\(~f·.'ClinicalEvaluation of Karpurar ~..f c', -; ~'.. •

i·~·(Chinnamomum Camphora (L.)~,~':;:Kshira (Milk) Aschyotana in

.Allerqlc Conjunctivitis. N. Srikanth

Ex lecturer~~<;. ' Indian Institute of Ayurvedic Medicine and Reserch:i:i:- ' JayaMahal Road. Bangalore-560006

Present Address:Asst. Research Officer (Ayurveda)

; Central Council for Research in Ayurveda and SiddhaNo. 61-65 Institutional Area, Opp '0' Block

Janak Puri, New Oelhi-110 058

tk:tlinical study of 76 cases of

.I(.~o-;'}unctivitiswas conducted to

~;~~;...r.~t~,:nheeffect of Indigenous Oph-! ·!.ti~tmlc:Drugs-Karpura(Chinnamomum

~iibtcr( L.) and Kshira(Cow Milk),

,~~gJ~~I~administration (Aschyotana) of

;~?l.~~~?j~!Jlonprepared with Karpura. ?~,{1~;~~naID()mumcamphora (L.) and

R r~;!~~pyvMlk) was scheduled for 5

J~J;Aschyotana procedure was

in!~i;for the same period at an\lqf~·.days. Fol/ow up observation

; ,; "' -0. or1e'fortwo months. Results wereAPCQur.aging. ., fl~t{.>.~,:..... ,

~:~Dtr~ctuction'r :~~~~_~ , . • •

. :~;~;:i.r~;;~~Iergicconjuntivrtrs :s common-

Iy occuring ocular problem in day-to-day'

ophthalmic practice. Apart from

phlyctenular conjunctivitis as a mani-

festation of endoceeouscatlerqy and

spring catarrh an exogenous aliegry

the conjunctiva may react to many ether

sensitizing factors viz. external plt/sl-

calor chemical. Allergy as a calise of

conjuctival congestion has however

been exaggerated. Anvthinqwtucn does

not fall into the description of ~ S!jE.:clflc

condition and any condition snow

aetioiogy is undermined is often attrib-

uted to allergy. This evasive diaqnosis

is further supported by the fa .crab!e

response of the conjuctyival conce stion

to steriods. (Ohanda et al 19:~!6}

Aetiology:There are however very specific

factors. which 00. cause well-defined

a'llergic reactionsTn the conjuctiva.

(Dtiar"da et a!19E)6, Agarwal and Gupta19:82'

'. )

* " Allergic reaction to foregin matter in

~:,.'{heconjunctival sac, e.q. leafy \jeg-

. etaticns, ants. cosmetics like eye

shadows etc.

Allerqic conditions like hay fever

, ai~'-!asthma

" Parasitic infestation in intestines

'" ..: AII~rgy, to edibles,like .eggs, mil~""".' :f(sh~'rr1'eats,certain fruhs':and veq- .'

etables.

* Drug allergy to local applications

commonly to chemotherapeutic

drugs like sulpha and antibiotics

like penicillin, streptomycin, tetra-

cycline and neomycin has been

known

*

Allergy to mediations like aninjec-

tion of xylocaine is well known.

Allergy to chemical substances like

plastic made contact lenses, pros-

thetic implants and the plastic of'

spectacle frames.

Allergy due to septic focus else-

where particularly staphylococcal

infection and tubercular focus

*

* Thediagnosisofallergicconlucti~itr~~'" ~

shouid be .made o,nly after excl~~'"

i'ng' specific causes of conjuctTv"

congestion. History of sudden bhset following use of some sensAI'

ing rriatenal. infestation of a drU~9,rf-'i~. food or of a medication appficatlo~ ..

'.. "4

suggests an allergic basis. A co

junctival smearforeosinophils, hi9;

er eosinophilic count in differenti, .

WBC counts and detection of int¥

tinal parasites may help diagnos'itNeed for Alternativ

Therapies:. I

Current line of manaceme. '.' ''''''1..,

advocates the. use of topical'st~ri9

decongestant drops along with antE

tarnine agents, is not found satis(a~

and temporary, should be ropeateqduring exacerbations, besides %verse effects. Which coulc eff,e~Jjtackle such conditions. AyurvediG,(

tures have recorded more than 5~'. .drugs, 30 metals, minerals ahd

products useful in the treatrnent ,

ious eye disordrs (SrikanthN.200'~'-rthe study, attempt has been ,m,a, _

evaluate the effect of IndigenoLJ,

thalrnic Drugs-Karpura (Chinnan,j

carnphora (L) and Kshira (CO~,

Drug Profile:.1·~jT

1. Name of the Drug: Chf'!.g,camphora (L.) .•.

It>

PharmacOlogical Profile:

Rasa- Tikta katu, madhura

Guna-Laghu, tikshna

Vipaka-Katu

, Virya-Sita

Ophthalmic Uses and Indi-

cations : chakushaya (conducive

to vision and eye.(.Netra Sukrhara

(effective in corneal opar.me s ,

(SrikanthN ,2000),ChinnamornLlmcamphora (L,) shows antibacterial

activity against gram-positive and

gram-negative bacteria, (Naqv: BS

et al)

2. Name of the Drug: Cow Milk

Pharmacological Profile:

Rasa-Madhura

Guna-Sniqdria

Vipaka-Madhura

Vlrya-Sitar I

Opthalmic Uses and Indications:

chakushaya (conducive to vision and

eye) (SrikanthN 2000)

Material & Method:

76 Clinically established ca::i,':',

of acute/chronic allergic conjunct.'. 'i!:;

were selected

Aims & Objectives:

The present study was airneo ..:

establishing clinical and therapeuic (:;-

ficacy of topical adrrunis trau.'-

IAser-lyotai,.):, ct tresr ,~cl',,1i(Jr'rk;: ~r::?l

with Kerpura rChinnL.:inCniLI,',·1;:::,;1'. ";cr,']

(L ) a'lC Kshira (COINn11!k) ,f :I~,~ i:.. ~S,,·cS

of a:lcrglc conjunctr-it s ~·,'1c·,;;,.- ::':S

has been made to or ser.c ;1,': ;,':dence of age sex O':Cl,C::t'(J,' :::. ":,.[,t,

and rcie of aetioloqrcal loc.(;"'_, " :<C'.~uon to the causation of :~-,,:(.:.'1'~'· '"

Selection of the Drug:

Fresh solution r'reiJ::;' , ,:.','i!j-,

Karpura (ChinnamOnll!ln (;3\i1!:;'.:,:,J IL )

and Kslura (COW Milf:! Vv8'S (::::'·0:1 for

. topica: use

Method of Preparation

•

Fresh solution should be pre-

pared by adding 1/2 g01, Karpur a

(Ctunnamomum camphora (L ) 10100-

011 of boiled and cooled Kshlra (COW

Milk)

Procedure of Aschyotana :

installation of 10-1;~ jrops of

medicated solution into C!,:ll; 1<::11"'; a I sac

vJhell eye is completely 01"'(''1 and pa-

ta::lI! IS in supine p~;s'I:!~:ill

Schedule of Administration:

All patle",!,> :,v:c,:.tl:,! fur tne study

\\Ert: treated 'Nit!!;· sci',y:._,,:,:'a for 5 (1, rvs

ano r,::oeated tI-:2 p,';;, c·,i: J<.. ~cr·ttl~ s arne

period at an interval '-if ,/;': \',t;E:k

Criteria for selection:

Patients peSEI1:!: i(J ,,'Jlth C:Jrdlllal

features c f elierql( (,onju1i( (;it's viz

rb

"---',---,,~""""""'~"""""' .. _-u ( 3~

RE;cinE-"ss.,j'~~;'1g lacrimationrrrita-

1,01', dnd ~~i~:i~')l;hobla

Cnron.cttv ·;.::SS than 5 years.

Criteria for exclusion:

AICPIC xerato conjunctivitis

Giant Papl!ta''j conjunctivitis

Stevens Johnson Syndrome

Parasitic infestation

Chronicity more than 5 years

A"erg~c skin diseases anywhere III

the bccy.

Criteria for assessment:

Tre) criterion for assessment was

o.ised on presenting signs and symp-

toms ana tl~elr aueviatron (Model score

sr.een Routine Hematological and SIC.-

chemical C: .-anunatrons were done be-

fore treatment

Model score sheet

Ctinical features Score

Observations:

o

Total 76 cases of both sexes

and the age group 15-24 yrs and 58-64 .

yrs were studied. Observation in table-

1 .ndicates the 23 (30 2%) cases were

males and 53 (69 7%) were feamals

The maximum numbers of 23 (:302%)

and 26 (34.2%) cases wet« between

the age group 15-24 yrs and 25-34 yrs

respectively. (Table-f ). A maximum

number of 43 (56.6%) cases were of

Kacha Prakriti. (Table-Z). A maximum

number of 42 (553C';/o) cases were field

worker s/studeuts. (Table-S) Further

under diet pattern. 54 .(71%) of the

cases were non-vegetarians and 22

(29%) were vegetarians (Table-a) As

per the chronicity of the Illness. a max-

imum number of 27 (35 5~;-;) where 0-6

months old and 18 (23 T:::.) were 7-12

months old. ,Table-51 Clinical features

.rz. Itching redness and Irritation were

present /II aii the 76 cases (1 OO~~)

lacrimationrn 71 (93~j:) photophoura In

17 (23 7':-,) were 7-12 months old. (Ta-

ble-5) Cnnica: features viz Itching red-

.ness and nruat.on were present III all tll~

76 cases (1 OC ") lacrimation II) 71 (93':1/0)

photophobra 1'1 17 (23 -/~)and Blepnantls

in 21 (27';,: cases Rlst: .n ESR wasobservec rn 14 .:S 4',':· __-,ses ;::3ble

F" e sent 30. Absent

oG : The aeuoioq.c.s ',,(7:) S ..:. ~·/'.;,::;s~;rt;

to troo.ca. '..,;-::;. '..~:; :v.. ~:~ .1.12

(158' _.)Ca:O.'=:-5 :'::r ...; ,- ~'in.rruants m

3-:- 48 6)~·) t-.,(O~h:l'· ;~ - ,tr'J8rlS In33

I; . preSE'-!H:::O Absent

,L;)i'~ Dresent 20. Absent C'

\+

~ JOff5m4fC1rt ~ \3:rrrR7 ~ 0 0 ~ '\ 57 A\. :I

(43.4%),Use of Cosmetics In16 (21 %), symptomswasobserved in 14 (1842%)

contactwith pets in 3 (3.9%) and No cases. (Table-9,,).1 specific cause was identified in 17 Discussion of Conclusion:

(22.4%)cases (Table-7).By considering the observa-

Results: tions and results, it may be concluded

Complete relief from presentingthat the colution prepares with Karpura(Chinnamomum camphora (L.) and

.~ symptomsviz. itching was noticed in 64Kshira (Cow Milk) may be successfully

(84%)(n=76)cases redness in 66 (86%) employed in the management of acutej(n=76), lacrimation in 64 (90%) (n-71) and chronic conjunctivitis of varied i

" whilecomplete relief and photophobia aetiology. The response obtained may :

wasobserved in 14 (82%) (n=17) sub- be explained with chakushaya, Netrya I

jects.(Table-8). (conducive to vision and eye) properties !(SrikanthN.2000) and antibacterial ac- :

Irrespective of symptomatic re- I

~Itivity against gram-positive and gram-

ilief,complete relief from all the present- negaUve bacteria (may be effective in Iingsymptom was noticed in 62 (81.5) preventing secondary infection) (Naqvi I,casesand relief from certain presenting 8S et al.) attributed to the above cruqs. !

~, I- '-..Table NO.1. ,

I"Age and Sex Distribution i

i!r Agein Male % Female % Total %..

Years i

;15-24 6 7.8 17 22 23 302- !r P:34 10 13.5 16 21 26 34.2

,. II) , 35-44 14.4 !

4 5.2 7 9.2 11 .----"Ii! ,• I, 45-54

2 2.6 5 6.5 7 9.2I ',!r- -.f 55-64 1 1.3 8 10.5 9 11.8'r--- .' ,

Iii ,Total 23 30.2 53 69,7 76 100I""--

I ,~ ,c,- .. -' ...... _ .. -- .. -_. -

~~.

<..'"---' 58 ) \. 3:rrgifcr ./..{F5/?1d1f1ry ~ ~t~JFTR'f ";(oo~~~~'I

\.,

"·1 .;~~

,Table NO.2 "

,Distributiorr of Prakriti · ,, I

"Prakrti

----..;No. Patients % j.

(n=76)!f~,

•. ....- • 17'

Vata 11 14.5-:--1

· ,I

Pitta 22 30 1 t,'j

I Kapha 43 56.6 · ,

I! :-~."

:, Table NO.3

Distribution of Occupation. i ,.

- -Occup.;~!on No. Patients % ,

(n=76)c,l

, ; !i Desk 1f:) 205

".,,

workers/i ,! Students .

I Fleldl 42 55.3I

Factroy .workers,

;

House Wife 19 25

Table NO.4

Dietary Habits -Diet No. Patients 0/0

(n-76) i -Veg 22 29

Non. Veg 54 71

-- --_. - .. _. ._. - _.. . ~ - .. - -~.-..- - ..~

19

.]~ 4I'5m4f(YJ"1 ~\ -~59F.J~ ";(oo:t

i

Table NO.5r i Chronicity of illness!

r Chronicity No. Patients %

Of illness (n=7f')I

(MlYr.) ,Ir

,; 0-6M 27 35.5,

7-12M 18 23.7

1Yr.-1Yr.6M 11 14.5I

i

1Yr.7M-2Yr. 3 3.9 :

2Yr.-2Yr.6M 6 , 7.8 I,

I 3 Yr-7M-3Yr. 2 2.6:

• ,3 Yr.-3Yr.6M 5 6.5

,Ii

3 Yr.7M-4Yr. 4 5.2 I

I;

i I

:,

Table No.6 ,I

Incidence of clinical features-i

Clirucal features No. Patients %

L (n=76) ,,

I Itching 76 100I

I Redness 76 100 ;

I Irritation 76 100 II !

I ;

t.acnmation 71 93 ,

17 22i

Photophobia I

IBlepharitis 21 27 !

i

Raise in'ESR 14 18.4 I

I , !

Raise in AEC 33 43 i., . I

L,

-....;;;:--- .. •• ___ M_ •• _______________ -------- -.---- ----- - . o. __ - - - --

---1 60 (J~ JO{i5m4i(itrf ~ Jf7RD ~oo~ -

"

rr\ !

I'

ITable No.7 I

I'

Distribution of Aetiological Factors *.

\ .

IAetiological Factors' No. Patients %

-\,I...

, (n=76) '.

I

! -Exposure to tropical winds 12 15.8

Occupational irritants 37 48.6 !

I Inflammation of surrounding 21 27,I

t

Itissues I,

Use of Irritant Drugs 2 2.6 ,I

Exogenous Allergens 33 43.4 ;

Use of Cosmetics 16 21

Contact with pets 3 3.9" ·No. specific cause 17 22.4I ' .'

: I

* Dhanda et et. 1996, Agarwal and Gupta 1982.,. )

;

\,,

Table NO.8 , i

Symptom wise Response,

!; .

IClinical features Response after treatment

:,

Relief No. ReliefI - ,

No. % No. %Patients Patients

Itching 64 84 12 15.8

(n-76)

I Redenss 66 86 10 13.15I

(n-76), Irritation 68 89 8 10.5:

(n-76)i; Lacrimation 64 90 7 9.8

I

(n-71 ),

I

Photophobia 14!

i 82 3 17.6 :I (n-17)

Ir

, -II - . - --- _.. - .. -. '"-

... . _ ..

A .Jngik J..{t5/?i..,q(1"1 ~ .J~ ~OO~ ~~~~~~~~~

Table NO.9

Response after TreatmentI I

Response after

Treatment

(n-76) ,

Complete Relief of all

Presenting Symptoms

Complete Relief from certain 14

Presenting Symptoms

No. Patients

62 81 5

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~

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