E-ISSN:2456-3110

Case Report

Krishna Tila

Journal of Ayurveda and Integrated Medical Sciences

2024 Volume 9 Number 7 JULY
Publisherwww.maharshicharaka.in

Effect of Sesame Seeds (Krishna Tila) In the Management of Menopausal Arthritis - Case Report

Belsare M B1*, Thatere V2, Jain S S3
DOI:10.21760/jaims.9.7.50

1* Belsare M B, Post Graduate Scholar, Department of Swastvritta and Yog, Government Ayurved College, Nagpur, Maharashtra, India.

2 Vidya Thatere, Guide and Associate Professor, Department of Swastvritta and Yog, Government Ayurved College, Nagpur, Maharashtra, India.

3 Jain S S, Professor and HOD, Department of Swastvritta and Yog, Government Ayurved College, Nagpur, Maharashtra, India.

Introduction: Menopausal arthritis is osteoarthritis (OA) that causes joint pain and inflammation early in menopause. Within five years of natural menopause or a hysterectomy, 64% of females with knee osteoarthritis experienced symptoms. Nonsteroidal anti-inflammatory drugs (NSAIDs), Corticosteroids and Hormone Replacement Therapy (HRT) have higher risk of serious side effects and health risks. So non-pharmacological management and dietary supplements gaining interest among patients with Arthritis. Sesamin, a sesame lignan found in sesame seeds was recently reported to be converted by intestinal microflora to enterolactone, a compound with estrogenic activity.

Aim and Objectives: This study aimed to study the efficacy of Sesame Seed powder with local treatment in the management of Menopausal Arthritis.

Methodology: A female patient of 53year old was came to OPD with complaining of pain, stiffness and swelling in right knee joint, difficulty while walking since 5-6 month. There was a significant joint space reduction in X ray of right knee joint. She was advised Krishna Tila (Seasame Seed) powder internally and locally Snehan (with Tila Taila), Swedan and Agnikarma settings was done.

Results and Discussion: After 1month, significant reduction was observed in all sign and symptoms of the patient. Also Reduction was seen in VAS score and Increase in Range of motion of Rt. Knee joint was seen. Krishna Tila is an excellent source of calcium, magnesium, iron, manganese. It also contains sesamin and sesamolin.

Conclusion: Patient got satisfactory relief in clinical features after 1 month. Sesame seed (Krishna Tila) along with Snehan-Swedan and Agnikarma can give worthy relief in Menopausal Arthritis.

Keywords: Krishna Tila, Sesame indicum, Menopausal Arthritis

Corresponding Author How to Cite this Article To Browse
Belsare M B, Post Graduate Scholar, Department of Swastvritta and Yog, Government Ayurved College, Nagpur, Maharashtra, India.
Email: 		Belsare M B, Thatere V, Jain S S, Effect of Sesame Seeds (Krishna Tila) In the Management of Menopausal Arthritis - Case Report. J Ayu Int Med Sci. 2024;9(7):318-321.
Available From
https://jaims.in/jaims/article/view/3151

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2024-05-16 2024-05-25 2024-06-05 2024-06-15 2024-06-25
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
None Nil Yes 13.31

© 2024by Belsare M B, Thatere V, Jain S Sand 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].

J Ayu Int Med Sci 2024;9(7)318
Belsare MB. et al. Effect of Sesame Seeds (Krishna Tila) In Menopausal Arthritis

Introduction

Menopause is a permanent cessation of menstruation. The median age of menopause is 51.[1] After menopause the ovaries cease to produce significant amount of oestrogen hormone therefore the symptoms and diseases associated with oestrogen deficiency are of increasing importance to women’s health.[2] When oestrogen levels drop during menopause, symptoms such as hot flashes, night sweats, mood swings, fatigue, weight gain, and dryness in the vagina, joint pain, swelling, and stiffness would occur.[3] Menopausal arthritis is osteoarthritis (OA) that causes joint pain and inflammation early in menopause and may persist even after other menopausal symptoms have gone away.[4] According to the Women's Health Initiative, 44% of the participating postmenopausal women reported having osteoarthritis.[5] Oestrogen plays an important role in maintaining the homeostasis of articular tissue, therefore, oestrogen protects against joint degeneration.

Sesame seeds are high in protein, vitamin B1, dietary fibre as well as excellent source of calcium, magnesium, iron, manganese, copper, zinc. It also contains sesamin and sesamolin.[6] Sesamin, a sesame lignan was recently reported to be converted by intestinal microflora to enterolactone, a compound with estrogenic activity.[7] Shushruta had explaind Tila as Balavardhakh, Snigdha, Keshya, Dantya, VataNashak along with other properties.[8] Osteoarthritis can be correlated with Sandhigatavata in Ayurveda. Various treatment options (Hormone Replacement Therapy, NSAIDS) in Menopausal OA are present but they cause multiple side effects such as Strokes, Heart Attack, Breast Cancer.[9] So, there is a great need to find effective Ayurvedic management for Menopausal Arthritis. Through this paper, a novel effort was undertaken to enlighten over the great efficacy Krishna Tila on Menopausal Arthritis.

History of Present Illness

A 53-year-old female patient was symptomless before 5-6 month but gradually she had symptoms such as pain in right knee joint and difficulty while walking, stiffness in both knee joints since 2-3 month, and swelling in right knee joint since 15 days. She had history of taking analgesic. But she got relief till only, she took the medicine.

So she approached Swasthvritta OPD, Government Ayurved Hospital, Nagpur, Maharashtra, India, for Ayurvedic treatment. Examination of the patient including Vitals Examination, Ashtvidh Parikshan (Table 1), and Specific Locomotor System examination was done. And after obtaining written informed consent, the treatment was started on.

Past History

H/O HTN since 5 years, Tab. Amlodipine 5mg/OD
Tab. Zerodol SP whenever necessary.

Personal History

Name: XYZ
Age/Sex: 53 years/F
OPD: 33951
Occupation: House Wife
Marital status: Married
Food habits: Mixed diet, excessive intake of spicy food.
Sleep: disturbed sleep due to pain
Addiction: No Addiction
Weight: 65kg
Height: 5’4’’

Vitals Examination

Blood pressure: 140/80mm Hg
Pulse: 68/min
Respiratory rate: 18/min

Table 1: AshtvidhParikshan

NadiVat-Pittaj
Mala (Bowel)Samyak (Normal)
Mutra (Urine)Samyak (Normal)
Jivha (Tongue)Saam (coated)
Shabd (Speech)Spasht (Clear)
Sparsh (Skin)Samshitoshn (Warm)
Druk (Eyes)Prakrut (Normal)
Aakruti (Built)Sthool (Heavy)

Table 2: Chief Complaints

SNChief complaintsGradeDuration
1.Pain in right knee joint3+5-6 months
2.Difficulty and pain while walking2+5-6 months
3.Stiffness in both knee joints2+2-3 months
4.Mild swelling over right knee joint2+15 days

Examination for locomotor system

Inspections

  • Difficulty and pain in both knee joints while walking for distance and sitting for long duration

J Ayu Int Med Sci 2024;9(7)319
Belsare MB. et al. Effect of Sesame Seeds (Krishna Tila) In Menopausal Arthritis
  • Swelling over right knee joint
  • Knee flexion deformity on right knee
  • Reflexes are intact
  • No varicosities are seen
  • Tenderness present over medial side of right knee joint
  • Crepitus present in both knee joints
  • Affected flexion and extension of right knee joint Range of movement (ROM)

Right knee: Flexion 80°, Extension 0°
Left knee: Flexion 125°, Extension 0°

Investigations: X-ray right knee Anteroposterior and lateral view had showed space reduction in knee joint, osteoporotic changes was seen.
Sr. Calcium - 7.12mg/dl

Diagnosis: Menopausal Arthritis

Table 3: Treatment

SNTreatment GivenDoseDuration
1.Krishna Tila17gm/BD30 Days
2.Snehan (Oleation) with Tila TailaAs required for local Application30 Days
3.Agnikarma at Rt. Knee Joint-3 Settings (on alternate day)

Observations and Results

After completion of therapy, the patient got significant relief in pain while walking, stiffness, and swelling of knee joint.

Table 4: Assessment on the basis of subjective and objective criteria

Type of assessmentA)  Subjective ParametersBefore treatmentAfter treatment
1.Pain in right knee joint (VAS score)3+0
2.Difficulty and pain while walking2+1
3.Stiffness in both knee joints3+0
4.Mild swelling over right knee joint2+0
5.Crepitus present in both knee joint3+1
B)  Objective Parameters
1.Range of movement: (Right leg)80120
2.Serum Calcium7.128.15

Discussion

By taking into consideration all factors, involved in the pathogenesis of this patient, treatment principles for Menopausal Arthritis was applied here.

After treatment of 1 month, patient got significant relief clinically, and a significant improvement was observed in Sr. Calcium level and ROM of Rt Knee joint. Treatment protocol mainly comprised of Krishna Tila which is one of common diet ingredients in Indian family. Krishna Tila seeds are rich in Calcium, Magnesium and also contain sesamin and sesamolin. Sesamin, a sesame lignan was recently reported to be converted by intestinal microflora to enterolactone, a compound with estrogenic activity. Sesame seeds increases High density lipoprotein (HDL), Sex Hormones (Oestrogen), Calcium and Calcitonin. Oestrogen fulfils a relevant role in maintaining articular tissue of joint and play protective role in development of OA. As Krishna Tila possess oestrogen it play vital role in Menopausal Arthritis. Krishna Tila Seeds are Balavardhakh, Snigdha, Keshya, Dantya, Vata Nashak in nature. It pacifies Vatadosha. Snehan (oleation) causes reduction in pain, improvement in muscle strength, and improvement in joint flexibility and provides symptomatic relief in osteoarthritis and range of motion increased Combined effect of overall therapy helped to decrease swelling, stiffness, and pain by breaking pathogenesis of disease; hence, an optimum positive result was obtained.

Conclusion

Results revealed that Menopausal Arthritis can be managed effectively with collaborative approach of Krishna Tila consumption internally and local Snehan with Tila Taila. As present study is a single case report hence result obtained in this study are needed to be accessed by conducting similar work on larger sample size. In other words validation of present findings is expected to create specific guideline for management of Menopausal Arthritis.

References

1. Peacock K, Ketvertis KM. Menopause. [Updated 2022 Aug 11]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK507826/

2. Berek and Novak‟s gynecology by Jonathen S. Berek.Edition 14th, 1st Indian reprint 2007, ISBN-10,81,89836- 11-0, Published by Wolter‟s Kluwer Health India Pvt.Ltd,New Delhi.Pg.no.1323.


J Ayu Int Med Sci 2024;9(7)320
Belsare MB. et al. Effect of Sesame Seeds (Krishna Tila) In Menopausal Arthritis

3. Sindhu M, Kishanrao S. Menopausal Arthritis-A Lesser-Known Problem-A Case Study. Ortho Res Online J. 2021;8(3). CrossRef

4. Pithadia P, Rahman MUR, Hussein IM, Abbas S. Development of Osteoarthritis in Post-menopausal Women and Different Ways to Manage it. J Orth Clin Res. 2023;1(2):69-77

5. Talsania M, Scofield RH. Menopause and Rheumatic Disease. Rheum Dis Clin North Am. 2017;43(2):287-302. PubMed | CrossRef

6. Pathak N, Rai AK, Kumari R, Bhat KV. Value addition in sesame: Aperspective on bioactive components for inhancing utility and profitability. Pharmacogn Rev. 2014 Jul;8(16):147-55. doi:10.4103/09737847.134249. PMID:25125886;PMCID:PMC4127822.

7. Wen-Huey Wu, Yu Ping Kung, Nai-Hung Wang, Nutrient physiology, Metabolism and Nutrient-Nutrient Interaction 2006, American socity for Nutrition.

8. Shushruta, Shushruta Samhita, Sutrasthana, adhyay46, edited by Shashtri A., Chaukhambha Sanskrit Sansthan Varanasi, 2014; vol (1): verse 39, pg 245.

9. org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. Menopause: What are the benefits and risks of long-term hormone therapy? [Updated 2020 Jul 2]. Available from https://www.ncbi.nlm.nih.gov/ books/NBK564986/


J Ayu Int Med Sci 2024;9(7)321