Introduction
According to Acharya Sushruta, when a person indulges in Nidan Sevan such as excessive exposure to Raja (dust), Dhuma (smoke), intense Abhitapa (severe heat), prolonged exposure to Pravat (headwind), and the suppression of natural urges like Mutra (urination) and Purisha (bowel movement), the Prakupit Doshas invade the Ghrana Pradesh, leading to the development of Nasarsha. These aggravated Doshas lodge in the nasal region, vitiating Twak, Mamsa, and Medo, resulting in the formation of Nasarsha. Sushruta described four types of Nasarsha: Vataja, Pittaja, Kaphaja, and Sannipataja, along with four types of treatments: Aushadhi, Kshar Karma, Agnikarma, and Shastra Karma. Nasarsha can be correlated with nasal polyps.[1] The body constantly attempts to expel unwanted substances, a process that can be correlated with the Chala quality of Vata, particularly Vyana Vayu and Prana Vayu for Urdhva Jatru. When the Nidana (causative factors) are excessive, the Samprapti (pathogenesis) of the disease becomes more complex, leading the body to intensify its efforts to expel these excessive vitiated Dosha from the body.[2] Nasal polyps, associated with conditions like rhinosinusitis, cystic fibrosis, and allergic fungal sinusitis, can be understood as hypersensitivity reactions primarily driven by Vata, aimed at eliminating excess from the body.[3] Therefore, the primary focus should be on avoiding the Nidana and implementing Shodhana (purification), Shamana (pacification), and Prakriti Sthapana (restoration of normalcy) to maintain the normal physiological structure. Special emphasis should be placed on Shodhana to remove the excessively vitiated Doshas from the Urdhva Jatru (region above the clavicle) while preserving the integrity of the nasal mucosa.
The annual incidence of CRSwNP is between 1 and 20 per 1000 population. This incidence declines after 60 years of age. In the normal population the prevalence is between 1 and 4% in adults and 0.1% in children. Nasal polyps are more common in males (2-4:1). There is no racial predilection. Certain systemic diseases carry a much higher incidence of nasal polyps.[4]
Staging of Polyps can be staged based on the size
Stage I: Limited to the extent of middle turbinate
Stage II: Extending beyond the limit of Middle Turbinate.
Stage III: Approaching inferior turbinate.
Stage IV: Going up to the floor of the nose.[5]
Common side effects of intranasal corticosteroids include local irritation and epistaxis. Potential adverse events related to the administration of intranasal corticosteroids are effects on growth, ocular effects, effects on bone and effects on the hypothalamic pituitary-adrenal axis. Cases of adrenal suppression and Cushing's syndrome from systemic absorption have been reported. acute cardiac toxicity is an increasingly recognized potential adverse effect of antimicrobial drug treatment and several agents of the macrolide class of antibiotics are known to interfere with the delayed rectifier potassium current, which results in accumulation of potassium ions in cardiac myocytes and thereby delays cardiac repolarization.[6] To avoid the adverse effects of allopathic medicines, Nasa Pichu is an excellent Chikitsa (treatment)
Acharya Charaka stated that Taila(oil) is highly effective for pacifying Vata due to its qualities such as Vyavayi, Ushna, Guru, and Sneha. When processed with Aushdha (drug) that possesses Vata-pacifying properties, its medicinal benefits are enhanced.[7]
Shikhari Taila, known for its anti-inflammatory and antihistaminic properties, contains ingredients that predominantly exhibit Katu Rasa, Laghu Guna, Ushna Virya, Katu Vipaka, and Kapha-Vata-shamaka qualities. Due to its Vyavayi and Sukhshma Guna, this medicated oil penetrates deep into the fine channels, facilitating Sroto Shodhan (cleansing of the channels).
Administering this medicated oil can help reduce post-nasal and anterior nasal drips, as well as soothe irritation by delivering targeted medicine to the mucosal lining for optimal absorption. Using Nasa Pichu increases the retention time of the oil in the nasal cavity, enhancing its bioavailability and absorption. Regular application of medicated oil in the nose prevents irritation of the mucous membrane caused by allergens such as pollen, dust, and brass particles, thereby helping to manage allergies or infections. Additionally, it aids in removing unwanted substances like allergens from the nasal cavity and supports proper drainage.
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