Gunja taila in darunaka
Upcoming SlideShare
Loading in...5
×
 

Gunja taila in darunaka

on

  • 4,076 views

A Clinical Study on Gunja Taila Shiro Abhyanga in the Management of Darunaka By Veerayya. R. Hiremath, Department of P G Studies in Shalakya Tantra, Sri Dharmasthala Manjunatheswara College of ...

A Clinical Study on Gunja Taila Shiro Abhyanga in the Management of Darunaka By Veerayya. R. Hiremath, Department of P G Studies in Shalakya Tantra, Sri Dharmasthala Manjunatheswara College of Ayurveda and Hospital, Hassan-573201

Statistics

Views

Total Views
4,076
Views on SlideShare
4,073
Embed Views
3

Actions

Likes
0
Downloads
30
Comments
0

2 Embeds 3

http://www.docshut.com 2
http://www.slashdocs.com 1

Accessibility

Categories

Upload Details

Uploaded via as Adobe PDF

Usage Rights

© All Rights Reserved

Report content

Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
  • Full Name Full Name Comment goes here.
    Are you sure you want to
    Your message goes here
    Processing…
Post Comment
Edit your comment

Gunja taila in darunaka Gunja taila in darunaka Document Transcript

  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of Darumaka A Clinical Study on Gunja Taila Shiro Abhyanga in the Management of Darunaka By Veerayya. R. Hiremath Dissertation Submitted to the Rajiv Gandhi University of Health Sciences, Karnataka, Bangalore In partial fulfillment of the requirements for the degree of Ayurveda Vachaspati (Master of Surgery) In Shalakya Tantra Under the guidance of Prof. M. V. Subramanyam Department of P G Studies in Shalakya Tantra,Sri Dharmasthala Manjunatheswara College of Ayurveda and Hospital, Hassan-573201 2006.
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of Darumaka Rajiv Gandhi university of Health Sciences Karnataka, Bangalore DECLARATION BY THE CANDIDATE I hereby declare that this dissertation / thesis entitled “A ClinicalStudy on Gunja Taila Shiro Abhyanga in the Management ofDarunaka” is a bonafide and genuine research work carried out by meunder the guidance of Prof. M. V. Subramanyam, Professor, Departmentof Post Graduate Studies In Shalakya Tantra, S. D. M. College of Ayurveda,Hassan – 573 201.Date : 07.08.2006. Signature of the CandidatePlace : Hassan Dr. Veerayya Hiremath
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of Darumaka CERTIFICATE BY THE GUIDE This is to certify that the dissertation entitled “A Clinical Study onGunja Taila Shiro Abhyanga in the Management of Darunaka” is abonafide research work done by Dr. Veerayya Hiremath in partialfulfillment of the requirement for the degree of Ayurveda Vachaspati(Master of Surgery) in Shalakya Tantra. Signature of the GuideDate : 07.08.2006. 26.02.2006 Prof. M.V. Subramanyam Professor,Place : Hassan. P.G. studies in Shalakya Tantra S.D.M. College of Ayurveda Hassan. View slide
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of Darumaka DEPARTMENT OF POST GRADUATE STUDIES IN SHALAKYA TANTRA S. D. M. COLLEGE OF AYURVEDA & HOSPITAL, HASSAN – 573 201 (Affiliated to Rajiv Gandhi University of Health Sciences, Bangalore, Karnataka)ENDORSEMENT BY THE H O D, PRINCIPAL / HEAD OF THE INSTITUTION This is to certify that the dissertation entitled “A Clinical Study onGunja Taila Shiro Abhyanga in the Management of Darunaka” is abonafide research work done by “Dr. Veerayya Hiremath” under theguidance of Prof. M. V. Subramanyam, Professor, Department of PostGraduate Studies In Shalakya Tantra, S. D. M. College of Ayurveda,Hassan. – 573 201.Seal & Signature of the H.O.D Seal & Signature of the PrincipalHead of the Department, Prof. Prasanna N. Rao.P.G. Studies in Shalakya Tantra Principal,S.D.M. College of Ayurveda & S.D.M. College of Ayurveda &Hospital, Hassan Hospital, Hassan View slide
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of Darumaka 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 / thesis in print or electronic format for academic / researchpurpose.26.02.2006 Signature of the candidateHassan Dr. Veerayya. R Hiremath © Rajiv Gandhi University of Health Sciences, Karnataka
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of Darumaka ACKNOWLEDGEMENT I express my profound sense of love to my beloved parents, Mr. RevanasiddayyaR. Hiremath and Mrs. Irabai R. Hiremath and my lovable brother Santosh who ever stayalong with me, and whose inspiration is the prime source of success in my life. I whole heartedly thank Dr. Veerendra Heggade, founder of this institution andour Principal Prof. Prasanna N. Rao for giving me a chance to study in this institute. I sincerely express my profound sense of gratitude to my guide Prof. M. V.Subramanyam for his, valuable guidance and encouragement. His indefatigable supportplayed a key role in the accomplishment of this work. I pay my obeisance to Prof. Dingari Lakshmana Chary because of whom Icould be able to fructify this work. I express my deep gratitude to my teachers Dr. Gurudip Singh, Dr. Ashwini.M.J., Dr. Shamsa Fiaz, and Dr. Shilaja Rao for directing me by their precioussuggestions And to Dr. Mona, Dr. Geetesh, Dr. Ashwin Bharti and Dr. Prakash fortheir help in preparation of the drug. I pay sincere respects to Dr. Sham Sampigettaya, ENT Surgeon for his kindsupport. Heartiest thanks to Dr. H. K. Amarnath, Dr. Rohith, Dr. Srikanth, Dr.Arunkumar, Dr. Manish, and Dr. Shrilata for their most valuable suggestions andample help whenever needed. I would like to express thanks to my colleagues, seniors and juniors for theirsupport. Special thanks to Dr. Ambili, Dr. Abhijit, Dr. Geeta, Dr. Mayur, Dr.Shailendra, Dr. Girish, Dr. Roopa, Dr. Pushpa, Dr. Satish, Dr. Sapana, Dr.Shrikant, Dr. Shrividya, Dr. Venkatesh. I wish to thank all my teachers, all the staffs of library, digital library, college,and hospital for their co operation in bringing out this work. I render my acknowledgement to my patients and well wishers who directly orindirectly helped me throughout my thesis work.26.02.2006 Signature of the CandidateHASSAN Dr. Veerayya. Hiremath
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of Darumaka LIST OF ABBREVIATIONS A.H. - Ashtanga Hridaya A.S. - Ashtanga Samhita B.P. - Bhava Prakash B.R. - Bhaishyaja Rathanavali Cha. - Charaka Samhita Chi - Chikitsa Sthana C.D. - Chakradatta Dk - Dvithiya kanda M.N. - Madhava Nidana Mk. - Madhyama Khanda Ni. - Nidana Sthana Sha. Sa. - Sharangadhara Samhita Su. - Sushruta Samhita U - Uttara tantra Y.R. - Yoga Ratnakara
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of Darumaka ABSTRACTBackground & Objectives Darunaka can be correlated to dry variety of pytiriasis capitis. This disease ishighly prevalent affecting a large population. It is the common cause of seborrhoeicdermatitis, blepharitis and other morbidities as its complications. Objective of the present study was to evaluate the efficacy of Gunja taila shiroabhyanga in the management of Darunaka (dry variety of pytiriasis capitis)Methods 20 patients fulfilling the inclusion criteria of Darunaka were randomly selectedand divided into GTSA Group and TTSA Groups each comprising of 10 patients. Source of patients is from O.P.D and I.P.D of Shalakya Tantra, S.D.M. AyurvedicCollege, Hassan. Shiro abhyanga was done everyday with similar method of massaging asmentioned in the classics with Gunja taila for one month of duration. Clinical signs andsymptoms were given with suitable scores according to their severity and assessed basedon relief after treatment. The results having P value less than < 0.05 were considered asstatistically significant in this study.Results Overall effect of therapy after one month of treatment showed that in GTSAgroup complete remission was found in 30%, marked improvement was found in 30%,
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of Darumakamoderate 30% and 10% mild relief. In patients of TTSA group only 30% moderate reliefand 10% mild relief from the Darunaka is noticed and 60% of the patients found no reliefInterpretation & Conclusion• Gunja taila shiro abhyanga has very significant effect in the management of Darunaka. Marked reduction in clinical symptoms was well appreciated within one month of treatment.• Gunja taila shiro abhyanga is proved to be cost effective, adoptive, safe and better drug of choice in the management of Darunaka.Key wordsShalakyaGunja.TilaTailaShiro abhyangaDarunakaDry variety of pytiriasis capitis.
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of Darumaka TABLE OF CONTENTS Page No.1) Introduction 12) Objectives 33) Review of Literature • Ayurvedic review 4 • Disease review 9 • Abhyanga review 20 • Modern review 28 • Drug review 434) Methodology 505) Observation & Results 566) Discussion 787) Conclusion 908) Summary 929) References & Bibliography 9410) Annexure 100
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of Darumaka LIST OF TABLESSl. Title Pg No.01 Showing Layers of skin as mentioned in ayurveda 802 Showing Nidanas of Darunaka 903 Showing relationship between Nidana and Dosha 1104 Showing Lakshanas of Darunaka in different Ayurvedic classics 1405 Showing the Vyavacchedaka Nidana of Darunaka and Indraluptha 1606 Showing the Vyavachhedaka Nidana of Darunaka and Arumshika 1607 Showing Pathyapathya for Shiroroga / Darunaka 1908 Showing Shiro abhyanga matra as per dhatus 2509 Showing the types of Pityriasis capitis 2910 Showing Differential Diagnosis of Pityriasis Capitis 3211 Showing the Drugs used in the preparation of the Gunja Taila 5212 Showing Gradation Index for assessment criteria 5313 Showing Age Wise Distribution of Patients 5614 Showing Sex Wise Distribution of Patients 5615 Showing Religion Wise Distribution of Patients 5816 Showing Socio – Economic Status Wise Distribution of Patients 5817 Showing Habitat Wise Distribution of Patients 6018 Showing Dietary Habit Wise Distribution of Patients 6019 Showing Prakruti Wise Distribution of Patients 6220 Showing Occupation Wise Distribution of Patients 6221 Showing Distribution of Nidanas in Patients 6422 Showing Incidence in Severity of Darunaka 6623 Showing Incidences of Symptoms in Patients 66
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of Darumaka24 Showing Incidences of use of cosmetic (materials used for head 68 bath) in Patients25 Showing Incidences of application of oils in Patients 6826 Showing the ‘t’ test results in reduction of severity of Kandu in 69 GTSA group and TTSA group after treatment and during follow up.27 Showing the ‘t’ test results in reduction of severity of 70 ROOKSHATA in GTSA group and TTSA group after treatment and during follow up.28 Showing the ‘t’ test results in reduction of severity of Twak sphutana 71 in GTSA group and TTSA group after treatment and during follow up29 Showing the ‘t’ test results in reduction of severity of Kesha chyuti 72 in GTSA group and TTSA group after treatment and during follow up30 Showing the ‘t’ test results in reduction of severity of Darunaka in 73 GTSA group and TTSA group after treatment and during follow up31 Showing the percentage of improvement in the symptoms of 74 Darunaka in GTSA and TTSA groups after treatment and during follow up32 Showing over all percentage of improvement in the patients of 74 GTSA and TTSA groups33 Patients (in percentage) having relief in each symptom after 76 treatment; and at the end of 1st, 2nd follow up34 Showing patients personal details 9735 Showing patients response to the treatment 98
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of Darumaka LIST OF GRAPHS, CHARTS & FIGURESSl. Figure Page no.01 Showing the Samprapti of Darunaka 1302 Showing treatment principles 1703 Showing the ingredients of the Gunja taila & Shiro Abhyanga 55 Procedure04 Showing Age Wise Distribution of Patients 5705 Showing Sex Wise Distribution of Patients 5706 Showing Religion Wise Distribution of Patients 5907 Showing S-E status Wise Distribution of Patients 5908 Showing Habitat Wise Distribution of Patients 6109 Showing Dietary habit Wise Distribution of Patients 6110 Showing the Prakriti wise Distribution of Patients 6311 Showing Occupation wise Distribution of Patients 6312 Showing Nidana wise Distribution of Patients 6513 Showing Severity wise Distribution of Patients 6714 Showing incidence of symptom wise Distribution of Patients 6715 Showing incidence of use of cosmetic wise Distribution of Patients 6916 Showing incidence of oil wise Distribution of Patients 6917 Showing the effect on individual symptoms 7518 Showing the overall effect of treatment 7519 Showing the results of the Gunja taila shiro abhyanga 77
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of Darumaka
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of Darumaka INTRODUCTION Shalakya Tantra is one among astangas1 and holding an important role in dealingwith the diseases of head and neck. Head is considered as uttamangam. In Ayurveda headis said to be root of the plant for possessing all special senses and prana. Hence it shouldbe protected and treated as early as possible in diseased conditions. Increasing urbanization and industrialization have posed greater danger due to airpollution, contamination of water, liberation of toxic, allergic and poisonous things thatcause disorder of Shiras. There are nineteen diseases described by vagbhata, they are 9 kapala rogas2 and10 shiro rogas. According to vagbhata and sharangadara the Darunaka is akapalagataroga but sushruta and other acharyas explained this disease underkshudrarogas, Dandruff is an irritative disease of the scalp in which shedding of dead tissue fromthe scalp with itching sensation is the cardinal feature. It can be correlated to Darunaka. As per our classics Rejection of kesha taila, Improper cleaning, sleeping duringday time, Night vigil, Exposure to dust, hot weather, etc are causative factors forDarunaka. Now a days, due to increased pollution, busy mechanical life scheduleapplication of impure oils to head, etc causing high incidence of Darunaka withsymptoms3 like Kandu, Rukshata, Twak sphutana, Kesha Chyuti,etc due to the vitiationof Vata and Kapha dosha. Till now there is no definite cause and solution for thisdisease. So there is a need to find a safe and effective remedy in the treatment ofDarunaka.
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of Darumaka Since time immemorial Ayurveda has adopted an easy procedure calledShiroabhyanga which is proven effective therapy not only in Darunaka but also in otherShiro rogas. This procedure is simple easy and can be employed by every body withoutany complications. Yogaratnakara has mentioned the application of Gunja taila4 (i.e. Gunja,Bhringaraj, Tilataila) in the treatment of Darunaka. The drugs of the yoga are easilyavailable, economical and effective. Therefore, a clinical research work is proposedentitled – “A Clinical Study on Gunja Taila Shiroabhyanga in the Management ofDarunaka” to contribute a solution for the Darunaka. In the present clinical study 20 patients were divided into two groups with tenpatients in each group. In GTSA group Shiro abhyanga was done with Gunja Taila andTTSA group the Shirobhyanga was done with Tilataila ten for comparative assessment. The entire study contains the contents like introduction review of literature ofboth Ayurvedic and contemporary science, review on shiro abhynga, drug review,clinical trials, methodology, observations and results, discussion, conclusion andsummary are explained.
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of Darumaka
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of Darumaka OBJECTIVES Shalakya is one among the ashta angas of Ayurveda and has importance in themanagement of diseases of head and neck. Among different diseases affecting the headand neck, Darunaka has been described under the diseases of kapalagata rogas. Even though Darunaka (dandruff) is not a life threatening disease, it has highcosmetic importance. The condition is all too familiar affecting a very large population.Modern science and present available treatment procedures are not satisfactorilyeffective. Ayurvedic classics dealt different procedures and medications to treat thedisease Darunaka. One such treatment is shiro abhyanga with Gunja taila. Thoughdifferent thesis works are undertaken with respect to Darunaka, Gunja taila abhyanga isnot yet studied. Considering its easy and routine applicability, and cost effectiveness thisresearch work is selected to study the efficacy of Gunja taila abhyanga in Darunaka withthe following objectives. • To evaluate the efficacy of shiro abhyanga with Gunja taila in the management of Darunaka. • To evaluate the efficacy of shiro abhyanga with Tila Taila in the management of Darunaka. • To compare the effects of shiro abhyanga with Gunja taila and with Tila Taila in the management Darunaka.
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of Darumaka
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of Darumaka REVIEW OF LITERATUREDARUNAKA NIRUKTIThe word Darunaka is derived from the verb, Darayati5 = ‘Splitting’ or tearing or difficult to tolerate. Dhalana says Daruna means Kathina6, difficult to bear or tolerate. Darunaka is a Kapala roga7 (Disease of the scalp). Kapala is the region whichcovers the skull. It is not counted in shiro roga but explained as Kapala roga by Vagbhataand Sharangadhar and as Kshudra roga by Sushruta, Bhavaprakasa, Madhavanidana,Yogaratnakara, Bhaishajya Ratnavali, Chakradatta. All the Acharyas have the sameopinion about the seat of this disease, which is Kapala.HISTORICAL PROSPECTIVE There are no references are regarding Darunaka in Vedic and prevedic textsDarunaka was described for the first time in Samhita kala. Reference of Darunaka as quated by acharya videha is compiled by dalhana in hiscommentary Nibandhasangraha on Sushruta samhita Nidanasthana 13th chapter. Astanga Sangraha has explanation of Darunaka in 17th and 18th chapters ofuttaratantra and in Astanga Hridaya at 23rd and 24th chapters of Uttaratantra. The description of Darunaka as quoted by Acharya Nimi and Videha are compiledby Madavakara in his commentary ‘Madhukosha’ on Madavanidana 55th chapter ofUttarardha. Darunaka is explained in Bhavaprakasha Uttarardha 61st Chapter, in Chikitsaprakaran, Yogaratnakara explained it by the name Kshudra roga nidana and chikitsaprakarana.
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of Darumaka Bhaishajya Ratnavali kshudra roga chikitsa 60th Chapters deals with treatmentaspects of Darunaka. In Chakradatta, kshudra roga chikitsa 55th chapter deals with treatment aspects ofdarunaka.TWAKNirukti The word ‘Twak’ or skin is derived from the root Twacha. “Twachiti samvrunoti medoshonitaadi karma iti"8 Meaning that Twak is the covering of the body which covers the fat, blood tissue;muscle tissue etc.Historical review Charma and Asrgdhara are the synonyms of Twak. The word ‘Twak’ ismentioned for the first time in the Vedas. The Rigveda tells about certain diseasesmanifesting on skin giving them the name of Twak rogas such as Kushta, Shwitra etc.Certain treatments consisting of the wearing amulets of medicinal herbs, and chanting ofhymns were also mentioned. Some references are found in the Ayurvedic treatises regarding the formationand development of Twak from the stage of fetus itself. According to Sushruta twak isformed at the time of fusion of Shukra (Purushabeeja) and Shonita (Stribeeja) similar tothe cream when the milk is boiled and allowed to cool by itself. The development of skinactually begins simultaneously with the formation of the zygote. Vagbhata states that theTwak completely formed by the sixth month9 of embryonic life. Sushruta has mentioned Sparshanendriya (sense of touch) and its quality Sparsha(touch) in relation to twacha10. As for Vagbhata Twak is formed during the time of Raktadhatuparinama. The seven layers of Twak are formed, after the Dhatuparinama, whenRakta converts into Mamsadhatu11.
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of Darumaka In Ayurveda, Rakta (blood tissue) Mamsa (muscle tissue), Majja (bone- marrow),guda (anus), etc, originate from the mother and hence they are known as matruja bhavas(maternal elements) Twak also considered as Matruja bhava. Almost all the ancient scholars consider Twak as an upadhatu of Mamsa. Anupadhatu is identical with a dhatu which is not subject to any transformation and itsupports the body. Updhatus are the by - products of dhatuparinama. Twak is an upadhatuor associate tissue of Mamsa dhatu (muscle tissue)12.Twak shareera: According to our ancient scholars, there are two opinions regarding the number oflayers of the skin. Charaka holds that it has six layers13.1) Udakadhara Twak: This is the external layer bearing lymph.2) Asrgdhara : It is the second layer and bearing blood capillaries.3) Thritiya Twak : Sidma and Kilasa are the diseases occurring in this layer.4) Chaturti Twak : The fourth layer is the seat for the manifestation of dadru and Kushta.5) Panchami Twak : The fifth layer is the seat for the manifestation of alaji and vidradhi.6) Shashti Twak : The sixth layer is that by the excision of which the vision becomes blurred and the individual feels darkness.
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of Darumaka According to Vagbhata and Sushruta, seven layers are explained in the skin.These layers are described from the exterior to the interior, i.e. 7th layer, which is theinnermost. Sushruta name them as follows14.1) Avabhasini : This is the outermost layer which reflects all the colours. The complexion of the skin is maintained by this layer. It is named so owing to its property. Its thickness is 1/18th of a vrihi. Sidhma and Padmakantaka are the diseases occurring in this layer.2) Lohita : its thickness is 1/16th of vrihi. Diseases such as Tilakalaka, nyacha, Vyanga etc, are manifested in this layer.3) Sweta : It measures the thickness of 1/127th of a vrithi. Diseases like Ajagalli, Charmadala, and Masaka are manifested in this layer.4) Tamra : It has a thickness of 1/87th of a vrihi. It is the seat of different varieties of Kustha and Kilasa.5) Vedini : The thickness is 1/57th of a vrihi. This is the seat of Kushta and visarpa.6) Rohini : Its thickness is 1 vrihi. The diseases such as Granthi, Apaci, Arbuda, Slipada, Galaganda, etc are manifested in this layer.7) Mamsadhara : It measures 2 vrihi in thickness and is the seat of Arsas, Bhagandhara etc. Sharangadhara has given the name ‘Sthula’ for the 7th Twak. In Ashtanga sangraha the sixth layer of Twak is named as pranadhara. In Pratyaksha shareera of Gananatha Sena15 detailed description of Twak presenthe said that it protects and covers the entire body and the seat of Sprshnendriya Sweatglands with their ducts, hairs, and hair follicles are embedded in the Twak. It is divided into external and internal layers. The external layer is very thin and responsible for colourand luster. Blisters are formed in this layer when it contact with fire. The internal layer isthick which protects the body. Ducts of sweat glands, sebaceous glands and sensorynerve endings are situated in this layer.
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of DarumakaFunctions of Twak 1) Protective : Twak protects the body from loss of body fluids. Being an upadhatu it supports the body. 2) Sensory : Twak is the Sparshajnanendriya (sense organ of touch) and is considered to be the seat of Sparshanendriya. 3) Absorption : Twak is the seat of Bhrajakapitta. Bhrajakapitta imparts colour, luster and natural complexion to a person. According to Sushruta, pitta which is located in the skin, is called as Bhrajakagniand it enables the digestion of substances used for Abhyanga, Pariseka, Lepana etc. According to Dalhana this Bhrajakapitta is situated in the Bahyatwak and isresponsible for the digestion of dravyas applied to the skin.Table no. 1 - Showing Layers of skin as mentioned in ayurveda14. Sl. No Name of the layer Thickness Common diseases occurring 1 Avabhasini 1/8 th of vrihi Sidma, Padma, Kantaka 2 Lohita 1/6th of vrihi Tilakalaka, Nycha, Vyanga 3 Sveta 1/12th vrihi Charmadala, Ajagallika, Masaka 4 Tamra 1/8th of vrihi Kilasa, Kushta 5 Vedini 1/5th of vrihi Kushta, Visarpa 6 Rohini 1 vrihi Granthi, Apachi, Arbuda 7 Mamsadhara 2 vrihi Bhagandara, Vidradhi, Arshas
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of Darumaka DARUNAKANIDANA PANCHAKA The detailed study of nidana Panchaka is helpful in understanding the disease andfor planning the treatment.Nidana There is no specific etiology narrated for the disease Darunaka in Ayurveda henceShiroroga nidanas is considered. There are Asatmendriyartha samyoga, Pranjaparadhaand Parinama are the three basic factors pertaining to Pathogenesis. The commonetiological factors in Vagbhata and Charaka can be arranged as follows.Table no. 2 - Showing Nidanas of DarunakaSl. No Causes Ch16 Vag17 Aharaja nidana 01 Amla ahara atisevana (Excessive in take of sour food) + - 02 Ati sheeta ambu sevana (Excessive intake or use of cold + + water) 03 Dusht ama (Indigestion) + + 04 Guru ahara (Intake of heavy food) + - 05 Haritha ahara atisevana (Excessive in take of green leafy + - vegetables) 06 Hima ahara (Intake of cold food) + - Viharaja nidana 07 Atapa athi sevana (Exposure to hot weather) + - 08 Ati swapna (Excessive sleeping) - + 09 Diva Swapna (sleeping during day time) + - 10 Jagarana (Night vigil) + - 11 Praagvata- (Exposure to east wind) + + 12 Rajaha savana (Exposure to dust) + - Related to vegas 13 Athi maithuna (Excessive sexual indulgence) + - 14 Bhaspa nigraha (Suppression of tears) + + 15 Rodrna (Excessive weeping) + + 16 Vegadharana (Suppression of urges) + + Defective hygiene 17 Abhyangadvesa (Absence of Oiling) - + 18 Mrja dvesa (Improper cleaning) - + Psychological factor 19 Manastapa (Mental agony) + +
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of Darumaka Acharyas have described these common etiological factors similarly. Acomparative study in these factors reveals the importance to dietary habits, climaticchanges and, personal habits psychological disturbances etc. The mentioning of“Manasthapa” by Charaka and Vagbhata holds ample evidence in this regard. Eventhough dietary habits are mentioned in both the texts, Charaka has given more elaborateddescription about “Ahara.” Charaka mentioned that the excessive use of Amla ahara, Harita ahara and Guruahara as the important causative factors of Shiroroga. The excessive intake of Guru aharacauses Agnimandya and there by Amadosha. Amla ahara increases Kapha and Pittaresulting in Kandu. Hima ahara produces Kapha and Vata. Excessive use of cold waterincreases Vata and Kapha. Harita ahara atisevana i.e. excessive use of green leafyvegetables causes the increase of Vatadosha. Shiro abhyanga is essential for preventing DarunakaIn the absence of that leads .to dry scalp because of increase of Rooksha guna of Vata. The aversion to maintain hygiene of the body is one of the main causes of itching.Daily bathing is essential to avoid dirt, dust and waste products accumulating over scalp.Bathing improves the complexion, strength, appetite and cleanses the body. Atapatisevana, Rajah Sevana, Dhooma sevana means excessive exposure to hotweather or sun, dust and fumes without proper protection of the head resulting inexcessive sweating by increasing Rakta and Pitta which further vitiates Vata. The excessive sexual indulgence (Atimaithuna) increases Vatadosha. Atiswapnaand Jagarana increases Kapha and Vata respectively. Vegarodha or suppression of natural urges results Vata vaigunya. Vegarodha likeMala, Mutra, Kshavatu, Nidra, Chhardi etc. produces headache, change in bodycomplexion, pruritus and other skin diseases.
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of Darumaka Manastapa (Tension and mental stress) is also a cause for Darunka. Mental stressproduces several types of skin diseases. In addition to this factor, the other etiologicalfactors of Shirorogas like Abhyanga dweshi, Pragvata sevana etc may also produce thedisease Darunaka. Analyzing the above etiological factors, excessive use of different types of Ahara,Abhyangadvesa and Mrjadvesa will lead to the aggravation of Vata and Kapha.Atimithuna, Jagarana, Vegavarodha and Manastapa increases Vata, where as Atiswapnaincreases Kapha. Atapa atisevana, Rajah sevana and Dhooma sevana vitiates Pitta andRakta.Table no. 3 - Showing relationship between Nidana and Dosha Sl. Vitiated factor Vitiated Sl. Vitiated factor Vitiated No dosh No dosh Aharaja nidana Related to vegas 1. Amla ahara Vata 7. Atapa atisevana Pitta atisevana 2. Atisheeta Vata 8. Atiswapna Kapha ambusevana 3. Dushta ama Kapha 9. Divaswapna Kapha 4. Guru ahara Kapha 10. Jagarana Vata 5. Harita ahara Vata 11. Praagvata Kapha atisevana 6. Hima ahara Vata 12. Rajaha savana Pitta Viharaja nidana Defective hygiene 13. Ati maithuna Vata 17. Abhyangadvesha Vata 14. Bhashpa nigraha Vata 18. Mrja dvesha Kapha 15. Rodana Vata Psychological factor 16. Vegadharana Vata 19. Manastapa Vata Hence with the above analysis, we can conclude that Darunaka disease is causedby the predominance of vitiated Kapha and Vata in association with Pitta and Rakta.
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of DarumakaSAMPRAPTI The formation of any disease takes place only when there is a combination ofvitiated Dosa with Dushya in srotas. This Dosha Dushya Sammurchana is explainedunder Samprapti. As per etiology, mainly Kapha and Vata get vitiated. The association of Pitta andRakta is mentioned by Videhacharya. Twak is formed from Raktadhatu during the timeof Dhatu parinama. According to Ashrya Ashrayi bhava of Dosha and Dushya, the Pittadosha is related with Dushya Rakta. The Bhrajakapitta is located in the skin. So when thepitta is vitiated in Darunaka, Rakta is also vitiated. Here the Sannikrishta nidana is thevitiation of Kapha and Vata. The vitiated Doshas circulate through the blood vessels and reach the scalp. Thevitiation and circulation of Doshas contribute in the progression of disease throughChaya, Prakopa and Prasara stages of the diseases, later in Sthanasamshraya or stage ofmanifestation, Dosha interacts with Dushya. The Doshas like Kapha, Vata and Pittainteract with the Dushyas rasa, Rakta at Kapala in the disease Darunaka. As a result, the vitiated Kapha and Vata produce Kandu, Keshachyuti, Swapa,Rookshata and Twak sphutana, and manifest the disease Darunaka. The main srotas vitiated here is Swedavahi srotas. The Swedavahi srothodushtilakshanas like itching, dryness of the skin, abnormalities of touch sensation etc. will bedeveloped. These symptoms are seen in Vyakta stage and the disease Darunaka ismanifested.
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of Darumaka The main Doshas vitiated in Darunaka is Kapha and Vata. These vitiated Doshasvitiate Raktadhatu. In all types of diseases related to head, vitiation of Rakta is aninvariable cause. These in turn vitiate Rasa and Svedovaha srotas. The vitiated Kaphagets accumulates in Srotas by Vataprakopa and Srotavarodha occurs. Sthanasamsraya ofthis disease takes place in the Kapala and thus symptoms of Darunaka get manifested. Figure – 1 showing the Samprapti of Darunaka Nidana kapha vata vitiation vitiates rasa Rakta dhatu vitiates rasa Rakta svedavahasrotus srotorodha stanasamraya in kapal DarunakaSAMPRAPTI GHATAKA Dosha : Kapha vata Dushya : Twak, Rakta, Srotas : Swedavaha Adhistana : Kapala Vyaktha stana : Kapala
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of Darumaka POORVA RUPA Poorva rupa denotes the symptoms that manifest incompletely before the Vyaktavastha. No reference is available regarding poorvaroopa of Darunaka in the classics. RUPA Kandu (Itching), Keshachyuti (falling of hair), Swapa (abnormalities of touch sensation), Rookshata (roughness or dryness of the skin) and Twak Sphutana (breaking or cracking of the skin) are the cardinal symptoms of the disease Darunaka12. Different Acharyas opinion is shown in table. Table no. 4 - Showing Lakshanas of Darunaka in different Ayurvedic classics Lakshanas A.H18 A.S19 Sar20 SU21 Y.R22 M.N23 B. P24 Vdh25Kandu + + + + + + + -Kesha chyuti + + + + + + + -Svapa + + + - - - - -Rukshata + + + + + + + -Tvak + + + - - - - -sphutanaDaruna - - - + + + + +Daha - - - - - - - +Raga - - - - - - - +Gaurava - - - - - - - +Toda - - - - - - - + Kandu is a symptom which is closely related to Kaphadosha and it has an important role in the pathogenesis of Darunaka. Kandu is one of the karma of diseased Kaphadosha. This is due to the factors like accumulation of malas on the scalp and the excessive secretion of sweat etc.
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of Darumaka Keshachyuti is caused by vitiated Pitta in association with Vata. The hair fallingin Darunaka may occur in Lack of Snigdhatha due to vitiated Vata, the hair becomes dulland rough. Owing to their abnormal dryness they become friable, short and thin andeasily fall out. Swapa or abnormality of touch sensation means temporary or partial loss ofsensation which is resulted due to vitiation of abnormal Vata. Rookshata is a Vata predominant disorder. Abhyangadvesa and other Vatavitiating nidanas can lead to roughness of scalp. Sushuruta had quoted Darunaka asKathina, Karkasha. This may be due to the symptom roughness produced by this disease. Twak sphutana is breaking or splitting of scalp is one of the symptoms ofDarunaka. It occurs owing to scratching and abnormal keratinization of epidermis. It isthe result of the vitiated Vata dosha.UPASHAYA AND ANUPASHAYA No particular description is available in the classics about the Upashaya andAnupashaya. As per the Samprapti Vata-kaphahara chikitsa is Upashaya.SADHYASADHYATA Darunaka is a curable disease as it limits itself in Twak. Even though it iscurable the rate of recurrence is high owing to the negligence of proper hygiene and suchother factors. In Vagbhata nine kapalagata rogas are mentioned. Darunaka is one of theKapalagata rogas. The prognosis of Darunaka is included in sadhya stage26.
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of DarumakaVYAVACHHEDAKA NIDANA Darunaka is required can be differentiated among Kapala vyadhis especially from 01. Indralupta 02. Arumsika Table no. 5 - Showing the Vyavacchedaka Nidana of Darunaka and Indraluptha Sl. Darunaka27 Indralupta28 No 1. The region of the hair loss has no The region of the hair loss has specific shape; it spreads all over specific shape. head. 2.. Keshapatana is less and gradual. Keshapatana is more and rapid. 3. Keshapatana occurs only on scalp. Keshapatana from head bearded area. 4. Kandu is more. Kandu is less. 5. Twak sputana is main. Twak sputana is absent Table no. 6 - Showing the Vyavachhedaka Nidana of Darunaka and Arumshika Sl. No Darunaka Arumshika29 1. No pidikas. Sarshapavat pidakas are seen in this disease. 2. Kleda and srava are absent. Kleda and srava are present 3. Occurs among all age Occurs usually among children. groups. 4. No Krimi darshana. Frequent Krimi darshana. 5. No patches of hair loss. The patches of hair loss are present.PREVENTION Maintenance of personal hygiene is the most important of this disease. Recurrencerate increases if proper hygiene is neglected. Acharya Sushruta had given importance for maintaining personal hygiene in hisnidanastana. Acharya Charaka30 had stated the importance of regular usage of oil and washingthe scalp can prevent this disease to a great extent.
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of Darumaka CHIKITSA VIVECHANA In the Ayurvedic literature references regarding the dietary measures,medicaments and various treatment modalities for Darunaka are explained by differentAcharyas. The treatment principles mentioned are siravyadha (Raktamokshana), Shiroabhyanga, Nasya, shiro lepana, shiro prakshalana and Shirobasti. In this study shiroabhyanga was taken for evaluation. Figure 2 – Showing treatment principles Treatment Sodhana Shamana 01. Siramokshana 02. Nasya Bahya Abhyantara Shiro abhyanga Internal medicaments Shiro vasti Shiro lepanaSHAMANA Shiro kshalanaSHAMANAShiro abhyanga31 1. Gunja taila32: taila is to be prepared with gunja seeds, and Bhringaraja swarasa, and applied on the scalp. 2. Bhringaraja taila33: taila is to be prepared with bhringaraja, lohakitta, triphala, and sariva and applied on the scalp. 3. Triphaladya taila34.
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of DarumakaShiro lepana35 1. Past of Priyal seeds, Yasti, Kushta, Masha, Sarshapa and honey and applied on the scalp36. 2. Past of Mango seeds, unripened Haritaki and milk, and applied on the scalp37. 3. Khakhasa beejadi lepa.38Shirokshalana Ksharambu prakshalana39.SHODHANASiramokshana40 After sneha and sweda karmas of moordha,Rakta mokshana by siravyadha inlalata41 region.Nasya Nasya with Prapoundarika taila42.PATHYA AND APATHYA Various dietary regimens, conducts, medicaments and the treatment modalitieswhich are Patya (helpful) and Apatya (hazardous) for the patient suffering with shirorogaare listed in the table No. 7. Same Pathyapathya is recommended in Darunaka as it is oneof the Shiroroga.
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of DarumakaTable no. 7 - Showing Pathyapathya for Shiroroga / Darunaka PATHYA43 Aharaja Upacharaja Aushadhi Varga01. Shastika shali 01. Swedana 01. Purana gritha02. Ksheera 02. Nasya 02. Patola03. Dhanva Mamsa 03. Dhumapana 03. Shigru04. Amra 04. Virechana 04. Draksha05. Amalaki 05. Lepa 05. Vastuka06. Dadhima 06. Seka 06. Karavellaka07. Matulunga 07. Langana 07. Haritaki08. Taila 08. Shirobasti 08. Kushta09. Takra 09. Raktamokshana 09. Bhrungaraja10. Kanjika 10. Agnikarma 10. Kumari11. Narikelam 11. Upanaha 11. Musta12. Yusha 12. Ushira Viharaja 13. Gandasara (chandana)01. Chandrika 14. Karpura (moonlight) APATHYA44 Aharaja Viharaja Viharaja01. Ksheera 01. Kshavatu 04. Vibudha jalamajjana02. Jala 02. Jrumba 05. Dantha kasta03. Virudha anna 03. Bhaspa, nidra, 06. Divaswapana vitnigraha
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of Darumaka SHIRO ABHYANGA The Shirobhyanga comes under the classification of the Murdha Taila45. Oleationor Snehana is Purva Karma of Panchakarma. Snehana is further classified into Bahya andAbhyantara types, obviously Shirobhyanga coming under the former type Bahya.Shirobhyanga Shirobhyanga is a subtype of abhyanga of Murdha taila. Acharya Vagbhata hasindicated Shirobhyanga in dryness and itching of the scalp and in accumulation of Malaon head46.Etymology of Abhyanga ‘Abhi’ upsarga to ‘Anga’ dhatu makes the word Abhyanga47 which means toinduce specific movements. Thus abhyanga (massage) indicates some movement done onthe body with the use of Taila, Ghrita, etc.Definition Massage of the body with Taila, Ghrita, etc. in the same direction of the body hair(Anulomana) is called Abhyanga.Paribhasha The oil applied to the Shirah Pradesha (shiro abhyanga) nourishes all the Indria,Srotas and body parts like Bahu, such a procedure are called Abhyanga.Paryaya Abhyanjana and Snehana are the two synonyms of Abhyanga.1. Abhyanjana : The word Abhyanjana is derived from root Anj by adding AbhiUpasarga with lyut pratyaya which means to smear or to Anoint48Also, the word Abhyanjana means applying oil all over the body including Shirah
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of Darumaka2. Snehana: The word Snehana is derived from the root Snih which means to be adhesiveor to be attached to49.BHEDAVatsyayana Kamasutra explained three types of massage as50, • Samvahana • Keshamardana • UtsadanaAccording to Tiruka (Author of textbook of Angamardana), there are mainly 5 types51. • Shushkanga Mardana • Tailanga Mardana • Ksheeranga Mardana • Svayamanga Mardana • Yamalanga MardanaBasis of Classification of Massage52:Character of techniques: • Stroking • Pressure • Percussion • VibrationDepth of tissue approached: • Light massage • Deep massagePart of body used: • General Massage • Local massageMeans of application of pressure: • Manual massage • Mechanical massageOn the basis of nature of drug used: • Dry Massage
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of Darumaka • Powder Massage • Oil MassageTypes of massage (Swedish) according to movements: • Touch – Is a sensation which is carried through brain. • Stroke – Touch with movement with one/both palms slowly. • Friction – Grasp the part & move with little amount of pressure. • Kneading – Alternative compression of the tissues by grasping them against the underlined body surfaces # Muscle mixing. • Vibration – Fine vibratory/Shaking movements communicated to the body through the hands. • Percussion – The movements/blows administered in various ways with varying degrees of force. • Joint movements – Both assisted & resisted movements are given.Indications of Abhyanga • Shiro abhyanga indicated in dry scalp with itching sensation53. • Taila Abhyanga is indicated in Bala, Vruddha, Krusha and Rogi. • All types of Vata Roga, Vishama Jvara and all Tvak Vikara. • In disease of hairs like Darunaka, Khalitya, Palitya, etc. • In daily routine to maintain the health of the body54.Contra Indication of Abhyanga55 • In Ajeerna and Nava or Taruna Jvara it is contra indicated because if performed the condition becomes Krucchra Sadhya or Asadhya.
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of Darumaka • After Samshodhana i.e., immediately after Vamana, Virechana and Niruha Basti Abhyanga is contraindicated as it causes Agnimandya. • Person suffering from Netra Roga, Karna Roga, Atisara, Adhmana, Peenasa, Agnimandya and other Saamadosha conditions. • Person suffering from Pitta Roga, Trishna, Rakta Pitta, Prameha and Ati Kshudhita. • If Abhyanga done in Kaphaja Roga and Santarpita Roga then it get aggravated. • Immediately after consumption of food, accustomed to Ruksha and Abhishyandhi Ahara. • Immediately after Snehapana and Tarpana Kriya. • After Snana,Vyayama, Divasvapna, Vegadharana, Prajagarana, Sheeta Vayu Sevana 55.Prerequisites to perform Abhyanga Abhyanga should be performed only when person has digested the previous foodtaken, when he is Kshudhita and Trusha 56.Time of Abhyanga • Abhyanga is advised to practice regularly once in a day or once in two days or once in three days as it does not vitiate any Dosha 57. • In children, daily Abhyanga is advised in night time 58.Direction of Abhyanga According to Chikitsa Manjari and Chikitsa Sangraha, generally Abhyanga shouldbe performed in Anuloma Gati. They have also mentioned the specific direction ofmovement depending on different involvement of Dosha as, One must follow AnulomaGati in Vata Dushti, Pratiloma Gati in Kapha Dushti and alternate Anuloma andPratiloma Gati in Pitta Dushti.
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of DarumakaAbhyanga Dravya • Abhyanga should be done with lukewarm medicated oil or ghee or ‘Vasa’ prepared with aromatic and ‘Doshaghna’ drugs59. • In general, oil is used for Abhyanga. • The oil should be lukewarm in general condition but in Shirobhyanga cold oil can be used. • Warm oil in winter season and cold oil in summer season is indicated.Method of Abhyanga • Abhyanga should be applied gently and in the direction of the hair. • Shiro abhyanga should be done with cold or lukewarm oil because the head is the place of all senses and it is considered as the most vital part. • Shiro abhyanga should be done gently with fingertips because forceful massage can damage the hair. • For proper massage of each and every part of body, seven positions are to be adopted. But in shiro abhyanga sitting position should be adopted.Effect of Abhyanga on Various Dhatu Dalhana, the commentator of Sushruta has described the effect of Abhyangaaccording to its duration. • The oil reaches to hair root when the Abhyanga is done for 300 Matras (1 Matra = 19/60 seconds so, 300 Matra means 95 seconds). • The oil reaches in skin in 400 matras (133 seconds). • It reaches in Rakta dhatu if done for 500 matras (160 seconds). • It reaches in Mamsa dhatu in 600 matras (190 seconds), in the Meda dhatu in 700 matras (228 seconds), in the Asthi dhatu in 800 matras (240 seconds) and in reaches to the Majja dhatu if the Abhyanga perform up to 900 matra (280 seconds) 60.
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of DarumakaTable no. 8 - Showing Shiro abhyanga matra as per dhatus60 Time Tissue Matra Seconds Hair follicles 300 95 Skin 400 127 Blood 500 159 Muscular tissue 600 190 Fat 700 220 Bones 800 254 Nervous tissue or Bone marrow 900 285Benefits of Shiro Abhyanga 61 Prevents dryness and itching of scalp. It prevents early graying and falling of hair, It improves complexion of hair on the face. Facial massage with oil and application of cosmetics to the face improve the skin of the face, prevent wrinkles and skin diseases such as pimples and also strengthen the eyes and cheeks, Helps the growth of hair on the scalp, which grows strong, long, soft and black, Improves strength to all the sense and motor organs. Improves vision. Useful in diseases of the central nervous system and head. It prevents headache and induces sleep. Helps the growth of hair on the scalp, which grows strong, long, soft and black. It prevents headache and induces sleep. A person who does Shiro abhyanga daily is never affected with headache, hair falling or hair graying. His hair becomes strong rooted, black and long.
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of Darumaka All senses of that person become healthy. His facial skin becomes soft, shiny and he gets a good sleep62. On virtue of such good properties, Shiro abhyanga has been included in thechapter of daily routine of a person (Dinacharya).Mode of Action of Abhyanga Mode of action of Abhyanga is described as under. The same should be understood in the case of Shirobhyanga. Dalhana has explained in detail the absorption of Sneha used in Abhyangaprocedure, accordingly the oil used in Abhyanga reaches up to the different Dhatus if it isapplied for the sufficient time. Hence, it is clear that the drug used in the Abhyanga getsabsorbed by the skin. Dalhana also mentions that when Snehana drug reaches to theparticular Dhatu it subside the diseases of that particular Dhatu. Charaka has alsodescribed that Vayu dominates in the Sparshanendriya and its Adhishthana is Tvacha i.e.skin. The Abhyanga is exceedingly beneficial to the skin, so one should practice itregularly63. Indriyas are in close contact of mind hence if Indriyas remain healthy mindautomatically remains healthy. Thus Abhyanga keeps body and mind healthy. The mode of action of Abhyanga can be understood by the properties ofSnehana drugs that are used for abhyanga in the following way: 1. Snigdha Guna – This is the main property of Snehana drug. Snigdha Guna acts through its Vatahara, Kaphakara and Vrishya properties. It performs the action like Snehana, Kledana and Vishyandana at cellular level of the body.
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of Darumaka 2. Guru Guna – It increases the bodily strength and Kapha. Hemadri has called it nutritious for the body. According to Bhavaprakasha Guru Guna have the properties like Vatahara, Kaphakara and Pushtikara. Due to these properties it alleviates the morbid Vata, increases the decreased Kapha and nourishes the body. 3. Sheeta Guna – It keeps the mind healthy by increasing pleasure and enthusiasm. It prevents fainting, decrease the perspiration. It stabilizes the muscles and organs. 4. Mridu Guna – Mridu means soft. This is the opposite attribute of Kathina guna. By this property Abhyanga reduces the stiffness. 5. Drava Guna – Drava means liquid, which causes humidity. By this Snehana drug propagates swiftly all over the body. If liquefies the Doshas and mobilizes them by increasing their flowing capacity. 6. Pichhila Guna – Pichhila means slimy. It causes longevity, increases body strength. It increases Kapha and produces heavy-ness. 7. Sara Guna – The common meaning of Sara is to slip or mobility. It mobilizes the Doshas and Mala i.e. waste products by this property. 8. Manda Guna – It is indicative of sluggishness. The snehana drug diffuses slowly by this and it remains in the contact of Doshas, Dhatus and Malas for long time. 9. Sukshma – Sukshma means subtle and it helps the drug to enter in the fine channels. In this way Abhyanga acts through the above properties of Sneha. Because all theproperties are opposite to the Vata, Abhyanga is considered useful treatment in thediseases occurred by provocated Vata.Modern Point of View Abhyanga improves arterial, venous and lymphatic flow and thus nourishes skinand local tissues. It improves the health of skin, which may cease hair fall.
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of Darumaka MODERN REVIEWPityriasis capitis64 (Darunaka)Synonyms – Dandruff, Scurf, Sikri or Bafa (in hindustani).Introduction Dandruff is the most common condition affecting the scalp. Dandruff is a natural process involving shedding of dead skin cells from thescalp. Although it is a minor problem, but when this shedding starts at an excessive rateit may cause some concern65. Excessive or severe dandruff with itching is known as seborrheic dermatitis. Itaffects scalp, forehead, naso-labial fold (smile line or laughter line), eyelash, eyebrows,and skin behind the ears, trunk and flexures (armpit, elbows). It requires medicaltreatment. Cradle cap is the term used when seborrheic dermatitis affects the scalp of infants.It occurs within a week or two after birth. It is characterized by dirty, yellow crusts on thetop of head (vertex) with little or no itching. The condition usually subsides by itself. Dandruff is not contagious and usually not serious, although can be embarrassingand itchy66. Dandruff can happen at any age but is most commonly found in people betweenthe ages of 12 and 8067 in which female are the more sufferers. Dandruff is not frequentin infancy, although it increases progressively from adolescence. By the age of 20, 50%of the population has suffered an outbreak. Dandruff responds very well to treatment, but will commonly recur if treatment isstopped.
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of DarumakaCauses Dandruff may be caused by several different factors, but the exact underlyingcause of dandruff is unknown. Possible cause like67 External causes Using spray, gels, hair colouring products or excessive use of hot hair curlers,cold weather, stress, anxiety and Infrequent shampooing or inadequate cleaning of thescalp and hair. Internal causes Hormonal imbalance, Poor health, Poor hygiene, Allergic hypersensitive, Lack ofrest, Emotional stress, Excessive consumption of sugar, fat, starch, Improper nutritionand Heredity predisposition68 An overgrowth of yeast fungus (pityrosporum ovale) can lead to dandruff. Thecondition may improve in the summer and get worse in winter, because UVA light fromthe sun counteracts pityrosporum ovale.Types of dandruff Two types of pityriasis capitis: dry (sicca)and greasy(steatoides)69Table no. 9 – Showing the types of Pityriasis capitis69 Dry variety Greasy variety 1. Scales are white, fine and Waxy, greasy, yellowish thick scales and furfuraceous dry and grayish; scales crusts; scalp may be pale red. fall freely on shoulders. 2. Hair dry and lusterless Hair greasy and may be matted; tendency of thinning 3. Mild or no itching Itching moderate. If severe, secondary eczematization or seborrheic dermatitis should be suspected. 4. Common in dry cold weather Common in hot and humid weather. But may be seen in cold weather. 5. Affects people reluctant to use oil on Affects seborrheic individuals. the scalp resulting in exaggeration of normal exfoliation of hairy areas. 6. Outlook better. Improves with oil Outlook not so good application.
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of DarumakaInvestigations70 Dandruff is easily detected. The condition is characterized by the appearance ofwhite flakes on the hair, shoulders and collar. With a proper clinical examination it canbe easily differentiated from conditions like psoriasis, ringworm (fungal) infection etcRisk Factor70Certain risk factors that may contribute to dandruff: • Severity increases during winters • Yeast infection (Pityrosporum ovale), is an important cause of dandruff especially in people with low immunity (immuno-compromised) like AIDS patients. • A familial predisposition may be seen in some cases. • More common in infancy (first 2 months) and in elderly people. • People with oily hair tend to have dandruff more often • Common in puberty • Diet deficient in vitamins especially vitamin B complexOther worsening factors • Excessive use of hairsprays and gels. • Improper use of hair-coloring products or excessive use of electric hair curlers • Cold weather and dry indoor heating. • Tight fitting hats and scarves. • Infrequent shampooing of the hair or inadequate rinsing. • Stress and anxietyComplications70Although a minor problem, if not treated it can lead to: • Seborrheic dermatitis • Hair loss • Blepharitis71
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of DarumakaObjectives of treatment72 • Control dandruff • Prevent complications Educate the person to identify the problem earlyPreventive measures72 • Eating healthy and well balanced diet • Avoiding excessive salt, sugar and alcohol • Maintaining proper hair hygiene by using shampoo prepared from herbs like henna, amla, shikakai, reetha. • Regularly disinfecting towel, comb, and pillow cover after use. • Avoiding usage of harsh cosmetics on the hair like hair dyes, gels, sprays etc. • Mild dandruff may be controlled by regularly shampooing the scalp with a mild, non-medicated shampoo. • While washing hair with a shampoo, care to be taken to rinse the hair properly, so that no traces of shampoo are left behind • Using a conditioner to keep hair from drying out • If one is having dry dandruff, give a warm-oil treatment to the hair to help loosen and soften dandruff scaling. • Avoiding stress by practicing meditation, yoga or relaxation exercises.Medication72 • Dandruff is treated with selenium sulphide (Selsun) or ketoconazole containing shampoos and other drugs like Zinc pyrithione ,Coal tar • Local application of corticosteroids (steroids) may be required in cases of seborrheic dermatitis. • Dandruff of eyelashes is treated with sodium sulfacetamide ophthalmic ointment. • Crusts may be removed by using 3-5% salicylic acid in olive oil. • Local application of anti-fungal cream may also be required.
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of DarumakaDIFFERENTIAL DIAGNOSIS OF PITYRIASIS CAPITIS73Table no. 10 – Showing Differential Diagnosis of Pityriasis CapitisSl. Disease Symptoms Signs Nature of Region ofNo Lesions Body01. Pityriasis Itching Small whitish The scales are Scalp, external Capitis (mild to scales, hair thin whitish dry auditory moderate) falling dry or greasy meatus, scalp. encircling the eyebrows, etc. hair follicle.02. Seborrhoeic Itching Large greasy Patchy or Scalp face dermatitis (mild to scales of dirty diffuse reddish trunk moderate) yellow areas covered retroauricular colour. with fine folds, etc. loosely adherent scales.03. Psoriasis Little or no Dry, well Well-defined Scalp itching defined Non-indurated eyebrows, macules, dry erthematous knees, elbows, papules and area with silvery frontol hairline, plaques and layer upon layer etc. plaques of scaling. erythema with silvery scales.EMBRYOLOGY OF SKIN74 The epidermis (ectoderm) begins to develop at four weeks of life and by sevenweeks, flat cells overlying the basal layer form the periderm which is eventually cast-off.The dermis (mesoderm) develops at 11 weeks and by 12 weeks, indented basal buds ofthe epidermis form the hair bulbs, with dermal papillae supplying vessels and nerves.Epidermis is formed from an ectodermal vestment of two layers. A single layer if stratumgerminativum which rest upon mesoderm become the dermis. During the third month, thesweat glands are found as parallel ridges arises form the lower surface of the epidermis,first upon the fingers, palms and sole. These glands later grow by downward buddingfrom the epidermis into the dermis.
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of Darumaka Hairs are first seen in the eyebrows, chin and upper lip regions at the end of thesecond month proliferating cells appear in group in the stratum germinativum. Thegrowth of such a hair germ into the dermis produces a gradually elongating compactepithelial cylinder. Under it the connective tissue is condensed and the hair papilla soformed protrudes from below into the epithelial cylinder. The direction of the latter is notperpendicular to the skin surface. The direction of the latter is not perpendicular to theskin surface. On the side of the cylinder, two rounded projections develop. In the upper ofthese the central cells undergo fatty transformation and their further developmentproduces the lobed outpouching from the hair follicles which is the sebaceous glands.The lower projection from the cylinder is the place of attachment of the erector pillimuscle. Within the bulb of the cylinder which caps a papilla. A central cone of cornifyingcells differentiates. These push upper wards by the multiplication of the cells on thesummit of the papilla and so from the hair sack. Nails are the seen as flat areas on theback of the terminal phalanges during the third month of the intra-uterine life.ANATOMY OF SKIN75 The skin is soft flexible membranous covering which covers the entire externalsurface of the body. It is continuous with the mucosa of the alimentary, respiratory anduro-genital tracts at there orifices. It is the largest organ of the body weighing three timesas much as the liver. Skin is attached closely or firmly to underlying structures so as toresemble a closely fitting elastic garment. Its averages 1.2 – 2.2 m square and itsthickness ranges from 1.5 – 4 mm. Total weight of the skin is 3000 to 3500 gramsapproximately. The skin is marked superficially by tiny wrinkles and furrows. Underlying glandscommunicates with the surface through pores. Color of the skin is determined by thepigment in the upper layers, by the blood capillaries in the dermis and the by vaso-construction, vasodilatation, cyanosis, local asphyxia, dehydration edema, etc. There aremany local variations such as in the thickness, mechanical strength degree ofkeratanisation, sizes and numbers of hairs and such other features.
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of DarumakaTypes of Skin76 • Thin hairy skin (Hairsute) • Thick non-hairy skin (Glabrous skin) Superficially the epidermis is made up of the keratinized stratified squamousepithelium and a deeper dermis made up of moderately dense connective tissues, bloodvessels and nerves.Epidermis 77 Epidermis is the outermost covering and contains the following layers. • Stratum cornium • Stratum malpighii. Stratum corneum is further divided into horny layer and lucid layer. Stratummalpighii is again divided into three. They are granular layer, prickle layer and basal celllayer. Dermis : It is the major bulk of the skin. And is about 8 mm in thickness. Thehair follicles and glands found in this layer are the down growths of dermis and not ofdermis. Dermis is divided into papillary layer and reticular layer. Subcutis : It is a loose network of fibrous tissue packed with fat globules. Pigmentation : The brown colour of the skin is due to an amorphous substancecalled melanin. Melanin is a chromoprotein. It is present as intra cytoplasmic granules inthe basal cells of the epidermis. Pigment production is increased by many forms ofirrigation and inflammation.
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of DarumakaSWEAT GLANDS78 Sweat glands are modified tubular glands which occur on all parts of the bodyexcept the margins of the lips, the glands penis and interior surface of the prepuce. Theyare most numerous on the palms and soles. Anatomically, a sweat gland has got twoparts. One is a body and second one is excretory duct.Apocrine glands Apocrine glands are found in pubic, abdomen, mammary glands.Sebaceous glands Sebaceous glands secrets sebum and are usually associated with hair follicles.Sebaceous glands occur on all parts of the body except the palms and the soles and theterminal phalanges. A sebaceous gland consists of a fibrous capsule, a membrane propria and acollection of epithelial elements. The capsule and lining membrane are continuous withthe corresponding layers of the hair follicles.Hairs Hair is a characteristic feature of mammals which plays an essential role in survivalespecially in the conservation of heat and evaporation of perspiration. Hairs arecylindrical, horny structures derived from epidermis and implanted in pouch likedepressions in the dermis. They occur on all parts of the body except the palms and soles,penis and phalanges.Nails Nails are flat, horny plates which overlie the dorsal surface of the distalphalanges of fingers and toes.
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of DarumakaBlood supply to skin The blood supply of the skin is formed of several networks of the blood vessels andsupplies the different structures they are as follows. • Deep arterial plexus • Superficial sub papillary arterial plexus • Sub papillary venous plexus • Subcutaneous veinsLymph circulation In the subcutis and dermis the lymphatic system forms a deep and superficialnetwork. The superficial lymphatic network arises in the papillary layer as blind roundeddilated capillaries. The second network of lymph vessels is in the lower part of thedermis.Nerve Supply The skin is richly supplied with nerve fibers, endings and special sensoryterminals. The skin is abundant with special sensory terminals which respond to variousstimuli such as pain, cold, heat and pressure, etc.PHYSIOLOGY OF SKIN79 Skin is primarily a barrier between body structures and environment. It serves inprotection sensation, heat regulation and chemical exchange with the exterior, thus skinperforms multiple functions. • Presents barrier to physical agents • Protects against mechanical injury • Prevents loss of body fluids • Reduces penetration of UV radiation
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of Darumaka • Helps regulate body temperature • Acts as a sensory organ • Plays a role in vitamin D production • Acts as an outpost for immune surveillance • Cosmetic associationAnatomy and Physiology of the Scalp80 Hair bearing area of the head extending into the forehead up to the superciliaryarch or the soft tissue covering seen in the superior portion of the frontal, partial andoccipital bones is known as scalp. The average area of adult scalp approximately 120 square inches. The boundariesof the scalp are, anteriorly superaorbital margins, posteriorly external occipitalprotuberance, superiorly nuchal lines and on each sides the superior temporal lines. Scalp overlaps the upper surface in region of the forehead. The hairline does notcorrespond to the boundaries of the scalp. It had shifted backwards due to the enlargingbrain. Hence, it leaves the forehead without hair. Hair is continuous with the hair of thetemple and the beard. The detailed structure of the scalp parallels that of the skin on the other parts ofthe body except that it is securely fixed to the epicranius muscle by fibrous processeswhich pass through a middle layer to the epicranius muscle by fibrous processes whichpass through a middle layer of subcutaneous fat. The scalp is made up of the followingfive layers. They are skin (S), connective tissue or superficial fascia (C) epicranialaponeurosis (A) loose areolar connective tissue or superficial fascia (L) and pericranium(P) if ; the above letter S.C.A.L.P. are put together they form the Scalp word.
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of Darumaka1. Skin Thick and hairy adherent to the epicranial aponeurosis through the densesuperficial. The epidermal appendages are hair, sweat glands, sebaceous glands and nails.Since the epidermal appendages are intimately involved in the dandruff, a detaileddescription of them is unavoidable.Hairs : Hairs or pili are epidermal outgrowths and are seen everywhere in the bodyexcept palms, soles, dorsal aspects of the distal phalanges of feet and hands, portion ofthe external genital organs and the lips. It consists of two parts, a shaft and a root. Theshaft is the superficial portion most of which projects above the surface of the skin. Theshaft of coarse hairs consists of three principle parts. Viz. Medulla, Cortex and Cuticle.The root is the portion below the surface that penetrates into the dermis and like the shaftit contains medulla. Cortex and cuticle surrounding the root is the hair follicle, the base ofeach follicle is enlarged into an onion shaped structure, the hair bulb.Hair follicle : It is formed by the invagination of the epidermis and corium. The hair follicle hasa fibrous part from part from the dermis and an epithelial part from the epidermis. Theepidermis part is called the inner root sheath and is composed of three distinctive layers.The innermost layer is the cuticular layer containing a single layer of flattened imbricatedcells with atrophied nucleus. Surrounding this cuticle is the middle layer otherwiseknown as Huxley’s layer, composed of a single or double layer of polyhedral nucleatedcells.
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of Darumaka The outermost layer or Henle’s layer consists of a single stratum of nucleatedcubical cells both horny and fibrous in character. The entire inner root sheath disappearsat the middle of the follicle, where the sebaceous gland secretion enters into the lumen ofthe follicle. The fibrous outer dermis hair sheath composed of three clearly defined parts. Itsinnermost layer resembles the basal layer of the epidermis and is characterized as thehyaline or vitreous membrane. There is then a compact middle vascular layercorresponding to the papillary layer of the skin. The final elastic layer corresponds to thereticular layer of the dermis. In the inner hair follicle, mitoses occur only on periods of activity. In such periodsmitosis become quite Nemours throughout the lower portions of the malphigian layers.These mitoses result in an outward motion along the hair axis of most components of thefollicle. In the course of this motion, the cells of the medulla and inner root sheathdesquamates. Thus only the cortex and cuticle, both of which are hard keratin structure,persists to form the emerging hair. The hair shaft consists of medulla cortex and cuticle. Medulla is composed of softkeratin, cortex is composed is composed of longitudinally arranged fibres consisting ofelongated, closley packed fusiform cells containing pigment and airspaces. Cuticleconsists of a layer of imbricated scales and undergoes high keratinization.There are three main types of hairs 1. Lunago hair 2. Vellus hair 3. Terminal hair
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of Darumaka 1) Lunago hair is fine, soft, non-pigmented which are presented in uterus and isshed by the eight month of pregnancy. 2) Vellus hair repalces lanugo hair post natally. It is fine soft usually non-pigmented and rarely more than a few milimeters in length. It occurs more or lessuniformly in the body surface. 3) Terminal hair is relatively long, course, pigmented and modulated hairs foundin the scalp, bread, axially, etc.Chemical Composition Hair has the following chemical constituents. Cystine, a hair protein, sulphur,nitrogen and insoluble keratin, water soluble organic compounds such as uric acid,glycogen, pentose, phenols, aminoacids, urea and ammonia. These compounds areconsidered to be by products of the process of hair formation.2. Connective tissue or superficial fascia The Fascia is more fibrous and dense in the center than at the periphery of thehead; it binds skin to the subjacent aponeurosis, and provides the proper medium for thepassage of the vessels and nerves to the skin. Wounds of the scalp bleed profuselybecause the torn vessels are prevented from retracting by the fibrous fascia, thesubcutaneous hemorrhages are never extensive, and the inflammations in this layer causelittle swelling but much pain.
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of Darumaka3. The deep fascia It consists of occipitoforntalis muscle and epicranial aponeurosis. The muscle hastwo bellies, occipitalis and frontalis both of which are inserted unto the epicranialaponeurosis. The occipital bellies are small and separate. Each arises from the lateral 2/3of the superior nuchal line. The forntal bellies are longer, wider and partly united in themedium plane each arises from the skin of the forehead, mingling with the orbicularisocculi and corrugator supercilli. The epicranial Aponeurosis : With the adherent skin and superficial fascia, isfreely movable on the pericranium. Anteriorly, it receives insertion of the frontalis, ½inch in front of the coronal suture; Posteriorly it receives the insertion of the occipitalisand is attached to the external occipital protuberance and the highest nuchal lines inbetween the occipital bellies. On each side the aponeurosis is attached to the superiortemporal line, but sends down a thin expansion which passes over the temporal fascia andis attached to the zygomatic arch. Wounds of the scalp do not gape unless the galae isdivided transversely.4. The fourth layer It is made up of loose aerolar tissue, which extends anteriorly into the eyelids.This is because frontalis muscle has two bony attachments, posteriorly to the highest andsuperior nuchal lines; and one each of the superior temporal lines. This layer known asthe dangerous area of the scalp because the emissary veins, which open here maytransmit the infection from scalp to the cranial venous sinuses, blood collection in thisspace and may extend anteriorly into the root of the nose and eyelids, causing black eye.
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of Darumaka5. Pericranium The fifth layer of scalp loosely attached to the surface of the bones, but is firmlyadherent to their structures, where the sutural ligaments bind pericranium to theendocranium therefore; fluid collections beneath the pericranium take the shape of therelated bones.Arterial Supply In front of the auricle scalp is supplied from before backwards by the (1)Supratrochlear (2) Supraorbital and (3) Superficial temporal arteries. The first two arebranches of the ophthalmic artery which in turn is a branch of the internal carotid artery.Behind the auricle, scalp is supplied from before backwards by the (4) posterior auricularand occipital arteries, both of which are branches of the external carotid artery. Thus, scalp has a rich blood supply derived from both the internal and externalcarotid arteries, the two systems anatomizing in the temple.Venous drainage The veins of the scalp accompany the arteries and have similar names.Lymphatic drainage The anterior part of the scalp drains into the pre-auricular (parotid) lymph nodes,and the posterior part of the scalp drains into the posterior auricular (mastoid) andoccipital lymph nodes.Nerve supply The scalp and temple are supplied by 10 nerves on each side, out of which thefour sensory and one motor enter behind the auricle.
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of Darumaka DRUG REVIEW In this chapter attempt has been made to review the drugs used in the managementof Darunaka. Gunja taila shiro abhyanga is selected for the study. An observational studywill be done on 20 patients who will receive abhyanga with Gunja taila for 30 days.The following are the drugs used in the study. • Gunja • Bhringaraj • Tila taila GUNJA81Latine name : Abrus pecatorius linn.Family : Fabaceae.Classical names : Gunja, Kakadani, Kakachinchi, Kakavallari, Krishnala,Kakananti, Raktika, Kakapeelu.Vernacular names : English : Indian lipuoric root, Crabes eye, wild liquorice root. Hindi : Rotti, Ghunghachi, Chanoti. Kannada : Gurugunj, Gulaganji, Gunja. Malayalam : Atimadhuram, Irattimadhuram, Madhukam. Marathi : Chanoti, Gunchi. Tamil : Kuntamani, Adisamiyai. Telugu : Guruvinda beeja. Urdu : Ghunchi.
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of DarumakaDescription82 A deciduous dextrose climber with slender flexible and tough branches. The stemattaining 4.5 meters high and 1.2 cm. diameter. Leaves 5-10 cm. long, paripinnate; rachis produced beyond the last pair of leaflets asa soft bristle. Leaflets 10-20 pairs, opposite, increasing slightly in size from the base,7.5-23 by 3.8-6 mm, liner or linear-oblong, thinly membranous, entire, round at bothends, glabrous above when mature, thinly pressed-silky beneath. Flowers 1-1.25 cm. long, pink, clustered, on tubercles arranged along the rachis ofone-side, usually leaf-bearing, axillary, pedunculate raceme 5-10 cm. long. Pod 2.5-4.3 by 1-1.25 cm, turgid thinly pubescent, scarlet with a black spot at thehilium polished.Distribution : It is found throughout the tropics; it is also planted.Parts used : Root, Leaf, Seed,Chemical composition Seeds contain toxic protein; abrusic acid, a glucoside; haemaglutannin, someurease, and glycine- like active abrin albuminoid. Seeds potency gets inerted when theyare boiled. Seed coat contains a red colouring substance.Pharmacological activities83 01. Fungistatic 02. Antibacterial 03. Germicide 04. Anticancer 05. CNS depressant 06. Analgesic
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of Darumaka 07. Antimuscarinic 08. Abrotifacient 09. Antispasmodic 10. Uterine stimulant 11. Antifertility 12. Emmenagogue 13. Antitumor 14. Antiimplantation 15. Antiestrogenic 16. Oxytocic 17. Antispermatogenic 18. Antimicrobial.Pharmacodynamics Rasa : Seed Tikta, Kashaya. Guna : Tikshna, Laghu, Ruksha. Veerya : Ushna. Vipaka : Katu. Doshaghnata : Kaphavatahara. Rogaghnata : Charmaroga, Kalitya, Indralupta. Karma : Seed Kushthaghna, Keshya.
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of Darumaka TILA84Latin Name : Sesamum indicum linn.Family : PedaliaceuaeClassical names : Tila, pavitra, homadhanya, papaghnaVernacular names : English : Sesame, Gingelly. Hindi : Til, Gingli. Kannada : Ellu, Yallu. Malayalam : Ellu, Schit-elu. Marathi : Til, Tila. Tamil : Ellu, Nal-lenny. Telugu : Nuvvulu, Nuvvu.Description85 An erect branched or unbrached annular, 60-180 cm height, slightly foetid, stedsoft tomentose. Leaves 7.5-12.5 cm. simple, or when variable, with upper ones narrowly oblong,middle ones ovate and toothed and the lower ones lobate or pedatisect; small or big insize being variable; lvs. Linear, oblong, lanceolate and in variable shape or kind, alternatein general Flowers white, pink or mauve-pink with darker markings, brine in racemes in theleaf-stalks; fls. Soft, hairy or glabrous; sub erect or drooping. Fruits capsular, oblong-sub triangular, slightly compressed, dehiscent, deeply 4-grooved, 1.5-5 cm. long .seeds black, brown or white, 2.5-3mm. long and 1.5mm.broad,small; white and black in Colour, red also.
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of DarumakaPharmacodynamics Rasa : Madhura, Anurasa, Kashaya, Tikta. Guna : Guru, Snigdha. Virya : Ushna. Vipaka : Madhura. Dosha karma : Vata shamaka, Kapha-Pitta prakopaka, Tridosha shamaka when processed with any other drug due to its ‘Yogavahi’ property. Karma : Snehana, Sandhaniya, Keshya, Tvachya, Balya, Vrana shodhana, Vrana ropana, Dantya, Vrishya. Uses : In Vatavyadhi, hair restorer, dermatopathy, dryness of the skin. Others : There are three varieties of Tila but the Krishna tila is best in all. Parts used : Root, Leaf, Seed.Chemical Composition Seeds contain various vitamins, particularly vitamin A, B and C Seeds oilcontains sesamin and sesaminin and they also contain sesamol, a phenol compound. Analysis of a number of samples of seame seeds oil for glyceriote compositionhave led to conclusion that the composition appears to be less affected by climatic andother factors during growth of the crop. Sesame oil is rich in oleic and linoleic acids.Which together account for 85 percent of the total fatty acids.Pharmacological activities86 01. Antioxidant 02. Colesterolemic 03. Antioxident 04. Hepatoprotective 05. Antitumour 06. Hypotensive 07. Nematicidal 08. Free radical scavenging activity 09. delta 5 desaturase inhibiting activity.
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of Darumaka BHRINGARAJA87Latin Name : Eclipta albaFamily : Asteraceae (Compositeae)Classical names : Markava, Kesh ranjana, Kesharaja,Vernacular names : English : Ttrailing Eclipta. Hindi : Bhamgra, Mochakand, Bhangara. Kannada : Garagada Soppu. Malayalam : Kannunni, Kayyonni. Marathi : Bhringuraja, Maka. Tamil : Kaikesi, Garuga. Telugu : Galagara, Guntagalijeru.Description88 Annual, erect, often branching, often rooting at the nodes; stem and branchesstrigose with appressed white hairs. Leaves sessile, 2.5-7.5 cm. long, variable in breadth, usally oblong-lanceolate,sub-entire, acute or sub-acute, sparsely strigose with appressed hairs on both sides, basetapering. Heads 6-8 mm. diam. Solitary or 2 together on unequal axillary peduncles.Involucral bracts about 8, ovate, obtuse or acute, herbaceous, strigose with apreading;scarely as long as the bracts, not toothed, white. Disk-flowers tubular, the corollas often4- toothed. Pappus 0, except occasionally very minute teeth on the top of the achenes. Achenes cuneate, compressed and with a narrowing, covered wing, covered withwarty excrescences.
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of DarumakaPart used : Whole plant, seedPharmacodynamics Rasa : Katu, Tikta. Guna : Ruksha, Laghu. Virya : Ushna. Vipaka : Katu. Dosha karma : Kapha-vata shamaka. Karma : Shothahara, Vedana sthapana, Keshya, Kesha Ranjana, Deepana, Pachana, Yakruta Uttejaka Rasayana, Koshthaghna, Chakshushya. Uses : In Khalitya, Palitya, Kamala, Kushtha, Kilasa, Shvitra. Used as a Rasayana and Vajikarana drug.Chemical Composition Plant contains resin in high quantity, and an alkaloid ecliptine. Leaves containleucine, isoleucine, valine, phenybalmine and menthionine, glycine, glutamine, glutamicacid, cytone and methionine, and they are richer in protein than any other greenvegetable.Pharmacological activities89 01. Antibacterial 02. Analgesic 03. Promoter for blackening and growth of hair 04. Antiviral 05. Hepatoprotective 06. Spasmogenic 07. Hypotensive 09. Antimyotoxic.Toxicology Steroid alkaloids from methanol extract of leaves are DNA-damaging and all thealkaloids showed weak cytotoxicity against the M-109 cell line.
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of Darumaka
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of Darumaka MATERIALS AND METHODSAIM OF THE STUDY To evaluate the efficacy of shiro abhyanga with Gunja taila in the management of Darunaka. To evaluate the efficacy of shiro abhyanga with Tila taila in the management of Darunaka. To compare the effects of shiro abhyanga with Gunja taila and with Tila Taila in the management Darunaka.SOURCE OF DATA The patients who fulfil the Diagnostic criteria for darunaka were selectedrandomly from the OPD and IPD of Shalakya tantra, S.D.M. Ayurvedic College andHospital, Hassan.CRITERIA FOR SELECTION OF PATIENTSInclusion criteria: • The patients presenting with classical features of Darunaka are selected irrespective of Age, Sex and Socio economic status.Exclusion Criteria: • Associated with other dermatological conditions such as psoriasis etc. • Other types of Kapala rogas.Investigations: 01. Blood for Hb%, TC, DC, ESR. 02. Urine for sugar, albumin. 03. Stool for-ova, cysts.
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of DarumakaRESEARCH DESIGNPatients were divided into 2 groups. i.e., Group A and Group B. Group A – Gunja taila shiro abhyanga was applied for thirty days, once daily, in the morning. Group B – Shiro abhyanga with Tila for thirty days was applied, once daily, in the morning. Both groups were followed at regular intervals (once in fifteen days) for aperiod of two moths. Following method was adopted for the application of shiro abhyanga.Method of shiro abhyanga 1. Application of medicated oil on the head is known as shiro abhyanga, it is done in the sitting position. 2. In the present study Gunja taila in group A and Tila taila in group B is taken for Abhyanga in the management of Darunaka. 3. Abhyanga should be applied gently and in the direction of the hair. 4. Shiro abhyanga is done with lukewarm oil because the head is the place of all senses and it is considered as the most vital part. 5. Shiro abhyanga is done gently with fingertips because forceful massage can damage the hair. 6. The process is continued for one mouth, then follow up to 2 mouths once in fifteen days duration.
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of DarumakaThe drugs / formulation taken for the study are: 1. Guja taila shiro abhyanga 2. Tila tailaI. Gunja taila shiro abhyanga The ingredients of Gunja taila used for shiro abhyanga are Gunja, Bhrungarajaand Tila taila which was used for abhyanga karma in Group A.II. Tila Tila taila was used for of shiro abhyanga in Group B.Collection of Drugs: • All the raw materials required for the preparation of Gunja taila were procured and purchased from the Department of Dravyaguna, S.D.M.C.A., Hassan. • Tila taila was purchased from our pharmacy.Method of preparation of Gunja taila: The trial medicine was prepared in the department of rasa shastra and bhishajyakalpana as per the classical reference90.Ingredients:Table No. 11 – Showing the Drugs used in the preparation of the Gunja Taila Sl.No. Drugs90 Quntity91 01. Gunja beeja 1 part. (To prepare kalka) 02. Tila taila 4parts 03. Bhrungaraja 16 parts (swarasa ) • Subjected to Snehapaka as per the classics. • The finally prepared taila should be Kharapaka92 in nature.
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of DarumakaCRITERIA FOR ASSESSMENT OF TREATMENTAssessment of treatment were made before and after the treatment based on, 1. Kesha bhoomi Rookshata 2. Kandu 3. Twak sphutana 4. Kesha chyutiGRADATION INDEXTable No. 12 -- Showing Gradation Index for assessment criteriaKesha bhoom Rookshata Kandu 0 – Absent 0 –Absent 1 – Negligible 1 –Occasionally 2 – Without discomfort on scalp 2 –Frequently 3 – With discomfort on scalp 3 –ConstantlyTwak sphutana(fine flakes) Keshachyuti 0 – Absent 0 – Absent 1 – Visible inside the hair 1 – Occasionally 2 – Visible over the hair 2 – Moderate loss 3 – Spreaded over the shoulder 3 – Maximum lossOverall effect of Therapy:Severity of Darunaka For assessing the severity of Darunaka in each patient the above adopted scoreswere grouped and assessed as follows Absent – 0 –0 Mild – 1 – 1 – 4 Score Moderate – 2 – 5 – 8 Score Severe – 3 – > 8 Score
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of DarumakaStatistical analysis of the result The results having p value less than < 0.05 is considered as statistically significantin this study.CRITERIA FOR ASSESSMENT OF OVERALL EFFECTS Overall effect of the therapy was assessed in terms of complete remission, markedimprovement, moderate improvement, and mild improvement and unchanged is observedby adopting the following criteria. • COMPLETE REMISSION : 100% relief in Chief complaints and no recurrence during follow up study were considered as complete remission. • MARKED IMPROVEMENT : 75 – 100% improvement in chief complaints is recorded as marked improvement. • MODERATE IMPROVEMENT : 50 - 75% improvement in chief complaints is recorded as moderate improvement. • MILD IMPROVEMENT : 25 - 50% improvement in chief complaints is considered as mild improvement. • UNCHANGED : Less than 25% reduction in chief complaints or recurrence of the symptoms to the similar extent of severity is noted as recurrence.Follow up study After the completion of treatment, all the patients were advised to attend theO.P.D for two months at regul ar interval of fifteen days for the follow up study to assessthe post effects of treatment.
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of DarumakaFigure No. 3 - Showing the ingredients of the Gunja taila DRUGS USED IN THE PREPARATION OF GUNJATAILA TILA GUNJA BHRINGARAJ GUNJA TAILAFigure No. 3. Showing the procedure of Shiro Abhyanga. PROCEDURE FOLLOWED FOR SHIRO ABHYANGA GUNJA TAILA ABHYANGA
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of Darumaka
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of Darumaka OBSERVATIONS AND RESULTSOBSERVATIONS 20 patients (pt’s) of Darunaka were registered for this clinical study. They weredivided into two groups, Gunja Taila Shiro abhyanga group (GTSA group) and Tila TailaShiro abhyanga group (TTSA Group) for the purpose of comparative assessment oftreatment. The Age, Sex, Religion, Socio – Economic Status, Dietary Habit, Occupation,and Nidana etc were observed and presented statistically as follows.Table No. 13 - Showing Age Wise Distribution of Patients Age GTSA group TTSA group Total No. of pt’s % No. of pt’s % No. of pt’s %10 – 19 Years 03 30 04 40 07 3520 – 29 Years 04 40 06 60 10 5030 – 39 Years 02 20 00 00 02 1040 – 49 Years 01 10 00 00 01 05 Age wise distribution of patients showed that 07 patients ( 35 %) were in the agegroup of 10 – 19 yrs, 10 patients ( 50 %) were in the age group of 20 – 29 years, 02patients ( 10 %) were in the age group of 30 – 39 years and 1 patient (05 %) was betweenthe age of group 40 – 49 yrs . The incidence of age in patients with Darunaka was more in 20 – 29 (50%) agegroup in the present study.Table No. 14 - Showing Sex Wise Distribution of Patients Sex Group A Group B Total No. of pt’s % No. of pt’s % No. of pt’s %Male 05 50 03 30 08 40Female 05 50 07 70 12 60 Out of 20 cases, the incidence of Darunaka is observed 08 (40 %) in the male and12 (60 %) in the female patients. The incidence of sex in patients with Darunaka was more in females (60%) in thepresent study.
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of DarumakaFigure No: 04 - Showing Age Wise Distribution of Patients AGEWISE DISTRIBUTION OF PATIENTS 70 60 60 GTSA TTSA Total 50 50 40 40 40 35 30 30 Percentages 20 20 10 10 10 5 0 0 0 10 – 19 20 – 29 30 – 39 40 – 49 Age GroupsFigure No: 05 - Showing Sex Wise Distribution of Patients SEX WISE DISTRIBUTION OF PATIENTS 80 70 70 60 60 50 50 50 40 40 30 30 Percentage 20 10 0 Sex Male Fem ale GTSA TTSA Total
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of DarumakaTable No. 15 - Showing Religion Wise Distribution of Patients Religion Group A Group B Total No. of pt’s % No. of pt’s % No. of pt’s %Hindu 08 80 09 90 17 85Muslim 02 20 01 10 03 15 Out of 20 patients, 17 (85%) were Hindu, 03 (15 %) were Muslim. The incidenceof religion in patients with Darunaka was more in Hindu 17 (85%) in the present study.Table No. 16 - Showing Socio – Economic Status Wise Distribution of PatientsS – E Status Group A Group B Total No. of pt’s % No. of pt’s % No. of pt’s %Upper class 01 10 01 10 02 10Middle class 04 40 03 30 07 35Lower class 05 50 06 60 11 55 Socio-economic status wise distribution of patients showed that 11 patients (55%)were belonged to lower class, 07 patients were (35%) to middle class and 02 patientswere (10 %) to upper class. The incidence of Socio-economic status in patients with Darunaka was more inLower class (55%) in the present study.
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of DarumakaFigure No: 06 - Showing Religion Wise Distribution of Patients RELIGION WISE DISTRIBUTION OF PATIENTS 100 90 90 85 GTSA TTSA Total 80 80 70 60 50 40 Percentage 30 20 20 15 10 10 0 Hindu Muslim ReligionFigure No: 07 - Showing S-E status Wise Distribution of Patients S-E STATUS WISE DISTRIBUTION OF PATIENTS 70 60 60 55 50 50 40 40 35 30 30 Percentage 20 10 10 10 10 0 Upper class Middle class Low er class S-E Status GTSA TTSA Total
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of DarumakaTable No. 17 - Showing Habitat Wise Distribution of Patients Habitat Group A Group B Total No. of pt’s % No. of pt’s % No. of pt’s %Urban 04 40 03 30 07 35Rural 06 60 07 70 13 65 Habitat wise distribution of patients shows that, out of 20 patients, 07 patients(35 %) were residing in urban area and 13 patients (65 %) were in rural area. The incidence of Habitat in patients with Darunaka was more in rural (55%) in thepresent study.Table No. 18 - Showing Dietary Habit Wise Distribution of PatientsDietary Group A Group B TotalHabit No. of pt’s % No. of pt’s % No. of pt’s %Vegetarian 03 30 06 60 09 45Mixed 07 70 04 40 11 55 Dietary Habit wise distribution of 20 patients shows that, 09 (45 %) patients werevegetarians and 11 (55%) patients were having mixed dietary habits. The Diet wise Incidence of patients with Darunaka shows more incidences i.e.55% in patients with mixed dietary habits.
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of DarumakaFigure No: 08 - Showing Habitat Wise Distribution of Patients HABITAT WISE DISTRIBUTION OF PATIENTS GTSA TTSA Total 80 70 70 65 60 60 50 40 40 35 30 30 Percentage 20 10 0 Habitat Urban RuralFigure No: 09 - Showing Dietary habit Wise Distribution of Patients DIATARY HABITAT WISE DISTRIBUTION OF PATIENTS 80 70 GTSA TTSA Total 70 60 60 55 50 45 40 40 30 30 Percentage 20 10 0 Vegetarian Mixed Diatary Habitat
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of DarumakaTable No. 19 - Showing Prakruti Wise Distribution of Patients Prakruti Group A Group B Total No. of pt’s % No. of pt’s % No. of pt’s %Vatakapha 02 20 03 30 05 25Vatapitta 04 40 03 30 07 35Kapha Pitta 04 40 04 40 08 40 Out of 20 patients, 05 patients (25 %) were of Vatakapha, 07 patients (35 %) wereof Vatapitta prakruti and 08 patients (40 %) were of Kapha pitta The incidence of Prakruti in patients with Darunaka was more in Kapha pittaprakruti (40%) in the present study.Table No. 20 - Showing Occupation Wise Distribution of PatientsOccupation Group A Group B Total No. of pt’s % No. of pt’s % No. of pt’s %Student 01 10 05 50 06 30Teacher 01 10 00 00 01 05Labourer 03 30 03 30 06 30Agriculture 03 30 01 10 04 20Housewife 02 20 01 10 03 15 Out of 20 Patients, 06 (30 %) were students, 01 (05 %) was Teacher, 06 (30%)were labour, 04 (20%) were agriculturist, 03 (15%) were Housewives.
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of DarumakaFigure No: 10 - Showing the Prakriti wise Distribution of Patients PRAKRITI WISE DISTRIBUTION OF PATIENTS GTSA TTSA Total 45 40 40 40 40 40 35 35 30 30 30 25 25 20 20 15 Percentage 10 5 0 Vatakapha Vatapitta Kaphapitta PrakritiFigure No: 11 - Showing Occupation wise Distribution of Patients OCCUPATION WISE DISTRIBUTION OF PATIENTS 55 50 GTSA TTSA Total 50 45 40 35 30 30 30 30 30 30 25 20 20 20 15 Percentage 15 10 10 10 10 10 5 5 0 0 Occupation Student Teacher Labourer Agriculture Housew ife
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of DarumakaTable no. 21 - Showing Distribution of Nidanas in PatientsNidanas Group A Group B Total No. of pt’s % No. of pt’s % No. of pt’s %Abhyangadvesa 09 90 08 80 17 85Mrujadvesa 06 60 07 70 13 65Rajahsevana 04 40 03 30 07 35Atapa atisevana 05 50 03 30 08 40Ati sheeta ambu sevana 04 40 03 30 07 35Praagvata 05 50 04 40 09 45Jagarana 01 10 00 00 01 05Diva swapna 05 50 03 30 08 40Guru ahara 07 70 05 50 12 60Hima ahara 04 40 02 20 06 30 Distribution of darunaka as per nidana shows that, out of 20 patients, 17 (85%)had abhyangadvesa, 13 (65%) with mrujadvesa, 07 (35%) rajahsevana, 08 (40%) withatapa tisevana, 07 (35%) with ati sheeta ambu sevana, 09(45%) praagvata, 01 (05%) withjagarana, 08 (40%) had diva swapna, 12 (60%) were using guru ahara, and 06 (30%)were using hima ahara. The incidence of Nidanas in patients with Darunaka was more in abhyangadvesa(85%) in the present study.
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of DarumakaFigure No: 12 - Showing Nidana wise Distribution of Patients NIDANA WISE DISTRIBUTION OF PATIENTS 100 90 90 85 80 GTSA TTSA Total 80 70 70 70 65 60 60 60 50 50 50 50 50 45 40 40 40 40 40 40 40 35 35 Percentage 30 30 30 30 30 30 20 20 10 10 5 0 0 AD MjD RS AtP S At SAS Pr Vs Jg D Sw G Ah H Ah Nidana ABBREVIATIONS AD – Abhyanga Dweshi MjD – Mrijadvesha RS – Rajah Sevana AtP S – Atapa Sevana At SAS – Ati Sheetambu Sevana Pr Vs – Prag Vata Sevana Jg – Jagarana D Sw – Diwaswapna G Ah – Guru Ahara H Ah – Hima Ahara
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of DarumakaTable No. 22 - Showing Incidence in Severity of DarunakaSeverity of Group A Group B TotalDarunaka No. of pt’s % No. of pt’s % No. of pt’s %Severe 04 40 05 50 09 45Moderate 06 60 04 40 10 50Mild 00 00 01 10 01 05 The patients with the severity of Darunaka was observed that out of 20 patients,09(45%) had severe, 10 (50%) had moderate and 01 (05%) have mild attack. The Incidence of severity of the disease in the present study shows more patients(50%) were with the moderate degree of affliction with darunaka.Table No. 23 - Showing Incidences of Symptoms in PatientsSymptoms Group A Group B Total No. of pt’s % No. of pt’s % No. of pt’s %Kandu 10 100 10 100 20 100Rookshata 10 100 10 100 20 100Twaksphutana 10 100 10 100 20 100Keshachyuti 09 90 08 80 17 85 Among 20 patients of Darunaka, 20 (100%) have Kandu, 20 (100%) haveRookshata, 20 (100%) have Twaksphutana and 17 (85%) have Keshachyuti.
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of DarumakaFigure No: 13 - Showing Severity wise Distribution of Patients SEVERITY WISE DISTRIBUTION OF PATIENTS 70 60 GTSA TTSA Total 60 50 50 50 45 40 40 40 30 Percentage 20 10 10 5 0 0 Severe Moderate Mild SeverityFigure No: 14 - Showing incidence of symptom wise Distribution of Patients SYMPTOMS WISE DISTRIBUTION OF PATIENTS GTSA TTSA Total 120 100 100 100 100 100 100 100 100 100 100 90 85 80 80 60 Percentage 40 20 0 Sym ptom s Kandu Rookshata Tw aksphutana Keshachuti
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of DarumakaTable No. 24 - Showing Incidences of use of cosmetic (materials used for head bath)in Patients Cosmetic Group A Group B Total (Materials used No. of pt’s % No. of pt’s % No. of pt’s % for head bath)Soaps 03 30 04 40 07 35Shampoos 06 60 05 50 11 55Soap nut 01 10 01 10 02 10 Among 20 patients of Darunaka, 07 (35%) were using Soaps, 11(55%) were usingShampoos, and 02 (10%) were using Soap nut. The incidence of Cosmetics in the patients with Darunaka was more in users ofShampoos (55%) in the present study.Table No. 25 - Showing Incidences of application of oils in PatientsApplication of oils Group A Group B Total No. of pt’s % No. of pt’s % No. of pt’s %Coconut oil 06 60 04 40 10 50Castor oil 03 30 02 20 05 25Seasum oil 01 10 04 40 05 25 Among 20 patients of Darunaka, 10 (50%) were using Coconut oil, 05(25%) wereusing Castor oil and 05 (25%) were using Seasum oil. The incidence of Application oils in patients with Darunaka was more in theusers of Coconut oil (50%) in the present study.
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of DarumakaFigure No: 15 - Showing incidence of use of cosmetic wise Distribution of Patients USE OF COSMETIC WISE DISTRIBUTION OF PATIENTS 70 GTSA TTSA Total 60 60 55 50 50 40 40 35 30 30 Percentage 20 10 10 10 10 0 Cosm etics Soaps Sham poos Soap nutFigure No: 16 - Showing incidence of oil wise distribution of patients. USEOF OILS WISE DISTRIBUTION OF PATIENTS 70 GTSA TTSA Total 60 60 50 50 40 40 40 30 30 25 25 20 Percentage 20 10 10 0 Coconut oil Castor oil Seasum oil Oils
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of Darumaka RESULTSKANDU The symptom of Kandu was recorded according to the gradation index. Data wascollected and statistically analysed.Table No. 26 - Showing the ‘t’ test results in reduction of severity of Kandu in GTSAgroup and TTSA group after treatment and during follow up. Kandu Mean score S.D of S.E of df ‘t’ ‘p’ mean mean BT AT Red. %G AT 2.3 0.6 1.7 73 0.48 0.15 9 11.13 <0.001TS FU1 2.3 0.5 1.8 78 0.42 0.13 9 13.50 <0.001A FU2 2.3 0.6 1.7 73 0.48 0.15 9 11.13 <0.001T AT 2.5 2.1 0.4 16 0.52 0.16 9 2.45 <0.05T FU1 2.5 2.2 0.3 12 0.48 0.15 9 1.96 <0.10SA FU2 2.5 2.3 0.2 8 0.42 0.13 9 1.50 <0.20In GTSA group, the mean reduction of Kandu is, • Before and after treatment shows changes from 2.3 to 0.6 showing a reduction of 1.7 (73%) which is statistically significant at the level of p <0.001. • Changes after 1st month follow up is from 2.3 to 0.5 showing a reduction of 1.8 (78%) which is statistically significant at the level of p <0.001. • Changes after 2nd month follow up is from 2.3 to 0.6 showing a reduction of 1.7 (73%) which is statistically significant at the level of p <0.001.In TTSA group, the mean reduction of Kandu is, • Before and after treatment shows changes from 2.5 to 2.1 showing a reduction of 0.4 (16%) which is statistically significant at the level of p <0.05. • Changes after 1st month follow up is from 2.5 to 2.2showing a reduction of 0.3 (12%) which is statistically significant at the level of p <0.10. • Changes after 2nd month follow up is from 2.5 to 2.3 showing a reduction of 0.2(8%) which is statistically significant at the level of p <0.20.
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of DarumakaROOKSHATA The symptom of Rookshata was recorded according to the gradation index. Datawas collected and statistically analysed.Table No. 27 - Showing the ‘t’ test results in reduction of severity of Rookshata in GTSAgroup and TTSA group after treatment and during follow up. Kandu Mean score S.D of S.E of df ‘t’ ‘p’ mean mean BT AT Red. %G AT 2.4 0.7 1.7 70 0.48 0.15 9 11.13 <0.001TS FU1 2.4 0.6 1.8 75 0.42 0.13 9 13.50 <0.001A FU2 2.4 0.7 1.7 70 0.48 0.15 9 11.13 <0.001T AT 2.4 1.8 0.5 25 0.71 0.22 9 2.29 <0.05TS FU1 2.4 2 0.4 16 0.52 0.22 9 2.45 <0.05A FU2 2.4 2.1 0.3 12 0.48 0.15 9 1.96 <0.10In GTSA group, the mean reduction in Rookshata is, • Before and after treatment shows changes from 2.4 to 0.7 showing a reduction of 1.7 (70%) which is statistically significant at the level of p <0.001 • Changes after 1st month follow up is from 2.4 to 0.6 showing a reduction of 1.8 (75%) which is statistically significant at the level of p <0.001 • Changes after 2nd month follow up is from 2.4 to 0.7 showing a reduction of 1.7 (70%) which is statistically significant at the level of p <0.001In TTSA group, the mean reduction in Rookshata is, • Before and after treatment shows changes from 2.4 to 1.8 showing a reduction of 0.5 (25%) which is statistically significant at the level of p < 0.05. • Changes after 1st month follow up is from 2.4 to 2 showing a reduction of 0.4 (16%) which is statistically significant at the level of p <0.05. • Changes after 2nd month follow up is from 2.4 to 2.1 showing a reduction of 0.3(12%) which is statistically significant at the level of p <0.10.
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of DarumakaTWAKSPHUTANA The symptom of Twak sphutana was recorded according to the gradation index.Data was collected and statistically analysed. Table No. 28 - Showing the ‘t’ test results in reduction of severity of Twaksphutana in GTSA group and TTSA group after treatment and during follow up Twak Mean score S.D of S.E of df ‘t’ ‘p’sphutana mean mean BT AT Red. %G AT 1.7 0.4 1.3 76 0.48 0.15 9 8.51 <0.001TS FU1 1.7 0.3 1.4 82 0.52 0.16 9 8.57 <0.001A FU2 1.7 0.4 1.3 76 0.48 0.15 9 8.51 <0.001T AT 1.8 1.2 0.6 33 0.70 0.22 9 2.71 <0.025TS FU1 1.8 1.3 0.5 27 0.71 0.22 9 2.24 <0.05A FU2 1.8 1.4 0.4 22 0.70 0.22 9 1.81 >0.1In GTSA group, the mean reduction of Twak sphutana is, • Before and after treatment shows changes from 1.7 to 0.4 showing a reduction of 1.3 (76%) which is statistically significant at the level of p <0.001 • Changes after 1st month follow up is from 1.7 to 0.3 showing a reduction of 1.4 (82%) which is statistically significant at the level of p <0.001 • Changes after 2nd month follow up is from 1.7 to 0.4 showing a reduction of 1.3 (76%) which is statistically significant at the level of p <0.001In TTSA group, the mean reduction of Twak sphutana is, • Before and after treatment shows changes from 1.8 to 1.2 showing a reduction of 0.6 (33%) which is statistically significant at the level of p <0.025 • Changes after 1st month follow up is from 1.8 to 1.3 showing a reduction of 0.5 (27%) which is statistically significant at the level of p <0.05 • Changes after 2nd month follow up is from 1.8 to 1.4 showing a reduction of 0.4(22%) which is statistically significant at the level of p >0.1.
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of DarumakaKESHACHYUTI The symptom of Kesha chyuti was recorded according to the gradation index.Data was collected and statistically analysed. Table No. 29 - Showing the ‘t’ test results in reduction of severity of Keshachyuti in GTSA group and TTSA group after treatment and during follow up Twak Mean score S.D of S.E of df ‘t’ ‘p’sphutana mean mean BT AT Red. %G AT 1.4 0.5 0.9 64 0.32 0.10 9 9.00 <0.001TS FU1 1.4 0.4 1 71 0.47 0.15 9 6.71 <0.001A FU2 1.4 0.5 0.9 64 0.32 0.10 9 9.00 <0.001T AT 1.4 0.8 0.6 42 0.70 0.22 9 2.71 <0.025TS FU1 1.4 0.8 0.6 42 0.70 0.22 9 2.71 <0.025A FU2 1.4 0.9 0.5 35 0.71 0.22 9 2.24 <0.05In GTSA group, the mean reduction of Kesha chyuti is, • Before and after treatment shows changes from 1.4 to 0.5 showing a reduction of 0.9 (64%) which is statistically significant at the level of p <0.001. • Changes after 1st month follow up is from 1.4 to 0.4 showing a reduction of 1 (71%) which is statistically significant at the level of p <0.001. • Changes after 2nd month follow up is from 1.4 to 0.5 showing a reduction of 0.9 (64%) which is statistically significant at the level of p <0.001.In TTSA group, the mean reduction of Kesha chyuti is, • Before and after treatment shows changes from 1.4 to 0.8 showing a reduction of 0.6 (42%) which is statistically significant at the level of p <0.025. • Changes after 1st month follow up is from 1.4 to 0.8 showing a reduction of 0.6 (42%) which is statistically significant at the level of p <0.025. • Changes after 2nd month follow up is from 1.4 to 0.5 showing a reduction of 0.9(35%) which is statistically significant at the level of p <0.05.
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of DarumakaSEVERITY OF DARUNAKA Severity of the Darunaka was recorded as per the history given by the patients.Data was graded according to gradation index. Statistical analysis is made on the basis ofdata, collected before and after treatment. Table No. 30 - Showing the ‘t’ test results in reduction of severity of Darunaka inGTSA group and TTSA group after treatment and during follow up.Severity Mean score S.D of S.E of df ‘t’ ‘p’ of mean meanDarunak BT AT Red. % aG AT 2.4 0.8 1.6 66 0.52 0.16 9 9.80 <0.001TS FU1 2.4 0.7 1.7 70 0.48 0.15 9 11.13 <0.001A FU2 2.4 0.8 1.6 66 0.52 0.16 9 9.80 <0.001T AT 2.4 2 0.4 16 0.52 0.16 9 2.45 <0.05TS FU1 2.4 2.1 0.3 12 0.48 0.15 9 1.96 <0.10A FU2 2.4 2.2 0.2 08 0.42 0.13 9 1.50 <0.20In GTSA group, the mean reduction of Severity of Darunaka is, • Before and after treatment shows changes from 2.4 to 0.8.showing a reduction of 1.6 (66%) which is statistically significant at the level of p <0.001. • Changes after 1st month follow up is from 2.4 to 0.7 showing a reduction of 1.7 (70%) which is statistically significant at the level of p <0.001. • Changes after 2nd month follow up is from 2.4 to 0.8showing a reduction of 1.6 (66%) which is statistically significant at the level of p <0.001.In TTSA group, the mean reduction of Severity of Darunaka is, • Before and after treatment shows changes from 2.4 to 2 showing a reduction of 0.4 (16%) which is statistically significant at the level of p <0. 05. • Changes after 1st month follow up is from 2.4 to 2.1 showing a reduction of 0.3 (12%) which is statistically significant at the level of p <0.10. • Changes after 2nd month follow up is from 2.4 to 2.2 showing a reduction of 0.2 (8%) which is statistically significant at the level of p <0.20.
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of Darumaka Thus, in all the above parameters of assessment, the percentage of improvement /relief can be made out as follows. Table No. 31 - Showing the percentage of improvement in the symptoms ofDarunaka in GTSA and TTSA groups after treatment and during follow ups. Percentage of Group GTSA Group TTSA relief AT FU1 FU2 AT FU1 FU2Kandu 73 78 73 16 12 08Rookshata 70 75 70 25 16 12Twak sphutana 76 82 76 33 27 22Kesha chyuti 64 71 64 42 42 35 Table No. 32 - Showing over all percentage of improvement in the patients ofGTSA and TTSA groups.Overall %age GTA Group TTA Groupimpr / relief AT FU1 FU2 FU3 FU4 AT FU1 FU2 FU3 FU4Complete 30 30 30 30 30 00 00 00 00 00remissionMarked relief 30 30 30 30 30 00 00 00 00 00Moderate 30 40 40 10 30 30 30 20 20 20reliefMild relief 10 00 00 00 10 10 10 10 10 00No relief 00 00 00 00 00 60 60 70 70 80
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of DarumakaFigure No. 17 - Showing the effect on individual symptoms % OF RELIEF IN INDIVIDUAL SYMPTOM 90 AT FU-1 FU-2 FU-3 FU -4 AT FU-1 FU-2 FU-3 FU-4 80 70 60 50 % of Improvement 40 30 20 10 0 Kandu Rookshata Tvaksputhana Keshachuti Sym ptom sFigure No. 18 - Showing the overall effect of treatment OVERALL RESULTS 90 80 AT FU 1 FU 2 FU3 FU4 AT FU1 FU 2 FU3 FU4 70 60 50 40 30 % of Relief 20 10 0 CR Mr R Mo R Mi R NR Result Assessm ent Criterias
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of Darumaka Table No. 33 - Patients (in percentage) having relief in each symptom aftertreatment; and at the end of 1st, 2nd follow up Mean score S.D S.E of df ‘t’ ‘p’ Kandu of mean BT AT Red. % meanG AT 2.3 0.6 1.7 73 0.48 0.15 9 11.13 <0.001TS FU1 2.3 0.5 1.8 78 0.42 0.13 9 13.50 <0.001A FU2 2.3 0.6 1.7 73 0.48 0.15 9 11.13 <0.001T AT 2.5 2.1 0.4 16 0.52 0.16 9 2.45 <0.05T FU1 2.5 2.2 0.3 12 0.48 0.15 9 1.96 >0.05S FU2 2.5 2.3 0.2 8 0.42 0.13 9 1.50 >0.05ARookshataG AT 2.4 0.7 1.7 70 0.48 0.15 9 11.13 <0.001T FU1 2.4 0.6 1.8 75 0.42 0.13 9 13.50 <0.001S FU2 2.4 0.7 1.7 70 0.48 0.15 9 11.13 <0.001AT AT 2.4 1.8 0.5 25 0.71 0.22 9 2.29 <0.05T FU1 2.4 2 0.4 16 0.52 0.22 9 2.45 <0.05S FU2 2.4 2.1 0.3 12 0.48 0.15 9 1.96 >0.05ATwak SphutanaG AT 1.7 0.4 1.3 76 0.48 0.15 9 8.51 <0.001T FU1 1.7 0.3 1.4 82 0.52 0.16 9 8.57 <0.001S FU2 1.7 0.4 1.3 76 0.48 0.15 9 8.51 <0.001AT AT 1.8 1.2 0.6 33 0.70 0.22 9 2.71 <0.025T FU1 1.8 1.3 0.5 27 0.71 0.22 9 2.24 >0.05S FU2 1.8 1.4 0.4 22 0.70 0.22 9 1.81 >0.05AKesha chyutiG AT 1.4 0.5 0.9 64 0.32 0.10 9 9.00 <0.001T FU1 1.4 0.4 1 71 0.47 0.15 9 6.71 <0.001S FU2 1.4 0.5 0.9 64 0.32 0.10 9 9.00 <0.001AT AT 1.4 0.8 0.6 42 0.70 0.22 9 2.71 <0.025T FU1 1.4 0.8 0.6 42 0.70 0.22 9 2.71 <0.025S FU2 1.4 0.9 0.5 35 0.71 0.22 9 2.24 >0.05A
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of DarumakaFigure No. 19 - Showing the results of the Gunja taila shiro abhyanga RESULT OF THE THERAPY BEFORE AND AFTER THE TREATMENT BEFORE TREATMENT AFTER TREATMENT
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of Darumaka
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of Darumaka DISCUSSION Discussion constitutes interpretation of clinical observations based on theknowledge of literary review. Hence different aspects pertaining to the present study arediscussed here.Discussion on selection of topic Even though Dandruff is not a life threatening disease, it has high cosmeticimportance. The condition is very familiar affecting a very large population. It causessocial disturbance with untidy look by producing irritation, lack of hygiene anddisturbance of work due to constant itching, shedding of the scales and hair falling.Modern science and present available treatment procedures are not satisfactorilyeffective. On the other hand if Dandruff is left untreated, it may lead to complicationslike seborroeic dermatitis. Ayurvedic classics dealt different procedures and medications to treat the diseaseDarunaka. One such treatment is shiro abhyanga with Gunja taila. Though different thesisworks are undertaken with respect to Darunaka, Gunja taila abhyanga is not yet studied.Considering its effective, easy and routine applicability, and cost effectiveness thisresearch work is selected to study the efficacy of Gunja taila abhyanga in Darunaka.Discussion on Review of literature Darunaka is one among the 9 types of kapalgata rogas, characterized by twaksphutana, kandu, rookshata, kesha chyuti etc. It can be correlated with pityriasis capitis incontemporary science, as both these conditions are diagnosed based on the differentsimilar signs and symptoms.
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of Darumaka Even though Darunaka is generally correlated to Dandruff or pytiriasis capitis, itresembles more accurately with the signs and symptoms of dry variety of pytiriasiscapitis. Few of the significantly resembling factors are twak sphutana (scales are dry,fine, white and fall freely on shoulders), rookshata (hair are dry and fine), kandu (milditching). But hair fall has not been directly mentioned in the modern classics; Even thenwe can consider kasha chyuti as a reason of rookshata of hairs.Discussion on classification of disease Review of different classical references infers that, Darunaka is classified underkapalagata and kshudra rogas and no direct reference is available regarding Darunaka asone among the different types of kushta. Since Darunaka affects the skin and shares fewof the similar characters of that of kushta, it can be included among the kushta types. Butbased on the following reasons, the non inclusion of Darunaka as one among the kushtacan be justified. They are – Darunaka affects only the kapala pradesha whereas kushtaaffects any part of the body in general. Kushta includes affliction of any or all of thesaptha dravyas (ch.chi.7.10) but there is no such reference for Darunaka.Discussion on Samprapthi The nidana mentioned in the classics such as ati-sheeta ahara sevana, abhyangadwesha, manastapa etc cause vitiation of vata dosha. It seems that, when these causativefactors results in the gunataha vrudhi (rooksha guna vrudhi) of vata dosha associated withaffliction in the kapala region lead to the excess rookshata of kapala pradesha. Since thekapala pradesha is predominant of kapha dosha, sheetadi gunas also vitiate the kaphadosha. Vitiation of both vata and kapha in kapala pradesha leads to the manifestation ofDarunaka.
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of DarumakaDiscussion on upashaya anupashaya It has been mentioned in the modern texts that, dry variety of pytiriasis capitis ismore commonly seen in cold and dry weather, but no explanation is given. In the classicsit has been mentioned while dealing with ritucharya that, in the sheeta ritu there will beaggravation of vata dosha due to sheetata leading to rookshata. Hence in the nidana ofDarunaka, factors such as pragvata sevana (exposure to cold weather) have beenmentioned. Thus exposure to cold and dry weather is anupashaya for Darunaka. The practice of abhyanga as mentioned in the dinacharya, seems to be theupashaya for Darunaka, because abhyanga dweshi is prone for affliction with Darunakadisease. Here abhyanga specifically involves shiro abhyanga.Discussion on drug review The drugs used in the preparation of the Gunja taila are Gunja, tila taila andbhrungaraja. These drugs are easily available throughout the year and are economical. The ingredients of the Gunja taila have different effective benefits in the treatmentof Darunaka. Such as, Gunja is known for it’s fungistatic, anti-inflammatory and antimicrobial effects, Bhrungaraja is proven promoter of hair growth and also blackening ofthe hairs. Tila taila is the best media for exhibition of effects of these drugs and it itself isan anti oxidant. Similar characters and benefits are attributed to these drugs in the classicsunder different nomenclatures like krimigna, keshya, twachya, snigdha etc… All the drugs of Gunja taila possess ushna veerya and it is a known fact that, drugacts by its veerya. The ushna veerya is necessary to counteract the vata and kapha dosha.Hence this taila is fond effective in the management of Darunaka.
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of Darumaka The effect of Gunja taila is directly dependent on its ingredients. Both Gunja andbhrungaraja have vata kapha shamana properties and tila specifically reduces vata dosha.Thus the combined effect of these drugs over the doshas is vata kapha shamana leading tosamprapti vighatana of Darunaka. Hence it is efficacious in the management of Darunaka.Discussion on shiro abhyanga The different aspects pertaining to abhyanga have been explained in detail whiledealing with the review of literature of classics. The matra kala of the procedure which was adopted in the study is 400 matra kala.The reason behind selecting 400 matra kala is that, it nourishes till the twacha of thekapala. By this, complaints like twacha sphutana, and kesha chyuti can be successfullycontrolled. The method of shiro abhyanga adopted in the present study is also of importance.The abhyanga is done in two parts of 400 matrakala each. The first part consists of shiroabhyanga of right and left parietal regions. The second part consists of shiro abhyanga offrontal, vertex and occipital regions. The procedure of the shiro abhyanga consists of soft, gentle massage of the scalpby patients own finger tips. By this procedure the friction and hair loss is reduced. It alsohelps to do the massage for 400 matrakala. Besides these benefits, it also reducesabhynga dwesha. The advantages of Gunja taila shiro abhyanga are self practiceable, easyprocedure, economic and effective.
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of DarumakaMode of action of shiro abhyanga The mode of action of shiro abhyanga can be understood by analyzing differentaspects related to it. The following are few of the factors by which the mode of action canbe studied. By studying the nidana panchaka, we can observe that, all the nidana are directedtowards avoidance of vatakaphahara aharadi and usage of vata kapha kara aharadi. Thisvitiation of vata kapha results in the sroto dushti of kapala pradesha which can beconsidered as sroto sanga (improper circulation) leading to the disease manifestation.Hence the chikitsa mentioned in the classics is directed towards counteracting all theseaspects thereby breaking the samprapthi ghatakas. The soft and gentle massage improves blood circulation to the kapala pradesha.The oiliness (snigdhata) present in the taila pacifies dryness thereby preventing theshedding of scales and hair fall. The gunas of ingredients present in the taila takes care ofthe microbicidal and other aspects as mentioned in the drug review. Thus Shiro abhyangacounteracts different aspects of the disease process thereby achieving the samprapthivighatana and thus pacifies the disease. Abhyanga provides comfortness at the site due to temperature created. The heatcauses the blood vessels to dilate, which increases blood circulation and promoteshealing, evacuation and cleansing of the secretory passages. The pressure effect and theheat produced by this procedure enhance the absorption of the medicine through the skin.
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of DarumakaDiscussion on materials and methods Taking all the relevant points into consideration, this comparative clinical studywas carried out on 20 patients of Darunaka. The patients were randomly selected andcategorized under two balanced groups. First group was administered with Gunja tailaShiro abhyanga and second group was given Shiro abhyanga with tila taila. Treatment iscarried out for a period of one month in both groups. The important observationsrecorded in this clinical trial of Darunaka are being discussed as hereunder.Age An observation of present study reveals that maximum numbers of patient’s i.e.50% (10 pt’s) were between the age group of 20 – 29 years. The minimum age of thepatient registered for the study is 13 years and maximum is 48 years. The exact reasonbehind the maximum occurrence of the disease in the age group of 20-29 years is notknown. But some of the survey studies also reveal that, Dandruff can occur at any age.The probable reason may be that, it is the age where a person is forced to indulge in thesaid causative factors. The other reason may be that during this age, individuals are mostconscious about their looks and Dandruff. Also hormonal disturbances, emotional ups &downs, usage of shampoo, hair conditioner, which are harmful to scalp are frequent inthis age group causing Dandruff.Sex It was observed that more number of patients were female i.e. 60% (12 pt’s) and40% (8 pt’s) were male. The custom of having long hairs by the Indian females may thereason for increase in incidence.
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of DarumakaReligion 85% (17 pt’s) patients belonged to Hindu community. This might be due toHindu’s residing here are more in number. Hence, has no research significance.Socio-economic status Socio-economic status wise distribution of patients in this study noted thatDarunaka is more prevalent (55% - 11 pt’s) in lower class than in the upper (10% - 2 pt’s)and middle class (35% - 7 pt’s). The reduced hygienic practices in the lower socioeconomic group may be the significant cause for the increased incidence. People in lowerincome appear to have a greater risk socially and economically due to lack of hygieneand nutrition.Occupation The chief occupations of the patients noted in this study are, labour and studentsconstitute each 30% (6 pt’s), Agriculture 20% (4 pt’s), housewives 15% (3 pt’s) andteachers 5% (1 pt). Occupation wise distribution infers that, Darunaka is prevalent inthose who work in or who in due course of their work get exposed to mist, dust, wind andavoidance of regular oiling the head along with exposure to stress and strain.Nidana sevana Most of the nidana described in the classics were observed in patients withDarunaka. Especially nidana like abhyanga dwesha, mruja dwesha, rajas sevana, atapasevana, ati sheetambu sevana, ratri jagarana and diwaswapna were reported. These canact either as an utpadaka or as a vyanjaka nidana for Darunaka. In this study, it is noted that among 20 patients 85% (17 pt’s) had abhyangadvesa,65% (13 pt’s) with mrujadvesa, 35% (7 pt’s) rajahsevana, 40% (8 pt’s) withatapatisevana, 35% (7 pt’s) with ati sheeta ambu sevana, 45% (9 pt’s) praagvata, 40% (8pt’s) had diva swapna, 60% (12 pt’s) were using guru ahara, and 30% (6 pt’s) were usinghima ahara. This observation supports the textual data stating that, above causes act aspredisposing factors for Darunaka.
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of DarumakaMaterials used for cleaning the head In the present study, it was observed that, the 35% (7 pt’s) of patients used soapsto clean the head and 55% (11 pt’s) of the patients used shampoo and 10% (2 pt’s) usedthe soap nut for head cleaning. By this data it can be inferred that, regular usage ofshampoo or soap or soap nut does not prevent Darunaka.Application of oils to the head Present study reveals that, 50% (10 pt’s) of the patients use coconut oil, 25% (5pt’s) each use castor oil and sesame oil to the head. By this observation, we can draw theconclusion that, application of simple oil alone may not have any curative effect overDarunaka.Habitat Habitat wise distribution of patients in the study noted that Darunaka is moreprevalent in rural population (65% - 13 pt’s) and less prevalent in urban population (35%- 7 pt’s). It may be due to lack of awareness and hygiene among the rural population. Thedisease is prevalent in those who work in or who in due course of their work get exposedto dust, smoke and extreme atmospheric conditions. By these, we can infer that workingenvironment also plays an important role in causing Darunaka.Prakruti It is observed that, most of the patients (40% - 8 pt’s) belonged to kaphapittajaprakruthi, vatapittaja 35% (7 pt’s) and vatakaphaja prakruthi (25% - 5 pt’s). Thecontribution of prakruti in the manifestation of Darunaka is not significantly observed inthe present study.
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of DarumakaIncidence of signs and symptoms The incidence of Darunaka showed that, 100% (20 pt’s) of patients hadRookshata, kandu, and Twaksphutana and 85% (17 pt’s) had Keshachyuti. SinceDarunaka is characterized by the presence of rookshata, kandu and twak sphutana all thepatients had these complaints.Diet Dietary wise distribution in the patients of Darunaka showed that, 55% (11 pt’s)of the patients have mixed diet and 45% (9 pt’s) have only vegetarian diet. Since thestudy sample is small, exact relationship of Darunaka with respect to dietary habits cannot be drawn.Severity of Darunaka In this study, 45% (9 pt’s) of patients had severe type, 50% (10 pt’s) of moderatetype and 05% (1 pt) suffered with mild type of Darunaka. The high incidence of severeand moderate affliction shows its chronicity and recurrent nature of the disease.DISCUSSION ON EFFECT OF THERAPIESEffect on Kandu Severity of Kandu is significantly reduced after treatment in Gunja taila group.The reduction of kandu within the groups was GTSA 73% and TTSA 16%. The effects ofGTSA group was significant at level of p<0.001. It indicates that, Gunja taila Shiro abhyanga is better than tila taila Shiroabhyanga. It is due to the effect of Gunja and Bhrungaraja present in the Gunja taila.
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of DarumakaEffect on rookshata Severity of rookshata of kapala pradesha is significantly reduced after treatmentin GTSA group with 70% of efficacy and TTSA group showed only 25% efficacy. Theeffect of GTSA group was significant at level of p<0.001. This data indicates that Gunjataila abhyanga is more effective in reducing severity of rookshata. Effect on Shedding of scales Severity of shedding of Scales is significantly reduced after treatment GTSAgroup with 76% of efficacy whereas TTSA group showed only 33% of efficacy inreducing the shedding of scales. The effect of GTSA group was significant at the level ofp<0.001. This data indicates that Gunja taila is more effective in reducing severity ofshedding of Scales than tila Taila.Effect on keshachyuti Severity of Falling of hairs is significantly reduced after treatment in GTSA groupwith 64% of efficacy and TTSA group showed a lesser efficacy of 42%. The effect ofGTSA group was significant at level of p<0.001. This data indicates that Gunja tailaabhyanga is more effective in reducing severity of hair fall.Discussion on Overall Effects of the Therapy Consideration of overall effect of therapies after one month of treatment showedthat in GTSA group complete remission was found in 30% (6 pt’s), marked improvementwas found in 30% (6 pt’s), moderate 30% (6 pt’s) and 10% (2 pt’s) mild relief. In patientsof TTSA group only 30% (6 pt’s) moderate relief and 10% (2 pt’s) mild relief from theDarunaka is noticed and 60% (12 pt’s) of the patients found no relief.
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of DarumakaFollow Up Study After the first and second follow up after stopping the treatment, it was observedthat in GTSA group there was no recurrence of Darunaka except only one case. But inTTSA group in first follow up only, the recurrence of the disease is observed in all thepatients. On the third and fourth follow up study, there were no significant changesobserved in both the groups. This implicates that after the two months of stopping thetreatment recurrence of Darunaka was less noticed in GTSA group whereas the TTSAgroup patients showed presence of the disease in a greater manifestation. On the basis of the above results it can be concluded that Gunja taila abhyanganot only provide cure to the patients of Darunaka, but it also prevents its recurrence. Inthe second follow up the recurrence in one patient of GTSA group might have occurreddue to indulgence in Nidana again and not following the advice.COMPARISON OF EFFECTS OF THERAPIES Gunja taila Shiro abhyanga: abhyanga with Gunja taila provided better relief inall symptoms of Darunaka especially in Kandu, rookshata, twak sphutana and keshachyuti. Tila Taila Shiro abhyanga: Abhyanga with tila taila provided moderate relief insymptoms like kandu etc… but 60% of the patients didn’t show any relief. The above discussions infer that in GTSA group the effect of the drug is higherthan TTSA group. Hence from the above results it may be abstracted that abhyanga with Gunja tailaprovided better overall effect to the patients of Darunaka with highly significantstatistical values than abhyanga with tila taila.
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of Darumaka
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of Darumaka CONCLUSION Following conclusions are drawn from the present clinical study.Conceptual : Application of Shiro abhyanga has been prevalent since samhita period. Darunaka of Ayurvedic classics can be correlated to dry variety of pytiriasis capitis of contemporary science. Darunaka is a complex phenomenon and various factors are involved in its pathogenesis. Hence various treatment aspects have been mentioned in the samhitas. Among the different treatment procedures, shiro abhyanga is of importance as it is easy to practice, adoptable, cheaper and widely accepted. Considering mode of action of abhyanga on Shiras, it causes stimulation of circulation by which drug exhibits its action to counteract Darunaka.Clinical : In the present clinical study, 20 patients presenting with the features of Darunaka were studied in two different groups containing ten in each. Gunja taila shiro abhyanga group is named as Group GTSA and Tila taila shiro abhyanga group is named as Group TTSA. The incidence of Darunaka showed that, 100% (20 pt’s) of patients had Rookshata, kandu, and Twaksphutana and 85% (17 pt) had Keshachyuti. Since Darunaka is characterized by the presence of rookshata, kandu and twak sphutana all the patients had these complaints.
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of Darumaka Consideration of overall effect of therapy after one month of treatment showed that in GTSA group complete remission was found in 30% (6 pt’s), marked improvement was found in 30% (6 pt’s), moderate 30% (6 pt’s) and 10% (2 pt’s) mild relief. In patients of TTSA group only 30% (6 pt’s) moderate relief and 10% (2 pt’s) mild relief from the Darunaka is noticed and 60% (12 pt’s) of the patients found no relief. Gunja taila shiro abhyanga has higher significant effect in pacifying the symptoms of Darunaka and marked reduction in clinical symptoms was well appreciated within one month duration. Overall effect of therapy shows supremacy of Gunja taila shiro abhyanga as treatment regimen than Tila taila Shiro abhyanga. As the preparation of Gunja taila had only two ingredients which are easily available and also easy to prepare. Hence Gunja taila can be used in daily practice. There was no topical and systemic adverse drug effects noted at the end of the study. And this preparation is definitely have the potential effect to treat Darunaka.Recommendation for further study: • Present study pattern can be contributed in the form of prospective clinical study with increased sample size and long duration of follow up. • Other drugs mentioned for Darunaka can be selected for the comparative study with Gunja taila.
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of Darumaka
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of Darumaka SUMMARY The present study entitled “A Clinical Study on Gunja Taila Shiro Abhyanga inthe Management of Darunaka” has been dealt under following five sections – 1. Conceptual Contrive 2. Drug Contrive 3. Clinical Contrive 4. Discussion 5. Summary and Conclusion Darunaka is the one of the disease of kapalagata roga, affecting about 50% of thepopulation more commonly seen in females. It can be correlated to dry variety ofpytiriasis capitis of contemporary science. Few researches were carried and possesslacunae in the management of this disease. Hence need a safe economic and reliablesolution to manage this problem efficiently. Thus with the same objective this clinicalstudy has been carried out. The nidana and laxanas of darunaka explained in our classics and the etiology ofdry variety of pytiriasis capitis merely relate to each other. The nidana like sheeta aharasevana, abhyanga dweshi, manastapa etc are considered as prime causative factorresulting in the manifestations of darunaka. Clinical features like Kandu, rookshata, twak sphutana, etc symptoms areanalogous with the symptoms of dry variety of pytiriasis capitis like itching, dryness andshedding of the scales.
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of Darumaka Different treatment modalities are explained in Ayurveda like Nidanaparivarjana(avoiding causative factors), Shiro Abhyanga (head massage) and etc. Among differentprocedures, shiro abhyanga is an easy, economic and adoptable procedure. This research work is carried out on 20 patients, with 10 patients each in twogroups. GTSA group patients were administered shiro abhyanga with Gunja taila and Tilataila shiro abhyanga was administered in TTSA group. Clinical data was graded as pergradation index of assessment criteria. Pre-test and post-test data was collected and takenfor the statistical analysis. The study was conducted with regular follow up associatedwith awareness of hygiene techniques. Discussion is done critically on review of literature, observations made onincidence of age, sex, family history, influence of nidana, etc; and the results of theclinical trails. The symptom wise percentage of improvement or relief, after one month durationof the treatment shows that – In GTSA group, Kandu 73%, rookshata 70%, twak sphutana 76%, kesha chyuti 64%. In TTSA group, Kandu 16%, rookshata 25%, twak sphutana 33%, kesha chyuti 42%. The over all improvement percentage in the patients of group GTSA are,complete remission was found in 30% (6 pt’s), marked improvement was found in 30%(6 pt’s), moderate 30% (6 pt’s) and 10% (2 pt’s) mild relief. In patients of TTSA grouponly 30% (6 pt’s) moderate relief and 10% (2 pt’s) mild relief from the Darunaka isnoticed and 60% (12 pt’s) of the patients found no relief. As per the statistical data, it is clear that, Gunja taila shiro abhyanga is moreeffective in the treatment of Darunaka than Tila taila shiro abhyanga.
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of Darumaka
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of Darumaka REFERENCES S.S.No. Reference 1 A. Sa. Su. 1/8. 2 A. Hr. U. 23/20 3 A. Sa. U. 17/18 4 Y. R. Kshudra roga adhikara. 107 5 Vachaspathyam Shabda kalpa druma 6 Dalhana, Su. Su. Ni. 13/35 7 A. Hr. U. 23/20 8 Shabda kalpa druma 9 A. Hr.ha. 1/56 10 S.S.Sha1/9 11 A.H.Sha 3/8 12 Ch. Chi 15/17 13 Ch. Sha 7/4 14 S.S. Sha 4/4 15 Hindi pratyaksha sharira pp 4 16 Ch. Su. 17/7-10 17 A. Hr. U. 23/1-2 18 A. Hr. U. 23/23 19 A. Sam. U. 17/17 20 Sar sam. Madyama. 1/52 21 Su. Ni. 13/35 22 Y. R. Kshudra roga. 30 23 Ma. Ni. U. 55/30 24 Bh. Pr. Chikitsa. 61 25 Dalhana, Su.Ni. 13/35 26 A. Hr. U. 23/31 27 A. Sam. U. 17/18 28 A. Sam. U. 17/19 29 A. Sam. U. 17/17 30 Ch. Su. 5/83 31 A. Sam. U. 18/94
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of Darumaka 32 Y. R. Kshudra roga. 108 33 Y. R. Kshudra roga. 106 34 Chakradatta. 55/88 35 Y. R. Kshudra roga. 106 36 A. Hr. U. 24/27 37 Bh. Pr. 69/17 38 Y. R. Kshudra roga. 108 39 A. Sam. U. 18/14 40 Su.Chi. 20/29 41 A. Sam. U. 18/14 42 Chakradatta. 55/93 43 Y. R. shiro roga. 81-83 44 Y. R. shiro roga. 84 45 A. Hr. Su. 22/23 46 A. Hr. Su. 22/23 47 Amara kosha 48 Shabda kalpa druma 49 Vachaspathyam 50 Kamasutra. 3/15 51 Anga mardana. pp74 52 Principles & practice of therapeutic massage. pp 4 53 A. Hr. Su. 22/24 54 K. N. Vihara varga. pp 166-167 55 A. Hr. Su. 2/ 9-18 Su. Chi. 24/30 Sh. Sam. U. 1/33 Y. R. 66 – 67 56 Kaiyadeva nighantu 57 A. Hr. Su. 2/8 58 Kashyapa. Chi. 59 A. Sam. Su. 3 60 Dalhana, Su.Chi. 24/3 61 Disease of skin & cosmetics. pp 49 62 Ch. Su. 5/81-83 63 Ch. Su. 5/87
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of Darumaka 64 Practice of dermatology. pp 403 65 http://bestonhealth.com/articles 66 http://rxinsider.com/dandruff.htm 67 http://en.wikipedia.org/wiki/Dandruff 68 http://rxinsider.com/dandruff.htm 69 Practice of dermatology. pp 403 70 http://bestonhealth.com/articles 71 http://en.wikipedia.org/wiki/Dandruff 72 http://bestonhealth.com/articles 73 Practice of dermatology pp 406 74 Practice of dermatology pp 18 75 Tortora et. al. pp140 76 Tortora et. al. pp145 77 T B Dermatology, Venereology & Leprology pp 6-7 78 Practice of dermatology pp 10 79 Tortora et. al. pp 151-155 80 Grays anatomy pp 789-791 81 Database on med plants pp 133 82 Dravya guna vignana pp 722 - 723 83 Database on med plants pp 135 84 Database on med plants pp 417 85 Dravya guna vignana pp 621 86 Database on med plants pp 419 87 Database on med plants pp 112 88 Dravya guna vignana pp 376 89 Database on med plants pp 114 90 Y. R. Kshudra roga 107 91 Rasatarangini 437-438 92 Sha Ma 9th 17, 18
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of Darumaka BIBLIOGRAPHY1. Agnivesha - Charakasamhita with Ayurveda Dipika commentary of Charkapanidatta. Chaukhambha surabharathi prakashana, Varanasi, reprint 2005.2. Agnivesha – Charakasamhita with Vidyothini Hindi Commentary by Pt. Kashinath Sastri and Dr. Gorakha Natha Chaturvedi, Reprint 1998. Chaukamba Bharati Academy Publication, Varanasi, Volume I.3. A.K. Khurana – Ophthalmology, Published by New Age International (P) Ltd. 3rd Edition, Reprint 2005.4. Annonymous – Yogaratnakara with Vaidyaprabha, Hindi Commentary by Dr. Indradevi Tripathi and Dr. Daya Shankar Tripathi, Krishnadas Academy, Varanasi, , 1st Edition, 1998.5. Bhavamisra – Bhavaprakash, Vidyotini Hindi Commentary, Choukambha Sanskrit Sansthan, Varanasi, 7th edition – 2000. Part I – 518, 697. Part II.6. Chakrapanidatta – Cakradatta with Tattvacandrika explanations and annotations of Sri Sivadas Sen and commentaries in Sanskrit by Pdt. Smd. Asubodha Vidyabushan and Pdt. Hityabodha Vidyaratha. Chowkhamba Orientalia, Varanasi. 1st Edition – 1993.7. C.K. Kokate, AP.Purohith, S.B.Gokhale – Pharmacognosy, Published by Nirali prakashan. April 2004.8. Dwivedi.R.N. Shalakya Tantra (NimiTantra).Chaukhambha Sanskrit series, Varanasi 12th th Edition 1997.9. Dingari. Laxmanachary –The Shalakya Tantra. Part II.1st Edition Aug 2000.10. Govind Dasa – Bhaishajyarathnavali vidhyodhini Hindi vyakya vimarsha by Kaviraj Sri Ambikadutta Shastri, Chaukhambha Sanskrit Sansthan, Varanasi, 15th edition – 2002.11. Gyanendra pandey-Dravyaguna vijnana, Published by Krishnadas Academy Varanasi.2nd Edition2002.12. Kirtikar & Basu – Indian Medical Plants, 2nd Edition, Editor Blatter E, Cailus J.F., International Book Distributors,9/3 Rajapur Road, Dehradun.13. Madhavakara – Madava nidana with madhukosha Sanskrit commentary by Sri Vijaya rakshita and Srikantadutta with Vmala Hindi commentary and notes by Dr.
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of Darumaka Bhramananda Tripathi, Published by Chaukhambha surabharathi prakashana, Varanasi, 2nd edition 1998.14. Monier monier Williams: Sanskrit English dictionary, The Clarendon Press, Oxford, 1951.15. P.V.Sharma: Dravya guna vijnana Choukhamba bharathi Academy, Varanasi, 16th Edition 1995.16. Raja Radhakantha deva – Shabdha kalpa dhruma, Chaukamba sanskrit series office, Varanasi, 3rd Edition – 1967.17. R. C. Choudhury – Sahlakya vijnana Chowkhamba Orientalia, Varanasi.20th Edition.18. Sharangadhara – Sharangadhara Samhita with Adamalla’s Dipika and Kashirams gudartha dipika, Chaukhambha Orientalia, Varanasi, 5th edition 2002.19. Shodala – Gadanigraha with vidhyothini Hindi commentary by Indradev Tripati, Choukamba Sanskrit series office Varanasi 5th edition 1993. Vol 3.20. Sri Gopal Krishna -Rasendra sara sangraha of text with English translation by Dr. Ashok D. satpute – notes and appendages, Choukambha Krishnadas Academy, Varanasi, , 1st Edition, 2003.21. Summy oommen,Ved and Krishnan Tropical Indian medicinal plants, Propagation method -2000, FLIGHT22. Sushruta – Sushruta Samhita Ayurveda TattvaSandipika, Hindi Commentary, 11th Edition, 1997. Editor, Kaviraja Ambikadutta Shastri, Chaukamba Sanskrit Bhavana. Part II,23. Sushruta – Sushurtasamhita with Nibandha Sangraha Commentary of Sri Dalhanacharya and Nyayachandrika panjika of Sri Gayadasacharya on Nidanasthana. Chaukhambha Orientalia, Varanasi, 6th edition Reprint-2004.24. Vagbhata – Astanga Hridya with Sarvanga Sundara commentary of Arunadutta and Ayurvedarasayana of Hemadri. Chaukambha Orientalia, Varanasi, 8th edition 1998.25. Vagbhata: Astanga sangraha with Hindi commentary by Kaviraja Atrideva Gupta. Published by Krishnadas Academy, Varanasi. Edition 1993 reprint.vol.II
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of Darumaka26. Vanga sena- Vangasena samhita Text with English translation, Notes, Historical Introduction comments, Index and Appendages by Dr.Nirmala saxena. Choukhamba sanskrith series office varanasi.1st Edition -2004.27. Chatterjee C. C.: Vol. – I “Text book of Human Physiology”, 9th Edition published by Medical Allied Agency, Calcutta (1980).28. Gerard Tortora, Sandra Grabowski: Principle of anatomy and physiology, 9th ed. John Wiley and Sons, Inc., New York (2000).29. George Clinton Andrews A.B. M.D.: Disease of the skin, W.B. Saunders Company, Philadelphia (1932).30. Harrison: Principles of Medicines, 14th edition edited by Anthony S. Fauci et al, McGraw Hill, Health Professions Division.31. Kasture H. S.: Ayurvediya Panchkarma Vigyana, 5th edition, Baidhyanath Ayurveda Bhavan, Nagpur (1997).32. Kopf and Andrade : Year book of dermatology, year book medical publishers, Chicago (1998).33. J S Pasricha & Ramji Gupta – Illustrated text book of Dermatology, jaypee brothers delhi1st edition, 1996.34. David J Gawkrodger – Dermatology an illustrated colour text, 3rd edition, Churchill Livingstone, 200335. A B Athavale – Diseases of the skin and cosmetics, 1994, Medical publishers, pp 4936. P N Behl et. al. , Practice of Dermatology, 10th edition, 2005, published by CBS Publications.
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of Darumaka
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of Darumaka ANNEXURE – 01 DEPARTMENT OF POST GRADUATE STUDIES IN SHALAKYA TANTRA S.D.M. COLLEGE OF AYURVEDA & HOSPITAL, HASSAN – 573 201 RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES KARNATAKA CASE SHEET PROFORMA “A CLINICAL STUDY ON GUNJA TAILA SHIRO ABHAYNGA IN THE MANAGEMENT OF DARUNAKA”Case No : Date :Name : OPD No. :Age : IPD No :Sex : M /F DOA :Religion : H /M /C /O DOD :Occupation : Address :Chief complaints with duration:Associated complaints:History of present illness:NIDANA: Ahara : Sheeta ahara / Amla ahara atisevana / Atiseethambu sevana / Guru ahara / Others. Vihara : Abhyangadvesa/ Mrujadvesa/ Rajo sevana/ Atapa sevana/ Tushara Sevana/ Pragvata sevana / Jagarana / Divaswapna / others Manasika : Shoka / Krodha/ Rodana / others Relieving factors : Natural / Local measures / Medication Aggravating factors : Cold / Hot / Sunlight / Wind / Temperature / other Symptoms Grade 1 Grade 2 Grade 3 Grade 4 Kandu Rookshata Twaksphutana KeshchutiHistory of past illnessFamily history
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of DarumakaPersonal historyAhara : Veg. / Non-veg. / Mixed.Anala : Aahara pachana sakti : Pravara / Madhyama / Avara Jarana sakti : Pravara / Madhyama / AvaraMicturations : Frequency – times / Day.Defecation : Regular / Irregular / Constipated.Nidra : Sound / Disturbed / Excess / Ratrijagarana / Divaswapna.Living environment : Rural / UrbanPrakruti : V / P / K / VP / VK / KP.Treatment historyOccupational history:Nature of work : Sedentary / Travelling / Labour / Agriculture.General examination :Pulse : Blood pressure :Temperature : Respiration Rate :Heart Rate :LOCAL EXAMINATIONAbout kesha • Kesha varna : Swetha / Peeta / Shyava / Others. • Kesha akruti : Straight / Curled. • Kesha swabhava : Mridu / Ruksha. • Kesha shuchi : Soap / Soap nut / Shampoo / Medicated or any others.About kesha bhoomi • Kesha bhoomi : Kandu / Rukshata / Kesha pathana / Shiro daha. • Kesha bhoomi varna : Krishna / Shweta / Pandura. • Affected kesha bhoomi: Frontal / Parietal / Temporal / Occipital / All over. • Taila using for scalp : Coconut / Tila / Eranda / Other taila / Nothing.LABORATORY INVESTIGATIONSBlood - Hb%........., TC……., DC……., ESR………Urine - Sugar…..., Albumin…….Stool - Ova………, Cysts………... (If Necessary)
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of DarumakaTREATMENT PLANShiro abhyanga with Gunja taila / Tila taila.Matra and Kala : 400 matra kala / day morning for 1 month.Treatment schedule : From ToFollow up : Patient will be followed at interval of 15 days for 2 months.Result : Complete / Marked / Moderate / Mild / Unchanged.ASSESSMENT CHART Sl. No. Assessment B A Follow up (in days) criteria T T 15 30 45 60 01. Kandu 02. Kesha chyuti 03. Rookshtha 04. TwaksputanaSignature of Scholar. Signature of Guide / H.O.D.
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of Darumaka
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of DarumakaTable No. 34 – showing patients personal detailsGUNJA TAILA SHIRO ABHYANGA – GROUP ASl. Name Date O.P.D. Age Sex Religion Occupatio Habitat S – E status Diet Prakruti n 1 Venkatesha. 18.08 05 425 23 M Hindu Labourer Urban Lower Mixed Vatapitta 2 chandrashekara 08.09.05 08767 27 M Hindu Agriculture Rural Lower Mixed Kaphapitta 3 krishnegouda 01.10.05 99262 48 M Hindu Agriculture Rural Middle Mixed Kaphapitta 4 Afrun 29.12.05 100358 18 M Muslim Labourer Urban Lower Mixed Vatakapha 5 Jayamma 30.12.05 100358 30 F Hindu Housewife Rural Middle Vegetarian Vatapitta 6 Dharesha 17.01.06 104173 27 M Hindu Teacher Urban Upper Vegetarian Kaphapitta 7 Shobha 16.02.06 107177 36 F Hindu Housewife Rural Middle Mixed Vatapitta 8 Nagaveni A.T 24.02.06 108706 19 F Hindu Student Urban Lower Mixed Vatapitta 9 Nageena 01.03.06 109709 25 F Muslim Agriculture Rural Lower Mixed Vatakapha10 Sharmila 31.03.06 109900 19 F Hindu Labourer Rural Middle Vegetarian Kaphapitta SHIRO ABHYANGA WITH TILA TAILA – GROUP B 1 Rahul 29.08.05 982 22 M Hindu Labourer Rural Middle Vegetarian Kaphapitta 2 pankaja 01.09.05 90968 28 M Hindu Student Urban Middle Mixed Kaphapitta 3 Rani.T 15.10.05 91251 19 F Hindu Labourer Rural Lower Mixed Vatapitta 4 Smitha 21.12.05 106677 17 F Hindu Student Urban Middle Vegetarian Kaphapitta 5 Shwetha 02.01.06 106678 21 F Hindu Student Urban Upper Vegetarian Vatapitta 6 Heermudhin 25.01.06 100805 24 M Muslim Labourer Rural Lower Mixed Vatakapha 7 Geethanjali 20.02.06 101921 21 F Hindu Agriculture Rural Lower Mixed Vatakapha 8 Komalatha 22.02.06 101557 24 F Hindu Housewife Rural Lower Vegetarian Vatakapha 9 P. Sunitha 27.02.06 103965 17 F Hindu Student Rural Lower Vegetarian Vatapitta10 Shruti.p.rao 06.03.06 107128 13 F Hindu Student Rural Lower Vegetarian Kaphapitta
  • A Clilnical Study on Gunja Taila Shiro Abhyanga in the Management of DarumakaTable no. 35 – showing patients response to the treatment GUNJA TAILA SHIRO ABHYANGA – GTSA Group Kandu Rookshata Twak Sphutana Kesha chyuti Res Rema B A F F B A F F B A F F B A F F ults rks T T U U T T U U T T U U T T U U (Relie 1 2 1 2 1 2 1 2 f)1 3 1 1 1 3 1 1 1 2 0 0 0 1 0 0 0 77% Mark ed2 2 0 0 0 2 0 0 0 1 0 0 0 1 0 0 0 100 Comp % lete3 2 0 0 0 2 0 0 0 1 0 0 0 2 1 1 1 85% Mark ed4 3 2 1 2 3 2 1 2 3 2 1 2 3 2 1 2 33% Mild5 2 0 0 0 2 0 0 0 2 0 0 0 1 0 0 0 100 Comp % lete6 3 1 1 1 3 1 1 1 2 1 1 1 2 1 1 1 60% Mode rate7 2 1 1 1 2 1 1 1 1 0 0 0 1 0 0 0 66% Mode rate8 1 0 0 0 2 1 1 1 1 0 0 0 1 0 0 1 80% Mark ed9 3 1 1 1 3 1 1 1 3 1 1 1 2 1 1 1 63% Mode rate1 2 0 0 0 2 0 0 0 1 0 0 0 0 0 0 0 100 Comp0 % lete TILA TAILA SHIRO ABHYANGA – TTSA Group Kandu Rookshata Twak Sphutana Kesha chyuti Res Rema B A F F B A F F B A F F B A F F ults rks T T U U T T U U T T U U T T U U (Relie 1 2 1 2 1 2 1 2 f)1 2 1 1 1 2 1 1 1 1 0 0 0 1 0 0 0 66% Mode rate2 3 3 3 3 3 3 3 3 2 1 2 2 2 1 1 2 20% No3 3 3 3 3 3 3 3 3 3 2 2 2 3 2 2 2 16% No4 2 1 1 1 2 1 1 1 2 0 0 0 2 0 0 0 75% Mode rate5 2 2 2 2 2 2 2 2 1 1 1 1 1 0 0 0 16% No6 3 3 3 3 3 3 3 3 3 3 3 3 2 2 2 2 0% No7 2 2 2 2 2 2 2 2 1 1 1 1 0 0 0 0 0% No8 3 3 3 3 2 2 2 2 2 2 2 2 2 2 2 2 0% No9 2 1 2 2 2 0 1 1 1 1 1 1 0 0 0 0 60% Mode rate1 3 2 2 3 3 1 2 3 2 1 1 2 1 1 1 1 44% Mild0