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    Gridhrasi Case Presentation

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    Amogha Kulkarni
    This document presents a clinical case of a 46-year-old male farmer presenting with low back pain radiating down both legs. On examination, he has reduced tone, strength and reflexes in the lower extremities. He was diagnosed with Gridhrasi (sciatica) based on the history and examination. He received treatments including oil massage, heat therapy, herbal medications and lifestyle modifications.

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    Gridhrasi Case Presentation

    Uploaded by

    Amogha Kulkarni
    1K views35 pages
    This document presents a clinical case of a 46-year-old male farmer presenting with low back pain radiating down both legs. On examination, he has reduced tone, strength and reflexes in the lower extremities. He was diagnosed with Gridhrasi (sciatica) based on the history and examination. He received treatments including oil massage, heat therapy, herbal medications and lifestyle modifications.

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    This document presents a clinical case of a 46-year-old male farmer presenting with low back pain radiating down both legs. On examination, he has reduced tone, strength and reflexes in the lower extremities. He was diagnosed with Gridhrasi (sciatica) based on the history and examination. He received treatments including oil massage, heat therapy, herbal medications and lifestyle modifications.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    1K views35 pages

    Gridhrasi Case Presentation

    Uploaded by

    Amogha Kulkarni
    This document presents a clinical case of a 46-year-old male farmer presenting with low back pain radiating down both legs. On examination, he has reduced tone, strength and reflexes in the lower extremities. He was diagnosed with Gridhrasi (sciatica) based on the history and examination. He received treatments including oil massage, heat therapy, herbal medications and lifestyle modifications.

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    You are on page 1of 35

    CLINICAL CASE

    PRESENTATION

    Presented by: Guided by:


    Dr. Mohammad Yaseen. Dr. A.S. Prashant M.D (Ayu), Ph.D
    Hullur B.A.M.S Professor & HOD
    1st Year P.G Scholar Dr. S.G Chavan M.D (Ayu)
    Professor

    DEPT OF PG STUDIES IN KC, AMV, HUBLI


    PATIENT DETAILS
    • Name: Noor Ahmad Mattur
    • Age: 46yr
    • Sex: Male
    • Religion: Muslim
    • Occupation: Farmer
    • Marital Status : Married
    • Address : Bannur, Shiggavi
    • IPD No : 431
    • OPD No : 19326
    Pradhana Vedana
    c/o
    • Back pain at lumbosaccral region
    • Pain radiating down both legs
    Anubandha vedana
    • Pain increases on walking, climbing, getting up from bed.
    H/O Present illness
    • Patient was apparently alright 2 months before.
    • Had a fall from bullock cart.
    • Injury to back.
    • Mild pain initially.
    • Patient continued doing farming.
    • Pain increased gradually.
    • Patient also had jwara, now subsided.
    • Patient took conservative treatment at local hospital in
    Shiggavi, got temporary relief.
    • Patient came to our hospital for further treatment.
    Personal history
    • Diet : Mixed (Eggetarian)
    • Addiction : Tobacco
    • Sleep : Normal
    • Occupation : Farmer
    • Bowel Habits : Normal
    • Micturition : 4-5 times/day
    ASTHAVIDHA PARIKSHA :

    • Nadi : 70/min
    • Jiwha : Alipta
    • Mala : Prakruta
    • Mutra : 4-5 time/day
    • Shabdha : Prakruta
    • Sparsha : Prakruta
    • Drikha : Prakruta
    • Akruti : Madhyama
    DASHAVIDHA PARIKSHA :
    • Prakruti : Vata kaphaja
    • Vikruti : Dosha- Vata
    Dushya- Rakta, Mamsa, Snayu
    • Sara : Madhyama
    • Samhanan : Madhyama
    • Pramana : Sama
    • Satmya : Madhyama
    • Satva : Madhyama
    • Abhyavaran Shakti : Madhyama
    • Jarana Shakti : Madhyama
    • Vyayamshakti : Pravara
    • Vaya : Madhyama
    GENERAL EXAMINATION :
    • Built : Moderate
    • Gait : Affected
    • Clubbing : Absent
    • Cyanosis : Absent
    • Icterus : Absent
    • Pallor : Absent
    • Edema : Absent
    • Lymphadenopathy : Absent
    VITAL SIGNS :

    • Pulse rate : 70/min


    • Respiratory Rate : 14/min
    • Blood Pressure : 130/90 mm of Hg
    SYSTEMIC EXAMINATION :

    • Respiratory System
    B/L- NVBS, No added sounds
    • Cardiovascular System
    S1, S2 (+)
    • Gastro Intestinal System
    PA-soft, non tender, no organomegaly,
    BS (+)
    TONE
    • Tone – lower extremity
    (passive range of motion, flexion and extension at knee and
    ankle)
    STRENGTH
    Strength – lower extremity (tested from proximal to distal part)
    • L2-hip flexion
    • L3-knee extension
    • L4-knee flexion
    • L5-ankle dorsiflexion
    • S1-ankle planter flexion
    Grading:
    • 0-no contraction
    • 1-slight contraction, no movement
    • 2-full range of motion without gravity
    • 3-full range of motion with gravity
    • 4-full range of motion, some resistance
    • 5-full range of motion, full resistance
    Stretch or Deep Tendon Reflexes (DTR’s)

    (using knee hammer- produces stretch to the muscle that results


    in a reflex contraction of the muscle)
    • Patellar or Knee – L2-4
    • Ankle – S1-2
    Grading DTR’s
    • 0-absent
    • 1-decreased but present
    • 2-normal
    • 3-brisk and excessive
    • 4-with clonus
    INVESTIGATIONS
    Patient does not have any investigative reports with
    him.
    DIFFERENTIAL DIAGNOSIS :
    • Katishoola
    Final Diagnosis
    • Gridhrasi
    Definition:
    • “Vikruta vatajanito asaadharana vyadhihi vatavyadhihi”
    • “Vatena janito vyadhihi vata vyadhihi”
    Nidana
    “Rukshasheetalpa laghvanna vyavaayaati prajaagaraihi |
    Vishamaadupacharaccha
    Doshasruk sravanaadati…………………………….
    Marmabhighaatatgajoshtra ashvasheeghrayaana
    aapatasamnaha ||” (Ch.Chi 28/15-17)
    Samprapti
    Vata prakopaka nidana sevana

    Vikruta vata dosha / vatakapha dosha

    Avarana of vata in dhamani, sira etc

    Rasa dushti Rakta dushti Mamsa dushti

    Gridhrasi
    Samprapti Ghataka
    • Dosha: Vata
    • Dushya: Rakta, Asthi, mamsa, snayu
    • Agni: Jatharagni, Dhatwagni
    • Ama: Jatharagni and dhatwagni mandyajanya ama
    • Srotas: Rasavaha, Raktavaha, mamsavaha, asthivaha
    • Sroto Dushti Lakshana: sanga
    • Udbhava Sthana: Pakwashaya
    • Sanchara Sthana: Rasayani
    • Vyakta Sthana: Adha shakha
    • Adhishthana: Kati, uru, janu, jangha,pada
    • Roga marga: Madhyama
    • Roga swabhava: Ashukari
    Different types of Gridhrasi
    • Vataja
    • Vatakaphaja
    Sciatica
    Definition : Sciatica is characterised by a sharp shooting pain
    running down back of thigh. Movement of limb generally
    intensifies the suffering. Sciatica arises due to compression of
    sciatica nerve or it’s roots.
    Causes
    -Vertebral canal causes: prolapsed disc
    -Vertebral Foramen causes : Tumour of nerve root,
    spondylolisthesis
    -Pelvic causes : Compression by abcess, Infection of prostate/
    female genital tract.
    -Other : fibrositis, neurofibroma.
    Sign and symptoms
    • Pain starts in back and radiates down towards both legs or one leg.
    • SLR if positive is diagnosis of sciatica.
    • Lasegue’s sign is present in all cases.
    TREATMENT
    CHIKITSA SUTRA :
    • “अनतरा कण्डरा गुल्फ़ो सिरा बस्त्यग्नि कर्म च ॥
    (च.चि ८)
    Shodana chikitasa
    • Siravyadha
    • Snehana
    • Swedana
    • Basti
    • Agnikarma
    Shamana chikitasa
    Rasa
    • Sameerapannaga Rasa
    • Brihatvata Chintamani
    • Vatagajankusha Rasa
    • Agnitundi Vati

    Churna
    • Ashwagandha churna
    • Panchakola churna
    • Shadadharana churna
    • Shankha Bhasma
    • Ajamodadi Churna
    Kwatha
    • Ashwagandharishta
    • Dashamoolarishta
    Taila
    • Bala taila
    • Ashwagandha taila
    • Narayana taila
    • Prasarni taila
    • Masha taila
    Grita
    • Dashmooladhya ghrita
    • Ashwagandha ghrita
    • Chitrakadhya ghrita
    Guggulu
    • Yogaraja guggulu
    • Mahayogaraja guggulu
    • Amrita guggulu
    Asava/arista
    • Dashmoolarista
    • Balarista
    • Ashwagandharista
    Rasayana yoga
    • Brahama rasayana
    • Chyavanaprasha
    • Amlakyadi rasayana
    • Hritakyadi rasayana
    • Shiva gutika
    • shilajatu
    RECENT TREATMENT IN
    HOSPITAL
    • Valuka Sweda
    • Sarvanga abhyanga with Kottamchikkadi taila
    • Sarvanga Swedana
    • Patrapinda Sweda
    Shamana Chikitsa
    • Tab Trayodashanga Guggulu DS Bd
    • Cap Orthofit Bd
    • Tab Painamruth Bd
    • Cap Xtragrapes Bd
    • Tab Gokshuradi Guggulu DS Bd
    • Tab Gandharvahastadi Kashaya Bd
    • Yogaraja Guggulu Bd
    PATHYA-APATHYA
    PATHYA
    • Sarpi, Taila, Kilaat, Dadhi, Godhuma, Maasha, (1yrs old),
    Shashti Shali, Kulatha, Kukuta Mamsa, Shigru, Vartaku,
    Lashuna, Dadima, Pakvatala, Jambira, Badara, Draksha,
    Naranga, Dugdha, Narikela, Eranda Taila, Tambula,
    Matsyandika, Etc.
    APATHYA
    • Chinta, Jagrana, Vegadharana, Atishrama, Atichankramana
    Navadhanya, Yava, Rajamasha, Mudga, Jambu, Kramuka,
    Karvelaka, Shitajala, Madhu,
    THANK YOU

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