A Clinical comparative study of Vasadi ghrita aschyotana with Carboxymethyl cellulose eye drops in the management of Arjuna w.s.r Subconjunctival hemorrhage

Eyes are the most precious gift of the god to the living beings. Good vision is crucial for social and intellectual development of person. So to protect this organ is not only a necessity but also a responsibility of every individual. India is having the highest rate of head injury in RTA in the world. Out of which 60% suffer from Subconjunctival hemorrhage. Subconjunctival hemorrhage or Ecchymosis is of very common occurrence. Subconjunctival hemorrhage” is a common benign condition of the eye that has characteristic features, such as the painless acute appearance of a sharply circumscribed redness of bleeding underneath the conjunctiva in the absence of discharge, and inflammation in contagious areas. While searching solution for Subconjunctival hemorrhage in ayurveda, its signs and symptoms match very much with Arjuna” described in “Shuklagata roga”. Which is having symptom painless red spot over white surface of eye. So taking these things into consideration “Vasadi Ghrita Aschyotana” was selected for treating the disease Arjuna. The ghrita contain “Vasa” and “Yashtimadhu” having pittashamaka, Shonitasthapan properties. 270 * Corresponding Author: Anand Vikram Kale Assistant Professor, Department of Shalakya Tantra, Dr. D Y Patil College of Ayurveda and Research Center, Pimpri, Pune 411018. India. Dr. D. Y. Patil Vidyapeeth, Pune (Deemed to be) Email Id: vdanandkale@gmail.com Anand Vikram Kale et.al., Study of Vasadi ghrita aschyotana and Carboxymethyl cellulose eye drops in Arjuna Published online in http://ijam.co.in ISSN No: 0976-5921 Secondary • To develop evidence-based support for the effects of Vasadi Ghrita Aschyotana as mentioned in our ancient literature. • To provide simple and effective treatment for Arjuna. Materials and Methods Drug information: Bhavprakash nighantu 1) Vasadi Ghrita Aschyotana –


Introduction
The eye, an organ of sight is of utmost importance as far as ones existence is concerned. Eyes hold special status among all the senses.
Eyes are the most precious gift of the god to the living beings. Good vision is crucial for social and intellectual development of person. So to protect this organ is not only a necessity but also a responsibility of every individual.
India is having the highest rate of head injury in Road traffic accident in the world. Out of which 60% are suffered from Subconjunctival hemorrhage. (1) Though Subconjunctival hemorrhage is not an medical emergency and a harmless condition, it can worry the patient. It often occurs without any obvious harm to eye, or it may be the result of strong sneeze or cough that causes break down of conjunctival blood vessels. While searching solution for Subconjunctival hemorrhage in ayurveda, its signs and symptoms match very much with Arjuna (2) described in Shuklagata roga. (3) Which is having symptom of painless red spot over white surface of eye.
The management of this condition is based on various measures in ayurveda like Aschyotana, Parisheka, Anjana etc carried out with the help of different medicinal plants according to demand with respect to the predominance of various etiological factors. But according to Acharya vagbhat, in every netra-rog Aschyotana " (7)" should be carried out first. Acharya also said that treatment of Arjuna is same as that of pittaj abhishyanda " (8)". So taking these things into consideration we decided to treat Arjuna by Vasadi Ghrita Aschyotana (4) method. The ghrita contain Vasa (5) and Yashtimadhu (6) having pittashamaka, Shonitasthapan properties.
According to modern science there is no specific treatment " (9)" for Subconjunctival hemorrhage. Carboxy methyl cellulose eye drops are used as placebo therapy. So I used it as a comparative group for the same study.

Aims and Objectives Aim
A Clinical comparative study of Vasadi ghrita aschyotana with Carboxymethyl cellulose eye drops in the management of Arjuna w.s.r Subconjunctival hemorrhage.

Abstract
Eyes are the most precious gift of the god to the living beings. Good vision is crucial for social and intellectual development of person. So to protect this organ is not only a necessity but also a responsibility of every individual. India is having the highest rate of head injury in RTA in the world. Out of which 60% suffer from Subconjunctival hemorrhage. Subconjunctival hemorrhage or Ecchymosis is of very common occurrence. Subconjunctival hemorrhage" is a common benign condition of the eye that has characteristic features, such as the painless acute appearance of a sharply circumscribed redness of bleeding underneath the conjunctiva in the absence of discharge, and inflammation in contagious areas. While searching solution for Subconjunctival hemorrhage in ayurveda, its signs and symptoms match very much with Arjuna" described in "Shuklagata roga". Which is having symptom painless red spot over white surface of eye. So taking these things into consideration "Vasadi Ghrita Aschyotana" was selected for treating the disease Arjuna. The ghrita contain "Vasa" and "Yashtimadhu" having pittashamaka, Shonitasthapan properties.

• To develop evidence-based support for the effects of
Vasadi Ghrita Aschyotana as mentioned in our ancient literature. • To provide simple and effective treatment for Arjuna.

Methods of drug preparation
Yashtimadhu roots and Vasa leaves were taken and washed thoroughly with water. then Ghrita siddhi done as per granthokta reference of Sharangadhara samhita madhyama khanda. " (11)".
Mixture of Vasa and Yashtimadhu , Ghrita and water mixed with proportion of 1: 4:16 respectively and heated till only the ghrita( ghee ) remains. Thus medicated ghrita( Ghee ) was prepared.

Method of selection of study subject A) Inclusion Criteria
• Age group-18yrs to 60yrs. •

Observations and Results
For this VASADI GHRITA ASCHYOTANA was used to one group of 30 patients of Arjuna for once. This group was termed as Trial group (Group A).
To compare the result of Vasadi Ghrita Aschyotana, a standard known drug was selected for that was applied to another group of 30 patients of Arjuna as Comparative group (Group B).

Discussion
The place where I have studied is known for its natural humid weather, added to this with the pollution due to heavy industrialization prone the individuals of this area to different types of eye diseases. Amongst which Subconjunctival hemorrhage or Ecchymosis is of very common occurrence. Also in modern science there is no specific treatment for Subconjunctival hemorrhage. Hence it was decided to start survey for Subconjunctival hemorrhage in the patients attending our Shalakya OPD.
In Ayurveda Arjuna is mentioned in Shuklagata roga.It is mainly Pitta Rakta dustijanya vyadhi. All acharya mentioned "VASA RAKTAPITTESHU" Agryam in their Samhitas. Vasa is useful in Sampraptibhanga of Subconjunctival hemorrhage due to its Kapha-Pittaghna properties & Yakritgamitva. Also Yashtimadhu has Sandhaniya, Shonitasthapana, 15 Pitta-Rakta Prashamana properties. So Aschyotana of Ghrita made with these two components were found to be beneficial in relieving the symptoms Burning of eyes, Swelling of eyes, Redness of eyes, Photophobia, foreign body sensation in eyes in these patients. On the other hand in 30 patients with comparative group Carboxy methyl cellulose eye drops showed only symptomatic relief in symptoms of Burning sensation of eyes, Photophobia.

Conclusion
The present clinical study has recorded encouraging results providing thought to ponder over the theory and practice of Kriyakalpa and drugs. A new horizon can be opened for the Arjuna by these treatments and further research should be carried out in this direction.
In nut shell we can say that • After statistical analysis and study, it is proved that better results found in group a i.e. Trial group than group B. i.e Comparative group. • No any adverse reactions were observed in patients of both groups. • The clinical research drugs are cheap, easily available and their preparation is easy. • The present study showed that Quick resolvation of subconjunctival hemorrhage is possible with Vasadi Ghrita in the period of study.