Abstract

EVALUATION OF THE EFFICACY OF ASHOK CHHAL POWDER IN REDUCING MENSTRUAL BLOOD LOSS IN WOMEN WITH KASRAT-E-TAMS: A UNANI CLINICAL STUDY

Dr. Khan Tamseen Jabbar*, Dr. Rafi Ahmed Chaudhry, Dr. Ghazala Mulla, Dr. Maryam Bano Baberali Shaikh, Dr. Pathan Hafeez Kha Nawaz Kha, Dr. Mohd. Danish

ABSTRACT

Heavy menstrual bleeding (HMB), traditionally described as Kasrat-e-Tams in the Unani system of medicine, is a common gynecological disorder that may adversely affect physical functioning, quality of life, and hematological status. Ashok Chhal (Saraca indica; syn. Saraca asoca) has traditionally been used in various gynecological disorders, particularly excessive uterine bleeding. The present study was undertaken to evaluate its efficacy in reducing menstrual blood loss in women with Kasrat-e-Tams and to assess the distribution of Mizaj among affected participants. An open-label, single-arm clinical study was conducted in the Department of Ilmul Qabalat wa Amraz-e-Niswan, Z.V.M. Unani Medical College & Hospital, Pune, following Institutional Ethics Committee approval. Forty patients were planned for recruitment to account for possible dropouts, of whom 30 completed the study and were included in the final analysis. Women aged 18–45 years with clinically established heavy menstrual bleeding for at least three consecutive cycles were enrolled. Ashok Chhal powder was administered at a dose of 5 g three times daily with water or milk from the first day of menstruation until cessation of bleeding for three consecutive menstrual cycles. Menstrual blood loss was assessed using the PBAC score, while duration of bleeding, number of sanitary pads used, abdominal pain, general weakness, and haemoglobin were assessed as clinical parameters. Mizaj was assessed using Ajnas-e-Ashra. Statistical analysis was performed using repeated-measures analysis of variance, with p<0.05 considered statistically significant. Among the 30 participants, the majority (63.3%) were aged 26–30 years, with a mean age of 25.96 ± 3.63 years. Damvi Mizaj was predominant, occurring in 70.0% of participants, followed by Balghami (20.0%) and Safravi (10.0%) temperament. The mean PBAC score decreased progressively from 302.20 ± 72.89 at Visit 1 to 236.37 ± 58.99 at Visit 2, 163.43 ± 76.86 at Visit 3, and 116.60 ± 75.06 at Visit 4. This represented reductions of 21.79%, 45.92%, and 61.41%, respectively, compared with baseline. Pairwise comparisons between Visit 1 and Visits 2, 3, and 4 demonstrated statistically significant reductions in PBAC scores (p=0.001 for each comparison). These findings indicate a progressive reduction in menstrual blood loss during the treatment period. Ashok Chhal powder demonstrated a significant reduction in PBAC scores and, consequently, menstrual blood loss among women with Kasrat-e-Tams in this open-label, single-arm study. The predominance of Damvi Mizaj among participants provides an interesting observation for further investigation of the relationship between temperament and heavy menstrual bleeding. The findings support the traditional use of Ashok Chhal in Kasrat-e-Tams and suggest that it warrants further evaluation through larger, controlled clinical trials to establish its efficacy and safety.

Keywords: Kasrat-e-Tams; Heavy menstrual bleeding; Menorrhagia; Ashok Chhal; Unani medicine; Mizaj; PBAC; Menstrual blood loss.