Therapeutic Efficacy of Nasa-agra Siravyadha and Shamana Chikitsa in Nasal Hyper-Reactivity (Kshavathu): A Case Study

Introduction: Kshavathu is described in Ayurvedic classics as a disorder characterized by repeated expulsion of vitiated Vata associated with Kapha through the nasal passage, leading to frequent sneezing. Clinically, it resembles Non-Allergic Rhinitis in modern medicine, where nasal hyper-reactivity causes recurrent sneezing without allergic etiology. Conventional management primarily focuses on symptomatic relief, and long-term satisfactory outcomes are often limited in cases of non-allergic rhinitis. This necessitates exploration of effective Ayurvedic interventions. In the present case, Siravyadha Karma was specifically performed at the Nasa-agra (tip of the nose) region. The targeted intervention resulted in significant reduction in the frequency and intensity of sneezing, along with improvement in associated nasal symptoms. This study highlights the effectiveness of localized Siravyadha Karma at Nasa-agra as a safe and promising therapeutic modality in the management of Kṣavathu, particularly in cases correlating with non-allergic rhinitis. 
Methods- A 36-year-old female patient diagnosed with of Kshavathu was selected. Siravedha Karma was performed in three sittings at 7-day intervals (Day 0, 7, 14). Anu Taila Pratimarsha Nasya (2 drops each nostril twice daily) and Shatavari Churna (Asperagus Racemosa) (3 g twice daily with milk) were administered for 30 days. Assessment was done on subjective symptom scoring before and after treatment. 
Results-Significant reduction in sneezing frequency, nasal irritation and watery discharge was observed. 
Conclusion- The combined therapy showed promising results in reducing nasal hyper-reactivity and recurrent sneezing in Kshavathu.