A Prospective Blinded Comparative study to Determine the Possible Specific Signs Of Diagnosis Through Siddha Neikkuri Examination Findings In Urine Samples Of Ilaippu Noi- Pulmonary Tuberculosis Patients

Birabanchana, K (2022) A Prospective Blinded Comparative study to Determine the Possible Specific Signs Of Diagnosis Through Siddha Neikkuri Examination Findings In Urine Samples Of Ilaippu Noi- Pulmonary Tuberculosis Patients. Masters thesis, National Institute of Siddha, Chennai.

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Tuberculosis is a potentially serious chronic infectious disease that mainly affects the lungs. Bacteria that cause tuberculosis spreads from person to person tiny as droplets suspended in air via cough and sneezes of the infected patients. ◉ Primary Objective of the study was to do a diagnostic blinded comparative study to establish the usefulness of Siddha neikkuri examination method as a diagnostic and/or prognostic tools in pulmonary tuberculosis patients and document the specific or non specific diagnostic pattern of Neikkuri in Ilaippu noi (pulmonary tuberculosis) or its complications. ◉ The study was approved by Institutional Ethics committees of Government Hospital of Thoracic Medicine, Tambaram Sanatorium, and National Institute of Siddha and the clinical part of the study was registered in the Clinical Trial Registry of India (CTRI/2021/11/038246). ◉ The study was conducted in both GHTM and NIS, Tambaram Sanatorium during 2022 in patients attending the OPD and IPD. The study participants were 449 in total. The participants of case group were 160 (36%) and in control group were 289 (64%). The control group had patients with complaints of respiratory complaints and even other complaints. In this study there were two group of patients, Tuberculosis confirmed and Non tuberculosis patients / subjects were randomized and presented to the Principal Investigator through the scrutiny of the research team at the OPD of Govt. Hospital of Thoracic Medicine, Tambaram Sanatorium. The investigator was masked about the identity, physical stature, health status and practically everything concerning the patients / participants. The investigator was given ample space and time to investigate the anonymous urine sample, and the findings of trihumoral, atypical, unamenable patterns including that of typical Kabam were noted as probable Tuberculosis for analysis. ◉ In overall distribution of Neikkuri patterns, Pitham was predominantly 216 (48.04%) observed. Kabam pattern was obtained in 156 participants and vatham patterns were observed in 77 cases (17%). ◉ The overall sensitivity of Tuberculosis detection was statistically calculated from the total study population of 449 participants as 61% which can be explained in non technical terms as that of Principal Investigator was able to detect 6 patients out of 10 in the mixed study population correctly which included even COPD patients. The COPD patients also were detected as probable TBs, which had reduced the specificity slightly and the sizable number of cases with mild or healing TB were not picked by the Neikkuri which might be the reason for reduced sensitivity. ◉ In control group Pitham patterns were observed in half of the cases 118 (48.49%), Kabam pattern was also observed in 101 (34.23%) cases. The presence of Kabam pattern may be due to the pathology in lungs. Vatham patterns were observed in 51(31.52%) cases. ◉ In gender distribution 90.4% were male and 9.57 % were female, in control 95% were male and 10 % female, while in cases all were males. As for age, most of the cases fell under 30-50 years in cases whereas 40-60 years in control. ◉ Analysis of neikkuri patterns in control group revealed that 23.08% pitha vatham, 20% had kabam, 14.57 % had pitham, 10.84% had pitha kabam, 9.47 had kabavatham, 6.44% had vatha pitham, 5.08% had vatha kabam, and 4.24% had kabha pitham. ◉ As per table, chi square test reveals that the neikkuri. analysis of case control group in tuberculosis is statisfically significant and the the sensitivity of interpretations in neikkuri sign tuberculosis is 61% and the specificity is 90%. ◉ According to Siddha literature, kabam is the main factor causing Ilaippu Noi. Sathaga Naadi states that Vatha Kabam and Kabavatham are unamenable conditions or asaathiyam. Rathiga. G et al. stated that kabam patterns were observed in majority of cases in cancer patients. There were no previous studies of Neikkuri that in Tuberculosis to the best of our knowledge. This study documented the Neikkuri patterns in various stages of tuberculosis. As given in Noi naadal Noi mudhal naadal oil on urine signs depicted patterns of scattered mustard seeds, pearl pattern, sieve pattern, three prolonged spear or trident (soolam), tomb, spectacles, human faces. ◉ In this study Neikkuri was observed for all cases from the moment the oil drop was instilled up to twenty four minutes. Atypical, Mustard, vacuolated sieve were some of the patterns observed in majority of cases. Most of cases manifested kabam in the Neikkuri observations. During oil instilling most of the cases had Kabam. ◉ Majority of cases showed the formation of sieve pattern of Neikkuri at once the oil was instilled into the patient urine. this clearly shows the kabam in the humoral status of the diseased body state at the given point in time. ◉ The diseases Ilaippu or shayarogam is said to be predominantly due to the extreme variation of kabam humor. Therefore the seive pattern and pearl beaded appearance in some of the cases clearly indicate the dominance of the kabam manifestation in the body that get expelled through the urine. ◉ The study was useful to document the various patterns of neikkuri in Ilaippu noi and diagnosis of the affected kuttram. ◉ One of the main benefit of the study is if the diagnosis is done in siddha way. it would be easy to treat the disease on tri humoural basis. it is also a cost effective and easy method of diagnosis of Ilaippu noi.(pulmonary tuberculosis). ◉ Till date no study was carried out in finding the neikkuri patterns of patients affected with tuberculosis. From this study it is hypothesized that atypical patterns of kabam like mustard scatter and particularly seive pattern of neikkuri, are suggestive of Ilaippu noi. Further elaborate studies have to be carried out to prove this fact. CONCLUSION: Summarizing and analysing the results of the blinded diagnostic comparative study, it is concluded that Neikkuri examination is a reliable tool of cost effective screening and diagnostic method. This study has thrown light over the detection of established tuberculosis infection affecting the lungs and even the diseases affecting the lungs to pick them for diagnosis and also prognosis to measure the treatment outcome.

Item Type: Thesis (Masters)
Additional Information: Reg.No.321915201
Uncontrolled Keywords: Prospective Blinded Comparative study, Possible Specific Signs, Diagnosis, Siddha Neikkuri Examination, Urine Samples, Ilaippu Noi-Pulmonary Tuberculosis Patients.
Subjects: AYUSH > Noi-naadal
Depositing User: Subramani R
Date Deposited: 01 May 2023 18:29
Last Modified: 07 May 2023 11:22
URI: http://repository-tnmgrmu.ac.in/id/eprint/21217

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