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• Glaucoma </p>
 
• Glaucoma </p>
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'''Diagnostic and assessment tools:'''
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<p style="text-align:justify;"> The condition of udakavaha srotas can be assessed by subjective methods like questionnaires and objective methods like blood investigations etc.. Udakavaha srotodushti can be assessed through a subjective questionnaire by which an ayurvedic physicians assess the normalcy and abnormality based on ayurvedic principles of examination (pariksha). Some of the objective methods which may be used to assess the normal functioning of udakavaha srotas are:
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1. Urine routine examination for specific gravity, volume, ph etc.
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2. Serum electrolyte (Sodium and potassium)
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3. MRI Scan for hypothalamus abnormality
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4. Blood sugar for assessing the abnormality.
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5. Dual-energy X-ray absorptiometry (DEXA)[11]
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6. Air displacement plethysmography,[12]
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7. Nuclear magnetic resonance spectroscopy [13], and
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8. Bioelectrical impedance analysis [14] [15]
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</p>
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'''Treatment of srotas abnormality'''
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<p style="text-align:justify;"> The treatment for the viation of udakavaha srotas should be done on the principles of management of thirst disorder (trishna chikitsa). [Cha. Sa. Vimana Sthana 05/26] [16]  The signs and symptoms of udakavaha srotas vitiation are comparable to morbid thirst (trishna), which develops as a result of vata and pitta vitiation. Because both doshas have absorbent (shoshaka) properties that degrade the rasavaha and udakavaha srotas. This leads to persistent desire for water. Rain water is the best way to quench thirst. However, nowadays rainwater is rarely stored and used for drinking. Therefore water with a mild astringent flavour, light to digest, cold characteristics, nice scent and taste, and no channel obstructing qualities should be deemed comparable to rain water in effect. [16] </p> 
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'''Dosha governing the water metabolism'''
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<p style="text-align:justify;">Dosha are the physiological entity in human body governing all systems. For maintenance of water balance different dosha work in synergy to each other. Acharya Charak clearly described the relation between  samana vayu and ambuvaha srotas. [Cha. Sa. Chikitsa Sthana 28/8] Samana vayu is situated in swedavaha, doshavaha and ambuvaha or udakavaha srotas. It showed the samana vayu is essential for maintainance of water regulation in human body. Along with samana vayu, pitta (pachaka) and kapha (bodhaka and kledaka) also help in water homeostasis. </p>
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[[File:Dosha helpful in water metabolism.jpg|center|Figure 03: Dosha helpful in water metabolism.]]
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'''Future area of research'''
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<p style="text-align:justify;">The future area of research is the preparation of a validated and standardized questionnaire for assessing the normalcy and abnormality of functioning of udakavaha srotas. Assessment of udakavaha srotas condition in various disease may be helpful in prognosis and treatment outcome. In various physiological conditions like pregnancy, lactation, childhood, old age, space, deep sea and high altitude, the udakavaha srotas assessment may be helpful to understand the dynamic changes occurred within the body. Animal studies to understand the anatomy and physiology of kloma may be helpful for future researches related to udakavaha srotas. </p>
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''Thesis works:'''
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<p style="text-align:justify;">1. Dash Maheshwar (1985): Srotas in ayurveda with special reference to udakavaha srotras, Department of Basic Principles, B.H.U.Varanasi, India
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2. Kambale V.(1997): Udakavaha srotas mulastana nischiti evam kloma tulanatmaka adhyayan, Department of sharir Rachana, Govt. Ayurveda Mahavidyalaya, Nanded. </p>
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'''Current researches:'''
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<p style="text-align:justify;"> Contemporary understanding of udakavaha srotas: The cerebrospinal fluid, salivary amylase, and digestive/hepatobiliary system secretions such HCL, bile, pancreatic lipase, and pancreatic amylase are all included in the udaka/ambuvaha srotas. It is also associated with rasa dhatu, which provides the fluid and oiliness needed to transport the necessary nutrients, lubricate various body processes, and support thermodynamic control.[10] </p>
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[[File:Dosha helpful in water metabolism.jpg|center|Figure 03: Dosha helpful in water metabolism.]]
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'''Udakavaha srotas and shwasa roga:''' <p style="text-align:justify;">Shwasa roga (dysnoea) occurrs due to vitiation of prana, anna and udakavaha srotas. But understanding the role of udakavaha srotas is difficult. In causative factors of shwasa (nidana), the majority causes of udakavaha srotas dushti are covered. The five varieties of shwasa exhibit its clinical features. In shwasa chikitsa, additional liquid preparations are suggested in order to correct the body's water balance. So, this review helps to understand the role of udakavaha srotas in shwasa roga. [17] </p>
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'''13.3 Udakavaha srotodushti with special reference to kapha dominant prameha (obstinate urinary disorders including diabetes):''' <p style="text-align:justify;"> In order to comprehend the notion of looseness of body components (sharira shaithilya) in the pathogenesis (samprapti) of kapha dominant prameha and to assess the application of the essential ayurveda principles of udakavaha stroto dushti, a clinical research on 40 clinically confirmed patients of kapha dominant prameha was done. The study came to the conclusion that srotodushti and pathogenic factors should be taken into account while treating diabetic patients, so that we can focus on treating sroto dushti and its root as well as the illness.[18] </p>
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'''References'''
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<p style="text-align:justify;"> 1. National AYUSH Morbidity and Standardized Terminologies Electronic Portal by Ministry of AYUSH Available on http://namstp.ayush.gov.in/#/Ayurveda
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2. A. C. Guyton and J. E. Hall, Textbook of Medical Physiology. 11th edition. Pennsylvania: Elsevier Saunders, 2006.
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3. Jéquier E, Constant F. Water as an essential nutrient: the physiological basis of hydration. Eur J ClinNutr. 2010;64(2):115-23.
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4. Amarkosha. Amarsimha, Edited by Pt. Haragovindasastri. Reprint Ed. Varanasi:Chaukhambha Sanskrit Sansthan, 2020.
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5. Sushruta. SushrutaSamhita. Edited by JadavajiTrikamjiAacharya. 8th ed. Varanasi: ChaukhambhaOrientalia; 2005.
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6. Monier-Williams, Monier William's Sanskrit-English Dictionary, 2nd Ed., Oxford University Press;1899.
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7. Nanal VM. The organ kloma: a fresh appraisal. AncSci Life. 1989;9(2):61-5.
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8. Knepper MA, Kwon TH, Nielsen S: Molecular Physiology of Water Balance. N Engl J Med 2015, 373(2):196.
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9. Cuzzo B, Padala SA, Lappin SL. Physiology, Vasopressin. [Updated 2022 Aug 22]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan.
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10. Al-Shura AN. 12 - Channels receiving food, prana, and water. In: Al-Shura AN, editor. Ayurvedic Perspectives in Integrative Healthcare: Academic Press; 2020. p. 109-15.
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11. Mazess RB, Barden HS, Bisek JP, Hanson J. Dual-energy x-ray absorptiometry for total-body and regional bone-mineral and soft-tissue composition. Am J ClinNutr. 1990;51:1106–1112.
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12. Dempster P, Aitkens S. A new air displacement method for the determination of human body composition. Med Sci Sports Exerc. 1995;27:1692–1697.
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13. Rebouche CJ, Pearson GA, Serfass RE, Roth CW, Finley JW. Evaluation of nuclear magnetic resonance spectroscopy for determination of deuterium abundance in body fluids: application to measurement of total-body water in human infants. Am J ClinNutr. 1987;45:373–380.
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14. NIH Consensus Statement. Bioelectrical impedance analysis in body composition measurement. National Institutes of Health Technology Assessment Conference Statement. December 12-14, 1994. Nutrition. 1996;12:749–762.
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15. Beertema W, van Hezewijk M, Kester A, Forget PP, van Kreel B. Measurement of total body water in children using bioelectrical impedance: a comparison of several prediction equations. J PediatrGastroenterolNutr. 2000;31:428–432.
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16. Sharma R..Trishna Chikitsa Adhyaya. In: Ojha S.N., Deole Y.S., Basisht G., eds. CharakSamhita New Edition. 1st ed. Jamnagar, Ind: CSRTSDC; 2020. https://www.carakasamhitaonline.com/mediawiki-1.32.1/index.php?title=Trishna_Chikitsa&oldid=42725. Accessed April 6, 2023.
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17. Teerthashree NS, Chetan M. Understanding of udakavahasrotas in shwasaroga. EPRA International Journal of Multidisciplinary Research (IJMR). 2022 May 12;8(5):63-8.
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18. Rahangdale D, Kumar B, Dave HH, A Conceptual and Clinical Study to Understand The Principle of Sharira-Shaithilyata and UdakavahaSrotodushtiw.s.r. to KaphajaPrameha (Type II Diabetes Mellitus) JOA XIII-3, 2019; 14 - 21
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