Study the Efficacy of Rodhradigana Vasti in the Management of Sthaulya (Overweight)

Background: Obesity (Sthaulya) has been one of the primary diseases of the modern period, with its changing lifestyles, climate, and eating habits. Everyone has become a victim of many diseases caused by poor eating habits, and obesity is just one of them. Obesity is the privilege of the new era of robots and materialistic devices. In 2008, the WHO assessed that 1.5 billion individuals, were overweight and more than 200 million men and almost 300 million women were fat. Objectives: To evaluate the effect of Rodhradigana Vasti in Sthaulya. Study Design: This was an open-labelled single-arm interventional clinical study. Methods: 15 patients of Sthaulya were registered from Panchakarma, and Rodhradigana Vasti was administered for 15 days. Statistical Analysis: The data were statistically analyzed using the Wilcoxon Signed Ranks Test for Subjective Parameter and paired t-test for Objective Parameter. Results: In this study, decreased weight, lipid profile and subjective parameters show positive finding after the intervention of Vasti. Conclusion: Rodhradigana Vasti is one of the best remedies for relieving Sthaulya. Original Research Article Parwe et al.; JPRI, 33(34B): 158-166, 2021; Article no.JPRI.70576 159


INTRODUCTION
Sthoulya (Obesity) has become a burning problem of the day caused by untraditional dietary habits. Obesity is considered a worldwide plague, expanding because of stationary ways of life and improved financial conditions [1]. World Health Organization (2016) stated that there are around 2 billion adults overweight; of those, 650 million are seen as impacted by robustness (BMI>30 kg/m2). That compares to (39% of men and 40% of women) of adults developed 18 or over who were overweight, with 13 % fat. The general inescapability of strength fundamentally expanded some place in the scope of 1975 and 2016. It is evaluated since, by far, most of the allout populace lives in countries where overweight and stoutness butchers a greater number of people than underweight [2].
Obesity is the closest therapeutic subject to Sthaulya in Ayurveda. Ayurveda defined eight varieties of 'Nindita Purusha,' out of which one is Atisthula. Atisthula is morbid obesity which is considered 40-50 BMI, and Super Obesity,i.e.more significant than 50 BMI. Adipose tissue/fat deposition in the body sections, such as the heart, abdomen, gluteal or thigh area, is caused by excessive high-calorie intake.
The periodical Shodhana has also proved its effectiveness, and Niruha Vasti is among the most effective and widely used therapies with a wide variety of therapeutic acts. Niruha Vasti eliminates Dosha (Humors) from the body and enhances the power of the body. And has Achintya Shakti (unpredictable effects). In this disorder, the excessive development of abnormal Meda Dhatu is clearly visualized. It has been shown that Kapha and Meda are the critical cause of the pathogenesis of Medoroga [3]. However, the first line of treatment is considered to limit the excess development of Kapha and Meda. There is a lot of research and treatment for controlling this condition, but no ideal cure for this issue has been identified. Even using conventional medicine, adverse results and longterm complications are usually seen, but in Ayurveda, obese people minimize their weight without any side effects. Lekhana Vasti is among the most crucialKarma listed by all the Acharyas for managing the Sthaulya Roga [4,5] To document and analyze this procedure for statistical interpretation, a present study entitled Effect of Rodhradi Gana Vastion Sthaulya was undertaken.

Selection of Patient
All the patient came from outdoor and indoor, which was recruited in the Panchakarma department. A total of 15 patients were registered in this study which is diagnosed with Sthaulya. According to their sign and symptoms.

Data Collection
Patients designated were completely analyzed by each subjective and objective parameter. A complete historywas taken, as well as a physical examination. Laboratory investigations was performed after following the inclusion and exclusion criteria.

Method of Administration
Poorvakarma: All the patients were asked to be in the hospital at or after 9 o'clock. Each patient advised mild Abhyanga and Swedanalocally just before the introduction of Vasti. The Abhyanga was done with simple TilaTaila, and Sweda was done only to the area below the ribs to the foot.

Materials for Therapeutic Intervention
For Niruha Vasti administration -Enema pot with soft rubber tubes at the end of the terminal.
For Anuvasana Vasti-Rubber Catheter and syringe was used.
Procedure: 100 grams of Rodhradigana Choorna added 1600 ml of water in a vessel kept on the gas and reduced to 1/2,i.e. 800ml, and used for the Vasti.  Til tail 30 ml

5.
TriphalaChurna 30 gm For Anuvasan Vasti We used tita tail 60 ml after food anuvasan was given

Preparation of Rodhradigana Niruha Vasti
The Different components of Rodhradigana Vastiare combined as follows.
Firstly, Madhu and Saindhava Lavanawere taken and mixed thoroughly with the aid of a wooden churner, and then Tila Tailawas gradually added and well mixed. No crystals of Lavanawere to be identified until Tailawas introduced. The Rodhradigana Kwath that is prepared both classically and freshly was added.
All ingredients are thoroughly combined, and special preparation is achieved without sediment deposition. It is performed by Sukhoshna, holding it over Ushnajala before the administration. (Vasti preparation was done as per Niruhavasti).

Pradhanakarma
The patient was advised to lie on the Panchakarmadroni in Vamaparshwa (left lateral position) pot be fitted with a soft rubber tube

Method of Assessment of Treatment
Both subjective and objective tests were conducted out before and after diagnosis in all cases. A separate rating has been provided for the subjective criteria of the evaluation, which include the following.

OBSERVATIONS AND RESULT
As per subjective parameters, patients had shown highly significant result in stana, udara, spik, chalatva, kshudrashwasa, dourbalya, swedadhikyata, atipipasa, atishuda and also a substantial reduction in remaining all symptoms of sthaulya with highly significant p-value (p<0.001).
As per Objective parameters like Weight, BMI, chest and abdomen circumference, total cholesterol, and Triglycerides had shown highly significant result. Therealso hadconsiderable variation in HDL, LDL and VLDL.

DISCUSSION
To contribute at least "squirrel service" to the medical field and, in turn, to the service of society, rational observation and useful discussion should be made for each research work. An attempt has been made to discuss the theories of both literary and clinical work.
Obesity is known as 'MedoRoga' in Ayurveda [8] and is characterized as the condition one where excess fat is retained in the body. If the Agni (digestive fire) is vitiated, the Ama (toxic substances) is produced in the body, leading to obesity [9].
Obesity is a state of an overabundance of fat tissue mass. Overweight alludes to an abundance of body weight that incorporates muscle, bone, fat, and water [10]. Obesityis an extreme medical issue that can prompt an early passing. Different clinical problems, including hypertension, heart issues, diabetes, rest apnea, sadness, and joint inflammation, have been connected with overweight. A grown-up who is 30% heavier than their optimal weight (controlled by standard clinical and protection information) is thought to be stout [11].   [16]. Ashoka by virtue of its Ttikta, Kashaya, Laghu, Ruksha, GunaKaphaghna in nature [17]. Related studies on obesity and assessment were reviewed [18][19][20]

CONCLUSION
The patients showed a marked difference in body circumferences, especially in abdominal girth and chest circumference. There was a relative improvement in subjective as well as objective criteria. It concluded that Rodhradi Gana Vasti has a highly significant effect on subjective and objective parameters of Sthaulya. After completing the study, that environmental factors play an essential role in preventing the disease.
A holistic approach required to tackle this multifactorial disease.

CONSENT
Informed consent was obtained from the patients before starting the intervention.

ETHICAL APPROVAL
As per international standard or university standard written ethical approval has been collected and preserved by the author(s).