Understanding critical factors to create a “bankable” project
switra - critical understanding
Transcript of switra - critical understanding
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Switra (Leucoderma) Its Different Treatment
Modalities
ByDr Deepti
PatilDept. of
Dravyaguna
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INTRODUCTION
“Black spot on white skin is a blessing; white spot on black skin is a curse”
• No pain, itching etc.• Causes more anxiety and social stigma in
Indian society.• Disturbs the sufferer cosmetically more and
rarely functionally.
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DEFINATION
• A whitish discolouration of the skin(sweta varna twacha) is called switra
• VITILIGO- (Vitellos-Latin-White Sheep)• 'Leuco' means 'white' and 'derma' means
'skin', thus leucoderma means abnormal whiteness of the skin LEUCODERMA
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STIPULATION WORLD WIDE
• Ranges from 40-50 million.
• About 1 to 2% of people in the world.
• 2 to 5 million people have the disorder in the
United States.
• Affects all races and both sexes equally.
• 95 % of its victims are below the age of 40yrs.
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INCIDENCES AND RISK PERSONALITIES
• More markedly noted in the dark people of the tropical countries.
• Most commonly affected areas are face, neck, back, wrist, hand, groin, genitals, armpits, etc.
• Occurance of leucoderma about 42 % is Stress related , 28% Heriditory and 30%. Is Worms infested.
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MYTHS……
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NIDANA
Aaharaja
Viharaja
Papa karmaja
Nidana
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BHEDA
Vataja •Aruna Varna
Pittaja •Tamra Varna
Kaphaja •Sweta Varna
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Conti..
Vranaja
Doshaja
2 Types
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LAKSHANA
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DIFFERENCE B/W SWITRA & KUSTA
SWITRA
• Sravarahita
• Caused due to vitiation of
one of the tridosha
• Involvement of only rakta,
mamsa, and meda dhatu
KUSTA
• Sravayukta
• Caused due to the vitiation
of all the tridosha
• Involvement of all the
saptadhatus.
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SADHYA LAKSHNA
• Ashukla loma
• Thin skin
• No overlapping of patches
• Newly manifested
• Anagni dagda
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ASADHYA LAKSHNA
• Switra in Guhya Sthanas like Linga, Yoni, Guda
• Switra in Pani, Tala, & Osta
• Agnidagda
- Asadhya Irrespective Of Purana & Naveena
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LEUCODERMA• Leucoderma is not a medical term
• Any white/light coloured skin patch
• Fed-up acquired skin disorder, making skin
white due to loss of the melanin pigment.
• Non-contagious disease.
• Also termed as vitiligo.
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CAUSES • Immune Hypothesis - Melanocyte destruction and
dysfunction or both may result into Hypo pigmentation.
• Neural Hypothesis - Neurochemical inhibitors are
released at nerve endings that destroy the melanocytes
or inhibit their functioning.
• Melanocyte Self-Destruction Hypothesis - Proposes that
an intermediate in melanin synthesis causes
melenocyte destruction.
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Conti…
• Dietary deficiency of Proteins and Cupro minerals is a major factor for causing vitiligo. Serum skin and cerebro-spinal fluid copper levels are low in these cases.
• GI Disorder like Chronic amoeboisis, chronic Dyspepsia and Intestinal Worms .
• Use of Broad Spectrum Antibiotics ,especially Chlormphenicol and Streptomycin
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• Local irritation caused by wearing the sari or Trousers too tightly.
• Composite Hypothesis : None of the theories alone is entirely satisfactory.
• Actual mechanism of inhibition or destruction of melanocytes is much more complex.
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SYMPTOMS • Odd, Harmless, White Spots Patches on the
skin surface
• More common in women than in men and is
mostly seen on the hands, neck, back and
wrist
• Mostly, no other symptoms can be noted
except whiteness of the skin.
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Contd..• May cause itching sometimes, due to
exposure to the sun or coming in contact with chemicals
• Shows easy friability and susceptibility of the skin.
• Sometimes appears pale, sometimes red and some other times, milky white.
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IS EVERY WHITE PATCH LEUCODERMA…..???????
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OTHER CONDITIONS WITH WHITE PATCHES
Halo nevus - a pale mole with surrounding hypo pigmentation
Skin injury - causes a white or pale patch during skin recovery.
Tinea versicolor
Lichen sclerosis et atrophicus
Leprosy
Morphea
Pityriasis Alba
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Halo nevus - a pale mole with surrounding hypo pigmentation
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Tinea versicolor
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Lichen sclerosis et atrophicus
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Leprosy
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Morphea
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Pityriasis Alba
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White patch will in all probability be
Leucoderma if it:
Has an outline darker than the skin.
Is irregular in appearance.
Gradually increases in size.
Appears milky white under an ultraviolet light.
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IS LEUCODERMA HEREDITARY?
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HEREDITARY FACTOR
• 28% Hereditary
• Parents where one or both have Leucoderma
are only at a fraction of a higher risk than the
general population.
• Even the general population is at a risk of
1-2 %.
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DIAGNOSIS AND INVESTIGATION
• No other special investigations are necessary
for diagnosing the complaints.
• there won't be any change in blood or urine.
• Biopsy can reveal the absence of pigments.
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PREVENTION OF SPREAD
• Maintain good general health and immunity.
• Non communicable disease.
• Any patch should be thoroughly examined first.
• Application of any unconfirmed tropical medication
on skin should be avoided.
• Use of synthetic clothes should be restricted.
• Avoid excess intake of Sour things.
• Avoid Steroids.
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DO'S• Take medicines regularly in the early days itself, so
that complete cure can be achieved.
• Don't worry about Leucoderma, since effective
treatment can arrest the course of the disease and
cure it.
• Use umbrella when out in the hot sun.
• Track all your eatables and habits to streamline all
the irritants or chemicals.
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DON'TS• Avoid direct exposure to sun rays.
• Avoid fast foods, citrus fruits, coffee, tea, cold
drinks, alcohol, beer, non-veg , egg, etc.
• Avoid multiple drugs or drug cocktails.
• Avoid chemical soaps.
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Different Treatment Modalities
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CHIKITSA
• Included under Raktaja roga.• Virechana, raktamokshana, upavasa• First samshodhana followed by shamana
chikitsa.
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TAILA
• Visha taila (Y.R)
• Jyotishmati taila (Y.R)
• Bhallatakadi taila (A.Hru)
• Aragvadadi Taila (Ck.D)
• Marichyadi Taila (Ck.D)
• Krishna sarpa bhasma sidda taila (su.sa)
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GHRITAS
• Somaraji Ghrita (B.P)
• Mahaneela ghrita
• Tilvaka ghrita
• Mahatiktaka ghrita
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KASHAYA’S
• Khadiradi Kashaya/Dhatrikhadira Kashaya
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LEPA’SAs per Charaka Samhita Kustha Chiksta 8th
chapter• Mansiladi lepa• Mayur pita + manasila• Bakuchi (Seed) + Laksha + Gorochana + Anjana
(Rasanajan And Sauveera Anjana) + Pippali + Loha(Krishna) bhasma
• Kathguular + Baakuchi + Chitraka + Gomutra etc.
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Cont…
As per Chakardatta (Kustha chikista)• Pootika Lepa• Gajadicharma masi Lepa• Avalgujabeeja Lepa etc.
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As per Sushruta Samhita
• Pootikadi lepa• Krisnasarpa bhasma lepa• Kilasahara lepa• Shivtrahara lepa • Tutthyadi lepa• Tilavakadi lepa etc.
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Cont…As per Bhavaprakasha • Bakuchi + Haratala + Manasila + Gunja (Seed)
+ Chitraka (Moola) + Gomutra• Neela Aparajeta (moola) lepa etc.As per Yogaratnakar• Shiladi lepa• Triphaladi lepa• Ayorajadi lepa etc.
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Cont…
As per Baishijya Ratnavali• Pootikadi lepa• Pootikeetadi lepa• Shwetajayantimoola lepa• Osta switra nashaka lepa
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EFFECTIVE HERBS IN SWITRA CHIKITSA
• Bakuchi
• Khadira
• Triphala
• Nileeni
• Brungaraja
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GOMUTRA
PROPERTIES OF GOMUTRA (Acc to Yogaratnakara)
• RASA: Katu, Tikta, Kshara.
• GUNA: Ushna, Laghu.
• KAGMA: Deepana, Medhya, Sara, Lekhana.
• DOSHAKRIYA: Kaphavatanashaka, Pittakara.
• ROGANASHAN: Shoola Gulma, Udara, Anaha
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Conti…
• Mainly its Kshar guna is highlighted.
• It contains various minerals- Copper, Iron,
Calcium, Sodium, Magnesium, Potassium,
Phosphate, Sulphur.
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PATHYAPATHYA
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PATHYA
• Laghu anna• Tikta Shakas• Nimba yukta anna• Ghrita prayoga• Jangala pashu-pakshi mamsa• Water kept in copper vessel
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APATHYA
• Amla• Lavana• Maricha• Dadhi• Dugda
• Guda• Anupa mamsa• Tila • Masha • Tikshna Aahara
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GENERAL TREATMENT
• There is no scheduled, conservative treatments at all.
• No single therapy for Leucoderma produces good results in all patients.
• Treatment course and medicines always vary and are unpredictable.
• Treatment is a long process which may take months or years.
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Cont…
• To control the disease
• To produce pigmentation
• Surgical treatment
• Melanocyte culture
• Cosmetic treatment
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MEASURES TO CONTROL THE DISEASE
• Replacement of vitamins and minerals• Topical steroids• Short course of systemic steroids
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FOR PIGMENTATION
• Photo chemotherapy (PUVA therapy for psoralens and UVA)
• Narrow band UVB (NBUVB)• Targeted phototherapy
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SURGICAL TREATMENT
• Removing of vitiligenous skin and
replacing with an autologous graft
• Useful in stable disease
• Segmental vitiligo
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MELANOCYTE CULTURE
• Culture melanocytes in the laboratory-transplant them in to affected area.
Treatment of future
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COSMETIC TREATMENT
Micropigmentation
Introduction of Iron pigments into the dermis
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COMPLICATIONS
• Common side effects of photochemotherapy
like nausea, vomiting, catatact, skin
cancer(long term treatment).
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CONCLUSION
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REFERENCES
• Charaka Samhita
• Susruta Samhita
• Astanga Hrudaya
• Astanga Samgraha
• Yogaratnakara
• Chakradatta
• Bhavaprakasha
• Baishajya Ratnavali
• Sahasrayoga
• http://
www.ayurvedaphysicia
n.com
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THANK YOU