From,
Dr. RAJSHEKHAR. K. TOKARE
Preliminary M. D. (Ayu) Scholar,
Department of Post Graduate Studies in RACHANA SHAREERA
N.K.J.A.M.C & P.G. Centre
BIDAR 585 403.
To,
The Registrar,
RajivGandhiUniversity of Health Sciences
BANGALORE, Karnataka.
Through :
The Principal and Head of the Department of PG studies in Rachana Shareera
N.K.J.A.M.C & P.G. Centre,
BIDAR 585 403
Subject : Submission of Completed Proforma for Registration of Subject for
Dissertation.
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.D. (Ayu) in Rachana Shareera.
THE TITLE OF DISSERTATION
“A STUDY OF STRUCTURAL CHANGES IN GUDAGATA
ARSHA DUE TO THE EFFECT OF PRATISARANEEYA KSHARA KARMA.”
I am enclosing completed proforma for registration of subject of dissertation.
Thanking You,
Yours faithfully,
Date : 21/11/2008
Place : Bidar
(Dr. RAJSHEKHAR. K. TOKARE)
RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES
BANGALORE - KARNATAKA.
Annexure – II
PROFORMA FOR REGISTRATION OF SUBJECT FOR
DISSERTATION
1. Name of candidate and :Dr. RAJSHEKHAR. K. TOKARE
Address :S/O. KASHINATHRAO TOKARE
DONAGAPUR :POST
TALUKA : BHALKI DIST : BIDAR
KARNATAKA.
2. Name of Institution :N.K. Jabshetty Ayurvedic Medical College
& P.G. Centre, Biar 585 403.
3. Course of Study & Subject:M.D. (Rachana Shareera)
4. Date of admission to Course :30/06/2008
5. Title of the topic :
“A STUDY OF STRUCTURAL CHANGES IN GUDAGATA
ARSHA DUE TO THE EFFECT OF PRATISARANEEYA KSHARA KARMA.”
6. BRIEF RESUME OF THE INTENDED WORK:
6.1 NEED FOR THE STUDY:
Shareera Rachana mainly deals with structural study of body. Ayurveda gives the information about the Shareera in a formulative form, So there is a need of study of these body parts in correlation with modern medical science to understand Ayurveda in better way.
In Shareera Rachana many Research works have been done on different anatomical structures with Ayurvedic and modern co-relation most of them are of literary works, hence a study of treated morbid Anatomy is the need of time.
Arsha is a pathological condition where the Anatomy has hampered, i.e. dilated, inflamed haemorrhoidal vein and most of the population suffering with this problem in day to day life. If the condition is neglected it will become worse and even some time fatal.
.
Kshara karma is one of the popular Ayurvedic procedure to manage the Arsha in successful way. In day to day practice many doctors using this procedure,but after treatment what changes takes place in anal region at cellular level is not clear till today, hence such critical study in anatomy is a need of time.
Hence here an attempt is made to study the anatomical (structural) changes in Arsha due to the effect of Pratisaraneeya kshara karma.
6.2 REVIEW OF LITERATURE:
1. Acharya charaka has classified Guda as one among the 15 kostangas and divided into two parts as UttaraGuda and AdharaGuda. (Cha.Sha.7/10)
2. According to susruta Guda is Mamsa marma. Vagbhata considered as Dhamani marma.(Su.Sha.6/7 ,Va.Sha.4/42)
3. Guda is a terminal part of the sthulantra and he described interior part of the Guda as 3 valis ie pravahini, visarjini, samvarani, which are situated at an interval of 11/2 angula and also he described Guda as a bahya srotas which opens to exterior.(Su.Ni.2/5,Cha.Chi14/6)
4. Charaka and Vagbhatacharya consider Guda as a Dashapranayatana.(Cha.Su.29/3,Va.Sha.3/13)
5. According to Charakacharya Guda is the place where the commonly Arshas occurs. (Cha.Chi.14/6)
6. Kshara karma is one among the four types of treatment mentioned by Sushruta such as Bhesaja, Shastra, Kshara and Agni.Kshara karma is indicated in Mrudu, Prasruta, Avagadha Arshas.(Su.Chi.6/3)
7. The kshara literally means that which destroys fleshy mass either healthy or unhealthy. Charaka says kshara is one which scrapes the abnormal tissue from it’s location and destroys after dissolvingin it. (Cha.Su.11/4)
PERVIOUS WORK DONE:
1. Pareek. S.R - Comparative study of pratisaraneeya kshara in management of Arsha – Gujarat Ayurved University Jamnagar - 1999.
2. Anil K. – Effect of kattappa taila in Arsha , TrivandramUniversity – 2003.
3. Nagule P.S – Comparision of Gudavali with Rectal folds. Study of pravahini In Gudarsha. PuneUniversity – 1993.
4. Mustaq M- Antomical and Shareera Rachanatmak Study of purishavaha srotas w.s.r to Gudavali in relation with Arshavyadhi – Pune University 2003.
5. P.V. Ramesh - Role of pratisaraneeya kshara in the management of piles Banars Hindu University Varanasi - 1996.
6. Mini. P – Clinical study of effect of apamarga kshara in management of Arsha Trivandram University- 2003.
6.3 OBJECTIVES OF STUDY:
1)To study the Guda Shareera with Modern science.
2)To study the structural changes in Gudagata Arsha.
3)To study the structural changes in Guda gata Arsha due to effect of
Pratisarneeya kshara karma.
7. MATERIAL AND METHODS:
7.1 SOURCE OF DATA:
1) Literary and conceptual study will be undertaken by the data, compiled from Brihatrays, Laghutryis and other classical texts including journals, presented papers, previous thesis work done and correlated, analysed with the knowledge of contemporary science on the subject.
2) Published latest and related thesis, journals, encyclopedia, abstracts, materials from websites are co-related and analyzed with the knowledge of contemporary sciences on the subjects.
3) Diagnosed and under treatment patients from OPD & IPD of Shalya department .
7. 2 METHOD OF COLLECTION O DATA:
1. Literary study:-
All available Ayurvedic classical text books, journals, reputed articles, website and relevant information will be collected and analyzed scientifically.
2. Clinical study :-
The patients of 1st and 2nd degree piles will be taken for the study after being diagnosed and treating by Shalya specialties from IPD & OPD of N.K.J. Ayurvedic Medical College & P.G centre Bidar.
All the patients will be followed up for progress.
INCLUSION CRITERIA:
1)30 Diagnosed patients of Ist & IInd degree piles.
2)Patients of both sex between 20-60 Age Group.
EXCLUSION CRITERIA:
1) Patients which are not fit for kshara karma
2) Patients with other systemic disease like Diabetes Melletus, Carcinoma, other local pathological conditions (fissure, fistula, abscess, prolapsed rectum etc ).
3)Secondary piles due to Ca-rectum, corhn’s disease, ulcerative colilis, etc.
4) 3rd and 4th degree pile mass.
ASSESSEMNT CRITERIA:
Diagnosed cases of Arsha are examined for structural changes before and after Partisarneeya kshara karma. By means of ;
- Proctoscope - Macroscopic study.
- Histopathological- Biopsy will be done after the 1st week of Kshar application under local anaesthasia by puncting proctoscope.
7.3.ADOES THE STUDY REQUIRE ANY INVESTIGATIONS TO BE CONDUCTED ON THE PATIENTS (OR) OTHER ANIMALS? IF SO PLEASE DESCRIBE BRIEELY.
Yes.
Routine clinical examination for blood and urine will be made to rule out the diabetes and other infections.
Biopsy will be taken to study the histopathology
7. 4 HAS ETHICAL CLEARANCE BEEN OBTAINED FROM YOUR INSTITUTION IN CASE OF 7.3
Yes.
The ethical clearance is obtained from institutional ethical committee. (Certificate enclosed.)
8. LIST OF REFFERENCES.
1. Atridev. Susruta samhita motilal Banarsidas publisher Delhi. 1994 413 pp.
2. Atridev. Susruta samhita motilal Banarsidas publisher Delhi. 1994 415 pp.
3. Recent Advances in the Management of Arshas Dr. Hemanatha Kumar Sai Charana Publications Hassan. First edition 2004.
4. Sri. Lalachandra Vaidya Asthanga Hridayam, motilal Banarsidas publisher Delhi. 1990 309 pp.
5. Tripathi Brahamand, charaka samhita. Vol II Choukhamba surbharti prakashan varnasi 1999. 508 pp
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