After careful review of the results obtained during the study, following conclusions can be drawn with respect to Pakshaghata and its clinical management, Pharmacological and Ayurgenomics study:

Ø  Peak incidence of the disease was after fifth decade establishing the degenerative aspect of Pakshaghata.

Ø  Physical and mental stress was the most common causative factor noticed. Disturbed biological clock associated with professions like security guards, drivers, farmers and fishermen were found to be more prone for development of Pakshaghata. Most of the patients affected by the disease were of Vata-paittika prakriti. Addiction of tobacco (chewing and smoking) was a prominent finding in most of the patients.

Ø  Maximum patients registered had a history of infarct while hemorrhagic cases were lesser in number. Most common presenting complain was weakness of the motor system involving upper and lower limbs followed by impaired speech and facial weakness. Minimal sensory involvement was seen. Most common associated features were vertigo and headache.

Ø  Group A (Virechana followed by Shamana) and Group B (Basti followed by Shamana) showed comparatively more improvement in clinical manifestations as compared to only Shamana (Masha Baladi Kwatha) treatment, i.e. Group C. These changes were statistically significant.

Ø  Basti provided relatively better improvement in the quality of life and in the management of higher mental functions. Basti was found to be more effective in management of Infarct cases while hemorrhagic cases were better addressed by Virechana.

Ø  Virechana followed by Shamana, managed Motor functions better than Basti followed by Shamana. Prognosis was better in the patients of younger age group and lesser chronicity.

Ø  Safe application of Basti and Virechana was demonstrated through animal study. No pathological findings were reported in the histopathological study.

Ø  Virechana and Basti showed lipid lowering effects after pharmacological study. Findings were more prominent in Basti group which was statistically significant.

Selected samples of Virechana and Basti were analyzed for Gene expression changes.

Ø  Many genes and signaling pathways were differentially expressed which had a significant role in relation to Stroke. This differential expression was significant as the first stride to establish Panchakarma therapies at a molecular level.

Ø  More protein translation functions were expressed in Basti samples than Virechana.

Ø  Ayurgenomics study also showed the importance of Snehapana and Samsarjana krama during Shodhana due to varied expression at different stages which actually justifies the extreme importance laid on management during Shodhana operations and thereafter.

Ø  This differential expression at Genomic levels may be a significant lead and pave the way for future studies for more extensive research to find a confirmatory relationship between Stroke management through Panchakarma therapies like Basti and Virechana.

Ø  Some pathways related to other diseases like Cancer, Alzheimer’s, Parkinson’s disease, Rheumatoid Arthritis etc. were also differentially expressed after Virechana and Basti, so these can also be considered for similar research in future.

ü  Finally, the Null hypothesis (H0) which stated that-Shamana after Virechana and Shamana after Basti and only Shamana are equally effective in Pakshaghata, was rejected.

ü  Alternate hypothesis (H2) stating that -Shamana after Basti is more effective in the management of Pakshaghata than shamana after Virechana or only Shamana, was accepted.

Therefore, we may conclude that Shamana after Basti in Pakshaghata was comparatively more effective considering the Clinical, Pharmacological and Ayurgenomics parameters.