RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,
KARNATAKA, BANGALORE.
COMPLETED PROFORMA FOR REGISTRATION OF SUBJECT
(PANCHAKARMA) FOR THE DISSERTATION IN M.D. (AYURVEDA)
“ROLE OF ROOKSHANA AS POORVAKARMA FOR VAMANA
IN THE MANAGEMENT OF STHOULYA w.s.r TO OBESITY”
By
DR. ADARSH. D. RAJ
1st Year P.G. Scholar (Ayu)
Dept. of P.G. studies in Panchakarma,
Alva’s Ayurveda Medical College,
Moodbidri, D.K District, Karnataka
GUIDE
DR. GAUTHAM ALVA M.D. (Ayu)
Assistant Professor,
Dept. of P.G studies in Panchakarma,
Alva’s Ayurveda Medical College,
Moodbidri, D.K District, Karnataka
2011-2012
ALVA’S AYURVEDA
MEDICAL COLLEGE,
MOODBIDRI, D.K, KARNATAKA.
From,
DR. ADARSH. D. RAJ
1st year P.G Scholar,
Dept. of P.G studies in Panchakarma,
Alva’s Ayurveda Medical College,
Moodbidri, D.K, Karnataka.
To,
The Registrar,
Rajiv Gandhi University of Health Sciences,
Karnataka, Bangalore.
Through,
The Principal and Head of Department of Panchakarma,
Alva’s Ayurveda Medical College,
Moodbidri, D.K District,
Karnataka
Sub: Submission of completed proforma for registration of synopsis of Dissertation in
M.D. (AYURVEDA).
Respected sir,
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, Karnataka , Bangalore, in partial fulfilment of M.D(Ayu) in Panchakarma.
THE TITLE OF DISSERTATION:
“ROLE OF ROOKSHANA AS POORVAKARMA FOR VAMANA
IN THE MANAGEMENT OF STHOULYA w.s.r TO OBESITY”
I am here with enclosing completed proforma for the registration of subject for the dissertation in M.D (Ayu).
Thanking you sir,
PLACE: MOODBIDRI yours faithfully,
DATE: 10/04/2012
DR. ADARSH. D. RAJ
RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,
KARNATAKA, BANGALORE.
ANNEXURE-II
COMPLETED PROFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION IN M.D. (AYURVEDA) PANCHAKARMA
1. NAME OF THE CANDIDATE : DR. ADARSH. D. RAJ
AND ADDRESS 1ST YEAR M.D (AY) SCHOLAR,
DEPT.OF.P.G.STUDIES IN PANCHAKARMA,
ALVA’S AYURVEDA MEDICALCOLLEGE,
MOODBIDRI-574227 D.K.
PERMANENT ADDRESS : DR. ADARSH. D. RAJ
S/O MR.K.DEVARAJAN
PUTHENVILA VEEDU
PANAYAM POOYAPPALLY P.O
KOLLAM DISTRICT
KERALA - 691537
2. NAME OF THE INSTITUTION : ALVA’S AYURVEDA MEDICAL COLLEGE
MOODIBDRI-574227 D.K
3. COURSE OF STUDY
AND SUBJECT : M.D (AYURVEDA)-PANCHAKARMA
4. DATE OF ADMISSION
TO THE COURSE : 20-8-2011
5. TITTLE OF THE TOPIC :
“ROLE OF ROOKSHANA AS POORVAKARMA FOR VAMANA
IN THE MANAGEMENT OF STHOULYA w.s.r TO OBESITY’’
6. BRIEF RESUME OF THE INTENDED WORK
6.1 NEED FOR THE STUDY
Obesity has reached epidemic proportions in India in the 21st century, with morbid obesity affecting 5% of the country's population where sedentary life style and unhealthy food habits being a major causative factors resulting in many serious systemic complications1.
In Ayurveda, Sthoulya comes under Santarpanajanya2 and Medo-Pradoshaja Vikara3 which is also a Kapha Pradhana Vyadhi4 where Apatarpana treatment modalities like Rookshana5, is indicated because it involves Marma, major Doshas and also for its Abhishyandi nature6.
Rookshana has been mentioned as Poorvakarma for Mamsala, Medhura, Bhurishleshma and Vishamagni persons before Snehapana prior to Shodhana7, where Sthoulya is one such condition. Vamana being an appropriate Shodhana procedure which is specific for the elimination of vitiated Kapha Dosha and also indicated in Sthoulya8..
Hence to evaluate whether Rookshana performed prior to Snehapana in Vamana Karma has any beneficial effect over classical Vamana in providing satisfactory relief to the patient of Sthoulya, this study is undertaken.
6.2 REVIEW OF THE LITERATURE
The review of literature includes screening of classical literatures, contemporary
Ayurvedic literatures, modern literatures, journals and internet sources to collect
sufficient data for the study. Few of the text books considered are as follows
• Caraka Samhita
• Susruta Samhita
• Ashtanga Hridaya
• Ashtanga Sangraha
• Davidson’s principles and practice of medicine
PREVIOUS WORKS DONE:
1. A clinical study on effect of Vamana and Udvartana Karma in the management of Sthoulya. By Dr.Jyoth V Hullale N.K.Jabshetty Ayurvedic Medical College & PG Research Centre Gumpa, Bidar (2008).
2. A clinical study to evaluate the efficacy of Vamana Karma in Medoroga WSR to Overweight/Obesity. By Dr Prajwal Narayan S D M College Of Ayurveda, Kuthpady (2007).
3. Clinical evaluation of Udgharshana in Sthoulya. By Dr.Shashi Kiran S D M College of Ayurveda, Kuthpady (2005).
6.3 OBJECTIVES OF THE STUDY
1. To evaluate the role of conventional Sneha Poorvaka Vamana Karma in the management of Sthoulya w.s.r to Obesity.
2. To evaluate the role of Rookshana Poorvaka Snehana and Vamana Karma in the management of Sthoulya w.s.r to Obesity.
3. To compare the effects of Sneha Poorvaka and Rookshana Poorvaka Snehapana
for Vamana in the management of Sthoulya w.s.r to Obesity.
6.4 HYPOTHESIS
H0: There is neither effect of Rookshana Poorvaka Snehana and Vamana Karma nor
Snehana Poorvaka Vamana in Sthoulya.
H1: Rookshana Poorvaka Snehana and Vamana Karma have significant effect than Snehana
Poorvaka Vamana in Sthoulya.
H2: Snehana Poorvaka Vamana has significant effect than Rookshana Poorvaka Snehana
and Vamana Karma in Sthoulya.
7. MATERIALS AND METHODS
7.1 SOURCE OF DATA
1. LITERARY SOURCE
All the classical, modern literatures and contemporary texts including the journals & website about the disease, drug and procedure will be reviewed and documented for the intended study.
2. SAMPLE SOURCE
Patients will be randomly selected from OPD and IPD of PG studies of Panchakarma, Alva’s Ayurveda Medical College & Hospital Moodbidri.
Medical camps and other referrals.
3. DRUG SOURCE
Medicines required for the treatment will be prepared in Alva’s pharmacy, Mijar.
7.2 METHOD OF COLLECTION OF DATA
I. Study Design –Comparative clinical study.
II. Sample Size – Minimum of 30 patients suffering from Sthoulya fulfilling the inclusion criteria of either of the sex will be selected for the comparative study. They will be assigned into two equal groups, A & B for the study.
III. Selection Criteria – The cases are selected as per signs and symptoms of Sthoulya.
a) Diagnostic criteria:
The patient will be diagnosed based on the following clinical features5.
1. Chala - Stana, Udara, Sphik
2. Atikshudha
3. Atipipasa
4. Nidradhikya
5. Daurgandya
6. Gourava
With or without other Lakshanas of Sthoulya.
b) Inclusion Criteria:
Patients fulfilling the diagnostic criteria.
Patients between the age group of 20 to 50 years.
Patients who are fit for Vamana & Rookshana Karma.
Patient having BMI(kg/m2) 25 to 35
c) Exclusion Criteria:
· Obesity due to endocrinal abnormality.
· Patients with systemic disorders which interfere with the course of the treatment.
· Patient’s contra indicated for Vamana & Rookshana.
· Patient having BMI (kg/m2) above 35.
d) Procedure: Group A: Rookshana Poorvaka Vamana
PROCEDURE / PREPARATION / DURATIONPoorva Karma / Rookshana / Abhyantara Rookshana :
1.Pana- Nisneha Takra Pana (Buttermilk - 300ml three times a day )
2. Anna-Yavanna (Yava in the form of chapathi i.e.1-2 chapathi, 3 times a day)
3. Bheshaja- Triphala Kwatha ( 15ml three times a day one hour before meal) / All the above Abhyantara and Bahya Rookshana are to be done simultaneously for 7 days or till the Samyak Rookshana Lakshanas appears, whichever is earlier
Bahya Rookshana: In the mode of Sarvanga Udvartana with Triphaladi Choorna (45mins) followed by Ushna Jala Snana.
Snehapana / MoorchitaTila Taila starting with Hrasiyasi Matra (50ml) / Arohana-Krama, till
Samyak Snigdha Lakshanas appears
Abhyanga
Swedana
Kapha Utkleshana / Moorchita Tila Taila (30mins)
Mrudu Sweda in the form of hot water bath.
Kapha Utkleshaka Ahara - / on the day of 2days Vishramakala
and Vamana
1day (During Vishrama Kala )
Pradhana
Karma / Vamana Karma / Vamana Karma9 will be performed as per the classics by using Madana Phala Pippali Yoga. / Till Samyak
Vamana Lakshanas appears
Pashchat Karma / Dhoomapana / Dhooma Varti / According to Pravara, Madhyama &Avara Shuddi
Samsarjana Krama / Tarpanadhi Samsarjana Krama
Group B: Snehana Poorvaka Vamana
PROCEDURE / PREPARATION / DURATIONPoorva
Karma / Deepana Pachana / Trikatu Churna in the dose of 4 grams three times a day 1 hour before meal along with Ushna Jala / For 5 days or Till the appearance of Nirama Lakshanas, whichever is earlier
Snehapana / MoorchitaTila Taila starting with HrasiyasiMatra (50ml) / Arohana-Krama, till Samyak Snigdha
Lakshanas appears (3-7days)
Abhyanga
Swedana
Kapha Utkleshana / Moorchita Tila Taila (30mins)
Mrudu Sweda in the form of hot water bath.
Kapha Utkleshaka Ahara - / on the day of 2days Vishramakala
and Vamana
1day (During Vishrama Kala )
Pradhana
Karma / Vamana Karma / Vamana Karma will be performed as per the classics by using Madana Phala Pippali Yoga. / Till Samyak
Vamana Lakshanas appears
Pashchat Karma / Dhoomapana / Dhooma Varti / According to Pravara, Madhyama and
Avara Shuddi
Samsarjana Krama / Tarpanadhi Samsarjana Krama
e) Study Duration/ Follow up
Totally the course of treatment along with late assessment (follow up-30days) will be
approximately
Group A: Maximum up to 53days
Group B: Maximum up to 51days
Patient is advised to follow strict diet and exercise till follow up.
f) Observation Period
Patients will be assessed before Treatment, after Rookshana, after Snehapana, after
Vamana, after Samsarjana Karma and follow up
g) Assessment Criteria:
Assessment of the condition will be done based on the detailed Proforma adopting
standard method of scoring of subjective and objective parameters which will be
analysed statistically
Subjective:
1. Chala - Stana, Udar, Sphik.
2. Atikshudha.
3. Atipipasa.
4. Nidradhikya
5. Daurgandya.
6. Gourava
Objective10:
1. Body weight
2. BMI (Kg/m2)
3. Anthropometrics features (Measuring skin fold thickness by using slide calipers.) Triceps, Biceps, Sub Scapular, Abdomen and Thigh.
a. Measurements taken at various levels viz.
b. Chest
c. Abdomen
d. Buttock
e. Mid-thigh
f. Mid Arm
Statistical Test:
Obtained data will be analysed statistically with relevant statistical test accordingly.
7.3 Does the study require any investigations or intervention to be conducted on patients or other humans or animals? If so describe briefly.
This study will be conducted clinically. No animal experiment will be carried out.
LABORATORY INVESTIGATIONS
Apart from routine investigations the following specific investigations will be carried out in the present study
Lipid Profile: - Total Cholesterol, LDL, HDL, VLDL and Triglycerides
If necessary, any other investigations will be done as per requirement
7.4 Has ethical clearance been obtained from your institution in case of 7.3?
Yes, clearance has been obtained through the ethical committee constituted
in the institution.
8. LIST OF REFERENCES:
1. http://en.wikipedia.org/wiki/Obesity_in_India
2. Agnivesha, Charka Samhita with Ayurveda Deepika commentary of Chakrapani Datta edited Vaidya Jadaviji Trikamji Acharya edited, published by Chaukamba Surabharati PrakashanVaranasi, Reprint 2008. Sutra Sthana 23/3-7 Pg.No:122.
3. Agnivesha, Charka Samhita with Ayurveda Deepika commentary of Chakrapani Datta edited Vaidya Jadaviji Trikamji Acharya edited, published by Chaukamba Surabharati PrakashanVaranasi, Reprint 2008. Sutra Sthana 28/15 Pg No179.
4. Agnivesha, Charka Samhita with Ayurveda Deepika commentary of Chakrapani Datta edited Vaidya Jadaviji Trikamji Acharya edited, published by Chaukamba Surabharati PrakashanVaranasi, Reprint 2008. Sutra sthana 20/17 Pg No: 115.
5. Agnivesha, Charka Samhita with Ayurveda Deepika commentary of Chakrapani Datta edited Vaidya Jadaviji Trikamji Acharya edited, published by Chaukamba Surabharati PrakashanVaranasi, Reprint 2008. Sutra Sthana 21/3-28 Pg No:116-117.
6. Agnivesha, Charka Samhita with Ayurveda Deepika commentary of Chakrapani Datta edited Vaidya Jadaviji Trikamji Acharya edited, published by Chaukamba Surabharati PrakashanVaranasi, Reprint 2008. Sutra Sthana 22/30 Pg No:121.
7. Vagbhata, Astanga Hridaya with Sarvangasundara commentary of Aruna Datta ,Ayurvediya Darshana Hemadri edited Bhishagacharya Harisastri Pardakara Vaidya, Reprint 2005 Sutra Sthana 16/37-38 Pg No 251.
8. Susruta , Susruta Samhita with Nibandhasangraha commentary of Dalhana Acharya edited Vaidya Jadaviji Trikamji Acharya Published by Chaukamba Surabharati Prakashan Varanasi, Reprint 2008 Chikhitsa Sthana 33/18 Pg No 517.
9. Vaidya Haridasa Sridhara Kastura,Ayurvadeya Panchakarma Vignjana, published by Sree Vaidyanadha Ayurveda bhavana Limited Nouni Ilahabad, Reprint 2008 Pg No 228,267.
10. Nicholas.A, Nicki.R, Brian.R, John A.A,editors. Davilson’s Principles and Practice
of Medicine. 20th Edition chapter 5, Pg No: 111-117.
9. Signature of the candidate:
10. Remarks of the Guide:
11. Name and designation of
11.1 Guide : DR.GAUTHAM ALVA M.D. (Ayu)
ASST PROFESSOR ,
DEPT. OF P.G.STUDIES PANCHAKARMA,
ALVA’S AYURVEDA MEDICAL COLLEGE,
MOODBIDIRI,D.K.DISTRICT,KARNATAKA
11.2 Signature & seal :
11.3 Head of the department : DR. S. G. PRASANNA AITHAL M.D (Ayu)
ASSISTANT PROFESSOR H.O.D
DEPT. OF P.G.STUDIES IN PANCHAKARMA,
ALVA’S AYURVEDA MEDICAL COLLEGE,
MOODBIDIRI,D.K.DISTRICT,KARNATAKA
11.4 Signature & seal:
12.1 Remarks of the Principal:
12.2 Signature & seal: