From:
DR. PUJARI RAVI KUMAR
1st year M. D.
Dept. of Panchakarma,
Shri Shivayogeeshwar Rural Ayurvedic Medical College & Hospital,
INCHAL - 591102
To
THE REGISTRAR
Rajiv Gandhi University of Health Sciences, Karnataka,
Bangalore.
Through:
The Principal and H. O. D. of Panchakarma
S. S. R. Ayurvedic Medical College & Hospital, Inchal.
Tq: Saundatti, Dist: Belgaum
Respected Sir,
Sub: Submission of completed proforma for Registration of subject
for Dissertation - Synopsis.
I humbly request you to kindly register the below mentioned subject against my name for the submission of the dissertation to the Rajiv Gandhi University of Health Sciences, Bangalore for partial fulfillment of M.D. (Ayurveda) in Panchakarma.
Title of the Dissertation
“THE STUDY OF THE EFFECT OF MULAK BEEJADI LEPA AND VIRECHANA IN THE MANAGEMENT OF KITIBHA KUSHTA W. S. R. TO PSORIASIS” – A COMPARATIVE STUDY.
Herewith, I am enclosing completed proforma of synopsis for registration of subject for dissertation.
Thanking you.
Place: INCHAL Yours faithfully
Date: 27-04-13
(Dr. PUJARI RAVI KUMAR)
RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES
KARNATAKA, BANGALORE
ANNEXURE-II
PROFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION
1) / NAME OF THE CANDIDATEAND ADDRESS: / Dr. PUJARI RAVI KUMAR
I M. D. Panchakarma,
S. S. R. A. M. C & H, INCHAL.
2) / NAME OF THE INSTITUTE / SHRI SHIVAYOGEESWARA RURAL AYURVEDIC MEDICAL COLLEGE HOSPITAL, INCHAL 591 102,
SAUDATTI TALUQ, BELGAUM DIST.
3) / COURSE OF THE STUDY AND SUBJECT / AYURVEDA VACHASPATHI
M.D. in PANCHA KARMA
4) / DATE OF ADMISSION TO THE COURSE / SEPTEMBER - 2012
5) / TITLE OF THE TOPIC:
“TO EVALUATE THE EFFECT OF MULAK BEEJADI LEPA AND VIRECHANA IN THE MANAGEMENT OF KITIBHA KUSTHA w. s. r. TO PSORIASIS” – A COMPARATIVE STUDY”.
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6 Brief resume of the intended work.
6.1 Need of the Study:-
We, the modern people are now in the 21th century, with many technological advancement and with lots of health related challenges as well. The levels of pollution are soaring high, which are in turn leading to a number of respiratory and integumentary diseases.
Ayurveda identified 2 Major types of skin diseases under Kushta Roga. They are further classified into 18 different types. The treatment of such diseases is discussed in detail in all the samhitas.
The disease Psoriasis is one among the commonest skin problems of these days both in India as well as in abroad. The lesions of Psoriasis are common, chronic skin eruptions and this disease is characterized by well defined, slightly, raised, dry, erythematous macules with silvery scales and typical extensor distribution.
In Ayurvedic classics all the skin problems explained under the one word i.e. Kushta, and again they are divided into Maha Kushta and Kshudra Kushta. Among them Kitibha Kushta is one of the Kshudra Kushta, which is explained by most of the Acharyas. The lakshanas of Kitibha Kushta are mentioned as scratching, rough, itching, course and black discoloration over the skin, it is mainly due to the vitiation of vata-kapha dosha. It further reveal that the lakshanas of “Kitibha Kusta” match almost with that of the disease Psoriasis, in other words, Kitibha Kusta and Psoriasis can be correlated with each other. Elaborate studies on Sushrutha Samhita, Charaka Samhita and Astang Sangraha.
According to some study, about 3% people of world population is suffering from Psoriasis. The patients who are suffering with psoriasis mainly due to the discoloration of skin, often experience a diminished quality of life and downcast as far as social life is concerned and leading to various psychological disturbances too.
As far as the treatment is concerned, modern science has some solution that is palliative than curative. These treatments include topical applications with drugs like Dithranoll and Corticostreroids etc. They have a little effect on long term use but often leads to side effects like stretch marks, thining of skin, brownish discoloration of skin and yellow stains on the cloths.
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Chikitsa in Ayurveda is grouped under Shamana and Shodhana. Shamana pacifies vitiated doshas in the body itself and may sometimes result in reoccurrence. Shodhana is a treatment procedure, in which, morbid doshas, that cause the disease, are eliminated from the body, avoiding any reoccurrence of the disease. Hence there is a slight advantage over Shamana chikitsa in those patients who are eligible (yogya) for shodhana.
Virechana karma is a type of shodhana, in which vitiated doshas are expelled through Adhomarga. Virechana Karma has got a wide range of indications, including various skin disorders because of its capacity to act over all the three doshas. As Shamana Chikitsa is more effective after the Shodhana chikitsa, In this present study, we are going to study the effect of Virechana karma with trivrit avaleha and “Mulak Bijadi Lepa” described in Chakra Datta as a topical application.
"Mulaka beeja" have the properties of vrana shodana, vrana ropana, vrana hara, and kusta hara properties. Hence, Mulaka beejadi lepa is taken up for the present study.
Hence the present study is directed to evaluate and compare the effect of Mulak Beejadi Lepa, Virechana karma and their combine effect in the management of Kitibha Kushta.
6.2 Review of literature:-
Specific nidana for Kitibha Kustha are not mentioned, so all the nidana of Kustha to be conceder as the nidana of Kitibha Kustha also1. As the same of nidana, specific samprapati of Kitibha Kustha is not mentioned, so here we should follow the general samprapati of Kustha.2 The lakshana of Kitibha Kustha is mentioned as Shyava, kandu, khara sparash etc.3 Acharya Chakradatta advised Mulak Beejadi Lepa in management of Kitibha Kustha.4 Acharyas explained VIRECHANA as chikitsa in all Kustha.5 Tila taila is the best snehana used for abhyanga before virechana in skin diseases.6 Acharya Chakradutta has explained about Maha Panchtikta Ghrita for Snehapaana in Kustha chikitsa7. Acharya Charaka has explained uses of tikta pradhana dravya in all kustha rogas8. Acharya Charaka has explained about trivrit avalehya.9
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Previous work done:-
1. Dr. Patil Sachin - Management of Kitibhaby Aragvadha patra lepa- A clinical study - Rajiv Gandhi University of Health Sciences, Bangalore, 1999.
2. Dr. Prasanna Kumar T - Preparation and physico-chemical analysis of Harata-Sattva dn its efficay in KitibhaKushta - Rajiv Gandhi University of Health Sciences, Bangalore, 2002.
3. Dr. Rajeshwar R H - Kitibhaand its management w. s. r. to Jalaukavacharana - Rajiv Gandhi University of Health Sciences, Bangalore, 1986.
4. Dr. Jayashree P. V - Efficay of Prachchanna in the management of Kitibha- A clinical evaluation - Rajiv Gandhi University of Health Sciences, Bangalore, 1988.
5. Dr. Vedavathi - Efficay of Tuvaraka Taila on Kitiba-Kushtha w. s. r. to Psoriasis.
6.2 Aim & Objectives of Study:
1. To Study the disease Kitabha Kushta.
2. To evaluate the efficacy of Virechana karma in the management of Kitabha Kushta.
3. To evaluate the efficacy of Mulak Beejadi Lepa in the management of Kitabha Kushta.
4. To analyse the combined effect of Virechan followed by Mulak Beejadi Lepa in the management of Kitabha Kushta.
7 Methodology:-
7.1 Source of Data:-
a) Literary Source - Required literary information for study will be procured from
Ayurvedic samhitas and modern books, Medical journals
and retrospective studies.
b) Drug Source -The drugs will be selected from market after proper
identification and the medicaments will be prepared in the
pharmacy of S. S. R. Ayurvedic Medical College & Hospital, Inchal.
c) Sample Source - Patients suffering from Kitibha Kushta, clinically diagnosed,
will be selected from OPD & IPD of Panchakarma Department of Sri. Shivayogeeshwar Ayurvedic Medical College and Hospital, Inchal.
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d) Composition of Trail Drugs:
1. Mulaka Beeja 2. Sarshapa Beeja
3. Haridra 4. Trikatu
4. Vidanga 6. Kustha 7. Gomutra
7.2 Method of Collection of Data:-
a) Sample size & grouping: A minimum of 30 patients of Vicharchika of either sex will be taken and made into 3 groups, of 10 for each.
Group “A” – 10 patients will be only local application of Mulak Beejadi Lepa.
Group “B” – 10 patients will be given Virechana only.
Group “C” – 10 patients will be given Virechana followed by application of Mulak Beejadi Lepa.
Study Design - A single blind comparative clinical study.
a) Diagnostic Criteria - Diagnosis will be made on the basis of classical signs & symptoms as mentioned in Ayurvedic texts.
b) Inclusion Criteria:-
1) Patients showing signs and symptoms of Kitabha Kushta, of either sex, with the features of itching, erythema, induration and desquamation.
2) Patients aged above 16 years and below 60 years of age.
3) Patients fit for virechana karma.
c) Exclusion Criteria:-
1) Patients below the age of 16 years and above the age of 60 years.
2) Patients with other systemic diseases.
3) Patients during Pregnancy and Lactation.
4) Patients with other skin diseases.
d) Parameters:-
i) Subjective Parameters
1. Itching
ii) Objective Parameters
1. Erythema
2. Induration
3. Desquamation
The Objective features shall be studied as per PASI scoring.
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d) Posology:-
GROUP A:-
Patients of Group A will be treated with external application lepa of Mulak Beejadi Lepa, twice daily, for a period of 14 days. After the completion of the treatment, changes in lakshanas will be observed and recorded on 7th and 14th day, in the proforma of Case Sheet prepared for the study.
GROUP B:-
1. Poorva karma
i) Deepana & Pachana with Trikatu choorna for 3 days
Dosage is 9 gms and Anupana is usna Jala.
ii) Snehapana with Panchatikta ghrita in arohana krama upto the appearance of samyaka snigdha lakshanas (about 3-5 days).
Dosage – 30 ml initially and Anupaana is Ushna jala.
iii) Vishrama Kala followed by Abhyanga and Swedana for 3 days.
a) Abhyanga with murchita tila taila.
b) Swedana with Sukhoshna (lukewarm) jalasnana.
2. Pradhana karma
Virechana yoga – Trivrit Avaleha.
Dosage – 1 Karsha
3. Paschat karma
Samsarjana Karma based on shudhi for 3, 5 or 7 days.
After the completion of the treatment, changes in lakshanas will be observed and recorded on 7th and 14th day, in the proforma of Case Sheet prepared for the study.
GROUP C:-
Patients are first subjected to Virechana average number of days for Virechana Karma including Samsarjana Karma 12 days as mentioned in group B, followed by the application of Moolaka beejadi lepa for 14 days. After the completion of the treatment, changes in lakshanas will be observed and recorded on 7th and 14th day, in the proforma of Case Sheet prepared for the study.
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e) Duration of the treatment and follow up -
· Total duration of the treatment for Group A: 28 days
External application of Mulak Beejadi Lepa for 14 Days + follow up on 7th and 14th day.
· Total duration of the treatment for Group B: 26 days
Average number of days for Virechana karma including samsarjana karma 12 days + follow up on 7th and 14th day.
· Total duration of the treatment for Group B: 40 days
Average number of days for Virechana karma including samsarjana karma 12 days + External application of Mulak Bijadi Lepa for 14 Days + followup on 7th and 14th day.
f) Assessment Criteria:-
Assessment of the results will be done on a detailed proforma adapting standard methods of scoring of subjective & Objective parameters and will be statistically analysis by using ‘t’ test. Other tests will be adopted as per the requirement.
7.3 Does the study require any investigations or interventions to be conducted on patients or other humans or animals? If so describe briefly.
Yes, the study will be conducted clinically. No animal experiments will be carried out.
Laboratory Investigations:-
Blood - Hb%, Total Leucocyte Count, Differential Count and ESR.
7.4 Has the Ethical Clearance been obtained from your institution?
Yes, Ethical Clearance has been obtained by the Ethical Committee.
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8. BIBLOGRAPHY:-
1. Acharya Charaka, Charaka samhita, Chikitsa sthana, 7th chapter, Shloka no 4-8, Pandit Kasinath pandey and Dr.Gorakhnath Chaturvedi. Varanasi: Chaukambha Bharti Academy; Reprinted 2007. P.182
2. Acharya Charaka, Charaka samhita, Chikitsa sthana, 7th chapter, Shloka no 9-10, Pandit Kasinath pandey and Dr.Gorakhnath Chaturvedi. Varanasi: Chaukambha Bharti Academy; Reprinted 2007. P.182
3. Acharya Charaka, Charaka samhita, Chikitsa sthana, 7th chapter, Shloka no 21, Pandit Kasinath pandey and Dr. Gorakhnath Chaturvedi. Varanasi: Chaukambha Bharti Academy; Reprinted 2007. P.184
4. Charadatta- shri hakrapani datt by Shri Jgadishvaraprasad Tripati. Edited By Bhimshagratna pt. Brahmashankara Mishra. . 5th ed. Varanasi: Choukhambaha Orientalia; 2005. Kusta Chikista 50 th Chapter Sloka No. 34. Page No. 383.
5. Govind dash, Bhaishajyaratnavali, 54th chapter, Shloka no 1, Kaviraj Dr. Ambikadutt Shastri. Edition no 15. Varanasi: Chaukhambha Sanskrit Sansthan; 2002. P. 618.
6. Acharya Charaka, Charaka samhita, Sutrasthana, 13th chapter, Shloka no 12, Pandit Kasinath Pandey and Dr. Gorakhnath Chaturvedi. Varanasi: Chaukambha Bharti Academy; Reprinted 2007. P.256
7. Chakradutta, Chakrapanidutta, 50th, Chapter, Shloka no 104-110, Prof. Ramanat Dwivedy. 3rd Edition. Varanasi: Chaukhambha Prakashan; 2000. P.288
8. Acharya Charaka, Charaka samhita, Chikitsa sthana, 7th chapter, Shloka no 59, Pandit Kasinath pandey and Dr.Gorakhnath Chaturvedi. Varanasi: Chaukambha Bharti Academy; Reprinted 2007. P.258
9. Acharya Charaka, Charaka samhita, Kalpasthana, 7th chapter, Shloka no 23, Pandit Kasinath pandey and Dr.Gorakhnath Chaturvedi. Varanasi: Chaukambha Bharti Academy; Reprinted 2007. P.920
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9) Signature of the Candidate :
(DR PUJARI RAVI KUMAR)
10) Remarks of the Guide :
11) Name and Designation :
11.1) Guide : Dr D Jaya Prakash
Professor & HOD, Dept. of Pancha Karma
Shri Shivayogeeshwar Rural Ayurvedic
Medical College & Hospital, Inchal – 591 121.
11.2) Signature :
11.3) Co-Guide : Dr G Vinay Mohan,M.D.(Ayu)
Professor, Dept. of Kaya Chikitsa
Shri Shivayogeeshwar Rural Ayurvedic
Medical College & Hospital, Inchal – 591 121.
11.4) Signature
11.5) Co-Guide Dr K.M.Khot,M.D.(Ayu)
Reader, Dept. of Pancha Karma
Shri Shivayogeeshwar Rural Ayurvedic
Medical College & Hospital, Inchal – 591 121.
11.6) Signature :
11.7) Head of the Department :
11.8) Head of the Department : Dr D Jaya Prakash
Professor & HOD, Dept. of Pancha Karma
Shri Shivayogeeshwar Rural Ayurvedic
Medical College & Hospital, Inchal – 591 121.
11.9) Signature :
12) Remarks of the Chairman
And Principal
12.1) Signature & Seal Principal/CMO
(Dr G Vinay Mohan)
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