Integrated Summary

Allopathy

Ayurveda

Vital Parameters

1. BP:90/70 mm of hg
2. Weight:64 kg
3. Height:158 cm
4. BMI:25.6

Astasthana Pariksha

1. Malam: Sama
2. Mutra: Sama
3. Jihva: Nirama
4. Shabda: Sadharana
5. Sparsha: Prakrutha
6. Drik: Prakrutha
7. Akruti: Prakrutha

Examinations

- GC: Fair
- CVS: NAD
- CNS: NAD
- RS: NAD
- PA: Percussion: Tympani

Dasa Vidha Pariksha

1. Prakriti - Vatha pitha
2. Vikriti - Vatha,pitha
3. Sara -Madhyama sara
4. Samhanana - Madhyama
5. Pramana - Madhyama
6. Satmya - Katu sathmya
7. Satva - Madhyama
8. Aharashakti - Madhyama
9. Vyayam Shakti - Madhyama
10. Vaya - Yuva
11. Desha - Bhoomi -
12. Kapha,deham-Vatha,pitha
13. Kala - Hemanta

Rogi Bala - Madhyam

Roga Bala - Madhyam

NidanaPanchaka
1. Nidana - katu rasa sevana,Athymabu pana
2. Purvaroopa -Bloating of abdomen
3. Roopa -Atopa,Adhmana
4. Updrava: Vibhannda
Arishta Lakshana:NA
5. Samprapti
A. Dosha - Vatha,pitha
B. Dushya - Rasa
C. Agni - Mandagni
D. Ama - Sama
E. Srotas - Rasa,Annavaha
F. Sroto Dushti Prakara - Sanga

Lab Tests

Findings
Endoscopy	On 10/2/14: Esophagus showed 2 linear mucosal breaks less than 5mm. Endoscopic diagnosis(EGD)-Reflux esophagitis Colonoscopy-normal mucosal study.
USG abdomen	On 31/5/14 - Right kidney shows 2 intra renal calculi in the middle and lower pole calyces each measuring 5 mm and 6 mm - Left kidney also shows an intra renal calculus in the middle pole calyx measuring 5 mm - No evidence of pelvocalyceal dialatation of ureter or calculi at both UVJ - Liver ,Gall bladder, Pancreas, Spleen,Bladder and prostrate show normal sonographic pattern - No evidence of thickened or dilated bowel segments
MRI study of Lumbo- Sacral spine	Mild disc bulge at L4-L5 and L5-S1 levels causing Indentation over ventral thecal sac Whole spine screening:Nasopharyngeal cyst noted
Haematology report	On 2/05/14 BT-1mts.45sec, CT-4 mts.45sec Total Bilirubin:0.87mgs% Direct:0.26 mgs% Indirect:0.61 mgs%

Diagnostic cystoscopy : Bladder Neck Obstruction

Revealed grade 1 bilateral lobes partially occlusive with roof of prostate tissue over anterior urethra extends backward and occluding intln meatus.Bladder capacity normal.Cystitis features+Bladder neck elevation

RogaSamprapti Flow Chart

- Vata with pita prakopaka Nidana.
- Amlaguna vrudha in pitha/Vatha kapha aggravation
- Vidhagda pitha ,Agnimandhya.
- Vidhagdha anna

Differential Diagnosis with reasoning

- Neurogenic bladder
- Esophagitis grade A

Differential Diagnosis with reasoning

- Mutrakruchra
- Agnimandhya
- Amlapitta

Evidence Based Diagnosis
- Neurogenic bladder
- Esophagitis grade A

Evidence Based Diagnosis
- Muthrakruchra
- Agnimandhya
- Amlapitha

ChikitsaVivechana:
Ahara + Vihara + Aushadh + Kriya

Details of Allopathy medicine if continued

Type –IPT
Duration – 22/2/15 to 8/3/15

Primary Treatments: Snehapanam, Udwarthanam

Main Treatments:Virechanam, Shirodhara,
Abhyanga, JPS

Post Treatments:Abhyanthara oushada sevana

Chikitsa Paddhati with details of dose of medicine.

From 22/2/15 to 1/3/15

Bilwadi lehyam 1 tsp +
1 tsp Ashta choornam twice daily before food
Thriphala choornam 1 tsp hours of sleep.

From 1/3/15

Indukantham kashyam -15 ml +
T.Hingu vachadi -2 7 AM
Gandharvahasthadi kashayam-15ml +
Dhanwantharam gulika-4 tab at 6 PM
Dasamoolahareethaki-2 tsp at bedtime
Vilwadi lehyam- 1 tsp Before lunch and dinner.

From Date	To Date	Procedure	Treatment Medicines
22/02/15	27/02/15	Snehapanam	Dadimadi + Kalyanak gritam
22//02/15	27/02/15	Sarvanga udwartanam + BS	Ellumnishadi + Kolakulattadi Churnam
22/02/15	27/02/15	Nasyam	Ksheerabaladi Tailam
28/02/15	-	Virechanam	Avipatty Churnam
01/03/15	07/03/15	Shirodhara	Bala Ashwagandhadi Tailam
01/03/15	07/03/15	Sarvanga Abhyanga + JPS	Dhanwantaram + Narayana Thailam, Bala Ashwagandhadi Tailam
01/03/15	8/03/15	Yogavasti	Erandamooladi

On 26/3/15
Indukantham kashyam -15 ml +
T.Hingu vachadi tablet-2 7 AM
Sapthasaram kashayam -15ml +
Kankayanam tab-2 mixed 5 PM
Dasamoolahareethaki-2 tsp at bedtime
Vilwadi lehyam- 1 tsp SOS

Referral Opinion Sought if any – No

Outcome

Samyak Lakshanas achieved ( Attached)
Outcomes

Before treatment	After treatment	On review
Bloating of abdomen (poor)	Bloating of abdomen reduced significantly. (Good)	Further, reduced (Good)
Heaviness (poor)	Heaviness reduced significantly.(excellent)	Further, reduced (Excellent)
Belching (poor)	Belching reduced significantly (Very good)	Further, reduced (Excellent)
Difficulty in micturition (Saama)	No episodes of difficulty in micturition.	No episodes of difficulty in micturition (Niraama)
Gurgling sounds (poor)	Gargling sounds reduced significantly. (Good)	Further, reduced (Excellent)
Motion-Constipated(Saama)	clear(Niraama)	clear(Niraama)
Sleep-Good	Good	Good
Energy level-Moderate	Moderate	High
Appetite –Mandagni	Samagni	Samagni
Stress (Manas)-Stressed	Relaxed	Relaxed
Weight:64kg	62.7kg
BP	90/70mm of hg	100/70mm of hg

Adverse Incident Report (Drug or Treatment): No adverse event reported

	Date	At the start of Treatment
Images/ Details of the site

Conclusion

Patient underwent the classical Ayurveda treatments at Apollo AyurVAID Hospitals Bangalore and all his treatments ended without any adverse events. His digestion along with appetite has improved significantly. Bowels are regular. He did not have the episodes of difficult micturition after the Ayurveda treatments. Further he was advised to continue all his internal medicines along with diet & regimen. A significant relief in management of symptoms like amlodgaara, aatopa, avipaka etc after the sodhana chikitsa was found and showed sustained effects even after follow up and no recurrence of symptoms was observed.

Ayurveda Treatment for Neurogenic Bladder

Brief Medical History

Integrated Summary

Outcome

Conclusion