Trishna Chikitsa: Difference between revisions

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Laboratory Tests:

==== Laboratory Tests ====

Blood Tests

===== Blood Tests =====

1. Glucose

====== 1. Glucose Elevated: ======

• Elevated:

• Diabetes mellitus

*Diabetes mellitus

• Cushing’s syndrome

*Cushing’s syndrome

• Early phase of hypovolemic shock (bleeding)

*Early phase of hypovolemic shock (bleeding)

• Pheochromocytoma

*Pheochromocytoma

2. Sodium:

• Normal levels (135-145 meq/L):

====== 2. Sodium: ======

• In most cases of dehydration (diarrhea, vomiting, excessive sweating)

• Within 8 hours of onset of acute bleeding

*Normal levels (135-145 meq/L):

• Hyponatremia (<135 meq/L)

**In most cases of dehydration (diarrhea, vomiting, excessive sweating)

• >8 hours after onset of bleeding, when interstitial fluid moves into the intravascular space

**Within 8 hours of onset of acute bleeding

• Sometimes after repeated vomiting or severe diarrhea

*Hyponatremia (<135 meq/L):

• Water intoxication

**>8 hours after onset of bleeding, when interstitial fluid moves into the intravascular space

• Diabetic ketoacidosis (usually)

**Sometimes after repeated vomiting or severe diarrhea

• Cerebral salt wasting (head injury, tumor)

**Water intoxication

• Hypernatremia (>145 meq/L)

**Diabetic ketoacidosis (usually)

• Dehydration (sometimes)

**Cerebral salt wasting (head injury, tumor)

• Diabetes insipidus

**Hypernatremia (>145 meq/L)

3. Potassium:

**Dehydration (sometimes)

• Hypokalemia:

**Diabetes insipidus

• Hyperaldosteronism

• Anorexia nervosa

====== 3. Potassium: ======

• Hyperthyroidism

*Hypokalemia:

• Hyperkalemia:

**Hyperaldosteronism

• Diabetic ketoacidosis (usually)

**Anorexia nervosa

4. Calcium:

**Hyperthyroidism

• Hypercalcemia:

*Hyperkalemia:

• Hyperparathyroidism

**Diabetic ketoacidosis (usually)

• Hypervitaminosis D

• Hypocalcemia:

====== 4. Calcium: ======

• Diabetic ketoacidosis (usually)

*Hypercalcemia:

5. CBC:

**Hyperparathyroidism

• White blood cells increased or decreased in sepsis

**Hypervitaminosis D

6. Hematocrit (HCT):

*Hypocalcemia:

• Decreased in water intoxication

**Diabetic ketoacidosis (usually)

7. Blood Urea Nitrogen (BUN):

• Increased in kidney failure

====== 5. CBC: ======

• Decreased in water intoxication

*White blood cells increased or decreased in sepsis

8. pH

• <7.3 (diabetic ketoacidosis)

====== 6. Hematocrit (HCT): ======

9. Proteins:

*Decreased in water intoxication

• Hypoalbuminemia in liver cirrhosis, nephrotic syndrome, severe malnutrition

10. Hormone levels:

====== 7. Blood Urea Nitrogen (BUN): ======

• ADH

*Increased in kidney failure

• Decreased in central diabetes insipidus

*Decreased in water intoxication

• Increased in nephrogenic diabetes insipidus

• ACTH may be increased in pituitary adenoma or adrenal hyperplasia

====== 8. pH: ======

• Cortisol may be increased in adrenal adenoma

*<7.3 (diabetic ketoacidosis)

• Aldosterone may be increased in adrenal adenoma or primary hyperaldosteronism

11. Urine Tests

====== 9. Proteins: ======

• Osmolality

*Hypoalbuminemia in liver cirrhosis, nephrotic syndrome, severe malnutrition

• <200 mOsm/kg in psychogenic polydipsia, diabetes insipidus

• Specific gravity

====== 10. Hormone levels: ======

• <1.005 in diabetes insipidus

*ADH

• Glucose

*Decreased in central diabetes insipidus

• Untreated diabetes mellitus 1 or 2

*Increased in nephrogenic diabetes insipidus

• Pheochromocytoma; rare

*ACTH may be increased in pituitary adenoma or adrenal hyperplasia

• Proteins

*Cortisol may be increased in adrenal adenoma

• In nephrotic syndrome

*Aldosterone may be increased in adrenal adenoma or primary hyperaldosteronism

• Sodium >20 meq/L: cerebral salt wasting

Principles of management:

====== 11. Urine Tests: ======

*Osmolality

*<200 mOsm/kg in psychogenic polydipsia, diabetes insipidus

*Specific gravity

*<1.005 in diabetes insipidus

*Glucose

*Untreated diabetes mellitus 1 or 2

*Pheochromocytoma; rare

*Proteins

*In nephrotic syndrome

*Sodium >20 meq/L: cerebral salt wasting

====== Principles of management: ======

The treatment modalities intended to pacify vata and pitta dosha are applied for management of trishna. Specifically rain water, water processed with drugs having manda (mild) and sheeta (cool) properties, various medicated ghee mentioned in the text are used to manage trishna.

@@ Line 1,224: / Line 1,224: @@
 |}
-Laboratory Tests:
+==== Laboratory Tests ====
-Blood Tests
+===== Blood Tests =====
-.	Glucose
+====== 1.	Glucose Elevated: ======
-•	Elevated:
-•	Diabetes mellitus
+*Diabetes mellitus
-•	Cushing’s syndrome
+*Cushing’s syndrome
-•	Early phase of hypovolemic shock (bleeding)
+*Early phase of hypovolemic shock (bleeding)
-•	Pheochromocytoma
+*Pheochromocytoma
-.	Sodium:
-•	Normal levels (135-145 meq/L):
+====== 2.	Sodium: ======
-•	In most cases of dehydration (diarrhea, vomiting, excessive sweating)
-•	Within 8 hours of onset of acute bleeding
+*Normal levels (135-145 meq/L):
-•	Hyponatremia (<135 meq/L)
+**In most cases of dehydration (diarrhea, vomiting, excessive sweating)
-•	>8 hours after onset of bleeding, when interstitial fluid moves into the intravascular space
+**Within 8 hours of onset of acute bleeding
-•	Sometimes after repeated vomiting or severe diarrhea
+*Hyponatremia (<135 meq/L):
-•	Water intoxication
+**>8 hours after onset of bleeding, when interstitial fluid moves into the intravascular space
-•	Diabetic ketoacidosis (usually)
+**Sometimes after repeated vomiting or severe diarrhea
-•	Cerebral salt wasting (head injury, tumor)
+**Water intoxication
-•	Hypernatremia (>145 meq/L)
+**Diabetic ketoacidosis (usually)
-•	Dehydration (sometimes)
+**Cerebral salt wasting (head injury, tumor)
-•	Diabetes insipidus
+**Hypernatremia (>145 meq/L)
-.	Potassium:
+**Dehydration (sometimes)
-•	Hypokalemia:
+**Diabetes insipidus
-•	Hyperaldosteronism
-•	Anorexia nervosa
+====== 3.	Potassium: ======
-•	Hyperthyroidism
+*Hypokalemia:
-•	Hyperkalemia:
+**Hyperaldosteronism
-•	Diabetic ketoacidosis (usually)
+**Anorexia nervosa
-.	Calcium:
+**Hyperthyroidism
-•	Hypercalcemia:
+*Hyperkalemia:
-•	Hyperparathyroidism
+**Diabetic ketoacidosis (usually)
-•	Hypervitaminosis D
-•	Hypocalcemia:
+====== 4.	Calcium: ======
-•	Diabetic ketoacidosis (usually)
+*Hypercalcemia:
-.	CBC:
+**Hyperparathyroidism
-•	White blood cells increased or decreased in sepsis
+**Hypervitaminosis D
-.	Hematocrit (HCT):
+*Hypocalcemia:
-•	Decreased in water intoxication
+**Diabetic ketoacidosis (usually)
-.	Blood Urea Nitrogen (BUN):
-•	Increased in kidney failure
+====== 5.	CBC: ======
-•	Decreased in water intoxication
+*White blood cells increased or decreased in sepsis
-.	pH
-•	<7.3 (diabetic ketoacidosis)
+====== 6.	Hematocrit (HCT): ======
-.	Proteins:
+*Decreased in water intoxication
-•	Hypoalbuminemia in liver cirrhosis, nephrotic syndrome, severe malnutrition
-.	Hormone levels:
+====== 7.	Blood Urea Nitrogen (BUN): ======
-•	ADH
+*Increased in kidney failure
-•	Decreased in central diabetes insipidus
+*Decreased in water intoxication
-•	Increased in nephrogenic diabetes insipidus
-•	ACTH may be increased in pituitary adenoma or adrenal hyperplasia
+====== 8.	pH: ======
-•	Cortisol may be increased in adrenal adenoma
+*<7.3 (diabetic ketoacidosis)
-•	Aldosterone may be increased in adrenal adenoma or primary hyperaldosteronism
-.	Urine Tests
+====== 9.	Proteins: ======
-•	Osmolality
+*Hypoalbuminemia in liver cirrhosis, nephrotic syndrome, severe malnutrition
-•	<200 mOsm/kg in psychogenic polydipsia, diabetes insipidus
-•	Specific gravity
+====== 10.	Hormone levels: ======
-•	<1.005 in diabetes insipidus
+*ADH
-•	Glucose
+*Decreased in central diabetes insipidus
-•	Untreated diabetes mellitus 1 or 2
+*Increased in nephrogenic diabetes insipidus
-•	Pheochromocytoma; rare
+*ACTH may be increased in pituitary adenoma or adrenal hyperplasia
-•	Proteins
+*Cortisol may be increased in adrenal adenoma
-•	In nephrotic syndrome
+*Aldosterone may be increased in adrenal adenoma or primary hyperaldosteronism
-•	Sodium  >20 meq/L: cerebral salt wasting
-Principles of management:
+====== 11.	Urine Tests: ======
+*Osmolality
+*<200 mOsm/kg in psychogenic polydipsia, diabetes insipidus
+*Specific gravity
+*<1.005 in diabetes insipidus
+*Glucose
+*Untreated diabetes mellitus 1 or 2
+*Pheochromocytoma; rare
+*Proteins
+*In nephrotic syndrome
+*Sodium  >20 meq/L: cerebral salt wasting
+====== Principles of management: ======
 The treatment modalities intended to pacify vata and pitta dosha are applied for management of trishna. Specifically rain water, water processed with drugs having manda (mild) and sheeta (cool) properties, various medicated ghee mentioned in the text are used to manage trishna.