RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, BENGALURU, KARNATAKA
Completed PROFORMA FOR the registration of SUBJECT FOR dissertation IN M.D (Ayurveda)
TITLE: A COMPARATIVE STUDY OF ANUTAILA MARSHA NASYA AND KATPHALA CHURNA PRAADHAMANA NASYA IN THE MANAGEMENT OF VATAJA PRATISHYAYA (ALLERGIC RHINITIS)
By
Dr. VIVEK.V.SHUKLA
1st Year M.D (Ayu) Scholar, Department of PG studies in Panchkarma,
Muniyal Institute of Ayurvedic Medical Sciences,
Manipal, Karnataka.
Guide
DR. CHETHAN.KUMAR M.D (Ayu)
Assistant Professor, Department of PG studies in Panchkarma,
Muniyal Institute of Ayurvedic Medical Sciences,
Manipal,
Co-Guide
DR.V.D.SHUKLA (M.S.A.M,Ph.D)
Ex-Professor & Head of Panchkarma-Manasroga department,
IPGT & RA, Gujarat Ayurved University, Jamnagar
DR.SATHYANARAYANA.B M.D (Ayu)
Principal, Muniyal Institute of Ayurvedic Medical Sciences,
Manipal, Karnataka.
2010-2011
MUNIYAL INSTITUTE OF AYURVEDIC MEDICAL SCIENCES,
MANIPAL, KARNATAKA
ANNEXURE –II
PROFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION
1. Name of the Candidate : Dr.VIVEK.V.SHUKLA.
Address : 1ST YEAR M.D. SCHOLAR,
DEPARTMENT OF P.G STUDIES IN PANCHKARMA,
MUNIYAL INSTITUTE OF AYURVEDIC MEDICAL SCIENCES,
MANIPAL, KARNATAKA.
Permanent address : S/o PROFESSOR.V.D.SHUKLA
“RASHMI-PRABHA”, 64/D,
NEW ARAM COLONY,
JAMNAGAR-361006
GUJARAT.
2. Name of the Institution : MUNIYAL INSTITUTE OF AYURVEDIC MEDICAL SCIENCES,
MANIPAL, KARNATAKA.
3. Course of study & Subject : M.D (AYU) IN PANCHKARMA
4. Date of admission of course : 02/11/2010
5. Title of the Topic : A comparative study of Anutaila marsha nasya and Katphalachurna pradhamana nasya in the management of Vataja Pratishyaya (Allergic rhinitis)
6.1 Need for the study:
Our world is fully surrounded by micro-organisms. Existence in every facet exposes us to bacteria, viruses, and such other micro-organisms as we have a natural microflora on all over the body, within all orifices.
Allergic rhinitis is commonly seen Respiratory disorder in all age, religion, region and sex. It affects approximately 20 % of the population1. It presents with complains like sneezing, headache, running nose, tearing eyes, anosmia, nasal congestion....etc2. It closely resembles to a type of “Pratishyaya” known as “Vataj Pratishyaya” in Ayurveda3. Ayurveda is of the opinion that Pratishyaya is a curable disease if treated properly and timely, otherwise it may give rise to many serious complications. Though it is known from the ancient era and inspite of worldwide efforts to control this disease, still there is no definite solution for the problem. Only symptomatic treatment in modern medicine is available.
This disease is also known for its recurrence and chronicity if not treated from its root. Panchkarma is a potent tool of Ayurveda to cure the disease from its root. Nasya karma is an important part of Panchkarma and is the best treatment for “Urdhavjatruroga”. The quotation “Nasa hi shirsho dwaram” itself explains its importance and it is the only karma which finds place in Dincharya. Nasya karma can expel the deep seated doshas and can cure it from its root.
In the present study Anutail marshanasya and Katphalchurna pradhaman nasya are selected for clinical study on Vataj Pratishyaya (Allergic rhinitis) since no such study in this pattern has been conducted so far.
6.2 Review of literature:
The review of literature includes study of classical literatures, Ayurvedic contemporary literatures, modern literatures and journals, internet and such others sources to collect complete data for the study.
Charak Samhita which principally deals with Kayachikitsa and Panchkarma has very well and elaborately explained about Pratishyaya. While explaining about Nidan it is said that “Sandharan”,Ajirna,Raja, Atibhasya,Krodha, Rituvaismya, Shiroabhitapa, Ratrijagran, Prajagar,Atiswapna, Ambuseeteyvasya,Maithun,Baspa, Dhoom are the causes for its occurrence4.
With this Nidan, kapha gets accumulated and Vata gets aggravated thus samprapti of Pratishyaya gets completely manifested5.
If it is not cured timely it leads to serious complications like- Dusta Pratishyaya, Khalitya, Swasa, Kasa, Jwara, Rakta-pitta, Rajyakshma6.
Therefore this disease needs timely care and treatment.Various treatment modalities are explained for this disease and Nasya is one among them and effective too recommended in all the Bhritatyris. Katphal churna is a common and effective drug used for pradhaman having Vataghna and Kaphagana properties while Anutail is specially indicated in VatajPratishyaya7. Moreover it is having Tridosghna properties8.
6.3 Previous work done:
1. Dr.L.Suchitra, Effect of Bark & seeds of shirisha in Allergic rhinitis, Ayurved college, Banglore, 1988.
2. Dr.V.N.Kumar, Role of Vyaghari in Pratisyayaw.s.r to Allergic rhinitis, IPGT & RA,Gujarat Ayurved University,Jamnagar,1993.
3. Dr.P.Y.John, Pharmaceutical development & clinical evaluation of an Ayurvedic compound in Allergic rhinitis, Government Ayurved college, Gwalior,1996.
4. Dr,Vilasgram Naveen, Clinical & experimental studies on Pratishyaya w.s.r to Allergic rhinitis, IPGT & RA,Gujarat Ayurved University,Jamnagar,1996.
5. Dr.Navinkumar-Clinical & experimental studies on Pratishya w.s.r to Allergic rhinitis.
Gwalior, IPGT & RA,Gujarat Ayurved University,Jamnagar, 1998.
6. Dr.Rajesh.Dodia, Clinical study on the etio-pathogenesis of allergic rhinitis (Sannipatika Pratishyaya) & role of Rasayan in its management, IPGT & RA,Gujarat Ayurved University,Jamnagar, 2001.
7. Dr.V.K.Tungal: A study on nasya karma with special reference to role of lakshadi tail in Pratishyaya, RGUHS,Bengaluru,2003.
8. Neelkanth: The effect of shidhana with vamana and shaman chikitsa with shatyadi choorna in kaphaja pratisyaya- A comparative clinical study, RGUHS,Bengaluru, 2005.
9. Nagre Sunil: Role of nasya karma in the management of dusta Pratishyaya with pathadi tail and vyaghri taila, RGUHS,Bengaluru,2008.
6.4 Objective of the study:
1. To study the efficacy of Anutail marsha nasya in the management of Vatajpratishya (Allergic rhinitis).
2. To study the efficacy of Katphalchurna pradhmana nasya in the management of Vatajpratishya (Allergic rhinitis).
3. To compare the effect Anutail marsha nasya and Katphalchurna pradhmana nasya in the management of Vatajpratishya (Allergic rhinitis).
4. To study the etio-pathogensis of Vataj Pratishyaya (Allergic rhinitis).
5. To study the mode of action of Nasya Karma.
6.5 Hypothesis:
Ho: Katphal churna Pradhmana nasya provides significant result in the management of Allergic rhinitis than Anutail Marsha nasya.
H1: Anutail Marsha nasya provides significant result in the management of Allergic rhinitis than Katphal churna Pradhmana nasya.
7. Materials and Methods
7.1 Source of the Data:
1. Literary source: All the classical Ayurvedic texts, literatures of modern science and contemporary texts, connected websites related to the disease and treatment will be reviewed and documented for the intended study.
2. Sample source: Panchkarma OPD, MIAMS hospital and other referrals.
7.2 Method of collection:
Minimum of 20 patient’s diagnosed as suffering from Allergic rhinitis fulfilling inclusion criteria will be randomly selected in each group for the clinical study with pre-test and post-test design.
Inclusion criteria:
1. Age group between 18 to 40 yrs
2. Patients irrespective of sex, religion and economical status
3. Patients with classical symptoms of Vatajpratishya (Allergic rhinitis).
Exclusion criteria
- Systemic disorders like; Tuberculosis, Ca lungs
- Pneumonia
- D.N.S.
- Nasal polyps
- Tumours of nose, etc.
Diagnostic criteria: Patient’s presenting with the classical symptoms of Vataj pratisyay like Shirahsoola, Kshvathu, Nasa-srava, Swarbheda..etc will be selected for the study
Process of Administration:
The study will be conducted in following two groups;
Group A: In this group patient’s will be administered with Anutail marsha nasya for a period of 6 days in the dose of 6-8 drops in each nostrils with an interval of 1 day after 3 days of treatment.
Group B: In this group patient’s will be administered with Katphal churna pradhaman nasya for a period of 6 days with an interval of 1 day after 3 days of treatment in the dose of 3 muchuti.
Assessment criteria:
Observation on parameters will be done on 1st,4th and 7th day of the treatment. Follow up for a period of 2 week will be carried out after the completion of 7 days of treatment. Analysis of symptoms will be done statistically on the basis of relief obtained in subjective and objective signs & symptoms during clinical observations.
ï Nasal obstruction
0 - No obstruction
1 -Partial, occasional and unilateral. Inhalation- exhalation with effort and with feeling of mild obstruction
2 -Partial, frequently and bilateral. Inhalation- exhalation with effort and with feeling of moderate obstruction.
3 -Complete, frequently and unilateral. Inhalation & exhalation to be supplemented with mouth breathing
4 -Complete blockage, bilateral, followed by mouth breathing.
ï Rhinorrhea
0 -No discharge
1 -Occasional Rhinorrhea with mild watery running nose.
2 -Rhinorrhea with occasional running nose with moderate watery fluid.
3 -Rhinorrhea with heavy running nose, requires moping but controllable
4 -Severe Rhinorrhea, with copious fluid, requires continuous moping
ï Sneezing
0 -No sneezing
1 -1 – 10 sneezing
2 -10 – 15 sneezing
3 -16 – 20 sneezing
4 -> 20 sneezing
ï Loss of smell (Anosmia)
0 -No loss of smell
1 -Smells mild odour with difficulty
2 -Cannot smell mild odour
3 -Cannot smell moderate odour
4 -Cannot smell strong odour
ï Headache
0 -No headache
1 -Mild headache, occasionally, with low intensity.
2 -Moderate headache, frequently, but not disturbing the daily routine work.
3 -Severe headache with restlessness, able to carry out routine work with great difficulty
4 -Severe headache which makes patient bed ridden, often associated with nausea, vomiting, etc.
ï Cough
0 -No cough
1 -Occasional cough (dry or unproductive)
2 -Moderate Cough (productive with scanty sputum)
3 -Continuous cough with throat & chest pain (productive with moderate amount of sputum)
4 -Severe continuous cough with throat & chest pain (productive with large amount of sputum).
ï Nature of onset.
0 -No sudden appearance & disappearance
1 -Attacks mild/patients almost comfortable does not feel any difficulty in resuming his duties during an attack.
2 -Attacks are mild/ patients slightly disturbed can carry out his duties with discomfort
3 -Attacks are severe, patients though disturbed can carry out simple duties but can not resume the duties which need some amount of concentration
4 -Attacks which make patients severely disturbed, feels inability to resume any of his duties because of sudden attack/resumes duties only on its sudden cessation
ï Naso-Pharynx congestion
0 -No congestion
1 -Mild congestion
2 -Moderate congestion
3 -Severe congestion
ï Redness of conjunctiva
0 -No redness
1 -Mild redness
2 -Moderate redness
3 -Severe redness
ï Redness around nose
0 -No redness around nose
1 -Mild redness around nose
2 -Moderate redness around nose
3 -Severe redness around nose
7.3 Does the study require any investigations or interventions to be conducted on patients or other humans or animals ?
The study will be conducted clinically. No animal experimentation will be carried out.
7.4 Has ethical clearance been obtained from your institution in case:
Yes, clearance has been obtained through the ethical committee formulated in this institute.
Laboratory Investigations: Depending upon the case and requirement following investigations will be carried out;
1. CBC.
2. ESR estimation.
3. X-ray PNS.
8. List of references:
1. 1. Javed Sheikh, MD; Chief Editor: Michael A Kaliner, MD Allergic Rhinitis, available at: http://emedicine.medscape.com/article/134825-overview
- Christine Bahls, Christine Laine, MD, MPH David Goldmann, MD, in the clinic Allergic rhinitis, available at: www.nlm.nih.gov/medlineplus/ency/article/00813.htm
- Acharya Agnivesa,Charak samhita elaborated by Charak Redacted by Drdhbala Volume-II edited with Vaidyamanorama hindi commentary by Achrya Vidyadhar.Shukla, Prof.Ravidutta.Tripathi Chikitsasthan 26th chapter Trimarmiya chikitsaadhyaya published by Chaukhambha Sanskrit Sansthan, Varanasi,UP edition -2007 shloka 641 pg-104.
- Acharya Agnivesa,Charak samhita elaborated by Charak Redacted by Drdhbala Volume-II edited with Vaidyamanorama hindi commentary by Achrya Vidyadhar.Shukla, Prof.Ravidutta.Tripathi Chikitsasthan 26th chapter Trimarmiya chikitsaadhyay published by Chaukhambha Sanskrit Sansthan, Varanasi, UP edition -2007 shloka 104 pg-641.
- Acharya Agnivesa,Charak samhita elaborated by Charak Redacted by Drdhbala Volume-II edited with Vaidyamanorama hindi commentary by Achrya Vidyadhar.Shukla, Prof.Ravidutta.Tripathi Chikitsasthan 26th chapter Trimarmiya chikitsaadhyay published by Chaukhambha Sanskrit Sansthan, Varanasi,UP edition -2007 shloka 105 pg-105.
- Acharya Agnivesa,Charak samhita elaborated by Charak Redacted by Drdhbala Volume-II edited with Vaidyamanorama hindi commentary by Achrya Vidyadhar.Shukla, Prof.Ravidutta.Tripathi Chikitsasthan 26th chapter Trimarmiya chikitsaadhyay published by Chaukhambha Sanskrit Sansthan, Varanasi,UP edition -2007 shloka 107-108-109 pg-642.
- Acharya Agnivesa,Charak samhita elaborated by Charak Redacted by Drdhbala Volume-II edited with Vaidyamanorama hindi commentary by Achrya Vidyadhar.Shukla, Prof.Ravidutta.Tripathi Chikitsasthan 26th chapter Trimarmiya chikitsaadhyay published by Chaukhambha Sanskrit Sansthan, Varanasi,UP edition -2007 shloka 139 pg-648.
- Acharya Agnivesa,Charak samhita elaborated by Charak Redacted by Drdhbala Volume-II edited with Vaidyamanorama hindi commentary by Achrya Vidyadhar.Shukla, Prof.Ravidutta.Tripathi Sutrasthan chapter Trimarmiya chikitsaadhyay published by Chaukhambha Sanskrit Sansthan, Varanasi,UP edition -2007 shloka 139 pg-648.
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