Abstract
Excellent memory, extraordinary intelligence,
great academic achievement, and successful career are the dreams of every
individual in this era of competition and professionalism. A good memory power
acts as a catalyst in all walks of life, be it academic success or maintenance
of personal relationships. It is observed that an average man uses only 10% of
his natural memory. Remaining 90% is left unused in a haphazard manner. As per
the American psychologist Carl Emil Seashore, if one is alert and makes
systematic attempts to awaken and use the natural memory properly, his/her
natural memory would be activated creatively and would offer benefits of higher
order. A comparative study was conducted comprising 90 subjects to know the
efficacy of Medhya Rasayana and Yogic practices
in short-term memory of school-going children. The study was conducted over a
period of 3 months. It was an open, prospective, and randomized clinical study.
The subjects of group A formed the control group and they were observed
silently for 3 months without any intervention. The subjects in group B were
administered with Choorna (powder) of four Medhya
Rasayanas, Mandukaparni (Centella asiatica Linn.), Yashtimadhu (Glycyrrhiza
glabra Linn.), Guduchi [Tinospora cordifolia (Willd.)
Miers ex Hook. f. and Thoms.], and Sankhapushpi (Convolvulus
pluricaulis Choisy), at a dose of 2 g twice daily with milk. Subjects
belonging to group C were advocated regular Yogic practices
of Asanas, Pranayama, and Dhyana. Further
study revealed that among the three groups, group B treated with Medhya
Rasayana showed highly significant and most effective changes with respect
to objective parameters in the tests, i.e. (1) short-term memory test pictures
and (2) serial recall effects test using memory scope. Among the three groups,
group C treated with Yogic practices showed highly significant
and most effective changes with respect to subjective and objective parameters
in mini mental status scale i.e. test 3. The treatment is cost effective and
devoid of side effects, which can be beneficial for the community. Mean
increase after first follow-up in group B was higher as compared to group C.
This shows that Medhya Rasayanas are quick in
action and bring about improvement in
memory faster when compared with Yogic practices. So, on
the whole, group B can be considered to be the most efficient among the three
groups.
1. Introduction
In the present era, individuals are overloaded
with stress, tension, anxiety, and lack of sleep, which adversely affect the
memory of most individuals. It is very common even in children. The prevalence
of attention-deficit hyperactivity disorder (ADHD) among children of age group
11-17 years was 2.1%, anxiety disorders was 6.9%, and depression was 2.1% in
the US in 2007.[1] Also, the prevalence of overall mental
illnesses is 12.5% in 0-16 year age group, prevalence of anxiety disorders in
developed countries is on an average 8% (2-24%) and in India, it is 4.1% among
4-16 year olds.[2] The prevalence of attention-deficit
hyperactivity syndrome is 1.7-17.8% in India. Hence, it very essential to
manage these mental faculties affecting the short-term memory of children by
advocating Medhyna Rasayanas and Yogic practices as mentioned in our
ancient classics.
Daily use of Medhya Rasayana is
not only good for memory but also good for promotion of mental health. Yogic practices
reduce stress in life and enhance lifespan along with increasing memory. Hence,
the present research work has been designed to know the relation between Prakritiand Sara of
children with short-term memory of school-going children, to evaluate the
effect of Medhya Rasayana on the improvement of
short-term memory and maintenance of health and to evaluate the effect of Yogic practices
in the improvement of short-term memory among school-going children.
2. Materials and
Methods
Approval was obtained from the departmental
research committee and ethical committee of the institute. This study was
conducted at a school, and subjects attending the OPD in an Ayurvedic institute
were the participants. Consent was obtained from the school authorities and
parents of the children participating in the study.
Research design
The study involved intragroup comparison as well as
intergroup comparison of three groups A, B, and C. It was an open, prospective,
and randomized clinical study.
Inclusion criteria
Age, 10-16 years; sex, both sexes.
Exclusion criteria
Age below 10 years and above 16 years, mental
retardation, epilepsy, any systemic disorder.
Study design and treatment schedule
In this study, 90 subjects were selected after taking consent from school authorities and parents. The 90 subjects were divided into three groups with each having 30 subjects. General history, general physical examination, and systemic examinations were done to rule out any illness. Selected questions from Hamilton's Stress Index questionnaire were also used to rule out any major stress among the subjects. The groupings were as follows:
Group A: Control group
Group B: Medhya Rasayana
Group C: Yogic practices.
Group A: This was the control group. No
treatment was given to this group.
Group B: Subjects treated with Medhya Rasayana.
Medhya Rasayana consists of Mandukaparni (Centella
asiatica Linn.) (Panchanga), Yashtimadhu (Glycyrrhiza
glabra Linn.) (root), Guduchi [Tinospora
cordifolia (Willd.) Miers ex Hook. f. and Thoms.] (stem), and Sankhapushpi(Convolvulus
pluricaulis Choisy) (Panchanga).[3] These four raw drugs were identified by
the experts in the Department of Dravyaguna. After identification,
they were taken in equal proportion and made into Suksmacurna (fine
powder). Subjects of this group were advised to take Medhya Rasayana 2
g twice daily with milk for 3 months. The combination comprised of fine powder
of the above-mentioned four MedhyaRasayana drugs, milk powder,
and sugar powder in the ratio 2:1:1. Totally 4 g of medicine (Medhya Rasayana 2
g, milk powder 1 g, and sugar powder 1 g) was given in one dose. These drugs
were mixed with milk powder and sugar powder to increase the palatability of
the drug, so that children could consume it easily. This combination was used
as the subjects were school-going children. Medhya Rasayana was
given in the morning and evening with milk.
Group C: Subjects treated with Yogic practices.
They were asked to practice Yogic practices regularly in the
following order.
General schedule for yoga
a.Joint movements: 5 rounds each/day
Toes- flexion and extension, foot- flexion and extension, ankle- rotation,
knee- rotation, hip- rotation, finger- flexion and extension, wrist- rotation,
elbow- flexion and extension, shoulder- rotation, neck- rotation
b.Standing Asanas: 5 rounds
each/day Tadasana, Tiryaka Tadasana, Vrukshasana,
Virabhadraseana, Trikonasana
c.Pranayama- Anuloma-Viloma-
15 rounds/day, Bhramari- 10 rounds/day, Omkar Dhyana-
15 min/day
d.Shatkarma- Kapalabhati-
up to 100 rounds/day.
Assessment criteria
The following criteria were used to evaluate the
improvement:
- Short-term memory test - Pictures
- Serial effects test - Words
- Mini Mental State Scale.
Short-term memory test - pictures
(test 1)
A sheet containing 20 pictures was provided to the
subjects. A 2-min time schedule was provided to memorize the pictures and the
sheet was collected back. The subjects were then asked to write down the names
of pictures on a blank sheet within 2 min. A sheet containing a new set of 20
pictures was provided at each follow-up so as to avoid remote memory effect.
Test 1 was done manually and scoring was out of 20.
Serial recall effect test - words (test 2)
This test was done with the help of Digital Memory
Scope MD-100, a microprocessor-based instrument designed primarily for testing
the memory of subjects. A set of 10 words was shown to each subject and he/she
was asked to reproduce the words in the same order as it was shown at the same
time duration. For every wrong answer, the esc key was pressed. At the end of
the test, the screen displayed the score. For each follow-up, a new set of 10
words was used to avoid repetition. Test 2 was scored out of 20.
Mini mental status examination (test 3)
This test, designed by Folstein, assesses the
mental status of a subject through a questionnaire, regarding orientation about
date, time, place, season, and factors, along with mental stress if any, which
directly affects the short-term memory and performance at the school. Some
questions regarding reproducing of numbers in the same and reverse order also
help to assess the recollection capacity or memory of an individual. Some
questions also analyze the writing skills of an individual. Test 3 was scored
out of 30.
3. Observations
and Results
The collected data were computed in Microsoft
Excel sheet showing various variables, and analysis was done using statistical
software SPSS version 16.0. The demographic profile and personal
characteristics were collected. Intragroup comparison was done by paired t-test
to compare initial and various follow-ups. Independent sample t-test
was done and difference of means of two independent groups was calculated for
intergroup comparison. Increase in mean values in test 1 in group B was 2.53
and 5.30 after the 1st and 2nd follow-ups,
respectively, compared to the initial value, and was statistically highly
significant, whereas the mean increase in group C at 1st follow-up
was 1.63 and was statistically not significant; however, the difference in a
mean score of 2nd follow-up was 4.93, which was statistically
highly significant. As the mean values in groups B and C were higher compared
to group A, groups B and C may be considered to be better than the control
group [Table 1].
Table 1: Within-group comparison by paired t test
Increase in mean values in test 2 in group B was
1.67 and 2.27 after 1st and 2nd follow-ups,
respectively, compared to the initial value, and was statistically highly
significant. Similarly, mean increase in group C at 1st follow-up
was 0.60 and was statistically insignificant. However, the difference in a mean
score at 2nd follow-up was 1.73, which was statistically highly
significant. As the increase in mean values in groups B and C was higher
compared to group A, groups B and C may be considered to be better than the
control group [Table 2].
Table 2: Within-group comparison by paired t test
Increase in mean values in test 3 in group B was
1.17 and 3.73 after 1st and 2nd follow-ups,
respectively, compared to the initial value, and they were statistically
significant and statistically highly significant, respectively. Whereas
increase in mean values in group C at 1st follow-up was 1.90
and 4.10 after 1st and 2nd follow-ups,
respectively, compared to the initial value, and was statistically highly
significant [Table 3]. However,
when the difference between initial and 2nd follow-up values
was compared between group A and group B as well as between group A and group
C, statistically highly significant results were obtained [Table 4]. Group C
was considered better than the control group as the increase in mean values in
C was higher.
Table 3: Within-group comparison by paired t test
Table 4: Intergroup comparison on difference of initial and follow-up
Deterioration and weakening of memory process can
be delayed by the intake of Medhya Rasayanas[4] and by the regular practice of Yoga
since childhood. Majority of children (i.e., 87.78%) belonged to 10-12 age
group [Table 5]. About
51.11% subjects were males and rest were females [Table 6]. Maximum
number of subjects (i.e., 83.33%) belonged to Hindu religion, followed by
Muslims (i.e., 16.67%). This signifies Hindu-dominant population in and around
Varanasi. About 62.22% subjects belonged to middle class, 20% to upper class,
and 17.78% to lower class.
Table 5: Distraction according to age
Table 6: Distraction according to sex
In this study, maximum number of subjects
had Kapha-Pittaja Deha Prakriti (i.e.,
36.67), followed by Vata-Pittaja Deha Prakriti (33.33%) [Table 7].
Basically, Pitta Prakriti persons are blessed with
excellence of memory,[5] but practically, finding Eka Doshaja Prakriti persons
is very difficult. Retention of the perceived object is brought about by Kapha as
it is the normal function or Kapha. Pitta, having Ashukari (fast
spreading) and Tikshna qualities, stimulates the mind and
helps in perception of the object and recollection of previous expression.
Further, people with Raktasarata and Satvasarata are
naturally gifted with good memory.[6] Regarding Samhanana,
maximum subjects (54.44%) had MadhyamaSamhanana and 45.56%
had Pravara Samhanana. This indicates the proper
development of body due to proper intake of food and good Vyayama.
Regarding Satmya, maximum subjects (62.22%) came under the Madhyama Satmya category,
followed by 32.22% in PravaraSatmya. This indicates that the
children consumed more than four Rasas regularly in the diet.
About 61.11% subjects belonged to MadhyamaSatva, whereas 24.44%
belonged to Pravara Satva and only 14.44% belonged
to Avara satva. This shows that proper Satva leads to good memory. Maximum subjects were not under major stress, which was assessed by means of selected questions from Hamilton's Stress Index. Majority of subjects (i.e., 65.56%) were having Pravara Abhyavaharanashakti,
while 27.78% subjects were having MadhyamaAbhyavaharanashakti. Jaranashakti was
also found to be Pravara in majority of subjects (61.11%).
This indicates that children are basically physically active, and because of
it, their Agni is increased. Hence, they need good amount of
energy through food. Majority of subjects (i.e., 55.56%) were having Madhyama Vyayamashakti.
This also indicates that subjects were physically fit for doing Yoga. In this
study, the effect of four Medhya Rasayanas, Mandukaparni, Yashtimadhu, Guduchi,
and Sankhapushpi, was studied. These are easily available, and they
are very beneficial for memory and also help in the prevention of many
diseases. Medhya Rasayana was given to group B
subjects at a dose of 4 g twice daily for 3 months.
Table 7: Distribution according to Deha Prakriti/i>
Mode of action of Medhya Rasayana
Medhya Rasayanas strengthen
the body and maintain normal body function. Pitta Dosha maintains
the intelligence and Kapha sustains the body with intelligence
and Dhriti (courage) by its Sthira Guna.[7] Pranavata performs the
intellectual function and it is the main factor involved in grasping and fast
recall, especially because of its Chala (mobile) and Vishada (fast-spreading)
properties. Sadhaka Pitta performs functions like
discrimination between right and wrong by the Nishchayatmaka Buddhi and Medha (intelligence).[8] Medhya Rasayanas help
to maintain vata, pitta, and Kapha Doshas normal
functions. According to Ayurveda, Mandukaparni is Medhya by Prabhava (special
effect). Mandukaparni present in Medhya Rasayana improves
learning and memory processes by modulating dopamine, 5-Hydroxytryptamine
receptor, and noradrenaline systems, which was also reported in a study on
rats.[9] It is also effective in preventing the
cognitive deficits as well as oxidative stress.[10] It also reduces stress which is one
among the factors leading to memory impairment by reduction in raised
circulating corticosterone. It also shows immune-modulatory activity and strong
antioxidant activity as revealed by increased level of superoxide dismutase
(SOD), glutathione peroxidase, and glutathione in mice. Ce. asiatica extract
and powder may ameliorate H 2 O 2 -induced
oxidative stress by decreasing lipid peroxidation via alteration of the
antioxidant defense system in rats.[11] Thus, it is a general health promoter.
It has neuronal dendritic growth-stimulating property.[12] This may help in enhancing concentration
power, thus improving short-term memory. Asiaticoside, an active principle
present in Ce. asiatica, imparts anxiolytic activity,[13] and thus, it helps in reducing the
anxiety which is one of the factors affecting the memory. Aqueous extract
of Ce. asiatica Linn. is reported to be effective in
preventing the cognitive deficits as well as oxidative stress caused by
intracerebroventricular streptozotocin in rats.
Madhura and Shita qualities
and Vatapittashamaka and Rasayana effects
of Yashtimadhu bring about soothing effect, and probably this
helps in bringing about Stairya and Dhriti to
establish stability of mind and for enhancing memory [Table 8]. The root
of G. glabra Linn. contains the active principles,
glycyrrhizin, glycoside, isoliquritin, liquiritin, steroid estrogen,
hispaglabridin B, isoliquiritigenin, and paratocarpin B. [14] Experiments showed that G.
glabra Linn. increases the blood circulation to the central nervous
system and balances the sugar levels in the blood. [15] The isoflavones glabridin and
hispalglabridins A and B of G. glabra Linn. have significant
antioxidant activity. The antioxidants protect susceptible brain cells from the
oxidative stress, resulting in reduced brain damage and improved neuronal
function, thereby enhancing the memory. [16]Ethanol extract of G. glabra Linn.
possesses cerebroprotective effect in hypoxic rats, which may be mediated by
its antioxidant effects. According to a study improvement in learning and
memory of mice was observed when they were administered aqueous extract of
liquorice in a dose of 150 mg/kg. This is probably due to facilitation of
cholinergic transmission in mouse brain. [17]
Table 8: Properties of plants as per Bhavaprakash Nighantu
Guduchi, another
component of Medhya Rasayana, has Katu, Tikta Rasas which
help in keeping the mind alert, so that things can be remembered properly.
By Tridoshahara property, it helps to establish a balance and
a good coordination of grasping, retention, and recall of memory.
Further, Rasayana Prabhava helps in retaining
things. T. cordifolia has active principles such as
tinosporone, tinosporic acid, cordifolisides A-E, syringen, berberine, giloin,
gilenin, crude giloininand, arabinogalactan polysaccharide, picrotene,
gilosterol, tinosporol, tinosporidine, sitosterol, cordifol, and glucan
polysaccharide. The root extract of T. cordifolia was found to
possess normalizing activity against stress-induced changes in norepinephrine,
dopamine, 5-hydroxytryptamine, and 5-hydroxyindoleacetic acid levels. T.
cordifolia enhances cognition (learning and memory) in normal rats.
Cyclosporine-induced memory deficit was successfully overcome with T.
cordifolia.[18] T. cordifolia, at a dose of 500
mg daily, enhances verbal learning and memory and logical memory (of immediate
and short-term type) compared to placebo in healthy volunteers.[19] According to Burton, T.
cordifolia has found a place in natural and herbal treatments of
ADHD. Guduchi is shown to have antioxidant activity and
amelioration.[20] This helps in health promotion as well
as preventing forthcoming diseases.
Sankhapushpi is
the most effective among the four Medhya Rasayana drugs
mentioned by Acharya Charaka.[21] It has Kashaya Rasa and Ushna Guna, which
may enhance the alertness and quick understanding and retention of experiences.
It has Tridoshahara property. C. pluricaulis contains
many phytonutrients like convolidine, convolvine, convolvidine, convoline,
confoline, phyllabine, subhirsine, and scopoline. These compounds help in brain
stimulation and increase the ability to concentrate.[22] C. pluricaulis reduces anxiety and stress by controlling the production of body's stress hormones, adrenaline and cortisol. It is reported to possess anxiolytic and memory-enhancing and mood-elevating effects, and is claimed to retard brain aging.[23] Neuroprotective role of C.
pluricaulis has been proved in the study by Bihaqi et al.
on aluminum-induced neurotoxicity in rat brain. The psychotropic effect
of C. pluricaulis was studied by Singh and Mehta on 30
outpatients of anxiety neurosis in 1976. After 1 month of treatment, a
significant reduction in the neurotic features was observed and immediate
memory span was significantly improved.
Mode of action of Yoga
Due to short-term memory loss, the individual
faces many problems and overall poor performance in work. Yoga can
help humanity in a major way by making individuals overcome the challenges
posed by loss of memory. An integrated approach to Yoga is necessary for the holistic development of memory. Tadasana develops
physical and mental balance. Tiryak Tadasana balances
the body as well as the mind. [24]Vrukshasana gives sense of balance
and poise. Virabhadrasana develops concentration power. Trikonasana stimulates
the nervous system and alleviates nervous depression. Kapalabhati energizes
the mind for mental work and removes sleepiness,[25] thus brings about alertness needed for
the improvement of short-term memory. While performing Anuloma-Viloma,
breathing through the left nostril tends to activate the right hemisphere and
breathing through the right nostril activates the left hemisphere. It has
calming effect and relieves anxiety, improves concentration, and
stimulates Ajna cakra. The brain centers are stimulated
to work nearer to their optimum capacity. Bhramari relieves
stress and cerebral tension, and thus helps in alleviating anger, anxiety, and
insomnia. Omkar Dhyana produces benefits at many
levels of life. It simultaneously influences body, emotions, mental
functioning, and relationships. Meditation also improves brain functioning,
enhances the ability to focus, improves perception and memory, promotes
development of intelligence, decreases craving for cigarette, alcohol, and drug
abuse, along with decreasing the withdrawal symptoms, induces relaxation, and
decreases stress. Meditation is an inherent ability of the human body.
Meditation is an activity whereby the nervous system, brain, and senses get
tuned themselves for best functioning. During meditation, the concentration on
different Cakras like on Muladhara Cakra enhances
health and Vidya, Manipura Cakra enhances Vidya and
capacity, and on Vishudha Cakra brings about
improvement in speech and knowledge. The Satvasarata state
leads to excellence of memory; this state can be brought about by the regular
practice of Yoga, so as to improve short-term memory.
Objective assessment
In test 1 (short-term memory test - pictures),
the intergroup comparison showed that group B treated with Medhya Rasayana was
most effective as the increase in mean values in the group was higher. A
similar study conducted also showed marked improvement in visual reproduction
of Wechsler memory scores after the practice of Yoga.[26]
Intergroup comparison showed that group B (Medhya Rasayana)
was most effective in test 2 (serial recall test). This shows that MedhyaRasayana enhances
the Granthagrahana Samarthya of students.[27] Intergroup comparison showed that in
test 3, group C with Yogic practices was the most effective as
the increase in mean values in the group was higher. This shows that the Yogic practices
help in the improvement of mental status like relief from day-to-day stress and
also help in the improvement of memory. When group B was compared with group C
in test 1, the difference between the 1st follow-up values was
found to be significant. Increase in mean values after 1st follow-up
in group B was higher as compared to group C. This shows that Medhya Rasayanas are
quick in action and bring about improvement in memory faster when compared
with Yogic practices. So, on the whole, group B can be
considered to be the most efficient among the three groups.
5. Conclusion
Medhya Rasayana helps
in improvement of memory power. Yogic practices help to
improve the concentration and calm the mind, resulting in memory improvement.
Among the three groups, group B treated with Medhya Rasayana was
highly significant and most effective with respect to objective parameters in
tests 1 and 2. Further, the treatment is cost effective and devoid of side
effects, so it can be applied in the community. Among the three groups, group C
treated with Yogic practices was highly significant and most
effective with respect to subjective and objective parameters in test 3. It is
also a cost-effective, non-pharmacological intervention; so, everyone can adopt
it to enhance memory as well as prevent many lifestyle disorders. Group B
treated with Medhya Rasayana is most effective in
improving short-term memory of school-going children among the three groups.
Acknowledgements
We are very much thankful to Prof. C. B. Jha,
Faculty of Ayurveda, Institute of Medical Sciences, Banaras Hindu University,
Varanasi and all the teachers, staff, and junior residents of our department.
Our special thanks to Shri Subhash Chandra Sharma, Principal, Kendriya
Vidyalaya, BHU and Smt. Savita Jain, Principal, Malaviya Shishu Vihar, BHU for
granting permission to conduct the study in their school. We heartily thank all
school children and their parents for their kind co-operation, without which
this work would not have been possible.
References
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About Authors: Atul Shankar Sarokte, Mangalagowri V Rao. Atulji is Junior Resident III, Department of Swasthavritta
and Yoga, Faculty of Ayurveda, Institute of Medical Sciences, Banaras Hindu
University, Varanasi, Uttar Pradesh, India. Mangalaji is Assistant Professor,
Department of Swasthavritta and Yoga, Faculty of Ayurveda, Institute of Medical
Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India.
Article
available online/offline on: AYU, Vol. 34, Issue 4, Oct-Dec 2013, Page
no.383-89, for more details please visit: www.ayujournal.org
Address for correspondence: Mangalagowri V Rao, Department of
Swasthavritta and Yoga, Faculty of Ayurveda, IMS, BHU, Varanasi - 221 005,
Uttar Pradesh India.
No part of this article may be reproduced in full or part without written permission of the Ayu Journal who can be contacted at ayujournal@yahoo.com