ardhita navana-pk
DESCRIPTION
TWO DIFFERENT NAVANA YOGAS IN CHARAKOKTA ARDITA, SHYLAJAKUMARI R., PANCHAKARMA, GOVERNMENT AYURVEDIC MEDICAL COLLEGE DHANWANTARI ROAD, BANGALORETRANSCRIPT
“A COMPARATIVE CLINICAL TRIAL ON TWO DIFFERENT
NAVANA YOGAS IN CHARAKOKTA ARDITA.”
BY Dr. VIJAYA V.VYEVHARE, B.A.M.S
Dissertation submitted to the Rajiv Gandhi University of Health
Sciences, Bangalore, for the partial fulfillment of Degree
AYURVEDA VACHASPATI
DOCTOR OF MEDICINE (AYURVEDA)
IN
PANCHAKARMA
Under the guidance of
Dr. SHYLAJAKUMARI R. MD (Ayu.)
Asst. Professor
Department of Post Graduate Studies in Panchakarma,
Government Ayurvedic Medical College Bangalore
DEPARTMENT OF POST GRADUATE STUDIES IN PANCHAKARMA
GOVERNMENT AYURVEDIC MEDICAL COLLEGE
DHANWANTARI ROAD, BANGALORE – 560009
2010-2011
DECLARATION BY THE CANDIDATE
I hereby declare that this dissertation entitled “A Comparative
clinical trial on two different Navana yogas in Charakokta Ardita” is a
bonafide and genuine research work carried out by me under the
guidance of Dr.Shylajakumari R.,Asst. Professor, Dept of PG studies in
Panchakarma, Government Ayurvedic Medical College, Bangalore.
Date: Signature of the candidate Place: (Dr. Vijaya V.Vyevhare)
Department of Post Graduate Studies in Panchakarma
Government Ayurvedic Medical College
Bangalore - 560009
CERTIFICATE BY THE GUIDE
This is to certify that the dissertation entitled “A Comparative clinical trial
on two different Navana yogas in Charakokta Ardita” is a bonafide
research work done by Dr. Vijaya V.Vyevhare. in partial fulfilment of the
requirement for the degree of “AYURVEDA VACHASPATI” – MD (Ayurveda)
in Panchakarma of the Rajiv Gandhi University of Health Sciences,
Bangalore.
I recommend this dissertation for the above degree to the University for
Assessment and approval.
Dr. Shylajakumari R.M.D (Ayu)
Asst. Professor, Dept. of PG studies in Panchakarma
GAMC, Bangalore - 09
Department of Post Graduate Studies in Panchakarma
Government Ayurvedic Medical College
Bangalore - 560009
ENDORSEMENT BY HOD & PRINCIPAL
This is to certify that the dissertation entitled “A Comparative clinical trial
on two different navana yogas in Charakokta Ardita” is a bonafide
research work done by Dr.Vijaya V.Vyevhare. in partial fulfilment of the
requirement for the degree of “AYURVEDA VACHASPATI” – MD
(Ayurveda) in Panchakarma under the guidance of Dr. Shylajakumari R.,
Asst.Prof., Dept of PG studies in Panchakarma, Government Ayurvedic
Medical College, Bangalore.
Dr. Shalini C. Eli, MD (Ayu.) D.N.Y. Principal
Prof. & Head of the Department, Govt. Ayurvedic Medical College,
Department of P.G. Studies In Panchakarma, Bangalore.
Govt. Ayurvedic Medical College,
Bangalore.
COPYRIGHT
DECLARATION BY THE CANDIDATE
I hereby declare that the Rajiv Gandhi University of Health Sciences,
Karnataka, Bangalore, shall have the rights to preserve, use and
disseminate this dissertation in print or electronic format for Academic /
Research purpose.
Date: Signature of the Candidate Place: (Dr.Vijaya V.Vyevhare.)
© Rajiv Gandhi University of Health Sciences, Karnataka.
ACKNOWLEDGEMENT Beyond all worldly things, there is a supernatural power which harmonize all
worldly interactions. I express my deep hearted reverence to that divine source. I bow
my head to the lotus feet of “Lord Dhanvantri” with whose showering of blessings this
task was ventured without any hindrances.
It’s my great pleasure to express my deep gratitude towards
Dr.Shaylaja Kumari R., Asst. Professor, my preceptor and guide whose erudite
expositions, benevolent teaching & critical suggestions had given me a propitious
direction to accomplish this work in all aspects.
I am also thankful to my H.O.D, Dr. Shalini C. Eli, for being a
supporting hand in my work.I am also thankful to Dr. Shridhara B. S. former.H.O.D.for
his constant encouragement.
I express my deep gratitude to Principals of G.A.M.C, Bangalore during
my study Dr .S.G.Mangalgi.
I am especially thankful to teachers of “Department of Panchakarma”
Dr.Janaki Y.S., Dr.Santhosh.L.Y., Dr.V.M.Hugar, Dr.Shaila Gurappa, whose constant
encouragement and useful suggestions helped me throughout the study period.
I am highly indebted to my Parents Shri Vishwanath vyevhare and
Smt.Sunanda played a key role in molding my thoughts towards higher studies.
I pay my obeisance to my all family members, especially my beloved
husband Dr.Kailash Sonmankar for taking pain in bringing me up to this position.
Also I would like to thank my elder sister Mrs.Tejaswini and brother Mr.Ravindra
,beloved friend Dr.Basavjyoti and Miss.Alaka for giving me constant & unending
support .
I am very much thankful to my seniors Dr.Usha,Dr.Ashwini Kulkarni,
Dr.Rajani Ramesh, Dr.Divya, Dr.Salma, Dr.Smina, Dr.Sandeep, Dr.Somnath & My
special thanks to my department colleagues and friends, Dr.Pooja
Dr,Basavjyoti,Dr.Sumit,Dr.Ravikumar,Dr.Srinivas,and also thankful to my juniors
Dr.Rashmi,Dr.Vanishri,Dr.Manjunath,Dr.Shridhar,Dr.Nandakishore,Dr.Mukund
Dr.Kamlesh and all other post graduate scholars for their needful support to fulfil this
task.
I thank library, hospital & office staff, R.M.O. Dr. Nagraj, Physicians, and all
my patients for their kind support during my study.
I take this opportunity to appreciate the generous co operation offered by my
patients by being highly obdient during my study period .
I take all my effort to laud Dr. Raghavendra, Statistician, without whose help
whole of my work would have looked meaningless. I am extremely grateful to my printer
Mr.Arvind who has printed and bounded my work legibly and neatly.
Last but not least, I express my thanks to each and every person who have helped
me directly & indirectly in accomplishing this task without any blemishes, with apologies
for my inability to identify them individually.
Dr.Vijaya V.Vyevhare
ABSTRACT
Charkokta Ardita is the manifestation of the condition involving weakness of
either half of face or along with half of the body. The disese is mentioned in maharoga
from the point of prognosis – difficult to cure. This vatavyaadhi can be correlated with
cerebrovascular accidents which is a global health problem of present era and a major
cause of disability.
In its management Nasya is the first line of treatment for Ardita in charaka
samhita. With this classical background, in the present study an attempt is made to
understand the separate & comparative efficacy of Karpasasthyadi taila nasya and
Rasnaputika taila nasya in the management of Charakokta Ardita.
Objectives of the study:
i] To evaluate the efficacy of Karpasasthyadi taila nasya in the management
of Charkokta Ardita.
ii] To evaluate the efficacy of Rasnaputika taila nasya in the management of
Charkokta Ardita.
Study Design: 30 patients presentng with classical symptoms of Charkokta Ardita
were randomly recruited in 2 groups. The Group A patients received 2 course of nasya
with Karpasasthyadi taila while Group B patients received 2 course of nasya with
Rasnaputika taila.
Results: Comparision of both the groups shown that in group B there is significant
improvement after first course in finger movement,loss of speech, pain and handgrip
power,whereas in group A there is significant results found in after second course.
Key Words: Ardita, Nasya,
TABLE OF CONTENTS
SL. NO CHAPTER PAGE
NUMBER 1 INTRODUCTION 1-2
2 REVIEW OF LITERATURE
a) PROCEDURE REVIEW 3-33
b) DISEASE REVIEW 34-83
c) DRUG REVIEW 84-92
3 MATERIALS AND METHODS 93-102
4 OBSERVATIONS AND RESULTS 103-140
5 DISCUSSION 141-155
6 CONCLUSION 156
7 SUMMARY 157-158
8 BIBLIOGRAPHY -
9 ANNEXURE ---
LIST OF ABBREVIATIONS
A.H. – Ashtanga Hridaya.
A.S. – Ashtanga Sangraha.
A.V. _ Atharvana veda
Aru. – Arunadatta.
B.P. – Bhavaprakasha.
B.R. – BhaishajyaRatnavali.
Bha.Ni. – BhavaprakashNighantu.
Bhel.S. – BhelaSamhita
Ch.Dt – ChakraDatta.
Ch. – CharakaSamhita Chi. – ChikitsaSthana
Dal. – Dalhana.
G.N. – GadaNigraha.
Ha. – HaritaSamhita.
Kal. – KalpaSthana
Ka.Sam. – KashyapaSamhita.
M.N. – MadhavaNidana
Ni. – NidanaSthana
Pur. - Purvakhanda.
Si. – SiddhiSthana
Sha.S – Sharangadhara Samhita
Su.S. – SushrutaSamhita
Su. – SutraSthana
Van.S. – VangasenSamhita.
Vi. – VimanaSthana
Utt. – Uttarkhanda.
Y.R. – YogaRatnakara
LIST OF TABLES
Sl.no Title pg.no
1 Table showing references in Charaka Samhita 4 2 Table showing Nasya references in Sushruta Samhita. 5 3 Table showing Nasya references in Astanga Hrudaya 5 4 Table showing Classification of Nasya according to Various Acharya 8 5 Table showing Dose of Nasya. 14 6 Table showing Indications Avapida Nasya 15 7 Table showing Contra Indications of Nasya mentioned in Brihatrayiee 17 8 Table showing Nasya Time schedule according to different seasons 18 9 Table showing Nasya Time schedule in DoshajaVikara 18 10 Table showing Courses in day of Nasya karma according to different
acharyas 18
11 Table showing Dosage of various types Nasya Karma 20 12 Table showing Nasya Yantra 21 13 Table showing Nasya Samyaka Yoga Lakshana 23 14 Table showing Nasya Ayoga Lakshana 24 15 Table showing Nasya Atiyoga Lakshana 24 16 Table showing Site of Ardita according to different acharyas 38 17 Table showing Dosha involved in Ardita according to different acharyas 38 18 Table showing Nidana of Ardita according to different acharyas 38 19 Table showing Rupa of Ardita according to different acharyas 45 20 Table showing Vataja doshanubandhi lakshanas found in Ardita 46 21 Table showing Pittaja doshanubandhi lakshanas found in Ardita 46 22 Table showing Kaphaja doshanubandhi lakshanas found in Ardita 47 23 Table Showing the Pathyapathya in Vatavyadhi 54 24 Table Differentating between three common causes of Hemiplegia 60 25 Table Showing Etiological factors according to onset of Hemipegia 61 26 Table Showing The Ingredients of Karpasasthyadi taila 85 27 Table Showing The Ingredients of Rasna putika taila2 88 28 Table showing Incidance of age 103 29 Table showing Incidance of Sex 104 30 Table Showing Education wise distribution 104 31 Table showing Incidance of Occupation 105 32 Table showing Incidance of Socioeconomic Status 105 33 Table showing Incidance of Marital Status 106 34 Table showing Incidance of Family history of stroke 106 35 Table showing Incidance of Food habit 106 36 Table showing Incidance of Sharira Prakruti 107 37 Table showing Incidance of Manasa Prakruti 108 38 Table showing Incidance of Sara 108
39 Table showing Incidance of Agni 108 40 Table showing Incidance of Koshta 109 41 Table showing Incidance of Onset of stroke 110 42 Table showing Incidance of Right/Left half of the body affected 110 43 Table showing Incidance of Duration 111 44 Table showing Incidance of Aharaja nidana 111 45 Table showing Incidance of Viharaja nidana 112 46 Table showing Incidance of Manasika nidana 113 47 Table showing Incidance of Past history of hypertension 113 48 Table showing Incidance of Nature of Sleep 114 49 Table showing Incidance of Vyasana 114 50 Table showing Incidance of Nasya karmukata 115 51 Table showing Incidance of Overall response 115
LIST OF GRAPHS
Sl.no Title Pg.no
1 Graph showing Incidance of age 104 2 Graph showing Incidance of Sex 104 3 Graph Showing Education wise distribution 105 4 Graph showing Incidance of Occupation 105 5 Graph showing Incidance of Socioeconomic Status 105 6 Graph showing Incidance of Marital Status 106 7 Graph showing Incidance of Family history of stroke 106 8 Graph showing Incidance of Food habit 107 9 Graph showing Incidance of Sharira Prakruti 107 10 Graph showing Incidance of Manasa Prakruti 108 11 Graph showing Incidance of Sara 108 12 Graph showing Incidance of Agni 109 13 Graph showing Incidance of Koshta 109 14 Graph showing Incidance of Onset of stroke 110 15 Graph showing Incidance of Right/Left half of the body affected 110 16 Graph showing Incidance of Duration 111 17 Graph showing Incidance of Aharaja nidana 112 18 Graph showing Incidance of Viharaja nidana 112 19 Graph showing Incidance of Manasika nidana 113 20 Graph showing Incidance of Past history of hypertension 113 21 Graph showing Incidance of Nature of Sleep 114 22 Graph showing Incidance of Vyasana 115 23 Graph showing Incidance of Nasya karmukata 115 24 Graph showing Incidance of Overall response in group A 116 25 Graph showing Incidance of Overall response in group B 116 26 Graph showing changes in Housebrackman scale 118 27 Graph showing changes in Finger movement 120 28 Graph showing changes in Lifting of Arm 122 29 Graph showing changes in Sitting from laying down 123 30 Graph showing changes in Standing from sitting 125 31 Graph showing changes in Drooping of wrist 127 32 Graph showing changes in Loss of Speech 129 33 Graph showing changes in Pain 131 34 Graph showing changes in Muscle Power 133 35 Graph showing changes in Hand grip Power 135
36 Graph showing changes in Muscle tone 136 37 Graph showing changes in Increase in walking Capacity 138 38 Graph showing changes in Reflexes 140
LIST OF FLOWCHARTS
Sl no Headings Page no
1 Showing Charaka’s classification of Nasya Karma 9
2 Showing Charaka’s classification of Nasya Karma according to action 9
3 Showing Charaka’s classification of Nasya Karma according to various parts of the drugs utilized 9
4 Showing Sushruta’s classification of Nasya Karma 10 5 Showing Vagbhata’s classification of Nasya Karma 11 6 Showing Kashyapa’s classification of Nasya Karma 11 7 Showing Sharangadhara’s classification of Nasya
K12
8 Showing Videha’s classification of Nasya Karma 12 9 Schematic representation of the Samprapti of Ardita 42
LIST OF FIGURES Sl. No.
Headings Pg. no
1 Figure Showing The Olfactory System
31
2 Figure showing The Internal Capsule 72
3 Figure Showing Olfactory pathway 145
Introduction
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita” Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09 1
INTRODUCTION
Ayurveda is an eternal science of life which is based on the principles of
tridosha theory. Tridoshas are eternally present and support the body as ‘vital
forces’ in their normalcy ,import development ,strngth ,complexion,and
cheerfulness to the body.All the activities of the body both external and internal
are essentially depend on vata and due to its quality of motivation it keeps kapha,
pitta,dhatus and malas in motion,which are incapable of independent motion1
Ardita is one among the vata vyadhis mentioned by many acharyas
where charaka has given different opinion regarding the disease. According to him in
Ardita not only half of the face,but involvement of half of the body ,is also noticed.
The condition as described in charaka samhita, makes the person more
difficult to perform his routine activity and disability to communicate also.
Greater the incidence of atherosclerosis and hypertension which are
the principal etiological factors of the cerebrovascular catastrophe and which are on
flare in today’s era. Stroke is currently the second leading cause of death in the
Western world, ranking after heart disease and before cancer, and causes 10% of
deaths worldwide.2 Prognosis for patient with stroke is worse than many forms of
cancer, with half of all patients dead or dependent on others after 1 year.
The impairment in the functions of indriyas (both jnanendriyas and
karmendriyas) resulting in vaksanga (Aphasia),Akarmanyata (loss of function in half
of the body mainly involving upper and lower limbs).
Considering all the above points one can safely conclude that the
adhistana for vata prakopa is in shiras where in all the vital centers including manas
Introduction
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita” Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09 2
are situated. Aradita is a severe blow to the sufferer’s life. It makes the patient
cursed creature so far his activities are concerned. The patient not only suffers from
bodily illness but also go through a severe mental depression on account of inability
to attend such duties as are essential for personal hygiene and maintenance of his
own cleanliness and attire. Such persons irrespective of religion, age, sex or
socioeconomic status, face a very miserable and dependent life. This disease not
makes the person only crippled but also makes him/her burden to the family. If he
or she is the only earning member in the family, the family has to face endless
problems.
Nasa has been mentioned as outlet of shiras.3 The drug administered
by nasya works upon the vitiated doshas and dushyas and expel the doshas situated
in urdhwajatrugata pradesha through nasa4 .Ardita is also one of the disease of
urdhwajatrugata pradesha and having shiras as its adhishatana, so nasya is preferred.
Taking the above points into mind, its poor prognosis and nature of inertia
the disease was selected, to find a measure that could help in restoring quality of life in
paralyzed patients. The present study has been designed with 2 groups:
1) Group-A--- Received Nasya with Karpasasthyadi Taila5 .
2) Group-B--- Received Nasya Rasnaputika taila6.
The present study is an effort to rule out an effect of Rasnaputika Taila and evaluate
the comparison between two formulations.
Procedure review
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita” Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09 3
NASYA KARMA
Historical Review of Nasya:
Rigveda
There is a Mantra of Rigveda, in which eradication of Roga from the routes
of Nasa (Nostrils), Chibuka (Chin), Shiras (Head), Karna (ear) & Rasana (tongue) are
mentioned.1 This shows that the reference of eradication of disease from the above
mentioned routes most probably refers towards Nasa (nose) or Shirovirechana.
Ramayana
Valmiki Ramayana gives reference regarding Nasyakarma is when Lakshmana
became unconscious; drug named Sanjeevini brought by Lord Hanuman was used by
Vaidya Sushena to make him conscious.2
Baudha Kala
In Buddha period there are Jataka stories about the famous vaidya “Jeevaka”.
He has utilized many times Nasya Karma such as –
1. Administration of medicated Ghruta for the treatment of Shirah Shoola in the form
of Nasya Karma to the wife of Sreshthi of Saketa Nagar.3
2. Lord Buddha was given virechana by nasya in the total dose of three Utpala Hasta.4
Vinaya Pitaka
The book Vinaya-Pitaka states that the use of one Utpala Hasta of Nasya was
sufficient for ten Virechana.5
Ayurvedic Classics
After Buddha period, Charaka Samhita & Sushruta Samhita became famous
accomplishments where the specification in the Nasya karma had reached to such an
extent of perfectness that it was also being used as one of the methods, for changing
the fetal sex. 6
Procedure review
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita”
Nasya karma is mentioned as a treatment in several diseases in Brihatrayi.
References are given below-
Charaka Samhita 7-19
Table no. 1:- Nasya references in Charaka Samhita.
Name of Adhyaya References of Nasya Karma
1. Jwara Chikitsa Ch.Chi. 3/254, 255
2. Raktapitta Chikitsa Ch.Chi. 4/97-140
Ch.Chi. 7/48, 49 3. Kustha Chikitsa
4. Rajayakshama Chikitsa Ch.Chi. 8/34, 35
5. Unmada Chikitsa Ch.Chi. 9/35,56-58,65,71-79,81-82
6. Apasmara Chikitsa Ch.Chi. 10/40-45
7. Kshawathu Chikitsa Ch.Chi. 12/17
Ch.Chi. 17/129-134 8. Hikka, Shwasa Chikitsa
9. Kasa Chikitsa Ch.Chi. 18/142
10. Visha Chikitsa Ch.Chi.23/54-60,190,193,-196 ,213
11. Trimarmiya Chikitsa Ch.Chi.26/137,151-159,174,176,178,180,
183-185
12. Vata Vyadhi Chikitsa Ch.Chi. 28/78,88,98,99,124,125-128,194
13. Trimarmiya Siddhi Ch.Si. 9-73,75,82,83,87,97
Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09 4
Procedure review
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita” Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09 5
SUSHRUTA SAMHITA 20-26
Table no. 2 :- Nasya references in Sushruta Samhita.
Name of Adhyaya References of Nasya Karma
1. Dwivraniyam Chikitsa Su.Chi. 1/8,9,125,126
2. Sadyovraniya Chikitsa Su.Chi. 2/43
3 . Bhagandar Chikitsa Su.Chi. 3/40,54,64,68
5. Mahavata Vyadhi Chikitsa Su.Chi. 9/3
6. Kustha Chikitsa Su.Chi. 14/11
7. Udara Chikitsa Su.Chi. 18/22,23,50
8. Granthi-Apachi-Arbuda Ganda Chi.
Su.Chi. 19/15 9. Vruddhi,Upadamsha, Shlipada Chi. Su.Chi. 20/30
10. Kshudra Roga Chikitsa Su.Chi.22/4,7,12-17,21,25,35,38,39,40,45,48,59,63,67
11. Mukha Roga Chikitsa Su.Chi. 31/3
12. Snehaupayogika Chikitsa Su.Chi. 32/17
13. Swedavacharniya Chikitsa Su.Chi. 34/12,19
14.Vamana-Virechana Chikitsa Su.Chi. 36/13
15. Netra basti Vyapad Chikitsa Su.Chi. 37/7
16. Anuvasana Uttar basti Chikitsa Su.Chi. 40/1,2,20-26,28-56
ASTANGA HRIDAYA 37-44
Table no. 3 :- Nasya references in Astanga Hrudaya.
Name of Adhyaya References
1. Jwara Chikitsa As.H.Chi. 1/125,126,150,161
2. Raktapitta Chikitsa As.H.Chi. 2/47
3 Shwasa Hikka Chikitsa As.H.Chi. 4/46-50
4. Rajayakshama Chikitsa As.H.Chi. 5/34,37,41,42,69
5. Chhardi, Hridroga, Trishna Chikitsa As.H.Chi. 6/27,74
6. Madatyaya Chikitsa As.H.Chi. 7/104,108,110,111
7. Shwitra krimi Chikitsa As.H.Chi. 20/28,33
Procedure review
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita” Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09 6
ETYMOLOGY OF NASYA:
It is derived from “Nasa” dhatu which is inferred in sense of nose. According
to Vachaspatyam word “Nasata” means beneficial for nose.
As per Acharya Sushruta, administration of medicine or medicated oils
through the nose is known as Nasya . According to charaka also it means the same
“ lÉÉxÉɲÉUålÉ pÉåwÉeÉ SÉlÉqÉç | ” 45
Arunadatta and Bhavaprakasha opine that all drugs that are administered
through the nasal passage are called Nasya.46 Sharangadhara and Vagbhata 47 also hold
the same view.
DEFINATION OF NASYA:
According to shabda kalpa druma:
“lÉÉÍxÉMüÉrÉÉrÉæÈ ÌWûiÉqÉç CÌiÉ lÉxrÉÈ’’
That which is good for nose is called as nasya.
According to Charaka 48
“ lÉxiÉ: MüqÉï cÉ MÑüuÉÏïiÉ ÍzÉUÉåUÉåaÉåwÉÑzÉÉx§ÉÌuÉiÉç |
²ÉUqÉç ÌWû ÍzÉUxÉÉå lÉÉxÉÉ iÉålÉ iÉSèurÉÉmrÉ WûÎliÉ iÉÉlÉç || ”
According to Sushruta
“AÉæwÉkÉÇ, AÉæwÉkÉ ÍxÉ®Éã uÉÉ xlÉãWûÉã lÉÉÍxÉMüÉprÉÉqÉç
SÏrÉiÉå CÌiÉ lÉxrÉÇ|” 49
A medicine or medicated oushadhi with Sneha administered through nasal route is
Nasya.
“iÉ§É rÉ: xlÉãWûlÉÉjÉïÇ vÉÑlrÉ ÍvÉUxÉÉÇ
aÉëÏuÉÉxMülkÉÉãUxÉÉÇ cÉ oÉsÉeÉlÉlÉÉjÉïÇ ..... uÉÉ xlÉãWûÉã
ÌuÉkÉÏrÉiÉã
Procedure review
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita” Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09 7
... lÉxrÉ vÉoS:|” 50
This definition refers for the importance of Nasya.
“lÉÉxÉÉrÉÉqÉç pÉuÉÇ lÉxrÉÇ| ” 51
“lÉÉxÉÉrÉÉqÉç mÉëhÉÏrÉqÉÉlÉqÉÉæwÉkÉÇ lÉxrÉÇ|”52
“lÉÉxÉrÉÉ ÍvÉUÍxÉ mÉëhÉÏrÉqÉÉlÉqÉÉæwÉkÉÇ lÉxrÉ xÉÇ¥ÉÉÇ
sÉpÉiÉã|” 53
That medicine which is put through nose is called as nasya
“AÉæwÉkÉÇ YuÉÉjÉxuÉUxÉ xlÉãWûÉÌS , lÉxrÉÍqÉÌiÉ lÉÉxÉÉrÉÉ
SÏrÉiÉã CÌiÉ lÉxrÉÇ|” 54
Medicines to be administered through Nasal route may be in the form of Kwatha,
swarasa, kalka, Sneha etc
Synonyms :
• Prachchardana (ch.su.1/85)
• Shirovirechana (su.)
• Shirovireka
• Murdhavirechana
• Navana
• Nastaha Karma
Among the various synonyms of Nasya karma Shirovirechana, Shirovireka
and Murdhavirechana are suggestive of elimination of Doshas from the Shira or parts
situated above the clavicle i.e. Prachchardana, whereas the terms Nastaha and Navana
indicates site of administration.
CLASSIFICATION OF NASYA KARMA :
Procedure review
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita” Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09 8
Nasya is classified in various ways by different Acharya. Each
classification has its own salient features and each is done with different angles.
Classification according to various Acharya is described in a tabular form as below.
Table No.4 Showing Classification of Nasya according to Various Acharya
No Name of Acharya Classification
1 Charaka According to mode of action - Rechana, Tarpana, Shamana
According to the method of administration –
Navana, Avapidana, Dhmapana, Dhuma, Pratimarsha
According to various parts of drugs utilized –
Phala, Patra, Mula, Kanda, Pushpa, Niryasa, Twaka
2 Sushruta Shirovirechana, Pradhamana, Avapida, Nasya, Pratimarsha
3 Vagbhata Virechana, Brimhana,
Shamana
4 Kashyapa Brimhana, Karshana
5 Sharangadhara Rechana, Snehana
6 Bhoja Prayogika, Snaihika
7 Videha Samgya Prabodhaka,
Stambhana,
CHARAKA’S CLASSIFICATION OF NASYA :
“ lÉÉuÉlÉqÉç AuÉmÉÏQûlÉqÉç kqÉÉmÉlÉqÉç kÉÔqÉ LãuÉ cÉ ||
mÉëÌiÉqÉvÉïxiÉÑ ÌuÉelÉãrÉÈ lÉxiÉÈ MüqÉï iÉÑ mÉlcÉkÉÉ ||
xlÉãWûlÉÇ vÉÉãkÉlÉqÉç cÉæ� ̲ÌuÉkÉÇ lÉÉuÉlÉqÉç xqÉëiÉqÉç ||
vÉÉãkÉlÉÇ xiÉqpÉlÉ¶É xrÉÉiÉç AuÉmÉÏ��ã ̲kÉÉ qÉiÉÈ ||
cÉÔhÉïxrÉÉkqÉÉmÉlÉqÉç iÉÌ® SãWûxÉëÉãiÉÉã ÌuÉvÉÉãÍkÉlÉqÉç ||
ÌuÉelÉãrÉÎx§ÉÌuÉkÉÉã kÉÔqÉÈ mÉëÉaÉÑ£üÈ vÉqÉlÉÉÌSMü ||
mÉëÌiÉqÉvÉÉãï pÉuÉixlÉãWûÉã ÌlÉSÉãïwÉ EpÉrÉÉjÉïMÚüiÉç ||
LuÉqÉç iÉSìãcÉlÉÇ MüqÉï iÉmÉïlÉÇ vÉqÉlÉÇ Ì§ÉkÉÉ. || ” cÉ. ÍxÉ. 9/89-92
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Acharya Charaka have classified Nasya in five types viz. Navana, Avapidana,
Dhmapana, Dhuma and Pratimarsha.55
Navana is further divided in to Snehana and Shodhana, Avapidana into
Shodhana and Stambhana, Dhuma into Prayogika, Vairechanika and Snaihika while
Pratimarsha is divided into Snehana and Virechana.
The above-mentioned five types of Nasya are regrouped according to their
pharmacological action into three groups viz. – Rechana, Tarpana and Shamana.56
Charaka has also mentioned 7 types of Nasya according to parts of the drugs to
be used in Nasya karma viz. – Phala, Patra, Mula, Kanda, Pushpa, Niryasa, Twak.57
Chart no.1
Nasya
Navana Avapidana Dhmapana Dhuma Pratimarsha
Snehana Shodhana Prayogika Snaihika Vairechanika
Shodhana Stambhana Snehana Virechana
Chart no. 2 According to the action of Nasya therapy:
Tarpana Shamana Rechana
Chart no. 3 According to various parts of the drugs utilized in Nasya
“ ÍvÉUÉãÌuÉUãcÉlÉÇ xÉmiÉÌuÉkÉqÉç ÄTüsÉ mÉ§É qÉÔsÉ MülS
mÉÑvmÉ ÌlÉrÉÉïxÉiuÉaÉÉ´ÉrÉ pÉãSÉiÉç,
Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09 9
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Phala Patra Mula Kanda Pushpa Niryasa Twaka
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CLASSIFICATION OF NASYA ACCORDING TO SUSHRUTA:
“ iÉSè ̲ÌuÉkÉqÉç ÍvÉUÉãÌuÉUãcÉlÉqÉç xlÉãWûlÉqÉç cÉ|
iÉSè ̲ÌuÉkÉqÉÌmÉ mÉlcÉkÉÉ iɱjÉÉ lÉxrÉ
ÍvÉUÉãÌuÉUãcÉlÉÇ, mÉëÌiÉqÉvÉÉãï AuÉmÉÏQûÈ mÉëkÉqÉlÉ cÉ||
iÉãvÉÑ lÉxrÉqÉç mÉëkÉÉlÉ ÍvÉUÉãÌuÉUãcÉlÉ cÉ lÉxrÉ ÌuÉMüsmÉÈ
mÉëÌiÉqÉvÉïçÈ ÍvÉUÉãÌuÉUãcÉlÉMüsmÉÉã AuÉmÉÏQû: mÉëkÉqÉlÉÈ
cÉ iÉiÉÉã lÉxrÉÈ vÉoSÈ mÉlcÉkÉÉ ÌlÉrÉÍqÉiÉÈ || (xÉÑ.ÍcÉ 40/21.
According to Sushruta, Nasya is of 5 types viz. Nasya, Avapida, Pradhamana,
Shirovirechana and Pratimarsha. These 5 types of Nasya are further classified
according to their functions into two groups viz. Shirovirechana and Snehana 58
Shirovirechana, Avapida and Pradhamana are used for Shirovirechana purpose.
i.e. for the elemination of morbid Dosha from Shira while Pratimarsha and Nasya may
be used for Snehana.59
Chart no.4 Classification according to Sushruta:
Nasya
Shirovirechana Snehana
Shirovirechana Pradhmana Avapida Nasya Pratimarsha
VAGBHATTA’S CLASSIFICATION OF NASYA:
Ashtanga Samgraha & Hridaya has mainly classified Nasya according to its effect viz.
Virechana, Brimhana and Shamana. Snehana and Brimhana Nasya have been further
subdivided according to the doses into two groups i.e. Marsha and Pratimarsha.60
Ashtanga Hridaya has mainly classified Nasya in 3 types viz. Rechana,
Brimhana and Shamana61.
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Chart No.5 Classification According to Karma (Pharmacological Action)
Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09 12
Rechana Brimhana Shaman
Samgyaprabodhana (Shodhana)
Krimighna Stambhana Karshana
Raktastambhan Doshastambhan
KASHYAPA’S CLASSIFICATION OF NASYA
According to Kashyapa Samhita, Nasya has been classified into two
groups i.e. Brimhana and Karshana. These two types are also known as Shodhana and
Purana Nasya 62.
Chart no.6 Classification according to Kashyapa:
Karshana (Shodhana)
Brimhana (Purana)
Nasya
SHARANGADHARA’S CLASSIFICATION OF NASYA
Sharangdhara has also classified Nasya according to their functions into two groups
viz. Rechana and Snehana. Rechana Nasya is further subdivied into Avapida and
Pradhamana while Snehana Nasya is subdivided into Marsha and Pratimarsha. 63abc
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Chart no.7 Classification according to Sharangadhara :
Nasya
Rechana Snehana
Pradhmana Marsha Avapida Pratimarsha
VIDEHA’S CLASSIFICATION OF NASYA
Videha has stated two types i.e. Sanjyaprabodhaka and Stamabhana 64
Chart no.8 Classification according to Videha :
Stambhana
Nasya
Sagnya Prabodhaka
It is clear from the above description that two types of classification of Nasya
Karma are available in Ayurvedic literature. One is based on the pharmacological
actions viz. Rechana, Tarpana etc. Other is based on the preparation of drug and the
method of its application e.g. Dhmapana (Powder is blowed) Avapida (Extracted
Juice is used) Dhuma (Smoking through nose)
Apart from classification on above basis other criteria are also described as follows :
♦ Classification according to preparation e.g. Avapida nasya which indicates the
use of expressed juice:
♦ Classification according to the dose to be dropped into the nostrils e.g. Marsha
and Pratimarsha described by Acharya Vagbhata.
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A) TARPANA NASYA
Tarpana is that type of Nasya, which is specially indicated in a Dhatukshaya
(degeneration). Tarpana Nasya resembles Snehana Nasya described by Sushruta and
Sharangadhara and Brimhana Nasya mentioned by Acharya Vagbhata in its properties
and actions.
Drugs: Drugs of Madhura skandha and Sneha prepared with Vata-Pittahara drugs are
used for above type. 65 Exudation of certain trees, meat soups and blood may also be
administered.
Indications:
Vatika Shiroroga, Dantapata, Keshapatana, Darunaka and other Vata-Pittaja
diseases. Sushruta advises Sneha Nasya for increasing general strength and to improve
the vision and its acuity. It is also used for curing the Shirah kampa and Ardita.66
Shodhana Nasya
Shodhana nasya eliminates excessive vitiated doshas in urdhwajatrugata
pradesha. Generally Avapidana, Dhmapana, Vairechanika are classified in Shodhana
nasya. Rechana, are the synonyms of Shodhana nasya. Sushruta’s Shirovirechana type
is included in Shodhana type of Navana Nasya. If Rechana Nasya is to be given in
patients of weak will power then Sneha preparation of Rechana dravya is applied.
Drugs :
Apamarga, Pippali, Maricha, vidanga , Shirisha etc. are drugs of choice that can
be used for Rechana Nasya.67In this type of Nasya, oil prepared by above
Shirovirechana Dravyas are selected. Kwatha, Swarasa or Tikshna sneha of above
drugs may also be utilized for the same.
Dose :It can be given in following dosage schedule according to Sushruta.
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Table No. 5. Dose of Nasya. 68
1 Uttama 8 drops
2 Madhyama 6 drops
3 Hina 4 drops
Indications :
It can be used in the following conditions; Kaphapurna Talu and Shira, Aruchi,
Shirogaurava, Shula, Pinasa, Ardhavabhedaka, Krimi, Pratishyaya, Apasmara,
Gandhagyananasha and Urdhvajatrugata Kapharogas 69 and Urdhvajatrugata Shopha, Praseka,
Arbuda and Kotha.
Avapida Nasya
Definition:
The word Avapida means it is expressed juice of leaves or paste (kalka) of
required medicine. 70
Method :
The paste (kalka) of required medicine is placed in a white and clean cloth and
thereafter it is squeezed to obtain the required quantity of juice, directly in the nostrils
of the patients. The administration of the drug in this way is known as Avapida
nasya.71
It may also be given by dipping the swab (pichu) into the Kwatha (decoction)
or Sheeta (cold infusion) or Swarasa (juice) of the required drug. Though Acharya
Sushruta has categorized this under Shirovirechana, Avapida has also been used for
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Stambhana purpose in treatment of Raktapitta where Sharkara and Ikshu rasa are
utilized for the same.72
Charaka has described two types of Avapida Nasya.
1) Stambhana Nasya : For this type ikshu rasa, milk etc. are used.
2) Shodhana Nasya : For this type Saindhava, Pippali etc. are used.
According to Chakrapani, Avapida nasya is of three types .
1) Shodhana
2) Stambhana
3) Shamana
Videha has mentioned two types of Avapida Nasya.
1) Samgya prabodhana : It is one type of shodhana nasya.
2) Stambhana : It is one type of shamana nasya.
Indications :
Table No.6- Indications Avapida Nasya. 73
Manasaroga Apasmara Shirovedana
Apatantraka Moha Mada
Murchha Sanyasa Bhaya
Krodha Bhiru Sukumara
Krisharogi Stri Raktapitta
Vishabhighata Chitta Vyakulavastha
Sharangdhara recommends the Avapida Nasya for the patients suffering from
Galaroga, Vishamajwara Manovikara and Krimi.
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INDICATIONS OF NASYA
Charaka has described the following general indications, where Nasya therapy
should be used.74
Shirostambha Gadgadatwa
Ardhavabhedaka Vaggraha
Shirahshula Grivaroga
Akshishula Swarabheda
Shukla Roga-Netragata Galashundika
Raji Galashaluka
Timira Galaganda
Vartmaroga Upajihvika
Pinasa Manyastambha
Nasa Shula Ardita
Danta Stambha Apatantraka
Danta Shula Apatanaka
Danta Harsha Karnashula
Danta Chala Arbuda
Hanugraha Skandharoga
Mukharoga Amsashula
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CONTRAINDICATION OF NASYA
Table No.7 Contra Indications of Nasya mentioned in Brihatrayiee have been
tabulated below :75,76,77
Sr. Nasya arha Charaka Sushruta Vagbhata 1 Bhuktabhakta + + + 2 Ajeerni + + - 3 Pita Sneha + + + 4 Pita Madya + + + 5 Pita Toya + + + 6 Snehadi Patukamah + - + 7 Snatah Shirah + - + 8 Snatukamah + + + 9 Kshudharta + - + 10 Shramarta + + - 11 Matta + - - 12 Murcchita + - - 13 Shastradandahrita + - - 14 Vyavayaklanta + - - 15 Vyayama klanta + +(Shranta) - 16 Pana klanta + - - 17 Navajwara Pidita + - - 18 Shokabhitapta + - - 19 Virikta + - +(Shuddha) 20 Anuvasita + +(DattaBasti) +(Datta Basti) 21 Garbhini + + + 22 Navapratishyaya arta + - - 23 Apatarpita - + +(Shuddha) 24 Pitadravah - + + 25 Trishnarta + + - 26 Gararta - + + 27 Kruddha - + - 28 Bala - + - 29 Vruddha - + - 30 Vegavarodhitah - + + (Vegarta) 31 Raktasravita - - + 32 Sutika - - + 33 Shwasapidita - - + 34 Kasapidita - - +
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SUITABLE TIME FOR GIVING NASYA
Charaka have opined that generally Nasya should be given in Pravruta, Sharada
and Vasanta Rutu.78 But in emergency it can be given in any season by providing
artificial conditions of the above mentioned seasons, for example in summer, Nasya
can be given in cold places and in cold season, it can be given in hot places.
Table No. 8.
Time schedule according to different seasons : 79
Slno Rutu Nasya to be given at 1 Grishma Rutu Morning 2 Shita Rutu Noon 3 Varsha Rutu When day is clear 4 Sharada + Vasanta Morning 5 Shishira + Hemanta Noon 6 Grishma + Varsha Evening
Table No. 9. Time schedule in DoshajaVikara should be as below. 80
Solano Doshaja Vikara Nasya to be given at 1 Kaphaja Vikara Morning 2 Pittaja Vikara Noon 3 Vataja Vikara Evening
Sharangadhara has followed the same as per Sushruta. He further states that – Nasya
can be given in night, if the patient is suffering from Lalasrava, Supti, Pralapa,
Putimukha, Ardita, Karnanada, Trushna, Shiroroga and such conditions like excessive
vitiated Doshas.81
TABLE No. 10 COURSE OF NASYA KARMA
No. Name of Acharya Days 1 Sushruta 1,2,7,21 2 Bhoja 9 3 Vagbhata 3,5,7,8
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Charaka
Charaka has suggested administering nasya according to the severity of
disease….
Sushruta
According to Sushruta, Nasya may be given repeatedly at the interval of 1, 2, 7
or 21 days depending upon the condition of the patient and the disease he suffers. 82
Vagbhata
Nasya Karma may be given for seven consecutive days. In conditions like Vata
Desha in head, hiccough, loss of voice, Manyastambha, Apatanaka etc. it may be done
twice a day (in morning and evening). 83
Nasya should be given for 3 days, 5 days, 7 days and 8 days or till the patient
shows the symptoms of Samyaka Nasya as stated in Ashtanga Samgraha.84
Bhoja ref. 85
Bhoja says that if Nasya is given continuously beyond nine days then it
becomes Stamya to patients and if given further, it neither benefits nor harms the
patients.
Age limit 86-87
“ lÉ lÉxrÉqÉÔlÉxÉmiÉÉoSå lÉÉiÉÏiÉÉzÉÏÌiÉuÉixÉUå | ”
A.¾Òû.xÉÔ.20/30
“ AÉeÉlqÉqÉUhÉÇ zÉxiÉ: mÉëÌiÉqÉzÉïxiÉÑ oÉÎxiÉuÉiÉç | ”
A.¾Òû.xÉÔ.20/30
Nasya should not be administered in those who are less than 7 years & more than
80 years of age. Pratimarsha can be given throughout life just like matrabasti.
DOSE OF NASYA
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The dose of Nasya drug depends upon the drug utilized for it and the variety of
the therapy. Charaka has not prescribed the dose of the Nasya. Sushruta and
Vagbhata have mentioned the dose in form of Bindu (drops), here one Bindu means
the drop which smears after dipping the two phalanges of Predestine (index) finger in
oil.88
Table. No.11 Showing The Dosage of Nasya Karma
Drops in each Nostril No.
Type of Nasya Rhaswa
Marta Madhyama Matra
Uttam Matra
1 Shamana Nasya 8 16 32 2 Shodhana Nasya 4 6 8 3 Marsha Nasya 6 8 10 4 Avapida Nasya (Kalka Nasya) 4 6 8 5. Pratimarsha Nasya 2 2 2
PROCEDURE:
The procedure of Nasya karma may be classified under following heading:
Purva Karma
Pradhana Karma
Paschat Karma
Purva Karma :
Prior to Nasya karma, it is advisable that all materials, drugs and equipments
necessary for Nasya karma are collected in sufficient quantity.
Patient should be prepared for Nasya karma. It can be described in detail as
under. Special room for Nasya should be prepared which should be free from
atmospheric effects like direct blow of air or dust and it should be lighted properly. 89
Nasya Asana :
It should be placed in Nasya room. It consists of -
A chair for sitting purpose
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A cot for lying purpose
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Nasya Aushadhi :
Drug required for Nasya karma in the form of Kalka, Churna, Kwatha,
Ksheera, Udaka, Sneha, Asava etc. should be collected in sufficient quantity.
Table No. 12 Nasya Yantra : It should be collected according to the types of
Nasya such as :
A dropper or Pichu For Snehana, Avapida, Marsha and Pratimarsha Nasya.
Shadangula Nadi For Pradhamana Nasya Dhuma Yantra For Dhuma Nasya
Besides it is also necessary that a stove, bowl, napkins, spitting pits and an efficient
assistant are kept handy.
Selection of The Patient :
The patient should be selected according to the indications and contra-
indications of Nasya described in classics.
Preparation of The Patient :
After passing natural urges,abhynga should be done to urdhava jatru pradesha
,followed by mrudu swedana.The eyes should be protected while doing swedana karm
by covering it with cotton cloth. Mrudu Svedana may be given for elimination of
Doshas and liquification of Doshas. Tapa sveda may be given on Shira, Mukha, Nasa,
Manya, Griva and Kantha region. Cloth dipped in hot water may be useful for Mrudu
Sveda.After Svedana smooth massage should be applied on regions of Gala, Kapola
and Lalata.
Pradhana Karma :
The procedure to be adopted for the Nasya karma is described here as per
the statements of Charaka, Vagbhata and Susrutha. 90abc
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Posture of The Patient :
The patient should lie down in supine position with ease on Nasya table. Shira (head)
should be “Pralambita” and foot part is to be slightly raised. Head should not be
excessively flexed or extended. If the head is not lowered, the nasal medication may
not reach to the desired distinction and if it is lowered too much, there may be the
danger of getting the medication to be lodged in brain. After covering the eyes with
clean cotton cloth, the physician should raise the tip of the patient’s nose with his left
thumb and with the right hand the luke warm medicine (Sukhoshna drug) should be
dropped in both the nostrils alternately, with the help of proper instrument like pichu,
dropper, shadangula nadi etc. according the type of Nasya. The drug should be proper
in dose and temperature.
The patients should remain relaxed at the time of administration of nasya and
should avoid speech, anger, sneezing, laughing and shaking his head.91
Pashchat Karma:
According to Brihatrayees following regimen should be followed after
administration of Nasya. Patient is asked to stay in same position till 100 matras i.e. 2
min approx. Later feet, shoulders, palms and ears should be massaged. Again mridu
tapa sweda should be done on forehead, cheeks and neck. For pacifying Vata dosha,
Rasna churna is rubbed on head.92,93
The patient is asked to expel out the drug which comes in oropharynx. Care
should be taken that no portion of medicated oil is left behind.
Medicated Dhumpana and Gandusha are advocated to expel out the residue
mucous lodged in Kantha.94.Laghu and sukhosna jala are advised.95. Patient is advised
not to expose to cold wind, dust, smoke, sunshine. He should avoid head bath, anger,
riding, excessive intake fat and liquid diet. 96A light meal and lukewarm water are
advised. Acharya Charaka further says that the patient should avoid day sleep and
should not use cold water for any purpose like pana, snana, etc.
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SAMYAK YOGA, AYOGA AND ATIYOGA OF NASYA KARMA :
Samyak Yoga :
The symptoms of adequate Nasya according to Charaka are Urah-shiro-laghava
(Feeling of lightness in chest and head). Indriyavishuddhi (sensorial proficiency) and
Srotovishuddhi (cleansing of channels) are considered as samyaka nasya laxanas. To
that, Sushruta includes Sukhaswapna-prabodhana (good sleep and awakening), Chitta-
Indriya-prasannata (mental and sensorial happiness) and Vikaropashama
(Improvement). Besides these Sukhochhvasa (proper respiration) and sneezing have
been described by Vagbhata .
Table.No.13 Showing Samyaka Yoga Lakshana 97-101
Symptoms Ch. Su. As. H. Sha. B. P. Ka. Urah Laghuta + - - - + - Shiro Laghuta + + - - - - Netra Laghuta - + + - + Laghuta - - - + - Srotovishuddhi + + - + + + Swaravishuddhi - + - - - Vaktravishuddhi - + - - - Indriya achchta-prasada + + - + + + Netrateja Vriddhi - + - - + Chitta Prasada - + - + + + Vikaropashama - + - + + - Sukha Swapna Prabod ha - + + - - - Sukhochhvasa - + - - - - Smruti - - - - - + Medha - - - - - + Bala - - - - - +
Ayoga :
If Nasya is not given in proper way or the dose is less, features of inadequate
Nasya arise which are Shirogaurava (heaviness in head), Galopalepa (throat coated
with mucus) and Nishthivana102 (excessive spitting). According to Sushruta, Kandu
(Itching), Upadeha (feeling of wetness), Guruta (heaviness), Srotasam Kapha Srava
(excess mucus secretion in channels) are the symptoms of Hina Shuddhi103. Vitiation
of Vata, dryness in Indriya, no relief in the symptoms of the disease 104, dryness in
mouth and nose are other symptoms of Ayoga of Nasya karma.
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Table No. 14. Ayoga Lakshana 105-109
Sl.No Symptoms Ch. Su. As. H. Sha. B.P. Ka. 1 Shirogaurava and Dehagaurava + - - + + + 2 Galopalepa + - - - - - 3 Nishthivana + - - - - - 4 Kandu - + + + + - 5 Kaphapraseka - - - - - - 6 Upadeha + - + + - - 7 Rukshata + - - + + + 8 Vata Vaigunya + - - - - - 9 Srotoriktata - - - - + - 10 Srotasam kaphasrava + - - + + + 11 Navasota - + - - - - 12 Asyashosha - + - - - - 13 Akshistabdhata - + - - - - 14 Shiroshunyata - + - - - - 15 Vyadhi Vrudhi - - - - - +
Atiyoga :
According to Charaka, the general features of excessive Nasya are, feeling of
Arati (uneasiness) and Toda (pricking like pain in the head, eyes, temporal region and
ears) 110. Kapha Srava (Salivation), Shirahshula (headache) and Indriya Vibhrama
(confusion) are the symptoms of Atiyoga of Nasya 111. Mastulungagamana,
Vatavriddhi, Indriyavibhrama and Shiroshunyata (emptiness of head) are also the symptoms of
Atiyoga of Shirovirechana
Table No. 15. Atiyoga Lakshana 112-116
Symptoms Ch. Su. As. H. Sha. B.P. Ka. Shirogaurava - + + + + - Shiroshunyata - + - + + - Shirovedana + - - - - + Netra Vedana + - - - - - Shankhavedana + - - - - - Suchitodavata Pida + - - - - - Indriya Vibhrama - + - + + + Mastulungagamana - + - - - - Snehapurna Srotasa - - - - + - Karna Talu Upadeha - - - - - - Vata Vriddhi + - - - - + Kandu - + - - - - Praseka - + + + - - Pinasa - + - - - - Aruchi - - + - - -
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Deha Daurbalya - - - - - + Unmada - - - - - - Pitta Vriddhi - - - - - - Hridaya Shula - - - - - - Suryavarta Roga - - - - - - Atripti - - - - - -
Vyapada :
Nasya vyapada (complication) occurs due to:
♦ If patient breaches the protocol to be followed after Nasya karma.
♦ On administration of Nasya in any contra-indicated condition.
♦ Due to technical failure by any means.
The complications occur through following two modes.
Doshotklesha : managed by Shodhana and Shamana chikitsa.
Doshakshaya : managed by Brimhana chikitsa.117
When Nasya is administered to the patient just after lunch or who is suffering
from indigestion then diseases like Kasa, Shwasa, Chhardi, Pratishyaya etc. may occur
due to obstruction of channels situated in upper part of body.
If Nasya is given in season in which it is contra-indicated for e.g. cloudy
atmosphere, then there is possibility of occurrence of Kapha roga like asthma.
Treatment :
In above-mentioned conditions treatment should be done with Kapha Nashaka
Upachara like Ushna, Tikshna Aushadha and Kapha Nashaka karma.
If Nasya is given in Krusha, Kshina (emaciated), Virikta (patient who had
taken virechana) Aura (anxious), Garbhini (pregnant lady), Vietnam kantar (exhausted
with exercise) and a thirsty person then vitiation of Vata dosha takes place which may
produce vata-vikara.
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In this condition, Vatanashaka treatment like snehana, swedana, brumhana
should be specially done, pregnant lady should be treated with ghruta and milk 118.
If Nasya is administered in a madya pita, person having fever and in
shokabhitapta then timira roga may occur. For this ruksha, sheeta lepa and Putapaka
should be applied.
Vyapada Due To Technical Failure:
This can occur in following conditions -
1) If the drug used for Nasya is very hot or cold.
2) The dose is not proper i.e. very less or in excess quantity.
3) If the posture is not proper i.e. patient has lowered his head more during
Nasya. In such conditions complications like Trishna and Udgara occur. Treatment
should be done according to the disease. If the patient faints at the time of Nasya he
should be treated with sprinkling of water on Lalata and Mukha. 119
BENEFITS OF NASYA
Patient who regularly observes Nasya Karma does not become victim of
diseases of eyes, ears and nose. His hair and beard does not turn gray. His hair doesn’t
falls but instead grows fast. Diseases like common cold, migraine, headache, facial
paralysis, etc. can be alleviated. The joints, sinus, tendons and bones of his cranium
acquire great strength. His face becomes cheerful and plump and his voice becomes
mallow, firm and stentorian. Strength of all sense organs increases greatly. There will
be no sudden invasion of disease in the upper parts (Urdhvajatrugata) of the body. He
experiences the symptoms of old age later.120
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RACHANA SHARIRA
Disease of the supra clavicular region are cured in the person who practices
Nasya. He gets clarity of senses, good smell of mouth and the strength of jaw, teeth,
arms, chest, etc. He never suffers from the premature appearance of wrinkles,
premature hair falling and Vyanga
In Ayurvedic classics detailed explanation about Nasa is not available.
Sushruta has mentioned it as pratyanga and mentions 8 urdhwaga dhamanis among
which Gandhavaha dhamanis are included.126
Importance of Indriaya-Pancha-panchaka:
Acharya Charaka has specified mainly the functional aspect of nose than
Anatomical aspect i.e. showing the importance of Nasa as gnyanendria. Charaka has
mentioned sense faculties for Nasa as below 127
Indriya — Ghranendriya Indria Artha --- Gandha
Indria Dravya – Prithvi Indria Buddhi --- Gandha jnana
Indria Adhishthana – Nasa
Sushruta telling importance of Indriya – pancha-panchaka, Panchabhibhuta
dhamanis have been told, i.e. the sense faculties perceive objects which are dominated
by the Mahabhuta specially constituting those respective faculties128. This tells about
Gandha gnyana / buddhi occurs, when Gandha Artha is perceived by Nasa through
particular dhamanis. Sushruta perhaps referred about particular receptors necessary
for smell. These Dhamanis have fine porous structures like stem of lotus.
Siras associated with Nose:
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While explaining about Siras, Sushruta has mentioned 124 Vatavaha Siras
for urdhwa jatrubhaga. Among these Vatavaha Siras, 6 Siras supply to Nasika 129.
The main function of these Vatavaha Siras is to perceive the impulses of particular
sense faculties to Manas and exact gnyana / Buddhi 5occurs. Even Ashtanga
Hridayakara claims in all 24 Siras are Nasashrita & these are Gandhavedini Siras 130.
Marmas associated with Nasa:131
Phana Marma: It is Sira marma located on both sides of Nasa srotomarga internally
which is responsible for Gandha gnyana. It is a Vaikalyakara Marma. Pramana-
Ardhangula.
Shringataka Marma: It is a sira Marma. This Marma is the association of Ghrana,
Akshi, Shrotra and Jiwha Siras. This is the Sadyopranahara Marma.
Applied Anatomy of Nose 132ab
The nasal cavity is bounded by floor, roof, medical and lateral walls.
Important anatomical structures for consideration are mainly the floor and the roof.
Floor is formed by the horizontal process of the Palatine bone.
Roof is very narrow and formed by:
Nasal and frontal bones, anteriorly,
Cribriform plate of ethmoid bone in the middle, and,
Body of sphenoid, posteriorly.
The roof of Nasal cavity is formed with the superior turbinate and cribriform
plate. This is a specific plate which forms the floor of the anterior cranial fossa, having
small pores in it. This is the specific area of olfaction formed by the superior turbinate
constituted with special mucous membrane; which is called as olfactory membrane.
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This olfactory epithelium, where olfactory receptors are located, is also called
as olfactory area. The total area of olfaction on each side is about 250mm2.
The olfactory area (epithelium) is composed of mainly the following types of
cells: Supporting (Substentacular cells)
Receptor cells and,
Basal cells
Supporting cells are columnar cells which secrete mucous. The Receptor cells
are those where one end forms into Axon and another end facing mucous layer, forms
into cilia which perceive the object (i.e., smell). These axons join together to form the
olfactory tract and the olfactory bulb.
Character of the Nasal Epithelium:
While learning Nasya Karmukata it is important to understand the
character of nasal epithelium. Olfactory mucosa occupies the olfactory portion of the
nose which extends over the upper part of septum and adjacent lateral wall up to the
superior turbinate. In each nostril, the olfactory membrane has a surface area of about
2-4 cm2 . The receptor cells for the smell sensation are the olfactory cells; which are
actually bipolar nerve cells derived originally from the C.N.S itself. There are about
100 million of these cells in the olfactory epithelium interspersed among sustentacular
cells. The mucosal end of the olfactory cell forms a knob from which 6-12 olfactory
hairs project into mucous that coats the inner cavity of the nasal cavity. These cilia /
hairs react to odors in the air and stimulate the olfactory cells.
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Stimulation of the olfactory cells:
The odorant substance coming in contact with olfactory surface first diffuses into
the mucous that covers cilia. Then it binds with a receptor protein that protrudes
through the ciliary membrane. This receptor is a long molecule that threads its way
through the membrane 7times, folding inward and outward. The odorant binds with
the portion of the receptor that fold to outside. The inside of the folding receptor, on
the other hand, is coupled to a so-called G-protein. This activates adenyle cyclase that
is attached to the inside of the ciliary membrane near the receptor cell body. This
activation in turn converts many molecules of intracellular adenosine triphosphate into
cyclic adenosine monophosphate (cAMP).This effects into a large number of sodium
ions to pour into the receptor cell cytoplasm. The sodium ions contribute positivity to
the inside of the cell membrane, thus exciting the olfactory neuron system and
transmitting action potentials into the C.N.S by way of an olfactory nerve. In addition
to the basic chemical mechanism by which the olfactory cells are stimulated, several
physical factors affect the degree of stimulation. First, only volatile substances that can
be sniffed into the nostrils can be smelled. Second, the stimulating substance must be
at least slightly water soluble, so that it can pass through the mucous to reach the
olfactory cells. And third, it is helpful to be at least slightly lipid-soluble, presumably
because the lipid constituents of the cilium membrane repel non-lipid-soluble odorants
from the membrane receptor proteins.
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Figure no.1 Showing The Olfactory System:
Membrane Potentials and Action Potentials in Olfactory Cells:
The membrane potential of unstimulated olfactory cells, as measured by
microelectrodes, averages about -55millivolts.At this potential, most of the cells
generate continuous action potentials at a very slow rate, varying from once every
20seconds up to 2-3/ second. Most odorants cause depolarization of the olfactory cells
membrane, decreasing the –ve potential in the cell from -55 down to as low as -30
millivolts or even less. Along with this, the number of action potentials increases to
about 20 per second, which is a high rate for the minute, fraction of micrometer
olfactory nerve fibers.
Transmission of smell signals into the C.N.S:
The olfactory bulb, which is a cranial nerve 1, its an anterior outgrowth of
brain tissue from the base of the brain having a bulbous enlargement, the olfactory
bulb, at its end that lies over the cribriform plate separating the brain cavity from the
Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09 33
Procedure review
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita”
upper reaches of the nasal cavity. This plate has small multiple perforations through
which an equal number of small nerves pass upward from the olfactory bulb in the
cranial cavity. There is a close relationship between the olfactory cells in the olfactory
membrane and the olfactory bulb, with a short axons terminating in multiple globular
structures within the olfactory bulb called glomeruli. Through these axons olfactory
sensations transmit into C.N.S.
Mode of action of Nasya karma
According to Charaka Samhita, the drug administered through the nose enters
into the Uttamanga and eliminates the morbid Doshas residing there133.
According to Vruddha Vagbhata: 134
Drug administered through nose -the doorway to Shiras
Reaches the Shringataka marma of Head (Shiras) which is a sira marma and formed by
the Shiras of nose, eyes, kantha and shrotra
The drug spreads by the same route
Apakarshana of morbid Doshas of Urdhwajatru and expels them from the Uttamanga
Indu, the commentator of Ashtanga Samgraha, opined that Shringataka is the
inner side of middle part of head i.e. “Shiraso Antar Madhyam”.
In Charaka also while explaining the drug pathway through Nasa- has
mentioned the special structures Munja shara and Ishika. Dictionary meanings of these
words refer; Munja Shara – A sort of Grass and Ishika—A painters brush. Charaka
mentions morbid Doshas get attracted to these structures like paint instilled brush135.
In this context Sushruta has clarified that Shringataka marma is a Sira marma formed
by the union of Siras (blood vessels) supplying to nose, ear, eye and tongue . Thus we
can say that drug administered through Nasya may enter the above sira and purifies
them. Under the complications of Nasya karma, Sushruta has mentioned that
Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09 34
Procedure review
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excessive eliminative errhine may cause Mastulunga Srava (flow of cerebrospinal
fluid out to the nose)136. Which suggest the direct relation of Nasal pathway to brain.
Drug Delivery: Nasal Route The nasal route is an attractive alternative to invasive administrations, and provides a
direct access to the systemic circulation. Certain drugs that are administered
intranasally are able to penetrate the nasal mucosa and enter the system. A rapid onset
of action is one advantage of the nasal route for the administration of systemically
acting,products.
The nose, or more precisely the nasal cavity, is the target of the
administration of a drug product. The anatomy and the physiology of the nose play a
decisive role in efficient drug administration. The nasal mucosa is much more
sensitive to external influences than the digestive mucosa in the stomach. Nasal
administration has several advantages. First, deposition of an active compound in the
nasal cavity results in avoidance of its degradation through the “first-pass”
metabolism. Second, enzymatic breakdown of the drug in the nose can be neglected.
Third, the onset of action of the drug is more rapid and even comparable to an invasive
route.
Drug review
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DRUG REVIEW
The study involves two compound drugs which are explained here:-
⇒ Karpasasthyadi Taila 1
The Karpasasthyadi Taila is taken from Sahastrayoga.
⇒ Rasnaputika Taila2
The Rasnaputika taila is taken from Yogaratnakara mentioned in vatavyadhi
chikitsa
KARPASASTHYADI TAILA:
It has Karpasbeeja and Masha,Bala,Kulatha ingredients for kashaya prepararation ,
along with Ajaksheera and kalka dravyas.
Kalka dravyas:
Devdaru,Rasna,Kushta,Sarshapa,Nagara,Shatahva,Pipplimula,Chavya,Shigru,and
Punarnava.
Indications: Ardita, Apabahuka Pakshaghata,
Uses : Navana , Abhyanga , Pana.
Karpas 3:
MüÉmÉÉïÍxÉMüÉå sÉbÉÑ: MüÉåwhÉÉå qÉkÉÑUÉå uÉÉiÉlÉÉzÉlÉ:|
iÉiÉç mÉsÉÉzÉÇ xÉqÉÏUblÉÇ U£üMÚülqÉÔ§ÉuÉkÉïlÉqÉç |
iÉiÉç MühÉïÌmÉQMüÉAlÉÉW mÉÔrÉx§ÉÉuÉÌuÉlÉÉzÉlÉqÉ |
iÉiÉç oÉÏeÉqÉç xiÉlrÉSÇ uÉÚwrÉÇ ÎxlÉakÉqÉç MüTüMüUÇ aÉÑÂÇ|û ( pÉÉ.mÉë.)
Hemigosypol – seed, Oil – Cyryophyllene,pinene,Limonene
Drug review
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Table no.26 Showing The Ingredients of Karpasasthyadi taila3-16
Si.no.
Name of the drug
Botanical Name Family Gana Parts
used Rasa Guna Virya Vipaka
Doshagnata
1 Karpasa
Gossypium
herbaceum Malvaceae Bruhaneeya,
Vatashamana Seed Katu Laghu, Tikshana Ushna Katu Vata
pittahara
2
Masha Phascolus mungo
Leguminosae,Papilionatate
Purishajanana Seed Madhra Guru snigdha Ushna Madh
ura
Vatahara,pitta
kaphavrdhaka
3 Bala
Sida cordifolia
Malvaceae Balya
,Brihaniya mula Madhur
a
Laghu snigdha sheet
Madhura
Vatapitthara
4
Kulattha Dolichos biflorus
Linn
Leguminoseae Ashmarighna seeds Kashay
a
Laghu,
Rooksha, Tikshna
Ushna Amla Kapha vata
shamaka
5
Devdaru Cedrus Deodara Conifereae
Katuka skanda,
stanyashodhana
kandasara Tikta Lagu.
snjgdha Ushna katu Kapha vata
shamaka
6 Rasna Pluchea
Lanceolata Composite
ae Anuvasanopa
ga Patra Tikta Guru Ushna Katu Kapha vata
shamaka 7
Kushta Saussurea luppa
Compositeae
Lekhaneeya,shukrashodhan
a, Roots
Tikta katu mada
Laghu RookshT
ikshna Ushna katu Kapha
vata hara
8 Sarshapa Brassica
campestris Cruciferae Kandughna Seed
Katu ,tikta
Laghu,Snigdha
Ushna
Katu
Kaphavatahara
9
Nagara Zingiber offiole
Zingibaeracae
Trptighna,shoola prashamana,
Rhizome Katu
Guru Ruksha, Tikshna
Ushna
Madhura
Kapha, Vata shaka
11 Shatahva
Anethum sowa Umbellifer
ae Asthapana Fruit Katu .Tikta
Laghu..ruksha,tik
shana Ushna katu
Kapha vata
shamaka 11 Pipplimu
la Piper
longum Piparacae Deepaneeya mula Laghu ,ruksha
Laghu, ruksha Ushna Katu Kapha
vatahara 12
Chavya Piparaceae
Piper chaba
shoolaprashamana kanda Katu
Laghu rooksha
Ushna
Katu
Kaphavatahara
13
Shigru
Moringa
ptyregosperma
Moringa ceae
Shirovirechana mula Katu
tikta
Laghu rooksha tikshna
Ushna katu
Kaphavatahara
14 Punarnav
a Borrhavia
diffusa
Nyctaginaceae
Swedopaga,vayasthapana,
Kasahara mula
Madhura tikta kashay
Laghu rooksha ushna katu Kaphava
tahara
Drug review
Ajaksheera:17
Rasa: Kashaya,Madhura
Veerya: Sheeta
Guna: Grahi,Laghu
Use: Raktapittatisara,Kshaya,Kasa,Jwara ,Sarvarogahara.
Rasnaputika Taila: Indications :
This can be used for nasya,shirobasti,pana in condition like
Ardita,Pakshaghata,Adhyavata,Padaharsha,Sarvagavata,Ekangavata,Pangu,Kalayakha
nja,Avabahuka,Jihvastambha,Hanustambha,Shirovata,Vishwachi,Vranayama.
Rasna:18
Botonical Name : Pluchea lanceolata
Family Name : Compositeae
Rasa : Tikta.
Veerya : Ushna.
Guna : Guru.
Dosha Karma : Kapha vata haram.
Parts used : Moola
Uses: : vata disorders. Amavata,Shotha,Udara.
Chemical composition: Proteins,quercetinn isorhamnetin,Pluchicin.
KARANJA19:
Karanja consists of dried root of Pongamia pinnata (Linn.)
Family :Fabaceae
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita” Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09 86
Drug review
Gana:Kandughna,Ktuka skanda,
Rasa: Tikta.katu,kashaya
Guna: Laghu,Tikshna
Veerya: Ushna
Vipaka : Katu
Karma : Kaphavatahara,Shothahara,Bhedana
Part Used: Root bark,Stem bark,Leaves,Seeds,Seed oil.
Constituents - Karanjin, Kanugin, Demethoxy-kanugin, Pongachromene
Therapeutic uses - Krimiroga, Prameha, Yoniroga,
Dose - 1-2 g. of the drug in powder form.
Tila taila20
Botanical name : Sesamum indicum
Family : Pedaliaceae
English name : Sesamum
Part used : Seed
Synonyms : Teel oil, gingelly oil
Rasa : Madhura, Koshaya, Tikta
Guna : Guru, Snigdha
Virya : Ushna
Vipaka : Madhura
Doshaghnata : Tridoshaghna
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Drug review
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Actions and uses:
It is Balya, Keshya, Twachya, Dantya, Agniprada, Pachana, Vrinahar, Netrya,
Mamsadhatu pustika, Pramehahara etc
Table no.27 Showing The Ingredients of Rasna putika taila21-79
Si.no. Name of the drug
Botanical Name Family Gana Parts
used Rasa Guna Virya
Vipaka
Doshagnata
1
Bilwa Aegle
marmelos corr.
Rutaceae
Shothahara, Arshaghna,
Asthapanapaga,Anuvasanopaga (Ch), Brihat Panchamoola
Root Kasha
ya, Tikta
Laghu, Ruksha
Ushna
K`atu
Kapha Vatasha
maka
2
Agnimanth
a
Premna Muronata
Verbernaceae
Shothahara; Shitaprashamana, Anuvasanopaga,
Root bark
Tikta, Katu, Kasha
ya, Madh
ur
Laghu, Ruksha
Ushna Katu
Kaphavatasham
aka.
3
Shonaka
Oroxylum Indian
Bignoniaceae
Shothahar,Shitaprashamna, Anuvasanopaga(ch)
Root bark
Madhur,
Tikta, Kasha
ya
Laghu, Ruksha
Ushna Katu
Kapha Vatasha
mak
4
Patala
Stereospermum
suavealens.
Bignoniaceae
Shothahara(Ch.)
Root bark
Tikta, Kasha
ya
Laghu, Ruksha
Ushna Katu
Tridoshashama
ka
5 Gambhari
Gmelina arborea
Verbenaceae
Shothahara, Virechanopaga, Dahaprashana
Root Tikta, Kasha
ya, Guru Ushn
a Katu Tridoshashama
ka 6 Brihat
i Solonum indicum
Solonaceae
Laghu, Ruksha, Tikshna
Root Fruit
Katu. Tikta
Laghu, Ruksha, Tikshna
Ushna Katu
Kapha vatashamaka
7 Kantakari
Solonum Xanthaca
rpun, Solanum
Surattense
Solanaceae
Kasahara, Kanthya,
Hikkanigrahana
Root, Panchanga
Tikta, Katu
Laghu, Ruksha, Tikshna
Ushna Katu
Kaphavatasham
aka
8
Gokshura
Tribulus terestris
Zygophylaceae
Mutravirechaniya, Shothahara,
Krimighana, Anuvasanopag
Fruit and
Root
Madhur
Guru, Snigdha Shita Mad
hura
Vatapittashama
ka
9 Shaliparni
Desmodium
gangetium
Leguminoceae
Papilionatae
Angamardaprashamana,Balya
panchanga
Madhura,Ti
kta
Guru,Snigdha
Ushna
Madhur
Tridoshashama
ka
10 Prishniparni
Uraria picta
Leguminoceae
Papilionatae
Shothahara.Sandhaniya,Anga
mardaprashamana
Root Madhura,Ti
kta
Lghu,Snigdha
Ushna
Madhur
Tridoshashama
ka
Drug review
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Si.no. Name of the drug
Botanical Name Family Gana Parts
used Rasa Guna Virya
Vipaka
Doshagnata
11 Shunti Zingiber
officinale zingibara
ceae
Trptighna,shoola prashamana, Deepaneeya
Rhizome Katu
Guru Ruksha, Tikshna
Ushna
Madhura
Kapha, Vata shaka
12 Maric
ha Piper
Nigrum. Piperacea
e
Shirovirechana, shoola prashamana, Deepaneeya
Fruit Katu Laghu.tikshana
Ushna Katu
Kapha vata
shamaka
13 Pippal
i Piper
longum Piperacea
e
Shirovirechana, shoola prashamana, Deepaneeya
Fruit Katu
Laghu.Snigdha,tikshan
a
Anushna
sheet
Madhura
Kapha vata
shamaka
14 Ajamoda
Carum roxburgh
ianum
Umbellifrae
shoola prashamana, Deepaneeya
Fruit Katu Laghu..ruksha,tikshana
Ushna katu
Kapha vata
shamaka
15 Shatapuspa
Anethum sowa Umbellif
ereae Asthapana Fruit Katu .Tikta
Laghu..ruksha,tikshana
Ushna katu
Kapha vata hara
16 Vidanga
Embelia Ribes Burm
Myrsinaceae
Krimighna,Trptighna, shoola
prashamna
Fruit Katu Laghu..ruksha,tikshna
Ushna katu
Kapha vata
shamaka
17
Yava Trachi
spermum Lini
Umbeliferae
Sheetprashamana Seed Katu
tikta. Laghu ruksha
Ushna katu
Kapha vata
shamaka
18
Vacha areceae Acorus calamus
Sajnasthapana,lekhaneeya,
Sheetprashamana
Bark Katu.tikta
Laghu.tikshna,s
ara
Ushana katu
Kapha vata
shamaka
19 Kusht
am Saussurea luppa
Compositeae
Lekhaneeya,shukrashodhana, Roots
Tikta katu madhura
Laghu Rooksh
a, Tikshna
Ushna katu
Kapha vata
shamaka
20 Devda
ru Cedrus
Deodara Conifere
ae Katuka skanda, stanyashodhana
kandasara Tikta Lagu.
snjgdha Ushn
a katu
Kapha vata
shamaka
21 Kulatt
ha
Dolichos biflorus
Linn
Leguminoseae Ashmarighna Seeds Kasha
ya
Laghu, Rooksha, Tikshna
Ushna
Amla
Kapha vata
shamaka
22
Kola Zizyphus sativus
Rhamnus
Depana
Kanda, phala majja
Amla, Madhura,
Kashyaya
Guru,
Snigdha, Pichila
Sheet
Madhur
Kapha pitta
shamak
24 Erand
a
Ricinus communi
s
Euphorbiaceae
Bhedaniya,swedopaga,Angamardaprashaman
a
Seeds
Madhur,katu,kash
aya
Snigdha,tikshana,sooks
hma
ushana
Madhur
Kaphavatahara
25
punaranava
Borrhavia diffusa
Nyctaginaceae
Swedopaga,vayasthapana,Kasa
hara Mula
Madhura tikta
kashay
Laghu rooksha
ushna katu Kaphav
atahara
Drug review
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita” Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09 90
Si.no. Name of the drug
Botanical Name Family Gana Parts
used Rasa Guna Virya
Vipaka
Doshagnata
26 Nirgundi
Vitex negundo
Verbenaceae
Vishaghna,Krimighna Patra katu Laghu
rooksha ushn
a katu Kaphavatahara
27
Ashwagand
ha
Withanaia
somnifera
Solanaceae
Balya ,Brihaniya Mula
Katu tikta
kashay
Sningdha
laghu
Ushna katu
Kaphavatahara
28 Varuna
Crataev a nurvala
Capparidaceae
Vatashmarinashana
,kaphashamarinashana
Mula Tikta kasha
y
Laghu rooksha
ushna katu
Kapha vatahar
a
29 Bala
Sida cordifolia
Malvaceae
Balya ,Brihaniya Mula
Madhura
Laghu snigdha sheet
Madhura
Vatapitthara
30
Shighru
Moringa ptyregosperma
Moringa ceae
Shirovirechana Mula Katu
tikta
Laghu rooksha tikshna
Ushna
katu Kaphavatahara
31
Jatamansi
Nordostayhcus
jatamannsi
Valerianaceae Sajnyasthapana Mula
Tikta kasha
y madhura
Laghu snigdha
Sheet
Katu
Tridoshahara
31 Vishatinduk
a
Strychnus nux
vomica
Loganiaceae Akshepajanana Beeja
Katu tikta
Laghu
Ushna
Katu
Kaphavatahara
32 Chavya
Pipera chaba
Piperaceae
shoolaprashamana Kanda Katu
Laghu rooksha
Ushna
Katu
Kaphavatahara
33 Manji
sta
Rubia cardifolia
Rubiaceae
Vishaghna,Jwarahara
Mula
Madhura tikta
Guru rooksha
Ushna
Katu
Kaphavatahara
34 Champak
Michelia champaka
Mangoliaceae
Pushpadi varga Twak, tikta
Laghu rooksha
Shet katu
Kaphavatahara
35 Hingu
Ferula narthex
Umbrllifareae
Sajnyasthapana,Deepaneeya
Niryasa
Katu
Laghu snigdha
Ushna
katu
Kaphavatahara
36 Shach
ara
Barleria prionitis
Acanthaceae
Vatasamshaman Moola
Tikta madhura
Laghu
Ushna
Katu
Kaphavatahara
37 Chandana
Santalum album
Santalaceae
Dahaparshamana,Vishaghna,Angamardpras
hamana
Kandasara,ta
ila
Tikta madhura
Laghu rooksha
Sheet
Katu
Kapha pittahar
a
Drug review
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita” Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09 91
Si.no. Name of the drug
Botanical Name Family Gana Parts
used Rasa Guna Virya
Vipaka
Doshagnata
38 Sarshapa
Brassica campestri
s
Cruciferae Kandughna Seed
Katu ,tikta
Laghu,Snigdha
Ushna
Katu
Kaphavatahara
39 Shata
vari
Asparaus recemosu
s Liliaceae Balya,vayastha
pana Moola
Madhur
,tikta
Guru ,snigdh
a
Sheet Katu
Kaphavatahara
40 Chitra
ka mula
Plumbago
zeylanica
plumbaginaceae
Dipaneeya,soolaprashamana,le
khaneeya, arshoghna
Root bark
Katu
Laghu ,ruksha,tikshan
a
Ushna
Katu
Vata kaphah
ara
41 Jatiphala
Myristica fragrans
Myristicaceae
Aoushadi varga
Seed,seed coat
Tikta katu
Laghu ,tikshan
a
Ushna
Katu
Kaphavatahar
42 Ushira
Vetiveria zizinoide
s
Graminae
Varnya,dahaprashamana
Root
Tikta ,madh
ur
Laghu ,rooksh
a
Sheet
Katu
Kaphapittahara
43
Badar
Ziziphus mauritina
Rhamnaceae
Hrudya,virechnopaga
Root ,leaf,fr
uit
Madhur
Amla
Guru snigdha
Sheet
Madhur /aml
a
Vata pittahar
a
44
Tagar
Valeriana wallichill
valerianaceae
Sheetprashama
na
Root
Tikta Katu, kasha
ya
Laghu snigdha
Ushana
Katu
Kapha vatahar
a
45 Haritaki
Terminalia
chebula
Combretaceae
Shothahara, vedana,
sthapana, anulomana
Phala
Kashaya
pradhana
Laghu,ruksha
Ushana
Madhur
Tridoshahara
46
Amalaki
Embelia officinali
s
Euphorbiaceae Vayasthapana Phala
Pancharasa
except Lavan
a
Guru,ruksha,sni
gdha
Sheeta
Madhur
Tridoshghna
47 Bhibhitaki
Terminalia
bellirica
Combrataceae Jwarahara Phala Kasha
ya Ruksha,
laghu Ushn
a Madhur
Tridoshara
48 Ankola
Alangium
lamarckii thwaites
Alangiaceae Krimighna Mula
Katu ,kasha
ya
TikshaSnigdha
Ushna Katu Kapapit
tahara
49 Mulaka
Raphanus sativus
Cruciferae
Moolakadi varga Kanda katu Ruksha
Ushn
a Katu Tridoshakar
50 Patha
Cissampelos
pareira
Minispermaceae
Jwarahara,Stanyashodhana Mula Tikta Laghu.
Tikshna Ushn
a Katu Kapapittahara
51 Yashtika
Glycyrrhiza glabra
Leguminoceae
Sandhaneeya jeevaneeya Mula Madh
ur Guru
snigdha sheet
a Madhur
Vatapittahar
52 Chitraka
Plumbago
zeylanica
Plumbaginaceae
Deepneeya Lekhaneeya
Mulatwaka
Katu
Laghu.ruksha,
Tikshna
Ushna katu
Kapha Vatahar
a
Drug review
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita” Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09 92
Si.no. Name of the drug
Botanical Name Family Gana Parts
used Rasa Guna Virya
Vipaka
Doshagnata
53 Duralabha
Trushnanigrahana
Fagonia cretica Zygophylaceae Panch
ang
Kashaya,tikta,mad
hr
Laghu,snigdha
Ushna
Katu
Vatapittahar
54 Twak Cinnamomum zeylanicum
Lauraceae
Trijataka Twak
Tikta, Madhura
Laghu, Ruksha, Teekshna
Ushna
Katu Vata and
Pitta
55 Ela Elettaria cardamomum
Zingiberaceae Shiro virechana Seed
Katu,Madhura
Laghu, Ruksha
sheet Madhur
Tridoshahara
56 Patra Cinnamomum tamala
Lauraceae Trijataka Patra
Tikta, Madhura
Laghu,Tikshana
Ushna
Katu Kapha Vatahar
a
57 Nagkesara Mesua
ferrea Guttiferae. Chaturjata
Stamens
(Kesara)
Kashaya,tikta
Laghu, Ruksha
Ushna
Katu Kaphapittashamaka
58 Guggulu
Commiphara Mukul
Burseraceae Sangya
Sthapana Gum Resin
Tikta, Katu
Laghu, RukshaTikshan Sukshma
Ushna
Katu Tridoshahara
Materials and methods
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita” Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09 93
MATERIALS AND METHODS
Clinical trial is a way of research and is the best method to evaluate therapy
involved in the line of treatment. In todays scenario the Ayurvedic therapeutic
approach needed to be explained on rational lines.
The present study was a comparative study where the efficacy of
Karpasasthyadi taila nasya was compared with the efficacy of Rasnaputika taila
nasya.
SOURCE OF DATA:
The patients attending the OPD and IPD of S.J.I.I.M., Hospital, Bangalore who
fulfilled all the inclusion criteria were randomly selected for the study.
DIAGNOSTIC CRITERIA:
Patients with classical signs and symptoms of Charkokta Ardita with presenting main
features like-
1) Mukhardha vakrata : Dakshina/Vama
2) Sharira ardha affected : Dakshina/Vama
3) Vaksanga
INCLUSION CRITERIA:
Patients of both the sexes in the age group of 12-80 yrs. who fulfill the diagnostic
criteria were included in the study.
EXCLUSION CRITERIA:
1. Chronicity of the disease more than 1 year.
2. Pateints with occurrance of Ardita of other systemic disorders..
3. Ardita due to head injury and lesion (brain stem).
4. Ardita of infectious cause.
Materials and methods
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita” Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09 94
RESEARCH DESIGN:
After the diagnosis of Charakokta Ardita based on the above parameters, the
selected patients were subjected for the Randomised Comparative Clinical Trial as
follows-
SAMPLE SIZE AND GROUPING:
A minimum sample of 30 patients with signs and symptoms of Charkokta
Ardita were selected for the study, and they were randomly distributed into 2 groups
of 15 patients
Group A: (Standard Group) 15 patients were subjected to Karpasasthyadi Taila
Nasya.
Group B: (Trial Group) 15 patients were subjected to Rasna putika Taila Nasya
STUDY DESIGN:
Total Study duration: 28 days
Group A: Patients of this Group received nasya with Karpasasthyadi taila for 7
days. A rest of 7 days was given followed by second course for another 7 days and
follwup after seven days.
Group B: Patients of this Group received nasya with Rasnaputika taila for 7 days. A
rest of 7 days was given followed by second course for another 7 days and follwup
after seven days.
Materials required for study for each sitting:
1) Tila Taila for abhyanga
2) A dropper or pichu for Nasya.
3) A cotton strip to cover the eyes
Materials and methods
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita” Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09 95
4) spitting pit or a kidney tray
5) Hot water
6) Nasya dravya
7) Nasya table
8) Towel
Preparation of the Drugs:
Karpasasthyadi taila manufactured by Nagarjuna Pharmacy,kerala.was used for
nasya. Rasna putika taila prepared at Sanjeevini Pharmaceuticals, Kengeri-
Bangalore, after procuring the raw drugs from authentic wholesale dealer.
PREPARATION OF RASNA PUTIKA TAILA:
Kashaya:
Dashmoola,bala,davdaru,ashwagandha,shatavari,varuna,eranda,nirgundi,shigru,shacha
ra,chitramoola,ankolamoola,poonarnava,bhupilu,yava,jivanti,vishatinduka,eranada,jata
mansi,kulatha all these drugs were taken in equal quantity. Rasna is taken in same
quantity as that of total of these drugs Karanja is taken equal to sum of all the above
drugs. All the drugs collected for kashaya are boiled in 16 times of water It was
reduced up to 1/8th part of it.Later the kashaya is filtered and kept aside.
Tila taila was taken equal to One fourth part of the kashaya.It was kept
in a container and heated. After allowing it to cool, the above kashaya was added to
taila. The kalka was prepared with guggulu tagar, jatamansi, pippali,
maricha,Triphala,Chaturjataka,kachoor,vidanga,hingu,rasna,vacha,kutaki,patha,yashti,
chitraka,priyangu,pippalimula,chandana,chavya,champaka,kushta,manjishta,shatapush
pa,sarshapa,jatiphala,usheera was also added to taila. The quantity of kalka is 1/16 th
part of tila taila.
Materials and methods
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita” Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09 96
The taila with kashaya,kalka, was then heated on mild fire. The
mixture was constantly stirred, Aja Ksheera was added and heating was continued.
Constant stirring of the ingredients was maintained to prevent charring of the contents.
The process of heating was continued till the watery portion evaporated and
phenodgamana (formation of froth) was observed and the kalka formed a varti when
rolled between the fingers and did not stick to the finger. After confirming that the
madhyamapaka lakshanas of Tailapaka was achieved the heating was stopped and the
oil was filtered through cloth. The oil was filtered again and allowed to cool. After
cooling it was stored in a clean air tight container.
METHODOLOGY OF STUDY:
PROCEDURE FOR NASYA KARMA:-
The procedure of Nasya karma is classified under following heading:
Purva Karma
Pradhana Karma
Paschat Karma
Purva Karma :
All materials, drugs and equipments like napkin, utensils necessary for Nasya karma
were collected in sufficient quantity prior to Nasya karma. Nasya was performed in
‘Nasya room’ located in Panchakarma theater,place having sufficient day light & is
devoid of direct atmospheric influences like dust, wind, etc.
Nasya Asana: A cot for lying purpose was kept in special room.
Nasya Aushadhi Nasya taila was taken in sufficient quantity.
Materials and methods
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita” Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09 97
Preparation of the Patient:
Patient was advised to attend the natural urges. Patients were asked to be
seated on ‘Nasya pitha’ comfortably for Snehana purpose. Then snehana i.e. Mrudu
abhyanga with Tila taila was done on scalp, forehead and particularly over neck region
for 3 to 5 minutes. After Abhyanga, sthanika Swedana i.e. was done on Shira,
Mukha, Nasa, Manya, Greeva and Kantha pradesha.
Pradhana Karma:
Patient was advised to lie down in supine position on Nasya table. The
head of the patient was lowered (Pravilambita) & was not excessively extended. After
covering the eyes with a clean cloth, the tip of patient’s nose was drawn upward by
left thumb. At the same time with the right hand 8 drops of koshna nasya taila was
administered in both the nostrils alternately. The patient was advised to remain relaxed
at the time of administration of nasya.
Pashchat Karma:
Patient was asked to stay in the same position till 100 matras i.e.
approx. 2 min. Later feet, shoulders, palms and ears were massaged. Again mrudu
tapa sweda was done on forehead, cheeks and neck. The patient was asked to expel out
the drug which comes in oropharynx. Gandusha with koshna jala was advocated to
expel out the residue mucous lodged in Kantha.
Special advise was given to all patients regarding the diet, i.e. –
a. Patients were advised to take light meal and lukewarm water.
b. To avoid cold food & drinks.
c. Prohibition of intake of salad.
d. curd should be excluded completely from the diet.
Materials and methods
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita” Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09 98
Vihara :
Advise was given to all patients regarding vihara
a) Avoid exposure to cold wind, dust, smoke, sunshine.
b) Patient was advised not to take head bath, and to avoid riding, excessive
c) talking, anger, sneezing, laughing and shaking his/her head.
d) Advised to always cover their ears & head.
e) Minimum 6 hrs. of sleep was advised.
f) Day sleep was prohibited.
Pathyapathya:
The patients were advised to follow the general Pathypathya for Ardita.
ASSESSMENT CRITERIA:
The assessment of the disease were done by scoring method. The patients were
assessed on the first day (before starting the treatment) & after completion of the first
course of treatment,before initiation and after completion of second corse and follow
up in both the groups.
Grade Definitation.
I. Normal Symmetrical function in all areas.
II. Slight weakness: noticeable only on close inspection.
- Compelte eye closure with minimal effort.
- Slight asymmetry of smile with maximal effort.
- Synkinesis barcly noticeable, contracture or
spasm absent.
Materials and methods
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita” Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09 99
III. obvious weakness, but not disfiguring
- may not be able to lift eyebrow.
- complete eye closure and strong but
asymmetrical mouth movement with a maximal
effort.
- Obvious, but not disfiguring synkinesis, mass
movement or spasm.
IV. Obivous - Inability to lift eye brow.
disfiguring - incomplete eye closure and
weakness asymmetry of mouth with maximal
effort.
- Severe synkinesis, mass movement, spasm.
V. Motion barely perceptible.
- Incomplete eye closure, slight movement corner of mouth .
- Synkinesis, contracture and spasm usually
absent.
VI. No movement Loss of tone, no synkinesis, contracture or spasm.
- may not be able to lift eyebrow.
Materials and methods
CRITERIA FOR ASSESSMENT :
1. House Brackmann grading scale
BT AT BT 2 AT 2 AF Grade 1 Grade 2 Grade 3 Grade 4 Grade 5 Grade 6
2.Finger Movement
Score BT AT BT 2 AT 2 AF No 4 Slight 3 Unable to hold object 2 Able to hold with less power 1 Normal 0 3.Lifting of Arm at Shoulder
Score BT AT BT 2 AT 2 AF No 4 Up to 45 3 Up to 90 2 Up to 135 1 Up to 180 0
4. Sitting From Lying Down
Score BT AT BT 2 AT 2 AF Unable 2 With support 1 Without support 0 5.Standing From Sitting
Score BT AT BT 2 AT 2 AF Unable 2 With support 1 Without support 0
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita” Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09 100
Materials and methods
6. Drooping wrist Score BT AT BT 2 AT 2 AF Full 3 Moderate 2 Slight 1 No 0 7. Associated Signs And Symptoms (a) Loss of Speech Score BT AT BT 2 AT 2 AF Aphasia 4 Utter voice 3 Speak few words 2 Speak with difficulty 1 Normal 0 (b) Pain
Score BT AT BT 2 AT 2 AF Frequent mild type 2 After exertion 1 No pain 0
8.Muscle Tone Score BT AT BT 2 AT 2 AF Severe rigidity 3 Moderate rigidity 2 Mild rigity 1 Normal 0 9.Loss of Muscle Power
Score BT AT BT 2 AT 2 AF No active contraction 0
Visible contraction without active movement
1
Movement possible when gravity eliminated
2
Movement possible againest gravity 3 Movement possible against gravity & resistant but weaker than normal
4
Normal 5
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita” Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09 101
Materials and methods
10.Handgrip Power
Score BT AT BT 2
AT 2 AF
0 – 10 mm Hg 3 10 – 20 mm Hg 2 20 -30 mm Hg 1 30 -40 mm Hg 0
11. Increase In Walking Capacity :
BT AT BT 2 AT 2 AF Before treatment 2 times than before 3 times than before 4 times than before 5 times than before
12. Reflexes
Score BT AT BT 2 AT 2 AF Very brisk 2 Brisk 1 Normal 0
For measuring handgrip power calf of B.P. apparatus was inflated upto 20
mmHg. This was counted as 0 mmHg. After that the rise in pressure was measured.
For measuring walking capacity patient was asked to walk the possible distance in a
stipulated time of 5 minutes. It was further counted and evaluated by any increase in it.
TOTAL RESPONSE TO THE TREATMENT:
1. Marked improvement relief of >75%
2. Moderate improvement 51-75% relief
3. Mild improvement 25-50% of relief
4. No Change 0% relief
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita” Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09 102
Observations
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita”
OBSERVATIONS
A total of 40 patients were screened for the study, out of which 33 patients met
the inclusion criteria. Among these 33 patients 3 patients did not apt for the study due
to various reasons. A total of 33 patients were registered for the present study. 16
patients were registered in group A, 1 patient dropped out in the middle, while 17
patients were registered in Group B, and 2 patients dropped out in the middle. The data
of 3 patients who dropped out of the study have not been included here.
All the patients were examined before and after the treatment according to the
case sheet format given in the appendix. The data recorded are presented here under
the following heading:–
I. Demographic data
II. Data related to the disease
III. Data related to over all response to the treatment
DEMOGRAPHIC DATA
Table No. 28 showing age wise distribution
No. of patients Age group Group A
Group B Total %
31-40 2 2 4 13.33 41-50 2 4 6 20 51-60 6 7 13 43.33 61-70 3 1 4 13.33 71-80 2 1 3 10
Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09 103
Observations
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita”
Graph No. 1
0
10
20
30
40
50
Group A Group B Total %
31-4041-5051-6061-7071-80
AGE: Age groups of 31-40, and 61-70 have 13.33 patients each, while the age group
41-50 yrs had 20% ,and the age group of 51-60 yrs had 43.33% of patients, ,in 71-80
age group 10 % patients were there.
Table No. 29 Graph No. 2 Showing Sex wise distribution
01020304050607080
1st Qtr Gr. A Gr. B Total %
Male
Female
Majority of the patients (70%) were males and only 30% were females.
No. of patients Sex Group A Group B Total %
Male 8 13 21 70
Female 7 2 9 30
Table No. 30 Showing Education wise distribution
No. of patients Education Group A Group B Total %
Illiterate 3 4 7 23.3 Primary 4 3 7 23.3 High school 6 6 12 40 Graduate 1 2 3 10 Post Graduate 1 0 1 3.3
Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09 104
Observations
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita”
Graph No. 3
0
5
10
15
20
25
30
35
40
Group A Group B Total %
Illi
P
H
G
PG
Majority of the patients (40%) could read and write, while 23.33% of patients
were from primary educated group ,23.33 % patients were illetrate and 1 patient
(3.3%) was Post Graduate.
Table No. 31 Showing Occupation wise distribution Graph No. 4
0
5
10
15
20
25
30
35
GROUPA
GROUPB
TOTAL %
PL
HW
DW
FW
Majority of patients 33% were occupied with Physical labor, while 30% of
the patients were house wives, and 26% of the patients were occupied with desk.10%
of patient from field work group.
No. of patients Occupation Group A
Group B
Total
%
Physical labor
4 6 10 33
House wife 7 2 9 30Desk work 3 5 8 26Field work 1 2 3 10
Table No. 32 Showing Socio economic status Graph no 5
No. of patients Socio
economic status
Group A
Group B Total %
0
10
20
30
40
50
60
Group A GroupB Total %
UM
M
LM
P
Upper middle class 1 2 3 10
Middle 2 3 5 16.6 Lower middle class 9 9 18 60
Poor 3 1 4 13.3
Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09 105
Observations
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita”
The above table shows distribution of patients across society with 10% from
Upper middle class, 16.6% from middle class ,Majority of patients were from 60%
from Lower middle class & 13.3% from the poor class.
Table No. 33
Showing marital status Graph No. 6
0
20
40
60
80
100
GROUPA
GROUP TOTAL %
UM
M
No. of patients Group A
Group B
Total %
Married 15 14 29 96.6
Unmarried 0 1 1 3.3
Among 30 patients 96.6% of the patients were married and 3.3% were
unmarried.
Table No. 34 Showing Family history of STROKE Graph No. 7
020
406080
100120
A B TOTAL %
PRESENT
ABSENT
3.3% of the patients gave family history of Stroke while majority of the patients
Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09 106
(67%) had no family history of Stroke. Table No. 35 Showing Food habit wise distribution
No. of patients Family History
Group A
Group B
Total %
Present 1 0 1 3.3 Absent 14 15 29 96.6
No. of patients Food habit Group A
Group B
Total %
Vegetarian 4 3 7 23.3Mixed 11 12 23 76.6
Observations
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita”
Graph No. 8
0
1020
30
40
5060
70
80
A B TOTAL %
VEG
MIXED
Majority ( 76.6% )of the patients were having mixed food habits and 23.3%
were vegetarians.
Table No. 36 showing Shareerika prakruti wise distribution
No. of patients Shareerika Prakruti Group A Group B Total % Vata Kapha 5 5 10 33.33 Vata Pitta 6 6 12 40 Kapha Pitta 1 1 2 6.66 Pitta Kapha 3 3 6 20
Graph No. 9
0
5
10
15
20
25
30
35
40
GROUP A GROUP B TOTAL %
KP
VK
VP
PK
Majority of the patients (40%) belonged to Vata pitta prakruti, 33.33% patients
belonged to Vata Kapha prakruti, while 20% patients belonged to Pittakaphaja
prakruti and 6.6% Kaphapitta prakruti .
Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09 107
Observations
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita”
Table No. 37
Showing Manasika Prakruti wise distribution Graph No. 10
0
10
20
30
40
50
60
70
GROUP A GROUP B TOTAL %
S
R
T
Majority of the patients (63%) belonged to Rajasika Prakruti and 13.33% of the
patients belonged to Satvika prakruti, while 23% patient belonged to Tamasika
prakruti.
No. of patients Manasika Prakruti Group
A Group B
Total %
Satvika 2 2 4 13.3Rajasika 9 10 19 63.3Tamasika 4 3 7 23.3
Table No. 38 Showing Sara wise distribution Graph No. 11
0
10
20
30
40
50
60
70
A B TOTAL %
Pravara
Madhyama
Avara
Majority of the patients (70%) belonged to Madhyama Sara while 26% of the
patients belonged to Avara Sara and 3.3% belonged to Pravara Sara category.
No. of patients Sara Group
A Group B
Total %
Pravara 1 0 1 3.3
Madhyama 11 10 21 70
Avara 3 5 8 26
Table No. 39 Showing Agni wise distribution
No. of patients Agni Group
A Group B
Total %
Sama 1 2 3 10 Manda 2 1 3 10 Vishama 7 6 13 43.33Teekshna 5 6 11 36.6
Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09 108
Observations
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita”
Graph No. 12
0
10
20
30
40
50
A B TOTAL %
Sama
Manda
Vishama
Teekshna
10% of the patients had Samagni,and Mandagni and 43.33% patients had Vishamagni
and 36.6% of the patients had Teekshnagni.
Table No. 40 Showing Koshta wise distribution
No. of patients Koshta Group
A Group B
Total %
Madhyama 7 8 15 50Mrudu 3 0 3 10Krura 5 7 12 40
Graph No. 13
0
10
20
30
40
50
60
A B TOTAL %
Madhyama
Mrudu
Krura
50% of the patients had Madhyama koshta, 40% of the patients had Krura
koshta and 10% of the patients had Mrudu koshta.
Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09 109
Observations
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita”
DATA RELATED TO DISEASE
Table No. 41 Showing no. of Incidence of Onset of stroke
No. of patients Incidence of
Onset of stroke Group A Group B Total % Sudden onset 12 14 26 86.6 Gradual onset 3 1 4 13.3
Graph No. 14
0
20
40
60
80
100
A B TOTAL %
sudden
Gradual
There were major no of ( 86.66% ) patients with sudden onset of stroke, 13.33% of the
patients suffered from stroke with gradual onset.
Table No. 42 Showing no. of Right/Left half of the body affected
Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09 110
Graph No. 15
0
10
20
30
40
50
60
A B TOTAL %
RIGHT
LEFT
No. of patients Half of the body affected Group A Group B Total % Right 4 8 12 40Left 11 7 18 60
Observations
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita”
A Total of 12 patients (40%) suffered from Loss of function of Right side of
the body, while 18 patients (60%) suffered from Loss of function of Left side of the
body.
Table No. 43
Showing duration of illness wise distribution
Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09 111
No. of patients Duration of Illness Group A Group B Total % 0-1Month 3 3 6 20 1–3Months 2 1 3 10 3- 6Months 6 5 11 36.67 6M -1 year 4 6 10 33.33
Graph No. 16
0
510
1520
25
3035
40
A B TOTAL %
0‐1Month
1‐3Months
3‐6Months
6M‐ 1year
Total 3 patients (10%) were having1-3 months of history of illness, while 11
patients (36.67%) had 3-6 Months history of illness and, 10 patients (33.33%) had
history of 6M -1 year and 20% patients were having 0-1 month of history of illness.
Table No. 44 showing Aharaja Nidana
60% of the patient consumed Rooksha ahara, 13.33% of the patients consumed
Sheeta ahara, 30% of the patients consumed Alpa ahara and 53.33% of the patients
consumed Laghu ahara. The pattern clearly shows that majority of the patients
consumed Vata Vardhaka ahara.
No. of patients Aharaja Nidana Group A Group B Total % Rooksha ahara 11 7 18 60 Sheeta ahara 2 2 4 13.33 Laghu ahara 10 6 16 53.33 Alpa ahara 5 4 9 30
Observations
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita”
Graph No. 17
0
10
20
30
40
50
60
A B TOTAL %
Ruksha
Sheeta
Laghu
Alpa
Table No. 45 showing Viharaja Nidana
No. of patients Viharaja Nidana Group A Group B Total % Ati vyayama 4 10 14 46.6 Ati adhva 2 5 7 23.33Ati prajagara 7 8 15 53.33Abhighata 2 1 3 10 Ati langhana 1 1 2 6.66 Bhojanottar chesta 2 4 6 20 Diva svapna 4 3 7 23.33Ati yana 2 4 6 20 Vega sandharana 3 4 7 23.33
Graph no.18
0
10
20
30
40
50
60
Group A GroupB Total %
Ati vyayama
Ati adhva
Ati prajagara
Abhighata
Ati langhana
Bhojanottar chesta
Diva svapna
Ati yana
Vega sandharana
Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09 112
Observations
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita”
Majority of patients are having Atiprajagarana 53.33%, Ativyayama is seen in
46.66% ,Bhojanottar chesta and Atiyana are seen in 20% patients. Vega sandharana
and Diwaswapna 23.33%,Abhighata 10% ,Atilanghana is seen in 6.66% pf patients.
Table No. 46 showing Manasika Nidanas Graph no. 19
No. of patients Manasika Nidana and other Nidana Group A Group B Total % Chinta 10 7 17 56.66 Shoka 3 0 3 10 Krodha 6 6 12 40 Bhaya 0 1 1 3.33
0
10
20
30
40
50
60
Group A Group B Total %
Chinta
Shoka
Krodha
Bhaya
In 40% of the patients Krodha was observed, while 56.66% of the patients had
Chinta, and in 10% of patients shoka as manasika nidana was observed. Bhaya was
observed in 3.33% of the patients.
Table No. 47 showing Presenting history of hypertension Graph no.20
No. of patients History of hypertension Group
A Group B
Total %
Present 12 9 21 70Absent 3 6 9 30
0
10
20
30
40
50
60
70
GROUP A GROUP B TOTAL %
Present
Absent
Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09 113
Observations
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita”
In 70% of the patients history of hypertension was observed, while 30% of the
patients were not having such history of hypertension.
Table No. 48 showing Presenting nature of sleep in stroke patients
No. of patients Nature of sleep Group
A Group B
Total %
Good 3 4 7 23.33 Disturbed 12 11 23 76.66
Graph no.21
0
10
20
30
40
50
60
70
80
GROUP A GROUP B TOTAL %
Good
Disturbed
The nature of sleep was disturbed in 76.66% in stroke patients.while in 23.33% were
having good sleep.
Table No. 49 showing Presenting vysana as etiological factors in stroke patients
No. of patients Type of
vyaasana Group A
Group B
Total %
Alcohol 4 7 11 36.66Smoking 2 3 5 16.66Betel 2 3 5 16.66Tobacco 3 4 7 23.33
Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09 114
Observations
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita”
Graph no.22
05
10152025303540
GROUP GROUP B TOTAL %
Alcohol
Smoking
Betel
Tobacco
In majority of patients Alcohol consumption(36.66%) was seen,Betel and Smoking
habits were seen in 16.66% patients each. Where in 23.33% patients Tobacco habit
was seen.
Table No. 50 Showing analysis of Nasyakarmukata Graph no.23
0
10
20
30
40
50
60
70
80
A B TOTAL %
Sukhauchvasa
Sukhaswapan
Sukha Bodha
Akshipatavam
Parameter A B Total %
Sukhauchvasa 12 8 20 66.66
Sukhaswapan 13 10 23 76.66
Sukha Bodha 10 11 21 70
Akshipatavam 8 6 14 46.66
Sukhaswapanam is in majority of patients (76.66%), Sukhauchvasam in (66.66%)
patients, Sukha Bodha 70% and Akshipatavam is seen in 46.66 % of patients.
Table No. 51 showing overall response for the treatment
Response Marked improvement
Moderate improvement
Mild improvement No Change Group
No. of patients % No. of
patients % No. of patients % No. of
patients %
Group A 01 6.66 04 26.67 07 46.66 03 20
Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09 115
Observations
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita”
Group B 01 6.66 04 26.67 08 53.33 02 13.33
In Group A out of 15 patients 1 patient (6.66%) showed marked improvement, 4
patients (26.67%) showed moderate improvement, 7 patients (46.66%) showed mild
improvement, and 3 patients registered no change.
Graph no. 24 over all response in group A:
0
10
20
30
40
50
% No.of Pt.
Marked
Moderate
Mild
No change
In Group B out of 15 patients 1 patient (6.66%) showed marked improvement, 4
patients (26.67%) showed moderate improvement, 8 patients (53.33%) showed mild
improvement, and a total of 2 patients (13.33%) registered no change.
Graph no. 25 Over all response in group B
0
10
20
30
40
50
60
% Total no.pt.
Marked
Moderate
Mild
No.Change
By comparing the overall response for the treatment it can be concluded that Group B
patients responded better than the Group A in case of mild improvement. In case of
marked and moderate improvement no. of patients are same in both the groups.
Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09 116
Results
RESULTS
1) HOUSEBRACKMAN SCALE :
a) Within group: Group 1(Karpasasthyadi taila):
Wilcoxons test was applied for within group comparision. There was no
significant improvement after first course (Z = 0.00, p=1.000), compared to
base line .There was significant improvement in Housebrackman scale after
second course (Z = -2.828, p=0.005) and at follow up (Z = -3.00, p=0.003)
compared to baseline within karpasasthyadi group.There was also a significant
reduction after follow up compared to second course.(p= 0.002)
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita” Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09 117
a.The sum of negative ranks equals sum of positive rankas
H AT - BT H AT 2 - BT HAF - BT
Z 0.000a -2.828b -3.000b
Asymp. Sig. (2-tailed) 1.000 .005 .003
b.based on positive ranks
Group 2 (Rasnaputika taila): Wilcoxons test was applied for within group comparision. There was no
significant improvement in finger movement after first course (Z = .000,
p=1.000),There was significant improvement after second course (Z = -2.236,
p=0.025) and at follow up (Z = -2.236, p=0.025) compared to baseline within
Rasnaputika taila group.
H AT - BT H AT 2 - BT H AF - BT
Z .000a -2.236b -2.236b
Asymp. Sig. (2-tailed) 1.000 .025 .025
a.The sum of negative ranks equals sum of positive rankas
b.based on positive ranks
Results
b) Between the group: Graph no.26
Comparison of mean scores of Housebrackman scale before and after treatment and
follow up between Karpasasthyadi taila and Rasnaputika taila groups.
Group H BT H AT H BT 2 H AT 2 H AF HATCHN HAT2CHN HATFCHN
Karpasasthyadi thaila N=15 Mean ±SD
2.13±0.51 2.13±0.51 2.13±0.52 1.60±0.50 1.53±0.52 0.00±0.00 0.53±0.52 0.60±0.51
Rasnaputika taila N=15 Mean ±SD
2.20±0.41 2.20±0.41 2.20±0.41 1.87±0.52 1.87±0.52 0.00±0.00 0.33±0.49 0.33±0.49
0
0.5
1
1.5
2
2.5
H BT H AT H BT 2 H AT 2 H AF
GROUP A
GROUP B
HATCHN HAT2CHN HATFCHN Mann-Whitney U 112.500 90.000 82.500
Wilcoxon W 232.500 210.000 202.500
Z .000 -1.087 -1.439
Asymp. Sig. (2-tailed) 1.000 .277 .150 b.grouping variable group
There was no significant improvement in between groups after treatment and
after follow up on Mann Whitney test.
2 ) FINGER MOVEMENT :
a) Within group: Group 1(Karpasasthyadi taila):
Wilcoxons test was applied for within group comparision. There was no
significant improvement following first course (Z = -1.000, p=0.357)
compared to base line There was highly significant improvement in finger
movement score after second course (Z = -3.606, p=0.<001) which was
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita” Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09 118
Results
maintained even after follow up (Z = -3.500, p=<0.001) compared to baseline
within karpasasthyadi group.
F AT - BT F AT 2 - BT F AF - BT
Z -1.000b -3.606b -3.500b
Asymp. Sig. (2-tailed) .317 .<001 .<001
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita” Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09 119
a.The sum of negative ranks equals sum of positive rankas
b.based on positive rank
Group 2(Rasnaputika taila): Wilcoxons test was applied for within group comparision. There was
significant improvement in finger movement following first course (Z = -
2.449, p=0.014).There was highly significant improvement after second
course (Z = -3.494, p=<0.000) and which was maintained after follow up (Z
= -3.494, p=<0.000) compared to baseline within Rasnaputika taila group.
F AT - BT F AT 2 - BT F AF - BT
Z -2.449b -3.494b -3.494b
Asymp. Sig. (2-tailed) .014 <0.001 <0.001
a.The sum of negative ranks equals sum of positive rankas
b.based on positive ranks
b) Between groups : Comparison of mean scores of finger movement before
and after treatment and follow up between Karpasasthyadi taila and
Rasnaputika taila groups.
Group F BT F AT F BT 2 F AT2 F AF FTCHN FTCHN2 FTCHNFP
Karpasasthyadi thaila N=15 Mean ±SD
3.07±0.89 3.00±0.86 2.87±0.91 2.20±0.78 2.13±0.83 0.07±0.26 0.87±0.35 0.93±0.46
Rasnaputika taila N=15 Mean ±SD
3.13±0.91 2.73±1.03 2.73±1.03 2.00±1.00 2.00±1.00 0.40±0.51 1.13±0.52 1.13±0.51
Results
Graph no.27
0
0.5
1
1.5
2
2.5
3
3.5
F BT F AT F BT2 F AT2 F AF
GROUP A
GROUP B
There was significant improvement in finger movement between groups after first
treatment(Z=-2.122 p= 0.034) and no significant improvement after second treatment
and followup on Mann Whitney test compred to baseline.
Test Statisticsb
FTCHN FTCHN2 FTCHNFP
Mann-Whitney U 75.000 85.500 92.500 Wilcoxon W 195.000 205.500 212.500 Z -2.122 -1.606 -1.122 Asymp. Sig. (2-tailed) .034 .108 .262
b.grouping variable group
3) LIFTING OF ARM:
Within group: Group 1(Karpasasthyadi taila):
Wilcoxons test was applied for within group comparision. There was no
significant improvement following first course (Z = -1.414, p=0.157),
compared to base line.There was highly significant improvement after second
course (Z = -3.464, p<0.001) and which was maintained even after follow up
(Z = -3.357, p< 0.001) compared to baseline within karpasasthyadi group.
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita” Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09 120
Results
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita” Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09 121
a.The sum of negative ranks equals sum of positive rankas
b.based on positive ranks
Group 2(Rasnaputika taila): Wilcoxons test was applied for within group comparision. There was
significant improvement in following first course (Z = -2.236, p=0.025
compared to base line.and highly significant improvement after second course
(Z = -3.176, p=<0.001) and which was maintained even after follow up (Z =
-3.176, p=<0.001) compared to baseline within Rasnaputika taila group.
a.The sum of negative ranks equals sum of positive rankas
b.based on positive ranks
a) Between groups : Comparison of mean scores of lifting of arm before and
after treatment and follow up between Karpasasthyadi taila and
Rasnaputika taila group.
LA AT - BT LA AT 2 - BT LA AF – BT
Z -1.414b -3.464b -3.357b
Asymp. Sig. (2-tailed) .157 .001 .001
LA AT - BT LA AT 2 - BT LA AF – BT
Z -2.236b -3.176b -3.176b
Asymp. Sig. (2-tailed) .025 .001 .001
Group LA BT L A AT LA BT2 L A AT2 LA AF LABTCHN LABTCHN2 LABTCHNFP
Karpasasthyadi thaila N=15 Mean ±SD
3.67±0.49 3.53±0.51 3.47±0.64 2.87±0.64 2.80±0.68 0.13±0.35 0.80±0.41 0.87±0.52
Rasnaputika taila N=15 Mean ±SD
3.73±0.46 3.40±0.63 3.27±0.79 2.67±0.90 2.67±0.90 0.33±0.49 1.07±0.70 1.07±0.70
Results
Graph no.28
0
0.5
1
1.5
2
2.5
3
3.5
4
LA BT LA AT LA BT 2 LA AT2 LA AF
GROUP A
GROUP B
There was no significant improvement in lifting of arm between groups after first
course of treatment and second course of treatment and after followup on Mann
Whitney test.
Test statisticsb
LABTCHN LABTCHN2 LABTCHNFP
Mann-Whitney U 90.000 88.500 94.500
Wilcoxon W 210.000 208.500 214.500
Z -1.273 -1.195 -.871
Asymp. Sig. (2-tailed) .203 .232 .384
b.grouping variable group
4 ) SITTING FROM LAYING DOWN :
a) Within group:
Wilcoxons test was applied for within group comparison. There was no
significant improvement following first course (Z = 0.00 p=1.00) and after second
course (Z = -1.633, p=0.102) and even after follow up (Z = -1.633, p=0.102)
compared to baseline within karpasasthyadi group.
Si AT - BT Si AT 2 - BT Si AF - BT
Z .000a -1.633b -1.633b
Asymp. Sig. (2-tailed) 1.000 .102 .102
a.The sum of negative ranks equals sum of positive rankas
b.based on positive ranks
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita” Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09 122
Results
Group 2(Rasnaputika taila): Wilcoxons test was applied for within group comparision. There was no
significant improvement following first course (Z = -1.414 p=0.157).After
second course there was significant improvement (Z = -2.449, p=0.014) and
at follow up (Z = -2.449, p=0.014) compared to baseline within Rasnaputika
taila group.
Si AT - BT Si AT 2 - BT Si AF - BT
Z -1.414b -2.449b -2.449b
Asymp. Sig. (2-tailed) .157 .014 .014
a.The sum of negative ranks equals sum of positive rankas
b.based on positive ranks
b) Between the group:
Comparison of mean scores of capacity of sitting from laying down before and
after treatment and follow up between Karpasasthyadi taila and Rasnaputika
taila groups.
Group SI BT SI AT SI BT2 SI AT2 SI AF SICHN SICHN2 SICHNFPKarpasasthyadi thaila N=15 Mean ±SD
0.73±0.79 0.73±0.79 0.67±0.72 0.47±0.64 0.47±0.64 0.00±0.00 0.27±0.59 0.27±0.59
Rasnaputika taila N=15 Mean ±SD
0.73±0.70 0.60±0.63 0.60±0.63 0.33±0.49 0.33±0.49 0.13±0.35 0.40±0.50 0.40±0.50
Graph no.29
0
0.1
0.2
0.3
0.4
0.5
0.6
0.7
0.8
SI BT SI AT SI BT 2 SI AT2 SI AF
GROUP A
GROUP B
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita” Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09 123
Results
There was no significant improvement in sitting from laying down between groups
before and after treatment and after followup on Mann Whitney test.
SICHN SICHN2 SICHNFP
Mann-Whitney U 97.500 100.500 100.500
Wilcoxon W 217.500 220.500 220.500
Z -1.439 -.580 -.580
Asymp. Sig. (2-tailed) .150 .562 .562
b.grouping variable group
5) STANDING FROM SITTING:
a) Within group:
Group 1(Karpasasthyadi taila):
Wilcoxons test was applied for within group comparision. There was no
significant improvement following first course (Z = -1.000, p=0.317)
compared to base line There was highly significant improvement after
second course (Z = 2.449, p=0.014) which was maintained even after follow
up (Z = -2.449, p=0.014) compared to baseline within karpasasthyadi group.
St AT - BT St AT 2 - BT St AF - BT
Z -1.000b -2.449b -2.449b
Asymp. Sig. (2-tailed) 0.317 0.014 0.014
a.The sum of negative ranks equals sum of positive rankas
b.based on positive ranks
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita” Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09 124
Results
Group 2(Rasnaputika taila): Wilcoxons test was applied for within group comparision. There was no
significant improvement following first course (Z = 0.00, p=1.000), There
was significant improvement after second course (Z = -2.236, p=0.025) and at
follow up (Z = -2.236, p=0.025) compared to baseline within Rasnaputika taila
group.
St AT - BT St AT 2 - BT St AF - BT
Z .000a -2.236b -2.236b
Asymp. Sig. (2-tailed) 1.000 .025 .025
a.The sum of negative ranks equals sum of positive rankas
b.based on positive ranks
b)Between the group:
Comparison of mean scores of standing from sitting before and after treatment and
follow up between Karpasasthyadi taila and Rasnaputika taila groups.
Group St BT St AT St BT2 StA T2 St AF STCHN STCHN2 STCHNFP
Karpasasthyadi thaila
N=15
Mean ±SD
0.87±0.64 0.80±0.56 0.80±0.56 0.47±0.51 0.47±0.51 0.07±0.26 0.40±0.51 0.40±0.51
Rasnaputika taila
N=15
Mean ±SD
0.87±0.83 0.87±0.83 0.87±0.83 0.53±0.52 0.53±0.52 0.00±0.00 0.33±0.49 0.33±0.49
Graph no.30
0
0.2
0.4
0.6
0.8
1
St. BT St AT St BT 2 St AT 2 StAF
GROUP A
GROUP B
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita”
Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09 125
Results
There was no significant improvement between groups after treatment and after
followup on Mann Whitney test.
STCHN STCHN2 STCHNFP
Mann-Whitney U 105.000 105.000 105.000
Wilcoxon W 225.000 225.000 225.000
Z -1.000 -.372 -.372
Asymp. Sig. (2-tailed) .317 .710 .710
b.grouping variable group
6) DROOPING OF WRIST :
a)Within group:
Group 1(Karpasasthyadi taila):
Wilcoxons test was applied for within group comparision. There was no significant
improvement in drooping of wrist following first course (Z = 0.00,p=1.000 )compared
to base line There was significant improvement in finger movement after second
course (Z = -2.828, p=0.005) which was maintained even after follow up (Z = -
2.828, p=0.005) compared to baseline within karpasasthyadi group.
D AT - BT D AT 2 - BT D AF - BT
Z .000a -2.828b -2.828b
Asymp. Sig.
(2-tailed) 1.000 .005
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita” Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09 126
.005
a.The sum of negative ranks equals sum of positive rankas
b.based on positive ranks
Group 2(Rasnaputika taila):
Wilcoxons test was applied for within group comparision. There was no significant
improvement in drooping of wrist following first course (Z = -1.414, p=0.157),
There was significant improvement in finger movement after second course (Z = -
Results
2.00, p=0.046) which was maintained even after follow up (Z = -2.00, p=0.046)
compared to baseline within Rasnaputika taila group.
D AT - BT D AT 2 - BT D AF - BT
Z -1.414b -2.000b -2.00b
a.The sum of negative ranks equals sum of positive
rankas Asymp. Sig.
(2-tailed) 0.157 0.046 0.046
b.based on positive ranks
b) Between groups :
Comparison of means scores of drooping of wrist before and after treatment and
follow up between Karpasasthyadi taila and Rasnaputika taila groups.
Group D BT D AT D BT2 D AT2 D AF DROPCHN DROPCHN2 DROPCHNFP
Karpasasthyadi thaila N=15 Mean ±SD
1.80±0.78 1.80±0.78 1.73±0.78 1.27±0.79 1.27±0.79 0.00±0.00 0.53±0.51 0.53±0.51
Rasnaputika taila N=15 Mean ±SD
2.20±0.78 2.07±0.96 2.07±0.96 1.93±0.96 1.93±0.96 0.13±0.35 0.27±0.46 0.27±0.46
Graph no.31
0
0.5
1
1.5
2
2.5
D BT D AT D BT 2 D AT 2 D AF
GROUP A
GROUP B
There was no significant improvement in drooping of wrist between groups
after treatment and after followup on Mann Whitney test.
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita” Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09 127
Results
Test statisticsb
DROPCHN DROPCHN2 DROPCHNFP Mann-Whitney U 97.500 82.500 82.500
Wilcoxon W 217.500 202.500 202.500 Z -1.439 -1.466 -1.466 Asymp. Sig. (2-tailed) .150 .143 .143
b.grouping variable group
7 )LOSS OF SPECH :
a) Within group:
Group 1(Karpasasthyadi taila):
Wilcoxons test was applied for within group comparision. There was no significant
improvement in loss of speech following first course (Z = -1.000, p=0.317), There
was significant improvement after second course (Z = -2.029, p=0.042) and at follow
up (Z = -2.029, p=0.042) compared to baseline within karpasasthyadi group.
LS AT - BT LS AT 2 - BT LS AF - MP BT
Z -1.000b -2.029b -2.029b
Asymp. Sig. (2-tailed) .317 .042 .042
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita” Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09 128
a.The sum of negative ranks equals sum of positive rankas
b.based on positive ranks
Group 2(Rasnaputika taila):
Wilcoxons test was applied for within group comparision. There was
significant improvement in loss of speech following first course (Z = -2.449,
p=0.014),second course (Z = -2.972, p=0.003) and at follow up (Z = -3.127,
p=0.002) compared to baseline within Rasnaputika taila group.
LS AT - BT LS AT 2 - BT LS AF - MP BT Z -2.449b -2.972b -3.127b Asymp. Sig. (2-
tailed) .014 .003 .002
a.The sum of negative ranks equals sum of positive rankas
b.based on positive ranks
Results
b) Between groups :
Comparison of mean scores of loss of speech before and after treatment and
follow up between Karpasasthyadi taila and Rasnaputika taila groups.
Group LS BT LS AT LS BT2 LS AT2 LS AF LSCHN LSCHN2 LSCHNFP
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita” Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09 129
Graph no.32
0
0.5
1
1.5
2
2.5
LS BT LS AT LS BT 2 LS AT 2 LS AF
GROUP A
GROUP B
There was significant improvement in loss of speech between groups after first
course of treatment . But there was no significant improvement after second
treatment and followup copared to first course in between groups on Mann
Whitney test. Test statisticsb
Karpasasthyadi thaila N=15 Mean ±SD
2.00±1.13 1.93±1.03 1.93±1.03 1.40±0.74 1.40±0.74 0.07±0.26 0.60±0.985 0.60±0.985
Rasnaputika taila N=15 Mean ±SD
1.93±1.10 1.53±0.74 1.53±0.74 1.13±0.64 1.07±0.70 0.40±0.51 0.80±0.68 0.87±0.64
LS CHN LS CHN2 LS CHN F Mann-Whitney U 75.000 109.000 103.000 Wilcoxon W 195.000 229.000 223.000 Z -2.122 -.165 -.459
Asymp.Sig.(2-tailed) .034 .869 .646
Results
7b ) PAIN a) Within group:
Group 1(Karpasasthyadi taila):
Wilcoxons test was applied for within group comparision. There was no significant
improvement in pain following first course (Z = -1.414, p<0.157), After second
course there was highly significant improvement (Z = -3.317, p<0.001) and which
was maintained at follow up (Z = -3.317, p<0.001) compared to baseline within
karpasasthyadi group.
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita” Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09 130
a.The sum of negative ranks equals sum of positive rankas
b.based on positive ranks
Group 2(Rasnaputika taila):
Wilcoxons test was applied for within group comparision. There was significant
improvement in pain following first course (Z = -2.00, p=0.046) and after second
course (Z = -3.162, p=0.002) and at follow up (Z = -3.162, p=0.002) compared to
baseline within Rasnaputika taila group.
a.The sum of negative ranks equals sum of positive rankas
b.based on positive ranks
b)Between groups :
Comparison of mean score of pain before and after treatment and follow up
between Karpasasthyadi taila and Rasnaputika taila groups.
PAIN AT - BT PAIN AT 2 - BT PAIN AF - BT Z -1.414b -3.317b -3.317b
Asymp. Sig. (2-tailed) .157 .001 .001
PAIN AT - BT PAIN AT 2 - BT PAIN AF - BT
Z -2.000b -3.162b -3.162b
Asymp. Sig. (2-tailed) .046 .002 .002
Results
Group PAIN BT PAIN AT
PAIN BT2
PAIN AT2
PAIN AF
PAINCHN
PAINCHN2
PAINCHNFP
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita” Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09 131
Graph no.33
0
0.5
1
1.5
2
PAIN BT PAIN AT PAIN BT 2 PAIN AT 2 PAIN AF
GROUPA
GROUP B
b.grouping variable group
There was no significant improvement in pain between groups after treatment and
after follow up on Mann Whitney test.
8) MUSCLE POWER :
a) Within group :
Group 1 (Karpasasthydi taila)
Wilcoxons test was applied for within group comparision. There was no significant
improvement in muscle power following first course (Z = -1.00, p=0.317), There
Karpasasthyadi thaila N=15 Mean ±SD
1.47±0.83 1.33±0.82
1.20±0.78
0.73±0.46
0.73±0.46
0.13±0.35
0.73±0.46
0.73±0.46
Rasnaputika taila N=15 Mean ±SD
1.80±0.41 1.53±0.52
1.47±0.52
1.13±0.52
1.13±0.52
0.27±0.46
0.67±0.49
0.67±0.49
Test Statisticsb
PAINCHN PAINCHN2 PAINCHNFP
Mann-Whitney U 97.500 105.000 105.000
Wilcoxon W 217.500 225.000 225.000
Z -.898 -.392 -.392
Asymp. Sig. (2-tailed) .369 .695 .695
Results
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita” Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09 132
was highly significant improvement after second course (Z = -3.606, p=<0.001) and
at follow up (Z = -3.500, p=<0.001) compared to baseline within karpasasthyadi
group.
MP AT - BT MP AT 2 - BT MP AF - BT
Z -1.000c -3.606c -3.500c
Asymp. Sig. (2-tailed) .317 P<0.001 P<0.001
a.The sum of negative ranks equals sum of positive rankas
b.based on positive ranks
c. Based on negative ranks.
d. Wilcoxon Signed Ranks Test
Group 2(Rasnaputika taila):
Wilcoxons test was applied for within group comparision. There was no significant
improvement in muscle power following first course (Z = -1.342, p=0.180), There
was highly significant improvement after second course (Z = -3.274, p=0.001) and
at follow up (Z = -3.274, p=0.001) compared to baseline within Rasnaputika taila
group.
MP AT - BT MP AT 2 - BT MP AF - MP BT
Z -1.342c -3.274c -3.274c
Asymp. Sig. (2-tailed) .180 P<0.001 P<0.001
a.The sum of negative ranks equals sum of positive rankas
b.based on positive ranks
B) Between groups : Comparison of mean scores of Muscle power before and after
treatment and follow up between Karpasasthyadi taila and Rasnaputika taila
groups.
Results
Group MP BT MP AT MP BT 2 MP AT 2 MP AF MPCHN MPCHN2 MPCHNFP
1.47±0.99 1.53±0.99 1.67±1.04 2.33±0.98 2.40±0.99 -.07±0.26 -.87±0.35 -.93±0.46 Karpasasthyadi thaila
N=15 Mean ±SD
1.07±1.03 1.27±0.96 1.27±096 2.07±0.96 2.07±0.96
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita” Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09 133
Graph no.34
0
0.5
1
1.5
2
2.5
3
MP BT MP AT MP BT 2 MP AT 2 MP AF
GROUP A
GROUP B
There was no significant improvement in muscle power between groups after
treatment and after followup on Mann Whitney test.
-.20±0.56 -1±.0.76 -1.00±0.76Rasnaputika taila
N=15 Mean ±SD
Test Statisticsb
MPCHN MPCHN2 MPCHNFP Mann-Whitney U 104.500 107.000 112.500
Wilcoxon W 224.500 227.000 232.500
Z -.637 -.309 .000
Asymp. Sig. (2-tailed) .524 .757 1.000
9 ) HAND GRIP POWER :
a) Within group:
Group 1(Karpasasthyadi taila):
Wilcoxons test was applied for within group comparision. There was no significant
improvement in hand grip power following first course (Z = -1.00, p=0.357), There
Results
was highly significant improvement after second course (Z = -3.317, p=0.001) and
at follow up (Z = -3.317, p=0.001) compared to baseline within karpasasthyadi group.
HG AT - BT HG AT 2 - BT HG AF - BT
Z -1.000b -3.317b -3.317b
Asymp. Sig. (2-
tailed) .317 .001 .001
a.The sum of negative ranks equals sum of positive rankas
b.based on positive ranks
Group 2(Rasnaputika taila):
Wilcoxons test was applied for within group comparision. There was significant
improvement in hand grip power following first course (Z = -2.00, p=0.046) and
second course (Z = -2.714, p=0.007) and at follow up (Z = -2.714, p=0.007)
compared to baseline within Rasnaputika taila group
b) Between groups :
Comparison of mean scores of Increase in Hand grip power before, and after
treatment and follow up between Karpasasthyadi taila and Rasnaputika
taila groups.
Group HGP BT HGP AT HGP BT
2
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita” Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09 134
HGP AT 2
HGP AF
HGPCHN
HGPCHN2
HGPCHNFP
Karpasasthyadi thaila N=15 Mean ±SD
2.93±026
2.8± 0.352
2.87±0.352
2.20±.0.561
2.20± 0.561
.067± 0.26
.73±0.457 .73±0.457
Rasnaputika taila N=15 Mean ±SD
2.53± 0.743
2.27±0.78
2.20±0.78
1.93± 0.884
1.93±0.884
.267± 0.457
.60±0.632 .60±0.632
HG AT - BT HG AT 2 - BT HG AF - BT
Z -2.000b -2.714b -2.714b
Asymp. Sig. (2-tailed) .046 .007 .007
Results
Graph no. 35
0
0.5
1
1.5
2
2.5
3
3.5
HGP BT HGP AT HGP BT2 HGP AT 2 HGP AF
GROUP A
GROUP B
There was no significant improvement in hand grip power between groups after treatment and after followup on Mann Whitney test.
Test Statisticsb
HGPCHN HGPCHN2 HGPCHNFP Mann-Whitney U 90.000 95.500 95.500 Wilcoxon W 210.000 215.500 215.500 Z -1.445 -.822 -.822
Asymp. Sig. (2-tailed) .148 .411 .411
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita” Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09 135
b.grouping variable group
10) MUSCLE TONE :
a)Within group:
Group 1(Karpasasthyadi taila):
Wilcoxons test was applied for within group comparision. There was no significant
improvement in Muscle tone following first course (Z = -1.342, p=0.180),There was
highly significant improvement after second course (Z = -3.274, p=0.001) and which
was maintained after follow up (Z = -3.274, p=0.001) compared to baseline within
karpasasthyadi group.
MT AT - BT MT AT 2 - BT MT AF - MP BT Z -1.342c -3.274c -3.274c
Asymp. Sig.
(2-tailed) .180 P<0.001 P<0.001
a.The sum of negative ranks equals sum of positive rankas
b.based on positive ranks
Results
Group 2(Rasnaputika taila):
Wilcoxons test was applied for within group comparision. There was no significant
improvement in Muscle tone following first course (Z = -1.00, p=0.317), There was
highly significant improvement after second course (Z = -3.606, p=<0.001) and
which was maintained after follow up (Z = -3.500, p=<0.001) compared to baseline
within Rasnaputika taila group
a.The sum of negative ranks equals sum of positive rankas
b.based on positive ranks
a) Between groups : Comparison of mean score of Muscle tone before, and
after treatment and follow up between Karpasasthyadi taila and
Rasnaputika taila groups.
Group MT BT MT AT MT BT 2
MT AT - BT MT AT 2 - BT MT AF - BT Z -1.000c -3.606c -3.500c
Asymp. Sig. (2-tailed)
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita” Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09 136
MT AT 2 MT AF MTCHN MTCHN2 MTCHNFP
Karpasasthyadi thaila N=15 Mean ±SD
1.47± 0.74
1.40± 0.63 1.40±0.63 1.27±0.46 1.27±0.46 0.06±0.26 0.20±0.41 0.20±0.41
Rasnaputika taila N=15 Mean ±SD
1.67±0.61 1.67±0.61 1.67±0.61 1.67±0.61 1.67±0.61 0.00±0.00 0.00±0.00 0.00±0.00
Graph no.36
0
0.5
1
1.5
2
MT BT MT AT MT BT 2 MT AT2 MT AF
GROUP A
GROUP B
There was no significant improvement in between groups after treatment and
after followup on Mann Whitney test.
.317 P<0.001 P<0.001
Results
Test Statisticsb
MTCHN MTCHN2 MTCHNFPMann-Whitney U 105.000 90.000 90.000 Wilcoxon W 225.000 210.000 210.000 Z -1.000 -1.795 -1.795 Asymp. Sig. (2-tailed) .317 .073 .073
b.grouping variable group
11) INCREASE IN WALKING CAPACITY:
a) Within groups:
Group 1 (karpasasthyadi taila):
Wilcoxons test was applied for within group comparision. There was no significant
improvement in increase in walking capacity following first course (Z = -1.414,
p=0.157), There was significant improvement after second course (Z = -2.53,
p=0.011) and at follow up (Z = -2.53, p=0.011) compared to baseline within
karpasasthyadi group.
IWC AT - IWC BT IWC AT 2 - IWC BT IWC AF - IWC BT
Z -1.414b -2.530b -2.530b
Asymp. Sig. (2-tailed)
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita” Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09 137
a.The sum of negative ranks equals sum of positive rankas
b.based on positive ranks
Group 2 (Rasnaputika taila):
Wilcoxons test was applied for within group comparision. There was significant
improvement in increase in walking capacity following first course (Z = -1.732,
p=0.083),second course (Z = -2.646, p=0.008) and at follow up (Z = -2,646, p=0.008)
compared to baseline within Rasnaputika taila group.
.157 .011 .011
Results
IWC AT - IWC BT IWC AT 2 - IWC BT IWC AF - IWC BT Z -1.732b -2.646b -2.646b
a.The sum of negative ranks equals sum of positive rankas
b.based on positive ranks
a)Between group:
Comparison of mean scores of Increase in walking capacity (grades) before and after
treatment and at follow up between Karpasasthyadi taila and Rasnaputika taila
groups.
Group IWC BT IWC AT IWC BT 2
Asymp. Sig. (2-tailed)
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita” Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09 138
IWC AT 2 IWC AF IWCCHN IWCCHN2 IWCCHNFP
Karpasasthyadi thaila N=15 Mean ±SD
4.00±0.00 3.87±0.4 3.87±0.4 3.47±0.64 3.47±0.64 0.13±0.35 0.53±0.63 0.53±0.63
Rasnaputika taila N=15 Mean ±SD
4.00±0.00 3.80±0.41 3.80±0.41 3.53±0.51 3.53±0.51 0.20±0.41 0.47±0.51 0.47±0.51
There was no significant improvement in reflexes between groups after treatment and
after followup on Mann Whitney test.
Graph no.37
3.23.33.43.53.63.73.83.94
4.1
IWC BT IWC AT IWC BT 2 IWC AT 2 IWC AF
GROUP A
GROUP B
.083 .008 .008
Results
12) REFLEXES:
a) Within Groups:
Group 1 (Karpasasthydi taila):
Wilcoxons test was applied for within group comparision. There was no significant
improvement in reflexes following first course (Z = 0.00, p=1.00),second course (Z
= -1.414, p=0.157) and at follow up (Z = -1.414, p=0.157) compared to baseline
within karpasasthyadi group.
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita” Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09 139
Group2((Rasnaputika taila) :
Wilcoxons test was applied for within group comparision. There was no significant
improvement in reflexes following first course (Z = 0.00, p=1.00),second course (Z
= -1.00, p=0.317) and at follow up (Z = -1.00, p=0.317) compared to baseline within
Rasnaputika taila group.
R AT - R BT R AT 2 - R BT R AF - R BT
Z .000a -1.000b -1.000b
Asymp. Sig. (2-
tailed) 1.000 .317 .317
a. The sum of negative ranks equals the sum of positive ranks. b. Based on positive ranks.
R AT - R BT R AT 2 - R BT R AF - R BT
Z .000a -1.414b -1.414b
Asymp. Sig. (2-
tailed) 1.000 .157 .157
a. The sum of negative ranks equals the sum of positive ranks.
b. Based on positive ranks.
Results
b ) Between groups
Graph no.38
1.6
1.7
1.8
1.9
2
R BT R AT R BT2 R AT2 R AF
GROUP A
GROUP B
Group R BT R AT R AT 2 R AF R BT 2 RBTCHN RBTCHN2 RBTCHNFP
Karpasasthyadi thaila
N=15
Mean ±SD
1.93±0.26 1.93±0.26 1.8±0.41 1.8±0.41 1.93±0.26 0.93±0.35 .13±0.35 .13±0.35
Rasnaputika taila
N=15
Mean ±SD
1.8±0.41 1.8±0.41 1.73±0.46 1.73±0.46 0.7 ±0.26 1.8±0.41 .07±0.26 .07±0.26
There was no significant improvement in reflexes between groups after treatment and
after followup on MannWhitney test.
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita” Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09 140
Test Statisticsb
RBTCHN RBTCHN2 RBTCHNFP
Mann-Whitney U 112.500 105.000 105.000 Wilcoxon W 232.500
225.000 225.000
Z .000
-.598 -.598 Asymp. Sig. (2-tailed) 1.000
.550 .550
b. Grouping Variable: Group
Discussion
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita” Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09 141
DISCUSSION
Any hypothesis or principle, if to be proved must be discussed thoroughly
from all angles, which has been clearly stated by Charaka long back. After the
formation of a hypothesis, it has to be tested and observed by various methods and
eventually the results are obtained. All these should be well supported by proper
reasoning or logic and finally concluded. A hypothesis gets established as a principle
if the reasoning given is satisfactory, otherwise it remains as it is. Charka has very
precisely said that, even the truth may not be accepted, as it is without the logical
interpretation.
Discussion improves the knowledge and discussion with science becomes base
establishment of the concept. Thus discussion is the most essential phase of any
research work. Keeping this in view, the facts which have emerged from the study can
be studied in 4 main headings.
• Discussion on Review of literature
• Discussion on Materials and Methods
• Discussion on Observation
• Discussion on Results
Discussion on Nasya Procedure:
According to Ayurvedic Classics, Nasya therapy is the most favourable in the
diseases of urdhwajatru pradesha and first line of treatment in Ardita according to
charaka samhita.As the adhishthana of Ardita is shiras ,Nasya is considered to be
beneficial.Charak told two tupes of Navana Nasya that are Snehana and Shodhana
Discussion
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita” Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09 142
Nasya .Here both the Nasya yogas are shodhana type of Nasya. Both the yogas are
mainly prepared with ushna veerya ,katu rasa pradhana dravyas.
Samprapti of vata vyaadhi is of two types , Upastambhita and Nirupastambhita.In
Upastambhita there is obstruction of Vata gati due to srotorodha. Nirupastambhita
vata vyadhis are those where there is dhatukshaya janya vata prakopa.
The incidence of cerebrovascular thrombotic lesion have involvement of vata
kapha. The incidence of cerebrovascular thrombosis is also reported to be maximum
among CVA
Among the embolic one also ,in many cases the source of embolus is
broken in pieces of atheroma which can be considered among kaphapradhana
vyadhi..Thus in majority of cases with thrombosis ,embolism,the line of treatment
should be vatakaphaghna. So,considering above said aspect,we can do Shodhana
nasya in such cases of CVA.
Discussion on Disese review:
Ardita is described in Nanatmaja vata vyadhis .Accordig to Charaka either half of face
or half of the face along with half of the body is considerd.
Sushrutachrya told only half of face.Different opinion is given by Vagbhatacharya
that is along with half of body and face, he has included adharanga also.
The Condition with involvement of half of the face along with half of the body is
worse than only half of face. Because in this condition not only speech but the routine
activity of the patient is hampered and patient becomes dependent on others for it.This
can be taken as a hemiplegic condition where the lesion is in internal capsule.The
fibers converge at this level and hence a lesion in this area causes complete hemipegia
Discussion
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita” Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09 143
on the opposite side with involvement of face,commonly happened due to
embolism,thrombosis and haemorrhage.
Where in Bell’s palsy which is commonly correlated with Ardita ( Involvement of
half of face ) ,where there is the damage of 7th cranial nerve. Recovery of 7th nerve is
more likely to occur when it happens with apoplexy .This can be justified to the
chakrapani commentary where he narrated the paroxysms nature of Ardita i.e. ‘Ardito
vegitaya bhavati’
Discussion on Drug review:
Rasna vataharanam as mentioned by charaka in Agrya sangraha Rasna is shreshta
dravya for vatavyadhi.Keeping this in mind the yoga Rasnaputika taila told
vatavyadhi chiktsa in Yogaratnakara is taken for the study where the ingredients are
mainly kaphaghna ,ushna virya,katu rasa,katu vipaka properties.are used for shodhana
nasya. Karpasasthyadi taila is also used in vatavyadhis,told in sahasrayoga.
Compairing the ingredients of both the drugs we can elicit that All
ingredients of Karpasasthyadi taila are found in Rasnaputika taila except karpasa and
masha.while in Rasnaputika taila we can find more ingredients which are having
vatakaphaghna properties.
Discussion on Materials and Methods :
This is a comparative clinical study conducted on Charakokta Ardita.As per the
inclusion and exclusion criterias, patients were selected randomly. A total of 30
patients, 15 in each group with 3 dropouts were registered for the study.
Patients of Group A underwent two course of nasya with Karpasasthyadi taila,
while the patients of Group B received two course of nasya with Rasnaputika
Discussion
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita” Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09 144
taila,Then both the groups were observed before and after every course of nasya.Total
duration of 28 days for completion of the treatment.
Probable Mode of action :-
Any medicine administered through the nasal route is called as Nasya according to
Ayurveda.
“ lÉÉxÉÉrÉÉÇ pÉuÉqÉç lÉxrÉqÉç | ” ( A.¾Òû. xÉÔ.
20/1 )
“lÉÉxÉÉrÉÉqÉçmÉëhÉÏrÉqÉÉlÉqÉÉæwÉkÉÇlÉxrÉÇ|”(A.xÉÇ.xÉÑ.29/2)
PURVA KARMA :
Importance of the Purva karma in Nasya karma is to facilitate drug absorption through
Nasal neurons and paranasal sinuses. In this, urdhwajatruga abhyanga causes an
impact on local blood circulation.swedana causes the dosha utklesha ,which are
further expelled by nasya procedure. The Vasodilator action over superficial surface
of the face facilitates for drug absorption. The second aspect of Purva karma; the
posture given during Nasya karma ( Pravilambita Shiras) has its relevancy in two
ways:
It creates the patency in channels of nasal cavity and Naso-pharynx,
The drug administered, reaches the upper part of the Nasal cavity and
stimulates the olfactory neuron where the actual drug is administered should remain
for momentary retention of the drug in Nasal cavity.
PRADHANA KARMA :- The provisions created by Purva karma help in the
Pradhana karma, so that the drug has a greater chance of absorption in the air sinuses.
As well as providing sufficient time for stimulating olfactory neurons.
Discussion
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita”
According to Ashtanga Samgraha Su. 29/3,
“ iɧÉÉuÉxÉåÍcÉiÉqÉÉæwÉkÉqÉÇ x§ÉÉåiÉ: zÉÚÇaÉÉOûMüqÉç mÉëÉmrÉ
urÉÉmrÉ qÉÑÎklÉïÇlÉå§É´ÉÉå§ÉMülPûÉÌSÍxÉUÉqÉÑZÉÉÌlÉcÉ
qÉÑÇeÉÉSÏÌwÉMüÉÍqÉuÉÉxÉ£üÉÇ EkuÉïeɧÉÑaÉiÉqÉç
uÉæMüÉËUMüqÉç xÉѤqÉåzÉÑ
SÉåwÉxÉÇWûÌiÉqÉѨÉqÉÉÇaÉÉSÉmÉMüͶÉÌiÉ: |
Acharya Charaka has mentioned one specific anatomical structure named
Munja-, which is like type of grass which acts like Ishika (i.e., like a painter’s brush).
This “painter’s brush” when instilled in the paint, absorbs the paint; in the same way
the Munja structure attracts the doshas when stimulated by the particular drug (Ref.
Cha.Si. 2/ 22). The Munja structure can be thought for an olfactory bulb and the
Ishika for the numerous neurons join together to form the olfactory tract.
Indu, the commentator of Astangha Sangraha mentioned the exact sthana of the
Shringataka Marma (i.e., Shiraso Antarmadhya Murdha) which can be considered for
Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09 145
Discussion
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita” Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09 146
the Middle Cephalic Fossa. The Middle Cephalic fossa is the region, which, in
connection with ethmoid and sphenoidal sinuses, consists of meningeal vessels,
mainly internal carotid artery, cranial nerves (3rd, 4th, 5th and 6th) and also the optic
nerve. The sphenoidal sinus is inferiorly in connection with the Naso-pharynx and
posteriorly with the brain stem. The above show the Shringataka Marma (structure
consisting of four siras in connection with four sense organs and the nerves and
vessels) can be related with the Middle Cephalic fossa. vatahara properties of the
drugs are useful to pacify the vitiated Vata, the drug spreads by the same root and
scratches the morbid doshas of Urdhwajatru and removes them from Khavaighunya &
cures the diseases.
Recently, the nasal route of administration has gained increasing consideration for
obtaining systemic absorption or brain uptake of drugs , due to the high
vascularization of the nasal mucosa . In the nasal cavity the respiratory region has the
highest degree of vascularity. The olfactory region is located in the top of the nasal
cavity and it is the only site of the body where the CNS is in contact with the external
environment. By this way drugs can be absorbed into the blood stream across the
nasal membrane of the respiratory region. Lipophilic molecules are easily transported
via a transcellular mechanism. On the other hand, polar or hydrophilic molecules pass
the nasal membrane via a paracellular mechanism that is dramatically less efficient
than the transcellular pathway.
Structure/solubility relationships (prodrugs)
The usual non-invasive approach, to improve the brain drug delivery, is to “lipidize”
the drug: the polar functional groups on the drug are masked with non-polar groups,
converting a water-soluble druginto a lipophilic “prodrug”.
Discussion
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita” Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09 147
From above discussion again we can elicit that nasya plays a major role in the
management of urdhwa jatrugata diseases.
Discussion
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita” Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09 148
PASCHAT KARMA :-
The absorption of the drug is also facilitated by the Paschat karma followed during the
procedure. This starts with mardana (oil massage) over the frontal, temporal,
maxillary, mastoid, and neck region. After administration of the drug, when the drug
reaches the distal ends of the air ways, the patient is asked for the Nishthivana Kriya
(spitting out of the medicine). The medicine should reach on the both sides of the
throat; otherwise the drug adsorption doesn’t occur in the siras properly (Ref; As.
Sa.Su.29). Also the light massage will produce pressure on barro receptors & may
soothen the excited nerve endings
Discussion on demographic data :
Age –
In the present study, majority of patients were from the age group of 51-60 yrs i.e.
43.33% .In 31-40 yrs of age group and 61-70 yrs group were having 13.33% each.
Least patients were seen in the age group of 71-80 years i.e. 10% only. As stroke is
seen after fourth decade of age it is evident but in this study more prevalence is seen
between 6th decade.It may be due to small sample size.
Sex:
Men are 25% more likely to suffer than women in case of evidence of stroke. The sex
wise distribution of patients reveals the same. Among 30 patients 70% of male
patients and 30 % of female patients observed.
Education:
Majority of the patients (40%) could read and write, while 23.33% of patients were
from primary educated group ,23.33 % patients were illiterate and 1 patient (3%) was
Post Graduate.
Discussion
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita” Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09 149
Occupation –
Maximum patients taken up for this study were having physical labour
Occupation plays major role in the manifestation of disease. It is known fact that
persons having professions like farmers, labourers, are prone to suffer from this
disease due to excess of work which may lead to vitiation of vata. The present data
also supports these facts.
Economical status:-
In the present clinical study, among the 30 patients selected, distribution of
patients across society with 10% from Upper middle class, 16.6% from middle class
,Majority of patients were from 60% from Lower middle class & 13.3% from the poor
class. This might be due to random sampling of the patients.
Agni:
Among the 30 patients selected, 13 were having vishama agni (43.33%), 11
patients were having teekshna agni (36.6%), 3 manda agni ( 10%) & 3 ( 10%) having
samagni. So it is evident that majority of patients were having vishama agni, reveals
the involvement of the vata dosha.
Koshtha:-
In the present clinical study, among the 30 patients selected, 10% were having
mrudu koshtha , 50% madhyama koshtha & 40 having kroora koshtha (53.3%).
Duration:-
For the present clinical study, among the 30 patients selected, 6 patients
(20%) had history of 0- 1Month of illness, 3 patients (10%) had 1-3 months of
history of illness, while 11 patients (36.67%) had 3-6 Months history of illness and,
Discussion
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita” Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09 150
10 patients (33.33%) had history of 6M -1 year . So it is clear that, patients suffering
since 3-6 months were seen more in duration.
Discussion on vyasana :
In majority of patients Alcohol consumption(36.66%) was seen,Betel and Smoking
habits were seen in 16.66% patients each.In 23.33% patients Tobacco habit was seen.
Alcohol in excess (more than 2 drinks a day) can contribute to hypertension
that we all know contributes directly to stroke. Alcohol can cause certain heart
problems which will contribute to stroke ( e.g.atrial fibrillation, cardiomyopathy)
There is also evidence that alcohol can inhibit coagulation and this might explain
why alcohol tends to directly relate to hemorrhagic stroke ( e.g.intracerebral
hemorrhage).
Aaharaja nidana :
60% of the patient consumed Rooksha ahara, 13.33% of the patients
consumed Sheeta ahara, 30% of the patients consumed Alpa ahara and 53.33% of
the patients consumed Laghu ahara. The pattern clearly shows that majority of the
patients consumed Vata Vardhaka ahara.
Diet Found To Be Protective In Cases of Stroke:
Diet adequate in Potassium levels is considered to be protective against stroke.
People with less Potassium are ten times more prone to Stroke (www.nalap.org).
Two tomatoes and Spinach every day gives enough Potassium.
Magnesium and high fiber diet are also found to be protective against stroke Persons
having low concentration of vitamin C are 2.4 times more prone to the development
of stroke. (www.hsph.harward.edu).
Discussion
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita” Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09 151
Diet deficient in Mg has been correlated with increased incidence of stroke cases.
Anashana Ruksha ahara can be considered as those deficient in micro nutrients.The
vatavyadhi nidana told in our classics resemble the same.
Viharajanya Nidana:
Majority of patients are having Atiprajagarana 53.33%, Ativyayama is seen in
46.66% ,Bhojanottar chesta and Atiyana are seen in 20% patients. Vega sandharana
and Diwaswapna 23.33%,Abhighata 10% ,Atilanghana is seen in 6.66% pf
patients.All these nidana are vataprakopaka nidana found play a role in manifestation
of the disease.
Ati Vyayama : Excessive exercise induces damage to mitochondria and DNA of
muscle cells. Ativyayama is considered as one of the nidana of vata vyadhi. Such a
condition may predispose some or many muscle groups of a person who is already
prone to stroke.
Relation of Atmosphere and Stroke :
More cases of stroke are reported when there is drop in temperature five days
previously (www.healthandage.do). Higher air pressure and humidity are also risk
factors for stroke.All these findings strengthen the Ayurvedic concept that Sheeta kala
is the precipitating factor of Vata vyadhi and Ushna kala prevents it.
Onset :
There were major no of ( 86.66% ) patients with sudden onset of stroke, 13.33% of
the patients suffered from stroke with gradual onset.Sudden onset is seen in case of
embolism,thrombosis,cerebral haemorrhage.In case of gradual onset the causes are
tumours,meningitis,encephalitis,congenital defects.
Discussion
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita” Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09 152
Manasika nidana:
In 40% of the patients Krodha was observed, while 56.66% of the patients had Chinta, and Bhaya was observed in 3.33% of the patients. Manasika nidana have a
a role in manifestation of vatavyadhi, which can be compared as like below:
Autonomic and neuro endocrine mechanisms also may underlie the relation between
anger expression and stroke risk. Prior research has shown that anger and hostility are
associated with excessive autonomic and neuroendocrine activation, especially under
conditions of stress, and in individuals who experience frequent episodes of anger. The
men who reported high levels of outwardly expressed anger also showed greater SBP
responses in anticipation of an exercise stress test, which is reflective of exaggerated
sympathetic arousal. These men also experienced a greater frequency of anger, as
indicated by higher hostility scores, and reported more stressful working conditions, as
indicated by higher scores on a measure of job demands. However, taken together,
available evidence suggests that excessive sympathetic arousal and associated
neuroendocrine activation in response to stress and frequently experienced angry
outbursts also could underlie the observed association between anger expression and
incident stroke. These and related hypotheses await additional research.
Histroy of Hypertension:
In 70% of the patients history of hypertension was observed, while 30% of the pa
tients were not having such history.Hypertension accounts for 35-50% of stroke risk.
Epidemiological studies suggest that even a small blood pressure reduction (5 to 6
mmHg systolic, 2 to 3 mmHg diastolic) would result in 40% fewer strokes. Lowering
blood pressure has been conclusively shown to prevent both ischemic and
hemorrhagic strokes. It is equally important in secondary prevention.
Discussion
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita” Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09 153
Nature of Sleep:
The nature of sleep was disturbed in 76.66% in stroke patients.while in 23.33% were
having good sleep.Atiprajagarana leads to rukshata in the body.Thus it causes
vitiation of vata.
Effect of Nasya:
Sukhaswapanam is in majority of patients (76.66%), Sukhauchvasam in (66.66%)
patients, Sukha Bodha 70% and Akshipatavam is seen in 46.66 % of patients.
Many nerve endings which are arranged in the peripheral surface of mucous
membrane, olfactory, trigeminal etc will be stimulated by Nasyadravya (the medicine
used to give nasya) and impulses are transmitted to the central nervous system. This
results in better circulation and nourishment of the organs
Over all improvement:
In Group A out of 15 patients 1 patient (6.66%) showed marked improvement,
4 patients (26.67%) showed moderate improvement, 7 patients (46.66%) showed mild
improvement, and 3 patients registered no change.
In Group B out of 15 patients 1 patient (6.66%) showed marked improvement,
4 patients (26.67%) showed moderate improvement, 8 patients (53.33%) showed mild
improvement, and a total of 2 patients (13.33%) registered no change.
Discussion on results :
The statistical analysis was done by applying Shapiro wilks test to find out
whether all the parameters were following the normal distribution or not. As all the
parameters were not following normal distribution, non parametric Mann Whitney
test is applied for between group analysis and Wilcoxons signed rank test for within
group analysis were followed.
Discussion
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita” Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09 154
1.Housebrackman scale :
Both Nasya yogas showed no significant results in first course of treatment. There
was significant difference observed in group A(p=0.05) and group B (p=0.025) after
second course and follow up.This indicates the necessity of two courses of nasya for
better results.
2.Finger movement :
There was no significant difference observed in group A (p=0.317) after first course
of nasya ,but in group B (p=0.014) there was significant improvement in first course
only. Both the groups shown significant improvement after second course and follow
up.
3.Lifting of Arm :
There was no significant difference observed in group A (p=0.157) after first course
of nasya ,but in group B (p=0.025) there was significant improvement in first course
only. Both the groups shown highly significant improvement (p=0.001) after second
course and follow up.
4.Sitting from laying down:
There was no significant difference observed in group A . In group B there was no
difference found. But after second course and follow up the results are found to be
significant with p value =0.014.
5.Standing from sitting :
There was no significant difference observed after first course of treatment in both
groups. In group B after second course and follow up the results are found to be
significant with p value 0.025 but,group A is found to be more effective as
compared to group B after second course and follow up the results are found to with
p value=0.014 which suggest more significance.
Discussion
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita” Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09 155
6.Drooping of Wrist:
There was no significant difference observed after first course of treatment in both
groups. In group B after second course and follow up the results are found to be
significant with p value 0.046 but,group A is found is more effective as compared to
group B after second course and follow up the results are found to with p
value=0.005.
7.Associated complaints :
a) Loss of Speech:
There was no significant difference observed in group A (p=0.317) after first course
of nasya ,but in group B (p=0.014) there was significant improvement in first course.
Group A shown significant improvement (p=0.042) after second course and which
was maintained even after follow up. Group B shown more improvement after second
course and follow up ( p=0.002) .The nasya dravya acts by reaching 'Sringataka
marma' a main vital point situated on the surface of the brain corresponding to the
nerve centres, which consisting of nerve cells and fibres responsible for the function
of speech-Broca's Centre.
b) Pain :
There was no significant difference observed in group A (p=0.157) after first course
of nasya, but there was significant improvement was observed. in group B (p=0.046)
Comparision of results of second course and follow up in both the groups reveals that
group A is highly significant (p=0.001),group B shows slightly less significant results
with p value = 0.002
Discussion
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita” Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09 156
8.Muscle Power:
Both the groups shown the same results.There was no significant difference observed
after first course of treatment in both groups. After second course and follow up the
results are found to be highly significant with same p value = 0.001.
9.Hand grip Power:
There was no significant difference observed in group A (p=0.317) after first course
of nasya, there was significant improvement was observed in group B (p=0.046)
Highly significant results was seen in group A p=0.001,where in group B p=0.007
which is significant but comparatively less than group A
10.Muscle tone :
There was no significant difference observed after first course of treatment in both
groups.(group A p=0.18 & group B p=0.317). Results are highly significant in both
the groups after second course and follow up (p<.001)
11. Increase in walking capacity:
There was no significant improvement observed after first course of nasya in group
A(p=0.157),where in group B significant improvement observed after first course,
Second course and follow up in group B (p=0.083).In group A there was also
significant improvement observed after Second course and follow up (p=0.01)
12.Reflexes:
There was no significant improvement observed after first course, Second course
and follow up in both group.
Conclusion
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita” Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09 156
CONCLUSION
The conclusion drawn from the present clinical study are as follows :
• Charakokta Ardita is defined in two terms by charkacharya as involvement of
only half of the face and with half of the body.
• The disease leads more disability to the sufferer’s in day to day activity and
hampering quality of life.
• The characteristic features of patients and disease studied shown that the disese
is more prevalent in males ,mostly affects in the later period of life,when vata
dosha is dominant.
• The complete recovery from the illness is rare ,but result of nasya showed that
it is useful to improve the functional ability add quality of living of disabled
patients.
• Here a comparative study of two navana yogas was done and found to be
effective.There was significant improvement seen in both the groups in all
parameters except in case of reflexes.
• Comparision of both the groups shown that in group B there is significant
improvement after first course in finger movement,loss of speech, pain
,handgrip power,where in group A there is significant results found in after
second course.
• The nasya treatment in both the groups was well tolerated by the patients
studied.
Suggestions for the future study:-
Study should be done on a large sample size.
A clinical study can be done with Rasnaputika taila in different indicated
disorders of this yoga.
Summary
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita” Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09 157
SUMMARY
The present clinical study was undertaken to evaluate the efficacy of
Karpasasthyadin taila Nasya & Rasnaputika taila nasya in the management of
Charkokta Ardita.The present work is distributed in two sections. The first section
deals with review of literature available for Nasya procedures, disease Ardita and
Drug Review.
Procedure review covers the historical background for Nasya classification
according various Acharyas, Indications and contraindications, Schedule, Dosage,
Administration of which includes,Purva karma, Pradhana karma and Paschat karma,
Samyka yoga, atiyoga, ayoga, Vyapada and Chikitsa .
Disease review includes, Historical review Nirukti, Paribhasha, and,
Nidana, Samprapti, Roopa, Bheda, Sadhya-asadyata, Chikitsa and Pathya-pathya for
Ardita . A brief discussion based on available Modern literature was also done with
reference to the above subjects.
The second section is related to clinical trials.The clinical trial includes
materials and methodology, the clinical observations, results and discussion. The
clinical study was done on 30 patients of both sexes, between the age group of 31-70
years were selected. The patients were divided into 2 groups namely Group A and
Group B. In group A Karpasasthyadi taila Nasya & in group B Rasnaputika taila nasya
was given .Both the groups were given similar poorva & paschat karmas.
Both Nasya karma was initiated with Mrudu abhyanga with tila taila to
urdhawa jatrugata pradesha followed by swedana the pradhana karma. Koshna jala
gandoosha was given as paschat karma to both the groups.
Summary
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita” Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09 158
The dosage of Nasya was followed according to Shodhana Nasya i.e. 8
drops. The assessment was done before the day of initiation of treatment and at the end
of each course and at follow-up. Thus total study duration was of 28 days.
The observations and results were tabulated and statistically analyzed with
relevant parameters like, Housebrackmann scale,muscle power,finger movement,pain &
reflexes. Both nasya yogas Showed significant improvement in Ardita except reflexes.
Statistically efficacy of group B was found superior to group A.
List of References
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita” Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09
RFERENCES
Introduction:-
1) Sh.S.Prathama khanda 5/25
2) http;//.wikipaedia.org /Nurology
3) A.S.Su.29/3
4) A.S.Su.29/3
5) Sahastrayoga P. no.252
6) Y.R.Vatavyadhi chikitsa P.541
Procedure Review:-
1) R.V.10-16-4.
2) Valmiki Ramayana Yuddha Kanda 6/102.
3) Ayurveda ka Bruhat Itihas pp. 68
4) Ayurveda ka Bruhat Itihas pp.105-106.
5) Vinaya Pitika 6/1/1-9.
6) Cha. Sha. 8/19.
7) Cha. Chi. 3/254,255
8) Cha. Chi. 4/97-104
9) Cha. Chi. 7/48/49
10) Cha. Chi. 8/34,35
11) Cha. Chi. 9/35,56-58,65,71-79,81-82
12) Cha. Chi. 10/40-45
13) Cha. Chi. 12/17
14) Cha. Chi. 17/129-134
15) Cha. Chi. 18/142
16) Cha. Chi. 23/54-60,190,193-196,213
17) Cha. Chi. 26/137,1151-159,174,176,178,180,183-185
18) Cha. Chi. 28/78,88.98,99,124,125-128,194.
19) Cha. Chi. 9/73,75,82,83,87,97.
20) Su. Chi. 1/8,9,125,126
21) Su. Chi. 2/43
22) Su. Chi. 3/40,54,64,68
List of References
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita” Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09
23) Su. Chi. 4/18,22
24) Su. Chi. 5/18,20,21,22
25) Su. Chi. 9/3
26) Su. Chi. 14/11
27) Su. Chi. 18/22,23,50
28) Su. Chi. 19/15
29) Su. Chi. 20/30
30) Su. Chi. 22/4,7,12-17,21,25,35,38,39,40,45,48.59,63,67.
31) Su. Chi. 31/3.
32) Su. Chi. 32/17
33) Su. Chi. 34/12,19.
34) Su. Chi. 36/13.
35) Su. Chi. 37/7
36) Su. Chi. 40/1,2,20-26,28-56
37) A. H. Chi. 1/125,126,150,161.
38) A. H. Chi. 2/47
39) A. H. Chi. 4/46-50
40) A. H. Chi. 5/34,37,41,42,69.
41) A. H. Chi. 6/27,74.
42) A. H. Chi. 7/104,108,110,111.
43) A. H. Chi. 20/28,33.
44) A. H. Chi. 21/17,26,30,43,44,62,63.
45) Cha.Su. 5/57.
46) Su. Chi. 40/21
47) A.S.Su.29/1
48) Cha.Si. 9/8
49) Su. Chi. 40/21
50) Su. Chi. 40/22
51) A.H. Su.20/1
52) A.S. Su. 29/2
53) A.S. Su. 29/5
54) Sha. U.K. 8/1
55) Cha.Si. 9/89-92
List of References
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita” Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09
56) Cha.Si. 9/92
57) Cha.Vi. 8/151
58) Su. Chi. 40/21
59) Su. Chi. 40/21,22
60) A.S. Su. 29/2
61) A.H. Su.20/2
62) Ka. Si. 4/2
63) a) Sha. U.K. 8/2
b) Sha. U.K. 8/11
c) Sha. U.K. 8/24
64) Su. Chi. 40/31
65) Cha.Si. 9/97
66) Cha.Si. 9/94
67) Su. Chi. 40/23
68) Su..Su. 40/36
69) Su. Chi. 40/23,24
70) A.S. Su. 29/7
71) Sha. U.K. 8/12
72) Su. Chi. 40/44
73) Su. Chi. 40/44
74) Cha.Si. 2/22
75) Cha.Si. 2/20,21
76) Su. Chi. 40/47
77) A.H. Su. 20/11,12,13.
78) Cha. Si. 2/23
79) Cha. Si. 2/23
80) Su. Chi. 40/24
81) Sha. U.K. 8/3
82) Su. Chi. 40/42
83) A.H. Su. 20/15,16.
84) A.S. Su. 29/16
85) Su. Chi. 40/22 Bhoja Tika
86) A.H. Su. 20/30
List of References
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita” Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09
87) A.H. Su. 20/32
88) A.H. Su. 20/9
89) Su. Chi. 40/25
90) a) Cha.Si. 9/98-104
b) Su. Chi. 40/25,26
c) A.H. Su. 20/17,22.
91) A.S. Su. 29/17
92) Cha.Si. 9/98-104
93) Su. Chi. 40/31
94) Sha. U.K. 8/47-53
95) Cha.Si. 9/108
96) Su. Chi. 40/32
97) Cha.Si. 1/51
98) Su. Chi. 40/32-33
99) A.H. Su. 20/23
100) Sha. U.K. 8/58
101) Ka. Si. 2
102) Cha.Si. 1/52
103) Su. Chi. 40/39
104) Su. Chi. 40/39
105) Cha.Si. 1/52
106) Su. Chi. 40/35
107) A.H. Su. 20/25
108) Sha. U.K. 8/59
109) Ka. Si. 2
110) Cha.Si. 1/52
111) Su. Chi. 40/34
112) Cha.Si. 1/52
113) Su. Chi. 40/34
114) A.H. Su. 20/24
115) Sha. U.K. 8/60
116) Ka. Si. 2
117) Su. Chi. 40/49
List of References
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita” Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09
118) Cha.Si. 9/113-115
119) A.H. Su. 20/21
120) Cha.Si. 5/57-62
121) Chakradatta Vatavyadhi Adhikara sl. 23,24
122) Yogaratnakara Vatavyadhi Adhikara sl.1,2.
123) Bh. Ratnavali 26/71-72
124) G. Ni. 2nd 19/117,118
125) Sha. U.K. 8/36,37
126) Su. Sha. 9/5
127) Cha. Su.8/8-12
128) Su. Sha. 9/11
129) Su. Sha. 7/8
130) A.H. Sha. 4/30
131) Su. Sha. 6/28
132) a)Guyton book of physiology ch.41 pp no. 516
b) The Pacific Journal of Science and Technology –338–
http://www.akamaiuniversity.us/PJST.htm
133) Cha. Si. 9/88
134) A.S.Su. 29/3
135) Cha. Si. 2/22
136) Su. Chi. 40/40
Disease Review:
1) R.V.10/2/13
2) A.V.6/109/3,A.V.6/44/33
3) Ayurved ka praamanika Itihasa, page 88
4) Ch.Su. 20/11
5) Ch.su.11/63
6) Ch.chi.28/36-40
7) Ch. chi.28/98
8) Bh.S. chi.10/1
9) Bh.S/.Chi. 27/26-3
List of References
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita” Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09
10) Ha.Trutiya sthana-23
11)Su. Ni.1/68-73
12)Su.Chi.5/22
13)Su.Ni.1/68-72 Haranachandra commentary
14)A.S.Ni 15/32
15)A.S.Chi.32/2-10
16) A.H.Ni.16/19-20
17)K.S.Su.27-28
18)K.S.Su.23/22
19)Sh.S.Pur.7/103
20)Su.S. Utt. 8/36-37
21)Bh.P.Madhyama khanada 24/60-72
22)The student’s sanskrit english dicitionary by V.S. Apte
23)Ch. Chi.28/64
24)Su.Ni.1/69
25)A.S.Ni.15/24
26)A.H.Ni.15/36
27)Bh.P.Ma. Vatavyadhi Chi.23/63
28)M.N.22
29)Y.R.Vatavyaadhi Chikitsa
30)Ha.Trutiyasthana 20/40
31)Bhel.10/1
32)Ch.Chi.28/38
33)Su.Ni.1/69
34)A.S.15/24
35)A.H.15/33
36)Bh.P.23/63
List of References
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita” Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09
37)M.N. Vatavyaadhi 22
38)Y.R.Vatavyadhi nidanam
39) Ha.Trutiyasthana 20/43
40) Bhel.10/10
41) Ch. Chi.28/15 -18, Su.Ni.1/67-68, Ka.Vatavyadhi/12, A.H.Ni.15/32,
B.P.Vaatavyadi/60-61, Y.R.Vatavyadhi Nidana/Ardita prakarana
42) Ch. Chi. 28/38-39
43) Su. Ni. 1/68-70
44) A H. Ni. 15/32-31
45) Y.R.Vatvyadhinidana 3/5
46) Bhela.Chi. 27/27-28
47) Su.Ni.1/68
48) A.H.Ni.15/32
49) M.Ni.22
50) B.P.Vatavyadhi 23
51) A.H.Ni.15/32
52) Ch. Ni. 1/8
53) A.H. Ni.1/3
54) Su. Ni. 1/71
55) Ch. Chi. 28/38-39
56) Su. Ni.1/68-70
57) Y.R.Vatavyahi 3-5
58) Bhela S.10/10
59) Ch.Su.11/49
60) Ch.Chi.28/39-42
61) Su.Ni.1/70-72
List of References
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita” Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09
62) A.S.Ni.15/24
63) A.H. 15/34-36
64) B.P.23 Vatavyadhi adhikara
66) Y.R. Vatavyadhi /16
67) Bhel.10/1
68) Ha.Trutiya sthana 20/40
69) B.P.23/64,
70) Y.R.Vatavyadhi/9
71) Ha.S. Trutiya stahana 20/41
72) B.P.23/65,
73) Y.R.Vatavyadhi/10
74) Ha.S. Trutiya stahana 20/42
75) B.P.23/66,
76) Y.R.Vatavyadhi/11
77) Ha.S. Trutiya stahana 20/43
78) Bhel S.10/10-11
79) Chakrapani commentry on Ch.Chi.28/42
80) Su.Su.33/4
81) A.H.Ni.8/30
82) Su.Ni.1/73
83) Su.Chi.5/22
84) Ch.Chi.28/99
85) A.H.Chi.21/42
86) A.S.Chi.23/23
87) B.P,23/68
88) Sh.S.Utt.8/37
89) Ch.Dt.Vatavyadhi chikitsa 17,18.
List of References
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita” Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09
90) How to examine a patient p.431.
91) Harrison’s Pricipals of Internal Medicine Vol.2 p.1934-1940. Drug review:
1) Sahastra yoga p.252
2) Yogartnaka vatavyadhi p.541
3) D.V.Vol.2 p.630
4) D.V.Vol.2 p.393
5) D.V.Vol.2 p.734
6) Bha.Ni. p.640
7) D.V.Vol.2 p.75
8) D.V.Vol.2 p.39
9) D.V.Vol.2 p.572
10) D.V.Vol.2 p.152
11) D.V.Vol.2 p.331
12) D.V.Vol.2 p.403
13) D.V.Vol.2 p.275
14) D.V.Vol.2 p.335
15) D.V.Vol.2 p.111
16) D.V.Vol.2 p.630
17) Bha.Ni.Dugdhavarga,p.760
18) D.V.Vol.2 p.39
19) D.V.Vol.2 p. 144,Bh.Ni.p.349
20) Bha.Ni.Vol.2 p.779
21) D.V.Vol.2 p.455
22) D.V.Vol.2 p.221
23) D.V.Vol.2 p.469
24) D.V.Vol.2 p.223
25) D.V.Vol.2 p.225
26) D.V.Vol.2 p.282
27) D.V.Vol.2 p.280
28) D.V.Vol.2 p.632
29) D.V.Vol.2 p.820
List of References
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita” Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09
30) D.V.Vol.2 p.822
31) D.V.Vol.2 p.331
32) D.V.Vol.2 p.362
33) D.V.Vol.2 p.275
34) D.V.Vol.2 p.497
35) D.V.Vol.2 p.403
36) D.V.Vol.2 p.503
37) Bha.Ni.p.640
38) D.V.Vol.2 p.28
39) D.V.Vol.2 p.572
40) D.V.Vol.2 p.75
41) Bha.Ni.p.640
42) Bha.Ni.571
43) D.V.Vol.2 p.743
44) D.V.Vol.2 p.58
45) D.V.Vol.2 p.630
46) D.V.Vol.2 p.66
47) D.V.Vol.2 p.763
48) D.V.Vol.2 p.652
49) D.V.Vol.2 p.732
50) D.V.Vol.p.111
51) D.V.Vol.2 p.31
52) D.V.Vol.2 p.83
53) D.V.Vol.2 p.335
54) D.V.Vol.2 p.800
55) D.V.Vol.2 p.721
56) D.V.Vol.2 p.350
57) D.V.Vol.2 p.185
58) D.V.Vol.2 p.715
59) D.V.Vol.2 p.152
60) D.V.Vol.2 p.562
61) J.L.N.Shastry p.314
62) J.L.N.Shastry p.459
List of References
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita” Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09
63) J.L.N.Shastry p.558
64) J.L.N.Shastry p.669
65) J.L.N.Shastry p.801
66) D.V.Vol.2 p.753s
67) D.V.Vol.2 p. 758
68) D.V.Vol.2 p.239
69) Bh.Ni.p.365
70) Bh.Ni.p.696
71) Bh.Ni.p.394
72) D.V.Vol.2 p.253
73) D.V.Vol.2 p.359
74) D.V.Vol.2 p.319
75) D.V.Vol.2 p.250
76) D.V.p.719
77) D.V.Vol.3 p.704
78) D.V.Vol.2 p.783
79) D.V.Vol.2 p.54
Bibliography
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita” Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09
BIBLIOGRAPAHY 1. Agnivesha. Charakasamhita, 4th edition. Varanasi: Chaukhamba Sanskrit
sansthan; 2005. (kasisanskrit series) 2. Sushruta. Sushruta Samhita, Editor Kaviraja Ambikadutta Shastri, 14th ed.Varanasi: Chaukhambha Sanskrit Sansthan; 2003. 3. Dalhana. Nibanda samgraha teeka on Sushruthasamhitha Varanasi: Krishnadas Academy; 1980. (Krishnadas Ayurveda series 51). 4. Madatraya Maharshi Hareetamuni. Samvadarupa Vaidya Granth, Harita Samhita
Edited by Khemraj Shrikrishnadas, Bombay: Swakiya Venkateshwar Mudranlaya; 1984.
5. Ashtangasangraha. Prof.K.R.Srikhantamurthy, editor.Varanasi: Chaukhambha Orientalia; 1996 (Jaikrishnadas Ayurvedic series 79) 6. Vagabhatta. Astangasamgraha with sasilekha teeka, Rudra parasava 1st ed. Varanasi: Chaukhamba Krishnadas Academy; 2006. 7. Vagabhatta. Astanga hrudaya, 8th ed. Edited by Vaidya Bhisagacharya Harishastri Paradaka . Varanasi: Chowkambha Orientalia; 1998.
8. Arunadatta. Sarvangasundari teeka on Ashtangahridaya, Varanasi: Krishnadas
Academy; 1982. (Krishnadas Academic series 4).
9. Vrudhajeevaka. kashyapasamhita siddisthan,4th ed. Varanasi: Chowkambha Sanskrit sansthan; 1988.
10. Bhelasamhita, Girijadayal Shukla editor. Varanasi: Chaukhambha Vidyabhavan; 1959. 11. Madhavakara. Madhavanidana, Varanasi: Chaukhambha Surbharathi Prakashan; 1998. (Chaukhambha Ayurvijnana Granthamala 46). 12. Sharangadhara. Sharangadhara samhita, 6th ed. Varanasi: Chowakambha Orientalia; 2005. (Jai. Krishnadas Ayurveda series) 13. Bhavamishra. Bhavaprakasha Purvakanda, 5th ed. Varanasi: Chaukhamba Sanskrit series ;130,1988.
Bibliography
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita” Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09
14. Yogaratnakar with vidyatini Hindi commentary edited by Vd.Sri Laxmipati Shastri Chaukambha Sanskrit Samsthan 7th edition 1999. 15 Sahastra yoga translated by Dr.Panditrao P.V. edited by Vaidya Mahendrapal Sinha Arya, New delhi, Kendriya Ayurveda Evam AnusandhamParishad,1990. 16. Raja Radhakantha Deva Bahadur. Shabdakalpadruma,
3rded.Varanasi:Chaukambha Sanskrit Series;Chaukambha Samskrita Granthamala-93.
17. Kasture VG. Ayurvediyapanchakarmavigyan, 6th ed. Nagpur: Shree
Baidyanath Ayurved Bhavan Ltd.; 1998.
18. B.D Chaurasia Human Anatomy 3rd ed. Vol-3. New Delhi: CBS publishers and distributors; 1995. 19. Harrisons’s principles of internal medicineVol-2.; McGraw Hill book company 11th edition 1987. 20. Peter. L. Williams. Grays Anatomy, 38th ed. Philadelphia: Churchill Living Stone; 2000. 21. Bhavamishra. Bhavaprakash Nighantu, Reprinted. Varanasi: Choukhambha Bharati Academy; 1999. 22. Shastry J.L.N. Dravyaguna Vijanam vol 2, 2nd edition. Varanasi: Chaukhamba Orientalia; 2005. 23. P.V.Sharma, Dravyaguna Vijanam vol 2, Reprinted. Varanasi: Choukhambha Bharati Academy; 2003.
24. Clinical examination , 7th Edition edited by John Macleod and John Munro English language book society, Churchill Livingstone, 1988. 25. Atridev Vidyalankar. Ayurvedasya Bruhat Itihas, 1st ed. U.P. Prakashan Shakha; 1960. 26. Sri Taranath Taraka Vachaspati. Vachaspatyam, Re-edited, Varanasi: Chowkhambha Sanskrit Series office; 2003. 27. Shastri Ramgopal. Vedon mein Ayurveda, Delhi: Madan Mohanlal Ayurveda Anusandhan trust; 1956.
Bibliography
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita” Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09
28. Martini.F.H. Fundamentals of Anatomy and Physiology, 4th ed. New Jersey: Prentice Hall Inc. Simon & Schuster; 1998. 29. Williams Monier Monier Sir. Sanskrit English Dictionary, cognate Indo-European
languages. New Delhi: Motilal Banarasi Das; 1970. 30. Davidson’s Principles and Practice of Medicine 20th Edition. 31. Atmakari Vinayakumar .Ayuredic Clinical Medicine:1st Edition1997. Mcnino desouza, How to examine a patient,Varghese Publishing House 5th
Edition;1982. 32. Pachakarma Treatment of Ayurveda :Sri Sadguru Publication,First edition2002 33. www.stroke-info.com 34. www.stroke.ahajournals.org 35. www.wemove.org 36. www.brainattacks.net 37. www.strokecenter.org/trails 38. www.righthealth.com 39. www.mdpi.org/molecules 40. www.ninds.nih.gov 41. Ayurveda-foryou-com/panchakarma/nasya,html 42. stroke.ahajournals.org/cgi/content/full/strokeaha;30/3/523
Annexure
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita”
Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09.
DEPARTMENT OF PG STUDIES IN PANCHAKAMA GOVERNMENT AYURVEDIC MEDICALCOLLEGE,BANGALORE - 09
CASE SHEET PROFOMA FOR “ COMPARATIVE CLINICAL TRIAL ON TWO DIFFERENT NAVANA YOGAS IN CHARAKOKTA ARDITA” P.G.SCHOLAR : Dr.Vijaya v. GUIDE NAME:Dr.Shylaja kumari R. Name of patient: Sl no: Age: OPD No:
Sex: M/F IPD No: Religion: H/M/C/O Bed No: Educational status: Group : Economical status: Poor/Middle/Upper middle/high Marital status: Married/Unmarried/Widow/Widower Occupation: Address: Phone No: Chief complaints: - Duration:- 1) Mukhardha vakrata : Dakshina/Vama 2) The Sharirardha affected : Dakshina/Vama 3) Vaksanga :
Annexure
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita”
Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09.
Associated complaints: - Duration:- History of present illness:- Onset : History of past illness:- Family History:- Treatment History:- Case:- Fresh/Treated/Under treatment /Untreated Previous medication:-Allopathic/Ayurveda/Other Response :- No response /Mild / Moderate / Good
Annexure
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita”
Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09.
Personal History:- Diet: - Type:-Veg/Nonveg/Mixed Time of intake of food:-Regular/ Irregular Quantity of food:-Less/ Moderate/More
Rasa dominance:-Madhura/Amla/Lavana/Katu/ Kashaya/Tikta
Bowel: - Frequency:- Consistency:- Micturition: - Frequency:- Sleep: - Sound/ disturbed /Divaswapna / Ratrijagarana
Habits: - Coffee/ Tea/ Smoking/ Tobacco/Betel chewing/ Drugs/ Alcohol/ Soft drinks/ Snuffing/ None Duration: Occasional/Regular/Reduced/Stopped Emotional Status: - Anxiety/ Tension/Depression/ Irritation/Anger/Fear/ Calm Type of Koshta:- Mrudu/Madhyama/Krura Type of Agni :- Mandagni/Vishamagni/Tikshnagni/Samagni Menstrual History:- Manarche ….yrs Menstrual cycle….days Regular / Iregular Menopause…. Other details:-Menorrhagia / Metrorrhagia/ Dysmenorrhea Leucorrhoea Obstetric History:- No. of delivaries….Nornal /Surgical Last delivery……..yrs back
Annexure
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita”
Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09.
General Examination : - Weight -
Height - Built - Odema - Cyanosis - Clubbing - Temp - B.P - Pulse - Respiration rate -
Systemic Examination:- Respiratory System:- Cardio vascular System:- Gastro intestinal System:- Central nervous System:-
a) Higher mental functions
b) Cranial nerves :
I Olfactory : sense of olfaction II Optic : seight Field of vision Colour sense III Occulomotor : eye movements IV Trochler : ptosis Nystagmus Diplopia V Trigeminal : mandibular movements Deglutition & mastication Sensibility of face
Annexure
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita”
Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09.
VI : Abducent : corneal reflex VII : Facial : Ability to close eyes Ability to raise eyebrows speech whistling test mouth inflation test
sense of taste in anterior 2/3 rd of tounge blowing test VIII Auditory : hearing vertigo
IX Glossopharngeal : pharyngeal & larengeal movements X Vagus : swalloing Voice XI Spinal accessory : elevation of shoulder XII Hypoglossal : tongue movement
c) Motor system : Nutrition of the muscles-
Mascular tone – Power of muscles – Coordination – Abnormal movements – Gait – d ) Sensory system : e ) Reflexes :
Annexure
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita”
Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09.
Dashavidha pareeksha : Atura Bhoomi Desha Pareeksha:-
Jangala Desha Anoopa desha Sadharana desha
Jatha
Samvridha
Vyadhita
Atura Deha Pareeksha Prakrititaha:- Shareerika Prakriti:- Manasika Prakriti:- Sarataha:- Pravara/ Madhyama/ Avara Samhananataha:-Susamhata/ Madhyama/ Asamhata Pramanataha:-Sama/ Adhika/ Heena Satmyataha;-Ekarasa/ sarvarasa/Vyamishra Satvataha;-Pravara/ Avara/ Madhyama Ahara Shakti;-Abhyavarana :-Pravara/ Madhyama/ Avara Jarana Shakti:-Pravara/ Madhyama/ Avara Vyayama Shakti:-Pravara/ Madhyama/ Avara Vayataha;- Balya/yuva/vruddha Vikrititaha:- Hetu: :- Ahara;- Vihara:- Manasika:- Anya:- Dosha:
Annexure
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita”
Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09.
Dushya: Prakruti:
Desha:
Kala:
Bala ASHTASTHANA PAREEKSHA: Nadi:vata/pitta/kapha.
Jihwa:liptata/aliptata; . Mala:badda/abadda; saama/nirama Mootra:prakruta/vikruta. Shabdha:prakruta/aprakruta. Sparsha:mrudu/khara. Druk:prakruta/vikrut Aakruti:sthula/madhyama/heena Laboratory Investigation: - Blood Investigation
Hb% T C DC ESR R B S
Urine Analysis;- Albumin
Microscopic Others if necessary
Annexure Chikitsa : 1) Group-A--- Nasya with formulation with Karpasathyadi Taila .
2) Group-B--- Nasya with formulation with Rasnaputika taila.
Group Date of initiation Date of completion 1st course 2nd course
Samyak Yoga Lakshana :
Symptoms 1st course 2nd course
Swaravishuddhi
Vikaropashama
Sukha Svapna Prabodha
Sukhochvasa
CRITERIA FOR ASSESSMENT :
1. Housebrackman scale:
House Brackmann grading scale
BT AT BT 2 AT 2
Grade 1 Grade 2 Grade 3 Grade 4 Grade 5 Grade 6
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita”
Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09.
Annexure 2.Finger Movement
Score BT AT BT 2 AT 2 No 4 Slight 3 Unable to hold object 2 Able to hold with less power 1 Normal 0
3.Lifting of Arm At Shoulder
Score BT AT BT 2 AT 2 No 4 Up to 45 3 Up to 90 2 Up to 135 1 Up to 180 0
4.Sitting From Lying Down
Score BT AT BT 2 AT 2 Unable 2 With support 1 Without support 0
5.Standing From Sitting
Score BT AT BT 2 AT 2 Unable 2 With support 1 Without support 0
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita”
Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09.
Annexure 6.Drooping wrist
Score BT AT BT 2 AT 2 Full 3 Moderate 2 Slight 1 No 0 7. Associated Signs And Symptoms (a) Loss of Speech
Score BT AT BT 2 AT 2 Aphasia 4 Utter voice 3 Speak few words 2 Speak with difficulty 1 Normal 0 (b) Pain
Score BT AT BT 2 AT 2 Frequent mild type 2 After exertion 1 No pain 0
8.Muscle Tone
Score BT AT BT 2 AT 2 Severe rigidity 3 Moderate rigidity 2 Mild rigity 1 Normal 0
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita”
Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09.
Annexure 9. Muscle Power Gradation
Score BT AT BT 2 AT 2 No active contraction 0
Visible contraction without active movement
1
Movement which is possible when gravity is eliminated
2
Movement which is possible against gravity
3
Movement which is possible against gravity and resistance but it is weaker than normal.
4
Normal 5
10.Handgrip Power
Score BT AT BT 2 AT 2 0 – 10 mm Hg 3 10 – 20 mm Hg 2 20 -30 mm Hg 1 30 -40 mm Hg 0 11.Increase In Walking Capacity :
BT AT BT 2 AT 2 Before treatment 2 times than before 3 times than before 4 times than before 5 times than before
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita”
Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09.
Annexure
12.Reflexes
Results :
Score BT AT BT 2 AT 2 Very brisk 2 Brisk 1 Normal 0
1. Marked improvement relief of >75%
2. Moderate improvement 51-75% relief
3. Mild improvement 25-50% of relief
4. No Change 0% relief
Signature of the investigator Signature of the Guide
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita”
Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09.
Annexure
“A Comparitive clinical trial on two different navana yogas in Charakokta Ardita”
Dept.Of P.G.Studies In Panchakarma-G.A.M.C.Bangalore-09.
Voluntary Consent Form I ____________________________, hereby willingly agree to participate in this
dissertation study titled,“A comparative clinical trial on two different navana yogas in
Charakokta Ardita”. I affirm that there has been no compulsion or monetary inducement
in my agreeing to be volunteer for this study which I do on my free will. I have been
explained the general purpose of the study. I am convinced that it is for the benefit of
science and mankind. I have been told about the risks involved which I am convinced. I
have also been told that I have to undergo following procedures during the study.
1. Collection of Blood samples
2. To remain under observation
I can opt out of this study at any time.
Signature of PG Scholar Signature of Volunteer
ABHYANGA
SWEDANA
NASYA