A Randomized Comparative Clinical Trial To Evaluate The Efficacy Of Elanir Kuzambu Anjana And Lauhadi Guggulu In The Management Of Arma (Pterygium)

TITLE : A Randomized Comparative Clinical Trial to Evaluate the Efficacy of Elanir kuzambu Anjana And Lauhadi Guggulu In the Management ofArma (Pterygium)

Background :

Ayurveda is known as Ashtanga Ayurveda (A science with eight branches) &Shalakya Tantra is one of them1Shalakya Tantra deals with the diagnosis and management of Urdhwajatrugata Rogas (diseases occurring above the clavicle). Viz. Diseases of eyes, ears, nose, throat,oral cavity, head and neck.2Acharya Vagabhatta quoted that this beautiful world is of no use for a blind, however healthy he may be, because day and night are same for him. So, one should always strive hard to preserve his vision life-long.3 So, any disorder which hampers the eyesight directly should be in priority for the treatment. Acharya Sushruta has mentioned 76 Netra Rogas which are further divided according to their respective Sthanaas Sandhigata 09, Vartmagata 21, Shuklagata 11, Krishnagata 04, Sarvagata 17 and Drishtigata

12.4 Among them Arma is mentioned under 11 types of *Shuklagata Netrarogas.*5

Arma (Pterygium) is a Netra Shuklagata Vyadhi characterized by MamsaPratichaya (growth of tissue) in Shuklamandala, which progresses towards the Krishna mandala (cornea). Arma is classified into 5 different types: Prastari Arma, Shukla Arma, Lohita Arma, Adhimamsa Arma, and Snayu Arma.6

Pterygium is a triangular fibro-vascular growth of degenerated conjunctival tissue. Pterygium appears on nasal side, or rarely on temporal side of the cornea. Sometimes, both temporal and nasal side involved (double-headed pterygium).According to modern science Pterygium divided as Regressive and Progressive Pterygium.7 Classically, a pterygium has four parts: (1) Head – a blunt apex, (2) Cap- a few infiltrates in front of the apex (3) Neck- a limbal part, and (4) Body- a bulbar portion extending between the canthus and the limbus.8

NEED OF STUDY & HYPOTHESIS :                   Pterygium is a response to prolonged effect of environmental factors such as hot and dry weather, dusty atmosphere, exposure to sunlight (ultraviolet rays), dry heat, high wind and abundance of dust can easily produce disease like pterygium, pinguecula, xerosis etc. Arma is a common ocular surface disease which cause defective vision, when it encroaches the pupillary area and cosmetic issues. The clinical aspects and the treatment options have been studies since many years, but uncertainties still exist.

Simple Pterygium excision is associated with a high rate of reoccurrence (About 33- 45%) often with more aggressive behavior then the original lesion.10 Considering its high cost for surgery and high recurrence rate after surgical excision, the present study has been selected.

 HYPOTHESIS :

**Null Hypothesis (H0)–**Elanir Kuzambu Anjana and Lauhadi Guggulu are not effective in the management of Arma(Pterygium).

**Alternative Hypothesis (H1)–**Elanir Kuzambu Anjana and Lauhadi Guggulu are effective in the management of Arma(Pterygium).

 Grouping : In the present trial, 40 clinically diagnosed patients of Pterygium (Arma) will be selected and randomly divided into two groups (20 patients in each group):Group A- This group will be treated with Elanir Kuzambu Anjana and Lauhadi Guggulufor 30 days.

Group B- This group will be treated with Elanir Kuzambu Anjana for 30 days.