যৌবন কালৰ এটি অবাঞ্ছিত সমস্যাৰ নামেই হৈছে ব্রণ। একনি ভালগাৰিচ অথবা ব্রণ মানুহৰ চালত হোৱা সাধাৰণ
ৰোগবিশেষ।জীৱন কালত ব্রণ বা শালমনৰ সমস্যাত নপৰা মানুহ হয়তো খুউব কমই আছে। বিশেষ কৈ তৰুণ- তৰুণী সকল ব্রণৰ সমস্যাত বেচিকৈ ভোগে। এই ব্রণ মূলত টিনেএজাৰ সকলৰ সমস্যা। এই বয়সত যেতিয়া মুখৰ সৌন্দৰ্যৰ প্রতি সকলোৱে আকর্ষণবোধ ও প্রয়োজনীয়তা অনুভব কৰে ঠিক সে বয়সতেই মুখত এই বিশ্রী গোটাসমূহ দেখা দিয়ে, যি যুৱক-যুৱতী সকলৰ অন্যতম দুশ্চিন্তাৰ কাৰণ হৈ পৰে।
ৰোগবিশেষ।জীৱন কালত ব্রণ বা শালমনৰ সমস্যাত নপৰা মানুহ হয়তো খুউব কমই আছে। বিশেষ কৈ তৰুণ- তৰুণী সকল ব্রণৰ সমস্যাত বেচিকৈ ভোগে। এই ব্রণ মূলত টিনেএজাৰ সকলৰ সমস্যা। এই বয়সত যেতিয়া মুখৰ সৌন্দৰ্যৰ প্রতি সকলোৱে আকর্ষণবোধ ও প্রয়োজনীয়তা অনুভব কৰে ঠিক সে বয়সতেই মুখত এই বিশ্রী গোটাসমূহ দেখা দিয়ে, যি যুৱক-যুৱতী সকলৰ অন্যতম দুশ্চিন্তাৰ কাৰণ হৈ পৰে।
কোন বয়সত বেচি হয় :-
১৩ পৰা ১৮ বছৰ বয়সত এই সমস্যা বেছি হয়। কোনো কোনোৰ ২০ ৰ পৰা ৩০ বছৰ বয়সলৈকে হোৱা দেখা যায়। টিনেজাৰ সকলৰ মাজত শতকৰা 90% ৰ ক্ষেত্ৰতেই কম অথবা বেচি পৰিমাণে এই সমস্যা হৈ থকা দেখিবলৈ পোৱা যায়। ২০ বছৰ বয়সৰ পাছৰ পৰা লাহে লাহে কমি আহে।
ব্রণৰ প্ৰকাৰ :-
o ট্রপিকেল একনি :– অতিৰিক্ত গৰম আৰু বাতাহৰ আর্দ্রতা বেচি হলে পিঠি, উৰুত ব্রণ হয়।
o প্রিমেনস্টুৰেল একনি :– কোনো কোনো মহিলাৰ মাহেকীয়াৰ আগত ৫-১০টা ব্রণ মুখত দেখা দিয়ে।
o একনি কচমেটিকা :– কোনো কোনো প্রসাধন সামগ্ৰী ব্যবহাৰ কৰাৰ ফলতো মুখত অলপ পৰিমাণে ব্রণ হব পাৰে।
o একনি ডিটাৰজিনেকচ :– মুখ অতিৰিক্ত ভাবে চাবোন দি ধুলেও ( দৈনিক ১/২ বাৰৰ বেচি) ব্রণৰ পৰিমাণ বাঢ়ি যায়।
o স্টেৰয়ড একনি :– স্টেৰয়ড ঔষধ সেবন কৰিলেও হঠাৎ ব্রণ দেখা দিয়ে। মুখত স্টেৰয়ড, যেনে– বটনোবেট ডার্মোভেট জাতীয় । ঔষুধ একেৰাহে বহুদিন ব্যবহাৰ কৰিলে ব্ৰণৰ পৰিমান বাঢ়ি যাব পাৰে ।
শৰীৰৰ কোন থাইত হয় :-
সাধাৰণতে মুখ যেনে গাল, নাক, থুতৰি ও কপালত দেখা যায়। শৰীৰৰ উপৰৰ অংশতো হব পাৰে।
Acne বা ব্রণ হোৱাৰ কাৰণ :-
বংশগত প্রভাব এটা অন্যতম গুৰুত্বপুর্ণ কাৰণ। সচৰাচৰ যৌৱন কালত এড্রোজেন হৰমনৰ প্ৰভাবৰ বাবে তেলেতীয়া ছালৰ মুখত পিম্পল উঠে। চালত থকা তৈল গ্ৰন্থি (Sebaceous gland)ত চেবাম নামৰ তৈল পদৰ্থ বেছি উৎপাদন হলে অতিৰিক্ত চেবাম বাহিৰলৈ উলাই অহে। তেতিয়া ধূলিবালি বোৰ নোমকূপত লিপিতখাই লাগি ধৰে। এনে অৱস্থাত চেবাম নামৰ তৈল পদাৰ্থ তৈল গ্ৰন্থিত সঞ্চিত হয়, ইয়াৰ লগতে নোমৰ গুৰিত কেৰাটিন নামৰ পদার্থ জমা হয়। আৰু নোমৰ গুৰিত থকা প্রোপাঅনি ব্যাকটেৰিয়াম একনি নামৰ ব্যাকটেৰিয়াই সংক্ৰমণ আৰম্ভ কৰে।এই কেৰাটিন, লিপিড আৰু মেলানিন পদার্থৰ পৰাই ব্লাক হেড বা ‘হোয়াইট হেড’ ৰুপে প্ৰকাশ পায়, ফোঁহা উলাই আৰু বিষাবলৈ ধৰে।
শালমনৰ লগত খাদ্যৰ সম্পৰ্ক :-
বহুতে ভাবে যে খাদ্যৰ লগত ব্ৰণৰ সম্পৰ্ক আছে। কিন্তু কথাটো বিশ্বাস যোগ্য নহয়। কোন প্ৰকাৰৰ খাদ্য বস্তুৰ লগত কিবা সম্পৰ্ক থকাটো ধৰিব পৰা নাযায়।
ব্রণ আৰু ক্রিম :-
যাৰ চাল তেলেতীয়া তেওঁলোকে তৈলাক্ত উপাদান থকা ক্ৰিম ব্যবহাৰ কৰা উচিত নহয়। এটা কথা মনত ৰাখিব ক্রিম যদি তেলেতীয়া হয় তেনে ক্ৰীম ব্ৰণ ৰোগীয়ে ব্যাৱহাৰ নকৰিব।
ব্রণ দূৰকৰাৰ ৬ টা অত্যন্ত কাৰ্যকৰী ফেচপেকঃ
কমলাৰ বাকলিয়ে কমাব পাৰে ব্রণ :-
কমলা তেঙাৰ বাকলি শুকোৱাই মিহি গুঁৰা কৰি লব। চন্দন পাউডাৰ, মুলতানি মাটি, কমলাটেঙাৰ শুকান গুৰি ভাল দৰে মিলাই লব। এই মিশ্রণৰ সৈতে দুই চামুচ গখীৰ মিহলাই লব পাৰে। মুখত লগাই কিছুসময় ৰখাৰ পাছত ধুই পেলাব। এই পেকটো নিয়মিত ব্যবহাৰ কৰিলে চালৰ উজ্জ্বলতা বাঢিব, ব্রণৰ উপদ্রব কমিব, ব্রণৰ দাগও দূৰ হৈ যাব।
নিমেও দুৰকৰে ব্রণ :-
চাৰি/পাঁচটা নিম পাত ভাল কৈ ধুই পিহি লওক। তাৰ লগত এক চামুচ মুলতানি মাটি, অলপ গোলাপ জল মিহলাই পেক বনাই লওক। মুখত লগাই কিছুসময় ৰাখি থব। ভালদৰে শুকাই যোৱাৰ পাছত কুহুঁমীয়া পানীৰে ধুই দিয়ক। মুখত ব্রণ থাকিলে খুওব সোনকালে নোহোৱা হৈ যাব।
লং অত্যন্ত ফলদায়ক :-
লং মূলত মচলা হিচাবে পৰিচিত হলেও ব্রণ দুৰিকৰণত ই খুবেই কার্যকৰী। লং তেলৰ দ্বাৰা চাল মাচাজ কৰা খুবেই উপকাৰী। চালত ব্রণৰ সংক্রমণ বেঢ়ি গলে লং গুঁডি কৰি লগত গোলাপজল মিলাই পেস্ট তৈয়াৰ কৰিব। ব্রণ উলোৱা থাইবোৰত মিশ্রণৰ ডাথ প্রলেপ দিব। ২০ মিনিট ৰাখি ধুই পেলাব।
এলোভেৰা যিকোনো ধৰণৰ ছালৰ বাবেই উপযোগী :-
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ভিডিঅটো চাবৰ বাবে তলৰ লিংটো ক্লিক কৰকঃ
ড. হৰিকান্ত দাস
গোগামুখ, ধেমাজি
ফোন নং- ৯৯৫৪৩৪০১০২













![web 10 At my last part, I have left upto the factor; Hyperprolactinaemia & Amenorrhoea, some points are left,so today i'm going to start from that, Hyperprolactinaemia causes secondary amenorrhoea in about 30% of women. There is anovulation & hypogonadotrophic hypogonadism. (I)Pituitary Adenoma (Prolactinoma):- Hyperprolactinaemia is commonly due to pituitary adenomas (microadenoma or macroadenoma). There are other various causes of hyperprolactinaemia. Causes of Hyperprolactinaemia; [A] Physiological:-(1) Stress & exercise(raised endogenous opioids) (2)Pregnancy(3)Stimulation of nipples (4) Sleep (5) Idiopathic.[B] Hypothalamus & pituitary:-(1) Craniopharyngioma (2) Tuberculosis (3) Hypothyroidism (4) Multiple endocrine disorder (Cushing's syndrome, Acromegaly) (5)Pituitary adenomas (Prolactinomas) (6) Resection of pituitary stalk. [C]Drugs:-Some drugs, like antidepressants [D] Others:- (1) Renal failure (2) Cirrhosis of liver (3) PCOS (4) Idiopathic. (J) SHEEHAN'S Syndrome:-There is history of severe postpartum haemorrhage, shock or severe infection. Depending upon the degree of anterior pituitary necrosis, the features vary. The common manifestations are failing lactation, loss of pubic & axillary hair, lethargy, hypotension, secondary amenorrhoea and atrophy of the breasts & genitalia. Gonadotrophin level is low, so also T3,T4 and cortisol. The hormones affected in order of frequency are, growth hormone (GH), prolactin, Gonadotrophins(FSH and LH),TSH and ACTH(Adrenocorticotrophic hormone). Hyponatremia may be present (30%). The syndrome may develop slowly over 8-10 years time. (K)Adrenal Tumour or Hyperplasia:-There is secondary amenorrhoea, infertility, acne and features of defeminisation followed by virilisation(hoarness of voice, hirsutism and enlargement of clitoris). In both the conditions there is excess production of androgens. Serum level of DHEA-S (dehydroepiandrosterone sulphate) correlates well with daily urinary 17KS excretion. (L) Cushing syndrome:- Cushing first described the syndrome in 1932. Androgens are formed as intermediate products in the synthesis of cortisol. The elevated cortisol level found in Cushing syndrome encompasses two distinct pathologic entities- (1) Cushing disease(ACTH dependent) (2) Adrenal tumour(ACTH independent). (Next part will upload at part 13 @Dr Priyanka Baishya) 13 Amenorrhoea(Part 13):-at my last part i have written upto the beginning of 'Cushing syndrome', so today i am going to discuss elaborately about this syndrome; In Cushing disease, there is excess production of ACTH from the anterior pituitary or from ectopic sites. The increased ACTH causes hyperstimulation of adrenal cortex leading to its hyperplasia which in turn leads to excess production of cortisol & androgens. ACTH independent causes(adrenal adenoma or cancer) may be iatrogenic(high dose corticosteroid therapy)or adrenal tumour. The cause of adrenal mischief is cortisol secreting adenoma which produces excess cortisol. The androgen production is usually less but may be markedly elevated in presence of adrenal carcinoma. Symptoms include:-weakness, oligomenorrhoea, amenorrhoea, acne and hirsutism. Virilism is rare. The syndrome is often associated with hypertension, osteoporosis and insulin dependent diabetes. (M) Thyroid Dysfunction:- Both hypo & hyperthyroid states may produce secondary amenorrhoea & anovulation, the former is common. Serum TSH is raised, while T3 and T4 values are lowered in hypothyroid state. In subclinical hypothyroid state,serum TSH is elevated but T4 is normal. Serum prolactin may be raised even beyond 20ng/ml in hypothyroid state. This is due to increased sensitivity of prolactin secreting cells of anterior pituitary to TRH (Thyroid Releasing Hormone). (N) Postpill Amenorrhoea:-It is observed in less than 1% of the women following the use of COC pills (Combined Oral Contraceptive) pills. The association is more coincidental rather than causal. Fertility rate is normal following discontinuation of the drug. Spontaneous resumption of menstruation occurs in majority of cases after a varying period. Otherwise such amenorrhoea should be investigated as in other cases of secondary amenorrhoea. (O) General disease:- Malnutrition, tuberculosis- both pulmonary & pelvic, diabetes & chronic nephritis are all implicated. Their diagnostic criteria vary accordingly. Straight X-ray chest in pulmonary tuberculosis, blood sugar in diabetes, urine analysis & blood urea in chronic nephritis are helpful to substantiate the diagnosis. [INVESTIGATIONS]:-Investigations aims at:- (1)To diagnose or confirm the offending factor. (2)To guide the management protocol either to restore menstruation and/or fertility.(Next part details about investigations will upload at part 14, 14 Amenorrhoea (Part 14); Investigations aims at:-In secondary amenorrhoea, there is altered coordinated function of the hypothalamopituitary ovarian axis are to some pathology. As such, it is not easy in most cases to pinpoint the diagnosis only by clinical examination. However, meticulous history taking & clinical examinations are mandatory. Laboratory investigations either to diagnose or to confirm the clinical diagnosis are mostly needed. These are especially helpful for formulation of management protocols either to restore menstruation or fertility. It should be emphasised that pregnancy must be excluded prior hand irrespective of the status of the women -married, unmarried, widow, divorced or separated. With the aetiological factors in mind, one should proceed for investigations. Detailed history :- Enquiry should be made about (1)Mode of onset:-whether sudden or gradual preceded by hypomenorrhoea or oligomenorrhoea. (2) Sudden change in environment,emotional stress, psychogenic shock, or eating disorder(anorexia nervosa) (3)Sudden change in weight-loss or gain. (4) Intake of psychotrophic or antihypertensive drugs. Intake of oral 'pills' or its recent withdrawal. History of radiotherapy & chemotherapy or surgery. (5) Appearance of abnormal manifestations either coinciding or preceding the amenorrhoea such as:- (a) Acne, hirsutism (excessive growth of hair in normal & abnormal sites in female)or change in voice. (b) Inappropriate lactation (galactorrhoea)- abnormal secretion of milk unrelated to pregnancy & lactation.(c)Headache or visual disturbances. (d)Hot flushes & vaginal dryness (6) Obstetric history:-overzealous curettage leading to synechiae. (a) Caesarean section may be extended to hysterectomy of which the patient may be unaware. (b) Severe postpartum haemorrhage, or shock or infection. (c) Postpartum or postabortal uterine curettage (d) Prolonged lactation:-The patient may be amenorrhoeic since childbirth or she may have one or two periods, followed by amenorrhoea. (7) Medical history of tuberculosis (pulmonary or extra-pulmonary), diabetes, and chronic nephritis or over hypothyroid state should be enquired. (8) Family history-Premature menopause often runs in the family(mother or sisters) General examination:-The following features are to be noted-(1)Nutritional status(2)Extreme emaciation or marked obesity(3)Presence of acne or hirsutism (4)Discharge of milk from breast. (Next part will be upload at part 15,Homoeopathic Treatment will come, @Dr Priyanka Baishya) 15 Amenorrhoea(Part 15):-at part(14)few points of investigations have been left; today i am going to end up the investigations part & will going to begin the 'Homoeopathic way of treatment'; Investigations:-Abdominal examination:-(1)Presence of striate associated with obesity may be related to Cushing disease.(2)A mass in the lower abdomen. Pelvic examination:- (1) Enlargement of clitoris.(2) Adnexal mass suggestive of tubercular tubo-ovarian mass or ovarian tumour. With these methods, either a probable diagnosis is made or no abnormality is detected to account for amenorrhoea. Even though there is no inappropriate galactorrhoea, serum prolactin, TSH estimations & X-ray sella turica are mandatory. If these are normal, the following protocols are followed:- Step-1:- Progesterone challenge test is employed; Step-2:- Oestrogen - progesterone challenge test; Step-3:- Estimation of serum gonadotrophins is to be done; Step-4:-GnRH(Gonadotropin releasing hormone) dynamic test. Homoeopathic Way of Treating Amenorrhoea:-'Homoeopathy treats the patient not only the disease'- is a commonly used epigram in Homoeopathy. The Homoeopathic Physician cures the sick man by reversing the diseased condition to healthy state as a whole. We the Homoeopathic Physicians treats the patient in a 'Holistic way' I. e; Patient as a whole; by complete case taking; physical, mental, general symptoms with past history, family history. Through totality of symptoms; we should give a constitutional remedy. Yes there are lots of therapeutic medicines; but Holistic approach should be maintained. Through therapeutic way here I am going to mention few medicines, with red line symptoms but always prefer constitutional similimum in Holistic approach to attain complete cure. Few therapeutic way medications:- (1) Pulsatilla:- Derangements at puberty; menses, suppressed from getting the feet wet, too scanty, too late, slimy, painful, irregular, intermittent flow, with intense pain & great restlessness & tossing about. Delayed first menstruation. (2)Cimicifuga:- Menses; irregular, exhausting, delayed or suppressed by mental emotions, from cold, from fever, with chorea, hysteria or mania, increase of mental symptoms during menstruation. (3)Ferrum Metallicum:-When amenorrhoea is relate with 'Iron deficiency anaemia'. Menses, too early, too profuse, too long lasting, with fiery red face, ringing in the ears, intermit two or three days & then return, flow pale, watery, debilitating. [Next part will upload at part 16 Amenorrhoea(Part 16); Homoeopathic Way of Treatment:- at my last part i have started about the 'Homoeopathic Way of Treatment', so today i am going to complete the topic; (4)Conium:-Menses; feeble, suppressed, too late, scanty of short duration with rash of small red pimples over body which ceases with the flow. (5)Calcarea Carb:- Menstruation too early, too profuse, too long lasting, with subsequent amenorrhoea & chlorosis with menses scanty or suppressed. (6)Sepia:-Irregular menses of nearly every form early, late, scanty, profuse, amenorrhoea Or menorrhagia. There are lots of medicines through therapeutic & constitutional way. I have mentioned few medicines with few red line symptoms; there should also count generalities, modalities, Past history, family history & then a similimum medicine will give. We Homoeopathic Physician select a medicine after proper case taking & miasmatic background of a case should be considered (Miasm:- Miasm denotes the dynamic disease producing power which pollutes the human organism & become the producer of every possible diseased condition). Never do any self medication; always consult with a Registered Homoeopathic Physician & take consultation. As Homoeopathic Medical Science treat a case through individualistic approach, so there are always different medicines to different individual. A same medicine which will come to an individual will never be the same with an another individual; So take medicines with a complete consultation with registered Homoeopathic Physician & be with a good health. So the vast series of 'Amenorrhoea' has completed today. Thanks to al](https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhhV5dRRhHnSxjEHNr-a4sql47rcmTJ_kxhbZ51jC2eLnaZIfYxsFOX8pse6xwq0AP1BjtS-0cNEhJ7kJzq2gkSuMlWt-C2d9GgiyBr2wJpIUCSP5xBooCRzRiyUH7HHEt3Af1OG_A-Dqo/s400/Untitled-26.jpg)
![web Secondary Amenorrhoea:- I have already written up to secondary amenorrhoea causes 'Ovarian factors'. So today going to start from next point; that's [C]Pituitary factors:- {(1) Adenoma (Prolactinoma), (2) Cushing's disease(3) Acromegaly}:-Micro adenoma usually associated with hyper prolactinaemia. It either inhibits ovarian steroid genesis directly or inhibits pituitary gonadotrophin release. {(4) Sheehan’s syndrome(5) Simmond's disease(unrelated to pregnancy)}:-There is partial or complete destruction of the pituitary by ischemia caused by venous thrombosis following severe postpartum haemorrhage and shock. The principal hormones affected are growth hormone, gonadotrophins, TSH, Adriano corticotrophins and prolactin. [D](1)(Psychogenic shock, stress, anorexia nervosa, strenuous exercise, pseudo cyesis, etc):- Inhibit the release of GnRH or affect dopamine metabolism. There is low level of oestrogen and LH but FSH level remains normal. {(2) Congenital malformation (3)Trauma:-Accidents; surgery or radiotherapy(4)Infection:-Tubercular or sarcoid granulomas, (5)Tumours:-Craniopharyngioma, meningioma}:-Lead to hypogonadotrophic hypogonadism. There may be hyperprolactinaemia due to altered dopamine inhibition. Tumours of the hypothalamus or pituitary need surgical excision or radiotherapy. [E]Adrenal factors:-(1)Adrenal tumour or hyperplasia :- Androgen excess opposes the effect of oestrogen on the endometrium. (2)Cushing syndrome [F] Thyroid factors:-Hypothyroid state:-Raised TSH and hyperprolactinaemia by direct action of TRH on the galactophore cells in the pituitary. [G]General disease:-Malnutrition, tuberculosis, chronic nephritis, diabetes, etc.:-Probably affecting the hypothalamopituitary ovarian axis. [I]Iatrogenic:-(1)Contraceptive pills(post pill amenorrhoea ):-Suppression of GnRH release. (2) Psychotrophic phenothiazine derivative drugs :-Dopamine receptor blocking agents raise the prolactin level. (3) Antihypertensive drugs like reserpine or dopamine antagonists:-Dopamine depleting agents raise the prolactin level. Common Causes of Secondary Amenorrhoea:-(A)Hypothalamus:-Stress, Post pill, Sudden change in weight :-either too much less or too much gain, Psychotrophic & antihypertensive drugs. (B)Pituitary:-Adenoma, Sheahan's (C)Ovary :-PCOS, Premature ovarian failure (D)Uterine:-synechiae. (E)Systemic:- Malnutrition, Hypothyroid state, Diabetes. (Next part will upload at Part 8](https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhiBWcdw8oWIyzW95JKe3FMmyJrPqJMXAk9Xqj1fI4isKkt601LmUhAd3gFG_pv3Rj8DaI327vB_KvSiUeKBb0sRPJyjCAB4mwmHanELvoAE8BuwfCmrjogaQ9EJGMtfDWvMtymC0nVXKQ/s320/Untitled-13.jpg)






