A Clinical Study Of Efficacy Of Jala Neti (Nasal Cleansing Procedure) In The Management Of Vataj Pratishayaya W.S.R. To Allergic Rhinitis.

Ayurveda is a science of life which always emphasizes on maintenance of

healthy body, in fact its first aim itself, is preservation and protection of

normal health. To fulfil this aim respected acharya focused on

swasthavritta to maintain method of keeping life healthy.

Pratishyaya is one of the ancient diseases. During the period of Atharva

Veda, words vekelandu, vilohita, devakosha were used for Pratishyaya1

.

Detailed description of Pratishyaya is found in Samhitas. Pratishyaya is a

disease characterized by shyaya or secretion through nose. It is correlated

with allergic rhinitis in the present day. Allergic rhinitis is the most common

chronic condition, with an estimated prevalence in the United States of

5%–22%, which increases from infancy, peaks in childhood and

adolescence, and decreases in the elderly2

. The pollution is increasing day

by day due to manmade environmental changes and over utilization of

natural resources. These changes cannot be avoided, so the best way to

tackle them is by enhancing the internal healing power by means of a

healthy diet and change in lifestyle. Yoga is one of the ideal ways to

prevent and cure pratishyaya and it also has a positive side effect, i.e.,

stress relieving effect, by which one can also prevent many dreaded

diseases like hypertension, diabetes mellitus, etc.According to Yoga, any

obstruction or derangement in the flow of prana due to accumulation of

toxins results in diseases. Human body is formed of 5 types of koshas as

per Upanishads. Annamaya kosha (food sheath), pranamaya kosha (pranic

sheath),manomaya kosha (mental sheath), vijnanamayakosha(gnostic

sheath) and anandamaya kosha (bliss sheath)3

.

Hathayoga Pradipika considers that the body is made up of 72000 nadis

through which the pranic energy flows4

. Any derangement in the flow of this pranic energy due to accumulation of mala (waste or foreign body)

results in disease. Anurjata or allergy is a result of weakened immune

system; hence, purification of nadis (channels) through samanu and

nirmanu nadishuddhi and bringing about strength, steadiness, calmness, in

the body by the practice of shatkarma (especially neti and kapalabhati),

asana, pranayama, dhyana, etc. A great strength develops through

harnessing of inner vital energies and training different organs and systems

to work in coordination. These help in both managing and preventing

allergic rhinitis5

.

Yoga is a group of Physical,Mental & Spiritual practices or disciplines which

originated in ancient India. Neti is an important part of Shatkarma. The

yogic system of body cleansing techniques. It is intended mainly to clean

the air passage. Ayurveda is a system of medicine with historical roots in

the Indian subcontinent. Ayurveda therapies and practices have been

integrated in general wellness application and in some cases in medical

uses.

Rational of

study

Due to urbanization and vast urban development, there is increase

in air pollution, persistent humid atmosphere, respiratory infections are

reported in large numbers in general medical practice and even though

exact statistical data are not available, large number of patients with

problem of allergic rhinitis, sinusitis also comes in OPD of any hospitals.

Ayurveda science mentioned air pollutants like Raja, Dhooma as causative

factors of respiratory illness including Allergic Bronchitis (Shwasa), Allergic

rhinitis (Pratishyaya), Cough (Kasa) and Hiccough (Hikka).

Pratishyaya/allergic Rhinitis occurs much more frequently than before. In

this condition once sinus is infected improper management negligence by

patients and faulty dietary habits lead the disease into a chronic phase. An

Indian study reported that prevalence of allergic rhinitis 10-30% of adults

and 40% of children of population. In modern medical science, quite

effective and wide range of antibiotics and decongestants are available but

these drugs can help only in the initial stage, the modern treatment

modalities for allergic rhinitis are expensive and not free from side effects.

A lot of treatment modalities are also explained by Acharya’s in Ayurveda

for this disease according to the condition of patient and progressions of

disease. All Acharya’s have described pratishyaya treatment according to

Dosha-Dushyasamurchhana.

In Gherand samhita and hathyog pradipika there is one

wander ‘jala neti suddhi kriya’ given and advised it’s Jala Neti in

urdhwajatrugata roga. Hence the study titled as "A Clinical Study Of

Efficacy Of Jala Neti (Nasal Cleansing Procedure) In The Management Of

Vataja Pratishayaya W.S.R. To Allergic Rhinitis.”

Objectives – 8.1 Primary Objective-

To study the effect of Jala neti in management of Vataja Pratishyaya.

8.2 Secondary Objective-

To study Vataja Pratishyaya disease.

To study the jala neti procedure.

Assessment Criteria

Subjective parameters

Based on sign & Symptoms of Allergic Rhinitis – Total Nasal Symptoms

Score 14

1. Nasal obstruction (Nasa avrodh)

2. Rhinorrhea (Nasastrav)

3. Nasal itching (Nasa kandu)

4. Sneezing (kshwathu)

Objective Parameters

6. Absolute Eosinophil count (CBC)

Parameters for

assessment of

study

outcomes

Overall Effect of Therapy (Overall Assessment Criteria) :-

Overall assessment will be done by following -

1. Not cured - No improvement in subjective Criteria

2. Improved - Improvement in Subjective criteria

3. Cured - Improvement in Subjective criteria

Efficacy of

Treatment

(Jalaneti)

Total Nasal

Symptoms

Score (Grade)

Total assessment

Excellent 0 100% Relief in sign &

symptoms

Very mild 1-3 75-99% Relief in sign

& symptoms

Mild 4-6 50- 75% Relief in

sign & symptoms

Moderate 7-9 25-50% Relief in sign

& symptoms

Severe

(Infective)

10-12 0-25% Relief in sign

& symptoms.

Total Nasal Symptoms Score (TNSS)

Minimum Score – 0

Maximum Score – 12