Case presentation of Ekakustha

Dr Payjani Dubey
nd
P G scholar 2 year
Dept of Kayachikitsa
Guided by- Dr Nikunj Thakkar
Dr Shailesh v.Deshpande
► Name - xyz
► Age – 50
► Sex – Male
► Religion - hindu
► Marital status -married
► Occupation – farmer
► Date of admission -11/3/19
► Date of discharge – 4/4/19
► Ward-201 kc male ward
► Consultant doctor-Dr nikunj
► O.p.d no -19007329
► I.P.D No - 190921
 Pradhan vedna

► c/o circular patches reddish whitish in

colour over both legs, lower abdomen,
back and scalp since 3-4 days with itching
in both legs.
Anubandha vedna

► C/O pain in both legs.

 Vedana vruttanta

► Patient came in parul ayurvedic hospital with the

complaint of
► Multiple papules with itching and watery discharge
since 3 year which gradually spread as large patches,
► After that multiple circular patches and reddish
whitish colour over both hand and both legs lower
abdomen and back since 3-4 days with itching .
POORVA VYADHI VRUTTANTA

► No history of Diabetes Mellitus, Hypertension,

Tuberculosis, Asthma and any other systemic disease.
Treatment history
► Not any specific history found.
 Vyaktika vruttanta

► Diet- veg
► Appetite-normal
► Bowel- irregular
► Urine frequency- 5-6 times /day
► Sleep- disturbed
► Habit-tea 2 times a day
 General physical examination

► General Condition : Fair.

► Built : Moderately built .
► Nourishment : Moderately nourished
► Pallor : present
► Oedema : absent
► Nails : No clubbing
► Cyanosis : Absent.
► Icterus : Absent.
► Lymphadenopathy : Absent.
► BP : 130/70 mmHg
► Pulse : 98 bpm
► RR : 18/ min
► Height : 156 cms
► Weight : 90 kg
Rogi pariksha

► Prakruti – vatakaphaja
► Sara - madhayam
► Sanhanan- madhayam
► Praman -156 cm wt- 90 kg
► Satmaya - madhyam
► Satva -Madhyam
► Aahar shakti - madhyam
► Vyayam shakti -madhyam
► Vaya - madhyam
► Jihwa - samaavastha
 SYSTEMIC
EXAMINATION
 PER ABDOMINAL EXAMINATION
► Inspection : Umbilicus centrally placed
► : mild distension
► : No any scar marks
► : No stretched marks
► Palpitation : Soft and non- tenderness
► : No organomegaly
► Percussion :
► Auscultation : Bowel sound heard
Respiratory examination
► Inspection : Shape of chest B/L symmetrical
► Respiratory rate 18/min
► Palpitation : Trachea – centrally placed
► no tenderness
► Auscultation : Normal Vesicular breath sound heard.
 Cardiovascular system

► Inspection- No scar, no pedal oedema present

► Palpation : Apex beat felt at 5th intercostal space 9 cm from the mid
► sternal line.
► Percussion : Defined area of cardiac dullness.
► Auscultation : S1 S2 Heard
► No murmurs
► No added sounds heard
Central nervous system

► Patient is conscious, well oriented.

Nidana panchaka
► Nidana- viruddhaahara, mandagni, ati vyayam after bhojana, chinta, shoka.
► Poorvarupa – not known
► Roopa – Raktavarna twak ,kandu
► Upashaya - After applying oil
► Anupshaya – at sunlight
► Samprapti ghataka
► Dosha- kapha Pradhan tridosha
► Dushya- Twak, rakta, mamsa, lasika
► Srotas- rasa,rakta, annavaha
► Srotodushti – sanga
► Agni – mandagni
► Ama- Samavastha
► Udhbhava sthana – aamashaya
► Vyakta sthana- sarvasharir twak
► Rogamarga – bahya
► Vyadhi svabhava – chirakari
► Sadhya asadhyata- krichra sadhya
 Samprapti
► Nidana sevana Tridosha Prakopa

spreaded in triayak gata shiras

Twaka, Rakta,Mamsa, lashika

Dosha- Dushya takes Sthanshanshraya in Twaka

Kushtha
Differential diagnosis
► Dadru – kandu raga pidika.
Chikitsa sutra
 Chikitsa vruttant
► Agnitundi vati -250 mg tab before food thrice in a day with water
► Chitrakadi vati -125 mg tab after food with water
► Avipattikar churna -5 gm tsf at night with water
► Kiashor guggulu 250 mg tab thrice in a day with water
► Marichayadi tail –l/a over skin
 On discharge medication

► Haridrakhand churna
► Yastimadhu churna mixed in equal proportion 5 gm tsf 2 times a day with
water
► Guduchi churna
► Arogyavardhani vati -250 mg tab bd with water
► Manjisthadi ghan vati 250 mg tab thrice in a day with water
► Panchtikta ghrut guggulu 250 mg tab thrice in a day with water
► Cutisora oil –l/a
 Sodhan chikitsa vaman
Panchtikta Ghrutpan was given 15/3/19 to 20/3/19
1 day-30 ml
2 day 70 ml
3 day 110 ml
4 day 130 ml
5 day 130 ml
20/3/19 abhyanga with marichyadi tail and vashpa peti swedana
Parisheka with panchvalkala kwath
22/3/19 vaman
7 vegas of vaman
Antiki Pariksha – Kaphanta
Laingiki – shiro gourav
 Sodhan chikitsa virechana
► 25/3/19 to 30/3/19 panchtiktta ghruta was given
► 1 day 30 ml
► 2 day 60 ml
► 3 day 90 ml
► 4 day 120 ml
► 5 day 150 ml
► 6 day 180 ml
► 7 day 210 ml
► 8 day abhyanga with marichyadai tail
► 30/3/19 raktmokshana
► 1/4/19 – virechana with truvruta lehya and 100 ml triphala kwath.
► 15 vegas of virechana
► Antiki – Pittanta, Laingiki – alpa gouravta
 Probable mode of action
Drug name Guna dharma Effect on kustha roga

Agnitundi vati Agni Dipan kaphahara It improves mandagni and

effective for dosha pachana

Chitrakadi vati Dipan, Pachan Beneficial for mandagni,dipan

pachan

Aviapattikar churna Vibandhhara Improves bowel movement,

Dosha Shodhana

Marichayadi tail Kustha rogadhikar Suppresses itching all over body

Drug name Guna dharma Effect on patient

Kaishore guggulu Kustha rogadhikar Useful for rakta shodhana and

improves twak vikar
Haridra khanda Shitpitta,udard.koth Useful in itching

Guduchi churna Pittakapha shamana Useful for rakta shodhana and

improves twak vikar
Arogyavardhani vati Kustha rodhikar Useful in itching

Panchatikta ghrut guggulu Kustha rogadhikar Useful for dosha pachan and
vyadhi shaman because of tikta
dravyas

Manjisthadi ghan vati Kustha roadhikar Useful for rakta shodhana and
improves twak vikar