SBEBA – SOLUTION TO ALL PROBLEMS IN AYURVEDA

Dr. Remya Krishnan MD PhD (Ay)

Questions to consider…

How do we know whether what we are doing for the patient is right or wrong?

Where do our “standards of practice” come from?

Why do we not gain global acceptance despite of research and publishing ?

Example: a patient with vicharchika Treatment for Agantu dosha ?

Rakta sodhana ?

Virechana ( treatment for kushta)?

There are endless confusions for an

Ayurvedic physician

How to decide medicine?

Based on empirical evidence of shared experience ?

Based on empirical evidence of medicine based study reports ?

Based on empirical evidence from tradition ?

Trial and error method?

How will I know what is correct ?

What faculty teaches ? It could be logical, he has PhD

He does the same for his large number of patients

What the eminent speakers in seminar highlighted could be correct . They are great speakers .

Too many medicines in one context, why I can’t randomly choose one ?

Why not go for dosha vipareetha approach ?

Jwara is Pitta predominant , but patient showing kapha features??

HOW MANY OF YOU FEEL LIKE THIS IN YOUR PRACTICE EVERY DAY ???

Science based reasoning guides clinical judgment

We have very much standardised and established Basic & applied science to pertinently guide our clinical judgement .

We have to pass through three steps in clinical decision making :a. Roga pareeksha ( examination of disease )

b. Rogi pareeksha ( examination of patient )

c. Tatwa pareeksha ( examination of Diagnostic & Treatment principles )

We need to accurately appraise Roga- rogi – Bheshaja tatwas before determining the treatment for sure to avoid any kind of uncertainity

A case of Acute fever How to examine & reach conclusion

Status of fever – Nidana panchaka

Status of patient – Dasavidha pareekshya ( charaka)

Bheshaja pareeksha – Langhana / Pachana / langhana + Pachana

Agantudosha guna vipareetha drug, diet and regimen selected in accordance to pertinent treatment principle

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Science Based -Evidence-based Medicine ( SBEBM)

Conscientious, explicit and judicious use of pertinent Science based evidence and optimise it to individual clinical situation

Say NO to intuition, unsystematic clinical experience, teachers’ choice , eminent speaker’s choice or peer reviewed journal reports

Only SBEBM will standardise the clinical practice and research of Ayurveda.

Scientificity

Teachers are correct if and only if they systematically followed science step by step.

Seminar speakers are correct if and only if they systematically explain the three staeps in the clinical context by Science based reasoning .

Peer review journals are correct if and only if the peers have adopted the Science based techniques for review and not statistics .

Otherwise the journals cannot be counted as peer reviewed

Another example for confusion

Tamaka swasa

How should it be managed?

Total chaos for Ayurvedic physicians

Unless timely managed, it leads to emergency .

Unless scientifically managed, it leads to emergency .

Should I take risk? How will I approach such a case ? The patient has fever also

Should I go for treating fever or manage Asthma first ?

How many of you get in chaos like this ??

We must follow science based guidelines

In diagnosis

In stagewise management

We have to adopt hetu vipareetha chikitsa .

Science based administration .

Accurate monitoring of status based on science based guidelines

Physicians lack insight about scientific ways

Physicians use medicine with medicine or medicine after medicine . Physicians using many contradictory approaches in the same situation and don’t understand why their treatments fail

Indefinite diagnosis leads to indefinite treatments and uncertain effects .

Medicines or system is blamed , not the way they practice

Why do Doctors cling to experience?

All Ayurvedic practitioners follow self experiences and tradition

Some follow blindly what others follow

Some follow specific formulations/ procedures blindly .

No standardised ways to follow science is implemented in today’s Ayurvedic practice .

Summary points

“Experience of wrong” induces and transmits confusions and uncertainity from generation to generation

Ayurveda which is practised today is far deviated from “Ayurveda as it is”

Understanding and applying Science Based Medicine reduces controversy and advances the field.

PRACTICAL SOLUTIONS

With this view, we have developed a school of thought called “Science Based Evidence Bsaed Ayurveda” ( SBEBA).

SBEBA incorporates standardised technique for appraisal of science of Ayurveda in clinical practice as well as research .

Acquiring knowledge and skills in SBEBA thus removes contradictions , confusions and uncertainity in medical practice and research.

Official proposal for SBEBA

With this is mind, we have made a detailed plan and proposal for the necessity of implementing it in curriculum of BAMS and MD .

We have submitted the proposal to Ministry of Health as well as to AYUSH in Ocober 2014.

We have not yet received any response so far .

Golden era for Ayurveda

Once the project is taken up , it will be a turning point in the field of Ayurveda.

It will tremendously contribute to Indian economy by decrease in treatment costs for all diseases , stay in the hospitals and expensive treatments and interventions gets reduced , number of ICU admissions will decline and number of man days will considerably improve .

It will eventually lead to global acceptance of Ayurveda as a medical system .

Urgent attention from Government is required

To take up the project

To discuss the action plans

To implement the action plans

To monitor the action plans

To evaluate the effects time to time

THANKYOU