A RANDOMIZED CONTROLLED CLINICAL STUDY ON THE EFFECT OF NASYA AND NASAPANA WITH DASHAMOOLADI KASHAYA IN THE TREATMENT OF VISHWACHI (CERVICAL RADICULOPATHY)

We are living in a world of bullet trains, AI (Artificial intelligence), and automation, where everything around is moving fast. Today’s lifestyle has led to various disease conditions that don’t necessarily cause death, but can significantly disrupt day to day life. One  such condition is Vishwachi, affecting upper limbs. It is one of the most common type of Vata vyadhi found in clinical practice, in which the Prakupita vata affects the Kandara of Bahu, it is a disorder typically occurs during the most active years of life, characterized by Teevra ruja, Ruk, Stamba, Toda, Karmakshaya, Bahu cheshtapaharana.  Pratyatma lakshana of Vishwachi is radiating pain from the Bahu Prishta to the Hastathalam and Pratyanguli, Acharya Dalhana opines that this condition is similar to Gridhrasi and has two types – Vatajaand Vatakaphaja. Being a Shoola pradhana vataja nanatmaja vyadhi, it deprives the patient’s ability to perform movements of upper limb which in turn makes them unable to carry their routine work. In Allopathy medicine, this condition can be correlated to Cervical Radiculopathy, Cervical radiculopathy is a neurologic    condition    characterized    by dysfunction of a cervical spinal nerve, the roots   of   the   nerve,   or   both.   It   usually presents with pain in the neck and one arm, with a combination of sensory loss, loss of motor  function,  or  reflex changes  in  the affected  nerve-root  distribution. It is associated with movement impairment of the upper limbs in 68% of the cases, scapular pain in 52.5% of cases, paraesthesia in 45.5% of the cases, among others. It’s also associated with diminish Musculoskeletal reflexes. The most common cause of Cervical Radiculopathy is the result of degenerative changes that affect the anatomy of the cervical spine including the vertebral bodies, the intra vertebral discs, the facet joints and the ligament component of cervical spine. Cervical radiculopathies occur at an incidence rate of approximately 85 persons per 100,000. The C7 nerve root is most frequently impacted, with more than half of all cases affecting this level. Roughly a quarter of cases involve the C6 nerve root. Nerve roots C1 to C5 and C8 are less impacted. Risk factors for developing radicular disease include manual labour with heavy lifting, driving, or operating vibrating equipment. Chronic smoking history can increase the risk of radiculopathies. The main goal of treatment in this illness is to alleviate pain , hence analgesics, muscle relaxants, and physiotherapy are all administered. People are turning to Ayurveda to discover a better solution for this ailment due to the negative side effects of pain relievers and surgery. Nasya, an essential part of Panchakarma, has its mesmerizing effect on almost all Urdhwajatrugata vata vyadhis which is already proven by several researches. The hidden element in Nasya, an inevitable therapy leading to another important procedure called Nasapana, an unique contribution given by Acharya chakradatta and has also mentioned in several context by different acharyas. The words "nasyanipeeto", "pibennasyam" are used in the contexts of Nasapana. The lack of extensive literature, standard guidelines on this procedure and dosage of Nasapana has led to its limited practice. however, on the basis of some recent SOP (standard operating procedure) this procedure will be carried out. when Nasya karma is compared  with Nasapana, basic difference is seen with dosage. All preparations are in Kashaya form for Nasapana with large doses compared to Nasya dosage. Hence when large dose in Kashaya is given, definitely has more residence time for Aushadha dravya and thus there is better nasal drug absorption. Some researches proved that, A slight modification in internal usage in the form of Nasapana can give combined effect of Nasya as well as Pana and may be more beneficial by cut shorting the time and frequency of multiple medicament administration i.e Nasya along with conservative medicine usage. This single procedure can save the time as well as it may gives more benefits than Nasya or Pana. Hence an attempt is made to compare the effect of Nasya and Nasapana using Dashamoolaadi kashaya.  Most of the dravyas in Dashamooladi Kashaya has Vatahara and Brihmana Property which can mitigate the shoola pradhana vataja nanatmaja vyadhi called Vishwachi.