RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES KARNATAKA, BANGALORE
SYNOPSIS
BY
Dr. LOVNISH
TITLE OF TOPIC
“A COMPARATIVE CLINICAL STUDY ON THE EFFECT OF AJMODADI CHURNA AND KATI BASTI IN THE MANAGEMENT
OF GRIDHRASI W.S.R. TO SCIATICA”
2011 – 12
SHRI. J.G.C.H. SOCIETY’S
AYURVEDIC MEDICAL COLLEGE, GHATAPRABHA
BELGAUM
FROM,
Dr. LOVNISH
I M.D, DEPT. OF KAYACHIKITSA
SHRI. J.G.C.H.S. AYURVEDIC MEDICAL COLLEGE
GHATAPRABHA, BELGAUM
TO,
THE REGISTRAR
RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES
BANGALORE, KARNATAKA
JAYANAGAR, 4TH BLOCK, BANGALORE
THROUGH
THE PRINCIPAL AND H.O.D. OF KAYACHIKITSA
SHRI. J.G.C.H.S. AYURVEDIC MEDICAL COLLEGE
GHATAPRABHA, BELGAUM
Sub: Submission of completed proforma for Registration of synopsis for dissertation
Respected Sir,
I request you to kindly register the below mentioned subject against my name for the submission of dissertation to the Rajiv Gandhi University of Health Sciences, Karnataka, Bangalore for the partial fulfillment of post graduation course in the specialization of Kayachikitsa M.D.(Ayu)
TITLE OF DISSERTATION
“A COMPARATIVE CLINICAL STUDY ON THE EFFECT OF
AJMODADI CHURNA AND KATI BASTI IN THE MANAGEMENT
OF GRIDHRASI W.S.R. TO SCIATICA”
I am enclosing completed proforma for registration of subject for dissertation.
Thanking you
Place: Ghataprabha Your’s faithfully,
Date: (Dr. LOVNISH)
RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES KARNATAKA, BANGALORE
ANNEXURE II
COMPLETED PROFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION
1. NAME OF THE CANDIDATE : Dr. LOVNISH
AND ADDRESS I yr M.D. (Ayu)
S/O VARINDER PRUTHI,
156/P Sant lal road,
Ferozepur cantt, Pin-152001
State- Punjab
2. NAME OF THE INSTITUTE : Shri. J.G.C.H Society’s
Ayurvedic Medical College Ghataprabha , Belgaum
3. COURSE OF STUDY : Ayurveda Vachaspathi
M.D.(Ayu) -(Kayachikitsa)
4. DATE OF ADMISSION OF COURSE: 28-10-2011
5. TITLE OF THE TOPIC : “A COMPARATIVE CLINICAL
STUDY ON THE EFFECT OF
AJMODADI CHURNA AND KATI
BASTI IN THE MANAGEMENT
OF GRIDHRASI W.S.R. TO
SCIATICA”
6. BRIEF RESUME OF THE INTENDED WORK:
6.1 Need for study-
Vatavyadhi is one of the most common and uprising health problem in our daily lives and Gridhrasi is one of them. Gridhrasi as mentioned in Ayurveda explains a disorder where in pain starts from Sphik pradesha and radiates downwards to kati, Prusta ,Uru, Janu, Jangha and the patient is unable to walk properly1.The presentation of Gridhrasi is similar in signs and symptoms to that of Sciatica.It is a symptom or a manifestation of some other problem in which the pain starts in the back and radiates down one or both lower limbs2.
Statistically it is estimated that About 60% to 80% of world’s population experience back pain at some time in their lives3. In a developing country like India most of the working class population suffers from Low Back Pain due to several stressful factors seen in their professional or social life and also due to wrong postural habits.
In the Modern medicine, administration of muscle relaxants, NSAIDS, corticosteroids, physiotherapy etc. gives temporary relief from pain and at the end the last option left is surgery, which is quite expensive, needs long hospital stay, has several complications and may even cause permanent loss of working capabilities. So there is a need of a research for safer drugs and some cost effective, non-invasive procedures having better efficacy.
To fulfill the above needs, a study on comparative management of Gridhrasi will be done in this clinical study with Ajmodadi churna and Kati basti. And their efficacy will also be assessed.
6.2 Review of Literature:
The review of the literature includes screening of Ayurvedic classics, modern literatures, journals and internet sources to collect sufficient data for the study.
Gridhrasi is described under vatavyadhi in Brihatrayis and Laghutrayis.
According to Charaka- Gridhrasi caused by aggravated vayu. Initially the hip is afflicted by stiffness pain and pricking sensation in the waist, back, thighs, knee and calf region. All these organs get twitching sensation frequently. If the ailment is caused by the aggravated vayu and kapha then the patient suffers from drowsiness, heaviness and anorexia4.
Acharya Susruta has described that when the kandara of heel and toes are affected by vata they obstruct the movement of leg .This is known as Gridhrasi5. Gridhrasi is explained by all of the authors like Ashtang Hridaya Nidana 1st chapter, Bhavprakash 2nd part 24th chapter, Yogratnakara vatavyadhi chikitsa , Madhava Nidana 1st part, 22nd chapter etc .
Ajmodadi churna6 has been mentioned in Sharangdhar Samhita madhyam khand ch.6 under churna kalpana.Its ingredients are mentioned as- Ajmoda, Vidang, Saindhav lavana, Devdaru, Chitrak, Pippali mula, Shatpushpa, Marich, Pippali-each one karsha i.e. 12gms,mixed with 5 karsha of Pathya and 10 karsha each of Vridhdaru and Naagar powdered finely.
Kati basti, although not directly mentioned in Ayurvedic classics but is popularly practiced in Keraliya Panchkarma for the management of Gridhrasi. Kati basti term in Ayurveda can be compared with bahya snehana i.e. external oleation which is mentioned in management of vata vyadhis. The special feature of Kati basti is that both Snehana and Swedana would be done simultaneously in the patient.
Previous work done:
1. A comparative study on the effect of Kati basti and Rasna gugglu in the management of gridhrasi w.s.r to sciatica ,by Dr.Bharat A Mungara,Jamnagar,2008.
2. The management of gridhrasi with vatari guggulu a clinical evaluation, by
Dr.A.M.Manoj,A.L.N.R.M.A.M.C,koppa,2007
3. Evaluation of efficacy of Punarnavadi guggulu & Mahamashadi taila Kati basti in the management of Gridhrasi by Dr.Gavisiddana Gouda G.Patil 2004
4. A comparative study on the effect of some indigenous compound drug and matra basti in the management of gridrasi,by Dr.Anamika kumari,Jamnagar,2006.
5. A comparative study of kati basthi and matra basti in the management of gridhrasi(sciatica),by Dr.Rita V Khagram,Jamnagar,2004
6. Role of vajigandhadi taila for both internal administration and basti karma in the management of Gridhrasi by Rao Kameswara –2004
7. R. Ramachandra- To evaluate the therapeutic effect of Kati basti in Gridhrasi.RGUHS, Bangalore, 2003.
6.3 Objectives of the study-
1. To study the aetiopathogenesis of Gridhrasi vis-à-vis Sciatica as per Ayurveda and
modern views
2. To understand the pathology of gridhrasi w.s.r. to vata vaigunya.
3. To observe and evaluate the effect of Ajmodadi churna in the management of
Gridhrasi
4. To evaluate the effect of Ajmodadi churna with Kati basti in the
management of Gridharsi.
7. Materials and Methods-
7.1
a). Source of data-
Patients of either sex diagnosed to be suffering from Gridhrasi with special reference
to Sciatica will be selected from OPD, IPD, by conducting special camps and other referrals
at Shri J. G. C. H. Ayurvedic Medical college and Hospital, Ghataprabha.
b). Source of drug-
The Sahcharadi taila and Ajmodadi churna will be prepared in our college pharmacy
authentically as per classical methods.
7.2 Method of collection of data-
· Patients of either sex will be selected based on the classical symptoms of Gridhrasi with special reference to Sciatica
· Patients are divided into 2 groups, Group-A (15 patients) and Group-B (15 patients)
· For Group-A patients Ajmodadi churna is given for 21 days
· For Group-B patients Ajmodadi churna for 21 days along with Kati basti with Sahachradi Taila7 for the initial 7 days along with Ajmodadi churna .
a) Inclusion Criteria-
· Age 40- 65 years
· Either sex
· Patients with pratyatmak lakshna of Gridhrasi i.e. Ruk ,Toda, Stabha, Spandana in the sphik, kati ,uru, janu, jangha, pada
b) Exclusion criteria-
· Age < 40 and > 65
· Patients with other systemic disorders like Diabetes, CA spine, Caries spine.
· Patients with history of any direct or indirect trauma to spine.
· Patients having severe Lumbar canal stenosis , 3rd & 4th degree disc prolapse.
· Pregnancy.
c) Diagnostic Criteria-
Patients with cardinal signs and symptoms of Gridhrasi are taken for the study like –
· Presence of Ruk, Toda, Stambha and Spandana in the Sphik, Kati,Uru,Janu, Jangha, and Pada
· Tenderness along the course of sciatica nerve.
· SLR test in affected leg.
· Bragard’s sign.
d) Assessment criteria-
Assessment will be based on following parameters-
Subjective parameters
· Ruk in the sphik, Kati,Uru,Janu,Jangha and Pada.
· Toda in the sphik, Kati,Uru,Janu,Jangha and Pada.
· Stabha in the sphik, Kati,Uru,Janu,Jangha and Pada.
· Spandana in the sphik, Kati,Uru,Janu,Jangha and Pada.
Objective parameters
· Straight Leg Raising Test
· Bragard’s Sign
· Deep tendon reflexes-knee reflex and ankle reflex.
· Improvement in the X-ray LS spine
· Improvement in the gait
· Muscle power
· Walking time
Subjective and Objective parameter before & after treatment are analysed statistically by using student ‘T’ test.
e) Investigations-
· X-RAY spine lumbo sacral region-AP and Lateral.
· Routine investigations i.e. routine haematological, urine and stool examination will be done to exclude any other disease.
· Routine biochemical investigations like PPBS, FBS, Serum Creatinine,Blood urea will be performed before and after treatment.
f) Study design (Interventions)-
A comparative clinical study will be conducted on selected patients assigned in 2 groups. The signs and symptoms will be scored on basis of standard parameters and analysed statistically by using student ‘t’ test. Patients will be treated with-
For Group-A –
Ajmodadi churna with ushna jal
Dose – 4 gms thrice a day8
Duration - for 21 days
Group-B –
Ajmodadi churna
Dose – 4 gms thrice a day
Duration – for 21 days along with
Kati Basti - with Sahacharadi taila for the initial 7 days
Method
· Poorva karma
Preparation of the dough:Required quantity of water is added to black gram dough so as to make a dough(ring) of circular shape.
Preparation of patient : On the day of Kati Basti patient is asked to lie down in prone position and the part to be treated is only exposed.
· Pradhana krama:
Required quantity of luke warm Sahacharadi Taila is poured slowly inside the ring and heat is maintained for 45 minutes by replacing the warm oil frequently.
· Paschath Krama:
After removed the dough the treated area is massaged.
.
Follow Up –
Every weekly follow up will be done for 3 weeks. After completion of the treatment another follow up will be done after weeks.
7.3 Does the study require any investigations or interventions to be done on
Patients or other humans or animals? If so please describe briefly.
· Yes. The present study requires investigations or interventions which are mentioned above.
7.4 Has ethical clearance been obtained from in case of 7.3?
· Yes, clearance has been obtained through the ethical committee formulated in the institution.
8. References-
1. Charaka samhita of Agnivesa ,elaborated by Acharya Charak and redacted by Dridhbala.Edited with ‘Vaidyamanorama hindi commentary alongwith special deliberations etc.by Acharya Vidyadhar Shukla and Prof.Ravi Dutt Tripathi.Chaukhamba Sanskrit Pratishthan ,Delhi.Edition 2007.Part 2nd Chikitsa stana 28/56 sloka.pg no.698
2. S.Das, A concise text book of surgery, Calcutta, Dr.S.Das publications, 5th edition, Pg-522,523
3. Davidson’s principles and practice of medicine edited by Nicholas A. Boon, John A.A Hunter 20th edition chapter 25,Pg.No 1083
4. Charaka samhita of Agnivesa ,elaborated by Acharya Charak and redacted by Dridhbala.Edited with ‘Vaidyamanorama hindi commentary alongwith special deliberations etc.by Acharya Vidyadhar Shukla and Prof.Ravi Dutt Tripathi.Chaukhamba Sanskrit Pratishthan ,Delhi.Edition 2007.Part 2nd Chikitsa stana 28/56 sloka.pg no.698
5. Susruta Samhita of Maharishi Susruta.Edited with Ayurveda-tattva-sandipika by Kaviraja Ambikadutta Shastri.Chaukhambha Sanskrit Sansthan,Varanasi.Part 1st Nidana stana 1/74.pg no.234 Ninth edition
6. Sarangdhara samhita by sarangdhara-a treatise on Ayurveda by prof.K.R.Srikanta Murty Chaukhambha Orientalia VARANASI.Madhayama khanda. Churna kalpana.6/113-115 .pg no.96
7. Ashtang Hridaya of Vagbhatta edited with ‘vidyotini hindi commentary’ by Kaviraja Atrideva Gupta and edited by Vaidya Yadunandan Upadhaya.Published by Chaukhambha prakashan ,Varanasi.chptr 21/67-69 pg.421
8. ‘Sarangadhara Samhita’ by sarangdhara-A treatise on ayurveda translated into English by Prof. Srikanta Murthy, reprint-2001, Chaukhambha orientalia,Gokul Bhawan,Gopal mandir lane,Varanasi(India),Madhyama Khanda,Chapter-6/1,PP-84.
9. Signature of the candidate :
10. Remarks of the Guide:
11. Names and Designation of
(In block letters)
11.1 Guide: : DR. J.K. SARMA
M.D. (Kayachikitsa)
Prof. Kayachikitsa Department.
Shri J.G.C.H.S.Ayurvedic Medical College.
Ghataprabha – 591 310
Tal-Gokak, Dist-Belgaum.Karnataka State
11.2 Signature :
11.3 Co-Guide : DR. S.M. GULED M.D. (Kayachikitsa)
Lecturer, Kayachikitsa Department.
Shri J.G.C.H.S.Ayurvedic Medical College.
Ghataprabha – 591 310
Tal-Gokak, Dist-Belgaum.Karnataka State
11.4 Signature:
11.5 Head of the Department : DR. J. K. SARMA
M.D. (Kayachikitsa)
Prof. Kayachikitsa Department.
Shri J.G.C.H.S.Ayurvedic Medical College,
Ghataprabha – 591 310
Tal-Gokak, Dist-Belgaum.Karnataka State
11.6 Signature :
12
12.1 Remarks of Chairman :
and Principal.
12.2 Signature :