A total of 12 patients of osteoporosis and osteopenia (Asthi-Majjakshaya) were registered on the basis of symptomatology and relevant Bone Mineral Density (BMD) test in camps organized at IPGT and RA Hospital, Jamnagar, irrespective of their sex, religion, etc. Written consent was taken from each patient after giving him/her detailed information about the treatment. Ethical clearance was also obtained from the Institutional Ethics Committee.
- Osteoporotic patients of either sex, whose BMD (t-score) was equal to or less than 1.
- Patients presenting with the classical symptoms of osteoporosis, with special reference to Asthi-Majjakshaya.
- Patients between the age group of 30 and 70 year.
- Patients of age below 30 years and above 70 years.
- Patients with BMD (t-score) above – 1.
- Patients with rheumatoid arthritis, gouty arthritis, and longstanding systemic disorders were excluded.
- Patients having diabetes mellitus (DM), uncontrolled hypertension (HTN), thyrotoxicosis, hyperparathyroidism, Addison's disease, Paget's disease, Cushing's syndrome, tuberculosis of bone, osteomalacia, chronic renal disease, hepatic and cardiac failure.
Criteria for diagnosis
The criteria of diagnosis was based on the signs and symptoms of osteoporosis and osteopenia (Asthi-Majjakshaya) and relevant physical examination carried out. In addition to this, BMD test was carried out in all the patients to confirm the diagnosis as well as to exclude the normal patients.
Totally, 12 patients fulfilling the criteria of diagnosis of osteoporosis (Asthi-Majjakshaya) were selected for the present study. They were treated with Majja Basti and Asthi Shrinkhala pulp capsule. Eight patients completed the treatment.
Drug, dose and duration
Majja Basti was administered for 16 days as a Matra Basti with 60 ml buffalo Majja (bone marrow of buffalo) along with Asthi Shrinkhala pulp powder filled in capsule (500 mg), two capsules three times daily for 3 months with milk.
The patients were advised to avoid the following: Apathya diet such as bitter, pungent, astringent taste dominant substances; dry, cold, light, etc. property predominant substances; Shushkamamsa (dry meat); Shushkashaka (dry vegetable); Madya (alcohol); excessive eating; fasting; heavy exercise; excessive sexual intercourse; day sleep; night awakening; suppression of natural urges; medicines like corticosteroid, anticonvulsant, etc.; smoking and other etiological factors which cause aggravation of Vata.
Criteria for assessment
Improvement in the patients was assessed on the basis of relief in signs and symptoms of the disease. All the signs and symptoms were given scoring depending upon their severity to assess the effect of the treatment objectively.
Parameters of the study: Subjective parameters
- Shoola (Pain)
Grade 0 – No pain
Grade 1 – Mild pain
Grade 2 – Discomforting pain
Grade 3 – Distressing pain
Grade 4 – Horrible
- Sparshasahyata (Tenderness)
Grade 0 – No tenderness
Grade 1 – Mild tenderness without any sudden response on pressure
Grade 2 – Wincing of face on pressure
Grade 3 – Wincing of face and withdrawal of the affected part on pressure
Grade 4 – Resist touch due to tenderness
- Dourbalya (General debility)
Grade 0 – No Dourbalya
Grade 1 – Not able to perform strenuous activity
Grade 2 – Not able to perform moderate activity
Grade 3 – Cannot perform moderate activity but can perform mild activity without any difficulty
Grade 4 – Even mild activities cannot be performed
Total score: BT AT
Bone mineral density (t-score): WHO criteria for assessing osteoporosis.
Normal – “t” score greater than – 1; osteopenia – “t” score between – 1 and – 2.5; osteoporosis – “t” score less than or equal to – 2.5 and severe osteoporosis – “t” score less than – 2.5 with fracture.
Overall effect of therapy
Marked improvement: >75–100% improvement
Moderate improvement: >50 to <75% improvement
Mild improvement: >25 to <50% improvement
Poor improvement: less than 25% improvement
Observations and Results
Out of 12 patients of osteoporosis selected (Asthi–Majjakshaya), 66.67% belonged to 51–60 years of age, 58.33% were males and 41.67% were females, 41.67% belonged to lower socioeconomic status, 33.33% patients were having the habit of tobacco chewing, 83.33% patients were having disease chronicity between 1 and 5 years, 66.67% patients were having Krurakoshtha, family history was present in 8.33% of patients, and 50% patients were having Avara Vyayama Shakti. Maximum, i.e., 66.67% patients, were taking Ruksha Ahara, followed by 33.33% taking Seeta Ahara, and 50% patients were taking Laghu Ahara and Vistambhi Ahara each. 83.33% patients of this series had history of Diva-Swapna (day sleep), whereas 74.44% patients had the history of Ratrijagarana (insomnia), and Vega-Sandharana (suppressed natural urge) and Ati-Sankshobha were found in 41.67% and 50% patients, respectively, whereas Ati Vyayama (>8 hours) was found in 33.33% patients. Also, 66.67% patients of this series reported to have Bhaya (fear) as one of the causes of their disease, and Shoka (grief) and Chinta (anxiety) were found in 24.44% and 50% patients, respectively.
Overall effect of therapy
Marked improvement and mild improvement were found in 12.50% patients each, whereas moderate improvement was found in 75% patients, and no patient remained unchanged in this study.