MODERN & AYURVEDA PERSPECTIVE OF SICKLE CELL ANAEMIA


Prof. Dr. S. N. Ohja

 

 

 

 

MODERN & AYURVEDA PERSPECTIVE OF SICKLE CELL ANAEMIA

Prof. S . N. Ojha (M.D.(Ayu.) Ph.D.)

Principal,

Pad. Dr. D. Y. Patil College of Ayurved  & Research Centre, Pimpri, Pune


Introduction

Sickle cell disease, or sickle – cell anaemia (or  drepanocytosis), is a genetic life-long blood disorder characterized by RBC that assume an abnormal, rigid, sickle shape.  Sickling decreases the cells flexibility and results in a risk of various complications. Life expectancy is shortened, average life expectancy of 42, & 48 years for males & females respectively.

Prevalence

Sickle cell disease, occurs more commonly in people from parts of tropical & subtropical regions where malaria is or was common. The clinical manifestations of sickle cell anaemia in India is seen to be milder than in Africa & Jamaica. Sickle cell trait or carrier state occurs in 10-30% of many predominantly tribal population throughout central India. Chhattisgarh is newly created state of central India belonging mostly to tribal & backward classes where malaria is endemic in many pockets of state, a large population is sufferring from Sickle Cell Disease. 15% of population of Chhattisgarh being Sickle trait (AS) and 1.27% Sickle cell anaemia.

Signs & Symptoms

Fatigue, Anaemia, Pain, Dactylitis (swelling & inflammation of the hands and / or feet) Arthritis, Acute Chest Syndrome (Fever, chest pain, difficulty in breathing and, pulmonary infiltrate on chest X-ray), Bacterial Infections, Splenic sequestration, Hemolytic crisis, Liver congestion, In Sickle cell trait which is always asymptomatic, manifest as the renal concentrating defect presenting with isosthenuria.

Ayurvedic Perspective

Sickle cell disease can be compared with pandu vyadhi in ayurved. To understand the ayurvedic perspective of sickle cell disease we have to understand:-

Normal rakta utpatti, Hetu, Lakshana, Samprapti, Chikitsa Sidhant, Chikitsa  Dravya

NORMAL RAKTH UTPATTI

 

Shudha raktha utpatti

Shudha raktha utpatti

 

Samprapthi


Hetu

Aetiological factors.

-Indulging in excessive intake of

Salt (athi lavana), Alkali ( Kshar )

Habitual intake of

Horse gram (kulatha), Black gram (mas ha), Legumes (nishpava),

Sesame oil (tila taila), Tubers (pindaalu),

Salads specially of  ( moolak)etc,

Animal flesh of aquatic (jalaj) and of marshy (aanup) origin,

Meat of animals living in holes (),

Meat of animals which snatch their food ()

-Excessive intake of

sour curd(),  vinegar ()

and other sour fermented liquids.

-Use of opposite qualities like milk products and non-veg () stale (), decomposed food items.

-Habitual day time sleeping after meals which are having qualities like unctuous, heavy to digest and liquid/fluid dominated meals.

-excessive intake of food,

excessive anger, exposure to sunlight and excessive direct wind.

-Suppressing urge of vomiting, avoiding bloodletting in specific period.

-Too much exertion, injury, indigestion, ingestion of food although there is prior indigestion, excessive meal, even though preceded.

-Naturally in the autumn.

Beej Dosh

यस्य यस्य ह्यवयवस्य बीजे बीजभागे वा दोषः प्रकोपमापद्यन्ते

तं तमवयवं विक्रुतिराविशाती

च शा ४!३०


बीजे इति कृत्स्न एवाराम्भके बीजे ! बीजभागे वेत्यवयवबीजस्य एकदेशे

चक्र च शा ४! ३०

यस्य यस्य ह्यवयवस्य बीजे बीजभागे वा दोषः प्रकोपमापद्यन्ते

तं तमवयवं विक्रुतिराविशाती

च. शा ४ l ३०


बीजे इति कृत्स्न एवाराम्भके बीजे ! बीजभागे वेत्यवयवबीजस्य एकदेशे

चक्र . च .शा ४ l ३०

CHIKITSA SIDHANTH


CHIKITSA DRAVYA

Amalaki,      Yashtimadhu,      Kutki,     Barangi,

Manjista,     Haridra,    Bakuchi,    Lodhra,    Lasuna,

Devadaru,     padma kashta,     raal,     usher,

jatamansi,     musta,     grandhiparni,     Nilika,     guduchi,

gambhari fala,      patala,      agnimantha,        sthuneyak,

laamanjak,      mashaparni,      vasa,      mahanimba,      madhusringi,

karpas patra,      vansha,      darbha,      sharpunkha,

duralabha,      mundi,       punarnava,

bringaraj,       bhramhi,      shringatak

CHIKITSA KALPA

Dadimadi ghruta,

Draksha Gruta,

taapyadi loha,

navayas loha,

dhatri avaleha,

mandoor vataka,

gomutra haritaki,

punarnava mandoor,

shilajit vataka,

guduchi swaras,

shatavaryadi gruta,

vasa gruta.

Diet in Sickle Cell Anaemia

A nutritional involvement in sickle cell anaemia has precedance in reports that this genetic disease is associated with high folic acid requirements.

Cyanate which inhibits sickling of RBC is formed as a product of the oxidation of thiocyanate. Hence thiocyanate may also be expected to possess anti-sickling value.

Diet containing thiocyanate – Cabbage – iRrkdksch] Cauliflower xksch, Raddish eqyh,

Turnip, Rapeseed (Mustard); Eggs of hen feed on Rapeseed meal has shown to be containing thiocyanate.

Nicosan a phytochemical useful in sickle cell anaemia is present in Sorghum bicolor (Jowar), Eugenia caryophyllum (Cloves), Pterocarpus osum, Piper guineenses.

Nitrilosides another phytochemical is present Sweet Potato, Spinach (Palak), Mung, Bamboo sprouts, Lentils (Masoor), Cassava, Black beans, Apple seeds, Blackberry, Eucalyptus leaves (Nilgiri), Millets

How can Sickle Cell Anemia Be Prevented?

You can’t prevent sickle cell anaemia because its an inherited disease. However you can take steps to reduce its complication

If you have sickle cell anaemia its important to

a)      Adopt or maintain a healthy lifestyle

b)      Take steps to prevent & control complication

c)      Learn way to cope with pain

Adopt / maintain healthy lifestyle

Follow healthy eating plan ie folic acid every day; 8 glasses of water which will help prevent dehydration. Regular physical activity to stay healthy (prevent over exercise). Enough sleep & rest Avoid smoking.

Prevent & Control Complication

Avoid decongestants such as pseudoephedrine. Avoid extreme heat or cold. Do not climb high altitudes without extra oxygen. Reduce stress. Avoid physical labor Vaccines to prevent infection. Regular hematological and medical checkups are compulsory. Learn sign & symptoms of major complications

Scope of future study

Role of shodhan before conception

Role of Raktabasti in sickle cell anaemia

Study of prevalence of sickle cell anaemia in doshaja prakruti and blood group.

Phytochemical study of drugs which are raktaprasadak and also acting on sarakta-meda in relation with sickle cell anaemia.

2 responses to this post.

  1. Dear Dr. Ojha , Congratulations for working on sickle cell anemia . I wish you all the best.

    Reply

  2. Posted by Dr Sachin G. Khedikar on March 13, 2012 at 11:24 pm

    Very nice article

    Reply

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