Title-Study oneffectiveness of ChakramardaGhrita&Go-Ghrita in the management of

Parikartika(fissure in ano)

1. Introduction- In the era of fast food, there is a change in the habit of taking food and its
timings as well as in life style which became sedentary.All thesecauses producedisturbancein
digestive system which results in many diseases amongst them anorectal disorderslike piles,
fissure, fistula, prolapse etc. constitute an important group.Among all anorectal disorders, fissure
in ano is the most common disease.

Anal Fissure is one of the major causes for pain at anal region.On the basis of the clinical symptoms
& durations of the disease, fissure-in-ano is classified into two varieties; viz. acute and chronic
fissure-in-ano. Either acute or chronic, pain and bleeding are the two main symptoms of this
condition, pain is sometimes intolerable. In long standing cases it may be associated with
haemorrhoids or a sentinel tag. Pruritus ani may be another symptom in this condition[1].In males
anal fissure usually occur in the midlineposterior- 90%, and much less commonly anterior 10%.
In females fissures on the midline posteriorly are slightly commoner than anteriorly (60:40)[2].

Parikartika can be correlated with Fissure in ano in modern medical sciences.References about
Parikartika are available from all Bruhatrayiand later authors of Ayurveda.Parikartika(fissure in
Ano) is very common condition. The factors responsible for causation of Parikartika are found in
various texts as Vamana–VirecanaVypada, Basti Karma vypada and Upadrava of Atisara,
Grahani, Arśa, Udāvarta[3].In this regard AcharyaSushruta explained the pathogenesis of disease
that if a person is debilitated, with Mrudukoshta (mild digestive power), Mandagni (poor appetite)
in such conditions more intake of food having the qualities of Ruksha (dry), Ushana (hot), Lavana
(salty) etc. vitiates Pitta and Vata and leads to manifestation of the disease[4].The word Parikartika
means Parikartanavatvedana around guda i.e. cutting type of pain. Parikartika is also having the
symptoms likeburning pain in anus, penis, umbilical region and neck of urinary bladder with
cessation of flatus[5].In KashyapSamhita we get the doshik classification aetiology,
symptomatology and treatment of Parikartika in the chapter GarbhiniChikitsa.[6]Further
AcharyaCharaka mentioned fissure in ano as a complication of VatajAtisara.[7]

2.Review of literature-
Text Sthan Adhyaya Topic Shloka no.
CharakSamhita Sidhisthan 6 Introduction 30
SusrutaSamhita Chikitsasthan 34 Definition 16
KashyapaSamhita ChikitsaSthan 10 Doshic 102-105
classification
RajNighantu Sathhadivarg Guna 199
Baily & Love short 68 Treatment
practise of surgery
S.Das a concise text 45 Symptoms &
book of surgery prevalence

3.Previous studies conducted-

1. Bhujbal A., Role of Durvaghrit in parikartika (fissure in ano)2016
Conclusion:Durvaghrit was found effective in the disease parikartika. All the sign and
symptoms were decreasing after application ofDurvaghrit. Durvaghrit might be more
effective on itching causing due to fissure in ano. There were no any complication of
durvaghrit. Majority of thepatients were from male group and mix diet.

2. Kulkarnin.h.,SharmaS.S., Clinical Evaluation ofMadhuyashtyadiGhrita and Anal

dilatation in the Management of Parikartika,2016.
Conclusion:It can be concluded without any hesitation that even though all the treatment
modalities are effective over the condition Fissure-in-Ano but Anal Dilation followed by
local application of MadhuyashtyadiGhrita in the post-operative period will be better in
comparison with MadhuyashtyadiGhrita application alone as a conservative measure or
Anal Dilation alone. There is need of few more research works regarding this concept on
larger samples of study.

3. Dwivedi A., Rathod A., Rathi A.., Clinical study to evaluate the local effect of
Doorvaghrita in management of parikartika, 2015.
 Conclusion:RaktaSrava, can be effectively controlled within 3- 4 applications of
Doorvaghrita.Thus from the present study it can be concluded that local application of
Doorvaghrita imparts very good local effect in the patients of Parikartika.

4. Vishwakarma N., Srinivasa K.K., Nagamani D., Clinical study on the effect of
Conclusion:It can be Dwiharidrarasakriyapichu in the management of
Parikartika(Fissure in ano), 2015concluded that the DwiharidraRaskriaPichu application
is most effective treatment for fissure in ano. It control streak of blood and itching; modality
effective for pain, burning sensation and sphincter spasm and less effective in controlling
tenderness, hence we can conclude that this medicine is very effective in Parikartika
(Fissure in ano). One advantage of this treatment is that patients can be treated at O.P.D.
level

5. Mali S.M., Borse N.V., BhagatV.,Study the role of shadhautghrita in parikartika

(fissurein ano), 2015.
Conclusion:ShatdhautGhrita because of its cooling, antiseptic, astringent and other
pittashamak properties is highly effective in the management of fissure in ano. By
increasing local cell immunity it prevents recurrent symptoms in patients treated with
ShatdhautGhrita. But time demands to work on more patients and detail research on fissure
in ano.

3. 1) Need of the study–

Modern surgical treatment procedures for anal fissure are Fissurectomy, Lord’s anal dilatation and
sphincterotomy.[8]These procedure may have the adverse effect like recurrence, incontinence,
infection, excessive bleeding .To find out a suitable solution and to sort out the above problems,
there is need to find out the non invasive treatment for the management of Fissure in ano. In
RajnighantuChakramardais indicated in the management of vrana, kandu, kusta, dadru, pama.[9]In
the present research work aim of study is the effectiveness of Chakramardaghrut and Go-ghrita in
the management of Parikartika.
चचचचचचचचचचचचचचचचचचचचचचचचचचचचचचचचच |
चचचचचचचचचचचचचचचचचचचचचचचचचचचचचचचचचचचचचचच ||

4.Aim–Study oneffectiveness of ChakramardaGhrita&GoGhrita in the management of

Parikartika

5.Objectives–
1.To assess the effectiveness of ChakramardaGhritain the management of Parikartika.
2.To assess the effectiveness of GO Ghritain the management of Parikartika
3.Toassess the effectiveness of Chakramardaghrita&Go Ghritain the management of Parikartika.
6.Material– The raw materials required for the preparation will be collected from Wardha and
area nearby it. It will be verified from Department of Dravyaguna

Composition of formulation-

SR. Name of the Botanical Name Part Used Proportion

NO ingredient

1 Chakramarda Cassia toraLinn. Leaves 1 part

Kalka

2 Go-Ghrita - - 4 part

3 Chakramardakwatha 4part

7.Methods–Chakramardaghrita was prepared by guideline of sneha-kalpana given by AFI.

Chakramardakalka (1 part) go-ghrita(4 part) chakramardakwatha (4part) was used as drava-
dravya while preparing chakramardaaghrita continuous heated and when siddhi lakshanofsneha
free from water no cracking sound on fire froth appearance desired colourodour taste of drug were
observed then the ghrita was collected.Ghritawill be prepared in Rasa Shala of MGACH&RC
under supervision of subject experts.

Chakramardakalka (1 part)
+
Goghrita(4 part)
+
Chakramardakwatha (4part)

Heating should be done until it attains siddhilakshan

Place – OPD and IPD ofShalyaTantra M.G.A.C.H.& R. C.

Sample size -30

Sample selection techniques: cs

Groups - Two groups with 15 patients in each.

Group Sample Size Local Application of Ghrita

Group A 15 Chakramardaghrita
Group B 15 Goghrita

Study design - Randomized single blind parallel.

Study type - Interventional

Inclusion Criteria –
- Patients with age group of 20yrs to 50yrs
- Patients with clinical features of Acute Fissure in ano will be included after screening.
Exclusion Criterion -
- Patients suffering with systemic disorders like Diabetes mellitus, Tuberculosis, HIV Positive,
Hepatitis B.
- Known cases of Malignancy, Crohn’s disease, Ulcerative colitis will be excluded.
- Chronic patient with 4th grade anal spasm will be excluded.

Investigations proposed - Hb
RBS
HIV
HbSAg

Dosage - Quantity sufficient will be taken for local application of Ghrita after Hot Sitz Bath
twice a day during the treatment period.

Any other departments expertise required - NO

Case definition–Parikartikacharacterized byParikartanavatvedanaaround guda that can be
considered as Acute Fissure in Ano in contemporary science.

8.Observations–
a) Subjective criteria- Pain
- Bleeding per Rectum
- Itching

b) Objective criteria -Parikartika Healing

- Tenderness
9.Assessment criteria –

a) Subjective criteria

1. Pain -
 SR.NO. GRADE EXPLANATION
1. Grade 0 No pain
2. Grade I Negligible or tolerable pain. No need of any medicine
3. Grade II Localized tolerable pain completely relieved by hot sitz bath
4. Grade III Need oral analgesics SOS.
5. Grade IV Need oral analgesics regularly.

2. Bleeding per Rectum -

SR. GRADE EXPLANATION

NO.
1. No Bleeding [Grade 0] No complaints of bleeding.
2. Bleeding per Rectum [Grade I] Complaints of bleeding from rectum.

3.Itching –

SR. GRADE EXPLANATION

NO.
1. Absent [Grade 0] No itching.
2. Mild [Grade I] Occasional itching.
3. Moderate[Grade II] Frequent itching.
4. Severe [Grade III] Continuous itching.

b) Objective criteria

1.Parikartika Healing –
 SR. GRADE EXPLANATION
NO.
1. Grade 0 Complete healed wound with healthy scar
2. Grade I Cleaned wound without slough/discharge
3. Grade II Partially healed wound with healthy granulation tissue
4. Grade III Wound with discharge

2.Tenderness (Soft tissue tenderness scale)

SR. GRADE EXPLANATION

NO.
1. Grade 0 No tenderness
2. Grade I Tenderness to palpation without grimace or flinch
3. Grade II Tenderness with grimace and/or flinch to palpate
4. Grade III Tenderness with withdrawal (+ “jump sign”)

10.Statistical Analysis–Wilcoxon Ramson Test

11.Ethical Consideration - After obtaining ethical clearance study will be started.

12.Withdrawal Criteria –If the symptoms get aggravated during treatment such subjects will be
withdrawn from study and suitable alternative will be provided free of cost till becomes alright.

13.Consent according to WHO Format - 10) Consent according to WHO Format

DattaMeghe Institute of Medical Sciences [Deemed University]

 [Accredited by NAAC With ‘A’+ Grade]
Mahatma Gandhi Ayurved College, Hospital s& Research Centre
Salod (Hirapur), Wardha (MS) 442001
College .07152-202632, Hospital 202631, Fax.287882
Email- mgayurvedcollege@gmail.com Web: www.mgachrc.org, www.dmims.edu.in

Informed Consent Form for

Clinical Studies

[Mahatma Gandhi Ayurved College, Hospital & Research CentreSalod (Hirapur), Wardha

(MS)][DMIMS (DU)]

Name of Proposal – “Study oneffectiveness of ChakramardaGhrita&GoGhrita in the

management of Parikartika”

PART I: Information Sheet

Introduction

I am ALOK KUMARDIWEDI PG student of ShalyaTantra Dept. Mahatma Gandhi Ayurved

College, Hospital & Research Centre Salod (Hirapur), Wardha (MS) Research Institute. We
are doing research on Parikartika, which is very common in this country. I am going to give you
information and invite you to be part of this research. You do not have to decide today whether or
not you will participate in the research. Before you decide, you can talk to anyone you feel
comfortable with about the research.

Purpose of the research. :“Study oneffectiveness of ChakramardaGhrita&GoGhrita in the

management of Parikartika“

Type of Research Intervention:-Interventional

Participant selection

1. Subjects of either sex with the age group between 20 - 50 years.

2. Patients having Pain Constipation and Bleeding per rectum will be selected in the study

Voluntary Participation

Information on the Trial Drug-ChakramardaGhrita&GoGhritaon affected area twice a day

(morning-evening ) for 14 Days

B. Description of the Process

Duration: 30

Side Effects: patients may be allergic to any of the ingredient of ChakramardaGhrita&GoGhrita

Risks: no potential risk

Benefits: it may relieve Parikartika (Fisuure in ano)

Sharing the Results

The knowledge that we get from doing this research will be shared with you through community
meetings before it is made widely available to the public. Confidential information will not be
shared. There will be small meetings in the community and these will be announced. After these
meetings, we will publish the results in order that other interested people may learn from our
research.
Right to Refuse or Withdraw

You do not have to take part in this research if you do not wish to do so and refusing to participate
will not affect your treatment at this clinic in any way. You will still have all the benefits that you
would otherwise have at this clinic. You may stop participating in the research at any time that
you wish without losing any of your rights as a patient here. Your treatment at this clinic will not
be affected in any way.

OR

You do not have to take part in this research if you do not wish to do so. You may also stop
participating in the research at any time you choose. It is your choice and all of your rights will
still be respected.

Alternatives to Participating

If you do not wish to take part in the research, you will be provided with the established standard
treatment available at the centre/institute/hospital.

Who to Contact

If you have any questions you may ask them now or later, even after the study has started. If you
wish to ask questions later, you may contact any of the following:

Name-Alok Kumar Diwedi

Address-Dubagga ,Lucknow,Uttarpradesh

Telephone number-9307128359
E-mail –alokd663@gmail.com

This proposal has been reviewed and approved by [IEC, DMIMS (DU)], which is a committee
whose task it is to make sure that research participants are protected from harm. If you wish to
find about more about the SRC, contact MGACHRC DMIMS (DU). It has also been reviewed by
the Institutional Ethics committee of the DMIMS (DU), which is funding/sponsoring/supporting
the study.

You can ask me any more questions about any part of the research study, if you wish to. Do you
have any questions?

PART II: Certificate of Consent

I have been briefed regarding the research studies for which myself in bring enrolled /or
given consent to enroll I/my son/ daughter/…………………………………………. I have
reviewed all the information regarding the study and read the foregoing information, or it
has been read to me. I have had the opportunity to ask questions about it and any questions
that I have asked have been answered to my satisfaction. I consent voluntarily to participate
as a participant in this research.

Name of Participant__________________

Signature of Participant ___________________

Date ___________________________Day/month/year

If illiterateI have witnessed the accurate reading of the consent form to the potential
participant, and the individual has had the opportunity to ask questions. I confirm that the
individual has given consent freely.
Print name of witness____________________ AND Thumb print of participant

Signature of witness ______________________

Date ________________________Day/month/year

Statement by the researcher/person taking consent

I have accurately read out the information sheet to the potential participant, and to the best
of my ability made sure that the participant understands that the following will be done:

1………………………………………………………………………………………………
2………………………………………………………………………………………………
3………………………………………………………………………………………………

I confirm that the participant was given an opportunity to ask questions about the study, and
all the questions asked by the participant have been answered correctly and to the best of
my ability. I confirm that the individual has not been coerced into giving consent, and the
consent has been given freely and voluntarily.

A copy of this ICF has been provided to the participant.

Print Name of Researcher/person taking the consent – Alok Kumar Diwedi

Signature of Researcher /person taking the consent__________________________

Date ___________________________Day/month/year

DattaMeghe Institute of Medical Sciences [Deemed University]

[Accredited by NAAC With ‘A’ Grade]
Mahatma Gandhi Ayurved College, Hospital & Research Centre
Salod (Hirapur), Wardha (MS) 442001
College .07152-202632, Hospital 202631, Fax.287882
Email- mgayurvedcollege@gmail.com Web: www.mgachrc.org, www.dmims.edu.in

संमतीपत्रकवैद्यकीयसंशोधनासाठी

[पपपपपपपपपपपपपपपपपपपपपपपपपपपपपपपपपपपपपपपपपपपपपपपपप
पप ...............................................................पपपपपपपपपपपपपपपपप.
पपपपपपपपपपपपपपपपपपपप
.पपपपपपपपपपपपपपपपपपपपपपपपपपपपपप.

पपपपपपपपपपपपपपपपपपपपपप-“Study oneffectiveness of
ChakramardaGhrita&GoGhrita in the
management of Parikartika”
चचचचचचचचचचचचचचचचचच-
चचचचचचचचचचचचचचचचचचचचचचचचचचचचचचचचचचचचचचचचचचचचचचचच
चचचचच (चचचचचचच), चचचचच, (चचचचचचचचचच)
चचचचचचचचचचचचचचचचचचचचचचचचचचचच
(चचचचचचचचचचचचचच)

ससससससससससससससससससस-“Study oneffectiveness of ChakramardaGhrita&GoGhrita

in the
management of Parikartika”
चचच-चच: चचचचचचचचचचच

चचचचचचचचचच
सससससससससससससससससससससससससससससससससससससससससससससससससस
, ससससस (ससससससस), ससससस, (सससससससससस)
सससससससससससससससससससससससससससस (सससससससससससससस).
सससससससससससससस.सससससससससससससससससससससससससससस.सससससस
सससससससससससससससससससससससससससससससससससस.,सससससससससससस
सससससससससससससससससससससससससससससससससससससससससससससससससस
ससससससससससससससससससस.
सससससससससससससससससससससससससससससससससससससससससससससससससस
सससससससससससससससससससससससससससससससससससससससससससससससस.
सससससससससससससससससससससससससससससससससससससससससससससस.

चचचचचचचचचचचचचचचचचचचचचचच -“Study oneffectiveness of

ChakramardaGhrita&GoGhrita in the
management of Parikartika”
चचचचचचचचचचचचचचचचचचचचचचचचचचचचचच - Interventional single group study

चचचचचचचचचचचचचचचचचचचचचचचचचचचचचचच -

चचचचचचचचचचचचचचचचचचचचचचचचचचचचचचचचचचचचचच–

चचचचचचचचचचचचचचचचचचचचचच [……………………………..]
............................................................................................................................................................
............................................................................................................................................................
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चचचचचचचचचचचचचचचचचचचचचचचच

............................................................................................................................................................
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च. चचचचचचचचचचचचचच

चचचचचचच-30

चचचचचचचचचच

चचचच

चचचचच

चचचचचचचचचच

चचचचचचचचचचचचच

चचचचचचचचचचचचचचच

चचचचचचचचचचचचचचचचचचचचचचच

चचचचचचचचचचचचचचचचचचचचचच
चचचचचचचचचचचचचचचचचच.

पपप.................................

पपपपप.................................

पपपपपपपपपपपपपपप.....................

प-पपप..................................

सससससससससससससससससससससससससससससससससससससससससससससससससस
सससस [सससससससससससससससससससससससससससस] (सससससससससससससस)
ससससससससससससससससससससससससससस.
ससससससससससससससससससससससससससससससससससससससससससससससससससस
सससससससससससस.
ससससससससससससससससससससससससससससससससससससससससससससससससससस
सससससससससससससससससससससससससससस
[सससससससससससससससससससससससससससस] (सससससससससससससस)
सससससससससससससससससससससससससससससससससससससससससससससससस,
ससससस (ससससससस), ससससस, (सससससससससस) ससससससससससससस.
सससससससससससससससससससससससससससससससससससससससससससससस.

सससससससससससससससससससससससससससससससससससससससससससससससससस
सससससससस. सससससससस?ससससससससससससससस?
चचचचचचचचचच

सससससससससससससससससससससससससससससससससससससससससससससससससस
.ससससससससससससससससससससससससससससससससससससससससस/ससससस/ससस
सस;सससस/ससससससस/सस./सससससस.....................................................................................
.............स्वेच्छेने सससससससससससससससससससस.
ससससससससससससससससससससससससससससससससससससससससससससस.
ससससससससससससससससससससससससससससससससससससससससससससससससस
सससससस.सससससससससससससससससससससस.सससससससससससससससससससस
ससससससससससससससससससससससससससससससस
.सससससससस्वेच्छेने ससससससससससससससससससससससससससससससससससससससस
ससससससस.

सससससससससससससससससस-

सससससससससससससससससससससससस

सससससस -............................

सससस / ससससस/ सससस

चचचचचचचचचचचचचच (चचचचचच)

ससससससससससससससससससससससससससससससससससससससससससससससससस
सससससससससससससससससससस.सससससससससससससससससससससससससससस
सससससससससससससससससससससससस.सससससससससससससससससससससससस
ससससससससससससससस/
सससससससससससससससससससससससससससससससससससससससस.

ससससससससससससससससससससससससस-

ससससससससससससससससससससससससस- चचचचच
ससससससससससससससचचचचचचचचच

सससससस-....................................

सससस/ससससस/ सससस

चचचचचचचचचचचचचचचचचचचचचचचचच

ससससससससससससससससससससससससससससससससससससससससससससससससस
ससससससस,
सससससससससससससससससससससससससससससससससससससससससससससससससस
ससससससससससससससससससससससससससससससससससससससससससस.

स.........................................................................................................................
स........................................................................................................................
स........................................................................................................................
 ससससससससससससससससससससससससससससससससससससससससससससससससस
सससससससससससससससससससससससससससससससससससससससस,
सससससससससससससससससससससससससस.सससससससससससससससससससससस
ससससससससससससससससससससससससससससससससससससससससससससससससस
ससससससससस.

ससससससससस -
ससससससससससससससससससससससससससससससससससससससससससससससससस.

ससससससससससससससस /सससससससससससस-..............................................................

ससससससससससससससस/सससससससससससससससससस -
...........................................................

सससससस-.............................

सससस/ससससस/सससस

14.Information to patients – procedureof application Chakramardaghrita will be

explained to subject.

15.References
1. Das S.A concise Text book of Surgery. 9th ed. Kolkata: Somen Das Publisher; 2016. pp 1084 -
1085.
2.Das S.A concise Text book of Surgery. 9thed. Kolkata: Somen Das Publisher; 2016. p 1083.

3.Yadavaji T.A. SushrutSamhita.Vol II. 2002. Chikitsasthan. Chaukhambaorientalia:

Varanasi. pp.207-8.
 4.Sharma P.V. SushrutaSamhita. Vol II. 2005. ChikitsaSthana. 34/16.Chaukhambha
Vishwabharti Publishers: Varanasi. p.595.
5.Shastri A.D. SushrutaSamhita. Vol I. 2013.Chikitsasthan.34/16.Chaukhambha Sanskrit
sansthan: Varanasi. p.155.
6.Sharma P.H. KashyapaSamhita. 3rd ed. 2013.KhilaSthana. 10/102-105.Chaukhambha
Orientalia Publishers: Varanasi.p.299.
7.Sharma P.V. SushrutaSamhita. Vol II. 2005. ChikitsaSthana. 34/16.Chaukhambha
Vishwabharti Publishers: Varanasi. p.595.
8.Connell W.B. Bailey & Love’s Short Practice of Surgery. 25th ed. UK: Edward Arnold
Publisher; 2008.P.1252.
9.Tripathi I. Rajnighantu – Dravyagunaprakashika. ShatavhadivargaChaukhambha

KrushnadasAcademy,Varanasi p.102.

13) Annexure–

14) Proforma

i)Case Sheet

Case Proforma

Department – Shalya-Tantra

Title - Study oneffectiveness of ChakramardaGhrita&Go-Ghrita in the management of

Parikartika
 Particulars of Patient

Name:______________________________________________________________________

Serial No.:____ OPD No. : _____________________ IPD No. :_____________________

Age: _________ Sex: Male/Female Marital Status: ____________________

Address:___________________________________ Occupation: ______________________

Economic Status: ____________________________DOA____________DOD____________

Chief Complaints with duration:

___________________________________________________________________________
______________________________________________________________________________
________________________________________________________________________
__________________________________________________________________________
______________________________________________________________________________
_______________________________________________________________________

Past History:
______________________________________________________________________________
________________________________________________________________________

Surgical History:
______________________________________________________________________________
________________________________________________________________________

Family History:
______________________________________________________________________________
________________________________________________________________________

Drug History:
___________________________________________________________________________

Personal History:
1 Habitat: Urban Rural

2 Socio-economic status: Poor Middle Higher Middle Higher Class

3 Marital status: Married Unmarried Divorcee Widow

4 Education: Literate Illiterate

5 Sleep: Sound Disturbed

6 Diet: Veg Mixed

7 Food Variety: Spicy Regular

8 Bowel Habit: Once/twice/more than twice a day

Regular Irregular

9 Hygiene: Good Poor

10 Addiction: Alcohol Smoking Tobacco chewing Kharra None

11 Psychological condition: Worried Depressed Irritative Happy

12 Nature of work: Sedentary Moderate Strenous

13 Menstrual history: Regular Irregular Menopause

Physical Examination -

Built: Normal Obese Slim

Height: ________ Weight: ________ Blood Pressure: _____________Pulse rate: ______

Respiratory rate: ______ Temperature: _______

Local Examination of Parikartika -

Location______________________________________________________________________
Apperance____________________________________________________________________
Pain__________________________________________________________________________
Spasm________________________________________________________________________

Investigation:-

1Hb:________________________________________________________________________
2RBS: ___________________________________________________________________
3HIV :
4HbsAg: ____________________________________________________________________

Diagnosis:_________________________________________________________________

Treatment -
Intervention - Application of ChakramardaGhrita / Go-Ghrita.
Hot sitz bath twice a daily
 Tab. TriphalaGuggul 500mg BD/After Meal
TriphalaChurna 1gm HS With luke warm water

Follow up and Assessment

Assessment of Subjective Parameter -

Sr. No. Parameter Grade Follow up

Day 0 Day 7 Day 14 Day 30
1 Pain
2 Bleeding
3 Itching

Assessment of Objective parameter–

Sr. Parameter Grade Follow up

No. Day 0 Day 7 Day 14 Day 30
1 Parikartika
Healing
2 Tenderness
 Guide P.G. Scholar
Dr. KiranKhandareAlokkumarDiwedi
Professor and H.O.D.

15) Budget duly certified by Guide and HOD

Sr. No Heads Amount per Quantity Total amount Remarks

unit in INR in INR
01 Chakramarda
leaves
02 Goghrita Rs.85/pt 15 Rs. 1275

03 Container Rs.12/pt 30 Rs.360

Total Rs.1635

Budget Proposal for Investigations –

Sr. No. Heads Cost/Unit Sample size Total cost Justification

01 Hb% 10/- 30 300/-For assessment of Anaemia
02 Random 40/- 30 1200/-
For rule out Diabetes
BloodSugar
03 HIV 100/- 30 3000/- For rule out AIDS
04 HbsAg 50/- 30 1500/- For rule out Hepatitis B
Total- 6000/- (Six Thousand Only)

Guide .Dr.KiranKhandare
AlokkumarDiwdiProfessor and H.O.D. P.G.
Scholar