A A STUDY ON SIRAJA GRANTHI AND ITS MANAGEMENT WITH S T PUNARNAVADI GUGGULU AND NIMBADI GUGGULU-A U D COMPARATIVE STUDY. G Y U O G N G U S L IR U A A J A N D G N R I A M N B T A H D I By I A G N Dr. NADAF A.N. U D G I T G Dissertation Submitted to the S U L M Rajiv Gandhi University of Health Sciences, Bengaluru, U A - N A A Karnataka C G O E In partial fulfillment of the requirements for the degree of M M P E A N R T AYURVEDA DHANWANTARI A W T (MASTER OF SURGERY) IV IT E H In S P T U U N SHALYA TANTRA D A Y R .N Under the guidance of A V Dr. B.A.VENKATESH A D BSAM, BAMS, MD (Ayu), FICA I Professor & H.O.D. Dept. Of P.G. Studies in Shalya Tantra G.A.M.C, Bengaluru - 09 DEPARTMENT OF POST GRADUATE STUDIES IN SHALYA TANTRA D r . 2 N GOVERNMENT AYURVEDIC MEDICAL COLLEGE 0 0A 9 D - A Bengaluru - 560009 2 0F 1 0A 2009 - 2010 . N . A STUDY ON SIRAJA GRANTHI AND ITS MANAGEMENT WITH PUNARNAVADI GUGGULU AND NIMBADI GUGGULU-A COMPARATIVE STUDY. By Dr. NADAF A.N. Dissertation Submitted to the Rajiv Gandhi University of Health Sciences, Bengaluru, Karnataka In partial fulfillment of the requirements for the degree of AYURVEDA DHANWANTARI (MASTER OF SURGERY) In SHALYA TANTRA Under the guidance of Dr. B.A.VENKATESH BSAM, BAMS, MD (Ayu), FICA Professor & H.O.D. Dept. Of P.G. Studies in Shalya Tantra G.A.M.C, Bengaluru - 09 DEPARTMENT OF POST GRADUATE STUDIES IN SHALYA TANTRA GOVERNMENT AYURVEDIC MEDICAL COLLEGE Bengaluru - 560009 2009 - 10 RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES KARNATAKA, BENGALURU DECLARATION BY THE CANDIDATE I hereby declare that this dissertation entitled “A study on Siraja granthi and its management with Punarnavadi guggulu and Nimbadi guggulu – Comparative study, is a bonafide and genuine research work carried out by me under the guidance of Dr.B.A.Venkatesh Professor and HOD of Dept of PG studies in Shalya Tantra, GAMC Bangalore. Date: Signature of the candidate Place: Dr.NADAF. A.N Department of Post Graduate Studies in Shalya Tantra. Government Ayurvedic Medical College Bengaluru : 560009 CERTIFICATE BY THE GUIDE This is to certify that the dissertation entitled “A study on Siraja granthi and its management with Punarnavadi guggulu and Nimbadi guggulu – Comparative study” is a bonafide and genuine research work carried out by Dr.NADAF.A.N in partial fulfillment of the requirement for the degree of “AYURVEDA DHANWANTARI” [Shalya Tantra] – Master of Surgery [Ayu]. I recommend this dissertation for the above degree to the University for assessment and approval. Date: Dr.B.A.Venkatesh BSAM,BAMS,M.D (Ayu),FICA Place: Professor and HOD Dept of PG Studies ShalyaTantra GAMC Bengaluru: 09 Department of Post Graduate Studies in Shalya Tantra. Government Ayurvedic Medical College Bengaluru: 560009 ENDORSEMENT BY HOD This is to certify that the dissertation entitled “A study on Siraja granthi and its management with Punarnavadi guggulu and Nimbadi guggulu – Comparative study” is bonafide research work done by Dr.NADAF.A.N under the guidance of Dr.B.A.VENKATESH. Professor and HOD, Dept of PG studies in Shalya Tantra. I recommend this dissertation for the above degree to the University for Assessment and approval. Head of the Department Dr.B.A.Venkatesh Professor and HOD Dept of PG Studies in ShalyaTantra GAMC Bengaluru: 09 Department of Post Graduate Studies in Shalya Tantra. Government Ayurvedic Medical College Bengaluru: 560009 ENDORSEMENT BY PRINCIPAL This is to certify that the dissertation entitled “A study on Siraja granthi and its management with Punarnavadi guggulu and Nimbadi guggulu – Comparative study” is a bonafide research work done by Dr. NADAF.A.N under the guidance of Dr.B.A.VENKATESH. Professor and HOD, Dept of PG studies in Shalya Tantra. I recommend this dissertation for the above degree to the University for Assessment and approval. Principal Govt.Ayurvedic Medical College Bengaluru COPYRIGHT DECLARATION BY THE CANDIDATE I hereby declare that the Rajiv Gandhi University of Health Sciences, Bengaluru, Karnataka, shall have the rights to preserve, use and disseminate this dissertation in print or electronic format for Academic / research purposes. Signature of the candidate Dr. NADAF.A.N @ Rajiv Gandhi University of Health Sciences, Bengaluru ACKNOWLEDGEMENT No work is a result of individual effort. It is contributory effort of many hearts, hands and heads. It gives me immense pleasure to offer my sincere thanks to all those who have rendered their wholehearted support, guidance and Co-operation in completing my thesis work. I place on record my utmost gratitude to my adorable guide and HOD Dr.B.A.Venkatesh, Professor and Head, Department of P.G.Studies in Shalyatantra G.A.M.C. Bengaluru, for his incessant, untiring, round the clock guidance with all the diligence, his sustained fostering and encouragement instilled considerable impetus in me enabling to achieve this milestone which otherwise would have lacked this particular finish. I extend earnest thanks to Dr. H.T.Sreenivas, Principal, G.A.M.C, Bengaluru, for unstinted help extended whenever solicited. I express my sincere thanks to, Dr. Vijaya Sarathi .R, Professor, Dr.R.KHibare, Professor, Dr.Ahalya, Professor and Dr. Narmada., Asst. Professor, Dr.Sridhar Rao.A, Asst. Professor Dr. Shivu Arekeri, Dr. Srinivas, Dr.Durgesh, lecturers, Dept. of P.G Studies in Shalya Tantra, G.A.M.C, Bengaluru, for their kind suggestion and guidance throughout the course of my study. I am at no words to explain the amount of gratitude and thanks to Dr.Ravikumar, Gen.Surgeon, KCG Hospital for his dedicated professionalism, indefatigable efforts and cheerful co-operation. I sincerely thank my Senior colleagues for their tremendous suggestions and support through out my work. I acknowledge my gratitude to all my colleagues, Dr. Vishwanath sharma, Dr. Ramya bhat, Dr. Veena koppal, Dr. Sweta, Dr. Abhinetri hegde and Dr.Rajeshwari, who gave me unstinted support and stood solidly beside me throughout my study. I also profusely thank my junior colleagues, Jayanth, Laxman, Prashanth, Manjunath Joshi, Vivek, Naveen, Jayashree and Divya lakshmi for their continuous support and kind help. I would like to thank my friend Dr.Naveen, for his support. I express my sincere gratitude to all the teaching fraternity, Physicians, library staff, hospital and office staff of G.A.M.C, Bengaluru, for sincere advices and assistance. I am very much thankful to my department colleagues and friends for their needful support to fulfill this task. It fills joy in my heart to express my sincere gratitude to all my Teachers of DGM Ayurvedic Medical College, Gadag, who designed my career in Ayurveda. I am grateful to all the teachers who came in my life and taught me ‘the science of life’. I sincerely thank Dr.Arun biradar for his utmost support and help during my study period. I thank Dr K.P.Suresh, Statistician, without whose help whole of my work would have looked meaningless I take this opportunity to appreciate the generous co-operation offered by my patients by being supportive and compliant during the study period. I express my thanks to all the persons who have helped me directly & indirectly with apologies for my ability to identify them individually. Dr. NADAF.A.N ABSTRACT Background: Siraja granthi (varicose veins) is one of the commonest disorders in surgical practice. Ayurveda has given a great contribution in the management of this disorder, while describing the management of Vata Vyadhi and siraja granthi. In Ayurveda there are various terminology for varicose veins such as Siraja granthi, Siraakunchan, Sirakutilata and Siragata vata. Research works have been done with both internal and external medicines along with conservative treatment such as external application of Sahacharadi Taila, internal Basti and Para surgical procedure such as Jaloukavacharana and Siravyadha. A preliminary pilot study was conducted on a selective patient of varicose vein for a period of 2 months where in selected subject were divided into 2 groups of 5 patients in each group. Group A was administrated with Punarnavadi guggulu vati in dose of two vati twice daily for a period of 2 months. In-group B, Nimbadi guggulu two vati twice daily was administered for a period of 2 months. Objectives of the study: • To evaluate the efficacy of the Punarnavadi guggulu in Siraja granthi. • To evaluate the efficacy of the Nimbadi guggulu in Siraja granthi. • To evaluate the comparative efficacies of Punarnavadi guggulu vati and Nimbadi guggulu vati in Siraja granthi. • To assess the management of varicose vein with that of conservative line of treatment like control study with elastic stockings.