This document provides an overview of Karaveera (yellow oleander) poisoning. It discusses the prevalence, introduction and types of karaveera in Ayurveda. The botanical description, toxic principles, effects, diagnosis and treatment of karaveera poisoning are explained. Case studies of karaveera poisoning are presented. The document also covers the medicolegal importance, uses mentioned in Ayurvedic texts, and research related to karaveera poisoning.
This document presents information on Madatyaya or alcoholism and chronic alcohol use. It discusses the stages of acute alcoholism, symptoms of chronic alcoholism according to doshas, systemic effects, withdrawal symptoms and conditions like delirium tremens. It outlines the diagnostic tests for drunkenness and drunk driving laws. The document presents the Ayurvedic view of the treatment of acute alcoholism, chronic alcoholism, withdrawal symptoms and dependence, including the use of medicated enemas, herbs and Panchakarma procedures.
Knowledge of Visha(Poisons)Upvisha(Low grade/Sub poisons)Minerals,Metals incl...Janardan Panday
This document provides information about various poisonous substances from Ayurveda, Siddha, and Unani systems of medicine in India. It lists 54 poisonous substances of vegetable, animal, and mineral origin from the Ayurvedic system, including plants like Datura, Aconite, and minerals like arsenic and mercury. It also lists 21 poisonous substances from the Siddha system, including plants like Datura, Gloriosa, and minerals. For the Unani system, it lists substances of vegetable origin like Datura, Aconite, animal sources like snake venom, and minerals including arsenic, mercury, and copper. It also details the schedules under the Drugs and Cosmetics Act
1. Karma refers to the inherent property of a drug that is responsible for its therapeutic action and physiological effects in the body.
2. Drug karma can be classified in various ways including by the organ or system affected, the dosha pacified or aggravated, the action performed such as cleansing, nourishing, or lightening.
3. Some examples of specific karmas described are deepana, pachana, shodhana, shaman, anulomana, bhedana, and rasayana. Each karma is characterized by the doshas, tissues, or parts of the body it acts on and the gunas or elements that predominate in the drug.
Pancha bhasma siddhi lakshana- Dr. Saroja M PatilSaru Patil
The document discusses the derivation, preparation methods, and evaluation tests for bhasmas, which are microfine ash formulations used in Ayurvedic medicine. It describes the general process of shodhana (purification), jarana (incineration), and bhavana (trituration). Key evaluation tests are listed to assess properties like fineness, tastelessness, and floatation. The five prime tests from the Rasa Ratna Samuchaya are summarized as varitara (floatation), rekhapurnata (ability to enter finger lines), apunarbhava (non-reversion to original substance), unama/uttama (continued floatation), and niruttha (non
This document discusses snake bites and treatments according to Ayurveda. It begins by introducing the prevalence and classification of snake bites in Ayurveda. It then focuses on "Darveekara" snakes, providing a list of 12 types. The document details the symptoms caused by each snake depending on the area affected. It lists 24 potential treatment measures and explains that the wise physician should examine each case and decide the appropriate treatments rather than applying all measures uniformly. The treatments may help restrict poison spread, eliminate it from the body, or counter its effects in different ways.
Vatsanabha is an important medicinal plant used in Ayurveda. It has several regional names and its botanical name is Aconitum ferox. It grows in high altitude Himalayan regions. The useful part is the root, which is dark brown to black in color. It has a bitter taste followed by a strong tingling sensation. Vatsanabha has many therapeutic uses including treating fever, inflammation and pain conditions. However, it is also highly toxic and can be fatal in high doses if not properly processed and administered.
Salina abdulmajid manek, a 3rd year student of BAMS, summarizes the symptoms and treatment of Dushi Visha (latent poison) according to Ayurvedic texts such as the Charaka Samhita. Dushi Visha can manifest due to deranged seasons, polluted land, toxic food, or excessive daytime sleep. It causes symptoms depending on the aggravated dosha (humor), such as chest pain for vata, sensory loss for pitta, and vomiting for kapha. Treatment involves detoxification therapies followed by ingesting anti-toxic herbs like pippali, lodhra, and chandana daily. Dushi Visha is generally curable
This document discusses Panchakarma treatment approaches for visha (poisoning or toxicity) according to Agada Tantra. It describes the five main Panchakarma treatments - vamana, virechana, nasya, lepa and basti. It provides details on how each treatment is used differently depending on the type of poison (sthavara, jangama etc.), which vega (stage) of poisoning it is being used for, and examples of herbal formulas and procedures used for each Panchakarma treatment in cases of various poisons. The document aims to explain the rationales behind these Panchakarma approaches and how they help remove toxins from the body quickly
This document presents information on Madatyaya or alcoholism and chronic alcohol use. It discusses the stages of acute alcoholism, symptoms of chronic alcoholism according to doshas, systemic effects, withdrawal symptoms and conditions like delirium tremens. It outlines the diagnostic tests for drunkenness and drunk driving laws. The document presents the Ayurvedic view of the treatment of acute alcoholism, chronic alcoholism, withdrawal symptoms and dependence, including the use of medicated enemas, herbs and Panchakarma procedures.
Knowledge of Visha(Poisons)Upvisha(Low grade/Sub poisons)Minerals,Metals incl...Janardan Panday
This document provides information about various poisonous substances from Ayurveda, Siddha, and Unani systems of medicine in India. It lists 54 poisonous substances of vegetable, animal, and mineral origin from the Ayurvedic system, including plants like Datura, Aconite, and minerals like arsenic and mercury. It also lists 21 poisonous substances from the Siddha system, including plants like Datura, Gloriosa, and minerals. For the Unani system, it lists substances of vegetable origin like Datura, Aconite, animal sources like snake venom, and minerals including arsenic, mercury, and copper. It also details the schedules under the Drugs and Cosmetics Act
1. Karma refers to the inherent property of a drug that is responsible for its therapeutic action and physiological effects in the body.
2. Drug karma can be classified in various ways including by the organ or system affected, the dosha pacified or aggravated, the action performed such as cleansing, nourishing, or lightening.
3. Some examples of specific karmas described are deepana, pachana, shodhana, shaman, anulomana, bhedana, and rasayana. Each karma is characterized by the doshas, tissues, or parts of the body it acts on and the gunas or elements that predominate in the drug.
Pancha bhasma siddhi lakshana- Dr. Saroja M PatilSaru Patil
The document discusses the derivation, preparation methods, and evaluation tests for bhasmas, which are microfine ash formulations used in Ayurvedic medicine. It describes the general process of shodhana (purification), jarana (incineration), and bhavana (trituration). Key evaluation tests are listed to assess properties like fineness, tastelessness, and floatation. The five prime tests from the Rasa Ratna Samuchaya are summarized as varitara (floatation), rekhapurnata (ability to enter finger lines), apunarbhava (non-reversion to original substance), unama/uttama (continued floatation), and niruttha (non
This document discusses snake bites and treatments according to Ayurveda. It begins by introducing the prevalence and classification of snake bites in Ayurveda. It then focuses on "Darveekara" snakes, providing a list of 12 types. The document details the symptoms caused by each snake depending on the area affected. It lists 24 potential treatment measures and explains that the wise physician should examine each case and decide the appropriate treatments rather than applying all measures uniformly. The treatments may help restrict poison spread, eliminate it from the body, or counter its effects in different ways.
Vatsanabha is an important medicinal plant used in Ayurveda. It has several regional names and its botanical name is Aconitum ferox. It grows in high altitude Himalayan regions. The useful part is the root, which is dark brown to black in color. It has a bitter taste followed by a strong tingling sensation. Vatsanabha has many therapeutic uses including treating fever, inflammation and pain conditions. However, it is also highly toxic and can be fatal in high doses if not properly processed and administered.
Salina abdulmajid manek, a 3rd year student of BAMS, summarizes the symptoms and treatment of Dushi Visha (latent poison) according to Ayurvedic texts such as the Charaka Samhita. Dushi Visha can manifest due to deranged seasons, polluted land, toxic food, or excessive daytime sleep. It causes symptoms depending on the aggravated dosha (humor), such as chest pain for vata, sensory loss for pitta, and vomiting for kapha. Treatment involves detoxification therapies followed by ingesting anti-toxic herbs like pippali, lodhra, and chandana daily. Dushi Visha is generally curable
This document discusses Panchakarma treatment approaches for visha (poisoning or toxicity) according to Agada Tantra. It describes the five main Panchakarma treatments - vamana, virechana, nasya, lepa and basti. It provides details on how each treatment is used differently depending on the type of poison (sthavara, jangama etc.), which vega (stage) of poisoning it is being used for, and examples of herbal formulas and procedures used for each Panchakarma treatment in cases of various poisons. The document aims to explain the rationales behind these Panchakarma approaches and how they help remove toxins from the body quickly
This document summarizes information about Kampillaka, the first drug of Sadharana Rasa. It discusses the following key points:
- Kampillaka comes from the Mallotus phillippinensis plant and is the red powdery substance found on its fruits.
- It is used in classical Ayurvedic formulations like Brihat Trayi.
- Adulterants include brick powder, annatto dye, and bark powders that can be identified through tests of solubility, color staining, and burning properties.
- Purification methods involve drying the powder in sunlight to remove excess moisture and impurities according to classical texts.
The document provides an introduction to the Ayurvedic concept of Vyadhi (disease). It discusses the etymology and definitions of Vyadhi, as well as synonyms. Various classifications of Vyadhi are described based on factors like prognosis, intensity, location, causes, and site of origin. Single-fold, two-fold, and three-fold classifications are presented, differentiating types of Vyadhi according to these factors. The document serves as an overview of the fundamental Ayurvedic understanding of the nature and categories of disease.
CLASSICAL AND CONTEMPORARY RELEVANCE OF DOOSHI VISHADr. Prerok regmi
1. The document discusses the classical and contemporary relevance of Dooshi visha, or cumulative toxicity, according to Ayurveda. It describes Dooshi visha as a transformed state of poison that remains in the body for a long time due to low potency.
2. Contemporary factors like agricultural pollution from pesticides, environmental pollution, and long term drug use can lead to a state similar to Dooshi visha over time. Oxidative stress from these toxins can cause similar conditions as described in classical texts.
3. Treatment of Dooshi visha and cumulative toxicity focuses on biopurification therapies like Vamana or Virechana as well as herbal formulations mentioned in classical texts
1. Dooshivishari Agada is used for dormant and cumulative poisoning and its complications. It contains ingredients like Pippali, Dhyamaka, Mamsi, etc. mixed with honey.
2. Bilvadi Agada contains 13 ingredients like Bilva, Surasa, Karanja mixed in goat's urine to treat various poisonings from snakes, scorpions, and insects and conditions like Ajeerna.
3. Dashanga Agada contains 10 ingredients like Vacha, Hingu, Vidanga, Saindhava to treat scorpion stings and other types of poisonings and infections.
4. Mruthasanjivana Ag
1.Ajeerna is one of the chief diseases of Annavaha sorts
2. When a anaatmavaan person takes Ahara without considering its
Pramana amount like a pashu then he suffers from Ajeerna.
3. Ajeerna is mula of many disease.
4. When Ahar Gets Vitiatd by Pittadi dosha
it leads to Ajeerna Roga.
The document discusses Vrischika Visha (scorpion poison) in Ayurvedic classics. It describes three varieties of scorpions based on toxicity - mild, moderate and severe. Symptoms and treatment are detailed for each variety. Local and systemic symptoms of scorpion sting are provided. Treatment focuses on alleviating vata and includes measures like sweating, oil application and anti-venom herbal formulations. A case study is presented of a patient experiencing blistering after a scorpion bite who was treated with herbal formulations and poultices.
Rasayana Tantra is one of the eight important clinical branches of Ayurveda. It deals with rejuvenation and longevity. Rasayana helps to achieve three types of action - protect youthfulness and avoid senility, encourage life span, intellect and potency, and check and cure disease. Rasayana has been classified in various ways including based on mode of administration as outdoor or indoor regimen, based on utility as preventive or curative etc. Many herbal formulations and procedures are mentioned in classical texts for rasayana therapy.
1. The document discusses two minerals - mica and tourmaline. It details their Sanskrit names, physical properties, varieties, purification processes, and incineration processes to produce bhasmas or ashes for medicinal use.
2. Mica is further described in terms of its occurrence in India, appearance as flexible sheets, varieties based on color and response to heating. Its uses include treating diabetes, tuberculosis and asthma.
3. Tourmaline is also described in terms of synonyms, occurrence locations, properties like hardness, and purification through steaming in a herbal decoction. Its bhasma benefits memory and rejuvenation.
Ayurveda a Food Science perfectly deals with the different kinds of food preparation which can be utilized in day to day life according to prakritti(basic constitution), desha(place), dosha(humors), kala(time).
in ayurvedic pharmacology some drugs have action according to their aura. this aura treat patients in various aspects eg wearing of jems and different stones
Viruddha Ahara referred in terms of food to food interactions or food processing interactions develops Toxicity because of antagonism. - by Ayurmitra Nadi Guru Prof KSR Prasad (Technoayurveda) 9290566566/9503227966 ‐ technoayurveda@yahoo.com
Sasyaka, also known as tuttha or blue vitriol, is the 6th mineral drug in the maharasa group. It is chemically identified as copper sulfate with the chemical formula CuSO4. The document discusses the various Sanskrit and regional names of sasyaka, its natural occurrences, mineralogical identification, historical references, types, purification process, therapeutic properties and uses when consumed in its purified or bhasma form. It describes how sasyaka bhasma is useful for treating diseases like kushta, netraroga and various skin disorders.
Alarka Visha (rabies) is described as predominantly affecting the Kapha and Vata doshas. It is caused when the vata dosha in a rabid dog's body combines with aggravated kapha, accumulating in the channels of the body. This leads to severe aggravation of the tissues and disruption of the channels. Symptoms exhibited by rabid dogs and those bitten include numbness at the bite site. Management involves burning the bite site, purgation, and internal medications including purified ghee and herbs like ankola. Rabies virus causes the disease in three stages, with treatment focusing on control, pre-exposure prophylaxis, and post-exposure prophylaxis.
This document provides information on Parada (mercury) according to Ayurvedic texts, including its synonyms, types, natural impurities, and Ashtasamskaras (eight purification processes). It defines Parada, lists its many Sanskrit synonyms, and describes its ideal color and appearance. The document outlines five types of Parada based on origin, five modes of movement, its eight natural impurities, and seven external impurities/coverings. It concludes by detailing each of the eight purification processes (Svedana, Mardana, Murchana, Utthapana, Patana etc.) involved in preparing Parada for medicinal use according to classical Ayurvedic texts.
The document discusses the different times (kala) for administering medicines according to Ayurveda. It describes 11 different times including administering medicines on an empty stomach, before meals, after meals, between meals, with each morsel of food, etc. The appropriate time depends on factors like the dosha involved, the disease location, the digestive fire strength, and the intended action of the medicine. Administering medicines at the proper time maximizes the therapeutic benefits and outcomes for patients.
Garavisha-Vidyashri useful class ppt in 3rd yearDrSathishMS1
This document provides an overview of garavisha (artificial poisoning) in Ayurveda. It defines garavisha as a type of artificial poison produced by combining substances like excreta, incompatible drugs, and mild poisons. It causes chronic toxicity if consumed regularly. The document outlines the various types, routes of administration, signs and symptoms, and treatments described in Ayurvedic texts for garavisha poisoning, including vamana (emesis therapy) and administration of hemacurna (gold ash).
Viruddhashara is a unique concept in Ayurveda referring to the consumption of incompatible foods. Eating incompatible foods can cause health issues similar to poison by disrupting the body's equilibrium. Some examples of incompatible food combinations mentioned are milk with sour substances, fish with milk, and honey processed with heat. Consuming incompatible foods can lead to diseases like vomiting, inflammation, and madness. The treatment involves cessation of the incompatible foods and use of opposing foods and herbs to restore balance.
A 2-day-old infant presented with shock and was found to have severe coarctation of the aorta. After discharge from the hospital following delivery, the infant collapsed at home. Examination showed poor perfusion and enlarged liver. Echocardiogram revealed severe coarctation, and the infant went into shock once the ductus arteriosus closed, obstructing left heart outflow. Management involved prostaglandin infusion to keep the ductus patent and stabilize the infant until surgery.
This document summarizes information about Kampillaka, the first drug of Sadharana Rasa. It discusses the following key points:
- Kampillaka comes from the Mallotus phillippinensis plant and is the red powdery substance found on its fruits.
- It is used in classical Ayurvedic formulations like Brihat Trayi.
- Adulterants include brick powder, annatto dye, and bark powders that can be identified through tests of solubility, color staining, and burning properties.
- Purification methods involve drying the powder in sunlight to remove excess moisture and impurities according to classical texts.
The document provides an introduction to the Ayurvedic concept of Vyadhi (disease). It discusses the etymology and definitions of Vyadhi, as well as synonyms. Various classifications of Vyadhi are described based on factors like prognosis, intensity, location, causes, and site of origin. Single-fold, two-fold, and three-fold classifications are presented, differentiating types of Vyadhi according to these factors. The document serves as an overview of the fundamental Ayurvedic understanding of the nature and categories of disease.
CLASSICAL AND CONTEMPORARY RELEVANCE OF DOOSHI VISHADr. Prerok regmi
1. The document discusses the classical and contemporary relevance of Dooshi visha, or cumulative toxicity, according to Ayurveda. It describes Dooshi visha as a transformed state of poison that remains in the body for a long time due to low potency.
2. Contemporary factors like agricultural pollution from pesticides, environmental pollution, and long term drug use can lead to a state similar to Dooshi visha over time. Oxidative stress from these toxins can cause similar conditions as described in classical texts.
3. Treatment of Dooshi visha and cumulative toxicity focuses on biopurification therapies like Vamana or Virechana as well as herbal formulations mentioned in classical texts
1. Dooshivishari Agada is used for dormant and cumulative poisoning and its complications. It contains ingredients like Pippali, Dhyamaka, Mamsi, etc. mixed with honey.
2. Bilvadi Agada contains 13 ingredients like Bilva, Surasa, Karanja mixed in goat's urine to treat various poisonings from snakes, scorpions, and insects and conditions like Ajeerna.
3. Dashanga Agada contains 10 ingredients like Vacha, Hingu, Vidanga, Saindhava to treat scorpion stings and other types of poisonings and infections.
4. Mruthasanjivana Ag
1.Ajeerna is one of the chief diseases of Annavaha sorts
2. When a anaatmavaan person takes Ahara without considering its
Pramana amount like a pashu then he suffers from Ajeerna.
3. Ajeerna is mula of many disease.
4. When Ahar Gets Vitiatd by Pittadi dosha
it leads to Ajeerna Roga.
The document discusses Vrischika Visha (scorpion poison) in Ayurvedic classics. It describes three varieties of scorpions based on toxicity - mild, moderate and severe. Symptoms and treatment are detailed for each variety. Local and systemic symptoms of scorpion sting are provided. Treatment focuses on alleviating vata and includes measures like sweating, oil application and anti-venom herbal formulations. A case study is presented of a patient experiencing blistering after a scorpion bite who was treated with herbal formulations and poultices.
Rasayana Tantra is one of the eight important clinical branches of Ayurveda. It deals with rejuvenation and longevity. Rasayana helps to achieve three types of action - protect youthfulness and avoid senility, encourage life span, intellect and potency, and check and cure disease. Rasayana has been classified in various ways including based on mode of administration as outdoor or indoor regimen, based on utility as preventive or curative etc. Many herbal formulations and procedures are mentioned in classical texts for rasayana therapy.
1. The document discusses two minerals - mica and tourmaline. It details their Sanskrit names, physical properties, varieties, purification processes, and incineration processes to produce bhasmas or ashes for medicinal use.
2. Mica is further described in terms of its occurrence in India, appearance as flexible sheets, varieties based on color and response to heating. Its uses include treating diabetes, tuberculosis and asthma.
3. Tourmaline is also described in terms of synonyms, occurrence locations, properties like hardness, and purification through steaming in a herbal decoction. Its bhasma benefits memory and rejuvenation.
Ayurveda a Food Science perfectly deals with the different kinds of food preparation which can be utilized in day to day life according to prakritti(basic constitution), desha(place), dosha(humors), kala(time).
in ayurvedic pharmacology some drugs have action according to their aura. this aura treat patients in various aspects eg wearing of jems and different stones
Viruddha Ahara referred in terms of food to food interactions or food processing interactions develops Toxicity because of antagonism. - by Ayurmitra Nadi Guru Prof KSR Prasad (Technoayurveda) 9290566566/9503227966 ‐ technoayurveda@yahoo.com
Sasyaka, also known as tuttha or blue vitriol, is the 6th mineral drug in the maharasa group. It is chemically identified as copper sulfate with the chemical formula CuSO4. The document discusses the various Sanskrit and regional names of sasyaka, its natural occurrences, mineralogical identification, historical references, types, purification process, therapeutic properties and uses when consumed in its purified or bhasma form. It describes how sasyaka bhasma is useful for treating diseases like kushta, netraroga and various skin disorders.
Alarka Visha (rabies) is described as predominantly affecting the Kapha and Vata doshas. It is caused when the vata dosha in a rabid dog's body combines with aggravated kapha, accumulating in the channels of the body. This leads to severe aggravation of the tissues and disruption of the channels. Symptoms exhibited by rabid dogs and those bitten include numbness at the bite site. Management involves burning the bite site, purgation, and internal medications including purified ghee and herbs like ankola. Rabies virus causes the disease in three stages, with treatment focusing on control, pre-exposure prophylaxis, and post-exposure prophylaxis.
This document provides information on Parada (mercury) according to Ayurvedic texts, including its synonyms, types, natural impurities, and Ashtasamskaras (eight purification processes). It defines Parada, lists its many Sanskrit synonyms, and describes its ideal color and appearance. The document outlines five types of Parada based on origin, five modes of movement, its eight natural impurities, and seven external impurities/coverings. It concludes by detailing each of the eight purification processes (Svedana, Mardana, Murchana, Utthapana, Patana etc.) involved in preparing Parada for medicinal use according to classical Ayurvedic texts.
The document discusses the different times (kala) for administering medicines according to Ayurveda. It describes 11 different times including administering medicines on an empty stomach, before meals, after meals, between meals, with each morsel of food, etc. The appropriate time depends on factors like the dosha involved, the disease location, the digestive fire strength, and the intended action of the medicine. Administering medicines at the proper time maximizes the therapeutic benefits and outcomes for patients.
Garavisha-Vidyashri useful class ppt in 3rd yearDrSathishMS1
This document provides an overview of garavisha (artificial poisoning) in Ayurveda. It defines garavisha as a type of artificial poison produced by combining substances like excreta, incompatible drugs, and mild poisons. It causes chronic toxicity if consumed regularly. The document outlines the various types, routes of administration, signs and symptoms, and treatments described in Ayurvedic texts for garavisha poisoning, including vamana (emesis therapy) and administration of hemacurna (gold ash).
Viruddhashara is a unique concept in Ayurveda referring to the consumption of incompatible foods. Eating incompatible foods can cause health issues similar to poison by disrupting the body's equilibrium. Some examples of incompatible food combinations mentioned are milk with sour substances, fish with milk, and honey processed with heat. Consuming incompatible foods can lead to diseases like vomiting, inflammation, and madness. The treatment involves cessation of the incompatible foods and use of opposing foods and herbs to restore balance.
A 2-day-old infant presented with shock and was found to have severe coarctation of the aorta. After discharge from the hospital following delivery, the infant collapsed at home. Examination showed poor perfusion and enlarged liver. Echocardiogram revealed severe coarctation, and the infant went into shock once the ductus arteriosus closed, obstructing left heart outflow. Management involved prostaglandin infusion to keep the ductus patent and stabilize the infant until surgery.
This document provides information about Raynaud's disease. It begins with an introduction that defines Raynaud's as a rare disorder affecting the arteries that causes vasospasm and reduced blood flow to the fingers and toes. It then covers the classification of Raynaud's disease into primary and secondary types. The causes, risk factors, pathophysiology, clinical manifestations, diagnostic evaluations, treatment options including medications and surgery, complications, health education, and nursing care plans are all discussed in detail.
This document provides information on CAD, gastroenteritis, and hypertension. It includes sections on causes, transmission, symptoms, and standard treatment protocols for each condition. It then presents a case study of a 58-year-old male patient with complaints of vomiting, abdominal pain, and weakness. His medical history and examination results are detailed. He is assessed as having gastroenteritis, hypertension, and CAD. A 5-day treatment plan is outlined, along with discharge instructions and counseling on lifestyle modifications and medication management.
1. The document discusses various cardiac arrhythmias including supraventricular tachycardias, atrial fibrillation, ventricular tachycardia, and ventricular fibrillation.
2. It provides details on characteristics, causes, diagnosis, and treatment of these arrhythmias based on American and European cardiology guidelines.
3. The treatment discussed includes electrical cardioversion, antiarrhythmic medications, catheter ablation, and implantable cardioverter defibrillators.
The document discusses acute pulmonary embolism (PE). PE is common but difficult to diagnose, with nonspecific symptoms. It describes a case of a 48-year-old woman presenting with sudden dyspnea, tachycardia, and leg swelling who may have PE. Risk factors for PE include recent surgery or trauma, prolonged immobilization, and inherited or acquired hypercoagulable states. Diagnosis involves clinical scoring, D-dimer, imaging like CTPA, and treatment includes anticoagulation with heparin or warfarin.
The patient presented with altered sensorium, decreased movement in their right side, and deviation of their mouth to the left. Imaging showed a non-hemorrhagic infarct in the left fronto-parietal region consistent with a stroke. An echocardiogram found left ventricular non-compaction (LVNC), a mobile clot attached to the left ventricle, and normal systolic function. The final diagnosis was LVNC, stroke, hyperhomocysteinemia, and hyperlipidemia. LVNC is a rare heart condition where the left ventricle fails to compact during development, leaving prominent trabeculations. It can cause heart failure, arrhythmias, and thromboemb
This document discusses the case of a 27-year-old male who was brought to the emergency department unconscious after having an argument at home. On examination, he was found to have pinpoint pupils, increased muscle tone, and other signs suggestive of organophosphate or carbamate poisoning. The document then goes on to discuss in detail the management of organophosphate poisoning, including decontamination, use of atropine and pralidoxime, and monitoring for intermediate syndrome. Common organophosphate compounds and their mechanism of action via acetylcholinesterase inhibition is also explained.
Dr Ashutosh Ojha Shiv Narayan Singh memorial oration 2020Dr Ashutosh Ojha
It is the Oration ,I gave at Patna Medical College on Foundation Day Celebration on 24 Feb2020.
Clinical Medicine is not taught much in Medical College and less used in advent of newer Tests .
To Remind The value , I gave this talk in Name of Legendary Physician
A 37-year-old female presented with acute onset weakness of all four limbs for 5 hours. On examination, she had flaccid quadriparesis with decreased tone and power in both upper and lower limbs. Investigations revealed hypokalemia, metabolic alkalosis, hypertension, and renal potassium wasting. CT angiogram showed bilateral thinning and stenosis of the subclavian arteries and diffuse aortic wall thickening. This is consistent with Takayasu's arteritis, a large vessel vasculitis most commonly affecting the aorta and its major branches in young females.
Herbal medicines can potentially cause various renal syndromes and failures through different mechanisms. Some herbs like Cape aloes and flavonoids from Taxus celebica have been associated with acute kidney injury. Aristolochic acid from mistakenly substituted herbs can cause chronic interstitial nephritis and urothelial malignancy. Excessive consumption of star fruit, licorice, and ephedra may lead to nephrolithiasis, hypokalemia, or hypertension respectively due to their pharmacological properties. Physicians should be aware of potential herb-drug interactions and risks of herbal medicine use.
Ischemic stroke explained with example of patient by soap note including all drugs , treatment, pharmacological treatment,non pharmacological treatment and councelling advices to the patient.
You can gain a huge knowledge on case reviewing in soap note.
It includes pharmacological treatment as well as non pharmacological treatment, councelling of patient.
general management of toxicological casesSama Queen
This document provides guidelines for evaluating and treating patients with acute poisoning. It outlines steps for initial stabilization including airway, breathing, and circulation control. A thorough history and physical exam can help identify the poison. Decontamination techniques like activated charcoal and gastric lavage aim to prevent or reduce absorption. Laboratory tests and specific antidotes when available also aid diagnosis and management. The overall goal is rapid stabilization and enhanced elimination of toxins from the body.
This document provides an overview of poisonings and toxicology for primary care providers. It discusses the basics of assessing and stabilizing a poisoned patient, including determining if they are stable or unstable based on vital signs and mental status. It covers various toxin categories like anticholinergics, cholinergics, opioids, sedatives, sympathomimetics, carbon monoxide, and toxic alcohols. For each category it describes signs and symptoms, mechanisms, and treatment approaches like supportive care, activated charcoal, antidotes, and specific reversal agents. The goal is to help primary care recognize poisoning presentations and provide initial stabilization before transfer if needed.
A 28-year-old female was admitted to the hospital for postpartum depression characterized by not feeding or accepting her baby and refusing to eat or speak. She was diagnosed with postpartum depression with cerebral venous thrombosis. Her treatment plan included levitaracetam, antibiotics, pantoprazole, ondansetron, enoxaparin, warfarin sodium, and mannitol to improve her quality of living and prevent complications while monitoring her platelet count and blood pressure. The physician recommended withdrawing levitaracetam, reducing anticoagulant doses due to her high platelet count, performing brain imaging, and adjusting anticoagulant dosing based on monitoring.
1. Syncope is often related to cardiac causes in adults. Common cardiac causes include structural heart disease, arrhythmias, and obstructive lesions.
2. Long QT syndrome is an inherited condition that can cause syncope, seizures, or sudden cardiac death, especially with exercise or emotions. It is diagnosed by an elongated QT interval on ECG.
3. Congenital heart defects can cause left-to-right shunts, obstructive lesions, or valvular issues, each with their own pathophysiology that can potentially lead to syncope.
This document discusses acute renal failure in children. It begins by describing a case of a 3-year-old boy presenting with vomiting, diarrhea, and inability to urinate who is found to have hyperkalemia, uremia, and a rise in creatinine, indicating acute kidney injury. It then defines acute kidney injury and differentiates it from acute renal failure. It reviews causes of acute kidney injury including pre-renal, intrinsic renal from vascular, tubular, glomerular or interstitial issues, and post-renal obstruction. Evaluation, management focusing on treating the underlying cause and complications, and outcomes are discussed.
The document provides information about acute renal failure (ARF), including:
- ARF is the rapid loss of kidney function over hours to days, resulting in failure to excrete waste and electrolyte imbalance.
- The main causes of ARF are pre-renal (decreased renal perfusion), intrinsic renal (damage to the kidneys), and post-renal (obstruction of urinary outflow).
- Evaluation involves laboratory tests like urinalysis and blood work to determine the specific cause and guide treatment, which ranges from intravenous fluids to dialysis depending on severity.
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2. CONTENTS
O Cases
O Prevalence
O In Ayurveda
O Introduction, synonymous, Types, Class of poison
O Botanical description
O Toxic principles, Toxicodynamics and Toxicokinetics
O Toxic part, Fatal dose, Fatal period
O Diagnosis,Treatment ,PM appearance
O Medicolegal importance
O Sodana, Parts used, medicinal dose
O Therapeutic uses, folkfore uses, Antidote
O Agada yogas and other yogas
O Research works
O References
3. Case 1
O A 14 years old boy presented with vomiting, loose stools and
giddiness.
O Had a history of consumption of 1 oleander..
O Examination revealed bradycardia with irregular rhythm
O Electrocardiograph (ECG) showed sinus bradycardia with pauses.
O Stomach wash was given with activated charcoal. Temporary
pacemaker implantation was done. Pacemaker was removed at the
end of 48hours as ECG showed normal pulse rhythm.
O DIAGNOSIS : Yellow oleander poisoning
4. CASE 2
O . A 42-year-old woman with a known history of malignant mesenchymal
cancer was admitted to the emergency department with vomiting,
gastrointestinal distress and cardiac symptoms with digoxin-
like toxicity of 4 hour duration. Her complaints began within an hour of
ingesting a bowl of Nerium oleander blooms which she took to reduce
the pain caused by the cancer
O . Oleandrin was detected in the blood sample at a concentration of 14.7
ng/ml.
O With the conservatie management the patient became stable
O DIAGNOSIS : Oleander poisoning
5. PREVALENCE
O In India, the overall percentage of plant poisoning ranges from 6% to
15%, and for rural population alone it can be high as 63% and the
oleander contributes most.
O Most imp cause of livestock poisoning reported in South Africa.
O At present yellow oleander poisoning has a 10% mortality rate in Sree
Lanka
O Ranks equally with mushrooms as major cause of children’s admission
to hospital after accidental plant ingestion worldwide.
6. IN AYURVEDA -KARAVEERA
O Mentioned in Brhatrayis, Laghutrayi s and Nighantus.
O One among upavisha in later texts like RT, RRS, YR etc..
7. Common Oleander Yellow Oleander
O Nerium odorum
Nerium indicum
O Apocynaceace
Common names
O White oleander, Pink
oleander, Rose laurel, Rose
bay, Rosa francesca, Laurier
rose, Adelfa
O Cerbera thevetia,
Thevetia peruviana,
T.nereifolia
O Apocynaceae
O Bastard oleander, Exile
oleander, Be-still tree, Lucky
nut, Tiger apple
8. O Regional name
O Sankrit name
O Hindi
O Tamil
: Arali
: Karaveera
: Kaner, Kanail
: Alari
O Synonymous
• Hyamaraka or Asvamaraka
• Karaveera
• Chandata
• Sataprasaha
• Pratihasa
• Angulipatraka
9. - Systemic ; Cardiovascular
Class of poison
O Modern
O Ayurvedic
Charaka, Susrutha ,AS – Moola visha among sthavara
BP, RT, RRS, YR - Upavisha
O Types
– 3 varietes ;
•Kaiyadeva Nighantu, Bhavaprakasha Nighatu
Sveta, Rakta, Peetha
•Raja Nighantu – 4 varities ; Sveta, Rakta, Peetha, Krishna
12. BOTANICAL DESCRIPTION
Common Oleander
O Habitat
Many subtropical and tropical areas
of the world.
Large evergreen ornamental shrub,
2-6 meters height
O Leaves
Long, narrow, lanceolate, leathery,
dark-green on upper surface, lighter
beneath, 10-25 cm
Yellow Oleander
O evergreen tropical shrub or
small tree, Ornamental (grows
to about 30 feet height)
O Pointed, lanceolate , dark
green upper surface, lighter
green undershades, edges-
rolled
13.
14.
15. Common Oleander Yellow Oleander
O Flowers
Pink,or white fragnant flowers
( with terminal clusters
O Fruit
Long narrow capsule, 8 to 10 cm
long, split open at maturity to
release numerous downy seeds
O Seeds
Pod is slim, cylindrical, ribbed ,
turns brown, dries and splits,
releasing small seeds tipped with
coma of light brown hairs, light
and dusky
O large ,yellowish funnel
shaped flowers
O Globular, light green,
contains single nut which is
triangular with a deep
groove along edge.
O Each nut contains 5 pale
yellow seeds. Seeds are
vaguely heart shaped.
21. TOXICOKINETICS
Cardiac glycosides- Toxic to cardiac myocytes and autonomic system
O Inhibit Sodium- Pottasium ATPase
O Increasing Cardiac Contractibility
O Decreasing AV conduction and heart rate.
A cardiac glycoside has 2 parts 1- carbohydrate , 2- aglyconic portion
• Carbohydrate- imp for solubility ,absorption and bioavailability.
• Aglyconic portion – divided into steroid backbone and unsaturated
lactone ring- role in primary interaction with receptor
22.
23.
24. Inhibit Na+-K+ -ATPase pump
an extracellular portion of the pump
Binding occurs within
Decreases
the active transport of Na+ with consequent excretion of
pottasium Increased intracellular sodium levels
leads to inhibition of NCX( Na+/ Ca 2+ exchanger)
Increased level of Ca 2+ in intracellular space
positive inotropic effect of cardenolides and toxicity
Na, Ca cause partial membrane depolarisation which increases
automaticity and ventricular ectopy
25. IN CARDINOMYOCYTES
O Leads to increased contractibility ( + ve inotropic effect)
O Reduce velocity of electrical conduction ( -ve dromotropic
effect) via AV node depression.
O Reduction of heart rate( -ve chronotropic effect) via SA node
depression.
O In neurons of vagal nerve leads to reduced velocity of
electrical conduction which causes reduced heart rate via a
reflexive reduction of sympathetic transmission
26. OLEANDRIN
O Due to prominent lipophilicity.
O Results in slow urinary excretion.
O Longer duration of action as cardio toxic agent.
O Rapid and conspicuous GI absorption with bioavailability
30 % .
27. TOXICODYNAMICS
INGESTION
• Frothy salivation
• Difficulty in swallowing & articulation
• Tingling and burning sensation in mouth and tongue.
•Dryness of throat
GIT
•Vomiting,
•Pain in the abdomen
• Nausea
•Diarrhea
CVS
• Pulse first slow , later rapid and weak
• Hypotension
• AV block
29. O Tetanic spasm
O Lock jaw
O Hyperkalemia – severe poisoning common
O Metabolic acidosis
O Asphyxial symptoms -later
O Respiratory paralysis , Death
Inhalation
• Headache • Respiratory difficulty
• Dizziness • Nausea
30. In Ayurveda,
O Moola visha lakshana –Susrutha
• Udweshnam - Voluntary stretching of the body
• Pralapam - Delerium
• Moham – Delusion
31. Common Oleander Yellow Oleander
O T
oxicpart
All parts esp root, including
nectar
seeds = roots > fruits > leaves
O Fatal dose
15-20 g root
5-15 leaves
O Fatal period
20-36 hours
All parts esp seeds and root
seeds = roots > fruits > leaves
O 8-10 seeds
15-20g root
5-10 leaves
O 2-3 hours
32. DIAGNOSIS
O Radio-immunoassay
O Fluroscence polarization immunoassay
O Thin layer chromatography
O Fluroscence spectrophotometry
O Reverse –phase HPLC and HPLC/MS –more specific
O Liquid chromatography(LC) with high resolution
masspectrometer (HRMS)
O LC-MS/MS - best of forensic interest
33. ECG
Potentially severe cardiac arrhythmias
• Premature ventricular beats.
• T-wave inversion or flattening.
• Deformed ST segment( “scooped” or “sagging” ST segments)
• ↓ QT interval
• ↑PR interval
• Atrial tachycardia with AV block.
34. TREATMENT
O Gastric lavage, activated charcoal
O Measure urea, electrolytes, magnesium and creatinine. Serum
potassium correlates cardiac toxicity.
O Hyperkalemia life threatening – IV bicarbonate, glucose, insulin.
O ECG monitoring
O Cardiac arrhythmias with anti rhythmic drugs
O Correction of fluid and electrolytic imbalances
35. O Atropine , Adrenaline, Noradrenaline for sinus bradycardia
and A-V block
O Digoxin-specific antibody fragments (Anti-digoxin fab
fragments)
O Correct hypotension by adequate fluid resuscitation with a
crystalloid.
O Correction of metabolic acidosis
O Hemodialysis or hemo perfusion
O Symptomatic treatment.
38. POSTMORTEM APPERANCE
Common Oleander
O Not characteristic
O Congestion of organs.
O Fragments of root may be
present in the stomach
O Petechial hemorrhages seen
on surface of heart
O Can be detected long after
death.
O Resist heat ,therefore can
be detected even from burnt
dead body
Yellow Oleander
O Not specific
O Stomach and deodenum
may be congested
O May show fragments of
seeds
O Subendocardial
ecchymoses
O Resists putrefaction and
can be detected long after
death in exhumed putrefied
bodies
39. MEDICOLEGAL IMPORTANCE
O Accidental poisoning - from its use in traditional medicine
• Herbal tea
• Children and animals may be attracted by its flowers
• Smoke from burning plant.
• When plant material used as firewood poisonous sap
transferred into food may be lethal
• Root is taken internally for treating venereal diseases.
• Root , used for treating cancers and ulcers as paste.
• Decoction of leaves externally to reduce swelling
O Suicidal – decoction or paste prepared from leaves, fruit or
root is common in rural areas.
40. O Homicidal rare – Powdered kernel of fruit mixed with alcohol.
O Abortifacient , root either locally or taken internally
O Cattle poison – juice of root is applied on piece of cloth and
inserted into anus of animal.
Also seeds are crushed and fed to animal with corn or bread.
41. SODHANA
O Dolayantra swedana of Karaveera with cow’s milk for 3
hrs Then wash with hot water and
get dried
( Yogaratnakara )
Cardenolide content less in post sodhana sample
Preparative TLC and LC-MS showed reduction in
oleandrin peak
42. Principles Pre Shoditha Post Shoditha
Saponins Absent Present
Alkaloids Present Absent
Carbohydrates Present Present
Proteins Present Present
Steroids Present Present
Triterpinoids Present Present
And in the post sodhitha sample absolute absence of
symptoms found in toxicity studies that when
compared with pre sodhitha sample.
43. PART USED
O Moolam, Moolatwak, Patrm
MEDICINAL DOSAGE
Choorna : 30-125 mg
(API)
45. O In Indralupta after Gada prachana ,lepana with juice of
Karaveera and honey is mentioned (AH.U.24.29)
O In Sannipata Udara along with madya moolakalka of
Kakadani, gunja and Karaveera mentioned (visha prayoga) –
(AH.Chi. 15.78)
O In Arsas, for lepana leaves of Karaveera along with other
drugs like sigru, nimba etc.. macreated with snuhi ksheera
mixed with hingu mentioned – (AH.Chi.8.23).
O In Kikkisa, Karaveera patra sidha Taila abhyanga for mardana
mentioned –(AH.Sa.1.61)
46. O Kaphaja Visarpa – Lepana of karaveera with other drugs like
triphala, ushira ….- (Ca.Chi 18.14)
O Visha Chikitsa – If any visual impairement, Anjana by devadru,
trikatu,karaveera etc by triturating with ajamootra.(Ca.Chi
.23.69)
O Apachi – karaveera taila is used as nasya (Su.Chi.18/22)
47. FOLKLORE USES
O Administration of choorna of root bark of Nerium oleander
cures Bronchitis, Bronchietasis, Emphysema.
O The seed oil is applied externally to treat skin infections.
O Toxic bites- External application of Nerium oleander.
O Dermatitis – Macerated leaved of oleander may be applied.
O Macerated leaves of oleander also used in superficial tumor,
syphilis, loss of hair.
O Gingivitis –Decotion of oleander leaves have been used.
49. AGADA YOGAS
O Sarvakarmika Agada – friuts and flowers of
Karaveera –AH.Utt.36.70
O Yapana Agada – AS.Utt 40.68.
50. OTHER YOGAS
O Malathyadi Tailam
O Kanakaksheeri taila
O Vajraka Tailam
O Brhat kaseesadi Tailam
O Karaveera Tailam
O Karaveeradya Tailam
– AH.U.24/24
– Ca.Chi 7/114
– Su.Chi 9/54, AH.Chi 19/79
– BP.5/60-62
- Chakradhatta 50/49
– Rasa Tarangini 24.493
51. RESEARCH WORKS
O Studies available regarding yellow oleander as a weight loss
supplement, antibacterial, antifungal, anti inflammatory effects
etc...
O Anti cancer agent – Leaf extract of Nerium oleander L. inhibits cell
proliferation, migration and arrest of cell cycle at G2 /M phase in
HeLa Cervical Cancer Cell.
O Oleandrin : A bioative phytochemical and potential cancer killer via
multiple cellular signaling pathways.
O Phytoremediation for urban landscaping and air pollution control- a
case study in Trivandrum city, Kerala, India. (pubmed)
52. O Analytical study of effect of sodhana on peetha karaveera moola
(Thevetia nerifolia juss ex Steud)- Praseethamol.K, K.V.G Ayurveda
medical college, Sullia.
O A comparative analytical study of moola of sweta karaveera (Nerium
indicum Mill) and peeta karaveera (Thevetia nerifolia juss)w.r.s to its
purification –Dr Pavithra. P, K.V.G Ayurveda medical college, Sullia.
O Safety and efficacy of karaveeradi taila as Lomashaatana on healthy
volunteers – Dr Anjana Mohan , K.V.G Ayurveda medical college,
Sullia.
O Pharmacological and phytochemical evaluation of karaveera beeja
(Thevetia nerifolia Juss ex Steud) w.s.r to its purificaion-
Dr.U.Santhosh Nayak, Alva’s Ayurvedic medical college & hospital.
53. REFERENCES
O https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6723884/
(assessed on 11 may 2021 10.32 am)
O https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6996654/ (assessed
on 11 may 2021 11.52 am)
O Comprehensive Medical Toxicology,3rd Edition ;V V Pillay,page no 963
O The essentials of forensic medicine &Toxicology; 34th edition Dr K.S N
Reddy ; Dr O P Murthy, page no 573
O International Journal of Applied Ayurved Research ISSN: 2347-6362 ;
A review of Karaveeraand its therapeutic utlitity
54. O Rasa Tarangini of Sri Sadananda Sarma; Dr Ravindra
Angadi, 1st edition, page no 484-485.
O Pharmacological and phytochemical evaluation of karaveera
beeja (Thevetia nerifolia Juss ex Steud) w.s.r to its
purificaion- Dr.U.Santhosh Nayak.
O Kriyakoumudhi-V.M .Kuttikrishna Menon page no 751
O A textbook of Agadatantra – Dr .U.R.Sekhar Namburi, page
no 110-114.
O A textbook of Agadatantra- Dr Sobha Bhat.K, page no 138-
142
55.
56. YOU ARE ONLY CONFINED BY THE WALLS YOU
BUILD YOURSELF