Kati Graham comes under Vatavyadhi and it is one of most common diseases. Their is no direct references about Kati Graham in Bruhatrayi it is explained by Kashyapa Samhita. It is characterised by Shoola, Stabdta, Vedana during Prasarana and Akunchana of Kati and invloves Vata and Kapha Dosha. It can be correlated to lumbar spondylosis and involves the Vata and Kapha Dosha. So treatment involves Vata Kapha Shamana i.e. Snehana, Swedana, Shodhana, Bahirparimarjana Chikista like Kati Basti etc. So research work is carried out with the aim to evalualate the efficacy and safety of traditional and Infrared aided Kati Basti with Sahachara Taila in Kati Graham, and also to make the therapies simpler, easier, convenient, effective and economical and less time taking. Stastically both groups show almost same results or group B shows better results compare to group B and clinically group B had good improvement

Dr. Anand Daddenavar

Dr. Asha Daddenavar

English

Journal of Ayurveda and Integrated Medical Sciences (JAIMS)

                                                      ORIGINAL ARTICLE May-June 2019  Journal of Ayurveda and Integrated Medical Sciences | May - June  2019 | Vol. 4 | Issue 3 1  Evaluation of efficacy and safety of traditional Katibasti and infrared aided Katibasti with Sahachara Taila in Katigraha (Lumbar Spondylosis) Dr. Asha Daddenavar,1  Dr. Anand Daddenavar2 1Assistant Professor, Dept. of Panchakarma, BVVS Ayurveda College and Hospital, Bagalkot, Karnataka, 2Assistant Professor, Dept. of Roga Nidana, Kalidas Ayurvedic Medical College and Hospital, Badami, Karnataka, INDIA.                   INTRODUCTION Ayurveda is one of the most ancient medical sciences of the world. It describes the basis of life process and its applied aspect, health, disease and management in terms of its own principal and approaches. All functions of our body and mind depend on Vata and it is important among Tridosha. Vitaition of it leads to vitiation of other Doshas and derangement of body system. Asthi  Dhatu makes Dharana of Deha. This Asthi Dhatu and Vayu are having Ashraya Ashrayi Sambhandha. When  Vata  Dosha is increased it prone Address for correspondence:  Dr. Asha Daddenavar Assistant Professor, Dept. of Panchakarma, BVVS Ayurveda College and Hospital, Bagalkot, Karnataka, INDIA. E-mail: drashaanandd@gmail.com  Submission Date: 26/04/2019 Accepted Date: 11/06/2019 Access this article online Quick Response Code Website: www.jaims.in  DOI: 10.21760/jaims.4.3.1 to get lodged in the Asthi and Sandhi of Kati Pradesha leads to Katigraha.[1] Panchakarma has become the fastest growing speciality of Ayurveda due to its long lasting healing effect, quick and radical cure. The cost of the treatment is becoming more due to costlier instruments and therapist salary.  An Ayurvedic physician needs a Panchakarma theatre, instrument and therapist for carrying routine Panchakarma procedures.  Now a day practitioners are facing scarcity of skilled therapist because of a very few training institutes. So there is urgent need of inventing newer tools and techniques in order to make the therapies simpler, easier, convenient, effective and economical and less time taking.  OBJECTIVE OF THE STUDY To compare the efficacy and safety of traditional Katibasti and Infrared aided Katibasti with Sahachara Taila in Katigraha. A B S T R A C T  Kati Graham comes under Vatavyadhi and it is one of most common diseases. Their is no direct references about Kati Graham in Bruhatrayi it is explained by  Kashyapa Samhita. It is characterised by Shoola, Stabdta, Vedana during  Prasarana and Akunchana of Kati and invloves Vata and Kapha Dosha. It can be correlated to lumbar spondylosis and involves the Vata and Kapha Dosha. So treatment involves Vata Kapha Shamana i.e. Snehana, Swedana, Shodhana, Bahirparimarjana  Chikista like Kati Basti etc. So research work is carried  out with the aim to evalualate the efficacy and safety of traditional and Infrared aided Kati Basti with Sahachara Taila in Kati Graham, and also to make the therapies simpler, easier, convenient, effective and economical and less time taking.  Stastically  both groups show almost same results or group B shows better results compare to group B and clinically group B had good improvement.      Key words: Katigraha, Lumbar Spodylosis, Kati Basti, Infrared Rays, Sahachara Taila. Dr. Asha Daddenavar et.al. Evaluation of efficacy and safety of traditional Katibasti and infrared aided Katibasti ISSN: 2456-3110                                                   ORIGINAL ARTICLE May-June 2019  Journal of Ayurveda and Integrated Medical Sciences | May - June  2019 | Vol. 4 | Issue 3 2  MATERIALS AND METHODS Source of Data 1. Patients of  Katigraha are randomly selected from OPD and IPD of  R.P. Karadi Ayurvedic Hospital attached to S.V.MA.M.C. Ilkal. 2. The literary aspect was collected from the classical text of Ayurveda and Modern text and research work done. 3. The trail drug is collected locally and prepared in pharmacy of S.V.M.A.M.C. Ilkal, after the identification under the guidance of Rasashashtra and Bhaishajya Kalpana experts. Preparation of Medicine Sahachara Taila[2]  Kalka Dravya :  Sahachara Moola Sneha Dravya: Tila Taila Drava Dravya:  Sahachara Panchanga, Godugda Prakshepaka Dravya: Sugar Procedure: As per classical reference.  Method of collection of data Study design A Randomized Comparative Clinical Study Sample Size ▪  40 patients were selected and divided into two groups, 20 patients in each group. ▪ Group A - 20  patients were treated with Traditional Kati Basti. ▪ Group B - 20 patients were treated with Infrared aided Kati Basti. Diagnostic criteria[3] 1. Pain 2. Tenderness 3. Stiffness 4. Restricted movements of Hip  - Forward bending and Backward bending Inclusion Criteria 1. Age 30 to 60 years of either sex. 2. Pain 3. Tenderness 4. Stiffness 5. Restricted movement of Hip -  Forward bending and Backward bending Exclusion Criteria 1. Age below 30 and above 60 years. 2. Acute inflammation. 3. Fracture and osteoporosis. 4. Bone disease eg -TB, etc.   5. Pregnant women. 6. Disc prolapse, Radiculopathy, Nerve compression. Intervention Group A - Traditional Katibasti [4] Procedure: Make thick dough with black gram powder by mixing with adequate quantity of water. Using this thick dough make a rim and fix it firmly on the low back region where the highest pain is present. Take the Sahachara Taila, warm it and pour on inner wall of rim taking care not to spill out. When oil becomes cool, remove it with cotton and again refill with warm oil. Optimum temperature should be maintained throughout the procedure, time and duration of the procedure is 30 minutes. After 30 min oil should be removed by cotton and then the dough should be removed. Group B - Infrared aided Katibasti  Procedure: Katibasti as same that of the group - A. But first oil is heated with infrared rays till it become warm than that oil was poured to Kati Basti and optimum temperature of oil is maintained with the help of infrared rays. The infrared lamp is kept at right angle to the Kati Basti in the distance of 2ft approximately horizontally from the patient. Surrounding area means other than Kati Basti was covered with cloth. After 30 min. infrared lamp was Dr. Asha Daddenavar et.al. Evaluation of efficacy and safety of traditional Katibasti and infrared aided Katibasti ISSN: 2456-3110                                                   ORIGINAL ARTICLE May-June 2019  Journal of Ayurveda and Integrated Medical Sciences | May - June  2019 | Vol. 4 | Issue 3 3  switched off and removed from the area. There after oil was removed by cotton and then the dough was removed. For both groups starch filled capsules 500 mg BD orally was given from 8th day to 30th day. Assessment Criteria[5] Detail performa adopting standard methods of scoring subjective and objective parameters was analyzed statistically. Subjective Criteria  Pain Grading ▪ Grade 0 - No pain ▪ Grade 1 - Mild pain lasting for less than 15 min occasionally not affects ADL (Activity of daily living) ▪ Grade 2 - Moderate pain lasting for more than 15 min frequently affects ADL. ▪ Grade 3 - Severe pain lasting for more than 30 min more frequently affects ADL badly.       Stiffness Grading ▪ Grade 0 - No stiffness. ▪ Grade 1 - Mild stiffness lasting for less than 15 min in morning occasionally not affects ADL. ▪ Grade 2 - Moderate stiffness lasting for more than 15 min in morning frequently affects ADL. ▪ Grade 3 - Sever stiffness lasting for more than 30 min in morning more frequently affects ADL badly. Mobility  ▪ Grade 0 - No restriction (mobility up to 20 cm) ▪ Grade 1 - Mild restriction (mobility up to 12-18 cm) ▪ Grade 2 - Moderate restriction (mobility up to 8-11 cm) ▪ Grade 3 - Sever restriction (mobility up to 0-7 cm) Scobers test ▪ Grade 0 - Bend up to 20 cm ▪ Grade 1 - Bend up to 15 cm  ▪ Grade 2 - Bend up to 10 cm   ▪ Grade 3 - Bend up to 5 cm SLR test ▪ Grade 0 - Lift up to 75° - 90°  ▪ Grade 1 - Lift up to 60° - Below 75°  ▪ Grade 2 - Lift up to 45° - Below 60° ▪ Grade 3 - Lift up to 30° - Below 45°  Walking time ▪ Grade 0 - 10 ft for 5 sec ▪ Grade 1 - 10 ft for 10 sec ▪ Grade 2 - 10 ft for 15 sec ▪ Grade 3 - 10 ft for 20 sec RESULTS Table 1: Overall response of the treatment.           Overall (%) Group A  Group B  Total  Poor response (Below 25%) 5 (25.0%) 3 (15.0%) 8 (16.0%) Mild response (25-50%) 12 (60.0%) 13 (65.0%) 25 (50.0%) Moderate response (51-75%) 2 (10.0%) 4 (20.0%) 6 (12.0%) Marked response (>75%) 1 (5.0%) 0 1 (2.0%) Total 20 (100.0%) 20 (100.0%) 40 (100.0%) Table 2: Overall response of treatment on Objective parameters. Overall assessment  Group A  Group B  No pain 15% 30% No stiffness 20% 30% No restriction 15% 20% Dr. Asha Daddenavar et.al. Evaluation of efficacy and safety of traditional Katibasti and infrared aided Katibasti ISSN: 2456-3110                                                   ORIGINAL ARTICLE May-June 2019  Journal of Ayurveda and Integrated Medical Sciences | May - June  2019 | Vol. 4 | Issue 3 4  Schober test bend up to 15 cm 50% 35% SLR test negative 30% 50% Walking test : 10ft in 5 sec 5% 0% DISCUSSION In Ayurvedic management of Katigraha, procedures like Snehana, Swedana, Lepa, Kati Basti, Basti and Agnikarma and Shamana Aushadhi  are explained to provide better relief from pain, swelling, mobility. In our trail work Kati Basti with Sahachara Taila act as Vata Kapha Shamaka and  Kati Basti simultaneously Snehana and Swedana will occur.[6]    Discussion on Probable mode of action of Sahachara Taila in Kati Graha[7] In our research work Sahachara Taila is taken for trail and it has following properties. Sahachara Taila contains Sahachara Panchanga, Tila Taila, Dugda and Sharkara.  Sahachara drug has Madhura, Tikta Rasa, Ushna Virya, it act as Vata and Kapha Shamaka. Tila is Madhura, Tikta, Kashaya Rasa and Madhura Vipaka and Ushna Virya all these act as Vata and Kapha Shamaka. Dugdha and Sharkara are Vata Shamaka and Bhrimhana in effect. So from above said properties it helps in Samprapti Vighatana of Kati Graha and helps in reliving symptoms.  Mode of action of  procedure[8] Kati Basti is a Bhahirparimarjana Chikista. In this procedure both effects of  Snehana and Swedana  are achieved at the same time. For Vatavyadhi, Snehana and Swedana are the best line of treatment. As in Kati Basti retension of warm oil is made for 30 mins and  temperature of oil is maintained throughout the procedure. This retention of oil will give the proper Snehana and Swedana effect, and absorption of the oil is get influenced. It is mentioned as heat is the one of factor which  influences  the drug absorption. All these properties will helps in reliving symptoms like Shoola, Stambhata, Veadana during Prasarana and Akunchana. Comparison of the effects of both the therapies It is obvious from the foregoing that Traditional Kati Basti and Infrared aide Kati Basti with Sahachara Taila  provide the slight improved results in  group B i.e.  Infrared aided Kati Basti in both subjective and objective criteria’s. This results are validated from stastical analysis. From this we can substitute the Traditional Kati Basti to Inrared aided Kati Basti which is safe and effective.  CONCLUSION Katigraha is the condition pertains to vitiation on Vata and Kapha Dosha in Kati Pradesha. Traditional Kati Basti and Infrared aided Kati Basti both treatments are very effective can be practiced safely. Traditional Kati Basti is already proved that it is treatment of choice as Bhahirparimarjana Chikitsa in all lumbar disorders. Satistically group A (Traditional Kati Basti) and group B (Infrared aided Kati Basti) both are showning significant results in subjective and objective parameters with slight improved results with group B. From statical analysis we can conclude as Traditional Kati Basti can be replaced to Infrared aided Kati Basti which is safe, effective and less time consuming. REFERENCES 1. Gadanigrha of  Shri Vaidya Sodhala with the vidyotini Hindi commentary, Edited by Sri Gangasahaya Pandeya, edition Reprint 2005, Chuakhamba Sankrit Publication, Varanasi, Part 2 Kayachikista khanda, chapter 26 shloka no. 160 page no.505 2. Charaka Samhita of Agnivesh, edited by Vaidya Harish Chandra Singh Kushwaha, Second Part, Published by Chaukhamba Orientalia, Varanasi, Reprint Edition 2012, Chikistasthana 28 chapter shloka no. 144 page no. 757 3. J. Maheshwari, Essential Orthopaedics, 2nd Revised and Enlarged edition, Published by Enterprint july 2000, chapter 35, page no. 254. Dr. Asha Daddenavar et.al. Evaluation of efficacy and safety of traditional Katibasti and infrared aided Katibasti ISSN: 2456-3110                                                   ORIGINAL ARTICLE May-June 2019  Journal of Ayurveda and Integrated Medical Sciences | May - June  2019 | Vol. 4 | Issue 3 5  4. Vasant Patil, Principle and Practice of Panchakarma, Second Edition, Published by Atreya Ayurveda Publications, chapter 8, page no 166. 5. MACLEOD’S Clinical Examination, Edited by Graham Douglas, 11th Edition, Published by Elsevier Churchill Lovingstone, chapter 10, page no 326. 6. Vaidya Jadavji Trikamji Acharya edited Susrutha Samhitha, Sanskrit translation, Reprint 2008, Choukhamba Surbharati Prakashan, Varanasi, Sutrastana, Chapter 1, Sloka no. 23, Page no. 6.  7. Charaka Samhita of Agnivesh, edited by Vaidya Harish Chandra Singh Kushwaha, Second Part, Chaukhamba Orientalia, Varanasi, Reprint Edition 2012, Chikistasthana 28 chapter shloka no. 144, page no. 757. 8. Vasant Patil, Principle and Practice of Panchakarma, Second Edition, Published by Atreya Ayurveda Publications, chapter 8, page no. 166.      ******************************* How to cite this article: Dr. Asha Daddenavar,  Dr. Anand Daddenavar. Evaluation of efficacy and safety of traditional Katibasti and infrared aided Katibasti with Sahachara Taila in Katigraha (Lumbar Spondylosis). J Ayurveda Integr Med Sci 2019;3:1-5. http://dx.doi.org/10.21760/jaims.4.3.1  Source of Support: Nil, Conflict of Interest: None declared. Copyright © 2019 The Author(s); Published by Maharshi Charaka Ayurveda Organization, Vijayapur (Regd). This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.  

Evaluation of efficacy and safety of traditional Katibasti and infrared aided Katibasti with Sahachara Taila in Katigraha (Lumbar Spondylosis)

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Evaluation of efficacy and safety of traditional Katibasti and infrared aided Katibasti with Sahachara Taila in Katigraha (Lumbar Spondylosis)

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