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Products that have been thawed should be infused without delay to pain management for dogs with bone cancer rizact 5 mg with mastercard avoid bacterial proliferation neuropathic pain treatment guidelines rizact 5mg with amex. If it is used as a source of labile coagulation factors, it should be used immediately and in any case within 6 hours of thawing. If used for a purpose other than coagulation factor replacement it should be transfused within 24 hours after it is thawed and stored at 1-60C. If there is visible red cell contamination in platelet and leucocytes concentrate, group specific and crossmatched product should be used. Verification of dose delivery system of the irradiator should be performed and documented annually. Irradiated components should be issued to immunologically normal patients provided there is compliance with required storage conditions and protocols of issue. Transfusion of Blood & Components Standards For Blood Banks & Blood Transfusion Services whichever is earlier. In case of neonate, the component should be transfused immediately after irradiation. The verification of leucocyte reduction should be done in 1% of products prepared of which 75% should contain less than 5x106 leukocytes in the blood bag. Transfusion Complications As the most common cause of hemolytic transfusion reaction is a clerical error, a system of preventing such errors should be in place. The blood group of the bag being issued should be re-confirmed by testing the sample from the donor tubing attached to the bag. Instructions should be given to transfusionists to check the identity of patient and ensure correctness of unit number on the bag as well as segment and the crossmatch report. In the event of suspected transfusion reaction, the personnel attending the patient should notify immediately the responsible physician and transfusion service with necessary documentation and appropriate samples. The details of all cases along with the interpretation of evaluation should be recorded and reported to the transfusion committee. There should be a written protocol for the investigations of transfusion reactions. The label on the blood container and all other records should be checked to detect if there has been an error in identifying the patient or the blood unit. Transfusion Complications Standards For Blood Banks & Blood Transfusion Services M-3. A direct antiglobulin test should be done on the post transfusion specimen and on pre reaction sample for comparison. Examination of post transfusion urine should be carried out for haemoglobin and its metabolites. Determination of bilirubin concentration in serum should be obtained preferably 5 to 7 hours after the transfusion. Expiry dated blood units should be tested periodically for bacteriological smear and culture. Other recipients who received components from the suspected blood unit should also be investigated. All reported cases of unexplained acute liver dysfunction occurring between two weeks to 6 months after the transfusion of blood or components should be investigated as possible post transfusion hepatitis. The donor of the implicated unit should be informed, counselled and permanently deferred. Autologous pre-deposit procedure requires consent of the donor-patient and a request from treating physician. Pre-deposit unit should be labelled "For Autologous Use Only" segregated and used solely for this purpose. Precaution should be taken to identify the donated unit and donorpatient before the transfusion procedure. If the blood collected for autologous transfusion is not used for the donor-patient, it should be discarded. Criteria for donation For autologous transfusion, rigid criteria required for donor selection are not applicable. The individual guidelines should be recorded in the procedure manual of the blood bank and clinical records of the donor-patient. The haemoglobin concentration of donor-patient should not be less than 11 g / dl and Haematocrit not less than 33% and must not fall N-1. Autologous Blood Standards For Blood Banks & Blood Transfusion Services below 10 gms per dl.

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The results of bone marrow aspiration and/or biopsy usually distinguish these two diseases pain medication for shingles treatment purchase rizact 10 mg fast delivery. Detection of atypical lymphocytes in peripheral blood smear and serologic evidence of Epstein-Barr or cytomegalovirus infection helps make a diagnosis pain treatment while on suboxone 5 mg rizact free shipping. Children with pertussis and parapertussis may present with marked leukocytosis and lymphocytosis, but the affected cells are mature lymphocytes. These presentations also can require bone marrow aspirate if a treatment with steroids for suspected rheumatoid diseases is planned. The first goal of antileukemic therapy is to induce a complete remission and restore normal hematopoiesis. Almost all protocols use glucocorticoid (prednisone/ dexamethasone), vincristine and L-asparaginase as so-called three-drug backbone plus intrathecal therapy. It is a matter of debate whether the addition of antracycline has an impact on the remission induction rate and on the duration of remission [6,91,92]. Most controversial in induction regimens is the choice of glucocorticoid, prednisone being used more frequently. There are data, however, that dexamethasone leads to more acute and long-term complications [95,96]. Three forms of L-asparaginase are available, each with different pharmacologic and pharmacokinetic profile. This may be due to early death (most often caused by infection or bleeding) or to chemoresistant leukemic cells. With restoration of normal hematopoiesis, children in remission become candidates for intensification therapy. The aim of early intensification therapy, administered immediately after remission induction, is to eradicate residual leukemic cells [101,102]. The intensity of chemotherapy varies considerably depending on risk group assignment. To minimize the development of drug resistance, cytotoxic agents were altered: prednisone was replaced with dexamethasone, doxorubicin was substituted for daunorubicin, and mercaptopurine was replaced with thioguanine [21]. Together with other drugs used in this phase, the minimal residual leukaemia cells may be further cleared up. On most trials, children with very high-risk features, treated with multiple cycles of intensive chemotherapy during the consolidation phase, have been considered candidates for allogeneic stem cell transplantation in first remission. After the completion of 6 to 12 months of more aggressive treatment, lower doses of cytotoxic drugs are used to prevent relapse. The aim of the maintenance phase is to further reduce minimal residual cells that are not detectable with current techniques at this stage of treat ment. Maintenance chemotherapy generally continues up to the time point of two or three years after the diagnosis or after achievement of morphological remission. On some studies, boys are treated longer than girls, while on others, there is no difference in the duration of treatment based on gender. Reduction of the duration of maintenance to less than 2 years led to an increased relapsed risk. However, patients with more aggressive leukemias who had received significant ly more intensive treatment, have less benefit of maintenance therapy [21]. There are large individual differences in the doses that are tolerated or needed to achieve the target leukocyte count. Children who receive maintenance therapy on a continuous rather than an interrupted schedule have longer remissions. Intensification of the maintenance by the administration of vincris tine/dexamethasone pulses was shown to provide no extra benefit [110]. It may be isolated event at one site (medullary or extramedullary) or may be combined (medullary and extramedul lary). Most relapsed leukemias retain their original immunophenotype and genotype, but rarely another cell lineage ("lineage switch") is observed. Molecular studies are helpful in distinguishing lineage switch from secondary leukemia, which usually occurs years later [44, 112].

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Having very hot showers back pain treatment vibration buy 5 mg rizact fast delivery, living in a dry environment pain memory treatment 5mg rizact with amex, normally cause this condition [23]. Stasis dermatitis Scaling and ulcerated skin appearing on the lower legs and around the ankles, are indicative of stasis dermatitis. Stasis dermatitis is caused by poor blood circulation and can happen in people with congestive heart failure, varicose veins, etc. Veins in the lower legs fail to return blood efficiently, causing pooling of blood and fluid build-up andoedema leading to irritation, especially round the ankles [24]. Seborrhoeic dermatitis Also called as cradle cap in infants, it generates greasy, yellowish scales on the scalp and eyebrows, behind the ears, and around the nose. This condition may be related to maternal hormonal changes affecting the sebaceous glands and may be aggravated by stress [25]. Some skin rashes may be caused by viruses, such as measles, chicken pox, shingles, etc. Rashes are often followed by skin irritation, which can have many reasons, including allergic reaction or sting from a plant. It can happen at any age, even in infancy often affecting the face, hands, knees, or feet. Plaque psoriasis, the most common type, causes thick red plaques covered with silvery scales. The most common areas affected are the scalp, elbows, knees, and lower back extending up to the nails and body folds. Although psoriasis can occur in members of the same family, it is not contagious and cannot be passed from person to person. Scleroderma is an autoimmune disorder where the skin gradually tightens, thickens or hardens and loses its ability to stretch [27,28]. Leprosy is an infectious nerve and skin disease affecting many parts of world, including India [29,30]. Viral Infections Shingles, warts and Molluscum contagiosum are the most common viral skin infections. Shingles or herpes zoster appears when the dormant chickenpox virus, Varicella zoster, is reactivated in the nerve tissues. Early signs of shingles include tingling and localized pain mostly accompanied with blistering rash having itching, burning or deep pain. In some people, it gets reactivated at some point in their lives, resulting in an outbreak of herpes zoster. Herpes zoster is more common in people older than age 50 with a depressed immune system. The virus usually results in a painful rash or small blisters on a strip of skin anywhere on the body. The children, most at risk for herpes zoster, are those whose mothers had chickenpox very late during pregnancy or who themselves had chickenpox during the first year of life [31]. Pityriasis versicolor or Tinea versicolor, is also a fungal infection of the skin. A fungal nail infection occurs when a fungus attacks a fingernail, a toenail, or the nail bed [32]. Pigmentation Related Problems Birthmarks are well known as coloured marks on the skin. Some of the birthmarks may be treated for cosmetic reasons while others can cause medical problems around the eyes, mouth or nose. Acanthosis nigricans causes dark, thickened patches on the skin in areas of neck, armpits, groins and under the breasts. Hyperpigmentation is excessive pigmentation or colouring of the skin, while hypopigmentation is a short condition in pigmentation. Hyperpigmentation is caused by an increase in melanin, the substance in the body that is responsible for skin colour. Vitiligo is a long-term skin condition that causes white patches and develops as a result of the lack of melanin.

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The number of household members in each of the six age-sex groups shown below were listed on the worksheet under the appropriate age-sex-group column pain medication for the shingles cheap rizact 10 mg on line, the sample selection worksheets were then ordered by segment number active pain treatment knoxville tn cheap rizact 5 mg with mastercard, and a systematic random sample of persons in each age-sex group was selected to be examined by using the following sampling rates: Age l-5 years. Sampling 112 1/4 1/4 1/2 1/4 1/1 rate which examinations were conducted during the survey. The final sampling stage involved the random selection of one of every two adults ages 25-74 years who were eligible for the sample. That is, data recorded for each sample person are inflated to characterize the subuniverse from which that sample person was drawn. When adjustments are made for differential sampling for high risk groups, the response rate becomes 75. The subsample of adults ages 25-74 years who received the detailed examination in addition to the more general nutrition examination was chosen syste matically after a random start, this group comprised one-fifth of the total sample of adults ages 2574 years and was selected in accordance with the following rates: Rate applied to nutrition sample Resultant effective sampling rate 1/10 1/10 3/20 1/4 Age 25-44 25-44 45-64 65-74 veers (mele). The Iuumerator of these factors consists of the sum of the weights for sample persons resulting from the reciprocal of the probability of selection, and the denominator consists of the sum of the weights for examined persons also resulting from the reciprocal of the probability of selection, Poststratification by age-sex-race. Bureau of the Census, of the population of each cell as of the mlidpoint of the survey. The effect of the ratio-estimating process is to make the sample more closely representative of the U. More detailed descriptions of the survey design and selection technique have been published. Sample locations of the first National Health Region, and Nutrition Examination Survey by ragion, county, and State coun W, 7 and state South St. Alameda, Contra-Costa, San Mateo, San Francisco, ColIin, Denton, Dallas, Ellisr Tex. Whether or not an individual participates is determined by many factors, some of them uncontrollable, and, therefore, the outcome may be reasonably treated as a random event with a particular probability of occurrence. If the probabilities of participation were known and were greater than zero for all persons, then the examined persons would constitute a probability sample from which unbiased estimates of the target population could be derived. In this situation, the effect of nonparticipation would only be to reduce the sample size, thereby increasing the sampling errors of examination findings. In practice, however, a potential for bias due to nonresponse exists because the exact probabilities are never known. A further potential for bias exists if: (1) a sizable proportion of sample persons have a zero probability of participation, that is, they would never agree to participate in an examination survey of the same procedures and inducements, and (2) these persons differ from other sample persons with respect to characteristics under examination. Population estimates for examination locations 1-65 by sex, race, and age at examination: Estimated population United States, 1971-74 Age at examina tion Total All races l-74years I year. Despite these intensive efforts, 26 percent of the sample persons from the 65-location nutrition examination sample and 30 percent of the sample persons from the 100-location detailed examination sample were not examined. Consequently, the potential for a sizable bias does exist in the estimates in this publication. From what is known about the nonrespondents and the nature of nonresponse, it is believed that the likelihood of sizable bias is small. The primary reasons given were that they had no need for a physical (48 percent), or that the examination times were inconvenient because of work schedules or c]ther demands (15 percent). For example, 20 percent of the examined persons reported that a doctor had told them they had arthritis, compared with 17 percent of the unexamined persons. Similarly, 18 percent of both the examined and the nonexamined persons had been told by a doctor that they had high blood pressure. A self-appraisal of being in poor health was made by 5 percent of the nonexamined persons and by 6 percent of those who were examined. Additionally, a different study of Cycle I datas 2 showed that comparisons between two extreme groups-those who participated in the survey with no persuasion and those who participated onIy after a great deal of persuasion­indicated that differences between the two groups generally had little effect on estimates based on numerous selected examination and questionnaire items. This was interpreted as evidence that no large bias exists between the two groups for the items investigated and was offered as further support for the belief that little bias is introduced to the findings because of differences in health characteristics between examined and nonexamined persons. As noted earlier, the data in this report are based on weighted observations, and one of the components of the weight assigned to an examined person was an adjustment for nonresponse. If homogeneous groups can be defined that are also homogeneous with respect to the characteristics under study, the procedure can be effective in reducing the potential bias from nonresponse.

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Example: Pippermint Oil back pain treatment guidelines cheap rizact 5 mg overnight delivery, Spearmint Oil-In this instance the freshly cut drug is added directly into the distillation flask prior to pain solutions treatment center woodstock ga cheap 10mg rizact with visa steam distillation. Likewise, volatile oils found in the rind of the fruit, such as: orange, lemon and bergamot peel, are best obtained by extrusion i. Even on a commercial scale these oils are produced by extrusion so as to preserve the natural fragrance that otherwise get deteriorated by distillation process. In actual practice, however, the expression may be accomplished by any one of the four following processes, namely: (a) Sponge Method: the citrous fruit (e. The rind is turned inside out by hand and squeezed when the secretary glands rupture. The oozed volatile oil is collected by means of the sponge and subsequently squeezed in a vessel. It is more or less a large funnel made of copper having its inner layer tinned properly. The inner layer has numerous pointed metal needles just long enough to penetrate the epidermis. The lower stem of the apparatus serve two purposes; first, as a receiver for the oil; and secondly, as a handle. Now, the freshly washed lemons are placed in the bowl and rotated repeatedly when the oil glands are punctured (scarified) thereby discharging the oil right into the handle. The liquid, thus collected, is transferred to another vessel, where on keeping the clear oil may be decanted and filtered. Initially, the liquid has a turbid appearance but on allowing it to stand the oil separates out which may be decanted and filtered subsequently. However, the use of heavy duty centrifugal devices may also be incorporated so as to ease the separation of oil/ water emulsions invariably formed. It is pertinent to mention here that with the advent of modern mechanical devices the oil out put has increased appreciably and the older methods have only remained for the sake of history. Examples: Volatile oils obtained from various flowers like Jasmine (Jasminum officinale Linn. Ver grandiflorum Bailey: family ­ Oleaceae); Sweat violet (Violaodorata Linn, family ­ Violaceae); Gardenia (Gardenia lucida Roxb. In general, the extraction of volatile oil from natural sources is carried out by two different methods, namely: (i) Extraction with volatile solvents. The resulting volatile oil containing solvent is removed under reduced pressure when the volatile oil will remain in the flask. It is possible to maintain an uniform temperature (usually 50oC) during most of these extractions which ultimately ensures the retention of a more intense and natural fragrance which otherwise cannot be achieved by distillation (perhaps due to chemical degradation of constitutents). In actual practice, these floral concretes represent an admixture of natural odoriferous components of flowers, plant waxes, colour pigments and certain albuminous material. In this instance, the volatile oil content usually present in the fresh plant sources eg. Grassein Southern France, is the wellknown centre for the extraction of flower volatile oil in the world. There are three methods that are used for the extraction of volatile oils from flowers with nonvolatile solvents, namely: (i) Enfleurage Method, (ii) Pneumatic Method, and (iii) Meceration Method. These plates are now stacked one over the other and enclosed in the wooden frame, whereby each layer of the flower shall be enclosed between two layers of the fat. Such batteries of loaded plates are allowed to remain for 24hours, after which the flowers are removed and recharged with fresh lots. This very process is repeated religiously for several weeks till the fatty layers appear to be fully saturated with the essential oils of the flowers or until a certain desired concentration of it is accomplished. The flowers are subsequently removed (defleurage) and the fat is separated carefully and stirred with absolute alcohol. The latter will dissolve the volatile oil portion thereby leaving the former undissolved in alcohol. The alcoholic extract is reasonably chilled and filtered to get rid off any traces of residual fat. The flowers are then strained, squeezed and the exuded fat is returned to the main bulk of the fat, unless and until a desired concentration is achieved.

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It diffuses the energy derived from food and breath throughout the entire organism including the skin heel pain treatment plantar fasciitis discount rizact 10mg visa. Vyana also carries sweat from the glands to coccyx pain treatment physiotherapy proven 10mg rizact the skin and is the force behind bodily expressions such as yawning and blinking. When vyana malfunctions, there is dryness of the skin and other body extremities, poor circulation, and diseases such as fever. Table -3 Doshas Prana Site Heart & Head, between Normal function Breathing and swallowing of food, life & thinking, heart rhythm Speech, voice, colour, strength, diaphragm and throat Udana From umbilicus to lung, throat and nose Samana Between diaphragm and navel (stomach and intestines) immunity,energy, memory,capacity for effort Helps action of digestive enzymes, assimilation of end products of food and separation into their various tissue elements & waste products. Apana Colon & organs of pelvis Elimination of stool, urine, fetus and menstrual blood. Five Fires of Pitta Pitta, formed from the elements of fire and water, also is said to reside in five sites. These sites are the centers of operation and systemic outreach through which the Pitta dosha influences the entire organism; they are: pachaka, ranjaka, sadhaka, alochaka and bhrajaka. Fire of the Stomach: Pachaka Pachaka is referred to in Ayurveda as the first fire of the body. It exists in the small intestine, duodenum, gall bladder, liver, and pancreas, and supports the remaining four fires, to be discussed below. An imbalance in this first fire, pachaka, causes indigestion as well as a revulsion for food. Fire of the Blood: Ranjaka True to its name, ranjaka, the second fire of Pitta, controls the formation and preservation of blood. Located in the liver, spleen, and stomach, ranjaka provides the blood with its colour and oxygen. When ranjaka is impaired, bile compounds may appear in the blood and diseases such as anaemia and jaundice may follow. Fire of the Heart: Sadhaka the finest of the fires, sadhaka, the third fire, is central to the activity of Pitta. With udana, it governs memory and the retention and wellness of all mental functioning. When sadhaka is impaired, there may be psychic disturbances, mental disorientation, extreme emotional states, and craving for extreme foods, drugs, and so on. Fire of the Eyes: Alochaka Alochaka, the fourth fire of Pitta, exists in the pupils of the eyes. It gives the eyes their lustre and diffuses light and its spectrum of colours throughout the body, When the fourth fire is vitiated, there is impairment of vision and yellowness may appear in the eyes. Fire of the Skin: Bhrajaka the fifth fire, bhrajaka, is located in the skin, given the skin its lustre and gleam. Bhrajaka protects the body from extreme atmospheric conditions and facilitates the assimilation of light, wind, water, and oil through the skin. When this fire is disturbed, skin diseases such as psoriasis, eczema, and leukoderma may result. Table -5 Doshas Site Normal function Ailments caused by its vitiation Pachaka Stomach intestines,gall bladder,liver,pancreas, & small Digesting and dissolving of food,regulating temperature,separation nutritive wastes Ranjaka Liver, spleen and stomach Blood formation and Anemia, Hepatitis Psychic Cardiac mental states Alochaka Eyes Vision, lusture of eyes Impairment of vision, disturbances, diseases, disorientation Jaundice elements body of from Indigestion, Anorexia preservation Sadhaka Heart Memory and other mental functions. If pitta dosha is in excess it results in: Table -6 Ambition Anger Envy Fear of Failure Sarcastic speech and actions Skepticism Excessive thirst Loss of sleep Frustration Decreased Pitta results in: Indigestion Abnormal loss of body heat Five Waters of Kapha Kapha, formed from the elements water and earth, also manifests in five doshic sites, through these centres of operation and systemic outreach it influences the entire organism. Water of the Stomach: Kledaka the first water of Kapha, kledaka, originates in the stomach. When the first water is aggravated, the digestion process becomes impaired, heaviness of the abdomen prevails, and nausea may also occur. Water of the Heart: Avalambaka the second water of Kapha, avalambaka, resides in the chest and heart. It provides a plasmic (fluid) tissue covering to the heart, thus insulating it from heart & acting as a shockabsorber. Heart originating diseases such as rheumatic fever and pains in the pericardium(tissue around the heart) may also occur. It registers each of the six tastes in nature and sends the appropriate impulses to the receiving tissue long before the food is ingested. This creates Ama, the foul undigested remnants of food which stick in the tissues and promote diseases such as obesity, bulimia, and anorexia. Generally, a thick white coating on the tongue indicates the presence of ama in the body.

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Rajoguna implies movement treatment for dog pain in leg effective 5 mg rizact, aggressiveness and extroversion and it operates on a sensual level northside hospital pain treatment center atlanta ga buy rizact 5mg on line. Rajoguna and Tamoguna are negative attributes which destabilise and weaken the mind. Yet all the three attributes are required of course in a balanced state and having a strong control of satvaguna are necessary for normal functioning of the mind. The Taste Process the first subjective experience of a substance on the tongue is taste (rasa). For instance, for hot chilli peppers, one immediately experiences its pungent taste (rasa) and heating energy (virya), observing a burning sensation in the faces and urine (vipaka). Virya ­ Heating or Cooling Energy When any medicinal herb or food substance is put in the mouth, the first experience is its taste. Later, and in some cases immediately, you feel its heating or cooling energy, either in the mouth or stomach. By experience, one can form general rules about what a taste "feels like" in the body. Prabhav ­ Specific Unexplained Action When two substances of similar taste, energy and post-digestive effect show entirely different action, it is called prabhav. Prabhav is therefore the specific, dynamic, hidden action of the awareness present in the substance. A list of the same is indicated below: Table 20 Milk with Melons with Starches with Honey with Radishes with Nightshades with Yogurt with Eggs with Fruit with Corn with Lemon with Water in Ayurveda: Different synonyms for water are used by the brilliant scholars of Ayurveda representing either the properties of the water or importance of the water in human life. For an Ayurveda fish, meat, curd, sour fruits, bread containing yeast, cherries, yogurt grains, starch, fried foods, dairy products eggs, tea, dairy, bananas, dates, most fruits when mixed with an equal amount of clarified butter, boiled or cooked honey milk, bananas, raisins potato, yogurt, milk, melon, cucumber, tomato, eggplant milk, sour fruits, melons, hot drinks, meat, fish, mangos, starch, cheese milk, meat, yogurt, melons, cheese, fish, bananas with any other food dates, raisins, bananas yogurt, milk, cucumbers, tomatoes physician water is not only an essential nutrient but is one among the five basic elements essential for the creation of this universe. According to charaka liquid, unctuous, cold, soft, sticky & sweet taste are the attributes of the substances predominanted by water. Moistening, unctuous, binding, oozing, softening and exhilarating are the effects of watery edible substances on the human body. Water is basically tasteless but as soon as it falls from the sky gets endowed with the properties of the five elements, or comes in contact with other substances & taste appears in water. Classification of Water: Charaka while describing the various types of water mentioned that, entire water is only one which falls down as rain from the sky, that while falling or having fallen down depend on place and time. He further says that water while falling down from sky & coming in contact with the moon the air & the sun which follows time, gets impregnated with the properties of cold, hot, unctuous, non unctuous etc. Soil & the Water: According to Charaka the pure rain water has by nature six qualities namely cold, pure, wholesome, palatable, clean & light. But when water falls on earth its properties change according to the soil on which it has fallen. In white soil it becomes astringent, in pale it becomes bitter, in brown alkaline, in usara i. The Season & the Water: According to charaka(1) the fresh rain water of the rainy season is heavy, cases blockage to the channels & sweet. The River & the Water: Charakacharya has described the properties of water from different rivers. The river originating from Himalayas, constantly used by the sages having water that is obstructed, agitated & beaten is wholesome & virtuous, says Charaka. Those originating from Himalaya, carrying stones & sand have clean water which is like nectar. This rivers flowing towards west have clean water & are wholesome while those joining the eastern sea are mostly mild flowing & do not have clean water. Best water is slightly astringent, sweet, thin, non slimy, light, non rough & does not block the channels of the body says Charaka. Jala Mahaboot & Human Body: While describing the predominance of Mahabhootaas in human body in Charak samhita Charakacharya cleared stated that, " the liquid, mobile, dull, unctuous, soft & slimy, plasma, blood, fat, kapha, pitta, urine, sweat etc. Udakavaha Srotas: Strotas are defined as transporting passages of dhatus undergoing transformation. The symptoms of their affliction are dryness of tongue, palate, lips, throat, pancreas & excessive thirst.


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