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Department of KAYACHIKITSAInstitute of Post Graduate Teaching and Research in Ayurveda
GUJARAT AYURVED UNIVERSITY, JAMNAGAR
MANAGEMENT OF VITILIGO WITH MITRAPANCHAK YOGA AND AVALGUJBEEJADI LEPA AFTER MRIDU KOSHTHA SHUDDHI
DR.NIRANK KUMAR
INTRODUCTION
• Skin is the largest organ of our body. The beauty andattraction of individual depends upon skin’s healthincluding physical and psychological health.
• According to Modern Dermatology, Shwitra can becorrelated with Vitiligo and Leucoderma. Vitiligo is aprogressive disease in which the melanocytes are graduallydestroyed causing unpigmented areas on the skin.
• Shwitra is comparable to vitiligo which is a commonpigmentation disorder.
• Researches suggest vitiligo may arise fromautoimmune,genetic,oxidative stress,neural or viralcauses.
WHY THIS TOPIC?
• The global incidence of Vitiligo is less than 1% with some populations averaging as high as 16 % but management is still unsatisfactory
MATERIALS &
METHODS
•Null Hypothesis(H0):
Mitrapanchaka yoga with Avalgujabeejadi Lepa is not effective in management of Shwitra.
•Alternative Hypothesis: (H1):
Mitrapanchaka yoga with Avalgujabeejadi Lepa is effective in management of Shwitra.
HYPOTHESIS
AIMS & OBJECTIVES
• To provide some better treatment for Shwitra.
ETHICAL CLEARANCE
• The study started after obtaining the clearancefrom the Institutional Ethics Committee.
• The Study is registered in C.T.R.I.
• Patient having signs and symptoms ofShwitra(Vitiligo) selected irrespective ofrace, religion, caste, sex etc. from OPD ofKayachikitsa Dept. of I.P.G.T. & R.A.Hospital, G.A.U.
• The prior informed written consent fromthe patient was taken before administrationof the drug.
SELECTION OF PATIENT
DIAGNOSTIC CRITERIA
Made on the basis of classical signs andsymptoms of Shwitra (Vitiligo) described inAyurvedic texts & Modern medical science asfollows.
MODERN
Depigmented macules.
Hairs remain same but in older cases theyalso get hypo pigmented.
Koebner’s phenomenon
AYURVEDA
•Tvak varna• Pandura• Rakta , Tamra, Shveta• Ruksha
•Roma • Shukla roma
DIFFERENTIAL DIAGNOSIS
Character Albinism Vitiligo
Time/Duration Since birth After birth
Eye involvement Present B/L Not involved
Koebner’sphenomenon
absent present
INVESTIGATIONS
• Blood –Hb %, TLC, DLC, E.S.R., PCV, R.B.S. etc.
• Urine – Routine & Microscopic examination.
• Stool macro and microscopic investigation will be carriedout to ascertain the presence of Krimi if any.
PLAN OF TREATMENT
Sanshamana,lepa
Mridu koshtha shuddhi
Langhana for 3 Days
DRUG PROFILE
Eranda bhiristha haritaki(for mridu kostha shuddhi)
Dose:4gm H.S. for 3 Days
Anupana : Luke Warm water
Ingredients Family Botanical name
Eranda Euphorbiaceae Ricinus communisLinn.
Haritaki Combretaceae Terminalia chebulaRetz.
Mitrapanchaka yoga(including anupana of Madhu,Sarpi in unequal amounts)for internal use
Dose: 6gm BDDuration: 60 Days
Drug Latin/English Name Parts used Dose(BD)
Shodhita Hartala Yellow Orpiment (As2S3)Whole 30mg
Shodhita Gandhaka Sulphur (S) Whole 125mg
Bakuchi Psoralea corilifolia (Linn.) Seeds 1000mg
Avalgujbeejadi- lepa DravyasDuration : On each fourth Day in 60 days of treatment
after it sit in sun rays for some time and increase this time until that limit when slight inflammation starts (15 minutes here)
Sanskrit
Name
Latin Name /
English Name
Parts
UsedRatio
Avalguja
beeja
Psoralea corilifolia
(Linn.)Seeds 1part
Shudh
Hartala
Yellow Orpiment
(As2S3)whole ¼ part
Gomutra Cow’s Urine - Q.S.
DISCUSSION
Content Rasa Guna Vipaka Virya Properties
Hartala Katu,Tikta,Kashaya
Snigdha, Guru
Katu Ushna K Raktadosh --hara
Gandhaka Katu,Tikta,Kashaya
Sar Madhur Ushna VK
Bakuchi Katu,Tikta Laghu, Ruksha
Katu Ushna VK
Madhu Kashaya, Madhur
Ruksha, Guru
Sheeta V K
Ghrita Madhur Madhura Sheeta VP
Gomutra Katu Krimi-kushthanuta
Katu Ushna VK
Drugs
Ushna Virya V,K
Tikta,KashayaRasa
P
DISCUSSION
ANUPANA
Anupana
Sheeta Virya
Adverse effects & P
Papers suggesting Arsenic activity
RESULT
• Skin colour came back to almost normalafter 2 months of therapy.Patient is still infollow-up.
• Before administration of medicines he had constipation,lower back ache,anorexia,dryness of skin but after 2 months none of these complaints exist.
Quality of life
COMPARISON
Before After
ADR
After applying Lepa and sitting in sun rays –
It caused local inflammation of skinassociated with burning sensation whichwas relieved spontaneously or after applyingNimba Patra lepa.Though it was beneficialfor patient.So not reported to ADR cell.
CONCLUSION
Administration of Mitrapanchak Yogainternally and local application ofAvalgujbeejadi Lepa simultaneously afterKoshtha Shuddhi is very effective inmanagement of Shwitra.