RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCEBANGALORE, KARNATAKA

COMPLETED PROFORMA FOR REGISTRATIONOF SUBJECT FOR DISSERTATION

“EFFECT OF JALUKAVACHARANA IN THE MANAGEMENT OF ABHISHYANDA WITH SPECIAL REFERENCE ALLERGIC CONJUNCTIVITIS”

BY

DR ARUN.G.DEV

DEPT OF SHALAKYA TANTRA

S.D.M COLLEGE OF AYURVEDA

HASSAN -573201

GUIDE:

DRASHWINI M.J [ M S (AYU)]

ASSOCIATE professor AND HEAD

dept of P.G STUDIES IN SHALAKYA TANTRA,

S.D.M COLLEGE OF AYURVEDA

HASSAN 573201

2012 – 2013

S.D.M. COLLEGE OF AYURVEDA AND HOSPITAL

HASSAN

From,

DR. ARUN.G.DEV

PRELIMINARY M.S. (AYU) SCHOLAR

DEPT. OF POST GRADUATE STUDIES IN SHALAKYA TANTRA,

S.D.M. COLLEGE OF AYURVEDA AND HOSPITAL,

HASSAN – 573 201.

To,

THE REGISTRAR,

RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES KARNATAKA,

BANGALORE.

Through,

THE PRINCIPAL AND

HEAD OF THE DEPT. IN SHALAKYA TANTRA,

S.D.M. COLLEGE OF AYURVEDA AND HOSPITAL,

HASSAN- 573 201

Respected Sir,

Subject: “Submission of synopsis of M.S. (Ayu:) with compliance for registration of subjectfor dissertation”.

I request you to kindly register the below mentioned subject against my name for the submission of the dissertation to Rajiv Gandhi University of Health Sciences Karnataka, Bangalore for partial fulfillment of M.S. (Ayurveda)

Title of the Dissertation: “Effect ofJalukavacharana in the management of Abhishyanda with special reference toAllergic Conjunctivitis”

Herewith I am enclosing completed Performa of synopsis for registration of subject for Dissertation.

Thanking you,

Yours faithfully,

Date:

Place: Hassan (Dr. Arun.G.Dev)

Rajiv Gandhi University of Health Sciences Karnataka
Bangalore.

ANNEXURE - II

Completed Performa for Registration of Subject for Dissertation.

1. Name of the Candidate: Dr.ARUN.G.DEV

AND Address PRELIMINARY M.S. (AYU) SCHOLAR.

(IN BLOCK LETTERS) Dept. of Post Graduate studies in Shalakya Tantra,

S.D.M. College of Ayurveda

AND Hospital, P.O. Box 164,

Hassan – 573 201.

PERMENANT ADDRESS: S/O DR.S.GOPALAKRISHNAN NAIR.

DEVIDERSAN,PALACEWARD, KRISHNAPURAM(P.O),KAYAMKULAM

ALAPPUZHA (DT :),kerala. 690533

2. Name of the Institution: S.D.M. College of Ayurveda

AND Hospital, Hassan – 573 201.

3. Course of the Study AND: M.S. (Ayurveda) –

SUBJECT SHALAKYA TANTRA

4. Date of Admission to : 03rd OCT 2012

the course

5. TITLE OF THE TOPIC :“EFFECT OF JALUKAVACHARANA IN THE MANAGEMENT OF ABHISHYANDA WITH SPECIAL REFERENCE TOALLERGIC CONJUNCTIVITIS”.

6. BRIEF RESUME OF THE INTENDED WORK:

6.1 need for the study:

Abhishyanda is one among theSarvagataNetraroga causing great threat to the vision with mild to gross visual loss. According to AcharyaSushruta, Abhishyanda is the main cause for all the eye diseases and it is Aupasargikaroga[1]. If not treated properly, it may lead to further complications like Adhimantha, Hatadimantha and Drustinasha.[2]

All the diseases of the eye can be produced by untreated Abhishyanda.[3]The symptoms of Abhishyanda includes Syanda(tears),[4]Vedana(pain), Raga(redness), Shoda(swelling), Gharsha (Foreign body sensation).[5]

Allergic Conjunctivitis is an atopic disorder commonly encountered in ocular clinicalpractice. It has been reported that about one-fifth of the entire human population suffers one form of allergy or another of which about 20% is due to allergic conjunctivitis. The prevalence of allergic conjunctivitis varies worldwide, usually ranging between 15% to 40%. These variations may be attributed both to genetic andenvironmental factors (including warm dry climate and extent of pollution).[6] It occurs at all ages but common in between 4-20yrs of age and seen more in boys.

Allergic Conjunctivitis is theinflammation of the conjunctiva due to anyallergen. Symptoms consist of itching, ropy discharge, redness, foreign body sensation of eyes and photophobia. There is mild inflammation of the palpebral and bulbar conjunctiva and often severe chemosis.

The commonest ocular complications found in patients with Allergic Conjunctivitis were corneal abrasionand Keratoconous.[7]Moreover the commonly used drug in the management of Allergic Conjunctivitis poses a threat of drug induced glaucoma.

Raktamoksha is one of the treatment indicated for Abhisyandha[8]Jalukavacharana is the most easier and safest method of Raktamoksha.Jalukavacharana described by AstangaSangraha and Astanga Hridaya had the property to subside immediately the pain, swelling, burning sensation and redness.[9]Hence, present study is an attempt undertaken toscientifically studytheeffect of Jalookavacharana in the management of Allergic Conjunctivitis.

6.2 Review of the literature

As the specific Nidana of Abhishyanda are not mentioned, the Samanya Nidana of NetraRoga[10] may be considered as its Nidana. Lakshanas of Abhishyanda are Syanda(tears),[4]Vedana (pain), Raga (redness), Shoda (swelling), Gharsha (Foreign body sensation).[5]

The symptoms of Abhishyanda can be co-related with that of Conjunctivitis.Inflammation of the conjunctiva is called Conjunctivitis. It has many grades and types- infective and non infective. Allergic Conjunctivitis comes under the category of non infective type.[11]

Allergic Conjunctivitis is one of the most common nontraumatic extraocular inflammatory conditions and includes Seasonal Allergic Conjunctivitis (SAC)/ Vernal Keratoconjunctivitis (VKC) / Spring Catarrh, Perennial Allergic Conjunctivitis (PAC),Atopic Keratoconjunctivitis(AKC) and Drug Induced Allergic Conjunctivitis (DIAC).[12]

The allergic reactions occuring in the conjunctiva brings symptoms like itching, ropy discharge associated with chemosis.[13]

Method of removing vitiated blood from body using Jalauka is considered as the most easier and convenient method.It is prescribed particularly for wealthy persons, children, old aged, frightful, debilitated, women and persons of tender constitution.[14]

Application of leech mitigates diseases in eyes.[15] Jalukavacharana has the property to subside immediately the pain, swelling, burning sensation and redness.[9]

Previous Research Works

Researchworks have been conducted in various institutions on Allergic Conjunctivitis. But till dateno research work has been conducted withJalukavacharanainAllergic conjunctivitis. The Research works are as follows:

  1. Vaishnava P. U. (1982): A clinical study of kriyakalpa to assess itstherapeutic efficacy in diseases of eye w.s.r. to Abhishyanda (conjunctivitis). Institute for post graduate Teaching and Research inAyurveda, Gujarat Ayurveda University, Jamnagar.
  2. Gopal S. R. (2001): Clinical management of NetraAbhishyanda (conjunctivitis) with ShigruPallava Rasa and Madhu Aschyotana. DR. B.R.K.R. Govt Ayurveda College, Osmania University, Vijayawada.
  3. Satish S Hadimani. A study on ErandaMooladiAjaKsheeraPakaAschyotana inthe management of VatajaAbhishyanda with special reference to Allergic Conjunctivitis. S.D.M. College of Ayurveda Hassan. Rajiv Gandhi University of Health Sciences, Bangalore.
  4. ElsyLukose. (2010): Clinical Evaluation of MahatriphaladyaGhrita in the management of VatajaAbhishyanda (Allergic Conjunctivitis). S.D.M. College of Ayurveda Hassan. Rajiv Gandhi University of Health Sciences, Bangalore is concluded that, the overall effect of therapies on 50 patients of allergic conjunctivitis is in this research is as follows- complete remission observed in 44% patients, marked relief was observed 46% patients, moderate relief was observed 10%, mild relief and unchanged not seen in any patients. Mahatriphaladyaghrita is proved to be chakshushyashodhahara, srotoshodhaka and shoolahara properties. Mahatriphaladyaghrita is safe and better drug for vatajaabhishyanda.

6.3Objectives of the study:

  • To evaluate the effect of Jalaukavacharana in the management of Abhishyanda (Allergic Conjunctivitis).

7.Materials and methods:

7.1 Source of data:

Patients will be selected from outpatient department and in patient department of ShalakyaTantra by SDM college of Ayurveda and Hospital, Hassan and various camps conducted by SDM college of Ayurveda and Hospital, Hassan.

7.2Methods of collection of Data:

30 patients who are fulfilling the criteria for diagnosis and inclusion will be selected for study.

Diagnostic criteria:

  • Raga[4](Redness).
  • Kandu[5] (Itching)
  • Syanda[5] (Watering of eyes).
  • Gharsha[5](Foreign body sensation).
  • Burning sensation in eye
  • Photophobia

Inclusion Criteria:

  • Patients of either genderin between 10 to 40 yrs of age.
  • Patients presenting with signs and symptoms of allergic conjunctivitis.

Exclusion criteria:

  • Patient suffering from infectiveconjunctivitis and other ocular infections.
  • Patients suffering from bleeding and clotting disorders.
  • Patients with positive results of HIV and HbsAg.

Study Design:

30 patients of Allergic conjunctivitis fulfilling the criteria for inclusion will be selected. The Jalukavacharana will be done for a period of 1 week on alternate days.

Procedure of Jalukavacharana:

The eyes of the allergic conjunctivitis patient will be cleaned by Triphala kashaya. The lid is everted and the active Jaluka is made to suck in the palpebral part of conjunctiva. After it get detached, eye is moped with cotton and 2 drops of Triphalaghrita is dropped in the eyes and bandaged for 3 hours.

Duration of therapy:1 week on alternate days (3 sittings)

7.3 Assessment criteria:

  • The changes in the following signs and symptoms of the disease will be assessed by adopting self formulated scoring pattern as per visual analogue scale.

Subjective parameters:

  • Redness
  • Itching
  • Watering of eyes.
  • Foreign body sensation.

Objective parameters:

  • Pictorial presentation of the eye.
  • AEC (Absolute Eosinophil Count).

7.4Laboratory investigation:

  • Absolute Eosinophil Count.
  • HIV
  • HbsAg

Follow up study:

After completion of the treatment the patients will be followed after 15 days for a period of one month.

7.5 Has ethical clearance been obtained from your institution? : YES

8. LIST OF REFERENCES

1)Acharya.J.T.Susruthasamhita of Susrutha with Nibandhasangraha of Sri Dalhanacharya. editionreprint.Varanasi:Choukambha Orientalia;2009.p.603.

2)Acharya.J.T.Susruthasamhita of Susrutha with Nibandhasangraha of Sri Dalhanacharya. editionreprint.Varanasi:Choukambha Orientalia;2009.p.604.

3)Acharya.J.T.Susruthasamhita of Susrutha with Nibandhasangraha of Sri Dalhanacharya. editionreprint.Varanasi:Choukambha Orientalia;2009.p.603.

4)Jyotir.M.AstangaSamgraha withSasilekha Commentary by Indu.edition reprint.Varanasi.Chaukhamba Sanskrit Sansthan; 2009.p.719

5)Sasthri.L.YogaRatnakara- Netra,editionreprint.varanasi: Chaukhamba Prakashan;2012.p.358

6)Abokyi.S, Koffuor.G.A, Ntodie.M, Kyei.S, Gyanfosu.L.Epidemiological profile and pharmacological management of allergicconjunctivitis: A study in Ghana, International Journal of Pharmaceutical and Biomedical research, 2012.p.195.

7)Wakamatsu.T.H, Tanaka.M, Satake Y, Dogru M, Fukagawa K, Igarashi. A.et al., Mol Vis 2011, 17.p.932.

8)Susrutha.J.TSusruthasamhita of Susrutha with Nibandhasangraha of Sri Dalhanacharya. editionreprint.Varanasi:Choukambha Orientalia;2009.p.610.

9)Jyotir.M.AstangaSamgraha with Sasilekha Commentary by Indu. Varanasi. Chaukhamba Sanskrit Sansthan; 2009.p.244.

10)Acharya.J.T.Susruthasamhita of Susrutha with Nibandhasangraha of Sri Dalhanacharya. editionreprint.Varanasi:Choukambha Orientalia;2009.p.597.

11)Sihota.R, Tandon.R, Disease of the conjunctiva, Parsons’ Diseases of the Eye. 21st C ed. Haryana. Elsevier India pvt: ltd; 2011.p.177.

12) Salim.B,Rosaliz.P. Ocular Allergy: Diagnosis & treatment Ophthalmology Clinics of North America 2005.p.485

13)Khurana.A.K.Comprehensive ophthalmology.5thedition. New delhi: New age international; 2012.p.72

14)Acharya.J.T.Susruthasamhita of Susrutha with Nibandhasangraha of Sri Dalhanacharya. editionreprint.Varanasi:Choukambha Orientalia;2009.p.55.

15) Harisadasivap.Astangahridaya of Vagbhata, with sarvangasundara and ayurvedarasayana.edition reprint. Varanasi: Chaukhamba Sanskrit Sansthan,2011.p.323

9. Signature of the Candidate:

10.Remarks of Guide:

11. Name and Designation of Guide: DR.ASHWINI M J (MS Ayu:)

ASSOCIATE PROFESSOR & HEAD

DEPT OF PG STUDIES IN

SHALAKYA TANTRA,

SDMCA&H, HASSAN.

signature:

12. Head of the Department:DR.ASHWINI M J (MS Ayu:)

ASSOCIATE PROFESSOR

DEPT OF PG STUDIES IN

SHALAKYA TANTRA,

SDMCA&H, HASSAN.

Signature:

13. Remarks of the

Chairman and Principal:

Principal: DR.PRASANNA N RAO (MS Ayu, Phd)

SDM COLLEGE OF AYURVEDA AND HOSPITAL, HASSAN.

Signature:

1