“A STUDY ON AHARAJA AND VIHARAJA HETUS IN THE ETIOPATHOGENESIS OF VISWACHI TO CERVICAL RADICULOPATHY”

health Cervical Radiculopathy(radix=root) or Cervical spondylotic radiculopathy shows compression of a nerveroot which occurs when a disc prolapses laterally which is due to osteophytic encroachment of the intervertebral foramina presenting the features of neck pain that may radiate in the distribution of the affected nerve root can be paralleled with viswachi.


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Cervical Radiculopathy(radix=root) or Cervical spondylotic radiculopathy shows compression of a nerveroot which occurs when a disc prolapses laterally which is due to osteophytic encroachment of the intervertebral foramina presenting the features of neck pain that may radiate in the distribution of the affected nerve root can be paralleled with viswachi.
It is universally accepted that radicular symptoms in the arm usually indicate nerve root entrapment secondary to a paracervical disc protusion or in the older population to the foraminal bony hypertrophy. Nerve root pain may be very distressing and is often compatible with manual or office work for a variable period of time, depending upon the pathology. The present study of Viswachi is limited to the cervical spine lesions. The degenerative diseases of the cervical spine, Cervical radiculopathy is clinically correlated with Viswachi of vatavyadhi.
It is commonly seen in old age, but in present scenario also seen in young and middle aged people. The annual incidence of cervical radicular symptoms to be 83.2per 100000 populations and its prevalence is most significant between 50-54 yr age group.
It is most prevalent among the farmers and labor class who lift heavy objects, push or pull heavy objects, operate vibrating equipments, some occupational odd postures, such as tailors, drivers, daily wage workers etc who involve in strenuous activities. And today as a result of modernization the most common trend we witness in this busy world is : people often going for long drives in vehicles, working for long hours in front of computers, night outs in call centersetc, ultimately resulting with early or late victims of Viswachi(Cervical radiculopathy), one of the commonest cause of neck pain.

Materials and Methods:-
The present study entitled "A STUDY ON THE AHARAJA AND VIHARAJA HETUS IN THE ETIOPATHOGENESIS OF VISWACHI W.S.R TO CERVICAL RADICULOPATHY" was carried out with the following methodology.

Duration of the study:
Since this is an observational study, patients were kept under observation till the clinical and radiological evaluation is done.

Follow up:
Study did not require follow up as this is an observational study.
Investigations: X-Ray, Cervical spine AP and Lateral view. In the present study, maximum no. of patients above the age group of 36 were recorded and among them most of the patients i.e. 40% of the age group between 36-50yrs had Viswachi. This is because of prolonged strenuous work during their 2 nd and 3 rd decade might be the reason. 2. Sex: In the present study there were 35 male patients i.e. 70% and 15 female patient's i.e.30%. This is because of involvement of men in more strenuous physical activities and due to some occupational postures. 3. Religion: 50% of the patients were Hindu's, 30% were Muslim's, and 20% were Christian's. Predominance of Hindu religion in and around is reflected in this sample. The high incidence of illness in Hindus reflects the prevalence of causation of the disease. As this may be the representation of the community distribution in and around Bengaluru city. 4. Education: In the present study it was observed that most of the people had education up to primary school and graduates. However education has minimum role on the pattern of disease. 5. Socio economic status: In the present study 48% were from middle class family, 46% were from lower class family, and 6% were from upper class. This data suggests that, lifestyle of middle class people either in the form of heavy work or influence of their profession in causing the particular disease. 6. Occupation and nature of work: While considering the nature of occupation, it was observed that maximum i.e. 40% were labourers, 20% were house wives, and 30% were professionals. Heavy manual works and improper postures may lead to sthanika vataprakopa pain greeva and amsapradesha resulting in viswachi. Cervical radiculopathy is considered as an occupational hazard as most of the professionals become its victim due to their improper working pattern which has its effect on cervical spine. 7. Marital status: In present study 70% were married and 30% were unmarried. This is because the incidence occurs as an occupational hazard in middle and old age. 8. Duration of complaints: Maximum number of patients i.e. 40% had complaints more than >5yrs, 30% were <1yr and 30% were>5yrs. It indicates the chronicity of the disease. 9. Aggravating factor: In the present study 40% had weight lifting as an aggravating factor and 20% had bathing.

Results:-
Heavy manual works and improper postures may lead to sthanika vataprakopa pain greeva and amsapradesha resulting in viswachi. 10. Family history: 96% of patients didn't have any family history. Thus we can conclude that the role of family history is very minimal in manifestation of viswachi. 11. Desha: Majority of the patients i.e. 40% of them belonged to sadharanadesha and the maximum no. of patients visiting the hospital are from surrounding locality. Hence it is difficult to draw any conclusion out of it. Dashavidha Pariksha 1. Prakriti: It was assessed based on the major physical, psychological and behavioural features of the patient. In the present study it was observed that majority of the patients had vata-kaphaja prakriti i.e.46% and also vatapittaja prakriti i.e.40%. As the prakupita vata effect will be more seen in these patients who have dominance of vata in them. 2. Sara: Vishudhhatara dhatu is called sara (Ca.Vi.8/102-115). The obtained data supports the view mentioned in classics that madhyama and avara sara people are prone to diseases. In this study, 90% of the patients belonged to madhyama sara and 10% had avara sara. 902 3. Samhanana: Data pertaining to samhanana reveals that patients of viswachi were associated with medium physical constitution. In this study, 92% of them had madhyama samhanana which is due to continuous dhatukshaya causing vatavriddhi. 4. Satva: The psychological factors play a chief role in causing progression of discomfort as we know that chinta, shoka, bhaya etc manasikakarana leads to vataprakopa. Acharya Charaka has stated the people with madhayama and avara satva are prone more to diseases. The analysis of satva revealed that 70% patient's had madhyama satva. 5. Vyayama Shakti: In this present study, 52% patients had avara vyayama shakti and 36% had madhyama vyayama shakti. This clearly mentions that the pain and discomfort due to viswachi invariably decreases vyayama shakti in an individual.

Vishamashana
Among all the 50 patients, 80% of them did vishamashana. "Aprapta atitakalam tu bhuktam vishamashanam iti" refers to untimely and delayed consumption, should be considered which leads to vitiation of agni resulting into formation of ama. And it is explained that ama is one of the major factors in pathogenesis of many diseases and viswachi is one among them.

Adhyasana
Among all the 50 patients, 40% of them did adhyasana. "Bhuktasyoparibhuktam adhyasana " Taking food before the digestion of previous food decreases the secretion of digestive enzymes and disturbs digestion of food and produces ama, which in turn is a major causative factor in pathogenesis of many diseases and viswachi is one among them.

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Vishtambhi ahara Among all, 40% of patients consumed vishtambhi ahara like chapati, ragi ball, masura, mudga, adhaki and other varieties belonging to this group. These dravya possess kashaya and madhura rasa, katu vipaka, shita and laghu guna. Hence these vishtambhi foods lead to vibandha which is a cause for vata prakopa and in turn is a cause for manifestation of viswachi.

Truna dhanya
In this study among 50 patients, trunadhanya such as ragi was consumed by 70% patients and jowar by 30% patients. Ragi is kashaya and tikta rasa predominant, is laghu and shita virya where all its properties cause vata prakopa and similarly jowar is kashaya rasa predominant and shita virya aiding for vata prakopa which in turn is cause for manifestation of disease viswachi.

Ruksha ahara
In this study among 50 patients, ruksha ahara such as chapatti, jowar roti, ragi ball was consumed by 90% of patients. These foods are ruksha guna predominant. Ruksha guna is responsible for shoshana, katinatva, and rukshana actions. Ruksha guna is mainly related to vatadosha. It subsides kapha and aggravates vata in turn is a cause for manifestation of diseases like viswachi and other vatavikara.

Laghu guna ahara
In this study among 50 patients, laghu ahara such as pongal, white rice, salad (cabbage, onion, tomato) was consumed by 100% of patients. These food items are laghu in guna and it does kaphashamana and vata vardhana and hence cause vataprakopa in turn causing manifestation of viswachi.

Kashaya dravya
In this among 50 patients, kashayadravyas such as unripe banana, okra/bhindi, chick peas were consumed by 100% patients. Kashayarasa is kaphapittahara and vatakara. It is having properties like ruksha, sheeta, and laghu which are also shared by vata. Excessive consumption of sheetaguna leads to obstruction of srotas, hinders the movement of vataetc. The gunas like khara, vishada and ruksha produces diseases like viswachi and other vata vikara.

Katu dravya
In this study among 50 patients, katu dravyas such as chilly, onion, garlic, ginger, black pepper were consumed by 100% patients. Katu rasa dravya has vayu and agni mahabhuta dominance. It has laghu and rukshaguna. It causes toda and bheda in the region of charana (feet), bhuja(shoulders), parshwa(flanks), prushta(back) and causes diseases of vata, among which one is viswachi.

Sheeta ahara
In this study among 50 patients, sheeta ahara such as ice-cream, cold-drinks, fruits(apple, grapes,melon,tender coconut) was consumed by 70% patients. Excessive consumption of sheeta guna leads to obstruction of srotas, hinders the movement of vata etc.The gunas like khara, vishada and ruksha produces diseases like viswachi and other vata vikara.

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Here all the above mentioned ahara dravyas quantity and the no. of times the person is consuming the ahara dravyais taken into account as it was consumed for maximum no. of times when compared to other foods on a daily basis and in large quantity per serving. Hence the person who does not follow ashta aharavidhi, dwadasha ashana pravicharas are more prone for the vitiation of vatadosha. Therefore the type of diet, its quality, and method of preparation, taste and potency, post digestive effects of the diet, time, season, and mental state during intake of food should be taken into account.
Dukha asana and dukhashayya i.e due to improper sitting and sleeping posture there will be obstruction in the pathway of vatadosha leading to its vitiation. In the present era this etiological factor has important significance as the professionals are in a habit of working for long hours and taking rest in improper postures.
Due to vegadharana and vegaudeerana there will be vilomagati of vatadosha leading to various dreadful vata vikaras. Nowadays in this busy lifestyle people have habit of suppressing their natural urges which reflects in various pathological conditions. Prime vitiation occurs to the vatadosha.
Ratrijagarana contributes rukshaguna of vata and brings about vataprakopa, hence causing manifestation of viswachi or other vatavikara. Nowadays in most of the profession night shifts are common and also people also watch media during late night without considering the right time to sleep. All these factors should be taken into account.
Ativyayama-"shareera aayasajanakam karmam vyayamam uchyate". Excessive vyayama i.e more than half extent of one's own capacity leads to shosha and vataprakopa leading to shoola. From today's point of view, we can consider weight lifters, swimming professionals, potters, daily wage laborers, market vendors, sweepers, cleaners etc; where finally all these individuals end up with the vitiation of vatadosha.
Ativyavaya-due to excessive indulgence in sex without following the rules explained in maithunavidhi leads to dhatukshaya and vataprakopa.
Ratha ati charyadue to excessive vehicle riding, vataprakopa happens in neck & shoulder region further leading to sthanasamshraya of doshas in bahu leading to viswachi vyadhi.
All the above mentioned vihara's lead to vataprakopa, hence cause manifestation of viswachi.
905 Acknowledgement:-I take this opportunity with pleasure to thank all the people who have helped me throughout the course towards producing this work. My deepest sense of gratitude to my HOD, Guide, Principal, Staff, my colleagues, & last but most importantly my dear family for supporting me throught the study period.
Medicinal research cannot be carried out without the enthusiastic attitude and due patience of the patient. I sincerely thank all my patients who kindly allowed me to carry this research work on themselves. Last but not the least I thank all those who have helped me directly and indirectly in successful completion of this work.