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RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,
BENGALURU, KARNATAKA.
SYNOPSIS BY
Dr. BIBI AMEENA YALLAPUR
FOR THE DEGREE OF AYURVEDA DHANWANTARI
M.S (AYURVEDA) IN SHALAKYA TANTRA
TITLE OF THE DISSERTATION
“A COMPARATIVE STUDY ON ATIVISHADI TAILA KARNA POORANA
AND PANCHAMULI BALA KSHIRA ORALLY IN THE
MANAGEMENTOF KARNA NADA”
NAME OF THE INSTITUTE
GOVERNMENT AYURVEDIC MEDICAL COLLEGE,
DHANWANTARI ROAD,
BENGALURU – 09,
KARNATAKA.
1
From,
Dr. BIBI AMEENA YALLAPUR,
I M.S, Dept of Post Graduate Studies in Shalakya Tantra,
Government Ayurvedic Medical College,
Bengaluru – 560009
To,
THE REGISTRAR,
Rajiv Gandhi University of Health Sciences,
Bengaluru – 560041
Through,
THE PRINCIPAL
G.A.M.C
Bengaluru – 560009,
AND
H.O.D OF POST GRADUATE
STUDIES IN SHALAKYA TANTRA
G.A.M.C. Bengaluru- 560009.
Respected sir,
Sub:-
Submission of
for Dissertation.
completed
proforma
for
registration
of
subject
I request you to kindly register the below mentioned subject against my name for the
submission of dissertation to the Rajiv Gandhi University of Health Sciences, Bengaluru, for the
partial fulfillment of M.S(Ayu) in (Shalakya Tantra).
TITLE OF DISSERTATION:
“A COMPARATIVE STUDY ON ATIVISHADI TAILA KARNA POORANA AND
PANCHAMULI BALA KSHIRA ORALLY IN THE MANAGEMENT OF KARNA
NADA.”
Herewith I am enclosing completed proforma for registration of subject for dissertation
work.
Thanking you,
Yours sincerely,
Place: Bengaluru.
Date:
(Dr. BIBI AMEENA YALLAPUR)
2
RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,
BENGALURU, KARNATAKA.
ANNEXURE II
PROFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION
1.
NAME OF THE CANDIDATE
AND RESIDENTIAL
ADDRESS
Dr. BIBI AMEENA YALLAPUR,
D/O ABDUL RUB YALLAPUR,
MRITYUNJAYA NAGAR, 3rd CROSS,
1st MAIN, PB ROAD,
RANIBENNUR – 581115.
DIST- HAVERI.
KARNATAKA.
2.
NAME OF THE INSTITUTION
GOVERNMENT AYURVEDA
MEDICAL COLLEGE,
DHANVANTARI ROAD,
BENGALURU-09
3.
COURSE OF STUDY AND
SUBJECT
AYURVEDA DHANVANTARI.
M.S. (AYU), SHALAKYA TANTRA
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DATE OF ADMISSION TO
THE COURSE
02/11/2010
5.
TITLE OF THE DISSERTATION:
A COMPARATIVE STUDY ON ATIVISHADI TAILA KARNA POORANA
AND PANCHAMULI BALA KSHIRA ORALLY IN THE MANAGEMENT OF
KARNA NADA.
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6. BRIEF RESUME OF THE INTENDED WORK
6.1 NEED FOR THE STUDY :
Ear is considered as one of the nava dwaras. There are various diseases affecting the
ears. As a preventive therapy our Acharyas have mentioned karna abhyanga and poorana , i.e
application of oil and massaging ear, filling it with oil in dinacharya (daily regimen). One who
doesn’t indulge in such regimens is sure to be afflicted by the disease of ear.
Karna nada is one among 28 karna rogas described by Acharya Sushrutha. Acc to
Vagbhata it is karna srotogata. Acc to Acharya charaka there are four types of karna roga, where
in Karna nada is one of the symptom of vataja karna roga. Karna nada is a disease where vitiated
vata gets lodged in shabdavaha srotas there by causing different types of sounds in the ear like
bheri, mridanga, shanka etc. In the present day as the incidence of Karna nada is increasing, it is
necessary to find out a solution for the same which is economical and free from side effects
compared to present synthetic preparations which have potential to cause side effects.
The features of Karna nada can be co-related to tinnitus. Tinnitus is the ringing sound
in the ear which causes great stress and emotional handicap. It is estimated that one out of every
5 people experiences tinnitus. The treatment in allied branches is not satisfactory, surgical
intervention is rare in cases and done only when presenting with complicating.
Thus the main aim of the study is comparison so that, to which modality of the
treatment could yield better results in giving relief to those affected by Karna nada.
6.2 REVIEW OF THE LITERATURE
AYURVEDIC VIEWS
:-
कर्णस्रोतास्थिते वाते श्रर्
ृ ोतत ववववधान्सथवरान ् ।
भेरर मद
ृ ङ्ग शङ्खानाां कर्ण नाद: स उच्यते ॥
Vata effecting the canals of ears makes the patient to hear sounds as that produced by
kettle drum, cymbal or conch. This is known as Karna nada. 3 (Ch. 57 Sl.2, p 193)
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NIDANA & SAMPRAPTI:अवश्याय जलक्रीडा कर्णकण्डू यनैमरू
ण त् ।
ममथ्ययोगेन शथरथय कुवितो अन्सयैश्च कोिनै: ॥
प्राप्य श्रोरमशरा: कुयाणच्छूलां स्रोतमस वेगवान ् ।
ते वै कर्णगता रोगा अष्टववांशततरीता: ॥
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( U K.R Sl.1, p312)
Exposure to snow and cold items, swimming / diving , pricking or probing the external
auditory canal, improper instrumentation, sound pollution, abhighata. By above said causes, the
vatadi doshas vitiates shabdavaha srotas and causes ear diseases like karna shoola , bhadirya ,
karna nada etc
LAKSHANA:शब्दवाहि मसरा सांथिे श्रोर्ोतत िवने मुिु: ।
नादान ् अकथमाद् ववववधान ् कर्णनादां वदस्न्सत तम ् ॥
When vata gets localized in the sira( channels ) which convey sound, the person hears
different kinds of sound often, without any reasons. This is known as Karna nada.2 (Us Ch.17
Sl.9, p 156)
यदा तु नाडडषु ववमागणमागणत: स एव शब्दामभविासतु तष्टी ।
श्रर्
ृ ोतत शब्दान ् ववववधाांथतदा नर: प्रर्ादमेनां कियस्न्सत चामयम ्॥
Ringing and various other sounds in the ear are heard when the deranged vayu of the
locality gets into the wrong way and remains there stuffed in the sound carrying channels of the
organ. This disease is called as Pranada 1 (Ut Ch.20 Sl.6, p 242)
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CHIKITSA:कर्णशूले प्रर्ादे च बाधधये क्ष्वेडयोरवि ।
चतर्
ु ाां अवि रोगार्ाां सामान्सयां भेषजां ववद:ु ॥
The course of medical treatment to be pursued in the four forms of ear diseases (all due to
the action of vayu )vis., Karna shula, Pranada , Badhirya and Karna Ksveda is the same.1 (Ut
Ch.21 Sl.3, p 245)
ATIVISHADI TAILA:
िक्वां प्रततववषा हिङ्गुमममशत्वक्थवस्जणकोषर्ै:।
ससुक्तै: िूरर्ात्तैलां रूक् स्रावाश्रतु तनादनुत ् ॥
Oil cooked with prativisha, hingu, mishi, twak, sarjika and ushana and added with shukta
filled into the ears cures pain, exudation and ringing in the ears.2 ( Ut Ch.18 Sl.25 p165)
lÉÉSoÉÉÍkÉrÉïrÉÉåÈ MÑürÉÉïSè uÉÉiÉzÉÔsÉÉå£üqÉÉæwÉkÉqÉç ||
In Karnanada(ringing in the ears) and Badhirya(deafness),the treatment prescribed for
Vatashula(pains caused by aggrevated vata should be done.2(Us Ch.18 Sl22,p165)
PANCHAMULI BALA KSHIRA:
िञ्चमूलीबलामसद्ध क्षीरां वातामये हितम ् ॥5 (Ch.26 Sl.5, p 518)
Kshira prepared with brihat pancha mula and bala mula is useful in vata vyadhi.
MODERN VIEW :6
TINNITUS
Definition :
Tinnitus is a very common and annoying symptom. It may be defined as ringing sound
or noise in the ear or head. The characteristic feature is that the origin of this sound is within the
patient. Tinnitus may be unilateral or bilateral. It has been variously described by the patient as
roaring, hissing, swishing, rustling, or clicking type of noise.
CHARACTERISTICS OF TINNITUS:
1. Intermittent : Tinnitus may be continuous or intermittent, with long or short intervals of
absence of tinnitus
2. Continuous : tinnitus may be present all time .
3. Fluctuant: tinnitus may vary in intensity. It is more marked when the patient is emotionally
perturbed ,or when he is in a quiet atmosphere.
4. Pitch : may be high or low. Sometimes pitch may vary.
CLASSIFICATION :
1. Subjective: which can only be heard by patient.
2. Objective: which can even be heard by the examiner with the use of a Stethoscope.
Causes of tinnitus :
A) SUBJECTIVE
Otologic
Non Otologic
* Impacted wax
* Diseases of CNS
* Fluid in the middle ear
* Anaemia
* Acute & Chronic otitis media
* Arteriosclerosis
* Abnormally patent Eustachian tube
* Hypertension
* Meniere’s Disease
* Hypotension
* Otosclerosis
* Hypoglycaemia
Otologic
Non Otologic
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* Presbyacusis
* Epilepsy
* Noise trauma
* Migraine
* Ototoxic drugs
* Tumours of VIII nerve
* Drugs
B) OBJECTIVE – Otologic

Vascular tumours of middle ear (Glomus tumour)

Aneurysm and arteriovenous shunt around the ear.

Live insects in the ear.

Clonic contractions of the Palatal or tympanic muscles
MANAGEMENT OF TINNITUS
In all forms of medicine, the first and most ideal line of treatment is to treat the cause.
When no cause is found, management includes :
1. Re assurance and psychotherapy.
2. Techniques of relaxation and biofeedback
3. Sedation and tranquillizers
4. Masking of tinnitus – use of fan, loudly clicking clock or a similar device may mask the
tinnitus, use of hearing aid, in persons with hearing loss.
5. Surgical treatment – sectioning of Chorda tympani nerve, or tympanic plexus of nerves or
cochlear nerve may be tried, but usually it does not help the patient.6(p145-146),7(p101-102)
ABBREVIATION :
Ut - Uttara tantra
Us - Uttara sthana
KR - Karna roga chikitsadhikara
Ch - Chapter
Sl - Shloka
P
- page number
U - Uttarardha
PREVIOUS DISSERTATION WORKS DONE :
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1. Maheshwar S Guggari – a clinical study on karna nada and its management with
Apamarga Kshara taila- Bengaluru: Rajiv Gandhi University of Health Sciences 1998.
2. Seetha Lakshmi B S – A study on Karna poorana & its role in the management of karna
nada- a clinical study- Bengaluru: Rajiv Gandhi University of Health sciences 2005.
3. Apeksha D Rao- A comparative study of karna poorana with nasya karma using bala taila
in the management of karna nada-Bengaluru: Rajiv Gandhi University of Health Sciences
2009-2010.
6.3 OBJECTIVES OF STUDY :
1. To evaluate the efficacy of karna poorana with Ativishadi taila in the management of
Karna nada.
2. To evaluate the efficacy of internal administration of Panchamuli bala kshira in the
management of Karna nada.
3. To evaluate the comparative efficacies of Ativishadi taila karna poorana with internal
administration of Panchamuli bala kshira in the management of Karna nada.
7.0 METHODOLOGY:
7.1 SOURCE OF DATA:
The patients with lakshanas of karna nada will be selected from OPD and IPD of
Shalakya Tantra of Sri Jayachamarajendra Institute of Indian Medicine, Bengaluru.
7.2 METHODS OF COLLECTION OF DATA :
A total number of 45 patients having clinical features namely various kinds of sounds
in the ear like hissing, rustling, vertigo, deafness and with no association of other systemic
disease are selected for study.
INCLUSION CRITERIA :
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1. The subjective features of tinnitus with associated symptoms like impaired hearing, vertigo
(giddiness) and fullness sensation are included.
2. Patients aged between 20-60years.
3. Karna nada with intact ear drum.
EXCLUSION CRITERIA :
1. Patients below the age of 20years.
2. Patients suffering from chronic suppurative otitis media.
3. Karna nada due to abhigata (injury).
4. Perforated ear drum.
5. Tinnitus associated with other diseases like vascular tumour of middle ear, aneurysms of
carotid artery, palatal myoclonus,meningitis.
STUDY DESIGN :
Total 45 patients will be selected for the study. They will be divided into 3 groups –
Group A : will be treated with Karna poorana using Ativishadi taila for 7 days with a gap of 7
days for three sittings of about 35 days.
Group B : will be treated with Panchamuli bala kshira orally 50ml twice a day for 7 days with a
gap of 7 days for three sittings of about 35 days.
Group C : will be treated by Ativishadi taila karna poorana along with panchamuli bala kshira
orally for 7 days with a gap of 7 days for three sittings of about 35 days.
DURATION :
Total duration of treatment will be 35 days in each group. In all the three groups clinical
findings and symptoms before treatment and changes in the same with treatment shall be
observed and same shall be recorded in the proforma of case sheet.
FOLLOW UP PERIOD :
Duration shall be fixed for 60 days in all the 3 groups after treatment for observing the
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possible recurrences.
ASSESSMENT CRITERIA :
Assessment will be done on the basis of clinical observations (subjective and objective)
before, during and after treatment.
PARAMETERS :
Subjective Parameter :
1. Ringing sound in the ear.
2. Impaired hearing.
3. Fullness sensation.
4. Vertigo.
Objective Parameter :
1. Pure tone Audiometry.
7.3 INVESTIGATIONS : Audiometric evaluation
ETHICAL CLEARANCE : has been obtained from ethical committee, Government
Ayurvedic Medical College, Bengaluru, for the above said clinical trial.
8. BIBLIOGRAPHY:
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1. Sushruta.Sushruta Samhita, Translated by Kaviraj Kunjalal Bhishagratna, Edited by
Dr.Laxmidhar Dwivedi, 1st ed. Varanasi : Chaukambha Sanskrit Series Office; 1999. vol III.
pp646.
2. Vaghbata.Ashtanga Hridayam, Translated by Prof K.R.Srikanth Murthy, 3rded. Varanasi :
Krishnadas Academy;2000.vol III. pp586.
3. Madhavakara.Madhava Nidana (Roga Viniscaya), Translated by Prof K.R.Srikanth
Murthy,3rd ed. Varanasi : Chaukambha Orientalia;2000.pp329.
4. Yogaratnakara, with ‘Vidyotini’ hindi commentary by Dr.Srilakshmipati Shastri, edited by
Bhishagratna Sri Brahma Shankar Shastri, Varanasi: Chaukambha Publications; 2005. pp504.
5. Govinda Das Sen. Bhaishajya Ratnavali with ‘Siddhiprada’ hindi commentary by Prof Siddhi
Nandan Mishra,1st ed. Varanasi: Chaukambha Sur Bharati Prakashan;Vol I. 2005.pp614.
6. P L Dhingra. Diseases of Ear, Nose and Throat, 5th ed. New Delhi: A division of Reed
Elsevier India Private Limited;2010.pp486.
7. K B Bhargava,S K Bhargava,T M Shah.A short text book of E.N.T Diseases, 7th ed.
Mumbai:Usha Publications;2005.pp426.
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9.
SIGNATURE OF THE
CANDIDATE
10.
REMARKS OF GUIDE
11.
NAME AND DESIGNATION OF
THE GUIDE
11.1
SIGNATURE OF THE GUIDE
11.2
CO-GUIDE IF ANY
11.3
SIGNATURE OF CO-GUIDE
11.4
NAME AND DESIGNATION OF
HEAD OF THE DEPARTMENT
11.5
SIGNATURE OF THE H.O.D.
12.1
REMARKS OF PRINCIPAL
12.2
SIGNATURE OF PRINCIPAL
Dr. SUMITRA .T. GOWDA. MD(AYU)
PROFESSOR, DEPT. OF P.G. STUDIES
IN SHALAKYA TANTRA,
GOVERNMENT AYURVEDA MEDICAL
COLLEGE, BENGALURU-560009
Dr. B.N. RAMESH.MD (AYU)(SHALAKYA)
PROFESSOR AND HOD,
DEPT OF P.G. STUDIES IN
SHALAKYA TANTRA,
G.A.M.C.,BENGALURU-560 009
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