The study entitled, “An observational study on Pramana Sharira with special reference to Vishama Ayama-Vistara and its relation with prognosis of chronic kidney disease (stage-5)” comprises of 6 chapters namely introduction, aim and objectives, review of literature, observational study, discussion and interpretation & conclusion and summary.

Chapter 1: Introduction

It gives compact idea of the subject of discussion namely Pramana Sharira. The Relevance of this topic especially based on its clinical importance, which was also highlighted.

Chapter 2: Aim and objectives

It gives an idea about aim & objectives of the study.

Chapter 3: Review of literature

Review of literature is sub-divided into historical review, previous research work, review of Pramana Sharira, review of anthropometry & review of CKD – Ayurveda and modern perspective. Historical review consists of references pertaining to Pramana in various ancient literatures of Vedic period, Samhita period and Sangraha Kala followed by a table with the information regarding previous research work. Review of Pramana Sharira, elaborates the details & importance of Pramana in various ancient ayurvedic texts, it also detailed regarding available references related to Anguli Pramana. Review of anthropometry deals with details of anthropometry and its utility. Ayurveda and modern perspective of CKD explained in the last part of this chapter.

Chapter-4: Observational study

Detail methodology of the present study was given in this chapter along with inclusion and exclusion criteria. Afterwards observations and results of 50 individuals of CKD (stage-5) were put forth by the tabular and graphical presentation.

Chapter 5: Discussion and interpretation

It is subdivided into discussion on review of literature, discussion on methodology, discussion on observation and results. It comprises the details of the analyzed data and comparison with the basic concept mentioned in the ancient literature & contemporary science, also dealt with the relevance in this era.

Chapter 6: Conclusion and summary

Summarizes the entire research work and it consists of conclusion drawn from the work carried out along with further scope of research.

Pramana is a crucial parameter among the Dashavidha Pareekshyabhava outlined in Charaka Samhita. As described in the Rogabhishagjitiyam Vijnanam, there exists a sutra that delves into the concept of “Sama Ayama-Vistara”, and its direct correlation with a healthy and happy life. This historical wisdom underpins the present study, which retrospectively explores Ayama-Vistara disparities in CKD individuals.

§  The eGFR values, ranging from 3.7 to 13.96 ml/min. The mean eGFR was calculated at 7.64±2.61 ml/min. This data reveals significant variability in kidney function within the studied population.

§  Ayama (Angula Pramana of rhs), ranging from 71.33 to 99.54 Angula. The mean of Ayama was calculated at 88.11±6.06 Angula. Vistara (Angula Pramana of rhs), ranging from 74.89 to 99.14 Angula. The mean of Vistara was calculated at 89.62±6.46 Angula. 

§  The difference of Ayama-Vistara (for rhs) ranged from 0 to 5.19 Angula, with a mean of 2.17±1.34 Angula. Which explored the difference between Ayama and Vistara measurements.

§  Results obtained from two-tailed paired t-test was found significant at p-value <0.0001. This suggests that there are significant differences between the Ayama and Vistara measurements. The t-statistic, was calculated to be 5.188 for the values which was measured in Angula (rhs). These high t-statistic values further emphasize that the differences between Ayama and Vistara measurements are not due to random chance. This indicates that the subjects under the study had poor Bala and Alpa Ayu. This information is important for our research and contributes to a better understanding of the subjects we studied.

§  The Karl Pearson coefficient of correlation resulted in a correlation coefficient (r) of   -0.6554. This number signified a significant negative relationship and suggests that a higher difference in Ayama-Vistara corresponds to lower eGFR values. The associated p-value was found to be <0.0001. This low p-value tells us that the correlation we observed is not likely due to random chance, indicating a strong statistical relationship between the difference in Ayama-Vistara measurements and eGFR. This relationship is particularly relevant in the context of CKD prognosis. It suggests that as the Ayama-Vistara difference increases, there may be a higher risk of lower eGFR values, which can be indicative of more severe kidney function issues.

§  In this study three distinct categories with 23, 22 and 5 number of individuals having differences in Ayama and Vistara measurements for assessing the prognosis of CKD with the mean score of eGFR values 9.26, 6.66 and 4.49 individuals having differences in Ayama and Vistara <2 Angula, 2-4 Angula and >4 Angula respectively. These findings indicating that difference in Ayama-Vistara is having significant negative correlation with the prognosis of CKD. So here null hypothesis is rejected and alternative hypothesis is established. This information offers clinicians a valuable tool for treatment planning and enhancing personalized patient care strategies.