RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES
KARNATAKA, BANGALORE
COMPLETED PROFORMA FOR THE REGISTRATION OF SUBJECT (KAUMARABHRITYA) FOR THE DISSERTATION OF M.D (AYURVEDA)
A COMPARATIVE CLINICAL STUDY ON NARASIMHA CHURNA AND H.P.E.R MIXTURE IN THE MANAGEMENT OF PEM
By
Dr. JOSHI ABHISHEK J
M.D (AY) Scholar.
Dept. of P.G Studies in Koumarabhritya,
Alva’s Ayurveda Medical College,
Moodbidri, D.K Karnataka.
Guide
Dr. k. lakshmeesh upadhya m.d (ayu),
Professor and h.o.d,
Alva’s Ayurveda medical college.
2008-2009
Alva’s Ayurveda Medical College
Moodbidri
FROM,
Dr. JOSHI ABHISHEK J
M.D (AY) Scholar,
Dept. of P.G Studies in Koumarabhritya,
Alva’s Ayurveda Medical College,
Moodbidri, D.K.
To,
The Registrar,
Rajiv Gandhi University of Health Sciences,
Karnataka, Bangalore.
Through Proper Channel
The Principal,
Alva’s Ayurveda Medical College,
Moodbidri, Karnataka.
Respected Sir,
Subject: Submission of Completed Performa for Registration of Subject for Dissertation.
I request you kindly to register the below mentioned subject against my name for submission of dissertation to Rajiv Gandhi University of Health Science Bangalore, Karnataka as partial fulfillment of M.D (AY) in Koumarabhritya.
Title of Dissertation
“A COMPARATIVE CLINICAL STUDY ON NARASIMHA CHURNA AND H.P.E.R MIXTURE IN THE MANAGEMENT OF PEM”
Here with I am enclosing completed proforma for registration.
Thanking you,
Yours Faithfully,
Place:
Date : Dr. Joshi Abhishek J.
RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCE
BANGALORE, KARNATAKA
COMPLETED PROFORMA FOR THE REGISTRATION OF SUBJECT
(KOUMARABHRITYA) FOR THE DISSERTATION OF M.D (AYURVEDA)
1. Name of the Candidate and address : Dr. Joshi Abhishek j.
Ist year M.D (ayu) Scholar,
Dept. of P.G Studies in Koumarabhritya,
Alva’s Ayurveda Medical College,
Moodbidri- 574227.D.K.
Permanent Address : Dr Joshi Abhishek J.
P.W.D quarter no. 1,
Opposite to library,
Veraval, Dist- Junagadh,
Gujarat.
2. Name of the Institution : Alva’s Ayurveda Medical College
Moodbidri-574227 D.K
3. Course of study and subject : M.D (AYU) Koumarabhritya
.
4. Date of admission to course : 30 july 2008
5. Title of Topic : A COMPARATIVE CLINICAL STUDY ON NARASIMHA CHURNA AND H.P.E.R MIXTURE IN THE MANAGEMENT OF PEM.
6. Brief Resume of Intended work:-
6.1 Need for the Study:
Protein energy malnourishment is widely recognized as a major health problem in developing countries including India.
According to WHO there are about 10.8 million child deaths every year globally. In South Asian region nearly 5 million children are dying every year and upto 3 million of these deaths are directly or indirectly associated with malnourishment. In India, in spite of large number of national programmes related to nutrition such as ICDS, mid day meal etc about 6600 under 5 children die every day, accounting to 46% child death due to PEM1. As per recent nationwide studies majority of children suffering from PEM are of mild to moderate degree which is 65-70% and severe only 2-5%2.
Undernourished children do not grow to their full potential of physical and mental abilities3.Malnutrition can be compared to an iceberg, while only the severe forms are seen above the surface of water those hidden under the surface constitute a vast majority of children suffering from mild to moderate forms of PEM which remains hidden in the community2. The condition needs special attention in initial stages to avoid grave ailments of grade 3 and grade 4 PEM like kwashiorkor, marasmus etc. So the present work is intended to study grade 2 PEM and its management.
The goal of treatment is to provide adequate calories for dual purpose, to replace losses and build up nutrition, to promote growth2. Hyderabad protein energy rich mixture (H.P.E.R.M) is indicated for home remedial treatment of mild to moderate PEM2,4. However the condition needs to be medically intervened to prevent the worsening of situation and provide adequate correction.
Narsimha churna is mentioned in Vangasena, rasayana adhaya5. It is said to bestow bala, pushti, utsaha, varna and kanti, also possessing kshyaghna and sarva roga hara effect. The combination is mentioned as rasayana. Hence an attempt is made to study the effect of Narasimha churna in the management of PEM and compare its effect with H.P.E.R.M.
6.2 Review of literature:
v Review of literatures related to PEM from modern texts like IAP, Nelson’s Textbook of Pediatrics etc.
v The conditions comparable to PEM as per Ayurvedic litearature from Kashyapa samhita, Ashtanga hrudaya, etc.
v Review of the drugs in Narasimha churna, as per Ayurvedic texts like Vanga sena.
v Other reliable sources like books by recent authors, research works, journals, internet related to PEM and formulation will be thoroughly screened.
6.3 Previous works done:
v Study on the role of Ayurvedic compound in the management of bala shosha, Suresh kumar, NIA, Jaipur, 2004.
v Bala sosha vyadhi par shatavari sunthi ksheera paka parinama ek adhyayana, Gore D N, Government Ayurveda College, Nagpur-1998.
v Bala shosha roga mein bala shosha hara rasayana ka chikitsatmaka adyayana, Sharma R, NIA, Jaipur-1992
v Study on the efficacy of shiv modaka and yapana basthi in management of bala sosha w.s.r to marasmus, Vyas P P, IPGTR&A, jam-1991.
6.4 Objective of the Study:
v To evaluate the effect of Narasimaha churna in PEM.
v To compare the effect of Narasimha churna with H.P.E.R.M in management of PEM.
v To study the concept of PEM with comparable entities of Ayurveda.
v To assess the changes in serum protein levels in PEM grade2.
6.5 Hypothesis:
H0:-There is no significant effect of Narasimha churna in the management of PEM.
H1:-There is significant effect of Narasimha churna in the management of PEM.
H2:-There is significant effect of Narasimha churna in comparison with H.P.E.R.M. . in the management of PEM.
6. Materials and Methods:-
7.1 Source of Data:
v OPD of Koumarabhritya, AAMC.
v Other referrals.
v Medical camps, Anganvadis etc.
7.2 Method of collection of Data:
Minimum of 30 patients will be randomly selected and grouped into two, for single blind study with pre-test and post-test design.
(a) Procedure of administration of drug
Study group- Narasimha churna will be administered internally 6 gms per day along with ghruta in two divided doses for a period of 6 weeks.
Standard group- H.P.E.R.M will be given internally 70 gms per day along with jaggery in divided doses for a period of 6 weeks.
(b) observation period
Study period- The child will be assessed clinically on 7th, 14th, 21st, 28th, 35th and 42nd . day.
Follow up- Assessment for one month at weekly intervals on 49th, 56th, 63rd and 70th day of observation period.
(c) Inclusion criteria:
v Child aged between 3-5 years.
v Patient evaluated with grade 2 PEM – IAP classification.
v Children of either sex, irrespective of, religion, socioeconomic status and food habits.
(d) Exclusion criteria
v Children below 3 years and above 5 years of age.
v Children evaluated with other grades i.e. normal, grade1, grade3 and grade4 of IAP classification.
v Children suffering from endocrinal disorders like Gigantism, Dwarfism, Cushing’s syndrome etc.
v Children having liver disorders like Hepatitis, Indian childhood cirrhosis etc.
v Children with Impaired renal function and cardiac disorders.
v Children suffering with any severe acute or chronic infections.
v Other systemic illness like T.B, HIV etc.
(e) Diagnostic Criteria:
v Weight
v Body Mass Index(B.M.I)
v Mid Arm Circumference(M.A.C)
v Skin Fold Thickness(S.F.T)
(f) Assessment criteria:
A detailed Proforma will be prepared and assessment will be done based on subjective and objective parameters. The data obtained will be analysed statistically.
7.3 Does the study need any investigation or interventions to be conducted on . Patients or other humans or animals ? If so, please describe briefly.
Yes, this study will be conducted clinically on human subjects. No animal . experimentation will be carried out.
Laboratory investigations:
v Blood routine
v Urine routine
v Total serum proteins, Albumin, Globulin, A/G ratio.
Other investigations will be carried out if necessary.
7.4 Has the ethical clearance have been obtained from your institution in case of . 7.3?
Yes, clearance has been obtained through ethical committee constituted in the . Institution.
8. List of references:
1) Bhatia V, Puri S, Swami H M, Gupye M, Singh G. Malnutrition among under 6 children: scarcity in plenty. Nov 22, 2008. Available at: http://www.jcdr.net/article.
2) Meenakshi N Mehta: Child Nutrition. In: IAP Textbook of pediatrics, 3rd edn. New Delhi: Jaypee Brothers medical publishers 2006:120-121-132-137
3) Park: Preventive Medicine in Obstetrics, Pediatrics and Geriatrics. In: Park’s Textbook of preventive and social medicine, 18th edn. Jabalpur: Banarasidas Bhanot publishers 2005: 406
4) Suraj Gupte: Pediatric Nutrition and Nutritional Deficiency States. In: The Short Textbook of Pediatrics, 10th edn. New Delhi: Jaypee Brothers medical publishers 2004:143
5) Vanga Sen: Rasayana adhikara 424-429. In Chikitsa Sar Sangraha, 1st edn. sNew Delhi: Chaukhambha publishers 1998:762
9. Signature of Candidate:
10. REMARKS OF GUIDE:
11. Name and Designation:
11.1 Guide : Dr. K. Lakshmeesh Upadhya M.D (AY)
Professor and H.O.D,
Dept. of PG studies in Koumarabhritya,
Alva’s Ayurveda Medical College,
Moodbidri- 574227
11.2 Signature and Seal:
11.3 Head of department: : Dr. K. Lakshmeesh Upadhya M.D (AY)
Professor and H.O.D,
Dept. of PG studies in Koumarabhritya,
Alva’s Ayurveda Medical College,
Moodbidri- 574227
11.4 Signature and seal :
12 . Remarks of chairman and principal:
12.1 signature :