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A CLINICAL STUDY TO STANDARDIZE THE<br />
PROCEDURE OF DHANYAMLA DHARA AND TO<br />
ASSESS ITS EFFICACY IN RHEUMATOID ARTHRITIS<br />
This dissertation is submitted to<br />
Kerala University of Health Sciences, Thrissur, Kerala,<br />
in partial fulfillment of requirements for the award of the Degree<br />
of<br />
DOCTOR OF MEDICINE (AYURVEDA)<br />
(Ayurveda Vachaspati - Panchakarma)<br />
by<br />
ARUN KUMAR BHADULA<br />
Under the supervision of<br />
Guide Co-Guide<br />
DR. K. RAVISANKARAN M.D. (Ay) DR. S. SEENA M.D. (Ay)<br />
H.O.D. & ASSOCIATE PROFESSOR ASSOCIATE PROFESSOR<br />
2010 – 2013<br />
DEPARTMENT OF PANCHAKARMA<br />
GOVT. AYURVEDA COLLEGE<br />
TRIPUNITHURA, KERALA
ENDORSEMENT BY THE H.O.D, PRINCIPAL/<br />
HEAD OF THE INSTITUTION<br />
GOVT. AYURVEDA COLLEGE, TRIPUNITHURA<br />
KOCHI, KERALA – 682301<br />
Forwarding certificate<br />
2010 – 2013<br />
This is to certify that the dissertation work entitled “A CLINICAL STUDY<br />
TO STANDARDIZE THE PROCEDURE OF DHANYAMLA DHARA AND TO<br />
ASSESS ITS EFFICACY IN RHEUMATOID ARTHRITIS”, is a bonafide research<br />
work done by Arun Kumar Bhadula under the guidance of Dr. K. Ravisankaran,<br />
M.D. (AY), HOD & Associate Professor and co-guidance of Dr. S. Seena, M.D. (AY),<br />
Associate Professor, Department of Panchakarma, Govt. Ayurveda College,<br />
Tripunithura.<br />
HOD PRINCIPAL<br />
Department of Panchakarma<br />
Govt. Ayurveda College Govt. Ayurveda College<br />
Tripunithura, Kerala Tripunithura, Kerala<br />
Date:<br />
Place: Tripunithura
DEPARTMENT OF PANCHAKARMA<br />
GOVT. AYURVEDA COLLEGE, TRIPUNITHURA<br />
KOCHI, KERALA – 682301<br />
Certificate by Guide<br />
2010 – 2013<br />
This is to certify that the dissertation work entitled “A CLINICAL STUDY<br />
TO STANDARDIZE THE PROCEDURE OF DHANYAMLA DHARA AND TO<br />
ASSESS ITS EFFICACY IN RHEUMATOID ARTHRITIS” is a bonafide research<br />
work done by Arun Kumar Bhadula in partial fulfillment of the requirement for the<br />
degree of DOCTOR OF MEDICINE (AYURVEDA) in PANCHAKARMA.<br />
Date: Guide<br />
Place: Tripunithura Dr. K. Ravisankaran M.D. (Ay.)<br />
HOD & Associate Professor<br />
Department of Panchakarma<br />
Govt. Ayurveda College, Tripunithura
DEPARTMENT OF PANCHAKARMA<br />
GOVT. AYURVEDA COLLEGE, TRIPUNITHURA,<br />
KOCHI, KERALA – 682301<br />
Certificate by Co-guide<br />
2010 – 2013<br />
This is to certify that the dissertation work entitled “A CLINICAL<br />
STUDY TO STANDARDIZE THE PROCEDURE OF DHANYAMLA<br />
DHARA AND TO ASSESS ITS EFFICACY IN RHEUMATOID<br />
ARTHRITIS” is a bonafide research work done by Arun Kumar<br />
Bhadula in partial fulfillment of the requirement for the degree of<br />
DOCTOR OF MEDICINE (AYURVEDA) in PANCHAKARMA.<br />
Date: Co-guide<br />
Place: Tripunithura Dr. S. Seena M.D. (Ay.)<br />
Associate Professor<br />
Department of Panchakarma<br />
Govt. Ayurveda College, Tripunithura
INSTITUTIONAL COMMITTEE FOR ETHICS IN RESEARCH<br />
Govt. Ayurveda College, Tripunithura, Kochi, Kerala – 682 301<br />
Patron<br />
Principal<br />
Dr. A. Nalinakshan<br />
GAVC, Tripunithura<br />
Members<br />
Adv. P.N. Money<br />
Xanadu, Puthiyakavu<br />
Mr. M. P. Antony<br />
Project manager, Rajagiri<br />
College of Social Sciences,<br />
Kalamassery<br />
Dr. Valsan P Kurian<br />
Professor,<br />
Dept. of Prasutitantra,<br />
GAVC, Tripunithura<br />
Rev.Fr. Joseph D.<br />
Palackel<br />
St. Francis Xavier’s Church<br />
Puthiyakavu<br />
Ref: IEC/109/2011 Date: 11.04.2011<br />
AC<br />
Certificate<br />
The ethical committee held on 05.04.2011,<br />
after scrutiny of the synopsis, unanimously<br />
approves the research project titled “A CLINICAL<br />
STUDY TO STANDARDIZE THE PROCEDURE<br />
OF DHANYAMLA DHARA AND TO ASSESS ITS<br />
EFFICAY IN RHEUMATOID ARTHRITIS” of<br />
Arun Kumar Bhadula under the supervision of<br />
Dr. K. Ravisankaran, in the department of<br />
Panchakarma in the condition that the work will be<br />
monitored by committee and alterations in the<br />
research protocol should have further clearance<br />
from the committee.<br />
Dr. K. Murali M.D. (Ay)<br />
Chairman<br />
Professor & HOD<br />
Dept. of Kayachikitsa<br />
GAVC, Tripunithura
Declaration by the candidate<br />
I hereby declare that this dissertation work entitled “A CLINICAL STUDY TO<br />
STANDARDIZE THE PROCEDURE OF DHANYAMLA DHARA AND TO ASSESS ITS<br />
EFFICACY IN RHEUMATOID ARTHRITIS” is a bonafide record of research work<br />
done by me under the guidance of Dr. K. Ravisankaran, M.D. (AY), HOD &<br />
Associate Professor and co-guidance of Dr. S. Seena, M.D. (AY), Associate<br />
Professor, Department of Panchakarma, Govt. Ayurveda College, Tripunithura. And<br />
no part of this work has been presented earlier for any degree/diploma or similar title<br />
of any other University.<br />
Date: Arun Kumar Bhadula<br />
Place: Tripunithura Post Graduate Scholar<br />
Department of Panchakarma,<br />
Govt. Ayurveda College, Tripunithura
MEMORABILIA<br />
MEMORABILIA<br />
“At times our own light goes out and is rekindled by a spark from another person. Each of us has<br />
cause to think with deep gratitude of those who have lighted the flame within us”<br />
- Albert Albert Schweitzer<br />
Schweitzer<br />
This is my hour to express my sincere thanks to all those persons who directly or indirectly helped<br />
me in any way to complete this work successfully.<br />
At this amenity of successful integrating of my work, I bow my head on the feet of lord almighty<br />
and my grandfather Late Shri Shri Jivanand Jivanand Bhadula Bhadula who enucleated in me enough amount of<br />
strength to do my duties immaculately and whose blessings made me reach here.<br />
Untrained intelligence is as much of use as a bottle without an opener. That’s why, it is matter of<br />
great pleasure and honor for me to express my gratitude whole heartedly and with profound<br />
respect to my ever respected guide Dr. Dr. K. K. Ravisankaran, Ravisankaran, H.O.D. & Associate Professor,<br />
Department of Panchakarma, Tripunithura for his valuable guidance. He was not merely the<br />
guide; many a time he was giving me constant inspiration, encouragement, support and a real<br />
parental affection with an inner creative impulse not dominated and fettered by an outside<br />
authority to touch this mile stone at this apt time successfully.<br />
I am especially thankful to my respected Co-guide, most revered, admirable, esteemed<br />
Associate Professor Dr. Dr. S. S. Seena, Seena, whose masterly suggestions and ablest guidance at every step<br />
inspired me and gave me considerable impetus not only to accomplish this mile stone but in all<br />
aspects, her encouragement and erudite suggestions helped me throughout the study period.<br />
I would like to express my immeasurable thank to Dr. Dr. Riyas K.A. K.A. (Assistant Professor),<br />
Dr Dr. Dr Remya Remya Vijayan Vijayan Vijayan (Assistant Professor) & Dr. Dr. Arun Arun Bhaskaran Bhaskaran (Assistant Professor),<br />
Department of Panchakarma, for there sincere advices, guidance and encouragement at every step<br />
of this work.<br />
I feel immense pleasure to offer my sincere gratitude to our esteemed and respectable Principal<br />
Professor Dr. T. K. K. Uma for her kind glance and munificence, without her kind support this work<br />
would never have been completed.<br />
I take this opportunity to thank Dr. A.G. Prasannakumari, Medical Superintendent, for<br />
providing all facilities for clinical study.
I wish to express my sincere regards to Dr. K. Murali, HOD & Professor, Department of<br />
Kayachikitsa, Tripunithura, for his time to time guidance, meticulous suggestions and constant<br />
support throughout the study.<br />
I also want to thank Dr. T. Sreekumar, HOD, Department of R & B, GAVC Tripunithura, for<br />
allowing me to prepare my study medicine in the pharmacy and for his immense support time to<br />
time, Dr. C. Shobhana Shobhana, Shobhana<br />
Professor, Department of R & B, for their valuable suggestions and timely<br />
help. I would like to thank my juniors Dr. Ranvijay, & & Dr. Dr. Harish Harish of R & B Department, for<br />
their immense support in preparing my study medicine.<br />
I am specially obliged and thankful to Dr. Dr. Ansari Ansari P. P. Y. Y., Y.<br />
HOD, & Dr. Sara Monsy Monsy Oomen Oomen, Oomen<br />
Associate Professor, Department of Dravyaguna vijyan, GAVC, Tripunithura, who were kind<br />
enough to provide me a venue in their department where I conducted the various laboratory<br />
analysis required for this study.<br />
I do solicit my generous gratitude to my seniors Dr. Jaya Jayalakshmi Jaya<br />
lakshmi lakshmi, , Dr. Amol, Dr. Shivangi,<br />
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<br />
and guidance in every field.<br />
With gratitude I summon up the assistance provided to me by my most cordial colleagues of the<br />
department Dr. Nadeem Arif, Dr. Dr. Lima Lima K Sen, & & Dr. Dr. Nancy Nancy Baby Baby who always provided a<br />
healthy environment for the research work and afforded sufficient moral support to accomplish the<br />
work.<br />
I fell short of words to extend my gratitude towards my supportive, affectionate and appreciable<br />
juniors of the department Dr. Dr. Dr. Azeem Azeem Ahmad Ahmad, Ahmad Ahmad,<br />
, Dr. Mahesh Khandate, Khandate, Dr. Dr. Rasna, Rasna, Rasna, Dr. Sreeja Sreeja, Sreeja<br />
,<br />
Dr. Dr. Manu, Manu, Dr. Dr. Smita, Smita, Dr. Dr. Dr. Jayapreet Jayapreethi Jayapreet i & & Dr. Dr. Unnikrishnan Unnikrishnan for their well-timed and<br />
unconditional sincere help to accomplish the work.<br />
I take this opportunity to express my sincere thanks to my seniors from other departments Dr.<br />
Rajiv Rajiv Tripathi Tripathi, Tripathi Tripathi,<br />
, Dr. Dr. Rajkumar, Rajkumar, Dr. Dr. Dr. Sanjay Sanjay Gupta, Gupta, Dr. Dr. Sanjay Sanjay Singh, Singh, Dr. r. r. Yogesh, Yogesh, Dr.<br />
Dr.<br />
Dayashankar,<br />
Dayashankar,<br />
Dr. Dr. Sahab, Sahab, Dr. Dr. Atul Atul Patil Patil, Patil<br />
, , my batchmates Dr. Mukesh, Dr. Atul, Dr. Dr. Pritam Pritam, Pritam ,<br />
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<br />
completing this research work. I would also like to thank my juniors from other department viz. .<br />
Dr. Dr. Kripa Kripa Shankar, Shankar, Dr. Dr. Manish,<br />
Manish,<br />
Dr. Dr. Dr. Ankush Ankush for their timely support.<br />
Dr. Dr. Parul, Dr. Dr. Dr. Amey, Amey, Dr. Dr. Anamika, Dr. Aditi, Dr. Dr. Dr. Rupesh Rupesh Rupesh &<br />
&<br />
Words fail when heart speaks. Not a single alphabet can express my deep feeling towards my<br />
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<br />
me what I am. One can do anything with the support of his family. I express my thanks to my<br />
respected brother Mr. Ajay Kumar Kumar Bhadula and sister in-law Mrs. Mrs. Sangeeta Sangeeta Bhadula Bhadula who have<br />
been a source of inspiration for my entire carrier. My sisters Mrs. Mrs. Rekha Rekha Rekha Sharma, Sharma, Mrs. Mrs. Mrs. Deepa<br />
Deepa<br />
Bansal Bansal & brother in-laws Mr. Mr. Deepak Deepak Deepak Sha Sharma Sha rma and Mr. Bhushan Bansal for their constant and<br />
unending support.<br />
I cherish the affectionate of my nephew Vaibhav and my nieces Vidushi Vidushi & Srishti Srishti whose love<br />
have been a source of inspiration for my career.<br />
I cannot move further before thanking to my intimate friend Dr. Amit Kumar Tanwar Tanwar who has<br />
stood indefatigable with me in each and every circumstance and gave me in depth sense of<br />
friendship. I take this moment to express my thanks to my friends Dr. Salman Salman Saleem Saleem, Saleem<br />
, Dr. Dr.<br />
Pushpender Pushpender, Pushpender Pushpender,<br />
, Dr. Ravinder Ravinder, Ravinder<br />
, , Dr. Dr. Shaily Shaily, Shaily , & Dr. Dr. Chanchal for their kind and moral support. I would<br />
also like to thank Mr. Tarun Kumar, my elder brother like figure, for his timely and unconditional<br />
support.<br />
I express my sincere gratitude to Mr. Mr. Man Manoharan Man Manoharan<br />
oharan (senior therapist) and all the Staff, Nurses and<br />
Therapists who was with me always during the study with their full support.<br />
I am thankful to Mr. P.J. P.J. Wels Wels, Wels<br />
librarian and whole staff of our college library for their kind co-<br />
operation during collection of literature. And also my special thanks to all the staff of college and<br />
Hospital, Tripunithura.<br />
I take this opportunity to thank all patients who co-operated with me wholeheartedly throughout<br />
the study.<br />
I take this opportunity to specially thank my senior Dr. Dr. Neeraj Neeraj Gupta Gupta and my roommate<br />
Dr. Dr. Dr. Sudhanshu Sudhanshu Sudhanshu Dutt Dutt Dutt Sharma Sharma Sharma for their guidance, valuable suggestions and moral support rendered<br />
during various stages of my work and throughout my course.<br />
Last but not the least, I sincerely, give my thanks to all those persons, who directly or indirectly<br />
helped me in my present work in any way. Errors are steps on the way and to err is human. At the<br />
end the author bears sole responsibility, seeks pardon & apologizes for any error either of omission<br />
and commission, which will still remains in the version. I thank all the listed and unlisted well<br />
wishers.<br />
- Arun Arun Arun Kumar Kumar Bhadula<br />
Bhadula