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aamvaat case presentation
1. RAJESH.K
I I YEAR PG SCHOLAR
DEPT., OF PG STUDIES IN KAYACHIKITSA
SKAMCH&RC, BANGALORE
1
CASE DISCUSSION
2. 2
Name : Mrs. mangala
Age : 36 Years
Sex : female
Religion : Hindu
Socio economic status : middle class
Marital status : Married
Education status : MBA
Occupation : house wife
Date of admission :24/07/15
Date of discharge :
3. 3
Ward : female General Ward
Source of history : Patient
Case taken on : 29/07/15
Consultant doctor : Dr. Byresh.A
O.P No : 16678
I.P. No : 2867/15
Address : # 12 ,3rd cross kallappa
compound,AD halli
Bangalore - 79
5. VEDANA VRUTTANTA
5
Patient was apparently normal 45 days ago. She had an
attack of raised body temperature along with chills
tiredness, & body ache. The same day she consulted a
physician and was prescribed with medication(details of
which are not available). After taking that medication
she found relief in fever (chills, tiredness & body ache
persisted) . After 6-7 days she started to get pain in her
both ankle joints which was localised in nature. Pain got
aggravated during early morning and used to resolve as
6. 6
the day progresses. Gradually she developed pain in
her both knee joints ; with morning stiffness persisting
nearly 2-3hrs.There was no complaints of crepitus in
joints and pain was always localised in nature. On
22/6/2015 she consulted SKAMCH & RC OPD and
was prescribed with medications. She started to get
pain in her both wrist joints, inter phallengeal joints;
disturbing her daily activities. So on her consulting
physician’s advice she got admitted in FGW on
24/7/15.
8. POORVA VYADHI VRUTTANTA
8
Patient is not a k/c/o Diabetes Mellitus,
Hypertension, Tuberculosis, Rheumatoid
Arthritis.
9. TREATMENT HISTORY
9
On 22/6/15
Amruthottharam kashayam
3tsp tonic + 9tsp water @7am-6pm
Simhanada guggulu 2-2-2 A/F .
Kottam chukkadi taila
Warm & apply to joints daily
T . Amla parimala 1-1-1 A/F
10. 10
ON 29/6/15
Tab .kaishora guggulu
Kokilaksha kashayam
2tab powdered + 3tsp of tonic+9 tsp of water @
7Am & 6pm.
pinda taila warm and apply to legs twice daily.
11. KAUTAMBIKA VRUTTANTA
11
Father and mother are suffering from Diabetes
mellitus.
Father-in-law also had fever along with her & got
subsided after taking medications .
Patient is married and has one son aged 10 years.
12. VYAKTIKA VRUTTANTA
12
Diet : Mixed (non- veg once in a week)
Appetite : good.
Bowel : once in a day , regular , complete evacuation.
Bladder : 4 to 5 times/day night.
Sleep : sound .
Habit : Tea – 5 to 6 per/day.
16. PER ABDOMEN EXAMINATION
16
INSPECTION
Shape – Scaphoid
Umbilicus inverted
No visible peristalsis, No scars.
No redness
PALPATION
Soft, no organomegaly.
Tenderness at right and left lumbar region
18. RESPIRATORY SYSTEM
18
INSPECTION
Shape of chest - Bilaterally symmetrical
PALPATION
Trachea - Centrally placed
Tactile Vocal Fremitus -Normal
PERCUSSION
Resonant sounds heard except the cardiac dullness.
AUSCULTATION
Normal Vesicular Breath Sounds heard
19. CARDIO VASCULAR SYSTEM
19
INSPECTION - No scar, No swelling .
PALPATION - Non tender, Apex Beat felt at 5th
intercostal space 9 cm from the mid sternal line.
PERCUSSION - Defined Area of cardiac dullness.
AUSCULTATION - S1 and S2 heard.
No added sounds heard.
No murmurs heard.
20. LOCOMOTOR SYSTEM EXAMINATION
20
Joints Tenderness Warmth Swelling Measurments Range of movements.
Ankle
joints &
foot
Rt- +++
Lt- +++
Rt-
present
Lt-
present
Rt- present
Lt- present
Rt – 11.8 inch
Lt – 9.4 inch
Flexion-Rt- painful, Lt-
painful
Extension-Rt- painful, Lt-
painful
Inversion – Rt- painful, Lt-
painful
Eversion- both normal
Knee
joints
Rt- ++
Lt- ++
Rt-
present
Lt-
present
Rt- present
Lt- present
Rt – 14.8 inch
Lt – 14.1 inch
Flexion- both normal
Extension-both normal
Internal rotation- both
painful
External rotation- both
painful
21. 21
Joints Tenderness Warmth Swelling Range of movements
Hip joints Rt- ++
Lt- ++
Rt-
present
Lt-
present
Rt- present
Lt- present
Flexion- both painful
Extension- both painful
Abduction-both painful,
Adduction- both Normal
Int.Rotation- both painful
Ext Rotation- both normal
Thumbs Rt- ++
Lt- ++
Rt-
present
Lt-
present
Rt- present
Lt- present
Flexion- both painful
Extension-both normal
Abduction- both normal
Adduction- both normal
Opposition- Rt-normal, Lt- painful
22. 22
Joints Tenderness Warmth Swelling Measurments Range of movements
Wrist joints Rt- +++
Lt- +++
Rt-
present
Lt-
present
Rt-
Present
Lt- Absent
Rt – 7.5 inch
Lt – 6.9 inch
Flexion- painful
Extension-painful
Adduction-painful
Abduction- painful
Hand grip – Normal
Elbow
joints
Rt- ++
Lt- ++
Rt-
present
Lt-
present
Rt-
Present
Lt- Absent
Rt – 10 inch
Lt – 9.5 inch
Flexion- painful
Extension-normal
Supination- normal
Pronation- normal
23. 23
B/L
Joints
Tenderness Warmth Swelling Measurements Range of movements
Shoulder
joints
Rt- ++
Lt- ++
Present
on both
Rt - Present
Lt – Absent
Rt – 14 inch
Lt – 12.8 inch
Flexion- Rt- upto 90
degree, Lt- upto 50 degree,
painful
Extension- both upto 20
degree, painful
Int Rotation- both painful.
Ext Rotation- not possible
in both.
Neck /
cervical
joint
- Present Absent Flexion- normal
Extension- painful
Rotation- Painful
Lateral Bending- painful
24. SUMMARY OF LMS EXAMINATION
24
Pain in all the joints
Tenderness & warmth in all the joints.
29. 29
Nidana sevana Agnimandya + Vata Dusti
Ama utpatti
Pravruddha ama propelled by vitiated vayu
Undergoes Vidhagdha and Results in Tridosha
Prakopa and Enters Dhamani
30. Lodges in sandhi, amashaya causing srotoavarodha
Produces symptoms like Angamarda, gourava, dourbalya,
jwara, shotha, shoola, stabdhata
Amavata
30
31. 31
POORVAROOPA -
ROOPA
Pain
Sotha in sandhi .
Pricking type of pain in joints .
Aruchi, agnimandya, gaurava, anaha,
Stabdhata in sandhis.
Jwara.
UPASAYA :
ANUPSAYA: .