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15 yr male C/o-Nasal bleeding since 7yrs Blood with urine once 6yrs back Patecheal hamerrorhages since 4 months general weakness since 7 years feeling of tieredness since 7 years O/e- Patient is otherwise healthy. Mentalle very active Nadi-Paittikam Jihwa-anupapluta sabda-Ksheenam Sparsha-Ushnam Drik-samanya Akriti-Madhyamam Ama-absent heart rate-60/min BP-120/80 mm of Hg. Appetite,sleep,bowel and bladder-normal Investigations:-Hb-6.4gm/dl DLC: N-8.2,L-90.4,M-0.8,E-0.3,B-0.3% Platelate counts-0.16 lacks/ml(this report is of 28 june 2010,Hb,neutrophil & Platelates count are gradually decreasing ,on 28 may,2010 Hb-9.1.N-38.3 & Platelet-0.96) Bone marrow biopsy: section shows bony traleculac and bone marrow, which is hypocellular with increased fat spaces. In between fat spaces cells of erythroid, lymphoid, myeloid and megakaryocytic series seen.---hypoplastic marrow. Erythropoiesis is normoblastic and and lymphoid cells constitute approx 60% of the leukocytes series. He is advised for bone marrow transplantation Please discuss about the Ayurveda diagnosis, prognosis and treatment. Patient is very poor and is from Nepal.
Responses (21)
  • Accepted Answer

    Thursday, July 08 2010, 09:11 AM - #Permalink
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    ??? ?????? ????? ??? ??? ??? ?? ??? ??? ??? ?? ??????? ???? ?? ?? ????? ?????? ?? ?? ????? ?? ?? ?? ???? ????? ?? ???? ?? ???????? ???? ????? ?? ????? ?? ?? ?? ?? ??? ??????? ???? ????? ???? ?? ?? ?? ???? ?? ??????? ???? ???? ?? ????????? ?????? ???? ???? ????? ?? ????????? ??? ?? ???? ????? ???? ??? ??????? ????? ?? ???? ?????? ???? ????? ?? ?? ??? ??? ?? ?????? ???? ???? ?????? ???? ????? ???????? ?????,????? ????? (?????????? ) ??? ??? ??????? ?? ?????? ?? ???? ?? (?? ????? + ??????? ???? ) ?? ????? ?????? ?? ???? ???? ?? ?????? ?? ???? ?? ?? ?????? ???... baaki allopathic treatment vaidya manish joshi se pataa kare...dhanyawaad


    • Vaidya Manish Joshi
      less than a minute ago
      sirjee, muze kahaa allopathy me phansaa rahe ho? aayurved treatment deta mai achchha nahi lagata hoo kya? by the way, very good joke by you and it will be " joke of the day"..........thanx....
    • VAIDYA MANAS RANJAN HOTA
      less than a minute ago
      Sir,If we follow the lakshana it is Raktapitta,but if we folloe the investigation the case seems to be pandu.Thanks for your valuable contributionn sir. regards,
    • Dr. T. Divakar Rao
      less than a minute ago
      i stll belive it is case of paandu sir..i may be wrong...
    • Dr. T. Divakar Rao
      less than a minute ago
      dear role change karne keliye kaha tha...yaar...bura laga toh sorry...hum ek hi treatment ke bareme har roj bata rahe hai na...adal bad karenge to kaisa hoga..isiliye maine hindi likhaa tha...CCIM part dekhneke baad mein thoda paagal hogaya tha...isliye aise likha..sorry yaar
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  • Accepted Answer

    Thursday, July 08 2010, 09:40 AM - #Permalink
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    ?? ?? ?????? ?? ?? ?? ????? ?? ???? ??
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    Thursday, July 08 2010, 09:49 AM - #Permalink
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    after the expert comment of dr. rao, i need not to say any thing.
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  • Accepted Answer

    Thursday, July 08 2010, 10:29 AM - #Permalink
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    ?????? ?? ????? apalstic anaemia ?? ???? ???? ???????? ?? ????? ?? ???????? ???? ????? ?? ??? ????. ?????? ??? ?? ????? ?? ?????? ???? ?? ???? ????-??????? ?? ????? ?? ??? ??. ?? ????? ??? ???? ????. ????? ??? ????-???? ???? ????? ??. ???? ????? ?? ?? ?? ????? ?? ???????? " ????-?????" ?? ????? ?? ???? ?????. " ?????? ????-????? "{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baddh ?? 3) usheer , chandan, haridra, daarvi, yashti, musta, manjishtha, padmakashtha, prawaal, mauktik pishti....... 4) padmakaadi gan siddha tel - abhyang ?? liye..... dhanyawaad .....
    • VAIDYA MANAS RANJAN HOTA
      less than a minute ago
      Dear Vaidya Joshi, Thanks a lot for quick reply.As such I could not find any nidana.I will definitely ask about the the appetite again.Please discuss about its sadhyasadhyata.
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  • Accepted Answer

    Thursday, July 08 2010, 11:03 AM - #Permalink
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    *???????? ?????????--??????? ?? ????? ??????? *????????? ???[??.?.--???????????????]--???? ?? ?????? *????+????+????????--????[?.??.?] *?????????? ?????-?.??.??.--????+??????+????? ?? ??? *????? ?? ??????? ?? ???
    • VAIDYA PARESH DANGE
      less than a minute ago
      jab pratham bar nasagat rakt strav hua tha tab jwar ka itihas tha?agar han to jwar nidan aur raktpitta-updrav swarup hai aur fir jwar ki aushadhi ka prayog bhi karna uchit hai.
    • VAIDYA MANAS RANJAN HOTA
      less than a minute ago
      Thanks Vaidy Dange, I am a fan of you trio.The way you repply a discussion with appropriate reference is marvellous.(other duo from Nasik too do the same).To be very frank I am both proud and jealous. I will ask about any history of fever.Please discuss about the Sadhasadhyata.
    • VAIDYA MANAS RANJAN HOTA
      less than a minute ago
      Thanks Vaidya Dange,I will lert you know about the developments.
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  • Accepted Answer

    Thursday, July 08 2010, 11:24 AM - #Permalink
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    I agreed with Manish Josh's views. It is different from the classical Pandu. It is a disease of auto immune disorder our Rasayan Therapy are useful along with treatment suggested by experts.


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  • Accepted Answer

    Thursday, July 08 2010, 11:35 AM - #Permalink
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    We consider it as rakat pitta so we shold go for Rakat pitta har chikitsa vasa patra swaras + honey +kehruba Pisti 125mg 3 times /per day till the Bleeding history is there Swaran soothshekar ras 125 mg + kamdudha ras 250mg Bd Should have milk in good quantity , No amal, kshar , katu , lavan ., Regards


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  • Accepted Answer

    Thursday, July 08 2010, 11:38 AM - #Permalink
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    it is a typical case of ubhaya raktaa pitta and charka says it is kasta sadhya or asadhya any way plz ref charak


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  • Accepted Answer

    Thursday, July 08 2010, 11:42 AM - #Permalink
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    it is udhvarga raktapitta as said by vaidya paresh ji and others. -durvarishtam -raktastambhan gulika.
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  • Accepted Answer

    Thursday, July 08 2010, 11:51 AM - #Permalink
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    Dear all, Thanks a lot for your early and valuable responses.My Ayurveda provisional diagnosis is Rakta Pitta. But here the important part is the prognosis(Sadhysadhyata).The mother of the patient works as a housemade at a very elite family.This family is providing financial support.Please share your suggestion whether the case is sadhya,krichhrasadhy,yapya or asadhy.If not asadhya then what improvement should they expect with our treatment and with in how much period of time? regards,
    • VAIDYA MANAS RANJAN HOTA
      less than a minute ago
      please read housemade as housemaid
    • VAIDYA PARESH DANGE
      less than a minute ago
      sir,thnx for compliments. abhi to ye kruchchrasadhy lag raha hai,21dino main positive result milna chahiye.[matlab thik nahi hoga lekin sudharna dikhani chahiye] nahi to chikitsa badal ke dekhe ya dignosis ke baare main fir se sochna padega.
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  • Accepted Answer

    Thursday, July 08 2010, 12:08 PM - #Permalink
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    Give treatment for Ubhaya raktapitta.


    • VAIDYA MANAS RANJAN HOTA
      less than a minute ago
      Thanks Dr. Do you think it will take care of the hypoplastic bone marrow too? regards,
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  • Accepted Answer

    Thursday, July 08 2010, 01:34 PM - #Permalink
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    Diagnosis definatly ????????????? ??...????? pandu ?? ????? ?? ??..?? ?????? ??? ?? ???? ??,?? ???????? ?? ???? ??... ???? ??? ?? ?? ?????? ?? ???? ??? ???????? ?? COATATION ??... ???????????? ?? ????????? ????????? ?????????????????.... ???? ?? ?? ?? PT .??? ????????? ?? ????? ?? \.. ???? ??? ???????? ???? ??... ??????? ?????????? ???????????????? ??????? ??????? ????????? ?????? ???????????.. // ?. ??. ??/ ? ???????? ??? ????? ????? ?? ???? ???????? ??? ?? ???? ?? ???? ?? ???? ?????? ?? ?? ????????? ?? ????? ??....[ hypoplastic bone ??????} Rx ?.????? ????? ?. ???? ???? ?? ????? ??? ?? ?? ???? ????????? + ?????? ?? ?? ?????????? ???? ????? ?? .... ??????? ?????? ?? ????? ??... i suggest acc.to doshyadushya ?.?????? + ??????? + ??????????? + ??????? ????? ???????? ?. ?????? ????? ??? ?. ???????- be specific - like ?.??. ?/?? charak says ????,????,???, ????????....it help in condition like hypoplastic bone marrow ... aplastic a . ?. ??????? ???..?. ??/?? ???? ?? ?????? ?????? ?? ???? pt ?? ???? ???????????? ???? ??.... ?????? ...????????????? ..?????????????????????.....?????????? ??? .... ??? ?? ???? ?? ?? ?? ????????????? use ?? ??? ??.... ?. fresh juice like - aamalki svara ,wheat grass juice , kumari svarasa--also for hypoplastic condition ...


    • VAIDYA MANAS RANJAN HOTA
      less than a minute ago
      Thanks Vaidya Deshmukh,again a Nasik wala master stroke.I will definitely consider your points. Regards,
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  • Accepted Answer

    Thursday, July 08 2010, 01:36 PM - #Permalink
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    going by ayurveda it is case of ubhayaj rakt pit but as there is patechial haemorrage what about BT,CT.as far as treatment is concerned i would prefer bol parpiti with kaharva pishti and praval pishti in honey or malai. B.D. sat giloya with abhrak sahastra puti O.D. cap. feroliv forte 2 b.d. along with syrup livomyn. with this treatment the case must improve in 15 days.
    • VAIDYA MANAS RANJAN HOTA
      less than a minute ago
      Thanks a lot sir.I am realy very happy to raed the line the case must improve in 15 days.We need this confidence sir, only experienced peoplke can say this.Sir, with this treatment can we increase platelet count too? regards,
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  • Accepted Answer

    Thursday, July 08 2010, 02:22 PM - #Permalink
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    good suggestio is o the panel.ple go wih lakshnik chikitsa.


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  • Accepted Answer

    Thursday, July 08 2010, 02:31 PM - #Permalink
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    ???? ?? ????? ???? ?? ?? ????? ???? ?? ?? ?? ??? ?? ???? ??. ????????????? ?? ???? ??? ??? ???? ?? ?????? ?? ?? ????? ??. ??? ???? ???? ?? ?? ????? ?? ?? ????? ?? ?? ????? ?? ??. ?? ?? ???????? ???? ?????. ????? ?? ???? ???? ?? ??????? ???????? ????? ????.


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  • Accepted Answer

    Thursday, July 08 2010, 03:51 PM - #Permalink
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    dear Dr RAnjan the bone marrow study revels bone marrow hypoplasia it is clear cut case of Aplastic Anemia there is Pluripotent stem cell in RBM from which all cells of erythroid lymphoid ,myeloid ,and mega karyocytic series is originated by differention the bleeding tendency is due Thrombocytopaenia which is always associated in Aplastic Anemia this ailment is almost incurable either by Rakta-pitta treatment or by Pandu roga treatment the treatment with gomutra ghan as DR Diwakar wrote is very much effective as it in stimulate kidneys to secrete Erythropoietin which is an hormone [Glyco-protien] which enhances erythropoesis and some herbal medicines which contains epithelial growth factor and IGF alpha can do miracles


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  • Accepted Answer

    Thursday, July 08 2010, 04:55 PM - #Permalink
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    too much advised by senior consultants on board.
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    Thursday, July 08 2010, 05:06 PM - #Permalink
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    Dear Dr., Greetings, what to say after the shots of all tp guns from Nasik and Dr. Rao. Nice opinions by all. Regards.
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  • Accepted Answer

    Thursday, July 08 2010, 08:24 PM - #Permalink
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    Dear Sir, Ayurvedic treatment advised by all respected vaidyas can be initiated. I don't feel the patient has deficiency of erythropoietin as kidney function seems to be normal. Just keep a track on his platelet count as severe depletion can be dangerous.


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  • Accepted Answer

    Friday, July 09 2010, 05:46 PM - #Permalink
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    Tiryak raktpitta Mochras basti Shatavaryadi/ doorvyadi ghrit Bol parpati Mukta pishti Pathyadikwath Rakt majja pachak
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  • Accepted Answer

    Friday, July 09 2010, 08:24 PM - #Permalink
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    **Since there is no such thing in Ayurveda as "aplastic anemia,treat on the lines of "??? ??????" ?.treat the immune dysfunction and improve normal bone marrow production. i.immunomodulators:????????, ??????, ???, ??????, ????????,??????,????????. ii.for improving bone marrow function:????/????? ????, ?????????????,???/???/?????? ?????? ???? ??. iii.???? ??? ????? ???? ???? iv.??????? ?????, ???????? ?????,??????? ???????? (choice of rasayan) v.???? ?????? ?? ????????? ????.
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