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Dr yashoda ppt
- 1. KNR UNIVERSITY OFHEALTH SCIENCES,WANARGAL, TELANGANA PRESENTTION OF DISSERTATION FOR IEC By Dr. K YASHODA 1ST YEAR PG SCHOLAR DEPT. OF KAYA CHIKITSA Dr. B.R.K.R GOVT. AYURVEDIC MEDICAL COLLEGE, ERRAGADDA, HYD
- 2. A CRITICAL EVALUATIONOF CLINICAL EFFICACY OF ‘VRIDDA DARVADI LOHA’ IN MANAGEMENT OF AMAVATA W.S.R TO RHEUMATOID ARTHRITIS By Dr. K YASHODA 1st YEAR P.G SCHOLAR P.G DEPT. OF KAYA CHIKITSA GUIDE Dr. P. SRIKANTH BABU. M.D (Ay) (K.C) GOLD MEDALIST PROFESSOR P.G DEPARTMENT OF KAYACHIKITSA
- 3. CONTENTS INTRODUCTION AIMAND OBJECTIVES MATERIALS AND METHODS PARAMETERS DIAGNOSTIC CRITERIA INCLUSION CRITERIA EXCLUSION CRITERIA DRUG REVIEW DRUG INTERVENTION REFERENCES
- 4. INTRODUCTION AMAVATA isthe most common debilitating joint disorder. Madavakara was the first person to give a detailed description of Amavata. It effects the individuals, who indulge in viruddhahara ( improper and irregular dietery habits ) viruddha chesta (improper physical and psychological activities) Amavata may be correlated with Rheumatoid arthritis, it is a chronic progressive autoimmune arthropathy and characterized by bilateral symmetrical involvement of joints with some systemic clinical manifestation. Acc to ICD -10 WHO RHEUMATOID ARTHRITIS, UNSPECIFIED is M06.9
- 5. RHEUMATOID ARTHRITISusually effects symmetrically, and most frequently attacks the wrist, hand, shoulders, knees and ankles. CLINICAL FEATURES Pain Swelling Morning stiffness Tenderness Fatigue, anorexia Local temperature Shifting pain Continued….
- 6. NEED OF STUDY Theincidence of Rheumatoid arthritis is reported to be 1-2% of general population with a female and male ratio of 3:1. With the use of NSAID’s glucocorticoids, DMARD’s, treatment remaining un satisfactory through modern system of medicine. So, in this clinical study of VRIDDADARVADI LOHA are selected for evaluate their efficacy in AMAVATA
- 7. AIM AND OBJECTIVES 1). To study the etiopathogenesis and treatment of Amavata in Ayurvedic perspective. 2). To evaluate the therapeutic efficacy of Vriddadarvadi Loha in patients suffering from Amavata
- 8. MATERIALS AND METHODS 1)SOURCES OF DATA A minimum of 30 patients will be randomly selected from OPD and of Dr. B.R.K.R. Govt Ayurvedic college, Erragadda, Hyd. Patients will also be selected from referral sources and special camps conducted for this purpose. 2) METHODS OF COLLECTION OF DATA Patients of either sex will be randomly selected based on the clinical features of AMAVATA. Patients will be assigned under a single group consisting minimum of 30 patients excluding drop-outs.
- 9. INCLUSION CRITERIA Patientswith clinical features of Amavata Patients of either sex and age 18 – 60 Patients who had fulfilled the revised criteria for rheumatoid arthritis fixed by the American college of rheumatology 2010 Patients of both RA factor positive (or) RA factor negative & A.S.O titer positives. Patients below 18 yrs and above 60 yrs Chronicity more than 10 yrs Systemic diseases like uncontrolled Diabeties , tuberculosis, hypertension Malignancy Pregnant and lactating women Having severe crippling deformities EXCLUSIVE CRITERIA
- 10. CLINICAL PARAMETERS SUBJECTIVE PARAMETERS Angamarda Aruchi Trushna Allasya Gourava Apaka Sunangatha Sandi shoola Sandi shotha Sandi stabdata Sparsha asahishnuta Agni dourbalya Jwara Vrischika damstravath vedana OBJECTIVE PARAMETERS RA Factor CRP ASO Titer Anti CCP ESR X-Ray of Grossly effected joints
- 11. DIAGNOSTIC CRITERIA Basedon classical features of AMAVATA Patients who fulfilled the revised ACR criteria. RA Factor CRP ASO Titer Anti CCP ESR X-Ray of Grossly effected joints
- 12. DRUG REVIEW 1. VriddadarvadiLoha Consists 15 drugs are Vruddadaru,Trivit,Danti,Gajapippali,Manakanda,Amalaki,Vibhitaki,Harit haki,Pippali,Maricha,Sunti,Citraka,Musta,Vidanga and Loha Vruddadharu Trivrit Danti Gajapippali
- 13. S.No Drug nameLatin name Family Rasa Guna Veerya Vipaka Karma Part used 1 Vruddadharu Argyreia speciosa Convolvulaceae Kashaya Katu Lagu Snigdha Ushna Madhura Vatha,Kaphahara Rasayana Vrishya Seed 2 Trivrit Operculina turpethum Convolvulaceae Tikta Katu Lagu Ruksha Tiksana Ushna Katu Kapha,Pittahara Rechana Root 3 Danti Baliospermum montanum Euphorbraceae Katu Guru Tiksana Ushna Katu Kaphavatahara Rechana Deepana Root 4 Gajapippali Piper chaba Pipperaceae Katu Lagu Ruksha Tiksana Ushna Katu Kaphavatahara Vrishya Deepana Pachana Fruit 5 Manakanda Alocasia indica Araceae Madhura Guru Snigdha Sita Madhura Deepana,Bhedana, vathakaphahara Tuber 6 Amalaki Emblica officinalis Euphorbiaceae Amla pradana pancha Rasa Expt.Lavana Guru,Ruksha,sheetha,Lagu Sita Madhura Thridoshahara Vayasthapana Rasayana Vrishya,Chaksusya Fruit 7 Vibhitaki Terminelia belerica Combretaceae Kashaya Ruksa Laghu Ushna Madhura Khaphapithahara Keshya, Chaksusya Bhedana, Madhakari Fruit •DRUG INTERVENSION: VRIDDADARVADI LOHA Ref/ Rasendra Sara Sangrha of Sri Gopalakrishna Bhatt.
- 14. 8 Harithaki Terminaliachebula Combretaceae Pancharsa kashaya paradana Expt.Lavana Laghu Ruksa Ushna Madhura Thridosha hara Anulomana,Rasayana Prajasthapana, Chaksusya Hrukleshana Fruit 9 Pippali Piper longum Piperacea Katu Laghu Snigdha Thekshana Ushna Madhura Vatha,Kaphahara (Ardhakha=Khapakara) Deepana,Rasayana Fruit 10 Maricha Piper nigrum Piperacea Katu Laghu Thekshana Ushana Katu Kaphavathahara,Avrisya,Deeana, Pramathi Fruit 11 Sunti Zingiber officinale Zingiberaceae Katu Guru,Ruksa,Tiksna Ushna Madhura Vathakaphahara,Deepana, Bhedana Rhizome 12 Citraka Plumbago zeylanica Plumbaginaceae Katu Lagu,Ruksa,Tiksna Ushna Katu Vathakaphahara,Deepana,Pachana,Grahi Root 13 Musta Cyperus rotundus Cyperaceae Pikta,Katu,Kashaya Lagu,Ruksa, Sita Katu Kaphapithahara,Deepana,Pachana,Grahi Rhizome 14 Vidanga Embelia ribes Primulaceae Katu,Kashaya Lagu,Ruksa, Tikshna Ushna Katu Lekhana,Vishagna,Krimigna, Deepena Fruit 15 Loha Iron Incinerated Ferrus --- --- ----- ----- --- --
- 15. DRUG INTERVENTION S.No Drugname Latin name Quantity 1 Vruddadharu Argyeia specinosa 1 part 2 Trivrit Operculina turpethum 1 part 3 Danti Baliospermum montanum 1 part 4 Gajapippali Piper chab 1 part 5 Manakanda Alocasia indica 1 part 6 Amlaki Emblika officinalis 1 part 7 Vibhitaki Terminelia belerica 1 part 8 Harithaki Termenelia chebula 1 part 9 Pippali Piper langum 1 part 10 Marica Piper nigram 1 part 11 Sunti Zingiberofficinali 1 part 12 Citraka Plumdago zeylanica 1 part 13 Musta Cyperus rotundus 1 part 14 Vidanga Embeliaca ribes 1 part 15 Loha Iron 1 4 parts All the drugs are taken in equal ratio ( Expt. Loha 14 parts) and made into fine powder and will be prepared according to the classical method. 500 mg per day for 30 patients for 60 days.
- 16. REVIEW 0 day 15days 30 days 45 days 60 days Pre assessment VRIDDADARVADI LOHA VRIDDADARVADI LOHA VRIDDADARVADI LOHA VRIDDADARVADI LOHA FOLLOW UP: Once in TWO months Pre assessment 0 day First assessment 15th day Second assessment 30th day Third assessment 45th day Fourth assessment 60th day
- 17. ASSESSMENT CRITERIA Thefinal result will be categorized as: Excellent Relief - >76% relief in signs & Symptoms Good Relief - 51 to 75% relief in signs & Symptoms Moderate Relief - 26 to 50% relief in signs & Symptoms Mild Relief - 0 to 25% relief in signs & Symptoms
- 18. REFERENCES Vangasena byVangasena in Amavata adhikarana Madhavanidana by Madhavakara Amavata nidana 25th chapter Yoga ratnakara in Amavata nidana Bhavaprakasha by Bhavamishra poorvakhanda Bhaishajya ratnavali by Govind das 29th chapter Amavata Dravyaguna vignana by J.L.N Sastry Harrison’s text of Internal medicine Davidson’s text book of principles and practice of medicine