THESIS

A CLINICAL STUDY TO STANDARDIZE THE
PROCEDURE OF DHANYAMLA DHARA AND TO
ASSESS ITS EFFICACY IN RHEUMATOID ARTHRITIS
This dissertation is submitted to
Kerala University of Health Sciences, Thrissur, Kerala,
in partial fulfillment of requirements for the award of the Degree
of
DOCTOR OF MEDICINE (AYURVEDA)
(Ayurveda Vachaspati - Panchakarma)
by
ARUN KUMAR BHADULA
Under the supervision of
Guide Co-Guide
DR. K. RAVISANKARAN M.D. (Ay) DR. S. SEENA M.D. (Ay)
H.O.D. & ASSOCIATE PROFESSOR ASSOCIATE PROFESSOR
2010 – 2013
DEPARTMENT OF PANCHAKARMA
GOVT. AYURVEDA COLLEGE
TRIPUNITHURA, KERALA

ENDORSEMENT BY THE H.O.D, PRINCIPAL/
HEAD OF THE INSTITUTION
GOVT. AYURVEDA COLLEGE, TRIPUNITHURA
KOCHI, KERALA – 682301
Forwarding certificate
2010 – 2013
This is to certify that the dissertation work entitled “A CLINICAL STUDY
TO STANDARDIZE THE PROCEDURE OF DHANYAMLA DHARA AND TO
ASSESS ITS EFFICACY IN RHEUMATOID ARTHRITIS”, is a bonafide research
work done by Arun Kumar Bhadula under the guidance of Dr. K. Ravisankaran,
M.D. (AY), HOD & Associate Professor and co-guidance of Dr. S. Seena, M.D. (AY),
Associate Professor, Department of Panchakarma, Govt. Ayurveda College,
Tripunithura.
HOD PRINCIPAL
Department of Panchakarma
Govt. Ayurveda College Govt. Ayurveda College
Tripunithura, Kerala Tripunithura, Kerala
Date:
Place: Tripunithura

DEPARTMENT OF PANCHAKARMA
GOVT. AYURVEDA COLLEGE, TRIPUNITHURA
KOCHI, KERALA – 682301
Certificate by Guide
2010 – 2013
This is to certify that the dissertation work entitled “A CLINICAL STUDY
TO STANDARDIZE THE PROCEDURE OF DHANYAMLA DHARA AND TO
ASSESS ITS EFFICACY IN RHEUMATOID ARTHRITIS” is a bonafide research
work done by Arun Kumar Bhadula in partial fulfillment of the requirement for the
degree of DOCTOR OF MEDICINE (AYURVEDA) in PANCHAKARMA.
Date: Guide
Place: Tripunithura Dr. K. Ravisankaran M.D. (Ay.)
HOD & Associate Professor
Department of Panchakarma
Govt. Ayurveda College, Tripunithura

DEPARTMENT OF PANCHAKARMA
GOVT. AYURVEDA COLLEGE, TRIPUNITHURA,
KOCHI, KERALA – 682301
Certificate by Co-guide
2010 – 2013
This is to certify that the dissertation work entitled “A CLINICAL
STUDY TO STANDARDIZE THE PROCEDURE OF DHANYAMLA
DHARA AND TO ASSESS ITS EFFICACY IN RHEUMATOID
ARTHRITIS” is a bonafide research work done by Arun Kumar
Bhadula in partial fulfillment of the requirement for the degree of
DOCTOR OF MEDICINE (AYURVEDA) in PANCHAKARMA.
Date: Co-guide
Place: Tripunithura Dr. S. Seena M.D. (Ay.)
Associate Professor
Department of Panchakarma
Govt. Ayurveda College, Tripunithura

INSTITUTIONAL COMMITTEE FOR ETHICS IN RESEARCH
Govt. Ayurveda College, Tripunithura, Kochi, Kerala – 682 301
Patron
Principal
Dr. A. Nalinakshan
GAVC, Tripunithura
Members
Adv. P.N. Money
Xanadu, Puthiyakavu
Mr. M. P. Antony
Project manager, Rajagiri
College of Social Sciences,
Kalamassery
Dr. Valsan P Kurian
Professor,
Dept. of Prasutitantra,
GAVC, Tripunithura
Rev.Fr. Joseph D.
Palackel
St. Francis Xavier’s Church
Puthiyakavu
Ref: IEC/109/2011 Date: 11.04.2011
AC
Certificate
The ethical committee held on 05.04.2011,
after scrutiny of the synopsis, unanimously
approves the research project titled “A CLINICAL
STUDY TO STANDARDIZE THE PROCEDURE
OF DHANYAMLA DHARA AND TO ASSESS ITS
EFFICAY IN RHEUMATOID ARTHRITIS” of
Arun Kumar Bhadula under the supervision of
Dr. K. Ravisankaran, in the department of
Panchakarma in the condition that the work will be
monitored by committee and alterations in the
research protocol should have further clearance
from the committee.
Dr. K. Murali M.D. (Ay)
Chairman
Professor & HOD
Dept. of Kayachikitsa
GAVC, Tripunithura

Declaration by the candidate
I hereby declare that this dissertation work entitled “A CLINICAL STUDY TO
STANDARDIZE THE PROCEDURE OF DHANYAMLA DHARA AND TO ASSESS ITS
EFFICACY IN RHEUMATOID ARTHRITIS” is a bonafide record of research work
done by me under the guidance of Dr. K. Ravisankaran, M.D. (AY), HOD &
Associate Professor and co-guidance of Dr. S. Seena, M.D. (AY), Associate
Professor, Department of Panchakarma, Govt. Ayurveda College, Tripunithura. And
no part of this work has been presented earlier for any degree/diploma or similar title
of any other University.
Date: Arun Kumar Bhadula
Place: Tripunithura Post Graduate Scholar
Department of Panchakarma,
Govt. Ayurveda College, Tripunithura

MEMORABILIA
MEMORABILIA
“At times our own light goes out and is rekindled by a spark from another person. Each of us has
cause to think with deep gratitude of those who have lighted the flame within us”
- Albert Albert Schweitzer
Schweitzer
This is my hour to express my sincere thanks to all those persons who directly or indirectly helped
me in any way to complete this work successfully.
At this amenity of successful integrating of my work, I bow my head on the feet of lord almighty
and my grandfather Late Shri Shri Jivanand Jivanand Bhadula Bhadula who enucleated in me enough amount of
strength to do my duties immaculately and whose blessings made me reach here.
Untrained intelligence is as much of use as a bottle without an opener. That’s why, it is matter of
great pleasure and honor for me to express my gratitude whole heartedly and with profound
respect to my ever respected guide Dr. Dr. K. K. Ravisankaran, Ravisankaran, H.O.D. & Associate Professor,
Department of Panchakarma, Tripunithura for his valuable guidance. He was not merely the
guide; many a time he was giving me constant inspiration, encouragement, support and a real
parental affection with an inner creative impulse not dominated and fettered by an outside
authority to touch this mile stone at this apt time successfully.
I am especially thankful to my respected Co-guide, most revered, admirable, esteemed
Associate Professor Dr. Dr. S. S. Seena, Seena, whose masterly suggestions and ablest guidance at every step
inspired me and gave me considerable impetus not only to accomplish this mile stone but in all
aspects, her encouragement and erudite suggestions helped me throughout the study period.
I would like to express my immeasurable thank to Dr. Dr. Riyas K.A. K.A. (Assistant Professor),
Dr Dr. Dr Remya Remya Vijayan Vijayan Vijayan (Assistant Professor) & Dr. Dr. Arun Arun Bhaskaran Bhaskaran (Assistant Professor),
Department of Panchakarma, for there sincere advices, guidance and encouragement at every step
of this work.
I feel immense pleasure to offer my sincere gratitude to our esteemed and respectable Principal
Professor Dr. T. K. K. Uma for her kind glance and munificence, without her kind support this work
would never have been completed.
I take this opportunity to thank Dr. A.G. Prasannakumari, Medical Superintendent, for
providing all facilities for clinical study.

I wish to express my sincere regards to Dr. K. Murali, HOD & Professor, Department of
Kayachikitsa, Tripunithura, for his time to time guidance, meticulous suggestions and constant
support throughout the study.
I also want to thank Dr. T. Sreekumar, HOD, Department of R & B, GAVC Tripunithura, for
allowing me to prepare my study medicine in the pharmacy and for his immense support time to
time, Dr. C. Shobhana Shobhana, Shobhana
Professor, Department of R & B, for their valuable suggestions and timely
help. I would like to thank my juniors Dr. Ranvijay, & & Dr. Dr. Harish Harish of R & B Department, for
their immense support in preparing my study medicine.
I am specially obliged and thankful to Dr. Dr. Ansari Ansari P. P. Y. Y., Y.
HOD, & Dr. Sara Monsy Monsy Oomen Oomen, Oomen
Associate Professor, Department of Dravyaguna vijyan, GAVC, Tripunithura, who were kind
enough to provide me a venue in their department where I conducted the various laboratory
analysis required for this study.
I do solicit my generous gratitude to my seniors Dr. Jaya Jayalakshmi Jaya
lakshmi lakshmi, , Dr. Amol, Dr. Shivangi,
Dr. Dr. Smitha Smitha T. T. V. V., V. Dr. Dr. Anil Anil Anil A A Bhawa Bhawade, Bhawa de, Dr. Dr. Jayadeep Jayadeep Jayadeep S S S & Dr. S. Pradeep for their co-operation
and guidance in every field.
With gratitude I summon up the assistance provided to me by my most cordial colleagues of the
department Dr. Nadeem Arif, Dr. Dr. Lima Lima K Sen, & & Dr. Dr. Nancy Nancy Baby Baby who always provided a
healthy environment for the research work and afforded sufficient moral support to accomplish the
work.
I fell short of words to extend my gratitude towards my supportive, affectionate and appreciable
juniors of the department Dr. Dr. Dr. Azeem Azeem Ahmad Ahmad, Ahmad Ahmad,
, Dr. Mahesh Khandate, Khandate, Dr. Dr. Rasna, Rasna, Rasna, Dr. Sreeja Sreeja, Sreeja
,
Dr. Dr. Manu, Manu, Dr. Dr. Smita, Smita, Dr. Dr. Dr. Jayapreet Jayapreethi Jayapreet i & & Dr. Dr. Unnikrishnan Unnikrishnan for their well-timed and
unconditional sincere help to accomplish the work.
I take this opportunity to express my sincere thanks to my seniors from other departments Dr.
Rajiv Rajiv Tripathi Tripathi, Tripathi Tripathi,
, Dr. Dr. Rajkumar, Rajkumar, Dr. Dr. Dr. Sanjay Sanjay Gupta, Gupta, Dr. Dr. Sanjay Sanjay Singh, Singh, Dr. r. r. Yogesh, Yogesh, Dr.
Dr.
Dayashankar,
Dayashankar,
Dr. Dr. Sahab, Sahab, Dr. Dr. Atul Atul Patil Patil, Patil
, , my batchmates Dr. Mukesh, Dr. Atul, Dr. Dr. Pritam Pritam, Pritam ,
Dr. Dr. Swati, Swati, Dr. Dr. Dimple, Dimple, Dr. Dr. Gandhali Gandhali & & Dr. Dr. Gauri Gauri who helped me in one way or the other in
completing this research work. I would also like to thank my juniors from other department viz. .
Dr. Dr. Kripa Kripa Shankar, Shankar, Dr. Dr. Manish,
Manish,
Dr. Dr. Dr. Ankush Ankush for their timely support.
Dr. Dr. Parul, Dr. Dr. Dr. Amey, Amey, Dr. Dr. Anamika, Dr. Aditi, Dr. Dr. Dr. Rupesh Rupesh Rupesh &
&
Words fail when heart speaks. Not a single alphabet can express my deep feeling towards my
parents Shri. Shri. Ram Ram Prasad Prasad Prasad Bhadula Bhadula & & Smt. Smt. Kaushalya Kaushalya Bhadula Bhadula, Bhadula who has been the source of

inspiration all through my career and my life, their constant support, penance and affection make
me what I am. One can do anything with the support of his family. I express my thanks to my
respected brother Mr. Ajay Kumar Kumar Bhadula and sister in-law Mrs. Mrs. Sangeeta Sangeeta Bhadula Bhadula who have
been a source of inspiration for my entire carrier. My sisters Mrs. Mrs. Rekha Rekha Rekha Sharma, Sharma, Mrs. Mrs. Mrs. Deepa
Deepa
Bansal Bansal & brother in-laws Mr. Mr. Deepak Deepak Deepak Sha Sharma Sha rma and Mr. Bhushan Bansal for their constant and
unending support.
I cherish the affectionate of my nephew Vaibhav and my nieces Vidushi Vidushi & Srishti Srishti whose love
have been a source of inspiration for my career.
I cannot move further before thanking to my intimate friend Dr. Amit Kumar Tanwar Tanwar who has
stood indefatigable with me in each and every circumstance and gave me in depth sense of
friendship. I take this moment to express my thanks to my friends Dr. Salman Salman Saleem Saleem, Saleem
, Dr. Dr.
Pushpender Pushpender, Pushpender Pushpender,
, Dr. Ravinder Ravinder, Ravinder
, , Dr. Dr. Shaily Shaily, Shaily , & Dr. Dr. Chanchal for their kind and moral support. I would
also like to thank Mr. Tarun Kumar, my elder brother like figure, for his timely and unconditional
support.
I express my sincere gratitude to Mr. Mr. Man Manoharan Man Manoharan
oharan (senior therapist) and all the Staff, Nurses and
Therapists who was with me always during the study with their full support.
I am thankful to Mr. P.J. P.J. Wels Wels, Wels
librarian and whole staff of our college library for their kind co-
operation during collection of literature. And also my special thanks to all the staff of college and
Hospital, Tripunithura.
I take this opportunity to thank all patients who co-operated with me wholeheartedly throughout
the study.
I take this opportunity to specially thank my senior Dr. Dr. Neeraj Neeraj Gupta Gupta and my roommate
Dr. Dr. Dr. Sudhanshu Sudhanshu Sudhanshu Dutt Dutt Dutt Sharma Sharma Sharma for their guidance, valuable suggestions and moral support rendered
during various stages of my work and throughout my course.
Last but not the least, I sincerely, give my thanks to all those persons, who directly or indirectly
helped me in my present work in any way. Errors are steps on the way and to err is human. At the
end the author bears sole responsibility, seeks pardon & apologizes for any error either of omission
and commission, which will still remains in the version. I thank all the listed and unlisted well
wishers.
- Arun Arun Arun Kumar Kumar Bhadula
Bhadula