OBSERVATIONAL STUDY TO ASSESS THE STATUS OF OJUS IN ASTHMA INDIVIDUALS

1. PG Scholar, Department of Kriya Sareera, GAVC Kannur, Kerala, India. 2. Assistant professor ,Department of Kriya sareera, Govt Ayurveda College, Kannur, kerala, India. 3. Associate professor, Department of Kriya Sareera, Govt Ayurveda college, Kannur, Kerala, India. ...................................................................................................................... Manuscript Info Abstract ......................... ........................................................................ Manuscript History Received: 14 February 2020 Final Accepted: 16 March 2020 Published: April 2020


ISSN: 2320-5407
Int. J. Adv. Res. 8(04), 693-701 694 infections and changes in diet. There is a wide variability in the geographical prevalence of asthma, with the highest rates observed in New Zealand, Australia and the UK, and the lowest in countries such as China and Malaysia.

Pathophysiology:
Asthma is multifactorialin origin, arising from the interaction of both genetic and environmental factors. Airway inflammation characterising asthma occurs when genetically susceptible are exposed to environmental factors, but the exact processes may vary from patient to patient, the timing, intensity and mode of exposure to aero-allergens are important environmental factors which stimulate the production of IgE.

Genetic susceptibility:
It has long been known that asthma and atopy run in families.Asthma which begins in childhood generally occurs in atopic individuals who produce significant amounts of IgE on exposure to small amounts of common antigens. This contrasts with those patients who develop asthma in adult life and who are non atopic, so called intrinsic or late onset asthma, first degree relatives of asthmatic patients have a higher prevalence of asthma when compared to relatives of non asthmatic patients. Atopic individuals demonstrate positive reactions to antigens delivered in skin prick tests and have a higher prevalence of asthma, allergic rhinitis , urticarial and eczema. Several potential gene linkages (eg; chromosome to asthma and atopy have been suggested; however, the genetic contribution to asthma remains poorly defined. It possibly involves polygenic inheritance with several genes contributing to the asthmatic tendency in any one individual, and genetic heterogeneity where different combinations of genes lead to asthma in different individuals.

Environmental factors: Indoor:
Indoor environment is a particularly important cause of asthma in children since allergen exposure early in life appears to be important in determining sensitisation. House dust mites abount in carpets, soft furnishings and bedding , and pet derived allergens are wide spread in houses where dogs or cats are kept. Other allergens of relevance are fungal spores and cockroach antigens. Pollutants such as nitrogen dioxide are found in higher concentrations indoors than outside as a result of gas cookers. Sulphur dioxide and particulate pollutants are released from open fires. Passive exposure to cigarette smoke immediately following birth increases the risk of developing asthma.

Outdoor:
Nitrogen dioxide , ozone, sulphur dioxide and airborn particulates exacerbate asthma symptoms. Work; many agents encountered in the work place may induce occupational asthma, eg.isocyanates, epoxy resins and wood dust.

Drugs:
Beta blockers can induce bronchoconstriction even when administered in the form of eye drops.Hence beta blockers should be avoided in patients with asthma or COPD.

Infections:
Many viral and bacterial infections of the respiratory system produce a transient increase in airway responsiveness in asthmatic patients. Viruses in particular are an important cause of asthma exacerbations.

Smoking:
Smoking during pregnancy is thought to increase the risk of developing atopic disease in infancy and passive exposure to smoking has an adverse effect on asthma and other respiratory diseases.

Anxiety and psychosocial factors:
Any cause of severe anxiety or stress can exacerbate asthma, and acute emotion may provoke an acute attack, but there is no evidence that asthmatics are primarily psychologically disturbed.

Clinical features:
Typical symptoms of asthma comprise wheeze, breathlessness, cough and a sensation of chest tightness. These symptoms may occur for the first time at any age, and may be episodic or persistant. Patients with episodic asthma are usullay asymptomatic between exacerbations, which occur during viral respiratory tract infections or after 695 exposure to allergens .this pattern of asthma is commonly seen in children or young adults who are atopic. In other patients the clinical pattern is of persistant asthma with chronic wheeze and breathlessness. This may sometimes make it difficult to distinguish from wheeze due to COPD or more unusual causes, eg. Cardiac failure . This pattern is more common in older patients with adult onset asthma who are non atopic and typifies intrinsic asthma. The variable nature of symptoms is a characteristic feature. Typically, there is a diurnal pattern with symptoms and peak expiratory flow measurement being worse in the early morning . Symptoms such as cough and wheeze often disturb sleep and the term` nocturnal asthma `emphasises this. Cough may be the dominant symptom and the lack of wheeze or breathlessness may lead to a delay in making the diagnosis of so called `cough variant asthma`. Symptoms may be specifically provoked by exercise. (exerciseindused asthma). All of these descriptive clinical terms are useful in emphasising the characteristic features of asthma particular to each patient and highlight the fact that asthma is not a uniform static disease but a broad dynamic syndrome.

Acute severe asthma:
This term has replaced status asthmaticus as a description of life threatening attacks of asthma. Patients are usually extremely distressed, using accessory muscles of respiration, are hyperinflated and tachypnoeic. Respiratory symptoms are accompanied by tachycardia, pulsusparaoxus and sweating. In very severe asthma central cyanosis occurs and airflow may have become so restrictive that rhonchi are no longer produced. The presence of a silent chest and bradycardia in such patients is an ominous sign.

Ojus:
The one which dwells in the heart and is predominantly white, yellowish and reddish in colour is known as ojus of the body; if the ojus is destroyed , the human beings will also perish. The form in which the theojus is produced in the body of the human beings for the first time is of the colour of ghee; in taste it is like that of honey, in smell it is like that of fried paddy, as the bees collect honey from the fruits and flowers , so the ojus it maintains the body of human being by virtue of its properties and actions.

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The ojus of superior quality is only of eight drops in quantity. The other type of ojus on the other hand is half an Anjali in quantity. This is the quantity of the slaismika type of ojus of sarira.
The ojus is of two types-the superior type and the other ordinary type, heart is the dwelling place for the superior type of ojus. The vessels attached to the heart are the site of other ordinary type. Heart is the dwelling place for the superior type of ojus. The vessels attached to the heart are the site of other ordinary type of ojus. As regards the first category of ojus,its volume is fixed. Any diminution in the volumes would amount to instantaneous death, diminution is however, possible in other type of ojus as it happens in the case of diabetes mellitus. synonyms:deepthi, avasthamba, prakasa, bala,tejus, sarvadhatutejus,kapha,bala,sleshma,rasa,rakta

Properties of ojus:
Aparaojus is also known as slaishmikaojus and it is considered as somatmakam denoting the predominance of Ap and Prthwimahabhootas.
According to susrutamsootram the colour of ojus is suklavarna .Dalhana opines that the colour of ojus is atisweda. According to charakamsootram , the colour of ojus is similar to that of ghee. He also opines that ojus has a red with slight yellow colour. As per Ashtanga sangraham and Ashtanga Hridayam sootram, ojus is a clear substance with a tinge of red and yellow colour.
Dalhana comments on Acharya charakas opinion that by the term` sukla ``suddha` is intended here. When ojus is understood in the context of `sukramoja`, it cannot be seen as a separate entity from sukra. Sukra is understood to be the sneha of rasadidhatus and ojus is a part of sukra. The existence of ojus and sukra is close that it is like ghruta and ksheera. Sukra is said to have the colour of taila and kshoudra and thus the colour of ojus as rakta and ishat pita can be justified. Kasyapa mentioned the colour of ojus as syava. As per charakamsootram, ojus smells like laja. According to charakamsootram, ojus tastes like madhu(honey) iemadhura with slight kashaya rasa. While describing the gunas of ojus, charaka states that it is madhura.
Signs and symptoms of diminution of ojus is the fear,complex, constant weakness,worry, affliction of sense organs with pain, loss of complexion, cheerlessness,roughness and emaciation.

Materials and Methods:-
Spirometric values, ojus assessing tool. Spirometric values are FVC, FEV, PEF,Vmax25, Vmax50, Vmax75. Ojus assessment tool: The tool was developed in the form of a structured close ended questionnaire. The questionnaire has 37 questions measuring 18 variables under 3 domains and 7 subdomains . Tool for the assessment of status of ojus is analysed in an objective way,grading from from high score to low score is possible. Score 0 to 30 considered as avaraojus and 31 to 60 considered as madyamaojus and above 60 considered as pravaraojus. Any score less than 30% are likely to have problems pointing towards severe ojakshayam.

Observation and Analysis:-
In this study out of 15 subjects 40% are males and 60% are females. Out of this moderate asthmatic subjects are 73.3% and severe asthmatic subjects are 26.7%. In this study found that avaramojus is 40% and madyamaojus is 60%.

Result:-
Between score of ojus and FVC was assessed using spearman correlation coefficient is 0.368 and the level of significance was found to be 0.08. Between score of ojus and FEV was assessed using spearmane`s correlation coefficient is 0.594 and significant at 0.01 level. Between score of ojus and PEFspearman correlation coefficient is 0.698 and significant at 0.01 level. Between score of ojus and Vmax was analysed using spearman correlation coefficient 0.640 and the level of significance was found to be 0.01. Between ojus score and status of asthma was assessed using spearman correlation coefficient -0.595 and level of significance was found to be 0.01.   .005 . N 15 15 **. Correlation is significant at the 0.01 level (1-tailed).