SlideShare a Scribd company logo
1 of 15
Syndicate JC Presentation
Mutrashmari (Urolithiasis)
Presenter-
Dr. Twinkle Joshi
Introduction
• Mootrashmari is a disease of mootravah srotas.
• It is considered as one amongst Ashtamahagad (eight most deadly
diseases).
Charak chikitsa 26
Sushrut Nidan 3, Chikitsa 7
Ashtang Hridaya Nidan 9, Chikitsa 11
Madhav Nidan 22
Bhav prakash 37
• “चतस्रोऽश्मर्यो भवन्ति; श्लेष्माधिष्ठानााः; तद्यथा
श्लेष्मणा, वातेन, धित्तेन, शुक्र
े ण चेधत ||” Su. Ni. 3/3
•Acharya Susrutha has described 4 types - Vataja, Pittaja, Kaphaja and
Shukraja.
Nidana and Samprapti
• “तत्रासंशोिनशीलस्यािथ्यकारिणाःप्रक
ु धिताः श्लेष्मा मूत्रस्पृक्ोऽनुप्रधव्य बन्ति
मश्मिींजनर्यधत ” Su. Ni 3/4
• Improper Shodhana
• Intake of unwholesome diet
• Indulgence in excessive kapha vardhak ahara and vihara
• “धवशोषर्येद्बन्तिगतं सशुक्र
ं मूत्रं सधित्तं िवनाः कफ
ं वा|
र्यदा तदाऽश्मर्युुिजार्यते तु क्रमेण धित्तेन्तिव िोचना गोाः” Cha Chi 26/36
• When the aggravated Vata dries up the semen, urine, Pitta and Kapha located
in the urinary bladder, then gradually stones are formed there, as Gorochana
(gall stone) is formed in bile inside the Gall- Bladder of cattle.
Samprapti Ghatak
Dosha Kapha pradhan tridosha
Dushya Mutra
Srotas Mutravaha srotas
Adhishthan Basti
Srotodushti Sanga
Sadhyaasadhyata Krichrasadhya
Purvarupa
• “तासाां पूर्वरूपाणि-
ज्विो बन्तििीडािोचकौ मूत्रक
पृक च्छ्
रं बन्तिधशिोमुष्कशेफसां वेदना क
पृक च्छ्
र ावसादो
बिगन्तित्वं मूत्रस्येधत ||५||
यथास्वर्ेदनार्िं दुष्टां सान्द्रमथाणर्लम् |
पूर्वरूपेऽश्मनः क
ृ च्छ्
र ान्मूत्रां सृजणत मानर्ःll” Su. Ni. 3/6
• Pain in bladder
• Fever
• Pain in scrotum, penis
• Anorexia
• Dysuria
• Smell of urine similar to goat
Samanya lakshan
• “नाधभबन्तिसेवनीमेहनेिन्यतमन्तिन् मेहतो वेदना मूत्रिािासङ्गाः सरुधििमूत्र
ता मूत्रधवधकिणं गोमेदकप्रकाशमत्याधवलं सधसकतं धवसपृकजधत; िावनलङ्घनप्ल
वनिपृकष्ठर्यानोष्णाध्वगमनैश्चास्य वेदना भवन्ति ” Su. Ni. 3/7
• Severe pain in region of umbilicus, bladder
• Pain in bladder
• Obstruction of urine
• Hematuria
• Resembles gomeda gem
• Pain while running, swimming
Types of Ashmari
• Vattaj ashmari –
• पीड्यमानो दन्तान् खादणत – grinding of teeth
• नाण ां पीडयणत – presses umbilical region
• र्ातमूत्रपुरीषाणि क
ृ च्छ्
रे ि चास्य मेहतो णनःसरन्तन्त – dysuria and painful
defecation
• श्यार्ा परुषा णर्षमा खरा कदम्बिुष्पवत्कण्टकाधचता र्णत – black, irregular,
rough calculus
• Pittaj Ashmari-
• दह्यते पच्यत इर् बन्तिरुष्णर्ातश्च र्णत – burning, sucking pain in bladder
• सरक्ता - hemeturia
• पीतार् ासा क
ृ ष्णा भल्लातकान्तथथप्रधतमा मिुवणाु वा र्णत – reddish –yellow
calculus
• Kaphaj Ashmari –
• द्दाल्यते ण द्यते णनिुद्यत इर् - crushing, pricking pain
• श्वेता णिग्धा महती – white, large calculus
• क
ु क्क
ु टाण्डप्रतीकाशा मिूकिुष्पवणाु र्ा र्णत
• Shukraj Ashmari -
• बन्तिर्ेदनाां र्ृषियोश्च - pain in bladder and scrotum
• श्वयथुमापादयणत swelling in scrotum
• पीणडतमात्रे च तन्तिन्नेर् प्रदेशे प्रणर्लयमापद्यते - liquefies on squeezing
• शक
व रा णसकता मेहो िाख्योऽश्मररर्ैक
ृ तम् - sharkara, sikta and
bhasmameha(mutra shukra) are also types of ashmari
Upadrava
• “दौबुल्यं सदनं का्यं क
ु धिशूलमिोचकम् |
िाण्डुत्वमुष्णवातं च तपृकष्णां हृत्पीडनं वधमम् ll” Su. Ni. 3/17
• Weakness and heaviness in body,
• emaciation ,
• pain in abdomen,
• anorexia,
• anaemia,
• polydypsia and vomiting.
Formation of Ashmari
• “आमुखात्सधलले न्यिाः िार्श्वेभ्याः िूर्युते नवाः ||२३||
घटो र्यथा तथा धवन्ति बन्तिमूुत्रेण िूर्युते |२४|”
• While explaining the formation of ashmari , Acharya Sushruta
narrates that, the manner in which even clean water collected
in pot precipitates in the bottom after sometime; similarly the
process of hardening of ashmari occurs with the kshara of
kapha dosha present in mutravaha strotas .
Chikitsa
• औषधैिरुिः साध्यः प्रर्ृद्धश्छे दमहवणत ||३||
तस्य पूर्ेषु रूपेषु िेहाणदक्रम इष्यते | Su. Chi 7/2
• घृतैः क्षारैः कषायैश्च क्षीरैः सोत्तरबन्तिण ः |
यणद नोपशमां गच्छ्े च्छ्े दित्रोत्तरो णर्णधः ll
• अणक्रयायाां ध्रुर्ो मृत्ुः णक्रयायाां सांशयो र्ेत् |
तिादापृच्छ्य कतवव्यमीश्वरां साधुकाररिा ll
Urolithiasis
• Refers to presence of stones within the kidneys.
• Stone formation occurs when there’s an excess of crystal-forming
substances that can’t be dissolved in the urine.
• High urinary excretion of calcium, oxalate, uric acid can promote stone
formation, whereas low excretion of citrate, has a protective effect.
Predisposing factors-
Environmental & Dietary Causes
• Low Urine volumes
• Diet : High protein, high sodium
• High sodium and oxalate excretion
• Low citrate excretion (hypocitraturia)
Acquired causes
• Hypercalcaemia
• Ileal disease
• Renal tubular acidosis type I
• Familial cysteinuria
• Primary hyperoxularia
Sites of Calculus Obstruction
•At the brim of lesser pelvis
•Opening of ureter into the urinary bladder
•Pelvi-ureter junction
Types of Kidney Stones
•Calcium oxalate stones - most common
•Cause – hypercalciuria and hyperoxaluria due to hyperparathyroidism. renal
tubular acidosis ,etc.
•Struvite stones aka infectious stones( associated with UTIs) especially those
caused by urea-splitting organisms Klebsiella , Staphylococcus, etc.
•Uric acid stones – hyperuricosuria due to high-protein diet , gout,
inflammatory bowel disease
Diagnosis and Management
• X-rays - calcium stones
• Non-contrast CT scan - uric acid (radiolucent) , cystine stones
• USG
• Management –
• Dietary modification and increase fluid intake
• Small stones ( 5-10 mm) without complications expectant
management using tamsulosin
• Larger stones - extracorporeal shock wave lithotripsy (ESWL)
shock waves to fragment the stone, breaking it into smaller pieces that
are excreted in the urine. It can only fragment low density stones, so
hard stones like cysteine or calcium oxalate can’t be treated with
lithotripsy.
• Percutaneous nephrolithotomy (PCNL) >2cm in size

More Related Content

What's hot

Mutrakricchra
MutrakricchraMutrakricchra
Mutrakricchravdsriram
 
panchakarma in tamaka swasa
panchakarma in tamaka swasapanchakarma in tamaka swasa
panchakarma in tamaka swasaSaurav Verma
 
Critical view on nidhana panchaka in understanding of mutra ashmari
Critical view on nidhana panchaka in understanding of mutra ashmariCritical view on nidhana panchaka in understanding of mutra ashmari
Critical view on nidhana panchaka in understanding of mutra ashmariSDM AYURVEDA COLLEGE HASSAN
 
Amavata by Dr.Swatika Sharma
Amavata by Dr.Swatika SharmaAmavata by Dr.Swatika Sharma
Amavata by Dr.Swatika SharmaDr.Swatika Sharma
 
Paschat karma of vamana
Paschat karma of vamanaPaschat karma of vamana
Paschat karma of vamanaAkshay Shetty
 
Dravya prayoga in pandu and kamala
Dravya prayoga in pandu and kamalaDravya prayoga in pandu and kamala
Dravya prayoga in pandu and kamaladrdev1
 
Concept of Grahani.pptx
Concept of Grahani.pptxConcept of Grahani.pptx
Concept of Grahani.pptxe-MAP
 
Comparative Study on Samprapti of Vatarakta
Comparative Study on Samprapti of Vatarakta Comparative Study on Samprapti of Vatarakta
Comparative Study on Samprapti of Vatarakta AyurvedaSamhithaandS
 
Tamaka swasa re edited
Tamaka swasa re editedTamaka swasa re edited
Tamaka swasa re editedKeshaw Gautham
 
Grahni an approach towards diagnosis and management of the
Grahni an approach towards diagnosis and management of theGrahni an approach towards diagnosis and management of the
Grahni an approach towards diagnosis and management of theDrBakhtyar Asharafi
 
Yapana basti ,Yuktarata Basti & Siddha Basti
Yapana basti ,Yuktarata Basti & Siddha BastiYapana basti ,Yuktarata Basti & Siddha Basti
Yapana basti ,Yuktarata Basti & Siddha BastiAkshay Shetty
 
Understanding Udararoga w.s.r to Jalodara vis-à-vis Ascites
Understanding Udararoga w.s.r to Jalodara vis-à-vis AscitesUnderstanding Udararoga w.s.r to Jalodara vis-à-vis Ascites
Understanding Udararoga w.s.r to Jalodara vis-à-vis AscitesDr Amritha Edayilliam
 

What's hot (20)

Mutrakricchra
MutrakricchraMutrakricchra
Mutrakricchra
 
panchakarma in tamaka swasa
panchakarma in tamaka swasapanchakarma in tamaka swasa
panchakarma in tamaka swasa
 
Critical view on nidhana panchaka in understanding of mutra ashmari
Critical view on nidhana panchaka in understanding of mutra ashmariCritical view on nidhana panchaka in understanding of mutra ashmari
Critical view on nidhana panchaka in understanding of mutra ashmari
 
Amavata by Dr.Swatika Sharma
Amavata by Dr.Swatika SharmaAmavata by Dr.Swatika Sharma
Amavata by Dr.Swatika Sharma
 
Paschat karma of vamana
Paschat karma of vamanaPaschat karma of vamana
Paschat karma of vamana
 
Kustha
Kustha Kustha
Kustha
 
Role of Panchakarma in Pakshaghata
Role of Panchakarma in PakshaghataRole of Panchakarma in Pakshaghata
Role of Panchakarma in Pakshaghata
 
Pakshaghate virechanam
Pakshaghate virechanamPakshaghate virechanam
Pakshaghate virechanam
 
Dravya prayoga in pandu and kamala
Dravya prayoga in pandu and kamalaDravya prayoga in pandu and kamala
Dravya prayoga in pandu and kamala
 
Sneha in chikitsa
Sneha in chikitsaSneha in chikitsa
Sneha in chikitsa
 
Tamaka swasa
Tamaka swasaTamaka swasa
Tamaka swasa
 
Concept of Grahani.pptx
Concept of Grahani.pptxConcept of Grahani.pptx
Concept of Grahani.pptx
 
Comparative Study on Samprapti of Vatarakta
Comparative Study on Samprapti of Vatarakta Comparative Study on Samprapti of Vatarakta
Comparative Study on Samprapti of Vatarakta
 
Vamanakarma
VamanakarmaVamanakarma
Vamanakarma
 
Tamaka swasa re edited
Tamaka swasa re editedTamaka swasa re edited
Tamaka swasa re edited
 
Grahni an approach towards diagnosis and management of the
Grahni an approach towards diagnosis and management of theGrahni an approach towards diagnosis and management of the
Grahni an approach towards diagnosis and management of the
 
Urusthambha chikitsaa.1
Urusthambha chikitsaa.1Urusthambha chikitsaa.1
Urusthambha chikitsaa.1
 
Virechana karma
Virechana karmaVirechana karma
Virechana karma
 
Yapana basti ,Yuktarata Basti & Siddha Basti
Yapana basti ,Yuktarata Basti & Siddha BastiYapana basti ,Yuktarata Basti & Siddha Basti
Yapana basti ,Yuktarata Basti & Siddha Basti
 
Understanding Udararoga w.s.r to Jalodara vis-à-vis Ascites
Understanding Udararoga w.s.r to Jalodara vis-à-vis AscitesUnderstanding Udararoga w.s.r to Jalodara vis-à-vis Ascites
Understanding Udararoga w.s.r to Jalodara vis-à-vis Ascites
 

Similar to Mutraashmari (Urolithiasis).pptx

Ashmari NIDANA SAMPRAPTI
 Ashmari NIDANA SAMPRAPTI  Ashmari NIDANA SAMPRAPTI
Ashmari NIDANA SAMPRAPTI Prashanth Jain
 
Urinary disorders final
Urinary disorders finalUrinary disorders final
Urinary disorders finaldrsaurabhjpr
 
Chikitsasutra of mutravaha srotas disorders
Chikitsasutra of mutravaha srotas disordersChikitsasutra of mutravaha srotas disorders
Chikitsasutra of mutravaha srotas disordersvdsriram
 
presentation-kidney-stonefinal.pptx
presentation-kidney-stonefinal.pptxpresentation-kidney-stonefinal.pptx
presentation-kidney-stonefinal.pptxMohamadAbusaad
 
Urinary Calculi.pptx
Urinary Calculi.pptxUrinary Calculi.pptx
Urinary Calculi.pptxPrativa Kafle
 
Mootrashmari wsr to urolithiasis
Mootrashmari wsr to urolithiasisMootrashmari wsr to urolithiasis
Mootrashmari wsr to urolithiasisKamal Sharma
 
Kidney Stones Causes, Symptoms and treatment options.pptx
Kidney Stones Causes, Symptoms and treatment options.pptxKidney Stones Causes, Symptoms and treatment options.pptx
Kidney Stones Causes, Symptoms and treatment options.pptxSaket Narnoli
 
Urolithiasis (kidney stones)
Urolithiasis (kidney stones)Urolithiasis (kidney stones)
Urolithiasis (kidney stones)Ivan Kato
 
Sandhivata (osteoarthritis)
Sandhivata (osteoarthritis)Sandhivata (osteoarthritis)
Sandhivata (osteoarthritis)vdsriram
 
presentation-kidney-stonefinal-150522095756-lva1-app6891.pdf
presentation-kidney-stonefinal-150522095756-lva1-app6891.pdfpresentation-kidney-stonefinal-150522095756-lva1-app6891.pdf
presentation-kidney-stonefinal-150522095756-lva1-app6891.pdfdeborayilma
 

Similar to Mutraashmari (Urolithiasis).pptx (20)

Nephrolithiasis ashmari
Nephrolithiasis   ashmariNephrolithiasis   ashmari
Nephrolithiasis ashmari
 
renal stone.pdf
renal stone.pdfrenal stone.pdf
renal stone.pdf
 
Ashmari NIDANA SAMPRAPTI
 Ashmari NIDANA SAMPRAPTI  Ashmari NIDANA SAMPRAPTI
Ashmari NIDANA SAMPRAPTI
 
Ostearthrosis knee
Ostearthrosis kneeOstearthrosis knee
Ostearthrosis knee
 
Ki̇dney stone
Ki̇dney stoneKi̇dney stone
Ki̇dney stone
 
Urinary disorders final
Urinary disorders finalUrinary disorders final
Urinary disorders final
 
Chikitsasutra of mutravaha srotas disorders
Chikitsasutra of mutravaha srotas disordersChikitsasutra of mutravaha srotas disorders
Chikitsasutra of mutravaha srotas disorders
 
Renal calculi
Renal calculiRenal calculi
Renal calculi
 
presentation-kidney-stonefinal.pptx
presentation-kidney-stonefinal.pptxpresentation-kidney-stonefinal.pptx
presentation-kidney-stonefinal.pptx
 
Urinary Calculi.pptx
Urinary Calculi.pptxUrinary Calculi.pptx
Urinary Calculi.pptx
 
Mootrashmari wsr to urolithiasis
Mootrashmari wsr to urolithiasisMootrashmari wsr to urolithiasis
Mootrashmari wsr to urolithiasis
 
Kidney Stones Causes, Symptoms and treatment options.pptx
Kidney Stones Causes, Symptoms and treatment options.pptxKidney Stones Causes, Symptoms and treatment options.pptx
Kidney Stones Causes, Symptoms and treatment options.pptx
 
Jaraa chikitsa healthy old age-ayurvedic view
Jaraa chikitsa healthy old age-ayurvedic viewJaraa chikitsa healthy old age-ayurvedic view
Jaraa chikitsa healthy old age-ayurvedic view
 
Renal stones.pptx
Renal stones.pptxRenal stones.pptx
Renal stones.pptx
 
UROLITHIASIS.pptx
UROLITHIASIS.pptxUROLITHIASIS.pptx
UROLITHIASIS.pptx
 
Urolithiasis (kidney stones)
Urolithiasis (kidney stones)Urolithiasis (kidney stones)
Urolithiasis (kidney stones)
 
Sandhivata (osteoarthritis)
Sandhivata (osteoarthritis)Sandhivata (osteoarthritis)
Sandhivata (osteoarthritis)
 
Renal stone.pptx
Renal stone.pptxRenal stone.pptx
Renal stone.pptx
 
renal and bladder calculi
renal and bladder calculirenal and bladder calculi
renal and bladder calculi
 
presentation-kidney-stonefinal-150522095756-lva1-app6891.pdf
presentation-kidney-stonefinal-150522095756-lva1-app6891.pdfpresentation-kidney-stonefinal-150522095756-lva1-app6891.pdf
presentation-kidney-stonefinal-150522095756-lva1-app6891.pdf
 

More from TwinkleJoshi4

More from TwinkleJoshi4 (15)

Shatkriya Kaala.pptx
Shatkriya Kaala.pptxShatkriya Kaala.pptx
Shatkriya Kaala.pptx
 
Peptic Ulcer Disease.pptx
Peptic Ulcer Disease.pptxPeptic Ulcer Disease.pptx
Peptic Ulcer Disease.pptx
 
Plantar fasciitis.pptx
Plantar fasciitis.pptxPlantar fasciitis.pptx
Plantar fasciitis.pptx
 
Leukemia.pptx
Leukemia.pptxLeukemia.pptx
Leukemia.pptx
 
PLAGUE
 PLAGUE PLAGUE
PLAGUE
 
YOGA
YOGAYOGA
YOGA
 
Role of yoga in physical mental health.pptx
Role of yoga in physical mental health.pptxRole of yoga in physical mental health.pptx
Role of yoga in physical mental health.pptx
 
Yoga in ayurveda.pptx
Yoga in ayurveda.pptxYoga in ayurveda.pptx
Yoga in ayurveda.pptx
 
Chickengunya.pptx
Chickengunya.pptxChickengunya.pptx
Chickengunya.pptx
 
Water seal drainage
Water seal drainageWater seal drainage
Water seal drainage
 
Color doppler
Color dopplerColor doppler
Color doppler
 
Non parametric tests
Non parametric testsNon parametric tests
Non parametric tests
 
Electromyography
ElectromyographyElectromyography
Electromyography
 
Shatkriya kala
Shatkriya kalaShatkriya kala
Shatkriya kala
 
Bronchial asthma ppt
Bronchial asthma pptBronchial asthma ppt
Bronchial asthma ppt
 

Recently uploaded

call girls in Dwarka Sector 21 Metro DELHI 🔝 >༒9540349809 🔝 genuine Escort Se...
call girls in Dwarka Sector 21 Metro DELHI 🔝 >༒9540349809 🔝 genuine Escort Se...call girls in Dwarka Sector 21 Metro DELHI 🔝 >༒9540349809 🔝 genuine Escort Se...
call girls in Dwarka Sector 21 Metro DELHI 🔝 >༒9540349809 🔝 genuine Escort Se...saminamagar
 
Basic principles involved in the traditional systems of medicine PDF.pdf
Basic principles involved in the traditional systems of medicine PDF.pdfBasic principles involved in the traditional systems of medicine PDF.pdf
Basic principles involved in the traditional systems of medicine PDF.pdfDivya Kanojiya
 
LUNG TUMORS AND ITS CLASSIFICATIONS.pdf
LUNG TUMORS AND ITS  CLASSIFICATIONS.pdfLUNG TUMORS AND ITS  CLASSIFICATIONS.pdf
LUNG TUMORS AND ITS CLASSIFICATIONS.pdfDolisha Warbi
 
History and Development of Pharmacovigilence.pdf
History and Development of Pharmacovigilence.pdfHistory and Development of Pharmacovigilence.pdf
History and Development of Pharmacovigilence.pdfSasikiranMarri
 
METHODS OF ACQUIRING KNOWLEDGE IN NURSING.pptx by navdeep kaur
METHODS OF ACQUIRING KNOWLEDGE IN NURSING.pptx by navdeep kaurMETHODS OF ACQUIRING KNOWLEDGE IN NURSING.pptx by navdeep kaur
METHODS OF ACQUIRING KNOWLEDGE IN NURSING.pptx by navdeep kaurNavdeep Kaur
 
Wessex Health Partners Wessex Integrated Care, Population Health, Research & ...
Wessex Health Partners Wessex Integrated Care, Population Health, Research & ...Wessex Health Partners Wessex Integrated Care, Population Health, Research & ...
Wessex Health Partners Wessex Integrated Care, Population Health, Research & ...Wessex Health Partners
 
Glomerular Filtration rate and its determinants.pptx
Glomerular Filtration rate and its determinants.pptxGlomerular Filtration rate and its determinants.pptx
Glomerular Filtration rate and its determinants.pptxDr.Nusrat Tariq
 
The next social challenge to public health: the information environment.pptx
The next social challenge to public health:  the information environment.pptxThe next social challenge to public health:  the information environment.pptx
The next social challenge to public health: the information environment.pptxTina Purnat
 
Biomechanics- Shoulder Joint!!!!!!!!!!!!
Biomechanics- Shoulder Joint!!!!!!!!!!!!Biomechanics- Shoulder Joint!!!!!!!!!!!!
Biomechanics- Shoulder Joint!!!!!!!!!!!!ibtesaam huma
 
Glomerular Filtration and determinants of glomerular filtration .pptx
Glomerular Filtration and  determinants of glomerular filtration .pptxGlomerular Filtration and  determinants of glomerular filtration .pptx
Glomerular Filtration and determinants of glomerular filtration .pptxDr.Nusrat Tariq
 
Informed Consent Empowering Healthcare Decision-Making.pptx
Informed Consent Empowering Healthcare Decision-Making.pptxInformed Consent Empowering Healthcare Decision-Making.pptx
Informed Consent Empowering Healthcare Decision-Making.pptxSasikiranMarri
 
Big Data Analysis Suggests COVID Vaccination Increases Excess Mortality Of ...
Big Data Analysis Suggests COVID  Vaccination Increases Excess Mortality Of  ...Big Data Analysis Suggests COVID  Vaccination Increases Excess Mortality Of  ...
Big Data Analysis Suggests COVID Vaccination Increases Excess Mortality Of ...sdateam0
 
Music Therapy's Impact in Palliative Care| IAPCON2024| Dr. Tara Rajendran
Music Therapy's Impact in Palliative Care| IAPCON2024| Dr. Tara RajendranMusic Therapy's Impact in Palliative Care| IAPCON2024| Dr. Tara Rajendran
Music Therapy's Impact in Palliative Care| IAPCON2024| Dr. Tara RajendranTara Rajendran
 
Report Back from SGO: What’s New in Uterine Cancer?.pptx
Report Back from SGO: What’s New in Uterine Cancer?.pptxReport Back from SGO: What’s New in Uterine Cancer?.pptx
Report Back from SGO: What’s New in Uterine Cancer?.pptxbkling
 
Let's Talk About It: To Disclose or Not to Disclose?
Let's Talk About It: To Disclose or Not to Disclose?Let's Talk About It: To Disclose or Not to Disclose?
Let's Talk About It: To Disclose or Not to Disclose?bkling
 
Radiation Dosimetry Parameters and Isodose Curves.pptx
Radiation Dosimetry Parameters and Isodose Curves.pptxRadiation Dosimetry Parameters and Isodose Curves.pptx
Radiation Dosimetry Parameters and Isodose Curves.pptxDr. Dheeraj Kumar
 
Culture and Health Disorders Social change.pptx
Culture and Health Disorders Social change.pptxCulture and Health Disorders Social change.pptx
Culture and Health Disorders Social change.pptxDr. Dheeraj Kumar
 
call girls in paharganj DELHI 🔝 >༒9540349809 🔝 genuine Escort Service 🔝✔️✔️
call girls in paharganj DELHI 🔝 >༒9540349809 🔝 genuine Escort Service 🔝✔️✔️call girls in paharganj DELHI 🔝 >༒9540349809 🔝 genuine Escort Service 🔝✔️✔️
call girls in paharganj DELHI 🔝 >༒9540349809 🔝 genuine Escort Service 🔝✔️✔️saminamagar
 
Primary headache and facial pain. (2024)
Primary headache and facial pain. (2024)Primary headache and facial pain. (2024)
Primary headache and facial pain. (2024)Mohamed Rizk Khodair
 
Hematology and Immunology - Leukocytes Functions
Hematology and Immunology - Leukocytes FunctionsHematology and Immunology - Leukocytes Functions
Hematology and Immunology - Leukocytes FunctionsMedicoseAcademics
 

Recently uploaded (20)

call girls in Dwarka Sector 21 Metro DELHI 🔝 >༒9540349809 🔝 genuine Escort Se...
call girls in Dwarka Sector 21 Metro DELHI 🔝 >༒9540349809 🔝 genuine Escort Se...call girls in Dwarka Sector 21 Metro DELHI 🔝 >༒9540349809 🔝 genuine Escort Se...
call girls in Dwarka Sector 21 Metro DELHI 🔝 >༒9540349809 🔝 genuine Escort Se...
 
Basic principles involved in the traditional systems of medicine PDF.pdf
Basic principles involved in the traditional systems of medicine PDF.pdfBasic principles involved in the traditional systems of medicine PDF.pdf
Basic principles involved in the traditional systems of medicine PDF.pdf
 
LUNG TUMORS AND ITS CLASSIFICATIONS.pdf
LUNG TUMORS AND ITS  CLASSIFICATIONS.pdfLUNG TUMORS AND ITS  CLASSIFICATIONS.pdf
LUNG TUMORS AND ITS CLASSIFICATIONS.pdf
 
History and Development of Pharmacovigilence.pdf
History and Development of Pharmacovigilence.pdfHistory and Development of Pharmacovigilence.pdf
History and Development of Pharmacovigilence.pdf
 
METHODS OF ACQUIRING KNOWLEDGE IN NURSING.pptx by navdeep kaur
METHODS OF ACQUIRING KNOWLEDGE IN NURSING.pptx by navdeep kaurMETHODS OF ACQUIRING KNOWLEDGE IN NURSING.pptx by navdeep kaur
METHODS OF ACQUIRING KNOWLEDGE IN NURSING.pptx by navdeep kaur
 
Wessex Health Partners Wessex Integrated Care, Population Health, Research & ...
Wessex Health Partners Wessex Integrated Care, Population Health, Research & ...Wessex Health Partners Wessex Integrated Care, Population Health, Research & ...
Wessex Health Partners Wessex Integrated Care, Population Health, Research & ...
 
Glomerular Filtration rate and its determinants.pptx
Glomerular Filtration rate and its determinants.pptxGlomerular Filtration rate and its determinants.pptx
Glomerular Filtration rate and its determinants.pptx
 
The next social challenge to public health: the information environment.pptx
The next social challenge to public health:  the information environment.pptxThe next social challenge to public health:  the information environment.pptx
The next social challenge to public health: the information environment.pptx
 
Biomechanics- Shoulder Joint!!!!!!!!!!!!
Biomechanics- Shoulder Joint!!!!!!!!!!!!Biomechanics- Shoulder Joint!!!!!!!!!!!!
Biomechanics- Shoulder Joint!!!!!!!!!!!!
 
Glomerular Filtration and determinants of glomerular filtration .pptx
Glomerular Filtration and  determinants of glomerular filtration .pptxGlomerular Filtration and  determinants of glomerular filtration .pptx
Glomerular Filtration and determinants of glomerular filtration .pptx
 
Informed Consent Empowering Healthcare Decision-Making.pptx
Informed Consent Empowering Healthcare Decision-Making.pptxInformed Consent Empowering Healthcare Decision-Making.pptx
Informed Consent Empowering Healthcare Decision-Making.pptx
 
Big Data Analysis Suggests COVID Vaccination Increases Excess Mortality Of ...
Big Data Analysis Suggests COVID  Vaccination Increases Excess Mortality Of  ...Big Data Analysis Suggests COVID  Vaccination Increases Excess Mortality Of  ...
Big Data Analysis Suggests COVID Vaccination Increases Excess Mortality Of ...
 
Music Therapy's Impact in Palliative Care| IAPCON2024| Dr. Tara Rajendran
Music Therapy's Impact in Palliative Care| IAPCON2024| Dr. Tara RajendranMusic Therapy's Impact in Palliative Care| IAPCON2024| Dr. Tara Rajendran
Music Therapy's Impact in Palliative Care| IAPCON2024| Dr. Tara Rajendran
 
Report Back from SGO: What’s New in Uterine Cancer?.pptx
Report Back from SGO: What’s New in Uterine Cancer?.pptxReport Back from SGO: What’s New in Uterine Cancer?.pptx
Report Back from SGO: What’s New in Uterine Cancer?.pptx
 
Let's Talk About It: To Disclose or Not to Disclose?
Let's Talk About It: To Disclose or Not to Disclose?Let's Talk About It: To Disclose or Not to Disclose?
Let's Talk About It: To Disclose or Not to Disclose?
 
Radiation Dosimetry Parameters and Isodose Curves.pptx
Radiation Dosimetry Parameters and Isodose Curves.pptxRadiation Dosimetry Parameters and Isodose Curves.pptx
Radiation Dosimetry Parameters and Isodose Curves.pptx
 
Culture and Health Disorders Social change.pptx
Culture and Health Disorders Social change.pptxCulture and Health Disorders Social change.pptx
Culture and Health Disorders Social change.pptx
 
call girls in paharganj DELHI 🔝 >༒9540349809 🔝 genuine Escort Service 🔝✔️✔️
call girls in paharganj DELHI 🔝 >༒9540349809 🔝 genuine Escort Service 🔝✔️✔️call girls in paharganj DELHI 🔝 >༒9540349809 🔝 genuine Escort Service 🔝✔️✔️
call girls in paharganj DELHI 🔝 >༒9540349809 🔝 genuine Escort Service 🔝✔️✔️
 
Primary headache and facial pain. (2024)
Primary headache and facial pain. (2024)Primary headache and facial pain. (2024)
Primary headache and facial pain. (2024)
 
Hematology and Immunology - Leukocytes Functions
Hematology and Immunology - Leukocytes FunctionsHematology and Immunology - Leukocytes Functions
Hematology and Immunology - Leukocytes Functions
 

Mutraashmari (Urolithiasis).pptx

  • 1. Syndicate JC Presentation Mutrashmari (Urolithiasis) Presenter- Dr. Twinkle Joshi
  • 2. Introduction • Mootrashmari is a disease of mootravah srotas. • It is considered as one amongst Ashtamahagad (eight most deadly diseases). Charak chikitsa 26 Sushrut Nidan 3, Chikitsa 7 Ashtang Hridaya Nidan 9, Chikitsa 11 Madhav Nidan 22 Bhav prakash 37 • “चतस्रोऽश्मर्यो भवन्ति; श्लेष्माधिष्ठानााः; तद्यथा श्लेष्मणा, वातेन, धित्तेन, शुक्र े ण चेधत ||” Su. Ni. 3/3 •Acharya Susrutha has described 4 types - Vataja, Pittaja, Kaphaja and Shukraja.
  • 3. Nidana and Samprapti • “तत्रासंशोिनशीलस्यािथ्यकारिणाःप्रक ु धिताः श्लेष्मा मूत्रस्पृक्ोऽनुप्रधव्य बन्ति मश्मिींजनर्यधत ” Su. Ni 3/4 • Improper Shodhana • Intake of unwholesome diet • Indulgence in excessive kapha vardhak ahara and vihara • “धवशोषर्येद्बन्तिगतं सशुक्र ं मूत्रं सधित्तं िवनाः कफ ं वा| र्यदा तदाऽश्मर्युुिजार्यते तु क्रमेण धित्तेन्तिव िोचना गोाः” Cha Chi 26/36 • When the aggravated Vata dries up the semen, urine, Pitta and Kapha located in the urinary bladder, then gradually stones are formed there, as Gorochana (gall stone) is formed in bile inside the Gall- Bladder of cattle.
  • 4. Samprapti Ghatak Dosha Kapha pradhan tridosha Dushya Mutra Srotas Mutravaha srotas Adhishthan Basti Srotodushti Sanga Sadhyaasadhyata Krichrasadhya
  • 5. Purvarupa • “तासाां पूर्वरूपाणि- ज्विो बन्तििीडािोचकौ मूत्रक पृक च्छ् रं बन्तिधशिोमुष्कशेफसां वेदना क पृक च्छ् र ावसादो बिगन्तित्वं मूत्रस्येधत ||५|| यथास्वर्ेदनार्िं दुष्टां सान्द्रमथाणर्लम् | पूर्वरूपेऽश्मनः क ृ च्छ् र ान्मूत्रां सृजणत मानर्ःll” Su. Ni. 3/6 • Pain in bladder • Fever • Pain in scrotum, penis • Anorexia • Dysuria • Smell of urine similar to goat
  • 6. Samanya lakshan • “नाधभबन्तिसेवनीमेहनेिन्यतमन्तिन् मेहतो वेदना मूत्रिािासङ्गाः सरुधििमूत्र ता मूत्रधवधकिणं गोमेदकप्रकाशमत्याधवलं सधसकतं धवसपृकजधत; िावनलङ्घनप्ल वनिपृकष्ठर्यानोष्णाध्वगमनैश्चास्य वेदना भवन्ति ” Su. Ni. 3/7 • Severe pain in region of umbilicus, bladder • Pain in bladder • Obstruction of urine • Hematuria • Resembles gomeda gem • Pain while running, swimming
  • 7. Types of Ashmari • Vattaj ashmari – • पीड्यमानो दन्तान् खादणत – grinding of teeth • नाण ां पीडयणत – presses umbilical region • र्ातमूत्रपुरीषाणि क ृ च्छ् रे ि चास्य मेहतो णनःसरन्तन्त – dysuria and painful defecation • श्यार्ा परुषा णर्षमा खरा कदम्बिुष्पवत्कण्टकाधचता र्णत – black, irregular, rough calculus • Pittaj Ashmari- • दह्यते पच्यत इर् बन्तिरुष्णर्ातश्च र्णत – burning, sucking pain in bladder • सरक्ता - hemeturia • पीतार् ासा क ृ ष्णा भल्लातकान्तथथप्रधतमा मिुवणाु वा र्णत – reddish –yellow calculus
  • 8. • Kaphaj Ashmari – • द्दाल्यते ण द्यते णनिुद्यत इर् - crushing, pricking pain • श्वेता णिग्धा महती – white, large calculus • क ु क्क ु टाण्डप्रतीकाशा मिूकिुष्पवणाु र्ा र्णत • Shukraj Ashmari - • बन्तिर्ेदनाां र्ृषियोश्च - pain in bladder and scrotum • श्वयथुमापादयणत swelling in scrotum • पीणडतमात्रे च तन्तिन्नेर् प्रदेशे प्रणर्लयमापद्यते - liquefies on squeezing • शक व रा णसकता मेहो िाख्योऽश्मररर्ैक ृ तम् - sharkara, sikta and bhasmameha(mutra shukra) are also types of ashmari
  • 9. Upadrava • “दौबुल्यं सदनं का्यं क ु धिशूलमिोचकम् | िाण्डुत्वमुष्णवातं च तपृकष्णां हृत्पीडनं वधमम् ll” Su. Ni. 3/17 • Weakness and heaviness in body, • emaciation , • pain in abdomen, • anorexia, • anaemia, • polydypsia and vomiting.
  • 10. Formation of Ashmari • “आमुखात्सधलले न्यिाः िार्श्वेभ्याः िूर्युते नवाः ||२३|| घटो र्यथा तथा धवन्ति बन्तिमूुत्रेण िूर्युते |२४|” • While explaining the formation of ashmari , Acharya Sushruta narrates that, the manner in which even clean water collected in pot precipitates in the bottom after sometime; similarly the process of hardening of ashmari occurs with the kshara of kapha dosha present in mutravaha strotas .
  • 11. Chikitsa • औषधैिरुिः साध्यः प्रर्ृद्धश्छे दमहवणत ||३|| तस्य पूर्ेषु रूपेषु िेहाणदक्रम इष्यते | Su. Chi 7/2 • घृतैः क्षारैः कषायैश्च क्षीरैः सोत्तरबन्तिण ः | यणद नोपशमां गच्छ्े च्छ्े दित्रोत्तरो णर्णधः ll • अणक्रयायाां ध्रुर्ो मृत्ुः णक्रयायाां सांशयो र्ेत् | तिादापृच्छ्य कतवव्यमीश्वरां साधुकाररिा ll
  • 12. Urolithiasis • Refers to presence of stones within the kidneys. • Stone formation occurs when there’s an excess of crystal-forming substances that can’t be dissolved in the urine. • High urinary excretion of calcium, oxalate, uric acid can promote stone formation, whereas low excretion of citrate, has a protective effect. Predisposing factors- Environmental & Dietary Causes • Low Urine volumes • Diet : High protein, high sodium • High sodium and oxalate excretion • Low citrate excretion (hypocitraturia) Acquired causes • Hypercalcaemia • Ileal disease • Renal tubular acidosis type I • Familial cysteinuria • Primary hyperoxularia
  • 13. Sites of Calculus Obstruction •At the brim of lesser pelvis •Opening of ureter into the urinary bladder •Pelvi-ureter junction
  • 14. Types of Kidney Stones •Calcium oxalate stones - most common •Cause – hypercalciuria and hyperoxaluria due to hyperparathyroidism. renal tubular acidosis ,etc. •Struvite stones aka infectious stones( associated with UTIs) especially those caused by urea-splitting organisms Klebsiella , Staphylococcus, etc. •Uric acid stones – hyperuricosuria due to high-protein diet , gout, inflammatory bowel disease
  • 15. Diagnosis and Management • X-rays - calcium stones • Non-contrast CT scan - uric acid (radiolucent) , cystine stones • USG • Management – • Dietary modification and increase fluid intake • Small stones ( 5-10 mm) without complications expectant management using tamsulosin • Larger stones - extracorporeal shock wave lithotripsy (ESWL) shock waves to fragment the stone, breaking it into smaller pieces that are excreted in the urine. It can only fragment low density stones, so hard stones like cysteine or calcium oxalate can’t be treated with lithotripsy. • Percutaneous nephrolithotomy (PCNL) >2cm in size