Abnormal Accumulation Of Fluid Research Articles

Activity-Oriented Antiedema Proprioceptive Therapy (TAPA) for Shoulder Mobility Improvement in Women with Upper Limb Lymphedema Secondary to Breast Cancer: A Multicenter Controlled Clinical Trial.

Background: Lymphedema, secondary to breast cancer (BCRL), is the abnormal accumulation of protein-rich fluid in the interstitium caused by a malfunction of the lymphatic system. It causes swelling, deficiencies in upper limb functions and structures, sensory pain and emotional alterations, which have a chronic course and affect the upper limb’s functionality. This study aims to verify the efficacy and efficiency in the upper limb´s functionality of a protocolized experimental approach based on occupational therapy, TAPA (activity-oriented proprioceptive antiedema therapy), in the rehabilitation of BCRL in stages I and II, comparing it with the conservative treatment considered as the standard, complex decongestive therapy (CDT), through a multicenter randomized clinical trial. Methods: a randomized and prospective clinical trial was conducted with experimental and control groups. Women diagnosed with BCRL belonging to institutions in Córdoba and Aragon (Spain) participated. Sociodemographic variables and those related to the functionality of the affected upper limb were evaluated before and after the intervention. Results: The results showed statistically significant differences in the analysis of covariance performed for the variable joint balance of the shoulder´s external rotation (p = 0.045) that could be attributed to the intervention performed; however, the effect size was minimal (η2 ≤ 0.080). In the rest of the variables, no significant differences were found. Conclusions: TAPA may be an alternative to the conservative treatment of women with BCRL. It was shown to be just as effective for volume reduction and activity performance as CDT but more effective in improving external rotation in shoulder joint balance.

Survival of Hydrops Fetalis with and without Fetal Intervention.

Objectives: To investigate the survival rate of hydrops fetalis after fetal interventions and neonatal intensive care. Methods: We reviewed the medical records of patients diagnosed with hydrops fetalis from January 2009 to December 2019 at Changhua Christian Children’s Hospital. All cases had abnormal fluid accumulation in at least two body compartments during pre- and postnatal examination. The primary outcome measure was the mortality rate. We also collected information regarding disease etiology, duration of hospital stay, Apgar score, gestational age at birth, initial hydrops fetalis diagnosis, fetal intervention, first albumin and pH levels, and maternal history. Results: Of the 42 cases enrolled, 30 survived and 12 died; the mortality rate was 28.6%. Furthermore, 22 cases received fetal intervention, while 20 cases did not; there was no significant difference in their survival rates (75% and 68%, respectively). Survival rate was associated with gestational age at birth, initial diagnosis time, birthweight, Apgar score, initial albumin and pH levels, and gestational hypertension. Only one case was immune-mediated. Among the nonimmune-mediated cases, the three most common etiologies were lymphatic dysplasia (12/42), idiopathic disorders (10/42), and cardiovascular disorders (5/42). Conclusions: Overall, hydrops fetalis was diagnosed early, and fetal intervention was performed in a timely manner. Preterm births were more frequent, and birthweight was lower in the cases that underwent fetal intervention than in those that did not, but there was no significant between-group difference in mortality. The initial diagnosis time, gestational age at birth, birthweight, Apgar score, and first albumin and pH levels were independently associated with mortality.

Can YouTube be used as an educational tool in lymphedema rehabilitation?

BackgroundLymphedema is defined as the abnormal accumulation of interstitial fluid and fibro-adipose tissues resulting from injury, infection, or congenital abnormalities of the lymphatic system. The gold standard approach in the treatment of lymphedema is Complete Decongestive Therapy and it has many components that require practical knowledge and skills. YouTube can be a useful tool to provide these skills to healthcare professionals and patients. The aim of this study was to examine the videos about lymphedema rehabilitation on YouTube and analyze their technical features, sources, contents, educational value and reliability.MethodsThe YouTube database was searched using the “lymphedema rehabilitation”, “lymphedema treatment”, “complete decongestive therapy”, “lymphedema massage”, and “lymphedema exercises” keywords. Two reviewers (Physical medicine and rehabilitation specialist) assessed videos for educational quality using a Global Quality Scale (GQS). To evaluate the reliability the 5-point Discern scale was used.ResultsA total of 90 videos, which met the inclusion criteria were included in the analysis. The mean duration of the videos was 8.9 ± 10.5 min. The mean number of daily views was 22.7 ± 47.1 for a day. The majority of the videos were created to inform patients (57.8%).The uploaders were mostly private healthcare institutions or healthcare professionals (65.6%). Information providers were lymphedema therapists mostly (63.3%). Manual lymphatic drainage was observed to stand out as the most mentioned lymphedema rehabilitation component on YouTube. The mean of reliability and GQS scores of the videos were 2.2 ± 1.0 and 2.7 ± 1.0, respectively.ConclusionsThe biggest obstacle for YouTube to be an excellent source of information is that it hosts large volumes of uncontrolled and low-quality data. When Youtube content related to lymphedema rehabilitation was examined, it was observed that many videos were quite insufficient and incomplete even though there were useful videos. If careful controlling measures are implemented and if medical videos aim to meet reliability and GQS criteria, YouTube can become an effective and useful source of information for lymphedema rehabilitation.

341 Idiopathic fetal ascites

Introduction: Fetal ascites is defined as an abnormal accumulation of fluid in the abdominal cavity of the fetus and usually detected by ultrasound during the perinatal period. Ascites can be isolated or observed with other alterations. In this case a rare idiopathic fetal pathology is presented. Case presentation: A 41-year-old, IV/I, at 25-week gestation was diagnosed with isolated fetal ascites. Additionally, HbS antigens and hepatitis B virus (HBV) DNR were found in patient’s blood, thus chronic HBV infection was diagnosed with no indicated treatment.

Abstract MP78: Heart Failure And The Subsequent Risk Of Lymphedema In The Community

Background: Lymphedema, abnormal lymphatic fluid accumulation in tissues, results in serious complications such as ulceration and reduces quality of life. Cancer treatment, through damage to lymph nodes and lymphatic vessels, is recognized as the main risk factor of lymphedema. However, understanding other risk factors is crucial for the prevention of lymphedema since there is no established curative treatment. Heart failure (HF) is considered an emerging risk factor for lymphedema through increased central and peripheral venous pressure, but the association of HF with incident lymphedema has not been systematically studied. Methods: In the Atherosclerosis Risk in Communities study, we included 9,895 individuals without prevalent lymphedema and cancer at visit 4 (1996-98) (n=9362 with no HF and n=533 with HF). Lymphedema was defined as two outpatient encounters (at least a week apart) or inpatient diagnoses through 2015 (ICD-9: 457.1 and ICD-10: I89.0). Participants without prevalent HF were categorized into two groups according to NT-proBNP, a marker of cardiac volume overload (>125 vs. ≤125 pg/mL [reference]), to acknowledge potential contribution of subclinical cardiac overload. Results: During a median follow-up of 17.7 (IQI 14.1-18.7) years, 149 participants developed lymphedema. 15-y cumulative incidence was higher in participants with HF and no HF with elevated NT-proBNP than those with no HF and non-elevated NT-proBNP (5.2% vs. 2.0% vs. 0.7%, respectively) ( Figure ). After accounting for potential confounders (e.g., body mass index, blood pressure, diabetes), the associations remained consistent (hazard ratios: 3.07 [95% CI 1.86, 5.08] for HF and 1.95 [1.33, 2.87] for no HF with elevated NT-proBNP). Results were consistent when using HF as a time-varying variable and censoring incident cancer. Conclusions: HF and subclinical elevation of NT-proBNP were associated with incident lymphedema, supporting the contribution of HF to the development of lymphedema.

Cerebral microcirculation mapped by echo particle tracking velocimetry quantifies the intracranial pressure and detects ischemia

Affecting 1.1‰ of infants, hydrocephalus involves abnormal accumulation of cerebrospinal fluid, resulting in elevated intracranial pressure (ICP). It is the leading cause for brain surgery in newborns, often causing long-term neurologic disabilities or even death. Since conventional invasive ICP monitoring is risky, early neurosurgical interventions could benefit from noninvasive techniques. Here we use clinical contrast-enhanced ultrasound (CEUS) imaging and intravascular microbubble tracking algorithms to map the cerebral blood flow in hydrocephalic pediatric porcine models. Regional microvascular perfusions are quantified by the cerebral microcirculation (CMC) parameter, which accounts for the concentration of micro-vessels and flow velocity in them. Combining CMC with hemodynamic parameters yields functional relationships between cortical micro-perfusion and ICP, with correlation coefficients exceeding 0.85. For cerebral ischemia cases, the nondimensionalized cortical micro-perfusion decreases by an order of magnitude when ICP exceeds 50% of the MAP. These findings suggest that CEUS-based CMC measurement is a plausible noninvasive method for assessing the ICP and detecting ischemia.

Clinical Course and Outcome of Non-Immune Fetal Hydrops in Singleton Pregnancies.

Nonimmune fetal hydrops is a condition defined by abnormal fluid accumulation in two or more body compartments. The aim is to evaluate factors associated with adverse outcome in diagnosed fetal hydrops and to investigate the aspects for the decision making in the case of termination of pregnancy. Therefore, a retrospective data analysis of pregnancies complicated by non-immune hydrops fetalis between 2004 and 2018 was performed in a single tertiary referral center. Of 361 pregnancies with diagnosed fetal hydrops, in 183 cases (50.7%), the parents decided to terminate the pregnancy. A strong relationship between etiology and termination of pregnancy was demonstrated, whereas the highest rates of termination of pregnancy were found if a chromosomal aberration was diagnosed. Of the remaining 178 cases, 51 cases (28.7%) had a miscarriage, 33 cases (18.5%) had an intrauterine fetal death, and 94 cases (52.8%) were live born, whereas 26 (27.7%) of these offspring died within the first week of life. The risk of an adverse outcome increased with lower gestational age at diagnosis (p < 0.001). A nuchal translucency thickness greater than 2.5 mm was associated with an adverse outcome (p < 0.01). Furthermore, pregnancies with adverse outcome had significantly more affected compartments (median: 3; IQR 2), compared with live born cases (median: 2; IQR 1; p < 0.01). In conclusion, adverse outcome in pregnancies with fetal hydrops was associated with a lower gestational age at diagnosis, nuchal translucency greater than 2.5 mm and a higher count of affected compartments. These results confirm that a precise clinical workup to identify the underlying etiology of non-immune fetal hydrops is essential for a better prognostic assessment and accurate counselling of parents.

Role of anaesthesiologist in the management of an infant with hydrocephalus for shunt surgery

Hydrocephalus is a disorder of abnormal accumulation of cerebrospinal fluid (CSF) in the ventricular system. Accumulation of CSF occurs due to an imbalance between CSF production and absorption. In the new-born and infants, hydrocephalus almost entirely presents as an enlarged head resulting from the separation of cranial bone plates, so any new-born or infant with an enlarged head should undergo evaluation. We report the case of a gross hydrocephalus in a 9-month-old infant (head circumference 55 cm) posted for ventriculoperitoneal shunt surgery with anaesthetic consideration of difficult intubation because of such a large head size, positioning, age-related pathophysiology and temperature regulation. The case was managed successfully with an uneventful hospital stay, and a significant decrease in head size was noted.

A retrospective case study of laryngeal edema causing airway obstruction immediately post COVID-19 vaccination

&lt;p&gt;&lt;strong&gt;Background:&lt;/strong&gt; Laryngeal edema is defined as abnormal accumulation of fluid and swelling in the tissues of the larynx commonly associated with laryngeal injuries and allergic causes. The objective of this study is for the prompt recognition and management of laryngeal edema caused by an anaphylaxis reaction after receiving the COVID-19 vaccination from Pfizer-BioNTech, which is extremely important in view of its high morbidity and mortality rate.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods:&lt;/strong&gt; A retrospective case reviews was conducted for all health care workers in Sabah who were administered COVID-19 vaccination from Pfizer-BioNTech from February 2021-April 2021.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results:&lt;/strong&gt; The mean age of study population in present study was found to be 33 years. Total of 42 patients were admitted during the period of 6 weeks out of 5000 health care workers who were vaccinated. Females constituted 64.3% of the study population while males constituted 35.7%. The clinical signs of laryngeal edema were dysphagia; the sensation of a lump in the throat; a feeling of tightness in the throat; voice changes, including hoarseness and roughness; and dyspnea within the period of 3 to 5 minutes post Pfizer COVID-19 vaccination. All patients received appropriate management using standard guidelines.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; The administration of the COVID-19 vaccination from Pfizer-BioNTech is life-threatening, however, its identification may aid in prompt emergency management in the future. Referral to an otorhinolaryngologist is necessary for patients who experience immediate or severe reactions.&lt;/p&gt;

Full Mouth Rehabilitation of Hydrocephalus Patient ? A Case Report

Dentist’s frequently encounter patients who are medically, physically or mentally compromised. One such medical condition is ‘hydrocephalus’. Hydrocephalus is basically a neurological disorder caused by excessive intracranial pressure due to abnormal accumulation of cerebrospinal fluid within the ventricles or subarachnoid space of brain and raised intracranial pressure. Ventriculo-Peritoneal Shunt (VPS) is the most commonly used treatment though ventriculo-atrial shunt is also another treatment option. To maintain the intracranial pressure within normal range, the patients are kept on medications which make them more prone for dental malformations and caries. Because of the poor oral hygiene, these patients require a regular dental care. This report discusses the dental management process employed for a five years old patient having hydrocephalus.

The AIUM Practice Parameter for the Performance of an Ultrasound Examination of the Neonatal and Infant Spine.

The AIUM Practice Parameter for the Performance of an Ultrasound Examination of the Neonatal and Infant Spine.

A Multimodal Treatment Approach on Rare Case of Meningomyelocele

Meningomyelocele, one of the neural tube defect (NTD) variants, is a condition in which meninges and neural tissue protrudes through a defect in vertebral arch and forms a cyst-like sac with an incidence of 0.5–11/1000 live births. Hydrocephalus is a major problem for majority of patients with meningomyelocele due to the abnormal accumulation of cerebrospinal fluid (CSF) in the ventricles of the brain. Meticulous preoperative evaluation with planning of the anesthetic technique, especially in regard to managing the airway, plays a crucial role in successful surgical management of these cases. Here, we report a case of lumbosacral meningomyelocele with hydrocephalus underwent a multimodal treatment approach for providing a comprehensive plan of care.

Tachycardia and hypertension enhance tracer efflux from the spinal cord

BackgroundDisruption of cerebrospinal fluid (CSF)/interstitial fluid (ISF) exchange in the spinal cord is likely to contribute to central nervous system (CNS) diseases that involve abnormal fluid accumulation, including spinal cord oedema and syringomyelia. However, the physiological factors that govern fluid transport in the spinal cord are poorly understood. The aims of this study were to determine the effects of cardiac pulsations and respiration on tracer signal increase, indicative of molecular movement following infusion into the spinal cord grey or white matter.MethodsIn Sprague Dawley rats, physiological parameters were manipulated such that the effects of spontaneous breathing (generating alternating positive and negative intrathoracic pressures), mechanical ventilation (positive intrathoracic pressure only), tachycardia (heart atrial pacing), as well as hypertension (pharmacologically induced) were separately studied. Since fluid outflow from the spinal cord cannot be directly measured, we assessed the molecular movement of fluorescent ovalbumin (AFO-647), visualised by an increase in tracer signal, following injection into the cervicothoracic spinal grey or white matter.ResultsTachycardia and hypertension increased AFO-647 tracer efflux, while the concomitant negative and positive intrathoracic pressures generated during spontaneous breathing did not when compared to the positive-pressure ventilated controls. Following AFO-647 tracer injection into the spinal grey matter, increasing blood pressure and heart rate resulted in increased tracer movement away from the injection site compared to the hypotensive, bradycardic animals (hypertension: p = 0.05, tachycardia: p < 0.0001). Similarly, hypertension and tachycardia produced greater movement of AFO-647 tracer longitudinally along the spinal cord following injection into the spinal white matter (p < 0.0001 and p = 0.002, respectively). Tracer efflux was strongly associated with all blood vessel types.ConclusionsArterial pulsations have profound effects on spinal cord interstitial fluid homeostasis, generating greater tracer efflux than intrathoracic pressure changes that occur over the respiratory cycle, demonstrated by increased craniocaudal CSF tracer movement in the spinal cord parenchyma.

Malignant Ascites in Ovarian Cancer: Cellular, Acellular, and Biophysical Determinants of Molecular Characteristics and Therapy Response.

Simple SummaryAccumulation of excess fluid in the abdomen typically indicates abnormal function or disease, such as cancer, in the underlying tissues. This accumulation of fluid, or ascites, occurs more frequently in patients with advanced-stage ovarian cancer than any other type of cancer. The presence of ascites indicates the poorest outcomes for patients with advanced stage ovarian cancer, but little is known about the reasons for these dismal outcomes. This review discusses the current understanding of ascites, starting with an overview of ovarian cancer and ascites, followed by a description of the tools used to analyze the components of ascites and how these components modulate ovarian cancer biology. A perspective on the mechanical effects of ascites and the impact of mechanical stress on treatment resistance is provided. Lastly, treatment options for ascites and opportunities to develop new therapeutic strategies to improve outcomes are discussed.Ascites refers to the abnormal accumulation of fluid in the peritoneum resulting from an underlying pathology, such as metastatic cancer. Among all cancers, advanced-stage epithelial ovarian cancer is most frequently associated with the production of malignant ascites and is the leading cause of death from gynecologic malignancies. Despite decades of evidence showing that the accumulation of peritoneal fluid portends the poorest outcomes for cancer patients, the role of malignant ascites in promoting metastasis and therapy resistance remains poorly understood. This review summarizes the current understanding of malignant ascites, with a focus on ovarian cancer. The first section provides an overview of heterogeneity in ovarian cancer and the pathophysiology of malignant ascites. Next, analytical methods used to characterize the cellular and acellular components of malignant ascites, as well the role of these components in modulating cell biology, are discussed. The review then provides a perspective on the pressures and forces that tumors are subjected to in the presence of malignant ascites and the impact of physical stress on therapy resistance. Treatment options for malignant ascites, including surgical, pharmacological and photochemical interventions are then discussed to highlight challenges and opportunities at the interface of drug discovery, device development and physical sciences in oncology.

Foetal hydrops: new challenges

Abstract Background Foetal Hydrops (FH) is an abnormal accumulation of fluid inside two or more serous cavities and may be linked with polyhydramnios and/or placental oedema. It has been correlated with several causes such foetal anaemia, chromosomal anomalies, congenital abnormalities, infections, twin-to-twin transfusion syndrome and maternal causes such as diabetes. Regardless the advances in diagnosis and therapy, the overall perinatal mortality rate remains high. Thereby, the main goal is to evaluate the autopsy findings including between 2010 and 2019. Methods 105 cases including perinatal and new-born autopsies with different gestation stages were studied, in order to understand the macroscopic and microscopic events that can elucidate FH. Results Macroscopically, a large number of foetuses demonstrated oedema effusions and intrauterine growth restriction. Regarding placenta, the most common macroscopic finding is oedema, such as described in the literature. Nodules and hemorrhagic areas are the new findings observed. Oedema remains the most relevant microscopic finding, whereas unspecified villi alterations and trophoblast pseudoinclusions were the new findings. Conclusions The results allowed the identification of new characteristics that can contribute to the knowledge of this foetal condition that remains a challenge. Future studies need to focus on identifying strategies for diagnosis and treatment is critical for foetal hydrops.

Alteraciones congénitas en cachorros de la raza Pug por apareamiento consanguíneo: Reporte de caso

Crossbreeding between individuals with a high degree of kinship often generate deformities to the fetuses. Inbreeding provides the formation of recessive genes that cause acrosomal defects responsible for malformations that can bring risks to the newborn's life. The objective was to report the follow-up and attendance to a delivery of a female PUG breed whose crossing took place with her grandfather, generating inbreeding and causing two neonates who had congenital malformations. The animal arrived at Tolevet – the veterinary clinic –, located in Toledo - Paraná, in labor, presenting uterine contractions and swelling in the region of the uterus in the abdomen. On physical examination, vital parameters were normal. At birth, seven puppies were born who received the care of removing the placental pouch, clearing the airways and umbilical ligation. Two puppies had congenital deformity; one had concurrent cleft lip with cleft palate (palatoschisis), the second, already in a state of death, presented abnormal fluid accumulation in fully edematous fetal tissue, defined as fetal hydrops. This report demonstrates the importance of avoiding common ancestors consanguineous mating, in order to minimize the incidence of birth defects in neonates that are incompatible with life or that pose a risk to the animal's health and quality of life.

Nonimmune hydrops fetalis with intrauterine fetal demise presenting at 41-weeks gestational age: the ultrasonographic findings and case report

Hydrops fetalis is the abnormal accumulation of fluid in two or more different fetal compartments and most times associated with polyhydramnios and placental edema, and has an estimated incidence of about 1 in 3000 pregnancies. A 27-year-old multigravida; G8P7, was referred for the first ultrasonography in the Index pregnancy on account of not feeling/observing fetal movement for about two-weeks. The obstetric ultrasonography demonstrated a single fetus with absent fetal heartbeat, in hyper-flexed position, accumulation of fluid in the abdominal cavity; right sub-diaphragmatic region and in the right pleural cavity in keeping with fetal ascites and fetal effusion. There is overriding of fetal skull with Thickened/edematous placenta with a thickness of about 7cm, and fetal skin thickness of about 10mm. There is associated intrafetal gas. The estimated femoral length gave a gestational age approximating 41-weeks. A diagnosis of hydrops fetalis most likely non-immune form with fetal demise presenting at 41-weeks gestational age in a multiparous woman with features anemia presumably from sepsis and urinary tract infection (bilateral pyelonephritis and cystitis) in a setting of poor antenatal care was entertained. The fetus was expelled following induction of labor at the peripheral centre, the patient had transfusion done with commencement of antibiotics for correction of anemia and sepsis with plans of further clinical and laboratory evaluation. We present the ultrasonographic features of hydrops fetalis with intrauterine fetal demise due to its unique presentation

Malignant Pleural Effusions-A Window Into Local Anti-Tumor T Cell Immunity?

The success of immunotherapy that targets inhibitory T cell receptors for the treatment of multiple cancers has seen the anti-tumor immune response re-emerge as a promising biomarker of response to therapy. Longitudinal characterization of T cells in the tumor microenvironment (TME) helps us understand how to promote effective anti-tumor immunity. However, serial analyses at the tumor site are rarely feasible in clinical practice. Malignant pleural effusions (MPE) associated with thoracic cancers are an abnormal accumulation of fluid in the pleural space that is routinely drained for patient symptom control. This fluid contains tumor cells and immune cells, including lymphocytes, macrophages and dendritic cells, providing a window into the local tumor microenvironment. Recurrent MPE is common, and provides an opportunity for longitudinal analysis of the tumor site in a clinical setting. Here, we review the phenotype of MPE-derived T cells, comparing them to tumor and blood T cells. We discuss the benefits and limitations of their use as potential dynamic biomarkers of response to therapy.

Efficacy of procalcitonin and pentraxin-3 as early biomarkers for differential diagnosis of pleural effusions.

ObjectivesPleural effusion, defined as an abnormal accumulation of fluid in pleural space, can be of two types: transudative and exudative. The primary aim of the study was to assess the predictive accuracy of procalcitonin (PCT) and pentraxin-3 (PTX-3) in comparison to other biochemical markers such as C-reactive protein (CRP), and adenosine deaminase (ADA) in the differential diagnosis of pleural effusions.MethodsA cross-sectional analytical study was conducted on patients with pleural effusion. Multiple comparisons and receiver-operating characteristics (ROC) analyses were made to evaluate the diagnostic significance of biochemical markers.ResultsSixty-six patients with exudative pleural effusion classified as malignant, tuberculous, and parapneumonic effusions (malignant pleural effusion [MPE], tuberculous [TPE], and parapneumonic [PPE]) were included. Significant differences in pleural fluid levels in both PCT (p-value: 0.001) and PTX-3(p-value: 0.001), as well as serum levels of PCT (p-value: 0.001), were observed between the three groups. ROC analysis showed both PTX-3 and PCT having favorable discrimination ability with high sensitivity (≥90%) and specificity to predict PPE from TPE and MPE.ConclusionsEvaluation of serum and pleural fluid PCT and levels of PTX-3 in the pleural fluid may be used as an early biomarker to differentiate the etiology of pleural effusion.

A REVIEW ON THE SIGNIFICANCE OF NITYA VIRECHANA IN THE MANAGEMENT OF JALODARA (ASCITES)

Jalodara is a type of Udara roga. It is such type of a disease which is difficult to cure. Its occurrence is increasing day by day in our society. In Jalodara, there is accumulation of fluid in between Tvak and Mamsa of Udara pradesha (abdomen). As a result, there is distension of abdomen. Its main causes are Mandagni, Srota avarodha and Apa dosha etc. Here vitiated Kapha and Vata are mainly involved. In this disease accumulated Doshas are mainly obstruct the Swedavaha and Ambuvaha srotas. It has three stages which are Ajatodakavastha, Picchavastha and Jatodakavastha. Jalodara in its Jatodakavastha is incurable. It can be correlated with Ascites based on its clinical features. Ascites is the abnormal accumulation of free fluid in the peritoneal cavity. Its most common cause is portal hypertension related to hepatic cirrhosis. Ascites is asymptomatic when there is small accumulation of fluid in peritoneal cavity. But when there is larger accumulation of fluid (&gt; 1 lit), it shows symptoms. In this article, Ayurvedic treatment principles for Jalodara have been discussed in details. These include Nidan parivarjana, Nitya virechana, therapies which remove the defects of liquid elements (Apam doshaharanam), Dipana and Shastra karma (abdominal tapping). This article is mainly based on the review of the significance of Nitya virechana in the management of Jalodara (Ascites).