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RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES
BANGALORE, KARNATAKA

COMPLETED PROFORMA FOR REGISTRATION OF SUBJECT FOR
DISSERTATION

“CLINICAL EVALUATION OF INDRASHANI CHOORNA IN MANAGEMENT OF
PANDU W. S. R TO IRON DEFICENCY ANAEMIA”

 BY

Dr. KAVERI. V. RAM B.A.M.S

DEPT. OF P.G. STUDIES IN KAYACHIKITSA

A.L.N.RAO MEMORIAL AYURVEDIC MEDICAL COLLEGE AND P.G. CENTRE KOPPA – 577126

 GUIDE:

Dr. DEBAJIT BHATTACHARYYA M.D (Ayu)

PROFFESSOR AND HEAD OF DEPT. OF P.G. STUDIES IN KAYACHIKITSA, A.L.N.RAO MEMORIAL AYURVEDIC MEDICAL COLLEGE AND P.G. CENTRE KOPPA – 577126

2010-2011
A.L.N.RAO MEMORIAL AYURVEDIC MEDICAL COLLEGE AND P.G. CENTRE

KOPPA-577126
CHIKMAGALUR DISTRICT, KARNATAKA
RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES
KARNATAKA BANGALORE
ANNEXURE II

PROFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATION

  1. Name of the candidate and address (in block letters)  :   KAVERI.V.RAM    DEPT.OF P.G.STUDIES IN KAYACHIKITSA, A.L.N.RAO MEMORIAL AYURVEDIC MEDICAL COLLEGE AND P.G.CENTRE, KOPPA 577126, CHICKAMAGALUR DISTRICT KARNATAKA

Permanent Address        :           DR.KAVERI.V.RAM

D/O K.SIVARAMAN NARMADA BHAVAN SASTHAMCOTTA (P.O) KOLLAM (DIST)

PIN 690521

  1. Name of the Institution :           L.N.RAO MEMORIAL AYURVEDIC MEDICAL COLLEGE AND P.G.CENTRE KOPPA-577126. CHICKAMAGALUR DISTRICT
  1. Course of study and subject: AYURVEDA VACHASPATI M.D. (AYURVEDA) IN KAYACHIKITSA
  1. Date of Admission :           16th SEPTEMBER, 2010 of course
  2. Title of the Topic :           “CLINICAL EVALUATION OF INDRASHANI CHOORNA IN MANAGEMENT OF PANDU W. S. R TO IRON DEFICENCY ANAEMIA”
  1. BRIEF RESUME OF THE INTENDED WORK:

6.1NEED FOR STUDY:

Anaemia is a condition in which the Haemoglobin content of the blood is lower than normal as a result of a deficiency of one or more essential nutrients regardless of the cause of  such deficiency1. If the same is resulted by deficiency of iron it is called as Iron Deficiency Anaemia(IDA)2. Anaemia is most prevalent in the under developed and developing countries especially in the economically backward and working class people, due to the nutritional deficiency and unhygienic food. The incidence of anaemia is highest among women and children, varying between 60 – 70%. Iron Deficiency Anaemia is the most common type of anaemia worldwide. In developed countries, one third of the women in their child bearing age suffer from Iron Deficiency Anaemia3.

In Ayurveda Iron Deficiency Anaemia can be considered as Panduroga as it displays many features in common with a collection of signs and symptoms that are typically diagnosed as Iron Deficiency Anaemia. The cardinal feature of Panduroga is Pandutwa. According to Acharya Charaka, it is one among the Rasavaha Srotodushti Lakshanas4 and according to Acharya Sushrutha as one among the Raktavaha Srotodushti Lakshanas5. Anaemia in moderate form, presents itself with symptoms like fatigue, loss of appetite, weakness, breathlessness and palpitation particularly with physical exertion and pallor of the skin and the mucous membrane. Further Iron Deficiency may impair cellular responses and immune functions to become susceptible to infections.

Number of single drugs and formulations has been attempted by research initiatives seeking holistic management of Panduroga, still there is a scope for innovative, safer and cost- effective formulation in the disease management.

For the present study, “Indrashani Choorna” mentioned in Choorna prakarana of Sahasrayoga, has been selected, which comprises of Tila, Pippali, Badara, Madhu, Makshika, Ayas, Shunthi and Sita6. The research hypothesis is that, “Indrashani choorna” is helpful in the management of Panduroga w.s.r. to Iron deficiency Anaemia.

REVIEW OF LITERATURE:

A thorough review of classical Ayurvedic texts including Brihatrayee and Laghutrayee, shall be made to collect all the relevant data and information relating to the study. Present time journals including websites and contemporary medical books also shall be referred for the study.

  1. Charaka Samhitha – Chikitsa sthana 16th Chapter4
  2. Susruta Samhitha – Uttara tantra 44thChapter 5
  3. Astanga Sangraha – Nidana sthana 18th, Chikitsa sthana 13th Chapter
  4. Astanga Hridaya – Chikitsa sthana 16th Chapter
  5. Sahasrayogam 13th Prakarana6
  6. Dravyaguna vijnana – Dr J L N Shastry7
  7. Ayurvedic Pharmacopeia of India
  8. Davidson’s Principles and practice of Medicine8
  9. Macleod’s Clinical Examination9
  10. Harrison’s Principles of Internal Medicine10
  11. Ross and Wilson-Anatomy And Physiology in Health and Illness
  12. Hutchison’s clinical methods11
  13. Text Book of Pathology12
  14. Indian Medicinal Plants, a compendium of 500 species13

PREVIOUS WORK DONE 

Some of the research works done on Panduroga are:

  1. Deshapande swati S-Clinical study of Panduroga and its managment with mandoora vataka.A V Samhitha ayurveda college, 2000.
  2. Vinay Mohan G-The study of managment of Guda-Hareetaki in the management of PandurogaGovernment Ayurveda Collage,AP University,Hydrerabad 2001
  3. Anuradha D – Clinical study on the effect of triphala Mandoora yoga in Panduroga, GVT Ayurveda college,hyerabad.2004
  4. Jaiswal Vipul – Efficacy of Ashta-Dashanga Loha in the managment of Pandu, College of ayurveda and research centre Pune university,2005

OBJECTIVES OF THE STUDY:

  1. To assess the efficacy of Indrashani choorna in Panduroga (IDA)
  2. To carryout comprehensive literary work covering classical and modern aspect of the disease Panduroga (IDA)

7.   MATERIALS AND METHODS

  • Source of data:
  • Literary source:

A complete review of all the classical literatures & contemporary system of medicine bearing the description related to the disease Panduroga (IDA) shall be made, so as to obtain the theoretical data for the present study, also review of all the relevant literatures shall be made to obtain references related to the formulation w.r.t the preparation, dosage etc., required for the study.

b.  Pharmaceutical source:

The formulation Indrashani Choorna selected for the present research work shall be prepared in the pharmacy attached to A. L. N. Rao Memorial Ayurveda Medical College and Hospital, Koppa as per the textual reference.

c.  Clinical source:

Patients of either sex attending OPD and IPD of A. L. N. Rao Memorial Ayurveda Medical College and Hospital, Koppa and its associated Hospitals who are diagnosed as Panduroga (IDA) will be selected for study.

Methods of collection of data (Including sampling procedures if any).

For the present study 30 patients of either sex of age group 16-60yrs diagnosed as Panduroga (IDA) will be selected from OPD and IPD of A. L. N. Rao Memorial Ayurveda Medical College Hospital, Koppa and its associated Hospitals. The patients will be selected strictly abiding to the inclusion and exclusion criteria. The patients thus selected will be grouped into a single trial group, of group size 30.

The trial group will be administered “Indrashani Choorna”, 2gm twice daily  before food (morning and night) and the duration of the treatment will be 30 days. The ingredients of the formulation will be properly identified by respective department of the institution.

The subjective parameters for assessment of the present study will be the classical lakshanas of Panduroga (IDA) according to Ayurvedic texts i.e. Panduta, Arohanayasa, Hriddrava, Shrama, Gourava, Bhrama, Aruchi, Agnimandya and Dourbalya. The objective parameters for assessment will be laboratory investigations of blood for Haemoglobin percentage and Peripheral Blood smear.

The patient will be thoroughly assessed through the subjective parameters as well as objective parameters, the detailed history and examination findings will be noted  before, during and after the scheduled treatment. The changes in signs and symptoms will be documented at an interval of 15 days in a specially designed Case Proforma.

Study Design:    Standard single blind clinical study with pre trial and post trial design is adopted.

A.   INCLUSION CRITERIA:

  1. Patients of both sexes with in the age group of 16 – 60 years
  2. Patients presenting classical signs and symptoms of Panduroga(IDA)
  3. Haemoglobin within the range of 7-10 gm%
  4. Blood picture of microcytic hypochromic (IDA)

B.   EXCLUSION CRITERIA

  1. Patients of age below 16 yrs and above 60 yrs
  2. Anaemia due to causes other than Iron Deficiency
  3. IDA due to other disorders like Hepatic Cirrhosis, Rheumatoid Arthritis, Uremia and Malignant Disorders
  4. Patients associated with other systemic disorder like heart diseases, tuberculosis, diabetes mellitus
  5. IDA in Pregnancy and lactating women
  6. Mrid-bhakshanajanya pandu

Treatment schedule: 

Sample size30 patients
MedicineIndrashani Choorna
Dose2mg twice daily before food
AnupanaHoney q.s.
Total Duration30 days

Note:

  • Post treatment Follow up study will be undertaken for 30 days.
  • During the period of study the patients will be advised to follow Pathyapathya

Assessment of response:

Subjective parameters-

The classical Laxanas of Panduroga namely Panduta, Arohana ayasa, Shrama, Gourava, Bhrama , Aruchi and Agnimandya.

The Objective parameters

Haemoglobin percentage, and peripheral blood smear (IDA). The scoring will be given for the subjective and objective parameters. The assessment will be done on the basis of result obtain from statistical analysis done by paired student ‘t’ test.

Does the study require any investigations or interventions to be conducted on patient or humans or animals? If so please describe briefly.

Yes, the study will be a human clinical study

1.  INVESTIGATIONS

  1. Blood Haemoglobin percentage
  2. Peripheral blood smear

Intervention: TRIAL GROUP

Sample size30 patients
MedicineIndrashani Choorna
Dose2 mg twice daily before food
Total Duration30 days
Anupanahoney q.s.

 

Has ethical clearance been obtained from your institution in case of 3?

Yes, the ethical clearance has been obtained through the ethical committee formulated in the institution.

8 REFERENCES

  1. K – Park’s Text book of preventive and social medicine,ch-10 Banarasi Das Bhanot, 2000, Jabalpur, 16th edition, 431 Pg
  2. Sembulingam& Prema.Sembulingam Essentials of Medical Physiology, Jaypee brothers medical publishers(p) Ltd, New Delhi, Fourth edition, 46 Pg
  3. Haslell Christopher, Chilvers Edwin.R, Boon Nicholas.A, Colledge Nicki.R-Davidson’s Principles and Practice of Medicine, Churchill Livingstone, ELNPLS -2002, 19th edition, 891, 902, 916 Pg
  4. Acharya Agnivesa – Charaka Samhitha, Sutrasthana, Ch – 7, Elaborated BY Charaka and Dridhabala with Ayurveda Dipika commentary by Chakrapani Dutta, edited by Vaidya Yadavji Trikamji Acharya,Chaukamba Sanskrit Sansthan ,2002,Varanasi ,179 Pg
  5. Acharya Susrutha- Susrutha Samhitha,sareerasthana ch- 9 ,with Nibandha samgreha commentary by Dalhanacharya,edited by Yadavji Thrikamji Acharya from beginning to 9th Chapter of Chikithsa sthana and the rest by Narayan Ram Acharya Kavyathirtha, Chaukamba Orientalia, 2002, 7th edi, Varanasi.386 Pg
  1. Sahasrayoga – Sanskrit hindi commentary by D V Pandith Roa,kendriya ayurveda and sidha parishith anuvad,175pg, 13th chapter
  2. J.L.N.Sastry,Dravya guna vijnana ,study of essentials of medicinal plants in ayurveda.452, 882, 669 Pg
  3. Haslell Christopher, Chilvers Edwin.R, Boon Nicholas.A,Colledge Nicki.R-Davidson’s Principles and Practice of Medicine,Churchill Livingstone, ELNPLS -2002,19th edition, 891, 902, 916 Pg
  4. Macleod- Macleod’s Clinical Examination, Section 1 ,Ch-2,edited by Graham Dougles, Fiona Nicol, Colin Roberston,2005,London,11th edition, 42 Pg
  5. W. Adamson el at Harrison’s Principle of internal Medicine,Heamatopoietic Disorders,Section 2,The Mc Graw Hill Companies,2005,USA,16th edition ,vol 1,586 Pg
  6. Hutchison- Hutchison’s Clinical Methods, Part-3,Ch-21,edited by Micheal Swash, W .B. Saunders, 2002, London,21st edition, 420Pg
  7. Harsh Mohan, Text book of Pathology, Section 2, Ch-12, Jaypee Brothers, 2002, New Delhi,325 Pg
  8. Ram P.Rastogi, Compendium of Indian medicinal plants-Vol-5,1990-1994,913,775,651Pg