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.