A Successfull Case Study of
Kranastarava in Terms of Nidan, Samprapati, Samprapti Ghatak and Samanya And Vishesh Chikitsa with Rakshoghna Dravya Karna Dhupan Karma and Internal Medications.
Case Study Full Article:
A study on the Efficacy of Rakshoghna Dravya Dhupana in the managment of Karnastrav.
https://medicaljournals.stmjournals.in/index.php/JoAYUSH/article/view/3337
Publication:
Journal Of AYUSH: Ayurveda, Yoga, Unani, Siddha and homeopathy.
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Case Study: Efficacy of Rakshoghna Dravya Dhupana in Managment of KarnaStrav.
1. RAKSHOGHNA DRAVYA DHUPANA IN
MANAGEMENT OF KARNA STRAV (ACUTE
SUPPURATIVE OTITIS MEDIA) – A CASE STUDY
By :
Sejal D. Gamit
Assistant Prof./ Consultant
Shalakya Tantra Department
Sumandeep Ayurved Medical College & Hospital.
6. Tympanic Membrane:
Synonyms: Ear drum, Myringa
Definition: A thin membrane that separates the external ear from the middle
ear.
Site: Located at medial end of the external auditory canal, separating it from the
middle ear cavity
Position: At an angle of 55° to the horizontal to the floor and directed
downward, forward and laterally. It is horizontal in newborns.
Shape: Oval Concave laterally (towards external auditory canal) and slightly
drawn inwards at its center – the umbo, where the handle of malleus is attached.
Size:
Length: 9-10 mm
Width: 8-9 mm
Thickness: 0.1 mm
Structure:
Outer epithelial/cutaneous layer
Middle fibrous layer
Inner mucosal layer
Color:
Pars tensa: pearly white/grey
Pars flaccida: pinkish
13. In Karnastrav there is one type of Vran occurs in Tympanic membrane
and then discharge comes out.
Achary Sushrut has described Sevral Dravya Dhupan for Karnastrava.
तो गुग्गुल्वगुरुसजणरसवचागौरसषणपचूणैलणवणशिम्बपत्रशवशमश्रैराज्ययुक्तैधूणपयेत् |
आज्यिेषेण चास्य प्राणाि् समालिेत ||
- सु.सू.5/18
There is also a reference of Rakshoghna Dhup for Vrandhupan So if
Karnastrav taken as Vran in tympanic membrane, Rakshoghna Dhup
Drugs were taken for Karnadupan in Karnastrav.
14. ASOM
Common infection affecting middle ear mucosa.
Stage of Tubal Occlusion
Stage of Pre-suppuration
Stage Of Suppuration
Stage Of Resolution
Stage Of Complication
16. CASE REPORT:
Age : 44 Years
Sex : Female
Occupation : House
Wife
Marital Status : Married
Address : Jodhpur,
Ahmedabad
COMPLAINTS - DURATIONS:
S.N. Symptoms Durations
1 Karna Gauravata-Heaviness of Both Ears 1 month
2 Karna Shul-Mild Pain 1 month
3 Karnastrav-Ear Discharge 1 month
4 Karna Shravan Alpata-Hearing Loss 15–20 days
5 Karna Avidhyaman Dhvani Shruti-Tinitus 15–20 days
6 Karna Kandu-Itching 15–20 days
7 Nasa Strav-Nasal Discharge 1 yr (Recurrent)
8 Shiro Gauravta-Heaviness of Head 1 yr (Recurrent)
17. PAST HISTORY:
Patient having Rhinitis and Heaviness of Head in recurrent condition since last
1 year.
The patient received oral antibiotics and analgesics medications since 15 days
but only get relief as long as the effect of the medicines lasts and symptoms
occurs intermediately.
PERSONAL HISTORY :
Diet : Mixed
Appetite : Good
Sleep : Disturbed
Bowel : 2 times / day
Micturition : 5-6 times /day
18. EXAMINATION:
• EAR:
External Auditory Canal - B/L Moderate Creamish Yellow Discharge present
• Moderate Pulsatile discharge
• Non-foul smelling
Tympanic Membrane – B/L Perforation
• Left :A small central perforation in the Antero inferior Quadrant.
• Right: Medium size central perforation.
• Hearing Test:
• Rinne test was negative.
• Weber test was lateralized to affected side and ABC was normal. Which shows Mild
Conductive Deafness.
19. • NOSE:
Nasal Mucosa – Mild inflamed
Left side Nasal septum Deviation
• THROAT:
Ant. And Post. Pillar – Mild Congested
P.P.W- Mild Congested
20. S.N. Type of Drug Drug Dose Anupana/Sahpana
1. Compound Drug Sitopaladi Churna–3 gm
Haridra Churna–2 gm
Trikatu Churna–500 mg
5 gm Twice a day After Meal Honey
2 Single Drug Yastimadhu Ghanvati 3–4 Tab. in whole day for
Chusanarthe.
-----
3 Single Drug Sarivadi Vati 2 tab. Twice a day After Meal Ushnodaka
4 Single Drug Gandhak Rasayan Tab. 2 tab. Twice a day After Meal -----
5 Karna Dhupan
(Ear Fumigation)
Guggalu, Sarjras, Agru,
Vacha, Lavan Nimb Patra,
Gaur Sarshap, Ghrit.
Twice a day ------
TREATMENT:
21. PATHYAPATHYA CHART :
Pathya Apathya
Aahara
• Grains: One Year Old Grains, Kulatha
• Pulses: Mung, Urad
• Vegetables: Kankoda, Sarsav, Mulak, Lahsun,
• Green Vegetables: Spinach, Fenugreek, Suva,Matla
• Fruits: Badar, Dadim, Kele, Mosambi, Amla, Nimbu, Harde.
• Milk Dish: Cow Ghee–Milk, Butter
• Others: Saindhav, Puran Madhu, Marich
• Pulses: Chickpeas, Peas, Samo
• Contraindicated food–All sour fruits with Milk–Meat–Onion–
Garlic–Radish–Carrot–Jaggery– With Basil, Ginger, Curd
with–Radish, Sesame, Garlic, Urad, Milk, Jaggery with–Sesame,
Banana,With Ghee Equal Parts Honey
• Other: Curd, Fish, Sour–Spicy Food
Vihara
• Drink cow's ghee mixed with fresh milk.
• Keeping silence
• Rest
• Karna Abhyanga: Massaging the ears withLuke warm oil.
• Consumption of dew point
• Bathe by dipping/pouring water on the head.
• Ear bud put In the ear
• Cleaning teeth with Dantun
• Anger, grief
• Anxiety
• Cool water/atmosphere
• Fasting
• More exercise
• Alcohol consumption
22. Gradations
Grades
Features
0 1 2 3
Ear Discharge Absent
Mild–scanty
secretion near the
tympanic membrane
Moderate–secretion irritating in
the ear canal
Profuse–secretion coming outof
ear canal
Pain Absent Not continuous
Continuous but not hamper
normal activity
Continuous throughout and
hamper normal activity
Itching Absent Occasional Continuous Mild Continues Sever
Hearing Loss Absent
Unable to hear the
whispering voice
Unable to hear normal voice Unable to hear a loud voice
Tinitus Absent Present ------------ ------------
Heaviness Absent Present ------------ ------------
Nasal
Discharge
Absent Present ------------ ------------
24. FOLLOW UP:
• The patient came regularly in interval of 7 days for 1 month.
• After completion of treatment there was no recurrence for 3 month, General
health of patient get improved by supporting treatment.
26. • According to Ayurveda classics, Vata Dosha is responsible for
Karnastrav in which Strav is the main symptom.
• One of the most important features of Ruksha sweda (Dry heat) is
dryness.
• Hence in Karnastrav, Karna Dhupan is a choice of treatment because
it not only dries up the Strav but also creates the unfavorable
condition for the growth of microbes. The fumes of Dhupan may
bring out the sedative effect and dries up the Strav.
• Heat also helps in vasodilatation and increased blood circulation
thereby helping in better absorption of drugs and healing.
• This Rakshoghna Drvavya drugs also having Anti-Fungal, Anti-
Bacterial, Anti-Inflammatory, Anti- Septic and Anti-Spasmodic
properties that helps to pacify the Dosha of Karna and helps to
reduce discharge.
WHY KARNA DHUPAN ?
27. Mode of Actions of Internal medications:
Sitopaladi Churna
Haridra Churna
Trikatu Churna
Combine work on
Tridosha
Helps to reduce
Inflammation and
pain
Reduce Nasal
Discharge and
heaviness of Head.
Yastimadhu Ghanvati
Madhur Rasa, Guru and Snigdha
Guna,
Madhur Vipaka and Sheeta
Virya and Sandhaniya,
Kandughna Karma
Helps internally to treat
Nasastrav and Karna kandu.
Also having Anti-
inflammatory, Anti-Viral,
Anti Allergic, healing
properties which helps to
subside the Inflammation
and congestion of nose and
Throat
Sarivadi Vati
Acts on Vata, Pitta and
Kapha Doshas
Useful in tinnitus,
ear infection and
chronic respiratory
diseases
Gandhaka Rasayana
Kandughna Properties
and bestowed with
powerful healing
properties including
Analgesic that reduces
tenderness and pain of
soft tissues.
28. CONCLUSION:
Karnastrava (ASOM) is disease which may lead to severe complications such as Putikarna,
CSOM and Cholestetoma.
The results of the study on Rakshoghna Dravya Dhupan with internal medications For the
management of Karnastrav have been extremely encouraging.
The study demonstrates that Rakshoghna Dravya Dhupan is an effective treatment for the
management of Karnastrav. Furthermore, it is easy to use and does not require any complicated
preparation.
Considering all aspects of Karnastrav External Treatment and Internal formulation aid in the
management of Karnastrav, It has been observed that it helps in reducing the symptoms of the
discharge, perforation, and impaired hearing. It was also found to be helpful in improving the
overall quality of life of the patients suffering from this condition.
The mode of treatment was found to be cost effective, safe and ease to implement.