A comparative clinical study to evaluate the efeect of Drakshaadi avleha and Pippalyadi avleha in the management of tamaka swasa w.s.r. to childhood asthmaa

“A comparative clinical study to evaluate the effect of
Drakshadi Avleha and Pippalyadi Avleha in the
management of Tamaka Swasa w.s.r. to Childhood
Asthma’’
Research Scholar
Dr. Bakhtyar Asharafi
B.A.M.S. (SAMC Indore)
M.D. (Ayu.) Scholar
Co-Guides
Dr. Rakesh Sharma
Reader
Dr. Minakshi Chaudhary
Lecturer
Guide
Dr. Vinod Kumar
Sr. Lecturer
P.G. Department of Kaumarbhritya
Rajiv Gandhi Govt. P.G. Ayurvedic College and Hospital,
Paprola, Distt.- Kangra (H.P.)

Constituents
Drug
review
Clinical
study
Introduction
Literary Review
conclusion

“Every Child we encounter is a divine appointment; they are like
wet cement whatever falls on them makes an impression”
Respiration is the first physical sign of life and is
also a sign of consciousness. This unique indicator of
life is affected in the disease Tamaka Swasa.
it is a frightening condition which can seriously
impede one’s ability to breathe, and suddenly rob the
individual of the most important nutrient of all -
oxygen.
Introduction

Some 235 million people currently suffer from
asthma. It is most common chronic disease among
children.
There is 2:1 male/female preponderance but the
sex ratio equalizes by age 30.
Bronchial Asthma is considered as a lifestyle
disorder. It is a chronic disease of the air passages
which is common in all ages. It is considered as one
of the most common chronic disease of children.

 The GINA Workshop report 2005 says, “The
rate of asthma increases as communities
adopt western lifestyles and become urbanized.
 Childhood asthma is an important cause of morbidity,
school absentees and frequent visits to the
pediatricians, clinics or hospital.
 Management of childhood asthma through Ayurveda
is a comprehensive therapeutic modality in itself. It
may help to enhance immunity, decrease the
recurrence and thus can help in treating the disease.

 Keeping in view the present scenario of highest
prevalence of Childhood Asthma its ill outcomes in
multiple areas of child’s functioning and lack of safe
and effective medication, the disease has been
selected for the study under title

Tamaka Swasa is mentioned as one of the
variety
among five types of Swasa. It is having its
own
etiology, pathology & management. It denotes
a
pathological state where a sense of darkness
prevails due to movement of Prana Vayu in
reversed direction.
 Swasa roga may be defined simply as a
disease in
which the respiration and exchange of air is
disturbed.
 Sushruta has clearly defined Swasa roga in
Uttartantra as

When the flow of Prana vayu is reversed due
to obstruction of srotas by kapha, it gets
vitiated & surrounds the neck & head, leading
to excess secretion of dusta kapha which
leads to pinasa & production of ghurghurkam
sound.
This condition causes acute dyspnoea
which suffocates the prana. Patient has a
feeling of entering into darkness, develops
thirst & become unconscious.
Paroxysmal attacks of kasa occur.
Patient is unable to expectorate and feels
irritated. Once the expectoration of dushit
kapha occurs, he gets relief for some time.

Samprapti Ghataka
Dosha Kapha and Vata (Kapha
dominant)
Kapha- ( Avalambaka &
Kledaka)
Vata- (Prana, Udana,
Samana)
Dushya Rasadhatu
Srotas Prana vaha Srotas
Udakavaha Srotas
Annavaha Srotas
Udbhava Sthana Pittasthana (Ch)
Amashaya (A.H.)
Vyadhi Marga Abhyantara Marga
Vyadhisthana Uraha, Phupphusa
(kapha sthana)
Sroto Dusti Lakshana Sang (by Kapha),

Nidana Sevan
Kapha
Prakopa
Kaphaprakopa in
pranavaha srotas
Margavrana of
vata
Pratiloma gati of
vata
Tamaka
Swasa
Amotpatti
Malarupa
Kaphavriddhi
Vata Prakopa
Sankocha in
pranavaha
Strotas
Resulting into
udirana of
kapha
Kapha doing
srotoavrodha

Chikitsa
Kapha dosha
Strong body
Samshodhan
a
Vamana
&Virechana
Samshaman
a
Dhumpana &
Leha
Vata dosha
Weak body
Vatanulomana
Samshaman
a
Sneha, Yusha,
Maans Rasa
Brimhana

Single Drugs
 Haridra
 Vasa
 Pushkarmula
 Shati
 Shirisha
 Kantakari
 Dhatura
 Draksha
 Bharangi
 Vacha
 Bibhitak
 Pippali,
 Madhuyasti
 Kushmanda
 Somlata

Definition
 It is a non-communicable disease of the bronchial
tubes in the lungs (the “airways”), characterized by
recurrent attacks of paroxysms (bouts) of dyspnea,
wheezing (predominantly expiratory) and cough
which vary in severity and frequency from person to
person.

Key facts
Asthma is a chronic disease of the
bronchial air passages, inflammation leading to
obstruction of air, to and from the lungs.
Most asthma related deaths occur in low and
lower middle income countries.
Asthma occurs in all ages but predominantly in
early life.

Clinical subtypes
Extrinsic
Asthma
Intrinsic
Asthma

Clinical Features
 Intermittent dry cough
 Expiratory wheezing
 Shortness of breath
 Chest tightness
 Chest pain
 Fatigue
 Difficulty keeping up with peers in physical activities
 Expiratory wheezing
 Prolonged expiratory phase
 Decreased breath sounds
 Crackles/ rales
 Accessory muscle use
 Nasal flaring
 Absence of wheezing in severe cases
 Pulses paradoxus

Early Childhood Risk Factors
 Parental Asthma
 Allergy
 Atopic dermatitis
 Allergic rhinitis
 Food allergy
 Inhalant allergen sensitization
 Food allergen sensitization
Severe lower respiratory tract infections
Wheezing apart from colds
Male gender
Low birth weight
Tobacco smoke exposure
Exposure to chlorinated swimming pools
Possible use of Acetaminophen

Asthma Triggers
 Common Viral infections
 Aeroallergens
 Air pollutants
 Ozone, Sulfur dioxide ; Particulate matter dust,
tobacco smoke
 Strong / noxious fumes
 Cold, dry air
 Exercise
 Occupational exposures
 Farm and barn exposure
 Formaldehyde, paint fumes
 Crying, laughter, hyperventilation
 Co morbid conditions: Rhinitis, Sinusitis

Identification and Prevention of contributing
factors of Childhood Asthma includes
 A good history recognize possible allergens
 Controlling the outdoor and indoor air pollutions
 Avoidance of tobacco smoke, overcrowding and
using clean fuel for cooking
 Avoidance of causative allergens such as house
dust mite, pets, moulds and certain food items

Management of mild acute exacerbation
 Nebulise β-2 agonists
(eg. Salbutamol <20kg body wt.
- 0.5ml, >20kg body wt.-1ml) or
as inhaler (MDI) with spacer ± masks, one puff of
medicine repeated every minute up to 10-20 puffs
(O.P.Ghai).
 If significant improvement then the child can be
discharged and advise to take oral inhaled β-2
agonists 6-8 hourly and come back to reassess &
long term treatment after1-2 week.

Monitoring of management
 PEF measurement should be done every 15-30
minutes after starting treatment. PEF chart
should be made 4-6 hourly and after inhaled
bronchodilator throughout the hospital stay.
 Continuous pulse oximetry is valuable to
maintain oxygen saturation above 92%.

Long term management of Childhood
Asthma
The step up & down management of chronic
persistent asthma is described as following:
 Step 1 :- Occasional use of inhaled short acting
β2-adrenoceptor agonists
 Step 2 :- Inhalation of regular anti-inflammatory
agents

 Step 3 :- Use of high dose inhaled
corticosteroids or low dose inhaled
corticosteroid plus a long- acting inhaled β2-
adrenoceptor agonist
 Step 4 :- Use of high-dose inhaled
corticosteroids and regular bronchodilators
 Step 5 :- addition of regular oral corticosteroid

Pharmacotherapy
 β – Adrenergic (β2 agonists) eg. Salbutamol,
Terbutaline etc.
 Xanthine derivatives eg. Theophylline
 Anticholinergic agents eg. Ipratropium bromide
 Mast cell stabilizers/chromone derivative eg.
Sodium chromoglycate
 Inhaled corticosteroids eg. Beclomethasone,
Budesonide
 Leukotriene modifying agents eg. Monteleukast

Drakshadi Avleha
Drug Reference : Su. U. 51/40
Formulation composition
Sr. No. Name Botanical name Family Part used
1 Draksha Vitis vinifera Linn. Vitaceae Fruit
2 Krikatshringi Pistacia
integerrima
Anacardiace Gall
3 Haritaki Terminalia chebula
Retz.
Combretaceae Fruit
pericarp
4 Pippali Piper longum Linn. Piperaceae Fruit
5 Duralabha Fagonia cretica
Linn.
Zygophyllaceae Whole Plant
6 Madhu - - -

Sr. No. Drug Rasa Guna Virya
1. Draksha Madhura Snigdha,Guru
, Mridu
Sheeta
2. Haritaki Pancharasa Laghu,
Ruksha
Ushna
3. Duralabha Madhura, Tikta,
Katu, Kasaya,
Laghu, Sara Sheeta
4. Pippli Katu, Madhura Laghu,Snigdh
a, Tikshna
Anushan
sheeta
5. Karkatshringi Kashaya, Tikta Guru Ushna
6. Ghrita Madhura Guru,
Snigdha, Sara
Sheeta
7. Madhu Madhura,
Kshaya
Laghu,
Ruksha,
Sheeta
Rasa-panchaka

Pippalyadi Avleha
Drug Reference :
Formulation composition
Baltantra 13/42
Sr. No. Name Botanical
name
Family Part used
1 Pippali Piper longum
Linn.
Piperaceae Fruit
2 Pippali mula Piper longum
Linn.
Piperaceae Root
3 Sunthi Zingiber
officinale
Roxb.
Zingiberaceae Rhizome
4 Madhu - - -

Sr. No. Drug Rasa Guna Virya
1. Pippali Katu,Madhura Laghu,Snigdh
a, Tikshna
Anushan
Sheet
2. Pippali Mula Katu Laghu,Ruksa Ushana
3. Sunthi Katu Laghu,
Singdha
Ushana
Rasa-panchaka

S.No. Drugs Effect on Body
1 Pippali, Duralabha Anti allergic
2 Pippali, Karkatshringi,
Haritaki, Duralabha
Anti inflammatory
3 Pippali Anti tussive
4 Pippali Bronchodilator
5 Draksha, Pippali, Haritaki,
Karkatshringi,
Expectorant
6 Draksha, Karkatshringi, Mucolytic
7 Pippali Immunomodulator
Probable Mode Of Action Of Drakshadi
Avleha

 Tikta, Katu & Kashaya Rasa all these are having Kapha
alleviating action. Laghu, Ushna & Ruksha guna, are
having opposite properties to that of Kapha; which helps in
alleviation of Kapha. Snigdha guna helps in alleviation of
Vata.
 Vata-Kaphahara property of most of the content alleviates
both Vata and Kapha, which are the main Doshas in the
pathogenesis.
 The main factor in this disease as in many other diseases
is Ama and the Deepana-Pachana properties of Pippali,
Hritaki, Ghrit will digest the Ama.

 Sothahara Karma of Pippali and Hritaki will neutralize the
Srotorodha in Pranavaha srotas due to Sotha created by
Sama Vata.
 Vatanulomana property (Pippali and Haritaki ) maintains
the normal flow of Vata.
 Swasa, Kasa Prabhava ( Draksha, Karkatshringi, Pippali,
Haritaki) act on the symptoms.
 Honey has good Kaphahara action and Yagavahi property.

S. No. Drugs Effect on Body
1 Pippali Anti allergic
2 Pippali, Shunthi Anti inflammatory
3 Pippali, Shunthi Anti tussive
4 Pippali Bronchodilator
5 Pippali, Pipplimula, Sunthi Expectorant
6 Pippali Immunomodulator
Probable Mode Of Action Of
Pippalyadi Avleha

 Vata-Kaphahara property of all the content acts on the
main Doshas which contribute to the Samprapti viz. Vata
and Kapha.
 The main factor in this disease as in many other diseases
is Ama and the Deepana-Pachana properties of Pippali,
Pippalimula and Shunthi helps in digestion of Ama.
 Sothahara Karma of all the drugs will neutralize the
Srotorodha in Pranavaha srotas due to Sotha created by
Sama Vata.

 Vatanulomana property of Pippali, Pippalimul and Sunthi
maintains the normal flow of Vata.
 Swasa, Kasa Prabhava Shunthi, Pippali, acts on the
symptoms.
 Honey has good Kaphahara action and Yagavahi property.
 The Ushna veerya-neutralises the doshik pathogenesis.

To review the Ayurvedic and modern
literature related to Tamaka swasa.
To compare the effect of Drakshadi Avleha
and Pippalyadi Avleha in the management
of Tamaka swasa in children.
To establish a safe and cost effective
medicine for the treatment of Tamaka
swasa.
To study the associated effect of trial drugs,
Aims and
objectives

Material and method
For the present study, patients
were selected from OPD of
Department of Kaumarabhritya
, R. G. G. P. G. Ayu. Hospital &
College , Paprola Distt.
Kangra, Himachal Pradesh.
Total 40 patients were registered and divided
into two groups. Out of 40 patients, 4 patients
were dropped out from the study as they never
turn up on subsequent follow ups.

Inclusion Criteria
Exclusion Criteria
 Parents/ Guardian of the
children willing to participate
in the research trial.
 Age group between 3 to 16
years.
 Only mild to moderate
stable
patients of childhood
asthma
will be included.
 Positive test of reversibility
in
Oxygen saturation& PEFR.
× Patients /parents of the
patients not willing to
participate in the trial.
× Patient having severe
childhood asthma/ Status
asthmaticus condition.
× Patient presenting systemic
illness like
pneumonitis, pleural
effusion, pulmonary T.B.
etc.
× Children with congenital
anomalies.
× Patient on prolonged (>6
week) medication with
corticosteroids,
bronchodialators, mast cell
stabilizers, anticholinergics
etc.

 Intermittent dry
coughing for >7 days
(spasmodic coughing
-nocturnal and early
morning).
 Prolonged expiratory
wheeze, dyspnea,
chest tightness
commonly provoked
by physical exertion.
 4-5 observed
attacks/year
 Response to
bronchodilators
 Oxygen saturation-
in children younger
less than 6 years
 Peak expiratory
flow rate in children
older more than 6
years
 Resspiration rate

A special scoring pattern was adopted to assess
improvement in various subjective/objective
parameter.
Grading
Nil 0
Mild 1
Moderate 2
Severe 3

S.No. SYMPTOMS Scoring
1 COUGHING
No cough 0
Intermittent cough 1
Persistent coughing provoked with exercise 2
Continuous coughing with chest pain 3
2 WHEEZING
None 0
Terminal expiration (Mild wheezing) 1
Entire expiration with stethoscope (Moderate wheezing) 2
During inspiration and expiration without stethoscope (Severe
wheezing)
3
3 DYSPNOEA
No breathlessness with coughing 0
Breathlessness on moderate exercise (playing etc.) 1
Breathlessness provoked with mild exercise (coughing etc.) 2
Continuous breathlessness 3
4 USE OF ACCESSORY MUSCLES(STERNOMASTOID ACTIVITY)
No apparent activity 0
Questionable increased activity (Mild retraction) 1
Apparent increased activity (Moderate retraction) 2
Maximal activity including nasal flaring (Severe retraction) 3

S.No. SYMPTOMS Scoring
5 SLEEP DISTURBANCE
No sleep disturbance 0
Little interruption with coughing 1
Moderate interruption with exacerbation 2
Frequent sleep disturbance 3
6 RESTLESSNESS
No difficulty in speaking 0
Mild difficulty in speaking 1
Moderate difficulty in speaking 2
Severe difficulty in speaking 3
7 NASAL DISCHARGE
No discharge 0
Running nose without visible fluid 1
Running nose with visible fluid 2
Continuous discharge with copious fluid 3
8 COLOUR OF FACE
Pink 0
Pale 1
Ashen grey 2
Cyanotic(bluish) 3

Treatment Schedule
Particulars Group I Group II
Drug Drakshadi
Avleha
Pippalyadi
Avleha
Duration 28 days 28 days
Dose 100mg/kg 100mg/kg

The analysis of obtained data was done
under the following headings
Demographic distribution
Clinical profile
Evaluation of the results on the basis of
improvement in the criteria of
assessment

Age wise distribution
0
2
4
6
8
10
3-6 year 7-11 year 12-16 year
7
6
7
7
8
5
No.ofPatients
Age pofile
Group I
Group-II
Age wise distribution shows that the maximum
numbers of patients were in age group 3-6 years
(35%) and also in 7-11 (35%) years while in 12-
16years have 30%.

Gender wise distribution
0
5
10
15
Male Female
16
4
12
8
No.ofPatients
Gender
Group I
Group-II
Sex wise distribution shows that maximum patients
i.e. 70 % were males and 30% were females.

Socio-economic status wise
distribution
0
2
4
6
8
10
12
Higher Middle Lower
5
12
3
5
14
1
No.ofPatients
Socio-economic status Wise Distribution
Group I
Group II
Maximum no of patients i.e. 65% belonged to
middle class family. While25% belonged to lower
class followed by 10% belonging to upper class.

Source of water wise distribution
0
5
10
15
Municipal Others
16
4
17
3
No.ofPatients
Source of drinking water
Group I
Group II
Maximum numbers of patients i.e. 82.5%
were using municipal water while 17.5%
were using others.

Dietary Pattern wise
distribution
0
5
10
15
Vegetarian mixed
11
9
10 10
No.ofPatients Dietary pattern
Group I Group II
Maximum no. of patients i.e. 52.5 % of patients
were taking both vegetarian and non-vegetarian
while 47.5 % were vegetarians.

Birth History wise distribution
0
2
4
6
8
10
12
FTNVD CS Forceps
15
5
0
12
6
2
No.ofPatients
Birth history Wise Distribution
Group I
Group II
Maximum i.e. 67.5% patients were having
history of normal delivery, while 27.5%
patients had history of caesarian section
and 5% were having forceps one.

Daihika Prakriti wise distribution
0
2
4
6
8
10
Vata-
pittaja
Vata-
kaphaj
Pitta-
kaphaja
3
15
22
17
1
No.ofPatients
Daihik prakriti Wise Distribution
Group I
Group II
80 % patients were of Vata kaphaj prakriti while
12.5 % were of Vata pittaja and 7.52% patients
were of Pittaja kaphaja prakriti.

Aggravating causes wise
distribution
8
7
5
3 3
5
1
0
8
5
8
7 7
10
1
0
0
2
4
6
8
10
12
Group-I
Group-II
In the present study aggravating factors for most of the
patients were Cold air or cold season, smoke,
seasonal changes, dust and pollens followed by cold
drinks, cloudy weather, and mental stress respectively.

Risk Factors wise distribution
The present study reveals that genetic susceptibility (52%) and
(32.5%) were of use of antibiotic in early life major risk factors in
patients of bronchial asthma followed by poor ventilation, passive
smoking, pets, soft toys & carpets and early weaning.
13
7
5
1
4
2
3
10
6 6
2
6
3
6
0
2
4
6
8
10
12
14
Group-I
Group-II

H/O Infectious illness wise
distribution
Data reveals h/o RURTI was present in all the patients
where as h/o pneumonia was present in 45% patients
followed by gastroenteritis, typhoid and jaundice
20
8 9
6
4
0
20
10
7 8
2
0
0
5
10
15
20
25
Group-I
Group-II

Effect of Therapy in Both Groups
Inter Group Comparison
Effect of Therapy on Coughing
No. of Patients
% D
SD
(±) S.E. ‘t’ ‘p’ ResultGroup I Group II
18 18 10.34 2.733 0.86 0.32 >0.05 N.S.
Group N
Mean score %
Relief SD# SE# ‘t’ ‘p'BT AT
I 18 2.444 1.111 54.54 0.485 0.114 11.662 <0.001
II 18 2.389 1.333 44.20 0.639 0.151 7.007 <0.001

Effect of Therapy on Wheezing
No. of Patients
% D
SD
18 18 1.45 1.48 0.492 0.11 >0.05 N.S.
Group N
Mean score %
I 18 2.000 1.000 50.00 0.343 0.080 12.369 <0.001
II 18 1.944 1.000 48.55 0.416 0.089 9.628 <0.001

Effect of Therapy on Dyspnoea
No. of Patients
% D
SD
18 18 7.04 0.494 0.164 0.676 >0.05 N.S.
Group N
Mean score %
I 18 1.889 1.278 32.34 0.502 0.118 5.169 <0.001
II 18 1.833 1.111 39.38 0.461 0.109 6.648 <0.001

Effect of Therapy on Use of Accessory
Muscles
No. of Patients
% D
SD
11 13 13.77 0.432 0.177 0.9830 >0.05 N.S.
Group N
Mean score %
I 11 1.182 1.545 53.80 0.505 0.152 4.183 <0.01
II 13 1.154 0.692 40.03 0.513 0.144 3.207 <0.01

Effect of Therapy on Sleep Disturbance
No. of Patients
% D
SD
13 15 17.11 0.523 0.197 1.062 >0.05 N.S.
Group N
Mean score %
I 13 1.462 0.385 73.66 0.494 0.137 7.867 <0.001
II 15 1.533 0.667 56.55 0.640 0.165 5.245 <0.001

Effect of Therapy on Restlessness
No. of Patients
% D
SD
15 13 9.85 0.359 0.135 0.722 >0.05 N.S.
Group N
Mean score %
I 15 1.067 0.200 81.25 0.352 0.090 9.539 <0.001
II 13 1.077 0.308 71.40 0.439 0.122 6.325 <0.001

Effect of Therapy on Nasal Discharge
No. of Patients
% D
SD
14 11 7.02 0.286 0.115 2.2 >0.05 N.S.
Group N
Mean score %
I 14 1.786 0.714 59.96 0.267 0.071 15.000 <0.001
II 11 1.545 0.727 52.94 0.405 0.122 6.708 <0.001

Effect of Therapy on Face Color
No. of Patients
% D
SD
11 13 13.77 0.432 0.177 0.9830 >0.05 N.S.
Group N
Mean score %
change SD# SE# ‘t’ ‘p'BT AT
I 11 1.182 1.545 53.80 0.505 0.152 4.183 <0.01
II 13 1.154 0.692 40.03 0.513 0.144 3.207 <0.01

Effect of Therapy on Respiration Rate
No. of Patients
% D
SD
18 18 2.74 0.504 0.168 0 >0.05 N.S.
Group N
Mean score %
I 18 1.833 1.056 42.44 0.428 0.101 7.714 <0.001
II 18 1.722 0.944 45.18 0.458 0.129 6.018 <0.001

Effect of Therapy on PEFR
No. of Patientse
% D
SD
13 13 2.16 0.376 0.146 1.05 >0.05 N.S.
Group N
Mean score %
Relief SD# SE# ‘t’ ‘p‘lBT AT
I 13 1.692 0.846 50.00 0.376 0.104 8.124 <0.001
II 13 1.846 1.154 37.48 0.480 0.133 5.196 <0.001

Effect of Therapy on Oxygen Saturation
No. of Patients
% D
SD
18 18 11.1 0.511 0.170 0.652 >0.05 N.S.
Group N
Mean score %
I 18 1.000 0.444 44.40 0.515 0.121 3.688 <0.01
II 18 1.000 0.667 33.30 0.485 0.114 2.915 <0.05

Effect of Therapy on Lab Investigations
Parameters
Group- I Group- II
Mean % D Mean % D
BT AT BT AT
Hb% 11.57 12.30 6.23 11.81 12.72 7.66
TLC 8661.11 8722.2 0.7 8083.33 7416.67 8.2
DLC
N 41.58 49.08 18.03 58.53 57.53 1.70
L 47.50 40.75 14.21 30.53 31.92 4.52
M 3.25 4.58 40.92 3.53 4.76 34.84
E 7.23 5.30 26.55 7.23 5.15 28.63
ESR 10.91 10.66 2.29 11.25 7.7 31.11
AEC 440.889 315.444 28.45 384.556 340.00 11.58
Inter Group Comparison AEC
No. of Patients
% D
SD
18 18 16.87 36.05 12.015 6.73 >0.05 N.S.

Results
Group I Group II
Total Percent
%
No. of
pts.
% No. of
Pts.
%
Complete
Remission
0 0 0 0 00 00
Markedly
Improved
0 0 2 11.11 02 5.5
Moderately
Improved
12 66.66 5 27.77 17 47.22
Mildly Improved 5 27.77 10 55.55 15 41.66
No Improvement 1 5.5 1 5.5 02 5.5
Overall Effect of Therapy

0
5.50%
47.22%
41.66%
5.50%
Complete Remission Markedly Improved Moderately Improved
Mildely Improved No Imrovement

Continuous and drastic change in the lifestyle in
the modern era is the root cause for the life
style disorders like Bronchial asthma.
Due to associated long term compromise in the
quality of life the Increasing prevalence of
Childhood asthma has become a global issue of
concern.
Child-hood asthma is an important cause of
morbidity, school absentees and frequent visits
to the pediatricians, clinics or hospitals.
The etiological factors mentioned in the GINA
guidelines are also similar to the Ayurvedic
Nidana concepts. The host factors mentioned is
nothing but the Dosha-dushya sammurcchana
in Ayurvedic concepts and the environmental

In both Ayurveda and modern management,
primary prevention (Nidanprivarjanam) strategy
has been given priority.
Trial drugs are effective in relieving signs and
symptoms of Tamaka Swasa.
There is no such difference observed in the
intergroup comparison of both trail drugs.
No adverse effects of the trial drugs were
observed during the study period.
Sample size in the study was small so further
extensive study is needed to authenticate the
result of the present study.

At the time of accomplishment, I express my heartfelt
thanks to Prof. Dr. Y.K. Sharma Principal of this institute for
providing all the needful facility to complete this work.
I want to express my sincere and deepest sense of
gratitude and heartfelt regard to my worthy teacher and HOD
Prof. Dr. T. Kishan My Guide Dr. Vinod Kumar my Co-guide Dr.
Rakesh Sharma and Dr. Minakshi Chaudhary for their constant
encouragement, vision, motivation and blessings.
I am much obliged to children and their parents who
voluntarily opted for their children in this clinical study
I am thankful to all my colleagues, seniors and juniors
for their valuable support and love.

A comparative clinical study to evaluate the efeect of Drakshaadi avleha and Pippalyadi avleha in the management of tamaka swasa w.s.r. to childhood asthmaa

A comparative clinical study to evaluate the efeect of Drakshaadi avleha and Pippalyadi avleha in the management of tamaka swasa w.s.r. to childhood asthmaa

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