Graduate Studies
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Item Timely intervention of Garbhani Paricharya to manage the increased tendency of pregnancy induced hypertension (PIH) (Garbhani Atiraktachapa)(Faculty of Graduate Studies, University of Kelaniya Sri Lanka, 2022) Perera, H. A. R. P.H. A. R. P.; Tharangani, W. A. S.; Attanayake, M. K. D. K.According to data, nearly one-third of the Sri Lankan adult population is hypertensive. Pregnancy induced hypertension (PIH) is one of the most common causes of both maternal and neonatal morbidity, affecting about 5-8% of pregnant women. According to Ayurveda, Athiraktachapa is a major complication (Teewra Upadrava) in gestational period. As per Ayurvedic view, Garbhani atiraktachapa is due to increased Vata and Pitta dosha and it involves Hridaya, Dasha dhamani, Sira, Ras raktvaha strotas, Manovaha strotas, Ras dhatu, Rakta dhatu and Mana as dushya. The risk of PIH for both mother and the fetus will be higher comparing with other major complications during pregnancy as it would result in placental abruption, stroke, intravascular blood coagulation, organ failures for mother and intrauterine growth retardation, premature delivery, intrauterine death for the fetus. The objective of this study was to estimate the increased tendency of PIH among pregnant women and to determine the timely intervention of Garbhani paricharya to manage this condition. In the methodology of this study, measured blood pressure levels of 446 pregnant women were collected during the first trimester of their pregnancy, who attended three antenatal clinics in Gampaha district as the subjective data and thereby tendency of PIH was determined in those pregnant women who attended the antenatal clinics from 2017 to 2021. Primary data regarding Garbhani Atiraktachapa and its prevention methods was collected from authentic books written in ancient times by Ayurveda authors. According to clinical data statistics, PIH percentages since 2017 to 2021 was 11.3%, 14.2%, 15.8%, 17.5% and 19.4% respectively which had shown that the tendency of PIH has been increased. Therefore, it could be suggested that timely intervention of Garbhani paricharya mentioned in Ayurveda classical texts should be recommended in which it has been prescribed the behavioral regimen and medicine to control the occurrence of PIH. As an example, the decoction of Gokshura (Tribulus terrestris Linn) can be recommended from sixth month of gestational period and analysis of the chemical constitutes of decoction of Gokshura confirms that it has several PIH reducing compounds including diuretic, absorption enhancing, cardiotonic, hepatoprotective, anti-inflammatory, analgesic activities. The contra-indicated factors mentioned in Ayurveda which are known as Garbhopaghatakara bhava are the main etiological aspects that can be identified to provoke PIH therefore correct guidance of Garbhani paricharya will be needed to prevent this condition rather than curing. PIH prevalence has been increasing yearly so as per Ayurvedic recommendations, taking the decoction of Gokshura and following other necessary behavioral regimens by a pregnant woman can be mentioned as a successful solution to PIH.Item Timely intervention of Garbhani Paricharya to manage the increased tendency of gestational diabetes mellitus (GDM) (Garbhani Madumeha)(Faculty of Graduate Studies, University of Kelaniya Sri Lanka, 2022) Perera, H. A. R. P.; Madugalle, S.; Tharangani, W. A. S.; Attanayake, M. K. D. K.There has been a marked increase in the prevalence of diabetes in Asia over recent years. Multi-ethnic studies have highlighted the increased risk of gestational diabetes mellitus among different Asian populations. Prevalence of gestational diabetes in Asian countries varies substantially according to the screening strategy and diagnostic criteria applied, and ranges from 1% - 20%, with evidence of an increasing trend over recent years. Diabetes prevalence (% of population ages 20 - 79) in Sri Lanka was reported as 11.3% in 2021, according to the World Bank collection of development indicators, compiled from officially recognized sources. Sri Lanka - Diabetes prevalence actual values, historical data, forecasts and projections were sourced from the World Bank in August of 2022. As per Ayurvedic view Garbha vruddhi can be co-related with GDM as it is a condition where the abdomen will be increase in size excessively with increased perspiration and therefore the labor also gets difficult. The objective of this study was to estimate the increased tendency of GDM among pregnant women and to determine the timely intervention of Garbhani paricharya. In the methodology of this study, the Oral Glucose Tolerance Test (OGTT) levels of 446 pregnant women were collected during the first trimester of their pregnancy, who attended three antenatal clinics in Gampaha district as the subjective data and thereby tendency of GDM was determined in those pregnant women who attended the antenatal clinics from 2017 to 2021. Primary data regarding Garbhani Madhumeha and its prevention methods was collected from authentic books written in ancient times by Ayurveda authors. According to clinical data statistics, GDM percentages since 2017 to 2021 were 31.6%, 34.5%, 45.9%, 47.8% and 49.2% respectively which had shown that the tendency of GDM has been increased. Therefore, it could be suggested that timely intervention of Garbhani paricharya mentioned in Ayurveda classical texts should be recommended in which the use of herbs as home remedies are indicated especially turmeric powder, bee honey, Attikka (Ficus racemose L.) etc. Scientific analysis of this compound revealed that bee honey helps in maintaining regularity in all internal functions of the body. Accordingly, it is confirmed that these remedies have the capability of preventing the occurrence of GDM and improving the normal functioning of the pancreas. Research papers explained that they have unique properties that help to minimize or prevent GDM. Attikka has been used in the treatments of diabetes due to its antidiabetic effect. Ayurveda recommends the use of the combination of turmeric powder with bee honey and as a special dietary supplement, to eat Attikka nuts with coconut. Research papers confirm that the chemical constitutes of Attikka act as hypoglycemic which can be used in the prevention of GDM. So, it is justifying to use these as home remedies to prevent GDM, which is currently on the rise and it is recommended that the primary health care has to be strengthened while the prevention, early diagnosis, and treatment of GDM to be given priority.Item The impact of the economic crisis on patient attendance at Pediatric Clinic of Gampaha Wickramarachchi Ayurveda Teaching Hospital – Yakkala(Faculty of Graduate Studies, University of Kelaniya Sri Lanka, 2022) Tharangani, W. A. S.; Wakkumbura, H. P.Sudden economic crisis followed by Covid-19 pandemic has affected almost all population while increasing the cost of basic and secondary needs. The Pediatric clinic of Gampaha Wickramarachchi Ayurveda Teaching Hospital - Yakkala (GWATH) could be identified as a leading clinic amongst Ayurveda and Western Pediatric clinics which serves in the management of a considerable population of pediatric diseases. Main objective of this study was to observe the prevalence of pediatric diseases during crisis situation based on patient attendance at pediatric clinic of GWATH. The secondary objectives were to identify which pediatric disease conditions have become more prominent during the crisis situation in Sri Lanka. Data was collected from the patients’ record book of Pediatric clinic, GWATH from January 2018 to July 2022. Percentages of patients’ attendance on each diagnosis with respect to the total patient count with respect to 2018 were compared to determine the prevalence of each disease. Based on the mean values (MV) of the patient count in each year, the total patient attendance was compared. The calculated MV of the total patient count in each year from 2018 to July 2022 (2018MV-26.7, 2019MV-28.8, 2020MV-12.0, 2021MV-7.7 and 2022MV-15.3) showed that the attendance of patients to the clinic has been decreased after the crisis situation compared with pre-crisis in 2018. Considering the total number of patients attended the clinic, it was identified that the prevalence of Ratha roga, Skin disease, Developmental delay and Immune thrombocytopenic purpura (ITP) have been increased compared to pre-crisis situation even though the total attendance has been reduced. In 2018, the prevalence of above-mentioned diseases was 4.6%, 3.3%, 6.2% and 0.0% respectively. And in the year 2022 by month of July it has been 7.6%, 7.3%, 11.6% and 5.8% respectively. ITP has become the most obvious disease condition from all the pediatric disease diagnosis. More than 80% of disease diagnosis is based on non-communicable diseases (NCD). With the increase of the patient count in 2022 compared to 2020 and 2021 it is interpreted that nevertheless the economic crisis or the pandemic, people are willing to attend the clinic for their major health conditions in seeking Ayurveda treatments. ITP has become a novel major pediatric complication compared with 2018 which makes it obvious that people are seeking Ayurveda treatments for NCDs rather than CDs.Item The impact of the current crisis on patient attendance at Gynecology Clinic of Gampaha Wickramarachchi Ayurveda Teaching Hospital – Yakkala(Faculty of Graduate Studies, University of Kelaniya Sri Lanka, 2022) Tharangani, W. A. S.; Wakkumbura, H. P.The sudden inflation of the country followed by the Covid-19 pandemic has affected almost all areas of the human life and it has been a burden for women seeking medical assistance for various diseases. The prevalence of gynecological disorders including subfertility, polycystic ovarian syndrome, fibroid and menstrual problems like endometriosis, irregular menstruation, amenorrhea have been increased in the present society and which is reflected by increased attendance for the Gynecology clinic of Gampaha Wickramarachchi Ayurveda Teaching Hospital - Yakkala (GWATH). The distinctive changes of the dietary and lifestyle patterns along with environmental factors could be considered as primary elements triggering these ailments. Apart from those causes, current economic and pandemic situation in the country have negatively affected not only for physical but also for psychological health of women. The main objective of this study was to identify the impact of economic crisis followed by Covid-19 pandemic on the prevalence of the gynecological disorders. Data was collected from the patients’ record book of Gynecology clinic, GWATH from January 2018 to July 2022. Comparing the patients’ attendance on each diagnosis which was taken as a percentage with respect to the total patient count in 2018, prevalence was decided and depending on that the impact of the crisis situation was inquired. Mean values (MV) of the patient count in each year was considered to compare the total attendance of the patients. The calculated MV of the total patient count in each year from January 2018 to July 2022 (2018MV-177.5, 2019MV-152.1, 2020MV-61.5, 2021MV-40.7 and 2022MV until July-58.0) showed that the attendance of patients to the clinic has clearly been decreased compared with pre-crisis in 2018. Furthermore, it was an obvious finding that the prevalence of disease conditions like endometriosis (2018-15.8% and 2020-6.1%) and polycystic ovarian syndrome (2018-21.3% and 2020-9.4%) has been decreased. On the other hand, the prevalence of female subfertility (2018-5.7% and 2020-25.2%), irregular menstruation (2018-6.7% and 2020-14.7%) and male subfertility (2018-4.9% and 2020-7.0%) has noticeably increased even though the total attendance of the patients has been decreased. By the increased prevalence of the patient count for subfertility and irregular menstruation, it can be assumed that the crisis situation has impacted on the psychological health of the patients where increased stress can be considered as a major factor for increased incidence of those conditions. In addition, it is also concluded that insufficiency and higher cost of the western medicines during the crisis situation, people have opted for seeking Ayurveda medicines.