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Table of Contents - Current issue
April-June 2022
Volume 16 | Issue 2
Page Nos. 85-174
Online since Monday, July 4, 2022
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EDITORIAL
Faculty development programs and student centered approach in teaching can improve the learning experiences in the students
p. 85
Sanjeev Sharma
DOI
:10.4103/joa.joa_156_22
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PRE - CLINICAL STUDY: ORIGINAL ARTICLE
An
In vitro
study to compare the antibacterial activity of
Kaphaketu Rasa
and its combination with
Rasa Sindura
in selective respiratory pathogens
p. 87
V Sreeja Kaimal, Amal S Chandran, PK Vineeth, Unnikrishna Pillai, KP Skandhan
DOI
:10.4103/joa.joa_94_21
Introduction:
Respiratory tract infection refers to any infectious disease involving the respiratory tract. The adverse effect of antibiotics and antibiotic resistance are the difficulties faced by the medical profession. It is the need of the hour to identify the antibacterial potential of the herbo – mineral drugs. So, this study is an effort to compare the efficacy of
Kaphaketu rasa
alone and its combination with
Rasasindura
against the bacteria causing respiratory infections such as
Staphylococcus aureus
and
Streptococcus pneumoniae
.
Methods:
Rasasindura
and
Kaphakethurasa
were prepared according to the classical reference. For
Rasasindura
preparation
Kupipakva
method was done.
Kaphaketu rasa
was prepared after doing
bhavana
of
sodhita Vatsanabha, Tankana, Pippali
and
Sankha Bhasma
with
Ardraka swarasa.
Antibacterial activity of
Kaphaketu rasa, Rasasindura
and its combination were tested by the agar well diffusion method.
Results:
Aqueous extract of
Kaphaketu rasa
and combination of
Kaphaketu rasa
with
Rasasindura
have zone of inhibition against both
S. pneumoniae
and
S. aureus
, which shows the antibacterial activity of the drugs. Aqueous extract of
Rasasindura
alone did not show any zone of inhibition against both bacteria.
Conclusion:
Kaphaketu rasa
has significant antibacterial activity against the respiratory pathogens
S. aureus
and
S. pneumoniae
. The findings suggest that
Kaphaketu rasa
can be used in respiratory tract infection and
Rasasindura
can be added with it for an additive effect.
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CLINICAL STUDY: ORIGINAL ARTICLES
An open-label randomized comparative clinical study of
Triphaladi vati
and
Jatyadi gandusha
on Tobacco Chewing-Induced
Mukhapaka
w.s.r. to stomatitis
p. 92
Sunita Kumari Bijarniya, Sushil Kumar Jangid
DOI
:10.4103/joa.joa_347_21
Introduction:
According to Ayurveda, tobacco plant (
Sthavara Patra Visha
) has properties such as
Tikta
and
Katu rasa, Laghu, Tikshna, Vyavayi, Sara, Vikashi
, and
Ushna guna
; all the properties match with
Dushi visha
(slow poison) induces chronic toxicity to the gastrointestinal tract on chronic use. Tobacco chewing causes
Mukhapaka (Sarvasara roga)
which is the clinical condition identified with
Paka, Lalima
(redness),
Daha
(burning sensation),
Sphota
(mouth ulcers/blisters),
Ksharokshit kshatsam
(erosion of buccal mucosa),
Vedna
(pain),
Tikta vaktrata
(bitter taste), difficulty in chewing, and enlargement of lymph nodes.
Mukhapaka
is a
Pitta Pradhana Sansargaja vyadhi. Gandusha
and
Virechaka
drugs are found effective to treat
Mukhapaka. Triphaladi vati
and
Jatyadi gandusha
are defined as
Mukha roga
treatment as the both
Yogas
have
Rasayana
(immunity booster),
Deepana
(appetizer),
Vishaghna
(detoxifier),
Vranaropana
(wound healing),
Pittasamsrana
(anti-inflammatory), and
Sandhanakara
(healing) properties useful in
Mukhapaka
(stomatitis). This study aims to access and compare the efficacy of
Triphaladi vati
and
Jatyadi gandusha
in
Mukhapaka
treatment.
Methods:
(i) Design: Open-labeled randomized comparative clinical trial of 30 patients of either sex. (ii) Intervention: 30 clinically diagnosed and Rajasthan Ayurved University (Jodhpur) outpatient department-registered patients of
Mukhapaka
(stomatitis) who were randomly divided into two groups (Group A and Group B) of 15 patients each. (iii) Duration: 45 days.
Results:
Both the selected preparations were found very effective in the treatment of
Mukhapaka
, but the most efficacy was seen in Group B which was given
Jatyadi gandusha
.
Conclusion:
The present study supports the use of both
Yogas
in treating
Mukhapaka
with the good acceptance by all treated patients.
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A comparative clinical evaluation of “
Varuna Kwatha
” and “
Kanchnara Triphala Kwatha
” in the management of
Dhatvagnimandhya
with special reference to hypothyroidism
p. 99
Rani Gurmeet, Sahu Kumar Ajay, Mutha Rashmi
DOI
:10.4103/joa.joa_202_21
Introduction:
Hypothyroidism is one of the most common thyroid disorders in India, its incidence increasing day by day. The current issue was chosen for research and its treatment by using
Ayurvedic
principles due to the vast range of the disease and its high incidence in society. The aim of the present study is to compare the efficacy of
Varuna Kwatha
and
Kanchnara Triphala Kwatha
in the management of
Dhatvagnimandhya
(Hypothyroidism).
Methods:
This was a randomized, interventional type and comparative study, in which 30 confirmed hypothyroidism patients with elevated serum thyroid-stimulating hormone >.5 μIU/ml were selected and treated with
Varuna Kwatha
and
Kanchnara Triphala Kwatha
for 30 days. To measure the unbiased impact of treatments, patients were instructed to stop using any hypothyroidism medications they were consuming.
Results:
Both the groups showed statistically highly significant (
P
< 0.001) improvement in tiredness, weakness, dyspnea, and dry coarse skin, while in a hoarse voice, hypomenorrhea, menorrhagia, oligomenorrhea, and cold intolerance, the groups showed the insignificant result. In objective parameters, both groups showed highly significant results (
P
< 0.001) in decreasing weight and body mass index. Both the groups showed insignificant result in T3, T4 parameters. Group A showed a 5.08% decrease in TSH, but statistically, it was insignificant, while Group B showed a significant result (
P
= 0.0234) with 30.54% relief.
Conclusion:
Kanchnara Triphala Kwatha
showed better results than
Varuna Kwatha
.
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A randomized controlled trial to evaluate the laxative effect of prescribed diet compared with
Triphala Churna
in
Vibandha
with special reference to constipation
p. 106
Pooja Saini, Sarvesh Kumar Agrawal
DOI
:10.4103/joa.joa_163_20
Introduction:
Constipation is a common gastrointestinal complaint in apparently healthy population as well as in patients with various predisposing disorders with approximately 12%–19% global prevalence. Constipation is defined as “delay or difficult defecation causing significant distress to the patient.” In
Ayurveda,
various clinical conditions such as
Krurakoshtha, Apanavayudusti
,
Vishtabdhajirna, Grahani
have symptom of constipation called
Vibandha.
The presently available laxative drugs are habit-forming and financial burden to the patients. Treatment of constipation cannot be continuing for a longer period; therefore, it is a better option to put the patient on proper diet having laxative action in the condition of constipation. The objective of this work is to prepare a dietary module for patient of constipation and to evaluate the laxative effect of that prescribed dietary module (
Pathyahara)
in constipation.
Methods:
This study was conducted in two groups. Group A (Control): 3–6g (½
Karsh
)
Triphala Churna
was given orally at night after meal daily with lukewarm water. Group B (Trial): Prescribed Dietary Module was advised as a daily diet.
Results:
Very significant result was found in both groups on all assessment parameters except weekly frequency of bowel movements in which result was significant in group A and no significant difference was there in all assessment parameters except weekly frequency of bowel movements and colic pain where the effect was more in Group B.
Conclusion:
Triphala Churna
and prescribed dietary module having laxative effect in constipation. The effect was statistically more in prescribed dietary group on two parameters.
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SURVEY STUDY: ORIGINAL ARTICLES
Role of
Aharaja Nidana
in etiopathogenesis of premature aging w. s. r. to skin health: A survey study
p. 112
Archana Singh, Pawankumar Godatwar, Reetu Sharma
DOI
:10.4103/joa.joa_235_20
Introduction:
Modern gerontologist accepted aging as a natural phenomenon which cannot be avoided. In Ayurveda, it is mentioned as
Jara
and believed as
Svabhavika Vyadhi
. There are various factors mentioned in
Ayurveda
which accelerates the process of aging and results in
Akalaja jara.
The sign of aging reflects the first on the skin in the third decade of life. The present study was intended to identify the potential factors that may accelerate the process of aging in the context of food habits, with special reference to skin health.
Methods:
A
Nidanatmaka
study was conducted at NIA Jaipur in which 492 participants aging between 30 and 65 years, having signs of aging were included after informed consent, and the data were collected to measure the prevalence of the etiological factors of early aging by incorporating a well-designed questionnaire.
Results:
Majority of participants were of the age group 30–39 years (64.43%), belong to middle socioeconomic class (66.05%) and urban habitat (95.32%) and having graduate level (24.79%) of education. Majority of participants were female (61.78%), married (85.97%), and homemakers (40.44%). The majority of the participants reported excessive intake of
Guru Ahara
(46.13%),
Snigdha Ahara
(59.75%), and
Ushṇa Ahara
(56.30%) sometimes, while rare intake of
Ati Shita Ahara
(54.47%) was reported in majority of participants. Most of the participants reported
Lavaṇa
as dominant
Rasa
(49.59%) and practicing
Viṣamasana
(50.20%).
Conclusion:
These data advocate the fact that faulty food habits contribute toward accelerated intrinsic aging which reflects on skin health.
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Knowledge, attitude and practice survey of prashana survey of prashana in neonates among Ayurvedic practitioners
p. 119
Chris Antony, Anubha Chandla, Kavita Vyas, Rajesh Sannd
DOI
:10.4103/joa.joa_369_21
Introduction:
Neonatal period is the most vulnerable period for infections. India is the first among top 10 countries with the highest number of newborn deaths in 2019. Ayurvedic newborn care measures like prashanas should be explored for extending quality affordable care to newborns.
Methods:
A descriptive cross-sectional study in the form of knowledge, attitude, and practice survey of prashana in neonates was carried out using self-administered questionnaire containing 28 questions through Google Forms among 402 Ayurvedic Practitioners of India following CHERRIES checklist. Validated questionnaire was pretested before fielding it.
Results and Conclusion:
55.4% of the participants agreed that prashana should be administered to all neonates and 91.5% agreed that it improves the health of the neonates. 53.4% preferred Swarna bhasma and 30.8% preferred elemental gold rubbed on stone in prashana. The dose of ghee was one to three drops (46%) and of honey was one to five drops (52%). 87.4% reported no adverse events due to prashana. Reduction in illnesses, improvement in intellect or school performance, growth, speech, etc., were the major positive responses received. Majority followed Acharya Kashyapa in prescribing prashana. The survey has brought to light the various methods of practice of prashana and also the lack of precise doses of Swarna bhasma, ghee, honey, etc. It will help in guiding the practitioners in implementing prashana in neonates and future research on its effects on neonatal mortality and morbidity including long-term effects on immunity, intellectual and behavioral outcomes.
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ANALYTICAL STUDY: ORIGINAL ARTICLES
Physico-chemical standardization and nutritional assessment of Devdarvadyarishta
p. 126
Chinky Goyal, Namrata Joshi, Khem Chand Sharma
DOI
:10.4103/joa.joa_14_21
Introduction:
Devdarvadyarishta is a honey based anti-diabetic formulation enlisted in Ayurvedic lexicon. Sandhana Kalpana is mentioned under both Ahara and Aushadha Varga, and Asava-arishta were used as food supplements since Vedic period. Devdarvadyarishta was prepared as per conventional method and was subjected to various analytical parameters and nutritional parameters to develop a standard.
Methods:
Three samples of Devdarvadyarishta were prepared in accordance with Bhaishjya Ratnavali and compared with the market sample on various physico-chemical and phytochemical parameters, high-performance thin-layer chromatography (HPTLC) profiling as well as nutritional value.
Results:
Respective mean values of prepared samples and market sample were found to be pH – 3.86 and 3.80, specific gravity – 1.0953 and 1.0934, refractive index − 1.41943 and 1.41910, total solid content % w/w − 22.05 and 22.92, reducing sugars 18.18 and 18.50, nonreducing sugars 0.84 and 0.91 and total phenolic content – 0.180% and 0.185%, alkaloids – 0.037% and 0.042%, tannins – 0.11% and 0.10%, saponins − 0.082% and 0.080%, flavonoids – 0.011% and 0.013%, terpenoids − 0.046% and 0.055% and Glycosides – 0.11% and 0.17%. Nutritive value showed mean carbohydrate % of 21.45, fat − 0.21%, protein − 0.07%, and total energy being 86.82 K cal in prepared samples whereas market sample showed 22.97% carbohydrate, 0.25% fat, 0.10% protein, and 88.35 Kcal energy. HPTLC analysis showed two major peaks at Rf 0.87 and 0.90 with Chloroform: methanol solvent system.
Conclusion:
Physicochemical data for standard of Devdarvadyarishta was set in as a Quality specification for the same. Nutritional value of Devdarvadyarishta, i.e., 86.82 kcal energy supports the ancient views of Sandhana products being used as food adjuncts.
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Detection of nonpermitted food color metanil yellow in turmeric: A threat to the public health and Ayurvedic drug industry
p. 134
Abhineet Verma, Satyen Saha, Shobha K Bhat
DOI
:10.4103/joa.joa_77_21
Introduction:
The food products available in the market today are made attractive by adding food colors. Fruits, vegetables, spices, sweets, and even the commonest drugs used as medicine in day-to-day life are adulterated with nonpermitted colors.
Haridra
or turmeric is the most popularly used
Vishaharadravya
/antitoxic drug which is taken internally almost every day both in diet and as medicine. Metanil yellow (MY) is a “nonpermitted” food colorant used extensively as an adulterant in different spices, especially turmeric. Though the quantity of intake would be small, when taken continuously, it may lead to several adverse life-threatening effects in humans.
Methods:
20 different samples of
Haridra
(Turmeric) were collected randomly from markets in and around Varanasi. The presence of nonpermitted food color-MY in these turmeric samples was first tested with preliminary color test followed by ultraviolet-visible spectroscopic studies. The color change and change in absorption spectra have been used to identify the contaminated samples.
Results and Conclusion:
Two out of twenty samples of
Haridra
were found to be adulterated with MY. Food adulteration in daily diet is a matter of great concern and is a strong cause for
Garavisha
. Mass awareness has to be raised on the issue. Our results suggest that special care has to be taken by the turmeric-based Ayurveda manufacturers to avoid the use of such contaminated turmeric.
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Insight into the Ayurveda theory of “Dravyasamgrahakala” on Shatavari (
Asparagus racemosus
Willd) root with reference to quality standard parameters
p. 140
Kinjal Parsotam Unadkat, Dilip Jani, Hari Om Gupta, Neha Parmar
DOI
:10.4103/joa.joa_88_21
Introduction:
India has been known to be the richest heritage of medicinal plants. Globally, there is a universal rise in the use of Ayurveda system of medicine. According to the WHO, it has been evaluated that 80% of world's population relies on traditional medicines. There are many factors such as geographical variations, place, habitat, season, and temperature can affect the quality of medicinal plants. The study is an endeavor to compare the effect of seasonal variations on plants on the basis of quality standard parameters to validate the basic principle of Ayurveda “
Dravyasamgraha kala.
” This study aims to evaluate analytical changes and compare the data of different samples of
Asparagus racemosus
Willd. collected in different seasons according to Ayurveda classics.
Methods:
In Ayurveda texts, there is also a description about parts of the plants that should be collected in specific seasons. For the purpose,
Shatavari
(
A. racemosus
Willd.) was selected for the study. In the current research, four samples of roots of
A. racemosus
were collected in four different seasons-
Grishma, Pravrut, Sharad,
and
Shishiraritu
(May, June, October, and January) to compare the data and find out whether there is any similarity or difference in analytical profile.
Results and Conclusion:
The quality difference including physicochemical parameters, phytochemical identification, and high-performance thin-layer chromatography was remarked in the samples. It can be concluded that chemical constituents make a unique revelation from different seasons. Proper time period of the collection of plant is very important to obtain good quality drug. The season has a significant role to validate the factors that influence the potency of the drug.
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REVIEW ARTICLES
Amrutikarana
of Ayurvedic metallic preparations: A systemic review
p. 147
Om Pandey, Prashant Bedarkar, Biswajyoti Patgiri
DOI
:10.4103/joa.joa_260_20
Objectives:
Ayurvedic metallic preparations are always a concern for the safety issue. A special process was also designed in the ancient classics of Rasashastra to remove the blemishes of such metallic preparation known as
Amrutikarana
. Different materials and methods are elucidated for this purpose which modifies the efficacy and glance of the incinerated metals and minerals.
Data Sources:
Eighty one Ayurvedic classical text books and published research studies were searched in the context of Amrutikarana. Online search engines namely J gate, Google scholar, Pubmed, DHARA online and AYUSH research portal were used for data mining of published research works.
Review Methods:
References and studies including the methods of preparation, safety, efficacy or toxicity studies of '
Amrutikarana
' or '
Amritikarana
' of Ayurvedic Bhasma were reviewed.
Results:
Amrutikarana process was invariably seen in the contexts of
Abhraka, Lauha
and
Tamra Bhasma
only in few texts. Research articles show that there are various physico-chemical changes involved in this process along with variations in the elemental level of Fe, Cu, C, oxides and particle size. Pharmacological studies clearly support the claim that
Amrutikarana
helps in reducing the toxicity of metallic preparations. However, clinical data is not available in support of the increased efficacy by this process.
Conclusion:
Amrutikarana
process of metallic
Bhasma
preparations is an important tool to counteract the possible ill effects by changing its physico-chemical property but the scientific published data still lacks the Standard manufacturing procedures of
Amrutikarana
for such
Bhasma
and efficacy evaluations on clinical grounds.
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Comprehensive review on physioanatomical aspects of
Manipura Chakra
p. 154
Sanchita , Anju Thomas, Remya K Simon, PS Jigisha
DOI
:10.4103/joa.joa_261_20
Introduction:
Chakra
(wheel) is the energy points which are present in the subtle body and are seven in number. Out of the seven
Chakra
,
Manipura Chakra
is the third one. It has control on several functions of the digestive system.
Objectives:
The objective of the study is to evaluate the physioanatomical aspects of the
Manipura Chakra.
To find out the relationship between
Manipura Chakra
and celiac plexus.
Data Source:
Textbooks related to awakening and healing of
Chakra, Sat Chakra Nirupana, Sushruta Samhita, Charaka Samhita, Ashtanga Hridaya
, B. D Chaurasia's Human Anatomy, Articles, and Internet sources.
Review Methods:
The present work is done by reviewing the literature on the basis of data compiled from classical texts, contemporary science, published research works, articles related to
Manipura Chakra
, and celiac plexus. The obtained literature was critically analyzed, interpreted, and presented.
Results:
The position of
Manipura Chakra
is said to near the navel. The fire is mentioned as the main attribute of the
Manipura Chakra
, which in the form of
Pachaka Pitta
with the help of
Samana Vayu
governs all the functional aspects of digestion and metabolism. On the basis of positional, structural, and functional similarity,
Manipura Chakra
can be considered as celiac plexus.
Conclusion:
Blockage of center of
Manipura Chakra
can impair gastrointestinal functions which in turn may lead to diseases such as irritable bowel syndrome and constipation. Stimulation of
Manipura Chakra
by means of
Beejamantra
recitation,
Yogasana,
and
Mudra
assists in overcoming diseases related to the gastrointestinal tract and promotes health.
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CASE REPORTS
A multi-dimensional approach to endometrial polyp through Ayurvedic intervention – A single-case study
p. 157
KM Susdev, Sunitha Joshi
DOI
:10.4103/joa.joa_34_22
Introduction:
Endometrial polyps (EPs) are epithelial proliferation arising from endometrial stroma or glands. They may be responsible for 57%–60% cases of abnormal uterine bleeding. A 36-year-old female patient diagnosed with EP was managed successfully through Ayurveda. In modern science, they are giving oral contraceptive pills or advising for surgery. In this case, we managed with Ayurvedic medication for the span of 3 months and relived completely.
Main Clinical Finding:
Presented with complaints of intermenstrual bleeding along with heavy menstrual bleeding for the past 1.5 years
Diagnosis:
The patient was already diagnosed with EP; correlated to
Yoni Arshas
in Ayurveda classics.
Interventions:
The patient was treated with internal medicines
Kanchanara guggulu, Lodrasava, Jahar mohra pishti,
and
Panchatikta ghruta guggulu
along with
Matravasti
with
Chandana bala lakshadi taila,
and
Uttaravasti
with
Kshara taila
.
Outcome:
After 3 months of treatment got complete relief in symptoms with normal USG findings.
Conclusion:
Ayurvedic treatment regime may be adopted as an alternate to surgical interventions in the management of EP effectively
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One-and-a-half syndrome and its management with Ayurvedic treatments: A case report
p. 161
Manjusree Radhakrishnan Parappurathu, Aravind Kumar, Krishnendu Sukumaran, Kavya Rama Varma
DOI
:10.4103/joa.joa_263_21
Introduction:
One-and-a-half syndrome is a condition characterized by horizontal gaze palsy and internuclear ophthalmoplegia. Its risk factors include conditions that predispose to pontine lesions and demyelinating conditions. The symptoms include blurred vision, diplopia, and oscillopsia. Management is addressing the underlying symptom and relieving the symptoms. The case of a 46-year-old hypertensive male who was diagnosed with one-and-a-half syndrome and who underwent inpatient management at an allopathic hospital is presented here. He initially approached Sreedhareeyam's OP division and was prescribed medicine and inpatient management.
Main Clinical Findings:
On examination, he had blurred vision, diplopia, and one-and-a-half syndrome.
Intervention:
He underwent an inpatient
Ayurvedic
protocol comprising of oral medicines, external therapies, and eye exercises.
Outcome:
Results at discharge and at three subsequent follow-ups demonstrated gradually improved ocular movements and relief of symptoms.
Conclusion:
This case illustrates that Ayurveda treatments may be explored for this condition.
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Ayurvedic management of infertility due to polycystic ovaries and tubal block: A case study
p. 170
Pushpalatha Buduru, Bharathi Kumaramangalam, Shalvi Sharma
DOI
:10.4103/joa.joa_276_21
Introduction:
Various factors responsible for
Vandhyatva
(infertility) are explained by
Acharya Charaka,
such as y
onidosha
(gynecological disorders),
Mansika-Abhitapa
(mental stress),
Shukra-Artavadosha
(disorders of sperm and ovum),
Ahara-Vihara Dosha
(food- and lifestyle-related disorders),
Akalyoga
(inappropriate timing),
Bala-Kshaya
(decreased strength). Two major factors which are associated with fertility problems are anovulation and defect in tubal patency. In the present article, there is a case study of ayurvedic management of infertility due to bilateral polycystic ovaries along with the bilateral tubal block.
Main Clinical Finding:
A 29-year-old female patient reached the hospital with the complaint of wants issues for 2 years, she also had increased intermenstrual interval and weight gain for 2 years.
Diagnosis:
Her ultrasonography finding revealed bilateral polycystic ovaries, delayed ovulation in the follicular study, and hysterosalpingography findings showed bilateral fallopian tubal block.
Interventions:
Ayurveda treatment, including a combination of oral medications (
Ashwagandha Ksheerapaka, Shatpushpa churna, Avipattikara churna, Pittantaka churna
, tablet
Leptaden
, tablet
Aloes
compound,
Phalasarpi, Pushpadhanva rasa,
and
Balabeej churna
) at different stages of menstrual cycle and
Sthanika Chikitsa
by
Yonipichu
(
Dhanvantaram taila
) application, was planned for 3 months.
Outcome:
The patient missed her period after 2 months of treatment and urine pregnancy test was found positive.
Conclusions:
Timely ovulation and tubal patency are important factors for successful fertilization and conception. Hence, oral medications consisting of
Aagneya
and
Vatanulomaka
drugs along with
Yonipichu
with
Dhanvantaram taila
are effective in correcting both of these factors.
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