Rajiv Gandhi Unversity of Health

RAJIVGANDHIUNIVERSITY OF HEALTH

SCIENCES KARNATAKA BENGALURU

PROFORMA FOR REGISTRATION OF SUBJECT (PANCHAKARMA) FOR

DISSERTATION MD (AYURVEDA)

BY

Dr.BINNY JACOB

1stPG Scholar(AYU)

Dept of PGstudies in Panchakarma

JSSAyurveda Medical college

Mysore

Karnataka

GUIDE

Dr .VEENA .G.RAO MD( Ayu)

Asst. Professor

Dept of PG studies inPanchakarma

JSS Ayurveda Medical College

Mysore

Karnataka

CO GUIDE

Dr. T. S VASAN MS,DNB,Mch(AIIMS)

Associate Prof- NEUROSURGERY,

JSS Medical College Hospital,

Mysore

FOR THE DEGREE OF AYURVEDA VACHASPATHI

M.D AYURVEDA

PANCHAKARMA

TITLE OF THE TOPIC

“ the effect OF rasnasapthaka niruha basti IN GRIDHRASI

W.S.R.TO SCIATICA”

2011-2012

NAME OF THE INSTITUTE

J.S.SAYURVEDAMEDICALCOLLEGE

MYSORE

FROM

Dr.BINNY JACOB

Ist PG Scholar

Dept of PG studies PANCHAKARMA

J S SAyurvedaMedicalCollege

MYSORE.

THE REGISTRAR

RajivGandhiUniversity of Health Sciences

Jayanagar, 4TH ‘T’ Block, Bengaluru.

THROUGH,

THE PRINCIPAL AND HOD OF PG STUDIES IN PANCHAKARMA

J S SAyurvedicMedicalCollege

MYSORE

Respected Sir,

SUB: Submission of the completed proforma for Registration of subject for dissertation.

I request you to kindly register the synopsis on below mentioned subject against my name for

the submission of dissertation to the Rajiv Gandhi University of Health Sciences, Karnataka,

Bangalore for partial fulfillment of postgraduate course in the specialization of PANCHAKARMA

M. D. (Ayurveda)

TITLE OF DISSERTATION : “the effect Of rasnasapthaka niruha basti

IN GRIDHRASI W.S.R.TO SCIATICA”

Here with I am enclosing complete proforma for the registration of subject for dissertation.

Thanking You,

Yours faithfully

Place:

Date: Dr.BINNY JACOB

RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES

KARNATAKA BENGALURU.

PROFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION

1. Name Of The Candidate : Dr. Binny Jacob

And Address 1st PG Scholar

Post Graduate Department of

PANCHAKARMA

Kizhekkayil (House)

Pottenkad p.o

Idukki (dst) ,

kerala

2. Name of The Institution :JSSAYURVEDAMEDICALCOLLEGE

Mysore

Karnataka.

3. Course of Study And : Ayurveda Vachaspati

Subject M.D. (Ayurveda) In PANCHAKARMA

4. Date of Admission To : 12 SEPTEMBER 2011

The Course

5Title of Dissertation :

“the effect OF rasnasapthaka niruha basti

IN GRIDHRASI W.S.R.TO SCIATICA.”

6) BRIEF RESUME OF THE INTENDED WORK:

6.1Need for the study:

Modern science describes sciatica as a benign syndrome characterized especially

by pain begins in the lower back radiating to the sacroiliac regions,buttocks and thigh.pain usually extends

below the knee1 .Although the disorder is not life threatening, it cripples the patient and seriously prevents

him from enjoying day to day life .

Our ancient acharyas had identified this problem long back and named it gridhrasi . Gridhrasi the

word meaning is “GRIDHRAMIVA SAYTI GACCHATI2” , i.e due to the severe pain patient has a typical

gait, i.e. the gait resemble with that of vulture. The description narrated in these classics exactly coincides

to the description of sciatica including the important diagnostic test SLR which is described

as sakthinkshepanigraha3 by our acharyas.

Life time incidence of low back ache is said to be 50%-70%. In 35% of cases Sciatica

precedes backache and in 25% of cases both backache and Sciatica are complained of simultaneously4.

In the conventional system of medicine except for surgical management in the presence

of confirmatory evidence of prolapsed intervertebral disc , administration of muscle relaxants, NSAIDS

(non steroidal anti inflammatory drug) narcotic analgesics, which gives temporary relief and it’s long term

usecauses adverse effects.

Among the Pancha karmas Vastikarma5 is unique because it expels the vitiated doshas rapidly

and easily from body. Thus bringing the vata to normalcy and overcoming the samprapti.In the chikitsa suthra

of gridhrasi many acharyas mentioned vasti.Hence in the presentStudy vasthi is selected.

Rasna sapthaka niruha Vasti is widely used in keraleeya panchakarma.

Rasna sapthaka kashaya is explained in Sahasrayogam6 and it is indicated in jangha-uru-prushta-

thrika-parswasoola.

The Rasna saptka qwatha dravyas(rasna,amrutha,aragwatha,devadaru,gokshura,eranda,punarnava)

are explained in asthapanopaga gana by Acharya Sushruta7 and Acharya charaka8 , which is used

for vasti formulation.

Thus the present study is designed to evaluate the efficacy of Rasnasapthaka niruha Vasti

with the hypothesis that the vasti may prove beneficial in combating the disease pathogenesis by brumhana

and vatahara property.

6.2 Review of Literature:

Review of the classical and contemporary literatures will be done as per the requirement including the internet.

1 In Caraka Samhita , nidana, samprapti, lakshanas and chikitsa of Gridhrasi has been explained in Chikista Stana of Vatavyadi chikitsa9.

2 In Ashtanga Hridaya, nidana, samprapti, lakshanas of Gridhrasi are explained in Nidana stana and chikitsa explained in Vata Vyadhi chikista10.

3 In Susrutha samhita, nidana, samprapti, lakshanas of Gridhrasi are explained in Nidana stana and

chikista explained in Vatavyadhi chikista in Chikitsa Sthana11

4 In Kashyapa Samhita, Gridhrasi and its managements are not found in his treatise but counted under

80ypes of Vata Vikara12.

5 In Bhela Samhita, Bhela mentioned Gridhrasi and treatment of gridrasi is described.13

6 In Haareeta Samhita, Haareeta was the first to give importance to Gridhrasi by naming 22nd chapter

of Triteeya Sthaana as Gridhrasi Cikitsaadhyaaya14.

7 In Madhava Nidhana he described the varieties of Gridhrasi i.e., Vataja and Vatakaphaja more

elaborately15.

8 In Sharangadhara Samhita Gridhrasi is counted under 80 types of Nanatmaja Vatavyadhi16 and treatment

of Gridhrasi is described17.

9 In Yogaratnakara symptomatology and classification of Gridhrasi has been mentioned under

Vatavyadhi Nidana18.

10 In Bhavaprakasha – a text book of Laghutrayi, Gridhrasi is described under Vatavyadhi Nidana19

The Bastikarma which is termed as Ardha chikitsa20, Basti is the principle treatment of Vatavyadhis, .

basti is indicated in Gridhrasi

Rasna , amrutha, aragwada ,devadaru , gokshura ,eranda, punarnava, are the qwatha dravyas

Rasna , .devadaru , eranda ,aragwadha ,mentioned by susrutha in niruhopayogi dravya7 .

Amrutha , punarnava , thrikantaka ,mentioned by charaka in asthapanopaka gana8.

The above mentioned drugs are the ingredients of rasnasapthakam kashayam which is mentioned

in sahasrayoga6 & it is indicated in jangha , uru , prushta , thrika shoola , parshwa shoola.

Ksheera bala thaila ,which is used for anuvasana basti contains , bala , ksheera .It is mentioned

in chikitsa manjari in vatha vyadhi chikitsa21.

previous work done;

A comparative clinical study of vaji gandhadi thaila basthi and kati basthi in the management of

Gridhrasi.By Dr.Janardhana mishra ,NKJAB Shetty ayurvedic medical college ,BIDAR

RGUHS (2005)

The effect of ardha mathrika basthi in gridhrasi By Dr. Padma Krishnan .SDM college of ayurveda

UDUPI RGUHS (2006)

An observational study on Vajigandhadi Yoga Basthi and Kati Basthi in gridhrasi By Dr. Adarsh E.K

DGM .GADAG RGUHS .(2006)

Comparative study of uthama and hina mathra of Eranda mooladi Nirooha Yoga Basti in Gridrasi

By DR. Rahul Mahesh K M ,SDM college , Hassan, RGUHS (2007)

A comparative clinical study on the effect of Mathra Basthi with Sahachara thaila and Moolaka thaila

in gridrasi By Dr Renjith K .T .KVG Sullia ,RGUHS (2008)

A comparative study of Erandamuladi Niruha Basti with and without Gomutra Arka in

Vata Kaphaja Gridhrasi by Shivani Tyagi,SDM Ayurveda Medical College,Hassan, RGUHS, 2009 .

6.3Objective of the study:

To study in detail about Gridhrasi W.S.R to Sciatica
To Evaluate the effect of rasnasapthaka niruha basthi in gridhrasi..

7.Materials and methods

7.1 Source of data:

Literary source: All classical ,modern literature and contemporary texts including the journals

and website about the disease, drug and procedure will be reviewed and documented for the study.

Drug source: raw drugs will be collected from the local market after proper identification.

Medicines required for the treatment will be prepared in JSS Ayurveda pharmacy , MYSORE.

Sample source: Patients will be randomly selected from OPD and IPD of PG studies of Panchakarma, JSSAyurveda hospital Mysore . Medical camps and other referrals.

7.2Method of collection data:

a)Sample size: 30 patients suffering from Gridhrasi will be selected(excluding the dropouts).

b)Study design: A clinicalstudy.

c)Selection criteria: The cases are selected as per signs and symptoms mentioned in classics.

d)Diagnostic criteria:Patientswill be diagnosed based on following clinical features:

Patients presenting with pain over kati radiating to posterior aspect of sphik ,uru janu

Janga .&pada with or without the other clinical features explained in classics.

Positive SLR test.

e)Inclusion criteria

Radiating pain over the posterior aspect of one leg (left or right)
Presence of clinical features of both vataja(ruk ,sthambha,thoda,spandana) and

Vata Kaphaja(tantra, gaurava-,arochaka)Gridrasi

Positive SLR test.
Patients between age group 20-60 year of either sex.
Patients fit for Bastikarma.

f) Exclusion Criteria

Traumatic ,infective ,neoplastic,and congenital disease of spine.
Patient with systemic disorders which interfere with the course of treatment .
Pregnant women and lactating mothers.
Surgical emergencies.
Patient contraindicated for basti.

g ) Assessment criteriae

Subjective

The assessment of results of treatment will be done on the basis of numerical scores assigned

for each of the following signs and symptoms;

Ruk - pain
Sthambhana-stiffness
Toda - pricking sensation
Spandana –fasciculation
Arochaka – anorexia
Gourava – heaviness
Tandra -torpor

Objective

Straight leg raising test

Study duration/follow up:

Treatment will be done for maximum of 31 days
Deepana, pachana –maximum of 7 days
Basti - for 8days
Pariharakala -for16 days
Follow up will be done on the 16th day of parihara kala after the basti karma and

twice in 10 days interval .i.e on 41st day,51st day

Statistical test:

Assessment of the condition will be done based on the scores assigned forsubjective

and objective parameters and will be analyzed statistically using paired’t’ test.

7.3DOES THE STUDY REQUIRE ANY INVESTIGATIONS OR INTERVENTIONS TO BE

CONDUCTED ON PATIENTS OROTHER HUMANS OR ANIMALS?

- Yes the study will be conducted clinically on human being, no animal experiment will be carried out.

Laboratory investigations;

X-ray of lumbo sacral spine- AP & lateral view. if required.
Other relevant investigations, if required.

Interventions:

Procedure : The Purva karma and Paschat karma will be done as mentioned in literature .

Purva karma ; As advised in Cakradatta22 -Deepana pachana for maximum of 7 days till nirama

lakshnas are seen.

sthanika abhyanga with ksheerabala thaila over udara ,shroni , and nitamba

will be done. nadi sweda will be given.

Pradana karma; anuvasana basthi –with kheerabala thailam 75 ml

Nirooha basti -Rasna sapthaka kashaya -380 ml

Thaila(ksheerabala thaila -100 ml

Madhu-100ml.

Shatahva-10gm

Saindhava lavana-10gm

Paschat karma:

After the administration of Basti ,and after the catheter is removed Tadana(strokes) done on

nitamba pradesha .Then patient is made to lie down in supine position, then rub soles of the patient,

and ask the patient to flex his legs at the hip and knee for several times.

The post treatment follow up will be taken after parihara kala on 31st and 41st day .

Clinical improvements will benoted,and grading will be given. The data collected before and

after the treatment will be compared and analyzed.

7.4Has the ethical clearance been obtained from your institution?

-Yes, It has been obtained.

8. LIST OF REFERENCES

1 Textbook of Orthopaedics, John Ebnezar, Jaypee Publications, 2nd edition 2000, page no-244, 251.

2 Raja RadhaKantha Deva Bahadur Edited, Shabda Kalpa Druma, Vol.2, 3rd Edition. Pub: Choukambha

Sankrit Series, pg 348-349

3 Susrutha Samhitha of Acharya Susrutha with Nibandasangraha commentary of Sri Dalhanacharya and the Nyayachandrika Panjika of Sri Gayadasacharya on nidanastana by Vaidya Acharya Trikamji Yadavaji, Chaukamba Orientalia, Varanasi, 6th edition-1997, Nidanastana 1/74 page no-268

4. A concise textbook of surgery by Das.S, chapter 30, 1st edition page no - 506.

5 Murthy Srikantha K.R, Astanga Hrudaya ,English translation pub; Krishnadas Academy, Varanasi,

3rd Ed 1996 ;Sutra stana Ch- 19/1 ,Page no-238

6 Vaidyan Krishnan V.K &Pillai Gopala .S ,Sahasrayogam ,pub;Vidyarambham Publishers ,Alappuzha,28th

Ed 2009 ; Page no-84

7 Murthy Srikantha K.R, Susrutha samhita ,English translation pub; Krishnadas Academy, Varanasi,

Chikitsa stana Ch- 38 / 24 - 28 ,Page no - 368

8 Sharma R.K, Dash Bhagwan ,Charaka Samhita ,English translation ,pub ; Chaukamba Sanskrit

Series Office ,Varanasi;6th Ed1999 ;Sutra Stana Ch – 2/ 11- 14 Page no -66

9 Sharma R.K, Dash Bhagwan ,Charaka Samhita ,English translation ,pub ; Chaukamba Sanskrit

Series Office ,Varanasi ;6th Ed 1999 ;Chikitsa Stana Ch – 28 / 101 Page no -51

10 Ashtanga Hridayam by Vaghbhata with the commenries Sarvangasundara of Arunadatta & Ayurveda Rasayana of Hemadri edited by Bhisagacharya Paradakara Harishastri,Chaukamba Orientalia, Varanasi, Nidanastana 15/54 page number-535,chikistastana 21,page no -722.

11 Susrutha Samhitha of Acharya Susrutha with Nibandasangraha commentary of Sri Dalhanacharya and the Nyayachandrika Panjika of Sri Gayadasacharya on nidanastana by Vaidya Acharya Trikamji Yadavaji, Chaukamba Orientalia, Varanasi, 6th edition-1997, Nidanastana 1/74 , page no-268, chikitsa stana 4/21-26

,page no-422

12 Prof .Tewari P. V, Kashyapa Samhita, pub; Choukhamba Bharati Academy,Varnasi ,2008

Sutrasthana, Ch 27 / 21, page no. 68.

13 Prof. Sharma Priyavrat edited, Bhela Samhita,,pub. Choukhamba Bharati Academy,Varanasi, 2008

Chikitsasthana ,Ch 25/ 44 - 45 , page no.454

14 PandeyVaidya Jaiminey edited, harita Samhita, pub.Choukhamba Bharati Academy,Varanasi,1st Ed

2010 , Triteeyasthana, Chapter 22, page no.380

15 Prof. Murthy Srikantha K.R, madhava nidana Pub; Choukhamba Orientalia , Varanasi,7th Ed 2005

Ch 22/54-56 Page no – 86

16 Prof . MurthySrikantha R.K,translated Sharangadhara Samhita,pub. Choukhamba Vidhya Bhavan 2009 Poorvakhanda, Chapter 7 /108 page no.40.

17 Prof . Murthy Srikantha R.K ,translated Sharangadhara Samhita,pub. Choukhamba Vidhya Bhavan

2009 Madhyamakhanda, Chapter 5 /6 page no 81.

18 Yogaratnakara with Vidyotini Hindi commentary by Vaidya Shastri Lakshmipathi edited by Bhisagratna Shastri Brahmashankar, Chaukambha Prakashana, Varanasi edition & Reprinted 2008,page no-563

19 Prof .Murthy Srikantha R. K , Bhava prakasha pub. Chaukambha Krishnadas Academy Varanasi Ed 3rd

2005 ,madhyamakhanda 24/129-140 page no - 331

20 Prof .Murthy Srikantha K.R ,Astanga Hridaya ,English translation pub; Krishnadas Academy, Varanasi,Ed 1st 1995 Sutra stana Ch- 19 / 86- 87 ,Page no– 254

21 D.Namboothiri Sreeman, Chikitsa manjari ,pub:Vidyarambham Publishers ,Mullakkal ,Alappuzha.;Ed 8th 2008Vatha vyadhi chikitsa /151 -152 page no -391 ,

22 Chakradatta- Sanskrit text with English translation by Sharma Priyavrat,chaukamba orientalia, Varanasi Second Edition-1998. vathavyadi chikitsa, Shloka 51-52, page no 189