Hepatitis C an Ayurvedic approach - A Case Study

[Find the meaning and references behind the names: Chavan, Daily, Modern, Baby, Code, Less, Doi, Class, India, Kasha, Scholar, Rna, Key, Date, Mild, Ring, Nous, Risk, Abd, Million, Loss, Fever, Pain, Ayu, Liver, Show, Cases, Hod, Flavi, Tools, Data, Blood, Viru, Patient, Alon, Prashanth, July, Guide, Stick, Post, Quick, Dark, Genu, Kasa, Case, Study, Strong, Weeks, General, Early, Repo, Blo, Aug, Look]

ISSN: 2456-3110 Journal of Ayurveda and Integ Hepatitis C an Ayu Vidyadhar Balikai, 1 Prashanth A. S 1, Post Graduate Scholar, 2 Professor an Mahavidyalaya, Hubli, Karnataka, India. I NTRODUCTION Hepatitis - C is an infectious disease the flavi-like virus, Hepatitis-C virus (HCV) Hepacivirus with RNA genome of >9000 genetic heterogeneity. Incubation period that primarily affects the liver during infection people often have mild or no Occasionally a fever, dark urine, abd and yellow tinged skin occurs. The virus p liver in about 75% to 85% of those initi Early on chronic infection typically has n Over many years however, it often l disease and occasionally cirrhosis. In s those with cirrhosis will develop compli as liver failure, liver cancer, or esophage varices [2] HCV is spread primarily by blood-to-blo Address for correspondence: Dr. Vidyadhar Balikai Post Graduate Scholar, Department of Kayachikitsa Mahavidyalaya, Hubli, Karnataka, India. E-mail: drvidyadhars@gmail.com Submission Date : 13/08/2017 Accepted Date Access this article online Quick Response Code Website: www.jaims.in DOI: 10.21760/jaims.v 2 i A B S T R A C T The effect of Gandharva Haritak Kashaya were studied clinically o Abdomen and Hematological inve and weekly basis after discharge, general weakness were completely Key words: Hepatits C, Gandharv CASE REPO ntegrated Medical Sciences | July - Aug 2017 | Vol. 2 yurvedic approach - A Ca . S., 2 S. G. Chavan 3 r and HOD, 3 Professor & Guide, Department o ease caused by CV) in the genus 00 nucleotides; riod 7–8 weeks [1] ring the initial r no symptoms. abdominal pain us persists in the initially infected. as no symptoms. n leads to liver some cases, mplications such ageal and gastric blood contact kitsa, Ayurveda Date: 24/08/2017 s.in s.v 2 i 4.9372 associated with intravenou medical equipment, ne healthcare, and transfusio the risk from a transfusion million. It may also be sprea to her baby during birth. It contact. It is one of five kn C, D, and E. Diagnosis is by either antibodies to the vi recommended in all people ritaki , Sudarshana Vati , Arogyavardhini Vati alon ly on a case of Hepatits - C by modern diagn investigations. The review of the patient was done ge, the clinical features like loss of appetite, heavin tely subsided during the 2 nd month of treatment arva Haritaki, Sudarshana Vati, Punarnavadi Kasha REPORT July-Aug 2017 ol. 2 | Issue 4 299 Case Study nt of Kayachikitsa, Ayurveda nous drug use, poorly sterilized needle stick injuries in usions using blood screening, usion is less than one per two pread from an infected mother It is not spread by superficial e known hepatitis viruses: A, B, is by blood testing to look for e virus or its RNA. Testing is ople who are at risk [2] along with Punarnavadi agnostic tools with USG one on daily basis in IPD aviness of abdomen and ashaya.

[Find the meaning and references behind the names: New, Portal, Carrier, Bile, Evidence, Care, Normal, Male, Hospital, Present, East, Chain, Central, Six, Try, Asia, Part, Ase, Person, High, Get, Few, Rise, Point, Due, Alt, Elisa, Take, Non, Wrong, Gross, Viral, Africa, Positive, Able, Need, Seven]

Vidyadhar Balikai et.al. Hepatitis C an Ayurvedic approach - A Case Study ISSN: 2456-3110 CASE REPORT July-Aug 2017 Journal of Ayurveda and Integrated Medical Sciences | July - Aug 2017 | Vol. 2 | Issue 4 300 Epidemiology An estimated 130–200 million people worldwide are infected with hepatitis C. In 2013 about 11 million new cases occurred. It occurs most commonly in Africa and Central and East Asia About 343,000 deaths due to liver cancer and 358,000 deaths due to cirrhosis occurred in 2013 due to hepatitis C. The existence of hepatitis C – originally identifiable only as a type of non-A non-B hepatitis – was suggested in the 1970 s and proven in 1989. Hepatitis C infects only humans and chimpanzees [2] HCV accounts for >90% of transfusion-associated hepatitis cases. IV drug use accounts >50% of reported cases of hepatitis C. Little evidence for frequent sexual or perinatal transmission Serology Hepatitis C testing typically begins with blood testing to detect the presence of antibodies to the HCV, using an enzyme immunoassay. If this test is positive, a confirmatory test is then performed to verify the immunoassay and to determine the viral load. A recombinant immunoblot assay is used to verify the immunoassay and the viral load is determined by an HCV RNA polymerase chain reaction. If there is no RNA and the immunoblot is positive, it means that the person tested had a previous infection but cleared it either with treatment or spontaneously; if the immunoblot is negative, it means that the immunoassay was wrong. It takes about 6–8 weeks following infection before the immunoassay will test positive. A number of tests are available as point of care testing which means that results are available within 30 minutes. Liver enzymes are variable during the initial part of the infection and on average begin to rise at seven weeks after infection. The elevation of liver enzymes does not closely follow disease severity [2] Diagnosis There are a number of diagnostic tests for hepatitis C, including HCV antibody enzyme immunoassay or ELISA, recombinant immunoblot assay and quantitative HCV RNA polymerase chain reaction (PCR). HCV RNA [3] can be detected by PCR typically one to two weeks after infection, while antibodies can take substantially longer to form and thus be detected. Chronic hepatitis C is defined as infection with the hepatitis C virus persisting for more than six months based on the presence of its RNA Chronic infections are typically asymptomatic during the first few decades, and thus are most commonly discovered following the investigation of elevated liver enzyme levels or during a routine screening of high-risk individuals. Testing is not able to distinguish between acute and chronic infections Diagnosis in the infant is difficult as maternal antibodies may persist for up to 18 months. Biopsy Liver biopsies are used to determine the degree of liver damage present; however, there are risks from the procedure. The typical changes seen are lymphocytes within the parenchyma, lymphoid follicles in portal triad, and changes to the bile ducts. There are a number of blood tests available that try to determine the degree of hepatic fibrosis and alleviate the need for biopsy [4] Prevention Exclusion of paid blood donors, testing of donated blood for anti-HCV. Anti-HCV detected by enzyme immunoassay in blood donors with normal ALT is often falsely positive (30%); result should be confirmed by HCV RNA in serum [5] C ASE R EPORT A male patient of 56 years approached the OPD of PG Kayachikitsa Department , Ayurveda Mavidyalaya and Hospital Heggeri, Hubli, with the chief compliants of Loss of Appetite Heaviness of Abdomen and General Weakness since 2 Years. Patient was diagnosed as Hepatitis-C Carrier and USG Abdomen shows Diffused / Enlarged liver with nodular margins. Spleenomegally with gross Ascities and Portal Vein Hypertention Patient approached for the treatment for the same to modern hospital but couldn’t get needful , After that he approached our hospital for treatment

[Find the meaning and references behind the names: Mouth, Bala, Dosha, Shala, Karma, Left, Anand, Jwara, Standing, Body, Long, Nagar, Acharya, Rbs, Arya, Diet, Eyes, Kamala, Rasa, Age, Warm, Nails, Vaidya, Manda, Pandu, Place, November, Tab, Pitta]

Vidyadhar Balikai et.al. Hepatitis C an Ayurvedic approach - A Case Study ISSN: 2456-3110 CASE REPORT July-Aug 2017 Journal of Ayurveda and Integrated Medical Sciences | July - Aug 2017 | Vol. 2 | Issue 4 301 Clinical Profile Age: 56 yrs, Sex : Male, Occupation : Buisness, Diet : Mixed, OPD NO : 19280, IPD NO : 430 Date : 03-11- 2016, Address : Anand Nagar, Hubli Case Presenatation and Clinical Examination The above said patient approached on 3 rd November 2016 with the compliants of Loss of Appetite Heaviness of Abdomen and General Weakness since 2 Years. He was diagnosed as Hepatitis-C Carrier and Patient is H/o Diabetes on Regular Treatment and other family history was not contributory. General examinations and examinations of CVS, RS, CNS revealed no abnormality, P/A shows Heapatomegally with tenderness with mild enlargement of Abdomen was seen. Laboratory investigations Haemogram Hb - 10.06 gm% TC - 5900 cells/cumm DC - P-76%, L-18, E-01% Platelet Count: 1,26,000 Cells/cumm Blood Chemistry RBS - 141.7 mg/dl, Serology HCV - POSITIVE USG Abdomen Study Diffused / Enlarged liver with nodular margins. Spleenomegally with gross Ascities Portal Vein Hypertention Ayurvedic Approch Patient symptoms were correlated with Kamala, Yakruttodara, Pleehodara and Upadrava of Arshas Yakrut and Pleeha are the Raktavahasrotomula . Madya Sevana is one of the Raktadushti Nidana explained by Charaka [6] Nidana Excess indulgence in Vidahi and Abhishyandi Ahara does Prakopa of Raktha and Kapha resulting in long standing Pleeha Vrudhi . Phleeha Vrudhi takes place on Vama Parshwa , i.e left side of the body. As this condition progresess patient will have Glani and suffers from Mandagni, Manda Jwara and Upadravas associated with Kapha and Pitta Dosha’s and becomes Pandu Varna Yukta with Ksheena Bala. [7] Lakshanas Lakshanas also compaired mainly with Yakruttodara / Pleehodara viz., Hepato/ Spleenomegaly, Avipaka, Aruchi, Trushna, Anaha, Avasada, Moorcha, Kasa, Swasa, Mandagni, Krushata, Asyavairasya, Udara Shoola and Pandu. [8] It can also be co related to Kostashrita Kamala [9] in other words Hepatic/Infective jaundice, symptoms explained in classics are yellowish discolouration of nails, skin eyes and mouth, Discolouration of urine and stool, Indigestion, weakness, lassitude, anorexia and burning sensation. Chikitsa According to Acharya Charaka treatment principle is mainly Shodhana Karma for Udara i.e. Yakruttodara Chikitsa [10] and Kamala Chikitsa [11] i.e. Virechana with Tikta Rasa Dravyas along with Gomutra . M ATERIALS AND M ETHODS Drugs selected for the study 1 Gandharva Haritaki Churna [12] (Arya Vaidya Shala) 2 Sudarshana Vati [13] 3 Arogyavardhini Vati [14] 4 Tab. Punarnavadi Kashaya [15] Treatment schedule Gandharva Haritaki with warm water, Sudarshana Vati, Arogyavardhini Vati along with Tab. Punarnavadi

[Find the meaning and references behind the names: Foods, Fruits, Netra, Dennis, Vata, Kasper, Hunger, Low, Thin, Excellent, Rid, Vital, Stephen, Guard, Fried, Ati, Anthony, Under, Major, Tablet, Tomato, Bhaya, Gram, Jala, Hauser, Days, Bitter, Plays, Hard, Joseph, Wiki, Role, Harrison, Green, Parts, Roga, Socio, Fauci, Katu]

Vidyadhar Balikai et.al. Hepatitis C an Ayurvedic approach - A Case Study ISSN: 2456-3110 CASE REPORT July-Aug 2017 Journal of Ayurveda and Integrated Medical Sciences | July - Aug 2017 | Vol. 2 | Issue 4 302 Kashaya each 1 tablet Sukoshna Jala as Anupana after the food for 10 days during admission. Diet Patient was advised to avoid tomato, cauliflower, non vegetarian, cheese, curds and excessive intake of fried and spicy foods. Fruits, Vegetables like cucumber, snake guard, bitter guard, green gram and poddrige etc. were advised as regular food items. O BSERVATION AND R ESULTS Chronology of clinical observations 1 Patient admitted in the IPD on 03-11-2016 with laboratory findings as above. 2 Patient was subjected to the above said scheduled treatment and kept under regular observations. 3 Patient got completely relived from the clinical symptoms like loss of appetite heaviness of abdomen and general weakness during the 2 nd week of the treatment. 4 Patient was continued the medication for 2 months. 5 Patient was discharged with said above treatment to continue for 3 months. Investigations after treatment Haemogram Hb - 11.06 gm% TC - 8000 cells/cumm DC - P-35%, L-59, E-06%, Platelet Count - 1,69,000 Cells/cumm Blood Chemistry RBS - 130.0 mg/dl, Serology HCV - Negative DISCUSSION The need for the discussion of Hepatities - C (Kamala and Udara Roga) becomes important due to the gravity of the problem. It is the commonest infective disorder all over the world and forms a major problem of mankind especially in a country like India due to low socio-economic status, illiteracy and unhygienic conditions in a major part of the population Hepatities - C is an infective origin disease where it need Nidana Parivarjana first and most i.e. with various aetiologies like Asatmyabhojana , Atimadyapana , Kshara , Nishpava , Pinyaka , Krodha , Bhaya that increase Vata and Pitta . These are Apatarpanakaraka . This Apatarpana may be grossly taken as, the inadequate dietary intake which can cause Kamala CONCLUSION Hepatities - C is Kasta Sadhya Vyadhi , if it is having the Lakshanas viz., Netra Shotha (odema over the eyes), hard penis ( Kutil Upastha ) wet and thin Skin ( Klinna Twacha ), emaciated ( Karsha ) odema over vital parts ( Swayathu ), exessive thirst, hunger, hiccup ( Ati Trushana, Hikka, and Swasa ) associated with vomitting and diarrhoea ( Chardi and Astisara ) it is Kasta Sadhya . Hence can be treated with effective Tikta , Katu along Ushna Dravyas as Virechana therapy plays an important role to get rid of the infection in many patients, in present study the patient shows excellent results along with improved symptoms REFERENCES 1 Harrison’s Principles of Internal Medicine, Edited by Anthony S Fauci & Dennis L Kasper, Stephen L.Hauser, Joseph Loscalzo, 18 th edition, Chapter No 163, 2013;p.1036. 2 https://en.wikipedia.org/wiki/Hepatitis_C as seen on 10/082017 3 Harrison’s Principles of Internal Medicine, Edited by Anthony S Fauci & Dennis L Kasper, Stephen L.Hauser, Joseph Loscalzo, 18 th edition, Chapter No 163, 2013;p.1036. 4 Harrison’s Principles of Internal Medicine, Edited by Anthony S Fauci & Dennis L Kasper, Stephen L.Hauser, Joseph Loscalzo, 18 th edition, Chapter No 163, 2013;p.1036.

[Find the meaning and references behind the names: Ajay Kumar, Kumar Sharma, Sharman, Mahadevan, Iyer, Sharma, Cite, Kumar, Sci, Ajay, Trust, Sharada, Banaras, Sarada, Nil, Varga, Med, Mishra, Mahadev, None, Khanda]

Vidyadhar Balikai et.al. Hepatitis C an Ayurvedic approach - A Case Study ISSN: 2456-3110 CASE REPORT July-Aug 2017 Journal of Ayurveda and Integrated Medical Sciences | July - Aug 2017 | Vol. 2 | Issue 4 303 5 Harrison’s Principles of Internal Medicine, Edited by Anthony S Fauci & Dennis L Kasper, Stephen L.Hauser, Joseph Loscalzo, 18 th edition, Chapter No 163, 2013;p.1036. 6 Vaidya Jadavji Trikamji Acharya,ed.Caraka Samhita- Cakrapani, sutrasthana 24 th chapter, Chaukamba Orientalia, Varanasi, 2007;p.124,250. 7 Ajay kumar Sharma, Kayachikitsa – II, 2017 edition, Choukamba Publishers, Varanasi, 2017;p.346,347 8 Ajay kumar Sharma, Kayachikitsa – II, 2017 edition, Choukamba Publishers, Varanasi, 2017;p.353,354 9 Ajay kumar Sharma, Kayachikitsa – II, 2017 edition, Choukamba Publishers, Varanasi, 2017;p.604. 10 Ajay kumar Sharma, Kayachikitsa – II, 2017 edition, Choukamba Publishers, Varanasi, 2017;p.359. 11 Ajay kumar Sharma, Kayachikitsa – II, 2017 edition, Choukamba Publishers, Varanasi, 2017;p.607. 12 Acharya Bhava Mishra, Bhava Prakasha Nigantu Poorva Khanda, Haritakyadi Varga context Verse no 19-21, Chowkamba Sanskrit Series Office Banaras, 1956;p.170. 13 Dr. L. Mahadevan. Critical Analysis of Ayurvedic Formulations (Sahasrayoga and Other Samhitas), Sarada Mahadev Iyer Ayurvedic Educational Trust & Charitable Trust Derisanamcope, Kanyakumari, 2014;p.109-110. 14 Dr. L. Mahadevan. Critical Analysis of Ayurvedic Formulations (Sahasrayoga and Other Samhitas), Sarada Mahadev Iyer Ayurvedic Educational Trust & Charitable Trust Derisanamcope, Kanyakumari, 2014;p.306-307 15 Dr. L. Mahadevan. Critical Analysis of Ayurvedic Formulations (Sahasrayoga and Other Samhitas), Sarada Mahadev Iyer Ayurvedic Educational Trust & Charitable Trust Derisanamcope, Kanyakumari, 2014;p.205-206 ******************************* How to cite this article: Vidyadhar Balikai, Prashanth A. S., S. G. Chavan. Hepatitis C an Ayurvedic approach - A Case Study. J Ayurveda Integr Med Sci 2017;4:299-303. http://dx.doi.org/10.21760/jaims.v 2 i 4.9372 Source of Support: Nil, Conflict of Interest: None declared.

Other Health Sciences Concepts:

[back to top]

Discover the significance of concepts within the article: ‘Hepatitis C an Ayurvedic approach - A Case Study’. Further sources in the context of Health Sciences might help you critically compare this page with similair documents:

Udararoga, Loss of appetite, Clinical feature, Ayurvedic treatment, Journal of Ayurveda, Incubation period, Patient symptoms, Kamalacikitsa, Case report, Ayurvedic approach, Arogyavardhini Vati, Case study, Virechana Therapy, Gandharva haritaki, Laboratory investigation, General weakness, Clinical observation, Chief complaint, Punarnavadi Kashaya, Infective Disorder, Chronic infection, Liver damage, Cirrhosis, Liver cancer, Hepatitis C virus (HCV), Hepatitis C virus, Liver enzyme, Hepatitis C, RNA genome, Tikta rasa dravya, Hepatic fibrosis, Esophageal varices, Clinical symptom, Blood donor, HCV RNA, Blood testing, Quick Response Code, Enzyme immunoassay.