Efficacy of Yashtimadhu Taila Nasya in Nasanaha with Special Reference to...

[Full title: Efficacy of Yashtimadhu Taila Nasya in Nasanaha with Special Reference to Inferior Turbinate Hypertrophy- A Case Study]

[Find the meaning and references behind the names: Man, Krishnan, Naveen, Long, Ayu, Ajoy, Kumari, Med, Geeta, Good]

166 Journal of Ayurvedic and Herbal Medicine 2022; 8(3): 166-168 Case Report ISSN: 2454-5023 J. Ayu. Herb. Med. 2022; 8(3): 166-168 Received: 29-07-2022 Accepted: 12-09-2022 © 2022, All rights reserved www.ayurvedjournal.com DOI: 10.31254/jahm.2022.8305 *Corresponding author: Dr. Shobita S Department of PG studies in Shalakya Tantra, SSCASR, Bengaluru, India Email: shobitas 94@gmail.com Efficacy of Yashtimadhu Taila Nasya in Nasanaha with Special Reference to Inferior Turbinate Hypertrophy- A Case Study Shobita S 1 , Naveen B S 2 , Geeta Kumari B 3 , Ajoy Viswam 4 , Krishnan Namboodiri G 5 1 PG Scholar, Department of PG studies in Shalakya Tantra, SSCASR, Bengaluru, India ORCID ID: https://orcid.org/0000-0001-8461-7793 2 Professor and HOD, Department of PG studies in Shalakya Tantra, SSCASR, Bengaluru, India ORCID ID : https://orcid.org/0000-0002-4135-3641 3 Geeta Kumari B, Professor, Department of PG studies in Shalakya Tantra, SSCASR, Bengaluru, India ORCID ID: https://orcid.org/0000-0002-7221-5807 4 Assistant Professor, Department of PG studies in Shalakya Tantra, SSCASR, Bengaluru, India ORCID ID: https://orcid.org/0000-0002-1806-1042 5 Assistant Professor, Department of PG studies in Shalakya Tantra, SSCASR, Bengaluru, India ORCID ID: https://orcid.org/0000-0002-1139-5701 ABSTRACT Acharya Vagbhata has explained about 18 Nasa rogas and Nasanaha is one among them. It occurs due to vitiation of Vata and Kapha and the treatments mentioned in the classics for Nasanaha include Snehapana, Nasya, and Dhoomapana . This case study is of a female patient who complained of recurrent nasal obstruction, watery nasal discharge and headache. Use of nasal decongestants gives her temporary relief from nasal obstruction and she came to the OPD for further management. In the present study, Nasya with Yashtimadhu taila is proved to give good results in Nasanaha . Keywords: Nasanaha, Turbinate Hypertrophy, Yashtimadhu Taila Nasya. INTRODUCTION Advances in science and technology have led to several changes in human lifestyle and behavior that made man less immunized. This also has a great impact in natural ecosystems, like environmental pollution and unnatural seasonal variations which are responsible for many diseases. Nose, being in direct contact with external environment is exposed to lot of microorganisms and pollutants present in the atmosphere and is one of the organs that is more prone to get afflicted by such diseases [1] . Nasanaha is one among the Nasarogas mentioned in the Ayurveda classics and it occurs when the vitiated Kapha dosha along with Vata dosha obstructs the nasal passage. Acharya Sushrutha and Charaka have used the term Nasa Pratinaha for explaining the disease. The distinctive feature of Nasanaha is nasal obstruction leading to difficulty in breathing. Nasal obstruction is one of the most frequently encountered symptoms in the clinical practice and it can interfere with the social activities, thus considerably compromise quality of life. Nasanaha can be correlated to nasal obstructive diseases like Hypertrophic Turbinates, Deviated Nasal Septum, Cysts, Tumors, Adenoids and Polyps. Among these disorders, the clinical features of Hypertrophic Turbinates can be best analysed with that of Nasanaha . Antihistamines, decongestants, and topical and systemic corticosteroids are widely used for medical treatment and may cause detrimental effects such as drowsiness, bleeding, dryness, and crusting of nose. This can only provide symptomatic relief and is not intended for long-term use. Surgical management is recommended when medical management approaches have failed, although it might result in complications such as hemorrhage and synechiae between the nasal septum and the turbinates, among other concerns [2] . According to Ayurveda classics the treatments for Nasanaha include Snehapana , Nasya , and Dhoomapana . Nasya is one among the Panchakarma treatment and is the first line of treatment in all Urdhwajatru Vikaras . According to Ashtanga Sangraha , it is indicated to use Madhura Varga Sadhitha Taila Nasya in the management of Nasanaha [3] . Yashtimadhu (Glycyrrhiza glabra. Linn) is one among the

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167 Journal of Ayurvedic and Herbal Medicine|July-September|2022 Madhura Varga Dravya which has Tridoshahara property. So in this case study, Nasya with Yastimadhu taila was given. CASE REPORT A 23-year-old female patient came to Shalakya tantra OPD with complaints of recurrent bilateral nasal obstruction, watery nasal discharge and dull frontal headache since 2 years which gets aggrevated on exposure to cold weather and wind. Her sleep was disturbed due to severe nasal obstruction at night. The patient used nasal decongestants but got only temporary relief so the patient came to the hospital for further management. Table 1: Showing treatment procedure with duration Nasya Karma Procedure After thorough examination, patient was made to lie on bed in supine position. As Purva karma , Mukhabhyanga was done with Murchita tila taila for 10 minutes and Nadisweda was given to face for 5 minutes. Then patient is made to lie on bed in supine position with head little lowered and 8 drops of lukewarm Yashtimadhu taila is put into each nostril as a continuous stream. After that, mild massage was given to the nose and the forehead in upward direction. After 7 minutes, Dhumapana was given with Haridra varti followed by Ushnajala kavala . The patient was advised to avoid cold air exposure and to refrain from having milk products and cold food items. RESULT After the administration of Nasya , patient noticed mild relief from nasal obstruction after the first day and the sleep of the patient improved as there was no severe nasal obstruction at night. After 7 days of Nasya , nasal obstruction reduced significantly whereas, watery nasal discharge and headache was completely resolved. Figure 1: 0 th day – Before treatment Figure 2: 7 th day – After treatment On examination- After treatment B/L nasal mucosa congestion was absent and B/L Inferior turbinate hypertrophy was reduced. In cold spatula test, fogging was seen on both sides though there was not much difference in the nasal septum deviation. DISCUSSION Inferior turbinate hypertrophy is often caused by swelling of the submucosa, and less rarely by expansion of the bone itself. Dilatation of the submucosal venous sinusoids causes this hypertrophy. This can be seen in diseases like allergic rhinitis, acute rhinosinusitis, vasomotor rhinitis, drug induced rhinitis and chronic rhinosinusitis [4] . The symptoms include nasal obstruction, rhinorrhea, anosmia, dull headache, otalgia and sore throat. Acharyas have explained only nasal obstruction as a symptom of Nasanaha. Acharya Vagbhata has mentioned that Nasa being the gate way to Shiras , the drug instilled through nostrils, reaches Shringataka Marma , thereafter spreading to the entire Murdha. This whole process disintegrates the morbid Doshas in supra clavicular region and extracts them similar to the removal of the central thread of a grass called Munja without damaging the surrounding tissues [5] . Probable Mode of Action Glycyrrhetinic acid 6 present in Yashtimadhu is antiinflammatory and it can help in improving the mucociliary function of the nasal cavity and decreasing inflammatory mediators in the nasal microenvironment. During Nasya karma , the medicine comes in contact directly with the nasal mucosa and the Snehana and Swedana karma prior to Nasya karma accelerates the local drug absorption. This could have helped in reducing the nasal mucosal swelling, relieving the nasal obstruction and discharge. Also, the reduced nasal mucosal swelling might have caused reduced pressure on the nerve endings which would have helped in relieving headache. CONCLUSION Nasanaha is one among the Nasarogas and is a Vatakaphaja vyadhi. It can be correlated to Turbinate hypertrophy. A case of inferior hypertrophic turbinate was taken up for the study and Yashtimadhu taila Nasya was given to the patient continuously for 7 days. Patient Procedure Medicine used Approximate duration Mukhabhyanga Murchita Tila taila 10 minutes Sweda Nadisweda 5 minutes Nasya Yashtimadhu taila Dose- 8 drops in each nostril 7 minutes Dhumapana Haridra varti 5 minutes Kavala Ushnajala 3 minutes

[Find the meaning and references behind the names: Sharma, Indu, Scott, John, Shah, Brown, Sah, Usha, Raton, Clarke, Raymond]

168 Journal of Ayurvedic and Herbal Medicine|July-September|2022 had considerable relief from nasal obstruction and the complaints of watery nasal discharge and headache got resolved completely. Internal medications having Rasayana property along with Nasya can be given to achieve sustenance of results after treatment. The study may be carried out in large number of subjects with longer duration to evaluate and analyze the results. Conflict of Interest None declared. Financial support None declared. REFERENCE 1 Bhargava KB, Bhargava SK, Shah TM. A Short Text Book of ENT Diseases. 9 th ed. Mumbai: Usha Publications. 2011. pp.155. 2 Sarmah J, Mahanta H, Sarma DR. A Clinical Study on Ksharakarma in the Management of Naspratinaha with special reference to Hypertrophied Inferior Turbinates. International Journal of Ayurveda and Pharma Research. 2017;5(1):24-27. 3 Vagbhata, Astanga Samgraha with Sasilekha Commentary by Indu, edited by Dr Shivprasad Sharma. Uttarasthana, Ch.24, Ver.29. 1 st Edition, Varanasi: Chowkhamba Sanskrit Series Office. 2006.p p.746. 4 Scott Brown. Management of enlarged turbinates. Scott Brown’s Otorhinolaryngology Head and Neck Surgery. Edited by John Watkinson and Raymond W Clarke. 8 th ed. Boca Raton: CRC Press. 2018. pp.1157. 5 Mitra J. Ashtanga Sangraha of Vruddha Vagbhata, Commentry: Sasilekha by Indu, Shareera sthana, Chapter 29 verses 2, Varanasi: Chowkambha Sanskrit Series; 2013. 6 Finney RS, Somers GF. The anti-inflammatory activity of glycyrrhetinic acid and derivatives. Journal of Pharmacy and Pharmacology. 1958;10(1):613- 20. HOW TO CITE THIS ARTICLE Shobita S, Naveen BS, Kumari BG,Viswam A, Namboodiri GK. Efficacy of Yashtimadhu Taila Nasya in Nasanaha with Special Reference to Inferior Turbinate Hypertrophy- A Case Study. J Ayu Herb Med 2022;8(3):166-168. DOI: 10.31254/jahm.2022.8305 Creative Commons (CC) License- This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY 4.0) license. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. (http://creativecommons.org/licenses/by/4.0/).