PRESENTING A WORK DONE BY Dr. DEVANGI PATEL IN THE YEAR 2004.

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1 The Role of Nasya (with Medhya drug) in the Rajo-NivrittiJanya Lakshana w.s.r. to Menopausal syndrome Scholar Dr. Jatinder kour PRESENTING A WORK DONE BY Dr. DEVANGI PATEL IN THE YEAR Dr. S.B. Donga Prof. L.P. Dei Department of Stree Roga & Prasooti Tantra Institute for Post Graduate Teaching & Research in Ayurveda Gujarat Ayurveda University, Jamnagar

2 Youth is a phase of excitement and adventure. Middle age is a period of career, family and responsibilities. And old age means time to relax and slow down. The years of play, adventure long working hours, stress, etc. Slow the body and may cause aches and pains. INTRODUCTION.txt

3 The woman is an axle Around whom not Only the family or the society but the whole Universe revolves. Her health is more important In all stages of her life more But menopausal condition more severe and difficult to handle without proper understanding medical advice, social support as well. Page 3

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5 Currently, 43 million Menopausal women Average age of Menopause 47.5 years According to IMS By 2026, 103 million Menopausal women Third consensus meeting of Indian Menopause Society (2008): A summary

6 Continue---- Now- a- days, due to change life style psychological and physiological symptoms of Menopause are much pronounced and require much importance in International Medicinal world. Free Powerpoint Templates Page 6

7 SYMPTOMS Hot flushes Night sweating Sleep disturbances Tingling sensations Mood swings Depression Anxiety Crashing fatigue Loss of libido Arthritis Dysuria Urine incontinence Urinary Frequency Dryness of vagina Dyspareunia Hypertension

8 WHY NOT HRT???? loss of memory endometrial cancer allergic reactions drug dependence impaired motor function immobility

9 Aims & Objectives To evaluate the therapeutic efficacy of Madhya Ghrita Nasya in Rajonivrittijanya lakshanas To study the effect of Nasya in psychological parlance w.s.r. to menopausal syndrome.

10 Materials and methods Patients were selected from the O.P.D. of the Department of Stree roga & Prasooti- tantra, I.P.G.T. & R.A. Jamnagar. Patients fulfilling the criteria for selection were integrated into the study irrespective of cast, religion etc. A detailed history was filled up in the specially prepared proforma on Ayurvedic guidelines as well as Modern.

11 Criteria for selection of Patients Willingness of patients Age years Psychological disturbances Inclusion criteria Amenorrhoea for 12 months Having clinical features of Menopausal syndrome

12 Cont Text Menopausal women with untoward effects Textof HRT Text Exclusion Criteria Text Evidence of malignancy Text Text Established cases of HTN, DM, hepatic disorders..

13 Investigations Haematological : Hb, TLC, DLC, ESR Bio-chemical : Lipid Profile, RBS Urine Examination : Sugar, Protein, WBC, RBC Specific Examination: Vaginal Cytology 1.

14 WHY MEDHYA GHRITA???? Psychotropic Anti-stress Anti Aging Tranquilizer The drugs given in the form of Ghrita, a form of lipid, is likely to be rapidly absorbed and distributed in the target areas of the body such as the nervous system in this case. The main reason behind this is the molecular structure of the blood brain barrier. The membrane separating the CNS tissue and the circulating blood is lipophilic in nature.

15 The test drug 'Medhya Ghrita were prepared in the pharmacy of Gujarat Ayurved Univeristy, Jamnagar..

16 WHY NASYA???? Nasya therapy is part of Panchakarma and is a natural route for delivering rejuvenating substances to the brain. 16

17 Treatment protocol Nasya Drug Medhya Ghrita Dose 8 drops in each nostril Route Nasal Duration 2 courses of 8 days with an interval of 8 days

18 CRITERIA FOR ASSESSMENT Results of the treatment were assessed on the basis of relief in signs & symptoms of Menopausal Syndrome with the help of specific scoring pattern as recorded in research proforma. To assess the effect of treatment Won Vaginal cytology were done before treatment (BT) and after treatment (AT) to see Maturation Index (MI) & The mean Maturation T Value (MV) for the estrogen level in the blood which has positive effect on vaginal cells.

19 Criteria for assessment of overall effect of the therapy Unchanged 25% changes in the signs and symptoms Mild Improvement: 25-50% relief in the signs and symptoms Moderate improvement 51-75% relief in the signs and symptoms Marked improvement: % relief in the signs and symptoms Statistical estimation of results The obtained data were analyzed statistically. The values were expressed as percentage of relief and Mean SEM and Paired t test. P > 0.05 P < 0.05 & 0.01 P < Insignificant Significant Highly significant

20 Status of the Patients Trial Group Total no. of the patients Registered 14 Completed 12 Discontinued 02

21 Pharmacodynamic Properties of the ingredients of Medhya ghrita No Drugs Rasa Guna Virya Vipaka Prabhava Doshaghnata 1. Manduk parni Tikta, Kashaya Laghu, Sheeta madhura Medhya Tridosha shamak 2.. Yastimadhu Madhura Tikta Snigdha, Guru Sheeta madhura Medhya, Kanthya,Va rnya Vata Pitta Shamak 3. Guduchi Tikta Kashaya 4. shankh-pushpi Tikta Katu Snigdh, Gurua Snigdha Pichchhila Ushna Madhura Rasayana, medhya,vr ishya Tridosh Shamak Sheeta Madhura Medhya Tridosh Shamaka Vata Pitta shamak 5. Jatamansi Madhura Tikta Kashaya Snigdha LaTikshnaG hu, Tikshna Sheeta Katu Bhutaghna (Manasdosha hara Tridosh Shamak

22 EFFECT OF THERAPY IN CHIEF SOMATIC COMPLAINTS % %

23 THERAPY ON CHIEF PSYCHOLOGICAL COMPLAINTS % %

24 EFFECT OF THERAPY ON VAGINAL CYTOLOGY(BY MI) No. Vaginal Epithelial cells Mean score of Maturation Index (MI) BT AT Changes in mean number of cells 1 Parabasal cells Intermediate cells 3 Superficial cells

25 TOTAL EFFECT OF THERAPY % % Marked improvement Moderate improvement Mild improvement No improvement

26 FOLLOWUP STUDY (Somatic symptoms) % %

27 FOLLOWUP STUDY (Psychological symptoms) % % 0

28 28 DISCUSSION As Menopause is considered as a Vardhakya janita vyadhi, Rasayana particularly in the form of Medhya Rasayana is the first line of treatment, which is Medhya, Smritikara, Vatahara, Ayuprada, Nidrajanaka, Bala Agnivardhaka, etc.

29 Efficacy of Medhya Ghrita The drug Medhya Ghrita, having Rasayan, Blaya, Medhya, Indriya Tarpaka etc. properties, when administered through nasal route, it reaches the Shirah (which is a pradhana indriya) by various siras, and acts mainly on Tarpaka Kapha, Prava Vayu and Manovaha Srotas, and gives benefits like Mental ability, Will power, Intellect, Strength, Immunity, Longevity, Vitality, Luster & Tint, Youthfulness, Vigor-competence etc., which will be helpful to extinguish the symptoms of Rajonivritti mainly in psychological background. Drug like Yastimadhu may act as estrogen and helps to alleviate stress. 29

30 Efficacy of Medhya Ghrita Apart from these, Nasya may have some effect on Thermoregulatory center of the brain, by which it could be able to pacify the Hot flushes, Excessive sweating, etc., symptoms of menopause. The probable role on Hypothalamo-Pituitary-Ovarian axis also should be taken into consideration in this regard. The action on brain may also seem to be beneficial in the symptoms like Palpitations, Sensation of pins and needles prick in palms and soles etc. The tranquilizing and antistress properties of majority ingredients may help to allay the symptoms related to Manovaha Srotas like Sleep Disturbances, Irritability, Depression, Mood Swings, etc.

31 31 Efficacy of Medhya Ghrita Due to limited actions of nasya, this therapy may not able to prove its efficacy in the symptoms related to GIT like Constipation, Flatulence etc and other systemic symptoms like Pain in joints, Backache, Loss of urinary control, etc. In these symptoms oral administration of drugs may be more beneficial.

32 conclusion Medhya Ghrita Nasya is better in various Psychological disturbances mainly include Irritability, Depression, Mood Swings, etc in comparison of Somatic Complaints including GIT disturbances as well as Vaginal dryness and Hot flushes, etc. In Vaginal Cytology, the process of Maturation of vaginal epithelial cells was observed, which indicates some hormonal (mainly estrogenic) effect of the drug. So, it can be concluded that in women with moderate symptoms of menopausal syndrome, Nasya therapy may give better result in both Somatic and Psychological complaints more on psychological.