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SYNOPSIS

AN OBSERVATIONAL STUDY TO EVALUATE THE KARNENDRIYA

SHAITHILYA IN PANDU ROGA (IRON DEFICIENCY ANAEMIA)
THROUGH NOISE SENSITIVITY SCALES AND AUDIOMETRY TEST

SHRI KRISHNA AYUSH UNIVERSITY, KURUKSHETRA

Submitted for the Partial Fulfilment of Ayurveda Vachaspati

PG. Scholar
Dr. Ritu Verma
GUIDE:
Dr. Nithin Krishnan
Associate Professor
Department Of Roga Nidana Evum Vikriti Vigyana

Department Of Roga Nidana Evum Vikriti Vigyana

Shri Dhanwantry Ayurvedic College and hospital
Sector-46 B,
CHANDIGARH
BATCH 2022-2025

1|P ag e

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CERTIFICATE FOR RESEARCH TOPIC APPROVAL:

It is certified that the research work entitled “an observational study to evaluate the karnendriya
shaithilya in pandu rogi (iron deficiency anaemia ) through noise sensitivity scales and
audiometry test” has been allotted, after approval from Department Research Committee to Dr. Ritu
Verma under the supervision of Dr. Nithin Krishnan. It would be a further advancement & innovative
idea in the field of Ayurveda.

Dr Sumit Srivastava
Professor, HOD
Department Of Roga Nidana Evum Vikriti Vigayana,
Shri Dhanwantry Ayurvedic College & Hospital,
Chandigarh.

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PERFORMA FOR REGISTRATION OF TOPIC FOR DISSERTATION:

1. Name of the candidate and address:

Dr. Ritu Verma
Shri Dhanwantry Ayurvedic College and Hospital,
Chandigarh, Pin- 160047.

2. Name of Guide:
Dr. Nithin Krishnan
Associate Professor
Department of Roga Nidana Evum Vikriti Vigayana
Shri Dhanwantry Ayurvedic College and Hospital, Chandigarh,
Pin:160047.

3. Name of the Institution:

Shri Dhanwantry Ayurvedic College and Hospital,
Chandigarh.

4. Course of Study:
Subject- M.D. (Ayurveda)- Roga Nidana evum Vikriti Vigyana.

5. Date of commencement of course:

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From Dr. Ritu Verma

First Year M.D Scholar
Department Of Roga Nidana Evum Vikriti
Vigyana Shri Dhanwantry Ayurvedic College
and Hospital Chandigarh -160047

To The principal.
Shri Dhanwantry Ayurvedic College and
Hospital Chandigarh -160047

Through Head of Department

Department of Roga Nidana Evum Vikriti
Vigayana Shri Dhanwantry Ayurvedic
College and Hospital Chandigarh -160047

Subject: Submission of Synopsis for Registration

Respected Sir,
I, undersigned PG scholar Dr. Ritu Verma, humbly request you to register my below
mentioned topic “An observational study to evaluate the Karnendriya Shaithilya in
Pandu Rogi (iron deficiency anaemia) through noise sensitivity scales and Audiometry
Test”- an observational study for postgraduation studies in Roga Nidana Evum Vikriti
Vigyana department. With this letter, I am enclosing complete Performa of the same for
registration.

Date: Yours faithfully

Dr. Ritu Verma

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TITLE
AN OBSERVATIONAL STUDY TO EVALUATE THE KARNENDRIYA
SHAITHILYA IN PANDU ROGI (IDA) THROUGH AUDIOMETRY TEST

NAME OF THE CANDIDATE: Dr. Ritu Verma

REMARKS OF GUIDE:

SIGNATURE OF GUIDE:

NAME OF THE GUIDE: Dr. Nithin Krishnan

SIGNATURE OF H.O.D:

NAME OF THE H.O.D: Dr. Sumit Srivastava

NAME OF THE INSTITUTION: Shri Dhanwantry Ayurvedic College

And hospital, Chandigarh
Pin: 160047

SIGNATURE OF PRINCIPAL:

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INDEX

S. No Particulars Page Number

1 Introduction 7

2 Review of Literature 8

3 Aims and Objective 9

4 Previous Work Done 10

5 Need Of Study 11

6 Research Methodology 12

7 Study Flow Chart 14

8 Criteria of Assessment 16

9 Study Timeline 19

10 Observation And Result 20

11 References 21

12 Annexure 23

13 Case Report Form 24

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TOPIC OF DISSERTATION: AN OBSERVATIONAL STUDY TO EVALUATE

THE KARNENDRIYA SHAITHILYA IN PANDU ROGA(IRON DEFICIENCY
ANAEMIA) THROUGH NOISE SENSITIVITY SCALES AND AUDIOMETRY
TEST

INTRODUCTION
Ayurveda is the study of life that focuses on the positive well-being in healthy and the treatment of
illness in unhealthy through its comprehensive methodology, way of life rehearses, dietary practices,
and more secure drugs. Ailing health either because of deficient dietary admission or absence of
adjusted eating routine in today’s time and age has led to the advancement of different diseases and
Pandu Roga is one of them.

Pandu is a disease manifested due to vitiation of Pitta Dosha. Acharya Charaka considers it a
Raktavahasroto Viddha Lakshana and Rasapradoshaja Vikara whereas Sushruta identifies Pandu as
a disease manifested due to vitiation of Rasavaha Srotas. Since Pandu Roga is a Pitta Pradhana
Vyadhi and Bhrajaka Pitta and Rakta, are responsible for the Prakrita Varna of body, so aggravation
of Pitta can cause hindrance of Prakrita Varna and pallor of skin (Panduta). Samanya Lakshanas of
Pandu Roga according to Ayurveda are Raktalpata, Medalpata, Nissarta, Vaivarnya, Ojogunakshaya,
Daurbalya, Aruchi, Bhrama, Shithilaendriya.

Pandu Roga can be correlated with Anaemia in modern science due to the resemblance in clinical
signs and symptoms. Anaemia is defined as a deficiency of haemoglobin in the blood. Iron deficiency
anemia (IDA) is the most common nutritional deficiency worldwide. According to WHO, it affects
nearly two billion people. It was found that nearly one-half of anemic individuals have IDA. It can
cause reduced work capacity in adults and impact motor and mental development in children and
adolescents. IDA may affect visual and auditory functioning.

So the aim of the study is to correlate findings in Audiometry & Audiometric Scales and Iron profile
& Hb Levels

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REVIEW OF LITERATURE
The word "Pandu" has been derived from the term "Padi Nasane", with the suffix "Ku", and ends with
Ni.

According to Charaka Samhita, patients with this condition exhibit discoloration of skin like Pandu,
Haridra, or greenish. According to Sushruta Samhita, Shweta raktam or Shweta pitta is more prevalent
in the patient's body, so it is called Pandu.

Different acharyas have explained the Lakshanas of Pandu. In Charak Samhita chikitsa sthana, Pandu
Lakshanas are explained as follows –

सोऽल्परक्तोऽल्पमेदस्को नननिःसाररिः ननननलेन्द्रिन िः। वैवर्ण्य भजते, तस्य हे त¸ुु शृण¸ सलक्षणम् ।।
(C.Ch. 16/6)
Means Raktalpata, Medalpata, Nissarta, Vaivarnya, Ojogunakshaya, Daurbalya, Aruchi, Bhrama,
Shithilaendriya.

इन्द्रि ाणाुु बल हत्वा तेजो वी ोजसी नता। पाण्ड¸ रोग करोत्यानु¸ बलवणा नननानुनम् || (M.N. 8)
Means Indriya Bala Kshaya, Varna Nasha, Agni Nasha.

Tridosha, Saptadhatu and Trimala are the basic concepts of Ayurveda. Dhatus are seven in number.
Rasadhatu, is first among the Saptadhatu and it is having prime importance of all Dhatu. And
according to Ayurveda, there are five Indriyas , one of which is Shrotrendriya. The sense organ which
perceives sound is called Shrotrendriya. External auditory meatus and external auditory canal are
hollow structures of the ears, which show predominance of Akasha Mahabhuta. Rasadhatu in its
decreased state produces some symptoms, one of which is Shabda Asahishnuta that is intolerability
towards sound which means Rasa Dhatu Kshaya affects the functioning of Srotrendriya . Lakshanas
of Rasa Dhatu Kshaya ar as follows
रसे रौक्ष् श्रनमिः नुुोषो ग्लानननिः नुब्दासनहष्ण¸ता| (A.H.Su. 11/17)
Means Rukshta, Shrama, Shosha, Glani, Shabdasahishnuta.
Also Pandu is one of the Rasapradoshaja Vikara.
पाण्ड¸ त्व स्रोतसाुु रोन िः क्लैब् सानदिः क
ृ नुुाङ्गता|
नानुुोऽनुुेरन ाकाल वलन िः पनलतानन च|| (Ch.Su. 28/9-10)

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Since Pandu Roga ia a Rasapradoshaja Vikara and one of its symptoms is Indriyashaithilya and one
of the symptoms of Rasa Dhatu Kshaya is Shabdasahishnuta, so this study is focused on Karnendriya
Shaithilya in Pandu Roga.

Symptoms of Pandu Roga are similar to Anaemia in modern science. There are different types of
Anaemia as described in modern, out of which Iron Deficiency Anaemia is the commonest nutritional
deficiency disorder throughout the world. A serum ferritin level of less than 15ug/l and hemoglobin
(Hb) level of less than 12 g/dl in women and 13gm/dl in men is indicative of iron deficiency.

Symptoms of Pandu Roga are similar to Anaemia in modern science. There are different types of
Anaemia as described in modern, out of which Iron Deficiency Anaemia is the commonest nutritional
deficiency disorder throughout the world.

Iron deficiency is the main cause of Iron Deficiency Anaemia where hemoglobin (Hb) level of less
than 13g/dl in men and less than 12 g/dl in women, Iron levels less than 60mcg/dL, and serum ferritin
level of less than 15ug/l is indicative of iron deficiency.

If you don’t get enough Iron, your cells can’t deliever oxygen properly, as iron helps blood cells carry
oxygen from lungs to the body.

The inner ear require an oxygen rich, healthy blood supply to function normally.

The blood supply of inner ear is highly susceptible to ischemic damage.

Therefore it is considered, that IDA can lead to hearing impairement.

Relationship between Karnendriya Shaithilya and Pandu can be correlated with hearing loss in Iron
Deficiency Anaemia. So and attempt is made to validate text in ayurvedic samhita that is Karnendriya
shaithilya in Pandu according to modern.

 AIMS
This study aims to investigate Karnendriya Shaithilya in Pandu (Iron Deficiency
Anaemia ) patients by correlating the findings of Audiometry & Noise sensitivity Scales

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with Iron Profile & Hb Levels.

 OBJECTIVE
 To assess Shabdasahishnuta in Pandu Rogi via Noise sensitivity Scales
 To assess Karnendriyashaithilya in Pandu Rogi via Audiometric Evaluation.

PREVIOUS WORK DONE:

1. Association of Iron Deficiency Anemia With Hearing Loss in US Adults

Kathleen M. Schieffer, BS1; Cynthia H. Chuang, MD, MSc2; James Connor, PhD3; et alJames
A. Pawelczyk, PhD4; Deepa L. Sekhar, MD, MSc5, April 2017
2. Sudden Sensorineural Hearing Loss Associated With Iron-Deficiency Anemia

A Population-Based Study Shiu-Dong Chung, MD, PhD1,2; Po-Yueh Chen, MD3; Herng-
Ching Lin, PhD2,4; et alShih-Han Hung, MD5, May 2014

3. The Relationship Between Iron Deficiency Anemia and Sensorineural Hearing Loss in the
Pediatric and Adolescent Population Kathleen M. Schieffer, James R. Connor, James A.
Pawelczyk and Deepa L. Sekhar 13June,2017
4. Auditory brainstem response in infants with iron deficiency anemia 2020, International
Journal of Pediatric Otorhinolaryngology February,2019
5. Study of Association of Sensory Neural Hearing Loss with Iron Deficiency Anaemia
Original Article Published: 15 May 2021
6. Schieffer KM, Chuang CH, Connor J, Pawelczyk JA, Sekhar DL. Association of Iron
Deficiency Anemia With Hearing Loss in US Adults. JAMA Otolaryngol Head Neck Surg.
2017 April
7. Taki M, Hasegawa T, Ninoyu Y, Mohri H, Hirano S. Low-Frequency Sensorineural Hearing
Loss Associated With Iron-Deficiency Anemia. J Int Adv Otol. 2021 Sep;17.
8. Sudden Sensorineural Hearing Loss Associated With Iron-Deficiency Anemia A Population-
Based Study Shiu-Dong Chung, MD, PhD1,2; Po-Yueh Chen, MD3; Herng-Ching Lin, PhD
May 2014

9. Iron deficiency is associated with poor prognosis in idiopathic sudden sensorineural hearing
loss Published online by Cambridge University Press: 29 April 2021

10. Relationship between Peripheral and Central Auditory Abilities and Iron Deficiency Anaemia

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in Adolescents Girls by Chandni Jain. 9Dec,2021.

11. Dr. Suvidha M. Pazare, Dr. Achal M. Doye, Dr. Aditi A. Gandhare, Dr. Virendra Kodape, &
Dr. Madhavi Charmore. (2020). A thematic review on Pandu with reference to Iron Deficiency
Anaemia. January-February, 2020
12. Rai, Shalini; Kar, Anukul Chanda1. A review on role of psychological factors in the
etiopathogenesis of Pandu Roga with reference to iron deficiency anemia. AYU (An
international quarterly journal of research in Ayurveda) 37(1):p 18-21, Jan–Mar 2016. |
13. A Study on Types of Pandu Roga with Special Reference to Iron Deficiency Anaemia with
the Help of Serum Ferritin Gaikwad, Anju Rajiv Gandhi University of Health Sciences
(India) 2018 .
14. Sheikh, Rozina; Chouragade, Bharat1. A survey study on correlation between symptoms of
Pandu and Anemia. Journal of Indian System of Medicine 6(4) Oct–Dec 2018.
15. Unravelling the mind-body connection: exploring the role of psychological factors in the
development of pandu roga (iron deficiency anaemia) dr. bhagyashri purushottam kamdi1 *,
prof. dr. jayashri katole2 and dr. ashish g. keche3 5 Nov,2023
16. Etio-pathogenisis of Pandu Roga w.s.r. to Iron Deficiency Anaemia an Literary Study Dr.
Chetan A. H., Dr. R. Y. Timmapur Sept-Oct,2019
17. A comparative study on the assessment of clinical features of Pandu roga and its subtypes vis
a vis various types of anemia. Journal article: Indian Journal of Traditional Knowledge, 2015,
Vol. 14, No. 4, 525-530 ref. 8 Authors: Shalini Rai Shalini Rai, A. C. Kar
18. Diagnostic variations in anemia types and types of pandu according to modern science and
ayurveda –a comparative study by Dr. Shekhar G Uike, 2023.
19. A conceptual analysis on pandu roga w.s.r. to iron deficiency anaemia’’- a review study
radha mishra* and o.p. vyas
20. Effects of iron-deficiency anemia on auditory function in school-aged children Gehan M.S.
Abd El-Salama, Eman Soliman Abd El-Gaffarb, Hala M. Abd El-Samad, 2018

NEED OF STUDY:

Since Pandu Roga ia a Rasapradoshaja Vikara and one of its symptoms is Indriyashaithilya and one of
the symptoms of Rasa Dhatu Kshaya is Shabdasahishnuta, so out of five Indriyas this study is focused
on Karnendriya Shaithilya in Pandu Roga.

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The purpose of the study is to validate the Ayurvedic concepts and to evaluate the correlation of
findings in Audiometry & Noise Sensitivity Scales with iron profile & Hb Levels.

RESEARCH QUESTION:
Is there any correlation of findings in Audiometry & Noise Sensitivity Scales with iron profile & Hb
Levels
HYPOTHESIS :
According to Acharya Charak, there is significant relation between Indriyashaithilya and Pandu. If
there is any correlation, then there must be a correlation between findings in Audiometry &
Audiometric Scales in Iron Deficiency Anaemia.

NULL HYPOTHESIS

There is no correlation of findings in Audiometry & Noise Sensitivity

Scales with iron profile & Hb Levels

ALTERNATE HYPOTHESIS

There is significant correlation of findings in Audiometry & Noise

Sensitivity Scales with iron profile & Hb Levels

RESEARCH METHODOLOGY:
Study Type – Observational study

STUDY DESIGN: This research will involve a Observational study conducted on a representative
sample of patients based on their iron profile and Hb levels between the age group of 15- 49 years at
Shri Dhanwantary Ayurvedic College and Hospital. All the information related to work and health
history would be collected. Audiometric assessments will be performed to evaluate the auditory
function of participants, with a focus on identifying any abnormalities associated with Pandu.

Traditional Ayurvedic texts, such as Charaka Samhita and Sushruta Samhita, will be reviewed for
insights into the Ayurvedic perspective on Iron Deficiency Anaemia and their potential impact on the
auditory system.

Participants with a serum ferritin level of less than 15ug/l and hemoglobin (Hb) level of less than

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12g/dl for women and less than 13g/dl for male will be selected from the Kayachikitsa and Panchkarma
OPD and Audiometric tests will be conducted in controlled environments to ensure the accuracy and
reliability of the results. We will then study the association between the Hb and Serum Ferritin levels
and hearing loss in these subjects.

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Sample Size -200

The minimum required sample size was calculated to be 179.This sample size was estimated using
COCHRAN(1963) formula for prevalence of 13% with 95% confidence level with critical value Z α
/2 at 1.96 & acceptable margin error is 5%

Cochran formula is

NAME AND PLACE WHERE THE STUDY WILL BE CONDUCTED:

Patients coming to OPD of Shri Dhanwantry Ayurvedic College and Hospital,
Chandigarh. CBC, Iron Profile and Audiometric tests would be done.

INCLUSION CRITERIA:
 Iron Deficiency Anaemia Patients
 All patients between the 15-49 years of age group.

EXCLUSION CRITERIA:

 Cases suffering from

 Deafness and other pathological conditions of ear
 Causes of anaemia other than iron deficiency

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CRITERIA OF ASSESSMENT

SUBJECTIVE CRITERIA:
Hyperacusis Impact Questionnaire (HIQ)

Please answer each item to the best of your ability as close to your experience as possible.

Over the last 2 weeks , how often would you say each of the following has occurred because of certain
environmental sounds that seemed too loud to you but that people around you could tolerate well?

1.Feeling anxious when hearing loud noises 0–1days 2–6days 7–10days 11–14days

2.Avoiding certain places because it is too noisy 0–1days 2–6days 7–10days 11–14days

3.Lack of concentration in noisy places 0–1days 2–6days 7–10days 11–14days

4.Unable to relax in noisy places 0–1days 2–6days 7–10days 11–14days

5.Difficulty in carrying out certain day-to-day 0–1days 2–6days 7–10days 11–14days

activities/tasks in noisy places
6.Lack of enjoyment from leisure activities in noisy 0–1days 2–6days 7–10days 11–14days
places
7.Experience in glow mood because of your 0–1days 2–6days 7–10days 11–14days
intolerance to sound
8.Getting tired quickly in noisy places 0–1days 2–6days 7–10days 11–14days

Sound Sensitivity Symptoms Questionnaire (SSSQ)

Over the last 2 weeks, how often have you been bothered by any of the following problems ?

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1. Having a problem tolerating sounds because they 0–1 days 2–6days 7–10days 11–14days
often seem “too loud” to you ?
2. Pain in your ears when hearing certain loud sounds 0–1 days 2–6days 7–10days 11–14days
? Examples: loud music, sirens, motorcycles,
buildingwork, lawn mower, train stations.
3. Discomfort (physical sensations other than ear 0–1 days 2–6days 7–10days 11–14days
pain) in your ears when hearing certain loud sounds?
4. Feeling angry or anxious when hearing certain 0–1 days 2–6days 7–10days 11–14days
sounds related to eating noises, lip smacking,
sniffling, breathing, clicking sounds, tapping ?
5. Fear that certain sounds may make your hearing 0–1 days 2–6days 7–10days 11–14days
and/or tinnitus worse?

Weinstein Noise Sensitivity Scale (WNSS)

The scale is composed of 21 items addressing affective reactions and attitudes to both general noise and
daily environmental sounds. Individual sensitivity is seen as lying on a continuum ranging from high to
low. Highly sensitive individuals are more sensitive to, and react more negatively to, perceived noise
than their less sensitive counterparts

Administration
The scale can be administered on paper or online and takes approximately 5 minutes to complete.

Scoring
Responses to each of the 21 items are scaled along 6 points with 0 indicating strong disagreement and 5
indicating strong agreement. After reverse coding relevant items, the unweighted sum of scores from
each of the items is tallied. Stronger agreement with the items results in a higher score (ranging from 0
to 105), indicating greater individual noise sensitivity.

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Strongly disagree Strongly agree

1) I wouldn’t mind living on a noisy street if the apartment I had was nice. 0 1 2 3 4 5

2) I am more aware of noise than I used to be. 0 1 2 3 4 5

3) No one should mind much if someone turns up his or her stereo full blast 0 1 2 3 4 5
once in a while.
4) At movies, whispering and crinkling candy wrappers disturb me. 0 1 2 3 4 5

5) I am easily awakened by noise. 0 1 2 3 4 5

6) If it’s noisy where I’m studying, I try to close the door or window or move 0 1 2 3 4 5
someplace else.
7) I get annoyed when my neighbors are noisy. 0 1 2 3 4 5

8) I get used to most noises without much difficulty. 0 1 2 3 4 5

9) It would matter to me if an apartment I was interested in renting were located 0 1 2 3 4 5

across from a fire station.
10) Sometimes noises get on my nerves and get me irritated. 0 1 2 3 4 5

11) Even music I normally like will bother me if I’m trying to concentrate 0 1 2 3 4 5

12) It wouldn’t bother me to hear the sounds of everyday living from neighbors 0 1 2 3 4 5
(f ootsteps, running water, etc.).
13) When I want to be alone, it disturbs me to hear outside noises. 0 1 2 3 4 5

14) I’m good at concentrating no matter what is going on around me. 0 1 2 3 4 5

15) In a library, I don’t mind if people carry on a conversation if they do it 0 1 2 3 4 5

quietly.
16) There are often times when I want complete silence. 0 1 2 3 4 5

17) Motorcycles ought to be required to have bigger mufflers. 0 1 2 3 4 5

18) I find it hard to relax in a place that’s noisy 0 1 2 3 4 5

19) I get mad at people who make noise that keeps me from falling asleep or 0 1 2 3 4 5
getting work done.
20) I wouldn’t mind living in an apartment with thin walls. 0 1 2 3 4 5

21) I am sensitive to noise. 0 1 2 3 4 5

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OBJECTIVE CRITERIA:
Audiometry - Audiometric thresholds are measured in decibles
Normal – 0- 20 dB hearing level

Haemoglobin- less than 10 g/dl is indicative of iron deficiency.

Serum Ferritin - Less than 12 g/l is indicative of IDA.

Sound Sensitivity Symptoms Questionnaire -The five-item SSSQ requires respondents to rate
the number of days during the past 2 weeks that they experienced each of several symptoms,
including loudness hyperacusis, pain or discomfort hyperacusis, annoyance hyperacusis/
misophonia, and fear hyperacusis.

Hyperacusis Questionnaire - The HQ has 14-items, each rated on a 4-point Likert scale from
“no” to “yes, a lot”15. Cronbach’s α for the English version of the HQ is 0.88.19 The overall
score ranges from 0 to 42. Scores of 22 or more were taken as indicating the presence of
hyperacusis.

Weinstein Noise Sensitivity Scale (WNSS) - Responses to each of the 21 items are scaled along
6 points with 0 indicating strong disagreement and 5 indicating strong agreement. After reverse
coding relevant items, the unweighted sum of scores from each of the items is tallied. Stronger
agreement with the items results in a higher score (ranging from 0 to 105), indicating greater
individual noise sensitivity.

STUDY TIMELINE -15 MONTHS

Literary Review 2 MONTHS

Screening and Enrollment of 6 MONTHS

Patients

Data Analysis 3 MONTHS

Data Interpretation

Writing the Thesis 4 MONTHS

Results
Conclusion

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STATISTICAL ANALYSIS

Data will be collected using case report form (CRF) designed by incorporating all aspects (Ayurveda &
modern medicine) for the study. We will utilize AI-enhanced capabilities in power BI and Tableau for
advanced Statistical analysis and data Visualization. Descriptive statistics will be computed to
understand the central tendencies and variabilities. SPSS will serve as the primary analysis tool,
supplemented by Python and R. Nominal & ordinal data will be analyzed using nonparametric tests like
Wilcoxon’s signed rank test,chi-square test, spearman’s rank correlation

ETHICAL CONSIDERATION:

This study will be conducted according to the prevalent standard of good clinical practices. This
protocol and any amendments will be submitted to the Institutional Ethics committee (IEC) for approval
of the study conduct.

OBSERVATIONS AND RESULT

Gradings of Hearing Loss using HIQ, SSSQ, WNSS Scale will be done and Hb, Serum Ferritin,
Peripheral Blood Smear will be done. Then correlation between findings in Audiometry & Audiometric
Scales and Hb & Ferritin levels will be evaluated and the result will be calculated after putting
appropriate statistical method.

EXPECTED OUTCOME:

1. Increase in intolerance of sound may be observed with decreasing levels of Hb and Serum
Ferritin as per Karnendriya Shaithilya as a lakshan of Pandu.

2. Findings of the study may help to revalidate the concept mentioned in our Ayurvedic texts.

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REFERENCES

1. Pandey K,Chaturvedi G. Vidyotini , Shrimad Agniveshena Praneeta Achaarya Charak And

Dridhabala, Chaukhambha Bharati Academy, Varanasi, Edition 2020, Charak Samhita, Vol 1,
Sutra Sthana 11/37, 200p.
2. Pandey K,Chaturvedi G. Vidyotini , Shrimad Agniveshena Praneeta Achaarya Charak And
Dridhabala, Chaukhambha Bharati Academy, Varanasi, Edition 2020, Charak Samhita, Vol 2,
Chikitsa Sthana 16/6
3. Pandey K,Chaturvedi G. Vidyotini , Shrimad Agniveshena Praneeta Achaarya Charak And
Dridhabala, Chaukhambha Bharati Academy, Varanasi, Edition 2020, Charak Samhita, Vol 1,
Sutra Sthana 28/9-10

4. Tripathi Brahmanand, Sutra Sthan1/13, Gupta K., Vagbhata, Asthanga Hridaya Vidyotini Tika
Chaukamba Sanskrit Sansthan, Varanasi, Ed 18 | Sutrasthana 11/17
5. Psychometric Evaluation of the Hyperacusis Impact Questionnaire (HIQ) and Sound Sensitivity
Symptoms Questionnaire (SSSQ) Using a Clinical Population of Adult Patients with Tinnitus
Alone or Combined with Hyperacusis Hashir Aazh, PhD 1,2 Chloe Hayes, BSc3 Brian
C.J.Moore, PhD4 Ali A .Danesh, PhD2 Silia Vitoratou, PhD
6. Weinstein Noise Sensitivity Scale (WNSS) (Weinstein, 1978) Profiled by: Debra L.
Worthington, PhD
7. The reliability and validity of decreased sound tolerance scale-screening Serpil Allusoglu a,∗,
Songul Aksoy
8. Brahmanand Tripathi. Varanasi: Chaukhambha Surbharati Prakashan; 1997. Hindi
Commentator, Charaka Samhita, Chikitsa Sthana16/6
9. Alvarez-Uria G, Naik PK, Midde M, Yalla PS, Pakam R. Prevalence and severity of anaemia
stratified by age and gender in rural India. Anemia. 2014;2014:176182. doi:
10.1155/2014/176182. Epub 2014 Dec 4. PMID: 25614831; PMCID: PMC4277798.
10. Ministry of Health and Family Welfare ANAEMIA MUKT BHARAT, 4th Feb, 2022
11. Madhav Nidanam, Shri Vijaya Rakshit, Chaukhamba Orientalia, Chapter 8
12. Aazh H, Hayes C, Moore BCJ, Danesh AA, Vitoratou S. Psychometric Evaluation of the
Hyperacusis Impact Questionnaire (HIQ) and Sound Sensitivity Symptoms Questionnaire
(SSSQ) Using a Clinical Population of Adult Patients with Tinnitus Alone or Combined with
Hyperacusis. J Am Acad Audiol. 2022 May;33(5):248-258. doi: 10.1055/a-1780-4002. Epub

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2022 Feb 23. PMID: 35196727; PMCID: PMC9788912.

13. Pandey Ajay Kumar, Textbook of Kayachikitsa, Vol. 2, Chapter 2, First Edition. New Delhi;
Chaukhmbha Publications, 2019; 168.
14. Fong DYT, Takemura N, Chau PH, Wan SLY, Wong JYH. Measurement properties of the
chinese weinstein noise sensitivity scale. Noise Health. 2017 Jul-Aug;19(89):193-199. doi:
10.4103/nah.NAH_110_16. PMID: 28816206; PMCID: PMC5594924.
15. Brahmanand Tripathi. Varanasi: Chaukhambha Surbharati Prakashan; 1997. Hindi
Commentator, Charaka Samhita, Chikitsa Sthana
16. Pandey Ajay Kumar, Textbook of Kayachikitsa, Vol. 2, Chapter 2, First Edition. New Delhi;
Chaukhmbha Publications, 2019; 168.
17. Pandey Ajay Kumar, Textbook of Kayachikitsa, First Edition, New Delhi; Chaukhambha
Publications, 2019; 2(2): 167.
18. Prof. Priyavarat Sharma, Sushrut Samhita Uttar Tantra Chaukhambha Sanskrita Sansthana
Varanasi. Edited with Ayurveda Tattva Sandipika by Kaviraj Ambikadutta Shastri, Reprint,
2005; 16/6.
19. Iron-Deficiency Anemia nlhbi|nih

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ANNEXURE

SHRI DHANWANTRY AYURVEDIC COLLEGE SECTOR-46 B, CHANDIGARH,

DEPARTMENT OF ROG NIDANA EVUM VIKRITI VIGAYANA

CONSENT FORM

For the study

“An observational study to evaluate the karnendriya shaithilya in pandu roga(iron deficiency
anaemia)through noise sensitivity scales and audiometry test”

Case Serial No.: Phone No.

Name of Patient:

Name of MD Scholar: Dr. Ritu Verma

Name of Guide: Dr. Nithin Krishnan

I……...........….......................... aged…….…. years R/o…........................................ have been

informed adequately about the study.

I have understood the information sheet for above study i.e. “an observational study to evaluate the
karnendriya shaithilya in pandu roga (iron deficiency anaemia) through noise sensitivity scales
audiometry test. I have been given the opportunity to question Dr. Ritu Verma on all the aspects of
the study. I am also aware of my right to withdraw anytime during the course of study without any
reason.

I have been informed to my satisfaction about the research and agree for the participation in this
study.

Name of patient with signature Name of witness With

signature

I confirm that I have explained purpose of study to Mr/Mrs……………………………

Date Signature of the

MD Scholar

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CASE REPORT FORM

Patient Name................................ OPD/IPD No. ..........................

TITLE
“an observational study to evaluate the karnendriya shaithilya in pandu rog (Iron
Deficiency Anaemia) through noise scales and audiometry test

PG. Scholar
Dr. Ritu Verma
B.A.M.S. (SDAC, Chandigarh)

Guide
Dr. Nithin Krishnan
M.D. (Ayu.),
Assistant Professor, HOD
Dept. of Rog Nidan Evum Vikriti Vigyana

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PERFORMA

Sr. No. –
Dated -
Name of the Patient: -

DEMOGRAPHIC DATA

Name of the patient ……………………………………………………….

Age.…………………… Sex: Male Female

Marital status: Married Unmarried

Address : ………………………………………………………………………...………
..……………………………………………………………………………

Telephone No.……………………

IPD No.: …………… OPD No.: …………………………

HISTORY OF THE PATIENT

Chief Complaints with Duration:

History of Present illness:

Drug allergy (if any):

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History of Past illness:

PERSONAL HISTORY:

PLACE OF RESIDENCE

Rural

Urban

Semi urban

EDUCATION

Literacy

Illiteracy

OCCUPATION

Job

Farmer

Business

NATURE OF WORK

Hard manual

Moderate manual
Sedentary

DIETIC HABIT

Vegetarian

Non vegetarian

Mix

ADDICTION

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Drinking

Smoking

Any other

SLEEP

Regular

Disturbed

BOWEL HABITS

Regular

Irregular

Constipation

URINE

Normal

Scanty micturition

Burning micturition

MENSTRUAL HISTORY

Age of menarche

Cycle (regular/ irregular)

Duration of flow

OBSTETRICAL HISTORY

GPLA

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GENERAL PHYSICAL EXAMINATION

General Appearance

Weight -................................ Kg.

BMI - ……...........................
Height -.................................cm
Respiration rate - ................................. per min.
Blood pressure -..................................mm Hg.
Pulse Rate - ……..………….Per min Regular
/Irregular

ASHTAVIDHA PARIKSHA

NADI
Rate -
Rhythm -
Dosh gati - V/ P/ K Dvi-doshajSannipataja

MOOTRA Frequency

Colour
Quantity a. Day time
b. Night time

MALA

Colour -
Consistency -
Odour -
Frequency -

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JIHWA

Appearance -

Any ulcer -Present/ Absent

Any fissure -Present/Absent

Coating- -Present/Absent

Pigmentation -Present/Absent

SHABDA

DRIK(EYES)

AKRITI

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DASHAVIDHA PARIKSHA:

Sr. Character Vataja Pittaja Kaphaja

No.
1. Appetite Laghu Bahubhuk Tikshankshudha Alpa kshudha
Dandshuka Ashanpriye

2. Thirst ................... Tikshan Alpa

Trisnan
3. Digestive Alpa Sheeghra- ……………
Power Paki
4. Economic Alpa dhan (poor) Madhya vitta Vasumanto
Status
5. Dreams Sky walking, Svapne Jalashaya aloki,
Watching vidyuta, ulka Svapane
mountains, pasyet spadyaman
Watching rivers. Savihand
malam,
stoyashyam
pashyati
6. Fertility Alpa apatya Alpa apatya Prabhutapatya

7. Religious Nastika ............. Dridhbhakti

Faith parayan
8. Likings Madhur amla Madhur Malya-
lavana snigadha Kashaya tikta, anulapena, katu
aahara, Sheeta,Malya- tikta kashaya,
Yatra, Geet hasya vilepana Ushna

9. Initiative Sheeghra arambha …………. Deerghsutri

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10. Knowledge Anavasthit mati Madhya Vidyavanta

Gyanvigyan

Prakriti
11. Sexual desire …………. Alpa – Prabhut,
Vyavaaya Atimaithunsam
rath
12. Bowel …………. Prabhut-srisht ………….
Movement
13. Bladder …………. Prabhut-srisht ………….
Movement
14. Respect of …………. …………. Manyita
Teachers Gurunam
15. Relation with Chala – souhard …………. Sthir mitra
Friends
16. Courage …………. …………. Maha utsaho

17. Helping …………. Ashrit vatsal ………….

Attitude (child loving)
18. Tolerance …………. Klesh ………….
Asahishanave
19. Faith in texts …………. …………. Dridhshastram
ati
20. Donation …………. …………. Pariganya
chirat dadatibahu
21. Gratitude Kritghna …………. Kritagya

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Sr. Character Vataja Pittaja Kaphaja

No.
1. Body Built Apachita (emaciated) Sukumar (tender), SnigdhangaSamhat,
Ruksha (dry), Alpa Avdatgatra(clear), Shalakshan, Paripurna,
(dwarf), Alpang, Stabdh Shithilang Sarvang
(Firmly fixed) (weak)

2. General Durbhaga (ugly) Durbhag (Ugly) Subhaga

Appearance

3. Look Chal Drishti .................... Prasanna

darshan

4. Color of Dhoosar gatra (grey) Gour (fair), Gour (fair)

Body Tamara

5. Strength Alpa bala Madhya bala Balvanta

6. Gait Laghu (light), ................ Avasthit gati

Chapala

7. Skin Parush (dry), Prabhut piplu, Soumya

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7. Skin Sphutita (cracked) Vyan (clean), Achha

ga , (clear)
Tilpidi
ka
8. Voice Pratat ruksha Vigrah Abhiyogvan
& (hoarse), vakta ,
Speec Ksham (dry), (hostile Parinishchit vakyapad,
h Sann (low), discussion Prasann svara
Sakta, Jarjar, )
Bahubhashi
9. Sweating Alpa sveda Prabuta Alpa sveda
10. Hair Ruksha, Alpa, Kapil, Mridu, Sthira, Kutil
Sphutita , Alpa, Kshipra ,
Dhusara palitya, Palitya Ghana, Neel
11. Forehead ................... ..................... Mahalalata
12. Eyebrows Chala (mobile), ..................... Avasthit
Anavasthit
13. Eyelashes Chala, Anavasthita Pingal, Alpa, Vishal
Chala Pakshma
14. Eyes Khar, Tamra, Susnigadha, Vishal,
Dhusara, Vritta, Raktanta ,
Vritta Himpriya, Suvyakta
Netra raag
15. Lips Anavasthita Tamra Upachita,
Paripurna
16. Teeth Alpa, Parush, ……………… Bahula
Antkhadi
17. Tongue Anavasthita Tamra ……………
(unstable) ……
18. Palate Sphutita (cracked) …………… ……………
……
19. Chin Anavasthita Tamra Upachita
(mobile) Paripurna
20. Face Parusha (dry) Tamra, ……………
Krodhen ……
madyen,
ravesh
cha masa ragam
21. Limbs Sphutita (cracked) Gaur, Ushna Maha lalat
Uro

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22. Nails Parush, Alpa …………… Suvibhakta

23. Hands Parush (dry), Tamra, Snigadha (oily), saumya

Anavasthita, Gaur (clean), Suvibhakta
Sphutita (fair),
(cracked) Parusha (dry)

24. Feet Parush (dry), Tamra, Snigadha (oily), Saumya

Anavsthita, Gaur (clean), Suvibhakta
Sphutita (fair),
(cracked) Parusha (dry)

25. Body odor …………… Prabhuta pooti ……………

……
26. Joints Chal, Anavasthita, Mridu sandhi Goodha,
Satata sandhi (loose & Snidha, Sushlishta
shabdagamini softjoints)
27. Sira Bahu kandar, ……………. ……………
kandara Bahu sira ……
dhamani pratan,
Bahudhama
ni

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PSYCHOLOGICAL FACTORS:

Sr. Character Vataja Pittaja Kaphaja

No.
1. Nature & Sheeghra kshobha, Ashrita vastsala, Shanta
behaviour Sheeghra trasa Abhimani
raag, Stena (thief)

2. Memory Alpa (short), Sheeghra ………………… Smritimaan

shruta
grahi, Chala
3. Jealousy Matsarya Irshyalu Vineeta
(jealous)
4. Anger Krodhi Kshipra kopa - Alpa
kshipra prasad, kroadh,Shaant

5. Truthfulness ………………. ………………… Satyavadi

6. Intellect Chala, Medhavi Gambhir

Avyavasthita buddhi

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 36

7. Greed Lolupa ………………… Alolupa

8. Self-control Ajitendriya, ………………… …………
Heensatva ………

9. Dignity ………………… ………………… Sulajja

DOSHAJA - ………………………………………………
Vataja-
Alpakesh/Krisha/Ruksha/Vachal/Chalmanas/Akashchariswapaneshu
Pittaja - Akal palit/
Dhiman/Swedi/Krodhi/Jyotishamdristeswapaneshu Kaphaja-
Gambhirbuddhi/Sthoolang/Snigdhkesh/JalashyaavlokiSwapaneshu

MANASA - ………………………………………………
Satvika-
Anryshanshaya/Samvibhagauruchita/Titiksha/Satya/D
haram/Gyanum / Budhi / Medha/ Smriti/ Dhriti/
Anabhishangi
Rajas -Dukh bahulata/ Atan shilata/ Adhriti/
Ahankar/Akarunya/ Dambh/ Mana/
Harsh/ Kama krodh
Tamas -Vishaditvam/ Nastikyam/ Adharam shilata/
Budhi nirodh/Agyanam/ Durmedhastvyam/
Akaramshilta/ Nidralutvam.
1. Vikriti: Lakshnanimitta Lakshya nimitta
Nimittanurupa

2. Sara ………………………………………………

Tvak (rasa)- Snigdha/ Slakshana/ Mridu/Prasan/Sukshma/Alpa/

Gambhir/Sukumaraloma/Tvakparabha
Rakta - Snigdha, Rakta, Bhrajishnu –Karna, akshi, mukha, jivha,
nasa, osth,Pani-padtal, nakh, lalat, mehan.

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Mansa- Sthira /Guruta/ Mansa upachit- shankha, lalata, akshi,

gandh, hanu,griva, skandh, udar, kaksha, vaksh, pani-
padsanthi etc.

Meda -Snigdha – varna, swara, netra, kasha, loma, nakh, dant,

ostha, mutra,purish.

Asthi -Sthoolaparava – parshani, gulfa, janu, aratni, jatru, sira,

Sthool –asthi, nakha, dant.

Majja -Mriduanga/ Balvan/ Snigdhavara, svara/ Sthool, vritasandhi

Shukra- Saumya/ Ksheerpurnalochanta, praharsha, Snigdha,

sam-samhat,Prassan, snigdha vran swara, bhrijishnu, mahasphik

Satva - Smriti, Bhakti, suchi, maha-utsaha, daksha, gambhir budhi

chesta,gyana, pavitra, dheer, kalyankaribudhi

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 38

3. Samhanana Balwan

Madhayama Bala
Alpa Bala

Adhik Sama
4. Parmana
Heena

Ekarasa
Sarvarasa
5. Satmaya
Misrarasa

6. Satva Pravara Madhyam

Avara

7. Aahar

 Abhayaransha 4 important meals and snacks in

kti
between 3 important meals and
snacks in between 2 important
meals and snacks in between
 Jaranshakti Fluctuating Excessive

fairly good Dull

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 39

8. Vyayam- Pravara Madhyama Alpa

9. Vaya: Bala Madhyam Vridha

Samprapti Ghatak:
Dosha - …………………………………
Dushya - …………………………………
Srotas - ………………………………….
Srotodushti - …………………………………
Rog marg - …………………………………

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SROTAS PAREEKSHA:

Srotas Lakshana

Pranavaha Atisrushta Alpashabda

Atibadha shoolauchvasam

Udakavaha Sosha of jihwa – talu – oshta – kanta – kloma

Atipipasa

Annavaha Anannaabhilasha Arochak

Avipaka Chardi
Rasavaha Ashradha Aruchi Asyavairasya

Arasanjata Hrrillasa Angamarda

Gourava Tandra Jwara

Tama Pandutwam Srotorodha

Klaibya Sada Krisha

Agninasha

Akala-Valaya-Palita

Raktavaha
Kushta Visarpa Pidaka

Raktapitta Asrkdara Guda–Medra

asyapaka

Gulma Vidradhi Pleeha

Neelika Kamala Vyanga

Piplava Tilakalaka Dadru

Charmadala Switra Pama

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Kotaasra Mandalam

Medovaha Dandatinammaladhyatwam tritt

Dahapanipadayo Dehachikkanata

madhurasyata

Asthivaha Adhyasthidantha danta asthi – bheda

– sula- vivarnata

Kesa – Loma – Nakha – Smashru – Dosha

Majjavaha Parvaruk Bhrama Murcha

Tamadarshanam Parvasthulamoola –
Murcha

Sukravaha Klaibya Aharshana

Garbhapata-Srava

Pureeshavaha Krichrenaalpa Sabda

Shoola

Atidrava Atigrathita

Atibahuupavishantam

Mutravaha Atisrushta Atibadha

Alpa mootra Bahushoolamootra

Svedavaha Aswedam Atiswedam

Parushyam Paridaha

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39