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Management of Nirupastambhita Vatavyadhi – a Case Study International Journal of Complementary & Alternative Medicine Case Report Open Access Management of nirupastambhita vatavyadhi – a case study Abstract Volume 13 Issue 4 - 2020 Nirupastambhita vatavyadhi is mainly a dhatukshayajanita vatavyadhi. Young age is a Jasminbegam B Momin, Kulkarni PV, Gogate vivardhamana avastha of life but occurrence of this disease in young age is usually due to dhatukshaya. This may be because of changing lifestyle habits and behavioral ways which VE Department of Kayachikitsa, Government Ayurved College, primarily lead to agnidushti, vataprakopa and ultimately vatavyadhi. Joint pain along with India swelling, tenderness, crepitations and restricted movements are the cardinal features of this disease. Some patients also suffer from constitutional symptoms like anorexia, irregular Correspondence: Jasminbegam B Momin, Department of bowel habits, generalized weakness, etc. A case of 18years old male patient suffering from Kayachikitsa, Government Ayurved College, India, nirupastabhita vatavyadhi is being discussed here. Ayurvedic chikitsa in terms of different Tel 7709691550, Email modalities like snehana, swedana, dashamula majjasneha basti and various ayurvedic preparations were used according to rugna bala, vyadhi avastha and dosha avastha. Received: June 01, 2020 | Published: July 02, 2020 Rasayana chikitsa and physiotherapy was also advocated. Nidana parivarjana was strictly followed by the patient during the course of treatment. The holistic approach of ayurveda towards chikitsa of nirupastambhita or dhatukshayajanita vatavyadhi led to satisfactory results with independent walking and free movements of bilateral knee joints of patient. There was much relief in constitutional symptoms and ESR as well as CRP values also got reduced. Thus, ayurvedic multidimensional approach is helpful in the treatment of nirupastambhita vatavyadhi. Keywords: Nirupastambhita vatavyadhi, dhatukshaya, snehana, swedana, dashamula majjasneha basti, rasayana chikitsa Introduction analgesics, anti-inflammatory drugs but produces troublesome side effects also.6 A case of 18 years old male patient suffering from Ayurveda ‘the science of life’ which is considered as a upaveda dhatukshayajanita vatavyadhi is being discussed here who was of Atharvaveda elaborates the importance preventive, promotive treated with conventional ayurvedic treatment. Sthanika chikitsa and 1 and curative aspects of health. This ancient science is primarily basti karma along with abhyanatara snehapana, shamana aushadhis, based on fundamental theory of tridosha which are namely vata, rasayana chikitsa and physiotherapy was administered to the patient 2 pitta and kapha dosha. Out of these, vata dosha brings the existence according to vyadhi avastha, rugna bala and dosha bala. Nidana 3 as well as destruction to all living things. It is the controller of parivarjana was strictly followed and this gives the excellent results in all other bhavapadarthas including pitta, kapha, sapthadhatu and all the complaints including joint pain, swelling and limb weakness. 3 trimalas. Vitiation of vata can be caused by two main reasons The constitutional symptoms were also much improved and laboratory 4 that is margavarodha and dhatukshaya. Hence, vatavyadhis are values of ESR and CRP were also significantly reduced. This holistic primarily classified into two types based on these etiological factors approach of ayurveda towards nirupastambhita vatavyadhi chikitsa and these are ‘upastambhita or margavarodhajanya vatavyadhi’ and gave satisfactory and encouraging results. ‘nirupastambhita or dhatukshyajanita vatavyadhi’.5 Though the common hetus of vataprokapa are responsible for the pathogenesis of Aim both these types, upastambhita vatavyadhi has kaphaprakopaka and aamotpadaka hetus also. Nirupastambhita vatavyadhi mainly occurs To study the efficacy of holistic approach of ayurvedic chikitsa in old age because of dhatukshaya6 but occurrence of this disease in towards nirapstambhita or dhatukshayajanita vatavyadhi. young age is mainly due to changing lifestyle and behavioral ways Objectives like fast-food, irregular dietary habits, lack of exercise, sedentary routine work, etc. Purana of prakupita vata occurs in the rikta a. To study the efficacy of sthanika karmas in relieving the signs or empty srotasas.5 During this process, the walls of srotasas are and symptoms of nirupastambhita vatavyadhi. stretched due to the force of vayu which lead to weakening of srotasas b. To study the efficacy of dashamula majjasneha basti in the and vitiated vata overwhelms these weakened srotasas to produce the management of nirupastambhita vatavyadhi. disease.5 Shleshaka kapha in the joints also get reduced in quality and quantity and sandhishaithilya is seen.7 The ashrayashrayi sambandha c. To study the efficacy of various ayurvedic preparations in leads to asthi dhatu kshaya and kshaya leads to khavaigunya in the the management of nirupastambhita vatavyadhi according to joints and the pathogenesis of the disease continuous.7 The continuous vyadhi avastha, rugna bala and dosha bala. hetusevana leads to severity of the disease. d. To study the combine effect of sthaniaka karmas, internal Allopathic line of treatment has its own limitations in managing medicaines along with physiotherapy in the management of this disease. It provides mainly symptomatic treatment by using nirupastambhita vatavyadhi. Submit Manuscript | http://medcraveonline.com Int J Complement Alt Med. 2020;13(4):135‒141. 135 ©2020 Momin et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and build upon your work non-commercially. Copyright: Management of nirupastambhita vatavyadhi – a case study ©2020 Momin et al. 136 Material and methods D. Srotasa Parikshana A clinical case study at our institute. ayurvedic treatment a. Annavaha srotasa – Annanabhilasha, arochaka, avipaka comprising of snehana, swedana, basti karma along with abhyanatara b. Rasavaha srotasa – Jwaraprachiti, daurbalya, angamarda, snehapana, shamana aushadhis, rasayana chikitsa and physiotherapy ashraddha, aasyavairasya, aruchi, karshyatva was given to the patient. c. Medavaha srotasa - Medohani, karshyatva Case report d. Asthivaha – Pain with swelling at bilateral knee joint, Pain and A. Primary data weakness of both lower limbs Patient’s name – XYZ e. Purishavaha - Irregular bowel habits, taking long time for Age – 18years defecation Sex – Male f. Swedavaha – Aswedana, jwaraprachiti Occupation – Student E. Nidana Panchaka B. History of past illness Hetu: Ati amla rasapradhana aahara, vishamashana, adhyashana, increased frequency of non-vegetarian diet, bhojanottara atyadhika a. History of loose motions, loss of appetite and weakness after jalapana, divaswapa, ratrau jagarana taking injections of calcium gluconate for the complaint of pain at left forefoot – 6months back Purvaraupa: Pain and swelling over right knee joint b. History of gradual pain and swelling over right knee joint and Rupa then over left knee joint – since 6months i. Pain and swelling at bilateral knee joints c. History of steroids taken for the complaints of knee joint pain ii. Pain and weakness at both lower limbs – 6months back iii. Difficulty in walking d. History of weight loss (from 48kg to 33kg) within a period of 6months iv. Low grade temperature e. No H/O DM/HTN/ Bronchial asthma v. Anorexia f. No H/O Blood transfusion vi. Irregular bowel habits g. No H/O Any addiction vii. Generalized weakness h. No H/O Any bleeding disorder Upashaya: Upashayanugami i. No H/O fall/trauma/weight lifting j. No H/O Ascites/pleural effusion/knee effusion k. No H/O Any surgical illness C. History of present illness A 18years old male patient was apparently normal and healthy before 6 months. Later on, he was having pain at left calcaneus region which was then proceeds to the left forefoot region. For this, he was treated with symptomatic medicines and 5 injections of calcium gluconate. Because of this treatment, he was suffered from complaints of loose motion, loss of appetite and generalized weakness. Then gradually, there was pain and swelling initially over the right knee joint and then over the left joint. Also, there was severe weight loss of the patient. His weight was reduced from 48kg to 33kg within a period Samprapti ghataka of 6 months. Then he was treated with symptomatic treatment and steroid therapy for all these complaints. By this time, he got relieved Mainly vata dosha, samana, vyana, apana from the complaints of GIT but the complaints of pain and swelling Dosha vayu, Pitta dosha,Pachaka pitta, Kapha over bilateral knee joints became more severe. Along with these, he dosha, Kledaka, shleshmaka kapha was having weakness and pain at both lower limbs and difficulty in walking. In addition, he was also having complaints of fever, irregular Dushya Rasa, meda, asthi dhatu bowel habits, anorexia and generalized weakness. Then he came to Upadhatu Sira, kandara, snayu OPD of our institute where he was treated with ayurvedic treatment comprising of snehana, swedana, basti karma along with abhyanatara Mala Purisha, sweda snehapana, shamana aushadhis, rasayana chikitsa and physiotherapy. Citation: Momin JB, Kulkarni PV, Gogate VE. Management of nirupastambhita vatavyadhi – a case study. Int J Complement Alt Med. 2020;13(4):135‒141. DOI: 10.15406/ijcam.2020.13.00507 Copyright: Management of nirupastambhita vatavyadhi – a case study ©2020 Momin et al. 137 Table Continued... Annavaha,
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