RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES

KARNATAKA, BANGALORE

COMPLETED PROFORMA FOR REGISTRATION

OF SUBJECT FOR DISSERTATION

“A CLINICAL STUDY TO EVALUATE THE THERAPEUTIC

EFFECT OF NAVA KARSHIKA KASHAYA
IN VATARAKTA ”
BY
DR. GAUHAR VATSYAYAN
M.D(Ayu), SCHOLAR
DEPARTMENT OF P.G. STUDIES IN KAYACHIKITSA
S.D.M COLLEGE OF AYURVEDA, KUTHPADY, UDUPI

GUIDE
DR. U.N. PRASSAD M.D. (AYU)
PROFESSOR & PRINCIPAL
DEPT. OF PG STUDIES IN KAYACHIKITSA
S.D.M. COLLEGE OF AYURVEDA,
KUTHPADY, UDUPI-574118

CO-GUIDE
DR. G. SHRINIVASA ACHARYA M.D (AYU)
PROFESSOR & H.O.D
DEPT. OF PG STUDIES IN KAYACHIKITSA
S.D.M. COLLEGE OF AYURVEDA,
KUTHPADY, UDUPI-574118

2008-09
S.D.M. COLLEGE OF AYURVEDA,
KUTHPADY, UDUPI-574118
From:
Dr. GAUHAR VATSYAYAN
M.D.(Ayu), SCHOLAR
DEPT. OF P.G. STUDIES IN KAYACHIKITSA
S.D.M. COLLEGE OF AYURVEDA,
KUTHPADY, UDUPI - 574118
To,
THE REGISTRAR
RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES
KARNATAKA, BANGALORE

Through,
THE PRINCIPAL
S.D.M. COLLEGE OF AYURVEDA
KUTHPADY, UDUPI - 574118

Respected Sir,
SUB: Submission of completed proforma for registration of synopsis for Dissertation.
I would request you to kindly register the below mentioned synopsis of dissertation
work against my name to Rajiv Gandhi University of Health Sciences, Karnataka, for
partial fulfillment of M.D. (Ayu) in Kayachikitsa.

Title of Dissertation:

“A CLINICAL STUDY TO EVALUATE THE THERAPEUTIC

EFFECT OF NAVA KARSHIKA KASHAYA
IN VATARAKTA”

Here with I am enclosing completed synopsis for registration of subject for dissertation.

Thanking You,
Place: Udupi Yours faithfully,
Date: 30 - 11 - 2007
( DR. GAUHAR VATSYAYAN )
1) NAME OF THE CANDIDATE : DR. GAUHAR VATSYAYAN.
M.D (Ayu) SCHOLAR,
DEPT.OF P.G.STUDIES IN
KAYACHIKITSA
S.D.M.COLLEGE OF AYURVEDA,
KUTHPADY, UDUPI

PERMANENT ADDRESS : DR. GAUHAR VATSYAYAN

SANJIVANI AYURVEDIC CENTRE
NEAR ROSE GARDEN MAIN GATE
LUDHIANA 141001, PUNJAB

2) NAME OF THE INSTITUTION: S.D.M. COLLEGE OF AYURVEDA,

KUTHPADY, UDUPI-574118
KARNATAKA
3) COURSE OF STUDY AND
SUBJECT : M.D.(AYURVEDA)IN KAYACHIKITSA

4) DATE OF ADMISSION OF
COURSE : 02- 06- 2007

5) TITLE OF THE TOPIC STUDY :

“A CLINICAL STUDY TO EVALUATE THE THERAPEUTIC

EFFECT OF NAVA KARSHIKA KASHAYA
IN VATARAKTA”

6) BRIEF RESUME OF THE INTENDED WORK

6.1) NEED FOR THE STUDY:
By principle, vata being the predominant among Tridosha has the potential to cause more
serious, perpetuating and lingering disorders than the other two. The etio-pathogenesis of
an illness by way of avarana is unique to the Vatavyadhi. Incidentally, much of the
treatment modalities of Vatavyadhi revolve around the correction of avarana. The two tier
samprapti of Margavarana leading to avarana of vata characterizes the illness Vata Rakta 1.
In the parlance of conventional medicine, Vata Rakta incorporates multitude of disorders
including Arterial as well as venous disorders collectively referred as vascular diseases.
These diseases strike a contrasting difference in their symptoms. Obstructive arterial
diseases are characterized by symptoms like pain, numbness, coldness and pallor. Contrary
to this, edema, eczema and dilated and tortuous peripheral veins are pathognomonic of
venous hypertension2. Identical to the venous hypertension, Sparshajnatatvam,
Karshnayam, Sphuranam, Vaivarnyam, Mandalotpatti along with dilated, tortuous,
elongated varicose veins are indicative of vatanubandhi Vata Rakta. More to add, as these
symptoms are based at Twak, Rakta and Mamsa dhatu, incidentally deduce the probability
of Uttana Vatarakta.
Due to changed and Faulty life style about 15-20% of the population suffers from
Varicose Veins in India. Women suffer four times more than men 3. Available management
include Palliative approach, which has a very limited scope, Fegan’s injection method,
which is only a long term policy of maintenance and the last option being the surgery 4.
Therefore there is a definite need to explore more efficacious conservative and radical
cure to this chronic progressive illness.

6.2) REVIEW OF LITERATURE

Vatarakta is also known as Adhyavata, Khudavata, Vatasrika and Vatabalaasa1.
Folks indulging in Mithyaharavihara cause a Margavarana of the increased Vata Dosha by
the Dushita Rakta in the body. Literature has explained both Shodhana and Shamana
chikitsa for Vatarakta. Shodhana includes Virechana, Basti and Rakta mokhshana.
Shamana includes both Antaparimarjana and Bahiparimarjana chikitsa. Nava Karshika
Kashaya is a popular common prescription for Vata Rakta and is said to be very effective 5

SOME OF THE PREVIOUS STUDIES DONE:

1. A single blind comparative study was carried on Vata Rakta / ischemic limb disease
with 10 patients of group A was treated with Kaishora Guggulu and Arogyavardhini
Vati. In group B, 10 patients were initially subjected to Yogabasti course of
Manjishthadi Kshara basti & Dhanvantara Tail Anuvasana Basti. The study revealed
better therapeutic response in patients treated with Manjishthadi Kshara Basti 6
2. In another single blind clinical study on therapeutic effect of Vatraktantak Rasa &
Lekhan basti was carried out in patients suffering from Vata Rakta / ischemic limb
disease. Twenty patients were taken and the results showed that mean initial score of
pain came down to 1.0 from 1.8. Burning sensation & Edema was reduced to 57.4% &
85.71% respectively 6.

The review of previous work done clearly indicate that almost all the randomized clinical
trials on Vatarakta is either related to ischemic limb disease or Rheumatoid arthritis. The
study on venous hypertension is limited to the therapeutic effect of raktamoksana in stasis
eczema. No trials were carried out on oral medication related to uttana vatanubandi
vatarakta / venous hypertension. Hence this study is planned to evaluate the effect of
Navakarshika kashaya in patients suffering from Uttana Vatanubandi Vatarakta / Venous
hypertension.

6.3) OBJECTIVES OF THE STUDY:

 Review of the literature unraveling the clinical understanding of vatanubandi
uttana vatarakta in relation to venous hypertension.
 To evaluate the therapeutic effect of Nava Karshika Kashaya in bringing about
remission of the symptoms/illness in patients suffering from vatanubandi uttana
vatarakta / venous hypertension.

7) MATERIALS AND METHODS :

 7.1) Source of data:
Minimum 20 patients with a definite diagnosis of vatanubandi uttana vatarakta / venous
hypertension, fulfilling the diagnostic/ inclusion and exclusion criteria will be selected
for the study irrespective of their sex, cast and religion. These patients will be recruited for
the study after getting a written consent.

7.2) Method of collection of data:

A special proforma will be prepared incorporating all the clinical manifestation and
assessment criteria including ancillary investigation findings of the vatanubandi uttana
vatarakta / venous hypertension. Complete clinical data is collected from all the selected
patients as per this proforma before the intervention and every week following this until
the completion of the study. Results obtained will be statistically analyzed by adapting the
paired‘t’ test.

Design of the study:

It will be a single blind clinical study with pre-test and post-test design

INTERVENTION
Navakarshika kasaya is orally administered in a dose of 60 ml twice daily before food.

Duration of study:
28 days of medication followed by another 28 days of follow up

Diagnostic criteria
1. Must have visible or palpable sirayama - reticular veins / varicosity at the thigh, lower
leg or foot.
2. May have other clinical manifestations of vata rakta / venous hypertension

Inclusion Criteria:
1. Patients fulfilling the criteria of diagnosis with no restriction of sex and religion
2. Patients between the ages of 16 to 70 years.

Exclusion Criteria:
1. Pregnant woman
2. Varicose Ulceration
3. Patient with any other systemic illness like diabetes mellitus.

Assessment Criteria:
1. Ruk, sphurana, karshnyata, sotha etc symptoms will be assessed by adapting Visual
Analogue Scale
2. The Venous Clinical Severity Score (VCSS)7

7.3) Does the study require any investigations or interventions to be conducted on

patients or other humans or animals? If so please describe briefly:
Study will be conducted on patients suffering from vatanubandi vatarakta /
varicosities only. No animal experiments will be done.

Investigations:
1) Blood- TC, DC, ESR, HB%,RBS
2) Lipid Profile

7.4) Has ethical clearance been obtained from your institution in case of 7.3?
Yes, concurrence has been obtained from the ethical committee of the institute.

8) List of References:
1) Agnivesa, Caraka Samhita, Vol II, Elaborated by Caraka, redacted by Drdhbala, Edited
with Vaidyamanorama commentary By Acharya Vidyadhar Shukla and Prof Ravi
Dutt Tripathi, Chaukhamba Surbharti Prakashan 2005. Pp 999. P.No 730-731

2) Cambell Bruce, Varicose Veins and their Management- 5/08/2006 (Cited 28/10/2008)
Available from www.bmj.com.

3) Pandey K.K, Varicose veins: A result of Sedentary style, – 1/9/2004 {cited 28/10/2008)
Available from http://www.tribuneindia.com/2004/20040901/health.

4) Das. S, ‘A concise text book of surgery’, Third Edition feburary 2002, published by Dr.
S Das. Pp 1324, P.No. 200-207

5) Bhavamishra, Bhavaprakasha edited with Vidyotini Hindi Commentary by pandit Sri

Brahma Shankara Mishra, part-2, 8th Edition,2003, Chaukambha Sanskrit Bhavan,
Varanasi, 221001, Pp.836,P.N0. 305—306

6) Patil K.V, A clinical study to evaluate the therapeutic effect of Vataraktantak rasa and
lekhan basti in Vatarakta SDMCA- Udupi (Unpublished Doctoral Dissertation,
RGUHS, Bangalore 2006-2007). Pp 151

7) Rutherford RB, Padberg Jr FT, et al. Venous outcome assessment. IN: Gloviczki P, Yao
JST (editors). Handbook of Venous Disorders, 2nd Edition. Guidelines of the
American Venous Forum. Arnold Publishers. 2001, P.No. 497-508

9) SIGNATURE OF THE CANDIDATE :

10) REMARKS OF THE GUIDE :

11) NAME AND DESIGNATION OF

11.1) GUIDE : DR. U.N. PRASSAD MD (AYU)

PROFESSOR & PRINCIPAL
DEPT. OF PG STUDIES IN
KAYACHIKITSA
S.D.M. COLLEGE OF AYURVEDA
KUTHPADY, UDUPI-574118

11.2) SIGNATURE

11.3) CO GUIDE : DR.G.SHRINIVASA ACHARYA

MD (AYU)
PROFESSOR& HOD
DEPT. OF PG STUDIES IN
KAYACHIKITSA
S.D.M. COLLEGE OF AYURVEDA
KUTHPADY, UDUPI-574118

11.4) SIGNATURE :
11.5) HEAD OF THE DEPARTMENT
: DR.G.SHRINIVASA ACHARYA
MD (AYU)
PROFESSOR& HOD
DEPT. OF PG STUDIES IN
KAYACHIKITSA
S.D.M. COLLEGE OF AYURVEDA
KUTHPADY, UDUPI-574118

11.5) SIGNATURE :

12) REMARKS OF THE CHAIRMAN

& PRINCIPAL :

12.1 ) SIGNATURE :