A clinical study on sotha

1. MANAGEMENT OF SARVANGA SOTHA
WITH VARDHAMANA GUDAARDRAKA
PRAYOGA.
- A Pilot study.
26-Sep-14 K.C DEPARTMENT 1
Presented by ;
Dr . Razimunnisa Begum .s k
P.G. scholar, dept . of K.C

2. 26-Sep-14 K.C DEPARTMENT 2
.EPIDEMIOLOGY
PREVALENCE
MORBIDITY &
MORTALITY
GENDER&AGE
INTERNATIONAL
RANKING
INTERNATIONAL
DISTRIBUTION
CAUSITIVE FACTORS

3. OBJECTIVES OF
THE STUDY
To assess the efficacy of
Vardhamana gudaardraka
prayoga in the management of
sarvanga sotha.
CLINICAL PLAN;
5 PATIENTS
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4. SUBJECTIVE
 Utsedhana
 Ushma
 Gouravam
 Vivarnyam
 Chirottana prasamana
 Presence of Pitting
/Absence of pitting
 Measurement of girth
OBJECTIVE
26-Sep-14 K.C DEPARTMENT 4
Hb%
 Serum electrolytes
Serum creatinin
Serum albumin
Plasma albumin
Blood urea
X-ray
Ref.ch.chi 12/11 & M.ni

5. 26-Sep-14 K.C DEPARTMENT 5
• Patients with sarvanga sotha
• Both the gender
• Any age group
INCLUSIVE
CRITERIA
• Trauma
• Heenabalasya sarvagah
• Krisa
• Sotha at trimarma stana
• Upadrava yukta
EXCLUSIVE
CRITERIA
• 1MonthDURATION

6. SOTHA
NIDHANA
SAMPRAPTHI
S.SOTHA
TYPES
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7. 26-Sep-14 K.C DEPARTMENT 7
DEFINITION
Oedema results from the accumulation of
excess fluid in the interstitial spaces or
serous cavities.

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9. Generalized edema
due to transudation of salt and water, as in
e.g- hypoproteinemic syndrome
congestive cardiac failure
acute glomerular nephritis
nephrotic syndrome
cirrhosis
Localized edema due to
• increased permeability of small blood vessels, e.g, infection,
trauma, burns, allergy
• lymphatic obstruction, e.g – malignancy, filariasis, chronic
infection.
• venous obstruction, e.g – thrombosis, malignant infiltration
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10. THE LEAK OF VEINS
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CAN ANY ONE GUESS IT?

11. T umor
H eart failure
E nteropathy (protein-losing)
L iver failure
E ndocrine (hypothyroidism, aldosterones,diabetes)
A ltitude sickness
K idney disease (renal failure, nephrotic syndrome)
O bstruction of lymphatics
F ilariasis
V enous thrombosis
E clampsia / pregnancy
I atrogenic
N utritional deficiency
S epsis / capillary leakage
(from Davidson Differential Diagnosis Mnemonics)
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12.  About 24 liters of fluid are
filtered through the capillaries per
day.
 85% - reabsorbed into the
capillaries.
 15% - returned to the circulation
via lymphatics
 The formation of ISF is regulated
according to the Starling
hypothesis,
which incorporates 5 factors –
capillary hydrostatic pressure,
interstitial tissue pressure,
plasma oncotic pressure,
endothelial permeability and
lymphatic function.
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A low plasma oncotic pressure or increased hydrostatic
pressure at the venous end of capillary will tend to cause
edema

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 An important stimulus to Aldosterone release comes from
Renin - Angoiotensin-Aldosterone system. (RAA)
Any fall in ECF volume
Stimulate Juxta glomerular apparatus of kidney
Renin secretion
(liver) (lung) ACE
Angiotensinogen Angiotensin 1 Angiotensin2

16. Angiotensin II Stimulate
"aldosterone" secretion from adrenal cortex
Vasoconstriction
Secretion of ADH by acting
on hypothalamus.
Final result is salt & water retentions.
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17. ↓ Plasma protein level
(esp. albumin)
↓oncotic pressure
transudation of solutes
Edema
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18. ↓Cardiac output
Accumulation of fluid in LV
Congestion of blood in LA
Congestion of blood in pulmonary veins
↑ Capillary hydrostatic pressure
Pulmonary edema
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Left Heart Failure

19. ↓ Contraction of RV
Congestion of RA
Congestion of SVC & IVC
↑Congestion in venules & capillaries
Generalized Edema
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20. Nephrotic Syndrome
Heavy Proteinuria
Hypoalbuminuria
Leaky glomerular
capillary wall ↓Plasma oncotic pressure
Generalized edema
Fluid retention Hypervolemia
Salt & Water Retention RAA system
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22. Cirrhosis
Nodule & fibrosis
plasma protein synthesis
Sinusoidal hypertension
↓ oncotic pressure
Portal Hypertension
Generalize Oedema
Ascities
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24.  Chest X-ray - sign of heart failure,
cardiomegaly
 Plasma albumin - low in nephrotic syndrome,
cirrhosis, malnutrition
 Blood urea and electrolytes - diminished GFR
in renal disease or in severe cardiac failure
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25. Vardhamana gudaardraka prayoga
“Prayojayedaadrakanagara va tulyam
gudenaardha palaabhi vridhaya maatraam
param pancha palaani maasamjeerne payo
yusha rasascha baktam”
ch.chi.12/47,48
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26. Fresh ginger
with equal
quantity of
jaggery total of
these 2 is ½
pala--- 1st day.
Increasing the
dose by ½ pala
per day to the
maximum of 5
palas. It become
the - (10th day).
This 5palas of
dose should be
continued from -
11th day to 30th
day.
Keeping on the
diet of milk
,vegetable soup(
or) meat soup
&rice.
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27.  Malabar vaidyas hold that juice expressed from fresh ginger in
gradually increasing doses,
 is a strong diuretic in case of general dropy what ever the cause
may be. Ref. Indianmateriamedica
 Shogaol shows Triphasic effect on blood pressure.
 It induced contactile response in isolated guinea pigs.
 And showed Inotrophic &Chronotropic activities on isolated rats.
 Gingerols1&2 from rhizomes potentiated contractions induced by
Isolated blood vessels of mice &rats . Because of
 Prostaglandin related structure.Ref compendium of Indian
Medicinal plants.vol-4.Jaggery Combats excess kapha in blood
system and hence effectively removes blocks in the channels and
vessels aid free circulation of blood and nutrients.
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28. 26-Sep-14 K.C DEPARTMENT 28
GRADING
Utsedha ,Ushma, Gourvam ,Vivarnya and Presnce of
pitting.
absent-0
Mild- 1
Moderate-2
Severe-3
Measurement of girth
normal-0
5%above normal-1
10% above normal-2
More than 10%-3

29. 26-Sep-14 K.C DEPARTMENT
SYMPTOMS B.T SCORE A.T SCORE
Utsedha 14 5
Ushma 12 7
Gouravam 16 6
Vivarnyam 18 11
Chirottana
prasamana
10 4
Pitting 12 5
Measurement of
girth
10 4
29

30. Intensity of swelling No . of patients Percentage
No swelling 3 60%
Mild swelling 2 40%
Moderate swelling 0 0
0 0
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Severe swelling
Results No. of Patients Percentage
Good/complete
relief
3 60%
Moderate relief 2 40%
Poor/No relief 0 0

31.  According to present Results 40% of patients belong to
smokers &alcoholics.
 Out of 5Patients 2 female&3 are male having oedema in lower
limbs& face.
 It is observed clinically the incidence of the disease is more
prevalent in the age group 40 to 59 yrs.
 3 Patients got maximum relief & 2Patients got moderate
relief.
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32.  In this clinical study, the VARDHAMANA GUDAARDRAKA
PRAYOGA shown highly significant anti inflammatory
activity.
 Puranaguda is having lagu guna ,vata hara ,pitta
hara,patyakara, anabhishyandhi.Mutrala.
 According to susrutha guda is adhikagunakari &atyantha
patyakara.
 Sunti is having katu rasa ,lagu,ruksha,teekshna guna,Ushna
virya & madhura viaka.
 Pharmacological action of sunti is kapha vata hara &sotha
hara.
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