Preliminary MD (AYU) Scholar,
Department of Post Graduate Studies in Swasthavritta,
S.D.M College of Ayurveda and Hospital,Hassan -573201
Rajiv Gandhi University of Health Sciences
The Principal and
Head of the Department of PG Studies in Swasthavritta
S.D.M College of Ayurveda and Hospital
Subject : Submission of completed proforma for registration of synopsis for dissertation.
I request you to kindly register the below mentioned subject against my name
For the submission of the dissertation to the Rajeev Gandhi university of health
Sciences ,Bangalore for partial fulfilment of M.D (Ayurveda ).
Title of Dissertation
“A clinical study to evaluate the effect of yashtimadhu in Mild
cognitive impairment of the aged”
Herewith I am enclosing a complete proforma of synopsis for registration of subject
Date: Yours faithfully,
RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,
RAJIV GHANDHI UNIVERSITY OF HEALTH SCIENCES,
PERFORMA FOR REGISTRATION OF SUBJECT FOR DESSEARTATION.
1) NAME OF THE CANDIDATE: DR.MALAVIKA SESHADRI
AND ADDRESS PRELIMINARY MD AYURVEDA,
(IN BLOCK LETTERS) DEPARTMENT OF PG STUDIES IN
S.D.M.C A &H
PERMANENT ADDRESS : D/O DR.V.R.SESHADRI
SRINIVASA NAGAR,PUZHIDHIVAKKAM POST
2) NAME OF THE INSTITUTE : S.D.M. COLLEGE OF AYURVEDA &HOSPITAL,
3) COURSE OF STUDY & : M.D (AYURVEDA), SWASTHAVRITTA.
4) DATE OF ADMISSION TO THE COURSE: 25/10/2010
5) TITLE OF THE TOPIC : “A clinical study to evaluate the effect of
yashtimadhu in Mild cognitive impairment of the aged”
6. BRIEF RESUME OF THE INTENDED WORK
6.1 NEED FOR THE STUDY:
Mild cognitive impairment (MCI) is an intermediate stage between the expected cognitive
decline of normal aging and a marked cognitive disorder such as dementia1,9. It involves
problems with memory, language, thinking and judgment that are greater than typical age-
related changes. Individuals who have cognitive impairments beyond that expected for their
age and education, and that which interferes with their daily activities to a minimal extent are
said to be suffering from ‘Mild Cognitive Impairment’. Studies suggest that these individuals
tend to progress to probable Alzheimer’s disease at a rate of approximately 10% to 15% per
year2. But all the cases of MCI do not progress to Alzheimer’s disease.
Loss of virility, strength, and cognitive power, are progressively noted from the 6th decade
of life3. Important changes in mental abilities during old age include poor retention of
memory and recall process, fall in learning capability and rigid personality11. The use of
Rasayanas prescribed in Ayurveda is a boon to old age. In the aspect of treatment, various
contra-indications have been mentioned for geriatric patients such as shodhana, dhumapana,
raktamokshana and other cumbersome procedures. Thus, the use of rasayanas alone proves to
be congenial as well as beneficial to such patients3.
Rasayanas form a unique concept in Ayurveda which aims in improving Smriti, medha,
arogya, prabha, varna, svara etc. The drugs used in Rasayana therapy detoxifies and
rejuvenates the body. Charaka has prescribed a set of medhya rasayanas intended to bestow
good mental health. Such Rasayanas retard brain aging producing antistress, adaptogenic and
memory enhancing effect.
A single drug which is said to possess all these qualities is yashtimadhu. It possesses
Madhura Rasa, Guru, Snigdha Guna, Seeta Virya, Madhura Vipaka due to which it is balya,
medhya, brhmana, vrshya, vayasthapaka8.As mentioned by Charaka,it is to be administered
with kshira to exhibit greater medhya properties.
Yashti madhu acts as a medhya rasayana by imparting 'anti-aging effect' on brain.
Carbenoxolone is the derivative of glycyrrhizinic acid in yashtimadhu which is a potent
medicine possessing 'nootropic effect'. Nootropics increases memory, cognition, intelligence,
motivation, attention and concentration. It has also shown to improve verbal memory and
verbal fluency in aged.
Therefore, this study is planned to evaluate the role of Yashtimadhu in the Mild
cognitive impairment of the aged and in prevention of further deterioration of the cognitive
6.2 REVIEW OF LITERATURE:
Jara is considered as ‘swabhavika vyadhi’ occurring at the 3rd deteriorating phase of
life according to Acharyas of Ayurveda6,7
Charaka and Vrudha Vagbhata consider person above the age of 60 years as ‘jara’
Sushrutha, Vagbhata, Bhavamisra consider 70 years and above as ‘jara’
Geriatrics has always been an inseparable part of Ayurveda. The 2 specialities
namely- Rasayana and Vajikarana are meant to tackle problems of ageing3
Both Vaghbatas have mentioned medhya rasayanas in ashtanga sangraha and ashtanga
hrudaya among which Yashtimadhu is one.4,5
Charaka, Sushrutha, and Vagbhata have mentioned specific lakshanas for jara such as
Heeyamana dhatu, indriya, bala, virya, grahana, dharana, smarana and Vachana
vigyana, deterioration of sara, mamsa, sandhi, asthi, twak etc
Acharya Charaka has prescribed Medhya rasayanas namely, guduci,
mandukaparni,yashti madhu, and sankhapuspi for the supplementation of mental
Acharya Sushrutha has illustrated rasayana in performing functions like vayah
sthapana, ayurmedabalakara, rogaghna.
Cold water, milk, honey and ghee each separately or in combination of two,three or
all together consumed in the morning stabilises age (prevents ageing)6
Yashti madhu is one among haritakyadi varga which aims in improving memory,
intelligence and strength of sensory organ8.
Yashti madhu has madhura rasa, guru, snigdha guna, sita virya, vata-pittahara8.
In kashyapa Samhita, ahara, jala, mamsa and kshira have been considered for their
best rasayana effect.
Yashtimadhu is said to be ‘jara vyadhi vidhwamsi’ by Bhavamisra
A clinical and behavioural study on the effect of certain medhya drugs on brain
functions – Dr.Rishi Ram Koirala, BHU (1992)
A clinical study of medhya rasayana therapy in apasmara w.s.r to epilepsy –
Dr.Kamalesh Kumar Dwivedi, BHU (1989)
A study on medhya rasayana – Dr.G.Muddanna, Mysore (1990)
Comparative clinical and experimental studies on the psychotropic effect of four
medhya rasayana drugs prescribed in Charaka Samhita, BHU, (1981)
In vitro and in vivo antiallergic effects of Glycyrrhiza glabra and its components15
Memory enhancing activity of Glycyrrhiza glabra in mice16
6.3 AIM AND OBJECTIVES:
To evaluate the effect of Yashtimadhu in Mild Cognitive Impairment of aged
7. MATERIALS AND METHODS:
7.1 SOURCE OF DATA:
Patients will be selected from the IP/OP of SDM College of Ayurveda and Hospital and in
old age homes.
7.2 METHOD OF COLLECTION OF DATA:
Aged patients with memory impairments will be screened in detail with the help of the
research proforma for Mild Cognitive Impairment (MCI).
Patients will be subjected to following cognitive assessment tests before and after the
Cases of mild cognitive impairment (MCI) will be diagnosed with the help of:
Mini-mental state examination (MMSE)10,12,15
Mental State Examination (MSE)10,13
The patients of MCI will also be diagnosed based on the following symptoms:
Impairment of memory and normal activities of daily living
Poor retention and recall process
Fall in learning capability
Lack of concentration
Patients of 60-80 years of age will be selected
Patients who have lost cognitive functions as a result of trauma, surgery etc
Patients with a history of hyper tension, renal failure and using digitalis preparations.
40 patients of MCI will be divided into following two groups each comprising of twenty
Group A: The patients of this group will be given yashti madhu churna in the dose of
5gm twice a day with 100 ml of lukewarm milk before meals for 2 months.
Group B: The patients of this group will be given suitable placebo with 100 ml
lukewarm milk twice a day as mentioned above for 2 months.
Duration of Treatment: 2 months
Routine diet will be allowed
Improvements will be assessed based on the cognitive assessment scales taken before
and after treatment and the following criteria:
Improvement in memory
Reduction in Irritability
Clarity of thoughts
Other notable changes
FOLLOW UP: After completion of the course of treatment, the patients will be visited for
2 months with an interval of 15 days to assess the recurrence.
7.3 HAS ETHICAL CLEARENCE BEEN OBTAINED FROM YOUR
8. LIST OF REFERENCES:
3) Geriatrics in Ayurveda, Dr.S.Suresh Babu,I Ed, Chaukhambha, Varanasi(2001) 7,8 P
4) Vagbhata - Ashtanga hrudaya, uttara sthana English translation by Prof.K.R Srikantha
Murthy, III Vol, 39th ch, Chaukhambha Orientalia, Varanasi(1992) 381,388 P
5) Vagbhata - Astanga sangraha, uttara tantra, English translation by Prof K.R Srikantha
Murthy III Vol, 49th ch, Chaukhambha Orientalia, Varanasi(1992) 460,471 P
6) Sushrutha – Sushrutha Samhita, chikitsa sthana, English translation by
Prof.K.R.Srikantha Murthy II Vol,27th Ch, II ed, Chaukhambha Orientalia, Varanasi,
(2005) 257 P
7) Charaka – Charaka Samhita, Chikitsa Sthana, English translation by R.K.Sharma and
Bhagwan Dash, Vol III, I Ch, Chaukhambha Sanskrit series, Varanasi, I Ed (1988)
8) Bhavaprakash nighantu, Dr.Amritpal Singh,Ch1/137-139, I Ed, chaukhambha
Orientalia,Varanasi (2007) 27 P
9) Geriatric care, O.P.Sharma, Viva books private limited, New Delhi (2004) 379,380 P
10) Essentials of psychiatry, M.S.Bhatia, 4th Ed, CBS Publishers and distributors, New
11) The Mini-Mental State Examination. In: Crook T, Ferris S, Bartus R, eds. Assessment
in geriatric psychopharmacology. New Canaan, Connecticut:Mark Powley, 1983:50-
12) Mental state examination by Jeff Patrick, 2000
13) James L.Jacobson, Alan M.Jacobson: Psychiatric secrets, Jaypee Brothers medical
publishers, New Delhi, I Ed, 1996, 9 P
14) Planta Med. 2007 Mar;73(3):257-61. Epub 2007 Feb 28.
15) J Ethnopharmacol. 2004 Apr;91(2-3):361-5.
9. SIGNATURE OF THE CANDIDATE:
10.REMARKS OF THE GUIDE :
11. NAME AND DESIGNATION:
11.1 GUIDE : DR.SHIVAKUMAR
READER, DEPARTMENT OF PG
STUDIES IN SWASTHAVRITTA,
11.2 SIGNATURE :
11.3 CO-GUIDE :
11.4 SIGNATURE :
11.5 H.O.D : DR.T.B.TRIPATHY
PROFESSOR & HOD,
DEPT OF PG STUDIES
12 SIGNATURE :
12.1 REMARKS OF CHAIRMAN AND : PRINCIPAL