TO STUDY THE CHANGES OF RED BLOOD CELLS IN PANDU

Not yet recruiting

Conditions: Aplastic and other anemias and other bone marrow failure syndromes. Ayurveda Condition: PANDUROGAH,

Registration Number: CTRI/2025/05/087664

Lead Sponsor: Shri NPA Govt Ayurved College Raipur

Brief Summary: v *Ayurveda* is a unique contribution of Indian wisdom in the field of medicine, which is based on eternal, philosophical and scientific background. This science deals with the knowledge of life or else longevity can be achieved through it, so it is called the Science of Life. In a healthy state, *tridosha*, *dhatu* and *mala* continue to perform their natural functions, hence they have been called the root cause of the body. *Vata, Pitta, Kapha* are the basic functional factors of the body and are responsible to sustain life in their homeostatic state. The function of the above three fundamental factors is varied and manifested by certain characteristics. The normalcy of the above three factors is termed as *Dhatusamya.* The implied term *dosha* is granted as *dhatu* in this state.

· Pandu has been described in detail in almost all the text of Ayurveda. The word Pandu has been derived from *Padi Nashne Dhatu* by adding *Ku* *Pratyaya* in it, meaning of which is always taken in sense of *Nashana*that is the **loss**. So by the above description there is **loss** of bodily lusture in *Pandu Roga.* The disease which is predominant in paleness all over the body is termed as *Pandu* *roga*. Acharya Charak has given the term *Vaivarnya* for *Pandu* *Roga*. According to *Acharya Sushruta*, the disease in which there is predominance of pallor   in the body and body parts, is called as *Pandu.**Vachaspatya* refers *Pandu* as the color of the patient resesmbles the color of the pollen grains of *ketki* flower *Pandanus odoratissimus*which is whitish yellow *pale*in appearance.

· *Pandu* *roga* has been described after *Grahani Dosha Chikitsa* by *Acharya Charaka* as aggravation of *Pitta* have predominant role in the causation of both the disease, thus *Pandu* *Roga* is a *Pitta* *Pradhan Tridoshaj Vyadhi*. Acharya Sushrut has mentioned it after *Hridroga* due to same *Sankhya, Samprapti* and *Chikitsa* of *Hridroga* like *Tikshna*, *Alpa*, *Katu*, etc may also cause the disease *Pandu*. Acharya Vagbhat described *Pandu Roga* after *Udara Roga* due to same *Doshaghnata*. While describing the pathological aspect of the diseases, *Dhatu Pradoshaja Vikaras* have been mentioned. Pandu is the disease of *Rasavaha Srotas* according to *Acharya Charaka* and *Acharya Vagbhatta* and *Raktavahasrotoviddha Lakshana and Rasadoshaja Vikara* as per *Maharshi Sushruta*.

Thus it is related with both important dhatus *Rasa* and *Rakta*, Principal function of both these *Dhatu* has been described as *Preenana* (providing nourishment) & *Jeevana* (life activity) *karma*. Also due to *Rakta kshaya* and *Ojo kshaya,* there is loss of lusture and radiance and patient becomes listless. Therefore, concising *Pandu Roga* on the basis of only one symptom i.e. loss/change in color of skin, doesn’t seem logical. Mainly five types of *Pandu* have been mentioned by the *Acharyas*- *Vataja Pandu, Pittaja Pandu, Kaphaja Pandu, Tridoshaja Pandu Sannipataja Pandu, Mridbhakshanajanya Pandu.*

*Acharya* *Sushruta* has not mentioned *Mridbhakshanjanya* *Pandu* as one of the type separately but has described it under *doshaj Pandu*, whereas *Acharya* *Harita* has mentioned eight types of *pandu* including *Kamala*, *Kumbhkamala*, and *Halimaka* along with the above five types.

The symptoms of Pandu as mentioned in Ayurvedic texts show similarities with the disease Anemia and hence can be co-related.

v There are number of definitions of Anaemia but the strict definition is an absolute decrease in RBC mass. To measure the RBC mass, the haematocrit or the haemoglobin in the blood is measured. Anaemia is typically diagnosed on complete blood count where RBC count, haemoglobin concentration, PCV, MCV, MCHC, are calculated and compared to the value adjusted for age and sex. Again, PBS study is done to see any abnormal RBC. Several schemes of classifications of anaemias have been proposed. Two of the widely accepted classifications are based on two criteria-

1 Pathophysiology of anaemia Anaemia due to blood loss, due to impaired red cell formation, due to increased red cell destruction

2 Morphological features in blood smear- Based on red cell size, haemoglobin content and red cell indices, anaemias are classified into three types-

a Microcytic, Hypochromic

b Normocytic, Normochromic

c Macrocytic, Normochromic

Most common form of anaemia, however, in the world, is due to nutritional deficiency of iron and Vitamin B12/folate, causing iron deficiency anaemia and megaloblastic anaemia respectively, together termed as nutritional anaemias.

**NEED OF STUDY**

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· National family health survey NFHS-5 reveals prevalence of anaemia to be 67.1 percent in children, among which 59.1 percent is seen in females age group between 15 to 19 years. Anaemia is seen in 52.2 percent of the pregnant women and 25 percent in adult men age group 15-49 years

·       The prevalence of anaemia in India is high, majorly due to poor diet, worm infestation, irregular and altered food habits, consuming bakery products, fast foods etc. and these causes have similarities with the causes of Pandu Roga like intake of incompatible food/allergic food *Asatmya* *Bhojanat*, intake of antagonistic food *Viruddha Bhojanat*.

·       Thus, the nearest correlation of *Pandu Roga* can be made with Anaemia*,* on the basis of causes, signs and symptoms.

·       Anaemia is often labelled as the silent killer and is a significant public health challenge in India.

·       In the clinical practice probably physician diagnose the patient as Anaemia by doing their haematological investigations and then usually advises Ayurvedic treatment of *Pandu* *roga* to the patient whereas different types of *pandu* *roga* have their specific line of treatment i.e. in *Vataj pandu- snehapradhan aushadhi,* in *Pittaj pandu- tiktarasa* and *sheeta veerya dravya,* in *Kaphaj pandu - katu, tikta, and ushna aushadhi,* in *Sannipataj pandu -vimishra aushadhi and in Mridbhakshan janya pandu- tikshna vaman virechana* should be advised to the patient.

·       Spontaneous diagnosis of specific type of *pandu* *roga* in general medical practice is difficult due to lack of standard diagnostic techniques in classics. So, this study will be done to observe, evaluate and to establish whether there is any change in the morphology of RBCs and if there is, then what kind of change in RBCs are mostly seen in patients with *Sannipataj* *Pandu* so that we can apply the specific treatment as mentioned.

·       There has been very least amount of work done taking *Sannipataj* *Pandu* into account, also there is no clear demarcation of *lakshanas* available in *Brihattrayi*, and as most of the patients in clinical practice presents with mixed symptoms of *doshaj* *pandu*, it   becomes very important to rule out *Sannipataj* *Pandu* as correct diagnosis by spontaneous lab investigatory methods. Hence the above topic **An observational study on Morphological changes of RBCs in *Sannipataj Pandu Roga*** has been taken.

Detailed Description: Not available

Recruitment & Eligibility

Status: Not Yet Recruiting

Sex: All

Target Recruitment: 110

Inclusion Criteria

Patient who are willing for the study Patient of either gender between the age group of 18 to 60 years Patient presenting with the common clinical features of Pandu Roga (mixed lakshanas of vataj, pittaj, kapahj pandu) as mentioned in Ayurvedic texts Blood sample showing Hb% between 6gm/dl to 10gm/dl Known cases of Thalassemia Known cases of Sickle cell anaemia.

Exclusion Criteria

Patient who are not willing for study.
Patient of age group below 18 years and above 60 years.
Ekdoshaj and MrittikaBhakshanJanya Pandu Roga Patient with Kamala, Kumbhkamla, Halimak, Panaki Patient with Pandu as Updrava.
Blood sample showing Hb% less than 6gm/dl Cardiovascular, Renal and Hepatic diseases.
Patients having Seropositive for HIV, HBsAg, HCV etc Anaemia due to Acute blood loss ,due to Malignancy, Tuberculosis Endocrinal and immunological disorders.
Pregnant and Lactating women.

Study & Design

Study Type: Observational

Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
In present context Sannipataj Pandu as described in classical ayurvedic texts can be correlated with a specific type of anaemia on the basis of morphology of RBCs.	12 months

Secondary Outcome Measures

Name	Time	Method

Trial Locations

Locations (1): Shri Khudadad Dungaji Govt Ayurved Hospital Raipur Chhattisgarh 492010 GE Road Raipur 492010
🇮🇳
Raipur, CHHATTISGARH, India
Shri Khudadad Dungaji Govt Ayurved Hospital Raipur Chhattisgarh 492010 GE Road Raipur 492010
🇮🇳Raipur, CHHATTISGARH, India
Dr Arpita Das
Principal investigator
07000047582
www.arpitaashok@gmail.com