INDIAN NONI AS A BOON FOR ASTHMA PATIENTS

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INDIAN NONI AS A BOON FOR ASTHMA PATIENTS
A CLINICAL TRAIL ON BRONCHIAL ASTHMA

• DR. BHABAGRAHI PATRI
• B.H.M.S., M.D. (HOM)
• P.G.D. DN.M (Utkal University)
• Dhabaleswar Homoeo Clinic Research Centre
• Ranihat Canal Road, Cuttack 753 003, Orissa

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INTRODUCTION

• Bronchial Asthma has long been recognized as an
  important global health problem affecting almost
  all age group.
• A number of explanations have been proposed
  including increased environmental pollution from
  motor vehicles, growing industrialization,
  reduction on plant life on forest areas, dietary
  changes with allergens to cause Bronchial Asthma.
  
• Now a days it is considered that between
  100-150 million people around the globeare
  suffering from this distress.

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Cont..

• Worldwide deaths from this condition have reached
  over 1,80,000 annually.
• Advantageously enough for all these positive
  factors, befitting answers could be provided by
  Indian Noni.
• Observing the positive effects of Indian Noni on
  Bronchial Asthma many people are now taking
  interest to administer the same in different
  types of chronic diseases.
• Indian Noni is effective for such chronic
  diseases due to its high immuno-modulating power.

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AIMS AND OBJECTIVES

• Keeping in view the above facts, a clinical
  trial was conducted in my personal clinic to
  study the efficacy of Indian Noni along with
  Homoeopathic Medicine. In case of both chronic
  and acute exacerbations of Bronchial Asthma.

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WHAT IS ASTHMA

• The American Society Committee on 1962 defined
  Asthma as A disease characterized by an
  increased responsiveness of the trachea and
  bronchi to various stimuli and manifested by
  widespread narrowing of the arrays that change in
  severity either spontaneously or as a result of
  treatment.
• Asthma is characterized by episodic, reversible
  Bronchospasm, resulting from an exaggerated
  bronchoconstrictor response to various stimuli
  (Robins).
• However Bronchial Asthma is due to a specific
  antigen antibody reaction (Type I immune Reaction
  IgE mediated) resulting in the excitation of
  the Bronchial end organs. Bronchial hyper
  responsiveness due to the allergens and the
  mediators humoral like histamine and lucotrines
  cause following three facts.
• Constriction of Bronchial smooth muscles.
• Oedema of the mucous membrane.
• Collection of mucous on the lumen.

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Asthma has traditionally been classified into two
basic types
Intrinsic (Non immune mechanism, caused due to
Extrinsic (intiated by IgE medicated
Atopic asthma
Occupational asthma (extrinsic non-atopic)
Bronchopulmonary aspergilloses
Pulmonary infections
Cold
Inhealed irritants
Exercise
Stress
Ingestion of aspirin
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AETIOLOGY

• Asthma is a complex disorder involving
  automatic, immunologic, infectious, endocrine and
  psycogenic factor in varying degrees in different
  individuals as the causative index.
• Predisposing factors such as
• Heredity
• Age (Pediatric group most affected within 10
  years of age)
• Sex (Male Female 2 1) within 10 year and
  equal on adults.
• Allergens Food, Inhalants, Bacteria.
• Respiratory infections, pharmacologic stimulants,
  occupational factors, exercise, climatic factors,
  low socio-economic status.
• Passive smoking
• Air pollution
• Obesity are responsible for producing Bronchial
  Asthma.

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PATHOPHYSIOLOGY

• A number of causes have been postulated for the
  increased airway reactivity of Asthma but basic
  mechanism remains unknown.
• The most popular hypothesis at present is that of
  airway inflammation.
• Increased number of mast cell, epithelial cells,
  neutrophils, oesinophils and lymphocytes have
  been found in the bronchoalveolar lavage fluid of
  patient with asthma, as have a variety of
  mediators.
• It is widely believed that the physiologic and
  clinical features of asthma derive from an
  interaction among the resident and infiltrating
  inflammatory cells in the airways and the surface
  epithelium.
• The cells who have to play important roles are
  mastcells, eosinophils, macrophages, neutrophils
  andlymphocytes.

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Cont..

• The mediators released are histamine, bradykinin,
  leukotriens, platelet activating factors and
  prostaglandins they produce an intense, immediate
  inflammatory reaction involving
  bronchoconstriction, vascular congestion an
  oedema formation.
• The leukotriens may also account for the other
  pathophysiologic features of asthma e.g.
  increased mucus production and impaired
  mucocilliary transport.
• In early reaction mast cells and cosinophils play
  an important role like destroying the epithelium,
  which is then sloughed into the bronchial lumen
  in the form of Creole bodies. Such damages elicit
  the production of cytokines leading to further
  inflammation.

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Cont..

• Lymphocytes play a quiet important role in
  inflammatory response.
• They are present in increasing number in
  asthmatic airways and produce cytokines that
  activate the cell mediated immunity as well as
  humoral immune responses.
• Cytokines e.g. interleukin (IL2) and interferon
  (IFN) can promote the growth and differentiation
  of B cells and activation of macrophages
  respectively.
• The cytokine IL4 and IL5 stimulate B-cell growth
  and immunoglobulin secretion and IL5 promotes
  casinophil proliferation, differentiation and
  activation by stimulation of B lymphocytes
  (Humoral lympho), the antibody formation against
  the allergens enhanced which subsequently reduces
  the hyper responsiveness of tracheobronchial tree.

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Cont..

• Clinical features
• Shortness of breath.
• Wheezing
• Cough
• Pain in abdomen in young children
• Profuse Sweat
• Symptoms of respiratory allergy.
• On Auscultatron, Ronchi and Crepitation in lungs
  field was found.

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DIAGNOSTIC CRITERIA

• Recurrent episodes of wheezing and cough.
• Appearance of allergic state.
• On auscultation Rhonchi crepitition in lung
  field

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LABORATORY DIAGNOSIS

• Blood investigation
• D.C., T.L.C., E.S.R. and radiology of chest,
  pulmonary function test.

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MATERIAL METHOD

• A clinical study was carried out at Dhabaleswar
  Homoeo Clinic and Research Centre, Cuttack,
  Orissa for a period of 4 months.
• 20 cases of Bronchial Asthma were screened out
  from the above private clinics for the study.
• A uniform schema of case taking was maintained
  for level of the patients by one standardized
  case taking format which was prepared strictly
  according to Homoepathic methods of case taking
  with an emphasis to different aspect of Bronchial
  Asthma.
• Indian Noni was administered to 10 patients along
  with Homeopathic medicines and 10 patients were
  administered only with Homeopathic medicines.

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EVALUATION OF PARAMETERS

• For clinical evaluation, preferred parameters are
• Marked improvement-patient feels completely well
  with no recurrences of Asthmatic attach.
• Moderate improvement-patients feels well with
  recurrent attack.
• No improvement-patient not feeling well.
• Dropped out.

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OBSERVATION

• 20 patients of Bronchial Asthma were taken for
  clinical study. Indian Noni was administered to
  10 patients along with Homeopathic Medicine and
  only Homoeopathic Medicine to other 10 patients.
• The results are shown in a tabular manner below.

Group Marked improvement Moderate improvement No improvement Dropped out Total number
Indian Noni with Homoeopathic Medicine 6 1 1 2 10
Only Homoeopathic Medicine 2 4 2 2 10
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ANALYSIS

• Morinda Citrifolia a predominant ingredient
  of Indian Noni exhibits the following actions
  which controlled asthmatic attack quickly.
• It stimulates IL1 and IL4 formation which
  subsequently helps for the growth of B
  lymphocytes (Humoral lymphocytes) which
  ultimately responsible for the more antibody
  formation in blood against the infiltrating
  allergens so that reducing the rate of allergic
  reactions.
• Antibacterial activity It acts against Bacillus
  subtilis, staphylococcus aureas, streptococcus,
  kilebsiella pneucoccus by reducing the further
  superadded infection of Bronchial tree and long
  field.
• Anti inflammatory activity It reduces the
  airway inflammation by producing anti-hista
  minergic factors.
• Antiviral Activity Reduces the superadded
  infection.
• C.N.S. effect Anti cholinergic effect
• Producing bronchodilatation Reducing asthmatic
  attack.

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CONCLUSION

• A clinical trial was conducted upon 20 patients
  of Bronchial Asthma. 10 patients were
  administered with Homoeopathic Medicines Indian
  Noni and other 10 patients with only Homoeopathic
  medicine.
• It was observed that more no. of patients i.e., 6
  patients of Group I exhibit marked improvement
  in comparison to 2 patients of Group II i.e.,
  (patients with only Homoeopathic Medicine).
• Again the study reveals that the Homoeopathic
  Medicines Indian Noni gives very quick
  improvement in acute exacerbations of Bronchial
  Asthma. So it may be concluded from the clinical
  trial that administration of Homoeopathic
  Medicines along with Indian Noni produces better
  and quick result than only Homoeopathic
  Medicines.
• Bronchial asthma is usually a chromic disease and
  attacks are episodic.
• Therefore to study the effect of Indian Nomi on
• patients it requires much time.

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Cont..

• That's why within last 4 months the effect of
  Indian Nomi in acute excerbations was well
  studied and the result was quite positive, but
  the recurrence of episodes takes place though the
  interval increased to some extent.
• In after 2 years of the clinical trial it can be
  concluded that whether adult bronchial asthma
  patients get permanent relief or not.
• The study required more time and more number of
  patients to establish the positive effect of
  Indian Nomi.
• May the Almighty shower this External Bliss upon
  this product so that it can occupy a better
  position in the Health map of the world.
• Due to insufficiency of time and less number of
  cases it becomes quite difficult to study the
  effect of Indian Noni upon adult asthma cases as
  regards permanent cure.

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Sathyprakash Dash, 2 yrs S/O Bishwaranjan
Dash, Mundamala, Choudwar, Cuttack, Orissa, (
9338482947
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Srusti Mohapatra, 10 yrs D/O Suresh Ch.
Mohapatra, Kapaleswar, Choudwar, Cuttack,
Orissa,
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Chandan Rout, 23 yrs Sikharpur, Upper Sahi,
Cuttack, Orissa ( 9338483662
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Sarita Mishra, 25 yrs Sankarpur, Cuttack,
Orissa ( 0671- 2334759
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Pratap Kr. Dalai , 26 yrs Baragodia, Jagatpur,
Cuttack, Orissa ( 9861242919
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Mamata Mishra, 39 yrs Choudwar Girls High
School, Choudwar, Cuttack, Orissa ( 9861390114
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Sudhansu Samal, 49 yrs Rahania, Balichandrapur,
Jajpur, Orissa ( 9937733566, 9861283839
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Parbati Jena , 52 yrs Qr. No. 2R-81, Labour
Tournment, Charibatia, Cuttack, Orissa (
9861067111
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Umesh Ch. Patnaik, 70 yrs Chauliaganja, Cuttack,
Orissa ( 9861063269
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Thank you