takradhara study

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RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES

BANGALORE,KARNATAKA

COMPLETED PROFORMA FOR REGISTRATION OF SUBJECT FOR

DISSERTATION

A COMPARATIVE STUDY OF TWO MODALITIES OF TAKRADHARA

IN ESSENTIAL HYPERTENSION

DR. SUMI S.R

BY

P.G SCHOLAR,

DEPT OF P.G.STUDIES IN PANCHAKARMA,

S.K.A.M.C, H & R.C,

VIJAYANAGAR, BANGALORE-560040

DR. SWATI DESHPANDE

GUIDE:

M.D(AYU),

READER,

DEPT OF P.G STUDIES IN PANCHAKARMA,S.K.A.M.C, H & R.C,

VIJAYANAGAR, BANGALORE-560040

2010 2011


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SRI KALABYRAVESHWARA SWAMY AYURVEDIC MEDICAL

COLLEGE, HOSPITAL & RESEARCH CENTRE, VIJAYANAGAR,

BANGALORE-560040

From,

DR. SUMI S.R

P.G SCHOLAR,

Dept of P.G Studies in Panchakarma,

S.K.A.M.C, H & R.C,

Vijayanagar, Bangalore-560040To,

THE REGISTRAR

Rajiv Gandhi University of Health Sciences,

Bangalore, Karnataka.

Through,

THE PRINCIPAL,

DEAN, PG STUDIES &

H.O.D. OF PG STUDIES IN PANCHAKARMA,

S.K.A.M.C,H & R.C,

Vijayanagar, Bangalore-560040

Respected Sir,

SUB: Submission of completed Proforma for Registration of subject

for Dissertation.

I hereby request you to kindly register the below mentioned subject against my

name for the submission of Dissertation to the Rajiv Gandhi University of Health

Sciences, Bangalore, Karnataka for partial fulfillment of M.D.(Ayu) in Panchakarma.


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Title of the Dissertation:

A COMPARATIVE STUDY OF TWO MODALITIES OF

TAKRADHARA IN ESSENTIAL HYPERTENSION

Here with,I am enclosing completed Proforma of Synopsis for Registration

of subject for Dissertation.

Thanking You

Place:Bangalore

Yours faithfully,

Date:

(Dr.Sumi.S.R)

1) NAME OF THE CANDIDATE: DR. SUMI S.R

ADDRESS: P.G SCHOLAR,

DEPARTMENT OF P.G STUDIES IN

PANCHAKARMA,

S.K.A.M.C, H & R.C,

NO 10, PIPE LINE ROAD,

R.P.C LAYOUT, VIJAYANAGAR,

BANGALORE-560040,

KARNATAKA.

PERMANENT ADDRESS: REVATHY,

THEKKEVILA.P.O,

KOLLAM-691016,

KERALA.


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In the present scenario many drugs that are administered to treat this condition, which in

the long run may lead to various adverse effects and the condition may require multiple drug

regimens.

Shirodhara is found to be beneficial in various psychosomatic disorders, Hypertensionbeing the commonest. Among the cluster of Shirodhara, Takradhara

5serves this purpose in a

better way. It is evident in references in classics and through various clinical trials that

Takradhara is effective in a multitude of psychosomatic disorders6. Patients of Hypertension,

owing to such high prevalence, would certainly derive significant benefits from Takradhara.

In the present study, among the various modalities of Takradhara7, 8

, two methods which

are found to be popular among the fraternity of Panchakarma are adopted to compare the

efficacy of both in the management of Essential Hypertension.

6.2) REVIEW OF LITERATURE:

1 Detailed description of Essential Hypertension is mentioned in Harrisons Principles ofInternal Medicine

9.

1 Sushruta explained the properties of Takra10.2 Astanga Hridaya mentioned about Shiroseka11.3 Detailed description of Takradhara is mentioned in Sahasrayoga12.4 Vaidyaratnam.P. S. Varier, mentioned about the preparations of Takradhara dravyas using

Ushira, Chandana, Yastimadhu in place of Musta13

.

5 The qualities of Amalaki14 and Musta15 are mentionedin Raja Nighantu.PREVIOUS WORKS DONE:

1 Rajashekhar.V.Sanapeti, A clinical study on the effect of Takradhara in EssentialHypertension, SDM College of Ayurveda, Udupi, RGUHS, Karnataka, 2006.

2 Shukla Maheshwar, Effect of Shirodhara by Takra in patients suffering fromHypertension, IPGT & RA, GAU, Jamnagar, 1983.

3 Pathaniya Sumit, Role of Takradhara & Sarpagandha ghanavati in the management ofUccharaktachapa (EHT), IPGT & RA, GAU, Jamnagar, 2001.

4 Birla.o.ch, Abhivriddha Raktachapa par Shirodhara, IPGT & RA, GAU, Jamnagar, 1973.


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5 Tamrakar B.ch, Comparative therapeutic evaluation of Shavasana and ShirodharaPanchakarma therapy in Hypertension, Govt Ayurvedic college , Ravishanker

University,Raipur, 1987.

6.3 ) OBJECTIVES OF STUDY:

1 To evaluate the therapeutic effect of Takradhara using Musta Ksheerapaka Siddha Takramixed with Amalaki Kashaya in the management of Essential Hypertension.

2 To evaluate the therapeutic effect of Takradhara using Takra mixed with MustamalakiKashaya in the management of Essential Hypertension.

3 To compare the therapeutic effects in both groups.7) MATERIALS AND METHODS:-

7.1) SOURCE OF DATA:

Randomly selected 40 patients diagnosed with Essential Hypertension will be taken for

the study from OPD and IPD of S.K.A.M.C, H & R.C, Bangalore-40.

7.2) METHOD OF COLLECTION OF DATA:

1 A comparative clinical study with pre-test and post-test design where in 40 patientsdiagnosed with Essential Hypertension of either sex will be selected randomly.

2 A case proforma will be specially designed with all the points of history taking, physicalsigns and laboratory investigations as mentioned in the texts.

3 The parameters of signs and symptoms will be scored as mentioned in the proforma.4 The following statistical method will be employed for data collection - descriptive

statistics, contingency table analysis, paired sample t test and repeated measure

ANOVA, using SPSS for windows software.

DIAGNOSTIC CRITERIA:

Criteria for diagnosis of Hypertension as defined by 7th Joint National Committee Report will be

followed16:

Category Systolic Diastolic

Normal


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Stage I Hypertension 140-159 90-99

Stage II Hypertension >160 >100

Three consecutive readings of blood pressure in supine posture will be observed and their

average is recorded for diagnosis. Patient with Stage I Hypertension will be selected.

INCLUSION CRITERIA:

Freshly diagnosed patient of Essential Hypertension / Primary Hypertension / Idiopathic

Hypertension.

Patient aged above 18 years.

Stage I Hypertension.

EXCLUSION CRITERIA:

1 Secondary Hypertension.2 Patient below 18 years.3 Stage II Hypertension.4 Pregnant women.5 Patient with any other systemic disorder which interfere with the course of treatment.

INTERVENTION:

All patients will be randomly categorized into two groups.

Group A: - 20 patients will be subjected to Takradhara prepared by Musta Ksheerapaka Siddha

Takra mixed

with Amalaki Kashaya.

Group B: - 20 patients will be subjected to Takradhara using Takra mixed with Mustamalaki

Kashaya.

Duration: The procedure will be performed for 45 minutes for 7 consecutive days in the

afternoon.

Post- test recording of B P will be done after Takradhara on 7thday.

Follow up: - On 14th

and 21st

day.

ASSESSMENT CRITERIA:


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The following subjective parameters17

and objective parameters will be assessed

1 Headache2 Palpitation3 Giddiness4 Perspiration5 Fatigue6 Impotence7 Epistaxis8 Haematuria9 Blurring of vision10 Assessment of blood pressure with Sphygmomanometer.

7.3) Does the study require any investigation or intervention to be conducted

on patient or other humans or animals ? If so please describe briefly.

Study will be conducted on humans who match inclusive criteria only.

LABORATORY INVESTIGATIONS

1 Random Blood Sugar2 Blood urea3 Serum creatinine4 Blood-Lipid profile5 Electro-Cardio Gram

7.4 ) Has ethical clearance been obtained from your institution in case of 7.3?

- YES

8) LIST OF REFERENCES:

1. Robbins and Cotran Pathologic Basis of Disease, edited by Vinay Kumar, Abdul K.Abbas, Nelson Fausto, W.B.Saunders International Edition, 7

th

edition, reprint-2006, Pp-

1525, Pg no 525.


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th

edition, reprint-2006, Pp-

1525, Pg no 526.

3. www.ncbi.nlm.nih.gov/pubmed/15652604


th

edition, 2006, Pp-1525, Pg

no 526.

, Global burden of Hypertension: analysis of

world wide data, Kearney PM, M Whelton, K Reynolds, P Muntner, Whelton P.K,

Department of Epidemiology, Tulane University School of Public Health and Tropical

Medicine, New Orleans, LA 70112, U.S.A, 2005.

5. Dr. Ramnivas Sharma, Dr. Surendra Sharma, Sahasrayogam, Sanskrit-Hindi translation,translated by Pandit Rao,edited by Vaidya Mahendrapal Simha Arya, CCRAS, New

Delhi, 1st

edition, 1999, Dharakalpa, Pp-621, Pg no 521.

6. Padmasri Dr. K.Rajagopalan, Keraliya Chikitsa Paddhati, Ayurveda Series-3, translatedby Dr.Pavana.J, Dr.Manoj Sankaranarayana, published by Dr.Rajagopalan Ayurveda

Granthamala Samithi, 1st

edition, Pp-195, Pg no 116,117.

7. Vaidya Haridas Sridhar Kasthure, Ayurvediya Panchakarma Vignana, Sri VaidyanathAyurveda Bhavana Limited, 9th edition, 2006, Pp-654, Pg no 95, 96.

8. Vaidyaratnam P.S. Varier, Chikitsa Samgraha, Kottakkal Ayurveda Series-3, translated byP.U.K.Warrier, Kottakkal Aryavaidyashala Publications, 7

thedition, 2008, Pp-271, Pg no

174.

9. Harrisons Principles of Internal Medicine, edited By Braunwald, Fauci, Kasper, Hauser,Longo, Jameson, Mc Graw-Hill Medical Publishing Division, 2001, 15

thedition, Volume

1, Pp-1442, Pg no 1414.

10.Sushruta, Sushruta Samhita, edited & translated by P.V.Sharma, ChaukhambhaVisvabharati Oriental Publishers & Distributors, Varanasi, 1

st

edition, 1999, Sutra Sthana,

45th

Chapter, Verse 84, Pp-568, Pg no 432.

11.Vagbhata, Astanga Hridaya, translated by K.R.Srikantha Murthy, ChowkhambaPublications, 5

thedition, 2007, Sutra Sthana, 22

ndChapter, Verse 23, Pp-520, Pg no 273.


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12.Dr. Ramnivas Sharma, Dr. Surendra Sharma, Sahasrayogam, Sanskrit-Hindi translation,translated by Pandit Rao, edited by Vaidya Mahendrapal Simha Arya,CCRAS, NewDelhi,

1st

edition, 1999, Dharakalpa, Pp-621, Pg no 521, 522.

13.Vaidyaratnam P.S. Varier, Chikitsa Samgraha, Kottakkal Ayurveda Series-3, translated byP.U.K.Warrier, Kottakkal Aryavaidyashala Publications, 7

thedition, 2008, Pp-271, Pg no

174.

14.Pandit Narahari, Rajanighantu, edited with Dravyaguna Prakasika Hindi Commentary byDr.Indradeo Tripathi, Chowkamba Sankrit series office Publishers and Oriental and

Foreign Book-seller, 2nd

edition, 1998, Pp-703, Pg no 371.

15.Pandit Narahari, Rajanighantu edited with Dravyaguna Prakasika Hindi Commentary byDr.Indradeo Tripathi, Chowkamba Sankrit series office Publishers and Oriental and

Foreign Book-seller, 2nd

edition, 1998, Pp-703, Pg no163.

16.www.nhlbi.nih.gov/guidelines/hypertension/jnc7full.pdf

17.Harrisons Principles of Internal Medicine, edited By Braunwald, Fauci, Kasper, Hauser,Longo, Jameson, Mc Graw-Hill Medical Publishing Division, 2001, 15

thedition, Volume

1, Pp-1442, Pg no 212.

, The7th

Report of the Joint

National Committee on Prevention, Detection, evaluation and treatment of High Blood

Pressure. JAMA 2003; 289(19):2560-2572.


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9) SIGNATURE OF CANDIDATE :

10) REMARKS OF GUIDE :

11) NAME AND DESIGNATION OF

11.1) GUIDE : DR. SWATI DESHPANDE

M.D(AYU),

READER,

DEPT OF P.G STUDIES IN

PANCHAKARMA,

S.K.A.M.C, H & R.C,

VIJAYANAGAR, BANGALORE-

560040

11.2) SIGNATURE :

11.3) CO-GUIDE :

11.4) SIGNATURE :

11.5) H.O.D. : DR. MURALIDHAR

M.D(AYU),

PROFESSOR AND H.O.D,

DEPT OF P.G STUDIES IN

PANCHAKARMA,

S.K.A.M.C, H & R.C,


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VIJAYANAGAR, BANGALORE-

560040

11.6) SIGNATURE :

12.1) REMARKS OF CHAIRMAN

& PRINCIPAL :

12.2) SIGNATURE :

Documents

takradhara study