From,

DR. NARESH PRASAD

Preliminary M.S. (Ayu) Scholar,

Dept of Shalya Tantra

Shri Shivayogeeshwar Rural AyurvedicMedicalCollege & Hospital

Inchal-591102

Dist-Belgaum

To,

THE REGISTRAR

RajivGandhiUniversity of Health Sciences,

Bangalore.

Through,

THE PRINCIPAL AND H.O.D OF SHALYA TANTRA,

Shri Shivayogeeshwar Rural AyurvedicMedicalCollege & Hospital

Inchal-591102 Dist-Belgaum

Respected Sir,

Sub: Submission of completed proforma for registration of subject for

Dissertation.

I humbly request you to kindly register the below subject against my name for submission of dissertation to Rajiv Gandhi University of Health Sciences, Bangalore for the partial fulfillment of M.S.(Ayu)

Title of Dissertation

“ROLE OF TILVAKA GHRITA IN THE MANAGEMENT OF

BAHYA VIDRADHI, FOLLOWED BY BHEDANA KARMA”

Here I am enclosing completed proforma for registration of subject for dissertation.

Thanking you sir,

Yours faithfully

Date : 25/04/2011

Place : INCHAL

(Dr. NARESH PRASAD)

RAJIVGANDHIUNIVERSITY OF HEALTH SCIENCE

BANGALORE. KARNATAKA

ANNEXURE II

PROFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION

1. NAME OF THE CANDIDATE: Dr. NARESH PRASAD

AND ADDRESS G/A SWETA SMRITI BHAVAN

NEAR JAKKANPUR P.S. BUS STAND

ROAD. PATNA 1. BIHAR . PIN :-800001

2. NAME OF INSTITUTION : SHRI SHIVAYOGEESHWAR RURAL

AYURVEDICMEDICALCOLLEGE &

HOSPITAL, INCHAL,

DIST:BELGAUM KARNATAKA

3. COURSE OF STUDY M.S.(AYU) SHALYA TANTRA

AND SUBJECT:

4. DATE OF ADMISSION:NOVEMBER 2010

5. TITLE OF THE TOPIC:

“ROLE OF TILVAKA GHRITA IN THE MANAGEMENT OF

BAHYA VIDRADHI, FOLLOWED BY BHEDANA KARMA”

6. Brief Resume of intended work. 6.1 Need for the study:

VIDRADHI is a localized soft tissue injury may be in the form of collection of pus in the body, caused due to inflammatory changes by various means like direct injury, contamination, infection through blood etc.

In Ayurvedic classics,VIDRADHI is compared with Abscess which is classified into 2 varities as Bahya and Abhyantara.

BAHYA VIDRADHI occurs due to dooshan of twak, rakta, mamsa and meda, which is very painful and inflammatory in nature4. Aushadh & Shastra karma are adviced for chikitsa of Bahya Vidradhi, in classical treatises2,8. According to Acharya Sushruta, if Vidradhi attains pakwa avastha,the method adopted for the removal ofpus should be BHEDANA KARMA and later, it should be treated as a Vrana2,8. It is a well known fact that all types of Vranas occur mainly due to Vata prakopa. So, vatashamak chikitsa is done initially and Ghrita is a good vatahara dravya. Hence Ghrita, prepared with addition of Tilvaka and some other dravyas,may be best drug for healing of the incised Vidradhi5,6. Once Bhedana karma is done and all pooya is removed, instillation of TILVAKA GHRITA for healing purpose is advised, which is having vatanashak karma, mentioned in Sushruta samhita, Charaka samhita and Ashtanga hridaya5,6,8.

On considering the above, the present study is planned with Bhedana karma and instillation with Tilvaka Ghrita in Bahya Vidradhi.

6.2 Review of literature

A) Review of disease:

Vidhradhi is being mentioned with great details in ayurvedic classics. Acharya Sushruta has described briefly about it in Nidana sthana, Chikitsa sthana and even Acharya Sushruta has advised to treat it initially by Bhedana karma and then it should be treated with TILVAKA GHRITA.

On other hand Acharya Charaka also gives its nirukti in Sutra sthana and an idea regarding TILVAKA GHRITA is proposed in Chikitsa sthana.

Acharya Vagbhata has emphasized its causes in Nidana sthana and highlights its treatment with shastra karma and application of TILVAKA GHRITA in Chikitsa sthana.

Other treatises like Yogaratnakara and Bhaishajyaratnavali also mentioned about VIDHRADHI Chikitsa by Shastra karma.

.

B) DRUG REVIEW:

TILVAKA GHRITA has to be instillated after INCISION of a pakwa Vidradhi by our Acharayas. According to Sushruta and Vagabhata2,8, Tilvaka Ghrita is one of the vatashamak ghritas, mentioned for BAHYA VIDRADHI5 .

*Previous research works conducted :

1 Dayanand S :Effecacy of shamana lepa & Darana lepa in the

Management of Bahya Vidradhi.1988 Bangalore

2 L. Naresh Kantilal :Study of Karanjadi ghrita &Triphala Guggulu

In incised external Vidradhi 2003 Udupi

3 Chovatia N.M :Role of Karanjadi Ghrita in the management of Dusta

Varna 1988 Jamnagar

4 Jesakar R.R :Role of pancha valkala Ghrita in the management of

Vidradhi a complete study 2003 Akola

6.3 Aims and Objectives.

a) To study the efficacy of TILVAKA GHRITA in the management of

Bahya Vidradhiafter BHEDANA KARMA.

b) To study the disease Vidradhi according to Ayurveda & modern surgery.

c) To introduce a comprehensive post operative wound healing agent in the

management of Bahya Vidradhi.

7. Materials and Methods.

7.1 Source of Data 40 Patients will be selected from OPD and IPD of Shalya Tantra at SHRISHIVAYOGEESHWARRURALAYURVEDIC MEDICAL COLLEGE & HOSPITAL, INCHAL,BELGAUM.

7.2. Method of Collection of Data:

Patients who are fulfilling the inclusion criteria will be considered for study.

a)Inclusion Criteria:

a) Patients irrespective of age, sex & occupation will be selectedfor study.

b) Established cases of Vidradhi will be included.

b) Exclusion Criteria:

a) Patients suffering with systemic diseases like TB, DM,CRF, CHD, HbsAg and HIV will be excluded.

b) Patients with Pregnancy& Malignancy will be excluded.

c)Deep abscess with sinus and bony pathology will be excluded.

c)Treatment group:

40 patients who are fulfilling the criteria for inclusion will be managed in single group in the intervention as follows.

The patients will be treated with incision and drainage of pus and is managed with instillation of TILVAKA GHRITA under aseptic precautions and dressing is done.

d)Duration of treatment:

Daily dressing will be done with instillation of TILVAKA GHRITA in abscess cavity for one week.

Follow up- Twice in a week for two weeks.

e)Assessment Criteria:

Assessment will be analyzed on the basis of objective and subjective parameters before and after treatment.

f) Objective Parameters & Subjective parameters:

Sl. No. / Objective / Subjective
1 / Wound margin / Pain
2. / Cavity of abscess / Purulent discharge
3. / Slough / Oedema
4. / Granulation / -

g)Follow up study:

After initial surgical and medical intervention of the first week of treatment, patient is advised to visit twice in a week for the next two weeks.

h) Statistical Analysis:

The data will be collected and statistically analyzed by consulting a

Bio-statistician.

7.3 Does the study require any investigation or intervention to be conductedon patients or human or animal, if so, please describe brief.

Yes.

a)Investigations: 1.Hb,T.C.,DC,ESR,RBS

2.HIV 1and 2& HbsAg for suspected cases.

3.Any other relevant tests, if required.

b) Interventions * The patient will be assessed before and after treatment as

per assessment criteria .

* The nature of study will be explained to the patient in

detail and pre treatment consent will be taken.

* The patient have full right to withdraw the on going

treatment/study at any time .

* The data will be maintained confidently and subjected

to statistical analysis.

7.4 Has the ethical clearance been obtained from your institution in case of 7.3 ?

Obtained and certificate is enclosed.

8.LIST OF REFERENCES:

  1. Acharya Charaka-Charaka Samhita,Sutrasthana, Hindi translated by Pandit Kansinath Shastri and Dr.Gorakhnath chaturvedi,ChaukambhaBhartiAcademy,Varanasi: Reprinted 2007: Edition Chapter no 17th. Shloka no 90-95, page no.358.
  2. Acharya Sushruta- Sushrata Samhita ,Chikitsasthan,Dr.Ambikadutt shastri,Chaukhambha Sanskrit Sansthan Varanasi. Reprinted in 2007, 16th Chapter no Shloka no35-37,page no 78.
  3. Acharya Sushruta, Sushrata samhita, Sutrasthana, Hindi Translated Dr.Ambikadutt shastri Varanasi. Chaukhambha Sanskrit Sansthan , Reprinted in 2007,Chapter no 5th , Shloka no5,page no 16.
  4. Acharya Sushruta, Sushruta samhita,Nidanasthana, Hindi translated Dr.ambikadutt ShastriVaranasi.Chaukambha Sanskrit sansthan , Reprinted in 2007,Chapter no 9th Shloka no4-5,page no 263.
  5. Acharya Sushruta, Sushruta samhita, Chikitsasthan, Hindi Translated Dr.Ambikadutt shastri.Varanasi. Chaukhambha Sanskrit Sansthan ,Reprinted in 2007,Chapter no 4th ,Shloka no27,page no 27.
  6. Acharya Charaka,Charaka Samhita, Chikitsasthan,, Hindi Translated by Pandit Kansinath shastri and Dr.Gorakhnath Chaturvedi.VaranasiChaukambhaBhartiAcademy, Reprinted 2007 Edition Chapter no 28th ,Shloka no 84, page no.762.
  7. Acharya Vaghbhata, Ashtanga Hridaya, Nidana Sthana, Hindi Translated Kaviraj Atridev Gupt.Reprinted in 2008,Varanasi: Chaukhambha Prakashan.Chapter no 11th , Shloka no 1-2,page no 350.
  8. Acharya Vaghbhata,Ashtanga Hridaya,Chikitsa sthana, Hindi Translated Kaviraj Atridev Gupt.Reprinted in 2008,Varanasi:Chaukhambha Prakashan,Chapter 13th Shloka no 19,page no 512.
  9. BhaishjyaRatnavali, BhaishjyaRatnavali,Hindi Translated Kaviraj Dr.Ambikadutt Shastri Vidradhi Chikitsa Prakarnam,Reprinted in 2002 ,Shloka no 24,page no 164.
  10. Yogratnakaraq,Yogratnakara Uttrardh,Hindi translated,Shri Brahmashankar Shastri . Varanasi: Chaukhambha Prakashan,Reprinted in1997,6thedition, Chapter 1shloka no2 ,page no .174.
  11. Chakradutta-Chakradutta,Hindi translated Pandit raj Vd.Ravidutt Shastri,Varanasi: Chaukhambha Prakashan, reprinted 2000,Chapter no 47sholka no21 ,page no257.
  12. S.Das A concise text book of surgery by page no 62-67,1st edition
  13. Bailey & Love’s short practice of surgery,Rains &Capper,page no 17-18.
  14. Manipal manual of surgery, K.Rajgopal Shenoy & Anitha nileshwar,3rdedition,page no11.

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