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A CLINICAL EFFECT OF TRIVRT-ASHTAKA CHURNA AS A VIRECHAKA YOGA IN THE MANAGEMENT OF TAMAKA SHWASA (BRONCHIAL ASTHMA)
Abstract
Virechana Karma is one of the prime modality of the treatment in Panchakarma. Different types and forms of Virechana Yoga's are mentioned with specific indications in classics. The trail drug Trivrt Ashtaka Churna is one of the such Virechana Yoga told in our classic. Clinical validation of this drug is further requires, scientific explanation and justification for its global acceptance as a Virechaka Yoga. Tamaka Shwasa occurs mainly due to vitiation Kapha Vata Dosha's in Pitta Sthana. It shows close resemblance with Bronchial Asthma on the basis of clinical manifestations. Managing Bronchial asthma on Ayurvedic line of treatment is totally different from that of conventional management. Virechana Karma is the best modality in management of Tamaka Shwasa. Hence the present study has been taken up to see the efficacy of trail drug Trivrt Ashtaka Churna on 30 cases of Tamaka Shwasa (Bronchial Asthma). Results: The study observations showed that the100% good palatability for Virechana Yoga, 64.3% patients got their first Vega on an average time 30 minutes, in 57.1% patients 16-18 Vegas were noted, Samyak Shuddi Lakshana with Pittanta was observed in 57.1% of patients.There was a highly significant improvement in symptoms like Swasa krichrata, Kasa, Ghurghuraka, Kaphanishtivana and in signs like Ronchi, Wheeze and Respiration rate got highly significant results (at p<0.001). Conclusion: After going through the clinical changes observed during and after the treatment, it may be opined that, Trivrt Ashtaka Churna acts as a Virechaka Yoga significantly in the management of signs and symptoms of Tamaka Shwasa.
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It would be of considerable interest to clinicians if the burden of chronic pulmonary aspergillosis (CPA) and allergic bronchopulmonary aspergillosis (ABPA) in India were known. Herein, we estimate the burden of CPA following pulmonary tuberculosis (PTB), and ABPA (and severe asthma with fungal sensitization [SAFS]) complicating asthma.
We used the population estimates for India from the 2011 census data. The burden of asthma was estimated using three different methods (Global Initiative against Asthma [GINA] report statement, World Health Survey [WHS] estimates, Indian study on the epidemiology of asthma and chronic bronchitis [INSEARCH]). Global and India-specific figures were used for calculating the prevalence of ABPA and SAFS. The World Health Organization estimates were used for calculating PTB rates while the frequency of CPA was assessed from a previously published scoping review. Sensitivity analysis was performed to determine the burden in various scenarios.
The total Indian population in 2011 was 1.2 billion. The asthma prevalence in adults was estimated at about 27.6 (range, 17-30) million. The burden of ABPA ranged from 0.12-6.09 million with different assumptions (best estimate, 1.38 [range, 0.86-1.52] million). The prevalence of SAFS was approximated at about 0.52-1.21 million (best estimate, 0.96 [range, 0.6-1.06] million). The incident TB cases were about 2.1 million while the annual incidence of CPA varied 27,000-0.17 million cases, with different estimates. If the mortality of CPA is estimated as 15% annually, the 5-year prevalence of CPA was placed at 290,147 cases with 5-year prevalence rate being 24 per 100,000.
There is a significant burden of ABPA, SAFS and CPA in India. Prospective community-based studies are required to accurately determine the prevalence of these disorders.
Asthma is a major cause of disability, health resource utilization and poor quality of life world-wide. We set out to generate estimates of the global burden of asthma in adults, which may inform the development of strategies to address this common disease.
The World Health Survey (WHS) was developed and implemented by the World Health Organization in 2002-2003. A total of 178,215 individuals from 70 countries aged 18 to 45 years responded to questions related to asthma and related symptoms. The prevalence of asthma was based on responses to questions relating to self-reported doctor diagnosed asthma, clinical/treated asthma, and wheezing in the last 12 months.
The global prevalence rates of doctor diagnosed asthma, clinical/treated asthma and wheezing in adults were 4.3%, 4.5%, and 8.6% respectively, and varied by as much as 21-fold amongst the 70 countries. Australia reported the highest rate of doctor diagnosed, clinical/treated asthma, and wheezing (21.0%, 21.5%, and 27.4%). Amongst those with clinical/treated asthma, almost 24% were current smokers, half reported wheezing, and 20% had never been treated for asthma.
This study provides a global estimate of the burden of asthma in adults, and suggests that asthma continues to be a major public health concern worldwide. The high prevalence of smoking remains a major barrier to combating the global burden of asthma. While the highest prevalence rates were observed in resource-rich countries, resource-poor nations were also significantly affected, posing a barrier to development as it stretches further the demands of non-communicable diseases.
'Asthma' is a Greek word which means 'breathless' or 'to breathe with open mouth'. The Global Strategy for Asthma Management and Prevention Guidelines define asthma as 'a chronic inflammatory disorder of the airways associated with increased airway hyper-responsiveness, recurrent episodes of wheezing, breathlessness, chest tightness, and coughing, particularly at night/early morning'. Airway inflammation produces airflow limitation through acute bronchocons- triction, chronic mucus plug formation and airway wall swelling or remodelling. These symptoms may be relieved either spontaneously or after treatment. Asthma can occur at any age. However, in half the cases the onset is before 10 years of age. Asthma is thought to affect about 3% of the population in most countries. The highest prevalence (almost 30%) is found in New Zealand. The prevalence in a number of countries falls in the range of 10%-17%. 1
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