turkish journal of physiotherapy and rehabilitation

Turkish Journal of Physiotherapy and Rehabilitation; 32(3)

ISSN 2651-4451 | e-ISSN 2651-446X

www.turkjphysiotherrehabil.org 17617

A COMPARATIVE CLINICAL STUDY TO EVALUATE THE EFFICACY OF

MASHA TAILA AND KARPASASTHYADI TAILA NASYA IN THE

MANAGEMENT OF PAKSHAGHATA.

Dr. Shipra Raheja1, Dr. Maitree Patel2, Dr. Ravi Pandya3, Dr.Dhimant Bhatta4 1Assi. Proof of Mahayogi Gorakhnath Vishva Vidhyalay, Gorakhpur 2Assi.Proff of Parul Ayurveda Hospital ,Parul university, Vadodara 3Assi.Proff of Parul Ayurveda Hospital ,Parul university, Vadodara

4Assi.Proff. G.J Patel Ayurveda Hospital, New Vvvngr.

ABSTRACT

Pakshaghatha is included under the Mahagadha and is an intricate disease to cure. According to National Stroke

Association, Stroke is one of the leading causes of long term disability in the elderly. An effective treatment

for the same is being searched for even today. Nasya is one of the treatment modality in Pakshaghatha. Nasya

is a simple method of treatment mentioned for many disorders and is considered effective in Vatavyadhi. Same

is being tried with sincere effort herein.

Objective of the study:

1. To evaluate the efficacy of Masha Taila Nasya in management of Pakshaghata.

2. To evaluate the efficacy of Karpasasthi Taila Nasya in management of Pakshaghata.

3. To study the comparative effect of Masha Taila over Karpasthyadi Taila.

The method followed was a randomized study. A special Performa was prepared with all points of history

taking, examination to confirm the diagnosis as mentioned in our classics and allied sciences. Patients were

randomly selected. Nasya is a therapy in which the medicinal oil is instilled in both the nostrils. The oil was

prepared in the Parul Ayurved pharmacy with the decoction method. Significant improvement was seen in

terms of gross movements. The study revealed that Nasya will help immensely to the patients suffering from

Pakshaghatha.

Key words: Pakshaghatha, Nasya, Masha, Karpasasthyadi.

I. INTRODUCTION:

Health and ailing, pleasure and pain, ease and disease are inborn properties of human life, centuries and centuries

succeeded in struggle between man and disease.

Ayurveda is a rich storehouse of time tested and effective methods for the treatment of several obstinate and

incurable diseases. Ayurveda has its own independent and practicable principles which can never be substituted by

other systems of medicines. Ayurveda is one among the most ancient medical sciences of the world. It conceives

and describes the basis & applied aspect of life process, health, disease & its management in terms of its own

principles & approaches.

Panchakarma is the most effectual and confirmatory therapy which ensuresthe disease does not persist. In Ayurveda

Pakshaghata is considered as one among the Vata vyadhi, which is considered Mahagada or Duschikitsya. Hence

an energetic and step by step approach towards the management of this disease is taken up in the classics like-

“Snehana, Swedana, Mrudu virechana, Basti, Nasya, Mastiskya”.

http://www.turkjphysiotherrehabil.org/


ISSN 2651-4451 | e-ISSN 2651-446X


Globally, Cerebrovascular disease (stroke) is the second leading cause of death.1 It is a disease that predominantly

occurs in mid-age and older adults. WHO estimated that in 2005, stroke accounted for 5.7 million deaths

worldwide, equivalent to 9.9 % of all death. Over 85% of these deaths will have occurred in people living in low

and middle income countries and one third will be in people aged less than 70 years. (www.WHO.htm). It is

surprising that (for stroke) no treatment exists that has been conclusively shown to reduce the risk of death or

disability. Despite a massive worldwide effort to rectify this early results are disappointing (Philip MW Bath, 1995).

The rate of recovery of all impairments is maximal in the first few weeks, slows down after 2 or 3 months, and

probably stops at about 6-12 months post stroke (Meerwald 1983; Wade, Wood and Langdon Hewer 1985; Wade

and Langdon Hewer 1987; Wade, Wood and Langdon Hewer 1988).Being a Vatavyadhi Pakshaghata is a

Maharoga. Its Samprapti evolves in Shira (head), which is a Mahamarma. Due to this devastating and refractory

nature of Pakshaghata a minimum course of three months of appropriate treatment is recommended by Sushruta

(Chi.4).

Aacharya Charaka, declared Pakshaghata incurable if not intervened in the early stage (Ch.Chi.28/73).

Shosha of Sira and Snayu, which is the most important event in the Samprapti, denotes craving for Brihana therapy.

Being an obstinate Vata disorder Pakshaghata demands a pioneer treatment of Vata.Pakshaghata, most of the times

is presented when it ventures in Yapya or Asadhya stage. This makes it difficult to treat it with the anticipation of

complete cure.

II. MATERIALS AND METHODS:

Aim of the study:

To evaluate the efficacy of Masha taila and Karpasasthyadi taila Nasya in the management of Pakshaghata.

Inclusion Criteria

Diagnosed case of Pakshaghata Patients between age group of 18 to 70 years.

Patients from both gender.

Patients presenting with clinical signs and symptoms of Pakshaghata.

Ischaemic patients with stable vitals and up to 5years.

Exclusion Criteria:

Patients with uncontrolled metabolic disorders and other systemic disorders.

Unconscious patients.

Paralysis complicated with heart disease.

Intracranial infections.

Hemorrhagic patients also if in acute condition.

Laboratry Investigations:

Hb, TLC, DLC, ESR (before treatment)

Urine (routine & micro)

Design:

It is a randomized clinical study with a pre-test and post-test design. In this study 30 patients diagnosed with

Pakshaghata of either gender were subjected to clinical study.



ISSN 2651-4451 | e-ISSN 2651-446X


PLAN OF TREATMENT:

Purva Karma – Abyanga of neck, face with tila taila, Tapa Sveda(mrudu) with cloth dipped in hot water will be

done for 10 minutes.

Pradhana Karma –

Position of the Patient:- supine with head endlowered.

Taila is slightly warmed indirectly with the help of hot waterbath.

8 drops of selected Taila is instilled in eachnostril.

Soles, palms, neck and ears aremassaged

Secretions are spittedout.

Paschat Karma – Haridra dhumapana and kavala with sukhoshna jala.

Total Duration – 21 consecutive Days.

Follow up Study: 15 days after completion of Nasya Karma

ASSESSMENT CRITERIA

Subjective & Objective Parameters include the clinical grading and standard scoring method of signs and symptoms

of the condition. These data were collected before the initiation of the treatment & after the completion of 21 days

of treatment.

Subjective Parameters:

Dakshin or Vama Paksha Chesta Nivriti (Hemiplegia)

Hasta Pada Sankoch (Stiffness of extremities)

Vak Stambha (Utter voice)

Objective Criteria (Hemispheric stroke scale)

Motor Dysfunction

Sensory Dysfunction

Cranial Nerve Dysfunction.

Autonomic Nerve Dysfunction

Visual fields

Test clinically and score hemi-field loss as:

3 = Severe loss; inability to recognize moving hand, no response to threat

2 = Moderate loss; inability to recognize stationary finger, sees moving finger

1 = Mild loss: defect to double simultaneous stimulation

0 = Normal



ISSN 2651-4451 | e-ISSN 2651-446X


Facial expression

Score movement:

3 = Severe weakness;drooling

2 = Moderate loss; asymmetry at rest

1 = Mild weakness; asymmetry on smiling

0 = Normal

MOTOR FUNCTION

Arm, proximal

Arm, distal

Leg, proximal

Leg, distal

All scored 0-7 as:

7 = No movement (MRC 0)

6 = Trace movement only (MRC 1)

5 = Motion without gravity only (MRC 2)

4 = Moves against gravity but not against resistance (MRC 3)

3 = Moderate weakness (MRC 4 -)

2 = Mild weakness (MRC 4)

1 = Positive drift of arm/leg (MRC 4 +)

0 = Normal (MRC 5)

Deep tendon reflexes

2 = Hypoactive or hyperactive

0 = Normal

Pathologic reflexes

2 = Babinski (plantar) and another abnormal

1 = Babinski (plantar) or another abnormal

0 = Normal

Muscle tone

2 = Increased or decreased

0 = Normal

Gait

Test ability to stand and walk, and score:



ISSN 2651-4451 | e-ISSN 2651-446X


6 = Unable to stand unsupported or cannot evaluate

5 = Can stand with support but cannot walk

4 = Severely abnormal; walking distance limited even with support (from aid or person)

3 = Moderately abnormal; no assistance required (apart from a stick/cane), but distance limited

2 = Mildly abnormal (weak, uncoordinated); can walk independently but slowly

1 = Minimally abnormal, no reduction in speed or distance

0 = Normal

SENSORY

Primary modalities (of affected side only),

Test touch, pain and score as

4 = Anesthesia

3 = Severe hypaesthesia

2 = Moderate hypaesthesia or deficit only; or extinction to double simultaneous stimulation

1 = Mild hypaesthesia or dysaesthesia

0 = Normal

(Reference: Hemispheric stroke scale.)

Assessment of NasyaKarma:

Samyak Yoga, Ayoga & Atiyoga Yoga Lakshanas of NasyaKarma were assessed daily after the procedure.

Lakshana Day 1 7 14 21 FU

Shiro laghva

Sukha swapn

Vikara prash

Sukhucchwas

Swapnabodha

III. OBSERVATION:

A total of known case of 30 patients of Pakshaghata, fulfilling the inclusion criteria were taken for

thestudy.Observations as well as results of the therapy are analyzed below.

1. Age wise distribution: The minimum age of the patient of this study was 20 years & maximum was 70 years.

Table shows that nature of distribution of patients in every 4-years age group. The maximum percentage of

patients i.e. (26.7%) was between 36-40 age groups and minimum 3.3% was between 20-25 age groups. And

5 (i.e. 16.7%) were between 51-65 years of age and 13.3% were between the age group of 41-45.

2. Religion wise distribution of the patients: The maximum no. of patients were from Hindu community i.e.

90% and minimum no. of patients were from Muslim community i.e. 3 (10%)

3. Education wise distribution of the patients: Among all the selected 30 patients maximum percentage of

patients were uneducated (46.7%), where as only 3.3% of patient has done graduation and 20% of patients have

completed their middle school education. 5 out of 30 i.e. 16.7% have done high schooling.



ISSN 2651-4451 | e-ISSN 2651-446X


4. Gender wise distribution of the patients: Out of the selected 30 patients, maximum no. of patients were male

i.e. 24(80%) and 20% of the patients were female.

5. Marital status wise distribution of the patients:Out of the total 30 patients 80 % of the patients were married

and 6 out of 30 were unmarried i.e. 20% of the total no. of patients.

6. Socio economic status wise distribution of the patients :Maximum no. of patients were poor i.e. 50%

patients were poor and 16.7% of the patients were from very poor socioeconomic status. 10 out of 30 patients

(33.3%) were middle class

7. Residential status wise distribution of the patients: Maximum no. of patients was from urban residential

area i.e. 18 out of 30 (60%). Minimum no. of patients was from rural area, 12 patients out of 30 (40%)

8. Occupation wise distribution of the Patients:Maximum patients were from the labor class and from

agriculture field i.e.30% of the total patients and 8 out of 30 patients were house holder i.e. 26.7% and 13.3%

of the patients were professional or employee.

9. Part of the body affected wise distribution:Maximum no. of patients were having the complaint of right side

hemiplegia i.e. 36.7% and 63.3% of patients were having the complaint of lt. side hemiplegia.

10. Classification according to vaka stambha:33.3% of the patients were having normal speech while 66.7 % of

the patients had difficulty in utring words

11. Classification according to Karma Hani:33.3% of the patients had complete loss of function and 66.7 % of

the patients had partial loss of function.

12. Classification according to facial expressions :Out of 30 patients 1 patient had normal facial expression

i.e.3.3% and 13.3% of the patients had mild weakness, 66.7% of the patients had moderate weakness while

16.7% of the patients had severe weakness with drooling.

13. Classification according to Dysarthria:40% of the patients had moderate dysarthria , 40% had severe

dysarthria , 20% of the patients were normal.

14. Distribution according to range of motion Arm (Proximal movement) 6.7% of the patients had mild

weakness of the hands, 26.7% of the patients had moderate weakness, 30% of the patients can move the arm

against the gravity and 16.7% cannot move against the gravity, 10% of the patients had trace movement of the

arm and 10% had no movement.

15. (Distal movement):20% of the patients had mild weakness in the distal movement of arm, 16.7% had moderate

weakness, 33.3 % can move the arm against gravity and 13.3% can move without gravity, 6.7% patients had

trace movement only and 10% had no movement.

16. Movement of leg:(Proximal movement) 20 % of the patients had mild weakness in the proximal movement of

leg and 50% had moderate weakness, 13.3% can move the leg against gravity and 6.7% cannot move without

gravity. 10% patients had no movement.

17. Pathological reflex :13.3% patients had normal reflexes, 10% patients had Babinski or other reflexes normal

and 23% had Babinski and other reflexes abnormal.

18. Muscle tone :100% of the patients had increased or decreased muscle tone.

19. Gait wise distribution:40 % patients had mildly abnormal gait i.e. they can walk independently but slowly,

33.3% patients had moderately abnormal gait, walking distance was limited even with support, 13.3% can walk

limited distance even with support, 3.3% patients can stand with support but cannot walk, 10% of the patients

were unable to stand.

20. Koshta wise distribution of the patients:Out of 30 patients 3 were of mridu kostha i.e. 10%patients were of

mridu koshtha, and 53.3% pts were of madhyama koshta and 36.7% were of kroora koshta.



ISSN 2651-4451 | e-ISSN 2651-446X


21. Distribution of patients according to family history:Out of total no. of 30 patients 26.7% were having the

family history of hypertension and 73.3% patients were having the family history of diabetes.

22. Distribution of patients according to the Aahara:The present study shows that maximum no. of patients

were having vegetarian diet (73.3%) whereas 26.7% of the patients were having mixed diet.

23. Classification of patients based on bowel :Study shows that maximum patients (66.7%) were having regular

bowel habits, 23.3% patients were having irregular bowel habits. 3 out of 30 patients i.e.10% were having the

problem of constipation.

24. Classification of patients according to addiction:The study shows that 60% of patients were not having any

addiction. 13.3% of the patients were having the addiction of smoking. 5 out of 30 patients i.e. 16.7% of patients

were alcoholic, 10% patients were addicted to tobacco chewing.

25. Classification of patients according to the treatment history:Study shows that maximum patients were

taking antihypertensive drugs 83.3% and 16.7% of patients were taking Ayurvedic medicine, Ayurvedic

medicine were stopped during the course of treatment.

26. Vyayam shakti wise distribution of the patients :3.3% of the patients had pravara vyayam shakti, 56.7% had

madhyama vyayam shakti, 40.3% had avara vyayam shakti.

27. Classification of patients according to the shabad pariksha:Study shows that 60% patients were having

vaikrut swara and 40% patients were having prakrut swara.

28. Classification of patients according to the sparsha pariksha :Study shows that 53.3% patients were having

ushna sparsha and 46.7% patients were having sheeta.

Friedman test

To know this first fried man test was applied, there was a statistically significant result found in the facial

expressions with chi-square value 46.185 and p value .000Wilcoxon signed rank test was applied along with

Bonferroni correction (P=.025) to see the effect on Facial expression before treatment and after 7, 14 and 21 days

of treatment. The test shows that it was quite significant after 7 days of treatment with p value .046 and after 14

and 21 days and after follow up with p value .001, this also shows that the treatment was significant for

Karpasasthyadi taila.Masha taila also showed significant result in Facial Expression with p value .008 which shows

that treatment was quite effective after 7 days and also after 14, 21 days and after follow up the p value was .001

which means result was significant.

Karpasasthyadi taila

Parameter N X2 P (value) Remark

Facial expression 15 46.185 .000 S

Masha taila


Facial expression 15 46.932 .000 S

Karpasasthyadi Taila

Post hoc test-Wilcoxon signed rank test with Bonferroni correction (p=.025)

Lakshans Negative Ranks Positive Ranks

Parameter N MR SR N MR SR Ties Total Z value P value Remark

Facial

expression

7D-BT

4 2.50 10 0 .00 .00 11 15 -2.000 .046 S



ISSN 2651-4451 | e-ISSN 2651-446X


F.Expresion

BT-14 D

12 6.50 78 0 .00 .00 3 15 -3.217 .001 S

F.Expresion

BT-21D

13 7.00 91 0 .00 .00 2 15 -3.307 .001 S

F.Expresion

BT-FU

13 7.00 91 0 .00 .00 2 15 -3.275 .001 S

Masha Taila



Facial

expression

7D-BT

7 4.00 28 0 .00 .00 8 15 -2.646 .008 S

F.Expresion

BT-14 D

12 7.50 105 0 .00 .00 1 15 -3.557 .000 S

F.Expresion

BT-21D

13 7.50 105 0 .00 .00 1 15 -3.416 .001 S

F.Expresion

BT-FU

13 7.50 105 0 .00 .00 1 15 -3.416 .001 S

Dysarthria

Friedman test was applied to know the effect on dysarthria there was a statistically significant result found in the

facial expressions with chi-square value 26.286 and p value .000 for Karpasasthyadi taila,

Statistically significant result was found also on Masha taila with chi- square value 20.735 and p value .000

Wilcoxon sign test was also conducted, there was a statistically significant result in dysarthria before treatment and

after 14 days, 21 days and after follow up of the treatment for Karpasasthyadi taila with p value .005 and it was not

significant before treatment and after 7 days of Nasya with p .083

For Masha taila, there was also statistically significant result found before treatment and after 14, 21 days and after

follow up of the treatment with p value .011 whereas there was no significant result seen before treatment and after

7 days of treatment.



Dysarthria 15 26.286 .000 S

Masha taila


Dysarthria 15 20.735 .000 S




ISSN 2651-4451 | e-ISSN 2651-446X



Dysphagia

7D-BT

0 0.00 0.00 0 .00 .00 15 15 0.000 1.000 NS

Dysphagia

BT-14 D

1 1.00 1.00 0 .00 .00 14 15 -1.000 .317 NS

Dysarthria

BT-21D

1 1.00 1.00 0 .00 .00 14 15 -1.000 .317 NS

Dysphagia

BT-FU

1 1.00 1.00 0 .00 .00 14 15 -1.000 .317 NS

Masha Taila



Dysphagia

7D-BT

0 0.00 0.00 0 .00 .00 15 15 0.000 1.000 NS

Dysphagia

BT-14 D

0 0.00 0.00 0 .00 .00 15 15 0.000 1.000 NS

Dysarthria

BT-21D

1 1.00 1.00 0 .00 .00 14 15 -1.000 .317 NS

Dysphagia

BT-FU

1 1.00 1.00 0 .00 .00 14 15 -1.000 .317 NS

Effect on Range of Motion:

Friedman test was applied to know the effect on proximal movement of arm, there was statistically significant result

found in the movements with chi-square value 48.978 and 56.481 for karpasasthyadi taila and Masha taila

respectively, p value .000 for Karpasasthyadi taila and Masha taila as well.

Wilcoxon signed test along with Bonferroni correction (p=.025)was applied to known the effect on Range of

movement of Arm Proximal Before treatment and at 7th day, 14th day , 21st day and after follow up, test shows that

both the oil show significant result in the range of movement of proximal movement of arm, Karpasasthyadi taila

shows p value of .005 after 7 days and .002 after 14th , 21st day and after follow up.

Masha taila also shows significant result in the range of motion with P value .002 after 7 days and .000 after 14

days and .001 after 21 days and follow up respectively.

karpasasthyadi Taila


Arm proximal 15 48.978 .000 S

Masha taila



ISSN 2651-4451 | e-ISSN 2651-446X



Arm proximal 15 56.481 .000 S





Arm

proximal

7D-BT

8 4.50 36 0 .00 .00 7 15 -2.828 .005 S

Arm

proximal

BT-14 D

11 6.00 66 0 .00 .00 4 15 -3.035 .002 S

Arm

proximal

BT-21D

14 7.50 105 0 .00 .00 1 15 -3.360 .001 S

Arm

proximal

BT-FU

14 7.50 105 0 .00 .00 1 15 -3.360 .001 S

Masha Taila



Arm

proximal

7D-BT

10 5.50 55 0 .00 .00 5 15 -3.162 .002 S

Arm

proximal

BT-14 D

15 8.00 120 0 .00 .00 0 15 -3.508 .000 S

Arm

proximal

BT-21D

15 8.00 120 0 .00 .00 0 15 -3.464 .001 S

Arm

proximal

BT-FU

15 8.00 120 0 .00 .00 0 15 -3.464 .001 S

Effect on Distal Movement of Arm

Friedman test was applied to know the effect on distal movement of arm there was statistically significant result



Wilcoxon signed test with Bonferroni correction (p=.025)was applied to known the effect on Distal Movement of

Arm.

Test shows that both the Taila shows significant result in the range of motion, with the P value .005 after 7 days,

after 14 days P value .000 shows highly significance and 21 days and after follow up the P value is .001 which

shows that Karpasthyadi taila is significant in the distal range of movement.



ISSN 2651-4451 | e-ISSN 2651-446X


Masha taila shows P value of .008 after 7 days which shows it is significant in the distal range of motion, after 14

days, 21 days and follow up the p value is .001 which means significant changes in the range of motion.



Arm distal 15 49.705 .000 S

Masha taila


Arm distal 15 50.795 .000 S





Arm distal

7D-BT

8 4.50 36 0 .00 .00 7 15 -2.828 .005 S

Arm Distal

BT-14 D

14 7.50 105 0 .00 .00 1 15 -3.494 .000 S

Arm Distal

BT-21D

15 8.00 120 0 .00 .00 0 15 -3.473 .001 S

Arm Distal

BT-FU

15 8.00 120 0 .00 .00 0 15 -3.473 .001 S

Masha Taila



Arm distal

7D-BT

7 4.50 28 0 .00 .00 7 15 -2.646 .008 S

Arm Distal

BT-14 D

14 7.50 105 0 .00 .00 1 15 -3.416 .001 S

Arm Distal

BT-21D

14 7.50 105 0 .00 .00 0 15 -3.372 .001 S

Arm Distal

BT-FU

14 7.50 105 0 .00 .00 0 15 -3.372 .001 S



ISSN 2651-4451 | e-ISSN 2651-446X


RANGE OF MOTION OF LEG:

Friedman test was applied to know the effect on proximal movement of leg, there was statistically significant result



Wilcoxon signed rank test with Bonferroni correction (p=.025) was applied to known the effect on the Proximal

Movement of leg. It shows significant result in the proximal movement of leg with P value of .001 after 7 days and

14 days of treatment and .000 after 21st day and follow up for karpasasthyadi taila, also for mashadi taila the p value

after 7 days and 14 days are .002 which shows its significance, after 21st day and after follow up it shows that the

significant result in the proximal movement of leg.

Effect on proximal movement of leg



Leg proximal 15 47.442 .000 S

Masha taila


Leg proximal 15 45.229 .000 S




Leg P (7D-

BT)

11 6.00 66 0 .00 .00 7 15 -3.317 .001 S

Leg P( BT-

14 D)

14 7.50 105 0 .00 .00 1 15 -3.448 .001 S

Leg P (BT-

21D)

15 8.00 120 0 .00 .00 0 15 -3.520 .000 S

Leg P

(BT-FU)

15 8.00 120 0 .00 .00 0 15 -3.508 .000 S

Masha Taila



Leg P (7D-

BT)

10 5.50 55 0 .00 .00 5 15 -3.162 .002 S

Leg P( BT-

14 D)

11 6.00 66 0 .00 .00 4 15 -3.127 .002 S



ISSN 2651-4451 | e-ISSN 2651-446X


Leg P (BT-

21D)

13 7.00 91 0 .00 .00 2 15 -3.307 .001 S

Leg P ( BT-

FU)

13 7.00 91 0 .00 .00 2 15 -3.307 .001 S

Effect on Distal movement of leg

Friedman test was applied to know the effect on distal movement of leg there was statistically significant result



Wilcoxon signed rank test with Bonferroni correction (p=.025)was applied to known the effect on the Distal

Movement of leg. It shows significant result in the proximal movement of leg with P value of .005 after 7days and

.001 after 14 days ,21 days and after follow up, Masha taila shows significant result after 7 days , 14 days , 21 days

and after follow up with P value .005 after 7 days and .001 after 14, 21 days and after follow up.



Leg distal 15 44.571 .000 S

Masha taila


Leg distal 15 48.075 .000 S





Leg distal

7D-BT

8 4.50 36 0 .00 .00 5 15 -2.828 .005 S

Leg distal

BT-14 D

12 6.50 78 0 .00 .00 4 15 -3.176 .001 S

Leg distal

BT-21D

13 7.00 91 0 .00 .00 2 15 -3.236 .001 S

Leg Distal

BT-FU

13 7.00 91 0 .00 .00 2 15 -3.228 .001 S

Masha Taila






ISSN 2651-4451 | e-ISSN 2651-446X


Leg distal

7D-BT

6 3.50 21 0 .00 .00 9 15 -2.449 .005 S

Leg distal

BT-14 D

14 7.50 105 0 .00 .00 1 15 -3.557 .001 S

Leg distal

BT-21D

14 7.50 105 0 .00 .00 1 15 -3.236 .001 S

Leg Distal

BT-FU

14 7.50 105 0 .00 .00 1 15 -3.228 .001 S

Effect on Deep tendon Reflex

Friedman test was applied to know the effect on deep tendon reflex, there was no statistically significant result


respectively, p value .155 & .092 for Karpasasthyadi taila and Masha taila respectively.

Wilcoxon signed rank test with Bonferroni correction (p=.025)was applied to known the effect on the deep tendon

reflex. It did not showed significant result in the proximal movement of leg with P value of 1.000 after 7days and

.317 after 14 days, .157 after 21 days and after follow up for karpasasthyadi taila and 1.000 after 7 days and .157

for 14 days, 21 days and follow up for Masha taila, which is not statistically significant.



DTR 15 6.667 .155 NS

Masha taila


DTR 15 8.000 .092 NS





DTR 7D-BT 0 0.00 0.00 0 .00 .00 15 15 0.000 1.000 NS

DTR BT-14

D

1 1.00 1.00 0 .00 .00 14 15 -1.000 .317 NS

DTR BT-

21D

2 1.50 3.00 0 .00 .00 13 15 -1.414 .157 NS

DTR BT-

FU

2 1.50 3.00 0 .00 .00 13 15 -1.414 .157 NS



ISSN 2651-4451 | e-ISSN 2651-446X


Masha Taila



DTR 7D-BT 0 0.00 0.00 0 .00 .00 15 15 0.000 1.000 NS

DTR BT-14 D 2 1.50 1.00 0 .00 3.00 14 13 -1.414 0.157 NS

DTR BT-21D 2 1.50 3.00 0 .00 3.00 13 13 -1.414 .157 NS

DTR BT-FU 2 1.50 3.00 0 .00 3.00 13 13 -1.414 .157 NS

Effect on Pathological Reflex

Friedman test was applied to know the effect on Pathological reflex, there was no statistically significant result

found in the reflexes for Karpasasthyadi taila with chi-square value 10.222 and p value .037 whereas it was

statistically significant for Masha taila with chi- square value16.308 and p value .003 for Masha taila respectively.

Wilcoxon signed rank test with Bonferroni correction (p=.025)was applied to known the effect on the pathological

reflexes. It did not showed significant result in the pathological reflex with P value of 1.000 after 7days and .083

after follow up. Masha taila showed significant result in the improvement of Pathological Reflexes with P value

.034 after the treatment.



Pathological reflex 15 10.222 .037 NS

Masha taila

DTR N X2 P (value) Remark

Pathological reflex 15 16.308 .003 S





Pathological

reflex 7D-

BT

1 1.00 1.00 0 .00 .00 14 15 .000 1.000 NS

Pathological

reflex -14 D

1 1.00 1.00 0 .00 .00 14 15 1.414 .157 NS



ISSN 2651-4451 | e-ISSN 2651-446X


Pathological

reflex -21D

2 1.50 3.00 0 .00 .00 13 15 -1.732 .083 NS

Pathological

reflex BT-

FU

2 1.50 3.00 0 .00 .00 13 15 -1.732 .083 NS



Pathological

reflex 7D-BT

2 1.50 3.00 0 .00 .00 13 15 -1.414 .157 NS

Pathological

reflex -14 D

5 3.00 15.00 0 .00 .00 10 15 -2.121 .034 S

Pathological

reflex -21D

5 3.00 15.00 0 .00 .00 10 15 -2.121 .034 S

Pathological

reflex BT-FU

5 3.00 15.00 0 .00 .00 10 15 -2.121 .034 S

Muscle tone

Friedman test was applied to know the effect on Muscle tone, there was statistically significant result found in the

Muscle tone for Karpasasthyadi taila with chi-square value 33.630 and p value .000 .It was also statistically

significant for Masha taila with chi- square value 37.943 p value .000 for Masha taila respectively.

Wilcoxon signed rank test with Bonferroni correction (p=.025)was applied to known the effect on the muscle tone.

It was not significant after 7 days with P value of 1.000 and significant after 14 days with p value .005after 14 days,

.003 after 21 days and after follow up for karpasasthyadi taila and for Masha taila p value .317after 7 days which

is not significant and .014 for 14 days which is quiet significant and p value .001after 21 days and follow up which

is statistically significant.



Muscle tone 15 33.630 .000 S

Masha taila


Muscle tone 15 37.943 .000 S







ISSN 2651-4451 | e-ISSN 2651-446X


Muscle tone

7 D-BT

0 .00 .00 0 .00 .00 15 15 .000 1.000 NS

Muscle

tone -14 D

8 4.50 36.00 0 .00 .00 7 15 -2.828 .005 S

Muscle

tone -21D

9 5.00 45.00 0 .00 .00 6 15 -3.000 .003 S

Muscle

tone BT-FU

9 5.00 45.00 0 .00 .00 6 15 -3.000 .003 S

Masha taila



Muscle tone

7 D-BT

1 1.00 1.00 0 .00 .00 14 15 .000 .317 NS

Muscle

tone -14 D

6 3.50 21.00 0 .00 .00 9 15 -2.449 .014 S

Muscle

tone -21D

12 6.50 78.00 0 .00 .00 3 15 -3.464 .001 S

Muscle

tone BT-

FU

12 6.50 78.00 0 .00 .00 3 15 -3.464 .001 S

GAIT

Friedman test was applied to know the effect on Gait, there was statistically significant result found for

Karpasasthyadi taila with chi-square value 46.995 and p value .000 .It was also statistically significant for Masha

taila with chi- square value 42.105 and p value .000 for Masha taila respectively.

Wilcoxon signed rank test with Bonferroni correction (p=.025) was applied to known the effect on gait. It was

significant after 7 days with P value of .005 and .000 after 14, 21 days and after follow up for karpasasthyadi taila

and for Masha taila p value .008 after 7 days which is significant and .001 after 14, 21 days and after follow up

which is quiet significant.



Gait 15 46.995 .000 S

Masha taila


Gait 15 42.105 .000 S





ISSN 2651-4451 | e-ISSN 2651-446X




Gait 7 D-

BT

8 4.50 36 0 .00 .00 7 15 -2.828 .005 S

Gait BT-

14D

14 7.50 105 0 .00 .00 1 15 -3.557 .000 S

Gait BT-

21D

15 8.00 120 0 .00 .00 0 15 -3.578 .000 S

Gait BT-FU 15 8.00 120 0 .00 .00 0 15 -3.573 .000 S

Masha taila



Gait 7 D-

BT

7 4.00 28 0 .00 .00 8 15 -2.646 .008 S

Gait BT -

14 D

13 7.00 91 0 .00 .00 2 15 -3.419 .001 S

Gait BT-

21D

13 7.00 91 0 .00 .00 2 15 -3.305 .001 S

Gait BT-FU 13 7.00 91 0 .00 .00 2 15 -3.304 .001 S

Effect on Touch- Pain Score

Friedman test was applied to know the effect on hypaestheisa, there was statistically significant result found for

Karpasasthyadi taila with chi-square value 10.588 and p value .032. It was also statistically significant for Masha

taila with chi- square value 16.603 and p value .002.

Wilcoxon signed rank test with Bonferroni correction (p=.025)was applied to known the effect on hypaesthesia. It

was not significant after 7, 14, 21 days and follow up with P value of 0.317, .083after 14 days and p value .102

after 21 days and after follow up for karpasasthyadi taila and for Masha taila it was not significant after 7 days with

p value .157 and significant after 14 days with p value .025 for 14 days and p value .034after 21 days and follow

up which is statistically significant.



Hypaesthesia 15 10.588 .032 S



ISSN 2651-4451 | e-ISSN 2651-446X


Masha taila


Hypaesthesia 15 16.603 .002 S





Hypaesthesia

7D-BT

1 1.00 1.00 0 .00 .00 14 15 -1.000 .0317 NS

Hypaesthesia

BT-14 D

3 2.00 6.00 0 .00 .00 12 15 -1.732 .083 NS

Hypaesthesia

BT-21D

3 2.00 6.00 0 .00 .00 12 15 -1.633 .102 NS

Hypaesthesia

BT-FU

3 2.00 6.00 0 .00 .00 12 15 -1.633 .102 NS

Masha Taila



Hypaesthesia

7D-BT

2 1.50 3.00 0 .00 .00 14 15 -1.414 .157 NS

Hypaesthesia

BT-14 D

5 3.00 15.00 0 .00 .00 12 15 -2.236 .025 S

Hypaesthesia

BT-21D

5 3.00 15.00 0 .00 .00 12 15 -2.121 .034 S

Hypaesthesia

BT-FU

5 3.00 15.00 0 .00 .00 12 15 -2.121 .034 S

Facial expressions

Mann-whitney test for before the groups

Parameter Group N Mean ranks Sum of ranks Z P value Remarks

F. E. 1D K

15 16.23 243.50 -.546 .585 NS

M

15 14.77 221.50

Total 30



ISSN 2651-4451 | e-ISSN 2651-446X


F.E.7 days K

15 17.47 262.00 -1.395 .163 NS

M

15 13.53 203.00

Total 30

F.E.14days K

15 16.37 245.50 -.647 .517 NS

M

15 14.63 219.50

Total 30

F.E.21 D

K

15 16.33 245.00 -.630 .529 NS

M

15 14.67 220.00

Total

30

F.E.FU

K 15 15.83 240 -.246 .806 NS

M 15 15.17 225

Total 30

Dysarthria



Dysarthria 1D K

15 16.90 253.50 -.937 .349 NS

M

15 14.10 211.50

Total 30

Dysarthria 7

days

K

15 16.60 249.00 -.745 .456 NS

M

15 14.40 216.00

Total 30

Dysarhria

14days

K

15 16.10 241.50 -.467 .640 NS

M

15 14.90 223.50

Total 30

Dysarthria 21D

K

15 17.60 264.00 -1.524 .128 NS

M

15 13.40 201.00

Total

30

Dysarthria .FU

K 15 17.60 264.00 -1.524 .128 NS

M 15 13.40 201.00

Total 30



ISSN 2651-4451 | e-ISSN 2651-446X


Dysphagia


Mann whitney test was applied to see the difference between two groups, it was found that there were no significant

changes seen in the between in the symptoms of pakshaghata.


Dysphagia 1D K

15 15.50 232.50 .000 1.000 NS

M

15 15.50 232.50

Total 30

Dysphagia 7 days K

15 15.50 232.50 .000 1.000 NS

M

15 15.50 232.50

Total 30

Dysphagia14days K

15 15.00 225.00 -1.000 .317 NS

M

15 16.00 240.00

Total 30

Dysphagia 21D

K

15 15.50 232.50 .000 1.000 NS

M

15 15.50 232.50

Total

30

Dysphagia .FU

K 15 15.50 232.50 -1.524 1.000 NS

M 15 15.50 232.50

Total 30

Arm proximal



Arm proximal 1D K

15 12.97 194.50 -1.619 .106 NS

M

15 18.03 270.50

Total 30

Arm proximal 7

days

K

15 13.17 197.50 -1.502 .133 NS

M

15 17.83 267.50

Total 30

Arm

proximal14days

K

15 13.87 208.00 -1.058 .290 NS

M

15 17.13 257.00

Total 30



ISSN 2651-4451 | e-ISSN 2651-446X


Arm proximal

21D

K

15 14.53 218.00 -.625 .532 NS

M

15 16.47 247.00

Total

30

Arm proximal

.FU

K 15 14.53 218.00 -.625 .532 NS

M 15 16.47 247.00

Total 30



Arm distal 1D K

15 15.00 225.00 -.320 .749 NS

M

15 16.00 240.00

Total 30

Arm distal 7

days

K

15 14.93 224.00 -.363 .717 NS

M

15 16.07 241.00

Total 30

Arm

distal14days

K

15 15.43 231.50 -.043 .966 NS

M

15 15.57 233.50

Total 30

Arm distal 21D

K

15 13.70 205.50 -1.161 .246 NS

M

15 17.30 259.50

Total

30

Arm distal .FU

K 15 13.67 205.00 -1.182 .237 NS

M 15 17.33 260.00

Total 30



Leg proximal

1D

K

15 14.80 222.00 -.468 .639 NS

M

15 16.20 243.00

Total 30

Leg proximal 7

days

K

15 14.53 218.00 -.650 .516 NS

M

15 16.47 247.00



ISSN 2651-4451 | e-ISSN 2651-446X


Total 30

Leg

proximal14days

K

15 15.43 231.50 -.044 .965 NS

M

15 15.57 233.50

Total 30

Leg proximal

21D

K

15 15.90 238.50 -.269 .788 NS

M

15 15.10 226.50

Total

30

Leg proximal

.FU

K 15 15.80 237.00 -.202 .840 NS

M 15 15.20 228.00

Total 30



Leg distal 1D K

15 14.90 223.50 -.386 .700 NS

M

15 16.10 241.50

Total 30

Leg distal 7

days

K

15 14.90 223.50 -.391 .696 NS

M

15 16.10 241.50

Total 30

Leg

distal14days

K

15 14.93 224.00 -.370 .711 NS

M

15 16.07 241.00

Total 30

Leg distal 21D

K

15 15.10 226.50 -.272 .786 NS

M

15 15.90 238.50

Total

30

Leg distal .FU

K 15 15.07 226.00 -.295 .768 NS

M 15 15.93 239.00

Total 30



DTR 1D K

15 15.50 232.50 .000 1.000 NS



ISSN 2651-4451 | e-ISSN 2651-446X


M

15 15.50 232.50

Total 30

DTR 7 days K

15 15.50 232.50 .000 1.000 NS

M

15 15.50 232.50

Total 30

DTR 14days K

15 16.00 240.00 -.598 .550 NS

M

15 15.00 225.00

Total 30

DTR 21D

K

15 15.50 232.50 .000 1.000 NS

M

15 15.50 232.50

Total

30

DTR FU

K 15 15.50 232.50 .000 1.000 NS

M 15 15.50 232.50

Total 30



Patho. reflex 1D K

15 15.93 239.00 -.365 .715 NS

M

15 15.07 226.00

Total 30

Patho. reflex 7

days

K

15 16.47 247.00 -.776 .438 NS

M

15 14.53 218.00

Total 30

Patho. reflex

14days

K

15 16.67 250.00 -.942 .346 NS

M

15 14.33 215.00

Total 30

Patho. reflex

21D

K

15 16.50 247.50 -.812 .417 NS

M

15 14.50 215.50

Total

30

Patho. reflex FU

K 15 16.50 247.50 -.812 .417 NS

M 15 14.50 215.50



ISSN 2651-4451 | e-ISSN 2651-446X


Total 30



Muscle tone BT K

15 15.50 232.50 .000 1.000 NS

M

15 15.50 232.50

Total 30

Muscle tone 7

days

K

15 16.00 240.00 -1.000 .317 NS

M

15 15.00 225.00

Total 30

Muscle

tone14days

K

15 14.50 217.50 -.720 .472 NS

M

15 16.50 247.50

Total 30

Muscle tone

21D

K

15 17.00 255.00 -1.175 .240 NS

M

15 14.00 210.00

Total

30

Muscle tone FU

K 15 17.00 255.00 -1.175 .240 NS

M 15 14.00 210.00

Total 30



Gait BT K

15 14.80 222.00 -.460 .646 NS

M

15 16.20 243.00

Total 30

Gait 7 days K

15 14.43 216.50 -.705 .481 NS

M

15 16.57 248.50

Total 30

Gait 14days K

15 14.40 216.00 -.731 .465 NS

M

15 16.60 249.00

Total 30

Gait 21D

K

15 13.80 207.00 -1.136 .256 NS

M

15 17.20 258.00



ISSN 2651-4451 | e-ISSN 2651-446X


Total

30

Gait FU

K 15 13.60 204.00 -1.283 .199 NS

M 15 17.40 261.00

Total 30



Hypaesthesia

BT

K

15 14.80 222.00 -1.240 .215 NS

M

15 16.20 243.00

Total 30

Hypaesthesia7

days

K

15 14.43 216.50 -1.234 .217 NS

M

15 16.57 248.50

Total 30

Hypaesthesia

14days

K

15 14.40 216.00 -1.624 .104 NS

M

15 16.60 249.00

Total 30

Hypaesthesia

21D

K

15 13.80 207.00 -1.795 .073 NS

M

15 17.20 258.00

Total

30

Hypaesthesia

FU

K 15 13.60 204.00 -2.408 .016 S

M 15 17.40 261.00

Total 30

Cochran's Q test for shirolaghavta


N 15

Cochran value 32.353

P value .000

Masha taila

N 15


P value .000


Parameter N Mean Std. deviation Min. Max.

S.laghava 1D 15 1.87 .352 1 2



ISSN 2651-4451 | e-ISSN 2651-446X


S.laghava 7D 15 1.00 .000 1 1

S.laghava 14D 15 1.07 .258 1 2

S.laghava 21 D 15 1.13 .352 1 2

S.laghava FU 15 1.27 .458 1 2

Masha taila


S.laghava 1D 15 2 .000 2 2

S.laghava 7D 15 1.07 .258 1 2

S.laghava 14D 15 1.20 .414 1 2

S.laghava 21 D 15 1.00 .000 1 1

S.laghava FU 15 1.20 .414 1 2

Cochran q test for Sukhaswpana


N 15


P value .000

Masha taila

N 15


P value .000



S.swapna 1D 15 1.93 .258 1 2

S.swapna 7D 15 1.33 .488 1 2

S.swapna 14D 15 1.07 .258 1 2

S.swapna 21 D 15 1.00 .000 1 1

S.swapna FU 15 1.27 .458 1 2

Masha taila


V. Prashmana 1D 15 2.00 .000 2 2

V. Prashmana 7D 15 1.67 .488 1 2

V. Prashmana 14D 15 1.40 .507 1 2

V. Prashmana 21 D 15 1.13 .352 1 2

V. Prashmana FU 15 1.13 .352 1 2

Cochran q test for sukh ucchwas


N 15


P value .000

Masha taila

N 15


P value .000



S. Ucchwas 1D 15 1.60 .507 1 2

S. Ucchwas 7D 15 1.40 .507 1 2

S. Ucchwas 14D 15 1.07 .258 1 2

S. Ucchwas 21 D 15 1.07 .258 1 2

S. Ucchwas FU 15 1.07 .258 1 2



ISSN 2651-4451 | e-ISSN 2651-446X


Masha taila


S. Ucchwas 1D 15 1.67 .488 1 2

S. Ucchwas 7D 15 1.53 .516 1 2

S. Ucchwas 14D 15 1.07 .258 1 2

S. Ucchwas 21 D 15 1.07 .258 1 2

S. Ucchwas FU 15 1.07 .258 1 2

Plan of study:The patients for the study were selected from the OPD and IPD section of Parul institute and

Khemdas hospital. 30 patients fulfilling the inclusion criteria and presented signs and symtoms of cervical

spondylosis areselected

• Total number of patients registered–30

• Completed –30

• Drop out –0

Clinical Study:A randomized clinical study was conducted on Patients suffering from Pakshaghata. Patients were

randomly selected and detailed proforma was prepared by incorporating all the sign and symtoms of Pakshaghata

and Nasya karma with Karpasasthyadi taila and Masha taila was done continuosly for 21 days. The follow up was

for 15 days after the treatment. The following observations are made.

Observations and results:

Age: The maximum percentage of patients i.e. (26.7%)was between 36-40 age groups and minimum was between

20-25 age groups.

Incidence of this disease shows increase prevelance till fourth decade of life.

Religion: 90% of the patients were from Hindu community, this is because of more no. of Hindu in that region.

(tableNo.2)

Education : study shows that maximum patients were uneducated (46.7%), this may be due to lack of

consciousness regarding health issue. 3.3% patients had done graduation,13.3% had done primary education,20%

middle primary,16.7% high primary (table no.3)

Gender: study shows that higher no. of patients were male, this may be due to more load of work in male due to

their pattern of work, Prevelance of stroke in men (46.78/100,000 persons) was higher than women (41.52/100,000)

Marital status: 80% of the patients were married and 20% were unmarried (tableNo.5)

Socio economic status: most of the patients were from poor economic status i.e.50% and 16.7% were from very

poor economic status that they have to do more hard work for survival; this may lead to vata prakopa and vata

vyadhi. 33.3% were middle class. (tableno.6)

Residential status: 60% of the patients were urban and 40% were from rural area. (tableno.7)

Occupation: maximum patients were from labor class and agriculture field which involve more hard work and

stress, more physical work may lead to vata prakopa and vata vyadhi. (tableno.8)

Side affected: right side was affected in 63.3% of the patients and left side was affected in 36.7% of the patients.

(tableno.9)

Associated disease: 26.7% patients had history of hypertension and 73.3% had diabetes. Hypertension and diabetes

are the major disease which comes under the major risk factor for stroke. (tableno.25)



ISSN 2651-4451 | e-ISSN 2651-446X


Diet: 73.3% patients were vegetarian and 26.7% were having mixed diet. (tableno.26)

Bowel habits: 66.7% patients were having regular bowel and 23.3% had irregular bowel habits and 10% patients

had constipation. (tableno.27)

Habits: 16.7% patients were alcoholic, 10% patients were having the habit of tobacco chewing, 13.3% patients

were smoker. These are the risk factors of Cerebro vascular accidents.(tableno.28)

Vyayam shakti: 40.3% patients were having Avara Vyayam shakti, 56.7% had Madhyama Vyayam Shakti and

3.3% patients had Pravra Vyayam Shakti.(tableno.30)

Koshta: 53.3% patients were Mridu koshthi, 36.7% of the patients were having Kroor koshta and 10% patients

were Mridu koshthi. (tableno.24)

Shabad: 60% of the patients were having vaikrut swara, 40% of the patients were having prakrut swara.(tableno.31)

Duration of illness: maximum patients were having less than 6 months of history of illness i.e.40% of the patients,

30% patients were having history of less than one year of illness,10% patients had history of illness between one

to one and half year,6.7% patients had the history of illness between 1to 1and half yrs,3% pts had the illness from

2 to 2and half yrs, 2and half to 3,3yrs to 3and half yrs, 3and half to 4, 4yrs to 4 and half yrs.(tableno.23)

Lakshana of Nasya Karma: in this clinical study, most patients showed the samyaka nasya lakshana, 93.3%

patients achieved the lakshana of shirolaghava, 96.7% got the lakshana of sukhaswapna, 93.3% got the lakshana

sukhaucchwas, 90% patients got the lakshana of swapnabodha, 80% patients achieved the lakshan of

vikarprashmana upto some extent.

IV. EFFECT OF THERAPIES

The present clinical study was conducted to evaluate the efficacy of Nasya in two groups, each group had 15

patients, course of nasya was for 21 days.

1. Effect on Facial Expressions:

Effect on the Facial Expressions: Both the taila show significant result in the facial expressions with p value .000,

so we can conclude that both the Nasya has significant result in the facial expressions. The p value was .046 before

the treatment changed to .001 after the treatment for Karpasasthyadi taila and for Masha taila thep value was .008

before the treatment and changed to .000 after 7 days of Nasya, which was quiet significant and later on p value

was .001 after 14 and 21 days, the change that occurred with the treatment was statistically significant. (p=.001)

2. Effect on Dysarthria:

Both the taila show significant result in dysarthria with mean value p value .000 after the treatment, p value was

.083 after 7 days of treatment and after 14 days it was .005 which was quiet significant statistically for

karpasasthyadi taila, this shows that there was marked improvement in dysarthria after 14 days of treatment. For

Masha taila the p value was .157 after 7 days of treatment and changed to .025 after 14 days and .011 after 21 days

and after follow up which shows good improvement significantally.

3. Effect on Dysphagia:

Both the taila doesnot show any significant result in dysphagia with p value .046 which was not significant

statistically.

4. Effect on Range Of Motion:

ARM: (Proximal movement)

Both the taila shows significant result in the proximal movement with p value .000 for both the taila, the p value

was .005 after 7 days of treatment and changed to .002 after 14 days of treatment and changed to .001 after 21 days

of treatment for Karpasasthyadi taila.



ISSN 2651-4451 | e-ISSN 2651-446X


For Masha taila the p value was quiet significant after 7 days of treatment i.e. .002 and changed to .000 after 14

days which was quiet significant and .000 after 21 days which shows that it shows significant result in the treatment.

Arm: (Distal movement)

Both the taila shows significant result in the distal movement with p value .000

The p value for karpasthyadi taila was .005 after seven days of treatment and .000 after 14 days which was quiet

significant statistically, the p value was .001 after 21days and after follow up of the treatment which shows the

treatment was significant.

For Masha taila, p value was .008 after 7 days of treatment and later on it was .001 after 14 days of treatment and

upto follow up which means that it is significant statistically.

V. LEG MOVEMENTS

Leg (proximal)

Both the taila shows significant results in the movement of the affected leg, with p value .000 for both the taila.

The p value for karpasasthyadi taila was .001after 7 days and 14 days of the treatment and .000 after 21 days and

follow up and .002 after 7 and 14 days for Masha taila and .001 after 21 days and after follow up,which means that

both the taila are showing significant results in the proximal movements.

Leg (distal)

Both the taila shows significant results in the distal movement of the affected leg, with p value .000 for both the

taila which is quiet significant.

The p value for karpasasthyadi taila and Masha taila as well was .005 after 7 days of treatment and .001 after 14,

21 days and after follow up, which is significant statistically.

Effect on DTR

Both the taila doesnot show any significant result in the deep tendon reflex with p value .155 for karpasasthyadi

taila and .092 for Masha taila.

Effect on Pathological Reflex

Masha taila shows significant result in the management of pathological reflex, Karpasasthyadi taila did not show

any significant results in the reflexes. The p value is .034 after 7 days and upto follow up which proves that its role

is significant in the management of reflexes.

Effect on Muscle Tone

Both the taila shows significant result in the muscle tone with p value .00 for both the taila means both are

significant in the management. The change that occurred with the treatment is greater than expected, there is

statstically significant change (p=.000)

The p value is .003 after 14 days for karpasasthyadi and .001 for Masha. The change that occurred with the treatment

is greater than expected.

Effect on Gait:

Both the taila shows significant result in the gait with p value .000 for both the taila. The change that occurred with

the treatment is greater than expected.

The p value is .000 after 14 days for group 1 and .001 for group 2

VI. OVERALL EFFECT OF THE THERAPY

Out of 15 patients of Pakshaghata treated with two schedule of Nasya Karma, all patients got marked improvement.



ISSN 2651-4451 | e-ISSN 2651-446X


Effect on Facial expressions:

The herb Bala strengthens the Nerves and the Muscles. Ashwagandha is an exceptional nervine tonic and nourishes

the nerves and improves nerve function. It helps in providing progressive, long lasting results for various health

concerns like aging, slow growth. Clinical trials and animal research support the role of Ashwagandha for anxiety,

cognitive and neurological disorders. The total alkaloids of Ashwagandha showed relaxant effect against several

spasmogens on intestinal, uterine and blood vascular muscles. The pattern of smooth muscle activity of the alkaloid

was similar to that of papaverine which suggests a direct musculotrophic action. Masha is described as

Paramvatahara in Charaka, Sutrasthana having Guru, Brimhana, Tarpana, Balya and Snigdha properties which

control vitiated vata and Dhatukshaya. Generally it is recommended in degenerative nervine disorders and it is

considered as nervine tonic.

Effect on speech: Eranda is Madhur, Katu, Kshaya Rasa, Ushna Virya and Madhur Vipaka and it helps to treat

Stambha, Sankoch.it may help to reduce Vakastambha.

Effect on leg and arm movements:

Atmagupta (mucuna puriens), supports a healthy central and peripheral nervous system, it supports the body ability

to handle stress, it promotes healthy motor skills and coordination.

Effect on gait:

Atmagupta supports physical balance and postures. It contains naturally occurring levodopa which is an essential

precursor of the neurotransmitter dopamine, it has many function in the brain and nervous system, it plays an

important role in cognition, voluntary movement, sleep. L-dopa reaches the central nervous system more readily.

Effect on Muscle Tone:

Ashwagandha has revitalizing action on nerves, bone marrow. Regular consumption is believed to rectify the

abnormalities of the sense organs and hypertrophy of muscles. It is also useful in stress, weakness, nervous

exhaustion, memory loss, muscular weakness. In Dhanwantar Nighantu and Raj Nighantu, Bala is considered as

tridoshanut, a nervine stimulant, Balya, Ojovardhaka, Dhatuvardhaka, Pushtikara and Vatanulomana. It is having

Laghu, snigdha and Picchila guna, Madhura Rasa and Madhura Vipaka, it is said to restore muscular function and

body strength. kapikacchu may help increase lean mucle mass by stimulating human growth hormone production.

Dopamine has been shown to increase protein synthesis and help stimulating muscle growth.

Effect on Touch Pain Score:

Effect on dysarthria:

Both the group shows marked improvement in dysarthria, it can be said that Nasya has checked the dushti of vitiated

vata especially Prana and Udana, it also effect on Indriya i.e.Vagindrya as it is mainly attached to Murdha, the

overall effect of Nasya with Masha Taila, a potent Vatashamaka, Kaphashamka, Swarakar property.

FOLLOW UP OF THE STUDY

In the recent study, 1 follow up was done after 15 days of the therapy. The effect of nasya karma in both the

groups were assessed in both the groups, relief is sustained, further improved and no changes were assessed.

Data of follow up shows that most of the patients attained sustained relief.

PROBABLE MODE OF ACTION OF NASYA:

The mode of administration of Aushada through Nasya Karma is having several advantages. The rich vascular

plexus of the nasal cavity provides a direct route into the blood stream for medications that easily cross

mucousmembranes.This direct absorption into the blood stream avoids gastrointestinal destruction and hepatic

first pass metabolism (destruction of drugs by liver enzymes) allowing more drug to be cost-effectively, rapidly,

and predictably bioavailable than if it were administered orally. The probable mode of action of Nasya Karma

can be assed under many aspects, these are:



ISSN 2651-4451 | e-ISSN 2651-446X


According to Anatomical Aspects:

The Sringataka Marma has been explained by recent authors as the middle cephalic fossa of the skull consisting of

meningial vessels, paranasal sinuses and nerves. One can see the truth of the narration made by Vagbhata here -

the drug administered enters the paranasal sinuses, that is, the Sringataka, where the ophthalmic vein and the other

veins spread out. The sphenoidal sinuses are in close relation with the intracranial structures. The mentioning of

the Sringataka in this context seems to be more reasonable. As the procedure of Nasya involves Mukhabhyanga

and Sveda over many Marmas existing on the face and head, these also help in allievation of Marmaksobha and

Vatashamana. Brumhana Nasya provides nourishment to the Shiras and other Supra clavicular organs there by

alleviates the vitiated Vata. Hence, it is useful in Vatajanyaailments.

According to Absorption in Nasal Epithelium:The richly supplied vascular nature of the nasal mucosa coupled with

its high drug permeation makes the nasal route of administration attractive for many drugs, especially lipids, and

lipid soluble drugs. Lipid soluble substances have grater affinity for passive absorption through the cell walls of

nasal mucosa, thus Navana Nasya may be superior to all the varieties. The cilia of the olfactory cells and perhaps

the portions of the body of the olfactory cells contain relatively large quantities of lipid materials;

thiscouldexplainwhy asubstancemustbe lipidsolubletocausestimulationof olfactory cell and further the

Mukhabhyanga and Svedana helps in vasodilatation and there by increases the rate and area of absorption.

The absorption of drugs is influenced by the residence (contact) time between the drug and the epithelial tissue.

The mucociliary clearance is inversely related to the residence time and therefore inversely proportional to the

absorption of drugs administered. A prolonged residence time in the nasal cavity may also be achieved by properties

of Viscosity. In this study Masha Taila is taken for the Nasya Karma and it is highly viscous.

The Specific gravity of Mashadi Taila, taken for the study was 0.9209 at 250C [API]. The pH of the drug has got

very important role in the Nasal delivery, why because the Nasal epithelium is very thin and heavily vascularised.

So the drug is of high pH, i.e. highly alkaline or acidic (5-14), it will be toxic. The pH of Mashadi Taila is 2, and

there by it will not cause any harm to the nasal epithelium, it will help in better absorptiononly.Thus Mashadi Taila

is having high viscosity and Specific Gravity and non-toxic pH; it will get more time for muco ciliary clearance,

and will retain for more time in the nasal cavity and will help in the better absorption.

According to the Aushadha:Ayurveda has mentioned medicated Sneha Dravya in a majority of the Nasya Karmas,

because nose is a highly vascular structure and its mucous membrane provides a good absorbing surface. Hence,

Siddha Sneha, on their administration, spread along the nasal mucous membrane. An active principle along with

Sneha gets absorbed inside the olfactory and respiratory mucosa. The networks of lymph vessels have

communications with the subdural and subarachnoid spaces. This fact is one of the important factors contributing

to the extension of the mentioned drugs from the nose into the cranial cavity. Therefore, these substances can pass

easily through the blood- brain barrier and can exert their actions. Certain lipids are used for providing energy to

the nervous tissue.

Masha Taila:

It contains many dravya having the qualities like Guru, Snigdha, Picchilaetc. and is Vata Shamaka. Tila Taila

(Sesamum indicum) is considered best among the oils. It is having the qualities like Snigdha, Ushna etc. Tailam

kapha sa vate cha”, if the disease is caused by vata along with kapha.Taila has got both the action of Brumhana and

Karshana. By these properties Taila will help in Brumhana in Vataja condition of Pakshaghata.

The lipid contents of the 'Masha taila' may pass through the blood-brain barrier easily due to their transport. Some

of the active principles may reach certain levels in the nervous system where they can exert their Vataghna property.

Masha Taila provides nourishment to the nervous system on its nasal administration; it reaches different Shirogata

Indriya and causes Vatashamana and Brumhana. On the basis of the foregoing observations we can state that the

procedures, properties & conducts explained for Masha Taila in Nasya Karma are of vital importance in drug

absorption & transportation. To conclude, Nasya Karma helps in Pakshaghata by its Vatashamana and Brumhana

Karma.


turkish journal of physiotherapy and rehabilitation

Documents