To Evaluate the Efficacy of sarshap Taila Ear Drops In the Management of Tinnitus (Karnashweda)

forwarded by-

Dr. G.A WAGHMAREMS(SHALAKYA)

Asst. ProfessorMOB +91 9096566633

E MAIL drgw007@gmail.com

SHALAKYA TANTRA DEPARTMENT

Tinnitus-

Tinnitus is the perception of sound in the

ears or head.

In Ayurveda Sushrutacharya refers it as

Karnashweda

AIMS & OBJECTIVE

1) To collect & study the literary data related to Tinnitus

(Karnasweda) from samhita grantha .

2) To study efficacy of sarshap Taila Ear Drops in Tinnitus

(Karnashweda )

sarshap Taila as experimental drug,

Bala taila as standard drug.

objective-

which includes patient’s history, Sign , symptoms

& diagnosis And treatment with sarshap Taila

Ear Drops, both WILCOXON SIGNED RANK TEST & MANN WHITENY TEST are used to find efficacy

of the above drugs in management of Tinnitus

(Karnashweda ) is the objective of my study.

Hetu(causes)AYURVED MODERN

OVER EXERTION

DHATU KSHAYA

FOOD DOMINANT IN

KASHAYA RASA & RUKSHA

GUNA

VAYU PRAKOPA

ABNORMALITY IN EXT,MIDDLE ,INTERNAL EAR.

8TH NERVE ABNORMALITY

ANAEMIA

ARTERIOSCLEROSIS

HYPERTENSION

OTOTOXICITY

Classification-

1)Subjective

&

2)Objective

1)Organic

&

2)functional

According to nature of

disease

1)Short duration

&

2)Long duration

1)Continuous

&

2)Intermittent or

fluctuant

SAMPRAPTI OF KARNASHWEDA

VATA & OTHER DOSHAS EITHER INDIVIDUALLY OR

IN COMBINATION ALONG WITH RAKTA DOSHA

GETS VITIATED BY EXCITING CAUSES &

ACCUMULATED IN SHABDAVAHA STROTAS THERE

BY PRODUCES KARNASHWEDA.

MATERIAL &METHOD

PLACE OF WORK-PATIENT WAS SELECTED FROM OPD & IPD OF SHALAKYA TANTRA DEPARTMENT

NUMBER OF PATIENT -- 60

30 PATIENT IN EACH GROUP.

DURATION OF TREATMENT-

TOTAL RELATIVE DURATION OF TREATMENT IN BOTH GROUPS WERE 21 DAYS,WITH 3 DAYS INTERVAL IN 3 SITTINGS.

GROUP A - sarshap TailaGROUP B - Bala TailaDOSE - 6 drops in each ear canal, in morning & evening.

PATHOLOGICAL INVESTGATION- Hb, TLC, DLC, ESR, BSL

OTHER- Otoscopic examination, Audiogram, X-ray Mastoid etc

METHOD -SIMPLE RANDOM SAMPLING METHOD WAS APPLIED

CRITERIA FOR ASSESMENT-

A)SELECTION

1)DIAGNOSIS FULLY BASED ON AYURVEDIC PRINCIPLE

2)PATIENT WITH AGE GROUP BETWEEN 30 TO 70 Yrs SELECTED

IRRESPECTIVE OF THEIR CASTE, RELIGION & SEX.

B)REJECTION

1)PATIENT SUFFERING FROM MENIERES DISEASE, OTOSCLEROSIS,CSOM.

2)PATIENT WITH OTORRHEA, OTOMYCOSIS & OTHER INFECTIOUS EAR

DISEASE.

Sr. No. Test Result

1. Description

Brown colour oil

-

2. pH(2gm in 100ml water)

Method :by pH Meter

4.86

3. Refractive Index at 400c

Method: as per IS-548

1.465

4. Viscosity at 400c

Method : by Ostwald viscometer

cps 77.44

5. Iodine value

Method : as per IS-548

gl/100gm 116

6. Acid value

Method : as per IS-548

mgkoh/gm 3.53

7. Saponification value

Method : as per IS-548

mgkoh/gm 182

Analysis of sarshap Taila

Sr. No. Test Result

1. Description

Brown colour

-

2. pH(2gm in 100ml water)

Method :by pH Meter

5.45

3. Butyro- Refractometer reading Method of sampling and test for

oils and fats(part1)IS- 548

42.5

4. Viscocity at 400c

Method : by Ostwald viscometer

cps 69.69

5. Iodine value

Method : as per IS-548

gl/100gm 56.19

6. Acid value

Method : as per IS-548

mgkoh/gm 5.59

7. Saponification value

Method : as per IS-548

mgkoh/gm 204

Analysis of BALA Taila

CRITERIA FOR EVALUATION

1.Relief from ringing in ear

2.Relief from deafness

3.Relief from dizziness

4.Relief from earache

5.Relief from blocking of ear

0

0.05

0.1

0.15

0.2

0.25

30-35yr 35-40yr 40-45yr 45-50yr 50-55yr 55-60yr 60-65yr 65-70yr

AGE

OBSERVATION &RESULT

0%

10%

20%

30%

40%

50%

60%

70%

80%

GROUP A B

MALE

FEMALE

Gender

0.00%

10.00%

20.00%

30.00%

40.00%

50.00%

60.00%

70.00%

80.00%

Hindu Boudha Muslim

Group A

Group B

RELIGION

0.00%

10.00%

20.00%

30.00%

40.00%

50.00%

60.00%

70.00%

80.00%

90.00%

Lower Middle High

Group A

Group B

ECONOMIC STATUS

0.00%

10.00%

20.00%

30.00%

40.00%

50.00%

60.00%

1 to 2 yrs 2 to 5 yrs. Above 5 yrs.

Group A

Group B

CHRONICITY OF DISEASE

0

0.1

0.2

0.3

0.4

0.5

0.6

0.7

VP VK PK

GROUP

A

B

PRAKRITI OF PATIENT

0.00%

10.00%

20.00%

30.00%

40.00%

50.00%

60.00%

70.00%

80.00%

Married Unmarried

Group A

Group B

MARRIETAL STATUS

0.00%

5.00%

10.00%

15.00%

20.00%

25.00%

30.00%

35.00%

40.00%

45.00%

Sama Manda Tikshna Visham

Group A

Group B

AGNI

0.00%

5.00%

10.00%

15.00%

20.00%

25.00%

30.00%

35.00%

40.00%

Sama Alpa Adhyashan Visham

Group A

Group B

AHAR PRAMAN

0.00%

10.00%

20.00%

30.00%

40.00%

50.00%

60.00%

70.00%

80.00%

Ruksha Snigdha Ushna Shit

Group A

Group B

AHAR GUNA

0.00%

5.00%

10.00%

15.00%

20.00%

25.00%

30.00%

35.00%

40.00%

45.00%

50.00%

Madhur Amla Lavan Katu

Group A

Group B

AHAR RASA

0.00%

10.00%

20.00%

30.00%

40.00%

50.00%

60.00%

70.00%

80.00%

90.00%

Veg Veg+Non Veg

Group A

Group B

TYPE OF AHAR

RESIDENTIAL AREA

0

0.1

0.2

0.3

0.4

0.5

0.6

0.7

0.8

NOISY CALM

A

B

0

0.05

0.1

0.15

0.2

0.25

0.3

0.35

0.4

0.45

0.5

LABOUR OFFICIAL HOUSEHOLD

GROUP

A

B

NATURE OF WORK

0

0.05

0.1

0.15

0.2

0.25

0.3

0.35

0.4

0.45

0.5

RATRIJAGRAN SAMYAK DIVASWAP

GROUP

A

B

NIDRA

0

0.05

0.1

0.15

0.2

0.25

0.3

0.35

TOBBACO SMOKING ALCOHOL NO HABBIT

GROUP

A

B

ADDICTION

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Vata Dushti Pitta Dushti Kapha Dushti

Group A

Group B

DOSH DUSHTI

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Rasa Dushti Rakta Dushti Mansa Dushti Asthi Dushti Majja Dushti

Group A

Group B

DUSHYA DUSHTI

50.00%

51.00%

52.00%

53.00%

54.00%

55.00%

56.00%

57.00%

Group A Group B

Dizziness

RELIEF IN SYMPTOMS

RESULT-

0.00%

10.00%

20.00%

30.00%

40.00%

50.00%

60.00%

70.00%

80.00%

Grop A Group B

Ringing in Ear

0.00%

10.00%

20.00%

30.00%

40.00%

50.00%

60.00%

70.00%

80.00%

Grop A Group B

Deafness

0.00%

10.00%

20.00%

30.00%

40.00%

50.00%

60.00%

Grop A Group B

Ear-ache

0.00%

10.00%

20.00%

30.00%

40.00%

50.00%

60.00%

Grop A Group B

Blocking of ear

0.00%

10.00%

20.00%

30.00%

40.00%

50.00%

60.00%

Grop A Group B

Total relief in symptom

0.00%

10.00%

20.00%

30.00%

40.00%

50.00%

60.00%

70.00%

80.00%

Excellent Good Fair Unchanged Bad

Group A

Group B

TOTAL EFFECT OF THERAPY

Ringing in ear Mean Median P value Inference

B.T.2.5 2.000

<0.05 Highly

Significant

A.T.0.6667 1.000

Dizziness Mean Median P value Inference

B.T.2.133 2.000

<0.05 Highly

Significant

A.T.0.9333 1.000

WILCOXON SIGNED RANK TEST(EXPERIMENTAL GROUP)

Deafness Mean Median P value Inference

B.T.2.467 2.500

<0.05 Highly

Significant

A.T.0.7000 1.000

Earache Mean Median P value Inference

B.T.1.333 1.000

<0.05 Highly

SignificantA.T.

0.5667 1.000

Blocking of ear Mean Median P value Inference

B.T.2.133 2.000

<0.05 Highly

Significant

A.T.0.9000 1.000

STANDARD GROUP

Dizziness Mean Median P value Inference

B.T.2.233 2.000

<0.05 Highly Significant

A.T.1.067 1.000

Ringing in ear Mean Median P value Inference

B.T.2.333 2.000

<0.05 Highly Significant

A.T.1.367 1.500

deafness Mean Median P value Inference

B.T.2.300 2.000

<0.05 highly Significant

A.T.1.067 1.000

Earache Mean Median P value Inference

B.T.1.467 1.000

<0.05 Highly Significant

A.T.0.8333 1.000

Blocking of ear Mean Median P value Inference

B.T.2.033 2.000

<0.05 Highly Significant

A.T.1.167 1.000

MANN WHITENY TESTDizziness Mean Difference P value Inference

Group A1.200

0.7944 In Significant

Group B1.167

ringing in ear Mean Difference P value Inference

Group A1.833

<0.05 Extremely Significant

Group B0.9667

Deafness Mean Difference P value Inference

Group A1.767

0.0003 Extremely

Significant

Group B1.233

Earache Mean Difference P value Inference

Group A0.7667

0.4641 In Significant

Group B0.6333

Blocking of ear Mean Difference P value Inference

Group A1.233

0.0396 Significant

Group B0.8667

DISSCUSSION

1)The Percentage relief in Dizziness

is found to be 56.25% in group A & 52.23% in group B

2) The Percentage relief in Ringing in ear

is found to be 71.62% in group A & 41.42% in group B

3) The Percentage relief in Deafness

is Found to be 56.25% in group A& 53.62% in group B

4) The Percentage relief in Earache

is Found to be 57.50% in group A & 43.18% in group B

5) The percentage relief In Blocking of ear

is Found to be 58.46% in group A & 42.62 % in group B

AFTER DOING INFERENCE STATISTCALLY BY WILCOXON SIGNNED RANK TEST IT IS FOUND THAT,

1)PATIENT IN GROUP A AFTER TREATMENT SHOWS HIGHLY SIGNIFICANT RESULT IN ALL SYMPTOMS

2)PATIENT IN GROUP B ALSO SHOWS SIGNIFICANT RESULT IN ALL SYMPTOMS

HOWEVER SIGNIFICANT RESULT SHOWNED BY GROUP A IS MORE THAN GROUP B…….

AFTER DOING MANN WHITNEY TEST TO EXAMINE DIFFERENCE BETWWEN RESULT OF BOTH GROUP, IT IS FOUND THAT,

FOR Earache & Dizziness THE INFERENCE IS IN-SIGNIFICANT

i.e THERE IS NO ANY DIFFERENCE IN EFFECT OF TREATMENT IN BOTH GROUP FOR ABOVE SYMPTOMS.

BUT FOR Ringing in ear, deafness & Blocking of ear

THE INFERENCE IS SIGNIFICANT

i.e THERE IS DIFFERENCE IN EFFET OF THERAPY IN BOTH GROUP

FOR ABOVE SYMPTOMS

EFFECT OF THERAPY IN GROUP A SHOWS BETTER RESULT

THAN IN GROUP B.