Assessment of Apar Ojas Expressions in the Subjects of Madhumeha; type 2 Diabetes Mellitus Using Self-Developed Ojas Assessment Tool (OAT) And Its Evaluation Using Immunological Marker Igg; A Cross-Sectional, Pilot Observational Study

Abstract

Introduction: Ojas is the quintessential component of the Saptadhatu (the seven fundamental constitutional elements) of the human body. It is a crucial indicator for determining the complete well-being of an individual’s body and mind. Assessment of Ojas can comprehensively reveal the physical, mental, and physiological status of an individual at any cross section of time. A decline in the Ojas expression is a chief underlying characteristic observed in the pathogenesis of Madhumeha disease (Type 2 Diabetes Mellitus). This research study attempted to record the same using a self-developed tool for Ojas assessment.

Objectives: The primary objective of this research study was to develop an Ayurveda parameter based subjective proforma that could record the Apar Ojas expressions in both diseased and healthy individuals irrespective of age and gender. The secondary objective was to compare the status of Apar Ojas and immunological marker Serum Total IgG in the diabetic subjects with that of non-diabetic apparently healthy individuals. The study also analysed the associations between the Age, Chronicity of Diabetes, Apar Ojas and Serum Total IgG expressions.

Methods: This research study was a cross sectional, pilot study with a sample size of 40 participants in total. Twenty individuals prediagnosed with Madhumeha (Type 2 Diabetes Mellitus) and twenty apparently healthy non-diabetic individuals were enrolled in this research. Clinical features of Madhumeha as described in Ayurveda classics, Fasting Plasma Glucose concentration (FPG ≥ 126mg/dl), Blood Sugar Level (post meal) (PPBS ≥ 200mg/dl) and Glycosylated Haemoglobin level (HbA1c ≥ 6.5 %) formed the criterion of diagnosis for the enrolment of subjects.

Results: This research study recorded significantly decreased Apar Ojas expression (25.70 v/s 33.65, t-test = 8.43, p<0.001) and significantly increased Serum Total IgG (12.03 v/s 9.77, t-test = 2.79, p<0.01) in the Type 2 Diabetes subjects when compared with expressions in non-diabetic apparently healthy individuals. A significantly hampered Physical Ability (2.35 vs. 2.85, t-test = 2.94, p<0.01), Voice Quality (2.00 vs 2.90, t-test = 4.47, p<0.001), Skin Quality (1.50 vs 2.55, t-test = 4.62, p<0.001), Audition Ability (1.75 vs 2.80, t-test = 5.73, p<0.001) , Optical Ability (1.85 vs 2.75, t-test = 4.13, p<0.001), Gustation Ability (2.60 vs 3.00, t test = 2.63, p<0.05), Excretion Ability (1.70 vs 2.80, t-test = 4.67, p<0.001), Libido Ability (1.25 vs 2.40, t-test = 3.83, p<0.001) and Higher Mental Functions Ability (2.70 vs 3.00, t-test = 2.85, p<0.01) was recorded in the Type 2 Diabetes subjects when compared with non-diabetic individuals of this study. However, no significant differences were recorded in the Nutrition Score, Stimulation Ability and the Olfaction Ability of the subjects between the two groups. A moderate positive non-significant association between the age and the Serum Total IgG expressions (r= 0.433, p= 0.056), a moderate negative significant association between the age and Apar Ojas expressions (r= -0.465, p=0.039) and a moderate negative non-significant association between the Apar Ojas and the Serum Total IgG expressions (r= -0.356, p= 0.123) was recorded in the diabetic subjects in this research study.

Conclusions: The Ojas Assessment Tool (OAT) can help in assessment of Apar Ojas status in individuals of any age or gender. The level of Apar Ojas declines in the patients suffering from Madhumeha. Thus, consideration of Ojas Vardhak Chikitsa (Ojas enhancing treatment) can give additional relief in the diabetic patients. The OAT may be validated through multicentric exploratory study to rule out geographical variables, and by taking larger sample size.

Trial Registration No.: The research study was prospectively registered in the Clinical Trial Registry of India (Registration no. CTRI/2019/10/021564, dated October 9, 2019) and approved by the Institutional Ethical Committee (Protocol number IEC/2018/PG-78).