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Synopsis of SNR

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Synopsis

SR
ITEM COMPONENT
NO.

A retrospective study of Dhatu Pradoshaja Vyadhi Hetus


1 TITLE (etiological factors responsible for vitiation of body tissues) in
known cases of Hypertension.

2 INTRODUCTION In present time hypertension has become a burning


problem all over the world. The prevalence of hypertension
has reached almost 30% in the world and almost the same
in India too. Being an Ayurveda scholar, we get curiosity
that how can we understand this disease with an Ayurvedic
perspective. Yes, almost all Ayurveda practitioners have
seen several cases of hypertension during their practice and
even cured that. So many people have tried to prove it with
a scientific method but still could not get satisfactory
results. And still we don’t have any scientifically proven
understanding about this disease according to Ayurveda.
That is why I decided to work over this topic and to try to
understand this disease according to Ayurveda with a
different approach to it. Dhatu is one of the main
components to understand the Samprapti.
The question arises that, which all Dhatus are involved in
Samprapti of Hypertension?
Answer to this question will be achieved after completion of
this study.
Answers to these questions will be achieved after completion
of this study.
Dhatu:
शरीरधारणात् धातवः। (अ.हृ.सू. 1/13)
Dhatus are those which holds the body.
Briefly we can compare it with connective tissues of the
body.
There are total 7 Dhatus,
1. Rasa – Plasma and Body Fluids
2. Rakta – Blood Tissue
3. Mamsa – Muscle Tissue
4. Meda – Adipose Tissue
5. Asthi – Skeletal Tissue
6. Majja – Nervous Tissue
7. Shukra – Reproductive Tissue
Function of Dhatus:
प्रीणनं जीवनं लेप : स्नेहो धारणपूरणे ।
गर्भोत्पादश्च धातूनां श्रेष्ठ कर्म क्रमात्
स्मृतम् ॥
(अ.हृ.सू. 11/4)

Dhatu Function

Rasa Preenan – To supply nutrients

Rakta Jeevan – Tissue Oxigenation

Mamsa Lepan – To cover body parts

Meda Snehan – Lubrication

Asthi Dharan – To maintain body posture

Majja Puran – To fill up the cavity

Shukra Garbhotpadan – Reproduction

Srotas:
Srotas are the body parts which facilitates easy movement of
any material in the body along with some physiological changes
by different kind of secretions. स्रवणात् स्रोतांसि (ch.
Su. 30/12). Acharya Sushruta gives definition of srotas as the
structures which have cavity at their root and which spreads all
over the body to do work of either secretion or transportation
or circulation or two or three of these works. And he adds that
dhamani and siras are different than srotas. Which means
dhamani and siras can be a srotas but all the srotases are not
dhamani or sira. These srotases does circulation, transportation
and secretion of certain entity of body.
Number of Srotas:
While talking about number of srotases, Acharya Charaka says,
यावन्तः पुरुषे मूर्तिमन्तो भावविशेषास्तावन्त
एवास्मिन् स्रोतसां प्रकारविशेषाः| (ch. Vi. 5/3)
which means there are as many srotases as there are corporeal
in the body. Now, according to Allopathic science cell is a
structural and functional unit of the body. That means cell is a
corporeal and cell are innumerable which determines that
srotases are also innumerable.
Grossly Acharya Charaka enumerated following 13 srotases in
compendia. And Acharya Sushruta have enumerated 2 more
Srotases in addition.

Srotas Secreted/transported/circulated entity

Pranavaha
Prana/Life
Srotas

Annavah
Ahara/Food
Srotas

Udakavaha
Udaka/Water
Srotas

Rasavaha
Rasa Dhatu
Srotas

Raktavaha
Rakta Dhatu
Srotas

Mamsavaha
Mamsa Dhatu
Srotas

Medovaha
Meda Dhatu
Srotas
Asthivaha
Asthi Dhatu
Srotas

Majjavaha
Majja Dhatu
Srotas

Shukravaha
Shukra Dhatu
Srotas

Mutravaha
Mutra/Urine
Srotas

Purishavaha
Purisha/Feces
Srotas

Swedavaha
Sweda/Sweat
Srotas

Stanyavaha
Srotas Stanya/Breast Milk
(Sushruta)

Artavavah
Srotas Artava/Menstual Blood
(Sushruta)

Table 2.1

broader sense Srotas can be considered as channels of the


body according to allopathic science.
Hypertension:
Hypertension is a condition where Systolic blood pressure
increases more than 140 mm Hg and diastolic more than 90
mm Hg. According to Allopathic science, there are no visible
symptoms in this phase but this condition increases the
chances of other diseases of different vital organs like heart
failure, Coronary Artery Disease, Left Ventricular Hypertrophy,
Stroke or Transient Ischemic Attack, Dementia, Chronic Kidney
Disease, Peripheral artery disease, Retinopathy etc.
Even allopathy doesn’t have any accurate curable solution for
this condition
As we all know, hypertension occurs due to some changes in
blood vessels, Srotas plays an important role in manifestation
of any disease according to Ayurveda. So, to understand the
etiopathogenesis of hypertension according to Ayurveda, it
becomes very important to know that which srotas is involved
in this disease. After knowing the srotas involvement planning
for treatment can be done in different way.

PRIMARY Are Dhatu Pradoshaja Hetus associated with Hypertension?


3
RESEARCH
(1)
QUESTION

4 NULL Dhatu Pradoshaja Hetus are not associated with Hypertension.


(1) HYPOTHESIS

4 ALTERNATIVE Dhatu Pradoshaja Hetus are associated with Hypertension.


(2) HYPOTHESIS

� A. Literature from Ayurveda Samhita.


1. Charak Samhita – in vimana sthana 5th chapter of
charaka Samhita, Acharya have explained the concept of
Dhatu Pradoshaja Hetus for each Dhatus.

REVIEW OF 2. Ashtanga Hridaya – In sutra Sthana we get the


5 explaination about all the Dhatus and its normal
LITERATURE
functions.
� B. Literature from allopathy science book.
1. Davidson’s book of Medicine
2. Harrison’s book of Medicine

● AIM: - To study the association of Dhatu Pradoshaja


Vyadhi Hetus (etiological factors responsible for
vitiation of body tissues) in Hypertension.
AIM &
6 ● OBJECTIVE: - To find out association of each Dhatu in
OBJECTIVE
hypertension by analysing Dhatu Pradoshaja Vyadhi
Hetus (etiological factors responsible for vitiation of
body tissues) retrospectively.

7 METHODOLOGY Material and Methods:

1. Study Design: Retrospective study


2. Study Centre: Dr. D. Y. Patil College of Ayurved, Hospital
& Research Center, Pimpri – Pune.
2
Z P(1−P)
Sample Size:n=
d2
( 1.645 )2 0.307 (1−0.307)
n= 2
(0.08)

n = 89.95 ≈ 90

Where,
n = Sample Size
P = Prevalence (30.7%)
Z = Standard normal variate at 90% confidence index
d = Absolute error (8%)
3. Sampling Techniques: Patients attending OPD/IPD will
be screened.
4. Method of selection of study subjects:
A. Inclusion criteria:
● Age Group: - 30 – 60 years
● Known cases of hypertension with maximum one year
of history.
B. Exclusion criteria:
● Pregnant women.
● Person who are known cases of diabetes mellitus, CVD
and thyroid disorders.
5. Study Instrument and Data Collection Tool:
a) Questionnaire Proforma.
6. Data Management & Analysis Procedure:
M.S.Excel & Other statistical software will be used.
7. Plan for Statistical Analysis:
Statistical analysis will be done using chi-square test.
Discussion:
The observation of all Dhatu Pradoshaja Hetus in
hypertensive patient will be discussed after analysis of
data.
Summary:
Whole work will be summarized data collection, analysis
and result.
Conclusion:
Appropriate conclusion will be drawn on the basis of
collected and analyzed data.

8. Flow chart:

Patients who comes under inclusive criteria will be selected.

They will be Informed about study and written consent will be


taken.

Hypertension will be confirmed after resting their medicines for


2 days.

Dhatu Pradoshaja Hetus will be assessed by interview in local


language through questionnaire.

Participants response will be noted with sign.

9 REFERENCES 1. Brian R. Walker, Nicki R. Colledge, Stuart H. Raltson, Ian


D. Penman, Hypertension, Davidson’s Principles and
Practice of Medicine, 22nd edition. Churchill Livingstone:
Elsevier; 2014.
2. Dennis L. Kasper, Eugene Braunwald, Anthony S. Fauci,
Stephen L. Hauser, Dan L. Longo, J. Larry Jameson,
Hypertensive vascular Disease, Harrison’s Principles of
Internal Medicine, 16th edition. McGraw-Hill: Medical
Publishing Division; 2005.
3. Yash Pal Munjal, Surendra K Sharma, AK Agrawal, Pritam
Gupta, Sandhya A Kamath, Milind Y Nadkar, RK Singal,
Shyam Sundar, Subhash Varma, Ghan Shyam Pangtey,
Anupam Prakash, Siddharth N Shah, Hypertension, API
Textbook of Medicine, 10th edition. Mumbai: Dr Yash Pal
Munjal for and behalf of The Association of Physicians of
India, Jaypee Brothers Medical Publishers (P) Ltd.; 2015.
4. Michael Swash, Michael Glynn, Hypertension,
Hutchison’s Clinical Methods an Integrated approach to
Clinical Practice, 22nd edition. Saunders: Elsevier; 2010.
5. Acharya Vagbhatta, Ashtangahridaya (A compendium of
the Ayurvedic system) with commentaries:
‘Sarvangasundar” of Arundatta & ‘Ayurveda Rasayana’
of Hemadri, Varanasii: Chaukhambha Surbharati
Prakashan, 2020
6. Acharya Charaka & Dridhabala, Vaidya Yadavji Trikamji
Acharya, Charaka Samhita of Agnivesha, Varanasii:
Chaukhambha Surbharati Prakashan, 2020

TIMELINE/GANTT
10
CHART

Dr. D. Y. Patil College of Ayurved, Hospital and Research Centre, Pimpri – Pune.

Questionnaire
NAME – DATE –
AGE – GENDER –

Thrice
Not Once in
in a Daily
Dhatu Hetu present a week
week
(3)
(0) (1)
(2)

Eating heavy food

Eating cold food

Eating over – unctuous food


Rasa
Food consumption in excessive
quantity

Doing excessive mental


work/taking excessive stress

Consumption of food and drinks


which are heavy to digest and
may cause burning sensation

Eating unctuous food


Rakta
Eating excessive hot food

Taking excessive amount of liquids

More exposure to sun or fire

Eating excessive channel blocking


(Abhishyandi) food

Eating excessive bulky (Sthoola)


food

Mamsa Eating excessive heavy (Guru)


food

Sleeping immediately after having


meal

Sleeping during day time

Meda Lack of physical exercise

Sleeping during day time

Excessive intake of fatty food

Food consumption in excessive


quantity
Excessive intake of alcohol

Excessive physical exercise

Excessive jerks to the body


Asthi Excessive rubbing of bones

Constant use of vata-aggravating


material

Injury which caused Crushing of


joints or bones

Eating excessive channel blocking


(Abhishyandi) food

Majja Sever physical trauma

Injury which caused Compression


of joints or bones

Repeated consumption of
incompatible foods

Sexual acts at inappropriate hours

Sexual acts through non-vaginal


tract

Suppression of discharge of
Shukra
semen

Excessive coitus

Faulty surgical procedures or


Kshara/Agni Karmas

Signature of Patient Signature of Doctor

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