A Clinical study to evaluate the role of Kharjooradi Mantha in the...

[Full title: A Clinical study to evaluate the role of Kharjooradi Mantha in the enhancement of Ojo Guna in Madatyayi subjects]

[Find the meaning and references behind the names: Guna, Javeed]

ISSN: 2456-3110 ORIGINAL ARTICLE Sep-Oct 2018 Journal of Ayurveda and Integrated Medical Sciences | Sep - Oct 2018 | Vol. 3 | Issue 5 14 A Clinical study to evaluate the role of Kharjooradi Mantha in the enhancement of Ojo Guna in Madatyayi subjects Dr. Aqeeb Javeed, 1 Dr. Vasudev Chate, 2 Dr. Shreevathsa 3 1 Post Graduate Scholar, 2 Reader, 3 Professor (I/C) & HOD, Department of PG Studies in Ayurveda Samhita and Siddhanta, Govt. Ayurveda Medical College & Hospital, Mysore, Karnataka, INDIA. I NTRODUCTION Wholesome food is responsible for the growth of living beings and the unwholesome for the diseases [1] Madhya is one of the Ahara Dravya . It acts like ambrosia if taken properly following the rules and regulations otherwise like a poison [2] If an ignorant person who abstains the rules and regulations of Madhya while consuming it ends up with the Address for correspondence: Dr. Aqeeb Javeed Post Graduate Scholar, Department of PG Studies in Ayurveda Samhita and Siddhanta, Govt. Ayurveda Medical College & Hospital, Mysore, Karnataka, INDIA. E-mail: javeedbidar 07@gmail.com Submission Date: 28/08/2018 Accepted Date: 02/10/2018 Access this article online Quick Response Code Website: www.jaims.in DOI: 10.21760/jaims.v 3 i 5.13813 Madatyaya Vyadhi and if one goes on doing the same mistake again and again then Ojas (essence of bodily tissues) gets impaired [3] As Ojas can be correlated to the immunity of modern science which gets affected due to one of the cause of excessive consumption of Madhya as which had been inferred by the similar statement of Ayurveda that Ojas has 10 Gunas which are exactly opposite to the 10 Gunas of Madhya [4] The treatment of Madatyaya consists of Doshavasechana , Rasayana , Santarpana and Satvavajaya Chikitsa . Kharjuradi Mantha is explained in Charaka Samhita, Santarpaniya Adhyaya which is indicated for all the Madatyayi patients [5] As Ojo Vikaras is included under Apatatarpanajanya Vyadhi for which Santarpana Chikitsa is advised. Kharjooraadi Mantha is having Tarpaka , Agnideepaka , Anulomaka properties. Though there is extensive description of uses and ill effects due to improper consumption of Madhya and consequently disease state named Madatyaya in Ayurveda but how far the Madhya A B S T R A C T A study was conducted to access clinical efficacy of ‘ Kharjooradi Mantha in the enhancement of Ojo Guna in the subjects of Madatyaya . As Madhya has 10 Gunas which are exactly opposite to the 10 Gunas of Ojas . 35 patients of Madatyaya were selected by simple random sampling method. Kharjooradi Mantha was given in two divided doses once in the morning and evening after food with Jala as Anupana for duration of 28 days. Gradation scale was used depending upon their severity to assess the effect of the treatment objectively and to monitor the disease; however at the time of statistical analysis the outcome was statistically analyzed i.e. before treatment and after treatment by using Descriptive Statistics, Chi squares test and Cramer’s V by using windows SPSS Software. It was revealed that Kharjooradi Mantha was effective in the enhancement of Ojo Guna in the subjects of Madatyayia . It significantly reduced the symptoms such as Chardi, Aruchi, Hrullasa, Tandra, Staimitya, Gaurava, Hikka, Svasa, Kasa, Pralapa, Sirakampa, Parashvashola, Nidranasha, Trsna, Daha, Dourbalya, Murcha and Sweda Kharjooradi Mantha did the Tarpana, Agnideepana and Anulomana there by increasing the Ojo Gunas . Key words: Ojas, Ojo Gunas, Madhya, Madatyaya, Kharjooradi Mantha.

[Find the meaning and references behind the names: Vega, Jeevan, Kala]

Dr. Aqeeb Javeed et.al. Role of Kharjooradi Mantha in the enhancement of Ojo Guna in Madatyayi subjects ISSN: 2456-3110 ORIGINAL ARTICLE Sep-Oct 2018 Journal of Ayurveda and Integrated Medical Sciences | Sep - Oct 2018 | Vol. 3 | Issue 5 15 Gunas effect the Ojo Gunas is yet not clear and there is no treatment specified which aims at improving the Ojo Gunas . Hence in present study an effort was made as an clinical study to evaluate the role of Kharjuradi Mantha in enhancement of Ojo Guna in Madatyayi ( Madhya used disorder subjects). A IMS AND O BJECTIVES To evaluate the role of Kharjooradi Mantha in the enhancement of Ojo Guna in Madatyaya subjects. M ATERIALS AND M ETHODS Selection of the drug Kharjooradi Mantha was selected as the drug of intervention from the Santarpaneeya Adhyaya of Charaka Samhita Sutrasthana [6] Preparation of the drug Mrdveeka, Vrkshamla, Amlika, Dadima, Paroshaka and Amalaki should be taken in equal quantity and added with four times of water with that of the total quantity of drugs and continued churning till this mixture attains its desired consistency [7] Special care should be taken that the Mantha should be neither too liquid nor too solid in consistency. The Kharjooradi Mantha was procured from GMP Certified NKCA Pharmacy, Mysuru. Selection of patients Inclusion criteria 1 Subjects fulfilling the diagnostic criteria irrespective of sex, caste, and socio-economic status were selected. 2 The subjects coming under the age group 25 to 60 years were selected. 3 The subjects willing to take medicine were selected for the study Exclusion Criteria 1 Subjects suffering from other systemic disorders were excluded 2 Pregnant and lactating women were excluded Diagnostic Criteria Criteria for the diagnosis of Madatyaya were; 1 Presence of 2 to 6 symptom’s from the DSM 5 (Diagnostic and statistical Manual for mental disorders) criteria’s [8] 2 Presence of any 2 symptom’s in other classical parameters of Ojo Kshaya Laxanas . ( Durbalata, Chardi, Abheekshnam Dhyayati, Bibeti, Varnabedha, Nidrahani, Kriyasannirodha, Aruchi, Shareera Rookshata and Kshamata ) [9] Place of Study After taking written, informed consent of patients, A total 35 patients were taken from the Jeevan Srushti Foundation and De-addiction centre, Mysuru and there after Medicines were given to the patients Plan of study Duration of Treatment Kalpa Freshly procured Kharjuradi Mantha Matra 100 ml in two divided dose once in the morning and once in the evening. Sevana Kala Once in the morning and evening after food Anupana Jala Pathya- Apathya As per the classical guidelines Kalavadhi For 4 weeks (28 days) Follow up There was no follow up in the study. Parameters used for assessment The pre and post test assessment of Madatyaya subject was done on 0 th day and 29 th day and the assessment was done on the 19 symptoms of Madatyaya [10] through a self-prepared gradation indexed case proforma. Table 1: Showing the subjective parameters and Gradation Index Utilized for the Assessment of Madatyaya subjects. Chardi (vomiting) Grade No Vega 0 1 - 2 Vega 1 2 – 3 Vega 2 3 and above 3

Dr. Aqeeb Javeed et.al. Role of Kharjooradi Mantha in the enhancement of Ojo Guna in Madatyayi subjects ISSN: 2456-3110 ORIGINAL ARTICLE Sep-Oct 2018 Journal of Ayurveda and Integrated Medical Sciences | Sep - Oct 2018 | Vol. 3 | Issue 5 16 Aruchi (tastelessness) Is a Swasamvedya Lakshana , which was graded as below in the table Grade No assessed during Prashna Pariksha. 0 Yes 1 Hrullasa Grade No Nausea 0 Nausea 1 Nausea along with excess salivation and regurgitation 2 Frequently vomiting 3 Tandra Grade No Arati 0 Arati /Jrumbha 1 Indriya Kriyalpata 2 Indriya Kriyahani 3 Staimitya Grade No Staimitya 0 Jadyam 1 Atijadyamsa-Ardrata 2 Baadhiryam 3 Gaurava Grade No Gaurava 0 Praatahaakalina Gaurava / Madhyaanha Paryanta Gaurava 1 Sayankala - Paryanta Gaurava 2 Sampurnadina Gaurava 3 Hikka Grade No Hikka 0 Occasionally 1 Frequently / Very frequently 2 Continuous 3 Shvasa Grade No Shwasa 0 Vyayamottara Shwasa / Nityadina Karmasahit Shwasa 1 Aayasena Shwasa 2 Anayasena Shwasa 3 Kasa Grade No Kasa 0 1-5 Vega /day 1 Muhurmuhur Kasa 2 Satata/Ahoratra Kasa 3 Pralapa Grade No Pralapa 0 Relevant talk with 5 - 15 words per minute 1 Relevant talk with 15 - 20 words per minute 2 Irrelevant talk. 3 Shirokampa Grade No Shirokampa 0 Occasionally/ Frequently 1 Continuous but not disturbing daily routine 2 Continuous and disturbing daily routine 3 Parshvashoola Grade No Parshvashoola . 0 Occasionally / Once or twice a day 1 Frequently 2 Continuous 3 Nidranasha Grade No Nidranasha , healthy sleep. 0 Kalantarena Nidra for app. 5-6 hrs at a stretch 1 3-4 hrs. of continuous sleep followed by Anidra . 2 Anidra or Nidra for 1-2 hrs. 3 Trishna Grade No Trishna 0 Trishna /Muhurmuhu Trishna 1

Dr. Aqeeb Javeed et.al. Role of Kharjooradi Mantha in the enhancement of Ojo Guna in Madatyayi subjects ISSN: 2456-3110 ORIGINAL ARTICLE Sep-Oct 2018 Journal of Ayurveda and Integrated Medical Sciences | Sep - Oct 2018 | Vol. 3 | Issue 5 17 Satata Trishna - Jala Sevanottar Samadhana 2 Satata Trishna - Jala Sevanottara Asamadhana. 3 Daha (Burning sensation) It is a Swasamvedya Lakshanas so categorized into only two grades. Grade No assessed during Prashna Pariksha 0 Yes 1 Jwara Grade Normal /98.6°F 0 99-102°F 1 103-104°F 2 Above 104°F 3 Dourbalya Grade No Dourbalya 0 Dyspnoea after moderate to severe work /mild to moderate work 1 Dyspnoea after mild work 2 Dyspnoea at rest 3 Murcha Grade No Murcha 0 Occasionally / Frequently 1 Often and with short disorientation. 2 More often and with prolonged disorientation 3 Sweda Grade No Sweda 0 Kapala and Shirapradesha Swedotpatti / Kaksha and Janghapradesha Swedotpatti 1 Sarwanga Swedotpatti 2 Sarwanga Swedotpatti with Sarwanga Vastra Ardrata 3 O BSERVATIONS AND R ESULTS Incidence of age Among the 35 subjects, maximum number of subjects i.e. 19 were belonging to the age group between 31- 40 years, where as in the remaining 16 , 7 were below of the age group between 25-30 years, 6 were from the age group between 51-60 years Incidence of occupation Among the 35 subjects 24, 7, 4 subjects were involved in doing high physical activity, moderate physical activity and sedentary occupation respectively . Incidence of socio-economic status Among the 35 subjects 17, 9, 8 and 1 subject belonged to lower middle class, below poverty line, upper middle class and rich respectively Incidence of marital status Among the 35 subjects 26 were married and remaining 9 were unmarried Incidence of education Among the 35 subjects 13, 11, 8 and 3 were belonging to higher school education, illiterate, primary education and under graduation respectively Incidence of locality Among the 35 subjects 21 subjects were within Mysore and the remaining 14 were from outside Mysore. Incidence of Prakruti Among the 35 subjects 15, 12, 8 were belonging to Vatapitta, Pittakapha, Kaphavata Prakruti respectively Incidence of type of alcohol Among 35 subjects 34 subjects were consuming hard type (more cocenterated) of alcohol where as one subject was consuming soft type (less concenterated) alcohol Incidence of reason for consuming Alcohol Among 35 subjects 14, 9, 6, 3 and 3 were consuming alcohol with the reason of Self-Motivation, Family Problems, Business problems, For relief from

[Find the meaning and references behind the names: Bala, Raja, Dharma, Karma, Sara, Shakti, Rupa]

Dr. Aqeeb Javeed et.al. Role of Kharjooradi Mantha in the enhancement of Ojo Guna in Madatyayi subjects ISSN: 2456-3110 ORIGINAL ARTICLE Sep-Oct 2018 Journal of Ayurveda and Integrated Medical Sciences | Sep - Oct 2018 | Vol. 3 | Issue 5 18 tiredness occurring due to strenuous works and other reasons respectively Incidence of mode of alcohol consumption i.e. diluted or undiluted Among 35 subjects, 32 were consuming diluted alcohol, 2 were consuming undiluted type of alcohol where as one subject was involved in consuming both i.e. sometimes diluted and sometimes undiluted. Incidence of timings of alcohol consumption Among the 35 subjects 17, 15, 2 and 1 were consuming alcohol in night time, anytime, morning and evening respectively Incidence of duration of alcohol consumption Among the 35 subjects 29, 4 and 2 were consuming alcohol without limits, >3 in a week, <Thrice in week respectively Incidence of quantity of alcohol 26 subjects were consuming > 1/2 quarters and the remaining < 1/2 quarters Incidence of Vihara Criteria’s of Viharas : 1) Aatapa Sevana 2) Raja Sevana 3) Divaswapna 4) Ativyavaya 5) Vyayama 6) Shoka 7) Bhaya 8) Krodha 9) Vegavarodh Among 35 subjects 20, 8, 6 and 1 were involved in doing the above specified any 2-4 criteria, any 1-2 criteria, any 5-6 criteria, any > 6 criterias respectively. Incidence of Vyasana Criteria’s 1) Adhobhakta 2) Anashana 3) Adhyashana 4) Vishamasana 4) Others Among 35 subjects 13, 13 and 9 were involved in doing the above specified criteria in the ratio of 1 critera, 2-3 criteria and > 3 criteria respectively. Incidence of Pareeksha Bhavas SN Type of Pariksha Pravara Madhyama Avara 1 Satva 2 31 2 2 Satmya 1 31 1 3 Sara 2 31 1 4 Samhanana 1 32 2 5 Bala 1 32 2 6 Ahara Shakti 4 28 3 7 Vyayama Shakti 9 22 4 R ESULTS OF THE STUDY Kharjooradi Mantha gave relief in the subjective symptoms. The result of this study showed there was significant improvement in the subjects of Madataya showing the Vruddhi of Ojo Gunas over Madhya Gunas . On 29 th day out of 17 symptoms, 15 symptoms i.e. Chardi, Aruchi, Hrullasa, Tandra, Staimitya, Gaurava, Shvasa, Kasa, Pralapa, Shirokampa, Parshvashoola, Nidranasha, Trishna, Daha, Dourbalya, Murcha and Sweda showed highly significant relief with p value less than 0.000. The Laxana Hikka showed significant relief p value less than 0.005 The Laxana Jwara showed no significant reduction in the severity. DISCUSSION All the symptoms were given scoring depending upon their severity to assess the effect of the treatment objectively and to monitor the disease. In the study Oja Guna and Karma was assessed based on the Laxanas of Madataya , because Gunas cannot be assessed by other Gunas it can be assessed only with the Karma . As Guna and Karma are having inseparable relation with each other which can be understood as; As Gunas are Nischeshta where as Karma is having Cheshta Rupa. Guna is Nishkriya where as Karma is Sakriya . Guna is the Dravya Siddha Dharma where as Karma is effect of Dravya , Guna is not the reason for Samyoga and Vibhaga where as Karma is the Karana for Samyoga and

[Find the meaning and references behind the names: Guru]

Dr. Aqeeb Javeed et.al. Role of Kharjooradi Mantha in the enhancement of Ojo Guna in Madatyayi subjects ISSN: 2456-3110 ORIGINAL ARTICLE Sep-Oct 2018 Journal of Ayurveda and Integrated Medical Sciences | Sep - Oct 2018 | Vol. 3 | Issue 5 19 Vibhaga . Hence in this study assessment of Ojo Guna and Karma was assessed based on the Vikruta Karma occurring in the Madataya subjects. It is very important to have the knowledge of pathogenesis of Madaatyaya and alcohol use disorders for better understanding of the rationality behind selecting the formulation. Due to the qualities of Madhya which are contrary to Ojas , chronic intake of Madhya against rules and regulations will result in Ojo Nasha and manifest as disease condition known as Madatyaya . The symptomatology will be varying depending upon the predominance of Dosha and constitution of an individual etc., but Madatyaya is always Sannipataja . Here for Samprapti Vighatana , we selected Kharjuradi Mantha which is having the properties like Agnideepana , Sroto Shodhana, Tarpana and Tridoshahara . Kharjuradi Mantha is having the following above desired qualities. Therefore, administration of the Kharjuradi Mantha was considered as more suitable in comparison with other formulations. Kharjuradi Mantha was given in the subjects of Madatayi with the dosage following classical references ( Sharangadhara Samhita , dosage of Mantha is Dvipalam i.e. nearly 100 ml) for duration of 28 days in two divided doses. The Aushadha Sevana Kala was Adhobhakta i.e. after food that was decided based on the reference of Sharangadhara . The intervention was conducted for duration of 28 days because concept of Dhatu Parinamana which is the basic entity of Ojo Uttpatti with Dhatu Poshana requires a minimum of 28 days time period. Hence the intervention was continued for duration of 28 days. Discussion on probable mode of action of the drug Maximum contents of the trial drug were having Guru and Snigdha Guna . The Guru Guna of the drugs act as Brimhana and Balya for the body. They do Srotauplepa, Triptijanana and Vatahara . These Guna increases the stability of the body and does Ojovardhana . Snigdha Guna increases Snehana, Mriduta, Adrata in the body. It acts as Vatahara , increases Varna , Bala of Shariradhatu, Malapravartaka, Rasayana and Vajikara which helps to cover the damage occurred to Dhatu and different organs of the body due to Mada . Schematic representation showing the effect of Kharjuradi Mantha. Guru → Prithivi + Jala → Guru Snigdha and Sheeta → Brumhana, Balya, Vatahara, Srotoupalepa → Provide stability to vitiated Doshas and relief in the symptoms of Madatyaya and does Ojovardhana. Snigdha → Jala → Snigdha and Sheeta → Snehana, Mriduta, Vatahara, Triptijanana, Varnya, Dhatuvardhaka, Balya, Vajikara → Provide stability to vitiated Doshas and relief in the symptoms of Madatyaya and does Ojovardhana. CONCLUSION Guna and Karma Samanyata of Kharjooradi Mantha with the Ojas caused Vruddhi in the Guna and Karma of Ojas which helped in relieving the Madataya Laxanas . The increased elements are treated by opposite Gunas but in case of Ojas , Vruddhi of Ojas is always considered as the beneficial one. Though Madhya is having opposite Guna to that of the Ojas it cannot be administered. Because Chikitsa is never aimed at Ojo-Kshaya and it is always aimed at bringing Samyata of Ojas, So Kharjooradi Mantha was selected, which was found to be potent enough in increasing the Ojo Gunas in the clinical study. Kharjooradi Mantha is highly significant in relieving the Laxanas of Madatyaya . REFERENCES 1 Acharya JT. Charaka Samhita with Ayurveda Dipika commentary of Chakrapani Datta. Reprint Ed. Varanasi (India): Chaukambha Orientalia; 2007;p.133 2 Acharya JT. Charaka Samhita with Ayurveda Dipika commentary of Chakrapani Datta. Reprint Ed. Varanasi (India): Chaukambha Orientalia; 2007;p.483 3 Acharya JT. Charaka Samhita with Ayurveda Dipika commentary of Chakrapani Datta. Reprint Ed. Varanasi (India): Chaukambha Orientalia; 2007;p.485

[Find the meaning and references behind the names: Williams, Nil, Med]

Dr. Aqeeb Javeed et.al. Role of Kharjooradi Mantha in the enhancement of Ojo Guna in Madatyayi subjects ISSN: 2456-3110 ORIGINAL ARTICLE Sep-Oct 2018 Journal of Ayurveda and Integrated Medical Sciences | Sep - Oct 2018 | Vol. 3 | Issue 5 20 4 Acharya JT. Charaka Samhita with Ayurveda Dipika commentary of Chakrapani Datta. Reprint Ed. Varanasi (India): Chaukambha Orientalia; 2007;p.489 5 Acharya JT. Charaka Samhita with Ayurveda Dipika commentary of ChakrapaniDatta. Reprint Ed. Varanasi (India): Chaukambha Orientalia; 2007;p.123 6 Acharya JT. Charaka Samhita with Ayurveda Dipika commentary of Chakrapani Datta. Reprint Ed. Varanasi (India): Chaukambha Orientalia; 2007;p.123 7 Acharya JT. Charaka Samhita with Ayurveda Dipika commentary of Chakrapani Datta. Reprint Ed. Varanasi (India): Chaukambha Orientalia; 2007;p.123 8 Kaplan and Sadock. Comprehensive textbook of psychiatry, 8 th Ed: Lippincott Williams and Wilkins publication; 2005;p.1169 9 Acharya JT. Charaka Samhita with AyurvEdaDipika commentary of Chakrapani Datta. Reprint Ed. Varanasi (India): Chaukambha Orientalia; 2007;p.103 10 Acharya JT. Charaka Samhita with AyurvEdaDipika commentary of Chakrapani Datta. Reprint Ed. Varanasi (India): Chaukambha Orientalia; 2007;p.487 ******************************* How to cite this article: Dr. Aqeeb Javeed, Dr. Vasudev Chate, Dr. Shreevathsa. A Clinical study to evaluate the role of Kharjooradi Mantha in the enhancement of Ojo Guna in Madatyayi subjects. J Ayurveda Integr Med Sci 2018;5:14-20. http://dx.doi.org/10.21760/jaims.v 3 i 5.13813 Source of Support: Nil, Conflict of Interest: None declared.

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Dosha, Bala, Daha, Oja, Satva, Anasana, Amalaki, Kasa, Dadima, Balya, Sara, Shoka, Hikka, Vyayama, Trishna, Gaurava, Shvasa, Rasayana, Adhyashana, Brimhana, Madhya, Satmya, Tandra, Pralapa, Charakasamhita, Murcha, Aruchi, Vajikara, Samhanana, Adhobhakta, Vatahara, Tridoshahara, Nidranasha, Vyayamashakti, Jwara, Ayurveda Samhita, Guna and karma, Inclusion criteria, Exclusion criteria, Diagnostic criteria, Satvavajaya Chikitsa, Sroto Shodhana, Vitiated dosha, Spss software, P Value, Objective assessment, Snigdha guna, Samprapti Vighatana, Simple random sampling, Dhatu Poshana, Subjective parameter, Divaswapna, Aushadha Sevana Kala, Agnideepana, Dourbalya, Ahara Dravya, Ojo Kshaya, Prashna Pariksha, Incidence of age, Raja sevana, Sweda, A Clinical Study, Santarpana chikitsa, Sheeta, Agnideepaka properties, Ojovardhana, DSM-5, Place of study, Vatahara properties, Sannipataja, De-addiction Centre, Subjective symptom, Doshavasechana, Descriptive statistic, Charaka Samhita Sutrasthana, Guru and Snigdha, Probable mode.