What is Lyme disease?

• Lyme disease is a spirochete (A group of bacteria of Spiral shape, some of which are serious pathogens for the humans) infection transmitted by the bite of infected black legged or deer ticks of the Ixodes ricinus complex.
• It is a tick- borne infection that is the most common in the United States and Europe.
• Spirochetes are ingested by the ticks at the time of sucking blood from infected animals or humans.
• Ticks used to attack at night; they remain attached for less than 30 minutes before returning to their hiding places. 
• Mode of transmission is either by a bite, through the infected saliva, or by contaminating mucosal membranes with infected coxal fluid.
• Incubation Period- 3 to 30 days

CAUSES

• Causitive Organism– Borrelia species like Borrelia burgdorferi, B.afzelii, Borrelia garinii etc.
• It is caused by a tick bite. The bacteria enter through the skin and make their way to the blood stream.
• The tick must be attached to the skin for 36 to 48 hours in order to transmit this disease.

SIGN AND SYMPTOMS

Early Stage signs and symptoms

• A small, red bump that is similar to the bump of a mosquito bite that often appears at the site of a tick bite or tick removal and resolves over a few days. This is absolutely normal occurrence doesn’t indicate Lyme disease.

Signs and Symptoms occur after a month of Infection-

• Rash- Rash occur 3 to 30 days after an infected tick bite, an expanding red area might appear that sometimes clears in the center.
• Pattern of rash  – bull’s-eye pattern
• The rash (erythema migrans) expands slowly over days and can spread to 12 inches (30 centimeters) across. It’s typically not itchy or painful but raised temperature may be noticed of the rash area on touch.
• One of the hallmarks of Lyme disease is Erythema migrans. 
• Everyone with Lyme disease may not develop the rash. Some people experience this rash at more than one place on their bodies.
• Other associated symptoms- Fever, chills, fatigue, body aches, headache, neck stiffness and swollen lymph nodes along with the rash.

Later stage signs and symptoms

• Erythema migrans- The rash may appear on other areas of your body.
• Joint pain- Bouts of severe joint pain and swelling are especially likely to affect your knees, but the pain may shift from one joint to the other.
• Neurological problems- One may develop inflammation of the membranes surrounding the brain (meningitis), Bell’s palsy or temporary paralysis of one side of your face, Feeling of numbness or weakness in your limbs, and impaired muscle movement may be noticed after weeks, months or even after years of infection.

Less common signs and symptoms

Several weeks after the infection the following symptoms may develop in some people-

• Heart problems like an irregular heartbeat
• Inflammation of eye
• Hepatitis or Liver inflammation 
• Severe fatigue

Complications

If this disease is ignored and left untreated the following complications can be there-

• Lyme arthritis- Chronic joint inflammation particularly of the knee joint.
• Neurological symptoms- Facial palsy and neuropathy
• Cognitive defects like impaired memory
• Irregularities of the Heart rhythm

AYURVEDIC ASPECT AND TREATMENT-

• In Ayurveda all the microorganisms such as microbes. Bacteria, virus or parasites comes under the “Krimi” which means Worm.
• There is neurological involvement so it may be considered that there is Vitiation of Vata Dosha.
• The main aim of treatment will be elimination of the bacteria and to prevent the body from the symptoms due to deranged Vata dosha and also strengthening of the immune system.
• Maintain a good diet and lifestyle.
• Practice Yoga and Pranayama
• Panchakarma therapies like Abhyanga, Shali shashtik pinda sweda, Patra pinda pottali sweda etc. might help to relieve pain and stiffness associated with the disease.
• Food for intake– pungent and bitter is good choice of food for this disease. 
• Food to be Avoided- Sweet taste food items, jaggery, curd, fermented products, newly cropped rice, Avoid leafy vegetables.
• Maintain a good sleep hygiene as sleep is an essential Key for the healing.

PREVENTION

The Lyme disease can be prevented by taking the following measures-

• Proper Covering up- While a walk through a wooded or grassy area, one should wear shoes, long pants tucked into your socks, a long-sleeved shirt, a hat and gloves.
• Try to avoid walking through low bushes and long grass. Keep your dog on a leash.
• Insect repellents- Whenever going outside apply insect repellent with a 20% or higher concentration of DEET to your skin. If applied to the children then avoid applying on their hands, eyes and mouth as it may have toxic effects.
• Try to make your Yard Tick-proof- Mow your lawn regularly, Clear bushes and leaves where ticks live. For discouraging rodents that carry ticks- Stack wood neatly in dry, sunny areas.
• Regular Checks- One should check your clothing, children and your pets for the ticks. One should be vigilant especially after spending time in the yard. Deer ticks are often no bigger than the head of a pin, so you might not discover them unless you search carefully.
• Take a Shower- On should take a shower as soon as you come indoors. Showering and using a washcloth might remove unattached ticks as they often remain on your skin for hours before attaching themselves. 
• Don’t assume you’re immune- One can get this disease more than once.
• Remove a tick as soon as possible with Forceps- tick should be grasped gently near its head or mouth. Try not to squeeze or crush the tick, but pull them carefully and steadily. After removal of tick dispose it by putting it in alcohol or flushing it down the toilet, and antiseptic ointment should be applied to the bite area.

Hypertension (High Blood Pressure) is a typical condition where the drawn out power of the blood against our artery valves is sufficiently high that it might in the end mess wellbeing up, like heart disease. 

Pulse is resolved both by the measure of blood your heart siphons and the measure of protection from blood stream in your arteries. The more blood your heart siphons and the smaller your conduits, the higher your circulatory strain. A circulatory strain perusing is given in millimeters of mercury (mm Hg). It has two numbers. 

• Top number (systolic pressing factor). The first, or upper, number estimates the pressing factor in your courses when your heart beats. 
• Bottom number (diastolic pressing factor). The second, or lower, number estimates the pressing factor in your conduits between beats.

In Ayurveda, Hypertension can be considered as a Raktaj Roga, where the Vata is the related (Anubandha) Dosha. Consequently, the term Raktagata Vata is more suitable to the condition rather than the over two. 

As indicated by Ayurveda, hypertension includes each of the three Doshas, the heart, and the veins. In hypertension we can see signs and indications of unsettling influence of Vata dosha that for the most part of ‘Vyana vayu’. The treatment is additionally on the premise to remedy of the equilibrium of Vata dosha.

Etiological factors of Hypertension

Primary Hypertension causes:

• Hereditary factor 
•  Environmental factor-packing, contamination, rivalry in work. 
•  Age and sex factor 
•  Habit of Alcohol and smoking 
•  Increase in lipid profile and serum cholesterol 
•  Obesity 
•  Psycho-social variables nervousness, strain. 
•  Dietary factor-more salt admission. 

Secondry Hypertension causes:  

• Because of organization of specific medications like preventative pills, steroids and so forth 
•  Hypertensive illnesses of pregnancy: Toxemias of pregnancy 
•  Renal causes: Acute nephritic condition, constant nephritis and polycystic kidney. 
•  Endocrinal causes: Thyrotoxicosis, myxedema and acromegaly. 
•  Metabolic causes: Diabetes mellitus, persistent gout and atherosclerosis. 
•  Congenital illnesses: Coarctation of aorta 
•  Collagenosis and different illnesses: SLE and polyarteritis nodosa. 
• Neurological: Encephalitis, cerebrum tumor and cerebrovascular mishaps

Common symptoms of Hypertension

• Cerebral pain 
• Nausea 
• Numbness and consuming sensation in hands and feet 
• Vertigo 
• Vomiting 
• Feeling of sluggishness, fretfulness 
• Breathlessness 
• Loss of hunger 
• Chest torment 
• Discomfort 
• Bleeding from nose 
• Swelling in legs and eyes 
• Irritability 
• Haziness of vision

Compalications of Hypertension

Uncontrolled hypertension can prompt after a few intricacies created in the human body: 

• Heart assault or stroke: Hypertension can cause solidifying and thickening of courses (atherosclerosis), which can prompt the heart assault, stroke or other cardio-vascular inconveniences. 
• Aneurysm: Hypertension can be reason for debilitate and protruding the veins, framing an aneurysm. 
• Heart failure: Heart muscle thickens in view of the siphoning of blood against the higher pressing factor in veins. The thickened muscle may struggle for siphoning enough blood to body’s necessities, which can prompt heart disappointment. 
• Organ malfunction: Debilitated and limited veins in kidneys and different organs, which keep such organs from typical working. 
• Vision loss: Hypertension harms the little veins in the retina of eyes can be lead to vision misfortune. 
• Metabolic disorder: Metabolic condition is a bunch of problems of body’s digestion, which including expanded midsection perimeter, high fatty substances, low HDL, high insulin levels and hypertension. In the event that individual has high blood pressure, it tends to be bound to have different parts of metabolic condition. The individual has the more serious danger of creating diabetes, coronary illness or stroke. 
• Memory issues: Uncontrolled hypertension might be influencing the capacity of the individual to think, recall and learn. Issue with memory or understanding ideas is more normal in individuals with uncontrolled high blood pressure.

Treatment of Hypertension in Ayurveda

1. Nidana Parivarjan 

• Evasion of etiological elements of a sickness is known as Nidana Parivarjanam. The accompanying causative components of hypertension ought to be rigorously kept away from. 
• Excessive admission of salt, vegetable oils, chilies, quick food sources, low quality nourishments, zesty food varieties, tea and espresso and so on Alcohol utilization and smoking. 
• Excitation, incitement, quarreling, stresses and tensions 
• Tight apparel 
• Excessive guilty pleasure in sexual exercises 

2. Way of life Modifications 

• Weight decrease 
• Regular actual exercise, day by day energetic strolling for half 60 minutes 
• Well-planned resting and arousing 
• Regular act of Yoga and home grown Meditation 
• Avoid the admission of slick, pungent, acrid and zesty food 
• Intake of adjusted eating routine, more utilization of leafy foods vegetables in diet 
• In diet more utilization of wheat, Barley, Sorghum, green gram, horse gram, Bitter gourd, Bottle gourd, Turnip, 
• Carrot, Radish, Indian gooseberry, Cucumber, Black grapes, Pomegranate, Apple, Pineapple, milk and so forth

Oligospermia is a condition found in men, which is described by a low sperm include in their semen. To impregnate a lady, a sound measure of sperm in a man’s semen is normally fundamental. As expressed by WHO in the year 2009, if the sperm tally is under 15 million sperm for every milliliter (mL), at that point the condition is called oligospermia. Oligospermia can be ordered into three classes: 

Mild oligospermia, when the sperm check is between, 10 to 15 million sperm/mL. 

Moderate oligospermia is analyzed when sperm check lies between 5 to 10 million sperm/mL. 

Severe oligospermia when the sperm tally is somewhere in the range of 0 and 5 million sperm/mL.

In ayurveda, Oligospermia is called as Shukralpta.

As per Ayurveda, infertility exists when a healthy couple can’t accomplish a pregnancy following at least two years or neglect to consider for quite a long while after the principal conveyance. To have posterity is a fantasy of each wedded couple.

Shukra Dhatu Kshaya and Oligospermia are not actually one and the equivalent. However, Oligospermia is a piece of Shukra Dhatu Kshaya showing quantitative vitiation of Shukra Dhatu. Sukra Dhatu Kshaya can be successfully contrasted and Oligozoospermia at the point when we associate it with low sperm check. 

Samprapti (Pathogenesis) of Oligospermia

Vitiated Vata and Pitta are the main culprit

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Vitiated Dosha causes Jatharagni Vaishamya

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Finishing off with Aamotpatti which causes

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Rasavaha Srotorodha

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Reformist evaluative transformation of Dhatu is hampered driving to helpless sustenance of Shukra Dhatu.

Causes of Oligospermia

Hormonal imbalances: The chemicals needed for sperm creation are delivered by the nerve center and pituitary organs. The sperm creation gets hindered if any adjustment happens in these chemicals. 

Ejaculatory issues: When semen as opposed to streaming out of the penis, inverts back to the bladder, at that point it is known as retrograde discharge. This condition can lessen the sperm includes and cause barrenness in men. 

Undescended balls: Men brought into the world with this condition are probably not going to be ripe. In the case of during fetal turn of events, the gonads don’t slip from the mid-region into the sac that structures the scrotum, at that point the richness of that individual gets hampered. 

Antisperm antibodies: Certain resistant framework cells known as against sperm antibodies will in general slaughter the sperm cells by erroneously distinguishing them as unsafe trespassers causing low sperm check. 

Chromosomal anomalies: Certain hereditary issues like Klinefelter’s condition, Kallmann’s disorder and Kartagener’ condition can cause unusual advancement in the male regenerative organs. 

Obsruction: Obstruction is one of the significant reasons for oligospermia. The cylinders that convey sperm, whenever obstructed by some strange improvements like cystic fibrosis or any injury due to earlier medical procedures and contaminations, can prompt a low progression of semen. 

Injury or Trauma: Some medical procedures like vasectomy, hernia fix a medical procedure, scrotal medical procedures, prostate medical procedures, and so forth can decrease the sperm include in your discharge. 

Certain meds: Certain prescriptions like antifungal, anti-microbial, ulcer medications, chemotherapy drugs, testosterone substitution treatment and so on can hinder sperm creation in one’s body. 

Environmental factors: Exposure to synthetics, radiation, and weighty metals can diminish sperm creation.

Manifestations of Oligospermia 

Common symtoms in Oligospermia

For certain men, there are no conspicuous signs and symptoms of oligospermia seen. Just when they discover trouble in imagining a kid, this ailment gets analyzed. In any case, if a man has oligospermia because of other basic issues like chromosomal irregularities, hormonal awkwardness or any obstacle, at that point certain signs and indications may happen. How about we investigate the side effects of oligospermia as given beneath: 

• Expanding, pain, or bump in testis. 
• Sexual working issues like the failure to keep an erection during sex or erectile brokenness. 
• Low facial and body hair development and different indications of chromosomal irregularities and hormonal uneven characters. 
• Thick release
• Extended and swollen veins in the scrotum. 
• In the event that this issue occurs because of transmission of an infection, one can encounter some consuming sensation while peeing.

Risk Factors

There is various danger factors related with low sperm check. Underneath recorded are the dangers of oligospermia: 

• Being overweight 
• Despondency or stress in work and everyday life 
• Being influenced by specific contaminations in past 
• Openness to poisons and synthetic substances 
• Gonads being presented to outrageous warmth 
• Injury or injury to the gonads 
• Utilization of specific prescriptions 
• Undescended gonads 

Treatment of Oligospermia (Shukrakshya)

The line of treatment for Shukrakshya as referenced in Ayurvedic writings are Snehana (oleation), Vamana (emesis), Virechana (purgation), Niruha (cured douche with decoction) Anuvasana (sedated purification with oil) and Shamana Aushadhi (palliative treatment) contingent upon the condition. As per these standards, it is upheld to utilize Shamana treatment in the wake of performing Virechana Karma (purgation).

Some of the suggested dravyas are cow’s milk, cow’s ghee, nectar, ashwagandha, bala, shatavari, triphala, shilajitu, musali pak, chyawanaprasha, vrishya vati, kushmanda avaleha, rasayana vati that are known to be useful in keeping up sexual health.

DIET RECOMMENDATIONS (AAHAR)

• Devour nutritious food like milk, explained spread, eggs, poultry, new natural products, nuts, grains and vegetables 
• Increment take-up of food varieties and organic products high in lycopene like tomatoes, cherries, melons and so on might be useful 
• Food sources plentiful in Vitamin-C, for example, citrus organic products (lemons, oranges and so on) might be utilized 
• Madhur rasa (sweet) and master ahara (substantial) is suggested (Like Ghee, oils, fats, and so on) 
• Keep away from food varieties that reason acid reflux, abundance salt, liquor and astringent food varieties 

Lifestyles CHANGES (VIHAR)

• Follow an efficient every day lifestyle (Dincharya) that incorporates suitable resting and waking examples, great quality and time for rest, sexual exercises, and activities 
• Stay away from exercises that lead to pressure 
• Try not to perform unreasonable activities 
• Keep away from concealment of desires (vegavidharan)

INTRODUCTION-

Periodontal disease is also known as gum disease. Other names are Pyorrhea, Periodontitis, and Gingivitis. It affects the tissues around the teeth and involving a set of inflammatory conditions.

Early stage symptoms – In early stage it is termed as gingivitis in which gums become swollen, red, and bleeding may be present.

Later stage-It is termed as periodontitis or more serious form. In this stage, the following symptoms are present- there is loosen teeth or teeth may fall due to loss of bone, gums can pull away, Bad breath may also be present. Further it can damage the ligaments, gums and supporting bone. 

Advance Stage- At the later stage it is the main cause of loss of teeth in adults. Basically, it is due to poor Oral hygiene.

Causative Organism- Pyorrhea Alveolaris

Most affected – People with age group of 30 years and above is more prone to this disease, Male is more affected than females, Others- Smokers, and people with Diabetes are more prone to this disease.

SYMPTOMS

• Tender gums
• Swollen gums 
• Bright red, dusky red, purplish gums or shiny surface
• Bleeding present in gums
• Bad breath
• Difficulty in eating food
• Loose teeth
• Formation of new spaces between teeth
• Recession of gums
• Pus discharge
• Pocket formation between tooth and gums
• Periodontal abscess

TYPES OF PERIODONTITIS-

The types of the periodontal disease are as follows-

• Chronic Periodontitis- It mainly affects the adults, children may also be affected.

This is the commonest type of Periodontitis in which there is formation of plaque and it involves slow disorientation that may improve and get worse over time but cause the destruction of the gums and bone and should be treated to prevent loss of teeth.

• Aggressive Periodontitis- It mainly occurs at the time of adolescence and affects some people. Further it leads to rapid progression in gums and bone and there are chances of teeth loss if left untreated.
• Necrotizing Periodontal Disease- In this type the process of necrosis starts in the gum tissue, ligaments and supporting bone due to lack of supply of blood and leads to severe infection. It is more common in the People with low immunity levels. For example- HIV infection, cancer treatment, malnutrition.

CAUSES

• It is triggered by bacterial activity and may be caused by indigestion and acidity.
• Due to poor oral hygiene a thin layer of harmful bacteria starts to build continuously upon our teeth leading to formation of plaque. 

It is formed after eating meals and plaque is removed after brushing of teeth.

• Use of mouth wash containing chemical
• If Brushing is not done properly
• Stagnation of food particles
• Frequent use of toothpicks.
• High sugary diet, Carbohydrate rich diet.
• Intake of alcohol and smoking. 

RISK FACTORS

• Gingivitis 
• Poor oral health Hygiene and habits.
• Smoking 
• Tobacco chewing
• Pregnancy or menopause- Hormonal changes
• Malnutrition
• Deficiency of Vitamin C
• Medication that cause dry mouth
• Bridges that won’t fit frequently 
• Immuno-compromised conditions- For Ex. leukemia, AIDS and cancer treatment
• Other diseases- diabetes, rheumatoid arthritis, and Crohn’s disease , Obesity 
• Old age

COMPLICATIONS

• Tooth loss
• Alveolar Bone destruction
• In advance stage it may involve heart, lungs and other parts of the body
• It may be linked with respiratory disease, coronary artery disease or rheumatoid arthritis
• Osteomyelitis may also be involved.

AYURVEDIC VIEW OF PERIODONTAL DISEASE

In Ayurveda, the gum related problem is basically due to vitiation of Rasa and rakta dhatu. If there is impaired digestion the toxins are produced and these toxins mix with the Rasa and Rakta Dhatu. These toxins in turn produce pyorrhea.

Ayurveda works on the root cause i.e. correction of the metabolic issues and maintaining proper elimination of harmful toxins on a regular basis. 

HOME REMEDIES

• Use of Herbal tooth powder is recommended.
• Apply Mustard oil mixed with pinch of salt on both gums and teeth are also helpful to inhibit further growth of bacteria. 
• Yashtimadhu or Licorice root powder mixed with honey should be applied for gum massage.
• Drink fresh juices of carrot and spinach.
• Oil pulling with sesame oil, olive oil and compressed coconut oil may help to strengthen the teeth and gums.
• Rub rock salt or camphor powder on gums to improve oral hygiene and prevents pyorrhea.
• Use decoction of Triphala for Gargling prevents infections in the oral cavity and help in curing pyorrhoea.

DIET AND LIFESTYLE –

• Avoid oily and spicy food items and heavy meals during night time.
• Eat a Healthy diet enriched with fiber in order to maintain your gut health.
• Avoid junk food or packaged food items that disturbs the metabolism.
• One should be physically active i.e. avoid Sedentary lifestyle
• Late-night meals should be avoided
• Diwaswapna or day sleep should be avoided in order to maintain a healthy digestion.
• Don’t ignore your oral Hygiene. It ashould be well maintained by brushing twice a day.
• Correct your brushing technique and choose a right toothbrush as to avoid gum injuries.
• Eating of fresh fruits For Ex. guavas, bananas, and oranges etc. help a lot in maintaining oral hygiene.

Bell’s palsy, or facial paralysis, is a loss of motion or extreme shortcoming of the facial muscles on one side of the face. 

It is accepted to be because of an expanding of the nerve that controls the muscles of the face.

Ardita is an illness causing the Facial nerve loss of motion is the condition which gives the deviation of half of the face and connected with the disability of engine and tactile elements of the influenced side of the face. The inabilities of the looks are hampered in Ardita, a Vata Vyadhi which is more normal in the current day situation because of openness to cold, wind face.

SAMPRAPTI OF ARDITA

Due to the excessive exposure to cold wind

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Aggrivated Vata with Kapha is involved in the genesis of the disease

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Prakupita vata dosha (aggravated vata) along with Kapha

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Settles in Sandhi’s (joints of above clavicle) of Sira (head), Nasa (Nose), Hanu (Mandible), Lalata (forehead), and Netra (eye). 

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Snayu (ligaments), Kandara (tendons) are affected by the Doshas

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Presented symptoms on the right half of the face

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Ardita vata

NIDANA (CAUSES) OF ARDITA

Counted Causes of Ardita in Ayurveda: 

• Speaking boisterously in overabundance. 
• Chewing of hard food stuffs. 
• Excessive giggling, yawning and sniffling. 
• Carrying hefty burdens on head, Sudden development of head and neck. 
• Sleeping in an awkward stance. 
• Use of cushions in wrong stance; either too high or too low and so on 
• Rakta Kshaya,(depletion of blood) in explicit gathering of patients get burdened by Ardita: Pregnant woman, Recently conveyed woman, Children, Old individuals, Emaciated people. 
• Following a physical issue. 
• By doing day rest unnecessarily. 
• Excessive tongue rejecting. 
• Siravyadhana (Bloodletting whenever done inappropriately). 
• Injury to the Marma (essential focuses in the head). 
• Excessive scouring of the eyes, ears and nose. 
• By devouring liquor, asavas in abundance and so on.

SIGN & SYMPTOMS OF FACIAL PALSY

Bending of the influenced side of the face (the mouth point is attracted over to the inverse side).If the patient attempts to giggle, the mouth point is attracted to the ordinary side. 

• Incomplete conclusion of the eye influenced 
• Distortion of the nose. 
• Difficulty in discourse and dryness of voice. 
• Hearing misfortune and hindrance in smell sensation and agony in the ear moreover. 
• The demonstration of rumination and gulping of food gets disturbed. 
• Sneeze gets stifled. 
• Severe agony in neck, jawline, teeth, on the influenced side. 
• Getting dread while dozing and here and there loss of memory too. 
• The food ingested can’t gulped as expected, it gets gathered in the vestibule part of the mouth, while snickering, talking and so on 
• The face gets digressed or mutilated to the typical side. 
• Speech gets slurred, weak, with roughness of voice, lopsidedness of the face, eyebrows, temple, eye and jawline. 

BELL’S PALSY: Bell’s paralysis is characterized as the facial loss of motion of intense beginning dared to be because of irritation of the facial nerve inside its waterway over the stylomastoid foramen. 

 Another SIGNS and SYMPTOMS: The indications of Bell’s paralysis are: 

• Usually one-sided, seldom two-sided, Pain inside ear or mastoid district or jawline. Beginning is unexpected or suddenly occurs 
• Paralysis of the muscles of facial expression.The upper and lower facial muscles are similarly influenced and intentional passionate and related developments are included. 
• Eyelid hangs, incapable to scowl and eyebrow rising is unimaginable, unfit to close eyes totally. At the point when the patient endeavors to close the eye, the ball moves upwards and southwards called as Bell’s marvel. 
• Impairment in lacrimal siphon system because of absence of flickering is the excellent reason for epiphora or expanded lacrimation. n
• Absence of Nasolabial overlay. 
• If sore is in the center ear divide: taste is lost over the ant.2/third of the tongue on a similar side. 
• If the nerve to stapedius is intruded on Hyperacusis – sharp sounds seems stronger than typical. 
• Lesions in the interior hear-able meatus – influence the hear-able and vestibular nerves cause deafness and Tinnitus.

CHIKTHSA (TREATMENT) OF ARDITHA

All the works of art have portrayed the treatment convention for arditha pretty much same, as follows: 

• Mordha tail to the head. (Application of oil)
• Nasya karma, Tarpana Kriya with sedated oil to the eyes and ears. 
• Nadi Sweda, Upanaha Sweda must be controlled. 
• Matishkyam, Shirovasti, Dhoomapana, Snehana -as per the Dosha included. 
• If related with sopha (irritation), Vamana (Medicated regurgitating) must be directed. 
• If related with daha and (consuming sensation), siravyadha (restorative blood draining) is suggested. 
• In the event of Maargavarana janya ardita, from the outset avarna line of treatment must be followed from there on the treatment of kevala vata must be followed. 

Kashayas: Dhanadanayanadi kashaya, Maharasnadi kashaya, Rasna dashamooladi kwatha, Mashabaladi kwatha. 

Tailas: Masha tail, Mashadi tail, Mashabaladi tail, Karpasastyadi tail, Dhanwantharam tail, Mahamasha tail, Kshirabala tail. 

Other prayogas: Rasona panda, Navaneetha lasuna.

DEFINITION- 

Dysmenorrhea, defined as throbbing painful cramps that occur just before and during their menstrual periods.  It is the most common gynecological problem among the women, one of the most common causes of pelvic pain. Pain starts from the lower abdomen and radiates to lower back and thighs.

CLASSIFICATION-

Dysmenorrhea can be broadly classified into:

Primary Dysmenorrhea–

 It is a lower abdominal pain happening during the menstrual cycle, which is not associated with other diseases or pelvic pathology. Prostaglandin (PGF) is the main contributor to the cause of dysmenorrheas. 

Secondary Dysmenorrhea-

It is usually associated with other pathology inside or outside the uterus. There are many common causes of secondary dysmenorrhea, which include uterine fibroids,overian cyst, endometrial polyps, pelvic inflammatory disease (PID) and the use of an intrauterine contraceptive device (IUD).

SIGN AND SYMPTOMS-

For some women, the discomfort is just annoying. For others, menstrual cramps can be severe enough to interfere with everyday activities for a few days every month. The clinical features of Dysmenorrhea are as follow-

• Prostaglandins induce abdominal contractions that can cause ache and gastrointestinal symptoms.
• Dysmenorrhea is associated with increased pain sensitivity and heavy menstrual bleeding.
• Throbbing or cramping pain in the lower belly that can be intense Pain that starts 1 to 3 days before your period.
• Symptoms  peaks 24 hours after the onset of your period  and subsides in 2 to 3 days
• Dull and continuous ache
• Abdominal Pain that radiates to lower back and thighs
• Niggling response to NSAIDS or oral contraceptives
• Painful sexual intercourse (Dyspareunia) 
• Abnormal vaginal discharge
• Some women also have nausea,vomiting, loose stools, fatigue and headache etc. 

CAUSES-

There are many causes of dysmenorrhea. Menstrual cramps can be caused by:

• Longer, heavier or irregular menstrual periods.
• Endometriosis- fragments of the endometrium are found on other pelvic organs, most commonly on ovaries, fallopian tubes, or the tissue lining your pelvis.
• Retroverted uterus-It is a condition where the uterus tilts backwards instead of forward.
• Uterine fibroids-These noncancerous growths in the wall of the uterus can cause pain and crams during periods.
• Psychological or social stress
• Adenomyosis-The tissue that lines your uterus begins to grow into the myometrium (muscular walls of the uterus).
• Menarche before age of twelve 
• Pelvic inflammatory disease (PID) – PID infection of the female reproductive organs is commonly caused by sexually transmitted bacteria.
• Cervical stenosis- In some women, the opening of the cervix is small enough to impede menstrual flow, causing a painful increase of pressure within the uterus.

DIAGNOSIS

• A proper medical history about the onset, duration and severity of the pain is taken 
• Pelvic examination
• Ultrasonography of the lower abdomen 
• Laparoscopy

RISK FACTORS-

• Genetic factors
• Stress 
• Depression/anxiety
• Early age at menarche
• Long and heavy menstrual periods
• Nulliparity
• Smoking
• Family history of dysmenorrhea
• Higher BMI (Body Mass Index)

PREVENTION –

Dysmenorrhea (kashtaarthava) can be prevented by modifying the lifestyle and diet.

 Lifestyle changes

• Regular Exercise  
• Retraction of tobacco smoking 
• Avoid stressful situation while approaching periods.
• Get proper sleep at least for 7 to 8 hours

Dietary changes

• Take good Dietary supplements such as vitamin E, omega 3 fatty acids and magnesium etc.
• Take Low fat diet 
• Reduce caffeine intake
• Decrease alcohol intake

Management-

In modern science-

Treating the cause is key to reducing the pain.Treatment of Primary Dysmenorrhea is directed providing relief from cramping pelvic pain and associated symptoms.

 NSAIDS and the combination of oral contraceptives are the most commonly used treatment modalities. 

NSAIDS reduce pain by lowering prostaglandin hormone levels thereby decreasing intrauterine contractions.

• Diclofenac
• Ibuprofen 
• Ketoprofem 
• Meclofenamate
• Mefanamic acid 
• Naproxen

 Oral contraceptives are the ideal option to those who do not want to conceive. Some of them are: 

• Estradiol valerate plus dienogest
• Ethinyl estradiol levonorgestrel
• Medroxyprogestrone
• Levonorgestrel 

Releasing intrauterine device Treatment of secondary dysmenorrhea involves correction of underlying organic cause. Specific measures such as medical or surgical may be required to treat pelvic pathological condition

IN AYURVEDA-

CHIKITSA SUTRA OF KASHTAARTHAVA-

 As vata dosha is the main cause for all yonivyapad, the treatment should be directed towards the vitiated vata and eradication of the cause.

 The principles of treatment can be subdivided into:-

SHODANA (PURIFICATION THERAPY) 

• Snehana (Oleation)- Bahya snehana- External oil massage with vata pacifying oil like Bala taila, Dhanwanthara tailam, sesame oil etc.  Abyantara Snehana- intake of traivrita sneha
• Swedana (fomentation)- with ksheera (milk)
• Virechana (purgation)- Mild purgation is good for all type yonivyapad Trivrit Lehyam is the best because it has vataanulomana properties (downward passage of vata) and sukha rechaka (mild purgation)
• Vamana (emesis)
• Basti (enema)- After proper snehana and swedana procedure decoction enema and medicated oil enema is given. It is most effective treatment to normalize the Apana vata localized in the abdomen by entering the srotas (channels) by removing the spasm.

SHAMANA (PALLIATIVE TREATMENT)

ABHYANTARA CHIKITSA (INTERNAL THERAPY)-

• Kashayam– Nyagrodhadhi kashayam, Maharasnadi kashayam, Sapthasaram Kashayam, Dashamoolakatutrayam kashayam, Dhanwantharam Kashayam, Vizhalveradi Kashayam, Kurunthotti kashayam
• Arishtam- Dashamoolarishtam, Jeerakaarishtam, Ashokaarishtam
• Gritham (medicated ghee)-Phala sarpi, Brhat shatavari gritam, Triphaldi gritam 
• Choornam (powder)- Hinguwashtaka Choornam, Pushyanaga Choornam
• Vati (tablets)- Rajapravaartini vati, Nashtapushpantaka rasa, Soubhaagyadi vati, Dhanwantharam gulika, Chandraprabha vati, Kanchanara guggulu

STHANIKA CHIKITSA (LOCALISED TREATMENT)-

• It is done using the drugs predominant for the vitiated doshas Kalka, pichu (tampon), yoni prakshalana (douching), abhyanga (massage) Pichu is done by soaking the tampon with oils like tila taila, Dhanwanthara tailam and inserted inside the vagina for specific time.
• Yoni prakshalana (douching) is done using with triphala Kwatha.
• Abhyanga over the abdomen with warm tila taila few days before menstruation is found to be very effective.

HOME REMEDIES-

• Take 2-3 garlic cloves in the early morning 
• Boil 5 g of Carom seeds/cumin seeds/fenugreek seeds/fennel during the menstruation 
• Boil around 1 tsp. of sesame seeds in 60 ml of water and drink every morning few days prior to menstruation
• Intake 5 ml of castor oil in warm milk provides immediate relief from menstrual cramps.
• Prepare a dessert with sesame seeds, cumin seeds mixed with jaggery and ghee and make small balls out of it. Consume it frequently.
• Intake 1 glass of parsley juice twice every day
• Drink cinnamon tea with honey during menstruation ¬ Intake of dark chocolate after meals proven to relief from menstrual cramps. 
• Massage the lower abdomen, thigh with war sesame oil/castor oil and apply hot bag fomentation 
• Avoid vata increasing factors such as travelling, stress, drinking caffeine etc. few days prior to menstruation. 
• Drink 6-8 glass of warm water daily 
• Always consume food which is warm and easy to digest.
•  Sip 2 cups per day of chamomile tea few days prior to menstruation