RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, KARNATAKA
BENGALURU.
COMPLETED PROFORMA FOR REGISTRATION OF SUBJECT
FOR DISSERTATION
EFFECT OF CERTAIN INDIGENOUS MEDICATIONS IN THE MANAGEMENT OF PITTALA YONIVYAPAT w.s.r TO PELVIC INFLAMMATORY DISEASES
BY
Dr. MANJU JOSEPH
M.S. (Ayu) SCHOLAR
DEPT OF POST GRADUATE STUDIES IN PRASUTI TANTRA&STREE ROGA
S.D.M.COLLEGE OF AYURVEDA KUTHPADY, UDUPI – 574118
GUIDE
Dr. MAMATHA K.V
M.D (Ayu)
PROFESSOR
DEPT. OF POST GRADUATE STUDIES IN PRASUTITANTRA&STREE ROGA
S.D.M. COLLEGE OF AYURVEDA KUTHPADY, UDUPI-574118
CO-GUIDE
Dr. VIDYA BALLAL
M.D (Ayu)
LECTURER
DEPT. OF POST GRADUATE STUDIES IN PRASUTI TANTRA & STREE ROGA
S.D.M. COLLEGE OF AYURVEDA KUTHPADY, UDUPI-574118
2011– 2012
DEPT. OF POST GRADUATION STUDIES IN PRASUTI TANTRA & STREE ROGA
S.D.M. COLLEGE OF AYURVEDA KUTHPADY, UDUPI – 574118
From,
DR.MANJU JOSEPH
M.S. (Ayu), SCHOLAR,
Dept. of P.G. studies in Prasuti Tantra & Stree Roga,
S. D. M. College of Ayurveda, Kuthpady, Udupi - 574118
To,
THE REGISTRAR,
Rajiv Gandhi University of Health Sciences,
Karnataka, Bengaluru.
Through,
THE PRINCIPAL,
S. D. M. College OF Ayurveda,
Kuthpady, Udupi-574118.
Sub: Submission of Completed Proforma for registration of subject for dissertation.
Respected sir,
I request you to kindly register the below mentioned subject in my name for the submission of dissertation to Rajiv Gandhi University of Health Sciences, Bengaluru, for partial fulfillment of M.S. (Ayu) in PRASUTI TANTRA &STREE ROGA.
Title of Dissertation:
“EFFECT OF CERTAIN INDIGENOUS MEDICATIONS IN THE MANAGEMENT OF PITTALA YONI VYAPAT w.s.r TO PELVIC INFLAMMATORY DISEASES”
Here with I am enclosing completed proforma for registration of dissertation subject.
Thanking you,
Yours faithfully,
Place: Udupi
Date: 12-04-2012 Dr. Manju Joseph
1) NAME OF CANDIDATE : Dr. MANJU JOSEPH
ADDRESS (IN BLOCK LETTERS) : P.G SCHOLAR,
DEPT OF P.G. STUDIES IN
PRASOOTHI TANTRA AND
STHREE ROGA,
S.D.M.COLLEGE OF AYURVEDA,
KUTHPADY, UDUPI-574 118.
PERMANENT ADDRESS : KANNANKALLEL HOUSE,
PINDIMANA P.O,
KOTHAMANGALAM,
KERALA.
2) NAME OF THE INSTITUTION : S.D.M.COLLEGE OF AYURVEDA,
KUTHPADY, UDUPI- 574 118.
3) COURSE OF STUDY & SUBJECT : M.S. (Ayu) IN PRASUTI TANTRA.
& STREE ROGA.
4) DATE OF ADMISSION OF COURSE : 31st OCTOBER 2011
5) TITLE OF THE TOPIC :
“EFFECT OF CERTAIN INDIGENOUS MEDICATIONS IN THE MANAGEMENT OF PITTALA YONI VYAPAT w.s.r TO PELVIC INFLAMMATORY DISEASES”
6) BRIEF RESUME OF INTENDED WORK:
6.1: NEED FOR THE STUDY
Pelvic inflammatory diseases are defined as ascending, often recurring infections of female genital tract, which involves uterus and adnexae.1 P.I.D affects one woman in 10 during her reproductive years and 25% will have serious sequelae including infertility, pelvic pain, ectopic pregnancy, hysterectomy, oophorectomy etc.1 This is associated with emotional stress and has effect on women’s reproductive health.
Yoni shuddhata1,2 is one among the major prerequisites for a healthy offspring. Twenty types of yoni vyapath3,4,5 mentioned in the classics are a major cause in hampering the normalcy of the female reproductive tract. Among them, pittala yoni vyapath3,4,5 can be correlated to the inflammatory pathology of female reproductive tract.
P.I.D typically has remissions and exacerbations, and is difficult to eradicate. 1 It has very little response to mere oral medications. As the condition affects the deeper cellular and glandular structures of the reproductive tract, it requires more extensive external and internal medications.
The treatment of P.I.D requires multi drug regimen or broad spectrum antibiotics including the intravenous administration of drugs which can be a financial burden to the patient. Drugs used in this study are safe, effective, without any side effects and are cost effective. So this regimen can be considered in the management of P.I.D
.
6.2) Review of Literature:
Pittala yonivyapath is explained in:
Charaka, in Charaka Samhita has explained about yonivyapath in yonivyapath chikitsitham adhyaya
of Chikitsa sthana.3
In Sushrutha Samhitha, descriptions about yonivyapaths has been given in Yonivyapath
Prathishedha adhyaya of Uttara tantra4
In Ashtanga Hridaya, vagbhata has explained about sthree and purusha jananendriya rogas in
Guhyaroga vijnaneeya adhyaya of Uttara sthana.5
Ashtanga Samgraha has also explained about the same in Guhyaroga Vijnaneeya adhyaya of Uttara
Tantra 2
Swedana and kalka dharana in yoni roga has mentioned in:
In Charaka Samhita,Swedana is mentioned in the treatment procedures of yonivyapath in the
Yonivyapathchikitsitham adhyaya of Chikitsa sthana 3
Adopting Snehadikrama in the management of yonivyapath is mentioned by Sushrutha in
Yonivyapath prathishedha adhyaya of Uttara Tantra. Different drugs for yonidharana is also
mentioned here.4
Sneha swedadi karma and yonidharana has been explained by Vagbhata in Ashtanga hridaya,
Guhyarogaprathishedha adhyaya of Uttaratantra5
6.3) Previous works done:
Makane(Ms)-Role of local application of Indrayava moola on endocervicitis with cervical erosion. -Gujarat Ayurveda University, Gujarat 1981 6
Suman, Madhuri G- Clinical management of paripluta yonivyapat by gokshuradi guggulu orally together with panchavalkaladi taila locally - A P University, Hyderabad 2005 6
Kumari,Suchetha M - Effect of certain indigenous drugs on pittala yoni vyapat- Rajiv Gandhi University of Health Sciences, Karnataka, 2005 7
Tavakari,Girija S-A study on Pittala Yoni Vyapat and its management. - Rajiv Gandhi University of Health Sciences Karnataka, 2007 8
6.4) Objectives of the Study:
· To compare the clinical presentations of pittala yonivyapat with Pelvic Inflammatory disease.
· To study the aetiopathogenesis of pelvic inflammatory diseases
· To evaluate the effect of the selected medications on the disease
7) MATERIALS AND METHODS:-
7.1 Source of data:
A group of 15 patients suffering from pittala yoni vyapat, vis-a-vis P.I.D, among the patients attending the OPD of Prasoothi tantra and sthree roga Department, S.D.M.C.A hospital, Udupi.
7.2 Method of collection of data:
· Selected patients showing clinical symptomatology of pittala yonivyapath, vis-a vis P.I.D are selected.
· The data will be collected by interrogation, inspection and necessary lab investigations.
· All the patients will be given the same medications, both externally and internally and the changes will be noted according to the assessment criteria
· A special proforma will be prepared with all the points of history taking, physical examinations, lab investigations, as mentioned in our classics and allied sciences and the patients will be analyzed and selected accordingly.
· Signs and symptoms will be assessed on the basis of standard method of statistical analysis.
b) INCLUSION CRITERIA:
· Married females.
· Patients within the age group of 20-50 yrs.
· Patients presenting with symptoms of vaginitis, cervicitis, endometritis and oophoritis will be selected.
· Patients presenting with mucopurulent per vaginal discharges will be selected
· Diagnosed cases of chronic P.I.D.
· Patients presenting with irregular menstruation and spotting due to P.I.D will be selected.
· Patients presenting with deep seated dyspareunia , post coital pain or discomfort due to P.I.D will be included.
· Patients with tubo-ovarian mass of inflammatory origin will be included..
c) EXCLUSION CRITERIA
· Pregnant females
· Patients with acute P.I.D and peritonitis
· Patients who require surgical interventions in cases like pelvic abscess
· Patients with reproductive malignancies
· Patients with P.I.D when seen associated with prolapsed uterus
· P.I.D associated with tubercular infections
· Patients with endometriosis/chocolate cyst.
· Patients with exclusively vulvitis and bartholinitis
· P.I.D when complicated with diabetes
· P.I.D associated with senility and menopause.
d) ASSESESSMENT CRITERIA:
Assessment is based on scoring method.
Scores are given on the basis of:
· Reduction in lower abdominal pain and tenderness
· Reduction in cervical motion tenderness and uterine or adnexal tenderness
· Reduction in quantity of discharges
· Changes in the consistency of discharges
· Reduction in the inflammatory changes of the genital organs
· Reduction in the congestion/inflammation/edema of cervix
· Correction in P.I.D induced menstrual irregularities and irregular spotting.
· Reduction in P.I.D induced back ache.
· Reduction in dyspareunia.
· Improvement in general condition.
e)FINAL ASSESSMENT:
· Cured: Absence of pain or tenderness
Absence of abnormal discharges
Absence of inflammation / congestion/edema of cervix
· Improved: Reduced pain and tenderness
Reduced per vaginal discharges
Reduction in the inflammation/congestion/edema of cervix
· No relief: No changes in the clinical symptoms
7.3) Does the study require any investigations interventions to be conducted on
patients or other humans or animals? If so please describe briefly:
Study will be conducted on patients who match inclusion criteria by interrogation, physical examination and investigations.
Animal experiment is not required for the study.
INVESTIGATIONS:
· Hb, TC, DC, ESR, RBS
· High vaginal swab for culture sensitivity if necessary
· Urine examination- Routine and Microscopic
· Pap smear, Cervical punch biopsy, USG and Laparoscopy if required
INTERVENTION
All the patients will be given with same internal and external medications.
External medications for 8 days
· Avagaha Sweda with Dashamula kwatha 9,10– once daily
· Kalkadharanam3 with Lodhradi churna kalka (Lodhra 11,12 ,nimba 11,12,vata11,12, ashwatha 11,12 and udumbara 11,12) – once daily
Internal medications for 45 days
· A combination of Pushyanuga churna 2,3,5 (5 g)+Amritha satwa 13(1 g)+Trivanga bhasma 14 (125 mg) with Tandulodaka and honey- b.d after food
· Guggulu thikthaka kashaya churna 5 -(for kashaya pana)- 40 ml b.d after food
· Shigruvadi guggulu (A combination of Gandhaka rasayana 15,thriphala guggulu 16 and shigru moola twak 11,12) 17 -500 mg tablets- 2 t.i.d after food
7.4) Has ethical clearance been obtained from your institution
Yes, Concurrence has been obtained from the ethical committee of S.D.M.
Ayurveda Hospital.
8) List of References:
1. Robboy,Stanley J, Malcolm .C.Anderson, Peter Russel, Pathology of Female Reproductive Tract, Harcourt Publishers, 2002 edition, Pp-929, pg no-516,285,419
2. Vriddha Vagbhata, Ashtanga Samgraha with “Sasilekha” commentary by Indu, edited by Dr.Shivaprasad Sharma, published by Choukhamba Sanskrit Series Office, Varanasi,2nd edition,Pp-965,pg no-841,838
3. Agnivesha, Charaka Samhita with Ayurveda deepika commentary of Chakrapanidatta edited by Vaidya Yadavji Trimkamji Acharya published by Choukhamba Prakashan,Varanasi, UP, 2009, Pp-738,pg- 639,110,634,635,636,637,638
4. Sushruta, Sushruta Samhita,with nibandha sangraha commentary of Sri Dalhanacharya and the Nyaya chandrika panjika of Sri Gayadasa acharaya on nidana sthana edited by Vaidya Yadavji Trikamji acharya from beginning of 9th adhaya of chikitsa sthana and resy by Narayan Ram Acharya ‘kaalitheertha’,published by Choukhamba Sanskrit Sansthan, Varanasi,UP,2010 reprint,Pp-824,pg no-668,669.
5. Vagbhata, Ashtanga Hridaya with “Sarvanga sundara” commentary of Arunadatta and ‘Ayurveda rasayana’ of Hemadri,annotated by Dr.Anna Moreshwar Kunte and Krsna Ramachandra Sastri Navre , edited by Pt.Hari Sadasiva Sastri Paradakara Bishak Acharaya, published by Choukhamba Sanskrit Sansthan, Varanasi,UP,2010 reprint, Pp-956, pg no-895,896,898,900,726,120.
6. Vaidya M.S Baghel, Researches in Ayurveda, 2nd edition, Mridu Ayurvedic Publication and sales, Jamnagar, Pp-381, pg no-52,174
7. Kumari, Suchetha M ,A clinical evaluation on the effect of certain indigenous drugs in pittala yonivyapat, Dissertation submitted to RGUHS, Bangalore,2005
8. Tavakari,Girija S, A study on Pittala yonivyapat and its management, Dissertation submitted to RGUHS, Bangalore,2007
9. Sri Bhavamishra, Bhavaprakasha Vol II, Commentary by Bulusu Sitaram,1st edition, Chaukhambha Orientalia, Varanasi.,Pp-770, pg no-46
10. Chakrapani Dutta, Chakradatta, edited by Priya Vrat Sharma, 2007 edition, Chaukhamba Orientalia, Varanasi.
11. Sri Bhavamishra, Bhavaprakasha Nighantu, edited by Late Dr G.S Pandey, commentary by Prof K.C Chunekar, Chaukhamba Bharati Academy, varanasi, 2010 edition, Pp-960, pg no- 124,314,501,504,503,324
12. Late Dr K.M. Nadkarni, Indian Materia Medica, Vol I, Popular Prakashan Pvt Ltd, 2010 edition, Pp1319, pg no-1186,776,543,548,552,811
13. Dr Indradev Tripath and Dr Daya Shankar Tripathi, Yogaratnakara, Krishnadas Academy, Varanasi,1st edition,Pp-894, pg no-302
14. Yadavji Trikamji Acharya, Siddhayoga Samgraha, Shri Baidyanath Ayurveda Bhavan Ltd, Nagpur, 8th edition, Pp-176, pg no- 159
15. Sri Madhava, Ayurveda Prakasha, edited by Vaidya Vachaspathi Sri Gulrajsharma Mishra, Chaukhamba Bharati Academy, Varanasi, 2007 edition, Pp-504, pg no-268
16. Sharangadharacharya, Sarangadhara Samhitha, translated by Dr. P. Himasagara Chandra Murthy, Chaukhamba Sanskrit Series office, Varanasi,2nd edition
17. Dr. Rao, Prasanna N, Role of Gandhaka Rasayana Guggulu inipost operative management, Ph.D dissertration,Banaras Hindu University,Varanasi, 1994.
9) SIGNATURE OF THE CANDIDATE :
10) REMARKS OF THE GUIDE :
11) NAME AND DESIGNATION :
11.1) GUIDE : Dr. MAMATHA K.V
M.D (Ayu).
PROFESSOR ,
DEPT: OF PG STUDIES IN PRASOOTHI
AND STHREE ROGA,
S.D.M. COLLEGE OF AYURVEDA,
UDUPI-574118.
11.2) SIGNATURE :
11.3) CO- GUIDE : Dr.VIDYA BALLAL
M.S (Ayu)
LECTURER,
DEPT. OF P.G STUDIES IN PRASOOTHI
AND STHREE ROGA,
S.DM COLLEGE OF AYURVEDA, UDUPI-574118.
11.4) SIGNATURE :
11.5) HEAD OF THE
DEPARTMENT : Dr. V.N.K. USHA
M.D (Ayu).
PROFESSOR AND H.O.D,
DEPT OF PG STUDIES IN PRASOOTHI AND STHREE ROGA,
S.D.M. COLLEGE OF AYURVEDA,
UDUPI-574118.
11.6) SIGNATURE :
12) REMARKS OF THE
CHAIRMAN &THE PRINCIPAL :
12.1) SIGNATURE :
11