RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES
KARNATAKA, BANGALORE
PROFORMA FOR REGISTRATION OF SUBJECT (PANCHAKARAMA) FOR DISSERTATION MD (AYURVEDA)
“EFFECT OF PADABHYANGA IN MADHUMEHAJA
PADA DAHA W.S.R TO DIABETIC SENSORY
NEUROPATHY”
By
DR. MAHALAKSHMI K.M, BAMS
1st Year P.G. Scholar
Department of P.G Studies in Panchakarma
J.S.S Ayurveda Medical College & Hospital
Mysore, Karnataka
GUIDE
DR. N.V KRISHNAMURTHY, MD (Ay)
Professor,
J.S.S Ayurveda Medical College & Hospital
Mysore, Karnataka
CO- GUIDE
DR. B. S KESHAVA
M.D (Internal Medicine), DM (Neurology)
Associate Professor of Neurology
J.S.S Medical College & Hospital
Mysore, Karnataka
2010-2011
J.S.S Ayurveda Medical College & Hospital, Mysore, Karnataka
From,
Dr. Mahalakshmi K.M
1st Year P.G. Scholar
Department Of P.G Studies in Panchakarma
J.S.S Ayurveda Medical College & Hospital
Mysore, Karnataka
To,
The Registrar
Rajiv Gandhi University of Health Sciences
Bangalore, Karnataka
Through:
The Principal and Head of Department of Panchakarma
J.S.S Ayurveda Medical College & Hospital
Mysore, Karnataka
Subject: Submission of Completed Proforma for Registration of Synopsis of
Dissertation in MD (Ay)
Respected Sir,
I request you to kindly register the below mentioned subject against my name for the submission of the dissertation to the Rajiv Gandhi University of Health Sciences, Bangalore, for partial fulfillment of MD (Ayurveda) in Panchakarma.
TITLE OF DISSERTATION: “EFFECT OF PADABHYANGA IN
MADHUMEHAJA PADA DAHA W.S.R. TO DIABETIC SENSORY NEUROPATHY”
Herewith I am enclosing completed Proforma for Registration of subject of dissertation.
Thanking you
Date: Yours faithfully,
Place :Mysore
(DR.MAHALAKSHMI)
RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES
KARNATAKA, BANGALORE
COMPLETED PROFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION IN MD(AYURVEDA) PANCHAKARAMA
1. NAME OF THE CANDIDATE : Dr. Mahalakshmi K.M,(B.A.M.S)
AND ADDRESS 1st MD (Ay) Scholar
Dept: Of P.G. Studies in
Panchakarma
JSS Ayurveda Medical
College & Hospital
Mysore, Karnataka
PERMANENT ADDRESS : Dr. Mahalakshmi K.M
D/o Marappa K.M
# 313, 1st Stage, Anandamarga
Siddartha Nagar
Mysore, Karnataka
2. NAME OF THE INSTITUTION : JSS Ayurveda Medical
College & Hospital
Mysore, Karnataka
3. COURSE OF STUDY & : M.D (AYURVEDA) PANCHAKARMA
SUBJECT
4. DATE OF ADMISSION TO :15/11/2010
THE COURSE
5. TITLE OF THE TOPIC : “EFFECT OF PADABHYANGA IN
MADHUMEHAJA PADA DAHA
W.S.R TO DIABETIC SENSORY
NEUROPATHY”
6. BRIEF RESUME OF THE INTENDED WORK:
6.1 Need for The Study
Diabetes mellitus is characterized by a syndrome of chronic Hyperglycemia. It affects more than 120 million people worldwide & it is estimated that it will affect 370 million by the year 2030. Its late complications results in reduced life expectancy & major health cost1.
Not all Diabetics are recognized at the time of onset. The development of foot ulcer, renal impairment, sensory loss, and retinopathy may be the presenting findings in a patient who is not known to have Diabetes. 30% of Diabetes patients are affected with Diabetic neuropathy2.
Diabetic foot is responsible for 50 % of hospital admission & may even end in amputation. It can be prevented by effective patient education & medical supervision2.
In Ayurveda Samhitha, Karapada daha is explained as samanya poorvaroopa of Prameha3,4,5. Daha is also mentioned as Samanya Upadrava of Prameha. In Bhaishajya Ratnavali Pramehamihira Taila Abhyanga is indicated in all the 20 types of Prameha6.
The modern medicine has some of the drugs which intend to give some temporary relief, but such medicine has adverse effects like ataxia, dizziness, nausea and vomiting.
So this work has objective to give a better relief treatment and with no side effect.Thus
the intended study is to evaluate the effect of Padabhyanga in Madhumehaja Pada daha w.s.r. to Diabetic Sensory Neuropathy.
6.2 Review of Literature
The review of literature includes screening of classical literature, contemporary Ayurvedic literature modern literature, journals and internet sources to collect sufficient data for the study. Few of the text books considered are as follows.
Davidson Principles & Practice of Medicine gives a detail description of Diabetes Mellitus
Kumar & Clack’s Clinical Medicine has explained Diabetic Neuropathy & gives a list of medicine2
In Sushrutha Samhitha, Nidhana of Prameha , Hastapadatala daha is
mentioned as one of the samanya poorvaroopa3
In Charaka Samhitha, the Sarva Prameha samanya poorvaroopa includes daha
In Astanga Hrudaya, in the context of Pramehanidhana, Panipada daha is stated as one of
samanya poorvaroopa of Prameha5
In Bhaishajya Ratnavali in the context of Prameha Chikithsa Pramehamihira
Taila is indicated for all 20 types of Prameha6
Pharmacology and Pharmacotherapeutics by R.S. Satoskar has described the effect &
adverse effects of drugs used in Diabetic Neuropathy7
In Sharangadhara Samhitha in poorvakhanda the Snehapaka vidhi is described8
In Madhava Nidana in samanya poorva roopa of Prameha panipada daha is told9
In Bhavaprakasha Samhitha in Pramepidakhadhikara padadaha is mentioned as a
Samanya poorvaroopa of Prameha10
Hand book of Neurologic Rating Scales by Robert M.Herndon gives scales for pain11
Scales and Scores in Neurology by Herald Masur give scales for pain12
In Ayurveda Panchakarma Vignana by Kasthure details of Padhabhyanga is given13
In Charaka Sutrasthana in the context of Matrashithiya Adhyaya properties of Abhyanga & Padabhyanga are given14
Previous Works Done
1.Effect of Dashamoola on Diabetic Neuropathy, Dvivedi K.N, Dept of
Dravyaguna, B.H.U, 1986
2. A study on the management of Sthoola Madhumeha w.s.r to Diabetes
Mellitus-a comparative study, Roopa, GAMC Mysore, RGUHS, 2002
3.A comparative study on the role of Basthi therapy and pramehaghna
drugs in the management of Madhumeha, Pawar Anand, Jamnagar, 2003
4.Clinical study on the role of virechna karma in the management of
Madhumeha,W.S.R.to Diabetic Millitus,Jamnagar,2005
6.3.Objective Of Study
1.To study in detail about Padabhyanga in Madhumehaja padadaha w.s.r to Diabetic Sensory Neuropathy.
2.To study in detail about Madhumehaja padadaha w.s.r to Diabetic Sensory Neuropathy
7. MATERIAL AND METHODS
7.1 Source
a. Literary source- Literary source of present study will be collected from classical texts of Ayurveda and recent reputed Journals and Modern text books.
b. Drug Source: Raw drugs will be collected from the market after proper identification and Tila Taila will be purchased from the market. Taila is prepared as per classics in JSS Ayurveda Pharmacy, Mysore.
c. Sample source- Patients suffering from Madhumeha (Diabetes Mellitus) with Padadaha will be selected from JSS Ayurveda Medical College and Hospital, Mysore, camps and other referrals.
7.2 Method of Collection of Data
a) Sample size-Minimum of 30 patients diagnosed with Diabetes Mellitus fulfilling the inclusion criteria will be selected for single blind study.
b) Study design: It is a single blind study.
c) Selection Criteria: The cases are selected as per signs & symptoms mentioned in classics.
d) Diagnostic Criteria:
1. Diabetic Mellitus presenting with burning sensation of the feet.
2. Laboratory Investigations.
e). Inclusion criteria:
1. Patients with either sex between the age group of 30-70 yrs suffering from
Diabetic Mellitus & pada daha.
2. Patients fit to undergo Padabhyanga.
3. Only burning sensation feature of Sensory Neuropathy are taken
f. Exclusion Criteria:
1. Patients with any other systemic disorders which may interfere with
the course of treatment will be excluded.
2. Trauma, infectious wounds, gangrene, non-healing ulcers of foot.
3. Mono neuropathies.
4. Neuropathies Secondary to causes other than Diabetes.
g. Assessment of results:
Assessment of the condition will be done based on the obtained proforma adopting standard method of scoring of subjective parameter which will be analyzed statistically.
Subjective parameters: Short-form McGill Pain Questionnaire
Study duration/ follow up
Totally the course of treatment is 14 days and follow up will be for 60 days.
h. Observation criteria
1. Initially on the 1st day before treatment.
2. On the 14th day after treatment.
3. On 21st day for late assessment.
4. On 30th day for late assessment.
5. On 60th day for late assessment.
i. Statistical test: Obtained data will be analyzed statistically with relevant statistical test (ANOVA).
7.3 Does the study require any investigation or intervention to be conducted on patients or other Humans or animals? If so please describe briefly?
This study will be conducted clinically. No animal experiment will be carried out.
Laboratory Investigation:
Blood - Fasting Blood sugar
Post Prandial Blood sugar
Glycosylated Haemoglobin (HbA1C)
Urine - Fasting urine sugar
Post Prandial urine sugar
Interventions:
Sample size- 30 patients
Purva karma – Cleaning of the feet with Sukhoshna Jala
Pradhana karma – Abhyanga of pada with Pramehamihira Taila for 48 Mins
Paschat karma – Washing the feet with Sukhoshna Jala
The post treatment follow up will be taken after 14 days for all patients. Clinical improvements will be done and grading will be given. The data collected before & after the treatment will be compared and analyzed.
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. Davidson Principles & Practice of Medicine 21ST Edition by Brian R Walker Sterart H
Ratston- Diabetic Neuropathy page no 831, 832, 833, 834, Diabetis Mellitus Chapter 21st Page 795
2. Kumar & Clack’s Clinical Medicine 7th edition, edited by Parveen Kumar Michael Clark- Diabetic Neuropathy & list of medicines are given.in page 1055.
3. Sushrutha Samhitha with Nibanda Sangraha Commentary of Sri Dalhanacharya & the Nyaya Chandrika panjika of Sri Gayadasa acharya on Nidhana Sthana Edited by vaidhya yadhavji Trikamji Acharya & Narayana Ram Acharya Published by Chaukhamba Surabharati Prakashan, Varanasi, chapter 6 shloka number 5 page 290.
4.Agnivesha Charaka Samhitha,Revised by Charaka and Drudabala with Ayurveda Dipika Commentary of Cakrapanidatta and with Vidyotini hindi commentary by Pt.Kasinatha sastri Edited by Dr.Gangasahaya Pandeya,Chukambha Sanskrit Sansthan,Prameha Chikitsa chapter 6thpage shloka no 13& 14, page no 190.
5. Astanga Hrudaya of Vagbhata with commentaries of Sarvang Sundara of Arunadatta & AyurvedaRasayana of Hemadri Edited by Bhaisagacharya Hari Shastri Paradakara Vaidhya,Prameha Nidhana Chapter no 10 shloka no 38 39 page no 505.
6.Bhaishajya Ratnavalli Vidhyothini Hindi Vyakhya Vimana Parishista Samhitha, Vyakhyakhara Kaviraja Sri Ambikadatta Shastri Ayurvedacharya Sampadaka Sri Rajeshwaradatta Shastri Ayurvdacharya published by Chaukambha Samskrutha Samsthana Varanasi, 10th Edition, Prameha Chikitasa page 421, Shloka no 228-236.
7.Pharmacology and Pharmacotherapeutics 21st Edition By R.S. Satoshkar &
S.D Bhandakar, Nirmala Rege-.Drugs used in Neuropathy Page 174, 122, 125, 131, 381.
8.Sharagadava Samhitha By Pandith Sharangadhara Acharya containing Anjananidana Of Maharshi Agnivesha Anointed With Deepika Hindi Commentary By Dr.Bramananda Tripati-.Snehapaka Vidhi Page 218, 219, 220, Sloka no 1,3,6,7,8.
9. Madhava Nidhanam of Sri Madhavakara with Madhukosha Sanskrit commentary by Acharya Vijayarakshitha & Srikanta Datta,edited with Vimala Madhudhara Hindhi Commentary by Dr.Brahmananda Tripathi Volume 2 Chapter no 33 Pramehapidaka nidhana Shloka no 5.
10.Bhava Prakash Of Sri Bhavamishra Edited With The Vidyothini Hindi Commentary By Pandith Sri Bramha Shankara Mishra Part 2,11th Edition 2009 Prameha Poorvaroopa Page 386,Shioka no 5.
11.Handbook of Neurologic Rating scales by Robert M Herndon Chapter 10- Page no 285.
12.Scales & Scores in Neurology by Harald Pain Chapter -91.
13. Ayurveda Panchakarma Vignana by Vaidhya Haridasa SridharaKasthure,Prakasha Sri Vaidhyanatha Ayurveda Bhavana 12th edition 2009 Sneha Adhyaya- Padabhyanga Page87.
14.Agnivesha,Charaka Samhitha,Revised by Charaka & Drudabala with Hindi Commentary by Pt.Kashinatha Sastri & Dr.Gorakha Natha Chaturvedi,Published by Chaukambha Bharathi Academy,Vol 2,Reprinted 1998,Chap 5 Matrashithiya adhyaya page 129 Shloka 88,89,90,91.
9 Signature of the candidate:
10.Remarks of Guide
11. Names and Designation
11.1 Guide : Dr. N.V. Krishnamurthy, MD(AY)
Professor
Dept: Of P.G. Studies In
Panchakarma
JSS Ayurveda Medical
College & Hospital
Mysore, Karnataka
11.2 Signature & Seal :
11.3 Co-Guide : Dr. B.S Keshava
MD (Internal Medicine)
DM (Neurology)
Associate Professor Of
Neurology
J.S.S. Medical College & Hospital
Mysore, Karnataka
11.4 Signature & Seal :
11.5 H.O.D : Dr. Ramakrishna Sharma
Professor & H.O.D
Dept of P.G.Studies in
Panchakarma
JSS Ayurveda Medical College & Hospital
Mysore, Karnataka
11.6 Signature & Seal :
12. Remarks of Principal :
12.1 Signature & Seal :