OPEN LABEL SINGLE ARM EXPERIMENTAL STUDY TO

STANDARDIZE DOSE OF MILK IN THE ASSESSMENT OF

KOSHTA.

Project Report

Project code: UGAYU115

NAME OF THE SCHOLAR

Miss NAVYA .R

Mob- 9611502333
Email: [email protected]

Name of the Guide: DR BHUPALE MAHANTESH SOMASHEKHAR

Designation: PROFESSOR
Mob- 9986621263
Email: [email protected]
Name of the Department: Kriya Shareera
Date of commencement of research activity: 26.10.2019
Date of completion: 25.01.2020

1
 Study Centre

Sri Kalabyraveswara Swamy Ayurvedic Medical College Hospital and Research

Centre Bangalore

10, Pipeline Road, R.P.C. Layout, Hosahalli Extension, Vijayanagar, Bengaluru,

Karnataka- 560104

Project Funded by:

Rajiv Gandhi University of Health Sciences, Karnataka

4th T Block, Jayanagar, Bangalore-41, Karnataka

2
 Certificate

This is to certify that Miss Navya R, UG Scholar, Sri Kalabyraveswara Swamy

Ayurvedic Medical College Hospital and Research Centre, Bangalore has conducted

the clinical study entitled “OPEN LABEL SINGLE ARM EXPERIMENTAL

STUDY TO STANDARDIZE DOSE OF MILK IN ASSESSMENT OF

KOSHTA” in this institution. This project was sponsored by Rajiv Gandhi

University of Health Sciences, Karnataka.

3
 ACKNOWLEDGEMENT

• Offering my humble pranams to Sri Sri Sri Dr

Balagangadharanatha Mahaswamiji.
• I would like to thank Sri Sri Sri Dr Nirmalanandanatha
Mahaswamiji and Sri Soumyanatha Swamiji for their constant
source of inspiration.
• I would like to thank Dr Kiran M Goud, Principal SKAMC for his
constant support and guidance throughout the study.
• I would like to thank my guide Dr Bhupale Mahantesh
Somashekar, HOD, Department of Kriya Shareera for his guidance
and support for the study.
• I would like to thank Dr Manjunatha Adiga, Professor, Department
of Kayachikitsa, SKAMC and Dr Priyanka BV, Associate
Professor, Department of Ayurveda Samhita & Siddhanta,
SKAMC for their constant guidance, inspiration and support for
the study.
• I would like to thank Dr Neetha , HOD department of agada tantra
for the valuable inputs given during the study.
• I would like to thank Dr Shreyas DM ,lecturer ,Department of
panchakarma, SKAMC ,for his support and valuable guidance
• I would like to heartily thank my mother ‘MV Meera’, my father
‘NV Raghuramu’, my brother ‘Arun’ and uncle ‘Ravi Kumar’ for
their unconditional support throughout the study.
• I would like to thank the girls hostel warden Smt Bhagya and boys
hostel warden Sri. Pappana for their cooperation to carry out the
study at the premises.
• I would like to thank all the research participants for their active
participation in making the research study successful.
• Lastly, I would like to thank all my teachers, friends and well-
wishers for their support and guidance throught the study
4
 ABSTRACT

TITLE-

Open label single arm experimental study to standardize the dose of milk in

assessment of Koshta.

By- Miss Navya R, UG Scholar, Sri Kalabyraveswara Swamy Ayurvedic Medical

College Hospital and Research Centre, Bangalore.

OBJECTIVE:

The research was mainly aimed at analysing and standardizing the dose of milk

needed for the assessment of Koshta in healthy volunteers.

MATERIAL AND METHODS:

THE RESEARCH WAS ABOUT- The research was mainly aimed at analysing and

standardizing the dose of milk needed in the assessment of Koshta in healthy

volunteers.

INCLUSION CRITERIA:

• Age of 18-25 years.

• Both the gender

• Healthy Volunteers

5
 EXCLUSION CRITERIA:

• Non Willing

• Lactose intolerance

ASSESSMENT CRITERIA:

• Bristol stool scale

• Frequency of Stools

• Consistency of Stools

• Sama and Nirama Mala

• Colour

• Smell

Healthy volunteers were screened for their health status using SF12 questionnaire,

thereafter assessment of koshta (nature of digestive system) was done using the

published questionnaire. 19 volunteers of Mrudu, 81 of Madyama and 4 of Krura

koshta were selected based on the questionnaire. The effect of milk was assessed

Based on the assessment criteria.

In this study, Nandini blue milk was used for assessing and fixing the dose for the

different Koshtha individuals among the Volunteers. The Study was initiated after

receiving Institutional Ethics Clearance [IEC No. SKAMCH AND RC/IEC/002/2019]

and informed consent from the volunteers.

6
METHODOLOGY

The Individuals were asked to have their dinner the previous night of the study. Next

day, in empty stomach, after passing the bowel, the individuals were given milk and

this was calculated based on the total volume of stomach which is 1500ml . With due

consideration to the quantity of fluids permitted for intake and allowing the free

movements of other gaseous substances and secretions as mentioned in Charaka

Samhita, is 1/3rd of the stomach capacity, with the stomach capacity being

1500/3=500, 500ml of milk was administered and the results were assessed using

assessment criteria, if no loose stools were observed, then the procedure was repeated

with the gap of 3-7days by increasing the quantity of milk by 100 ml each time.

The final outcome was observed and the assessment was stopped once the desired

outcome based on the assessment criteria was achieved or the maximum permissible

limit of milk was reached (1000ml).

The quantity of milk and the results were then tabulated of all the volunteers. And

attempt to standardise the dose required for assessment of the koshta (digestive

system pattern) was done.

RESULT:

The Dose of milk needed to cause purgation in mrudu koshta was 500-600ml,for that

of madyama was 600 to 700ml for madyama tara was 700-800ml madyama tama was

800to 900ml,the dose of milk needed to cause purgation in krura could not be elicited

and this was supported by the statement made by acharya sushrutha that krura koshta

individuals do not purgate with milk.

7
CONCLUSION:

The Dose of milk needed to cause purgation in mrudu koshta can be standardized as

500-600ml,for that of madyama koshta as 600 to 700ml for madyama tara as 700-

800ml and madyama tama as 800to 900ml,the dose of milk needed to cause purgation

in krura koshta could not be elicited and this is supported by the statement made by

acharya sushrutha that krura koshta individuals do not have purgation with milk.

8
 INDEX

Topics Page No.

1. Introduction 9-17

2. Objective 17-18

3. Material & Methods : 18-24

4. Observation and Results 25-33

5. Discussion 34-35

6. Conclusion 35-36

7. References & 37-39

Bibliography

9
INTRODUCTION

In Ayurveda, in order to decide the dose, duration and type of

medicine for Panchakarma (detoxification therapy) especially Vamana (Emesis) and

Virecana (Purgation), Assement of Koshtha (nature of digestive tract) is considered as

a prerequisite. The doshas (foundational concepts of the body) Vata (air), Pitta (fire)

and Kapha (fluid) have their qualities and actions predominant in Krura(hard), Mrudu

(soft)and Madyama(moderate) Koshtha (nature of digestive tract) respectively. The

equilibrium of all the three Doshas (foundational concepts of the body) are observed

in Sama [balanced] Koshtha (nature of the digestive tract).1

In Koshtha (digestive tract) if Shleshma Dosha (fluid constituent) is in excess, then it

leads to proper Vamana (emesis) and if it is less, then it leads to Virecana (purgation).

Also in Madhyama Koshtha (moderate nature of the digestive tract) if Shleshma (fluid

component) is in excess, Virecana (purgation) does not occur sufficiently. 2

Madhyama Shodana dravya (moderately detoxifying drug) if administered to the

Krura Koshtha (hard natured digestive tract) leads to Hina Yoga (reduction in

outcome), in Mrudu Koshtha (soft natured digestive tract) leads to Ati Yoga

(excessive outcome) and in Madhyama Koshtha (moderate nature of the digestive

tract) leads to Samyak Yoga (sufficient outcome).

In Samshodana (detoxification), the Samyak (sufficient), Ati (excess) and Hina yoga

(reduced outcome) depends on the preparation of body through Snehana (oleation)

and Swedana (fomentation). The person having Mrudukoshta (soft nature digestive

tract) attains symptoms of proper oleation therapy in three days, whereas Krura

Koshta (hard nature of digestive tract) attains the symptoms of proper oleation therapy

by seven days.3

10
 In Mrudu Koshtha (soft natured digestive tract) if jaggery, sugarcane juice, liquid part

of curd, Milk, Curd, Payasa, Krushara (sweet kichidi), Ghee, Kashmarya

(Gmelinaarborea), Triphala Rasa (juice of Amalaki -Emblica officinalis; Bibitaki -

Terminalia bellirica and Haritaki-Terminalia chebula.), Draksha Rasa (juice of

Vitisvinifera), Peelu (Salvadorapersica), hot water and medicated alcohol are advised

as it leads to purgation but it won’t be so in Krura Koshtha.4

However, they have not specified the quantity of any of the above said dravyas.

Hence this study was conducted for standardizing the quantity of milk required

according to the type of koshta.

REVIEW OF LITERATURE

STOMACH - FUNCTIONAL ANATOMY OF THE STOMACH

Stomach is a hollow organ situated just below the diaphragm on the left side in the

abdominal cavity. Volume of empty stomach is 50 ml under normal conditions; it can

expand to accommodate 1 to 1.5 L of solids and liquids. However, it is capable of

expanding still further up to 4 L.

11
PARTS OF STOMACH

In humans, stomach has four parts-

Cardiac region is the upper part of the stomach where the oesophagus opens. The

opening is guarded by a sphincter called cardiac sphincter that opens only towards

stomach. This portion is also known as the cardiac end.

Fundus is a small dome-shaped structure. It is elevated above the level of oesophageal

opening.

Body or corpus is the largest part of the stomach forming about 75 to 80 per cent of the

whole stomach. It extends from just below the fundus up to the pyloric region.

Pyloric region has two parts, antrum and pyloric canal. The body of stomach ends in

antrum. The Junction between the body and antrum is marked by an angular notch called

incisura angularis. Antrum is continued as the narrow canal which is called the pyloric

canal or pyloric end. Pyloric canal opens into the first part of the intestine called

duodenum. The opening of pyloric canal is guarded by a sphincter called pyloric

sphincter. It opens towards duodenum. Stomach has two curvatures, one on the right side

is lesser curvature and the other on left side is the greater curvature.

Structure of stomach wall-

1. Outer serous layer is formed by peritoneum

2. Muscular layer- this layer is made up of three layers of smooth muscle fibres,

namely inner oblique, middle circular and outer longitudinal.

3. Sub mucus layer-this wall is formed by areolar tissue, blood vessels, lymph

vessels and meissner nerve plexus.

12
 4. Inner mucus layer- This is formed by the mucus secreting columnar epithelial

cells. The gastric glands are situated in this layer. Under resting conditions, the

mucosa of the stomach is thrown into many folds, these folds are called rugae.

The rugae disappear when the stomach is distended after meals. Throughout the

inner mucus layer, small depressions called gastric pits are present. Glands of the

stomach enter into these pits. Inner surface of mucus layer is covered by 2mm

thick mucus.

Glands of the stomach-

Glands of the stomach or gastric glands are tubular structures made of different types of

cells. These glands open into the stomach via gastric pits.

Classification of glands of the stomach

1. fundic glands are situated in body and fundus of stomach

2. pyloric glands are present in the pyloric part of the stomach

3. cardiac glands are located in the cardiac region of stomach

Functions of stomach-

Mechanical function includes the storage function. The food is stored in the stomach for

a long period, i.e. for 3 to 4 hours and emptied into the intestine slowly. The maximum

capacity of stomach is up to 1.5L. Slow emptying of stomach provides enough time for

proper digestion and absorption of food substances in the small intestine. Formation of

chime- peristaltic movements of stomach mixes the bolus with gastric juice and converts

it into the semisolid material known as chime. Digestive function includes the protective

function, haemopoietic function and excretory functions under which many substances

like toxins, alkaloids and metals are excreted through gastric juice.6

13
Muscles of the stomach7-

There are three layers of the stomach. The outer two are continuous with the muscle

layers of the oesophagus and duodenum. The inner layer is peculiar to the stomach. The

outer layer of the longitudinal muscle is thickest at the curvatures but is very thin or

absent along the middle of each wall. Some of its fibres turn into the circular layer at the

pyloric sphincter and may help to open the pylorus.

The middle layer is a complete circular layer which gradually thickens in the pyloric

canal and forms the pyloric sphincter. This thickening ceases abruptly at the duodenum.

The inner layer consists of oblique fibres which loop over the cardiac notch. To the left,

the fibres fan out in the fundus and body of the stomach and a well-developed ridge

passes towards the pylorus on each side of the membrane which lies deep into them and

thus cut off a tubular part of the stomach along the lesser curvature through which the

fluids may pass directly to the pylorus7.

Blood supply of the stomach-

The lesser curvature is supplied by the left gastric artery, a branch of the coeliac trunk

and the right gastric artery, a branch of the proper hepatic artery. Along the greater

curvature, it is supplied by the gastro duodenal and the left gastro epiploic artery, a

branch of the splenic artery. Fundus is supplied by 5 to 7 short gastric arteries which are

also branches of the splenic artery. The veins of stomach drain into the portal superior

mesenteric and splenic veins.8

Lympatic drainage

The stomach can be divided into four lymphatic territories - upper part of left 1/3rd drains

into the pancreatico-splenic nodes lying along the splenic artery i.e. on the back of the

14
stomach, lymph vessels from these nodes travel along the splenic artery to reach the

coeliac nodes. Right 2/3rd drains into the left gastric nodes lying along the artery of the

same name. These nodes also drain the abdominal part of the oesophagus into coeliac

nodes. The lower part of left 1/3 drains into the right gasteropoeitc nodes that lie along

the artery of the same name. Lymph vessels arising in these nodes drain into the sub

pyloric nodes which lie in the angle between the first and second parts of the duodenum.

From here, the lymph is drained further into the hepatic nodes that lie along the hepatic

artery and finally into the coeliac nodes. Lymph from pyloric part drains in different

directions i.e., into the pyloric, hepatic and left gastric nodes and passes from all these

nodes to the coeliac nodes. Lymph nodes from the stomach finally reach the coeliac

nodes, from here it passes through the intestinal lymph trunk to reach the cisterna chyli.8

REVIEW OF KOSHTA

Koshta nirukthi – Kush Aawarane9

Koshtangas - It includes the Heart, Pancreas, Lungs or Trachea, Liver, Spleen, Kidneys,

Urinary bladder, Caecum, Stomach, Large Intestine, Sigmoid colon, Rectum, Anal canal,

Anal Opening, Small intestine, Large intestine and Peritoneum (Layers covering and

protecting abdominal viscera).10

Charaka tells that Koshta is also called as Mahasrotas (Antahasrotas) which means the

largest channel of the body. It is located in the deep recess in the middle portion of the

body and is comprised of Amashaya and Pakwashaya11. Koshta are said to be of three

types being krura, mridu and madya koshta12. Krura koshta has vata dosha predominance

and hence the people have unsatisfactory bowel habits and they often complain about

constipation. Such people require Snehana for minimum of 7 days.13. In case a person

15
has excess of pitta, he may complain about diarrhoea and in such cases, he purgates even

with milk14. But The person with mrudu koshta needs only 3 days for oleation15.

Sushruta explains Koshta as a place or cavity occupied by the organs.16

While doing chikitsa (treatment) koshta parikshana is importanat. According to koshta,

we can decide the suitable drug for chikitsa. If patient can get virechana (Purgation) with

only kshira (milk), Aaragwadha, ikshu, takra, mastu, guda, krushara, nava-madhya,

ushnodaka or draksha, then we can guess the pitta-bahulyatha. Such koshta will be

Mrudu. If patient can get virechana with Shama, Kushata, Triphala or Sudhathan, we can

guess that there is Vata-bahulyatha and such koshta will be Krura.17

REVIEW ON COW’S MILK-

Ksheera (cowmilk) is balya [strengthening], acts as immune modulator, memory

enhancer, boosts the bodily strength, cures dyspnoea, dizziness, toxicity, cough, dysuria

and bleeding disease.18 Milk Increases moistness in the channels and tissue pores,

slightly unctuous, heavy for digestion, rejuvenator, mitigates Rakta and Pitta, cures

bleeding diseases, cold in potency, sweet in taste, best to mitigate the aggravation of

Vata and Pitta.. Milk has Sweetness, coldness, softness, unctuousness, dense, smooth,

slimness, heaviness, slowness and clarity. Similar to that of Ojas guna.19

Milk is Sweet in taste, cold in potency, unctuous, Jeevaniya (strengthening effect),

Rasayana (acts as immune modulator), nourishes the tissues, helps produce milk in the

breast, alleviates Vata pitta diseases.20. Milk is Rasayana (acts as immunomodulator),

increases strength, beneficial for the heart functioning, increases the memory power,

slightly unctuous, heavy for digestion, rejuvenator, cures bleeding diseases, cold in

16
potency, sweet in taste, best to mitigate aggravation of Vata and Pitta., mitigates Rakta

and Pitta aggravation.21

HEALTH BENEFITS OF MILK

MILK AND DAIRY PRODUCT COMPOSITION

For Cow Milk-Traditionally, two cattle species have been recognized, Bostaurus

(humpless cattle) and Bosindicus (zebu cattle), although there is no reproductive barrier

between them. Some listings identify as many as 1000 cattle breeds, even though some

of these are actually local varieties of a breed (Buchanan, 2002). Even so, nearly 35

percent of dairy cows (about 70 million head) belong to the Holstein-Friesian breed. The

popularity of this breed is largely because of its high average milk production (Fox,

2008) and superior ability to convert feed into protein (Buchanan, 2002). This is not an

ideal situation from a biodiversity point of view, and widespread use of this one breed

may put some breeds in danger of extinction (Buchanan, 2002). Cow milk accounted for

83 percent of global milk production in 2010(FAOSTAT, 2012). Cow milk contains

more protein and minerals, especially Vitamin content in milk from minor dairy animals

(per 100 g of milk).22

The protein in cow milk is of high-quality (defined as protein that supports maximal

growth), containing a good balance of all the essential amino acids, including lysine.

Many human diets are deficient in certain essential amino acids. For example, wheat and

maize-based diets contain only 57 percent and 58 percent of required levels of lysine,

and cassava-based diets are deficient in leucine, valine and isoleucine, containing only

79 percent of required levels (WHO, FAO and UNU, 2007). More than 600 million

people depend on cassava in Africa, Asia and Latin America for food security (FAO,

2002). Including milk (and dairy products) in staple-based diets increases availability of

17
these limiting amino acids, improving overall dietary quality. Cow milk contains more

protein than human milk, but human milk contains more lactose, resulting in comparable

energy contents. Cow milk and human milk differ in the amounts of various proteins

they contain. Human milk does not contain β-lactoglobulin, one of the main proteins

associated with cow milk allergy. Caseins comprise nearly 80 percent of the protein in

cow milk but less than 40 percent in human milk. Caseins can form leathery curds in the

stomach and be difficult to digest. In addition, the type of caseins that predominate in the

two milks also differ, human milk contains more β-casein which is more susceptible to

peptic hydrolysis than αS-casein, particularly αs1-casein, which predominates in cow

milk (El-Agamy, 2007). The casein content of cow milk varies between breeds and

cheese makers often use milk from breeds with a higher casein content in their milk

(Bonfatti et al., 2010).

TABLE 1

COMPOSITION OF COWS MILK23

COMPONENT PERCENTAGE
PROTEIN 3.30
LACTOSE 4.44
TOTAL SOLIDS 13.50
SOLIDS NOT FAT 9.11
ASH 0.73
CALCIUM 0.12
SODIUM 0.05
POTASSIUM 0.15
PHOSPHOROUS 0.10
CITRATE 0.18
CHLORIDE 0.10

18
Cow milk generally contains between 3 and 4 g of fat/100 g, although values as high

as 5.5 g/100 g have been reported in raw milk. Most milks consumed now contain a

standardized fat content of around 3.5 g/100 g. Cow milk contains a higher proportion

of saturated FA (SFA) than human milk: 65-75 g/100 g total FAs, of which about 40

percent are C12:0–C16:0. Cow milk also has a high content of C18:0. The mono-

unsaturated FA (MUFA) that is present in highest concentration in cow milk is C18:1

(oleic acid).The conjugated linoleic acid (CLA) content in cow milk is generally

reported to vary from 0.1 to 2.2 g/100 g total FA depending on season, region,

farming system and feeding, animal and breed (Elgersma, Tamminga and Ellen,

2006).

For example, milk from the Mafriwal cow breed was shown to contain a significantly

higher (P < 0.05) percentage of CLA than Jersey cow milk (0.35 g/100 g total FA vs

0.23 g/100g total FA) (Yassir et al., 2010). This has possible implications with

regards to promoting cow breeds with a higher CLA content in their milk. Levels of

water-soluble vitamins in human milk reflect maternal levels and depend on the

mother’s diet, but these vitamins are synthesized within the body of the cow and

levels are not diet-dependent in cow milk.

19
 TABLE 2

COMPOSITION OF NANDINI BLUE MILK PER 100ML

COMPOSITION IN GRAMS IN PERCENTAGE

CARBHOHYDRATES 4 29
FATS 3 49
PROTEINS 3 22

Nandini blue milk contains 4 grams of protein, 3grams of fat and 3 grams fat yielding

60 calories per 100ml of serving.24

Research activities and papers published

1. ASSESSMENT OF AGNI (DIGESTIVE FUNCTION) AND KOSHTHA

(BOWEL MOVEMENT) WITH SPECIAL REFERENCE TO

ABHYANTARA SNEHANA (INTERNAL OLEATION) - Dr.Vasant C.

Patil, Prof. M. S. Baghel, and Dr. A. B. ThakarAncient Science of Life, Vol.

28, No. 2(2008) Pages 26-28

2. A CRITICAL REVIEW ON KOSHTHA - Madhumati S. Chidre,R.

S.Dhimdhime, PG Scholar, 2HOD&Professor, Associate Professor,

KriyashariraG.A.C, Osmanabad, MaharashtraIAMJ:Volume 6, Issue 11,

November – 2018 pg2563

3. KOSHTHA AND ITS CLINICAL SIGNIFICANCE - R.S.Dhimdhime, K.R.

Pabitwar, Amruta Vedpathak, AshwiniMaind, INTERNATIONAL

AYURVEDIC MEDICAL JOURNAL ISSN: 2320 5091

4. AYURVEDIC CONCEPT OF KOSHTHA AND ITS IMPORTANCE IN

PANCHKARMA - Dr.ShriramShivajiraoRagad *Dr. Maya VivekGokhale

M.D. Panchakarma (Scholar). Department of Panchkarma, Sumatibhai Shah

20
 Ayurveda Mahavidyalaya, Hadapasar, Pune, India, M.D (Panchakarma), PhD

(Kayachikitsa) HOD & Professor, Department of Panchkarma, Sumatibhai

Shah Ayurveda Mahavidyalaya, Hadapasar, Pune, India [Ragad et. al., Vol.7

(Iss.7): July 2019] ISSN- 2350-0530(O), ISSN- 2394-3629(P) DOI:

10.5281/zenodo.3370488

5. “KOSHTA - THE BASIC CONCEPT OF AYURVEDA” - VD.

DNYANESHWAR. K. JADHAV & VAIDYA. PATIL ARATI S, Research

Scholar, Department of Kaychikitsa, S.G.R. Ayurved Mahavidyalaya, Solapur,

Maharashtra, India TJPRC: International Journal of AYUSH, Medicine &

Research (TJPRC: IJAMR), ISSN(E) : 2456-6209, Vol. 1, Issue 2, Dec 2016,

11-14

OBJECTIVE

To standardize the dose of milk required for the assessment of koshta in Healthy

volunteers .

MATERIAL & METHODS

TITLE

Open label single arm experimental study to standardize dose of milk in assessment of

Koshta.

21
RESEARCH WAS ABOUT

The research was mainly aimed at analysing and standardizing the dose of milk in

assessment of Koshta in healthy volunteers.

INCLUSION CRITERIA

• Age of 18-25 years.

• Both the gender

• Healthy Volunteers

EXCLUSION CRITERIA

• Non Willing

• Lactose intolerance

ASSESSMENT CRITERIA

• Bristol stool scale

• Frequency of Stool

• Consistency of Stool

• Sama and Nirama Mala

• Color

• Smell

Healthy volunteers were screened for their health status using the SF12 questionnaire,

there after assessment of koshta (nature of digestive system) kwas done using

questionnaire published.25 Minimum of 19 volunteers of Mrudu, 81 of Madyama and

4 of Krura koshta were selected. The effect of milk was assessed using the assessment

criteria.

22
In this study, nandini blue milk was used for assessing and fixing the dose for

different Koshtha Volunteers. Study was initiated after receiving Institutional Ethics

Clearance [IEC No. SKAMCH AND RC/IEC/002/2019] and informed consent from

the volunteers.

METHODOLOGY

Individuals were asked to have their dinner previous night of the study. Next day in

empty stomach after passing the bowel the individuals were given milk and this was

calculated based on the total volume of stomach -1500ml26. Taking into account the

quantity of fluid that can be permitted for intake while allowing the free movements

of other gaseous substances and secretions according to Acharya Charaka is one third

of the stomach capacity, this can be calculated as1500/3=50027. 500ml of milk was

administered and the results were assessed using assessment criteria, if no loose stools

were observed then the procedure was repeated with the gap of 3 -7 days by

increasing the quantity of milk by 100 ml each time.

The final outcomes were observed and the assessment was stopped once the desired

outcome based on the assessment criteria was got or the maximum permissible limit

of milk wass reached (1000ml).

The quantity of milk and the results were then tabulated of all the volunteers. And an

attempt to standardise the dose required for assessment of the koshta (digestive

system pattern) was done.

23
FILLING THE CONSENT FORMS AND QUESTIONNAIRES BY THE

VOULNTEERS.

24
PURCHASE OF NADINI BLUE MILK

25
BOILING THE MILK BEFORE ADMINSTRATION

26
MEASUREMENT OF MILK QUANTITY BEFORE
ADMINSTRATION

27
ADMINISTRATION OF MILK

28
29
 BRISTOL STOOL SCLAE

IMAGE -WIKIPEDIA

30
 OBSERVATION AND RESULTS

Distribution of Volunteers Based on Age

Table No 3: Distribution of Volunteers Based on Age

Age No %

18- 22 96 92.30

23-25 8 7.69

Total 104 100.0

Out of 104 subjects, 96 subjects were from the age group of 18-22 years (92.30%),

whereas 8 subjects belonged to the age group of 23-25 years (7.69%).

Distribution of Volunteers
Based on Age
120
96
100
80
60
40
20 8
0
18- 22 23-25

Graph No 1: Distribution of Volunteers Based on Age

31
 Distribution of Volunteers Based on Gender

Table No 2: Distribution of Volunteers Based on Gender

Gender No %

Male 21 20.19
Female 83 79.80
Total 104 100.0

Out of 104 subjects, 21 were male (20.19%), whereas 83 subjects were female

(79.80%).

Distribution of Volunteers Based

on Gender
100
83
80

60

40
21
20

0
Male Female

Graph no.2 Distribution of Volunteers Based on Gender

32
 Distribution of Volunteers Based on Religion

Table No 3: Distribution of Volunteers Based on Religion

Religion No %

Hindu 89 85.57

Muslim 06 5.76

Christian 9 8.65

Out of 104 subjects, 89 were Hindu, 6 were Muslim and 9 were Christian.

Distribution of Volunteers Based on

Religion
100 89

80

60

40

20 9
6
0
Hindu Muslim Christian

Graph no 3. Distribution of Volunteers Based on Religion

33
 Distribution of Volunteers Based on Prakruti

Table No 4: Distribution of Volunteers Based on Prakruti

Prakruti No %
VATAPITTA
54 51.9

PITTAKAPHA
35 33.7

KAPHAVATA 15 14.4

Total 104 100.0

Out of104 subjects, 54 subjects were of vata pitta prakruthi (51.9%), 35 subjects were

of pitta kapha prakruthi [33.7%] and 15 subjects belonged to kapha vata prakruthi

[14.4%].

Distribution of Volunteers Based

on Prakruti
60 54

40 35

20 15

0
VATAPITTA PITTAKAPHA KAPHAVATA

Graph no 4: Distribution of Volunteers Based on Prakruti

34
 Distribution of Volunteers Based on KOSHTHA

Table No 5: Distribution of Volunteers Based on KOSHTHA

Koshtha
No %
MRUDU 19 18.3

MADHYAMA 81 77.9
KRURA 4 3.8

Total 104 100.0

Based on questionnaire out of 104 subjects 19 subjects were mrudu koshta [18.3%],

81 subjects were madyama koshta [77.9%] 4 subjects were krura koshta [3.8%].

Distribution of Volunteers Based on

KOSHTHA
100
81
80
60
40
19
20 4
0
MRUDU MADHYAMA KRURA

Graph no 5: Distribution of Volunteers Based on KOSHTHA

35
 Distribution of subjects based SF 12 heath assessment

Table 6: Distribution of subjects based SF 12 heath assessment

Overall health status No %

Fair 4 3.84
Good 60 57.69
Very Good 34 32.69
Excellent 6 5.7
Total 104 100

Out of 104 subjects the heath of 4 subjects [3.84%] was fair, health of 60 subjects was

good [57.69%], health of 34 subjects was very good[32.69%]and health of 6 subjects

was excellent[5.7%].

Distribution of subjects based SF 12

heath assessment
70
60
60
50
40 34
30 No

20
10 4 6

0
Fair Good Very Good Excellent

Graph no 6: Distribution of subjects based SF 12 heath assessment

36
 RESULT

Distribution of subjects based Koshta and 1st dose of Milk

Table 6: Distribution of subjects based Koshta and 1st dose of Milk

KOSHTHA MILK 1ST DOSE

500 600 Total

MRUDU 9 2 11
MADHYAMA
43 29 72

KRURA 1 2 3
Total 53 33 86

Out of 86 subjects, 9 subjects having Mrudu Koshtha got Virecana on 500ml and 2

subjects on intake of 600ml, 43 Madyama Koshtha subjects got Virecana on 500ml

and 29 on intake of 600ml and 1 krura Koshtha subject got Virecana on 500ml and 2

on intake of 600ml

Graph no 6: Distribution of subjects based Koshta and 1st dose of Milk

37
 Distribution of subjects based Koshta and 2st dose of Milk

Table 7: Distribution of subjects based Koshta and 2st dose of Milk

MILK 2ND DOSE

500 600 800 900 Total
KOSHTH MRUDU 7 2 0 2 11
A MADHYA
42 21 1 8 72
MA
KRURA 2 1 0 0 3
Total 51 24 1 10 86

Out of 86 subjects, 7 Mrudu Koshtha subjects got Virecana on 500ml, 2 on 600ml and
2 on intake of 900ml, 42 Madyama Koshtha subjects got Virecana on 500ml, 21on
600ml , 1 on 800 ml and 8 subjects on intake of 900 ml, 2 Krura Koshtha subject got
Virecana on 500ml and 1 on 600ml.

Graph no 7: Distribution of subjects based Koshta and 2st dose of Milk

Distribution of subjects based Koshta and 3st dose of Milk

Table 8: Distribution of subjects based Koshta and 3st dose of Milk

MILK 3RD DOSE

0 700 900 Total
KOSHTH MRUDU 10 1 0 11
A MADHYA
69 2 1 72
MA
KRURA 3 0 0 3
Total 82 3 1 86

Out of 86 subjects, 10 Mrudu Koshtha subjects got Virecana on 500ml and 1 on

700ml, 69 Madyama Koshtha subjects got Virecana on 500ml and 2 on 700ml of Milk
and 1 on intake of 900 ml, 3 Krura Koshtha subjects got Virecana respectively.
38
 Graph no 8: Distribution of subjects based Koshta and 3st dose of Milk

Distribution of subjects based Koshta and no of Vega

Table no 9: Distribution of subjects based Koshta and no of Vega

Milk Dose Mean Std. Deviation Std. Error t df Sig.

Mean (2-
tailed)
MILK 1ST 5.3720 48.99078 5.28281 101.690 85 .000
DOSE -
NOOFVI1ST
MILK 2ND 2.8072 352.01767 37.95904 7.395 85 .000
DOSE -
NOOFV2ND
MILK 3RD 3.4697 159.19489 17.16643 2.021 85 .046
DOSE -
NOOFV3RD

39
The dose of milk was found statistically highly significant at the 1st dose (p=0.000),

highly significant at 2nd dose of milk with that of vega (p=0.000) and significant at 3rd

milk dose (p=0.046).

N Correlation Sig.
MILK 1ST DOSE &
NOOFVI1ST 86 -.041 .705

MILK 2ND DOSE &

NOOFV2ND 86 .387 .000

MILK 3RD DOSE &

NOOFV3RD 86 .756 .000

Distribution of subjects based Koshta and no of Vega on 1st dose

Table 9: Distribution of subjects based Koshta and no of Vega on 1st dose

NO OF Vegas 1ST
0 1 2 3 4 Total
KOSHTHA MRUDU 4 1 2 4 0 11
MADHYA
MA 38 7 9 14 4 72

KRURA 3 0 0 0 0 3
Total 45 8 11 18 4 86

Out of 86 subjects, 4 Mrudu Koshtha subjects got no vegas, 1 subject got 1 vega, 2

subjects got 2 vegas and 4 subjects got 3 vegas, 38 Madyama Koshtha subjects got no

vegas, 7 subjects got 1 vega, 9 subjects got 2 vegas, 14 subjects got 3 vegas and 4

subjects got 4 vegas, 3 subjects of krura koshta got no vegas.

40
 Graph 9: Distribution of subjects based Koshta and no of Vega on 1st dose

Distribution of subjects based Koshta and no of Vega on 2nd dose

Table 10: Distribution of subjects based Koshta and no of Vega on 2nd dose

NOOFV2ND
0 1 2 3 6 10 Total
KOSHTH MRUDU 9 1 0 1 0 0 11
A MADHYA
57 0 2 11 1 1 72
MA
KRURA 2 0 0 1 0 0 3
Total 68 1 2 13 1 1 86

41
 Out of 86 subjects, 9 Mrudu Koshtha subjects had no vegas, 1 got 1 vega and 1

subject got 3 vegas, 57 Madyama Koshtha subjects had no vegas, 2 subjects got 2

vegas, 11 subjects got 3 vegas, 1 subject got 6 vegas and 1 subject got 10 vegas,2

krura Koshtha subjects had no vegas, 1 subject got 3 vegas respectively.

Graph no 10: Distribution of subjects based Koshta and no of Vega on 2nd does

42
 Distribution of subjects based Koshta and no of Vega on 3rd does

Table 11: Distribution of subjects based Koshta and no of Vega on 3rd does

NOOFV3RD
0 3 6 7 Total
KOSHTH MRUDU 10 0 1 0 11
A MADHYA
70 1 0 1 72
MA
KRURA 3 0 0 0 3
Total 83 1 1 1 86

Out of 86 subjects, 10 Mrudu Koshtha subjects had no vegas and 1 subject got 6

vegas, 70 Madyama Koshtha subjects had no vegas,1 got 3 vegas and 1 got 7 vegas

and 3 krura Koshtha subjects had no ve

43
Graph no 11: Distribution of subjects based Koshta and no of Vega on 3rd dose

Distribution of Koshta and vegas

Table no 12: Distribution of Koshta and vegas

Paired Samples Test

Paired Differences
95% Confidence Sig.
Std. Std. Interval of the (2-
Deviati Error Difference taile
Mean on Mean Lower Upper t df d)
Pair 1 KOSHTH
- -
A - MILK 48.842 5.2667
5.36465 -546.93687 525.993 -101.858 85 .000
1ST 05 7
E2 36
DOSE
Pair 2 KOSHTH
- -
A - MILK 352.64 38.026
2.79488 -355.09587 203.880 -7.350 85 .000
2ND 619 82
E2 87
DOSE
Pair 3 KOSHTH
-
A - MILK 160.00 17.254
3.29767 -67.28242 1.32893 -1.911 85 .059
3RD 750 05
E1
DOSE

The distribution of koshta and vegas was found to be statistically highly significant at
1st dose (p=0.000), highly significant at 2nd dose (p=0.000) and non-significant at 3rd
dose (p=0.059)

44
 Distribution of subjects based Koshta and Stool Consistency on last dose

Table 13: Distribution of subjects based Koshta and Stool Consistency on last

dose

BRISTOL SCALE
SEVE
NORM R
AL NORMAL MILD DIAR
SAUS SOFT LACK IN DIAR RHE
0 AGE SAUSAGE FIBRE HEA A Total
KOSHT MRUDU 0 1 2 1 6 1 11
HA MADHY
14 3 10 9 33 3 72
AMA
KRURA 2 0 0 1 0 0 3
Total 16 4 12 11 39 4 86

Out of 86 subjects, 0 subject had 0 value, 1 subject had normal sausage, 2 subjects got

normal soft sausage, 1 had lack in fibre, 6 had mild diarrhoea, 1 had severe diaarhoea,

14 subjects had madhyama koshta, 3 had normal sausage, 10 had normal soft sausage,

9 had lack in fibre, 33 had mild diarrhoea, 3 had severe diarrhoea, 2 had krura had 0

value, 1 had lack in fibre

45
Graph 13: Distribution of subjects based Koshta and Stool Consistency on last

dose.

DISCUSSION

The research entitled Open label single arm experimental study to standardize dose of

milk in assessment of Koshta was aimed at standardizing the dose of milk for the

assessment of the different koshta types. The work was initiated by selecting healthy

volunteers of age group 18-25 on the basis of SF12 standardized health assessment

questionnaire. The healthy volunteers were then grouped into different koshta types

based on the questionnaire of which the outcome was a total of 19 mrudu, 81

madyama and 4 krura total accounting to be 104 healthy volunteers.

The volunteers were then instructed to have food normally the previous night

,morning after evacuation of the bowels milk was administered in empty stomach.

The dose of milk was calculated based on the trividha kukshiya adhyaya of charaka

vimana sthana which tells that the stomach has to be divided into 3 parts of which one

46
part is for solids one is for the liquids and the other is for the movement of the doshas.

The volume of stomach is 1500ml as per physiology text, based on these references

1/3 of 1500 was 500 hence the minimum dose of milk to be administered was

calculated to be 500 ml .The healthy volunteers were then administered boiled and

cooled 500ml milk in the morning, later in the evening the results were assessed based

on the Bristol stool Scale and number of loose stools encountered.

Based on the outcomes the volunteers who did not have virechana were administered

the second and third dose by increasing the quantity of milk to

600ml,700ml,800ml,900ml and the outcomes were then recorded. These obtained

results where then tabulated and analyzed for their significance and the results were

concluded.

Out of 104 subjects, 96 subjects were from the age group of 18-22 years (92.30%),

whereas 8 subjects belonged to the age group of 23-25 years (7.69%). 21 were male

(20.19%), whereas 83 subjects were female (79.80%), 89 subjects were of Hindu

religion (85.57%), whereas 06 subjects belonged to Muslim religion (5.76%), and 09

[8.65%] subjects belonged to Christian religion. 54 subjects were of vatapittaprakruthi

(51.9%), 35 subjects were of pitta kapha prakruthi [33.7%],and 15 subjects belonged

to kapha vata prakruthi [14.4%]. Based on questionnaire out of these 104 subjects 19

subjects were mrudukoshta[18.3%],81 subjects were madyama koshta[77.9%] 4

subjects were krura koshta [3.8%].These 104 subjects were analysed for health status

using SF12 questionnaire as per which the health of 4 subjects [3.84%] was fair,

health of 60 subjects was good [57.69%],health of 34 subjects was very

good[32.69%]and health of 6 subjects was excellent[5.7%].

47
Of these 104 subjects 18 subjects were dropouts hence the total administration was

carried out among 86 subjects. Of these 86 subjects on administering 500-600ml 8

had 1 vega,11 had 2 vegas, 14 had 3 vegas,4 had 4 vegas subjects who passed stools

but did not have the indication as diarrhea on Bristol stool scale [type 6 or 7] were not

counted for the above stated outcome .this outcome accounts to be a total 37 subjects

who had type 6 and 7 stool on Bristol scale[diarrhea]

On administering a dose of 600-900ml to individuals 1 had 1 vega,2 had 2 vegas,14

had 3 vega,2 had 6 vegas, 1 had 7 vegas1 had 10 vegas these do not include

individuals who passed stools that were not of type 6 or 7 on the Bristol scale. This

accounts to be a total of 21 subjects who had virechana at different doses from 600 to

900 ml.

A dose of 900 and above was administered to the other individuals who had not got

the desired outcomes of stools of type 6 and 7 but no effect was seen on such

individuals hence this could prove the statement mentioned in sushrutha samhita that

a krura koshta person does not purgate with milk.28

On analyzing these outcomes we can tell that people who had virechana At a dose of

500-600ml can be considered as mrudu koshta individuals,subjects having virechana

at 600-900 ml can be further classified into Madhyama Madhyama tara and

Madhyama tama based on classification given by acharya sushrutha -as madyama

type of koshta individual purgates with a dose of 600 to 700ml,madyama tara at 700

to 800ml and madyama tama koshta at 800-900ml.29

Hence we can tell that quantity of milk required to cause purgation in mrudu koshta

individuals is 500-600ml,for madyama is 600-700ml ,for madyama tara is 700-800ml

,for madyama tama is 800 to 900ml, and quantity of milk needed to cause purgation in

48
krura koshta could not be standardized which also holds good as per the reference

given in sushrutha samhita.29

Practically equal number of subjects of each koshta type could not be taken as most of

the individuals were found to fall in the category of madyamakosta which is 81/104

this practical difficulty is due to one reason being the non-availability of a perfect

standardized questionnaire to assess the koshta type and other being predominance of

the madyama koshta type of individuals .

The dose required to cause virechana vegas in that of a krura koshta individual could

not be found as the limt of milk that could be administered according to

trividhakukshiadhyaya was reached, consumption of 1000ml of milk in empty

stomach practically led to discomfort and nausea in the volunteers for which the

highest possible dose that was administered in case of a krura koshta individual was

900ml and also this result holds good based on the fact mentioned in sushruta samhita

that person with krura koshta does not purgate with milk.

The consistency and color of the stools were analyzed based on the Bristol stool

scaling to assess virechana. However samata and niramata of puresha could not be

practically efficiently appreciated by the subjects as there were many number of vegas

and the subject could not effectively give a statement about the samata and niramata

and the smell of puresha .

The outcomes got after administering milk were in some cases not corresponding to

the type of koshta as assessed based on the questionnaire this practical difficulty was

due to lack of availability of a detailed standardized questionnaire for the assessment

of koshta.

49
CONCLUSION

The dose of milk needed to cause purgation in mrudu koshta can be standardized as

500-600ml, for that of madyama as 600 to 700ml for madyama tara as 700-800ml

madyama tama as 800to 900ml,the dose of milk needed to cause purgation in krura

koshta could not be elicited and this is supported by the statement made by acharya

sushrutha that krura koshta individuals do not purgate with milk.

CONTRIBUTIONS MADE TOWARDS INCREASING THE STATE OF

KNOWLEDGE IN THE SUBJECT

What future studies can be done- there is a need of a detailed standardized

questionnaire for the assessment of koshta types more accurately. Administration of a

dose lesser than 500ml can be done in order to standardize a lower dose required for

mrudu koshta individuals. Any other substance like dadhimastu or sugarcane juice as

mentioned by charaka could be used as a toll instead of milk to analyze the effects on

koshta. Any other nandini milk apart from blue could be tried as the amount of fat

varies in each and there are chances of getting results at a lesser dose of milk for a

particular koshta type of individual.

• Through this research study the quantity of milk was assessed that helps in

assessment of different koshta (nature of digestive system) types.

• Through the standardization of the quantity of milk one can easily asses the

type of koshta in an individual as koshta (nature of digestive system) is the

basis on which the panchakarma (detoxification procedures) like vamana

50
 (emesis) and virechana(purgation) can be planned without any hurdle in order

to obtain the desired outcome.

• The number of days of administration of oleation therapy is based on the type

of koshta (nature of digestive system) of the individual and this study helps in

the proper assessment of the type of koshta (nature of digestive system)

• Different koshta needs different potency medications to get the desired level

of purification through the panchakarma therapy for this proper assessment of

koshta (nature of digestive system) is necessary failing which the

panchakarma procedure may have hina (reduced outcome) or atiyoga

(excessive outcome) leading to improper purification.

REFERENCES

1. Vaghbata Ashtanga hrudya,sarvangasundara commentary by hemadri ,reprint

sutra stana [ 1/8 ] pg 8, Chaukhambha Surbharati Prakashan, Varanasi,

(2017)

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sutra stana [ 1/8 ] pg 8, Chaukhambha Surbharati Prakashan, Varanasi,

(2017)

3. Agnivesha, Charaka Samhita, Ayurveda-Dipika commentary by

Chakrapanidutta, revised ed., Siddhi Sthana ( 1:08), pg 677. , Chaukhambha

Surbharati Prakashan, Varanasi, (2005)

4. Agnivesha, Charaka Samhita, Ayurveda-Dipika commentary by

Chakrapanidutta, revised ed., Sutra Sthana ( 13:23), pg. 73, Chaukhambha

Surbharati Prakashan, Varanasi, (2005)

51
5. Stomach medicine available at

http://gastroenterology2.blogspot.com/2012/02/functional-anatomy-of-

digestive-system.html

6. essentials of medical physiology by k sembulingam Premasembulingam

seventh edition sanatprinters chapter 36 page 231,232,233.

7. cunninghams manual of practical anatomy by GJ romanes 15th edition vol 2

oxford medical publication pg 134.

8. BD chaurasias human anatomy seventh edition vol 2 pg 277cbs publishers and

distributers pvt ltd

9. Amarsimha, , TheAmarkosha(Namalinganusasana) by amarasimha With the

Commentary by AvranaKrishnajigovindoka thirdkanda,third chapter

visheshaynigravarga page no.194.verse no.40 LAW PRINTING PRESS

publication, Poona,1993.

10. Agnivesha, Charaka Samhita, Ayurveda-Dipika commentary by

Chakrapanidutta, revised ed., Sharera Sthana ( 7:10), pg 338. , Chaukhambha

Surbharati Prakashan, Varanasi, (2005),

11. Agnivesha, Charaka Samhita, Ayurveda-Dipika commentary by

Chakrapanidutta, revised ed., Sutra Sthana ( 11;48), pg.77 , Chaukhambha

Surbharati Prakashan, Varanasi, (2005)

12. Vaghbata Ashtanga hrudya,sarvangasundara commentary by hemadri ,reprint

sutra stana [ 1/9 ] pg8, Chaukhambha Surbharati Prakashan, Varanasi,

(2017)

13. Agnivesha, Charaka Samhita, Ayurveda-Dipika commentary by

Chakrapanidutta, revised ed., Sutra Sthana ( 13/65], pg75. Chaukhambha

Surbharati Prakashan, Varanasi, (2005),

52
14. Sushrutha ,sushrutha samhita,Nibandha sangraha commentary by

dalhanaacharya reprint chikitsa stana [33/21 ] pg 518, Chaukhambha

Surbharati Prakashan, Varanasi, (2017)

15. Agnivesha, Charaka Samhita, Ayurveda-Dipika commentary by

Chakrapanidutta, revised ed., Sutra Sthana ( 13:65), pg.77 , Chaukhambha

Surbharati Prakashan, Varanasi, (2005],

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dalhanaacharya reprint chikitsa stana [2/12 ] pg 409, Chaukhambha

Surbharati Prakashan, Varanasi, (2017)

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(2017)

18. Agnivesha, Charaka Samhita, Ayurveda-Dipika commentary by

Chakrapanidutta, revised ed., Sutra Sthana ( 27:218-224), pg. 197,

Chaukhambha Surbharati Prakashan, Varanasi, (2005)

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sutra stana [ 5/21-26] ] pg-16, Chaukhambha Surbharati Prakashan,

Varanasi, (2017)

20. NrupaMadanaphala,Madanaphalanighantu with hindicommentarybyPt.Ram

Prasad, Khemrajshrikrishnadas publications verse 61-81, pg-167-171,

Mumbai, 1st edition 1998,Paniyadivarga

21. Priyavatsharma, DhanvantariNighantu Translation by Dr.Guru Prasad sharma,

Chapter Drava Dravyani, verse 148-172. Pg205-210,

Chokambaorientalia,Varanasi, 3rdedition, 2002,

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22. Ramani Wijesinha-Bettoni and Barbara Burlingame Nutrition Consultant,

Nutrition Division, Food and Agriculture Organization of the United Nations

(FAO)Rome, Italy; Deputy Director, Nutrition Division,FAO, Rome, Italy

23. Milk and dairy products cited 2006-2013 available at www.dairyforall.com

24. Know your milk cited 2009 – 2016vailable at

www.kmfnandini.coop.knowyourmilk

25. EXPLORATORY STUDY TO ASSESS THE EFFECT OF ANULOMANA

AND RECHANA KARMA ONPUREESHA Nidhin PS et al / Int. J. Res.

Ayurveda Pharm. 6(6), Nov - Dec 2015Nidhin PS,, Yaligar MG Arun Raj GR

Anusree D

26. essentials of medical physiology by k sembulingam Premasembulingam

seventh edition sanatprinters chapter 36 page ,233

27. Agnivesha, Charaka Samhita, Ayurveda-Dipika commentary by

Chakrapanidutta, revised ed., vimana Sthana ( 2:3), pg. 168, Chaukhambha

Surbharati Prakashan, Varanasi,

28. Sushrutha ,sushrutha samhita,Nibandha sangraha commentary by

dalhanaacharya reprint chikitsa stana [31/36 ] pg 511, Chaukhambha

Surbharati Prakashan, Varanasi, (2017)

29. Sushrutha ,sushrutha samhita,Nibandha sangraha commentary by

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54
 UTILIZATION CERTIFICATE FOR 1st INSTALMENT OF

RESEARCH GRANTS

UGAYU115
PROJECT CODE

Name of the UG Researcher Miss NAVYA .R

Mobile No and Email ID Mob- 9611502333

Email: [email protected]

Name of the Guide DR BHUPALE MAHANTESH

SOMASHEKHAR

Mobile No and Email ID Mob- 9986621263

Email: [email protected]

Name & address of the College Sri KalabyraveswaraSwamy Ayurvedic

Medical College Hospital and Research
Centre Bangalore
10, Pipeline Road, R.P.C. Layout,
Hosahalli Extension, Vijayanagar,
Bengaluru, Karnataka 560104Karnataka

OPEN LABEL SINGLE ARM

Title of the Project EXPERIMENTAL STUDY TO
STANDARDIZE DOSE OF MILK IN
ASSESSMENT OF KOSHTA

Total Research Grants Sanctioned Rs 15000

Grants payment vide Cheque No. and

date

55
The sum released, has been completely utilized for the purpose of conduct of research
project. This expenditure incurred is as per the guidelines issued by RGUHS. The
original vouchers duly certified with regards to the expenditure are enclosed with this
Utilization Certificate.

Signature of the Signature of the Signature

of the Researcher Guide Internal Auditor
of college

It is also certified that I have satisfied myself that the conditions on which the grants
was sanctioned by the University has been duly fulfilled and that I have exercised all
necessary checks to see that the money was actually utilized for the purpose for which
it was sanctioned.

Date:

Place: Signature of the

Head of the Institution

Encl: 1. Statement of Expenditure

2. All original vouchers duly certified

3. Auditor’s Report

56
Statement of expenditure

PROJECT CODE UGAYU115

Miss NAVYA R
Name of the Principal Investigator
Mobile No and Email ID Mob- 9611502333
Email: [email protected]
Name & address of the College Sri KalabyraveswaraSwamy Ayurvedic
Medical College Hospital and Research
Centre Bangalore
10, Pipeline Road, R.P.C. Layout,
Hosahalli Extension, Vijayanagar,
Bengaluru, Karnataka 560104Karnataka
OPEN LABEL SINGLE ARM
Title of the Project EXPERIMENTAL STUDY TO
STANDARDIZE DOSE OF MILK IN
ASSESSMENT OF KOSHTA

Total Research Grants Sanctioned RS 15000

First Instalment Grants released
First Instalment Grants payment vide
Cheque No. and date

57
SL NO Particulars of Amount spent Bill/Voucher Remarks
expenditure No.

TOTAL

Signature of the Signature of the Signature of the

Researcher Guide Internal Auditor of college

58
The Registrar,
Rajiv Gandhi University of Health Sciences,
4th T Block Jayanagar, Bangalore-41

Sir,

Sub: Regarding submission of RGUHS Research project report entitled “OPEN

LABEL SINGLE ARM EXPERIMENTAL STUDY TO STANDARDIZE DOSE OF

MILK IN ASSESSMENT OF KOSTAS”

Ref: RGUHS /R&D/Res/__________ dated _______ (reference no)

With reference to subject cited above, Miss Navya R, UG Scholar, Sri

Kalabyraveswara Swamy Ayurvedic Medical College Hospital and Research Centre
Bangalore, Principal Investigator of RGUHS, Bangalore funded project entitled
““OPEN LABEL SINGLE ARM EXPERIMENTAL STUDY TO STANDARDIZE
DOSE OF MILK IN ASSESSMENT OF KOSTAS” has been carried out in our
Institution. We are hereby submitting four copies of final report of the project with
necessary documents for your kind perusal. Kindly accept the report and do the needful.

Thanking you,

Yours sincerely

PRINCIPAL

Enclosures:

1. Final report
2. Utilization Certificate
3. Statement of expenditure
4. Internal Auditors report
5. Bank passbook photocopy
6. Original bills/vouchers (with signature of head of the institute and guide)

59