The study of the effect of swarna makshik bhasma followed by gomutra in Vicharchika by M

The study of the effect of swarna makshik bhasma followed by gomutra in Vicharchika by M. Ramadas Dr.B.R.K.R. Govt. Ayurved College /Hospital Vijayawada, Hydrabad (1992). He concluded that the treatment of vicharchika with swarna makshik bhasma followed by gomutra is proven as statistically viable 59.
2. A comparative clinical study of Vicharchika (eczema) with Shamana (rasayana) & Shodhana therapy by dr. sudha k. nakum, Gujrat Ayurveda University, Jamnagar (2003). She concuded that Virechana therapy was provided comparatively better relief which showed that Virechana Karma followed by Rasayana & local application is more effective for the prevention & recurrence of the disease in comparison to other groups i. e. without performing any Shodhana Karma 60.
3. Comparative study of virechan karma and jalaukavacharan in the management of vicharchika by Bhimani ketan, Gujarat Ayurveda University, Jamnagar (2005). He had concluded that jalaukavacharan karma is more effective for curing the disease in comparision to virechan karma 61.
4. A clinical study on the role of virechana and kusthaghna mahakashay in management of vicharchika by Rajesh Sachdevani, Gujarat Ayurved University, Jamnagar (2006). He had concluded that better result were obtained in virechan group than compare to shaman group 62.
5. A comparative clinical study of Vamana and Jalaukavacharana in the management of Vicharchika by Kapil A Pandya, Gujrat Ayurveda University, Jamnagar (2007). He concluded that Vamana and Jalaukavacharana definitely effective, but Jalaukavacharana is more effective than Vamana karma 63.
6. A comparative study of Raktmokshana by jalaukavacharan and shiravedhana in the management of vicharchika (Eczema) by Hiren Raval, Gujarat Ayurved University, Jamnagar (2010). He concluded that overall Jalaukavacharana karma proved to be more effective in the management of Vicharchika in comparision result provided by Siravedhana 64.
7. To study the effect of jalaukavacharan and nimb tail in comparison with local application of nemb tail in vicharchika w.r.t. dry eczema by Vandana Shinde, Govt. Ayuervedic College Vazirabad, Nanded (2010). She concluded that Jalaukavacharan and nimb tail pratisaran is combine more effective than nimb tail pratisarana 65.
8. Assessment of efficacy of Vaman karma in the management of vicharchika by Abhishek Yadhav, Govt. Akhandanand Ayurved College, Ahmedabad (2011). He had concluded the vaman karma has better result in vicharchika 66.
9. The Etiopathological Study on Vicharchika and its Management by Triphaladi Ghana and Triphaladi ghtita by Dipam H Tripathi, Gujrat Ayurveda University, Jamnagar (2011). He concluded that oral administration of Triphaladi ghruta as a shaman snehapan, Triphaladi ghanavati and along with external application of Avalgujjadi lepa having the better results than oral administration of Triphaladi ghanavati and along with external application of Avalgujjadi lepa 67.

10. Exploratory study to assess the efficacy of jalaukavacharana (Hirudotherapy) in the management of Vicharchika (Eczema) by Abhay Prakash et al, Shri Dharmasthala Manjunatheshwara College of Ayurveda and Hospital, Hassan, Karnataka, India (2013).He concluded that Blood-letting by use of leeches has found to be very is effective in reliving the signs and symptoms of Eczema 68.
11. Identification and application of vedhya sera (punncturable vein) in vicharchika (eczema) by siravedh (venepuncture) by Vaikos C D et al www.ijrap.net Int. J. Res. Ayurveda Pharma 5(5), Sep-Oct 2014 Concluded that after siravedh, significant result was found on symptom kandu, ruja, raji and rukshata. Overall effect of siravedh in term of improvement was 80% of patients show improvement in disease. This show the efficacy of siravedhan in Vicharchika 69.
12. Comparative assessment of Jalaukavacharana (Leech Application) and
Shringavacharana (Horn Application) in Vicharchika by Manoj L. Sonaje et al
Lt .K.R. Ayurveda Medical College, Gadhinglaj, Kolhapur (2011) concluded that Raktamokshana by Jalaukavacharana and Shringavacharana both are effective in the management of Vicharchika 70.

MATERIALS AND METHODS –
MATERIAL FOR CUPPING THERAPY-
Sterile cups
Pupm for suction/vaccum creation.
Equipments for sterilization
Sterilized gloves
Sterilized cotton.
Betadine
Spirit
Sponge holding forcep
Surgical blade no.11
Kidney tray
Cotton
Sterile guaze piece
Sterile cotton pad
Bandage.
Drugs to prevent shock and handling emergency
MATERIAL FOR JALAUKAVACHARAN –
NirvishaJalauka
Water
Haridra powder (Curcuma long Linn.)
sterilized gloves
Sterilized Cotton
Kidney tray
Clean Bowl
Sterile cotton pad
Bandage
Scissor.
METHODS-
PLACE OF THE STUDY-
Patient who report in the OPD and IPD of our hospital will be carefully selected on the basis of diagnostic, inclusive criteria.
CONSENT-
Well informed written consent of all patients included in my study will be taken before starting treatment.
TYPE OF STUDY-
The present study is single blind, randomized, controlled, prospective clinical trial using two groups.
GROUP A
GROUP B
SAMPAL SIZE-
GROUP A- 30 Patients.
GROUP B- 30 Patients.
GROUPS AND TREATMENT USED-
GROUP A (Experimental group) – Treatment of eczema (vicharchika) with Raktamokshan by cupping therapy.
GROUP B (Control group) – Treatment of eczema (vicharchika) with Raktamokshan by jalaukavachran.
DURATION OF TREATMENT- Two setting (On 1st and 7th day). (15 Days)
QUANTITY OF BLOOD LETTING BY CUPPING THERAPY- 30-50ml. (Depending upon the lesion size and site of the lesion)
FOLLOW UP- 2nd, 7th, 15th days.
INCLUSIVE CRITERIA
All patient presenting with sign and symptoms of eczema (vicharchika) like itching (kandu), erythema, hyperpigmention (shyavata), discolouration (vaivarnata), Pustules (pidaka), oozing lesion (bahusrava), dryness (rookshata).
Patients of either sex.
Patients of age group 16-60 year.
Size not more than 10X10cm.

EXCLUSIVE CRITERIA-
Patient having any major systemic illness.
Patient having blood coagulopathies, anemia, Haemophilia, perpura.
Patient with diabetes.
HIV, HBsAg reactive patient.

INVESTIGATIONS-
CBC
B.T and C.T.
BSL(R)
ESR
HIV
HBsAg
URINE- Routine
Microscopic.

SUBJECTIVE CRITERIA FOR ASSESSMENT-
Table no. 19: ITCHING (KANDU)
CRITERIA
SCORE

No Itching
0

Occasionally Itching
1

Intermittent Itching not disturbing daily routine
2

Continuous Itching disturbing daily routine
3

Table no. 20: DISCOLOURATION (VAIVARNYA) 61
CRITERIA
SCORE

Nearly normal skin
0

Brownish discolouration
1

Blackish red
2

Blackish discolouration
3

Table no.21: DISCHARGE (SRAVA)
CRITERIA
SCORE

No discharge
0

Occasionally serous discharge
1

Continuous serous discharge
2

Purulent discharge
3

Table no.22: PAIN (VEDANA)
CRITERIA
SCORE

No pain
0

Presence of pain
1

Table no.23: DRYNESS (ROOKSHATA) 64
CRITERIA
SCORE

No dryness
0

Dryness with rough skin
1

Dryness with scaling
2

Dryness with cracking
3

OBJECTIVE CRITERIA
Pre and post treatment size of lesion will be calculated by Transparence graph paper (By tracing out the lesion by keeping the clean Transparence graph paper over the lesion & the number of square covered by eczematous lesion are counted and size of the lesion will be calculated.)
Table no.24:

CRITERIA
SCORE
Size of lesion calculated by transparence graph paper

Pre treatmemt
Post treatment

No lesion
0

In between – 0 to 4 cm2
1

– 4 to 7 cm2
2

– 7 to 10 cm2
3

Pre and post treatment photographs of Eczematous Lesions.

Cupping therapy
Procedure of cupping therapy
The basic principle of cupping (shringa and aalabu) was followed as per the samhitas only slight modifications were made according to the need.
Purvakarma
After thorough evaluation of the case and investigations the diagnosis of the patient was done and the procedure is as followed,
Patient was asked to report OPD at 9 am after the breakfast
No pre procedure medicine was used
Written informed consent was taken
Patient blood pressure and pulse was observed
Inj. T.T.0.5ml im is given
Patient was kept in supine position or depending upon site of ezematous lesion, right lateral or left lateral or in any positions he / she feels comfortable.
Pradhan karma
Under all aseptic precautions local cleaning of eczematous area with betadine and spirit done. Mild suction was created using a sterile cup and pump on the selected area and left for about 5 minutes. It increases the local blood flow of that area. Then the cups are removed gently by releasing the vaccum with the help of small nozzle presenting on the top of the cupps. Then the small superficial skin incisions are made using a surgical blade no.11. A second suction is done to draw out the vitiated blood. The cups are placed at that site for about 10-15 minuts, in between small suction are done about interval of 4-5 minuts. Then after 30-50 ml of bloodletting (depending upon size and site of patches) cups are removed gently by releasing the pressure.
Paschat karma
The site is cleaned with betadine and dressing is done. It is kept for 24 hours. Post procedure blood pressure and pulse were examined. Patient was observed for any complications. Patient was asked to come on next day for follow up. On 7th day for next setting.
Follow up was taken on 2nd, 7th, 15th the day.