J ism-v2(3)-2014-july-sept14

A CONSTITUENT UNIT OF DATTA MEGHE INSTUTUT E OF MEDICAL SCIENCES (DU)

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Official Publication of

Mahatma Gandhi Ayurved College,

Hospital & Research Centre

Salod (H), Wardha– 442 004,

Maharashtra (India)

July - September, 2014 Volume 2 Number 3 ISSN 2320 -4419

JOURNAL OF

INDIAN SYSTEM OF MEDICINEQUARTERLY PEER REVIEWED INTERNATIONAL JOURNAL ON RESEARCH IN AYURVEDA

REMODELING AYURVEDA THROUGH EVIDENCE BASED SCIENTIFIC RESEARCH

Acorus calamusAcorus calamus

July - September, 2014 Volume 2 Number 3 ISSN 2320 -4419

REMODELING AYURVEDA THROUGH EVIDENCE BASED SCIENTIFIC RESEARCH

JOURNAL OF INDIAN SYSTEM OF MEDICINE

Official publication ofMahatma Gandhi Ayurved College, Hospital & Research Centre

Constituent College Under

Datta Meghe Institute of Medical Sciences (DU)(Declard as Deemed to be University under sec 3 of the UGC act 1956)

Salod (H), Sawangi (Meghe), Wardha 442 004, Maharashtra (India)

Acorus calamusAcorus calamus

Journal of Indian System of Medicine Vol.2-Number 3, , 2014July-September

Journal of Indian system of Medicine

©All rights are reserved

Publication date : September 22 , 2014

ISSN No. (Print) : ISSN-2320-4419

Printed at : Swami Art & Computers, Wardha

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(A Quarterly Peer Reviewed International Journal of

Research in Ayurveda) is a publication of Mahatma Gandhi Ayurved

College, Hospital & Research Centre, DMIMS (DU) , Wardha

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nd

Note:

The institute / Editorial Board assume no responsibility for the statements expressed by the contributors. The

editorial staff in their work of examining papers received for publication is assisted in an honorary capacity by

distinguished scholors working in various field and parts of India as adjudicators.


JOURNAL OF INDIAN SYSTEM OF MEDICINEQUARTERLY Peer reviewed International Journal on research in Ayurveda

PATRONS

Hon. Shri Datta Meghe

Dilip Gode

Sagar Meghe

Rajiv Borle

Ravi Meghe,

Prakash Behere

Lalit Waghmare

Vice-Chancellor DMIMS-DU

Treasurer, DMIMS

Registrar, DMIMS-DU

Personnel & Planning, DMIMS

Director, R & D, DMIMS-DU

Dean Interdiscliplinary Sciences, DMIMS-DU

Vedprakash Mishra

Sameer Meghe

S.S.Patel

Abhuday Meghe

Shyam Bhutada

Arvind Bhake

Chief Advisor, DMIMS-DU

Secretary, DMIMS

Chief Coordinator, DMIMS

O.S.D, DMIMS

Dean, MGACHRC

Chief Editor, JDMIMS

ADVISORY BOARD

Chief EditorKSR Prasad (technoayurveda)

Associate EditorsBharat Chouragade, Srihari S, Rohit Gokarn

Editorial Advisory Board

Kuldeepraj Kohli

Chandola H.M.

Ram Harsh Singh

Ramesh Babu Devalla

Nisteshwar K

Joshi V.K.

Vanita Murlikumar

Amitabh Pande

Ashutosh Kulkarni

Prasanna Rao N

Nath S.K.

Abhay Gaidhane

Zaheer Quazi


Kayachikitsa

Panchakarma

Prasuthi & Streeroga

Shalya & Salakya

Kaumarabhrutya

Roga Nidana

Pharmacology

Madhavi Mahajan, Maharashtra

Ramalingeswar Rao S, Telangana

Kishore Kumar R, Karnataka

Srinivasulu M, Telangana

Morandi, Italy

Jaiswal SK,

Sivaramudu , Karnataka

Eswara Sarma, M.P, Kerala

Manjari Dwivedi, UP

Priyanka Gupta,

Swamy G.K., AP

Saranagpani S, AP

Varshney S.C,

Dhiman KS, Gujarat

V.L.N.Sastry, AP

Palekar PP,

Lakshmesh Upadhya K, Karnataka

Sreedhar Rao, Karnataka

Chapadgaonkar S,

Ila Tanna,

Manish Deshmukh,

Rajasekharan. S, Kerala

Maharashtra

Prakhya

Maharashtra

Maharashtra

Maharashtra

Maharashtra

Maharashtra

Maharashtra

Shaeera

Basic Principles

Rasashastra & Bhaishajya

Dravyaguna & Agadtantra

Swasthavritha

Giridhar Kanthi, Karnataka

Sudhir Kandekar,

Pradnya Dandekar,

Priti Desai,

Khedikar SG,

Sreedhar Tirunagiri, AP

Vidyanath R, AP

PHC Murthy, AP

Gopi Krishna, M., Karnataka

Bharat Rathi,

Prajapati PK, Gujarat

Venkata N Joshi, London, UK

Sastry JLN, New Delhi

Paramkusha Rao M, AP

Chandrashekhar K, UP

AP

Abhay Patkar,

Venkateshwarlu G., Karnataka

Maharashtra

Maharashtra

Maharashtra

Maharashtra

Maharashtra

Maharashtra

P.V.V. Prasad,

REVIEWER'S BOARD


JOURNAL OF INDIAN SYSTEM OF MEDICINEOfficial publication of the

Mahatma Gandhi Ayurved college Hospital & Research Centre

A Constituent College under Datta Meghe Institute of Medical Sciences (DU)

III

Contents

Cover Page : Acorus calamus (Vacha)

Journal of Indian

System of Medicine

Date of Publication: 22-09-2014

QR Code: Kaywa QR code

Editorial

Original Article

Future and Past of Ayurveda

109-112

Evaluation Of Effect Of Shunthyadi TailaAnd

Triphaladi Taila Nasya In Vataja Pratishyaya

(Allergic Rhinitis)

113-117

Management of Sthula Madhumeha with

Ghanasatva of Kadar, Khadir & Guggula- A

Clinical Study

118-126

Brahmi taila shiroabhyanga in chittodwega

(Anxiety Neurosis)

127-131

Role of Shigru Twak Kwatha in Amavata

132-138

A Brief review of pre-clinical and clinical

researches on Vacha (Acorus calamus Linn)

143-147

Carbon dating of Charaka Samhita

148-151

SRP Kethamakka

Sagar M. Bhinde

SRP Kethamakka

Hhiremath. V.R

Ashish A. Thatere ,

Vidya B. Wasnik, Kabra. P. R.

Madhavika Prakash Chaudhari,

KSR Prasad

Sadhana Misar(Wajpeyi)

Pravin Masram, Dhiraj Singh Rajput

Review Article

Importance of Stool Examination in Babies

139-142

Case Report

Current Themes

Communication

Announcements

152-154

155-157

159-161

National Workshop on “Ayurvedic

Interventions in Cerebral Palsy”

162-163

164-164

Bilateral variations of renal vessels -A case

study

Management of high anal fistula by Kshara

Sutra ligation along with partial

Fistulotomy - A Case Report,

Recent approaches of Pre-clinical

Researches in Ayurveda

Giridhar M Kanthi, Arun N P, Harshita M

S, Anoop Kumar N S, Visakh Sakthidharan,

Vishnu Damodar,

Srihari S

Santosh Y Mudakappagol, Mathew Sunny,

Rohit Gokarn, Supriya R. Gokarn


Journal of Indian System of Medicine [ISSN-2320-4419]

Manuscript Title :

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their best abilities and take public responsibility for it. I/We believe the manuscript represents valid work and no

sort of plagiarism has been done. Neither this manuscript nor one with substantially similar content under our

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covering letter. We certify that no data from the study has been or will be published separately.

I /We hereby transfer, assign, or otherwise convey all copyright ownership, including any and all rights

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All persons who have made substantial contributions to the work reported in the manuscript, but who are

not contributors, are named in the Acknowledgment and have given us their written permission to be named. If

we do not include an Acknowledgment that means we have not received substantial contributions from non-

contributors and no contributor has been omitted.

Author's Declaration and Copyright form

______________________________________________________________________________________

Journal of Indian System of Medicine,

Name / Address / E-Mail / Cell Number Signature

Author

Co-Author-1

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Journal of Indian

System of MedicineEditor’s Note

Future and Past ofAyurveda

SRPKethamakka

Head, Panchakarma, MGACH&RC, Salod (H), Wardha, [email protected]

JISM1433E Received:August 21, 2014;Accepted: September 14, 2014

How to cite the article: SRP Kethamakka, Future and past of Ayurveda, 3 JulyJ-ISM, V2 N , -September 2014, pp.109-112

medicine that has effect will even

side effect. At the of criticism on Ayurvedic

medicine's nephro and renal toxicity, 21 century

for Ayurveda retain self esteem

Ayurveda in modern era challenge to bridge a

gap for the future in terms of evidence based medicine

and on the other hand to retain traditionalism and

integrity of the system of the past. To preserve

connections of the past knowledge we need to study

the manuscripts and Ayurvedic Anthropology.

Unfortunately, in the past 1000 years, Traditional

Indian sciences have faced turbulences under Muslim

and British rule. Recent evidence for such harm is

witnessed in the Indo-British Heritage Trust of

London which organized a debate on the eve of the

inaugural event to mark the 400th anniversary of

formal relations between India and Britain back in

1614 on 21 Sep, 2014. A historic debate that put the

mighty empire on a mock trial at the Supreme Court

and the conclusion drawn was “The British Raj did

more harm than good in the Indian subcontinent” [1].

To meet the needs of future outcomes that are

pre-defined, measurable and monitored, we depend on

the ingenuity of Ayurveda and the strength of the

system. This lies in promotive, preventive &

rehabilitative health care, diseases and health

conditions relating to women and children, mental

health, stress management, problems relating to older

person, non-communicable diseases etc. The

Department of AYUSH should align its programs and

policies with the of

reducing IMR, MMR, TFR, Malnutrition, Anemia,

Population Control and Child Sex Ratio, etc. [2].

Even though in 11th Plan period, major

A have

outset

inst

it

is essential to .

faces

AYUSH

National Health outcome, Goals

achievements of scheme implementation were

achieved such as Acquisition/ digitization and

publication of 23 manuscripts and Publication

/translation of 14 books and manuscripts [3], still a lot

of manuscripts are in suspension mode at British and

German libraries.

A recommendation made in 1920 by Indian

National Congress - “

should be

remembered here [ ]. The National Health Policy of

2002 noted that

It is undoubted that the strength of India

remains in medicinal plants [6]. The National

Medicinal Plants Board (NMPB) has in collaboration

with QCI launched a voluntary certification scheme

for medicinal plants produce (VSCMPP) which is

based on WHO GAPand GCPguidelines [7].

To ensure a good future we do need the utility

and control over Information Technology tools which

would be applied significantly to improve quality of

educat ion, research, heal th services and

manufacturing. Tools like Meta databases, search

engines and software of various research

there should be an Integrated

System of Medicine and Research which should be

combination of both our Ayurveda, Unani, Tibb,

Siddha, and Modern medicine system choosing the

best out of all and thus supporting one system by

another to serve mankind to its best”

4

“Under the overarching umbrella of

the national health frame work, the alternative

systems of medicine Ayurveda, Unani, Siddha, and

Homeopathy have a substantial untapped potential of

India and build up credibility … by encouraging

evidence based research to determine their efficiency,

safety and dosage and also encourage certification

and quality marking of products to enable a wider

popular acceptance of these system of medicine” [5].

Journal of Indian System of Medicine Vol.2-Number 3, , 2014July-September 109

developments with several function are useful in this

regards. Examples include clinical documentation,

indexing, cataloguing, semantic analysis, cloud

sourcing, encyclopedias, E-learning modules, E-

books, graphic, entity relationship maps, portals and

websites.. To fulfil this goal, the establishment of

seven online national libraries for each of the seven

components of AYUSH through an all India

coordinated program is proposed [8]. A proper

support and utility by community can take us to the

heights and establish theAyurveda as EBM.

New holistic research perspectives,

frameworks and tools are required for (proposed in

12 five year plan ofAYUSH):

a) Clinical research that focuses on

rather than single and uniformly

applied drugs,

b) Trans-disciplinary and bridging research

strategies that correlate AYUSH concepts of health,

pathogenesis, nutrition, physiology, pharmacology

with bio-medical concepts, thus creating new

knowledge that has potential to improve the quality

of life of the masses,

c) Fundamental research that also uses IT tools and

Indian epistemological perspectives to uncover the

depth and width of highly sophisticated “original

AYUSH concepts” referenced from dozens of

literary sources on different dimensions of health and

disease.

d) Identification and scientific development of

selected Indian medicinal plants that would meet

global market needs, wherein scientific evidence

related to their efficacy and safety through rigorous

scientific assessment would be taken up in order to

meet the emerging global demands for registration

under food additives/health supplements/ traditional

herbal medicinal products /phyto-medicinal

ingredients [9].

To enrich Ayurveda Steering Committee

recommends the Establishment of a National

Mission on Medical Manuscripts with operational

and Financial Autonomy/ independence and

development of Core Metadata Standards for

therapeutic

outcomes and multi-pronged, individualized,

interventions,

,

Indexing [10]. Apart from development of new

scientific monographs, the revision of already

published monographs in the 12th Plan has to be

under taken [11].

Since the inception of human civilization,

India has been a center of learning for religion,

philosophy, and science. Manuscripts contain

writings from eminent scholars. These writings are

available on materials such as cloth, birch bark,

leaves, clay, etc. They cannot survive without proper

handling and care. Central Library, BHU has a large

collection of manuscripts that are in regular demand

by scholars in different disciplines. This leads to

regular consultation of these rare classics which is a

cause for the further deterioration of its condition.

Efforts are being made to preserve the collection.

Simultaneously, conservation of documents is also

being done to keep the body and content of the

scripture intact. The collaboration of NMM and BHU

has advanced efforts in the eastern UP of India in

protecting old manuscripts. The collaboration also

promises a more intense coordination between the

scientific community and manuscriptologists, to

bring forth better technological tools and techniques

to decipher, search, and retrieve the knowledge

stored in these rare scriptures. Last but not least, these

efforts help inculcate a sense of responsibility in

society toward our rich past. Issues that must be

considered include, Identification of type of scholars,

Scholars who have contributed to the development of

the manuscript database of the region and Access

Policies [12].

Medical anthropology, a new discipline

within cultural anthropology, offers much to physical

therapists who often find themselves practicing in

settings with a variety of ethnic groups or

predominance of one ethnic group. Culture can be

described as a design for living. Cultural beliefs exist

to answer certain universal concerns and questions.

These cultural orientations are so ingrained that they

seem self-evident, but dissonance can occur when

these orientations contrast with the values of

Manuscripts:

MedicalAnthropology

SRP Kethamakka,Future and past of Ayurveda, pp.109-112

Journal of Indian System of Medicine Vol.2-Number 3, , 2014July-September110

individuals from other cultures. At times,

unexamined assumptions that clinicians hold can bias

treatment planning as well as lead to frustration or

even hostility[13]. The indigenous knowledge system

has promoted immense bio-diversity in India which

of course is negotiated and maintained in a variety of

ways keeping the identity of Indian civilization.

Peripatetic are one of the links in the complex process

[14].

A good practical definition of medical

anthropology comes from Cecil Helman: “Medical

anthropology is about how people in different

cultures and social groups explain the causes of ill

health, the types of treatment they believe in, and to

whom they turn if they do get ill” [15].

Medical anthropology is the study of human

health and disease, health care systems, and bio-

cultural adaptation.Akey concept in medical ecology

is "adaptation," the changes, modifications, and

variations that increase the chances of survival,

reproductive success, and general wellbeing in an

environment [16].

Medical anthropology examines the

influence of social and cultural factors, such as

professional roles, religion, technology and political

economy on health care, and recognizes their

potential practical relevance for providing and

maintaining health. In multicultural and class-divided

societies where health systems function at different

social levels (medical pluralism), Medical

anthropology, therefore, also considers the exercise

of power and differential access to resources, and

their impact on people's health [17]. The term

'medical anthropology' however, is a misnomer. It

implies identification with the biomedical or

scientific perspectives of disease and health, which is

questionable because of medical anthropology's

interest in dimensions of health care that lie beyond

the sphere of biomedicine. Also, one of its aims is to

challenge the supremacy of biomedicine as the

dominant medical tradition in coexistence with other

medical traditions [18].

The most common answer one receives in

Mysore city after asking the benefits of Ayurvedic

treatment is that it does not have side effects.

Apparently the medical, cosmological and

philosophical basis of Ayurveda is obscure and

imprecise for most laymen. In short, whether

allopathy or Ayurveda, the medicine is frequently

reduced to the icons of efficacy, if one offers quick

fixes, the other has no side effects. This connection

between Ayurveda and biomedicine, or an English

medicine as it is often referred to in an everyday life in

South India, leads us to issues that are relevant for the

arguments [19].

One of the most debated issues among

Ayurvedic practitioners concerns the advantages and

disadvantages of the incorporation of biomedical

instruments, technology and concepts into Ayurvedic

routines. Regarding the current situation in India the

term 'integration' is, however, more appropriate than

'syncretism', for the latter is, apparently, too narrow

and problematic to elucidate a state of affairs.

However, as emphasized, the present situation in the

clinical reality of Mysore does not suggest

syncretism, in the historical sense of the term, but to a

deliberate and symbolic integration of things,

concepts and routines into Ayurvedic practices

basically to serve the interests of practitioners and

clients.

Apparently the disparity in treatment in the

field of Ayurveda is a result of several interrelated

reasons, such as: (1) the establishment of luxurious

private Ayurvedic centers, actively advertised for

foreigners and wealthy consumers, (2) the fact that

Governmental subsidies for public Ayurvedic

institutions lag behind the ones given to biomedical

care, which strengthens the differentiation of

Ayurvedic services, (3) the increase in the price of

Ayurvedic products and services due to the

commercialization and standardization of Ayurvedic

therapy in the context of a booming industry and

marketing and (4) the conversion of Ayurvedic

practitioners from 'small-scale producers to

consumers of large-scale manufactures' (Banerjee

2002, p. 446), an aspect that effectively associates

Ayurvedic practitioners with an Ayurvedic industry

[20] .



Anthropology offers two perspectives that

can be useful in making health care more acceptable

to diverse ethnic groups. The first, ethnography, a

central tool in cultural anthropology, involves getting

a mental mapping of the patient's world. In other

words, the clinician strives for the emic view by

learning the patient's definitions and seeing the world

from the patient's point of view. The therapist needs to

know from what the patient believes he or she is

suffering. A doctor's diagnosis, though medically

correct from an orthodox point of view, may not be at

all representative of the patient's view of the situation.

An view is composed of analytical language such

as concepts and theories. An view refers to the

native view or the insider's view. A problem can

result when etic terminology and emic terminology

are identical in vocabulary but mean different things,

assume different origins, and may result in different

consequences [21].

:

etic

emic

References

[1] http://economictimes.indiatimes.com/news/politics-

and-nation/british-raj-did-more-harm-than-good-in-

indian-subcontinent-uk-supreme-court-

debate/articleshow/43096059.cms, Accessed on 22.9.14

[2] Report of the Steering Committee on AYUSH For

12th Five Year Plan (2012-17), 4th May

2011, P 11

[3] Ibid [2] p 17

[4] Ibid [2] p 66

[5] Ibid [2] p 68

[6] Ibid [2] p26

[7] Ibid [2] p 31

[8] Ibid [2] p37

[9] Ibid [2] p 24

[10] Ibid [2] p38-39

[11] Ibid [2] p46

St 2- Ayush,

[12] Tripathi, Sneha and Mishra, V.K., "Retrospective

Conversion of Ancient Knowledge, Issues and

Challenges: A Case Study of Central Library, Banaras

Hindu University, India" (2010).

Paper 363.

http://digitalcommons.unl.edu/libphilprac/363

[13] aunders L, Hewes G: Folk medicine and medical

practice. J Med Educ 28:43-46,1953

[14] , Indigenous Knowledge in

India:Dimensions and Relevance, Jr. Anth. Survey of

India, 61(2) & 62(1) : (373-377), 2012-2013

[15] Lynn Sikkink, Medical Anthropology in Applied

Perspective, 2009 (Helman, Cecil 1994. Third Edition.

. Oxford: Butterworth Heineman)

Wadsworth, Belmont, CA 94002-3098, USA, p1,

[16] A. McElroy Medical Anthropology, Aus:

D.Levinson, M. Ember (Hrsg.) Encyclopedia of

Cultural Anthropology. Henry Holt, New York 1996;

[17] Stephné Herselman ,Health Care ThroughACultural

Lens:Insights From MedicalAnthropology,

Current Allergy & Clinical Immunology, June 2007 Vol

20, No. 2, p62

[18] Janzen J.

. New York:

McGraw-Hill, 2002.

[19] Tapio Nisula, In the Presence of Biomedicine:

Ayurveda, Medical Integration and Health Seeking in

Mysore, South India, Anthropology & Medicine, Vol.

13, No. 3, December 2006,p 208 of pp. 207224

[20] For a critique of the modern versions of Ayurveda,

see Zimmermann (1992), Nichter and Nichter (1996,

pp. 292299), and Banerjee (2002). Banerjee 2002, p.

446 Tapio Nisula, In the Presence of Biomedicine:

Ayurveda, Medical Integration and Health Seeking in

Mysore, South India, Anthropology & Medicine, Vol.

13, No. 3, December 2006,p 208 of p215 of pp. 207224

[21] Katherine K. Parry, Concepts from Medical

Anthropology for Clinicians, 1984;

64:929-933.Downloaded from http://ptjournal.apta.org/

by guest on September 22, 2014

Library Philosophy

and Practice (e-journal).

P. K. Misra1

Culture, Health and Illness: an Introduction for Health

Professionals

The Social Fabric of Health: An

Introduction to Medical Anthropology

PHYS THER.

S



Journal of Indian

System of Medicine

Introduction

Allergic Rhinitis is disease pertaining Nose

induced by an immunoglobin E(IgE)-mediated

inflammatory reaction after allergic exposure of the

membranes lining the nose [1]and is characterized by

watery nasal discharge, Nasal congestion , sneezing

and itching in the nose [2].

is compared to allergic

rhinitis because most of the signs and symptoms of

alike such as (watery nasal

discharge), (Sneezing) and

(congestion) [3] ' ' is a

and one among five types of

a

Vataja Pratishyaya

Nasagata Tanusrava

Kshavatu Nasavarodha

. Vataja Pratishyaya

Nasagataroga

OriginalArticle

Role of and

in (Allergic

Rhinitis)

Shunthyadi Taila Triphaladi

Taila Nasya Vatajapratishyaya

Hiremath V.R, Srinivasaprasad B, ,

How to cite the article: Hiremath V.R, , Srinivasaprasad B, Shunthyadi Taila And Triphaladi Taila Nasya In Vatajapratishyaya

(Allergic Rhinitis), J-ISM, V2 N3, July-September 2014, pp.113-117

Ph.D Scholar [ ], Pofessor, K.L.E U`s Shri B.M.K. Ayurveda Mahavidyalaya,

Shahapur, Belgaum, Karnataka, India.

[email protected]

JISM1419N Received for publication: June 23, 2014;Accepted: 14 September, 2014

Abstract:

Key words:

Vataja Pratishyaya Nasagata Tanusrava, Kshavatu

Nasavarodha.

Kshavathu Pradhana

Lakshana Vataja Pratishyaya Shuntyadi Taila Nasya

Taila Dhatus

Triphaladi Taila Pratishyaya

Shunthyadi Taila Triphaladi Taila Nasya

Shunthyadi taila Triphaladi taila Vataja

Pratishyaya Shunthyadi taila Nasya Triphaladi Taila

Vataja Pratishyaya Shunthyadi Taila Triphaladi Taila.Nasya.

is a disease which possesses symptoms like and

These types of symptoms are also found in allergic rhinitis which is induced by an IgE mediated

inflammation of the nasal membrane. Allergic rhinitis is the most common type of chronic rhinitis, affecting 10

to 20% of the population. Severe allergic rhinitis has been associated with significant impairments in quality of

life, sleep and work performance. Till date no satisfactory medical management has been developed for this

problem. Hence, it creates a need to search a simple and effective remedy. As is the

of , has been selected for the present study because most of

the ingredients of this will promote the nourishment of which ultimately increases the general and

local immunity. In the same way has also been indicated in . Hence to assess and

compare the efficacy of and in the form of the present study had been

taken. Both and were found to be very beneficial in all the cases of

. However, Group A with gave better result than in Group

B.

,Allergic Rhinitis, ,

Pratishyaya

Nasya

[4].Allergic rhinitis is the most common

type of chronic rhinitis, affecting 10 to 20% of the

population, and evidence suggests that the

prevalence of the disorder is increasing. Severe

allergic rhinitis has been associated with significant

impairments in quality of life, sleep and work

performance [5].

All medical disciplines are trying to find the

ways to fight against such challenging tasks. Till date

no satisfactory medical management has been

developed for this problem. Hence, it creates a need

to search a simple and effective remedy. Among the

various treatment modalities, is the chief


procedure to drain from [6].

in the form of has been

highlighted as drug of choice for the management of

[7]. As is the

of ,

has been selected for the present study, In the

same way has also been indicated in

[8]. Hence to assess and compare the

efficacy of and in

the form of the present study had been taken.

A. Patients: The diagnosed patients of

were selected from OPD and IPD of

Department of Shalakyatantra. Recoupment of the

patients into trail and control groups were done by

Envelop method.

B. Study design: comparative study with two equal

Groups.

C. Sample size: 24 patients (12 patients in each

Group).

D. Posology (Table No.1)

E. Selection of drugs

Equal parts of

made into form, to these 4 parts

of and 16 parts of is

added and boiled till it attains

( ).

Equal parts of

and were taken.

To these 1 quantity of was added and

boiled to prepare Then to this

equal quantity of and

were added along with two parts of Then

along with 1 quantity

of Tila taila was added and was done to

prepare .

Doshas Shirah

Shunthyadi Taila Nasya

Kshavathu Kshavathu Pradhana

Lakshana Vataja Pratishyaya Shunthyadi Taila

Nasya

Triphaladi Taila

Pratishyaya

Shunthyadi Taila Triphaladi Taila

Nasya

Vataja

Pratishyaya

Shunthi, Kushta, Pippali,

Bilwa, Draksha kalka

MoorchitaTila Taila Shuddhajala

Sneha Siddha

Lakshana Mrudhu Taila Paka

Triphala, Guduchi, Ketaki,

Chandana, Bala, Eranda Indravali

Drona Jala

Kashaya. Kashaya

Bhringaraja Amalaki Swarasa

Ksheera.

Prakshepaka Dravyas Prastha

Tailapaka

Triphala Taila

Materials and methods

Shunthyadi Taila:

Triphaladi Taila:

Intervention:

Methodology:

Inclusion criteria:

Exclusion criteria:

Diagnostic Criteria:

Laboratory investigations:

Subjective criteria:

Nasyakarma

Taila

Vataja

Pratishyaya

Doshaja Pratishyaya

was done in the morning

time 8.30am to 9.30am, 8 drops of each in each

nostril was administered.

- Patients fulfilling the diagnostic criteria of

(Allergic Rhinitis)

- 15 to 50 years of age group.

- Subjects were recruited irrespective of sex,

religion, occupation etc.

- Other , Systemic infections

like Tuberculosis, Leprosy etc.

-Associated with Nasal polyp, Bronchial asthma etc.

-Age less than 15 years and more than 50 years.

Diagnosis was established on the basis of -

1.Clinical features: Rhinorrhoea, Sneezing, and

Nasal obstruction.

2.Anterior and posterior Rhinoscopy for signs of

allergy:e.g. pale Oedematus Turbinate with thin

strings of mucus.

3.Absolute Eosinophil Count: Raised blood

Eosinophils.

4.Nasal smear: shows large number of Eosinophils.

A.E.C, Nasal smear

Criteria for assessment

Record and follow of all the patients included in the

trial was documented and maintained in the case

record from the efficacy of the therapy was assessed

on subjective and objective criteria and

multidimensional scoring system was adopted for

easier statistical analysis of the result score.

The score was given according to the severity of the

symptoms as follows

�Sneezing

�Running nose

�Nasal Congestion


Hiremath V.R , Srinivasaprasad B, Shunthyadi Taila And Triphaladi Taila Nasya In Vatajapratishyaya (Allergic Rhinitis), 113-117pp.


Objective criteria:

Grading:

Statistical analysis:

�

�A. E. C

�Nasal smear

1. None or on occasional

2. Limited occasional

3. Mild symptom but easily tolerable

4. Steady symptom but easily tolerable

5. Moderate bothersome i.e. hard to tolerate

6.Moderate bothersome and interfere with

activities of daily life

7 Severe symptoms i.e. person can't function at

all

(Table No.3, 4 & Graph No.1)

All the data generated and collected during the study

was subjected to statistical analysis. Students paired t

test was applied to calculate the 'p' value. Conclusions

were drawn based on the results obtained.

Assessment of the effect of therapy:

� On factor: During the study it was

observed that, there was statistically significant effect

of on i.e. 'p' value<0.05%,

in the same way had also the

statistically significant effect over the i.e.

'p' value<0.05%, but by comparing the results of both

groups group had better results than

group.

� On factor: During the study it

was observed that, there was statistically significant

effect of on , i.e.

'p' value<0.05%, in the same way

had also the statistically highly significant effect over

the i.e. 'p' value<0.01%, hence

by comparing the results of both groups

group had better results than

group.

On factor: During the study it was

observed that, there was statistically highly

significant effect of on

factor, i.e. 'p' value<0.01%, in the same

way had also the statistically

Kshavatu

Shunthyadi taila Kshavatu,

Triphaladi taila

Kshavatu

Shunthyadi Taila

Triphaladi Taila

Nasagata Tanusrava

Shunthyadi Taila Nasagatatanusrava

Triphaladi Taila

Nasagatatanusrava

Triphaladi

Taila Shunthyadi Taila

Nasavarodha

Shunthyadi Taila

Nasavarodha

Triphaladi Taila

significant effect over the factor i.e. 'p'

value<0.05%, hence by comparing the results of both


group.

�OnAEC test: During the study it was observed that,

there was statistically significant effect of

onAEC value, i.e. 'p' value<0.05%,

in the same way had also the

statistically significant effect over the AEC value i.e.

'p' value<0.05%, but by comparing the results of both


group.

�On nasal smear test: During the study it was

observed that, there was statistically highly

significant effect of on Nasal Smear

test, i.e. 'p' value<0.01%, in the same way

had also the statistically significant effect over

the Nasal Smear test i.e. 'p' value<0.05%, hence by

comparing the results of both groups

group had better results than

group

Sources say much about the incidence of the

allergic rhinitis in Male than female [9]. In our study

also it was found to be correct in which 62.5% were

male and 37.5% were female patients. This disease

has no bar for religion and geographical distribution,

is described as a condition of

less complication and with good prognosis in

Ayurvedic classics [10] is the chief

procedure selected because this is a procedure which

performs which can expel the

vitiated easily. was

administered in GroupA.

Most of the ingredients of this are

having the properties like having

;

and

, and properties will

promote the nourishment of which ultimately

increases the general and local immunity. This might

Nasavarodha

Shunthyadi taila

Triphaladi taila

Shunthyadi Taila

Triphaladi Taila

Shunthyadi Taila

Triphaladi Taila

Shunthyadi Taila

Triphaladi

Taila

Shunthyadi

Taila Triphaladi Taila

Vataja Prathishyaya

Nasya Shodhana

Uttamanga Shuddhi

Doshas Shunthyadi Taila Nasya

Taila

Vata-Kaphahara

Katu, Tikta, Madhura Rasa; Laghu, Snigdha Guna

Ushna Veerya Madhura Vipaka. Madhura Rasa,

Sheeta Veerya Snigdha Guna

Dhatus

.

Discussion:


DRUG GROUP-A GROUP-B

Name of the Medicine Shunthyadi Taila Nasya Triphaladi Taila Nasya

Duration Total duration- 7 days Total duration- 7 days

Dose 8 drops in each nostril 8 drops in each nostril

Table No.1: Showing the Posology

Table No.2: Showing the ingredients of

Shunthyadi taila

Shunthikalka- 1 part

Kushta - 1 part

Pippali - 1 part

Bilwa- 1 part

Draksha- 1 part

Tila Taila- 4 parts

Shuddhajala- 16 parts

Graph No.1: Showing the 'T' value of Group



PA R AM ETER M EA N M ean

diff

S D T-V alue P- V alue R em ark s

BT A T

Ks ha va tu 5.91 5 .58 0 .33 0 .492 2 .34 < 0.05 S ig

N as a ga ta tan usra va 5.66 5 .08 0 .58 0 .51 3 .92 < 0.01 H igh S ig

N as a va ro dha 5.66 5 .33 0 .33 0 .49 2 .34 < 0.05 S ig

AE C 541.5 463.3 78 .16 54 .75 4 .94 < 0.001 H igh S ig

N as a l sm ea r 11.91 11 .25 0 .66 0 .77 2 .96 < 0.05 S ig

Table No.4: S how ing the Statist ical A n alysis of P aram eters, G roup B

PA R A M E T E R M E A N N et

M ean

S D T -

V a lu

e

P- V alu e R em a rk s

B T A T

Ks ha va tu 5 .7 5 5 .33 0 .4 1 0 .5 1 2 .8 <0 .05 S ig

N a sa ga tata nus ra v a 5 .6 6 5 .25 0 .4 1 0 .5 1 2 .8 < 0 .0 5 S ig

N a sa va rodh a 5 .6 6 5 .08 0 .5 8 0 .5 1 3 .92 < 0 .0 1 H ig h S ig

A E C 5 7 1. 4 2 9 1 42 .5 4 3 .5 1 1 .3 4 <0 .00 1 H ig h S ig

N a sa l s m ea r 1 2 .5 9 .08 3 .4 1 1 .3 1 9 .02 < 0 .0 01 H ig h S ig

T a ble N o .3 : S ho w in g the Stat ist ica l A na ly sis of P ara m eters, G rou p A

be the reason where we got statistically highly

significant effect over AEC and Nasal

smear test factors as well as significant effect over the

and .

was administered in Group B.

possess a good spreading capacity through

minute channels which make .

Most of the ingredients of this are having the

properties like having

. With these properties it

is having

effect as a combined form.

In this way it can counteract the .

Even in this study it is proved as it had statistically

highly significant effect over

and AEC. In the same way it had significant effect

over the and Nasal smear

test factors.

The therapeutic effect of with

(Group A) and

were found to be very beneficial in all the

cases of .

group had 3 parameters out of 5 parameters as highly

significant, whereas nasya group

had 2 parameters out of 5 parameters as highly

significant values. Hence by comparing the statistical

Nasavarodha,

Kshavathu Nasagata Tanusrava Triphaladi

Taila Nasya Triphaladi

Taila

Srothoshodakatwa

Taila

Tridoshahara Tikta, Katu,

Maadhura Rasa; Laghu, Snigdha Guna; Ushna

Veerya and Madhura Vipaka

Indriya-Dardyakaratwa, Balya, Rasayana,

Vatahara and Brimhana

Vataja Pratishyaya

Nasagata Tanusrava

Kshavathu, Nasavarodha

Nasyakarma

Shunthyadi Taila

Vataja Pratishyaya Shunthyadi Taila Nasya

Triphaladi Taila

Conclusion:

Triphaladi Taila

(Group B)

values it was concluded that Group A has better

results than Group B.

,

References

[1] Dykewicz MS, Hamilos DL: Rhinitis and sinusitis. J

Allergy ClinImmunol 2010, 125:S103-15

[2] PL Dhingra, Diseases of Ear, Nose and Throat, 3

edition reprint, Reed Elsevier India Private

Limited;2005:204

[3] Bramhananda Tripath i , Charaka samhi ta ,

Chikitsasthana, 26 chapter, verse -105, Chaukamba

SurabharatiPrakashana; Varanasi; 2012:885

[4] Kaviraja Ambikadatthashastri, Sushrutha samhitha,

Uttaratantra, 22 chapter, Verse -5, vol-2, Chaukamba

Sanskrit Sansthan,Varanasi; 2004:104.

[5] Dykewicz MS, Hamilos DL: Rhinitis and sinusitis. J

Allergy ClinImmunol 2010, 125:S103-15

[6] Hemadri D, Ashtanga Hridaya Sadashiva SP, editors.

Varanasi: Chaukhamba Surbharati Prakashana; 2007.

Vagbhata..SarvangaSundari Comm. Arunadatta&

Ayurveda Rasayana comm.

[7] Bhavaprakash Nighantu Uttarardha Ed, by

Bhi shag ra tna Pand i t Sh r i Bramha Shanka r

Mishra;65:19 Chaukhamba Sanskrita Samsthana,

Varanasi: 9 Edn, 2005. pp.694.

[8] Dr.Ramnivasa Sharma, Dr.Surendra Sharma,

Sahasrayogam, Taila Prakarana, 39 , Triphaladi Taila,

Choukambha Sanskrit Pratishthana, re-edition 2004,

Varanasi, page number- 91

[9] Durham SR. Mechanism and treatment of allergic

rhinitis. In: Mackay IS, Bull TR, editors. Scott Brown's

Otolaryngology, Vol 4, 6th ed. Oxford:

1997; 6: 1-16.

[10] Kaviraja Ambikadatthashastri, Sushrutha samhitha,

Uttaratantra, 24 chapter, Verse -15, vol-2, Chaukamba

Sanskrit Sansthan,Varanasi; 2004: page number-119.

rd

th

th

,

th

th

th

Butterworth

Heinemann;



117

Management of with

of &

AClinical Study

Sthula Madhumeha

Ghanasatva Kadar, Khadir Guggulu -

AshishA. Thatere , Vidya B. Wasnik , Kabra. P. R.1 2 3

1 2

3

Asst. Prof. Dept. of Kayachikitsa, [[email protected]], Asso. Prof. Dept. of Swasthavritta,

Prof. & HOD, Dept. of Kayachikitsa, Govt.Ayurved College, Nagpur

JISM1355N Received for publication: December 12, 2013 Accepted: September 14, 2014

How to cite the article: Ashish A. Thatere, Vidya B. Wasnik, Kabra. P. R, Management of Sthula Madhumeha with Ghanasatva ofKadar, Khadir & Guggula- A Clinical Study, J-ISM, V2 N3, July-September 2014, pp.118-126

Abstract:

Keywords:

Alteration in life style in the present days, results in manifestation of several life threatening disorders like

I.H.D., diabetes mellitus, obesity etc. In future Ayurvedic science also commented regarding the importance of

and for maintaining normal health status. is one of such diseases with very

rapid incidence and is a type of modalities of treatment has been

explained as its management tool. After reviewing previous works done on it was found that

of have not been studied till now. So the effect of the said

drug was evaluated & the results observed are mentioned in full paper.

Ahara Vihara Sthula Madhumeha

Santarpanajanya vyadhi. Shaman & Shodhana

Madhumeha,

Ghanasatva Kadar, Khadir & Guggulu Apatarpaka

Sthula, Madhumeha, Shaman, Shodhana, Apatarpana

Journal of Indian

System of MedicineOriginalArticle

Introduction

has stressed upon the concept of

total health for which multi dimensional unique

concepts have been explained to achieve its goal of

maintaining total health & curing the disease. In this

context certain rules for proper life style are also

explained. Life style disorders like &

are increasing now days. The incidence

of is rising very rapidly which is

very hazardous as it is one of the .

Keeping this in mind the study was planned.

has advised the of &

as for managing the patients of

(A.S.C. 14/33). But instead of

of the said drugs was given to one group

of 20 patients of because it is

easy to take.

in

perspective is just like type II diabetes. Symptoms

Ayurveda

Sthulata

Madhumeha

Sthula Madhumeha

Kulaj Vikar

Vagbhat

Kvatha Kadar, Khadir Guggulu

Apatarpaka Sthula

Madhumeha Kwatha,

Ghanasatva

Sthula Madhumeha

Sthu la Madhumeha Ayurved ic

mentioned in are similar to type II diabetes.

According to Hunter John, diabetic having BMI more

than 23 should be treated as type II diabetes i.e,

.

Park predicted that number of patients of

type II diabetes is going to be doubled in 2025.

Ramchandran A, et al mentioned that prevalence rate

in different parts of urban India is 12 to 18. He

pinpointed, that the prevalence at national level is

12.1.This increase in prevalence is attributed to

different causes such as increased monthly family

income, age, gender family history, reduced physical

activity.

There are so many researches done to

control diabetes mellitus till now, but still this disease

is not completely curable. There are many

complications of diabetes mellitus such as diabetic

retinopathy, diabetic neuropathy, diabetic

ketoacidosis, hyperglycemic hyperosmolar state,

Ayurveda

Sthula

Pramehi


coronary heart disease, cerebrovascular disease &

others, so this disease is called as Silent Killer.

Therefore it is necessary to control blood sugar level

to avoid complications.

One can only control the blood sugar

level along with medicine. For control of Diabetes

mellitus diet regimen, exercise, proper lifestyle is

also important. At present many drugs are available

to control the blood sugar level in type II diabetes but

still complications are observed in many patients. It

was assumed that Ayurvedic contention of treatment

of will be helpful. According to

is to be administered to

type of (S.C.1/4).

According to Dalhana is .

Further Dalhana added that includes

administration of or the drugs

having (Dal.Com.S.C.11/4),by

virtue of these properties of these drugs

might be acting on and more

having property so that will

be reduced. This concept will be helpful to decrease

the weight or BMI of particular

i.e. type II diabetics. This concept of management

might be helpful to control blood sugar level and

may avoid complications.

Therefore the drugs having these properties were

thought of. As mentioned in

herbal formulation of drugs such as

and were selected to control

blood sugar level and to bring down weight.

40 patients of were

randomly selected from OPD & IPD of Kayachikitsa

dept., Govt.Ayurved Hospital,Nagpur irrespective of

sex, socio economical status & religion.

The study was carried out in two groups (trial

& control) of patients of . Both

groups comprised of 20 patients each.

Sthula Madhumeha

Sushruta Apatarpana

Apathyanimittaj Prameha

, Apatarpana Langhana

Apatarpana

Vyayama, Shodhana

Katu and Tikta Rasa

Apatarpaka

Abaddha Meda Kapha

Drava Meda and Kapha

Sthula Madhumehi

Astanga Sangraha

Apatarpaka

Kadar, Khadir Guggulu

Sthula Madhumeha

Sthula Madhumeha

consequences like diabetic

Materials & Methods

Study Design

Selection of Drug:

Criteria of Selection:

Criteria of Rejection:

Criteria of Assessment:

The patients of trial group were given the

(Acasia Suma),

(Acasia Catechu) & (Commiphora Mukul)

in the dose of 1 gm Bid with lukewarm water before

meals for 6 weeks. The patients of control group

were given Tab. Glibenclamide 5 mg OD with water

before meals for 6 weeks. All the patients were

explained about particular & with

respect to . Light diet was

prescribed in divided timings and sweets were

restricted from diet.

Selection of the patients was

made on the basis of following criteria:

1.Clinical signs & symptoms of

2.BMI more than 25 were selected

3.Fasting blood sugar less than 220 mg/dl and Post

prandial blood sugar less than 400 mg/dl

4.Serum cholesterol less than300 mg/dl

5.Serum triglycerides less than 250 mg/dl

Rejection of the patients was

made on the basis of following criteria:

1.BMI less than 25 were rejected

2.Fasting blood sugar more than 220 mg/dl and Post

prandial blood sugar more than 400 mg/dl

3.Serum cholesterol more than300 mg/dl

4.Serum triglycerides more than 250 mg/dl

5.Patients having complications like diabetic

neuropathy, nephropathy, retinopathy, vasculopathy,

Myocardial infarction were rejected.

The patients were assessed

on the basis of following criteria:

1.Effect of drug on symptoms of

2. To evaluate the effect of drug on the quantity of

Urine & sugar in urine.

3.To evaluate the effect of drug on weight & BMI.

4.To study the effect of drug on fasting and post meal

blood sugar level.

5.To study the effect of drug on lipid profiles.

Ghanasatva of Kadar Khadir

Guggulu

Ahar Vihar

Sthula Madhumeha

Sthula Madhumeha

Apatarpak Sthula

Madhumeha.


Ashish A. Thatere, Vidya B. Wasnik, Kabra. P. R, Management of Sthula Madhumeha with Ghanasatva of Kadar, Khadir & Guggulu-A Clinical Study, J-ISM, V2 N3, July-September 2014, pp.118-126 118-126pp

A criterion's for General Symptom Score:

Observation

Scoring was done as described by Kagde S. T. (2000)

as follows:

A. 2 marks for each symptom before treatment for

moderate condition and 3 for severe condition.

B. 1 mark was allotted after remarkable reduction of

symptoms after the treatment.

C. Complete reduction in symptom was considered

as zero mark.

D. No change in symptom after treatment was taken

as 2 marks.

The study was carried out in 40 Patients of

. Two groups comprising 20

patients each viz. treated group (T.G.) and control

group (C.G.) were made. Patients of treated group

were given of and

while that of control group were given Tab.

Glibenclamide 5 mg OD. Patients who are having

B.M.I. more than 25 were considered as overweight

i.e. with fasting blood sugar level less than

220 mg/dl and post meal blood sugar level less than

400 mg/dl were selected for the said study.

All the clinical parameters, physical characters,

hematological and biological parameters were noted

one day before starting the treatment and were

considered as before treatment (B.T.) values. The

course of the treatment was of 6 weeks in both

groups. One day after the completion of the course

all the parameters were again recorded as after

treatment (A.T.) values. However three patients each

of treated and control group were not ready for lipid

profiles due to some unknown reasons best known to

themselves. Following observations were made after

the completion of the study:

were relieved on

average by 57% in treated group as compared to

14.29% in control group. In the same manner

were reduced on average

by 37.98% in treated Group as compared to 17.59%

in control group.

Sthula Madhumeha

Ghanasatva Kadar, Khadir

Guggulu

Sthula

Kapha Vriddhi Lakshanas

Rasa

Dhatu Dushti Lakshanas

More than 50% of the relief in the patients of

treated group in some symptoms like

and

was observed which was more in treated

group as compared to control group except

.

Weight in Kg in the patients of treated group

was significantly reduced by 1.9 ± 0.72, t= 11.7719

and P‹0.001. In the same manner weight was also

reduced in control group as presented in Table-4.

As we go through Table-4 it was observed that B.M.I.

was also significantly reduced in both the groups

(Table-4).

Ayurvedic concept of “

” was tested with respect to Fasting and post

meal blood sugar level in the patients. F.B.S. in

treated group was reduced very highly significantly

as presented in Table-5; t was 8.630, P‹0.001 while in

case of control group it reduced insignificantly. As

presented in Table-5, post meal blood sugar levels of

patients in both groups were reduced very highly

significantly.

It is highlighted that only 34 patients were

evaluated before and after the treatment with respect

to lipid profiles. As presented in Table-6, only Serum

triglycerides levels were significantly brought down

in both the groups. Data highlighted in Table-6

proved it.

To decide better drug to reduce triglyceride

levels unpaired T-test was carried out. Unpai red

T-test was 2.7518, P‹0.01. This statistical analysis

proves that one of the groups was better between

them. The drug in control group was responsible for

that (Table-7).

Quantity and specific gravity of urine was

decreased by the respective therapies in both the

groups. However statistical results showed that it was

insignificant.(Table-08)

Table 9 showing Total Effect of the Therapy

Mukh

Madhurya, Supti, Daha, Trishnadhikya, Alasya,

Nidradhikya, Tandra, Mutradhikya, Avil Mutrata,

Kshudhadhikya, Anutsaha, Daurbalyata

Svedadhikya

Mukh

Madhurya

Madhuryat cha

Tanorata



indicated that 65% of the patients in treated group and

50% of the patients in control group were markedly

improved. While 35% of treated group patients and

45% of control group patients were improved. One

patient of control group remains unchanged after the

completion of the therapy. It is very clear that treated

group was better than that of control group.

In this study 40 patients of

i.e. patients suffering from diabetes

mellitus who had B.M.I. more than 25 were studied.

Patients of this study were selected randomly

irrespective of age, sex, religion and socio-

economical status. The patients were selected as per

the criteria of selection. Six of them did not turn up for

the follow up of lipid profiles for unknown reasons.

Table-1 shows that most of the symptoms

were relieved by more than 50% in treated group may

be due to the properties of trial drug. In control group

also there was fair percentage of relief. However it

was more in treated group.

The effect of drug was observed on a unique

contention of Ayurveda i.e.

and . Table-2 and 3

highlighted effect of drug on

score and

respectively. More reduction in treated group was

observed in and

score. These tables suggest that the drug in treated

group had more percentage of relief than control

group.

Weight and B.M.I. were evaluated in all the

patients. Table-4 suggested that the drug in treated

group and control group highly significantly reduced

weight and B.M.I. So unpaired t-test was carried out

for the comparison between two independent treated

and control group.

Effect on fasting and post meal blood sugar

level was also evaluated in all the patients. Table-5

shows that very highly significant reduction (diff. of

mean= 31.915 mg/dl) in F.B.S. of patients in treated

ScientificAnalysis of Results

Sthula

Madhumeha

Dosha Vriddhi Lakshana

Dhatu Dushti Laskshana

Dosha Vriddhi

Lakshana Dhatu Dushti Lakshana

Vata- Kapha Pitta Vriddhi Lakshana

group, while in case of control group reduction

F.B.S. was insignificant. In case of P.M.B.S. in

treated group reduced by 48.325 mg/dl t= 4.6076, P

0.001. In the same manner P.M.B.S. in control

group was also reduced very highly significantly.

Therefore further comparison between the levels of

P.M.B.S. in both groups was carried out by

unpaired t test.

The effect of drugs in both groups on total

cholesterol, HDL, LDL was noted. Reduction in

total cholesterol in both groups was insignificant.

There was a marginal insignificant increase in HDL

while LDL in both groups increased by very

marginal levels which did not show any significant

role. Effect on triglycerides in both groups noted

was favorable. Reduction in treated group was

significant while in control group it was more

significant (Table-6).

As significant reduction in triglycerides

prompted to evaluate the better drug for that

unpaired t test for unmatched data was carried out

(Table-7).

It was

observed that weight, B.M.I., P.M.B.S. and

triglycerides reduced significantly at different

levels of significance in both groups. Therefore

further comparison of two independent groups was

carried out by unpaired t test, which is highlighted

in Table-7.

Difference of mean of weight in T.G. was

1.9 ± 0.72 which was more by 0.52 kg weight than

the difference of mean in C.G. This difference was

tested statistically by unpaired t test; t was 2.3985, P

0.05. The result was significant. More difference

of mean of weight in T.G. Was clearly suggestive

that weight in T.G. reduced significantly.

Similarly B.M.I. was also reduced very

highly significantly as presented in Table-7. ean

of B.M.I. was observed in T.G.

C.G.

˂

˂

Comparison between the two groups:

M

difference more in

comparison to and was found to be highly

significant.



As both group exhibited significant

difference of mean in P.M.B.S. Therefore

of both groups were statistically tested. Their

was insignificant as highlighted in Table-

7.

Difference exhibited in patients of T.G. was

compared with that of in C.G. with respect to

triglycerides values. More diff. of means shown in

C.G. by 24.04 mg/dl was found to be highly

significant i.e. the drug in control reduced

triglycerides in C.G. (Table-7).

and in equal

proportion were taken and its compound

was prepared. This have ,

and .

This drug has the action on and

. Alleviation of may be more potently

done as compared to and . of

has been exclusively mentioned as and

. This drug by virtue of its maximum

(50% of ) might be enhancing

of ultimately by increasing

of ; reduction in weight and B.M.I. was

observed. in this compound might be

spreading all over the mucous membrane of the

intestine where the absorption of glucose is

mentioned. Layer of this drug on mucous membrane

may restrict the absorption of . Thus

over all blood sugar level might have been reduced

significantly in treated group. The drug was given for

the duration of six weeks in this study; however long

term indulgence of this compound may show more

reduction in B.S.L., weight and B.M.I.

It is very evident from the observations and

results of the study that drug definitely

reduced which has important role in

manifestation of . The significant

reduction in weight, BMI, blood sugar level, specific

gravity and quantity of urine and serum triglycerides

established efficacy of the of

and on . If fore

said herbal formulation is used for prolonged period

it might definitely affect and

difference

difference

Probable mode ofAction of Trial drug

Discussion and Conclusion

Kadar, Khadir Guggulu

Ghanavati

Ghanavati Tikta-Katu Rasa

Shita Virya, Laghu-Ruksha Guna Katu Vipaka

Vata, Pitta Kapha

Dosha Kapha

Pitta Vata Dushti Meda

Bahu

Abadhha Meda

Rasa Tikta Rasa

Pachan Meda Dhatvagni

Meda

Guggulu

Madhur Rasa

Apatarpaka

Meda Dhatu

Madhumeha

Ghanasatva Kadar,

Khadir Guggulu Sthula Madhumeha

,

Sthula Madhumeha

consequently may help to restrict hazardous

complications.

Although none of the patients was cured,

maximum patients of treated group were markedly

improved and remaining were improved as

compared to control group which proves the

Ayurvedic contention of on

.

Apatarpana Chikitsa

Sthula Madhumeha

References

[1] Bhavmishra, Bhavprakash, 1999, published by

Chaukhamba Sanskrit Sansthan, Varasani

[2] Chakrapanidatta, A commentary entitled Ayurved

Dipika on Charak Samhita, 2000, published by

Chaukhamba Surbharti Prakashana, Varanasi

[3] Charak, Charak Samhita, 1941, published by Nirnay

Sagar Press, Mumbai and edited by Yadavji Trikamji

Acharya

[4] Dalhan, A commentary entitled Nibandhasangraha on

Sushrut Samhita, 1994, edited by Yadavji Trikamji,

published by Chaukhamba Surbharti Prakashana,

Varanasi

[5] Hunter John, Harrison's Principles of Internal

Medicine, 2002, published by Mc Grawhill Health

Professions Division, USA

[6] Kagde S. T. ,AClinical Study on Tamak Shvasa and its

Management with Brimhan Chikitsa, 2000, Government

Ayurved College, Nagpur.

[7] RamchandraA. et al, Journal Diabetes Care, may 2000

Sushrut, Sushrut Samhita, 1980, published by

Chaukhamba Orientalia, Varanasi

[8] Sushrut, Sushrut Samhita, 1980, published by

Chaukhamba Orientalia, Varanasi

[9] Madhavakar, Madhav Nidan, 1993, published by

Chaukhamba Sanskrit Sanstha, Varanasi

[10] Michael Swash, Hutchison's Clinical Methods, 2000,

Harcour Publications

[11] Siddharth N, Shah, A.P.I. Textbook of Medicine,

2003, published by Association of Physicians of India,

Mumbai.

[12] Vagbhat, Astanga Sangraha, 1980, published by

MaheshAthavale ShrimadAatreya Prakashan, Pune



Table–01: Showing Effect of Apatarpaka Drug on Symptom Score in

40 Patients of Sthula Madhumeha

Sr.

No.

Symptoms Groups Symptom Score %age relief

BT AT Diff

1 Mukha- Madhurya Treated

Control

44

38

15

12

29

26

65.90

68.42

2 Supti Treated

Control

20

10

07

05

13

05

65

50

3 Daha Treated

Control

38

29

13

12

25

17

65.79

58.62

4 Trishnadhikya Treated

Control

46

38

16

15

30

23

65.22

60.53

5 Alasya Treated

Control

37

40

18

21

19

19

51.35

47.5

6 Maladhikya Treated

Control

13

06

08

05

05

01

38.46

16.67

7 Nidradhikya Treated

Control

28

25

12

13

16

12

57.14

48

8 Tandra Treated

Control

24

14

11

09

13

05

54.17

35.71

9 Mutradhikya Treated

Control

51

48

20

25

31

23

60.75

47.92

10 Aavil Mutrata Treated

Control

29

30

11

13

18

17

62.07

56.67

11 Kshudhadhikya Treated

Control

28

18

10

10

18

08

64.29

44.44

12 Medadhikya Treated

Control

47

42

25

24

22

18

46.81

42.86

13 Anutsaha Treated

Control

31

36

15

20

16

16

51.61

44.44

14 Sakashta Maithun Treated

Control

09

06

07

06

02

00

22.22

00.00

15 Durbalata Treated

Control

47

40

17

19

30

21

63.83

52.5

16 Durgandhi Sharir Treated

Control

18

10

12

09

06

01

33.33

10

17 Svedadhikya Treated

Control

45

34

16

17

29

17

64.44

50.00

Table -2: Showing Effect of Therapy on Dosha Vriddhi Lakshana Score in 40 Patients of Sthula

Madhumeha

SN Dosha Vridhhi Lakshana Symptom score Percentage of

ReliefTreated Group Control Group

B.T. A.T. Diff B.T. A.T. Diff T.G. C.G.

1

A

Vata Vriddhi Lakshana

Bhrama 12 04 08 14 10 04 66.67 28.57

2

A

Pitta Vriddhi Lakshana

Shita Kamita 28 18 10 24 19 05 35.71 20.83

3

A

B

C

D

E

Kapha Vriddhi Lakshana

Gauravam

Sada

Tandra

Shvasa

Atinidra

14

14

24

30

30

10

10

11

24

18

04

04

13

06

12

14

12

14

33

32

12

10

09

29

28

02

02

05

04

04

57

28.57

54.17

20

40

14.29

16.66

35.71

12.12

12.5

4 Total of Kapha Vriddhi

Lakshana

112 73 39 105 88 17 34.82 16.19



Table -3: Showing Effect of Therapy on Dhatu Dushti Lakshana in 40 Patients of Sthula Madhumeha

S.

N.

Dhatu Dushti Lakshana Symptom score Percentage of

ReliefTreated Group Control Group

B.T. A.T. Diff B.T. A.T. Diff T.G. C.G.

A Rasa Dhatu

1. Asya Vairasya 24 11 13 26 20 06 54.17 23.077

2 Gaurav 14 10 04 14 12 02 57 14.28

3 Tandra 24 11 13 14 09 05 54.17 35.17

4 Angamard 12 08 04 08 07 01 33.33 12.5

5 Srotorodha 20 14 06 20 18 02 30 10

6 Klaibya 09 07 02 06 06 0 22.22 0

7 Sada 14 10 04 12 10 02 28.57 16.67

8 Wrinkles on Skin 12 09 03 08 07 01 25 12.5

9 Total score 129 80 49 108 89 19 37.98 17.59

B 1 Meda Dhatu

Udar Stana Chala Sphik 47 25 22 42 34 18 48 42

2 Nirutsaha 31 15 16 37 20 17 51.61 45.95

C1 Majja Dhatu

Bhrama 12 04 08 14 10 04 66.67 28.57

D1 Shukra Dhatu

Klaibya 09 07 02 06 06 00 22.22 0

Table 4: Showing Effect of Therapy on Weight & BMI of 40 Patients of Sthula Madhumeha

S.N. Parameters Groups Mean ± SD Diff. Of

Mean ±

SD

SEd T P

BT AT

1 Weight in kg Treated 70.15 ±11.86

68.25 ±11.94

1.9 ± 0.72 0.16140 11.7719

<0.001

Control 65.25 ±11.93

63.87 ±11.97

1.38 ±0.65

0.145 9.2 <0.001

2 BMI in kg/m2 Treated 29.60 ±

3.91

28.62 ±

3.822

0.98 ±

0.620

0.13825 7.099 <0.001

Control 27.87 ±

3.799

27.240 ±

3.623

0.630 ±

0.370

0.083 7.6265 <0.001




Table 9: Showing Total Effect of Therapy on 40 Patients of Sthula Madhumeha

S.N. Total Effect of Therapy Groups Total no. of Patients Percentage

1 Cured Treated 00 00

Control 00 00

2 Markedly Improved Treated 13 65

Control 10 50

3 Improved Treated 07 35

Control 09 45

4 Unchanged Treated 00 00

Control 01 05

5 LAMA Treated 00 00

Control 00 00


Journal of Indian

System of Medicine

Brahmi Taila Shiroabhyanga Chittodwegain

(Anxiety Neurosis)Madhavika Prakash Chaudhari , KSR Prasad

1 2

UG scholar MGACH&RC [[email protected]], Professor, Dept. of Panchakarma,

MGACH&RC,Wardha, MS [[email protected]]

1 , 2

JISM1411H Received: May 1, 2014; Accepted: September 14, 2014

Abstract:

Keywords:

Anxiety is arguably an emotion that predates the evolution of man. Its ubiquity in humans, and its presence in a

range of anxiety disorders, makes it an important clinical focus. Neurotic disorders are basically related to stress,

reaction to stress (usually maladaptive) and individual proneness to anxiety. Interestingly, both stress and coping

have a close association with socio-cultural factors. Anxiety has been defined as an unpleasant emotion that is

characterized by feelings of dread, worry, nervousness or fear etc. and when a neurotic disorder is associated, it is

termed as anxiety neurosis. Ayurveda describes (Anxiety) among revalence rate

higher in women than men. The present study accounts sleep anxiety, disturbances,

restlessness, fear, depression, along with blood pressure undertaken

in reliving anxiety. A head massage once periodicaly on 30 patients,

relived stress and patient felt comfortable in all symptoms presented, with a mean gradation of anxiety reduction

to 1.6. (53.2%) which was statistically highly significant (<0.001). Hence it was concluded that,

Anxiety,Anxiety neurosis, sleep, ,

chattodwega

Brahmi taila shiroabhyanga

Chittodwega, Manasaroga, Shirobhyanga

Manas roga.

Brahmi taila

shiroabhyanga

P of

Anxiety is said to be

changes in . The study has been to evaluate

the role of

was beneficial in alleviating anxiety.

How to cite the article:Madhavika Prakash Chaudhari, KSR Prasad, Brahmi tail Shiroabhyanga in Chittodwega (Anxiety Neurosis),J-ISM, V2 N3, July-September 2014, pp.127-131

Introduction:-

Anxiety is arguably an emotion that predates

the evolution of man. Its ubiquity in humans, and its

presence in a range of anxiety disorders, makes it an

important clinical focus [1]. Developments in

nosology (Nasal Medications), epidemiology and

psychobiology have led to significant advancement

in our understanding of the anxiety disorders in

recent years [2]. Advances in pharmacotherapy and

psychotherapy of these disorders have brought

realistic hope for relief of symptoms and

improvement in functioning to patients.

Indian continent made its top place in the

past with its knowledge and philosophy. Present

scenario is to imitate the west for beautification and

lifestyle. This situation pushes us in to psycho

somatic / psychological disorders like anxiety, stress,

-

etc. Generalized Anxiety Disorder Prevalence is

about 2-4% in normal population, this constituted

25-30% of psychiatric out patients [3]. The lifetime

prevalence of depression, anxiety, and stress

among adolescents and young adults around the

world is currently estimated to range from 5% to

70%, with an Indian study reporting no depression

among college going adolescents. Detecting

depressive, anxiety, and stress-related symptoms in

the college population is a critical preventive

strategy, which can help in preventing disruption to

the learning process. Health policies must integrate

young adults' depression, stress, and anxiety as a

disorder of public health significance [4].

The ever growing stress and strain in life

lead to deterioration in various mental and

physiological functions of body, causing


Original Article

psychological disorders like anxiety neurosis.

Anxiety has been defined as an unpleasant emotion

that is characterised by feelings of dread, worry,

nervousness or fear etc.And when a neurotic disorder

is associated with it becomes anxiety neurosis [5].

Neurotic disorders are basically related to

stress, reaction to stress (usually maladaptive) and

individual proneness to anxiety. Interestingly, both

stress and coping have a close association with socio-

cultural factors. Culture can effect symptom

presentation, explanation of the illness and help

seeking [6].

Charaka samhita mentions ' ' as a

. plays

an effective role in as is a herb

for calming brain and nervous system. is a

brain tonic and enhances memory, intelligence and

longevity [7]. Detecting depressive, anxiety, and

stress-related symptoms in the college population is a

critical preventive strategy, which can help in

preventing disruption to the learning process. Health

policies must integrate young adults' depression,

stress, and anxiety as a disorder of public health

significance [8].

Anxiety is defined as a subjective feeling of

apprehension or dread about the present or the past

accompanied by a number of autonomic and somatic

signs and symptoms. It is the feeling of fear with no

adequate causeAnxiety is the commonest psychiatric

symptom in clinical practice and anxiety disorders

are one of the commonest psychiatric disorders in

general population [9].

To study the efficacy of

(GeneralizedAnxiety Disorder)

Anxiety that is generalized and persistent but

not restricted to, or even strongly predominating in,

any particular environmental circumstances (i.e. it is

"free-floating"). The dominant symptoms are

variable but include complaints of persistent

Chittodvega

Manasika Vikara Brahmi Tail Shiroabhyanga

Chittodwega Brahmi

Brahmi

- Brahmi Taila Shirobhyanga

in Chittodvega

Objectives

ICD F41.1 - Generalized anxiety disorder

(Chiitodwega) [10]:

nervousness, trembling, muscular tensions,

sweating, lightheadedness, palpitations, dizziness,

and epigastric discomfort. Fears that the patient or a

relative will shortly become ill or have an accident

are often expressed. Excludes: neurasthenia (F48.0)

drugs helps to attain

longevity, memory, intellect, youth, Excellence of

luster, complexion and voice, excellent potentiality

to all body and sense organs. drugs

mentioned in the classics have an effective action

over mind and GAD [11]. (

) [12] is one such drug,

significantly decreased whole brain acetyl

cholinesterase activity. BR might prove to be a useful

memory restorative agent in the treatment of

dementia seen in elderly. has an action

against decreasing anxiety too. It is not only

anxiolytic but also anti depressant [13]. In the

present study is used in the form of for

head massage.

Patients suffering from

MGAC&RC,

Wardha, Maharastra

30 Patients

Head massage once in

every 3 days for15minutes in 5 patterns(oilonthe

scalp palm massage, finger massage, combing back

head massage, see fig-1) is done for 7 sittings.

� uncontrolled diabetes mellitus,

hyper tension and other systemic diseases.

� suffering from other psychiatric illnesses

(F48.0)

�Patients suffering from organic brain diseases.

� Patients suffering from complications of substance

abuses.

�Subjectsbetweentheage20-50years irrespective of

gender and socioeconomic status.

� The subjects who are ready to sign the informed

consent form

Medhya Rasayana

Medhya

Brahmi Bacopa

monnieri Medhya

Brahmi

Brahmi Taila

Material & Methods

Source of the Data:

Sample size:

Study Duration & Plan:

Exclusion criteria:

Inclusion criteria:

Chittodvega

Chittodwega.

attending the hospital of

Patients with

-

Patients

� Patient suffering from clinical signs and

symptoms of


Madhavika Prakash Chaudhari, KSR Prasad, Brahmi tail Shiroabhyanga in Chittodwega (Anxiety Neurosis), pp.127-131


Parameter Before After % relief T value P value Sig.

Restlessness 3.1 1.3 58.2 5.5 <0.001 HS

Anxiety 3.5 1.6 53.2 7.76 <0.001 HS

Loss of sleep 3.4 0.9 74.04 7.14 <0.001 HS

Hamilton Anxiety

scale

30.5 21.7 28.7 3.3 <0.05 HS

Table 1: Data showing parameters of anxiety before and after study

Fig 2: Outcomes of the

i n t e r v e n t i o n w e r eFig 3: Improvement in the study


Assessment criteria:

Material:

.)

.)

� Subjective Parameters: Restlessness,Anxiety, Loss

of sleep

�Objective parameters:Hamilton Anxiety Scale

� prepared in MGACHR&C pharmacy

with (Bacopa monnieri Linn and

(oilof SesamumindicumLinn in method.

BrahmiTaila

Bhrahmi Tila Taila

Tailapaka

Improvement:

Improvement Patients %

Very Good [70-100%] 18 60.0

Good [40-70%] 10 33.34

Minimum [30-40%] 1 3.33

No relief [0-10%] 1 3.33

Total 30 100

Table 2: Improvement of the study Brahmi tail

shiroabhyanga in chattodwega(Anxiety Neurosis)

Results:

Outcomes of the intervention were assessed

by using, signs and symptoms score, Hamilton

Anxiety rating scales. Significance is calculated

through Mean scores noted before and after the

treatment for relief in percentage.

Mean gradation of anxiety before

treatment was 3.5 and after the treatment it reduced to

1.6. This reduction of 53.2% was statistically

significant (<0.001). Hamilton Anxiety scale was

30.5 and after completion of course it reduced to 21.7,

with a reduction of 28.7% was statistically significant

(<0.05) (table-1, fig-2). The overall result of the

expresses statistical

Restlessness

observed before the treatment was 3.1 and after

the completion of the treatment mean was 1.3

(58.2%) relief, which is statistically significant

(<0.001).

Brahmi taila shirobhyanga

significance and clinically satisfaction (table-2, fig-

3) with 60% very good and 34% good results. No

adverse reaction or complaints received during the

treatment.

:

In the present study (

(Linn.) is a brain tonic and enhances memory,

intelligence and longevity, has been used for

. It has other effects such as

pacification of vitiated and skin diseases,

neuralgia, inflammations, epilepsy, insanity, ulcers,

splenomegali, flatulence, fever, and general debility.

plays an effective role

in as is an herb for calming

brain and nervous system. The method

enriches the alkaloid content of , so the

penetrability of oil through the high vascular scalp is

more than normal estimated 2%.

Anxiety has been defined as an unpleasant

emotion described by Ayurveda as and

chattodwega. The present study undertaken with

showed significant in

sleep disturbances, restlessness, fear, depression,

and anxiety. A head massage once in every 3 days

for 15 minutes in 5 patterns is done for 7 sittings on

30 patients. All the subjects were relived from stress

and felt comfortable with good sleep patterns from

the first sitting onwards. The mean gradation of

anxiety was 3.5 and after the treatment it reduced to

1.6. This reduction of 53.2% was statistically highly

significant (<0.001). Hence it can be recommended

that

Discussion

Conclusion:

References

Brahmi Bacopa monnieri

S

Vata Pitta,

Brahmi Taila Shiroabhyanga

Chittodwega Brahmi

Tailapaka

Brahmi

Manas roga

Brahmi Taila Shiroabhyanga

hiroabhyanga

Brahmi Taila Shiroabhyanga is benificial in

treatingAnxiety neurosis and related disorders.

[1] Trivedi JK, Gupta PK., An overview of Indian

research in anxiety disorders, Indian J Psychiatry. 2010

Jan;52(Suppl 1):S210-8.

http://www.ncbi.nlm.nih.gov/pubmed/21836680

[2] Kushangi Bhanushali, Scope of Homoeopathy in the

Treatment of Anxiety Disorders, thesis submitted to

Hahnemann College of Homeopathy, London, 2011,

http://www.pghomeopathy.com/ images/pdf/thesis.pdf

[3] M.S.Bhatia: Essentials of psychiatry, CBS



publications & distributors 4536/1a 11, daryaganj New

Delhi.

[4] Sahoo S, Khess CR , Prevalence of depression,

anxiety, and stress among young male adults in India: a

dimensional and categorical diagnoses-based study.

J Nerv Ment Dis. 2010 Dec;198 (12):901-4. doi:

10.1097/NMD.0b013e3181fe75dc.

[5] Veena kumari, “Role of Guduchyadi Medhya Rasayana

in the Management of Chittodvega W.S.R. To General

Anxiety Disorder,

www.slideshare.net/ayurmitra/ chittodwega-kc013-hyd

[6] Trivedi JK, Gupta PK., An overview of Indian research

in anxiety disorders, Indian J Psychiatry. 2010

J a n ; 5 2 ( S u p p l 1 ) : S 2 1 0 - 8 . H t t p : / / w w w .

ncbi.nlm.nih.gov/pubmed/21836680

[7] Acharya JT ed, The Charaka Samhita with , Ayurveda

dipika, 5 ed.; 1995. Chaukhambha Orientalia, Varanasi P

254

PUB

MED

thesis submitted to RGUHS, Bangalore,

th

[8] Sahoo S, Khess CR , Prevalence of depression, anxiety,

and stress among young male adults in India: a

dimensional and categorical diagnoses-based study.

J Nerv Ment Dis. 2010 Dec;198 (12):901-4. doi:

10.1097/NMD.0b013e3181fe75dc.

[9] V.M.D Namboothiri :A concise text book of psychiatry

second edition pg-147

[10] http:/ /www.who.int/classif ications/icd/en

/bluebook.pdf

[11] Vaidya Yadavji Trikamji Acharya edited Charaka

Samita, Chikitsasthana, 1 chapter, sholoka no-7, Eight

edition 2005, Chaukambha Orientalia P.B.No 1032.Gokul

Bhawan, K 37/109, Gopal Mandir Lane Golghar-

Maidagin Varanasi 221001.

[12] Hanumanthachar Joshi and Milind Parle, Evid Based

Complement Alternat Med. 2006 March; 3(1):

7985.,Http://www.ncbi.nlm.nih.gov/pmc/articles/

PMC1375237/

[13]Yogesh S Deole, BK Ashok, Vinay Shukla, B

Ravishankar, HM Chandola, Psycho-Pharmacological

study on Antidepressant and Anxiolytic Effect of Brahmi

Ghrita,AYU, 2008, Volume : 29, Issue : 2 pp : 77-83

PUB

MED

st



Journal of Indian

System of Medicine

Role of inShigru Twak Kwatha Amavata

Sadhana Misar (Wajpeyi)

Associate Professor, Department of Kayachikitsa, Mahatma Gandhi Ayurved College,

Hospital & Research Center, Salod (H), Wardha. ( )

J

[email protected]

ISM1 H416 Received: May 25, 2013; Accepted: September 14, 2014

How to cite the article: Sadhana Misar(Wajpeyi), Role of Shigru Twak Kwatha in Amavata, J-ISM, V2 N3, July-September 2014,pp.132-138

Abstract

Key words: s

The main pathological factors in the development of this disease are and . Clinically it can be correlated

to Rheumatoid Arthritis. Due to present lifestyle, prevalence of is increasing. The present study

comprised of 60 patients, divided in three groups, each containing 20 patients, Group A (n=20) were given

, Group B (n=20) were given and Group C (n=20) were given

for one month. On analysis of the results, it was found that provided better results as

compared to and in management of . The therapy with

not only helps in reducing the signs and symptoms of but also corrects the pathogenesis of

. In conclusion comparison of therapies i.e. and tablet

Nimesulide revealed that in all respects proved to be a better choice in the treatment of

patients.

Ama Vata

Amavata

Shigru Twak Kwath Simhanad Guggul Nimesulide

Shigru Twak Kwath

Simhanad Guggul Nimesulide Amavata Shigru Twak

Kwath Amavata

Amavata Shigru Twak Kwath, Sinhanad Guggul

Shigru Twak Kwath

Amavata

- Amavata, Rheumatoid arthritis, Shigru Twak Kwath, Simhanad Guggulu

Introduction

Amavata

Ama Vata . Ama apakwa

rasa dhatu

Agnimandya .

Ama

sandhies

Amavata .

rheumatoid arthritis

is a most common inflammatory

arthritis.chronic inflammatory joint disease with

multisystem involvement. It is supposed to be an

incurable and one of the most crippling diseases. The

main pathological factors in the development of this

disease are and [1] is a ,

undigested and fermented which is

produced in the body due to [ 2,3] This

circulates in the body and gets located in the

(joints) causing pain, stiffness and swelling

over the joints. Madhavkara was the first who

described the etiology, pathogenesis, symptoms and

types of ss for the term coined [4]

Clinically it can be correlated to

which is a chronic inflammatory autoimmune

disease involving multiple joints. Due to present

lifestylesedentary lifestyle, prevalence of many

diseases is increasing and is not an

exception to this. affects

approximately 0.5 to 1% of the adult population

worldwide. The figure of prevalence vary

substantially ranging from 0.3% to 2.1% of the

population[5] All over the world an enormous

amount of research work has been done [6 to 13].

Some effective drugs have also been searched but

none of them can be considered as specific. In modern

medicine the treatment of the disease includes

steroids and immunomodulatory drugs along with

non-steroidal anti-inflammatory drugs[14]. Long

term use of these drugs have many adverse effects on

the body and there is obvious need for effective

Amavata

Rheumatiod arthritis

.


Original Article

treatment for In various literature

like

properties of

have been described as

and Treatment of according to

Ayurvedic Classics is carried out as -

and [15] Property of

comprises of

dru processing these properties is ideal in ,

and other [16,17] Hence present study

was planned to evaluate and compare the efficiency

and role of

and tablet Nimesulide patients in

The study was carried out at Department

, Vidarbha Ayurved Mahavidyalaya,

Amravati. Patients were selected randomly from

O.P.D. as well as I.P.D. The study comprised of 60

patients, which were randomly divided in three

groups Group A (n=20), Group B (n=20), Group C

(n=20) were given

and tab Nimesulide respectively Group A

patients were given 100ml 3

times a day, Group B were given

250mg 3 times a day, Group C were given Nimesulide

tablet 100mg twice a day

Group A=Patients were given

100ml 3 times a day .

Group B=Patients were given

250mg 3 times a day.

Group C=Patients were given tablet

100mg twice a day . All the patients were explained

the purpose of the study, a proper consent of patient

was obtained. Assessment of the progress of the

disease was entered into specially prepared proforma.

The patients presenting with signs

and symptoms as per were

preferentially considered. The criteria set up by the

Amavata. Ayurveda

Bhavaprakash, Shushrut Samhita, Vagbhat

Samhita, Dhanvantari Nighantu Shigru

Deepan, Pachan, Shothahar

Shoolahara. Amavata

Langhan,

Swedan, Tikta, Katu ,Deepan Drugs, Virechan,

Snehapan Basti . Shigru

Tikta, Katu Ras, Laghu, Ruksha Gun,

Ushna, Virya, Nand, Katu, Vipaka Deepan, Pachan,

g Amavata

Vata Vyadhies .

Shigru Twak Kwath, Simhanad Guggul

Amavata.

Kayachikitsa

Shigru Twak Kwath, Simhanad

Guggul

Shigru Twak Kwath

Simhanad Guggul

.

Shigru Twak

Kwath

Sinhanad Guggul

Nimesulide

Madhav Nidana

Material and Methods

Inclusion Criteria

ARA 1988 were also taken into consideration as

follows Morning stiffness lasting for >1 hour,

Arthritis of three or more joints, Arthritis of hand

joints, Symmetrical Arthritis, Presence of

Rheumatoid nodules, Presence of Rheumatoid

factors (RA factor), Radiological changes, Duration

>=6 weeks, First four criteria must be present for

duration of 6 weeks or more, Diagnosis of

Rheumatoid arthritis was made with four or more

criteria .[18]

Patients suffering from hypertention,

diabetes mellitus, traumatic or infective joints,

ischemic heart disease, tuberculosis and other

systemic disorders,

Chronicity for more than 10 years, Having severe

crippling deformity and

Irregular follow up were excluded.

All the patients were screened for

investigations like Hb%, TLC, DLC, ESR, RA

factor, urine routine examination, ASO titer before

and after treatment. Observations were recorded in

the tabular form and thereafter results were worked

out.[19]

The was prepared from

fresh bark . Prepared was given to the

patients three times a day that is 8 hourly. Every time

a fresh was prepared and was administered in

lukewarm state.

was prepared by the

method given inAyurvedic Classics [21]

Nimesulide is a non-steroidal anti-

inflammatory drug of the sulphonanilide class.[22]

1) -

In case of big joints of the lower limbs the

patients were asked to walk. If not, asked to move the

joint. For the joints of the upper limbs , patients were

Shigru Twak Kwath

Shigru

Kwath

Simhanad Guggul

Exclusion criteria:

Investigations:

Preparation of :

Preparation of

ClinicalAssessment

Joint pain

Shigru Twak Kwath

Simhanad Guggul:

[20]

133Journal of Indian System of Medicine Vol.2-Number 3, , 2014July-September

Sadhana Misar(Wajpeyi), Role of Shigru Twak Kwatha in Amavata, pp.132-138

asked whether they can work with the affected limb

joints, if not, asked to move the joint. Grading of pain

was done as follows :

1. Severe pain Pain so severe that patient

could not move the joint at all.

2. Moderate pain Patient could not work or

walk but some movement of joint was possible (

movement was very painful )

3. Mild pain Patient could walk or work and

the pain was bearable.

The severity of pain at “0” day was

considered to be 100%. Then at 1 , 2 , 3 and 4

week the reduction of pain was noted as 25% , 50% ,

75% and 100% reduction with reference to “0” day ,

as described by the patient.

2)

Joint tenderness was recorded with the help

of sphygmomanometer and a 10 ml. syringe. The

sphygmomanometer cuff was removed and the

nozzle of the syringe, the piston fully withdrawn till

the graduated marking was connected to the tubing of

the sphygmomanometer ( mercury column ).

The point over the affected joint which was

most tender was selected and the particular joint

tested was noted in the case sheet of the patient. The

base of the piston of the fully withdrawn syringe was

kept on the selected tender point and the barrel was

pushed against the joint as a result this causes

pressure over the affected joint and patient starts

feeling pain as the pressure is increased. At the same

time the air in the syringe raises the mercury column

in the sphygmomanometer. The sphygmomanometer

reading where the patient starts, feeling pain was

recorded. As it signifies initiation of tenderness such

3 readings were taken at the same point in the samse

joint in one sitting. Average of the three was recorded

in the case sheet of the patient. The test was carried

out in the same joint after completion of the

treatment.

3)

This is useful to assess the functional power

st nd rd th

Joint Tenderness

Grip Power

of wrist and smaller joints of the hands. For this the

patient is asked to press the inflated cuff of

sphygmomanometer with one hand at a time.

Reading was taken before treatment ( 0'day ) , 1

week , 2 week, 3 week , 4 week. When after

treatment the reading was increased by +10 mm Hg a

power of wrist and smaller joints was considered to

be improved.

4)

Morning stiffness was assessed by asking the

patient to walk fixed distance (50 feet) and the time

was noted in seconds. Reading was taken before

treatment ( 0'day ), 1 week, 2 week, 3 week, 4

week. It was considered to be improved. When there

was decrease in time for at least 5 sec. after the

treatment.

5)

The measurement of the joint

swelling was done on the first visit of the patient. The

circumference of the affected joint was measured in

the centimeters at the broadest part. After 1 , 2 , 3

and 4 week the same joint was measured at the same

broadest part. The percent reduction of swelling was

calculated.

6)

This was estimated by measuring the

degree of limitation based on comparison with the

normal joint. In this active as well as passive

movements were recorded. For actual range of

movement “Goniometer” can be used.

7)

This was done by feeling the

temperature of normal part and soon after the affected

part with the help of dorsum of the hand. It was

labeled either normal or raised.

8)

This is useful to assess the functional states

of shoulder, elbow and wrist joint. For this the patient

was asked to press the inflated cuff of

sphygmomanometer by both hands. Readings were

taken before treatment ( 0'day ), 1 week, 2 week, 3

st

nd rd th

st nd rd th

st nd rd

th

st nd rd

Morning Stiffness

Joint Swelling

Range of Movement

Local temperature of Joint

Pressing power



week, 4 week. It was considered to be improved

when increased by +10 mm of Hg.

The obtained information was analyzed

statistically. Student's paired 't' test was applied to

assess the statistical significance of results of different

therapies before and after treatment .The level of

statistical significance was judged as per the 'p' values

as given below

a)p>=0.05 Not significant

b)p<0.05 significant

c)p<0.01 highly significant

Table 1 shows effect of different parameters like joint

swelling, tenderness, grip power, pressing power &

walking time. It is seen that Group A is showing

highly significant effects on all parameters.

Table 2 is showing comparative percent relief (No. of

patients) in signs & symptoms. Group A is seen to

have about 80-90% relief in all symptoms as against

saganst Group B & C .

The basic pathology in the is the

formation of in the body due to

followed by vitiation of all the three ,

predominantly [23].

properties,

hence it has

properties which help in breaking

pathogenesis of [24 to 29]. Due to

property it corrects It also

digests and reduces excessive

removing the obstruction of

removes

the adhered from [30].

Out of 60 patients studied, the maximum no.

of patients (53.33%) belonged to 30 40 yrs. of age

group. It was more frequently observed in females

(65%)[31] It was observed that urban population was

th

Statistical methods used

Result

DISCUSSION

Amavata

Ama Agnimandya

Doshas

Vata Shigru has Katu Tikta Rasa,

Laghu Ruksha Guna, Ushna Virya, Katu Vipaka,

Deepan, Pachan, Shothahar and Shulahar

Amapachan, Vata Kapha Shamaka,

Strotoshodhaka

Amavata

Agnivardhak Agnimandya.

Amarasa Kapha,

Strotasas. Lekhana

Karma of Laghu, Ruksha Guna and Tikta Ras

Doshas Dushita Strotas

.

more affected (63.33%), maximum patients

(73.33%) were from middle socioeconomic group.

Maximum no. of patients (55%) were having

and (65%). It was

found that in Group A 11 patients (55%) got 50%

relief from severe pain whereas in Group B and C, 9

patients (45%) and 12 patients (60%) got relief from

severe pain. Reduction of local temperature temp. of

joints was better with Group A than Group B and C.

The improvement in range of joint movement was

more in Group A (65%) than Group B (30%) and

Group C (60%). Joint swelling revealed that Group

A had highly significant 't' (5.36) and 'p' (p > 0.01)

values as against moderately significant values

found in Group C ( t=2.63 and p < 0.05) and non

significant values (t=2.06 and p >= .05) found in

Group B. Grip power results showed highly

significant values (t=4.2 and p < 0.01 ) in Group A

than Group B (t=2.01 and p>=0.05) and Group C

(t=2.95 and p<0.05). Pressing power results showed

highly significant values in Group A (t=5.51 and

p<0.01) and Group C (t=4.16 and p<0.01) and non

significant values in Group B (t=2.5 and p>0.05).

Walking time assessment for lower limb joints 't' and

'p' values were highly significant in Group A (t=5.49

and p<0.01), significant in Group C (t=2.81 and

p<0.05) and non significant in Group B (t=2.00 and

p>= 0.05).

Mean Hb% improvement was more than 1

gm% as compared to 0.05 gm% and 0.04 gm % mean

rise in Group B and Group C respectively.

Measurable fall in ESR (Mean 20 mm/hr.) was seen

in Group A indicating good prognosis with its

undoubted anti inflammatory property. RA test

response was non conclusive in all the three groups

because of shorter duration of treatment. ASO titer

was not found positive in this study. Out of the

symptoms studied i.e.

Vatakaphaja prakruti Mandagni

Aruchi, Agnimandya,

Trishna, Alasyam, Gauravam, Jwar, Apak,

Angamarda, Sandhishotha, Sandhishool,

Sandhigraha, Bahumutrata, Nidraviparya,



Malavaddhata, Shigru Twak Kwata

Shigru

Shigru Twak Kwath

.

Shigru Twak

Kwath

Amavata

Shigru Twak Kwath

Amavata

Amavata

Shigru Twak Kwath, Sinhanad Guggul

Shigru Twak Kwath

Amavata

etc. in the group

percent relief (no. of patients) in signs and symptoms

was highest about 80 90% whereas in Group C it was

60 70%.

is freely available everywhere at no

cost. It can be also stated that has

negligible side effects as compared to those of tablet

Nimesulide such as nausea, gastric irritation,

vomiting, peptic ulceration, hypersensitivity,

etc.[32] It is further recommended that long term

studies will confirm the efficacy of

over Nimesulide in respect to the recurrence

of the disease after stoppage of treatment and

prevention of long term complications of

such as deformities, renal and respiratory

complications. The therapy with

not only helps in reducing the signs and symptoms of

but also corrects the pathogenesis of

.

In conclusion comparison of therapies i.e.

and tablet

Nimesulide revealed that in all

respects proved to be a better choice in the treatment

of patients.

Conclusion:

References:

[1] Upadhyaya Yadunandan ,Madhavnidan (Madhukosh)

Part 1 ,Chaukhamba Prakashan, 2008,p.508

[2] Shinivasulu M.,Concept of ama in Ayurveda,

Vishishta rog chikitsa (Amavata) ,Banaras Ayurved series

11 ,chapter 9, 1st Edition, 2005,p. 99

[3] .Shrinivasulu M., Concept of Ama in Ayurveda, ,

Formation of Ama at different level, Banaras Ayurved

Series 11, 1st edition, 2005, p. 37.

[4].Singhal G.D. , Madhav Nidan (Ayurvedic

ClinicalDiagnosis), Part 1 Amavata Nidanam 25th

Chapter, 2007, p. 453.

[5] Shah Ankur, E. William St. Clair, Harrison's Principles

of Internal Medicine Volume 2, 18th edition, Chapter 321,

RheumatoidArthritis, p. 2738.

[6] Bhavana,.Dwivedi K.K.,Shukla K.P., Clinical

evaluation of Swedan and Ayurvedic compound drug in

Amavata vis-à-vis Rheumatoid Arthritis, the journal of

MML Centre for Rheumatic diseases (Rheumatism)

December 93, Volume 29.

[7] Udupa K.N., Chaturvedi G.N. and Tripathi S.N., the

diagnosis of Amavata (Rheumatoid Arthritis), Advances

in research in Indian Medicine 1970, Banaras Hindu

University, Varanasi, India.

[8] Jhala Jigisha,. Gurdip Singh,Vyas S.N., A Clinical

Study on the role of Virechana and Dashmula Kshara

basti in the management of Amavata, Ayu, Gujarat

Ayurved University, Jamnagar, June 1996.

[9] Pandey S.A., Joshi N.P.,Pandya D.M., Clinical

efficacy of Shiva Guggulu and Simhanad Guggulu in

Amavata (Rheumatoid Arthritis), AYU, April-June 2012,

Vol. 33, Issue 2, p.247.

[10] Soni Anamika, Patel Kalapi,.Gupta S.N., Clinical

evaluation of Vardhamana Pippali Rasayana in the

management of Amavata (Rheumatoid Arthritis), AYU

April-June 2011, Vol. 32, Issue 2. p.177.

[11] SachitraAyurved, Role of Sigru Patra Pindasweda In

Sandhi Gata Vata A Clinical Study, A journal on Ayurved

and Health, Nov. 1999, Vol. 5, p.576 585.

[12] Barve Anand, Deshpande Sadanand, Amavatata

Vaitarana Basticha Upayoga, Ayurvidya, Sept.1998,

p.13.

[13] N. Kumar and A. Kumar, An applied aspect of

Rheumatoid Factor in Rheumatoid Arthritis An

Ayurvedic Approach, Journal of research in Ayurveda

and Sidhha, Vol. XVI, No. 3-4, (1995), p. 134-142.

[14] Nicki R.Colledge, Brian R.Walker, Stuart

H.Ralston, Davidson's Principles and Practice of

Medicine, 21st edition, 2010, p. 1094

[ 1 5 ] S h a r m a P. V. , C h a k r a d u t t a , A m a v a t a

Chikitsa,Edition 2007 Chap. XXV, p.227.

[16]Ambika Dutta Shastri Ayurvedacharya, Bhaishajya

Ratnavali, Amavata Chikitsa Prakaran, 19th edition,

2008, p.613.

[17] Chunekar, Bhavprkash Nighantu (Indian Materia

Medica), 2013, p.326.



Medicine, 21st edition, 2010, p.1089



Medicine, 21st edition, 2010, p.1091





Table 2 : Comparative effects of the three drugs on different signs and symptoms in in

the studied groups

Amavata

1 : Effects of different Parameters Before treatment (B.T.) and After treatment (A.T.) with their

't' and 'p' values

Group A Group B Group C

Parameters B.T. A.T D t p B.T. A.T d t p B.T. A.T d t P

1 Swelling

in cms

(Mean +/-SEM)

18.3

±

0.74

16.1

±0.78

2.2

±0.41

5.36 P<0.01 18.1

±0.65

17.3

±0.76

0.8

±0.38

2.06 p=0.05 17.9

±0.65

16.9

±0.47

1

±0.38

2.63 P<0.05

2 Tenderness

in mm of

Hg(mean)

60.7

±2.96

74.9

±4.39

14.2

±2.56

5.54 P<0.01 54.9

±3.78

63.1

±4.75

8.2

±2.41

3.4o p=0.05 61.7

±3.81

71.7

±3.62

9.4

±2.45

3.83 P<0.05

3 Grip

Power inmm of

Hg(mean)

28.72

±1.18

36.63

±1.61

4.9

±1.15

4.2 P<0.01 31.16

±1.58

32.5

±1.5

1.33

±0.66

2.01 p=0.05 31.4

±1.68

35

±2.35

3.6

±2.35

2.95 P<0.05

4 Pressing

Power in

mm ofHg(mean)

39.6

±0.74

46

±1.26

6.4

±1.16

5.51 P<0.01 40

±1.15

43.33

±0.66

3.33

±1.33

2.5 p=0.05 38.66

±1.76

46

±1.15

7.33

±1.76

4.16 P<0.05

5 Walking

Time in

Sec.(mean)

25

±0.7

20

±0.81

5

0.81

5.49 P<0.01 23.6

±1.28

21.8

±1.74

1.8

±0.91

2 p=0.05 24

±0.53

21.57

±0.09

2.42

±0.86

2.81 P<0.05

Group A Group B Group C

Signs &Symptoms

B. T.(no of

pts.)

A.T.(no

ofpts)

% relief(no of

pts)

B. T.(no of

pts.)

A.T.(no of

pts)

% relief(no of

pts)

B. T.(no of

pts.)

A.T.(no of

pts)

% relief(no of

pts)

1 Aruchi 18 3 83.33% 17 5 70.58% 19 4 78.94%

2 Agnimandya 20 3 85% 19 4 78.94% 18 4 77.77%

3 Trishna 14 2 85.74% 12 5 58.33% 14 4 71.42%

4 Alasyam 19 4 78.94% 18 6 66.66% 17 5 70.585 Gauravam 16 3 81.25% 15 5 66.66% 17 4 76.47%

6 Jwar 18 0 100% 14 3 78.75% 16 0 100%

7 Apak 17 2 88.23% 18 4 77.77% 19 4 78.94%

8 Angamarda 19 3 84.21% 18 8 55.55% 18 4 77.77%

9 Sandhishoth 20 7 65% 20 12 40% 20 8 60%10 Sandhishool 20 1 95% 20 6 70% 20 2 90%

11 Sandhigraha 20 7 65% 20 14 30% 20 9 55%12 Bahumutrata 6 2 66.66% 5 3 40% 4 2 50%

13 Nidraviparya 16 4 75% 15 5 66.66% 14 4 71.42%14 Malabaddhata 10 2 80% 16 2 66.66% 8 4 50%

138 Journal of Indian System of Medicine Vol.2-Number 3, , 2014July-September


[20]Srikantha Murthy K.R.,Sharangdhara Samhita,

Chaukhamba Prakashana Varanasi,7th edition2007,p.56

[21]Shastri Shrilaxmipati, Yogaratnakar,Chaukhamba

Prakashana,,Amavata Nidana, edition 2011,p.569

[22]Laurence L. Brunton ,Goodman and Gliman's The

Pharmacological Basis Of Therapeutics ,12 th

edition,2011,p. 992

[23] Rastogi Sanjeev ,Singh R.H.,Advances in Ayurved

Medicine ,Chaukhamba Vishwa Bharti ,1st Edition,2005,

p. 18

[24].Deshpande A.P., Ranade Subhash, Dravyaguna

vidnyana, 2010 July, p.340.

[25] Sharma P., Dravyagunvidnyana Part 2, 2005, p.111.

[26] Gokhte V.M., Ayurvedic Pharmacology and

therapeutic uses of medicinal plants (Dravyagun

vidnyana), Edition 2012, p.499. [27 ShastriAmbikadatta,

Sushrutsamhita (Sootrasthan), Shaakavarga, 2014, p.262.

[28] P.S. Varier's Arya Vaidya Shala, Kottakkal, Indian

Medicinal Plants Vol.4, 2007, p.59.

[29] Desai V.G., Aushadhi Sangraha, Chap.no.235, 1975,

p.194

[30]Tripathi Indradev, Chakradutta, Chakrapanidutta

virachita,Amavata Chikitsa, 4th edition, 2002, p.166.

[31]. Nicki R.Colledge, Brian R.Walker, Stuart H.

Ralston: Davidson's Principles and Practice of Medicine,

21st edition, 2010, p.1088.

[32]Laurence L. Brunton ,Goodman and Gliman's The

Pharmacological Basis of Therapeutics ,12th

edition,2011,p. 973

Journal of Indian

System of Medicine

Importance of Stool Examination in BabiesSagar M. Bhinde

I/C Head & Assistant Professor, Dept. of Kaumarbhritya, G J Patel Institute of

Ayurved Studies & Research Center, New V V Nagar, Anand. ([email protected])JISM1417N Received: May 29, 2014;Accepted: September 14, 2014

Review Article

How to cite the article: Sagar M. Bhinde, Importance of Stool Examination in Babies, J-ISM, V2 N3, July-September 2014, pp.139-

142

Abstract:

Key Words:

Mala Pariksha

Samhita Kala

Mala Pariksha

Balaroga

Mala Pariksha

(stool examination) has been emphasized as important examination tool after the era of Acharya

Yogaratnakara. Before that, in , characteristic of stool has mentioned in scattered manner in the

symptomatology of various diseases. In clinical practice, the importance of has been declined

day by day due to the easy availability of other examination tool. But in pediatric age group it is still holding the

key role in the way of diagnosis. History taking doesn't have much importance in (pediatrics). Because

Pediatric group cannot complain their pain and discomfort and examiner should gather the information by

observation and examination only. So in this paper an attempt has been made to correlate the various stool

characteristics with condition of the baby.

, Baby's stool, Stool examination in InfantileAge Group

Introduction:

Aims and objectives:

Mala Pariksha

Ashtavidha

Pariksha

has been emphasized as

important examination tools since the era of Acharya

Yogaratnakara, during the discussion of

(eight fold examinations) [1]. Ailments of

Pediatric group are so difficult to diagnose, as baby

cannot complain their pain and discomfort. In such

kind of condition history taking could not be the best

way rather examination will be the choice to reached

to the confirm diagnosis. [2] Most new parents find

baby stool quite surprising. It has so many shades and

consistencies that even experienced parents may not

have seen them all. Thus an examination by doctor is

very important in the pediatrics. Various

characteristic of stool and health condition of baby

has been discussed in this paper. In infantile age

group one should very keen to differentiate the

physiological and pathological condition in various

areas including stool.

To understand the health conditions of a baby by

merely examine the stool.

Material & method:

Data and discussion:

Newborn stool (meconium): Photograph no 1

This article is purely based on information

which was collected through various authentic

books, journals, and internet. A critical review has

been done for this important issue.

It is easy way to examine the nappies of baby

to get all information regarding the color,

consistency and smell of the stool. The photographs

may give a better idea of what's normal and what's

not, especially when the baby is newborn. As

newborn grows, drinks breast milk or formula, and

starts eating solids. One should find out when not to

worry and when it's wise to be concerned. Some

important features of the stool have been discussed

underneath.

1.

Newborn's diaper may have greenish-black,

tarry, sticky stool that looks like motor oil. Since

meconium is made of amniotic fluid, mucus, skin

cells, and other substances ingested in utero, it

doesn't smell.After 2 to 4 days, stool becomes lighter


140 Journal of Indian System of Medicine Vol.2-Number 2, April-June, 2014

in color (sort of an army green) and less sticky. This is

called transitional stool which is a sign that breast or

formula milk digestion started and intestinal tract is

okay.

2.

If baby is exclusively breastfed, stool will be

yellow or slightly green and have a mushy or creamy

consistency. always suggests the

healthy integrity of ones intestine. [3] It could be

runny enough to resemble diarrhea. Breastfed stool

typically looks like mustard and cheese mixed

together and may be dotted with little seed-like

flecks and smell isn't so bad. Still there are many

shades of normal in breastfed baby. If baby doesn't

experience any other symptoms, there's no need to

give medications.

Bright green and frothy stool might be due

to, too much foremilk (the low calorie milk that

comes first in a feeding) and not enough hindmilk

(the higher fat and super nutritious). It could mean

that mother is not feeding her baby, long enough on

each breast. Remedy to this, starting each feeding on

the breast ended upon.

Formula-fed babies have pasty, peanut

butter-like stool on the brown color spectrum: tan-

brown, yellow-brown, or green-brown. It's more

pungent than stool from breastfed babies and a little

less pungent than stool from babies who are eating

solid food.

If baby is on an iron supplement, his stool

may turn dark green or almost black. This doesn't

happen often, but it's a completely normal variation.

But if baby is not taking an iron supplement and still

stool looks blackish, then it could be melena.

Once baby start changing the input to solid

foods (rice cereal, pureed bananas and so on) almost

instantly a change in their output can be observed,

especially if baby is breastfed. Solid-food stool tends

to be brown or dark brown and thicker than peanut

butter, but still mushy. It's also smellier.

Healthy breastfed stool: Photograph no 2

3. Healthy formula fed stool: Photograph no 3

4. Iron-fortified stool: Photograph no 4

5. Solid-food stool: Photograph no 5

Nirama Mala

6. Stool with partially digested food:

Photograph no 6

7. Diarrhea: Photograph no 7

8. Constipation: Photograph no 8

Sama Mala

Stool will have identifiable chunks of food in

it or be tinged with a surprising hue of the rainbow,

like red, orange or dark blue. Red could mean beets,

orange suggests carrots, and dark blue implies grapes

(pieces of the skin of grapes could also be there). If

dropped in water, stool will sink to the bottom. This is

identified as . [4] It could happen because

certain foods are only partially digestible or travel so

quickly through the intestines that they don't break

down completely. It also happens when baby eats a

lot of one type of food or doesn't chew a mouthful

completely before he swallows. This all condition

could bring plenty of disease condition in adult, but

this could be normal in pediatric age group. The

matter of concern is if baby's stool consistently has

undigested food in it.

In babies, diarrhea is very runny and appears

to be made up of water more than solids. It can be

yellow, green, or brown and can seep out of the

diaper.

Diarrhea can be a sign of an infection or

allergy, and if it lasts for a while without being

treated, can lead to dehydration. The stages of

dehydration can change very rapidly in babies. if

baby is 3 months old or younger, has more than two

or three diarrhea-filled diapers,[5] or continues

having diarrhea for more than a day or two then it

must be taken seriously. It is matter of concern if

baby's diarrhea contains visible blood or mucus.

In constipated baby's stool will be hard and

looks like little pebbles. Baby may be visibly

uncomfortable when deficating and the stool may

even be tinged with blood from irritating the anus on

the way out. One or two pebbly diapers isn't a

concern, but if baby has three or more (or if bloody),

it's best to attend the problem immediately.

Constipation often happens in babies who are being

introduced to solid foods, or it can be a sign of milk or

soy protein sensitivity or a lack of tolerance to

Sagar M. Bhinde, Importance of Stool Examination in Babies, pp.139-142

something in breast milk or formula. It is

recommended giving water, juice or honey to move

things along.As per Ayurveda it can be taken as

aggravated stool. [6]

Greenish stool streaked with shiny,

glistening strings means there is mucus in it. Mucus in

stool is also a sign of an infection or allergy. If it's

accompanied by any other symptoms or shows up in

baby's diaper for two days or more, it is time to rule

out the problems.

Sometimes the blood in a baby's stool is bright red,

and sometimes it's black (which means it's been

digested). Bright red blood can show up in baby stool

for a few different reasons.

Normal stool tinged with red blood, which is often a

sign of a milk protein allergy

Constipated stool with a hint of red blood,

likely a result of tears in the anus or tiny hemorrhoids.

Diarrhea mixed with red blood, which can indicate a

bacterial infection.

When black blood appears in a baby's diaper

usually in little flecks that look like black sesame

seeds, it's often because the baby is breastfed and

swallowing blood from Mother's cracked and

bleeding nipples, it doesn't pose a threat to baby. Still,

doctor should make sure that, it's not something more

serious, like bleeding from baby's intestines.

:

The character of the stool in older children is

more variable than in adult. Some healthy children

pass frequent, loose stools containing undigested

vegetable matter 'toddler's diarrhea'. But the stool of

children with celiac disease or cystic fibrosis is bulky,

odoriferous and quite characteristic. [7] Thus it is very

important for a pediatrician to know that what is

normal and what is abnormal (alarming sign) in baby

regarding the stool. As initial one or two years of

postnatal life are main age for somatic growth, [8]

baby requires proportionally more intake during this.

That's why; Kashyapa has mentioned the

importance of food intake by telling

Vata

Acharya

Ahara

9. Stool with mucus: Photograph no 9

10. Bloody stool: Photograph no 10

Conclusion

Mahabhaishajam. [9] Amount of intake, Quality of

assimilation and status of intestine is very faithfully

understood by the examination of stool. Pediatrician

should neither act in hurry (in physiological

condition) nor delayed (in pathological condition) in

the disease of elementary canal. Thus stool

examination must be included in the routine practice

while examining the infants or young toddlers.

[1] Vaidhya Shree Lakshmipati Shastr i ,

'Yogaratnakara', Chaukhambha Prakashana Varanasi,

reprint 2012, Purvardha, Roginam Ashtasthana

Nirikshana, shloka No. 1; Page no. 5

[2]Pandita Hemaraja Sharma, 'Kashyapa Samhita',

Chaukhambha Sanskrita Samsthana Varanasi, reprint

2008, Sutra Sthana 25 Vedanadhyaya, Shloka No.

4; Page no. 33

[3] Acharya Sushruta, 'Sushruta Samhita', Dalhana

Commentary, edition-reprint 2009, Chaukhambha

Sanskrita Samsthana, Uttara tantra 40 - Atisara

Pratishedha, Shloka No. 18; Page no.698

[4] Acharya Sushruta, 'Sushruta Samhita', Dalhana

Commentary, edition-reprint 2009, Chaukhambha

Sanskrita Samsthana, Uttara tantra 40 - Atisara

Pratishedha, Shloka No. 17; Page no.698

[5] Nelson, 'Essentials of Pediatrics', 5 edition 2005,

Elsevier Publisher, Page no 587

[6] Vaidhya Shree Lakshmipati Shastr i ,

'Yogaratnakara', Chaukhambha Prakashana Varanasi,

reprint 2012, Purvardha, Mala Pariksha, shloka No.

1; Page no. 12

[7] Robert Hutchison, 'Clinical methods- a guide to

the practical study of medicine.' casell and company

limited, 22nd edition 2013, Page no.333

[8] O P Ghai, 'Essential Pediatrics', 6 edition; 2005,

Growth and development, Page no. 3

[9] Pandita Hemaraja Sharma, Kashyapa Samhita,

Chaukhambha Sanskrita Samsthana Varanasi, reprint

2008, Khila Sthana 4 - Yush Nirdeshniya, Shloka

No. 6; Page no.249

References:

th

th

th

th

th

th




Photograph no 1 Photograph no 2 Photograph no 3

Newborn stool (meconium) Healthy breastfed stool Healthy formula fed stool


Iron-fortified stool Solid-food stool Stool with partially digested food


Diarrhea Constipation Stool with mucus

Photograph no 10

Bloody stool


Journal of Indian

System of Medicine

A Brief Review of Pre-Clinical and Clinical

Researches on ( Linn.)Vacha Acorus calamusPravin Masram Dhiraj Singh Rajput

1 2

1

2 .

Ph.D.Scholar, Department of Kaumarbhritya I.P.G.T. & RA Gujarat Ayurved

University Jamangar Gujarat, Asst Professor, Department of Rasashatra

And Bhaishajyakalpana, Ashwin Rural Ayurveda Collage and Hospital,

Manchi Hill Sangamner, MaharashtraJISM1410N Received:April 29, 2014;Accepted: September 14, 2014

Review Article

How to cite the article: Pravin Masram, Dhiraj Singh Rajput, A Brief review of pre-clinical and clinical researches on Vacha

(Acorus calamus Linn), J-ISM, V2 N3, July-September 2014, pp.143-147

Abstract

.

Key words:

:

Linn. is a useful medicinal plant which gives benefit in different fields of medicines.

This herb is generally used from the Ancient and Vedic periods due to its wonderful power of rejuvenation of

brain, nervous system and normalizing the appetite. leaves and rhizomes have been used medicinally

against different ailments such as fever, asthma, bronchitis, cough and mainly for digestive problems such as gas,

bloating, colic, and poor digestive function has many wide varieties which were used in

different studies possesses antimicrobial, anti-inflammatory, antioxidant, antidiarrheal, antiulcer,

antispasmodic, immunosuppressant and mitogen inhibitor activity. They were also used in the treatment of

simple diseases such as stomach cramps, toothache, colic, fever, throat irritation, and cough and also in the

treatment of the severe diseases like nephropathy, chronic diarrhea, tumors and epilepsy. Some research works

has been published on the beneficial effects of this drug. Hence in present study an attempt has been made and

review work has been carried out on various therapeutic aspect of

Vacha (Acorus calamus )

Vacha

Acorus calamus

Acorus calamus.

Vacha, Acorus calamus, Pre-Clinical and Clinical researches

Introduction:

or sweet flag or bunch plant

has been known as medicinal plant since from ancient

period. It is one of the most utilized and valuable plant

in the Indian medical system almost throughout the

India. The word 'acorus' is originated from the Greek

divine word 'acoron' used by the Dioscorids derived

from the 'coreon' word means 'pupil' because it is used

in the treatment of eyes diseases and its inflammation

[1].

The rhizome is extensively used as nervine

tonic, hypotensive, sedative, analgesic, spasmolytic,

and anticonvulsant. It is also used for bronchial

catarrh; The Ayurvedic Pharmacopeia of India

indicates the use of dried rhizomes as a brain tonic for

memory impairment and epilepsy [2] Wide range of

Acorus calamus

.

utility of this drug has attracted traditional as well as

modern researchers. There are numerous

formulations of found mentioned in

classical texts which indicated therapeutic

importance of this drug. Some research works are

also conducted and published on specific property of

Although such published works

have some limitations as they emphasis on single

property of test drug and it is well known truth that a

single drug can be utilized in treating various

ailments. According to various published research

works, Acorus calamus contain various active

constitutes which are beneficial as antibacterial,

antifungal, antidiabetic, anti-inflammatory,

antihepatotoxic, antispasmodic, anti-diarrhoeal,

anticancer, bronchodilatory, anti-depressant and in

Acorus calamus

Acorus calamus.


Pravin Masram, Dhiraj Singh Rajput, A Brief review of pre-clinical and clinical researches on Vacha (Acorus calamus Linn),pp.143-147

ischemic heart disease. Hence in present work an

attempt has been made to make a brief review on pre-

clinical and clinical research work done on

Present work will help in knowing wide

range of therapeutic properties of Acorus calamus

and will also establish importance of this valuable

drug in the field of medical science.

A brief review of pre-clinical and clinical

published research works done on

Linn has been collected, studied and the valuable

conclusions has been withdrawn. The compiled

information was interpreted with the therapeutic

properties of . mentioned in

Ayurvedic classics and the probable mode of action

with its significance is discussed to establish

therapeutic importance of this medicinal herb. An

attempt has also been made to establish the

pharmacodynamic and pharmacokinetic action based

on findings of research works and the phytoconstitute

present in .

According to an anti-microbial study, the leaf

and rhizome part of are found to

possess the antibacterial activity. The methanolic

extract of showed the inhibitory

action against the bacterial strains of

and [3] This

study supports the use of mentioned

in Ayurveda such as (anti-microbial) and

(anti-pyretic).

rhizomes has been reported to

possess the antifungal activity against the yeast strain

of ,

and also against

has been found to be

good inhibition on the fungi strains of

Acorus

calamus.

Acorus calamus

Acorus calamus

Acorus calamus

Acorus Calamus

Acorus Calamus

Salmonella

typhi, Pseudomonas aeruginosa, Klebsiella

pneumoniae, Staphylococcus aureus .

Acorus calamus

Krimighna

Jwaraghna

Acorus Calamus

Candida Albicans Cryptococcus Neoformans,

Saccharomyces Cerevisae [4],

Aspergillus Niger [5].

Acorus calamus

Pencillium

Material and methods:

Antibacterial study:

Antifungal study:

An in-vitro study on β-asarone compound

fraction obtained from the crude methanolic extract of

The α- and β- asarone

compound which were isolated from the different

extracts of

Chrysogenum Aspergillus Niger, Aspergillus

Flavus, Microsporum Canis

Cryptococcus Gastricus Candida Albicans [6]

Acorus calamus

Kushtha Acorus

calamus Tikta Katu Rasa, Katu Vipak

Ushna Virya.

Bhrajaka

Ranjaka Pitta Pitta Dosha

Acorus calamus

Acorus calamus

Acorus

calamus

Acorus calamus.

Acorus calamus

Acorus

calamus Tikta Rasa Medhya

Acorus calamus

Acorus

calamus

Acorus calamus

,

and yeast strain of

and

has been included as an ingredient in

many formulations indicated in treating various

(skin disease).As mentioned earlier,

is and in has

and All these properties are very useful

in restoring the malfunction of and

(types of which are

responsible for colour, appearance of skin and

normal formation of blood cells respectively). Thus

acts as good anti-fungal drug.

is widely used in the

treatment of diabetes in the traditional folk medicine

of America and Indonesia. A research work utilized

four fractions obtained from the radix of

to study insulin releasing or alpha-

glucosidase inhibitory action [7]. The ethyl acetate

fraction of has been found to

possess hypoglycemic, hypolipidemia and other

beneficial effects through the mechanism of insulin

sensitizing and hence possess the great potential for

the treatment of diabetes and other cardiovascular

complications [8]. Use of for anti-

diabetic purpose is limited in Indian system of

medicine but utilized as nerve tonic and memory

enhancer. It is understood that properties of

such as and are good

anti-hyperglycemic effect and to prevent diabetic

neuropathy.

is a traditional remedy for

the inflammation problems but their biological

function in the human skin cells not well

characterized. In an anti-inflammatory study,

has been found to inhibit the expression of

polyI: C-induced IL-6 and IL-8 which indicates their

inhibitory effect on the expression of the cytokines

which were likely to be in association with the

suppression of NF- B activation and phospho-

rylation of IRF3 which shows can

Antidiabetic study:

Anti-inflammatory study:

κ


be used as a promising immunomodulatory agent in

the inflammatory skin diseases [9].

has been also found to have inflammatory activity in

the tested rat model of vincristine induced painful

neuropathy and chronic constriction injury induced

neuropathic pain in rats [10].

A research work had found that

possesses good anti-hepatotoxic activity.

According to this research work, the antihepatotoxic

activity of the ethanolic extract of the plant is due to

increase in the level of serum hepatic enzymes such as

glutamate oxaloacetate transaminase (GOT),

glutamase pyruvate transaminase (GPT), alkaline

phosphatase (ALP) and total bilirubin in tested models

which has in turn showed their recovery from

hepatocellular damage in the hepatotoxicity induced

animal model. This indicates the ethanol extract brings

the anti-lipid peroxidation and / or adaptive nature of

the systems against the free radicals damaging effect

[11].

An antispasmodic and anti-diarrheal study

was conducted in rabbits by using calcium channel

blockers. According to this study, in the isolated rabbit

jejunum preparation the crude extract (Ac. Cr), which

tested positive for the presence of alkaloid, saponins

and tannins, caused inhibition of spontaneous and high

K (80 mm) induced contractions, with respective EC

values of 0.42 ± 0.06 and 0.13 ± 0.04 mg/mL, thus

showing spasmolytic activity, mediated possibly

through calcium channel blockade (CCB). These

results suggest that the spasmolytic effect of the plant

extract is mediated through the presence of CCB-like

constituent(s) which is concentrated in the n-hexane

fraction and this study provides a strong mechanistic

base for its traditional use in gastrointestinal disorders

such as colic pain and diarrhea [12]. In Ayurvedic

classical texts is advised for

and which is equivalent to antispasmodic

and anti-diarrheal effect, but it can be interpreted that

possesses these activities but they are

not its main indications. There are other superior drugs

+

Acorus calamus

Acorus

calamus

Acorus calamus Vibandha

Udara Shula

Acorus calamus

Antihepatotoxic study:

Antispasmodic andAnti-diarrheal study:

50

than regarding these activities. It

may be the reason that is not much

utilized in Ayurveda for antispasmodic and anti-

diarrheal effect.

An anticancer study was done on the oil

obtained from Essential oil obtained

from this plant is b-asarone which is also responsible

for its anticarcinogenic activity [13].

In Ayurveda is clearly

indicated for cough and asthma. This claim is

supported by a recent study which was undertaken to

provide a pharmacological basis for traditional use of

in airways disorders. For this

purpose isolated guinea-pig trachea and atria were

suspended in organ baths bubbled with carbogen and

mechanisms were found using different parameters.

Result shows crude extract of was

more effective than carbachol in causing relaxation of

high K (80 mM) preconstruction's, similar to

verapamil, suggesting blockade of calcium channels

[14].

memory enhancers is the main

indication of This drug is a very

vigorous brain tonic, because it shows results in a very

short time. A study on raditional Indian memory

enhancer herbs and their medicinal importance

showed that increases the overall

memory of the person and strengthens the nervous

system. In almost all studied civilizations, there have

been attempts to discover the best herbs for brain

enhancement with minimum side-effects. All the

herbs Ayurveda uses for its brain tonics have

minimum side-effects and are quite safe for the

human beings and is found one of the

best drugs among studied herbs [15].

In clinical trial on 45 patients of IHD at OPD

of S. S. Hospital BHU Varanasi the efficacy of the

drugs was tested. The patients were

Anticancer activity:

BronchodilatoryActivity

Memory enhancers:-

t

Clinical Study:

Ischemic Heart Disease (IHD):

Acorus calamus

Acorus calamus

Acorus calamus.

Acorus calamus

Acorus calamus

Acorus calamus

Medhya ( )

Acorus calamus.

Acorus calamus

Acorus calamus

Acorus calamus

+



145

randomly divided into three groups. The first group

was given trial drugs in the dose of 1.5-3 g/day in

divided dose for 3 months were given. The second

group was given purified (

(Arn.) Bhandari) in the dose of 9-6 mg/day in

divided dosages for 3 months while the third groups

was the controlled groups was given capsule

containing lactose powder for 3 months .There was

an encouraging improvement in the first group and

group. The drugs was found to effective in the

improvement of chest pain, dyspnea on effort,

reducing of the body weight index, improving ECG,

decreased serum cholesterol, decreased SLDL

(serum low density lipoproteins) and increased

SHDL(serum high density lipoproteins) [16].

In this clinical study fifty cases of

depression at OPD of the S.S Hospital BHU

Varanasi; (500 mg in doses of 2 tab

three time a day after meal with water) given for a six

weeks showed reduction in the degree of severity of

depression and better rehabilitation. There was also

a significant improvement in the assessment based

in the rating of symptoms on Hamilton depression

rating scale. The rate of improvement before and

after treatment was statically significant.(p<0.001)

[17]. This study strongly elaborates the classical

claim of as brain tonic.

Few herbs mentioned in classical texts are

found highly useful in treating large number of

different ailments. is one of such

herb. Classical texts have mentioned its properties in

brief but utilized this drug in numerous

formulations. The dried rhizomes of

is emetic, stomachic used in dyspepsia, colic and as

nerve tonic, It considered to passes antispasmodic,

carminatives, insect fuse and anthelmintic

properties and are used for the treatment of host

disease such as epilepsy and other mental ailments,

chronic diarrhea and dysentery, bronchial catarrh,

intermittent fever, snake bite and glandular and

abdominal tumors. It is also employed for kidney

Guggulu Commiphora

Wightii

Acorus calamus

Acorus calamus

Acorus calamus

Acorus calamus

Depression:

Discussion:

and liver, troubles rheumatisms and eczema. The

rhizome is used in the form powder, balm, enemas,

and pills and also in ghee preparation. The skin of

rhizomes is said to hemostatic.

The above studies support that is the

good Ayurvedic herb for medicinal purpose.

is effective against bacteria and fungi and

can be used as antibacterial and antifungal drug.

is a very good brain tonic and

possesses significant memory enhancer effect.

Experimental studies indicate that is

useful in the diabetes, as an anti-inflammatory, in

IHD, Anti-cancer, anti-spasmodic, anti-bacterial,

bronchodilator, anti-hepatotoxic activity and in

depression. These all research works elaborates all

indications mentioned inAyurvedic classical texts.

[1] Divya G, Gajalakshmi S, Mythili S, Sathiavelu

A. Pharmacological activities of Acorus calamus: a

review: J Asian J Biochemical and Pharmace Rese

2011;4:1:2231-2560

[2] Khare CK. Indian Medicinal Plants, an

Illustrated Dictionary, Springer Science, Springer-

Verlag, Berlin/Heidelberg 2008, p. 16.

[3] K. Pokharel, B.R. Dhungana, K.B. Tiwari & R.B.

Shahi., Antibacterial Activities of Some Indigenous

M e d i c i n a l P l a n t s o f N e p a l ,

http://kiranbabutiwari.blogspot.com/2008/07/antiba

cterial-of-some-html.

[4] Phongpaichit S, Pujenjob N, Rukachaisirikul V,

Ongsakul M. J Sci Technol 2005,27

[5] Tiwari N, ChaudharyA, MishraA, Bhatt G. Intern

J Chemi andAnal Sci. 2010:1:9::211

[6] Asha S, Deepak G. Antimicrobial activity of

Acorus calamus (L.) rhizome and leaf extract. Acta

Biologica ,2009;53:1:45

[7] M.M. Si , J.S. Lou, C.X. Zhou, J.N. Shen, H.H.

Wu, B.Yang, Q.J. He & H.S. Wu., Journal of

Ethanopharmacology., 2010, 128, 154.

[8] Wu HS, Zhu DF, Zhou CX, Feng CR, Y. Lou J,

Yang B. He QJ. J Ethnopharmacology. 2009;123:

288

Conclusions:

References:-

LAD

Vacha

Acorus

calamus

Acorus calamus

Acorus calamus



146

[ 9 ] K i m a H , H a n b T H , L e e a S G . J

Enthanopharmocology. 2009:122:149

[10] Muthuraman A, Singh N, Jaggi AS. Food and

Chemical Toxicology. J Complem and Altern Med.

2011;11:24

[11] Palani S, Raja S, Kumar P, Venkadesan D, Devi

K, Sivaraj A, Kumar S. Intern j Interg Biology,

2009;7:1:39.

[12] Gilani AH, Shah AJ, Ahmad M, Shaheen F.

Antispasmodic effect of acorus calamus Linn. in

rabbits mediated through calcium channel blockade.

Phytother Res 2006;20:1080-4

[13] S. Palani, S. Raja, P. Kumar, P. Parameswaran,

S. Kumar. Acta Pharmaceutica Sciencia, 2010;

:52:89

[14] Nalamwar VP, Khadabadi SS, Aswar PB,

Kosalge SB, Rajurkar RM et al. In vitro licicidal

activity of different extracts of Acorus calamus

Linn. (Araceae) Rhizome. Int J Pharm Tech Res

2009;1:96-100.

[15] Debjit B, Chiranjib, Tiwari P, Tripathi KK,

Sampathkumar KP. Traditional Indian memory

enhancer herbs and their medicinal importance; J

Annals of Biological Res 2010;1:1:41-46

[16] Mamgain P, Singh RH. Control clinical trial of

the Lekhaniya drug Vaca (Acorus calamus) in case

of ischemic heart diseases. J Res Ayur Siddha

1994;15:35-51

[17]Tripathi AK, Singh RH. Clinical study on an

indigenous drug Vaca (Acorus calamus) in the

treatment of depressive illness. J Res Ayur Siddha

1995;16:24-34



147


SRP Kethamakka

How to cite the article: SRP Kethamakka,J-ISM, V2 N , , pp.3 July-sept 2014 148-151


Head, Panchakarma, MGACH&RC, Salod (H), Wardha, (MS), [email protected]

JISM1437H Received: , 2014;Accepted: September 14, 2014September 8

Journal of Indian

System of Medicine

It is all accepted fact that the Charaka

Samhita is the oldest Medical recordings of Indian

Heritage. The question is how old is it? Historians

date it to be very recent and of 2000 year old. But the

fact suggests different. Charaka (Agnivesha), when

records his first words of testimonials, states that the

first ever meeting of the health seekers / workers took

place at Himalayan province with the participation of

sages from all over world. He narrated the concepts of

Ayurveda in the form of conversations of the

participants and statements. One of such

conversational statement returns us to the dates of

Ayurveda development in Human Interface. Till that

time only the “ ” are known with this Medical

measures and the human are unaware. This is clear as

the “Bharadwaja” went to Indra (deity), as the sole

representative of the entire human race to learn the

Ayurveda, the Health science.

The propagation of Ayurveda in human races

are said to be at the early days of “ ” i.e.

Devata

Tretayuga

Propagation ofAyurveda in Human

approximately 14000 years back. To have

authenticity of this we refer the sentences used in

chapter as “

”. It states that, long back in the

diseases spread extensively and killed the huge

human population. Later on such incidents are not

seen. There were no mentions of

or even , anywhere in the

Charaka Samhita. With this we understand that the

era of human interface with Ayurveda first occurred

in early .

Another word here used is the Human

interface. Bharadwaja, who is the first Human

disciple of Indra, have no Prior Ayurveda learner

from the human race. The rest Dhanvantari

(Divodasa) and others learned Ayurveda in due

course from Indra and Bharadwaja, Punarvasu, etc.

The Indra of Veda times is a deity and later on it

became as a post by times and who ever

performs the 100 has the eligibility to

become “Indra” like Nahusha. Is the initial “Indra” is

Janapadodhwansa Dhrishyati

Kritayuge Kritayuga

Tretayuga,

Dwaparayuga Kaliyuga

Treatayuga

Purana

Yagnya

Review Article

Abstract:

Keywords:

Antiquity of the Ayurvedic literature available is not properly estimated by the scientific explanations of

present day. In fact, the Ayurveda, even ages back to millions of years and the Charaka Samhita, a

compendium of ancient Indian health information in the form of seminars, statements and discussions is

considered as oldest documentation, and is with a minimum of 14000 years old antiquity, based on the

astronomical references, ecological references,RemoteSensingpictures,oceanographic reports,paleobotanical

research, archaeological excavations and anthropological research reports establishing Indian mythology as

a fact.

Charaka Samhita. Antiquity, Ayurveda anthropology, manuscript


an Extra terrestrial?

Is this Ayurveda descending from extra

terrestrial or developed in Human knowledge?

Was it really happened 14000 years ago or

even long enough?

This age is based on evidence from

radiometric age dating of meteorite material and is

consistent with the ages of the oldest-known

terrestrial and lunar samples. Following the

scientific revolution and the development of

radiometric age dating, measurements of lead in

uranium-rich minerals showed that some were in

excess of a billion years old [1].

The , lasted from 65.5 ± 0.3 Ma

(ICS 2004) to 55.8 ± 0.2 Ma (ICS 2004). In many

ways, the Paleocene continued processes that had

begun during the late Cretaceous Period. During the

Paleocene, the continents continued to drift toward

their present positions.Supercontinent Laurasia had

not yet separated into three continents -

Europe and Greenland were still connected

North America and Asia were still intermittently

joined by a land bridge, while Greenland and North

America were beginning to separate [2].

The age of the Earth is 4.54 ± 0.05 billion years

(4.54 × 109 years ± 1%)

Paleocene

The Laramide orogeny of the late

Cretaceous continued to uplift the Rocky Mountains

in the American west, which ended in the succeeding

epoch. South and NorthAmerica remained separated

by equatorial seas (they joined during the Neogene);

the components of the former southern super-

continent Gondwanaland continued to split apart,

withAfrica, SouthAmerica,Antarctica andAustralia

pulling away from each other. Africa was heading

north towards Europe, slowly closing the Tethys

Ocean, and India began its migration to Asia that

would lead to a tectonic collision and the formation

of the Himalayas [3].

During its long span of existence,

Gondwana, through movements that would have

been imperceptibly slow to the unaided human

senses, merged with a northern hemispheric land

mass, Laurasia, to form the super-continent Pangaea,

until the two masses gradually parted again. That is,

Gondwana existed both before the super-continent

Pangaea formed near the end of the Paleozoic era

(roughly 350 to 260 million years ago), and it

remained together, with some changes, after Pangaea

broke up during the Triassic and Jurassic periods of

the Mesozoic (with this rifting beginning about 208

million years ago). Gondwana itself began to break

up in the mid to late Jurassic period about 150 million

years ago [4].

The earliest phase of tectonic evolution was

marked by the cooling and solidification of the upper

crust of the earth surface in theArchaean era (prior to

2.5 billion years) which is represented by the

exposure of gneisses and granites especially on the

Peninsula. These form the core of the Indian craton.

The Aravalli Range is the remnant of an early

Proterozoic orogen called the Aravali-Delhi orogen

that joined the two older segments that make up the

Indian craton. It extends approximately 500

kilometres (311 mi) from its northern end to isolated

hills and rocky ridges into Haryana, ending near

Delhi [5].


SRP Kethamakka, Carbon dating of Charaka Samhita, J-ISM, V2 N3, July-September 2014, pp.148-151

It is clear that the history of present India is

long and started 140 million years ago as

“Jambudwipa” and float long time to join the present

Russia to form Himalayan range. The Indian time

calculation used delineated measures like Kalpa,

Manwantara, Mahayuga, Yuga, etc. The present

Kaliyuga 5114 years are part of one of such

Mahayuga and with its prior Krita, Treta and

Dwapara. With the fixation of present set yuga

timeline, we are clear to say the Ayurveda is older

then Ramayana. Historicity of Ramayana and

Mahabhart Eras are fixed in "Scientific Evidences

from the depths of Oceans to the Heights of the

Skies" which was held in New Delhi on 14th March,

2012, by ISERVE. The venue is placed in R.K. Sadan

of Kurukshetra University Campus. Ramayana time

is fixed by various aspects as 14000 years and even

older.

They are as follows.

i) in Rigveda

represent the sky view of dates belonging to the

period 8000 BC to 4000 BC and those mentioned in

Valmiki Ramayana refer to sky views seen

sequentially on dates around 5000 BC.

ii) in ancient books,

especially those relating to melting of glaciers and

fluctuations in water volumes of ancient rivers, seem

to corroborate such astronomical dates. Recent

research reports on paleoclimatic changes have

revealed that, after the last ice age and in the

beginning of the Holocene, the glaciers first melted

near the equator i.e. in south India, and civilization

started developing on the Banks of the rivers which

started flowing there. When populations multiplied,

these river waters became insufficient and some

more adventurous people started traveling from

south to north. Such northward migration continued

for several centuries and finally when these people

reached the banks of Himalayan Rivers, they got

climatic conditions conducive to long term

development of civilization on the banks of these

The astronomical references

The ecological references

rivers providing security of water, food and shelter.

This period starts from around 10000 BC and covered

Vedic and Ramayana eras.

iii) taken by ISRO,

corroborated by geological reports, have revealed

that a mighty river system, referred to in Vedas and

Epics as Saraswati, was flowing with full majesty

during Ramayana period i.e. around 6000- 4000 BC.

However this river system slowly started drying up

and almost disappeared around 3000 BC as in

Mahabharat it is stated to have disappeared near

Vinasan in Rajasthan. These conclusions have been

supported by sedimentology, hydrogeology and

drilling data. These conclusions not only support the

astronomical dates of Vedas and Epics but also

support such references in ancient books.

iv) The on fluctuations of

water levels in the oceans have revealed that sea level

was around 9 to 10 feet below the present level

Therefore Ram Sethu was a walkable bridge around

5000 BC therefore, it could be used as a land route

from Rameshwaram to Talaimannar in Ramayana

era.

v) The reports have

revealed that certain cultivated varieties of plants,

trees and herbs, which are mentioned in Vedas and

Epics, have existed in India continuously for more

than 8000 years. Remains of cultivated rice, wheat

and barley have been found belonging to 7000 BC;

melon seeds, lemon leaf, pomegranate, coconut and

date palm etc relating to 4000 BC; lentils, millets and

peas etc from 3000 BC; use of reetha, amla and

shikakai for making shampoo since 2500 BC. These

plants remained in use continuously indicating that

there was not any abrupt end of ancient Indian

civilization as is normally being taught in schools and

colleges and that their references in Ramayana and

Mahabharat get corroborated scientifically.

vi) The latest have

revealed large volume of new data which has proved

the indigenous origin and development of civilization

Remote Sensing pictures

oceanographic reports

paleobotanical research

archaeological excavations



in the Indian Subcontinent since 7000 BC Some

examples are: Lahuradeva, Jhusi, Tokwa and

Hetapatti in Ganga Valley in the east; Mehrgarh, Kot

Diji and Nausharo in Indus valley in the northwest;

Lothal and Dholavira in the west. The material

testimonies of these excavations have shown gradual

cultural developments from the 7 -6 millennium BC

in the entire region of Indus-Saraswati-Ganga system

for a period of almost eight thousand years. Thus

archaeology is also supporting the astronomical,

ecological and anthropological conclusions that

Aryans were originals of India, they have been

creating and nurturing a continuously developing

civilization for last 10000 years and dispersal

probably happened the other way round.

vii)

The Genome studies during the Holocene have

revealed that the genetic profile of humans settled in

north, south, east and west of India is the same and has

remained the same for the last more than 11000 years.

It is also significant to note that the inhabitants of the

Harappan civilization were not a mysterious people of

unknown biological origins, or migrants from

western/central Asia, but they were the indigenous

people identified with the pre/early Harappan cultures

of northwestern region of the Indian subcontinent.

Therefore, contrary to the popular belief, the

Dravidians as well as north Indians have common

ancestors and both are originals of India, have

.

The anthropological research reports have

established that DNA dating for Paleolithic

continuity starts from 60000 BC.

th th

common genetic profile and thus had common

ancestors.

This corroborates the details of geneology charts

prepared for Ramayana era. Astrologically, another

important landmark is the initiation of Medicine on

“Pushyami” star day. Pre Ramayana periods used to

calculate the Zodiac from Pushyami and it is said as

the new year start. Today we fixed the Ashwini and

Chaitra as the New Year day and celebrate as

“Yugadi”. Ayurveda even today practices

Pumsavana, etc, auspicious medicinal distribution on

Pushyami star day. With these we may have a

conclusion that the Ayurveda is brought from a

Known (Devata / Extra terrestrials) source of those

days (the Devata interferences are recorded till

Mahabharata period i.e. 5000 years ago and may be

we lost the connection now) and propagated among

Human 14000 years ago, i.e. before to Ramayana

period for the welfare of human race.

[1] http://en.wikipedia.org/wiki/Age_of_the_Earth

[2] J.J. Hooker, 2005, "Tertiary to Present:

Paleocene," in Richard C. Selley, L. Robin McCocks,

and Ian R. Plimer. Encyclopedia of Geology,

(Oxford, UK: Elsevier Limited. ISBN 0126363803),

459-465

[3]http://www.newworldencyclopedia.org/entry/Ge

ological_history_of_Earth

[4]http://www.newworldencyclopedia.org/entry/Go

ndwana

[5] http://en.wikipedia.org/wiki/Geology_of_India

References:



Bilateral Variations of Renal Vessels -

A case study

Journal of Indian

System of MedicineCase Report

Giridhar M Kanthi ,

Arun N P, Harshita M S,Anoop Kumar N S, Visakh Sakthidharan, Vishnu Damodar

1

2

1 2Prof Dept of Anatomy S D M College of Ayurveda Udupi, Final year Anatomy P G Scholars

JISM1362N Received: December 28, 2013; Accepted: September 14, 2014

How to cite the article: Giridhar M Kanthi, Arun N P, Harshita M S, Anoop Kumar N S, Visakh Sakthidharan, Vishnu Damodar,Bilateral variations of renal vessels -A case study, J-ISM, V2 N3, July-September 2014, pp.152-154

Abstract:

Keywords:

Knowledge of variations of renal vessels are important during operative, diagnostic and endovascular

procedures of the abdomen and pelvic region and its importance have been greater than before because of the

widespread development in the renal transplantation surgeries. During routine dissection of a 60 year aged

female cadaver bilateral variations of renal vessels was observed. There were two renal arteries superior and

inferior accompanied by two renal veins one anterior and one posterior to the artery on the right side. On the left

side we found two renal arteries superior and inferior accompanied by two renal veins superior and inferior with

a communicating vein connecting the superior and inferior renal veins on left side. Left gonadal vein drained

into the inferior renal vein, which in turn drained into the inferior vena cava. Left suprarenal vein drained into

the superior renal vein which further drained into the inferior vena cava. Such unusual and complex variations

must be kept in mind during radiological and surgical procedures to prevent inadvertent injury to the related

structures and also for their clinical implications.

Renal artery, renal vein, bilateral variation

Introduction

Renal arteries are a pair of lateral branches of

the abdominal aorta, arising at the level of L1 and L2

vertebra, just below the origin of the superior

mesenteric artery. Renal arteries course anterior to the

renal pelvis before entering into the hilum.

Classically, a single renal artery supplies each kidney.

The right renal artery is longer and often higher and

pass posterior to the inferior vena cava, right renal

vein, head of the pancreas and descending part of the

duodenum whereas the left renal artery pass behind

the left renal vein, the body of pancreas and the

splenic vein. It may be crossed by the inferior

mesenteric vein anteriorly.

Generally, each kidney is drained by a single

renal vein; right renal vein is shorter and drains into

the inferior vena cava, whereas the left renal vein

which is three times longer than the right renal vein

drains into the inferior vena cava by coursing anterior

to the aorta. In addition, left renal vein also receives

tributaries of left gonadal vein from below and left

suprarenal vein from above.[1]

During the dissection of a female cadaver

aged about 60 years, in Alva's Ayurvedic Medical

College Moodabidri, Karnataka, and variations in

renal vessels bilaterally was found.

There were two renal arteries as superior and

inferior. The superior renal artery again divided into

2 to 3 branches before entering into the hilum.

Case report

Variation on the right side


Fig. 1: Right kidney arteries variations

There were two renal veins one anterior to

the renal artery (normal) and another one posterior to

the artery and both were attached to the hilum of the

kidney.

Fig. 2: Right kidney veins variations

Variation on the left side

In the left side also there were two renal

arteries as superior and inferior along with two renal

veins as superior and inferior. Superior vein was

present between the two arteries. The superior renal

vein received suprarenal vein and inferior renal vein

received the gonadal vein. A number of tributaries

joined inferior renal vein and also there was a

communicating vein present in between the superior

and inferior renal veins.

Fig.3: Left kidney veins variations

Discussion

The variations in the renal vessels are mainly

due to various developmental positions of the

kidney.[2] Renal arteries exhibit a high degree of

variations compared to the renal veins. A variation

occurring in both arteries and veins together is rare;

also, variations among the renal veins are not as

common as arteries. [3] In this case we observed

bilateral variations in the renal arteries and renal

veins.

A single main renal artery is seen in 70% of

individuals, and accessory renal arteries are common

in 30% and usually arise from the aorta above or

below (most commonly below) the main renal artery

and follow it to the renal hilum. Rarely, accessory

renal arteries may arise from the coeliac trunk or

superior mesenteric arteries near the aortic

bifurcation or from the common iliac arteries. These

accessory renal arteries are called as persistent

embryonic lateral splanchnic arteries. Near the

hilum, each renal artery divides into anterior and

posterior divisions which further divide into

segmental, lobar, inter lobar and arcuate arteries.

These are end arteries with no anastomoses.[1]

However renal artery variations are very common.

Variations regarding their origin and number have

been reported by many researchers. Renal

vasculature variations are important for the

angiographers and urologists.[4] The knowledge of

Fig 4: Percentage of occurrence of variation in the

renal artery


Giridhar M Kanthi et.al. Bilateral variations of renal vessels -A case study, pp.152-154

Giridhar M Kanthi et.al. Bilateral variations of renal vessels -A case study, pp.152-154

entry of renal veins into the inferior vena cava and

their variations is equally important during

catheterization and planning porto-renal shunt

procedures.[5]

Bilateralvariationintherenalarteryandveinis

ararecaseofoccurrence.Astheinvasiveinterventions

suchasrenaltransplantation,interventionalradiologic

procedures and urologic operations increase,

awarenessofthepossiblevariationsoftherenalarteries

is necessary for adequate surgical management in the

aforementionedspecialties.

[1] Standring S, ed. Gray'sAnatomy: TheAnatomical

Basis of Clinical Practice. 39th Ed., London,

Elsevier, Churchill Livingstone. 2005; 1118, 1121,

1274, 1276.

[2] Moore KL, Persaud TVN. The Developing

Human: Clinically Oriented Embryology. 8th Ed.,

Philadelphia, Saunders, Elsevier. 2008; 249251.

[3] Soni S, Wadhwa A. Multiple variations in the

paired arteries of abdominal aorta clinical

implications. Journal of Clinical and Diagnostic

Research. 2010; 4: 26222625.

Conclusion

References

Fig 5: Radiological image showing the position of

renal artery

[4] Krishnasamy N, Rao KGM, Somayaji SN,

Koshy S, Rodrigues V. An unusual case of unilateral

additional right renal artery and vein. Int J Anat Var

(IJAV). 2010; 3: 911.

[5] Satyapal KS. Classification of the drainage

patterns of the renal veins. J Anat. 1995; 186:

329333.


Journal of Indian

System of Medicine

How to cite the article: Santosh Y Mudakappagol, Mathew Sunny, Management of high anal fistula by Kshara Sutra ligation alongwith partial Fistulotomy - A Case Report, J-ISM, V2 N3, July-September 2014, pp.155-157

Management of High Anal Fistula by

ligation along with Partial Fistulotomy

A Case Report

Kshara

Sutra

-1 2Santosh Y Mudakappagol, Mathew Sunny

1

2

Assistant Professor, Dept of Shalya Tantra, KLE U B M Kankanawadi Ayurved Mahavidyalaya,

Belgaum, ([email protected]), PG scholar Dept of Shalya Tantra, KLE U B M KankanawadiAyurved Mahavidyalaya, BelgaumJISM1427N Received: August 9, 2014; Accepted: September 14, 2014

Case Report

Abstract

Key-words:

Fistula-in-ano is the chronic phase of anorectal infection and is characterized by chronic purulent drainage or

intermittent pain associated with cyclical accumulation of an abscess with discomfort at the perineal area.

Fistula in ano is classified as low anal and high anal, where management of low anal fistula is easier compared to

high anal fistula. Conventional surgical treatments, like fistulotomy, fistulectomy and Seton thread technique

sever the anal sphincters and may cause incontinence. The recurrent rate of “lay-open” fistulotomy was reported

between 2-9 % with functional impairment ranging from 0 to 17%. This has a profound effect on the patient's

quality of life. Here is the case report where complex posterior high anal fistula managed with

(Medicated thread) and partial fistulotomy.

A F

Kshara Sutra

Bhagandara, Kshārasūtra, nal istula.

Introduction

Fistula in ano is one of the common conditions seen in

the perineal area. These fistulas are difficult to treat

by their nature of tract formation, recurrence, sepsis,

etc. Fistulas are classified as high anal & low anal

according to the length of tract. A high anal fistula

describes a track that passes through or above a large

amount of Sphincter muscles. A range of treatment

options are available, but none is universally

successful or without risk [1]. Where surgical

techniques like Laying open (Fistulotomy), excision

of tract (Fistulectomy) & Seton threading technique

of such fistulas would damage considerable amounts

of sphincter muscle and result in impaired bowel

control. These high anal fistulas are therefore also

considered complex. The exact cause or mechanism

of infection has not been fully elucidated, Infection of

anal glands progresses to acute anorectal abscesses

and fistulas; the “cryptoglandular hypothesis.” It is

not clear why certain cases of perianal sepsis are

limited to abscess formation whereas others are

associated with fistula formation. A recent review of

perianal abscess and fistula quotes a fistula formation

rate of 26-37% after perianal abscess [2].

m [3]

(anal fistula). It is enlisted among [4]

(Eight intricate diseases) which by nature are difficult

to cure considering its morbidity, recurrence and

social burd

[5]. As these high

anal fistulas are complex in nature hence they need

multicentric approach. Acharya Sushruta mentioned

different treatment options like [6]

etc (excision, incision) in treating the various types of

effectively, which are to be used

judiciously. Amongst them practice of

Fistula in ano is well described in

Suśrutasa hitā under the name of bhagandara

en. The condition is termed bhagandara as

it does (tears) of (perineum),

(rectum) and (pelvis)

Asta

ṇ B G

B

Chedana, Bhedan

Bhagandara

Ksahrasutra

māhāgad

āra ā haga uda

astipradeśa

4

D


Santosh Y Mudakappagol, Mathew Sunny, Management of high anal fistula by Kshara Sutra ligation along with partialFistulotomy - pp.155-157

[7] is well established in the management of

In present study the combination of

treatment modalities has been carried out to treat the

case successfully.

A 34 year old male patient non diabetic, non

hypertensive presented with complaints of

intermittent pus discharge while defecation and pain

at anal region after defecation, associated with

Bhagandara.

Case History

discomfort while sitting since one month. The exact

history started one year back during which the patient

experienced same complaints for which patient had

undergone surgery in a private hospital, but didn't get

relieved from the complaints. With above said

complaints patient approached our institute for

further treatment. There was no associated history of

fever, bleeding per rectum or constipation. Patient

did not give any history of major illnesses or major

surgery done in the past apart from present illness and

was on higher antibiotics and anti-inflammatory

drugs. Personal history of patient revealed that he

was Hindu, vegetarian with good appetite, elderly

married and business man by occupation with no

habits of tobacco & alcohol use.

On examination, the patient's vital

parameters were stable. On local examination, there

was visible external opening at 7 'o clock, 2.5 cms

away from the anal verge position on the posterior

side of anal verge; along with scar marks of previous

surgery at 9 'o clock position. There was hard

Fig 1. Shows 1 visit of patient to our OPDst

Fig 2. Shows fistulogramFig 3. Shows healing of the tract

after thread removed


indurated swelling with tenderness over the external

opening possibly due to chronic infection. On

Probing it was found that the tract was going straight

in the sphincteric plane. Internal opening was

palpable as irregular surfaced tender point in the anal

canal at a distance of approximately 6-8cms from the

anal verge, then case was clinically diagnosed as high

anal complex fistula which was confirmed later on by

the fistulogram.

Anal fistulas will not heal without

intervention, and failure to treat may lead to

progression of the disease process. If left untreated,

anal fistulas are at risk of recurrent formation of a

perianal abscess interspersed with partial healing of

the fistula track. This can become a chronic septic

focus with the establishment of a complex fistula

network. The consequences for the patient may

include pain, bleeding, incontinence, cellulitis, and

systemic sepsis.

In High anal fistula there is higher risk of post

op complication like incontinence of stool and

recurrence. Conventional surgical techniques namely

complete fistulotomy and fistulectomy are not

possible due to definite complication of

incontinence. Seton technique, sever the internal anal

sphincters and may damage the external anal

sphincters. The recurrent rate of “lay-open”

fistulotomy was reported between 2-9% with

functional impairment ranging from 0 to 17% [1,2].

Sushruta mentioned a mechanism

of drug delivery precisely at the tissues involved

through unique way i.e., in the

of (Fistula In Ano) which is a medicated

thread prepared by the coatings of ,

with as binding agent.

Here acts as powerful

(Excision), (incision) & [8]

(debriding) agent & selectively acts on the unhealthy

Discussion

Acharya

Kshara-sutra Chikitsa

Bhagandar

Apamarga Kshara

Haridra Churna Snuhi Ksheer

Kshara Chedan

Bhedan Lekhan

tissues, pus pockets etc. acts as

(antimicrobial) & also enhance the (healing)

of tract. binds the medicines to the

thread & thread keeps the tract patent. This process of

debridement & healing starts from deeper tissues &

travels towards periphery in stages.

As the exernal opening has greater tendency

to get narrowed or closes due to unhealthy

granulation tissue growth due to which drainage of

the debrided tissue & sepsis is not done effectively

which causes hindrance in the healing of the tract and

delays patient's recovery period hence This degraded

tissues & sepsis drainage is facilitated by making the

external opening widening by partial fistulotomy.

By adopting this partial fistulotomy

procedure along with the thearpy in

such high anal complex fistulas would enhance the

successful cure rate and reduce the suffering the

patient & also reduce the cost of the treatment. One

can get 100%success rate without any

complications.

aridra Krimigna

Ropan

Snuhi Ksheer

Kshara Sutra

H

Conclusion

References

[1] Jacob TJ, Perakath B, Keighley MR. Surgical

intervention for anorectal fistula. Cochrane Database Syst

Rev2010;5: CD006319.

[2] Malik AI, Nelson RL, Tou S. Incision and drainage of

perianal abscess with or without treatment of anal fistula.

Cochrane Database Syst Rev2010;7: CD006827.

[3] Ambikadatta shastri ed, Sushruta samhita Nidan Ch 4,

Ayurveda Tattva Sandipika, Chaukamba Sanskrit Sanstan

Varanasi Edition, reprint 2007. P- 244.

[4] Ambikadatta shastri ed, Sushruta samhita Sutra Ch 33

Verse 4-5, Ayurveda Tattva Sandipika, Chaukamba

Sanskrit Sanstan Varanasi Edition, reprint 2007. P-261.

[5] Ambikadatta shastri ed, Sushruta samhita Chikitsa

Ch 8, Ayurveda Tattva Sandipika, Chaukamba Sanskrit

Sanstan Varanasi Edition, reprint 2007. P 45.

[6] Ibid [5] Ch 8 Verse 5-11 & 20-22, P 45-46.

[7] Ibid [5] Ch 15 Verse 30-32, P -81.

[8] Ibid [4] Ch 11 Verse 3, P -34.


Santosh Y Mudakappagol, Mathew Sunny, Management of high anal fistula by Kshara Sutra ligation along with partialFistulotomy - pp.155-157

157

Recent approaches of Pre-clinical

Researches in Ayurveda

Journal of Indian

System of Medicine

How to cite the article: Rohit Gokarn, Supriya R. Gokarn, Recent approaches of Pre-clinical Researches in Ayurveda, J-ISM, V2N3, July-September 2014, pp.159-161

1 2Assistant Professor,Department of Rasashastra and Bhaishajya Kalpana,Assistant Professor, Department of Dravyaguna, Mahatma Gandhi AyurvedaCollege,Hospital and Research Centre,Salod(H),Wardha.JISM1436H: Received September 8, 14,Accepted September 14, 14

Rohit Gokarn , Supriya R. Gokarn1 2

Current Theme


Abstract

Keywords:Ayurveda, Pre-clinical, Safety, Invivo, Invitro

Research in Ayurveda is still in its primitive stage and has to upgrade and update to the current trends.

Contributions by various ancient sears were not just speculation but collective work with clean neat acquisition

of clinical data. This innovative approach has come to halt in past few decades and is not in accordance with

current research designs. A thorough review through present research modules will help investigators to apply

and adapt to the need of the hour. Appropriate research design and collaborative work with interdisciplinary

approach is at most necessary to derive concrete conclusion.

Introduction:

Ayurveda -Traditional Indian System of

Medicine has an enriched historical background and

is one of the great living traditions. Considerable

research on pharmacognosy, chemis t ry,

pharmacology and clinical therapeutics has been

carried out on Ayurvedic medicaments. Several

preclinical studies have been carried out on

cytoprotective, immunomodulatory and antidiabetic

potential of Ayurvedic medicines. There is a growing

need for an “evidence based medicine” hence

research is the prime need of contemporary

.[1] A narrative review of prior research by

screening published research papers will lay the

foundation for identifying strengths and gaps in the

evidence base that is available to analyse the safety

and efficacy ofAyurvedic interventions. [2]Although

Ayurveda has contributed a lot to humanity, it fails to

cope with current scenario due to poor data

acquisition and research designs. Developing

standards and SOP for raw drugs and formulation is a

tedious and lengthy process but a good networking of

Ayurveda

researchers can solve this problem. One can

concentrate towards only single problem at a time by

controlling all other possible variables. A single

platform which can work in favor of science can be of

great help. Holistic and systemic approach supported

by experiential base can serve as an innovative and

powerful discovery engine for newer, safer and

affordable medicines. [3] Hence to analyze the

different preclinical research modalities and their

relevance present study was designed.

A review of Research works available in

pubmed was done to explore different research

modalities and to understand nature of works carried

out in conventional and with newer dimensions. Few

words like Pharmacognosy, Characterization, In

vitro, In vivo,Antioxidants, Cell-line,Antimicrobial,

Safety, Toxicity etc were searched to find out the

number of works carried out and their relevance

Studies. The search was refined by adding the key

term "Ayurveda" in all cases. A summarized

overview of prior research on Ayurveda could be

sketched on the basis of the comprehensive analysis.

Materials & Methods:

158

Rohit Gokarn, Supriya R. Gokarn, Recent approaches of Pre-clinical Researches in Ayurveda, pp.159-161


Observations and results:

Table 1. Observation of search in Pubmed with different key words

Sl.no Type of study Number of articles

1 Cell line studies

With Key word Ayurveda 122

Free full text 40

Without key word Ayurveda 816745

2 Anti microbial study

With key word ayurveda 12

Free full text 01


3 Anti oxidant study


Free full text 07

With key word Ayurveda 17

4 Anti inflammatory study


Free full text 47


5 Anti diabetic study


Free full text 09


6 Safety studies


Free full text 52

Without Key word Ayurveda 170291

7 Fingerprinting Techniques


Free full text 01


08 Pharmacovigilance


Free full text 05


09 In vitro studies


Free full text 26


10 In vivo studies


Free full text 19


11 Pharmacognosy


Free full text 73


12 Immunomodulatory study


Free full text 09


159



Cell line studies

Anti microbial study

Anti oxidant stduy

Anti diabetic Study:

Safety studies :

Finger printing techniques

Pharmacovigilance

:

122 studies related to Ayurveda were

screened. Various herbs have been tried for their anti

cancerous activity. root,

aqeuous extract of , water extract

of , z-guggululosterone and

guggulolipid extract of have

shown significant action.[4] Also

, curcumin, have shown

postive results in anti cancerous study, is

reported to have anti-hepatitis C virus action.[5]

:

Drugs like extract,

,

, have been reported for

their anti microbial action. [6]

:

Anti oxidant action has been evaluated and

reported in single drugs like

. Two works on

polyherbal formulations i.e and

, a non classical formulation

named Pepticare , a mineral preparation i.e

was found. [7]

,

have been reported to have anti

diabetic activity. A study on ( )

having a protective role in diabetic cataract has also

been reported. [8]

Various reports are found out of which some

are ,

. [9]

:

The finger printing of mineral preparations

like

polyherbal formulation named BHU ,herbals like

Asparagus, sesame oil is found. [10]

:

Seven articles related to Ayurveda are

available which discusses ADR's and reporting

system, change in scenario in field of Ayurveda,

contribution of WHO in global acceptance of

Ayurveda. [11]

Ichnocarpus fruitescens

Tinospora cordifolia

Ashwagandha

commiphora mukul

Tulsi, Arjuna,

Murraya koenigi eclipta alba

Eclipta alba

Vasa, Jatropha, Chitraka

Terminalia chebula Eclipta alba, Ocimum sanctum,

caesalpinia bonduc Nimba

Haridra, Zingiber

officinale, cassia occidentalis

Maharasnadi kwatha

Vaysthapana Rasayana

Tamra

bhasma

Guduchi sa tva , Yashada bhasma

Pterocarpus marsupium, Eugenia jambolana,

Gymnema sylvestre

Bilva Aegle marmelos

Vasaguduchyadi kwatha Rasamanikya, yashada

Bhasma, tamra bhasma

Trivanga bhasma, swarnamakshika bhasma,

x

In vitro studies

In vivo studies

in

Pharmacognosy

Ayurvedic

Anti inflammatory Study:

Immunomodulatory study:

Discussion:

:

In vitro assay of three indian medicinal

plants was done to see if plants mediate their anti-

diabetic effects through anti-oxidant and apoptoic

action, cognitive effects of special extract of

, a ten yrs research report, anti malarial and

safety study of . Genotoxic and

antigenotoxic potential of alkaloid Punarnavine

from are some of the works.

:

Molecular targets and mechanisms of cancer

prevention and treatment by withaferin a, a naturally

occurring steroidal lactone.,

( ) leaf extract inhibits human pancreatic

tumor growth athymic mice by Apoptosis are few

important works. [13]

:

Impact of Seasons and Dioecy on

Therapeutic Phytoconstituents of

, a Drug. Pharmacognostical and

Preliminary physicochemical evaluation of

granules - A polyherbal

formulation are some important works. [14]

Anti inflammatory activity of

and poly herbal prepara t ion

are some of the works found in

search. [15]

Single drugs like

, and polyherbal preparations like

compound, ,

, , are

reported to have immune-modulatory activity

[16,17].

Analysis of the preclinical work done in the field of

Ayurveda gives important leads to identify priorities

for future research [18]. Lack of adequate Pre-

formulation studies like Qualitative and quantitative

estimation of raw drugs, Characterization of mineral

drugs, Pharmaceutical Standardization are the major

Bacopa

monniera

Pluchea lanceolata

Boerrhavia diffusa

Achyranthes aspera

Apamarg

Tinospora

cordifolia Rasayana

Triphaladi

embllica

officinalis, Chandrashura, grewia asiatica, withania

somni fera

Chandraprabha vati

Convolvulus pluricaulis,

Picrorhiza kuroa, Tinospora cordi fol ia,

Caesalphinia bonucella, Asparagus racemosa,

Withania somnifera, Tylophora indica, boerhavia

diffusa Shirishadi

amalako rasayana vachadhatryadi

avaleha shirishavaleha Brahma rasayana

[12]

160

drawback for further studies on the single drugs or

formulations.AsAyurveda utilizes drug as a whole, it

is quite difficult to quantify the

constituents, but to know the quality, parameters like

HPTLC, HPLC, GCMS can be adapted to identify

the active constituents. In case of metallic and

mineral medicine Characterization of raw minerals

and finished drugs is much easier task and has

definite conclusive results. Research findings on

inclusion of organic matter in mineral drugs has

changed complete course of medicine and is looked

in different way, known by organo-metallic complex

molecule [19]. One can find lot of studies on

Pharmaceutical standardization, but here the

approach by researchers suggests that, very few

follow the Pharmacopial references. Uniformity in

pharmaceutical process is very important to find

standard drug which may be prepared in any corner

of the country. Controlling variables in

pharmaceutical process to derive to definite

conclusion is needed. One more int sting debate is

need for reforms in animal models according

yurvedic pharmacokinetics and dynamics. As such

there have been only few attempts to design animal

models as per yurvedic drug action but this can be a

area of research for future. Safety studies of single or

compound formulations with key word yurveda are

limited to 112. There is urgent need of safety studies

especial ly in organo-metall ic compound

formulations which are in day to day practice. Only

few studies on safety of ,

are available.

Efficacy study of Ayurvedic medicaments are also

outnumbered by allied science. Most of the studies

related to Ayurveda comprises of studies on isolates

or extracts and not whole drug. The studies on whole

drug are still lacking and there is need of rigorous

works and data acquisition. The other concern is

there are very few studies on compound formulation

and more on single drugs as such the situation is

reverse when it comes to actual utilization of these.

A comprehensive review on articles available in

pubmed showed lack of publication of Ayurvedic

researches in reputed journals. Most of the studies

were done by isolation of active constituents or

extraction. There is need of quality research in

individual

ere

on to

A

A

A

Makaradhwaja Tamra

Bhasma, Kajjali, Trivanga Bhasma

Conclusion:

Ayurveda with interdisciplinary approach.

References:

[1]. Ram H Singh, Exploring issues in the development of

Ayurvedic Research Methodology, Journal of Ayurveda and

Integrative medicine, 2010,1(2) P-91

[2]. Manohar R, Eranezhath S, MahapatraA, Manohar R S.A

narrative review of research on Ayurveda.

2012, 12(Suppl

1):P427

[3] . Ethnopharmacology and drug discovery.

2005Aug 22;100(12):50-2

[4] http://www.ncbi.nlm.nih.gov/pubmed/?term=

cell+line+ayurveda/page1, date of access 14/09/2014


cell+line+ayurveda/page2, date of access 14/09/2014


anti+microbial+study+ayu... date of access 14/09/2014


anti+oxidant+activity+ayu.. date of access 14/09/2014


anti+diabetic+study+ayurveda, date of access 14/09/2014


safety+study+ayurveda, date of access 14/09/2014


fingerprinting+techniques+..., date of access 14/09/2014

[11] Http://www.ncbi.nlm.nih.gov/pubmed/?term=

pharmacovigilance+ayurveda, date of access 14/09/2014


in+vitro+studies+ayurveda, date of access 14/09/2014


in+vivo+studies+ayurveda, date of access 14/09/2014


pharmacognosy+ayurveda, date of access 14/09/2014


anti+inflammatory+study+..., date of access 14/09/2014


immunomodulatory+study... /page1, date of access

14/09/2014


immunomodulatory+study... /page2, date of access

14/09/2014

[18] Manohar R, Eranezhath S, Mahapatra A, Manohar R S.

A narrative review of research on Ayurveda.

2012, 12(Suppl

1):P427

[19] Balaji Krishnamachary et al. Elucidation Of A Core-

Shell Model For Through Physicochemical

Characterization. International Journal of Pharmacy and

Pharmaceutical Sciences, Vol 4, Issue 2, 2012

BMC

Complementary and Alternative Medicine

BMC

Complementary and Alternative Medicine

Lauha Bhasma

Patwardhan B J

Ethnopharmacol.



National Workshop on

“Ayurvedic Interventions in Cerebral Palsy”

Srihari S

Assistant Professor, Department of Kaumarabhritya, Associate Editor, J-ISM, MGACH & RC, Wardha,

[[email protected]]

September 8, 14 September 8, 14JISM1435H Received for publication: ;Accepted:

How to cite the article:

Journal of Indian

System of MedicineWorkshop Report

A national workshop on Ayurvedic Interventions

in Cerebral Palsy was organised by Department

of Kaumarabhritya, Mahatma Gandhi Ayurved

College, Hospital & Research Centre, Wardha

which is a constitute college under Datta Meghe

Institute of Medical Sciences (DU), Maharashtra,

India on 27th & 28th June, 2014. The workshop

aimed at generating a concrete knowledge on

various possible interventions in treating

children affected with Cerebral Palsy. The

workshop acted as platform for sharing

knowledge between resource personnel's who

have hands on experience in successfully

managing these children and young aspirant

scholars in the field of Kaumarabhritya. The

program was attained by around 150 delegates

including under graduate students, post graduate

scholars, medical officers and faculties from

various colleges all over India.

On the 1 day the workshop started under the

chairmanship of Dr. Shyam Bhutada, Dean,

MGACH & RC with inauguration by Dr.

Amitabh Kumar Pandey, Vice President, Central

Council of Indian Medicine, New Delhi, India

and Dr. Ramesh Babu Devalla, Chairman

st

Regulation Committee, CCIM, New Delhi and

Ex-Director General Central council of

Research inAyurvedic Sciences, New Delhi.

Speaking on the eve chief guest Dr. Ramesh

Babu Devalla, said Research works conducted

from past 10-12 years with various Ayurvedic

therapeutic procedures like and

internal medications administered to children

affected with different types of cerebral palsy

has shown 15-20% of relief on the various

complaints, spasticity being the major one.

These relief itself is of a significant importance,

while other system of medicines have very

limited treatments in managing these types of

children. He congratulated the organizing team

for bringing in the expertise like Prof Shailaja U

Rao, from SDM college of Ayurveda, Hassan,

Karnataka who is the first researcher in the field

of Ayurveda to conducted studies on Ayurvedic

interventions in Cerebral palsy.

Dr. Amitabh Kumar Pandey, who was the Guest

of Honor during the inaugural function said

Ayurveda the traditional system of Indian

medicine practiced since more than 5000 years

has in store a rich potential medicines and

Panchakarma


Srihari S, National Workshop on “Ayurvedic Interventions in Cerebral Palsy”, pp 162-163

variety of therapeutic procedures which plays a

significant role in children affected with cerebral

palsy. He also praised the doctors of the college

and hospital that in a short span of time they had

made a significant mark by providing successful

treatments to many serious diseases like Cerebral

Palsy.

Prof Shailaja U Rao, delivered the key note

address on the topic of “Recent advances

in the management of cerebral palsy in

Ayurveda”. She discussed the concept of cerebral

palsy in Ayurveda which is a

(untold disease), possible treatment modalities

and discussed the results obtained in her hospital

from past 10 years. She also emphasized the

newer approaches followed in regarded with

diagnosis andAyurvedic management followed.

This was followed by 26 paper presentations and

5 poster presentations by PG scholars as well as

faculties from different colleges all over India.

On the second day there was discussions by Dr.

Prema Khatri (M. Sc. Physiotherapy) and Mrs.

Madhuri Wane (Occupational Therapist,

AVBRH hospital, Wardha) on physiotherapy and

occupational therapy for its role in rehabilitating

the children of cerebral palsy. This was followed

by an interesting session by Dr. Rajagopala S

from Institute for post graduate teaching and

Research in Ayurveda, Jamnagar, Gujarat on

“Critical analysis of Research works conducted

in the field of Ayurveda” by post graduate

scholars all over India and works conducted by

Anuktha Vyadhi

various institutes and researchers. An in depth

critical analysis was done by him in order

understand how Ayurvedic therapies and

medicines would be beneficial in managing this

lifelong prevailing condition in children.

Afternoon session was dedicated to live

demonstration of various occupational therapy

measures adopted in cerebral palsy children by

Mrs. Madhuri Wane followed by demonstrations

of various therapies applicable in

children by Dr. Renu B Rathi, Head, Dr. Srihari S

and Dr. Jyothy K B, Asst. Professor in

department of Kaumarabhritya, MGACH & RC.

The evening session was dedicated to one on one

open discussion with the delegates and all the

resource persons which lasted 2 hrs. This was

followed by Valedictory function where prizes

was awarded to best paper and poster

presentation. First best paper prize was won by

D r . M a d h u m i t h a , P G S c h o l a r i n

Kaumarabhritya, SDM College of Hassan,

Karnataka. Second best paper prize was won by

D r. S u m e e t G o y a l , P G S c h o l a r i n

Kaumarabhritya, NIA, Jaipur. Third best paper

was won shared by Dr. Sukhadha Mayekar, PG

Scholar in Kaumarabhritya, L.R.P. Ayurvedic

Medical College, Hospital & Research Centre,

Ishwarpur, Sangli and Dr. Sahana Shankari, PG

Scholar in Kaumarabhritya, SDM College of

Ayurveda, Udupi, Karnataka. Best Poster prize

was won by Dr. Savitha Chougule, PG Scholar in

Kaumarabhritya, Alva's Ayurvedic Medical

College, Moodbidri, Karnataka.

Panchakarma


Announcements

Details of Event Contact info:


National seminar on

to be held on 2 Nov, 2014

By: Department of Rasashastra and Bhaishajya

Kalpana,

Mahatma Gandhi Ayurved College, Hospital &

Research Centre, Salod(H), Wardha,

Maharashtra.

''Reverse Pharmacology''

8th

Dr Bharat Rathi- 9011058301

Dr Rohit Gokarn-7720909139

Mr. Maneesh Deshmukh-9324326262

Rectification:

In the issue V2-N2, April-June 2014 contents, the article title in the short communication - important

tool for health and disease” is misprinted along with withdrawn co-author's name. The inconvenience is deeply

regretted.

“Prakriti

A National Workshop

“Research / Book Writing skills”

On

To be held on - December 2014

Under the guidance of Journal of Indian

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By Department of Panchakarma

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12 13th th

Send your registrations to

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Authors should follow the following specifications

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” is

Quarterly Peer Reviewed International Journal of

research in Ayurveda published from Mahatma

Gandhi Ayurved College, Hospital & Research

Centre, a Constituent College under Datta Meghe

Institute of Medical Sciences, (DU) Nagpur. It offers

the publication of -

· Randomized

controlled trials, interventions studied, studies of

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and surveys with high response rate. (

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· Systemic critical assessments

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· The referencing (Books, Article, Reports,

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and the references are typed Arabic

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running text and also at the references place.

e.g. [1]

Agnivesha,

chapter 18/32 sloka., 5th ed. New Delhi:

Munshiram Mohanlal Publishers Pvt. Ltd.;

1992. p.541.

[2] Choudhury P, Prajapati NC, Puri RK,

Sachdev HP. Impact of national immunization

schedule on vaccine preventable diseases: A

hospital based study. Indian Pediatr 1992; 29:

33-38.

Do not write headings in al l

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5 Keywords ( 8 Introduction –

Methods – Observations & Results –

Discussion – Conclusion – References

(Authors

/ Editors: Name of chapter, Name of book,

Publisher, Place, year, inclusive page

numbers)

(e.g.: [13])

Jadavaji Trikamji Aacharya ed,

Charaka Samhita, Chikitsa Sthana,


CAPITALS.

recommend a Reviewer

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that the author is abiding with the regulations of

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Initially the editorial team scrutiny the content

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Research Centre,Salod (H), Wardha- 442004,

(MS) India


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