A 26-year-old male patient presented with a gradual weight gain of 10 kg, excessive sweating, and blurred vision over six months. Diagnosed with obesity and myopia, the patient underwent Ayurvedic treatments including sadyovamana and virechana, leading to significant improvements in weight and visual symptoms. Follow-up indicated a reduction in weight from 82 kg to 73 kg and improvements in overall health metrics.

1. CASE PRESENTATION
Guided by:
Dr. Ramya R V
Assistant professor
Department of Panchakarma

2. PRELIMINARY DATA
Source of history - patient
• Name: XYZ
• Age: 26 years
• Gender: Male
• Address: Bangalore
• Occupation: Accountant
• Socio economic status: Middle class
• Religion: Hindu
• Marital status: unmarried
• OPD No – 23030901
• IPD No –IP2301467
• DOA: 17/07/23
• DOD:4/09/23

3. PRADHANA VEDANA
• Pt c/o gradual increase in weight around 10
kgs since 6 months
• Also c/o Heaviness in the body, excessive
sweating and feeling of laziness since 2
months

4. ANUBANDHA VEDANA
• Patient c/o Burning sensation and mild
blurred vision on exposure to system for more
than 2 hours since 6 months

5. VEDANA VRITTANTA
A male patient aged 26 years was apparently
normal six months ago, he gradually started
gaining weight around 10 kgs from past 6 months
and He noticed heaviness in the body, excessive
sweating and feeling of laziness since 2 months
He also noticed burning sensation and mild
blurring of vision on exposure to system for more
than 2 hours since 6 months for these complaints
he got admitted in our hospital for further
management.

6. POORVA VYADHI VRITTANTA
K/c/o Myopia since 10 years (Rt eye; -6 D and Lt
eye; -7 D)

7. POORVA VYADHI CHIKITSA VRITTANTA
Corrected with concave lens (spectacles)

8. KOUTUMBIKA VRITTANTA
• Father is a k/c/o Hypothyroidism
• Paternal uncle is a k/c/o obesity

9. VAYAKTHIKA VRITTANTA
• Ahara: Mixed (non veg 2-3/week)
• Nidra: deep un disturbed sleep (9-10 hrs)
• Mala pravrutti: Once daily ( no hard stools)
• Mutra pravrutti: 3-4 times in day / 1-2 times at
night
• Vyasana: No habits

10. MANASIKA VRITTANTA
No h/o stress, depression or anger issue
UDYOGA PARISHAD VRITTANTA
He is working as an accountant for past 3 years

11. SAMANYA PAREEKSHA
• Pulse rate: 81bpm
• Respiratory rate: 19cpm
• Blood pressure: 120/80mmHg
• Temperature: Afebrile
• Height: 160cm
• Weight: 82kg
• BMI: 32kg/m2
• cyanosis: absent
• Clubbing: Absent
• Pallor: Absent
• Icterus: Absent
• Lymphadenopathy: Absent
• Edema: Absent

12. ASTHA STHANA PARIKSHA
• Nadi: not elicited
• Mala: Once daily ( no hard stools)
• Mutra: 3-4 times in day / 1-2 times at night
• Jihwa: Aliptata
• Shabda: Prakruta
• Sparsha: Anushnasheeta
• Drik: Vikruta( myopia)
• Akruthi: Sthoulya

13. DASHA VIDHA PARIKSHA
• Prakriti: Vatakapha
• Vikruti: samana vata, kapha
• Saara: mamsa, meda
• Samhanana: Madhyama
• Pramana: Ht:160 cm ; Wt: 82kg BMI:32 kg/m2 (sthoola)
• Satmya: Sarvarasa satmya
• Satva: Madhyama
• Ahara shakti: abhyavarana shakthi-pravara
jarana shakthi- avara
• Vyayama shakti: Avara
• Vaya: Madhyama

14. SAMSTHANIKA PARIKSHA
• CNS- conscious, well oriented to time, place and person
• CVS-S1S2 heard, no added sounds
• GIT- Inspection- No added sounds
Palpation- Soft, non tender
Auscultation- Normal bowel sounds heard
• RS- Inspection- No chest deformity
Palpation- Normal inspiration and expiration
Percussion- Normal resonance heard
Auscultation- NVBS heard

15. STHANIKA PAREEKSHA
• Hight – 160cm
• Weight – 82 kgs
• BMI-32kg/m2
• CC- 96cm
• MAC-
34cm
• MTC-
52cm
• WC-
98cm
• HC-
93cm

16. INVESTIGATIONS

17. NIDANA PANCHAKA
• NIDANA :-
Ahara: excessive intake of junk food, dairy products, bekery
items , fried items and non veg 2-3/week
Vihara: not doing any exercise (avyayama)
• POORVAROOPA:- sleeping for long duration
• ROOPA:- weight gain , heaviness in the body, excessive
sweating , feeling of laziness

18. • SAMPRAPTI:
due to nidana sevana(meda and kaphakara ahara)
Amarasa( jataragni mandya )
Medho dathu vriddi
obesity
srotorodha

19. medho datu nourishment and improper nourishment of
uttarottara dhathus
vimargagamana ( aggravation of vata )
Koshta sacharana (retaining of vata in abdomen)
Teekshnata of agni
Over appetite and thirsty

20. SAMPRAPTI GHATAKA
• Dosha: kapha pradana tridosha
• Dushya: rasa,meda ,and mamsa
• Agni: Jataragni, medadhatvagni mandya
• Ama ; agni mandyajanya ama
• Srotas: medovaha, mamsavaha, rasavaha
• Sroto dushti: Sanga, vimargagamana
• Udhbava sthana: Amashaya
• Sanchara sthana: Rasayani
• Vyakta sthana : whole body
• Adisthana: sarva shareera( specially sthana, udara and sphik)
• Rogamarga: Bahya
• Sadhya asadhya: Krucchra sadya
• Swabhava: Chirakari

21. SAPEKSHA NIDANA
DISEASE INCLUSIVE CRITERIA EXCLUSIVE CRITERIA
Hypothyroidism Weight gain
Puffy face
Constipation, hair loss,
normal thyroid level
DM-Type2 Weight gain, excessive
sweating, blurred vision
Burning feet, increased
frequency of micturition,
normal blood sugar levels
Hypertension Weight gain, blurred vision Severe headache, normal
blood pressure
Nephrotic syndrome Weight gain Edema is absent,
proteinuria is absent

22. DIFFERENTIAL DIAGNOSIS
DISEASE INCLUDING CRITERIA EXCLUDING CRITERIA
Cushing syndrome Weight gain, blur vision High blood pressure,purple
striae,
Obesity (sthoulya) Weight gain , heaviness of
body, excessive sweating
-

23. VYADHI VINISCHAYA
• Sthoulya- grade 1 Obesity

24. CHIKITSA GIVEN
• गुरु चातर्पणं चेष्टं स्थूलानां कर्शनं प्रति| कृशानां
बृंहणार्थं च लघु सन्तर्पणं च यत्||
( ch.su.21/20-21 )
• शस्तमुल्लेखनं तत्र विरेकोरक्तमोक्षणम्|
• व्यायामश्चोपवासश्च धूमाश्च स्वेदनानि च||८||
• सक्षौद्रश्चाभयाप्राशः प्रायो रूक्षान्नसेवनम्|
• चूर्णप्रदेहा ये चोक्ताः कण्डूकोठविनाशनाः||९||
( ch. Su 23/ 8-9)

25. • Netra seka with triphala Kashaya followed by
tarpana with jeevantyadi gritha 2 days
• Sadyovamana
• Classical virechana
• Chakshushya basti( yoga basti)

26. DATE TREATMENT MEDICINE
13/07/23--14/7/23 Netra seka Triphala kashaya
13/07/23 – 14/07/23 Tarpana Jivantyadi ghrita
17/07/23- 18/07/23 Deepana pachana Agnitundi vati 2-2-2 BF
19/07/23 Snehapana Varunadi Ghrita 150ml
20/07/23 Sarvanga Abhyanga,
Swedana,Vamana
Ksheerabala taila
21/07/23-23/07/23 Samsarjana Krama

27. DATE TREATMENT MEDICINE
24/07/23 Normal Diet
25/07/23-27/07/23 Snehapana Varunadi Ghrita (40ml, 70 ml,
100ml)
28/07/23-29/07/23 Sarvanga Abhyanga,
Bashpa Swedana,
mahanarayana Taila
30/07/23 Sarvanga Abhyanga,
Bashpa Swedana
mahanarayana Taila,
Trivrit Lehya -50g
Triphala Kashaya -200ml

28. DATE TREATMENT MEDICINE
31/07/23-
02/08/23
Samsarjana Krama
3/8/2023
08/08/23
Oral Medication Sitopaladi churna 1tsp with honey QID
Lakshmi vilasa Rasa 1 BD
9/8/2023
21/08/23
Oral Medication Saptamrutha loha 0-0-1 a/f with milk
Tab. Garcini 1-0-1 b/f
22/08/23-
29/08/23
Chakshushya Basti
Chakshushya Basti - 450 ml
Honey 100ml, Saindavalavana 15g
Triphala Ghrita 100ml
Shatapushpa Churna 30g
Eranda Mooladi Kashaya 200ml
4/9/2023 Oral Medication Saptamrutha loha 0-0-1 a/f with milk
Tab. Garcini 1-0-1 b/f

29. S.No Samaya Pana Dravya Vega Vamita Dravya
Pramana
Other Symptoms
1 6:50 AM ksheera 1 madhyama
2 6:53 AM ksheera 1 madhyama
3 7:00 AM ksheera 2 madhyama
4 7:05 AM ksheera 1 bahu
5 7:13 AM ksheera 1 bahu Tiredness
6 7:18 AM madanaphala pippali
7 7:40 AM yastimadhu phanta 1 madhyama
8 7:46 AM yastimadhu phanta 1 madhyama
9 7:49 AM yastimadhu phanta 1 bahu Tiredness
10 7:53 AM yastimadhu phanta 2 bahu,madyama Tiredness ,burning sensation in throat
11 7:58 AM yastimadhu phanta 1 madyama Tiredness ,burning sensation in throat
12 8:05 AM yastimadhu phanta 2 madyama Tiredness ,burning sensation in throat
13 8:13 AM yastimadhu phanta 1 bahu Tiredness ,burning sensation in throat
14 8:20 AM lavanodaka 1 madyama Tiredness ,burning sensation in throat
15 8:30 AM lavanodaka 1 madyama Tiredness ,burning sensation in throat
16 8:34 AM lavanodaka 3 alpa Tiredness ,burning sensation in
throat
17 8:41 AM lavanodaka 1 alpa Tiredness ,burning sensation in
throat
18 8:49 AM lavanodaka 1
Total
Vegas -5
Upavega
s-17
madyama Tiredness ,burning sensation in
throat
VAMANA CHART

30. VIRECHANA CHART
vegas Vega Samaya Matra of Mala Characters of Mala
1 9:40 AM madyama drava
2 9:49 AM madyama drava
3 9:55 AM madyama drava
4 10:15 AM madyama drava
5 10:33 AM madyama drava
6 11:02 AM madyama drava
7 11:30 AM madyama drava
8 11:40 AM madyama ati drava
9 12:30 PM madyama ati drava
10 1:10 PM alpa ati drava
11 1:45 PM alpa ati drava
12 2:55 PM alpa ati drava
13 4:10 PM alpa ati drava

31. BASTI CHART
Date Basti Data Kala Pratyagamana Kala No. of Vegas
22/8/23 8:30am 8:38am 3
23/8/23 8:30am 8:37am 1
24/8/23 8:30am 8:41am 2
25/8/23 8:30am 8:42am 2
26/8/23 8:30am 8:43am 1
278/23 8:30am 8:40am 1
28/8/23 8:30am 8:39am 2
29/8/23 8:30am 8:38am 1

32. MEDICATIONS INGREDIENTS & IMPORTANCE REFERENCE
Tab. Saptamruta
loha
yastimadhu, haritaki, vibhitaki, amalaki,
loha basma, ghruta, madhu
Indicated in timira, chardi,jwara ,shotha
,anaha
bhaishajya ratnavali shoola
rogadhikara 83-84
Lakshmivilasa rasa abhraka bhasma,shudda gandaka,
shudda parada, karpoora, jatiphala,
vriddhadaru,datura, bhanga,vidari,
shatavari,nagabala,atibala,gokshura,nic
hula,nagavalli
Indicated in hrid roga , prameha, kasa
bhaishajya ratnavali jwara
chikitsa 1223-1235

33. MEDICATIONS INGREDIENTS & IMPORTANCE REFERENCE
agnitundi vati shudda parada,shudda
gandaka,visha,ajamoda,triphala,yava
kshara, vahni,saindava and samudra
lavana, vidanga,tankana basma
Indicated in agnimandya, ama jwara
bhaishajya ratnavali
agnimandya rogadhikara 93-
94
Chakshusha Basti madhu,saindava lavana, Triphala
Ghrita, Shatapushpa Churna,Eranda
Mooladi Kshaya
Help to reduce the refractive error
AH.KA.4/28
Varunadhi Ghrita Varuna,Sairyeka,Shatavari,Chitraka,B
ilwa,Brahati,Karanja,Jaya,Pooti
Karanja,Darbha,Vishanika
Indicated for mandagni, medas,
adyavata, shirashoola
Ashtanga Hridaya Sutrastana
15/21-22

34. MEDICATIONS INGREDIENTS & IMPORTANCE REFERENCE
Tab. Garcini Vrikshamla,shudda guggulu,triphala
Uses to reduce the appetite
G. C PHARMA
jeevantyadi gritha jeevanti,ksheera,gritha,prapundarika,pippali,
lodhra,saindava lavana,
shatahva,madhuka,draksha,sita,daruharidra,triphala,
Bwnefits – chakshusya
ashtanga
Hridaya
uttararastana
1/1-3
sitopaladi churna sitopala,vamshalochana,pippali,ela,twak
Benefits- anti-inflammatory, appetizer, jwarahara,
kasahara,shwasahara,
charaka chikitsa
sthana 8/134-
137

35. ADVICE ON DISCHARGE
• Tab. Garcini 1-0-1 b/f for 1 month
• Saptamrutha loha 0-0-1 a/f with milk for 1
month
• Advised to avoid junk food and non veg
• Revisit advised after 1 month

36. OP FOLLOW UP
• REVISIT ON 11/10/23
• c/o increased weight around 2 kgs
Treatment
T. Decrine plus 1-0-1 b/f
T. Garcini 1-0-1 b/f
Varunadi kashaya 15ml-0-15ml with 15ml of
warm water in empty stomach for 15 days

37. OBSERVATION BEFORE TREATMENT AFTER TREATMENT
Weight 82 kgs 73 kgs
BMI 32 kg/m2
28.5 kg/m2
CC 96 cm 95 cm
MAC 34 cm 33 cm
MTC 52 cm 50 cm
WC 98 cm 92 cm
HC 93 cm 91 cm
SYMPTOMS Excessive sweating, laziness
and feeling of heaviness in
body
reduced sweating and
laziness and no feeling of
heaviness of body

38. RESULT
BEFORE
TREATMENT
AFTER
VAMANA
AFTER
VIRECHANA
AFTER
FOLLOW UP
weight 82kgs 79 kgs 73 kgs 75 kgs
BMI 32 kg/m2
30.9kg/m2
28.5kg/m2
29.3Kg/m2

39. CONCLUSION
A male pt aged 26 years diagnosed with sthoulya (BMI-32kg/m2
)
is compared to kaphamedo avrita as per ayurvedic classics and was
treated with sadyovamana, virechana other shamana aushadi
effectively.
Patient was also having myopia since 10 years( Rt eye; -6 D and Lt
eye; -7 D) as a preventive measure tarpana was given before
vamana
chakhusya basti was given as virechanottara karma to prevent
further damage to the eyes in this case
Significant improvement was seen in the patients with respect to
obesity and eyesight ie blurring and burning sensation .

40. ACKNOWLEDGEMENT
• I would like to express my special thanks of
gratitude to Dr.Ramya.R.V Assistant professor,
department of panchakarma and Dr.Harish
gopal Assistant professor department of
Shalakya tantra , of Sushrutha Ayurvedic
Medical College and Hospital for valuable
guidance during this case presentation

41. Before treatment After treatment