E-ISSN:2456-3110

Research Article

Garbhini Chardi

Journal of Ayurveda and Integrated Medical Sciences

2022 Volume 7 Number 7 August
Publisherwww.maharshicharaka.in

A clinical study in the management of Garbhini Chardi with Dhatripanaka w.s.r. to Emesis Gravidarum

Patel D.1*, Rachana H.2
DOI: http://dx.doi.org/10.21760/jaims.7.7.3

1* Dharmista Patel, Post Graduate Scholar, Department of Prasooti Tantra and Stree Roga, Sri Sri College of Ayurvedic Science and Research, Bengaluru, Karnataka, India.

2 H.V. Rachana, Associate Professor, Department of Prasooti Tantra and Stree Roga, Sri Sri College of Ayurvedic Science and Research, Bengaluru, Karnataka, India.

Background: Health of pregnant women is of at most importance. A series of physiological and psychological changes happen in different stage of women, some of them may end in discomfort and trouble. Ayurveda classics have mentioned Garbhini Chardi as one among the Vyakta Garbha Lakshanas, which can be correlated with emesis gravidarum. Emesis gravidarum is a worldwide common obstetrical problem seen in the first trimester in about 50% of pregnant women. In this condition nausea and vomiting tend to be the start in the morning and frequently continue throughout the day. Altered hormonal and immunological states are considered responsible for the initiation of the manifestations which is probably aggravated by the neurological factors. For such physiological alteration, if proper care is not given, it may lead to complication like tiredness, weight loss, etc. which may affect mother and growing fetus. Aim: To analyze the efficacy of Dhatripanaka in the management of Garbhini Chardi with special reference to Emesis Gravidarum. Method: A randomized open labelled controlled clinical study of two groups consisting 15 patient each in control and trial group. Results: Dhatripanaka was found to be effective in all subjective and objective parameters. Conclusion: Dhatripanaka and Tab. Doxinate is equally effective in Garbhini Chardi w.s.r. Emesis Gravidarum.

Keywords: Garbhini Chardi, Emesis gravidarum, Dhatripanaka, Pregnancy

Corresponding Author How to Cite this Article To Browse
Dharmista Patel, Post Graduate Scholar, Department of Prasooti Tantra and Stree Roga, Sri Sri College of Ayurvedic Science and Research, Bengaluru, Karnataka, India.
Email: 		Dharmista Patel, H.V. Rachana, A clinical study in the management of Garbhini Chardi with Dhatripanaka w.s.r. to Emesis Gravidarum. J Ayu Int Med Sci. 2022;7(7):20-28.
Available From
https://jaims.in/jaims/article/view/1982

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2022-06-28 2022-06-30 2022-07-07 2022-07-14 2022-07-21
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
Nil Nil Yes 19%

© 2022by Dharmista Patel, H.V. Rachanaand Published by Maharshi Charaka Ayurveda Organization. This is an Open Access article licensed under a Creative Commons Attribution 4.0 International License https://creativecommons.org/licenses/by/4.0/ unported [CC BY 4.0].

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Introduction

Pregnancy is considered as most sensitive part of women’s life. During pregnancy, maternal physiology is under continual adoptions. These, often interlinked, changes affect all the body systems and are affected by the hormonal influences of the placenta and mechanical adaptations required to accommodate the growing fetus.[1] These serious of physiological changes happening in different stages of pregnancy sometime land in discomfort and trouble. Garbhini Chardi or emesis gravidarum is one among such troublesome result of physiological changes taking place in pregnancy which is having major impact on various aspects of the women’s life, including daily life functioning and quality of life.[2] Garbhini Chardi is mentioned as one among the Vyakta Garbha Lakshana along with other Lakshana such as Artava Adarshana, Asyasamsravana, Arochaka, Gurugatrata, Stanamandala Krushnata. These Lakshanas are found in the Garbhini due to the presence of Garbha.[3,4] As Chardi is seen as a Vyakta Garbha Lakshana is not associated with much harm on growing fetus & mother, because of which it is considered as physiological disorder, But when it is seen in excess it becomes pathological condition that is Hyperemesis gravidarum in which early intervention is needed to prevent that symptoms severe dehydration, tiredness, weight loss congenital defects in fetus, premature labour etc which may affect the growing fetus.[5] Acharya Harita has also mentioned about Hrullasa and Chardi as one among the Garbha Vyadhi,[6] hence proper care has to be taken in the initial stage only to assure a safe motherhood as well as a healthy progeny in her womb.

According to Ayurvedic classics, Garbhini Chardi is explained due to various physiological and pathological causes’ i.e., Vatavaigunya, Dauhruda Avastha and Garbhanimitta. While explaining regarding Chikitsa of Garbhini Chardi Acharya have mentioned that the Garbhini should be given things that are easily palatable, Hrudya and the things which she likes.[8] Panaka Kalpana is having good palatability which can be easily prepared and it’s liked by Garbhini. Dhatripanaka which is prepared from Amalaki, Draksha, Khanda Sharkara and honey are easily available in market and liked by Garbhini as it is having Hrudya, Ruchikara properties.

The metabolism and absorption of the medicine starts from the month itself because of the presence of glucose and fructose in the formulation moreover drugs like Madhu, Drakha and Khandasarkara in the formulation are having Chardighna property. Dhatripanaka is having good palatability and can be easily prepared hence this present formulation is taken for the study.

Objectives of the Study

1. To evaluate the efficacy of Dhatripanaka in Garbhini Chardi.

2. To re-evaluate the efficacy of Tab. Doxinate in Garbhini Chardi.

3. To do conceptual study of Garbhini Chardi.

4. To compare the efficacy of Dhatripanaka and Tab. Doxinate in Garbhini Chardi.

Materials and Methods

Since the present study was a controlled study two drugs i.e., a standard and the test drug was selected, they are:

1. Tablet Doxinate

2. Dhatripanaka

Dhataripanaka ingredients are Amalaki, Khanda Sarkara, Draksha, Madhu. Amalaki Churna and Khanda Sharkara Churna preparing was prepared at Department of Rasa Shastra and Bhaishajya Kalpana, Sri Sri College of Ayurvedic Science and Research Hospital, Bengaluru.

Procedure of preparation of Dhatripanaka was explained to the patient. Patient was provided with Dhatri churna, Draksa, Khanda Sarkara and Madhu and was asked to prepare the Dhatripanaka by them.

Sampling method and research design

Source of data: A series of 30 subjects with Garbhini Chardi were randomly selected, from the OPD and IPD of Sri Sri College of Ayurvedic Science and Research Hospital, Bengaluru. The selected 30 patients were divided into 2 equal groups of 15 patients. A detailed Proforma were prepared considering all points pertaining to the study were prepared. The parameters considered for the study was scored on the basis of Standard methods and were analysed statistically.


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Research design: It is an open labelled controlled clinical study with pre and post-test design, where 30 subjects with Garbhini Chardi were selected for the study.

Daignostic Criteria

  • Garbhini with Nausea.
  • Garbhini with vomiting.

Lab Investigations

1. CBC

2. USG

3. Urine routine and microscopic

Inclusion Criteria

1. Subjects having confirmed diagnosis of pregnancy.

2. Subjects presenting the classical symptoms of Garbhini Chardi.

3. Subjects presenting with symptoms of Emesis Gravidarum.

4. Subjects diagnosed as Garbhini Chardi in all trimester pregnancy.

5. Primigravida and multigravida.

Exclusion Criteria

1. Subjects with Hyperemesis gravidarum.

2. Vomiting caused due Intestinal infestation, Urinary tract infection.

3. Vomiting caused due to Peptic ulcer, Appendicitis.

4. Vomiting caused due red degeneration fibroid, Twisted Ovarian tumor.

5. COVID-19 Positive

Table 1: Showing Intervention in both the groups

SN Group Group Medication Dose No. of patients Days
1. Group A Trail group Dhatripanaka 50 ml QID 15 15 Days
2. Group B Control Group Tab. Doxinate 10mg BD 15 15 Days

Assessment Criteria

Subjective Parameters

  • Aversion to smell
  • Agnimandya
  • Alasya
  • Anidra
  • Angamarda
  • Brama
  • Daurbalya
  • Talu shosha
  • Jihwa shosha
  • Shira shula

Objective Criteria

  • PUQE Form

Table 2: Showing Grading of subjective criteria

Aversion to smell Grade 0 Absent
Grade 1 Present
Alasya Grade 0 Absent
Grade 1 Present
Agnimandya Grade 0 Absent
Grade 1 Present
Agnamarda Grade 0 Absent
Grade 1 Present
Brama Grade 0 Absent
Grade 1 Present
Daubalya Grade 0 Absent
Grade 1 Present
Talu Shosha Grade 0 Absent
Grade 1 Present
Jihwa Shosha Grade 0 Absent
Grade 1 Present
Shira Shula Grade 0 Absent
Grade 1 Present
Agnimandya Grade 0 Absent
Grade 1 Present

Table 3: Showing Grading of PUQE form

Parameter Finding Points
PUQE Form Score Not at all 0
Mild 1
Moderate 2
Severe 3

Observations

All the 30 patients who approached the OPD and IPD of Sri Sri College of Ayurvedic Science and Research Hospital, Bengaluru. All the patients were the fresh case and were not initiated on other allopathic and Ayurvedic drugs. Among 30 patients maximum number of subjects i.e., 13 subjects (43%) and 12 subjects (40%) belongs to the age group of 20 -24 years and 25 -29 years respectively


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followed by 4 subjects (13.33%) belongs to age group of 30 - 34 years and 1 subject (6.66%) belongs to 35 - 39years of age group. The observation on the distribution of occupation revealed that among 30 subjects, 24 subjects (80%) were housewife and 6 subjects (6%) were students. Among 30 subjects, 28 subjects (93.3%) belonged to Hindu and 2 subjects (6.7%) belonged to Christian community. Observation on Education revealed that Among 30 subjects, maximum number of 15 subjects (50.0%) had educational status of high school, 11 subjects (36.6%) had graduation & above and 4 subjects (13.3%) had Primary school.

The socioeconomic status in patient of Garbhini Chardi - Among 30 subjects, maximum number of 23 subjects (76.6%) belonged to middle class, 2 subjects (16.6%) belonged to lower class and 1 subject (6.6%) belonged to higher middle class. On considering the habitat, it was found that among 30 subjects, 18 subjects (60.0%) were from Rural and 12 (40.0%) were from urban. The dietary pattern in the patient with Garbhini Chardi found that maximum number of 21 subjects (70.0%) were consuming mixed diet and 9 subjects (30.0%) were vegetarian. The incidence of Prakruti it was observed that maximum number of subject i.e., 16 (53.33%) were having Pitta - Kaphaj Prakruti followed by 8 (26.66%) subjects having Vata-Pittaj Prakruti and 6 (20.00%) subjects having Vata- Kaphaj Prakruti. Among 30 subjects’ maximum number of subjects i.e., 22 (73%) were having Avara Ahara Sakti, 8 (26%) subjects were having Madhyama Ahara Sakti. The observation based on Ahara Sakti it was revealed that among 30 subjects’ maximum number of subjects i.e., 22 (73%) were having Avara Ahara Sakti, 8 (26%) subjects were having Madhyama Ahara Sakti. The incidence of gravida, among 30 subjects, maximum number of patients i.e. 21 (70%) subjects were Primi gravida and 09 (30%) subjects were Multi gravida. The distribution of patients based on Trimester, among 30 subjects, maximum number of patients i.e., 22 (73.33%) subjects were in 1st trimester followed by 06 (20%) subjects in 2nd trimester and 02 (6.66%) subjects were in 3rd trimester.

In the present study for subjective parameter statistical analysis was done using Friedman’s test within the group and Mann Whitney U test between the groups.

Table 4: Showing effect on Aversion to Smell in Group A and Group B.


Aversion to smell Group A (N = 15) Group B (N =15) P value between the groups
Mean SD P value Mean SD P value
0th day 1.73 .458 0.001 (HS) 1.87 .352 0.001  (HS) 0.367 (NS)
15th day 1.40 .507 1.53 .516
30th day 1.27 .458 1.20 .414

Table 5: Showing effect on Agnimandya in Group A and Group B.


Agnimanya Group A (N = 15) Group B (N =15) P value between the groups
Mean SD P value Mean SD P value
0th day 1.87 .352 <0.001 (HS) 1.80 .414 0.096 (NS) 0.004 (S)
15th day 1.27 .414 1.60 .507
30th day 1.13 .352 1.40 .507

Table 6: Showing effect on Brama in Group A and Group B.


Brama Group A (N = 15) Group B (N =15) P value between the groups
Mean SD P value Mean SD P value
0th day 1.40 .507 0.001 (HS) 1.33 .488 0.002 (S) 1.00 (NS)
15th day 1.00 .000 1.00 .000
30th day 1.00 .000 1.00 .000

Table 7: Showing effect on Angamarda in Group A and Group B.


Angamarda Group A (N = 15) Group B (N =15) P value between the groups
Mean SD P value Mean SD P value
0th day 1.47 .516 0.004 (S) 1.13 .352 0.392 (NS) 0.775 (NS)
15th day 1.13 .352 1.17 .258
30th day 1.07 .258 1.07 .258

Table 8: Showing effect on Talu Shosha in Group A and Group B.


Talu Shosha Group A (N = 15) Group B (N =15) P value between the groups
Mean SD P value Mean SD P value
0th day 1.33 .488 0.02 (S) 1.27 .458 0.029 (S) 0.061 (NS)
15th day 1.00 .000 1.20 .414
30th day 1.00 .000 1.00 .000

Table 9: Showing effect on Jivha Shosha in Group A and Group B.

Jivha Shosha Group A (N = 15) Group B (N =15) P value between the groups
Mean SD P value Mean SD P value
0th day 1.47 .516 0.001 (HS) 1.27 .458 0.029 (S) 0.061 (NS)
15th day 1.07 .258 1.20 .414
30th day 1.00 .000 1.00 .000

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Table 10: Showing effect on Shira Shoola in Group A and Group B.

Shira Shoola Group A (N = 15) Group B (N =15) P value between the groups
Mean SD P value Mean SD P value
0th day 1.27 .458 0.019 (S) 1.27 .458 0.019 (S) 1.00 (NS)
15th day 1.07 .258 1.07 .258
30th day 1.00 .000 1.00 .000

Table 11: Showing PUQE in Group A and Group B.

PUQE FORM Group A (N = 15) Group B (N =15) P value between the groups
Mean SD P value Mean SD P value
0th day 2.20 .561 0.679 (NS) 2.33 .488 <0.001 (HS) 1.00(NS)
15th day 1.13 .743 0.87 .834
30th day 0.53 .743 0.87 .743

Table 12: Effect on different parameter after treatment and follow-up in Group A.

Parameter Group A 15th Day (AT) 30th Day (FU)
Mean SD ESD Mean SD ESD
Aversion to smell A 1.40 ± 507 0.2 (S) 1.27 ± 458 0.1(T)
B 1.53 ± 516 1.20 ± 414
Agnimandya A 1.27 ± 414 0.7 (M) 1.13 ± 352 0.6(M)
B 1.60 ± 404 1.40 ± 507
Alasya A 1.20 ± 507 1(L) 1.07 ± 458 0.6(M)
B 1.73 ± 458 1.40 ± 507

Table 13: Effect on PUQE after treatment and follow-up in Group A.

Parameter Group A 15th Day 30th Day
Mean SD ESD Mean SD ESD
PUQE Form A 1.13 ± 743 0.3 (S) .53 ±743 0.4 (S)
B .87 ± 834 .87 ±743

Discussion

Dhatripanaka is an Ayurvedic preparation mentioned in Bhaishajya Ratnvali in Chardiroga Chikitsa. The ingredients of Dhatripanaka are Amalaki, Draksha, Khanda Sharkara and Madhu.Amalaki is having Amla Pradhana Pancha Rasa, Madhura Vipaka and Sheeta Virya which is Hydrya Ruchikara, Rasayana and Vrushya property[8] hence it is easily palatable and Dhatu Pushtikara, Amalaki is Tridosha Shamaka but mainly Pittashamaka which will reduce the excessive Gastric secretion and hence reduces the Quantity of vomiting. Amla Rasa which is the Pradhana rasa in Amalaki is having Lalastrava Kara, Rochana, Deepana , Pachana and Vata Anulomana properties[9] which will reduces the associated complaints of Garbhini Chardi like Aruchi, Agnimandya, Jihva And Talu Shosha.

Draksha is having Madhura Rasa, Madhura Vipaka and Sheeta Virya having Kapha Pittahara , Vrushya and Shramahara Properties,[10] Madhura Rasa act as Brumhara and Tarpana97 and help in reducing the symptoms like tiredness and Giddiness which is the most common symptoms associated with Garbhini Chardi and it also helps in Dhatu Poshana. With the Presence of honey and sugar it becomes easily palatable. All the drugs in the formulation contains Glucose and Fructose due to which there will be reduction in the Carbohydrate starvation thus it will breaks the vicious cycle of vomiting and prevent the further episode of vomiting.

Thus Dhatripanaka with its Agnideepana, Amapachana, Brumhana, Tarpana, Ruchikara and Rasayana Property maintains the Doshas in normacaly and thereby helps in controlling the vomiting and also helps in nourishment of Garbha and Garbhini.

PUQE FORM: PUQE FORM (The Pregnancy Unique Quantification of Emesis) is a scoring system to quantify the severity of nausea and vomiting in pregnancy. Nausea and vomiting in pregnancy is due to Dwaridaja Awastha, Vata Vaigunya and Apanna Satwa. According to modern point of view, it is due to the hormone produced by the Placenta called Human chorionic gonadotropin (HCG).The level of HCG is peak between 12 to 14 week of gestation hence incidence of Emesis gravidarum is more during that period.

Effect of treatment in Group A: In this study, within the group A when we compared the effect of Dhatripanaka on PUQE FORM before and after treatment, relief was found in the symptom with the decrease in mean value but it was noted as statistically insignificant with p value 0.679 and when it was compared after the treatment and follow up, the mean values had decreased which was statistically significant with p value 0.05.

The Kashaya property of Amalaki and Madhu act as Sthambaka and reduces the Chardivega. The Pittashamaka property of the drug reduces the excessive gastric secretions thereby reduces the Quantity of vomiting. Draksha acts as anti-vomiting by reducing gastric pressure as Draksha is rich in fibbers, it is known to increase gastric emptying hence the increase gastric emptying may reduce the gastric pressure and retrograde flow of stomach content to oesophagus.


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The formulation act as oral rehydration due the presence of glucose, fructose and sucrose which breaks the vicious cycle of Emesis gravidarum and maintain the state of nutrition in pregnant women.

Effect of treatment in Group B: In this study, within the group B when we compared the effect of Tablet Doxinate on PUQE FORM before and after treatment, the mean values have decrease and the difference was statistically highly significant with p value 0.001 and when it was compared after the treatment and follow up, the values have increase but difference was found statistically insignificant with p value 0.9.

Doxylamine is an antihistamine that blocks H1 receptors. In general, antihistamines directly inhibit the action of histamine at the H1 receptor and indirectly affect the vestibular system, decreasing stimulation of the vomiting centre.

Muscarinic receptor inhibition may also play a role in antihistamine antiemetic activity.

Pyridoxine (vitamin B6) is a water-soluble vitamin that is an essential coenzyme for the metabolism of amino acids, lipids, and carbohydrates.

Agnimandya: Pregnancy is considered as Kapha Prakopa Avastha due to which there is impaired function of Agni and Vayu. Vitiation of Vata and Kapha Dosha leads to Agnimandya which in turns leads to Chardi, Hridyavyatha and Adhamana.

According to modern science, the pregnancy hormone progesterone relaxes the intestinal muscle and oesophageal sphincter and causes alterations in the gastrointestinal motility so these symptoms such as heartburn, nausea, vomiting and constipation occurs.

Effect of treatment in Group A: In this study, within the group A when we compared the effect of Dhatripanaka in Agnimandya before and after treatment, relief was found in the symptom with the decrease in mean value which was statistically highly significant with p value <0.001 and when it was compared after the treatment and follow up, when it was compared after the treatment and follow up, the values remained the same showing sustained effect of the treatment.

The drug like Amalaki, Draksha, Madhu are having Agnideepana and Amapachana and Ruchikara property thereby showing relief in Agnimandya.


Effect of treatment in Group B: In this study, within the group B when we compared the effect of Tablet Doxinate on Agnimandya before and after treatment, the mean values have decrease but the difference was found statistically non-significant with p value 0.317 and when it was compared after the treatment and follow up, the values have decreased than initial but difference was found statistically insignificant with p value 0.157.

Alasya: During Pregnancy Rasadhatu of Garbhini is used for three functions i.e., for Garbha Poshana, Stanya formation and for her own Poshana. Garbhini Chardi leads to Rasa Kshaya therefore the is a deficiency of nutritional requirement of Garbhini causing Alasya moreover the hormone Progesterone depresses the CNS which can lead to tiredness.

Effect of treatment in Group A: In this study, within the group A when we compared the effect of Dhatripanaka in Alasya before and after treatment, 100% relief was found in the symptom with the decrease in mean value which was found to statistically highly significant with p value 0.00 and when it was compared after the treatment and follow up, the values remains the same showing sustained effect of the treatment.

Effect of treatment in Group B: In this study, within the group B when we compared the effect of Tablet Doxinate on Alasya before and after treatment, the mean values have decrease but the difference was found statistically non-significant with p value 0.102 and when it was compared after the treatment and follow up, the values have decrease than initial but difference which was found to be statistically significant with p value 0.02.

Daurbalya and Brama: Emesis gravidarum causes loss of fluids and electrolytes leading to fatigue and giddiness moreover due to the production of hormone relaxin during pregnancy there will be relaxation of blood vessels leading to increase in blood flow.

Effect of treatment in Group A: In this study, within the group A when we compared the effect of Dhatripanaka in Daurbalya and Bhrama before and after treatment, relief was found in the symptom with the decrease in mean value which was found to statistically significant with p value 0.01 and 0.014 respectively and when it was compared after the treatment and follow up, the values remains the same showing sustained effect of the treatment.


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This could be due to the Madhurarasa which act as Brumhara and Tarpana and help in reducing the symptoms like tiredness and Giddiness. The Drug like Amalaki and Draksha possess Rasayana and Vrushya property which will help in Dhatuposhana.

Effect of treatment in Group B: In this study, within the group B when we compared the effect of Tablet Doxinate in Daurbalya and Brama before and after treatment, the mean values have decrease was found statistically significant with p value 0.02 and when it was compared after the treatment and follow up, the values remains the same showing sustained effect of the treatment.

Talu Shosha and Jivha Shosha

Effect of treatment in Group A: In this study, within the group A when we compared the effect of Dhatripanaka in Talushosha and Jivhashosha before and after treatment, relief was found in the symptom with the decrease in mean value which was found to statistically significant with p value 0.042 and 0.02 respectively.

This could be because of the drug like Draksha, honey and Khandasarkara in the formulation are having chemical components such as D - Glucose and D - Fructose which help in oral rehydration and giving relief in the symptom.

Effect of treatment in Group B: In this study, within the group B when we compared the effect of Tablet Doxinate in Talushosha and Jivhashosha before and after treatment, the mean values have decrease but it was not found statistically significant with p value 0.0257 and 0.257 respectively and when it was compared after the treatment and follow up, relief was found in the symptom with the decrease in mean value which was found to statistically significant with p value 0.032 and 0.032 respectively.

Overall effect of treatment

Group A i.e., Dhatripanaka due to its Sthambaka, Agnideepaka, Amapachaka, Rochaka, Brumahiya, Tarpaniya, Shrama and Trishnanighraniya properties helps in relief of Emesis gravidaram and its associated symptoms like Agnimandya, Alasya, Brama, Daurbalya, Talu and Jivha shosha.

Group B i.e., Tablet Doxinate contains Doxylamine and pyridoxine due to its anti-histaminic action helped in controlling

nausea, vomiting and dizziness. The another drug Pyridoxine helps in metabolism of amino acids, lipids and carbohydrates due to which relief was found in symptoms like Daurbalya and Brama.

The effect size difference for Group A in comparison to Group B in PUQE FORM is 0.3 which falls under small size band which indicates the clinical difference efficacy of the treatment of group B is marginally better than group A. Thus, Null hypothesis is accepted.

Conclusion

The present study was completed with 30 patients randomized into 2 groups comprising 15 subjects each group - Subject in Trail group (Group A) were treated with Dhatripanaka and Subjects in control group (Group B) were treated with Tablet Doxinate. The interventions were administered for a span of 15 days and both Objective and Subjective parameters of Garbhini Chardi w.s.r. Emesis Gravidarum were assessed on 0th day, 15th day and 30th day and observations were noted. Statistical analysis for objective parameters was done using Repeated period ANOVA test and Mann Whitney U test for within the group and between the group respectively. Statistical analysis for Subjective parameter was done using Friedman’s test within the group and Man Whitney U test between the groups.

In this Clinical study Group A (trail group) showed significant Result in subjective parameter and in objective parameter Group A (control group) showed clinical improvement but it was statistically non-significant whereas Group B showed Significant result in objective parameter. Since clinical effect size between the group in objective parameter is small (0.3). Null hypothesis has been accepted i.e., Dhatripanaka and Tab. Doxinate is equally effective in Garbhini Chardi w.s.r. Emesis Gravidarum.

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Journal of Ayurveda and Integrated Medical Sciences 2022;7(7)27