The development and validation of a diagnostic tool for sāma nirāma differentiation in patients with Rheumatoid arthritis

Rheumatoid Arthritis is an immune-inflammatory systemic disorder with clinical signs and symp-toms mainly affecting synovial joints. Effective treatment of Rheumatoid arthritis has been ham-pered by the heterogeneity of the disease. Although early intervention can result in disease remis-sion, it requires early diagnosis and current diagnostic tests are not sufficiently accurate or sensitive in the early stages of RA. As a result, RA is typically diagnosed only once damage to the joints has already begun, a time at which the window for optimal treatment may have been missed. On the other hand Ayurveda Physicians do treat the patients of RA based on the Dosha evaluation and Sāma Nirāma differentiation. But there are difference of opinions among Ayurveda practitioners regarding the diagnosis, Sāma Nirāma Differentiation and management.

Concept of ama is a unique one which helped in understanding the disease and classifying the dis-ease in to sāma and nirāma avastha. In classical literature of Ayurveda, the concept of Sāmavastha and Nirāmavastha of the doshas and diseases is given importance because it plays a key role in proper management of the disease and from the diagnostic point of view. Also the line of treatment for both these stages are different from one another. Specific parameters are required to understand and confirm the prevalence of Ama, its severity and also the Nirāma stage in the body for the selec-tion of the accurate therapeutic measure. So this study is aimed to develop and evaluate a tool de-signed to understand and confirm the prevalence of Ama, its severity and also the Nirāma stage in the body which ease the task of screening and management of rheumatoid arthritis may be one of the needed interventions .The tool will be validated and grades will be included on the basis attainment of sāma nirāma lakshana.