From,
DR. BHAGYALAKSHMI S.R.
Preliminary M.S. (Ayu.) Scholar
Department of Post Graduate Studies in Shalya-Tantra.
N.K.J Ayurvedic Medical College & Research Centre, Gumpa,
Bidar-585403
To,
The Registrar,
Rajiv Gandhi University of Health Sciences
Bangalore, Karnataka
Through,
The Principal
N.K.J Ayurvedic Medical College & Research Centre Gumpa,
Bidar-585403
Subject: 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 Rajiv Gandhi University of Health Sciences Bangalore, for the partial fulfillment of M.S. (Ay.) in Shalya-Tantra.
TITLE OF DISSERTATION:
“THE MANAGEMENT OF POST OPERATIVE PAIN WITH VEDANASTHAPANA GHANAVATI w.s.r. TO HAEMORROIDECTOMY”
Herewith, I am enclosing completed Proforma for registration of subject for dissertation.
Thanking you, Yours Sincerely
Date:
Place: Bidar (DR.BHAGYALAKSHMI S.R.)
RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES
KARNATAKA-BANGALORE
ANNEXURE-II
PROFORMA FOR REGISTRATION OF SUBJECTS FOR
DISSERTATION
1. Name of the Candidate : DR. BHAGYALAKSHMI.S.R.
D/O S.P.RANGARAJU
C/O DR.SHASHIKUMAR SOMESHWARA NILAYA
6TH MAIN SHIVMUKAMBIKA NAGAR, UPPARAHALLI (P),
TUMKUR. 572102
KARNATAKA.
2. Name of Institution : N.K.J. AYURVEDIC MEDICAL
COLLEGE AND POST GRADUATE
CENTRE BIDAR-585 403.
KARNATAKA (INDIA).
3. Course of study and Subject : M.S. (SHALYA-TANTRA)
4. Date of Admission to Centre: 31/10/2011
5 .Title of Topic :
“THE MANAGEMENT OF POST OPERATIVE PAIN WITH VEDANASTHAPANA GHANAVATI w.s.r. TO HAEMORROIDECTOMY”
6. BRIEF RESUME OF THE INTENDED WORK.
INTRODUCTION
Pain is the most common symptom that brings patients to see a physician and it is the basic and most challenging problem for surgeons from primitive era and is the very common post operative manifestation after any surgical procedure, no matter how good operation is performed, due to which patients are afraid to undergo surgery. Excessive pain will be unbearable and will lead to other effects like nausea, palpitation and increase or decrease of blood pressure. When post operative pain is inadequately treated the suffering of the patient increases the stress of the whole procedure and can delay recovery1.
Hence management of postoperative pain has been a global challenge since the inception of surgery with opiates especially, there are exaggerated fears regarding their potential for side effects and their addictions. In present modern era also a well established NSAID, Diclofenac sodium has various side effects like nausea/vomitting, ulceration, GI bleeding and adverse renal effects1.The lack of effective analgesics in Ayurvedic medicines is the main disadvantage for the down fall of Ayurvedic surgery, so there is constant quest for an ideal Ayurvedic analgesic therapy .i.e.vedanasthapana upaya.
6.1 NEED FOR STUDY:
In the field of Ayurvedic surgery, management of Anorectal disorders is gaining popularity and has been proved by various research studies. But Ayurvedic surgeons are facing the problem of post operative pain management. Advent of an Ayurvedic analgesic drug or procedure will be of a great sign of relief to Ayurvedic proctologists. So in the present study the patients who have undergone surgery for Arsha, one among Anorectal disorder will be subjected to some of vedanasthapana gana dravyas in the form of ghanavati in post operative period.
शालकट्फलकदम्बपद्मकतुम्बमोचरसशिरीषवन्जुलैलवालुकाशोका इति दशेमानि वेदनास्थापनानि भवन्ति । ( च.सू.४/४८)
An assessment of these analgesic effects will be evolved. An effort will be made in this study to find safe and effective vedanasthapana upaya for those who have undergone surgery for arshas.
6.2 REVIEW OF LITERATURE :
· Acharya Sushruta described, due to shastra karma vata dosha gets aggrevation and it leads to sanjnavaha srothas irritation causes the vedana2.
· Acharya Charaka told Vedanasthapana gana- shaala, katphala, kadamba, padmaka, thumba, mocharasa, shirisha vanjula eluvaluka ashoka3
.
· General method of preparation of ghanavati as described in sushrutha samhitha and sharangadhara samhitha. 4(a&b) .
The list of previous research work
1. Anilkumar 1988. clinical evaluation of some indigenous drugs as analgesic in surgical cases.,BHU, varanasi.
2. Baidur Anjali 1991.Experimental study on Analgesic activity of Indigenous drugs used in shalyatantra, Govt. ayurvedic medical college, Bangalore.
3. Komalan.B.K.1993. A clinical study on vedanasthapana gana w.s.r.to its efficacy in relief pain.Govt ayurvedic college, kerala university,trivendrum.
4. Yogesh kumar pandey.2008. The management of post operative pain in Gudagatha vikara(Bhagandara) with yastimadhu yoga, NKJAMC, Bidar.
6.3 AIMS AND Objectives of the STUDY:
1. To observe the therapeutic effect of vedanasthapana gana dravya ghanavati in post operative pain management of patients undergone Haemorroidectomy.
2. To Review and analyse available literature of vedana and vedanasthapana upaya in ayurvedic science and modern science.
7. MATERIALS AND METHOD
7.1 SOURCES OF DATA
· The patients will be selected from Shalyatantra OPD/IPD of Sri Siddharudha Charitable Hospital attached to NKJ Ayurvedic Medical college, Bidar.
· Samhithas, Modern books of Surgery and Physiology, Dravya guna nighantus Journals, digital library etc.
· Collection of drugs from the market under the supervision of Dravyaguna Specialist.
· Pharmacy attached to college for the preparation of Ghanavati under the supervision of Rasashastra & Bhaishajya kalpana experts.
MATERIALS:-
Vedanastapana gana dravyas, Droni, Jala , Pulverizer to prepare Ghanavati.
7.2 METHOD OF COLLECTION OF DATA
Being a clinical study 30 patients will be selected by simple randomized sampling method. All patients will be screened out by inclusion and exclusion criteria after proper examination and investigation, and recorded in specially prepared case sheet. Then divided in to two equal groups.
Group1(trial group)-15 patients will be treated with vedanasthapana ghana vati orally.
Dose: 2 vati TID (1vati=500mg)
Duration : 7days
Group2(control group)-15patients will be treated with standard analgesic drug T.Diclofenac sodium 50mg orally.
Dose: 1 tab TID
Duration:7days
INCLUSION CRITERIA:-
1. Patients of both sex in age group 16-70 years will be included.
2. Patients who have underwent Haemorroidectomy.
3. Patients those who are having pravara satva.
EXCLUSION CRITERIA:-
1. Patients having unexplained severe pain before operation
2. Patients who develop other complications apart from pain in post operative period
3. Patients having systemic diseases like diabetes, hypertension.
ASSESSMENT PARAMETERS:
Subjective parameters
Assessment of post operative pain
· Onset of pain
· Progress of pain-
1. increase of pain
2. severity of pain
3. relief of pain
Objective parameters
No any objective parameters
Assessment criteria
Criteria of assessment will be based on MRC scale. Review of intensity of post operative pain every 3 hourly on 1st day and every 6 hourly on consecutive 6days, Findings will be subjected for statistical analyses.
BTG1 Vs ATG1 / Will be assessed / ATG1 Vs ATG2 / Will be assessed and evaluatedBTG2 Vs ATG2
MEDICAL RESEARCH COUNCIL GRADING SCALE AS FOLLOWS
G0- Absence of pain/ no pain
G1- Mild pain, patient that can be easily ignored( those who are having pain and able to bear it without any drug or medication
G2- Moderate pain, that can be ignored, interferes with the daily activities and needs treatment from time to time.
G3-Severe pain, pain of such intensity which the patient were unable to bear, use of analgesics is essential.
G4- Totally incapacitating pain/ most excruciating pain.
7.3 INVESTIGATION REQUIRED:
No specific tests or investigations are required in this clinical study.
7.4 HAS ETHICAL CLEARANCE BEEN OBTAINED FROM YOUR
INSTITUTION – Yes obtained
8. LIST OF REFERENCES:-
- Bailey and Love’s short practice of surgery, ARNOLD Publications London, 24th edition2004, p.no.51-53.
- Shastri kaviraja Ambikadattha, ,sushruta samhita with Ayurveda tatva sandipika,hindicommentary,poorvardha, sutrasthana, chowkambha publications,2006 edition p.no.19
- Shastri kashinath, Charaka samhitha with Ayurveda dipika commentary,1st part, sutrasthana, chowkamba publications, 2004 edition,p.no.70.
- a)Sharma Priyavath, sushrutha samhitha with dalhana commentary, English translation of text, vol.1, sutrasthana, chowkambha publications,2004 edition, p.no.351
b)Tripati Bramhananda,Sharangadhara samhitha with dipika hindi vyakhya, madhyama khanda, chowkambha publications,2004 edition,p.no.210.
9. SIGNATURE OF THE CANDIDATE:
10. REMARKS OF THE GUIDE :
11. NAME & DESIGNATION OF :
11.1 GUIDE : DR.ASHOK NAIKAR
BAMS.MS(AYU)
LECTURER,
DEPT.OF.SHALYATANTRA
11.2 SIGNATURE :
11.3 CO-GUIDE : DR.VIJAY KUMAR BIRADAR
BAMS.MS(AYU)
ASST.PROFESSOR,
DEPT.OF.SHALYATANTRA
11.4 SIGNATURE :
11.5 HEAD OF DEPARTMENT : DR.B.N.MURTHY
BAMS.MD(AYU)
1.6 SIGNATURE :
12.1 REMARKS OF THE CHAIRMAN & :
PRINCIPAL
12.2 SIGNATURE :
10