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180 ISSN Print: 2394-7500 ISSN Online: 2394-5869 Impact Factor: 5.2 IJAR 2020 62: 180-182 www.allresearchjournal.com Received: 25-12-2019 Accepted: 27-01-2020 Dr. Jaya Singh M.D. Panchakarma Department Government Ayurvedic College Chowka Ghat Varanasi Uttar Pradesh India Dr. Shweta Mishra Lecturer Department Of Kaya Chikitsa Government Ayurvedic College Chowka Ghat Varanasi Uttar Pradesh India Correspondence Author: Dr. Jaya Singh M.D. Panchakarma Department Government Ayurvedic College Chowka Ghat Varanasi Uttar Pradesh India Role of Ayurveda in Jalodar: A case study Dr. Jaya Singh and Dr. Shweta Mishra Abstract Ayurveda emphasises that all the diseases are the result of weak state of Agni. Improper functioning of Agni leads to various metabolic disorders. Ascites is the accumulation of free fluid in the peritoneal cavity. In Ayurveda it can be compared with Jalodar and Yakritadaludar. Cirrhosis is the final phase of Alcoholic liver disease which is one of the major cause of ascites associated with hepato-splenomegaly. Due to mandagni and malavriddhi udar Roga occurs. A 51 year old male patient approached with grade II ascites with bilayeral pedal oedema. He was alcoholic since 8 years. He was subjected to treatment involving Ayurvedic drugs in specific dosing pattern wirh restricted diet plan for 1 month. This case report demonstrated the succesful treatment of ascites due to alcoholic liver disease. Keywords: Ayurveda jalodar yakritadaludar Introduction Alcoholic liver disease ALD causes damage to the liver and its functions. Alcohol induced liver injury may be classified as Alcoholic fatty liver AF Alcoholic hepatitis AH Alcoholic cirrhosis of liver AC. ALD occurs after years of heavy drinking over time scarring and cirrhosis can occur. Cirrhosis is the final phase of ALD. Cirrhosis is hardening of the liver due to the formation of fibrous tissue. The clinical presentation of cirrhosis is highly variable. Some patients are asymptomatic and diagnosis is made incidentally at ultrasound or at surgery. Others present with isolated ascites hepatomegaly splenomegaly or signs of portal hypertension. When symptoms are present they are non-specific and include weakness fatigue muscle cramps weight loss anorexia nausea vomiting and upper abdominal discomfort. Hepatomegaly is common when the cirrhosis is due to alcoholic liver disease and hemochromatosis. Jaundice is usually mild when it first appears. Hepatomegaly may occur as the result of a general enlargement of the liver. Although all causes of cirrhosis can involve hepatomegaly it is much more common in alcoholic liver disease. Ascites is present when there is accumulation of free fluid inthe peritoneal cavity. Small amounts of ascites are asymptomatic but with larger accumulations of fluid 1L there is abdominal distension fullness in the ascites is marked a fluid thrill is present on palpation. The spleen has to be enlarged twoto three times its normal size to be clinically palpable. According to Ayurveda it’s a disease of Swedavaha and Ambuvaha strotodushti in which symptoms of Hepatosplenomegaly and Ascites i.e. Nausea vomiting swelling of feet and ankles High blood pressure loss of appetite weakness etc. symptoms are quietly similar to udara Roga in whichabdominal distension swelling on ankle feet hand Indigestion and loss of appetite anemia jaundice lean and thin body mild feverweakness fluid thrill etc. symptoms andsign are quite similar. The line of treatment followedin such a case is Udara roga chikitsa. A case report A 51 year old male patient came to us with chief complaints of - 1 udarvriddhi increased abdominal girth 2 jwarprachiti fever 3 dourbalya gen. weakness 4 kshudhamandya decreased appetite 5 ubhaypadshoth pedal oedema Patient had above complaints since 6 months H/O alcoholic liver disease International Journal of Applied Research 2020 62: 180-182

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181 International Journal of Applied Research http://www.allresearchjournal.com N/H/O Dm/HTN History of Personal Illness The patient was normal 1 year back. Since then patient have been suffering from Udarvriddhi increased abdominal girth Jwaraprachiti fever Droubalya Gen. Weakness Kshudhamandya decreased appetite Ubhaypadshoth pedal edema. For this patient took treatment from different modern doctor tapping was done several times but got no relief then he came to our hospital – Rajkiya ayurved college hospital Varanasi in Panchkarma department opd. For better Management we admitted patient in Ipd. Personal History Occupation: Businessman Bad Habits: Chronic alcoholism. O/E: Nadi pulse 80/min. Mala stool Normal. Mutra urine Normal. Jeeva tounge Eshatha saam. Agni Kshudhamandya. Shabda speech Normal. Druka eyes Pallor ++ icterus +++. Akruti madhyama Bala heena. Raktadaaba B.P 130/80 mm/Hg. Systemic examination per abdomen  Inspection: Distended abdomen  Palpation: Hepatomegaly 2 cm below the right costal margin Splenomegaly tenderness in the right left hypochondriac region  Percussion: Shifting dullness and fluid thrill present Investigation 1. CBC 2. Liver function test 3. Renal function test 4. Urine analysis 5. USG Material and Method Material 1. Chitrakadi vati 1 tab tds 2. Jalodarari ras 250mg Shwet parpati 250mg bd Yava kshara 250mg Punarnava mandur 250mg 3. Arogyavardhini vati 250mg bd 4. Punarnavadi kwath 50ml bd 5. Haritaki churna 3gm Hs All above medicine was taken with cow milk Panchkarma 1. Nitya virechana with eranda tail 10 ml in 1 cup cow milk Hs 2. Ichhabhedi rasa 250 mg OD with cow milk It was given every 7 th day for 1 month Pathya-Apathya Diet was restricted to the patient and he was kept on only cow milk. All types of food items were restricted for 1 month. When the patient was hungry or thirsty she was given luke warm godugdha only. Medicine were also given with cow milk as an adjuvent. Method Type of study: simple random single case study Duration of treatment: 1 month Discussion Discusion on Jalodar Ascites Ayurvedic term Jalodar Vyadhi is homologous to Ascites described in modern medicine. According to Ayurveda Chikitsa sutra of Udara choice of treatment is ‘Nitya Virechana’ purgative Agnidipan increase appetite Balaprapti and Yakritottejaka Chikitsa Stimulating hepatic function and also Arka pattabandhan over abdomen as external application. Appreciable results were observed in the form of reduction of abdominal girth bipedal oedema increase appetite increase strength. Hetu of jalodar as 1 Ahar  Improper and irregular diet causes the disturbance of vatadosha.  Jirna Madyapana Chronic Alcoholism.  Ati-ruksha Lawan Vidahi Annasevan. 2 Vihar  Suppression of natural urges  Ratri jagran Table 1: Samprapti Ghatak Dosha Vata Prana Samana Apana Pitta Pachak Sadhak Dushya Rasa Mala Sweda Srotas Ambuvaha Swedavaha Sthana Udara Samprapti Discusion on Action of Drug and Other Procedure  Aarogyavardhini vati: Grahanishodhak dipan pachan pakwashyadushti nashka.  Punarnawadi kwatha Punarnava mandura: Shotaghna mutral. Both corrects pandu shotha swash.  Chitrakadi vati: Dipan pachan  Haritaki churna: Vatanulomana  Yavakshara Shweta parpati: Mutral used in shula anaha adhman amlapitta.

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182 International Journal of Applied Research http://www.allresearchjournal.com  Jalodarari rasa: vata pitta shamaka virechaka  Ichhabhedi rasa: virechaka vatanulomana shulaghna shothaghna.  Virechana: chikitsa sutra of jalodar is - ‘Nitya Virechna’. Liver yakrit is the mula-sthana of Rakta. Rakta-Pitta has Ashray and Ashraayi sambhnda hence for elimination of vitiated Pitta Dosha virechan is the best Chikitsa. Virechana also decreases abdominal girth and oedema by decreasing fluid in the abdominal cavity. Here we use tablet Ichhabhedi rasa 250 mg od Eranda tail 10 ml Hs with 1 cup luke warm cow milk for virechan.  Aahar 14 : Role of diet also important as equal to medicine. Diet in jalodar acitis should be milk Godugdha only. Godugdha Cow Milk is only complete food which is full of nutrients and easily digestible. With Godugdha we advised patient to take Takrapaan and jwari Roti as Supplimentary food with Godugdha. Observation and result Table 2: Showing Abdominal Girth Measurement Date 8 cm above umbilicus at umbilicus 8 cm below umbilicus 6.3.2018 80 cm 80.5 cm 75.5 cm 10.3.2018 80 cm 81 cm 76 cm 14.3.2018 81 cm 81.5 cm 75 cm 18.3.2018 76.5 cm 76 cm 71 cm 22.3.2018 70.5 cm 69 cm 67.5 cm Table 3: Showing Improvement In Pedal Oedema Date Just Above Knee Just Below Knee 6.3.2018 Rt 30 Cm Rt 26 Cm Lt 31 Cm Lt 25 Cm 12.3.2018 Rt 28 Cm Rt 23 Cm Lt 29 Cm Rt 23 Cm 22.3.2018 Rt 26 Cm Rt 19 Cm Lt 25.5 Cm Lt 19.5 Cm Table 4: Invstigation Before and After Treatment Test Before treatment After treatment Hb 7.8 gm/dl 10.2 gm/dl WBC count 10000/cmm 6300/cmm Platelet count 124000 129000 Urine analysis Pus cells 3-5 hpf Albumin trace normal RFT Sr. Urea-40mg/dl Sr. Urea-40mg/dl Sr. Creatinine 94 mg/dl Sr. Creatinine 94 mg/dl LFT Sr. Billirubin Total- 4.3 Indirect- 2.8 Direct- 2.0 Sr. Billirubin Total- 1.6 Indirect- 0.8 Direct- 0.8 USG Abdomen Liver cirrhosis Mild Splenohepatomegaly Grade II ascites Liver cirrhosis mild Hepatomegaly Ascites absent The patient had started improving during hospital stay at end of 15th days there is good improvement in all symptoms of patents. After one month follow up there is nearly nil of all symptoms. Conclusion Ayurveda has unique concepts with all disease its chikitsa siddhanta work and stand test to the time. Since the therapy for jaodar acitis has limitation in other pathies Ayurvedic management of jalodar acitis is one of the most effective therapy. References 1. Dr. Brahmanada Tripathi. Charak Samhita of Maharshi charak Chukhambha prakashan Varanasi Chikitsastan chapter 13 verse no.15 2011. 2. Dr. Brahmanada Tripathi. Charak Samhita of Maharshi charak Chukhambha prakashan Varanasi Chikitsastan chapter 13 verse no.20 2011. 3. Emedicine.medscape.com/article/170907-overview. 20 October 2018 12.30 pm. 4. Dr. Brahmanada Tripathi. Charak Samhita of Maharshi charak Chukhambha prakashan Varanasi Chikitsastan chapter 13 verse no.61 2011. 5. Dr. Brahmanada Tripathi. Charak Samhita of Maharshi charak Chukhambha prakashan Varanasi Chikitsastan chapter 13 verse no.47 2011. 6. Dr. Brahmanada Tripathi. Charak Samhita of Maharshi charak Chukhambha prakashan Varanasi Chikitsastan chapter 13 verse no.12-15 2011. 7. Vd. Vishu Gogate Dravyagunavidnyana Vaidyamitra prakasana Pune dravya no-315 2008. 8. The Ayurvedic pharmacopoeia of india-part-1 Gov. of India ministry of health family welfare Department of AYUSH. New Delhi 2. 9. The Ayurvedic pharmacopoeia of india-part-1 Gov. of India ministry of health family welfare Department of AYUSH. New Delhi 1. 10. www.sharangdhar.com/ayurvedic-product/pachakvati/ 20 October 2018 12.30 pm. 11. Vd.Gune GP. Aushadhi Gundharma shatra. part-2 kalpa no 10 reprint 2005 208. 12. Vd.Panchanana Gune. Ayurvediya Ayushadhigunadharmashatra Part-4 kalpa No.81 453. 13. Vd.Panchanana Gune. Ayurvediya Ayushadhigunadharmashatra Part-5 kalpa No.21 661. 14. Dr. Brahmanada Tripathi. Charak Samhita of Maharshi charak Chukhambha prakashan Varanasi Chikitsastan 2011.

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