A Clinical Study on the Effect of Indukanta Ghrita Matra Basti in Janu Sadhigata Vata

A Clinical Study on the Effect of Indukanta Ghrita Matra Basti in Janu Sadhigata Vata

RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES

KARNATAKA,BANGALORE.

COMPLETED PROFORMA FOR THE REGISTRATION OF SUBJECT

(PANCHAKARMA) FOR THE DISSERTATION IN M.D. (AYURVEDA)

A COMPARATIVE STUDY ON THE EFFECT OF INDUKANTA GHRITA MATRABASTI AND JALAUKAVACHARANA ON JANU SANDHIGATAVATA

By
Dr. Chanabasappa Pujar
1st M.D.(Ay) Scholar
Dept. of P.G. Studies in Panchakarma
Alva’s Ayurveda Medical College,
Moodbidri, D.K,Karnataka

Guide
Dr.Zenica D’souza M.D(Ay)
Asst.Professor and H.O.D.
Dept of P.G. Studies in Panchakarma
Alva’s Ayurveda Medical college,
Moodbidri, D.K, Karnataka

2008-2009
Alva’s Ayurveda Medical College,
Moodbidri, D.K,Karnataka.

From ,
Dr. Chanabasappa. R. Pujar
1st M.D.(Ay) Scholar,
Dept. of P.G. Studies inPanchakarma,
Alva’s Ayurveda Medical College,
Moodbidri. D. K.Karnataka.

To,
The Registrar,
Rajiv Gandhi University of Health Sciences,
Karnataka, Bangalore.

Through proper channel

Subject: Submission of Completed Proforma for Registration of

Subject for Dissertation in M. D. (Ay).

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 fulfillment of M.D(Ay) in Panchakarma.

Title of dissertation
“A COMPARATIVE STUDY ON THE EFFECT OFINDUKANTA GHRITA MATRABASTI AND JALAUKA AVACHARANA ON JANUSANDHIGATA VATA’’

Here with I am enclosing completed proforma for registration.

Thanking you,

Place:Moodbidri yours faithfully,

Date: .11.2008 Dr. Chanabasappa Pujar

RAJIV GANDHI UNIVERSITYOF HEALTH SCIENCES, KARNATAKA, BANGALORE.

COMPLETED PROFORMA FOR THE REGISTRATION OF SUBJECT FOR DISSERTATION IN M.D.(AYURVEDA) PANCHAKARMA

1. Name of the Candidate and Address: Dr. Chanabasappa Pujar

1st year M.D. (Ay) Scholar

Dept.of P.G. Studies inPanchakarma

Alva’s Ayurveda Medical College

Moodbidri – 574227 D.K.

Permanent address : Dr. Chanabasappa Pujar

S/o Sri Rangappa L. Pujar

At/Post- Neerabudihal

Tq- Badami

Dist- Bagalkot, Karnataka- 587206

2. Name of the Institution : Alva’s Ayurveda Medical College,

Moodbidri – 574227 D.K.

3.Course of Study and Subject : M.D. (Ayurveda) Panchakarma

4.Date of admission to the Course : 4th July 2008

5. Title of the Topic :

“A COMPARATIVE STUDY ON THE EFFECT OFINDUKANTA GHRITA MATRABASTI AND JALAUKAVACHARANA ON JANUSANDHIGATA VATA’’

6. Brief Resume of the intended Work
6.1 Need for the study
Sandhigata Vata stands one among the commonly encountered Vata vikaras in clinical practice.It is kastasadhya as it involves the madhyama rogamarga and occurs in later decades of life.The signs and symptoms includessandhivedana,sandhistabdata,sandhishotha and sandhiatopa1.

Osteoarthritis in modern parlance is a degenerative articular disorder mainly of the weight bearing joints, which limits everyday activities like walking, climbing, standing, making the individual crippled. There is steady rise in prevalence from age 30 such that by 65, 80% of people have radiographic evidence of OA,though only 25 to 30% are symptomatic2.

Basti is mentioned as a choice of treatment forVatavyadhi. Matra Basti is selected for the present study as it is administered in all the rutus irrespective of age, sex time. Indukanta ghrita is taken for Matra Basti in the present study as it isindicated in Vatamaya.3 In Vatavyadhi Chikitsa ‘Raktamokshana’ is also indicated.4 Many international research works on the efficacy of leech therapy in Osteoarthritis have been conducted in past and are also in progress in the present.5a&b
Therefore the present study is intended to compare the efficacy of Indukanta ghrita Matrabasti with Jalaukavacharana in Janusandhigata Vata.
6.2 Review of Literature

The review of literature include a thorough screening of Ayurvedic texts,contemporary Ayurvedic literatures, modern texts and the internet sources to collect sufficient data. Some of the texts are as follows.

  • Nidana, samprapti and lakshanas of Sandhigata Vata are explained in Charaka samhita, chikitsa sthana, 28/15-18, 37.1
  • In Chikitsa of Vatavyadhi Raktamokshana is indicated in Susrutha samhita, chikitsa sthana 4/7.4
  • Indukanta ghrita has been explained in Sahasra Yoga Ghrita Prakarana.3
  • Davidsons principles and practice of medicine mentions about prevalence of the disease.2

Previous works done

  1. A Comparative study of Matra Basti & some Indigenous compound in the

management of Sandhigata Vata. By Mayuri Shah – Jamnagar – 2006

  1. Effect of Jalaukavacharana and Janubasti in vedana of JanuSandhigata Vata- A

Comparative clinical study By Sandeep B.R.-G.A.M.C. Mysore-2006

  1. A clinical study on the role of Matra Basti & Shamana yoga in the management

of Sandhigata Vata ByAlpesh Joshi – Jamnagar- 2004

6.3 Objectives of the study

  • Evaluation of the effect ofMatra Basti withIndukanta Ghrita on Janusandhigata Vata.
  • Evaluation of the effect of Jalaukavacharana on Janusandhigata Vata.
  • To compare and ascertain the effect of Indukanta Ghrita matrabasti with Jalaukavacharana on Janusandhigata Vata.

6.4 Hypothesis

H0 –There is neither effect of Matrabasti nor Jalaukavacharana on

JanusandhigataVata.

H1-There is significant effect of Matrabasti on Janusandhigata Vata.

H2-There is significant effect of Jalaukavacharana on Janusandhigata Vata.

H3- There is significant effect of Matrabasti over Jalaukavacharana on

JanusandhigataVata.

H4-There is significant effect of Jalaukavacharana over Matrabasti on

Janusandhigata Vata.

7. Materials and Methods

7.1 Source of data

1. Literary source

All the Ayurvedic texts, contemporary Ayurvedic literatures and internetsources about the disease, drug & procedure will be reviewed & documented for the Intendedstudy.

2. Drug source

The drugs will be selected from local areas & market after proper identification& the Ghrita will be prepared in ALVA’s pharmacy Mijar. Leeches will be collected from local areas.

3.Sample source

Patientssuffering from Janusandhigata vata are selected from the PanchakarmaPost Graduate O.P.D. & I.P.D. of ALVA’s Ayurveda Medical College & Hospital Moodbidri & from other camps & referrals.

7.2 Method of Collection of Data

A minimum of30 patients fulfilling the diagnostic and inclusion criteria of

eithersex will be selected for a single blind comparative study. They will be assigned

into two equal groups M and J.

Diagnostic Criteria:

  • Pain in unilateral or bilateral Knee joints.
  • Radiographic evidence of Sandhigata vata.

Inclusion Criteria:

  • Patients fulfilling the above mentioned diagnostic criteria.
  • Patients aged above 30 yrs.
  • Patients fit for Bastikarma & Jalaukavacharana.
  • Previously treated and untreated patients.

Exclusion Criteria:

  • Patients aged below 30yrs.
  • Pregnant and lactating mothers.
  • Patients suffering from systemic disorders which would interfere with the present

study.

  • Osteoarthritis secondary to rheumatoid arthritis, gouty arthritis, knee joint traumas, fractures and joint surgeries.
  • Patients contraindicated for Basti Karma such as Anal fissure, Fistula in

Ano.(specifically for Group- M)

  • Patients with bleeding disorders and coagulopathies (specifically for Group- J)

Procedure

GROUP-M

  • Poorva Karma:

Sthanika abhyanga with Murchita Tila taila & sthanika Nadi sweda will be done.

  • Pradhana Karma:

Matra Basti with 60 ml of Indukanta ghrita will be given in the afternoon after

food.

  • Paschat Karma:

Paschat karma will be done according to Bastichikitsa.

Assessment will be done on 1st, 4th, and 7th days of treatment.

Follow up: Will be done on 20th and 30th days.

  • Study duration:

Matra Basti – 7 days
Total study duration- 30 days.

GROUP- J

A single sitting of Jalaukavacharana will be done by using 2 medium sized leeches which will be applied on the postero-medial and postero-lateral aspects of affected knee joint.

Assessment will done on the day of the Procedure.

Follow up: Will bedone on 4th, 7th, 20thand 30th days.

  • Study duration:

Jalaukavacharana- 1 day.
Total study duration- 30 days.

Assessment Criteria:

Assessment of the condition will be done on a detailed proforma adoptingstandard methods of scoring of subjective & objective parameters and will be statistically analyzed by using unpaired ‘t’ test. Other tests will be adopted as per the requirement.

  • Subjective Parameters:
    Pain
    Stiffness
  • Objective Parameters:
    Swelling

Range of Movement – Maximumflexion.

Gait

Crepitus
Tenderness

7.3 Does the study require any investigations or interventions to beconducted 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

  • Routine hematological and urine examinations will be done to assess the general condition of the patient as well as to exclude other diseases.
  • X- ray of affected knee joint- AP & Lateral view.
  • CT and BT will be done for Group J.
  • Other investigations according to the need.

7.4 Has ethical clearance been obtained from your institution in
case of 7.3?

The ethical clearance has been obtained by the ethical committee formulated in this institution.

8. List of References:

1). Acharya Agnivesha. Vaidya Jadavji Trikamji Acharya edited Charaka samhita with Ayurveda Deepika commentary of Chakrapanidatta, published byChoukambha Krishnadas academy Varanasi-2006 Pg. No 618.(Chikitsa sthana 28/37).

2) .Nicholas A Boon & others edited Davidsons Principles and Practice ofmedicine20th edition- 2006. Published by Churchill Livingstone. Pg. No .1096.
3).Dr. K. Nistheshwar & Dr.R.Vidyanath edited Sahasra Yogam 1st edition- 2006. Published byChaukambha Sanskrit series Varanasi.GhritaPrakarana Pg.No 62.

4). Acharya Susrutha.Vaidya Jadavji Trikamji Acharya edited Susrutha samhita with Nibandhasamgraha commentary of Sri Dalhanacharya, published by Choukambha krishnadas academy Varanasi- 2004.Pg. no. 420. (Chikitsa sthana 4/7).

5). Effectiveness of Leech therapy in Osteoarthritis of the knee.

a).Effect of leeches therapy (Hirudo medicinalis) in painful osteoarthritis of the knee 2001;60:986. releases/2001-09/bsjIrt091301.php

b). A randomized, Controlled trial Andreas Michalsen, MD;Stefanie Klotz, RN;

Rainer ludtke, PhD, volume 139 Issue 9 Pages 724-730.

9. Signature of the Candidate:

10. Remarks of the Guide :

11. Name and Designation of

Guide : Dr. Zenica D’souza M.D.(Ay)

Asst. Professor and H.O.D.

Dept of P.G. Studies in Panchakarma
Alva’s Ayurveda Medical College,
Moodbidri, D.K. Karnataka

Signature & seal :

12. Head of the Department : Dr. Zenica D’souza M.D.(Ay)

Asst. Professor and H.O.D.

Dept of P.G. Studies in Panchakarma
Alva’s Ayurveda Medical College,
Moodbidri, D.K. Karnataka

Signature & Seal :

12. Remarks of the Principal :

Signature & Seal :

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