Gang Prasad Ananta Rao Waghmare

doi:10.19080/GJO.2018.18.555995

Case Report

Ayurvedic Management of Presbycusis - A Case report

Gang Prasad Ananta Rao Waghmare

KG Mittal Ayurved College, India

Submission: December 04, 2018; Published: December 13, 2018

*Corresponding author: Ganga prasad Anant Rao Waghmare, MS, PhDSch, PGDCS, Assistant Professor, KG Mittal Ayurved College Charni Road, West Mumbai, India.

How to cite this article: Ganga P A R W. Ayurvedic Management of Presbycusis - A Case report. Glob J Oto, 2018; 18(4): 555995. DOI: 10.19080/GJO.2018.18.555995

Abstract

Presbycusis is one among the many socio-medical proliferated by 25-50% of people in the age group of 65-70 yrs& by nearly 50% of those over 75 ms, which is considered as a disability in older people. In the India hearing difficulty is years of age. According to WHO the proportion of population that are elderly is increasing at a rapid rate-by 2025, nearly 1.2 billion people will be over the age of 60yr consequently the prevalence of age related auditory & vestibular dysfunction will increase. A Hindu married 63 yr. old male patient visited the outpatient department of k G Mittal Ayurved hospital, Mumbai with complaint of Diminished of hearing in both ear, Ringing sensation in both ear & Vertigo. The patient was diagnosed as case of Presbycusis. Tablet Amarsundari Vati 2TDS (each250mg), Powder combination of Amalaki churna (1gm)+ Ashwagandha Churna(1gm)+ Punarnava Churna(500mg)+Bala Churna (500mg)+Sunhihurna (250mg) & Syp Maharasnadi Kwath10ml TDS were administered for 3 months. After the 3 months treatment, a significant response in various symptoms such as Diminished of hearing, Ringing sensation & Vertigo was found.

Keywords: Presbycusis; Hearing loss; Diminished of hearing; Tinnitus, Vertigo; Badhirya

Introduction

Presbycusis is one among the many socio-medical problems, which is considered as a disability in older people. The hearing impairment in elderly people is described as Presbycusis. Hearing problems among elderly people is a major issue and a person with hearing loss may be unable to hear to respond. All this can make them feel frustrated, lonely and depressed. It is the third most common chronic condition after arthritis and hypertensive diseases among elders. According to WHO the proportion of population that are elderly is increasing at a rapid rate-by 2025, nearly 1.2 billion people will be over the age of 60yr consequently the prevalence of age related auditory & vestibular dysfunction will increase [1]. In the India hearing difficulty is reported by 25-50% of people in the age group of 65-70yrs.& by nearly 50% of those over 75 years of age. Hearing loss can be improved by using the hearing aids. Hearing aids work well for some while for others; it may not be a perfect solution due to many reasons such as some people does not buy aids that meet their needs, incorrect amplification adjustments [2], low custom design etc. In classics of Ayurveda this ailment has been described as Badhirya under the heading of ear diseases . Vatahar Chikitsa (Neuroprotective Treatment) is one of the major treatments for ear diseases explained in classics. Clinical observation has shown its effectiveness in the management of Hearing loss [3].

Case Report

A Hindu married 63 yr. old male patient visited the outpatient department of k G Mittal Ayurved hospital OPD No. 201816520, Mumbai with complaint of Diminished of hearing in both ear, Ringing sensation in both ear & Vertigo. The patient was diagnosed as case of Presbycusis. A history of the present illness revealed that the patient was apparently normal 3 year back. Gradually he experienced the above said symptoms. The problem increased day by day, and the patient consulted his family physician & was on internal medicine which relieved the condition for a time being. After 1 month, the patient experienced frequent ringing sound in both ear, increased deafness & dizziness [4,5]. Hence, the patient consulted ENT surgeon where the patient was diagnosed as Presbycusis disease through otoscopic examination of Ear, Audiometry & clinical examination. The patient was on conservative treatment for 1year (tablet vermin 16mg tds, tablet minicar 1 bd, tablet neurobionics forte 1 bd) where the patient had no Long-term relief. The personal history revealed that the patient is vegetarian. Patient was addicted to smoking. There was no genetic linkage of the disease observed in the family. The general examination of patient showed pulse rate of 74/min, respiratory rate of 20/min, blood pressure of 130/80mm of Hg & body weight of 59kg. Otoscopic examination of Tympanic membrane showed Bilateral sclerosis with retraction of Tympanic membrane. Tuning fork test revealed positive rinne’s test for both the ear while Weber’s test showed sound lateralised to both the ear equally. Audiological Examination (Pure tone Audiometry) showed moderate to moderately high Sensory neural deafness on both the ear. Based on clinical examination, the patient was diagnosed as a case of Presbycusis [6].

The following oral medicines were administered for 3 months.

I. Tb. Amarsundari Vati 2TDS (each250mg)

II. Powder combination of following medicines= 1tsf two times daily

a. Aamalakichurna (1gm)

b. Ashwagandha Churna (1gm)

c. Punarnava Churna (500mg)

d. Bala Churna (500mg)

e. Sunthi churna (250mg)

III. Syp Maharasnadi Kwath10ml TDS.

The medicines were procured from outside Ayurvedic pharmaceutical shop. Follow up was taken once in 15 days for 3 months. On the first follow up, the patient reported reduction in the symptom of blocking of ear. Ringing in ear were seen once in 4 days or occasionally. Improvement was observed in Dizziness. Improvement was noted in general sound sleep, anxiety. Complete relief was noted in all the signs & symptoms by the patient on the third follow up, after 3 months of treatment with above medication patients Audiometry report shows mild hearing Loss. So, Hearing loss from Moderate to Moderately High After 3 months of treatment reduced to mild Hearing Loss. The patient was on follow up till 2 months, without any single episode of relapse [7].

Discussion

According to Ayurved, the patient was diagnosed as a case of Badhirya with main dosh being Vata. Hence the line of treatment mainly includes Neuro-protection, antioxidation & vasodilation [8]. The smoking addiction of patient was reduced by counseling & Advised to avoid noisy environment. The property of Amarsundari Vati is acts Oto- neuroprotective by virtue of its Vatashamak & Majjakshobhshamak properties. Amarsundari vati is acts as Vatanadishamak due vatashamak ingredients present in it. It also has potent antioxidant effect. Amarsundari Vati is acidic in nature, excess of hydrogen ions is useful for capillary circulation. Increased H+ ions concentration dilate the capillary [9]. As Amarsundari Vati is having excess of H+ ions concentration it causes dilatation of capillary. The powder combination Medicine are also acting as Neuro Protective. The powder combination acts as Rejuvenating to Vestibule-Cochlear Nerve, also acts as Anti-inflammatory reducing degenerative condition of Nerve due to old age. Syp. Maharasnadi Kwath produces vasodilatation, reduces pain & inflammation. Improves functional efficiency of affected part. Reduces stiffness of Ossicular Joints [10].

Conclusion

Based on clinical signs & symptoms, the disease Presbycusis can be correlated to ayurvedic Badhirya. In this study Tablet Amarsundari Vati, Powder combination of amalaka churna (1gm)+ Ashwagandha Churna(1gm)+ Punarnava Churna (500mg)+Bala Churna (500mg)+Sunthi churna (250mg) & Syp Maharasnadi Kwath was found to be safe & effective in the management of Presbycusis (Badhirya).

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