Effect Of Bá¹›hatá¿‘phalÄdi Cream with internal administration of Ä€ragvadha Tvak Kaá¹£Äya in YonÄ«Kaṇá¸u Vulvar Fungal Infection

Vulvovaginalinfections have increased dramatically in terms of its severity and incidencerecently. Dermatophytes aremost common fungal infection globally and according to WHO the prevalence is20-25%. About75% women show avulvovaginal candida episode through their life time and 5-10% will experiencerecurrence; more than 4 episodes per year. Hence the vulvar fungal infection ifleft untreated it may increase the risk of long term complications due toascending infections. Fungal infection of vulva is not a life threatening conditionbut itching from it can be  veryuncomfortable and there will be significant decrease in quality of life. Yonikandu as an individual disease is mentioned in BhaishajyaRatnavali YonikanduChikitsa Prakarana as a Kaphaja vyadhi. In all Samhitas Yonikandu is mentionedas a symptom of Kaphaja Yoni Vyapat. If it is left untreated it may progress toother diseases like Acarana, Atyananda, Aticarana and Karnini where Yonikanducoexists with other symptoms making  thetreatment more complicated.While assessing the Ayurvedicliteratures Acharya Susruta in uttaratantra has specifically mentioned acombination for external application in Yonikandu. And hence through this studyan attempt will be made to develop the combination into a more user friendlycream form(Brihati phaladi cream) and a combination therapy with internalmedication(Aragwadaha twak kashaya) will be studied on vulvar itch from fungalinfections. 30 patients in the age group 16-50yrs complaining of vulvar itchwith or without discolouration of skin will be selected  from the OPD and IPD of Amrita School ofAyurveda, to be screened by taking skin scrapings of the affected area followedby KOH wet mount test to diagnose vulvar fungal infection. If the diagnosis isconfirmed treatment will be done on OP basis by providing medicines, Aragwadha twakkashaya choorna which has to be prepared as decoction [1 pala(48gm) powdereddrugs is to be boiled in 16 parts of water(768ml) and reduced to 1/8parts(96ml)] for internal administration. Brihati phaladi cream has to beapplied in the affected area twice daily. Medicines will have to be continuedfor 21 days. Assessment will be done for itching(yoni kandu) on day 0, day 11 and day 22nd by 5 D Itch scale and Quality of life of patients will be assessed using Dermatology LifeQuality Index(DLQI)  on day 0 and day 22nd. Followup will be done on 30th day after treatment.