“A COMPARATIVE CLINICAL STUDY ON THE EFFECT OF NASYA WITH KARPASASTHYADI TAILA AND NAGARA TAILA IN THE MANAGEMENT OF AVABAHUKA”

“A COMPARATIVE CLINICAL STUDY ON THE EFFECT OF

NASYA WITH KARPASASTHYADI TAILA AND NAGARA TAILA

IN THE MANAGEMENT OF AVABAHUKA”

BY

Dr. FEBIN.P.JOSE

Dissertation Submitted to the Rajiv Gandhi University of Health Sciences,

Karnataka, Bangalore

In partial fulfilment of the degree of

AAYYUURRVVEEDDAA VVAACCHHAASSPPAATTII

IN

PANCHAKARMA

Under the guidance of

Dr. KRISHNAPRAKASH.M.K M.D. (AYU)

Professor

Dept. of Panchakarma

And co-guidance of

DR. SANATH KUMAR D.G. M.D.(AYU) LECTURER

POST GRADUATE DEPARTMENT OF PANCHAKARMA

K.V.G.AYURVEDA MEDICAL COLLEGE AND HOSPITAL, SULLIA – 574327

2013

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Rajiv Gandhi University of Health Sciences


DECLARATION BY THE CANDITATE

I hereby declare that this dissertation / thesis entitled “A comparative clinical study on

the effect of Nasya with Karpasasthyadi Taila and Nagara Taila in the management

of Avabahuka” is a bonafide and genuine research work carried out by me under the

guidance of Dr. Krishna Prakash.M.K M.D. (Ayu) Professor and the co-guidance of Dr.

Sanath Kumar D.G.M.D. (Ayu) Lecturer K.V.G. Ayurvedic Medical College And Hospital,

Sullia.

Date: Signature of the Candidate

Place: Sullia. Dr. Febin.P.Jose.

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CERTIFICATE BY THE GUIDE

This is to certify that the dissertation entitled “A comparative clinical study on


of Avabahuka” is a bonafide research work done by Dr. Febin.P.Jose in partial

fulfillment of the requirement for the degree of Ayurveda Vachaspathi. M.D.

(Panchakarma).

Date:

Place: Sullia

DR. KRISHNA PRAKASH.M.K. M.D. (AYU)

Professor

Dept. of Post Graduate Studies in Panchakarma

K.V.G. Ayurveda Medical College & Hospital,

Ambatedka, Sullia,

�

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CERTIFICATE BY THE CO-GUIDE



of Avabahuka” is a bonafide research work done by Dr.Febin.P.Jose in partial

fulfillment of the requirement for the degree of Ayurveda Vachaspathi. M.D.

(Panchakarma).

Date:

Place: Sullia

DR. SANATH KUMAR D.G. M.D.(AYU)

Lecturer

Dept. of Post Graduate Studies in Panchakarma

K.V.G. Ayurveda Medical College & Hospital,

Ambatedka, Sullia

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ENDORSEMENT BY THE H.O.D AND PRINCIPAL OF

THE INSTITUTION



of Avabahuka” is a bonafide research work done by Dr.Febin.P.Jose under the guidance

of Dr. Krishna Prakash.M.K M.D. (Ayu) Professor, and co-guidance of, Dr.Sanath Kumar

D.G.M.D. (Ayu) Lecturer K.V.G.A.M.C, Sullia and contributed good values to the Ayurvedic

research.

Date: Date:

Place: Sullia Place: Sullia

Dr. N.S.Shettar M.D. (Ayu),

Principal,

K.V.G Ayurvedic Medical College & Hospital,

Sullia

Dr. N.S.Shettar M.D. (Ayu),

Prof. and H.O.D.

Dept of Panchakarma

K.V.G Ayurvedic Medical College & Hospital,

Sullia

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COPYRIGHT

Declaration by the Candidate

I hereby declare that the Rajiv Gandhi University of Health Sciences, Karnataka

shall have the rights to preserve, use and disseminate this dissertation / thesis in print or

electronic format for academic / research purpose.

Date: Signature of the Candidate

Place: Sullia. Dr. Febin.P.Jose

© Rajiv Gandhi University of Health Sciences, Karnataka.

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ACKNOWLEDGMENT

I have constantly witnessed Divine Providence in many instances and experiences

of my life. I thank Almighty for helping me soar to a new high today. I humbly seek this

opportunity to bow my head to the feet of the Almighty LORD DHANWANTHARI for

showering his blessings and empowering me to this eventful out-come without any

impediments.

I express my deep sense of gratitude to Sri. Kurunji Venkatramana Gowda for

giving me opportunity to study in this institution.

I give my respect at this moment to my father Dr.(Prof) T.F.Josekutty, my mother

Prof. Rosalie Jose, my Brother Fenil.F.Jose and my sister Dr.Frilla.F.Jose for their

blessings which gave me enough strength. Thanks need not but remembrance is a must.

Their warmth is vital for me throughout the life.

The inspiring forces throughout this research work; was my guide

Dr. Krishna Prakash.M.K, M.D. (Ayu). I use this opportunity to express my immense

gratitude and heart full thanks for his timely advises constant encouragement, critical

analysis, untiring help and rousing clinical knowledge.

I would like to avail the opportunity to express my gratitude to my respected co-

guide Dr. Sanath Kumar D.G, M.D. (AYU), for his humble nature, indulgence, dynamic

supervision and scholarly suggestions during the course of this research work.

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I express my gratefulness to Dr. N.S.Shettar, M.D.(Ayu), Principal and HOD, Dept

of Panchakarma for his inspiration, critical suggestions and timely help rendered me

through out this work.

I express my sincere gratitude to Dr.Deenaprakash Bharadwaj MS(Ayu)

Professor ,Dr Rohini. D .Bharadwaj M.D(Ayu) Professor , Dr Rajashekara N

M.D(Ayu) Professor ,Dr Udaya Shankar.L .M S( Ayu) Professor, Dr. Purushotham K.

G M.D (Ayu) Assist Professor,Dr Leeledhar D.V M.D (Ayu) Assist Professor, , Dr.

Hari Prasad Shetty .M , MD (Ayu) Assist Professor , Mrs. Shashikala Lecturer,

Dr.Harshitha Purushotham MD (Ayu) Lecturer Dr. Kavitha B.M. MD (Ayu), Dr

Harshavardhana.K .M S( Ayu) Lecturer , Dr. Bhagyesh.K. MD (Ayu) Lecturer, Dr.

Thasneem MD (Ayu), Lecturer

I express my sincere and deep gratitude to Mr.John winner and Dr.Gururaj M.D.

(Ayu) for their wholehearted encouragement as well as providing all necessary facilities for

the statistical work.

. I take the privilege to thank library Staffs Ms.Sahana and Ms. Thejaswini who

provided me all the necessary books and time for my literary work.

I am very much thankful to the entire Pharmacy Staffs, Hospital Staffs, Office

Staffs and Masseurs, for their help during the study.

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I pay sincere regards to my fellow colleagues Dr. Rajath K.T, Dr. Vasudevan

Moss, Dr.Amal.G.K, Dr.Soumya S.V, Dr. Vijayalakshmi , for their truly help and co-

operation.

I feel extremely thankful to Dr.Srelatha Bhattatiripade, Dr. Shobhana,

Dr.Aatish, Dr. Prajeesh, Dr. Nisamuden, Dr.Nishanth, Dr.Mini, Dr.Allex.M.George,

Dr.Jeeson N.G, Dr. Anjaly, Dr. Sreejin K, Dr. Shaiju, Dr. Mahesh, Dr. Anish, Dr.Anoop,

Dr.Jinu, Dr. Vijaygopal, Dr. Rejina Dr. Deeksha , Dr.Prasanna Aital, Dr Varun,

Dr.Sageeve M.M, Dr. Sreejith S, Dr. Lakshmeesha, Dr. Prasanna. Dr. Manish Sharma,

Dr. Varghese, Dr. Litty, Dr.Akila, Dr.Robins, Dr Swathy ,Mrs. Amjidha, Mr.Hafis and

others for valuable suggestions.

I thank specially to P G Scholars of other Departments, juniors, Internees and UG

friends for their help and supports.

It is my duty to remember and thank one and all especially my patients, Who have

helped directly and indirectly, whose works, are foundation bricks of this attempt.

Last but not the least I thank Mr. Shashidhara K., Hi-Tech Computers, for the

neat and clean printing of this research work.

Date :

Place : Sullia Dr. Febin.P.Jose

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LIST OF ABBREVIATIONS USED

A.H – Ashtanga Hrudaya

A.S – Ashtanga Samgraha

B.P – Bhavaprakasha

C.S – Charaka Samhita

G.N – Gada Nigraha

M.N – Madhava Nidana

S.S – Sushruta Samhita,

Y.R – Yogaratnakara

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ABSTRACT

Avabahuka is a common condition which badly affects the routine domestic

activities of patients like combing; bathing etc. interference in occupation by the illness is

equally true both in patients with sedentary office work as well as heavy field work.

Ayurveda has a great role to manage this disease successfully. Nasya is one among the

treatments told by Acharyas for the management of this disease. A comparative clinical

study on Nasya with Karpasasthyadi Taila and Nagara Taila had been taken to assess the

effect of Nasya Karma and the drug in managing Avabahuka. The comparative effect in

managing the same disease is also assessed.

OBJECTIVE OF THE STUDY

1. To evaluate the efficacy of Karpasasthyadi Taila Nasya in Avabahuka.

2. To evaluate the efficacy of Nagara Taila Nasya in Avabahuka.

3. To compare efficacy of Karpasasthyadi Taila Nasya and Nagara Taila Nasya

in Avabahuka.

Two groups were made and the results obtained in both the individual groups

were compared. The study design selected for the present study was prospective

comparative clinical trial. The sample size for the present study was 30 patients suffering

from Avabahuka as per the selection criteria. Patients were randomly distributed to both

the groups of equal size.

Group A - 15 patients received Nasya with Karpasasthyadi Taila.

Group B – 15 patients received Nasya with Nagara Taila.

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In group A 15 patients (100%) had got Prayika Shamana(61-99%) , and no patient

(00%) had got no response to the treatment ie Guna Alabha. In group B 13 patients

(81%) had got Prayika Shamana(61-99%),02 patients(19%) had got Amshika Shamana

(31-60%), and no patient (00%) had got no response to the treatment ie Guna Alabha.

In Group A Shoola B T -53% and after follow up 91%, and in Sthabthatha i.e.

Unnamana - B T- 42% and after follow up 66%, Avannamana B T- 43% and after follow

up 84%,Akunchana B T-39 % and after follow up 81% and Prasarana B T- 61% and after

follow up 87%, Triyakgamana BT-60% and after follow up 77%.

In Group B Shoola B T -51% and after follow up 81%, and in Sthabthatha ie

Unnamana - B T- 34% and after follow up 63%, Avannamana B T- 30% and after follow

up 76%,Akunchana B T-31 % and after follow up 69% and Prasarana B T- 43% and after

follow up 80%, Triyakgamana BT-35% and after follow up 65%.

Group A had got good results while comparing with Group B.That means Nasya

with Karpasasthyadi Taila had got good effect than Nasya with Nagara Taila in

Avabahuka for the present study.

Key words; Nasya, Avabahuka, Karpasasthyadi Taila, Nagara Taila,

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TABLE OF CONTENTS

SI. NO. TITLE PAGE

NO.

01 INTRODUCTION 1

02 OBJECTIVES 4

03 REVIEW OF LITERATURE 6

04 MATERIALS AND METHODOLOGY 77

05 OBSERVATIONS AND RESULTS 87

06 DISCUSSION 122

07 CONCLUSION 145

08 SUMMARY 147

09 BIBLIOGRAPHY REFERENCES 149

10 ANNEXURES 176

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LIST OF TABLES

SI.

NO

TITLE PAGE

NO.

01 Nidana of Avabahuka 16

02 Sapeksha / Vyavachedaka, Nidana of Avabahuka 22

03 Pathya/ Apathya in Vatha Vyadhi 28

04 Muscles acting on Shoulder Girdle. 32

05 Showing Classification of Nasya according to Various Acharya 40

06 The difference between pratimarsha and marsha Nasya. 46

07 The indications for Shodhana Nasya. 47

08 The indications of Brumhana Nasya. 48

09 The Contraindication of Nasya 49

10 The course of Nasya karma 52

11 The Dosage of Nasya karma 53

12 The Samyaka yoga 58

13 The Ayoga Lakshana 59

14 The Atiyoga lakshana 60

15 Complications of Nasya Karma and their management 61

16 Properties of Nagara 70

17 Guna-Karma of Tila 71

18 Kasaya Dravyas of Karpasasthyadi Taila 73

19 Kalka Dravyas of Karpasasthyadi Taila 74

20 Distribution of Patients Based on Sex 87

21 Distribution of Patients Based on Age 88

22 Distribution of Patients Based on Occupation 89

23 Distribution of Patients Based on Religion Involved: 91

24 Distribution of Patients Based on Socio Economic Status 92

25 Distribution of patients by Education: 93

26 Distribution of patients by Marital Status 94

27 Distribution of Patients Based on Dietary Habit 95

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28 Distribution of Patients Based on Agni 96

29 Distribution of Patients Based on Koshta 97

30 Distribution of patients by Prakruti 98

31 Distribution of patients by Duration of illness 99

32 Distribution of patients by Vysana 100

33 Distribution of Patients Based on Rasa 101

34 Distribution of Patients Based on Onset 102

35 Distribution of Patients Based on Vihara 103

36 Distribution of Patients Based on Satva 104

37 Distribution of Patients Based on Vyadhi Bala 105

38 Distribution of Patients Based on Habitat 105

39 Distribution of Patients Based on Nidra 106

40 Distribution of Patients Based on Joint 107

41 Effect of Group-A on Shoola of Avabahuka 108

42 Effect of Group-B on Shoola of Avabahuka 109

43 Effect of Group-A Unnamana of Avabahuka 110

44 Effect of Group-B on Unnamana of Avabahuka 110

45 Effect of Group-A Avannamana of Avabahuka 111

46 Effect of Group-B on Avannamana of Avabahuka 112

47 Effect of Group-A on Akunchana 113

48 Effect of Group-B on Akunchana 113

49 Effect of Prasarana on Group-A 114

50 Effect of Prasarana on Group-B 114

51 Effect of Triyakgamana on Group-A 115

52 Effect of Triyakgamana on Group-B 116

53 Overall effect of Karpasasthyadi Taila Group-A 117

54 Overall effect of Karpasasthyadi Taila Group-B 118

55 Comparative results of Group-A and Group-B 119

56 Comparative Results of Group A and Group B 120

57 Overall results of the Patients 121

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LIST OF FIGURES

SI

NO

TITLE PAGE

NO

01 Anatomy of the Shoulder Joint 29

02 Bursae Related to the Shoulder Joint 30

03 Exercises for frozen shoulder 35

04 Anatomy of Nose 66

05 Incidence of sex 88

06 Incidence of age 89

07 Occupation incidences 90

08 Incidence according to the religion 91

09 Distribution of patients by socio economic status. 92

10 Showing distribution of patients by Education 93

11 Distribution of patients by Marital Status 94

12 Incidence of Dietary habits 95

13 Incidence of Agni 96

14 Distribution of Patients Based on Koshta 97

15 Distribution of patients by Prakruti 98

16 Distribution of patients by Duration of illness 99

17 Distribution of patients by Vysana 100

18 Distribution of Patients Based on Rasa 101

19 Distribution of Patients Based on Onset 102

20 Distribution of Patients Based on Vihara 103

21 Distribution of Patients Based on Satva 104

22 Distribution of Patients Based on Vyadhi Bala 105

23 Distribution of Patients Based on Habitat 106

24 Distribution of Patients Based on Nidra 107

25 Distribution of Patients Based on Joint 108

26 Effect of Group A and Group-B on Shoola 109

27 Effect of Group A and Group-B on Unnamana 111

28 Effect of Group A and Group-B on Avannamana 112

29 Effect of Group A and Group-B on Akunchana 114

30 Effect of Group A and Group-B on Prasarana 115

31 Effect of Group A and Group-B on Triyakgamana 116

32 Result on Group A 117

33 Result on Group B 118

34 Comparative results of Group-A and Group-B 120

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LIST OF ILLUSTRATION

SI

NO

TITLE PAGE

NO

01 Schematic Representation of Samprapti of Avabahuka� 21

02 Nasya according to Charaka 41

03 Nasya According to the action 42

04 According to various parts of the drugs utilized in Nasya

therapy

42

05 Classification of Nasya according to Sushruta 43

06 Classification of Nasya according to Vagbhata 43

07 Classification of Nasya according to Kashyapa 44

08 Classification of Nasya according to Sharangadhara 44

09 Classification of Nasya according to Videha 45

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LIST OF PHOTOGRAPHS

�

SI

NO

TITLE PAGE

NO

01 Procedure of Nasya Karma 83

Health & Medicine

“A COMPARATIVE CLINICAL STUDY ON THE EFFECT OF NASYA WITH KARPASASTHYADI TAILA AND NAGARA TAILA IN THE MANAGEMENT OF AVABAHUKA”