Dr. Yogitha Bali M.R

Background: With an incidence of 3%-5% in the general population and up to 20% in people with diabetes, peak incidence of frozen shoulder is more common in women and in manual workers between the age of 40 and 60yrs. Though multiple interventions have been studied on the frozen shoulder, the complete and the effective treatment is indefinite. Nasya karma is one among the panchakarma therapies of Ayurvedic system of medicine which can deliver the potential effects to the patients of frozen shoulder or apabahuka. Purpose: The objective of this study was to review the case reports and case series that are published on nasya karma and apabahuka or frozen shoulder. Design: Systematic review. Methods: PubMed/MEDLINE, Cochrane (CENTRAL), EMBASE, Google Scholar, TKDL, AYUSH and DHARA databases were screened from inception until March 8th, 2020. References of the full text articles were screened and selected articles by searching manually as a next step. Based on the pre-specified inclusion criteria articles were screened and finally 5 case reports and 0 case series were included for the study. Results: All the 5 studies included in the review administered nasya karma to the patients suffering from apabahuka or frozen shoulder and assessed pain, severity of the pain, VAS (visual analogue scale), stiffness, ROM (Range of movements) like flexion, extension, abduction, adduction, internal rotation and external rotation, forward elevation, lateral elevation, restricted movements and constant assessment scale of shoulder joint before and after the treatment which showed significant improvement in all the parameters. Conclusions: Nasya karma, one of the panchakarma therapies in Ayurvedic system of medicine constitutes the prime modality of treatment in the management of jatru-urdhwagata rogas mainly apabahuka or the frozen shoulder. Though present review showed significant changes in all the parameters, there are several limitations besides the quality of reporting, that is generally low in the included case reports. In addition, this review provides a comprehensive knowledge that may assist the researcher as a supplementary by giving an intuition for the execution of RCT’s and clinical studies further on the domain studied. Having negligible number of systematic reviews in Ayurveda and absence of systematic reviews on case studies or reports and series, this review may serve as a preliminary step towards conducting more systematic reviews in Ayurvedic system of medicine which is the need of hour..

Nasya karma is an important therapy in which the medicine is administered through the nose either in the form of ghrita, oil, powder, liquid or smoke. It is particularly useful in treating the diseases of organs above the clavicle. Sinusitis is one such disease. All the recently published guidelines have adopted the term rhinosinusitis (RS) instead of sinusitis. RS is the inflammation of the nose and paranasal sinuses characterized by two or more symptoms, one of which should be either, nasal blockage/ obstruction/ congestion or nasal discharge and the second either facial pain/pressure or reduction/loss of smell or both of these with objective findings on either computed tomography or nasal endoscopy. Nasya karma is a unique therapy of Ayurveda that does both the shamana and shodhana of the doshas thereby relieving the symptoms and preventing the problem from progressing. Though there are a large number of studies on the topic, more studies with larger sample size needs to be carried out to understand nasya therapy in depth and its role in sinusitis.

Background Labour is a natural process that requires minimal assistance, but due to the altered anatomy and physiology, it may suddenly become abnormal and even fatal. Labour is vastly described in Ayurveda as Prasava and its being practised since centuries. Application of the Ayurvedic concept of labour and its practices is the need of hour in prevention of un toward complications of labour. Design This was a randomized comparative clinical study. It included 40 patients assigned into two groups, Group A and Group B each with 40 patients respectively. Group A patients were administered Krishnavacha Lepa mixed with Eranda Taila Lepa and in Group B, Vaasamoola Lepa was applied after attaining the true labour pain in the first stage of labour with proper operative procedures. Results Repeated measures analysis of variance (RMANOVA) with Bonferroni showed significant changes both between and within the groups. Krishna Vacha Eranda Taila Lepa showed significant changes compared to Vaasamoola Lepa with (p≤0.05) in Cervical effacement, Cervical Position, Cervical Dilatation, Cervical Consistency, Head Station, Number of contractions and Duration of contractions. Conclusion Krishna Vacha Eranda Taila Lepa application was more effective compared to Vaasamoola Lepa in the management of first stage of Prasava in patients with true labour pain.