RAJIVGANDHIUNIVERSITY OF HEALTHSCIENCES

BENGALURU, KARNATAKA

SYNOPSIS BY

DR.VISHALSINGH.V. DEVAMANI

FOR THE DEGREE OF AYURVEDA DHANWANTARI

M.S AYURVEDA IN SHALYATANTRA

2013

TITLE OF THE TOPIC

“TO STUDY THE EFFICACYOF BADARASMA PISTI AND VARUNADI KASHAYA IN THE MANAGEMENT OF MUTRASHMARI W.S.R TO UROLITHIASIS”

NAME OF THE INSTITUTE

SRI SHIVAYOGEESHWARA RURAL AYURVEDIC MEDICAL

COLLEGE AND HOSPITAL,

PO: INCHAL, TQ: SAUDATTI,

DIST: BELGUAM,

KARNATAKA.

FROM,

DR VISHALSINGH.V. D

MS (AY), Department of PG Studies

Sri Shivayogeeshwara Rural Ayurvedic Medical College

Inchal

TO,

THE REGISTRAR,

Rajiv Gandhi University of Health Sciences,

Bangalore- 41,Karnataka.

THROUGH,

THE PRINCIPAL AND HOD OF P.G. STUDIES IN SHALYATANTRA,

Sri Shivayogeeshwara Rural Ayurvedic Medical College,

Inchal

Respected sir,

Subject: Topic for Dissertation-Submission of completedproforma.

I request you to kindly register the under mentioned subject against my name as the topic for dissertation in partial fulfillment of M.S (Ayurveda) in Shalyatantra under Rajiv Gandhi University of Health Sciences, Bangalore.

TITLE OF THE DISSERTATION

“TO STUDY THE EFFICACYOF BADARASMA PISTI AND VARUNADIKASHAYA IN MANAGEMENT OF MUTRASHMARI W.S.R TO UROLITHIASIS”

I am here with enclosing completed proforma for registration of the subject for dissertation.

Thanking you

Place: Inchal Your’sfaithfully,

Date:

Dr. Vishalsingh.V.D

RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,

BENGALURU, KARNATAKA.

ANNEXURE - II

COMPLETED PROFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION

1. / Name Of The Candidate
and Address / : / Dr. Vishalsingh.V. D
S/O Geetha V Devamani
#39/A, 2nd Phase, Guttur Colony
Harihar.
Dist: Davangere, Karnataka
2. / Name of the Institute / : / Sri Shivayogeeshwara Rural Ayurvedic Medical College And Hospital,
Inchal
3. / Course of Study In Subject / : / Ayurveda Dhanvantari,
Ms (Ay), Shalya Tantra.
4. / Date of Admission to the Course / : / 26/12/2012
5. / Title of theDissertation / : / To Study The Efficacy OfBadarasma Pisti And Varunadi Kashaya In Mutrashmari W.S.R To Urolithiasis

6.Brief Resume of the Work:

6.1)Need for the Study :

Ashmari is known to mankind since time immemorial from the ancient time.It becomes evident that the urological problems remain a very important part of medical science. In Samhita period Sushrutha, the father of surgery has explained urinary calculi under the heading “ASHMARI” in detail including etiological factors, classifications, symptoms, pathology, complications and its management in most scientific manner.

Ashmari description is the specific contribution of Acharaya Sushrutha and he included it in ’Asta Mahagada’(Su.Su-33/4), may be owing its potentiality to disturb the anatomy and physiology of urinary system. Rigveda and Atharveda (2000-5000BC) also mentioned the stone and advised people not to ride on horse. Charaka have mentioned medical management and whereas Sushruthacharaya have advised both conservative and surgical removal of stone through perineal root cystolithotomy.

Urolithiasis is the third most common affliction of the urinary tract exceeded only by UTI and BPH.

The term Urolithiasis refers to the formation of the solid concretions consisting of both proteins and crystalline materials in the lumen of urinary tract attached to the uroepithelium. There are an unknown but probably large number of individuals with urolithiasis that is sub clinical with no signs and symptoms,numerous defense mechanisms contribute to prevent crystal formation and their adherence to the uroepithelium and failure in these defense mechanisms may lead to urolithiasis.

The Urinary stones have peculiar tendency of recurrence despite of their surgical removal which prove that surgery is only a part of treatment but not the complete treatment.

To avoid incidence of recurrence of the surgical removalof stone as in search of effective conservative treatment the present work has been taken.

Modern science has emphasized on various factors like hereditary, sex, age, metabolic disease,sedentary lifestyle, hydration status, mineral content of water, nutritional deficiency along with different theories like supersaturated solution, (para thyroidism), vitamin D etc in relation to urinary stone formation.

An alarming rise in the incidence of urolithiasis compelled with a motivation provided by WHO to explore the possibility and discovering cure on traditional live has created impetus for further removal in light of Ayurvedic Knowledge.

6.2) Review of Literature:

Review of disease:

The following classical texts will be reviewed:

  1. Susrutha samhita explains in detail about nirukti,bheda,nidana,sampraptiLaksana and

treatment in detail.13

  1. Charaka samhitaexplains in detail aboutbheda,samprapti,nidana,poorvaroopa,chikitsa of

ashmari .4

  1. Astanga Hrudaya explains in detail about the nirutki bheda nidana,samprapti and chikitsa

of ashmari.6,7

  1. Madava nidana also elaborately explains about itslaksana,bheda,sadyasadyata of

ashmari.8

Review of drug:

Badrasma Pisti:

The reference of this pisti is found in ‘Sidha Yoga Sangraha by Yadavji Trikamji Acharya’ in 18th chapter namely – Ashmari, Mutrakrucha Adikara.In Unani it is named as Hajarulyahuda Bhasma .It is a long, Round, stone containing lines. Unani practitioners use this pisti to treat stones in urinary tract.

Varunadi kashaya:

It Contains drugs namely varuna, shigru, tarkari, meshashringi, karanga,naktamala,murva,agnimanta,saireyaka,bimbi,chitraka,shatavari,bilva,kantakari,brihati.

  1. The detailed description of varunadi kasaya in ashmari is found in classical texts like

charaka samhita,susrutha samhita,astanga hrudaya,baisajya ratnavali.9,2,5

  1. The detiled description of badarasma in ashmari is found in siddha yoga

sangraha,rasamrutam,rasatantrasara evam siddha yoga sangraha,bhavaprakasa nigantu,rasadarpana.10,11,12,13,14

  1. In modern books like S.Das ,Manipal manual of surgery there is through description of

urolithiasis its signs and symptoms,types,operative procedures,radiological investigations to be adopted.15,16

Previous Research Work Done:

  • Dr. Vankata Ramaiah (1994): Role of Sunthyadi Kwatha in the management of

Mutrashmari,GAU Jamnagar

  • Dr. Deepak Kulsreshtha (1996): Role of Punarnavadi compound in the

management of Mutrashmari, GAU Jamnagar

  • Dr. Dhiraj V. Malaviya (1997): Role of Badarashma Pishti in the management of

Mutrashmari, GAU Jamnagar

  • Dr. Sharma Anil Kumar (2001): Role of imaging techniques in the diagnosis of

Mutrashmari (Urolithiasis) and Sikhadi compound in its management, GAU Jamnagar

  • Dr. Shailesh Chovatiya (2004): Role of Nagaradi Kashaya in the management of

Mutrashmari (urolithiasis), GAU Jamnagar

  • Dr.Shrikant.P.I(2007): Role of Badarasma pisti in the management of Mutrashmari,sri Gavisiddeshwara ayurvedic college, Koppal,RGUHS

6.3) Aims and Objectives of Study:

i)To study the efficacy of Varunadi Kasaya in the management of Ashmari WSR to

Urolithiasis

ii)To study the efficacy of Badamrasma pisti in the management of Ashmari WSR to urolithiasis

iii) To compare the efficacy of Badamrasma pisti with Varunadi Kasayain the management of Ashmari

Group A

Badrasma Pisti:

The reference of this pisti is found in ‘Sidha Yoga Sangraha by Yadavji Trikamji Acharya’ in 18th chapter namely – Ashmari, Mutrakrucha Adikara.In Unani it is named as Hajarulyahuda Bhasma

  • Swarupa:

It is a long, Round, stone containing lines.Unani practitioners use this pisti to treat stones in urinary tract.

Group B

  • Varunadi kashaya:

There are so many preparations mentioned in our classics for treatment of Ashmari they are:

  • Aushada Chikitsa – decoctions(Kashaya), grita, churana used to treat Ashmari (Su.Ni-7/9-13)
  • Kshara Chikitsa
  • Basti Chikitsa
  • Shastra Chikitsa.

Therefore keeping in mind the principle of treatment of Ashmari by Shushrutha compound drug Varunadi kashaya has been selected.

7)METHADOLOGY:

7.1) Source of Data:

Patients with Ashmari attending the OPD and IPD of SSRAMC, Inchal will be selected for the study.

7.2)Method of Selecting Data:

A total of 60 cases presenting with the features of Ashmari namely-pain in flanks, urinary symptoms, Haematuria, fever with chills, GI symptoms will be selected and confirmed by Ultra sonography shall be selected.

1) Inclusion Criteria:

  • Patients with features of Ashmari namely pain in flanks, urinary symptoms, fever

with chills,vomiting, nausea and USG report,KUB X-ray, IVP confirming

Ashmari.

  • Patient with Ashmari size varying from 1mm-12mm

2) Exclusion Criteria:

  • Patients suffering with severe systemic disorder
  • Pregnancy
  • HIV positive patient
  • Age of patients below 16 years and above 60 years.
  • Renal disorders like C.K.D where Blood urea and Sr. Creatinine is elevated.
  • Above 12mm size.

3) Sampling design :

  • A total of 60 cases of Ashmari after considering the above mentioned criteria shall be included for study.
  • The 60 cases will be randomly allotted into 2 groups namely group A, Goup B, 30 patients in each group.
  1. Study Design:
  2. Methodology in group A:

In group A patients shall be given badarasma pisti .

Duration:60days

Dose:500mg BD

Anupana:tender coconut water, barley, almonds.

  • Methodology in Group B:

In group B patients shall be given Varunadi Kashaya

Duration:60 days

Dose:25ml BD diluted with 50ml of water

Anupama:tender coconut water, kulatta, Barley, Almonds.

Duration of 60 days is fixed to access the changes the patients shall be advised to have liberal amount of fluids. Includes Kulatta, tender coconut water, Barley, almonds in their diet.

Assessment criteria:

Assessment will be made before before, during and after treatment with suitable grading parameters.

Subjective Parameters:

  • Pain
  • Urinary symptoms
  • Fever with chills

Objective Parameters :USG report,KUB X-ray, IVPbefore and after the treatment will be accessed

Statistical analysis :

The data will be collected and stastically analysed by consulting a bio statistician.

7.3)Does the study require any investigation or intervention to be conducted on patients or human or animal, if so please describe briefly.

  • Yes
  1. Investigations:
  • USG Report, KUB X-ray, IVP
  • Laboratory Investigation:
  • TC,DC,ESR
  • Blood Urea
  • Sr. Creatinine
  1. Intervention:
  • The patient will be assessed before and after treatment as per assessment criteria.
  • The nature of the study will be explained to the patients in detail and pre treatment

consent will be taken

  • The patient have full right to withdraw from study at anytime
  • The data will be maintained confidentially and subjected to statistical analysis

7.4) ETHICAL CLEARANCE

Ethical clearance shall be obtained from ethical committee,

8)LIST OF REFERENCES:

1. Acharya Susrutha,susrutha samhita ,nidana stana,3chapter sloka No3-4,edited by

Y.T.Acharya and Narayana Ramacharya,9th edition2007,Chowkamba orientalia,Varanasi.

p276

2. Acharya Susrutha,susrutha samhita ,chikitsa stana,7chapter sloka no 9-14,edited by

Y.T.Acharya and Narayana Ramacharya,9th edition2007,Chowkamba orientalia,Varanasi.

p435

3. Acharya Susrutha,susrutha samhita ,sutra stana,38 chapter sloka no 10, edited by

Y.T.Acharya and Narayana Ramacharya,9th edition2007,Chowkamba orientalia,Varanasi.

p164

4. Acharya Charaka,charaka samhita of agnivesha,chikitsa stana,chapter No.26,thrimarmiya

chikitsa adhyaya sloka no 36,39-40,editor Y.T Acharya,Choukamba orientalia,Varanasi.

p599

5. Acharya Vagbhatta,astanga hrudaya, edited by Bhisagacharya harisastri paradakara

vaidya,edition 2005,Chowkamba orientalia,Varanasi, chikitsa stana,11chapter,sloka no

16-17. p673

6. Acharya Vagbhatta,astanga hrudaya, edited by Bhisagacharya harisastri paradakara

vaidya,edition 2005,Chowkamba orientalia,Varanasi, sutrastana,15chapter,sloka no 21.

p236

7. Acharya Vagbhatta,astanga hrudaya, edited by Bhisagacharya harisastriparadakara

vaidya,edition 2005,Chowkamba orientalia,Varanasi, nidanastana,9chapter,sloka no 6-15.

p498

8. Acharya Madhava,madhava nidana,vol1,edited by Prof Yadunandan upadyaya,edition

2002,chapter no 32,sloka no 1-10,Choukamba Sanskritbhavan,Varanasi. p562

9.Acharya Govinda Das,bhaishejya ratnavali,editor Prof Siddhinandan mishra,reprint edition

2009,chapter 36,sloka 3,Chowkamba surabharati prakasana. P688

10. Vaidya Yadavji Trikamji Acharya, Rasamrutham, Varanasi:ChoukambhaSanskrit

Samsthana 2008 Pp:180;P83

11, Vaidya Yadavji Trikamji Acharya, Sidhayoga sangraha 8th edition 1998, Sri Baidyanath

Ayurveda Bhavan. Pp:176. P.97

12. Shastri Vishwanath Dwivedi, Bhavaprakasha Nighantu 9thedition,

Dehli.Pp:630,P:543,544

13. Rasatantrasara evam sidhaprayogasangraha 14th edition, Krishna Gopal ayurveda Bhavan

1999 Pp:881.P.218

14. Bhajandas Swami Dadupanth, Rasadarpana 5th edition, Patiyala:Swami Prakashan 1992,

Pp:437.P: 341, 342

15.S.Das,a practical guide to operative surgery,5th edtion,2007,by Dr.Somen Das.p436

16.S.Das,a manual on clinical surgery,10th edition,2013 by Dr.Somen Das.p556

9) / SIGNATURE OF
THE CANDIDATE / :
10) / REMARKS OF THE
THE GUIDE / :
11.1 / NAME AND
DESIGNATION
OF THE GUIDE / : / DR.S.Koteshwar Rao
Reader
Dept. of P.G. studies in Shalyatantra,
S.S.R.A.M.C
Inchal
11.2 / SIGNATURE / :
11.3 / CO – GUIDE / : / DR.V.K.Mugadur
Lecturer
Dept. of P.G studies in Shalyatantra
S.S.R.A.M.C
Inchal
11.4 / SIGNATURE / :
11.5 / HEAD OF THE
DEPARTMENT / : / DR.M.D.P.Raju
Professor & HOD,
Dept. of P.G. Studies in Shalyatantra,
Sri Shivayogeeshwara Rural Ayurvedic
Medical College And Hospital,
Inchal
11.6 / SIGNATURE / :
12 / REMARKS OF THE
CHAIRMAN AND
PRINCIPAL / :
12.1 / SIGNATURE / : / Principal/C.M.O
(Dr.G.Vinay Mohan)

1