Sunday, September 26, 2010



General Theory of Vasculitis.


 "Marxism is not a dogma but a guide to action, a scientific methodology”e
Einstein believed that deep truths about the workings of the universe would always be "as simple as possible”

Dr. Raj Kumar Dhaugoda
 MBBS (IOM,TU)-1999,Nepal.       
 MD Family Medicine(BPKIHS)-2006,Nepal.        
 Date of birth 2026/02/29 (1969,june 11th)     
 Address:Nepal;Kavre Palanchok District,Panauti Municipality,Ward No.6      
 Special interest in dialectical materialism and medical researches.         
Destination of carrier- MARXIST philosopher and Medical scientist.       
  Hallmark guideline principle-Dialectical Materialism(foundation of  Marxism)      
   E-mail address : ( well-come to valuable critics and comments )   


    From the various conclusions of various literature reviews, discussions, and various studies and findings, which are presented previous chapters( THE BOOK -    RKDHAUGODA'S GENERAL THEORY OF VASCULITIS -PART-I). It is hypothesized to build the general theory of vasculitis, with the help of guide line theory that is dialectical materialism, to express the objective reality of the physiological and pathological laws within the human body and to solve many problems in the field of management of health and disease in the huge proportional of population, in terms of effective, preventive, curative with least costs and simple techniques and coordinating with other various scientific approaches. According to this theory:
(1) Any inflammatory (infectious or non infectious & endogenous or exogenous originated disease is associated with varying degree of vaculitis in relation to time, space, motion and matter (antigen specific/strss factors/antistress factors). It means the main / key pathology of any inflammation is the vaculits (primary or secondary vaculitis). Vaculitis is the inflammation of vascular system,and associated with inflammation of any types of cells of the body. The vascular system in human body is widely and extensively distributed (except hair, nail and cornea). The vascular system e.g. micro vessels namely capillaries, sinusoids, venules are connected with every cells of the body by means extra cellular fluids. Hence any tissue or cell damage is associated with vascular abnormalities.
(2) All the inflammatory originated diseases having the common pathology vasculitis are principally mediated by the major factor TNF- alpha). It means TNF- alpha is the principle cytokine, and principle pathogenic mediator for all types’ vasculitis diseases (from boils to cancer pathology).
(3) All these vasculitis pathology have relatively high level of TNF- alpha in the circulation, which are associated with relative hypo- ANTI-STRESS ELEMENT). Because in any hypo- ANTI-STRESS ELEMENT condition, there is increased synthesis of TNF- alpha and they’re appearance of inflammatory response, and then various degree of vasculitis process is developed.
(4) These relations of vasculitis, TNF- alpha and relative level of intracellular ANTI-STRESS ELEMENT, remains in functional state, when there remains constant i.e. the possibility of reversion of pathogenesis of involved organ. This functional limitation of reversibility of pathogenesis is represented by the R.K.Dhaugoda’s. constant equals to 1, this value remains constant up to before irreversibility damaged of organic function (e.g. chronic renal failure, chronic liver failure, brain death, chronic brain damage /severe encephalopathy).
(5) All these disease, which is associated with vasculitis pathology, are treated with pharmocotherapy of ANTI-STRESS ELEMENT principally, and with adjunctive therapeutic tools, antimicrobials, antiviral, antifungal, antiparasitic, and other various supporting drugs and techniques viz biomechanical (surgical/mechanical ventilation) until stabilization of severe disease pathology, and clinical stability. Then oral ANTI-STRESS ELEMENT is given for chronic and long-term preventive as well as curative management of various incurable diseases are treated with various integrated ways (to maintain the optimum level of intracellular ANTI-STRESS ELEMENT relatively), e.g.(a) By increasing education level of individual/ society regarding scientific understanding of disease process, causation, intervention, complications, prevention, and ways of scientific management, and the biological, physiological role of ANTI-STRESS ELEMENT and its importance via increasing the knowledge and practice of dialectical materialism thought and principles, broadly throughout the world. Because this dialectical materialistic view is the core/root science for all the remaining branched sciences. Without its knowledge, we can’t understand the laws of universe and its contents scientifically.(b) By modifying nutrition, lifestyle and behaviors (being anti sadists to ownself and to others). Viz taking, low fat diet, low sugar diet, moderate physical exercise, relatively high ANTI-STRESS ELEMENT containing diets avoiding smoking, alcohol, excess tea, coffee, sodium, azinomotto ( mono-sodium-glutamate), and avoiding excessive worry ness and anxiety these all positive activities cause increased intracellular ANTI-STRESS ELEMENT  relatively.(c)  Practicing various types of physical exercises:-anaerobic exercise, yoga,pranayam .      

 (6) In this theory, it is estimated even sub clinical stage of diseases or pre-estimation of relative risk of diseases. By means measuring the relative level of the C- reactive protein (a functional biological marker of hypo-ANTI-STRESS ELEMENT, inflammation in the body, and the level of cytokine e.g., TNF- alpha in the circulation). It says that even a person with relatively non-significant clinical disease, by measuring of C-RP level, if it is relatively high comparing to normal value, it is predicted the various risk for various diseases, specially Chronic diseases.  A person having Type -2 DM, arteriosclerosis, vascular diseases and with high C-RP level has more risk for cardiovascular diseases e.g., Heart attack, Angina, Ischemic heart disease, CRF and stroke etc.

(7) In this theory, it is applied the dialectical materialism principle which is the root science for all the branched sciences. The pathology of any disease is represented relatively & commonly by vasculitis. The intracellular relative level of ANTI-STRESS ELEMENT    represents body’s physiological status (immune status), Vasculitis and magnitude of Intracellular ANTI-STRESS ELEMENT (immune status) are opposite phenomena in the human body but not isolated from each other, but interdependent and interrelated each other by the relative level of TNF- alpha and C-reactive protein or stress factor in the circulation.In the physiological level range there is relatively less stress factors and less level of TNF- alpha and C- reactive protein (very low level is dominated by bodies immune status) and not causing disease. But when there is relative low level of intracellular ANTI-STRESS ELEMENT. Relative hypo-ANTI-STRESS ELEMENT in comparison to stress factors. It is started to synthesis and activations of TNF- alpha and starts inflammatory response by the body causing various degree of tissue / cell injury. Causing pathogenesis of vasculitis, and synthesis of C-RP in the liver is increased in response to inflammation in the body, overall causing increased level of TNF- alpha, C-RP and appearance of various degree of vasculitis, (Sub clinical to clinical stages). Hence, here the two opposite phenomena immune status (optimum level of intracellular ANTI-STRESS ELEMENT) and disease process /         Inflammation (vasculitis) is connected in terms of TNF- alpha and C-RP and stress factors.
(8) In this theory, it is correlated the level of intracellular ANTI-STRESS ELEMENT, TNF- alpha, and degree of various vasculitis, by blood circulation level of C-reactive protein. In practice, it is very difficult to measure sub clinical & clinical vasculitis, like wise the TNF- alpha level and intracellular ANTI-STRESS ELEMENT level very difficult, needs sophisticated instruments, highly qualified man power and excessive costly. But here it is correlated by the level of C-RP with the level of other three parameters e.g. severity of vasculitis, level of TNF- alpha and intracellular ANTI-STRESS ELEMENT level. When there is increased value of C-RP there should be relative hypo-ANTI-STRESS ELEMENT, increased level of TNF- alpha and various degree of sub clinical to clinical form of vasculitis. In absence of other interfering factors for C-RP level in the body e.g. use of Steroids, NSAIDS, Vigorous exercise, excessive Coffee / tea, Hormone replacement therapy, Intra-Uterine device, Pregnancy, use of Statin etc.
(9)  highly sensitive C-RP is non-specific biological marker of inflammation and body stress, raised its value in various types of Inflammations and exposure to stress factor by the body systems.

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