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INDEX – GJRMI, Vol.2, Iss. 1, January 2013 Medicinal plants Research Natural Resource VARIATION OF ESSENTIAL OILS COMPOSITION OF PITURANTHOS SCOPARIUS IN ALGERIA Takia Lograda, Messaoud Ramdani, Abderazak Kiram, Pierre Chalard and Gilles Figueredo

1–9

Bio-Tech & Genetic Engineering MEDICINAL PLANTS USED BY KABIRAJ OF FOURTEEN VILLAGES IN JHENAIDAH DISTRICT, BANGLADESH Masum Gazi Z H, Sharkar Priyanka, Nayeem Md. Abu, Rahman M Mafizur, Rahman M Mizanur

10–22

Indigenous medicine Ayurveda THE ROLE OF PANCHAKARMA THERAPY FOR MUSCULOSKELETAL DISORDERS WITH SPECIAL REFERENCE TO VATAVYADHI Dass Ranjip Kumar 23–29 A CLINICAL STUDY TO COMPARE VIRECHANA AND JALAUKAVACHARANA PROCEDURES IN THE MANAGEMENT OF VICHARCHIKA Dass Ranjip Kumar, Nayak Annada Prasad

30–39

A CLINICAL STUDY ON THE EFFECTIVENESS OF DM II HERBAL COMPOUND (KALPIT) IN THE MANAGEMENT OF OBESE DIABETICS Agarwal Vivek 40–51 A COMPARATIVE CLINICAL EVALUATION OF THYROMAX POWDER AGAINST THYROXINE SODIUM IN THE MANAGEMENT OF HYPOTHYROIDISM Ujjaliya Nitin, Krishnankutty S V, Remadevi R

52–64

RUDRAKHA: A REVIEW ON MYTHOLOGICAL, SPRITUAL AND MEDICINAL IMPORTANCE Kumar Naresh, Dubey Mukesh, Agarwal Vivek 65–72

COVER PAGE PHOTOGRAPHY: DR. HARI VENKATESH K R, PLANT ID – FLOWERS OF BARRINGTONIA RACEMOSA (L.) SPRENG. OF THE FAMILY LECYTHIDACEAE PLACE – KOPPA, CHIKKAMAGALUR DISTRICT, KARNATAKA, INDIA


Global J Res. Med. Plants & Indigen. Med. | Volume 2, Issue 1 | January 2013 | 1–9 ISSN 2277-4289 | www.gjrmi.com | International, Peer reviewed, Open access, Monthly Online Journal

Research article VARIATION OF ESSENTIAL OILS COMPOSITION OF PITURANTHOS SCOPARIUS IN ALGERIA Takia Lograda1*, Messaoud Ramdani2, Abderazak Kiram3, Pierre Chalard4 and Gilles Figueredo5 1, 2, 3, 4, 5

Laboratory of Natural Resource Valorization, Sciences Faculty, Ferhat Abbas University, 19000 Setif, Algeria 4 Clermont Université, Université Blaise Pascal, BP 10448, F-63000 Clermont Ferrand 5 LEXVA Analytique, 460 rue du Montant, 63110 Beaumont, France *Corresponding author: Email - tlograda63@yahoo.fr ; Phone: (213)36835894; Fax: (213)36937943.

Received: 20/11/2012; Revised: 27/12/2012; Accepted: 31/12/2012

ABSTRACT By means of gas chromatography and mass spectroscopy, was realized the analysis and identification of essential oils of four populations of Pituranthos scoparius, obtained by hydrodistillation. An average yield of 0.93% was obtained. From the leaf, essential oil of P. scoparius, 63 compounds were separated; 51 compounds in the oil of Boussâada population, representing 99.6% of the total essential oil mass, 40 compounds in Elkantra population, representing 75.9% of the oil, 47 compounds in the oil of T’kout population, representing 98.5% of the total essential oil and 28 compounds were identified in Mechouneche population, representing 85.1% of the total essential oil. The major compound was sabinene (14.8–24.8%), other components present in appreciable contents were: α-pinene (8.3–23.3%), α-terpinene (3.7–7.7%) and β-pinene (2.8–5.1%). The comparison of our results with those of literatures allowed us to detect the presence of three chemotypes in this species. The limonene chemotype is located in the south (region of Ghardaia), the dill apiole chemotype is located in the North (Djelfa and Laghouat regions) and the sabinene chemotype is localized in the North East (region of Biskra and Batna). KEYWORDS: Pituranthos scoparius, Ombiliferes, essential oil, Chemotype, Algeria.

Cite this article: Takia Lograda, Messaoud Ramdani, Abderazak Kiram, Pierre Chalard and Gilles Figueredo (2013), VARIATION OF ESSENTIAL OILS COMPOSITION OF PITURANTHOS SCOPARIUS IN ALGERIA, Global J Res. Med. Plants & Indigen. Med., Volume 2(1): 1–11

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Global J Res. Med. Plants & Indigen. Med. | Volume 2, Issue 1 | January 2013 | 1–9

INTRODUCTION The genus Pituranthos (family Apiaceae) is represented by more than 20 species. This plant is characterized by stems in the form of rushes which are often much ramified, without leaves or nearly so, with small fruits of less than 3 mm. Four species are present in Algeria (Ozenda, 2004). The species studied in this work, Pituranthos scoparius (Coss. & Dur.) Schinz (Syn: Deverra scoparia Coss. & Dur.), is an endemic of North Africa and is widespread in Algeria, especially in the high plateau and in most parts of the Sahara. P. scoparius is an aphyllous perennial plant; the upper leaves are reduced to their sheath. The stems are erect, 40–80 cm high, and form dense clumps that send out laterally short rigid branches (Quézel et Santa, 1962–1963). Pituranthos species are used in traditional medicine (Boukef et al., 1982; El Rhaffari et Zaid, 2002; Vérité et al., 2004; Hammiche and Maiza, 2006; Benmekhbi et al., 2008; Yangui et al., 2008; Sharaby et al., 2009; Krifa et al., 2011). Phytochemical studies have been carried out on P. scoparius (Hammiche and Maiza, 2006; Boutaghane et al., 2004; Haba et al., 2004; Dahia et al., 2009; Smaili et al., 2011; Gourine et al., 2011). The essential oil of populations of P. scoparius show that they are rich in α-pinene, β-pinene, limonene, myristicin, dill apiole and germacrene-D (table 1) (Hammiche and Maiza, 2006, Vérite et al., 2004; Smaili et al., 2011; Gourine et al., 2011). The aim of the present study is to carry out a large scale investigation on the essential oil composition and the determination of P. scoparius chemotypes in Algeria which involved different regions and search relationships between populations and ecology. MATERIALS & METHODS Plant material

were collected during the flowering stage in October 2011. The air dried materials were subjected to hydro-distillation for 3 h using a clevenger apparatus type. Voucher specimens were deposited in the herbarium of the Department of Biology, Ferhat Abbas University, Algeria. Essential oil analysis The essential oils were analysed on a Hewlett-Packard gas chromatograph Model 5890, coupled to a Hewlett-Packard model 5971, equipped with a DB5 MS column (30 m X 0.25 mm; 0.25 μm), programming from 50°C (5 min) to 300°C at 5°C/min, with a 5 min hold. Helium was used as the carrier gas (1.0 mL/min); injection in split mode (1:30); injector and detector temperatures, 250 and 280°C, respectively. The mass spectrometer worked in EI mode at 70 eV; electron multiplier, 2500 V; ion source temperature, 180°C; MS data were acquired in the scan mode in the m/z range 33–450. The identification of the components was based on comparison of their mass spectra with those of NIST mass spectral library (Masada, 1976; NIST, 2002) and those described by (Adams, 2001) as well as on comparison of their retention indices either with those of authentic compounds or with literature values (Adams, 2001). Statistical analysis Data were first subjected to Principal Components Analysis (PCA) to examine the relationships among the terpenes compounds and identify the possible structure of the population. Cluster analysis (UPGMA) was carried out on the original variables and on the Manhattan distance matrix to seek for hierarchical associations among the populations. The cluster analyses were carried out using STATISTICA 9 software. RESULTS

Pituranthos scoparius is collected from four localities in eastern Algeria, Boussâada (M’sila), T’Kout (Batna), ElKantra and Mechouneche (Biskra) (Figure 1). Aerial parts

The extract of the aerial parts of P. scoparius gave yellow-green oil with a characteristic odour and an average return

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Global J Res. Med. Plants & Indigen. Med. | Volume 2, Issue 1 | January 2013 | 1–11

(1.16%) (v/w). The greater yield of essential oil was (2.29%) found in the population of Elkantra and the minimum (0.47%) in T’kout population. The essential oils of P. scoparius

were analyzed by GC and GC-MS. The compounds identified in these oils and their relative proportions are listed in order of their elution (Table 2).

Table 1: Major components, in essential oil, of Pituranthos scoparius growing in different areas of Algeria Authors

Smaili et al., 2011

Localities

M’Sila

Populations compounds

Vérité et al., 2004

Gourine et al., 2011 Djelfa

Laghouat

Ghardaïa

1

2

3

4

5

6

7

8

9

10

11

12

13

14

α-pinene

17.4

23.7

26.7

27.0

35.8

35.1

8.1

11.2

4.7

8.4

5.5

10.4

4.4

6.8

Sabinene

7.5

1.1

0.9

4.6

2.2

1.1

0.2

0.2

0.4

0.3

0.4

0.3

β-pinene

3.7

5.3

4.1

1.7

5.2

5.2

0.5

2.9

1.2

0.5

2.0

1.2

1.7

3.8

Myrcene

1.7

0.6

1.2

0.9

1.3

1.1

0.7

0.6

0.3

0.6

0.6

0.9

0.6

α-Phellandrene

15.6

1.2

1.9

0.8

1.0

2.0

4.6

6.4

2.1

0.7

4.1

1.7

3.6

7.1

Limonene

0.9

7.8

4.0

7.0

30

66.5

49.5

32.7

45

37.2

58.3

34.4

9.8

β-phellandrene

6.1

0.9

0.6

0.6

0.7

0.6

2.6

0.8

2.0

0.4

1.9

-

β-ocimene-Z

4.7

3.2

3.8

1.2

γ-terpinene

1.0

2.3

0.9

2.0

0.1

2.0

1.3

0.9

0.4

0.8

0.3

Terpinene-4-ol

0.9

0.6

0.6

1.1

0.4

0.1

0.2

0.4

0.2

0.4

p-cymen-8-ol

6.7

2.0

2.1

1.0

1.6

0.5

1.8

0.7

0.6

2.4

1.0

2.4

Bornyle acetate

9.6

9.5

3.0

0.1

0.3

Bicyclo-germacrene

0.6

0.4

0.3

0.4

0.6

2.0

1.3

0.8

2.3

0.7

2.7

Myristicin

24.1

18.2

2.5

0

1.9

5.2

12.4

2.6

25.1

0.4

31.1

7.2

Dill-apiole

3.4

1.4

30.3

47.3

25.7

9.9

11.3

1.03

22.6

23

0.9

0.4

1.1

1.1

β-eudesmol

0.3

0.3

0.8

4.1

Germacrene-D

4.0

3.3

1.1

2.5

1.3

1.6

2.1

3.8

4.3

2.8

5.9

6.3

5.3

12.7

γ cadinene

1.4

0.5

0.6

0.6

0.5

0.5

1.2

1.3

1.0

1.3

2.0

0.9

2.3

Methyl eugenol

1.7

0.7

0.2

0.1

0.3

0.6

1.4

2.7

1.9

5.9

α-thujene

2.1

0.4

β-ocimene-E

1.9

4.2

Spathulenol

4.5

Camphene

2.1

2.4

1.2

2.3

Δ -carene

1.1

1.4

1.0

0.2

Linalool

1.94

0.2

0.1

0.6

γ cadinol

0.4

0.9

3.6

3.1

0.2

t-muurolol

1.6

0.7

0.2

0.2

1.0

0.4

0.5

0.7

1.7

0.2

3.6

β-caryophyllene

1.7

Bicyclo-elemene

1.1

3

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Boussaada

T’Kout

Elkantra

Mechouneche

Compounds

Boussaada

T’Kout

Elkantra

Mechouneche

Table 2: Chemical composition of essential oils of Pituranthos scoparius

Yield v/w

0.85

0.47

2.29

1.04

Yield v/w

0.85

0.47

2.29

1.04

Number of compounds

51

47

40

28

Number of compounds

51

47

40

28

Total %

99.6

98.5

75.9

85.1

Total %

99.6

98.5

75.9

85.1

Compounds

KI

KI

α-thujene

932

2.5

3.1

1.9

1.6

Phellandral

1274

0.2

1.8

α-pinene

939

16.4

23.3

8.3

13.4

Bornyle acetate

1279

0.1

1.8

Thuja-2,4(10)-Diene

948

0.2

0.2

0.1

Carvacrol

1299

1

0.1

0.1

Camphene

953

0.3

0.4

α-cubebene

1341

0.2

0.2

Verbenene

968

0.3

α-copaene

1370

0.7

0.2

0.1

Sabinene

976

14.8

18.6

18.9

24.8

β-bourbonnene

1378

2

0.6

β-pinene

979

2.8

5.1

3.6

4.5

β-cubebene

1381

0.3

0.2

0.1

Myrcene

990

1.3

0.9

1.5

Methyl eugenol

1394

0.5

0.3

0.3

α-Phellandrene

1005

0.7

2.2

3

2

β-caryophyllene

1412

0.9

0.5

0.1

α-terpinene

1014

5.8

7.7

3.7

3.8

β-copaene

1423

0.3

0.5

Para-cymene

1023

1

1.5

3.2

2.4

Sesquisabinene-A

1445

0.2

0.5

Limonene

1027

0.7

1.3

1.8

2.5

α-humulene

1449

4.7

0.2

β-phellandrene

1029

3.9

0.6

β-acoradiene

1466

0.8

β-ocimene-Z

1036

1

3.6

0.3

γ-murolene

1468

1.3

0.1

0.1

β-ocimene-E

1045

1.6

7.6

0.1

Germacrene-D

1475

0.4

0.2

0.9

γ-terpinene

1057

0.5

0.1

1.4

2.1

β-Selinene

1482

0.3

1.3

0.1

cis hydrate de sabinene

1069

0.3

0.7

α-Farnesene

1495

7.7

0.3

0.1

Terpinolene

1083

0.4

5.3

0.5

0.7

Bicyclogermacrene

1500

2.7

3-methyl-2(2-methylbutenyl) furane

1090

0.6

2.3

Germacrene-A

1509

0.1

0.1

trans hydrate de sabinene

1098

0.3

0.5

Δ3-Cadinene

1510

0.7

0.6

Menthatriene, 1,3,8-Para-

1109

0.1

Myristicin DB5-1691

1523

0.7

7.6

α-camphoaldehyde

1124

0.1

0.7

0.3

α-Calacorene

1533

1.3

Trans-pinocarveol

1140

0.4

0.3

0.2

0.2

β-Calacorene

1563

0.6

0.5

Sabinacetone (origan)

1155

2

0.2

0.1

Elemicin

1571

0.1

Pinocarvone

1159

0.8

0.3

Caryophyllene oxyde

1575

9.7

0.5

Terpinene-4-ol

1182

3.8

4.6

Spathulenol

1580

0.3

2

0.3

p-cymen-8-ol

1186

1.5

0.2

0.3

Salvial-4(14)-en-1-one

1590

2.8

0.3

0.1

0.2

Myrtenal

1192

0.7

1,5-epoxysalvial-4(14)-ene

1592

0.4

Estragole

1195

0.3

0.5

Humulene-1,2-Epoxyde

1601

0.8

0.2

Myrtenol

1200

0.4

0.3

Dill apiole

1610

0.9

0.4

6.6

16.8

Verbenone

1203

0.2

0.2

0.3

α-epi-muurolol

1636

0.4

0.8

0.7

Cuminaldehyde

1239

0.1

β-eudesmol

1648

1.4

0.2

0.4

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Global J Res. Med. Plants & Indigen. Med. | Volume 2, Issue 1 | January 2013 | 1–11

Sixty four compounds were identified, showing high amounts in monoterpenes. Some samples are rich in oxygenated compounds such as dill apiole. Fifty-one compounds were identified in Boussâada population representing 99.6% of the total oil, 47 compounds were identified in T’kout population representing 98.5%. 40 compounds were identified in Elkantra population; representing 75.9% and 28 compounds were identified in Mechouneche population, representing 85.1% of the total oil. The samples investigated present a large quantitative and qualitative variability. The main components identified are α-pinene (8.3– 23.3%), sabinene (14.8–24.8%), α-terpinene (3.7–7.7%), limonene (0.7–2.5%), α-thujene (1.6–3.1%), p-cymene (1–3.2%), β-pinene (2.8–5.1%) and dill apiole (0.4–16.8%).

between the 43 variables presented three axes comprising 87.28% of the total variation present in the original data. This analysis clustered populations in tree groups, but the separation of the populations is not clear. The ordination of population’s means obtained for the three vectors is shown in (figure 2).

The Boussaada population is individualized, compared to other populations, with high levels of caryophyllene epoxide (9.7%), α-farnesene (7.7%), α-humulene (4.7%), β-phellandrene (3.9), salvial-4(14)-en1-one (2.8%), sabinacetone (2%), βbourbonnene (2%), β-eudesmol (1.4%) and a rate average of the α-pinene (16.4%) and sabinene (14.8%). The population of T'kout (Batna) is rich in α-pinene (23.3%), sabinene (18.6%), α-terpinene (7.7%), α-ocimene-(E) (7.6%), terpinolene (5.3%), β-pinene (5.1%), 3methyl-2(2-methylbutenyl)-furan (2.3%), bicyclogermacrene (2.7%) and spathulenol (2%).

The third group formed by Batna and Biskra Populations, are characterized by the presence of the α-penene, sabinene, β-pinene, α-thujene and α-terpinene. It should be noted that this group has a high rate of sabinene, which is poorly represented in the rest of populations. We noted that the first group is well separated from the other groups, while the separation of groups (2 and 3) is less clear. All populations of this species have showed high αpinene, β-pinene and dill apiole levels and low quantitative variations in all their components, the rest of the components present a quantitative and qualitative variability. The terpenoids variability reflects the heterogeneity of the genetic structure of Pituranthos scoparius. Genetic analyses were carried out using terpenoids including some compounds that have been shown in other species to be under the control of single locus with two alleles.

The two populations of Biskra (Elkantra and Mechouneche) have the same major components with similar rates. In Elkantra population we noted the presence of compounds that are absent in Mechouneche population (α-phellandrene (0.6%), α-ocimene(Z) (3.6%), estragole (0.5%), germacrene-D (0.9 %), myricticin (7.6%) and caryophyllene oxide (5%). The dill-apiole is present with a rate of 6.6% against 16.8% in the population of Mechouneche. In order to investigate the differences between the essential oils samples of the different regions, we have chosen the cluster analysis using the principal component analysis (PCA) performed on the correlations

The result showed the existence of three groups. The first group consists of Ghardaïa populations, studied by (Hammiche and Maiza, 2006). This set is characterized by limonene, myristicin, α-phellandrene and germacrene-D. The second group, formed by the populations in northern sampling area, M’sila, Djelfa, Laghouat and Ghardaia studied by (Smaili et al., 2011; Gourine et al., 2011). The group is very rich in α-pinene, myristicin.

The dendrogram based on UPGMA clustring (Manhattan distance), shows the presence of two group (figure 3), that confirms result obtained from ACP analyses. The first group (Group I) formed by populations of Ghardaia. This group is individualized by the presence of high levels of limonene (32.7-66.5%) and myristicin (0.4 to 31.1%). The rate of α-pinene closer to the

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subgroup III located to the north of the study area and separates the subgroup II located in the southern part. We also note the presence of germacrene-D which approximates group III. The second group is divided into three subgroups. The first is formed by the populations of Boussaada, T'kout, ElKantra and Mechouneche, located to the north-east of the study area, are rich in α-pinene, sabinene, αterpinene, β-pinene, dill-apiole and a low rate of limonene. The second subgroup formed by Djelfa and Laghouat populations, located in the middle of the transect study, is characterized by the presence of high levels of α-pinene (26.7 to 35.8%), β-pinene, dill-apiole and a low rate of limonene, myristicin and germacrene-D. the third subgroup. The third subgroup formed by the populations of M'sila and Djelfa, is characterized by an average rate of α-pinene, βpinene, a high rate of α-phellandrene, βocimene-Z, myristicin and germacrene-D.

DISCUSSION Our results are in agreement with those of the bibliography (Smaili et al., 2011; Gourine et al., 2011) who investigated the yield of essential oil from P. scoparius from M’Sila and Laghouar respectively. The compounds found in the Pituranthos scorparius populations generally resembled those previously reported to occur in Algeria (Hammiche and Maiza, 2006; Smaili et al., 2011; Gourine et al., 2011). In particular (α-pinene, sabinene, myrcene, αphellandrene, limonene, myristicin, dill-apiole and germacrene-D), in the sampling areas, the compounds concentrations present a variability. Aggregation of P. scoparius populations into small groups is an indication of terpenoids variability in this population. The diversity of the terpenoids content reflects the existence of considerable genetic variability (Forrest, 1980; Raddi and Sümer, 1999).

Figure 1: Populations of Pituranthos scoparius studied

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Global J Res. Med. Plants & Indigen. Med. | Volume 2, Issue 1 | January 2013 | 1–11

Factor 3: (9.57%)

Figure 2: Ordination of the first three principal axes of P. scoparius populations.

Djelfa 03

Ghardaia 03 Ghardaia 07 Ghardaia 05

Djelfa 02

Ghardaia 04

M'Sila Laghouat 01Djelfa 01

Ghardaia 01 Ghardaia 02

Ghardaia Laghouat08 02

Ghardaia 06 Elkantra Mechouneche Boussâada T ’kout

r cto

Fa 2: %

53 2.

(2 )

: (55.1

1 Factor

8%)

Figure 3: Dendrogram based on Manhattan similarity distance.

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Global J Res. Med. Plants & Indigen. Med. | Volume 2, Issue 1 | January 2013 | 1–11

The UPGMA analysis of terpene traits confirms this variability, and a clear conclusion can be transmitted between population’s geographic distribution and a composition of the essential oil of this species. This later observation confirms the potential occurrence of chemotypes in these essential oils and could explain the variability of the results reported for the same essential oil of P. scorpius. The limonene is present in individuals of Ghardaia, it is poorly represented or even absent in other populations studied. The rate of α-pinene deteriorates from north to south. The αphellandrene has a more or less homogeneous concentration. The diall-apiole in P. scoparius decrease from south to north, while germacrene-D is very low among populations of M'Sila, Batna and Biskra, its concentration increases from south to north.

CONCLUSION Pituranthos scoparius is rich in α-pinene, limonene, sabinene, dill-apiole and β-pinene. Our study and previous studies decortications’ on this species, we were able to detect the presence of α-pinene-dill apiole chemotype, located in the north of the study area (M'sila Djelfa and Laghouat). The north-eastern part surveyed (M'sila, Batna and Biskra) contains αpinene-sabinene chemotype. We note the decrease in the concentration of α-pinene from east to west. Finally Limonene chemotype is observed in the northern study area (Ghardaia). ACKNOWLEDGMENTS The works was supported by Algerian MESRS and Chemical Laboratory of carbohydrates Heterocyclic of Clermont Ferrant, France

REFERENCES Adams R P (2001). Identification of essential oil components by gas chromatography and quadrupole mass spectrometry. Allured Publ. Corp., Carol Stream IL. Benmekhbi L, Kabouche A, Kabouche Z, AitKaki B, Touzani R and Bruneau C (2008). Five glycosylated flavonoids from the antibacterial butanolic extract of Pituranthos scoparius. Chemistry of Natural Compounds. 44(5): 639–641. Boukef K, Souissi H R and Ballansard G (1982). Contribution à l’étude des plantes utilisées en médicine traditionnelle tunisienne. Plants. Med. Phyto. 16: 260–279. Boutaghane N, Nacer A, Kabouche Z and AitKaki B (2004). Comparative antibacterial activities of the essential oils of stems and seeds of Pituranthos scoparius frome Algerian septentrional Sahara. Chemistry of Natural Compounds. 40(6): 606–607.

Dahia Mostefa, Laura Siracusa, Hocine Laouer and Giuseppe Ruberto (2009). Constituents of the Polar Extracts from Algerian Pituranthos scoparius. Natural Product Communications. 4(12): 191– 192. El Rhaffari U et Zaid A (2002). Pratique de la phytothérapie dans le sud-est du Maroc (Tafilalet). Un savoir empirique pour une pharmacopée rénovée, Origine des pharmacopées traditionnelles et élaboration des pharmacopées savantes, Des sources du savoir aux médicaments du Futur, pp. 293–316. Forrest G I (1980). Seasonal and spatial variation in cortical monoterpene composition of Sitka spuce oleoresin. Can J. For. Res. 10: 452–457. Gourine N, Merrad B, Yousfi M, Stocker P and Gaydou EM (2011). Chemical composition of the essential oil of Pituranthos scoparius. Nat Prod Commun. 6(8): 151–154.

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Haba H, Benkhaled M, Massiot G, Long C and Lavaud C (2004). Alkylated Isocoumarins from Pituranthos scoparius. Nat. Prod. Res. 18(5): 409– 411. Hammiche Victoria and Khadra Maiza (2006). Traditional medicine in Central Sahara: Pharmacopoeia of Tassili N’ajjer. Journal of Ethnopharmacology. 105: 358–367. Krifa

Mounira, Tahar Gharad, Rabiaa Haoualab (2011). Biological activities of essential oil, aqueous and organic extracts of Pituranthos tortuosus (Coss.) Maire. Scientia Horticulturae. 128: 61–67.

Masada Y. (1976). Analysis of Essential Oils by Gas Chromatography and Mass Spectrometry, Halsted, Nueva York, 334. NIST (2002). Mass Spectral Search Program for the NIST/EPA/NIH Mass Spectral Library, vers. 2.0. fiveash data, USA. Ozenda P (2004). Flore du Sahara, CNRS, Paris, 663 pp. Quézel P et Santa S (1962-1963). Nouvelle flore de l’Algérie et des régions désertiques méridionales. CNRS, Paris, 2 tomes. Source of Support: Nil

Raddi S and Sümer S (1999). Genetic diversity in naturel Cupressus Sempervirens L. populations in Turkey. Biochem. Syst. Ecol. 27: 799–814. Sharaby A, Abdel-Rahman H and Moawad S (2009). Biological effects of some natural and chemical compounds on the potato tuber moth, Phthorimaea operculella Zell. (Lepidoptera:Gelechiidae). Saudi Journal of Biological Sciences. 16: 1– 9. Smaili

Tahar, Zellagui Amar, Gherraf Noureddine, Flamini Guido and Cioni Pier Luigi (2011). Essential oil content of the flowers of Pituranthos scoparius in Algeria. International Journal of Phytomedicines and Related Industries. 3(2): 177–179.

Vérité P, Nacer A, Kabouche Z, Seguin E (2004). Composition of seeds and stems essential oils of Pituranthos scoparuis (Coss & Dur). Flavour Frag. J. 19: 562–564. Yangui T, Bouaziz M, Dhouib A and Sayadi S (2008). Potential use of Tunisian Pituranthos chloranthus essential oils as a natural disinfectant. The Society for Applied Microbiology, Letters in Applied Microbiology. 48: 112–117. Conflict of Interest: None Declared

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Global J Res. Med. Plants & Indigen. Med. | Volume 2, Issue 1 | January 2013 | 10–22 ISSN 2277-4289 | www.gjrmi.com | International, Peer reviewed, Open access, Monthly Online Journal

Research article MEDICINAL PLANTS USED BY KABIRAJ OF FOURTEEN VILLAGES IN JHENAIDAH DISTRICT, BANGLADESH Masum Gazi Z H1, Sharkar Priyanka2, Nayeem Md. Abu3, Rahman M Mafizur4, Rahman M Mizanur5* 1, 2, 3, 4, 5

Department of Biotechnology and Genetic Engineering, Islamic University, Kushtia-7003, Bangladesh. *Corresponding author: Email: mmrahmanbtg79@hotmail.com; Phone: +8807162201-6 ext 2306; Fax: + 887154400; Cell: +8801712562730

Received: 06/12/2012; Revised: 05/01/2013; Accepted: 07/01/2013

ABSTRACT Medicinal plants use simple formulations of whole plant or plant parts from medicinal plants for treatment of various ailments. The objectives of this study were to identify native medicinal plants, their uses, type of conservation measures and evaluation of their contribution to income generation of participating farmers and Kabiraj. Data were collected from the beneficiaries’ local people and Kabiraj through direct interview, group discussion and visit to the gardens of medicinal plants from 14 villages Jhenaidah district. A total of 121 medicinal plant species belonging to 64 families have been identified. The most frequently used families are Apocynaceae with 7 and Asteraceae with 6 species followed by Moraceae, and Solanaceae with 5 species. Among the selected species the maximum contribution was recorded for herbs with 48 species (40%) followed by the trees with 39 species (32%), shrubs with 25 species (21%) and the climbers with 9 species (7%). These plant species are utilized by local peoples against various a liver complaints, digestive problems, jaundice, asthma, bronchitis, anemia, piles, mental disorder, cancer, general weakness, diabetes, gonorrhoea, sexual disorders, syphilis, leprosy and insect-bites. It was noted that if proper marketing facility could be ensured, there would be greater scope of income generation and better chances of biodiversity conservation through regular cultivation of these native medicinal plants. This survey signifies ethno-medicinal values of plant species that occur in Jhenaidah district. KEY WORDS: Medicinal plants, Kavirajas, ethno-medicinal, Jhenaidah district.

Cite this article: Masum Gazi Z H, Sharkar P, Nayeem Md. Abu, Rahman M, Rahman M. M (2013), Medicinal Plants Used by Kabiraj of Fourteen Villages in Jhenaidah District, Bangladesh, Global J Res. Med. Plants & Indigen. Med., Volume 2(1): 10–22

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Global J Res. Med. Plants & Indigen. Med. | Volume 2, Issue 1 | January 2013 | 10–22

INTRODUCTION Medicinal plants serve as important therapeutic agents as well as valuable raw materials for manufacturing numerous traditional and modern medicines. They offer alternative remedies with tremendous opportunities to generate income, employment and foreign exchange for developing countries (Rawat and Uniyal, 2004). Many traditional healing herbs and their parts have been shown to have medicinal value and can be used to prevent, alleviate or cure several human diseases (Dhar et al., 1999). It is estimated that 70–80% of people worldwide rely chiefly on traditional, largely herbal medicine to meet their primary healthcare needs (Farnsworth and Soejarto, 1991; Pei Shengji, 2001). It has further been observed that a number of modern pharmaceuticals have been derived from plants used by indigenous people (Balick and Cox, 1996; Rahmatullah et al., 2010). Important modern drugs that have been derived from observations of traditional curing methods of indigenous people include aspirin, atropine, ephedrine, digoxin, morphine, quinine, reserpine and tubocurarine (Gilani and Rahman, 2005; Rahmatulla et al., 2010). Out of the 350,000 plant species identified so far, about 35,000 (some estimate up to 70,000) are used worldwide for medicinal purposes and less than about 0.5% of these have been chemically investigated (Comeran, 1996). In Bangladesh, medicinal plants are found to grow naturally in the forest, bushes and marginal land along the canal and in other places and, a long tradition of indigenous herbal medicinal systems, based on the rich local plant diversity, are considered as very important component of the primary health care system. Bangladesh has over 5,000 floral species and many of them are in use by the Kabirajas in folk medicine. The previous ethnomedicinal studies conducted among folk and tribal medicinal practitioners of the country have noticed considerable variation between the medicinal plants selected by different Kabirajas for treatment of a given ailment (Nawaz et al., 2009; Hasan et al., 2010; Hossan

et al., 2010; Mollik et al., 2010a; Rahmatullah et al., 2010a; Jahan et al., 2011). These variations exist even between Kavirajas practicing in adjoining villages with identical flora. There are over 87,000 villages in Bangladesh and most villages have one or two practicing Kabirajas. The inescapable conclusion is that if one has to obtain a comprehensive picture of the medicinal plants used by the folk medicinal practitioners, then as many Kavirajas as possible need to be interviewed to learn about the diseases treated, medicinal plants used, and the formulations of their administration. Knowledge of medicinal plant used by the Kavirajas of Bangladesh can be a good source for further scientific studies in the quest for better drugs from the medicinal plants used and with lesser side-effects (Rahmatulla et al., 2010). The objective of the present study was to conduct an ethnomedicinal survey among the Kavirajas of fourteen villages of Jhenaidah district, which lies in the South-western region of Bangladesh. METHODS AND MATERIALS Study Area The study was conducted in Jhenaidah district, the south-western part of Bangladesh. The study area is in Table 1 covers fourteen villages in Jhenaidah Sadar and Harinakundu upazilas. It was observed that Kavirajas of that area often collect their raw materials from these villages. Albeit this region is found to be a rich source of a variety of medicinal plants, no systematic study conducted yet. Time and procedure of data collection Data for this study were collected through personal interview by the researchers themselves during 29th April to 20th June 2012 using questionnaires prepared earlier. The collection of data through interviews of Kavirajas and local people were conducted with the help of a semi-structured questionnaire and the guided field-walk method of Martin (1995) and Maundu (1995). Briefly, in this method, the Kavirajas and others took the interviewers on field-walks to Jhenaidah where

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Global J Res. Med. Plants & Indigen. Med. | Volume 2, Issue 1 | January 2013 | 10–22

they usually collected their medicinal plants, pointed out the plants and described their uses. All provided information was double-checked with them in later evening sessions. Excellent cooperation was obtained from all the respondents during data collection.

Identification of plant spices The medicinal plants were identified with the help of National Herbarium, Mirpur, Dhaka- 1216, Bangladesh, where the voucher specimen has been deposited.

Table 1 Studied area of different villages under Jhenaidah district SL No.

Villages

Unions

Upazila

1 2 3 4 5 6 7 8 9 10 11 12 13 14

Rajapur Kulfadanga Kisnopur Rasnagar Nagarpathan Mohespur Kusiarchar Kutirhat Charpara Porahati Tola Raghunathpur Mandera Horispur

Paglakanai Mahajpur Ganna Kumabarai Kumabarai Kumabarai Kanchanpur Kanchanpur Raghunathpur Raghunathpur Raghunathpur Raghunathpur Raghunathpur Bhayna

JhenaidahSadar

RESULTS AND DISSCUSION Present status of medicinal plant species grown in study area A total of 121 medicinal plants belonging to 62 families were documented from the study area. The documented medicinal plants and their ethno-medicinal uses along with common name have been summarized (Table 2). Major

Harinakunda

families contributing plant species towards treatment of various diseases included, Apocynaceae, Combretaceae, Euphorbiaceae, Fabaceae, Moraceae, Piperaceae, and Poaceae families (Table 3). Among the selected species ethno-medicinally, the maximum contribution was recorded for herbs with 48 species (40%) followed by the trees with 39 species (32%), shrubs with 25 species (21%) and the climbers with 9 species 7% (Fig 1).

Fig 1 Habit pattern of medicinal plants in the study area

7% Herb 21%

40%

Tree Shrub Climber

32%

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Global J Res. Med. Plants & Indigen. Med. | Volume 2, Issue 1 | January 2013 | 10–22

Table 2 Medicinal plants used for treatment of various ailments by Kavirajas of fourteen villages surveyed in Jhenaidha district, Bangladesh. Serial

Scientific Name

Family Name

Local Name

Distri bution

Part used

Medicinal Uses

No. 1

Aloe barbadensis Mill.

Aloaceae

Gheetokumari

Herb

Leaf

2

Aegle marmelos L.

Rutaceae

Bel

Tree

Fruit

Leaf pulp - lung disease, stomach disorders, skin burns. Fruit pulp-Diarrhoea, dysentery.

3

Acacia catechu (L. f.)

Fabaceae,

Khayar

Tree

Bark

4

Ageratum conyzoides L.

Asteraceae

Fulkuri

Herb

Whole plant

5

Andrographis paniculata (Burm. F.)

Acanthaceae

Kalomegh

Shrub

Whole plant

6

Acacia nilotica L.

Mimosaceae

Babla

Tree

Whole plant

7

Areca catechu L.

Arecaceae

Supari

Tree

Root

Bark powder -intestinal pain. Bark paste - skin diseases Leaf - boils as a poultice. Leaf and stem - skin disease. Flower buds cure cancerous growth Used in liver complaints, constipation, cholera, dysentery, diabetes. Bark-cough, bronchitis , gumsexual debility ,leaf-eucoderma, gonorrhoea Root paste-Toothache.

8

Abutilon indicum L.

Malvaceae

Potari

Shrub

9

Averrhoa carambola L.

Oxalidaceae

Kamranga

Tree

Whole plant Fruit

Whole plant - fever, cough, piles, stones in bladder. Fruit pulp - Cold, cough, dandruff.

10

Moraceae

Kathal

Tree

Gum

11

Artocarpus heterophyllus Lam. Asparagus racemosus Willd.

Liliaceae

Satamuli

Herb

Root

12

Alstonia scholaris L.

Apocynaceae

Chatim

Tree

Bark

13

Anthocephalus chinensis (Lam.)

Rubiaceae

Kodom

Tree

Leaf

Gum - dry cracked heels, hemorrhoids. Tuberous roots are used as aphrodisiac, alterative, tonic, and demulcent, diuretic. Bark - swellings of mouth, scurvy, ulcer. Leaf juice - fever.

14

Azadirachta indica A. Juss

Meliaceae

Neem

Tree

Whole plant

15

Adhatoda vasica Nees.

Acanthaceae

Basak,

Shrub

Whole plant

16

Achyranthes aspera L.

Amaranthaceae

Apang

Herb

Whole plant

17

Abroma augusta L. f.

Sterculiaceae

Ulotkombol

Tree

Bark

18

Bacopa monnieri (L.) Pennel

Scorphulariace

Braham,

Herb

Whole plant

19

Boerhaavia diffusa L.

Nyctaginaceae

Punarnav, Gandhaprna

Herb

Whole plant

20

Borassus flabellifer L.

Arecaceae

Tal

Plam tree

Fruit

21

Bambusa arundinacea (Retz.) Willd

Poaceae

Bans

Tree

Whole plant

stem-blood, leucoderma leafcough, cold, roots- joint pains

22

Blumeala cera (Burn .f.) DC.

Asteraceae

Shealmoti

Herb

Whole plant

Leaf juice-bleeding piles, bronchitis; Roots–cholera. Rhizomes -dysentery

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Various parts of the plant are used in inflammation of gums, gingivitis, sores, fever, spleen complaints, tumors, smallpox. The root, bark and leaves are useful in cough, asthma. Whole plant used in coughs, pneumonia, piles, kidney stone and colic. Bark -menstrual problems, urinary troubles. Plant juice is given orally as diuretic, cardiac tonic and memory enhancer. Root and leaf juice is effective as diuretic in anasarca and dropsy. Leaves and roots are also useful in jaundice, anaemia, ascites ophthalmia, gonorrhea. Fruit juice - coughs and pulmonary affection.


Global J Res. Med. Plants & Indigen. Med. | Volume 2, Issue 1 | January 2013 | 10–22 23

Brassica nigra (L.) Koch.

Brassicacee

KaloSarisha

Herb

Seeds

24

Buettneria pilosa Roxb

Sterculiaceae

Harjora

Climber

Stem

25

Borreria articularis (L. F.) F. N. Will.

Rubiaceae

Madnabata

Herb

Whole plant

26

Bombax ceiba L.

Bombacaceae,

Shimul

Tree

Root

27

Apocynaceae

Noyontara

Herb

Leaf

28

Catharanthus roseus (L.) G. Don Centella asiatica (L)

Apiaceae,

Thankoni

Herb

Whole plant

29

Calotropis gigantea (L) W.T

Apocynaceae

Akand,

Shrub

Whole plant

30

Canna indica L.

Cannaceae

Kalaboti.

Herb

Whole plant

31

Carica papaya L.

Caricaceae

Papa

Shurb

Latex

32

Citrus limon (L.) Burm. f.

Rutaceae,

Labu

Shurb

Leaf

Leaves are chewed intestinal worms.

33

Capsicum frutescens L.

Solanaceae

KachaMorich

Herb

Fruit

Fruit -gastric problems, ulcer.

34

Convolvulus obscurus L.

Convolvulaceae

Ban kalmi

Climber

Leaf

Leaf juice - aphthous affection.

35

Coccini agrandis (L.) J. Voigt

Cucurbitaceae

Telakachu

Climber

Leaf

Leaf juice -hypertension, diabetes, indigestion.

36

Carissa carandas L.

Apocynaceae

Koromcha

Tree

Fruit

Fruit- Cold, cough

37

Cynodon dactylon (L.) Pers.

Poaceae,

Durba grass

Climbers

Whole plant Whole plant Tuber

Plant paste-cuts, wounds. Rootbleeding piles, indigestion. Plant juice-earache. Whole plant - bone fracture. Wound healing Tuber infusion, with sugar/salt is given orally in dysentery. Bark and leaf juice -Diarrhoea, dysentery and gonorrhea. Seeds, leaves and roots are used in insanity, fever with catarrh, diarrhoea, skin diseases and cerebra Sex stimulant

Cissus ouadrangularis L.

Vitaceae

Harjod

Shrub

38 39

Cyperus rotundus L.

Cyperaceae,

Mutha gas

Herb

40

Dalbergia sissoo Roxb

Fabaceae

Shissu

Tree

41

Datura metel L.

Solanaceae

Dhutura

Herb

42

Dillenia indica L.

Dilleniaceae

Chalta

Tree

Fruit

43

Dendrophthoe alcata (L. f) Etting.

Loranthaceae

Manda

Tree

Bark

44

Diplazium esculentum (Retz.)

Woodsiaceae

Dhekishak

shrub

Leaf

45

Euphorbia tirucalli L.

Euphorbiaceae

Latadaona,

Tree

Stem

Whole plant Whole plant

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Seeds are emetic; powdered seeds are used as vesicant and rubefacient Paste of stem used in fractured bones. Whole plant -inflammation of eye, diarrhoea, dysentery Root decoction is given as tonic, anti-dysenteric and in urinary troubles. Leaf -Cancer, diabetes, fungal infection Plant-in skin diseases, leprosy, and mental disorder. Leaf juice indigestion. Extracts of roots and leaves abdominal tumors, boils, syphilis, leprosy, skin diseases, piles, wonds and insect-bites. Root-fevers, dropsy. Seed juice relieves earaches. Rhizomeringworm. Fever, blood dysentery. to

expel

Bark -Skin diseases, asthma, menstrual Problems Fever. Leaves and stems are cooked and Eaten as vegetable. Stem is useful in gonorrhoea, whooping cough, asthma, d, leprosy, enlarged spleen, dyspepsia.


Global J Res. Med. Plants & Indigen. Med. | Volume 2, Issue 1 | January 2013 | 10–22 46

Zingiber officinale Roscoe

Zingiberaceae

Ada

Herb

Rhizome

Cough, cold, fever, indigestion, and constipation, bronchial infections.

47

Eclipta prostrata L.

Asteraceae

Kesraj

Herb

Leaf

48

Pontederiaceae

Kochuripana

Herb

49

Eichhornia crassipes (M.)Solms Euphorbia antiquorum L.

Euphorbiaceae

Bojbaran,

Shrub

Whole plant Latex

Leaf juice - hair fall, bronchitis, itching, night blindness. Plant juice - fever, goiter.

50

Enhydra fluctuans Lour.

Asteraceae

Helencha,

Herb

51

Foeniculum vulgare Mill.

Apiaceae

Muhori,

Herb

Whole plant Seeds

52

Ficus racemosa L.

Moraceae

Dumur

Shrub

Fruit

53

Ficus rumphii Blume.

Moraceae

Ashok, Pakur

Tree

Bark

54

Ficus hispida L .f.

Moraceae

Joggodumur

Tree

Fruit

Latex -rheumatism, toothache, nervine diseases, Whole plant-inflammation, biliousness; Seed-cures eye diseases, amenorrhoea, cough and asthma. Seed oil- hook-worms Jaundice, diabetes. Fruits are cooked with mustard oil and taken as vegetable Hematuria (passing of blood with urine).Juice obtained from crushed bark is taken with honey. Fruits are taken for diabetes

55

Ficus benghalensis L.

Moraceae

Bot

Tree

Gum

Kidney pain.

56

Flacourtia indica (Burm. f.) Merr.

Flacourtiaceae

Boichi,

Tree

Whole plant

57

Foeniculum vulgare Mill.

Apiaceae

Pan Muhori

Herb

Seed

58

Gloriosa superba L.

Liliaceae

Karihari

Climber

Rhizome

59

Glycosmis arborea (R.) A. DC. Gastrochilus longiflorua Wall. Heliotropium indicum L.

Rutaceae

Matmati

Herb

Zingiberaceae

Shoti

Herb

Whole plant Rhizome

Boraginaceae

Hatishur

Herb

Leaf

Fruits - jaundice and enlarged spleen. Bark -eczema. Root nephritic colic. Gum - cholera Seed -diseases of the spleen, kidney, amenorrhoea, cough and asthma. Rhizome paste –ringworm, skin diseases. Leaf juice –ascaris, liver complaints.. Roots - low fever, Rhizome - fore head to cure cataract. Leaf juice-Conjunctivitis.

Hemidesmus indicus (L.) R. Br. Hedyotis corymbosa (L.) Link.

Apocynaceae

Anantamul,

Shrub

Root

Rubiaceae

Titkuipata

Herb

Whole plant

64

Hibiscus

Malvaceae

Jaba

Shurb

Flower

65

Hyptis suaveolens (L.) Poit.

Lamiaceae

Tokma

Herb

Leaf

66

Ipomoea batatus (L.) Lamk.

Convolvulaceae

MistiAlu.

Herb

Whole plant

67

Ipomoea reptans Poir.

Convolvulaceae

KalmiShak.

Herb

Whole plant

68

Ixora cuneifolia Roxb.

Rubiaceae

Musea

Shrub

Leaf

69

Ixora coccinea L.

Rubiaceae

Rangan

Shurb

Whole plant

70

Ipomoea mauritiana Jacq.

Convolvulaceae

Vuikumra

Shrub

Leaf

71

Justicia adhatoda L.

Acanthaceae

Asuro

Shrub

Leaf

60 61 62 63

rosa sinensis L.

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Root-leucoderma, paralysis, cough, asthma Whole plant - jaundice, and liver complaints. Flower juice - acute dysentery, hair fall. Leaf paste - used in cancer and tumor Whole plant -low fever, skin diseases. Root - strangury and diarrhoea Leaf juice -arsenic. Leaves and seeds cooling. Buds -ringworm. Flower - inflamed eyes as a drop. The root juice -diarrhoea. leaf is given in fevers Root -fever, gonorrhoea, a dysentery; flower - bronchitis; leaf - diarrhoea Sexual disorders Leaf -treat asthma, cough. Juice of leaf is inhaled in bleeding nose.


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Kalanchoe pinnata (Lam.) Pers.

Crassulaceae

Patharkuchi,

Herb

Leaf

73

Crassulaceae

Heamkancha

Herb

Leaf

Anacardiaceae

Jiga

tree

Bark

75

Kalanchoe pinnata (Lam.) Pers. Lannea coromandelica (Houtt.) Merr. Linumusi tatissimum L.

Linaceae

Tishi

Herb

seed

76

Lawsonia inermis L.

Lythraceae

Mehedi,

Shrub

Leaf

77

Lamiaceae

Dulfi.

Herb

78

Leucas aspera (Willd.) Link. Lantana aculeata L.

Verbenaceae

Chotra

Shrub

Whole plant Leaf

79

Mimosa pudica L.

Fabaceae,

lajjaboti

Herb

80

Mimusop selengi L.

Sapotaceae

Bokul

Tree

Whole plant Bark

81

Moringa oleifera Lam.

Moringaceae

Sajnagach

Tree

Leaf

Leaf juice-Diabetes, hypertension.

82

Musa sapientum L.

Musaceae

kola

Herb

Leaf

83

Menispermum cordifolium Willd.

Menispermacea e

Gulancha

Climber

Whole plant

Diarrhea, diabetes, blood purifier, coughs, dysentery, insect bite. Whole plant - pimples, gonorrhoea, cough, fever, skin affections

84

Momordica charantia L.

Cucurbitaceae

Usta

climbers

Fruit

85

Mesua nagassarium (Burm. F.) Kosterm.

Clusiaceae

Nageshwar

Herb

Flower

Diabetes, cancer, headache, skin Disorder. Fever.

86

Mangifera indica L.

Anacardiaceae

Aam

Tree

Leaf

Diarrhea, headache

87

Nerium indicum Mill.

Apocynaceae

Korobi

Shrub

Whole plant

88

Nicotiana tabacum

Solanaceae

Herb

Leaf

89

Nigelia sativa L.

Ranunculacee

Tamak, Tobacco. Kalojira,

Herb

Seeds

90

Nyctanthes arbortristis L.

Oleaceae

Shefali

Tree

Whole plant

91

Nymphaea nouchali. Burm. F.

Nymphaeaceae

Shapla

Herb

Whole plant

92

Ocimum tenuiflorum L.

Lamiaceae.

KaloTulsi

Herb

Whole plant

93

Opuntia elatior Mill.

Cactaceae

Phanimansa

Shrub

94

Oxalis corniculata L.

Oxalidaceae

Amrul

Herb

95

Piper betel L.

Piperaceae

Pan, Betel-leaf,

Climbers

Whole plant Whole plant Leaf

Leaf - itch, .flowers- headache, scabies. Root and root barkcancer, ulcers, Roots and leaf-skin diseases and leprosy Used for the treatment of rheumatic swellings, skin diseases. Purgative drugs; good in cough, jaundice and piles. Leaves - rheumatism. Bark -cures bronchitis. Flowers -lessen inflammation. Seeds -skin diseases. Flower- cough, bile, vomiting, worms ; filament- pile; seed cutaneous disease plant is given in fever, cough, cold, headache, nausea and skin diseases. Whole plant juice - whooping cough, ashma and gonorrhea Whole plant juice – fever, anaemia.

96

Phyllanthus acidus L.

Euphorbiaceae

Arboroi, Harbori, .

Tree

Fruit

74

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Leaf -bronchial affections, kidney stones, blood dysentery, gout and jaundice. Leaf juce-Cold, polyuria (excessive urination), Abdominal pain. Bark juice–Diabetes. Seed and seed oil - burns and boils. Seed poultice - rheumatic and swellings. The leaves are emetic, diuretic given in jaundice. Plants -snake insecticide. Leaf juice -psoriasis, chronic skin. Leaf juice - measles, malaria and tetanus. Leaf paste is applied on hydrocele. Leaf and root - piles. Coughs, toothache acidity,

Leaf juce-Sexual problems, indigestion, colic, diarrhea, headache. Used in bronchitis, biliousness, urinary concretions and piles; useful in thirst, vomiting and constipation.


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Phyllanthus emblica L.

Euphorbiaceae.

Amaloki

Tree

Fruit

98

Physalis micrantha link.

Solanaceae

Phutka

Herb

Fruit

99

Phoenix sylvestris L.

Arecaceae

Khajur

Juice

100

Polygonum orientale L.

Polygonaceae

Bishkatali

Palm tree Herb

101

Punicagra natum L.

Lythraceae

Dalim

102

Piper nigrum L.

Piperaceae

103

Psidium guyava L.

104

Fruits decoction is given orally in shore throat and as tonic. Fruit -gonorrhea and spleen disorder Juice – gonorrhea, cough, fever. Whole plant - healing wounds.

Shrub

Whole plant Bark

Golmorich

Shrub

Fruit

Myrtaceae

Peyara

Tree

Whole plant

Paederia foetida L.

Rubiaceae

Gondhovadal,

Herb

Leaf

105

Rauvolfia serpentina Benth.exKurz

Apocynaceae,

Sarpagandha

Shrub

Whole plant

106

Ricinus communis L.

Euphorbiaceae

Bherenda

Shrub

107

Santalum album L.

Santalaceae

Shetchondon

Tree

Whole plant Stem

Cold, jaundice, Rabies, gastric problems, ulcer, dysentery. Fruits-diarrhea and dysentery , Young leaf extract -antibacterial and antifungal properties Indigestion, gout and Urinary stone. Reduce high blood pressure. Root infusion is given orally in intestinal disorders. Leaf - galactagogue, headache. Seeds paste- counter irritant. Dysentery. Beauty

108

Shorea robusta C.F. Gaertn.,

Dipterocarpacea e,

Shal

Tree

Bark,

Bark juice is used as eardrop in earache.

109

Smilax zeylanica L.

Smilacaceae

Kumrakhata

Climbers

Whole plant

Sexual problems

110

Solanum violaceum Orteg.

Solanaceae

Tit baegun

Herb

Fruit

Snake bite, itches

111

Saccharum officinarum L.

Poaceae

Kushul, Aakh

Herb

Stem

Indigestion. Jaundice

112

Syzygium cumini (L.) Skeels

Myrtaceae

Jam

Tree

Whole plant

113

Tamarindus indica L.

Caesalpiniaceae

Tetul,

Tree

Fruit

114

Terminalia arjuna (Roxb. ex DC.) Wight &Arn.

Combretaceae

Arjun

Tree

Bark

Bark, Leaf and seed powder is given orally to reduce sugar level in blood Used in asthma, fever, and topically for loss of sensation in paralysis. Low sperm count, dysentery, heart Disease.

115

Terminalia belerica (Gaertn.) Roxb.

Combretaceae

Bohera

Tree

Whole plant

116

Terminalia chebula Retz.

Combretaceae.

Horitoki

Tree

Whole plant

117

Terminalia catappa L.

Combretaceae.

Kath badam

Tree

Leaf

118

Typhonium trilobatum (L.) Schott. Vitex negundo L.

Araceae

Ghetkol

Herb

Vitaceae,

Nishindagach

Shrub

Whole plant Leaf

Wedelia chinensis (O.) Merr. Xanthium indicum Koenig. L.

Asteraceae

Kesraj

Herb

Leaf

Asteraceae

Ghagra

Herb

Whole plant

119

120 121

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Bark juice-dysentery.

Bark juice-cut, wounds, and skin diseases. Fruits powder- cough, cold, respiratory problems. Bark - urinary problems. Fruits cough, cold, respiratory troubles, fever. Leaf juice-Skin disorder Whole plant - stomach complaints Leaf juice is given orally in cough, cold, sinusitis, fever, stomach problems. Leaf juice - orally in cough, cold; bark paste - applied on boils Roots-cancer. Fruits –cooling, demulcent. Seeds-swelling. Leaf malaria


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Table 3: Family of the medicinal plant species Family Acanthaceae Aloaceae Amaranthaceae Anacardiaceae Annonaceae Apocynaceae Araceae Arecaceae Apiaceae Vitaceae Woodsiaceae Asteraceae Brassicaceae Bombacaceae Boraginaceae Caesalpiniaceae

Plants no 3 1 1 2 1 7 2 3 2 2 1 6 1 1 1 1

Family Cactaceae Caricaceae Combretaceae Convolvulaceae Crassulaceae Cucurbitaceae Cyperaceae Clusiaceae Cannaceae Dilleniaceae Dipterocarpaceae Euphorbiaceae Fabaceae Flacourtiaceae Lamiaceae Liliaceae

Plants no 1 1 4 4 1 2 1 1 1 1 1 5 3 1 3 2

Sources of medicinal plant The study was reported in Table 4 that 58.6% of the respondents collected different medicinal plants species from fallow land and road side. This is naturally grown. On the other hand, 20.7%, 13.8%, and 6.7% of the respondents collected medicinal plants from local market, vesoj nursery sources and neighbor’s house, respectively. Medicinal value of different plant species Among the selected species, parts used wise contribution was maximum for whole plant with 46 species (38%) followed by the leaf with 26 species (22%), fruit with 15 species (12%), bark with 10 species (8%), seeds with 5 species (4%), root and stem with 4 species (3%), rhizome with 3 species (2%), gum, latex and flower with 2 species (2%), juice and tuber with 1 species 1% respectively (Fig 2). Ornamental with 25 species (21%), fruit with 23 species (19%) and timber with 22 species (18%) were documented (Fig 3). Use of medicinal plants against different diseases The medicinal plants were reported to be effective against diarrhea, cough and cold, skin

Family Linaceae Lythraceae Loranthaceae Malvaceae Menispermaceae Meliaceae Mimosaceae Moraceae Moringaceae Musaceae Myrtaceae Nymphaeaceae Nyctaginaceae Oleaceae Oxalidaceae Piperaceae

Plants no 1 2 1 2 1 1 1 5 1 1 2 1 1 1 2 2

Family Polygonaceae Poaceae Pontederiaceae Ranunculacee Rubiaceae Rutaceae Sapotaceae Scorphulariaceae Solanaceae Sterculiaceae Santalaceae Smilacaceae Verbenaceae Zingiberaceae

Plants no 1 3 1 1 6 3 1 2 5 1 1 1 1 2

diseases, cuts and wounds, joint pain, headache, consumption, eye disorders, antidote for harmful insect bites, stomach disorders, urinary troubles, liver complaints, digestive problems, jaundice, asthma, bronchitis, inflammations, anemia, piles, mental disorder, abdominal pain, bone fracture, paralysis, impotency, indigestion, cancer, general weakness, skin burns, diabetes, fungal infection, gonorrhoea, gastric problems, sexual disorders, syphilis, leprosy, wounds and insectbites by the responding Kavirajas and local inhabitants. However, various parts from the same plant were observed to be used to treat different diseases. A single plant part also would be used for treatment of multiple diseases. For example, Seeds of Datura metel L. are used to treat skin rashes, ulcers, bronchitis, jaundice and diabetes (Khaton and Shaik, 2012).To cite one instance of each, the bark of Lannea coromandelica was used for treatment of diabetes. The barks of Mangifera indica were used for treatment of diarrhea, while young leaves of the same plant were used for treatment of headache. The leaves of Aloe barbadensis were used for treatment of two highly different ailments like dysuria and constipation. Paste of leaves of Glycosmis arborea with ginger is used in eczema and skin affections. Leaf juice of Nyctanthes arbortristis with honey the juice is given in chronic

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fever. The anti-diabetic activities of whole plants or plant parts of Catharanthus roseus, Ficus racemosa, Moringa oleifera, Musa sapientum, and Syzygium cumini have also been reported which goes very well with previous surveys conducted by Rasineni et al., 2010; Islam et al., 2009; Hafizur et al., 2011;

Sangsuwan et al., 2004; Ahmed and Urooj, 2010; Jaiswal et al., 2009; Adewoye et al., 2009; Pandey and Khan, 2002. The scientific validation of medicinal plant usage by the Kavirajas that could be helpful to modern science for extensive investigation of the plants used.

Table 4 Sources of planting materials of medicinal plant species Sources

Respondent No.

Fallow land and road side Local market Vesojnursery Neighbors house

17 6 4 2

Percentage (%) 58.6 20.7 13.8 6.7

Rank 1 2 3 4

Fig 2 Useable parts of medicinal plant in this area 3%

2% 2% 2% 1% 1% 2%

Whole plant Leaf

3%

Fruit 4%

38%

Bark Seed

8%

Root Stem 12%

Rhizome 22%

Gum Latex

Fig 3 Different medicinal plant species in this area

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Global J Res. Med. Plants & Indigen. Med. | Volume 2, Issue 1 | January 2013 | 10–22

18%

21%

Ornamental Fruit Timber

19%

Threatened medicinal plant species It is identified that 28 medicinal plants which are under threat now in Bangladesh. In the study area, we found amloki, arjun, helencha, mander, shefali, lajjaboti, kathbadam hatishur and bel are likely to be threatened. CONCLUSIONS There were many important medicinal plant species available in the study area and these could be promising source of manufacturing modern medicine in Bangladesh and source of income generation to the rural households. The

common people were found to encourage using medicinal plants for ailments of common and frequently caused illnesses, especially for fever, cough, pain, catarrh etc. This was mainly because of awareness created among the farmers on the value of medicinal plants for their livelihood and its impact on biodiversity conservation. Finally, it can be concluded that timely availability of native medicinal plant species, development of rural and community based resources could be useful for restoring the eco-biodiversity processes and for generating income for resource poor farmers and village practitioners.

REFERENCES Adewoye EO, Taiwo VO, Olayioye FA (2009). Anti-oxidant and anti-hyperglycemic activities of Musa sapientum root extracts in alloxan-induced diabetic rats. Af. J. Medicine Med. Sci. 38: 109–117. Ahmed F, Urooj A (2010). In vitro studies on the hypoglycemic potential of Ficus racemosa stem bark. J. Sci. Food Agri. 90: 397–401. Balick JM, Cox PA (1996). Plants, People and Culture: the Science of Ethnobotany, Scientific American Library, New York. pp. 228.

Comer M, Debus E (1996). A partnership: Biotechnology, biopharmaceuticals and biodiversity. In. Biodiversity. Science and development. (Di Castri, F. and Younnes, T. eds.), CAB International, Oxford, pp. 488–499. Dhar U, Rawal RS, Samant SS, Airi S, Upreti J (1999). People’s participation in Himalayan biodiversity conservation: a practical approach. Current Sci. 76: 36– 40. Farnsworth NR, Soejarto DD (1991). Global importance of medicinal plants. In The conservation of medicinal plants (ed. O.

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Akerele, V. Heywood and H. Synge). Cambridge University Press, Cambridge, UK. pp. 25–51. Gilani AH, Rahman AU (2005).Trends in ethnopharmacology. J. Indian Medicinal Plants with active principles. Part-1 (AK), CSIR, New Delhi, India. Hafizur RM, Kabir N, Chisti S (2011). Modulation of pancreatic _-cells in neonatally streptozotocininduced type 2 diabetic rats by the ethanolic extract of Momordica charantia fruit pulp. Natural Product Res. 25: 353–367. Hasan MM, Annay MEA, Sintaha M, Khaleque HN, Noor FA, Nahar A, Seraj S, Jahan R, Chowdhury MH, Rahmatullah M (2010). A survey of medicinal plant usage by folk medicinal practitioners in seven villages of Ishwardi Upazilla, Pabna district, Bangladesh. Ame. Eur. J. Sust. Agri.. 4: 326–333. Hossan MS, Hanif A, Agarwala B, Sarwar MS, Karim M, Rahman MT, Jahan R, Rahmatullah M (2010). Traditional use of medicinal plants in Bangladesh to treat urinary tract infections and sexually transmitted diseases. Ethnobotany Res. Applications. 8: 61– 74. Islam MA, Akhtar MA, Khan MR, Hossain MS, Alam AH, Ibne-Wahed MI, Amran MS, Rahman BM, Ahmed M (2009). Oral glucose tolerance test (OGTT) in normal control and glucose induced hyperglycemic rats with Coccinia cordifolia L. and Catharanthus roseus L. Pak. J. Pharma. Sci. 22: 402–404. Jahan

FI, Hasan MRU, Jahan R, Seraj S, Chowdhury AR, Islam MT, Khatun Z, Rahmatullah M (2011). A Comparison of Medicinal Plant Usage by Folk Medicinal Practitioners of two Adjoining Villages in Lalmonirhat district, Bangladesh. Ame. Eur. J. Sust. Agri. 5(1): 46–66.

Jaiswal D, Kumar R, Kumar A, Mehta S, Watal G (2009). Effect of Moringa oleifera Lam. Leaves aqueous extract therapy on hyperglycemic rats. J. Ethnopharmacol. 123: 392–396. Khaton M M and Shaik M M (2012). Review on Datura metel L.: A Potential Medicinal Plant. Global J Res. Med. Plants & Indigen. Med.1 (4):123–132. Martin GJ (1995). Ethnobotany: a ‘People and Plants’ Conservation Manual, Chapman and Hall, London. pp: 268. Maundu P (1995). Methodology for collecting and sharing indigenous knowledge: a case study. Indigenous Knowledge and Development Monitor. 3: 3–5. Mollik MAH, Hassan AI, Paul TK, Sintaha M, Khaleque HN, Noor FA, Nahar A, Seraj S, Jahan R, Chowdhury MH, Rahmatullah M (2010b). A survey of medicinal plant usage by folk medicinal practitioners in two villages by the Rupsha River in Bagerhat district, Bangladesh. Ame. Eur. J. Sust. Agri. 4: 349–356. Mollik MAH, Hossan MS, Paul AK, Rahman MT, Jahan R, Rahmatullah M (2010a). A comparative analysis of medicinal plants used by folk medicinal healers in three districts of Bangladesh and inquiry as to mode of selection of medicinal plants. Ethnobotany Res. Applications. 8: 195–218. Nawaz AHMM, Hossain M, Karim M, Khan M, Jahan R, Rahmatullah M (2009).An ethnobotanical survey of Rajshahi district in Rajshahi division, Bangladesh. Ame. Eur. J. Sust. Agri. 3: 143–150. Pandey M, Khan A (2002). Hypoglycaemic effect of defatted seeds and water soluble fibre from the seeds of Syzygium cumini (Linn.) Skeels in

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alloxan diabetic rats. Ind. J. Experimental Biology. 40: 1178–1182. Pei Shengji (2001). Ethnobotanical approaches of traditional medicine studies: some experiences from Asia. Pharma. Botany. 39:74–79.

Rahmatullah M, Khatun MA, Morshed N, Neogi PK, Khan SUA, Hossan MS, Mahal MJ, Jahan R (2010b). A randomized survey of medicinal plants used by folk medicinal healers of Sylhet Division, Bangladesh. Advan. Natural Appl. Sci. 4: 52–62.

Rahmatullah M, Azam KNM, Mollik MAH, Hasan MM, Hassan AI, Jahan R, Jamal F, Nasrin D, Ahmed R, Rahman MM, Khatun A (2010). Medicinal plants used by the Kavirajas of DaulatdiaGhat, Kushtia district, Bangladesh. Ame-Eur. J. Sust. Agri. 4: 219–229.

Rahmatullah M, Noman A, Hossan MS, Rashid MH, Rahman T, Chowdhury MH, Jahan R (2009b). A survey of medicinal plants in two areas of Dinajpur district, Bangladesh including plants which can be used as functional foods. Ame. Eur. J. Sust. Agri. 3: 862–876.

Rahmatullah M, Ferdausi D, Mollik MAH, Azam MNK, Rahman MT, Jahan R (2009a). Ethnomedicinal Survey of Bheramara Area in Kushtia District, Bangladesh. Ame. Eur. J. Sust. Agri. 3: 534–541.

Rasineni K, Bellamkonda R, Singareddy SR, Desireddy S (2010). Antihyperglycemic activity of Catharanthus roseus leaf powder in streptozotocin-induced diabetic rats. Pharmacognosy Res. 2: 195–201.

Rahmatullah M, Ferdausi D, Mollik MAH, Jahan R, Chowdhury MH, Haque WM (2010a). A Survey of Medicinal Plants used by Kavirajas of Chalna area, Khulna District, Bangladesh. Afr. J. Trade.Complemen. Alternative Med. 7: 91–97.

Rawat RBS, Uniyal RC (2004). National Medicinal Plants Board, Committed for overall development of the sector. Agrobios.1: 12–17.

Source of Support: Nil

Sangsuwan C, Udompanthurak S, Vannasaeng S, Thamlikitkul V (2004). Randomized controlled trial of Tinospora crispa for additional therapy in patients with type 2 diabetes mellitus. J. Med. Association Thai. 87: 543–546.

Conflict of Interest: None Declared

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Global J Res. Med. Plants & Indigen. Med. | Volume 2, Issue 1 | January 2013 | 23–29 ISSN 2277-4289 | www.gjrmi.com | International, Peer reviewed, Open access, Monthly Online Journal

Review article THE ROLE OF PANCHAKARMA THERAPY IN MUSCULOSKELETAL DISORDERS WITH SPECIAL REFERENCE TO VATAVYADHI Dass Ranjip Kumar1* 1

Assistant Professor, Dept. of Panchakarma, M.S.M. Institute of Ayurveda, B.P.S. Mahila Vishwavidyalaya, Khanpur Kalan, Sonipat (Haryana) *Corresponding Author: E-Mail: drranjipayu@yahoo.co.in Received: 01/11/2012; Revised: 25/12/2012; Accepted: 31/12/2012

ABSTRACT The collective meaning of Vatavyadhi indicates the specific disorders occurring due to the Vata Dosha. Due to various etiological factors, Whenever Vata Dosha (the humor called Vata in Ayurveda) gets vitiated it at first enters in all Srotases (the empty channels) of the body and then creates different types of Vata disorders described in classical Ayurvedic texts including Musculoskeletal disorders like Ardita (Facial Paralysis), Pakshaghata (Hemiplegia), Mansa Shosa/Kshaya (Muscular Dystrophy), Joint Disorders (SandhiVata, AmaVata, Vatarakta etc.), Asthi Shosa/Kshaya (Osteoporosis.), Myopathy etc. But when it is obstructed (Avrita) by various Dhatus, then mainly Mansa, Meda & Asthi Dhatus (various tissues) are affected as they are the main constituents of our body & the chief sites of Vata Dosha. As a result of these, Dhatu Kshaya (Degeneration of Skeletal & Muscle tissue) occurs, by which Nervous tissues supplying the affected parts lack proper nutrition & gets deactivated. This Pathophysiology leads to Musculoskeletal Disorders. The classical treatments in Musculoskeletal disorders, like various Panchakarma (five purification procedures in Ayurveda) therapies preceded by Snehana & Swedana which are used for relaxation as well as giving tone to the muscles & for promoting the blood circulation and Mriduvirechana with various Basti Karmas are very much beneficial which pacifies the provoked Vata Dosha, increases strength of the person, maintains health & longevity. An attempt has been made to review the treatment procedures in Ayurveda with reference to Vatavyadhi. KEY WORDS: Vatavyadhi, Musculoskeletal Disorders, Sanshodhana, Snehena, Swedana

Cite this article Dass Ranjip Kumar (2013), THE ROLE OF PANCHAKARMA THERAPY IN MUSCULOSKELETAL DISORDERS WITH SPECIAL REFERENCE TO VATAVYADHI, Global J Res. Med. Plants & Indigen. Med., Volume 2(1): 23–29

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Global J Res. Med. Plants & Indigen. Med. | Volume 2, Issue 1 | January 2013 | 23–29

INTRODUCTION Ayurveda is entitled as a “Divine science” due to its origin as well as its unimaginable potency in curing the diseases and protecting the health of a healthy person, physically and mentally. Even centuries after its golden period, Ayurveda continues to play a major role in maintaining the health status of majority of Indians and some sections of people of many other countries. The world is recognizing Ayurveda as a system which can become a universal health care system in treating a number of diseases which has minimal treatment options in the contemporary sciences. (Sudev C et al., 2012). The word “Vatavyadhi” has been composed from the different words Vata and Vyadhi. Vata is considered to be the most powerful and active amongst the three Doshas. As we know that “Pitta Pangu Kapha Pangu Pangavo Mala Dhatavah Vayuna Yatra Niyante Tatra Gachhanti Meghavat ‟‟ (Sha.Pu.5/25) Vayu is the main element of body among 3 Doshas which give support to the body & controls all the activities of body. Pitta, Kapha, Mala & Dhatus are functionless without Vata. That means it motivates & controls all other Doshas, Dhatus & Malas. It has also predominant influence on the 3 principal routes of diseases namely as Sakha, Kostha & MarmAsthisandhi. Moreover Vayu is responsible for the formation, communication & spread of Sweda, Mala, Mutra, Kapha & other biological substances in the body. It increases the strength of muscles & maintains health and longevity. Although the entire body is the dwelling of three Dosha – Vata, Pitta and Kapha, but the prime importance has been given to Vata due to its capacity to move in the entire body without help of other Doshas. To explore the supremacy of Vata, it has been mentioned that “Vayu is life and vitality; Vayu is the supporter of all embodied beings; Vayu is verily the whole universe and Vayu is the lord of all. Thus is Vayu extolled” (Charaka, 200

BC). By this reference, it is clear that Vayu is the main factor, which is responsible for the healthy and diseased status of the individual. Pitta and Kapha have also a capacity to disturb the normal state of the health, but they are crippling without the support of Vata. Due to the higher efficacy, Vata can produce eighty types of defects and derangements in the body. The word “Vyadhi” i.e. Disorder is suggestive of circumstances in which body and mind both are in distress. In this way the collective meaning of Vatavyadhi indicates the specific disorders occurring due to the Vata Dosha. While commenting on the word “Vatavyadhi” Chakrapani (the commentator on Charaka Samhita) has given two definitions of it. – “Vata Eva Vyadhi Vatavyadhih”. Which means Vata, itself disordered and combined with particular Dushyas attains the form of generalized or localized affections and because of producing pain it is called as Vatavyadhi. “Vataat Vyadhi Vatavyadhi”. It means that Vata Dosha causes the disease by particular pathogenesis in which particular type of Dosha – Dushya Sammurcchana (the pathological derangement of the 3 Humors & Tissue elements in the body) leads to the particular disease. To distinguish the Vatavyadhi from Samanya Vyadhi, it has been mentioned that though diseases like Jvara etc., are also caused by Vata, the role of Pitta and Kapha in causing Jvara can never be ruled out and hence it can not be called a Vata Vyadhi (Chakrapani, 12th Cent. AD). Whereas Vatavyadhi cannot be manifestated until and unless Vata is involved and this type of diseases of Vata are known as Nanatmaja disorders of Vata (80 types). The exact meaning of the word “Vatavyadhi” is “Vata Eva Vyadhi”. It indicates that Vata itself is a disease (Vijayraksita on Madhav Nidnana, 11th AD). Hence no one can be considered as healthy because Vayu has been called life and vitality (Charaka, 200 BC). The other definition “Vatat Vyadhi Vatavyadhi”, is also not suitable because according to this definition all the diseases in which Vata plays a major role as one of the causative factors may be included under the Vatavyadhi. Then there is no importance

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remains of the separate description of Vatavyadhi. Vijayraksita has explained his own thought about the meaning of Vatavyadhi just after discussing on Chakrapani’s definitions of Vatavyadhi. He explained that “Vata Janito Asadharana Vyadhi Vatavyadhi”, means specific diseases caused by vitiated Vata are known as Vatavyadhi. This definition seems to be correct because of its specificity and differentiality from other Samanya diseases of Vata (Vijayraksita on Madhav Nidan.– Vata Vyadhi,11th AD). Pathogenesis of Vatavyadhi “Dehe Srotansi Riktani Purayitwa Anilo Bali Karoti Vividhan Vyadhin Sarvangaikanga Sansritan” (Charaka, 200 BC) Due to Vata Prakopaka, Nidan Sevana, Whenever Vata Dosha vitiates it at first enters in all the empty channels (Srotas) of the body and then creates different types of Ekangagata (local) & Sarvangagata (general), a total 80 types of Vata disorders described by classics including Musculoskeletal disorders like Ardita (Facial Paralysis), Pakshaghata (Hemiplegia), Mansa Shosa/Kshaya (Muscular Dystrophy), Joint Disorders (SandhiVata, AmaVata, Vatarakta etc.), Asthi Shosa/Kshaya (Osteoporosis.), Myopathy etc. Pathogenesis of MSD When Vata Dosha is more provoked & obstructed (Avrita) by Rasa, Raktadi Dhatus, then mainly Mansa, Meda & Asthi Dhatus are affected as they are the main constituents of our body (As the body of human being is mainly supported by skeletons & muscles, which are the chief sites of Vata Dosha. As a result of this, Asthi, Meda & Mansa Dhatu Kshaya (Degeneration of Skeletal & Muscle tissue) occurs, by which Nervous tissues supplying to that affected parts lacks proper nutrition & gets deactivated. This Pathophysiology leads to Musculoskeletal Disorders. According to Modern Medical Science, disorders pertaining to both muscle & skeletal tissue are known as Musculoskeletal Disorders

(Harrison, Principals of Internal Medicine, 2003). One should determine whether the Musculoskeletal complaint is (1) articular or nonarticular in origin, (2) inflammatory or noninflammatory in nature, (3) acute or chronic in duration, and (4) localized or widespread (systemic) in distribution. 1) Articular disorders may be characterized by deep or diffuse joint pain, limited range of motion on active and passive movement, swelling caused by synovial proliferation or effusion or bony enlargement, crepitation, instability, locking, or deformity. 2) By contrast, Non-articular disorders tend to be painful on active but not passive range of motion, demonstrate point or focal tenderness in regions distinct from articular structures, and have physical findings remote from the joint capsule. Moreover, Non-articular disorders seldom demonstrate crepitus, instability, deformity, or swelling. 3) Inflammatory disorders may be identified by the presence of some or all of the four cardinal signs of inflammation (erythema, warmth, pain &swelling), by systemic symptoms (Prolonged morning stiffness, fatigue, fever, weight loss) or by laboratory evidence of inflammation (Elevated ESR or C-reactive protein level, thrombocytosis, anemia of chronic disease, or hypoalbuminemia). 4) Non-inflammatory disorders may be related to trauma (rotator cuff tear), ineffective repair (osteoarthritis), cellular overgrowth (pigmented villo-nodular synovitis), or pain amplification (fibromyalgia). They are often characterized by pain without swelling or warmth, the absence of inflammatory or systemic features, little or no morning stiffness, and normal laboratory findings. In this way Individuals with Musculoskeletal complaints should be evaluated in a uniform, logical manner by means of a thorough history, a comprehensive physical examination, and if appropriate, laboratory testing. With such an approach and an understanding of the pathophysiologic

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processes that underlie Musculoskeletal complaints, an adequate diagnosis can be made in the vast majority of individuals. However, some patients will not fit immediately into an established diagnostic category. Many Musculoskeletal Disorders resemble each other at the outset, and some take weeks or months to evolve into a readily recognizable diagnostic entity. This consideration should temper the desire always to establish a definitive diagnosis at the first encounter (Harrison, 2003). Panchakarma Therapy for Vatavyadhi w.s.r. to Musculo Skeletal Disorders The exposition of the line of treatment of the diseases due to the provocation of Vata has been given in all the major Ayurvedic texts. Ayurveda makes a unique approach to cure. The Ayurvedic Cure is a 2 fold strategy comprising of 1) Samsodhana (or Biopurification) by Pancha Karma & related measures and 2) Samsamana (or Palliation) of imbalances by appropriately planned diet, drug, & life style interventions. The Ayurvedic Classics describe the full range of therapeutics through Sadupakarmas (Six major treatment categories) consisting of Langhana – Brimhana, Rukshana – Snehana, Swedan Stambhana. This classic scheme incorporates both Samsodhana & Samsamana and the popular Panchakarma Therapy is an offshoot of the same. But the diseases as prevalent today manifest themselves in such a complex manner that it becomes difficult to treat them by merely administering palliative treatment or Shamana therapy. It has been specially mentioned that the diseases/ Doshas controlled by Samsamana Therapy have the possibilities of re-provoking while there is no such probability in the eventuality of the control of Disease /Doshas treated by Samsodhana Therapy (Panchakarma Therapy) (Charaka, 200 BC). Here, the general line of treatment mentioned for Vata disorders in relation to Musculoskeletal disorders are being described, (According to Charaka & Astanga Hridaya), viz:-

Snehana (Oleation Therapy) : Depending upon the application of Snehana, it can be divided into 2 types, viz: 1) Abhyantara Snehana (Internal Oleation) & 2) Bahya Snehana (External Oleation or Massage). If there is a simple provocation of Vata without any Upastambha or Avarana, it should be treated at first with oral administration of unctuous preparations such as Ghrta, Tailaa, Vasa and Majja. The person, when overstrained by the Snehana should be comforted and again Snehana should be done with milk. Further he should be treated with Oleated Yusas, meat juices of domestic, wet land and aquatic animals mixed with unctuous articles. Preparations of milk and Krisara may be given for eating. Patient should be administered with Anuvasana Basti having Amla and Lavana Rasa, Snigdha Nasyas and Tarpanas (Charaka, 200 BC). But when Vata Dosha is more provoked & obstructed (Avrita) by Rasa, Raktadi Dhatus, then in this case External Oleation or Massage therapy should be applied which is used for relaxation as well as giving tone to the muscles, for promoting the blood circulation & treating various musculoskeletal disorders. It improves the quality of skin, making it tender, delicate & strong. Again Massage therapy is of 14 types described in the classics at various places viz. 1) Abhyanga 2) Lepa 3) Udvartana 4) Mardana 5) Padaghata 6) Pariseka 7) Samvahana 8) Gandusha & Kavala Graha 9) Murdha Taila – Shira Tarpana (Shiro-Abhyanga, Shirah Seka, Sirah Pichu & Shiro-Vasti) 10) Akshi Tarpana 11) Nasa Tarpana 12) Karna Purana 13) Mastikya 14) Snehavagahana (Oil Bath). For any types of Musculoskeletal Disorders Particularly Udvartana by Yava, Masa, Masura etc.coarse powder, Abhyanga (Massage) by Bala Taila, Dasamula Taila, Narayana Taila, Kshirabala Taila & Sahacharadi Taila, Lepa by Nirgundi (Vitex nigundo) Patra, Dhatura (Datura metel) Patra & Arka (Calotropis procera) Patra kalka (Paste), Mardana (Massage with pressure) by above oils (Which removes the fatigue of muscles, relieves myalgia & neuralgia), Snehavagahana (Tub

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Bath) by Bala taila, Pariseka by Taila, Milk or Mansa rasa etc., Siro-vasti & Sirodhara by Tila & Bala Taila, Siro Lepa by Amalaki Kalka are being practiced. Swedana (Sudation Therapy) after Snehana: When patient becomes well oleated with Snehana therapy he should be given Svedana treatment. After Abhyanga the patient may be subjected to the suitable type of Sveda like Nadi Sveda, Prastara Sveda, Samkara Sveda etc., in which unctuous articles should be mixed (Tripathi Brahmanand, Hindi commentary on Charaka Samhita, 1999). It relieves stiffness, heaviness & coldness of the body and liquefy the Snigdha vitiated Doshas (Brought about by Snehana Karma) which are spread throughout the body. As a result of this, the vitiated Doshas are made easily eradicable in the form of induction of sweating or with the help of Pradhana Karma such as Vamana, Virechana, Basti etc. Acharya Charaka has mentioned that Swedana therapy is the best treatment for vitiated Vata & Kapha dominant diseases (Charaka, 200BC). The Svedana procedures should be repeatedly administered in order that the disorders of Vata may not stay in the Kostha softened by Snehana procedure (Tripathi Brahmanand, Hindi commentary on Charaka Samhita, 1999). Various types of Swedan Karma like Nadi sweda, Baspa sweda by using the decoction of Dashamula (Roots of ten drugs), Balamula (Sida cordifolia) & Eranda (Ricinus communis) mula (Roots), Patrapinda sweda by using Nirgundi (Vitex nigundo) Patra (Leaves), Sastika Shali Pindasweda by using the decoction of Bala (Sida cordifolia) & Milk and Pizhichil are practiced for any types of Musculoskeletal disorders. Samsodhana (Panchakarma Therapy): If due to excessive morbidity, the humors (i.e. Vata Dosha) do not subside with the above procedures, Samsodhana is to be given by mild drugs mixed with unctuous articles.

Mriduvirechana (Mild Purgation):For this purpose the patient may take the medicated Ghee prepared with Tilvaka or Saatala or he may take Eranda Taila mixed with milk, which are beneficial to expel the morbid humors (Tripathi Brahmanand, Hindi commentary on Charaka Samhita, 1999). By excessive use of Snigdha, Amla, Lavana and Usna etc. articles of diet, the Mala i.e. excretotary matter gets accumulated and by occluding the various Srotas, cause obstruction to the path of Vata; hence the Anulomana of Vata is essential to expel it out (Charaka, 200 BC) & it is possible by giving Virechana. Basti (Therapeutic Enemata):The patient, who is debilitated and as a consequence, in whom Virechana is contraindicated, should be given Niruha Basti. He should be administered with the diet having Dipana and Pachana drugs (Tripathi Brahmanand, Hindi commentary on Charaka Samhita, 1999). Basti is considered as the most useful therapeutic procedures in which medicated oils, decoctions, decoctions with Milk, Mansa Rasa or paste of herbs or oils or ghee are introduced into the large intestines through rectum with the help of Basti Yantra (Enema Apparatus). Basti produces Sodhana of Doshas, Samsamana of the diseases, Mala Sangrahana, Increases Shukra in Shukrakshina patients and if the patient is Sthula (Obese), he will become Krisa (Weak) & vice versa after administration of Basti therapy. Basti increases strength of the persons in whom it is advocated, maintains health & longevity. Basti is the best chikitsa (treatment) for Vata Doshas, so also for Pitta, Kapha, Rakta in Sansarga & Sannipata Doshas. Thus Basti produces extensive benefits to each & every part of the body. Since the Basti has the capacity to eradicate most of diseases occurring in Sakha, Kostha & Marma Sthana, it is referred to as “Half of the whole treatment” and sometimes a “Complete treatment” (Charaka, 200BC).

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Basically Basti is of two types, viz. 1) Anuvasana Basti (By medicated oil) 2) Niruha Basti (By decoctions of drugs indicated). Both types of Bastis are indicated for many types of Vata disorders. Here Anuvasana Basti in the form of Sneha Basti (6 Pala), Anuvasana Basti (3 Pala) & Matra Basti (11/2 Pala) by Bala Taila is used for any types of Musculoskeletal disorders (Like SandhiVata, Gridhrasi, Katishula etc.). It can be administered daily without producing any complications in the body (Sushruta, 2000 BC). Various Niruha Bastis like different Yapana Bastis (Mustadi Yapana Basti, Baladi Yapana Basti, Dwitiya Baladi Yapana Basti & Tritiya Baladi Yapana Basti) for Mansa Shosa/Kshaya (Muscular Dystrophy), Madhutailaika Basti & Dasamula Niruha Basti for all types of Musculoskeletal disorders, Panchatikta Kshira Basti for Ankylosis Spondylosis & AmaVata, Vaitarana Basti for AmaVata & Dasamula Kshara Basti for AmaVata are commonly used in Panchakarma. In most of occasions, a combination of both these types of Bastis (Both Anuvasana & Niruha) is given in the form of Karma Basti (30 Number), Kala Basti (16 Number) & Yoga Basti (8 Number) except for fewer specific indications where single or continued use of one or the other type of these two Bastis is indicated. Some specific types of Basti like Kati Basti, Urah Basti, Janu Basti by Bala Taila, Mahavisagarbha Taila, Sahacharadi Taila, Kubja Prasarini Taila & Panchaguna Taila for Musculoskeletal complaints of specific part of the body are also practiced. In some cases of Musculoskeletal disorders like Ardita (Facial Paralysis), Pakshaghata (Hemiplegia), Ekangaghata (Monoplegia), Adharangaghata (Paraplegia) & Dhanustambha (Tetanus), Nasya Karma by

different method like by medicated oil (Anu Taila, Brahmi Grhita etc.), by powder Katphal (Myrica esculenta), Haridra (Curcuma longa) etc.) & by Dhumapana, Shirodhara by medicated oil, Takra, Dhanyamla etc. and ShiroBasti by Bala oil, Jyotismati oil, Himasagar oil etc. are commonly used. In all these Panchakarma Therapy, Snehana & Swedana procedures are done repeatedly as Purvakarma (pre-operative procedures). DISCUSSIONS & CONCLUSIONS When Vata Dosha is get vitiated & obstructed by various Dhatus, then especially the skeletal and muscular tissues are more affected as these are the chief sites of Vata Dosha. As a result of this, Degeneration of Skeletal & Muscle tissue is occurred. This pathogenesis leads to deactivation of Nervous tissues supplied to those affected parts. In this way the Pathophysiology of Vatavyadhi leads to Musculo-skeletal Disorders according to Modern Medical Science. Now-a-days no any permenent solutions of these cases of Musculoskeletal disorders has invented yet in Modern Medical Science. But the Ayurvedic Classics describe the full range of therapeutics through various Panchakarma Therapies to eradicate these complaints like Snehana & Swedana which are used for relaxation as well as giving tone to the muscles & for promoting the blood circulation and Mriduvirechana with various Basti Karmas are very much beneficial which eradicates the provoked Vata Doshas, increases strength of the persons, maintains health & longevity. Various research work has also been done on Vatavyadhi with special reference to Muskulo-skeletal disorders in various research institution of India, where it can be concluded that Panchakarma Chikitsa has a major role to eradicate any types of Musculo-skeletal Disorder.

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REFERENCES Charaka, (200 BC), „Charaka Chandrika‟ Hindi Commentary by Tripathi Brahmanand on Charaka Samhita, 6th Edition, Chaukhambha Surbharati Prakashan; 1999, Varanasi, Vol.I & II.: Ch. Su. 14, 16; Ch. Si. 1; Ch.Chi. 28 Harrison: Principals of Internal Medicine, 15th edition CD-ROM (International edition), 2003, Section-3, PP: 320 Sudev C, Suresh R D (2012), A clinical study on Gokshuradi churna in the management of Oligospermia, Global J

Source of Support: Nil

Res. Med. plants & Indigen. Med. 1(1):11–19 Sushrut, (2000 BC) „Ayurveda-TattvaSandipika‟ Hindi Commentary by Shastri Kaviraja Ambikadutta, Sushruta Samhita, 11th Edition, Chaukhambha Sanskrit Sansthan; 1997, Varanasi, , Vol. I Su.Ch.35/18, PP: 154 Tripathi Brahmanand (1999), „Charaka Chandrika‟ Hindi Commentary on Charaka Samhita, 6th Edition, Chaukhambha Surbharati Prakashan; 1999, Varanasi, Vol. II.: Ch.Chi.28

Conflict of Interest: None Declared

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Global J Res. Med. Plants & Indigen. Med. | Volume 2, Issue 1 | January 2013 | 30–39 ISSN 2277-4289 | www.gjrmi.com | International, Peer reviewed, Open access, Monthly Online Journal

Research article A CLINICAL STUDY TO COMPARE VIRECHANA AND JALAUKAVACHARANA PROCEDURES IN THE MANAGEMENT OF VICHARCHIKA Dass Ranjip Kumar¹, Nayak Annada Prasad²*

¹

Assistant Professor, Dept. of Panchakarma, M.S.M. Institute of Ayurveda, B.P.S. Mahila Vishwa vidyalaya, Khanpur Kalan, Sonipat, Haryana, India ² Assistant Professor, Dept. of Kayachikitsa, M.S.M. Institute of Ayurveda, B.P.S. Mahila Vishwa vidyalaya, Khanpur Kalan, Sonipat, Haryana, India *Corresponding Author: E-Mail: vd_apnayak@rediffmail.com

Received: 10/12/2012; Revised: 27/12/2012; Accepted: 03/01/2013

ABSTRACT Now-a-days, Vicharchika (one among 11 types of mild skin diseases as per Ayurveda) has become one of the prime skin diseases at general O.P.D. level due to offensive diet habits, fast life style, industrial and occupational hazard, repeated use of chemical additives etc. Ayurveda has a lot to offer in this regard since times immemorial. Virechana (Purgation) is the chiefly advocated, purificatory measure in this disease and so it was taken in the present study for treatment purpose. Considering Rakta dushti (vitiation of blood) in all types of skin diseases, Jalaukavacharana (bloodletting by Leech) provides excellent results by its ideal method to expel out the vitiated blood safely, quickly and effectively. In this study total 28 patients were randomly distributed into two groups, as Group – A, where the patients were given Virechana (purgation) by classical method followed by Gandhaka Rasayana (an Ayurveda medicine prepared from purified Sulphur) for 1 month and Group– B, where the patients were given four sittings of Jalaukavacharana for 1 month followed by Gandhaka Rasayana for 1 month. It was concluded that although Virechana (purgation) has provided significant relief in the symptoms of Vicharchika yet, Jalaukavacharana (bloodletting by Leech) has provided relatively better relief in most of the symptoms. KEY WORDS: Virechana (purgation), Jalaukavacharana Karma (bloodletting by Leech), Vicharchika (one among 11 types of mild skin diseases as per Ayurveda), Shamana drug (Palliation drugs)

Cite this article: Dass Ranjip K, Nayak A P (2013), A CLINICAL STUDY TO COMPARE VIRECHANA AND JALAUKAVACHARANA PROCEDURES IN THE MANAGEMENT OF VICHARCHIKA, Global J Res. Med. Plants & Indigen. Med., Volume 2(1): 30–39

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INTRODUCTION The skin is a highly complex organ which plays vital role in the body‟s general functioning. Skin is described as an ornament of the body in classics. The study of Indian medical classics reveals that all skin diseases were described under the broad heading of “Kushtha” (Skin diseases). According to Vagbhattaa(who wrote astanga hridaya), Kushtha (skin disease) (Vagbhatta, 4th AD) is a disease which involves breakage in the charm of skin. Sushruta (who wrote Susruta sahmita) has described Vicharchika (one among 11 types of mild skin diseases as per Ayurveda) as one of the Kshudra Kustha (11 mild skin diseases) (Susruta, 2000 BC). The Vicharchika simulate with Eczema. It is one of the blazing problems in the society as accurate medicament is not available to treat the disease and to control its reappearance. The Shodhana (Purification) therapy and Shamana (palliative medicines) treatment forms the core of this reputed discipline of medicine. Because of preventive, promoting, prophylactic and rejuvenating properties as well as providing a radical cure; Panchakarma (five purification procedures) is a very unique therapeutic procedure, serving as a Shodhana (purification) therapy. Virechana (Purgation) procedure has been selected for the present study, is chiefly advocated for purification measure in Vicharchika (one among 11 types of mild skin diseases as per Ayurveda) (Charaka, 200 BC). Though the pathology of kustha (Skin diseases) establishes raktadusti (vitiation of blood), Jalaukavacharana (bloodletting by Leech) is being advocated here to expel out the vitiated blood safely.

With this point of view, a study was undertaken to evaluate the effects of virechana (purgation) and Jalaukavacharana (bloodletting by Leech) in the management of Vicharchika. MATERIAL AND METHODS A. Selection of Patients Total 28 patients fulfilling the criteria for diagnosis (mentioned below) of the disease were registered for the present study irrespective of the age, sex, religion, etc. Among these, 8 patients left full course of the treatment before the completion of the therapy. All patients were selected from the O.P.D. and I.P.D. of the Department of Panchakarma (five purification procedures). Institutional ethics committee has approved the trial on 24.05.11 with letter no. Inst. Ayu. /11/2447. B. Criteria for Diagnosis The patients were diagnosed on the basis of classical signs and symptoms (Kandu (itching), Pidaka (Eruption)), Shyavata (darkness of skin), Srava (secretion) etc.) of Vicharchika (one among 11 types of mild skin diseases as per Ayurveda) described in Ayurvedic classics. Inclusion criteria: Age more than 15 years and less than 70 years. Patients fulfilling the symptomatology of Vicharchika (one among 11 types of mild skin diseases as per Ayurveda), like Kandu (itching), Pidaka (Eruption), Shyavata (darkness of skin), Srava (secretion) etc. Exclusion criteria: Patients suffering from Diabetes Mellitus, Hypertension with hyperlipidemia, age less than 15 years and more than 70 years and patients having any other systemic disorders.

Scoring criteria: Table -1, Kandu (Itching) Score 1 2

Grade Often mild type of itching (1–2 times in a day Moderate itching along with mild itching episode (1–2 times in a day)

3

Moderate itching along with moderate itching episode (3–4 times in a day) Severe itching episode (more than 5 times a day even)

4

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0 1 2 3

Table -2, Daha (Burning sensation) No burning sensation even after rubbing Mild type of burning sensation, sometime and not disturbing normal activity After rubbing mild type of burning sensation Severe burning sensation disturbing normal activity

0 1 2 3

Table -3, Shrava (secretion) No discharge Moisture on the skin lesion Weeping from the skin lesion Weeping from the skin lesion followed by crusting

0 1 2 3

Table -4, Rukshata (Dryness/Roughness) No dryness (Snigdha) Dryness with rough skin (Ruksha) Dryness with scaling (Khara) Dryness with cracking (Parushang)

0 1 2 3

Table -5, Pidika (Eruption) No eruption in the lesion Scanty eruption in few lesion Scanty eruption in at least half of the lesion All the lesions full of eruption

0 1 2 3

Table -6, Vaivarnya (De-pigmentation) Nearly normal skin color Brownish red discoloration Blackish red discoloration Blackish discoloration Table -7, Raji (Thickening Of Skin) No thickening of the skin Thickening of the skin but no criss-cross marking Thickening of skin with criss-cross marking Severe lichenification

0 1 2 3 Grouping Pattern: The patients were randomly distributed in to 2 groups.

Table -8, Distribution of 28 patients of Vicharchika (one among 11 types of mild skin diseases as per Ayurveda) in both groups Patients Total No. of Patients Group A Group B Completed 10 10 20 LAMA 05 03 08 Total 15 13 28

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Group-A (Virechana (purgation) + Shamana (Palliative) drugs): Method of Virechana (purgation) (Dwivedi Acharya Mukundilal, 2008): Virechana (Purgation) was carried out as per classical indications.  Purva Karma (preparatory procedure): Abhyantara Snehapana (Internal oleation) was carried out by Shuddha Ghrita (pure ghee)in increasing dose starting from 30 ml then in multiplication for a maximum of 7 days as per the conditions of Agni (digestive capacity) and Koshtha (bowel habit) of patient till the occurrence of Samyak Snigdha Lakshana (symptoms of proper oleation). Sarvang Abhyanga (whole body massage) and Mrudu Vaspa Sweda (mild fomentation by steam) were performed after getting the Samyak Siddha Snehapana lakshanas (symptoms of proper oleation) for 3 days in morning and evening

the dose of 5 gm/day in Capsule form into three divided doses for the duration of 30 days with water as Anupana (adjuvant during intake of medicine). Group-B (Jalaukavacharana (bloodletting by Leech) + Shamana (palliative) drug ): Jalaukavacharana (bloodletting by Leech): In this group one sitting of Jalaukavacharana (bloodletting by Leech) was carried out on every week for four weeks. Number of Jalaukas (leeches) used per sitting were decided depending upon the condition of affected lesion. Shamana (Palliative) drugs: After completion of four sittings of Jalaukavacharana (bloodletting by Leech) the patients were given powder of Gandhaka Rasayana as a Shamana Yoga (palliative formulation) in the dose of 5 gm/day in Capsule form into three divided doses for the duration of 30 days with water as Anupana (adjuvant during intake of medicine). Criteria for Overall Effect of Therapy

 Pradhana Karma (main procedure) (Kasture H. S., (2004): After proper Snehana-Swedana (Oleation and fomentation), patients were given Virechaka Yoga (purgation drugs) on empty stomach. Virechana Yoga (medicines for purgation) (Charaka, 200 BC) was prepared by Triphala + Trivrita + Danti along with Eranda Taila and Icchabhedi Rasa (if needed).  Pashchat Karma (post purification procedure): Samsarjana Krama (special dietary regimens after purgation) was given as per type of purification and in sequence mentioned by classics. Shamana (Palliative) drug: After completion of Virechana (purgation) process and Samsarjana Krama (special dietary regimens after purgation), the patients were given powder of Gandhaka Rasayana (Shastri Laxmipati, 2004) as a Shamana Yoga (Palliative formulation) in

The total effect of the therapy was assessed considering the following criteria.  Cured: 100% relief in the sign and symptoms with plain skin surface and significant changes in color of the affected skin lesion towards normal were considered as cured.  Complete remission: More than 75% relief in the signs and symptoms were recorded as complete remission with marked improvement in pigmentation and thickening of the skin.  Marked Improvement: 51–75% relief in sign and symptoms were considered showing marked improved with moderate improvement in pigmentation and thickening of the skin.  Improvement: Patients showing improvement in between 26–50% in sign and symptoms with slight improvement of pigmentation and thickening of the skin was taken as improvement.  Unchanged: Below 25% relief in sign and symptoms was considered as unchanged.

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Statistical Analysis: 

  

The information gathered on the basis of classical symptomatology was subjected to statistical analysis in term of mean (X), standard deviation (SD) and standard error (SE). Paired „t‟ test was carried out at P < 0.10, P < 0.05, P < 0.01, P < 0.001 significance level. The obtained results were interpreted as – Insignificant - P > 0.05 Significant - P < 0.05 Highly significant - P < 0.01, P < 0.001.

DRUGS CONTRIVE:    

Snehapana (internal oleation): by Suddha Ghrita (pure ghee) 30ml/day increasing dose Abhyanga (oil massage): by Bala taila q.s. for twice 3 days Swedana (fomentation): by Baspa Sweda (steam bath) for 20 mins for twice 3 days Virechana Yoga (formulation for purgation) contains:- Triphala Kwatha (decoction of three herbal fruit): 100 ml - Trivrita Churna (powder of Operculina turpethum): 50 gm - Danti Churna (powder Baliospermum Montanum): 25 gm - Eranda Taila (castor oil): 50 ml - Ichchabhedi Rasa (an Ayurvedic medicine): 2 Tab. (S.O.S.) Samsarjan karma (special dietary regimens after purgation): by Peya, Vilepee (recipe made from rice) etc as per texts.

For Virechana (purgation), drug was attributed in accordance with Charaka (the author of Charaka Samhita) in which combination of Triphala, Trivrit, Danti, Eranda Taila was given after considered necessary Snehapana (internal oleation) by Suddha Ghrita (pure ghee). Here Combination of medicine taken for Virechana (purgation), act like: Triphala (fruit of Terminalia chebula, Terminalia bellirica, and Emblica officinalis) is mild laxative in action, Trivritta (Operculina

turpethum) has property to liquefy the Mala (fecal matter) of Annarasa (chyle), Danti (Baliospermum Montanum) acts as strong Virechaka (purgative) which cleans Annavaha Srotas (alimentary canal) by removing sticking Mala also and Eranda Taila (castor oil) provides soothing effect to intestinal mucosal membranes to ease Virechana (purgation). Jalaukavacharana (bloodletting by Leech) (Charaka, 200 BC) is the safest and scientific method amongst Raktamokshana (bloodletting) procedures. Merely Panchakarma (five purification procedures) is not the complete treatment, but it is just a preparatory procedure for application of medicaments; hence Gandhaka Rasayana (Shastri Laxmipati, 2004) (an Ayurveda medicine prepared from purified Sulphur) in the dose of 5 gm/day for 30 days for both groups is chosen as a Shamana (palliative) drug after the completion of Shodhana (purification) procedure. RESULTS Observations Observations of Group-A: Samyaka Snehana (proper oleation) was found on 7th day in 70.00% of patients. Total amount of Abhyantara Snehana (Internal oleation) was about 840 ml in 70.00% of cases. 40.00% of the patients showed Madhyama Shuddhi (medium purification). Observations of Group-B: Maximum 40% patients were used nearly 16–20 Jalauka (leech) during full course of treatment, whereas 30% patients were used 21–25 number of jalauka (leech), 10% patients were used 25–30 Jalauka (leech) and 20% patients were used 11–15 jalauka (leech). . Maximum 55% of Jalauka (leech) have been sucked for 1–2 h. The effect of both therapies in various symptoms of the diseases can be highlighted as follows -

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Sr. No.

Table no.-9, The Effect of Therapies on Individual Signs and Symptoms Symptoms % of Relief Group-A 48.15 (>0.05) 57.15 (<0.05) 36.85 (<0.001) 61.89 (<0.01) 25.64 (<0.01) 61.11 (<0.01) 33.33 (>0.05) 24.98 (<0.05)

Kandu (Itching) Daha (Burning sensation) Pidika (eruption) Srava (Secretions) Vaivarnya (De-pigmentation) Shotha (Inflammation) Rukshta (Dryness) Raji (Thickening Of Skin)

1 2 3 4 5 6 7 8

Group-B 69.70 (<0.001) 76.31 (<0.001) 58.35 (<0.05) 75.00 (<0.01) 38.24 (<0.001) 87.50 (<0.001) 55.17 (<0.01) 66.67 (<0.01)

Graph No.-1, The Effect of Therapies on Individual Signs and Symptoms

Table No.-10 : Overall effect on symptoms of Virechana Karma (Purgation) + Shamana Chikitsa (Palliative treatment) in Group-A Sr. No. 1 2 3 4 5 6 7 8

Symptoms

BT

AT

X

%

SD

SE

T

P

Kandu(n=10) Daha(n=10) Pidika(n=6) Srava(n=8) Vaivarnya(n=10) Sotha(n=10) Rukshta(n=10) Raji(n=9)

2.700 2.000 2.111 2.333 3.900 1.800 2.625 2.222

1.400 0.857 1.333 0.889 2.900 0.700 2.250 1.667

1.300 1.143 0.778 1.444 1.000 1.100 0.875 0.555

48.15↓ 57.15↓ 36.85↓ 61.89↓ 25.64↓ 61.11↓ 33.33↓ 24.98↓

0.823 0.900 0.441 1.014 0.816 0.748 1.356 0.527

0.260 0.340 0.147 0.338 0.258 0.233 0.479 0.176

1.300 3.360 5.292 4.274 3.873 4.714 1.823 3.162

>0.05 <0.05 <0.001 <0.01 <0.01 <0.01 >0.05 <0.05

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Table No.-11 Overall effect on symptoms of Jalaukavacharana Karma (Leech therapy) + Shamana Chikitsa (Palliative treatment) in Group-B Sr. No. 1 2 3 4 5 6 7 8

Symptoms

BT

AT

Kandu(n=10) Daha(n=10) Pidika(n=6) Srava(n=8) Vaivarnya(n=10) Sotha(n=10) Rukshta(n=10) Raji(n=9)

3.300 2.330 2.000 1.500 3.400 1.600 2.900 2.667

1.000 0.552 0.833 0.375 2.100 0.200 1.300 0.889.

_ X 2.300 1.778 1.167 1.125 1.300 1.400 1.600 1.778

It can be observed from the above mentioned table that although Virechana (Purgation) has provided significant relief in the symptoms of Vicharchika (one among 11 types of mild skin diseases as per Ayurveda), yet, Jalaukavacharana (bloodletting by Leech) has provided relatively better relief in most of the symptoms.

%

SD

SE

t

P

69.70↓ 76.31↓ 58.35↓ 75.00↓ 38.24↓ 87.50↓ 55.17↓ 66.67↓

0.789 0.440 0.753 0.835 0.675 0.699 1.350 1.202

0.249 0.146 0.307 0.295 0.213 0.221 0.427 0.401

8.820 12.090 3.796 3.813 6.091 6.331 3.748 4.438

<0.001 <0.001 <0.05 <0.01 <0.001 <0.001 <0.01 <0.01

result in Group-B, Unchanged was noted in 30% patients of only in Group-A as shown on table no.13 and Graph no.2. The effect of all the therapies viz. Jalaukavacharana (Leech therapy) on the cardinal signs and symptoms of the disease was remarkable; however, Virechana (purgation) provided comparatively better relief.

Overall effect of therapy This showed that Jalaukavacharana Karma (Leech therapy) is more effective in curing the disease in comparison to Virechana (purgation).

Complete remission was found in 30 % patient of Group-B, Marked improvement was noted in 40% patients of Group-A and only 10% patients of Group-B, Moderate improvement was observed in 30% patient in Group-A where 60% shows improved effective

Sr. No. 1

Table No.-13- Overall Effect of therapy in both groups Result Group-A % Group-B Complete remission 0 00 3

% 30

2

Marked improvement

4

40

1

10

3

Improvement

3

30

6

60

4

Unchanged

3

30

0

00

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Graph No.-2, Total Effect of therapy in both groups Total Effect of Therapy in Both Groups

70

60 60 50

Complete Remission

40 40

30 30

30

Marked Improvement

30

Improvement

20 10 10 0

0

Unchanged

0 Group-A

DISCUSSION Commonest age of occurrence of Vicharchika has been reported between 41–50 years. Cool atmosphere is much susceptible for eczematous patients. Vicharchika (one among 11 types of mild skin diseases as per Ayurveda) is Kaphapradhana Vyadhi. (Kapha dominant disease) (Charaka, 200 BC). So humid, cold, watery contacts may increases the symptoms of Vicharchika (one among 11 types of mild skin diseases as per Ayurveda). Excessive intake of Lavana (salty diet), Katu (pungent diet) and Madhura rasa (sweetening diet) are common causative factors for Vicharchika (one among 11 types of mild skin diseases as per Ayurveda). Viharaja Nidana (unlawful habit) like allergic factors and industrial pollutants can be considered as main causative factors behind the increasing incidence of Vicharchika. Same as Kushtha (skin disease), Vicharchika (one among 11 types of mild skin diseases as per Ayurveda) is also Tridhoshik (three basic constituent of body as vata, pitta and kapha) in which Kapha (one among three basic constituent) and Vata (one among three basic constituent) are dominant involved. Disturbed sleep is interesting symptoms of Vicharchika (one among 11 types of mild skin diseases as per Ayurveda), which leads Vata prakopa (vitiation of vata) and may further deteriorate the diseased condition. Hence, it becomes a vicious cycle. Leech saliva, contains Hirudin, which has property of anti coagulants. So it may be helpful in other skin diseases,

Group-B

obstructive blood disorders like Thrombosis, Hemangioma, and Gangrene etc. Probable Mode of Action of Virechana karma (Purgation): Snehapana (oleation) by virtue of its Doshotkleshana (vitiation of dosha) effects separates toxins accumulated in the patient‟s body by Nidanas (causes) like Viruddha ahara (food ingestion either in inappropriate way or quantity etc. and the separated Utklilshta Doshas (vitiated humours) are eliminated by Virechana (purgation). Virechana (purgation) might have removed the toxins from the cellular level, improving Jatharagni (Digestive fire) and Dhatvagni (hormones and enzymes), so that metabolism is normalized. Probable mode of action of Jalaukavacharana (bloodletting by Leech): Vicharchika (one among 11 types of mild skin diseases as per Ayurveda), is a type of Kushtha (Skin diseases) having Tridosha prakopa (vitiation of all the three doshas), pradhana Raktadushti (vitiation of blood dominantly) and Chirakari (chronic) manifestation. Sushruta (the author of Susruta Samhita) has given great emphasis to Jalaukavacharana (bloodletting by Leech) in the treatment of Raktapradoshaja Vyadhi (Blood originated disease), Tridosha Prakopajanya (vitiated all three body humours) and Chirakari (chronic) diseases. Jalaukavacharana (bloodletting by Leech) is

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Global J Res. Med. Plants & Indigen. Med. | Volume 2, Issue 1 | January 2013 | 30â&#x20AC;&#x201C;39

better for the superficial blood (Avagadha grathita Rakta). Vitiated Rakta (blood) may be washed-out by application of Leeches after slight scraping on the lesion of Kushtha (skin disease). Thus; it is well proved that Jalauka (leeches) gives better effect in Raktaja Roga (Blood originated disease), or Kushtha (skin disease) on the basis of classical references. Jalauka (leech) sucks the impure blood only with ideal example of Swan by Vagbhatta (the author of Astanga Hridaya). Leeches when applied to the skin, sucks the blood at superficial level might be from capillaries or extra-cellular so it may be more impure than other body channels, Jalauka (leech) (Vridha Vagbhatta, 4th AD) can easily suck impure blood due to superficial distribution of veins. Leech application has counter irritant effect on the lesion, which creates new cellular division after removing dead cell layer, and result in reduction of local Swelling and Lichenification. Leech sucks blood from restricted area. When leech applied in only pathogenic area, then it can be said that leech expelled blood from where the pathological state is more. So ultimately blood of that area comparatively more vitiated than other area. Hence, it can be said that leeches give best effect in Vicharchika (one among 11 types of mild skin diseases as per Ayurveda) by expelling the morbid, vitiated Doshas (three basic constituent of body) and Dhatus (7 types of body tissues). The effect of therapy is not only by expelling the vitiated blood but also by leech that emits some enzymes in the wound. CONCLUSION It can be observed from the table number10 and 11 that although Virechana has provided significant relief in the symptoms of Vicharchika yet, Jalaukavacharana (bloodletting by leech) has provided relatively better relief in most of the symptoms. Most of

the patients had reported in the chronic stage of Vicharchika. Negligence in early stage of eczema is common phenomenon observed in patients. Most of the affected sites for Vicharchika are lower feet, axilla and neck like skin folds regions. Relapsing nature of Vicharchika is most common, which suggest that, long term intensive therapy is necessary for eradication of the disease. Virechana (purgation) provides comparative better result in symptoms of Shushka Vicharchika (dry eczema) like, Shotha (oedema), Shyavata (secretion), Pidika (eruption), Raji (Thickening of Skin) etc. Jalaukavacharana (bloodletting by leech) is a choice of therapy for Sravi Vicharchika (wet eczema) symptoms like, Kandu (itching), Srava (secretion), Daha (burning) etc. Markedly improved was obtained in 40% of group-A, 10% of group-B. Improved was found in 30% in group-A, 60% in group-B. Only 30% of patients of group â&#x20AC;&#x201C;A remain unchanged. The effect of all the therapies viz. Jalaukavacharana on the cardinal signs and symptoms of the disease was remarkable; however the Virechana therapy was provided comparatively better relief. ACKNOWLEDEMENT We acknowledge gratitude to Prof. Vijay Kaushik, Dean and superintendent of M.S.M. Institute of Ayurveda & Hospital, Khanpur Kalan for his extensive support in providing all resources in the OPD & IPD of the hospital. We express our gratitude to Dr. K.V.Singh, H.O.D, M.S.M. Institute of Ayurveda & Hospital, Khanpur Kalan for his inspiring spirit and parental affection besides his subject knowledge and direction that helped in accomplishing this work. We owe our thanks to our friends, hospital staffs, laboratory staffs, library staffs of M.S.M. Institute of Ayurveda and patients for their sincere support in this clinical trial.

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REFERENCES Charak, (200 BC), Charak Chandrika Hindi Byaksha, Tripathy Brahmananda, Charak Sahmita, 4th edition, Chaukhamba Surabharati Prakasana, 1995, Varanasi, Vol-I & II, Sutra Sthan24; Chikitsa Sthan-7, Dwivedi Acharya Mukundilal, Sharma Tarachanda and Mishra Bhairava, (2008) Ayurvediya Panchakarma Chikitsa: Chaukhambha Sanskrit Pratishthan, Delhi. PP-444–448 Kasture H. S., (2004), Ayurvediya Panchakarma Vijnan:, 8th edition, Shri Vaidyanath Ayurved Bhawan Limited, PP.294–300

Source of Support: Nil

Shastri Laxmipati, (2004), Vidyotini Hindi Commentary, Shastri Brahmasankar, Yog Ratnakar, PP-501 Susruta, (2000 BC), Ayurveda Tatwa Sandeepika Hindi Commentary, Shastree Kaviraj Ambikadatta, Susruta Sahmita, 11th edition, Chaukhamba Sanskrit Bhawan, 1997, Varanasi, VolI, Nidan Sthana.- 5/5, PP -247. Vagbhatta, (4th AD), Vidyotini Bhasa commentary, Gupt Kaviraj Atridev, Astanga Hridaya, twelfth edition, Chaukhamba Sanskrit Bhawan, 1997, Varanasi, Nidan Sthana, 14/3,PP 271 Vriddha Vagbhata, (4th AD), Soroj Hindi commentary, Tripathy Ravidutta, Astanga sangraha, Chaukhamba Sanskrit pratisthana, 1996, Delhi, Sutra sthan-35/4, PP.600

Conflict of Interest: None Declared

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Global J Res. Med. Plants & Indigen. Med. | Volume 2, Issue 1 | January 2013 | 40–51 ISSN 2277-4289 | www.gjrmi.com | International, Peer reviewed, Open access, Monthly Online Journal

Research article A CLINICAL STUDY ON THE EFFECTIVENESS OF DM II HERBAL COMPOUND (KALPIT) IN THE MANAGEMENT OF OBESE DIABETICS Agarwal Vivek1* 1

Assistant Professor, Department of Rog Nidan, MSM Institute of Ayurveda, BPS Women University Khanpur kalan, Distt. Sonipat, Haryana, Pin – 131305 *Corresponding Author: E-mail- drvivek91@gmail.com; Phone – 09416608598

Received: 04/12/2012; Revised: 29/12/2012; Accepted: 02/01/2013

ABSTRACT Diabetes is pandemic in both developed and developing countries. In 2000, there were an estimated 175 million people with diabetes worldwide and by 2030 the projected estimate of diabetic is 354 million. One out of 20 persons in new millennium will be diabetic. The study was planned to assess the effect of DM II Herbal compound in Sthula Pramehi (Obese diabetics i.e. NIDDM) on the basis of subjective and objective parameters. For the purpose of study ninety diagnosed Sthula Pramehi are randomly divided into three groups, thirty of each, Group A Participants were given modern medicine, Group B Participants were given modern medicine with DM II Herbal compound and Group C Participants were given DM II Herbal compound alone. Results were noted after two month drug trial. Group B showed more significant results than Group A and C. KEY WORDS: DM II Herbal compound, Sthula Pramehi, Non Insulin Dependent Diabetes Mellitus, Chala Sphiga Udara Stana (CSUS)

Cite this article: Agarwal Vivek (2013), A CLINICAL STUDY ON THE EFFECTIVENESS OF DM II HERBAL COMPOUND (KALPIT) IN THE MANAGEMENT OF OBESE DIABETICS, Global J Res. Med. Plants & Indigen. Med., Volume 2(1): 40–51

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INTRODUCTION Today is the era of modernization and fast life. Rapid urbanization and industrialization have produced advancement of the social and economic front in developing countries such as India. As a result, this dramatic life style changes lead to related diseases like NIDDM. The transition from a traditional to modern life style, consumption of diets rich in fat and calories combined with a high level of mental stress has compounded the problem further. Now days, it is concluded that the group of metabolic risk factors in one person which has given a name Metabolic syndrome or Syndrome X which usually includes Abdominal obesity, Atherogenic dyslipidemia, Hypertension, Diabetes mellitus. (Davidson, 2002). The predominant underlying risk factors for the metabolic syndrome appear to be abdominal obesity and insulin resistance. Other associated factors are physical activity, ageing, hormonal imbalance, atherogenic diet and insulin resistance which is an essential cause of the metabolic syndrome, predisposes to hyperglycemia and type 2 diabetes mellitus. Individuals who are insulin resistant may not be clinically obese, but they commonly have an abnormal fat distribution that is characterized by predominant upper body fat. Upper body obesity can occur either intraperitoneally (visceral fat) or subcutaneously, both of them are correlated strongly with insulin resistance and the metabolic syndrome. In present era, Sthaulyata is a burning problem which is a byproduct of urbanization. It is not only the root cause of major aliments like diabetes, heart problems, hypertension etc but it has also significant life running effect on the patient’s quality of life. The quality of life measurements are increasingly being used in assessing the treatment outcomes in these conditions as they measure the missing dimensions of healthcare. Diabetes is a metabolic illness requiring regular medications and ability on the part of patient to monitor and modify diets and lifestyle (Niranjan Y et al., 2012). The etiological factors mentioned in context to Sthaulya and Prameha are almost the

same, as both the diseases are considered as santarpanajanya-vyadhi in Ayurveda i.e. the disease caused by indulgence of madhurya (sweetness), snigdha (unctuousness), sita (coldness), guru (heaviness), picchila ahara (sliminess), meat of aquatic animals and decreased physical activities like divasvapna (sleep during day time), avyayama (lack of exercise) etc. (Charaka, 200 BC). According to the pathogenesis of these diseases, kapha plays important role which is aggravated first, then in turn aggravates the medo-dhatu (lipid) as their properties are similar in some extent. Now the aggravated or the dushit medo-dhatu (abnormal lipid) works as a dosha, causing atiSthaulya and Prameha (Charaka, 200 BC). As per modern medical science, obesity is associated with carbohydrate intolerance, insulin resistance and hyper-insulinism, which are the features of Non-insulin dependent diabetes mellitus (Harsh Mohan, 2000). Hence a study was planned to assess the effect of DM II Herbal compound in Sthula Pramehi (Obese diabetics i.e. NIDDM) on the basis of subjective and objective parameters. MATERIAL AND METHODS (1) Selection of Participants Participants for therapeutic drug trial were selected from the OPD and IPD of the MSM Institute of Ayurveda and Hospital, khanpur kalan Distt. Sonipat (Haryana) after screening as per Ayurvedic and Modern criteria for Sthula Pramehi. Selection had been carried out according to relevant history, sign, symptoms and Laboratory investigations including Body Mass Index for Sthula persons & the study carried out as per Institutional Ethical Committee clearance Reg.No.RAU/AK/Ph.D /184/08-09. (a) Inclusion criteria  Participants in the age group between 35 to 65 years irrespective of either sex.  Diagnosed cases of NIDDM (as per subjective and objective parameters) with BMI > 25.

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(b) Exclusion criteria  Participants with major complications and requirement of emergency treatment.  Participants taking drugs like corticosteroids, tricyclic antidepressant, cycloheptadine which leads to weight gain.  IDDM Cases.  Pregnant women

(c) Diagnostic criteria All the Participants were diagnosed on the basis of following criteria – i) Clinical signs and symptoms (Table 1) ii) Body Mass Index iii) Hip and waist circumference iv) InvestigationsHematological (Routine Test) - TLC, DLC, ESR, Hb% Bio-chemistry - FBS, PPBS, Blood Urea, Lipid Profile Urine examination - FUS, PMUS, Albumin, pH, Specific gravity etc.

Table No. 1 -Symptoms observed in Participants for diagnosis S.No. Symptoms Explanation Chala, sphiga, udara and stana Show movement of buttocks, abdomen and 1 breast during activity Ayathopachaya Disproportionate body 2 Prabhoot mootrata Polyurea 3 Aavil mootrata Turbidity in Urine 4 Pipasadhikya Polydipsea 5 Kshudhadhikya Polyphagia 6 Swedatipravritti Excessive sweating 7 Daurbalya Weakness 8 Aalasya Lassitude 9 Atinidra Excessive sleep 10 Vibandh Constipation 11 Malavritta Jihwa Coated tongue 12 Kar-paada daha Burning sensation in hand and foot 13 Mukhmadhurya Sweetness of mouth 14 Tandra Drowsiness 15 Krichvyavyata Sexual dysfunction 16 Sandhi shula Joint pain 17 Scoring Criteria Feature No Symptom Mild Symptom Moderate Symptom Severe Symptom

Score 0 1 2 3

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(2) General Observations a) Demographic Profile: The Participants registered under the present trial were closely interviewed according to the Performa of study. In incidence of their age, sex, socio-economic status, marital status, religion, habitat, dietary habits, nature of job and other relevant information’s were worked out. b) Physical Measurement: All the measurement was made with the Participants in empty stomach i.e. before, during and after the treatment. (i) Height (ii) Weight (iii) Body Mass Index (iv) Waist Circumference It was measured in inches, when the Participants were in standing position, using a standard tape measure, over the unclothed abdomen of the patient at the midpoint between the costal margin and the iliac crest. (v) Hip Circumference It was measured to the nearest inches with the patient standing, using a standard tape measure at the level of the greater trochanters. Note – Normal W/H ratio should be 0.8 in female and 1.0 in males. c). Determination of Prakriti (3) Clinical Observations Selection of drugs

Aamrasthi majja (Mangifera indica), Jambu seeds (Syzygium cumini), Karvellaka fruit (Momordica charantia), Nimba (Azadirachta indica), Bilwa leaves (Aegle marmelos), Meshshringi leaves (Gymnema sylvestre), Haridra kanda (Curcuma longa), Danamethi seeds (Trigonella foenum-graecum), Triphala dried fruits (Phyllanthus emblica, Terminalia bellarica, Terminalia chebula). Preparation of drug Above mentioned all the eleven ingredients are taken in equal quantity and prepared in the form of churna (fine powder) in the pharmacy of MSM Institute of Ayurveda, Khanpur kalan (Sonepat, Haryana). Administration of drug Ninety clinically diagnosed Sthula Pramehi (obese diabetic) Participants were divided into three groups – Group A – 30 Participants were recommended allopathic medicine before 15 minutes of meal for two month as a control group. (Under supervision of allopathic physician) Group B - 30 Participants were recommended allopathic medicine along with DM II Herbal compound 5 gm twice a day with Luke warm water before 15 minutes of meal for two month. Group C - 30 Participants were recommended DM II Herbal compound 5gm twice a day with Luke warm water before 15 minutes of meal for two month. Follow up study

For the present study, selection of the drug combination DM II Herbal compound which was on the basis of various textual references. The drugs in this compound are easily available and having the high degree of clinical significance in Sthula Pramehi.

Participants were followed up after 15 days up to two month. Laboratory investigations were repeated after the duration of trail. Improvement and other effects were noted.

Ingredients of DM II Herbal compound are as follows (Sharma P V, 2001)

Note- Not any side effect and toxic effects of DM II Herbal compound was reported by any individual during trial.

Chirabilwa bark (Holoptelea integrifolia), Daruharidra kanda (Berberis aristata),

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OBSERVATIONS AND RESULTS Table No. 2 – Distribution based on Family History of Obese Diabetics Participants S.N Family Number of Participants Total % o. History Group-A Group-B Group-C Present 20 23 21 64 71.11 1. Absent 10 07 09 26 28.88 2. 30 30 30 90 100 Total

S.No. 1. 2. 3. 4. Total

Table No. 3 – Distribution based on the BMI of Participants BMI Number of Participants Total (In Kg/m2) Group-A Group-B Group-C 18.5–24.9 25–29.9 23 22 25 70 30–34.9 07 08 05 20 > 35 30 30 30 90

Symptoms

Table No. 4 – Improvement in Symptoms in Group A N Mean Dif. Improvement% SD SE BT

AT

% 77.77 22.22 100

t

P

CSUS Ayathopachaya

28 24

1.79 1.88

1.21 1.29

0.57 0.58

32.00 31.11

0.50 0.50

0.10 0.10

6.00 5.67

<0.001 <0.001

Prabhoot mootrata

30

2.27

1.10

1.17

51.47

0.70

0.13

9.14

<0.001

Aavil mootrata Pipasadhikya

26 28

1.50 1.75

0.73 0.86

0.77 0.89

51.28 51.02

0.51 0.63

0.10 0.12

7.62 7.51

<0.001 <0.001

Kshudhadhikya

30

1.77

1.13

0.63

35.85

0.72

0.13

4.83

<0.001

Swedatipravritti

29

1.79

0.97

0.83

46.15

0.66

0.12

6.77

<0.001

Daurbalya

30

1.77

1.03

0.73

41.51

0.78

0.14

5.12

<0.001

Aalasya Ati nidra Vibandh Malavritta Jihwa

24

1.92

1.04

0.88

45.65

0.74

0.15

5.79

<0.001

24 23 24

1.25 1.52 1.63

0.83 0.83 0.92

0.42 0.70 0.71

33.33 45.71 43.59

0.58 0.56 0.62

0.12 0.12 0.13

3.50 5.97 5.56

<0.001 <0.001 <0.001

Karpada daha

26

1.77

0.88

0.88

50.00

0.52

0.10

8.74

<0.001

Mukh Madhurya Tandra

23 26

1.39 1.35

0.61 0.73

0.78 0.62

56.25 45.71

0.60 0.57

0.13 0.11

6.26 5.49

<0.001 <0.001

Krichvyavayata

26

1.65

1.04

0.62

37.21

0.50

0.10

6.32

<0.001

Shula

25

1.68

1.12

0.56

33.33

0.51

0.10

5.53

<0.001

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Table No. 5 – Improvement in Symptoms in Group B Symptoms N Mean Dif. SD SE t Impro BT AT vemen t% 30 2.07 1.23 0.83 40.32 0.46 0.08 9.90 CSUS 25 2.08 1.28 0.80 38.46 0.50 0.10 8.00 Ayathopachaya Prabhoot mootrata 30 2.33 0.80 1.53 65.71 0.63 0.11 13.36 27 1.44 0.89 0.56 38.46 0.51 0.10 5.70 Aavil mootrata 28 1.75 0.46 1.29 73.47 0.81 0.15 8.40 Pipasadhikya 0.86 1.10 56.14 0.86 0.16 6.91 Kshudhadhikya 29 1.97 29 2.14 0.69 1.45 67.74 0.91 0.17 8.57 Swedatipravritt 28 2.04 0.82 1.21 59.65 0.74 0.14 8.70 Daurbalya 26 2.15 1.27 0.88 41.07 1.21 0.24 3.73 Aalasya 30 1.77 0.70 1.07 60.38 0.83 0.15 7.06 Ati nidra 26 1.81 0.58 1.23 68.09 0.76 0.15 8.21 Vibandh 0.85 1.04 54.90 0.71 0.14 7.63 Malavritta Jihwa 27 1.89 26 1.81 0.77 1.04 57.45 0.92 0.18 5.78 Karpada daha 0.76 0.80 51.28 0.76 0.15 5.24 Mukh Madhurya 25 1.56 27 1.93 1.00 0.93 48.08 0.87 0.17 5.51 Tandra 24 1.88 1.17 0.71 37.78 0.62 0.13 5.56 Krichvyavayata 27 1.85 0.93 0.93 50.00 0.62 0.12 7.82 Shula Table No. 6 – Improvement in Symptoms in Group C Symptoms N Mean Dif. Impro SD SE vemen BT AT t% 27 1.93 1.44 0.48 25.00 0.51 0.10 CSUS 23 2.00 1.22 0.78 39.13 0.52 0.11 Ayathopachaya Prabhoot mootrata 29 1.93 0.83 1.10 57.14 0.67 0.13 26 1.42 0.85 0.58 40.54 0.50 0.10 Aavil mootrata 28 1.36 0.68 0.68 50.00 0.55 0.10 Pipasadhikya 29 2.07 1.28 0.79 38.33 0.77 0.14 Kshudhadhikya 28 1.71 0.71 1.00 58.33 0.67 0.13 Swedatipravritt 25 2.32 1.08 1.24 53.45 0.72 0.14 Daurbalya 26 1.77 1.04 0.73 41.30 0.60 0.12 Aalasya 27 1.67 0.93 0.74 44.44 0.71 0.14 Ati nidra 26 1.69 0.81 0.88 52.27 0.59 0.12 Vibandh 27 1.67 0.81 0.85 51.11 0.66 0.13 Malavritta Jihwa 27 1.85 0.81 1.04 56.00 0.85 0.16 Karpada daha 0.59 0.96 61.90 0.81 0.16 Mukh Madhurya 27 1.56 27 1.56 0.93 0.63 40.48 0.56 0.11 Tandra 23 1.61 1.04 0.57 35.14 0.51 0.11 Krichvyavayata 28 1.82 1.21 0.61 33.33 0.57 0.11 Shula

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P

<0.001 <0.001 <0.001 <0.001 <0.001 <0.001 <0.001 <0.001 <0.001 <0.001 <0.001 <0.001 <0.001 <0.001 <0.001 <0.001 <0.001

t

P

4.91 7.24 8.83 5.84 6.55 5.52 7.94 8.57 6.17 5.40 7.67 6.68 6.31 6.19 5.79 5.35 5.67

<0.001 <0.001 <0.001 <0.001 <0.001 <0.001 <0.001 <0.001 <0.001 <0.001 <0.001 <0.001 <0.001 <0.001 <0.001 <0.001 <0.001


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Table No. 7 - Improvement in Objective Parameters in Group A Objective N Mean Dif. % SD SE t Parameters BT AT 30 35.53 34.50 1.03 2.91 0.89 0.16 6.36 Waist Circum. 30 37.87 36.33 1.53 4.05 0.82 0.15 10.25 Hip Circum. 30 72.13 70.20 1.93 2.68 1.53 0.28 6.92 Weight 30 28.39 27.72 0.68 2.38 0.39 0.07 9.57 BMI Table No. 8 - Improvement in Objective Parameters in Group B N Mean Dif. % SD SE t BT AT 30 36.40 33.80 2.60 7.14 1.00 0.18 14.19 Waist Circum. 30 37.27 34.93 2.33 6.26 1.09 0.20 11.69 Hip Circum. 30 73.57 70.20 3.37 4.58 1.19 0.22 15.51 Weight 30 29.07 27.64 1.43 4.92 0.80 0.15 9.80 BMI Objective Parameters

Table No. 9 - Improvement in Objective Parameters in Group C Objective N Mean Dif. % SD SE t Parameters BT AT 30 36.43 34.33 2.10 5.76 1.03 0.19 11.18 Waist Circum. 30 37.90 35.70 2.20 5.80 1.06 0.19 11.33 Hip Circum. 30 72.67 70.20 2.47 3.39 1.17 0.21 11.58 Weight 30 28.43 27.44 0.99 3.48 0.39 0.07 13.79 BMI

Investigation

Table No. 10 – Improvement of Investigations in Group A N Mean Mean Mean % S.D. S.E. B.T. A.T. Diff.

Hb%

30 11.66

TLC Polymorph Lymphocytes ESR Fasting Blood Sugar

<0.001 <0.001 <0.001 <0.001

P <0.001 <0.001 <0.001 <0.001

P <0.001 <0.001 <0.001 <0.001

‘t’ ‘p’ Value Value

0.44

3.80

0.46

0.08

5.29

<0.001

30 7243.50 7401.67 30 58.97 59.47 35.23 35.17 30 17.50 12.73 30 174.23 141.03

158.17 0.50 0.07 4.77 33.20

2.18 0.85 0.19 27.24 19.05

483.62 2.96 4.52 5.41 19.26

88.30 0.54 0.82 0.99 3.52

1.79 0.93 0.08 4.83 9.44

>0.01 >0.01 >0.01 <0.001 <0.001

Post Prandial Blood Sugar

30 259.77

194.87

64.90

24.98 24.86

4.54

14.30

<0.001

Blood Urea

30 28.17

27.00

1.17

4.14

5.54

1.01

1.15

>0.01

S.Cholesterol

30 214.74

201.30

13.44

6.26

19.81

3.62

3.72

<0.01

S.Triglyceride

30 123.31

127.40

4.09

3.32

18.56

3.39

1.21

>0.01

H.D.L.

30 57.64

59.17

1.53

2.65

6.28

1.15

1.33

>0.01

L.D.L. V.L.D.L. Fasting Urine Sugar

30 131.45 30 24.81 30 1.75

116.65 25.48 0.13

14.79 0.67 1.63

11.25 19.21 2.71 3.65 92.86 0.81

3.51 0.67 0.20

4.22 1.01 8.06

<0.001 >0.01 <0.001

0.93

2.07

68.97 0.70

0.13

15.83

<0.001

Post Meal Urine Sugar 30 3.00

12.11

P

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Investigation

Table No. 11 – Improvement of Investigations in Group B N Mean Mean Mean % S.D. S.E. B.T. A.T. Diff.

Hb%

30 12.04

TLC

2.68

0.41

30 7317.83 7255.00 62.83

0.86

379.12 69.22 0.91

>0.01

Polymorph Lymphocytes ESR Fasting Blood Sugar

30 57.83 36.47 30 12.97 30 173.57

58.73 35.20 9.23 123.03

0.90 1.27 3.73 50.53

1.56 3.47 28.79 29.11

3.16 3.32 4.38 20.18

0.58 0.61 0.80 3.68

1.56 2.09 4.67 13.72

>0.01 <0.01 <0.001 <0.001

Post Prandial Blood Sugar

30 255.50

171.30

84.20

32.95 25.85

4.72

17.84

<0.001

Blood Urea

30 28.90

28.20

0.70

2.42

0.71

0.99

>0.01

S. Cholesterol

30 204.24

164.60

39.64

19.41 18.19

3.32

11.93

<0.001

S. Triglyceride

30 134.57

104.17

30.40

22.59 20.97

3.83

7.94

<0.001

High Density Lipoprotein

30 56.95

58.77

1.81

3.18

0.81

2.24

<0.01

Low Density Lipoprotein

30 120.46

84.36

36.10

29.97 18.15

3.31

10.89

<0.001

Very Low Density Lipo.

30 26.88

21.43

5.44

20.25 3.54

0.65

8.43

<0.001

Fasting Urine Sugar

30 1.80

0.07

1.73

96.30 0.70

0.18

9.54

<0.001

Post Meal Urine Sugar

30 2.90

0.27

2.63

90.80 0.81

0.15

17.83

<0.001

In Investigation

12.37

0.32

3.87

4.44

0.08

‘t’ ‘p’ Value Value

Table No. 12 – Improvement of Investigations in Group C N Mean Mean Mean % S.D. S.E. B.T. A.T. Diff. 2.21

0.43

3.24

<0.01

TLC

30 7364.67 7108.33 256.33 3.48

742.50 135.56 1.89

>0.01

Polymorph Lymphocytes ESR

30 57.20 38.27 30 14.57

58.47 35.43 9.60

1.27 2.83 4.97

2.21 3.96 7.40 5.98 34.10 5.14

0.72 1.09 0.94

1.75 2.60 5.30

>0.01 <0.01 <0.001

Fasting Blood Sugar

30 157.50

128.03

29.47

18.71 12.32

2.25

13.10

<0.001

Post Prandial Blood Sugar

30 223.00

175.50

47.50

21.30 16.22

2.96

16.04

<0.001

Blood Urea

30 29.83

28.00

1.83

6.15

0.99

1.85

>0.01

S.Cholesterol S.Triglyceride

30 192.13 30 129.03

165.33 111.77

26.80 17.27

13.95 15.55 13.38 16.07

2.84 2.93

9.44 5.88

<0.001 <0.001

High Density Lipoprotein Low Density Lipoprotein

30 57.40 30 109.45

59.80 83.41

2.40 26.04

4.18 3.58 23.79 15.01

0.65 2.74

3.67 9.50

<0.01 <0.001

Very Low Density Lipo.

30 25.27

22.15

3.12

12.35 2.32

0.42

7.36

<0.001

1.33

0.11

1.22

91.67 0.44

0.15

8.32

<0.001

30 2.20

0.43

1.77

80.30 0.73

0.13

13.29

<0.001

5.43

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0.08

‘t’ ‘p’ Value Value

30 11.64

Post Meal Urine Sugar

0.26

<0.001

Hb%

Fasting Urine Sugar 9

11.89

4.27


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Table No. 13 – Comparative improvement of Lipid Profile, Blood sugar & B.M.I. S.No. Parameters Group A Group B Group C Lipid Profile 5.238% 19.08% 13.53% 1. Blood Sugar 22.01% 31.03% 20% 2. B.M.I. 2.38% 4.92% 3.48% 3.

S.No. 1. 2. 3.

Table No.14 – Comparative improvement in percentage of Sthula Pramehi Observations Group A Group B Group C Subjective 43.01% 53.46% 45.75% Improvement Objective Improvement 3.005% 5.725% 4.607% Investigation 19.31% 27.45% 23.94% Improvement

OVER ALL GRAPHIC ASSESSMENT

Group A

50.00% 40.00% 30.00% 20.00% 10.00% 0.00%

Group A Subjective Objective Investigation Improvement Improvement Improvement

Group B 60.00% 40.00% 20.00% 0.00%

Group B Subjective Objective Investigation Improvement Improvement Improvement

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Group C 50.00% 40.00% 30.00% 20.00% 10.00% 0.00%

Group C

Subjective Objective Investigation Improvement Improvement Improvement

DISCUSSION Discussion on Conceptual Study The Prameha is one among the eight troublesome diseases described by Ayurveda. So, it is difficult to treat with single drug therapy i.e. why a combination of drug is chosen for therapeutic study of Sthula Pramehi. The sthula (obese) pramehi have more strength as compared to krisha or asthenic Participants. But generally asthenics are preferred than obese, as the complications of obesity are more than compared with disadvantages of being asthenic. In Prameha the obese Participants have good prognosis than the asthenic Participants. (Charaka, 200 BC) All varieties of Prameha, if not treated in time, will ultimately become madhumeha which is incurable. One more thing, which has conceived through this study, is that the two types of madhumeha i.e. dhatukshayah janya and Aavaran janya can be called IDDM & NIDDM respectively. (Sushruta, 2000BC) Thus in the Ayurvedic texts the interrelationship is described, inference is that Prameha especially the madhumeha is strongly related to the Sthaulya (obesity). Discussion on Subjective Parameters Group A This group showed maximum percentage subsidence in Mukhmadhurya (56.25%), Prabhoot mootrata (51.47%), Aavil mootrata

(51.28%), Pipasadhikya (51.02%), Kar-pada daha (50%), but over all study shows symptomatic improvement in Group A was 43.01%. Group B This group showed maximum percentage subsidence in Pipasadhikya (73.47%), Vibandh (68.09%) Swedatipravritti (67.74%), Prabhoot mootrata (65.71%), Atinidra (60.38%), Daurbalya (59.65%), Kar-pada daha (57.45%), but over all study shows symptomatic improvement in Group B was 53.46%. Group C This group showed maximum percentage subsidence in Mukhmadhurya (61.90%), Swedatipravritti (58.33%), Prabhoot mootrata (57.14%), Kar-pada daha (56%), Daurbalya (53.45%), Vibandh (52.37%) but over all study shows symptomatic improvement in Group C was 45.75%. Discussion on Objective Parameters Group A The percentage of change in Body weight (2.68%), Body mass index (2.38%), Waist circumference (4.65%) & in Hip circumference (4.05%). Over all percentage of improvement is 3.005%. Group B The percentage of change in Body weight (4.58%), Body mass index (4.92%), Waist circumference (7.14%) & in Hip circumference

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Global J Res. Med. Plants & Indigen. Med. | Volume 2, Issue 1 | January 2013 | 40–51

(6.26%). Over all percentage of improvement is 5.725%. Group C The percentage of change in Body weight (3.39%), Body mass index (3.48%), Waist circumference (5.76%) & in Hip circumference (5.80%). Over all percentage of improvement is 4.607%. Discussion on Investigations In Routine investigations, Haemoglobin and ESR showed highly significant results but TLC & DLC showed statistically insignificant results in all the three groups. Blood Urea in all the three groups showed statistically insignificant results. Group A The reduction percentage of Blood sugar &Urine sugar after the treatment was 22.01% & 80.91%. Both parameters showed statistically highly significant improvement. The result percentage of Lipid Profile was 5.238%. In which cholesterol showed significant results but other parameters do not show such significant improvement. Over all percentage of improvement is 19.31%. Group B The reduction percentage of Blood sugar, Urine sugar and Lipid Profile after the treatment was 31.03%, 93.55% & 19.08%. All the above said parameters showed statistically highly significant improvement except HDL i.e. significant. Over all percentage of improvement is 27.45%. Group C The reduction percentage of Blood sugar, Urine sugar and Lipid Profile after the treatment was 20.00%, 85.98% & 13.53%. All the above said parameters showed statistically highly significant improvement except HDL i.e. significant. Over all percentage of improvement is 23.94%.

CONCLUSION Declaration of diabetes mellitus as an epidemic by WHO signifies the gravity of disease. More incidences can be avoided by early education, early detection, and changing life style, food habit & proper exercise. Sthula Prameha (NIDDM) is personality damaging disease; it affects not only somatic level but also psychic level. As per observations & Results, maximum number of Participants having Rajasik dominant Manasik Prakriti. Sthaulya & Prameha both are dusit medoja vyadhi in which medodhatu acts an aetiological factor. Sthaulya (Medoroga) is a Nanatmaja kapha vyadhi and Prameha is predominant kaphaj, their pathogenesis is almost same. Prameha, Prameha pidika are considered as complications of the Medoroga, which explains their interrelationship. One should understand the fact that in diabetes the main culprit is not the sugar but fat. Diabetes mellitus is a metabolic syndrome where each cell of the body sufferers, characterized by chronic hyperglycemia with disturbances of carbohydrates. Fat & protein metabolism. Resulting from improper insulin secretion. From its complication it is clear that it is a ama vyadhi thus the line of treatment should address diabetes as a total and should include shodhana, ama-pachana (Anti-oxidants), rasayana along with specific anti-diabetics or hypoglycemic. The present research work showed that Medodusti in type-2 Diabetes mellitus (NIDDM) is more common in higher socio-economic society because of their sedentary and comfortable life style. The Traditional tribal combination used for prevention of Diabetes mellitus had shown almost full result so for. ‘DM II Herbal Compound’ was very effective in reducing physical examination parameters, Blood and Urine sugar levels and some extent of Lipid Profile. Participants who were dependent on Ayurvedic drugs had better improvement than those on modern medicines. Group B showed better results of improvement than Group A and Group C on the basis of clinical parameters.

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ACKNOWLEDGEMENT I would like to thank Prof. Loknath Sharma, Ex. HOD of Rog Nidan, National Institute of Ayurveda Jaipur, for his valuable guidance,

precious support and priceless blessings showered on each and every step, right from the commencement.

REFERENCES Charaka, (200 BC), Hindi commentary, Shastri Kashinath and Chaturvedi Gorakhnath, Charaka Samhita, Chaukhambha Bharti Academy, Reprint 1998,Varanasi, Vol.1 & II, Sutrasthana 21/17; Chikitsasthana 6/4-5 Davidson, (2002) Principles & Practice of Medicine, Churchill Livingstone Publication, 19th Edition, New York. Page no.-655 Harsh Mohan, (2000), Text Book of Pathology, Jaypee Brothers, 4th edition, New Delhi, Chap.24, page no.803

Source of Support: Nil

Niranjan Y, Santwani M A, Baghel M S (2012), Quality of life consequences in diabetic polyneuropathy, Global J Res. Med. Plants & Indigen. Med. 1(7): 295– 300 Sharma P.V., (2001), Dravya Guna Vigyan, Chaukhambha Bharti Academy, 2nd Edition, Reprint 2001, Varanasi, Vol. II Sushruta, (2000 BC) ‘Ayurveda-TattvaSandipika’ Hindi Commentary, Shastri Kaviraja Ambikadutta, Sushruta Samhita, Chaukhambha Sanskrit Sansthan, 14th Edition, 2003, Varanasi, Vol. I Su.Ni.6/30, page no. 255 Conflict of Interest: None Declared

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Global J Res. Med. Plants & Indigen. Med. | Volume 2, Issue 1 | January 2013 | 52–64 ISSN 2277-4289 | www.gjrmi.com | International, Peer reviewed, Open access, Monthly Online Journal

Research article A COMPARATIVE CLINICAL EVALUATION OF THYROMAX POWDER AGAINST THYROXINE SODIUM IN THE MANAGEMENT OF HYPOTHYROIDISM Ujjaliya Nitin1*, Krishnankutty S V2, Remadevi R3 1

Assistant Prof., Dept. of Dravyaguna Vijnana, Shri Dhanwantry Ayurvedic College & Dabur Dhanwantry Hospital, Chandigarh, India 2 Head, Department of Internal medicine, Maulana Hospital, Perinthalmanna, Kerala, India 3 Prof. & Head, Dept. of Dravyaguna Vijnana, V.P.S.V. Ayurveda College, Kottakkal, Kerala, India *Corresponding Author: Email: drnujjaliya@gmail.com

Received: 06/12/2012; Revised: 01/01/2013; Accepted: 07/01/2013

ABSTRACT The thyroid gland regulates metabolism of the body by virtue of its hormones. Insufficient levels of thyroid hormone causes signs and symptoms such as slower metabolic rate, weight gain, sleepiness, dry and cool skin, as well as others. This condition collectively can be called as Hypothyroidism. Of the different types, Primary Hypothyroidism is the commonest which occurs after destruction of thyroid follicles mainly because of autoimmunity. Hypothyroidism is most common in women than men. According to a study, it affects 3.9% people with 9.4% subclinical condition. The sole available treatment for this in conventional science is Hormone Replacement Therapy which is not always free from side effects and has to be taken lifelong. This study was aimed to search an option for Hypothyroidism in terms of herbs. Traditionally practiced drugs Guducī Satvam (Tinospora cordifolia Miers.) and Āmalakī cūrnam (Phyllanthus emblica Linn.) was taken in a combination named „Thyromax powder’ which was standardized before commencing with clinical trial. A controlled clinical trial was planned with 20 newly diagnosed participants, which were not exposed to any medicament, with Thyroxine sodium in control group and Thyromax powder in study group for the duration of 3 month. Assessment was done on the basis of six subjective parameters and thyroid function test. Statistically, study drug showed a positive correlation on subjective parameters while control group showed significant result on T3 and T4 levels. Both the groups were found statistically insignificant on TSH level. KEY WORDS: Thyromax powder, Hypothyroidism, Standardization, controlled clinical trial.

Cite this article: Ujjaliya Nitin, Krishnankutty S V, Remadevi R (2013), A COMPARATIVE CLINICAL EVALUATION OF THYROMAX POWDER AGAINST THYROXINE SODIUM IN THE MANAGEMENT OF HYPOTHYROIDISM, Global J Res. Med. Plants & Indigen. Med., Volume 2(1): 52–64

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INTRODUCTION Endocrinology concerns the synthesis, secretion and action of hormones. Hormones are chemical messengers which have diverse molecular structures and are related to endocrine glands thereby coordinate the activities of different cells. Some endocrine disorders are common, particularly those of the thyroid gland. At present thyroid diseases form the second most common endocrine disorder in India next to Diabetes mellitus. (Sir Stanley Davidson, Davidson Principles & Practice of Medicine; 2006). According to the report of N. Kochupilli, thyroid disorders (5.4%) are the most common among all the endocrine diseases in India (N. Kochupillai et al., 1986). Unfortunately many people may have this disease and even not realize it. According to a study known as a “Colorado thyroid disease prevalence study” there may be as 13 million Americans with an undiagnosed thyroid condition (Gay J Canaris et al., 2000). In the state of Kerala, India, 9.4% people who suffer from hypothyroidism are asymptomatic (Unnikrishnan AG et al., 2011). Wickham Survey suggested that there is a high possibility of developing Hypothyroidism in the population with raised TSH and thyroid antibodies. In the after follow up study it was demonstrated to be much accurate. It was inferred that increasing values of serum TSH above 2mU/l increases the probability of developing hypothyroidism which was further increased in the presence of anti-thyroid antibodies (Vanderpump MP, 1995). According to a study anti-thyroid antibodies were found in 89.6% of the women between 15–35 years of age and the overall prevalence of classical Hypothyroidism was found to be 10 times more than the men (K.P. Paulose, 2011). This made the medical society to consider it with a higher importance, as it may result in severe complications. The possibility of incidence of the disease also increases with a higher rate in old age. In Hypothyroidism, body function decreases and this leads to a slow heart rate, an increase in cholesterol level, mild anemia, pervasive fatigue, depression, low body

temperature, cold intolerance, coarsening of skin, muscles and joint aches, constipation, weight gain, slow hair growth, loss of libido, infertility, increased risk of miscarriage and irregular menstrual cycle in women etc. In the most common case of Hypothyroidism, namely Primary Hypothyroidism resulting from an intrinsic disorder of thyroid gland, serum T3 and T4 is low and TSH elevated also called as classical Hypothyroidism, resulting above signs and symptoms. (Sir Stanley Davidson, Davidson Principles & Practice of Medicine; 2006). According to the signs and symptoms, it is concluded that Hypothyroidism is a resultant of Vāta-kapha-medo vikrti and Dhātvāgnimāndhya (Alsa mariyam kalathancheri, 2008 and Chanchal Gupta, 2003). Guducī and Āmalakī are known for Rasāyana property and have action on Dhātvāgni specially Rasa and Rakta. Both the drugs have been proven as immunomodulators and anti-oxidant effects. (Dikshit V et al., 2003 and Shukla V et al., 2009). Prevalence of autoimmune Hypothyroidism is much higher (K.P. Paulose, 2001). Considering rejuvenative effect of these herbs, they may rejuvenate destroyed follicles of thyroid gland which are responsible for production of thyroid hormones; of course it is questionable and needs further research. These are proved drugs for many diseases and found non toxic. These two drugs are not found to have any drug interactions. (Database on Medicinal Plants used in Ayurveda, 2005). Guducī Satvam (extract of Tinospora cordifolia Miers.) along with Āmalakī cūrnam (powder of fruit of Phyllanthus emblica Linn.) is used by the traditional vaidyas for Hypothyroidism in Madhya Pradesh and found effective. In modern medicine hormone supplement is the only management for this disease. Though it is thought to be a successful therapy but a long term hormone therapy is not always free from complications as well as side effects. Most often it is needed to continue throughout the life in adjusted doses.

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Global J Res. Med. Plants & Indigen. Med. | Volume 2, Issue 1 | January 2013 | 52–64

This study was an effort to evaluate the effect of these two drugs in a combination which is named as “Thyromax powder” on the clinical symptoms and T3, T4 and TSH levels of Hypothyroidism.

standardization of drug and extraction of plant constituents. (Quality Standards of Indian medicinal Plants, and The Ayurvedic Pharmacopoeia of India, 2001). (Table no. 2 4)

MATERIALS AND METHOD

Phytochemical analysis

Study design

Quantification of characteristic compounds

The study design was a controlled clinical trial. Randomization was not done due to two different settings. Newly diagnosed participants were selected as per the inclusion and exclusion criteria. The control selected here was not a concurrent control. The control group was selected from an accessible population at Maulana Hospital, Perinthalmanna, Kerala, India. A detailed clinical examination was done before and after the study using a prepared case record form. Analysis of both the treatments was done by evaluating subjective and objective parameters.

The extracts obtained were subjected to qualitative tests for the identification of various plant constituents. (Quality Standards of Indian medicinal Plants, 2003 and The Ayurvedic Pharmacopoeia of India, 2001). (Table no. 5 7)

Sample collection and preparation of study drug The fresh Stem of Tinospora cordifolia were collected from nearby areas of Kottakkal, Kerala, India. The stem cuttings were properly identified in the department using external morphological and histological characters. Satvam was prepared as per the procedure given in the text. (Yogaratnākara Rājayaksamā Cikitsā; 328, Verse no. 1-11/2) The fresh fruit of Phyllanthus emblica of similar size were bought from market. The fruits were identified in the department and well dried in shade. Powder was prepared in the size of 40–80 microns. (The Ayurvedic Pharmacopoeia of India, 2001) Physicochemical Thyromax powder

Standardization

of

In the present study the combination of Satvam of Tinospora cordifolia and fine powder of dried fruits of Phyllanthus emblica in the ratio of 1:3; given the name Thyromax powder were subjected to preliminary physicochemical screening for the

Thin Layer Chromatography & HPTLC Selection of chromatographic layer Pre-coated TLC silica gel 60 F254 (E. Merck) plates on aluminum sheet were used for chromatographic profile for individual drugs and for Thyromax powder. TLC of all successive solvent extractives of Thyromax powder was prepared. While HPTLC fingerprinting of methanolic extract of Guducī Satvam, Āmalakī cūrnam and Thyromax powder was prepared. Selection of mobile phase for TLC a] For Thyromax powder Before the application of the samples to the plates, an appropriate solvent system was selected. The solvent system was chosen by the trial and error method. The solvent systems used for the TLC analysis were different for different successive solvent extractives.  For Petroleum ether extract – n-hexane : ethyl acetate : formic acid (10:2:0.2)  For Cyclohexane extractive – Toluene : ethyl acetate : formic acid (8:2:0.2 )  For Acetone & Ethanol extract – Toluene : ethyl acetate : formic acid (5:5:1) Selection of mobile phase for HPTLC a] For Guducī Satvam  For methanolic extract – toluene : ethyl acetate : formic acid (7:5:1)

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b] For Āmalakī cūrnam  For methanolic extract – toluene : ethyl acetate : formic acid (7:5:1) c] For Thyromax powder  For methanolic extract – toluene : ethyl acetate : formic acid (7:5:1) Application of sample For the application of sample CAMAG Automatic TLC sampler IV were used and the concentration of sample extractives were between 0.2 to 0.6 micro liters. Pre-conditioning Saturated chamber by lining with filter paper for 30 minutes was prepared prior to development for getting better Rf values. For this CAMAG ADC-2 Automatic development chamber was used. Chromatographic development and drying After development, the plates were taken out and mobile phase was completely removed from the plate by drying in vacuum desiccators. Detection and visualization Detection under UV light is the first choice so plates were visualized in CAMAG TLC Visualizer and photographs were taken in UV 254 and 365 nm. wavelength. Since very dim spots were obtained in visible light, the TLC plates were then sprayed with Anasaldehyde sulphuric acid and dried in hot air oven at 110oC. The colors of the spots were recorded and their positions were marked. The distance travelled by each band was measured and respective Rf values were calculated. TLC analysis of Thyromax powder For TLC study of Thyromax powder, Petroleum ether, Cyclohexane, Acetone and Ethanol extractives were spotted in the solvent system given in the literature of TLC under heading selection of solvent system. Eluents were different for all extractives (common for Acetone and Ethanol) hence Rf values, TLC photographs are given separate.

HPTLC analysis HPTLC profile was prepared for Guducī Satvam, Āmalakī cūrnam and for the combination Thyromax powder separately. The mobile phase and extracts were different for samples and has been mentioned earlier. For Methanolic extract of Guducī Satvam and Āmalakī cūrnam table of Rf value, TLC plate photos and HPTLC over view and area graphs are given separately. Clinical study In the present study randomization was not done hence comparison of demographic details and base line values of both the groups were done. Comparison of response to the treatment within both the groups was done. Total 20 participants were registered for the present study, each 10 in study and control group. All participants received full course of treatment and completed their course successfully without any interruption, hence there were no dropouts in the study. Data outcome were tabulated; mean deviation, standard deviation and percentage between the assessments were calculated. Student „t‟ test was applied to find out level of significance for all the parameters with in the treatment and control group. The data were statistically analyzed before and after intervention. RESULTS Organoleptic characters Detailed in (Table 1) Powder microscopy Guducī satvam Starch grains of Guducī showed deep blue color when mounted with Iodine solution. Every particle of Satvam was separated from each other. The shapes of Satvam particle was not similar and varies in size from other particles. Starch grains of Guducī were approximately 5.5–11.20µ in diameter and 6– 11.28µ in length. (Fig. no. 1&2).

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Powder microscopy of Āmalakī cūrnam Powder showed hexagonal, thick, straightwalled epidermal cells in surface view embedded with small prismatic crystals of silica; isolated or groups of thin-walled pitted stone cells; fragments of thick walled fibers and

sclereids; fragments of pitted vessels, tracheids and parenchyma, crystals of silica and simple oval to spherical starch grains scattered as such or embedded in the parenchymatous cells of the mesocarp. (Fig.no.3-6) (The Ayurvedic Pharmacopoeia of India).

Table 1. Organoleptic Characters No. Characters Characteristics of Satvam Characteristics of Āmalakī cūrnam Touch Fine and Smooth Rough 1 Color White Light grey 2 Taste Sweet Bitter, Sour and Sweet astringent 3 Odor Odorless Odorless 4 Consistency Fine powder Fine powder 5 Fig. 1–2 Powder Microscopy of Guducī Satvam

Fig. 3–6 Powder Microscopy of Āmalakī Cūrnam

Table 2. Physicochemical standards of Thyromax powder Sr. No. 1. 2. 3. 4. 5. 6.

7.

Experiments Total ash Water insoluble ash Acid insoluble ash Moisture content Volatile oil content Sugar content a. Total Sugar b. Reducing sugar Fibre content

Percentage 3.05% 2.23% 1.47% 11% 01% 13.1% 7.23% 3.0%

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Table 3. Percentage of water soluble and alcohol soluble extractives No. Name of extract Percentage of extract Color / Consistency 1.

Hot water soluble

80.75%

Blackish brown / Dry

2.

Cold alcohol soluble 27.40%

Dark brown / Oily

3.

Hot alcohol soluble

Dark brown / Oily

50.00%

No.

Table 4. Successive solvent extractives Experiments Percentage Color /Consistency

1. 2.

Petroleum ether Cyclohexane

1.63 % 0.80 %

Light yellow / Oily Lemon yellow/Oily

3. 4.

Acetone Ethanol

12.0 % 11.0 %

Dark brown / Oily Dark brown / Oily

Table 5. Qualitative Phytochemical analysis of the extractives Solvent Steroid Alkaloids by Phenol Flavonoids Tannins Mayer’s DDR Petroleum ether Cyclohexane Acetone Ethanol Water Cold alcohol Hot alcohol

– + – – – – –

+ – + + + + +

+ + + + – + +

– – + + + + +

– – + + + + +

+ + + + + + +

Table 6. Rf values of different spots of Thyromax powder ether Cyclohexane Acetone extract Ethanol extract extract 5 Spots 3 Spots 7 Spots

Petroleum extract 7 Spots Colour of Rf Spot 0.24 Violet

Colour of Spot

Rf

0.40

Colour of Rf Spot Brown 0.12

Pale brown

0.07

Colour of Spot Purple

Rf

Violet

0.31

Purple

0.48

Brown

0.34

Pale brown

0.13

Violet

0.36

Purple

0.66

0.46

Pale brown

0.17

Violet

0.40

Violet

0.78

Light violet -

-

Pale brown

0.24

Pale pink 0.61

Violet

0.88

-

-

Brown

0.35

Violet

0.68

-

-

-

-

Light green

0.41

Pale Violet

0.80

-

-

-

-

Light violet

0.49

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TLC of Thyromax powder (Fig. no. 7-18) Fig. no. 7- 9: TLC plate of Petroleum ether extract of Thyromax powder Fig. no. 10- 12: TLC plate of Cyclohexane extract of Thyromax powder

7: 254 nm

8: Derivatized plate.

9: 366 nm.

10: 254 nm.

11: Derivatized plate.

12: 366 nm.

Fig. no. 13- 15: TLC plates of Acetone extract of Thyromax powder Fig. no. 16- 18: TLC plates of Ethanolic extracts of Thyromax powder

13: 254 nm

14: Derivatized plate.

15: 366 nm.

16: 254 nm.

17: Derivatized plate.

18: 366 nm.

Table 7. Rf value details of Methanolic extract of Guducī Satvam, Āmalakī cūrnam and Thyromax powder. Guducī Satvam Āmalakī cūrnam Thyromax powder Spots Color

Spots Rf

Color

Light orange 0.80 Blue

Spots Rf

Color

0.18 Dark blue

Rf 0.18

Light orange 0.40 Blue

0.60

Light violet

0.70 Pink

0.70

Pink

0.80

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TLC of Āmalakī curnam and Guducī satvam (Fig. no. 19-23) Fig. no. 19- 21: TLC plates of Methanolic extract Fig. no. 22- 23: TLC plates of Methanolic extract of Thyromax powder.

19: Āmalakī at 254nm

20: Āmalakī at 366nm

21: Guducī at 366nm.

22: 254 nm

23: 366nm

HPTLC Over view graphs of study drugs (Fig. no. 24-31) Fig. no. 24: Over view graph of Methanolic extract of Āmalakī at 254nm Fig. no. 25: Area graph of Methanolic extract of Āmalakī at 254 nm.

Fig. no. 26: Over view graph of Methanolic extract of Guducī Satvam at 254 nm Fig. no. 27: Area graph of Methanolic extract of Guducī Satvam at 254 nm

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Fig. no. 28: Over view graph of Methanolic extract of Thyromax powder at 254 nm Fig. no. 29: Area graph of Methanolic extract of Thyromax powder at 254 nm

Fig. no. 30: Over view graph of Methanolic extract of Thyromax powder at 366 nm Fig. no. 31: Area graph of Methanolic extract of Thyromax powder at 366 nm

Data related to response to the treatment Graph 1. Effect of the treatment on weight gain

Graph 2. Effect of the treatment on excessive sleep

Effect of the treatment on weight gain 1.2 1.3 1.4 1.2 1 0.8 0.6 0.4 0.2 0

Effect of the treatment on excessive sleep 2.2

1.2

0.3

Study Control

2.5 2 1.5 1 0.5 0

1.6 0.2

Study Control

BT BT

1.9

AT

AT

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Graph 3. Effect of the treatment on muscle cramp

Graph 4. Effect of the treatment on edema

Effect of the treatment on muscle cramp 3

2

2.2 2.0

1.7

1.5

Effect of the treatment on edema 1.8 1.3 1.1

2

Study

0.2

1

Control

0

0.4

1

Study Control

0.5

0 BT

AT

BT

Graph 5. Effect of the treatment on dry skin

Graph 6. Effect of the treatment on constipation

Effect of the treatment on dry 2.0 skin 2 1.8 1.6 1.4 1.2 1 0.8 0.6 0.4 0.2 0

1.5

3

1.4

AT

2.5

Effect of the treatment on 2.8 constipation 2.4 2.1

2

0.6

Study Control

Study

1.5

Control

1

0.0

0.5 0 BT

AT

BT

AT

Graph 7. Effect of the treatment on T3 parameter

Graph 8. Effect of the treatment on T4 parameter

Effect of the treatment on T3 parameter

Effect of the treatment on T4 parameter

1 0.8 0.6 0.4 0.2 0

0.822 0.696 0.658 0.719

Study Control

BT

AT

70 60 50 40 30 20 10 0

54.01

54.91 65.92

Study

43.76

Control

BT

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AT


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Graph 9. Effect of the treatment on TSH

Effect of the treatment on TSH 62.79 70

55.99

60 50 40

23.46

30

Study Control

8.17

20 10 0 BT

DISCUSSION Pharmacognostical study Moisture content of the shade dried drug determined by Dean & Starks apparatus was found to be 11%. Total ash of any drug is the residue obtained on its complete incineration in an electric Bunsen burner. This mainly represents the inorganic salts present in the drug, if the drug is pure and any impurities like sand, soil etc. adhering to the drug will also remain as ash, thus increasing the ash value several fold. Ash value is the general criterion to ascertain the purity of the drug. Total ash value of the drug was found to be 3.05%. Water insoluble ash mainly gives the percentage of organic matter present in the ash and this was found to be 2.23%. Acid insoluble ash, which mainly gives the percentage of the sand and impurities that remain insoluble in HCl and it was found to be 1.47%. Water soluble extracts of the drug mainly represents the percentage of organic constituents such as tannins, sugars, plant acids, mucilage and glycosides. Alcohol soluble extracts mainly represents the percentage of organic constituents such as alkaloids, phenols, flavanoids, steroids, sugars etc. present in the drug. Successive solvent extraction, which is the extraction of the drug with organic solvents of

AT

increasing polarity, was applied for the isolation of active constituents from the crude drug. The highest percentage of extract was obtained by the extraction with acetone (12.0 %) and least with the solvent cyclo-hexane 0.80 percent. The extracts obtained by exhausting crude drugs are indicative of approximate measure of their chemical constituents. Successive extraction showed scattered results because of the combination of two drugs. Due to Āmalakī cūrnam (Phyllanthus emblica) tannin present in all the extracts and steroids are present in all except cyclohexane extractive. While alkaloid (by Mayer‟s reagent) is present only in cyclohexane extract and alkaloid by Dragendroff‟s reagent present in all except water soluble extract. Phenol and flavonoids are present in all the extract except petroleum ether and cyclohexane extractives. Clinical study Student „t‟ test was applied to find out level of significance for all the parameters with in the treatment and control group. The data were statistically analyzed before and after intervention. Both the groups were not compared since only study group showed significant improvement on subjective parameters and only control group showed

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significant improvement on T3 and T4 level. None of them showed significant effect on TSH parameter. Probable Mode of Action in a nut shell It has been established for a very long time that there is a complex relationship between thyroid disease, body weight and metabolism. (K.P. Paulose, 2011). Thyroid hormones regulate metabolism in human. It is also reported that difference in BMRs are associated with changes in energy balance. (K.P. Paulose, 2011). Studies concluded that under secretion of thyroid hormones leads to low BMR and thereby weight gain, decrease in energy balance causes sleepiness and muscle cramps. Once the drug holds the body metabolism all these symptoms get relieved. Functions of thyroid hormone have a close resemblance to the Dhātvāgni (digestive potency of cells). (Alsa mariyam kalathancheri, 2008). Constipation is the foremost symptom of this disease which may be due to Agnimāndhya (loss of appetite) and Āma (indigested food material). Both the drugs are considered most excellent Pitta śamakas (drugs which mollify Pitta) and hence balance the Pitta and regularize the Dhātvāgni. Madhura (sweet) and Amlarasa (sore), Snigdha guna, Madhura Vipāka and Usna Vīrya (warmth in potency) of drugs simply mollify the aggravated Vāta. Kasāya rasa, Ruksa guna and Usna Vīrya eliminate the kapha in channels and also help in improving Agni. Once Agni get normalized, the signs and symptoms of Hypothyroidism like constipation, weight gain, excessive sleep and muscle cramp all get relieved. Guducī Satvam having Snigdha guna and Madhura rasa reduces the dryness of skin.

Āmalakī cūrnam by virtue of its Ruksa guna reduces the excess accumulated water in case of Hypothyroidism which is the main cause of weight gain. Study drugs, Guducī Satvam and Āmalakī cūrnam both having Rasāyana properties are best for longstanding disease like Hypothyroidism. In case of primary Hypothyroidism, the anomaly happens is in thyroid gland itself. The under-production of thyroid hormones leads to increased TSH from pituitary and various signs and symptoms. Considering rejuvenative property of drugs, their outcome can be justified. Being pitta śamana, they reduce inflammatory changes; being vāta śamana (drugs which mollify vāta) may reverse the condition of destroyed thyroid follicles or hold up the follicles to amplify the liberation of hormones. Anti-oxidant and immuno-modulatory effect of these drugs helps in this action. CONCLUSION HPTLC finger print showed more than four chemical constituents present in Guducī Satvam. HPTLC finger print showed 11 peaks may represent chemical constituents present in Āmalakī cūrnam. There is no negative impression in HPTLC profile of Thyromax powder due to combination of two herbs. Thyromax powder is found to be more effective in reducing the subjective parameters. Thyroxine sodium is found to be more effective on T3 and T4 parameters. Thyromax powder and Thyroxine sodium both are found to be insignificant on TSH level parameter.

REFERENCES Alsa mariyam kalathancheri (2008). Ayurvedic perspective on endocrinology with special reference to Hyperthyroidism and Hypothyroidism. Thesis submitted to Kerala University, Thiruvananthapuram.

Anonymous, Indian Council for Medical Research, New Delhi (2003). Appendix I and II, Quality Standards of Indian medicinal Plants. Vol. 1, 1st edition.235–37.

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Anonymous, The Controller of Publication (Reprint 2001), Appendix 1, 2.1, 2.2, 3 and 4, New Delhi. The Ayurvedic Pharmacopoeia of India. Part 1, Vol. II, 1st edition. 205–08. Anonymous. Pharmacopoeia of India (2001), Govt. of India, Ministry of Health. The The Controller of Publication. Vol.2; A – 53–55. Billore

KV, Yelne MB, Dennis TJ, Chaudhari BG (2005). Database on Medicinal Plants used in Ayurveda. Vol. 3, 1st edition. New Delhi, CCRAS,;11.

Chanchal Gupta (2003). A comparative study of Pipalī prayoga and Śodhan purvaka Śamana cikitsā in the management of dhātvāgni vikṛ ti (Hypothyroidism) Thesis Submitted to Gujarat Āyurveda University, Jamnagar. Dikshit V, Damre AS, Kulkarni KR (2003). Priliminary screening of immunocin for immunomodulatory activity. Indian J. Pharm Sci.71:254–7. Gay J Canaris, Neil R Manowitz, Gilbert Mayor, Chester Ridgway (2000). The Colorado Thyroid disease prevalence study. Arch. Intern Med.160:526–34. Source of Support: Nil

K.P. Paulose (Editorial) (July 2011). Kerala Medical Journal.; Issue4. N. Kochupillai, C S Pandav, MM Godbole, M Mehta and M M S Ahuja (1986). Iodine deficiency and neonatal hypothyroidism. Bill World Health organ. 64(4):547–51. Shukal V, Vashistha M, Singh SN (2009). Evaluation of Antioxidant profile and activity of Amalaki, Spirulina and wheat grass. Indian Journal of Biochem.24(1):70–75. Sir

Stanley Davidson (2006). Hypothyroidism. In: Davidson Principles & Practice of Medicine, 20th Edition, Churchill Livingstone Elsevier Health Science, Philadelphia, 691.

Unnikrishnan AG, Usha V Menon (2011). Thyroid disease in India- An epidemiological perspective. Indian J. Endocr Metab. 15:S78–81. Vanderpump MP (1995). The incidence of thyroid disorders in the community: A twenty year followup of the Whickham Survey. Clin Endocrinol (Oxf). 43(1):55–68.

Conflict of Interest: None Declared

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Global J Res. Med. Plants & Indigen. Med. | Volume 2, Issue 1 | January 2013 | 65–72 ISSN 2277-4289 | www.gjrmi.com | International, Peer reviewed, Open access, Monthly Online Journal

Review article RUDRAKHA: A REVIEW ON MYTHOLOGICAL, SPRITUAL AND MEDICINAL IMPORTANCE Kumar Naresh 1, Dubey Mukesh2, Agarwal Vivek3* 1

Assistant Professor, Department of Dravyaguna, M.S.M. Institute of Ayurveda, B.P.S. Mahila Vishwavidyalaya, Khanpur kalan, Distt. Sonipat, Haryana – 131305, India 2 Assistant Professor, Department of Agada Tantra, M.S.M. Institute of Ayurveda, B.P.S. Mahila Vishwavidyalaya, Khanpur kalan, Distt. Sonipat, Haryana – 131305, India 3 Assistant Professor, Department of Roga Nidana, M.S.M. Institute of Ayurveda, B.P.S. Mahila Vishwavidyalaya, Khanpur kalan, Distt. Sonipat, Haryana – 131305, India *Corresponding author: Email- drvivek91@gmail.com; Mobile: +919416051032

Received: 10/12/2012; Revised: 25/12/2012; Accepted: 05/01/2013

ABSTRACT Since long time back, Rudraksha, has been recognized in Ayurveda due to its spiritual and medicinal uses. According to Hindu mythology, it is believed that anyone who wears Rudraksha beads get the mental and physical prowess to achieve spiritual enlightenment. As an Ayurvedic medicine it is used in the management of blood pressure, mental disorders, neurological disorders, asthma, diabetes and gynecological disorders. It retards the aging process. Modern medical science also recognises its anchoring effect on heart and circulatory system because of its electric and diamagnetic properties. This review article is aimed at explaining the ancient mythological, spiritual and medicinal attributes of Rudraksha on the basis of modern science. Key words: Rudraksha, mythology, diamagnetic properties.

Cite this article: Kumar Naresh, Dubey Mukesh, Agarwal Vivek (2013), RUDRAKHA: A REVIEW ON MYTHOLOGICAL, SPRITUAL AND MEDICINAL IMPORTANCE, Global J Res. Med. Plants & Indigen. Med., Volume 2(1): 65–72

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INTRODUCTION

Habitat:

In Hindu mythology, Rudraksha beads bear a great spiritual, religions and materialistic significance. The Hindu mythology considers Rudraksha as symbol of link between earth and heaven. It is believed that it contains the secrets of evolution of entire cosmos within itself (Chaturvedi B K, 2004). For centuries, the Hindu sages believe that one can cultivate mental, physical and spiritual prowess to attain fearlessness to achieve the ultimate enlightenment (Seetha K N, 2008).

This plant is native of Indonesia. Now a day, trees of Rudraksha are found in tropical and subtropical areas at the altitude ranging from sea level to 2000 meters above sea level. It is mostly found in South East Asia, Island of Java, Sumatra, Borneo, Bali, Iran, Timor (Indonesia) and Nepal. (Yelne M. B., 1995).

According to Shivpurana, the one who wears the rosary of Rudraksha beads around his/her wrist, arm, neck or head can roam in the world fearlessly as does the Rudra and he/she cannot be killed by a living being. Wearing it makes the person respected and honoured by all (Chaturvedi B K, 2004). As per Ayurvedic system of medicine, wearing Rudraksha beads relieves strain, insomnia, anxiety, lack of concentration, depression, palpitation, hypertension, rheumatism, infertility and asthma. It has antiaging effect also (Dennis T. J., 1993). Plant description: Nearly 360 species of Rudraksha trees are found in different parts of the world. Elaeocarpus ganitrus Roxb. is the scientific name for the most popular species of Rudraksha tree. It belongs to the family Tiliaceae. This species was named by Dr. William Roxburgh. Elaeocarpus, this scientific name was taken from Greek words, Elaei which means – Wild olive, Carpus – fruit. Rudraksha is named differently in different languages across India. Rudraksha – in Sanskrit & Marathi languages. Rudrakshi as in Kannada language. Aakkam as in Tamil language. Its English name is Litrasum bead tree. This variety matches to the given specifications as found in our epic books which are old enough. This popular species is found in Nepal and Indonesia in more concentration. (Yelne M. B., 1995).

Botanical Description of Plant: It is a large evergreen tree with broad leaves. Its height ranges from 50–200 feet. Leaves are large and shining green on the sun facing side and dull leathery on earth facing side. Flowers appear in the month of April-May and are white in colour. Fruits start appearing in June and ripen by October. Ripe fruit is fleshy and has a seed with blue shell. Inner part or bead lying in the seed is called Rudraksha. (Yelne, M. B., 1995). Chemical compostion: C-H-N analyzer and gas chromatography has shown that it contains 50.30% Carbon, 0.95% Nitrogen, 17.897% Hydrogen and 30.53% oxygen. Among other elements it contains Aluminium, Chlorine, chloride, Copper, Cobalt, Nickel, Iron, Magnesium, Manganese, Phosphorus, Potassium, Sodium, Zinc and Silicon oxide. (Pandey V B and Bhattacharya S K,1985). Properties of Rudraksha as per Ayurveda: (Dennis T. J., 1993). It is guru (heavy), snigdha (unctuous) in native, madhura (sweet) in taste, madhura in vipaka (sweet in post-digestive taste and sheet virya (cooling potency). Because of all these attributes it has vata-pitta pacifying action on the body.

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Medicinal properties as per Ayurveda: (Dennis T. J., 1993) and (Saminathan K R, 2009). Rudraksha beads have several amazing powers due to their electromagnetic properties. Wearing it affects the body and performs following actions: Rudraksha is a natural tranquilizer. Wearing rosary of its beads relieves stress, insomnia, anxiety, depression and lack of concentration. It calms mind and cool down the body temperature. Wearing it around heart controls heart beats and keeps blood pressure under control. It slows down the aging process.Wearing three faced Rudraksha cures frequent fever in children. Wearing Garbhgauri Rudraksha helps women in conceiving and get rid of threatened abortion. It has antiparalysis properties. It helps balancing the vital chakras of human body that control wind, bile and phlegm. Its systemic use is useful in following conditions: Five faced Rudraksha possesses antihypertensive properties. Dip two beads of it in a glass of water in night and leave it over-night. Drinking this water in the morning in empty stomach condition controls blood pressure. Powder of beads when mixed with any Ayurvedic herb improves its effectiveness and period of treatment. Paste of ten faced beads taken with milk thrice a day cures cough. External use of paste and systemic use of powder form cures skin disorder, sores, pimples, boils, burns and ringworm. Use of mixture of powder and black pepper in equal quantity taken with water is useful in smallpox. Boil two beads of four faced Rudraksha in one glass of milk and drinking this milk is very useful in patient of manas rogas (mental disorders) and poor memory.

Electric properties of Rudraksha: Diamanti, 2001).

(Joyce

The whole human body behaves as a complex bio-electric circuit consisting of nervous system and other organs. A number of electrical impulses are generated in the human body because of continuous heart beats, blood circulation, and conduction of sensory and motor impulses in nerves, contraction and relaxing of muscle fibers. These electrical impulses are known as bio-electricity. Because of difference in the energy levels of different body parts, flow of bio-electric current starts. Smooth and controlled flow of this bio-electric current in the body provides streamlined functioning of different body systems. All the activities in our sense organs are governed by flow of this bio-electric current. Psycho-somatic stress and maladjustment disrupts this streamlined flow of bio-electric current as well as normal functioning of the body systems which results in uncomfortable feeling, illness and abnormal psyche. Rudraksha beads possess the property of a stabilizing anchor. Wearing these beads controls and normalizes the flow of bio-electric current in body. Rudraksha exhibits the following electrical properties (David W. Lee, 1991) Resistance â&#x20AC;&#x201C; Rudraksha of particular type of mukhi have a definitive factor of resistance. It resists the flow of bio-electric current generated due to potential difference between different organs or parts of the body. This resistance generates a specific ampere of current flow depending on the factor of resistance. This acts in tandem with heartbeat, streamlining it and sending out specific impulses to brain to generate certain bio-chemicals in the brain which brings positivity in mood and more confidence making us feel better, more poised and energetic. It is important to mention here that specific variety of Rudraksha sends specific impulses acting on a specific type of bio-chemicals in the

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brain thereby bringing specific positive changes in the personality.

explained by the diamagnetic property of Rudraksha. (Sarkar P K et al., 2000).

Capacitance: This term means ability to store the bio-electric energy. The values are measured in the units of Farad. This property of Rudraksha makes them capable of stabilizing and anchoring the flow of bio-electric current thereby controlling and normalizing heart beat and sensory activities in the body. The increased level of stress results in increased physical activity in the body along with increase in heart beats, hormonal and nervine activities, thus increasing energy levels and potential differences at different levels. As a result the magnitude of flow of bio-electric current increases.

Supply of oxygen and energy to the different body parts is hampered if the circulation of blood is blocked or reduced because of any blockage in the passage of blood vessels. This results in impaired functioning of the affected body part thereby causing illness.

Rudraksha beads acts as capacitor or dielectric store when directly comes in contact with body and absorbs or store this excess of bio-energy streamlining the overall activity in the body to normalcy. Inductance: Specific type of Rudraksha sends out specific inductive vibrations because of unique magnetic properties. These vibrations are the reason for why the people feel better even when the beads do not touch them physically. Magnetic properties of Rudraksha: (Joyce Diamanti, 2001). The beneficial healing properties of magnets are an established factor. Rudraksha also heave magnetic properties. It has both paramagnetic and diamagnetic properties. It has unique feature of having ability to change its polarity. This feature is called dynamic polarity. In Rudraksha, it is by virtue of diamagnetism which is defined as the ability of any substance to acquire temporary magnetic property in presence of an external magnetic field. The polarity of the charge induced is always opposite to that of the external field inducing the charge. How the Rudraksha beads streamline the functioning of heart and circulatory system is

We know that every cell of the arteries and veins as well as blood cells is either charged positive or negative. When a magnet comes in contact with a body part the opposite poles of the magnet and that of the cells get attracted. This attraction, in case of blood vessels, causes expansion of the passage and opening up of them facilitating the normal blood circulation. Normal supply of oxygen and energy through streamlined blood circulation makes us rejuvenated. If an ordinary magnet is brought near any part of the body it attracts the cells of only those sections of the blood vessels which oppositely charged hence complete streamlining of blood circulation cannot be ensured. We know the circulation of blood & heart beats continuously induces a magnetic field around the body and particularly heart region. The bio-electric flow in the body also develops bio-magnetism depending on the polarity of the induced magnetic field. When Rudraksha comes in contact with body it acquires a polarity that is opposite to the inducing field. Thatâ&#x20AC;&#x2122;s why it helps in opening up of the blood vessels better than magnets. Pure and Genuine Rudraksha:- (Yelne M. B., 1995). Now a day, rarely faceted Rudraksha beads such as ek mukhi (one faced) beads are being manufactured by artificial means to make financial benefits. In such circumstances, it is important to check the purity and genuine-ness of the beads before buying them by any of these methods:

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Global J Res. Med. Plants & Indigen. Med. | Volume 2, Issue 1 | January 2013 | 65–72

Cut test: – This test is most reliable for checking the genuineness of Rudraksha beads. If, on cutting the bead horizontally the bead shows same number of compartments as that of facets or faces, it is a genuine bead. But, this method has a major drawback that the bead gets destroyed.

Water test: – The higher valued beads like Trijuti and Gauri-shankar Rudraksha manufactured by artificially gluing the two or three beads can be tested with this method. On boiling the bead with water, sharp discolouration appears at the joints of artificial Rudraksha.

Copper coin test: – If a Rudraksha bead is placed between two copper coins or copper chips, the bead rotates slightly because of its physical and magnetic properties.

The genuine beads sink in water. Fake traders of Rudraksha deceive the customers by dipping the beads in water. But, it is important to mention, here that fake beads prepared out of wood and impregnated with lead will sink in water thereby giving a fake impression of real Rudraksha.

Electro–magnetic properties: – The original beads manifests properties like resistance, capacitance, inductance, conductance of electric current, magnetic forces etc.

Table No. 01: Different type of Rudraksha their Ruling God, Planet and Beej Mantra (Empowering verse) (Swarnalatha N, 2000) and (Vigyananand Swami, 2000). Type of Rudraksha

Ruling God

Planet

Beej Mantra

1 Faced

Shiva

Sun

Om Hreem Nama

2 Faced 3 Faced 4 Faced 5 Faced 6 Faced 7 Faced 8 Faced 9 Faced 10 Faced 11 Faced 12 Faced 13 Faced 14 Faced

Ardhnareeshwar Agni Brahma Kalaagni Kartikeya Mahalaxmi Ganesh Durga Vishnu Hanuman Sun Indra Hanuman

Moon Mass Mercury Jupiter Venus Saturn Rahu Ketu None None Sun Venus None

Gauri Shanker

Moon

-

Om Namah Om kleemNamha Om Kleem Namha Om Hreem Om Hreem Hoom Namah Om Hoom Om Hoom Namah Om Heem Hoom Namah Om Hreem Namha Namah Om Hreem Hoom Namah Om Drom Sarom Ram Namah Om Hreem Namah Om Namah Om Shree Gauri Shankar

Ganesh Rudraksha

Ganesh

-

-

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Global J Res. Med. Plants & Indigen. Med. | Volume 2, Issue 1 | January 2013 | 65–72

Table No. 02: Different type of Rudraksha and their indication (Dennis, T. J., 1993) Type of Rudraksha 1 Faced 2 Faced 3 Faced 4 Faced 5 Faced 6 Faced 7 Faced 8 Faced 9 Faced 10 Faced 11 Faced 12 Faced 13 Faced 14 Faced 15 Faced 16 Faced 17 Faced 18 Faced 19 Faced 20 Faced 21 Faced Trijuti/tribhagi Gaurisankar Garbha gauri

Indication Chronic asthma heart problems, mental anxiety, T.B, paralysis, stroke, eye problem bone pain and head ache. Impotency, renal failure, stress, anxiety, lack of concentration, depression, negative thinking, eye problems, mental chaos, hysteria and intestinal disorder. Depression, schizophrenia, weakness multifarious, directive of the menstrual cycley/menstrual stress, fixation or guilt induced complexes, blood pressure, mood swings, fever or weakness, jaundice and mental disability. Blood circulation, cough and brain linked illness, asthma, hesitate, memory lapse and respiratory strip problems. Blood pressure, heart problems, stress, mental disability, fatness, anger management, diabetics, piles, neurotic and maladjustment problems. Epilepsy and gynecological problems. Asthma, pharyngitis, impotency, foot related disease, respiratory and confusion. Stomach ache, stress, skin diseases and anxiety. Work as mysterious medicine for treating strange diseases. Hormonal inequality in the body, mental insecurity and whooping cough. Body pain, backache, chronic alcoholism and liver diseases. Bone diseases, rickets, osteoporosis, mental disability and anxiety. Muscular dystrophies Brain related and many other types of disease. Skin diseases, recurring miscarriage and still birth. It is measured as a blessing for women who are incapable to imagine and in such case both the partner should wear it for fruitfulness. Leprosy, tuberculosis, cor – pulmonale and lung diseases Memory lapse and body functional disorders Mental harmonization and loss or power. Blood disorder and spinal disorder. Eyesight problems and snake bites It eliminates all form of disease. Internal and external body disorders Sexual and behavioral disorders Gynecological disorders

Types of Rudraksha: – (Swarnalatha N, 2000). According the Hindu mythology, the Rudraksha has originated from tear drops fallen from the three eyes of Rudra (Lord Shiva). Three eyes of Rudra represent sun, moon and fire. Rudraksha beads born out of tears of solar eye of Rudra are brown in colour and are of 12 types. Those beads which are born of his lunar eye are fair and are of 16 types. The furious eye

tears gave origin to black Rudraksha which are of 10 types. In this way, ancient scriptures mention 38 types of Rudraksha. Traditionally, Rudraksha beads are categorized on the basis of clefts or faces or mukhas the beads bears. Two mukhi to fourteen mukhi Rudraksha are commonly available in the market. One mukhi and Fifteen to twenty one mukhi Rudraksha are rare and costly

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Global J Res. Med. Plants & Indigen. Med. | Volume 2, Issue 1 | January 2013 | 65–72

varieties. Three more varieties namely Ganesh Rudraksha, Gauri Shankar Rudraksha and Garbh–Gauri Rudraksha are also available in the markets.

scientifically. But, ancient scriptures classify and tag the quality and importance to different mukhi beads according to the number or type of mukha (Faces) the bead has.

Invocation of Rudraksha – (Swarnalatha N, 2000).

CONCLUSION

Before bearing, it should be sanctified. Specific type of Rudraksha is sanctified by chanting specific Beej mantra (empowering verse) and performing specific rites and rituals. It empowers and blesses the beads with amazing powers. Usually this sanctification ceremony is performed in the morning of Monday and the sanctified bead is worn the same day after touching it with Shivalinga (the symbol of Lord Shiva) (Parthasarathy V, 1993). DISCUSSION Since the epic times, Rudraksha beads have been attracting the attention of not only the ordinary human beings but also the sages, scientists and physicians because of attributes and powers. Across the world, scientists from the field of Physics, Bio Chemistry, Pharmaceutics and Medicine etc. are doing research on molecular levels on this herb. Recent researches on Rudraksha have proved the existence of miraculous electro-magnetic properties in it. The beneficial effects of these electro-magnetic properties on human body are also no more secret now. Classification on the basis of external features of the beads is not correct

REFERENCES: Bodhi Nighantu (2010), Singh Gurucharan, Guazuma ulmifolia (Rudrasham) from Delhi, Bodhi Nighantu, Retrieved from URL on 30/11/2012: URL groups.google.com/group/bodhinighantu

The mythological and spiritual importance of anything has roots in faith and belief the human beings have. They do not require any explanations. But, the myths about miraculous effects of Rudraksha on human body have been proved true by modern science. The medicinal uses of Rudraksha beads in human body have been established through clinical trials under controlled and standard conditions. The exceptional electro- magnetic properties, especially diamagnetism contained in these beads are responsible for the beneficial effects on the different systems of human body through mere contact with these beads or wearing them. Out of nearly 360 species of Rudraksha, three specieses namely Elaeocarpus ganitrus Roxb. ex. G. Don, (Syn: Elaeocarpus sphaerica Gaertn) and Elaeocarpus angustifolius Blume. have been found possessing the properties for which these beads are in demand. At places even Guazuma ulmifolia Lam., Ulmaceae, commonly known as Badraksha is taken as a poor substitute of Rudraksha. (Bodhi Nighantu, 2010) Till date, comparative evaluation of all the properties of different mukhi (types of) Rudraksha has also not been done scientifically under controlled conditions. Scientific research from this point of view will further unfold the mysteries related to Rudraksha. Chaturvedi B.K. (2004). Shiv Purana, Vidyeshwar Samhita, Chapter 25, Diamond Books (P) Ltd., New Delhi, Parts 01–95

David W. Lee (1991). Ultrastructural basis and function of iridescend blue colour of

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Global J Res. Med. Plants & Indigen. Med. | Volume 2, Issue 1 | January 2013 | 65–72

fruits in Elaeocarpus, Nature, Vol. 349, No.6306, p. 260–262.

Saminathan K. R. Veda (2009). The Amazing Power Of Rudraksha, P.55.

Dennis T. J. (1993). Rudraksha - Not Just a Spiritual Symbol But Also a Medicinal Remedy, Sachitra Ayurved 46, 2, p 142.

Sarkar. P. K., Bhattacharya S.S. and Sengupta (2001), Further observations with Elaeocarpus ganitrus on Normal and Hypodynamic Heart, Department of Pharmacology, Medical College Calcutta.

Parthasarathy Vanamala, (1993), Ancient Indian History and Culture of the Anathacharya Indological Research Institute, Bombay, 1993, p. 98–100). Joyce Diamanti (2001). More about Rudraksha, The Bead Society of Greater Washington Newsletter, 18(2): p.6–8. Swarnalatha N., (2000), Rudraksam, Journal of Sukrtindra Oriental Research Institute, Vol. 03, P.17–22. Pandey V. B. and S. K. Bhattacharya (1985). Scientific appraisal of Rudraksha (Elaeocarpus ganitrus): chemical and pharmacological studies", JREIM, P.66–71. Source of Support: Nil

Seetha K.N. (2008). The Power of Rudraksha, 4th edition, Jaico Publishing House, 2008, Mumbai, p. 23–78. Vigyananand Swami (2000), Srimad Devi Bhagvatam, 11th Skanda, Allahabad Panini Office, Allahabad, Vol. 26, Chapter 3–7. Yelne, M. B. (1995) Notes on The Botanical Identity of Beads Found Under The Name: Rudraksha, Biorhythm, AYU. academy series, 44, P. 39–44.

Conflict of Interest: None Declared

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