A Randomised clinical comparative study of CHANDRAMANDAL CHEDAN KARMA(Excision) By modified CHANDRAMANDAL CHEDAN SHATRA Followed by TAILDAGHDHA And Conventional Excision in Manegement of KADAR with special reference to CORN

Corn is a thickened area of skin caused by pressure ,commonly found on soles and

toes .It looks like white circular spot that can be very painful when touched ,corns

can also be formed beacause of some forgein body that stuck in skin after

penetration some part stuck in there causes infection and not treated then devoveps

fibrous mass it can also develop over side and tip of the toes ,through it is less

common sometimes corn apper between the toes, where they are softer and less

painful

Corns are painful because they have a cone shaped core that can press on a nerve

,causing severe discomfort and making it feel like you,re walking with a sharp pebble

in your shoe .

The incidence of corn on feet has been reported to range from 5% to 20% . so the

privalance rate is 2.07 % [25]

Corns can be compared to a condition called KADAR ,as described in the ancient

Ayurvedic texts .In the classical literature ,such as the shushrut samhita ,kadar has

been categorized under the Kshudra Rogas [1].It is caused by an imbalance of the vata

and kapha doshas ,which then affects the rakta and meda dhatus .

Clinical presentation includes Shauk ( Pain ) occasionally ,shape like that of

kolaphala ,sakila (Cone ) ,Kathina (Hard /Thickened ) and Nimnormadhya ( It is

centrally dipressed and raised peripherally ) .If condition left untreated undergoes

paka ,leading to strava ( Discharge )

If Kadar is left untreated ,it can cause back,hip,and knee pain due to changes in

walking patten from severe discomfort .Treating corns involves removing the

abnormal tissue using methods like salicylic acid application,CRYOHERAPY ,LASER

treatment ,electric and chemical CAUTERIZATION ,and SURGICAL EXCISION .These

treatments are invasive modalities ,expensive and require wound care in post –

surgical period .Moreover ,there is lot of recurrence rate .

In Conventionalcorn excision once anesthetized ( either by IV sedation or local

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anesthesia ) ,the surgeon will completely remove the corn and underlying bony

prominence .

After corn removal surgery ,patient may feel throbbing ,aching ,burning ,or even

numbness in your foot . surgeon may recommend to elevate foot above the level of

heart for at least 48 hours after the surgery .also Folowed by pain medications .this

will aid with pain relief and minimize the swelling after surgery Surgeon will

probabaly advise to modify placing any weight on the foot that was oprated on.You

wil be placed in either a surgical shoe or boot and your surgical dressing canno get

wet .Most likely recommended that you keep your foot dry wih a shower bag until

your incision heal .Typically it takes 6 weeks to 3 months to fully recover from corn

removal surgery .The recovery time truly depends upon he extent of the surgery and

any complications that may arise from it .

Acharya SHUSHRUT mentioned MANDALAGRA SHATRA for CHEDAN KARMA which

is beneficial for CHEDAN KARMA in HASTA( Hand ) and PAD ( Leg ) in

SHAATRAVACHARNYA AHYAY[2] it should be VRUNTA (Round) MUKH , KHURAKAR(

Sharp) and with proper handle for grip.[3]

Acharya SHUSHRUT also mentioned TAILDAGHDHA after chedan karma in

MANEGEMENT of kadar in KSHUDRAROGCHIKTSA ADHYAY[1] . for better results in

this procedure after proper removal of con under all aspetic mesurments it should

be burned with tela so it would heal faster and SNEHAN KARMA also be done within

it for softening of wound edges .

This study is carried out with an aim for betterment of corn excision procedure with

CHANDRAMANDAL CHEDAN by MANDALAGRA CHEDAN SHASTRA FOLLOWED BY

TAIlDAGHDHA as it is very cost effective ,rapidly performed as compared to

Conventionalcorn excision ,easy procedure ,instruments can be reused after proper

sterilization ,realtively easy to learn ,bleeding is less,wound care is less .

Amongst from all the patients suffering from corn are from

economically lower class they don’t have that much money and time for recovery for

the betterment.Also they bear a fear regarding the surgery and also don’t have that

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much time for recovery .As most of patients are farmers and workers due to that

thing they are not financially stable. They will have to join there workplace as soon as

possible after surgery .CHANDRAMANDAL CHEDAN WITH MANDALAGRA CHEDAN

SHATRA FOLLOWED BY TAILDAGHDHA is simple and safe office procedure .The

incidence of recurrence is reduced as the whole corn with the central core is excised

.Mutiple corns can be removed in a single sessions .

There is immediate pain relif ,no requirement of rest and patient can return to

the workplace immediately .This is minimally invasive and less messy technique with

minimal blood loss .

Even through ,Conventionalcorn excision is the line of treatment for KADAR(

Corn) ,it has been throught to treat the cases of KADAR wih CHANDRAMANDAL

CHEDAN WITH MANDALAGRA CHEDAN SHATRA FOLLOWED BY TAILDAGHDHA i.e.

CHEDAN FOLLOWED BY SNEHAN .Hence in this present study one group of subjects

will be treated with CONVENTIONALCORN EXCISION and OTHER group of subjects

will be treated with CHANDRAMANDAL CHEDAN WITH MANDALAGRA CHEDAN

SHATRA FOLLOWED BY TAILDAGHDHA .Thus CHEDAN FOLLOWED BY SNEHAN will

be subjected for trial and the results of he same will be assessed and compared .The

generated data wil be calculated with suitable statistical methods after completion of

clinical study .