From,

DR. AMIT KUMAR SHARMA

Preliminary M.S. (Ayu) Scholar,

Dept of Shalya Tantra

N.K.J Ayurvedic Medical College & P.G. Research Centre,

Bidar-585403.

To,

THE REGISTRAR

Rajiv Gandhi University of Health Sciences, Bangalore,Karnataka

Through:

The Principal and head of department of P.G.studies in Shalya Tantra

N.K.J.A.M.C. & P.G.Reaserch cent. Bidar-585403.

Subject:Submission of Completed Proforma for registration of Synopsis for Dissertation.

Respected Sir,

I request you to kindly register the below mentioned subject against my name for the submission of dissertation to RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES BANGLORE, KARNATAKA for the partial fulfillment of M.S (Ayurveda) in Shalya Tantra.

Title of Dissertation

“ A COMPARATIVE STUDY OF PEELU TAILA VARTI & KASEESADI TAILA VARTI IN THE MANAGEMENT OF ABHYANTARA ARSHAS ”

Yours faithfully

Date : /04/2013

Place : BIDAR (Dr. Amit Kumar Sharma)
RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCE

KARNATAKA, BANGALORE.

ANNEXURE II

PROFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION

1.NAME OF THE CANDIDATE: DR.AMIT KUMAR SHARMA

AND ADDRESSS/O SRI RAJKISHOR SHARMA,

VILLEGE & POST

PATHERDEVA BAZAR, DIST. DEORIA .

UTTAR PRADESH . 274404

2. NAME OF INSTITUTION :N.K.J. AYURVEDIC MEDICAL

COLLEGE & P.G CENTER

MAN HALLI ROAD GUMPA BIDAR -585403.

KARNATAKA (INDIA)

3. COURSE OF STUDY :M.S. (AYU) SHALYA TANTRA.

AND SUBJECT

4. DATE OF ADMISSION :30/08/ 2012.

5. TITLE OF THE TOPIC :

“ A COMPARATIVE STUDY OF PEELU TAILA VARTI & KASEESADI TAILA VARTI IN THE MANAGEMENT OF ABHYANTARA ARSHAS ”

6. BRIEF RESUME OF THE INTENDED WORK;

INTRODUCTIONS

In Ayurvedic Samhitas, Arsha is considered as one of the Ashtamahagada1, notorious for its troublesome pain like enemy, which afflicting mankind for thousands of years since Vedic period. The disease arsha is a clinical condition in which metabolic & structural derangement take place. During the process of pathogenesis vitiated

Apanadi doshas get localized in mamsa, meda & twak of guda pradesha resulting in appearance of abnormal fleshy out growth in guda.

आरिवत्प्राणिनो मांसकीलका विशसन्ति यत् ।

अर्शासि तस्मादुच्यन्ते गुदमार्गनिरोधतः ॥2

Arsha is one of the commonest diseases which occurs in ano-rectal region and its incidence increases with advancing age, at least 40%- 50% of people over the age of 50 years have some degree of symptoms related to haemorrhoids3. The presentlifestyle is adding to theprevalence in the rateof arsha.

Arsha (haemorrhoids) is engorgementof thehaemorrhoidal venous plexus i.e. the dilated veins within the anal canal and in the sub epithelial region formed by radicals of the superior, middle and inferior rectal veins characterized by bleeding per rectum, constipation, pain, prolapse and discharge4.

Despite of many more modern treatments like Elastic band ligation, Sclerotherapy, Photocoagulation, Cryosurgery, Haemorrhoidectomy etc. Ayurveda is well known for the treatment of Arsha with application of taila’s & varti for its negligible rate of recurrence.

With this ideology the present study is a new approach to evaluate the efficacy ofPEELU TAILA VARTI in the management of Arsha .

6.1 NEED FOR THE STUDY:-

Inspite of technological advancement in the field of medicine and, conservative therapy still continues to be a solution for reversible ailment . Many people can not afford the recent treatment modalities which are very expensive and painful & needs longer hospitalization & a chances of recurrence. So there is a need to find out an alternative cost effective affordable and easily available management of Arsha ,without any complication, which avenues to be conservative.

Even though a lot of research has been done in piles , there is still a vast scope for new avenues to be explored.

पीलुतैलेन संलिप्ता वर्तिका गुदमध्यगा ।

धातयत्यर्शसां शीघ्रं सकलां वेदनां तथा ॥5 रसरत्न. समुच्चय ८६/१५

Taila prepared with paste of peelu applied in varti form daily after defecation which relieves pain and destroys the “PILEMASS”

Drug of peelu is easily available, low cost effective and safely administrable without any

Complication.

6.2 REVIEW OF LITERATURE

  1. Acharya Sushruta and Charaka described about nidana, samprapti, lakshana, chikitsa of arsha.
  2. In Rasaratna Sammuchaya Peelu taila is mentioned for the treatment of arsha.
  3. In Sharangadhara Samhita general method of preparation of taila is described.
  4. Astanaga hrudaya nidana sthana arsha nidana has been explained.

PREVIOUS WORKS

  1. Sharma K.P.- Arsha ki Ksharsutra chikitsa karma mein lord vidhi ki upayogita.1992- jaipur.
  2. Gautam SurendraKumar – Arsha chikitsa mein snuhi ksheera nirmita ksharasutra evam udumbasa ksheer nirmita ksharasutra ka tulanatmaka adhyayana 2004 – jaipur.
  3. Rao Vankata Sivakoteshwar – Effect of Manibhadra Yoga & Kasisadi taila in the manament of Arsha 1998- Hyderabad.
  4. Baraskar K.G.- Arsha main Ksharsutra Patana- 1978- Jamanagar.

6.3 AIMS ANDOBJECTIVES:

  • To evaluate the efficacy of Peelu taila varti in comparison with Kaseesadi taila varti in the management of Abhyantara Arsha.

7. MATERIAL AND MATHODS.

7.1) Source of Data:-

  • All Cases of Arsha will be registered from Shalya-Tantra OPD of Sri Siddharoodha Charitable Hospital,ateaching hospital of N.K.J.Ayurvedic Medical College & PG centre, Bidar.
  • Samhita & Modern books of Surgery.

NationalInternational Medical & Surgical Journals, Magazines, digital library and web sites.

  • The drugs will be collected from near by forest with the supervision of Dravya-guna specialist and prepared in the pharmacy attached to the college under the guidance of Bhaishajya kalpana specialist

Materials:

Peelu taila, Sterile gloves, Sterile Pads, Dressing gauzes, Disposable syringe.

7.2. Method of Collection of Data:

Being a clinical study 30 patients will be selected by simple randomized sampling procedure. All the patients will be screened out by inclusive and exclusive criteria after proper examination of the patient then register the patients for clinical trial.

Group –1
Trial Group / Peelu Taila varti / A 3inch Gauge soaked in Peelu Taila and kept in the anal canal after defecation daily once a day.
Group – 2
Contol Group / Kaseesadi Taila varti / A 3inch Gauge soaked in the Kaseesadi Taila and kept in the anal canal after defecation daily once a day.

Duration - Treatment will be done once in a day for 15 days& assessment will be done on every 5th day

Follow up- 2follow ups are taken with an interval of 15 days

SELECTION CRITERIA

A) Inclusion Criteria:

  1. Patients with 1st &2nd degree pile mass.
  2. Irrespective ofsex.
  3. Patients age group between 20-50 Years

B) Exclusion Criteria:

  1. Patients suffering from External Hemorrhoids.
  2. Patients suffering from 1st & 2nd digree Internal Hemorrhoids, associated with other proctological diseases (Fistula in ano, Fissure in ano, Rectal prolapse, Rectal polyps, and malignant growth) will be excluded.
  3. The patients suffering from other severe systemic disorders like DM, HIV etc. will be excluded.

Assessment Criteria:

Assessment will be done on subjective & objective criteria before & after the treatment.

Subjective Criteria:

Pain in anal region

Bleeding per rectum

Objective Criteria:

Size of Pile mass

Number of Pile mass.

Statistical Analysis:

The progress will be noted in specially prepared research case sheet as per the assessment parameters. All the collected data will be evaluated scientifically and statistically as follows.

BTG1 Vs ATG1 / Will be assessed / ATG1 Vs ATG2 / will be assessed & evaluated by “t” test
BTG2 Vs ATG2

GRADING OF ASSESSMENT CRITERIA

SUBJECTIVE CRITERIA

1)Pain: Assessed by MRC (Medical Research Council ) scale.

G0- Absence of pain.

G1–Mild pain-that can easily be ignored

G2- Moderate Pain- that can not be ignored, interferes with function, and needs treatment from time to time

G3- Severe pain – That is demanding constant attention

2)Bleeding per rectum :

G0– No bleeding

G1- Found on toilet paper

G2- dripping

G3- Sluice.

OBJECTIVE CRITERIA

1)Size of pile mass

G0- Almost none

G1- size of the tip of little finger(approx 2cm3)

G2- size of the tip of index finger(approx 3cm3)

G3- size of the tip of thumb (approx 4cm3)

2)Number of pile mass

G0- No pile mass

G1- One pile mass

G2- Two pile mass

G3- Three pile mass.

7.3) INVESTIGATIONS:

1. Hb, TLC, DLC, ESR, RBS.

2. HIV. HbsAg

3. Any other relevant investigation as per necessity.

7.4) Has Ethical Clearance Been Obtainad From Your Institution - YES

8) List of References:

(1)Kaviraj Dr.Ambika Dutta Shastry-Susrutha Samhitha-Volume I-Nidana Sthana-

2/3,2007 Edition, Chaukamba Sanskrit Sansthan Publishers,Varanasi, Page No.236

(2)Pof.Murthy Srikanth,Astanga Hridaya,2nd volume ,Choukambha Krishnadas Academy

,Varanasi,Nidana Sthana 7/166Edited by: John Goligher Edition: 5th vol: 1 2001

(3)John Goligher: Surgery of the anus, rectum and colon. “Haemorrhoids or Piles” chapter

(4) S Das. A Concise Text Book of Surgery. 4th ed. Calcutta: S Das; 2006. Pp. 1344.

(5)Indra Dev Tripath, Rasratna Samuchchaya, 12th edition by Ch 15th .

(6) Dr.Ram Karan and Bagawan Dash-Charaka Samhitha-Volume III-Chikitsa Sthana- 14/5,2007 Edition,Chaukamba Sanskrit Series Office,Varanasi,Page No.575.

9.) SIGNATURE OF THE CANDIDATE :

DR. AMIT KUMAR SHARMA

10.) REMARKS OF THE GUIDE :

11.) NAME & DESIGNATION OF :

11.1 GUIDE : DR.B.N.MURTHYMD(AYU)

PROFESSOR & HOD

PG DEPT. OF SHALYA TANTRA.

11.2 SIGNATURE :

11.3 CO-GUIDE : DR. VIJAYKUMAR M.S(AYU)

ASSISTANT PROFESSOR

P.G. DEPT. OF SHALYA TANTRA

11.4 SIGNATURE :

11.5 HEAD OF : DR.B.N.MURTHY M.D.(AYU)

DEPARTMENT PROF. & H.O.D.

P.G. DEPT. OF SHALYA TANTRA.

11.6 SIGNATURE :

12)12.1 REMARKS OF THE CHAIRMAN:

& PRINCIPAL

12.2 SIGNATURE:

1