Browsing by Author "Attanayake, M. K. D. K."

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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.
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.