CLINICAL ACTIVITY CONTENTS

Sl. No Name of the clinical activity Page Date Instructor Remarks

No. Signature

1 to 4. ART OF HISTORY TAKING

C 1.1 Chief complaint & history of

to 1.2 present illness

C 2.1 Past illness & treatment history

Family history with pedigree chart, Social

C 3.1 history, Environmental history, Seasonal
history & Occupational history

C 4.1 Personal history

5. GENERAL PHYSICAL EXAMINATION

C 5.1 A comprehensive general physical

to 5.2 examination

6. COMPREHENDING SYSTEMIC INTRICACIES

C 6.1
Respiratory system examination
& 6.3

C 6.2 Cardiovascular system

& 6.4 examination

C 6.5
Oral & Abdominal examination
& 6.7

C 6.6
Nervous system examination
& 6.8

C 6.9 Musculoskeletal system

& 6.11 examination

C 6.10
Integumentary system examination
& 6.12
 Sl. No Name of the clinical activity Page Date Instructor Remarks
No. Signature

7. DECODING INSIGHTS

C 7.1 Anaemia evaluation

C 7.2 Urinary Tract Infection evaluation
C 7.3 Hepatic evaluation

C 7.4 Renal evaluation

C 7.5 Thyroid evaluation

C 7.6 Diabetes Mellitus evaluation

C 7.7 Stroke evaluation

C 7.8 Arthritis evaluation

C 7.9 Fever evaluation

C 7.10 Male infertility evaluation

C 7.11 Helminthiasis evaluation

8. RADIOGRAPHIC INSIGHTS

C 8.1 X-Ray reading (Basics –Positioning, etc.)

C 8.2 X-Ray reading and interpretation (Chest)

C 8.3 X-Ray reading and interpretation (Bones and Joints)

9. ELECTRO CARDIO GRAPH

C 9.1
Basic ECG interpretation
& 9.2
10. CASE TAKING

C 10.1
Case taking (History to diagnosis & prognosis)
to 10.5

Student’s signature Teacher’s signature

 ROGA NIDAN EVAM VIKRITI VIGYAN ACTIVITY BOOK
SERIAL NO: 1 CLINICAL NO: C 1.1

1. Activity Name
Chief complaint & history of present illness

2. Activity Description:
Interact with patient and record their chief complaints and history of present illness. Write the
narrative based on the instructions provided and conclude with your inference.

3. Materials and Equipment:

Case format, Stethoscope, Sphygmomanometer, Thermometer, Pen torch, Reflex hammer,
Tuning fork, Measuring tape, Disposable tongue depressors, Cotton swabs, Disposable tissues
or wipes, Rulers or Scales, Pins and Hand sanitizer.

4. Patient information:
Age:

Sex: M/ F/Others

Marital status:

Education:

Occupation:

Religion:

Socio-economic status:

Date of Consultation:

Out Patient Number:

Date of Admission:

In Patient Number:

Bed number:

Place of residence:

1
5. Pradhana Vedana with Kala prakarsha (Chief complaints with duration) :
(List complaints succinctly using bullet points, avoid medical terminology, and if there are
multiple symptoms, present them in chronological order.)

6. Vedana sammuchraya (History of present illness) : (Write the history of present illness
along with duration in chronological order with components such as Onset, Location, Duration,
Characteristic or nature, Relieving factors, Aggravating factors, Radiation, Timing or
frequency, and severity in paragraph)

2
 Write your inference on below mentioned points (As applicable to chief complaints and
history of present illness):
Sl.
Parameters to be assessed Item observed in patient Rationality
No

1 Dosha and dhatu vridhhi and kshaya

2 Sama/ Nirama Dosha avastha

3 Srotas involved

4 System/ systems involved

5 Any other

Student’s signature Teacher’s signature

3
 SERIAL NO: 1 CLINICAL NO: C 1.2

7. Activity Name
Chief complaint & history of present illness

8. Activity Description:
Interact with patient and record their chief complaints and history of present illness. Write the
narrative based on the instructions provided and conclude with your inference.

9. Materials and Equipment:

Case format, Stethoscope, Sphygmomanometer, Thermometer, Pen torch, Reflex hammer,
Tuning fork, Measuring tape, Disposable tongue depressors, Cotton swabs, Disposable tissues
or wipes, Rulers or Scales, Pins and Hand sanitizer.

10. Patient information:

Age:

Sex: M/ F/Others

Marital status:

Education:

Occupation:

Religion:

Socio-economic status:

Date of Consultation:

Out Patient Number:

Date of Admission:

In Patient Number:

Bed number:

Place of residence:

4
11. Pradhana Vedana with Kala prakarsha (Chief complaints with duration): (List
complaints succinctly using bullet points, avoid medical terminology, and if there are multiple
symptoms, present them in chronological order.)

12. Vedana sammuchraya (History of present illness) : (Write the history of present
illness along with duration in chronological order with components such as Onset, Location,
Duration, Characteristic or nature, Relieving factors, Aggravating factors, Radiation, Timing
or frequency, and severity in paragraph)

5
 Write your inference on below mentioned points (As applicable to chief complaints and
history of present illness):

Sl.
Parameters to be assessed Item observed in patient Rationality
No

1 Dosha and dhatu vridhhi and kshaya

2 Sama/ Nirama Dosha avastha

3 Srotas involved

4 System/ systems involved

5 Any other

Student’s signature Teacher’s signature

6
 ROGA NIDAN EVAM VIKRITI VIGYAN ACTIVITY BOOK
SERIAL NO: 2 CLINICAL NO: C 2.1

1. Activity Name
Past illness & treatment history

2. Activity Description:
Enquire and record about past illness and treatment history. Write your inference in the space
provided.

3. Materials and Equipment:

Case format, Stethoscope, Sphygmomanometer, Thermometer, Pen torch, Reflex hammer,
Tuning fork, Measuring tape, Disposable tongue depressors, Cotton swabs, Disposable tissues
or wipes, Rulers or Scales, Pins and Hand sanitizer.

4. Patient information:
Age:

Sex: M/ F/Others

Marital status:

Education:

Occupation:

Religion:

Socio-economic status:

Date of Consultation:

Out Patient Number:

Date of Admission:

In Patient Number:

Bed number:

Place of residence:

7
5. Poorvavyadhi Vruttanta (History of Past illness) *(The signs and symptoms of
respective system pathology can be enquired – Cardiovascular, Respiratory, Gastrointestinal,
Neurological, Musculoskeletal, Endocrine, Immunological, Psychiatry, and Urogenital history
in past illness, or any abnormalities such as diabetes mellitus, hypertension, bronchial asthma,
Carcinoma, Myocardial infarction, Jaundice, Road Traffic Accident, Hospital admission, Blood
transfusion, Surgeries, Childhood, etc including Immunization (e.g., Vaccinations, Booster
Shots) can be mentioned in relation to the present complaints).

6. Chikitsa Vruttanta (Treatment history): **(Consider the following points while

enquiring treatment history: Current Medications (with Dose/ Route of administration/
Chemical name/ Frequency/ Duration), Previous Medications (with Dose/ Route of
administration/ Chemical name/ Frequency/ Duration), Medication Allergies or Intolerances,
Date of Surgery, Type of Surgery, Surgeon/Provider Name, Outcome or Complications,
Physical Therapy, Occupational Therapy, Speech Therapy, Rehabilitation Programs,
Counselling or Psychotherapy, Injections or Infusions, Other Therapeutic Intervention, Dates of
Hospitalizations, Reason for Hospitalization, Procedures Performed, Length of Stay, Discharge
Summary, Herbal Supplements or Remedies, Acupuncture, Massage Therapy, Chiropractic
Care, Ayurvedic Treatments, Other Complementary or Alternative Treatments, Treatment
Adherence or Compliance, Treatment Modifications, Reasons for Modifications (e.g.,
Efficacy, Side Effects), Date of Consultation/Referral, Specialist/ Consulting Provider
Name, Reason for Consultation/ Referral, Recommendations or Findings from
Consultation, Previously Attempted Alternative Treatments, Reasons for Discontinuation or
Change of Alternative treatments, Outcome or Response to Previous Alternative Treatment,
Patient's Response to Treatment, Treatment Efficacy or Effectiveness, and Side Effects or
Adverse Reaction

8
 Clinical **Treatment/ Surgery done or on-going Outcome &
condition (If Not Applicable mention NA) Duration Remarks

Mention Asatmya with reference to Aushadha (Drug allergy) (If any):

Write your inference in relation to the past/ present clinical condition:

Parameters to be Item observed in Relation to the
Sl. No
assessed past illness present illness
Dosha – Anubandhya and
1
Anubandha dosha
2 Dushya involved
3 Sroto dushti
4 System involved
5 Paraspara anubandha vyadhi
6 Vyadhi sankara

Student’s signature Teacher’s signature

9
 ROGA NIDAN EVAM VIKRITI VIGYAN ACTIVITY BOOK
SERIAL NO: 3 CLINICAL NO: C 3.1

1. Activity Name
Family history with pedigree chart, social history, environmental history, seasonal
history and occupational history

2. Activity Description:
Record and draw a pedigree chart reflecting the family history and write the summary.
Write your inference in the space provided.

Interact and record social history, environmental, seasonal and occupational history of patient.
Write your inference on possible impact of social history, environmental, seasonal and
occupational history in reducing or aggravating or causing the current condition of the patient.

3. Materials and Equipment:

Case format, Stethoscope, Sphygmomanometer, Thermometer, Pen torch, Reflex hammer,
Tuning fork, Measuring tape, Disposable tongue depressors, Cotton swabs, Disposable tissues
or wipes, Rulers or Scales, Pins and Hand sanitizer.

4. Patient information:
Age:
Sex: M/ F/Others
Marital status:
Education:
Occupation:
Religion:
Socio-economic status:
Date of Consultation:
Out Patient Number:
Date of Admission:
In Patient Number:
Bed number:
Place of residence:

10
5. Kula vruttanta (Family history) Along with pedigree chart:
*Enquire following details: Genetic or Hereditary Conditions (Runs in family/ Identified
genetic mutations or abnormalities), Any family member with similar complaints,
Consanguineous marriage history, Ethnicity and Heritage (of patient and family),
Environmental Factors (of patient and family), Cause of death of any family members,
Confirmation and Source (Family history) and record in the respective section.
Family Medical *Details of the Write your
Member & Condition medical inference with
Relation to (Relevant to condition relevance to
patient family history – current condition
common and of patient if
rare conditions) applicable

Pedigree chart:
Symbols for drawing Pedigree chart:
[Image Source: Visual Paradigm Online]

Affected by history female and

male

11
 Draw the Pedigree chart for the patient:

Write your inference on below mentioned points:

Any relation to
Sl. Observations in family
Parameters to be assessed the current
No member
illness
Bija dushti (Specify Bija, Bija bhaga, Bija bhaga
1 Yes/ No
avayava dushti if possible)
Adibala (Hereditary)
2 Yes/ No

Janmabala (Congenital)
3 Yes/ No

6. Samajika Vruttanta (Social history):

(Enquire the following details in respective sessions –
1. Patient's current living arrangements, including whether they live alone, with family, in any
health care centres, or in other housing situations
2. Single, married, divorced, separated, or widowed
3. Patient's educational background, and any vocational training or higher education degrees 4.
Patient's social support system, including family, friends, and community resources that play a
role in their life, any significant relationships and sources of support
5. Patient's history of substance use, including alcohol, tobacco, and recreational drugs along
with the type, frequency, and duration of substance use, as well as any history of substance
abuse or addiction

12
 6. When appropriate and relevant, report on the patient's sexual history, including sexual
orientation, sexual activity, and any history of sexually transmitted infections
7. Patient's cultural and religious affiliations, beliefs, and practices that may be relevant to their
healthcare. Consider how these factors may influence their health beliefs and healthcare
decision- making
8. Highlight the patient's hobbies, interests, and recreational activities that contribute to their
social engagement and well-being. This may include sports, arts, volunteering, or other leisure
activities
9. Patient's financial status, including their employment income, insurance coverage, and
any financial challenges that may impact their access to healthcare
10. Significant life events, social stressors, or challenges that the patient is facing, such as recent
loss, family conflicts, or housing instability
11. Any additional social factors that is relevant to the patient's health and well-being, such as
immigration status, military service, or involvement in the criminal justice system)

Relevance in terms of
Areas to be enquired (Refer the
Observations shareerika dosha
above paragraph)
and manasika bhava

1
Living Situation

2
Marital/Relationship Status

3
Education

4
Social Support Network

5
Substance Use History

6
Sexual History

7
Cultural and Religious Background

8
Hobbies and Recreational Activities

9
Financial Status

10
Social Stressors and Challenges

11
Other Relevant Social Factors

13
7. Desha (Environmental history):
Specify jaata and vyadita desha:
Jaata - Jangala/ Anupa/ Sadharana;
Vyadita - Jangala/ Anupa/ Sadharana

Areas to be enquired Observations Relevance in terms

of shareerika dosha
and manasika
bhava
Climate and geographical location of
Residential area

Duration of stay in the

residential area with location

Duration of stay (If shifted from

previous residence to
a new location - mention details)

Travel history and exposures related

to travel

8. Kala (Seasonal): (Describe below any aggravation of complaints with relevance to the kala
or season):

14
 9. Occupational history: *(Enquire regarding current occupation, job duration, work
environment, hazards and exposures, protective measures, work schedule, previous
occupations, occupational injuries, psychosocial factors, occupational health screenings):

*Occupational history *Write Your observation Relevance to shareerika

dosha and manasika
bhava
Physical environment

Psychological environment

Student’s signature Teacher’s signature

15
 ROGA NIDAN EVAM VIKRITI VIGYAN ACTIVITY BOOK

SERIAL NO: 4 CLINICAL NO: C 4.1

1. Activity Name
Personal history

2. Activity Description:
Enquire and record about personal history. Write your inference on possible impact of personal
history in aggravating or causing the current condition of the patient.

3. Materials and Equipment:

Case format, Stethoscope, Sphygmomanometer, Thermometer, Pen torch, Reflex hammer,
Tuning fork, Measuring tape, Disposable tongue depressors, Cotton swabs, Disposable tissues
or wipes, Rulers or Scales, Pins and Hand sanitizer.

4. Patient information:
Age:

Sex: M/ F/Others

Marital status:

Education:

Occupation:

Religion:

Socio-economic status:

Date of Consultation:

Out Patient Number:

Date of Admission:

In Patient Number:

Bed number:

Place of residence:

16
5. Vaiyaktika Vruttanta (Personal history):

Ahara, Agni, Koshta, Mala – Pureesha/ Bowel: Ahara:

Tick appropriate:

Ahara matra or Abhyavaharana shakti – Poorvakaleena

i.e Heena/ Madhyama/ Pravara

Ahara matra or Abhyavaharana shakti – Adyatana

i.e Heena/ Madhyama/ Pravara

Most commonly Identify the predominant Write your

consumed food items Rasa, Guna and classify in inference
terms of satvika, rajasika, regarding
tamasa influence on Agni,
Dosha (Manasika
and Shareerika),
and Dushya

Ahara vidhi:
• Regular/ Irregular;
• Interval between two consumptions…………Hrs;
• Frequency of meals per day………..

17
 Upavasa:
• Engaging/ not engaging.
• If engaging mention pattern of fasting…………..

Mention Asatmya with reference to Aahaara (If any):

Agni (*Enquire the mentioned points to the patient to infer regarding the Agni bheda -
Teekshna/ Manda/ Vishama/ Sama agni):

Pattern of Digestion Tick the type of agni

Even small quantity of regular meal (easily digestible) may
take longer time to digest & reduced appetite for the next
scheduled meal.
Regular serving of meal consumed on regular intervals Mandagni
gets digested normally and good appetite for next
scheduled meal.
Regular serving size of regular meal gets digested quickly Samagni

with frequent hunger pangs & making the person to eat at

frequent intervals before next meal scheduled time. Even Teekshnagni

heavy meals get digested easily before the next scheduled

meal time.
Irregular phase of digestion & indigestion which may also Vishamagni

be associated with regular bowel movement and

constipation.

18
 Mala pravrutti – Pureesha/ Bowel:

Parameters to be Write your

Write your observation
enquired inference

Frequency (Per day) ……..Per day.

Ati grathita (Knotty or hard stool)/ Ati drava Sama/ Nirama (Also
Consistency (Watery)/ Picchila (Slimy)/ Any mention predominance of
Other……. dosha)
Tila pishta nibha (Pale or Clay coloured)/
Peeta (Yellowish)/ Shyava (Blackish)/ Rakta
Colour & Appearance
(Reddish)/
Harita (Greenish)/ Any other…..

Pravahika (With tenesmus) Yes/ No

Complete/ Incomplete (Kricchra pureesha,

Evacuation
Alpa pureesha, etc.)

Faecal incontinence Present/ Absent

Any other complaints Sa shoola/ Any other….

Mutra pravrutti – Micturition:

Write your
Urine
Write your observation inference on
characteristics
dosha involved
Frequency at day

Frequency at night

Stream Forceful/ Weak/ Dribbling/ Split/ praying/ Narrow

Colour Pale yellow/ Dark yellow/ Amber/ Brown/ Pink or red/ orange

Burning sensation Yes/ No

LUTS* Yes/ No

Any other

19
 *LUTS – Lower Urinary Tract symptoms: Voiding or obstructive symptoms: Hesitancy,
Poor and/or intermittent stream, Straining, prolonged micturition, Feeling of incomplete
bladder emptying, Dribbling, Any other. Storage or irritative symptoms: Frequency, Urgency,
Urge incontinence, Nocturia, Any other.

Koshta (Mridu/ Madhyama/ Krura):

Influence of mentioned items on koshta observed Tick the type of koshta
and other features in
the patient
Has regular bowel movements, typically once or
twice daily. Stools are either semi-formed or fully
formed, making defecation easy and requiring less
time. Experiences satisfaction after bowel Mridu koshta
movements. Weak laxatives and the consumption of
Ikshu, Ksheera, Payasa, Sarpi, Draksha, and Ushna
jala can easily lead to loose stools.
Has daily bowel movements, passing formed stools
with minimal stress and taking a slightly longer time
compared to a mridu koshta. Experiences satisfaction Madhyama koshta
after defecation and rarely encounters loose stools or
hard stools.
Irregular bowel movements with infrequent stool
passage. Stools are hard and dry, necessitating
straining and an extended time for defecation. Bowel
clearance is unsatisfactory, and hard stool is more Krura koshta
prevalent than loose stools. Generally requires
laxatives to clear stools.

20
 Work, Nidra, Vyasana:
Inference for
Write your observation and
Nature of work shareerika dosha and
inference
manasika dosha
Type of karma (Work) Shareerika/ Manasika/ Vachika
*Nature of work (Refer below)
Timing/ Duration of work
Morning/ Evening/ Night/ Any
If shifting duties (Specify pattern)
other….
Sedentary Yes/ No
Yes/ No; If Yes - Physically/
Exertional Mentally/
Both
Performs beyond or less than Ardha
shakti (Shareerika)**Refer More/ Less
below

*(Enquire for Work: Manual Labour – Lifting, Carrying, Pushing, Pulling, Grasping,
Manoeuvring heavy objects; Repetitive Movements - Repetitive lifting, Continuous bending,
Prolonged standing, Frequent kneeling; Fine Motor Skills - Precision tasks, Small object
manipulation, Detailed handwork; Sedentary Work - Desk work, Computer-based tasks,
Administrative duties; Outdoor Work - Exposure to weather conditions, Physical activities in
varying climates, Fieldwork; Heavy Machinery Operation - Operating equipment, Machinery
handling, Vehicle driving; Construction Work - Building structures, Demolition work,
Carpentry; Healthcare Professions - Patient care, Medical procedures, Surgical interventions;
Agricultural Work - Farming activities, Animal care, Crop harvesting; Service Industry -
Waitstaff duties, Customer service roles, Retail tasks; Athletic or Sports Activities -
Training sessions, Competitive sports, Coaching responsibilities; Educational Field - Teaching
tasks, Classroom activities, Lab work)

** Kaksha lalaata nasaasu hasta paadaadati sandhishu prasvedan mukha shosha. Hruda
sthaana sthito vaayu yadha vaktram prapadyate.

21
 Mention Asatmya with reference to Vihaara (If any):
Nidra:
Nidra Write your observation and Inference for
inference shareerika dosha and
manasika dosha
Normal (Sufficient sleep and Freshness
Status of nidra after getting up or not)/
Excess/ Disturbed*
Difficulty in getting the sleep/
Difficulty in maintaining the sleep/
*If disturbed -
Early morning
awakening

Duration in hrs per day and night

Present/ Absent (If present specify

Divasavpna
duration)

Present/ Absent (If present specify

Ratri jagarana
duration)

Vyasana:
Addictions/ Habits Duration & Dependence Yes/ No Inference for shareerika
Quantity dosha and manasika
dosha
Smoking

Alcohol

Tobacco chewing

Screen time

Any Others

22
Raja pravrutti – Menstrual history:
Menstruation and Menstrual cycle Write your Inference for
characteristics observation shareerika dosha
Raja pravrutti - Regular/ Irregular

Days of flow

Duration of cycle

Nature of flow - Quantity (E.g. No. of

Pads, or menstrual cup, etc.)
Clots, odour, etc.

Any other complaints or observation

Obstetric History (Mention G P L A D with details of delivery and complications, if any):

G - Gravida, P - Parity, L - Living Child, A – Abortion D – Death after live birth
*(Furnish information regarding GPLAD below as subscript
Eg: G = Gravida (Times conceived)
P = Para (Number of pregnancies crossed viability)
L= Live (Number of live births)
A = Abortion (Number of abortions)
D = Death after live birth (Number of deaths after live birth).

G3 P1 L1A2D0 =
G3 - Patient got pregnant 3 times out of which
P1 - 1 pregnancy crossed Viability age,
L1 - one pregnancy delivered live baby and
A2 - out of 3 pregnancies 2 abortions happened and
D0 - no death after live birth.
*G P L A D (Write as sub script here. Ex - G3 P1 L1A2D0)

23
Delivery (First/ Second/ Mode of delivery (Normal Post-partum complication
etc.) vaginal/ Forceps/ LSCS) (Yes/ No; If Yes elaborate)

Write inference based on your observation:

Manasika bhava (Emotional makeup): *(Write the manasika bhava experienced by the
patient such as Shoka, Chinta, Bhaya, Dvesha, Krodha, Lobha, Mada, or any other)

*Manasika bhava (Emotion) Write your inference (Regarding manasika dosha

experienced by the patient affected)

Vegadharana: Present/ Absent (If present, specify with duration and frequency)

Any other relevant information to be furnished in personal history:

Student’s signature Teacher’s signature

24
 ROGA NIDAN EVAM VIKRITI VIGYAN ACTIVITY BOOK

SERIAL NO: 5 CLINICAL NO: C 5.1

1. Activity Name
A comprehensive general physical examination

2. Activity Description:

Perform and record general physical examination of patient, and write your inference in the
space provided.

3. Materials and Equipment:

Case format, Stethoscope, Sphygmomanometer, Thermometer, Pen torch, Reflex hammer,

Tuning fork, Measuring tape, Disposable tongue depressors, Cotton swabs, Disposable tissues
or wipes, Rulers or Scales, Pins and Hand sanitizer.

4. Patient information:

Age:

Sex: M/ F/Others

Marital status:

Education:

Occupation:

Religion:
Socio-economic status:
Date of Consultation:
Out Patient Number:

Date of Admission:

In Patient Number:

Bed number:

Place of residence:

25
 5. General physical examination:

Sangya jnana (Consciousness):

Conduct a subjective evaluation of consciousness, considering reporting in Ayurveda as Moha,

Murcha, Mada, Tandra, Mada, Sanyasa, Tama pravesha, Nisangya, as well as subjective
descriptors such as Lethargy, Drowsy, Stupor, Obtundation, Coma, etc.

Write the observations on Sangya Write your inference

jnana
(Consciousness) – Subjective assessment

Vitals:

Pulse examination/ Nadi pareeksha: Site:

Parameters to be Write the observations on Pulse Write your inference

examined
(Regarding dosha involved)

Palpable Yes/ No

Rate ……. Per minute

(Tachycardia/ Bradycardia)

Rhythm Regular/ Irregular (If

irregular – Regularly
irregular, Irregularly irregular)

Character Water-Hammer Pulse (Corrigan's

Pulse)/ Pulsus Parvus et Tardus/
Any
other……..

26
Illustrate your observations on the blank graph, following the example provided on the left side
for pravara, madhyama, or avara. The left-side graphs serve as visual guides (Black line
represents Vata, Green represents Pitta, Blue represents Kapha) for creating graphs on the right,
considering the amplitude and volume of the felt pulse. Dedicate one graph for each finger—
Index, Middle, and Ring finger. The final graph is for collective observations, providing a
graphical representation based on dosha-wise analysis:

Example Observation

PRAVARA

MADHYAMA

AVARA

Index finger

27
 PRAVARA

MADHYAMA

AVARA

Middle finger

PRAVARA

MADHYAMA

AVARA

Ring finger

PRAVARA

MADHYAMA

AVARA

VATA PITTA KAPHA

Collective observation

28
 Write your inference on predominant dosha associated:

Heart rate: *(Furnish details on rate and rhythm)

Parameters to be assessed *Write the observations Inference

Heart rate

Rhythm

Blood pressure:

Patient position Write the observations on Blood Write your inference

pressure (Palpatory and (Normotensive/
Auscultatory method) Hypertensive/
Hypotensive)

Supine

Sitting

Standing

Temperature:

Site of Time of Temperature in Write your

measurement measurement Celsius or inference (Low
Fahrenheit grade, Moderate
grade, High grade)

Respiratory rate:

Write the observations on Write your inference (Tachypnoea,

Respiratory rate (per minute) Bradypnea)

29
 Observe for Pallor, Icterus and Cyanosis. Write your inference below:

Pallor (Pandutvam):

Site Pallor (Yes/No) Write your inference

Palpebral conjunctiva

Lips

Oral mucosa

Tongue

Face

Skin (Palm/ Sole/

General)

Nails

Icterus (Peeta mukha, netra, tvak):

Site Icterus (Yes/No) Write your inference

Sclera

Oral cavity

Sublingual mucosa

Skin (Palm/ Sole/

General)

Nails

30
 Cyanosis (Central and Peripheral) (Shyava varna):

Site Cyanosis (Yes/No) Write your inference

Nose tip (Central)

Lips (Central)

Tongue (Central)

Finger/ Toe tip

(Peripheral)

Nails (Peripheral)

Peripheral parts of
body
(Peripheral)

Nakha pareeksha (Examination of nail & nail bed):

Parameters to be observed Write your observations and inference

(Eg: Rough nails indicate rookshata, Shiny nails indicate
snigdhata, etc.)
Nail clubbing (With grade)

Spooning of nail (Koilonychia)

Brittleness and crumbling

Colour of the nail bed

Capillary refill of nail bed

Tenderness of nail bed

31
 Shareera pramana, Akriti, Samhanana, Sara and other features (Height, Weight, Body
Mass Index, Built, Nutrient deficiency):

*Use thumb width in centimetres as anguli pramana (Charaka). Measure width of thumb in
centimetres using standard measuring tape. Measure height in centimetres using standard
measuring tape. Convert the height in anguli pramana by using the following formula:

Height (in cm)/ Width of thumb (in cm) =............................................ Anguli pramana of
height

Normal height of an individual is 84 anguli. <84 anguli is hrsva. >84 anguli is dheerga.

For example height of an individual is 168 cm and width of thumb is

1.9 cm, so his height is 168/1.9 = 88 Anguli pramana (Dheerga)

Parameter to be Observation Inference

assessed
Shareera pramana
*Height (Refer above) Deergha/ Hrsva/ Prakruta
Weight (Weight in Ati sthoulya/ Atikrisha
Kilograms
Body Mass Index Ati sthoulya/ Atikrisha
(Refer BMI Chart
below)* Formula: Weight (kg) /
Height (m)2
(BMI) calculation.

Ati sthoulya/
Atikrisha
Akriti - Built - Ati sthoulya/ Atikrisha
Endomorphic, ectomorphic,
and
mesomorphic

32
 Nourishment status
Muscle bulk (Left mid upper Over nourished/ Well- nourished/
arm Under nourished
circumference in
centimetres)

Subcutaneous fat thickness

(Triceps skin fold thickness
of mid arm in
millimetres)

Macronutrient deficiency Absent/ Present (If present specify)

(Protein/
Carbohydrate/ Fat)

Micronutrient (Vitamin & Absent/ Present (If present specify)

Mineral
deficiency)

*BMI Chart:

[Image source: Quizlet Flash cards]

33
 Sparsha pareeksha:

Oedema (Shotha):

* Examine regions such as Face, Hands, Legs, Sacral, or any other specified areas, and record
distinct observations in separate rows, indicating the side (Right/ Left) for each.

*Site of Observation Darshana – Observation Sparshana – Write your inference in

oedema Inspection Palpation terms of dosha and
examined dushya
(Refer
above)

Visible swelling – Present/ Absent Consistency – Firm/ Soft

Symmetry – Symmetrical/ Temperature – Normal/

Asymmetrical Altered (If altered
mention)

Skin colour – Normal/ Altered (If

altered mention)……. Tenderness – Present/
Absent

Pitting/ Non – pitting

oedema

Circumference
……..

34
Features to be observed for shotha in patient Tick the type of shotha

The migrating pitting oedema, primarily localized

in the lower extremities, amplifies throughout the
day (diva bali), yet significantly diminishes by night. Vataja

The non-pitting or slowly pitting oedema, Kaphaja

predominantly affecting the upper body, notably the
face, escalates during the night (ratri bali), reaching
its
peak visibility in the early morning

hours, and gradually diminishes as the day progresses.

The swiftly advancing localized edema exhibits

diverse hues like brown, reddish, coppery red, or
black. It presents warmth, tenderness upon touch,
and intense burning sensations. Occasionally, Pittaja
systemic indications hint
at potential suppuration.

35
 Lymphadenopathy:

*Examine various sites, including the neck, underarms, and groins, for nodes such as submental,
submandibular, pre-auricular, post-auricular, occipital, deep and superficial cervical chain,
axillary, inguinal. Record positive findings in separate rows, specifying the side (Right/ Left)
of involvement if observed.

*Site/ ** Write the ** Write the Write your inference

Lymph observations on observations on (Include comments on
node Lymph node Lymph node involvement of drainage areas
examine Examination – Examination – of respective node if involved)
d (Refer 2Sparshana –

above) 1Darshana –
Palpation
Inspection;

Visible swelling – Present/ Tenderness – Present/

Absent Absent

Symmetry – Symmetrical/ Consistency – Firm/

Asymmetrical Soft/ Rubbery/ Hard

Size (Measure using

finger breadth or
measuring tape
or callipers) –

Mobility – Freely
movable/ Fixed

36
 Shabdha pareeksha – Examining voice and speech of patient:

Parameter Observation Inference

Voice Prakruta/ Vaikruta

Speech Prakruta/ Vaikruta

Dosha assessment (Kapha -

Guru; Pitta - Sphuta (broken, split); Vata
- Khara, Parusha)

Jihwa pareeksha (Tongue examination):

*(Varna – Pandu, Rakta, Haridra, Harita, Krishna, Neela, Shweta; Pramana – Tanu,
Sama, Sandra; Upalepa; Chalana)

Parameters *Write the observations on Jihwa Write your

inference

Colour

Contour and size

Coating

Appearance

Dosha assessment (Vata - Khara

sparsha, sphutita, Sheeta; Pitta -
Raktashyama
varna; Kapha - Shweta, Ati picchila)

37
 Jugular Venous Pressure (JVP): Present/ Absent (If present
mention in centimetres)

[Image source: Quizlet Flash cards]

Mention the height of JVP on diagram above sternum

Any other relevant information to be furnished in general physical examination:

Student’s signature Teacher’s signature

38
 SERIAL NO: 5 CLINICAL NO: C 5.2

6. Activity Name

A comprehensive general physical examination

7. Activity Description:

Perform and record general physical examination of patient, and write your inference in the
space provided.

8. Materials and Equipment:

Case format, Stethoscope, Sphygmomanometer, Thermometer, Pen torch, Reflex hammer,

Tuning fork, Measuring tape, Disposable tongue depressors, Cotton swabs, Disposable tissues
or wipes, Rulers or Scales, Pins and Hand sanitizer.

9. Patient information:

Age:
Sex: M/ F/Others

Marital status:

Education:

Occupation: Religion:

Socio-economic status:

Date of Consultation:

Out Patient Number:

Date of Admission:

In Patient Number:

Bed number:

Place of residence:

39
 10. General physical examination:

Sangya jnana (Consciousness):

Conduct a subjective evaluation of consciousness, considering reporting in Ayurveda as Moha,

Murcha, Mada, Tandra, Mada, Sanyasa, Tama pravesha, Nisangya, as well as subjective
descriptors such as Lethargy, Drowsy, Stupor, Obtundation, Coma, etc.

Write the observations on Sangya Write your inference

jnana
(Consciousness) – Subjective assessment

Vitals:

Pulse examination/ Nadi pareeksha: Site:

Parameters to be Write the observations on Pulse Write your inference

examined
(Regarding dosha involved)

Palpable Yes/ No
Rate ……. Per minute
(Tachycardia/
Bradycardia)
Rhythm Regular/ Irregular (If
irregular – Regularly
irregular, Irregularly irregular)

Character Water-Hammer Pulse (Corrigan's

Pulse)/ Pulsus Parvus et Tardus/
Any
other……..

40
Illustrate your observations on the blank graph, following the example provided on the left side
for pravara, madhyama, or avara. The left-side graphs serve as visual guides (Black line
represents Vata, Green represents Pitta, Blue represents Kapha) for creating graphs on the right,
considering the amplitude and volume of the felt pulse. Dedicate one graph for each finger—
Index, Middle, and Ring finger. The final graph is for collective observations, providing a
graphical representation based on dosha-wise analysis:

Example Observation

MADHYAMA
PRAVARA

AVARA

Index finger

41
 PRAVARA

MADHYAMA

AVARA

Middle finger

PRAVARA

MADHYAMA

AVARA

Ring finger

PRAVARA

MADHYAMA

AVARA

VATA PITTA KAPHA

Collective observations
42
 Write your inference on predominant dosha associated:

Heart rate: *(Furnish details on rate and rhythm)

Parameters to be assessed *Write the observations Inference

Heart rate

Rhythm

Blood pressure:
Patient position Write the observations on Blood Write your inference
pressure (Palpatory and (Normotensive/
Auscultatory method) Hypertensive/
Hypotensive)

Supine

Sitting

Standing

Temperature:
Site of Time of Temperature in Write your
measurement measurement Celsius or inference (Low
Fahrenheit grade, Moderate
grade, High grade)

Respiratory rate:

Write the observations on Write your inference (Tachypnoea,

Respiratory rate (per minute) Bradypnea)

43
 Observe for Pallor, Icterus and Cyanosis. Write your inference below:

Pallor (Pandutvam):

Site Pallor (Yes/No) Write your inference

Palpebral conjunctiva

Lips

Oral mucosa

Tongue

Face

Skin (Palm/ Sole/

General)

Nails

Icterus (Peeta mukha, netra, tvak):

Site Icterus (Yes/No) Write your inference

Sclera

Oral cavity

Sublingual mucosa

Skin (Palm/ Sole/

General)

Nails

44
 Cyanosis (Central and Peripheral) (Shyava varna):

Site Cyanosis (Yes/No) Write your inference

Nose tip (Central)

Lips (Central)

Tongue (Central)

Finger/ Toe tip

(Peripheral)

Nails (Peripheral)

Peripheral parts of
body
(Peripheral)

Nakha pareeksha (Examination of nail & nail bed):

Parameters to be observed Write your observations and inference (Eg: Rough

nails indicate rookshata, Shiny nails indicate snigdhata,
etc.)
Nail clubbing (With grade)

Spooning of nail (Koilonychia)

Brittleness and crumbling

Colour of the nail bed

Capillary refill of nail bed

Tenderness of nail bed

45
 Shareera pramana, Akriti, Samhanana, Sara and other features (Height, Weight, Body
Mass Index, Built, Nutrient deficiency):

*Use thumb width in centimetres as anguli pramana (Charaka). Measure width of thumb in
centimetres using standard measuring tape. Measure height in centimetres using standard
measuring tape. Convert the height in anguli pramana by using the following formula:

Height (in cm)/ Width of thumb (in cm) =............................................ Anguli pramana of
height

Normal height of an individual is 84 anguli. <84 anguli is hrsva. >84 anguli is dheerga.

For example height of an individual is 168 cm and width of thumb is

1.9 cm, so his height is 168/1.9 = 88 Anguli pramana (Dheerga)

Parameter to be assessed Observation Inference

Shareera pramana
*Height (Refer above) Deergha/ Hrsva/ Prakruta
Weight (Weight in Ati sthoulya/ Atikrisha
Kilograms
Body Mass Index Ati sthoulya/ Atikrisha
(Refer BMI Chart
below)* Formula: Weight (kg) /
Height (m)2
(BMI) calculation.

Ati sthoulya/
Atikrisha
Akriti - Built - Endomorphic, Ati sthoulya/ Atikrisha
ectomorphic, and
mesomorphic

46
 Nourishment status
Muscle bulk (Left mid upper Over nourished/ Well- nourished/
arm Under nourished
circumference in
centimetres)

Subcutaneous fat
thickness (Triceps skin
fold thickness of mid arm
in
millimetres)

Macronutrient deficiency Absent/ Present (If present specify)

(Protein/
Carbohydrate/ Fat)

Micronutrient (Vitamin & Absent/ Present (If present specify)

Mineral
deficiency)

*BMI Chart:

[Image source: Quizlet Flash cards]

Sparsha pareeksha:

Oedema (Shotha):

* Examine regions such as Face, Hands, Legs, Sacral, or any other specified areas, and record
distinct observations in separate rows, indicating the side (Right/ Left) for each.

47
 *Site of Observation Darshana – Observation Sparshana Write your inference in
oedema Inspection – Palpation terms of dosha and
examined dushya
(Refer
above)

Visible swelling – Present/ Consistency – Firm/

Absent Soft

Symmetry – Symmetrical/ Temperature – Normal/

Asymmetrical Altered (If altered
mention)

Skin colour – Normal/ Altered (If

altered mention)……. Tenderness – Present/
Absent

Pitting/ Non – pitting

oedema

Circumference
……..

48
Features to be observed for shotha in patient Tick the type of shotha

The migrating pitting oedema, primarily

localized in the lower extremities, amplifies
throughout the Vataja
day (diva bali), yet significantly diminishes by
night.

The non-pitting or slowly pitting oedema, Kaphaja

predominantly affecting the upper body, notably
the face, escalates during the night (ratri bali),
reaching its
peak visibility in the early morning

hours, and gradually diminishes as the day

progresses.
The swiftly advancing localized edema exhibits
diverse hues like brown, reddish, coppery red,
or black. It presents warmth, tenderness upon Pittaja
touch, and intense burning sensations.
Occasionally, systemic indications hint
at potential suppuration.

Lymphadenopathy:

*Examine various sites, including the neck, underarms, and groins, for nodes such as submental,
submandibular, pre-auricular, post-auricular, occipital, deep and superficial cervical chain,
axillary, inguinal. Record positive findings in separate rows, specifying the side (Right/ Left)
of involvement if observed.

49
 *Site/ ** Write the ** Write the Write your inference (Include
Lymph observations on observations on comments on involvement of
node Lymph node Lymph node drainage areas of respective
examined Examination – Examination – node if involved)
(Refer 2Sparshana –

above) 1Darshana – Palpation

Inspection;

Visible swelling – Present/ Tenderness – Present/

Absent Absent

Symmetry – Symmetrical/ Consistency – Firm/

Asymmetrical Soft/ Rubbery/ Hard

Size (Measure using

finger breadth or
measuring tape
or callipers) –

Mobility – Freely
movable/ Fixed

50
 Shabdha pareeksha – Examining voice and speech of patient:

Parameter Observation Inference

Voice Prakruta/ Vaikruta

Speech Prakruta/ Vaikruta

Dosha assessment (Kapha -

Guru; Pitta - Sphuta (broken, split); Vata
- Khara, Parusha)

Jihwa pareeksha (Tongue examination):

*(Varna – Pandu, Rakta, Haridra, Harita, Krishna, Neela, Shweta; Pramana – Tanu,
Sama, Sandra; Upalepa; Chalana)

Parameters *Write the observations on Jihwa Write your

inference
Colour

Contour and size

Coating

Appearance

Dosha assessment (Vata - Khara

sparsha, sphutita, Sheeta; Pitta -
Raktashyama
varna; Kapha - Shweta, Ati picchila)

51
 Jugular Venous Pressure (JVP): Present/ Absent (If present
mention in centimetres)

[Image source: Quizlet Flash cards]

Mention the height of JVP on diagram above sternum

Any other relevant information to be furnished in general physical examination:

Student’s signature Teacher’s signature

52
 ROGA NIDAN EVAM VIKRITI VIGYAN ACTIVITY BOOK

SERIAL NO: 6 CLINICAL NO: C 6.1

1. Activity Name

Respiratory system examination

2. Activity Description:

Perform and record respiratory system examination of patient. Write your observations and
interpretation on possible conditions or diseases the patient is suffering from.

3. Materials and Equipment:

Case format, Stethoscope, Sphygmomanometer, Thermometer, Pen torch, Reflex hammer,

Tuning fork, Measuring tape, Disposable tongue depressors/ Stainless steel tongue depressor,
Cotton swabs, Disposable tissues or wipes, Rulers or Scales, Peak flow meter, Pins and Hand
sanitizer.

4. Patient information:

Age:
Sex: M/ F/Others
Marital status:
Education:
Occupation:
Religion:

Socio-economic status:

Date of Consultation:

Out Patient Number:

Date of Admission:

In Patient Number:

Bed number:

Place of residence:

53
 5. Respiratory system examination:

Prashna pareeksha – Short history (Including upashaya anupashaya) – Relevant to the

patient:

Darshana pareeksha - Inspection:

*Perform Nasa pareeksha –

Upper respiratory tract – External appearance like structure of nose, shape, symmetry,
deformities, lesions, swellings or any other changes on skin), nasal cavity (mucosal colour,
swelling, discharge and any other abnormalities), septum (deviation), turbinate (hypertrophy),
nasal polyps, nasal discharge - nasa srava (colour) and record the findings with inference below:

*Site of *Observations Inference

examination

54
 *Observe Mukha/ Taalu/ Gala pareeksha - Oral cavity and throat (oral cavity, tonsils, uvula
and pharynx, post nasal drip) and record the findings with inference below:

*Site of *Observations Inference

examination

Shape of chest: Normal/ Abnormal (Barrel shaped) ……..

Antero-posterior diameter of Chest:……

Transverse diameter of Chest:……

1
Perform Ura pareeksha (Kubjatva – Yaduktam hrudayam yadi va prushtam unnatam kramasha sa
ruk – Hrudayam unnatam – pectus carinatum or pigeon shaped chest and Pectus excavatum or
funnel shaped chest; Prushtam unnatam – Kyphosis, Lordosis, Scoliosis)

Identify whether these deformities are there Sahaja (since birth) or Jataja (acquired), see for
2
Harrison’s sulcus, symmetry of the chest, 3Trail’s sign, and 4Apex beat:

1Mention shape of chest (Refer Sahaja/ Jataja Inference

above)

2Harrison’s sulcus Inference

(Present/ Absent)

55
 3Trail’s sign (Present/ Absent) Inference

4Apex beat (Observed/ Not Inference

observed) If observed
approximate
location

Symmetry of chest: Symmetrical/ Asymmetrical Respiratory

movements:

*Observe for respiratory movements – different areas of chest (Supraclavicular, Infraclavicular,

Mammary, Infra mammary, Axillary, Supra scapular, Inter scapular and Infra scapular areas)

Respiratory movements: Equal/ Diminished Right/ Left

Movement of accessory respiratory muscle:

*Observe for movement of accessory respiratory muscles - sternocleidomastoid muscle,

scalene muscles, trapezius muscle, and abdominal muscles and record the findings with
inference below (Yes/ No)

If Yes provide details regarding **Notching of suprasternal and supra clavicular area,
Indrawing of intercostal muscles, and Type of breathing (Thoraco-abdominal breathing, and
Abdomino-thoracic breathing):

*Name of *Movement Present/ Inference (**Mention the outcome of

Accessory Absent laboured breathing)
respiratory muscle

56
 Nishteevana (Examination of sputum):

Mention features of Observation Inference

nishteevana
Character - Shushka kapha,
Sa kapha (If kapha present -
Tanu Kapha, Ghana Kapha,
Alpa kapha)

Colour - Peeta nishteevana,

Raktayukta kapha, Harita kapha,
Puyopama kapha

Consistency - Alpatam vrajet (Non

– sticky and little), Krcchran
muktva (thick tenacious sputum),
Snigdha kapha

Odour - Durgandha yukta

kapha (As per patient’s
statement)

Special observations - Poorva

kaasate sushkam tat shteevate sa
shonitam, Shleshma aavruta mukha
srota kapha (frothy sputum)

Any other -

Write your inference on below mentioned points:

57
Sl. Parameters to be assessed Item observed in patient Rationality
No
1 Dosha – Anubandhya and
Anubandha dosha
2 Sama/ Nirama Dosha avastha

Sparshana pareeksha of Kantha and Uras - Palpation:

Position of trachea: Central/ Deviated ----- Right/ Left............ Expansion of the

chest ------------------------------------------ cms
Movement of the chest: Equal/ Diminished
Tenderness: Absent/ Present (If present mention the location) Tactile vocal
fremitus: Present/ Absent

Shabdha prakshobha pareeksha - Percussion:

Conduct percussion in the intercostal space at Supraclavicular, Infraclavicular, Mammary,

Infra mammary, Axillary, Supra scapular, Inter scapular and Infra scapular areas for various
percussion notes such as Resonant, Hyper resonant, Tympanic, Dull, Stony dull note and mark on
given diagram below with respective observation and inference.

[Image source: Springer Link – Anatomic, Physiologic, and Therapeutic Principles of Surgical
Diseases]

58
 Shrotrendriyataha pareeksha - Auscultation:

Breath sounds (Specify the particular area corresponding to ribs or lobes of the lungs, and
indicate the side of examination when documenting observations):

Breath Sounds Audible / Not Unilateral/Bilateral Observation with

Audible (Specify area) interpretation

Vesicular

Bronchial

Bronchovesicular

#Click here to listen for bronchial, vesicular and broncho vesicular sounds:
https://www.youtube.com/watch?v=JFWMJGtmG5E

Added sounds:

Added Sounds Audible/ Not Unilateral/ Inspiratory Expiratory Both Observation

Audible Bilateral (Early/ Late) with
(Specify area) interpretation

Crackle/
Crepitation

#Click here to listen for crackle or crepitation:

https://www.youtube.com/watch?v=AbfsN1YgeSw

Added Audible/ Unilateral/ Inspiratory/ Monophonic/ Fixed/ Observation with

Sounds Not Bilateral Expiratory/ Polyphonic Random interpretation
Audible both

Wheeze/
Ronchi

#Click here to listen for wheeze or rhonchi:

https://www.youtube.com/watch?v=aMMlclpBNpg
https://www.youtube.com/watch?v=7cIEXfqnYRQ

59
 Added Audible/ Not Unilateral/ Observation with interpretation
Sounds Audible Bilateral
Pleural rub

#Click here to listen for pleural rub: https://www.youtube.com/watch?v=yq0Z3TgGWS4

Voice sounds:

Voice Sounds Audible/ Not Unilateral/ Observation with interpretation

Audible Bilateral

Bronchophony

Aegophony

Whispering
pectoriloquy

#Link for bronchophony, aegophony, whispering pectoriloquy:

https://www.youtube.com/watch?v=wb15Dex0EFI
https://www.youtube.com/watch?v=E6VC1esEPcY

Provide a summarized overview of the information pertaining to breath sounds in the diagram
presented below:

[Image source: Springer Link – Anatomic, Physiologic, and Therapeutic Principles of Surgical Diseases]

60
Conduct a comprehensive assessment by considering history (including upashaya anupashaya),
a thorough physical examination, systemic examination, and relevant investigations.
Additionally, perform a differential diagnosis (sapeksha and vyavachedaka nidana) based on
the gathered data.

6. Summarize the observations:

#The respective owners hold the copyright for the links to YouTube videos, and these links are
exclusively provided for educational purposes

Student’s signature Teacher’s signature

61
 SERIAL NO: 6 CLINICAL NO: C 6.3

7. Activity Name

Respiratory system examination

8. Activity Description:

Perform and record respiratory system examination of patient. Write your observations and
interpretation on possible conditions or diseases the patient is suffering from.

9. Materials and Equipment:

Case format, Stethoscope, Sphygmomanometer, Thermometer, Pen torch, Reflex hammer,

Tuning fork, Measuring tape, Disposable tongue depressors/ Stainless steel tongue depressor,
Cotton swabs, Disposable tissues or wipes, Rulers or Scales, Peak flow meter, Pins and Hand
sanitizer.

10. Patient information:

Age:

Sex: M/ F/Others
Marital status:
Education:
Occupation:
Religion:
Socio-economic status:
Date of Consultation:
Out Patient Number:

Date of Admission:

In Patient Number:

Bed number:

Place of residence:

62
11. Respiratory system examination:

Prashna pareeksha – Short history (Including upashaya anupashaya) –

Relevant to the patient:

Darshana pareeksha - Inspection:

63
 *Perform Nasa pareeksha –

Upper respiratory tract – External appearance like structure of nose, shape, symmetry,
deformities, lesions, swellings or any other changes on skin), nasal cavity (mucosal colour,
swelling, discharge and any other abnormalities), septum (deviation), turbinate (hypertrophy),
nasal polyps, nasal discharge - nasa srava (colour) and record the findings with inference below:

*Site of *Observations Inference

examination

*Observe Mukha/ Taalu/ Gala pareeksha - Oral cavity and throat (oral cavity, tonsils, uvula
and pharynx, post nasal drip) and record the findings with inference below:

*Site of *Observations Inference

examination

Shape of chest: Normal/ Abnormal (Barrel shaped) …….. Antero-posterior

diameter of Chest:……
Transverse diameter of Chest:……

1
Perform Ura pareeksha (Kubjatva – Yaduktam hrudayam yadi va prushtam unnatam kramasha sa
ruk – Hrudayam unnatam – pectus carinatum or pigeon shaped chest and Pectus excavatum or
funnel shaped chest; Prushtam unnatam – Kyphosis, Lordosis, Scoliosis)

64
 Identify whether these deformities are there Sahaja (since birth) or Jataja (acquired), see for
2
Harrison’s sulcus, symmetry of the chest, 3Trail’s sign, and 4Apex beat:

1Mention shape of chest (Refer Sahaja/ Jataja Inference

above)

2Harrison’s sulcus Inference

(Present/ Absent)

3Trail’s sign (Present/ Absent) Inference

4Apex beat (Observed/ Not Inference

observed) If observed
approximate
location

65
 Symmetry of chest: Symmetrical/ Asymmetrical Respiratory

movements:

*Observe for respiratory movements – different areas of chest (Supraclavicular, Infraclavicular,

Mammary, Infra mammary, Axillary, Supra scapular, Inter scapular and Infra scapular areas)

Respiratory movements: Equal/ Diminished Right/ Left

Movement of accessory respiratory muscle:

*Observe for movement of accessory respiratory muscles - sternocleidomastoid muscle,

scalene muscles, trapezius muscle, and abdominal muscles and record the findings with
inference below (Yes/ No)

If Yes provide details regarding **Notching of suprasternal and supra clavicular area,
Indrawing of intercostal muscles, and Type of breathing (Thoraco-abdominal breathing, and
Abdomino-thoracic breathing):

*Name of *Movement Present/ Inference (**Mention the outcome of

Accessory Absent laboured breathing)
respiratory muscle

66
 Nishteevana (Examination of sputum):

Mention features of Observation Inference

nishteevana
Character - Shushka kapha,
Sa kapha (If kapha present -
Tanu Kapha, Ghana Kapha,
Alpa kapha)

Colour - Peeta nishteevana,

Raktayukta kapha, Harita kapha,
Puyopama kapha

Consistency - Alpatam vrajet (Non

– sticky and little), Krcchran
muktva (thick tenacious sputum),
Snigdha kapha

Odour - Durgandha yukta

kapha (As per patient’s
statement)

Special observations - Poorva

kaasate sushkam tat shteevate sa
shonitam, Shleshma aavruta mukha
srota kapha (frothy sputum)

Any other -

67
 Write your inference on below mentioned points:

Sl. Parameters to be assessed Item observed in patient Rationality

No
1 Dosha – Anubandhya and
Anubandha dosha
2 Sama/ Nirama Dosha avastha

Sparshana pareeksha of Kantha and Uras - Palpation:

• Position of trachea: Central/ Deviated ----- Right/ Left............ Expansion

of the chest ------------------------- cms
• Movement of the chest: Equal/ Diminished

• Tenderness: Absent/ Present (If present mention the location) Tactile vocal
fremitus: Present/ Absent

Shabdha prakshobha pareeksha - Percussion:

Conduct percussion in the intercostal space at Supraclavicular, Infraclavicular, Mammary,

Infra mammary, Axillary, Supra scapular, Inter scapular and Infra scapular areas for various
percussion notes such as Resonant, Hyper resonant, Tympanic, Dull, Stony dull note and mark on
given diagram below with respective observation and inference.

[Image source: Springer Link – Anatomic, Physiologic, and Therapeutic Principles of Surgical
Diseases]

68
Shrotrendriyataha pareeksha - Auscultation:

Breath sounds (Specify the particular area corresponding to ribs or lobes of the lungs, and
indicate the side of examination when documenting observations):

Breath Sounds Audible / Unilateral/Bilateral Observation with

Not (Specify area) interpretation
Audible
Vesicular

Bronchial

Bronchovesicular

#Click here to listen for bronchial, vesicular and broncho vesicular sounds:
https://www.youtube.com/watch?v=JFWMJGtmG5E

Added sounds:
Added Sounds Audible/ Not Unilateral/ Inspiratory Expiratory Both Observation
Audible Bilateral (Early/ Late) with
(Specify area) interpretation
Crackle/
Crepitation

#Click here to listen for crackle or crepitation:

https://www.youtube.com/watch?v=AbfsN1YgeSw
Added Audible/ Unilateral/ Inspiratory/ Monophonic/ Fixed/ Observation with
Sounds Not Bilateral Expiratory/ Polyphonic Random interpretation
Audible both
Wheeze/
Ronchi

#Click here to listen for wheeze or rhonchi:

https://www.youtube.com/watch?v=aMMlclpBNpg
https://www.youtube.com/watch?v=7cIEXfqnYRQ

69
Added Audible/ Not Unilateral/ Observation with interpretation
Sounds Audible Bilateral
Pleural rub

#Click here to listen for pleural rub: https://www.youtube.com/watch?v=yq0Z3TgGWS4

Voice sounds:

Voice Sounds Audible/ Not Unilateral/ Observation with interpretation

Audible Bilateral
Bronchophony

Aegophony

Whispering
pectoriloquy

#Link for bronchophony, aegophony, whispering pectoriloquy:

https://www.youtube.com/watch?v=wb15Dex0EFI
https://www.youtube.com/watch?v=E6VC1esEPcY

Provide a summarized overview of the information pertaining to breath sounds in the diagram
presented below:

[Image source: Springer Link – Anatomic, Physiologic, and Therapeutic Principles of Surgical
Diseases]

70
 Conduct a comprehensive assessment by considering history (including upashaya anupashaya),
a thorough physical examination, systemic examination, and relevant investigations.
Additionally, perform a differential diagnosis (sapeksha and vyavachedaka nidana) based on
the gathered data.

12. Summarize the observations:

Student’s signature Teacher’s signature

71
 ROGA NIDAN EVAM VIKRITI VIGYAN ACTIVITY BOOK

SERIAL NO: 6 CLINICAL NO: C 6.2

1. Activity Name

Cardiovascular system examination

2. Activity Description:

Perform and record cardiovascular system examination of patient. Write your observations and
interpretation on possible condition the patient is suffering from.

3. Materials and Equipment:

Case format, Stethoscope, Sphygmomanometer, Thermometer, Pen torch, Measuring tape,

Disposable tongue depressors, Cotton swabs, Disposable tissues or wipes, Rulers or Scales,
Peak flow meter and Hand sanitizer.

4. Patient information:

Age:
Sex: M/ F/Others
Marital status:
Education:
Occupation:
Religion:
Socio-economic status:
Date of Consultation:

Out Patient Number:

Date of Admission:
In Patient Number:
Bed number:
Place of residence:

72
 5. Cardiovascular system examination:

Prashna pareeksha – Short history (Including upashaya anupashaya) – Relevant to the

patient:

Darshana Pareeksha - Inspection:

Features to be Observation Inference

observed
Precordial bulge

Location of apex impulse

Double apical beat

Neck pulsation

73
 Sparshanendriyataha pareeksha - Palpation:

Feature to be examined Observation Inference

Location of apex beat Not palpable/ Palpable (If palpable

mention the Intercostal space)

Thrills Present/ Absent

Shabdha prakshobha pareeksha - Percussion:

Shrotrendriyataha pareeksha - Auscultation:

Feature to be examined with observation Inference

Heart Rate & Rhythm

Intensity of S1

Intensity of S2

74
Character of S1: ................. split............ (Physiological/
Pathological)

Character of S2: .................... split.........

(Physiological/ Pathological – Wide, Wide fixed, Paradoxical)

S3 and S4: Present/Absent

Gallop: Present/Absent

#Click here to listen for heart sound (S1 S2 and Split/ S3 and S4, Gallop):
https://www.youtube.com/watch?v=eF-6Cm8amIM
https://www.youtube.com/watch?v=7J72wFtBdU4
https://www.youtube.com/watch?v=o8eqYHCy7dw

Added sounds to be examined with observation Inference

(Specify area)
Ejection clicks: Present/Absent

Opening snaps: Present/Absent

Murmurs (Daraa – Dara darika): Intensity Pitch Manoeuvres

*Present/Absent *(If present answer below)

75
*Systolic murmur - Pan systolic, Long
systolic/Early systolic, Mid systolic, Late systolic: Present/
Absent

*Diastolic murmur - Early diastolic, Mid diastolic, Pre

systolic

Continuous murmur: Present/ Absent

Carey Coombs murmur: Present/ Absent

Austin Flint murmur: Present/ Absent

#Click here to listen for cardiac murmur with details, Carey Coombs murmur and Austin
Flint murmur: https://www.youtube.com/watch?v=IrWEAucHoA0
https://www.youtube.com/watch?v=prcdXzhS5EE
https://www.youtube.com/watch?v=y5CcncRHl38

6. Summarise your observations:

76
 Conduct a comprehensive assessment by considering history (including upashaya anupashaya),
a thorough physical examination, systemic examination, and relevant investigations.
Additionally, perform a differential diagnosis (sapeksha and vyavachedaka nidana) based on
the gathered data.

Student’s signature Teacher’s signature

77
 SERIAL NO: 6 CLINICAL NO: C 6.4

7. Activity Name

Cardiovascular system examination

8. Activity Description:

Perform and record cardiovascular system examination of patient. Write your observations and
interpretation on possible condition the patient is suffering from.

9. Materials and Equipment:

Case format, Stethoscope, Sphygmomanometer, Thermometer, Pen torch, Measuring tape,

Disposable tongue depressors, Cotton swabs, Disposable tissues or wipes, Rulers or Scales,
Peak flow meter and Hand sanitizer.

10. Patient information:

Age:
Sex: M/ F/Others
Marital status:
Education:
Occupation:
Religion:
Socio-economic status:
Date of Consultation:

Out Patient Number:

Date of Admission:
In Patient Number:
Bed number:
Place of residence:

78
 11. Cardiovascular system examination:

Prashna pareeksha – Short history (Including upashaya anupashaya) – Relevant to the

patient:

Darshana Pareeksha - Inspection:

Features to be Observation Inference

observed
Precordial bulge

Location of apex impulse

Double apical beat

Neck pulsation

Sparshanendriyataha pareeksha - Palpation:

Feature to be examined Observation Inference

Location of apex beat Not palpable/ Palpable (If palpable

mention the Intercostal space)

Thrills Present/ Absent

79
Shabdha prakshobha pareeksha - Percussion

Shrotrendriyataha pareeksha - Auscultation:

Feature to be examined with observation Inference

Heart Rate & Rhythm

Intensity of S1

Intensity of S2

Character of S1: ................. split............ (Physiological/

Pathological)

Character of S2: .................... split.........

(Physiological/ Pathological – Wide, Wide fixed, Paradoxical)

S3 and S4: Present/Absent

Gallop: Present/Absent

#Click here to listen for heart sound (S1 S2 and Split/ S3 and S4, Gallop):
https://www.youtube.com/watch?v=eF-6Cm8amIM
https://www.youtube.com/watch?v=7J72wFtBdU4
https://www.youtube.com/watch?v=o8eqYHCy7dw

80
 Added sounds to be examined with observation Inference
(Specify area)
Ejection clicks: Present/Absent

Opening snaps: Present/Absent

Murmurs (Daraa – Dara darika): Intensity Pitch Manoeuvres

*Present/Absent *(If present answer below)
*Systolic murmur - Pan systolic, Long
systolic/Early systolic, Mid systolic, Late systolic: Present/
Absent

*Diastolic murmur - Early diastolic, Mid diastolic, Pre

systolic

Continuous murmur: Present/ Absent

Carey Coombs murmur: Present/ Absent

Austin Flint murmur: Present/ Absent

#Click here to listen for cardiac murmur with details, Carey Coombs murmur and Austin
Flint murmur: https://www.youtube.com/watch?v=IrWEAucHoA0
https://www.youtube.com/watch?v=prcdXzhS5EE
https://www.youtube.com/watch?v=y5CcncRHl38

81
 12. Summarise your observations:

Conduct a comprehensive assessment by considering history (including upashaya anupashaya),

a thorough physical examination, systemic examination, and relevant investigations.
Additionally, perform a differential diagnosis (sapeksha and vyavachedaka nidana) based on
the gathered data.

Student’s signature Teacher’s signature

82
 ROGA NIDAN EVAM VIKRITI VIGYAN ACTIVITY BOOK SERIAL

NO: 6 CLINICAL NO: C 6.5

1. Activity Name

Oral & Abdominal examination

2. Activity Description:

Perform and record oral and abdominal examination of patient. Write your observations and
interpretation on possible conditions the patient is suffering from.

3. Materials and Equipment:

Case format, Stethoscope, Sphygmomanometer, Thermometer, Pen torch, Measuring tape,

Disposable tongue depressors, Cotton swabs, Disposable tissues or wipes, Rulers or Scales and
Hand sanitizer.

4. Patient information:

Age:
Sex: M/ F/Others
Marital status:
Education:
Occupation:
Religion:
Socio-economic status:
Date of Consultation:
Out Patient Number:
Date of Admission:
In Patient Number:
Bed number:
Place of residence:

83
5. Oral and abdominal examination:

Prashna pareeksha – Short history (Including upashaya anupashaya) – Relevant to the

patient:

Oral examination:

Write the observations for

Jihwa pareeksha - Tongue (normal/ colour/ fissure/ glossitis/ coated/ bald/ ulcerated/
geographic) (Tongue – atrophy of papillae, ulcers and white lesions, and enlargement of
tongue):

Gum bleeding: Present/ Absent

With your observation and inference:

84
 Per abdominal examination (Specify the area and side wherever applicable):

Darshanendriyataha pareeksha – Inspection:

Write your observation on

1
Udara akriti (Mandala udara/ Adhmaata udara/ Udara utseda);

Shape of the abdomen (normal/ scaphoid/ distended/ fullness of the flanks);

2
Nabhi pareeksha – Umbilicus: Normal/ Everted/ Scarring

3
Distended veins - Sira santhata (Caput medusa/Collateral veins)

4
Skin striae - Raji janma or raji santhata

5
Discoloration of skin – Varna - (Cullen’s sign, Turner’s sign)

6
Visible peristalsis: Examine in a step ladder pattern/ left to right/ right to left
7
Antra vruddhi - Hernia orifices

Feature to be inspected for Observation Inference

1
Udara akriti

2
Nabhi pareeksha

3
Sira santhata Present/ Absent

4
Raji janma Present/ Absent

5
Varna Normal/ Abnormal

Movement of the different parts of Present/ Absent

the abdomen

Visible pulsation Present/ Absent

85
Divarication of rectus abdominis Present/ Absent

Scars and sinuses Present/ Absent

Visible mass Present/ Absent

Sister Mary Joseph nodule Present/ Absent

6
Visible peristalsis Present/ Absent

7
Antra vruddhi Visible/ Not visible

Sparshanendriyataha pareeksha - Palpation (superficial palpation, deep palpation, bimanual

palpation, ballottement, and dipping method) – Mention the observations in table and mark on
the diagram given below:

Palpation Observation Inference

Sparsha asahata - Tenderness Present/ Absent

Ashaya vruddhi – Present/ Absent

Organomegaly. (If
organomegaly present
answer for below)
Yakrut vruddhi - Liver Size……….. Surface:
Regular/ Irregular
Basti vruddhi - Kidney Right/ Left

Pleeha vruddhi - Spleen Not palpable/ Palpable

Mootra ashaya vruddhi - Urinary Not palpable/ Palpable

bladder

86
 Mark and mention the observations regarding palpation on the diagram given below:

[Image source: Elsevier. Swash & Glynn: Hutchison’s Clinical Methods 22e]

Shabdha prakshobha pareeksha – Percussion:

Mention the observations regarding percussion in table and mark on the diagram given
below:

Per Abdominal - Percussion Observation Yes/ No (If Yes Inference

note specify area)

Hyper resonant

Resonant

Dull

Stony dull

87
 Special test for ascites - Observation Inference
Percussion
Puddle sign Present/ Absent

Shifting dullness - Udaka poorna druti Present/ Absent

shabdha
Horseshoe-shaped dullness Present/ Absent
- Udaka poorna druti shabdha

Fluid thrill - Udaka poorna druti Present/ Absent

sparsha

Mark and mention the observations regarding percussion on the diagram given below:

[Image source: Elsevier. Swash & Glynn: Hutchison’s Clinical Methods 22e]

88
 Shrotrendriyataha pareeksha – Auscultation:

Auscultation Observation Inference

Bowel sounds If Yes, mention number per
minute

Succussion splash over abdomen Present/ Absent

Arterial bruits/ venous hums Present/ Absent

6. Summarise your observations:

Conduct a comprehensive assessment by considering history (including upashaya anupashaya),

a thorough physical examination, systemic examination, and relevant investigations.
Additionally, perform a differential diagnosis (sapeksha and vyavachedaka nidana) based on
the gathered data.

Student’s signature Teacher’s signature

89
 SERIAL NO: 6 CLINICAL NO: C 6.7

1. Activity Name

Oral & Abdominal examination

2. Activity Description:

Perform and record oral and abdominal examination of patient. Write your observations and
interpretation on possible conditions the patient is suffering from.

3. Materials and Equipment:

Case format, Stethoscope, Sphygmomanometer, Thermometer, Pen torch, Measuring tape,

Disposable tongue depressors, Cotton swabs, Disposable tissues or wipes, Rulers or Scales and
Hand sanitizer.

4. Patient information:

Age:
Sex: M/ F/Others
Marital status:
Education:
Occupation: Religion:
Socio-economic status:
Date of Consultation:
Out Patient Number:
Date of Admission:
In Patient Number:
Bed number:
Place of residence:

90
Oral and abdominal examination:

Prashna pareeksha – Short history (Including upashaya anupashaya) – Relevant to the patient:

Oral examination:
Write the observations for

Jihwa pareeksha - Tongue (normal/ colour/ fissure/ glossitis/ coated/ bald/ ulcerated/ geographic)
(Tongue – atrophy of papillae, ulcers and white lesions, and enlargement of tongue):

Gum bleeding: Present/ Absent

With your observation and inference:

Per abdominal examination (Specify the area and side wherever applicable):

Darshanendriyataha pareeksha – Inspection:

Write your observation on

1
Udara akriti (Mandala udara/ Adhmaata udara/ Udara utseda); Shape of the abdomen (normal/

scaphoid/ distended/ fullness of the flanks);

2
Nabhi pareeksha – Umbilicus: Normal/ Everted/ Scarring
3
Distended veins - Sira santhata (Caput medusa/Collateral veins)
4
Skin striae - Raji janma or raji santhata
5
Discoloration of skin – Varna - (Cullen’s sign, Turner’s sign)
6
Visible peristalsis: Examine in a step ladder pattern/ left to right/ right to left
7
Antra vruddhi - Hernia orifices

91
Feature to be inspected for Observation Inference
1
Udara akriti
2
Nabhi pareeksha
3
Sira santhata Present/ Absent
4
Raji janma Present/ Absent
5
Varna Normal/ Abnormal

Movement of the different parts of the Present/ Absent

abdomen
Visible pulsation Present/ Absent

Divarication of rectus abdominis Present/ Absent

Scars and sinuses Present/ Absent

Visible mass Present/ Absent

Sister Mary Joseph nodule Present/ Absent

6
Visible peristalsis Present/ Absent
7
Antra vruddhi Visible/ Not visible

Sparshanendriyataha pareeksha - Palpation (superficial palpation, deep palpation, bimanual

palpation, ballottement, and dipping method) – Mention the observations in table and mark on the
diagram given below:
Palpation Observation Inference
Sparsha asahata - Tenderness Present/ Absent

Ashaya vruddhi – Present/ Absent

Organomegaly. (If
organomegaly present
answer for below)
Yakrut vruddhi - Liver Size……….. Surface:
Regular/ Irregular

Basti vruddhi - Kidney Right/ Left

Pleeha vruddhi - Spleen Not palpable/ Palpable

Mootra ashaya vruddhi - Not palpable/ Palpable

Urinary bladder
92
 Mark and mention the observations regarding palpation on the diagram given below:

[Image source: Elsevier. Swash & Glynn: Hutchison’s Clinical Methods 22e]

Shabdha prakshobha pareeksha – Percussion:

Mention the observations regarding percussion in table and mark on the diagram given
below:

Per Abdominal - Percussion Observation Yes/ No (If Yes Inference

note specify area)
Hyper resonant

Resonant

Dull

Stony dull

93
 Special test for ascites - Observation Inference
Percussion
Puddle sign Present/ Absent

Shifting dullness - Udaka poorna druti Present/ Absent

shabdha
Horseshoe-shaped dullness Present/ Absent
- Udaka poorna druti shabdha

Fluid thrill - Udaka poorna druti Present/ Absent

sparsha

Mark and mention the observations regarding percussion on the diagram given below:

[Image source: Elsevier. Swash & Glynn: Hutchison’s Clinical Methods 22e]

94
 Shrotrendriyataha pareeksha – Auscultation:

Auscultation Observation Inference

Bowel sounds If Yes, mention number per
minute

Succussion splash over abdomen Present/ Absent

Arterial bruits/ venous hums Present/ Absent

7. Summarise your observations:

Conduct a comprehensive assessment by considering history (including upashaya anupashaya),

a thorough physical examination, systemic examination, and relevant investigations.
Additionally, perform a differential diagnosis (sapeksha and vyavachedaka nidana) based on
the gathered data.

Student’s signature Teacher’s signature

95
 ROGA NIDAN EVAM VIKRITI VIGYAN ACTIVITY BOOK

SERIAL NO: 6 CLINICAL NO: C 6.6

1. Activity Name

Nervous system examination

2. Activity Description:

Perform and record nervous system examination of patient. Write your observations and
inference on possible conditions the patient is suffering from.

3. Materials and Equipment:

Case format, Pen torch, Reflex hammer, Tuning fork (More than or equal to 128 Hz) Measuring
tape, Cotton swabs, Disposable tissues or wipes, Coffee and Tea powder sachet, Pins, Visual
acuity and Ishihara colour charts and Hand sanitizer.

4. Patient information:

Age:
Sex: M/ F/Others
Marital status:
Education:
Occupation:
Religion:
Socio-economic status:
Date of Consultation:
Out Patient Number:
Date of Admission:
In Patient Number:
Bed number:
Place of residence:

96
 5. Nervous system examination:

Prashna pareeksha – Short history (Including upashaya anupashaya) – Relevant to the

patient:

1. Sangya jnana - Level of consciousness and orientation (Place person time)

Assess the level of consciousness: response to eye opening/ painful stimuli and verbal response.
Normal – fully conscious and alert; Stuporous/ drowsy – response to verbal/ painful stimuli;
Comatose – no response (Glasgow coma Scale - GCS) and write the inference

Glasgow Coma Scale Scoring Inference

E - ;V- ;M-

Assess the orientation (to place / person / time) and write the inference

Orientated to Place Person and Time Inference

Yes/ No –

97
 2. Vak indriya - Speech and language

Shabdha pareeksha – Examining voice and speech of patient:

Speech defect Contemporary Observation Inference

understanding
Mooka, Vak sangha, Aphasia Yes/ No
Jihvataleshvalasastu
Minmina Hyper nasal speech Yes/ No

Gadgada, Vak stambha, Dysarthria Yes/ No

Kala vak
Vakya graha Dysprosody Yes/ No

Svaraghna Hoarseness Yes/ No

Deena svara Dysphonia Yes/ No

Deena vak Scanning speech Yes/ No

Jihma vak Apraxia Yes/ No

Samutkshipta vak Cluttering speech Yes/ No

98
 3. Uhya - Perceptions

Assess the Uhya - Perceptions (Sensory awareness of object and its relation) including
hallucination and delusions and write the inference

Mention the perceptions Observation Inference

Hallucination Present/ Absent

Delusions Present/ Absent

4. Smriti – Memory

Assess the Remote memory/Recent memory and write your inference

Mention about memory Observation Inference

Recent memory Present/ Absent

Remote memory Present/ Absent

99
 Cranial nerve examination (Sensory & Motor):

Mention side (right and left) wherever applicable

Cranial nerve Components to be examined Write your observation on

mentioned
components and conclude with
your inference

Olfactory nerve Gandha jnana –

Sense of olfaction………….
Optic nerve Netradeenam cha vaikrutim –

Visual acuity……….. Visual

field…………
Colour vision…………..
Fundi…………

Oculomotor, Sthabdha Netra/ Netradeenam cha

Trochlear, vaikrutim –
Abducens
Pupil size…….
Symmetry……. Light
reflex…….
Consensual reflex……
Accommodation reflex……..
Ptosis………
Squint……… Nystagmus…..
Conjugate eye ball
movement…….
Diplopia (concomitant/ paralytic)………

Trigeminal nerve Vakrikaroti hanu/ Shankha/ Shravana/ Ganda

ruk –

Sensory part: Corneal

reflex……

100
 Others (Ophthalmic, Maxillary &
Mandibular branch
observations)…………

Motor part:
Jaw clenching……. Lateral jaw
movement……

Glabellar reflex……….

Facial nerve Vakri karoti nasa bhru lalata/ Mukham

jihmam/ Vrujati asye bhojana/ Kshavathu
nigraha –

Motor part for Upper face: Raising eye

brow.......
Frowning the forehead..... Bell’s
phenomenon.............

Motor part for Lower face: Nasolabial

fold......
Clenching the teeth...... Whistling.........
Blowing the mouth.........

Taste sensation (Anterior 2/3rd of tongue):

……………

Vestibulo cochlear Badyate shravana –

nerve
Cochlear component:
Rinne’s test…….
Weber’s test…… Hearing
tests - impression…………..
Conductive/ sensori neural/ mixed

101
 Vestibular component: Nystagmus/ calorie
test:………….

Glossopharyngeal nerve Bhidyate swara/ Mukham jihmam

and vagus nerve –

Position of uvula……………. Taste

perception (Posterior 1/3rd of
tongue)……………..
Gag reflex…………………..

Spinal accessory nerve Upashoshya bahum –

Sternocleidomastoid
muscle…………….
Trapezius muscle……………

Hypoglossal Mukham jihmam –

nerve
Wasting: Absent/ present…………..
Fasciculations: Absent/ present…………….
Deviation: Right side/ left side Movements
of tongue: Normal/ abnormal………….
Power of tongue……………

Summary
Affected nerve Sensory Motor

Karmendriya pareeksha/ Chesta - Motor system examination (Specify site examined

with side of body wherever applicable):

Mamsa pareeksha/ Mamsa bala/ Supushta mamsa/ Bala heena mamsa – Muscle bulk, Muscle
Power and Muscle tone examination.

102
 Evaluate the muscle mass at different locations in centimetres, specifying the type of muscle
bulk and providing your analysis. Assess the area 10 cm above the elbow for the arm and below
the elbow for the forearm, referencing the olecranon process of upper limb. Measure 18 cm
above the patella for the thigh and 10 cm below the tibial tuberosity for the calf. Report your
findings accordingly.

Limb Muscle bulk (Mention the Normal/ Atrophy (Anga Inference

side and site of shosha)/ Hypertrophy/
measurement along Pseudohypertrophy
with comparing side)

Upper limbs
(Arm/ Fore arm)

Lower limbs
(Thigh/ Calf)

Assess the muscle power of various sites with grading and your inference

*Muscle power grading chart:

0 – no muscle contraction visible

1 – muscle contraction visible, but no movement of joint
2 – joint movement with gravity elimination
3 – movement sufficient to overcome gravity
4 – movement overcomes gravity with added resistance
5 – normal power with full resistance

103
 Limb Location for examining Muscle Mention Inference
power with side Muscle power
grading*

Upper limbs

Lower limbs

Assess the muscle tone of various sites with observation and your inference

Limb Location for Mention Muscle tone type Inference

examining (Normotonic/ Hypotonic or
Muscle tone flaccid (Shaithilya)/
Hypertonic (Sankocha) –
Clasp knife, Lead pipe, Cog
wheel)

Upper limbs

Lower limbs

Reflexes: hyperreflexia/ hyporeflexia – Shareera dhatu vyuhakara, sandhanakara

shareerasya:
104
 Assess the reflexes of various sites with observation and your inference. Mention grades of
reflex –

[Image Source: Quizlet Flash Cards]

Reflex Observation (Hyper- Inference

reflexia/ Hypo-reflexia/
Areflexia)
Deep tendon reflexes

Biceps jerk

Triceps jerk

Supinator jerk

Jaw jerk

Knee jerk

Ankle jerk

Superficial reflexes

Cremasteric reflex

Babinski sign

Abdominal reflex

105
Kampa/ Vepathu –
Involuntary movements - Absent/ Present (If Present mention details below):

Rhythmic Absent/ Present – Resting tremor

Non rhythmic Absent/ Present – Intention tremor/ Chorea/ Athetosis/

Ballismus/ Hemiballismus/ Myoclonus/ Asterixis

Anga gati pareeksha/ Skalita gati pareeksha - Co-ordination assessment tests:

Assess the coordination of the patient using following methods, write your observation and
inference below

Name of test/ condition Coordination Inference

Present/
Absent
Rapid alternating Rapid alternating movements
movements
of arms
Finger tapping (Index finger
and Thumb)
Rapid alternating movements
of foot
(Touching ball of foot with
arms)
Point to point movements Finger nose test

Heel to shin test

Gait Tandem walking

Walking on toes and heels

Hop in place

Shallow knee bending

106
 Rising from sitting position
(without arm
support)

Stance Romberg’s test

Pronator drift test
Dysdiadochokinesia Present/ Absent

Gati pareeksha – Gait:

Assess the gait of the patient; write your observation and inference below.

Gait – Intact/ Affected; If affected mention the type with inference (Scissor gait, Stamping
gait, High stepping gait, Festinating gait, Ataxic gait, Hemiplegic gait)

Mention type of gait observed Inference

Sparsha jnana pareeksha (Supti/ Sparsha ajnana, etc.) - Sensory system examination:

Sensation of touch:

Touch sensation Dermatome Observation Inference

Crude touch

Fine touch

Two-point discrimination

Point localization

Sensation of Pain and pressure:

Pain and pressure Dermatome Observation Inference

Pain

Pressure

107
 Temperature sensation:
Temperature Dermatome Observation Inference
Temperature

Assess the joint position for various joints and write your observation and inference
Joint position Joint Observation Inference

Assess the Vibration sensation on designated sites of body and write your observation and
inference

Site of body Observation Inference

Assess the *Stereognosis and **Graphesthesia on designated sites of body and write your
observation and inference

Site of body Observation* Inference

Site of body Observation** Inference

108
 Write your inference on below mentioned points:

S Observation Dosha and dushya Inference to be made based

l. involvement on guna of vata
N
o
1

Conduct a comprehensive assessment by considering history (including upashaya anupashaya),

a thorough physical examination, systemic examination, and relevant investigations.
Additionally, perform a differential diagnosis (sapeksha and vyavachedaka nidana) based on
the gathered data.

Student’s signature Teacher’s signature

109
 SERIAL NO: 6 CLINICAL NO: C 6.8

6. Activity Name

Nervous system examination

7. Activity Description:

Perform and record nervous system examination of patient. Write your observations and
inference on possible conditions the patient is suffering from.

8. Materials and Equipment:

Case format, Pen torch, Reflex hammer, Tuning fork (More than or equal to 128 Hz) Measuring
tape, Cotton swabs, Disposable tissues or wipes, Coffee and Tea powder sachet, Pins, Visual
acuity and Ishihara colour charts and Hand sanitizer.

9. Patient information:

Age:
Sex: M/ F/Others
Marital status:
Education:
Occupation:
Religion:
Socio-economic status:
Date of Consultation:
Out Patient Number:
Date of Admission:
In Patient Number:
Bed number:
Place of residence:

110
10. Nervous system examination:

Prashna pareeksha – Short history (Including upashaya anupashaya) – Relevant to the

patient:

111
 5. Sangya jnana - Level of consciousness and orientation (Place person time)

Assess the level of consciousness: response to eye opening/ painful stimuli and verbal response.
Normal – fully conscious and alert; Stuporous/ drowsy – response to verbal/ painful stimuli;
Comatose – no response (Glasgow coma Scale - GCS) and write the inference

Glasgow Coma Scale Scoring Inference

E - ;V- ;M-

Assess the orientation (to place / person / time) and write the inference

Orientated to Place Person and Time Inference

Yes/ No -

6. Vak indriya - Speech and language

Shabdha pareeksha – Examining voice and speech of patient:

Speech defect Contemporary Observation Inference

understanding
Mooka, Vak sangha, Aphasia Yes/ No
Jihvataleshvalasastu
Minmina Hyper nasal speech Yes/ No

Gadgada, Vak stambha, Dysarthria Yes/ No

Kala vak
Vakya graha Dysprosody Yes/ No

Svaraghna Hoarseness Yes/ No

Deena svara Dysphonia Yes/ No

Deena vak Scanning speech Yes/ No

Jihma vak Apraxia Yes/ No

Samutkshipta vak Cluttering speech Yes/ No

112
 7. Uhya - Perceptions

Assess the Uhya - Perceptions (Sensory awareness of object and its relation) including
hallucination and delusions and write the inference

Mention the perceptions Observation Inference

Hallucination Present/ Absent

Delusions Present/ Absent

8. Smriti – Memory

Assess the Remote memory/Recent memory and write your inference

Mention about memory Observation Inference

Recent memory Present/ Absent

Remote memory Present/ Absent

113
 Cranial nerve examination (Sensory & Motor):

Mention side (right and left) wherever applicable

Cranial nerve Components to be examined Write your observation on

mentioned
components and conclude with
your inference

Olfactory nerve Gandha jnana –

Sense of olfaction………….
Optic nerve Netradeenam cha vaikrutim –

Visual acuity……….. Visual

field…………
Colour vision…………..
Fundi…………

Oculomotor, Sthabdha Netra/ Netradeenam cha

Trochlear, vaikrutim –
Abducens
Pupil size…….
Symmetry……. Light
reflex…….
Consensual reflex……
Accommodation reflex……..
Ptosis………
Squint……… Nystagmus…..
Conjugate eye ball
movement…….
Diplopia (concomitant/ paralytic)………

Trigeminal nerve Vakrikaroti hanu/ Shankha/ Shravana/ Ganda

ruk –

Sensory part: Corneal

reflex……

114
 Others (Ophthalmic, Maxillary &
Mandibular branch
observations)…………

Motor part:
Jaw clenching……. Lateral jaw
movement……

Glabellar reflex……….

Facial nerve Vakri karoti nasa bhru lalata/ Mukham

jihmam/ Vrujati asye bhojana/ Kshavathu
nigraha –

Motor part for Upper face: Raising eye

brow.......
Frowning the forehead..... Bell’s
phenomenon.............

Motor part for Lower face: Nasolabial

fold......
Clenching the teeth...... Whistling.........
Blowing the mouth.........

Taste sensation (Anterior 2/3rd of tongue):

……………

Vestibulo cochlear Badyate shravana –

nerve
Cochlear component:
Rinne’s test…….
Weber’s test…… Hearing
tests - impression…………..
Conductive/ sensori neural/ mixed

115
 Vestibular component: Nystagmus/ calorie
test:………….

Glossopharyngeal Bhidyate swara/ Mukham jihmam

nerve and vagus nerve –

Position of uvula……………. Taste

perception (Posterior 1/3rd of
tongue)……………..
Gag reflex…………………..

Spinal accessory nerve Upashoshya bahum –

Sternocleidomastoid
muscle…………….
Trapezius muscle……………

Hypoglossal Mukham jihmam –

nerve
Wasting: Absent/ present…………..
Fasciculations: Absent/ present…………….
Deviation: Right side/ left side Movements
of tongue: Normal/ abnormal………….
Power of tongue……………

Summary
Affected nerve Sensory Motor

Karmendriya pareeksha/ Chesta - Motor system examination (Specify site examined with
side of body wherever applicable):

Mamsa pareeksha/ Mamsa bala/ Supushta mamsa/ Bala heena mamsa – Muscle bulk, Muscle
Power and Muscle tone examination.

116
Evaluate the muscle mass at different locations in centimetres, specifying the type of muscle bulk
and providing your analysis. Assess the area 10 cm above the elbow for the arm and below the elbow
for the forearm, referencing the olecranon process of upper limb. Measure 18 cm above the patella
for the thigh and 10 cm below the tibial tuberosity for the calf. Report your findings accordingly.

Limb Muscle bulk (Mention the Normal/ Atrophy (Anga Inference

side and site of shosha)/ Hypertrophy/
measurement along Pseudohypertrophy
with comparing side)

Upper limbs
(Arm/ Fore arm)

Lower limbs
(Thigh/ Calf)

Assess the muscle power of various sites with grading and your inference

*Muscle power grading chart:

6 – no muscle contraction visible

7 – muscle contraction visible, but no movement of joint
8 – joint movement with gravity elimination
9 – movement sufficient to overcome gravity
10 – movement overcomes gravity with added resistance
11 – normal power with full resistance

117
 Limb Location for examining Muscle Mention Inference
power with side Muscle power
grading*

Upper limbs

Lower limbs

Assess the muscle tone of various sites with observation and your inference

Limb Location for Mention Muscle tone type Inference

examining (Normotonic/ Hypotonic or
Muscle tone flaccid (Shaithilya)/
Hypertonic (Sankocha) –
Clasp knife, Lead pipe, Cog
wheel)

Upper limbs

Lower limbs

118
 Reflexes: hyperreflexia/ hyporeflexia – Shareera dhatu vyuhakara, sandhanakara
shareerasya:

Assess the reflexes of various sites with observation and your inference. Mention grades of
reflex –

[Image Source: Quizlet Flash Cards]

Reflex Observation (Hyper- Inference

reflexia/ Hypo-reflexia/
Areflexia)
Deep tendon reflexes
Biceps jerk

Triceps jerk

Supinator jerk

Jaw jerk

Knee jerk

Ankle jerk

Superficial reflexes
Cremasteric reflex

Babinski sign

Abdominal reflex

119
Kampa/ Vepathu – Involuntary movements - Absent/ Present (If Present mention details below):

Rhythmic Absent/ Present – Resting tremor

Non rhythmic Absent/ Present – Intention tremor/

Chorea/ Athetosis/
Ballismus/ Hemiballismus/
Myoclonus/ Asterixis

Anga gati pareeksha/ Skalita gati pareeksha - Co-ordination assessment tests:

Assess the coordination of the patient using following methods, write your observation and
inference below
Name of test/ Coordination Present/ Inference
condition Absent

Rapid alternating Rapid alternating

movements
movements of arms
Finger tapping (Index finger
and Thumb)
Rapid alternating
movements of foot
(Touching ball of foot with
arms)

Point to point Finger nose test

movements
Heel to shin test
Gait Tandem walking
Walking on toes and heels

Hop in place
Shallow knee bending

Rising from sitting position

(without arm
support)
Stance Romberg’s test

Pronator drift test

Dysdiadochokinesia Present/ Absent

120
Gati pareeksha – Gait:

Assess the gait of the patient, write your observation and inference below.

Gait – Intact/ Affected; If affected mention the type with inference (Scissor gait, Stamping gait,
High stepping gait, Festinating gait, Ataxic gait, Hemiplegic gait)

Mention type of gait observed Inference

Sparsha jnana pareeksha (Supti/ Sparsha ajnana, etc.) - Sensory system examination:

Sensation of touch:

Touch sensation Dermatome Observation Inference

Crude touch

Fine touch

Two-point discrimination

Point localization

121
 Sensation of Pain and pressure:

Pain and pressure Dermatome Observation Inference

Pain
Pressure

Temperature sensation:

Temperature Dermatome Observation Inference

Temperature

Assess the joint position for various joints and write your observation and inference

Joint position Joint Observation Inference

Assess the Vibration sensation on designated sites of body and write your observation and
inference

Site of body Observation Inference

Assess the *Stereognosis and **Graphesthesia on designated sites of body and write your
observation and inference

Site of body Observation* Inference

Site of body Observation* Inference

122
 Write your inference on below mentioned points:

Sl. Observation Dosha and dushya Inference to be made based

No involvement on guna of vata
1
2
3
4

Conduct a comprehensive assessment by considering history (including upashaya anupashaya),

a thorough physical examination, systemic examination, and relevant investigations.
Additionally, perform a differential diagnosis (sapeksha and vyavachedaka nidana) based on
the gathered data.

Students’s signature Teacher’s signature

123
 ROGA NIDAN EVAM VIKRITI VIGYAN ACTIVITY BOOK

SERIAL NO: 6 CLINICAL NO: C 6.9

1. Activity Name

Musculoskeletal system examination

2. Activity Description:

Perform and record musculoskeletal system examination of patient. Write your observations
and inference on possible conditions the patient is suffering from.

3. Materials and Equipment:

Case format, Pen torch, Reflex hammer, Tuning fork, Measuring tape, Disposable tissues or
wipes, Goniometer and Hand sanitizer.

4. Patient information:

Age:
Sex: M/ F/Others
Marital status:
Education:
Occupation:
Religion:
Socio-economic status:
Date of Consultation:
Out Patient Number:
Date of Admission:

In Patient Number:
Bed number:
Place of residence:

124
 5. Musculoskeletal system examination:

Prashna pareeksha – Short history (Including upashaya anupashaya) – Relevant to the

patient:

Darshnendriyataha pareeksha – Inspection (Mention location and side of examination

wherever applicable):

Gati pareeksha – Gait:

Gait –

Affected/ Not Affected;

If affected mention the type

Mention type of gait observed Inference

Antalgic gait

Trendelenburg gait

Any other

125
Sl Joints Inspection
No Sandhi Shotha Sandhi Sandhi karma Sandhi
vaikalyata
(Swelling) vaivarnya/ (Prasaarana (Deformity)
Raga akuncana)
(Redness)
1 Temporomandibular

2 Shoulder

3 Elbow

4 Wrist and hand

5 Hip

6 Knee joint

7 Ankle and foot

Sparshanendriyataha pareeksha – Palpation (Mention location and side of examination

wherever applicable):

Sl Joints Palpation
No Sandhi Sandhi Sandhi Sparsha
Shotha ushnata asahanata
(Swelling) (Local rise (Tenderness)
of
Temperature)
1 Temporomandibular

2 Shoulder

3 Elbow

4 Wrist and hand

5 Hip

6 Knee

7 Ankle and foot

126
Spine:

Feature to be observed *Mention the abnormality observed Inference

Deformity
*(Kyphosis/ Scoliosis/
Lordosis/ Stepping in spine;
Loss of normal curvatures at
different levels)
Gibbus

Cervical spine:

Feature to be observed/ *Mention the abnormality Inference

Tests observed
Tenderness

Foramina compression test

Lhermitte's sign
(Lhermitte’s phenomenon)

Range of movements

127
Lumbar spine:

Feature to be observed/ *Mention the abnormality observed Inference

Tests
Tenderness

Range of movements

SLR test
(Sakthnaha kshepam
nigraha): Positive/ Negative
If SLR Test is Positive

Mention

Range

Bragard’s

test

Lasegue’s

sign
Femoral nerve root
compression test:
(Sakthnaha kshepam
nigraha): Positive/ Negative

Knee joint:

Feature to be observed/ Tests *Mention the abnormality Inference

observed
Grind test

Patellar tap test

Baker’s cyst

Crepitus

128
Write your inference on below mentioned points:

Sl. Observation Dosha and dushya Inference to be made based

No involvement on guna of vata
1

Conduct a comprehensive assessment by considering history (including upashaya anupashaya), a

thorough physical examination, systemic examination, and relevant investigations. Additionally,
perform a differential diagnosis (sapeksha and vyavachedaka nidana) based on the gathered data.

Student’s signature Teacher’s signature

129
 SERIAL NO: 6 CLINICAL NO: C 6.11

6. Activity Name

Musculoskeletal system examination

7. Activity Description:

Perform and record musculoskeletal system examination of patient. Write your observations
and inference on possible conditions the patient is suffering from.

8. Materials and Equipment:

Case format, Pen torch, Reflex hammer, Tuning fork, Measuring tape, Disposable tissues or
wipes, Goniometer and Hand sanitizer.

9. Patient information:

Age:
Sex: M/ F/Others
Marital status:
Education:
Occupation:
Religion:
Socio-economic status:
Date of Consultation:
Out Patient Number:
Date of Admission:
In Patient Number:
Bed number:
Place of residence:

130
 10. Musculoskeletal system examination:

Prashna pareeksha – Short history (Including upashaya anupashaya) – Relevant to the

patient:

Darshnendriyataha pareeksha – Inspection (Mention location and side of examination

wherever applicable):

Gati pareeksha – Gait:

Gait – Affected/ Not Affected; If affected mention the type

Mention type of gait observed Inference

Antalgic gait

Trendelenburg gait

Any other

131
Sl Joints Inspection
No Sandhi Shotha Sandhi Sandhi karma Sandhi
vaikalyata
(Swelling) vaivarnya/ (Prasaarana (Deformity)
Raga akuncana)
(Redness)
1 Temporomandibular

2 Shoulder

3 Elbow

4 Wrist and hand

5 Hip

6 Knee joint

7 Ankle and foot

Sparshanendriyataha pareeksha – Palpation (Mention location and side of examination

wherever applicable):
Sl Joints Palpation
No Sandhi Sandhi Sandhi
Shotha ushnata sparsha
(Swelling) (Local rise of asahanata
Temperature) (Tenderness)
1 Temporomandibular

2 Shoulder

3 Elbow

4 Wrist and hand

5 Hip

6 Knee

7 Ankle and foot

132
Spine:

Feature to be observed *Mention the abnormality observed Inference

Deformity *(Kyphosis/
Scoliosis/ Lordosis/ Stepping
in spine; Loss of normal
curvatures at different levels)

Gibbus

Cervical spine:

Feature to be observed/ *Mention the abnormality observed Inference

Tests
Tenderness

Foramina compression test

Lhermitte's sign (Lhermitte’s

phenomenon)

Range of movements

133
Lumbar spine:

Feature to be observed/ *Mention the abnormality observed Inference

Tests
Tenderness

Range of movements

SLR test (Sakthnaha kshepam

nigraha): Positive/ Negative

If SLR Test is Positive

Mention

Range

Bragard’s test

Lasegue’s

sign
Femoral nerve root
compression test: (Sakthnaha
kshepam nigraha): Positive/
Negative

Knee joint:

Feature to be observed/ *Mention the abnormality observed Inference

Tests
Grind test

Patellar tap test

Baker’s cyst

Crepitus

134
 Write your inference on below mentioned points:

Sl. Observation Dosha and dushya Inference to be made based

No involvement on guna of vata
1

Conduct a comprehensive assessment by considering history (including upashaya anupashaya),

a thorough physical examination, systemic examination, and relevant investigations.
Additionally, perform a differential diagnosis (sapeksha and vyavachedaka nidana) based on
the gathered data.

Student’s signature Teacher’s signature

135
 ROGA NIDAN EVAM VIKRITI VIGYAN ACTIVITY BOOK

SERIAL NO: 6 CLINICAL NO: C 6.10

1. Activity Name

Integumentary system examination

2. Activity Description:

Perform and record integumentary system examination of patient. Write your observations and
inference on possible conditions the patient is suffering from.

3. Materials and Equipment:

Case format, Pen torch, Magnifying glass, Glass slide, Scale or skin callipers, Markers,
Disposable tissues or wipes and Hand sanitizer.

4. Patient information:

Age:
Sex: M/ F/Others
Marital status:
Education: Occupation:
Religion:
Socio-economic status:
Date of Consultation:
Out Patient Number:
Date of Admission:
In Patient Number:
Bed number:
Place of residence:

136
 5. Integumentary system examination:

Prashna pareeksha – Short history (Including upashaya anupashaya) – Relevant to the patient:

137
Tvak pareeksha - Assessment of skin:

Inspection:

Varna/ Colour: Shyava aruna, Raga, Shweta, Krishna, Aruna, Raktaparyanta, Shyava, Taamra,
Peetaparyanta, Neela, Peeta, Varnabheda, etc.

Size and shape: Khara paryanta, Utsanna madhya, Tanu paryanta, Hrsva, Dheergha, Mandala,
Vishama, Vistrta, Yagjnopaveeta sankasha, etc.
Dome shaped – Trichoepithelioma, Flat topped - Verruca plana, Umbilicated - Molluscum
contagiosum, Acuminate - Condylomata acuminata, Verrucous - Verruca vulgaris,
Pedunculated – Skin tags.

Configuration: Annular - T. corporis, Granuloma annulare, Round/ discoid - Nummular

eczema, discoid lupus. Polycyclic - Urticaria, Sub Cutaneous Lupus Erythematosus, Arcuate -
Urticaria. Linear - Scabies burrow, Lichen nitidus. Kobners phenomenon. Reticular - Livedo
reticularis, Serpiginous - cutaneous larva migrans, Targetoid lesions-with 3 distinct zones.
Erythema multiforme. Whorled - Incontinentia pigmenti.

Arrangement of lesion: Grouped/ herpetiform - HSV-1, Scattered

Distribution of lesions: Dermatomal/ zosteriform. Blaschkoid - Following lines of skin cell

migration during embryogenesis. Longitudinal on limbs. Circumferential on trunk.
Lymphangitic - strep. Or staph cellulitis. Sun exposed - Photodermatitis, Polymorphous Light
Eruption, Subcutaneous Lupus Erythematosus, Sun protected - Parapsoriasis, Mycosis
fungoides. Acral - Chilblains, Palmoplantar pustulosis. Truncal, Extensor – Psoriasis, Flexor-
atopic dermatitis, Intertriginous – Candidiasis, Localized – Cellulitis, Generalized- exanthema,
Drug eruptions. B/L (Bilateral) symmetrical – Vitiligo. Universal - Alopecia universalis.

138
 *Type of skin lesion 1Colour and 1Configuration Arrangement Distribution
Size
(Primary) pigmentatio and symmetry of of lesion over the
n of lesion lesion body
surface

Vaivarnya – Macule/
Patch

Sookshma
pidaka - Papule

Udvrtta pidaka
- Plaque

Granthi - Nodule

Varathi dashta
samsthana
shotha - Wheal

Sphota - Vesicle

Vishphota – Bullae

Putimamsa pidaka -
Pustule

139
 *Type of skin lesion Colour and Size Shape and Distribution over the
(Secondary) pigmentation symmetry body surface
Grushta Vrana - Erosion

Vrana - Ulcer

Daari - Fissure

Sthira cipitika - Crust

Shakala - Scale

Charmakhya –
Lichenification and
Hyperkeratinisation
Kshaya - Atrophy

Rajyo ati kandu - Excoriation

Vruna vastu – Scar

Neelika, Mashaka – Nevus

Pidaka – Comedone

Bahya Krimi pidaka - Burrow of

scabies
Sirajala – Telangiectasia

Any other

Palpation/ sensation/ deformities/ odour:

*Enquire and perform for following parameters:

Palpation:

140
Specify – Rooksha, Khara, Parushya, Daha, Kleda, Snigdha, Shaitya, Ghana, etc.

Sensory symptoms: Specify – Toda (Sparsha akshamatva), Prakwatita daha, Tvak svapa, Harsha,
etc.

Deformity: Tvak sankocha, Tvak ayaama, Tvak shosha, Kaunya, Angulipatana, Anga patina,
Karna nasa bhanga, etc.

Odour/ Srava/ Krimi/ etc:

• Visra gandha, etc.
• Puya srava/ Lasika srava/ Puya rakta/ Lasika srava/ Bahu bahala picchila rakta srava etc.
• Krimi janma, etc.

Type of skin *Palpation *Sensory *Deformity *Odour/ Srava/

lesion (Texture/ symptoms Krimi
temperature) (Tvak
swapa/
daha)

141
 Special tests:

Special tests Observation Inference

Candle grease sign

Auspitz’s sign

Koebner’s phenomenon

Blanch test

Nikolsky’s sign

Any other observations

Any other special tests and observations can be mentioned here:

Nakha pareeksha - Assessment of nail and nail bed:

*Abnormalities like clubbing of fingers, paronychia, onycholysis, Terry’s nails, white spots
(leukonychia), transverse white lines (Mees’ lines), Pitting of nails - Psoriasis, and Beau’s lines

Nail:

*Features to be examined Observation Inference

Colour

Shape

Any lesion

142
Nail bed:

• Nail bed tenderness – Present/ Absent Swelling –

Present/ Absent
• Redness – Present/ Absent

Kesha pareeksha - Assessment of hair:

*Distribution Khalitya (Alopecia Areata, Androgenetic Alopecia, Central Centrifugal Cicatricial

Alopecia, Chemotherapy Induced)

Alopecia, Frontal Fibrosing Alopecia, Lichen Planopilaris, Telogen Effluvium, Traction

Alopecia, Trichotillomania) and Palitya (colour):

*Features to be examined Observation Inference

Quantity

Distribution

Texture

Colour

143
Tick Appropriate:

Onset of Khalitya: Kalaja/ Akalaja Onset of Palitya:

Kalaja/ Akalaja

Write your inference on below mentioned points:

Sl. Parameters to be assessed Item observed in patient Rationality

No
1 Dosha – Anubandhya and
Anubandha dosha

2 Dushya

Conduct a comprehensive assessment by considering history (including upashaya anupashaya), a

thorough physical examination, systemic examination, and relevant investigations. Additionally,
perform a differential diagnosis (sapeksha and vyavachedaka nidana) based on the gathered data.

Student’s signature Teacher’s signature

144
 SERIAL NO: 6 CLINICAL NO: C 6.12

6. Activity Name

Integumentary system examination

7. Activity Description:

Perform and record integumentary system examination of patient. Write your observations and
inference on possible conditions the patient is suffering from.

8. Materials and Equipment:

Case format, Pen torch, Magnifying glass, Glass slide, Scale or skin callipers, Markers,
Disposable tissues or wipes and Hand sanitizer.

9. Patient information:

Age:
Sex: M/ F/Others
Marital status:
Education:
Occupation:
Religion:
Socio-economic status:
Date of Consultation:
Out Patient Number:
Date of Admission:
In Patient Number:
Bed number:
Place of residence:

145
 10. Integumentary system examination:

Prashna pareeksha – Short history (Including upashaya anupashaya) – Relevant to the patient:

Tvak pareeksha - Assessment of skin:

Inspection:

Varna/ Colour: Shyava aruna, Raga, Shweta, Krishna, Aruna, Raktaparyanta, Shyava, Taamra,
Peetaparyanta, Neela, Peeta, Varnabheda, etc.

Size and shape: Khara paryanta, Utsanna madhya, Tanu paryanta, Hrsva, Dheergha, Mandala,
Vishama, Vistrta, Yagjnopaveeta sankasha, etc.
Dome shaped – Trichoepithelioma, Flat topped - Verruca plana, Umbilicated - Molluscum
contagiosum, Acuminate - Condylomata acuminata, Verrucous - Verruca vulgaris, Pedunculated –
Skin tags.
Configuration: Annular - T. corporis, Granuloma annulare, Round/ discoid - Nummular eczema,
discoid lupus. Polycyclic - Urticaria, Sub Cutaneous Lupus Erythematosus, Arcuate - Urticaria.
Linear - Scabies burrow, Lichen nitidus. Kobners phenomenon. Reticular - Livedo reticularis,
Serpiginous - cutaneous larva migrans, Targetoid lesions- with 3 distinct zones. Erythema
multiforme. Whorled - Incontinentia pigmenti.

Arrangement of lesion: Grouped/ herpetiform - HSV-1, Scattered

Distribution of lesions: Dermatomal/ zosteriform. Blaschkoid - Following lines of skin cell

migration during embryogenesis. Longitudinal on limbs. Circumferential on trunk. Lymphangitic -
strep. Or staph cellulitis. Sun exposed - Photodermatitis, Polymorphous Light Eruption,
Subcutaneous Lupus Erythematosus, Sun protected - Parapsoriasis, Mycosis fungoides. Acral -
Chilblains, Palmoplantar pustulosis. Truncal, Extensor – Psoriasis, Flexor-atopic dermatitis,
Intertriginous – Candidiasis, Localized – Cellulitis, Generalized- exanthema, Drug eruptions. B/L
(Bilateral) symmetrical – Vitiligo. Universal - Alopecia universalis.

146
 *Type of skin 1Colour and 1Configuration Arrangement of Distribution
Size
lesion (Primary) pigmentation of and symmetry of lesion over the
lesion lesion body
surface

Vaivarnya –
Macule/ Patch

Sookshma
pidaka -
Papule
Udvrtta pidaka
- Plaque

Granthi - Nodule

Varathi dashta
samsthana
shotha -
Wheal

Sphota - Vesicle

Vishphota –
Bullae

Putimamsa
pidaka -
Pustule

147
 *Type of skin lesion Colour and Size Shape and Distribution over the
(Secondary) pigmentation symmetry body surface
Grushta Vrana - Erosion

Vrana - Ulcer

Daari - Fissure

Sthira cipitika - Crust

Shakala - Scale

Charmakhya –
Lichenification and
Hyperkeratinisation
Kshaya - Atrophy

Rajyo ati kandu - Excoriation

Vruna vastu – Scar

Neelika, Mashaka – Nevus

Pidaka – Comedone

Bahya Krimi pidaka - Burrow of

scabies
Sirajala – Telangiectasia

Any other

Palpation/ sensation/ deformities/ odour:

*Enquire and perform for following parameters:

Palpation:

148
Specify – Rooksha, Khara, Parushya, Daha, Kleda, Snigdha, Shaitya, Ghana, etc.

Sensory symptoms: Specify – Toda (Sparsha akshamatva), Prakwatita daha, Tvak svapa, Harsha,
etc.

Deformity: Tvak sankocha, Tvak ayaama, Tvak shosha, Kaunya, Angulipatana, Anga patina,
Karna nasa bhanga, etc.

Odour/ Srava/ Krimi/ etc:

Visra gandha, etc.
Puya srava/ Lasika srava/ Puya rakta/ Lasika srava/ Bahu bahala picchila rakta srava etc.
Krimi janma, etc.

Type of skin *Palpation *Sensory *Deformity *Odour/ Srava/

lesion (Texture/ symptoms Krimi
temperature) (Tvak
swapa/
daha)

149
Special tests:

Special tests Observation Inference

Candle grease sign

Auspitz’s sign

Koebner’s phenomenon

Blanch test

Nikolsky’s sign

Any other observations

Any other special tests and observations can be mentioned here:

Nakha pareeksha - Assessment of nail and nail bed:

*Abnormalities like clubbing of fingers, paronychia, onycholysis, Terry’s nails, white spots
(leukonychia), transverse white lines (Mees’ lines), Pitting of nails - Psoriasis, and Beau’s lines

Nail:
*Features to be examined Observation Inference

Colour

Shape

Any lesion

150
Nail bed:

Nail bed tenderness – Present/ Absent Swelling – Present/

Absent
Redness – Present/ Absent

Kesha pareeksha - Assessment of hair:

*Distribution Khalitya (Alopecia Areata, Androgenetic Alopecia, Central Centrifugal Cicatricial Alopecia,
Chemotherapy Induced)

Alopecia, Frontal Fibrosing Alopecia, Lichen Planopilaris, Telogen Effluvium, Traction

Alopecia, Trichotillomania) and Palitya (colour):

*Features to be Observation Inference

examined
Quantity

Distribution

Texture

Colour

151
Tick Appropriate:

Onset of Khalitya: Kalaja/ Akalaja Onset of Palitya:

Kalaja/ Akalaja

Write your inference on below mentioned points:

Sl. Parameters to be assessed Item observed in patient Rationality

No
1 Dosha – Anubandhya and
Anubandha dosha

2 Dushya

Conduct a comprehensive assessment by considering history (including upashaya anupashaya), a

thorough physical examination, systemic examination, and relevant investigations. Additionally,
perform a differential diagnosis (sapeksha and vyavachedaka nidana) based on the gathered data.

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SERIAL NO: 7 CLINICAL NO: C 7.1

Anemia evaluation – ABC (45 years) has been experiencing fatigue, weakness, and shortness of
breath for the past few months. He has noticed a decrease in his exercise tolerance and feels tired
even after minimal physical exertion. He denies any significant weight loss, changes in appetite,
or other associated symptoms. His medical history is unremarkable, and he takes no regular
medications. There is no family history of anemia or other significant medical conditions.

Initial Physical Examination:

• General appearance: Pale conjunctiva and skin

• Vital signs: Blood pressure 120/80 mmHg, pulse rate 90 bpm, respiratory rate 16 breaths
per minute, temperature 98.6°F (37°C)
• Cardiovascular examination: Regular heart sounds, no murmurs
• Respiratory examination: Normal breath sounds
• Abdominal examination: No hepatosplenomegaly or masses
• Extremities: No peripheral edema or clubbing

List of Tests for Anaemia Evaluation:

Preliminary tests:
1. Complete Blood Count (CBC): Red blood cells (RBCs), Hemoglobin, Hematocrit, Mean
corpuscular volume (MCV), Mean corpuscular hemoglobin (MCH), Mean corpuscular
hemoglobin concentration (MCHC), and Red cell distribution width (RDW)
2. Peripheral Blood Smear
3. Reticulocyte Count
Further investigation:
4. Iron Studies: Serum iron, Total iron-binding capacity (TIBC), and Ferritin levels
5. Vitamin B12 and Folate Levels
6. Renal Function Tests
7. Bone Marrow Aspiration and Biopsy

Mention the patient preparation, sample collection, type of investigation, indication, and
interpretation of Sl. No 1(Excluding platelets) and 2

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Materials required: Format to fill, Laboratory methods/ Clinical pathology textbooks if required.

1. Complete Blood Count (CBC): Red blood cells (RBCs), hemoglobin, hematocrit, mean
corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), meancorpuscular
hemoglobin concentration (MCHC), and Red cell distribution width (RDW)

Patient preparation:

Sample collection:

Type of investigation:

Indication:

Interpretation:

2. Peripheral Blood Smear:

Patient preparation:

Sample collection:

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 Type of investigation:

Indication:

Interpretation:

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 ROGA NIDAN EVAM VIKRITI VIGYAN ACTIVITY BOOK

SERIAL NO: 7 CLINICAL NO: C 7.2

UTI evaluation – ABC (30 years) complains of increased frequency of urination, accompanied
by a burning sensation during urination and lower abdominal pain for the past two days. She
denies any fever, back pain, or blood in the urine. ABC has a history of recurrent UTIs and is
sexually active. She has no known allergies and takes no regular medications.

Initial Physical Examination:

• Vital signs: Blood pressure 120/80 mmHg, pulse rate 80 bpm, respiratory rate 16 breaths
per minute, temperature 98.6°F (37°C)
• Abdominal examination: Mild tenderness in the lower abdomen
• Genitourinary examination: No abnormal findings, no cervical discharge

List of Tests for UTI Evaluation:

Preliminary tests:
1. Urinalysis:
Urine physical examination (Appearance, Colour, Odor, Urine specific gravity)
Urine chemical examination (Urine-pH, Sugar, Albumin, Bile pigment, Bile salt, Occult
blood, Ketones, Urobilinogen)
Urine microscopic examination (Epithelial cells, WBCs, RBCs, Leukocytes, Casts,
Crystals and) bacteria (suggesting a bacterial infection)
2. Complete Blood Count (CBC)
3. C-reactive protein (CRP)
Further investigation:
4. Urine Culture and Sensitivity
5. Imaging Studies: Ultrasound or CT scan.
6. VDRL
7. Urethral Swab or Vaginal Swab.

Mention the patient preparation, sample collection, type of investigation, indication, and
interpretation of Sl. No 1 and 6.

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Materials required: Format to fill, Laboratory methods/ Clinical pathology textbooks if required.

1. Urinalysis: Urine physical examination (Appearance, Color, Odor, Specific gravity),

chemical examination (Urine-pH, Sugar, Albumin, Bile pigment, Bile salt, blood, Ketone,
Urobilinogen), Microscopic Examination (Epithelial cells, WBCs, RBCs, Leukocytes,
Casts, Crystals) and bacteria (suggesting a bacterial infection):

Patient preparation:

Sample collection:

Type of investigation:

Indication:

Interpretation:

2. VDRL:

Patient preparation:

Sample collection:

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 Type of investigation:

Indication:

Interpretation:

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 ROGA NIDAN EVAM VIKRITI VIGYAN ACTIVITY BOOK

SERIAL NO: 7 CLINICAL NO: C 7.3

Hepatic evaluation – ABC (50 years) presents with complaints of persistent abdominal pain,
yellowing of the skin and eyes (jaundice), and significant fatigue. He has a long history of heavy
alcohol consumption, consuming approximately 8 to 10 alcoholic drinks per day for the past 20
years. He admits to having trouble controlling his alcohol intake and has previously experienced
episodes of alcohol-related liver inflammation. He has no known allergies and takes no regular
medications.

Initial Physical Examination:

• General appearance: Jaundiced, fatigue

• Vital signs: Blood pressure 130/80 mmHg, pulse rate 90 bpm, respiratory rate 18 breaths
per minute, temperature 99.1°F (37.3°C)
• Abdominal examination: Tenderness in the right upper quadrant, hepatomegaly
(enlarged liver), and possibly splenomegaly (enlarged spleen)
• Skin examination: Spider angiomas (tiny blood vessels visible on the skin), palmar
erythema (redness of the palms), and jaundice

List of Tests for Alcoholic Liver Disease (ALD) Evaluation:

Preliminary tests:
1. Liver Function Tests: AST, ALT, GGT, Bilirubin levels, Protein levels,
Prothrombin time, Clotting time.
2. Imaging Studies: Abdominal Ultrasound
Further investigation:
3. Complete Blood Count (CBC)
4. Imaging Studies: FibroScan or Transient Elastography
5. Viral Hepatitis Serology
6. Serum Ferritin and Iron Studies
7. Alpha-fetoprotein (AFP) Level
8. Coagulation Profile
9. Gastroscopy

Mention the patient preparation, sample collection, type of investigation, indication, and
interpretation of Sl. No 1 and 8.

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 Materials required: Format to fill, Laboratory methods/ Clinical pathology textbooks if
required.

1. Liver Function Tests: AST, ALT, and GGT, bilirubin levels, albumin levels, and
prothrombin time, clotting time

Patient preparation:

Sample collection:

Type of investigation:

Indication:

Interpretation:

2. Coagulation profile

Patient preparation:

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 Sample collection:

Type of investigation:

Indication:

Interpretation:

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SERIAL NO: 7 CLINICAL NO: C 7.4

Renal evaluation – ABC (60 years) presents with complaints of persistent fatigue, decreased
urine output, and swelling in her legs for the past few months. She has a medical history of
hypertension and diabetes, both of which have been poorly controlled. She also reports a family
history of kidney disease. She takes medications for her underlying conditions but admits to being
non-compliant with her prescribed medications. She has no known allergies.

Initial Physical Examination:

• General appearance: Fatigue and lethargy

• Vital signs: Blood pressure 160/90 mmHg, pulse rate 80 bpm, respiratory rate 16 breaths
per minute, temperature 98.6°F (37°C)
• Abdominal examination: No specific findings
• Extremities examination: Lower extremity edema

List of Tests for Chronic Kidney Disease (CKD) Evaluation:

Preliminary tests:
1. Renal Function Tests: Serum Creatinine, Blood Urea Nitrogen (BUN), Serum uric acid
2. Estimated Glomerular Filtration Rate (eGFR)
3. Urinalysis
4. Urine Albumin-to-Creatinine Ratio (ACR)
5. Imaging Studies: Renal Ultrasound
Further investigation:
6. Complete Blood Count (CBC)
7. Electrolyte Levels: Serum Potassium, Serum Sodium and Serum Chloride
8. Serum Calcium and Phosphate
9. Lipid Profile
10. Blood Glucose Levels
11. Kidney Biopsy

Mention the patient preparation, sample collection, type of investigation, indication, and
interpretation of Sl. No 1, 4, 7 and 8

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 Materials required: Format to fill, Laboratory methods/ Clinical pathology textbooks if
required.

1. Renal Function Tests: Serum Creatinine, Blood Urea Nitrogen (BUN), Serum uric
acid

Patient preparation:

Sample collection:

Type of investigation:

Indication:

Interpretation:

2. Urine Albumin-to-Creatinine Ratio (ACR)

Patient preparation:

Sample collection:

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 Type of investigation:

Indication:

Interpretation:

3. Electrolyte Levels: Serum Potassium, Serum Sodium and Serum Chloride

Patient preparation:

Sample collection:

Type of investigation:

Indication:

Interpretation:

164
4. Serum Calcium and Phosphate

Patient preparation:

Sample collection:

Type of investigation:

Indication:

Interpretation:

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SERIAL NO: 7 CLINICAL NO: C 7.5

Thyroid evaluation – ABC (35 years) presents with complaints of persistent fatigue, unexplained
weight gain, feeling cold all the time, and constipation. She has noticed a decrease in her energy
levels and a gradual increase in her weight over the past few months. She has a family history of
thyroid disorders. She takes no regular medications and has no known allergies.

Initial Physical Examination:

• General appearance: Fatigue and lethargy

• Vital signs: Blood pressure 120/80 mmHg, pulse rate 70 bpm, respiratory rate 16 breaths
per minute, temperature 98.6°F (37°C)
• Skin examination: Dry skin, hair loss, and brittle nails
• Neurological examination: Slow reflexes, slow speech, and slowed mental processes

List of Tests for Hypothyroidism Evaluation:

Preliminary tests:

1. Thyroid Function Tests: Thyroid-Stimulating Hormone (TSH) Level, T3, T4,F T3, F T4
2. Antithyroid Antibodies (Anti-thyroid peroxidase)
Further investigation:

3. Lipid Profile
4. Complete Blood Count (CBC)
5. Additional tests: Basal Body Temperature, Serum Prolactin Level, Electrocardiogram
(ECG)

Mention the patient preparation, sample collection, type of investigation, indication, and
interpretation of Sl. No 1

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 Materials required: Format to fill, Laboratory methods/ Clinical pathology
textbooks ifrequired.

1. Thyroid Function Tests: Thyroid-Stimulating Hormone (TSH) Level, T3, T4,

F T3, FT4

Patient preparation:

Sample collection:

Type of investigation:

Indication:

Interpretation:

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 ROGA NIDAN EVAM VIKRITI VIGYAN ACTIVITY BOOK

SERIAL NO: 7 CLINICAL NO: C 7.6

Diabetes Mellitus evaluation – XYZ (45 years) presents with complaints of increased thirst,
frequent urination, and unexplained weight loss over the past few months. He also reports feeling
tired and experiencing blurred vision. He has a family history of diabetes. He takes no regular
medications and has no known allergies.

Initial Physical Examination:

• General appearance: Alert and oriented

• Vital signs: Blood pressure 130/80 mmHg, pulse rate 80 bpm, respiratory rate 16 breaths
per minute, temperature 98.6°F (37°C)
• Skin examination: No specific findings
• Neurological examination: No abnormalities

List of Tests for Diabetes Mellitus Evaluation:

Preliminary tests:
1. Fasting Plasma Glucose (FPG) Test
2. Postprandial Plasma Glucose (PPPG)
3. Glycated Hemoglobin (HbA1c) Test
Further investigation:
4. Oral Glucose Tolerance Test (OGTT)
5. Urine Analysis
6. Lipid Profile
7. Kidney Function Tests: Serum Creatinine, Blood Urea Nitrogen (BUN), Urine Albumin-
to-Creatinine Ratio (ACR)
8. C- peptide Level
9. Liver Function Tests
10. Thyroid Function Tests
11. Additional Tests: Autoantibodies (Islet cell antibodies, Insulin autoantibodies)

Mention the patient preparation, sample collection, type of investigation, indication, and
interpretation of Sl. No 1 to 4 and Sl. No 8

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 Materials required: Format to fill, Laboratory methods/ Clinical pathology textbooks if
required.

1. Fasting Plasma Glucose (FPG) Test

Patient preparation:

Sample collection:

Type of investigation:

Indication:

Interpretation:

2. Postprandial Plasma Glucose (PPPG)

Patient preparation:

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 Sample collection:

Type of investigation:

Indication:

Interpretation:

3. Glycated Hemoglobin (HbA1c) Test

Patient preparation:

Sample collection:

Type of investigation:

170
 Indication:

Interpretation:

4. Oral Glucose Tolerance Test (OGTT)

Patient preparation:

Sample collection:

Type of investigation:

Indication:

171
 Interpretation:

5. C – Peptide level

Patient preparation:

Sample collection:

Type of investigation:

Indication:

Interpretation:

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SERIAL NO: 7 CLINICAL NO: C 7.7

Stroke evaluation – ABC (60 years) presents with a sudden onset of weakness and numbness on
the right side of his body. He has difficulty speaking and experiences confusion. There is no
history of trauma or seizure activity. He has a past medical history of hypertension and smoking.
He takes antihypertensive medication but is non-compliant with his treatment. He has no known
allergies.

Initial Physical Examination:

• General appearance: Alert but appears anxious and distressed

• Vital signs: Blood pressure 160/90 mmHg, pulse rate 80 bpm, respiratory rate 18 breaths
per minute, temperature 98.6°F (37°C)
• Neurological examination: Right-sided hemiparesis (weakness), right-sided sensory loss,
dysarthria (difficulty speaking), and facial droop on the right side

List of Tests for Atherosclerotic Stroke Evaluation:

Preliminary tests:
1. Non-Contrast Computed Tomography (CT) Scan of the Brain
2. Magnetic Resonance Imaging (MRI) of the Brain
3. Lipid Profile: Total cholesterol, LDL cholesterol, HDL cholesterol, and Triglycerides
Further investigations:
4. Diabetic profile
5. Renal Function Tests
6. Electrocardiogram (ECG)
7. Carotid Doppler Ultrasound
8. Coagulation Profile
9. Complete Blood Count (CBC)
10. Additional Tests: Carotid Angiography, Holter Monitor
11. Transthoracic Echocardiogram (TTE) or Transesophageal Echocardiogram (TEE)

Mention the patient preparation, sample collection, type of investigation, indication, and
interpretation of Sl. No 3

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 Materials required: Format to fill, Laboratory methods/ Clinical pathology textbooks if required.

1. Total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides

Patient preparation:

Sample collection:

Type of investigation:

Indication:

Interpretation:

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 ROGA NIDAN EVAM VIKRITI VIGYAN ACTIVITY BOOK

SERIAL NO: 7 CLINICAL NO: C 7.8

Arthritis evaluation – ABC (55 years) presents with complaints of joint pain, swelling, and
stiffness in her hands, wrists, and knees. She reports that the symptoms have been persistent for
the past few months and have been affecting her daily activities. She does not recall any recent
injuries or trauma to the joints. She has no significant past medical history and no known allergies.

Initial Physical Examination:

• General appearance: Alert and in mild discomfort

• Vital signs: Blood pressure 120/80 mmHg, pulse rate 72 bpm, respiratory rate 16 breaths
per minute, temperature 98.6°F (37°C)
• Musculoskeletal examination: Swelling and tenderness in the small joints of the hands
and wrists, as well as the knees. Limited range of motion and crepitus may be noted.

List of Tests for Arthritis Evaluation:

Preliminary tests:
1. Rheumatoid Factor (RF), Antistreptolysin O (ASO) and Anti-Cyclic Citrullinated
Peptide (anti-CCP) Antibody
2. Uric Acid Level
3. Erythrocyte Sedimentation Rate (ESR), C-Reactive Protein (CRP) Level
4. X-rays
Subsequent tests:
5. Antinuclear Antibodies (ANA) Profile
6. Complete Blood Count (CBC): White blood cell count and platelet
7. Joint Fluid Analysis
8. Ultrasound or Magnetic Resonance Imaging (MRI)

Mention the patient preparation, sample collection, type of investigation, indication, and
interpretation of Sl. No 1 (RF & ASO), 3 (CRP)

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Materials required: Format to fill, Laboratory methods/ Clinical pathology textbooks if required.

1. RF/ ASO/ CRP

Patient preparation:

Sample collection:

Type of investigation:

Indication:

Interpretation:

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 ROGA NIDAN EVAM VIKRITI VIGYAN ACTIVITY BOOK

SERIAL NO: 7 CLINICAL NO: C 7.9

Fever evaluation – ABC (32 years) presents with complaints of persistent fever, abdominal pain,
and gastrointestinal symptoms for the past week. She reports experiencing high-grade fever,
reaching up to 104°F (40°C), along with severe headaches and body aches. She also mentions
having abdominal pain, particularly in the right lower quadrant, and experiencing diarrhea with
loose, watery stools. She denies any recent travel but mentions consuming food from street
vendors. She has no significant past medical history and no known allergies.

Initial Physical Examination:

• General appearance: Fatigued, mildly dehydrated

• Vital signs: Blood pressure 120/80 mmHg, pulse rate 100 bpm, respiratory rate 18
breaths per minute, temperature 102.2°F (39°C)
• Abdominal examination: Tenderness in the right lower quadrant, possible hepatomegaly
(enlarged liver)

List of Tests for Fever Evaluation:

Preliminary tests:

1. Complete Blood Count (CBC): Platelet, Total Leukocyte Count, Differential Leukocyte
Count and Erythrocyte Sedimentation Rate
2. Bleeding time
3. Widal Test
4. Malarial parasite (Peripheral smear/ card test)
5. Dengue NS 1 – IgG, IgM (Card test)
6. Leptospirosis test
7. Urinalysis
8. Chest X-ray
Further investigation:
9. Blood Culture
10. Abdominal Ultrasound
11. Stool Culture
12. HIV Testing
13. Liver Function Tests

Mention the patient preparation, sample collection, type of investigation, indication, and
interpretation of Sl. No 1, 2, 3, 4 and 5

177
Interpretation of sl. No 1, 2, 3, 4 and 5

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Materials required: Format to fill, Laboratory methods/ Clinical pathology textbooks if required.

1.Complete Blood Count (CBC) – Platelet, Total Leukocyte Count, Differential

Leukocyte Count, and Erythrocyte Sedimentation Rate

Patient preparation:

Sample collection:

Type of investigation:

Indication:

Interpretation:

2. Bleeding time

Patient preparation:

Sample collection:

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 Type of investigation:

Indication:

Interpretation:

3. Widal test

Patient preparation:

Sample collection:

Type of investigation:

Indication:

Interpretation:

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4. Malarial parasite (Peripheral smear/ card test)

Patient preparation:

Sample collection:

Type of investigation:

Indication:

Interpretation:

5. Dengue NS 1 – IgG, IgM (Card test)

Patient preparation:

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 Sample collection:

Type of investigation:

Indication:

Interpretation:

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 ROGA NIDAN EVAM VIKRITI VIGYAN ACTIVITY BOOK

SERIAL NO: 7 CLINICAL NO: C 7.10

Male infertility evaluation – ABC (32 years) presents with a complaint of difficulty in
conceiving a child with his partner despite trying for more than a year. He and his partner have
been engaging in regular unprotected sexual intercourse without any success. ABC reports no
prior history of fertility issues or significant medical conditions. He denies any recent infections,
surgeries, or exposure to environmental toxins. His partner has undergone a thorough
gynecological evaluation and has been deemed medically fit for conception.

Initial Physical Examination:

• General appearance: No apparent abnormalities

• Vital signs: Blood pressure 120/80 mmHg, pulse rate 80 bpm, respiratory rate 16 breaths
per minute, temperature 98.6°F (37°C)
• External genital examination: Normal appearance of the penis, scrotum, and testes

List of Tests for Male Infertility Evaluation:

Preliminary tests:
1. Semen Analysis: Assess the quantity, quality, and motility of sperm. Parameters
evaluated include sperm count, motility, morphology (shape), and presence of any
abnormalities or infections.
Further investigation:
2. Hormonal Profile: Testosterone, Follicle-Stimulating Hormone (FSH), Luteinizing
Hormone (LH), Prolactin
3. Ultrasound Imaging (Scrotal)
4. Post-Ejaculatory Urinalysis

Mention the patient preparation, sample collection, type of investigation, indication, and
interpretation of Sl. No 1

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Materials required: Format to fill, Laboratory methods/ Clinical pathology textbooks if required.

1. Semen Analysis: Assess the quantity, quality, and motility of sperm. Parameters evaluated
include sperm count, motility, morphology (shape), and presence of any abnormalities or
infections

Patient preparation:

Sample collection:

Type of investigation:

Indication:

Interpretation:

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 ROGA NIDAN EVAM VIKRITI VIGYAN ACTIVITY BOOK

SERIAL NO: 7 CLINICAL NO: C 7.11

Helminthiasis evaluation – XYZ (35 years) presents to the clinic with complaints of persistent
abdominal pain, nausea, and weight loss over the past month. He also mentions noticing worms
in his stool. XYZ has no significant medical history and has never experienced similar symptoms
before.

Initial Physical Examination:

Upon examination, the physician notices mild tenderness in the right lower quadrant of the
abdomen. There are no other remarkable findings on physical examination

List of Tests for Ascariasis Evaluation:

Preliminary tests:
1. Stool Examination: (Colour, Consistency. Microscopy - Ova , Cyst, Pus
cells)Further investigation:
2. Complete Blood Count (CBC)
3. Imaging Studies (CT scan)

Mention the patient preparation, sample collection, type of investigation, indication, and
interpretation of Sl. No 1

Materials required: Format to fill, Laboratory methods/ Clinical pathology textbooks if required.

1. Stool Examination: (Colour, Consistency. Microscopy - Ova , Cyst, Pus cells)

Patient preparation:

185
 Sample collection:

Type of investigation:

Indication:

Interpretation:

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 ROGA NIDAN EVAM VIKRITI VIGYAN ACTIVITY BOOK

SERIAL NO: 8 CLINICAL NO: C 8.1

1. Activity Name

X-Ray reading (Basics – Positioning, etc.)

2. Activity Description:

Evaluate chest X-Ray for positioning, rotation, and penetration.

3. Materials and Equipment:

Format to fill, Books related to radiology if required, X Ray films.

4. Basics of X Ray:

Positioning:

Rotation:

Penetration:

Any other observations:

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 Write your inference on the given X-Ray:

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 ROGA NIDAN EVAM VIKRITI VIGYAN ACTIVITY BOOK

SERIAL NO: 8 CLINICAL NO: C 8.2

1. Activity Name

X-Ray reading and interpretation (Chest)

2. Activity Description:

Evaluate chest X-Ray for Airway and tracheobronchial tree, Bones and Bony Structures,
Cardiac Silhouette, Diaphragm, Effusions (Pleural), Fields (Lung Fields), Gastric Bubble
(Stomach), and Hilum. Write your comments on the given X-Ray.

3. Materials and Equipment:

Format to fill, Books related to radiology if required, X Ray films.

4. Chest X Ray:

Airway and tracheobronchial tree:

Bones and Bony Structures:

Cardiac Silhouette:

Diaphragm:

Effusions (Pleural):

189
Fields (Lung Fields):

Gastric Bubble (Stomach):

Hilum:

Any other observations:

Write your inference on the given X-Ray:

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 ROGA NIDAN EVAM VIKRITI VIGYAN ACTIVITY BOOK

SERIAL NO: 8 CLINICAL NO: C 8.3

1. Activity Name

X-Ray reading and interpretation (Bones and Joints)

2. Activity Description:

Evaluate X-Ray for various bone and joints. Write your comments on the given X-Ray.

3. Materials and Equipment:

Format to fill, Books related to radiology if required, X Ray films.

4. Bones and joints X Ray:

Study Details:

Imaging Modality: X-ray -

Body Part: (Specific bones or joints examined) -

Radiographic Views: (Specific views obtained) -

Technique: (Exposure details, if available) -

Findings:

List and describe the relevant bones or joints examined -

Provide a detailed description of the observed abnormalities, including fractures,

dislocations, joint space narrowing, bone density changes, or any other significant
findings -

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Include measurements or quantitative details, if applicable -

Impression:

Provide a concise summary of the overall findings -

Mention any specific diagnosis, if possible -

Indicate the significance or clinical relevance of the observed abnormalities -

Recommend any additional imaging studies or consultations, if necessary -

Recommendations:

Suggest any further diagnostic steps or follow-up examinations -

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 ROGA NIDAN EVAM VIKRITI VIGYAN ACTIVITY BOOK

SERIAL NO: 9 CLINICAL NO: C 9.1

1. Activity Name

Basic ECG interpretation

2. Activity Description:

Evaluate ECG for any abnormalities. Write your comments on the given ECG.

3. Materials and Equipment:

Format to fill, Books related to ECG if required, ECG.

4. ECG interpretation:

ECG reporting:

ECG Technical Details:

A. ECG lead configuration (standard or modified) -

B. Paper speed (25 mm/s or 50 mm/s) -
C. Calibration (in millivolts per millimeter) -
D. Any artifacts or technical issues encountered during the recording -

Heart Rate and Rhythm:

A. Heart rate (calculated or measured) -

B. Rhythm interpretation (sinus rhythm, atrial fibrillation, etc.) -
C. Presence of any ectopic beats or arrhythmias -

P-Wave Analysis:

A. P-wave morphology (duration, amplitude, and shape) -

B. Presence of P-wave abnormalities (e.g., P-wave abnormalities indicating atrial
enlargement) -

PR Interval:

A. PR interval duration -
B. Assessment of atrioventricular conduction -

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 QRS Complex:

A. QRS complex duration -

B. Assessment of ventricular conduction and morphology – ST Segment:

A. ST segment morphology (elevation, depression, or isoelectric) -

B. Presence of ST segment abnormalities indicating myocardial ischemia or injury - T-Wave

Analysis:

A. T-wave morphology (symmetry, amplitude, and shape) -

B. Presence of T-wave abnormalities (inversion, flattening, or peaked T-waves) - QT Interval:

A. QT interval duration -
B. Assessment of QT interval prolongation - Axis and

Intervals:

A. Electrical axis of the heart (normal or deviated) -

B. Measurement of other intervals (e.g., PR, QRS, QTc) - Additional

Findings:

A. Any additional findings, such as ventricular hypertrophy, chamber enlargement,

or ST-Twave abnormalities -

Clinical Impression:

A. Interpretation and overall impression of the ECG -

B. Differential diagnosis and possible clinical implications –

Recommendations:

A. Suggested follow-up or additional investigations, if necessary -

Student’s signature Teacher’s signature

194
 SERIAL NO: 9 CLINICAL NO: C 9.2

5. Activity Name

Basic ECG interpretation

6. Activity Description:

Evaluate ECG for any abnormalities. Write your comments on the given ECG.

7. Materials and Equipment:

Format to fill, Books related to ECG if required, ECG.

8. ECG interpretation:

ECG reporting:

ECG Technical Details:

A. ECG lead configuration (standard or modified) -

B. Paper speed (25 mm/s or 50 mm/s) -
C. Calibration (in millivolts per millimeter) -
D. Any artifacts or technical issues encountered during the recording -

Heart Rate and Rhythm:

D. Heart rate (calculated or measured) -

E. Rhythm interpretation (sinus rhythm, atrial fibrillation, etc.) -
F. Presence of any ectopic beats or arrhythmias -

P-Wave Analysis:

C. P-wave morphology (duration, amplitude, and shape) -

D. Presence of P-wave abnormalities (e.g., P-wave abnormalities indicating atrial
enlargement) -

PR Interval:

C. PR interval duration -
D. Assessment of atrioventricular conduction -

195
QRS Complex:

C. QRS complex duration -

D. Assessment of ventricular conduction and morphology –

ST Segment:

C. ST segment morphology (elevation, depression, or isoelectric) -

D. Presence of ST segment abnormalities indicating myocardial ischemia or injury - T-

Wave Analysis:

C. T-wave morphology (symmetry, amplitude, and shape) -

D. Presence of T-wave abnormalities (inversion, flattening, or peaked T-waves) - QT

Interval:

C. QT interval duration -
D. Assessment of QT interval prolongation - Axis

and Intervals:

C. Electrical axis of the heart (normal or deviated) -

D. Measurement of other intervals (e.g., PR, QRS, QTc) -

Additional Findings:

B. Any additional findings, such as ventricular hypertrophy, chamber

enlargement, or ST-Twave abnormalities -

Clinical Impression:

C. Interpretation and overall impression of the ECG -

D. Differential diagnosis and possible clinical implications –

Recommendations:

B. Suggested follow-up or additional investigations, if necessary -

Student’s signature Teacher’s signature

196
 ROGA NIDAN EVAM VIKRITI VIGYAN ACTIVITY BOOK

SERIAL NO: 10 CLINICAL NO: 10.1

Write in detail the case of a patient with details furnished under specific headings (For subheadings
and reporting refer previous activities)

1. Patient information:

Age:

Sex: M/ F/Others

Marital status:

Education:

Occupation:

Religion:

Socio-economic status:

Date of Consultation:

Outpatient Number:

Date of Admission:

In Patient Number:

Bed number:

Place of residence:

197
2. Pradhana Vedana with Kala prakarsha (Chief complaints with duration):

3. Vedanasammuchraya (History of present illness ):

198
4. Poorvavyadhi Vruttanta (History of Past illness):

5. Chikitsa Vruttanta (Treatment history)

199
 6. Kula Vruttanta (Family history) Along with pedigree chart:

7. Samajika Vruttanta (Social history):

200
8. Vayaktika Vruttanta (Personal history):

9. General physical examination:

201
10. Systemic examination/ Srotopareeksha (General systemic and Local systemic/
Examination of affected system

11. Investigations (Available reports and suggested investigations):

202
12. Differential diagnosis/ Sapekshanidana:

13. Vyadhi vinischaya (Diagnosis):

203
 14. Samprapti ghataka (Samprapti ghataka of the patient based on history taking and
examination):

Dosha: Shareerika

Vriddhi / Kshaya
Samsarga / Sannipata:
Sama samsarga / sannipata
Or Vishama samsarga / sannipata
Anubandha -
Anubandhya -
Dosha bheda:
Gati: Urdhva / Adha / Tiryak; Shakha / Koshta / Marma asthi sandhi

Dosha: Manasika

Raja / Tama

Dushya:
Write Vriddhi/ Kshaya/ Dushti of Dhatu(Specify)
Upadhatu (Specify)
Mala (Specify) Manas
(Specify) Indriya
(Specify) Avayava
(Specify)

Srotas: Primary srotas (Specify)

Secondary srotas (Specify)

Sroto dushti lakshana: Primary sroto dushti (Specify)

Secondary sroto dushti (Specify)

Agni: Koshtagni: Sama / Vishama / Teekshna / Manda

Dhatwagni: Sama / Manda
Bhutagni: Sama / Manda

Ama: Koshtastha ama / Dhatugata ama / Malarupi ama / Dosharupi ama

Udbhava sthana: Amashaya / Pakvashaya

Vyakta sthana: Sarva dehika / Sthanika (Specify)

Bahya rogamarga / Madhyama rogamarga / Abhyantara rogamarga

204
15. Sadhyasadhyata (with rationality)

Student’s signature Teacher’s signature

205
 ROGA NIDAN EVAM VIKRITI VIGYAN ACTIVITY BOOK

SERIAL NO: 10 CLINICAL NO: 10.2

Write in detail the case of a patient with details furnished under specific headings (For subheadings
and reporting refer previous activities)

1. Patient information:

Age:

Sex: M/ F/Others

Marital status:

Education:

Occupation:

Religion:

Socio-economic status:

Date of Consultation:

Outpatient Number:

Date of Admission:

In Patient Number:

Bed number:

Place of residence:

206
2. Pradhana Vedana with Kala prakarsha (Chief complaints with duration):

3. Vedanasammuchraya (History of present illness ):

207
4. Poorvavyadhi Vruttanta (History of Past illness):

5. Chikitsa Vruttanta (Treatment history)

208
 6. Kula Vruttanta (Family history) Along with pedigree chart:

7. Samajika Vruttanta (Social history):

209
8. Vayaktika Vruttanta (Personal history):

9. General physical examination:

210
10. Systemic examination/ Srotopareeksha (General systemic and Local systemic/
Examination of affected system)

11. Investigations (Available reports and suggested investigations):

211
12. Differential diagnosis/ Sapekshanidana:

13. Vyadhi vinischaya (Diagnosis):

212
 14. Samprapti ghataka (Samprapti ghataka of the patient based on history taking and
examination):

Dosha: Shareerika

Vriddhi / Kshaya
Samsarga / Sannipata:
Sama samsarga / sannipata
Or Vishama samsarga / sannipata
Anubandha -
Anubandhya -
Dosha bheda:
Gati: Urdhva / Adha / Tiryak; Shakha / Koshta / Marma asthi sandhi

Dosha: Manasika

Raja / Tama

Dushya:
Write Vriddhi/ Kshaya/ Dushti of Dhatu(Specify)
Upadhatu (Specify)
Mala (Specify) Manas
(Specify) Indriya
(Specify) Avayava
(Specify)

Srotas: Primary srotas (Specify)

Secondary srotas (Specify)

Sroto dushti lakshana: Primary sroto dushti (Specify)

Secondary sroto dushti (Specify)

Agni: Koshtagni: Sama / Vishama / Teekshna / Manda

Dhatwagni: Sama / Manda
Bhutagni: Sama / Manda

Ama: Koshtastha ama / Dhatugata ama / Malarupi ama / Dosharupi ama

Udbhava sthana: Amashaya / Pakvashaya

Vyakta sthana: Sarva dehika / Sthanika (Specify)

Bahya rogamarga / Madhyama rogamarga / Abhyantara rogamarga

213
15. Sadhyasadhyata (with rationality)

Student’s signature Teacher’s signature

214
 ROGA NIDAN EVAM VIKRITI VIGYAN ACTIVITY BOOK

SERIAL NO: 10 CLINICAL NO: 10.3

Write in detail the case of a patient with details furnished under specific headings (For subheadings
and reporting refer previous activities)

1. Patient information:

Age:

Sex: M/ F/Others

Marital status:

Education:

Occupation:

Religion:

Socio-economic status:

Date of Consultation:

Outpatient Number:

Date of Admission:

In Patient Number:

Bed number:

Place of residence:

215
2. Pradhana Vedana with Kala prakarsha (Chief complaints with duration):

3. Vedanasammuchraya (History of present illness ):

216
4. Poorvavyadhi Vruttanta (History of Past illness):

5. Chikitsa Vruttanta (Treatment history)

217
 6. Kula Vruttanta (Family history) Along with pedigree chart:

7. Samajika Vruttanta (Social history):

218
8. Vayaktika Vruttanta (Personal history):

9. General physical examination:

219
10. Systemic examination/ Srotopareeksha (General systemic and Local systemic/
Examination of affected system

11. Investigations (Available reports and suggested investigations):

220
12. Differential diagnosis/ Sapekshanidana:

13. Vyadhi vinischaya (Diagnosis):

221
 14. Samprapti ghataka (Samprapti ghataka of the patient based on history taking and
examination):

Dosha: Shareerika

Vriddhi / Kshaya
Samsarga / Sannipata:
Sama samsarga / sannipata
Or Vishama samsarga / sannipata
Anubandha -
Anubandhya -
Dosha bheda:
Gati: Urdhva / Adha / Tiryak; Shakha / Koshta / Marma asthi sandhi

Dosha: Manasika

Raja / Tama

Dushya:
Write Vriddhi/ Kshaya/ Dushti of Dhatu(Specify)
Upadhatu (Specify)
Mala (Specify) Manas
(Specify) Indriya
(Specify) Avayava
(Specify)

Srotas: Primary srotas (Specify)

Secondary srotas (Specify)

Sroto dushti lakshana: Primary sroto dushti (Specify)

Secondary sroto dushti (Specify)

Agni: Koshtagni: Sama / Vishama / Teekshna / Manda

Dhatwagni: Sama / Manda
Bhutagni: Sama / Manda

Ama: Koshtastha ama / Dhatugata ama / Malarupi ama / Dosharupi ama

Udbhava sthana: Amashaya / Pakvashaya

Vyakta sthana: Sarva dehika / Sthanika (Specify)

Bahya rogamarga / Madhyama rogamarga / Abhyantara rogamarga

222
15. Sadhyasadhyata (with rationality)

Student’s signature Teacher’s signature

223
 ROGA NIDAN EVAM VIKRITI VIGYAN ACTIVITY BOOK

SERIAL NO: 10 CLINICAL NO: 10.4

Write in detail the case of a patient with details furnished under specific headings (For subheadings
and reporting refer previous activities)

1. Patient information:

Age:

Sex: M/ F/Others

Marital status:

Education:

Occupation:

Religion:

Socio-economic status:

Date of Consultation:

Outpatient Number:

Date of Admission:

In Patient Number:

Bed number:

Place of residence:

224
2. Pradhana Vedana with Kala prakarsha (Chief complaints with duration):

3. Vedanasammuchraya (History of present illness ):

225
4. Poorvavyadhi Vruttanta (History of Past illness):

5. Chikitsa Vruttanta (Treatment history)

226
 6. Kula Vruttanta (Family history) Along with pedigree chart:

7. Samajika Vruttanta (Social history):

227
8. Vayaktika Vruttanta (Personal history):

9. General physical examination:

228
10. Systemic examination/ Srotopareeksha (General systemic and Local systemic/
Examination of affected system)

11. Investigations (Available reports and suggested investigations):

229
12. Differential diagnosis/ Sapekshanidana:

13. Vyadhi vinischaya (Diagnosis):

230
 14. Samprapti ghataka (Samprapti ghataka of the patient based on history taking and
examination):

Dosha: Shareerika

Vriddhi / Kshaya
Samsarga / Sannipata:
Sama samsarga / sannipata
Or Vishama samsarga / sannipata
Anubandha -
Anubandhya -
Dosha bheda:
Gati: Urdhva / Adha / Tiryak; Shakha / Koshta / Marma asthi sandhi

Dosha: Manasika

Raja / Tama

Dushya:
Write Vriddhi/ Kshaya/ Dushti of Dhatu(Specify)
Upadhatu (Specify)
Mala (Specify) Manas
(Specify) Indriya
(Specify) Avayava
(Specify)

Srotas: Primary srotas (Specify)

Secondary srotas (Specify)

Sroto dushti lakshana: Primary sroto dushti (Specify)

Secondary sroto dushti (Specify)

Agni: Koshtagni: Sama / Vishama / Teekshna / Manda

Dhatwagni: Sama / Manda
Bhutagni: Sama / Manda

Ama: Koshtastha ama / Dhatugata ama / Malarupi ama / Dosharupi ama

Udbhava sthana: Amashaya / Pakvashaya

Vyakta sthana: Sarva dehika / Sthanika (Specify)

Bahya rogamarga / Madhyama rogamarga / Abhyantara rogamarga

231
15. Sadhyasadhyata (with rationality)

Student’s signature Teacher’s signature

232
 ROGA NIDAN EVAM VIKRITI VIGYAN ACTIVITY BOOK

SERIAL NO: 10 CLINICAL NO: 10.5

Write in detail the case of a patient with details furnished under specific headings (For subheadings
and reporting refer previous activities)

1. Patient information:

Age:

Sex: M/ F/Others

Marital status:

Education:

Occupation:

Religion:

Socio-economic status:

Date of Consultation:

Outpatient Number:

Date of Admission:

In Patient Number:

Bed number:

Place of residence:

233
2. Pradhana Vedana with Kala prakarsha (Chief complaints with duration):

3. Vedanasammuchraya (History of present illness ):

234
4. Poorvavyadhi Vruttanta (History of Past illness):

5. Chikitsa Vruttanta (Treatment history)

235
 6. Kula Vruttanta (Family history) Along with pedigree chart:

7. Samajika Vruttanta (Social history):

236
8. Vayaktika Vruttanta (Personal history):

9. General physical examination:

237
10. Systemic examination/ Srotopareeksha (General systemic and Local systemic/
Examination of affected system)

11. Investigations (Available reports and suggested investigations):

238
12. Differential diagnosis/ Sapekshanidana:

13. Vyadhi vinischaya (Diagnosis):

239
 14. Samprapti ghataka (Samprapti ghataka of the patient based on history taking and
examination):

Dosha: Shareerika

Vriddhi / Kshaya
Samsarga / Sannipata:
Sama samsarga / sannipata
Or Vishama samsarga / sannipata
Anubandha -
Anubandhya -
Dosha bheda:
Gati: Urdhva / Adha / Tiryak; Shakha / Koshta / Marma asthi sandhi

Dosha: Manasika

Raja / Tama

Dushya:
Write Vriddhi/ Kshaya/ Dushti of Dhatu(Specify)
Upadhatu (Specify)
Mala (Specify) Manas
(Specify) Indriya
(Specify) Avayava
(Specify)

Srotas: Primary srotas (Specify)

Secondary srotas (Specify)

Sroto dushti lakshana: Primary sroto dushti (Specify)

Secondary sroto dushti (Specify)

Agni: Koshtagni: Sama / Vishama / Teekshna / Manda

Dhatwagni: Sama / Manda
Bhutagni: Sama / Manda

Ama: Koshtastha ama / Dhatugata ama / Malarupi ama / Dosharupi ama

Udbhava sthana: Amashaya / Pakvashaya

Vyakta sthana: Sarva dehika / Sthanika (Specify)

Bahya rogamarga / Madhyama rogamarga / Abhyantara rogamarga

240
15. Sadhyasadhyata (with rationality)

Student’s signature Teacher’s signature

241