Dr Sudhir Shah M D D M Neurology

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

A Case Study of Jai Ambe (Prahladbhai M. Jani) There are many phenomena happening which are difficult to understand explain on the scientific basis. One such phenomenon, we came across very recently was regarding Mr. Prahladbhai Jani (Mataji).

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 )

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

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

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)

Study – Panel of Doctors § 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

The Affidavit

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

Protocol § Examination by a panel of 3 doctors daily § Examination by experts at least once every 5 th 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

Protocol 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 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 § 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.

§ 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.

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 -16 min § BP: 110/60 mm. Hg § (Vitals s/o some autonomic control ? ) § Bladder capacity was checked by ultrasound twice daily

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

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.

Hematology DATE 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. TC /c. mm. DC PC /c. mm. 4. 17 4. 37 4. 49 4. 87 5. 17 4880 5780 5640 8180 7690 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 3, 52, 000 4, 25, 000 4, 53, 000 5, 03, 000 4, 86, 000 ESR 10 mm/1 hr - - - 25 mm/1 hr 52 mm/ 2 hrs MPV fl. HCT MCV MCHC - 35. 8 37. 9 38. 5 42. 0 42. 2 85. 9 86. 7 85. 7 86. 2 81. 6 25. 9 25. 6 25. 3 25. 0 30. 2 29. 8 29. 9 29. 3 30. 6 9. 0

Biochemistry 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 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 - - - -

Biochemistry 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 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 Unconj Bilirubin 0. 10 - - - - 0. 38 - - - - Delta 0 - - - - SGPT 21. 0 - - - 10. 0 24 - 23. 0 SGOT 22. 0 - - - - S. Alkaline phosphatase 95. 0 - - - - S. Acetone - - 30. 0 - FBS 85. 7 - - 76 - - RBS - - - 84. 9 162. 0 - - 99. 8

Biochemistry 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 - - - PCO 2 - - 48 - - - PO 2 - - 23 - - - TCO 2 - - 25 - - - HCO 3 - - 23 - - - BE - - -3. 0 - - - O 2 sat - - 35% - - - Plasma Cortisol AM: - - - 11. 0 - -

Metabolic Profile

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 70 ml.

MR Angio Intracranial

MR Brain

MR Abdomen

MR Pelvis

MR Chest

MRCP

MR Abdomen

USG Kidneys

USG Bladder

USG Bladder

13/11/2003 14/11/2003 15/11/2003

18/11/2003

§ Audiological Evaluation: (17/11/03) Bilateral severe to profound degree of sensori-neural hearing loss. § ECG and cardiac evaluation were normal. 2 D Echo showed LVEF 60% Doppler study showed no evidence of aetherosclerotic plaque § Cartography (26/11/03): Normal vascular and cardiac study. § Genetic Study: Normal

ECG

Doppler Study

Genetic Study

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

Hypothesis 1. 2. 3. 4. Chronic Adaptation § Down regulation of cellular and receptor function. Cosmic Energy § Photosynthesis: Pathway § Role of pineal gland § Hypothalamus, pituitary, amygdala & limbic system § Role of mind § Meditation, Yoga, mechanical & chemical Energy economy and recycling energy Genetics, Engineering and cloning

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 ?

Application of this phenomenon § Cosmic energy § Cloning research and Genetic engineering § Challenging calorie mathematics and Science § Obesity and malnutrition

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.