CHARDI.pptx

chardi presentation

1. CHARDI

2. Definition Since it covers the mouth by bouts, causes discomfort by bending of the body and doshas expelled out of the mouth, is called Chardi .

3. Aetiology

4. Pathogenesis Due to the aetiological factors, udana vayu becomes abnormal and aggravates all the doshas and make them move upwards giving rise to chardi .

5. Types

6. photo

7. Treatment (A.H.Chi.6)

8. Langhana is ideal in the beginning itself except in Vataja Vamana is indicated in those who are strong, have increase of doshas and who vomits large quantities repeatedly using wine, fruit juice or milk Shamana oushadhas should be administered for those who are dry and debilitated In associated fever decotion with Jwaraghna oushadhas can be administered

9. (A.H.U.2/58) Vomiting immediately after every feed should be treated with Panchakola churna with Varthakiphala rasa, ghee and honey.

10. K.Su.25/16

11. Laja vilwadi – preferably as Phanta kashaya can be used in all types of vomiting Marichadi churna can be used along with honey (ARKD)

12. Vomiting Vomiting encompasses all retrograde ejection of gastrointestinal contents from the mouth.

13. Causes of vomiting in Neonatal period Necrotizing enterocolitis Meconium plug Gastro esophageal reflux Inborn errors of metabolism Generalized infection Bacterial meningitis Birth asphyxia Hydrocephalus Faulty feeding technique

14. Causes of vomiting in Infancy Congenital hypertrophic pyloric stenosis Malrotation Volvulus Intursusception Gastro esophageal reflux Gastroenteritis CNS infection Peritonitis CNS space occupying lesion Hydrocephalus Subdural hematoma Inborn errors of metabolism Uraemia Cow milk protein allergy Over feeding Faulty feeding technique

15. Causes of vomiting in Childhood Intestinal obstruction Intursusception Gastro esophageal reflux Gastroenteritis UTI Hepatitis Pneumonia Peritonitis CNS space occupying lesion Hydrocephalus Diabetic ketoacidosis Uraemia Toxins Postnatal dribbling Psychogenic

16. Approach Arrive at a correct diagnosis – most imp Ask abt duration, frequency, presence of blood or bile in the vomits, abdominal pain, recent changes in feeding pattern or colour of urine, drug consumption, presence of fever and altered sensorium .

17. Occasional vomit at the onset of acute fevers – disregarded Vomiting due to benign non-organic causes does not lead to dehydration or loss of weight

18. Features indicating organic causes Persistent forceful vomiting Abdominal distension Palpable mass / visible peristalsis Failure to gain weight Altered sensorium Bulging fontanel Persistent irritability in an infant with vomiting

19. Site of lesion Esophagus – infant has excessive frothing soon after birth, choking on attempted feeding, swallowed milk returned promptly often relatively undigested and unchanged Stomach – child may vomit immediately or after some hours. Vomiting is not very forceful. Milk is curdled but is not bile stained. Intestine – vomitus is bile stained, greenish if the obstruction is beyond ampulla of water Central causes – vomiting is often sudden, unexpected and forceful. Persistent headache and signs of increased ICP is evident

20. Management Recognition and treatment of the primary causes of vomiting in addition to symptomatic therapy and correction of dehydration. Symptomatic – stomach wash (neonates and infants), withholding oral fluids for few hrs and gradually restarting in sips. Sips of cold and clear fluids are better tolerated than the hot beverages like coffee and tea. If the child is persistently vomiting and dehydrated or has electrolyte imbalances, IV fuilds are necessary