From,

Dr. AMBILI ARAVIND,

1st Year Postgraduate Scholar,

Department of Postgraduate Studies in Kaya Chikitsa,

Ayurvedic Medical College & PG studies,

Davangere – 577 566.

To,

THE REGISTRAR,

RajivGandhiUniversity of Health Sciences,

Bangalore.

Through:

The Principal and Head of the Department of Kaya Chikitsa,

AyurvedicMedicalCollege, Davangere – 577 566.

Respected Sir,

Subject: Submission of Dissertation synopsis of registration.

As desired by Rajiv Gandhi University of Health Sciences for the postgraduate studies I am forwarding herewith the synopsis dissertation topic in duplicates in respect of M.D. (Ayurveda) Kaya Chikitsa specialty for the academic year 2008 – 2009.

Title of the topic

COMPARATIVE CLINICAL EVALUATION OF THE EFFECT OF SHILAJATU WITH SHALASARADI GANA KASHAYA AND KHADIRA KASHAYA IN THE MANAGEMENT OF MADHUMEHA (DIABETES MELLITUS 2)

This for your kind information, kindly acknowledge the same.

Thanking you,

Your’s faithfully

Place: Davangere

Date: (Dr. AMBILIARAVIND)

RAJIVGANDHIUNIVERSITY FO HEALTH SCIENCES

BANGALORE, KARNATAKA

ANNEXURE – II

PROFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION

  1. Name of the candidate DR. AMBILIARAVIND,

1STYEARPGSCHOLAR,

DEPARTMENT OF

POSTGRADUATE STUDIES

IN KAYA CHIKITSA

DEPARTMENT,

AYURVEDAMEDICALCOLLEGE

& PG CENTRE,

DAVANGERE

DR. AMBILI ARAVIND

D/O. ARAVIND,

“AMBILI”, P.O. CHOVVA,

KANNUR,

KERALA – 670 006.

  1. Name of the Institute AYURVEDIC MEDICAL

COLLEGE & PG CENTRE, DAVANGERE.

  1. Course of the Study and SubjectM.D(Ayu) KAYA CHIKITSA
  2. Date of Admission to the Course22.04.2008
  3. Title of the topic COMPARATIVE CLINICAL

EVALUATION OF EFFECT OF SHILAJATHU WITH

SHALASARADI GANA KASHAYA

AND KHADIRA KASHAYA IN

THE MANAGEMENT OF

MADHUMEHA (DIABETES

MELLITUS 2)

  1. BRIEF RESUME OF INTENDED WORK :

6.1Need for the Study

Madhumeha is one of the Ashta mahagada1. The prevalence of type- 2 diabetes is increasing all over the world particularly in the developing countries. It has emerged as a major health problem in our country. The WHO estimated that there were 31.7 million people with diabetes in India in 2000 and that this number is likely to be 71.4 million in 2030. India has the distinction of having largest number of diabetics in the world. Studies suggest that Indians as an ethnic group had a genetic propensity to develop diabetes which was precipitated by life style2. The metabolic dysregulations associated with diabetes mellitus causes secondary pathophysiologic changes in multiple organ system. It is the leading cause for end stage renal disease, cardio vascular disorder, lower extremity amputations and blindness. Diabetes mellitus will be a leading cause of morbidity and mortality for the foreseeable future with an increasing incidence in our country3.

Shilajathu has been considered as sarva roga hara4. Sushruta and vagbhata has mentioned it as madhumeha hara. Shilajathu is rasayana5 and helps in preventing complication of DM-2. So the study is aimed at evaluating the madhumeha hara property of Shalasaradi gana bhavita shilajathu with shalasaradi gana Kashaya as anupana6 and Khadira Kashaya bhavita shilajathu and with Khadira Kashaya as anupana7, where shalasaradi gana and Khadira are said to have anti diabetic action. So it’s also an attempt to evaluate the madhumeha hara property of shalasaradi gana and Khadira.

6.2REVIEW OF LITERATURE

Madhumeha is reviewed in

1.Nidana, samprapti, poorvaroopa, roopa of madhumeha has been mentioned in Charaka samhita nidana sthana chapter No. 4 sloka No. 37, 44 and in sutra sthana 17/808.

2.Nidana, samprapti, poorvarupa, roopa of madhumeha has been mentioned in Sushruta nidana sthana 6th chapter 3, 4, 5, 6, of 14th sloka, madhumeha chikitsa has been explained in chikitsa sthana 13th chapter.9

3.Nidana, samprapti, roopa of madhumeha has been mentioned in Ashtanga Hrudaya Nidana sthana 10th chapter sloka No. 2, 3, 4, 5, 7, chikitsa sthana 12th chapter prayoga of shilajathu with Khadira in madhumeha with madhumeha chikitsa10.

Shilajathu is reviewed in

4.Shilajathu with guna karma and its prayoga with shalasaradi gana are reviewed in madhumeha chikitsa of Sushruta chikitsa sthana sloka No. 10, chapter No. 1311.

5.Rasayana effect of Shilajathu & its shodana-bhavana is reviewed in charaka chikitsa 3 chapter12.

6.Shilajathu guna karma & shodana is reviewed in Rasa Ratna Samuchaya chapter No. 213.

Description of drugs

7.Description of shalasaradi gana drugs and Khadira-Dravya guna vignana by P V Sharma14.

Diabetes is reviewed in

8.Signs and symptoms of diabetes mellitus-2 are reviewed in Harrison’s principles of internal medicine volume – II chapter No. 33815.

9.Diabetology viewed in API text book of medicine16 .

10.Pathology of diabetes mellitus in Text book of pathology by Harsh Mohan17.

PREVIOUS WORK DONE

BHU – 2002 – Dr. Adhikari K.S. – A Clinical study of Ojomehahara drugs, shilajathu and vijayasara with special reference to dravya prabhava.

BHU – 1995 – Dr. Chaturvedi S.K. – Pharmaceutical standardization of different samples of shilajathu with special reference to diabetes.

BI – 2000 – Dr. Asangihal Basappa B - Evaluation of hypoglycemic effect of shilajathu in comparison Arogyavardhini vati on madhumeha.

6.3OBJECTIVES OF THE STUDY

1.To evaluate the effect of Shalasaradi gana bhavita Shilajathu with shalasaradi gana as anupana in kwatha form.

2.To evaluate the effect of Khadira Kashaya bhavita shilajathu with Khadira Kashaya anupana in kwatha form.

3.To compare & evaluate the results in both the groups.

7.0 MATERIALS AND METHODS

7.1.Source of the data :

The patients of either gender diagnosed as being afflicted by madhumeha will be taken for the study from OPD / IPD and special camps conducted in Ashwini Ayurveda medical college hospital, Davangere.

7.2.Method of collection of data :

The study will be carried out on the patients attending to ayurvedic medical college hospital, Davangere, will be selected incidentally and will be registered for the study after examining in detail.

Inclusion Criteria:

1.Patients diagnosed as Madhumeha rogi.

2.Patients falling in the age Group 35- 60 years.

3.Patients with FBS value > 110 mg / dl and < 250mg/ dl

Exclusion Criteria:

1.Patients suffering from other systemic disorder.

2.Patients with complications of this disease will be excluded.

3.Patients unfit for virechana will be excluded.

STUDY DESIGN

  • Total number of cases selected for study with is 40. The patients will be divided into 2 groups, i.e. Group A and group B, each consisting of 20 patients.

GROUP A / GROUP B
  • Ama pachana with Agni kumara rasa.
/
  • Ama pachana with Agni kumara rasa.18

  • Snehapana with vatashani taila in arohana karma uptill alpa snigdha laxanas.
/
  • Snehapana with vatashani taila19 in arohana karma uptill alpa snigdha laxanas.

  • Virechana with trivrith lehya. Samsarjana krama followed.
/
  • Virechana with trivrith lehya20. Samsarjana krama followed.

  • Followed by intake of shalasaradi gana Kashaya bhavita shilajathu with shalasaradi gana kashaya as anupana. .
/
  • Followed by intake of Khadira Kashaya bhavita shilajathu with Khadira Kashaya as anupana.

POSOLOGY:

  • Agni kumara rasa for Ama pachana 1 TDS with ushna jala as anupana until nirama laxanas are attained.
  • Vatashani taila for snehapana in arohana karma according to agnibala of the patient till alpa snigdha laxanas.
  • Trivrith lehya for Virechana 30gms approx.
  • Shilajathu 1gm BD, Shalasaradi Kashaya 20ml BD and Khadira Kashaya 20 ml BD on empty stomach.

DURATION OF THE STUDY

Total period of study will be for 3months. Follow ups will be once in a month during the course of treatment.

PARAMETERS OF STUDY

SUBJECTIVE PARAMETERS

  • Reduction in the symptoms of madhumeha.

OBJECTIVE PARAMETER

  • Reduction in blood sugar level

7.3 DOES THE STUDY REQUIRE ANY INVESTIGATION OR INTERVENTION TO BE CONDUCTED ON PATIENTS OR OTHER HUMAN OR ANIMALS? IF SO PLEASE DESCRIBE BRIEFLY

YES
The study will be conducted on madhumeha rogi only.

STATISTICAL ANALYSIS

Results will be analysed by using Standard Statistical test (paired test)

INVESTIGATION

  1. FBS,
  2. PPBS
  3. FUS
  4. Other investigation if necessary.

7.4 HAS THE ETHICAL CLEARANCE BEEN OBTAINED FROM YOUR INSTITUTION IN CASE OF 7.3?

Yes, Certificate enclosed.

8. LIST OF REFERENCE

  1. Sushruta Samhita of Maharshi Sushruta sutra sthana 33rd/4, pg no: 126, Edited with Ayurveda tatva sandeepika by Kaviraj Ambika Dutt Shastri.
  2. APItextbookofmedicine volume 2 Chapter no.18th, pg.no: 1042, edited by Sidharth N. Shah.
  3. Harrison’sprinciples ofinternalmedicine volume 2, Chapter No. 338, Pg. No. 2275 by T.R. Harrison
  4. Sushruta Samhita of maharshi Sushruta chikitsa sthana 13/5, pg no: 65, Edited with Ayurveda tatva sandeepika by Kaviraj Ambika Dutt Shastri.
  5. CharakaSamhita chikitsa sthana chapter no: 3/49, pg.no:32, redacted by Charaka and Drdabala, edited with Vydya Manorama hindi commentary by Acharya Vidyadhar Shukla and Prof. Ravidutt Tripati.
  6. Sushruta Samhita of Maharshi Sushruta chikitsa sthana 13/10-11, pg no: 65, Edited with Ayurveda tatva sandeepika by Kaviraj Ambika Dutt Shastri.
  7. AshtangaHrudayam of Srimadh Vaghbata chikitsa sthana 12th/34, pg.no: 719 by Brahmananda Tripati with Nirmala Hindi Commentary.
  8. CharakaSamhita of Agnivesha nidana sthana chapter no: 4/36, 37, 44 pg.no: 507-508, sutra sthana 17/80-81 pg.no:267, redacted by Charaka and Drdabala, edited with Vydya Manorama hindi commentary by Acharya Vidyadhar Shukla and Prof. Ravidutt Tripati.
  9. Sushruta Samhita of Maharshi Sushruta nidana sthana 6/3, 4, 5, 6, 14; pg no: 251-254, Edited with Ayurveda tatva sandeepika by Kaviraj Ambika Dutt Shastri.
  1. AshtangaHrudayam of Srimadh Vaghbata nidana sthana 10th/2, 3, 4, 5, 7. pg.no: 494 by Brahmananda Tripati with Nirmala Hindi Commentary.
  2. Sushruta Samhita of Maharshi Sushruta chikitsa sthana 13/4, 5 ,6 ,7, 8; pg no: 64, Edited with Ayurveda tatva sandeepika by Kaviraj Ambika Dutt Shastri.
  3. CharakaSamhita of Agnivesha chikitsa sthana chapter no: 3/48, 49; pg.no: 32, redacted by Charaka and Drdabala, edited with Vydya Manorama hindi commentary by Acharya Vidyadhar Shukla and Prof. Ravidutt Tripati.
  4. RasarathnaSamuchayaofVagbatacharya chapterno: 2/110-111 edited Hindi commentary by Ambika dutt shastri.
  5. Dravyagunavignana by P V Sharma.
  6. Harrison’sprinciples ofinternalmedicine volume 2, Chapter No. 338, Pg. No. 2275 by T.R. Harrison
  7. APItextbookofmedicine volume 2 Chapter no.18th, pg.no: 1042-1081, edited by Sidharth N. Shah.
  8. Textbookofpathology, chapter no: 25, 842-854; by Harsh mohan.
  9. Sahasrayogam by Abhinava Vaghbata, gulika yoga pg.no: 123.
  10. Sahasrayogam by Abhinava Vaghbata, taila yoga pg.no: 308.
  11. Sahasrayogam by Abhinava Vaghbata, lehya yoga pg.no: 221.

BIBLIOGRAPHY

SL.NO / TITLE OF THE BOOK / AUTHOR / PUBLISHER / EDITION & YEAR
1. / API Text book of medicine / Siddharth
N Shah / Association of Physicians of India / 2008
8th Edition
2. / Astanga Hrudaya by Srimad Vaghbata / Brahmanand Tripati / Chaukambha Sanskrith Pratishthan / 2007
3. / Charaka Samhita Of Agnivesha
Vol 1& 2 / Acharya Vidyadhar Shukla & Prof. Ravi Dutt Tripati / Chaukambha Sanskrith Pratishthan / 2002 & 2004
4. / Dravya Guna Vignana / P V Sharma / ChaukambhaBharathiAcademy / 2001
5. / Harrison’s Principle of Internal Medicine / T R Harrison / Mc Graw Hill / 2008
17th Edition
6. / Rasa Ratna Samuchaya of Vaghbata / Ambika Dutt Shastri / Chaukambha Publication / 2001
9th Edition
7. / Sahasrayogam / Abhinava Vaghbata / Vidhyarambha
Publication / 2006
26th edition
8. / Sushruta Samhita of Maharshi Sushruta / Kaviraj Ambika Dutt Shastri / Chaukambha Sanskrith Sansthan / 2007
9. / Text book of Pathology / Harsh Mohan / Jaypee Publication / 2006