E-ISSN:2456-3110

Case Report

Cracked Feet

Journal of Ayurveda and Integrated Medical Sciences

2024 Volume 9 Number 10 OCTOBER
Publisherwww.maharshicharaka.in

Role of Sarjarasa Malahara in the management of Padadari (Cracked Feet): Case Study

Waddar SB1*, Chalageri CC2, Waddar SB3
DOI:10.21760/jaims.9.10.50

1* Sujata B Waddar, Phd Scholar and Associate Professor, Department of Shalya Tantra, SDM Ayurvedic Medical College, Terdal, Karnataka, India.

2 Chaitra C Chalageri, BAMS Scholar, SDM Ayurvedic Medical College, Terdal, Karnataka, India.

3 Shridhar B Waddar, Associate Professor, Department of Shalya Tantra, SDM Ayurvedic Medical College, Terdal, Karnataka, India.

Introduction: Ayurveda (Science of life) considers lifestyle and cosmetic aspects. Feet are the most often neglected and affected part of the body which forms most important part of the body Padadari (Crack heels) is condition which occurs due to excessive walking, wearing improper footwear/barefoot walkers and dirt, is characterized with appearance of dryness of feet, cracks, flaring patches, itchy skin, pain in palms and soles. Its prevalence is experienced everywhere and common in rural, cannot be considered as minor and neglected. It is considered under Kshudra Roga (minor ailments). Can be compared with Cracked heels/Heel fissures.

Methods: in present study patients of Padadari (Crack heel) were treated with topical application of Sarjarasa Malahara (Sarjarasa Ointment).

Results: Pharmacodynamics of ingredients were effective in management of Crack Fissures.

Discussion: Sarjarasa Malahara (Ointment) was used as remedy for Padadari. Response to treatment was recorded on assessment parameters at respective intervals and therapeutic effect was evaluated through symptomatic relief.

Conclusion: Improvement was observed in parameters on completion of treatment.

Keywords: Padadari, Crack heels, Sarjarasa Malahara, Kshudraroga

Corresponding Author How to Cite this Article To Browse
Sujata B Waddar, Phd Scholar and Associate Professor, Department of Shalya Tantra, SDM Ayurvedic Medical College, Terdal, Karnataka, India.
Email: 		Waddar SB, Chalageri CC, Waddar SB, Role of Sarjarasa Malahara in the management of Padadari (Cracked Feet): Case Study. J Ayu Int Med Sci. 2024;9(10):299-305.
Available From
https://jaims.in/jaims/article/view/3677

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2024-09-15 2024-09-25 2024-10-05 2024-10-15 2024-10-21
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
None Nil Yes 13.39

© 2024by Waddar SB, Chalageri CC, Waddar SBand Published by Maharshi Charaka Ayurveda Organization. This is an Open Access article licensed under a Creative Commons Attribution 4.0 International License https://creativecommons.org/licenses/by/4.0/ unported [CC BY 4.0].

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Introduction

Ayurveda is the science of life which not only deals with the health and illness of human being but also considers the lifestyle and cosmetic aspects.[1] Padadari (Crack Heel) told under Kshudraroga. Padadari (Crack Heel) is a condition where Vata gets aggravated and gets Sthanasamsraya (site) in the foot region.[4] can be compared to cracked heels/heel fissures. When the fissures are deep, they get bleed and become painful later may get infected. It diminishes the beauty of feet. Due to hectic schedules, people find difficult to make time to protection of foot. This negligence results in the crack heel and may cause condition like Padadari (cracked heel), one of the most prevalent and minor illness. Occurs due to Vata elevating certain activity like excessive walking, poor hygiene, barefoot, improper footwear or environmental factors like summer, rainy etc. are causative factors of cracked heels. There are various treatments Principles explained like administration of drugs internally, external applications, Padabhyanga (Foot Massage) and all. Many drugs like Vranaropaka (Wound healing), Krimighna (Anthelmintic), Kushtahara (Skin disorders) selected for the treatment procedure in ancient days.[6]

There are so many preparations in Ayurveda which prove effective against Kshudra Kushta like Tutha, Kapoor[2] etc. In Padadari (Cracked foot), local therapy is more effective than systemic. In this study External application of Sarjarasa Malahara[7,8] (Sarjarasa Ointment) which has Snigdha property, Vrana Ropana, Vrana Shodhana, Sandhaniya properties, which will elevate Rookshsa Guna and relive symptoms.

Aim and Objective

To assess clinical effect of Sarjarasa Malahara in management of Padadari (Crack heel)

Materials and Methods

Table 1: Content of Sarjarasa Malahara

IngredientsEnglish name
Tila TailaSesamum indicum
Sarja RasaShorea robusta
Tuttha BhasmaCopper sulphate
KarpuraCinnamomum camphora
Madhuchista Cera alba

Table 2: Pharmacodynamics of the Ingredients of Sarjarasa Malahara

SNDrugRasaGunaViryaVipakaKarmaDoshaghnata
1.Tila TailaMadhura, Kashaya, Tikta, KatuGuru, SnigdhaUshnaMadhuraSnehana, Vranashodana, SandhaniyaTridosha Shamaka
2.SarjarasaKashayaRukshaSheeta KatuSheeta KatuVranaropaka, SandhaniyaPittakapha Shamaka
3.Tuttha BhasmaKatuLaghuSheetaVishanashakaVatapittahara
4.KarpuraTikta, Katu, MadhuraTikta, Katu, MadhuraTikta, Katu, Madhura
5.Madhuchista Snigdha, MruduKustaghnaVataghna Vranaropaka

Criteria of assessment

1. The subjective parameters of pain, cracks of feet, itching sensation and
2. Objective parameters of depth of crack, roughness, dryness of heel, recorded on basis of score adopted with grading (0,1,2, 3 and 4)
3. After completion of treatment, assessment of scar was done on basis of gradation (0, 1, 2, 3 and 4).

Assessment Parameters

Subjective Parameters[3]

Cracks associated with pain

Grade 0No pain
Grade 1Mild pain in cracked area
Grade 2Moderate pain in cracked area
Grade 3Severe pain in cracked area and patient is unable to walk
Grade 4Associated with sleep disturbance

Cracks of feet

Grade 0No Crack
Grade 1Mild crack [1-7 cracks]
Grade 2Moderate crack [8-15 cracks]
Grade 3Severe crack [16-23 cracks]
Grade 4Very severe [more than 24 cracks]

Itching sensation

Grade 0No itching
Grade 1Occasionally feels itching
Grade 2Intermittent itching
Grade 3Frequent itching
Grade 4Always itching

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Objective Parameters
Depth of cracks

Grade 0No cracks seen
Grade 1½ to superficial crack
Grade 2Few superficial cracks
Grade 3Deep cracks but not bleed
Grade 4Deep cracks and bleed

Roughness of heel

Grade 0No roughness
Grade 1Slight rough to touch
Grade 2Mild rough can be seen and felt
Grade 3Moderate rough can be seen and felt
Grade 4Severe rough which is permanent

Dryness of the Feet

Grade 0No dryness
Grade 1Slight dry to touch
Grade 2Mild dry to touch
Grade 3Moderate dry to touch
Grade 4Severe dry to touch

Case Report - 1

A 45-year female presented with crack heel since 3 months and pain while walking appreciated in patient since 3 months. So, she came to Shalya tantra OPD hospital for the treatment.

Sthanika Pariksha (Local Examination)
Inspection

  • Site: Both Foot
  • Size: 0.1cm
  • Cracks: Present at heel
  • Dryness: Present

Palpation

  • Tenderness - Absent
  • Roughness - Present

Assessment of the Symptoms

Subjective and Objective

Symptoms & SignsBefore Treatment7th Days14th DayAfter Treatement 30th Day
Crack with PainGrade 2Grade 1Grade 0Grade 0
CracksGrade 3Grade 1Grade 1Grade 1
ItchingGrade 0Grade 0Grade 0Grade 0
DepthGrade 2Grade 2Grade 1Grade 1
Dryness of FeetGrade 2Grade 1Grade 0Grade 0
Roughness of HeelGrade 2Grade 1Grade 0Grade 0

Case 1: Images Before and After

jaims_3677_01.JPG
Before Treatment [0th day]

jaims_3677_02.JPG
After treatment [30th day]

Result: Improved

Case Report - 2

A 22-year female presented with crack heel since 1 month and Pain while walking appreciated in patient since 1 month. So, she came to Shalya tantra OPD hospital for the treatment.

Sthanika Pariksha (Local Examination)

Inspection

  • Site: Both Foot

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Sujata BW et al. Role of Sarjarasa Malahara in the management of Padadari
  • Size: 0.1cm
  • Cracks: Present at Toes
  • Dryness: Present

Palpation

  • Tenderness - Present
  • Roughness - Present

Assessment Criteria

Subjective and Objective

Symptoms & SignsBefore Treatment7th Days14th DayAfter Treatment 30th Day
Crack With PainGrade 2Grade 2Grade 1Grade 1
CracksGrade 2Grade 2Grade 1Grade 1
ItchingGrade 0Grade 0Grade 0Grade 0
DepthGrade 2Grade 2Grade 1Grade 1
Dryness Of FeetGrade 2Grade 1Grade 0Grade 0
Roughness Of HeelGrade 3Grade 2Grade 1Grade 0

Case 2: Images Before and After

jaims_3677_03.JPG
Before Treatment [0th day]

jaims_3677_04.JPG
After treatment [30th day]

Case Report - 3

A 24-year female presented with crack heel since 3 year associated with bleeding during summer and burning sensation since 1 yr. So, she came to Shalya tantra OPD hospital for the treatment.

Sthanika Pareeksha (Local Examination)

Inspection

  • Site: Both Foot
  • Size: 0.1cm
  • Cracks: Present at heel
  • Dryness: Present

Palpation

  • Tenderness - Present
  • Roughness - Present

Case 3: Images Before And After

jaims_3677_05.JPG
Before Treatment [0th day]

jaims_3677_06.JPG
After treatment [30th day]


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Assessment Criteria

Subjective and Objective

Symptoms & SignsBefore Treatment7th Days14th DayAfter Treatment 30th Day
Crack With PainGrade 2Grade 2Grade 1Grade 1
Cracks of FeetGrade 3Grade 2Grade 2Grade 1
ItchingGrade 0Grade 0Grade 0Grade 0
DepthGrade 2Grade 2Grade 1Grade 1
Dryness of FeetGrade 2Grade 1Grade 0Grade 0
Roughness of HeelGrade 3Grade 2Grade 1Grade 0

Case Report - 4

A 29-year female presented with crack heel since 7 months associated with pain at heel since 7 months. So, she came to Shalya tantra OPD hospital for the treatment.

Sthanika Pareeksha (Local Examination)

Inspection

  • Site: Both Foot
  • Size: 0.1cm
  • Cracks: Present at heel
  • Dryness: Present

Palpation

  • Tenderness - Present
  • Roughness - Present

Case 4: Images Before And After

jaims_3677_07.JPG
Before treatment [30th day]

jaims_3677_08.JPG
After treatment [30th day]

Result: Improved

Assessment Criteria

Subjective and Objective

Symptoms & SignsBefore Treatment7th Days14th DayAfter Treatment 30th Day
Crack With PainGrade 1Grade 1Grade 0Grade 0
Cracks Of FeetGrade 1Grade 1Grade 1Grade 1
ItchingGrade 0Grade 0Grade 0Grade 0
DepthGrade 2Grade 2Grade 1Grade 1
Dryness Of FeetGrade 1Grade 1Grade 0Grade 0
Roughness Of HeelGrade 1Grade 1Grade 0Grade 0

Methodology

All patients were advised for Foot bath and asked to dry of feet, Sarjarasa Malahara was asked to apply at affected site with the help of spatula twice a day. Post Procedure Patient were advised to avoid exposure to dust and bare foot walk.

Quantity: QS (quantity sufficient).

Discussion

Padadari has been explained under Kshudra Roga, common site being foot, Vata located in sole gets vitiated reduces all Kleda (moisture content of foot) resulting in Cracks known as Padadari. Lepa is one of the classical clinical-based explanations in Shashti Upakrama (60 Procedures); hence, Sarjarasa Malahara Lepa (Sarjarasa Ointment) was planned on Padadari (Crack Heel).


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As it contains Tilataila (sesamum indicum), Sarjarasa (Shorea Robusta), Madhuchista (Bee Wax), Karpura (Cinnamum Camphora), and Tuttha (Copper Sulphate). Pharmacodynamics of Sarjarasa, Tilataila have Snigdha Guna (Moisturizing/Humidifying). Pharmacodynamics of Karpura are like Madhura Rasa, Sheeta Virya, Tikshna Guna (Sharp penetrating qualities create cleansing effects on body). The Lepa (Ointment) does the Snehana (Moisturing) and Vranaropana (Healing) in Padadari (Crack Heel). So, more efficacy on Padadari.[10]

Conclusion

Based on this study following conclusion may be drawn: Padadari (Crack heel), is considered under Kshudra Roga (minor ailments) it can be managed easily, in the present study Sarjarasa Malahara (Sarjarasa Ointment) was used for topical application. Properties of the formulation are, Snehana (Oleation), Ropana (Healing), Lekhana (Scraping) and Varnya (Beautifying) also has Snigdha Guna (Moisturizing/Humidifying), Sandhaniya (Approximation), Shodhana (wound cleansing), together with these properties Malahara was helpful to alleviate Vata Dosha improving in dryness, roughness, Cracks and its complications. Therefore, topical application of Sarjarasa Malahara has improved outcome and is easy, safe, cost-effective preparation.

References

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9. Manishkumar RV, Malathi K, Vikram S. Role of Mahishi Navaneeta and Madhuchista as a base for healing fissures of the feet W S R to Malahara Kalpana. J Ayurveda Integr Med Sci 2019;4:244-8.
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