E-ISSN:2456-3110

Research Article

Sannipataj Jwar

Journal of Ayurveda and Integrated Medical Sciences

2024 Volume 9 Number 7 JULY
Publisherwww.maharshicharaka.in

An Ayurvedic perspective of Sannipataj Jwar - Sepsis along with WBC morphology

Dhole VV1*, Joshi VN2, Mandal S3
DOI:10.21760/jaims.9.7.9

1* Vaishnav Vinod Dhole, Post Graduate Scholar, Department of Rog Nidan, Dr Dy Patil College of Ayurved and Research Centre Pimpri, Pune, Maharashtra, India.

2 Vinayak N Joshi, Professor and HOD, Department of Rog Nidan, Dr DY Patil College of Ayurved and Research Centre Pimpri, Pune, Maharashtra, India.

3 Snehal Mandal, Consulting Pathologist, Department of Rog Nidan, Dr DY Patil College of Ayurved and Research Centre Pimpri, Pune, Maharashtra, India.

Background: Microscopic evidence based WBC Morphology would help Ayurveda physicians to give appropriate Ayurvedic treatment to Sepsis i.e. Sannipataj Jwar patients. Sepsis affected 49 million people in 2017 with 11 million deaths i.e. 1 in 5 deaths worldwide.

Objective: To observe the correlation of Sepsis with Ayurvedic Sannipataj Jwar along with WBC Morphology.

Material and Methods: It includes Literature Review, Initial assessment & enrollment of patients, Microscopic observational changes to correlate Sepsis with Sannipataj Jwar, Observation & Interpretation.

Results: It shows the correlation of Sepsis with Ayurvedic Sannipataj Jwar along with WBC Morphology.

Conclusion: This study finds the correlation of Sepsis with Ayurvedic Sannipataj Jwar along with WBC Morphology. This study would help Ayurveda physicians to give appropriate Ayurvedic treatment to Sepsis patients on the basis of evidence based WBC Morphology.

Keywords: Sepsis, Septic Shock, Sannipataj Jwar

Corresponding Author How to Cite this Article To Browse
Vaishnav Vinod Dhole, Post Graduate Scholar, Department of Rog Nidan, Dr Dy Patil College of Ayurved and Research Centre Pimpri, Pune, Maharashtra, India.
Email: 		Dhole VV, Joshi VN, Mandal S, An Ayurvedic perspective of Sannipataj Jwar - Sepsis along with WBC morphology. J Ayu Int Med Sci. 2024;9(7):69-73.
Available From
https://jaims.in/jaims/article/view/3253

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2024-05-14 2024-05-24 2024-05-31 2024-06-08 2024-06-23
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
None Nil Yes 13.39

© 2024by Dhole VV, Joshi VN, Mandal 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)69
Vaishnav VD et al. An Ayurvedic perspective of Sannipataj Jwar

Introduction

Sepsis is potentially a life-threatening condition that arises when the body's response to infection causes injury to its own tissues and organs. Sepsis affected about 48.9 million people in 2017 with 11 million deaths i.e., 1 in 5 deaths worldwide.

In 2017, almost half of all global sepsis cases occurred among children, with an estimated 20 million cases and 2.9 million global deaths in children under 5 years of age.

Regional disparities in sepsis incidence and mortality exist; approximately 85% of sepsis cases and sepsis-related deaths worldwide occurred in low- and middle-income countries.

Risk factors include young or old age, cancer, diabetes, major trauma, asthma, COPD, multiple myeloma, burns. The usual onset may be rapid (<3hours) or prolonged (several days).

Initial stage of sepsis is followed by suppression of the immune system along with Signs and Symptoms include fever, increased heart rate, increased breathing rate, and confusion.

There may also be symptoms related to a specific infection, such as a cough with pneumonia, or painful urination with a kidney infection, severe sepsis causes poor organ function or blood flow.

Septic shock is low blood pressure due to sepsis that does not improve after fluid replacement. Sepsis is caused by many organisms including bacteria, viruses and fungi.

Common locations for the primary infection include the lungs, brain, urinary tract, skin, and abdominal organs. qSOFA criteria for sepsis include at least two of the following three: increased breathing rate, change in the level of consciousness, and low blood pressure.

Other potential causes of similar signs and symptoms include anaphylaxis, adrenal insufficiency, low blood volume, heart failure, and pulmonary embolism.

Sepsis requires immediate treatment. The risk of death from sepsis is as high as 30%, while for severe sepsis it is as high as 50%, and septic shock 80%. According to Ayurved, Achaarya Charak defined Jwar as Pradhaan in all types of Vyadhi i.e.

‘देहेंद्रियमनस्तापी सर्वरोगाग्रजो बलीI ज्वर:प्रधानो रोगाणामुक्तो भगवता पुरा II च.चि.३/४-५. Achaarya Charak also defined Sannipata Jwar along with Lakshana as क्षणे शीतमस्थिसन्धिशिरोरुजाI सास्रावे कलुषे रक्ते निर्भुग्ने चापि दर्शनेII सस्वनौ सरुजौ कर्णौ कण्ठः शूकैरिवावृत:I तन्द्रा मोहः प्रलापश्च कासः श्वासोऽरुचिर्भ्रमःII परिदग्धा खरस्पर्शा जिह्वा स्रस्ताङ्गता परम्I ष्ठीवनं रक्तपित्तस्य कफेनोन्मिश्रितस्य चII शिरसो लोठनं तृष्णा निद्रानाशो हृदि व्यथाII स्वेदमूत्रपुरीषाणां चिराद्दर्शनमल्पश:II कृशत्वं नातिगात्राणां प्रततं कण्ठकूजनम्I कोठानां श्यावरक्तानां मण्डलानां च दर्शनम्II मूकत्वं स्रोतसां पाको गुरुत्वमुदरस्य च चिरात् पाकश्च दोषाणां सन्निपातज्वराकृतिःII च.चि ३/१०१-१०६.

Meaning of all these Lakshanas are correlated with Sepsis in the point - Initial assessment and enrollment of patients.

Material and Methods

Literature Review

↓

Initial assessment & Enrollment with written consent

↓

Microscopic observational changes to correlate Sepsis with Sannipataj Jwar

↓

Assessment criteria along with WBC Morphology

↓

Observation, Interpretation & Statical Analysis

Literature Review

It includes Ayurvedic and Modern Medical Science References.

Initial assessment and enrollment of patients

Sannipataj Jwar Lakshanas can be correlated with Sepsis as follows:

Above reference is taken from the Article: Sama Sannipata Jwara- Sepsis, SIRS, MODS, Septic Shock and Delirium of Dr. Prasad Mamidi & Dr. Kshama Gupta. With the help of above reference Sannipataj Jwar can be correlated with Sepsis. One patient is enrolled in this study having Bacterial Sepsis. Microscopic observational changes to correlate Sepsis with Sannipataj Jwar along with WBC Morphologies - Precursor stages of Neutrophil i.e. Left Shift shown as follows:


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Vaishnav VD et al. An Ayurvedic perspective of Sannipataj Jwar
Sannipataj Jwar LakshanasSepsis
Kshane Daha & Kshane SheetaFever & Hypothermia; Temperature > 38.5 or < 35°C
Asthi Sandhi RujaArthralgia, Myalgia
Shiro RujaHeadache (due to hypotension or upper/lower respiratory tract infection)
Saasraave Kalushe Rakte LochaneConjunctivitis
Saswanau Karnau & Karna RujaOtitis media
Kantha ShookairivaPharyngitis / Laryngitis
TandraFatigue / Malaise (sepsis / acute respiratory tract infection / hypotension)
MohaConfusion / Loss of consciousness (septic shock / hypotension / delirium)
PralaapaIrrelevant speech (delirium?)
KaasaCough (upper respiratory tract infection / pneumonia)
ShwaasaShortness of breath (tachypnoea / respiratory rate > 20 breaths per minute / Acute lung injury / Acute respiratory distress syndrome)
AruchiLoss of appetite / Anorexia (respiratory tract infection / sepsis)
BhramaHypotension / reduction of cerebral blood flow
Paridagdha, Khara Sparsha JihwaDehydration (indicates need of fluid resuscitation / septic shock)
SrastaangataMalaise / weakness / fatigue (sepsis / respiratory infection)
Kapha Yukta Rakta ShteevanamHaemoptysis (respiratory infection / pneumonia)
Shiraso LothanamRestlessness / Septic encephalopathy
TrishnaDehydration (septic shock / denotes requirement of fluid resuscitation)
Nidraa NaashaRestlessness / Sleeplessness (delirium)
Hridi VyadhaHypotension / Tachycardia / pericarditis
Chiraat and Alpa Sweda, Mutra and PurishaDehydration / Anuria / Oliguria / Acute kidney injury / Constipation / MODS (Multiple organ dysfunction syndrome) / septic shock
Krushatwam Naati GaatraanaamEdema (due to hypoperfusion of tissues / hepatic injury / cute kidney injury / hypoxemia)
Pratatam Kantha KoojanamTachypnoea / ARDS (Acute respiratory distress syndrome) / ALI (Acute lung injury)
Shyaava, Rakta Kotha and MandalaShyaava, Rakta Kotha and Mandala
MookatwamLoss of voice (due to laryngitis)
Sroto PaakaSIRS (Systemic inflammatory response syndrome)
Udara GauravamHepatomegaly? / Edema in severe sepsis due to capillary leak;
Chiraat Paakashcha DoshaanaamSlowly progressive / latent pathological process (indicates chronic / recurrent infections in immuno-compromised individuals leading to sepsis / septic shock / delirium / death)
MaranamPoor prognosis (MODS / delirium / septic shock)
Upadrava - Karnamoola ShothaMastoiditis leading to meningitis and death

jaims_3253_01.JPG
Neutrophils

jaims_3253_02.JPG
Hypersegmented Neutrophil

jaims_3253_03.JPG
Band Form

jaims_3253_04.JPG
Band Form

jaims_3253_05.JPG
Metamyelocyte


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jaims_3253_06.JPG
Myelocyte

Above Images showing Neutrophilic leucocytosis with shift to left i.e., precursor developmental stages which includes Hypersegmented Neutrophil, Band form, Metamyelocyte & Myelocyte showing significance of Sepsis.

Observation and Interpretation

It is observed that Sannipataj Jwar can be correlated with Sepsis along with WBC Morphology with the help of Patient’s Data as follows:

Patient had Sannipataj Jwar Lakshanas i.e., Sepsis having Total WBC Count 35,400 & Differential WBC count includes Neutro-84 %, Lymphocytes-7%, Eosinophils-1%, Monocytes-8%, Basophils-0% showing Neutrophilic leucocytosis with shift to left s/o Sepsis.

jaims_3253_07.JPG
WBC Histogram

Results

This study shows the correlation of Sepsis with Sannipataj Jwar along with WBC Morphology.

Conclusion

This study finds the correlation of Sepsis with Sannipataj Jwar along with WBC Morphology.

This study would help Ayurveda physicians to give appropriate Ayurvedic treatment to Sepsis patients on the basis of evidence based WBC Morphology.

References

1. Kashinath Shastri & Vijay Shankar Kale e.d. Charak Samhita Chikitsa Sthaan3/4-5. Chaukhamba Bharti Academy Publication.

2. Kashinath Shastri & Vijay Shankar Kale e.d. Charak Samhita Chikitsa Sthaan 3/101. Chaukhamba Bharti Academy Publication.

3. Kashinath Shastri & Vijay Shankar Kale e.d. Charak Samhita Chikitsa Sthaan 3/102. Chaukhamba Bharti Academy Publication.

4. Kashinath Shastri & Vijay Shankar Kale e.d. Charak Samhita Chikitsa Sthaan 3/103. Chaukhamba Bharti Academy Publication.

5. Kashinath Shastri & Vijay Shankar Kale e.d. Charak Samhita Chikitsa Sthaan 3/104. Chaukhamba Bharti Academy Publication.

6. Kashinath Shastri & Vijay Shankar Kale e.d. Charak Samhita Chikitsa Sthaan 3/105. Chaukhamba Bharti Academy Publication.

7. Kashinath Shastri & Vijay Shankar Kale e.d. Charak Samhita Chikitsa Sthaan 3/106. Chaukhamba Bharti Academy Publication.

8. Wikipedia - https://en.wikipedia.org/wiki/Sepsis

9. Prasad Mamidi, Kshama Gupta. Sama Sannipata Jwara- Sepsis, SIRS, MODS, Septic Shock and Delirium.

10. Essentials of Clinical Pathology by Shirish M Kawthalkar Section II Laboratory Hematology Chapter 19 Hematopoesis.

11. Essentials of Clinical Pathology by Shirish M Kawthalkar Section II Laboratory Hematology Chapter 21 Automated Complete Blood Cell Count.

12. Essentials of Clinical Pathology by Shirish M Kawthalkar Section II Laboratory Hematology Chapter 24 Total Leucocyte Count.

13. Essentials of Clinical Pathology by Shirish M Kawthalkar Section II Laboratory Hematology Chapter 27 Examination of Blood Smear.


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14. Essentials of Medical Physiology by K Sembulingam, Prema Sembulingam Section II Blood & Body Fluids.

15. WHO - https://www.who.int/news-room/fact-sheets/detail/sepsis

16. Images of WBC Morphology from Hematology Section of Pathology Laboratory of Dr.D.Y.Patil College of Ayuved & Research Centre Pimpri, Pune -411018, Maharashtra, India.


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