To Study the Shulaghna effect of Shatapushpa and Shatavari Siddha Taila Matra Basti in Management of Udavarta Yonivyapad W . S . R . to Dysmenorrhoea

Udavarta Yonivyapada is a disorder, with difficult menstruation, as a result of morbid vata dosha, which affects the women in their reproductive age. In mithyachara, the diet and mode of life which vitiate vata is to be considered. The diet which is ruksha, sheeta, shushka vitiates vata. Similarly they may lead to nutritional deficiency. In both groups patients having followed up of for 3 cycles it was observed that Matra basti of Shatpushpa Shatavari siddha tail reduces and cures the symptom Vedana significantly. Mann Whitney test applied to effect of therapy on symptoms of both groups was found highly significant, in Group-A as compared to Group-B except in Malavashtambha.It shows that, Shatpushpa Shatavari siddha tail acts effectively in Udavarta yonivyapada.


Introduction:
Today many women are suffering from sashul raja pravrutti. The severity of this pain is to such an extent that it interferes with their routine life and they are not able to do the routine work and have to take rest.
Raja pravrutti is regulated by Apana vayu since it plays a vital role in dharan and nishkraman of raja, vitiation of Apana vayu therefore leads to sashul raja pravrutti . (5) Udavarta yonivyapada is one of the yonivyapada where morbid vata obliterates the Artava and expel it with difficulty. Painful menstruation is the cardinal symptom in this condition and it is mostly seen that in common practise at around 50% to 60% of women suffer from this. It is considered as an extensive personal and public health problem for woman.
Basti karma and sanshodhan chikitsa have been described in granthas for Udavarta yonivyapada. . (5) Considering these factors an attempt has been made to study scientifically and statistically a formulation which comprehensively give relief to the symptom pain seen in Udavarta yonivyapada.

Aims and objectives
Aim:- Udavarta yonivyapadais considered as Sadhya if vata is controlled then the disease can be cured. (5) Chikitsa of Udavarta Yonivyapada:  To reduce pain -Pain relieving preparations.  To reduce rukshataand kharata-Oil preparation for external and internal use.  To bring Apana vayu in its normal gati -Mild Laxatives and Basti chikitsa is to be given. (5) Basti karma and sanshodhanchikitsa have been described in granthas for Udavarta yonivyapada. (6) Considering these factors an attempt has been made to study scientifically and statistically a formulation which comprehensively give relief to the symptom pain seen in Udavarta yonivyapada. The formulation selected is Shatpushpa Shatavarisiddha tail matra basti in Udavarta yonivyapada.

Dysmenorrhoea.
The Cardinal symptom is difficulty in expelling the raja. Although all Acharya's agree with this Charakahas mentioned the relief of symptom once the flow starts, which denotes the primary dysmenorrhoea.
Menstruation is a normal physiological process, if accompanied with pain is called as dysmenorrhoea. (9) Dysmenorrhoea refers to the chronic, cyclic pain or discomfort in the pelvic region during a menstrual period. (9) Dysmenorrhoea means painful menstruation and is classified as primary (from the onset of menstruation) or secondary (due to some physical cause and usually of later onset). (9) The uterus is a muscle. Like all muscles, it contracts and relaxes. Most uterine contractions are never noticed, but strong ones are painful. During strong contractions, the uterus may contract too strongly or too frequently, causing the blood supply to the uterus to be temporarily cut off. This deprives the muscle of oxygen, causing pain. This pain may be located in the abdomen or the back. (9) Who is at risk for Dysmenorrhoea. Severe (can't work, bed ridden) 3

Statistical Analysis:-
The statistical analysis of the effect of therapy on symptoms of Udavarta yonivyapada by Wilcoxon sign rank test and Mann Whitney test. (10) By applying Wilcoxon sign rank test on all the symptoms in both the groups, the P<0.001, means it is significant. By applying Mann -Whiteney test on all the symptoms while comparison, the P<0.001, means it is significant.
In the present study, according collected data, it is observed that both the drugs i.e.

Shatavari Shatpushpa Tail and Mefanamic
Acid have provided significant relief in the symptoms of Udavarta Yonivyapad. But Shatavari Shatpushpa Tail has provided relatively better relief than Mefanamic Acid in all symptoms of Udavarta Yonivyapad.

Discussion:-
Discussion is the important step which helps in understanding the subject and it guides to make a conclusion.
For the study of efficacy of Shatavari Shatpushpa siddha tail matra basti, in management of Udavarta yonivyapada, 60 patients were selected. They were examined, observed for the signs & symptoms. The results and observations after study were completed and are mentioned earlier and discussed as follows-

Mode of action of drug:
Drugs are Tridoshagnha and specially Vatagnha, it specifically acts on Vata dosha and are said to be best vatagnha dravya's. They also act as Artava Janan which cure the symptoms as vandyatva. It acts as vatanulomak cures vegavrodh and acts for raja strav.
Drug has Ushna veerya has Deepana, Pachan, Virechan and Vilayan property which softens and liquefies the morbid Vata dosha which are ultimately expelled out due to Anulomak karma.

Conclusion:
Udavarta Yonivyapada is a disorder, with difficult menstruation, as a result of morbid vata dosha, which affects the women in their reproductive age.
In mithyachara, the diet and mode of life which vitiate vata is to be considered. The diet which is ruksha, sheeta, shushka vitiates vata. Similarly they may lead to nutritional deficiency.
Anxiety, depression and lack of reproductive knowledge in puberty age are been associated with udavarta yonivyapada.
Stress and exertion which are the result of present life style, is the risk factor in udavarta yonivyapada.
Udavarta is a sadhya vyadhi. Vata is to be controlled in this with appropriate medicine.
The condition udavarta resembles the description of almost all types of dysmenorrhoea.
On the basis of the symptom of immediate relief of pain following discharge of menstrual blood, it appears to be nearer to spasmodic or true dysmenorrhoea.
In both groups patients having followed up of for 3 cycles it was observed that Matra basti of Shatpushpa Shatavari siddha tail reduces and cures the symptom Vedana significantly.
Psychological factors like stress, anxiety were observed as causative factors for udavarta yonivyapada. Percentage of udavarta yonivyapada was observed more in VataPittaja prakriti Unmarried, Nulliparous, Students &working women's.
Socio-economic status wise, religion wise, there was no significant conclusion drawn.
Mann Whitney test applied to effect of therapy on symptoms of both groups was found highly significant, in Group-A as compared to Group-B except in Malavashtambha.