ANVESHANA EFFECT OF ARAGVADHA PATRA KALKA AND ARNALA LEPA WITH AND WITHOUT CHAKRAMARDA SEED POWDER IN DADRU

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1 ANVESHANA Research Article AYURVEDA MEDICAL JOURNAL ISSN: EFFECT OF ARAGVADHA PATRA KALKA AND ARNALA LEPA WITH AND WITHOUT CHAKRAMARDA SEED POWDER IN DADRU Deepika Thakur 1, M. Paramkussh Rau 2, Pramod Kumar Patel 3, Anshuman Biswal 4 1,4 PG Scholars, 2 Prof. and HOD, Department of Dravyaguna, S. V. Ayurvedic College and Hospital, Tirupati, India 3 PG Scholar, Dept. of Rasashastra and Bhaishajya Kalpana, NIA, Jaipur, India Corresponding Author: deepika.smiling@gmail.com ABSTRACT Dadru (Ringworm) is one of the commonest skin disease found in society. It is a fungal disease caused due to fungus Tinea. Acharya Charaka included Dadru in Kshudra Kushtha, on the other side Acharya Sushruta and Acharya Vagbhata included it in Mahakushtha. The reason may be that they realized the severity of the disease. Clinically also initially Dadru looks like Kshudra Kushtha, which is easily curable by simple application also. But if it is neglected, it goes into deeper tissues and take the shape of Mahakushtha. At this stage Dadru is not easily curable. Taking all these into consideration it was decided to take this disease for study and Aragvadha patra kalka and Arnala was used for external application in Dadru. This is a reference of Gada Nigraha. Aragvadha is a very useful drug in skin disorders. It is included in both Kushthaghna and Kandughna Mahakashaya by Acharya Charaka. In one group of patients Chakramarda was also given internally along with external medication. The treatment Aragvadha patra kalka and Arnala given for Dadru gave very significant results. But in some patients recurrence of Dadru occurred. And the study became completely successful when Chakramarda was given as internal medicine along with the external medication. Key words: Dadru, Tinea, Aragvadha patra kalka, Arnala, Chakramarda INTRODUCTION Ayurvedic system of medicine is the only system where importance of plants for curing ailments is recognized. Dravyaguna deals with studying about the plants and using them in curing diseases and thus have unique importance in the field of Ayurveda. Since centuries, this well-established branch serves Indian community with its unique formulations. We can use the drug in the form of different Kashaya Kalpanas depending upon the Prakriti, Dosha and Vyadhi of patient. Along with internal medicine, the medicine can also be used as external medicine in the form of Lepa etc. The skin is highly complex organ which plays a vital role in the body. We notice that ordinary civic is too much aware about the purity of Skin, as it is an ornament of the body. Kushtha is a disease which creates breakage of the charm of skin. Ayurvedic Classics have considered each type of Kushtha to be a Tridoshaja manifestation. Nonetheless their Doshika identity can be established on the basis of

2 dominance of Dosha in the samprapti. All Acharyas have described this disease and its treatment. Dadru is one of them and much common to get its incidences from every place. Acharya Charaka included Dadru in Kshudra Kushtha 2, on the other side Acharya Sushruta included it in Mahakushtha 3. The reason may be that they realized the severity of the disease. Clinically also initially Dadru looks like Kshudra Kushtha, which is easily curable by simple application also. But if it is neglected, it goes into deeper tissues and take the shape of Mahakushtha. At this stage Dadru is not easily curable. This is the reason why Charaka included Dadru in Kshudra Kushtha and Sushruta included it in Mahakushtha. Due to changing life style and food habits there is increased incidence of Dadru in practice and other systems fail to find a permanent solution for it. Almost 12.4% amongst the total diseases come for treatment is related to skin 4. Fungal infections occupy a major component among this, and currently up to 21% of the world s population may be infected by Ringworm alone. Therefore it is necessary to find a solution for it through Ayurveda. Taking all these in consideration it has been decided to take this disease for study and Aragvadha patra kalka and Arnala is used for external application. This is the reference of Gada Nigraha 1. Aragvadha is a very useful drug in skin disorders. It is included in both Kushthaghna and Kandughna Mahakashaya by Acharya Charaka. In one group of patients Chakramarda seed powder is also given internally along with the external medication. MATERIALS AND METHODS Materials 1. Aragvadha leaves 2. Chakramarda seeds 3. Arnala Preparation of drug: Arnala: First of all a mud pot was taken and 1 part of coarse wheat powder was put into the pot. Then 3 times of water to wheat powder was added to the pot. Then that pot was closed by a mud lid. The lid was tightly closed and packed with Sandhibandhana method. This pot was left for 7 days for fermentation process. After 7 days the Sandhibandhana was opened and Arnala was obtained. Preparation of Aragvadha and Arnala kalka:- Preparation 1- Fresh leaves of Aragvadha were taken and they were grinded by adding Arnala. They were grinded to make a fine paste. The fresh paste was given to patients of Dadru for external application. It is given in an amount of 50 g to each patient. Preparation of Chakramarda seeds powder: Preparation 2- Fine powder of Chakramarda seeds was prepared and filled in capsules of 500 mg each. Group 1- Aradvadha Patra Kalka + Arnala applied locally. This is given to 20 patients. Group 2- Aradvadha patra kalka + Arnala applied locally and Chakramarda seed powder is given internally. This is given to 20 patients. Dosage: The lepa was applied in 2 mm thickness on the lesion. It was kept until it is completely dried. Time of administration: The lepa was applied two times a day in morning and evening. Duration of treatment: The medicine was given for 21 days. This duration was selected because in 21 days the infection is seen to be completely cured. Patients: 40 patients of Dadru (Ringworm) were selected at random from OPD of P.G AAMJ / Vol. 1 / Issue 4 / July Aug

3 Department of Dravyaguna, S.V Ayurvedic Hospital, Tirupati, A.P, India. Grouping of patients: The effect of drugs was screened in 40 patients who have completed the treatment, 20 patients in each group. The patients were randomly divided into 2 groups as follows. Table 1: Showing groups of patients and Drug administered Group Patients Drug administered Dose Vehicle Time of administration Duration of treatment 1 20 Aragvadha+ Arnala fresh lepa Morning and evening 21 days 2 20 Aragvadha+ Arnala fresh lepa, Chakramarda seed powder internally 1g BD (A+A- Aragwadha patra + Arnala, CSP- Chakramarda seed powder) During the treatment all the patients are regularly analyzed and advised to attend O.P.D twice in a week till the end of trial (21days) and the notable changes are duly recorded. Inclusion criteria: It is applied in age group of 20 to 60 years, either male or female. Patients with symptoms Raktavarna, Kandu, Pidika, Utsannata, Mandal Exclusion criteria: Patients suffering with following diseases are not included in the study:- Diabetes, Skin cancer, Skin Tuberculosis, Scabies, Psoriasis, Contact dermatitis, Cellulites, Hansen s disease, Generalized eczema, Malignant conditions, Secondary infection with lymphadenopathy. Parameters: Criteria to assess the effect of the trial drug: All the selected patients were advised to come for follow up twice in a week up to 21 days. Subjective assessment: This is assessed on the basis of symptomatology and grading, depending on Table 2: Interpretation of result Water Morning and evening 21 days signs and symptoms of patients. The symptoms that are assessed in patients are: Raktavarna (Raga), Kandu, Pidika, Utsannata, Mandal Pramana, Mandal Sankhya. Grading of Symptoms: Grade 0- Grade 0 is given to the condition when the symptom is nil or absent. Grade 1- Grade 1 is given to the condition when the symptom is present in mild form. Grade 2- Grade 2 is given to the condition when the symptom is present in moderate form. Grade 3- Grade 3 is given to the condition when the symptom is present in severe form. Statistical Analysis: The information is gathered on the basis of above observations. These observations are subjected to statistical analysis using Graph Pad Instat. Software Version As the criteria selected for analysis are non-parametric hence Wilcoxon matched pairs test is applied for statistical improvement analysis in the clinical features of Dadru in all two groups. P value Wording Summary <0.001 Extremely significant E.S to 0.01 Very significant V.S to 0.05 Significant S Not significant N.S. AAMJ / Vol. 1 / Issue 4 / July Aug

4 RESULTS Sl. no. Table 3: Showing the results of statistical analysis of Group 1 Parameter Mean (n=15) % Change S.D. (±) S.E (±) p value Result B.T. A.T. Diff. 1. Raktavarna < ES. 2. Kandu < ES. 3. Pidika < ES. 4 Utsanna < ES. 5 Mandal Sankhya < ES. 6 Mandal Pramana < ES. Group BT AT Difference Rakta varna Kandu Pidika Utsanna Mandal Samkhya Mandal Pramana Graph 1: Showing the results of statistical analysis of Group 1 Effect of Aragvadha + Arnala fresh on Effect of Aragvadha + Arnala fresh on Raktavarna of Dadru: Aragvadha+ Arnala Utsanna of Dadru: Aragvadha+ Arnala fresh fresh reduce Raktavarna of Dadru by 87.10% reduce Utsannata of Dadru by 90.62% which which was statistically highly significant was (p<0.0001) Effect of Aragvadha + Arnala fresh on Mandal Effect of Aragvadha + Arnala fresh on Kandu Sankhya of Dadru: Aragvadha+ Arnala fresh of Dadru: Aragvadha+ Arnala fresh reduce reduce Mandal Sankhya of Dadru by 84% Kandu of Dadru by 87.50% which was which was statistically highly significant (p<0.0001) Effect of Aragvadha + Arnala fresh on Pidika Effect of Aragvadha+ Arnala fresh on Mandal of Dadru: Aragvadha+ Arnala fresh reduce Pramana of Dadru: Aragvadha+ Arnala fresh Pidika of Dadru by 91.30% which was reduce Mandal Pramana of Dadru by 96.66% which was statistically highly significant (p<0.0001) Table 4: Showing the results of statistical analysis of Group 2 Sl. no. Parameter Mean (n=15) % Change S.D. (±) S.E (±) p value Result B.T. A.T. Diff. 1. Raktavarna < ES. 2. Kandu < ES. 3. Pidika < ES. 4 Utsanna < ES. 5 Mandal Sankhya < ES. 6 Mandal Pramana < ES. AAMJ / Vol. 1 / Issue 4 / July Aug

5 Group BT AT Difference Rakta varna Kandu Pidika Utsanna Mandal Samkhya Mandal Pramana on Raktavarna of Dadru: It reduced Raktavarna of Dadru by 87.50% which was on Kandu of Dadru: It reduced Kandu of Dadru by 91.89% which was statistically highly significant (p<0.0001) on Pidika of Dadru: It reduced Pidika of Dadru by 92.31% which was statistically highly significant (p<0.0001) on Utsannata of Dadru: It reduced Utsannata of Dadru by 92.86% which was statistically highly significant (p<0.0001) on Mandal Sankhya of Dadru: It reduced Mandal Sankhya of Dadru by 85.71% which was on Mandal Pramana of Dadru: It reduced Mandal Pramana of Dadru by 90% which was Recurrence: In Group 1 (Aragvadha + Arnala fresh) there is significant improvement in symptoms raktavarnata, Kandu and Pidika. Graph 2: Showing the results of statistical analysis of Group 2 The surface of skin became smooth and the colour of skin became about normal. The improvement in this group was very significant. But in 3 patients out of 20 patients recurrence of Dadru occurred. And in rest of the 17 patients no recurrence occurred. In Group 2 along with external application of fresh Aragvadha + Arnala lepa Chakramarda powder was given internally. This treatment was also given to 20 patients. In this group of patients no recurrence of Dadru occurred in patients. DISCUSSION AND CONCLUSION externally given for Dadru gave very significant results. But in some patients recurrence of Dadru occurred. This suggested that internal medicine for Dadru is also needed to avoid recurrence. Chakramarda seed is also a very popular medicine in Dadru, but usually it is found in the form of Lepa externally. But as in Bhavaprakasha Samhita, Chakramarda is mentioned in Dadru along with diseases like Shwasa etc. which shows its internal use 5. Basing on that Chakramarda seed powder is given internally in Dadru patients. And the study became completely successful when Chakramarda was given as internal medicine along with the external medication. Thus when Dadru covers large area of body and patient comes in chronic condition; internal medicine AAMJ / Vol. 1 / Issue 4 / July Aug

6 should also be added for fast response and to avoid the recurrence. This is because initially Dadru looks like Kshudra Kushtha, which is easily curable by simple application also. But if it is neglected it goes into deeper tissues and take the shape of Mahakushtha. At this stage Dadru is not easily curable. This is the reason why Charaka Samhita included Dadru in Kshudra Kushtha and Sushruta Samhita included it in Maha Kushtha. The study concluded that Aragvadha+Arnala lepa externally given for Dadru gave significant results. But in some patients recurrence of Dadru occurred. After adding Chakramarda seed powder internally along with the external medication for Dadru there is no recurrence. REFERENCES 1. Indradeva Tripathi Gadanigraha of Acharya Sodhala, with Vidyotini Hindi commentary, edited by Ganga, Chaukhambha Sanskrit Sansthana, Varanasi, 3 rd edition, 1999, Kayachikitsa Khanda Kushthadhikara 36, Shloka no.176, Page no Acharya Charaka, Charaka Samhita, Vol. I& II, Edited and Published by Dr.Brahmanand Tripathi, Chaukhambha Surbhrati Prakashan, Varanasi, Reprint Charak Chikitsa7/ Acharya Susruta, Susruta Samhita, Reprint Edition, Part I & II, Edited with Ayurveda Tattva Sandipika by Kaviraja Ambikadutta Shastri, Chaukhambha Sanskrit Sansthan, Varanasi , 2007.Su.Sutra5/5. 4. Skin Diseases in Family Medicine: Prevalence and Health Care Use, Ann Fam Med July; 6(4): Bulusu Sitaram, Bhavaprakasha of Bhavamisra, Chaukhambha Orientalia, Varanasi, 2006, Haritakyadi varga, BPN - 1/210, 211, 212, Page no.179. How to cite this article: Rakesh & Isha. Effect of aragvadha patra kalka and arnala lepa with and without chakramarda seed powder in dadru. AAMJ 2015; 1: Source of Support: Nil. Conflict of Interest: None declared Fresh leaves of Aragvadha Arnala Fresh Kalka of Aragvadha and Arnala Fresh Aragvadha and Arnala kalka packed in 50g packet Fig. 1: Preparation of Aragvadha patra and Arnala kalka AAMJ / Vol. 1 / Issue 4 / July Aug

7 Chakramarda seeds Chakramarda seeds powdered Chakramarda seeds powder filled in capsules Fig. 2: Preparation of Chakramarda seeds powder AAMJ / Vol. 1 / Issue 4 / July Aug