🔺CASE STUDY : NO 51 🔺 PART NO : 01 🔺YAKRIT ROGA (LIVER DISORDERS IN AYURVEDA) 🔺 NIDANAM (ETIOLOGY / CAUSES) - Aharaja Nidana (Dietary causes): -Ati Snigdha, Guru, Amla, Lavana, Katu, Vidahi Ahara -Excessive alcohol intake (Madya Sevanam) -Viruddha Ahara (incompatible food combinations) - Vihara (Lifestyle factors): -Divaswapna (day sleep) -Stress and anger -Sedentary lifestyle - Manasika Nidana: -Krodha, Shoka * Dosha Dusti: -Primarily Pitta Dushti -Also involvement of Kapha and Rakta * Agantuja Hetu (external causes): *Viral infections (analogous in modern terms) (Classical Reference:Charaka Samhita, Chikitsa Sthana 16 (Kamala Chikitsa) Madhava Nidana, Chapter 5) 🔺 POORVAROOPAM (PRODROMAL SYMPTOMS) *Aruchi (loss of appetite) *Daurbalya (weakness) *Gaurava (heaviness) *Haridra Netra and Twak (yellowish eyes and skin) *Shiroruja (headache) *Trishna (excessive thirst) 🔺 LAKSHANAM (SIGNS AND SYMPTOMS) *Kamala (Jaundice) symptoms – relevant to Yakrit Roga: *Haridra varna of netra, twak, nakha, mutra (yellowish discoloration) *Daha (burning sensation) *Arochaka (anorexia) *Agnimandya (poor digestion) *Udara Shoola (abdominal pain) *Mutra daha (burning micturition) *Mala pichchhila (mucous in stools) *In Kumbha Kamala (cirrhosis): *Yakrit-Pleeha vriddhi (enlargement of liver and spleen) *Jalodara (ascites) *Panduta (anemia) 🔺Systemic Examination In Yakrit Roga (Liver Disease) *General Examination -Icterus: Yellowing of sclera and skin *Pallor: Suggests anemia *Clubbing: In chronic liver disease (CLD) *Edema: Pedal edema due to hypoalbuminemia *Spider angioma: Dilated superficial blood vessels *Palmar erythema: Due to altered estrogen metabolism *Gynecomastia / Testicular atrophy: In CLD (especially alcoholic liver disease) *Asterixis (flapping tremor): In hepatic encephalopathy *Abdominal Examination *Inspection: Distended abdomen (ascites), dilated veins (caput medusae) *Palpation: *Hepatomegaly: Enlarged, tender liver in acute hepatitis; firm/non-tender in CLD *Splenomegaly: Often in portal hypertension *Percussion: Shifting dullness, fluid thrill (ascites) *Auscultation: Rarely hepatic bruit * Systemic Signs *Neurological: Confusion, altered sleep pattern (hepatic encephalopathy) *Hematological: Easy bruising, bleeding (due to coagulopathy) *Endocrine: Amenorrhea, infertility 🔺 LABOURTARY FINDINGS *Liver Function Tests (LFTs) *These are the most common initial tests done when liver disease is suspected: *ALT (Alanine Aminotransferase) Enzyme found mainly in liver Elevated in hepatitis and liver cell injury *AST (Aspartate Aminotransferase) Enzyme in liver, heart, muscle Less specific than ALT; increased in hepatitis, alcohol-related liver disease *ALP (Alkaline Phosphatase) Enzyme in bile ducts Increased in cholestasis, bile duct obstruction, infiltrative diseases *GGT (Gamma-glutamyl Transferase) Biliary enzyme Elevated with ALP in cholestasis; alcohol and drug use *Bilirubin (Total, Direct, Indirect) Breakdown product of hemoglobin Jaundice, hemolysis, cholestasis, liver failure *Albumin Liver-produced protein Decreased in chronic liver disease, malnutrition *Prothrombin Time (PT)/INR Coahepatitis Prolonged in liver failure (decreased clotting factor synthesis) 📌 To detect hepatitis *HBsAg, anti-HBs, anti-HBc, HBeAg – Hepatitis B *Anti-HCV, HCV RNA – Hepatitis C *HAV IgM, HEV IgM – Acute hepatitis A or E 🛑https://chat.whatsapp.com/KLufxKFrXwbIIAXLxXDqOB