From,

DR. MEENU WAHI

Preliminary M.S.(Ayu) Scholar

Department of Post Graduate Studies in Prasuti Tantra and Stree Roga,

N.K.J Ayurvedic Medical College & Research Centre,

Gumpa, Bidar-585403.

To,

The Registrar,

Rajiv Gandhi University of Health Sciences

Bangalore, Karnataka.

Through,

The Principal

N.K.J Ayurvedic Medical College & Research Centre

Gumpa, Bidar- 585403.

Subject: - Submission of Completed Proforma for registration of Synopsis

For Dissertation.

Respected Sir,

I request you to kindly register the below mentioned subject against my name for the submission of dissertation to Rajiv Gandhi University of Health Sciences Bangalore, for the partial fulfillment of M.S (Ayu.) in Prasuti Tantra and Stree Roga.

TITLE OF DISSERTATION:

CLINICAL STUDY ON THE EFFICACY OF PANCHAJEERAKA

GUDA IN SUTIKA PARICHARYA.

Herewith, I am enclosing completed Proforma for registration of subject for dissertation.

Thanking you,

Yours Sincerely

Place: Bidar

Date: (DR. MEENU WAHI)

RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES

KARNATAKA - BANGALORE

ANNEXURE- II ‌‌

PROFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION

1. Name of candidate and address : DR. MEENU WAHI

D/O SUDARSHAN WAHI

H.NO.82, KATRA MOTI RAM , I/S HATHI GATE, AMRITSAR,(PUNJAB)

2. Name of institution : N.K.JABSHETTY
AYURVEDIC MEDICAL COLLEGE

AND P.G CENTRE, BIDAR

KARNATAKA

3. Course of study : M.S (PRASUTI TANTRA AND

STREE ROGA)

4. Date of admission to centre : 9th JUNE, 2008

5. Title of topic :

CLINICAL STUDY ON THE EFFICACY OF PANCHAJEERAKA GUDA IN SUTIKA PARICHARYA

6). BRIEF RESUME OF INTENDED WORK:-

INTRODUCTION: -

Puerperium is period following childbirth during which all body tissues revert back approximately to a pre-pregnant state. All Ayurvedic samhitas have given a detailed account for sutika paricharya but the exact definition of sutika is given by Kashyapa. According to Acharya kashyapa after delivery of child till placenta is not expelled women can not be called as sutika1 .

Except Acharya Charaka all other classics have given a definite period for specific dietetic management of sutika which can be considered as normal period of puerperium.

Mortality & morbidity of mother are most challenging problems of our country. Most maternal deaths take place during 6 wks. after child birth. A recent survey by BJOG (2004) in certain villages in India mentions incidence of maternal morbidity as 52.6%. Of this 17.7% is during labour and 42.9% during puerperium. Frequent post- partum morbidity & its association with adverse perinatal outcome suggest need for post- partum care in developing country for both mother and baby.

6.1. NEED FOR THE STUDY: -

The International Conference on Population and Development (ICPD) 1994 defined reproductive health as a state of complete physical, mental and social well being and not merely absence of disease or infirmity in all matters relating to reproductive system and to its function and process.

It is well known that certain psycho-somatic changes takes place during Sutika-kala such as loss of weight, loss of body fluid, lacerated genital tract, constipation, mental stress etc. Most of these changes lead to ati-aptarparpana of mother during Sutika-kala. This status causes Vata-vriddhi which is responsible for different types of health problems such as puerperal sepsis, anaemia, prolapse of uterus. These diseases are difficult to treat and some also become incurable. These risk factors could be partially reduced by facilitating early recovery process.

So, management of Sutika is essential to avoid casualities, occurrence of infections, severe anaemia etc. in order to promote recovery of maternal health so that mother may become able to resume her normal activities as early as possible.

6.2  REVIEW OF LITERATURE :-

a)  In kashyapa samhita, khila sthana ch.11, he explained in detail about Sutika

Paricharya.

b)  Acharya Sushruta had also explained sutika paricharya in shareera sthana ch.10.

c)  Both Vagbhatas, Bhavaprakash, Yogaratanakar have given a detailed explanation

regarding Sutika kala and its management.

d)  Chakradatta in ch.63, mentioned about Sutika Paricharya.

PREVIOUS WORK DONE:-

1.  Dr. Kolte C.G, Pune (1994) Study of Hingu in Sutikavastha.

2.  Dr. Punde P.P, Pune (1995) Lohakhandayukta Panchmoola Kwathache Sutika vasthet upayoga.

3.  Mamta (Mrs.) BS (1998) Varanasi: Management of Sutika - An Ayurvedic view.

4.  Srivasthava Sarika (2001) Varanasi: Role of Shigru in management of Sutikarti (Puerperal discomfort)

5.  Sunita Suman (2004) Varanasi : Management of Sutika with Panchkola Churna.

6.  Dr. Chaudhary Sachin (2005) Bidar : Efficacy of Panchkola Ghrita in Sutika

Paricharya

6.3 OBJECTIVE OF THE STUDY :-

To evaluate the role of PANCHAJEERAKA GUDA in Sutika Kala.

7. MATERIAL & METHODS:

SOURCE OF DATA:

  1. Patients will be selected from Shri Siddharoodha Charitable Hospital and Research Centre attached to N.K.J. Ayurvedic Medical College and PG Centre, BIDAR.
  2. Ayurvedic Samhitas and Modern Medical books related to Obs. and Gynae.
  3. Journals, Magazines, Seminars, Conferences, Digital Library, Internet.
  4. Raw drugs will be purchased from local market under supervision of Dravyaguna specialist and under the supervision of Rasashastra expert of this institution trial drug will be prepared.

7.2. METHODS OF COLLECTION OF DATA:-

30 patients will be selected on the basis of simple randomized sampling procedure and a single blind study will be carried out. Patient with FTND will be included in study after thorough physical examination and complete obstetrical history.

SELECTION CRITERIA:-

INCLUSION CRITERIA:-

Full term normal delivery.

EXCLUSION CRITERIA:-

  1. Cesearean section
  1. Post- partum hemorrhage.
  1. Puerperal shock.
  1. FTNVD with IUD.

RESEARCH DESIGN:-

Selected patients will be divided into 2 groups:

TRIAL GROUP: - 15 patients will be given PANCHAJEERAKA GUDA in dose of

6 gms. BD for 45 days with milk as Anupana.

CONTROL GROUP:- 15 patients will be given a placebo 6 gms. BD for 45 days.

PROPERTIES:-

DRUG NAME/ LATIN NAME / FAMILY / RASA / GUNA / VEERYA / VIPAKA
Jeeraka /
Cuminum cyminum / Umbelliferae / katu / Laghu, ruksha / ushna / katu
Hapusha/
Juniperus communis / Pinaceae / Katu, tikta / Laghu, ruksha, teekshna / ushna / katu
Dhanyaka /
Coriandrum sativum / Umbelliferae / Katu, tikta,
madhura / Laghu, snigdha / Ushna / madhura
Shatahvah/
Anethum sowa / Umbelliferae / Katu,tikta / Laghu, teekshna, ruksha / Ushna / katu
Badar/
Zizyphus jujube / Rhamnaceae / Amla, madhura kasaya. / Guru, snigdha,
pichila / Sheeta / Madhura
Yavani/ Trachespermum ammi / Umbelliferae / Katu, tikta / Laghu, ruksha, teekshna / Ushna / Katu
Rajika/
Brassica juncea / Cruciferae / Katu / Laghu, teekshna / Ushna / Katu
Hingupatrika/ Gardenia gummifera / Rubiaceae / Katu, tikta / Laghu,
ruksha, teekshna / Ushna / Katu
Kasmarda/
Cassia occidentalis / Leguminosae / Tikta,
madhura / Ruksha, laghu, teekshna / Ushna / Katu
Pippali/
Piper longum linn. / Piperaceae / Katu / Laghu, snigdha,
teekshna / Anushna / Madhura
Pippalamula/
Piper longum / Piperaceae / Katu, tikta / Laghu, ruksh teekshna / Ushna / Katu
Ajmoda/ Carum roxburghianum / Umbelliferae / Katu, tikta / Laghu, ruksh teekshna / Ushna / Katu
Chitraka/
Plumbago zeylanica / Plumbaginaceae / Katu, tikta / Teekshna, laghu, ruksha / Ushna / katu
Kasheruka/
Scirpus grossus / Cyperaceae / Madhura, kashaya / Guru, ruksha / Sheeta / Madhura
Nagara/
Zingiber officinale / Zingiberaceae / Katu / Laghu, snigdha / Ushna / Madhura
Kushtha/
Saussurea lappa / Compositae / Tikta,katu, madhura / Laghu, ruksha,
teekshna / Ushna / katu

Ghrita, Godugda, Guda in appropriate quantity

YOGA: PANCHAJEERAKA GUDA.

( Chakradatta Ch. 63/ 45-50).

PREPARATION:-

Firstly gudapaka is made by taking guda and ghrita with double quantity of milk and same amount of water. When it becomes thick like Leha then churna of above drugs are added and mixed properly.

ASSESSMENT CRITERIA :-

A) SUBJECTIVE CRITERIA:-

  1. Agni.( appetite)
  2. Pureesha avarodh.
  3. Mutra avarodh.
  4. Lactation.
  5. Nidra (Sleep).
  6. Udhar shula (Pain abdomen)
  7. Vitapchedan vrana (Healing of episiotomy wound).

B.) OBJECTIVE CRITERIA: -

  1. Measurement of involution of uterus in relation to pubic symphysis in cms.
  2. Abdominal girth.
  3. Vaginal discharge. (lochia.)
  4. Depression & anxiety.

Patients will be assessed each day up to discharge from hospital with specially prepared case sheets.

FOLLOW UP :-

4 follow ups will be given.

1st follow up – after 7 days.

2nd follow up - after 15 days.

3rd follow up - after 30 days.

4th follow up – after 45 days.

STATISTICAL ANALYSIS:-

Subjective parameters:

The result will be statistically assessed by employing some non parametric tests.

Objective parameters:-

Within the groups:-

If the observations are paired type (Depending) then to test significant difference between two dependent means or paired means we may use paired ‘t’ test (students ‘t’ test). The test statistics

t =d √n/s where d = ∑ d/n

d = Difference between before treatment values & after treatment values.

n = Number of observations.

s = Standard deviation of the difference ═

Degrees of freedom = n-1

Between the groups:-

For testing the significant difference between two independent means. Student‘t’ test for testing two independent means may be employed. The‘t’ test statistics is-

t = Where = ∑ x/n1 x = Treatment group. = ∑ y/n2 y = Control group.

S = Pooled standard deviation =

n1 = No. of observation in Treatment group.

n2 = No. of observation in the Control group.

Degree of freedom = n1 + n2 - 2

The observation will be analyzed critically & scientifically .The result will be evaluated for its significance .If needed Chi square test can be used.

7.3) LAB. INVESTIGATIONS REQURED :-

  1. Hb gm%.
  2. CBC.
  3. ESR.
  4. Urine R/M

All the tests will be performed on both 1st & 45th day.

7.4. HAS ETHICAL CLEARANCE BEEN OBTAINED FROM YOUR

INSTITUTION?

Yes, obtained

8.) LIST OF REFERENCES: -

  1. Prof. P.V Tewari, Kashyapa Samhita or Vrddhajivakiya tantra, Chaukhambha Visvabharati, Varanasi (2002), Khil Sthana, ch.11 pg.576-577.
  2. Prof. P.V.SHARMA, CHAKRADATTA, Chaukhamba Publications, Varanasi(U.P) 2002 pg.541-42.
  3. Prof. Sharma P.V, Dravyaguna Vijnana. Vol.2, Chaukhamba Bharati Academy, Varanasi(U.P)2003 Pg.129,275,287,322, 331,359,365,403,405,494, 497,572,586, 644.
  4. Prof. (Kum.) Premvati Tewari Ayurvediya Prasuti Tantra Evam Stri-Roga (part1) Chaukhamba Orientalia, Varanasi (UP)2003. Pg. 543-545.
  5. Dr. D.C.DUTTA, Text book of Obstetrics, New Central book agency(Pvt.) kolkatta. 1995 pp 153-163.
  6. A scientific study of management of puerperium through Ayurveda by Dr. K.K.Pandey krishnadas Academy Varanasi - 2002.
  7. Dr. C.S Dawn, Text book of Obstetrics and Neonatology –2004 Ch. 29. pg. 267 – 271
  8. Shri. Lakshmipati Shashtri, Yogaratnakar Streeroga Chiktsa Chaukhambha Publication, Varanasi – 2004 pg. 426.
  9. Mudaliar and Menon’s Clinical Obstetrics (tenth editon) edited by Sarala Gopalan, Vanita Jain, 2006 pg. 120- 127

9. SIGNATURE OF THE CANDIDATE:

10. REMARKS OF THE GUIDE :

11. NAME & DESIGNATION OF :

(In block letters)

11.1. Guide : Dr. SUSMITA PRIYADARSHINEE OTTA

BAMS, M.S (AY) PRASUTI TANTRA & STREE ROGA (U.U)

ASST. PROF. OF PG DEPT. OF PRASUTI TANTRA & STREE ROGA, N.K.J.A.M.C & RESEARCH CENTRE, BIDAR.

11.2 Signature :

11.3 Co- Guide :

11.4 Signature :

11.5 Head of Department : DR. PRABHA SHARMA

M.D Ph. D (BHU)

PROF & HOD OF PRASUTI TANTRA & STREE ROGA

N.K.J.AM.C & RESEARCH CENTRE, BIDAR.

11.6. Signature :

12). 12.1 Remarks of Chairman & Principal/Dean:

12.2. Signature :

12