RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, KARNATAKA BANGALORE COMPLETED PROFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION A CLINICAL

STUDY TO EVALUATE THE EFFECT OF NASYA KARMA IN CERVICAL SPONDYLOSIS

BY, DR. VIGNESH HOBLIDAR M.D. (Ayu) SCHOLAR DEPT OF P.G STUDIES IN PANCHAKARMA S.D.M.COLLEGE OF AYURVEDA, UDUPI

GUIDE DR. NIRANJAN RAO M.D (AYU) PROFESSOR DEPT OF P.G STUDIES IN PANCHAKARMA S.D.M.COLLEGE OF AYURVEDA, UDUPI

CO-GUIDE DR.SHREEKANTH.U. M.D(AYU) PROFESSOR, HOD& DEAN DEPT OF P.G STUDIES IN PANCHAKARMA S.D.M.COLLEGE OF AYURVEDA, UDUPI 2009 - 2010 S.D.M.COLLEGE OF AYURVEDA, KUTHPADY, UDUPI 574 118

From, DR. VIGNESH HOBLIDAR 1st year M.D Dept of P.G Studies in Panchakarma S.D.M.C.A, Udupi To, The Registrar, Rajiv Gandhi University of Health Sciences Bangalore, Karnataka ThroughThe Principal and Head of the Department (Panchakarma) S.D.M.College of Ayurveda, Kuthpady, Udupi- 574118 Subject: Submission of completed proforma for registration of subject for dissertation Respected sir, I 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 for the partial fulfillment of M.D. (Ayu) in Pancha karma. Title of Dissertation: A CLINICAL STUDY TO EVALUATE THE EFFECT OF NASYA KARMA IN CERVICAL SPONDYLOSIS

Herewith I am enclosing completed proforma for registration of subject for dissertation Thanking you, Yours sincerely,

Place: Date: (DR. VIGNESH HOBLIDAR) 1) Name of the candidate :

DR. VIGNESH HOBLIDAR 1st year M.D DEPT OF P.G STUDIES IN PANCHAKARMA S.D.M.C.A, Kuthpady, UDUPI

Permanent address : DR. VIGNESH HOBLIDAR S/O RATHNAKAR HOBLIDAR LAXMI VENKATESH, DR.SALIM ALI ROAD, VODERHOBLI KUNDAPURA 576 201, UDUPI DIST.

2) Name of the institution : S.D.M.COLLEGE OF AYURVEDA KUTHPADY, UDUPI 574 118

3) Course of study and subject : M.D. ( Ayu- Panchakarma )

4) Date of admission of course:

16th JUNE 2009 5) Title of the topic:

A CLINICAL STUDY TO EVALUATE THE EFFECT OF NASYA KARMA IN CERVICAL SPONDYLOSIS

6) Brief resume of the intended work:

6.1 Need for Study: Urdhwa Jatru Vikareshu Visheshaat Nasyamishyate1 Nasya karma is considered as a prime line of treatment in urdhwa jatru vikaras. The phenomenon of cervical spondylosis is affecting the neck. A neck injury having a history of several years may predispose to cervical spondylosis. Meanwhile another risk factor is ageing. 60-70% women and 85% of men may show changes related with cervical spondylosis by the age 45, rhontgenologically2. 23.6% patients presenting with non traumatic myelopathic symptoms have cervical spondylosis. This is the cause for non traumatic spastic paraparesis and quadriparesis. The prevalence of cervical spondylotic myelopathy ranges between 96-100%, by the age 70 years in females and males respectively. Radiographic changes are more severe in men then in women 2. For the sake of clinical identification vishwachi, apabahuka and such disorders compared with cervical spondylosis. The prime line of treatment in such urdhwa jatru vikara is Nasya karma. Ketakyadi taila mentioned in the text is useful in such disorders 7,8,9,10,11,12 . With such a view in background the study of Nasya karma with Ketakyadi taila is taken in the disease cervical spondylosis. 6.2 Review of Literature References regarding Ketakyadi taila are available in ayurvedic text books. In disorders of astigata vata, ketakyadi nasya is indicated. 7,8,9,10,11,12 Nasya karma has been mentioned in Ayurvedic Classics6 . Vishwachi and Apabahuka disorders are mentioned in Ayurvedic texts 3,4 . Cervical spondylosis has been explained in modern text books.12,13,14,15

Previous Research Works Done:

Shaligram, Asthimajja vata with special reference to cervical spondylosis , and role of snehana and nasya karma in its management. Gujarat Ayurveda University , Jamnagar 1998 2. Sulochana Rathi Management of Greeva sthamba vis--vis cervical spondylosis , UTKAL University, Puri, Orissa 1997
1. 3. Andanagoud S Patil the effect of Ketakyadi taila as katibasti in katishoola, RGUHS University ,Bangalore 2000.

6.3 Objectives of Study: 1. To study the effect of Ketakyadi taila Nasya karma in the management of cervical Spondylosis.

7. MATERIALS AND METHODS

7.1 Source of Data Minimum of 30 patients suffering from cervical spondylosis will be taken for the study from OPD and IPD of S.D.M Ayurveda Hospital, Udupi. 7.2 Methods of Collection of Data Minimum 30 patients will be included in clinical study. Patients will be selected from OPD and IPD of S.D.M. College of Ayurveda and Hospital, kuthpady, Udupi, and detailed proforma will be prepared by incorporating all the sign and symptoms of cervical spondylosis.

Diagnostic Criteria
Neck pain Pain in medial scapular region and shoulders Headache characteristically occipital and often dercribed as spreading up over the back of the head to frontal region usually worse in morning In more advanced stage, there is wasting of relevant muscle due to involvement of motor root.13,14 Inclusion Criteria Patients of either sex and age between 30 to 70 years will be taken. Patients presenting with the signs and symptoms of cervical spondylosis will be selected. 3. Patients who are fit for nasya karma.

1. 2.

Exclusion Criteria Patients with traumatic injury of cervical spine. Patients suffering from neoplastic disorders. PLAN OF TREATMENT: Purva Karma Abyanga of neck, face with ksheerabala taila, Taapa Sveda(mrudu) with cloth dipped in hot water will be done for 10 minutes. Pradhana Karma o Position of the Patient :- supine with head end lowered. o Ketakyadi Taila is slightly warmed indirectly with the help of hot water bath. o 8 drops of Ketakyadi Taila is instilled in each nostril. o Soles, palms, neck and ears are massaged

o Secretions are spitted out. Paschatkarma Haridra dhumapana, kavala with sukhoshna jala. Total Duration 7 consecutive Days. Follow up Study : 7 days after completion of Nasya karma.

Asse ssment Criteria

Subjective parameters : o Neck pain o Samyak Lakshanas of Nasya karma o Radiation of pain to occipito frontal region, shoulder down to both arms o Paraesthesia o
o o o o

Objective parameters : Tenderness Movements of neck Sensory loss Motor weakness Tendon reflexes

7.3Does this study requires any investigations or intervention to be conducted on patients or other humans or animals?
The study will be a human clinical study , no animal experiments will be conducted.

Laboratory investigations
X ray cervical spine AP and Lateral(Before treatment). Blood routine investigation. CR protein, RA factor

7.4 )Has the ethical clearance is obtained from your institution in case of 7.3?
YES, ethical clearance is obtained through the ethical committee formulated in this institution

8. LIST OF REFERENCES
1.

Vagbhata, Astanga Hrudaya , commentaries of Sarvangasundara of Arunadatta and Ayurvedrasayan of Hemadri, edited by Paradakara Hari Sadashiv Shastri, Varanasi, Chaukamba Surbharti Prakashan,Print 2007, Pp: 956: Page no.287

2.

3. 4. 5. 6.
7.

8. 9. 10. 11. 12. 13. 14. 15. 16.

eMedicine from webMD, Medscapes continually updated clinical reference, Cervical spondylosis, Diagnosis and management, by Sandeep S Rana , MD, Clinical Associate Professor of Neurology, Drexel university/College of medicine, updated 14th Aug 2009, cited 30th oct 2009,available at http://emedicine.medscape.com/article/1144952-overview Susruta,Susrutha Samhitha with Nibandhasangraha commentary and Nyayachandrika Panjika of Sri Gayadasacharya on Nidanastana , edited by Vaidya Jadavji T rikam ji A charya, C haukam ba S urbharati Prak ashan , R eprint 2008, Pp:824: page no 268 Bhavamishra, Bhavaprakasha edited with the vidyodini hindi commentary, Part II, eleventh edition, Chaukamba Sanskrit Bhavan, 2007, Varanasi. Pp:836: page no 235 Vagbhata, Astanga Hrudaya , commentaries of sarvangasundara of arunadatta and Ayurvedrasayan of Hemadri, edited by Paradakara Hari Sadashiv Shastri, Varanasi, Chaukamba Surbharti Prakashan, Print2007, Pp: 956: Page no.725 Agnivesha, Charaka Samhita elaborated by Charaka and Drdhabala with the Ayurveda Deepika commentary by Chakrapanidatta edited by Vaidya Jadavaji Trikamji A charya, C haukam ba S urbharati Prak ashan , V aranasi, reprint 2008, Pp: 738, Page.no. 722. Sahasrayogam; English translation by, Dr.Nishteshwar & Dr. R. Vidyanath; First edition; Chaukamba Samskrit Series Office, Varanasi, 2006, Pp: 540: Page no 112. Chakradatta of Shri Chakrapani datta with Vaidyaprabha hindi commentary by Dr. Indradeva Tripathi, Editor Ramanath Dwivedi, Published by Chaukamba Publications, 2005, Pp: 539: Page no. 145 Bharat Bhaishajya Ratnakara:Samgruhita- Shree Nagindas Chaganlal Shah, SamalankrutGopinath Gupta, Samshodith- Nivaran Chandra Bhattacharya, B.Jain Publishers Pvt Limited, Delhi, Reprint 1995, Pp:650: Page no.269 Shri Vaidya Shodala ,Gada nigraha; with Vidyotini hindi commentary by Dr. Indradeva Tripathi, edited by Sri Gangashaya Pandeya Part II , Chaukamba Samskrit Series Office, Varanasi , First edition 1969, Pp: 971: Page no.512 Vrndamadhava or Siddayoga , Edited and translated by Dr. Premavati Tiwari and Dr. A sh a K u m a ri; C h a u k a m b a B h a ra ti A c a d em y , V ara n a si, F irst ed itio n 2 0 0 6 , P art I ; P p :5 6 0: P a g e n o .3 4 0 Vangasena, Chikitsa Sara Sangraha, English translation by DR. Nirmal Saxena Vol I Chaukamba Publications , Varanasi 2004; Pp: 669: Page no.400 Davidsons Principles and practice of medicine, Edited by Nicholas A. Boon, 20th edition, Reprinted 2006, Publishers Libreary of Congress Cataloging in Publication data, Pp :1326: Page no.1241 Harrisons principles of internal medicine, Edited by Fauci AS, Braunwald E, Kasper DL, Hauser SL, Longo DL, Jameson JL, Loscalzo, Volume I, 17th edition, Mc Graw-Hill, Medical Publishing Division, Pp: 1364 : Page no.116 Golwalla Medicine for Students by ASPI F. Golwalla and Sharukh A. Golwalla, 21st edition 2005; Published by ASPI Golwalla; Pp: 1212: Page no.587 API Textbook of Medicine, Chief Editor Siddarth N. Shah, Executive editor M. Paul Anand, 7th Edition 2003; Published by The Association of Physicians of India ; Pp: 1511: Page no.88

9. SIGNATURE OF THE CANDIDATE :

10. REMARKS OF GUIDE

11. NAMES AND DESIGNATION 11.1. GUIDE

: :
DR. NIRANJAN RAO M.D(AYU) PROFESSOR DEPT OF P.G STUDIES IN PANCHAKARMA S.D.M.COLLEGE OF AYURVEDA, UDUPI

11.2. SIGNATURE

11.3. CO-GUIDE

DR.SHREEKANTH.U. M.D(AYU) PROFESSOR, HOD & DEAN DEPT OF P.G STUDIES IN PANCHAKARMA S.D.M.COLLEGE OF AYURVEDA, UDUPI

11.4. SIGNATURE

11.5. H.O.D.

DR.SHREEKANTH.U. M.D(AYU) PROFESSOR, HOD & DEAN DEPT OF P.G STUDIES IN PANCHAKARMA S.D.M.COLLEGE OF AYURVEDA, UDUPI

12. SIGNATURE 12.1. REMARK OF CHAIRMAN & PRINCIPAL 12.2 SIGNATURE

: :