RAJIV GANDHI UNIVERSITY OF HEALTH

SCIENCES KARNATAKA BENGALURU.

PROFORMA FOR REGISTRATION OF SUBJECT PANCHAKARMA FOR

DISSERTATION MD (AYURVEDA)

BY

Dr.C.Pradeeph

1st PG Scholar(Ayu)

Dept of PG studies in Panchakarma

JSS Ayurveda Medical College

Mysore

Karnataka

GUIDE

Dr.N.V.Krishnamurthy

MD(Ayu)

Professor & H.O.D

PG studies dept of Panchakarma

JSS Ayurveda Medical College

Mysore

CO GUIDE

Dr. Manjunath.B.H

MS (Ortho)

Department of orthopaedics

Asst. Professor

JSS Medical College & Hospital

Mysore

FOR THE DEGREE OF AYURVEDA VACHASPATHI

M.D AYURVEDA

IN

PANCHAKARMA

“EFFECT OF VIRECHANA AND PATRA PINDA SWEDA IN THE MANAGEMENT

OF JANU SANDHIGATA VATA W.S.R TO KNEE OSTEOARTHRITIS”

2011-2012

J.S.S AYURVEDA MEDICAL COLLEGE

MYSORE

FROM

Dr.C.PRADEEPH

Ist PG Scholar

Dept of PG studies PANCHAKARMA

J S S Ayurveda Medical College

Mysore.

To

THE REGISTRAR

Rajiv Gandhi University of Health Sciences

Jayanagar, 4TH ‘T’ Block, Bengaluru.

THROUGH,

THE PRINCIPAL AND HOD OF PG STUDIES IN PANCHAKARMA

J S S Ayurveda Medical College

Mysore.

Respected Sir,

SUB: Submission of the completed proforma for Registration of subject for dissertation.

I request you to kindly register the synopsis on below mentioned subject against my name for

the submission of dissertation to the Rajiv Gandhi University of Health Sciences, Karnataka,

Bangalore for partial fulfillment of postgraduate course in the specialization of

PANCHAKARMA M. D. (Ayurveda)

TITLE OF DISSERTATION:

“EFFECT OF VIRECHANA AND PATRA PINDA SWEDA IN THE MANAGEMENT

OF JANU SANDHIGATA VATA W.S.R TO KNEE OSTEOARTHRITIS”

Here with I am enclosing complete proforma for the registration of subject for dissertation.

Thanking You Sir,

Yours faithfully

Place:

Date: Dr.C.PRADEEPH

RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES

KARNATAKA BENGALURU.

PROFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION

1. Name Of The Candidate : Dr.C.Pradeeph

And Address 1st PG Scholar

Post Graduate Department of Panchakarma.

S/o G.Chandrasekar

19/2, Pitchu Street, Mylapore, Chennai,

TamilNadu-600004.

2. Name of The Institution : JSS AYURVEDA MEDICAL COLLEGE

Mysore

Karnataka.

3. Course of Study And : Ayurveda Vachaspati

Subject M.D. (Ayurveda) In PANCHAKARMA

4. Date of Admission To : 12SEPTEMBER 2011

The Course

5. Title of Dissertation : “EFFECT OF VIRECHANA AND PATRA PINDA SWEDA IN THE MANAGEMENT OF JANU SANDHIGATA VATA W.S.R TO KNEE OSTEOARTHRITIS”

6) BRIEF RESUME OF THE INTENDED WORK:

6.1  Need for the study:

Sandhigata vata(osteoarthritis) is a most common form of arthritis. It shows a strong association with ageing. Osteoarthritis may be defined as a condition of synovial joints characterized by focal loss of articular hyaline cartilage with proliferation of new bone and remodeling of joint contour. There is steady rise in the prevalence from age 30 such that by 65, 80% of people have radiographic evidence of OA, though only 25 to

30% are symptomatic. The knee and hip are the principal joints involved, affecting 10-25% of those old aged

Over 65 years1.

According to Ayurveda the characteristic features of sandigata vata are Sandhi Shoola, Shotha,

Stambha2 and Atopa3

General line of treatment for all vatavyadhi are Snehana, swedana, mridu virechana and basti4,5,6.

Virechana karma is a type of shodhana, in which vitiated doshas are expelled through adhomarga.

After proper sneha and sweda Virechana Karma acts as vata anulomana.

Different kinds of swedana are mentioned for vatavyadhi. In sandhigata vata sweda plays an

important role. Pinda sweda, a form of sankara sweda in which patras of Vatahara properties are used in pottali serves the purpose of alleviation of vitiated vata dosha7.

Hence the present study is intended to evaluate the effect of Virechana and Patra pinda sweda in

janu sandigata vata.

6.2  Review of Literature:

Review of the classicals and contemporary literature will be done as per the requisite including journals

and additional sources available .

Nidana, samprapti and lakshanas of Sandhigata Vata are explained in Charaka chikitsa sthana 28th chapter,Ashtanga hridaya chikitsa sthana 21st chapter, Sushrutha chikitsa sthana 4th chapter2,8,9.

Signs and symptoms of osteo arthiritis explained in Davidson’s internal medicine1.

Mrudu Virechana is explained as general line of treatment of vata vyadhi 4,5,6.

Sukumara gritha is mentioned in sahasrayogam gritha prakara10

Trivrit lehya is mentioned in Ashtanga hridaya kalpa sthana 2nd chapter.

Ksheera Bala Taila is a Vatahara Taila it is said to cure all diseases caused by Vata11.

Patrapinda sweda is explained in Charaka sutra sthana 14th chapter, Ashtanga hridaya sutra sthana 12,13.

Previous work done:-

·  Evaluation Of The Comparative Efficacy Of Matra Basti And Janu Basti With Bala Taila In Sandigata

Vata-by Dr.Madhu Shree H in 2005, Shri D G Melmalagi Ayurvedic Medical College &Hospital, Gadag,RGUHS

·  Study on the effect of snehana with marma taila & pindasweda in sandhigata vata w.s.r to O.A-by Deshpande Ramesh in 2003,Tilak Ayurveda mahavidyalaya, Pune, Pune University.

·  Clinical Study on Sandhigatavata (Osteoarthiritis) w.s.r to its management by shamana and shodana therapy –Dr. Sengupta Sanjuktha in 1999– GAU, Jamnagar.

·  Comparative study of therapeutic efficacy of samshodana and samshamana chikitsa in sandigata vata (Osteoarthiritis) by Dr.Arora P.K in 2002 – Benares Hindu University, Varanasi.

6.3  Objective of the study:

1  To study in detail about janu sandhi gata vata w.s.r to knee Osteoarthritis

2  To Evaluate the effect of Virechana and Patra pinda sweda in janu sandhi gata vata.

7.Materials and methods

7.1 Source of data:

a.  Literary source: All classical ,modern literature and contemporary texts including the journals

and website about the disease, drug and procedure will be reviewed and documented for the study.

b.  Drug source: raw drugs will be collected from the local market after proper identification.Medicines required for the treatment will be prepared in JSS Ayurveda Medical College Pharmacy, Mysore

c.  Sample source: Patients will be randomly selected from OPD and IPD of JSS Ayurveda Medical

College, Mysore.

7.2  Method of collection data:

a)  Sample size: 30 patients suffering from janu sandhi gata vata belonging to either sex irrespective of socio economic status and caste will be select for clinical study, excluding drop outs.

b)  Study design: It is a clinical study.

c)  Selection criteria: The cases are selected as per signs and symptoms mentioned in classics.

d)  Diagnostic criteria: Patients will be diagnosed based on -Signs & Symptoms mentioned in classics & supplemented with signs & symptoms of Osteoarthritis of Knee joint.

1.  Sandhi shoola

2.  Sandhi shotha

3.  Vedana during prasarana & akunchana

4. Atopa

e)  Inclusion criteria :

Patients fulfilling the diagnostic criteria.

Patient fit for virechana.

Patient fit for Sweda.

Patients between the age group of 30 to 70 years.

f)  Exclusion criteria :

Pregnant women and lactating mothers.

Osteoarthritis associated with any systemic disorders such as tuberculosis, malignancy, trauma & rheumatoid arthritis.

g)  Assesment of results:

Subjective:

Pain in the joint

Stiffness in the joint

Crepitus

Objective:

Swelling

Range of Movement

Study duration/follow up:

Totally the course of treatment will be 32 days.

Post treatment follow up will be taken on 7th, 14th, 21st day for all the patients

Assessment of the condition will be done based on detailed proforma adopting standard scoring .

Methods of subjective and objective parameters and will be analyzed statistically using Paired ‘t’ test.

7.3  DOES THE STUDY REQUIRE ANY INVESTIGATIONS OR INTERVENTIONS TO BE

CONDUCTED ON PATIENTS OR OTHER HUMANS OR ANIMALS?

- Yes the study will be conducted clinically, no animal experiment will be carried out.

Laboratory investigations;

X- Ray of affected knee joint- Antero posterior & lateral view.

Other investigations are done according to the need.

Interventions:

Procedure :

Virechana-

Poorva karma :

Deepana, pachana with Panchakola choornam 3-5 gms twice daily with warm water before food , till niramavastha is obtained.

Sneha pana - Sukumara gritha in arohana krama for 3-7 days till samyak snigdha lakshanas are obtained.

Abhyanga with ksheera bala taila followed by bhashpa sweda for 3 days.

Pradhana karma :

On the day of virechana ,Trivrit avalehya will be given according to the koshta.

Paschat karma:

Samsarjana karma - According to the samshuddhi for 3-7 days.

Patra pinda sweda –

Sthanika abhyanga with ksheera bala taila

Patra pinda sweda done on janu sandhi for a period of 30 mins for 7 days

Follow up period: The post treatment follow up will be taken after 7th, 14th, 21st day for all the patients.

Clinical improvements will be noted and gradings will be given. The data collected before and after the

treatment will be analyzed.

7.4 Has the ethical clearance been obtained from your institution?

- Yes, it has been enclosed

8. LIST OF REFERENCES

1)Nicholas A Boon & others edited Davidson’s Principles and Practice of medicine 20th edition- 2006.

Published by Churchill Livingstone. Page no-1096.

2)Trivikramji Yadavji , Acharya Agnivesha, Charaka Samhitha with Ayurveda Dipika commentary of Chakrapani Datta, Published by- Chaukamba Sanskrit series office, Varanasi, 4thedition 1994, Chikitsa stana,Vatavyadi Chikitsitham 28/37. Page no- 618.

3) sreekantadatta, Madhavakara, Madhava Nidana with madhukosha commentary .Published by

chaukamba Sanskrit sansthan, Varanasi. M.N. - 22/21 page no-528

4) Jadavji Trikamji Acharya , Agnivesha, Charaka Samhita , 5thedition, 2001,Chaukambha publication,

Varanasi, Pageno-620.

5) Kaviraja Atrideva Gupta ,Astanga Samgraha, ,Reprint 1993,Krishnadas Acadamy, Varanasi,Vol:2,

page no-124.

6) Sharma Priyavrat, Chakradatta- Sanskrit text with English translation ,Chaukamba orientalia, Varanasi

Second Edition-1998.Vatavyadhi chikitsa,shloka number 78 & 79 page no-193.

7) Acharya Agnivesha, charaka samhitha with Ayurveda Deepika commentary of Chakrapanidatta chikitsa

stana 28/56, Chaukamba Orientalia, Varanasi, 8th edition- 2004, page no -704.

8) Bhisagacharya Paradakara Harishastri, Ashtanga Hridayam by Vaghbhata with the commentaries Sarvangasundara of Arunadatta & Ayurveda Rasayana of Hemadri ,Chaukamba Orientalia, Varanasi, Nidanastana 15/54 page number-535,chikistastana 21,page no -722.

9) Trikamji Yadavaji, Susrutha Samhitha of Acharya Susrutha with Nibandasangraha commentary of Sri Dalhanacharya and the Nyayachandrika Panjika of Sri Gayadasacharya on nidanastana , Chaukamba Orientalia, Varanasi, 6th edition-1997, Nidanastana 1/74 , page no-268, chikitsa stana 4/21-26,

page no-422.

10) ) Sahasrayogam english translation by Dr.K.Nishteshwar and Dr.R.Vidyanath.

Published by Choukamba Sanskrit Series Office Varanasi.2nd edition 2008.

11) Sahasrayogam english translation by Dr.K.Nishteshwar and Dr.R.Vidyanath.

Published by Choukamba Sanskrit Series Office Varanasi.2nd edition 2008. Page no- 110

12) Chaturvedi Gorakhanatha, Acharya Agnivesha, Caraka Samhita , Chaukhamba Orientalia, Varanasi,

Reprint 2001 Sutra Sthana 14/4 page no 260

13) Astanga Sangraha Hindi commentary by Gupta Atrideva Kaviraj, Chaukhamba Orientalia, Varanasi,

Reprint 1993, Sutra Sthana 26/8 page no 193.

14) Vaidya Bhagel MS .Research in Ayurveda , Jamnagar: Mridu Ayurvedic Publications and sales ; 2005.