Comparative study of nimbadi vs. yastyadi ointment on episiotomy healing.

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Journal name: Ayushdhara
Original article title: A comparative clinical study of nimbadi and yastyadi ointment on episiotomy wound w.s.r. to wound healing
AYUSHDHARA is an international peer-reviewed journal. It focuses on research in Ayurveda, Yoga, Unani, Siddha, Homeopathy, Allopathy, and Pharmaceutical Sciences.
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Author(s):

*Sonika Pal
M.S.Scholar, PG Dept. of Prasutitantra and Striroga, National Institute of Ayurveda, Jaipur
B. Pushpalatha
Associate Professor, PG Dept. of Prasutitantra and Striroga, National Institute of Ayurveda, Jaipur
K. Bharathi
Professor & HOD, PG Dept. of Prasutitantra and Striroga, National Institute of Ayurveda, Jaipur


Ayushdhara:

(A peer-reviewed, bi-monthly open-access journal)

Full text available for: A comparative clinical study of nimbadi and yastyadi ointment on episiotomy wound w.s.r. to wound healing

Year: 2017

Copyright (license): CC BY-NC-SA 4.0


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Summary of article contents:

Introduction

Episiotomy, a surgical incision made during childbirth, has been a common practice aimed at preventing perineal lacerations. However, it often leads to postnatal complications, including significant pain and infection at the site. Careful management and prompt treatment of episiotomy wounds are essential for ensuring quick healing and minimizing discomfort. This study compares the efficacy of two Ayurvedic ointments, Nimbadi and Yastyadi, in promoting wound healing for women undergoing episiotomy. By applying these ointments twice daily for 14 days, the study evaluates the clinical outcomes based on various parameters related to wound healing.

Wound Healing Mechanisms: Shodhana and Ropana

In Ayurvedic medicine, the concepts of Shodhana (cleansing) and Ropana (healing) are vital for effective wound management. The study emphasizes that these two processes are critical for treating wounds, including those resulting from episiotomy. The analysis highlights that both Nimbadi and Yastyadi ointments possess healing properties attributed to their herbal ingredients. For instance, Nimbadi contains Neem, known for its antimicrobial effects and ability to promote collagen formation, while Yastyadi is centered around Yashtimadhu, valued for its soothing and healing properties. These ingredients work synergistically to reduce inflammation, promote healing, and protect against microbial infections.

Comparative Efficacy of Nimbadi and Yastyadi Ointments

The study involved 30 participants divided into two groups to assess the effectiveness of Nimbadi and Yastyadi ointments. Group A, treated with Nimbadi, showed a significant 66.62% improvement in healing parameters, with over half of the subjects achieving a "good" status of healing. In contrast, Group B, using Yastyadi ointment, demonstrated a 49.50% improvement with a predominant "average" healing status. Specific parameters such as pain relief, tenderness, and redness were markedly better in the Nimbadi group. These findings illustrate that Nimbadi ointment may have superior efficacy in managing episiotomy wounds compared to Yastyadi ointment.

Conclusion

The research concludes that both Nimbadi and Yastyadi ointments are effective in facilitating wound healing following episiotomy; however, Nimbadi ointment outperformed Yastyadi. Promoting relief from pain and improving healing outcomes, Nimbadi demonstrates significant potential for treating postnatal wounds. This study underscores the applicability of Ayurvedic remedies in modern medical practices and reinforces the importance of exploring cost-effective, herbal treatments for postpartum care. Importantly, no adverse effects were noted, highlighting both formulations' safety and applicability in clinical settings.

FAQ section (important questions/answers):

What is the purpose of the comparative clinical study?

The study aims to compare the effectiveness of Nimbadi and Yastyadi ointments in promoting healing of episiotomy wounds, evaluating parameters such as pain relief and wound healing status among patients.

How were the patients grouped for the treatment in the study?

Thirty patients were randomly allocated into two groups: Group A received Nimbadi ointment, while Group B received Yastyadi ointment, both applied twice daily for 14 days to assess their effects on episiotomy wound healing.

What were the results of using Nimbadi and Yastyadi ointments?

Nimbadi ointment showed 66.62% relief with 53.33% achieving good healing status, while Yastyadi ointment result was 49.50% relief with 46.66% at average healing status, indicating better outcomes with Nimbadi.

Glossary definitions and references:

Scientific and Ayurvedic Glossary list for “Comparative study of nimbadi vs. yastyadi ointment on episiotomy healing.”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.

1) Pain:
Pain is a common symptom associated with the episiotomy wound, causing considerable discomfort and distress for the patient. In the study, pain levels were assessed and showed significant reduction, especially in the group treated with Nimbadi ointment, which provided 56% relief as noted in clinical recovery metrics.

2) Yashtyadi (Yastyadi):
Yastyadi refers to an ointment used in the study made from ingredients like Yastimadhu and Tila, and it showed significant results in wound healing properties, although it was less effective than Nimbadi ointment. The ointment exhibited a 49.50% relief in signs and symptoms of the episiotomy wound.

3) Nimbadi:
Nimbadi refers to an ointment used in the study that contains ingredients like Nimba, Daruharidra, and Yastimadhu. It showed higher efficacy in wound healing with a 66.62% relief in symptoms and a good status of healing in 53.33% of patients.

4) Drug:
The term drug in the study refers to the medicinal preparations, Nimbadi and Yastyadi ointments, used for topical application on episiotomy wounds. These Ayurvedic formulations demonstrated various pharmacological properties such as anti-inflammatory, anti-microbial, and wound healing activities.

5) Honey:
Honey, referred to as Madhu in the text, is used as a base in the ointments due to its known actions in wound healing. It has properties like Madhura, Kashaya rasa, and attributes that aid in soothing inflammation, keeping wounds moist, and releasing antiseptic hydrogen peroxide.

6) Edema (Oedema):
Edema is the medical term for swelling, often assessed as a parameter to measure inflammation and wound healing. In the study, edema was notably reduced by 88% in the group treated with Nimbadi ointment, showing better results compared to the group treated with Yastyadi ointment.

7) Rasa (Rasha):
Rasa in Ayurveda refers to taste, which is a key characteristic in determining a substance's properties and effects. Various herbs like Neem (Nimba) and Tila (Sesamum indicum) have different Rasa that contribute to their properties such as wound healing and anti-inflammatory effects.

8) Neem:
Neem, or Nimba (Azadirecta indica), is a primary component in the Nimbadi ointment. It is known for its wound healing, anti-inflammatory, anti-microbial, and cooling properties, which help in cleansing wounds, reducing pain, and accelerating the healing process.

9) Kashaya (Kasaya):
Kashaya, or astringent taste, is an important property of some Ayurvedic herbs used in the study, such as Neem. It helps in stopping bleeding, reducing discharge, and exerting a haemostatic action, which is crucial for effective wound healing.

10) Tila:
Tila, known as Sesamum indicum, is a component in both Nimbadi and Yastyadi ointments. It has properties such as Madhura (sweet), Kashaya (astringent), and Tikta (bitter), along with Vatashamaka (pacifying Vata), which help in Snehana (nourishing) and Vedanasthapana (pain relief).

11) Inflammation:
Inflammation is a key aspect of the wound healing process involving symptoms like pain, redness, and swelling. The study aimed to reduce inflammation using Ayurvedic herbs in the ointments, with Nimbadi ointment showing a highly significant reduction in inflammation-related symptoms.

12) Madhura:
Madhura, or sweet taste, is a property found in ingredients like Yashtimadhu and Tila, contributing to their nourishing and healing qualities. This taste aids in Dathuposhana (nourishing tissues) and supports the wound healing process by pacifying inflammation and promoting tissue growth.

13) Tikta:
Tikta, or bitter taste, is a prominent feature in herbs like Neem and Berberis aristata. Bitter taste has functions such as Vranaropana (wound healing), Krimihara (anti-bacterial), and anti-inflammatory properties, which are crucial for effective wound management in the study.

14) Berberis aristata:
Berberis aristata, also known as Daruharidra, is an ingredient in the Nimbadi ointment known for its Ushnaveerya (hot potency) and Tikta Rasa (bitter taste). It has significant wound healing, anti-inflammatory, and anti-bacterial properties, facilitating Shodhana (cleansing) and Ropana (healing) of wounds.

15) Daruharidra (Daru-haridra):
Daruharidra, also referred to as Berberis aristata, is a key herb in Nimbadi ointment. It possesses anti-inflammatory, anti-bacterial, and wound healing properties due to its Ushnaveerya (hot potency) and Tikta Rasa (bitter taste), aiding in both Shodhana and Ropana processes of wound management.

16) Vranaropana (Vrana-ropana):
Vranaropana refers to the process of wound healing. This study compared the wound healing efficacy of Nimbadi and Yastyadi ointments, with Nimbadi showing a higher percentage of Vranaropana due to the combined properties of its herbal ingredients.

17) Yashtimadhu (Yastimadhu, Yashti-madhu):
Yashtimadhu, or Glycyrrhiza glabra, is the main component of Yastyadi ointment. Known for its Madhura Rasa (sweet taste) and anti-inflammatory properties, it aids in wound healing by reducing pain, soothing inflammation, and preventing infections, thus being effective in the healing process.

18) Ayurveda (Ayus-veda):
Ayurveda is the traditional Indian system of medicine that emphasizes natural healing. The study employs Ayurvedic principles using medicinal herbs formulated into Nimbadi and Yastyadi ointments, demonstrating their effectiveness in wound healing based on Ayurvedic concepts of Shodhana and Ropana.

19) Alepa:
Alepa, or the application of medicinal paste, is the first line of treatment for wounds according to Sushruta. In the study, Alepa was converted into ointment form (Malhar) to allow easy administration, improving the effectiveness of Nimbadi and Yastyadi ointments on episiotomy wounds.

20) Nimba:
Nimba, also known as Neem, is a primary ingredient in Nimbadi ointment. It has various medicinal properties such as Tikta (bitter taste), anti-inflammatory, anti-microbial, and wound healing capabilities, making it a potent agent in treating and accelerating the healing of episiotomy wounds.

21) Vranashodhana (Vranasodhana, Vrana-shodhana):
Vranashodhana refers to the cleansing of wounds, a critical step in the wound healing process. The herbs in Nimbadi and Yastyadi ointments, such as Neem and Daruharidra, have properties that ensure effective Vranashodhana, preparing the wound for subsequent healing (Vranaropana).

22) Striroga (Stri-roga):
Striroga, meaning women’s diseases, is relevant to the context of the study, which focuses on episiotomy wounds that occur in women post-childbirth. The research was conducted in the PG Dept. of Prasutitantra and Striroga at the National Institute of Ayurveda, Jaipur.

23) Jaipur:
[see source text or glossary: Jaipur]

24) Aureus:
Staphylococcus aureus is a common pathogenic bacterium that causes infections. The study notes the antibacterial properties of Neem, one of the ingredients of Nimbadi ointment, effective against strains of bacteria including Staphylococcus aureus, thus helping in wound healing.

25) Bitter:
Bitter taste (Tikta Rasa) is a characteristic of several herbs used in the study, such as Neem and Berberis aristata. Bitter taste is known for its wound healing (Vranaropana), anti-inflammatory, and anti-microbial properties, which are integral to the effectiveness of Nimbadi ointment.

26) Vrana:
Vrana means wound, which is the primary focus of the study. The research investigates the healing properties of Nimbadi and Yastyadi ointments on episiotomy Vrana, highlighting the Ayurvedic approaches of Shodhana and Ropana to ensure effective Vrana management.

27) India:
[see source text or glossary: India]

28) Ghi (Ghee):
Ghee is used as a base in both Nimbadi and Yastyadi ointments due to its supreme penetrating quality. It acts as a carrier, effectively delivering the active principles of herbs deep into the tissues, facilitating the healing process of wounds, and exhibiting soothing and nourishing properties.

29) Glycyrrhiza glabra:
Glycyrrhiza glabra, or Yashtimadhu, is a key ingredient in Yastyadi ointment. It is known for its anti-inflammatory, anti-microbial, and wound healing (Vranaropana) properties. Its Madhura Rasa (sweet taste) and Sheeta Veerya (cool potency) contribute significantly to tissue regeneration and healing.

30) Burning sensation:
Burning sensation is one of the symptoms addressed in the episiotomy wound healing study. The Sheeta (cool potency) property of herbs like Neem and Yashtimadhu helps in relieving this sensation, promoting comfort and aiding in the overall healing process of wounds.

31) Pharmacological:
[see source text or glossary: Pharmacological]

32) Madhurarasa (Madhura-rasa):
Madhura-rasa, or sweet taste, is found in herbs like Yashtimadhu and Tila. This taste is crucial for nurturing tissues, reducing inflammation, and promoting healing. It contributes to the Vranaropana (wound healing) process by providing essential nutrients and supporting tissue regeneration.

33) Tuberculosis:
[see source text or glossary: Tuberculosis]

34) Krimihara (Krmihara, Krimi-hara):
Krimihara refers to the property of being wormicidal or bactericidal. Herbs like Neem have Krimihara properties, making them effective in removing microbes and cleansing wounds, thus facilitating the Shodhana process and preparing the wound for efficient healing (Ropana).

35) Shodhana (Sodhana):
Shodhana involves the cleansing of wounds, a vital initial step in managing injuries. The study emphasizes using Ayurvedic herbs with Shodhana properties in Nimbadi and Yastyadi ointments to clear debris and prevent infections, thereby preparing the wound for subsequent healing.

36) Swelling:
[see source text or glossary: Swelling]

37) Samhita:
[see source text or glossary: Samhita]

38) Disease:
[see source text or glossary: Disease]

39) Mineral:
[see source text or glossary: Mineral]

40) Ropana:
Ropana represents the healing phase in wound management. In the study, ingredients like Neem and Yashtimadhu in Nimbadi and Yastyadi ointments exhibit Ropana properties, promoting tissue regeneration, reducing inflammation, and accelerating the overall wound healing process.

41) Varṇya (Varnya):
Varnya refers to the property promoting normal coloration and texture of skin. In the study, Yastimadhu demonstrates Varnya properties by ensuring that the wound heals with minimal scarring and the skin regains its natural color, thus improving the aesthetic outcome of the healing process.

42) Pitta:
[see source text or glossary: Pitta]

43) Vata:
[see source text or glossary: Vata]

44) Guna:
[see source text or glossary: Guna]

45) Sesamum indicum:
Sesamum indicum, known as Tila, is used in Nimbadi and Yastyadi ointments. It has properties like Madhura (sweet), Kashaya (astringent), and Tikta (bitter). These properties contribute to Snehana (nourishment), Vedanasthapana (pain relief), and effective wound healing (Vranaropana).

46) Vedanasthapana (Vedana-sthapana):
Vedanasthapana refers to pain-relieving properties. Ingredients like Tila and Yashtimadhu in the ointments exhibit Vedanasthapana by reducing localized pain at the wound site, hence promoting comfort and facilitating the healing process.

47) Dahaprashamana (Dahaprasamana, Daha-prashamana):
Dahaprasamana is synonymous with Daha-prasamana, referring to the cooling effect that alleviates burning sensations in wounds. Ingredients like Neem demonstrate Dahaprasamana properties, providing relief from pain and soothing the wound area.

48) Agantujavrana (Agantuja-vrana):
Agantujavrana means external trauma-induced wounds. Though not directly discussed in Ayurvedic classics, the episiotomy wounds in the study are treated as Agantujavrana, where Shodhana (cleansing) and Ropana (healing) principles are applied using Nimbadi and Yastyadi ointments.

49) Sandhaniya:
Sandhaniya properties refer to the ability to facilitate the connection and healing of tissues. Herbs like Yashtimadhu and Tila in the ointments demonstrate Sandhaniya, aiding in the closing and healing of the wound effectively.

50) Shothahara (Sothahara, Shotha-hara):
Shothahara refers to anti-inflammatory properties. In the study, herbs like Neem and Daruharidra in the Nimbadi ointment exhibit Shothahara, reducing swelling, redness, and overall inflammation at the wound site, thus supporting the healing process.

51) Discussion:
[see source text or glossary: Discussion]

52) Krimighna (Krmighna, Krimi-ghna):
Krimighna refers to anti-microbial properties. Herbal ingredients like Neem in Nimbadi ointment exhibit Krimighna, effectively combating bacteria and preventing infections in wound treatment, thereby promoting a clean environment for healing.

53) Stambhana:
Stambhana refers to haemostatic properties that halt bleeding. Ingredients like Neem and Tila have Stambhana properties, helping control bleeding from the wound and facilitating the early stages of the healing process by forming clots.

[Note: The above list is limited to 75. Total glossary definitions available: 96]

Other Science Concepts:

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