Ayurveda Interventions in the Management of Tubal Blockages- Case Studies

Failure to conceive within one or more years of regular unprotected coitus is defined as Infertility. Tubal blockage is one of the most common causative factors in female infertility. The prevalence is 19.1% in the fertility age group. This condition is not described in Ayurvedic classics as itself tubal blocks but Blockages of fallopian tubes can be better correlated with Vandhyatvadue to Artavbijavahasrotavrodha (Blockages in fallopian tubes). All three doshas are responsible for causing blockages. Normalizing the vitiated Vata-kapha-doshaleads to restoration of tubal function and easy conception. Here are two cases with bilateral tubal blockage which were treated successfully with certain Ayushakti herbal remedies and Uttarbasti (Intrauterine enema) with Ksharbasti. Recording and publishing this data is worthwhile as there are minimum chances of complication with assured results. With this treatment we can definitely avoid unnecessary use of hormones and IVF protocol and can give cost effective and promising results

Hubungan rinitis alergi dan disfungsi tuba Eustachius dengan menggunakan timpanometri

Latar belakang: Rinitis alergi merupakan masalah kesehatan global dengan prevalensi yang terusmeningkat serta dapat berdampak pada penurunan kualitas hidup penderitanya. Ko-morbiditas rinitis alergi salahsatunya adalah otitis media yang sangat erat hubungannya dengan gangguan fungsi tuba Eustachius yangberkaitan dengan tekanan telinga tengah. Tujuan: Mengetahui hubungan rinitis alergi dengan disfungsi tubaEustachius dengan menggunakan timpanometri. Metode: Satu studi kasus-kontrol. Disfungsi tuba ditentukandengan pemeriksaan timpanometri (MEP negatif/<-25 daPa) dan hasil tes fungsi tuba (ETF) yang tidak baik.Analisis hasil dengan uji Chi-square dan regresi logistik. Hasil: Penelitian ini melibatkan 60 sampel. Tipetimpanogram terbanyak pada kedua kelompok yaitu tipe A, dimana kelompok RA tipe A sebesar 73,3% (rerataMEP -40,8 daPa), tipe As 10%, tipe Ad dan tipe B masing-masing 3,3%, tipe C 10%. Kelompok kontrol tipe Asejumlah 93,3% dan tipe As 6,7%. Pada kelompok kasus 83,3% hasil tes fungsi tuba abnormal dan 16,7%normal, sedangkan kelompok kontrol yaitu 93,3% normal dan 6,7% abnormal. Uji chi-square menunjukkanperbedaan yang signifikan antara klasifikasi RA dan disfungsi tuba Eustachius (p=0,006) dan perbedaan yangsignifikan antara jenis alergen dan disfungsi tuba Eustachius (p=0,041). Hasil uji multivariat terdapat bahwa tiperinitis alergi berpengaruh tiga kali lebih besar terhadap disfungsi tuba Eustachius (OR 2,9; 95% IK: 1,52-241,90dan nilai p=0,022) sedangkan jenis alergen dua kali lebih berpengaruh terhadap disfungsi tuba dengan OR 2,2;95% IK: 0,01-7,31 dan nilai p=0,295. Kesimpulan: Rinitis alergi memiliki kemungkinan 3 kali lebih seringmengalami disfungsi tuba Eustachius dari pada kelompok kontrol OR:2,5 (95% CI 2,36-2,99) P=0,000.Kata kunci: rinitis alergi, disfungsi tuba Eustachius, rerata tekanan telinga.ABSTRACTBackground: Allergic rhinitis is a global health problem with increasing prevalence and can have impacton the quality of life of sufferers. One of co-morbidity of allergic rhinitis is otitis media which is closely relatedto Eustachian tube dysfunction, associated with middle ear pressure. Purpose: To determine the relationshipbetween allergic rhinitis and Eustachian tube dysfunction, using tympanometry. Methods: A case-control study.Tubal dysfunction was determined with tympanometry (MEP negative / <-25 Dapa) and tubal function test resultwas not good (≤15 daPa). Chi-square test and logistic regression analysis used for data analysis. Results: Therewere 60 samples. The most common tympanogram type in both groups were type A, which AR group was 73.3%(mean -40.8 daPa MEP), type As 10%, type ad and type B respectively 3.3%, type C 10.0% and control groupstype A 93.3%, type As 6.7%. In AR group, 83.3% showed abnormal tubal function and 16.7% was normal. As incontrol group, 93.3% was normal and 6.7% was abnormal. Chi-square test showed a significant differencebetween AR classification and Eustachian tube dysfunction (p = 0.006), and also between type of allergens andEustachian tube dysfunction (p= 0.0041). Multivariate test revealed AR classification contributed to Eustachiantube dysfunction OR:2.9 (95% CI 1.52-241.90) p=0.022, not between type of allergens and Eustachian tubedysfunction OR:2.2 (95% CI 0.01-7.31) p=0.295. Conclusion: Allergic rhinitis contributes three times higher toEustachian tube dysfunction than the control group. OR: 2.5 (95% CI 2.36-2.99) p= 0.000.Keywords: allergic rhinitis, Eustachian tube dysfunction, Mean Ear Pressure.