Comparative clinical study of efficacy of Rohni Sikhta Taila, Rohni Sarjarasa Malahara & Rohni Ointment in the management of Agantuja Vranashotha with special reference to superficial thrombophlebitis

Superficial thrombophlebitis is inflammation of the vein which is common complication of intravenous administration of drugs as by IV Cannulation. This inflammatory condition arises due to local injury and microbial contamination. Local treatment seems better than systemic drugs and if not treated timely can cause cellulitis and even suppuration. Hence immediate treatment needed which includes topical ointment, Hand Elevation, Use of Antibiotics etc. Acharya Sushruta has mentioned a detail description of inflammatory swelling under the heading of Vranashotha. IV Cannulation induced Superficial Thrombophlebitis can be correlated with Aagantuja Vranashotha. There are many modalities for treating this condition amongst which Lepa is one of the important measures. For this purpose, we had hypothesized a drug, which could reduce local signs and symptoms of Vranashotha as mentioned in various Ayurvedic text. In this study we had prepared Rohni iSiddha Taila with 3 Kalka dravya like Rohitak, Haridra & Nirgundi which was further divided into Rohnii Sikhta Taila by mixing Sikhta (i.e beewax), Rohni Sarjarasa Malahara by mixing Sarjarasa (i.e Shala Niryasa resin extract) & Rohni Ointment(i.e with Alcohol extract + Petroleum Jelly). Considering the Initials of the


Superficial
thrombophlebitis is inflammation of the vein which is common complication of intravenous administration of drugs as by IV Cannulation. This inflammatory condition arises due to local injury and microbial contamination. Local treatment seems better than systemic drugs and if not treated timely can cause cellulitis and even suppuration.

Material and Method:
Ayurveda provides an effective solution to the problem of curing Vranashotha with the use of herbs, use of herbal powder massage and local Application of herbal drugs like Lepa The Ayurvedic Manoeurve suggests that lepa is the topical formulation and should be gently rubbed in an upward or reverse direction of the hair over the skin. The main indication for the use of Lepa is mentioned in shashti vrana upkrama (60 steps to treat wound) The use of this prepared Rohni Sikhta Taila, Rohni Sarjarasa Malahara & Rohni ointment was done in various swellings like cellulitis, lymphatic swelling, fracture induced swelling etc apart from IV Cannulation induced thrombophlebitis which yielded significant results.

So, it was decided to do comparative clinical study of Rohni Sikhta Taila, Rohni Sarjarasa Malahara & Rohni ointment
Classifying into 3 Different groups used in the management of Agantuja Vranashotha with special reference to superficial thrombophlebitis.

Selection of the drug:
The prepared Drug is divided into 3 Different Groups as Group

Clinical observation Score Grade
No Evidence of erythema 0 0

OEDEMA-
The Inflammatory oedema is reduced which is probably due to dhatushoshak (Absorptive) effect of kashaya and tikta rasa and also Kledashoshaka (astringent) effect of Haridra. The laghu Ruksha Guna of Haridra also helps for the same. Other content in the drug especially Nirgungi alleviates vitiated kapha to reduce the oedema working as Shothahara (sindhu shotham varyati Iti Sindhuvara-bhavprakash) 3. ERYTHEMA-Erythema in inflammatory process due to increase blood supply over injured area due to vasodilatation.The prepared drug formulation is found to reduce erythema (redness)also does the work of Raktaprasadana especially by Haridra and Rohitak (Bhavprakash and Dhanvantari Nighantu) In present study prepared 3 groups of drugs has been effective in terms of reduction in erythema (Redness). This might pittashamaka & Pittarechaka effect of the Haridra acting as cooling agent and astringent. The kashaya, Tikta rasa and sheeta virya of the contents in this drug formulation have capability to constrict blood vessels, hence it reduces erythema.

OTHER BENEFITS-
It has remarkable action on skin acting as Varnya (skin illuminator) and also Vranashodhak & Vranaropaka. Nirgundi has prominent effect on all kinds of Vrana so called as Sarvavraneshujita ( ChakraDutta) Haridra called as Twakdoshahara Healing all the ailments of skin Taila used for Rohni Siddha taila having shukshma guna makes the deep penetration into tissues possible giving high efficacy. Also, the Shala niryasa used for Rohni Sarjarasa Malahara gives a base to the preparation by enhancing binding effect making it patient use friendly and handy for application. Most of the patient showed significant relief and found to be free from toxic effect of disease within 5 days of the application of the prepared drug formulation.

Conclusion:
This formulation of 3 different groups reduces all cardinal features of vranashotha with special reference to superficial thrombophlebitis. Thus, it can be proven as potent anti-inflammatory medicine. No adverse reaction was found after topical application In This case series total 45 patients, each group 15 were enrolled and all the selected patients showed significant improvement in thrombophlebitis within 5 days like in Oedema, Erythema, Pain and Tenderness but to be concluding amongst the 3 groups namely Rohni Sikhta Taila, Rohni Sarjarasa Malahara & Rohni Ointment the group 3 i.e the Rohni Ointment is most effective as compared to other 2 groups. The same contents when processed with alcohol extraction method and mixed with petroleum jelly resulted in Ointment having highest significance The constituents of Rohni Sikhta Taila, Rohni Sarjarasa Malahara & Rohni Ointment are easily available without much efforts, relatively cheap and with no obvious adverse effects making it certainly more desirable then the conventional ointments in use.