RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,

KARNATAKA, BENGALURU-560041

REGISTRATION OF SUBJECT FOR DISSERTATION

BY

Dr. RAKESH.S.R

FOR THE DEGREE OF AYURVEDA DHANVANTARI

M.S (AYURVEDA) IN SHALYATANTRA

TITLE OF THE TOPIC:

A STUDY ON “COMBINED EFFECT OF SIRAVYADHA AND

ARAGVADHA PATRA LEPA” IN THE MANAGEMENT OF KITIBHA

W.S.R.TO PSORIASIS ’’

GOVERNMENT AYURVEDA MEDICAL COLLEGE

DHANVANTARI ROAD

BENGALURU – 09

KARNATAKA

From:

Dr. RAKESH S.R.I MS (Ayu),Dept. of P.G. Studies in Shalya tantra,Government Ayurveda Medical College,Bengaluru-560009To:

The REGISTRAR,

Rajiv Gandhi University of Health Sciences,

Bengaluru-560041

Through

THE PRINCIPAL AND H.O.D. OF P.G. STUDIES IN SHALYATANTRA,GOVERNMENT AYURVEDA MEDICAL COLLEGE, BENGALURU- 560009.

Respected Sir,

Sub: - Submission of completed proforma for registration of subject for

Dissertation.

With referenced to above subject, I request you to kindly register the below mentioned

subject against my name for Dissertation by the Rajiv Gandhi University of Health

Sciences, Bengaluru for the partial fulfilment of MS (Ayu) in Shalyatantra.

TITLE OF DISSERTATION:

A STUDY ON“ COMBINED EFFECT OF SIRAVYADHA AND ARAGVADHA

PATRA LEPA” IN THE MANAGEMENT OF KITIBHA W.S.R.TO PSORIASIS

I am herewith enclosing completed proforma for registration of subject for Dissertation.

Thanking you,

Yours faithfully,

Place: Bengaluru

Date: Dr. RAKESH .S.R

2

RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,

BENGALURU,KARNATAKA

ANNEXURE-II

PROFORMA FOR REGISTRATION OF SUBJECT FOR

DISSERTATION

1. NAME OF THE CANDIDATE : DR.RAKESH.S.R.

AND ADDRESS S/O RAMAKRISHNEGOWDA.V

C/O RANGADHAMAIHA.T.

MATHRUKRUPA.NO.12

GNANABHARATI WARD129.

VISHWANIDHAM POST

ANNAPOORNESHWARI

NAGARA

HEALTH LAYOUT, 1ST CROSS.

BENGALURU-560091

2. NAME OF THE INSTITUTION : GOVERNMENT AYURVEDA

MEDICAL COLLEGE,

DHANVANTARI ROAD,

BENGALURU-560009.

3. COURSE OF STUDY : AYURVEDA DHANVANTARI,

AND SUBJECT M.S.(AYU) SHALYATANTRA

4. DATE OF ADMISSION TO : 08.10.2012

THE COURSE

5. TITLE OF DISSERTATION : A STUDY ON “ COMBINED

EFFECT OF SIRAVYADHA AND

ARAGVADHAPATHRA LEPA”

3

IN THE MANAGEMENT OF

KITIBHA W.S.R.TO PSORIASIS.

6. BRIEF NOTE OF THE INTENDED WORK :

6.1 NEED FOR THE STUDY:

Skin, the outermost covering of the body acts as an insulator and protector

of the body and also adds beauty to it. Every human being living on this Earth wants

to have good looking skin. Skin diseases not only destroy the normal structure and texture

of the skin and gives it an ugly look, but also affects the normal health of a person.

To overcome this, Ayurveda has given importance to skin disease and reference

of Kushta can be found since Vedic period. Even during Samhita Period, details of

Kushta can be found and have categorised it under Mahagada. Kushta has been classified

as Maha Kushta and Kshudra Kustha. Kitibha is one among Kshudra Kustha.

Considering the sites of lesions such as scalp, elbows, knees, the features

shyavaarunavarna, kharasparsha, rookshata and kandumata, vrutta, creating sound on

scratching, rithu anupoorva roga vyapti, that is the attacks are also liable to occur more

commonly in winter and rainy seasons, frequent occurrence, the kitibha resembles with

psoriasis . Psoriasis is a complex disorder that negatively impacts the quality of life, it is a

“flaming scabbiness from head to toe” – RUSSEL

Psoriasis is a non-infectious, chronic inflammatory disease of the skin,

characterised by well-defined erythematous plaques with silvery scale, with a predilection

for the extensor surfaces and scalp and chronic fluctuating course. It is commonest skin

disease in all age groups all over the world with incidence rate of 1to-2% seen in practice;

this is associated with high rate of remissions.

Modern science consists of oral and topical corticosteroids such as emollients,

topical immune modulators, vitamin-D agonist, weak tar or dithranol preparations, uv

therapies such as UVB, and photo therapy like PUVA, the side effects of these are

thinning of skin, stretch marks, unwanted hair growth, redness of skin, carcinogenic 4

effect. In spite of this, psoriasis is challenging to treat and reoccurrence is common,

which in turn affects the physical, psychological, social and Economical conditions of the

patient. Hence, these draw backs of modern science have stressed upon the necessity for

an effective measure, which can treat the condition without disturbing the structural

integrity of the skin and as used to minimise the reoccurrence, there is need for therapy

which can fill the void created by those, which is vague.

Ayurveda text include kayashodhana, raktamokshana and shamana aushadhas.

The Siravyadhana is a unique blood letting, therapeautic procedure mentioned in classics,

specially indicated for kusta and twak vikaras associated with raktha dusta janya vyadhis,

Rakthamokshana by siravyadhana is opted because it is easiest procedure, less expensive,

and hospitalisation is not needed to patient. As the raktha dusti being generalised throught

the body, siravyadhana becomes the most suitable shodhana therapy, this is followed by

aragvadha patra lepa, as the lepa forms the base in managing all types of external

disorders. Here the aragvadha drug has kustghna property, with kapha and pitta

doshaghnata and ability to cure the disease of vata origin thus acting on all tridoshas.In

general,there will be involvement of all three doshas, rasa,raktha,mamsa and ambu(lasika)

in the origin of kushtarogas.

Considering all the above facts the work is focussed on

A STUDY ON “COMBINED EFFECT OF SIRAVYADHA AND

ARAGVADHA PATRA LEPA IN THE MANAGEMENT OF KITIBHA

W.S.R.TO PSORIASIS’’

5

6.2 REVIEW OF LITERATURE:

Ayurvedic review on Kitibha:

Nidana and samprapthi:

ÍqÉjrÉÉWûÉUÉcÉÉUxrÉ ÌuÉzÉåwÉÉSaÉÑÂÌuÉ®ÉxÉÉiqrÉÉeÉÏhÉÉïÌWûiÉÉÍzÉlÉ: xlÉåWûmÉÏiÉxrÉ uÉÉliÉxrÉ uÉÉurÉÉrÉÉqÉaÉëÉqrÉkÉqÉïxÉåÌuÉlÉÉå aÉëÉqrÉÉlÉÑmÉÉæSMüqÉÉÇxÉÉÌlÉ uÉÉ mÉrÉxÉÉÅpÉϤÉhÉÉ rÉÉå uÉÉ qÉ‹irÉmxÉÔwqÉÉÍpÉiÉmiÉ: xÉWûxÉÉ NûÌSïÇ uÉÉ mÉëÌiÉWûÎliÉ, iÉxrÉ ÌmɨÉzsÉåwqÉÉhÉÉæ mÉëMÑüÌmÉiÉÉæ mÉËUaÉë½ÉÌlÉsÉ: mÉëuÉëÑ®ÎxiÉrÉïaaÉÉ: ÍxÉUÉ: xÉÇmÉëmɬ xÉqÉÑ®ÕrÉ oÉɽÉÇ ÇqÉÉaÉïÇ mÉëÌiÉ xÉqÉliÉÉ̲ͤÉmÉÌiÉ, rÉ§É rÉ§É cÉ SÉåwÉÉå ÌuÉͤÉmiÉÉå ÌlɶÉUÌiÉ iÉ§É iÉ§É qÉhQûsÉÉÌlÉ mÉëÉSÒpÉïuÉÎliÉ, LuÉÇ xÉqÉÑimɳÉxiuÉÍcÉ SÉåwÉÉåxiÉ§É iÉ§É cÉ mÉËUuÉëÑ먂 mÉëÉmrÉÉmÉëÌiÉÌ¢ürÉqÉÉhÉÉåÅprÉliÉUÇ mÉëÌiÉmÉkrÉiÉå kÉÉiÉÑlÉÍpÉSÒwÉrÉlÉ||In the person with faulty diet and behaviour particularly eating heavy, incompatible,

unsuitable and unwholesome items and also during indigestion; or indulging in physical

exercise and sexual intercourse after intake of sneha (unctuous substance) or emesis; or

frequently eating meats of domestic, marshy and aquatic animals with milk; or taking dip

in water after having been heated by fire (or the sun); or by suppressing vomiting

suddenly increased vayu carrying aggravated pitta and kapha reaches the obliquely

moving channels further aggravates and scatters them allaround towards the external

passage; wherever scattered dosa moves patchesappear;thus dosa started in skin further

increases and, if not treated, goes inwards vitiating dhatus.1(Ni.Ch.5. sl.3 p.36)

ÌuÉUÉåÍkÉåųÉmÉÉlÉÉÌlÉ SìuÉÎxlÉakÉaÉÑÂhÉÏ cÉ| pÉeÉiÉÉqÉÉaÉiÉÇ NûÍkÉïÇ uÉåaÉÉǶÉÉirÉÉlmÉëÌiÉblÉiÉÉqÉ||4||urÉÉrÉÉqÉ qÉÌiÉxÉÇiÉÉmÉqÉÌiÉpÉÑYiuÉÉåmÉxÉåÌuÉlÉÉqÉ| ÍzÉiÉÉåwhsÉÇbÉlÉÉWûÉUÉlÉ ¢üqÉÇ qÉÑYiuÉÉ ÌlÉwÉåÌuÉhÉÉqÉ||5||

6

bÉqÉï´ÉqÉpÉrÉÉiÉÉïlÉÉÇ SìÓiÉÇ ÍzÉiÉÉqoÉÑxÉåÌuÉlÉÉqÉ| AeÉÏhÉÉïkrÉÍzÉlÉÉÇ SìÓiÉÇ mÉÇcÉMüqÉÉïmÉcÉÉËUhÉÉqÉ||6||lÉuÉɳÉSÍkÉqÉixrÉÉÌiÉsÉuÉhÉÉqsÉÌlÉwÉåÌuÉhÉÉqÉ| qÉÉwÉqÉÑsÉMüÌmɹÉlÉÉÌiÉsɤÉÉUaÉÑQûÉÍzÉlÉÉqÉ||7||urÉuÉÉrÉ crÉÉÌmÉeÉÏhÉãïA³Éå ÌlÉSìÉÇ cÉ pÉeÉiÉÉÇ ÌSuÉÉ| ÌuÉmÉëÉlÉ aÉÑÂlÉ bÉwÉïrÉiÉÉÇ mÉÉmÉÇ MüqÉï cÉ MÑüuÉïiÉÉqÉ||8||Those who habitually take incompatible food items and liquids, unctuous and heavy

substances, suppress the natural urges particularly of vomiting, are exposed to physical

exercise and intense heat after eating excessively, use cold, hot, lightening measures and

diet against the prescribed order, apply cold water immediately after intensive exposure to

sun, exertion and fear, take food during indigestion and when previous meal is not

properly digested, use contraindicated items while undergoing pancakarma therapy, use

excessively new cereals, curd, fish, salt and sour substances, indulge in eating black gram,

radish, (rice) flour preprations, sesamum, milk and jaggery, perform sexual intercourse

during indigestion, sleep regularly in day, insult Brahmanas, teachers (and other

respectable persons) and indulge in sinful activities (fall prey to leprosy and other skin

disorders).2(Chi. Ch.7 sl.4-8 p.125)

uÉÉiÉÉSrÉx§ÉrÉÉå SÒ¹xiuÉaÉë£Çü qÉÉÇxÉÉqÉqoÉÑ cÉ| SÒwrÉrÉÎliÉ xÉ MÑü¹ÉlÉÉÇ xÉmiÉMüÉå SìurÉxÉÇaÉëWû:||9|| AiÉ: MÑü¹ÉÌlÉ eÉÉrÉliÉå xÉmiÉ cÉæMüÉSzÉåuÉ cÉ| lÉ cÉæMüSÉåwÉeÉÇ ÌMüÎlcÉiÉ MÑü¹Ç xÉqÉÑmÉsÉprÉåiÉå||10||

The three dosas (vata etc.) being vitiated affect the skin, blood, and lymph, thus

these seven are the pathogenic materials for leprosy and other skin disorders.

Henceforth seven types (of proper leprosy) and eleven types (of other skin disorders)

arise. No leprosy or other skin disorder is caused by a single dosha .2(Chi.Ch.7 sl.9-

10.p.125)

Laxanas of Kitibha:

श्यावं कि�णखरस्पर्श� परुषं कि�टि�मं स्मृतम् ।

Kitima type of kushta is charecterised as follows:

(1)It is blackish brown in colour;

7

(2)It is rough in touch like a scar tissue;and

(3)It is hard to touch.3(Chi.Ch.7sl.22.p.325)

कि�टि�भं पुनः ।रूक्षं कि�णखरस्पर्श �ण्डूमत्परुषासि&तम् ।Kitibhakushta has dry skin; rough, and hard, creating sound on scratching,hard and

black.3 (Ni. Ch.14. sl.20-21.p.36)

कि�टि�भं यत् स्राकिव वृतं्त घनमुग्र�ण्डू ।तत् स्निस्नग्ध�ृष्णं कि�टि�भं वदन्ति1त ॥

That which is discharging, round, dense, severely itching and oily black is known as

kitibha.2 (Ni.Ch.5.sl.14.p.39)

Dosha pradhanyatha:

AÂ: xÉÍxÉkqÉ UMüxÉÉ qÉWûŠ rÉŠæMüMÑü¹Ç MüTüÉeÉÉlrÉÉÌlÉ |uÉÉrÉÉå: mÉëMüÉåmÉÉiÉç mÉËUxÉmÉïqÉåMÇü zÉåwÉÉÍhÉ ÌmɨÉmÉëpÉÉuÉÍhÉ ÌuÉkrÉÉiÉ ||

Of these, sthularuska, sidhma, rakasa, mahakustha, and ekakustha are caused by

kapha; parisarpa alone is caused by vata; while the remaining ones are caused by pitta.1

(Ni.Ch.5 sl.16 p.40)

&वा�णिण �ुष्ठाकिन &वाताकिन &किपत्ताकिन &शॆ्लष्माणिण &कि7मीणिण च भवन्ति1त,उत्&न्नतस्तु दोषग्रहणमणिभभवात् ॥

All types of kushta are associated with vata,pitta,kapha and organisms,it is only due to

predominance that causation of one of the doshas is indicated.1(Ni.Ch.5 sl.6 p.36)

चमा�ख्यमे��ुष्टं च कि�टि�मं & किवपाटिद�म् ।�ुषं्ठ चाल&�ं जे्ञयं प्रायो वात�फाधिध�म् ॥Predominant vitiation of one or more doshas in charma, ekakhya, kitima, vipadika and

alasaka are vata and kapha.2 (chi.ch.7sl.29p.326)

8

Chikitsa: 1)Siravyadha:

�ुषॆ्ठ सि&राव्यधस्याभ्यर्हिहIतत्वम्

High suitability of venisection in (cases of )kushta:रक्तोद्भवाकिन �ुष्ठाकिन &धिन्नपातोद्भवाकिन च ॥तस्मात्तेषां प्रथमतः सि&रा�म� किवधीयते ॥ Kushtas(in general) are born due to (vitiation) in blood and also the synergetic

action of the three doshas.It is therefore that venisection(bloodletting) is prescribed for

them at the first step(itself).4( chi.ch.6.sl.39.p.333)

iÉ§É ÎxlÉakÉÎxuɳÉqÉÉiÉÑUÇ rÉjÉÉSÉåwÉmÉëirÉÌlÉMÇü SìuÉmÉëÉrÉqɳÉÇ pÉÑ£üuÉliÉÇ rÉuÉÉaÉÑÇ ÌmÉiÉuÉliÉÇ uÉÉ rÉjÉÉMüÉsÉqÉÑmÉxjÉÉmrÉÉÍxÉlÉÇ ÎxjÉiÉÇ uÉÉ uÉx§ÉmÉûcÉqÉÉïl§ÉuÉsMüsÉsÉiÉÉlÉÉqÉlrÉiÉqÉålÉ rÉl§ÉÌrÉiuÉÉ lÉÉÌiÉaÉÉRÇû lÉÉÌiÉÍzÉÍjÉsÉÇzÉÉUÏU mÉëSåzÉqÉÉxÉÉkrÉ mÉëÉmiÉÇ zÉx§ÉqÉÉSÉrÉ ÍxÉUÉÇ ÌuɱåiÉ || Now, the patient having been uncted and sudated should be given diet, contrary

to the respective dosa, mainly liquids or gruel and, at appropriate time, should be asked to

sit or stand comfortably. Then after fixing with anyone of cloth, skin, inner bark, and

creeper and selecting area of the body neither too hard nor too loose should puncture the

vein with proper instrument.1 (Sa.Ch.8 sl.6 p.207)

qÉÉÇxÉsÉåwÉÑuÉMüÉzÉåwÉÑ rÉuÉqÉɧÉÇ zÉx§ÉÇ ÌlÉSkrÉÉiÉ. AiÉÉåÅljÉjÉÉÅkÉïrÉuÉqÉɧÉÇÌuÉëÌWûqÉɧÉÇ uÉÉ ÌuÉëÌWûqÉÑZÉålÉ, AxjlÉÉqÉÑmÉËU

MÑüOûÉËUMüÉrÉÉ ÌuÉkrÉåSkÉïrÉuÉqÉɧÉqÉ||

In muscular parts, instrument should be inserted as deep as the measure of a

barley grain, otherwise, as measure of half barley or vrihi (rice) with vrihimukha

instrument; on bone, however, operation should be performed with kutharika instrument

as deep as half barley grain.1 (Sa.Ch.8 sl.9 p.209)

9

oÉÍsÉlÉÉå oÉWÒûSÉåwÉxrÉ uÉrÉ:xjÉxrÉ zÉËUËUhÉç:||mÉUÇ mÉëqÉÉhÉÍqÉcNûÎliÉ mÉëxjÉÇ zÉÉåÍhÉiÉqÉÉå¤ÉÉhÉ ã||

In an adult person who is strong and has plenty of dosa, the maximum limit of

blood-letting is one prastha.1 (Sa.Ch.8 sl.16 p 210)

AÉzÉÑ®Ç xÉëÉuÉrÉå°ÕrÉ: xÉÉrÉqÉylrÉmÉUåÅÌmÉ uÉÉ |xlÉåWûÉåmÉxMÚüiÉSåWûxrÉ mɤÉÉ²É pÉÚzÉSÒÌwÉiÉqÉ ||

Vitiated blood should be removed again either in the same evening or the next

day; if the blood is found greatly vitiated (with more quantity of dosas) it should be

removed again after a fortnight, after administering oleation therapy to the body.5

(su.ch.27.sl.44.p.316)

2) Aragwadha pathra lepa:

रै्शरीषी त्व�् पुष्पम् �ापा�स्या राजव्रुक्षपत्राणिण। किपष्टा च �ा�मासिच चतुर्हिवIध: �ुष्ठनुलेप:॥

Application of the paste of either the bark of Shirisha or the flower of Karpasa or the

leaves of Rajavriksha or Kakamachi cures kushta,obstinate skin diseases including

Leprosy.2 (chi.ch.7.sl.96.p.34)

Modern review of Psoriasis:Psoriasis is a non- infectious,chronic inflammatory disease of the skin,charecterised by

well defined Erythematous plaques with silvery scale,with a predilection for the extensor

surfaces and scalp,and a chronic fluctuating course.The clinical course of psoriasis is very

variable.As a general rule,clinical impressions suggest that the ,earlier the age of onset

and the more severe the initial presentation,the more severe the lifetime course of the

disease.6 (p.1287)

Aetiology:

There are two key pathophysiological aspects to the abnormalities in psoriatic plaques:

10

First, the keratinocytes hyperproliferate with a grossly increased mitotic index and

an abnormal pattern of differentiation involving the retention of nuclei in the

stratum corneum (in normal skin the stratum corneum cells do not have nuclei )

Second, there is a large inflammatory cell infiltrate comprising polymorphs, T

cells and other inflammatory cells.

The evidence implicating a key role for an immune pathogenesis relates to :

The assosciation with certain HLA groups (HLA Cw6 )

The success of certain immuno suppressive drugs ( such as cyclosporine ) in

improving the clinical state of the disease.

Reports of the development of psoriasis in recipients of bone marrow transplants

from donors with history of psoriasis.

FACTORS CAUSING FLARE UPS OF PSORIASIS

Trauma

When the condition is erupting lesions apper in areas of skin damage such as scratches or

surgical wounds(kobner phenon)

Infection

β- haemolytic streptococcal throat infections often precede guttate psoriasis

Sunlight

Rarely,UVR may worsen psoriasis

Drugs

Antimalarials,β- adrenoreceptor antagonists(β-blockers ) and lithium may worsen

psoriasis and the rash may ‘rebound’after systemic corticosteroids or potent local

corticosteroids are stopped

Emotion

Anxiety precipitates some exacerbations

Clinical features

Stable plaque Psoriasis

11

This is the most common type. Individual lesions are well demarcated and range from a

few milimtres to several centimetres in diameter.The lesions are red with dry,with a

silvery-white scale,which may be obvious only after scraping the surface.The

elbows,knees and lower back are commonly involved.6(p1288)

Treatment

Treatment can be classed in four broad categories:

easily applied topical agents such as emollients,corticosteroids,vitamin D

agonists,or ‘weak’tar or dithranol preparations

ultraviolet tharapies such as PUVA and UVB

systemic agents such as retinoids or immunosuppressives such as ciclosporin,or

one of a range of new biological therapies(‘biologics’)

intensive inpatient or day-patient care with topical agents and UVR under

medical supervision.6(p1290)

Abbreviation:

p – Inclusive page number

Ni – Nidana sthana

Ch – Chapter

Sl – Shloka

Chi – Chikitsa

Sa – Sarira sthana

Su – Sutra sthana

Pp -- Printed pages

6.3 PREVIOUS WORKS DONE:

1) P.V.Jayasree.Efficacy of Pracchana in the Management of Kitibha.A Clinical

Evaluation.(dissertation). Bangalore: Bangalore university; 1988.

2) Sachin.N.Patil.Management of Kitibha(Psoriasis) by Aragwadha Pathralepa.A

clinical study.(dissertation). Bangalore: Bangalore university; 2000.

3) Durgappa.H .Kitibha kushta and its Management by Aragwadha Pratisaraneeya

kshara lepa-Aclinical study. Bangalore: Rajiv Gandhi University

of Health Sciences; 2004.

12

4) Shankaragouda.S.Patil.A study on clinical efficacy of Jaloukacharana and

Gomutradi lepa in the management of Kitibha.Bangalore:Rajiv Gandhi

University of Health Sciences; 2007.

5) Ravishankar.B.Efficacy of Shirishatwak lepa in the management of

Kitibha.w.s.r. to Psoriasis-A clinical study;2012.

6.4 OBJECTIVES OF THE STUDY:

1) To study the combined effectof Siravyadha followed by Aragwadhapatralepa in

the management of Kitibha.

2) To study the effect of Aragwadhapatralepa in the management of Kitibha.

3) To compare the combined effect of both Siravyadha and Aragwadhapatralepa and

only Aragwadhapatralepa in the management of Kitibha.

7. METHODOLOGY:

7.1 SOURCE OF DATA:

Patients suffering from features of Kitibha will be selected from OPD and IPD of

Sri Jayachamarajendra Institute of Indian Medicine hospital, Bengaluru-09.

7.2 METHOD OF COLLECTION OF DATA:

A total of 40 cases with clinical features of Kitibha shall be selected for the present

study.

INCLUSION CRITERIA:

Patients with classical features of Kitibha namely khandu, kharasparshata,

rukshata,shyavavarnata and parushata will be included.

Chronicity of less than 1 year.

EXLUSION CRITERIA:

Kitibha assosciated with other skin disorders

Any other systemic disorders13

Pregnancy

Age below 16 and above 70 years

SAMPLING DESIGN:

A total of 40 cases of kitibha after considering the above mentioned criteria shall

be included for the study and will be randomly allotted into two groups namely Group-A

& Group-B, each consisting of 20 patients.

C. STUDY DESIGN:

GROUPPOORVA

KARMA

PRADHAN

KARMA

PASCHAT

KARMA

GROUP A

1)Tila yavagu pana.

2)Sthanikaabhyanga

by Tila taila.

3)Nadi sweda.

1)Siravyadha on

1st, 15th & 30th day.

2)Application of

Aragwadhapatra lepa

once daily for 30

days.

Bandha

GROUP B

Application of

Aragwadhapatralepa

once daily for 30 days.

Note:

1) The veins on the forehead, arms and legs are selected to cut and to let out the

blood depending on the severity of the disease.

2) 10 ml of Guggulu thiktaka ghritha is given daily till the completion of treatment

in both the groups.14

3) The observations made with respect to parameters, before the treatment, on 1st

day, on 15th day and on 30th day shall be recorded in the proforma of case sheet

prepared for the study.

4) In cases where total relief would be observed, a duration of 60 days from the day

of completion of treatment would be fixed to observe the possible recurrence.

5) The changes observed with the treatment shall be statistically analysed and

conclusion will be drawn.

6) Suitable pathya and apathya shall be adviced to all the patients.

D. ASSESSMENT CRITERIA:

Subjective parameters:

1.Kandu

Objective parameters:

1.Khara sparshata

2.Parushata

3.Shyava varnatha

4.Rukshata

7.3 INVESTIGATION :No investigation will be conducted for the present

Study

7.4 ETHICAL CLEARANCE: Ethical clearance shall be obtained from ethical

committee, Government Ayurveda medical college,

Bangalore.

8.BIBILIOGRAPHY:

1) Sushrutha.Sushrutha samhita-translated by Priyavrath sharma,

Varanasi:chaukambavivabharathi;vol 2,ed.reprint,2010,pp 695

15

2) Charaka.Charaka samhitha translated by Dr.R.K.Sharma and BhagwanDash.

ed.reprint, Varanasi:chowkhambaSanskritseries office;2010,vol.3.pp 632

3) Vagbhata. Astanga Hridaya- Translated by Prof.K.R.Shrikantha K Murthy,

ed.reprint, Varanasi: Chowkamba krishnadas academy; 2010,vol 2,pp 596

4) Bhela.Bhelasamhitha-translated by K.H.Krishnamurthy.Editor-P.V.Sharma.

reprint, Varanas:Chaukamba visvabharati;year 2005. pp 660

5) Vagbhata.AstangaHridaya.Translated by Prof.K.R.Shrikantha Murthy,ed.reprint.

Varanasi: Chowkamba krishnadas academy;2008, vol 27;pp368

6)Sir Stanley Davidson.Davidson’s Principles & Practice of Medicine-20th ed ,reprint

Edinburg,printed in china published by Nicholas A.Boon, Nicki R.Colledge,

Brain R.Walker, John A.A.Hunter,2008,pp 1381

09 SIGNATURE OF

THE CANDIDATE

10 REMARKS OF THE

THE GUIDE

11 NAME AND DESIGNATION

OF THE GUIDE

Dr.S.M.SRIDHARA RAO. B.S.A.M.,B.A.M.S., M.D ( AYU).,

Professor.Dept. of P.G. Studies in Shalyatantra,Govt. Ayurvedic Medical College,Bangalore – 560 009

11.1 SIGNATURE OF THE GUIDE

16

11.2

NAME AND DESIGNATION

OF HEAD OF THE

DEPARTMENT

DR.R.VIJAYASARATHI. B.S.A.M.,B.A.M.S., M.D(AYU).,

Professor and HOD,Dept. of P.G. Studies in Shalyatantra,Govt. Ayurvedic Medical College,Bangalore – 560 009.

11.3 SIGNATURE OF HOD

12 REMARKS OF THE

PRINCIPAL

12.1 SIGNATURE OF THE

PRINCIPAL

17