INTERNATIONAL JOURNAL OF AYURVEDA & ALTERNATIVE MEDICINE

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1 p-issn e-issn Vol - 3 / Issue - 5 / Sept - Oct Free Full I J A A M INTERNATIONAL JOURNAL OF AYURVEDA & ALTERNATIVE MEDICINE Bi-Monthly Peer Reviewed Indexed International Journal

2 INTERNATIONAL JOURNAL OF AYURVEDA & ALTERNATIVE MEDICINE eissn : Editor in Chief Dr. Swati D. Bhingare BAMS, MD (Ayu) editorijaam@gmail.com Executive Editor Dr. Dhanashri H. Mahajan BAMS, MS (Ayu) Associate Editors Dr. Ranjeet S. Sawant Assistant Professor Dept. of Rasashastra & B.K. KGMP Ayurved College, Charni Rd., Mumbai (Maharashtra) Dr. Manish S. Bhoyar Assistant Professor Dept. of Rasashastra & B.K. Govt. Ayurved College, Nagpur (Maharashtra) ADVISORY BOARD MEMBERS Dr. Sandeep V. Binorkar Assistant Professor Dept. of Agadatantra Govt. Ayurved College, Nanded (Maharashtra) Dr. Amitabh Kumar Vice-President - Ayurveda Central Council of Indian Medicine New Delhi, India Prof. K. R. Kohli Director of AYUSH, Govt. of Maharashtra, Fort, Mumbai India Prof. Laxmikant Dwivedi Dept of Rasashastra & BK, GJAC & RC, New V. V. Nagar, Anand, (Gujarat) India Prof. Shrikrishna Sharma (Khandel) Europa University, Viadrina, Frankfurt Oder, Germany, Naturafarm GmbH, Togo st, Berlin Joerg Gruenwald Analyze & realize GmbH, Waldseeweg 6, Berlin, Germany Dr. Babasaheb Patil Professor & Principal I/c B.S. Ayurveda College, Sawantwadi Maharashtra Dr. Mary Smitha Golden Kiwi Ayurveda Health Centre Member of New Zealand Ayurvedic Association and Natural Health Practitioners, Auckland, New Zealand Dr. Neeta Mahesekar Professor, Head of the Department (Ob. & Gy.), Dange Ayurveda Medical College, Ashta, Maharashtra, India Dr. Anand B. Kulkarni Professor & Head, Dept. of Agad Tantra & Vyavahar Ayurved, B.S.D.T s Ayurved Mahavidyalaya, Wagholi, Pune India Prof. A.P.G. Amarasinghe Professor, Institute of Indigenous Medicine (IIM) University of Colombo, Rajagiriya, Sri Lanka Shanmugamurthy Lakshmanan Vice President for International Research & Distinguished Scientific Advisor, World Institute for Scientific Exploration, Baltimore, MD & Research Scientist, Wellman Center for Photomedicine, Massachusetts General Hospital Harvard Meical School, Boston, USA Dr. A.B. Pant Senior Scientist & I/c In Vitro Toxicology, CSIR-Indian Institute of Toxicology Research, Lucknow (UP) ***** IJAAM Vol: 3 / Issue: 5 / Sept - Oct 2015 i

3 INTERNATIONAL JOURNAL OF AYURVEDA & ALTERNATIVE MEDICINE eissn : EDITORIAL BOARD MEMBERS Dr. Dilip K. Jani Associate Professor & Head, Department of Dravyaguna, G. J. Patel Ayurved College, New Vallabh Vidyanagar, Anand , Gujarat Dr. Sanjeev Rastogi Associate Professor and Head Dept of Pancha Karma, State Ayurvedic College & Hospital, Tulsi Das Marg,Lucknow Dr. Manojkumar Shamkuwar Lecturer, Department of Panchakarma A & U Tibbia College & Hospital, Karol Bagh, New Delhi Dr. Ashvin Bagde Asst. Professor, Sanskrit, Samhita Siddhant, Govt. Ayurved College, Osmanabad (Maharashtra) Dr. Anuradha Patil Associate Professor, Dept of Rasashastra & Bhaishajya Kalpana, L.R.P. Ayurvedic Medical College, Islampur, Dist. Sangli Dr. K. Ravindra Bhat Assistant professor, Dept. of Kayachikitsa, Karnataka Ayurveda Medical College, Ashoknagar, Mangalore Karnataka Dr. Harish Kumar Singhal Assistant Professor, Department of Kaumarbhritya Dr. S. R. Rajasthan Ayurved University, Jodhpur, Rajasthan Dr. Kiran Nimbalkar Lecturer, Department of Agadatantra A & U Tibbia College & Hospital, Karol Bagh, New Delhi Dr Yogita Shrivas Professor, Department of Kaumarbhritya Government Ayurved College, Nagpur Maharashtra Dr. Guruprasad Assistant Professor, Department of Swasthavritta Sri Jayendra Saraswathi Ayurveda College & Hospital Nazarathpet, Chennai, Tamilnadu Dr. Pooja Kohli Ayurveda Expert Central Council of Indian Medicine (CCIM) Janakpuri, New Delhi, INDIA Dr. Ajay Gopalani Ayurveda Consultant Shah Satnamji Speciality Hospitals Sirsa , Haryana Dr. Pramod C. Baragi Reader, Dept. of Rasashastra & BK N. K. Jabshetty Ayurvedic Medical College Manhalli Road, Gumpa,Bidar (Karnataka) Dr. Kamini Kaushal Professor,Dravyaguna Department, Rishikul Govt. Ayurvedic PG college, Haridwar (UttaraKhand) INDIA Dr. Umapati C. Baragi Associate Professor, Dept. of Basic Principles, S.D.M. College of Ayurveda, Udupi, Karnataka Dr. Vijaykumar D. Nandvadekar Associate Professor Department of Kriya Sharir, Gomantak Ayurveda College, Vazem, Shiroda, Goa Min-hui Li National Resource Center for Chinese Materia Medica China Dr. Yogesh S. Deole Assistant Professor & Consultant Dept. of Kayachikitsa, G. J. Patel Ayurved College, New Vallabh Vidyanagar, Anand , Gujarat ***** IJAAM Vol: 3 / Issue: 5 / Sept - Oct 2015 ii

4 INTERNATIONAL JOURNAL OF AYURVEDA & ALTERNATIVE MEDICINE THE JOURNAL: International Journal of Ayurveda & Alternative Medicine (IJAAM) is a peer reviewed scientific open access professional journal, publishing full-length original research papers and reviews on Ayurveda, Complementary & Alternative Medicine and allied health disciplines. The journal endow with an inter-disciplinary platform for linking contemporary & traditional knowledge with the most recent developments in scientific world. IJAAM will explore disciplines like Ayurveda, Yoga, Naturopathy, Pharmacognosy, Botany, Ethnobotany, Ethnomedicine, Taxonomy, Ethnopharmacology, Biology, Biotechnology, Medicinal Chemistry, Pharmacology, Clinical Pharmacology, Phytochemistry, Clinical Research, Animal Experiments. All manuscripts contributed to IJAAM will be subjected to rigorous editorial & double blind expert peer review process considering that the same have not published previously and also are not under consideration for publication elsewhere. AIM & SCOPE: International Journal of Ayurveda & Alternative Medicine (IJAAM) publishes original scientific research reports, case reports, short communications, letters to the editor and reviews which cover significant new findings in all areas of Ayurveda and Alternative health care sciences (including epidemiology, public and environmental health). Book reviews, scientific news and conference proceedings are published on special request. IJAAM follows stringent guidelines to select the manuscripts on the basis of its originality, importance, timeliness, accessibility, grace and astonishing conclusions. IJAAM is also popular for rapid publication of accepted manuscripts. 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The limit of such articles is 15 pages and does not include references. Abstract up to 250 words is a must. Brief Communication: Though they are much like original articles they have certain limitations in the study. The limit of such articles is 5 pages and does not include references. Abstract up to 250 words is a must. Case Report: Interesting cases which are very significant will come under this category. The purpose of reporting the case should be mentioned in the introduction. The limit of such articles will be 5 pages and does not include references. Abstract up to 250 words is a must. Letter to the Editor: This section should be short and decisive observation and should not require any further iii

5 INTERNATIONAL JOURNAL OF AYURVEDA & ALTERNATIVE MEDICINE paper for validation. The limit of such articles will be 2 pages and does not include references. Symposia: Will include commissioned articles from the editorial board. AUTHORSHIP CRITERIA: A person can be author when he /she make an important and substantial contribution towards the making of the article in relation to the content, concept, data, its analysis and its interpretation. All authors should be in a position to take public responsibility for the contents of the article. The order of naming the authors should be based on the relative contribution of the authors towards the study and writing the manuscript. Number of contributors should not be more than six. No change in the order of names or inclusions as author will be done unless it is supported by the written consent of all the contributors. No change will be permitted after acceptance of the article. 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6 INTERNATIONAL JOURNAL OF AYURVEDA & ALTERNATIVE MEDICINE assay for anti inflammatory drugs. Proc Soc Exp Biol 1962; (111):544. Website reference: s.php [Accessed date ] Ethical Guidelines: Studies on human beings should indicate whether the procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional or regional) and with the Helsinki Declaration of 1975, as revised in 2000 ( c_e.html) A statement on ethics committee permission and ethical practices must be included in all research articles under the 'Materials and Methods' section. Evidence for approval by a local Ethics Committee (for both human as well as animal studies) must be supplied by the authors on demand. The ethical standards of experiments must be in accordance with the guidelines provided by the CPCSEA and World Medical Association Declaration of Helsinki on Ethical Principles for Medical Research Involving Humans for studies involving experimental animals and human beings, respectively). The journal will not consider any paper which is ethically unacceptable. Processing Fee / Charge: There are no fee / charges for initial submission of manuscript and for its evaluation. Only on acceptance of the manuscript after peer review, corresponding author will have to pay nominal amount /charges for processing, handling, editing, indexing and web maintenance. The mode of payment will be informed by mail to the corresponding author. Merely a submission of manuscript does not guarantee the final publication until and unless the manuscript pass all the required criteria and peer review. ADVERTISING POLICIES IJAAM accepts and display classified advertisements from the pharmacies, hospitals and manufacturers of medical equipments. Discounts on frequent publications and special positions are available on request. Further inquiries about advertising can be sent to editorijaam@gmail.com IJAAM reserves the right to accept or reject Copyright: The entire contents of International Journal of Ayurveda & Alternative Medicine (IJAAM) are protected under Indian & international copyrights the journal however grants to all the users a free unalterable worldwide uninterrupted right to access to and a licence to copy, use, distribute and display the work widely in any digital medium for any reasonable non-commercial purpose, subject to proper attribution of authorship and ownership of the rights. The IJAAM also grants the right to make small number of printed copies for their personal non commercial use. Disclaimer: The information and opinions published in the IJAAM reflects the views of the authors only and not of the journal or its editorial board or publisher. Publication does not constitute endorsement by the IJAAM. Neither the International Journal of Indian Medicine nor the publishers including the persons involved in creating, producing or delivering assumes any liability or responsibility for the precision, completeness or usefulness of any information provided in the journal. IJAAM shall not be responsible for any direct, indirect or consequential damages arising as a result of use of information published in IJAAM. Readers are hereby requested to confirm the information contained herein with the other relevant and reverent sources. Address for Communication: Editor-in-Chief International Journal of Ayurveda & Alternative Medicine (IJAAM) # 401/8-A, 4th Floor, Shiv Shrishti Apt. Nardas Nagar, TP Rd., Bhandup (W), Mumbai (Maharashtra) INDIA editorijaam@gmail.com ***** IJAAM Vol: 3 / Issue: 5 / Sept - Oct 2015 v

7 INTERNATIONAL JOURNAL OF AYURVEDA & ALTERNATIVE MEDICINE INTERNATIONAL JOURNAL OF AYURVEDA & ALTERNATIVE MEDICINE (IJAAM) IS INDEXED / CITED IN FOLLOWING DATABASE 1. National Library of Medicine (NLM) Division of NCBI (PubMed) USA (NLM ID ) 2. AYUSH Portal - Evidence Based Research Data of AYUSH System at Global Level 3. International Scientific Indexing (0.815) UAE 4. International Society for Research Activity (ISRA) - JIF Directory of Research Journals Indexing 6. Cite Factor - Academic Scientific Journals 7. Global Impact Factor (GIF) (2014) 8. Directory of Science Central (Popularity Score 26.65) 9. Google Scholar 10. Indian Science 11. Research Bible 12. Eurasian Scientific Journal Index 13. Scientific Indexing Services 14. Scientific Journal Impact Factor (SJIF) (2012) 15. International Impact Factor Services 16. Open Academic Journals Index 17. Efita 18. Science Central 19. JIFACTOR 20. COSMOS Impact Factor 21. Gaudeamus 22. Budapest Open Access Initiative 23. Scholarsteer 24. Journal Index 25. Academic Keys 26. WILBERT 27. Virtual Library Eastern Europe 28. GetInfo 29. Social Science Open Access Repository 30. GIGA German Information Centre (Electronic Journals Library) 31. KVK Zeitschriftendatenbank 32. Universitatsbibliothek Ilmenau 33. ERIH PLUS 34. Electronic Journals Library - University Library of Leipzig 35. Electronic Journals Library - University of Regensburg 36. Electronic Journals Library - Social Science Research Centre Berlin 37. Open Access Journals Search Engine (OAJSE) 38. Green Pilot 39. Sonic Run 40. ISEDN 41. Exact Seek 42. Polish Scholarly Bibliography 43. Directory of Open Access Journals (DOAJ) - (In Process) 44. Index Copernicus (Under Evaluation) 45. Advance Sciences Index 46. International Institute of Organized Research (I2OR) 47. UCSF Library (Parnassus Ave, San Francisco, CA, United States) 48. American Standards for Journals and Research (ASJR) Texas, USA 49. The International Committee of Medical Journal Editors (ICMJE) 50. JournalTOCs, Edinburgh, EH14 4AS, UK 51. Publication Integrity & Ethics 52. Ourglocal - Academic Resources 53. Ayubhisak 54. ROAD - Directory of Open Access Scholarly Resources 55. Portal on Central Eastern & Blkan Europe (PECOB) 56. International Journal Impact factor IJIF 57. Directory of abstract indexing for Journals IJAAM Vol: 3 / Issue: 5 / Sept - Oct 2015 vi

8 INTERNATIONAL JOURNAL OF AYURVEDA & ALTERNATIVE MEDICINE CONTENTS Article No. REVIEW ARTICLES Title & Author Page No 1 CRITICAL ANALYSIS OF RASAYANA DRAVYAS FROM BHAVPRAKASH NIGHANTU ON THE BASIS OF RASAPANCHAKA Dhalpe Bipin 1*, Kulkarni Yogini ORIGINAL RESEARCH ARTICLE 2 STHOULYA (OBESITY) A MOST COMMON ETIOLOGY FOR SANDHIVATA- AN EPIDEMIOLOGICAL STUDY Das Jeuti Rani 1*, Das Hemanta Bikash 2, Mandal Sisir Kumar 3, Sharma Surendra Kumar MANAGEMENT OF OSTEO-ARTHRITIS WITH AYURVEDA Mayur Pawaskar 1*, V.C. Bawane 2, Nikhil Joglekar COMPARATIVE STUDY OF MUSTADI KWATH (AYURVEDIC HERBAL DECOCTION) AND NAVAK GUGGULU (HERBAL PREPARATION) IN THE MANAGEMENT OF MEDOROGA (OBESITY) Bharat Zinjurke 1*, Shaunak Mirikar 2 OPTIMIZATION OF NETHRA PARISHEKA KRIYAKALPA (PROCEDURE FOR CLOSED EYE IRRIGATION) - A SURVEY STUDY ON PREVALENT PRACTICE K.S. Dhiman 1, G.Gopinath 2, Riju Agarwal 3*, V.J. Shukla 4 STUDY OF ROLE OF DARUHARIDRA RASAKRIYA & MADHU PRATISARAN IN MANAGEMENT OF PITTAJ SARVASAR (STOMATITIS) K. S. Wakode 1 * FUTURE EVENTS 7 CONFERENCES / SEMINARS / SYMPOSIA 282 Entire ISSUE IJAAM- Vol:3/ Issue:5/ Sept Oct ***** IJAAM Vol: 3 / Issue: 5 / Sept - Oct 2015 vii

9 REVIEW ARTICLE Impact Factor (2014) by International Scientific Indexing (ISI) UAE CRITICAL ANALYSIS OF RASAYANA DRAVYAS FROM BHAVPRAKASH NIGHANTU ON THE BASIS OF RASAPANCHAKA Dhalpe Bipin 1*, Kulkarni Yogini 2 1. Assistant Professor, Dept. of Dravyaguna, R. A. Podar Medical College (Ayu), Mumbai, Contact No , - bipindhalpe@gmail.com 2. Professor, Dept. of Dravyaguna, PDEA S College of Ayurveda and Research Centre, Nigdi Pune, MS Article Received on - 25 th Oct 2015 Article Revised on - 30 th Oct 2015 Article Accepted on - 5 th Nov 2015 All articles published in IJAAM are peer-reviewed and can be downloaded, printed and distributed freely for non commercial purpose (see copyright notice below). (Full Text Page IJAAM This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( which permits unrestricted non commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Dhalpe Bipin & Kulkarni Yogini, Critical Analysis of Rasayana Dravyas from Bhavprakash Nighantu on the Basis of Rasapanchaka, Int. J. Ayu. Alt. Med., 2015; 3(5):

10 REVIEW ARTICLE CRITICAL ANALYSIS OF RASAYANA DRAVYAS FROM BHAVPRAKASH NIGHANTU ON THE BASIS OF RASAPANCHAKA *Corresponding Author Dhalpe Bipin Assistant Professor, Dept of Dravyaguna, R. A. Podar Medical College (Ayu), Mumbai Contact No , - bipindhalpe@gmail.com QR Code IJAAM ABSTRACT: Bhavprakash Nighantu is a clinically important Nighantu as compared to other nighantu granathas. The Rasayana dravyas contributes to the promotion of health, longevity and prevention of diseases, which leads to the sustainability of Ojus status resulting increase in immunity. By screening rasayana dravyas from bhavprakash nighantu can give useful information regarding use of these Rasayana dravyas in daily routine to adopt healthy life style. The literary screening inferred that there is about 21 Audadhid dravyas are recommended as rasayana in sutras, but their action as rasayana is not defined on the basis of their rasapanchakas. A literary review of rasapanchakas of these rasayana dravyas explained in bhavprakash Nighantu is done to make an attempt to assess their probable mode of action as rasayana. Key Words: Rasayana, Bhavaprakash Nighantu, Rasapanchaka INTRODUCTION The term Rasayana (Rasa + Ayana) essentially refers to nutrition and nourishment. More specifically refers to bioavailability of nutrition. In today s busy era maintaining good health has become as a big challenge. Due to sedentary life style and faulty dietary habits lead to various disorders. In order to conquer such hazards use of Rasayna dravyas will be beneficial. The Rasayana drugs and formulations provides longevity, memory, intelligence, freedom from disorders, youthful age, excellence of luster, complexion and voice, oratory, optimum strength of physique and sense organs, respectability and brilliance. Bhavaprakash Nighantu is a well-known nighantu amongst other nighantu granthas in ayurveda. Most of the ayurveda physicians refer bhavaprakash nighantu in day to day practice. In Bhavaprakash Nighantu there are 21dravyas explained as rasayana in sutras. This review article will throw light on probable mode of action of rasayana dravyas on the basis of their rasapanchakas. On critical review all the dravyas explained as rasayana are possessing rasayana Karma related pharmacological activity.maximum dravyas are having Madhura Rasa, Madhura Vipaka and Sheeta Veerya. AIM AND OBJECTIVES 1) To enlist dravyas mentioned as rasayana in sutras of Bhavaprakash Nighantu 2) To screen the above selected dravyas to assess their probable action as rasayana. 3) To classify the dravas on the basis of rasadi properties, doshaghnata and also specific pharmacological actions responsible for rasayana karma. MATERIAL AND METHODS 1) Bhavaprakash Nighantu by Krishna Chandra Chunekar commentary. 2) Pubmed and Google scholar websearch regarding rasayana action. Methods 1) Dravyas mentioned as rasayana in sutras from Bhavaprakash Nighantu are enlisted. 2) The review of the selected Rasayana dravyas from Bhavaprakash Nighantu for their Rasadi properties, doshaghnata, part used, Sanskrit names, Latin names and its Rasayana related pharmacological activity were taken. 3) The Pub Med and Google scholar web search of enlisted rasayana dravyas was done for their rasayana action as per modern pharmacology. 4) The classification of dravyas on the basis of above review done. 5) Critical analysis of these dravyas to assess probable, mode of action as rasayana on the basis of their rasadi properties, doshaghnata and modern pharmacological activities responsible for rasayana karma. Page246 Dhalpe Bipin & Kulkarni Yogini, Critical Analysis of Rasayana Dravyas from Bhavprakash Nighantu on the Basis of Rasapanchaka, Int. J. Ayu. Alt. Med., 2015; 3(5):

11 Table No 1: List of Dravyas along with their Family, Latin name and Part used. [1] Dravyanam Family Latin Name Useful Part Haritaki Combrataceae Terminalia chebula Retz. Fruit Amalaki Phyllanthaceae Phyllanthus emblica Gaertn. Fruit Pippali Piperaceae Piper longum Linn. Fruit, Root Bakuchi Leguminosae Psoralia corylifolia Linn. Seed, Oil Lashun Amaryllidaceae Allium Sativum Linn. Bulb, Oil Guggul Burseraceae Commiphora mukul DC. Resin Guduchi Menispermaceae Tinospora cordifolia Willd Stem, Leaves Gambhariphal Verbenaceae Gmelina arborea Roxb. Root, Fruit Shalparni Fabaceae Desmodium gangeticum DC. Root, Whole Plant Jivanti Asclepiadaceae Leptadenia reticulate Ketz. Root, Fruit Vidarikand Fabaceae Pueraria tuberose DC. Rhizome Mushali Asparagaceae Asparagus adscendens Roxb. Rhizome Shatavari Asparagaceae Asparagus racemosus Willd. Rhizome Ashwagandha Solanaceae Withania somnifera L. Root Vridhhadaru Convolvulaceae Argyreia nervosa L. Root Kumari Liliaceae Aloe Vera L. Leaves Bhringraj Asteraceae Eclipta alba L. Whole Plant, Seeds Kakamachi Solanaceae Solanum nigruml. Whole Plant, Fruit Shankhapushpi Convolvulaceae Convolvulus pluricaulis Choisy Whole Plant Brahmi Scrophulariaceae Bacopa monnieri L. Whole Plant Shalmali Bombacaceae Bombax malabaricum DC. Root, Flower, Resin Table 2:_Dravya List along with Rasapanchaka information [1] Dravyanam Rasa Vipaka Veerya Guna Doshaghnata Haritaki Lavanarahitpancharas, Kashaya pradan Madhuar Ushna Laghu, Rukshsa Tridoshahar Amalaki Lavanarahitpancharas, Guru, Rukshsa, Madhuar Sheeta Amlapradan Sheeta Tridoshahar Pippali Katu Madhur AnushnaSheeta Laghu, Snigdha, Teekshna Kaphavatashamak Bakuchi Katupikta Katu Ushna Laghu, Rukshsa Kaphavatashamak Lashun Amlarahitpancharas Katu Ushna Snigdha, Teekshna, Guru, Sara, Pichhil Kaphavatashamak Guggul Tiktakatu Katu Ushna Laghu, Rukshsa, Teekshna, Vishada, Tridoshahar Sukshma, Sugandhi Guduchi Tiktakashaya Madhura Ushna Guru, Snigdha Tridoshashamak Gambharipha Madhurkashaya Madhura Sheeta Guru, Snigdha Vatapitashamak Shalparni Madhurtikta Madhura Ushna Guru, Snigdha Tridoshashamak Jivanti Madhura Madhura Sheeta Laghu, Snigdha Tridoshahar Vidarikand Madhura Madhura Sheeta Guru, Snigdha Vatapitashamak Mushali Madhura Madhura Sheeta Guru, Snigdha Vatapitashamak Shatavari Madhurtikta Madhura Sheeta Guru, Snigdha Vatapitashamak Ashwagandha Tiktakatumadhura Madhura Ushna Laghu, Snigdha Kaphavatashamak Vridhhadaru Katutiktakashaya Madhura Ushna Laghu, Snigdha Kaphavatashamak Kumari Katu Katu Sheeta Guru, Snigdha,Pichhil kaphapittanashak Bhringraj Katutikta Katu Ushna Laghu, Rukshsa Kaphavatashamak Kakamachi Tikta Katu Anushna Laghu, Snigdha Tridoshashamak Shankhapushpi Tikta Madhura Sheeta Snigdha,Pichhil Tridoshahar Brahmi Tikta Katu Ushna Laghu Kaphavatashamak Shalmali Madhura Madhura Sheeta Laghu, Snigdha,Pichhil Vatapitashamak Page247 Table 3:-Rasayana Dravya as per their Veerya. [1] Virya No. Of Dravyas Ushna 10 Sheeta 10 Anushna 1 Dhalpe Bipin & Kulkarni Yogini, Critical Analysis of Rasayana Dravyas from Bhavprakash Nighantu on the Basis of Rasapanchaka, Int. J. Ayu. Alt. Med., 2015; 3(5):

12 Table 4:-Rasayana Dravya as per their Rasa. [1] Rasa No. of Dravyas Madhura 8 Katu 2 Tikta 3 Katu-tikta 3 Tikta-kashaya 1 Tikta-katu- madhura 1 Katu-tikta-kashaya 1 Lavanarahitpancharas, Kashaya pradan 1 Lavanarahitpancharas, Amlapradan 1 Table 5:-Rasayana Dravya as per their Rasa. [1] Vipaka No. of Dravyas Madhuara 14 Katu 7 Table 6:-Rasayana Dravya as per their Guna. [1] Guna No. of Dravyas Laghu- Rukshsa 3 Guru- Rukshsa- Sheeta 1 Laghu- Snigdha- Teekshna 1 Snigdha- Teekshna- Guru- Sara- Pichhil 1 Laghu- Rukshsa- Teekshna- Vishada- Sukshma- Sugandhi 1 Guru- Snigdha 6 Laghu- Snigdha 4 Guru- Snigdha-Pichhil 1 Snigdha-Pichhil 1 Laghu 1 Laghu- Snigdha-Pichhil 1 Table 7:-Rasayana Dravya as per their Doshghanata. [1] Doshaghnata No. of Dravyas Tridoshahar /Tridoshashamak 8 Kaphavatashamak 7 Vatapittashamak 5 Kaphapittanashak 1 Table 8:-Rasayana drugs along with their related Pharmacological Activity Responsible for Rasayana Karma Dravyanam Haritaki [2] Amalaki [19] Pippali [20] Bakuchi [21] Lashun [17] Guggul [15] Guduchi [14] Gambhariphal [13] Shalparni [12] Jivanti [16] Vidarikand [8] Mushali [18] Shatavari [21] Ashwagandha [11] Vridhhadaru [9] Kumari [7] Bhringraj [3] Kakamachi [10] Shankhapushpi [5] Brahmi [4] Shalmali [6] Related Pharmacological Activity Responsible for Rasayan Karma Immunomodulatory, Antioxidant, Ati-aging, Adaptogenic, Cytoprotective Immunomodulatory, Antioxidant, Adaptogenic Immunomodulatory, Antioxidant Antioxidant Immunomodulatory, Antioxidant Antioxidant Immunomodulatory, Antioxidant, Anti-stress Antioxidant Immunomodulatory, Antioxidant Antioxidant, Anti-depressent Nootropic Immunomodulatory, Antioxidant, Anti-stress Immunomodulatory, Antioxidant, Adaptogenic Immunomodulatory, Antioxidant, Anti-stress, Adaptogenic,Anti-aging Immunomodulatory, Nootropic, Antioxidant Immunomodulatory, Antioxidant, Anti-aging Immunomodulatory, Antioxidant Immunomodulatory, Antioxidant Antioxidant, Anti-stress, Anti-depresent, Nootropic Antioxidant, Anti-stress, Anti-depresnet, Adatopgenic Antioxidant,Androgenic& Anabolic Page248 Dhalpe Bipin & Kulkarni Yogini, Critical Analysis of Rasayana Dravyas from Bhavprakash Nighantu on the Basis of Rasapanchaka, Int. J. Ayu. Alt. Med., 2015; 3(5):

13 DISCUSSION As Rasapanchakas are concerned 08 dravyas are having Madhura Rasa and 14 dravyas having Madhura Vipaka. Out of 21 dravyas screened from Bhavaprakasha nighantu 20 dravyas are having antioxidant activity.14 dravyas had proved for their immune-modulatory action. It was observed that most of the dravyas possessed Madhura rasa and Madhuravipaka.08 dravyas are possessing Tridoshahara property.guna point of view 06 dravyas are having Guru, Snigdha guna and 04dravyas are having laghu, snigdha guna.as per Veerya is concerned about 10 dravyas are having Sheeta veerya and 10 dravyas are having Ushna veerya. The Rasayana dravya may act at various levels of bio-system to promote nutrition; at the level of agni by promoting digestion and metabolism, at level of strotas by promoting microcirculation and tissue perfusion and at the level of dhatu from Rasa to Shukra, ultimately resulting in increased amount of Ojus. Maximum dravyas which are screened are having Sheeta veerya, Guru snigdha guna and Madhura Vipaka.Sheeta veerya, Guru snigdha guna and madhura vipaka which are responsible for SaptadhatuVardhana starting from from first Dhatu Rasa to last Dhatu shukra, which ultimately increases Saptadhatu Sara i.e. Ojus. In Ayurveda it has been cited that more the amount of Oja more the rasayana action.also there are ushna veerya dravyas which are having rasayana karma by increasing Sapta dhatwagni vardhana leading to Prashasta Saptadhatu and oja. In this context these ushna veerya dravyas are having laghu,snigdha gunas which helps in srotoshodhana process. Most of the dravyas having tridoshahara property by which they maintain tridosha balance which leads to rasayana karma. Page249 Dhalpe Bipin & Kulkarni Yogini, Critical Analysis of Rasayana Dravyas from Bhavprakash Nighantu on the Basis of Rasapanchaka, Int. J. Ayu. Alt. Med., 2015; 3(5):

14 CONCLUSION Out of 21 Dravyas screened from Bhavaprakasha nighantu, Madhura Rasa, Madhura Vipaka, Guru snigdha Guna and Tridoshahara Karma are predominant amongst the Rasayana dravya group. Ushna and Sheeta veerya equally contribute for the rasayana karma. All 21 dravyas show Rasayana related pharmacological activity on screening. About20 dravyas are having antioxidant activity. As per the modern science antioxidant property is responsible for rejuvenation, which validates that rasayana dravyas explained by Bhavaprakash nighantu are supported by modern pharmacology. Routine use of these Rasayana dravyas will promote life, maintain positive health and prevent youth by maintaining balance of tridosha and psyche. REFERENCE 1. Dr. Chunekar K.C., Dr. Pandye, Bhavaprakasha Nighantu, 7 th ed. 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J. Ayu. Alt. Med., 2015; 3(5): Source of Support Nil Conflict of Interest None Declared Page250 Dhalpe Bipin & Kulkarni Yogini, Critical Analysis of Rasayana Dravyas from Bhavprakash Nighantu on the Basis of Rasapanchaka, Int. J. Ayu. Alt. Med., 2015; 3(5):

15 RESEARCH ARTICLE Impact Factor (2014) by International Scientific Indexing (ISI) UAE STHOULYA (OBESITY) A MOST COMMON ETIOLOGY FOR SANDHIVATA- AN EPIDEMIOLOGICAL STUDY Das Jeuti Rani 1*, Das Hemanta Bikash 2, Mandal Sisir Kumar 3, Sharma Surendra Kumar 4 1. PG Scholar, Department of Roga Evam Vikriti Vijanana, National Institute of Ayurveda, Jaipur, Rajasthan, Contact No , ID- djeutirani@yahoo.in 2. PG Scholar, Deptt of Prasuti and Stri roga, Govt. Ayurveda College, Guwahati, Assam, Contact No , ID- dhemantabikash@gmail.com 3. Assistant prof. Department of RogaEvamVikritiVijanana,National Institute of Ayurveda, Jaipur, Rajasthan, Contact No , ID- todrskmandal@gmail.com 4. Associate prof. Department of RogaEvamVikritiVijanana,National Institute of Ayurveda, Jaipur, Rajasthan, Contact No , ID- drsksn31@rediffmail.com Article Received on - 22 nd June 2015 Article Revised on - 20 th Sept 2015 Article Accepted on - 25th Oct 2015 All articles published in IJAAM are peer-reviewed and can be downloaded, printed and distributed freely for non commercial purpose (see copyright notice below). (Full Text Page IJAAM This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( which permits unrestricted non commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Das Jeuti Rani et.al., Sthoulya (Obesity) A Most Common Etiology for Sandhivata- An Epidemiological Study, Int. J. Ayu. Alt. Med., 2015; 3(5):

16 RESEARCH ARTICLE STHOULYA (OBESITY) A MOST COMMON ETIOLOGY FOR SANDHIVATA- AN EPIDEMIOLOGICAL STUDY *Corresponding Author Das Jeuti Rani PG Scholar, Department of Roga EvamVikritiVijanana, National Institute of Ayurveda, Jaipur, Rajasthan, Contact No , ID- djeutirani@yahoo.in QR Code IJAAM ABSTRACT: Sandhivata is a Vatavyadhi and now days it is common health problem in the world. There are mainly three causes of Vatavyadhi which are Swanidana, Dhatukshayajanya and Margavarodha. Among which Dhatukshaya is also an important one. As a Vatavyadhi the Nidana of Sandhivata is same with this. In the Nidana of Vata Vyadhi, Sthoulya is not mention, but it leads Sandhivata due to Dhatukshaya. Here a survey study was done to analyze the prevalence of Sthoulya among patient having Sandhivata with classical sign and symptoms, Sthoulya (obesity) on the basis BMI in National institute of Ayurveda, Jaipur with a duly formed proforma. Among 101 patients, out of which 78 patient was Sthoulya. With the help of this it was also try to find out the pathogenesis of Sandhivata in perspective to Sthoulya (obesity). Key Words: Sandhivata, Sthoulya, Dhatukshaya, Obesity, Nidanarthakararoga INTRODUCTION In Ayurvedic text there are some diseases which is called Nidanarthakara Roga, where one diseases is the cause of other disease. [1] Here Sthoulya is the Nidanarthakara of Sandhivata. Sometime the Nidanarthakara Roga subside after producing the disease then it is called Ekarthikari Roga and sometime remain with the disease which is produced by this then it is called Ubhayarthakari. [2] Here Sthoulya is Ubhayarthakari for Sandhivata, because with Sandhivata, Sthoulya also present. From the Samhita period onwards, the disease Sandhigatavata has identified as a separate clinical entity. It is a Vatavyadhi, but it is not mentioned under 80 types of Nanatmaja Vyadhi, by any Acharyas. Acharya Charaka has described it by the name of Sandhigata Anila with the symptoms of Sotha, which is Vata Purna Driti Sparsha (palpable as air filled bag) and Akunchana Prasarane Vedana (Pain on flexion and extension of the joints) [3]. Except Acharya Caraka all Brihatrayee and Laghutrayee mentioned it as Sandhigatavata which is under Vatavyadhi. So, the Nidana of Sandhivata is same as Vatavyadhi. These Nidana can be categorized as Swanidana, Dhatukshayjanya and Margaavarodha. Swanidana [4] include all the Aharaja, Viharaja and Manashika Nidana which directly vitiates Vata & Dhatukshaya is that which increases Vata Dosha after Kshaya of any Dhatu and in Margaavarodha Vayu vitiate after obstruction [5]. In the Nidana of Vatavyadhi, it is not found that Sthoulya is a causative factor, but Uttara Dhatukshaya(asthi, majja) which occur after Sthoulya(obesity) leads the disease Sandhivata. Sthoulya is that where excessive fat and muscle is deposited in buttock, abdomen and breast for which the person has not proper body built and zeal. [6] In modern science Price said that obesity is a condition in which there is an excessive amount of fat. Sthoulya (obesity) is now a global problem, and it leads to Sandhivata. Here a survey study was done to analyze that Sthoulya is a causative factor of Sandhivata on the basis of sign and symptom of Sandhivata and Sthoulya. WHO (2000)1 defines obesity as "abnormal or excessive fat accumulation in adipose tissue, to the extent that health is impaired" [7] AIM AND OBJECTIVE To study the etiopathology of Sandhivata in perspective of Sthoulya that may be considered as one of the most important causative factor in modern era. MATERIAL AND METHOD A survey study was conducted at I.P.D. and O.P.D. of N.I.A. Jaipur in a time period from Nov 13 to Dec 14 in 101 patients in a duly formed proforma in age Group 20-70, satisfying the inclusion criteria. Inclusion criteria: 1. Patients having classical sign and symptoms of Sandhivata 2. Not suffering from any systemic disease 3. Age between 20yrs-70yrs Page252 Das Jeuti Rani et.al., Sthoulya (Obesity) A Most Common Etiology for Sandhivata- An Epidemiological Study, Int. J. Ayu. Alt. Med., 2015; 3(5):

17 4. Patients were taken irrespective of sex, religion, occupation. Exclusion criteria 1. suffering from any systemic disease 2. Age less than 20yrs and more than 70 yrs RESULT AND DISCUSSION The study was done on 101 patients of known case of Sandhivata, among them 78 patient were found with Sthoulya. The demographic data of 78 patients was like this-regarding age out of 78 cases maximum no. of cases i.e. 91% were found in the age group of The next common age group was years (8.97%), followed by 0 cases in age group of 21-35years (figure1). Which shows that among age group yrs Sthoulya(obesity) was more. Among 78 patient weights from kg was 8.97%, from kg was 48.71%, kg was 38.46% and kg was 3.84 % (figure2). Height among 78 patients was 29.48% from meter and 70.52% from meter (figure3). According to their height and weight BMI was like this from kg/m 2 was 32.05% and from kg/m 2 was 67.94%(figure4), which shows that more BMI more is the prevalence rate of Sthoulya(obesity). Distribution of sex in 78 cases reveals that 70.51% of cases were female followed by 29.48% was male (figure5). Prevalency was more among the female. Out of 78 patients 97.43% were from urban habitat and 2.57% from rural habitat(figure6). Due to rising technology there is less physical activity so Sthoulya(obesity) is more in urban area. out of 78 surveyed patients different type of occupation was found among which maximum 62.82% were housewife, 2.56% were serviceman 30.76% businessman, 2.56% farmar, 1.28 teacher, (figure7). The disease is maximum in house wife because spending time in front of T.V., lack of physical activity leads to Sthoulya(obesity). Out of 78 patients 33.33% were Vatapitt Prakriti, 55.12% were Vatakapha Prakriti, 11.53% were Pittakapha Prakriti (figure8). It can be said that patients were more in Vatakapha dominancy(55.12%) and as a whole Vata Prakriti patients was suffering from this Vatavyadhi (Sandhivata) is more. Out of 78 patients 87.17% were Rajasik Prakriti and 12.82% were Tamashik Prakriti (figure9). Vatavyadhi was more prevalent in Rajashik Prakriti because this Prakriti is Vata dominant. In this modern era people become more Rajashik Prakriti, because they forget about the rules of Sadvritta, which is also a cause of Vata Vyadhi. Out of 78 patient taking of cold substance (ice cream, cold drink, shield water) daily was 73.07%, sometime 5.12% and never 21.79%(figure10), Sita is a Guna of Kapha, if excessive amount is taken then it produced Amarasa and leads Srotorodha by Medodhatu Vridhi, which cause Asthidhatukshaya (because Uttaruttardhatu get nutrition) [8],as a result Vata is increased and produced Sandhivata. Out of 78 patients, ghee used in extra amount was % (figure11). This indicate that excessive amount of Sneha increase Meda and leads Sthoulya(obesity) [9]. Out of 78 patient 56.41% were taken MAL(Madhur, Amla, Lavana) Rasa daily, 2.56% were taken ML(Madhur Lavana), 31.17% were taken MALK(Madhur, Amla, Lavana, Katu), MAK(Madhur, Amla, Katu) 1.28%, MKLT(Madhur, Katu, Lavana,Tikta) 2.56% (figure12), almost every patient had taken Madhur substance which increases Kapha, which is the causative factor of Sthoulya [10] among 78 patient day sleep was taken by 53.84% patient(figure13). Day sleep(divaswapna increases Snigdhata) [11] Assessment of Sthoulya(obesity): In Ayurvedic text Sthoulya (obesity) is that where Udara (abdomen), Nitamba (hip) and Stana (breast) size is increase in a person. To measure this there is description of Pramana(measure) of every part of body which is measured by one s own Anguliparva (digit). According to Caraka height of the individual is 84 Angula [12] and according to Susruta it is 120 Angula [13] by patients own Anguli, though the variation is mainly due to postural difference. Measurement of normal Udara its length is 12 Angula and breadth is 10 Angula, [14] distance between two Stana (breast) is 2 angula. [15] In case of Sthoulya (obesity) the measurement of Udara and distance between two breast is decreased. Again in case of Sthoulya(obesity)there is more sweating, cannot bear labour, lack of zeal, thirst and hunger is increased, lack of Vyavaya (sexual intercourse). [16] Again Sthoulya (obesity) can be best measured by BMI (the weight of a person in kilograms divided by the square of the height of that person in meters), between is overweight and > 30 is clinically declared as obesity (Sthoulya). Pathophysiology: Sandhigata Vata is a Vatavyadhi so the pathogenesis is same as Vatavyadhi, either Nidana is Dhatukshayjanya or Margavarodhajanya. In case of Sthoulya (obesity) it is a Dhatukshayjanya Nidana, if we go through the pathogenesis of Sthoulya (obesity) then we see that the person who used to take Madhur Rasa, Sleshmala food and after that if enjoy the day sleep & does no physical exercise then the food substances get converted to Sneha Dravya and these Sneha increases Medodhatu [17], which results Sthoulya (obesity). In modern science it is Page253 Das Jeuti Rani et.al., Sthoulya (Obesity) A Most Common Etiology for Sandhivata- An Epidemiological Study, Int. J. Ayu. Alt. Med., 2015; 3(5):

18 also said that consumption of refined and processed foods, causing nutrient bankruptcy in our body and the lack of adequate physical activity to burn calories and build health. Refined and processed foods are rich in fats, sugars, trans fats, and preservatives. They are also poor providers of nutrition. The lack of nutrients combined with the excess sugar and fats and lack of exercise lead to obesity and poor health [18] As a result other Dhatu get no nourishment due to obstruction of channels by Meda. The next Dhatu of Meda is Asthi, so Kshaya of Asthi Dhatu takes place slowly. Asthi makes Sandhi, [19] so due to Kshaya of Asthidhatu Vata is increased. As a result Vata is located in Sandhi and causes Sandhivata. Samprapti of Sandhivata due to Sthoulya Demographic Data % % Fig1: Age wise % prevalence of 78 patients Fig2: weight wise % Prevalence of 78 Patients % % 50.00% 0.00% % kg/m2 % % kg/m2 Page254 Fig3: Height wise % prevalence of 78 patients Fig4: BMI wise % Prevalence of 78 Patients Das Jeuti Rani et.al., Sthoulya (Obesity) A Most Common Etiology for Sandhivata- An Epidemiological Study, Int. J. Ayu. Alt. Med., 2015; 3(5):

19 VOL 3 INTERNATIONAL JOURNAL OF AYURVEDA & ALTERNATIVE MEDICINE eissn F % Urban M Fig5: Sex wise % prevalence of 78 patients % Rural Fig6: Habitat wise % Prevalence of 78 Patients % % Fig7:occupation wise % prevalence of 78 pts Fig8:Sharirik prakriti wise % Prevalence of 78 Pts Tamashik prakriti % % Fig9: Manashik prakriti wise % prevalence of 78 patients Fig10: weight wise % Prevalence of 78 Patients % Page ghee used in not used extra amount was 255 Rajashik prakriti % Fig11: using of ghee wise % prevalence of 78 patients Fig12: weight wise % Prevalence of 78 patients Das Jeuti Rani et.al., Sthoulya (Obesity) A Most Common Etiology for Sandhivata- An Epidemiological Study, Int. J. Ayu. Alt. Med., 2015; 3(5):

20 55.00% 50.00% 45.00% 40.00% % yes % no Fig13: Day sleep wise % prevalence of 78 patients CONCLUSION Sandhivata occurs in sthoulya person due to dhatukshayjanya vata. Its samprapti is same as vatavyadhi. Due to changing lifestyle as result of urbanization it is increase day by day. Low REFERENCES 1. Lakshmidhar Dwevedi, Dr. B.K. Dwevedi, et al editors, commentatory of Cakrapani on Caraka Samhita, 1 st ed. Varanasi: Chaukhambha Krishnadas Academy; 2008.p Lakshmidhar Dwevedi, Dr. B.K. Dwevedi, et al editors, commentatory of Cakrapani on Caraka Samhita, 1 st ed. Varanasi: Chaukhambha Krishnadas Academy; 2008.p Lakshmidhar Dwevedi, Dr. B.K. Dwevedi, et al editors, Caraka Samhita of Caraka, 1 st ed. Varanasi: Chaukhambha Krishnadas Academy; 2013.p Lakshmidhar Dwevedi, Dr. B.K. Dwevedi, et al editors, Caraka Samhita of Baraka, 1 st ed. Varanasi: Chaukhambha Krishnadas Academy; 2013.p Lakshmidhar Dwevedi, Dr. B.K. Dwevedi, et al editors, commentatory of Cakrapani on Caraka Samhita, 1 st ed. Varanasi: Chaukhambha Krishnadas Academy; 2013.p Lakshmidhar Dwevedi, Dr. B.K. Dwevedi, et al editors, Caraka Samhita of Carak, 1 st ed. Varanasi: Chaukhambha Krishnadas Academy; 2008.p WHO. Obesity- Preventing and managing the Global Epidemic: understanding how overweight and obesity develop, Tech Rpt Ser, 2000: 894, Ambikadutta Sashtri, editor, Susruta Samhita of Susruta, reprint Varanasi: Chaukhambha Sanskrita Samsthan; 2012.p.81 nutritious and high calorie diet with day sleep is the most causative factor of sthoulya (obesity) and with other health problem it also causes sandhivata. 9. Yadavji Trikamji, editor,madhavnidana of Madhavkara, reprint, Varanasi: Chaukhambha orientalia; 2010.p Yadavji Trikamji, editor,madhavnidana of Madhavkara, reprint, Varanasi: Chaukhambha orientalia; 2010.p Lakshmidhar Dwevedi, Dr. B.K. Dwevedi, et al editors, Caraka Samhita of Carak, 1 st ed. Varanasi: Chaukhambha Krishnadas Academy; 2008.p Lakshmidhar Dwevedi, Dr. B.K. Dwevedi, et al editors, Caraka Samhita of Carak, 1 st ed. Varanasi: Chaukhambha Krishnadas Academy; 2008.p Ambikadutta Sashtri, editor, Susruta Samhita of Susruta, reprint Varanasi: Chaukhambha Sanskrita Samsthan; 2012.p Lakshmidhar Dwevedi, Dr. B.K. Dwevedi, et al editors, Caraka Samhita of Carak, 1 st ed. Varanasi: Chaukhambha Krishnadas Academy; 2008.p Lakshmidhar Dwevedi, Dr. B.K. Dwevedi, et al editors, Caraka Samhita of Carak, 1 st ed. Varanasi: Chaukhambha Krishnadas Academy; 2008.p Yadavji Trikamji, editor,madhavnidana of Madhavkara, reprint, Varanasi: Chaukhambha orientalia; 2010.p Yadavji Trikamji, editor, Madhavnidana of Madhavkara, reprint, Varanasi: Chaukhambha orientalia; 2010.p [Accessed on 20 Aug 2015] 19. Brahmananda Tripathi, editor, hindi Commentary Dipika of Sarangadhar Samhita of Sarangadhar, Varanasi:Chowkhambha Surbharati Prakashan,2012, p 62 CITE THIS ARTICLE AS Das Jeuti Rani et.al., Sthoulya (Obesity) A Most Common Etiology for Sandhivata- An Epidemiological Study, Int. J. Ayu. Alt. Med., 2015; 3(5): Source of Support Nil Conflict of Interest None Declared Page256 Das Jeuti Rani et.al., Sthoulya (Obesity) A Most Common Etiology for Sandhivata- An Epidemiological Study, Int. J. Ayu. Alt. Med., 2015; 3(5):

21 RESEARCH ARTICLE Impact Factor (2014) by International Scientific Indexing (ISI) UAE MANAGEMENT OF OSTEO-ARTHRITIS WITH AYURVEDA Mayur Pawaskar 1*, V. C. Bawane 2, Nikhil Joglekar 3 1. Assistant professor, Dept. of Shalyatantra, School of Ayurveda, D. Y. Patil University, School of Ayurveda, Nerul, Navi Mumbai, Contact No , - mail@drmayur.com 2. Associate professor, Dept. of Streerog & Prasutitantra, School of Ayurveda, D. Y. Patil University, School of Ayurveda, Nerul, Navi Mumbai. Contact No , drvcbawane@gmail.com 3. Assistant Professor, Dept. of Kayachikitsa, School of Ayurveda, D.Y.Patil University, School of Ayurveda, Nerul, Navi Mumbai. Ph. No , drnikhiljoglekar@gmail.com Article Received on - 10 th Aug 2015 Article Revised on - 25 th Nov 2015 Article Accepted on - 26 th Nov 2015 All articles published in IJAAM are peer-reviewed and can be downloaded, printed and distributed freely for non commercial purpose (see copyright notice below). (Full Text Page IJAAM This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( which permits unrestricted non commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Mayur Pawaskar et.al., Management of Osteo-Arthritis with Ayurveda,, Int. J. Ayu. Alt. Med., 2015; 3(5):

22 RESEARCH ARTICLE MANAGEMENT OF OSTEO-ARTHRITIS WITH AYURVEDA *Corresponding Author Mayur Pawaskar Assistant professor, Dept. of Shalyatantra, School of Ayurveda, D. Y. Patil University, School of Ayurveda, Nerul, Navi Mumbai, Contact No , - mail@drmayur.com QR Code IJAAM ABSTRACT: Osteoarthritis or degenerative Joint Disease (DJD) may first appear without symptoms between 20 and 30 years of age. The symptoms, such as pain and inflammation, appear in middle age. Till the age of 55 it occurs equally in both sexes; after 55 the incidence is higher in women. It is estimated that approximately four out of 100 people are affected. The incidence of osteoarthritis in India is as high as 12%. By 2030, 20% of Americans which is about 70 million people who have passed their 65th birthday will suffer from Osteoarthritis. Osteoarthritis will be common before age of 45 more in men than women and after age of 45 more common in women. Osteoarthritis is the most common articular disorder which begins asymptomatically in the 2nd and 3rd decades and is extremely common by age 70. Almost all persons by age 40 have some pathologic change in weight bearing joint. 25% females and 16% males have symptomatic OA. Osteoarthritis can be considered as Sandhigatavataand it is described under Vatavyadhi in all the Samhita and Sangrahagrantha. In Vriddhavastha, all Dhatus undergo Kshaya, thus leading to Vataprakopa and making an individual prone to many diseases and among these SandhigataVata tops the list.till date SandhigataVata is a challenging disease and is the number one cause of disability in industrialized countries. The affliction of Sandhis by PrakupitaVata is the main phenomena in Samprapti of SandhigataVata.Sandhis come under the MadhyamaRogaMarga and thus, involvement of MadhyamaRogaMarga, VataDosha and Dhatukshaya figures disease KashtaSadhya.A common treatment for VataVyadhi has been described by Acharya Charaka i.e. Repeated use of SnehanaandSwedana,Basti and MruduVirechana. Acharya Sushruta has mentioned the treatment for SandhigataVata clearly i.e. Snehana, Upanaha, Agnikarma, Bandhana andunmardana.in this Clinical study, A Shamana yoga has been prescribed in patients of Osteoarthritis. 150 patients have been treated withshamanmedicines. The results have shown to be satisfactory in terms of relief in osteoarthritis. Key Words:Sandhigatavata,Vaatvyadhi, Osteoarthritis, Degenative disorder, Shaman chikitsa INTRODUCTION Ayurveda is an ancient and effective medical science and according to Ayurveda, Health is not merely freedom from disease. To be healthy, a person should be happy mentally, physically, socially and also spiritually. Sandhigatavata is described under Vatavyadhi in all the Samhita and Sangraha Grantha. In Vriddhavastha, all Dhatus undergo Kshaya, thus leading to Vataprakopa and making an individual prone to many diseases and among these Sandhigata Vata tops the list. [1] Acharya Charaka was the first person who described the disease separately named Sandhigata Anila, but has not included it under 80 types of Nanatmaja Vyadhi. [2] Acharya Vagabhatta has also considered VataVyadhi as a Maharoga. Till date Sandhigata Vata is a challenging disease and is the number one cause of disability in industrialized countries. The affliction of Sandh is by Prakupita Vata is the main phenomena in Samprapti of Sandhigata Vata. Sandhis come under the Madhyama Roga Marga and thus, involvement of Madhyama Roga Marga, Vata Dosha and Dhatukshaya figures disease Kashta Sadhya. Osteoarthritis or degenerative Joint Disease (DJD) may first appear without symptoms between 20 and 30 years of age. The symptoms, such as pain and inflammation, appear in middle age. Till the age of 55 it occurs equally in both sexes; after 55 the incidence is higher in women. It is estimated that approximately four out of 100 people are affected. The incidence of osteoarthritis in India is as high as 12%. By 2030, 20% of Americans which is about 70 million people who have passed their 65th birthday will suffer from Osteoarthritis. Osteoarthritis will be common before age of 45 more in men than women and after age of 45 more Page258 Mayur Pawaskar et.al., Management of Osteo-Arthritis with Ayurveda,, Int. J. Ayu. Alt. Med., 2015; 3(5):

23 common in women. [3] Osteoarthritis is the most common articular disorder which begins asymptomatically in the 2nd and 3rd decades and is extremely common by age 70. Almost all persons by age 40 have some pathologic change in weight bearing joint. 25% females and 16% males have symptomatic OA. [4] The disease Osteoarthritis may be regarded as a reward of longevity. It seems man has paid price for standing on hind limbs in form of osteoarthritis of weight bearing joints of the body. The disease Arthritis causes work disability. It limits everyday activities such as walking, dressing, bathing etc., thus making individual handicapped. No treatment is available which can prevent the disease process. In western medical science, mainly analgesics, anti-inflammatory drugs or surgery are the options for the treatment of Osteoarthritis; don t provide remarkable recovery, but causes greater adverse effects. Researchers are trying their level best for making drugs which can prevent or slows down or reverse joint damage. A common treatment for Vata Vyadhi has been described by Acharya Charaka i.e. Repeated use of Snehana and Swedana, Basti and Mrudu Virechana. [5] Acharya Sushruta has mentioned the treatment for Sandhigata Vata clearly i.e. Snehana, Upanaha, Agnikarma, Bandhanaand Unmardana. [6] OBJECTIVES OF THE STUDY 1. To identify the stage of osteoarthritis based on the clinical features. 2. To evaluate the effect of shaman treatment in the management of osteoarthritis. MATERIALS AND METHODS Institutional Ethics Committee Approval and Regulatory Compliance Before the initiation of the study, the study protocol and related documents were reviewed and approved by Institutional Ethics Committee at D. Y. Patil School Of Ayurveda, Nerul, Navi Mumbai. The study was conducted in accordance with Schedule Y of Drugs and Cosmetics act, India, amended in 2005 and ICMR ethical guidelines for biomedical research on human participants Ethical clearance was obtained for the present study. (Letter No: PDDYPU/AYU/587/2014) Type of study- Randomized uncontrolled open study. Patients were randomly selected on the basis of clinical features of the disease. Criteria for Inclusion of patients Age- The patients of yrs of age. Sex- Male & female both. Patients having signs & symptoms of sandhigata Vata (Vatavyadhi) mentioned in ayurvedic texts. Patients with X-ray findings suggestive of osteoarthritis Criteria for Exclusion of patients The patients with signs & symptoms of lumber spondylosis, ankylosing spondylosis, R.A., T.B. spine, cervical spondylitis etc. Patients suffering from systemic diseases like DM, HTN & cardiac diseases etc. Treatment Tab GokshuradiGuggulu1 t.d.s. Tab VishamusthiVati1 t.d.s. Avipathikara Choorna ½ tsp b.d. Gokshuradi Guggulu: [7] This combination contains Gokshura, Guggulu, Trikatu, Triphala, Musta. Gokshura which is a best Rasayana,Guggulu acts as Vatahara, Shoolahara. Vishamusti Vati: [8] This combination contains ShudhaKuchala, Yavaani, Saindhava, Visha, Ajamodha, Nadihingu, Vatsanabha, Maricha, Latakarnja, Vaaranga, Nagara, Pippali, Pippalimoola, Indraja, Devakusuma. Kupeelu acts a best VedhanaShamaka. AvipathikaraChoorna: [9] This contains Shunti, Amalakhi, Trijataka, Amboda, Krmighna, Trivruth, Sitha. This combination acts as Vataanulomana. Patients were further evaluated on the basis of Proforma prepared for the study. Duration of Treatment: Medicines were administered for 90 days. Assessment Parameters &Grading: Pain: Pain was assessed on the basis of VAS scale. Swelling: Absent - 0 Mild 1 Moderate 2 Severe 3 Page259 Source of Data: 150 patients diagnosed to have osteoarthritis of the knee joint. Methods of collection of data: Degenerative Changes: Absent 0 Palpable crepitus 1 Audible crepitus 2 Mayur Pawaskar et.al., Management of Osteo-Arthritis with Ayurveda,, Int. J. Ayu. Alt. Med., 2015; 3(5):

24 Follow up: Follow up was carried out after every 15 days. OBSERVATIONS Graph 1 Effect on Pain in Osteoarthritis day 15 day 30 day 45 day 60 day 75 day 90 Graph 2 Effect on Swelling in Osteoarthritis day 15 day 30 day 45 day 60 day 75 day 90 Graph 3 Effect on degenerative changes in Osteoarthritis day 15 day 30 day 45 day 60 day 75 day 90 Page260 DISCUSSION Starting from the etiology of this disease we found that the major etiological factors which leads to this disease were sheet gunasevana i.e. excessive work in cold water, air conditioned offices, food preserved in refrigerators, cold drinks, kind of Mayur Pawaskar et.al., Management of Osteo-Arthritis with Ayurveda,, Int. J. Ayu. Alt. Med., 2015; 3(5):

25 work i.e. housewives doing excessive domestic work, tailoring job, clerical job, increased travelling, sitting in front of computers, irregular dietary habits etc. physical as well as mental stress & strain causing vitiation of Vatadosha. Thus, all these play an important role in the generation of this disease. Osteoarthritis is not simply a disease of wear and tear that happens in joints as people get old. It is a degenerative disease that can leave people unable to walk. Arthritis can affect a person at any time. Vatavikara are usually due to Dhatukshaya or Margavarana. Different manifestations like pain and deformity can be due to Dhatukshaya where as swelling can be related to Margavarana. Probable mode of action of Drug Chikitsa means nothing but the treatment given to disintegrate or destroy the Samprapti or pathogenesis of the disease. Generally Samprapti is found in the genesis of the disease. Sandhigata Vata is produced mainly due to Vata with Agnimandya, Asthimajjavaha Strotodushti, Dhatukshaya like symptoms with vitiation of VataDosha giving rise to symptoms like Sandhi Shoola, Sandhi Graha, Mansabala Kshaya etc. For the disintegration of Samprapti of Sandhigata Vata, the drug must possess some essential properties like Vata Shamaka, Vata Dushtihara, Agnivardhaka, Dhatvagnivardhaka, strengthen the joints, Dhatuvardhan along with Vedanashamak & Snehana actions. The drug Gokshuradi Guggul is a combination of 6 herbs including Guggulu processed in ghee. The constituents like Gokshura & Trikatu are known as rejuvenators & provides strength to Dhatus. & Jatharagni where as Guggulu is especially acting on Asthidhatwagni. Ghee with its yogavahi property helps in better absorption &penetration of the drug. Thus, Gokshuradiguggulu directly impacts on the etiology of Sandhigata Vata & helps in the disintegration of the Samprapti & settles down the vitiated Vatadosha. Vishamusti Vati helps in reducing the pain in osteoarthritis & contents of Avipattikarachurna helps in vatanulomana & regularize vatadosha. CONCLUSION In Osteoarthritis associated with Dhatukshaya, Gokshuradi Guggulu predominantly acts as Vatahara and Rasayana thereby supplementing Ksheena Dhatu. Vishamustivati contains Kupeelu which depresses the inhibitory post synaptic potentials in the Spinal cord. Gokshuradi Guggulu is also a drug of choice in Shotha. Avipathkara Choorna acts as Vata Anulomana and is useful in all above conditions which removes excess vata from its moolasthana. So, it can be firmly said that Pain, Swelling and degenerative changes in Osteoarthritis can be effectively managed with Ayurveda. REFERENCES 1. Acharya Yadavji Trikamji, Sushruth samhita: Choukambha publication,varanasi, 2000 p Acharya Yadavji Trikamji Agnivesha: Charaka samhitha,, Chaukambha Orientalia, 5 th Edition 2001, Varanasi. p Otis, James AD, and Brian McGeeney. "Managing pain in the elderly." Clinical Geriatrics 8 (2000): Felson, David T., and Yuqing Zhang. "An update on the epidemiology of knee and hip osteoarthritis with a view to prevention." Arthritis & Rheumatism 41.8 (1998): Acharya Jadavji Trikamji Agnivesha: Charaka samhitha, Chaukambha Orientalia, 5 th Edition 2001, Varanasi. p.738, Acharya Yadavji Trikamji, Sushruth samhita, Choukambha publication,varanasi, 2000 p [accessed on 20th Aug 2015] 8. [accessed on 20th Aug 2015] 9. [accessed on 20th Aug 2015] CITE THIS ARTICLE AS Mayur Pawaskaret.al., Management of Osteo-Arthritis with Ayurveda, Int. J. Ayu. Alt. Med., 2015; 3(5): Source of Support Nil Conflict of Interest None Declared Page261 Mayur Pawaskar et.al., Management of Osteo-Arthritis with Ayurveda,, Int. J. Ayu. Alt. Med., 2015; 3(5):

26 RESEARCH ARTICLE Impact Factor (2014) by International Scientific Indexing (ISI) UAE COMPARATIVE STUDY OF MUSTADI KWATH (AYURVEDIC HERBAL DECOCTION) AND NAVAK GUGGULU (HERBAL PREPARATION) IN THE MANAGEMENT OF MEDOROGA (OBESITY) Bharat Zinjurke 1*, Shaunak Mirikar 2 1. Assistant Professor, Department of Swasthavritta, Smt. K G M P Ayurvedic Collage, Netaji Subhash Road, Mumbai , Contact no , drbharatdz@gmail.com 2. Medical officer, NRHM, Dept. of AYUSH, Civil Hospital, Ahmednagar, Maharashtra , Contact no , - drmirikar@gmail.com Article Received on - 16 th Sept 2015 Article Revised on - 20 th Oct 2015 Article Accepted on - 25 th Oct 2015 All articles published in IJAAM are peer-reviewed and can be downloaded, printed and distributed freely for non commercial purpose (see copyright notice below). (Full Text Page IJAAM This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( which permits unrestricted non commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Bharat Zinjurke & Shaunak Mirikar, Comparative Study of Mustadi Kwath (Ayurvedic Herbal Decoction) and Navak Guggulu (Herbal Preparation) in the Management of Medoroga (Obesity), Int. J. Ayu. Alt. Med., 2015; 3(5):

27 RESEARCH ARTICLE COMPARATIVE STUDY OF MUSTADI KWATH (AYURVEDIC HERBAL DECOCTION) AND NAVAK GUGGULU (HERBAL PREPARATION) IN THE MANAGEMENT OF MEDOROGA (OBESITY) *Corresponding Author Bharat Zinjurke Assistant Professor, Department of Swasthavritta, Smt. K G M P Ayurvedic Collage, Netaji Subhash Road, Mumbai , Contact no , drbharatdz@gmail.com QR Code IJAAM ABSTRACT: Medoroga (Obesity) is most common nutritional disorder associated with many serious disorders like DM, HTN, IHD, stroke, colorectal cancer, anxiety neurosis and sterility. Various single & compound herbal & herbo-mineral preparations are mentioned in Ayurved texts for management of Medoroga. In this open randomized study 60 patients predominantly complaining of obesity were screened. Such patients were recruited & treated with Mustadi Kwath and Navak Guggulu for the period of 12 weeks. According to statistical analysis, Mustadi kwath and Navak Guggul are equally highly effective in the management of Medoroga. Key Words: Medoroga, Obesity, Navak Guggulu, Mustadi Kwath INTRODUCTION Obesity is becoming the most common nutritional disorder in the middle and upper middle economic class societies in India. Its significance requires constant emphasis because this disease is associated with serious disorders like diabetes mellitus, hypertension, ischemic heart disease, stroke, colorectal cancer, anxiety neurosis and sterility. Obesity predisposes development of these diseases. It also diminishes the efficiency and happiness of the patient. Charakacharya has stressed Medorogi (Atisthulata) as one of undesirable constitution. [1] Medoroga is Santarapananimittaja vikara which is caused by over nutrition like heavy, sweet, fatty diet, day sleeping, lack of physical and mental work. Ancient Ayurvedic texts has also narrated complications of Medoroga like Prameha, Bhagandara, Vatavikara etc. [2] Lot of work has been done by various research scholars about Medoroga in the field of Ayurveda and modern medicine in order to find ideal line of treatment. But still there is need of research work about Medoroga, as large number of patients who are suffering from Medoroga and its complications, are coming to clinical set-ups and health clubs in order to get rid of their suffering. In this research study 60 patients with signs and symptoms of Medoroga are treated with two drugs Musthadi kwath and Navak Guggul. Mustadi kwath [3] is decoction of Mustadi churna which is told by Charakacharya in Santarpaniya Adhaya where as Navak Guggul [4]described by Vagbhatacharya. Comparative assessment of results as improvement in subjective and objective criteria is done with the help of statistical methods. OBJECTIVE To study efficacy of Mustadi Kwath and Navak Guggul in the management of Medoroga comparatively Method of Preparation of Drug Musthadi kwath Mustadi kwath is prepared by making decoction of powder of following herbs in equal parts. Page263 Table 1 Ingredients of Mustadi Kwatha Name Latin Name Part used Proportion Musta Cyperus rotundus Rhizome 1 part Aaragvadha Cassia fistula Fruit pulp 1 part Patha Cyclea peltata Whole plant 1 part Aamalki Emblica officinalis Fruit 1 part Haritaki Terminalia chebula Fruit 1 part Bibhitak Terminalia belerica Fruit 1 part Deodaru Cedrus deodar Stem 1 part Bharat Zinjurke & Shaunak Mirikar, Comparative Study of Mustadi Kwath (Ayurvedic Herbal Decoction) and Navak Guggulu (Herbal Preparation) in the Management of Medoroga (Obesity), Int. J. Ayu. Alt. Med., 2015; 3(5):

28 Shwadanshtra Tribulus terrestris Fruit 1 part Khadir Acasia catechu Skin 1 part Nimba Azadiracta indica Skin 1 part Haridra Curcuma longa Rhizome 1 part Daruharidra Berberis aristata Root 1 part Twak Cinnamomum zeylanicum Skin 1 part Vatsaka Holarrhena antidysentrica Skin 1 part Method of Preparation A coarse powder of 20 gm of above mentioned drugs was soaked overnight (apprx. 12 hours) in 16 times water (320ml). Next morning it was boiled on medium heat till it reduced to 1/8 i.e. 40 ml. Filtered and used. [5] Table 2 Ingredients of Navak Guggulu Name Latin Name Part used Proportion Sunthi Zingiber officinale Rhizome 1 Part Maricha Piper nigrum Fruit 1 Part Pippli Piper longum Fruit 1 Part Musta Cyperus rotundus Rhizome 1 Part Vidanga Emblica ribes Fruit 1 Part Chitrka Plumbaga zeylenica Root 1 Part Haritaki Terminalia chebula Fruit 1 Part Bibhitaka Terminalia belerica Fruit 1 Part Amlaki Emblica officinalis Fruit 1 Part Guggul Commiphora mukul Resin 9 Part Method of Preparation The above mentioned herbal drugs are dried & made into fine powders separately. These drugs and purified Guggulu put into the iron mortar and mixed well until homogenous mixture formed. While mixing above mentioned, ghee is also added for smoothening of the mixture. After formation of mixture pills were made. Criterion to determine the final stage before making pills is that it should not stick to the fingers when rolled. Pills dried in shed. These pills were kept in air tight containers. These pills were not exposed to sunlight. [6] Design of Study Ethical clearance Institutional Ethics Committee Approval and Regulatory Compliance Before the initiation of the study, the study protocol and related documents were reviewed and approved by Institutional Ethics Committee at Gopal Nanji Tank Hospital, Vidarbha Ayurved Mahavidyalaya, Amravati. The study was conducted in accordance with Schedule Y of Drugs and Cosmetics act, India, amended in 2005 and ICMR ethical guidelines for biomedical research on human participants (IEC Clearance No VAMA/IEC/67/2004 dated ) Selection of patients- Patients were selected through OPD and IPD of Gopal Nanji Tank Hospital, Vidarbha Ayurved Mahavidyalaya, Amravati. Patients were selected without any discrimination of sex, caste, religion, occupation, social and economic status. Selection of patients for clinical study is done according to signs and symptoms of Medoroga as discussed below. The patient possessing, those signs and symptoms given in subjective [7] and objective criteria and having body mass index more than 27kg/m² were selected for the research trial. Subjective criteria- 1. Sharir gaurav 2. Kshudhadhikya 3. Trishnadhikya 4. Nidradhikya 5. Alasya 6. Kshudrashwasa 7. Swedadhikya 8. Daurgadhya 9. Daurbalya 10. Sandhivedana Objective Examination:- 1. Body mass index 2. Waist circumference 3. Hip circumference Body mass index is derived by dividing weight in kilogram of the patient by his squared height in metre. Patients were graded according to BMI as per WHO guidelines. [8] BMI (kg/m²) Class Overweight Obesity Class I Obesity Class II 40< Obesity Class III Page264 Bharat Zinjurke & Shaunak Mirikar, Comparative Study of Mustadi Kwath (Ayurvedic Herbal Decoction) and Navak Guggulu (Herbal Preparation) in the Management of Medoroga (Obesity), Int. J. Ayu. Alt. Med., 2015; 3(5):

29 Patient ranging in overweight class are also included in the study which possess subjective criteria. Skin fold measurement is not included as objective criteria due to its poor repeatability. Blood pressure is also not included as it is mentioned is exclusion criteria (Hypertention). Laboratory Investigations These investigations are done to patient fulfilling subjective and objective criteria. Hb%, TLC, DLC, ESR Blood sugar level (Fasting & postprandial) Lipid profile (Total cholesterol, HDL, LDL, VLDL, Triglycerides) Thyroid function test Only lipid profile test results are considered for assessment, other test are done to exclude the patient from the trail if he is suffering from any disease mentioned in exclusion criteria. Criteria for exclusion of patient - Patients below 12 years & above 70 years of age. - Pregnancy and lactation - Cardiovascular diseases - Hypothyroidism - Cushing syndrome - Malignancy - Tuberculosis - Diabetes mellitus - Hypertention - AIDS Treatment Groups Group A: - Mustadi kwatha 40ml Musthdi Kwath in the morning empty stomach for 3 months. OBSERVATIONS & RESULTS Group B: - Navak Guggul 500mg 2 tablet twice daily before meal with Luke warm water Criteria for assessment for results The improvement in the patient is assessed mainly on the basis of relief in the subjective criteria, mentioned earlier in the study. For the purpose, these main signs and symptoms are scored according to their severity. Statistical significance of the results is found using statistical methods. Criteria for assessment of the total effect of therapy considering the overall improvement shown by the patients in symptoms, total effect of therapy has been assessed as below. 1. Cured / complete improvement 100% relief in the symptoms 2. Moderate improvement - >50% relief in symptoms 3. Mild improvement 25-50% relief in symptoms 4. Benefitted 1-25% relief in symptoms 5. No relief 0% relief in symptoms Assessment of subjective Criteria 1. Shirogaurav 2. Kshudhadhikya 3. Trishnadhikya 4. Nidradhikya 5. Aalsya 6. Kshudrashwasa 7. Swedadhikya 8. Daurgandhya 9. Sandhivedana 10. Daurbaly Table 3 Classification according to Body Mass Index Body Mass Index Group A Group B Total Percentage Overweight % Class I % Class II % 40< Class III % Total % Table 4 Presence of symptoms of 60 patients Sr. No. Symptoms Group A Group B Total Percentage 1. Sharirgaurav % 2. Kshudhadhikya % 3. Trishnadhikya % 4. Nidradhikya % 5. Aalsya % 6. Kshudrashwasa % 7. Swedadhikya % 8. Daurgandhya % 9. Sandhivedana % 10. Daurbalya % Total % Page265 Bharat Zinjurke & Shaunak Mirikar, Comparative Study of Mustadi Kwath (Ayurvedic Herbal Decoction) and Navak Guggulu (Herbal Preparation) in the Management of Medoroga (Obesity), Int. J. Ayu. Alt. Med., 2015; 3(5):

30 Table 5 Effect of therapy on weight Treatment Group Weight in kg BT Weight in kg AT (mean) (mean) Mean reduction Group A Group B Table 6 Effects of therapy on Waist Circumference Treatment Group Waist circumference in cm BT (mean) AT (mean) Mean reduction Group A Group B Table 7 Effect of treatments on Hip circumference Treatment Group Hip circumference in cm BT (mean) AT (mean) Mean reduction Group A Group B Table 8 Total effect of treatment on patients Improvement Group A Group B Complete 0 0 Moderate Mild 6 2 Benefited 2 3 No relief 0 0 Total Statistical Analysis Data is analyzed using computer based statistical package SPSS (statistical package for social science) all pair are tasted at p 0.05 or 0.01 level. Group statistics (paired samples after treatment observations to test which drug is more effective) Table 9 Comparison of treatments of Experimental & Control group Signs & symptoms Treatment N Mean Standard Deviation Standard Error Mean BMI (AT) Mustadi kwath Navak Guggul Hip circumference (AT) Mustadi kwath Navak Guggul Waist circumference (AT) Mustadi kwath Navak Guggul Weight (AT) Mustadi kwath Navak Guggul Total symptom score (AT) Mustadi kwath Navak Guggul Unpaired t test applied using differences between before treatment and after treatment observation of group A and Group B. (df = 58 tabulated t58 at 5% level of sig is 2.00) Sings & symptoms Table 10 comparison between effect of Mustadi Kwath and Navak Guggul Mean of diff. Between BT & AT Observed difference Standard error t value Significance Group A Group B Weight BMI Total symptoms score Waist circumference Hip circumference Page266 Bharat Zinjurke & Shaunak Mirikar, Comparative Study of Mustadi Kwath (Ayurvedic Herbal Decoction) and Navak Guggulu (Herbal Preparation) in the Management of Medoroga (Obesity), Int. J. Ayu. Alt. Med., 2015; 3(5):

31 DISCUSSION Body mass index / Obesity class:- It was observed that in the present study, persons having BMI ranging kg/m² Obesity Class I (53.33%) are more found among all obese population. According to statistical analysis which drug is more effective, there is no significant difference in waist circumference between Group A and Group B. According arithmetic basis Navak Guggul is more effective in waist circumference reduction than Mustadi Kwath (5.96 Vs 5.13). Weight In patients of Group A, there is 5.23kg mean reduction in weight whereas in patients of Group B, there is 6.23kg mean reduction in weight. Reduction of weight in both groups is statistically highly significant. According to statistical analysis there is no difference in weight reduction effect between Group A and Group B, but it can be stated on the arithmetic basis that (Group B) Navak Guggul is more useful than Mustadi kwath(group A). Navak Guggul And Mustadi kwath, both the drug possess Tikta, Katu, Kashaya Rasa, Ushna Virya, Laghu, Ruksha, guna And Katu Vipaka majorly which decreases the vitiated kapha and meda which intern reduce weight of the Medorogi. BMI In patient of Group A, there is 1.98 kg/m² mean reduction in BMI where as in the patients of Group B, there is 2.49 kg/m² mean reduction of BMI. Reduction in BMI in both groups is statistically highly significant. According to statistical analysis, there is no diffence in BMI reduction effect between Group A and Group B. i.e. both, Mustadi kwath and Navak Guggul are equally effective in reducing BMI, but on arithmetic basis, it can be stated that Navak Guggul is more effective than Mustadi kwath in reduction of BMI (2.49 kg/m² Vs 1.98 kg/m²). Waist circumference Mean waist circumference is reduced 5.13 cm in Group A where as in Group B waist circumference mean reduction is 5.96cm. Reduction in waist circumference in both group is statistically highly significant i.e. Mustadi kwath and Navak Guggul are highly effective in reducing the waist circumference. CITE THIS ARTICLE AS Hip circumference Mean reduction in Hip circumference in Group A is 4.07cm where as in Group B is 3.93 cm. Reduction in Hip circumference in Group A and group B is statistically highly significant. CONCLUSION According to statistical analysis, Mustadi kwath and Navak Guggul are equally highly effective in the management of Medoroga. On the arithmetic basis, Navak Guggul is more highly effective than Mustadi kwath in the management of Medoroga. It is concluded that Mustadi kwath and Navak Guggul are safe medicine for Medoroga having no side effect. Prescribed Ahara vihara plays an important role in the controlling Medoroga. While treating Medoroga it is to be kept in mind that Medoroga cannot be cured completely as the treatment and pathyapathy should be followed lifelong till the disease last. 3 months duration of treatment is shorter time span for the management of Medoroga, but the results came out are very encouraging. Still there is large scope for further research work in the field of Medoroga. REFERENCE 1. Tripathi B, editor, Charak Samhita reprint, Chaukhambha Surbharati Publication, Varanasi, India, P Ibid.p Ibid.p Tripathi B.,editor, Ashtang Hridaya Ist edition, Chaukhambha Saskrit Publication, Delhi, India.1999.p Parashar R. Editor Sharangadhar Samhita 3 rd edition, Baidyanath Ayurved Bhavan Limited publication. Nagapur, India, 1984.p Ibid.p Ibid.p Shrilakshmi B, Dietetics, 7 th edition, New Age International Publication, New Delhi, India p.236 Bharat Zinjurke & Shaunak Mirikar, Comparative Study of Mustadi Kwath (Ayurvedic Herbal Decoction) and Navak Guggulu (Herbal Preparation) in the Management of Medoroga (Obesity), Int. J. Ayu. Alt. Med., 2015; 3(5): Source of Support Nil Conflict of Interest None Declared Page267 Bharat Zinjurke & Shaunak Mirikar, Comparative Study of Mustadi Kwath (Ayurvedic Herbal Decoction) and Navak Guggulu (Herbal Preparation) in the Management of Medoroga (Obesity), Int. J. Ayu. Alt. Med., 2015; 3(5):

32 RESEARCH ARTICLE Impact Factor (2014) by International Scientific Indexing (ISI) UAE OPTIMIZATION OF NETHRA PARISHEKA KRIYAKALPA (PROCEDURE FOR CLOSED EYE IRRIGATION) - A SURVEY STUDY ON PREVALENT PRACTICE K.S. Dhiman 1, G.Gopinath 2, Riju Agarwal 3*, V.J. Shukla 4 1. Director General, CCRAS, New Delhi, Former Professor & Head-Shalakya Tantra, IPGT & RA, Gujarat Ayurved University, Jamnagar, Gujarat. 2. Ph. D. Scholar, Dept. of Shalakya Tantra, IPGT & RA, Gujarat Ayurved University, Jamnagar, Gujarat. 3. Associate Professor & Head, Dept. of Shalakya Tantra, Ch.Brahm Prakash Ay. Charak Sansthan, N. Delhi, Contact No , - rijuagarwal@gmail.com 4. Head, Pharmaceutical laboratory, IPGT & RA, Gujarat Ayurveda University, Jamnagar Article Received on - 13 th Oct 2015 Article Revised on - 24 th Oct 2015 Article Accepted on - 30 th Oct 2015 All articles published in IJAAM are peer-reviewed and can be downloaded, printed and distributed freely for non commercial purpose (see copyright notice below). (Full Text Page IJAAM This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( which permits unrestricted non commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. K.S. Dhiman et al, Optimization of Nethra Parisheka Kriyakalpa (Procedure for Closed Eye Irrigation) - A Survey Study on Prevalent Practice, Int. J. Ayu. Alt. Med., 2015; 3(5):

33 RESEARCH ARTICLE OPTIMIZATION OF NETHRA PARISHEKA KRIYAKALPA (PROCEDURE FOR CLOSED EYE IRRIGATION) - A SURVEY STUDY ON PREVALENT PRACTICE *Corresponding Author Riju Agarwal Associate Prof. & Head, Dept. of Shalakya Tantra, Ch.Brahm Prakash Ayurved Charak Sansthan, New Delhi, Contact No , - rijuagarwal@gmail.com QR Code IJAAM ABSTRACT: Survey research is useful for documenting existing community conditions, characteristic of population, comparing groups of communities and documenting community opinion. This usually involves constructing a set of questions that are either asked by means of a questionnaire or through an interview. To know the present status of practice of Nethra Parisheka/Seka kriyakalpa (procedure for closed eye irrigation) this will further become for optimization of its Standard Operational Procedure (SOP) and later on standardization. As a part of optimization of SOP of Nethra Parisheka/Seka (closed eye irrigation) procedure, the study has been planned into three phases viz. Survey study, execution of the procedure on healthy individuals thus to further refine it on the basis of response factor and finally validate the refined SOP clinically. A survey on Nethra Parisheka/Seka (closed eye irrigation) procedure was conducted in four pioneer institutes where all kriyakalpa (procedures) are practiced; documented on a survey proforma containing the questionnaire which was prepared on the basis of classical as well as traditional practices prevailing in reputed centers of Nethra Chikitsa (Treatment of ocular disease). The data collected from the survey was discussed and critically analyzed for moderation and then an average opinion was accepted in respect of different step of the procedure like height and width of Nethra Parisheka/seka (closed eye irrigation) stream, temperature, quantity and time of application of the solution (Seka (fomentation), Drava (liquid) etc.). Thus moderated/ accepted parameters were subjected for response of healthy volunteers for finalizing in second phase and validated through clinical study in third phase. This survey revealed that Nethra Parisheka/seka kriyakalpa (procedure for closed eye irrigation) is not practiced uniformly in the country and all emphasized the utmost need of formulation of SOP their optimization & standardization. Key Words: Standard Operational Procedure, Nethra Parisheka/Seka, Optimization of Parameters, Survey INTRODUCTION Kriyakalpa (Topical Ocular Therapeutic procedures) remained in a progressive phase of development since their inception in Agnivesha Tantra. Aacharya Sharangadhara not only highlighted Pindi Kriyakalpa (Procedure for Poultice in closed eye), but also gave a clinical order of application of these procedures. He opined that Nethra Parisheka/Seka (closed eye irrigation), Ashchyotana (Eye drops), Pindi (Poultice application), Bidalaka (Lid ointing), Tarpana (Satiation), Putapaka (retention of medicinal decoction along with Mansrasa (serum like material) on eyes), Anjana (Collyrium/eye ointment) are the seven procedures in order of their clinical application [1]. The first four are applied in Aamavastha (acute inflammatory stage) whereas the later three are indicated in Niraamavastha (chronic stage) of Nethra roga (Eye diseases). Each of these therapeutic measures has their specific indications, preoperative, operative and postoperative procedures mentioned in the classics of Ayurveda, but various ancient teachers have some differing opinions regarding these indications and operational procedures. Presently, various centers of Nethra roga Chikitsa (treatment of ocular disease) are practicing these therapeutic measures by their own accepted/convenient parameters. The importance of these local ocular therapeutic and their variables measures in eye care is immense, it was felt important to sum up these variables and forefront the more used and acceptable kriyakalpa (Topical ocular therapeutics procedures). Study is aimed to promote universality in Kriyakalpa (Topical ocular therapeutics procedures) and further in future can be subjected for standardization after validation of the SOPs. Page269 K.S. Dhiman et al, Optimization of Nethra Parisheka Kriyakalpa (Procedure for Closed Eye Irrigation) - A Survey Study on Prevalent Practice, Int. J. Ayu. Alt. Med., 2015; 3(5):

34 To begin with, the first and foremost ocular therapeutic procedure i.e. Nethra Seka also termed as Netra Parisheka (Ocular irrigation on closed eyes) has been taken. The role of this procedure has been evaluated in different disease conditions at postgraduate center of Netra Chikitsa (Shalakya- Eye & ENT department of Ayurveda) [2,3,4,5] but question of optimization and standardization has not been addressed so far anywhere. Hence it was felt necessary to undertake the present work so that the standardization of this procedure can be done in future after optimization of the procedure. This work was completed in three phases viz. 1. Status of prevailing practice of Nethra Parisheka/seka (closed eye irrigation) procedure in country and its moderation. 2. Response of healthy subject to the moderated SOP to further refine them. 3. Clinical efficacy evaluation of the adopted SOP. In the present article foremost phase of prevailing practice & moderation is only presented. Nethra Parisheka/Seka (procedure for eye irrigation) is the method of pouring of a very fine stream of medicated fluid over the closed eye from a height of 8 cm (4 Angulas:Sharangadhara) [6] for a specified time period. Nethra Parisheka/Seka (procedure for eye irrigation) is indicated in Aamavastha of Nethra roga (Acute ocular inflammatory condition) that too in highly exaggerated phase [7] i.e. redness, lacrimation, foreign body sensation, pain, itching, burning sensation, discharge, intolerance to light (photophobia) and swelling i.e. acute inflammatory phase of the ocular surface. Multi-ingredient formulations having many attributes are indicated in different pathological conditions, for e.g. Snehana Parisheka (oil based closed eye irrigation) in Vataja disorders, Ropana Parisheka (Closed eye irrigation having healing properties) in Pittaja and Raktaja vikaras (disorder of blood) and Lekhana Parisheka (closed eye irrigation having scrapping properties) in Kaphaja nethrarogas [8] (Eye disease due to Kapha dosha).therefore, a formulation which pacifies all the Doshas i.e. Triphala decoction is chosen for this study, which can be used in all types of Abhishyanda [9,10] (Conjunctivitis). AIM To know the status of prevailing practices of Nethra Parisheka/Seka kriyakalpa (procedure for closed eye irrigation) and to moderate/optimize it for further evaluation. OBJECTIVES 1. Optimization of Standard Operational Procedure of Nethra Seka Kriyakalpa (procedure for closed eye irrigation). 2. To make the adopted SOP as baseline for standardization of this ocular therapeutic procedure. MATERIAL AND METHODS 1. Classical literature of Ayurveda was explored to study the conceptual part of the Nethra Parisheka/seka kriyakalpa (procedure for closed eye irrigation) in detail. 2. Prevailing practices of Nethra Parisheka/Seka: i) A survey study on Nethra Seka kriyakalpa was carried out among the practitioners of Shalakya for which pioneer national institutes of Nethra Chikitsa (Treatment of eye diseases) viz: Government Ayurvedic Colleges at Thiruvananthapuram and Mysore, Sreedhareeyam Eye Hospital and Research Centre, Koothattukulam and Sudarshanam Nethra chikitsalayam, Thiruvalla, Kerala where all Kriyakalpa procedures are practiced as regular ocular treatment method were visited. ii) The opinion of Shalakki (Persons who are expertise in Shalakya Tantra Eye & ENT problems) regarding their practice of Nethra Parisheka/Seka was recorded in the proforma incorporating following variables: Clinical definition Indications Dimension of the vessel used Dhara (stream)-single/multiple Position Pre-op. / Post-op. measures Open/Closed eyes Height of dhara (Stream) Site of application of dhara (Stream) Temperature of Dhara (Stream) Duration of procedure No. of times seka (procedure for closed eye irrigation) performed/day Whether same kwatha (decoction) can be used again & again in same sitting? Whether the kwatha (decoction) prepared in the morning can be used in the evening also? How can we understand Hina (subnormal) & Atiyoga (Excessive) of Seka? Clinical suggestion or opinion regarding concept & practice of Nethra Seka. 3. Initial optimization of Nethra Seka Procedure: Based on the concept developed through extensive review of literature, analysis of prevalent practices in the various centers; the survey proforma of each center and Shalakya expert was discussed/ analyzed critically. All steps of the Nethra Page270 K.S. Dhiman et al, Optimization of Nethra Parisheka Kriyakalpa (Procedure for Closed Eye Irrigation) - A Survey Study on Prevalent Practice, Int. J. Ayu. Alt. Med., 2015; 3(5):

35 Parisheka/Seka procedure as per the final outcome of discussion from these centers were taken as the initial optimized steps of the procedure in respect of following variables: Dosage& Method of preparation of Seka drug. Volume of liquid used (dose), Height of Seka dhara (stream) Temperature of dhara Width of dhara and Time duration of application in single sitting, Number of repetitions per day Nethra Parisheka/Seka (Closed eye irrigation) Aacharya cakradatta clearly depicts the importance of fomentation (Swedana), medicated application (Pralepa), bitter diet (Tikta annam), therapeutic procedure like Nethra seka and fasting (Langhana) for four days (Dina chatushtayam) in the acute state of eye disease (Aamavastha of Nethra roga). These six measures help in the metabolization and elimination (pachana) of toxins (Aama) in Nethra roga [11]. Anjana (collyrium), Purana (tarpana & putapaka), Kwathapanam (drinking of decoction) are contraindicated in Aama Nethra roga (acute infections of the eye). Conceptually Nethra Seka is a type of Drava sweda (liquid fomentation) i.e. seka. Here Seka means sechanam (to pour) in the form of sukshma dhara (stream) in and around the eyes called Parisheka. Hence Nethra seka is also termed as Nethra parisheka and Nethra Dhara. The medication and temperature of the liquid depends upon the particular dosha involved e.g. Madhura aushda (drug having sweet taste) and cold liquid is preferred in Pittaja Nethra roga [12] In Susruta Samhita, while describing the management of Vrana shotha (localized inflammation with impending suppuration), Seka is mentioned among sixty measures (shashti upakrama) for the same as an external cleansing (bahir-parimarjana) of doshas in inflammation (Shotha) [13]. The procedure is considered to be Apatarpana (Langhana) in nature; hence is a suitable procedure in Aamavastha of Nethra roga for pachana as well as bahir- parimarjana of dosha. The externally applied medicines viz: Seka (irrigation), abhyanga (massage), lepa (anointing), avagaha (immersion) etc. come in contact with Bhrajaka pitta (a metabolic factor/ body humour seated in cutaneous tissue of the body); is absorbed and modifies the local tissue pathology by virtue of its attributes and mobilize the toxins faster to the systemic circulation which are finally eliminated from the body. [14] As a whole the procedure can be applied in the initial management of acute eye diseases. SURVEY STUDY Nethra Parisheka/Seka survey report a. As a part of standard operating procedure of Nethra Seka, a survey had been conducted with the permission of the institute in the month of January 2012 following pioneers Nethra Chikitsa institutes/ hospitals were visited: i) Sreedhareeyam Eye hospital, Koothattukulam ii) Trivandrum Govt. Ayurveda college, Trivandrum iii) Sudarshanam Nethra Chikitsalayam, Thiruvalla iv) Govt. Ayurveda College, Mysore b. The visit aimed at collection of maximum data regarding the practice of Nethra Seka procedure. c. For data collection, a special Nethra Seka survey proforma was prepared on the basis of classical as well as traditional practice which is presently prevailing. d. The survey proforma were filled by interview method with the chief/ senior Shalakya practitioner of the particular institute. Most of the practitioners interviewed were having good clinical hand in kriyakalpa practice with more than twenty years of experience. e. Each and every step of the procedure including the vessels, their dimensions, time & quantity of the dravadravya aqueous solution used etc. had been observed thoroughly and documented. f. Patients were also interrogated regarding the procedure and its compliance. To maintain the privacy of the pioneer institute & Shalakya expert in mind, the name of the institute and clinician has been highlighted in the study by the name of Center1, 2, 3,4 and Shalakki 1,2 respectively. They were interviewed personally and their method of practicing Nethra seka on patients were observed and documented. OBSERVATION & DISCUSSION From each Centre two efficient clinicians were interviewed with the help of Nethra Seka survey Proforma, their clinical observations and experiences regarding Nethra Seka procedure were noted in the proforma format and the comprehensive outcome on each variable as per format is as follows. Data contained following observations Nethra Seka procedure practice. 1. Terminology used by the practitioners which signify clinically, was found to be Nethra seka Page271 K.S. Dhiman et al, Optimization of Nethra Parisheka Kriyakalpa (Procedure for Closed Eye Irrigation) - A Survey Study on Prevalent Practice, Int. J. Ayu. Alt. Med., 2015; 3(5):

36 on majority however Nethra dhara and Nethra parisheka are also used in the literature of Ayurveda for this procedure. 2. Indications: All of the Shalakya experts were of the opinion that they use this procedure in the classical indications i.e. Intense phase of Raaga (redness), Ashru (hyper lacrimation), Gharsha (FB sensation), Ruk (Pain), Daaha (burning sensation-pain), Toda-Bheda (pricking-cutting pain), Paka (suppuration), Shopha (Inflammation /swelling/ chemosis) and Kandu (Itching) in eye i.e., Aama (acute) stage of Nethra roga. Although these features are similar to acute inflammatory conditions of eye yet when specific Modern diagnosis was stressed they were of the opinion it cannot be pin pointed like modern medical science. optimization of the SOP of Nethra Seka procedure. 6. Position of patient: All experts were executing the procedure in supine position of the patient. 7. Pre-operative and Post- operative measures: Wiping/ cleaning the skin of lids and orbital area with cotton swab before and after Nethra seka was observed by majority of the experts. 8. Open/Closed eyes: Majority of them of the opinion the procedure should be performed in the closed eyes as is indicated in the classical literature, but when observed practically they were practicing in open eyes too. 3. Mode & method of preparation of Kwatha (decoction) for Seka: a) Form of the drug to be used is yavakoota (Coarse powder) b) Proportion, quantity and method of preparation since the term Kwatha (decoction) is used then the proportion is 1: 4 (Drug: Water) and reduced to half but it is for internal purpose. Acharya Todarmal is also of the opinion that for purpose of Nethra seka Same concentration of Kwatha (reduced to half) is indicated which seem to be a guru (Concentrated) for relieving the Aama - avastha of Nethra roga; hence reduced to half concentration is not required for external application so they were of the opinion 1:4 of Triphala coarse powder to water and reduce it by ¼ so that remaining 3/4 th solution is available will be Laghu (light) for this condition. 4. Pot/Vessels/Device for Nethra seka: It was observed that all the institutes followed different types of vessels like Kindi (A type of vessel used in Kerala) water drinking pot (glass), steel bowl with different dimensions. Thus Dhara-stream of the Nethra seka was not uniform as well as Sukshma- thin stream as mentioned in classics. 5. Single/Multiple Dhara (Stream)-: Original classical reference is Sukshma Dharabhi but Majority of the Nethra Chikitsa centers are using single stream procedure/ method. One expert only opined that multiple dhara will be of much clinical importance. Thus a proper pot/ device for the procedure with thin stream outlet were the basic need for the 9. Height of Dhara: All practitioners were well aware that it should be poured from four Angulas (fingers) but while observing their practice in their institute/hospital they give least importance to height. Anguli Pramana (dimension in finger) measurement for height of the dhara was also not uniform among the interviewed experts of the Nethra Chikitsa. 10. Site of Dhara: Pouring the stream over Kaneenka Sandhi (inner canthus) as well as whole Orbital was equally practiced in the country as per our survey. 11. Temperature: No standard temperature regulation of the irrigating Kwatha (decoction) was practiced, but temperature which comforts the patients, Kwatha at room temperature was practiced mostly. 12. Duration of Performing Nethra Dhara: Duration of the procedure at one sitting varied from 2 minutes to 20 minutes among he interviewed experts in this survey. 13. Number of times Nethra seka performed in a day: 2 to 4 times repetition of the procedure in a day was reported by the experts; however one of the experts was of the opinion that it can also be repeated 2 hourly in acute pain full condition. 14. Whether same Kwatha (decoction) can be re-used on same patient in same sitting of the procedure: The trend of reusing the kwatha solution is prevailing at many treatment centers barring few. Those doing this practice were of strict opinion that in eye Page272 K.S. Dhiman et al, Optimization of Nethra Parisheka Kriyakalpa (Procedure for Closed Eye Irrigation) - A Survey Study on Prevalent Practice, Int. J. Ayu. Alt. Med., 2015; 3(5):

37 condition where profuse discharge etc. (infection) is there then it should not be reused. 15. Whether Kwatha prepared in the morning can be used in the evening: Three Nethra Chikitsa (Eye clinic) centers (6 experts) were of the opinion that it can be used and no complication is ever noted in their practice however the Kwatha (decoction) solution should be well/ properly stored, they pointed out. One center opined that it should freshly prepared whenever to be used. 16. Kwatha (decoction) can be refrigerated and can be used next day: None of the center and expert recommended this practice and proper shelf life and physico-chemical study is needed to substantiate the fact. 17. Any complications: No complication of the procedure noticed if well filtered and the temperature is not high, otherwise foreign body sensation and redness are experienced by the patients. There was no standard method of temperature regulation all were using the skin touch method. 18. How one can understand Heena yoga (underuse) and Atiyoga (overuse): Since it is simple procedure none of them observed any Heena and Ati yoga. All the Shalakya practitioners were well cooperative and showed much enthusiasm to share their clinical experiences. All were of the opinion that standardization of all Kriya Kalpa procedures is need of the hour. It was also observed that method of practicing Nethra seka varied from one institute to another as well as among the clinicians of the same institute. Nowhere, neither the classical method was practiced nor basic concepts were applied in modifying the procedure. Dimension of the device, height and width, time, temperature of the dhara was highly variable among the institutes. Most of the practitioners consider it as a safe, best and simple procedure. Since the procedure is more soothing in nature, enjoys good compliance from the patients. By summarizing all the observations from the centers, following are the commonly practiced methods of Nethra seka by most of the centers are as below in Table No.1 Table No.1 - Commonly practiced methods of Nethra seka Sr. No. Survey Questionnaire Common observations 1. Paribhasa (Terminology which signify clinically) Nethra seka 2. Indications Classical 3. Mode and Methode of Preparation of Kwatha (Decoction) Nothing specific No uniformity in preparation of Kwatha i.e. proportion of drug and water 3. Dimension of the vessel used for seka (specification) No special pot or equipment was used by anyone. 4. Dhara (stream)-single/ Multiple (suksma dharabhihi) Single but no specific dimension of the outlet of the stream 5. Position Supine 6. Any preoperative or post-operative measures, if yes mention with its advantage Nothing specific was mentioned i.e. none of the practitioner was performing any preoperative or post operative procedure. 7. Open/Closed eyes Closed eyes 8. Height of dhara (following any specific height other than Less than classical height (3-6cm) classical method) 9. Site of application of dhara Whole eye 10. Temperature of Dhara (following in clinical practice) Patient s comfort 11. Duration of performing Dhara Varies from 2-4 mins 12. Number of times seka performed in a day Two times 13. Whether same kwatha can be used again and again in Not recommended same sitting? 14. Whether the kwatha prepared in the morning can be used Yes, it can be. in the evening also? 15. Whether the kwatha can be refrigerated and used for next day? No 16. Any complication /clinical findings during the procedure or after the procedure by not following the classical method? 17. How can we understand Hina (underuse) and Atiyoga (overuse) of Parisheka (assessement) No such observation has been made by any of the Netra Chikitsaka None of the Netra Chikitsaka has experienced / observed such events in their practice. Page273 K.S. Dhiman et al, Optimization of Nethra Parisheka Kriyakalpa (Procedure for Closed Eye Irrigation) - A Survey Study on Prevalent Practice, Int. J. Ayu. Alt. Med., 2015; 3(5):

38 CONCLUSION The practice of Nethra Parisheka/seka Kriya Kalpa (closed eye irrigation procedure) varies from center to center and from person to person. All the senior experts involved in the survey agreed to the fact that uniformity/optimization is urgently needed to remove the variability and ambiguity so that its role can be established in Nethra Chikitsa. Based upon the critical review of the literature of kriyakalpa (topical ophthalmic therapeutic procedures); prevalent practice of Nethra seka, it was observed that except the patient s position during procedure and indications clinical application as well single dhara (stream) no other step of the procedure was similar among the experts and treatment centers. Hence, two phased manner steps in the direction of the optimization were planned i.e. (i) application of the each step of the procedure with more than 2 variants on healthy volunteers to note the response (acceptance and rejection factor). Thus the most accepted parameter of height, width of stream, site of application, temperature; frequency of application was taken as the initial optimized parameters. Classical literature has already given the guideline about duration [8] of Nethra seka application in one sitting hence by optimizing the width of Nethra dhara (stream) the quantity/volume of the drava (solution) will be finalized. (ii) In the next phase the parameter of each step evolved through the response of healthy volunteers will be subjected for clinical evaluation and validation on the patients of an Aama Nethra roga (Acute ll). Thus the validated parameters will become the base for further standardization of Nethra seka procedure. Both these activities in the direction of optimization will be presented in separate research articles. REFERENCES 1. Adhamalla. Deepika commentary, Sharangadhara Samhita. 7 th ed. Varanasi: Chaukhamba Orientalia; 2008.p Prabhakar Vardhan, Kartar Singh Dhiman. Clinical study to assess the efficacy of Keshanjana and Netra Parisheka in the management of Shushkakshipaka (dry eye syndrome). AYU 2014;(35): Islam MA. The management of Myopia with Triphala Kashaya. PG Thesis, Puri: Gopabandhu Ay. Mahavidyalaya; Kumar D. Role of Triphala eye drops in the management of Abhishyanda (Acute Conjunctivitis). PG thesis, Varansai: IMS BHU; Dhiman K.S., Shukla Jaishankar. Nethra rogeshu kriyakalpa vimarsh. Ph.D. thesis, Varanasi: Sampoornanand Sanskrit University; Adhamalla. Deepika commentary, Sharangadhara Samhita. 7 th ed. Varanasi: Chaukhamba Orientalia; 2008.p Dalhana, Nibandhasangraha commentary. Sushruta Samhita. Varanasi: Chowkhambha Orientalia; 2002.p Dalhana, Nibandhasangraha commentary. Sushruta Samhita. Varanasi: Chowkhambha Orientalia; 2002.p Adhamalla. Deepika commentary, Sharangadhara Samhita. 7 th ed. Varanasi: Chaukhamba Orientalia; 2008.p Agarwal riju, Rani Manju, Dhiman KS. A clinical study on the effect of Rasanjana extract of Berberis aristata) eye drops in the treatment of Netra Abhishyanda (Infective Conjunctivitis). Int Res J Pharma 2014;5(3): Jagadishvarprasad tripathi. Bhavarthasandipini commentary, Chakradutta. 6 th ed. Varansi: Chaukhambha sanskrit series office; 2018.p Adhamalla. Deepika commentary, Sharangadhara Samhita. 7 th ed. Varanasi: Chaukhamba Orientalia; 2008.p Dalhana, Nibandhasangraha commentary. Sushruta Samhita. Varanasi: Chowkhambha Orientalia; 2002.p Adhamalla. Deepika commentary, Sharangadhara Samhita. 7th ed. Varanasi: Chaukhamba Orientalia; 2008.p.51. CITE THIS ARTICLE AS K.S. Dhiman et al, Optimization of Nethra Parisheka Kriyakalpa (Procedure for Closed Eye Irrigation) - A Survey Study on Prevalent Practice, Int. J. Ayu. Alt. Med., 2015; 3(5): Source of Support Nil Conflict of Interest None Declared Page274 K.S. Dhiman et al, Optimization of Nethra Parisheka Kriyakalpa (Procedure for Closed Eye Irrigation) - A Survey Study on Prevalent Practice, Int. J. Ayu. Alt. Med., 2015; 3(5):

39 RESEARCH ARTICLE Impact Factor (2014) by International Scientific Indexing (ISI) UAE STUDY OF ROLE OF DARUHARIDRA RASAKRIYA & MADHU PRATISARAN IN MANAGEMENT OF PITTAJ SARVASAR (STOMATITIS) K. S. Wakode 1 * 1. Assistant Professor, Dept. of Shalakyatantra, Government Ayurved College, Vazirabad road, Nanded, Maharashtra, India, Contact No , -kalpanawakode@gmail.com Article Received on - 10 th March 2015 Article Revised on - 19 th Oct 2015 Article Revised on - 2 nd Dec 2015 Article Accepted on - 2 nd Dec 2015 All articles published in IJAAM are peer-reviewed and can be downloaded, printed and distributed freely for non commercial purpose (see copyright notice below). (Full Text Page IJAAM This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( which permits unrestricted non commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. K. S. Wakode, Study of Role of Daruharidra Rasakriya & Madhu Pratisaran in Management of Pittaj Sarvasar (Stomatitis), Int. J. Ayu. Alt. Med., 2015; 3(5):

40 RESEARCH ARTICLE STUDY OF ROLE OF DARUHARIDRA RASAKRIYA & MADHU PRATISARAN IN MANAGEMENT OF PITTAJ SARVASAR (STOMATITIS) *Corresponding Author K. S. Wakode Assistant Professor, Dept. of Shalakyatantra, Government Ayurved College, Vazirabad road, Nanded, Maharashtra, India, Contact No , QR Code IJAAM ABSTRACT: Daruharidra (Berberis aristata) is having pitta shamaka, dahashamak, shothhar, vednasthapan, vrana shodhan and vrana ropan, properties and it is having Tikta, Kashay rasa, Ruksha and Laghu guna. Madhu (Honey) is also having vranasthapan, vranaropan, vranashodhana, Raktshamak and Ptta shamak properties and it is yogvahi and sukshmagami. It increases medicinal properties of drug and penetrate deeply in the tissue. Considering all these properties Daruharidra Rasakriya with Madhu (Honey) is selected in pittaj sarvasar. For clinical trial total 60 patients having age between 10 to 50 year selected and randomly & divided into two groups. Experimental group was treated with Daruharidra Rasakriya Madhu pratisaran and Control group was treated with Triphala Gandush, two times in a day for 7 days and follow up will be taken on every 3 rd, 5 th, 7 th day. Finally finding suggests that Daruharidra Rasakriya Madhu pratisaran is the safest, simplest and effective drug in management of pittaj mukhapaka. Key Words: Daruharidra (Berberis aristata), Madhu, Mukhroga, Berberis aristata INTRODUCTION 21 st century is the century of science and innovations; life is too much faster in this time. Civilizations have changed human life considerably; with not only good benefits of it, but some bad effects on human health. As the life style is changed individuals are consuming excessive quantity of apthyakar ahar i.e. mixed type of food, acidic foods, spicy foods, chat foods, instant foods, chinees, coid drinks etc. also addiction like chewing tobacco, suppari-(bettel nut), gutka, tobacco with lime, smoking, drinking alcohol etc. which internal disturb the normal physiology of the body. These dietary ir-regulations, Dietary allergen, habits and addictions perform long bad effects on human body which reduces the immunity and make them prone to many diseases; one of them is sarvasar i.e. Stomatitis. Many treatment modalities like antibiotics, antiinflammatory, anesthetics drugs, supplements like vitamins etc. are tried in modern science, which are either limited or unsatisfactory. Hence medical science is in the search of a safe, easily available cheap, therapy for this disease. In Mukhapak mainly pitta dosha and raktavah and mamsa are the dushyas. To break this samprapti, pitta doshahar, rakta prasadak, vranashodhak, vranropak, shothahar chikitsa is essential. Review of Ayurvedic text was done and according to various Acharyas, prescribed treatment for sarvasar is in the form of kawalgraha, gandush, pratisaran, raktmokshan etc. Particularly in case of sarvasar, Daruharidra Rasakriya along with madhu pratisaran is adviced. Both are having properties like-anti- inflammatory, Vedanasthapan, Vranashodhan, Vrana ropan and Rakta pittahar, kaphashamak, ulcer healing properties. No doubt Daruharidra Raskriya along with madhu pratisaran is used since centuries to cure such diseases, still the clinical trial were conducted as guided by Acharya Vagbhata [1] AIM To study Role of Daruharidra Rasakriya and Madhu Pratisakran in management of Pittaja Sarvasara (stomatitis). OBJECTIVES To treat pittaja sarvasara with Ayurvedic Remedy. To achieve good complicities of patient and reduce intolerance to spicy foods. To avoid the life threatening complications of sarvasara like OSMF(oral submucosal fibrosis), oral malignancies, leukoplakiya etc. To establish a safe, effective and cheap remedy. For pittaja sarvasara. To assess the ancient mode of treatment of sarvasara. Review of Ayurvedic Literature Mukharoga Nidana Hetu In general Aayoge, Atiyoga and mithya yoga of kala, buddhi and Indriyarth. are the causative factors for Page276 K. S. Wakode, Study of Role of Daruharidra Rasakriya & Madhu Pratisaran in Management of Pittaj Sarvasar (Stomatitis), Int. J. Ayu. Alt. Med., 2015; 3(5):

41 any disease. In other words, the causes of the diseases relating to both mind and body are threefold wrong utilization, non-utilization and excessive utilization of time, mental facilities and objects of sense organs [1] In Ayurvedic literature, special nidan has been mentioned for mukharoga. The causative factors in general are mentioned for all types of mukharoga. Samanya Samprapti of Mukharoga - Due to specified etiological factors, tridosha get vitiated and among which kapha is aggravated more producing mukharoga. Mukha is sthan of the Bodhak kapha. So the etidogical factors, of the mukhroga do the vikruti of the Bodhak kapha. Madhur and amla rasas are the main etiological factors for the vikruiti of the bodhak kapha. Due to the above factors mainly kapha pradhan prakopit Dosha causes the mukharog [1] Mukharoga Samanya Roopa Kashayapa has told the signs and symptoms of the mukhroga in children. Excessive salivary secretions, refusal for breast feeding pain in oral cavity, restlessness of child, vomiting after milk feeding and increased respiratory rates, crying etc [2] Mukharoga Samanya Chikista Sutra In oral Cavity, in Mukharoga mainly kapha and Rakta dusti is there so Rakta mokshana is main chikitksa. Kosteshudhi by virechana and as need vamak medicinal dravyas are helpful kawalagraha, gandusha, Nasya, shirovirechana. Pratisarana, Dhooma, Agnikarma, Ksharakarma, are also helpful in mukhrogas. Charak has told pradhamana nasya, virechana, vaman, lekhana and vat, pitta, kapha, shamak ahar and dravyas. Mukhroga Samanya Pathya Generally in all mukhroga-old Rice, Joa, Muga, Kulalthya, karella, paravala, komal, muli, Hot water tikta and kandu Rasa are all pathayakar. Specially kapha and rakta shodhak ahar is useful in Mukhroga. Green vegetables, fruit, dry fruits, butter, carrot, tomato, orange, limes, santra, palaka, Awala, Hari-dhaniya are useful in mukhroga which contains vit. A, B, C. etc [3] Apathyas Generally in all mukhroga Amala padartha, cured milk,, sweet padartha, vidahi, Rukshanna, kathina bhari and Abhishyandi ahar are apathyakar, cold water, brushing, eating of hard padartha, fish, anupadesh, goat Animal s mamsa, sleeping at day time are ahitkar. Adhomukha shayana is also Ahitkar [4] Disease Review Acharya sushruta had described mukhroga in Nidansthan. There are 65 mukhroga which occur at seven locations such as lips, teeth tongue, palate, throat and oral cavity. Out of them 8 occur in lips, 15 in gums, 8 in teeth, 3 in tongue, 9 in palate, 17 in throat and 3 in entire mouth. Sarvasar The disease, which affects the whole oral cavity, i.e. buccal mucosa is called as sarvasar. As the disease spreads very quickly in the oral cavity it is called as sarvasar. Acharya sushruta had told types of sarvasar as vataj, pittaj, kaphaj, and Raktaj. Pittaj Sarvasar Burning type of red and yellow coloured crackling thing blisters / boils or ulcers in the mouth Burning and combusting type of pain with feeling of bitterness in the mouth Ulcers in the mouth are formed like that of the ulcers formed by alkalies. Samanya Chikitsa of the Mukhapaka are 1. Sheera Vedha 2. Sheero Virechana 3. Kaya Virechana 4. Kawalgrah (Gargels) with mutra, oil, Ghee, madhu, Milk [4] Kawal grah (Gargles) Kawalgraha & Gandusha are the procedures of gargling with the medicinal liquikas either kwatha, taila etc. kept in mouth for a period of a Dharana kala. Basic difference in kawala and Gandusha is kawala is that of quantity of drug which can be easily moved in mouth and if it is taken full of mouth is called as Gandusha. Vishesha Chikitsa Pittaja Mukhapakak / Sarvasara Chikitsa In case of pittaja sarvasora / Mukhapaka pittahar ckhikitsa of all types with the help of Madhu and sheetal medicinal Dravyas are advised. Pitta and Rakta shaman chikitsa should be done in pittaja sarvasar/mukhpak [4] Drug Review Daruharidra (Berberis aristata) Daruharidra consists of dried stem of Berberis aristata. It is an erect, spinous, decicluovs, shrub, usually m in height. Found in Himalaya rangas at an elevation of m, and in the nilgiri bills in south India. Gana Arshoghna, kandughna, lekhaniya (charaka) Haridradi, Mustadi, Lakshodi (sushruta) Page277 K. S. Wakode, Study of Role of Daruharidra Rasakriya & Madhu Pratisaran in Management of Pittaj Sarvasar (Stomatitis), Int. J. Ayu. Alt. Med., 2015; 3(5):

42 Family Barberide (from ber berys Arabic name) Berberidaceae. Kula Daruharidra Kula. Latin Name Berberis aristata. Properties - Rasa Tikta, Kashaya Veerya Ushna, fruit Sheeta, veerya. Vipaka Katu. Guna Laghu, Ruksha Doshghnata Kapha Pitta hara Karma Shothaghna, vedanasthapak, vranashodhona, vrana Ropana, chakshushya Gandomalaghar. Rogahnata Charaka Vrana Ropanartha Sushruta Pishtameha Vaghbhata Shleshmik Vridhoau Dosage Juice of Root 10 to 20 ml, Decoction- 50 to 100 ml. Rasanjan ¼ to ½ Gms. Fruit 1 gm. Tongue depressor STUDY DESIGN The whole study was divided in 2 group / types. 1) Conceptual study. 2) Clinical study. 1) Conceptual Study Detailed review of Ayurvedic and modern literature was carried out to know about disease Pittaj Sarvasarentity and treatment. 2) Clinical Study Total 60. Patients of pittaj sarvosar was selected and randomly divided into two groups viz. Clinical trial group & Control group Patients were reviewed at 3 rd, 5 th, 7 th day and 15 th, 30 th day if required and the prognosis of disease was recorded of each patient 1) Experimental group The study group i.e. trial group was treated with Daruharidra Raskriya Madhu pratisarana twice times in a day. Therapy will be given upto 7 days and follow up will be taken on every 3 rd, 5 th, 7 th, day & necessary advice was given to the patient time to time. Daruharidra Rasakriya Nirman Vidhi As per kwath vidhi described by sharangdhar samhita take 1 part Daruharidra Bharad churna and ¼ shesh, 1.6 poot jal and should be boiled upto ¼ should be remaining then with of filtered. Again boil the filtrate (shesh kwoth) on slow flame i.e. mandagni, till evaporation. This semi solid part is called as Raskriya Then dried it under sunlight [5] Madhu(honey) Guna Korma Kashay Madhur Rasa Guna Guru, Sheeta Dosha Rakta, Pittahara, Kaphashamaka, Vatavarahaka, chedana sandhaniya. MATERIALS AND METHODS Materials for examination of patient 1. Bulls Lamp 2. Head Mirror 3. Torch 4. Tongue depressor 5. Autoclaved hand gloves 6. Autoclaved cotton. Materials for Administration of Medicament Chair to sit the patient Daruharidra Raskriya in a sterile bottle Madhu in a sterile bottle Sterile gloves Napkin etc. Head mirror 2) Control group - Control group was treated with triphala Gandusha 2 times in a day for 7 days. Follow up was taken as per study group. Sampling Techniques A random sampling technique was adopted. Inclusion Criteria Patient of age group 10 to 50 yr. of both sex. That the patient should give history of burning sensation in oral cavity. Patient with intolerance to eat spicy foods. Change in colour of oral mucosa. Ulcers in oral cavity. Above complains with recurrent episodes of pittaj sarvasar. Exclusive Criteria Patients having gingivitis, pyrorrhoea, etc. Tubercular ulcers / syphilitic ulcers / diabetic ulcer. Conidial ulcer, oral thrush. Ulcers due to herpes zoster. Traumatic ulcers. Immuno-suppressive disorders. Oro-dental fistula. Known oral, throat, tongue malignancies etc. Severe Anaemia. OSMF(oral submukosal fibrosis). Known case of gastritis. Page278 K. S. Wakode, Study of Role of Daruharidra Rasakriya & Madhu Pratisaran in Management of Pittaj Sarvasar (Stomatitis), Int. J. Ayu. Alt. Med., 2015; 3(5):

43 Criteria for Assessment - The effect of treatment result was assessed in regards to the clinical sign and symptoms to the basis of grading and scoring system and overall improvement. Clinical Assessment The signs and symptoms were assessed by adopting suitable scoring method. The details are as follows. Parameter - 1) Change in colour of by equal mucosa for redness i.e. congestion. Absent o Reddish + Red ++ Cherry red +++ 2) Increase in tolerance of spicy foods Relief (good tolerance to spices) - 0 Tolerance to light spices - + Burning at light spices - ++ Burning at any food Burning at rest Ulceration Pinkish colored mucosa with no ulcer- 0 Only congestion with one or two ulcer - + Few ulcers with congestion - ++ Multiple ulcers with congestion Photographical study Photographical study of buckle mucosa was done before & after treatment intervention. Total effect of therapy was assessed with the help of result of above parameters. STATISTICAL ANALYSIS Table 1: Analysis of change in colour of buccal mucosa Sr.No Days Mean difference of Mean difference of Experimental Group Control Groups Table 2: Analysis of Intolerance to spicy foods Sr.No. Days Mean difference of Mean difference of Experimental Group Control Group Sr.No Table 3: Analysis of Ulceration in Oral Cavity Days Mean difference of Experiment Group Mean difference of Control Group From above groups and statistical analysis it is clear that both the drugs i.e. Daruharidra Raskriya madhu and triphala kwath acts on pittaj mukhapaka but positive symptomatic relief and ulcer healing are comparatively better in experimental group. Patients were examined thoroughly before and after treatment change in symptoms were recorded at every follow up and it was noted in the form of qualitative data and then it was converted to quantitative data for the convenience of statistical analysis. As sample size is small, students paired t test applied to determine the significance of improvement in symptoms. The level of significance was set at 5% or P>0.05 calculated t > t table t >p indicates significance of the findings. Unpaired t test is applied to compare the effectiveness of both the groups and to determine superiority of the treatment. Page279 K. S. Wakode, Study of Role of Daruharidra Rasakriya & Madhu Pratisaran in Management of Pittaj Sarvasar (Stomatitis), Int. J. Ayu. Alt. Med., 2015; 3(5):

44 Table 4: showing effect of treatment on signs of Experimental Group Sr. No Sign N Mean S.D S.E t P 1 A P< B P< C P< 0.05 In case of all symptoms p<0.05 hence the test is significant that means the drug is effective in treatment of pittaj sarvasar Table 5: showing effect of treatment on signs of control group Sr.No Sign N Mean S.D S.E t P 1 A P< B P< C P< 0.05 Table 6: In case of change in colour of buccal mucosa Experimental Control S E t P Mean S D Mean S D P< Applying unpaired t test to compare the results achieved by both treatment are In case of change in colour of buccal mucosa t calculated is 2.4, t table is 2.05 i.e. t cal > t tab, 2.4 > Hence t test is significant indicates that effect of experimental drug is more than control drug on change in colour of buccal mucosa. Table 7: In case of Intolerance to spicy foods Experimental Control S E t P Mean S D Mean S D P< In case of intolerance to spicy foods t calculated is 2.85, t table is 2.02 i.e. t cal > t tab, 2.85 > Hence t test is significant indicates that effect of experiment drug is more than control drug of Intolerance to spicy foods. Table 8: In case of ulcers in oral cavity Experimental Control S E t P Mean S D Mean S D P< In case of ulcers in oral cavity t calculated is 2.5, t table is 2.02 i.e. t cal > t tab, 2.5 > Hence t test is significant indicates that effect of experimental drug on ulcers in oral cavity. DISCUSSION Pittaja Sarvasar/Mukhapaka is a disease of oral cavity; it is the paka of oral mucosa and produces ulcers in oral cavity. Various treatment modalities from different medical faculties are in this disease like local application, local anti- inflammatory, agents like kenalog, orabase. The paste application locally upto heal the ulcer. Tetracyelline mouthelline mouthwash, then application of thick layer of Triamcinolone Acetoride is recommended. Oral or systemic antibiotic are administered if necessary. Supplementation of vitamins and iron is also recommended. These treatment have very limited or unsatisfactory results. In pittaja sarvasara/mukhapaka pitta dosh prokopa and rakta, Mamsa,dhatu, dushti is dushya is there, localizing in oral cavity. Hence the line of treatment should be pittashamaka, Shothahara, Vedanasthapana, vranashodhana, Vranaropana, Rakta prasadaka, Mamsa dhatu pustikara. Scholars have selected pratisarana with Daruharidra Rasakriya and Madhu, Proved to be very effective in this disease. Daruharidra is kapha pittahar, laghu, ruksha gunas. It is having properties like-anti inflammatory activity, wound healing properties, antipyretic and antiseptic. Madhu when applied locally to mucous membrane, it causes stimulation of mucous Page280 K. S. Wakode, Study of Role of Daruharidra Rasakriya & Madhu Pratisaran in Management of Pittaj Sarvasar (Stomatitis), Int. J. Ayu. Alt. Med., 2015; 3(5):

45 membrane. Madhu removes vitiated doshas, improve wound healing. Patients of study group trated with Daruharidra Rasakriya Madhu pratisarana and that of control group with Triphala Kwatha Gandusha, for same period and same pattern, follow up of each finding was recorded symptom wise in qualitative form and difference noted before and after treatment. After study we came across the effect of Daruharidra Rasakriya Madhu Pratisarana was better in all respect than that of control group. Mukhapaka is the paka Avastha i.e. inflammatory candition of the oral mucosa membrane. Mukhapaka is often called as sarvsara. It is named so because it is having a spreading nature in the oral cavity. This study was aimed to assess the role of Duruharidra Raskriya madhu pratisarana in the management of pittaja sarvasar/mukhapaka. The object of study was to establish of safe, effective economical & ideal therapy of pittaja mukhapaka and to prevent forth coming complications and recurrence and to achieve good compliance of patients. Pittaja mukhapaka may resemble with apthous ulcer (stomatitis) This study of randomly selected 60 patients, having male-female ratio, 2:1 incidence of pittaja mukhapaka found more in age groups. Mukhapa is more common in students excessive consumption of spicy foods, acidic foods, mixed type of food, instant foods, dietary allergens & addiction, like chewing tobacco, betel-nut, gutca, tobacco with lime, drinking cold drinks, alcohol, etc, & mental stress, lack of sleep are some of the etiological factors. Burning sensation in mouth, intolerance to spicy foods, ulcers in oral cavity, difficulty in chewing ulcer the commonest signs & symptoms observed. Buccal mucosa is the commonest site involved in almost all cases, followed by soft palate, tongue, floor of mouth. Daruharidra Raskriya madhu pratisaran is method of treatment for pittaja mukhapaka in major nomber of Ayurvedic classics. There was marked improvement in the subjective symptoms like burning sensation. In mouth intolerance to spicy foods, difficulty in chewing and objective findings like change in colour of buccal mucosa, Ulceration in the mouth, size & shape, position, their number, tenderness, depth etc. Improvement was also assessed by examining the condition of the oral mucosa, by examining the type & nature of the ulcer, buccal mucosa before and after the treatment. Treatment with Daruharidra Raskriya Madhu Pratisarana proved to be very effective pittaj mukhapaka and good compliance of patient achieved. As comparison experimental group is more effective than the control group. Present study reveals and confirms that the Daruhoridra Raskriya Madhu Pratisarana is the so fast, simplest, economical and effective drug therapy in the management of pittaj mukhapaka. CONCLUSION Daruharidra Raskriya Madhu Pratisorana acts better on pittaja Mukhapaka. Give best relief from symptoms, like burning sensation, intolerance to spicy foods and promote speedy healing of the ulcer in oral cavity. REFFERENCES: 1. Dr. Ganesh Krushna Garde, Sarth Vagbhat uttartantra 3 rd ed, Anmol publication, 1999 p Pandit Hemraj Sharma, Kashyap samhita sutrasthan, chokhamba publication, 2010.p Dr. Shivprasad Sharma, Ashthang Sangrah, Krushnadas Chokhamba publication, 2006, p Kaviraj Ambikadas Shastri, Sushrut Chikistathan, Chokhamba publication, 2010.p Acharya Vidyadhar Shukla and prof. Ravi Dutt Tripathi, Charak Chikistathan, Chokhamba publication p.6. CITE THIS ARTICLE AS K. S. Wakode, Study of Role of Daruharidra Rasakriya & Madhu Pratisaran in Management of Pittaj Sarvasar (Stomatitis), Int. J. Ayu. Alt. Med., 2015; 3(5): Source of Support Nil Conflict of Interest None Declared Page281 K. S. Wakode, Study of Role of Daruharidra Rasakriya & Madhu Pratisaran in Management of Pittaj Sarvasar (Stomatitis), Int. J. Ayu. Alt. Med., 2015; 3(5):

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