WELCOME TO ALL

JOURNAL PRESENTATION

DEPARTMENT OF SAMHITA SAMSKRITA SIDDANTA

BY

Dr.S.KAMALAKAR PURIPANDA

1ST YEAR PG

THE HEALTH OF NATION MAINLY DEPENDS ON THE

HEALTH OF WOMAN,BECAUSE HEALTHY AND HAPPY WOMAN

LAYS THE FIRST STEP OF A PROSPEROUS NATION

CONCEPTUAL STUDY ON NIDANA AND SAMPRAPTI OF SVETAPRADARA WITH SPECIAL REFERENCE TO

LEUCORRHOEA

AUTHOR: B IT I SINGH,DEPARTMENT OF BAS IC PR INC IPLES

S .V.AYURVEDIC COLLEGE, T IRUPAT I , ANDHRA PRADESH

SOURCE: International Journal of Ayurvedic Medicine

YEAR:2013

SEVERAL STUDIES WERE DONE ON SVETAPRADARA AND ITS TREATMENT,

BUT NO WHERE ITS N IDANA AND SAMPRAPTI WERE D ISCUSSED IN

DETAIL.

THIS STUDY MAINLY DEALS WITH DETAILED DISCUSSION ON NIDANA

AND SAMPRAPTI OF SVETAPRADARA . .

AIM OF THE ARTICLE

CLASSICAL AYURVEDIC TEXTS ALONG WITH THE COMMENTARIES WERE

CAREFULLY STUDIED TO COMPILE INFORMATION ABOUT SVETAPRADARA AND TO EVALUATE THE

NIDANA AND SAMPRAPTI OF THE DISEASE

METHOD EMPLOYED BY

AUTHOR

■VERY S IMPLE, EASILY UNDERSTANDABLE LANGUAGE

■GRAMATICALLY CORRECT,STRAIGHT TO POINT

■HAS SYSTEMATICALLY ARRANGED THE INFORMATION UNDER PROPER HEADINGS

AUTHOR LANGUAGE STYLE AND EXPRESSION

HIGHLIGHTS OF THE ARTICLE

CONTENTSINTRODUCTIONSAMANYA NIDHANA& SAMPRAPTHIVISISTA NIDHANA &SAMPRAPTHISAMPRAPTI GHATAKASAUTHOR’S CONCLUSIONFURTHER UNDERSTANDINGDISCUSSIONMY CONCLUSION

INTRODUCTION♥ SVETAPRADARA IS A CONDITION CHARACTERIZED BY WHITE VAGINAL DISCHARGE NOT ASSOCIATED WITH FOUL SMELL, PAIN, BURNING SENSATION AND ITCHING THUS WE CAN CORRELATE IT WITH LEUCORRHOEA.

♥THE WORD SVETAPRADARA HAS NOT APPEARED IN BRIHATRAYI..BUT COMMENTATOR CHAKRAPANI AND THE AUTHORS OF SARANGADHARA SAMHITA, BHAVA PRAKASH AND YOGA RATNAKARA HAVE USED THE WORD SVETAPRADARA FOR WHITE VAGINAL DISCHARGE.

♥SVETAPRADARA IS QUITE FREQUENT COMPLAINT OF MORE THAN 60% OF WOMEN IN GYNAECOLOGIC CLINIC.

SAMANYA NIDHANA AND SAMPRAPTHI

NIDANA OF YONIVYAPADNIDANA

CHARAKA SUSRUTHA VAAGBHATA

Mithyachara (improper conduct)

Pravrddha linga purshati sevana (excessive indulgence into sex with a man of abnormally developed penis)

Dushtabhojana (vitiated food), visamanga seyana bhrshamaithuna sevana (intercourse in improper position and excessive indulgence into sexual act]

Artava dushti (menstrual disorder)

Atimaithuna(excessive indulgence into sexual act)

Apadravya sevana (use of artificial things for sexual pleasure]

Beeja dosha (genetic morbidity)

Beeja dosha Beeja dosha

Daiva (devine factors)

Daiva Daiva

VATA PRAKOPA AHARA VIHARA ↓

AGGRAVES VATA ↓

STHANIKA VATA PRAKOPA

↓

VISHAMAGNI ↓ TAKES STHANASAMSHRAYA IN YONI PRADESHA ↓ ASHAYAPAKRSHA OF KAPHA DOSHA AND RASA DATHU ↓ ATIPRAVRITTI OF RASA DATHU AND KAPHA FROM YONI PRADESHA

KAPHA PRAKOPA AHARA VIHAR ↓ AGGRAVATES KAPHA ↓ CAUSES MANDAGNI AND AMA FORMATION ↓ OBSTRUCT THE SROTHAS ↓ AGGRAVATES VATA IN YONI ↓ VATA VITIATES STHANIKA KAPHA AND RASA DATHU IN YONI PRADESA

SAMPRAPTIAS THE IMPORTANT CAUSE OF ALL YONIVYAPADA IS VITIATION OF VATA. SO, THE MAIN ETIOLOGICAL FACTOR FOR SVETAPRADARA AS DESCRIBED IN YONIVYAPAD IS VATA AND THE DISCHARGE IN SVETAPRADARA IS OF PANDURA VARNA WHICH SHOWS PREDOMINANCE KAPHA DOSHA.

THIS VITIATED VATA TAKES STHANASAMSHRAYA IN YONI PRADESHA, THERE IT VITIATES STHANIK KAPHA AND RASA DATHU AND EXPELS IT EXCESSIVELY IN THE FORM OF WHITISH DISCHARGE FROM YONI.

VISISTA NIDHANA AND SAMPRAPTI

VATA PRAKOPA:RITU VAISHAMYA

RATRIJAGARANA

VEGASANDHARANA

MANASIK BHAVAS

IUD[APADAVYA PRAYOGA]

ILL HEALTH AND CHRONIC DISEASES

MUCUS POLYP

NIDANAKAPHA PRAKOPASAMASHANA VISHAMASANA ATIMATRA BOJANA

GURU SEETHA MADHURA AHARA

CHRONIC CERVICITIS

DADHI SEVANA

VATA AND KAPHA PRAKOPASNANA WITH ATI SEETHALA JALA

SHEETALA JALA

VITIATES VATA AND KAPHA

TAKES STHANA SAMSHRAYA IN YONI PRADESA, VITIATES STHANIKA DOSA AND DATHU IN YONI PRADESHA

VRIDDHA VATA EXPELS OUT ALONG WITH KAPHA AND RASA DATHU

SAMPRAPTHI♥DUE TO VATA PRAKOPA AHARA VIHARA, VATA VITIATES AND MAKES JATARAGNI IRREGULAR, EVENTUALLY FORMED UNDIGESTED MATERIALS[AMA]

♥LATER DUSTA AMA CIRCULATES ALL OVER BODY THROUGH RASA VAHA SROTHAS BY THE MOTIVE FORCE OF VYANA VAYU

♥CIRCULATING AMA CAUSES SROTO AVARODHA

♥DUE TO AGNI VAISHAMYA AND SROTOVARODHA KAPHA DOSHA AND RASA DHATHU ARE FORMED EXCESSIVELY IN YONI PRADESHA

♥APPEARANCE OF WHITE DISCHARGE THROUGH VAGINA BY THE ACTIVITY OF EXPULSION OF APANA VAYU

SAMPRAPTI GHATAKAS

DOSA VATA AND KAPHADUSYA RASADATHUADHISTANA YONI,GARBHASAYAUDHBAVA STHANA AMASAYASROTHAS RASAVAHASROTHODUSTI ATIPRAVRITTIVYAKTHA STHANA YONIROGAMARGA ABHYANTARA

CONCLUSIONAYURVEDA TREATMENT MAINLY DEPENDS ON NIDHANA AND SAMPRAPTI.

IF PHYSICIAN UNDERSTANDS THE SAMPRAPTI IN A PROPER WAY PHYSICIAN WILL NEVER FAIL IN THE MANAGEMENT OF DISEASE

FURTHER UNDERSTANDING

SVETAPRADARA(YONI SRAVA) RELATED TOPICS

IN BRIHATRAI

2.ACHARANA&VIPLUTHA

3.UPAPLUTHA

1.KAPHAJA YONI vyapad

CA.CHI.30,SU.UT 38,A,S.U.38,A.H.UT.33

1.KAPHAJA YONI vyapad [VAGINITIS/CANDIDIASIS]

A CLINICAL ENTITY CHARACTERISED BY ITCHING

AND MUCOID DISCHARGE

SHEETALA YONI - DEVOID OF NORMAL TEMPERATUREYONI KANDU - ITCHINGPAICHILYA YONI - MUCOID SECRETIONALPA VEDANA - LOW GRADE PAINPANDU VARNA - WHITISH DISCHARGE

2.ACHARANA&VIPLUTHA[PRURITIS VULVA]

CH.CHI.30SU.UT.38

UNCLEANINESS OF GENITAL ORGAN

KANDU – ITCHINGSRAVA – DISCHARGEATI NARA KAAMKSHA – INCREASE INTREST IN SIC

3.UPAPLUTHA[CANDIDIASIS]

CH.CHI.30A.S.UT.38A.H.UT.33

A CLINICAL ENTITY CHARACTERISED BY WHITE MUCOID DISCHARGE WITH

PAIN

PAANDU[SHWETHA SRAVA] – WHITE DISCHARGEKAPHA SRAVA – MUCOID DISCHARGETODA YUKTHA SRAVA – DISCHARGE WITH PAIN

MODERN POINT OF VIEW

NORMAL VAGINAL ENVIRONMENT

A DYNAMIC INTERELATIONSHIP BETWEEN LACTOBACILLUS ACEDOPHILINS AND OTHER ENDOGENOUS FLORA, OESTROGEN,GLYCOGEN,VAGINAL PH AND METABOLIC BY PRODUCTS OF FLORA AND PATHOGENS CHARACTERISE THE NORMAL VAGINAL ENVIRONMENT.

L.A. PRODUCES HYDROGEN PEROXIDE WHICH IS TOXIC TO PATHOGENS AND KEEP THE VAGINAL PH BETWEEN 3.8-4.2

SEEN IN NEWBORN BABY FOR A WEEK DUE TO MATERNAL OESTROGEN.SEEN IN GIRLS DURING PUBERTY DUE TO HORMONAL CHANGES.AT THE TIME OF OVULATION AND IN EARLY PREGNANCY.DURING SEXUAL EXCITEMENT.

GENERAL ILL HEALTH AND UNDER NUTRITION.DYSFUNCTIONAL STATE IN GENITAL TRACT.PSYCHOLOGICAL FACTORS.

LEUCORRHOEANormal Discharge Abnormal Discharge

HORMONAL RELATEDMODERATEODORLESS,PAIN LESSWITH OUT PRURITISMILKY DISCHARGE

HORMONAL RELATEDEXCESSIVEFOUL SMELL,PAIN FULLITCHING,STICKY,FROTHYCURDY DISCHRGE

LEUCORRHOEA PHYSIOLOGICAL PATHALOGICAL

1.WHAT IS THE COMMON TYPE OF VAGINAL DISCHARGE?

2.WHAT IS QUITE FREQUENT COMPLAINT OF MORE THAN 60% OF WOMEN IN GYNAECOLOGIC CLINIC?

CANDIDIASISDEFINITION:- A CLINICAL ENTITY CHARACTERISED BY WHITE CURDY DISCHARGE WITH PAIN AND ITCHING.ETIOLOGY AND PATHOGENISIS:-1] EXCESSIVE USING OF ANTIBIOTICS- THEY CAN KILL THE NORMAL GOOD BACTERIA IN VAGINA. 2]BEING OVER WEIGHT 3]DM 4]USING STEROIDS.SYMPTOMS:- VULVA VAGINAL ERYTHEMA,ODEMA,THICK WHITE CURDY DISCHARGE THAT ADHERES TO VAGINAL WALLS,ITCHING.

LEUCORRHEA IS NOT A DISEASE,BUT SYMPTOM OF SO MANY DISEASES

Kaphaja yoni

vyapad[chronic cervicitis]

Upaplutha[Candidiasiss]

Durbalata and jirna

vyadhi[health and chronic

diseases]

Acharana&viplutha

Antarmukhi/

Mahayoni[retroverted/

prolapsed uterus]

Karnini[mucus polyp]

CLINICAL DIAGNOSIS

Excessive normal

secretion

Vaginal Thrush[VT]

BV

Cervical Erosion[CE]

Endocervicitis[EC]

Carcinoma of

cervix[Ca.Ce]

Foreign body[FB]

Endometrial Polyp[EP]

Trichomoniasis,Gonococal,

Chlamydia,Candidiasis

DIAGNOSIS

DISEASE CAUSITIVE ORGANISM

DISCHARGE ODOR SYMPTOMS

CANDIDIA CANDIDIA ALBICANS [YEAST]

WHITE CURD LIKE

NO ODOR

ITCHING,ERYTHMATOUS VULVA

CHLAMYDIA TRACHOMATIS [BACTERIA]

MUCOPURULENT

VARIES LAP,LBP,ITCHING

TRICHOMONIASIS

TRICHOMONOS VAGINALIS

WHITE-YELLOW, PURULENT,FROTHY

PRESENT

ITCHING, ERYTHMATOUS

BACTERIO VAGINALIS

GARDENELLA [BACTERIA]

WHITE-GREY FISHY ITCHING

GONORRHEA NEISSERIA [BACTERIA]

THICK YELLOW

PRESENT

BURNING,ITCHING

LAB INVESTIGATIONS

High vaginal swabHVS+Wet saline microscopySpeculum examinationEndocervical swabCervical smearBiopsyHysteroscopy

QUESTIONS AND ANSWERS

1.WHAT IS THE SOURCE OF VAGINAL DISCHARGE?

V.D IS NOT FROM THE VAGINA AS THE VAGINA CONTAINS NO GLANDS.THE DISCHARGE IS FROM THE CERVIX.

2.WHAT IS THE COMMON TYPE OF VAGINITIS?

C.V.

3.WHAT IS PRURITIS VULVAE,WHAT SYSTEMIC DISORDERS ASSOCIATED WITH PRURITIS?

ITCHING. HEPATITIS,DIABETIS,CRF.

4.WHAT SKIN DISEASES CAN CAUSE PRURITIS?

SCABIES,PSORIASIS,TINEA.

5.HOW IS PREGNENCY RESPONSIBLE FOR INCREASED V.D?

THE INCREASED OESTROGEN LEVELS DURING PREGNENCY MAKES THE V.PH FAVOURBLE FOR V.D

6.WHAT LESIONS WILL YOU RULE OUT ON THE CERVIX IN CASE OF EXCESSIVE V.D?

CH.CERVICITIS,C.P,CE.

7.WHAT IS THE ROLE OF RBS ESTIMATION IN CASE OF V.D?

RECCURENT VD/VAGINITIS SEEN IN PATIENTS OF DM.THE GLYCOGEN CONTENTS OF THE VAGINAL CELLS INCREASE S THEREBY PREDISPOSING FOR VAGINAL INFECTION.

8.WHAT ARE THE FACTORS CAUSING CANDIDIASIS?

IMPROPER HYGIENE,UNTIDY UNDERGARMENTS,UNCLEANED NAILBEDS,CLEANING THE GENITAL PARTS WITH SOAPS .

S9.HOW OCP ARE RESPONSIBLE FOR INCRESED

INCIDENCE OF VD?

OESTROGEN ENCOURAGES THE INCREASED LEVEL OF

GLYCOGEN IN THE VAGINAL CELLS WHICH FAVOUR THE

GROWTH OF ORGANISMS IN THE VAGINA.

10.WHAT IS STRAWBERRY CERVIX?

IT IS SEEN IN THE TRICHOMONAL VAGINALIS

INFECTION.COLPOSCOPIC FINDINGS WHERE PETICHIAL

LESIONS IN THE CERVIX APPEARS AS STRAWBERRY LIKE

MY CONCLUSIONVAGINA IS SELF-CLEANING. A DELICATE BALANCE OF GOOD BACTERIA AND NATURAL FLUIDS KEEPS THE VAGINA HEALTHY AND FREE FROM INFECTIONS.

LUCHORRHEA IS NOT A DISEASE,BUT SYMPTOM OF SO MANY DISEASES HOWEVER ,SOMETIMES THIS SYMPTOM IS SO SEVERE THAT IT OVERSHADOWS SYMPTOM OF ACTUAL DISEASE AND WOMEN COME FOR THE TREATMENT OF ONLY THIS SYMPTOMS.

AYURVEDA HAS GIVEN MORE EMPHASIS TO NIDHANA AND SAMPRAPTI AS SAMPRAPTI VIGHATANA IS CHIKITSA.

THANK U DOCTORS