Introduction

INTRODUCTION :

All Ayurvedic Samhitas has given a detailed account for Sutika. The woman is called Sutika who has just given birth to a baby and after Aparapatna1.Sutika-kala means Puerperium. Puerperium is the period following childbirth during which the body tissues, specially the pelvic organs revert back approximately to pre-pregnant state both anatomically and physiologically.Except Acharya Charaka all other classics has given a definite period for specific diet and regimen management of Sutika. Acharya Sushruta and Vagbhatas said that of one-n-half month,some said that till reappearance of menstruation,four months or six months.Different procedures followed in Sutika-kala,including Aahara and Aachar for the purpose of Punar-naveekarna of Stree in SutikaParicharya.

       There are amples of changes occuring in Garbhavastha and Prasavastha.The Doshas,Kleda, Raktastrav, Dhatukshayta and Shunyata of her body after stage of Sukha-Prasava makes SutikaAbala and more prone to Vata-prakopakAvastha. In ancient days females used to follow strict guidelines during early postpartum days which helps them early recovery but in modern era due to changing lifestyle,MithyaAahar and Vihar,Sutika is more prone to Vataprakopa. Hence Sutika needs a specific management due to loss of her Dhatu during labour as well as aggravation of Vata due to exhaustion and DhatuKshay.

It is a clinical study, where patients in Sutika-Avastha taken having anatomically and physiologically changes occuring in body.All Sutika’s had same diet,oral Snehan,local Swedan,Yonidhupan,Pattabandana,use of boiled water2.

AIM & OBJECTIVES: -

AIM: -

To study the effect of Nirgundyadi Kwath and Dashmool Kwath in Sutika Avastha.

OBJECTIVES: -

1. To study and understand Sutika-avastha in details with Ayurvedic and modern references.
2. To assess the effect of Nirgundyadi Kwath in Sutika-kala.
3. To assess the effect of Dashmool Kwath in Sutika-kala .
4. To study the comparative effect of Nirgundyadi Kwath and Dashmool Kwath in Sutika-kala.

REVIEW OF LITERATURE: -

All the references of Sutika and its drugs  studied from

1. Ancient Granthas of Ayurveda.
2. Modern Textbooks of Obstertics.

MATERIAL & METHODS: -

Randomly selected 60 patients of Sutika Avastha attending the O.P.D and I.P.D department of Streeroga avum Prasutitantra were included in study and divided into 2 groups.

Group A and Group B:

All the patients fulfilling inclusion and exclusion criteria were selected with fully informed consent.

Group -A- Total 30 patients were given Nirgundyadi Kwath for21 days and 3 follow up were taken.

Group-B- Total 30 patients were given Dashmool Kwath for 21 days and 3 follow up were  taken.

Drug Introduction :-

Drug Preparation:

Good qualities of raw material were collected from genuine sources and standardization of drugs was done in an authentic lab. Drug was prepared at Rasashala of our college.

Method of Collection of Data: -

            Patients delivered in Prasutitantra Avum Streerog department of our hospital and pts in OPD come on first day of Sutika(PNC). After through Physical examination and Obstetrical history,patients with FTND were included.60 patients were included in study.

SELECTION CRITERIA

BASELINE ASSESSMENT :-

            This included a detailed history including family history, personal history, obstetric history etc. Clinical examination including all Stroto-pariksha, Ashtavidh-pariksha and Artavahastrotas-pariksha were carried out.

INCLUSION CRITERIA :-

1. Age group between 20-40 years.
2. Delivered by Prakrut Prasava.

EXCLUSION CRITERIA :-

1. Delivered by CS
2. PPH/perineal third degree tear
3. Peurpural shock/IUD
4. Sutika with history of HIV/any infection( systemic or local infection).

SUBJECTIVE CRITERIA :-

1. Agni
2. Udar-shool
3. Kati-shool
4. Malavshtambha
5. StanyaPravartana

OBJECTIVE CRITERIA :-

1. Garbhashay Rrhas (Measurement of involution of uterus in relation of pubic symphysis in cms)
2. Yonigat Raktastrav Lochia (pad used and colour of flow)

ASSESSMENT CRITERIA :- GRADATION OF SYMPTOMS AGNI

UDARSHOOL :-

KATISHOOL

MALAVSHTAMBHA

STANYAPRAVARTANA

GARBHASHAYRRHASA (Involution of uterus in cm from pubis symphysis)

It was assessed clinically by noting the height of fundus in relation to pubic symphysis. Measurement was taken carefully at fixed time everyday. Bladder emptied before hand. Uterus was centralized and with measuring tape fundal height was measured above pubic symphysis. Following delivery fundus lies about 13.5cm above the pubis. During first 24 hrs the level remains constant there after, there is steady decrease in height by 1.25 cm in 24 hrs.

YONIGATRAKTASTRAV (Lochia flow and colour)

Sterile pads  of size 28x7x3 cm were provided to patient.

1 pad soaked = 40ml blood

Withdrawal  criteria: -

• Patients willing to discontinue trial.
• Patients absent for follow up.
• Patients develop any allergic condition.

INVESTIGATION: - as  needed

• CBC,BT,CT.
• Urine<RM
• USG pelvis

ADVERSE DRUG REACTION: -Patients were instructed to report adverse drug reaction if any and they were given suitable treatment.

FOLLOW UP: -Every 7 Days.

Discussion

In Group A, Nirgundyadi Kwath showed significant results. It has shown good results in increasing the appetite of the Sutika, increasing and establishing adequate lactation, healing of Vitapa Chheda Vrana when compared to Group B. In Group B, Dashamool Kwath showed significant results in the parameters like Katishula, Udarshula, regularizing the bowel and micturition habits, normalizing Lochial discharge, Nidra, involution of uterus when compared to group A.

Conclusion

The kwath given in both the groups, showed significant and satisfying results in most of the parameters during assessment. Overall, there are encouraging results of administration of kwath of each of the groups and can be advised in Sutika Paricharya with great confidence.