RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES
BANGALORE – KARNATAKA
COMPLETED PROFORMA FOR REGISTRATION OF SUBJECT
FOR DISSERTATION
“A COSMETIC APPROACH OF AYURVEDA ON VYANGA ROGA W.S.R TO MELASMA”
BY
DR. PRIYA PUESH PARGOTRA
1st Year M.D. (AYU.),
Dept. of P.G. Studies in Kaya Chikitsa
GUIDE
Dr.GOPALAKRISHNA.G.S. M.D(AYU)
Professor & HOD,
Department of Post Graduate Studies in Kaya Chikitsa,
BMJ Ayurvedic Medical College and PG Centre,
Gajendragad-582114.
2010 - 2011
BHAGAWAN MAHAVEER JAIN AYURVEDIC MEDICAL COLLEGE
& PG RESEARCH CENTRE
Gajendragad, Gadag (dist), Karnataka - 582114.
From:
DR. PRIYA PUESH PARGOTRA,B.A.M.S.,
1st year M.D. (Ayu.),
Department of P.G. Studies in Kayachikitsa,
BMJ Ayurvedic Medical College and PG centre,
Gajendragad,
Gadag Dist.
To:
The Registrar,
Rajiv Gandhi University of Health Sciences,
Bangalore, Karnataka.
Through: The Principal and Head of the Department in Kayachikitsa,
Bhagawan Mahaveer Jain Ayurvedic Medical College& PG Centre,
Gajendragad, Gadag Dist, Karnataka.
Respected Sir/Madam,
SUB: Submission of Completed Proforma of synopsis 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 partial fulfillment of M.D. (Ayu) course in Kaya Chikitsa.
TITLE OF DISSERTATION:
“COSMETIC APPROACH OF AYURVEDA ON VYANGA ROGA W.S.R TO MELASMA”
Here with I am enclosing the completed Proforma for registration of subject for dissertation.
Thanking you,
yours faithfully,
Place: Gajendragad,
Date: 18-4-2011
Dr. PRIYA PUESH PARGOTRA B.A.M.S
RAJIVGANDHI UNIVERSITY OF HEALTH SCIENCES
BANGALORE, KARNATAKA.
ANNEXURE – II
COMPLETED PROFORMA FOR REGISTRATION OF SUBJECT FOR
DISSERTATION
1) Name of Candidate : DR. PRIYA PUESH PARGOTRA
and
Address (In block Letters) : 1ST YEAR M.S.(AYU),
DEPT OF P.G. STUDIES IN KAYACHIKITSA,
BMJ AYURVEDIC MEDICAL COLLEGE AND
PG CENTRE
GAJENDRAGAD.
Permanent Address : DR.PRIYA PUESH PARGOTRA
LANE NO 6, H NO 23-A
TAWI VIHAR SIDHARA COLONY,
JAMMU (J&K),
2) Name of the Institution : BHAGAWAN MAHAVEER JAIN AYURVEDIC
MEDICAL COLLEGE AND PG CENTRE,
GAJENDRAGAD,
GADAG DIST., KARNATAKA.
3)Course of Study & Subject : AYURVEDA VACHASPATI,
M.D. (Ayu) IN KAYACHIKITSA.
4) Date of Admission of Course : 15th NOVEMBER 2010
5) Title of the Topic : “COSMETIC APPROACH OF AYURVEDA
ON VYANGA ROGA W.S.R TO MELASMA.”
6) BRIF RESUME OF INTENDED WORK:
6.1) Need for the study:
The skin would reflect any unhealthy state of the physique or the psyche, as beauty manifests through the appearance of the complexion of the skin. Skin is the largest organ in the body both by weight and surface area. The beauty and attraction of individual is reflected in the skins health (including general health). The colour of the skin is important biologically, cosmetically and socially. Skin diseases though afflicts bodily but gives lot of psychological disturbances. Whether we admit it or not, society places a high value on appearance.
“Beautiful women and Intellectual men are always praised”
Today in market the corporate world is attracting the public towards cosmetics as
Ayurvedic products. so we can say that Ayurveda is the reason behind glowing,
glittering and beautiful faces.The word cosmesis (Gr- Kosmesis) means,
· The preservation, restoration or bestowing of bodily beauty.
· Surgical correction of disfigured physical defects (4)
Vyanga is a Ksudra roga having simple etiology and symptoms,but in exceptional cases these can produce a marked cosmetic disability and give rise to much mental stress. As
Vyanga is a distressing disorder, there is a definite need for treatment as a disease and of cosmetic value too essential.
In the disease Vyanga an important sign is the presence of Neeruja, Tanu, Shyava varnayukta mandala on Mukhapradesha.(5) According to Modern view, the patches can be taken under the heading of Pigmental disorder. The disease Vyanga can be correlated with hyper pigmentation with special reference to Melasma. In this, the patches of hyper pigmentation are seen especially on cheeks, nose, forehead and chin.(6)
In Ayurveda, skin is a route of administration of drugs, is considered equally important, as the other routes of administration and many preparations in different forms are available in classics, which are to be used topically in variety of diseases. The Abyanga helps in removing the doshas locally and give rise to normal colour. So Abyanga was selected for the management of Vyanga to make the treatment simple, effective and convenient to the patient.
In India, lots of cosmetic products are available in market and most of the people spent lots of money over cosmetics . But cosmetic products doesn’t give satisfactory result. But Ayurveda relatively proved to be efficacious in the treatment of skin diseases.(7) Ayurveda provides effective, safe and economically cheaper method of treatment.
Thus, present study is intended to know the effect of the Varnya Maha Kasaya (internally) as in Caraka samhita, Sutra sthana, Chapter 4, sloka 8 and Kanaka tailam (externally) as in Cakradatta, Ksudra rogadhikara, sloka no.44-80 Vyanga, as these are explained as capable of destroying hyper-pigmentation found on mukhapradesh.(1,2)
6.2 Review of Literature:
1.Nidana, Samprapti and Lakshana of Vyanga are explained in,
a) Susrutha samhitha, Reprint 2005, Uttara tantra, 13th Chapter, page no.92, sloka no.45,46
b) Ashtanga Hridaya, Reprint 2008, Uttara sthana, Chapter 31th, page no.754, sloka no.28,29
c) Madhava nidana, Edition 2004, Part 2, Nidana sthana, Chapter 55th,page no.210, sloka no.39
d) Bhavaprakasha, Edition 2005, Madhya khandam, Chapter 61th ,page no.657, sloka no.37,38
e) Yogaratnakar, Edition 5th 1993, Uttarardha, Ksudra rog nidanam, page no.273, sloka no.42,43
2.The Chikitsa of Vyanga is explained in,
(a)Caraka samhita, Reprint 2003, Volume 1, Sutra sthana, Chapter 4, sloka 8,
page no.78..
(b)Cakradatta, Edition 4th 2002, Ksudra rogadhikara, page no.315-318,
sloka no.44-80
(c)Bhaishajaratnavali, Edition 8th revised 2005, - - 60th chapter, Ksudraroga chikitsa, page no.956,
sloka no.113-11.
(d)Susruta samhita, Reprint 2005, Ksudra roga, Chapter 20, page no.465,
sloka no.33,36
e)Astanga hrudaya, Reprint 2008, Uttara sthana, Kshudra roga chikitsa, 31th chapter, page
no.756-758, sloka no.16,17,21-32
f)Bhava prakasa, Edition 2005, Madhya khandam, Ksudra rogadhikara, Chapter 61, page no.
657,658, sloka no.39-51
g)Yogaratnakar, Edition 5th 1993, Ksudraroga chikitsa, Uttararta, page no.282-283, sloka
no.7-10,13,14
h)Sarangadhara samhita, Edition 4th 2001, Uttara khandam, Chapter 9, page 237, sloka no.
9-15
e)Rasaratna samuchya, Edition 2nd 2003, Ksudra roga, 25th chapter, page no.333, sloka no.3-
5
3) The description of Melasma is available in:
a. R. G. Valia ed. Text book of Dermatology, vol -1, 1st ed. 1994, Bhalan Publication House,pp8,11,12 pp 552,553
b. Harrison’s Principal of internal medicine vol-1,14th edition1998,library of congress cataloging –in-Publication data,pp 296
c. Dorling Kindersley ed. Oxford Dictionary, 80th ed. 2007, Oxford University
Press, pp188.
6.3) Previous works done:
(1) Effect of Nasya Karma in Vyanga by Prakash, P.G. Thesis, 1994, Mysore
(2) Clinical management of Vyanga with Manjishtha-Madhu Alepa with and without
Kumkumadi Taila Nasya by Anitha, P.G. Thesis, 1999, Hyderabad
(3) A study on Ayurvedic Cosmetic formulations w.s.r. to Vyanga Roga, Swapna C.,
(4) Evaluation of the efficacy of Mukha Lepa in Vyanga w.s.r. to Arjuna tvak lepa
and Pancha-Nimba choorna internally- A clinical study by Angadi Savita S, P.G.
Thesis, 2001, Bangalore
(5) Raktachandnadi Lepa Nirmana evam Uske Guna-Karmo ka Vyanga ke
Pariprekshya mein Aturalayein Adhyayana by Sahu Swapna, P.G. Thesis, 2002,Nagpur.
(6) The study of Mukhkantikara lep as a cosmetic in Ayurveda by Godbole manik, 2002,
Mumbai
(7) Cosmetic approach in Ayurveda w.s.r. to aetiopathogenesis and management of vyang
roga, Shah zarana V, 2005, Jamnagar.
(8) Evaluation of the efficacy of Varnya Yoga in Vyanga w.s.r. to Melasma, Prasan VJoshi,
2009, Gadag.
6.4) Objectives of the Study:
· To study about ayurvedic approach in the field of cosmetology
· To study the disease vyanga with its Etiopathology and symptomatology according to ayurvedic as well as modern literature
· To assess the role of massage with kanaka tailam in the management of vyanga
· To assess the role of internal medicine Varnya Maha Kasaya in the management of disease Vyanga.
7. Materials and methods:-
7.1. Source of data:
· Patients attending O.P.D and I.P.D of the BMJ Ayurvedic medical college hospital will be selected for the study.
· Special camps will be conducted by BMJ Ayurvedic Medical College and Hospital, and will be taken for study.
7.2) Method of data collection:
· Study will be carried out in the patients fulfilling the criteria of Vyanga.
a) INCLUSION CRITERIA:
· Patients presenting with the signs and symptoms of Vyanga will be selected.
· Patients of either sex with the age group between 10- 50years will be selected.
b) EXCLUSION CRITERIA:
· Age <10yrs and > 50yrs
· Hyperpigmentation caused since birth like nevus of ota.
· Hyperpigmentation caused by tumor like malignant melanoma.
· Patients with secondary systemic involvement
· Vyanga along with Kushta roga to be excluded.
· Patients suffering with other systemic disorders like renal failure, hepatic
disorders and endocrine system related disorders.
· Associated with any other systemic and metabolic disorders are excluded
because, they may alter the results of observation.
· Pregnant women’s are excluded because even though the drug composition is herbal and safe still may be placental barrier and affect the foetus.
· Lactating mothers are excluded because even though the drug composition
is herbal and safe still may have effect over food (milk) of infant.
· Women’s using oral contraceptives are excluded because it may alter the
results of observation.
· Hyper pigmentation caused since birth is excluded because, the
prognosis is very bad in these conditions.
· DIAGNOSTIC CRITERIA:
As per the clinical features of Vyanga mentioned in classics, cases are diagnosed.
Lakshanas considered are-
1) Twak Rukshatvam
2) Twak Snigdatwam
3) Color of the patches
4) Size of the patches
5) Presence/ Absence of Kandu
6) Presence/ Absence of Daha
STUDY DESIGN:
A Clinical study.
SAMPLE SIZE:
Total number of patient taken for the study will be 60 excluding dropouts
· Varnya Maha kasayam:
Dose: Abhyantara – 2 palas in divided doses, after meal (Sa.sam. mad.kandam.2/3)
· Kanaka tailam:
Bahya : Abyanga (Sa.sam.Utt.kandam.11/2)
DURATION:
For 30 days
FOLLOW UP:
Follow up for 2 months.
SOURCE OF FORMULATION:
Kanaka Tailam and Varnya Maha Kasayam will be prepared in the Rasa shastra Dept. of BMJ Ayurvedic Medical College, Gajendragad, according to the classical references.
ASSESSMENT OF RESULTS:
Depending upon Subjective and Objective criteria assessment of the responses will be made. Statistical analysis will be made using paired standard ‘t’ test.
PARAMETERS OF STUDY :
The improvement provided by therapy was assessed on the basis of classical signs and symptoms, all the signs and symptoms were assigned score depending upon their severity to assess the effect of the drugs objectively. The detail of which is as shown below.
SUBJECTIVE CRITERIA:
1) KANDU (Itching) Score
∗ No Itching / 0∗ Mild Itching
→ Occasional itching but does not disturb routine activity / 1
∗ Moderate Itching
→ Frequent itching, disturbs routine activity but does not disturb sleep / 2
∗ Severe Itching
→ Frequent itching that disturbs routine activity as well as sleep / 3
2) DAHA (Burning sensation) Score
∗ No Burning sensation / 0∗ Mild Burning sensation (Occasional burning sensation
mostly when patient undergoes to Sun exposure)
/ 1
∗ Moderate Burning sensation → (Frequent burning sensation
which increases when patient
undergoes to Sun exposure) / 2
∗ Severe Burning sensation
→( Continuous burning sensation
with or without sun exposure) / 3
3) Oily skin ( singadhta) score
OBJECTIVE CRITERIA:
1) DRY SKIN (Rukshata/Kharata/Parushata) Score
∗ Normal / 0∗ Mild Dryness
→ Not seen but felt by touch / 1
∗ Moderate Dryness
→ Stretching of the skin that person feels / 2
∗ Severe Dryness
→ Visible dryness (Chapping of the
skin) & hardness of the skin / 3
∗ Normal / 0
∗ Mild Oiliness
→ Not seen with naked eye
→ Oiliness feel by touch
→ No need to wash face frequently
(only 1-2 times a day) / 1
∗ Moderate Oiliness
→ Oiliness is visible on skin
→ Need to wash face frequently
(3-4 times a day) / 2
∗ Severe Oiliness
→ Excessive Oiliness
→ Formation of Acne
→ Need to wash face more frequently
( >4 times a day) / 3
3) SIZE Score
∗ 0-1 cm / 1∗ 1-3 cm / 2
∗ 3-6 cm / 3
∗ >6 cm / 4
When lesions or patches are multiple,the size of the largest lesion is taken into consideration.
4) COLOUR Score
∗ Light Brown / 1∗ Brown / 2
∗ Dark brown / 3
∗ Black / 4
∗ Dark black / 5
7.3 Does the study require any investigations or interventions to be conducted on patients or other humans or animals? If so please describe:
Yes, study will be a human observational study. No animal experimentation will be conducted. The study will be conducted on patients who match with the inclusion criteria by taking case history, physical examination & investigations.
INVESTIGATIONS:
The following investigation is undertaken to estimate the patient’s general health condition, if needed;
· Hb%
· AEC
· ESR
7.4) Has ethical clearance been obtained from your institution in case of 7.3?
Yes.
LIST OF REFERENCES:
1) Charakasamhita of agnivesha revised by caraka and Dridabala reprinted 2003, with introduction by vaidya samrata sri satyanarayan sastri with elaborated vidyotini, hindi commentary by Pandit Kashinath sastri, Dr Gorakhanath chaturvedi, chowkhamba Sanskrit samsthan, Varanasi, Volume 1, Sutra sthana, Chapter 4, sloka 8, page no.78.
2) Sri chakarapanidatta chakradatt with the vaidayaprabha hindi commentary by Dr indradeva tripathi published by chaukhamba Sanskrit sansthan Varanasi,edition 4th 2002, ksudra rogadhikara sloka 44-80, page no.315-318
3) Trivikramatmaja yadav Sharma ed. Sushruta Samhita vol- 1, Sutra 15/41, 7thed,
2002, choukambha Orientalia, Varanashi pp775.
4) Dorling Kindersley ed. Oxford Dictionary, 80th ed. 2007, Oxford University
Press, pp188.
5) Dr. Ambikadatt Shastri ed. Sushruta Samhita vol- 1, Nidana 13/43-46, 2nd ed.
2005, Choukambha publication, Varanashi, pp 268.
6) R. G. Valia ed. Text book of Dermatology, vol -1, 1st ed. 1994, Bhalan
Publication House, pp 552.
7) R. G. Valia ed. Text book of Dermatology, vol -1, 1st ed. 1994, Bhalan
Publication House, pp 553.