E-ISSN:2456-3110

Research Article

Swarnamakshika Bhasma

Journal of Ayurveda and Integrated Medical Sciences

2024 Volume 9 Number 11 NOVEMBER
Publisherwww.maharshicharaka.in

A comparative clinical study of Swarnamakshika Bhasma and Dhatri Lauha in the management of Pandu w.s.r. to Iron Deficiency Anaemia

Pal A1*, Kumar Y2
DOI:10.21760/jaims.9.11.6

1* Anita Pal, Assistant Professor, Dept of Kayachikitsa, Babu Yugraj Singh Ayurvedic Medical College, Lucknow, Uttar Pradesh, India.

2 Yogendra Kumar, Assistant Professor, Dept of Swasthavritta and Yoga, Babu Yugraj Singh Ayurvedic Medical College, Lucknow, Uttar Pradesh, India.

Anaemia, a silent condition without symptoms, can lead to chronic health issues such as impaired fatal development, delayed cognitive development, increased risk of infection in young children, and reduced physical capacity. Women of childbearing age need to absorb 2-3 times the amount of iron required by men or older women. In Ayurveda, Pandu is a specific disease with its own pathogenesis and treatment. In India, Anemia affects 50% of the population, with 20 - 40% of maternal deaths due to anemia. Allopathic treatment for mild to moderate anemia involves supplementation of ferrous sulfate, fumarate, or gluconate. Ayurveda can provide better management in this area. The objective of the study is to know the efficacy of Swarnamakshika Bhasma and Dhatriloha in Pandu. 40 patients of Pandu (iron deficiency anemia) were taken who fulfilled the inclusion criteria and divided into two groups randomly. Group A - 20 patients of Pandu (IDA) were given Swarnamakshika Bhasma. Group B - 20 patients of Pandu (IDA) were given Dhatri Loha for 45 days. Both the groups are having similar effect on reducing the symptoms statistically. Among the subjective and objective parameters, the B group showed better results than Group A.

Keywords: Pandu Roga, Iron Deficiency Anemia (IDA), Dhatriloha, Swrnamakshika Bhasma

Corresponding Author How to Cite this Article To Browse
Anita Pal, Assistant Professor, Dept of Kayachikitsa, Babu Yugraj Singh Ayurvedic Medical College, Lucknow, Uttar Pradesh, India.
Email: 		Pal A, Kumar Y, A comparative clinical study of Swarnamakshika Bhasma and Dhatri Lauha in the management of Pandu w.s.r. to Iron Deficiency Anaemia. J Ayu Int Med Sci. 2024;9(11):38-42.
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https://jaims.in/jaims/article/view/3766

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2024-10-13 2024-10-22 2024-11-02 2024-11-12 2024-11-22
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
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© 2024by Pal A, Kumar Yand 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(11)38
Download PDFBack To ArticleIntroductionAim and ObjectivesObservationResultDiscussionConclusionReferences
Yogendra K et al. Swarnamakshika Bhasma and Dhatri Lauha in the management of Pandu

Introduction

Rakta has been considered a key factor for the Jeevana, Preenana, Dharana, and Poshana karma of the body. Many times, it is seen that Rakta gets vitiated by Doshas, mainly by Pitta Dosha, as Rakta is Pitta Vargeeya and diseases like Pandu appear.

In Ayurveda, Pandu is considered a specific disease with its own pathogenesis and treatment. (Cha. Chi. 16th chap, Su. Utt. 44th chap) Pandu is explained as Rasapradoshaja Vikara by Charaka,[5] but Sushruta considered it to be Raktavaha Shrhoto Dushti Vikara. Thus, an attempt has been made to study the disease Pandu Roga according to Ayurvedic text in the context of iron deficiency anemia. Iron Deficiency Anaemia is a reduction of hemoglobin, the number of RBCs in millions/cmm of blood, and the quantity of Hb%, resulting in pallor of the skin. In Greek, anemia means ‘Lack of Blood’. In India, anemia affects an estimated 50% of the population.

The problem becomes more severe as more women are affected by it as compared to men. It is estimated that about 20 - 40% of maternal deaths in India are due to anemia, and one in every two Indian women (56%) suffers from some form of anemia. According to the National Family Health Survey (NFHS), the incidence of anemia was 71% in urban areas, 84% in rural areas, and overall, 79%. In allopathic, mild to moderate iron deficiency anemia is treated by supplementation of ferrous sulphate, ferrous fumarate, or ferrous gluconate. By these supplementations, side effects like upset stomach or darkening of stools and less amount of iron absorption along with food are experienced. No significant therapy is there for chronic anemia, which occurs due to metabolic defects. Ayurveda can provide better management of this area.

Dhatri Loha is explained in the context of Shoola Pratishedha and is also indicated in Pandu. Dhatriloha is proved to be an effective formulation in the management of Pandu. Swarnamakshika Bhasma is explained in Rasendra Sara Sangrah, Rasa Tarangani, and Rasa Ratna Samuchya, mainly indicated in Pandu Roga. Madhur, Tikta Kashaya Rasatmak. Laghu Gunatmak Sheet Virya & Madhur Vipak pacifies all three Doshas (Tridoshas), but it is more beneficial in Pitta Dosha and then Kapha Dosha dominance. Effectively acts on Pandu Roga.

Aim and Objectives

1. To evaluate the clinical efficacy of Swarnamkshik Bhasma in the management of Pandu with special reference to iron deficiency anemia.
2. To evaluate the clinical efficacy of Dhatri Loha in the management of Pandu with special reference to iron deficiency anemia.
3. To compare the efficacy of both groups.

Hypothesis

H0: Swarnamakshika Bhasma and Dhatriloha either of drugs have same efficacy.
H1: Swarnamakshika Bhasma has more efficacy than Dhatriloha
H2: Dhatriloha has more efficacy than Swarnamakshika Bhasma

Method of Collection of Data

The present study is a ‘randomized clinical study.

  • A comparative clinical study where in 40 patients presenting with Lakshan of Pandu, of either sex was randomly assigned into two groups; each Comprising of 20 patients.
  • A case proforma containing all necessary details pertaining to study was prepared. The parameters considered for the study were scored as mentioned in the Proforma.

Drug Requirements

Table 1: Swarnamakshika Bhasma

Swarna Makshik or Chalcopyrite, is composed of mainly following elements: Copper, Iron & Sulphur. So, the raw Swarna Makshik has Chemical formula of Chalcopyrite, which is CuFeS2. According to X-ray Diffraction (XRD) analysis of prepared Swarna Makshik Bhasma, it contains:[1]

SNChemical NameChemical FormulaProportion
1.Ferrous oxide of IronFe2O334.5%
2.Iron (III) sulphide (ferric sulphide)FeS230.5%
3.Copper sulphideCuS30.5%
4.Silicon dioxideSiO2

Table 2: Dhatri Loha

SNName of PlantBotanical NameMaterial usedProportion
1.DhatriEmblica officinalisFruit4
2.Lohabhasma-Ore2
3.YashtimadhuGlycyrrhiza glabraRoot1
4.Guduchi (Amruta)Tinospora cordifoliaStem, leaf1

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Yogendra K et al. Swarnamakshika Bhasma and Dhatri Lauha in the management of Pandu

Research Design

40 Patients of Pandu (Iron deficiency anaemia) are taken one who fulfilling the inclusion criteria and divided into two groups randomly.

Group A

20 patients of Pandu (Iron Deficiency Anaemia) are given,

Yoga: Swarnamakshika Bhasma

Dosage: According to Rasatarangini, the dose of Swarnamakshika Bhasma is ½ to 2 Ratti (60mg–250mg) considering the strength and disease condition of patient, half an hour before food.

Duration: For 45 days

Follow Up: For 15 days

Anupana: Madhu

Group B

20 patients of Pandu (Iron Deficiency Anaemia) are given,

Yoga: Dhatri Lauha[8]

Dosage: 250 mg to 500 mg in two divided dose half an hour before meal, considering the strength and disease condition of patient

Duration: For 45 days

Follow Up: 15 days

Anupana: Koshna Jala

Inclusion Criteria

1. Patients with cardinal symptoms of Pandu s.r. Iron deficiency anaemia.
2. Patients with HB % range of 7 to 10%
3. Patients of either sex
4. Patients age of 10 to 60 years
5. HB%, PCV, CBC.

Exclusion Criteria

1. Patients with history of systemic disorders like cardiac, renal, liver disorders, rheumatoid arthritis, diabetes mellitus and hypertension.
2. Congenital disorders like haematopoietic system like thalassemia, sickle cell anaemia, leukaemia.
3. One who is suffering from bleeding disorders like haemophilia.
4. Pregnant ladies

Diagnostic Criteria

Clinical signs and symptoms of Pandu Roga[5] / Iron Deficiency Anaemia

1. Pandutha
2. Alasya
3. Durbalata
4. Aayasaja- Swash
5. Shiroruja
6. Hridayaspandana
7. Aruchi
8. Nidraluta
9. Shotha
10. Jwara
11. Rukshata

Observation

Table 3: Showing the distribution of patients on the basis of presenting complaints.

Presenting complaintGroup AGroup BTotal
Patients%Patients%Patients%
Panduta20100%20100%40100%
Nidraluta1575%1575%3075%
Alasya1680%1785%3382.5%
Daurbalya1995%1995%3895%
Hritspandan1050%1155%2152.5%
Siroruja1155%1050%2152.5%
Sotha1365%0840%2152.5%
Rukshta1680%1890%3485%
Aayasaja- Swash525%420%0922.5%
Aruchi735%840%1537.5%
Jwara210%315%0512.5%

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Yogendra K et al. Swarnamakshika Bhasma and Dhatri Lauha in the management of Pandu

Table 4: Showing improvement Percentage wise in Both Group A and Group B

Effects onGroup AGroup B
Panduta60%66.6%
Nidraluta66%76%
Alasya84%94%
Daurbalya85%100%
Hritspandan61.5%66.5%
Siroruja61%84%
Rukshta77%94%
Aayasaja- Swash75%54%
Aruchi100%100%
Jwara60%100%
Haemoglobin10%24%
PCV11%14%

Result

Unpaired t Test

Table 5: Showing the statistical analysis of Group A and Group B after treatment.

ParametersGroup AGroup BtdfpRemarks
NMDSDNMDSD
Pandutha200.60.5200.750.550.900238>0.05NS
Alasya200.00.0200.20.412.1738<0.05SS
Daurbalya200.00200.250.442.538<0.05SS
Nidraluta200.10.31200.350.491.938>0.05NS
Shiroruja200.250.55200.550.370.6738>0.05NS
Hritspandan A20.200.41200.300.470.7638>0.05NS
Rukshata200.10.31200.050.220.5838<0.05SS
Shotha2000200.150.371.8338>0.05NS
Shwasa20002000038>0.05NS
Aruchi200.60.6200.250.442.100638<0.05SS
Jwara200.20.420002.17380.0269SS
Hb201.480.53202.850.915.8238<0.001HS
PCV202.473.27205.734.592.5938<0.05SS
RBC200.63.3200.924.31.238>0.05NS

Based on the results obtained from unpaired t test the overall improvements seen in Group B are more significant than that of Group A.

Discussion

The present study has facilitated the proper understanding of the importance and gravity of Pandu Roga. It is Pitta predominant disorder. Vitiated Pitta with Vayu enters between Mamsa and Twak, and vitiated Tridoshas, Twak, Rakta, and Mamsa produces Panduta, Harita, Haridra etc. Varna. The three-fold approach in treatment of Pandu viz. Shodhana – Shamana – Brimhana, is unique to Ayurveda in comparison to other contemporary medical systems.

The scientific approach of our Acharyas in prescribing Iron compounds is awe- inspiring. Iron is not administered in its inorganic elemental form, but processed with organic herbs to make it readily acceptable by the body. Further, the presence of Amalaki, a rich source of Vitamin C which is essential for iron absorption, in most of the Loha Yogas portrays the deep insight and wisdom of our Acharyas. Anemia is defined as a state in which the blood HB% is below the normal range, with relation to patient’s age and sex.

Iron deficiency occupies an unusual classification of anemia, moderate form, it presents itself with symptoms like fatigue, loss of appetite, weakness, breathlessness, and palpitation, particularly with physical appetite, weakness, breathlessness, and palpitation, particularly with physical exertion and pallor of the skin and the mucous membrane.

Conclusion

The statistical analysis of the results obtained in the present clinical work suggests that the interventions of both Group A and Group B are effective in the management of Pandu Roga. But Group B (Dhatri Loha) showed significantly better response than Group A (Swarnamakshika Bhasma), The study reiterates the efficacy of Dhatri Loha in the management of Pandu Roga, The study shows that Swarnamakshika Bhasma is also useful in the management of Pandu Roga with special reference to iron deficiency anemia.

References

1. https://www.ayurtimes.com/swarna-makshik-bhasma/


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2. Sharangdhar samhita of pandita Sarangdharcharyaan noted with ‘Dipika’ hindi commentary by Dr. Brahmanand Tripathi published by chaukhambha subharati prakashan, Varanasi 2019 editon, madhyam khand, 7-chapter rog gadna shlok 19, pg no.64.

3. Astanghrdayam composed by Vagbhata with the commentaries (Srimadvagbhata) of Nirmala edited by Dr. bhrahmanand Tripathi published by chaukhambha orientalia Varanasi ninth edition pandu rog shof visharp nidan addhyay 13th page no 518.

4. Kayachikitsa edited by Vaidya Yashvant govind Joshi published by vaidyamitra prakashan,2002 edition Pandu Rog chapter 6 pg no 189

5. Charaksamhita ‘Vaidyamanorama’ hindi commentary edited by Dr Vidyadhar shukla Uttarardha published by Chaukhambha Sanskrit Publication, Varanasi 2010 edition, pandu chikitsa chapter 16th, page no 395.

6. Yogratnakara with ‘Vaidyaprabha’ hindi commentary by Indradev Tripathi and Dr Daya Shankar Tripathi published by Krishnadas Academy, 2013 edition, pandu nidanam, page no 264.

7. National Family Health Survey (NFHS-III), 2005-2006, http://www.nfhsindia.org/pdf/pdf.

8. Bhaisajya Ratnawali 12/30

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