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Conclusion CONCLUSION At the end of the study following conclusions can be drawn on the basis of observations, achieved result and discussion. 1. Amavata is a disease which is not stated in Brihattrayee as a separate chapter form, but it is somewhat mentioned in vata vyadhi chapter (In both charak & shusruta) in a hidden form with a clear cut clinical feature. In 7th A.D. Acharya Madhava added some new clinical feature to it only & gave a vivid description. 2. Amavata in modern medical science, clearly resembles with RA. This comparison is almost undoubtful, but including RA, some other diseases in modern medical science also comes under the Amavata in Ayurveda. An exact comparision of Amavata with RA is still a matter of resoning in Ayurvedic field. 3. The peak age, for the disease Amavata, was found to be third and 5th decade of life but it can occur at early age / 6th decade also. 4. Observation of this study support the previously established fact of prevalent ratio of disease in female and male i.e., 3:1 5. Amavata is chronic in nature and has insidious onset. It may aggravate within a very short time period. 6. Predominance of vata, kapha & mandagni along with tridosha dusti was found to play an important role. Maximum doshanubandha found as vata & kapha in this study sample. 7. Mandagni produces the Ama which disturbs the normal state of bodily elements (Dosha, Dushya etc). All the 5 types of vata play a major role in the disease process. 8. Maximum number of patients in the study sample were having Madhya kostha (55%) and krura kostha (37.5%) which shows the disturbance kapha & vata dosha. 9. From the dashavidha rogi pareeksha – it is conclude that – most patients in the study sample were with madhya sara, samhanana, pramana having predominance of vata kapha prakriti, avara vyayama shakti & ahara shakti, irregular dietary patter & bowel habit. 10. The maximum joints involved in Amavata is knee, wrist joint, followed by PIPJs & elbow joint. Since Sandhis are the sthanas of Shleshma Dosha, any joint of the body can be involved in Amavata. (All joints involvement are not mainly calculated in RA) 213 Conclusion 11. Presence of Rheumatoid factor does not help in diagnosis of RA rather than it helps to consider prognosis. 12. All three groups proved their efficacy in reducing the cardinal signs and symptoms, but C-group showed better results than B-group and B group better results than A- group. A group showed a significant result on Ama lakshana also but to a lesser extent, than other two group therapy. 13. In the features of Amavata, Sandhiraga is not found frequently in patients of both the groups. One of the symptom ‘Jvara’ also not frequently associated. Most of the patients were having the symptoms without ‘Jvara’ which also similar to the textual reference. (S.N.) 14. Shodhan with Shaman therapy found effective on the all parameters where as Shaman therapy did not shown better improvement . 15. Shodhan with Shaman therapies proved its efficacy on amelioration of vata and kapha dosha, similarly only Shaman therapy found relatively less effective on Dosha dusti lakshana. 16. Regarding the Nidana sevana – it is found that guru, shita, abhishyandi, ahara, vishamashana, diva swapna, nischestata, bhojanattara vyayama chinta, shoka are the most atiological aggravative factors of the disease Amavata. 17. Comparison of overall effect observed in patients of three groups showed that Group C offer better result though Group B and B group better results than A- group; also proved its efficacy in alleviating symptomatology of Amavata but to a very lesser extent. 18. Finally it can be concluded that the Drug taken for the trial (Rasonadi Kwatha, Shiva Guggul, Amrit manjari rasa with Vaitaran Vasti) was found very effective in alleviating the symptoms of Amavata and also restricting the further disease progress when used after proper sharira / kostha suddhi. 19. Anupana helps the drug to act in its proper way. It adds synergetic results to the aushadha guna. So in the trial drug, Sunthi siddha Godugdha as Anupana found very effective, as Sunthi is the best Ama pachaka. Here the Anupana adds the extra result with the trial drug. This work was done by keeping in view all the caution. In spite of that, there may be the chance of bios in research and also in interpretation of concepts in appropriate way 214 Conclusion as the study sample contains a very small no. of patients. It may be hoped that, the reader of this dissertation would gain some additional aspects of knowledge giving up the errors/mistakes peeping in this dissertation. Current research in RA Following are examples of current research directions in rheumatoid arthritis supported by the Federal Government through the NIAMS and other parts of the NIH. Scientist are looking at the immune systems of people with rheumatoid arthritis and in some animal models of the disease to understand why and how the disease develops. For example, small studies are looking at the role of T cells, which play an important role in immunity and in the progression of rheumatoid arthritis. Findings from these studies may lead to precise, targeted therapies that could stop the inflammatory process in its earliest stages. They may even lead to a vaccine that could prevent rheumatoid arthritis. Researcher are studying genetic factors that predispose some people to developing rheumatoid arthritis, as well as factors connected with disease severity. For example, by studying genetically engineered mice, scientists supported by the NTH discovered that immune cells called mast cells play a key role in the development of rheumatoid arthritis. Findings from these studies should increase our understanding of the disease and will help develop new therapies, as well as guide treatment decisions. To help identify the multiple factors that predict disease course and outcomes in rheumatoid arthritis in African Americans, the NIH is supporting the Consortium for the Longitudinal Evaluations of African Americans with Early rheumatoid arthritis (CLEAR) Registry at the University of Alabama at Birmingham. This registry aims to collect clinical and x-ray data and DNA to help scientists analyze genetic and non genetic factors that predict disease course and outcomes of rheumatoid arthritis. Scientists are also unearthing the genetic basis of rheumatoid arthritis by studying rats with a condition that resembles rheumatoid arthritis in humans. NIAMS researchers have identified several genetic regions that affect arthritis susceptibility and severity in these animal models of the disease. These genetic regions are the potential to change damaged tissue in which they are placed. These and other advances will lead to an improved quality of life for people with rheumatoid arthritis. 215