SYNOPSIS
Title of dissertation:
“A CLINICAL COMPARATIVE STUDY ON CHINCHA KSHARA SUTRA AND APAMARGA KSHARA SUTRA IN THE MANAGEMENT OF ARSHAS.”
For the degree of M.S [Ayu] in Rajiv Gandhi University of Health Sciences,
Bangalore, Karnataka.
By,
Dr. SUDARSHAN M. M.
B.A.M.S
1st Year M.S.(Ayu.),
Department of Post Graduate Studies in Shalya Tantra,
Ayurvedic Medical College and PG Centre, Davangere – 577566
Guide : Dr. Dayanand S. M.S. (Ayu.)
Professor, Department of Post Graduate Studies in Shalya Tantra, Ayurvedic Medical College & PG Centre, Davangere 577566.
Co-Guide : Dr. Bharathi D.A. M.S. (Ayu)
Professor, Department of Post Graduate Studies in Shalya Tantra, Ayurvedic Medical College & PG Centre, Davangere 577566.
From:
Dr. SUDARSHAN M. M. B.A.M.S
1st Year M.S.(Ayu.),
Department of Post Graduate Studies in Shalya Tantra,
Ayurvedic Medical College and PG Centre, Davangere – 577566
To,
The Registrar,
Rajiv Gandhi University of Health Sciences,
Bangalore, Karnataka.
Through: The Principal & Head of the Department in Shalya Tantra,
Ayurvedic Medical College and PG Centre, Davangere.
Respected Sir/Madam,
Sub.: Submission of completed proforma of Synopsis for Registration of the Dissertation.
I request you to kindly register the below mentioned title of the synopsis in my name for the registration of the subject for dissertation to the Rajiv Gandhi University of Health Sciences, Bangalore for the partial fulfillment of M.S. (Ayu.).
Title of the Dissertation:
“A CLINICAL COMPARATIVE STUDY ON CHINCHA KSHARA SUTRA AND APAMARGA KSHARA SUTRA IN THE MANAGEMENT OF ARSHAS.”
Here with I am enclosing completed proforma of Synopsis for registration of the dissertation.
Thanking you,
Place: Davangere Yours faithfully,
Date: 15-10-2008 (DR. SUDARSHAN M.M.)
RAJIV GANDHI UNIVERSITY OF HEALTH SCEINCES, BANGALORE, KARNATAKA.
ANNEXURE – II
COMPLETED PROFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION
1.Name of the Candidate : Dr .SUDARSHAN M. M.
And Address 1ST YEAR M.S. (Ayu.)
(In Block letters) A/P: BHOJ.
TAL:CHICKODI
DIST:BELGAUM
STATE:KARNATAKA
PIN:591263
2. Name of Institution AYURVEDIC MEDICAL COLLEGE &
PG CENTRE,
NEAR BATHI LAKE, P.B.ROAD,
DAVANGERE – 577566.
3. Course of Study AYURVEDA DHANWANTRI,
M.S.(Ayu.) IN SHALYA TANTRA
4. Date of Admission 30th MAY 2008
5. Title of Topic “A CLINICAL COMPARATIVE STUDY ON CHINCHA KSHARA SUTRA AND APAMARGA KSHARA SUTRA IN THE MANAGEMENT OF ARSHAS.”
6. BRIEF RESUME OF INTENDED WORK:
6.1 Need for the study
Acharya Sushruta has mentioned Arshas1 as one among asthamahagadas which gives troublesome pain like an enemy.2
Due to modern life style changes and sedentary occupation and other causative factors too, the hemorrhoids are extremely common lesions affect about 5% of the general population.3 Which interrupts the patients day today activities, so there is a need for effective and safe remedy to overcome from this dreadful condition.
Inspite of different medico-surgical modalities its prognosis for complete cure is still obscure due to operative and post operative complications.4
Acharya Sushruta has explained kshara karma is one among the four different treatment modalities for arshas.5 As kshara sutra is a medicated thread having simultaneous effect of cutting and healing 6 with less complications. Its advantages include minimum hospitalization, less of anaesthesia, cost effective with better results.
Various clinical trials have been done in the management of arshas by different kshara sutra. Now an attempt is made to evaluate the clinical comparative efficacy of two different kshara sutra like Chincha kshara sutra and Apamarga kshar sutra in Arshas, I would intend this study.
6.2.REVIEW OF THE LITERATURE:
1. Nidana,Samprapti, and Lakshan of Arshas is reviewed in :
a. Sushruta Samhita -Nidana Sthana – 2nd Chapter
b. Charaka Samhita –Chikitsa Sthana – 14th Chapter
c.In Asthtanga Hridya Nidana Sthana 7th chapter.
d. Madava Nidana 5th chapter .
2.kshara karma for Arshas is reviewed in :
a.Sushrutha Samitha ,Chikitsa Sthana 6th chapter , 1st shloka
b. Sushrutha Samhita ,Sutra Sthana 11th chapter,7th shloka
c.Charaka Samhita, Chikitsa Sthana 14th chapter,33rd shloka
3. The description of ‘Chincha kshara’ is found in:
a. Bhava prakash nigantu – pratham khand- Haritakyadi varga – Shloka No. 258th.
b. Ayurveda Sarasangraha –kshara lavanadi varga.
4. The description of ‘Apamarga kshara’ is found in:
a. Chakradatta– 5th Chapter – Shloka No. 9th.
b. Rasa tarangini -14th Chapter – Shloka No. 70-71th.
5. The description of ‘ kshara sutra’ is found in:
a. Sushruta Samhita –Chikitsa Sthana – 17th Chapter Shloka No. 29-33.rd
b. Bhaisajya Ratnavali– 9th Chapter Shloka No. 35th,271-272nd.
PREVIOUS WORKS DONE :
1. Sharma A.L- Arsha chikitsa mei vibhinna kshara sutra ka tulnatmaka adhyaya.-1990-National Institute of Ayurveda, Rajasthana University, Jaipur.
2. Reddy Prasanna kumar – A clinical comparative study on the management of Arsha – Prolapsed Pile by transfixation with tankana kshara sutra 1996.-Dr.B K R R Govt. Ayurveda College, A.P. University ,Vijayawada- Hyderabad.
3. Mini P .A.-Clinical study on the effect of Apamarga kshara in the management of Arsha -1999- Govt. Ayurvedic College, Kerala University, Thiruvananthapurum .
6.3 OBJECTIVE OF THE STUDY:
· To evaluate the efficacy of Chincha Kshara Sutra in group - A patients.
· To evaluate the efficacy of Apamarga Kshara sutra in group-B patients.
· To evaluate the comparative efficacy of both the groups.
7. MATERIELS AND METHODS:
7.1. Source of Data:
a. The study will be carried out in multi centre :OPD and IPD patients of Ayurvedic medical college and hospital- AMCH and Anada Theertha Memorial Hospital –ATMH,Davangere.
b. The special camps conducted in AMCH,andATMH will be taken for study .
7.2 Method of collection of data :
A detail examination of patient will be done and the study will be carried out on the patients irrespective of sex, occupation etc .
Inclusion criteria:
· Clinically diagnosed cases of Arshas.
· Patients aged between 18-50 years will be selected.
Exclusion criteria:
· Arshas with complications and other anorectal disorders .
· Patients suffering from systemic diseases like Diabetes Mellitus,Hepatitis –B ,Tuberculosis, HIV, uncontrolled hypertension, Anaemia, and Bleeding disorders etc .
Study Design : Comparative Clinical Study.
Group-A / Group –BPurvakarma: Examination of patient ,consent and patient preparation etc. / Purvakarma: Examination of patient, consent and patient preparation etc .
Pradhan karma: Infiltration of local anaesthesia and Ligation of chincha kshara sutra etc. / Pradhan karma: Infiltration of local anaesthesia and Ligation of Apamarga kshara sutra etc.
Paschata karma:Switz bath and Triphala choorna etc. / Paschata karma: Switz bath and Triphala Choorna etc.
Type of kshara sutra. / Chinha / Apamarga
Follow up days / Alternate days until pile mass falls off and then once in a
week for next three weeks. / Alternate days until pile mass falls off and then once in a
week for next three weeks.
Assessment of results:
Depending upon subjective and objective criteria assessment of the response will be made.
PARAMETERS OF STUDY:
Subjective criteria:
Bleeding:
- Present
- Absent
Pain:
- Present
- Absent
Itching:
- Present
- Absent
Objective criteria:
Pile mass:
- Present
- Absent.
7.3 Does the study requires any investigation or interventions to be conducted on patients or other animals? If so describe briefly.
The study will be conducted on patients suffering from arshas only.
Investigations:
Hb% ,CT .BT
Blood grouping
Rhesses factor
VDRL
HIV
Biopsy – if necessary etc. .
7.4. Has ethical clearance been obtained from your institution in case of 7.3?
Yes, certificate enclosed.
Particulars / Days1 / 2 / 3 / 4 / 5 / 6 / 7 / 8 / 9 / 10
1 / History recording, P/R examination etc.
2 / Investigations Hb%,CT,BT etc.
3 / Ligation of Chincha Kshara sutra
4 / Ligation of Apamarga Kashara Sutra.
5 / Follow up until mass falls
6 / Observation follow up for next 3 weeks
7 / Findings
Statistical analysis: Obtained data will be analysed by applying applicable tests.
Discussion: Obtained data will be discussed in detail.
Conclussion: After thorough study of the data unbiased conclusion will be drawn.
8. List of references:
1. Maharshi Susrutas sushruta samhita, sutra sthana, Chapter 33rd, sloka No. 4th, page no.126, with the Ayurveda tatva sandipika commentary by kaviraj shastri ambikadutta.
2. Maharshi Charaka’s Charaka Samhita, chikitsa sthana chapter 14th with vaidlya manoruma hindi commentary by Acharya Vidhyadhar Shukla by Prof. Ravi. Dutt.Tripathi Varanasi.
3. Robbins and cortron pathologic basis of disease, 7th edition, page.no. 854.
4. Bailey and Loves, Short practice of Surgery, 61st chapter, page no. 1132.
5. Maharashi Susrutas sushruta samhita, sutrasthana, Chapter 6th, Shloka no 3rd, page no.36 ,with the ayurvedatatva sandipika commentary by kaviraj shashtri Ambika data.
6. Maharashi Susrutas sushruta samhita, sutrasthana, Chapter 4th, 3-5 sloka, with sushruta vimarshani hindi commentary by Acharya Ananat Ram Sharma.
7. S.Das concise text book of surgery, 54th Chapter ,page no. 1061.
8. Manipal Manual of Surgery, 31st Chapter,page no.527.
9. Signature of the student :
10. Remark of the Guide :
11. Name & Designation of
11.1 Guide : Dr. Dayanand S. M.S. (Ayu.)
Professor, Department of Post Graduate Studies in Shalya Tantra, Ayurvedic Medical College & PG Centre, Davangere 577566.
11.2 Signature :
11.3 Co-Guide : Dr. Bharathi D.A. M.S. (Ayu)
Professor, Department of Post Graduate Studies in Shalya Tantra, Ayurvedic Medical College & PG Centre, Davangere 577566
11.4 Signature :
11.5 Head of the department : Dr. Manjunath S. M.D. (Ayu.)
Professor, Department of Post Graduate Studies in Shalya Tantra, Ayurvedic Medical College & PG Centre, Davangere 577566.
11.6 Signature :
12.1 Remark of the Chairman :
and Principal.
12.2 Signature :
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