EFFICACY OF NYAGRODHA TWAK CHOORNA, ELA CHOORNA WITH MADHU IN MUKHAPAKA IN CHILDREN

Mukhapaka is one of the common diseases in day today practice which disturbs childrens ability to eat, drink, talk and lack of sleep. This disease is relentlessly increasing among the children in India, with an overall incidence of 25%.Vitamins deficiency, nutrition deficiency, iron deficiency, is very common in children and one of the causative factors of Mukhapaka, so patients of Mukhapaka are in need of a cost effective, palatable and easily available medicine. Therefore, NyagrodhaTwakchoorna, Elachoorna with Madhu, has been selected.These drugs have an action of anti-inflammatory, haemostatic, antibacterial, antiviral, antifungal, improves wound healing and provides cooling effect by their Pitta samaka property. These can be administered both internally and externally.Currently the treatment for the Mukhapka being very limited, the present clinical study was designed to evaluate the efficacy of Nyagrodhatwakchoorna and Elachoorna with Madhu for Pralepa in Mukhapaka.


1081
Method of collection of data: 1. A minimum sample of 30 patients presenting with signs and symptoms of Mukhamayawere selected for the study with Nyagrodhatwak and Elachoorna with Madhu. 2. A special pro forma is prepared which includes detailed history taking, physical signs and symptoms as mentioned in our classics. Patients are clinically examined, analyzed and selected accordingly. 3. Nyagrodhatwak and ElaChoorna are given in the dose as much as required for oral application, i.e. quantity enough to combine completely with Madhu, three times in a day after oral feeds for 3/5/7 days as per the severity of the symptoms 12 .

Study Design:
It is a clinical study with follow up of children suffering from the Lakshanas of Mukhapaka.
Assessment criteria: Assessment of every patient was totally based on clinical observation and information given by patient/ parents/ guardian. 1082 NyagrodhaTwak -3kg Ela seeds -3kg from SDMTAMC Pharmacy. Madhu -organic honey from local vendor was used. Used to mix with ingredients to form a homogenous paste as per requirement quantity. 1. The ingredients were subjected to pounding and powdered using sieve-85 to prepare fine powder. These preparations were done at department of BhaisajyaKalpana, pharmacy centre in SDMTAMC. 2. These powdered drugs were cleaned and kept in shade for drying, to remove remnant moisture and later the drugs were stored in clean air sterile tight containers.
Procedure of application of the formulation: 1. Patient position: Patients were made to sit in a comfortable in erect posture and asked to open the mouth widely.
2. The site, number and other characteristic features of the ulcers are properly visualized using a torch, noted before and after the treatment. Then adequate quantity of the formulation is taken using a wooden spatula/cleaned finger and applied over the affected sites in a manner of thick paste. 3. The patients were asked to sit in the same posture for a minimum of two minutes then were allowed to go and carry on their routine activities. 4. The patient/parents/attender were properly advised to carry out the method of application even after going home, thrice a day as demonstrated by the investigator.

Duration And Follow Up Of Study:
Since this is a clinical study, the patients are kept under observation till the evaluation is completed. Study required follow up in the pattern of 3/5/7 days, till the resolution of symptoms.

Investigations:
Where ever required following investigation advised -Complete blood counts; Oral swab/throat swab for culture and sensitivity; HIV-TRI-DOT Test.

Observation And Results:-
The observations made during the study were as follows: Majority of the patients, i.e., 33.33% belonged to the age group of 3-6 and 6-9 years respectively; 77% of the sample were females; majority of the patients belonged to Hindu religion-63%; 67% of the sample belonged to the economic status of lower class, 90% of the patients were from rural locality; 73% of the sample followed mixed diet; 53% of the sample reported disturbed sleep; 50% of the sample had indulgence in Katu

Discussion:-
Mukhapaka is a PittajaNanatmajavyadhiintiated by Ushna-teekshna-viruddhaharanidana leading to Yugapat vitiation of Vata-Pitta-Kapha which causes Vrana in MukhaGuha, especially involved with PakaPrakriya. The main disease pathology in this disease is the production of Paka in the Dushyas.
The drugs used for the present formulation showed efficacious and promising results, which could probably be due to the following properties: 1. NyagrodhaTwak Excellent Pittaprashamaka, having Kashaya -Madhura Rasa, Guru Guna, ShitaVirya. It is also a Raktaprasadaka drug and thus helps in relieving the PakaPrakriya or the inflammatory pathology. 2. Ela It predominantly has Shitavirya, MadhuraAnurasa by which it takes care of Pitta Prakopa; but Katupradhana which alleviatskaphadosha. It also has Krumihara property, by virtue of which it proves to be anti-fungal, anti-bacterial and anti-viral. It is also anti-inflammatory in nature. 3. Madhu It is mainly VranaShodhaka, VranaRopaka and VranaSandhanakara in nature. It is Kapha-Pitta