An Ayurvedic perspective of Sannipataj Jwar - Sepsis along with WBC morphology

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[Find the meaning and references behind the names: Patil, Vinod, Joshi, Low, Mandal, Heart, Vinayak]

ORIGINAL ARTICLE July 2024 Journal of Ayurveda and Integrated Medical Sciences | July 2024 | Vol. 9 | Issue 7 69 An Ayurvedic perspective of Sannipataj Jwar - Sepsis along with WBC morphology Vaishnav Vinod Dhole 1 , Vinayak N. Joshi 2 , Snehal Mandal 3 1 Post Graduate Scholar, Department of Rog Nidan, Dr. D.Y. Patil College of Ayurved & Research Centre, Pimpri, Pune, Dr. D.Y. Patil Vidyapeeth, Pune (Deemed to be University), Maharashtra, India. 2 Professor & HOD, Department of Rog Nidan, Dr. D.Y. Patil College of Ayurved & Research Centre, Pimpri, Pune, Dr. D.Y. Patil Vidyapeeth, Pune (Deemed to be University), Maharashtra, India. 3 Consulting Pathologist, Department of Rog Nidan, Dr. D.Y. Patil College of Ayurved & Research Centre, Pimpri, Pune, Dr. D.Y. Patil Vidyapeeth, Pune (Deemed to be University), Maharashtra, India. I NTRODUCTION Sepsis is potentially a life-threatening condition that arises when the body's response to infection causes injury to its own tissues and organs. Sepsis affected about 48.9 million people in 2017 with 11 million deaths i.e., 1 in 5 deaths worldwide. In 2017, almost half of all global sepsis cases occurred among children, with an estimated 20 million cases and 2.9 million Address for correspondence: Dr. Vaishnav Vinod Dhole Post Graduate Scholar, Department of Rog Nidan, Dr. D.Y. Patil College of Ayurved & Research Centre, Pimpri, Pune, Dr. D.Y. Patil Vidyapeeth, Pune (Deemed to be University), Maharashtra, India. E-mail: vaishnavdhole 85@gmail.com Submission Date: 14/05/2024 Accepted Date: 23/06/2024 Access this article online Quick Response Code Website: www.jaims.in DOI: 10.21760/jaims.9.7.9 global deaths in children under 5 years of age. Regional disparities in sepsis incidence and mortality exist; approximately 85% of sepsis cases and sepsis-related deaths worldwide occurred in lowand middle-income countries. Risk factors include young or old age, cancer, diabetes, major trauma, asthma, COPD, multiple myeloma, burns. The usual onset may be rapid (<3 hours) or prolonged (several days). Initial stage of sepsis is followed by suppression of the immune system along with Signs and Symptoms include fever, increased heart rate, increased breathing rate, and confusion. There may also be symptoms related to a specific infection, such as a cough with pneumonia, or painful urination with a kidney infection, severe sepsis causes poor organ function or blood flow. Septic shock is low blood pressure due to sepsis that does not improve after fluid replacement. Sepsis is caused by many organisms including bacteria, viruses and fungi. Common locations for the primary infection include the lungs, brain, urinary tract, skin, and abdominal organs. qSOFA criteria for sepsis include at least two of the following three: increased breathing rate, change A B S T R A C T Background : Microscopic evidence based WBC Morphology would help Ayurveda physicians to give appropriate Ayurvedic treatment to Sepsis i.e. Sannipataj Jwar patients. Sepsis affected 49 million people in 2017 with 11 million deaths i.e. 1 in 5 deaths worldwide. Objective: To observe the correlation of Sepsis with Ayurvedic Sannipataj Jwar along with WBC Morphology. Material and Methods: It includes Literature Review, Initial assessment & enrollment of patients, Microscopic observational changes to correlate Sepsis with Sannipataj Jwar , Observation & Interpretation. Results: It shows the correlation of Sepsis with Ayurvedic Sannipataj Jwar along with WBC Morphology. Conclusion: This study finds the correlation of Sepsis with Ayurvedic Sannipataj Jwar along with WBC Morphology. This study would help Ayurveda physicians to give appropriate Ayurvedic treatment to Sepsis patients on the basis of evidence based WBC Morphology. Key words: Sepsis, Septic Shock, Sannipataj Jwar.

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[Find the meaning and references behind the names: Moha, Karna]

Vaishnav Vinod Dhole et al. An Ayurvedic perspective of Sannipataj Jwar - Sepsis along with WBC morphology ISSN: 2456-3110 ORIGINAL ARTICLE July 2024 Journal of Ayurveda and Integrated Medical Sciences | July 2024 | Vol. 9 | Issue 7 70 in the level of consciousness, and low blood pressure. Other potential causes of similar signs and symptoms include anaphylaxis, adrenal insufficiency, low blood volume, heart failure, and pulmonary embolism. Sepsis requires immediate treatment. The risk of death from sepsis is as high as 30%, while for severe sepsis it is as high as 50%, and septic shock 80%. According to Ayurved , Achaarya Charak defined Jwar as Pradhaan in all types of Vyadhi i.e. ‘ देहेंद्रियमनस्तापी सर्वरोगाग्रजो बली I ज्र्र : प्रधानो रोगाणामुक्तो भगर्ता पुरा II च चच ३ / ४ - ५ . Achaarya Charak also defined Sannipata Jwar along with Lakshana as क्षणे शीतमस्स्िसस्धधशशरोरुजा I सास्रार्े कलुषे रक्ते ननभुवग्ने चापप दशवने II सस्र्नौ सरुजौ कणौ कण्ठः शूकैररर्ार्ृत :I तधिा मोहः प्रलापश्च कासः श्वासोऽरुचचर्भ्वमः II पररदग्धा खरस्पशाव स्जह्वा स्रस्ताङ्गता परम ् I ष्ठीर्नं रक्तपपत्तस्य कफेनोस्धमचितस्य च II शशरसो लोठनं तृष्णा ननिानाशो हृद्रद व्यिा II स्र्ेदमूत्रपुरीषाणां चचराद्दशवनमल्पश :II कृशत्र्ं नानतगात्राणां प्रततं कण्ठकूजनम् I कोठानां श्यार्रक्तानां मण्डलानां च दशवनम ् II मूकत्र्ं स्रोतसां पाको गुरुत्र्मुदरस्य च चचरात् पाकश्च दोषाणां सस्धनपातज्र्राकृनतः II च चच ३ / १०१ - १०६ Meaning of all these Lakshanas are correlated with Sepsis in the point - Initial assessment and enrollment of patients. M ATERIAL AND M ETHODS Literature Review ↓ Initial assessment & Enrollment with written consent ↓ Microscopic observational changes to correlate Sepsis with Sannipataj Jwar ↓ Assessment criteria along with WBC Morphology ↓ Observation, Interpretation & Statical Analysis L ITERATURE R EVIEW It includes Ayurvedic and Modern Medical Science References. Initial assessment and enrollment of patients Sannipataj Jwar Lakshanas can be correlated with Sepsis as follows: Sannipataj Jwar Lakshanas Sepsis Kshane Daha & Kshane Sheeta Fever & Hypothermia; Temperature > 38.5 or < 35°C Asthi Sandhi Ruja Arthralgia, Myalgia Shiro Ruja Headache (due to hypotension or upper/lower respiratory tract infection) Saasraave Kalushe Rakte Lochane Conjunctivitis Saswanau Karnau & Karna Ruja Otitis media Kantha Shookairiva Pharyngitis / Laryngitis Tandra Fatigue / Malaise (sepsis / acute respiratory tract infection / hypotension) Moha Confusion / Loss of consciousness (septic shock / hypotension / delirium) Pralaapa Irrelevant speech (delirium?) Kaasa Cough (upper respiratory tract infection / pneumonia) Shwaasa Shortness of breath (tachypnoea / respiratory rate > 20 breaths per minute / Acute lung injury / Acute respiratory distress syndrome) Aruchi Loss of appetite / Anorexia (respiratory tract infection / sepsis) Bhrama Hypotension / reduction of cerebral blood flow Paridagdha, Khara Sparsha Jihwa Dehydration (indicates need of fluid resuscitation / septic shock)

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[Find the meaning and references behind the names: Ali, Gupta, Prasad, Sama]

Vaishnav Vinod Dhole et al. An Ayurvedic perspective of Sannipataj Jwar - Sepsis along with WBC morphology ISSN: 2456-3110 ORIGINAL ARTICLE July 2024 Journal of Ayurveda and Integrated Medical Sciences | July 2024 | Vol. 9 | Issue 7 71 Srastaangata Malaise / weakness / fatigue (sepsis / respiratory infection) Kapha Yukta Rakta Shteevanam Haemoptysis (respiratory infection / pneumonia) Shiraso Lothanam Restlessness / Septic encephalopathy Trishna Dehydration (septic shock / denotes requirement of fluid resuscitation) Nidraa Naasha Restlessness / Sleeplessness (delirium) Hridi Vyadha Hypotension / Tachycardia / pericarditis Chiraat and Alpa Sweda, Mutra and Purisha Dehydration / Anuria / Oliguria / Acute kidney injury / Constipation / MODS (Multiple organ dysfunction syndrome) / septic shock Krushatwam Naati Gaatraanaam Edema (due to hypoperfusion of tissues / hepatic injury / cute kidney injury / hypoxemia) Pratatam Kantha Koojanam Tachypnoea / ARDS (Acute respiratory distress syndrome) / ALI (Acute lung injury) Shyaava, Rakta Kotha and Mandala Shyaava, Rakta Kotha and Mandala Mookatwam Loss of voice (due to laryngitis) Sroto Paaka SIRS (Systemic inflammatory response syndrome) Udara Gauravam Hepatomegaly? / Edema in severe sepsis due to capillary leak; Chiraat Paakashcha Doshaanaam Slowly progressive / latent pathological process (indicates chronic / recurrent infections in immuno-compromised individuals leading to sepsis / septic shock / delirium / death) Maranam Poor prognosis (MODS / delirium / septic shock) Upadrava - Karnamoola Shotha Mastoiditis leading to meningitis and death Above reference is taken from the Article: Sama Sannipata Jwara - Sepsis, SIRS, MODS, Septic Shock and Delirium of Dr. Prasad Mamidi & Dr. Kshama Gupta. With the help of above reference Sannipataj Jwar can be correlated with Sepsis. One patient is enrolled in this study having Bacterial Sepsis. Microscopic observational changes to correlate Sepsis with Sannipataj Jwar along with WBC Morphologies - Precursor stages of Neutrophil i.e. Left Shift shown as follows: Neutrophils Hypersegmented Neutrophil Band Form

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[Find the meaning and references behind the names: Shankar, Vijay]

Vaishnav Vinod Dhole et al. An Ayurvedic perspective of Sannipataj Jwar - Sepsis along with WBC morphology ISSN: 2456-3110 ORIGINAL ARTICLE July 2024 Journal of Ayurveda and Integrated Medical Sciences | July 2024 | Vol. 9 | Issue 7 72 Band Form Metamyelocyte Myelocyte Above Images showing Neutrophilic leucocytosis with shift to left i.e., precursor developmental stages which includes Hypersegmented Neutrophil, Band form, Metamyelocyte & Myelocyte showing significance of Sepsis. O BSERVATION AND I NTERPRETATION It is observed that Sannipataj Jwar can be correlated with Sepsis along with WBC Morphology with the help of Patient’s Data as follows: Patient had Sannipataj Jwar Lakshanas i.e., Sepsis having Total WBC Count 35,400 & Differential WBC count includes Neutro-84 %, Lymphocytes-7%, Eosinophils-1%, Monocytes-8%, Basophils-0% showing Neutrophilic leucocytosis with shift to left s/o Sepsis. WBC Histogram R ESULTS This study shows the correlation of Sepsis with Sannipataj Jwar along with WBC Morphology. CONCLUSION This study finds the correlation of Sepsis with Sannipataj Jwar along with WBC Morphology. This study would help Ayurveda physicians to give appropriate Ayurvedic treatment to Sepsis patients on the basis of evidence based WBC Morphology. REFERENCES 1 Kashinath Shastri & Vijay Shankar Kale e.d. Charak Samhita Chikitsa Sthaan 3/4-5. Chaukhamba Bharti Academy Publication. 2 Kashinath Shastri & Vijay Shankar Kale e.d. Charak Samhita Chikitsa Sthaan 3/101. Chaukhamba Bharti Academy Publication. 3 Kashinath Shastri & Vijay Shankar Kale e.d. Charak Samhita Chikitsa Sthaan 3/102. Chaukhamba Bharti Academy Publication. 4 Kashinath Shastri & Vijay Shankar Kale e.d. Charak Samhita Chikitsa Sthaan 3/103. Chaukhamba Bharti Academy Publication. 5 Kashinath Shastri & Vijay Shankar Kale e.d. Charak Samhita Chikitsa Sthaan 3/104. Chaukhamba Bharti Academy Publication.

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

Vaishnav Vinod Dhole et al. An Ayurvedic perspective of Sannipataj Jwar - Sepsis along with WBC morphology ISSN: 2456-3110 ORIGINAL ARTICLE July 2024 Journal of Ayurveda and Integrated Medical Sciences | July 2024 | Vol. 9 | Issue 7 73 6 Kashinath Shastri & Vijay Shankar Kale e.d. Charak Samhita Chikitsa Sthaan 3/105. Chaukhamba Bharti Academy Publication. 7 Kashinath Shastri & Vijay Shankar Kale e.d. Charak Samhita Chikitsa Sthaan 3/106. Chaukhamba Bharti Academy Publication. 8 Wikipedia - https://en.wikipedia.org/wiki/Sepsis 9 Prasad Mamidi, Kshama Gupta. Sama Sannipata Jwara- Sepsis, SIRS, MODS, Septic Shock and Delirium. 10 Essentials of Clinical Pathology by Shirish M Kawthalkar Section II Laboratory Hematology Chapter 19 Hematopoesis. 11 Essentials of Clinical Pathology by Shirish M Kawthalkar Section II Laboratory Hematology Chapter 21 Automated Complete Blood Cell Count. 12 Essentials of Clinical Pathology by Shirish M Kawthalkar Section II Laboratory Hematology Chapter 24 Total Leucocyte Count. 13 Essentials of Clinical Pathology by Shirish M Kawthalkar Section II Laboratory Hematology Chapter 27 Examination of Blood Smear. 14 Essentials of Medical Physiology by K Sembulingam, Prema Sembulingam Section II Blood & Body Fluids. 15 WHO - https://www.who.int/news-room/factsheets/detail/sepsis 16 Images of WBC Morphology from Hematology Section of Pathology Laboratory of Dr.D.Y.Patil College of Ayuved & Research Centre Pimpri, Pune -411018, Maharashtra, India. ******************************* How to cite this article: Vaishnav Vinod Dhole, Vinayak N. Joshi, Snehal Mandal. An Ayurvedic perspective of Sannipataj Jwar - Sepsis along with WBC morphology. J Ayurveda Integr Med Sci 2024;7:69-73. http://dx.doi.org/10.21760/jaims.9.7.9 Source of Support: Nil, Conflict of Interest: None declared. Copyright © 2024 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/4.0/unported [CC BY 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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