RÉSUMÉ
Skin, the body’s largest organ, protects from deleterious environmental impacts (physical, chemical, microbiological) and is crucial for the maintenance of temperature, electrolyte and fluid balance and tactile sensation, it sets a boundary between the organism and the environment. Any change in the normal skin texture disturb the patient both mentally and physically. Psoriasis is a common, chronic, recurrent inflammatory disease of the skin, characterized by circumscribed, erythematous, dry, scaly plaques of varying sizes. The severity of psoriasis is found to be ever fluctuating. Individuals are likely to cycle between differing levels of severity throughout lifetime. The course of the disease is punctuated by spontaneous flare-ups and remissions. Psoriasis being a chronic and often disfiguring condition, cause a marked impairment in quality of life. There is no certain cure for this disease. Ayurvedic diagnosis is as Vatha-Kapha predominant Mahakushta namely Sidhma kushta. Here an effort to treat a 13-year-old child having plaque psoriasis by Samsodhana and Samsamana therapy. Initially 6 days Virechana was performed and then followed by Samsamana with intermittent Virechana karma. PASI score is used to assess the severity of psoriatic lesions and the patient’s response to treatment. PASI score before the treatment was found to be 15.7 which became 0 at the end of the treatment. This case report showed the treatment modalities done in the patient obtained great result with no recurrence in the last 1.5 years.
RÉSUMÉ
Cauda equina compression at the level of L4/L5 or L5/S1 level is a surgical emergency with potentially significant consequences, including motor and sensory dysfunction. The causes include disc herniation, spinal stenosis, cancer, trauma, epidural abscess. The common cause is usually a disc herniation which is most commonly due to trauma, age, connective tissue disorders and congenital disorders. Cauda equina syndrome a disorder caused by compression of the nerve roots in the cauda equina region. This can cause permanent loss of bladder and bowel control if not treated within time. The incidence of a herniated disc is about 5 to 20 cases per 1000 adults annually and is most common in people in their third to the fifth decade of life with a male to female ratio 2:1. If decompressive surgery is delayed, there can be catastrophic consequences for the patient in terms of bladder, bowel and sexual function. In the present case study, a 36 year old female patient who was diagnosed as a case of Cauda Equina compression due to an extruded L4-L5 disc refused to undergo surgery and opted for Ayurvedic treatment. She was admitted in the Kayachikitsa IPD for 45 days. She was treated with the principle of Gridrasi along with Pakwasayagata vata. Deepana pachana and Vasti or Sodhana is the main treatment choice. Rooksha and Snigdha swedas were done which also help to reduce the stiffness and pain. After the management her physical condition and quality of life improved.