FROM,
DR.R.ASHOK KUMAR
I M.S.,
Department of Shalya tantra,
Shri Shivayogeeshwar Rural Ayurveda medical
College& Hospital, Inchal, Saundatti, Belgaum,
Karnataka-591102.
TO,
THE REGISTRAR,
Rajiv Gandhi University of Health Sciences,
Bangalore, Karnataka.
THROUGH,
THE PRINCIPAL & HOD, Dept.of Shalya tantra,
Shri Shivayogeeshwar Rural Ayurveda Medical
College&Hospital, Saundatti ,Belgaum , Karnataka-591102.
Respected sir,
SUB: Submission of completed proforma for registration of subject for dissertation.
I request you to kindly register the below mentioned subject against my name for submission of dissertation to the Rajiv Gandhi University of Health Sciences, Bangalore as partial fulfillment of M.S. (Ayu) in Shalyatantra.
TITLE OF DISSERTATION
“MANAGEMENT OF CHARMAKEELA BY AGNIKARMA WITH PANCHALOHA SHALAKA AND KSHARAKARMA WITH PALASHA KSHARA-A CLINICAL COMPARATIVE SYUDY”
Here I am enclosing the completed Proforma for registration of subject for dissertation.
Thanking you,
Date : Yours Sincerely,
Place : Inchal
(DR. R. ASHOK KUMAR)
RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES
KARNATAKA , BANGALORE
ANNEXURE II
PROFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION
1. NAME OF THE CANDIDATE : DR.R.ASHOK KUMAR
AND ADDRESS : 881,TAMARAI STREET,
ANBARASU NAGAR,
NAZARATH PET,
CHENNAI,
TAMIL NADU-600123.
2. NAME OF THE INSTITUTION : SHRI SHIVAYOGEESHWAR
RURAL AYURVEDA MEDICAL
COLLEGE&HOSPITAL,
INCHAL,
SAUNDATTI TQ,
BELGAUM DT.
KARNATAKA -591102.
3. COURSE OF STUDY & SUBJECT : MASTER OF SURGERY(AYU.)
IN SHALYA TANTRA.
4. DATE OF ADMISSION OF COURSE : NOVEMBER 2012
5. TITLE OF TOPIC :
“MANAGEMENT OF CHARMAKEELA BY AGNIKARMA WITH PANCHALOHA SHALAKA AND KSHARAKARMA WITH PALASHA KSHARA- A CLINICAL COMPARATIVE STUDY.”
6. BRIEF RESUME OF INTENDED WORK:
6. 1. Need for the study: -
Ayurveda, the upanga of Atharva veda which is meant for treating the human kind from diseases, and insisting about Achara rasayana. Sushruta was the first surgeon and developed the wing of cosmetic surgery.
In day to day life Charmakeela as non hazardous condition, but it causes pain and cosmetically it gives inconvenience and leads to depression and lake of concentration in their work. So I have selected this topic, management of Charmakeela by using our ancient Para surgical procedures like Agni karma1 and, Kshara karma2 in my research work.
Acharyas explained the different treatment principle for charmakeela as aushadha, shasthra,kshara and agni karmas. As such aushadha & chedana karma (shasthra karma)are done, recurrence rate is more. So that I have taken this kshara and agni karma in the management of charmakeela.
As Samprapthi of charmakeela explained by Sushruta vyana vata getting aggravated and associating with kapha gives rise to peg like, immovable sprouts in the exterior skin is called as Charmakeela or Twakarsas3. According to Ashtanga hridaya black, painless, sprouts (moles) on the skin resembling Tila are known as Tilakalaka. These only are known as Masaka when they are raised. More projections than Masaka is Charmakeela4 (warts) which may be either white or black.
Agni karma prevents recurrence, where as Kshara karma will do ksharana, lekhana property and Ropana karma.
As per modern view warts can be due to so many reasons, my study is limited to viral origin warts since the lakshanas of Charmakeela matching with Viral Warts.
Kshara karma done by Pratisaraneeya kshara of Palasha can be taken and Agni karma can be done with Panchaloha shalaka in the management of Charmakeela in my clinical study.
6. 2. Review of literatures:
A) Review of disease:
· As Samprapthi of charmakeela explained by Sushruta vyana vata getting aggravated and associating with kapha gives rise to peg like, immovable sprouts in the exterior skin is called as Charmakeela or Twakarsas3. According to Ashtanga hridaya black, painless, sprouts (moles) on the skin resembling Tila are known as Tilakalaka. These only are known as Masaka when they are raised. More projections than Masaka is Charmakeela4 (warts) which may be either white or black.
· Nidana,Samprapthi and Lakshanas of Charmakeela explained in Sushrutha Nidana Sthana5
· Nidana and Samprapthi explained in Ashtanga Hridaya Nidana sthana6.
· Ashtanga Hridaya Utharasthana the management of Charmakeela7 is explained.
· All the classical and contemporary information including the website, mentioning the procedure and the disease along with proposed clinical study will be thoroughly recorded and reviewed.
B) Drug Review:
Agnikarma and Ksharakarma explained in sushrutha suthrasthana Kshara to be prepared with Palasha.
Palasha belongs to Rodradi gana, having the properties of kapha vata hara, Lekhana Karma and indicated in Arsas and Charma Roga8.
Previous works done
· Musale Asha N - A comparative study in the management of Charmakeela (Wart) with Chitraka Kshara and Snuhi Kshara Lepa - A clinical study, R.G.U.H.S , 2002
· Kulkarni Pramod – Charmakeelavat Shalya Kshara Chikitsa , R.G.U.H.S , 2001
· Jeevitesh – A comparative study in the management of Charmakeela with Agnikarma by electric cautery , PNT 1986
6.3 Aims and Objectives: -
· Detailed study on Charmakeela.
· Detailed study of Agnikarna and Ksharakarma.
· Study on the Clinical effect of Agnikarma with Panchaloha Shalaka and Ksharakarma with Palasha Kshara
· To compare the efficacy of Agnikarma with Panchaloha Shalaka and Ksharakarma with Palasha Kshara.
7. Materials & methods:
7.1 Source of data: -
60 Patients will be selected from O.P.D. and I.P.D. of Shalya tantra,at Shri Shivayogeeshwar Rural Ayurveda Medical College & Hospital, Inchal, Belgaum.
7.2 Method of collection of data: -
Established cases of Charmakeela as per inclusive criteria will be selected for the study.
a) Inclusion criteria :
a) Age group -- Between 18 and 60 years,
b) Irrespective of religion, sex and other socio-
economic conditions fulfilling all the clinical
features of common warts
b) Exclusion criteria :
a) Below 18 and above 60 year
b) All type of systemic disorders like Diabetes, TB, HIV
c) During pregnancy
d) Venereal warts
e) Durbalas
c) Treatment group : 60 patients who are fulfilling the criteria for inclusion will be divided into two groups ,each group will contain 30 patients.
Group A) Agnikarma : The lesion is prepared with all aseptic measures. Then Panchaloha Shalaka is made red hot and is to be applied over the affected area. After Samyak Dagdha Lakshana, dressing is to be done with Jathyadi Gritha and bandage is to be done.
Group B) Kshara Karma : The lesion is prepared with all aseptic measures. The Pratisaraniya type of Palasha kshara is to be applied over the affected area after Samyak Lekhana, wait for Shatamatra Kala, treated with Nimbu Swarasa. After Samyak Dagdha Lakshana, dressing is to be done with Jathyadi Gritha and bandage is to be done.
d) Duration of treatment: Agnikarma and Ksharakarma are to be carried out in single sitting. After the procedure,every day dressing of the wound is to be done for 10 days.Later observation is noted on once in every 10 days i.e.on 20th,30th,40th,50th and 60th day.
e)Assessment criteria
Assessment will be analyzed on the basis of following objective and subjective parameters before and after treatment.
f) Objective parameters & Subjective parameters :
Subjective - a) Pain
b) Tenderness
Objective a) Roughness
b) Condition of surrounding area
c) Duration of healing
d) Size of warts
g) Follow up study :
Charmakeela recurrences observed on every month upto the period of 3 months.
h) Statistical analysis:
The data will be collected and statistically analyzed by consulting a biostatistician.
7.3. Does the study require any investigations or interventions to be conducted on patients or humans or animals? If so, please describe briefly: -
Yes.
a) Investigations: CBC, CUE,
RBS,
HIV/HbsAg,
Any other relevant investigations as per necessity.
b) Interventions:
1. The patients will be assessed before and after treatment as per assessment criteria.
2. The nature of the study will be explained to the patients in detail and pre-treatment
consent will be taken.
3. The patients have full right to withdraw from the study at any time.
4. The data will be maintained confidentially and subjected to statistical analysis.
7.4. Has ethical clearance been obtained from your institution in case 7.3?
Yes, Obtained and certificate enclosed
8) References:
1. Acharya sushrutha,Sushruta Samhita, Suthrasthana, 12th chapter,10th sloka, Translated by Sri kantha murthy.Varanasi:Chaukhamba Orientalia; Reprinted in 2008, P.72.
2. Acharya sushruta,Sushruta Samhita, Suthrasthana, 11th chapter,7th sloka, Translated by Sri kantha murthy. Varanasi: Chaukhamba orientalia; Reprinted in 2008, P.64.
3. Acharya Sushrutha ,Sushruta Samhitha , Nidanasthana, 2nd chapter, 18th- 20th sloka,Translated by Sri kantha murthy. Varanasi: Chaukhamba Orientalia; Reprinted in 2008, P .481.
4. Acharya Vagbhata, Ashtanga Hridayam, Uttarasthana , 31st chapter,25b-26th sloka, Translated by Sri kantha murthy. Varanasi: Krishnadas Academy;Reprinted in 2009, P.295.
5. Acharya Sushrutha ,Sushruta Samhitha , Nidanasthana, 2nd chapter, 18th- 20th sloka,Translated by Sri kantha murthy. Varanasi: Chaukhamba Orientalia; Reprinted in 2008, P .481.
6. Acharya Vagbhata, Ashtanga Hridaryam, Nidanasthan 7th chapter,57-58th sloka, Translated by Srikantha murthy. Varanasi: Krishnadas Academy;Reprinted in 2009, P. 75.
7. Acharya Vagbhata, Ashtanga Hridayam, Uttarasthana , 32nd chapter,14th sloka,Translated by Sri kantha murthy. Varanasi: Krishnadas Academy;Reprinted in 2009 , P.301.
8. P.V. Sharama, Dravya guna vignana vol.II, Varanasi: Chaukhambha Bharati Academy;Reprinted in 2003, P.506.
9. Davidson’s principles of medicine, chapter 21st, 19th edition 2002 print.,P.1084.
10. Dr. S. DAS Manual on clinical surgery, chapter 3,5th Edition,Calcutta,P.43.
11. Text book of surgery by Dr. S.DAS, Chapter no:10,3rdedition 2005 Reprint, Calcutta,p.122.
9) SIGNATURE OF THE CANDIDATE :
(Dr.R.Ashok kumar)
10) REMARKS OF THE GUIDE :
11) NAME AND DESIGNATION OF
11.1) GUIDE : DR.M.D.P.RAJU MS (AYU)
PROFESSOR&HOD
DEPT.OF SHALYA TANTRA,
S.S.R.A.M.C.,
INCHAL,BELGAUM.
11.2) SIGNATURE & SEAL OF GUIDE :
11.3) CO-GUIDE : DR.R.C.YAKKUNDI MS (AYU)
LECTURER,
DEPT.OF SHALYA TANTRA,
S.S.R.A.M.C.,
INCHAL,BELGAUM.
11.4) SIGNATURE & SEAL :
11.5) HEAD OF THE DEPARTMENT : DR.M.D.P.RAJU MS(AYU),
DEPT.OF SHALYA TANTRA,
S.S.R.A.M.C.,
INCHAL,BELGAUM,
11.6) SIGNATURE&SEAL :
12) REMARKS OF THE PRINCIPAL :
12.1 SIGNATURE AND SEAL :
PRINCIPAL/C.M.O
(Dr.G.Vinay mohan)