Therapeutic evaluation of Marham-e-Akbar in Nar-e-farsi -An Observational study

Atopic dermatitis (AD) is a chronic and relapsing disease affecting an increasing number of patients.1 The prevalence of Atopic Eczema has risen substantially in many countries in recent decades, and this increase has been attributed mainly to changes in lifestyle, nutrition, and environmental factors 2. Since 1960s, the prevalence of AE has increased more than 3-fold. The reasons for the rising prevalence are as yet unclear. We suggest that the basis for this increase in prevalence, as well as the causes of AE, involve an in­teraction between genetic and environmental factors3.

Eczema is described as Narfarsi in almost all classical books of Unani System of Medicine. Unani physicians have been treating this disease for thousands of years and they have mentioned various drugs (single as well as compound) for its treatment. However, these drugs have not been scientifically studied so far, for their described effects. Although, certain topical and systemic drugs of allopathic medicine provide effective treatment but recurrence rate has been reported too high with these drugs. Therefore, the present study entitled “Therapeutic Evaluation of the clinical efficacy of Marham-e-Akbar 4 in Nar-e-Farsi (Eczema)†is being designed**.**

Theterms ‘eczemaâ€and ‘dermatitis’ are synonymous. They refer to distinctive reaction  patterns  in the skin , which can be either acute or chronic and are due to a number of causes.5Majoosi (930-994) said that Nar Farsi occur sometime as single and sometimes with Small pox (Chechak) and the same treatment is applied for both.6 Akbar Arzani (1722 AD) also described Nar Farsi in his book Tibb  e Akbar as a skin disease associated with vesicle formation, itching and burning.7  Eczema or dermatitis is a group of inflammatory  skin diseases provoked by a wide variety of stimuli including direct injury from toxic chemicals, mechanical  trauma  and immunological reactions. The word eczema is derived from the Greek word  ‘eczein ’meaning ‘to boil over ’ or  ‘to effervesce ’ The terms dermatitis  and eczema are often used as synonyms but, the term eczema is preferably used for exudative dermatitis 8

It argues that atopic eczema cannot be a purely genetic disease , otherwise why should it clear at all.9 The majority of people with atopic dermatitis experience mild disease , whereas only a small proportion have a severe from of the disease10. The major atopic disorders, eczema, allergic rhinitis and asthma, cause significant disease burdens worldwide11. Eczematoid rash is characterised by an erythematous scaly rash with an ill-defined border in different phases, acute, subacute and chronic12.

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1.      Bieber T. Pathophysiology and Clinical Aspects of Atopic Dermatitis. Ann Dermatol. 2010; 22(2): 125-137.

2.      Civelek E, Sahiner UM ,Yuksel H, Boz AB, Orhan F, Uner A et al. Prevalence, Burden, and Risk Factors of Atopic Eczema in School children Aged 10-11 Years: A National Multicenter Study .2011 ;(4):270-277.

3.      Lee H J , Son S W , Cho S H, A Comprehensive Review of the Treatment of Atopic Eczema .Allergy Asthma Immunol Research.2016;8(3):189-190.

4.      Ghani N. Qarabadeen Najmul Gani. New Delhi: CCRUM. Ministry of Health and Family Welfare; Govt. of India; 2010:1037.

5.      Boon NA, Colledge NR, Walker B Hunter JAA. Davidson’s Principles & Practice of Medicine. 20th Edition. Churchill Livingstone Elsevier. 2006; 1283-1287.

6.      Majoosi IA. Kamilus Sana. Vol 2. Idara Kitabush Shifa. New Delhi. 2010; 243.

7.      Arzani H A. Tibbe Akbar. Urdu Translation by Hk M Hussain, Deoband: Faisal, YNM: 700-701.

8.      Shah S N, Paulanand M, Billimoria AR, Kamath SA, Karnad DR, Munjal YP. et al. API Textbook of Medicine Vol-II 8th Edition. Mumbai: The association of Physicians of India; 2009:1280-1284.

9.      Williams HC, Strachan DP. The natural history of childhood ecze­ma. Observations from the British 1958 birth cohort study. Br J Der­matol. 1998; 139: 834-839.

10.  Mgeladze N, Karseladze R, Dadeshidze I, Tsagareishvili G, Khojava K, Tsagareishvili N.Clinical controlled study of ascancol: effect on atopic dermatitis. 2005july/September;5(3):164-167.

11.  Allen J S, Jordan S, Storey M, Thornton A C, Gravenor B M, Garaiova I, Et al.Probiotics in the prevention of eczema: A randomized controlled trial;2014;99:1014-1019.

Dr.KK LO.Practical Approach for “Eczemaâ€.The Hong Kong Medical Diary.2010; 15(11) :5-7.