Management of Charmakeela by Viddha Karma followed by Arka Ksheeradi Lepa...

[Full title: Management of Charmakeela by Viddha Karma followed by Arka Ksheeradi Lepa externally and Vidanga Churna orally]

[Find the meaning and references behind the names: Loop, Mode, Modern, Code, Sharman, Doi, Class, Lepa, India, Amc, Aim, Palmar, Sharma, Karma, Key, Life, Date, Chosen, Normal, Arun, Body, Bed, Hot, Falls, Plana, Hospital, Present, Pain, Show, Time, Cases, Hod, Main, Large, August, Size, Oral, Data, Under, High, Patient, Days, Acid, Cost, Veena, Quick, Female, Arka, Rate, Non, Laser, Case, Parts, Study, Strong, Weeks, Lean, End, Principal, Common]

CASE REPORT August 2024 Journal of Ayurveda and Integrated Medical Sciences | August 2024 | Vol. 9 | Issue 8 326 Management of Charmakeela by Viddha Karma followed by Arka Ksheeradi Lepa externally and Vidanga Churna orally L. Manonmani 1 , Veena Arun 1 1 Principal & HOD of Shalya Tantra, TMAE’S Ayurvedic Medical College, Hospet, Karnataka, India. 2 Medical Practitioner, Sharma Ayurveda Vaidyashala, Jayanagar, Bangalore, Karnataka, India. I NTRODUCTION The very purpose of this case study is to reach the indigent category of population through non-invasive, cost-effective treatment mode. Wart being most frequently affecting the teenage population at large an attempt has been made for a remedial measure. EGW is a most common disorder with most cases Address for correspondence: Dr. L. Manonmani Principal & HOD of Shalya Tantra, TMAE’S Ayurvedic Medical College, Hospet, Karnataka, India. E-mail: principal_amchpt@rediffmail.com Submission Date: 13/07/2024 Accepted Date: 24/08/2024 Access this article online Quick Response Code Website: www.jaims.in DOI: 10.21760/jaims.9.8.52 reported between ages of 12 to 16 yrs. Among the common types viz. verrucca vulgaris, filiform, verruca plana and condylomatous warts, Verucca Vulgaris (palmar warts) was chosen for this case study, the main symptoms being pain, itching, discomfort with or without discharge. Depending on the site manifestation of warts shows its impact on life varying from pain to guilt, so also social stigma when it occurs on exposed body parts. Its treatment available at present are: Applications like, a) Salicylic acid, liq. N 2 and Podophyllin [1] b) Loop electro surgical excision c) CO 2 laser surgery d) Interferon injection The Chramakeela falls under the category of Kshudra Rogas mentioned by our Acharyas . Here are the textual references of this skin disorders. A B S T R A C T Introduction: Charmakeela is one of the most common skin disorders affecting the children and teenage group by and large. It can be correlated to warts according to modern science owing to signs and symptoms. The incidence rate of EGW (extra genital warts) =10% Approx. Globally, 2-25% approx. India. The Incubation period of warts is around 90 days and the high recurrence rate in various modern treatment modalities. Aim: To evaluate the efficacy of Viddha Karma followed by Teekshna, Lekhana, Ropana, Krimighna properties of Arka Ksheera and Haridra Churna externally and Vidanga Churna Orally. Objectives: To arrive at a cost effective result oriented medication with least recurrence. Materials and Methods: A lean built Female patient, presenting with multiple warts on both the palms was selected from T.M.A.E’S AMC Hospital, Hospet. The patient was treated with Vidanga Churna (0-0-5 mg) with hot water bed time and with aseptic precautions a 2 ml syringe needle was taken and random pricks were made on the surface and surrounding the warts. This was followed by application of Arka Ksheera mixed with Haridra Lepa and was bandaged. The procedure was repeated once a week for 5 weeks. Results: A significant reduction in the size and other symptoms of warts was seen by 2 weeks and by the end of 5 weeks the palms were completely clear and appeared normal. After a regular follow upto 8 weeks with oral medication alone no recurrence was noticed. Conclusion: The treatment was successful in warding off recurrence and effectively curing all warts with economical, noninvasive technique Key words: Charmakeela, Warts, Arka Ksheera, Haridra, Vidanga Churna, Viddha Karma, Sterile Needle.

[Find the meaning and references behind the names: Charma, Daily, Rice, Vata, Local, Shield, Rough, Day, Nad, Low, Bind, Krishna, Acharya, Swetha, Ase, Sleep, Nail, Person, Habit, Wedge, Pin, Kila, Agni, Nil, Hard, Centre, Due, Bolt, Pitta, Color, Carman, White, Black, General, Location]

L. Manonmani et al. Management of Charmakeela by Viddha Karma ISSN: 2456-3110 CASE REPORT August 2024 Journal of Ayurveda and Integrated Medical Sciences | August 2024 | Vol. 9 | Issue 8 327 The Utpatti of the word Charma Keela is as under Charma, is derived from two words चर ् and म , च + सर्वधतुभ्योमनिि [2] Where चर is a धातु , म is a प्रत्यय। [3] कील is derived from कील्यतेरुद्यतेसौअिेिअत्रार्ा। Definition: चमवनिगुह्यस्यचमावनिकीलईर्ेनतर्ा। A nail like growth developed on skin surface or in private parts is called as Charmakeela Charma - that means things which shield. Keela - that means things which bind like pin, bolt or wedge etc. Charmakeela can be defined as hard nail like growth on the surface of the skin. The Pathogenesis of Charmakeela is due to the aggravations of Vyana Vata which unites with Kapha giving rice to Sprouts like or Nail like eruptions on the surface of the skin which is immovable in nature, there can be involvement of all Tridoshas w here in deranged Vayu dislodges Kapha from its site which manifests as rough hard growth on the skin. It may present itself with symptoms of Vata- Toda , Parushatva and pricking pain with rough surface. Kapha - Savarna (same color as skin) and Grathita (knotty in texture) Pitta - Peeta (Yellowish White), or with Peetaabha Swetha Krishna (Black) Kandu ( Srava , Itching and discharge etc. through the entire the lesion. According to Samprati, Lakshana and Chikitsa described by Acharya Shusrutha , Charmakeela can be compared with warts [4] According to modern science Definition: A benign lesion occurring in the mucosa of the skin commonly caused by HPV which can spread from one location to other and person to other by contact [5] is called was warts. The treatment modalities in Ayurveda being 1 Agni Karma [6] 2 Kshara Karma [7] 3 Chedana Karma [8] Viddha Karma was adopted as one of the treatment modalities followed by Lepana and oral medicine in this case study. C ASE R EPORT A lean built female patient presenting with multiple warts on both the palms and digitals was selected from TMAE‘S AMC Hospital and research Centre Hospete. History of present illness The patient was complaining of pain, discomfort and itching, whitish yellow coloured multiple rough eruptions on both the palms since 4 to 5 months which was hampering her household chores. Previous history - Nil Personal history - Nil General Examination Appetite - Low Habit - Wearing others clothes and using public washrooms Bowel - Once daily Micturition - 4 to 5 times per day Sleep - Disturbed Occupation - Laborer, housemaid Icterus - Pallor Clubbing - Absent Cyanosis - Absent Lymphadenopathy - Absent Height - 135 cm Gait - NAD Tongue - Slightly Coated Systemic Examination Per Abdomen - Soft CVS - NAD CNS - NAD RS - NAD Local Examination O/E Inspection Site - Palmar aspect

[Find the meaning and references behind the names: Luke, Hands, Garden, Care, Ready, Round, Bud, Pale, Rbs, Running, Areas, Ear, Johnson, Sec, Area, Till, Take, Hours, Lie]

L. Manonmani et al. Management of Charmakeela by Viddha Karma ISSN: 2456-3110 CASE REPORT August 2024 Journal of Ayurveda and Integrated Medical Sciences | August 2024 | Vol. 9 | Issue 8 328 Size - Multiple lesions varying from 2 to 10 mm Shape - Varied from round to spherical Numbers - Multiple Surface - Rough, spherical Discharge - Absent Color - Pale Yellow and Whitish Surrounding Area - No Redness On palpation Tenderness - present Sensation - intact Reducibility - irreducible Compressibility - Non compressible Bleeding on touch - Absent Consistency - Firm and hard Temperature - NAD Investigations Before the treatment Hb - 11.5 % BT - 1.4 Sec CT - 3.5 o Sec RBS - 104 Mg/Dl HIV - Negative HBSAg - Negative A IM To evaluate the efficacy of 1 Viddha Karma 2 Tikshna, Lekhana, Ropana, Krimigna properties of Arka Ksheera, Haridra Churna externally 3 Vidanga Churna internally O BJECTIVES To arrive at – 1 Cost effective Management 2 Non invasive technique 3 Result oriented medicines 4 Least recurrence M ATERIALS 1 2 Ml Sterile Syringe Needle 2 Containers with a) Triphala Kashaya , b) Latex of Arka c) Haridra Churna d) Vidanga Churna e) Johnsons ear buds M ETHOD Fresh latex of Arka was collected from TMAE’S Herbal Garden and all the above materials were kept ready to follow the procedure as under - Purva Karma The patient’s hands were first washed with soap and hot running water and then washed with Luke warm Triphala Kashaya. The patient was made to lie down on supine position on the bed. Pradhana Karma Random pricks were made with needle on the surface and surrounding areas of warts. Care was taken to prick superficially to avoid bleeding. Later Lepa was applied with Johnson ear bud dipped in Arka Ksheera , and covered the entire surface area including periphery and lesions. Once the latex became sticky Haridra Churna was sprinkled on the entire surface of the wound. Paschat Karma After the latex completely dried the wound was covered with gauze and bandaged. The patient was kept under observation for 3 hours and was advised to take Vidanga Churna (0-0-5 mg) with hot water at bed time throughout the course of the treatment. The above procedure was repeated once a week for five weeks. Follow up was done till eight weeks.

[Find the meaning and references behind the names: Guna, Tion, Mild, Vas, Cat, Rasa, Snigdha, Red, Chemical, Severe, Ane, Green, Bar, Min, Katu]

L. Manonmani et al. Management of Charmakeela by Viddha Karma ISSN: 2456-3110 CASE REPORT August 2024 Journal of Ayurveda and Integrated Medical Sciences | August 2024 | Vol. 9 | Issue 8 329 Assessment criteria Observation Subje ct criteri a 1 s t d ay 1 st we ek 2 nd we ek 3 rd we ek 4 th we ek 5 th we ek 6 th we ek 7 th we ek 8 th we ek Pain 8 6 5 3 1 0 0 0 0 Burni ng sensa tion 4 3 1 0 0 0 0 0 0 Itchin g 5 3 2 1 0 0 0 0 0 Grading For pain - VAS Scale was used A) For Burning Sensation Cat-1 - Mild - 0 to 3 Cat-2 - Moderate - 4 to 5 Cat-3 - Severe - more than 5 B) For Itching Cat-1 - Mild - 0 to 3 Cat-2 - Moderate - 4 to 5 Cat-3 - Severe - more than 5 No of Weeks Y Axis - 1 Week = 0 to 1 X Axisone category = 1 column Burning Sensation Itching Sensation Y Axis No of weeks X- Axis- Itching Sensation Green Bar = Timings 4 to 5 Min in a day per week Red Bar = Frequency 15 to 20 Times in a day per week R ESULTS A significant reduction in the size of warts along with symptoms like Itching, pain & discomfort consistently on 1 st, 2 nd, 3 rd & 4 th Week subsequently and palms appeared normal by 5 th week. After regular follow up till 8 weeks with oral medication throughout the course of the study, no recurrence was noticed. Rasa Panchaka [10] SN Drug Rasa Guna Veerya Vipaka 1. Arka Ksheera Tikta, Lavana Ushna, Snigdha Ushna Katu 2. Vidanga Katu, Kashaya Laghu, Ruksha, Tikshna Ushna Katu 3. Haridra Tikta, Katu Laghu, Ruksha Ushna Katu Chemical composition [11,12] Pharmacological Actions Arka Vidanga Haridra Antiinflammatory Hexane, dichlorometh ane, Tannin Curcumin 0 1 2 3 4 Category 4 Category 3 Category 2 Category 1 0 1 2 3 4 5 6 Category 5 Category 4 Category 3 Category 2 Category 1 Series 2 Series 3

[Find the meaning and references behind the names: New, Raja, Upadhyaya, Bharati, Faster, Act, Cite, Pandita, Deva, Delhi, Sutra, Sci, Base, Anitha, Jain, Vaidya, Shenoy, Edi, Given, Vina, Alpha, Med, Manual, Rajagopal, None]

L. Manonmani et al. Management of Charmakeela by Viddha Karma ISSN: 2456-3110 CASE REPORT August 2024 Journal of Ayurveda and Integrated Medical Sciences | August 2024 | Vol. 9 | Issue 8 330 ethylacetaten-butanol Analgesic Ethanol - Alpha phellandrene Anti ulcer Hydroalcoholic - - Anti keloidal Latex - - Wound healing Aqueous extract, ethanolic extract Ethanol extract, Embela - Anti-bacterial - - Curcumin Anti-cancer - - Alpha phellandrene ▪ Hexane, dichloromethane, ethylacetate-n-butanol in Arka , Tannin in Vidanga and Curcumin Haridra which are anti-inflammatory act on the warts to reduce the size and inflammation. ▪ Ethanol and Embela in Vidanga helps in faster the epithelization, It also helps in high rate of wound contraction through collagenation. ▪ Ethanol and Alpha phellandrene have analgesic effect. ▪ Hydro-alcoholic, Aqueous extract, ethanolic extract and Latex helps in anti-ulcer, anti-keloidal, wound healing effect. ▪ Curcumin acts as antibacterial and Alpha phellandrene acts as anti-cancerous activity. CONCLUSION The combined effect of all the above mentioned drugs has helped in destroying the HPV and curing the warts. Viddha Karma has helped in removal of clogging of the warts surface to channelize the medicine to enter into deeper tissue there by facilitating and hastening the healing process. The latex of Arka has worked by disseminating into all the warts to reach deeper tissues there by producing the medicinal effect to the entire warts from the surface to the base. Haridra being antiseptic, anti-inflammatory has helped to prevent the spread of infection. Even though above study has given successful results and proved efficient, a prospective study regarding the above drugs is required to obtain a complete analysis of drug. REFERENCES 1 Manthappa M. Manual of Medicine, 3 rd ed, CBS Publishers, 2021 2 Mahamahopadhyaya Pandita Shivadatta dadimatha, Amarakosha Delhi, Choukhambha Sanskrit Pratishtana 1915. 3 ShabdaKalpadruma by Raja Radhakanta Deva 3 rd Edition 1976, Choukhambha Sanskrit Series, Varanasi. 4 Shusruta Samhita, with Dulhana Commentary edited by Priyavrat Sharma Varanasi, Choukhambha Orientalia 1 st Edition-2000, Nidana Sthana Chapter 2 Shloka 18-20. 5 K Rajagopal Shenoy, Anitha Nileshwar, Manipal Manual of Surgery, 6 th Edi, New Delhi. CBS Publishers and distribution, Satishkumar Jain-2023 Vol-01 6 Vagbhata Ashtanga Sangraha, Edited and commented Vaidya Yadunandan Upadhyaya, 14 th Edition 1979, Nidana Sthana Chapter-57 7 Shusruta Samhita, with Dulhana Commentary edited by Priyavrat Sharma Varanasi, Choukamba Orientalia 1 st Edition- 2000, NidanaSthana Chapter 13 Shloka 03. 8 Vagbhata Ashtanga Sangraha, Edited and commented Vaidya Yadunandan Upadhyaya, 14 th Edition 1979, Nidana Sthana Chapter-57, Shloka 47 to 48. 9 Shusruta Samhita, with Dulhana Commentary edited by Priyavrat Sharma Varanasi, ChoukambaOrientalia 1 st Edition- 1999 Sutra SthanaChapter 12 Shloka 10. 10 Neelakanteshwar, Ayurvedic Remedies for common skin diseases Delhi. Choukhambha Sanskrit Pratishtan 2009. 11 Acharya Priyavat Sharma, Dravyaguna Vijnana, Varanasi, Choukhambha Bharati Academy 2018, Haridra Vol-2 Pg -694, Arka Vol- 2 Pg -433, Vidanga Vol-2 Pg -503 12 Vinayaka, Bhavamishra, Bhavaprakash Nighantu Varanasi, Choukhambha Orientalia Academy. How to cite this article: L. Manonmani, Veena Arun. Management of Charmakeela by Viddha Karma followed by Arka Ksheeradi Lepa externally and Vidanga Churna orally. J Ayurveda Integr Med Sci 2024;8:326- 330. http://dx.doi.org/10.21760/jaims.9.8.52 Source of Support: Nil, Conflict of Interest: None declared.

Other Health Sciences Concepts:

[back to top]

Discover the significance of concepts within the article: ‘Management of Charmakeela by Viddha Karma followed by Arka Ksheeradi Lepa...’. Further sources in the context of Health Sciences might help you critically compare this page with similair documents:

Ayurveda, Vata, Kapha, Lekhana, Lepa, Ropana, Haridra, Kshudraroga, Shalyatantra, Krimighna, Vyanavata, Katuvipaka, Pain, Katurasa, Hot water, Itching, Burning sensation, Sensation, Antibiotic, Complete analysis, Textual reference, Itching sensation, Signs and symptoms, Medical practitioner, Household chores, Modern science, Treatment modalities, Healing process, Ayurvedic remedies, Journal of Ayurveda, Wound healing, Incubation period, Follow-up, Consistency, Redness, Significant reduction, Spread of infection, Chemical composition, Herbal garden, Assessment criteria, Rasa-panchaka, Ayurvedic Medical College, Analgesic effect, Case study, Aseptic precaution, Anti-inflammatory, Local examination, Female patient, Regular Follow-up, Cost effective, Ushna veerya, Anti-cancerous activity, Pharmacological action, Charmakeela, Oral medication, Viddha karma, Prospective study, Haridra Churna, Combined effect, Noninvasive technique, Skin disorder, Salicylic acid, Teekshna, Modern Treatment Modalities, HPV, Arka Ksheera, Verruca vulgaris, Wound Healing Effect, Benign lesion, Non-invasive, Non-invasive technique, Medicinal effect, Skin surface, Vidanga Churna, Palmar aspect, Economical, Warts, Alpha-phellandrene, Noninvasive.