Dr. Sudhir Shah M.D., D.M. (Neurology) Consultant Neurologist Honorary Professor & Head, Dept. of...

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Shah M.D., D.M. (Neurology) Consultant Neurologist Honorary Professor & Head, Dept. of Neurology K.M. School of PGMR Smt. NHL Municipal Medical College Director of Neurosciences, Sterling Hospital Head of research panel – Mataji’s case Sterling Hospital

Transcript of Dr. Sudhir Shah M.D., D.M. (Neurology) Consultant Neurologist Honorary Professor & Head, Dept. of...

Page 1: Dr. Sudhir Shah M.D., D.M. (Neurology) Consultant Neurologist Honorary Professor & Head, Dept. of Neurology K.M. School of PGMR Smt. NHL Municipal Medical.

Dr. Sudhir Shah M.D., D.M. (Neurology)

Consultant Neurologist Honorary Professor & Head, Dept. of Neurology

K.M. School of PGMRSmt. NHL Municipal Medical College

Director of Neurosciences, Sterling Hospital Head of research panel – Mataji’s case Sterling

Hospital

Page 2: Dr. Sudhir Shah M.D., D.M. (Neurology) Consultant Neurologist Honorary Professor & Head, Dept. of Neurology K.M. School of PGMR Smt. NHL Municipal Medical.

A Case Study of Jai Ambe (Prahladbhai M.Jani)

There are many phenomena happening which

are difficult to understand and explain on the

scientific basis. One such phenomenon,we

came across very recently was regarding

Mr.Prahladbhai Jani (Mataji).

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Page 4: Dr. Sudhir Shah M.D., D.M. (Neurology) Consultant Neurologist Honorary Professor & Head, Dept. of Neurology K.M. School of PGMR Smt. NHL Municipal Medical.

Many of the doctors who were involved with this case

study were also involved with the prolonged fasting of

Mr. Hira Ratan Manek of Calicut and Jasmuheen of

Australia. Dr.Sudhir Shah humbly tried to explain this

phenomenon by a hypothesis - Prolonged fastings :

how is it possible ? -A Hypothesis-published in an

Index Journal (Gujarat Medical Journal March -

2001 )

Page 5: Dr. Sudhir Shah M.D., D.M. (Neurology) Consultant Neurologist Honorary Professor & Head, Dept. of Neurology K.M. School of PGMR Smt. NHL Municipal Medical.

Introduction

Name : Jay Ambe

Prahaladbhai Maganlal Jani

Date of Birth : 12-13/08/1929, Monday

Time of Birth : 2.04 A.M.

Place of Birth : Charada

Moonsign : Scorpio

Birth Nakshatra : Vishakha-Chaturtha Charan

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Page 7: Dr. Sudhir Shah M.D., D.M. (Neurology) Consultant Neurologist Honorary Professor & Head, Dept. of Neurology K.M. School of PGMR Smt. NHL Municipal Medical.

History A Physically fit 75/M-Prahlad Jani (Chunriwala Mataji) Wandered in jungles since age of 7 Experiences enormous light and strength when he goes in

state of samadhi He claims -

1. He does not eat, does not drink liquids, nor does he pass urine/stool since age of 11

2. Limited ability to read and write

3. In 1942 was investigated at J. J. Hospital, under care of doctors and police for 45 days

4. He has a hole in his palate which supposedly secretes nectar for his survival

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Page 9: Dr. Sudhir Shah M.D., D.M. (Neurology) Consultant Neurologist Honorary Professor & Head, Dept. of Neurology K.M. School of PGMR Smt. NHL Municipal Medical.

Study – Panel of Doctors Dr. Sudhir V. Shah (Consultant Neurophysician, Sterling Hospital/Associate

professor of neurology at K. M. School of PGMR, Ahmedabad)

Dr. Urman Dhruv (Physician & Secretary of Association of Physicians of

Ahmedabad (APA))

Dr. V. N. Shah (Endocrinologist, Director-Sterling Hospital)

Dr. Bharat Gadhavi (General Surgeon/Medical Superintendent-Sterling Hospital)

Dr. Kandarp Parikh (Urologist)

Dr. Dinesh Patel/Dr. Hemant Patel (Neuroradiologists)

Dr. Sanjiv Haribhakti (G. I. Surgeon)

Dr. Sanjay Mehta (Radiologist & Sonologist)

Dr. Navneet Shah (Physician, Endocrinologist)

Dr. Gargey Sutaria (Radiologist)

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Dr. Shrenik Shah (Cardiologist)

Dr. Bansi Saboo (General Physician)

Dr. Prakash Darji / Dr. Sonal Dalal / Dr. Pankaj Shah (Nephrologists)

Dr. Dhanesh Patel (General Surgeon)

Dr. O. M. Modi (Senior Physician)

Dr. Hemang Desai (Psychiatrist)

Dr. Jayesh Sheth (Genetician & Endocrinologist)

Dr. Dhaval Modi (Ophthalmologist)

Dr. Jayeeta Chaudhary (Dietician)

Dr. Mukesh Patel (Pulmonologist)

Dr. Ruchir Shah (ENT)

Several other doctors also examined him from time to time

Study – Panel of Doctors

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The Affidavit

Page 12: Dr. Sudhir Shah M.D., D.M. (Neurology) Consultant Neurologist Honorary Professor & Head, Dept. of Neurology K.M. School of PGMR Smt. NHL Municipal Medical.

Monitoring at Sterling Hospital (12/11/03 to 22/11/03)

Monitored strictly regarding his claim by unbiased august body – Association of physician of Ahmedabad and Executive Committee of the Association

Strict protocol was followed He was confined in a special room with a glass door and a toilet door was sealed. He

was monitored by- CCTV camera

- Staff Vigilance

- Security

- Doctor on duty

- Monitoring panel

- Specialist doctors

- Hospital surveillance

For first 24 hours he was strictly monitored in ICU Notes of doctors

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Page 14: Dr. Sudhir Shah M.D., D.M. (Neurology) Consultant Neurologist Honorary Professor & Head, Dept. of Neurology K.M. School of PGMR Smt. NHL Municipal Medical.

Protocol

Examination by a panel of 3 doctors daily

Examination by experts at least once every 5th day

The project was not done with an intention to prove or disprove an individual but to create an opening of a new dimension in science

Page 15: Dr. Sudhir Shah M.D., D.M. (Neurology) Consultant Neurologist Honorary Professor & Head, Dept. of Neurology K.M. School of PGMR Smt. NHL Municipal Medical.

The project was to be terminated if:

1. The reports of investigations crossed the predetermined safe range

2. When it seemed that no further information would be available by prolonging the project

3. At no cost, project was to be prolonged for the sake of records

4. At no cost, safety, dignity and privacy of Mr. Jani was to be endangered

Protocol

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Prahladbhai Jani refused for any invasive

procedures like IV Injections, IV Dyes or IV

Fluids. So, investigations were restricted to

non-invasive procedures only.

Protocol

Page 17: Dr. Sudhir Shah M.D., D.M. (Neurology) Consultant Neurologist Honorary Professor & Head, Dept. of Neurology K.M. School of PGMR Smt. NHL Municipal Medical.

The project was to be carried out for 7 days to begin

with, but would be extended as far as possible, till

criteria 1 and 2 of termination were satisfied.

A panel of doctors used to meet/discuss daily or on

alternate day for the length of project, to discuss

daily progress, need for alteration in the protocol of

investigations if any, and plan further strategies.

Protocol

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Page 19: Dr. Sudhir Shah M.D., D.M. (Neurology) Consultant Neurologist Honorary Professor & Head, Dept. of Neurology K.M. School of PGMR Smt. NHL Municipal Medical.
Page 20: Dr. Sudhir Shah M.D., D.M. (Neurology) Consultant Neurologist Honorary Professor & Head, Dept. of Neurology K.M. School of PGMR Smt. NHL Municipal Medical.
Page 21: Dr. Sudhir Shah M.D., D.M. (Neurology) Consultant Neurologist Honorary Professor & Head, Dept. of Neurology K.M. School of PGMR Smt. NHL Municipal Medical.

After day 10, the committee declared that it is satisfied with

following matter:

The protocol was strictly adhered to.

Mr. Jani has not passed or dribbled urine during these 10 days.

He has not taken anything by mouth or by any other route not

even water for 10 days.

All his parameters are till date within physiological range.

He has shown evidence of formation of urine, which seems to

be reabsorbed from his bladder wall. However at present the

committee does not have any scientific explanation for the

same but the help of senior scientists and medical personnel of

the country is being taken for the same.

Page 22: Dr. Sudhir Shah M.D., D.M. (Neurology) Consultant Neurologist Honorary Professor & Head, Dept. of Neurology K.M. School of PGMR Smt. NHL Municipal Medical.
Page 23: Dr. Sudhir Shah M.D., D.M. (Neurology) Consultant Neurologist Honorary Professor & Head, Dept. of Neurology K.M. School of PGMR Smt. NHL Municipal Medical.

Daily Checking

General clinical examination

Daily weight (Varied from 42 kg to 38 kg)

Vital data like Temperature, Pulse, BP and Respiration.

Pulse: 42-46/min

RR: 12-16min

BP: 110/60 mmHg

(Vitals s/o some autonomic control ?)

Bladder capacity was checked by ultrasound twice daily

Page 24: Dr. Sudhir Shah M.D., D.M. (Neurology) Consultant Neurologist Honorary Professor & Head, Dept. of Neurology K.M. School of PGMR Smt. NHL Municipal Medical.

Various Tests Hematological examination every alternate day. Biochemistry reports repeated every fourth day. Neuropsychological evaluation and EEG. ECG, 2-D Echo & Cardiac evaluation Radiological examination: MRI Brain and whole gut. Chest evalutaion and pulmonary function test. Endocrinal and Hormonal profile. Doppler vascular study of carotid and peripheral vessels. Cartography including BMR Audiological examination Genetic study

Page 25: Dr. Sudhir Shah M.D., D.M. (Neurology) Consultant Neurologist Honorary Professor & Head, Dept. of Neurology K.M. School of PGMR Smt. NHL Municipal Medical.

Psychological Assessment

Patient was conscious, co-operative and awake.

Patient was not irritable throughout the period of

observation.

Mood stable, no perceptual disturbances.

No disturbance in memory span.

No pattern of personality disorder noted.

Page 26: Dr. Sudhir Shah M.D., D.M. (Neurology) Consultant Neurologist Honorary Professor & Head, Dept. of Neurology K.M. School of PGMR Smt. NHL Municipal Medical.

HematologyDATE 12/11/03 14/11/03 16/11/03 18/11/03 20/11/03

Hb: G% 10.8 11.3 11.5 12.3 12.9

T. RBC: /c.mm.

4.17 4.37 4.49 4.87 5.17

TC/c.mm.

4880 5780 5640 8180 7690

DC 

40/47/10/03/00 47/41/09/03/00 52/36/09/03/00 66/27/04/03/00 62/25/04/05/01

PC /c.mm. 

3,52,000 4,25,000 4,53,000 5,03,000 4,86,000

ESR 10mm/1hr-

- -

- -

- -

25mm/1hr52mm/ 2 hrs

MPV fl. 

- - - - 9.0

HCT 

35.8 37.9 38.5 42.0 42.2

MCV 

85.9 86.7 85.7 86.2 81.6

MCH 

25.9 25.9 25.6 25.3 25.0

MCHC 

30.2 29.8 29.9 29.3 30.6

Page 27: Dr. Sudhir Shah M.D., D.M. (Neurology) Consultant Neurologist Honorary Professor & Head, Dept. of Neurology K.M. School of PGMR Smt. NHL Municipal Medical.

BiochemistryDATE 12/11/03 14/11/03 15/11/03 16/11/03 18/11/03 20/11/03 21/11/03 25/11/03

Prolactin 3.80 - - - - - - -

S. Cortisol 12.2 - - - - - - -

T. Proteins 7.27 - - - - - - -

Albumin 4.05 - - - - - - -

Globulin 3.22 - - - - - - -

A/G Ratio 1.26 - - - - - - -

Gamma GT 31.0 - - - - - - -

T-3 0.86 - - - - 0.97 - -

T-4 5.90 - - - - 9.0 - -

TSH 3.15 - - - - 2.1 - -

H. Growth Hormone

0.14 - - - - - - -

Page 28: Dr. Sudhir Shah M.D., D.M. (Neurology) Consultant Neurologist Honorary Professor & Head, Dept. of Neurology K.M. School of PGMR Smt. NHL Municipal Medical.

S.Cholesterol 216.0 - - - - - - -

S.Triglycerides 127.6 - - - - - - -

HDL 57.2 - - - - - - -

Direct LDL 118.9 - - - - - - -

Cal. LDL 133.28 - - - - - - -

VLDL 26 - - - - - - -

LDL/HDL 2.079 - - - - - - -

Cholesterol/ HDL

3.776 - - - - - - -

S. Na+ 139.8 145.1 143.7 148.3 154.3 155.9 143.5 137.5

S. K+ 4.61 4.60 - 4.97 4.37 4.67 4.16 3.40

S. Cl- 103.2 107.0 - 106.8 107.5 115.9 101.5 -

Non Prostatic ACP

2.58 - - - - - - -

S. Acid Phosphatase

4.58 - - - - - - -

Biochemistry

Page 29: Dr. Sudhir Shah M.D., D.M. (Neurology) Consultant Neurologist Honorary Professor & Head, Dept. of Neurology K.M. School of PGMR Smt. NHL Municipal Medical.

DATE 12/11/03 14/11/03 15/11/03 16/11/03 18/11/03 20/11/03 21/11/03 25/11/03

Prostatic acid Phosphatase

135.19 - - - - - - -

T. Bilirubin 0.48 - - - - - - -

Conj. Bilirubin

0.10 - - - - - - -

Unconj Bilirubin

0.38 - - - - - - -

Delta 0 - - - - - - -

SGPT 21.0 - - - 10.0 24 - 23.0

SGOT 22.0 - - - - - - -

S. Alkaline phosphatase

95.0 - - - - - - -

S. Acetone - - 30.0 30.0 30.0 - 30.0 -

FBS 85.7 - - - - 76 - -

RBS - - - 84.9 162.0 - - 99.8

Biochemistry

Page 30: Dr. Sudhir Shah M.D., D.M. (Neurology) Consultant Neurologist Honorary Professor & Head, Dept. of Neurology K.M. School of PGMR Smt. NHL Municipal Medical.

Blood Urea 33.0 46.9 - 59.6 63.7 77 87.5 48.2

S. Creatinine 1.36 1.53 - 1.52 1.75 1.7 1.46 1.40

S. Uric acid 5.26 - - - 11.44 - - -

Venous (ABG) PH

- - - - 7.31 - - -

PCO2 - - - - 48 - - -

PO2 - - - - 23 - - -

TCO2 - - - - 25 - - -

HCO3 - - - - 23 - - -

BE - - - - -3.0 - - -

O2 sat - - - - 35% - - -

Plasma Cortisol AM:

- - - - - 11.0 - -

Biochemistry

Page 31: Dr. Sudhir Shah M.D., D.M. (Neurology) Consultant Neurologist Honorary Professor & Head, Dept. of Neurology K.M. School of PGMR Smt. NHL Municipal Medical.

Metabolic Profile

Page 32: Dr. Sudhir Shah M.D., D.M. (Neurology) Consultant Neurologist Honorary Professor & Head, Dept. of Neurology K.M. School of PGMR Smt. NHL Municipal Medical.

Radiological Investigations X-Ray Chest PA (12/11/03): No significant abnormality detected. USG Abdomen (12/11/03): No significant abnormality detected. Doppler examination of carotid, vertebral, abdominal aorta and

peripheral arterial system of lower limbs were quite normal. MRI of Brain, Neck & abdomen was unremarkable. MR Angio of Brain. MR Oesophagus: Normal study MR cholanigopancreatography: Normal study MRI Abdomen – pelvis : Presence of bowel gas, etc were seen. Gall bladder collapsed. Urinary bladder partially filled with

urine around 70ml.

Page 33: Dr. Sudhir Shah M.D., D.M. (Neurology) Consultant Neurologist Honorary Professor & Head, Dept. of Neurology K.M. School of PGMR Smt. NHL Municipal Medical.

MR Angio Intracranial

Page 34: Dr. Sudhir Shah M.D., D.M. (Neurology) Consultant Neurologist Honorary Professor & Head, Dept. of Neurology K.M. School of PGMR Smt. NHL Municipal Medical.

MR Brain

Page 35: Dr. Sudhir Shah M.D., D.M. (Neurology) Consultant Neurologist Honorary Professor & Head, Dept. of Neurology K.M. School of PGMR Smt. NHL Municipal Medical.

MR Abdomen

Page 36: Dr. Sudhir Shah M.D., D.M. (Neurology) Consultant Neurologist Honorary Professor & Head, Dept. of Neurology K.M. School of PGMR Smt. NHL Municipal Medical.

MR Pelvis

Page 37: Dr. Sudhir Shah M.D., D.M. (Neurology) Consultant Neurologist Honorary Professor & Head, Dept. of Neurology K.M. School of PGMR Smt. NHL Municipal Medical.

MR Chest

Page 38: Dr. Sudhir Shah M.D., D.M. (Neurology) Consultant Neurologist Honorary Professor & Head, Dept. of Neurology K.M. School of PGMR Smt. NHL Municipal Medical.

MRCP

Page 39: Dr. Sudhir Shah M.D., D.M. (Neurology) Consultant Neurologist Honorary Professor & Head, Dept. of Neurology K.M. School of PGMR Smt. NHL Municipal Medical.

MR Abdomen

Page 40: Dr. Sudhir Shah M.D., D.M. (Neurology) Consultant Neurologist Honorary Professor & Head, Dept. of Neurology K.M. School of PGMR Smt. NHL Municipal Medical.

USG Kidneys

Page 41: Dr. Sudhir Shah M.D., D.M. (Neurology) Consultant Neurologist Honorary Professor & Head, Dept. of Neurology K.M. School of PGMR Smt. NHL Municipal Medical.

USG Bladder

Page 42: Dr. Sudhir Shah M.D., D.M. (Neurology) Consultant Neurologist Honorary Professor & Head, Dept. of Neurology K.M. School of PGMR Smt. NHL Municipal Medical.

USG Bladder

Page 43: Dr. Sudhir Shah M.D., D.M. (Neurology) Consultant Neurologist Honorary Professor & Head, Dept. of Neurology K.M. School of PGMR Smt. NHL Municipal Medical.

13/11/2003

14/11/2003

15/11/2003

Page 44: Dr. Sudhir Shah M.D., D.M. (Neurology) Consultant Neurologist Honorary Professor & Head, Dept. of Neurology K.M. School of PGMR Smt. NHL Municipal Medical.
Page 45: Dr. Sudhir Shah M.D., D.M. (Neurology) Consultant Neurologist Honorary Professor & Head, Dept. of Neurology K.M. School of PGMR Smt. NHL Municipal Medical.

18/11/2003

Page 46: Dr. Sudhir Shah M.D., D.M. (Neurology) Consultant Neurologist Honorary Professor & Head, Dept. of Neurology K.M. School of PGMR Smt. NHL Municipal Medical.
Page 47: Dr. Sudhir Shah M.D., D.M. (Neurology) Consultant Neurologist Honorary Professor & Head, Dept. of Neurology K.M. School of PGMR Smt. NHL Municipal Medical.

Audiological Evaluation: (17/11/03)Bilateral severe to profound degree of sensori-neural hearing loss. 

ECG and cardiac evaluation were normal.2D Echo showed LVEF 60%Doppler study showed no evidence of aetherosclerotic plaque

Cartography (26/11/03):Normal vascular and cardiac study.

Genetic Study: Normal

Page 48: Dr. Sudhir Shah M.D., D.M. (Neurology) Consultant Neurologist Honorary Professor & Head, Dept. of Neurology K.M. School of PGMR Smt. NHL Municipal Medical.

ECG

Page 49: Dr. Sudhir Shah M.D., D.M. (Neurology) Consultant Neurologist Honorary Professor & Head, Dept. of Neurology K.M. School of PGMR Smt. NHL Municipal Medical.

Doppler Study

Page 50: Dr. Sudhir Shah M.D., D.M. (Neurology) Consultant Neurologist Honorary Professor & Head, Dept. of Neurology K.M. School of PGMR Smt. NHL Municipal Medical.

Genetic Study

Page 51: Dr. Sudhir Shah M.D., D.M. (Neurology) Consultant Neurologist Honorary Professor & Head, Dept. of Neurology K.M. School of PGMR Smt. NHL Municipal Medical.

Points for Debate

Reabsorption of urine from bladder

Some internal secretion from the hole in palate

Transient signs of dehydration

Transient altered renal functions

Weight loss

Role of Meditation

Page 52: Dr. Sudhir Shah M.D., D.M. (Neurology) Consultant Neurologist Honorary Professor & Head, Dept. of Neurology K.M. School of PGMR Smt. NHL Municipal Medical.

Hypothesis1. Chronic Adaptation

Down regulation of cellular and receptor function.

2. Cosmic Energy Photosynthesis: Pathway Role of pineal gland Hypothalamus, pituitary, amygdala & limbic system Role of mind Meditation, Yoga, mechanical & chemical

3. Energy economy and recycling energy

4. Genetics, Engineering and cloning

Page 53: Dr. Sudhir Shah M.D., D.M. (Neurology) Consultant Neurologist Honorary Professor & Head, Dept. of Neurology K.M. School of PGMR Smt. NHL Municipal Medical.

Application of this phenomenon

Sustaining and surviving in adverse situations like soldiers in mountains

Long term survival for space travelers

Mental strength and agility

Effect on ageing process – Preventing Atherosclerosis

Cognitive improvement and psychic achievement

Option of food ?

Page 54: Dr. Sudhir Shah M.D., D.M. (Neurology) Consultant Neurologist Honorary Professor & Head, Dept. of Neurology K.M. School of PGMR Smt. NHL Municipal Medical.

Cosmic energy

Cloning research and Genetic engineering

Challenging calorie mathematics and Science

Obesity and malnutrition

Application of this phenomenon

Page 55: Dr. Sudhir Shah M.D., D.M. (Neurology) Consultant Neurologist Honorary Professor & Head, Dept. of Neurology K.M. School of PGMR Smt. NHL Municipal Medical.

Acknowledgement Association of physicians of Ahmedabad : Dr.

Bipin Patel, Dr. Urman Dhruv and the executive committee for monitoring and protocol.

All consultants involved in research project Sterling Hospital : Dr. V. N. Shah (Director)

Dr. Bharat Gadhavi (Supdt)& management for sponsor & ethical aspects.

Dr. Harsha Jivarajani, Dr. Kavita Banthia, Ms Chittal Pathak & Mr.Roby Thomas for preparing the case presentation.