🔺CASE STUDY : NO 41 🔺PART NO : 01 🔺HIKKA ( HICCUPS ) 🔺 NIDANAM (CAUSES) -Excessive water intake -Overeating -Dry food intake -Suppression of natural urges -Exposure to cold air -Heavy, oily food Reference: Ashtanga Hridaya Nidana Sthana 6/4-5 🔺POORVA ROOPAM (PRODROMAL SYMPTOMS) -Cough -Throat constriction -Itching in throat -Excess salivation -Alteration in voice Reference: Ashtanga Hridaya Nidana Sthana 6/6 🔺 LAKSHANAM (SYMPTOMS) -Common symptoms: -Sudden hiccups with sound -Pain in chest/flank -Difficulty in speaking or breathing(Reference: Charaka Samhita Chikitsa Sthana 18/1–7) 🔺 SYSTEMIC EXAMINATION 📌Hiccups lasting >48 hours are termed persistent; >2 months are intractable. 📌General Examination -Observe frequency, duration, and triggers -Assess nutritional status (may be affected if chronic) -Check for respiratory distress, dehydration, or electrolyte imbalance 📌 CNS Examination -To Rule out - Brainstem lesions - Increased intracranial pressure -Stroke (especially medulla) - MS or meningitis 📌Respiratory System - Look for: -Infections (pharyngitis, bronchitis, pneumonia) -Pleural effusion -Diaphragmatic irritation 📌 Cardiovascular System -Assess for: -Pericarditis - Myocardial infarction (especially inferior wall) 📌Gastrointestinal System - Check for: -Gastric distention - GERD - Peptic ulcer - Esophagitis -Hiatal hernia 📌ENT & Neck -Look for: - Pharyngitis - Foreign body -Tumors compressing phrenic/vagus nerves 🔺 LABORATORY INVESTIGATIONS -Basic Blood Work CBC: To detect infection or anemia -ESR/CRP: For inflammation or malignancy - Liver Function Tests: For hepatic causes - Renal Function Tests: To rule out uremia - Electrolytes: Check for: Hyponatremia,Hypocalcemia,Hypokalemia (can trigger hiccups) - Imaging Chest X-Ray: To detect pneumonia, pleural effusion, mediastinal mass, or cardiomegaly - CT/MRI Brain: For CNS lesions (stroke, tumor) -Abdominal Ultrasound: For liver, gallbladder, stomach issues - Barium swallow / Endoscopy: For GERD, ulcer, or hiatal hernia -ECG To rule out myocardial infarction - Laryngoscopy To assess pharynx, larynx, and vocal cords if ENT involvement is suspected 🛑https://chat.whatsapp.com/JtHGdxv7A5SA9bAe8ZNIS2