Agnimantha in vishoshi kashaya dg
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Comparative evaluation of vishoshi kashaya, aqueous extract and hydro alcoholic extract of Agnimantha moola (Clerodendron phlomidis.Linn.F) for medohara activity ...

Comparative evaluation of vishoshi kashaya, aqueous extract and hydro alcoholic extract of Agnimantha moola (Clerodendron phlomidis.Linn.F) for medohara activity
W.S.R to hyperlipidaemia –An experimental study - POORNIMA.H.V.R, Dravyaguna Vijnana Government Ayurveda Medical College Bangalore

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Agnimantha in vishoshi kashaya dg Document Transcript

  • 1. “A Comparative evaluation of vishoshi kashaya, aqueousextract and hydro alcoholic extract of Agnimantha moola(Clerodendron phlomidis.Linn.F) for medohara activityW.S.R to hyperlipidaemia –An experimental study”M.D. DISSERTATION DR. POORNIMA.H.V.R2009-2010 1
  • 2. Department of Post Graduate Studies in Dravyaguna Vijnana Government Ayurveda Medical College Bangalore CERTIFICATE BY THE GUIDE This is to certify that the Dissertation entitled “A Comparative evaluation of vishoshi kashaya, aqueous extract and hydro alcoholic extract of Agnimantha moola (Clerodendron phlomidis .Linn .F) for medohara activity W.S.R to hyperlipidaemia –An experimental study” Is a bonafide research work done by Dr. POORNIMA.H.V.R in partial fulfillment for the degree of Ayurveda Vachaspathi, Doctor of Medicine (Ayurveda) in Dravyaguna Vijnana of the Rajiv Gandhi University of Health Sciences, Bangalore.Place: BangaloreDate: Guide: DR. ASHALATHA.M. MD Professor, Dept of Post Graduate studies in Dravyaguna Vignana, G. A. M. C Bangalore –560009. 2
  • 3. Dept of Pharmacology and Toxicology Veterinary College Hebbal, Bangalore-24 CERTIFICATE BY THE CO-GUIDEThis is to certify that the Dissertation entitled “A Comparativeevaluation of vishoshi kashaya, aqueous extract and hydroalcoholic extract of Agnimantha moola (Clerodendronphlomidis.Linn.F) for medohara activity W.S.R to hyperlipidaemia–An experimental study” is a bonafide research work done by Dr.POORNIMA.H.V.R. in partial fulfillment for the degree ofAyurveda Vachaspathi, Doctor of Medicine (Ayurveda) inDravyaguna Vijnana of the Rajiv Gandhi University of HealthSciences, Bangalore.Date:Place: Bangalore Co-Guide Dr. N.B.SHRIDHAR Ph.D. Asst. Professor, Dept of Pharmacology and Toxicology Veterinary College Hebbal, KVAFSU Bangalore-24 3
  • 4. Department of Post Graduate Studies in Dravyaguna Vijnana Government Ayurveda Medical College Bangalore ENDORSEMENT BY HEAD OF THE DEPARTMENT This is to certify that the Dissertation “A Comparative evaluation of vishoshi kashaya, aqueous extract and hydro alcoholic extract of Agnimantha moola (Clerodendron phlomidis.Linn.F) for medohara activity W.S.R to hyperlipidaemia –An experimental study” under the guidance of Dr. ASHALATHA.M MD Professor, Dept of Post Graduate Studies in Dravyaguna, G.A.M.C, B’lore.Date:Place: Bangalore HEAD OF THE DEPARTMENT 4
  • 5. GOVERNMENT AYURVEDA MEDICAL COLLEGE Bangalore - 09 ENDORSEMENT BY THE PRINCIPALThis is to certify that the Dissertation ““A Comparative evaluationof vishoshi kashaya, aqueous extract and hydro alcoholic extract ofAgnimantha moola (Clerodendron phlomidis. Linn.F) formedohara activity W.S.R to hyperlipidaemia –An experimentalstudy”.” under the guidance of Dr. ASHALATHA.M MD,Professor, Dept of Post Graduate Studies in Dravyaguna,G.A.M.C, B’lore.Date:Place: Bangalore PRINCIPAL 5
  • 6. DECLARATION BY THE CANDIDATE I hereby declare that this dissertation entitled, “A Comparative evaluation of vishoshi kashaya, aqueous extract and hydro alcoholic extract of Agnimantha moola (Clerodendron phlomidis. Linn. F) for medohara activity W.S.R to hyperlipidaemia –An experimental study” is a bonafide and genuine research work carried out by me under the guidance Dr. ASHALATHA.M. MD, Professor, Dept of P. G. Studies in Dravyaguna, GAMC, B’lore-09 and under the Co-guidance of Dr. N.B.SHRIDHAR Ph.D. Asst. Professor, Dept of Pharmacology and Toxicology, KVAFSU, Veterinary College Hebbal, Bangalore-24Date: Signature of the candidatePlace: Bangalore (Dr. POORNIMAH.V.R) 6
  • 7. COPYRIGHT DECLARATION BY THE CANDIDATE I hereby declare that the Rajiv Gandhi University of health Sciences,Karnataka shall have the rights to preserve, use and disseminate thisdissertation in print or electronic format for academic / research purpose.Date: Signature of the candidatePlace: (Dr. POORNIMA.H.V.R)© Rajiv Gandhi University of Health Sciences, Karnataka 7
  • 8. ACKNOWLEDGEMENTIt gives me immense pleasure to express my acknowledgement for thehelp received from various source in the course of the preparation ofthis dissertation work.I pay my obeisance to the almighty for providing me smooth andsuccessful completion of this dissertation. This work is a reflection ofthe rays of Mercy emitted from the Almighty. At this happiestjuncture, I prostrate to the lotus feet of lord “Dhanvantari” with whoseshower of blessings this task has ventured without any hindrances.At this juncture, it would be my first and foremost duty to paygratitude to my Parents, Sri.Ramappa.V and Smt.Chandrika for thelove and affection showered on me and pain staking efforts enduredfor my progress and success.I express my deepest gratitude to my beloved guide Dr. Ashalatha.MM.D, Professor, Department of Postgraduate studies in Dravyaguna,G.A.M.C, Bangalore for her valuable suggestions, care and guidancethroughout my Dissertation work.It’s my privilege to thank my co-guide Dr. N.B. Sridhar Ph.D. Asst.Professor, Dept of Pharmacology and Toxicology, Veterinary College,KVAFSU, Hebbal, Bangalore-24, for the functional freedom,guidance, encouragement & for providing me all the facilities incarrying out my work throughout the study.I express my sincere respects and immense gratitude to Dr. JagadeeshM.S, MD Professor and HOD, Post graduate studies in Dravyaguna,G.A.M.C, Bangalore, for his guidance, constant encouragement, andkind co-operation in carrying out this work. 8
  • 9. I am grateful to Dr.S.L.Mohan. Asst. Professor, Dr.lalitha B.R Asst.Professor and Dr.Shivaram .N. Gayathri, Asst. Professor,Dr.Veena.M.S , Dr.Mamatha Acharya, Dr.Sharada Mani. Dept. ofPG studies in Dravyaguna, GAMC Bangalore, for their support andthe help during this study.I wish to express my thanks to Dr.H.T.Sreenivas, Principal, G.A.M.C,Bangalore for his kind co-operation.I whole heartedly thank Dr. Umakanth, Professor Dept of Poultry andDr. Narayanswamy professor, Dept of Pathology KVASFU,Veterinary College, Hebbal, for their timely support during the study.My heartfelt thanks to my dear colleagues Dr. Deepakini, Dr.Sujata,Dr. Naveen, Dr. Shridevi, Dr.Lakshmi and Dr.Aruna for theircooperation and constant support throughout my work. Special thanksto Dr. Deepa kini, for her timely help and cooperation rendered duringthe whole course of study.I extend my thanks to PG Scholars of Veterinary faculty Dr. Lohit,Dr. Mallikarjun, Dr.Shrikanth, Dr.Bair, for their unforgettableguidance and help during my study.My heartfelt thanks to Dr.Rajendran. Green chem., Dommaluru,Bangalore, for the help rendered to carryout alcoholic and aqueousextracts of the drugs and Dr. Ramachandra, and Dr.Roza, IIS,Bangalore who provided animals for experimentIt would be invidious to name a few from my family, when manyhave helped me; nevertheless I am grateful to each one of themspecially My Husband Mr.Devkumar.T.G, My Mother in lawSmt.Gangamma, My nephews Mr.Vinayraj, Mr. Shivraj and all myfamily members, who have helped me throughout the work. 9
  • 10. My sincere thanks to Dr.Prakash, for making Histopathological slides, Mrs. Uma and Mr.Srivatsa who have helped in serum analysis, Dr. Revathi and the authorities of Bangalore test house for their help during Phytochemical and TLC studies and Dr.Suresh .K.P for making statistical analysis. My heartfelt thanks to my junior friends, Dr.Soumya, Dr.Vidya, Dr.Tejaswini, Dr.Pratibha, Dr.Sunitha, Dr.ParvatheGowda, Dr.Vishwanathreddy, Dr.Triveni and my beloved friends Dr.Kotresh, Dr.Gayathri, Dr.Girishkumar, Dr.Arunkumar, Dr.Ravikumar and all my seniors for their timely help during my Thesis work. Lastly I thank one and all who helped me directly & indirectly in bringing out this workDate: Dr. POORNIMA.H.V.RPlace: Bangalore 10
  • 11. DISEASE REVIEW ABBREVIATIONS Ashtanga Hridaya A.H Ashtanga Samgraha A.S Ashtanga Nighantu A. N Amara kosha A.K Bhaishajya Ratnavali B.R Bhavaprakasha Nighantu B.N Bhela Samhita B. S Charaka Samhita C. S Dhanvantari Nigantu D.N Gadanigraha G.N Harita Samhita H.S Kashyapa Samhita K.S Kaiyadeva Niganthu K.N Mahoushadi Nigantu M.N Nigantu Adarsha N.A Priya Nigantu P.N Raja Nigantu R.N. Saushruthi nighantu S.N Sharanghadhara Samhita S.S Shabda Kalpadruma S.K.D Sushruta Samhita Su. S Yoga Ratnakara Y.R.Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 80 Dept of PG studies dravyaguna
  • 12. DISEASE REVIEW Table of contents 1. Introduction 1 2. Drug review Agnimantha 4 Clerodendrum phlomidis 26 3. Disease review Medodhatu , medoroga 41 Rasa dhatu 66 Plasma 69 Kapha Dosha 70 Hyperlipidaemia 80 4. Lekhana karma 105 5. Vishoshi kashaya 111 6. Experimental models 114 7. Materials and methods 117 8. Observations and results 142 9. Discussion 170 10. Conclusion 182 11. Scope for further study 184 12. Summary 185 13. Bibliography 187Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 81 Dept of PG studies dravyaguna
  • 13. DISEASE REVIEW ABSTRACTBackground and Objectives:Hyperlipidaemia is established as a major health concern due to strong causalrelationships with ischemic heart disease, ischemic stroke, overall mortality, and due toits high prevalence. Prevention and control of non-communicable diseases is a highpriority for the World Health Organization and obesity and hyperlipidaemia managementis an important part of their strategy. The most effective class of these agents, the HMG-CoA reductase inhibitors, are though potent, produce skin rash, myalgia, abnormalities ofliver function and other problems in patients. The cost of these drugs may also be ofsignificant concern, especially in view of the long-term nature of the therapy.Agnimantha ( Clerodendron phlomidis .Linn. F) is one of the Brihatpanchamoola, whichhas got reference as medohara dravya in Ayurvedic samhitas.Objectives : • To compare and evaluate medohara activity of Agnimantha moola vishoshi kashaya, aqueous extract and hydro alcoholic extract in hyperlipidaemia induced Wister albino rats. • To compare and evaluate medohara activity of trial drug with that of standard drug group in hyperlipidaemic Wister albino rats.Materials and method: Agnimantha root was procured from its natural habitat, and usedin the form of vishoshi kashaya, aqueous and hydroalcoholic extract. Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 82 Dept of PG studies dravyaguna
  • 14. DISEASE REVIEW7groups of 8 male Wister albino rats were taken, they were induced hyperlipidaemia byfeeding vanaspati and coconut oil in the ratio of 3:2, at 10ml/kgbody weight, for 30days . Group 1.NC served as normal control which did not receive induction, Group 2 HFC served as High fat control which received induction for 30 days and was not given any drug therapy. Group 3 Received Standard hypolipidaemic drug -Atervostatin at 2mg/kgbodyweight. Group 4 Received Agnimantha moola vishoshi kashaya, at 2ml dosage. Group 5 Received Agnimantha kashaya along with induction for 30 days Group 6 Received aqueous extract of Agnimantha root at 1000mg/kg body weight Group 7 Received hydroalcoholic extract at 1000mg /kg body weight.Blood serum lipid parameters like- Total cholesterol, Triglycerides, HDL, LDL, VLDL,body weight were tested once in 30days and Histo pathology of liver, kidney and Aortawere done at the end of the study.Vishoshi kashaya showed highly significant effect in reducing TC, TG, LDL,VLDL andraising HDL . P<0.001** , Aqueous and hydroalcoholic extract showed moderatesignificant effect in reducing TC,LDL,VLDL, and TG and raise in HDL was moderatelysignificant. P<0.05*, similarly the response in Histopathology, were also in accordanceto serum parameters.Key words, Medoroga, Hyperlipidaemia, Agnimantha, Serum lipids. Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 83 Dept of PG studies dravyaguna
  • 15. DISEASE REVIEWDRUG REVIEWAYURVEDIC REVIEW OF AGNIMANTHA References regarding the drug Agnimantha are widely available in most of thetexts of Ayurveda. A significant role in the treatment of different diseases, it is havingboth curative and nutritive values. It is used in the form of both single drug andcompound formulation. The literatures of Agnimantha which is obtained from different texts can becompiled under the following headings. • Historical review • Nama rupa vijnana • Gana and varga • Bheda and Sandhigdhata • Guna karma • Prayoga • Botanical description of Clerodendron phlomidis. • Ethno medical use and research on AgnimanthaHISTORICAL REVIEW Agnimantha is a very important plant during Vedic period where in its stem/stickswere used to produce fire. We find usage of Agnimantha in Rig-Veda and Atharvaveda.Is quoted as “The person enlightened with the knowledge of Agnimantha, Whose land isilluminated by the brightness. Agnimanthya is considered to be superior as he is alsoendowed with Brahmajnanna.1 Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 84 Dept of PG studies dravyaguna
  • 16. DISEASE REVIEW Acharya Charaka considered Agnimantha in Shothahara, Sheetaprashamana andAnuvasanopaga ganas.11-13 Sushruta categorised the drugs under many ganas. Among those Agnimantha isincluded under Varunadi, Vatashamana and Virataravadi ganas. Varunadi ganas isattributed for mainly kaphamedohara karma, gulma , vidradi etc, and Veeratarvadigana is indicated for shota, rajayakshma, vidradi, bala roga etc. If we observe the ganas of Astanga Sangraha there is mentioning of Arani whichis the synonym of Agnimantha. This drug is included under Virataravadi gana which isindicated for vataja Vyadhi, ashmari, mutraghatha and also in Varunadi gana which isindicated for gulma, medoroga, vidradi etc. In Laghutrayis also wide references are available regarding the medicinalproperties of Agnimantha. Nighantukaras have also explained Agnimantha in detail not only the medicinalproperties but also morphological characters. They have given many synonyms forAgnimantha depending on its properties and its morphology. Nighantus of medieval period and modern era have also explained aboutAgnimantha. One such Dravyaguna Vijnana by P.V.Sharma contains much informationabout habit, habitat, morphology and chemical composition of drug. PARIBHASHA: 1 AÎalÉqÉljÉ:-AÎalÉÇ qÉjlÉÉÌiÉ, qÉljÉ ÌuÉsÉÉåQûlÉå |( pÉÉ.mÉë) By friction of two sticks it yields sparks. Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 85 Dept of PG studies dravyaguna
  • 17. DISEASE REVIEW 2. aÉÍhÉMüÉËUMü:- aÉhÉå xÉqÉÔWåû pÉuÉÉ mÉëxÉUÌiÉ cÉaÉÍhÉMüÉËUMü | (pÉÉ.mÉë) It grows along with other plants in a group 3 iÉMüÉïUÏ:- iÉMïüqÉç GcNûÌiÉ CÌiÉ| (pÉÉ. mÉë) Many people after doing tarka considered it as good one 4. uÉæeÉrÉÎliÉMüÉ:- uÉæeÉrÉÎliÉMüÉ mÉiÉÉMåüuÉ CÌiÉ. (pÉÉ.mÉë) As this is superior among the drugs it is compared to flag which tells its superiority. 5. lÉÉSårÉÏ:- lɱÉqÉç pÉuÉÉ lÉÉSårÉÏ pÉÉ It grows on the river bank. 7 eÉrÉÉ-eÉrÉÎliÉ: eÉrÉÌiÉ CÌiÉ. | It overcomes many diseases like shotha, pandu etc hence it is called jaya,jayanti 8´ÉÏmÉÍhÉï:- ´ÉÏ: mÉhÉåïwÉÑ AxrÉ CÌiÉ| There is shree i.e. luck, wealth in its leavesSYNONYMS In ancient time ancestors were in intimacy to the nature. ThereforeAcharyas have not given importance regarding identification of the drugs.On the basis of pharmacological actions Acharyas used to give their ownnames. Later on the nighantukaras compiled these names under the heading Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 86 Dept of PG studies dravyaguna
  • 18. DISEASE REVIEW paryayanama. These synonyms play a major role in the identification of the plants. Table No. 1 Synonyms of Agnimantha: 2-10SL Synonyms C S A Su A D M R K B Sa H N Mu PNNo. S S S N N N P N N N N N A N1. Agathu +2. Agnimantha + + + + + + + + + + + + + +3. Arani + + + +4. Aranika + + +5. Aranimantha +6. Aranik + + +7. Ganika +8. Ganikarika + + + +9. Havirmantha +10. Jaya + + + + + + + +11. Jayanthi + + + + + +12. Karnika + + + +13. Kethu + + +14. Mantha +15. Manthana +16. Nadeyi + + + + +17. Shreeparani + + +18. Tarkari + + + + + + + + + +19. Thejamantha + +20. Vanhimantha + Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 87 Dept of PG studies dravyaguna
  • 19. DISEASE REVIEW21. Vyjanthika + + + + + + + + + + GANA VARGA The Acharyas have classified the drugs on the basis of morphological characters and pharmological actions. The Gana-varga means group of drugs, which are having almost similar properties and action. Charaka’s classification of the drugs into fifty Mahakashayas which is unique classification based on main action of the drugs. Nomenclature to the varga has been done on the basis of Karma. Acharya Sushrutha arranged the drugs in thirty-seven groups and named according to the main drug of the group. Vagbhata has followed both. Similarly the Nighantukars have classified the drugs on the basis of morphology. Thus originated the gana or varga. 5 Brahatpanchmoola + 6 Guduchayadivarga + + + 7 S.No Haritakyadigana C S AS A S A D M R K Su B N Mau + P Gana 8 Nirgundyadi varga S S + H N N N N N N N N A N N 9 1 Prabhadradi varga Anuvasnopaga + + 10 2 Sheetaprasamana Araninamagana + + 11 3 Shotahara Aushadhivarga + + 12 4 Varunadigana Bilwadivarga + + + + + + + + Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 88 Dept of PG studies dravyaguna
  • 20. DISEASE REVIEW13 Vatashamana +14 Virataravadigana +Table no. 2 Showing Gana-varga of Agnimantha:BHEDA AND SANDHIGDHATA During literary research it is noticed that there are controversy regarding varietiesof Agnimantha. Many of the scholars did not mention the varieties of Agnimantha, someof them mentioned two varieties of Agnimantha i.e. Kshudraghnimantha and Brihadaghnimantha. There is difference of opinion among the commentators of modernnighantus. They consider genus of Premna and Clerodendron as Agnimantha, opinions ofdifferent authors is compiled below. Charaka has mentioned two varieties - Agnimantha and Tarkari. Sushruta while explaining Varunadi gana Tarkari and Agnimantha are mentionedseparately, this indicate these two are separate drugs. Astanga Sangraha mentiones ‘Tarkari dwayam’, while writing vimarsha for thissloka the commentator explains the Agnimantha is of two varieties Tarkari andAgnimantha. Tarkari is also called as Laghu arani and botanically it is identified asPremna integrifolia Linn.Mont. Agnimantha is also called as Vruddha arani andbotanically identified as Clerodendron phlomidis. Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 89 Dept of PG studies dravyaguna
  • 21. DISEASE REVIEW In Dhanwantari nighantu two varieties of Agnimantha are mentioned Agnimanthaand Kshudraghnimantha or Kshuraghnimantha. Commentator considered Clerodendronplomoides Linn. as Agnimantha. Premna integrifolia as kshudragnimantha. In Mahoushadhi nighantu and Madanapala nighantu , no types of Agnimantha hasbeen mentioned, Arani and Agnimantha are used synonymously. The commentatorconsidered Premna integrifolia Linn. Mont. as Agnimantha. In Priya nighantu also no classification of Agnimantha has been mentioned. In Raja nighantu and Shaligrama nighantu two varieties are mentioned asAgnimantha and Kshudraghnimantha. In Bhavaprakasha there are no varieties of Agnimantha but the editor whilewriting the vimarsha highlights the following points. According to Ganga saya Pandeyand K.C.Chunekar while editing Bhavaprakasha nighantu, explained two types ofAgnimantha Brihat and Kshudraghnimantha. They have mentioned that, BrihatAgnimantha is Premna integrifolia and laghu Agnimantha is Clerodendron phlomidis. According to Dravya guna Vijnana written by P.V.Sharma, Agnimantha is of twotypes Agnimantha and Tarkari. He considered Premna mucronata Roxb.as Agnimantha,Clerodendron phlomoides Linn. as Tarkari. According to Gyanendra Pandey, Agnimantha is of two varietiesBrihataghnimantha and Kshudraghnimantha. They are Clerodendron phlomidis andPremna integrifolia and respectively. According to Bapalal vaidya, two varieties have been told laghu and brihatAgnimantha, Clerodendron phlomidis and Premna integrifolia are considered Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 90 Dept of PG studies dravyaguna
  • 22. DISEASE REVIEWrespectively. He has compiled that in south, Premna is used as Agnimantha and in northClerodendron phlomidis is used as Agnimantha. According to API and “Data base on medicinal plants used in Ayurveda”,Clerodendron phlomidis is considered as Agnimantha. But as the Guna karma of both are considered as same both can be used in theplace of other. By compiling all these factors the plant used with the name of Agnimanthaare as follows – • Clerodendron phlomoides Linn. • Clerodendron inforttunatum Linn. • Clerodendron multiflorum • Premna integrifolia Linn. Mont. • Premna latifolia Roxb. Hort, Beng. • Premna mucronata. RoxbGUNA KARMAS Guna-karma vignana in Ayurveda deals with the properties and actions of thedrugs. The mode of action of the drugs depends on its pancha-mahabhutas configuration.These five elementary principles in different combinations affect the human constitutionin different ways. The gunas, which are there in the body, are also present in the drugswhenever there is deficiency of gunas in the body they are fulfilled by providing the sameentity in the form of drug; hence it is very much necessary to study the pharmacological Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 91 Dept of PG studies dravyaguna
  • 23. DISEASE REVIEWproperty of the drug. Thus Rasa, Guna, Veerya and vipaka, which are simplestparameters to ascertain the actions of the drugs and diets, are considered as the base ofthe pharmacology in Ayurveda. The pharmacological properties of Agnimantha is mentioned in both samhita andnighantus. There is no much difference of opinion regarding the properties. Most of theAcharyas mentioned laghu, ruksha, guna, katu tikta, kashaya, rasa and katu vipaka,ushna veerya. The guna karma mentioned according to different Acharyas are tabulatedbelowTable no. 3 Showing Guna – karma: 19-26Guna-karma D R K Sa B N Mau P N I A Dg N N N N N A N N R M P Pv P I Guru +Guna Laghu + + Rooksha + + Katu + + + + + + + + + + +Rasa Tikta + + + + + + + + + + + + Kashaya + + + + + + + Madura + + +Veerya Ushna + + + + + + + + + + +Vipaka Katu + +Table no. 4 Showing Karma of Agnimantha Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 92 Dept of PG studies dravyaguna
  • 24. DISEASE REVIEWSl. D M R K B Mau P N I Dg KarmaNo. N N N N N N N R M pv P1 Kaphavathahara + + + +2 Sothahara + + +3 Deepana + + +4 Jwaraghna + +6 Shophaghna + + + +7 Admananasha +8 Vishahara +9 Vatahara - + +10 Kaphaghna + + + +11 Anuvasanopaga +12 Agnimandyanasha + + + + +13 Seetaprasamana14 Vatakaphahara + +15 Hrudya +16 Amavatahara + +17 Swayathuhara + +18 Vibandha + +PRAYOGA By an exclusive study of samhita and nighantu it is found that it was usedsince vedic period. The drug Agnimantha is used as single drug and also ascompound formulation. The drug Agnimantha is indicated as a single drug in Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 93 Dept of PG studies dravyaguna
  • 25. DISEASE REVIEWmany diseases, Varunadi gana, virataravadi gana, vata shamana gana, indicatedfor shirashoola, gulma, ashmari, mutraghata, Charaka included Agnimanthaunder ganas such as sheetaprashamana, shothahara, anuvasanopaga. Vagbhataalso mentioned in Varunadi gana indicated for svayathu etc. The recent authors also mentioned the use of Agnimantha as a single drug someof the references are Agnimantha moola kashaya indicated for vatashamana, puyameha,Agnimantha moola kalka is indicated for sheeta pitta, shotha. Agnimantha patra swarasaindicated in pandu, dourbalya and shotha. The drug Agnimantha is used as an ingredient of many yogas which are indicatedfor many diseases, eg. In dashamoola it is one of the ingredients. In Charaka samhita the drug Agnimantha is used in formulations such asAgarwadi taila, indicated for jwara. Dasha moola ghrita indicated for hikka swasa, Baladilepa indicated for granthi. In Sushruta samhita also the drug Agnimantha is being mentioned in formulationssuch as Dvipanchamoola kwatha, indicated for shoola, pravahika and panchamooladighrita indicated for shiroroga, karna roga. Astanga sangraha also has mentioned in many preparations like Agastya haritakirasayana , indicated for Kasa, Kshaya, Prameha. Gandeeraarista indicated for Shotha,Amavata, Gulma roga. Similarly in nighantus Agnimantha is used in yogas as tabulated below. 27-33Table No: 5 Therapeutic effects of Agnimantha.Disease C S A A A D M R K Su B N Mu P N A DG KB S S H S N N N N N N N A N N R P PV DG Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 94 Dept of PG studies dravyaguna
  • 26. DISEASE REVIEW IAdamana + +Amavata + + +Arsha + + + + +Balaroga + +Granthi +Gulma + +Hrudhya +Jwara + +Kasa +Kota +Medaroga + + + + +Mutrakrichrahara +Nadishoola +Pandu + + + + + + +Peenasanasha +Pramehaghna + + +Pratishayanasha + +Rajayakshma +Sitapitahara + +Sophaghna + + + + +Sotha + + + + + + + Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 95 Dept of PG studies dravyaguna
  • 27. DISEASE REVIEWSthoulya + +Swasahara +Swayathu +Udavartha + +Udarda +UrusthambaVasameha +Vibandhanasha + + +Vishaghna + +PRAYOJYA ANGA Active principle of the drugs differs according to its part. Hence the concept ofPrayojya anga is developed. Agnimantha is having different pharmacological actions forits different parts of it. Panchanga of Agnimantha is used i.e. Moola, patra, phala, shakaand pushpa are useful. In ‘Ayurvedic pharmacopoeia of India’ root is mentioned asofficial part used as a medicine. In ‘Wealth of India’ medicinal properties of its root ismentioned.POSOLOGY Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 96 Dept of PG studies dravyaguna
  • 28. DISEASE REVIEW The word posology is derived from Greek word ‘posos’ meaning how much and‘Logas’- science. It is a branch of medical science, which deals with doses or quantity ofdrug, which is to be administered to produce the required pharmacological action. Dose of a drug can not be fixed rigidly. Because while prescribing a drug manyfactors are to be considered. According to which dose differs. Dose depends upon someof the factors like age, sex, severity of the disease, potency of the drug, withstandingcapacity of the patient, Locality of the drug and the patient etc. General adult doseaccording to Sharangadhara samhita Madhyama kanda for swarasa is 12ml for kwatha is100ml and that of churna is 10g. Agnimantha can be used in the form of swarasa, churnaand kwatha for internal administration. According to Dravyaguna P.V.Sharma dose of churna 1 to 3gm, Swarasa form10-20ml, Kwatha 50 – 100ml.VISHISHTA YOGA Different types of compound preparations are mentioned in ancient texts, whichcontain various drugs. The ingredients may have similar properties to enhance the actionof main ingredient or else have quite opposite properties to diminish the severity ofadverse effects of the main ingredient but never inhibits the main action. Such formulations are named on the basis of main drug or on the main action orelse depending on the founder of formula etc. Agnimantha is being used as a mainingredient or one among the ingredients in various preparations as tabulated below:Table No.6 Showing Vishistayogas of Agnimantha by different Acharyas. Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 97 Dept of PG studies dravyaguna
  • 29. DISEASE REVIEW(a)Charaka samhita:Sl.no Vishista yoga Rogaghnata References1 Shonakadi lepa Urustambha Cha.Chi.27/572 Baladi lepa Granthi Cha.Chi.21/1253 Agaruwadi taila Jwara, sheetajwara Cha.Chi.3/2694 Kansaharitaki leha Raktapitta, amlapitta, Cha.Chi.12/50 amavata, gulma, swasa5 Brahma rasayana Rasayana, deergayu, Cha.Chi.1.1/43 manoabhilasha6 Chavanprasha leha Rasayana, kasa, swasa, Cha.Chi.1/697 Tarkaryadi lepa Urustambha Cha.Chi.27/528 Dashamooladi ghrita Kasa, Hikka, Swasa Cha.Chi.17/1409 Dashamoola kwatha Kasa, Swasa Cha.Chi.17/10510 Dwipanchamooladi ghrita Kshaya, kasa Cha.Chi.18/16011 Dashamooladi yavagu Swasa, Hikka Cha.Chi.19/10312 Agastya haritaki Vishama jwara, kshaya, Cha.Chi.18/62 kasa13 Patoladi basti kashaya Udavartha, vibandha Cha.Chi.2/1314 Moola kashaya Kaphaja meha Cha chi 6/2815 Kashaya sechana Urustambha Cha.chi 27/5216 Taila Kaphaja peenasa Cha.chi 26/15217 Kshara Udara roga Cha.chi 13/171 Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 98 Dept of PG studies dravyaguna
  • 30. DISEASE REVIEW18 Agnimanthadi swarasa Medoroga stoulya Cha.Chi.21/24(b) Sushruta samhita:Sl.No. Vishista yoga Rogaghnata References1. Aushadheeya ayaskriti Sthoulya, mutrakrichra, Su.Chi.10/13 prameha2 Kalyanaka lavana Vataroga, gulma,pleeha, 4/32 ajeerna ,arochaka3 Moola Kashaya Ikshumeha , vasameha 11/84 Kashaya Naigamesha graha dosha 36/3 (ut.sta)5 Nadi sweda Karna shoola 21/6(u.s)6 sura Kushta 10/87 Panchamooladi ghrita Shiroroga, karnaroga Su.Chi.26/58 Dashamoola ksheera basti Shoola, pravahika Su.Ut.9. Dwipanchamoola kwatha Shoola, pavahika Su.Ut.40/14410. Bilwadi sura Garbhini vyapat Su.Ut(c)Astanga Hridaya:Sl.No. Vishista yoga Rogaghnata References1. Agnimanthadi lepa Vatajashopha A.H.Chi.172. Agnimantha dhumapana Dushtapeenasa A.H.Chi.20/163. Dashamooladi avaleha Svayathu, jwara, gulma, amavata A.H.Chi.17/164. Kalamushkakadi kshara Ashmari, gulma, agnimandya, arbuda A.H.Su.10/12 Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 99 Dept of PG studies dravyaguna
  • 31. DISEASE REVIEW5. Agasthya haritaki rasayana Rasayana, kasa, swasa, kshaya, A.S.Chi.5/81 prameha,6. Dashamoola haritaki Shotha, amavata, gulmaroga, pandu A.S.Chi.19/297 Lepa Vataja galaganda 22/668 Dhoomapana Kaphaja pratishyaya 20/169. Gandeerarista Pandu, granthi, arbuda, A.S.Chi.18/21(d) Chakradatta chikitsa sangraha:Sl.No. Vishista yoga Rogaghnata References1. Guggulu prayoga Kaphaja vidradhi 43/112. Punarnavadi pralepa Kaphavataja shotha, 44/93. Punarnavadya ghritam Shotha 39/314. Punarnavadya avaleha Shotha 39/46References for drug review 1. rÉÉå uÉæ iÉå ÌuÉkrÉÉSUhÉÏÈ rÉÉqrÉÉÇ ÌlÉqÉïjrÉjÉå uÉxÉÑ| xÉ ÌuɲÉlÉç erÉå¹qÉlrÉåiÉxrÉ ÌuÉkrÉÉiÉç oÉëqWûhÉÉqÉWûiÉç|| (AjÉuÉïuÉåS) 2. AÎalÉqÉljÉÉå WûÌuÉqÉïljÉÉå aÉlkÉmÉ§É¶É MüÐÌiÉïiÉÈ| oÉÉsÉlÉÉå aÉlkÉuÉëÑ¨É¶É iÉåeÉÉåqÉljÉ¶É zÉoSiÉÈ|| (xÉÉæ.ÌlÉ) 3. eÉrÉÉÎalÉqÉljÉÉåÅUÍhÉMüiÉMüÉïËUuÉæeÉrÉÎliÉMüÈ|| (A.ÌlÉ) 4. AÎalÉqÉljÉÉå ÅAÎalÉqÉrÉlÉxiÉMüÉïËU uÉæeÉrÉÎliÉMüÉ| Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 100 Dept of PG studies dravyaguna
  • 32. DISEASE REVIEW uÉÌ»ûqÉljÉÉåÅUhÉÏMåüiÉÑÈ ´ÉÏÈmÉhÉÏïMühÉÏïMüÉeÉrÉÉ|| (kÉ.ÌlÉ) 5. AÎalÉqÉljÉÉå qÉjÉ: MåüiÉÑUUÍhÉ uÉæeÉrÉÎljÉMüÉ|| (qÉ.mÉÉ.ÌlÉ) 6. iÉMüÉïUÏ MüiÉÑÃwhÉ cÉ ÌiÉ£üÅÌlÉsÉMüTüÉmÉWû|| (UÉ.ÌlÉ) 7. AÎalÉqÉljÉÉåÅUÍhÉMüÉ iÉMüÉïËU uÉæeÉrÉÎliÉMüÉ| |qÉjÉlÉÉå uÉÌ»ûqÉjÉlÉÉå aÉÍhÉMüÉ aÉÍhÉMüÉËUMüÉ|| (Mæü.ÌlÉ) 8. AÎalÉqÉljÉÉå eÉrÉÈ xrÉÉiÉç ´ÉÏmÉhÉÏï aÉhÉÏMüÉËUMü| eÉrÉÉ eÉrÉliÉÏ iÉMüÉïUÏ lÉÉSåÌrÉ uÉæeÉrÉÎliÉMüÉ|| (pÉÉ.mÉë.ÌlÉ) 9. iÉMüÉïËU MüOÒûMüÉÎxiÉ£üÉiÉrÉÉåwhÉÉÌlÉsÉ mÉÉhQÒûÎeÉiÉç|| (xÉÉ.ÌlÉ) 10. AÎalÉqÉljÉÉUÍhÉqÉljÉÉÈ MüÍhÉïMüÉ aÍhÉMüÉËUMüÉ| eÉrÉÉ eÉrÉÎliÉ lÉÉSårÉÏ iÉMüÉïËU uÉæeÉrÉÎliÉMüÉ|| (qÉWûÉæ.ÌlÉ) 11. UÉxlÉÉxÉÑUÉSÉÂÌoÉsuÉqÉSlÉzÉiÉmÉÑwmÉÉuÉëÑwcÉÏUmÉÑlÉlÉïuÉ ÉµÉSÇw§ÉÉÎalÉqÉljÉ| zrÉÉålÉÉMüÉ CÌiÉ SzÉåqÉÉlrÉlÉÑuÉÉxÉlÉÉåmÉaÉÉÌlÉ pÉuÉÎliÉ| (cÉ. xÉÔ. 4/26) 12. mÉÉOûsÉÉÎalÉqÉljÉzrÉÉålÉMüÌoÉsuÉMüÉzqÉrÉïMülOûMüÉËU oÉëÑWûiÉÏ zÉÉsÉmÉhÉÏï mÉëÑÎzlÉmÉhÉÏï aÉÉå¤ÉÑUMüÉ CÌiÉ SzÉåqÉÉÌlÉ µÉrÉiÉÑWûUÉÍhÉ pÉuÉÎliÉ|| (cÉ.xÉÔ.4/37) 13. iÉaÉUÉaÉÃkÉÉlrÉMüÉ ´ÉÑÇaÉuÉåU pÉÔiÉÏMü uÉcÉÉMülOûMüÉrÉÉïÎalÉqÉljÉzrÉÉålÉMü ÌmÉmmÉsrÉ CÌiÉ SzÉåqÉÉÌlÉ|| (cÉ.xÉÔ 4/42) 14. ÌoÉsuÉÉÎalÉqÉljÉÌOûhOÒûMümÉÉOûsÉÉÈ MüÉzqÉrÉÉïzrÉåÌiÉ qÉWûiÉç|| (xÉÑ.xÉÔ. 39/69) 15. uÉÏUiÉà xÉWûcÉU²rÉ SpÉïuÉëѤÉÉSlÉÏaÉÑlSìÉlÉsÉMÑüzÉMüÉzÉqÉpÉåSMüÉÎalÉqÉljÉqÉÉåEvaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 101 Dept of PG studies dravyaguna
  • 33. DISEASE REVIEW UOûuÉxÉÑMü uÉÍxÉUpÉssÉÔMüMÑüU LOûMåülSÏuÉUMümÉÉåiÉuÉlMü µÉSÇw§ÉÉcÉåÌiÉ|| (xÉÑ.xÉÔ.39/10) 16. uÉÂhÉÉiÉïaÉsÉzÉÏaÉëÑqÉkÉÑzÉÏaÉëÑiÉMüÉïËUqÉåwÉ´ÉÑÇaÉÏ mÉÔiÉÏMü lÉ£üqÉÉsÉÉ qÉÉåUOûÉÎalÉqÉljÉqÉæUårÉMü²ÉÌoÉqoÉÏuÉxÉÑMüuÉÍxÉUÍcɧÉMü zÉiÉuÉUÏ ÌoÉsuÉÉeÉ´ÉÑlaÉÏ SÉpÉÉï oÉëÑWûÌiɲrɶÉåÌiÉ|| (xÉÑ.xÉÔ.39/8) 17. uÉÂhÉxÉæUårÉMürÉÑaqÉzÉiÉÉuÉUÏSWûlÉqÉÉåUOûÌoÉsuÉÌuÉwÉÉhÉ ÏMüÉ:| ̲oÉëÑWûiÉÏ̲MüUleÉ eÉrÉɲrÉÇ –oÉWûsÉmÉssÉuÉSpÉïÂeÉÉMüUÈ|| (A.¾Òû.xÉÔ.15/21) 18. uÉÂhÉxÉæUårÉMürÉÑaqÉzÉiÉÉuÉUÏSWûlÉqÉÉåUOûÌoÉsuÉÌuÉwÉÉhÉ ÏMüÉ:| ̲oÉëÑWûiÉÏ̲MüUleÉ eÉrÉɲrÉÇ –oÉWûsÉmÉssÉuÉSpÉïÂeÉÉMüUÈ|| (A.xÉÇû. xÉÔ.16) aÉÑhÉMüqÉï: 19. iÉMüÉïUÏ MüOÒûMüÉ ÌiÉ£üÉ iÉjÉÉåwhÉÉÅÌlÉsÉ mÉÉlQÒûÎeÉiÉç| zÉÉåjÉzsÉåzqÉÉÎalÉqÉÉlkrÉÉqÉÌuÉoÉlkÉɶÉç ÌuÉlÉÉzÉrÉåiÉç|| (kÉ.ÌlÉ) 20. AÎalÉqÉljɲrÉÇ cÉæuÉ iÉÑsrÉ uÉÏrÉïUxÉÉÌSwÉÑ| iÉimÉërÉÉåaÉÉlÉÑxÉÉUåhÉ rÉÉåeÉrÉiÉç xuÉqÉlÉÏwÉrÉÉ|| (UÉ.ÌlÉ) 21. iÉMüÉïUÏï MüOÒûMüÉ ÌiÉ£üÉiÉÑuÉUÉ qÉkÉÑUÉÎalÉS| | uÉÏrÉÉåïwhÉ WûUiÉå uÉÉiÉMüTüµÉrÉjÉÑ mÉÉhQÒûiÉÉ:|| (Mæü.Så.ÌlÉ) 22. AÎalÉqÉljÉ: µÉrÉjÉÑlÉÑiÉç uÉÏrÉÉåïwhÉ: MüTüuÉÉiɾÒûiÉç| mÉÉhQÒûMüOÒûMüÎxiÉ£üxiÉÑuÉUÉå qÉkÉÑUÉåÎalÉS|| (pÉÉ.mÉë.ÌlÉ) 23. iÉMüÉïUÏ MüiÉÑÃwhÉÉ cÉ ÌiÉ£üÉÌlÉsÉMüTüÉmÉWûÉ|| (ÌlÉ.AÉ) 24. AÎalÉqÉljÉ; MüOÒûÎxiÉ£ü: MüwÉÉrÉÉå qÉkÉÑUÉåÎalÉkÉÉ:|| (qÉWûÉæ.ÌlÉ) 25. AÎalÉqÉljÉÉå UxÉÉåÌiÉ£üÈ MüwÉÉrÉÈ MüTüuÉÉiÉlÉÑiÉç|Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 102 Dept of PG studies dravyaguna
  • 34. DISEASE REVIEW uÉÏrÉÉåïwhÉ: zÉÉåjɾÒû²è uÉÌ»ûSÏmÉlÉÉå euÉUlÉÉzÉlÉ|| (ÌmÉë.ÌlÉ) 26. AÎalÉqÉljÉÉå ÌoÉëWûimÉëÉå£üÈ MüiÉÑÃwhÉÉ¶É qÉÉkÉÑUÈ| ÌiÉ£üxiÉÑ iÉÑuÉU¶ÉÉÎalÉSÏmÉMüÉå uÉÉiÉlÉÉzÉlÉ|| (ÌlÉ.U) 27. iÉMüÉïUÏMüOÒûMüÌiÉ£üÉ iÉjÉÉåwhÉÅÌlÉsÉ mÉÉhQÒûÎeÉiÉç| zÉÉåjÉ zsÉåwqÉÉÎalÉqÉÉlkrÉÉqÉÌuÉoÉlkÉÉ¶É ÌuÉlÉÉzrÉåiÉç|| (kÉ.ÌlÉ) 28. AÎalÉqÉljÉÉå qÉjÉÈ MåüiÉÑUUÍhÉuÉæeÉrÉÎliÉMüÉ| AÎalÉqÉljÉ: µÉrÉjÉѲÏrÉÉåïwhÉMüTüuÉÉiÉlÉÑiÉç|| (qÉ.mÉÉ.ÌlÉ) 29. iÉMüÉïUÏ MüOÒûÃwhÉÇ cÉ ÌiÉ£üÉÅÌlÉsÉ MüTüÉmÉWû| zÉÉåTüzsÉåwqÉÉÎalÉqÉÉlkrÉÉzÉïÌuÉQèoÉlkÉÉkqÉÉlÉlÉÉÍzÉÌlÉ||(UÉ.ÌlÉ) 30. AÎalÉqÉljÉÈ µÉrÉjÉÑlÉѲÏrÉÉåïwhÉÈ MüTüuÉÉiɾÒûiÉç| mÉÉhQÒûlÉÑMüOÒûMüÉÎxiÉ£üxiÉÑuÉUÉå qÉkÉÑUÉåÅÎalÉSÈ|| (pÉÉ.mÉë.ÌlÉ) 31. AÎalÉqÉljÉÈ MüOÒûÎxiÉ£üÈ MüwÉÉrÉÉå qÉkÉÑUÉåÅÎalÉSÈ| MüTüuÉÉiÉWûUÈ mÉÉhQÒûzÉÉåTüÉqÉzÉÉåï ÌuÉwÉÉmÉlÉÑiÉç|| (qÉWûÉæ.ÌlÉ) 32. AÎalÉqÉljÉÉå UxÉÉåÌiÉ£üÈ MüwÉÉrÉÈ MüTüuÉÉiÉlÉÑiÉç |uÉÏrÉÉåïwhÉÈ zÉÉåjɾÒûSè uÉÌ»ûSÏmÉlÉÉå euÉUlÉÉzÉlÉ|| (ÌmÉë.ÌlÉ) 33. mÉëÌiÉzrÉÉrÉÇ MüTÇü zÉÉåjÉqÉzÉï¶ÉæuÉÉqÉuÉÉiÉWûUqÉç| qÉsÉUÉåkÉÇ cÉÉÎalÉqÉÉlkrÉÇ mÉÉhQÒûUÉåaÉÇ ÌuÉwÉÇ iÉjÉÉ|| AÉqÉÇ cÉ qÉåSÉåUÉåaÉÇ cÉ lÉÉzÉrÉåÌSÌlÉ MüÐÌiÉïiÉÈ| aÉÑhÉÈ sÉbuÉÉÎalÉ qÉljÉxrÉ mÉëÉå£üÉÈ uÉëѬÎalÉqÉljÉuÉiÉç| ÌuÉzÉåwÉÉsÉåmÉlÉå cÉÉåmÉlÉWåû zÉÉåTåü cÉ MüÐÌiÉïiÉÈ|| (ÌlÉ.U) Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 103 Dept of PG studies dravyaguna
  • 35. DISEASE REVIEW PLATE: 1 AGNIMANTHA PLANT Clerodendrum phlomidis.Linn.F Leaves and fruit Fruit of Agnimantha Agnimantha Clerodendron phlomidis.Linn.F Roots of Agnimantha Flowers of AgnimanthaEvaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 104 Dept of PG studies dravyaguna
  • 36. DISEASE REVIEW CLERODENDRON PHLOMIDIS.LINN.FNomenclature: AgnimanthaScientific name: Clerodendron phlomidis. Linn .f The word Clerodendron is made of two words i.e., ‘kleros’ and ‘dendron’ wherekleros stands for fate or fortune and dendrum or dendron is a tree. Together it means “Atree of fate” it is said that Clerodendron’s are plants of maluy magic.Vernacular names: The drug is universally known and accepted by its scientific name. Still theknowledge of Local name and the name in regional language is necessary to get genuinedrug for the practice. Hence the vernacular names are necessary. Some of the vernacularnames are as follows. 1. Bengali : Ganiyari, Ganira 2. Gujarati : Aranel, Airanamula 3. Hindi : Arni, Agathu, Ganiyari 4. Kannada : Arani, Taggiberu, Taggi 5. Malayalam : Tirutali 6. Marathi : Airana, Takalu, Chamari 7. Oriya : Hontari 8. Sanskrit : Ganikarika, Jaya, Jayanthi Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 105 Dept of PG studies dravyaguna
  • 37. DISEASE REVIEW 9. Tamil : Talanaju, Munnay 10. Telugu : Gabbunulli 11. French : Arbe a la migraineClassification:Division - AngiospermaeClass - DicotyledanaeaeSubclass - GamopetalaeSeries - BicarpellateOrder - LamicealesFamily - VerbenaceaeGenus - ClerodendronSpecies - phlomidisFAMILY FEATURES OF VERBENACEAEHabit: Mostly annual and perennial herbs may be shrubs or trees (tectona) or rarelywoody climbers or halophyte in tropical shores.Leaves: Simple or palmately or pinnately compound, opposite or whorled, exstipulate,entire or divided.Inflorescence: Cymose, Racemose or spike. Cymes often compound or paniculate.Bracts usually small.Flowers: Often brightly coloured. Hermaphrodite (rarely polygamous) usually irregular.Zygomorphic, hypogynous. Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 106 Dept of PG studies dravyaguna
  • 38. DISEASE REVIEWCalyx: Compamelate, truncate or 5 toothed or sub-5 partite, partite persistent oftenaccrescent or coloured.Corolla :Gamopetalous, tube usually cylindrical or dilated above. Often curved limb, 2-lipped or subsequent lobed. Lobes 5-4(rarely more).Androceium: Stamens-4. Didynamous (rarely 2, very rarely 5-6) inserted on the corollatube. Filaments free anthers 2-celled opening by longitudinal slits disc usuallyinconspicuous.Gynoecium: Ovary superior, sessile 2-4 (rarely 8) celled entire or 4 lobed. Bicarpellarysyncarpous 2 celled becomes 4 celled due to false septum ovule one in each locule asaxile placentation. Ovules variously attached 2 (sometimes 1) in each all style terminal.Stigma usually entire, less commonly 2 or more lobed.Fruit: Fruit more or less drupaceous. 2-4 or 1 celled mesocarp- juicy. Fresh or dry.Endocarp usually bony. Seed erect or pendulous, separate in distinct cell. Albumen -0 inIndian genera.Pollination: Entomophilous.Root : Tap, branched, pneumatophore { avicennia}Stem : Erect, herbaceous or woody, young branches quadrangular, in some branchesspiny.Diagnostic features.Plants, herbs, shrubs or trees, leaves simple, exstipulate, opposite or whorled; Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 107 Dept of PG studies dravyaguna
  • 39. DISEASE REVIEWInflorescence: cymose, racemose or spike. Flowers: Hermaphrodite, zygomorphic,hypogynous. Calyx : Gamosephalous, persistent. Corolla: 5 lobed, gamopetaloussometimes two lippedStamens: Four, didynamous unequally paired, epipetalousCarpel: Two, syncarpous, superior, axile placentationFruit: Drupe. In Verbenaceae there are about 77 genera, 3020 species , out of which21 generaand 125 species occur in India. All most in all tropical and sub tropical areas also extendinto temperate lands.Characters of - Clerodendron phlomidisHabit: A large bushy shrub.Leaves: Simple, opposite, exstipulate, broadly ovate, petiolate, puberulous with crenatemargin. In young plants they are much larger while very small ones occur on and nearpanicle of old stems. Leaf is dorsiventral with 1 to 2 or three layers of palisade cells. Bothglandular and non glandular hairs are present. Stomata are cruciferous. Palisade ratio is2.4, Stomatal index is 8.26(upper) and 10.29 (lower), vein islet number 11 and veinlettermination number 17.Flower: In 3-9 axillary cymes, white coloured, fragrant, borne in a terminal, roundedpanicle.Calyx: companulate, truncate or 5 toothed or sub-5 partite, persistent often accrescent orcoloured. Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 108 Dept of PG studies dravyaguna
  • 40. DISEASE REVIEWCorolla tube: Slender, cylindrical, usually long filiform; spreading more or less oblique,Stamens-4.Anthers: Long exerted.Ovary Imperfectly 4 celled, 4 ovuled.Style ; Filiform, shortly bifidDrupe – Globose, succulent, 4 grooved, separating into 4 pyrenes of which 1-3 areoften suppressed. Obovoid, black when ripe.Seeds; oblongFlowers are seen in the month of April-may and fruits in the month of JuneDistribution: This is available in all most all the forest of India especially the nearestforest of Gangatata, bihar , Orissa, in sub Himalayan tracts, Chota Nagpur, Bihar, BengalPunjab, Gujarat , konkan, deccan and Karnataka. In Karnataka- Belgaum, Bellary, Bidar,coorg, north kanara, raichur.Propagation and Cultivation: It can be propagated by seeds and root suckers and growswell on a variety of soil. In nature, it is found generally on waste lands, along railwaytracks etc.Phormacognasy of Root: A drug can be identified by thorough observation of the plant which includesmacroscopic and microscopic study of the drug. Characters of Agnimantha are explainedbelow.Macroscopic characters: Drug pieces 7-15cm long, 0.2-3.0cm thick, occasionallybranched, cylindrical, tough, yellowish-brown externally, bark thin, occasionally easily Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 109 Dept of PG studies dravyaguna
  • 41. DISEASE REVIEWpeeled, outer surface rough due to exfoliation, wood yellow, fracture hard: taste slightlyastringent.Microscopic characters: Root shows exfoliating cork, consisting of 10-15, occasionallymore, rows of tangentially elongated, thin-walled cells; secondary cortex consists ofround to oval parenchymatous cells, a few containing rhomboidal crystals of calciumoxalate; secondary phloem consists of iso diametric, thin walled, parenchymatous cells, afew of them containing rhomboidal crystals of calcium oxalate; phloem rays distinct ,consisting of radially elongated cells; secondary xylem shows a wide zone, consisting ofusual elements, all being lignified; vessels found in single or in groups of 2-3, scatteredthroughout xylem region; xylem parenchyma simple pitted, squarish wide lumen; xylemrays 1-5 serriate, consisting of radially elongated cells. Rhomboidal crystal of calciumoxalate packed in xylem parenchyma and xylem rays; abundant simple, round starchgrains measuring 6-17 mue in diameter found scattered throughout.Powder : dull yellow, shows fragment of cork cells, small, pointed, aseptate, lignifiedfibres, simple pitted vessels, lignified cells packed with rhomboidal crystals of calciumoxalate and numerous simple, round to oval starch grains having narrow hilum,measuring 6-11 mue in diameter.IDENTITY, PURITY AND STRENGTH:Foreign matter: Not more than 2%Total ash: Not more than 6%Acid insoluble ash: Not more than 1%Alcohol soluble extractive- Not less than 2%Water soluble extractive- Not less than 5% Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 110 Dept of PG studies dravyaguna
  • 42. DISEASE REVIEWPHYTO CHEMISTRYRoots contain- Ceryl alcohol, clerodin, clerosterol and clerodendrin A . B –sitosterol,diterpinoid, tannins, lupeol ester, unidentified ester.Stem contains: D manitol, B –sitosterol- B-D-Glucoside and Ceryl alcoholLeaves contains: Scutellarein, pectolinarigenin (4’, 6-dimethyl scuttelarin), ethylcholesta-5, 22, 25, trine-3beeta-ol, monoglucoside, beta and gama sitosterols, anunidentified sterol, ceryl alcohol and palmitic and cerotic acidsFlowers contains: pectolinargenin, hispudulin, apigenin and luteolinSUBSTITUTES AND ADULTERANTS Two varieties have been mentioned in literature which may be botanicallyspecified as Agnimantha, Clerodendron phlomidis Linn and second one is Premnalatifolia Roxb, syn. Premna Mucronata Clarke. The regional names such as Gineri,Agethu, Tekara or Tankali are only disorted forms of more recent Sanskrit namesGanikarika, Agnivadhu and tarkari. There is not much difference in the tree sizes of thetwo kinds and thus any attempt to differentiate them as Bruhat and Kshudra kindsuntenable on the base of plant size may however be limited to different species of Premnaonly. It is however reasonable and useful for the sake of field identification to name thePremna species. In the south Premna has been used as Agnimantha by the vaidyas. In Gujarat andNorth, Clerodendron genus is used as Agnimantha. Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 111 Dept of PG studies dravyaguna
  • 43. DISEASE REVIEW Ayurvedic pharmacopoeia of India suggest Clerodendron phlomidis Linn. as aactual drug of Agnimantha. It is found throughout India. According to Wealth of India, in Assam and Nepal the drug Premna integrifoliaand Premna obtusifolia are used as Agnimantha, but in the absence of these twosubstitutes are Premna coriaceae, B.clark and Premna latifolia. Roxb.Hort.Beng. In Punjab Premna mucronata Roxb and Premna latifolia used as Agnimantha, In Unani the drug Agnimantha root is used for laxative, stomachic, livercomplaints. The root bark has a characteristic agreeable odour, the fresh bark isfirst sweetish but bitter and astringent later. The supplies of the drug comemostly from Sundarabans and Travancore. The roots of a few other species, suchas Premna coriacea C.B. Clarke and Premna latifolia Roxb.Hort.Beng. are used assubstitutes or adulterants. (Datta and Mukherji, Bull. Pharmacogn, lab. No.1,1950 113). The Ayurvedic formulary of India suggest Clerodendron phlomidias Linn. fas Agnimantha and Premna obtusifolia R.Br. and Premna mucronata Roxb. In Bombay, Malaysia, Ceylon, Andaman- Premna intigrefolia Linn. used asAgnimantha. In Bengal, Premna latifolia is used as Agnimantha. Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 112 Dept of PG studies dravyaguna
  • 44. DISEASE REVIEWRESEARCH PROFILE 1. On medoroga: Gomootra arka bhavita agnimanthamoola (Clerodendron phlomidis) in sthoulya showed a significant reduction of obesity. ( Dr. Shah Chinmayi. C, Jamnagar 2004). Agnimantha kwatha bhavita shilajatu in Medoroga by Dr.V Muralikrishna, Hyderabad. 2. Antifungal Activity: The ethyl acetate and hexane extracts of leaves and stems of Clerodendron phlomidis were screened for antifungal activity. Both ethyl acetate and hexane extracts of C. phlomidis stem and leaf exhibited appreciable inhibition on all the studied plant and human pathogenic fungi. (Shyama et all) 3. Immunomodulatory Activity: The present study was aimed at evaluating the two roots for their immunomodulatory potential. Oral administration of methanol extracts of both the roots (300 mg kg-1 x 7 days) in mice prior to immunization with Sheep Red Blood Cells (SRBC) resulted in a significant increase inEvaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 113 Dept of PG studies dravyaguna
  • 45. DISEASE REVIEW haemagglutinating antibody titre, plaque forming cell assay and delayed type hypersensitivity to SRBC. C. phlomidis showed higher specific immune activity as compared to P. integrifolia, C. phlomidis and P. integrifolia enhanced the non specific immune response in carbon clearance test and showed significant immune prophylactic effect, when tested on E. coli induced abdominal sepsis. In the present study C. phlomidis showed higher response to specific immune activity as compared to P. integrifolia. (R.H. Gokani et all) 4. Anti inflammatory activity. Clerodendron phlomidis roots decoction showed potent anti inflammatory bydecreasing paw oedema induced by cararageenan in rats at a dose of 1g /kg body wt(Surendrakumar 1988) 5. Anti amnesic evaluation of C. phlomidis Linn. Bark extract in mice . In the present study C. phlomidis was investigated for its potential as a nootropicagent in mice. The aqueous extract of the C. phlomidis (100 and 200 mg/kg, p.o.) wasadministered for 6 successive days to both young and aged mice. Exteroceptivebehavioral models such as elevated plus maze and passive avoidance paradigm wereemployed to evaluate short term and long term memory respectively. Scopolamine (0.4mg/kg, i.p.), diazepam (1 mg/kg, i.p.) were employed to induce amnesia in mice. Todelineate the mechanism by which C. phlomidis exerts nootropic action, its effect on Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 114 Dept of PG studies dravyaguna
  • 46. DISEASE REVIEWbrain acetyl cholinesterase levels were determined. Piracetam (200 mg/kg, i.p.) was usedas a standard nootropic agent. Pretreatment with C. phlomidis (100 and 200 mg/kg, p.o.)for 6 successive days significantly improved learning and memory in mice. It reversedthe amnesia induced by scopolamine, diazepam and natural ageing. It also decreased theacetyl cholinesterase levels in the whole brain. The bark of C. phlomidis can be ofenormous use in the management of treatment of cognitive disorders such as amnesia andAlzheimers disease . (Hanumanthachar Joshi) 6. Acute toxicity studies C. phlomidis aqueous extract at different doses (50-5000 mg/kg) wasadministered orally to the rats with the help of a specially designed oral needle connectedto a polythene tube. Mice, which received extracts in doses above 2000 mg/kg, exhibitedptosis (dropping of upper eyelids) and were found lethargic. The parameters such ashyperactivity, grooming, convulsions, sedation, hypothermia and mortality wereobserved. The dose selected were 1000 mg/kg. (Medicinal and Aromatic Plant Scienceand Biotechnology 1(1), 142-150 ©2007 Global Science Books) 7. Antimicrobial activities Anti infective compounds from natural resources are of great interest as theexisting drugs are getting less effective due to increased tolerance of micro organisms. A Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 115 Dept of PG studies dravyaguna
  • 47. DISEASE REVIEWnumber of species from the genus Clerodendron were documented in ancient texts fortheir antimicrobial action. To validate these claims, research work was carried out withvarious Gram positive and Gram negative bacterial strains and also with fungal and viralpathogens.). Pectolinarigenin and chalcone glycoside isolated from leaf of C. phlomidisshowed antifungal activity (Roy et al. 1995). 8. Hepato protective activity. Clerodendron phlomidis root aqueous extract is proved to be potent hepato protective in CCl4 induced hepatic injury in rats at 800mg/kg body wt. it was effective as silimarine which was taken as standard ( N.Gopal etal 2002, Pune) ETHNOMEDICAL USES A number of species from this genus were documented to be used as folkmedicine by various tribes in Asian and African continents. Many species of the genushave also been documented in traditional systems of medicine practiced in countries likeIndia, China, Korea, Thailand and Japan. Roots and leaf extracts of C. indicum, C. phlomidis, C.serratum, C. trichotomum,C. chinense and C. petasites have been used for the treatment of rheumatism, asthma andother inflammatory diseases (Anonymous 1992; Hazekamp et al. 2001; Kang et al. 2003;Panthong et al. 2003; Choi et al. 2004; Sungwook et al. 2004; Kanchanapoom et al.2005). Plant species such as C. indicum and C. inerme were used to treat coughs,serofulous infection, buboes problem, venereal infections, skin diseases and as a Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 116 Dept of PG studies dravyaguna
  • 48. DISEASE REVIEWvermifuge, febrifuge and also to treat Beriberi disease (Anonymous 1992; Rehman et al.1997; Kanchanapoom et al.2001). It was also reported that tribals use C. inerme as an antidote of poisoning fromfish, crabs and toads (Rehman etal. 1997; Kanchanapoom et al. 2001; Pandey et al.2003). C. phlomidis, C. colebrookianum, C. calamitosum and C. trichotomum have beenreported to have antidiabetic, antihypertensive and sedative properties (Singh et al.1980;Chaturvedi et al. 1984; Khan et al. 1996; Cheng et al. 2001;Kang et al. 2003; Chaeet al. 2004; Choi et al. 2004). C. phlomidis has been used as an astringent and also in the treatment of gonorrhea(Rani et al. 1999; Murugesan et al.2001). This plant is also reported to have diuretic andantibacterial properties (Cheng et al.2001)., while in China the plant is used as medicinefor malaria (Hazekampet al. 2001; Panthong et al. 2003). Leaves of C. buchholziiarereported in African pharmacopeia for treatment of furunculosis, echymosis and gastritis(Nyegue et al. 2005). Other than their therapeutic use, some of the species of thegenussuch as C. inerme, C. thomosonae, C. indicum and C. speciosumare also cultivatedand used as ornamental plants. References for Drug review 1. http/medicinal plants/ Clerodendron phlomidis/07/21/14. 2. Pandey,Gyanendra “Uncommon plant drugs of Ayurveda” Sri Satguru publications, division of Indian Books center, Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 117 Dept of PG studies dravyaguna
  • 49. DISEASE REVIEW 3. Pandey Gynanendra, Dravyaguna Vijnana (Materia Medica Vegetable Drugs) Part III 3rd Edition,Varanasi,chaukhamba Krishnadas Academy,2005,Tpg:933. 4. Shastry .J.L.N., Dravyaguna Vijnana Vol II Foreward by Prof.K.C.Chunekhar,2nd Edition,Varanasi,Chaukhamba Orientalia,2005,Tpg:1134 5. Magadi R. Gurudeva, “Botonical and Vernacular Names of South Indian Plants” Divya Chandra Prakashana, Basaveshwara Nagar, Bangalore, 1st Edn, 2001, T.pg : 1004. 6. Saxena and Saxena, Plant Taxonomy 5th Revised Edition, Meerut, Praghathi Prakhashan ,2006, Tpg:628. 7. D.B.Basu, Kirthikar K.R, Indian Medicinal Plants, Vol 1 Dehradun, International Book Distributors ,Reprint 1999 Tpg:838 8. Ayurvedic Pharmacopoeia of India, Ministry of Health and Family Welfare, Govt of India, 1st Edition, Dept of Indian Science of Medicine and Homeopathy, New Delhi, Controller of Publication Civil Lines, Reprint 2001,Tpg:260. 9. P.C Sharma, M.B Yelne, “Database on medicinal plants used in Ayurveda” , Central council for research in Ayurveda and Sidda: Department of ISM&H, ministry of health and family welfare, Govt of India , 2001 pp,590 10. D.B.Basu, Kirthikar K.R, Indian Medicinal Plants, Vol 1 Dehradun ,International Book Distributors ,Reprint 1999 Tpg:838 11. Y.K.Sarin, “Illustrated manual of herbal drugs used in Ayurveda”, New Delhi, Council of Scientific and Industrial Research and Indian Council of Medical Research, 1996:132.Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 118 Dept of PG studies dravyaguna
  • 50. DISEASE REVIEW 12. Sri Bapalal Vaidya, “Some Controversial drugs in Indian medicine ”, Varanasi, Choukambha orientala , 1982 13. Neeta shrivastava and Tejas patel “Clerodendron and health care an overview” published by PERD publishers, available in herb and care.com. 14. http//journals.tubitak.gov.tr/biology/06-30-03/.pdf 15. RH gokhani,S.K Lahari, international journal of pharmacology 3(4): 352- 356,2007 16. Medicinal and aromatic plant science and biotechnology. 1(1),142-150, 2007 Global Science Books.MEDO DHATUMeda is an important dhatu among Sapta dhatu and its main functions is to smoothen thebody by its sneha Property. “Medhyati Snihyati Anena Iti Medah”Utpatti: It is derived from the word ‘medh’ by adding ‘ach’ pratyaya.1Shabdhartha : 2 1 Meda : Fat 2 Medas: Fat, marrow (one of the seven dhatu of the body and suppose to lie in the abdomen) 3 Corpulence, fat of the body 4 Excessive fatness, morbid corpulence. 5 Medaswin: . Fat corpulence, Strong robust Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 119 Dept of PG studies dravyaguna
  • 51. DISEASE REVIEW Synonyms of Meda: 3 1. Mamsaja and Mamsatej: Medadhatu is found from mamsa dhatu by mamsa agnipaka. So it is known as Mamsaja or Mamsatej. 2. Asthikruta: Formation of Asthi is done from meda so it is known as Asthikruta. 3. Vasa and Vapa: The fatty substance which locates in mamsa is called as Vasa and when its depot in abdomen, it is termed as Vapa. 4. Majja: Asthi Madhyagata Sneha is known as Majja. 5. Goda: “Mashtishkagata Sneha” is known as Goda or MastulungaHistorical concept :Vedas : (10,000 – 500 B.C) In Yajurveda a disease named “upachita” has been described. In the same contextthey have advised to strengthen and harden the body like a stone indicating the hazard offlabbiness of the body due to morbid obesity which is mainly due to meda.4Above references denote us regarding the then existing knowledge of meda and itsdiseases in Vedic era.Samhita kala: (200 B.C to 400 A.D)Charaka samhita. Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 120 Dept of PG studies dravyaguna
  • 52. DISEASE REVIEW Maharshi Atreya who is the father of Indian medicine conducted earliest scientificstudies on medo pradoshaja vikaras and dealt under “Ashta nindita purusha” which isrecorded by Agnivesha in Charaka samhita. Sushrutha samhita : The father of surgery has narrated the nidana lakshanas chikitsa and Upadrava ofthis at various places.Ashtanga Hridaya: Acharya Vagbhata has also given a wide explanation ofmedodhatu, medoroga and chikitsaTable no: 7 Reference of medo dhatu in brihatrayeesReference Charaka Sushrutha VagbhataAshta nindita purusha + - -Medovaha sroto moola + + +Medo vruddi kshaya lakshana + + +Medo dhatu utpatti + + +Medo sara purusha lakshana + + +Medodushti kaarana , lakshna , chikitsa + + +Santarpana nimittaja vyadhi + + +Langana yogya Vyadhi + + +Rasa as kaarana for sthoulya and kaarshya - + +Laghutrayi: Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 121 Dept of PG studies dravyaguna
  • 53. DISEASE REVIEW Madhava Nidana: A separate chapter has been dedicated to describe the vikaras of meda called“medoroga”, in an elaborate manner. New symptoms like moha were mentioned in thisbook.Sharangadhara samhita : This text book has described medodosha in purvakhanda. He has mentionedmadhu as the single drug treatment for meda vriddhi.Bhava Prakasha: Pharmacological aspects of many Ayurvedic drugs have been explained in thisbook. Sthoulya has been explained in separate chapter. Treatment aspects have beenstressed more in this text, when compared to brihatrayis. Special dhupa like malayaniladhupa, various lepa and udvartana are being quoted in order to treat sthoulya.Others:Kashyapa samhita - Ashta nindita purusha (sutra 28/6)Harita samhita - No references in the present available incomplete workBhela samhita - Vitiated meda and Sthoulya (sutra 2nd)Yogaratnakara - Many formulations for treatmentChakradatta - Sthoulya chikitsa (chapter 36)Baishajya ratnavali - Chikitsa aspects (chapter 39)Gada Nigraha - Vyadhi as whole (chapter 31)Rasaratnasamucchaya - Many rasaoushadis mentioned (chapter 18) Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 122 Dept of PG studies dravyaguna
  • 54. DISEASE REVIEWMany other commentators like Dalhana, Indu, Arunadatta, Hemadri, Gangadhahara,Vijayarakshita etc..,contributed a lot to understand this disease in better methods.Patho-Physiological considerations: The vital role of maintenance of sneha in the body for sustainment of life is carriedby meda and thus the importance of meda.The literal meaning of the word medaaccording to Vachaspatyam denotes sneha which stands for fat, oil, lipid etc.., thissignifies meda is predominant of snigdha guna in it. Many other structures also possesssnigdhatva in them. On the whole we can see sneha in the body as 3 types. 1. Meda which is Sandra and like ghrita 2. Vasa which is present with in mamsa 3. Majja which is present inside the asthiVasa: It is considered different from medas in form as it is snehamsha of shuddha mamsa. 5aAccording to Sushruta and Charaka. After dhatwagnipaka of mamsa dhatu vasa isformed as upadhatu. It is ghee like fatty substance situated underneath the skin asdescribed by Gananathsen. As per C. Dwarakanath, this is included under connectivetissue. Even by the views of different scholars it is clear that vasa is upadhatu of mamsaand different from meda. Still it possess similar qualities of meda like snigdhata becausemeda is produced from the sara bhaga of mamsa and the same mamsa dhatu producesvasa as its upadhatu. Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 123 Dept of PG studies dravyaguna
  • 55. DISEASE REVIEWMajja : It is completely different dhatu as mentioned and different in all other aspects likevriddhi lakshanas, kshaya lakshanas, Sara purusha lakshanas etc..,Sthana and Swarupa of Meda dhatu: 5b The site of medodharakala is Udara and Anuasthi, Sphik, Sthana, Gala are also depotsof poshya meda . Medadhatu is also considered as a sneha dominant drava dhatu which isGuru, Snigdha guna yukta and dominance of Pruthvi, Ap and Teja mahaboothas.Utpatthi: 5c,6b On contact of medhodatwagni the sukshma bhaga of mamsa dhatu gets paka due toits agni and ambu guna and is transformed into medodhatu. The ambu guna present inmeda increases sneha guna making meda snigdha predominant dhatu. Rakta Sukshmabhaga 5c Mamsa Dhatwagni Sthulabhaga Sukshmabhaga Kittabhaga Mamsa dhatu Vasa & twak MedhoDhatwagni Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 124 Dept of PG studies dravyaguna
  • 56. DISEASE REVIEW Sthula bhaga Sukshmabhaga Kittabhaga Meda dhatu Snayu and sandhi Asthi Dhatwagni Sthula bhaga Sukshmabhaga Kittabhaga Asthi Dhatu Dhatuparinama Continues upto Shukra Fig No Schematic representation of Meda dhatu Utpathi through their respective Dhatus The process of nourishment of Dhathus is explained with the help of 3 theoriesnamely 5d - (i) Khale kapota Nyaya – Selective permeability (ii) Kedarikulya Nyaya – Reservoirs and Tributaries (iii) Ksheeradadhi Nyaya – Total conversion. All the 3 theories are applicable at various levels. When the nutrition is flowing inchannels / vessels (Srothas) it refers to Kedarikulya Nyaya. During the effect ofDhatvagni & Bhoothagni on the nutrient factors the total change that can occur inDhathus can be compared to Ksheeradadhi Nyaya.At different levels of Dhathu Poshana, Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 125 Dept of PG studies dravyaguna
  • 57. DISEASE REVIEWdhathu / Cell has selectivity to identify the respective nutrient fraction is compared withKhale kapota nyaya, Pigeon selecting the grains. 5e,6cPramana of Meda dhatu: Total quantity of meda is two anjali and vasa (muscle fat) are three anjali. Thustotal content of snehamsha in the body is considered as 5 anjali. The total measurablebody elements are counted as 56.5 anjali and sneha content of the body contributesapproximately 11 to 12%. This quantity may vary from person and exact measurement ofbody humors is not possible due to unpredictability and ever changing nature of body.16Karma of Meda dhatu: 5f,7a On compilation of opinions by different Acharyas, following information about guna and karma of medas are listed out. Snehana is the prime function of meda dhatu. It is having guru and snigdha guna resulting in bala and brimhanatva of body. It is responsible for the production of sneha and sweda in the body, gives drudata to shareera and provides poshana to asthi dhatu. According to Sushrutha, snehana, swedana, drudata and asthipushti are the functions of meda dhatu Netra snigdhata and gatrasnigdhata are the additional functions of meda mentioned by Vagbhata. With the property of Snehana it helps to maintain the luster of skin, hair, eye and other structures. Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 126 Dept of PG studies dravyaguna
  • 58. DISEASE REVIEW Nourishment of succeeding dhatu and also nourishes upadhatu snayu, which provides support to the asthi for maintaining the postural structure. Production of sweda as mala. 5g,Medovaha srotas:The internal transport system of the body is represented as srotas. It has been given aplace of fundamental importance in Ayurveda both in health and disease conditionsDhatu nourished through their respective srotas and are dhatu specific.The meda dhatu gets nutrition from the preceding poshaka dhatu i.e. mamsa dhatuthrough its own srotas called medovaha srotas which are two in number.Moola of Medovaha Srotas: 5g,6d Each srotas has its origin from any one of the koshtangas which is identified as themoola of that specific srotas, these structure helps in the transportation, transformation ofthe nutrient material, dhatu, malas etc to their respective places in the body. There is difference of opinion regarding the moola of medavaha srotas. Charaka: Vrikka and vapavahana. Sushrutha: Vrikka and katiCharaka gives importance more for physiology where as Sushrutha for anatomical sitealso.Vrikka: 9 Formed by the sara of rakta and meda dhatu and one among the 15 koshtangas.They are two in number situated on cavity. According to Sharangadhara’s version theynourish meda dhatu present inside the stomach area of abdominal cavity. Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 127 Dept of PG studies dravyaguna
  • 59. DISEASE REVIEWWhile Charaka has considered as moola, these structures must be directly related with fatmetabolism. In contemporary science as such no exact evidences for the role of kidneysin fat metabolism. If we consider the structures situated above the kidneys i.e. suprarenalglands as vrikka, which fulfills the most aspects of fat metabolism.Vapavahanam : 6e This is also one among koshtanga, Chakrapani has interpreted it as tailavartikawhile Dr. Ghanekar has considered it as omentum where the maximum meda is stored.Kati: Sushrutha clearly mentioned the exact site of Kati and mentioned it as the placewhere the fat accumulates in excess. 6fUpadhatu: Snayu is the upadhatu of meda . 6fMala: Sweda is mala of medaAshrayaashrayee bhava of meda: 7b Dhatu is the reside for dosha of its allied nature, depicts the concept of ashrashrayeebhava. In this nature meda provides seat for kapha which is ashrayee. Similar alliedproperties of homogenous dhatu or dosha may serve as a cause to the development,maintenance or vitiation of a dosha or dhatu. Thus meda and kapha play a major role inmaintaining normalcy and or vitiation leading to this disease.Medo dhara kala: 5b It is the third kala present in udara and Sukshma asthi. (.S.Sh.9/12)Meda Dhatu Vriddhi Lakshana : 5h, 7c Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 128 Dept of PG studies dravyaguna
  • 60. DISEASE REVIEW Snigdhata of shareera, vriddhi of udara and parshva, kasa, swasa, hikka,dourgandhya of shareera are seen as medavriddhi lakshanas.(S.Su.15/14)Vagbhata addsto this that persons will have shrama and increase in size of sphik, sthana and udara.Meda Dhatu Kshaya Lakshanas: 5i, 6h,7d In meda kshaya there will be sandi sputana, glani, akshi aayasa, and udara tanutwa.The depletion of this dhatu is seen as pleehavriddhi, sandhi shunyatha, rukshata andliking of atisnigdha and mamsa. The other symptoms are shunyata of kati, krushashareera.Meda sara Purusha : 5j, 6i Adhika snehamsha in varna, swara, netra, kaksha, loma, nakha, danta, oushta, mutraand pureesha. The person will have dhana, ishwarya, sukha, upabhoga. He will havedaana- sheela, sarala, komala and bhavasucaka characters. Sushrutha mentioned that these persons will have large body and will find difficultyin performing heavy work.Medo vaha sroto dusthti hetu: 6j The dhusti of medas is caused by avyayama, divaswapna, excess indulge in medayukta aahara.Medo pradhoshaja vikaras : 6k,6l,5k Aacharya Charaka mentioned ashtanindita purusha and poorvarupa of prameha. But Sushrutha added sthoola granthi, vriddhi, galaganda, arbuda, oshta prakopa,madhumeha, atisweda.Medho vaha srotoviddha lakshanas : 5L Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 129 Dept of PG studies dravyaguna
  • 61. DISEASE REVIEW Sweda (excess sweating), snigdhata in anga (excess oilyness of the body), talu shosha (dryness of palate), stoola shopha ( large swelling, lipoma ? ) and pipasa ( thirst). Nidana : Acharya Charaka has mentioned the nidana of sthoulya one of the ashtanindita purusha which can be considered for medoroga as whole, most analytically, Most of them are exogenous and he has mentioned bheeja dosha is also one of the causes. But Acharyas Sushrutha and Vagbhata have added ‘Ama’ as important causative factors.All the nidanas said in our classics can be categorized under the following groups like 1. Role of aahara 2. Role of vihara 3. Role of beeja Dosha 4. Role of anya nidaanas 5,6,7,9,12 Table no 8 : Showing the aaharatmaka nidanaS.N Aharatmaka Nidana C S AS AH MN BP1 Atisampurna (over eating) + - + - - -2 Santarpana (high caloriediet) + - + + - -3 Adyashana (repeated eating short intervals) - + - - - -4 Guru aharasevana (excessive consumption of heavy + - - - - - Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 130 Dept of PG studies dravyaguna
  • 62. DISEASE REVIEW food)5 Madhura aahara sevana (excessive consumption of + - + + - + sweet food)6 Sheeta aahara sevana(excessive consumption of cold + - - - - diet7 Snigdha aahara sevana (excessive consumption of + - + + - + unctuous food)8 Sleshmala ahara sevana (kapha increasing food) + + - - + +9 Navanna sevana (usage of fresh grains) + - - - - -10 Nava madya sevana (usage of fresh alcoholic + - - - - - preparations)11 Gramya rasa sevana (usage of domestic animals meat + - - - - - and soups )12 Audak rasa sevana (usage of aquatic animals meat and + - - - - - soups )13 Mamsa sevana (excessive use of meat) + - + + - -14 Paya vikara sevana (excessive usage of milk and its + - + + - - preparations)15 Dadhi sevana (excessive use of yoghurt) + - - + - -16 sarpi sevana (excess use of ghee) + - - + - -17 Ikshu vikara sevana (usage of sugarcane preparations) + - - - - -18 Guda vikara sevana (jaggery preparations) + - - - - - Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 131 Dept of PG studies dravyaguna
  • 63. DISEASE REVIEW19 Shali sevana (excessive use of rice) + - - - - -20 Godhuma sevana (excessive use of wheat) + - - - - -21 Masha sevana (Phasiolous mungo) + - - - - -22 Rasayana sevana + - - - - -23 Vrushya sevana + - - - - -24 Bhojanothara jalapana - - + - - + Table no : 9 Showing the viharatmaka nidana of medo pradoshaja vikaras: SN Viharatmaka Nidana C S AS AH MN BP 1 Avyayama (lack of physical exercise) + + + - + + 2 Avyavaya (lack of sexual intercourse) + - + - - - 3 Divaswapna (day sleep) + + + - + + 4 Aasana sukha (luxurious sitting) + - + + - - 5 swapna prasangat (excessive sleep) + - + + - - 6 Gandhamalyanu sevana (use of perfumes, + - - - - - garlands) 7 Bhojanothara snana (bathing after taking the + - - - - - meals) 8 Bhojanothara nidra (sleeping after meal) - - - - - + 9 Bhojanothara aushadha sevana (drugs after - - + - - - meal) Table no : 10 Showing the manasika nidana Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 132 Dept of PG studies dravyaguna
  • 64. DISEASE REVIEWs.N Manasika Nidana C S As AH MN BP1 Harshanitya (uninterupted happiness) + - + + - -2 Achintya (lack of worries) + - + + - -3 Manasonivritthi (relaxation from tension) - - + + - -4 Priyadarshana (observation of beloved things) + - - - - -5 Saukhyena (happiness about of life) - - - + - -Table no : 11 Showing the anya nidana.S.N Anya Nidana C S AS AH MN BP1 Ama rasa - + - - - +2 Snigdha madhura vasti sevana (addition of unctuous + - + + - - and sweet enema)3 Tailabhyanga (massaging of oil) + - + + - -4 Snigdha udvartana (unctuous unction) + - - - - -Poorva Rupa :In this context none of Acharyas have stressed up on the poorva rupa. But it doesn’tmean that they are absent. Mild exhibition of actual features of disease it self can beconsidered as poorva rupa other wise it is very difficult to identify the features of poorvarupa. Acharya while describing consideration of poorva rupa lakshanas for the unsaiddisease as in case of vata vyadhi, urakshata, trishna mentioned that the initialmanifestation of a disease should be taken as poorvarupa. Same rule can be applied hereLakshanas of kapha vriddhi like aalasya, angashaithilya, madhurasyata, atinidra,atipipasa etc., also be considered as purvarupas. Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 133 Dept of PG studies dravyaguna
  • 65. DISEASE REVIEW 5m,6L,7cRupa : The medopradhoshaja vikaras are ashtanindita purusha; poorvarupas ofprameha according to Charaka. Sushrutha, Vagbhata have added some more lakshanas.This can be summarized asAshtaninditani : Sushruta :1.Atidhirga Sthoolatha2.Atihrasva Granthi3.Atiloma Vriddhi4.Aloma Galaganda5.Atikrishna Arbuda6.Atigaura Oshtaprakopa7.Atisthoola Madhumeha8.Atikrisha Atisweda The lakshanas or above vikaras are said to be the rupa. Besides these lakshanasAcharya Charaka have mentioned eight disabilities of sthoulya which affect during itslong course. They are • Ayuhrasa, Jawoparodha ,Kricchravyavaya, Dourbalya ,Dourgandhya Sweda baddha, Kshut atimatra ,Pipasa atimatra, Sushruta added :Sarva kriya asamarthata, Alpa prana, and Panchatva gati. Prameha poorvarupas: • Aasyamadhuryata ,Suptata, dahata of kara-pada, Mukha talu kantha shosha, Pipasa, Alasya , Malam kaye, Upadeha of kaya chidra, Shareera Visra Gandha., Nidra , Tandra Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 134 Dept of PG studies dravyaguna
  • 66. DISEASE REVIEWAtisthoola : 6n, 5m 1. Chala udara, sthana and sphik (pendulous, abdomen, breast and buttocks). These are caused by excessive accumulation medodhatu in them. Due to shaithilyata and guaruta of aggrevated kapha and meda these are caused. 2. Javaporodha or utsaha nasha (hampering of movements and loss of enthusiasm): When shareera becomes sthoola there will be shaithilyata and sukumarata. Because medhodhatu is having guru guna and hence sthoola person will attain laziness to do any work. 3. Ayathopacaya (improper nourishment): Due to the obstruction of srotas by excessive production and accumulation of meda all dhatus are malnourished. 4. Ayuhrasa (hampering of life span): Because of improper nourishment of rasadidhatus it leads to decrease in life span. 5. Kruchravyavayata (difficulty in several intercourse): By excessive accumulation of medodhatu srotas are obstructed, so all dhatus except meda are formed in very little quantity including shukra dhatu, which causes difficulty in sexual intercourse. 6. Durbalata (debility): Because of improper nourishment of dhatus except meda leads to durbalata. 7. Sweda bhadha (unpleasant effect by excessive perspiration): Kapha and meda both are having same gunas like vishyandana, guruta. By excessive accumulation of meda, sthoola prurusha is unable to do any physical exercise and also meda produces atisweda. By this the person feels very discomfort / unpleasantness. Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 135 Dept of PG studies dravyaguna
  • 67. DISEASE REVIEW 8. Dourgandhyata (bad odour of the body): It is one of the major characteristic feature of medavriddhi due to heavy sweating, bad odour comes through sweda. 9. Atikshudha (excessive appetite): The reason for atikshudha is by margavarodha; which increases vata and causes hyper functioning of the jataragni which leads to atikshudha. 10. Atitrishna (excessive thirst): Because of hyper functioning of jataragni and excess production of sweda sthoola suffers from atitrishna. 11. Atinidra (excessive sleep): Charaka explained seven types of nidra, among them shleshma samudbhava nidra is one which is due to kapha vruddhi, obese person suffers from atinidra due to kaphavruddi. 12. Atisweda (excessive sweating): Sweda is mala of meda dhatu, kapha and meda are having similar qualities as like guruta, snigdhata, and vishyandana. So only they are called samana dharmi. As there is meda vishyanda means meltingof medas which combines with kapha causing atisweda. 13. Kshudra swasa (dyspnoea on effort): Shwasa roga is the disease of pranavahasrotas as the Kapha is increased in urahapradesh, it obstructs the breathing even by little exertion, he will get kshudra swasa. 14. Shrama (tiredness): All the dhatus except meda is unnourished that will cause the shrama, even if it is of short period of work. 15. Karya akshamata (inability to do work): As a result of soukumaryata due to meda and kapha vriddhi this is seen. 16. Jadyata (laziness): This is mainly due to medovriddhi in the body, which makes the person unable to do work and so he becomes inactive.Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 136 Dept of PG studies dravyaguna
  • 68. DISEASE REVIEW 17. Gadgadatwa: Aggrevated vata along with kapha obstructs shabdhavahini dhamani causing gadgadatwa. 18. Moha (delusion): This is due to increased kapha. 19. Sadana (body ache): As amarasa is produced in the body, sthoola suffers from sadana. 20. Alpa prana: Due to obstruction of different srotas by meda and kapha. 21. Panchatvagati: Due to complication of sthoola like prameha, pramehapidaka, vidradhi, vatavikara etc..,Samprapti: 6 ‘O” ,9Acharya Charaka mentions “Snigda, madhura, guru aahara” as common pathogenicfactor for meda pradushana where as Sushrutha mentions ama as one of nidaanas.For better analisation it can be studied as follows. 1. Saamanya samprapti 2. Samprapti ghatakas 3. Role of ama 4. Analysis of important featuresSamanya samprapti : Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 137 Dept of PG studies dravyaguna
  • 69. DISEASE REVIEW For any disease manifestation body needs few components vitiation like doshadhushya, srotas and agni, similar incidence happen even in this condition. Some of theprime derangements are listed below.Dosha : Kapha pradhana vyadhi, but vata and pitta involvement cannot be denied ascollaboration of these tridoshas propagates the process of samprapti.Dushya: The sammurchana of dosha dhushya is inevitable for the diseases to be exhibited.Meda dhatu which is abnormal is considered here as dhushya. As kapha is main dosha it also causes vitiation of asthiradhatus such as rasa, mamsa,meda, majja and shukradhatu making them to get involved in the disease.Srotas: Avyayama, diwaswapna, ati sevana of madhura dravya and varuni are nidana formedaovaha srota dusti.Even rasavaha srota dushti is seen as the disease starts from it.“rasanimittameva sthoulya kaarshyam cha. The involvement of udaka vahasrotas seenby atipipasa, swedavaha by atisweda and dourgandhya in the later stages. In theconsequent stages of samprapti can see the meda dhatu deposition in mamsa indicatingthe involvement of mamsa vaha srotas resulting in sthoulya.Agni : Atimadhura sevana, adhyashana leads to the formation of ama due to agnimandayatawhich causes medovriddhi and this leads to obstruction of vata moving towards koshtaresulting in teekshnagni which influences person to indulge in adhyashana. Thispradeepta jataragni and vitiated vata does leading to production of excess meda. Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 138 Dept of PG studies dravyaguna
  • 70. DISEASE REVIEWIt can be summarized as follows: When a person indulges in the nidanas specified, therewill be production of ama annarasa, which is madhuradhikya along with snehamsharesults in dhatudwayamatikramana This happens mainly due to similar gunas of this amaand meda rasa. Even according to Vagbhata, madhura rasa is not predominant of tejobhuta which isresponsible for formation of rasa and rakta dhatu so direct formation of meda dhatu isseen. This vikruta medas leads to mal development of uttarothara dhatu. This meda iskept in deha sancara through out the shareera resulting in vata vriddhi due to avarodha,causes atisandhukshana of jataragni. This condition result in excess hunger, and if hedoes not consume food, various derangement of vata, pitta are originated. If consumesfood, nourishment of only medas is seen due to sroto dushyata. Thus this vicious cycleresult in abnormal vriddhi of meda dhatu which circulates through out the body. Finally if this process is not checked result in accumulation of that vriddha medain certain anatomical regions or all parts of the body going to further stage of diseasecalled sthoulya.Samprapti ghatakas : Dosha: Kapha, vata Dushya: Rasa, meda Agni: Jataragni Medadhatwagni Ama: Meda dhatwagni mandhaya janya Srotas: Rasa vaha, medovaha, swedavaha, mamsavaha Dushti prakara: Sanga Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 139 Dept of PG studies dravyaguna
  • 71. DISEASE REVIEW Sancara : Rasayanis Vyakthasthana : kati, stana, udara, spik, Vyadhiprakara : Chirakari Sadhywasadhyata : kruchra sadhya Rogamarga : Abhyantara Samprapti - ChakraBeeja doshas Hetu Sevana Viharaja and Manasika Aaharaja (Madhura rasadika) Agnidushti Amaannarasa utpatti Dhatu dwaya matikramya (rasa rakta aposhaka) Medodhatwagnimandhaya Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 140 Dept of PG studies dravyaguna Medodhatu upachaya Atinidra, avyayama Avyavaya,
  • 72. DISEASE REVIEWUpadrava (complication):5n,6l, 7e,9,12,Prameha ,Prameha pidaka, Jwara , Vidradhi , Bhagandhara, Udararoga ,UrusthambhaVatavikara, Shwasa,Visarpa , Atisara ,Arsha ,Shleepada ,Kamala ,Kushta, TrishnaVarnanasha ,Sanyasa Chikitsa: (5o,6p,7f) The measures performed to bring the equilibrium of dosha dhatus is called as Chikitsa.For any disorder it is of 3 types 1. Nidana parivarjana 2. Antahparimarjana and bahiparimaarjana which includes a. Samshodhana , b. SamshamanaNidana parivarjana: Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 141 Dept of PG studies dravyaguna
  • 73. DISEASE REVIEW The above said aharatmaka, viharatmaka, manasika and anya nidana which areresponsible for diseases should be avoided.ChikitsaBahirparimarjana : rooksh udwartana, dhoopa, lepasAbhyantara chikitsa like , Vamana, Virechana, niruha basti, Samshamana therapy : 50,6p,7f The substance which is guru, apatarpaka and possessing the vata, sleshma medonashaka properties are mainly used. Chakrapani commented that guru guna causesalleviation of vriddha agni and apatarpana cause medonasha. Gangadhara has interpretedthat guru property alleviate tikshnagni and vitiated vata which ultimately reducesatikshudha. Eg : madhu, triphala, takrarishta, vidanga, nagara, kshara, yava, amalaka coorna,bilvadi panchamoola with madhu, Shilajatu prayoga with Agnimantha, madhoodaka,Guggulu and rasanjana are also indicatedSadthyasadhyata: According to Charaka the two diseases viz kaarshya and sthoulya are perpetuallyafflicted with disease and one to be treated with constant slimming and nourishingremedies respectively. Among the above two condition krishata is desirable. WhileSushrutha says that the above two conditions are undesirable for treatment whencompared a person who is having proportionate body. Vagbhata quotes, krisha purushais better for treatment, but to bring back the normalcy of vata, agni, and medas is difficult Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 142 Dept of PG studies dravyaguna
  • 74. DISEASE REVIEWcase of sthoulya. The same is considered for medo vriddhi as sthoulya is resultant ofexcess meda.Pathya and Apathya : 6p,5o,7f,12,13,14 According to different aacharyas many diseases are produced by the apathyakaraahara and vihara. For swastha rakshana and roganashana pathya is prime importance i.e.is considered as part of chikitsa. It is rightly mentioned that if one follows pathya then there is no need of medicineand if not followed then there is no use of therapeutic measures. Charaka has mentioned that for stoola purusha, guru and apatarpaka aahara shouldbe given as jataragni will be teekshna. Aahara should not be santarpaka. Because insthoulya only medodhatu is more nourished for the purpose of reducing the medadhatu,rooksha gunayukta aahara should be administered.Charaka also mentions that aahara vihara which alleviate vata, kapha, meda.Should be added in sthoulya. Pathya aahara mentioned for sthoulya areAdhakibeeja ,Amalaki , Kodrava , Kulattha ,Mudga ,Madhodaka , Madhu , Priyangu ,Patola, Puranashali ,Shyamaka, Uddalaka ,Vartaka, Yava.Commentators like Chakrapani, Gangadhara have mentioned that sthoka bhojana / alpabhojana are best karshana kaaraka.. They have given importance to samskara, as theyhave mentioned that aahara dravyas should be used after converting it to guru throughsamskara in sthoolapurusha. Table no: 12 Showing pathya – apathya of viharaPathya Shrama, Jagarana , Nitya bramana, Ashwa rohana, Hastyavarohana, Vyavaya Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 143 Dept of PG studies dravyaguna
  • 75. DISEASE REVIEWApathya Sheetal jalasevana, diwaswapna, avayvaya, avyayaama, atiashana, sukha shaiyya Table no: 13 Showing vaicharika pathya and apathya.Pathya Chinta, shoka, KrodhaApathya Nitya harshana, Acintana ,ManasonivruttiRASA DHATU Rasa is gati vaachaka dhatu which denotes gati ie movement. It is the first dhatu,which is formed after the interaction of pachakagni on consumed food, in the intestine.With the help of vyana vayu, rasa dhatu traverses to hridaya and from hridaya it will becirculated all over the body through 24 dhamani’s .5pRASA DHATU UTPATTI5q When pancha boutika, chaturvida, dwividaveerya-ashtavidhaveerya, many gunayukta aahara, under goes paripaka, the Sara which is formed, having sukshma guna isknown as rasa dhatu. Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 144 Dept of PG studies dravyaguna
  • 76. DISEASE REVIEWTYPES OF RASA DHATU 14It is of two types: a. Sthayi b. AsthayiSthayi rasa dhatu is poshya rasa dhatu which does not circulate through dhamanis (ex.Tissue fluids, intracellular fluids)Asthayi rasa dhatu is poshaka rasa circulates through the dhamanis and nourishes all theshareera avayava. (ex –plasma, lymph) Rasa dhatu circulates with the help of vyana vayu. Vyana Vayu which travels allover the body carries rasa dhatu to all the parts of body. Rasa travels in the body similarto shabda (oblique movement), archi ie agni (in upward direction and jala (in downwarddirection) and does the nourishment of Dhatus.5r, 6rPRAMANA OF RASA DHATU.15The quantity of rasa dhatu mentioned is Nava anjali. One anjali contains nearly about 180ml of liquid. 9 anjali approximately comes to 2 litres. However in modern science it ismentioned that a person weighing about 70kgs has 5-6 litrs of blood and 3-3.5 liters ofplasma is present in it.FUNCTIONS OF RASADHATU. 5r,6sIt does tarpana,( satisfying) vardhana, ( growth) dharana,( supporting /preserving) Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 145 Dept of PG studies dravyaguna
  • 77. DISEASE REVIEWyaapana. ( maintainace) preenana (contentment) and rakta pushti (nourishment ofRakta). By looking at its Snehana, tarpana and dhaaranaadi Soumya karma’s rasa dhatuis considered as Soumya dhatu.RASAVRIDDHI LAKSHANAS 5t,7gWhen rasa dhatu increases abnormally, there will symptoms which is similar to increaseof kapha. They are hrudayotkleda ( hrullasa ) praseka (vomiting) agnisadana (decreaseddigestive power) alasya (lazyness) gowrava (heaviness in the body) paleness in the body,coldness, slatangatwa ( laxity ) shwasa ( dyspnea) kasa (cough) atinidrata( increasedsleep). 5u,6uRASAVAHA SROTHAS: The mula of rasavaha srothas are hridaya anddashadhamanis. According to Sushrutha hridaya and rasavaha damanis. 6vRASAVAHA SROTHO DUSHTI KARANA : Intake of guru, sheetha, athisnigdaaahara and intake of excessive food, excessive worry leads to vitiation of rasa vahasrotas.RASA VAHA SROTO DUSHTI LAKSHANA: 5t,6wWhen rasa vaha srotas gets vitiated then the person feels tastelessness, nauseating,heaviness in the body, lethargy, body ache, raise in temperature, blackout, anemic,obstruction in the srotas ,impotency, weakness in the body decreased digestive powerand premature grey hair and skin wrinkles. Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 146 Dept of PG studies dravyaguna
  • 78. DISEASE REVIEW According to Sushrutha in rasa vaha dushti, the person will have shosha and lakshanas of pranavaha sroto dushti and even death will be there RASA VAHA SROTO DUSHTI CHIKITSA: 5u, 6u All types of langana are indicated for rasaja vikaras. According to Sushrutha, rasa is the causative factor for Sthoulya and kaarshya. Formation of Rakta from rasa 5v: When that jala rupi rasa reaches yakrut and pleeha itattains red colour. This liquid which has attained red colour by action of tejas onannarasa is known as Rakta. While explaining the formation of dhatus Dr,Ghanekar hasmentioned that, the annarasa gets divided into sthoola and sookshma bhaga, sthoola bhagabecomes rasa and sookshma bhaga forms Rakta this sthoola bhaga can be compared withplasma according to modern science.Plasma: 16 Plasma is straw coloured liquid in which the blood cells are suspended. It consists around 90 -92% water and 8-10% remainder including proteins, minerals, salts, lipids and waste products. Table no : 14 COMPOSITION OF BLOOD PLASMA: Component Water Proteins Salts Lipids Glucose Percentage ~92% 6-8% 0.8% 0.6% 0.1% Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 147 Dept of PG studies dravyaguna
  • 79. DISEASE REVIEW Functions: Acts as medium for blood cells. Circulates throughout the body, provides nutrition and waste cleanup. Harbors immune system cells which attack infections in the body. It is used to deliver hormones and clotting factors to areas where they are required. They are : Various ions (NA+ , Ca, HCO3) etc Glucose and traces of other sugars Amino acids Other organic acids Cholesterol and other lipids Hormones Urea and other wastes KAPHA DOSHA: The word Sleshma is made up of “shlish alingane” meaning ‘to bind’ or ‘tocombine’. Which means the factor which keeps the body structure together, acts asembracing factor is known as sleshma The Word kapha has the meaning “kena jalenaphanati iti” That which is formed by the predominacy of Jala. This does upasleshana,and poshana( nourishment) of different organs in the body with the help of rasa dhatu.KAPHA GUNA: 6z Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 148 Dept of PG studies dravyaguna
  • 80. DISEASE REVIEWThe gunas mentioned for kapha are Guru, sheeta, mrudu, snigda, madhura, sthira, andpicchila, slkshna, mrudu, madhura, Sandra, manda, vijjala. Sushruta has added shweta andmentions that prakrutha rasa is madhura and in Vidagdavasta it attains lavana rasa. Kaphais considered as pratiroopa of moon and similar to moon it does soothing effect on body,nourishes and strengthens body and mind.KAPHA KARMA : according to Charaka, It does Snehana (unctousness), banda bindingsthiratwam(maintains structural integrity) gowravam ( stability ) vrushata, bala(strong/robustness), Thus it does moistening and lubrication of the body. Brings stabilityin the joints and organs and softness of the body, overall nourishment ,wound healing ,fertility, mental stability , strength, energy, enthusiasm, courage ,knowledge, honesty andrighteousness, broad mindness are the prakrutha karma of kapha. 6x,5wKAPHA STHANA: Ura Pradesh, kanta, shiras, kloma, parva. greeva, rasa, meda,nasika, bahu and amashaya are considered as kapha stana. Acharya charaka ,sushruta andVagbhata have considered Amashaya as main seat for Kapha and Acharya Kashyapa hasconsidered hridaya as a main seat for kapha.KAPHA VRIDDHI LAKSHANAS: 5z,6z, 7hIf kapha is increased there will be shloukya (paleness) , shaithya (coldness) sthairya(rigidity), gowrava (heaviness) avasada (fainting) tandra (lethargy), nidra ( increasedsleep) and sandi vishleshana ( rigidness in the joints) , agnisaada ( decreased digestivepower) praseka (nausea) alasya (laziness) Shwasa (dyspnea) kasa ( cough). Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 149 Dept of PG studies dravyaguna
  • 81. DISEASE REVIEWKAPHA PRAKOPA KAARANA: 5z1The factors which are responsible for slesma prakopa kaarana are, diwaswapna, (sleepingin day time), avyaama (lack of physical exercise ) aalasya (laziness), intake of madhura,amla lavana rasa, sheeta snigda, guru , picchila abhishyandi aahara like masha dugda,ikshuvikara maamsa etc. causes vitiation of kapha Dosha .PRAKOPA LAKSHANA: 6z, 7iWhen kapha gets vitiated then it shows the lakshanas like, increased ( shwaithya)paleness, shaithya ( coldness), sthairya (rigidity), gowrava ( heaviness) sneha (increasedmoisture), supti (insensibility), kandu (ithchy sensation), kledopadehaaccumulation/covering of kleda ).Kapha prashamana : 7jThe qualities opposite to sleshma gunas are considered as pacifying factors of sleshma.Such as dravyas which are having , ruksha, teekshna , ushna, guna katu tikta, kashaya rasapradhana are considered for treatment of vitiated kapha. Vamana is considered as best fortreating vitiated sleshma. Table No: 15 COMMON FEATURES BETWEEN MEDA, KAPHA AND RASA Meda Kapha Rasa Karma Snehana, Snehana Snehana Guna Guru snigda guna, Guru , snigda, shita, sthira Snigda, guna Reason for Avyaama, diwaswapna, diwaswapna, Avyaama Guru, sheeta, vitiation Excessive intake of food Aalasya intake of atisnigda, atimatra which increase meda, madhura, amla lavana bhojana Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 150 Dept of PG studies dravyaguna
  • 82. DISEASE REVIEW like snigda, madhura, rasa, sheeta snigda, guru sheeta, ati bhojana, picchila, bhishyandi varuni sevana aaharaLakshana Asta nindita purusha Shwaithya, shaithya Similar to sleshmaof vitiation Ati snigdata of deha, sthairya, gowrava, sneha, vruddi lakshana Asya madhuryata, supti, kandu Alasya upadeha of kaya kledopadeha, Shwasa, chidra, shareeravisra dhamani pratichaya and Gandha, Nidra, Tandra. Upalepa is mentioned in Shwasa naantmaja Vyadhi of kaphaChikitsa Apatarpana chikitsa The dravyas having Langana whichindicated which includes langana, opposite qualities of comes under Deepana, Pachana, kapha like katu, thikta, apatarpana chikitsa drugs having agni and kashaya rasa, ushna, which includes vayu bhuta dravya paachana, Deepana, predominance. vyaayama, shodana chikitsa. SHLOKAS FOR DISEASE REVIEW 1. xÉÉlSì xÉÌmÉïxiÉÑsrÉÈ xlÉåWû kÉÉiÉÑÈ zÉUÏUxrÉ | iÉxrÉ xjÉÉlÉqÉÑSUÉliÉÈ iuÉcÉÉqÉkɶÉ|| (zÉÉ.mÉë.ZÉ.A.2) 2. uÉxÉÉ :- zÉѬqÉÉÇxÉxrÉ rÉÈ xlÉåWûÈ xÉ uÉxÉÉ mÉËUMüÐÌiÉïiÉÉ (xÉÑ.zÉÉ.4/13) 3. qÉÉÇxÉÉlqÉåSÈ mÉëeÉÉrÉiÉå (cÉ.ÍcÉ 15/15) 4. xuÉÉåwqÉhÉÉ mÉYuÉqÉåuÉ iÉiÉç|xuÉiÉåeÉÉãÅqoÉÑaÉÑhÉÎxlÉakÉÉåÌSì£Çü qÉåSÉåÅÍpÉeÉÉrÉiÉå|| (cÉ.ÍcÉ 15/28) Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 151 Dept of PG studies dravyaguna
  • 83. DISEASE REVIEW 5. UxÉÉSì£ÇüiÉiÉÉåqÉÉÇxÉÇ qÉÉÇxÉÉlqÉåSÈ mÉëeÉÉrÉiÉå|qÉåSxÉÉåÅÎxjÉ iÉiÉÉå qÉ‹É qÉelÉÈ zÉÑ¢Çü iÉÑ eÉÉrÉiÉå|| (xÉÑ.xÉÔ 14/10) 6. SÉæ (AlgÉsÉÏ) qÉåSxÉ:|| (cÉ.zÉÉ. 7/16) 7. qÉåSÈ xlÉåWûxuÉåSÉæ SìÓRûiuÉÇ mÉÑ̹qÉxjrÉÉÇ cÉ|| (xÉÑ.xÉÔ 15/6) 8. xlÉåWûÈ ............. qÉåSxÉÉ ´Éå¹MüqÉï (A.¾Òû.xÉÔ11/15) 9. qÉåSÉåuÉWûÉlÉÉÇ xÉëÉåiÉxÉÉÇ uÉëÑMçMüÉæ qÉÔsÉÇ uÉTüÉuÉWûlÉÇ cÉ ( cÉ .ÌuÉ 5/7) 10. qÉåSÉåuÉWåû ²å,iÉrÉÉåqÉÔïsÉÇ MüÌOû uÉëÑMçMüÉæ cÉ, iÉ§É ÌuɬxrÉ xuÉåSÉaÉqÉlÉÇ ÎxlÉakÉiÉÉ iÉÉsÉÑzÉÉåwÉ: xjÉÔsÉzÉÉåTüiÉÉ ÌmÉmÉÉxÉÉ cÉ| (xÉÑ.zÉÉ.9/18) 11. qÉåSÉåuÉ×̬ eÉÌlÉiÉ SÉåwÉÉå qÉåSÉåSÉåwÉ: iÉiÉç mÉëÉrÉåhÉ ESUÎxjÉiÉÇ pÉuÉÌiÉ|| (SH.Pra.5/84 ) 12. qÉåS xÉÈ xlÉÉrÉÑ xÉÇpÉuÉÈ|| (cÉ.ÍcÉ 15/17) 13. xuÉåSxiÉÑ qÉåSxÉçÈ || ( cÉ.ÍcÉ 15/ 18-19) 14. iɧÉÉxjÉÌlÉ ÎxjÉiÉÉå uÉÉrÉÑÈ ÌmɨÉÇ iÉÑ xuÉåSU£ürÉÉåÈ| zsÉåwqÉÉ zÉåwÉåwÉÑ iÉlÉæwÉÉqÉÉ´ÉrÉÉ´ÉÌrÉhÉÉÇ ÍqÉjÉ: (A.H.Su.11/27) 15. iÉ×iÉÏrÉÉ qÉåSÉåkÉÉUÇ qÉåSÉåÌWû xÉuÉïpÉÔiÉÉlÉÉqÉÑSUxrÉqÉhuÉÎxjÉwÉÑ cÉ qÉWûixÉÑ cÉ qÉ‹É pÉuÉÌiÉ|| (xÉÑ.zÉÉ.4/12) 16. uÉxÉÉ :- zÉѬqÉÉÇxÉxrÉ rÉÈ xlÉåWûÈ xÉ uÉxÉÉ mÉËUMüÐÌiÉïiÉÉ (xÉÑ.zÉÉ.4/13) qÉåSÉå uÉëÑ̬ sɤÉhÉ 17. qÉåSÎxlÉakÉÉ…¡ûiÉÉqÉÑSUç mÉɵÉï uÉ×Ì¬Ç MüÉxɵÉÉxÉÉSÏlÉÇ SÉæaÉïl±¶É| (xÉÑ.xÉÔ 15/17) 18. iɲlqÉåSxiÉjÉÉ ´ÉqÉqÉç| AsmÉåÅÌmÉ cÉå̹iÉå µÉÉxÉÇ ÎxTüM xiÉlÉÉåSUsÉqoÉlÉqÉç|| (A.¾Òû.xÉÔ 11/10)Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 152 Dept of PG studies dravyaguna
  • 84. DISEASE REVIEW 19. xÉÇkÉÏlÉÉÇ xTÑüOûlÉÇ asÉÉÌlÉU¤hÉÉåUÉrÉÉqÉ LuÉ cÉ| sɤÉhÉÇ qÉåkÉÍxÉ ¤ÉÏhÉå iÉlÉÑiuÉqÉÑSUxrÉ cÉ || (cÉ.xÉÔ 17/64) 20. qÉåSȤÉrÉå msÉÏWûÉÍpÉuÉëÑÌ¬È xÉÎlkÉzÉÔlrÉiÉÉ UÉæ¤rÉÇ qÉåSÒUqÉÉÇxÉmÉëÉjÉïlÉÉ cÉ| (xÉÑ.xÉÔ 15/10) 21. qÉåSÍxÉ xuÉmÉlÉÇ MüšÉ msÉÏWûÉuÉëÑÌ¬È M×üzÉÉ…¡ûiÉÉ|| (A.¾Òû.xÉÔ.11/18) 22. uÉhÉï xuÉUlÉå§ÉMåüzÉsÉÉåqÉlÉZÉSliÉÉæ¹qÉÔ§ÉmÉÑUÏwÉåwÉÑ ÌuÉwÉåzÉiÉÈ xlÉåWûÉå qÉåSÈxÉÉUhÉÉqÉç| xÉÉ xÉÉUiÉÉ ÌuɨÉæµÉrÉïxÉÑZÉÉåmÉpÉÉåaÉmÉëSÉlrÉÉeÉïuÉÇ xÉÑMÑüqÉÉUÉåmÉcÉÉUiÉÉÇ cÉÉcɹå| (cÉ.ÌuÉ.28/106) 23. ÎxlÉakÉqÉÔ§ÉxuÉåSxuÉUÇ oÉÚWûicÉUÏUqÉÉrÉÉxÉÉxÉÌWûçwhÉÑÇ qÉåSxÉÉ || (xÉÑ.xÉÔ 35/18) 24. AurÉÉrÉÉqÉÌSuÉÉxuÉmlÉÉlqÉåkrÉÉlÉÉÇ cÉÉÌiÉ pɤÉhÉÉiÉç|qÉåSÉåuÉÉÌWûÌlÉ SÕwrÉÎliÉ uÉÉÂhrÉÉÌiÉxÉåuÉlÉÉiÉç|| (cÉ.ÌuÉ 5/16) 25. ÌlÉÎlSiÉÉÌlÉ mÉëqÉåWûÉhÉÉÇ mÉÔuÉïÃmÉÉÍhÉ rÉÉÌlÉ cÉ. ( cÉ.xÉÔ 28/15) 26. A¹ÉæmÉÑÂwÉÉ ÌlÉÎlSiÉÉÌlÉ pÉuÉÎliÉ; iɱjÉÉ-AÌiÉSÏbÉï¶É, AÌiɾûxuÉ¶É AÌiÉsÉÉåqÉÉcÉ AsÉÉåqÉÉcÉ, AÌiÉMÚüwhÉÉ¶É AÌiÉaÉÉæU¶É AÌiÉ xjÉÔsÉ¶É AÌiÉ¢ÑüzɶÉåÌiÉ| (cÉ.xÉÔ 21/3) 27. aÉëÎljÉuÉÚ̬aÉsÉaÉhQûÉoÉÑïS qÉåSÉåeÉÉæ¹ÉmÉëMüÉåmÉqÉkÉÑqÉåWûÉÌiÉxjÉÉæsrÉÉAÌiÉxuÉåSm ÉëpÉëÑiÉrÉÉå qÉåSÉåSÉåwÉeÉÉÈ|| (xÉÑ.xÉÔ 25/13) 28. mÉëqÉåWû mÉÔuÉïÃmÉ eÉÌOûsÉÏpÉÉuÉÇ MåüzÉåwÉÑ, qÉÉkÉÑrÉïqÉÉxrÉxrÉ, MüUmÉÉSrÉÉåÈ xÉÑmiÉiÉÉSÉWûÉæ qÉÑZÉiÉÉsÉÑMühOûzÉÉåwÉÇ ÌmÉmÉÉxÉÉqÉç, AÉsÉxrÉÇ qÉsÉMüÉrÉå MüÉrÉÎcNûSìÉåwÉÔmÉSåWÇû mÉËUSÉWÇû xÉÑmiÉiÉÉÇ cÉÉ…¡åûwÉÑ wÉOèmÉSÌmÉmÉÏÍsÉMüÉÍpÉ¶É zÉUÏU qÉÔ§ÉÉÍpÉxÉUhÉÇ qÉÔ§Éå cÉ qÉÔ§ÉSÉåwÉÉlÉç ÌuÉxÉë zÉUÏUaÉlkÉÇ ÌlÉSìÉÇ iÉlSì cÉ xÉuÉïMüÉsÉÍqÉÌiÉ| (cÉ.ÌlÉ4/47)Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 153 Dept of PG studies dravyaguna
  • 85. DISEASE REVIEW 29. qÉåSÉåuÉWåû ²å,iÉrÉÉåqÉÔïsÉÇ MüÌOû uÉëÑMçMüÉæ cÉ, iÉ§É ÌuɬxrÉ xuÉåSÉaÉqÉlÉÇ ÎxlÉakÉiÉÉ iÉÉsÉÑzÉÉåwÉ: xjÉÔsÉzÉÉåTüiÉÉ ÌmÉmÉÉxÉÉ cÉ| (xÉÑ.zÉÉ.9/18) 30. iÉSÌiÉxjÉÉæsrÉqÉÌiÉxÉqmÉÔUhÉÉiÉç aÉÑÂqÉkÉÑUzÉÏiÉÎxlÉakÉÉåmÉrÉÉåaÉÉSurÉÉrÉÉqÉÉ̬uÉÉxuÉmlÉû WûwÉï ÌlÉirÉÉiuÉÉSÍcÉliÉÉlÉɯÏeÉxuÉpÉÉuÉŠÉåmÉeÉÉrÉiÉå|| (cÉ.xÉÔ 21/4) 31. UxÉÌlÉÍqɨÉqÉåuÉ xjÉÉæsrÉ MüÉzrÉïÇ cÉ| iÉ§É zsÉååwqÉsÉÉWûÉU xÉåÌuÉlÉÉåűzÉlÉ zÉÏsÉxrÉÉurÉÉrÉÉÍqÉlÉÉå 32. ÌSuÉÉxuÉmlÉUiÉxrÉ cÉÉqÉ LuÉɳÉUxÉÉå qÉkÉÑUiÉU¶É zÉUÏUqÉlÉÑ¢üÉqɳÉÌiÉxlÉåWûÉlqÉåSÉå eÉlÉrÉÌiÉ| iÉSÌiÉxjÉÉæsrÉqÉÉmÉÉSrÉÌiÉ| (xÉÑ.xÉÔ 15/32) 33. AurÉÉrÉÉqÉÌSuÉÉxuÉmlÉzsÉåzqÉsÉÉWûÉU xÉåÌuÉlÉÈ |qÉkÉÑUÉåųÉUxÉÈ mÉëÉrÉÈ xlÉåWûÉlqÉåSÈ mÉëuÉkÉïrÉåiÉç|| (qÉÉ.ÌlÉ.34/ 1-2) 34. A¹ÉæmÉÑÂwÉÉ ÌlÉÎlSiÉÉÌlÉ pÉuÉÎliÉ; iɱjÉÉ-AÌiÉSÏbÉï¶É, AÌiɾûxuÉ¶É AÌiÉsÉÉåqÉÉcÉ AsÉÉåqÉÉcÉ, AÌiÉ¢ÑüwhÉÉ¶É AÌiÉaÉÉæU¶É AÌiÉ xjÉÔsÉ¶É AÌiÉ¢ÑüzɶÉåÌiÉ| (cÉ.xÉÔ 21/3) 35. AÌiÉ xjÉÔsÉxrÉ iÉÉuÉSÉrÉÑwÉÉå ¾ûÉxÉÉå eÉuÉÉåmÉUÉåkÉÈ ¢ÑücNíû urÉuÉÉrÉiÉÉ SÉæoÉïsrÉÇ SÉæaÉïl±Ç xuÉåSÉoÉÉkÉÈ ¤ÉÑSÌiÉqÉɧÉÇ ÌmÉmÉÉxÉÌiÉrÉÉåaɶÉåÌiÉ|| (cÉ.xÉÔ21/4) 36. iÉxrÉ AÌiÉqÉɧÉqÉåSÎxuÉlÉÉå qÉåS LuÉÉåmÉcÉÏrÉiÉå lÉ iÉjÉåiÉUå kÉÉiÉuÉÈ iÉxqÉÉSÉrÉÑwÉÉå ¾ûÉxÉ: ÍzÉÍjÉsrÉÉiÉç xÉÉæMÑüqÉÉrÉÉïiaÉÑÂiuÉÉŠ qÉåSxÉÉå eÉuÉÉåmÉUÉåkÉÈ zÉÑ¢üÉoÉWÒûiuÉÉlqÉåSxÉÉÅÅuÉëÑiÉqÉÉaÉïiuÉÉiÉçŠ ¢ÑücNíûurÉuÉÉrÉiÉÉ SÉæoÉïsrÉqÉxÉqÉiuÉɲÉiÉÔlÉÉÇ,SÉæaÉïl±Ç qÉåSÉåSÉåwÉÉlqÉåSxÉÈ xuÉpÉÉuÉÉiÉç xuÉåSlÉiuÉÉŠ, qÉåSxÉ zsÉåwqÉxÉÇxÉaÉÉï̲wrÉÎlSiuÉÉ°ÒiuÉÉiÉç aÉÑÂiuÉÉSèurÉÉrÉÉqÉÉxÉWûiuÉÉŠ xuÉåSÉoÉÉSÈ,Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 154 Dept of PG studies dravyaguna
  • 86. DISEASE REVIEW iÉϤhÉÉÎalÉiuÉÉiÉç mÉëpÉÔiÉMüÉå¹uÉÉrÉÑiuÉÉŠ ¤ÉÑSÌiÉqÉɧÉÉÇ ÌmÉmÉÉxÉÉÌiÉrÉÉåaɶÉåÌiÉ|| (cÉ.xÉÔ 21/4) 37. iÉqÉÌiÉxjÉÔsÉÇ ¤ÉÑSìµÉÉxÉ ÌmÉmÉÉxÉɤÉÑixuÉmlÉxuÉåSaÉɧÉSÉæaÉïlkrÉ¢üjÉlÉaÉɧÉxÉÉSaɪ SSiuÉÉÌlÉ Í¤ÉmÉëqÉåuÉÉÌuÉzÉÎliÉ,xÉÉæMÑüqÉÉrÉÉïlqÉåSxÉÈ xÉuÉïÌ¢ürÉÉxuÉxÉqÉjÉïÈ ; MüTüqÉåSÉåÌlɬqÉÉUaÉiuÉÉŠÉsmÉurÉuÉÉrÉÉå pÉuÉÌiÉ AÉuÉëÑiÉqÉÉaÉïiuÉÉSåuÉ zÉåwÉÉ kÉÉiÉuÉÉå lÉÉmrÉÉrÉliÉåÅirÉjÉïqÉiÉÉåÅsmÉmÉëÉhÉÉå pÉuÉÌiÉ, ((xÉÑ.xÉÔ 15/37) 38. qÉåSxÉÉuÉ×iÉqÉÉaÉïiuÉɲÉrÉÑÈ MüÉå¹å ÌuÉzÉåwÉiÉÈ | cÉUlÉç xÉÇkÉѤÉrÉirÉÎalÉqÉÉWûÉUÇ zÉÉåwÉrÉirÉÌmÉ|| iÉxqÉÉiÉç xÉ zÉÏbÉëÇ eÉUrÉirÉÉWûÉUÇcÉÉÌiÉMüÉǤÉÌiÉ| ÌuÉMüÉUÉǶÉÉzlÉÑiÉå bÉÉåUÉlÉç MüÉÇͶÉiMüÉsÉÉurÉÌiÉ¢üqÉÉiÉç || LiÉÉuÉÑmÉSìuÉMüUÉæ ÌuÉzÉåwÉÉSÎalÉqÉÉÂiÉÉæ| LiÉÉæ ÌWû SWûiÉÈ xjÉÔsÉÇ uÉlÉÉSÉuÉÉå uÉlÉÇ rÉjÉÉ|| qÉåSxrÉiÉÏuÉ xÉÇuÉëѬå xÉWûxÉæuÉÉÌlÉsÉÉSrÉÈ|ÌuÉMüÉUÉlÉç SÉÂhÉÉlÉç M×üüiuÉÉ lÉÉzÉrÉlirÉÉzÉÑ eÉÏÌuÉiÉqÉç|| (cÉ.xÉÔ.21/7) 39. qÉåSxÉÉÅÅuÉëÑiÉqÉÉaÉïiuÉÉiÉç mÉÑwrÉlirÉlrÉå lÉ kÉÉiÉuÉÈ|qÉåSxiÉÑ cÉÏrÉiÉå iÉxqÉÉSzÉ£üÈ xÉuÉïMüqÉïxÉÑ|| (qÉÉ.ÌlÉ.34/2) 40. mÉëqÉåWûÌmÉQûMüÉeuÉUpÉaÉÇSUÌuÉSìÍkÉuÉÉiÉÌuÉMçÉUÉhÉÉqÉlr ÉiÉqÉÇmÉëÉmrÉ mÉÇlcÉiuÉqÉÑmÉrÉÉÌiÉ| xÉuÉï LuÉ cÉÉxrÉ UÉåaÉÉ oÉsÉuÉliÉÉå pÉuÉlirÉÉuÉëÑiÉqÉÉaÉïiuÉÉiÉç xÉëÉåiÉxÉÉqÉç, AiÉxiÉiÉÉåimĘ́ÉWåûiÉÑÇ mÉËUWûUåiÉç.|| (xÉÑ.xÉÔ 15/37) 41. AÌiÉxjÉÉæsrÉÉÅmÉÍcÉ...........................................MÑü¹ÉSÏlÉÌiÉSÉÂhÉÉl Éç|| (A.¾Òû.xÉÔ 14/20) 42. aÉÑ cÉÉiÉmÉïhÉÇ cÉå¹Ç xjÉÔsÉÉlÉÉÇ MüzÉïlÉÇ mÉëÌiÉ| (cÉ.xÉÔ.21)Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 155 Dept of PG studies dravyaguna
  • 87. DISEASE REVIEW 43. uÉÉiÉblÉÉlrɳÉmÉÉlÉÉÌlÉ zsÉåwqÉqÉåSÉåWûUÉÍhÉ cÉ| äÉÉåwhÉ oÉxiÉrÉxiÉϤhÉÉ Ã¤ÉÉhrÉѲiÉïlÉÉÌlÉ cÉ|| aÉÑQÕûcÉÏ pÉSìqÉÑxiÉÉlÉÉÇ mÉërÉÉåaÉx§ÉæTüsÉxiÉjÉÉ| iÉ¢üÉËU¹ mÉërÉÉåaÉ¶É mÉërÉÉåaÉÉå qÉÉÎYzÉMüxrÉ cÉ|| ÌuÉQÇû…Ç lÉÉaÉUÇ ¤ÉÉUÈ 44. MüÉsÉÉsÉÉåWûUeÉÉå qÉkÉÑ| rÉuÉÉqÉsÉMücÉÔhÉÉïÇ cÉ mÉërÉÉåaÉ ´Éå¸ EcrÉiÉå|| ÌoÉsuÉÉÌSmÉlcÉ qÉÔsÉxrÉ mÉërÉÉåaÉÈ ¤ÉÉæSìxÉÇrÉÑiÉÈ| ÍzÉsÉÉeÉiÉÑ mÉërÉÉåaÉ¶É xÉÉÎalÉqÉljÉUxÉÈ mÉU: || (cÉ.xÉÔ.21/ 23) 45. EimɳÉå iÉÑ ÍzÉsÉÉeÉiÉÑaÉÑaaÉÑsÉÑaÉÉåqÉÔ§Ȩ́ÉTüsÉÉsÉÉåWûUeÉÉåUxÉÉg ÉlÉ qÉkÉÑrÉuÉqÉѪMüÉåUSÒwÉMü zrÉÉqÉÉMüÉå¬ÉsÉMüÉSÏlÉÉÇ ÌuÉäÉhÉcNåûSlÉÏrÉÉlÉÉÇ cÉ SìurÉÉhÉÉÇ ÌuÉÍkÉuÉSÒmÉrÉÉåaÉÉåurÉÉrÉÉqÉÉå sÉåZÉlÉoÉx¨rÉÑmÉrÉÉåaÉxcÉåÌiÉ|| xÉÑ.xÉÔ.15/32 46. iÉ§É qÉåSÉåÅÌlÉsÉzsÉåwqÉ-lÉÉzÉlÉÇ xÉuÉïÍqÉwrÉiÉå| MÑüsÉijÉ...........................SÏmÉlÉÇ(A.¾Òû.xÉÔ 14/28) 47. mÉÑUÉhÉ: zÉÉsÉrÉÉå ....EmÉuÉÉxÉÉå AxÉÑZÉzÉrrÉÉ xÉiuÉÉæSÉrÉï iÉqÉÉåeÉrÉ:|| (pÉÉ.mÉë.qÉ.ZÉ) 48. xÉÇiÉmÉïhÉ ¢ÑüiÉæ.......................... ÌoÉsuÉÉÌS mÉlcÉqÉÔsÉxrÉ mÉërÉÉåaÉ: UxÉkÉÉiÉÑ 49. UxÉ kÉÉiÉÑ iÉ§É UxÉ aÉiÉÉæ kÉÉiÉÑ:| AWûUWûaÉïcNûiÉÏirÉiÉÉå UxÉ || xÉÑ.xÉÔ.14/1 50. iÉ§É mÉÉgcÉpÉÉæÌiÉMüxrÉ, cÉiÉÑÌuÉïkÉxrÉ wÉQíûxÉxrÉ Ì²ÌuÉkÉuÉÏrÉïxrÉ A¹ÌuÉkÉuÉÏrÉïxrÉ uÉÉÅlÉåMü aÉÑhÉÉãmÉåiÉxrÉÉåmÉrÉÑ£üxrÉÉWûÉUxrÉ xÉqrÉMçüü mÉËUhÉiÉxrÉ rÉxiÉåeÉÉåpÉÔiÉÈ xÉÉUÈ mÉUqÉxÉÔ¤qÉÈ xÉ ‘UxÉ’ CirÉÑcrÉiÉå|| ( Su .su 14/3) 51. ̲ÌuÉSÉå UxÉÈ xjÉÉrÉÏ mÉÉåwÉMü¶ÉåÌiÉ (cÉ¢ümÉÉÍhÉ)Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 156 Dept of PG studies dravyaguna
  • 88. DISEASE REVIEW 52. xÉ WØûSrÉÉŠiÉÑÌuÉïÇzÉÌiÉ kÉqÉÌlÉUlÉÑmÉëÌuÉzrÉÉåkuÉïaÉÉSzÉ SzÉÉkÉÉåaÉÉÍqÉlrɶÉiÉxÉë ÌiÉrÉïaaÉÉ: M×üixlÉÇ zÉUÏUqÉWûUWûxiÉmÉïrÉÌiÉ uÉkÉïrÉÌiÉ kÉÉUrÉÌiÉ rÉÉmÉrÉÌiÉ cÉÉSعWåûiÉÑMåülÉ MüqÉïhÉÉ || xÉÑ.xÉÔ.14/3 53. xÉ UxÉ zÉoSÉÍcÉïeÉïsÉxÉl¨ÉÉlÉuÉSqÉÑlÉÉ ÌuÉzÉåwÉåhÉÉlÉÑkÉÉuÉirÉåuÉÇzÉUÏUåMåüuÉsÉqÉç || iɧÉæwÉÉÇ kÉÉiÉÔlÉÉÇ AÉWûÉUUxÉÈ mÉëÏhÉÌrÉiÉÉ |xÉÑ.xÉÔ.15/19 54. iÉxrÉ cÉ WØûSrÉÇ xjÉÉlÉqÉç | 55. urÉÉlÉålÉ UxÉkÉÉÉiÉÑÌWïû ÌuɤÉåmÉÉåÍcÉiÉMüqÉïhÉÉ | rÉÑaÉmÉiÉç xÉuÉïiÉÉåÅeÉxÉëÇ SåWåû ÌuÉͤÉmrÉiÉå xÉSÉ ||cÉ.ÍcÉ.15/36 56. Pramana of Rasa Dhatu: lÉuÉ|gleÉsÉrÉ: || (cÉ.zÉÉ.7/12) 57. UxÉxiÉÑÌ¹Ç mÉëÏhÉlÉÇ U£ümÉÑÌ¹Ç cÉ MüUÉåÌiÉ || xÉÑ. xÉÔ. 15/6 UxÉÉSì£Çü... mÉëeÉÉrÉiÉå|| (cÉ,ÍcÉ15/15) UxÉÌlÉÍqɨÉqÉåuÉ xjÉÉæsrÉ MüÉzrÉïqÉç cÉ (xÉÑ.xÉÔ 15/33) 58. UxÉÉåÅÌiÉuÉ×®Éå WØûSrÉÉåiYsÉåSÇ mÉëxÉåMÇü cÉÉmÉÉSrÉÌiÉ || xÉÑ.xÉÔ.15/15 zsÉåwqÉÉÅÎalÉxÉSlÉmÉëxÉåMüÉsÉxrÉ aÉÉæUuÉÇ | µÉæirÉzÉæirÉzsÉjÉÉÇaÉiuɵÉÉxÉMüÉxÉÉÌiÉÌlÉSìiÉÉ: || UxÉÉåÅÌmÉ zsÉåwqÉuÉiÉç || A.WØû.xÉÔ.11/7,8 59. :UxÉuÉWûÉlÉÉÇ xÉëÉåiÉxÉÉÇ WØûSrÉÇ qÉÔsÉÇ SzÉ cÉ kÉqÉlrÉÈ | cÉ.ÌuÉ.5/9û 60. aÉÑÂzÉÏiÉqÉÌiÉÎxlÉakÉqÉÌiÉqÉɧÉÇ xÉqÉzlÉiÉÉqÉç | UxÉuÉÉÌWûlÉÉå SÒwrÉÎliÉ ÍcÉlirÉÉlÉÉÇ cÉÉÌiÉÍcÉliÉlÉÉiÉç ||cÉ.ÌuÉ.5/18 Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 157 Dept of PG studies dravyaguna
  • 89. DISEASE REVIEW 61. A´É®É cÉÉÂÍcɶÉÉxrÉuÉæUxrÉqÉUxÉ¥ÉiÉÉÈ | WØûssÉÉxÉÉåaÉÉæUuÉÇ iÉlSìÉ xÉÉXèaÉqÉSÉåï euÉUxiÉqÉÈ|| mÉÉhQÒûiuÉÇ xÉëÉåiÉxÉÉÇ UÉåkÉÈ YsÉæurÉÇ xÉÉSÈ M×üzÉÉ…¡ûiÉÉlÉÉzÉåÅÎalÉUrÉjÉÉMüÉsÉÇ uÉsÉrÉÈ mÉÍsÉiÉÉÌlÉ cÉ | UxÉmÉëSÉåwÉeÉÉ UÉåaÉÉÈ || cÉ.xÉÔ.28/89 iÉ§É A³ÉÉ´É®ÉUÉåcÉMüÉÌuÉmÉÉMüÉXçaqÉSï euÉUWØûssÉÉxÉ iÉ×ÎmiÉaÉÉæUuÉ WØûimÉÉhQÒûUÉåaÉqÉÉaÉÉåïmÉUÉåkÉ MüÉzrÉï uÉæUxrÉÉ…¡ûxÉÉSÉMüÉsÉuÉsÉÏmÉÍsÉiÉSzÉïlÉmÉëpÉ×iÉrÉÉå UxÉSÉåwÉeÉÉ ÌuÉMüÉUÉÈ | xÉÑ.xÉÔ.24/9 62. Chikitsa : UxÉeÉÉlÉÉÇ ÌuÉMüÉUÉhÉÇ xÉuÉï sÉÇbÉlÉqÉÉæwÉkÉqÉç|| 63. xÉ ZÉsuÉÉmrÉÉå UxÉÉå rÉ¢ÑüimsÉÏWûÉlÉÉæ mÉëÉmrÉ UÉaÉqÉÑmÉæÌiÉ|| (xÉÑ.xÉÔ.14/5) UÎleÉiÉÉxiÉåeÉxÉÉ iuÉÉmÉÈ zÉUÏUxjÉålÉ SåÌWûlÉÉqÉç|AurÉÉmɳÉÉÈ mÉëxɳÉålÉ U£üÍqÉirÉÍpÉkÉÏrÉiÉå|| (xÉÑ.xÉÔ , 14/6) 64. ÌMü Çû UxÉxrÉ iÉÑ MüTüÉå. (cÉ.ÍcÉ.15/17) MüT 65. xlÉåWûzÉæirÉzÉÉæYsrÉaÉÉæUuÉqÉÉkÉÑrÉïxjÉærÉïmÉæÎcNûsrÉ.... AÉiqÉÃmÉÉÍhÉ | cÉ.xÉÔ.20/18 66. EUÈ ÍzÉUÉåaÉëÏuÉÉmÉuÉÉïhrÉÉqÉÉzÉrÉÉå qÉåS¶ÉzsÉåzqÉxjÉÉlÉÉÌlÉ iɧÉÉmrÉÑUÉå ÌuÉwÉåzÉåhÉ zsÉåzqÉ xjÉÉlÉqÉç | cÉ.xÉÔ.20/8 67. EUÈ MühOûÍzÉUÈ YsÉÉåqÉ mÉuÉÉïhrÉÉqÉÉzÉrÉÉåUxÉÈ | qÉåSÉåbÉëÉhÉgcÉÎeÉÀûÉ cÉ MüTüxrÉ xÉÑiÉUÉqÉÑUÈ |A.WØû.xÉÔ.12/3 qÉåSÈ ÍzÉU EUÉå aÉëÏuÉ xÉÎlkÉuÉÉïrÉÑÈ MüTüÉ´ÉrÉÈ | Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 158 Dept of PG studies dravyaguna
  • 90. DISEASE REVIEW WØûSrÉÇ iÉÑ ÌuÉwÉåzÉåhÉ zsÉåzqÉhÉÈ xjÉÉlÉqÉÑcrÉiÉå | MüÉ.xÉÔ.27/11 AÉqÉÉzÉrÉÈ zsÉåzqÉhÉÈ | xÉÑ.xÉÔ.21/5 68. aÉÑ zÉÏiÉ qÉ×SÒ ÎxlÉakÉ qÉkÉÑU ÎxjÉU ÌmÉÎcNûsÉÈ | cÉ.xÉÔ.1/61 zsÉåzqÉ µÉåiÉÉå aÉÑÂÈ ÎxlÉakÉÈ ÌmÉÎcNûsÉÈ LuÉ cÉ | 69. xlÉåWûÉå oÉlkÉÈ ÎxjÉUiuÉÇ cÉ aÉÉæUuÉÇ uÉ×wÉiÉÉ oÉsÉÇ | ¤ÉqÉ kÉ×ÌiÉUsÉÉåpÉ¶É MüTüMüqÉÉï ÌuÉMüÉUeÉqÉç | cÉ.xÉÔ.18/59 xlÉåWûqÉ…¡åûwÉÑxÉlkÉÏlÉÉÇxjÉærÉïÇoÉsÉqÉÑSÏhÉïiÉÉqÉ | MüUÉåirÉlrÉÉlÉç aÉÑhÉÉǶÉÉÌmÉ oÉsÉÉxÉÈ xuÉÉÈ ÍxÉUɶÉUlÉç |xÉÑ.zÉÉ.7/11 70. uÉ×ή sɤÉhÉ : zsÉåzqÉ uÉ×®Éæ zÉÉæYsrÉÇ, zÉæirÉÇ, xjÉærÉïÇ, aÉÉæUuÉqÉuÉxÉÉSxiÉlSì, ÌlÉSìÉ, xÉÎlkÉÌuÉzsÉåzÉ¶É | xÉÑ.xÉÔ.15/14 zsÉåzqÉÉÎalÉxÉSlÉ mÉëxÉåMüÉsÉxrÉaÉÉæUuÉÇ | µÉæirÉzÉæirÉzsÉiÉÉ…iuÉǵÉÉxÉMüÉxÉÉÌiÉÌlÉSìiÉÉÈ|| A.WØû.11/7-8 µÉæirÉzÉæirÉaÉÉæUuÉxlÉåWûqÉÉkÉÑrÉïxjÉærÉïmÉæÎcNûsrÉÉqÉÉixl rÉÉïÌlÉzsÉåzqÉhÉ AÉiqÉÃmÉÉÍhÉ | cÉ.xÉÔ.20/18 71. mÉëMüÉåmÉ MüÉUhÉ: ÌSuÉÉxuÉmlÉÉmÉÉurÉÉrÉÉqÉÉsÉxrÉqÉkÉÑUÉqsÉsÉuÉhÉzÉÏiÉÎxlÉakÉ aÉÑÂÌmÉÎcNûsÉÉÍpÉwrÉÎlS WûÉrÉlÉMürÉuÉMülÉæwÉkÉåiMüOûqÉÉwÉqÉWûÉqÉÉwÉaÉÉåkÉÔqÉÌi ÉsÉÌmɹÌuÉM×üÌiÉSÍkÉSÒakÉM×üzÉUÉmÉÉrÉxÉå¤ÉÑÌuÉMüÉUÉlÉÔmÉ ÉæSMüqÉÉÇxÉ uÉxÉÉÌuÉxÉqÉ×hÉÉsÉMüxÉåÂMü ´É×…¡ûÉOûMü qÉkÉÑU uÉssÉÉæTüsÉÉ xÉqÉzÉlÉÉkrÉzÉlÉ mÉëpÉ×ÌiÉÍpÉ: zsÉåwqÉÉmÉëMüÉåmÉqÉÉmɱiÉå || (xÉÑ. xÉÔ. 21/23) 72. mÉëMüÉåmÉsɤÉhÉ: µÉæirÉzÉæirÉMühQÕûxjÉærÉïaÉÉæUuÉxlÉåWûxÉÑÎmiÉYsÉåSÉåmÉS åWûoÉlkÉqÉÉkÉÑrÉïÍcÉUMüÉËUiuÉÉÌlÉzsÉåwqÉhÉ:MüqÉÉïÍhÉiÉæUÎl SiÉÇ zsÉåwqÉÌuÉMüÉUqÉåuÉÉkrÉuÉxrÉåiÉç | cÉ. xÉÑ. 20/18 Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 159 Dept of PG studies dravyaguna
  • 91. DISEASE REVIEW zsÉåwqÉhÉ: xlÉåWûMüÉÌPûlrÉMühQÕûzÉÏiÉiuÉaÉÉæUuÉqÉç ||oÉlkÉÉåmÉsÉåmÉ xiÉæÍqÉirÉ zÉÉåTüÉmÉYirÉÌiÉÌlÉSìiÉÉ | uÉhÉïÈ µÉåiÉÉåUxÉÉæxuÉÉSÒsÉuÉhÉÉæÍcÉUMüÉËUiÉÉ || A.WØû.xÉÔ. 12/53-54 73. mÉëzÉqÉlÉ : MüOÒûÌiÉ£üMüwÉÉrÉÉxiÉÑ LlÉÇ zÉqÉrÉÎliÉ | cÉ. ÌuÉ.1/6 zsÉåwqÉhÉÈ ÌuÉÍkÉlÉÉ rÉÑ£Çü iÉϤhÉÇ uÉqÉlÉ UåcÉlÉqÉç| A³ÉÇ Ã¤ÉÉsmÉiÉϤhÉÉåwhÉÇ MüOÒû ÌiÉ£ü MüwÉÉrÉMüqÉç|| (A.¾Òû.xÉÔ 13/10) 74. MüTülÉÉlÉiqÉeÉ UÉåaÉ: §ÉÑÎmiɶÉ,iÉlSìÉ cÉ, ÌlÉSìÉÍkÉYrÉÇ cÉ xjÉæÍqÉjrÉÇ cÉ, aÉÑÂaÉɧÉiÉÉ cÉ, AÉsÉxrÉÇ cÉ, qÉÑZÉqÉÉkÉÑrÉïÇ cÉ, qÉÑZÉxÉëÉuɶÉ, zsÉåwqÉÉåå̪UhÉÇ cÉ qÉsÉxrÉÉÍkÉYrÉÇ cÉ, oÉsÉÉxÉMü¶É, AmÉÌ£ü¶É, ¾ÒûSrÉÉåmÉsÉåmɶÉ, kÉqÉlÉÏmÉëÌiÉcÉrɶÉ, aÉsÉaÉhQû¶É, AÌiÉxjÉÉæsrÉÉÇ cÉ, zÉÏiÉÉÎalÉiÉÉ cÉ,ESSï¶É, µÉåiÉÉuÉpÉÉxÉiÉÉ cÉ, µÉåiÉqÉÔ§ÉlÉå§ÉuÉcÉïxiuÉÇ cÉ, CÌiÉ ÌuÉÇzÉÌiÉ zsÉåwqÉÌuÉMüÉUÉhÉÉqÉmÉËUxÉÇZrÉårÉÉlÉÉqÉÉÌuÉwM×üiÉÉiÉqÉÉ urÉÉZrÉÉlÉÉÇ pÉuÉÎliÉ|| (cÉ.xÉÔ 20/17) HYPERLIPIDEMIA Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 160 Dept of PG studies dravyaguna
  • 92. DISEASE REVIEWLipids:16,17 Lipids are heterogeneous groups of compounds related to fatty acids, theyare insoluble in aqueous medium but soluble in organic solvent The four formsof lipids present in the plasma are: - 1. Fatty acids 2.Triglycerides 3 .Phospholipids, 4. Cholesterol 1. FATTY ACIDS :- There are straight chain compounds, the length of chain depending on the numberof carbon atoms in the molecule, the fatty acids may be saturated (containing no doublebond) such as palmitic (16 c atoms) and stearic. (19 c atoms) or unsaturated (with one ormore double bonds). Further the tally acids may be esterified with glycerol to formglycerides or they may be free, and are called free fatty acids. (FFA) or non-esterifiedfatty acids (NEFA). FFA is an immediate available energy source and provide much ofthe energy required by the body.2. TRIGLYCERIDES:- Triglycerides consist of glycerol, each molecule of which is esterified withthree molecules of fatty acids.3. PHOSPHOLIPIDS: There are complex compounds containing in addition to fatty acids andglycerol, a phosphoric acid residue, nitrogen containing bases and other, Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 161 Dept of PG studies dravyaguna
  • 93. DISEASE REVIEWsubstituents. These are integral components of the cell membrane and cellorganells, they are mainly synthesized in liver & to some extent in extra hepatictissues.4. CHOLESTEROL : It has a steroid structure and other steroids are synthesized from it. Itoccurs in animal fats, but not in plant fats, and is widely distributed in all cells ofthe body. In the plasma, it exists in free as well as in esterified states. 75% of thecholesterol is esterified with fatty acids. In human beings these are palmitate,oleate linoleate, palmitoleate, stearate & myristeate. The esterification ratio seemsto be influenced during atherosclerotic process. Beaumont et al (1970) showed correlation between raised cholesterol /phospholipids ratio (c/p ratio) and atherosclerosis. Thus the risk ofatherosclerosis seems to increase with the number of lipid abnormalities presentand the net effect of any lipid can be defined only by discrimination and byfurther analysis.CHOLESTEROL METABOLISM:-Liver plays an important role in the metabolism of fats Stores fats. It helps in the oxidation of fats Site of synthesis of cholesterol from acetate Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 162 Dept of PG studies dravyaguna
  • 94. DISEASE REVIEW Synthesizes phospholipids Synthesizes fats from carbohydrates and proteins Unused free fatty acids(FFA) released from fat depot is converted to triglycerides and other lipids to meet energy requirement In carbohydrate deficiency, the fat metabolism in the liver is increased and fat is partially converted to glucose or glycogen. Fat soluble vitamins example A,D,E,K are stored here.a) Absorption of cholesterol: The dietary cholesterol (free & esterified) after getting mixed with theendogenous cholesterol in the lumen of small intestine is acted upon by the bilesalts, cholesterol esterase and other intestinal secretions. Cholesterol esterase play an important role in cholesterol absorption, but it is more easily absorbed in the presence of dietary fat and bile salts. These bile salts form complexes with cholesterol in the intestinal lumen and then they pass into intestinal cell or emulsify cholesterol or act as co-factors for cholesterol esterase. Following absorption cholesterol is transferred via lymph to plasma & incorporated in to chylomicrons. In blood, it is again hydrolyzed, so that free cholesterol is produced & is transported to liver where it again enters the metabolic pools. Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 163 Dept of PG studies dravyaguna
  • 95. DISEASE REVIEW Thus the absorption of steroid varies widely depending upon the quantity fed, chemical structure, total fat content of the diet and the species. The absorption of dietary cholesterol is incomplete and generally less than 50 %. of daily intake.Functions of Lipids:- 1. Food material; Provides high calorific value (1 gm, produces about 9.3 K.cal of heat) 2. Food reserve: Acts as reserved food materials because, it is readily stored in the body on account of its insolubility in aqueous solutions. 3. Heat insulations: Being deposited in subcutaneous tissue lipid acts as insulator. 4. Defensive action: cholesterol is intimately related to the defensive mechanism of the body , during acute infections cholesterol level falls and rises during recovery. 5. Solvents: lipid acts as vehicle of natural fat soluble vitamins – A, D &E. 6. Structural constituent: It is structural component of cell membrane. 7. Fat transport – Phospholipids play an important role in absorption & transportation of fatty acids. 8. Hormone synthesis: Adrenocorticoids, sex hormones, Vit – D and cholic acids are synthesized from cholesterol. 9. Controls cell permeability: Being a constant constituent of the cell membrane. It is believed to be related to the permeability of tissue cells. 10. Prevents haemolysis: In some unknown way it protects the RBC’s being easily haemolysed. Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 164 Dept of PG studies dravyaguna
  • 96. DISEASE REVIEW 11. Formation of cholic acid: In the bile salts. It has been shown that cholesterol is the mother substance from which cholic acid is synthesized. 12. Control cell division :Rapidly growing tissues are very rich in cholesterol. Such as granulation tissue of healing ulcer, tumors, etc. .Excretion:1. In the bile ; It is found as free cholesterol, but a good part of it is reabsorbed from the intestines.2. In stools ; A part of bile cholesterol undergoes bacterial putrefaction in the intestines and isexcreted as coprosterol.3. In urine: It appears in urine only in traces, but appears in a large amount indifferent diseases mainly in hyper-cholesterolemia, where blood cholesterol ishigh.4. In the Skin : Sebum - secretion of the sebaceous glands of the skin, contains largequantities of cholesterol, thus drying of skin is prevented. Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 165 Dept of PG studies dravyaguna
  • 97. DISEASE REVIEW PLATE: 2 DIFFERENT TYPES OF LIPOPROTEINS TRIGLYCERIDES LDLEvaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 166 Dept of PG studies dravyaguna
  • 98. DISEASE REVIEW DISEASE REVIEW HYPER LIPIDAEMIA Hyper lipidaemia is increase in the total plasma lipids. This is the manifestation ofdisturbed lipid metabolism. A high fat meal causes a rise in plasma lipid. (Hyper lipidaemia). Plasmalipids rise with in a couple of hours, reach a peak in four to six hours, and then asharp fall brings them back to the fasting level. Most of the rise is due to neutralfats (Hyper lipidaemia), with minor contributions from cholesterol andphospholipids. Values for the plasma cholesterol are low in the new born (about 50 mg /100 ml) and tend to rise from adolescence to the age of 50-55 years, especially incorpulent population; in very old age the values tends to drop. The cholesterolcontent is raised during pregnancy to about 30-40 percent above the level of thenon-pregnant state. It is also raised after menopause, in health the cholesterolphospholipids ratio is stable. Table No: 16 Distribution of Plasma lipids in healthy (fasting state) Substance Concentration in mg / 100ml Total lipids 400 to 1000 Neutral fats 0 to 280 Fatty acids 110 to 400 Unesterified fatty acids 10 to 90 Total cholesterol 125 to 300 Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 167 Dept of PG studies dravyaguna
  • 99. DISEASE REVIEW Free cholesterol 30 to 70 (20-40% of total cholesterol) Esters of cholesterol 90 to 200 (60-80% of total cholesterol) Phospholipids 110 to 250 Lecithin 80 to 200 Cephalin 0 to 30 Ephingomyclin 0 to 50 Glycolipids cerebrosides 3 to 6 There are two main lipids found in the blood, cholesterol andtriglycerides, also known as serum lipoproteins. Cholesterol is an essentialchemical with in the body, without it we will die, yet if our blood levels ofcholesterol & triglycerides are too high we are at risks for coronary arterydisease. This is a major cause of death in the United States today. Cholesterol is an essential element contained in all human cellmembranes. It is a structural component of steroid hormones and bile acids.Triglycerides are important in helping to transfer energy from food in to bodycells. Lipoproteins are categorized based on how dense they are. Density isbased on the amount of cholesterol, triglycerides and appoproteins. The densest Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 168 Dept of PG studies dravyaguna
  • 100. DISEASE REVIEWand smallest are called high density lipoproteins or HDL, also known as “GOODCHOLESTEROL”. Lipoproteins that are a little less dense are called low densitylipoproteins, (LDL). The least dense and the largest of the lipoproteins are thevery low density lipoproteins or VLDL. Chylomicrons are also classified as lipoproteins, and are composed oftriglycerides, cholesterol and protein. HDL “GOOD CHOLESTEROL” are inverselyrelated to heart disease risk and are there fore known as “anti risk” or protective factors.Types of Hyper lipidaemia:- Etiologically Hyperlipidaemia falls in to two main groups, 1. Primary and 2. Secondary1. The primary Hyperlipidaemia are either. i. Due to genetically determined defects in lipid or lipoprotein metabolism OR ii. May be precipitated / aggravated by some environmental factors such as diet – including alcohol intake and drugs particularly oestrogens as contained in contraceptives & steroid hormones. Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 169 Dept of PG studies dravyaguna
  • 101. DISEASE REVIEW2. The common diseases that are often associated with the SECONDARYHYPERLIPIDEAMIA are Hypothyroidism, Insulinopenic diabetes mellitus, Nephrotic syndrome, biliary obstruction, Pancreatitis, obesity and Dysglobulinaemia.DRUG RISK FACTORS: ♦ Birth control pills , Hormones such as Estrogen ,Cortico steroids ♦ Certain diuretics & Beta blockersDIETARY RISK FACTORS: ♦ Dietary fat intake greater than 40 % of total calories ♦ Saturated fat intake greater than 10 % of total calories. ♦ Cholesterol intake greater than 300 mg / day ♦ Habitual excessive alcohol use & obesity ♦ Cigarette smoking with Hyperlipidaemia.Sex ratio: Hyperlipidaemia is more common in men than women.SYMPTOMS: There are no symptoms.SIGNS & TESTS Physical examination : May display xanthalasmata or fat deposits on the skin.Laboratory tests : May be performed to identify secondary causes of Hyperlipidemia or familialdisorders, if lipoprotein analysis is elevated. Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 170 Dept of PG studies dravyaguna
  • 102. DISEASE REVIEWFasting lipid (or lipoprotein test) analysis 1. Total cholesterol 2. LDL (Bad cholesterol) 3. HDL (Good cholesterol) 4. Triglycerides A defined “high” cholesterol (lipid) level depends on other factors includingsmoking, high BP, low HDL, family history of heart disease, male over 45 or female over55. Total cholesterol values over 200 may indicate an increased risk for heart disease. However, LDL levels better predict risk factors for heart disease, those withknown heart disease (Previous heart attack or peripheral vascular disease) or diabetesshould have levels under – 100. LDL over 130 with two or more of the above risk factors is abnormal. An LDL over 100 with one or fewer of the risk factors is also abnormal.HDL cholesterol more than or equal to 60, takes away one risk factor and decreases riskfactor for heart disease. Levels under 40 of HDL add a risk factor.Normal triglyceride level are under 150 however, as with other components of the lipidtest, fasting less than 9-12 hrs may alter triglyceride results. Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 171 Dept of PG studies dravyaguna
  • 103. DISEASE REVIEWTesting : Serum cholesterol testing in adults is recommended every 1-5 yrs.Early detection and early control of high cholesterol in person without symptoms is animportant step in reducing the development & progression of CHD & atherosclerosispersons with diabetes and a family history of high cholesterol are more likely to havehigh cholesterol & may need to be tested at more frequent intervals.Prevention and treatment: In the prevention and treatment of high cholesterol, DIET MODIFICATION isconsidered by experts to be the corner stone of the therapy. Adjuncts to the preventionand or treatment of high cholesterol also include. ♦ A regular exercise regimen ♦ Cessation of smoking and excessive alcohol intake ♦ The addition of antioxidants to the diet ♦ Lipid lowering Agents ♦ Eating a diet that lowers total calorie intake and reduces total fat and cholesterol intake. ♦ Limiting total daily fat intake to not more than 30% of total calories ♦ Cholesterol intake should be less than 300 mg daily ♦ Carbohydrate intake should total 55%-60% of total daily calories ♦ Avoid sugar rich diet Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 172 Dept of PG studies dravyaguna
  • 104. DISEASE REVIEW ♦ Fiber intake from foods not supplements, should be 25-30 gms daily ♦ Use of mono saturated oils such as olive. ♦ Eat five or more servings of fruit & vegetables daily. ♦ Limit salt intake to six gms / day. Limit salt intake to 3 gms / days or less for patients with HTN or diagnosed IHD ♦ Add the antioxidants, Vit – C beta-carotene & Vit - E, in the recommended comments to the diet which help in reversing the effects of oxidized LDL on the system ♦ Eat variety of foods; avoid eating the same foods every day: variation of foods you eat, allows for a greater intake of vitamins & minerals the body needs.Complications of Hyperlipidaemia: ♦ Atherosclerosis, Coronary artery disease ,Stroke and also death .Atherosclerosis: Atherosclerosis a disease which affects large and medium sized arteries isnow a leading cause of death in many developed countries. The lesioncharacteristic of Atherosclerosis is a localized plaque in the intima and iscomposed of cholesterol esters, proliferation of smooth muscle, deposition offibrous proteins (predominantly collagen) and calcification such plaques, Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 173 Dept of PG studies dravyaguna
  • 105. DISEASE REVIEW ♦ Narrow the arterial lumen causing distal ischemia. ♦ Ulcerate in to the arterial lumen, with thrombosis of the artery and distal embolisation or ♦ Weaken the arterial wall leading to formation of aneurysms .The coronary and the cerebral circulations are common sites of aneurysms. PLATE: 3 FORMATION OF ATHEROSCLEROSISThe causes of Atherosclerosis is not known although several factors have beenblamed in the pathogenesis of Atherosclerosis, A lot of experimental and Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 174 Dept of PG studies dravyaguna
  • 106. DISEASE REVIEWepidemiological evidence suggests a relationship between Atherosclerosis andelevated levels of plasma lipids (cholesterol triglycerides)Although there is no diagnostic abnormal pattern of the plasma lipids in subjectwith atherosclerosis, an increase in plasma LDL cholesterol and triglycerideshasbeen observed in such patients, the risk of ischemic heart disease (IHD) inindividuals with hyper cholesteraemia, is about THRICE as great as in those withnormal plasma cholesterol. Hence a reduction of plasma lipid levels either bydietic restriction or by drugs may prevent the development of Atherosclerosis orarrest its progress; studies have shown that a reduction in plasma cholesteroldoes in fact reduce the risk of MI (Myocardial Infarction) Table No: 17 Serum lipid levels ( mg/dl) & the risk of IHDLipid Desirable level Border line level Abnormal level ( high (Low risk) (moderate risk) risk)Tot. 200 200-240 240cholesterolLDL 130 130-160 160cholesterolHDL 60 40-60 40cholesterolTriglycerides 200 200-400 400The risk increases further with other risk factors such as smoking DM & HTN Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 175 Dept of PG studies dravyaguna
  • 107. DISEASE REVIEW The constituents of atheroma being cholesterol and other lipids, whichmay be free in the intimal tissues or in intracellular layers, At a later stage thedeposition of cholesterol, forms a lesion which becomes sclerosed and calcified.Thrombosis is liable to occur on the surface of the plaque particularly if itulcerates, embolism is frequent, which results in many dreadful disease like IHD,cerebral thrombosis etc.Risk Factors for Atherosclerosis:1. Not Reversible. Aging , Male sex , Genetic traits- family history of premature atherosclerosis2. Reversible: Cigarette smoking , Hypertension , Obesity3. Potentially or partially reversible Hyperlipidemia, Diabetes mellitus, Low levels of HDL (40 mg / dl)4. Other possible factors: Physical inactivity , Emotional stress and personalityFactors to be considered in patients with Hyperlipidemia1. Disorders to which Hyperlipidemia is Secondary: a. Uncontrolled DM (insulin deficiency) b. Hypothyroidism c. Uremia Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 176 Dept of PG studies dravyaguna
  • 108. DISEASE REVIEW d. Nephrotic syndrome e. Obstructive liver disease. f. Dysproteinaemia (multiple myeloma lupus erythematosas)2. Drugs producing or aggravating Hyperlipidemia a. Oral Contraceptives b. Estrogens c. Glucocorticoids d. Antihypertensive3. Dietary factors a. Caloric intake (recent weight gain) b. Content of saturated fats & cholesterol c. Alcohol intake4. Genetic disorders (primary Hyperlipidemia) a. Family history of Hyperlipidemia or xanthomas b. History of Pancreatitis or recurrent abdominal pain. Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 177 Dept of PG studies dravyaguna
  • 109. DISEASE REVIEWManagement of HYPER LIPIDEAMIA In the management of Hyperlipoprotinemia weight reduction, appropriatemodification of diet, abstinence from alcohol and specific treatment of the causativedisease, if any, such as hypothyroidism and diabetes mellitus, are much more importantthan lipid-lowering drugs. The corner-stone of the current therapy is improvement in thelife style for the primary and secondary prevention of CHD. Non-pharmacological treatment comprises: ⇒ Dietary modification ⇒ Increased physical activity. ⇒ Elimination of associated risk factors. Example: Smoking etc.Dietary modification implies: • Decreasing the consumption of foods such in total and saturated fats and cholesterol (High fat meats, butter, eggs and whole milk) • Increasing the consumption of poultry, low fat fish and skimmed milk, together with large helpings of vegetables and fruits. • Reduce the body weight to the ideal level. • Decrease the consumption of total fats to 15-20% of the daily caloric intake. Excessive use of poly unsaturated fats in diet is no longer recommended as they are known to lower the protective HDL CHD levels. Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 178 Dept of PG studies dravyaguna
  • 110. DISEASE REVIEWDRUG THERAPY IS INDICATED IN: • In whom the above dietary measures are not successful. • Who find the dietary restrictions, irksome and • Who are at risk of Pancreatitis because of very high levels of (1000 mg %) of serum triglycerides: Drug therapy should be started with the understanding that it will have to becontinued life long. The drugs do not cure the basic disorder of lipoprotein metabolism.But symptomatically control only one aspect of the disease process. Further the drugs areexpensive. However, used judiciously they are capable of retarding the atheroscleroticprocess and prolonging life.Antihyperlipidemic drugs:These drugs act predominantly on: • Elevated cholesterol Eg:- Cholestyramine resin, HMG COA reductase inhibitors (statins), ezetimide, probucol, fiber. • Elevated triglycerides Eg:- Fibric acid derivatives (fibrates), fish oil or • Both Eg: Nicotinic acid. Hyperlipidaemic drugs are most beneficial to those at greatest risk, includingthose with symptomatic atherosclerotic disease such as angina and many cardio vascularrisk factors, as well as to those with the highest plasma levels of cholesterol. Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 179 Dept of PG studies dravyaguna
  • 111. DISEASE REVIEW STAINS: (HMG COA reductase inhibitors):-(1) LOVASTATIN: Statins inhibit the enzyme Hydroxymethyl glutaryl. Co-enzyme (HMG CO=A-reductase). The hypolipidemic effect is dose dependent and is observed in 10 days. Simvastatin and atorvastatin, in addition raise HDL level in some patients andlower the tryglyceride levels.Table no : 18 Dose of commonly used statins:Drug Starting / Max. dose mg. / day1) Lovastatin 20/802) Pravastatin 20/403) Simvastatin 20/804) Fluvastatin 20/805) Atorvastatin 10/806) Cerivastatin 0.4/0.87) Rosuvastatin 10/40Atorvastatin may be given at any time of the day, pravastatin and fluvastatin at bed time,others with evening meal.Therapantic uses: Statins are useful in lowering blood LDL, CHD, particularly in thosepatients who do not respond to dietary therapy. They have been shown to reduce. (a) Progression of atherosclerotic lesions. (b) Occurrence of myocardial infarction and Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 180 Dept of PG studies dravyaguna
  • 112. DISEASE REVIEW (c) Total mortality from all causes in men up to 70 years of age with known IHD. Statins, used alone can lower LDL level. By 40-60%. Addition of cholestyramineresin further lowers the LDL level, addition of nicotinic acid lowers the LDL level bymore than 70%. The stains may have several non-lipid beneficial effects, they are: ⇒ Decrease in platelet aggregation and in fibrinogen levels. ⇒ Decrease in macrophage infiltration into the vessel wall. ⇒ Decrease in the arterial muscle proliferation and ⇒ Decrease LDL oxidation in the vessel wall. ADR’s ⇒ Dose dependent myalgia, Muscle weakness. Rarely statins may cause impotence, gynecomastia, peripheral neuropathy and memory loss. Contra Indication:- ⇒ In pregnancy and Woman planning to become pregnant. ⇒ During breast feeding. ⇒ Patients with severe liver disease. Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 181 Dept of PG studies dravyaguna
  • 113. DISEASE REVIEW(2) SITOSTEROL:- Clinically it has been observed that plant sterols lower serum cholesterol levels by15-20% in patients of hypercholesterolemia, the maximum effective dose being 10 gm./day.MOA: Sitosterol retards the intestinal absorption of cholesterol by competing for sites ofesterification. It has been observed that sitesterol brings about increase in fecal steroidexcretions by preventing the absorption of ingested cholesterol.Side effects (ADR) : - Anorexia, Cramps and diarrhoea.(3) CHOLESTYRAMINE: The chorid salt of this resin is used as a drug. Upon ingestion, the resin releases itchloride anion in exchange for the anion of bile acids which are firmly bound with theinsoluble resin and excreted in the faeces.MOA: Cholestyramine is not absorbed or digested in the gastro intestinal tract and bindsbile acid in the intestinal lumen thus preventing their re-absorption and increasing theirfecal elimination.Side effects (ADR): Bowel disturbances, usually constipation may occur, diarrhoea occurs in certain cases, nausea,flatulence and irritation of the tongue and perineal region.(4) NEOMYCIN: Neomycin, an antibiotic significantly reduces the serum cholesterol level in manby 10.36%. In the dose of 1-2 gm. per day it is relatively well tolerated. Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 182 Dept of PG studies dravyaguna
  • 114. DISEASE REVIEWMOA: The decrease of serum cholesterol by neomycin could be explained on the basisof increased elimination of cholesterol in the form of bile acids and neutral sterols infaeces. Thus, increased fecal loss of bile acids by neomycin may reduce sterol and fatabsorption like cholestiramine i.e., bile acid deficient.Side effects: Large doses cause diarrhoea and malabsorption syndrome due to partialvillous atrophy of jejunal mucosa.(5) CLOFIBRATE: It is the most widely used Antihyperlipidemic agent. The chemical name of thecompound is ethyl ester of P-chlorophenoxy isobutyric acid.MOA: Despite extensive studies in animals and man, the Antihyperlipidemic mode ofaction of clofibrate is still not clearly understood, clinically it is mainly effective inreducing endogenous triglycerides of VLDL, with much less effect on plasma cholesteroland LDL.Side effects (ADR) :Mild nausea, flatulence and diarrhoea, possibly due to its oilynature. Rarely – Wt gain, transient increase in SGOT levels and myositis have also beenreported in few cases .(6) NICOTINIC ACID: In does of 3-6 gm / day, nicotinic acid was found to be effective in lowering theblood, cholesterol in approximate 75% of the cases but showed less effect on thetriglycerides level. Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 183 Dept of PG studies dravyaguna
  • 115. DISEASE REVIEWMOA: Despite its use for the last so many years, the precise mode of action is not clearalthough several mechanisms have been suggested. Recently Meittinen(1970) observedthat nicotinic acid might stimulate catabolism of serum lipoprotein and inhibit theirformation, thus leading to augmented excretion of cholesterol into bile.Side effects (ADR) ⇒ Cutaneous flushing. ⇒ Parasthesia and various GI side effects, like nausea, heart burn, flatulence, diarrhoea.Chronic administration: Impaired glucose tolerance as well as hepatic dysfunction.(7) DEXTRO THYROXINE: By this drug, serum cholesterol, phospholipids and beta – lipoprotein levels wereprimarily increased but had inconsistent effects on the triglycerides level.MOA: Act as a hypocholesteramic agent by increasing the rate of oxidative removal ofcholesterol to bile acids. On the contrary gries et al (1962) observed that it stimulatesHMG COA reductase, the key enzyme in the biosynthesis of cholesterol.Side effects: Nervousness, sweating, insomnia tremor, hair loss, menstrual irregularities,nausea, and diarrhoea. Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 184 Dept of PG studies dravyaguna
  • 116. DISEASE REVIEWREFERENCES FOR DISEASE REVIEW. 1. Radhakanthadeva Raja, “Shabdakalpadruma”, Vol 3, 3rd ed Varanasi, Chaukhamba Sanskrit Series office, 1967, Tpg:555 2. Apte Vaman Shivram, “The Student’s Sanskrit English Dictionary”, 2nd ed, Delhi, Motilal Banarsidas Publishers, 1970, T.pg 664. 3. Umeshaachandra Gupta Kaviraj, “Vaidyaka Shabda Sindu”, 4th ed, Varanasi, Chaukhamba Orientalia, 1999, Tpg:1212 4. “Vedome Ayurveda” -yajurveda 8/12/18, Choukamba bharati academy, Varanasi. 5. Susruta,Susruta Samhita,Vol I(Edited with Ayurveda Tattva Sandipika)by Shastri Kaviraja Ambikadutta, 12th ed.Varanasi:Chaukhamba Sanskrit Sansthan 2001,Tpg:879 5a - S.Sha.4/13, 5b: Su.Sha 4/15, 5c : Su. su 14/10, 5d: Su.Su 15/44, 5e –Su.Su 15/6,5f:Su.Sha9/18,5g:Su.Su15/17,5h: Su.Su15/10 5i:Su.Su35/18 5j:Su.Su15/13, 5k–Su.Su9/18,5l: Su.Su15/37,5m:Su.Su15/37,5n:Su.Su15/38 5o:Su.Su15/32, 5p:Su.Su14/14 5q Su.Su14/3,5r:Su.Su14/16,5s:Su.Su15/33,5t:Su.Su15/5 5u:Su.Su14/5,5v:Su.Su21/5. 5w –Su.Su 21/15,5x:Su.Sha7/11,5y:Su.Su15/14 6 Agnivesa’s, “Charaka Samhita” (revised by Charaka and Dridhabala) with ‘Ayurveda Deepika’ commentary of Chakrapanidatta, Edited by Vaidya Acharya Jadavaji Trikamji, 5th ed, Varanasi, Chaukambha Sanskrit Sansthan 2001, T.pg: 738 6a C.Chi 15/15 ,6b C.Chi 15/28,6c c.sha 7/6, 6dC.Vi 5/7, 6e C.Vi 5/8 Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 185 Dept of PG studies dravyaguna
  • 117. DISEASE REVIEW 6f C.Chi 15/17 ,6g C.Chi 15/18,6h C.Su 17/64, 6i C.Vi 28/106, 6j C.Vi 5/16 6k C.Su 28/14,6l C.Su 21/3,6m C.Su 21/4, 6n C.Su 21/4, 6o C.Su 21/7 6p C.Su 21/9 ,6q C.Su 20/17,6r C.Chi 15/36, 6s C.sha 7/12, 6t C.Chi 15/15 6u C.Vi 5/9 ,6v C.Vi 5/18,6w C.Su 28/81, 6x C.Su 20/18, 6y C.Vi 8/16 6z C.Su 18/51 6z2:C.Su 20/18 7 Vagbhata’s, “Ashtanga Hridayam”, with commentaries (Sarvangasundara) of Arunadatta and (Ayurvedarasayana) of Hemadri, collated by Dr.Anna Moreshwar Kunte and Krishna Ramachandra Shastri Navare, 8th ed, Varanasi, Chaukhambha Orientalia, 1998, Tpg:956. 7a A.h.su 11/15 , 7b A.H.Su 11/27, 7c A.H.Su 11/10, 7d A.H.Su 11/18, 7e A.H.Su 14/207f A.H.Su 13/12 , 7g A.H.Su 11/7, 7h A.H.Su 12/53, 7i A.H.Su 13/10. 8 Sharangadharacharya’s “The Sharangadhara Samhita”, with Adhamalla’s ‘Dipika’ and Kasirama’s ‘Gudartha Dipika’ commentaries, Varanasi, Krishnadas Academy, Reprint 2000, T.pg 398 5/84 9 Madhavakara,Madhava Nidana, Madhokosa Commentary on Maharshi Atreya- Haritha Muni Samhith revised by Kavirathna Tripati Kaliprasad,Mumbai,Sri Venkateshwara Steam Press, 1984,:Tpg:512. 10 Sen Govindaraj Kaviraj, “Bhaishajya Ratnavali”, Edited by Siddhiprada Hindi Commentary by Prof Siddhinandan Mishra, 1st ed, Varanasi, Chaukhamba Surabharathi Prakashan, 2005, Tpg:1196 pg 742Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 186 Dept of PG studies dravyaguna
  • 118. DISEASE REVIEW 11 Bhavamishra, Bhavaprakasha,Vidhyotini Hindi Vyakya,Shri Bhramashankar Shastri(Purvardha),4th edition, Sirija,Varanasi,Chaukhamba Samskritha,1961Tpg:941 12 Yogaratnakara, Vidyotini Hindi Tika Vaidya Shri Lakshmipathi Shastri,2nd edition Varanasi,Chaukamba Samskritha Sirija 1973,Tpg:503 14 Chakrapanidatta, “Chakradatta”, (Sanskrit text with English translation by Priyavat Sharma), Varanasi, Chaukamba Orientalia, 1998. 15 Vidhydhar shukla , “Ayurvediya vikruthi vignanana” choukamba samsruta Prakaashana, srijou printers reprint 2004, Varanasi, 16 C.C.Chatterjee, Human physiology” published by A.K Chatterjee, Tenth edition , 1994, Calcutta . 17 Harsha Mohan ‘Text Book of Pathology by J.P.Brothers Medical publishers 4th Edition New Delhi’.pp 949. 18 R.S.Satoskar,S.D.Bhandarkar, Nirmala N.Rege “ Pharmacology and Pharmacotherapeutics ,Twentieth Edition, Popular Prakashan ,Mumbai. Pp1130. 19. www.pubmed.com 20. www.science direct.comEvaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 187 Dept of PG studies dravyaguna
  • 119. DISEASE REVIEW Lekhana karma In the subject Dravyaguna, Lekhana refers to a pharmacological activityadvocated in such of the conditions where thinning, attenuating, drying is required.Derivation of Lekhana:The word Lekhana is derived from the root √ ÍsÉZÉç, which means to scrape.ÍsÉZÉç + srÉÑOèû sÉåZÉlÉÇ , x§ÉÏ vÉoSÍsÉZÉç + srÉÑÈ sÉåZÉlÉÈ , mÉÑÇ vÉoSThe terms like Lekhaniya, Samlekhana and Avalekhana are often used as synonyms forLekhana.Definitions of Lekhana: Lekhana karma is resulted through various types of activities which become moreconspicuous at different contexts. • The activity which is capable of reducing or drying the dhatus (especially medas) and malas (the morbid factors adherent to srothas) is Lekhana.2 While Sharangadhara defines Lekhana to be an activity which especially dries up the dhatus and malas of the body, the commentator Adhamalla clarifies that the word dhatu refers to all the rasadi dhatus and the activity results in reduction or emaciation. • Both Charaka and Vagbhata have mentioned the Lekhaniya gana dravyas but do not define the activity. Acharya Indu, the commentator of Ashtanga Sangraha, in his Shashilekha commentary, defined Lekhana as, “that activity which is capable of separating the coated or deposited morbid factors (Upalepa) from any part of Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 188 Dept of PG studies dravyaguna
  • 120. DISEASE REVIEW the body (like srotas etc.) which is responsible for total or partial blockage (Avarana) in the passage.3 • The mechanism of reduction of a dhatu or mala or morbid factor can be carried out in dual ways; one by reducing the bulk by thinning4 (Patalikarana) and the other by drying5 (Shoshana). Here drying up refers to the reduction in fluidity and/or fatty consistency (drava and snigdha). The conditions where shoshana kriya is indicated are Vranakleda (wound with more of slough), Shonitakleda or Raktadushti (such of the principles in the blood which when increased gives rise to variation in the viscocity), Meha (diabetes insipidus and diabetes mellitus).5Lekhana dravyas: Lekhana dravyas are said to have predominantly Agni and Vayu mahabhutas,often possessing Tikta and Kashaya rasas, Laghu and Khara guna.6Charaka and Vagbhata classify the medicinal plants based on their activity under fiftymahakashayas, each comprising of ten drugs and one among them is Lekhaniya Gana.Acharya Sushrutha has identified groups of drugs possessing similar activities and givesan opinion that the plants falling under each group could be used either singly orcollectively to achieve the efficacy. Out of 35 ganas, 10 ganas have been attributed with Kaphahara and Medoharaactivities which in turn can be compared with Lekhana activity. These drugs are alsoindicated in Lekhana basti, in Sthoulya chikitsa. The ganas are as follows; • Ushakadi ,Varunadi,Salasaradi,Rodhradi, Arkadi, Mushkakadi, Nyagrodhadi, Tryushanadi, Mustadi, Vachadi Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 189 Dept of PG studies dravyaguna
  • 121. DISEASE REVIEW A critical analysis of the literature unravels the properties and types activities, aLekhana dravya should possess and is as follows; • Gunas like laghu, Khara and ruksha in order to counteract the gunas of kapha (or medas) like guru, shlakshna and snigdha. • Different actions can be attributed for lekhana karma as mentioned below. Table No : 19 Showing different forms of lekhana Karma.Sthoulyahara, Karshana, Shoshana, Medohara Anti obesity activityPathalikarana, Shonita sanghata bhedana Fibrinoloytic or Thrombolytic activityKledahara, Kledopashoshana, kaphahara Anti hyperlipidemic activitySrothorodhahara, Margavivarana, Dhamani Anti atherosclerotic activitypratichayahara, Dhamani upalepaharaPathalikarana Thinning activityShodhana Wound debridement Apart from the above mentioned activities, every diseased status, as per theprinciples of Ayurveda, needs the Agni to be rectified. This can be achieved through theusage of Deepana, Pachana individually. It is seen that the drugs having above mentionedactivities possess Deepana and Pachana activities also.Therapeutic actions of Rasas:Agnimantha is having katu, tikta and kashaya rasa according to majority of authors andvery few authors have mentioned madhura rasa also. The therapeutic actions of theserasas are as follows;1] Katu Rasa: The drug having Katu rasa; • Keeps the mouth clean, Increases appetite and promotes digestion, Helps in better absorption of food, Causes secretion through nose and produces Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 190 Dept of PG studies dravyaguna
  • 122. DISEASE REVIEW lacrimation. It helps in proper functioning of sense organs, it relieves diseases like Alasaka, Shvayathu, Upachaya, Udarda, Abhishyanda • Helps in elimination of waste products like sneha, sweda, kleda etc.,Causes deliciousness in food, Relieves itching, poisonous effects and skin diseases. • Terminates excessive growth of ulcers, Acts as germicidal, Scrapes off the muscle tissue. Breaks blood clots and other obstructions.Clears / dilates the channels. Alleviates kapha. 2] Tikta Rasa: The drug having Tikta rasa; • Though it is not delicious by itself, promotes deliciousness in food, Acts as anti toxic and germicidal. Relieves fainting, burning sensation, itching, skin diseases, thirst and fever. Promotes firmness to skin and muscles. Increases appetite and promotes digestion. Purifies breast milk. Possess Lekhana activity and causes drying of moisture, fat, muscle fat, bone marrow, lymph, pus, sweat, urine, stool, pitta and kapha. 3] Kashaya Rasa: The drug having Kashaya rasa; • Is astringent or constipative. Promotes union of broken tissue, promotes healing of wounds • Absorbs body fluid, Possess Lekhana karma and dries up the moisture. • Alleviates kapha and raktapitta. ReferenceDefinitions:1. Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 191 Dept of PG studies dravyaguna
  • 123. DISEASE REVIEW • sÉåZÉlÉÇ DwÉccÉqÉïÌuÉSUhÉÇ bÉwÉïhÉãlÉ, iÉxqÉæ ÌWûiÉÇ sÉåZÉlÉÏrÉqÉç |[aÉÇaÉÉkÉU] • vÉsrÉiÉl§Éå MüÌPûlÉÉåixÉ³É qÉÉÇxÉÉlÉÉÇ uÉëhÉÉlÉÉÇ vÉx§ÉåhÉ ¤ÉÉæqÉÉÉÌSÍpÉuÉÉï bÉwÉïhÉÇ sÉåZÉlÉÍqÉirÉÑcrÉiÉå | [xÉÑ.ÍcÉ.1] • sÉåZÉlÉÇ xuÉsmÉ qÉÉÇxÉÉÇMÑüUÈ |[QûsWûhÉ] • sÉåZÉlÉÇ uÉëhÉɱÑixɳÉqÉÉÇxÉxrÉ |[xÉÑ.xÉÔ.42/10]2kÉÉiÉÔlÉç qÉsÉÉlÉç uÉÉ SåWûxrÉÌuÉvÉÉåwrÉÉåssÉåZÉrÉåccÉ rÉiÉç | sÉåZÉlÉÇ iɱjÉÉ ¤ÉÉæSìÇ lÉÏUqÉÑwhÉÇ uÉcÉÉ rÉuÉÉÈ ||[vÉÉ.qÉ.4/10] • rÉiÉç SìurÉÇ UxÉÉSÏlÉç qÉsÉÉlÉç uÉÉ | ÌuÉvÉÉåwrÉ vÉÑwMüÉlÉç M×üiuÉÉ sÉåZÉrÉåiÉç xjÉÔsÉxrÉ M×üvÉiÉÉÇ MüÉUrÉåiÉç iÉssÉåZÉlÉqÉç | [ARûqÉssÉ OûÏMüÉ] • sÉåZÉlÉÇ MüTüqÉåSxÉÉåÈ |[QûsWûhÉ] • SåWûkÉÉiÉÑ qÉsÉÉlÉç uÉÉ ÌuÉvÉÉåwrÉ rÉssÉåZÉrÉåiÉç iÉiÉÈ | rÉjÉÉ ¤ÉÉæSìqÉç ||[pÉÉ.mÉë.mÉÔ.6/224] • sÉåZÉlÉÇ qÉåSÉãWûUqÉç |[xÉÑ.xÉÔ.45/112] • sÉåZÉlÉÇ ÌuÉMüwÉïhÉqÉç |[AÉrÉÑuÉåïS UxÉÉrÉlÉ OûÏMüÉ, A.WØû.xÉÔ.6/11] • sÉåZÉlÉÇ SÉãwÉxÉëÉuÉhÉɳÉrÉlÉxrÉ ËU£üÏMüUhÉqÉç |[xÉÑ.E.18/53]3. sÉåZÉlÉÇ SåWåû EmÉsÉåmÉÉÌSMüÉlÉç pÉÉuÉÉlÉç ÌuÉÎcNû³ÉÌiÉ |[ClSÒ] • EmÉsÉåmÉÈ vsÉåwqÉhÉÉ, iÉÇ WûUiÉÏÌiÉ |[cÉ.ÍcÉ.26/213]4. sÉåZÉlÉÇ MüqÉïMüÉUÏ mÉiÉsÉÏMüUhÉÈ |[xÉÑ.xÉÔ.46/519] • sÉåZÉlÉÇ mÉiÉsÉÏMüUhÉÈ |[QûsWûhÉ]5. vÉÉåwÉhÉÈ MüTüqÉåSxÉÉå: SìuÉÎxlÉakÉrÉÉåÈ |[xÉÑ.xÉÔ.38/9] • vÉÉåwÉhÉÉå SìuÉkÉÉiÉÉåÈ uÉëhÉqÉåWûÉSÏlÉÉÇ uÉÉ |[xÉÑ.xÉÔ.42/10] • vÉÉåwÉhÉÈ uÉëhÉYsÉåSxrÉ |[xÉÑ.xÉÔ.11/5] • vÉÉåwÉhÉÉå SÒ·U£üÉSåÈ |[xÉÑ.ÍcÉ.13/9] • ÌuÉvÉÉåwÉÏ SìuÉkÉÉiÉÉåÈ |[xÉÑ.xÉÔ.46/25]6. Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 192 Dept of PG studies dravyaguna
  • 124. DISEASE REVIEW • sÉåZÉlÉÇ AÌlÉsÉÉlÉsÉaÉÑhÉpÉÔÌrɸqÉç |[xÉÑ.xÉÔ.41] • ÌiÉ£üÉå UxÉÈ………sÉåZÉlÉÈ…..|[cÉ.xÉÔ.26/4] • MüwÉÉrÉÉå UxÉÈ…….sÉåZÉlÉÈ……|[cÉ.xÉÔ.26/5] • rÉxrÉ sÉåZÉlÉå vÉÌ£üÈ xÉÉ ZÉUÈ |[WåûqÉÉÌSì] • sÉbÉÑxiÉ̲mÉUÏiÉÈ xrÉÉiÉç sÉåZÉlÉÉå UÉåmÉhÉxiÉjÉÉ |[xÉÑ.xÉÔ]7.MüOÒû UxÉ: • MüOÒûMüÉå UxÉÉå uÉ¢üÇ vÉÉåkÉrÉÌiÉ, AÎalÉÇ SÏmÉrÉÌiÉ, pÉÑ£üÇ vÉÉåwÉrÉÌiÉ, bÉëÉhÉqÉÉxÉëÉuÉrÉÌiÉ, cɤÉÑÌuÉïUåcÉrÉÌiÉ, xTÑüOûÏMüUÉåiÉÏÎlSìrÉÉÍhÉ, AsÉxÉMüµÉrÉjÉÔmÉcÉrÉÉåSSÉïÍpÉwrÉlS xlÉåWûxuÉåSYsÉåSqÉsÉÉlÉÑmÉWûÎliÉ, UÉåcÉrÉirÉvÉlÉÇ, MühQÕûÌuÉïlÉÉvÉrÉÌiÉ, uÉëhÉÉlÉuÉxÉÉSrÉÌiÉ, Ì¢üqÉÏlÉç ÌWûlÉÎxiÉ, qÉÉÇxÉÇ ÌuÉÍsÉZÉÌiÉ, vÉÉåÍhÉiÉxÉÇbÉÉiÉÇ ÍpÉlÉͨÉ, oÉÇkÉÉÇÎvNûlÉͨÉ, qÉÉaÉÉïlÉç ÌuÉuÉ×hÉÉåÌiÉ, vsÉåwqÉÉhÉÇ vÉqÉrÉÌiÉ, sÉbÉÑÂwhÉÉå Ã¤É¶É | [cÉ.xÉÔ.26/4] • MüOÒûMüÉå SÏmÉlÉÈ mÉÉcÉlÉÉå UÉåcÉlÉÈ xjÉÉæsrÉÉsÉxrÉ MüTüM×üÍqÉÌuÉwÉMÑü¸MühQÕûmÉëvÉqÉlÉÈ xÉÎlkÉoÉlkÉÌuÉcNåûSlÉÉåÅuÉxÉÉSlÉÈ xiÉlrÉvÉÑ¢üqÉåSxÉÉqÉÑmÉWûliÉÉ cÉåÌiÉ | [xÉÑ.xÉÔ.42/4]8.ÌiÉ£ü UxÉ: • ÌiÉ£üÉå UxÉÈ xuÉrÉqÉUÉåÍcÉwhÉÑUmrÉUÉåcÉMüblÉÉå ÌuÉwÉblÉÈ Ì¢üÍqÉblÉÉå qÉÔNûÉïSÉWûMühQÕûMÑü¸iÉ×whÉÉmÉëvÉqÉlÉxiuÉXèûqÉÉÇxÉrÉÉå È ÎxjÉUÏMüUhÉÉã euÉUblÉÉå SÏmÉlÉÈ mÉÉcÉlÉÈ xiÉlrÉvÉÉåkÉlÉÉå sÉåZÉlÉÈ YsÉåSqÉåSÉåuÉxÉÉqÉeeÉsÉxÉÏMüÉmÉÔrÉxuÉåSqÉÔ§ÉmÉÑUÏwÉÌm ɨÉvsÉåwqÉÉåmÉvÉÉåwÉhÉÉå äÉÈ vÉÏiÉÉå sÉbÉÑ¶É | [cÉ.xÉÔ.26/5] • ÌiÉ£üvNåûSlÉÉå UÉåcÉlÉÉå SÏmÉlÉÈ vÉÉåkÉlÉÈ MühQÕûMüÉåPûiÉ×whÉÉqÉÔNûÉïeuÉUmÉëvÉqÉlÉÈ xiÉlrÉvÉÉåkÉlÉÉåEvaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 193 Dept of PG studies dravyaguna
  • 125. DISEASE REVIEW ÌuÉhqÉÔ§ÉYsÉåSqÉåSÉåuÉxÉÉmÉÔrÉÉåmÉvÉÉåwÉhÉÈ cÉåÌiÉ | [xÉÑ.xÉÔ.42/5]9.MüwÉÉrÉ UxÉ: • MüwÉÉrÉÉå UxÉÈ xÉÇvqÉlÉÈ xÉÇaÉëÉWûÏ xÉlkÉÉlÉMüUÈ mÉÏQûlÉÉå UÉåmÉhÉÈ vÉÉåwÉhÉÈ xiÉqpÉlÉÈ vsÉåwqÉU£üÌmɨÉmÉëvÉqÉlÉÈ vÉUÏUYsÉåSxrÉÉåmÉrÉÉå£üÉ Ã¤ÉÈ vÉÏiÉÉåÅsÉbÉÑ¶É | [cÉ.xÉÔ.26/6] • MüwÉÉrÉÈ xÉÇaÉëÉWûMüÉå UÉãmÉhÉÈ xiÉqpÉlÉÈ vÉÉåkÉlÉÉå sÉåZÉlÉÈ vÉÉåwÉhÉÈ mÉÏQûlÉÈ YsÉåSÉåmÉvÉÉåwÉhɶÉåÌiÉ | [xÉÑ.xÉÔ.42/10] VISHOSHI KASHAYA Ayurvedic pharmacology envisages multiple attributes of a single drug throughdifferent dosage forms. Ayurvedic pharmaceutics gives pivotal importance to processingof drugs. Pharmaceutical skills can be very well appreciated as early as 3000 BC throughCharaka’s quotes – The potentiality of a drug can either be minimized or enhanced byadding or deleting certain drugs from a group, by the influence of kala and by subjectingit to specific processing techniques. These specific processing techniques are termed as‘Kalpas’. Acharya Harita, one of the students of Punarvasu Atreya gives a unique insighttowards the reductive methodology of Kwatha kalpana (one of the panchavidha kashayakalpana) in Harita Samhita, wherein during the processing of the drugs, as the reduction Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 194 Dept of PG studies dravyaguna
  • 126. DISEASE REVIEWof water content increases the karma ascribed to the kwatha varies from tarpana toapatarpana. In the context of Jwara, Harita cites the usage of Sapta vidha kashays (seven typesof decoctions) depending on the state of the dosha, dhatu and mala and the specificactivity required to bring them to normalcy. The Sapta vidha kashayas as mentioned byHarita are: Pachana kashaya, Deepana kashaya, Shodhana kashaya, Shamana kashaya,Tarpana kashaya, Kledana kashaya and Vishoshi kashaya. mÉÉcÉlÉÉå SÏmÉlÉÏrÉ¶É zÉÉåkÉlÉ: zÉqÉlÉxiÉjÉÉ | iÉmÉïhÉ: YsÉåSlÉ: zÉÉåwÉÏ YuÉÉjÉ: xÉmiÉÌuÉkÉ: xqÉ×iÉ: || (WûÉ.xÉÇ.iÉ×.1/47)Method of preparation of Saptavidha kashayas: Pachana kashaya is prepared by reducing the water to half. Deepana kashaya is prepared by reducing the water to one tenth. Shodhana kashaya is prepared by reducing the water to one twelfth. Shamana kashaya is prepared by reducing the water to one eighth. Tarpana kashaya is prepared by just boiling with no reduction in volume of water. Kledana kashaya is prepared by reducing the water to one fourth. Vishoshi kashaya is prepared by reducing the water to one sixteenth. • mÉÉcÉlÉÉåÅkÉÉïuÉzÉÉåwÉÏ xrÉcNûÉåkÉlÉÉå ²ÉSzÉÉÇzÉMü: | YsÉåSlɶÉiÉÑU…¡û¶É zÉqÉlÉÉåŹÉuÉzÉåÌwÉiÉ: || SÏmÉlÉÏrÉÉå SzÉÉÇzÉxiÉÑ iÉmÉïhÉ¶É xÉqÉÉÇzÉMü: | ÌuÉzÉÉåwÉÏ wÉÉåQûzÉÉÇzÉ¶É YuÉÉjÉpÉåSÉ: mÉëMüÐÌiÉïiÉ: || (Wû.xÉÇ.iÉ×.1/48-49)Utility of Sapta vidha kashayas: Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 195 Dept of PG studies dravyaguna
  • 127. DISEASE REVIEW Pachana kashaya does dosha pachana, Deepana kashaya does agni deepana,Shodhana kashaya does malashodhana, Shamana kashaya does roga shamana, Tarpanakashaya does dhatutarpana, Kledana kashaya does hridaya kledana and Vishoshi kashayadoes shoshana. • mÉÉcÉlÉ: mÉcÉiÉå SÉåwÉÉlSÏmÉlÉÉå SÏmrÉiÉåÅlÉsÉqÉç | zÉÉåkÉlÉÉå qÉsÉzÉÉåkÉÏ xrÉÉcNûqÉlÉ: zÉqÉiÉå aÉSÉlÉç || iÉmÉïhÉxiÉmÉïiÉå kÉÉiÉÔlYsÉåSÏ WØûiYsÉåSMüÉUMü: | ÌuÉzÉÉåwÉÏ zÉÉåwÉqÉÉkɨÉå iÉxqÉÉiYuÉÉjÉÇ mÉUϤÉrÉåiÉç || YsÉåSÏ ÌuÉzÉÉåwÉÏ ÌuÉ¥ÉÉrÉ uÉÉqÉlÉÇ MüÉUrÉå³ÉUqÉç |(WûÉ.xÉÇ.iÉ×.1/50-51) Bheshaja kala of Sapta vidha kashayas: mÉÉcÉlÉÇ cÉ lÉUå SårÉÇ ÌlÉzÉÉxÉÑ mÉëÌuÉeÉÉlÉiÉÉ||mÉÔuÉÉï»åû zÉqÉlÉÉå SårÉÉåÅmÉUÉ»åû SÏmÉlÉÈ xqÉ×iÉÈ|| xÉliÉmÉïhÉÉå pÉåSlÉ¶É MüsrÉå mÉÉlÉÉrÉ SÉmÉrÉåiÉç|| zÉÉåwÉhÉåÅÌmÉ mÉëpÉÉiÉå cÉ YuÉÉjÉÈmÉÉlÉå mÉëMüÐÌiÉïiÉÈ|| (WûÉ.xÉÇ.iÉ×1/43) Pachana kashaya is administered in the 2nd yama of night (Nisha), Shamanakashaya in purvahana, Deepana kashaya is administered in the aparahna, santarpana andbhedana kashaya and shoshana kashaya in prabhata kaala. Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 196 Dept of PG studies dravyaguna
  • 128. DISEASE REVIEW INDUCTION METHODS In research and development of antidyslipidemic drugs the animal models areextensively created through feeding with cholesterol rich high fat diet (HFD). Forscreening of antidyslipidemic drugs the selection of an appropriate animal model thatclosely resemble with humans should be done. A number of animals like rabbits, mice, pigeons, dogs, pigs and monkeys are usedas models of dyslipidemia and atherosclerosis (Moghadasian et al., 2001). The two mostcommonly used animal models are rabbit and rat. Other animal models can be used aredog, pig, monkey and primates (Gerhard and Wolfgang, 1997). As reported by Gerhard and Wolfgang (1997) rabbits were the good models sincethere was better absorption of dietary cholesterol. Transgenic rat models such as Brown-Norway-Congenic strain, Wistar-albino rats and New Zealand hypertensive rats wereused for hyperlipidemic studies and for the screening of anti hyperlipidaemic drugs.Rat as animal model for Hyperlipidaemia: Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 197 Dept of PG studies dravyaguna
  • 129. DISEASE REVIEW The normal adult virgin rat serves as good model for hyperlipidemia ordyslipidemia. Male breeder rats will develop signs of advanced metabolic anddegenerative changes, including obesity, hyperlipidemia and arteriosclerosis easily.(Wexler, 1976). Dietary fat is one of the most important factors associated with cardiovasculardisease. High levels of cholesterol and saturated fat in diets have been shown to promotehyperlipidaemia and atherosclerosis (McNamara, 2000). Male Sprague-Dawley rats were fed for at least two weeks to producehyperlipidaemia with diet containing 1% cholesterol and 10 per cent olive oil (Lasser etal., 1973). Hyperlipidemia was induced in male rats by feeding diet containing 1%cholesterol or 15% lard (Chi, 1982). Wistar or Sprague-Dawley male rats of 6 to 8months old developed dyslipidemia after two weeks of feeding with diet containing 20per cent beef tallow (Hennig and Dupont, 1983). Seetharamaiah and Chandrasekhara (1989) induced hypercholesterolemia inmale albino rats which were fed hyperlipidemic diet containing starch, casein, sugar,groundnut oil and cholesterol. Male Sprague-Dawley rats of four weeks age were fed with diet supplementedwith 20 per cent beef tallow for four weeks that, developed dyslipidemia with high LDL-C, triglycerides, hepatic total lipid and low HDL-C levels compared to control rats (Ryu Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 198 Dept of PG studies dravyaguna
  • 130. DISEASE REVIEWand Cha, 2003). Similar reports about the usage of Sprague Dawley rats for inducinghyperlipidaemia or dyslipidaemia are available (Chi et al., 1982; Chetty et al., 2003;Megalli et al., 2005). High fat diet (HFD) made up of a mixture of coconut oil and vanaspathy inthe ratio 2:3 w/w has been used by for induction of dyslipidemia. HFD wasadministered at the dose of 10 ml per kg body weight for 30 days. Hyperlipidemia inexperimental rats was evidenced by a significant enhancement in the level oftriglycerides and phospholipids in serum (Shyamala et al. 2005). Hypercholesterolemia was induced in rats by feeding high cholesterol diet for 20days (Monte and Jimenz. 1993), by feeding 1% cholesterol and groundnut oil for 3 weeksin New Zealand white rabbits (Odetola et al. 2004) By administration of Triton WR-1339 to mice (Oh et al., 2006), by feedingatherogenic diet containing 1% cholesterol (Dhandapani, 2007), Rats fed with cholesterol(4.5%), sodium cholate (1.8%), butter (37%) and propylthiouracil (0.3%) for induction ofhypercholesterolemia showed serum cholesterol levels of as high as 1350 mg/dl. Thenumber of lesions which contained fat deposits was related to level of cholesterolemia(Countard and Mary, 1982). Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 199 Dept of PG studies dravyaguna
  • 131. DISEASE REVIEWMATERIALS AND METHODS The experimental evaluation of medohara activity (antihyperlipidaemic) ofAgnimantha in Wister Albino rats was designed under two headings: 1. Collection and Preparation of the Drugs 2. Phytochemical study 3. Experimental studyPLACE OF WORKPlace of experiment The study was carried out in the Department of Pharmacology and Toxicology, Government Veterinary College, Hebbal, Bangalore. The hydro alcohol extract (ethanol) and aqueous extract of roots of Clerodendron phlomidis was prepared at the GREEN CHEM. HAL Bangalore.Place of Phyto chemical analysis: Physico-chemical analysis was carried out at lab of Dravya Adhyayana Vibhaga, Government Ayurvedic Medical College-Bangalore-560009. TLC Study was carried out at Bangalore Test House, Vijayanagar-Bangalore-40. Histo-pathological study was carried at, Dept of Pathology Government Veterinary College, Hebbal- Bangalore. Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 200 Dept of PG studies dravyaguna
  • 132. DISEASE REVIEWPlace of purchase of required materials Test Kits were purchased from Swemed biomedical pvt.ltd, chunchunnagatta cross, yellachenahalli, Bangalore-560062. The drug Atervostatin was purchased from Manjushri Medical store, M.K.K road Rajajinagar. Bangalore Vanaspati of dalda company and coconut oil was purchased from local provision store, Rajajinagar. Bangalore.PROCUREMENT OF PLANT MATERIAL Roots of Clerodendron phlomidis was procured from its natural habitat from M.Khubli near Dharwad , Karnataka .The genuinity of the sample was confirmed at FRLHT, Bangalore.PREPARATION OF CHURNA 12.2 kgs of roots of Clerodendron phlomidis was procured; it was washed toremove the physical impurities and dried under shade then it was powdered by usingpulverizer using mesh number 20 at Government Central Pharmacy, Bangalore. Thecoarse powder was stored in an air-tight polythene bag to minimize the absorption ofmoisture.PREPARATION OF VISHOSHI KASHAYA:- Vishoshi Kashaya was prepared according to reference from Sharangadharasamhita, Madhyamakhanda i.e. one part of coarse powder of the drug and 16 parts of Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 201 Dept of PG studies dravyaguna
  • 133. DISEASE REVIEWwater was added, boiled and reduced to 1/16th part under low flame and filtered withwhite cloth. Using this method, kashaya was prepared as per the requirement.PREPARATION OF EXTRACTThe herb is powdered in 20 no mesh and extracted using respective medium (80%Ethanol or water) under boiling temperature three times using 3-4 volumes of themedium for 3 hours each time.The extracts are concentrated together under vacuum at 50-70ºC. The paste obtained isdried under vacuum at 60-70 ºC and powdered.PREPARATION OF VANASPATI AND COCONUT OIL FOR INDUCTION OFHYPERLIPIDAEMIA.Everyday vanaspati and coconut oil was taken separately and it was made to melt bykeeping in hot water and then it was measured and mixed in the ratio of 3:2. Thismixture was used for gavaging at 10ml/kgbodywt.DRUG AUTHENTIFICATION: It was authentified as Clerodendron phlomidis bythe botanist in FRLHT.DRUG ANALYSIS Physico-chemical analysis Phyto-chemical analysis Thin-layer chromatography Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 202 Dept of PG studies dravyaguna
  • 134. DISEASE REVIEWPHYSICO-CHEMICAL ANALYSIS ORGANOLEPTIC TESTS OF CHURNA AND KASHAYA Carried out for the parameters like – Colour, Odour, Texture, and TasteDETERMINATION OF FOREIGN MATTER:Materials required -Drug, digital balance.Procedure • 10g of the crude drugs were examined for the presence of foreign matter like mud, pieces of stalk, sand etc. • Foreign matter was separated and the drug was weighed again. • Percentages of foreign matter were calculated.DETERMINATION OF MOISTURE CONTENT (Loss on drying)Materials required: Powdered drugs, digital balance, petridish, dessicator and hot airoven.Procedure- • Accurately weighed 5g of coarsely powdered drugs was taken in a dried, weighed Petridish. Then it was kept in hot air oven at 110°c for half an hour.Petridish was taken out, cooled in a dessicator (dessicator was filled with copper sulphate crystals to absorb the moisture) and weighed.Drying was continued till constant Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 203 Dept of PG studies dravyaguna
  • 135. DISEASE REVIEW weight was obtained.Percentages of moisture content with reference to the air dried drugs were calculated by using formula Difference in weight Result: % of moisture = 100 Weight of the sample • DETERMINATION OF TOTAL ASHMaterials required - Digital balance, silica crucible, muffle-furnace, dessicator, air-dried drugs, electric bunsen.Procedure- • Accurately weighed 2 g of the coarsely powdered drugs were taken in clean, pre- heated and weighed silica crucibles. They were ignited in an electric bunsen till the fumes appear indicating charring of the drug.Heating was continued till no further fumes emerged from the silica crucible.Then the crucibles were kept in ignited Muffle-furnace where the temperature was allowed to increase up to 450°C, until white coloured ash was obtained, indicating the absence of carbon. • The crucibles were cooled in a dessicator and weighed. Using formulaResult: Total ash = Weight of residue 100 Weight of the sample • DETERMINATION OF ALCOHOL SOLUBLE EXTRACTIVE VALUEMaterials required – Digital balance, air dried drug, iodine flask(or reagent bottle fittedwith a glass stopper or rubber cork), ethyl alcohol, distilled water, measuring jar, funnel,whatman filter paper, hot air oven, water bath, beaker(flat bottomed dish). Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 204 Dept of PG studies dravyaguna
  • 136. DISEASE REVIEWProcedure- Accurately weighed 5 grams of coarsely powdered drug was taken in 250ml iodine flask containing 95ml of ethyl alcohol and 5ml of distilled water (i.e, 95% ethanol). The lid was closed for 24 hours. Frequent agitation was done during first 6 hours and allowed to stand for 18 more hours without shaking.After 24 hours, it was filtered to remove insoluble matter.25 ml of the filtrate was taken in a flat- bottomed dish and kept on water bath for evaporation.The residue was dried in hot air oven at 105oc, cooled and weighed.Drying was continued till constant weight was obtained.Percentage of alcohol soluble extractive value with reference to the air dried drug was calculated. • WATER-SOLUBLE EXTRACTIVE VALUE The Materials and procedures are same as the alcohol soluble extractive value. Instead of ethyl alcohol, water was used. • DETERMINATION OF ACID INSOLUBLE ASH • To the total ash obtained, 25ml of dilute hydrochloric acid was added and stirred well for 15 minutes. It was filtered through an ash less filter paper to separate the insoluble matter.The residue along with the filter paper was taken in a pre-heated, weighed silica dish.This was ignited in an electric Bunsen till the fumes cease to appear from the silica dish.The dish was transferred to muffle furnace and ignited Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 205 Dept of PG studies dravyaguna
  • 137. DISEASE REVIEW for half an hour at the temperature not exceeding 450°c. The dish was cooled in a dessicator and weighed again.Heating was continued till constant weight of the dish was obtained.The percentages of acid insoluble ash with reference to the air- dried drugs were calculated by the formula % of acid insoluble ash = Difference in weights 100 Weight of the sampleDETERMINATION OF pH VALUESMaterials required - pH meter, buffer tablet no.4 and no.9, powdered drug, aqueousextract, alcoholic extract, kashaya, distilled water, filter paper.The measurement of pH is generally done with a suitable potentiometer known as pHmeter fitted with two electrodes, one constructed of glass and sensitive to hydrogenationactivity and the other a calomel reference electrode. The determination is carried out at atemperature of 25± 2°.Procedure – • The electrodes of the pH meter were dipped in distilled water for 24 hours prior to calculating the pH of the respective solution.Buffer solutions of pH 4 and pH 9 were prepared by dissolving the buffer tablets separately in 100ml distilled water. • The electrodes of the pH meter were dipped in buffer solution and the instrument was calibrated at pH 4 and pH 9 at 25°c.To 1g of coarsely powdered drugs, 100ml of distilled water was added, stirred for 5 minutes, and filtered.Buffer solution was taken out. The electrodes were washed in distilled water and wiped. Then electrodes were immersed in the solution of the test drug and the reading on the Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 206 Dept of PG studies dravyaguna
  • 138. DISEASE REVIEW pH meter was recorded. Again the electrodes were washed in distilled water, wiped, immersed in the test solution and the reading was recorded. • The procedure was repeated till the difference between the reading and the original value is lesser than 0.5 The same procedure was repeated with the other forms of the drug.PHYTO-CHEMICAL ANALYSISA. Chemical Tests for Detection of Organic Chemical Constituents 1.TEST FOR ALKALOIDS: Hager’s Test: To the acidic solution, Hager’s reagent was added. Yellow precipitate confirms the presence of alkaloid. Hager’s reagent: Saturated picric acid solution is called Hager’s reagent. 2. TEST FOR FLAVONOIDS: Lead acetate solution test: To the alcoholic extract, few drops of 10% lead acetate solution were added. White or yellow precipitate formation indicates Flavonoids in it. 3. TESTS FOR SAPONINS: Dissolve the extract in little distilled water and test the filtrate for the presence of Saponin Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 207 Dept of PG studies dravyaguna
  • 139. DISEASE REVIEW Froth test: To 5ml of extract, add drop by drop sodium bicarbonate solution. Shake the mixture vigorously and leave for 3 minutes. Observation – Honey comb like froth indicates presence of Saponin. 4. TESTS FOR GLYCOSIDES: Modified Borntrager’s test: To the extract, 5ml of 5% ferric chloride solution and 5ml of dilute hydrochloric acid were added and boiled on water bath. After cooling, benzene or any organic solvent was added and shaken well. The benzene layer was separated and equal volume of dilute ammonia was added. If Ammonical layer shows pinkish red colour, glycoside is confirmed. 5. TESTS FOR TRITERPENOIDS. The extracts were dissolved in chloroform & tested for the presence of triterpenoids. Salkowski test: A few drops of concentrated sulphuric acid when added to the chloroform solution, shaken & allowed to stand, formation of golden yellow colour in the lower layer indicates the presence of triterpenoids. 6. TESTS FOR TANNINS: Ferric chloride test: The residue of the extract was dissolved in water and a few drops of ferric chloride were added. Observation – Black or brownish precipitate indicates the presence of tannins.Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 208 Dept of PG studies dravyaguna
  • 140. DISEASE REVIEW 7. TESTS FOR PROTEINS: Biuret test: To the filtrate, 40% sodium hydroxide and few drops of 1% copper sulphate was added. Blue colour produced indicates presence of proteins 8. TEST FOR CARBOHYDRATES Benedict’s test: To the filtrate, equal volume of Benedict’s reagent was added and boiled in water bath. Green, yellow or red precipitate was formed depending on the amount of reducing sugars present in the test solution. 8. TESTS FOR STEROIDS: Li- bermann-Buschard test: The different forms of Agnimantha samples were treated with1-2 drops of dilute sulphuric acid and acetic anhydride. Observation – Greenish discoloration indicates the presence of steroids.TESTS FOR ORGANIC ACIDS:The aqueous extract of the drug was neutralized with dilute ammonium hydroxidesolution and the following tests were performed.a) Oxalic acid:i) To 2ml of test solution, few drops of 1% potassium permanganate were added. Onaddition of dilute sulphuric acid, colour of potassium permanganate if disappearsimmediately confirms the presence of oxalic acid Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 209 Dept of PG studies dravyaguna
  • 141. DISEASE REVIEWb) Tartaric acid:i) To 2-3ml of test solution, a drop of dilute ammonium hydroxide and excess 5% silvernitrate solution was added. White precipitate was formed immediately. The test tube waskept in boiling water bath for 15 minutes. Formation of “Shilling mirror” confirms thepresence of tartaric acid.c) Citric acid:i) To 2-3ml of test solution, a drop of dilute ammonium hydroxide and excess silvernitrate solution was added and boiled for 15 minutes in water bath. Blackish silver mirrorconfirms citric acid.d) Malic acid:To 2-3ml of test solution, few drops of 5% ferric chloride solution were added. Yellowishcolour indicates mallic acid.B] CHEMICAL TESTS FOR DETECTION OF INORGANIC CHEMICALCONSTITUENTS: Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 210 Dept of PG studies dravyaguna
  • 142. DISEASE REVIEWThe ash of the drug was prepared. 50% v/v hydrochloric acid or 50% v/v nitric acid wasadded to ash and kept for 1 hour. Then it was filtered and the filtrate was tested for thepresence of various inorganic constituents.1] Calcium:i) To 10ml filtrate, 1 drop of dilute ammonium hydroxide and saturated ammoniumoxalate solution were added. White precipitate of calcium oxalate if formed confirmscalcium, Precipitate will be soluble in hydrochloric acid but insoluble in acetic acid.2] Magnesium:i) To the filtrate, ammonium carbonate solution was added. White precipitate wasformed.3] Sodium:i) To 10ml of the filtrate, 2ml of potassium permanganate solution was added. Whiteprecipitate was formed.4] Potassium:i) To the filtrate, few drops of sodium cobalt nitrate solution were added. Yellowprecipitate of potassium cobalt nitrate was observed.5] Iron: Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 211 Dept of PG studies dravyaguna
  • 143. DISEASE REVIEWi) To the filtrate, few drops of 2% potassium ferrocyanide solution were added. Dark bluecolouration was observed.6] Sulphate:i) To the filtrate, few drops of 5% barium chloride solution were added. White crystallinebarium sulphate which is insoluble in hydrochloric acid indicates sulphate.8] Chloride:i) To the filtrate, 3-5ml of lead acetate solution was added. White precipitate formationwhich is soluble in hot water confirms chloride.9] Carbonate:i) To the filtrate, mercuric chloride solution should be added. Brownish red precipitateformation confirms carbonate.10] Nitrates:i) To the test solution, ferrous sulphate solution should be added and concentratedsulphuric acid was added slowly from the sides of the test tube, a brown ring formationat the junction of two liquids confirms the test.Thin layer chromatography (TLC): It is a technique used to detect, separate and isolate different chemicalconstituents present in the sample. Materials required: Plant extracts, Precoated T.L.C plates, Capillary tubes, T.L.Cchambers, Hot air Oven, Solvents and Spray reagents.Procedure: Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 212 Dept of PG studies dravyaguna
  • 144. DISEASE REVIEW • Extracts were dissolved in solvent (Methanol/chloroform),A small amount of the mixture to be analyzed was spotted near the bottom of the Precoated T.L.C plate with the help of capillary tubes.T.L.C Chamber was cleaned & dried before use. • Suitable solvent system was selected, poured into the T.L.C chambers & closed with glass lid.The chamber was kept undisturbed for saturation. • The spotted plate was immersed in the TLC Chambers (Which were already saturated) & lid was closed.When the solvent reached up to 3/4th of the plate, the plate was removed & dried solvent front was marked with pencil & separated components were visualized.Suitable detecting agents were used for spraying • Dried in hot air oven for few minutes • Rf Values were calculated. Rf = Distance traveled by the spot Distance traveled by the solvent frontThe spots were evaluated by using different solvent systems as mentioned below, fordifferent plates Table No: 20Table no: 22 Stationary Mobile phase Location ResultsTLC analysis phase ReagentPhyto-chemicalAlkaloids Silica gel 60 Chloroform: methanol Dragendroff’s Brownish- F254 pre- (90:10) red band coated platesGlycosides Silica gel 60 Benzene: Ethanol P-Anisaldehyde Blue band F254 pre- (7:3) coated plates Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 213 Dept of PG studies dravyaguna
  • 145. DISEASE REVIEWSteroids Silica gel 60 1,2dichloroethane:methanol:water Alkaline blue Pink band F254 pre- (95:4.8:0.2) Tetrazolium coated platesFlavonoids Silica gel 60 Benzene: ethyl acetate  Yellow F254 pre- (4:1) band coated plates Experimental study: Pharmacology in its broadest sense is concerned with the study of drugs. Theoverall actions of a drug have to be analyzed. This is done by conducting research onlower animals to assess the effect of the drug on whole body, isolated systems of thebody like tissues or organs, in other words on biochemical mechanisms. Only after knowledge from such work is available, it is possible to check for theeffect of the same drug on human beings.Generally the experimentation study is undertaken to • Asses the effect of the drug. • Asses the mechanism of drug • Asses the site of action of drug • Study the toxic effects. • Determine the safety levels of the drug in other words to evolve the therapeutic index.Types of Experimental methods:In vitro method: The physical and chemical assay, culture tests etc conducted outsidethe animal body on individual isolated organs are known as In vitro studies. Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 214 Dept of PG studies dravyaguna
  • 146. DISEASE REVIEW In vivo method: a) Animal experiments/ biological experiments to asses the effects of different drugs. The present study is coming under In vivo method; here the effect of Agnimantha is studied on Wister albino rats after induction of hyperlipidaemia. The experimental trial was conducted in the Department of Pharmacology and Toxicology, Govt Veterinary College, KVAFSU, Hebbal, Bangalore .Objective: The present study was designed to evaluate the medohara karma of Agnimanthamoola,(Clerodendron phlomidis) vishoshi kashaya, hydro alcoholic extract and aqueousextract in Wister albino rats, with special reference to hyperlipidaemia. In whichhyperlipidaemia was induced by feeding vanaspati (dalda) and coconut oil in the ratio of3:2 at the dose of 10ml/kg body wt.Parameters selected : Total cholesterol, Serum triglycerides, HDL, LDL, VLDL, Bodyweight and Histopathology of liver, kidney and aorta.Source of animals: The required numbers of healthy adult male Wister albino rats weighing between150-200 grams were procured from ‘Indian Institute of Science’, Bangalore.Preparation of the cages:- Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 215 Dept of PG studies dravyaguna
  • 147. DISEASE REVIEW All the cages used for the experiment were cleaned with detergent before thecommencement of the experiment and once in three days thereafter till the end of theexperiment. Paddy husk was used as bedding material. The cages were labeled with thenumber of animals and dosage groups.Feeding schedule:- Normal feeding schedule was adapted to all the experimental rats.The rats were given 15 -20 gm of rat pellet / day and water adlibitum. Animal feed waspurchased from Amruth laboratory, commercial street, Bangalore, which wasmanufactured by ‘pranav agro industries ltd’ Sangli ; Maharashtra.COMPOSITION OF ANIMAL DIET : (For 10 kg of Animal diet)Ingredients QuantityWheat 5kgBengal Gram 4kgMilk powder 600gmYeast 400gmSalt 100gmCod liver oil 25gmSesame oil 50gmMaintenance:- Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 216 Dept of PG studies dravyaguna
  • 148. DISEASE REVIEW All the experimental animals were maintained at Animal house, Department ofPharmacology and Toxicology, Government Veterinary College, Hebbal, Bangalore.Under standard laboratory conditions.Examination of the animals prior to the experiment: All the Wister albino rats were subjected to general check up for sex and weight.The animals with abnormal behavior and health were excluded. • Animals of 2 - 3 months of age as specified by the breeders were selected. • Sex is determined by looking at external genital organ • Weight of each animal was checked by using spring balance • Heart rate was counted as number of beats/minute by feeling the heart rate by thumb. • Respiratory rate was counted as number of inspiration and expirations/minute observing the movement of abdomen. • Temperature was checked by inserting the digital thermometer in the rectum of the animals and recorded with the Fahrenheit scale. • Grouping was done by specific markingPILOT STUDY:A) The pilot study was conducted to determine the effective dose, and toleranceDosage forms of the drug. : Agnimantha moola vishoshi kashaya : Agnimantha moola aqueous extract : Agnimantha moola hydro alcoholic extract Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 217 Dept of PG studies dravyaguna
  • 149. DISEASE REVIEWThis was compared with standard hypolipidaemic drug Atervostatin which was taken asthe Standard in this study. B) Toxicity study: As per the earlier studies done, Rats, which receivedaqueous and ethonolic extracts in doses above 2000 mg/kg, exhibited ptosis (dropping ofupper eyelids) and were found lethargic. The parameters such as hyperactivity, grooming,convulsions, sedation, hypothermia and mortality were observed. (Medicinal andAromatic Plant Science and Biotechnology 1(1), 142-150 ©2007 Global Science Books) Keeping this as reference, toxicity study was not done and doses were fixedbased on same.Mode of administration:- Different dosage forms of Agnimantha root were administrated through intragastrictube using 2 ml syringe fitted with 18 gauze rat gavaging needle with round tip made ofsteel. Prescribed dose of suspended drug was loaded in syringe and the tube was insertedof the tube into the oesophagus and drug was administered.Calculation of the dose of trial drug:- The dose was calculated by keeping the human standard. 1. Dose of vishoshi Kashaya: - As there is no separate mentioning of dose of vishoshi kashaya, the same dosage is taken as that of kashaya. Dose of the kashaya in human beings=2pala=96ml/60kg body weight. = 1.6ml/kg Rat dose of kashaya = Human dose of the kashaya/kg × Human km Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 218 Dept of PG studies dravyaguna
  • 150. DISEASE REVIEW Rat km = 1.6×37 6 km = unique value to each species = 9.86 ml/kg body weight. Therefore for 200g weighing rat = 200 × 9.86 1000 Dose of kashaya = 1.97 ml/rat = 2 ml /rat 2. Dose of aqueous and methanolic extract :- Three different doses are fixed for pilot study. Table no: 21 Pilot study design Sl.no Groups No of Drug administered Animals 1 Control I 3 Normal food and water 2. Trial -1 a. lower dose 3 Agnimantha vishoshi kashaya b. middle dose 3 at,1, 11/2,2ml dose C .higher dose 3 3 Trial -2 a. lower dose 3 Agnimantha hydro alcoholic b. middle dose 3 extract at 500,1000 andEvaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 219 Dept of PG studies dravyaguna
  • 151. DISEASE REVIEW c. higher dose 3 2000mg/kg bd wt. 4 Trial – 3 a. lower dose 3 Agnimantha hydro alcoholic b. middle dose 3 extract at 500,1000 and c. higher dose 3 2000mg/kg bd wt. Dose fixation for standard drug: Human dose of Atervostatin is 10-80mg OD. As per the earlier studies both 20mg and 40mg human dose was proved effective in reduction of serum lipids in rats and there was no significant difference in between them . Hence the dose selected was 20mg. Conversion of human dose to rat dose is made based on the formula.: Human dose X 0.018X5 = Dosage of animal per kg bodywt Human dosage Animal dosage Per 200 gms 20mg 1.8mg 0.36mg =0.4mgThe dose of the drug mentioned was dissolved in distilled water and gavaging was done. Procedure: - Before induction of hyperlipidaemia, blood was collected from all the rats for conducting serum parameters. Vanaspati and coconut oil in the ratio of 3:2 were gavaged at the dose of 10ml/kg body wt for 30 days to induce hyperlipidaemia One group was given vishoshi kashaya along with the induction to observe the prophylactic action of the drug, which was sacrificed on 30 th day after induction. After 30 days, induction was stopped and trial drug was given for 30 days. Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 220 Dept of PG studies dravyaguna
  • 152. DISEASE REVIEW From 31st day to 60th day all the trial group rats were received the trial drug orally for a period of 4 weeks. Standard drug group received Atervostatin for 4 weeks. 3 animals were retained from each group till 75th day to check for the maintenance of the serum levels. Blood collection was done on 0th, 30 and 60th and 75th day of the study.COLLECTION OF BLOOD: The blood was collected from the Retro-orbital space bysmall capillary tube of 1mm size by anaesthetizing rats with ketamine –IP 40mg /kgwtand xylozane IM - 10ml/kg body wt. 2ml of blood was collected in sterile test tube fromeach rat and the serum was separated by centrifuging at 3000rpm for 15 min. Then serumwas stored in deep freezer at -20°C, and used for different investigations..SACRIFICATION OF ANIMALS: The animals were sacrificed by excess dose ofketamine and xylozane. Kidney, liver and aorta were isolated. The isolated organs from the animals under study were perfused with cold saline, dried in between folds of filter paper and weighed. Later they were preserved in neutral buffered formalin solution separately to send the organ for Histopathological study. Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 221 Dept of PG studies dravyaguna
  • 153. DISEASE REVIEW EXPERIMENTAL TRIAL PROPER After determining the Effective dose of the trial drug and standard drug by pilotstudy, actual experimental trail was carried out.VEHICLE FOR ADMINISTRATION OF DRUG: Distilled water was added to the extract to make a homogenous suspension and administered orally once a day after calculation of dose according to body weight. Atervostatin was mixed with distilled water and administered. Control group was given normal food and water.Study design: Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 222 Dept of PG studies dravyaguna
  • 154. DISEASE REVIEWGroups: Table showing the different groups to evaluate medohara karma (hypolidaemic)activity of Agnimantha moola vishoshi kashaya, aqueous extract and hydro alcoholicextract. Seven groups of 8 animals in each group were formed from the randomlyselected animals. PLATE: 4 DIFFERENT DOSAGE FORMS OF AGNIMANTHA Agnimantha kashaya choorna Vishoshi kashaya Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 223 Dept of PG studies dravyaguna
  • 155. DISEASE REVIEW Aqueous extract after mixing Aqueous extract with water Hydro alcoholic extract Hydro alcoholic extract after mixing with waterable 22: Grouping for main studySl. Groups Details No. of StudyNo animals1. GI Normal control 8 Normal water and normal food2. GII High fat control 8 High fat was given to rats for 30 days and no drug was administered3 G III Standard positive 8 Atervostatin was administered at 0.4mg Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 224 Dept of PG studies dravyaguna
  • 156. DISEASE REVIEW control dosage for 30 days after induction.4 G IV Vishoshi kashaya of 8 2ml of vishoshi kashaya of Agnimantha Agnimantha moola. was started along with induction for 30 days5 GV Vishoshi kashaya of 8 2ml of vishoshi kashaya of Agnimantha Agnimantha moola. was administered for 30-days after induction of hyperlipidaemia6 GVI Hydro alcoholic extract 8 200mg of hydro alcoholic extract of of Agnimantha Agnimantha moola was administered for 30-days after induction of hyperlipidaemia7 GVII Aqueous extract of 8 200mg of aqueous extract of Agnimantha Agnimantha moola was administered for 30-days after induction of hyperlipidaemia7. Group VII Standard positive 8 Atervostatin was administered at 0.4mg control dosage for 30 days after induction.• Then animals were subjected to experimental parameters like, body weight on every 7th day, serum parameters like Total cholesterol, HDL, Triglycerides, LDL ,and VLDL , on every 30th day.• On 60th day animals were sacrificed and organs were collected.• 3 animals were kept from each group till 75th day without any drug to check the reversal. Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 225 Dept of PG studies dravyaguna
  • 157. DISEASE REVIEW• The results obtained from the experimental trail were compared with that of standard positive group. The data was statistically and graphically evaluated and results were interpreted. OBSERVATIONS AND RESULTSThe present study has been carried out under three headings. 1. Preparation of the drug 2. Phyto-chemical analysis 3. Experimental study Table no: 23 Observation during the collection of the drug Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 226 Dept of PG studies dravyaguna
  • 158. DISEASE REVIEWSl. No Observations Agnimantha root1. Collected drug 12.2 Kg2. Obtained drug after washing and drying 10.3Kg3. Powdered using 20 no. mesh in pulverized and yield obtained 10Kg Table no: 24 Organoleptic study of Agnimantha Sl.no Shabdha (fracture) Fibrous fracture 1 Sparsha (external Rough, exfoliating, light brown surface, wood light yellow, surface) outer surface easily peelable by hand. 2 Rupa (shape) Cylindrical and slightly twisted, 3 Varna (colour) Light brown surface 4 Rasa (taste) Astringent 5 Gandha (odour) Not agreeable Table No: 25 Organoleptic study of aqueous and hydroalcoholic extracts Colour Odour Taste FormAqueous extract Light Mild disagreeable Tikta, Powder Brown KashayaHydro Alcoholic Dark disagreeable Tikta Powderextract brown KashayaEvaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 227 Dept of PG studies dravyaguna
  • 159. DISEASE REVIEW MICROSCOPIC STUDY OF AGNIMANTHA ROOT Findings under microscope T.S. of the root circular in out line, consisting of outer layer cork with 15 to 20 layers or even more, tangentially elongated, thin walled cells. Secondary cortex consists of round to oval thin walled parenchymatous cells. Vascular region is well developed, phloem thin walled, compactly arranged Xylem shows broad zone consisting of xylem vessels which are highly lignified with sclerenchymatous cells. Diagnostic characters 1) Presence of abundant simple starch grains through out the stellar region that is in the tracheid region. 2) Presence of abundant simple starch grains in the medullary rays. , which are biseriate to multiseriate. PLATE: 5a MICROSCOPIC STUDY OF AGNIMANTHA ROOTSEvaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 228 Dept of PG studies dravyaguna
  • 160. DISEASE REVIEW Cortex Medullary ray Stellar region Cork T.S of the root of Agnimantha FINDINS UNDER MICROSCOPE Xylem Lignified Sclerenchymatous cells Starch grains Cells showing lignification LIGNIFIED SCLERENCHYMATOUS CELLS PLATE: 5b MICROSCOPIC STUDY OF AGNIMANTHA ROOTSEvaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 229 Dept of PG studies dravyaguna
  • 161. DISEASE REVIEW Starch grains TRACHEIDS WITH STARCH GRAINS Starch grains MEDULLARY RAYS WITH STARCH GRAINS Table No : 26 Observations during preparation of vishoshi kashayaEvaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 230 Dept of PG studies dravyaguna
  • 162. DISEASE REVIEW Sl. No Procedure Observation 1. Coarse powder of the drug taken 30gms in 480 ml of water (1:16) 2. 30ml Kashaya obtained 3. Dark brown Colour 4. Liquid Consistency 5. Astringent predominant Odour 6. Kashaya, Tikta TasteTable no : 27 Observations during preparation of hydro alcoholic and aqueous extractEvaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 231 Dept of PG studies dravyaguna
  • 163. DISEASE REVIEW ObservationsSl. No Aqueous extract Hydro alcoholic 2.5kg 2.5 kg 1. Coarse powder of drug taken 382 gm 192.5 gm 2. Extract obtained 15.7% 7.7% 3. Yield 4. Colour Dark Brown Brown 5. Consistency Solid Solid Fine powder 6. Nature Fine powder Characteristic odour Characteristic odour 7. Odour Astringent and bitter 8. Taste Astringent and bitter Dark brown 9. Colour of prepared solution Light brown Dark brown colour of extracts indicates presence of more Tannin content. Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 232 Dept of PG studies dravyaguna
  • 164. DISEASE REVIEW Table No: 28 Physical Constants of the Drug Sl. Test Permissible limit for Obtained percentage for No Agnimantha Agnimantha 1 Loss on drying at - 5.28% 110°C 2 Total ash Not more than 6% 1.4% 3 Acid insoluble ash Not more than 1% 0.24% 4 Water soluble Not less than 5% 29.5% extractive 5 Alcohol soluble Not less than 2% 11.80% extractive 6 PH value Dosage form pH Vishoshi kashaya 4.97 Aqueous extract 4.23 Hydro alcoholic extract 4.30 7 Foreign matter - 0.47% The observed values confirm that Agnimantha is in accordance with the standards given in “Ayurvedic pharmacopoeia of India”. Above that pH analysis reveals that the Agnimantha is acidic in nature, & more water soluble extractives.Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 233 Dept of PG studies dravyaguna
  • 165. DISEASE REVIEW Table no. 29 Phyto-chemical analysis of Agnimantha: SL. Phyto Name of the test VK AQE HAE no constituents 1 Alkaloid Hager’s reagent Present Present Present 2 Steroid Liebermann Present Present Present Bruchrdt Test 3 Glycoside Borntrager’s Test Present Present Present 4 Flavonoids Lead acetate Test Present Present Present 5 Carbohydrates Benedict’s Test Present Present Present 6 Tannins Ferric chloride test Present Present Present 7 Proteins Biuret test Absent Absent AbsentEvaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 234 Dept of PG studies dravyaguna
  • 166. DISEASE REVIEW Table no. 30 TLC findings of the drug Agnimantha in different dosage forms Dosage Number of Reagent used Rf values Colour form used spots 1.Light yellow Under UV 0.10Kashaya , hydro 4 zones Remaining 4 fluorescent zones 0.38alcoholic and blue 0.59aqueous extract 0.90Kashaya , hydro 0.10,0.38,0.59,0.78,alcoholic and Iodine vapour 6 Yellow 0.87aqueous extract 5% methanolicKashaya , hydro phosphomolyblic 0.10, 0.38, 0.59,alcoholic and acid reagent and 6 Grey 0.78, 0.87, 0.98aqueous extract heating the plate at 105o C PLATE: 6 TLC FINDINGS OF AGNIMANTHAEvaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 235 Dept of PG studies dravyaguna
  • 167. DISEASE REVIEW On exposure to Iodine Under visible Light Vapour On spraying Bands seen under 366nm phosphomolyblic acid U.V reagent EXPERIMENTAL STUDYEvaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 236 Dept of PG studies dravyaguna
  • 168. DISEASE REVIEW It was carried out in two Phases i). Pilot study ii). Study proper Observations during Pilot study: During pilot study, observations were recorded with regards to behavior, body weight, serum parameters to fix the effective dose needed to evaluate the medohara karma Observation during effective dose fixation: Administration of drug was done through intra gastric tube using 2 ml disposable syringe, fitted with gavaging needle. The rats which received kashaya and aqueous extract accepted the drug easily than the other groups. While administering hydro alcoholic extract of Agnimantha rats showed resistance, especially to higher doses. To determine the effectiveness of vanaspathi and coconut oil in induction of hyperlipidaemia. Initially after starting feeding of vanaspati and coconut oil in the ratio of 2:3, at10ml/kg body wt, blood serum was checked for every 15days for raised lipid levels,there was significant raise noted on 30th day. After confirming hyperlipidaemia trial drugwas started. Observation during induction: Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 237 Dept of PG studies dravyaguna
  • 169. DISEASE REVIEWAll the groups which received fat combination found to be lethargic. This lethargicnesswas not present in the group which received vishoshi kashaya simultaneously (KA) withinduction and in normal control group (NC) Trial drug dose fixation:After induction, Wister albino rats were administered different dosage forms ofAgnimantha in different doses for 20days. Vishoshi kashaya: Group receiving kashaya at 1ml showed very minimum effect, Group receiving 11/2 ml showed moderate effect and groups receiving 2ml showed very good effect in reducing the cholesterol levels. Hence 2ml was selected for the study. Aqueous extract and Hydroalcoholic extract: group which received 500 mg/kgb.wt, did not show any significant effect, where groups receiving 1000mg/kg, and2000mg/kg.b.wt showed significant effect but rats receiving 2000mg/kg body wtbecame furious and irritable, so the effective dose of the drug was taken as 1000 mg/kgb.wt. Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 238 Dept of PG studies dravyaguna
  • 170. DISEASE REVIEW PLATE: 7 EXPERIMENTAL STUDIES ORAL GAVAGING BLOOD DRAWING EXCISSION OF ORGANSEvaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 239 Dept of PG studies dravyaguna
  • 171. DISEASE REVIEW STUDY PROPER The main study was carried out after determining the effective doses ofAgnimantha kashaya, as 2ml/rat and Aqueous and hydroalcoholic extract as 1000mg /kgbody wt . STATISTICAL EVALUATIONThe results were statistically interpreted under two groups:-• Within the groups and• In between the groups.The statistical methods: ⇒ Descriptive statistical analysis has been carried out in the present study. ⇒ Results on continuous measurements are presented on Mean ± SD (Min- Max) and results on categorical measurements are presented in Number (%). ⇒ Significance is assessed at 5 % level of significance. Analysis of variance (ANOVA) has been used to find the significance of study parameters between three or more groups of patients. ⇒ Student t test (two tailed, dependent) has been used to find the significance of study parameters on continuous scale with in each group. SIGNIFICANT FIGURES: ⇒ + Suggestive significance (P value: 0.05<P<0.10) ⇒ Moderately significant ( P value:0.01<P ≤ 0.05) ⇒ ** Strongly significant (P value : P≤0.01) Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 240 Dept of PG studies dravyaguna
  • 172. DISEASE REVIEWGroup I: NC : Normal controlGroup II: HFC: High fat controlGroup III: STD: Standard drug Atervostatin.Group IV: KA: Simultaneously vishoshi kashaya of Agnimantha with induction.Group V: VK: Vishoshi kashaya after inductionGroup VI: AQE: Aqueous extract after inductionGroup VII: HAE: Hydro alcoholic extract after induction. Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 241 Dept of PG studies dravyaguna
  • 173. DISEASE REVIEWTable No: 31 TOTAL CHOLESTEROL Total cholesterol NC HFC STD KA VK AQ HAE Significance (mg/dl) 50.50 53.50 54.33 55.50 54.50 56.17 52.670th day ±1.87 ±3.61 ±2.50 ±1.87 ±3.61 ±4.78 ±2.34 F=2.116;p=0.105 54.83 140.17 124.33 54.5 119.83 130.50 129.8330th day ±3.19 ±27.59 ±16.95 ±5.21 ±16.34 ±9.65 ±17.88 F=32.166;p<0.001** 53.83 125.5 60.33 60.83 89.67 99.0060th day ±4.36 ±30.51 ±15.69 - ±13.99 ±19.09 ±18.63 F=15.261;p<0.001** 55.67 123.67 62.67 64.33 95.33 102..6775th day ±5.13 ±42.36 ±15.53 - ±19.63 ±18.15 ±11.24 F=4.069;p=0.022** P value from 0th day30th day 0.076 0.001** <0.001** 0.698 <0.001** <0.001** <0.001** -60th day 0.203 0.003** 0.392 - 0.210 <0.001* 0.003** -75th day 0.246 0.060+ 0.402 - 0.380 0.124 0.363 -30th day to 60th day 0.447 0.364 <0.001** - <0.001** <0.05* 0.05*P value (60th vs 75th day) 0.939 0.257 0.136 - 0.827 0.057+ 0.063+On 0th day: No significance was observed suggesting that the parameters weremaintained in uniform range in all the groups (F=2.116 p=0.015)On 30th day:There was no significant difference in NC group (P=0.076).In HFC (P=0.001**) and STD, VK, AQ and HAE group. P value being <0.001** showedhighly significant raise in total cholesterolIn KA group the change was not statistically significant (p=0.698) which showed that thetotal cholesterol did not raise inspite of induction as it was receiving Kashaya.On 60th day: NC group showed no significant change (p value is 0.447) Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 242 Dept of PG studies dravyaguna
  • 174. DISEASE REVIEWIn HFC group though reduction in total cholesterol was there it was not statisticallysignificant (P=0.364)SD and VK groups showed highly effective reduction in total cholesterol which wasstatistically highly significant (P=0.001**)AQE and HAE group showed reduction in total cholesterol which was moderatelysignificant.(P<0.05*) Table no. 32 Significance of values for comparing total cholesterol in between the groups on 60th day Groups HFC STD VK AQ HAE NC 0.001** 0.392 0.385 <0.01* 0.01* HFC - <0.001** <0.001** <0.001** 0.001** STD - - 0.134 0.078+ 0.089+ VK - - - 0.075+ 0.084+ AQ - - - - 0.286The significance in between the groups:Group 1: NC group when compared to HFC group showed highly significantdifference , statistically insignificance with STD and VK group and moderatesignificance when compared to AQ and HAE groupGroup 2: HFC this group when compared to NC, STD, VK, AQE and HAE groupshowed statistically high significant difference. Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 243 Dept of PG studies dravyaguna
  • 175. DISEASE REVIEWGroup 3: STD , this group has shown statistically insignificant result when compared toVK and suggestive of significance when compared to AQE and HAEVK group has shown result suggestive of significance when compared to AQE and HAEgroupsThe difference of results between AQE and HAE were statistically insignificant. Graph 1. TOTAL CHOLESTEROL 160 140 120 0th day 100 30th day 80 60th day 60 75th day 40 20 0 NC HFC STD KA VK AQE HAE Graph 1a. TOTAL CHOLESTEROL LEVELS ON 0TH, 30TH, 60TH 75TH DAY 150 100 BT 50 AT 0 NC HFC STD VK AQE HAE Graph 1b. TOTAL CHOLESTEROL BEFORE AND AFTER TREATMENT Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 244 Dept of PG studies dravyaguna
  • 176. DISEASE REVIEW Table no: 33 TRIGLYCERIDES LEVELS .Triglycerides(mg/dl) NC HFC SD KA VK AQ HAE Significance 61.17 59.33 64.50 65.17 65.17 58.83 64.83 F=0.989;0th day ±2.23 ±14.5 ±14.40 ±2.04 ±7.70 ±7.49 ±15.12 p=0.448 64.17 106.00 114.00 69.00 105.50 106.17 109.17 F=11.213;30th day ±3.60 ±22.93 ±17.47 ±5.29 ±19.74 ±7.96 ±16.01 p<0.001** 65.50 95.17 71.67 69.50 79.67 84.50 F=6.71560th day ±2.51 ±12.58 ±10.07 ±10.52 ±10.97 ±16.24 ;p<0.001** 65.00 91.67 73.67 69.00 76.33 91.67 F=1.926;75th day ±4.58 ±14.57 ±14.36 ±13.89 ±19.09 ±26.84 p=0.163P value from 0th day30th day 0.172 0.005** 0.001** 0.145 <0.001** <0.001** 0.001** -60th day 0.114 0.001** 0.428 0.499 0.038* 0.024* -75th day 0.208 0.062+ 0.529 0.511 0.184 0.219P value (30 th to 60th day) 0.102 0.082+ 0.003** 0.003** <0.05* 0.05*P value from (60th to 75th 0.899 0.497 0.103 - 0.319 0.101 0.286 -day )On 0th day, there was no significant difference suggesting all the values were in uniformrange. F=0.989, P= 0.448On 30th day, though there was raise of TG in normal control group (NC) it was notsignificant statistically. (P=0.072)In KC group also there was insignificant raise of TG (P=0.145)There was highly significant raise of TG in HFC, SD, VKA, AQE and HAE group.(P<0.001**) Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 245 Dept of PG studies dravyaguna
  • 177. DISEASE REVIEWOn 60th day, no significant changes were observed in NC group (p=0.102), and in HFCgroup (P=0.82+ suggestive of significance)There was highly significant effect were observed in SD and VK group (P=0.003**)There was moderate significant effect in AQE and HAE group.On 75th day , there was no significant difference compared to 60th day was observed in allthe groups Table no: 34 Comparison of triglycerides in between the groups on 60th day. Groups HFC STD VK AQ HAE NC 0.001** 0.232 0.292 0.01* <0.01* HFC - <0.001** <0.001** <0.001** 0.001** STD - - 0.153 0.048+ 0.082+ VK - - - 0.054+ 0.084+ AQ - - - - 0.376Group1. NC showed highly significant difference when compared to HFC group, nonsignificant difference when compared to STD and VK group. And moderate significancewhen compared to AQ and HAE group.Group 2 HFC showed highly significant difference when compared to all the othergroups.Group 3 STD showed non significant difference when compared to VK and suggestive ofsignificance when compared to AQ and HAE groups. Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 246 Dept of PG studies dravyaguna
  • 178. DISEASE REVIEWGroup 4 VK showed the difference suggestive of significance when compared to AQEand HAE group. There was no significant differences between AQE and HAE group. 120 100 80 0th day 60 30th day 60th day 40 75th day 20 0 NC HFC SD KA VK AQE HAE Graph 2a. TRIGLYCERIDE LEVELS ON 0TH, 30TH, 60TH 75TH DAY 120 100 80 60 BT 40 AT 20 0 NC HFC SD VK AQE HAE Graph 2b. TRIGLYCERIDE LEVELS BEFORE AND AFTER TREATEMENT Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 247 Dept of PG studies dravyaguna
  • 179. DISEASE REVIEWTable no: 35 HDL levels HDL(mg/dl) NC HFC SD KA VK AQ HAE Significance 19.17 20.00 20.17 21.00 20.17 19.50 20.67 F=1.079;0th day ±1.47 ±1.41 ±1.47 ±2.19 ±1.17 ±3.78 ±2.50 p=0.394 19.18 13.17 11.00 18.00 12.83 11.40 12.17 F=7.371;30th day ±2.04 ±2.14 ±1.55 ±2.53 ±3.66 ±1.14 ±2.14 p<0.001** 18.17 14.50 21.80 22.00 18.17 17.11 F=8.593;60th day ±2.79 ±1.87 ±2.86 ±3.22 ±2.79 ±2.71 p<0.001** 17.00 15.33 21.33 19.00 19.00 18.33 F=2.553;75th day ±1.00 ±4.73 ±1.15 ±1.00 ±1.00 ±2.52 p=0.085+P value from 0th day30th day 0.141 <0.001** <0.001** 0.191 0.005** 0.022* 0.001** -60th day 1.000 0.001** 0.090+ - 0.076+ 0.403 0.120 -75th day 0.157 0.268 0.423 - 0.257 0.173 0.118P value (30th to 60th day) 0.123 0.269 <0.001** 0.001** 0.011* 0.038*P value from 60th to 75th day 0.580 0.560 0.405 1.000 0.667 1.000 -On 0th day there was no significant differences between the values suggesting theuniformity of range.On 30th day NC and KA group did not show any significant difference compared to 0thday (p=0.141 and 0.191)There was highly significant reduction in HDL in all the other groups HFC, SDP<0.001**, VK (0.005**) HAE (0.001**), moderate reduction in AQE (0.022*)On 60th day: there was no significant difference in NC group.There was highly significant increase of HDL in SD (p< 0.001**) and VK group(p=0.001**) and moderate raise of HDL in AQE and HAE group (p=0.011* and 0.038*)respectively. Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 248 Dept of PG studies dravyaguna
  • 180. DISEASE REVIEWOn 75th day there was no significant difference when compared to 60th day value.Table no: 36 Significance of values for comparing HDL in between the groups on 60th day Groups HFC STD VK AQ HAE NC 0.002** <0.075+ 0.087+ 0.375 0.421 HFC - <0.001** <0.001** <0.001** 0.001** STD - - 0.183 0.038+ <0.05* VK - - - 0.084+ 0.032* AQ - - - - 0.145Group 1 NC showed highly significant difference when compared to HFC group,suggestive of significant difference with STD and AQ group, and non significantdifference with AQE and HAE. As the mean raise of HDL levels were better comparedto NC it showed significance comparison.Group 2. HFC showed highly significant difference with all the groupsGroup 3. STD showed non significant difference with VK suggestive of significance withAQ group and moderate significance with HAEGroup 4. VK suggested significance with AQ, and moderate significance with HAEGroup 5 AQE showed non significant difference with HAE. Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 249 Dept of PG studies dravyaguna
  • 181. DISEASE REVIEW 25 20 0th day 15 30th day 10 60th day 75th day 5 0 NC HFC SD KA VK AQE HAE Graph 3a. HDL LEVELS ON 0TH, 30TH, 60TH ,75TH DAY 25 20 15 BT 10 AT 5 0 NC HFC SD VK AQE HAE Graph 3b . HDL LEVELS BEFORE AND AFTER TREATEMENTEvaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 250 Dept of PG studies dravyaguna
  • 182. DISEASE REVIEWTable no : 37 LDL levels LDL(mg/dl) NC HFC SD KA VK AQE HAE Significance 20.17 22.67 21.33 22.00 20.67 23.33 20.83 F=1.073;0th day ±2.12 ±3.28 ±2.25 ±4.17 ±1.51 ±4.18 ±1.26 p=0.397 24.00 108.17 90.33 22.83 91.60 96.50 95.67 F=37.62130th day ±4.00 ±26.69 ±13.78 ±4.17 ±9.45 ±7.82 ±16.82 ;p<0.001** 23.00 99.00 24.40 23.00 33.50 35.17 F=12.613;60th day ±3.90 ±8.04 ±11.61 ±3.90 ±7.94 ±11.87 p<0.001** 24.67 98.67 26.33 24.33 38.00 36.33 F=5.134;75th day - ±5.13 ±9.27 ±13.05 ±16.2 ±13.00 ±8.96 p=0.009**P value from0th day30th day 0.113 0.001** <0.001** 0.702 <0.001** <0.001** <0.001** -60th day 0.194 0.003** 0.737 - 0.431 0.002** 0.003** -75th day 0.742 0.119 0.392 - 0.424 0.076+ 0.083+ -P value (30th 0.104 0.128 <0.002** <0.001** 0.015* 0.017* -day to 60th day)P value (60th 0.383 0.093+ 0.314 - 0.074+ 0.149 0.287 -day to 75th day)0th day, there was no significant changes observed in any of the groups suggesting thatthe values were in uniform range.30th day: NC group did not show any significant difference in the values ( P=0.113)KA group did not show significant difference (P=0.702)There was highly significant raise in HFC, SD, VK, AQE and HAE group (P <0.001**)60th day: NC group: There was no significant difference in the values when compared to0th day. (P=104)HFC group: Though there was reduction in LDL levels, it was not statistically significant.(P= 0.128), Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 251 Dept of PG studies dravyaguna
  • 183. DISEASE REVIEWSD and VK group showed highly significant reduction in LDL , (P<0.002** and<0.001**)AQE and HAE group showed moderate significant reduction in LDL(P<0.015* and 0.017*)On 75th day there was no significant difference observed when compared to 60th day in allthe groups.Table no: 38 Significance of values for comparing LDL in between the groups on 60th day Groups HFC STD VK AQ HAE NC 0.002** 0.167 0.156 0.055+ 0.049+ HFC - <0.002** <0.001** <0.001** 0.001** STD - - 0.113 0.054+ 0.047+ VK - - - 0.064+ 0.045+ AQ - - - - 0.105Group 1 NC showed highly significant difference when compared to HFC, no significantdifference compared to SD and VK group and suggestive of significant difference whencompared to AQE and HAE group.Group 2 HFC showed highly significant difference when compared to STD, VK ,AQEand HAEGroup 3 STD showed no significant difference when compared VK and suggestive ofsignificance compared to AQE and HAEGroup 4 VK had difference which was suggestive of significance when compared toAQE and HAEGroup 5 AQE did not show any significant difference compared to HAE. Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 252 Dept of PG studies dravyaguna
  • 184. DISEASE REVIEW 120 100 80 0th day 60 30th day 60th day 40 75th day 20 0 NC HFC SD KA VK AQE HAE Graph 4a. LDL LEVELS ON 0TH, 30TH,60TH ,75TH DAY 120 100 80 60 30th day 60th day 40 20 0 NC HFC SD VK AQE HAE Graph 4b . LDL LEVELS BEFORE AND AFTER TREATEMENTEvaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 253 Dept of PG studies dravyaguna
  • 185. DISEASE REVIEWTable no: 40 VLDL levels on 0th, 30th, 60th and 75th day. VLDL(mg/dl) NC HFC SD KA VK AQ HAE Significance 12.33 11.83 14.33 12.83 13.00 11.83 13.00 F=0.988;0th day ±0.52 ±2.93 ±1.51 ±0.41 ±2.83 ±1.6 ±3.16 p=0.448 12.67 22.33 22.17 13.67 23.00 21.33 21.83 F=10.790;30th day ±0.82 ±4.63 ±4.12 ±1.03 ±3.90 ±1.63 ±3.43 p<0.001** 13.17 20.20 13.67 14.17 15.00 16.00 F=6.194;60th day ±0.75 ±2.53 ±2.25 ±2.14 ±2.19 ±3.10 p<0.001** 13.00 18.67 13.78 14.33 15.33 17.00 F=1.941;75th day ±1.00 ±3.21 ±2.89 ±3.21 ±4.16 ±5.29 p=0.161P value from 0thday30th day 0.363 0.004** 0.001** 0.142 0.001** <0.001** 0.001** -60th day 0.093+ 0.001** 0.286 0.482 0.034* 0.051+ -75th day 0.423 0.001** 0.742 0.678 0.188 0.119P value (30th day 0.176 0.165 0.001** 0.001** 0.012* 0.019*to 60th dayP value from 60 to 1.000 1.000 0.184 0.225 0.184 0.250 -75th dayOn 0th day there was no significant difference observed suggesting the values were inuniform range. (F=0.988, P=0.448)On 30th day, NC group did not show any significant difference in the VLDL values,KA group did not show significant difference in the values compared to 0thday(P=0.142) Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 254 Dept of PG studies dravyaguna
  • 186. DISEASE REVIEWAll the other groups- HFC, SD, VK, AQE, and HAE showed highly significant increasein the levels of VLDL. (P≤ 0.001**)On 60th day, though there was reduction in VLDL levels in HFC group, it was notstatistically significant.(P=0.165)There was highly significant decrease of VLDL levels in SD, VK, group. (P-0.001**)There reduction of LDL in AQE and HAE was moderately significant. (P=0.012*,0.019*)Table no: 40 Significance of values for comparing VLDL in between the groups on 60th day Groups HFC STD VK AQ HAE NC 0.001** 0.107 0.126 0.055+ 0.042+ HFC - <0.002** <0.002** <0.001** 0.001** STD - - 0.103 0.054+ 0.041+ VK - - - 0.164 0.045+ AQ - - - - 0.102 Group1. NC showed highly significant difference when compared to HFC group,There was no significant difference in between the values of NC with that of STD andVK group and the difference was suggestive of significance when compared to AQE andHAE groups.Group 2 HFC showed highly significant difference when compared to STD, VK, AQEand HAE group. Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 255 Dept of PG studies dravyaguna
  • 187. DISEASE REVIEWGroup 3 STD showed no statistical significant difference when compared to VK group,but showed difference which was suggestive of significance when compared with AQEand HAE group.Group 4 : VK showed no statistically significant difference when compared to AQE ,showed significance when compared with HAE group values.Group 5 AQE did not show any statistical significant difference when compared withHAE group. Graph 5 VLDL LEVELS 25 20 0th day 15 30th day 10 60th day 75th day 5 0 NC HFC SD KA VK AQE HAE Graph 5a. VLDL LEVELS ON 0TH, 30TH,60TH ,75TH DAY 25 20 15 BT 10 AT 5 0 NC HFC SD VK AQE HAE Graph 5b.VLDL LEVELS BEFORE AND AFTER TREATMENT Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 256 Dept of PG studies dravyaguna
  • 188. DISEASE REVIEWTable no : 42 Showing body weight Body weight NC HFC SD KA VK AQE HAE Significance (gm) 141.67 156.83 164.67 160.83 162.67 164.67 161.00 F=0.515; 0th D ±12.63 ±28.17 ±32.95 ±33.2 ±22.14 ±25.72 ±31.79 p=0.793 148.50 178.50 184.33 163.50 188.50 182.50 187.33 F=1.869; 1st wk ±11.64 ±26.17 ±30.64 ±34.38 ±23.31 ±20.68 ±31.81 p=0.114 155.50 194.50 203.50 168.83 211.67 202.50 216.67 F=4.124 2nd wk ±12.77 ±25.37 ±31.51 ±34.39 ±24.51 ±18.02 ±36.81 ;p=0.003** 162.33 213.17 222.00 175.33 235.33 225.50 243.17 F=7.565; 3rd wk ±11.71 ±25.59 ±32.55 ±31.95 ±20.78 ±18.16 ±39.37 p<0.001** 168.33 242.17 242.67 176.67 258.33 246.33 245.50 F=10.760; 4th wk ±15.06 ±29.55 ±33.19 ±30.99 ±19.42 ±19.51 ±35.02 p<0.001** 172.20 239.11 231.52 230.32 240.21 238.23 F=8.564 5th wk - ±15.13 ±28.21 ±31.12 ±18.33 ±17.84 ±34.14 ;p<.001** 175.67 236.50 228.83 228.33 234.17 233.00 F=5.104; 6th wk - ±16.81 ±28.18 ±29.36 ±20.55 ±16.94 ±34.27 p=0.002** 176.50 231.33 206.33 204.50 212.17 223.00 F=3.467; 7th wk - ±17.73 ±27.62 ±31.99 ±17.85 ±19.51 ±30.25 p=0.003** 180.00 230.17 190.00 185.67 194.83 201.50 F=2.879; 8th wk - ±18.54 ±27.84 ±35.97 ±16.59 ±18.37 ±29.1 p=0.001** 183.17 233.00 186.33 172.33 190.50 199.50 F=4.889 9th wk - ±19.33 ±28.38 ±27.94 ±16.02 ±20.69 ±31.65 ;p=0.002** 188.00 238.67 183.00 179.67 187.67 198.00 F=2.393 10th wk - ±25.53 ±40.53 ±30.79 ±9.71 ±28.57 ±48.38 ;p=0.100 P value from 0 to 0.786 <0.002** 0.002** 0.100 0.002** 0.001** <0.001** th 4 week 4th week to 8th 0.563 0.524 0.001** 0.001** <0.05* 0.031 * week 8th week to 10th 0.654 0.234 0.245 0.201 0.212 0.103 week Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 257 Dept of PG studies dravyaguna
  • 189. DISEASE REVIEW0th day values showed no significance suggesting that they were in uniform range.4th week: There was highly significant raise in body wt was observed in HFC, STD, VK,((P <0.002**) AQE and HAE group, (P< 0.001**)Though there was raise in body weight observed in NC and KA group it was statisticallyinsignificant. (P=0.746, and 0.100) respectivelyOn 8th week, NC group showed raise in body weight, but it was not statisticallysignificant (P=0.563),HFC group showed reduction in body weight, which was not significant statistically(P=0.524)There was highly significant fall in the body weight of STD and VK groups (P<0.001**)AQE and HAE groups showed moderate significant reduction in Body weight.(P<0.05*,0.031*) respectively.Table no: 42 Significance of values for comparing body weight in between the groups on 60th day Groups HFC STD VK AQ HAE NC 0.002** 0.137 0.146 0.065+ 0.012* HFC - <0.001** <0.001** 0.001** 0.031* STD - - 0.124 0.174 0.022* VK - - - 0.184 0.085+ AQ - - - - 0.112Group1. NC showed highly significant difference when compared with HFC, nosignificant difference when compared to STD, VK groups and suggestive of significance Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 258 Dept of PG studies dravyaguna
  • 190. DISEASE REVIEWwhen compared with AQE group and moderately significant difference when comparedwith HAE group.Group2. HFC showed highly significant difference when compared with STD, VK,AQE,HAE groups.Group 3. STD showed no significant difference when compared with VK group and AQEgroups and moderate significant difference when compared with HAE group.Group 4 VK showed no significant difference when compared with AQE group andmoderate significance when compared with HAE group.Group 5 AQE showed difference which was insignificant statistically. Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 259 Dept of PG studies dravyaguna
  • 191. DISEASE REVIEW Graph 6 BODY WEIGHT 300 250 200 0th day 150 4th wk 8th wk 100 10th wk 50 0 NC HFC SD KA VK AQE HAE Graph 6a. BODY WEIGHT ON 0TH, 30TH,60TH ,75TH DAY 300 250 200 150 BT AT 100 50 0 NC HFC SD VK AQE HAE Graph 6b. BODY WEIGHT BEFORE AND AFTER TREATMENTEvaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 260 Dept of PG studies dravyaguna
  • 192. DISEASE REVIEW 250 200 NC HFC 150 STD 100 VK AQE 50 HAE 0 TC TG HDL LDL VLDL WEIGHT Graph 7 COMPARISISON OF ALL THE PARAMETERS ON 60TH DAY IN BETWEEN THE GROUPSEvaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 261 Dept of PG studies dravyaguna
  • 193. DISEASE REVIEWTable no : 43 Histo pathology of Liver, kidney and aorta.Group Liver Kidney AortasNC Normal Normal NormalHFC Presence of abundant fat Tubular epithelium shows Cardiac vacuoles in liver. fatty vacuolar changes myocytes Hyperlipidaemic plasma in showing mild blood vessels along with RBC; lipidosis, Hepatocyte showing fatty hemorrhage and vacuolar deposits. fatty changes.SD Very Mild fatty changes in Very Mild tubular changes No thickening liver of the wallKA Very mild fatty changes Mild tubular changes Intact wallVK Hepatocytes showing very Normal Smooth mild fatty changes in liver EndotheliumAQE Some fatty vacuoles in the Moderate fatty tubular Wrinkling of liver,+ changes aortic wall showing progression in Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 262 Dept of PG studies dravyaguna
  • 194. DISEASE REVIEW healing of lesions.HAE Fatty vacuoles + Moderate fatty vacuolar Slight Wrinkling changes in tubules. of endothelial wall showing progression of healing of lesions caused after inductionEvaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 263 Dept of PG studies dravyaguna
  • 195. DISEASE REVIEW HISTOPATHOLOGY LIVER KIDNEY AORTA NC HFC STDEvaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 264 Dept of PG studies dravyaguna
  • 196. DISEASE REVIEW LIVER KIDNEY AORTA KA VK HAE AQEEvaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 265 Dept of PG studies dravyaguna
  • 197. DISEASE REVIEW DISCUSSIONThe results of the present experimental study have been discussed at 3 levels. a. Drug selected for the study b. Analytic study c. Experimental studyThe drug Agnimantha (Clerodendron phlomidis) has been mentioned in Varunadi ganawhich is mainly attributed for kapha medohara karma. Acharya Charaka whilementioning the treatment for sthoulya indicated Agnimantha with Shilajatu andBrihatpanchamoola Kwatha in which Agnimantha is one of them. Acharya Sushruthaand Vagbhata have also considered Agnimantha for medoroga.BHEDA AND SANDHIGDHATA: In Ayurveda two varieties are mentioned brihat and laghu, and there iscontroversy regarding their botanical sources, some consider Premna integrifolia, andClerodendron phlomidis were mainly identified as Brihat and laghu Agnimantharespectively. And it is also mentioned that as the Guna karma of both are consideredas same both can be used in the place of other. According to API and “Data base onmedicinal plants used in Ayurveda” Clerodendron phlomidis is considered asAgnimantha. Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 266 Dept of PG studies dravyaguna
  • 198. DISEASE REVIEWHence for the present study, Clerodendron phlomidis was taken to asses medohara karmabased on following factors. ⇒ Based on its rasa panchaka ⇒ Based on its easy availability and non expensiveness ⇒ By keeping the reference from Brihattrayees and other samhitas. ⇒ As the effect of Agnimantha in medoroga is not singled out. Agnimantha is having katu, tikta kashaya rasa, laghu rooksha guna, katu vipaka ushna veerya. And kapha vatahara karma was apt for this study. Part used: Agnimantha is included under Brihat pancha moola suggesting the importance of root as useful part. Hence root was taken for the study.DISCUSSION REGARDING DISEASE. Though there is no direct mentioning of the disease hyperlipidaemia in Ayurveda,by Dosha dhatu mala and sroto vignana it can be understood.Rasa dhatu which is gatiyukta is circulating throughout the body through 24 dhamani.Kapha is considered as mala of rasadhatu, rasa dhatu and medodhatu are having manycharacters which are similar. Medo dhatu and kapha also share many commoncharacters as medo dhatu is ashraya for kapha.Vitiating factors for medodhatu, rasa dhatu and kapha are almost similar like guru ,snigdasheeta aahara, madhura rasa, atibhojana, etcIn dustilakshana of medovaha srotas, Astanindita purusha and prameha poorvaroopa arementioned. Astanindita purusha includes the condition sthoulya. And hence thedescription mentioned for the disease sthoulya can be considered for medodhatu dushti. Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 267 Dept of PG studies dravyaguna
  • 199. DISEASE REVIEWBahudrava and abadda meda are two morbid components involved in pathogenesis ofprameha, which are found to be vitiated in medodushti also. So kapha sanchaya andrasadushti lakshanas related to poorvaroopa of prameha can be considered here.The presence of kapha in rasa dhatu can be compared to lipids in plasma; aahara , viharaleading to vitiation of medodhatu may also vitiate rasadhatu inturn there may beformation of increased malarupi kapha in rasadhatu.A question may be raised here, when mala has to be excreted, why kapha as mala isobserved constantly in circulating rasadhatu? This is because for pureesha and mootrathere are ashayas from which they can be evacuated periodically. But in circulating rasa,both mala and dhatu coexist because it is a continues process in which srotas carry saaraand mala bhaga of dhatu. Theshaha thu malaprasaadakyanaha dhathunam srotamsyayana mukhani thani yatha Vibhagena yathaswaha dhathunaha poorayanthi || (cha su 28/5)It is known fact that hyperlipidaemia is a condition of increased lipids in blood plasma.And it is also established fact that hyperlipidaemia is precursor to arteriosclerosis.Dhamani pratichaya and srotopalepa are mentioned in our classics in the context ofkaphananatmaja vikara which indicates a coating /deposition of malarupi kapha inside thelumen of vessel. This condition can be correlated with arteriosclerosis.Further, based on ashraya ashrayee Bhava, medadhatu is ashraya for kapha andaggravation of one can aggravate other factor. Thus medovruddi can increase kaphaDosha and kaphavruddi can aggravate medas. Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 268 Dept of PG studies dravyaguna
  • 200. DISEASE REVIEWTreatment indicated for both the condition is apatarpana chikitsa in which lekhana karmais prime requirement - “lekahnam kapha medaso”. Based on Dhatu parinama Concept of mala Ashraya ashrayee Bhava Similarity between medodhatu, kapha and rasadhatu It is advisable to compare hyperlipidaemia to rasapradoshaja vikara which is also influenced by medodushti. Phyto chemical study The drug Agnimantha selected for the study showed physico chemical standards according to API and were with in normal limits. The macroscopic and microscopic study of the root confirms the genuinity of the drug Agnimantha. In Organoleptic observation, Agnimantha choorna, and aqueous extract was having dark brown color, probably indicates the presence of more tannin content. And hydroalcoholic extract was light brown in colour which may indicate less tannin content in it. Phyto chemical analysis carried out for Agnimantha vishoshi kashaya, aqueous extract and hydro alcoholic extract showed Alkaloids, Glycosides, Tannins, Steroids, Triterpenoids, Saponin, Carbohydrates in it. Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 269 Dept of PG studies dravyaguna
  • 201. DISEASE REVIEW The yield obtained for aqueous and alcoholic extract was 15.7% and that of Hydro alcoholic is 7.7% which indicates that there are more water soluble extractives in Agnimantha than alcohol soluble. Total ash for Agnimantha is 1.4% indicates less inorganic constituents and more organic constituents. pH value of vishoshi kashaya, aqueous an hydroalcoholic extract was 4.97, 4.23 and 4.30 respectively shows all the three are acidic in nature and comparatively Hydro alcoholic extract was more acidic. The Phytochemical constituents present in Agnimantha are attributed for the following action. Diterpenoid alkaloids are one of the alkaloids present in Agnimantha. These are proved to exhibit some of the pharmacological activities like hypolipidaemic, anti platelet aggregation and triglyceride lowering activities (Chem.Pharm.Bull.(Tokyo).2004, April 52(4):494-7) Tannins: They are secondary metabolites present in solution form in the cell sap and also in distinct vacuoles. They have been since long time as astringent substances, having the capacity to combine with tissue proteins and precipitate them. These are proved to act as Inhibitor of lipid peroxidation (Zhong Yao Cai.2003, June 26(6):444-8). Volatile oil: These are odorous, volatile principles of plant and animal source. As they evaporate on exposure to air at ordinary room temperature, they are called Ethereal oils. They represent essence or active constituents of plant hence called as Essential oils. Chemically, they are derived from terpenes and their oxygenated compounds. They are soluble in alcohol, ether and insoluble in water. They are lighterEvaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 270 Dept of PG studies dravyaguna
  • 202. DISEASE REVIEW than water. They act as carminative, anthelmintic, diuretic, antiseptic, local anaesthetic, sedative and counter irritant. Triterpenoids: These are the basic units of volatile oils. They are made up of isoprene units (C6H8). Based on the number of isoprene units, they are classified as mono (2), sesque (3), diterpene (4), triterpene (6) etc. They exert wide spectrum of activities like antiseptic, stimulant, carminative, diuretic, anthelmintic, analgesic, antirheumatic and counter irritant. Pilot study Though there are many models explained for induction of Hyperlipidaemia in animals, no model is standardized, hence here in the present study in vivo method for induction selected was (Shyamala et al method) using vanaspati and coconut oil 3:2 ratio. The induction of hyperlipidemia, in particular hypercholesterolemia, by feeding experimental animals a high-fat diet (HFD), has been suggested by many scientists. Dietary fat is one of the most important environmental factors associated with cardiovascular disease, and high levels of cholesterol and saturated fat in diets have shown to promote atherosclerosis (McNamara, 2000). In present scenario of lifestyle, man is going for fast foods and short eats, which are mainly made up of saturated fats, The vegetable fat is well known atherogenic agent. This edible fat which is used for food preparation, when consumed in excess may be harmful. With this idea rats were gavaged with HFD for a period of four weeks for induction of hyperlipidemia. Hyperlipidemia in experimental rats was evidenced by aEvaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 271 Dept of PG studies dravyaguna
  • 203. DISEASE REVIEW significant enhancement in the level of total cholesterol, triglycerides, VLDL cholesterol, LDL cholesterol and significant reduction in HDL cholesterol which was in accordance with Shyamala et al. (2005). This model was selected as it was simple, convenient and affordable method. Male Wister albino rats were selected as the tendency of hyperlipidaemia is more in male than in female and male breeder rats will develop signs of advanced metabolic and degenerative changes, including obesity, hyperlipidemia and arteriosclerosis easily. (Wexler, 1976). Dosage form selected for analysis of Agnimantha for medohara karma was vishoshi kashaya, aqueous and hydroalcoholic extract. Vishoshi kashaya was attributed for lekhana and shoshana karma which are required to treat medaja vikara – hyperlipidaemia. Dosage was fixed depending on the effect on serum lipid parameters in pilot study. Vishoshi kashaya 2ml, aqueous and hydroalcoholic extract at 1000mg/kg body wt. Study proper The objective parameters like serum total cholesterol, triglycerides, HDL, LDL, and VLDL and body weight were selected, as they are the only parameters to confirm the disease hyperlipidaemia. The trial drug was proved to be toxic above 2000mg/kg body wt from different experimental studies carried out before. In the present study induction of hyperlipidaemia was done till 30th day and trial drug was started from 30th day and it was given till 60th day, in 7 groups, one group wasEvaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 272 Dept of PG studies dravyaguna
  • 204. DISEASE REVIEW kept as normal control and another group was kept as high fat induced control to check the levels of lipid parameters in non induced and induced rats. One group was given vishoshi kashaya simultaneously with the induction to check the prophylactic effect of the Drug. Atervostatin was taken as standard drug for comparison as it is a proved drug in reducing total cholesterol, LDL, HDL, and VLDL and also has effect in raising the HDL levels. Histo pathology of Liver, kidney and aorta was done, as in these organ the fatty deposits are appreciated and atherosclerotic changes are well appreciated in Aorta. Statistical analysis: Analysis of variance (ANOVA) has been used to find the significance of study parameters between three or more groups. Student t test (two tailed, dependent) has been used to find the significance of study parameters on continuous scale with in each group. DISCUSSION ON RESULTS 0th day : There was no significant difference in any of the parameters as no induction was done. (p=0.015) 30th day: The changes in NC group were non significant in all the parameters. Total cholesterol (P=0.076), TG (P=0.172), LDL (P=0.113), VLDL (P=0.363) body weight (P=0.786 ) No significant change was observed in any of the parameters in KA group. In Total cholesterol (P=0.698), TG (P=0.145), LDL (P=0.702) VLDL (P=0.142),Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 273 Dept of PG studies dravyaguna
  • 205. DISEASE REVIEW HDL (P=0.091) this may because of prophylactic effect of vishoshi kashaya which was given simultaneously with induction for 30days. There was highly significant raise in TC, LDL, TG, VLDL (p<0.001**), and highly significant fall in HDL levels (p<0.001**) in all the groups and highly significant raise (P < 0.001** ) in body weight was also observed this was due to feeding of rats with saturated fats –vanaspati and dalda. This confirms hyperlipidaemia induction in rats. 60th day: There was highly significant fall (P<0.001** ) in TC, LDL, VLDL and TG in SD and VK group, moderate significant (P<0.05* ) fall in AQ and HAE group. Significant raise in HDL ( P< 0.001** ) was observed in SD and VK and moderate significant raise ( P< 0.05* ) was observed in AQ and HAE group. Significant reduction in weight was observed in SD and VK group (P<0.001** ) and moderate significant fall in AQ and HAE group. This reduction is due to the effect of Drug. In HFC group, though there was reduction in all the parameters, it was not statistically significant, this can be attributed for the withdrawing of High fat Diet. Histo pathology examination: Normal control group showed normal liver, kidney and aorta as it was neither induced nor treated with drug. in HFC group: Liver showed abundant fat vacuoles, Hyperlipidaemic plasma in blood vessels along with RBC; Hepatocyte showing fatty vacuolar deposits. In kidney, tubular epithelium showed fatty vacuolar changes. In Aorta, CardiacEvaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 274 Dept of PG studies dravyaguna
  • 206. DISEASE REVIEW myocytes showing mild lipidosis, hemorrhage and fatty changes This shows the changes and damage caused due to high fatty diet. In HAE and AQ group: liver - Moderate fatty vacuoles, Kidney: Mild tubular changes. In Aorta- Slight Wrinkling of endothelial wall showing progression of healing of lesions caused after induction. This was in accordance with the serum parameters, which indicates that the reduction has started in serum parameters. May be it required more time to bring back the parameters in to normalcy. SD, VK and KA group showed very mild fatty changes in liver, kidney and aorta which confirm the effectiveness of the drug Agnimantha in the form of vishoshi kashaya which was almost equal to standard drug group. PROBABLE MODE OF ACTION OF AGNIMANTHA Agnimantha is having katu, tikta, kashaya rasa, katu vipaka, ushna veerya, laghu rooksha guna and kapha vatahara karma. By its katu rasa it acts as Deepana and Pachana , thus prevents the formation of Ama, helps in elimination of waste products like sneha, sweda, kleda removes avarodha in the srotas and clears /dilates the channels. By its Thikta rasa it does lekhana karma, tikta rasa and Rooksha guna accounts for shoshana (drying) of meda, kleda. By its kashaya rasa it does shoshana and chedana of medas and kleda present in rasa dhatu. Laghu guna helps in alleviation of Sleshma (laghupakaha sleshmagnaha –su.su41) Ushna veerya helps in paachana and kaphavata shamana.Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 275 Dept of PG studies dravyaguna
  • 207. DISEASE REVIEW Histopathological reports in this study shows re establishment of disturbed liver tissues, which is suggestive of Hepato protective activity of the drug ( substantiated by previous work by, N .Gopal et al). Thus it has its effect in not only reducing serum lipids, but also safeguards liver. The genus Clerodendron belonging to Verbenaceae is reported to demonstrate biological activities such as hypoglycemic, hypolipidaemic, hepato protective, anti inflammatory activities (Kilimozhi et al). Hence Agnimantha belonging to the same genus is attributed with the constituents which act on hyperlipidaemia. Though the exact mechanism can not be known by this study, it can be inferred that, Agnimantha is having some chemical constituents, which may act in minimizing lipid absorption, or inhibiting lipid peroxidation or increasing lipid excretion through bile. All the available hypolipidaemic drugs are for life time use, because they are not capable of correcting lipid protein metabolism. But this study gives a clue regarding its utility in correction of same Hence by all these gunas which are opposite to kapha and medo gunas, Agnimantha acts effectively in treating hyperlipidaemia.Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 276 Dept of PG studies dravyaguna
  • 208. DISEASE REVIEW CONCLUSION Hyperlipidaemia is established as a major health concern due to strong causal relationships with ischemic heart disease, ischemic stroke, overall mortality, and due to its high prevalence. There is also strong evidence of the efficacy of cholesterol-lowering in reducing morbidity and mortality related to hyperlipidaemia. The most effective class of these agents, the RMG-CoA reductase inhibitors, are though potent, produce skin rash, myalgia, abnormalities of liver function and other problems in patients. Hyperlipidaemia- Raise of Lipids in plasma can be correlated with the increase of mala rupi kapha in rasa dhatu, which is influenced by medo dhatu dushti The treatment adopted here was kapha medohara karma ie lekhana karma aptly told by Sushrutha by including Agnimantha in Varunadi gana which is attributed for kapha medohara karma. With all the attributes Agnimantha which is having opposite quality of kapha and medas was chosen in this study. The animal model selected was Shyamala et al method, proved to be appropriate convenient, and effective in this study. Atervostatin was chosen as standard as it is proven hypolipidaemic drug which acts as HMG-CoA inhibitor. Vishoshi kashaya was chosen as dosage from as it is attributed for lekhana guna in Harita samhita.Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 277 Dept of PG studies dravyaguna
  • 209. DISEASE REVIEW All the three dosage forms , vishoshi kashaya, aqueous and hydroalcoholic extract of Agnimantha , selected in this study in proved effective in reducing hyperlipidaemia Vishoshi kashaya proved as highly effective in treatment of hyperlipidaemia, both as prophylactic and after induction. This may be attributed maximum concentration of the constituents in it. Comparative less effectiveness of hydro alcoholic extract can be attributed for its less alcohol soluble extractives which are responsible for this activity. In persons who are used to consume high fat diet, periodical and intelligent use of Agnimantha may avert hyperlipidaemia Limitations regarding the available treatments is long term use of drug; Antihyperlipidemic and hepatoprotective activity shown in this study says, here is a drug, which can correct lipid protein metabolism. Thus we can conclude that the drug mentioned as medohara in our classics has proved its efficacy in lowering the lipid levels and also in raising good cholesterol HDL effectively. Thus maintaining the equilibrium necessary for health.Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 278 Dept of PG studies dravyaguna
  • 210. DISEASE REVIEW SCOPE FOR FURTHER STUDY.This study was carried out by using roots of Clerodendron phlomidis; the same study canbe done by using bark .Leaf being prayojya anga , study can be carried out on the same in view of conservationof the plants.HPTLC can be done to know the specific components of Clerodendron phlomidis.Investigations regarding marker compounds can be taken up in order to understand thepharmaco kinetics and pharmaco dynamics of hypolipidaemic action of the drug better.Experimental studies can be carried on other species of higher animals.Clinical study can be done to confirm its efficacy on human beings.Follow up study can be extended up to 90 days, to observe for complete normalcy oftissues. Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 279 Dept of PG studies dravyaguna
  • 211. DISEASE REVIEW SUMMARYThe present study entitled “A Comparative Evaluation of Agnimantha moola(Clerodendron phlomidis) vishoshi kashaya, aqueous extract and hydroalcoholic extractfor medohara karma W.S.R to Hyperlipidaemia – An experimental study was carriedout.Roots of Agnimantha was procured from its natural habitat.The drug was authentified by botanist, and Microscopic study. Phytochemicalconstituents were analysed by analytical study and TLC study.Induction of hyperlipidaemia was done by feeding Vanaspati and coconut oil in theratio of 3:2 at 10ml/kg body wt. for 30 daysPilot study was done to fix the effective dose and period.Total study duration was 75 days in which induction of hyperlipidaemia for 30 days,drug treatment for next 30 days and follow up for 15 days.Standard drug Atervostatin was given at the dose of 2mg/kg body weight of rats.Kashaya at 2ml, aqueous extract and hydroalcoholic extract at 1000mg/kg body wt wasfixed as effective dosage.One group was given vishoshi kashaya along with the induction to check prophylacticeffect of the drug.Assessment of hyperlipidaemia was done based on serum parameters like TotalCholesterol, triglycerides, LDL,VLDL and HDL supported with Histo pathology ofliver, kidney and Aorta.All the three dosage forms have shown effective results in reducing hyperlipidaemia, inwhich vishoshi kashaya has shown highly significant effect. (p<0.001**)Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 280 Dept of PG studies dravyaguna
  • 212. DISEASE REVIEW The reduction in elevated serum lipids in Aqueous extract and hydroalcoholic extractwas moderately significant (p<0.05*) and HDL levels were also raised in these groupswhich was significant moderately.The effect of Vishoshi kashaya was almost equal to Standard drug Atervostatin.Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 281 Dept of PG studies dravyaguna
  • 213. DISEASE REVIEW BIBLIOGRAPHY 1. Agnivesha, Charaka Samhitha revised by Charaka and Drudhabala, with Ayurveda deepika commentary of Chakrapanidatta at Chaukhamba surabharathi Prakashan post box No 1129, Varanasi-221001. 2. Anonymous, Cultivation and utilization of Aromatic plants 1989, CSIR, Jammu-tawi, New Delhi, P No - 744. 3. Anonymous, The Wealth of India, Raw materials vol - I , CSIR, New Delhi. 4. Anonyms, programme profile, International liasin brings global vision to CAM, CAM at NIH 1996: 3:3. 5. Ashwatha Narayana, dravyaguna shastra part-I, Kannada Ayurveda Mahavidyalaya, Nirvahaka samithi, Mysore, P No 334-341. 6. Balwanth Singh and Chunekar K.C, Glossary of Vegetable drugs in Bruhatrayees, Choukamba sanskrith Series office, Varanasi - 31. 7. Bhava Mishra, Bhavaprakasha with Vidyothini Hindi Commentary Ist and IInd part, 7th Edition-1990, Chaukambha Sanskrit samsthana Varanasi-1, P No 130-134. 8. Blumenthal, Busse, W.R. Goldberg, A et al the complete German Commisssion E Monographis, Therapeutic guide to herbal medicines, Austin (Tx) American Botanical council 1998. 9. Caraka, Caraka Samhitha ( Agnivesha treatise refined and annotated by Caraka and redacted by Drudabala) Ayurveda deepika commentary Chakrapani, Varanasi:choukamba sanskritha samsthana: fifth edition:2001: 10. Chakrapanidatta, Chakradatta with Bhavartha sandeepini Hindi commentary 5th edition 1983, Chowkamba Sanskrit series office, Varanasi - 01.Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 282 Dept of PG studies dravyaguna
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  • 215. DISEASE REVIEW 23. Kaviraj Yugas kishoregupta, Siddha Bheshaja Samgraha, Ist Edition 1953, the Chaukambha Sanskrit series Office, Varanasi-1, P No 522. 24. Kirthikar and Basu B.D, Indian Medicinal plants, publisher; Sudhindranath Basu, Allahabad, P No 972-973. 25. Krishna shastri R Navare Edited, Nighantu Ratnakara part –I, 1936, published by Panduranga Javji, P No 170-171. 26. Madanapala Nrupa, Madanapala Nighantu, Ist Edition: 1954 published: Gangavishnu Srikrishnadas, Bombay P No 169-170. 27. MAPA- publications and informations directorate, CSIR, New Delhi. 28. Mayaram uniyal shastri, Prayogatmata Abhinava dravyaguna Vignana, Ist Edition 1991, publisher; Sri Baidyanath Ayurveda Bhavan Ltd, Patna, P No 367-368. 29. Mukund Sabins V D, Chemistry and Pharmacology of Ayurvedic medicinal plants, Choukamba Amarabharathi Prakashan, Varanasi: 2006, P No 83. 30. Nadkarni K.M, Indian Materia medica vol-I, 3rd Edition: 1976, popular prakashan Bombay, P No 65-71. 31. Narahari pandith, Raja Nighantu Ist Edition 1982 krishnadas academy varanasi, P No 197-198. 32. P.N.Bennett, M.J.Brown, Clinical pharmacology, 9th edition, Churchil Livingstone, London, P No 136, T P 788. 33. PDR-for Herbal medicines, Ist Edition Medical economics Company Montvale, New Jersy 1. P No 626-628. 34. Pharmacological investigation of certain medicinal plants and compound formulation used in Ayurveda and Siddha. CCRAs publication New Delhi.Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 284 Dept of PG studies dravyaguna
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  • 217. DISEASE REVIEW 46. Sharma P.V, Dravyaguna vignana, vol-II 16th Edition 1995, Choukamba bharathi academy, Varanasi-221001(India), P No 72-75. 47. Shodala, Gadanigraha Part-2 & 3 with Vidyothini Hindi teeka 3rd Edition, 1994 Chaukamba Sanskrit samsthana Varanasi - 1. 48. Siddharth N Shah, API text book of medicine, 7th edition, The association of physician of India 2006, P No 221. 49. Sushrutha, Sushrutha Samhita contd, Dalhana 3rd Edition published by panduranga jawaji, Nirnayasagar press Bombay. 50. Tropical Gastroenterology, 2006, jan-march 27(1): P No 26-30. 51. Uday Chand dutta, The Materia Medica of Hindus 3rd Edition- 1980, Chowkambha Saraswathibhavan, Varanasi -221001, P No 262-264. 52. Vagbhata, Astanga Hrudayam with Sarvanga Sundara commentary of Arunadatta, Varanasi, Choukamba orientalia, 7th edition, Uttaratantra, cha 39, SL No 127, P No 932. 53. Vagbhata, Astanga Hrudayam with the commentary Sarvanga Sundaram of Arunadatta, Chaukambha Orientalia, 7th Eition: 1982 N.S Press Bombay, Varanasi- 221001. 54. Vagbhata, Astanga Sangraha with Indu commentary, Varanasi: Choukamba orientalia, Sutrasthana, cha 23, P No 162. 55. Vaidya .V.M Gogte, Ayurvedic pharmacology & Therapeutic uses of medicinal plants, bharateeya vidya bhavan, Swami prakashananda Ayurveda Research Centre: 2000, P No 471.Evaluation of Agnimantha moola (Clerodendron phlomidis ) ….. for medohara activity W.S.R to hyperlipidaemia 286 Dept of PG studies dravyaguna
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