Effect of Shashti Shali Pinda Swedan and Sahchar Tail Matra Basti in the...

[Full title: Effect of Shashti Shali Pinda Swedan and Sahchar Tail Matra Basti in the management of Young Onset of Parkinson Disorder (YOPD) - A Case Report]

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[Find the meaning and references behind the names: Harsha, Babita, Sharma, Gupta, Main]

CASE REPORT June 2023 Journal of Ayurveda and Integrated Medical Sciences | June 2023 | Vol. 8 | Issue 6 258 Effect of Shashti Shali Pinda Swedan and Sahchar Tail Matra Basti in the management of Young Onset of Parkinson Disorder (YOPD) - A Case Report Chhaya Baghel 1 , Babita Dash 2 , Harsha Gupta 3 1,3 Post Graduate Scholar, Department of Panchkarma, Pandit Khushilal Sharma Govt. Ayurveda College Bhopal, Madhya Pradesh, India. 2 Lecturer, Department of Panchkarma, Pandit Khushilal Sharma Govt. Ayurveda College Bhopal, Madhya Pradesh, India. I NTRODUCTION Young onset Parkinson’s disease is a subtype of Parkinson disease occurring at a young age with specific symptoms, genetic correlation and treatment plan. YOPD is a rare genetic Parkinson’s disorder characterized by an age of consent between 21 to 45 preva lence of young onset Parkinson’s disease (YOPD) in Europe is estimated to be 1/5000-8000 (5-10% of all Address for correspondence: Dr. Chhaya Baghel Post Graduate Scholar, Department of Panchkarma, Pandit Khushilal Sharma Govt. Ayurveda College Bhopal, Madhya Pradesh, India. E-mail: chhbghl@gmail.com Submission Date: 13/04/2023 Accepted Date: 21/05/2023 Access this article online Quick Response Code Website: www.jaims.in DOI: 10.21760/jaims.8.6.41 PD patients) male are more affected than females (1.7:1). Women develop the disease 2 year later than men [5] The distinction between young onset Parkinson’s disease and late onset Parkinson’s disease is supported by genetic differences (a genetic etiology is more common in people with YOPD) and clinical differences (eg., dystonia and levodopa induced dyskinesia’s are more common in YOPD) Young onset Parkinson's disease is characterized by motor symptoms and non-motor symptom. Motor symptoms include tremors, rigidity Bradykinesia and non-motor symptoms psychosis, confusion, hallucination can be present. The early indication of the disorder multiple out searching of bradykinesia such as micrography, mobility problem, decreased facial expression, decreased blinking rate are common in young onset Parkinson disease. In Ayurveda due to similar disease presentation YOPD can be compared with Kampavata . Kampavata has been described the under Vataja Nanatmaja Vikara . The term Kampavata was explained for the first time in the text Basavarajeeyam . A B S T R A C T The young onset Parkinson disease is a progressive neurodegenerative disease characterized by both motor and non motor features. The diseases affect families and caregivers through its progressive degenerative effect on mobility and the muscle control [1] The main difference between young onset of Parkinson disorder (YOPD)and the late onset of Parkinson disorder (LOPD) is genetic etiology and clinical symptoms e.g., dystonia and levodopa induced per dyskinesia are common in YOPD. YOPD person carrying a greater social economic burden compared to late onset of Parkinson disease due to age factor. YOPD Patients more prone to levodopa related motor complication. Parkinson’s disease is referred to in the ancient Indian medical system of Ayurveda under the name Kampavata which is characterized by Kampa (Tremors), Stambha (Rigidity), Chesthahani (Akinesia) & Gativikriti (Gait Disorders). The case study is of a 45 years old male who has been diagnosed with early stage idiopathic Parkinson’s disease. No satisfactory treatment is seen in contemporary system of medicine so treatment is planned in here study. Key words: Shashti Shali Pinda Swedan, Sahchar Tail Matra Basti, Young Onset of Parkinson Disorder, YOPD.

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

Chhaya Baghel et al. Effect of Shashti Shali Pinda Swedan and Sahchar Tail Matra Basti in YOPD ISSN: 2456-3110 CASE REPORT June 2023 Journal of Ayurveda and Integrated Medical Sciences | June 2023 | Vol. 8 | Issue 6 259 Kampavata is a Vata Vyadhi which occurs due to pathological increase of Chala Guna of Vata . Treatment consists of both internal and external administration of different forms aimed to reverse pathology of Vata imbalance. C ASE R EPORT A 45 year old male patient apparently quite well before 10 years, gradually tremors appear in lower limb after having symptoms he goes under supervision modern allopathic treatment where he diagnosed with YOPD. After taking initial medications such as drugs like tab clonazepam (0.5 mg), tab Pantop (40 mg), tab propranolol and Levadopa & carbidopa (110 mg) since 2018. He got temporary relief later on symptoms aggravated and he developed tremors in both upper and lower limbs, disturbed mental condition, slurred speech, constipation, cervical pain and disturbed sleep. So, he came to Pt KLS Hospital Bhopal date on 20/07/21 for Ayurvedic treatment. Personal history Diet - Mixed Addiction - Tea Appetite - Normal Bowel - Constipation Sleep - Disturbed Assessment criteria Bradykinesia Absent 0 Minimum slowness 1 Moderate slowness poverty of movement 2 Marked slowness and poverty of movement 3 Severe slowness, unable to move all four limb simultaneously 4 Insomnia Sleep questionnaire packet (glass gour scale) No clinically significant insomnia (0-7) 0 Sub-threshold insomnia (8-14) 1 Moderate (15-21) 2 Severe (22-28) 3 Constipation No constipation 0 Mild constipation 1 Moderate constipation 2 Severe constipation 3 Speech Normal 0 Mildly affected, no difficulty in understand 1 Moderately affected, sometime asked to repeat statement 2 Severely affected, frequently asked to repeat statement 3 Tremor None 0 Minimal 1 Moderate 2 Severe but still able to read 3 Severe, unable to read, unable to watch TV 4 Intellectual impairment None 0 Mild consistent forgetfulness with partial recollection of events and no other difficulties 1 Moderate memory loss with disorientation 2 Severe memory loss with disorientation for time and often place 3 Severe memory loss, unable to make judgements or solve problems requires much help with personal care 4

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[Find the meaning and references behind the names: Raja, Guru, Mala, Rasa, Sneha, Honey, Sundar, Min]

Chhaya Baghel et al. Effect of Shashti Shali Pinda Swedan and Sahchar Tail Matra Basti in YOPD ISSN: 2456-3110 CASE REPORT June 2023 Journal of Ayurveda and Integrated Medical Sciences | June 2023 | Vol. 8 | Issue 6 260 Treatment regimen SN Treatment Dose Frequency Duration 1. Kampavatari Rasa 250 mg b.d. with honey 3 weeks 2. Ashwagandhadi Leham 15 gm b.d. with milk 3 weeks Panchakarma procedure SN Procedure Duration 1. Shashtishali Pinda Swedan (45 min) 3 weeks 2. Matra Basti with Sahchara Tail after meal 3 weeks R ESULT SN Symptoms BT AT Percentile 1. Bradykinesia 3 2 33.3% 2. Sleep pattern 4 0 100% 3. Constipation 3 2 33.3% 4. Speech 2 0 100% 5. Tremor 3 2 33.3% 6. Intellectual impairment 2 0 100% DISCUSSION YOPD is a neurodegenerative illness. About 10 to 20 percentage of people with PD experience symptoms before age 50 which is called young onset PD. The cause is still unknown exact some factor like genetic factor, environment factor etc. The treatment both PD and YOPD are same but younger people may experiences the disease differently. The progration of the disease in general is slower specially for dyskinesia younger people can take medication other than levodopa. Other medications are MAO-B inhibitor, Amantadin, a dopamine agonists or when tremor is particularly prominent an anticholinergic drug. According to the Ayurveda the disease Kampavata describe under Nanatmaja Vatavyadhi . In Kampavata Avarana of Vata and Dhatukshya are the main pathological manifestation. Acharya Charaka has mentioned Srotoshuddhi , Vatanulomana and Rasayana Chikitsa in management of Avarana . In this disease our intension is given to the treatment with the help of Ayurvedic formulations and Panchakarma therapy in motor and non-motor symptoms and complications of YOPD. In this study we used Matra Basti of Sahchara Tail . Matrabasti is a type of Sneha Basti in which the Sneha administration is minimal. Basti is administered through Guda which enters in Pakwashaya and pacifies the Vata Dosha in its main Sthana and expels Kapha, Pitta, Mutra and Mala with its potency it reaches all over the body to perform the action. Sahchara Taila having specific property like ( Madhur, Tikta Rasa & Ushna Viryatmaka ) Gati Visheshatvam (help to move), difficulty in walking, pain and stiffness [3] Shashtishali Pinda Swedan is the bolus of boiled Shashtika Shali with Balamoola Kwath and Ksheera . The main property of Shashtika are Snigdha , Guru , Sthira , Sheeta & Tridoshgna though a Swedana Karma [2] Superficial layer of skin is generally impermeable, to most of the things. Phospholipids are present in milk, which is an important component of cell membrane. It pacifies the morbidity of Vata , afflicted joints, muscles and soft tissues it also enhances the flexibility of the body, soothes the nerves and improve blood circulation. In YOPD Shashtika Shali Pinda Swedan are provided heat, massage and pressure which nourish muscle and stimulate nerve ending. Shaman drugs like Kampavatari Rasa and Ashwagandhadi Leham are used in present study. Kampavatari Rasa is a unique herbomineral formulation mentioned in the classics Rasa Raja Sundar in Vatavyadhi and indicated mainly in Kampavata and it has property like Tridoshashamaka and Rasayana . Ashwagandhadi Leham is described in the Nighantus and recommended for rheumatism, cough, dropsy and debility. It is also Balya, Rasayana, Vajikaran , strong appetizers, digestive and carminate in nature.

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

Chhaya Baghel et al. Effect of Shashti Shali Pinda Swedan and Sahchar Tail Matra Basti in YOPD ISSN: 2456-3110 CASE REPORT June 2023 Journal of Ayurveda and Integrated Medical Sciences | June 2023 | Vol. 8 | Issue 6 261 CONCLUSION In YOPD Ayurvedic oral medications like Ashwagandhadi Leham, Kampavatari Rasa and Panchakarma therapies like Shashtika Shali Pinda Swedan , and Shahachara Taila Matra Basti are found to be beneficial in improving the quality of life of the patient. While treating YOPD the main aim of the therapies is to slow or stop progression of the symptoms and finally, in this case study by above treatment, moderate improvement was seen. REFERENCES 1 https://www.hopkinsmedicine.org/health/conditionsand-diseases/parkinsons-disease/young-onsetparkinsons-disease 2 Agnivesh, Charak, Dridhabala, Charak Samhita, Sutra- Sthana, Swedadhyaya, 14/41, edited by Kashinatha Shastri and Gorakhnath Chaturvedi, Chaukhambha Bharti Academy Varanasi, Reprint; 2013. p. 290. 3 Vaidya Yadavagi Trikamji Acharya, Charaka Samhita of Agnivesha. Varanasi: Choukhamba Surbharati Publications; 2013, 1 stedition, Sutrasthan (20/13). 4 https://www.sciencedirect.com/science/article/abs/pii /S 1740676504000690 5 https://pubmed.ncbi.nlm.nih.gov/17258379/ 6 http://www.rroij.com/open-access/a-review-onpharmacological-profile-of-withania-somniferaashwagandha.php?aid=33844 ******************************* How to cite this article: Chhaya Baghel, Babita Dash, Harsha Gupta. Effect of Shashti Shali Pinda Swedan and Sahchar Tail Matra Basti in the management of Young Onset of Parkinson Disorder (YOPD) - A Case Report. J Ayurveda Integr Med Sci 2023;06:258-261. http://dx.doi.org/10.21760/jaims.8.6.41 Source of Support: Nil, Conflict of Interest: None declared. Copyright © 2023 The Author(s); Published by Maharshi Charaka Ayurveda Organization, Vijayapur (Regd). This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by-nc-sa/4.0), which permits unrestricted use, distribution, and perform the work and make derivative works based on it only for non-commercial purposes, provided the original work is properly cited

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Guru, Ayurveda, Vata, Pitta, Kapha, Sthira, Balya, Mala, Matra-basti, Snigdha, Rasayana, Mutra, Basti, Vatavyadhi, Vatanulomana, Shashtikashali, Snehabasti, Vatadosha, Speech, Kampavata, Sleeping, Vajikaran, Mental condition, Treatment, Constipation, Early stage, Medication, Ayurvedic treatment, Tikta Rasa, Treatment regimen, Upper limb, Internal administration, Lower limb, Age factor, Rasayana-chikitsa, Ayurvedic formulation, Panchakarma Therapy, Case report, Acharya Charaka, Motor symptoms, Parkinson's disease, Rigidity, Bradykinesia, External Administration, Tridoshashamaka, Panchakarma procedure, Sleep quality, Dystonia, Srotoshuddhi, Vata Imbalance, Madhur Rasa, Intellectual impairment, Genetic factor, Levodopa, Cervical pain, Chala guna, Genetic differences, Sheeta, Sleep pattern, Slurred speech, Non-motor symptoms, Shaman drug, Dopamine Agonist, Dyskinesia, Gait disorder, Sleep Questionnaire, Anticholinergic drug, Tremor, Muscle control, Familie, MAO-B inhibitor, Caregiver, Clinical difference, Levodopa induced dyskinesia, Mobility problem.