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Yasyashyavanimittiyam Indriyam Adhyaya (view source)
Revision as of 06:53, 14 October 2020
, 06:53, 14 October 2020→Vidhi Vimarsha (Applied Inferences )
If patient suffers from an incurable disease and shows [[arishta]] signs, physician should inform the relatives about the exact condition of the patient and suggest care to keep the patient comfortable. If the legal guardian of the patient requests the physician for treatment then only he should treat the patient. [Verse 14-17]
If patient suffers from an incurable disease and shows [[arishta]] signs, physician should inform the relatives about the exact condition of the patient and suggest care to keep the patient comfortable. If the legal guardian of the patient requests the physician for treatment then only he should treat the patient. [Verse 14-17]
=== Contemporary views ===
The prognostic features described in the text can be observed in various disease conditions in contemporary clinical practice. The probable relevant conditions are summarized in the table 1.<ref>Mamidi P. et.al., Yasya Shyava Nimitteeyam of Charaka Indriya Sthana - An Explorative Study, Int. J. Ayu. Alt. Med., 2019; 7(6):252-263</ref>
{| class="wikitable"
|+ Table 1: Contemporary views of prognostic features
|-
! Prognostic feature!! Contemporary views and relevant disease condition
|-
| | Poor prognosis in Pitta disorders [Cha.Sa.[[Indriya Sthana]] 9/3-5] || Alkaptonuria; Nevus of Ota; Jaundice due to various underlying pathological conditions; Acute brain dysfunction; Coma; Delirium; Hypovolemic shock; Caput medusae in portal hypertension due to cirrhosis of liver;
|-
| | Poor prognosis in [[Rajayakshma]] [Cha.Sa.[[Indriya Sthana]] 9/6] || Secondary palmar hyperhidrosis in tuberculosis (TB); Peripheral artery disease (PAD) in TB; Terminal cachexia;
|-
| | Poor prognosis in [[Shosha]] [Cha.Sa.[[Indriya Sthana]] 9/7] || Cavitating pulmonary TB; Subphrenic abscess; Opportunistic infections in immunocompromised patients; Perforation of peptic ulcer; Carcinoma of chest;
|-
| | Poor prognosis in grave diseases [[ashta mahagada]] [Cha.Sa.[[Indriya Sthana]] 9/8-9] || Cachexia and sarcopenia in chronic debilitating conditions like CHF (congestive heart failure), COPD (chronic obstructive pulmonary disease), CKD (chronic kidney disease) and AIDS (acquired immunodeficiency syndrome)
|-
| | Poor prognosis after therapeutic purgation ([[virechana]]) [Cha.Sa.[[Indriya Sthana]] 9/10] || MBO (malignant bowel obstruction); Functional abdominal bloating and distension (FABD); Irritable bowel syndrome (IBS);
|-
| | Poor prognosis with dysphagia [Cha.Sa.[[Indriya Sthana]] 9/11] || Liquid dysphagia or Orophrayngeal dysphagia in various neuromuscular or neurodegenerative or neuroinflammatory or infectious conditions; Lower motor neuron syndromes (LMNs); Amyotrophic lateral sclerosis (ALS); Motor neuron disease (MND); Progressive bulbar palsy (PBP);
|-
| | Poor prognosis with feeble voice [Cha.Sa.[[Indriya Sthana]] 9/12] || Advanced stages of dementia; Delirium; Lower motor neuron syndromes (LMNs); Amyotrophic lateral sclerosis (ALS); Motor neuron disease (MND); Progressive bulbar palsy (PBP);
|-
| | Poor prognosis with shallow breathing and groin pain [Cha.Sa.[[Indriya Sthana]] 9/13] || Acute abdomen; Intra abdominal or intra pelvic hemorrhage; DIC (disseminated intravascular coagulation) in sepsis or septic shock;
|-
| | Poor prognosis with delirium and hallucinations [Cha.Sa.[[Indriya Sthana]] 9/14] || Auditory hallucination in Alzheirmer’s dementia or other types of dementia; Delirium; Organic psychosis etc.
|-
| | Poor prognosis with sudden deterioration [Cha.Sa.[[Indriya Sthana]] 9/15-17] || Various demyelinating diseases like Multiple sclerosis (MS); Various autoimmune diseases like Relapsing polychondritis (RP); Opportunistic infections in immunocompromised individuals; Relapsing fevers; Malaria; Leishmaniasis; Viral infections of CNS (central nervous system); Tuberculsosis (TB) etc.; Cancer induced cachexia (CIC);
|-
| | Poor prognosis with sputum test [Cha.Sa.[[Indriya Sthana]] 9/18]|| Chronic airway diseases like chronic bronchitis, cystic fibrosis, Asthma, Bronchiectasis and diffuse panbronchiolitis; Cavitary pulmonary diseases, lung abscesses, TB, and lungs or bronchial carcinomas etc.
|-
| | Poor prognosis with stool test [Cha.Sa.[[Indriya Sthana]] 9/18]|| Chronic constipation; Partial intestinal obstruction; Megacolon; Ulcerative colitis; Carcinoma’s of gastrointestinal tract etc.
|-
| | Poor prognosis with semen test [Cha.Sa.[[Indriya Sthana]] 9/18] || Hematospermia; Pyospermia; Prostatitis; Carcinomas; Hemangiomas; varices; Epididymo-orchitis; Lymphoma; Testicular tumours; Condyloma; Leukemia; Sarcoma etc.
|-
| | Poor prognosis with discoloration of sputum [Cha.Sa.[[Indriya Sthana]] 9/19] || Bacterial infections; COPD (chronic obstructive pulmonary disease); Tuberculosis (TB); Melanoptysis; Carcinoma of lungs or bronchi; Bronchiectasis; Pulmonary oedema; Pneumonia; Opportunistic lung infections in immunocompromised individuals such as patients suffering with AIDS (acquired immunodeficiency syndrome) etc.
|-
| | Poor prognosis in [[shankhaka]] [Cha.Sa. [[Indriya Sthana]] 9/20] || Inflammatory pseudo tumour of the temporal bone; Giant cell arteritis (GCA); Cavernous hemangiomas; Cavernous sinus thrombosis; Arterio-venous malformations (AVMs); Malignant lesions like angiosarcoma or liposarcoma;
|-
| | Poor prognosis with hemoptysis [Cha.Sa. [[Indriya Sthana]] 9/21] || Hemoptysis seen in lungs or bronchial carcinoma’s, bronchitis, pneumonia, tuberculosis, congestive heart failure and lung abscesses etc.; Pseudo hemoptysis (bleeding originating from upper gastrointestinal tract or upper respiratory tract pathologies);
|-
| | Poor prognosis with cachexia [Cha.Sa. [[Indriya Sthana]] 9/22] || Anorexia-Cachexia in lung cancers or AIDS or in chronic debilitating conditions; CIC etc.
|-
|}
'''Acknowledgement:''' The contributors acknowledge support of Dr. M. Prasad and Dr.G.Kshama for providing table 1 from their published article referred in this chapter.
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== References ==
== References ==