The clinical study to evaluate the Rasayana effect of Bharangi Guda in Post-Covid Subjects - Research Article

Roopa N; SN Belavadi

doi:10.21760/jaims.9.11.8

The clinical study to evaluate the Rasayana effect of Bharangi Guda in Post-Covid Subjects - Research Article

Roopa N^1*, SN Belavadi²

DOI:10.21760/jaims.9.11.8

^1* Roopa N, Post Graduate Scholar, Department of PG Studies in Kayachikitsa, DGM Ayurvedic Medical College, Gadag, Karnataka, India.

² SN Belavadi, Professor and Principal, Department of PG Studies in Kayachikitsa, DGM Ayurvedic Medical College, Gadag, Karnataka, India.

In COVID-19, long term intake of Antivirals, Antibiotics, Antimicrobials, Corticosteroids and ventilator exposure leads to ill effect in individual. Such as Fatigue, Weight loss, Weakness, Intermittent raise in Temperature, Headaches, Myalgias etc. are signs and symptoms noted in after effect of COVID-19. It is necessary to combat Post-covid signs and symptoms in patients and restore the normalcy of body functions or to build their immune system. Rasayana an Ayurvedic rejuvenation therapy which helps in maintenance and promotion of health. It means nutrition at all levels from macro to micro cellular levels. Replenishes from the vital fluids of body; boost the Ojas (immune system), thus keeping away from diseases. In the study; Naimittika Rasayana (consequent to diseases), Bharangi Guda which is indicated in Pranavaha Sroto Vikara like Swasa (asthma), Kasa (cough), Jwara (fever) etc. Ingredients like Bharangi, Dashamoola, Harithaki, Guda, Trikatu, Trijatha, Yava. Actions like Antispasmodic, Anti-asthmatic, Carminative, Antihistaminic principle, Tonic and refrigerant. Active principles like Saponin, D-mannitol, Tanin etc. Study design is Simple Randomized Clinical Study. Total 30 post-COVID patients shows highly significant in subjective parameters and significant and not-significant in objective parameters.

Keywords: Post-covid, Bharangi Guda, Rasayana, Janapadodhwamsa

Corresponding Author	How to Cite this Article	To Browse
Roopa N, Post Graduate Scholar, Department of PG Studies in Kayachikitsa, DGM Ayurvedic Medical College, Gadag, Karnataka, India. Email:	Roopa N, SN Belavadi, The clinical study to evaluate the Rasayana effect of Bharangi Guda in Post-Covid Subjects - Research Article. J Ayu Int Med Sci. 2024;9(11):49-55. Available From https://jaims.in/jaims/article/view/3649

Introduction

Towards to the end of 2019,^[1] a novel coronavirus, now designated as severe acute respiratory distress or SARS-CoV-2, was identified as the cause of a cluster of pneumonias in Wuhan, Hubei province of China.

Epidemics^[2] have not been new to India, Ayurveda being in the fore front of health care of those times, has recorded its valuable experiences of epidemics and termed them as Janapadodhwamsa [1, Vimana Sthana 3/1-4] or Maraka [2, Sutra Sthana 6/19]. It has vividly described their mechanisms of Causation (Nidana), factors affecting severity and actions complicating illnesses, their management and prevention.

Long COVID or long-haul COVID (also known as post-COVID-19 syndrome, post-COVID-19 condition,^[3,4] Post-Acute Sequelae of COVID-19 (PASC) or Chronic COVID Syndrome (CCS) is a condition characterized by long-term health problems persisting or appearing after the typical recovery period of COVID-19. Long COVID has been described as having the potential to affect nearly every organ system, causing further conditions (sequelae) including respiratory system disorders, nervous system and neuro-cognitive disorders, mental health disorders, metabolic disorders, cardiovascular disorders, gastrointestinal disorders, musculoskeletal pain and anemia

Jwara is considered to be the “lord” of diseases. Sannipataja Jwara refers to a condition where there is disturbance in all the three dosha. Classical textbooks of Ayurveda describe Jwara as the most powerful among diseases capable of afflicting body, mind and senses. Jwara is a Rasadhatu Pradoshaja Roga affecting the Abhyantara Rogamarga which includes Koshta or Amashaya and Pakvashaya together. Rasadhatu Pradoshaja Roga is usually treated by Langhana and same in various forms used in the management of Jwara also.

Careful analysis of signs and symptoms of COVID-19 reveals that the diseases affect the Abhyantara Rogamarga with fever and respiratory symptoms as main manifestation.

This Jwara can also be classified as being Agantuja (external) caused by Bhoota Abhishanga (virus), which aggravates all the three Doshas considering the Agantu a Janapadodwamsa nature of diseases.

Rasayana^[5] therapy is a part of preventive Ayurvedic healthcare. Rasayana is defined as those medicines (and non-medicines including conduct, lifestyle changes, behavior etc) which are helpful in gaining high quality tissue in optimum and desired quantity. Dhatus in good quality and quantity form the foundation of a good immunity and paves way for leading disease free life.

The ingredients of Bharangi Guda^[6] are Bharangi, Bilva, Shyonaka, Gambari, Patala, Agnimantha, Shalaparni, Prishniparni, Brihati, Kantakari, Gokshura, Haritaki, Guda, Shunti, Maricha, Pippali, Twak, Ela (Suksmaila), Patra (Tejapatra), Yavaksara (Yava). These are available drugs and preparation method is easy. Actions like Antispasmodic, Anti-asthmatic, Carminative principle, Tonic and refrigerant. Active principles like Saponins, D-mannitol, and Tannin etc.

Karma:^[7] Agnivardhaka, Pustikaraka.

Rogaghnata:^[7] All types of Kasa, Swasa, Yakshma, Bala, Jeerna Jwara and Hikka.

Materials and Methods

Method of Collection of Data

Study Design: Simple random clinical study

Sample Size: Total 30 Post-Covid subjects have been selected

Inclusion Criteria

Post-Covid subjects with signs and symptoms of Fatigue, Dyspnoea, Disturbed sleep, Cough, Anorexia and Weight loss were selected.
Subject selected between age group of 20 to 60 years, irrespective of sex.
Subjects Haemoglobin greater than 8gm/dl were selected.
Upto 1 year subjects have been considered for study and diagnosed as COVID-19 positive.
Trials subject’s RT-PCR report confirmed negative.
Subjects were vaccinated either 1^st dose or 2^nd dose or both doses.
Subjects either RT-PCR or RAT positive reports are were collected to claim that they have exposed to SARS-CoV-2 virus.

Exclusion Criteria

Patient having history of Diabetes mellitus.
Other Systemic diseases like Sexual Transmitted Diseases (STD’s), Acquired Immuno Deficiency Virus (AIDS) etc
Other Post-Covid complications like Mucormycosis etc.
Pregnant and lactating mothers were excluded from study.

Withdrawal Criteria

Subjects who develop acute complications of Post-Covid or any other diseases or develop serious adverse drug reactions to the interventions in the study period were withdrawn from the study as such no one had complications.

Diagnostic Criteria

Reverse Transcription- Polymerase Chain Reaction (RT-PCR) report outcome is Positive.
RAT report outcome is positive.

Posology

For Deepana and PaIchana: Chitrakadi Vati- 500 milligrams - 1 TID with Sukoshna Jala before food.
For Koshta Shodhana: Haritakyadhi Yoga:^[15] 12 grams at night with Sukoshna Jala after food.
For Shamana Yoga: Bharangi Guda: 12 grams- two times a day with Ksheera after food.

Table 1: Study Duration

Chikitsa	Kala
Deepana and Pachana - Chithrakadhi Vati	3 days
Koshta Shodhana - Harithakyadhi Yoga	2 days
Shamanaushadhi - Bharangi Guda	30 days
Follow up	15 days
Total study duration	50 days

Patients will be assessed clinically on 0^th, 35^th and 50^th
CBC, IgG, IgM, CRP, Weight will be assessed on 0^th and 35^th

Criteria for Assessment of Result

Subjective Parameters

Fatigue
Anorexia
Disturbed sleep

Cough
Dyspnoea
Weight loss

Objective Parameters

Complete blood count (CBC)
CRP (C-Reactive Protein)
IgG, IgM antibodies
Weight

Investigations

Blood - CBC (Complete blood count)
IgG, IgM
CRP (C - reactive protein)

Grading of Subjective Parameters

Fatigue - Chalder fatigue scale (CFS-11)^[7]

Table 2:

Grade	Assessment
G0	Better than usual
G1	No more than usual
G2	Worse than usual
G3	Almost always

Anorexia^[8]

Table 3:

Grade	Assessment
G0	Normal desire to take food
G1	Most of the time dislikes food
G2	Dislikes the food even though hungry but takes the food
G3	Dislike the food and takes little or does not take food

Disturbed sleep - Sleep Quality scale^[9]

Table 4:

Grade	Assessment
G0	Few
G1	Sometimes
G2	Often
G3	Almost always

Cough - MEG Cough severity index scale-CSI^[10]

Table 5:

Grade	Assessment
G0	Never
G1	Almost Never
G2	Sometimes
G3	Almost always
G4	Always

Dyspnoea - Medical research council [MRC Dyspnoea scale]^[11]

Table 6:

Grade	Assessment
G1	Not troubled by breathless except on strenuous exercise
G2	Short of breath when hurrying on a level or when walking up a slight hill
G3	Walks slower than most people on the level, stops after 15minutes walking at own place
G4	Stops for breath after walking 100 yards or after a few minutes on level ground
G5	Death

Weight loss - before and after weight measurement in Kilograms (Kg).

Overall Assessment Criteria

Assessment of results were done on objective and subjective parameters of baseline data to pre medication data comparing with gradation. The final result will be categorized as:

Table 7:

SN	Results	Criteria
1.	Good improvement	76% - 100% reduction in signs and symptoms
2.	Moderate improvement	51% - 75% reduction in signs and symptoms
3.	Mild improvement	26% - 50% reduction in signs and symptoms
4.	No improvement	Less than 25% reduction in signs and symptoms

Results and Discussion

Graph 1: Showing Distribution of Average Relief Rate of Subjective Parameters of 30 Subjects

Graph 2: Showing Distribution of Average Relief Rate of Objective Parameters of 30 Subjects

Graph 3: Overall Assessment Subjects Based on both Subjective and Objective Parameters

Discussion on the Results

Discussion on Subjective Parameters

Subjective Parameters	Mean BT	Mean AT	Mean deviation	Std. deviation	SE	t-value	PV	Result
Cough	2.87	0	2.87	1.203	0.223	12.869	0.00001	HS
Dyspnoea	2.73	1.06	1.67	0.699	0.129	12.945	<0.00001	HS
Sleep Disturbance	2.2	0	2.2	0.4	0.074	29.729	<0.00001	HS
Fatigue	2.8	0	2.8	0.541	0.100	28	<0.00001	HS
Anorexia	2.97	1.97	0.657	0.657	0.122	16.14	<0.00001	HS
Weight	58.73	59.66	0.93	1.547	0.287	3.240	0.00294	S

Discussion on Objective Parameters

Objective Parameters	Mean BT	Mean AT	Mean deviation	Std. deviation	SE	t-value	PV	Result
Hb%	11.65	11.13	0.52	0.763	0.141	3.687	0.00092	S
RBC	4.20	3.77	0.43	0.658	0.122	3.524	0.00612	S
PCV	37.17	36.33	0.84	3.681	0.683	1.229	0.231	NS
MCV	81.65	78.96	2.69	8.440	1.567	1.716	0.0964	NS
MCH	28.67	27.39	1.28	1.458	0.270	4.740	0.00008	HS
MCHC	34.34	33.65	0.69	3.995	0.741	0.931	0.363	NS
RDW	11.82	11.14	0.68	1.729	0.321	2.118	0.042	S
NEUTROPHIL	53.4	51	2.4	7.692	1.428	1.680	0.103	NS
LYMPHOCYTES	39.56	40.49	-0.93	7.991	1.483	0.627	0.534	NS
EOSINOPHIL	2.96	3.36	-0.4	2.138	0.397	1.007	0.322	NS
MONOCYTES	3	3	0	1.183	0.219	0	1	NS
PLATELET	2.69	2.04	0.65	0.796	0.147	4.421	0.00013	S
IgG	680.49	547.69	132.8	231.69	43.023	3.086	0.0045	S
IgM	111.63	85.09	26.54	50.391	9.357	2.836	0.00823	S
CRP	3.55	2.37	1.18	1.641	0.304	13.881	0.00059	S

Conclusion

The conclusion drawn from above mentioned interpretations, it is clear that COVID-19 is Aupasargika and Janapadhodhwamsa Vyadhi caused by a type of Krimi or Bhoota (SARS-CoV-2) which comes from outside the body.

The clinical symptoms of COVID-19 resemblance with Abhisangaja Jwara, Vata-Kaphaja Jwara and Sannipataja Jwara. The post effect in the individual will persists in every exposure to the epidemic. In this study at DGM AMC, we have came across more number subjects suffering from the Post-COVID effect. Subjects were suffering with mild to severity of dyspnoea, cough, mental disturbance etc even after 1-2 years after the exposure to COVID-19. Naimittika Rasayana Bharangi Guda, mentioned in Shwasa-Hikka condition, and individual properties of Dashamoola and Haritaki was helpful in post-COVID conditions associated with Dyspnoea, Cough, Fatigue and Anorexia. Rasayana as a form helpful in Kshaya kind of conditions. In Subjective parameters we have seen clinically and statistically high significance with the intervention. In Objective parameters we have seen significance and non-significance statistically, but could be drawn good conclusion if we have come across acute conditions of post-COVID. During COVID-19, this kind of interventions is needed to prevent post-effect in the individual.

References

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Manuscript Received	Review Round 1	Review Round 2	Review Round 3	Accepted
2024-10-09	2024-10-22	2024-11-02	2024-11-12	2024-11-22
Conflict of Interest	Funding	Ethical Approval	Plagiarism X-checker	Note
None	Nil	Yes	14.54

Research Article

Bharangi Guda

Journal of Ayurveda and Integrated Medical Sciences

The clinical study to evaluate the Rasayana effect of Bharangi Guda in Post-Covid Subjects - Research Article

Roopa N1*, SN Belavadi2

Introduction

Materials and Methods

Results and Discussion

Discussion on the Results

Conclusion

References

Roopa N^1*, SN Belavadi²