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ISBN 978-93-5173-179-3 ISSN 2320-7329
http://www.ayurlog.com Vol. 3 Issue: 2nd April- June 2015
Ayurlog: National Journal of Research in Ayurved Science A Web based quarterly online published Open Access peer reviewed National E-journal of Ayurved
Clinical Study of MustadiYogNasya, Tarpana and Basti in TritiyaChaturthapatalagataDoshadushtiw.s.r to Age
Related Macular Degeneration (ARMD)1
Clinical Study of MustadiYogNasya, Tarpana and Basti in
TritiyaChaturthapatalagataDoshadushtiw.s.r to Age Related Macular
Degeneration (ARMD)
Minal B. Sardar*1, Madhukar Lahankar
2, Sarala G. Dudhat
3
__________________________________________________________________
1. P. G. Scholar,
2. Associate Professor and H. O. D., Department of Shalakyatantra,
Email: drmadhulahankar@gmail.com; mob.no. 9223378878
3. Asst. Professor Department of Shalakyatantra,
Email:sarala.dudhat@gmail.com mob no. 9869021885
*Corresponding Author: Email:dr.minalsardar@gmail.com mob no. 7303083575
__________________________________________________________________
Abstract:
To Evaluate the effect of
MustadiyogaNasya, Tarpana, Basti in
Tritiyachaturthapatalagatadoshadushti
w.s.r. to Age related macular degeneration.
For this study we defined the aim and
objects are study effect of new Ayurvedic
regimen on Age related macular
degeneration, re-evaluate the ayurvedic
principles inNetraroga and to suggest an
effective remedy to treat
Tritiyachaturthapatalagatadoshadushtiw.s.r
to Age related macular degeneration.
[1]ssARMD is degenerative disease
associated with aging that affects the macula
and causes gradual loss of central vision due
to which person is unable to do his day to
day work like reading,writing,driving or
recognizing person.Modern science doesn‟t
have anyeffective and definite treatment on
this disease.While searching solution for
ARMDin Ayurvedathere is no direct
reference but some diseases
likeTritiyachaturthapatalagatadoshadushtis
hows some of the symptoms of
ARMD.There are many formulations
mentioned in samhitasin the form of
kriyakalpas in the mananagement of
drishtigatarogas like Tarpana, Putpaka,
Anjanaandpanchakarmaprocedure like
Nasya, Virechana,Basti keeping this view in
mind an attempt has been made to conquer
the situation by Ayurvedic remedy
ISBN 978-93-5173-179-3 ISSN 2320-7329
http://www.ayurlog.com Vol. 3 Issue: 2nd April- June 2015
Ayurlog: National Journal of Research in Ayurved Science A Web based quarterly online published Open Access peer reviewed National E-journal of Ayurved
Clinical Study of MustadiYogNasya, Tarpana and Basti in TritiyaChaturthapatalagataDoshadushtiw.s.r to Age
Related Macular Degeneration (ARMD)2
i.eMustadiyoga in the form of Nasya,
Tarpana,Bastion ARMD.
We got significant result in dimness
of vision and distorted vision after
completion of
MustadiyogaNasya,Tarpana,Basti treatment.
Keywords:
ARMD,Tritiyachaturthapatalagatadoshadus
hti, Mustadiyoga, Nasya, Tarpana, Basti.
Introduction:
ARMD as the name suggest is a age related
degenerative disorder. Mustadiyoga contains
Musta and other drugs
of[3]
CharkoktVaysthapakganai.eHaritaki,
Aamalaki, Guduchi,
Shatavari,Jivanti,Rasna,Shaliparni,Manduk
parni, Punarnava, Aparajita.Musta is
chosen as it is shreshthadipan and pachan
drug and Vaysthapakagana as the name
suggest all the drugs are shreshtha in
controlling aging and it‟s disorder and has
rejuvenating property. Since ARMD is
degenerative disorder and occurring due to
Dhatukshayaso Brihannasya in the form of
Mustadiyogaghrita is chosen. For topical
drug delivaryTarpanawas chosen because it
is directly indicated in vatapitta disorders.
ARMD is disease of old age which is the
period of vatadosha. As it is the disease of
Tritiyachaturthapatala which is called
AsthyashritandBastiis main treatment of
Vatadosha,Asthi and degenerative disorders
so Bastiis preferably chosen for internal
route. Keeping this in mind the present study
was planned to evaluate the effect of
Mustadi yoga Nasya,Tarpana,Bastiin
ARMD.
Material & method:
Study design: Clinical study with pre &
post study design.
Patients: Patients with classical signs &
symptoms were selected by preset inclusion
and exclusion criteria from the OPD and
IPD of ShalakyatantraDept. of Podar college
worli Mumbai.
Trial drug: The ingrediants of study drug
were purchased from local market.
All the herbs were identified,authentified.
Diagnostic criteria:
Diagnosis was established on the basis of
history and symptoms mentioned in classical
texts and by objective parameters /
investigations mentioned in contemporary
texts.
Inclusion criteria:
Patients between age group 40-80
Both sexes
Controlled DM and HTN
Immature cataract
ISBN 978-93-5173-179-3 ISSN 2320-7329
http://www.ayurlog.com Vol. 3 Issue: 2nd April- June 2015
Ayurlog: National Journal of Research in Ayurved Science A Web based quarterly online published Open Access peer reviewed National E-journal of Ayurved
Clinical Study of MustadiYogNasya, Tarpana and Basti in TritiyaChaturthapatalagataDoshadushtiw.s.r to Age
Related Macular Degeneration (ARMD)3
Cataract operated
Exclusion criteria:
Age < 40 and >80
Cataract
Glucoma
HBsAg and HIV
Familial dominant drusen
Other retinopathies like DRetc.
Pts having infective&inflammatory
disease
Laboratory investigations:
Blood Hb%, C.B.C., ESR,Lipid Profile,
LFT, RFT, BSL-Fasting & P.P. Urine-
Routine µscopic, HIV, HBsAg etc.
Treatment Group:-10 patients were selected
for study purpose.
Procedure:
1) MustadiyogaGhrit-As mentioned
inSharangdharasamhita,madhyamak
handa[6]
2/9 siddha ghrit prepared
byfollowing method.
Mustadiyogakalka- 1part
Goghrit-4part
Mustadiyoga kwath-16part
Raw material mixed in above proportion and
with the help of heat reduced upto level of
quantity of ghrita.
2) MustadiyogaBasti-preparedas per the
kshirbasti procedure stated
in[4]
Charaksamhitasiddhisthan 12/15-
1.Kwath is prepared by
bharaddravyas of Mustadiyoga each
20 gm and 1 litre water is put in
itand remained ¼ of itthen 200ml of
godugdhais added in kwatha and
heated upto godugdhare mained.
Madhu ,saindshava ,kalka, ghrita are
mixed one by one in separate jar and
above mentioned kwatha siddha
godugdha is added in this mixture
and given to the patient in 250ml
quantity.
Process Content Dose Duration Cycles
Nasya Mustadiyogaghrit 6 drops in each
nostrils
7 Days 1st 2nd 3rd
Tarpana Mustadiyogaghrit Starting from 100
matra increasing
50matra/day
7 Days 1st 2nd 3rd
ISBN 978-93-5173-179-3 ISSN 2320-7329
http://www.ayurlog.com Vol. 3 Issue: 2nd April- June 2015
Ayurlog: National Journal of Research in Ayurved Science A Web based quarterly online published Open Access peer reviewed National E-journal of Ayurved
Clinical Study of MustadiYogNasya, Tarpana and Basti in TritiyaChaturthapatalagataDoshadushtiw.s.r to Age
Related Macular Degeneration (ARMD)4
Basti Mustadiyoga siddha
kshirbasti
250 ml 14 Days 1st 2nd 3rd
Study duration:-3 months study was done.
Follow up -followup after 15 days of each
cycle.
Method of collection of data:
The disease assessment and the response of
therapy were assessed based on following
subjective & objective parameters.
Subjective parameters
1-Dimness of vision
2-Distorted vision
Objective parameters:
Ophthalmoscopic findings-
Drusens.
RPE (Retinal Pigment epithelium)
changes
Geographic atrophy of macula
Observation in tabular form:-
Sr No. Sign and Symptom Observations
1st month 2nd month 3rd
month
1 Visual acuity
2 Distorted vision (by Amsler grid)
3 Drusens
Assessment criteria
SUBJECTIVE CRITERIA
1) DIMNESS OF VISION:
It is recorded with help of Snellenschart.Distant vision recorded as aided vision…
DISTANT VISION
Visual acuity Score
6/6 to 6/6p 1
6/9 to 6/9p 2
6/12 to 6/12p 3
6/18 to 6/18p 4
ISBN 978-93-5173-179-3 ISSN 2320-7329
http://www.ayurlog.com Vol. 3 Issue: 2nd April- June 2015
Ayurlog: National Journal of Research in Ayurved Science A Web based quarterly online published Open Access peer reviewed National E-journal of Ayurved
Clinical Study of MustadiYogNasya, Tarpana and Basti in TritiyaChaturthapatalagataDoshadushtiw.s.r to Age
Related Macular Degeneration (ARMD)5
6/24 to 6/24p 5
6/36 to 6/36p 6
6/60 to 6/60p 7
2)DISTORTED VISION
Distorted vision(This is assessed by using an Amsler‟s grid)
Grade 0 No distorted vision
Grade 1 Lines are crooked or bent
Grade 2 Boxes appeared different in size and shape from each other
Grade 3 Boxes and Lines are wavy, missing.
OBJECTIVE CRITERIA
1) Drusen
2) Pigmentay changes
3) Geographicalatropy:- These are assessed
by fundus photograph before and after
treatment by improved or not improved
criteria.
1) Drusen-
ACCORDING TO AGE-RELATED EYE DISEASE STUDY—FACULTY OF
OPHTHALMOLOGY AMERICA
Grade1 No drusen, or nonextensive small drusen only, in both eyes
Grade 2 Extensive small drusen, nonextensive intermediate drusen, or pigment
abnormalities at least in one eye.
Grade 3 Large drusen, extensive intermediate drusen, or non-central geographic atrophy
in at least one eye
Grade 4 Geographical atrophy in at least one eye
Grade 5 (Neo vascular) evidence suggesting CNVM or RPE detachment,
(serous/haemorrhagic) in one eye.
Total % of Sign & Symptoms Present in the Patients month wise
Sign & symptom 1st month 2
nd month 3
rd month
ISBN 978-93-5173-179-3 ISSN 2320-7329
http://www.ayurlog.com Vol. 3 Issue: 2nd April- June 2015
Ayurlog: National Journal of Research in Ayurved Science A Web based quarterly online published Open Access peer reviewed National E-journal of Ayurved
Clinical Study of MustadiYogNasya, Tarpana and Basti in TritiyaChaturthapatalagataDoshadushtiw.s.r to Age
Related Macular Degeneration (ARMD)6
Result:-Gradation wise Improvement in Sign & Symptoms
Discussion:
We have selected the “Mustadiyogaghrita”
having guna,rasa, veerya,vipak which are
suggestive to break down the
Samprati(aetiopathology) of Tritiya-
Chaturthapatalgatadoshdushti.Ithas a
Chakshushyadrugs and alleviates vata, pitta
and kaphadosha. The drug such as Sarpi,
which got the main peculiarity like
„Sanskaranuvartana’ which not only
alleviates Vayu but it also increases the
symptoms of kapha.But, this kapha is kept
in equilibrium(state) by
kaphashamakaaction of drugs. Their
combined karmuktwa only is responsible in
destroying the doshadushti.AsTritiyapatala is
MedashritGuduchi,Musta acts on
Medodhatu also these drug
haveRasayana&Chakshushya properties.
Chaturthapatala which is called
AsthyashritandBastiis main treatment of
Asthidhatu.
The probable action of drug according to
modern review can be described in the
following way.Drugs of Mustadiyoga are
having Antidislipidemic, Rasayana, Anti-
inflammatory,Neuro Protective, Antioxidant
And Antiplatelet activity properties
according to chemical composition of
drugNasya-Either essence (Veerya) of the
Nasya or NasyaDravyais reaching and
acting on important centers controlling
different Neurological, Endocrine and
Circulatory functions and thus showing
local & systemic effects.Tarpanais the
procedure for „Snehana’ (Lubrication),
truptior soothing of eye. This procedure has
DOV
Distorted vision
Drusens
SN Symptoms Total
BT
Total
AT
Total Difference
BT-AT
Result
BT-AT*100/BT
1 DOV 76 45 31 40.78%
2 Distorted vision 23 7 16 69.56%
3 Drusens 14 14 0 0%
ISBN 978-93-5173-179-3 ISSN 2320-7329
http://www.ayurlog.com Vol. 3 Issue: 2nd April- June 2015
Ayurlog: National Journal of Research in Ayurved Science A Web based quarterly online published Open Access peer reviewed National E-journal of Ayurved
Clinical Study of MustadiYogNasya, Tarpana and Basti in TritiyaChaturthapatalagataDoshadushtiw.s.r to Age
Related Macular Degeneration (ARMD)7
been widely used in the various types of eye
disorders showing satisfactory resultsto
prevent the progress of such diseases also
protect the eyes from the occurrences of
diseases and strengthen all layers of eyes. It
is also helpful to improve muscle strength
and visual acuity by accommodation.
Sukshmguna (Micro properties) in snehacan
reach uptosukshmastrotasas (Micro
channels that includes vessels, vacuoles and
at cellular level) and perceive its subject i.e.
Roopgraham(Ability to see the object). But
the role and mechanism of its action is still
not clear and existing science techniques are
unable to predict the mechanism. According
to modern science, anatomically anterior
cilliary veins opens into Schlem‟s canal. The
medicated ghrita may get absorbed through
anterior cilliary vessels into Schlem‟s canal
and through which; it may enter in anterior
chamber then passes into posterior chamber
and may get absorbed into retina. It relieves
tiredness and also improves eyesight.
Tarpanaa, putapaka are usually lipid based
medicaments to enable easy, faster and far
penetrating effect into the posterior segment
of eyes.
The main chemical composition of
Mustadiyogaghrita ,chebulagic acid,
chebulinic acid & vitamin A. vitamin „A‟ in
ghrita is very useful in forming visual
purple in the retina.Bastiprayoga may have
Anti-oxidant, Rasayan ,Bruhana property
and hence it plays an important role in
ARMD. Thus we have tried to explain the
action of Mustadiyogaghrita in ARMD.
Mustadiyoga Nasya, Tarpana &
Bastihas significant relief in visual acuity &
Distorted vision but there is no improvement
in drusen,Pigmentary changes & Geographic
Atrophy. It maytake more period to show
changes in fundus as it is degenerative
process & 3 Month is not a sufficient period
to improve these changes.Positive point is
that no patient had worsenthesymotoms.As
ARMD is an progressive disease controlling
its further progression is also a big
achievement.
Probable Correlation:-
The condition ARMD has no definite
comparision in Ayurvedictexts.InAyurveda
the clinical features related to visual
disturbances are seen only in
drishtigataroga.A part of the clinical
features of
ISBN 978-93-5173-179-3 ISSN 2320-7329
http://www.ayurlog.com Vol. 3 Issue: 2nd April- June 2015
Ayurlog: National Journal of Research in Ayurved Science A Web based quarterly online published Open Access peer reviewed National E-journal of Ayurved
Clinical Study of MustadiYogNasya, Tarpana and Basti in TritiyaChaturthapatalagataDoshadushtiw.s.r to Age
Related Macular Degeneration (ARMD)8
TritiyaChaturthaPatalagataDoshadushtican
be correlated with ARMD.In ARMD there is
gradual loss of central vision due to which
patient can‟t recognize the face of person
this symptom can be co relate with
TritiyaChaturthaPatalagataTimirasymptom
of [5]
“Karna Nasa Akshi Viparitani
Vikshate”. means when person looks at face
of somebody he can‟t recognize his
ears,eyes & nose properly or he seems to be
without ear,nose &eyes. Certain lakshanas
of TritiyaPatalagathTimiramentioned by
our Acharya‟s like: 1) loss of vision in a
particular region, according to location of
dosha in patala. Lakshanas of
Chaturthapatal mentioned by Aacharya are
1)
“Runadhisarvatodrushtilingnashasauchyate
” here drushtimeans Macula so all macular
disorders can be correlated with
ChaturthaPatala.
Conclusion:-
Due to similarity in clinical
features disease Tritiya
Chaturtha Patalagata
Doshadushtican be correlated
with ARMD.
MustadiyogaNasya, Tarpana,
Basti showed significant results
in Dimness of vision and
Distorted vision after statistical
analysis.
Although there is no
improvement in drusens in
fundus photograph as disease is
age related and degenerative and
3 month period may not be
sufficient to show fundus
changes.It may require more
period upto 1 year.
No any adverse reaction were
observed in patients
Reference:-
1. Parsons‟ Diseases of the Eye, Editted
by Ramanjit Sihota &
RadhikaTandon, Elviser Publishers
21th Edition,20th
Chapter p.319
2. Clinical Opthalmology.Jack J
Kanski& Brad Bowling, Elviser
Publisher 7th
Edition 14th
Chapter
p.611-616
3. Agnivesha,“Charak
Samhita”,.Editted By
AcharyaVidyadharshukla&prof.Ravi
duttaTripathi, sutra Sthana,Chapter
4,Chaukhambha
SurbhartiPrakashan2007.(ch.su.4/8-
50)
4. Agnivesha,
“CharakSamhita”,.Editted By
AcharyaVidyadharshukla&prof.Ravi
duttaTripathi, siddhi Sthana,Chapter
8,Chaukhambha
SurbhartiPrakashan2007.(ch.si.12/15
-1)
ISBN 978-93-5173-179-3 ISSN 2320-7329
http://www.ayurlog.com Vol. 3 Issue: 2nd April- June 2015
Ayurlog: National Journal of Research in Ayurved Science A Web based quarterly online published Open Access peer reviewed National E-journal of Ayurved
Clinical Study of MustadiYogNasya, Tarpana and Basti in TritiyaChaturthapatalagataDoshadushtiw.s.r to Age
Related Macular Degeneration (ARMD)9
5. AacharyaSushruta„„SushrutaSamhita
”Edited
ByKavirajaAmbikaduttashastri,
Uttartantra Chapter 7, Chaukhambha
Sanskrit SansthanPrakashan.(su.u
7/12)
6. Sharangdharacharya
„SharangdharaSamhita‟‟JivanpradaS
avimarsha Hindi VyakhyaSamhita,
Edited By Dr.
ShrimatiShailajaShrivastav,Chaukha
mbhaOrientaliyaPrakashan
2011.Madhyamakhanda 9
snehaprakaran
7.
ISBN 978-93-5173-179-3 ISSN 2320-7329
http://www.ayurlog.com Vol. 3 Issue: 2nd April- June 2015
Ayurlog: National Journal of Research in Ayurved Science A Web based quarterly online published Open Access peer reviewed National E-journal of Ayurved
Clinical Study of MustadiYogNasya, Tarpana and Basti in TritiyaChaturthapatalagataDoshadushtiw.s.r to Age
Related Macular Degeneration (ARMD)10
ISBN 978-93-5173-179-3 ISSN 2320-7329
http://www.ayurlog.com Vol. 3 Issue: 2nd April- June 2015
Ayurlog: National Journal of Research in Ayurved Science A Web based quarterly online published Open Access peer reviewed National E-journal of Ayurved
Clinical Study of MustadiYogNasya, Tarpana and Basti in TritiyaChaturthapatalagataDoshadushtiw.s.r to Age
Related Macular Degeneration (ARMD)11
.
Cite this article:
Minal B. Sardar, Madhukar Lahankar, Sarala G. Dudhat
Clinical Study of MustadiYogNasya, Tarpana and Basti in TritiyaChaturthapatalagataDoshadushtiw.s.r to
Age Related Macular Degeneration (ARMD)
Ayurlog: National Journal of Research in Ayurved Science-2014; 3(2): 1-11
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