Babchi unani marketed formulation effective in treatment of vitiligo: A case study

 

Shaikh Habeeba1*, Shaikh Siddiqua2

1Department of Pharmacognosy, Pravara Rural College of Pharmacy, Pravaranagar Maharashtra, India.

2Department of Pharmaceutical Chemistry, SND College of Pharmacy, Babhulgaon, Maharashtra, India.

*Corresponding Author E-mail: habibashaikh762@gmail.com

 

ABSTRACT:

Bars (vitiligo) are defined in ancient unani classic as an idiopathic achromia in which skin looses its color. Due to melanocytes deficiency, white spots appeared on body. It may be localized or may spread and become generalized. The disease condition may be stable or some time spread over the body. leucotricha is also sometimes associated with Bars. The achievement of treating this condition in conventional medicines is limited and sometimes, treatment follows with side effects. Though a few case records are documented in the past about the success of various unani medicines. Numerous Unani drugs are well known for the regeneration of melanocytes. The current study was planned to highlight the use of Unani formulation to fight Vitiligo. A 11 year old male have chalky white patches with hypopigmentation without itching over hand, legs, stomach or on back for 1 year, gradually spreading over the chest. The patient was treated with unani oral medication (nobar tablet) and applied ointment, babchi oil locally. After treatment there was repigmentation of skin without any side effect. The treatment modility showed color changes of patches from chalky white to brown and it conclude that unani formulation effective in treatment of vitiligo.

 

KEYWORDS: Bars, Vitiligo, Unani medicines, Formulations, Babchi.

 

 


INTRODUCTION:

Bars (vitiligo) have been defined by ancient unani physicians as a skin disease. Bars (vitiligo) is becoming a common social as well as dermatological problem which has affected 1-2 % of the world population1. Bars (vitiligo) are acquired de-pigmentation of skin result from destruction of melanocytes. On a coloured skin the condition is visibly striking since the patient has two contrasting colours of the body. Although it is only cosmetic in nature, it has devastating effect on the psyche of the patient as it distorts the body image and causes extreme fear, anxiety and concern.

 

Its dermatological, metabolic, cosmetic, social and genetic role is well documented2,3. Absence of the pigment is the only symptoms and presents no textural changes and is clinically normal in every aspect except for sensitivity to solar irradiation. Vitiligo, in modern medicine, is defined acquired, cutaneous achromia, characterized by various sizes or shape, single or multiple patches of milky white colour usually presenting hyper pigmented borders and a tendency to enlarge peripherally4. It affects both the sexes, and 17.8 percent of the vitiligo cases give a positive family history5.

 

According to Jalinoos (Galen) (130-200 AD) as mentioned in the manuscript Moalijat-e-Buqratiya (10th century AD), the cause of bars is the weakness of Quwwat-e-Mughaiyarahwa Mushabbiha (transformative faculty) in the organs. Rabban Tabari (810-895 AD) while describing the aetiology of Bars in his famous book Firdaus al-Hikmat says: "Fasad-ud-dam (impairment of blood) and Buruda t-ud-dam (coldness of blood) are the main causes of Bars. Due to the digestive faculty of the body cannot digest the food properly the blood of the whole body becomes impure. When this impurity occurs due to Balgham (phlegm) or coldness, appears the Bars6 ".

 

Currently available many modern anti-vitiligo drugs are effective in the treatment of Vitiligo (Bars) but also produce certain adverse side effects and have high cost7. At present time now people searching the herbal medicines for curing the disease. The Unani formulations show their effective role in the treatment of Bars (Vitiligo) with no or negligible side effects.

 

Case report:

Presenting complaints with duration:

A 11 year old male patient complaining about white patches over skin leg, hand, stomach and chest from last one year. Initially lesion was small discrete, later progressively increased in size and then spread to over body with multiple lesion. There is no associated complain confined to lesion like itching, burning sensation. There was history taking homeopathic and allopathic treatment but none was successful in stopping the progression of vitiligo.

 

History of present illness:

According to patient’s parents he was asymptomatic then after gradually develops very small white dots over leg and then increasing in size and numbers initially with itching and dryness over left lower legs for this patient treated with allopathic and homeopathic medicines and also tried some ayurvedic medicine but no any satisfactory relief found patient and parents worried for this simultaneously patches spread rapidly day by day and patient also suffering from loss of appetite and lose interest in study.

 

Negative history:

No any loss of sensation in white patches and no any other major illness in the body.

 

Past history:

No history of ant medical or surgical illness in past.

 

Family history:

Not any family history of any genetic or other major illness.

 

Personal history:

 

Bowel- constipation frequently,

 

Bladder- normal 4-5 times, pale yellow color

Sleep- normal

 

Appetite- less than average

 

Dietary history- Takes outside fast food, junk food 3-4 times in a weak, salty items and bakery products preferred mostly. Eat non veg (meat chicken, fish) 2 to 3 times in weak.

 

Local examination:

1. Sites of lesion- hyper pigmented patches over the body

2. Distribution- Asymmetrical

3. Characteristic of lesion- color- white

4. No. of lesion- multiple

5. size-patches on different size up to1 to 5cm

6. Itching-itching was in initial days of disease at present there is no itching

7. Inflammation- absent

 

MATERIAL AND METHOD:

Case study:

A 11 old year male patient have complaint about white patches on the body since last 1 year patches are gradually increasing. The patient was treated with unani medicines like oral tablets nobars tablet, backuchi oil buy from unani medical store and it is easily available in unani medical store.

 

Name of Effective unani marketed formulations used in treatment of vitiligo:

1.     Nobars tablet

2.     Nobars ointment

3.     Bursnil oil

4.     Bursnil Majun

5.     Roghan chameli

 

Duration:

If positive changes seen in the lesion, their size is decreasing and slowly turns in to normal skin colour or brown color then continue to apply this topical medicine over lesions. Maximum healing achieved in 8-9 months.

 

When to stop:

(Adverse effect evaluation criteria) If any server adverse effect is seen after applying or taking bars tablet like burning, highly swelled, watery discharge, fever, stomach pain, vomiting or any other changes seen in lesion after application of medication than stop the use of medicines.

 

Restriction of food after taking these medications:

Milk, milk products, lemon, and lime, tamarind, oranges, cashew nuts, egg, fish, beef, spicy food, tomatoes was highly restricted.

 

 

Recommended diet:

Recommended foods included wheat, pulses, pure ghee, beans, spinach, bitter gourd, onion, beet root, carrot, chilies, maize, figs (fresh as well as try) walnuts, dates, potatoes, rice papaya, mutton, this diet was prescribed according the patients need.

 

Treatment duration:

9 months given the medication to the patient regularly

 

Table no.1 treatment protocol of unani medicine

Sr no

Medication

Time duration of topical medication/ oral medication

Total duration

1.

Nobars tablet

2 tablet each in the morning and evening before meal with water

9 months

2.

Nobars ointment

Apply on affected area in 5 to 10 min in morning sun light.

9 month

3.

Bursnil oil

5-10ml to be rubbed or massaged on effected area. Apply it in night.

9 month

5.

Bursnil majun

10 gm taken twice daily with water

9 month

4.

Roghan chameli

5-10ml to be rubbed or massaged on affects area. (Only when apply if inflammation or ulcer occurs on the side of lesion).

9 month

 

Table no.2 Details ingredients of marketed unani formulations

Sr. no

Name of the drug

Ingredients used in formulation

1.

Nobars tablet

Babchi Psoralea corylifolia

ZanjabeelZingiber officinale

Bhangra siah Eclipta alba

Kushta tamesar Copper calcined

Qand safaid

 

2.

 

Nobars ointment

Babchi (Psoralea corylifolia)

Zanjbeel (Zingiber officinale)

Bhangra Siah (Eclipta alba)

Geru (Red ochre)

Mom Zard (Cera)

Roghan Kunjad (Oleum Sesamum indicum)

3.

Bursnil oil

Babchi ((Psoralea corylifolia)

Neem (Azadirechta indica)

Kalonji (Nigella sativa)

Till (sesamum indicum)

Suhaga briyan (borax)

4.

Bursnil majun

Babchi ((Psoralea corylifolia)

Neem (Azadirechta indica)

Kishta sadafa (Calx of oyster shell

Kushta Tamesar (Calx of cooper)

Sugar (Sachrum officinarum)

Preservative (Sodium Benzoate)

 

Fig.1 Marketed unani Babchi formulations used in treatment of vitiligo

 

RESULT:

Continuous and regular use of internal or external application of nobars ointment, bursnil oil and nobars tablet result in repigmentation of white patches, in 9 months of treatment patient got 100% relief. All the white patches were regimented. The colour of the patches became pinkish and then brown finally match with our normal skin texture.

 

The babchi contain common in three formulation it have antioxidant property and bavachin and psoralidin has inhibitory against antigen induced granulation.

 

Fig.2 Before treatment

 

After continuous treatment of unani medicine like, Bursnil oil, Bars ointment, majun and oral tablet after 4 month the patches size became reduces. The skin became changed in white to brownish on the side of lesions.

 

Fig.3 after 4 month treatment with unani marketed formulation

 

Fig.4 after 8-9 months treatment with unani marketed formulation

 

DISCUSSION:

In the unani system of medicines both internal and external medicines was very effective in the treatment of vitiligo. The babchi well known for antilucodermal activity since the ancient. It has been extensively used by the unani scholar in hyperpigmentation with excessive success. It contains psoralens, which on exposure to the sun bring out melanin in the depigmented lesion9. The bursnil oil or nobars ointment applying topically follow up to 9 months. There are majour changes seen in lesion like it converted its whitish colour into brown. The bursnil oil or ointment have special ingredient which help brighten the skin by visibly reducing pigmentation. By continuous application of it result in repigmentation of white patches in 6 months. To avoid recurrence of white patches patient should be strictly flows the diet and should avoid the restricted food which is mentioned in above paragraph.

 

CONCLUSION:

Vitiligo (Bars) is hyperpigmentation disorder may be genetic or acquired the cause of disease having high impact on the body and mind. Due to eating habits, faulty lifestyle. The unani drug was found to be effective and safe in the treatment of vitiligo. However, this case Speaks about the success of unani medication in vitiligo without any adverse effect. After the recovery of the patient strictly follow the diet and still advice as per physician.

 

REFERENCE

1.      M. Iqbal Ali, M.M. Ali Khan, A.R. Shakera. Bars (Vitiligo): A Literary Review.Seminar on Bars (Leucoderma). 10-11 March, 1979, Hyderabad.

2.      Rabia Begum, S. Quamaruddin. Functional and Morphological study of normal skin and in cases of Bars. Seminar on Bars (Leucoderma). 10-11 March, 1979, Hyderabad.

3.      M.M. Ali Khan, M.A. Mirza, Taherunnisa. Aetiological Factors of Bars. Seminar on Bars (Leucoderma). 10-11 March, 1979, Hyderabad

4.      S.J. Hussain and T.N. Srivastava. A study of Unani Medicinal Plant 'AATRlLAL' and its allied species: A cure for Leucoderma. Seminar on Bars (Leucoderma). 10-11 March, 1979, Hyderabad.

5.       M. Iqbal Ali, Bahuddin, Khursheed Bano, Munawar Sultana. Bars lesions on Scalps: A Clinical and therapeutic study. Seminar on Bars (Leucoderma). lOll March, 1979, Hyderabad.

6.      P.V. Goud, S.M. Haq, K.R.K. Reddy. The Histological and Pathological investigations in Vitiligo. Seminar on Vitiligo. April, 8, 1988. Hyderabad.

7.      Ference, J.D and Last, A.R., 2009. Choosing topical corticosteroids. Am. Fam. Physican 79: 135-40.

8.      Xu Jianguo, Effects of Fructus psoraleae on tyrosinase activation, Chinese Herbal Medicine 1991:22(4):169.

9.       Micheal holick “sunlight and vitamin D for bone health and preventation of autoimmune disease, cancer, and cardiovascular disease” The American Journal of clinical nutrition: ajcn.nutrition.org /content/8016/16785

 

 

 

Received on 20.09.2021         Modified on 24.11.2021

Accepted on 31.12.2021       ©A&V Publications All right reserved

Res. J. Pharmacognosy and Phytochem. 2022; 14(1):1-4.

DOI: 10.52711/0975-4385.2022.00001