Ayurveda adapt comprehensive psychosomatic approach to maintain health and cure disease. According to basic concept pravar satva sara person is able to bear any kind of mental stress, strain and pain. Cancer is one of the disease where needs psychosomatic approach of treatment to improve quality of life, specially breast cancer in females patients. Thus with an objective to know the importance of satvasarata in prognosis of female breast cancer female, in relation with blood indices, study was carried out. 60 patients selected according to selection criteria. Assessment Satva sara was done with proforma provided by MUHS, Nashik. Blood indices Hb, TLC, platelets, Blood urea, serum creatinine, SGOT and total bilirubin were observed for three consequently fallow up, on the basis of data obtained; pravar satva sarata female patients show good response to treatment with minimal changes in their blood indices.

Keywords: ayurveda, breast cancer, satva sarata

Ayurveda is science of life. It describe life as the complex combination of sharira (body), indriya (senses), satva (mind) and atma (soul).¹ Anything that interferes with lifecan have an access to any one of these four and hence the treatment differs accordingly. Socially informal behaviors involve actions arising out of envy, pride, fear, anger, greed, attraction, self-righteous and delude thinking. All these activities arising out of raja and tama guna of mind and therefore included in pragyaparadh (intellectual error).² Satva sara person not affected by the pragyaparadh as the person having psyche as a essence (satva sarata) are endowed with memory, devotion, grateful, learned, pure, courageous, skillful, resolute, free from anxiety, having well-directed and serious intellect and activities and engaged in virtuous acts.³ pragyaparadh can also minimized by sadvrutta (code of good conduct) and by retaining natural urges related to mind as kam (lust), krodh (anger), lobha (greedness), moha (attachment), irshya (jealous), mad (narcosis), shok (sorrow), chinta (worry), bhaya (fear)etc.

Classification of mental disorders based on exogenous and endogenous factors has been very systematically done in the ancient Ayurvedic manas dosh janya vyadhi. Endogenous factors are tridosha (vata, pitta, kapha) and triguna (satva, raja, tama). These disorders can be equated with neurotic disorders. It has been mentioned that occasionally manas roga (mental illnesses) may have contract with physical illnesses which may be equated to psycho-somatic disorders, and cure of some diseases also depends on psyche of the patient. Cancer is one of such a disease which hampered quality of life. Breast cancer among woman ranked second position in spreading.

Burden of cancer is alarmly increasing in economically developing countries like India, with respect to increasing population, aging and growth of country. In 2012, 1.7 million women globally diagnosed with breast cancer.⁴ Breast cancer is the most frequently diagnosed cancer and the leading cause of cancer death among females, accounting for 23% of the total cancer cases and 14% of the cancer deaths.⁵ Chemotherapy may be given with a curative intent or to reduce symptoms (palliative chemotherapy) so as to promote quality of life. Surgery, chemotherapy, and radiation therapy are very important step in the treatment of such tumor to increase the opportunity for breast conservation.⁶

Modern application of drugs in the treatment of a person with cancer usually involves strong chemotherapeutic drugs used to attack the disorganized cancer cells and kill them. In this scenario, it is common for the patient to experience disabling side effects as fever, cough, hair loss, anorexia, fatigue, diarrhea, constipation, mouth ulceration, drowsiness, mood alteration etc which indicate some kind of harm to the normal functioning of body. In addition to this, surgical removal of breast adversely affects women beauty, this is also the major factor which disturb female mentally.⁷. More support is needed towards the end of chemotherapy, when side effect comes aggressively some women should be referred for psychological support and Information.⁸ Ayurveda requires rediscovery in light of our current knowledge of allopathic (modern) medicine for the therapeutic and preventive purpose.⁹

Dhatusarata examination is one of tool used by ancient scientist. Among these ashtavidh dhatu sara examination of satva sarata is one, rasadhatu, raktadhatu, mansdhatu, meddhatu, ashtidhatu, majjadhatuand shukradhatu.¹⁰ Satva sarata (essence of psyche) rules out the mental state of patient. With respect to vitality, satvasarata is of 3 types pravara (high), Madhya (moderate)and avara (low). In case of pravara-satva persons, no effect is seen on them due to diseases caused by vata, pitta and kapha. Madhya-satva persons have the attitude of good accommodation with other individuals. They can endure the diseases, due to their, medium pain bearing capacities. Hina satva persons can’t control their urges. That means they have least capacities to bear the pain of disease.¹¹ Hence somewhere there is a relation between psyche condition and physical factors involved, which may equated to organic psychosis today. So with an objective to assess the use of satva sarata in prognosis of female breast cancer patient study was carried out.

To study use of satva sarata in assessing prognosis of female of breast cancer receiving chemotherapy in relation with blood indices.

Study design

This is an observational descriptive study design conducted after obtaining necessary permission from the institutional ethical committee. For this study 60 female patients were selected randomly from hospital namely Rashtrasant Tukdoji Maharaj cancer government hospital, Nagpur.

Inclusion criteria

Diagnosed female patients of breast cancer of age group 30 to 70 years receiving combined neo-adjuvant chemotherapy were enrolled for study.

Exclusion criteria

1. The patient undergone for surgery of breast cancer was excluded.
2. The patient of distant metastasis excluded from study.

According to selection criteria diagnosed female patients of breast cancer were taken for the study. Satva sarata parikshan was carried out on the basis of proforma of dhatusarata examinationprovided by Maharashtra university of Health Sciences, Nashik. (Annexure I) Examination of satva sarata was done before starting neoadjuvant chemotherapy, along with laboratory investigation for hemoglobin, total leukocyte count, platelet count, blood urea, serum creatinine, SGOT, and total bilirubin. These lab investigations repeatedly have done after three successive chemotherapies. Total 14 attributes are available to assess satva sarata. (Annexure I) These 14 attributes considered as a 100%. The obtained satva saratawas analyzed by following criteria.

Pravar sarata- scoring 65% and above Madhyam sarata- scoring 33.1 % to 64.9 %
Avar sarata- scoring 33 % and less
On the basis of score obtained, evaluation of pravar, madhyam and avar saratawas done.

The statistical analysis was done by using SPSS 16.0 software. The comparison between avar satva sarata and pravar satva sara femalein the form of quantitative data of different variables before first chemotherapy and after third chemotherapy was analysed by pair t test of parametric distribution (Figures 1-7), (Table1).

Figure 1 Showing before and after changes in hemoglobin (Hb) in avar sarata & pravar sarata.

Figure 2 Showing before and after changes in Total leukocyte (TLC) in avar sarata & pravar sarata.

Figure 3 Showing before and after changes in Platelet (PL) in avar sarata & pravar sarata.

Figure 4 Showing before and after changes in Blood urea (BU) in avar sarata & pravar sarata.

Figure 5 Showing before and after changes in Serum creatinine (SC) in avar sarata & pravar sarata

Figure 6 Showing before and after changes in SGOT in avar sarata & pravar sarata.

Figure 7 Showing before and after changes in Total bilirubin (TB) in avar sarata & pravar sarata.

The examination of emotional factors (manasika bhavas) and the importance of mental characteristics for determining the prognosis of the diseases have been brightly described in Ayurveda.¹² The importance of examination of satva is stressed as the determination of psychic personality (manas prakriti) is essential to the treatment of the patient.¹³ According to physiology of sapta dhatu health is depend upon rakta dhatu (blood).¹⁴ Therefore it was taken under consideration. Classification of tissues described in Ayurveda is based on some rational observations. The dhatu production and formation depends upon ‘Jathaaagni’ and ‘dhatvagni’ also. If these fractions become over active, there will be lead to ‘Ksaya’ (Catabolism) of ‘dhatu’ and if they become depressed, there will be abnormal ‘Vrddhi’ of ‘dhatu’. Suggesting that in case of avar dhatu sarata people, dhatvagni is abnormal condition which may be due to nonstandard factors like dietary habits, living styles and psychological status.

This might be due to possessing special characteristics of pravar dhatusarata, person of pravar dhatusara have all the essence of dhatu. They are strong and happy in all the conditions, they are enduring confidant in all actions, they are inclined to caring acts, they are capable to express happiness in trouble condition as well, and having good relation with society boost their mind to get rid from fear of disease make them good response to treatment. However, it is very difficult to explain the association between psychological effects using blood investigation by exploratory study. For this further research with more sample size could be done.¹⁵ Hence in pravar satva sarata person Hb, TLC, Pl and SC not declined up to level, as in case of avar satva sara. The following factors also influence the promotion of immunity like place of birth, time of birth, favorable weather, excellence of genetic qualities, excellence of properties of food being consumed, excellence of physique, good ability to tolerate various factors, excellence of mental status, favorable factors related to nature, youthfulness, exercise and cheerful attitude Such qualities are deficient in avar satva sarata therefore may shows poor response.

Dashavidhaatur parikshawas explained by Acharya Charaka to examine a patient in respect to determine strength and the intensity of the diseased before giving any treatment. Therefore, physician should aim to improve quality of life of patient by means of proper choice of treatment, selection of proper drugs, and special care to be taken in case of avar satva sarata patient so as to improve immunity of asara and madhya sara dhatu with proper food and medicines and maintain uttam sarata of particular dhatu with proper counseling.

Pravar satva sara female of breast cancer receiving chemotherapy shows good response to treatment with minimal changes in their blood indices while Avar satva female are more susceptible for early side effects. Therefore, psychological and somatic disorders are more cause of disturbance in their integrity.

None.

The authors declare that there are no conflicts of interest.

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