A conceptual study on the effect of Amaritadi ghanvati in urticaria

[Full title: A conceptual study on the effect of Amaritadi ghanvati in urticaria : a review article.]

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Volume- 2, Issue- 5 IRJAY 37 IRJAY, vol- 2, issue-5, Sept-Oct:2019; 37-43 Abstract- Urticaria affects 20% of people at some point in their lifetime. In some cases, the disorder is relatively mild, recurrent and frustrating for both the patient and the physician. In other cases, it manifests as part of a spectrum of systemic anaphylaxis, which may be life threatening. The disability and distress caused by skin disorders can lead to serious impairment of quality of life, almost comparable to that experienced by patients with cardiovascular disease. To further complicate the issue, a fairly extensive list of diseases can cause Urticaria. Patients often see medical attention with the hope that a reversible cause can be identified. There are so many internal and external patent Ayurvedic drugs are available in market but still allergic skin diseases are not ended. Most of ingredients of Amaritadi ghanvati had raktshodhak property ,dipan,pachan, krimighan, shothhar ,tridoshghan and Volume- 2, Issue- 5 Review Article A conceptual study on the effect of Amaritadi ghanvati in urticaria : a review article. Dr.Rajveer Sason 1 , Dr. Dinesh Kumar Kumawat 2 , Dr. Rashmi Saini. 3 1. Ph.d Scholar, PG department of Agada Tantra, National Institute of Ayurveda, Amer Road, Jaipur, 302002. 2. M.D. Agad Tantra & Vyavahara Ayurveda, National Institute of Ayurveda Jaipur(Raj). 3. PG Scholar, Agad Tantra Dept. National Institute of Ayurveda Jaipur Article received on- 15 oct Article send to reviewer- 16 oct. Article send back to author- 20 oct. Article again received after correction- 22 oct. Corresponding author - Dr. Rajveer Sason, Phd. Scholar, PG department of Agada Tantra, Email ID: sasonrajveer 2@gmail.com

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Volume- 2, Issue- 5 IRJAY 38 IRJAY, vol- 2, issue-5, Sept-Oct:2019; 37-43 immunomodulator properties, along with Vatasnabh which is vyavahi and vikasi in nature which proved in increasing the action of drugs. The drug had been taken from “ Sahestrayog Pratham prakran 3/1. As we know that if we use poison in control and proper way, we get its medicinal effects as said in CharakSamhita.So present paper gives an idea about its work in urticaria. Introduction Amaritadi ghanvati was given in Sahestrayog pratham prakran -3 Ayurveda has a vast treasure of drugs for the treatment of urticaria mentioned in our renowned treaties. However according to acharya it is indicated in 1 1.Visarp 5. Masurika 2.Kushtha 6.Sheetpita 3.Visphota 7. Jwar 4.Kandu 8.Vish Table containing contents and properties of Amaritadi ghnavati. 2-10 S.No. Commo n name Botanical name Rasa Guna Veerya Vipaka Karma 1. Amrita 2 Tinosporia cordifolia Tikta,kashya Laghu ushna madhura Raktasodhaka , Depana, Rasayana, 2. Vish 3 Acotinum ferox Madhura Laghu,tik shna ushna madhura kapha vatvroga, 3. Patol 4 Trichosanthus dioica Tikta Laghu,ru ksha ushna katu Vishaghna, raktasodhaka, sothaghna, 4. Mustak 5 Cyperus rotundus Tikta,kashya Laghu,ru ksha Sheeta katu Twakavikar Agnimandya, Ajeerna, 5. Saptparn 6 Alstonia scholaris Katu,tikta Laghu,sn igdha ushna katu Kusthaghana 6. Khadir 7 Acacia catechu Tikta,kashya Laghu,ru ksha Sheeta katu Krimighna, Kushthaghna Raktasodhaka , 7. Nimb Patra 8 Azadirachta indica Tikta,kashya Laghu Sheeta katu Kandughna, Kusthghna,

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Volume- 2, Issue- 5 IRJAY 39 IRJAY, vol- 2, issue-5, Sept-Oct:2019; 37-43 Jantughna, Dahaprasama na 8. Haridra 9 Curcuma longa Katu,tikta Ruksha Ushna katu Visha, Prameha, kandu, kustha, vrana 9. Daruhari dra 10 Berberis aristata Tikta,kashya Laghu,ru ksha Ushna Katu Kandu,Vrana, Meha , Visha, AIMS AND OBJECTIVES  To study the effect of Amaritadi ghanvati  To evaluate and discuss the Ayurvedic property of Amaritadi ghanvati and its mode of action in urticaria . MATERIALS AND METHODS The study on Urticaria and Amaritadi ghanvati was done with the help of Ayurvedic Samhitas and conceptualize and summarize the data of different samhita and respective commentaries. The text book of modern medicine and index medical journal has been also referred to review of material of consent topic. CONCEPTUAL STUDY Urticaria is extremely common („nettle rash‟ or „wheals‟ or „hives‟ are popular names for this disorder) and there are few individuals who do not experience the disorder in one form or another during their life time. Urticarial lesions are itchy red papules and plaques of variable size that arise suddenly, often within a few minutes, and last 6-24 hours. They may assume odd polycyclic annular and geographic forms 11 Epidemiology : 12 1) Incidence : 20% of total population may suffer from Urticaria once in their life. Acute Urticaria is most common in young patients while chronic type is in middle-aged women. A personal or family history of Atopy is no more common in patients with Urticaria. Patients with active atopic dermatitis or hay fever have an increased incidence of allergic Urticaria 2) Age : Bandkowski {1968} gave an age incidence of 3.4% in babies and children compared with general population rate of 1.87% and he also pointed out that of 885 cases of Urticaria only one had occurred in a patient over 65 year of age. Urbech and Gottlieb showed that of 500 cases, 2/3 rd occurred between ages of 20 – 40 years. It is generally agreed that chronic Urticaria is common in third and fourth decade of life. 3) Sex : Generally, women having a greater tendency for Urticaria. Volterani {1965] reported 64% of cases were females.

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Volume- 2, Issue- 5 IRJAY 40 IRJAY, vol- 2, issue-5, Sept-Oct:2019; 37-43 CAUSES 13 Causes of Urticaria can be classified as under : IgE antibodies mediated Foods : Nuts, Eggs, Fresh fruits (especially citrus), Chocolates, Fish and shellfish, Tomatoes Milk and cheese, Spices Yeasts, Foods additives and preservatives such as tartrazine Drugs : Pain killers/Anti-rheumatics e.g. aspirin, codeine, Antibiotics, penicillin, sulphonamides. Salicylates, Indomethacin and other non-steroidal anti-inflammatory drugs, Opiates, Radiocontrast media, Sodium benzoate Insulin, Menthol (cigarettes, toothpaste, iced tea, hand cream, lozenges, candy). Insect stings PHYSICAL STIMULI : Simple friction or scratching (dermatographism), sunlight, pressure, heat, cold temperature, water, vibration INHALANTS : Latex, dust, animal dander, pollen INFECTIONS : Viral upper respiratory infections, bacterial (sinusitis, dental abscess, otitis), viral hepatitis, vaginitis, fungal (tinea pedis - athelete's foot), helminth, protozoa SYSTEMIC DISEASES : Collagen vascular diseases, leukemia, lymphoma, and ocrinopathies (Hyperand hypothyroidism, Hashimoto's thyroiditis), menstruation Complement-mediated factors : C 3 b-inactivator deficiency Hereditary or acquired angioedema, Urticarial vasculitis, serum sickness Direct mast cell-releasing agents : Opiates Radiocontrast media Curare, tubocurarine chloride DESCRIPTION OF SHITAPITA, UDARDA AND KOTHA 14 In Ayurvedic texts Shitapita- Udarda-kotha are described almost similar having few different characters and different causative factors. Madhavakara described Shitapitta and udarda as synonyms of each other[ M.N.50/41], but then he quoted that Shitapita having ‘Vatika Dominancy‟ while „ Udarda ‟ having „ kaphaja dominancy‟ [M.N. 50/4] and also mentioned specific character of „ udarda ‟ as mandala [rashes] having inflamed edges with depressed centre[M.N.50/5] Chakrapani has described kotha as a “ Vartidamshta Aakara Sotha ” (Ch.Su.7/14). In the classics kotha has been described as the itchy red rashes covering major part of skin and chronic in nature‟[M.N.50/6] Though these three „Shitapitta, Udarda and Kotha has been described as different entities but they can be considered as different types of the Shitapita or urticaria as they all having same cardinal symptom i.e itchy red rashes on the skin.‟[M.N.50] Probable mode of action of Amaritadi ghan vati-

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Volume- 2, Issue- 5 IRJAY 41 IRJAY, vol- 2, issue-5, Sept-Oct:2019; 37-43  Considering all above things in mind trial drug Amaritadi ghanvati Sahestrayog pratham prakran -3 was selected for this study. In the original form yoga is described as a ghanvatikalpana was prepared by the method mentioned in Sharangdhara Samhita, was made in Rasayanshala , Rasashastra Dept., National Institute of Ayurveda , Jaipur. There are so many internal and external patent Ayurvedic drugs are available in market but still allergic skin diseases are not ended.  Most of ingredients of Amaritadi ghanvati having raktshodhak property ,dipan,pachan, krimighan, shothhar ,tridoshghan and immunomodulator properties, along with Vatasnabh which is vyavahi and vikasi in nature which helps to increase the action of drugs and also having rasayan property. As we know that if we use poison in control and proper way, we get its medicinal effects as said in Charak Samhita.  Amaritadi ghan vati containing Amrita, Vish, Patol, Mustak, Saptparn, Khadir, Nimb Patra, Haridra, Daruharidra. These all drugs had mostly Katu, Tikta, Kashaya Rasa as well as Laghu Ruksha Guna which acted on vitiated tridosh especially kaph pitta as allergic skin disease has tridosh predominant vyadhi, so drug works as Doshapratyanika Chikitsa . Drug amrita, patola, haridra, nimb, khadir ,act as Kushthghna,vishghan i.e. Vyadhipratyanika Chikitsa . It is believed that it must have anti-toxic activity and having curative effect on skin ailment, specially caused by Dushivisha known allergic skin disorders identified by the presence of elevated skin lesions or eruptions or visphot . For a layman it appears a small elevation as a result of Vartidansh Sadrishya shoth  As the Dushivisha has its specific effects to vitiate Shonit dhatu specially create Kandu , Shoth , Daha , Todaa etc. by its effects. So they also providing support to Dushivisha also situated, collected, manifested in the body system silently and waiting for further support, therefore by nature it is called Vishagunanubandhi . By the combined effect of Virudhahar, Ahitahar, Apathya, Dhatusaithilya, Dhatuvaigunya, Dosh prakopa and Utklesh Srotodaaushti and Manodushti occur respectively and prepare a suitable climate inside the dhatu where dosha with the help of Dushivisha and garvisha already create Shitpitta, udarda, koth , etc. which are basically common eruptive disorders.  As described by Acharya Charak in Sutrasthana 26 TiktaRasa has the property of Deepana and Pachana and thus it helps in Amapachana formed due to Nidanasevana . Tikta Rasa also has the property of Raktaprasadana , Vishaghna , Kushthaghna , Kandughna and dahaprashamana . It also has Kaphaghna property. Thus through these properties acts on disease.  Also Katu Rasa possesses Deepana and Pachana properties through which it acts at level of Agni .Other properties of Katu Rasa described by Acharya Charaka are Vishaghna, Kandughna, Krimighna and Vranaprasadana.

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Volume- 2, Issue- 5 IRJAY 42 IRJAY, vol- 2, issue-5, Sept-Oct:2019; 37-43  As regards to Veerya , majority of the drugs have UshnaVirya. Ushna Veerya has Vatakaphashamaka property and it has Ashupaka property by which it acts quickly at micro channels  Looking to the Karmas , it is clear that almost all the drugs are having Kushthaghna , Kandughna , Raktashodhak , Twagdoshaahara, Krimighna, Vishaghna and Rasayana properties, which clearly explain its mode of action in skin diseases.  It also helped in removing the effect of Virudhahar , Ahitahar by providing strength to Agni and treated agnimandaya by the use of deepana drugs like guduchi and mustaka Conclusion According to the classical references in Ayurveda the Urticaria can be treated successfully if it is in sadhya (easily curable) condition. Table mentioned above clearly envisage that the herbal medications have excellent potential to treat various ailments including urticaria. The contents of Amaritadi ghanvati used in the treatment of Urticaria shows markeable properties which could help in treating ailment. The method of preparation and mode of action is also simple and convenient. They are comparatively safer than synthetic drugs However; further studies are required to identify the phytochemicals responsible for these medicinal yoga and also various other formulations. References 1.Sahasrayogam by Dr. K. Niteshwar Chowkhambha Sanskrit Series office Edition 2017 pp 11. 2. The Ayurvedic Pharmacopoeia of India. Ist ed.Vol 1, Part-1, p.no 53-55 New Delhi: Govt. of India, Ministry of Health and Family Welfare:2001 3.The Ayurvedic Pharmacopia of India. Ist ed.Vol 1, Part-1, p.no 180-182 New Delhi: Govt. of India, Ministry of Health and Family Welfare:2003 4. Gyanendra Pandey Dravyaguna Vijana Vol 1,3 rd edition Chaukhamba Krishna Das Academy, Varanasi., 2005; 411-424. 5.The Ayurvedic Pharmacopia of India. Ist ed.Vol 3, Part-1, p.no 130-132 New Delhi: Govt. of India, Ministry of Health and Family Welfare:2001 6.The Ayurvedic Pharmacopia of India. Ist ed.Vol 1, Part-1, p.no 129-131 New Delhi: Govt. of India, Ministry of Health and Family Welfare:2001 7.The Ayurvedic Pharmacopia of India. Ist ed.Vol 1, Part-1, p.no 96-97 New Delhi: Govt. of India, Ministry of Health and Family Welfare:2001 8. The Ayurvedic Pharmacopia of India. Ist ed.Vol 1, Part-1, p.no 64 New Delhi: Govt. of India, Ministry of Health and Family Welfare:2001 9. The Ayurvedic Pharmacopia of India. Ist ed.Vol 1, Part-1, p.no 60-62 New Delhi: Govt. of India, Ministry of Health and Family Welfare:2001 10 The Ayurvedic Pharmacopia of India. Ist ed.Vol 2, Part-1, p.no 34-36 New Delhi: Govt. of India, Ministry of Health and Family Welfare:2001

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Volume- 2, Issue- 5 IRJAY 43 IRJAY, vol- 2, issue-5, Sept-Oct:2019; 37-43 11. Leznoff A, Sussman GL. Syndrome of idiopathic chronic urticaria and angioedema with thyroid autoimmunity: A study of 90 patients. J Allergy Clin Immunol. 1989;84:66–71. 12. Grattan CE, Sabroe RA. Chronic urticaria. J Am Acad Dermatol. 2003;28:123–127. 13. Grattan CE, Sabroe RA. Chronic urticaria. J Am Acad Dermatol. 2003;28:126–128. 14 Madhava Nidana - Hindi Translation by Narendranath Shastri, Motilal Banarasidas Pratisthana, Dellhi, Chapter 50, pp. 638.

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Kandu, Kushtha, Vishaghna, Masurika, Vish, Ushnavirya, Udarda, Dushivisha, Curcuma longa, Cyperus rotundus, Food, Jwar, Katurasa, Specific character, Causative factor, Botanical name, Tikta Rasa, Mode of action, Urticaria, Deepana and Pachana, Trial Drug, Systemic disease, Herbal Medication, Ayurvedic Drug, Conceptual study, Classical reference, Skin disorder, Raktasodhaka, Immunomodulator properties, Chronic urticaria, Acute urticaria, Medical Journal, Katu-Tikta-Kashaya-Rasa, Laghu-Ruksha-Guna, Physical Stimuli, Synthetic drug, Insect stings, Systemic anaphylaxis, Medicinal effect, Age Incidence, Agnimandaya, Ayurvedic property, Aims and objective, Vyadhipratyanika chikitsa, Total population, Kaphaja dominancy, Vatika dominancy, Rasayan property, Allergic skin disorder, Allergic urticaria, Allergic skin disease.