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International Journal of Ayurveda and Traditional Medicine Clinical Study to Evaluate the Efficacy of ​Vamana Karma​ with M

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International Journal of Ayurveda and Traditional Medicine Clinical Study to Evaluate the Efficacy of ​Vamana Karma​ with M ORIGINAL ARTICLE IJATM.2019;1(1):3-8. International Journal of Ayurveda and Traditional Medicine Clinical study to evaluate the efficacy of Vamana Karma with Mudgara (Jasminum ​ ​ ​ ​ ​ malabaricum Wight.) Patra Swarasa in Psoriasis. ​ ​ ​ 1 2 2 Yogesh Prasad Baidya ,​ Shreekanth U ,​ Niranjan Rao 1 ​ ​ ​ S​ hree Mithila Ayurveda College and Research Centre. 2 P​ G Department of Panchakarma, SDM College of Ayurveda, Kuthpady, Udupi. ABSTRACT Introduction: Vamana Karma is one of the Panchakarma Therapy for the elimination of vitiated Kapha Dosha. Psoriasis ​ ​ ​ ​ ​ is an immune-mediated chronic inflammatory disorder which manifests as dermatological lesions. In Ayurveda, psoriasis is a Kapha Pradhana Kustha on the basis of their clinical presentations.. ​ ​ Method: In this present clinical study, Mudgara (Jasminum malabaricum Wight.) Patra Swarasa was used to evaluate the ​ ​ ​ ​ ​ efficacy of Vamana Karma in psoriasis. Multidimensional assessment of psoriasis was done with ‘Psoriasis Area Severity ​ Index’ (PASI), 5D Itch Score, Auspitz Sign and Candle Grease Sign. An open clinical trial was done on 20 diagnosed psoriatic patients selected from the OPD/ IPD of the Department of Panchakarma at Shree Dharmasthala Manjunatheshwara Ayurveda Hospital, Kuthpady, Udupi, Karnataka. After proper Pachana-Deepana and Samyaka ​ Snigdha Lakshana, patients were subjected to Abhyanga and Parisheka for 2 days. Vamana Karma was performed as ​ ​ ​ ​ ​ mentioned in the classical Ayurveda text. Patients were examined before Snehapana, after Vamana Karma and on the 7th ​ ​ ​ day after the Vamana clinically and Auspitz Sign, Candle Grease Sign, PASI & 5 D Itch Scores were determined. ​ ​ Result: The result of this study showed statically significant reduction in PASI and 5D Itch Scores (P < 0.01). No marked changes were observed in Candle Grease sign after treatment. Conclusion: This study suggests that Mudgara (Jasminum malabaricum Wight.) Patra Swarasa is found effective in the ​ ​ ​ ​ management of Psoriasis. _________________________________________________________________________________ Keywords: Mudgara (Jasminum malabaricum Wight.); Patra Swarasa; Psoriasis; Vamana. ​ ​ ​ ​ ​ ​ ____________________________________________________________________ ​ INTRODUCTION Panchakarma, the unique therapy of Ayurveda, attract the Vamana Karma is one of the Panchakarma procedures ​ ​ 1 attention of people for the treatment of various disorders coined as Paramaushadha in Kaphaja Vyadhi. I​ t is a ​ ​ ​ ​ ​ and also for their preventive and promotive effects. With the increase of awareness and global acceptance, it is the need of the hour to work on individual Karma (Panchakarma procedure), with different formulation for ​ different diseases, in a scientific manner. IJATM I VOL 1 I ISSUE 1 I DEC 2019 ​ ​ ​ ​ ​ ​ Free Full Text Articles are Available at https://ijatm.org/ ​ ​ 3 ​ Yogesh Prasad Baidya, Shreekanth U, Niranjan Rao. Clinical study to evaluate the efficacy of Vamana Karma with Mudgara ​ ​ ​ (Jasminum malabaricum Wight.) Patra Swarasa in Psoriasis. ​ ​ ​ ​ choice of treatment for several Kaphaja Vyadhi like the Academic year 2014-15. (Ref. No. ​ Shwasa, Kasa, Hrullasha, Pinasa, Ajeerna, Kustha etc.2 SDMCAU/ACA-49/EC46/14-15, Date: 23/4/2015). ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ ​ In Ayurvedic texts, varieties of skin diseases are Patients suffering from psoriasis and who were fit for collectively mentioned as “Kustha”. 18 types of Kustha ​ ​ ​ Vamana Karma were included for the study. Patients Roga (~skin diseases) are classified under Kustha. ​ ​ suffering from Diabetes Mellitus, Hypertension, Hiatus Psoriasis is related to Kapha Pradhana Kustha like ​ hernia and other systemic diseases and who are unfit for Ekakustha, Mandal Kustha, Kitibha, etc, depending upon Vamana Karma were excluded. ​ ​ ​ ​ ​ ​ their clinical presentation.3 ​ Written informed consent was obtained from each Among the skin diseases, psoriasis is one of the common registered patient who met with inclusion criteria and fit presentations affecting about 2% to 3% of the total for Vamana Karma. population of the world and 0.44% to 2.8% of Indian ​ In Poorva Karma, Pachana-Deepana was done by population. The etiology of psoriasis is still poorly ​ ​ ​ Agnitundi Vati (two tablets thrice a day) with lukewarm understood but it is clear that there is a genetic component ​ water till Ama Pachana and Agni Vruddhi took place. to the disease. A positive family history, environmental ​ ​ Acha Snehapana was done with Panchatikta Guggulu factors are also contributing factors to the disease.4 ​ ​ Ghrita in Arohana Krama till the appearance of Samyaka According to Sushruta Samhita, Vamana Karma is ​ ​ ​ ​ ​ ​ Snigdha Lakshana. Then Abhyanga with Stree Kutaja prescribed once in 15 days as the best treatment for ​ ​ ​ Taila followed by Parisheka with Karanjanimbadi Kustha. As there is no sufficient time to recover out of ​ ​ ​ ​ Kashaya were done early morning, after voiding natural Pariharya Kala, Mridu Vamana is prescribed in Kustha. ​ ​ ​ urges, at empty stomach, for 2 days i.e next day after Hence, with this thought, Tikhsna Vamaka Dravya is not ​ completion of Snehapana and on the day of Vamana. On be used for such repeated Vamana Karma to the patients ​ ​ ​ ​ ​ the day before the Vamana, patients were instructed to eat in this study. So, there is a need to find out Mridu Vamaka ​ ​ ​ ​ lots of Kaphotkleshakara Ahara like curd, sweets made Dravya and its efficacy to use it repeatedly for Sodhana ​ ​ ​ ​ ​ out of milk, eatables made of black gram (eg. Idli, Plain (Mridu Vamana) in case of Kustha. Mudgara (Jasminum ​ ​ 6,7,8 ​ ​ ​ ​ Dosa, etc), Kheer, Khichadi of Maasha (~black gram) malabaricum Wight.) ,​ as per the knowledge and ​ ​ ​ ​ ​ ​ along with Jaggery, etc. Non vegetarian patients were observations of Folk Vaidya acts as Mridu Vamaka ​ ​ ​ allowed to take fish or mutton meat. Counseling was done Dravya. Hence, to evaluate the efficacy of Mudgara ​ ​ on the day before Vamana about the procedure as well as (Jasminum malabaricum Wight.) Patra Swarasa in ​ ​ ​ to develop a courageous mind. They were also advised to inducing Vamana for the management of psoriasis, this ​ be in an empty stomach and to pass bowel and bladder the study has been conducted. next morning before Abhyanga, Parisheka and entering ​ into Vamana room. ​ ​ In Pradhana Karma, Vamana Karma was performed METHOD ​ ​ with administration of 100 ml of Mudgara (Jasminum It was a clinical study with Pretest and Posttest Design ​ ​ malabaricum Wight.) Patra Swarasa as Vamaka Dravya, ​ ​ ​ ​ conducted at Outdoor Patient Department (OPD) / Indoor Akanthapana by lukewarm milk, quantity sufficient of Patient Department (IPD) of the Department of Yashtimadhu Phanta as Vamanopaga Dravya followed by ​ ​ Panchakarma at Shri Dharmasthala Manjunatheshwara lukewarm water and Saindhava Jala. Blood pressure and ​ Ayurveda Hospital, Kuthpady, Udupi, Karnataka. pulse of the patients were recorded before, during and A total of 20 patients suffering from psoriasis of both the after the Vamana Karma. ​ sex having age in between 16-55 years were selected for For this study, fresh leaves of Mudgara (Jasminum ​ ​ ​ the study. malabaricum Wight.) were collected from plants available ​ The Institutional Ethical Committee of SDM Institute of around Shri Dharmasthala Manjunatheshwara College of Ayurveda and Allied Sciences, approved the protocol to Ayurveda, Kuthpady, Udupi, Karnataka. carry out the clinical trial at SDM Ayurveda Hospital for Preparation of Swarasa was done by plucking sufficient ​ quantities of fresh green healthy leaves of Mudgara ​ 4 IJATM I VOL 1 I ISSUE 1 I DEC 2019 ​ ​ ​ ​ ​ ​ Free Full Text Articles are Available at https://ijatm.org/ ​ Yogesh Prasad Baidya, Shreekanth U, Niranjan Rao. Clinical study to evaluate the efficacy of Vamana Karma with Mudgara ​ ​ ​ (Jasminum malabaricum Wight.) Patra Swarasa in Psoriasis. ​ ​ ​ ​ (Jasminum malabaricum Wight.) and washed properly were service holders, 55% patients were Unmarried. ​ ​ with water. Leaves were torn into smaller pieces and Regarding Prakriti, 55% were of Kapha Pitta dominant pounded on Khalva Yantra in order to make Kalka. Kalka Prakriti. Madhyama Koshtha was found in 65% of ​ ​ ​ ​ was squeezed and then filtered out by means of clean patients and Mridu Koshtha was found in 10% of patients. cloth piece and the Swarasa was collected. [Table 1] 15% of patients were associated with positive family ​ ​ history of Psoriasis. In Paschat Karma, Dhumapana was given with Haridra The average time taken for Samyaka Snigdhata was 4-5 ​ ​ ​ ​ ​ Churna after providing a rest of 45 minutes after the days. Average amount of Ghrita required to attain ​ Vamana Karma. After analyzing Vegaki Shuddhi and Samyaka Snigdha Lakshana was 282.50 ml. Average time ​ ​ ​ Manaki Shuddhi, conclusion regarding the grades of taken to expel the first Vega was 4.85 minutes. Average ​ ​ ​ Shodhana was assessed as Pravara / Madhyama / Avara time taken for completion of Vamana Karma was 35.7 ​ ​ Shuddhi and accordingly Samsarjana Krama of 7 or 5 or minutes. ​ ​ 3 days was planned respectively. Symptoms observed after administration of Vamaka ​ Dravya were such that Adhmana was observed in 70% of ​ the patients, Sweda Pradurbhava in 60%, Lalasrava in ​ ​ ​ ​ 55%, Hrillasa in 35%, Udgara in 30%, Romaharsha in ​ ​ ​ ​ ​ METHODS OF ASSESSMENTS 20% and Nisthivana in 35%. ​ ​ The data were collected from the patient and confidentially recorded. Subjective and objective parameters were assessed before Snehapana, on the
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