From,

DR KAVITHA.C.NOORANDEVARMATH

Preliminary M. S. (Ay) Scholar,

Department of Post Graduate Studies in PrasutiTantra and StreeRoga,

N.K.J.A.M.C. & P.G. Centre,

BIDAR- 585403.

To,

The Registrar,

Rajiv Gandhi University of Health Sciences,

BANGALORE, Karnataka.

Through,

The Principal and H.O.D, P.G. studies in PrasutiTantra and StreeRoga,

N.K.J.A.M.College & P.G. Centre,

BIDAR-585403.

Subject: Submission of Completed Proforma for Registration of Synopsis ofDissertation.

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 M.S. (Ay) in PrasutiTantra and StreeRoga.

THE TITLE OF DISSERTATION:

“CLINICAL MANAGEMENT OF PRASRAMSINI YONI WITH MISHRAKA SNEHA PICHU DHARANA & SHATAVARI CHURNA”

I am enclosing completed proforma for Registration of Subject of dissertation.

Thanking You,

Yours faithfully,

Date:

Place: Bidar. (DR KAVITHA.C.N)

RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES

KARNATAKA-BANGALORE

ANNEXURE-II

PROFORMA FOR REGISTRATION OF SUBJECT FOR

DISSERTATION

  1. Name of the CandidateDR KAVITHA.C.NOORANDEVARMATHand Address D/O CHANDRASHEKAR.N.

KUMBAR GALLI, DODDAPETE. RANEBENNUR, DIST- HAVERI-581115.

KARNATAKA.

  1. Name of Institution N.K.J. AYURVEDIC MEDICALCOLLEGE &

P.G CENTRE, BIDAR-585403.

KARNATAKA (INDIA).

3.Course of study and Subject M.S. (PRASOOTI TANTRA & STREE ROGA)

4.Date of Admission to Centre : 28 October 2010

5. Title of the topic:

“CLINICAL MANAGEMENT OF PRASRAMSINI YONI WITH MISHRAKA SNEHA PICHU DHARANA & SHATAVARI CHURNA”

6. BRIEF RESUME OF INTENDED WORK:

6.1 NEED FOR THE STUDY:

According to Ayurvedic classics, Prasramsini Yoni is explained by Sushruta & co-related with 1st & 2nd degree uterine prolapse. It is a clinical condition met in a day to day gynaecological practice specially amongst parous women. This condition is mainly due to consequent injury to supporting structures of uterus during labour, malnutrition, frequent childbirths, precipatedlabour & even in nulliparous women due to congenital weakness of structure.

Due to mithyaaharavihara, artava, beejadosha & curse of God does vitiation of vatadidosha and enters yoni & leads to 20 types of yonivyapad, where as Sushruta given explanation regarding Prasramsini yoni under pittaja type1.

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Sushruta says that in this condition any irritation causes, excessive vaginal discharge or its displacement , & labour is also difficulty due to abnormality of passage, associated with pitta vitiation i.e osha(burning), chosha(suppuration), daha(sensation of heat) etc.

MadhavaNidana, Yogaratnakar and Bhavaprakash followed Sushruta.As the uterine body is not seen outside the perineum, this condition is considered as 1st & 2nd degree uterine prolapse. Different acharyas had advocated various procedures in the management of Prasramsini yoni such as snehana, swedana etc.

Keeping in the view of above clinical problems, the hypothesis of study was proposed to evaluate the effect of Mishrakasnehapichudharana2 and orally shathavarichurna , in the management of Prasramsini yoni.

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6.2. REVIEW OF LITERATURE

•Prasramsini yoni described in SushrutaSamhitaUttaratantra 38thchap, can be co-related with 1st & 2nd degree uterine prolapse with its treatment.(1)

•Description of Prasramsini yoni with its treatment is seen in AstangaHrudaya 34th chap”Guhyarogaadhyaya”.(2)

•Prasramsini yoni has been explained in BhavaPrakash,(3) yoni roga chikitsa,70 chapter.

• In Yogaratnakar, Yonirogadhyayachikitsa,Uttararda(4),Prasramsini yoni has been explained.

•Genital prolapse is mentioned in the Text Book of Gynecology, D.C.DUTTA.(5)

PREVIOUS WORKS

•Dr Anuradha.C -A study on the medical management of urogenitalprolapse.IPGT & RA GujaratAyurved University, Jamnagar in 1979.

•Dr Ramadevi.G - A study on the effect of veshavaradharana in Prasramsini yoni,Govt AyurvedCollege, Trivandrum in 1998.

•Dr Rajeshwari.H- A clinical management of Prasramsini yoni withbalachoornamooshakamamsatailapichu.N.K.J. Ayurvedic college, Bidar in 2005.

•Dr Anupama.- Effect of phalagrhitapichu in Prasramsini yoni.SDM college,Udupi in 2002.

•Dr Vandana- A clinical study to evaluate the therapeutic effect of lodradi Kalka pichuashwagandakshirapakachangerigrhta orally in Prasramsini yoni.SDM College,Udupi in 2009.

6.3 OBJECTIVES OF STUDY

•To study Prasramsini yoni in detail.

•To evaluate the efficacy of Mishrakasnehapichu and shatavarichurna.

7. MATERIALS AND METHODS

7.1 Source of data

1. Patients will be selected from the OPD of Prasutitantrastreeroga of Sri Siddaroodh Charitable Hospital attached to N.K.J. Ayurvedic Medical College & P.G. Centre, Bidar.

2. Samhitas, Nighantus, Modern books of Gynecology, medicine, physiology and pharmacology.

3. Pharmacy attached to the college for preparation of drug.

4. The raw drugs will be collected from market underguidance of Rasashastra and Dravyaguna specialist.

DRUG REVIEW

Mishrakasneha consists one pala each of Pippali, Amalaka, Draksha, and Shyama,one prastha each of Erandataila and Havis( ghrith) all are boiled in milk, six times their quantity this preparation is known as MishrakaSneha.(6,7)

7.2METHOD OF COLLECTION OF DATA

The study will be conducted in the department of PrasootiTantraStreeRoga only those patients fulfilling below criteria are selected. Detail history including gynaecological and obstetrics history will betaken and noted on research case sheet.

Sample size & Procedure:-

30 patients will be selected according to inclusion criteria, patient fulfilling above criteria will be assigned in one group.

TREATEMENT GROUP: 30 patients will be treated with Mishrakasnehapichushatavarichurna orally twice a day for 3 consecutive cycles after cessation of menses.

Yoni Pichu:

Dose: qs

Duration: 10 days.

ShatavariChoorna :

Dose : 10 gms,BD

Anupana: Milk.

FOLLOW UP:Assessment and recording the degree of prolapsed mass will be done on each cycle.

INCLUSIVE CRITERIA

•Patients aged from 25-50 years

•1st & 2nd degree prolapse.

•Excessive vaginal discharge

•Backache or dragging pain in pelvis

•Mass felt per vagina during increased intra-abdominal pressure

EXCLUSIVE CRITERIA:-

• 3rd degree prolapse

• Patient with congenital anomalies of uterus.

• Patient suffering from diseases like malignancy

• Fibroid, polyps.

• Veneral diseases

ASSESMENT CRITERIA

Subjective parameter

•Dragging Pain in pelvis

•P/V discharge (purulent)

•Frequency of micturation

•Difficulty in defecation

Objective parameters

•Assessment of degree of prolapsed mass.

STATISTICAL ANALYSIS:

Statistical evaluation of the above parameters will be analysed by using students‘ t ’ test.

7.3 INVESTIGATIONS REQUIRED

  • CBP
  • Urine routine.
  • HAS ETHICAL CLEARANCE BEEN OBTAINED FROM YOUR INSTITUTION: Yes.

8. LIST OF REFERENCES :

  1. KavirajDr.AmbikaduttaShastri – SushrutaSamhita of Sushrut,UttaratantraPg.No 158, (38/13,14). Chaukambha Sanskrit Bhavan. Varanasi, 3rd edition.
  2. Pt HariSadasivaSastriNavare – AstangahradayauttartantraPg.No 898 (34/24) with commentaries Sarvangasundara of ArunaduttaAyurvedarasayana of Hemadri. ChaukambhaSurbharatiPrakashan Varanasi. Reprint 2007.
  3. PanditBrahmashankarMishra –BhavaprakashChikitsaSthanaPg.No 765,773, (70/8 & 40) ., 9th edition 2005
  4. Vaidyashrilaxmipathyshastri- Yoga RantnakaraVidyotiniTika Yoni RogaAdhyayachikistauttarardagathaPg.No 404/ 3rdshlokaPg.No 410/9thshloka,Chaukambha Sanskrit Bhavan. Varanasi edition 2004.
  5. D.C. DUTTA- Text Book Of Gynaecology, 4th edition pgno 190, published by New central book agency. Calcutta.
  6. Prof .K.R.Shrikanthamurthy,VagbhatasAsthangaHrdayam(14/89-90) PgNo 416 vol 2, ChoukambhaKrishnadasAcadamy,Varanasi.Reprint 2006
  7. Prof P.V.Sharma, Dravyagunavol 2, PgNo 275,678,133,419. ChaukambhaBharathiAcadamy, Varanasi. Reprint 2005.

9. SIGNATURE OF CANDIDATE:

10. REMARKS OF THE GUIDE:

11.NAME AND DESIGNATION OF:

11.1 GUIDE : DR.SRIDEVI SWAMY , M.S.

ASST PROFESSOR. P.G.DEPT

PRASUTI TANTRA & STREE ROGA.

11.2 SIGNATURE :

11.3 CO-GUIDE :

11.4 SIGNATURE :

11.5 HEAD OF DEPARTMENT : DR.SUKHADA DEVI, M.D.(PTSR)

PROF & HOD P.G.DEPT

PRASUTI TANTRA & STREE ROGA

11.6 SIGNATURE :

12. 12.1 REMARKS OF THE CHAIRMAN :

PRINCIPAL/DEAN

12.2 SIGNATURE :

1