E-ISSN:2456-3110

Case Report

Kshudraroga Kadara

Journal of Ayurveda and Integrated Medical Sciences

2024 Volume 9 Number 11 2024
Publisherwww.maharshicharaka.in

Efficacy of Herbal Madayantikyadi Cap in the management of Kshudraroga Kadara (Corn) - A Case Series

Mavale A1,2*, Dasar D3,4
DOI:10.21760/jaims.9.11.48

1* Abhishek Mavale, Post Graduate Scholar, Dept of Shalya Tantra, Mahatma Gandhi Ayurved College Hospital and Research Centre Salod (H), Wardha, Maharashtra, India. 2Datta Meghe Institute of Higher Medical and Research, Wardha, Maharashtra, India

3 Devyani Dasar, Associate Professor, Dept of Shalya Tantra, Mahatma Gandhi Ayurved College Hospital and Research Centre Salod (H), Wardha, Maharashtra, India. 4Datta Meghe Institute of Higher Medical and Research, Wardha, Maharashtra, India

Kadara is an Ayurvedic term for a skin condition that is similar to a corn in modern medicine. Patients in the current case series were chosen for local application of Madayantikyadi Cap on alternate days for eight days after visiting the OPD of Shalyatantra of Mahatma Gandhi Ayurved College Hospital and Research Centre Salod(H), Wardha for the treatment of Kadara. Local Madayantikyadi Cap application, two follow-ups were conducted at intervals of 15 and 21 days. Complete scraping occurred, pain and sensitivity decreased, and no recurrence was seen till the follow-up period.

Methodology: Five patients of Kadara (Foot corn) disorders to get Madayantikyadi Cap local application and kept overnight for alternate day for 8 days.

Result: The outcomes of using Madayantoikyadi cap locally were quite favorable. Significant reductions were made in pain and difficulty during walking, tenderness and size of lesion. In terms of overall results, foot corns patients were entirely cured.

Conclusion: Madayantoikyadi cap locally is beneficial in reducing pain and difficulty during walking, tenderness, and size of lesion, according to several treatments, assessments, and discoveries. As a result, it is possible to conclude that local application has therapeutic value in the treatment of foot corn. It Concluded application of Local Madayantikyadi cap formulation as an Anubhoot Yoga more effective on Kadara (foot corn).

Keywords: Ayurvedic Kshudraroga, Kadara (corn), Ayurvedic Management, Madayantikyadi cap.

Corresponding Author How to Cite this Article To Browse
Abhishek Mavale, Post Graduate Scholar, Dept of Shalya Tantra, Mahatma Gandhi Ayurved College Hospital and Research Centre Salod (H), Wardha, Maharashtra, India.
Email: 		Mavale A, Dasar D, Efficacy of Herbal Madayantikyadi Cap in the management of Kshudraroga Kadara (Corn) - A Case Series. J Ayu Int Med Sci. 2024;9(11):325-331.
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https://jaims.in/jaims/article/view/3693

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2024-10-13 2024-10-23 2024-11-02 2024-11-12 2024-11-22
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© 2024by Mavale A, Dasar Dand 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].

J Ayu Int Med Sci 2024;9(11)325
Download PDFBack To ArticleIntroductionCase -ACase -BCase -CCase -DMethodologyResultDiscussionConclusionReferences
Abhishek Mavale et al. Efficacy of Herbal Madayantikyadi Cap in Kshudraroga Kadara (Corn)

Introduction

Acharya Sushruta was the first to mention Kadara in Nidana Sthana Adhyaya Kshudra Roga. Extreme pain and agony are experienced by the afflicted individual. The site of the swelling, the underlying causes, clinical characteristics, and other elements may all be used to correlate Kadara. In India, there are around 10 million instances of corn each year. Corn caps, salicylic acid paints, cryotherapy, and surgical excision are the current therapeutic options available in modern science. A high risk of recurrence is linked to each of these modalities. All allopathy management mention local plaster application as the course of management in Kadara (foot corn). Agnikarma and the local use of Pippali Taila as the Sneha Dravya to be employed for Agnikarma are especially mentioned by Acharya Sushruta and Acharya Charaka. Patients in the current case series were chosen for local application of Madayantikyadi Cap on alternate days for eight days after visiting the OPD of Shalyatantra of Mahatma Gandhi Ayurved College Hospital and Research Centre Salod(H), Wardha for the treatment of Kadara.

Information about patients and Operative management

Case - A

A 34-year-old female patient arrived at Shalya OPD complaining of formation of lesion on left foot sole great toe region, and complaining of pricking like pain during walking or after applying pressure also tenderness from the last one month. Following local examination stated that Kadara (foo corn). Following all normal investigations, surgical intervention was selected. In the Shalya Tantra Department of MGACH and RC, the procedure involved application of Madayantikyadi cap locally and kept overnight alternate days for 8 days.

Case - B

A 40-year-old male patient arrived with symptoms of pricking like pain and difficulty during walking because of formation of round lesion on right sided foot sole from last 8 days. After conducting all necessary tests, and local examination we diagnosed that Kadara (foot corn). So, patient came to MGAC Hospital, for further management.

The procedure involved application of Madayantikyadi cap locally and kept overnight alternate days for 8 days

Case - C

A 26-year-old girl who came at Shalya OPD of MGAC Hospital with complained of developed lesion on left foot sole lateral eminence. Pricking like pain after walking and applying pressure also tenderness.

After local examination found a Kadara (foot corn). Performing all necessary tests, and advice for application of Madayantikyadi cap locally and kept overnight alternate days for 8 days

Case - D

A 61-year-old male patient consulted Shalya OPD with symptoms of formation of lesion on left foot sole also Pricking like pain and intermittent discomfort during walking also tenderness on a local examination, diagnosed with Kadara (foot corn).

After patient come to Shalya Tantra Department of MGACH and RC, advice for application of Madayantikyadi cap locally and kept overnight alternate days for 8 days

Table 1: Investigations

InvestigationABCD
RBS102mg/dl117mg/dl138mg/dl155mg/dl
HIV and HBSAGNegative and Non-ReactiveNegative and Non-ReactiveNegative and Non-ReactiveNegative and Non-Reactive

Table 2: Postoperative maintenance

Following each case, the common treatment plan detailed in table no. 2 below was carried out.

Herbal DrugsManagementDuration
Madayantikyadi capMadayantikyadi cap local application kept overnight alternate dayFrom Day - 0 To Day - 8
Tab. Triphala GuggulAfter local application of Madayantikyadi cap, Take 2 tabs of Triphala Guggul with a cup of moderately warm water.From Day - 0 For 15 Days

Table 3: Posology

InterventionDose and FrequencyDurationApplication periodAssessment periodFollow up
Madayantikyadi CapAlternate Day7 Days1st, 3rd, 5th, 7th day2nd, 4th, 6th, 8th day15th, 21st day

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Abhishek Mavale et al. Efficacy of Herbal Madayantikyadi Cap in Kshudraroga Kadara (Corn)

Table 4: Assessment Criteria

ParametersGradeCriteria
Size of Lesion[1]0No Lesion
1< 10mm
2Diameter Between 10-20 Mm
3>20 Mm
GradeCriteria
Pain[2]0No pain
1Mild pain but no difficulty in working
2Moderate pain severe difficulty in working
3Severe pain and working not possible
GradeCriteria
Tenderness[3]0Tenderness absent
1Mild tenderness to palpation
2Moderate tenderness to palpation
3Severe Tenderness on palpitation with withdrawal
4Severe tenderness with withdrawal from noxious stimuli
GradeCriteria
Difficulty During Walking [4]0Nil, No pain when walking
1Mild pain reported when walking, but managed to walk without any abnormality or without disturbing the pattern of walking
2Moderate pain when walking, can walk, but the pattern of walking is disturbed
3Severe pain, very difficult to walk, the pattern of walking is disturbed very much

Table 5: Assessment Parameters

SNAssessmentsDayCase-ACase-BCase-CCase-D
1.PainDay-03333
DAY-23213
DAY-42112
DAY-61102
DAY-80001
2.TendernessDay-03434
DAY-22323
DAY-41223
DAY-60112
DAY-80001
3.Difficulty During WalkingDay-02223
DAY-22112
DAY-41002
DAY-60001
DAY-80000
4.Size of LesionDay-02333
Day-21223
Day-41212
Day-60111
Day-80100

All five of the patients' metrics have shown a significant improvement. After the administration of Madayantikyadi cap local application, significant differences were seen in terms of pain and difficulty during walking, tenderness, and even size of lesion. The assessments of the patients and their observations are displayed in the following table.

Figures

jaims_3693_01.JPG
Figure 1: Before Treatment

jaims_3693_02.JPG
Figure 2: Application of Madayantikyadi Cap


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Abhishek Mavale et al. Efficacy of Herbal Madayantikyadi Cap in Kshudraroga Kadara (Corn)

jaims_3693_03.JPG
Figure 3: After Treatment

Methodology

Patients were selected with symptomatic findings and written informed consent was taken. Investigations (HbsAg, HIV, RBS, etc.) were done. Patient sat in a comfortable. Position over the table and the site of the lesion was cleaned with Normal saline, Madayantikyadi cap was applied and tight bandaging was done and cap was applied continuously for alternate days for 8 days. Patient was advised to keep the cap overnight. The observation was recorded before the treatment and after the treatment regarding the changes in the symptoms with the above procedures in the case proforma specially designed for the study.

Result

In this study patients had a symptom of pain and difficulty in walking also tenderness from the baseline after application of Madayanatikyadi cap locally gradually decreases day by day as shown in assessment in Table No. 5. After treatment there was significant reduction in size of lesion, within 15-21 days as shown in figure.3 with no tenderness, size also decrease and tissue recovery was also observed there were no complications.

Discussion

Our Acharyas have proposed various therapeutic methods for managing diseases. In Bhaishajya Kalpana, the external application of herbal drugs in the form of a paste is referred to as Lepa Kalpana, one of the Shasti Upakramas.[5] This practice involves applying medicinal substances to the skin or mucous membranes, commonly used for conditions like inflammation, wound healing, and cleansing. The effectiveness of Lepa Kalpana requires further research to validate its benefits. Madyantikadi Cap are a modern adaptation of this concept.[6]

In today's fast-paced world, where following traditional Ayurvedic treatments exactly as prescribed in the Samhitas can be difficult, the development of Madyantikadi cap offers a convenient and effective solution for treating Kadara.[7] Acharya Sushrut explains the similar symptoms under the topic of Kshudra Rogas, specifically as Kadara. Kadara is a Kolamatra Granthi that is observed when a person is hit by a stone or thorn over foot.[8] owing to which the person experiences a sharp pain and discomfort which hampers the quality of life of person. In this case series, we have studied and evaluated the efficacy of an Anubhoot Yoga which works excellent in curing the symptoms of Kadara (foot corn). This Anubhut Yoga is Madyantikadi cap, which contains Madyantika, Sasyaka, Haridra, Karpoor as the main ingredients. All these four drugs and their extract

Madayantika (Lawsonia inermis)

The leaves, flowers, and seeds are used for medicinal purposes. The external application of the paste of its leaves is useful in burning hands and feet, headaches, and skin diseases like scabies and ringworms. It is one of the best herbs, used to alleviate the burning sensation of the body (Daha Prasamana) like Ushira, Candana, and Madhuka flowers. By using the disc diffusion method, the antibacterial activity of Lawsonia inermis was assessed against six bacterial strains: Escherichia coli, Staphylococcus aureus, Bacillus subtilise, Salmonella typhi, Klebsiella, and Pseudomonas aeruginosa. All of the examined bacterial strains were resistant to the antibacterial effects of crude ethanolic, hexane, ethyl acetate, and aqueous methanol fraction, especially when applied.


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Lawsonia inermis leaf extracts, both alcoholic and aqueous, were tested for their antibacterial properties against Staphylococcus aureus and Staphylococcus epidermidis, two bacteria that were isolated from clinical cases of acne vulgaris.[9]

Sasyaka (Tuttha - Copper sulphate)

Properly prepared 'Sasyaka Bhasma' possesses 'Lekhana' and 'Bhedana" Karma, Kaşaya and Madhura Rasa and Laghu Guņa. It is a good 'Krmighna'. It is useful in Netraroga, Prameha and Medoroga.It mitigates 'Kapha-Pitta Doșa. It possesses Sankocaka and strengthens the 'central nervous system'. Its internal or external use will cure many types of skin diseases. - Effective in reducing thickened and hardened skin areas, such as calluses, by breaking down the excess keratinized tissue. Sasyaka (Copper sulphate) Bhasma possesses Katu (Pungent), Kashaya (Astringent), Madhura (Sweet) and Kinchit Kshara Rasa (Slight Alkaline), Laghu (Light), Guru Guna (Heavy), Ushna Veerya (Hot), Katu (Pungent) Vipaka and Tridoshashamana (Alleviates Kapha, Pitta and Vata) and Lekhana (Scraping) karma.[10]

Karpoor (Cinnamomum Camphora)

It also smooths rough, cracked, and coarse heels, tones the skin, and aids in the healing of burn scars. Its antispasmodic qualities can effectively alleviate a variety of issues, including sprains, joints, cramps, and spasms. When applied locally, camphor has antiperspirant, analgesic, and skin-beneficial properties. Extracted camphor offers a substantial quantity of antioxidant capabilities, according to research. Biochemicals called antioxidants have the ability to lessen all oxidation processes, which can result in the production of free radicals. Inflammation of the blood vessels around a nerve can cause neuralgia, a very painful condition that may be alleviated with the use of camphor oil.[11]

Haridra (Curcuma longa)

The anti-inflammatory and pain-relieving properties of Haridra hold high significance in treating different types of ulcers. It forms reactive oxygen species that damage the proteins and DNA of normal cells. Additionally, nitric oxide plays a vital role in the up-regulation of cytokines that trigger the development of inflammatory diseases. Facilitates wound healing whereas the paste of turmeric powder not only helps in stopping blood flow from a cut or wound but also helps in treating the scar tissue.

Imbued with potent antioxidant, antimicrobial and anti-inflammatory properties, Haridra offers blood purifying activity that helps in removing toxins from the blood and hence helps to manage a host of skin diseases.[12]

Conclusion

Madyantika caps are formulated with a blend of drugs characterized by Laghu, Ruksha, and Tikshna properties, and possess Vatakaphahara qualities, particularly effective in reducing Kapha. This helps to reduce swelling, balance the Doshas, and lower the risk of recurrence. Additionally, these caps have attributes like Vedana Stapana (pain relief) and Daha Prashamana (soothing inflammation), which effectively reduce pain. The therapy is also more economical compared to surgical excision, as it minimizes the need for post-surgical dressings, antibiotics, analgesics, anti-inflammatory medications, and wound-healing agents. The unique properties like scrapping, pain relieving, scar healing of the various drugs in Madyantikadi cap make it highly effective in treating Kadara. The cohesive action of Madyantika, Sasyaka, Karpoor and Haridra have demonstrated remarkable results, as observed in the post-treatment follow-up (refer to Fig.). Additionally, the patient expressed great satisfaction with the treatment and provided positive feedback, noting that there was no recurrence even during later follow-ups.

Acknowledgement

I would like to express our sincere gratitude to all individuals and institutions that contributed to this case report. Our heartfelt thanks go to the healthcare professionals who provided invaluable support and guidance throughout the study. I also appreciate the cooperation of the patient, who’s willingness to share their experience was essential to this work. Additionally, I am thanking PG-STAR Team Central Council for Research in Ayurvedic Sciences (CCRAS) Ministry of AYUSH, Govt. of India for their constructive feedback and encouragement during the preparation of this report. Finally, I acknowledge the resources and facilities provided by our institution, which made this study possible.

Funding

This research was funded by PG-STAR Team Central Council for Research in Ayurvedic Sciences (CCRAS) Ministry of AYUSH, Govt. of India under grant number STAR/296/47.


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Informed consent

The patient gave their informed agreement for the publication of their de-identified medical records.

Declaration of competing interest

According to the study's authors, there were no commercial or financial relationships that would have increased the risk of a conflict of interest. Since every clinician who worked on the case in both episodes is named as an author, there is no conflict of interest. Furthermore, the treating physician in both cases was the same chief physician.

Ethical Approval

Not needed as it was case report.

Author contributions

Dr. A. M. worked in software, methodology, and conceptualization. Dr. D. D. is curating data and preparing original drafts of her writing. Dr. A. M. worked in investigation and visualisation. The supervising doctor was D. D. Programmes and Verification Dr. A. M. is the author, and he has reviewed and edited the work.

References

1. Weerasekera, Kumudu & Weerasekara, Sahani. (2020). The Effect of Roghan e Khas, Soap and Chunam Paste for "Kadara" (Corn) as an External Application -A Case Study. International journal of Ayurveda research. 2456-6640.

2. Weerasekera, Kumudu & Weerasekara, Sahani. (2020). The Effect of Roghan e Khas, Soap and Chunam Paste for "Kadara" (Corn) as an External Application -A Case Study. International journal of Ayurveda research. 2456-6640.

3. Weerasekera, Kumudu & Weerasekara, Sahani. (2020). The Effect of Roghan e Khas, Soap and Chunam Paste for "Kadara" (Corn) as an External Application -A Case Study. International journal of Ayurveda research. 2456-6640.

4. Weerasekera, Kumudu & Weerasekara, Sahani. (2020). The Effect of Roghan e Khas, Soap and Chunam Paste for "Kadara" (Corn) as an External Application -A Case Study. International journal of Ayurveda research. 2456-6640.

5. Narayan Ram Acharya, Kavyatirtha, Sushrutasamhita, Sutra sthana 18/6 Varanasi, ChaukhambhaSurbharti prakashan, P.841 G.Wagh. Rajendra, Lepakalpana-A Review, Journal of Ayurveda andIntegrated Medical Science, 2018; 3(5): 2456-3110.

6. Shrivastava Shailaja, Shargadhara samhita, Uttarahanda, Jeevanprada Hindi Commentary, 4thedition, Varanai, Chaukhambha Orientalia, 2005;424: 11-12

7. Ayurvedacharya shreeyadunandanaopadhyaya, Madhavanidanam Part-1, Chokhamba Sanskruta Sansthana, Varanasi, 31st Edition, 2002, Adhyaya no.55, Kshudraroganidan,Sutra no.26, Page 203.

8. Ayurvedacharya shreeyadunandanaopadhyaya, Madhavanidanam Part-1, Chokhamba Sanskruta Sansthana, Varanasi, 31st Edition, 2002, Adhyaya no.55, Kshudraroganidan,Sutra no.26, Page 203.

9. Batiha, Gaber & Teibo, John & Shaheen, Hazem & Benjamin, Babalola & Ayandeyi Teibo, Titilade Kehinde & Al-kuraishy, Hayder & Al-Garbeeb, Ali & Alexiou, Athanasios & Papadakis, Marios. (2023). Therapeutic potential of Lawsonia inermis Linn: a comprehensive overview. Naunyn-Schmiedeberg's Archives of Pharmacology. 397, P 1-16.

10. Reddy, M. S., & Srinivasan, R. (2004). Efficacy of copper sulphate in controlling powdery mildew in cucumber,Journal of Agricultural Science and Technology, 6(1), 57-62.

11. Nidhi Garg, Dr. Akhil Jain. Therapeutic and Mediciinal uses of Karpura – A Review. International Journal of Science and Research (IJSR) ISSN (Online): 2319-7064. Index Copernicus Value (2015): 78.96.

12. Niranjan A et. Al., Chemical Constituents and biological activities of turmeric (Curcuma longa L.)- a review, published at Research Gate from Nutraceutical Chemistry, National Botanical Research Institute, Lucknow, India, on 2008.

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