A study on naadi examination in vippuruthi / putru: A randomized and blinded case control study

Arivu Oli, R (2017) A study on naadi examination in vippuruthi / putru: A randomized and blinded case control study. Masters thesis, National Institute of Siddha, Chennai.

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Abstract

Vippuruthi/Puttru (Cancer) is a leading cause of morbidity and mortality worldwide, with approximately 14.1 million new cases and 8.2 million deaths in a year. In developing countries cancer more often results in death as it is generally diagnosed at late stage and the resources for early detection and treatment are limited. Hence, the early diagnosis and management of patients with cancer is very vital and they can be cured if diagnosed early. In order to determine the effectiveness of Naadi diagnosis of cancer, a small effort is made to throw the light over Naadi or pulse Examination. Naadi Examination is obviously non costly and can help immensely in picking up an insidious onset of a malignant condition on incidental routine examination of Naadi. The proposed study was conducted and it is proved and established that, it can serve as a powerful tool of early cancer detection which can help the patient to take appropriate treatment at the appropriate time to get cured and extend the life span. It is important to diagnose cancer in early stage. Early detection of cancer greatly increases the chances for successful treatment. Through early diagnosis and screening we can prevent the cancer relegating to the stage of metastasis. Early detection is the key for very essential to effectively treating cancer and saving lives of cancer patients. Considering the importance of early detection of cancer a solution was sought to evaluate a cost effective, skill based, non invasive, desk side, physical / clinical examination. Only for this purpose it was decided to conduct a clinical study and validate the traditional practice of Naadi (Siddha method of pulse perception) examination and put into practice for a routine screening of all patients for cancer. The study was unanimously approved by the Institutional Ethics Committee (IEC/9/2014-15/25) and was registered in Clinical Trials Registry of India (CTRI/ 2017/02/007870). In this study two groups of patients, cancer confirmed and non cancer patients/ subjects were randomized and presented to the principal investigator through a hand –hole from behind the veil. It was only the hand that was presented through the small hole in the veil. The investigator was masked about the identity, physical stature, health status and practically everything concerning the patients /subjects. The investigator was given adequate time to perceive the subtle variations in the differential pulse perception of Vatham, Pitham and Kabam humors manifesting through Naadi. The investigator also recorded and noted the Guru Naadi manifested in the patients. It was carefully discerned for the showing up of double impinge of the pulse over the investigators pulp of the thumb longitudinally placed over the long axis of the radial bone. The research team which randomized the cancer and non cancer patients by means of simple randomization to the investigator recorded all the case details and also collected the pulse detected information from the investigator soon after the end of the pulse examination with each trial participants to prevent bias and later manipulation. Among the research team one investigator cross examined the patient/subject (unblinded) for Naadi before presenting to the principal investigator through the veil. This open unblinded observation by the second investigator has been done prior to the principal investigator‘s assessment to avoid bias of the second investigator. The Naadi thus examined were compared for similarities and variations. It is estimated from this study that, the sensitivity of detecting cancer by the investigator is 76.5%. When the Kabavatham Naadi was presented the probability of the presence of underlying incurable or serious malignant condition was 80.3%. When the Kabapitham Naadi was presented the probability of the presence of underlying incurable or serious malignant condition was 71%. The two Naadi patterns Kaba vatham and Kaba pitham themselves constituted 50% manifestation in the cancer group patients. In non-cancer patients Kabavatham and Kabapitham together constituted around 24% in the general study population. Much importance has been given for the double line Guru Naadi pulsation in the detection of cancer. Among the 66% percentage of cancer patients who presented with doubleline gurunaadi the Kabavatham Naadi was co-presented in 80%. This finding substantiates the importance of double line Guru Naadi which is pathognomonic of underlying serious illness and here cancer in this study. But even in the absence of double line Guru Naadi, when the patient exhibited Kaba vatham the investigator confidently attributed to probable cancer diagnosis. This Kaba vatha Naadi finding happened to be accurate in the prediction of underlying serious illness (Cancer here) even when the double line Guru Naadi was not manifested. The Kaba Vatha Naadi was presented in 5.6% of the non cancer patients whereas in cancer patients it was presented by 34% of them. In this study, the investigator attributed almost all Kaba Vatha Naadi manifesting participants as to be probable cases of cancer while doing so there was a false positivity of 80% though in a very small percentage of non-cancer patients and subjects whereas, all (41/41=100%) the cancer patients who exhibited Kaba Vatha. Naadi were picked up by the investigator as cancer probables without missing even a single case. Therefore it can be categorically stated that, the sensitivity of detecting cancer in Kaba Vatha Naadi exhibiting cancer patients was 100%. Therefore the Kaba Vatha Naadi when detected perfectly in cancer patients will be a perfect screening test for diagnosis. Similarly in the case of Kaba Pitha Naadi the investigator had a sensitivity of 92.5% in detecting the cancer patients in this study. Though there was false positivity while detecting with Kaba Pitham, this Naadi combination was presented only by a meagre 6.2% of normal subjects/non cancer patients. Because of the high sensitivity of Kaba Pitha Naadi in cancer, this Naadi pattern was also very useful in screening of the cancer patients. Any screening test will serve its purpose when the sensitivity of the test is high, less expensive, less time consuming and could be done with simple skill and training. In this manner this Naadi examination is a perfect fit to be a screening test to detect alarming conditions like cancer. The salient points to detect the probable cancer cases are standardized as hereunder: • Presence of Kabavatha Naadi on repeated examinations excluding senility. • Presence of sharp beats of Kabam excluding the respiratory ailments. • Presenting of Kabapitha Naadi on repeated examinations. • Manifestation of double line beats of Guru Naadi. When the above guidelines are followed, though it might be picking up some non cancer persons, the chance of missing cancer patients is very low. Hence Naadi examination following these guidelines is highly reliable as a screening test. CONCLUSION: Summarizing and analyzing the results of the randomized control study it is concluded that Naadi examination is a reliable tool of cost effective screening and diagnostic method. This study has thrown light over the early detection of cancer and other serious underlying illnesses thereby helping to institute total cure to such patients. Early detection of cancer through the above validated study will enable many patients to be cured completely giving a new lease of life.

Item Type: Thesis (Masters)
Additional Information: (Reg.No: 321415201)
Uncontrolled Keywords: naadi examination ; vippuruthi ; putru ; randomized and blinded case control study.
Subjects: AYUSH > Noi-naadal
Depositing User: Kambaraman B
Date Deposited: 25 Sep 2018 08:44
Last Modified: 25 Sep 2018 08:48
URI: http://repository-tnmgrmu.ac.in/id/eprint/9615

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