From,

Dr. Bindu.P.Patil

PG Scholar,

Department of PG Studies in Panchakarma,

JSS Ayurveda Medical College & Hospital,

Mysore.

To,

THE REGISTRAR,

Rajiv Gandhi University of Health Sciences,

Karnataka, Bangalore.

Through,

THE PRINCIPAL AND HEAD OF THE DEPARTMENT OF POST GRADUATE STUDIES IN PANCHAKARMA,

JSS Ayurveda Medical College & Hospital, Mysore.

Respected Sir,

SUB: “Submission of completed proforma for Registration of the subject for dissertation”.

I request you to kindly register the below mentioned subject towards my name for the submission of dissertation to the Rajiv Gandhi University of Health Sciences, Karnataka, Bangalore for the partial fulfilment of M.D (Ayurveda) in Panchakarma.

Title of dissertation

“EFFECT OF MASHA SAINDHAVA TAILA NASYA IN THE MANAGEMENT OF APABAHUKA W.S.R TO FROZEN SHOULDER”

Herewith, I am enclosing the completed proforma for Registration of the subject for dissertation.

Thanking you,

Yours Faithfully,

Date:28.04.2011

Place: Mysore. (Dr. Bindu.P.Patil)

RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES

KARNATAKA,BANGALORE.

ANNEXURE II

PROFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATION

1. Name of the candidate : DR.BINDU.P.PATIL , B.A.M.S

Address I P.G.SCHOLAR,

DEPARTMENT OF P.G.STUDIES IN

PANCHAKARMA,

J.S.S.AYURVEDA MEDICAL COLLEGE,

MYSORE.

Residential address : #298,13thCROSS,B’BLOCK,J.P.NAGAR,

MYSORE-570008.

2. Name of the institution : J.S.S.Ayurveda medical college,

Mysore.

3. Course of the study and subject : AYURVEDA VACHASPATHI

M.D.(Ay) in Panchakarma.

4. Date of admission to the course : 18thNovember,2010

5. Title of the topic :

“EFFECT OF MASHA SAINDHAVA TAILA NASYA IN THE MANAGEMENT

OF APABAHUKA W.S.R.TO FROZEN SHOULDER”.

  1. BRIEF RESUME OF THE INTENDED WORK

1.1.Need for the study

Apabahuka is considered as vatavyadhi with association of kapha that affects the amsa sandhi.Patients present with the symptoms Bahupraspandithahara i.e,restricted movement of shoulder joint,due to stiffness and Shoola i.e,shoulder pain (3). With these, it can be effectively paralleled with the condition, Frozen Shoulder.

A number of peri-articular disorders have become increasingly common over the past two or three decades. (1).Self reported prevalence of shoulder pain is estimated to be between 16% to 26%. Estimated prevalence is 11% to 30% in diabetic patients and 2% to 10% in non-diabetics.5% of consecutive new patients attend a shoulder clinic for the complaint of gleno-humeral disorders like frozen shoulder. It is more common in women between the ages of 40 to 70 years. About 10% of people with this condition will get frozen shoulder on the other side within 5 years (2).According to the statisticaldata ,cases of diabetes mellitus are moreprevalent in India, socases of Frozen Shoulder will also be more.

Nasya is said to be the first line of treatment in the management of Apabahuka (3). There is direct reference of nasya with Masha Saindhava Taila in apabahuka, which is mentioned in Vatvyadhi adhikara in our classics4&5.

As there is no effective permanent cure in the contemporary science, so an attempt is made to treat this disease with Nasyakarma and to assess the effect of Masha Saindhava Taila Nasya in the management of Apabahuka W.S.R to frozen Shoulder.

6.2)Review of literature

In Charaka Samhitha, there is no direct reference regarding the disease Apabahuka but there is a reference regarding the disease Bahushosha in Sutrasthana 6.In Sushrutha samhitha samprapthi, laxanas and chikitsa of Apabahuka has been discussed in the context of Vatavyadhi 7.In Astanga Hrudaya, Lakshana and Chikithsa have been dealt 8.In Ashtanga Sangraha, Chikithsa and Nidana have been quoted 9&10.

Masha Saindava Taila is mentioned for Nasya in Chakradutta 11 and Bhaishajya Ratnavali 12, Commentators like Arunadutta, Dalhana and Hemadri have analysed about apabahuka. In Madhava Nidana, Apabahuka is explained in Vathavyadhi13 .

In Bhava Prakasha Nighantu ,a detailed description of Masha and Saindava have been given14.There are references regarding lakshanas of apabahuka in gadanigraha,sharangadhara samhitha,yogaratnakara and bhavaprakasha.15-18 In text books of modern medicine,a detailed description of frozen shoulder is available.19-21

6.3)Previous work done

1.“A Clinical Study to evaluate the effect of Sahacharadi Taila Nasya in the management of Apabahuka W.S.R to frozen Shoulder”. Kiran Kumar Agadi, GAMC, Mysore.RGUHS-2008.

2.“A comparative clinical study in the management of Apabahuka through Brumhana Nasya W.S.R to Frozen Shoulder” . Bharath Narendra S ,Dr. BNMR College, Bijapur,RGUHS-2008

3. “To evaluate the effect of two schedules of Nasya Karma with Ksheera Bala Taila in the management of Avabahuka (Frozen Shoulder). Rahul.HSDM, Hassan,RGUHS-2009

4. “Comparative clinical study on jinjinyadi Nasya Taila and Ashwagandha gritha nasya in the management of Avabahuka. . Girish N Deshpande,NK Jabshetty Ayurveda medical College & PG Centre – Bidar,RGUHS-2007

6.4 Aims and objectives of the study

  1. To evaluate the effect of Masha Saindava Taila Nasya in the management of Apabahuka.

2. To study in detail about Apabahuka w s r to frozen shoulder.

7. Materials and methods

7.1 Sources of data

a) Literary source: From the Ayurvedic classics,modern text books ,recent reputed journals and internet source.

b) Drug source: After proper identification , the drugs and tila taila will be purchased from the local market and Taila will be prepared at JSS AMC Pharmacy.

c) Sample source: Patients suffering from Apabahuka will be selected from JSS Ayurveda medical college and hospital Mysore, medical camps and other referrals.

7.2 Method of collection of data

a)Sample size: A minimum of 30 patients suffering from pabahuka will be selected excluding the dropouts.

b)Study design: It is a single blind clinical study.

c)Diagnostic criteria:

Classical Signs and Symptoms of Apabahuka i.e,Frozen shoulder:

  • Bahupraspandhitahara i.e,restricted movement of shoulder joint.
  • Amsa sandhi Shoola i.e,shoulder pain
  • Amsa sandhi stabdhata i.e, shoulder stiffness.

d) Inclusion criteria:

  • Patients fulfilling the above mentioned diagnostic criteria.
  • Patients of both sexes within the age group of 20 to 60 years.
  • Patients fit for Nasya.
  • Patients of diabetes Mellitus with Frozen Shoulder.

e) Exclusion criteria:

  • Patients suffering from any other local shoulder pathology and systemic disorders which would interfere with the present study.
  • Pregnant and Lactating mothers.

f)Study duration:One month.

g)Assessment of results:

Assessment will be done by adopting standardmethods of scoring for subjectiveand objective parameters.These datas will be subjected for statistical analysis by applying student’s paired ‘t’test.Based on these, results will be interpreted.

i)Subjective parameter:

Classical signs and symptoms of apabahuka i.e., frozen shoulder :-

Amsa sandhi shoola -shoulder pain,

Amsa sandhi stabdhatha –shoulder stiffness.

ii)Objective parameter:

Bahupraspandithahara-Range of motion(ROM)- will beassessed by using Goniometer.

7.3DOES THE STUDY REQUIRE ANY INVESTIGATIONS OR INTERVENTIONS TO BE CONDUCTED ON PATIENTS OR OTHER HUMANS OR ANIMALS? IF SO DESCRIBE BRIEFLY.

Yes, the study will be conducted on Apabahuka patients only.No animal experiments will be carried out.

Investigations:

X-ray of shoulder joint.

Interventions:

Sample Size : 30 Patients

PURVA KARMA : Patient is advised to come with empty stomachin the morning.

: Mukha Abhyanga and Sweda will be done with

Masha saindhava taila.

.

PRADHANA KARMA :Nasya with 8 drops of Masha Saindhava Taila to each

Nostrils.

PASCHATH KARMA :Rubbing of palms and soles ,mouth gargling with warm

Water.dhoomapana with haridra churna.

Treatment Duration :7 Days

Follow up : every week for 1 month i.e,on8th,15th,22nd,30th day.

Total Study Duration : 1 Month

Observations :Before treatment and on the days of follw up after

treatment.

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

YES, enclosed.

8. List of references

  1. Karper Fanci Brannwald, Harrison’s Principles of internal, Medicine. 17th Edition. pp. 2185
  1. British Medical Journal (2006), Internet.
  1. Bhishagcharya Harisadashiva Shastry Paradakar Vaidya, Ashtanga Hrudaya reprint 2010 Chaukhamba Surbharathi Prakashan, Varanasi, pp 534, pp 725.
  1. Sastri Ravi Datta, Chakra Datta of Srichakrapani Datta with Padartha bodhini hindi commentary, Chaukhamba Surbharathi Prakashan, Varanasi.
  1. Shastri Kavirajshri Ambika Datta – Bhaisajyaratnavali, Chaukhamba Sanskruthi Samsthan, Varanasi, pp. 412.
  1. Sastri Kasinat and Dr.Chaturvedi Gorkhanatha,Charaka samhitha, Chaukhamba Bharathi Academy, Varanasi, 20th edition – 1995, pp 399.
  1. Acharya Yadavji Thrikamji, Sushrutha Samhita, Chaukhamba Orientalia, Varanasi, 6th edition – 1997.
  1. Bhishagcharya Harisadashiva Shastry Paradakar Vaidya, Ashtanga Hrudaya reprint 2010 Chaukhamba Surbharathi Prakashan, Varanasi, pp 534, pp 725.
  1. Dwivedi Mukundilal – Ayurvediya Panchakarma Chikitsa, Chaukhamba Sanskrit Prathishtan, Delhi, 2nd edition – 2008.
  1. Gupta Kaviraja Atrideva, Ashtanga Sangraha, Vol.1, Krishna Das Academy, Varanasi (1993), pp. 402.
  1. Sastri Ravi Datta, Chakra Datta of Srichakrapani Datta with Padartha bodhini hindi commentary, Chaukhamba Surbharathi Prakashan, Varanasi.
  1. Shastri Kavirajshri Ambika Datta – Bhaisajyaratnavali, Chaukhamba Sanskruthi Samsthan, Varanasi, pp. 412.
  1. Upadhyaya Yadunandana – Madhava nidhana, Chaukhamba Sanskruthi Samsthan, Varanasi, 30th edition – 2000, pp. 445
  1. Dr G S Pandey,Bhavaprakasha nighantu,chaukamba bharathi academy,Varanasi,reprint -2009.
  1. Shri Vaidya Sodhala – Gadanigraha, Vol.2, edition reprint 2005, Chaukhamba Sanskruthi Samsthan, Varanasi, pp.491.
  1. Tripati Brahmanand – Sarangadhara Samhita, Chaukhamba Surbharathi Prakashan, Varanasi, pp. 108.
  1. Yogaratnakara with Vidyothini hindi commentary, Chaukhamba Prakashan, Varanasi, edition – reprint 2008, pp. 513
  1. Shri Bhavmishra – Bhavaprakasha by Bhisagratna Pandit Shri Brahmashankara Misra, Vol.2, Chaukhamba Sanskrith Bhavan, Varanasi,

11th edition – 2009

  1. Boon Nicholas A, Brikin & Walker, Davidsons Principles and Practice of Medicine, 20th edition.
  2. Ebnezar John, Text book of Orthopaedics, J P Brothers publishers, New Delhi.
  1. Karper Fanci Brannwald, Harrison’s Principles of internal, Medicine. 17thEdition. pp. 2185

9. Signature of the candidate :

10. Remarks of the guide :

11. Name & Designation of :

11.1 Guide : Dr.VEENA.G.RAO M.D(AY)

ASSISSTANAT PROFESSOR,

DEPARTMENT OF P.G.STUDIES IN PANCHAKARMA,

J.S.S.AYURVEDA MEDICAL COLLEGE,MYSORE.

11.2 Signature :

11.3 Co-Guide(if any) :

11.4 Signature :

11.5 Head of the department : DR RAMAKRISHNA SHARMA K.S.M.D.(AY)

PROFESSOR AND HOD OF P.G.STUDIES IN

J.S.S.AYURVEDA MEDICAL COLLEGE,MYSORE.

11.6 Signature :

12.

12.1 Remarks of the chairman and

Principal :

12.2 Signature :