SCIENTIFIC EVALUATION FOR THE EFFECT OF A UNANI PHARMACOPEIAL PREPARATION "NUQU-E-UNNAB" IN SHARA (URTICARIA)

Urticaria is a vascular reaction of the skin characterized by the appearance of wheals generally surrounded by a red Hals or flare and associated with severe itching, stinging or pricking sensation.

The actual cause of Shara (Urticaria) is believed to be the Fasad-e-Dam (blood impairment) caused by the vapours of Dam-e-Merari (bilious blood) or Balgham-e-Boraqi (acidic phlegm) coming towards the skin or periphery of the body. 

Need of the study

1. CSU is a highly prevalent disease, It has a great impact on general population representing a burden for national health system due to its variability and yet unknown pathogenesis.

2. CSU significantly impairs the quality of life. The lack of clinical and laboratory biomarkers able to define the severity and prognosis usually leads to frustration of patients as well as of physicians. 

3.  Moreover, CSU has a variable rate of response to the approved newest therapies. The therapeutic approach of chronic urticaria aims at symptom relief. Licensed doses (1 tablet daily) of modern second-generation antihistamines are the first line treatment. Levocetirizine is second generation histamine antagonist and it has high affinity and selectivity for H₁ receptor. The response rates to current third line treatment like cyclosporine and Omalizumab are each close to 75% but omalizumab is expensive and not reimbursed worldwide while Cyclosporin A has a high incidence of adverse effects. For leukotriene receptor antagonists, the level of evidence for efficacy is low. 

4.  In a retrospective analysis on the clinical and demographic information of patients with CSU, Sánchez Borges et al. reported that Anti Histaminic resistant-CSU was more frequent among Hispanic female patients (aged 14 to 60 years) and usually associated with other clinical indicators of severity such as atopic asthma, rhinosinusitis, hypertension, and thyroid disease.

WHO reports indicate that around 80%of the global population still relies on botanical drugs and several herbal medicines have been advanced to clinical use in modern medicine (Mahmood Z A et.al 2010). 

 Unani System of Medicine possesses many drugs that are highly effective for the treatment of skin diseases caused by imbalance in akhlat. Going through the literatures it is found that many single and compound formulations have been described for these purposes in various pharmacopoeias. One such nuskha is taken from "QARABADEEN QADRI" by Hm. Akbar Arzani, CHAPTER 20, PAGE NO. 475 matba munshi nawil Kishore Lucknow press. In the recent study Nuqu-e-unnab has been proposed to carry out its efficacy in shara through preclinical as well as clinical subjects.