Dr. RAHUL.pptx

“A COMPARATIVE CLINICAL STUDY ON
NASYA KARMA WITH AND WITHOUT
GREEVA BASTI IN MANYASTAMBHA
(CERVICAL SPONDYLOSIS)’’
SUPERVISOR
Vd. KETAN MAHAJAN
PROFESSOR
HEAD OF THE DEPARTMENT
CO – SUPERVISOR
Dr. PRABHAT KUMAR
ASSISTANT PROFESSOR
DEPARTMENT OF PANCHAKARMA
PATANJALI BHARTIYAAYURVIGYAN EVAM ANUSANDHAN
SANSTHAN HARIDWAR, UTTARAKHAND
BY : Dr. RAHUL , PG SCHOLAR

AIMS & OBJECTIVES
To evaluate and compare the effect of Nasya Karma
with and without Greeva Basti of Mahanarayan Taila
in the management of Manyastambha (Cervical
Spondylosis).

INTRODUCTION
Manyastambha has been described in various Ayurvedic
Texts including Bhruhatries and Laghutries. Such as
Acharya Charaka has described as Vataja nanatmaja
vikara in Sutrasthana. (20/11)
 Acharya Sushruta has also explained in Nidana sthana
(1/67) and Chikitsa sthana.(5/20)

 It is Vataja nanatmaja vikara which causes ruka (pain),
toda, stambha (stiffness and restricted movements) in
Manya Pradesh.
 Due to day time sleeping, wrong sleeping area, watching
downwards and upwards for the long time, causing over
stretching of neck leading to tridosha prakopa .
 The vitiated doshas obstructs the channels of Vata
leading to painful and restricted neck movements .

It can be compared with cervical spondylosis. It is the
general term for age related wear and tear in cervical spine
(neck) that can lead to pain, swelling and stiffness etc.
It is more common in Men as compared to Women.
It is the result of Osteoarthritis in the cervical spine.
 It is characterized by degeneration of the Intervertebral
discs and Osteophyte formation.

MATERIALS AND METHODS
It is a randomized comparative, single blind,
interventional clinical study.
The study is carried out in 30 patients of
Manyastambha excluding drop outs with pre test
study design.
 Level of Study: O.P.D. & I.P.D. level
Period of Study: 18 months

SELECTION OF PATIENTS
 Patients with classical features of MANYASTAMBHA
selected randomly from OPD and IPD of Patanjali
Ayurved Hospital , Haridwar.
Divided randomly into 2 groups , each comprising of
15 patients each on the basis of inclusion and exclusion
criteria with detailed clinical history and physical
examination and other necessary investigations.

INCLUSION CRITERIA
 Age 18 – 70 years, either sex
 Patient fit for Nasya Karma and Greeva Basti
 Patients with classical features of
MANYASTAMBHA
Patient with radiological findings of CERVICAL
SPONDYLOSIS.

EXCLUSION CRITERIA
Patients who are unfit for Nasya and Greeva basti.
Pregnant and Lactating mothers.
Critical illness like : Cardiac disease ,Carcinoma,
Tuberculosis, HIV, Trauma etc.

INVESTIGATIONS
 Cervical Spine X – ray
AP (Anterior Posterior) view
Lateral view
 CBC (Complete Blood Count )
ESR ( Erythrocyte Sedimentation Rate )
 RBS ( Random Blood Sugar )

SELECTION OF DRUG
SELECTED DRUGS: -Mahanarayan taila
REFERENCE:- Bhaishajya Ratnavali, Chapter 26 /325 –
336, Vatavyadhi Rogaadhikars.
FORM OF MEDICINE:- Medicated taila
PREPARATION OF MEDICINE :-It is prepared
classically by Divya Pharmacy, Haridwar used for study.
ROUTE OF DRUG ADMINISTERATION:-
Nasal route and External application.

INTERVENTION
Group A (Nasya Karma)
Patients of this group have been administered Nasya
Karma with Mahanarayan Taila once daily in the
dosage of 8 bindus (4 bindus in each nostril) for 7 days
in the morning .

Group B (Nasya Karma with Greeva Basti)
Patients of this group have been treated with Nasya
Karma in the dosage of 8 bindus (4 bindus in each
nostril) in the morning along with Greeva Basti (
quantity of oil – approx 250 ml) of Mahanarayan Taila
for 7 consecutive days in the morning.

ASSESSMENT CRITERIA
Both subjective and objective parameters have been
applied for assessment of the impact of the treatment
induced in respective groups.

SUBJECTIVE PARAMETERS
Greeva Shoola (Neck pain )
 Radiation of Pain
Greeva stambha (Neck Stiffness)
Weakness
Parasthesia
Bhrama (Vertigo)

OBJECTIVE PARAMETERS
Tenderness over Cervical Region
Restricted Movements of Neck
Sensory Loss

OBSERVATIONS AND RESULTS
STATISTICAL ANALYSIS :-
Statistical study was carried out in terms of mean .
Wilcoxan signed rank test ( P value )was applied to
parameters of Group A and Group B .
Mann Whitney U Test is used to compare two related
samples or to conduct a paired difference test .

OVERALL ASSESSMENT
 Conclusion has been made on the basis of the
observation which is done on subjective and objective
parameters. The result has been analyzed statistically.

CRITERIA FOR ASSESSING THE SCORE
(RELIEF IN SIGNS, SYMPTOMS AND CLINICAL TESTS )
Complete Remission - 100 %
Marked Improvement - 75 % to 99%
Moderate Improvement - 50 % to 74
Mild Improvement - 25 % to 49 %
Unchanged - < 25%

Group A (Nasya Karma ) provided Marked
Improvement in 6.67 % of the patients, Moderate
improvement in 53.33 % of the patients and 40.00 %
of the patients got Mild improvement after
completion of 7 days treatment.

Group B (Nasya Karma with Greeva Basti)
provided Marked Improvement in 6.67 % of the
patients, Moderate improvement in 93.33 % of the
patients and not any patients got Mild improvement
after completion of 7 days treatment.
No patient was found getting Complete remission
and Unchanged after treatment in the both groups.

FOLLOW UP
Follow up Assessment of 30 Patients of
Manyastambha
After 30 days of placebo (both group):-
In Group A (Nasya Karma), the follow up
assessment of 30 patients of Manyastambha showed
relief is sustained in 53.33 % and further improvement
was seen in 46.66% patients.

In Group B (Nasya Karma with Greeva Basti),
the relief is sustained in 73.33%, 26.66% patients
showed further improvement after follow up
No patient was found unchanged in the both
groups.

1
6
8
0
14
1 0 0
OVERALL EFFECT
Group A Group B
FOLLOW UP EFFECT
11
7
4
0
0

DISCUSSION
ON CHIEF COMPLAINTS
 In Group A (Nasya Karma) in symptom
Greevashool, Radiation of Pain, Greeva stambha,
Greeva Sparsha Akshamatva, Greeva Hundana, the
total effect of treatment provided statistically
extremely significant (P < 0.05) result.

 In Group B (Nasya Karma with Greeva Basti)
in symptom Greevashool, Radiation of Pain, Greeva
stambha, Greeva Sparsha Akshamatva, Greeva
Hundana, the total effect of treatment provided
statistically extremely significant (P <0.05) result.

ON ASSOCIATED COMPLAINTS
 In both groups in associated symptom Bhrama,
the total effect of treatment provided statistically
extremely significant (P <0.05) result.

Probable mode of action of Nasya karma
Nasya Dravya administered through the nose
Reaches Sringataka Marma( Local Surface of Brain i.e Cavernous
sinuses )
Spreads in Murdha ( Enters into the intra Cranial circulation )
Reaches at a junction place of Netra, Srota , Kantha and Siramukhas
Scratches the morbid Dosha from Urdhavajatru pradesha

CONCLUSION
MANYASTAMBHA
 It can be positively correlated with Cervical
Spondylosis because of its etiology, clinical
manifestation, pathogenesis and complications.
 The samprapti of Manyastambha is mainly of two
type’s viz. Dhatukshayajanya and Avaranjanya.

NASYA KARMA
It is regarded as main line of treatment in
Urdhwajatrugata Vikaras which does Bruhmana in
Kshayaja Avastha as well as Shamana in Prakopa
Avastha and helps in calming both Vata and Kapha .
GREEVA BASTI
It is the therapy in which both qualities of Snehana and
Swedana are included that help in calming Vata Dosha.

MAHANARAYAN TAILA
It is very effective in the management of
Manyastambha (Cervical Spondylosis).
The administration of Mahanarayan Taila as
internal application in the form of Nasya Karma and
external application in form of Greeva Basti are found
markedly beneficial in management of
Manyastambha.

Statistically significant changes observed in the
symptoms like pain, stiffness and restricted movements
in both the groups.
Meanwhile, Group B (Nasya Karma with Greeva
Basti) provided better symptomatic result than Group A
(Nasya Karma).
Hence, Nasya Karma with Greeva Basti are better line
of treatment for such disease.

Dr. RAHUL.pptx

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