wjpmr, 2019, 5(2), 139-153 SJIF Impact Factor: 4.639 Research Article WORLD JOURNAL OF PHARMACEUTICAL AND MEDICAL RESEARCH ISSN 2455-3301 www.wjpmr.com WJPMR PREVALENCE OF - (POLYARTHRITIS) IN VICINITY OF LUCKNOW UTTAR PRADESH Dr. Zeshan Haider Rizvi* 1, Masood Ahmad 1, Mohd Tariq 1, Mohd Naime 1, Jamal Akhtar 2 and Maqbool Ahmad Khan 1 1 Central Research Institute of Unani Medicine, Lucknow. 2 Central Council for Research Institute of Unani Medicine, New Delhi. *Corresponding Author: Dr. Zeshan Haider Rizvi Central Research Institute of Unani Medicine, Lucknow. Article Received on 25/11/2018 Article Revised on 18/12/2018 Article Accepted on 09/01/2019 ABSTRACT Joints pain (arthritis) is well described in ancient classical literature of Unani system of Medicine. The ancient physicians not only discovered the disease they also put light to that this problem may lead to cripple the movement of affected person. The disease itself has become so common that globally and in India that according to an estimate it affects 15% people i.e. over 180 million people in India. This prevalence is higher than many well known diseases such as diabetes, AIDS and cancer. Shortage of classical literature has led to its management by untrained doctors, practitioners of allopathic medicine and quacks which mainly rely on pain killers and steroids which have their deleterious effects on body. This article aims at providing scientific information on arthritis showing its prevalence in Vicinity of Lucknow Uttar Pradesh to protect and promote health of population in large. These commitments requires the re-orientation of health and social care services that support the promotion of health and the development of the skills and capacity of those outside the Health promotion workforce to adopt a stronger evidence-based health promoting role. KEYWORDS: Polyarthritis, Waja a - a, Unani Medicine. INTRODUCTION According to National Unani Morbidity Code Waja a - a a is defined as a type of arthalgia which involves several joints [1,2,3] As per involvement of humours it is of four types i.e. 1. Damawi 2. Balghami 3. a 4. Sa d ī According to severity of symptoms it is again divided into acute and chronic type. When two humours are involved this is known as Waja a - a a a Prevalence by meaning according to Cambridge Business English Dictionary Cambridge University Press) stands for the fact of something existing or happening often. [4] Unani concept of Osteoarthritis In the book Alakseer Azam it is written, when the patient of joints pain suffers from the disease for longer duration. The joints become immovable as the madda (fluid) freeze in the joints and they become hard. This happens because of purification of madda like its thickness or coldness and stickiness. Sometimes it happens due to mistake of physician by mishandling of the prob. [5] As per Modern System of Medicine according to ABC of Rheumatology Kraus VB et al has defined Arthritis Osteoarthritis (OA) is the most common condition to affect synovial joints, the most important cause of locomotor disability, and a major challenge for health - care providers Because OA increases significantly with age. It was long considered to be a degenerative disease that was an inevitable consequence of ageing and trauma. However, it is viewed now as a metabolically dynamic process characterized by an imbalance of joint breakdown in association with a maladaptive and insufficient repair process. [12] www.wjpmr.com 139
X-ray of hip showing changes of Osteoarthritis. Note the superior joint space narrowing (N), subchondral sclerosis (S), marginal osteophytes (white arrows) and cysts (C). [7] According to Harrison s Principle of Internal Medicine Osteoarthritis (OA) is a disorder characterized by progressive joint failure in which all structures of the joint have undergone pathologic change. The pathologic sine qua non of OA is hyaline articular cartilage loss accompanied by increasing thickness and sclerosis of the subchondral bone plate, outgrowth of osteophytes at the joint margin, stretching of the articular capsule, and weakness of the muscles bridging the joint. There are numerous pathways that lead to OA, but the initial step is often joint injury in the setting of a failure of protective mechanisms. [8,9,10] www.wjpmr.com 140
DISCUSSION The data was collected from the respective five spots which are mentioned as follows: 1. Bhauli:- The spot situated at distance of 13 km in north west direction having population of 10,000 of which from 5,000 SC population, Health facility was not available, 60-70% open field sanitation, unsafe drinking water and poor hygienic conditions was present, transport facility availability was not so good either by government and private transport facility. 2. Ismailganj:- The spot situated at distance of 18 km in east direction having population of 4500 of which from 2,500 SC population, 1 PHC was situated at kamta but no Unani centre was present and 30-40% open field sanitation, unsafe drinking water and poor hygienic conditions was present, transport facility available by government and private transport service. water and poor hygienic conditions was present, only private transport facility available. Table No. 1 Showing Total No. of Patients in Undertaken Villages. S. No Name of the Spots Total No. of Patients 1 Bhauli 414 2 Ismailganj 186 3 Moulviganj 482 4 Mahona 652 5 Mirzapur 109 3. Maulviganj:- The spot situated at distance of 20 km in West direction having population of 12000 of which from 2000 SC population, Health facility was not available, 10-20% open field sanitation, unsafe drinking water, water logging is very common no proper drainage of water and poor hygienic conditions was present transport facility availability was not so good either by government and private transport facility. 4. Mahona:- The spot situated at distance of 14 km in SOUTH direction having population of 10,000 of which from 2500 SC population, Health facility was not available, 25-30% open field sanitation, unsafe drinking water and poor hygienic conditions was present, transport facility available both by government and private transport facility. 5. Mirzapur:- The spot situated at distance of 09 km in NORTH direction having population of 5000 of which from 2200 SC population, Health facility was not available, 70-75% open field sanitation, unsafe drinking Graph No. 1: Showing Total No. of Patients in Undertaken Villages. Spot no 1 Bhauli Table 2: Total No. of Patients at Bhauli. No. of Patients % Complete Relief 70 16.90% Partial Relief 203 49.03% No Response 26 6.28% Dropout 115 27.77% Total 414 100% Graph 2: Total No. of Patients at Bhauli. www.wjpmr.com 141
Table 3. Age wise Response of Patients at Bhauli. Age 11 to 20 21 to 30 31 to 40 41 to 50 51 to 60 61 to 70 71 to 90 Complete Relief 16 25 20 6 2 1 0 Partial Relief 0 7 32 48 56 40 20 No Response 0 4 6 9 1 5 1 Dropout 2 9 20 19 35 21 9 Total 18 45 78 82 94 67 30 Graph 3: Showing Age Wise Response at Bhauli. Table 4: Response of Patients According To Dietary Habits at Bhauli. Vegetarian Non Vegetarian No. of Patients % No. of Patients % Complete Relief 49 11.83 21 5.07 Partial Relief 163 39.37 40 9.66 No Response 20 4.83 6 1.44 Dropout 93 22.46 22 5.31 Total 325 78.50 89 21.49 Graph 4: Showing Response According to Dietary Habits at Bhauli. www.wjpmr.com 142
Table 5: Response of Patients According to Sex at Bhauli. Male Female No. of Patients % No. of Patients % Complete Relief 25 6.03 48 11.59 Partial Relief 66 15.94 137 33.09 No Response 6 1.44 20 4.83 Dropout 36 8.69 79 19.08 Total 133 32.12 284 68.59 Graph 5: Showing Statistics of Response According to Sex at Bhauli. Table 6: Statistics of Response According to Caste at Bhauli. SC General No. of Patients % No. of Patients % Complete Relief 30 6.03% 40 11.59% Partial Relief 137 15.94% 66 33.09% No Response 18 1.44% 8 4.830% Dropout 74 8.69% 41 19.08% Total 259 62.56% 155 37.43% Graph 6: Showing Statistics of Response According to Caste at Bhauli. www.wjpmr.com 143
Spot No 2 Ismailganj Table 7: Total No. of Patients at Ismailganj. No. of Patients % Complete Relief 41 22.04% Partial Relief 84 45.16% No Response 18 9.67% Dropout 43 23.11% Total 186 100% Table 8: Total No. of Patients at Ismailganj. Graph 7: Total No. of Patients at Ismailganj. Age 11 to 20 21 to 30 31 to 40 41 to 50 51 to 60 61 to70 71 to 90 Complete Relief 3 11 12 16 0 0 0 Partial Relief 0 4 9 7 32 23 8 No Response 0 1 6 3 5 2 1 Dropout 1 5 11 10 9 5 2 Total 4 21 38 36 46 30 11 Graph 8: Showing Age Wise Response at Ismailganj. www.wjpmr.com 144
Table 9: Showing Response According to Dietary Habit at Ismailganj. Vegetarian Non vegetarian No. of Patients % No. of Patients % Complete Relief 25 13.44% 16 8.60% Partial Relief 56 30.10% 28 15.05% No Response 10 5.37% 8 4.30% Dropout 31 16.66% 12 6.45% Total 122 65.59% 64 34.40% Graph 9: Showing Response According to Dietary Habit. Table 10: Showing Response According To Sex at Ismailganj. Male Female No. of Patients. % No. of Patients % Complete Relief 13 6.98 28 15.05 Partial Relief 29 15.59 55 29.56 No Response 8 4.30 10 5.37 Dropout 14 7.52 29 15.59 Total 64 34.40 122 65.59 Graph 10: Showing Response According to Sex at Ismailganj. www.wjpmr.com 145
Table 11: Showing Response According to Caste at Ismailganj. SC General No. of Patients. % No. of Patients. % Complete Relief 20 10.75% 21 11.29% Partial Relief 47 25.26% 37 19.89% No Response 9 4.83% 9 4.83% Dropout 24 12.90% 19 10.21% Total 100 53.76% 86 46.23% Graph 11: Showing Response According to Caste at Ismailganj. Spot No 3 Moulviganj Table No. 12: Showing Total No of Patients at Moulviganj. No. of Patients. % Complete Relief 81 16.80% Partial Relief 209 43.36% No Response 36 7.46% Dropout 156 32.36% Total 482 100% Graph No. 12: Showing Total No of Patients at Moulviganj. www.wjpmr.com 146
Table No 13: Showing Age wise Response at Moulviganj. Age 11 to 20 21 to 30 31 to 40 41 to 50 51 to 60 61 to 90 Complete Relief 7 32 25 17 0 0 Partial Relief 0 9 31 68 56 45 No Response 1 2 7 14 3 9 Dropout 1 20 36 40 32 27 Total 9 63 99 139 91 81 Graph 13: Showing Age wise Response at Moulviganj. Table No. 14: Showing Response According To Dietary Habit At Moulviganj. Vegetarian Non Vegetarian No. of Patients % No. of Patients % Complete Relief 4 0.82% 77 15.97% Partial Relief 10 2.07% 199 41.28% No Response 2 0.41% 34 7.05% Dropout 5 1.03% 151 31.32% Total 21 4.35% 461 95.64% Graph No. 14: Showing Response According to Dietary Habit at Moulviganj. www.wjpmr.com 147
Table No. 15: Showing Response According To Sex. Male Female No. of Patients % No. of Patients % Complete Relief 16 3.31% 65 13.48% Partial Relief 92 19.08% 117 24.27% No Response 16 3.31% 20 4.14% Dropout 59 12.24% 97 20.12% total 183 37.96% 299 62.03% Spot No 4 Mahona Table No. 16: Showing Total No Patients at Mahona. Graph 15: Showing Response According To Sex. No of Patients % Complete Relief 117 17.94% Partial Relief 285 43.71% No Response 83 12.73% Dropout 167 25.61% TOTAL 652 100% Graph 16: Showing Total No Patients at Mahona. www.wjpmr.com 148
Table 17: Showing Age wise Response at Mahona. Age 11 to 20 21 to 30 31 to 40 41 to 50 51 to 60 61 to 90 Complete Relief 18 28 42 24 5 0 Partial Relief 2 16 56 71 78 62 No Response 3 4 19 19 20 18 Dropout 4 17 31 35 49 31 Total 27 65 148 149 152 111 Graph 17: Showing Age wise Response at Mahona. Table 18: Showing Response according to Dietary Habit at Mahona. Vegetarian Non Vegetarian No of Patients % No of Patients % Complete Relief 85 13.03% 32 4.90% Partial Relief 213 32.66% 75 11.50% No Response 59 9.04% 24 3.68% Dropout 130 19.93% 37 5.67% Total 487 74.69% 168 25.76% Graph 18: Showing Response According to Dietary Habit at Mahona. www.wjpmr.com 149
Table 19: Showing Response According to Sex at Mahona. Male Female No of Patients % No of Patients % Complete Relief 25 3.83% 90 13.80% Partial Relief 87 13.36% 198 30.36% No Response 33 5.06% 50 7.66% Dropout 57 8.74% 110 16.87% Total 202 30.98% 448 68.71% Graph 19: Showing Response According to Sex at Mahona. Table 20: Showing Response According to Caste at Mahona. SC General No of Patients % No of Patients % Complete Relief 77 11.80% 40 6.13% Partial Relief 224 34.33% 61 9.35% No Response 61 9.35% 22 3.37% Dropout 126 19.32% 41 6.28% Total 488 74.84% 164 25.15% Graph 20: Showing Response According to Caste at Mahona. www.wjpmr.com 150
Spot No 5 Mirzapur Table No 21: Showing Total No Patients at Mirzapur. No of Patients % Complete Relief 24 22.01835 Partial Relief 36 33.02752 No Response 8 7.33945 Dropout 41 37.61468 Total 109 100 Table No. 22: Showing Agewise Response At Mirzapur. Graph No. 21: Showing Total No Patients at Mirzapur. Age 11 to 20 21 to 30 31 to 40 41 to 50 51 to 60 61 to 90 Complete Relief 2 13 7 2 0 0 Partial Relief 0 2 6 11 11 6 No Response 0 2 1 3 1 1 Dropout 3 8 4 13 4 9 Total 5 25 18 29 16 16 Graph 22: Showing Age wise Response at Mirzapur. www.wjpmr.com 151
Table No. 23: Showing Response According To Dietary Habit at Mirzapur. Vegetarian Non Vegetarian No of Patients % No of Patients % Complete Relief 17 15.59633 7 6.422018 Partial Relief 27 24.77064 9 8.256881 No Response 7 6.422018 1 0.917431 Dropout 29 26.6055 12 11.00917 Total 80 73.3945 29 26.6055 Graph No. 23: Showing Response According To Dietary Habit at Mirzapur. Table No. 24: Showing Response According To Sex At Mirzapur. Male Female No of patients % No of Patients % Complete Relief 3 2.75 21 19.26 Partial Relief 5 4.58 31 28.44 No Response 2 1.83 6 5.50 Dropout 14 12.84 27 24.77 Total 24 22.01 85 77.98 Graph 24: Showing Response According To Sex At Mirzapur. www.wjpmr.com 152
Table No. 25: Showing Response According to Caste at Mirzapur. SC General No of Patients % No of patients % Complete Relief 20 18.34 4 3.66 Partial Relief 30 27.52 6 5.50 No Response 32 29.35 1 0.91 Dropout 7 6.42 9 8.25 Total 89 81.65 20 18.34 Graph 25: Showing Response According to Caste at Mirzapur. This study showed that the risk of disability increases with the presence of joint pain in the centre of population. It will be more widespread and will be an imperative grounds of disability in the future. There is a requirement of instant awareness toward this concern in the figure of inference of problem of OA and various risk factors responsible for its development. There is a need to take suitable steps regarding OA in order to amplify consciousness of variable factors like significance of daily exercise, proper positioning of the body during daily activities and also control over the other modifiable known factors such as dietary habits, obesity, adequate treatment and rehabilitative services in the form of physiotherapy and advanced therapy. REFERENCES 1. Anonymous, Standard Unani Medical Terminology, Central Council For Research In Unani Medicine, Department of Ayurveda, Yoga & Naturopathy, Unani, Siddha and Homoeopathy (AYUSH), Ministry of Health & Family Welfare, Government of India, 290; 2012. 2. Anonymous, National Unani Morbidity Codes, Central Council For Research In Unani Medicine, Department of Ayurveda, Yoga & Naturopathy, Unani, Siddha and Homoeopathy (AYUSH), Ministry of Health & Family Welfare, Government of India, 2012. 3. http://namste.ayushnext.com. 4. https://dictionary.cambridge.org/dictionary/english/p revalence. 5. Maqbool Ahmad Khan, Mohd Tariq, Mohd Naime, Jamal Akhtar. Tahajjur Mafasil Understanding The Etiology, Pathophysiology, Complications And Treatments. World Journal of Pharmaceutical and Medical Research, 2018; 4(9): 138-142. 6. Ade Adebajo, ABC of Rheumatology, Fourth edition, Wiley Blackwell Publishing House, Yorkshire, UK, 51-70. 7. Colledge et al, Davisdson s Principles and Practices of Medicine, 21 st edition, Churchill Levingston, Elsevier s. 8. Fauci et al, Harrison s Principle of Internal Medicine, 17 th Edition, Mc Graw Hill Publication, New York, 901-902. 9. http://pib.nic.in/newsite/printrelease.aspx?relid=15 5555. 10. https://currentaffairs.gktoday.in/tags/swasthyaraksha-programme. www.wjpmr.com 153