geriatric ppt.

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geriatric ppt.

  1. 1. ByDr. Nutan Panda
  2. 2. INTRODUCTION“THE GOAL OF LIFE IS TO DIE YOUNG ASLATE AS POSSIBLE” -Asle Montegue1) Ayurveda , deals with physical, psychological as well as spiritual well being of an individual.2) The desire to live is common to all living creatures evolved on this graceful planet, the Earth.3) Man, is a step ahead in the sense, desires not only to live but to live a long, happy and disease free life as far as possible.
  3. 3. CRITERIA OF TOPIC SELECTION 200 YEARS AGO TODAY COMMUNICABLE DISEASES CHRONIC DISEASE (like HT, DM, Cancer etc.) 1)World shifting from young to old world.2)Incorrect life style &dietary habits.3)Increase stress in day to day life.4)Elderly population in India by 2016 will be 113 million i.e.10-12 % of whole population The present study undertaken is designed with the hypothesis that Stress, incorrect Life style & Dietary Habits have found to be major impacts on Ageing. 5
  4. 4. LIFE EXPECTANCY OF THE WORLD India-67.5- 70yrs SWEDAN CANADA RUSSIAN FEDERATION UK USA JAPAN CHINAMEXICO INDIA AFHGANISTAN BRAZIL ANGOLA & ZAMBIA AUSTRALIA ARGENTINA 6
  5. 5. JARA:- An Ayurvedic Review
  6. 6. Etymology of JaraJara (old age) is from root “t`”k o;ksgkukS”by applying the sutra ^^f”kfnkfnH;ksMM~-** the term indicates to the loss in the period oflife span. The deduction from the remaining halfof the expected duration and every spent yearwould be considered as a loss in the age.
  7. 7. Synonyms of Jara & VriddhaOF JARA (Sources: Vachaspatyam and Gurubala prabodhika) LFkfoje~ & LFkfoja rq o`)Roe~ -The aspect of being old foL=lk & folzalrs v/k%irfrA -The degeneration of the ShareeraOF VRIDDHA o`)% & o/kZrs o`)% -One who has already attained Vriddhi. izo;% & izxra ;kSouk[;a o;ks·L;sfr izo;%-One who has crossed his youth. LFkfoj% & cgq dkya fr”Brhfr LFkfoj%- One who has stayed for a long time. thu% & thufr o;lks gh;rs thu%-One who is attaining deterioration. th.kZ@tju~ & th;rs th.kZ% tjp -Same meaning. T;k;u~% & o”khZ;ku~ n’kfe T;k;u~ -One who is at the stage of 90 years. tfjr% & t’k tkr vL; rkjdkA
  8. 8. Types of Jara Kalaja Jara: Jara coming at the proper age is Kalaja Jara(after 60 yrs.). It is‘Parirakshana Krita’ means it occurs at the proper age even after following the dailyand seasonal regimen mentioned in Swasthavritta. This is nothing but chronologicalAgeing. Dhatu kshaya janya jara. Akalaja Jara – The Concept of Premature Ageing:‘ Akalotpanna lakshana Akalaja’, ‘ Akale jata iti Akalaja’means that thing which occurs Akalaja i.e. before its prescribed time. occurs beforethe proper age due to not taking the proper care of personal hygiene(Swasthavritta). This Akalaja Jara is of greater intensity, rapidly progressing one ifneglected. This is Biological Ageing. Marga avarodha janya jara.
  9. 9. CAUSES OF JARA ACCORDING TO AYURVEDA iUFkk% ‘khra dnUukfu o;kso`)k’p ;ksf”kr%Aeul% izkfrdwY;a p tjk;k% ip gsro%A ¼j-j-l-26@2½ In Ras Ratna Samucchaya. The etiologicalfactors of Akalaja Jara described are :-Continuous walking after tirednessIntake of unwholesome foodIntake of cold substancesStaying in cold houseSexual indulgence with an old womanPressure of mind because of unbearable affairs.
  10. 10. Etiological Factors of Ageing Related to Dietary Habits “we are what we eat”1. Lavana (salt), Amla (sour), Katu (spicy) rasa pradhana2. Kshara (alkali)3. Suska shaka & Mamsa (dry vegetable & Meat)4. Tila Samyoga5. Pista Anna6. Viruddha Anna (Incompatible Diet)7. Asatmya Anna (Unfavorable Diet)8. Ruksha Anna (Dry Cereal)9. Abhisyandi Anna10. Klinna & Guru Anna (Heavy Diet)11. Puti & Paryushita Anna (Polluted & Out dated Diet)12. Vishamashana (Improper Eating Habits)13. Adhyashana (Over Eating) 12
  11. 11. Etiological Factors Related to Life style:1. Atimarga Gamana (Excessive Walk)2. Diwa Swapna (Day Sleeping)3. Nitya Stri Sevana (Excessive Intercourse)4. Nitya Madya Sevana (Excessive Intake of Alcohol)5. Vishama Vyayama Sevan (Improper Exercise) 13
  12. 12. The etiological factor of Ageing related to disturbed Mental Health1. Bhaya (Fear)2. Krodha (Anger)3. Shok (Sorrow)4. Lobha (Greed)5. Moha (Affection)6. Ruksha Vani (Harsh words)7. Kalah Priya Bharya (Quarrelsome Wife)8. Kuputra/ Kuputri (Maladroit child) 14
  13. 13. Ageing Srotokhar Vata atwa vriddhi (srotovah ani) Improper Ojo How Vata absorption & vriddhi occurs assimilationkshaya of ahara during ageing? rasa Uttarota Disequilibr ium in ra dhatu upchaya & kshaya apchaya Rasa dhatu kshaya
  14. 14. Etiopathogenesis of Ageing Disturbances in Manasika Bhava Dosha Rajas Dushti, Tamas, satva(Bhaya ,krodha, Shok ,Lobha, Moha ) Vikrit AgniMana Dushti Ajirna/Agnimandya Ama Free radicals Injury to cells Gradually damage to all over cell Ageing
  15. 15. DECADE WISE AGEING PROCESS Vagbhatta was the first one to record such an observation, which was followed laterby Sharangadhara. ckY;a o`f)% NfoZes?kk RoXn`f”V% ‘kqdzfodzekSA c`f)% desZfUnz;a psrks thfora n’krks g`lsr AA ¼’kk-la-iw-6@20½ ckY;s o`f)a izHkkes/kkRod ‘kqdzkf{k=qrhfUnz;e~A n’kds”kq dzek?kkfUr eu% losZfUnz;kf.k pAA ¼v-la-‘kk-8@25½ It is clear that ageing does not occur simultaneously in all the tissues. Differentbody tissues are affected ageing at different time period. Gradual declination of aparticular faculty takes place in each decade of life and by the end of decade, thatparticular faculty is lost.Decade Loss of tissues Vagbhata Sharngadhara I Childhood Childhood ΙΙ Growth Growth ΙΙΙ Complexion Complexion IV Intellect Intellect V Skin Skin VI Reproductive Capacity Vision VII Vision Reproductive Capacity VIII Hearing Valour IX Mind Knowledge X Sensory & Motor organs Motor organs XI - Mind XII - Life
  16. 16. CHIEF COMPLAINTS1.Twak Parushata (Dryness of skin) 14. Medha hani (Decreased functions of2. Slatha sara (Flabbiness Intellect) of the body) a. Grahana (Grasping Power)3. Slatha Mamsa (Decreased muscle b. Dharana (Retention Power) tone) c. Smarana (Memory Power)4. Slatha Asthi (Bone d. Vachana (Speech) weakness) e. Vijnana (Knowledge)5. Slatha Sandhi (Flaccid joint) 15. Utsaha hani (Decreased Enthusiasm)6. Dhatu Kshaya (Loss of 16. Parakrama hani (Decreased Physical Strength) tissues) 17. Paurusha hani (Decreased Virility)7. Kayasya Avanamanam (Bending of the body) 18. Prabha hani / Chhavi Hras (Changes in Complexion)8. Vepathu (Tremors) 19. Shukra Kshaya9. Khalitya (Falling of hairs) 20. Dristi Hras (Diminished Vision)10. Vali (Wrinkling) 21. Karmendriya hani (Decreased Loco11. Palitya (Graying of hairs) motor Activities)12. Kasa (Coughing) 22. Buddhi hani (Deterioration in13. Shwasa (Short breath) Wisdom) 18
  17. 17. Ageing Process :- A Modern Review
  18. 18. History of Geriatrics Greek word “geros” mean the old age + Iatric mean themedical treatment. This is the branch of medicine concerned with theproblems of Ageing, including physiological, pathological, andpsychological problems. Nascher was the first to coin the term Geriatrics. Hepublished a paper in New York medical journal in1909 and a textbookon it in 1914. Thus Geriatric came to be recognized as a specialbranch in first decade of 20th century.
  19. 19. Definition of Ageing “The processes that occur during life which culminate in changes thatdecrease an individuals ability to cope with biological changes”.GERIATRICS: - A branch of medicine dealing exclusively with the problems ofageing and the diseases of the elderly. It is derived from the Greek root “ger-gero- geronto” meaning “old age” or “the aged”. SYNONYMS OF AGEING:Senescence: is the process by which the capacity for cell division, growth andfunction is lost over time, ultimately leading to an incompatibility with life i.e., theprocess of senescence terminates in death.Senility: This term is from the Latin origin ‘senilitus’, which means the period ofphysical and mental deterioration, associated with old age.Senium: Identical to the term senility, one more term senium is also used in themedical field; it is marked by the deterioration and weakness that mayaccompany the age advancement.Geria: This also indicates the old age.
  20. 20. CLASSIFICATION OF AGE AGE Chronological age Biological age – Psychological age - number of years age by body – age how lived function individuals feels itCHRONOLOGICAL CATEGORIES•Young-Old - (ages 65 - 74) Set Old Age•Middle-Old - (ages 75 - 84) Old Old Age•Old-Old - (age 85 and older) Ripe Old Age
  21. 21. CLASSIFICATION OF CAUSES OF AGEINGoIMPROPER DIET Acidic foods Food additives: Food additives are added to improve the shelf life and stability of processed and smoked foods, but these are not "body friendly". Food preparation: oily food preparationoIMPROPER LIFESTYLE oSmoking oAlcohol oIrregular sleeping pattern oPhysical inactivity or improper exerciseoSTRESSoEXOGENOUS AGENTS •Environmental pollution: - People living in any metropolitan area are exposed to pollution, and if regularly commute in traffic jams or live near any industrial areas, body is exposed to more harmful air particles, and increased production of free radicals. •Pesticides: - pesticides causes more oxidative stress in the body. •Sun exposure •X-rays DRUG ABUSE
  22. 22. EFFECT OF STRESS ON BODY SYSTEMS
  23. 23. Some Theories of Ageing are given below: Waste Accumulation Theory Limited Number of Cell Divisions Theory Hay flick Limit Theory Death Hormone Theory (DECO) Thymic -Stimulating Theory Mitochondrial Theory Errors and Repairs Theory Redundant DNA Theory Cross-Linkage Theory Autoimmune Theory Caloric Restriction Theory Gene Mutation Theory The Rate of Living Theory Order to Disorder Theory The Telomerase Theory of Ageing Neuro Endocrine theory or Weak Link Theory Free Radical Theory of Ageing 25
  24. 24. FREE RADICAL THEORYFree radical is a term used to describe any molecule that differs fromconventional molecules in that it possesses a free electron, a property that makesit react with other molecules in highly volatile and destructive ways. The changesinduced by free radicals are believed to be a major cause of Ageing, diseasedevelopment or/and death
  25. 25. EFFECT OF FREE RADICAL DAMAGE
  26. 26. Free Radical AmaStress Disturbed Manasika BhavaExogenous Causes- Pollutants, dangerous Paryavaran pradushan/Chemicals , certain products Mithya Ahara ViharaEndogenous Causes- Due to deficiency of certain MandagnienzymesAtom/Molecule containing one or more unpaired Apachyamanaelectron,Inassimilable to body components exist in free state. Visha RupamCause damage to cell membrane destroy cells, Durgandhatvamleads to putrefaction foul smell generation. SuktatvamQuickly interact with healthy molecules of the body Reaction of aam vish withthus setting chain reaction. normal cells/ AashukariImpaired action of Free Radicals Scavengers Dhatvagni DaurbalyaIncreased production at the site Ama SanchayaCirculation in the body PrasaraStarts reacting to the weak cell membrane Sthana sanshraya at the site of KhavaigunyaProduction of Sign Symptoms of Ageing Production of Sign Symptoms of Jara
  27. 27. CHANGES OCCURING DURING AGEING 29
  28. 28. 30
  29. 29. 31
  30. 30. 32
  31. 31. 33
  32. 32. Selected Age-related Changes and their consequences 34
  33. 33. ANTI AGEING THERAPIES1. Deprenyl2. Human Growth Hormone3. DHEA4. Melatonin5. Acetyl-L-Car nitine6. Coenzyme Q107. Alpha Lipoic Acid8. Cysteine and Procysteine9. NADH10. Lycopene11. Vitamin E12. Vitamin B5 (Pantothenic Acid)13. Vitamin B6 (Pyridoxine)14. Synthetic Antioxidants15. Levodopa (L- Dopa)16. Calorie Restriction (can be correlate with “astha aahar vidhi visheshytan”) 35
  34. 34. CONCEPT OF RASAYANA
  35. 35. RASAYANA “Rasasya Ayanam Rasayanam” jlL; v;ua izki.ka jlk;ue~ ¼jk-fu-½ The Therapy, which gives the benefit ofgood Rasa, is Rasayana. Hence, it is thetherapy by which one gets the Rasa, RaktadiDhatus of optimum quality.
  36. 36. DEFINATIONjlk;urU=a uke o;% LFkkiuek;q esZ/kkcydjajksxkigj.ke leFkZapA ¼lq-lw-1@7@2½ Rasayana Tantra is one which dealswith delaying of ageing process, increasing ofintellect and strength, prolongation of life and curingof disorders.
  37. 37. S. No Classification Types Of Rasayana1. Main division Dravyabhuta Adravyabhutas Rasayana Rasayana2 As per method Kuti Praveshika Vatatapika Droni- praveshik of use (Charak)3 As per Scope of use Kamya Rasayana NaimittikaRasayana Ajasrika Rasayana Prana Kamya Medha Kamya Shri Kamya4 As per content of Ahara Rasayana Aushadha Rasayana Achara Rasayana Rasayana (Dietary Rasayana) (Medicinal Rasayana) (Conduct of Rasayana)5 Specific Rasayana Medhya Rasayana Achara Rasayana drugs measures Buddhi Medha Vardhaka Ayu Vardhaka6 According to Samshodhana Samshamana Prabhava Rasayana Rasayana7 According to Ritu Satmya Desh Satmya Satmya Aadana Kala Sadharana Desha Visarga Kala Jangala Desha Anupa Desha8 According to (1)Rasa (2) Rakta (3) Mamsa (4) Meda (5) Asthi (6) Majja Sapta Dhatus (7) Shukra9 According to Modern To Promote To improve To improve endocrine and Medical Science Immunity metabolism exocrine secretions
  38. 38. PROBABLE MODE OF ACTION OF RASAYANAFour Modes of Action of RasayanaRasayana basically promotes the nutrition through four modes.They are:1. By directly enriching the nutritional intake of the body through increasing the consumption of Amalki, Satavarai, Milk, Ghee, etc2. ON AGNI: By improving Agni i.e. digestion and metabolism through Bhallataka, Pippali etc, thereby promoting nutrition.3. SROTOVISHODHANA : By promoting the capability of Srotas or microcirculatory channels in the body, through herbs like Haritaki, Guggulu, Tulsi, and so on4. By its VISHAGHNA property
  39. 39. Procedure effect of Rasayana intake SodhankarmaSrotonirmalta Peyadikarma Kayagni deepti Dhatu suddhi Dhatwagni deepti RASAYAN PRAYOGA Improved quality of dhatus OJOVRIDDHILongevity and health Immunity Mental competence REJUVENATION 41 “Yajj jara vyadhi vidhvasi bheshajam tad rasayanam”
  40. 40. EFFECT OF RASAYANAThe word Rasayana =Rasa +Ayana.Rasa: means the Rasa dhatu and the remaining dhatuRakta , Mamsa , Meda, Asthi, Majja and Sukra.Ayana: Ayana means the road, a path, a way and a movement. “Rasasya Ayanam Rasayanam “ “Labho payo sashtanam rasadinam rasayanam”(ch.chi.1.)The Therapy, which gives the benefit of good Rasa, is Rasayana. Hence, it is thetherapy by which one gets the Rasa, Raktadi Dhatus of optimum quality.In short Rasayana - Gives Long life Delays Ageing and death Increase intelligence, memory and luster Excellence in the body tissues Increases the immunity Removes diseases Gaining “Moksha” (Final Entity) and “Divya Lakshana”
  41. 41. RASAYANA YOGA GHNA VATIThe Rasayana yoga for research work comprises of six medicines viz. 1) Ashwagandha 2) Aamalki 3) Bala 4) Guduchi 5) Yashtimadhu 6) Vanshalochan References for above 1. to 5. medicine are taken from “MEDICINAL PLANTS IN GERIATRIC HEALTH CARE” an evidence based approach of Central Council for Research in Ayurveda and Siddha (CCRAS).. 44
  42. 42. PHARMACOLOGICAL ACTIVITIES OF DRUGS1) Aamalki:-(Embelica officinale)RASA - MADHURA KASAYA TIKTA KATUGUNA - GURU RUKSHA SHEETAVEERYA - SHEETAVIPAKA - MADHURAPRABHAVA - RASAYANADOSA-PRABHAVA -TRIDOSA SHAMAKA PITTACNSdepressant, Hypolipidemic, Antiatherosclerotic, Antimicrobial, Antioxidant, Immunomodulator, Hypoglycemic, Anti-inflammatory, Antitumor.2)Ashwagandha :-(Withania somnifera)RASA - TIKTA,KATU,MADHURGUNA - LAGHU,SNIGDHAVEERYA - USHNAVIPAKA - MADHURPRABHAVA - RASAYANADOSA-PRABHAVA - KAPHAVATA SHAMAKHypotensive, Immunomodulator, Adaptogenic, Antistress, CNSdepressant, Antioxidant, Analgesic, Antiarthritic, Cardioprotective, Antiageing, Psychotropic. 45
  43. 43. 3)Guduchi:-(Tinosporia cordifolia)RASA - KASAYA TIKTAGUNA - GURU SNEEGDHAVEERYA - USHNAVIPAKA - MADHURAPRABHAVA - RASAYANADOSA-PRABHAVA- TRIDOSA SHAMAKAHypoglycemia, Antihyperglycemic, CNSdepressant, antistress, Hepatoprotective, antiarthritic, AntiallergicImmunostimulant, Antidiabetic, Adaptogenic, Antioxidant, Diuretic.4)Bala:-(Sida cordifolia)RASA - MADHURAGUNA - LAGHU, SNEEGDHA,PICHILAVEERYA - SHITAVIPAKA - MADHURAPRABHAVA - RASAYANADOSA-PRABHAVA- VATA PITTA SHAMAKAAntioxidant, Thyroregulatory ,Hepatoprotective, Immunomodulatory,Antihypertensive, Hypoglycemic, Adaptogenic. 46
  44. 44. 5)Yashtimadhu:-(Glycirrihza glabra)RASA - MADHURAGUNA - GURU SNEEGDHAVEERYA - SHITAVIPAKA - MADHURAPRABHAVA - RASAYANADOSA-PRABHAVA- VATA PITTA SHAMAKAHypolipidaemic, Antiatherosclerotic ,Hypotensive, Hepato- protective,Antiexudative, Antioxidant, Anti-inflammatory6)Vanshalochana:-(Bambusa arundinacea)RASA - KASAYA MADHURAGUNA - GURU SNEEGDHAVEERYA - SHITAVIPAKA - MADHURADOSA-PRABHAVA- VATA PITTA SHAMAKAAntidiarrhoel, Antiparalytic, Carminative, Expectorant, It is cooling, nutritive,stimulant, digestive, aphrodisiac and febrifuge agent. It is known to help in chronicand general debility, cough and indigestion. 47
  45. 45. DRUG PROPERTIESDRUGS PRABHAVA KARMA DOSHAGHNATAAmalki Rasayana, Rasayana,Hridya,Vrishya, Nadibalya,Deepaniya, Tridhosh shamak , Vrishya Medhya, Anulomana, Shramahara, Balya, Esp. Pitta-shamaka Vayasthāpana, Jivaniya, Sarvadoshahara, Nadi- Indriya Balaprada, Rochana,Ashwa Rasayana, Balya, Brihana, Rasayana, Vajikarana, Nidrajanan Vata Kaphagandha Vrishya ShamakBala Vrishya, Balya, Vatahara, Hridya, Shukral, Prajasthapan, Rasayana Vata- pitta shamakGuduchi Vrishya, Rasayana ,Deepana, Pachana, Balya, Medhya Tridhosh shamak Rasayana Raktashodhana, Vayasthapana, Vrishya,Pathya, Shukra dourbalya, Dhatukrita, Shramahara, MutrajananaYashti madhu Rasayana, Rasayana, Balya, Nadibalya, Medhya, Vrishya, Keshya,Swarya,Vedanasthapana Vata -pitta ShamakVansha Balya, Vrishya, Shamak, Trishnanigrahana, Grahi, Hridya,lochana Brihana Shwasahara, Mootrala, Jwarghna, Balya, Vata- pitta Shamak Brimhan
  46. 46. RASAYANA YOGA GHANA VATI PERCENTAGE OF RASA PANCHAKAS. No. RASA PROPERTIES PERCENTAGE1. RASA Madhura 38.46 % Amla 07.69 % Katu 15.38 % Tikta 23.07 % Kashaya 15.38 %2. GUNA Guru 20.00% Laghu 20.00% Sheeta 06.67% Snigdha 26.67% Ruksha 13.33% Picchila 06.67% Tikshna 06.67%3. VEERYA Sheeta 66.67% Ushna 33.33%4. VIPAKA Madhura 100.00%5. DOSHAGHNATA Tridosha Shamaka 25.00% Vata-Pitta Shamaka 50.00% Kapha-Vata Shamaka 25.00%
  47. 47. Action of Rasayana Yoga Ghana Vati  Vaya Sthapana,  Brihana,  Balya,  Rasayana,  Deepan Pachana,  Vata Shamaka properties,  Vrishya  Hridya
  48. 48. RASAYANA YOGA GHANA VATI VEHICAL RASAYANA YOGA GHANA VATI MILKMilk pacifies vitiated Vata and Pitta Dosas. As the milk is having identical propertiesof Ojas, it promotes Ojas. The Cow’s milk acts asRasayana, Tarpaka, Jivaniya, Hridya, Ahladakara and Buddhi prabodhaka.
  49. 49. Importance of Anupan ( cow’s milk)In Ayurveda, Cow’s milk is much appreciated for the therapeutic purposes and also in preparation of the formulation as a media. The Go- dugdha possesses properties like Madhuram, Jivaniyam, Prinanam, Rasayanam, Brihanam, Vrishyam, Medhya, Baly a, Dipaniya ,Shonita pittaharam, Shreshtham etc. Chemical Composition of milk: 87.3% water 3.9% milk fat 8.8% solids- not fat Protein – 3.25% Lactose – 4.6% Minerals – 0.65% - Ca, P, Mg, K, Na, Zn, CO, Fe, Cu, sulphates, bicarbonatesAcid – 0.18% - citrates, formats, acetate, lactate, oxalate.Enzymes – peroxidase, catalase, phosphatase, lipase.Gases – oxygen, nitrogen.Vitamins – A, C, D, thiamine, riboflavin, others. 52
  50. 50. MODE OF ACTION OF RASAYANA YOGA GHANA VATI(1)According to Rasa: - Main content is Madhura rasa (38.46%) which helps to increasedhatus, especially saumya dhatus which form the major portion of the body. After Madhura ,Tikta rasa is the predominant one (23.07%)in present compoundformulation.Tikta rasa is having properties of Agnideepana, Pachana ,Srotoshodhana Rasayanaprabhava in dhatu nourishment process. Katu rasa (15.38%) by svabhava is agnideepaka, Pachaka, Srotoshodhaka Kaphanashaka.(2)According to Guna:-it has got the predominance of Snigdha(26.67%).So it is Bala , Varnavardhaka and Vajikar. After Snigdha guna ,Guru guna(20.00%) is predominant. It causes brimhanaand it is Balya provide poshana. These guna are mainly used in pacifying the Vata prakopa Kapahavardhan.(3)According to Vipaka : - It is mainly Madhura (100%) causes the expulsion of mala mutrafrom the body releases the toxins it is Shukral in nature.(5)According to Veerya : - Most of the contents have Sheeta veerya (66.67%) which acts asprahladana, Kledana Stambhana, Balya, Prasadana Jeevaniya .It is Kapha Vata Shamaka.(6) According to Doshakarma: - It works as Vata-Pitta Shamaka (50.00%) also tridosha shamaka(25.00%).Thus it helps maintain doshic imbalance in the body make person healthy.
  51. 51. AIM AND OBJECTIVES1)To study the conceptual basis of ageing (jara) according toAyurveda and different theories of ageing according to modernmedical science.2) To evaluate the efficacy of Rasayana yoga clinically in themanagement of ageing.3)To evaluate the role of main causes of ageing– Physical Mental Stress, Improper Life Style Dietary Habits andmedication of the proper Rasayana Drugs at proper time in aproper way.4) To access the effect of Rasayana Dravya on different agegroup clinically
  52. 52. THE PATIENTS WERE Simple RandomMATERIAL Methods SELECTED FROM O.P.D. and I.P.D. of Kayachikitsa Department of Govt. Sampling Ayurvedic college hospital methods Raipur(C.G.)
  53. 53. •The patients having sign and (1)Patients of age group below 40symptoms mentioned as per Ayurvedic and above 70 years.and Modern literatures. Multiple andsimple random sampling method has (2)Patients with severe cardiacbeen adopted for the selection of 60 disease, Pulmonary Tuberculosis,uncomplicated cases. Severe hypertension and DM,•Age incidence-The Patients between HIV, Hepatitis B etc40 to 70 years of age. (3)Patients with malignant•Sex- Patients of either sex wereincluded. carcinoma•Duration of illness – Not more than 3 (4)Pregnant lactating mothersyears.•Habitat-Both urban and rural areaswere selected.•Religion, Occupation, Caste, Socio-economic status-No bar.•Patient willing to follow up regularly.
  54. 54. Having the Signs and Symptoms of Jara as described in Ayurvedictexts.Detailed history was taken and physical examination was done on thebasis of a special Proforma incorporating all the signs and Symptomsof the disease.The routine hematological and urine examination was carried out inselected patients to exclude any other pathology as well as to assessthe present condition of the patient.
  55. 55. ASSOCIATED SYMPTOMS1. Indigestion2. Altered Bowel pattern3. Altered Sleep pattern4. Palpitation5. Anger6. Irritability7. Early Menopause8. Altered Urinary Symptoms9. Recurrent Infections10. Fatigue11. Weakness12. Loss of Hearing13. Weakening of Teeth 59
  56. 56. HEALTH PARAMETERS (DIAGNOSTIC CRITERIA)(a) Walking Time(b) Handgrip Power(c) Foot Pressure(d) Short Term Memory(e) Long Term Memory(f) Breath Holding Time(g) Pulse, B.P., Temperature Weight All these vital data are recorded before after treatment. As per above sign symptoms patient examination proforma will be prepared patients will be selected for trial. 60
  57. 57. CLINICAL STUDY It will be undertaken on following parameters:-A) Number of patients:- 60(sixty) patients will be selected for randomized clinical trial.B) Place of selection of patients:- Patients will be selected from the OPD IPD of Govt. Auto. Ayurvedic College Hospital, Raipur, ChhattisgarhC)Criteria for selection of the patient:- i) Patient between 40 -70 yrs age group will taken for present study. ii) Patients will be selected on the basis of sign symptoms available in Ayurveda texts viz. Charak Samhita, Sushrut Samhita Ashtang Samgraha. 61
  58. 58. GROUPINGS “In all the three groups, Haritaki Churna – 5 gms is used during samanya samsodhan with luke warm water for Koshtha Srotas Shuddhi before starting the medication”1) Group A: 20(twenty) patients will be taken between 40 -50 yrs age group and will be given Rasayan yoga orally. Drug dose: 1 gm BD Anupana: Milk Duration: 02(Two) Months2) Group B: 20(twenty) patients will be taken between 51 -60yrs age group and will be given Rasayan yoga orally. Drug dose: 1 gm BD Anupana: Milk Duration: 02(Two) Months3) Group C: 20 (twenty) patients will be taken between 61-70yrs age group and will be given Rasayan yoga orally. Drug dose: 1 gm BD Anupana: Milk Duration: 02(Two) Months 62
  59. 59. InvestigationsThe Routine Routine Serum of thehaematological microscopic urine patients were testedexamination of blood analysis were for HDL, LDL, carried out to detectlike Hb% , TLC , DLC Triglyceride, the involvement ofMCH, MCHC, MPV, Creatinine , Albumin, kidneys and toMCV,ESR were done. exclude the urinary Globulin, A/G Ratio, tract infectious blood urea, Blood conditions like Sugar (Fasting PP) veneral disease, ,Total protein, Total syphilis etc. cholesterol.
  60. 60. OBSERVATIONS Status wise distribution Age sex wise distribution 20 19 20 17 20 7No. of patients 15 8 No. of patients 15 11 Group C F 10 Group C M 10 3 Group B F 5 1 12 13 0 9 Group B M 5 0 Group A F Completed LAMA Group A M 0 Status 40-50 51-60 61-70 Age Group Group A Group B Group C
  61. 61. Sex wise distribution Religion wise distribution 13 12 20 17 14 11 15 9 14 No. of pateints 12 No. of patients 8 15 10 7 8 10 6 4 5 33 2 2 11 0 1 1 2 0 00 0 0 Female Male Hindu Muslim Christian Sikh Other Sex group Religion group Group A Group B Group C Group A Group B Group C Marital status wise distribution Education wise distribution 18 7 7 20 7 6 15 6 5 5 Group A No. of patientsNo. of patients 15 11 5 4 4 4 4 4 3 3 3 Group B 10 7 3 22 4 2 1 5 2 Group C 11 0 0 0 1 1 0 Illiterate Graduate PG Primary High.Sec. 0 Umarried Married Widow Divorce Marital status Education Group A Group B Group C
  62. 62. Residence wise distribution Occupation wise distribution 15 7 13 14 7 6 66 15 No. of patients 6 5 5 5 Group A 5 4 44No. of patients 10 7 4 3 3 Group B 5 6 3 2 11 5 1 0 0 00 Group C 0 Service Labourer Retired Household Unemployed Buiseness 0 Rural Urban Residence group Group A Group B Group C occupation Socio-economic wise distribution 10 9 8 7 No. of patients 8 6 4 4 4 4 4 3 3 3 3 3 2 2 1 2 0 Poor Lower Middle Upper Rich middle middle Socio-economic status Group A Group B Group C
  63. 63. Type of diet wise distribution 14 15 15 12No. of patients 8 10 6 5 5 0 Vegetarian Mixed Type of diet Group A Group B Group C
  64. 64. Supplementary diet wise distribution Addiction wise distribution 20 19 88 20 17 8No. of patients 7 6 6 6 66 Group A No. of patients 15 12 6 10 10 5 4 4 10 88 88 4 3 Group B 3 5 3 2 2 5 2 1 000 1 0 0 Group C 0 0 Smoking Alcohol Tobbaco Sedatives Panmasala Tea Coffe Cold Milk Other chew drink Supplementary diet group Group A Group B Group C Addiction Dominant Rasa of Ahara wise distribution 2018 20 18 18 18 17 16 16 15 14 No. of patients 15 12 12 10 6 5 3 3 5 2 3 0 Madhra Amla Lavana Katu Tikta Kashaya Type of Aha ra Rasa Group A Group B Group C
  65. 65. Dominant Guna of Ahara wise distribution 14 14 13 13 1313 12 12 12 12 12 12No. of patients 12 10 11 10 9 10 88 8 8 6 4 2 0 Guru Laghu Sheeta Ushna Snigdha Ruksha Type of Ahara Guna Group A Group B Group C Ayogya Ahara Vidhi wise distribution 20 Anushna 18 16 Asnigdha No. of patients 14 Amatravata 12 10 Ajirne 8 6 Viryaviruddha 4 2 Anishtadesha 0 Group A Group B Group C Anishta upakarana Types of Ayogya ahara vidhi Anmanaska Atmanam
  66. 66. Diet habit wise distribution Kostha wise distribution 16 11 12 16 13 10 9 8 8 8 14 No. of patients 7No.f patients 7 6 12 8 6 9 10 6 8 6 5 4 4 6 3 2 2 4 2 2 0 0 Samashana Vishmashana Adhyashana Mridu Madhyam Krura Diet habit Type of Kostha Group A Group B Group C Group A Group B Group C Exercise wise distribution 14 13 12 Group No. of patients 10 A 88 8 6 Group 6 5 4 4 B 4 3 2 2 1 11 11 1 0 Group 0 0 C 0 Ir lar E er R se ex lar s se P s es s p o u i u ci Le rc ro N eg eg xc er xe r E Exercise group
  67. 67. Nidra wise distribution Dincharya Palana wise distribution 18 18 16 18 17 15 15 14 16 16 13 13 13 14 14 GroupNo. of patients No. of patients 12 12 11 10 A 12 10 10 9 10 9 Group 10 7 B 8 6 8 4 5 6 5 5 Group 6 C 3 4 4 2 22 2 2 0 0 Samyaka Asamyaka na As aka ka a s ta pa na a ut i ap ya nd Al ra Dincharya group bh y ag m am w a a Kh Sa Pr rij iw at D R Group A Group B Group C Nidra group Ratricharya wise distribution 14 14 12 11 12 No. of pateints 9 8 10 6 8 6 4 2 0 Sa mya ka Asa mya ka Ra tricha rya group Group A Group B Group C
  68. 68. Ritucharya Palana wise distribution Sadvritta Palana wise distribution 16 17 16 16 16 13 20 14 11 No. of patientsNo. of patients 12 15 9 10 7 8 10 4 4 6 4 5 3 4 2 0 0 Samyaka Asamyaka Samyaka Asamyaka Ritucharya group Sadvritta group Group A Group B Group C Group A Group B Group C Sha ririka pra kriti w ise distribution 15 16 14 12 Group A No. of patients 12 9 10 8 7 Group B 6 4 4 4 4 4 1 Group C 2 0 0 0 00 0 0 ap haj j aj j j ha ha a itt at p os os P V a K kd aj rid ha a at E T itt V P K Sha ririka pra kriti
  69. 69. Manasika Prakriti wise distribution 12 Sara wise distribution 13 12 10 14 9 11 No. of patients 10 8 7 12 9 No. of patients 8 6 10 8 6 4 8 5 4 2 2 6 4 3 4 3 2 4 0 2 Rajasika Tamsika Rajasika- 0 Tamsika Pravara Madhyama Avara Manasika prakriti Type of Sara Group A Group B Group C Group A Group B Group C Satva wise distribution 14 Samhanana wise distribution 13 12 11 14 10 12 10 10 No. of patients 8No. of patients 10 7 7 8 6 8 6 5 5 4 4 6 6 3 3 2 2 4 4 2 2 0 0 Pravara Madhyama Avara Pravara Madhyama Avara Type of satva Type of samhanana Group A Group B Group C Group A Group B Group C
  70. 70. Pramana wise distribution Satmya wise distribution 13 14 12 12 11No. of patients 12 12 10 10 10 10 No. of patients 8 5 8 6 7 7 6 4 4 5 4 3 3 6 4 3 3 2 2 0 2 Pravara Madhyama Avara 0 Type of pramana Pravara Madhyama Avara Group A Group B Group C Group A Type of satmya Group B Group C Vyayamshakti wise distribution 15 16 14 No. of patients 12 10 9 10 7 8 5 5 6 4 4 4 1 2 0 Pra va ra Ma dhya ma Ava ra Vya ya msha kti Group A Group B Group C
  71. 71. Agni wise distribution 14 14 13 12 10 Abhyavarana shakti wise distributionNo. of patients 10 8 6 6 5 4 10 10 4 2 2 10 9 11 1 1 2 7 No. of patients 0 Mandagni Tikshnagni Vishmagni Samagni 8 6 6 Type of agni Group A Group B Group C 6 5 4 4 3 Jarana shakti wise distribution 2 10 10 8 0 7 7 7 7 Pravara Madhyam Avara No. of patients 8 6 5 6 3 Abhyavarana shakti 4 2 Group A Group B Group C 0 Pravara Madhyam Avara Jarana Shakti Group A Group B Group C
  72. 72. Percentage 95.00% 53.33% 90.00% 88.33%98.33% 80.00%70.00% 43.33% 90.00% 81.66% 80.00% 51.66% 86.66% Indigetion Constipation Disturbed sleep Palpitation Anger Irritability Loss of hearing W eakning of teeth Early menopause Recurrent infection Fatigue W eakness Altered urinary symptoms
  73. 73. Dhatu Kshaya wise distribution 20 20 20 20 19 19 19 20 18 18 18 17 16 17 16 16 16 16 14 14 Group A 13 14No. of patients 12 10 Group B 7 8 6 6 4 Group C 4 2 Ojodushti wise distribution 0 i sa a sa a a th ja kt kr ed 17 aj a s am 20 a u R A M M R h M S 14 No. of patients Dhatu 15 11 9 9 10 7 7 7 4 5 0 Vyapada Visramsa Kshaya Type of ojodushti Group A Group B Group C
  74. 74. SHOWING PERCENTAGE OF IMPROVEMENT IN VARIOUS SIGN AND SYMPTOMS AFTER TWOMONTH OF TREATMENT IN 20 PATIENT OF JARA ROGA OF “GROUP A”S. No. Sign Symptoms Before Treatment After Treatment G0 G1 G2 G3 Total G 0 G 1 G 2 G 3 Total % OF RELIEF 1. Twak Parushata 6 5 6 3 26 15 3 2 0 7 73.08% 2. Slatha sara 0 4 8 8 44 14 3 2 1 10 77.27% 3. Slatha mamsa 2 3 8 7 40 14 2 2 2 13 67.50% 4. Slatha Asthi 2 8 5 5 33 14 2 1 3 13 60.60% 5. Slatha Sandhi 4 7 6 3 28 14 4 1 1 9 67.86% 6. Dhatu Kshaya 0 12 4 4 32 14 4 2 0 8 75.00% 7. Kayasya 19 1 0 0 1 20 0 0 0 0 100.00% Avanamana 8. Vepthu 15 3 1 1 8 18 2 0 0 2 75.00% 9. Khalitya 0 7 8 5 38 13 2 4 1 13 65.79% 10. Vali 2 10 5 3 29 13 3 2 2 13 55.17% 11. Palitya 2 9 7 2 29 14 2 3 1 11 62.07%
  75. 75. 12. Kasa 06 7 6 1 22 14 4 2 0 8 63.64%13. Shwasa 13 5 2 0 9 18 1 1 0 3 66.67%14. MEDHA HANI i. Grahana hahi 1 15 3 1 24 14 4 1 1 9 62.50%ii. Dharana hani 1 16 2 1 23 15 4 1 0 06 73.91%iii. Smarana hani 0 7 10 3 36 13 3 3 1 12 66.67%iv. Vijnana hani 13 3 4 0 11 17 2 1 0 4 63.64%v. Vachana hani 0 0 0 0 0 0 0 0 0 0 00.00%15. Utsaha hani 6 5 5 4 27 15 2 1 2 10 62.96%16. Parakrama hani 2 7 6 5 34 13 1 4 2 15 55.88%17. Paurusha hani 19 1 0 0 1 20 0 0 0 0 100%18. Prabaha hani 3 13 3 1 22 15 2 2 1 9 59.09%19. Shukra Kshaya 15 3 2 0 7 16 2 2 0 6 14.28%20. Drishti Hrasa 4 12 4 0 20 6 12 2 0 16 20.00%21. Karmendriya hani 10 6 4 0 14 17 2 1 0 4 71.42%22. Buddhi hani 15 4 1 0 6 18 1 1 0 3 50.00%
  76. 76. SHOWING PERCENTAGE OF IMPROVEMENT IN VARIOUS SIGN AND SYMPTOMS AFTER TWOMONTH OF TREATMENT IN 19 PATIENT OF JARA ROGA OF “GROUP B”S. Sign Symptoms Before Treatment After TreatmentNo. G0 G1 G2 G3 Total G 0 G 1 G 2 G 3 Total % OF RELIEF 1. Twak Parushata 2 7 6 4 31 10 7 2 0 11 64.52% 2. Slatha sara 0 5 10 4 37 10 7 1 1 12 67.57% 3. Slatha mamsa 2 3 9 5 36 11 5 2 1 12 66.67% 4. Slatha Asthi 1 7 8 3 32 11 6 2 0 10 68.75% 5. Slatha Sandhi 0 6 8 5 37 12 4 1 2 12 67.56% 6. Dhatu Kshaya 0 4 11 4 38 10 4 3 2 16 57.89% 7. Kayasya 13 3 2 1 10 15 3 1 0 5 50.00% Avanamana 8. Vepthu 11 3 3 2 15 14 3 1 1 8 46.67% 9. Khalitya 0 6 11 2 34 1 8 8 2 30 11.76%10. Vali 0 3 13 3 38 0 7 10 2 33 13.16%11. Palitya 0 6 12 1 33 4 4 10 1 27 18.18%
  77. 77. 12. Kasa 2 4 9 4 34 11 4 4 0 12 64.71%13. Shwasa 5 5 6 3 26 13 4 2 0 8 69.23%14. MEDHA HANI i. Grahana hahi 0 9 5 5 34 10 3 4 2 17 50.00%ii. Dharana hani 0 12 4 3 29 11 5 2 1 12 58.62%iii. Smarana hani 0 10 7 2 30 10 6 2 1 13 50.00%iv. Vijnana hani 13 2 3 1 11 16 1 1 1 6 45.45%v. Vachana hani 18 1 0 0 1 18 1 0 0 1 00.00%15. Utsaha hani 2 9 6 2 27 11 4 3 1 13 51.85%16. Parakrama hani 0 8 7 4 34 10 2 5 2 18 47.06%17. Paurusha hani 14 3 1 1 8 16 2 1 0 4 50.00%18. Prabaha hani 1 13 3 2 25 7 9 2 1 16 36.00%19. Shukra Kshaya 13 3 2 1 10 14 3 1 1 8 20.00%20. Drishti Hrasa 2 9 8 0 25 3 8 8 0 24 4.00%21. Karmendriya hani 9 5 3 2 17 15 2 1 1 7 58.82%22. Buddhi hani 11 5 3 0 11 14 5 0 0 5 54.55%
  78. 78. SHOWING PERCENTAGE OF IMPROVEMENT IN VARIOUS SIGN AND SYMPTOMS AFTER TWOMONTH OF TREATMENT IN 17 PATIENT OF JARA ROGA OF “GROUP C”S.No. Sign Symptoms Before Treatment After Treatment G0 G1 G2 G3 Total G 0 G 1 G 2 G 3 Total % OF RELIEF 1. Twak Parushata 0 3 10 4 35 2 5 7 3 28 20.00% 2. Slatha sara 0 0 9 8 42 4 9 2 2 19 54.76% 3. Slatha mamsa 0 2 10 5 37 8 2 6 1 17 54.05% 4. Slatha Asthi 1 4 7 5 33 6 6 3 2 18 45.45% 5. Slatha Sandhi 0 3 8 6 37 5 10 1 1 15 59.46% 6. Dhatu Kshaya 0 0 10 7 41 2 5 6 4 29 29.27% 7. Kayasya Avanamana 13 1 2 1 8 13 1 2 1 8 00.00% 8. Vepthu 11 4 2 0 8 13 3 1 0 5 37.50% 9. Khalitya 0 3 6 8 39 0 3 8 6 37 05.13%10. Vali 0 2 11 4 36 0 5 8 4 33 08.33% 11. Palitya 0 0 7 10 44 0 0 7 10 44 00.00%12. Kasa 2 3 7 5 32 8 6 1 2 14 56.25%

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