E-ISSN:2456-3110

Research Article

Cerebral Infarction

Journal of Ayurveda and Integrated Medical Sciences

2022 Volume 7 Number 1 Jan-Feb
Publisherwww.maharshicharaka.in

Randomized comparative study on Ekangavir Rasa, Vaitarana Basti, Shirobasti in combination on Barthel Index and NIH Stroke Scale in Pakshavadh with special reference to Cerebral Infarction

V Gundo J.1*, Thatere A A.2, Deolekar S P.3, Dorage P.4, Kabra P R.5
DOI: http://dx.doi.org/10.21760/jaims.7.1.1

1* J V Gundo, Post Graduate Scholar, Department of Kayachikitsa, Government Ayurved College & Hospital, Nagpur, Maharashtra, India.

2 A Thatere A, Assistant Professor, Department of Kayachikitsa, Government Ayurved College & Hospital, Nagpur, Maharashtra, India.

3 P Deolekar S, Post Graduate Scholar, Department of Kayachikitsa, Government Ayurved College & Hospital, Nagpur, Maharashtra, India.

4 P Dorage, Post Graduate Scholar, Department of Kayachikitsa, Government Ayurved College & Hospital, Nagpur, Maharashtra, India.

5 R Kabra P, Professor, Department of Kayachikitsa, Government Ayurved College & Hospital, Nagpur, Maharashtra, India.

Introduction: Stroke also called CVA (cerebrovascular accident) is a medical emergency. It is defined as rapid onset of focal neurological deficit, resulting from diseases of the cerebral vasculature and its contents. This disease that affects the arteries leading to and within the brain. It occurs when blood vessels that carries oxygen and nutrients to the brain is either blocked by a clot or burst. Symptoms of stroke include trouble walking, speaking and understanding as well as paralysis or numbness of the face. Methodology: In this study, patients were treated with combination of Ekangavir Rasa, Vaitarana Basti and Shirobasti in trial group and Ekangavir Rasa with Vaitarana Basti in control group on Barthel Index and NIH Stroke Scale of Pakshavadh, after that after treatment assessment was done. Result: 60 cases were recorded and treated. Observation & results showed significant improvement in patients. Conclusion: The results obtained from this study were encouraging. details are explained in full paper.

Keywords: Pakshavadh, Ekangavir Rasa, Vaitarana Basti, Shirobasti, Cerebral Infarction

Corresponding Author How to Cite this Article To Browse
J V Gundo, Post Graduate Scholar, Department of Kayachikitsa, Government Ayurved College & Hospital, Nagpur, Maharashtra, India.
Email: 		J V Gundo, A Thatere A, P Deolekar S, P Dorage, R Kabra P, Randomized comparative study on Ekangavir Rasa, Vaitarana Basti, Shirobasti in combination on Barthel Index and NIH Stroke Scale in Pakshavadh with special reference to Cerebral Infarction. J Ayu Int Med Sci. 2022;7(1):1-11.
Available From
https://jaims.in/jaims/article/view/1548

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2022-01-17 2022-01-19 2022-01-26 2022-02-02 2022-02-09
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
Nil Nil Yes 16%

© 2022by J V Gundo, A Thatere A, P Deolekar S, P Dorage, R Kabra Pand Published by Maharshi Charaka Ayurveda Organization. This is an Open Access article licensed under a Creative Commons Attribution 4.0 International License https://creativecommons.org/licenses/by/4.0/ unported [CC BY 4.0].

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Gundo V. et al: Randomized comparative study Ekangavir Rasa, Vaitarana Basti, Shirobasti

Introduction

Stroke also called CVA, Cerebrovascular accident, it is medical emergency. It is defined as rapid onset of focal neurological deficit, resulting from diseases of the cerebral vasculature and its contents.[1] This disease that affects the arteries leading to and within the brain. It occurs when blood vessels that carries oxygen and nutrients to the brain is either blocked by a clot or burst. Symptoms of stroke include trouble walking, speaking and understanding as well as paralysis or numbness of the face.[2] Hemiplegia is paralysis of one half of the body i.e. upper and lower limb of the same side. It may be associated with weakness of facial muscle of same side (Ipsilateral) or opposite side (contralateral) hemiplegia.[3]

According to Ayurved, stroke can be correlated with Pakshavadh.[4] Charak include it in Madhyam Roga Marga[5] and in Nanatmaja Vata Vyadhi[6] According to Charak[7] excessive intake Ruksha, Shit, Alpa Anna, Ativyayay, Krodh are causes etc. Pain, difficulty in walking and half side of the body as it affects ligament, nerve and major blood vessels leads to Pakshavadh. Sushrut describe[8] Urdhva, Adha and Tiryak Dhamani in body mainly affected by Vata and causes dislocation of Sandhibandh or tingling sensation and responsible for loss of movement of affected side Vata Pradhan. Regarding Sadhyasadhyatva of Pakshaghat, Sushrut had stated that Shuddha Vataj Pakshaghat is Kruchhasadhya, Kshayaj is Asadhya and Doshanubandhaj is Sadhya.

According to Charak[9] and Ashtang Hridaya[10] Snehan, Svedan, and Virechan are the management  tools for Pakshavadh. Sushrut had also described Snehan, Mridu Shodhan, Anuvasan and treatment like Akshepak in Pakshaghat.[11]Vishesh Chikitsa like Mastishkya Shirobasti, Anutail for Abhyanga, Salvan Upnah, Bala tail for Anuvasan are also advised.[12] Charak has strongly recommended beneficial role of Kala Bast.[13] Importance of Vaitarana Basti is described by Chakradatt in Niruhadhikar Adhyay.  It leads to Karmendriyahani means eleven Indriya which are situated in Mastishka which are under control and Sthana of Prana Vayu. Vikriti of Prana Vayu leads to Pakshavadh. Its Vikriti because of Avarana of Kapha or Pitta and Anonya Avarana of Vayu. Vayu controls the functions of Pitta & Kapha.[14]

Considering this obstructive pathology Snehan, Svedana, Virechana and Lekhan Basti Chikitsa can be applied to breakdown this Samprapti.

After considering above facts the study was planned with Ayurvedic concepts and basic principles for contribution in management of Pakshavadh. Therefore question was in mind that Ekangavir Rasa along with Vaitarana Basti would be as effective as along with Shirobasti. Considering all above said fact the study entitled “Randomized comparative study on Ekangavir Rasa, Vaitarana Basti, Shirobasti in combination on Barthel Index and NIH Stroke Scale in Pakshavadh with special reference to cerebral Infarction. In this study patients were diagnosed with help of CT brain, thrombotic and embolic origins of stroke were included and haemorrhagic stroke was excluded. Considering this, given line of management was applied.

Materials and Methods

Inclusion Criteria

  1. Patients having signs and symptoms of Pakshavadh mentioned in Ayurvedic texts.
  2. Patient having muscle power grade < or = 3.
  3. Patients of non-progressive cerebral infarction i.e., ischemic stroke due to cerebral thrombosis.
  4. Patients of Pakshavadh of duration not more than 5 years.
  5. Patients of either sex aged between 21 years -70 year.
  6. Patient willing and able to participate in the study.
  7. Patients who have not participated in any research project in last 6 months.
  8. Patients of Pakshavadh having controlled hypertension (systolic upto140 mm of Hg and diastolic up to 90 mm of Hg) and diabetes mellitus (BSL fasting up to 130 mg/dl and Post Prandial up to 180 mg/dl).

Exclusion Criteria

  1. Patients of cerebral infraction due to atrial fibrillation, embolic stroke, carotid occlusion, cerebellar stroke and haemorrhagic stroke were excluded.
  2. Patients having seizers, hydrocephalous, pulmonary embolism, dysphagia, M.I., cardiac arrhythmia and septicaemia were excluded.

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Gundo V. et al: Randomized comparative study Ekangavir Rasa, Vaitarana Basti, Shirobasti
  1. Patients who have lost bowel and bladder control.
  2. Comatose and unconscious patients.
  3. Patients having age < 21 years and > 70 years were excluded.
  4. Patients having intra cranial infection, encephalitis and meningitis etc.
  5. Patient having trauma, cerebral tumour, cerebral abscess.
  6. Patient with congenital heart diseases like POA, ASD, VSD and FOD.
  7. Patients contraindicated for Abhyanga like skin diseases, infective disease etc. Were excluded.
  8. Patients who were not fit for Basti.
  9. Pregnant and lactating mothers.
  10. Patients having acute progressive cerebral infarction.

Selection of drug

  1. Ekangavira Rasa[15]
  2. Vaitarana Basti[16]
  3. Prasarini Taila[17,18]

Criteria of Assessment

  1. Clinical features of Pakshavadh as described in classics
  2. Barthel Index[19]
  3. NIH Stroke Scale[20]
  4. Muscle Power Grade[21]
  5. Muscle Tone[22]
  6. Investigational Parameters

Clinical parameters

1. Mukhvakrata

SN Gradation Score
1. Normal 0
2. Mouth angle deviation less than 10 degrees 1
3. Mouth angle deviation 10-20 degrees 2
4. Mouth angle deviation more than 20 degrees. 3

2. Ruja

SN Gradation Score
1. No power 0
2. Present in some part of one affected extremity 1
3. Present in one affected extremity completely 2
4. Present in some part of both affected extremities 3
5. Present in complete half side 4

3. Hatpaksha


SN Gradations Score
1. Not present 0
2. Involvement of only one extremity with good movement 1
3. Involvement of half side with one extremity affected more than other 2
4. Complete involvement of half side with some movement in both affected extremities 3
5. Complete involvement of half side with fine movement 4

2. Barthel Index 

SN Activity Gradation Score
1. Feeding Unable 0
Needs help cutting, spreading butter, etc. or requires modified diet 5
Independent 10
2. Bathing Dependent 0
Independent (or in shower) 5
3. Grooming Needs to help with personal care 0
Independent face / hair / teeth / shaving (implements provided) 5
4. Dressing Dependent     0  
Needs help but can do about half unaided 5
Independent (including buttons, zips, laces, etc.) 10
5. Bowels Incontinent (or needs to be given enemas) 0
Occasional accident 5
Continent 10
6. Bladder Incontinent or catheterized and unable to manage alone 0
Occasional accident 5
Continent 10
7. Toilet Use Dependent 0
Needs some help, but can do something alone 5
Independent (on and off, dressing, wiping) 10
8. Transfers (bed to chair and back)   Unable, no sitting balance   0
Major help (one or two people, physical), can sit   5
Minor help (verbal or physical)   10
Independent   15
9. Mobility (on level surfaces)   Immobile or < 50 yards   0
Wheelchair independent, including corners, > 50 yards   5
Walks with help of one person (verbal or physical) > 50 yards   10
Independent (but may use any aid; for example, stick) > 50 yards   15
10. Stairs   Unable   0
Needs help (verbal, physical, carrying aid)   5
Independent   10

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Gundo V. et al: Randomized comparative study Ekangavir Rasa, Vaitarana Basti, Shirobasti

3. NIH Stroke Scale Scoring

SN Symptoms Gradation of symptoms Score   
1.a Level of Consciousness (LOC) Arousal Status Alert (or awakens easily and stays awake) Drowsy (Responds to minor steam. but falls back asleep) Obtunded (Responds only to deep pain or vigorous steam) Comatose (No response) 0 1 2 3
1.b LOC- Questions Month? Age?   0 1 2
1.c LOC– Commands Opens/closes eyes /closes Opens hands   0 1 2
2. Eye Movements: Horizontal eye Movements   0 1 2
3.   Visual fields: Sees objects in Four quadrants   0 1 2 3
4. Facial: Facial movements   0 1 2 3
5.a Motor – Left Arm Hold arm straight out from chest   0 1 2 3 4 N/A
5.b Motor – Right Arm Hold arm straight out from chest Normal (No drift at all) Drift (Drifts downward but NOT to bed before 10 sec.) Drifts to bed within 10 seconds Movement, but not against gravity Complete paralysis (No movement at all) Amputation or joint fusion 0   1   2   3   4   N/A
6.a Motor – Left leg Keep leg off bed Normal (No drift at all) Drift (Drifts downward but NOT to bed before 5 sec.) Drifts to bed within 5 secs Movement, but not against gravity Complete paralysis (No movement at all) Amputation or joint fusion 0   1   2 3   4   N/A
6.b Motor – Right leg Keep leg off bed Normal (No drift at all) Drift (Drifts downward but NOT to bed before 5 sec.) Drifts to bed within 5 seconds Movement, but not against gravity Complete paralysis (No movement at all) Amputation or joint fusion 0   1   2   3   4   N/A
7. Limb Ataxia Finger-Nose Heel-Knee-Shin Absent (no ataxia, OR pt cannot move arm/leg) Present in one limb Present in two or more limbs (is absent if patient cannot understand or is too weak to do) 0   1   2
8. Sensory Hemisensory loss: (Test on face, arm & thigh) Absent (no ataxia, OR pt cannot move arm/leg) Present in one limb Present in two or more limbs (is absent if patient cannot understand or is too weak to do) 0   1 2
9. Language/Aphasia Repetition & Comprehension “Today is a bright sunny day” Normal ability uses words and follow commands Mild to Moderate (Repeats / names with some difficulty) Severe Aphasia (very few words correct or understood) Mute (no ability to speak or understand at all) 0   1     2      
10. Dysarthria (slurred) Speech clarity (slurring) Normal Mild to moderate slurred speech (some or most) Severe (unintelligible - none understandable) Intubated or another physical barrier 0 1   2   N/A
11. Neglect Ignores touch or vision to one side No abnormality Mild (either visual or tactile – partial neglect) Profound (Visual and tactile – complete neglect) 0   1   2
  Total Score    

4. Muscle Power Grade

SN Gradation Score
1. No power 0
2. Flicker of contraction only 1
3. Movement with gravity eliminated 2
4. Movement against gravity 3
5. Movement against gravity and some resistance 4
6.      Normal Power 5

5. Muscle Tone

Grade Description
0 No increase in muscle tone
1 Slight increase in muscle tone, manifested by a catch and released or by minimal resistance at the end of the range of motion when the affected part (s) is moved in flexion or extension.
1+ Slight increase in muscle tone, manifested by a catch, followed by minimal resistance throughout the remainder (less than half) of the ROM.
2 More marked increased in muscle tone through most of the ROM, but affected part (s) easily moved
3 Considerable increased in muscle tone, passive movement difficult.

6. Investigational Parameters: CBC with ESR, BSL- Fasting & Post-Prandial, Urine Routine & Microscopic, Lipid Profile

Overall Assessment of the Therapy

1. Complete relief 100% relief in the all signs and symptoms of the patient
2. Marked Improvement More than 75% relief in signs and symptoms
3. Moderate Improvement Relief between 50% to 75% all the signs and symptoms of the patient will be considered as moderately improved.
4. Mild Improvement 25% to 50%of relief in the signs and symptoms will be categorised as mild improved.
5. Unchanged Less than 25% of relief in signs and symptoms will be considered as unchanged.
6. LAMA Patients discontinuing treatment due to any circumstances will be included in LAMA group (Left against Medical Advice).

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Gundo V. et al: Randomized comparative study Ekangavir Rasa, Vaitarana Basti, Shirobasti

Study Procedure: In the present study entitled “Randomized comparative study on Ekangavir Rasa, Vaitarana Basti, Shirobasti in combination on Barthel Index and NIH Stroke Scale in Pakshavadh with special reference to Cerebral Infarction” total 60 patients of Pakshavadha were thoroughly studied. Patients of Pakshavadh attending O.P.D and I.P.D of the Kayachikitsa Department of this institute were randomly selected irrespective of age, sex, religion and socio-economic status. All these patients were diagnosed with the help of clinical features and laboratory investigations in both Ayurvedic and modern perspective. All these patients were randomly distributed into two groups namely Trial Group and Control Group by using chit method, described earlier. 30 patient of Trial Group were given Vaitarana Basti and Anuvasana Basti by Kaal Basti Krama for 16 days as stated by Charaka and Shirobasti for 15 days, along with this Shaman Drug Ekangvir Rasa for 30 days was given. Investigation and Assessment were done on 0 day, 16 day and final on 31st day. Same treatment was given to Control Group but without Shirobasti.[23,24] All observations and results obtained in both group are described in tabular form.

Observations and Result

Table 1: Showing Effect on Symptom Score of 60 Patients of Pakshavadh

SN Symptoms Trial Group Control Group
BT AT Diff % of Relief BT AT Diff % of Relief
1. Hatekpaksha 75 46 29 38.66 68 34 34 50
2. Mukhavakrata 23 11 12 52.17 17 09 08 47.05
3. Ruja 76 46 30 39.47 79 41 38 48.10

Table 2:  Showing Effect on Functional Parameter Score

SN Parameter Trial Group Control Group
BT AT Diff % of Relief BT AT Diff % of Relief
1. Barthel Index 1920 2430 510 26.56 2425 2710 285 12.75
2. NIH stroke Scale 274 172 102 37.22 208 94 114 54.80
3. Grip Power 2245 3290 1045 46.54 2890 4360 1470 50.86

Table 3: Showing effect on Muscle Power Grade Parameter Score

SN Parameter Trial Group Control Group
BT AT Diff % of Relief BT AT Diff % of Relief
1. RUL 120 134 11 09.16 126 138 08 06.34
2. LPL 106 124 18 16.98 120 130 10 08.33
3. RLL 122 133 07 05.73 135 143 11 08.14
4. LLL 128 136 08 06.25 129 133 04 03.10

Table 4: Showing Wilcoxon Signed Rank Test on symptom score

SN Symptoms Groups W T+ T_ Median Mean ± SD % of Relief Z   P
BT AT BT AT Diff ± SD
1. Hataekapaksha TG 231 231 0 2 1 2.42±0.49 1.56±0.76 0.90±0.78 36.11 226.23 <0.0001
CG 351 351 0 2 1 2.26±0.63 1.13±0.81 1.13±0.81 98.39 346.23 <0.0001
2. Mukhavakrata TG 78 78 0 1 0 0.76±0.67 0.36±0.49 0.40±0.49 33.33 73.23 0.0005
CG 28 28 0 0 0 0.56±0.67 0.300±0.46 0.26±0.52 13.33 23.23 0.0156
3. Ruja TG 325 325 0 2 1 2.52±1.04 1.36±0.92 1.16±0.87 41.61 320.23 <0.0001
CG 351 351 0 2 1 2.63±0.99 1.36±1.15 1.26±0.98 44.83 346.23 <0.0001

Table 5: Showing Mann Whitney Test on symptom score of 60 Patients of Pakshavadh


SN Symptom U’(U1) U stat (U2) T1 (sum of Rank TG T2 (Sum of Rank CG Median Mean ± SD of TG Mean ±SD of CG Z P
TG CG
1. Hataekapaksha 519 381 846 984 1 1 0.83±0.79 1.06±0.86 1.013 0.30
2. Mukhavakrata 540 360 1005 825 0 0 0.40±0.59 0.20±0.40 1.32 0.17
3. Ruja 445 424 880 899 1 1 1.10±0.90 1.06±8.06 0.37 0.87

Table 6:  Showing Wilcoxon Signed Rank Test on Parameters of Assessment 

SN Symptoms Groups W T+ T_ Median Mean ± SD % of Relief Z   P
BT AT BT AT Diff ± SD
1. Barthel Index TG -406 0 -406 65 85 64±20.26 81±17 -17 ± 13.94 18.33 -410.77 <0.0001
CG -231 0 -231 82 95 80.83±15.14 90.33±15.30 -9.5 ±8.93 -12.55 -235.7 <0.0001
2. NIH Stroke Scale TG 444 454 -10.15 8 5 9.13±5.29 5.66±3.60 3.46±3.30 36.51 439.23 <0.0001
CG 406 406 0 6.5 2 6.93±3.24 3.13±2.96 3.80±2.69 55.991 401.23 <0.0001
3. Grip Power TG -231 0 -231 81.57 120 83.14±79.52 113.4±99.49 -38.40±34.72 33.59 -235.77 <0.0001
CG -276 0 -276 80 145 96.33±85.52 145.33±99.81 -49.00 ±53.06 28.38 -280.77 <0.0001

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Gundo V. et al: Randomized comparative study Ekangavir Rasa, Vaitarana Basti, Shirobasti

Table 7: Showing Mann Whitney Test on Assessment Score of 60 Patients of Pakshavadh

SN Symptom U’(U1) U stat (U2) T1 (sum of Rank TG T2 (Sum Of Rank CG Median Mean ± SD of TG Mean ± SD of CG Z P
TG CG
1. Barthel Index 543 297 732 978 15 10 15.17±16.71 9.31±9.03 1.36 0.056
2. NIH stroke scale 493 372 841 928 2 3 3.40±3.34 3.58±2.47 1.14 0.3786
3. Grip power 510 389 854 975 30 40 34.16±35.38 49±53.06 0.89 0.3741

Table 8: Showing Wilcox on Signed Rank Test on Assessment Score on Muscle Power Grade

SN MPG Groups W T+ T_ Median Mean ± SD % of Relief Z   P
BT AT BT AT Diff ± SD
1. RUL TG -36 0 -36 4 5 4.06±1.34 4.46±0.76 0.40±0.84 -3.49 -40.77 0.0078
CG -36 0 -36 5 5 4.20±1.32 4.60±0.72 -0.40 ±0.77 -5.55 -40.77 0.0078
2. LUL TG -78 0 -78 4 5 3.53±1.64 4.13±1.36 -0.60±0.98 -9.46 -82.77 0.0005
CG -28 0 -28 4 4 4.00±1.71 4.33±0.84 -0.33 ±0.80 -1.5 -32.77 0.0156
3. RLL TG -36 0 -36 4 5 4.06±1.18 4.43±0.80 -0.36±0.83 21.26 -40.77 0.0078
CG -21 0 -21 5 5 4.50±0.73 4.76±0.50 -0.26±0.54 5.833 -25.77 0.0313
4. LLL TG -36 0 -36 4.26 5 4.26±0.89 4.54±0.67 -0.28±0.51 -8.06 -40.77 0.0078
CG -6 0 -6 4 4 4.30±0.59 4.43±0.56 -0.133±0.43 -3.88 -10.77 0.2500

Table 9: Showing Mann Whitney Test on Muscle Power Grade Score

SN MPG U’(U1) U stat (U2) T1 (sum of Rank TG T2 (Sum Of Rank CG Median Mean ± SD of TG Mean ±SD of CG Z P
TG CG
1. RUL 460 409 874 895 0 0 -0.38±0.84 -0.20±0.77 0.59 0.6959
2. LUL 496 373 838 931 0 0 -0.60±1.003 -0.34±0.81 1.13 0.3436
3. RLL 443 427 908 862 0 0 0.23±0.50 0.34±1.01 0.33 0.9060
4. LLL 476 393 858 911 0 0 -0.23±0.56 -0.12±0.44 0.83 0.5173

Table 10: Showing Effect on Wilcox on Signed Rank Test on Investigation Score 


SN Symptoms Groups W T+ T_ Median Mean ± SD % of Relief Z   P
BT AT BT AT Diff ± SD
1. HB % TG 34 220 186 12 13 12.19±2.85 13.10±3.03 0.19±1.38 9.37 215.23 0.7067
CG 52 201 149 13 13 12.91±2.15 12.45±3.85 0.54±3.07 7.38 196.23 0.5165
2. TLC TG 34 220 186 12 13 12.19±2.85 13.10±3.03 0.19±1.38 16.77 215.23 0.7067
CG 30 247 297 6900 700 6520±2766 6403±2328 117±1505 16.38 242.23 0.7655
3. LDL TG 351 351 0 128 120 131±57 116±43.69 14.63±37.49 7.00 346.23 <0.0008
CG 287 306 19 135 128 143±29.26 135±26.80 8.66±24.12 5.18 301.23 0.0001
4. HDL TG 26 139 113 40 40 36.26±20.33 36.76±17.40 0.49±10.19 19.71 134.23 0.6845
CG 119 186 67 42 40 43±9.12 40±8.81 2.83±9.54 6.44 181.23 0.0534
5. BSL (F) TG 41 197 238 92 91 92.70±25.50 93.27±22.17 0.56±13.23 0.88 192.23 0.6653
CG 200 317 117 97 98 107±27.86 99.56±19.96 8.16±18.95 13.13 312.23 0.0313
6.        BSL(PP)   TG 124 279 155 111 111 127±49.98 114±28.50 12.86±41.28 2.08 274.23 0.1825
CG 169 302 133 122 116 129±36.96 114±23.86 14.40±33.12 7.41 297.23 0.069

Table 11: Showing Effect of Therapy by Paired t-Test on Haematological Parameter


SN Parameter Groups Mean ± SD Mean of Diff. ± SD SED t P
BT AT
1. ESR TG 28.83±20.2 18.03±13.23 10.18±14.55 2.65 4.065 0.0003
CG 28.63±21.40 19.03±17.89 9.60±10.46 1.91 5.025 <0.0001
2. TC TG 186±71 156±35.05 29.90±67.82 12.38 2.41 0.0223
CG 183±65.14 155±30.47 27.66±52.86 9.65 2.86 0.0077
3. TG TG 141±64.96 149±59.63 13.39±49.19 9.13 1.46 0.1534
CG 143±74.67 122±53.33 21.23±44.42 8.11 2.61 0.0129

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Gundo V. et al: Randomized comparative study Ekangavir Rasa, Vaitarana Basti, Shirobasti

Table 12: Showing Overall Assessment on Total 60 Patients of Pakshavadh

SN Overall Assessment Trial Group Control Group
No. of Patients Percentage % No. of Patient s Percentage %
1. Complete remission 00 00 00 00
2. Moderate improvement 00 00 00 00
3. Marked Improvement 00 00 00 00
4. Mild Improvement 14 46.66 06 20
5. Unchanged 16 53.33 24 80
6. LAMA 00 00 00 00

Discussion

Vayu the most vital Dosha has an important role in living being as it acts as Pranadayak and Chetanakaraka. Life of all individuals or general physiology of body depends upon Vayu because it has Gati. Under the influence of Vayu; Kapha and Pitta gets activated and works normally and properly. If Vayu increases or obstructed by Vikrit Kapha, Pitta, Dhatu, Mala or Paraspar Avarana of Vata this leads to manifestation of Vata Vyadhi. Pakshavadh as explained by Charak is one of the diseases of Madhyam Roga Marga and it is suppressed to be a Kashtasadhya Vyadhi.

There are various causes responsible for Pakshavadh. A chronic habit of tobacco chewing, alcohol consumption, cigarette smoking and betal nuts chewing are increasing day by day. This causes atherosclerotic changes or decreased oxygen supply to blood vessels or create toxicity to the blood leads to formation of thrombus, clot, emboli or increased in pressure on blood vessels may also leads to haemorrhage. All these factors causes increased arterial pressure leads to hypertension. According to modern science treatment for stroke consist of diuretics that will be further helpful to minimize released pressure on blood vessels of brain. Anti-platelet and Anti-coagulant to dissolve clot are also given adventurously. Also, in some patients oxygen supply may require in acute conditions or it can also be given for other causes like Asthama and Vascular diseases. Only primary treatment is given and patient left with physical disability and patient turn towards Ayurveda for further management. And side effect of modern drugs also observed in some days. Considering this fact Vaitarana Basti, Anuvasana Basti with Prasarini Tail, Ekangvir Rasa and Shirobasti was taken in the study.

Conclusion

Combination of this Ayurvedic treatment definitely reduced symptoms of Pakshavadh and had beneficial role on Barthel Index and NIH Stroke Scale of Pakshavadh with special reference to cerebral infarction.

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Gundo V. et al: Randomized comparative study Ekangavir Rasa, Vaitarana Basti, Shirobasti
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