To study the efficacy of Makarasana as an Agnivardhana Karma

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ISSN: 2456-3110 ORIGINAL ARTICLE Sep-Oct 2017 Journal of Ayurveda and Integrated Medical Sciences | Sep - Oct 2017 | Vol. 2 | Issue 5 47 To study the efficacy of Makarasana as an Agnivardhana Karma Kiran V. Pawar, 1 Sagar V. Ital, 2 Apeksha D. Patil, 3 Dhiraj B. Patil. 4 1 Assistant Professor, Dept. of Swasthavritta, 2 Assistant Professor, Dept. of Samhita-Siddhanta, 3 Assistant Professor, Dept. of Rasashastra and Bhaishajya Kalpana, 4 Assistant Professor, Dept. of Agada Tantra, Matoshri Asarabai Darade Ayurved College, Babhulgaon, Nashik, Maharashtra, India. I NTRODUCTION In today’s competitive life it is very difficult to keep away oneself from stress, tension, improper food habits. In short, What we call as - “Hurry -Worry- Curry” Generally in young age one doesn’t experience any major health problems and keeps on doing Address for correspondence: Dr. Kiran V. Pawar Assistant Professor, Department of Swasthavritta, Matoshri Asarabai Darade Ayurved College, Babhulgaon, Nashik, Maharashtra, India. E-mail: dran 1221@gmail.com Submission Date : 05/09/2017 Accepted Date: 15/10/2017 Access this article online Quick Response Code Website: www.jaims.in DOI: 10.21760/jaims.v 2 i 05.10253 Mithya Aahara and Vihara which leads to Agnimandya. It means that, person is said to be ‘ Swastha’ whose Doshas, Agnis, Dhatus and Malas are in the state of equilibrium along with mental, sensory and spiritual pleasantness and happiness When a person keeps on doing Mithya Aahar and Vihar it will leads to Agnimandya which becomes cause of various diseases. R EVIEW OF LITERATURE According to Vagbhata all diseases are mainly occur due to disarrangement of Agni [1] and also according to Charaka , disarrangement of Agni leads to different diseases [2] Hence it is important to maintain equilibrium state of Agni for healthy life that is Swastha . Maharshi Gheranda in his Gheranda Samhita recommended seven chapters for maintaining healthy body and happiness of mind. A B S T R A C T Generally in young age, keeps on doing Mithya Aahara and Vihara which leads to Agnidusthi and which become cause of various diseases. As they work restless, their sedentary habits and stress full lifestyle. They are ought to do Vishamashan, Krodha etc., due to their lifestyle. This type of lifestyle leads to Agnidushti and which becomes cause of various diseases. 80 volunteers of age group 20-40 years were selected for the study. They underwent for clinical study on the basis of number of Lakshanas present. These were taken as subjective parameter and which were Samanya and Vishesh Lakshanas. Those were Arochaka, Vidagdha Udgara, Vishtambha, Aadhmana, Anga-Marda, Atijrumbha, Shirshula, Guru Gatrata, Utklesh. Jarana Kala and Abhyavaharan Shakti were objective parameters, as these two are important to assess Agni of a person. For Jarana Kala gradation was done on the basis of hours of time taken to show Laghuta and Kshuda Bodha , because these are Jeerna Aahara Lakshanas. For Abhyavaran Shakti gradation was done on the basis of quantity of food. To assess Agnivardhana , specific diet chart was prepared by considering their daily requirement of calorie. Volunteers were advised to do three Avartana of Makarasana in the morning; Significant changes were seen in Abhyavaharana Shakti in both groups. 56.7% relief in group A and 72% relief were seen. There were significant changes seen in Jaran Kala in both groups. 54.9% relief in Group A and 74% relief in Group B. Key words: Makarasana, Kutki Churna, Agnivardhana.

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Kiran V. Pawar et.al. To study the efficacy of Makarasana as an Agnivardhana Karma ISSN: 2456-3110 ORIGINAL ARTICLE Sep-Oct 2017 Journal of Ayurveda and Integrated Medical Sciences | Sep - Oct 2017 | Vol. 2 | Issue 5 48 Here Gheranda Samhitakar describes Makarasana as Agnivardhak [3] Hence study taken to evaluate the efficacy of Makarasana as an Agnivardhan Karma. O BJECTIVES To study the efficacy of Makarasana as an Agnivardhan Karma . M ATERIALS AND M ETHODS Total 104 volunteers were selected for study; out of which 80 volunteers completed the treatment on OPD basis. The volunteers were randomly selected irrespective of Age, Economical status, Sex. Out of 80 volunteers, 40 volunteers were subjected to Makarasana and 40 volunteers given Kutaki Churna for the treatment of Agnivardhana. Methodology Two groups of volunteers were considered for study ▪ Group A : Volunteers treated with Makarasana = 40 volunteers ▪ Group B : Volunteers treated with Kutaki Churna = 40 volunteers O BSERVATIONAL S TUDY Sample sizes of 80 volunteers were selected irrespective of region and sex Daily dietary charts were prepared Special Questionnaire was prepared in order to ask people about the Lakshanas Volunteers were asked to maintain a notebook to mention Lakshanas . Volunteers were advised to don’t addiction (Vyasana) during study period Written informed Consent was taken prior to study Selection of Volunteers Inclusion Criteria 1 Volunteers of both sexes were selected irrespective of religion and caste 2 Age group of 20-40 years. Exclusion Criteria 1 Any individuals suffering from severe systemic illness. 2 Any individuals suffering from irritable bowel syndrome. 3 Any individuals having spine anomalies or disease. 4 Any pregnant women and lactating mother. Place of work The study was carried out at Swastharakshan OPD in our hospital. Procedure For Group A : Makarasana (Trial Group) Position - Lie down in a prone position with the hands above the head keeping straight alongside the head resting the palms on the ground, touching the chin on the floor, and legs together soles facing up, keep the body from toes to head in a straight line. Step 1 - Spread the legs apart; heels facing each other, toes facing outwards. Step 2 - Fold the right hand and place the right palm on the left shoulder. Then similarly keep the left palm on the right shoulder. Keep the chin on the point where the two arms cross (Rest and relax in this posture) Step 3 - Remove the left palm and unfold the left hand, similarly the right palm and hand and come back to step no 1. Step 4 - Bring the legs together that is come back to the position This procedure were repeated for again two times. Volunteers were advised to do three Avartana of Makarasana in the morning, each Avartana takes 5 min, for 28 days. For Group B: (Control Group) Kutaki Churna 500 mg were given twice a day, after meal with Anupana Koshna Jala. Duration of the study Total duration of study was for 28 days for each group.

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Kiran V. Pawar et.al. To study the efficacy of Makarasana as an Agnivardhana Karma ISSN: 2456-3110 ORIGINAL ARTICLE Sep-Oct 2017 Journal of Ayurveda and Integrated Medical Sciences | Sep - Oct 2017 | Vol. 2 | Issue 5 49 C RITERIA OF A SSESSMENT Subjective Parameters 1. Arochaka 2. Vidagdha Udgar 3. Atijrumbha 4. Guru Gatrata 5. Aadhman 6. Vishtambha 7. Shir Shula 8. Angamarda 9. Utklesh Objective Parameters 1. Time taken to digest the food ( Jarana Kala ) 2. Quantity of food ( Abhyavaharana Shakti ) Follow up 1 st follow up - 7 th day 2 nd follow up - 14 th day. 3 rd follow up - 21 st day. 4 th follow up - 28 th day. Grading for subjective parameters SN Criteria for subjective parameters Grade 1 No Lakshana present 0 2 At least 3 Lakshanas present 1 3 At least 6 Lakshanas present 2 4 All Lakshanas are present 3 Abhyavaran Shakti (quantity of food) These criteria will be assessed on consumption of quantity of food. ▪ Grade 0 - more than quantity fixed ▪ Grade 1 - as per quantity fixed ▪ Grade 2 - less than quantity fixed Jarana Kala (time taken to digest the food) ▪ Grade 0 - 4 hours ▪ Grade 1 - more than 4 hours to 6 hours ▪ Grade 2 - more than 6 hours to 8 hours ▪ Grade 3 - more than 8 hours O BSERVATIONS AND R ESULTS Observations were made on the basis of data collected by clinical assessment and it was presented in the form of tables and graphs 1 Total no. of Volunteers included in the study - 104 2 No. of volunteers who completed study - 80 Table 1: Age wise distribution of 80 volunteers. Age in yrs Group - A Group - B Total % 20 - 25 10 15 25 31.2 26 – 30 12 10 22 27.5 31 - 35 10 8 18 22.5 36 - 40 8 7 15 18.8 Total 40 40 80 100 Graph 1: Group wise distribution of 80 volunteers according to Age. Table 2: Sex wise Distribution of 80 volunteers. Gender Group - A Group - B Total % Female 24 18 42 52.5 0 5 10 15 20 - 25 26 – 30 31 - 35 36 - 40 N o . o f c ases Age group in yrs Age distribution Group-A Group-B

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Kiran V. Pawar et.al. To study the efficacy of Makarasana as an Agnivardhana Karma ISSN: 2456-3110 ORIGINAL ARTICLE Sep-Oct 2017 Journal of Ayurveda and Integrated Medical Sciences | Sep - Oct 2017 | Vol. 2 | Issue 5 50 Male 16 22 38 47.5 Total 40 40 80 100 Table 3: Distribution of 80 volunteers according to Diet. Diet Group - A Group - B Total % Mix 33 29 62 77.5 Veg 7 11 18 22.5 Total 40 40 80 100 Table 4: Distribution of 80 volunteers according to Koshtha . Koshtha Group - A Group - B Total % Krura 17 20 37 46.3 Madhyam 18 16 34 42.4 Mrudu 5 4 9 11.3 Total 40 40 80 100 Table 5: Distribution of 80 volunteers according to Agni . Agni Group - A Group - B Total % Mandagni 6 8 14 17.5 Madhyagni 10 12 22 27.5 Vishamagni 24 20 44 55.0 Total 40 40 80 100 Table 6: Distribution of 80 volunteers according to Vishamashana . Vishamashana Group - A Group - B Total % Never 9 7 16 20.0 Sometimes 20 23 43 53.7 Always 11 10 21 26.3 Total 40 40 80 100 Table 7: Distribution of 80 volunteers according to Exercises. Exercises Group-A Group-B Total % Never 14 11 25 31.3 Sometimes 26 29 55 68.7 Always 0 0 0 0 Total 40 40 80 100 Table 8: Effect on subjective parameter in both groups. Subjective Parameter BT AT Group - A 2.5 1 Group - B 2.63 0.57 Table 9: Effecct on Jarana Kala in both groups. Jarana Kala BT AT Group-A 2.33 1.05 Group-B 2.42 0.63 Table 10: Effect on Abhyavaharan Shakti in both groups. Abhyavaharan Shakti BT AT Group - A 2.15 0.93 Group - B 2.5 0.7 Table 11: Total effect on subjective and objective parameter in both groups. Total score BT AT Group - A 6.98 2.98

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Kiran V. Pawar et.al. To study the efficacy of Makarasana as an Agnivardhana Karma ISSN: 2456-3110 ORIGINAL ARTICLE Sep-Oct 2017 Journal of Ayurveda and Integrated Medical Sciences | Sep - Oct 2017 | Vol. 2 | Issue 5 51 Group - B 7.55 1.9 Graph 2: Total Effect on subjective and objective parameter in both groups. S TATISTICAL A NALYSIS Table 12: Effecct on subjective parameter in both groups. Subjectiv e Paramet er BT AT % Relie f Z P X̄ Sd X̄ Sd Group - A 2.5 0 0.59 9 1.0 0.81 6 60.0 5.33 9 <0.00 1 HS Group - B 2.6 3 0.58 6 0.5 7 0.67 5 78.3 5.54 5 <0.00 1 HS Effect of Makarasana in Group A showed significant with respect to Agnivardhana (AT-28 days) with an improvement of 60.0% (p<0.001), whereas the Kutaki in Group B proved significant with 78.3% (p<0.001). i.e. both are significant but percentage of relief is more in Group B. Table 13: Comparison on subjective parameter in both groups. Subjective Parameter Mean difference score Sd Z P Group - A 1.50 0.88 2.867 0.004 Sig Group - B 2.05 0.78 When we compare between groups, Group A and Group B, it shows significant i.e. z=2.867 and P=0.004, but the mean difference score is more in Group B. Table 14: Statistical analysis of improvement in Jarana Kala. Jarana Kala BT AT % Relief Z P X̄ Sd X̄ Sd Group - A 2.33 .526 1.05 .783 54.9 5.232 <0.001 HS Group - B 2.42 .594 .63 .705 74.0 5.376 <0.001 HS Effect of Makarasana in Group A showed significant with respect to Agnivardhana (AT-28 days) with an improvement of 54.9% (p<0.001), where as the Kutaki in Group B proved significant with 74.0% (p<0.001). Jarana Kala Mean difference score Sd Z P Group - A 1.28 0.78 2.531 0.011 Sig Group - B 1.80 0.94 When we compare between Group A and Group B, it shows highly significant, z=2.531 and P=0.011, but the mean difference score is more in group B. Table 15: Statistical analysis of Abhyavaharana Shakti. Abhyavahara na Shakti BT AT % Relie f Z P X̄ Sd X̄ Sd Group - A 2.1 5 .66 2 .9 3 .82 9 56.7 5.25 8 <0.00 1 HS Group - B 2.5 0 .55 5 .7 0 .75 8 72.0 5.30 5 <0.00 1 HS 0 2 4 6 8 Group-A Group-B M e an sco re Total Score BT AT

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Kiran V. Pawar et.al. To study the efficacy of Makarasana as an Agnivardhana Karma ISSN: 2456-3110 ORIGINAL ARTICLE Sep-Oct 2017 Journal of Ayurveda and Integrated Medical Sciences | Sep - Oct 2017 | Vol. 2 | Issue 5 52 Effect of Makarasana in Group A showed significant with respect to Agnivardhana (AT-28 days) with an improvement of 56.7% (p<0.01), whereas the Kutaki in Group B proved significant with 72.0% (p<0.001). Abhyavaharana Shakti X̄ Sd Z P Group - A 1.23 0.77 2.627 0.009 Sig Group - B 1.80 1.02 When we compare between Group A and Group B, it shows highly significant i.e. z=2.627 and P=0.009, but the mean score is more in Group B Table 16: Total score of subjective and objective parameters. Total Score BT AT % Relie f Z P X̄ Sd X̄ Sd Grou p - A 6.9 8 1.02 5 2.9 8 1.56 1 57.3 5.54 3 <0.00 1 HS Grou p - B 7.5 5 1.21 8 1.9 0 1.48 2 74.8 5.53 6 <0.00 1 HS Total Score Mean difference score Sd Z P Group - A 4.00 1.57 4.093 <0.001 HS Group - B 5.65 1.85 Table 17: Percentage of relief in both group. Symptoms % Relief Group - A Group - B Subjective Parameter 60.0 78.3 Jarana Kala 54.9 74.0 Abhyavaharana Shakti 56.1 72.1 Total Score 57.2 75.1 Graph 17: Percentage of relief in both group. Table 18: Overall effect in both group. Overall Effect No. of Cases Group - A Group - B No change 0 1 Poor (<25%) 2 0 Moderate change (25% - 49.9%) 9 1 Good change (50% - 99%) 27 34 Complete Remission (100%) 2 4 Graph 18: Overall effect in both group. 0 10 20 30 40 50 60 70 80 90 % % Relief Group-A Group-B 0 5 10 15 20 25 30 35 N o . o f c ases Overall Effect Group-A Group-B

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Kiran V. Pawar et.al. To study the efficacy of Makarasana as an Agnivardhana Karma ISSN: 2456-3110 ORIGINAL ARTICLE Sep-Oct 2017 Journal of Ayurveda and Integrated Medical Sciences | Sep - Oct 2017 | Vol. 2 | Issue 5 53 DISCUSSION The present clinical study was planned in two groups of 40 volunteers each, aimed to study agnivardhan with Makarasana in Group A and Kutaki Churna in Group B and follow up for after every 7 days during study. The discussion on incidences, etc. observed during study is as follows: Discussion on observation Gender In this study a different number of volunteers were recorded. The present study does not provide any significant data may be due to small sample size Out of 80 volunteers of 42 (52.5%) volunteers were female and 38 (47.5%) were males. It means that the number of female volunteers increasing nowadays. It is Because of more burdens of household works There were 18 (22.5%) Vegetarian and 62 (77.5%) were mixed diet volunteers. It may say that Agnivardhan Karma required more in who takes mixed diet can get Agnidusti easily In this study, out of 80 volunteers, 37 belongs to Krura Kostha , 34 volunteers were Madhyama Kostha and 9 volunteers belong to Mridu Kostha. Mandagni -14, Madhyam - 22 and Vishamagni - 44 volunteers 2.5% Volunteers never does Vishamashana , 72.5% volunteers were doing Vishamashana sometimes and 25% Volunteers were doing Vishamashana always 31.3% Volunteers were never doing exercises, 55% Volunteers were doing sometimes and none of them were doing always In the present study Makarasana has been selected as per its classical references for the Agnivardhan Karma. As per Bhavaprakasha, Kaiyadeva and Priya Nighantu, Kutaki has property of Agnivardhana , so in this study Kutaki Churna used in Group B as control drug. The drug had collected from GMP certified company. The effect of Makarasana and Kutaki Churna on subjective parameter were observed and analyzed statistically Symptom wise of subjective parameters were taken from ancient texts of Ayurveda. The commonly found symptoms selected for the study. Some special and common symptoms of agnidusti were selected for the study. Abhyavaharan Shakti was assessed on the basis of consumption of quantity of food. Since Makarasana and Kutaki Churna increases the ‘Agnivardhana’ effect. It is nothing but the consumption of the quantity of the food Since Makarasana as the Agnivardhan effect, Abhyavaharan Shakti was assessed Jaran Kala was based on the time taken for digestion of the food. Grade 0 was taken as four hours as it is considered to be normal time required for digestion. It is based on the ‘Laghuta’ and ‘Kshuda’ as it is easily noticed in volunteers CONCLUSION On the basis of above study it can be concluded that both Makarasana and Kutaki Churna has statistically significant effects on Agnivardhana . In this study Kutaki Churna has more positive effect on the Agnivardhana Karma comparative to Makarasana in volunteers. Makarasana put the pressure on abdomen, lower back and at the same time enables mind to concentrate on breathing. All these together have positive effect on digestive strength. It has been said that it awakes ‘Kundalini Chakra’ , so this has positive effect on mind. During the study no any adverse effects were noted. By practicing it daily in the morning, it enforces habit of exercise. And by doing for 5 min daily improves health and may become good option for them REFERENCES 1 Dr. Brahmanand Tirpathi, Ashtanga Hridaym, , Chaukhamba Sanskrit Pratishthan, Delhi, Edition 2015; 512. 2 Brahmanand Tirpathi, Charaka Samhita, Chaukhamba Sanskrit Pratishthan, Delhi, Edition 2014; Vol.2, 471.

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Kiran V. Pawar et.al. To study the efficacy of Makarasana as an Agnivardhana Karma ISSN: 2456-3110 ORIGINAL ARTICLE Sep-Oct 2017 Journal of Ayurveda and Integrated Medical Sciences | Sep - Oct 2017 | Vol. 2 | Issue 5 54 3 Rai Bahaddur Srisa Chandra Vasu, Gheranda Samhita, Sri Sadguru Publication, 1979;19. ******************************* How to cite this article: Kiran V. Pawar, Sagar V. Ital, Apeksha D. Patil, Dhiraj B. Patil. To study the efficacy of Makarasana as an Agnivardhana Karma. J Ayurveda Integr Med Sci 2017;5:47-54. http://dx.doi.org/10.21760/jaims.v 2 i 05.10253 Source of Support: Nil, Conflict of Interest: None declared.

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Lakshana, Vihara, Dhatu, Dosha, Agni, Vyasana, Mala, Agnimandya, Vishamagni, Mandagni, Agnidushti, Krodha, Makarasana, Laghuta, Vishamashana, Vishtambha, Samanyalakshana, Arochaka, Angamarda, Krurakoshtha, Agnivardhana, Abhyavaharanashakti, Madhyamakoshtha, Yoga posture, Group A, Significant change, Age-group, Utklesh, Swastha, Subjective parameter, Objective parameter, Overall effect, Mithya Aahara, Mrudu Koshtha, Madhyam Koshtha, Mithya Aahar, Mixed diet, Mithya Vihara, Kutaki Churna, Vishamashan, Total score, Group B, Aadhmana, Kutki Churna.