Study of Sama-Snayugata Vata and Synovial Fluid Analysis
Journal name: Ayushdhara
Original article title: An Observational Study for the Clinical Correlation of Sama-Snayugata Vata (Non-Specific Chronic Synovitis) with the Analysis of the Synovial Fluid
AYUSHDHARA is an international peer-reviewed journal. It focuses on research in Ayurveda, Yoga, Unani, Siddha, Homeopathy, Allopathy, and Pharmaceutical Sciences.
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Balveer Singh
MS Scholar, Department of Shalya Tantra, National Institute of Ayurveda (Deemed to be University), Jaipur, Rajasthan, India.
Jitesh Bansal
MS Scholar, Department of Shalya Tantra, National Institute of Ayurveda (Deemed to be University), Jaipur, Rajasthan, India.
Ashok Kumar
Professor, Department of Shalya Tantra, National Institute of Ayurveda (Deemed to be University), Jaipur, Rajasthan, India.
Narinder Singh
Associate Professor, Department of Shalya Tantra, National Institute of Ayurveda (Deemed to be University), Jaipur, Rajasthan, India.
Sona Goyal
Consultant Pathologist, Department of Shalya Tantra, National Institute of Ayurveda (Deemed to be University), Jaipur, Rajasthan, India.
P. Hemantha Kumar
Professor & HOD, Department of Shalya Tantra, National Institute of Ayurveda (Deemed to be University), Jaipur, Rajasthan, India.
Ayushdhara:
(A peer-reviewed, bi-monthly open-access journal)
Full text available for: An Observational Study for the Clinical Correlation of Sama-Snayugata Vata (Non-Specific Chronic Synovitis) with the Analysis of the Synovial Fluid
Year: 2023 | Doi: 10.47070/ayushdhara.v10i5.1401
Copyright (license): CC BY-NC-SA 4.0
Download the PDF file of the original publication
Summary of article contents:
Introduction
The study explores the Ayurvedic concept of Sama-Snayugata Vata, which refers to the vitiation of Vata dosha affecting the musculoskeletal system, particularly focusing on knee effusion—a condition characterized by the abnormal accumulation of synovial fluid in the knee joint. Through the analysis of synovial fluid, the research aims to correlate the Ayurvedic understanding of Shleshmadhara Kala, which denotes optimal nourishment and lubrication of bodily tissues essential for joint health, with pathological changes observed in knee effusion. The study’s insights are intended to enhance therapeutic strategies aimed at balancing Vata dosha and rejuvenating affected tissues.
The Role of Synovial Fluid
Synovial fluid serves as a critical component within diarthrodial joints, providing lubrication, nourishment, and protection to the joint structures. Normally, its biochemical composition is similar to that of plasma, but in pathological conditions like arthritis, this composition changes, offering valuable insights into the underlying joint pathology. The study emphasizes the importance of assessing synovial fluid characteristics—such as color, viscosity, and white blood cell count—as they are crucial indicators of the presence of inflammation or infection in joints. Notably, a low viscosity and increased white blood cell counts in synovial fluid can indicate inflammatory processes, which align with the clinical manifestations of Sama-Snayugata Vata.
Correlation between Disease and Synovial Fluid Analysis
The research involved an analytical study of 50 patients suffering from knee effusion, employing arthrocentesis to obtain synovial fluid samples for detailed analysis. The findings indicated a mean white blood cell count of 2204.76 cells/µL, with differential counts showing 37.78% neutrophils and 62.14% lymphocytes, signifying mild inflammatory changes. Additionally, total protein and albumin levels were elevated, suggesting chronic, nonspecific inflammation. These observations corroborate the existence of underlying pathological processes consistent with the imbalances described in Ayurveda, particularly the exacerbation of Vata dosha and the deterioration of Shleshmadhara Kala involved in joint health.
Conclusion
Overall, the findings from the synovial fluid analysis illustrate a significant correlation between the clinical presentation of non-specific chronic synovitis and the alterations in synovial fluid composition. Enhanced understanding of these changes suggests that the observed biochemical and cellular modifications in the synovial fluid are indicative of underlying low-grade inflammation. This reinforces the Ayurvedic principles concerning the health of the Janu Sandhi (knee joint) and provides a scientific backing for potential therapeutic strategies aimed at restoring balance and improving the functionality of affected joints.
FAQ section (important questions/answers):
What is Sama-Snayugata Vata and its relation to knee effusion?
Sama-Snayugata Vata refers to a condition in Ayurveda where vitiation of Vata dosha affects musculoskeletal health, leading to issues like knee effusion due to abnormal accumulation of synovial fluid.
How is synovial fluid analyzed in cases of knee effusion?
In knee effusion, synovial fluid is analyzed through arthrocentesis, which involves aspirating fluid for physical, biochemical, and microscopic evaluation to assess inflammation, infection, and joint disorders.
What biochemical changes occur in synovial fluid during inflammation?
During inflammation, synovial fluid shows increased white blood cells, altered protein levels, decreased glucose levels, and changes in viscosity, indicating underlying conditions like chronic synovitis or arthritis.
Glossary definitions and references:
Scientific and Ayurvedic Glossary list for “Study of Sama-Snayugata Vata and Synovial Fluid Analysis�. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.
1) Vata:
In Ayurveda, Vata refers to one of the primary doshas responsible for movement and various physiological functions. It plays a key role in the pathogenesis of Sama-Snayugata Vata, where its vitiation affects the musculoskeletal system causing non-specific chronic synovitis.
2) Sama (Shama):
Sama indicates balance or equilibrium. In Sama-Snayugata Vata, equilibrium is disturbed resulting in the accumulation of ama (toxins) within the joints, contributing to inflammation and chronic conditions like synovitis.
3) Sandhi (Shandhi, Samdhi):
Sandhi refers to a joint within the body. In this study, Janu Sandhi, or the knee joint, is specifically examined for its role in Sama-Snayugata Vata where synovial fluid analysis helps understand the pathophysiology.
4) Dosha (Dosa):
In Ayurveda, doshas are fundamental bio-energies or functional principles of the body, classified as Vata, Pitta, and Kapha. The study focuses on the vitiation of Vata dosha in conditions such as Sama-Snayugata Vata.
5) Vatadosha (Vatadosa, Vata-dosha):
Vata dosha is one of the three Ayurvedic principles, characterized by air and ether elements. Its imbalance specifically impacts mobility and nerve impulses, frequently studied in contexts like Sama-Snayugata Vata.
6) Inflammation:
Inflammation is a key clinical feature observed in various pathological conditions including Sama-Snayugata Vata. Synovial fluid analysis in this study indicates inflammatory changes within the knee joint affecting the overall joint health.
7) Kapha:
Kapha is another primary dosha in Ayurveda, responsible for stability and lubrication. The study examines how the depletion of Sleshaka Kapha within the knee joint contributes to conditions like Sama-Snayugata Vata.
8) Janusandhi (Janu-sandhi):
Janu Sandhi specifically refers to the knee joint. The study details the pathophysiological changes within the Janu Sandhi, examining factors like knee effusion and synovial fluid analysis in Sama-Snayugata Vata.
9) Janu:
Janu refers to the knee in Sanskrit. The study investigates synovial fluid within the Janu Sandhi (knee joint) to understand conditions like Sama-Snayugata Vata, focusing on how inflammation affects joint movement and health.
10) Kala:
Kala, in the context of Ayurveda, refers to a physiological phase or layer nourishing tissues. Shleshmadhara Kala is essential for joint lubrication and is disturbed in conditions like Sama-Snayugata Vata, leading to knee effusion.
11) Disease:
Disease in this study is examined through the lens of Sama-Snayugata Vata, where the disruption of natural dosha balance within the body leads to chronic synovitis and knee effusion.
12) Snayu:
Snayu refers to tendons and ligaments. The study focuses on the role of Snayu within the knee joint and their involvement in the pathogenesis of Sama-Snayugata Vata, especially in relation to knee effusion.
13) Blood:
Blood cells like WBCs and lymphocytes are analyzed in the synovial fluid to diagnose and understand inflammatory changes occurring in conditions like Sama-Snayugata Vata.
14) Rheumatoid arthritis:
Rheumatoid arthritis is a pathological condition noted for its inflammatory effects on joints. The study's findings on synovial fluid provide insights into how similar inflammatory changes affect the knee joint in Sama-Snayugata Vata.
15) Vishamagni (Vishama-agni, Visamagni):
Vishamagni refers to the irregular metabolic function in Ayurveda, often leading to the formation of ama. Its role is crucial in understanding the genesis of ama in Sama-Snayugata Vata and subsequent knee effusion.
16) Vitiation (Vitiated):
Vitiation describes the disturbance of doshas, particularly Vata dosha in this study. This imbalance leads to pathological conditions like Sama-Snayugata Vata, affecting joint health and function.
17) Ayurveda (Ayus-veda):
Ayurveda is the ancient Indian science of life that forms the foundation of this study. It provides the conceptual framework for understanding conditions like Sama-Snayugata Vata, focusing on the balance of doshas within the body.
18) Asthi (Ashthi):
Asthi refers to bones. In Sama-Snayugata Vata, the study investigates how Vata dosha vitiation affects bone health, leading to symptoms like osteoarthritis and knee effusion.
19) Dhatu:
Dhatus are the seven fundamental tissues in Ayurveda. The vitiation of Vata dosha affects these tissues, particularly in conditions like Sama-Snayugata Vata, leading to joint disorders and effusions.
20) Kumar:
Referenced in the study, P. Hemantha Kumar is one of the authors contributing to the research on Sama-Snayugata Vata and synovial fluid analysis in knee effusion.
21) Vayu:
Vayu is the Sanskrit term for air and represents Vata dosha. Its imbalance causes movement disorders like Sama-Snayugata Vata, impacting the musculoskeletal and nervous systems.
22) Food:
Food or ahara plays a significant role in Ayurveda. Consuming Vata-aggravating foods can lead to the vitiation of Vata dosha, contributing to conditions like Sama-Snayugata Vata.
23) Fire:
Fire or Agni in Ayurveda refers to the body's metabolic and digestive processes. Irregular Agni, or Vishamagni, contributes to ama formation, which plays a crucial role in the pathogenesis of Sama-Snayugata Vata.
24) Pain:
Pain, or shoola, is a common clinical manifestation in Sama-Snayugata Vata due to the vitiation of Vata dosha, impacting the knee joint and leading to synovial inflammation.
25) Shalyatantra (Salyatantra, Shalya-tantra, Shalyatamtra):
Shalya-tantra is a branch of Ayurveda dealing with surgery and related treatments. This department conducted the study on Sama-Snayugata Vata, focusing on the analysis of synovial fluid in knee effusion.
26) Majjadhatu (Majja-dhatu):
Majja-dhatu refers to bone marrow. In the study, depletion of Majja Dhatu is noted as one of the pathophysiological outcomes in Sama-Snayugata Vata, affecting bone health and contributing to arthropathies.
27) Dhatukshaya (Dhatuksaya, Dhatu-kshaya):
Dhatukshaya means depletion of bodily tissues. In Sama-Snayugata Vata, chronic inflammation leads to dhatukshaya, affecting joint health and contributing to conditions like knee effusion.
28) Kaphadosha (Kaphadosa, Kapha-dosha):
Kapha dosha is one of the three primary bio-energies responsible for stability and lubrication. Depletion of Kapha in the knee joint contributes to the pathogenesis of Sama-Snayugata Vata.
29) Vyanavayu (Vyana-vayu):
Vyana-vayu is a subtype of Vata dosha responsible for circulation. Its vitiation plays a crucial role in the systemic spread of Sama-Snayugata Vata, affecting the knee joint and causing effusion.
30) Discussion:
The discussion section in the study analyses the data from synovial fluid analysis and correlates it with the clinical symptoms of Sama-Snayugata Vata, providing insights into its pathogenesis and treatment.
31) Science (Scientific):
The study takes a scientific approach to explore the clinical correlation between Sama-Snayugata Vata and synovial fluid analysis, using methodologies like cytological examination under strict protocols.
32) Vyanavata (Vyana-vata):
Vyanavata refers to the aggravated state of Vyana Vayu. Its vitiation in Sama-Snayugata Vata leads to systemic symptoms and localized effects in the knee joint, causing effusion and pain.
33) Rajasthan:
Rajasthan is the state in India where the study was conducted, specifically at the National Institute of Ayurveda in Jaipur, exploring knee effusion in the context of Sama-Snayugata Vata.
34) Adhyasthi:
Adhyasthi refers to abnormal bony outgrowth. Its formation is one of the effects of chronic Vata vitiation in conditions like Sama-Snayugata Vata, impacting the knee joint.
35) Stiffness:
Stiffness, commonly observed in the knee joints, is a clinical manifestation of Sama-Snayugata Vata due to the inflammation and reduced synovial fluid viscosity affecting mobility.
36) Vibandha:
Vibandha represents constipation or obstructive symptoms. It is listed as one of the systemic manifestations of Sama-Snayugata Vata due to the vitiation of Vata dosha.
37) Swelling:
Swelling, or sopha, is a key feature observed in Sama-Snayugata Vata, particularly in the knee joint, due to the accumulation of inflammatory synovial fluid leading to knee effusion.
38) Utpatti:
Utpatti refers to the origin or production. In the study, adhyasthi utpatti (bone spur formation) is analyzed as a pathological outcome of Vata vitiation in Sama-Snayugata Vata.
39) Tantra (Tamtra, Tantrism):
Tantra refers to methods or techniques. Shalya-tantra is specifically noted in the study for its techniques in analyzing and treating surgical conditions, shedding light on Sama-Snayugata Vata.
40) Alasya:
Alasya translates to lethargy or decreased energy levels. It is a systemic symptom associated with the vitiation of Vata dosha in conditions like Sama-Snayugata Vata.
41) Sthana:
Sthana means place or site. In the study, Kapha sthana (joint site with lubricating fluid) is crucial in understanding the pathological changes in Sama-Snayugata Vata.
42) Vihara:
Vihara signifies lifestyle practices. The study indicates that improper lifestyle (Vihara) factors can contribute to the vitiation of Vata dosha, leading to conditions like Sama-Snayugata Vata.
43) Kshaya (Ksaya):
Kshaya denotes depletion or reduction. In Sama-Snayugata Vata, Kapha kshaya (reduction of lubricating fluid) in the knee joint is a significant pathological event contributing to pain and stiffness.
44) Shalya (Salya):
Shalya means 'surgical instrument' or 'surgery.' The Department of Shalya Tantra at the National Institute of Ayurveda conducted this analytical study on Sama-Snayugata Vata and knee effusion.
45) Guruta:
Guruta refers to heaviness. It is one of the systemic symptoms of Sama-Snayugata Vata as the imbalance of Vata dosha affects overall physical and joint health, leading to feelings of heaviness.
46) Nidana:
Nidana translates to cause or pathology. The study explores multiple Nidanas (causal factors) like age and lifestyle, leading to the development of Sama-Snayugata Vata and knee effusion.
47) Srotas (Shrotas):
Srotas are the channels within the body transporting nutrients and wastes. Their obstruction by ama (toxins) plays a crucial role in the pathogenesis of Sama-Snayugata Vata, leading to knee effusion.
48) Jaipur:
Jaipur is the city in Rajasthan, India, where the National Institute of Ayurveda is located and where this study on Sama-Snayugata Vata and synovial fluid analysis was conducted.
49) Repair:
Repair in the context of Sama-Snayugata Vata involves therapeutic strategies aimed at tissue rejuvenation. The study aims to devise treatments to restore balance and ensure proper repair of affected knee tissues.
50) Nature:
Nature in the study deals with the characteristics of diseases like Sama-Snayugata Vata, driven by the nature of dosha imbalances and their effects on joint health and synovial fluid composition.
51) Aruci:
Aruchi means lack of interest in food or anorexia. It is noted as a systemic symptom in the pathological condition of Sama-Snayugata Vata due to Vata dosha vitiation.
52) Ahara:
Ahara refers to diet. The study notes that consumption of Vata-aggravating ahara leads to the vitiation of Vata dosha, which plays a central role in the manifestation of Sama-Snayugata Vata.
53) Vyana:
Vyana is a subtype of Vata dosha responsible for circulation and movement. Its vitiation facilitates the spread of Sama-Snayugata Vata throughout the body, particularly affecting the knee joint.
54) Majja:
Majja is bone marrow. The depletion of Majja Dhatu, noted in Sama-Snayugata Vata, impacts bone health and is a crucial aspect discussed in the study, relating to chronic synovitis in the knee.
55) Shopha (Sopha):
Sopha means swelling. The study identifies sopha as a significant clinical manifestation of Sama-Snayugata Vata, particularly in the knee joint's synovial fluid analysis, indicative of inflammation.
56) India:
India is the country where this research takes place, specifically in Rajasthan at the National Institute of Ayurveda, exploring the clinical correlation of Sama-Snayugata Vata with knee effusion.
57) Ayus (Ayush):
Ayush stands for Ayurveda, Yoga, Unani, Siddha, and Homeopathy. AYUSHDHARA journal publishes research in these areas, including the study on Sama-Snayugata Vata.
58) Cula:
Soola means pain. In Sama-Snayugata Vata, soola in the knee joint is a primary clinical symptom due to the vitiation of Vata dosha and accompanying inflammation.
59) Jara (Jara°, Jará):
Jara refers to aging. It is noted as one of the Nidanas (causal factors) for the vitiation of Vata dosha, leading to conditions like Sama-Snayugata Vata and contributing to knee effusion.
60) Agni:
Agni means the digestive fire in Ayurveda. Vishamagni (irregularity in Agni) contributes to the formation of ama (toxins), which plays a role in the pathogenesis of Sama-Snayugata Vata.
61) Shona (Sona, Soshna):
Referenced in the study, Sona Goyal is one of the authors contributing to the research on synovial fluid analysis and its correlation with Sama-Snayugata Vata.
62) Salt (Salty):
Salt in this context refers to the various biochemical constituents of synovial fluid. Analysis of these salts and other components helps understand the pathological changes in Sama-Snayugata Vata.
Other Science Concepts:
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