The effectiveness of Ayurvedic oil based nasal instillation (Nasya) medicines for the treatment of facial paralysis (Ardita): a systematic review protocol

Abstract

Review question/objective The objective of this review is to establish the effectiveness of oil based nasal instillation medicines in the treatment of Ardita (facial paralysis). The question that will be asked in the review is: Which of the commonly used Ayurvedic nasal instillation medicated oils is the most effective for treating Ardita either solely or in combination with other Ayurvedic medical interventions? Inclusion criteria Types of participants Adults (18-70 years of age) with Ardita (chronic or acute) are the participants to be included in this review. More specifically, the review will consider for inclusion studies that have examined the effectiveness of Naysa for treating acute or chronic Ardita in adults. An inclusive approach will be adopted with respect to geographical location of the participants with patients located in any country, and both rural and urban areas to be considered. Participants of any socio-economic status, both sexes and all ethnic origins will be considered. Studies whose participants have been pregnant women, adults older than 70 years and patients with allergic rhinitis, fever, intracranial tumour/haemorrhage and bilateral facial palsy will be excluded from the review. The reason for the lower age limit of 18 is because oil based Nasya is not usually administered to children, according to the ancient textual source Astanga Hridaya Sootra Sthanna. Types of intervention(s) and comparator(s) The review will include for consideration all quantitative studies conducted worldwide that have examined the effectiveness of nasal instillation of Ayurvedic oil-based herbal medicine. All studies that quantified the effectiveness of Nasya either administered by a therapist or by self administration in treating facial paralysis will be considered for inclusion. All dosages and frequencies of Nasya use will be considered and if possible how effectiveness varies with dosage and frequency of use will be detailed in the analysis. All studies in which the comparator was conventional medical management or placebo will be considered for inclusion. However, studies of Ayurvedic Nasya medicine in conjunction with conventional medicine, if any, will be excluded. As the objective is not only to shed light on the effectiveness of Nasya for treating facial paralysis, but also the effectiveness of one kind of Nasya medicine compared to another, all studies that have compared the effectiveness of one Nasya instillation medicine compared to another will be considered. Types of Outcomes The review will consider both Ayurvedic and Conventional medicine outcome assessment criterion as described in the research papers. With respect to the conventional medicine this will include, but not be limited to facial function as measured by the House-Brackmann grading of facial function measure. With respect to the Ayurvedic medicine approach this will include but not limited to Ayurvedic diagnostic scoring.