RESUMO
BACKGROUND: Excessive Daytime Sleepiness (EDS) is inferred as persistent sleepiness and often a general lack of energy during the day even after apparently adequate or even prolonged nighttime sleep. The subjects may not be identifying excessive daytime sleepiness but may present as feeling tired, lack of energy etc. They may seem apparently healthy and without any other systemic illness. The prevalence was found to be as high as 18 % in 2012 in United Kingdom. Also, it is a risk factor for diseases like Alzheimer's disease, Parkinson's disease and other neurodegenerative diseases. Conventional management (Modafinil, Sodium Oxybate and Stimulants) addresses only the subjective condition in EDS and is associated with adverse effects compromising the quality of life. In the current health scenario there is a need for alternative interventions to manage this disease. On analyzing this condition through Ayurveda, we could understand it as Nidradhikya (Excessive daytime sleepiness) which is caused due to vitiated Kapha Dosha along with Vriddha Tamoguna (increased Tamoguna) that can be managed by Shodhana (biopurification) followed Shamana (pacification) therapies. OBJECTIVE: This study was aimed to assess the combined effect of Vamana (therapeutic vomiting) and Sarasvata Churna in reducing Excessive Daytime Sleepiness. MATERIALS AND METHODS: This was a single-arm exploratory open-label clinical trial. 10 subjects having EDS diagnosed using Modified Epworth Sleepiness Scale (MESS) with a score of 10-24 with proper exclusion were recruited from OPD and IPD, Department of Kayacikitsa, Amrita School of Ayurveda. All the participants were clinically examined, sought for medical history and further checked biochemically to exclude any other systemic illness that may lead to this condition. Only healthy subjects with quality night sleep (assessed by PSQI) and without any other systemic illness were selected. The treatment protocol adopted was Vamana Karma followed by 30 days of Sarasvata Churna as Shamana Aushadha (medicine for pacification). Assessment was done using MESS on 0th day and after 30 days of Shamana Aushadha Sevana. After completion of treatment, the results were statistically analysed using Wilcoxon Signed Rank Test and final conclusion was drawn. RESULTS: On analysis of the symptoms using Modified Epworth Sleepiness Scale, the mean total score reduced from 14.8 to 2.8 with 81.08 % relief in these 10 subjects and a significant p value < 0.05 after Vamana followed by 30 days of Shamana Aushadha Sevana. DISCUSSION: Vamana helps in Kapha Nirharana (expelling) which removes the Avarana (occlusion) of Manas seen in Nidradhikya. This results in Hrit Shuddhi (purity of heart) that helps in bringing the equilibrium of Mano Gunas (qualities of mind) (Satvoudaryam Tamojayaha) which forms the line of management. Sarasvata Churna which was administered as Shamana Aushadha possesses Medhya (Nootropic), Buddhi Smriti Dhriti Vardhaka (intellect, memory and patience promoting) attributes and is being indicated in Vicetas. Most of the drugs in Sarasvata Churna are Rasayana (rejuvenation) that imparts Indriya Bala (strengthening of senses) and Priti (contempt) to Manas by Prinana (nourishing) of Rasa Dhatu. CONCLUSION: From this study, we could conclude that the combination of Vamana Karma followed by Sarasvata Churna administration is effective in reducing EDS.
RESUMO
BACKGROUND: Amavata is a chronic immuneinflammatory systemic disorder caused by the formation of Ama and its association with Vata at Kaphasthana (joints) and can be simulated with rheumatoid arthritis (RA). Published evidences show that treatment indicated in Amavata is effective in RA. Increased inflammatory status in RA is suggestive of gut dysbiosis involving gut microbiota (GM). AIM: The aim of the present study was to analyze the influence of diet on GM of RA patients based on Pathya (dietary advice) mentioned for Amavata. MATERIALS AND METHODS: Laghutrayis such as Bhavaprakasha Samhita, Madhava Nidana and Sharangadhara Samhita, Bhaishajya Ratnavali and Nighantus (Sanskrit glossary) such as Raja Nighantu, Bhavaprakasha Nighantu and Yogaratnakara, Ashtanga Hridaya also different databases were reviewed for Pathya of Amavata. Different databases such as PubMed, Scopus, DHARA, Google Scholar, Science Direct were searched with research papers establishing the role of nonnutritive bioactive components in horse gram, barley, garlic, ginger, drumstick leaves, cow urine and buttermilk in the management of RA were also reviewed. It was found that Pathya influences on the GM by lowering or inhibiting inflammatory markers such as interleukin6 (IL6), 17 and leukotrines through BowmanBirk inhibitors and polyphenolic compounds. Among them, Takra is already a proven probiotic. Gomutra augments B and T lymphocytes, IL1 and IL2, strengthening the immune system. CONCLUSION: It was concluded that Pathya Ahara mentioned for Amavata have a direct link with GM of RA patients. Even though the pharmacological actions have been clinically proven/practised, this review creates evidence for its scientific basis.
RESUMO
Visphota kushta (blistering skin disease) is characterized by transparent blisters with thin skin covering. Management of Visphota Kushta in Ayurveda is rarely reported. The case reported here showed significant regression in the condition in short span of time and could completely stop the use of anti histamines and corticosteroids. A 32 year old female, presented with complaints of blisters over both upper and lower extremities associated with edema, burning sensation, pain, severe itching and oozing since three months. The treatments were given after ascertaining the involved dosha and the samprapti (pathogenesis). The involved dosha were and Pitta (metabolic factor) and Kapha (binding factor) dosha. Pitta - kapha dosha hara line of treatment was adopted in terms of mitigating and purificatory therapy. It helped in arresting the progression of the condition and a complete healing of blisters. Photographs were taken during and after the treatment for records. The blister completely resolved and the skin was normal as before. The patient was back to her normal routine with no signs of relapse. The outcome was a combined effect of both shamana and shodhana chikitsa along with pathya sevana.
RESUMO
Avapeedaka Snehapana is a unique and special method of internal administration of Sneha dravya (unctuous medicine) mentioned in the classical ayurveda texts. It is mainly indicated in mutravegarodha janya vikara (diseases due to the suppression of urge of micturition). Because of the lack of adequate review and analysis, this method of administration of snehapana (internal administration of lipid) is losing its significance from the practices and the concept remains unexplored. The reasons for not being practiced like other snehana (oleation therapy) procedures are because of the less understanding of the concept of administration, scattered and minimal textual references. Through this review, we intend to have a detailed analysis on the concept of avapeedaka snehapana mentioned in the Brihatrayees (Caraka Samhita, Sushruta Samhita, and Ashtanga Hridaya-the 3 main texts of ayurveda) with its possible practical methods of administration. The role of ghrita (ghee) in inducing the ketogenesis is also analyzed. Being a ketogenic diet, the benefits of ghrita are interpreted. These efforts may help bring down avapeedaka snehapana into the mainstream of practice.