Abhinandan Y. Patil. B.A.M.S

Abhinandan Y. Patil. B.A.M.S

From,

ABHINANDAN Y. PATIL. B.A.M.S.

Preliminary M.D (Ayu) Scholar,

Dept. of P.G. Studies in Manasa Roga,

S.D.M.College of Ayurveda & Hospital,

Hassan -573201.

To,

The Registrar,

RajivGandhiUniversity of Health Sciences, Karnataka,

Bangalore.

Through,

The Principal and Head Of The Department Of Manasa Roga,

S.D.M.College of Ayurveda and Hospital, Hassan.

Subject: Submission of completed proforma for Registration of Subject for Dissertation.

Respected sir,

I hereby request you kindly to register the mentioned subject against my name for the submission of Dissertation to the Rajiv Gandhi University of Health Sciences, Karnataka, Bangalore for partial fulfillment of M.D. (Ayu).

Title of the Dissertation:“A CLINICAL STUDY ON ROLE OF KALYANAKA GHRITA AND SHIREESHADI ANJANA IN THE MANAGEMENT OF KAPHAJA UNMADA W.S.R.TO DEPRESSIVE DISORDERS”

Here with I am enclosing completedproforma of synopsis for registration of subject for dissertation.

Thanking you.

Date : 31-10-2007. Yours faithfully

Place : Hassan

Abhinandan Y.Patil.

RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, KARNATAKA, BANGALORE.

ANNEXURE - II
COMPLETED PROFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION

1.NAME OF THE CANDIDATE : ABHINANDAN Y.PATIL AND ADDRESS PRELIMINARY M.D.(AYU)

SCHOLAR

DEPT. OF P.G. STUDIES IN MANASA ROGA,

S. D. M COLLEGE OF AYURVEDA & HOSPITAL, HASSAN -573201.

PERMANENT ADDRESS : S/O DR.YUVARAJ S. PATIL

“SAVITRI CLINIC” YALLAMA CHOWK, ISLAMPUR. TAL- WALWA,

DIST-SANGLI,

MAHARASHTRA 415409.

2. NAME OF INSTITUTION : S.D.M.COLLEGE OF AYURVEDA HOSPITAL, HASSAN,

KARNATAKA.

3. COURSE OF STUDY IN SUBJECT: M.D. (Ayu) in MANASA ROGA

4. DATE OF ADMISSION OF : 25th MAY 2007.

COURSE

5. TITLE OF THE TOPIC : “A CLINICAL STUDY ON ROLE OF KALYANAKA GHRITA AND SHIREESHADI ANJANA IN THE MANAGEMENT OF KAPHAJA UNMADA W.S.R.TO DEPRESSIVE DISORDERS”

6. BRIEF RESUME OF THE STUDY:

6.1 Need for the study:

The World Health Organization Report 2001 identified “Mood disorders” as the 4th cause of DALY (Disability-Adjusted Life Years) in all ages and the 2nd cause in the age group of 15-44 years. Depressive Disorder comes under Mood Disorder. The prevalence rate for all mental disorders was observed to be 65.4 per 1000 population, out of which prevalence rate for affective disorders (depression) is 31.2 per 1000 population1. About 2/3 of all depressed patients contemplate suicide and 10 to 15 percent of people commit suicide 2. Mental normality is the expression of a person’s normal behavior, forms and functions that prevail in a social environment, so Depressive Disorders lead to disturbance in personal, familial and social harmony.

In Ayurveda, Unmada is a common entity, represents almost all Psychiatric Disorders. In this ailment the intellect, mind and memory get perverted 3a. Unmada can be applied to the disordered state of mind, in which an individual loses the power of regulating his actions and conduct according to the rules of society in which he is moving. Kaphaja Unmada is one of the varieties of Nija Unmada having lakshanas like Sthanamekadeshe (staying in one place), Tushnibhava (keeping silence), Alpashachankramana (reduced motor activity),Sadana (fatigue), Anannabhilasha (disinclination for food),Alpabhug (less appetite), Rahaskamata (prefer or love for solitude), Bhibhatsyatva (disgust feeling), Shauchadvesha (aversion for cleanliness), Svapnanityata (hypersomnia), Shvayathuranana (edematous face), Chardi(vomiting) and Alpamati (less intellectual activity)3b, 4a.

The symptoms of Kaphaja Unmada are almost similar with Depressive Disorder, which is characterized by depressed mood and loss of interest or pleasure associated with appetite disturbance, sleep disturbance, psychomotor agitation or retardation, decreased energy, feeling of worthless, difficulty in concentrating, thoughts of death and suicide or suicidal attempts.

By seeing the prevalence rate of Mood Disorders, which affect the productivity and quality of life of an individual in turn family, society and country, non drug-dependent treatment is need of the hour.The Ayurvedic formulations may bring the abnormal mind back to normalcy without leaving any side-effects and having dependency.

Ghrita enhances intellect, memory and play an important role in the treatment of Unmada6a. Hence Ghrita formulation especially Kalyanaka Ghrita3c is described for the management of Unmada because it alleviates Rajas and Tamas and increases Kalyanamsha (Satva). Most of dravyas in Kalyanaka Ghrita like Vishala (Cirullus colocynthis), Devadaru (Cedrus deodara), Haridra (Curuma longa), Kushta (Saussurea lappa), Vidanga (Embelia ribes), Bhadraila (Amomum subulatum) etc. haveKaphahara properties i.e. Katu-Tikta Rasa, Laghu-Ruksha Guna, Ushna Veerya and Katu Veepaka. So Kalyanaka Ghrita may be useful in Kaphaja Unmada.

Anjana is one of treatment modality indicated in Unmada. Acharya Vagbhata6b emphasis its importance that even though all medications for Unmada like Vamana, Virechana etc. fail, then one should do Teekshna Anjana Karma. Shireeshadi Anjana, comprising of Teekshna dravyas like Shireesha (Albizia lebbek), Madhuka (Glycyrrhiza glabra), Hingu (Ferula northax Bioss), Lashuna (Allium sativum), Tagara (Valeriana wallichii DC), Vacha (Acorus calamus) and Kushta (Saussuria lappa) is decribed in the management of Unmada3d,5a.

In view of all these facts, this study is planned to see the role of Kalyanaka Ghrita and Shireeshadi Anjana in the management of Kaphaja Unmada w.s.r.to Depressive Disorders.

6.2 Review in literature:

  1. Acharya Charaka explained Unmada is vibhrama of Manas, Buddhi, Sanjnajnana, Smrti, Bhakti, Shila, Cesta, and Acara3e and explains samanya lakshanas of Unmada3f. Separate nidana, samprapti, lakshanas and chikitsa of Vata, Pitta, and Kapha sub types of Unmada are described3g.
  2. According to Sushruta, Unmada is distraction of mind due to the upward movement of doshas4b and lakshana of Kaphaja Unmada are Chardi, Agnisada, Sadana, Aruci, Yoshitaviviktarati, Alpamati, Alpapracara, Nidra aparo, Alpa kathanam, Alpabhug, Ushnasevi, Ratraubhrusham4a.
  3. Acharya Vagbhata explained lakshana of Kaphaja Unmada5b,6c
  4. Madhavakara7 and Yogaratnakara8 followed the description given for samprapti and lakshana of KaphajaUnmada in Caraka Samhita.
  5. Acharya Charaka described Kalyanaka ghrita in the context of Unmada Chikitsa3c.
  6. Acharya Charaka and Vagbhata emphasis the importance of Teekshna Anjana

in treatment of Unmada3h,6b.

  1. Shireeshadi Anjana is described in the management of Unmada3d,5a.

Research Work Done at Different Institutes:

  1. Nath Sushil Kumar : A Clinical study on depressive illness and its Ayurvedic management - IMS, BHU (1988).
  2. Purohit Narendra : Katipaya Dravyon ka Shlaishmika Unmada par Karmukattva Parigyana – M.M.M.Govt. Ayu. College, Udaipur(1997)
  3. Mevekari Hamid S: The Role of Dhoopana and Dhoompana in the management of Kaphaja Unmada w.s.r.to Brahmyadi Varti- V P S V Ayurveda College, Kottakkal (2003).
  4. Shaikh Anwar K.S. : A study of Kaphaja Unmada in relation to depressive disorders - V P S V Ayurveda College, Kottakkal (2004).
  5. Devadas P B: A Randomized controlled trial on Shireeshadi Avapeeda-Nasya in the management of Kaphaja Unmada- V P S V Ayurveda College, Kottakkal (2005).
  6. Shyla M G : A Study on effect of Kalyanaka Ghrita in Adhija-Unmada – S.D.M.C.A. Hassan (2006).

6.3.Objective of the study:

  1. To evaluate the effect of Kalyanaka Ghrita in the management of Kaphaja Unmada.
  2. To evaluate the effect of Kalyanaka Ghrita along with Shireeshadi Anjana in the management of Kaphaja Unmada
  3. To compare the effect of both groups with respect to management of Kaphaja Unmada

7. MATERIALS AND METHODS:

7.1. Source of data:

Patients attending the OPD and IPD of Department of Manasa Roga, S.D.M. Ayurvedic College and Hospital, Hassan .

7.2. Methods of collection of data:

Patients will be selected on the basis of following criteria.

A: Criteria for diagnosis:

The diagnosis will be made on the basis of signs and symptoms of Kaphaja Unmada as per Ayurvedic Classics and Depressive Disorders in I.C.D.10 and D.S.M. IV-TR criteria.

B. Inclusion criteria:

  1. Patients diagnosed as per the criteria for Kaphaja Unmada.
  2. No discrimination of sex, race, caste and religion
  3. Age group 15-50 yrs
  1. Exclusion criteria:
  1. Patients of other Nija Unmada and Bhutonmada..
  2. Diagnosed case of Schizophrenia, Schizophreniform Disorder.
  3. Patients suffering from any other psychotic disorders.
  4. Patients having substance use disorders.

D. Plan to study the effect of the treatment:

30 patients fulfilling the inclusion criteria will be randomly selected and assigned into 2 groups each consisting of 15 patients.

Grouping:

Group A (Control Group):

15 patients will be administered Kalyanaka Ghrita in the dosage of 20 ml twice daily with hot water, one hour before food for a period of one month.

Group B (Treated Group):

15 patients will be administered Kalyanaka Ghrita in the dosage of 20 ml twice daily with hot water, one hour before food along with application of Shireeshadi Anjana into both eyes, in the morning hours, twice in a week for a period of one month.

E. Assessment criteria

The result of the treatment will be evaluated as to the degree of Depression according to Self Prepared Rating Scale for Kaphaja Unmada and Hamilton Depression Rating Scale (HDRS) before and after treatment.

Assessment of results.

Statistical evaluation of the results will be done by using Unpaired and paired ‘t’ test.

G. Follow Up:

After the completion of the treatment, patients will be asked to report for the follow-up study at the fortnightly interval for one month.

7.3Laboratory Investigations: Routine Laboratory investigation for blood and Urine

7.4 Has Ethical Clearance Been Obtained From Your Institution : Yes

8. LIST OF REFFERENCES –

  1. Indian Journal of Community Medicine. 2001 Oct-Dec; 26(4): 198-200
  2. Benjamin James Sadock and Virginia Alcott Sadock: Synopsis of Psychiatry, published by Lippincott Williams and Wilkins, 10th edition (2007), page no. 543.
  3. Charaka:Charaka Samhita with Ayurveda Deepika Commentary of Chakrapanidatta, edited by Vaidya Jadavaji Trikamji Acharya, published by Chaukamba Sanskrit Sansthan, Varanasi, 4th edition (1994)

3a- Chikista Sthana 9:8 , page no: 468

3b- Nidana Sthana 7:6(3) , page no: 223

3c- Chikista Sthana 9:35-41 , page no: 471

3d- Chikista Sthana 9:64-65 , page no: 473

3e- Nidana Sthana 7:5 , page no: 223

3f- Chikista Sthana 9:6-7 , page no: 468

3g-Chikista Sthana 9:9-14 , page no: 468

3h- Chikista Sthana 9:29, page no: 470

  1. Sushruta: Sushruta Samhitha with Nibandha Sangraha Commentary of Dalhana edited by Vaidya Jadavaji Trikamji Acharya, published by Chaukamba Sanskrit Surbharati Prakashan, Varanasi, 4th edition( Reprint-1994)

4a- Uttara Sthana 62:10, page no: 804

4b- Uttara Sthana 62:3, page no: 803

  1. Vagbhata: Astang Samgraha with the Sasilekha Sanskrit Commentary by Indu, edited by Dr. Shivprasad Sharma, published by Chaukamba Sanskrit Series office, Varanasi, 1st edition (2006)

5a- Uttara Sthana 9:25, page no: 679

5b- Uttara Sthana 9:9, page no: 677

  1. Vagbhata: Astanga Hrdayam with the commentaries of Sarvangasundara of Arunadatta and Ayurvedarasayana of Hemadri, edited by Pt.- Bhisajacharya Harishastri Paradkar Vaidya, published by krishnadasa academy Varanasi (Reprint-2000)

6a- Uttara Sthana 5:37-38, page no: 73

6b- Uttara Sthana 6:20, page no: 799

6c- Uttara Sthana 6:12-13, page no: 798

  1. Madhav Nidanam: Madhav Nidanam with Sanskrit Commentary of Madhukosa, edited by Dr. Brahmananda Tripathi, published by Chaukamba Surbharati Prakashan, Varanasi, 4th edition( Reprint-2003), Volme-1, Unmadanidanam/11-12 ,page no: 483
  2. Yoga Ratanakara: Yoga Ratanakara with Vaidyaprabha hindi commentary, edited by Dr. Indradev Tripathi and Dr. Daya Shankar Tripathi, published by krishnadasa academy Varanasi, 1st edition (2003), Unmada Chikitsa :13-14, page no: 387.

9. SIGNATURE OF THE CANDIDATE -

10. Remark of the Guide -

11. Name and Designation Of

11.1. Guide- Dr. NARAYANA PRAKASH.B M.D. (Ayu)

PROF. AND H.O.D. DEPARTMENT OF P. G. STUDIES IN MANASAROGA.

S.D.M.C.A. & H., HASSAN.

11.2.Signature-

11.3. CO-Guide:- Dr. SUHAS KUMAR SHETTYM.D. (Ayu)

ASST. PROF.

DEPT OF P.G. STUDIES

IN MANASA ROGA

S.D.M.C.A. & H., HASSAN.

11.4. Signature-

11.5. Head of the department - Dr. NARAYANA PRAKASH B.M.D. (Ayu)

PROF. AND H.O.D

DEPT. OF P.G. STUDIES IN MANASA ROGA

SDMCA & H, HASSAN.

11.6. Signature:-

12.

12.1. Remark of Chairman -

and Principal

12.2. Signature-

1

Top View