides additional relief and thus helps in eradication of the diseases (psoriasis) completely.

“Kitibha” is a type of “kshudrakushtha” described in different Ayurvedic classics. It is a “Vata-Kaphaja” disorder. The clinical symptoms of “Kitibha” described in Ayurveda resembles with the clinical symptoms of Psoriasis. The clinical features of Kitibha described by Kashyapa represent remission, relapse and seasonal variation, which is present in Psoriasis. It is one of the most common dermatological problems of unknown aetiology. It is a chronic, genetically determined, inflammatory and proliferative disease characterized by dry, well-circumscribed, silvery scaling papules and plaques of various sizes with spontaneous remission, relapse and seasonal variation.

Medicines which are used in Ayurveda are safe and being practiced since thousands of years. A large number of drugs are described in Ayurveda for the treatment of Psoriasis,


NAMAMI, the holistic health retreat, situated in Kochi, Kerala, basically relays on integrating the best of Ayurveda, Yoga, Meditation and Naturopathy in treating such chronic skin issues.

We have formulated certain special combinations and treatment protocols to cure psoriasis and reduce the relapses. “Takradhara”, “Snehapanam”etc are some of the unique treatments practised at NAMAMI. We have also got expert Ayurvedic consultants visiting our centre to handle such patients with various skin disorders.

Namami is an Ayurvedic wellness resort integrating the ethos of Ayurveda, Naturopathy, Yoga and meditation and is situated by the banks of River periyar near Cochin International Airport.



By
Dr.Bejoy, B.A.M.S,
RMO, Namami Purnagram

Monday 20 June 2016

HYPERTENSION


Hypertension is a condition in which the blood pressure in the arteries is persistently elevated. High blood pressure usually does not cause symptoms but rarely heaviness of head, dizziness etc. Long term high blood pressure is however a major risk factor for coronary artery disease,stroke,heart failure,peripheral vascular disease,vision loss and chronic kidney disease.

The increase in prevalence of the condition is due to life style and dietary factors such as physical inactivity,alcohol and tobacco use and a high sodium rich diet usually from processed and fatty foods.
Blood pressure is the force exerted by the blood against the walls of arteries.Normal blood pressure ranges from 120 mm of mercury – Systolic - (the pressure as the heart pumps blood around the body) and 80 mm of mercury - Diastolic - (the pressure as the heart relaxes and refills with the blood).Hypertension is defined as having a blood pressure higher than 140 over 90 mm of mercury

CLASSIFICATION
Primary(essential)High Blood Pressure-About 90% to 95% of cases are primary, defined as blood pressure due to non specific life style and genetic factors.
Secondary High Blood Pressure-Remaining 5% to 10% of cases are secondary high blood pressure due to identifiable causes such as chronic kidney disease, hormonaldisorders, narrowingof kidneyarteries etc.

FEATURES
Most probably asymptomatic but associated symptoms such as Headache,Dizziness,Bleeding through nose,Ringing sound in ears,Blurred vision,Palpitation,Depression,Irritability,Fatigue are seen.

MANAGEMENT    
Modification in life style by Salt restriction
Moderation of alcohol consumption
High consumption of vegetables, fruits and a low fatty diet.
Reduction of weight
Regular physical exercise
Stress reduction
Medication includes diuretics,beta blockers,calcium channel blockers etc.

AYURVEDIC VIEW
Ayurveda -the science of life - has a holistic approach and aims to not only cure the patient but also bring about complete health.
In Ayurveda hyper tension is considered as VYANA VATA VAISHAMYA.
According to Ayurvedic concept Vyanavata is one among the five types of vata which is located in heart and is responsible for circulation of fluid all over the body through blood vessels.By the excessive intake of cold,dry foods,spicy items,alcoholic beverages,caffeine and adopting regimen which cause excessive physical exertion,smoking,suppression of natural urges,fear, depression leads to aggravation of Vata and produce many symptoms such as head ache,fatigue,dizziness,DHAMANI PRATICHAYA(PRESSURE ON BLOOD VESSELS)etc.

MANAGEMENT
The treatment for hyper tension is to bring vitiated vyanavata to equilibrium by adopting healthy changes in diet and regimen such as:
Low sodium diet
Low fat diet
Regular intake of fruits and vegetables
Meditation
Pranayama
Yoga
Regular exercise
Weight reduction
Positive attitude
Medications


NAMAMI SPECIAL PROTOCOL TO TREAT HYPERTENSION
In Namami we have an expert team of doctors experienced in treating Hypertension resorting to the traditional treatment procedures.We also have a special team to provide utmost care in dealing with hypertensive patients to modify their life style and diet.

The treatment is strictly based on the condition of the patient and the stage of the disease taking into consideration of the constitution,strength,season,digestive capacity,habitat,age,mental state of the patient.Special diet, therapies, internal medications, Yoga postures and modification of lifestyle are provided in accordance with the condition of the patient. Some of the therapies include:
Effective herbal medications such as decoctions, tablets are given to pacify the vitiation.
Therapies like SHIRO ABHYANGA,SHIRA SEKA,SHIRO PICHU,SHIRO BASTHI etc provide extreme relaxation  and relief from mental stress.

SARVANGA DHARA is a whole body therapy giving relaxation to the body and different medicated liquids are used for different patients according to the condition and constitution of the patients.
Certain special yoga postures are advised by the Yoga instructor in consultation with the doctor to regain energy and mental strength.
Diet of the patient is specially charted out by the Naturopathic doctor and the Nutritionist taking care of all the aspects.
Namami healthcare cares for the total wellbeing of the patient by adopting classical Ayurveda treatments along with other alternative systems of medicines such as Naturopathy, Yoga and meditation etc.


Namami is an Ayurvedic Retreat Center Practicing Ayurveda therapies in the best manner situated by the banks of River Periyar near Cochin International Airport




By
Dr Aiswarya Bimal, B.A.M.S,MD
RMO, Namami Purnagram