E-ISSN:2456-3110

Case Report

Dengue Fever

Journal of Ayurveda and Integrated Medical Sciences

2024 Volume 9 Number 10 OCTOBER
Publisherwww.maharshicharaka.in

Ayurvedic management of Dengue Fever - A Case Study

Bhagwatkar NV1*, Laddha S2
DOI:10.21760/jaims.9.10.41

1* Nikita V Bhagwatkar, Post Graduate Scholar, Dept of Kriya Sharir, Government Ayurved College, Nagpur, Maharashtra, India.

2 Sujata Laddha, Assistant Professor, Dept of Rasashastra and Bhaishajya Kalpana, Government Ayurved College, Nagpur, Maharashtra, India.

Dengue fever is the fastest spreading vector-borne virus disease, transmitted through the bite of female mosquitos of the Aedes aegypti species. Dengue fever has surged in recent decades, with estimates putting 40-50% of the world's population at risk for the disease[1] In Ayurveda, dengue fever can be correlated with Vishamjwara. Various formulations have been mentioned in Jwara Prakaran. A case study of dengue fever was done which was successfully managed with Ayurvedic medications. So, it can conclude that dengue fever can be managed without any side effect in Ayurveda. In this study 20 years old male patient with complaints of fever with chills, headache, body ache and itching over body was present. Blood investigations revealed dengue positive along with decreased platelets count. It was managed with Ayurvedic medications for 7 days and also developed good immunity against the disease. The subject was treated on the base of Vishamjwara with various formulations given in Jwara Prakaran. Lab tests were also done on time to monitor the changes. Symptomatology and haematological profile both significantly improved.

Keywords: Dengue fever, Vishamjwara, Jwara Chikitsa, Ayurvedic medications

Corresponding Author How to Cite this Article To Browse
Nikita V Bhagwatkar, Post Graduate Scholar, Dept of Kriya Sharir, Government Ayurved College, Nagpur, Maharashtra, India.
Email: 		Bhagwatkar NV, Laddha S, Ayurvedic management of Dengue Fever - A Case Study. J Ayu Int Med Sci. 2024;9(10):251-255.
Available From
https://jaims.in/jaims/article/view/3678

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2024-09-13 2024-09-23 2024-10-03 2024-10-12 2024-10-22
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
None Nil Yes 12.55

© 2024by Bhagwatkar NV, Laddha 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].

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Nikita VB et al. Ayurvedic management of Dengue Fever - A Case Study

Introduction

Dengue is the most rapidly spreading vector borne viral disease transmitted by the bite of female mosquitoes of the species Aedes aegypti.[2] Regarding morbidity and mortality, Dengue is regarded as the most serious mosquito-borne arboviral disease in the world. Dengue is also known as breakbone fever with the symptoms range from high grade fever, severe headache, intense muscle and joint pain, rashes and in one third patients haemorrhagic shock leads to death. Increased human population density, urbanization, climatic change, inadequate sanitation (which provides mosquito breeding grounds) leads to Dengue fever. Dengue fever has grown into a global public health hazard, affecting more than 2.5 billion people in nation.[3] Dengue virus can cause a spectrum of illness ranging from asymptomatic dengue infection to dengue fever (DF) to dengue hemorrhagic fever (DHF) to dengue shock syndrome (DSS). It is estimated that close to 3.6 billion are at risk with 390 million infections of which 96 million are symptomatic. Among the 96 million symptomatic cases, 2 million ends in severe form of infections, that is, DHF and DSS, and around 21,000 fatal cases occur annually around the world.[4] Dengue is caused by one of any of four related viruses: dengue virus 1, 2, 3, and 4 hence person can be infected with dengue multiple times in their life.[4] The viruses travel in the blood stream and that they destroy the body capacity to produce new platelets and the platelet count started falling after 2 to 3 days of the infection. In Ayurveda there is no direct reference and description is given but dengue fever can be correlated with Vishamjwara in Ayurveda. Various formulations have been mentioned in Jwara Chikitsa. Repeated use of antibiotics causing resistance of body to it. So, its need of time, the globe is turning to alternative medical systems like Ayurveda these days to cure illnesses in such life-threatening conditions like dengue. A case study of dengue fever was done which was successfully managed with Ayurvedic medications.

Case Report

The present case study is successful Ayurvedic management of a case of Dengue fever. A 20 year old male patient presented with the symptoms of Sheetpurvak Jwara Prachiti (fever with chills), Shirshool (Headache),

Angamarda (Body ache), Sarvang Kandu (Itching over body) and Aruchi (Anorexia) since from 3 to 7 days. Patient was taking allopathic medication for the same, but the symptoms doesn’t resolved, so he came for Ayurvedic medication to manage the fever. On first visit after taking history and vitals of patient we have done lab investigations of patient for Malaria, Dengue and Typhoid. Where Dengue test was positive. Patient was willing to continue Ayurvedic medications. So, The Informed written consent for day observation of patient were taken for further management.

Patient information

Patient Name - xyz
Age - 20 yrs
Sex - male

History of Present illness

20yr old male patient with complaints of Sheetapurvak Jwarprachiti (fever with chills), Shiroshool (headache), Angamarda (bodyache), Sarvang Kandu (itching over body) and Aruchi (Anorexia) were present since 8 days. In history, patient told about Daurbalya (weakness) and Tiktasyata were present before six months. Lab investigations of patient were done for Malaria, Dengue and Typhoid. Where Dengue test was positive of a patient. Hence the case was diagnosed with Dengue fever.

History of past illness

No any history of HTN, Diabetes mellitus and thyroid.
No history of any surgery.
No history of covid-19 disease.
No any other major illness.

Personal history

Aahar - Tikta Madhur Rasatmak Aahar
Pradhan Gun Sevan - Ushna, Tikshna, Singdha, Guru
Vihar - Daily habit of Ratri Jagaran

Ashtavidha Parikshan

Nadi - 92/ min (Pitta Vataj)
Mala - Samyak (1-2 veg/day)
Mutra - Pitamutrata (4-5 veg/day)
Jivha - Saam
Shabda - Spashta
Sparsha - Ushnasparshatva


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Nikita VB et al. Ayurvedic management of Dengue Fever - A Case Study

Druk - Prakrut
Aakruti - Madhyam

On examination

Blood Pressure - 130/90 mmHg
Respiratory Rate - 20/min
Temperature - 102.30°F
Weight - 52 kg

(Temperature charting was done every 6 hourly to assist the fever)

Assessment criteria[5]

Fever Grade

CharacteristicsGrade
High (102 - 104°F)4
Moderate (100 - 102°F)3
Low (99 - 100°F)2
Very low (up to 99°F)1
No fever0

Headache Grade

CharacteristicsGrade
Severe, requires medicine4
Moderate3
Mild2
Occasional1
No headache0

Body ache Grade

CharacteristicsGrade
Severe, hamper routine work4
Moderate3
Mild2
Occasional1
No body ache0

Haematological Profile

TLC Grade

CharacteristicsGrade
3000-3500 cells/cu mm4
3500-4000 cells/cu mm3
4000-4500 cells/cu mm2
4500-5000 cells/cu mm1
More than 5000 cells/cu mm0

Platelet Count Grade

CharacteristicsGrade
Less than 50,000 cells/cu mm4
50,000-65000 cells/cu mm3
65,000- 80000cells/cu mm2
80000 -95000cells/cu mm1
More than 95,000 cells/cu mm0

Shaman Chikitsa

SNMedicationsDoseKalaAnupanDuration
1.Jaymangal Ras[7]1 (120 mg)Vyanodane7 days
2.Raktapachak Yog[8]
(Patol, Sariva, Musta, Patha, Kutaki)		10 gmsVyanodaneKoshna Jala15 days
3.Pittaj Jwaraghna Yog [9]
(Dhamasa, Pitapapada, Bhunimba, Vasa, Kutaki, Musta, Mishri)		10 gmsVyanodaneKoshna Jala15 days
4.Sanshamani Vati[10]1VyanodaneKoshna Jala15 days
5.Avipattikar Churna [11]5 gmsNishikaleSakhar + Jala15 days
6.Mahasudarshan Kadha[12]30 mlVyanodaneKoshna Jala15 days
7.Syp. Plateforte 20 mlVyanodane15 days
8.Mauktik Kamdudha [13] 1Apane 15 days

Date wise symptoms with haematological profile of the patient

DateSymptomsTotal leucocytes countPlatelet count
03/08/2023Fever, body ache, headache, loss of appetite3900 cells/cumm93000 cells/cumm
04/08/2023Reduction in the intensity of fever and headache and body ache.4400 cells/cumm1,01000 cells/cumm
05/08/2023Marked diminution in frequency and intensity of fever, no headache5200 cells/cumm1,10000 cells/cumm
06/08/2023Low grade fever (up to 98°F) with no headache, body ache markedly improved along with improvement in appetite.6100 cells/cumm1,12000 cells/cumm

Results

The subject was treated on the base of Vishamjwara with various formulations given in Jwara Prakaran. Lab tests were also done on time to monitor the changes. Symptomatology and haematological profile both significantly improved.


SNCharacteristicsBefore treatmentAfter treatment
1.Fever41
2.Headache41
3.Body ache31

Effect of therapy (Based on grading)

SNLaboratory investigationsBefore treatmentAfter treatment
1.TLC30
2.Platelet count10

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Discussion

Fever (Jwara) is presenting as Vishama Arambha, Vishama Kaala, Vishama Kriya so it can be categorised under Vishamajwara.[14] Dengue fever can be compared to any specific type Vishamajwara.

The medications used in this management includes Jaymangal Rasa is a novel herbo-mineral formulation prescribed in Vegavastha of Jwara. It balances Raktagat Ushma thereby balancing Tridosha. Ingredients of Jaymangal Rasa are Hingul, Swarna Bhasma, Rajat Bhasma, Lohabhasma, Tankan, Maricha, etc. which are known as Raktaprasadak, Ojovardhak, Vishaghna and Rasayan. Hingul is specially indicated in Amashayottha Vikara, as Samprapti of Jwara starts from Amashaya due to Agnimandya. It controls Jwaravega by improving digestive fire. Raktapachak Yog mentioned in Jwara Chikitsa mostly contains Tikta Rasatmak and Sheet Viryatmak Dravya which are effective in Anorexia, Agnimandya seen in Jwara. Raktapachak Yog improves digestive fire and also improves Quality of blood. Pittaj Jwaraghna Yog contains Tikta Rasatmak and Jwarahar Dravya which improves conditions like Agnimandya, Aruchi, Trishna which is seen in manifestations of Jwara. Sanshamani Vati which is reference of Sidhhayog Sangraha of Yadavji Trikamji contains Guduchi as a main ingredient having Tiktaras and Ushna Virya which acts as Jwarghna.[15] In Avipattikar Churna Khandasharkara contributes major quantity. Apart from Khandasharkara the main ingredient is Trivruta (Nishoth). It has Katu, Tikta Rasa, Laghu Tikshna Guna, Ushna Virya and Katu Vipak.[16] It has Rechana and Shothahar properties leading to Pitta Virechana useful in Samprapti Vighatana of Jwara. Mahasudarshan Kadha contains Chirayata, Musta, Shunthi, Nimba, etc. where Swertia chirayata is 50% of the total quantity of remaining ingredients. It is well known for antipyretic and antiviral activity. According to Ayurveda, Jwara is Pitta Pradhan Vyadhi and Mahasudarshan Kadha contains Pittavirechaniya Dravya. It reduces Dhatu Agnimandya by increasing Dhatu Agni due to its Tiktarasa Pradhanata. In dengue fever rapid destruction of platelets are seen which results in thrombocytopenia. Syrup Plateforte contains Papaya leaves extract which stops destruction of platelets also helps in improving platelets health and it has anti inflammatory property.

Dengue fever has traditionally been treated using C. papaya leaves.[17] This plant's aqueous extract showed possible action against dengue disease by boosting neutrophils, white blood cells, and platelets. Mauktik Kamdudha is commonly used in Pittaj Vikar. It contains Dravyas of Sudha Varg like Prawal, Mukta, Muktashukti, Shankha, Kapardik, etc. which are Sheet Viryatamak and Pittashamak and reduces aggravated Pitta.[18] Breakdown of platelets is generally due to vitiated Ushna Guna of Pitta in body, as Kamdudha is Sheeta Gunatmak it inhibits destruction of platelets.

Conclusion

The case study leads to the conclusion that the formulations demonstrated a significant therapeutic impact on the feverish dengue condition and its associated symptoms. Temperatures below 104°F (40°C) linked with common viral diseases, such as the flu, may aid the immune system in fighting sickness and are normally harmless. In such cases, instead of taking antipyretic medicines, natural immunomodulators from Ayurveda as part of Jwarachikitsa help to avoid complications and improve overall health. Dengue Fever can be effectively managed with Ayurvedic drugs if treated promptly. Apart from it, within five days, the medications also treated thrombocytopenia and leucopenia. During the admission, no negative effects were seen. However, more research is required to observe the effectiveness of the above formulation in other febrile illnesses as well. Secondly, more patients should be included in the study, and it should be conducted for a longer period of time to note any additional benefits.

References

1. https://emedicine.medscape.com/article/215840-overview?form=fpf
2. Golwalla A, Golwalla’s medicine for Students,25th edition, Jaypee the health sciences publisher,p-755
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4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7149978/


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