From

Dr. Vidya Narayan

Preliminary M.S. (Ayu) Scholar

Dept. of P.G. Studies in Prasuti Tantra avam Stree Roga

S.D.M.College of Ayurveda and Hospital

P.O. Box 164 Hassan – 573 201

To

The Registrar

RajivGandhiUniversity of Health Sciences

Bangalore

Karnataka.

Through,

The Principal,

S.D.M.College of Ayurveda,

Hassan.

Respected sir,

Sub:Submission of completed proforma for registration of subject for dissertation.

I request you to kindly register the below mentioned subject against my name for the submission of dissertation to the Rajiv Gandhi university of health sciences, Bangalore, for the partial fulfillment of MS (Ayu.) in Prasuti Tantra avam Stree Roga

TITLE OF THE DISSERTATION:

CLINICAL STUDY ON ARTAVA DUSTI WITH SPECIAL REFERENCE TO POLY CYSTIC OVARIAN DISEASE (PCOD) AND ITS MANAGEMENT WITH CHANDRPRABHAVATI

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

Thanking you, Yours faithfully,

Date:

Place: Hassan (Dr. Vidya Narayan)

RAJIVGHANDHIUNIVERSITY OF HEALTH SCIENCES,

BANGALORE, KARNATAKA.

ANNEXURE -II

COMPLETED PROFORMA FOR REGISTRATION OF SUBJECT

DISSERTATION.

1. NAME OF THE CANDIDATE Dr. VIDYA NARAYAN

AND ADDRESS : PRELIMINARY M.S (AYU)

SCHOLOR, DEPARTMENT OF

POST GRADUATES STUDIES IN

PRASUTI TANTRA AVAM STREE ROGA,

S.D.MCOLLEGE OF AYURVEDA

HASSAN – 573 201

PERMANENT ADDRESS : D/O Dr. JAYAPRAKASH NARAYAN

93 3RD CROSS 1ST STAGE

DOLLAR SCHEME

BTM LAYOUT

BANGALORE – 560 068

2. NAME OF THE

INSTITUTION : S.D.MCOLLEGE OF

AYURVEDA AND HOSPITAL

HASSAN – 573 201, KARNATAKA.

3. COURSE OF STUDY

AND SUBJECT : M.S (AYURVEDA)

PRASUTI TANTRA AVAM STREE ROGA

4. DATE OF ADMISSION : 25/11/2010

TO COURSE

5. TITLE OF THE TOPIC : CLINICAL STUDY ON ARTAVA DUSTI WITH SPECIAL REFERENCE TO POLY CYSTIC OVARIAN DISEASE (PCOD) AND ITS MANAGEMENT WITH CHANDRPRABHAVATI

6. BRIEF RESUME OF THE INTENDED WORK:

6.1 NEED FOR THE STUDY:

The fertility element responsible for reproduction in the female body is called “Artava”. All three Doshas play important and distinctive roles in the processes behind the female reproduction which includes the ovarian cycle and the menstrual cycle. When Artava is vitiated by three Doshas, women suffer from Artava Dusti. Polycystic ovarian disease (PCOD) is one such Artava Dusti.

The main clinical feature of Granthi is swelling or protuberance1. Granthi denotes its specific character i.e. glandular or nodular swelling2.On this very basis subject matter relating to Granthi available in Ayurvedic classics has to be recapitulated with PCOD

Poly cycstic ovarian diseaseis a condition that has cysts in the ovaries that prevent the ovaries from performing normally. Women with poly cycstic ovarian disease (PCOD) present with menstrual abnormalities, hirsutism, obesity and infertility. It is the most common endocrine disorder of reproductive aged women.

Recent statistics on poly cycstic ovarian disease (PCOD) shows its occurrence in 4% - 8% of all reproductive aged women with symptoms like menstrual abnormalities and anovulation by disturbing one’s physical, psychological, spiritual and social well-being irrespective of races and nationalities3.

Chandraprabha Vatiis a useful medicine,as said in Sarangadhara Samhita as Sarva rogapranashini. Itwhich is indicated in Granthi, Arbuda, Streenam artavajam rujam. It is Tridosha hara, Vrishya and Rasayana4.

No clinical study has been conducted on the effect of Chandraprabha Vati in PCOD. Therefore the clinical study of Chandraprabha Vati in Artava Vikaras with to polycystic ovarian disease is taken.

6.2 REVIEW OF THE LITERATURE:

1) Review of disease:-

The clinical features of PCOD can be constructed by taking into consideration of the following Yonivyapad and Artava Dusti.

Arajaska yonivyapad mentioned by caraka describes amenorrhoea as a symptom5.

In both samhitas of Vagbhata, Lohitakshaya yonivyapad where the raja is decreased has been mentioned6.

Susruta writes that in Vandhyayoni, Artava is destroyed7. Madhava nidana8 and Yogaratnakara9 have followed Susruta. Bhavaprakasha has mentioned absence of Artava instead of its destruction10.

Susruta11 and both Vagbhata12 have mentioned about Kshenartava dushti where the menstrual blood is scanty and is associated with pain.

Susruta13 and Bhavaprakasha14 have mentioned Artava kshaya where there is delay of the menstruation and is scanty. There is also the mention of the food articles desires for a woman suffering from Artavaksaya15.

In Caraka samhita16 it is said that there is a similarity in the basic clinical feature in both sotha and granthi. They are situated in different parts of the body. But specific description of granthi of reproductive system is not available in our classics. Therefore the treatment is based on the clinical features and location of the granthi.

Susruta in nidana stana has said that the vitiated vata, etc doshas deranges the dhatus such as mamsa, rakta and medas along with kapha and gives rise to the formation of round, knotty, elevated swellings called granthi17.

2) Review of drug:

Chandraprabha vati as mentioned in Sarangadhara samhita. It contains the powders of chandraprabha (karpura), vacha, musta, bhunimba (kiratatikta), amrita, daruka(devadaru), haridra, ativisha, daarvi (daruharidra), pippalimula (pippali), chitraka, dhanyaka, haritaki, bibhitaka, amalaki, cavya, vidanga, gajapippali, sunthi, marica, pippali, bhasma of makshika, both the ksaras (swrji and yava), lavana traya (saindhava lavana, sauvarchala lavana, vida lavana, powdered trivrut, danti, patraka, tvak, ela,

vamshalochana, bhasmas lauha, sita, shilajatu and guggulu.

This medicine is beneficial in so many disorders. It cures all the abnormalities of Artava. It is indicated in Granthi18.

PREVIOUS WORK DONE:

  1. Dr. Jose Preethi: The study to evaluate the effect of an Ayurveda formulation in PCOD, 2003. Trivandrum
  2. Dr. Suniti: A clinical trail on Jataharini Puspaghni with an indifenous compound w.s.r to PCOD, 2005. RGUHS
  3. Dr. Gayathri Bhat N V: A clinical study on Puspaghni Jataharini with special reference to PCOD and it management with Varunadi Kwatha and Kanchanara Guggulu, 2005 RGUHS
  4. Dr. Shwetha S Suvarna: A critical analysis of PCOD in Ayurvedic perspective and the Role of Shatapushpa and Asanadi gana kwatha in PCOD, 2006 RGUHS

6.3 OBJECTIVE OF THE STUDY:

  1. Analysis of Polycystic ovarian disease (PCOD) in Ayurveda
  2. To study the effect of Chandraprabha Vati in the management of Polycystic ovarian disease.

7. MATERIALS AND METHODS:

7.1) Source of data:

Minimum 30 patients diagnosed as PCOD attending OPD and IPD of SDM Ayurvedic Hospital, Hassan shall be taken for study.

7.2)METHOD OF COLLECTION OF DATA:

Present study will be single blind clinical study with pre test and post test design. Data obtained during study will be collected and tabulated statistically.

Based on self reported symptoms suggestive of PCOD

Based on investigations such as ultrasonogram (USG).

Hormonal assay

(A)DIAGNOSTIC CRITERIA:

  1. Women with menstrual abnormality in the form of oligomenorrhoea / amenorhhoea
  2. Signs of hyper androgenism
  3. Poly cystic ovaries

Any two of the following three criteria19

  1. Hormonal assay presenting with elevated levels of Luteinizing hormone (LH)

(B)INCLUSION CRITERIA:

Age : 18 – 40 yrs.

(C)EXCLUSION CRITERIA:

  1. PCOD with metabolic and systemic diseases
  2. PCOD with malignant diseases
  3. Pregnancy and lactation

INTERVENTION:

Drug: Chandrprabha Vati will be taken from Dhootapapeshwar Pharmacy, which has GMP standards. Ref: Bharata Bhaisajya Ratnakara20

Dose: 500mg twice daily with water

Duration: Treatment will be given for 3 months

Anupana: Jala

Diet: Patient will be advised to follow Ahara and Vihara according to Prakruti

FOLLOW – UP STUDY:

During the treatment the patients will be asked to report at fortnight interval for three months to assess whether the relief is provided by the drug.

(D)ASSESSMENT CRITERIA:

The assessment of the effects of the therapy will be done on the following criteria.

SUBJECTIVE:

Menstrual abnormalities: oligomenorrhoea / amenorhhoea / dysfunctional uterine bleeding (DUB)

OBJECTIVE:

Poly cystic ovaries diagnosed by USG

Volume of the ovary

Presence of multiple cysts

Size of the cysts

Hormonal assay: Levels of Luteinizing hormone (LH) and Follicle stimulating hormone (FSH)

7.3)PARAMETERS OF THE STUDY:

LABORATORY Investigations:

  1. Complete blood picture
  2. Fasting blood glucose / post prandial blood glucose / random blood glucose
  3. Ultrasonogram – Abdomino-Pelvis / Transvaginal
  4. Hormonal assay: Levels of Luteinizing hormone (LH) and Follicle stimulating hormone (FSH)

7.4) Has ethical clearance been obtained from your institution:

YES, the clearance has been granted by the ethical committee.

8)List of references:

  1. Susruta Samhita, sutrasthana, 17th chapter, 3rd shloka
  2. Caraka Samhita, chikitsasthana, 12th chapter, 81st shloka, Chakrapani teeka
  3. Sarangadhara Samhita, madhyama khanda, 7th chapter, 40th to 49th shloka
  4. Caraka Samhita, chikitsa sthana, 30th chapter, 17th shloka, Chakrapani teeka
  5. Astanga Sangraha, Uttaratantra, 38th chapter, 47th shloka and Astanga Hrudaya, Uttaratantra, 33rd chapter, 45th shloka
  6. Susruta Samhita, Uttaratantra, 38th chapter, 10th – 11th shloka
  7. Madhava Nidana, 62nd chapter, 4th shloka
  8. Yogaratnakara, yoniroga adhyaya
  9. Bhavaprakasha, chikitsa sthana, 70th chapter, 6th – 7th shloka
  10. Susruta Samhita, Sharira sthana, 2nd chapter, 4th shloka
  11. Astanga Sangraha, Sharira sthana, 1st chapter, 24th shloka and Astanga Hrudaya, Sharira sthana, 1st chapter, 11th shloka
  12. Susruta Samhita, sutrasthana, 15th chapter, 12th shloka
  13. Bhavaprakasha, Purvardha, 7th chapter, 90th, 91st, 111th shloka
  14. Caraka samhita, chikitsa sthana, 12th chapter, 74th shloka
  15. Susruta Samhita, Nidana sthana, 11th chapter, 3rd shloka
  16. Prof. Premvati Tewari Ayurvediya Prasuti tantra avum Stree Roga, 2nd volume, second ed. 20000, Chowkhamba Publications
  17. Diana Hamilton – Fairley: Lecture Notes, Obstetrics and Gynaecology, 2nd edtion, Blackwell Publishing
  18. D C Dutta, Textbook of Gynaecology including contraception, fifth edition, New central book agency publication
  19. Bharata Bhaisajya Ratnakara, Volume II, The Encyclopaedia of Ayurvedic Formulations, compiled by Vaidya Nagin das Chhagan Lal Shah with Bhavaprakasika commentary, commented by Vd. Gopinath bhishagratna, B.Jain Publishers (P) Ltd.
  20. Obstetrics and Gynaecology, Lawrence Impey 1999 edition
  21. Advances in Obstetrics and Gynaecology, Sumita Mehta, Shalini Rajaram, Neerja Goel, Vol 3, 2011 edition

9. SIGNATURE OF THE CANDIDATE :

10.REMARKS OF THE GUIDE :

11. NAME AND DESIGNATION OF :

11.1 GUIDE : Dr Vandana BaranwalM.D (AYU)

Professor

Department of Prasuti Tantra and

Strirora,

S.D.M.C.A and H, Hassan, Karnataka.

11.2 SIGNATURE :

11.3 CO-GUIDE :

11.4 SIGNATURE :

11.5 HEAD OF THE DEPARTMENT : Dr Gayathri N.V. Bhat, M.D (AYU),.

Reader and HOD,

Department of Prasuti Tantra and Stree

Roga

S.D.M.C.A and H, Hassan, Karnataka.

11.6 SIGNATURE :

12. REMARKS OF CHAIRMAN AND :

PRINCIPAL

12.1 SIGNATURE :