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   Table of Contents - Current issue
Coverpage
April-June 2019
Volume 40 | Issue 2
Page Nos. 67-135

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EDITORIAL  

Threats and challenges of emerging viral diseases and scope of Ayurveda in its prevention Highly accessed article p. 67
Mandip Goyal
DOI:10.4103/ayu.AYU_18_20  
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REVIEW ARTICLES Top

Enigma in paraphrasing Ayurvedic Grantha p. 69
Kanchipurum Sundaraman Balasubramanian, Mangal Vinod Kshirsagar, Tarak Mahendra Mehta
DOI:10.4103/ayu.AYU_206_16  
Three different axioms of Sushruta Samhita-Sharira Sthana were analyzed and its translations by respectable translators were studied. The different Sanskrit terms were also analyzed using Monier-Williams and Apte Sanskrit dictionaries as a part of intercomparison study. The Sanskrit terms used in Ayurveda are those which seem to be commonly used, but their meanings are not the same as commonly understood or known. The article is an attempt to understand this ancient wisdom from Sushruta Samhita so as to highlight the peculiarities of Ayurvedic concepts and remove the bigotry regarding the use of common Sanskrit terms for explaining Rachana Sharira (anatomy) this will further help for the correct translation of Samhita. Axioms 4-22, 4-31 and 5-28 of Sushruta Samhita-Sharira Sthana are clinically important, because the clinical acumen is based on the correct knowledge of the human body.
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Gut microbiota: One of the new frontiers for elucidating fundamentals of Vipaka in Ayurveda p. 75
Anagha Vishwas Ranade, Amey Shirolkar, Sharad Daulatrao Pawar
DOI:10.4103/ayu.AYU_210_18  
With the increasing resurgence of Ayurvedic medicine in recent years, a lot of focus is laid on pharmacokinetics of herbs in arresting disease pathology. Ayurveda has enlisted some fundamentals in relation to drug pharmacokinetics, namely Rasa (perception), Virya (potency), Vipaka (postdigestive effect), Guna (properties), and Prabhava (special effect). In recent years, research has emphasized the role of gut microbiota in human health and metabolic processes. A thorough review was done to understand the role of microbiota in drug metabolism if any. The holistic mechanism of gut microbiota coincides to some extent, with the doctrines of Ayurveda in the context of pharmacodynamics and pharmacokinetics. This discussion is a thought put forth with an aim to elucidate the concept of Vipaka vis-a-vis gut microbiota functions.
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ORIGINAL ARTICLES Top

Effect of Agnikarma (therapeutic heat burns) and Raktamokshana (therapeutic bloodletting) in the management of Kati Sandhigata Vata (lumbar spondylosis) p. 79
Foram Joshi, Vyasadeva Mahanta, Tukaram S Dudhamal, Sanjay Kumar Gupta
DOI:10.4103/ayu.AYU_142_16  
Background: Agnikarma (therapeutic heat burns) and Raktamokshana (therapeutic bloodletting) are the treatment modalities mentioned in Ayurveda texts to combat the clinical condition of Sandhigata Vata (osteoarthritis) which occurs due to provoked Vata Dosha and/or Vyana Vayu overlapped with Kapha. Lumbar spondylosis is a degenerative disorder presenting with lower back pain, stiffness, numbness, difficulty in movement etc., with evidence of osteophytes and reduced disc height in plain film radiograph. Aims and Objectives: The aim of the study was to evaluate the role of Agnikarma and Raktamokshana in the management of Kati Sandhigata Vata (lumbar spondylosis). Materials and Methods: After obtaining CTRI registration, total 32 cases of lumbar spondylosis were registered and allocated into two groups by simple random sampling method. 16 patients were treated with Agnikarma with Panchadhatu Shalaka (group A) and 16 patients were treated with Raktamokshana by modified Shringa Yantra (group B). Results: The result was assessed using the Wilcoxon signed-rank test and paired t-test. Significant results were observed in relieving lower back pain, stiffness, numbness and painful movements in both the groups. Conclusion: Agnikarma was found more effective in relieving pain and numbness in lower back and Raktamokshana was found better in relieving pain and stiffness of lower back.
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Efficacy of Sattvavajaya Chikitsa in the form of relaxation techniques and Guda Pippalimula Churna in the management of Anidra (insomnia) - An open labelled, randomized comparative clinical trial p. 89
Priyanka Rawal, Mahesh Vyas, AS Baghel, Shubhangi Kamble
DOI:10.4103/ayu.AYU_91_17  
Background: Condition of insomnia may not be a life-threatening illness, but it has tendency to damage the person's daily life. In the current era of modernization, most of the person are is suffering from stress either it is personal or professional. Stress may cause sleeping problems or make existing problems worse. Sattvavajaya Chikitsa is a specialized type of treatment influencing the psychological aspect of body. It can be applied in the form of Yogic practices and other mind control techniques. With this research interest, the present study has been undertaken to assess the efficacy of the Sattvavajaya Chikitsa in the form of relaxation techniques (RT) and Guda Pippalimula Churna in Anidra (insomnia). Objectives: The objective of the study was to evaluate the efficacy of Sattvavajaya Chikitsa in the form of RT and Guda Pippalimula Churna in Anidra. Materials and Methods: The study was an open-labeled randomized clinical trial in which sixty patients having symptoms of Anidra belonging to the age group of 20–60 years were enrolled and received Sattvavajaya Chikitsa (RT) and Guda Pippalimula Churna orally in 2gm dosage with jaggery for 28 days. The assessment of symptoms was done on the basis of relief in the scores given to signs and symptoms according to their severity. Results: Both the groups showed significant results in chief as well as associated symptoms of disease. Regarding overall effect of therapy in both the groups, marked improvement is high followed by moderate improvement. No adverse reactions were documented. Conclusion: Sattvavajaya Chikitsa and Guda Pippalimula Churna are effective on Anidra, but Sattvavajaya Chikitsa was found more effective in reducing Manasa symptoms such as Chinta (tension), Bhaya (fear) and Krodha (anger).
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Efficacy of Seetarama Vati (A Sri Lankan traditional drug) and Vatari Guggulu in the management of Amavata (rheumatoid arthritis)-an open labeled randomized comparative clinical trial p. 97
M G. Sandeepanie K Maragalawaththa, Mandip Goyal
DOI:10.4103/ayu.AYU_65_18  
Introduction: Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease caused by type III hypersensitivity reaction due to antigen antibody complexes which deposit at the joints resulting in arthritis. As per the concept of Ayurveda, it can be co-related with Amavata, the disease arising from deranged metabolism and Vata vitiation. Despite of advancement in diagnostic approach of RA, management of it remains challenge. Vatari Guggulu and Seetarama Vati are the formulations having analgesics properties due to their Ushna (metabolism enhancing) and Tikshna Guna (micro channel cleaning) and simultaneously possess anti-inflammatory properties. Aims and Objectives: To evaluate and compare the efficacy of Vatari Guggulu and Seetarama Vati in the management of Amavata w.s.r. to rheumatoid arthritis. Material and Methods: For the present study, 58 patients were selected and divided into two groups. Patients of group A and group B were given Vatari Guggulu and Seetarama Vati respectively with warm water after meal for one month. Before administration of trial drugs in both of groups' patients were given 4-6 grams of Triphala powder depending upon the Koshtha of the patient, on empty stomach early morning for the purpose of Koshtha Shuddhi (purgation) for 3 days. In addition to assess effect on signs and symptoms of Amavata, haematological investigation, biochemical investigation including quantitative C-reactive protein (CRP) and rheumatoid factor (RA factor) and routine urinary examination were carried out before and after treatment in all the registered patients. The effect of therapy was assessed on the basis of changes in score in comparison to end point score. Discussion: All the cardinal and associate complaints were statistically significant improved after the course of the trial drug. Most of the functional parameters had statistically significant improvement after treatment except left side foot pressure and DAS 28 scale in B group. Biochemical and hematological parameters were within normal limit before and after treatment. The difference of effect of trial drug on chief complaints was statistically insignificant. The difference of effect of trial drug on associate complaints was statistically insignificant. Difference of effect of trial drugs on ESR of both the groups was statistically insignificant. The difference of effect of trial drug on RA factor and CRP between groups was statistically significant. The difference of effect of trial drug on functional parameters between groups were statistically significant. Conclusion: The study revealed that, though both the trial drugs; Vatari Guggulu and Seetarama Vati are effective in the management of Amavata, but clinically Seetarama Vati is comparatively more effective than Vatari Guggulu in the management of Amavata.
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Role of Terminalia arjuna Wight and Arn. in the treatment of chronic coronary artery disease from pharmacovigilance point of view p. 104
Shridhar Dwivedi, Deepti Chopra, Bharti Bhandari
DOI:10.4103/ayu.AYU_114_18  
Background and Objectives: Terminalia arjuna Wight and Arn. (Arjuna) has been used in indigenous system for the treatment of cardiac ailments since 500 BC. However, there is a lack of vigilance studies during long-term therapy. The present clinical study was planned to examine the long-term safety of Arjuna as an adjunct drug in chronic coronary artery disease (CAD) patients. Materials and Methods: During the study period, a total of 35 patients of chronic CAD were enrolled to receive Arjuna bark extract powder (500 mg three times daily) along with conventional drugs. The control group (35 patients) received conventional drugs alone. Hemogram, liver function tests and kidney function tests were done at baseline and then every 6 months until the end of the study. Electrocardiography was done every 6 months and echocardiography was done yearly for left ventricular ejection fraction and regional wall motion abnormalities. Any adverse drug reactions reported by the patients were also recorded. Results: The mean age of patients in test and control groups was 60.88 ± 9.02 and 58.51 ± 12.64 years, respectively. There was a predominance of male patients in both the groups. The patients were observed for duration ranging from 9 months to 4 years and 9 months. Other than baring gastritis and constipation, no other noteworthy adverse effects were reported. No significant difference was found in laboratory value on baseline and end of therapy in both the groups. Conclusion: The results of the present study concluded that Arjuna is safe and effective in patients with chronic coronary artery disease.
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Comparison of antiplaque effectiveness of herbal toothpaste: A randomized triple-blinded cross-over clinical trial p. 109
Ramamurthy Shanmugapriya, Ulaganathan Arunmozhi, Rathinasamy Kadhiresan, Sudarsan Sabitha, Ravikumar Anirudhya, Govindarajan Sujatha
DOI:10.4103/ayu.AYU_185_19  
Background: Cleansing the teeth with a toothbrush and paste is an indubitable mechanical plaque control method practiced by almost everyone. Eliminating dental plaque is an essential, fundamental and mandatory step to prevent the occurrence of periodontal diseases that are rife globally. The aim of the present study is to compare the antiplaque effectiveness of a prepared herbal and commercially available dentifrice. Materials and Methods: Thirty healthy individuals within the age group of 18–25 years were recruited to participate in the study. After achieving induced gingivitis and measuring plaque levels using Turesky modification of the Quigley Hein Plaque index in all the subjects, they were randomly divided into test arms A and B. Commercial dentifrice was distributed to one group, whereas the other group received prepared herbal dentifrice. Supervised brushing was carried out for 5 min, and plaque amounts after brushing were noted. After a washout period of 1 week, the same steps were repeated as per the cross-over study protocol. Unpaired t-test and paired t-tests were employed with P < 0.05. Results: Both the toothpastes show the difference in plaque scores immediately after brushing when compared to baseline and was statistically significant (P = 0.001). The mean plaque scores of commercial dentifrice (1.93 ± 1.52) were less than that of the prepared herbal dentifrice (2.35 ± 1.39) after brushing. Conclusion: The prepared herbal dentifrice had good antiplaque action. However, the plaque inhibitory action of self-prepared herbal toothpaste was marginally less when compared to commercial dentifrice.
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A cross-sectional study on the role of stress in hyperglycemia and the effect of Mahatiktaka Kashaya (an Ayurvedic formulation) in its management p. 114
Prakash Mangalasseri, Snigdha Roy, E Surendran, CV Jayadevan, A K. Manoj Kumar, Seetha Chandran
DOI:10.4103/ayu.AYU_200_19  
Background: Stress is a potential contributer to chronic hyperglycemia. Pitta Prakriti (body constitution) individuals are more prone to stress and the prevalence of type 2 diabetes in stressed out individuals is much more. Aim of study was to evaluate the role of stress in hyperglycemia in individuals of Pitta predominant constitution and to assess the effectiveness of Mahatiktaka Kashaya in stress-induced hyperglycemia. Methodology: A cross-sectional study was carried out in 100 Pitta predominant patients having fasting blood sugar level greater than 140 mg/dl, to find the association of stress and hyperglycemia, using International Stress Management Association questionnaire followed by open lebelled clinical trial with Mahatiktaka Kashaya (Decoction). Trial drug was administered at a dose of 15 ml twice daily for 14 days. Assessment was done before and after the treatment. Observation and Analysis: 80% of Pitta predominant individuals have reported stress-associated hyperglycemia. Overall effect of Mahatiktaka Kashaya in major domains of Stress Assessment Questionnaire, i.e., symptoms, stability and strategies was significant. Furthermore, the trial drug showed significant improvement in biochemical parameters of diabetes. Conclusion: The study concludes that there is significant association between stress and hyperglycemia in the individuals of Pitta constitution. Mahatiktaka Kashaya is found to be highly significant in stress-associated hyperglycemia in the above said group.
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Antioxidant and nutritional evaluation of Bhu Udumbara (Ficus semicordata Buch.-Ham. ex Sm.) leaves and fruits: An extra pharmacopoeial drug of Ayurveda p. 120
Shashi Gupta, Rabinarayan Acharya
DOI:10.4103/ayu.AYU_289_18  
Background: Ficus semicordata Buch.-Ham. ex Sm. (Moraceae) has been attributed with copious therapeutic claims in Indian traditional medical systems, especially for its ethnomedicinal and economical uses. Aims: The present study was carried out to evaluate the heavy metal, pesticide, aflatoxin content, antioxidant and nutritional value of leaves and fruits of F. semicordata. Materials and Methods: Heavy metal content; pesticide residues; aflatoxin content; antioxidant potential; and different nutritional parameters such as total carbohydrate, true protein, protein, total fat, energy, Vitamin C, Vitamin A, iron, zinc, manganese, phosphorus, calcium of the leaves, and fruits were evaluated following the standard guidelines. Results: Fruit powder shows the presence of 72.94 ppm Pb while <0.01 ppm Pb in leaf powder whereas Cd, Hg, and as were <0.01 ppm in both leaf and fruit powders. Pesticide residue and aflatoxin cotent in both leaves and fruit were below the limit of quantification. Antioxidant activities of both leaves and fruits increased with increasing concentrations in the dose-dependent manner by Diphenylpicrylhydrazyl (DPPH) assay, ferric-reducing antioxidant power assay and phosphomolybdenum assay. Fruits are found more nutritious with highest content of true protein, total fat, energy, Vitamin A, iron, zinc and phosphorus whereas the leaves are having highest content of total carbohydrate, protein, Vitamin C, manganese and calcium. Conclusion: The results of this study shows that in the leaves and fruits of F. semicordata mercury, cadmium, arsenic, pesticides residues and aflatoxin content are below the limit of quantification and possess mild antioxidant properties. Fruits are found more nutritious with the highest content of true protein, total fat, energy, Vitamin A, iron, zinc and phosphorus. Being wild, it is easily accessible and cheaper source of nutrition.
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Turmeric based oral rinse “HTOR-091516” ameliorates experimental oral mucositis p. 127
Suryakanth Dattatreya Anturlikar, Mohammed Mukhram Azeemuddin, Sandeep Varma, Onkaramurthy Mallappa, Dilip Niranjan, Ashok Basti Krishnaiah, Shruthi Manjunath Hegde, Mohamed Rafiq, Rangesh Paramesh
DOI:10.4103/ayu.AYU_282_18  
Background: Prevalence and incidence of oral mucositis (OM) are rigorously increasing and there is no effective treatment. The herbal formulation “HTOR-091516” containing Curcuma longa, Triphala and honey were evaluated for the treatment of OM. Aim: The aim of this study was to evaluate the safety and efficacy of HTOR-091516, employing cellular model, human gingival fibroblasts-1 (HGF-1), and 5-fluorouracil (5-FU)-induced mucositis model in rats. Materials and Methods: The cell viability was assessed using 3-(4, 5-dimethylthiazolyl-2)-2, 5-diphenyltetrazolium bromide (MTT) assay and the inhibitory effect of HTOR-091516 on tumor necrosis factor-alpha (TNF-α) was evaluated using TNF-α bioassay in lipopolysaccharides-induced HGF-1. 5-FU and glacial acetic acid were used to induce OM in rats. Animals were divided into two groups, group 1 served as mucositis control and group 2 was treated with HTOR-091516 at the dose of 200 μl and TNF-α was estimated in plasma samples. Results: The in vitro safety of HTOR-091516 was evaluated in reconstructed human oral epidermis and was found to be nontoxic and exhibited concentration-dependent TNF-α inhibition in HGF-1. The treatment with HTOR-091516 reduced mucositis scores and mortality rate and also decreased the plasma TNF-α level. Conclusion: The present data indicate that HTOR-091516 is effective in the treatment of OM.
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LETTER TO EDITOR Top

Illusion of the “p-value” theory in Ayurveda research: A need for perceptible alternative p. 134
Arunabh Tripathi, Saket Ram Trigulla
DOI:10.4103/ayu.AYU_52_19  
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