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Year : 2019  |  Volume : 40  |  Issue : 5  |  Page : 9-34  

AYUSH Cancer Conclave 2019 Accepted Oral Papers with Abstracts

Date of Web Publication23-Jul-2021

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How to cite this article:
. AYUSH Cancer Conclave 2019 Accepted Oral Papers with Abstracts. AYU 2019;40, Suppl S1:9-34

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. AYUSH Cancer Conclave 2019 Accepted Oral Papers with Abstracts. AYU [serial online] 2019 [cited 2023 Jun 9];40, Suppl S1:9-34. Available from: https://www.ayujournal.org/text.asp?2019/40/5/9/321981

   1. A case report on grade 2 oligodendroglioma by Ayurveda intervention Top

Sundara Raman1, Ashwini B.N2, K.Sivabalaji2

1Director, Niligiris Ayurveda Treatment centre Pvt Ltd, Coonoor, India, 2Associate Professor, Dept of Shalakya Tantra, Amrita School of Ayurveda, Amrita University, India

Corresponding author: Dr.Sundara Raman, Email: [email protected]

Background: The current treatment modality for oligodendroglioma is surgical intervention and radiation treatment. This case report shows the effective management with Ayurvedic treatment of a case diagnosed as Grade II oligodendroglioma identifed in left temporal lobe which was posted for resection and chemotherapy based on magnetic resonance imaging (MRI) findings.Case history: A 26-year young lady who was diagnosed with grade II oligodendroglioma was admitted in the hospital. She was posted for excision, resection, chemotherapy and radiotherapy. The features were suggestive of grade II oligodendroglioma based on MRI findings.Diagnosis and interventions: Panchakarma procedures including Snehapana with Panchatiktaka Guggulu Ghrita for 4 days with dosage of 25ml, 40ml, 70ml, 100ml followed by Virechana by Avipattikara Yoga (therapeutic enema therapy), Nasya was done for 7 days with 4 drops of Anutaila mixed with 8 drops of Kshirabala Taila (therapeutic intranasal medication) and Shirodhara with 75% Brahmi Taila and 25% Kottamcukkadi Taila was done for 7 days (therapeutic oleation at head) were administered along with internal medications such as Kanchanara Guggulu, Guduchi Sattva, Ashvagandha capsules and surgery was not performed because the patient responded positively. Observations and Results: Surgery was deferred because the patient responded positively. The outcome of this case study reveals that there was significant reduction (<50% of the tumour mass) of the grade II oligodendroglioma which was documented by MRI before and after the treatment. Conclusion: This case demonstrates the reduction of Grade II oligodendroglioma by non-surgical intervention. Multiple clinical trials should be conducted to establish this treatment as general treatment for the oligodendroglioma.

Keywords: Alternative intervention, brain tumour, Shodhana therapy

   2. Case series on cervical cell dysplasia and its Ayurvedic management- a promising measure to prevent cervical cancer Top

Nilofar Shaikh1, S.N. Gupta2, Sandhya Patel3, Jasmina Acharya4,

1Associate Professor, Prasutitantra evam Streeroga Department, 2Professor, Kayachikitsa Department, 3Professor, Kaumarbhritya Department, 4Professor, Prasutitantra evam Streeroga Department, JS Ayurveda Mahavidhyalaya, Nadiad, Gujarat

Corresponding author: Dr. Nilofar Shaikh, Email: [email protected]

Background: This paper aims to report the efficacy of Ayurvedic intervention in cervical dysplasia. Cervical dysplasia, also called as cervical intraepithelial neoplasia (CIN), is a precancerous condition strongly associated with human papillomavirus (HPV) infection. Aims: To screen symptomatic cases for Cervical dysplasia and report effect of Ayurvedic management in known cases of low grade squamous intraepithelial lesion/ cervical dysplasia. Material and methods: In this study, since year 2017, total 530 women in the age of 20-65 years were screened for cervical cell pathology with Pap test, out of which 05 cases turned out positive for cervical dysplasia [Low grade squamous intraepithelial lesion (LSIL) /CIN-1] and they were treated with oral medicaments of Kanchanara Guggulu, a combination of Rasayana Churna and termeric powder along with local application of Jatyadi Taila Yonipichu (vaginal tampoon) for 3 months. The effect of therapy was assessed on the basis of relief in subjective and objective criteria. Results: At the end of three month-treatment, 90.9% (n=5) relief was found in vaginal discharge and 100% (n=5) relief was found in post coital bleeding. Four patients of cervical dysplasia got complete remission and their Paps smear reports were found normal for a dysplasia while one patient had shown reduction in the severity with presence of a few atypical cells. One patient who had koilocytosis along with cervical dysplasia denoting HPV infection also turned negative for HPV and continued to remain HPV and dysplasia free after one year. Four patients of cervical dysplasia got complete remission and their  Pap smear More Details reports were found normal for a dysplasia while one patient had shown reduction in the severity with presence of a few atypical cells. All four patients with cervical dysplasia remained dysplasia free after one year of follow up. Conclusion: Encouraging results, involving a small number of cases in the category of low grade squamous intraepithelial lesion (LSIL)/cervical intraepithelial neoplasia (CIN)-1, appear to have a very promising outcome. The advantages of this treatment are its short-term course; cost-effectiveness and maintaining negative status (for the premalignancy) for long term without any surgical intervention.

Keywords: Cervical dysplasia, Jatyadi Taila Yoni Pichu, Kanchanara Guggulu, koilocytosis, Pap test, Rasayana Churna,

   3. Effect of individualized homoeopathic treatment on quality of life of patients with gynecological cancers Top

Jay Shah1, Nilesh Shah1, Arun Jadhav2,

1Physician, Bhaktiii Group of Homoeopathy Dispensaries, Pune, India, 2Physician, Bharati Vidyapeeth (Deemed To Be) University Homoeopathic Medical College, Pune, India

Corresponding author: Dr. Jay Shah, Email: [email protected]

Background: In India, over 70% patients affected by cervical, uterine and ovarian cancers have poor survival with high mortality due to reporting of diagnosis and treatment at an advanced stage of disease.In such cases, the primary goals of treatment are to control the symptoms and improvement in the Quality of Life (QoL). Chemotherapy and radiotherapy are interventions of choice even though benefits are disputable. Aims: The aim of the study was to examine whether homoeopathic medicines can improve quality of life (QoL) in patients with gynaecologic cancers. Material and methods: This was a prospective, mono-centric, open-label, uncontrolled, pragmatic study conducted during years 2005 to 2017. Female patients between age group of 30 to 70 years diagnosed with cervical, uterine or ovarian cancers and treated with or without standard line of treatment (operative, radiation or chemotherapy) were included in this study. Primary outcome was QoL measured using the EORTC QLQC-30 and SF-36 questionnaire. Homoeopathic treatment was prescribed to the patients on the basis of the principles of homoeopathy. Results: Twenty-seven patients were treated (mean age: 52.2±13.6years). Patients were pre-diagnosed with cervical cancer [12(44.44%)], ovarian cancer [13(48.15%)] and uterine cancer [2(7.41%)]. Mean duration of disease at baseline was 10.4±13.4 months. The mean follow-up of patients was 19.2±37.4. Most patients were diagnosed with International Federation of Obstetrics and Gynecology (FIGO) stage II [12(44.44%)], stage III [11(40.74%)] and stage IV [4(14.81%)]. The QoL status improved significantly (p<0.0001) after the homoeopathic treatment as assessed by EORTC QLQC-30 and SF-36 respectively. Conclusion: Gynecologic cancer patients treated with homoeopathic treatment showed considerable improvement in QoL and further studies are recommended to establish the efficacy of the homoeopathic treatment in the management of gynaecologic cancers.

Keywords: Gynecologic cancer, homeopathy, quality of life

   4. Ayurvedic management of oral lichen planus- A case study Top

K Shanti1, K.V Subhadra Antherjanam2

1AssistantProfessor, Dept of Shalakya Tantra, Amrita School of Ayurveda , Kollam, Kerala,2Professor, Dept of Shalakya Tantra, Amrita School of Ayurveda , Kollam, Kerala

Corresponding author: Dr. K Shanti, Email: [email protected]

Background: Lichen planus is an oral precancerous lesion. Oral lichen planus is a disease which affects the skin and the underlying mucosa of the oral cavity. Case history: The 52 year old, non diabetic female patient complained of severe pain and burning sensation in the mouth since 4 months associated with excessive sliminess of saliva making her spit out saliva several times a day. Due to burning sensation, she was unable to take any food and was on blanch diet. Lacy web white thread like striated linear, raised lesions were found on the right side of the cheek. Diagnosis and interventions: Biopsy ruled out malignancy and was thus diagnosed to be reticular type of lichen planus. As per Ayurvedic evaluation symptoms suggest the involvement of Pitta, Vata and Kapha Dosha. So the line of treatment adopted was Tridosha Shamaka (alleviating the three humours) in nature. The first treatment given was Gandusha (holding of medicated liquid in mouth) with the Kashaya (decoction) of (Glycyrrhiza glabra Linn.) and Lodhra (Symplocos racemosa Roxb.). This was followed by Gandusha with plain Ghrita (ghee). This helped to further alleviate Vata Pitta Dosha and also had Ropana (healing) action. Pratisarana (external application of medicine) was done with the paste of Triphala mixed with honey and Saindhava (rock salt) and Pratimarsha Nasya was done with Anu Taila. The patient was administered Guduchyadi Kashayam and Avipattikara Churnam internally. Results: In 1 week of treatment, the pain, burning sensation and sliminess of saliva got reduced and the patient felt better. After 20 days of treatment, she was relieved of all the symptoms and the buccal mucosa attained normalcy. When followed up after a year, the relapse of the condition was not noted and the normalcy of the buccal mucosa had been maintained. Ayurvedic treatment was effective not only in curing the condition but also in preventing its relapse. A pre malignant condition like the oral lichen planus, for which there is no potential cure in the contemporary science can easily be managed through Ayurvedic intervention if the condition is properly assessed in terms of involvement of Dosha and by correcting the diet and lifestyle of the patient. Conclusion-Lichen planus may be manged with Tridosha Shamaka treatment, local (Gandusha, Pratisarana) and internal management with Guduchyadi Kashayam and Avipattikara Churnam within 20 days.

Keywords: Ayurveda, Gandusha, oral lichen planus

   5. Gandoosha as a supportive care for radiotherapy and chemotherapy induced xerostomia: A review Top

Ashitha Ali1, Sivabalaji K2, Ashwini B N2,

1PG Scholar, 2Assistant.Professor, Dept of Shalakya Tantra, Amrita School of Ayurveda, Kollam, Kerala,

Corresponding auithor: Dr. Ashitha Ali, Email: [email protected]

Background: Chemotherapy usually impairs the function of salivary glands. Studies have shown that saliva secretion returns to physiologic level approximately twelve months after the completion of chemotherapy. Xerostomia may affect 80% of the patients who need radiotherapy as a primary treatment, as an adjunct to surgery, in combination with chemotherapy or as palliation. In Ayurvedic medicine, dry mouth results from aggravation of Vata. Gandusha (holding of medicated liquid in mouth) is a procedure of holding fluids in mouth to its full capacity with oil, milk, ghee, honey, meat soup and other medicinal formulations according to vitiated Dosha and symptoms produced. It is effective in most of the diseases pertaining to head and neck. Aim: This review study on foucused on Gandoosha as a supportive care for radiotherapy and chemotherapy induced xerostomia.Oil, Kanjika, Dhanyamla and Tilakalkodaka (paste of sesame) are indicated for Gandusha in dry mouth and the best oil of choice is Tila Taila (sesame oil) which is indicated for regular oil pulling. Material and methods: A systematic literature search was conducted in the databases Medline/PubMed and the Cochrane Library using MeSH terms: [Xerostomia] and [Chemotherapy] or [Radiotherapy], [Xerostomia] and [Ayurveda]. Results: After applying filters, 54 articles were obtained and 14 relevant studies were reviewed. By reviewing available literature, it was revealed that many treatment options exist like topical agents, systemic therapy or newer devices but no standard treatment guidelines are available. Pilocarpine is approved for radiotherapy-induced xerostomia. Since pilocarpine has limitations for its usage and other treatment options bring in many cases no substantial relief, Gandusha mentioned in Ayurvedic classics can be a better option in xerostomia and improving quality of life of patients with HNC. Conclusion: Ayurveda emphasizes on personalized medicine in which different medicinal formulations can be chosen depending on Prakriti (constituents), vitiated Dosha and severity of disease. Proper research should be conducted on this aspect aiming to improve quality of life and to help patients carry on with necessary treatments for HNC without being affected much by its side effects.

Keywords: Dry mouth, head and neck cancer, oil pulling.

   6. Evidence based cure for breast cancer through Ayurvedic line of treatment – A case study Top

Vivek J1, Nisha Manikantan2

1Associate Professor, Ayurvedic Onco-Consultant & Ayurvedic Surgeon, 2HOD & Chief Ayurvedic Onco-Consultant, Sri Sri Cancer Unit, Sri Sri College of Ayurvedic Science & Research Hospital, Bangalore

Corresponding auithor: Dr. Vivek J, Email: Ayurveda [email protected]

Background: Breast cancer is one of the common types of cancer in women. Every one in eight is women diagnosed by breast cancer. In many cases of breast cancer, even after undergoing standard protocol of treatments like surgery, chemotherapy, radiotherapy and hormonal therapy etc., there is early recurrence or metastases. Many patients even hesitate to undergo surgery for the fear of losing their breasts, to which they are very much psychologically connected. Patients are also worried about side effects of chemotherapy & radio therapy. Hence there is a need of effective alternate therapy which is devoid of side effects for the management of breast cancer. Case history: A diagnosed case of breast cancer, who was advised for mastectomy & chemotherapy has come to Sri Sri cancer unit 3 years ago asking for Ayurvedic treatment. On examination there was a lump measuring 3.85 x 1.24 x 3.52 cm in upper outer quadrant along 11 '0' clock axis of right breast with metastatic right axillary lymphadenopathy measuring 2.74 x 1.45cm. After having studied all her reports & after assessing Dosha (functional enrgy of body), Dhatu (body tissues), Mala (waste product o body), Agni (balanced digestion), Ama (poor digestion), Strotas (macro and micro channels of body), Roga Marga (ways of diseases), Bala (body strength) etc. of the patient, Ayurvedic treatment was started. Acharya Vagbhatta has indicated Vamana in case of Arbuda (tumour). Considering breast cancer as Sthana Arbuda (place of tumour) & since it is a Kapha Sthana, first classical Vamana (therapeutic vomiting) therapy was started. After 6 months classical Virechana was done. Then classical Vamana & classical Virechana (therapeutic purgation) procedures were repeated alternatively once in 6 months for 3 years. Totally three procedures of Vamana & three Virechana were done. Along with Urdhwa & Adhah Shodhana (internal and external clensing process), patient was given Paneeya Kshara (liquefied alkaline ash) & other Kaphahara Ahara &Grantihara Yoga. Periodically, Mammogram & ultrasound scan of breast was done to assess the size of the breast tumour. To our surprising the breast tumour size constantly reduced & there was no spread of the disease (no metastases). Detailed treatment protocols, Shamana Aoushadhi (pacifying medicines) were given. Results: After three years of treatment, with repeated classical Vamana Karma, classical Virechana Karma, Paneeya Kshara & other Shamana Aushadhi (pacifying medicines) the breast tumour which was malignant & 3.85 x 1.24 x 3.52cm before the treatment, it was reduced to 0.5cm and turned into benign cyst and also the metastatic right axillary lymph node which was measuring 2.74 x 1.45cm before treatment was reduced to 8 mm. Ayurvedic treatment in this case was very effective in reducing the size of the tumour & also arrested the spread of the disease/metastasis. Before treatment BIRADS category was VI i.e. known malignant, which after 3 years of treatment, became BIRADS category II i.e. benign findings. The results were effective & encouraging. During the course of treatment patient didn't experienced any untoward reaction or side effect, the treatment was 100% success without even any single short term or long term side effect. Conclusion: Ayurveda has got definitely major role in the management of breast cancer, but we have to understand the breast cancer & all other modern investigation reports on the basic concepts of Ayurveda like Dosha (functional enrgy of body), Dhatu (body tissues), Mala (waste product o body), Agni (balanced digestion), Ama (poor digestion), Strotas (macro and micro channels of body) etc. After evaluation of breast cancer classically, then we should treat it with some specific Ayurveda line of treatment (Chikitsa Sutra) for the success. Breast cancer can not be managed merely with administration of so called some anti cancerous herbal drugs.

Keywords: Ayurveda, breast cancer, metastases, Paneeya Kshara Vamana Karma, Virechana Karma

   7. Formulation development and optimization of 3 myrobalans mouthwash for its cytotoxic potential in oral carcinoma Top

Tushar Gupta1, Veena Deo2, Bharat Bhushan Shrikhande3, Neha Dandewar4

1Phytochemist, 4Pharmacologist, Shree Baidhynath Ayuved bhawan, Nagpur, 2Clinical Research Head, 3Director, Siddhayu Ayurvedic Research Foundation Pvt. Ltd. Nagpur.

Corresponding author: Bharat Bhushan Shrikhande, Email: [email protected]

Background: Literature search suggests potential of Triphala in the management of carcinoma. Aim: To develop and optimize the combination of three Myrobalans in the form of mouthwash and to explore its cytotoxic and antibacterial potential in the management of oral carcinoma. Material and methods: The raw materials Amla (Emblica officinalis Gaertn), Harada (Terminalia chebula Retz) and Baheda (Terminalia bellirica (Gaertn.) Roxb.) were procured from approved and authenticated vendors Nagpur. The standard concentration of three Myrobalans mentioned in API is 1:1:1. An attempt was made to optimize concentration of 3 myrobalas from different concentrations in to formulation in the form of mouthwash and check its potential against oral carcinoma. The different formulations were TM 1, TM 2 and TM 3. The formulations were made by simple decoction method. Formulation was evaluated for phytochemical screening and antimicrobial property and anticancer activity. Results: In Phytochemical screening of formulation, it was found that it contains large amount of tannins i.e 616.4±11, 602.3±14, 574.8±02 for TM 1 (1:1:1), TM 2(1:4:1), TM 3(3:5:2) and in TM 1 highest amount of tannins was present. In antimicrobial study, the formulation TM 3 showed potent activity against S. mutant and E. coli where as TM 2 showed potent antimicrobial activity against S. aureus. The anti-proliferative assay using Saccharomyces cerevisiae yeast model the inhibition of viable cells was best observed as 81.36% at a concentration of 6mg/ml of TM 1, 80.34% at a conc. of 6mg/ml of TM 2 and 81.36 at a conc. of 6m/ml of TM 3. TM 3was near to the standard anticancer drug methotrexate which exhibited 27.79% and 82.71% at the dose of 50 and 100 μg/ml. For anticancer activity against human oral squamous cell line SCC-40 by sulforhodamine B (SRB) assay TM 3 showed potent anticancer activity and it was found that it is more potent than that of standard drug adriamycin (ADR), the GI 50 value of TM 3 was found to be 7.6 (Standard<10). Conclusion: The three Myrobalans mouthwash is a good inhibitor of cytotoxic cell growth and it has a potent anti carcinogenic activity from which TM 3 showed potent anticancer activity than standard Adriamycin.

Keywords: Antimicrobial, cell line, herbal mouthwash, 3 myrobalans, oral carcinoma

   8. Clinical insights for tackling cancer in Ayurveda - A conceptual study Top

Praveen Kumar K S1, Anup Thakar2

1Research Officer, Central Ayurveda Research Institute, CCRAS, Guwahati, 2Director, ITRA, Jamnagar, Gujarat.

Corresponding author: Dr. Praveen Kumar K S, Email: [email protected]

Background: Descriptions about cancer are spread under different headings in Ayurvedic classical textbooks. Granthi (cyst), Arbuda (tumour), Adhyarbuda, Dwirarbuda, Gulma (mass or nodule), Pandu (anemia), Vidradhi (abcess) & certain Asadhya Vyadhi (difficult to treat disorders) etc. points out to cancer. Aims: The purpose of this study is to bring all the scattered relevant information about cancer under an umbrella. Materials and methods: Classical text books of Ayurveda representing typical reference points pointing out to the symptoms of cancer were analyzed. Modern Textbooks and journals from on and off the internet were also screened for information. These sources were studied for methodological criteria used for rigorous study and for information regarding cancer, further; these were classified under different heads.Results: Cancer is understood under different headings like Granthi or Arbuda. The stages of cancer can be summarized in a sequence as Shopha (odema), Arbuda (tumour), Chiravridhi Apaka (chronic suppuration), Analpamula, Achala (fixed), Mahavastuparigraha, Samprasruta, Adhyarbuda and Dvirarbuda. Chronic inflammation and metabolic syndromes are cardinal for cancer development. Vitiated Vata causes uncontrolled growth; Pitta and degraded Ojas promotes ulcers and spreading; while Kapha makes it a silent killer. In treatment, disintegration of cancer by Sweda (sweting) and Lepa (medicated paste) are mentioned. Paka (suppuration), followed by drainage, Agnikarma (cauterization) /Ksharakarma (application of alkaline ash) are done for complete destruction and prevention of spread or regrowth. Techniques like radiation and chemotherapy may be used at certain conditions, while Ayurveda can work synergistically to reduce their side effects. A study on 36 different cancer patients receiving chemo and radiotherapy were divided into two groups and studied for 75 days. One group was given Rasayana Avaleha along with it but the second group was kept as control. The Rasayana (rejuvenation) group got 43.75% marked improvement when compared with control group which had 22.22% of patients with worsened condition. Conclusion: The clinical features of cancers were well understood in the evolutionary history of Ayurveda. Chronic inflammation and metabolic syndromes are cardinal for cancer development. Prevention, single/integrative management and rehabilitation are the stages where Ayurveda can contribute fruitfully.

Keywords: Cancer alternative medicine, cancer integrative approach, clinical insights cancer, cancer treatment Ayurveda

   9. Formulation and development of herbal syrup for the management of chemotherapy related side effects Top

Manoj Gomkale1, Veena Deo2, Bharat Bhushan Shrikhande3, Neha Dandewar4

1Phytochemist, 2Clinical Research Head, 3Director, Siddhayu Ayurvedic Research Foundation Nagpur, 4Pharmacologist, Shree Baidhynath Ayuved bhawan, Nagpur

Corresponding author: Dr. Manoj Gomkale, Email: [email protected]

Background- Chemotherapy is associated with unpleasant side effects. A herbal syrup is proposed for the management of side effects related with chemotherapy in breast cancer patients. Aim: To develop a herbal syrup for the management of side effects of chemotherapy. Material and Methods – To relieve the side effects of chemotherapy like nausea, vomiting, diarrhea and loss of appetite the herbs are selected on the basis of phytoconstituents like primary and secondary metabolites, alkaloids, glycosides and tannins as well as Rasa Virya, Vipaka and Karma. Quality control tests like PH, Specific gravity, HPTLC and phytochemical screening of the herbs was done to develop the herbal syrup. A case study was carried out in six breast cancer patients undergoing chemotherapy at Baidyanath Life sciences Nagpur. The duration of the study was six months. Results- It was found that this formulation has efficacy to provide relief from the side effects of chemotherapy like nausea, vomiting, diarrhoea and loss of appetite. Conclusion–The formulated herbal syrup containing active phytoconstituents is significantly effective in relieving symptoms associated with chemotherapy in cancer patients. It is specifically providing relief to the symptoms like nausea and vomiting.

Keywords: Chemotherapy, cancer, side effects, phytoconstituents, herbal syrup

   10. Effectiveness of Basti on adverse effects of chemotherapy in oesophageal cancer to improve quality of life –A case report Top

Amit Awadhiya1, Anup Thakar2

1MD Scholar, 2Director & HOD deparment of Panchakarma, IPGT & RA, GAU, Jamnagar, Gujarat

Corresponding author: Dr. Amit Awadhiya, Email:[email protected]

Background: In cancer treatment after chemotherapy an adverse effect occurs, which hampers the normal function of gastro-intestinal tract and quality of life of the patients. In the pathogenesis of disease, there will be vitiation of Vata Dosha mainly and it is the same for cancer of oesophagus. Kapha Dosha is also involved in the pathogenesis of any kind of cancer. Case history:A 48 year old male patient with diagnosed oesophageal cancer came with complaints of severe constipation, difficulty to walk, anxiety, fear, chest pain, dysphagia, abdominal pain, recurrent vomiting, cough, insomnia, body ache etc. He had completed 6 cycles of chemotherapy before 2 months. After evaluation, the patient was admitted in IPD of Panchakarma department of IPGT and RA, Jamnagar. Shodhana Basti (therapeutic enema for cleasing of internal body) was done first with Eranda Taila (medicated castor oil, (50ml), Saindhava (rock salt 10gms) and lukewarm water, 200ml for 3 days. Basti Chikitsa (medicated enema for treatment) was started by Karma Basti pattern with Anuvasana Basti (therapeutic enema with Guduchi Ghrita, 100ml) and Asthapana Basti (therapeutic enema with Guduchyadi decoction, 800ml). Result and Discussion: Assessment was done before treatment, 15thday and after treatment. Quality of life was evaluated with Karnofsky performance index where the scores improved from 40 on the 1st day to 70thday after treatment. After treatment, the patient was able to walk and eat properly. Pain in the chest reduced considerably while the pain in stomach and constipation got subsided. Nausea and vomiting subsided while fear and anxiety was reduced considerably. Basti is able to balance the Dosha in the body mainly by producing Anulomana to Vata. Once Vata is controlled, the main symptoms seen are reduced and other Dosha are also balanced. Guduchi is able to balance the vitiated Pitta and Vata Dosha due to chemotherapy.

Keywords: Basti Karma, Guduchyadi Karma Basti, Quality of life

   11. Understanding cancer from the siddha perspective Top

Lekha G S1, Kanaga Rajan2

1Reasearch Officer, 2Assistant Director, Siddha Regional Research Institute, Thiruvananthapuram

Corresponding author: Dr. Lekha G S, Email: [email protected]

Background: This paper aims to review ancient Siddha medical literature to gain an understanding of description, diagnosis and management of the cancer. Aim: The aim of this paper is to highlight the pathology, diagnosis and therapeutic approach of various types of Cancers mentioned in siddha literatures. Materials and methods: The pathology, diagnosis and therapeutic aspects of 'Cancer like illnesses' explained in Siddha system in the form of condensed poems are reviewed in Siddha literatures Aathmaratsamirtham ennum Vaidya saara sankirakam, Siddhar aruvai maruthuvam, Yugi vaidhya cinthamani, Siddha Vaidya Thirattu, Therayar Maha Karisal, Therayar Yamagam, Brahma Muni Karukkadai, Yogi Vatha Kaviyam, Noi illa neri and Pothu maruthuvam. Moreover this paper explicates the review on herbal drugs indicated for cancer related ailments, pre-clinical study of Siddha formulations and Case studies. Results: The descriptive aspects of Cancer have resemblance with the clinical entities of Vippuruthinoipadalam (carcinoma like illness), Mega Katti, Kandamaalai Rogapadalam (lymphoma like illness), Kiranthinoigal (malignant tumour), Pilavai and Putrunoi (tumour) revealed in Siddha Literatures. The Siddha formulations indicated for ccancer are Rasagandhi Mezhugu, Chithramoola Kulikai, Serankottai Nei, Neeradimuthu vallahy ilakam, Vallarai Nei, Rasakarpoora Kuligai, Megathennai, Chenkatthari ennai, Vippuruthi ennai, Pancha-pashana chendhooram, Namachivaaya Chendhooram, Mutthu chendhooram, Abbraka Parpam, Thalaka chendhooram, Velvanka parpam, Pavala vanka chendhooram, Thamira Kattu Chendooram, etc. The external therapeutic procedures indicated for the treatment of Cancer are Poultice - Pattru (Amukkara, Neerkovai maathirai, etc), Poochu – Panchakkini thailam, Thaila muzhukku – Milaku thailam, Chuttikai (cauterization), Vatthiraanjana pugai, etc. Conclusion: Siddha medicine provides specific nomenclature, description, classification and management of cancer which can be studied in comparison with descriptions in modern medicine, Ayurveda, Unani and other traditional systems of medicine.

Keywords:Cancer, siddha, tumour, malignant, benign, carcinoma, lymphoma.

   12. A study on the effectiveness of nutrition and Ayurvedic diets in the successful management of pancreatic cancer -a single case study Top

Mohamad Saleem

PG Scholar, SVM Ayurvedic Medical College, Ilkal, Bagalkot, Karnataka

Corresponding author: Dr. Mohamad Saleem, Email: [email protected]

Background: In Ayurvedic nutrition and diets is said to be cause of stability for all living beings .There is nothing else except diet for sustaining the life of living beings. GIT cancer is rapidly emerging as major health hazard in last few years. More than 20 % GIT cancer cases are pancreatic cancer. In spite of surgery, chemotherapy and radiation therapies evolving, the survival rate of pancreatic cancer rate is much lower in India. Second year relative survival is only 12 %. Eleventh most commonly diagnosed cancer in men. Here the study with reference of Bhavapraksha in Abyanthara Vidradhi (internal abscess) mentioned Sigru soup as Ayurvedic diet for healing. Case history: 65 years man diagnoses as adenocarcinoma pancreas on 01.07.2017 presenting the symptoms with severe abdominal pain, anorexia, weight loss, hemtemesis and fatigue. Duration more than 9 months. Patient is not willing to undergo surgery or chemotherapy or any other allopathic treatment. Patient first visited our Ayurvedic treatment center with above said complaints. As per the reference of Bavapraksha Nigatu Antra Vidradhi Chikitsa mentioned ayurvedic diet with Sigru (Moringa Oliefera) given daily. Morning Sigru decoction with Hingu and Saindava advised .Night Sigru Twaka soup added with honey suggested to take at bed time. Morning 11 am patient was advised to take soup with Asthi Valkala (Cissus quadrangularis L.) , Kohl Rabi (Brassica oleracea var. italica), Ridge Gourd (Luffa cylindrica (L.) Rox.), Haidra (Curcuma longa Linn), Ardraka (Zingiber officinale Rosc.), Maricha (Piper nigrum Linn.) boiled and added with Saindava Lavana (rock salt). These 3 different types of Ayurvedic Diet prescribed to the patient for 6 days in a week. Patients' shows miracle results with these Aushadha Yuktha Ahara (therapeutic food articles) within 10 days. Suggested to the patient continue the diet for 100 days. In between 10 days gap was provided for every 3rd month. More than 13 months he is on observation only with above mentioned Ayurvedic diet. The patient is now completely clinically no symptoms. He is a farmer. Nowadays he is doing all his routine farmer work without any symptoms .From the beginning itself patient is not taking any other medication except these food. He is taking regular food. No malena. No hemetememis. Gradual weight gain also observed. Oncology diet is very much needed in this present era. Post chemotherapy most of the patient lose their metabolism and bio feed mechanism. Ayurvedic nutrition and diets has solution to this cancer patient managements effectively.

Keywords: Aushdha Ahara, Ayurvedic diets, Ayurvedic nutrition, pancreatic cancer

   13. Applications of Tamra Bhasma for anticancer Drug delivery: A review Top

Saumya Gulati1, Namrata Joshi2

1PG Scholar, 2 Associate Professor, Dept. of Rasashastra & Bhaishajya Kalpana, Faculty of Ayurveda, Institute of Medical Sciences, Banaras Hindu University

Corresponding author: Dr. Saumya Gulati, Email: [email protected]

Background: Tamra Bhasma is an organometallic compound of copper classified under Shuddha Lauha (processed iron) which exhibit Chedana (excision) and Lekhana (therapeutic scapping) properties for management of cancer. Aim: An attempt is made to understand the action of Tamra Bhasma on the basic pathology of cancer. Methods: Database, Keywords, Results, Filters, Papers were selected for review. Results: 1)A probable hypothesis has been structured based on actions of Tamra Bhasma as evidenced from different treatises of Rasa Shastra and from contemporary science. 2) Recent researches on several properties of Tamra Bhasma as well as copper nanoparticle from Science Citation Index (SCI) indexed journals were analysed. The pharmaceutical procedures involved in the processing of the Bhasma preparation enable certain specific physico-chemical changes thus removing the toxic properties and enhancing the therapeutic value. Tamra Bhasma is best known for its Lekhana property which supports in pacifying Ama Dosha (incomplete metabolism) and vitiated Kapha. It also exhibit antioxidant and anti-inflammatory property. In-vitro anticancer study of CuO nano-particles induced intracellular ROS (reactive oxygen species) generation in a dose-dependent manner and significantly reduced cervical carcinoma colonies. This positive result provides useful figures for scheming a better anticancer compound using Copper in the form of Ayurvedic Bhasma. Amassing all the above facts, it can be conjectured that Tamra Bhasma would display anti-cancerous property. Conclusion: The literature review points to Tamra Bhasma as a potential anti-cancer drug. Further preclinical studies are needed before systematic human trials can be conducted.

Keywords: Anti-cancer drug, cancer, copper nanoparticle, Tamra Bhasma

   14. A descriptive review on exploration of cannabis in the management of cancer Top

Sukruth G1, Laxmi Narayan Gupta2

1PG Scholar, 2Assistant Professor, Dept. of Rasashastra & Bhaishajya Kalpana, Faculty of Ayurveda , Institute of Medical Sciences, Banaras Hindu University

Corresponding author: Dr. Sukruth G, Email: [email protected]

Background: Cannabis sativa L. (hemp) is a psychedelic plant with regulatory restrictions on it human use. In recent times, this herb has been reported to have potential in managing the Grade 5 pain that presents as a symptom in cancer. Aim: To explores the rationale behind the worldwide demand for the legalisation of cannabis for medicinal purposes. Material and methods: Database, keywords, results, filters, relevant papers selected for review. Results: Phyto-pharmaceutical understanding of cannabis and their pharmacological actions are accessed; Legalization and intervention of cannabis in first world countries for the management of cancer are studied. Ayurvedic and Traditional Utility of Cannabis historically are explored. Recent updates and researches in India are looked upon for their novelty.The anti-cancer properties of Δ9-tetrahydrocannabinol (THC), cannabidiol (CBD) are already well established. The terpenoids, 'minor' cannabinoids contribute to 'entourage effect' of cannabis-based medicines. The alcohol and coconut oil extracts of Cannabis has shown benefits for cancer and palliative care for pain of various grades. The adverse effects of chemotherapy are suppressed by the intervention of cannabis. The cannabinoid extracts do not exhibit the psychotic dependency contrary to that of the tobacco and morphine. In-vitro and in-vivo studies reveal that non-hallucinogenic Cannabinoids are beneficial in the management of breast cancer, lung cancer, multiple sclerosis, Parkinson's disease and Crohn's disease. Conclusion: Highlight how Ayurvedic physicians can make use of Cannabis in management of cancer and related symptoms.

Keywords: Cannabinoid extracts, Carcinoma, Entourage effect, Legalization

   15. Preventive oncology in Ayurveda with special reference to Rasa-Shastra – A comprehensive approach (conceptual study) Top

Aishwarya Mohan

PG Scholar, Dept. of Rasashastra and bhaishajya Kalpana, Govt Ayurveda college, Tripunithura

Corresponding author: Dr. Aishwarya Mohan, Email: [email protected]

Background: This paper attempts to outline a prophylactic approach to cancer prevention by applying the concepts of Janapadodhvamsa (Ayurvedic Epidemiology), Ashuddha (un-purified) and Apakva Bhasma Sevana Dosha Chikitsa (improperly processed metallic formulations) as well as Rasayana (rejuvenation) treatment. Aim: Present research work focused on preventive oncology in Ayurveda with special reference to Rasa-Shastra. Materials and methods: Database, Keywords, Results, Filters, Relevant papers selected.

Results: Cancer etiology is comprised of certain modifiable and non-modifiable risk factors. Preventive strategies aimed to reduce the build-up of these risks for specific cancers, or to modify the bodily responses of exposure to the risk factors are attempted. The identification of high risk demographic zones such as certain industrial units and its interaction with high risk population as in cases of greater genetic predisposition, family history, age, lifestyle, dietary habits, occupation, exposure to chemical contaminants etc. needs to be delineated. Preventive intervention through the application of concepts and treatment of Ayurvedic epidemiology can be explored in this context. Also, the treatment discussed in oral intake of un-purified and improperly processed metallic formulations may be envisaged as a potential concept with possibility of application in preventive oncology due to the undeniable susceptibility of individuals to multiple heavy metal contaminants. This can yield a novel direction to investigate the prospect for a lesser economic burden inflicted by the disease. Ageing is another fundamental factor for the development of cancer. The incidence of cancer rises dramatically with age.[W.H.O]. Here the application of principles of Rasayana during the early or middle age can play a key role in prevention. Conclusion: Hence a methodological approach to cancer through the concepts of Ayurveda in accordance to the possible etiological factors, overall risk accumulation and genetic succesptibility can pave the way to effective prevention of cancers.

Keywords: Preventive oncology, Rasashastra, Ayurveda and oncology

   16. Critical review of Abhyanga to prevent breast cancer. Top

Dr. Prajkta Kulkarni

Ayurveda Consultant, Indo Ayurveda research and clinic

Corresponding author: Dr. Prajkta Kulkarni, Email: [email protected]

Background: Abhyanga (therapeutic oil massage) which is among the Dincharaya is an ancient Indian approach adopted for helping, relaxation and treating various diseases. By doing massage the vital points gets stimulated and produce positive energy, thereby protecting, rejuventing and increasing the immunity towards environmental changes. Nitya Abhyanga over (Stana) breast cancer. Pathophysiology of cancer (Arbuda)- female has twenty more muscles. Ten muscles are found in the breast. Muscular tissues is the most common Sharira Sthana affects by cancer through any Sharira Sthana can be. Aacharya Sushruta said that when Prakriti Dosha in Rasavaha Strotasa and its Upadhatu Sthanyavaha Strotasa obstruct the way due to obstruction of Aam (aggregated toxins). An extra-large growth appears called Arbuda developed. Blood circulation and lymphatic drainage of the breast are more prone towards obstruction. Aim: In this review study point-out to prevention of breast cancer by Abhyanga. Material and methods: of Abhyanga over breast- Abhyanga is effective at moving lymph. Abhyanga over breast improves breast blood circulation and lymphatic drainage as prevent stagnation of Rasa Dhatu. Results: Breast are made up of fatty tissues with lymph constantly flowing through and cleaning tissues. Fat molecules hangs out in this tissues such as pesticides and other environment toxins. Abhyanga helps to eliminate toxins by improving blood circulation and lymphatic drainage. Conclusion: Abhyanga over breast for daily routine prevent breast cancer through maintaining blood circulation and cleaning toxins through lymphatic drainage.

Keywords: Abhyanga, Stana Arbuda, breast cancer

   17. Role of classical Ayurvedic formulations in management of cancer – A review Top

Shobha Katara1, Neeraj Kumar2

1PG Scholar, Institute of Medical Sciences, Banaras Hindu University, Avinash Baberwal, SDAMCRC Ayurvedic Colloge, Mathura, 2Faculty of Ayurveda, Institute of Medical Sciences, Banaras Hindu University

Corresponding author: Dr. Shobha Katara, Email: [email protected]

Background: Review literature on anticancer drug of plant origin revealed identification of newer several ayurvedic drugs that can be used for the treatment of one of most dreaded i.e. cancer. Aim: To review research papers reporting the use of Ayurvedic drugs and formulations in the management of cancer. Materials and methods: Database, keywords, results, filters, relevant papers selected for review. Results: Some of important formulations that can be used for treating cancer just like Kanchnara guggulu in sarngadhara Samhita, Arbudahara Rasa in Rasa Ratna Sammuchyya, Vajra Bhasma in Rastantra Sara, Roudra Rasa in Rasendrasar Sangraha etc. Conclusion: Distinguish between formulations that are mentioned in texts but not studied, not mentioned in texts but in practice, mentioned in texts and in practice and those that have also been studied or not studied.

Keywords: Ayurvedic treatment, cancer, Rasa Yoga, Samsmana Chikitsa

   18. Diet-nutrition: Kayakarpam herbs for cancer prevention – Siddha perspectives Top

Kalaiselvi G G1, Mirunaleni P Vivek2

1PG Scholar, Government Siddha Medical College Arumbakkam Chennai, 2Research Officer, Siddha clinical research unit, A & U Tibbia college campus, karolbagh

Corresponding author: Dr. Kalaiselvi G G, Email: [email protected]

Background: Cancer is one of the common disease of high mortality rate and a lot of limitation in present medical treatments. Food and lifestyle modification plays a major role in the management of Cancer. Aim: The objective of the study is to create awareness in prevention of cancer through Siddha healthy lifestyle, dietary measures by Kayakarpam herbs. Materials and methods: Search will be made using search engines like PubMed, Cochrane and Google Scholars. To cull out the search through ancient medical information, Siddha textbooks will also be extracted. Results: The knowledge we have gained of the carcinogenesis process and the role of dietary constituents on the effects of tumorigenesis processes, it is now a widely accepted concept that cancer is mostly a preventable disease. A new concept for diet and cancer prevention, research and strategy must be developed to include the nutrition modulation of the carcinogenesis pathway by nutrients, micronutrients and phytochemicals. This pathway includes nutrition modulation of DNA damage and repair mechanisms; antioxidant rearranging and oxidative stress modulation; target receptors and signaling pathways; cell cycle controls and check points; and antiangiogenic properties. Recent researches on herbs has enlightened that the components of Kayakarpam herbs seems to target the reactive oxygen species which are significant cancer causing agents. Conclusion: Research on eating behaviour and changing dietary patterns as well as psychobiological approaches must be included in cancer prevention strategy. New frameworks are to be developed logically, using multidisciplinary approaches that include lifestyle and environmental changes, dietary modifications and physical activity to reduce the burden of cancer for the general population as well as high risk individuals . According to siddha literature, Food itself is a medicine. Foods in our diet either enhance or disturb the potency of the drug consumed. Hence, let your medicine be your food and your food be your medicine.

Keywords: Antioxidants, Dietary measures, Kayakarpam herbs, Prevention

   19. Holistic approach to manage depression and other associated symptoms induced by panhysterectomy for granulosa cell ovarian cancer – A case report Top

Anil kumar Kala Akhila1, Prince Raji Chippy1, Anjaly Muraleedharan2, Parvathy Unnikrishnan2, Hemavathi Shivapura Krishnarajabhatt3

1PG Scholar, 2Assistant Professor, 3Professor, Amrita School of Ayurveda, Amrita Vishwa Vidyapeetham

Corresponding author: Dr. Anil kumar Kala Akhila, Email: [email protected]

Background: A cancer diagnosis can have a huge impact in our life. If detected early, 80% can be cured of the disease. After treatment also, even for every ache or pain, many survivors fear of cancer recurring. About 25% of cancer survivors develop stress, depression, anxiety, fear thereby affecting their emotional health. The severity of these symptoms will be more if the patient is a female and has underwent panhysterectomy as it results in surgically induced menopause and also hormonal imbalance. In this scenario, Ayurvedic medicines and life style modifications can help the patients to ease off the symptoms.

Aim: To assess the efficacy of Ayurvedic holistic approach in the management of post cancer anxiety and depression. To assess the efficacy of Ayurvedic holistic approach in management of surgically induced menopause related symptoms. Material and methods: This is a case report of a 48 year old lady suffering from severe anxiety and depression following the panhysterectomy because of granuloma cell tumour with haemorrhage in the right ovary, left ovary stromal hyperplasia and seedling leiomyomas in uterus. She was under tension if the carcinoma still persists or if it will recur. Associated complaints include lethargy, hot flushes, increased sweating and reduced sleep. The patient was advised to do Surya Namaskara (A set of 12 yoga postures), Pranayama (Breathing technique in Yoga) and meditation along with external therapies like Thalam, Pratimarsha Nasyam (therapeutic nasal oil therapy), Abhyanga (therapeutic oil massage therapy) and internal medications. Counselling along with dietary modification was also given. Pre and post assessment was done with Zung self rating depression scale and MENQOL questionnaire. Result: After 3 months, patient got good relief of the symptoms. Conclusion: The sudden surgically induced menopause had created hormonal imbalance in the patient. Adding to that is the fear of cancer recurrence. The treatment protocol was hence designed giving due consideration to the somatic, psychological and spiritual factors.

Keywords: Fear of cancer recurrence, granulosa cell tumour, holistic approach, post cancer depression

   20. Effect of jalookavacharana in gingivobuccal carcinoma- A case report Top

Anupama J dileep1, Jayakrishnan A1, Ashwini B.N.2, Sivabalaji K3

1PG Scholar, Dept. of Shalakya Tantra, Amrita school of Ayurveda ,Kollam, Kerala, 2Assistant Professor, RMD Ayurveda College Valsad, Gujarat, 3Associate Professor, Dept. of Shalakya Tantra, Amrita school of Ayurveda, Kollam, Kerala

Corresponding author: Dr. Anupama J Dileep, Email: [email protected]

Background: Gingivobuccal carcinoma is one amoung the squamous cell carcinoma found in the oral cavity. The lip, tongue, buccal mucosa, gingivobuccal (GB) sulcus tumours are more common. This is because of the extensive usage of quid of tobacco with lime which is kept in GB sulcus. Management will depend upon the stage of disease as early stages treated by surgery alone and advanced stages require multimodality treatment which involves chemoradiation in addition to surgery. Case history: The patient complaining of non-healing ulcer in oral cavity, halitosis, odynophagia and trismus was heated. This case report discuss the effective management with Jalukavacharana (local application of leech) on a case diagnosed as gingivobuccal carcinoma measuring 5.5 x 3.7 cm in axial dimension and 4.5cm supero-inferiorly with multiple rounded lymph nodes in submandibular region and who underwent ultrafast multislice multiplanar pre and post IV contrast CT scan of neck. Jalukavacharana was done externally over the large mass in right buccal wall for a period of 1 month i.e.; weekly once with four sittings. Results: Progression of symptoms in Gingivobuccal carcinoma especially odynophagia and trismus is effectively managed by Jalukavacharana modality which is one among Raktamokshana (bloodletting) procedure. This is because the leech saliva contains numerous bioactive constituent which possess anti-inflammatory, analgesic, thrombolytic, antioxidant, vasodilator, anti-coagulant and blood circulation enhancing factors. Conclusion: This case reveals that the Gingivobuccal Carcinoma can be effectively managed by Jalukavacharana modality which is one among the Raktamokshana Marga (route of bloodletting). Due to its proximity to mandible and posteriorly infratemporal fossa, extent of surgery remains critical to provide cure with satisfactory functional and esthetic outcomes. On this principle, studies must be conducted to validate the management of this condition. Further studies are needed to assess the sustained results.

Keywords: Leech therapy, Raktamokshana, Squamous cell carcinoma

   21. Haridra – A golden spice in the management of cancer Top

Priya S R Nair1, Pratibha Kulkarni2,

1Final Year Post Graduate Scholar, 2Professor and HOD, Department of Kriya Sharir, SDM College of Ayurveda and Hospital Hassan Karnataka.

Corresponding author: Dr. Priya S R Nair Email: [email protected], [email protected]

Background: Haridra (Curcuma longa Linn, family-zingiberaceae) is a rhizomatous plant which is widely used herb in India, since ancient time. Also known as 'Golden Spice of India', it has been used in traditional medicine as a household remedy for various diseases, including hepatic disorders, cough, diabetic wounds, rheumatism and sinusitis. Also as an anti-inflammatory, anti-oxidant, anti-carcinogenic, anti-mutagenic, anti-venom, anti-ulcer, in addition to its use as a spice and pigment, Haridra and its constituents mainly of curcuminoids and essential oils show a wide spectrum of biological action. The term neoplasm or new growth i.e., a mass of tissue formed as a result of abnormal, excessive, uncoordinated, autonomous and purposeless proliferation of cells even after cessation of stimulus for growth which causes cancer, in such cases Haridra plays an important role. Aim: To review the anticancer activities of Termeric. Materials and methods:Online published researches and classical textbooks of Ayurveda were searched for probable utility of Haridra in the management of cancer. Results: As per ancient Ayurvedic classics, Haridra possessproperties like Tikta- Katu Rasa (bitter-acrid in taste), Ruksha- Laghu Guna (dry-light properties), Ushna Virya (hot), Katu Vipaka (acrid) and Kapha-Vata Shamaka (pacifier). Also it is useful in Kapha-Vataja disorders, Lekhana Karma (scraping), Vishaghna (anti toxic), Varnyakara (complex enhancer), Kushthaghna (alleviate skin disorders), Krimighna (anti anthelmintic), Kandughna (anti-itching). Use of Haridra in Medoja Arbuda (fatty tumour) is explained in Ayurveda . Chemical constitution of Haridra mainly includes curcumin and essential oils. Curcumin gives yellow colour to Haridra and now recognised as being responsible for most of the therapeutic effect. Curcumin in Haridra acts as a potent anti-carcinogenic compound. Lekhana property of Haridra can be taken as the action of curcumin over apoptosis inhibited cell cycle progress and in preventing cancerous cell growth. Curcumin inhibits the topoisomerase enzyme, which is required for the replication of cancer and parasite cells. It strongly inhibits DNA and RNA synthesis and increase mitochondrial membrane permeability; it also prevents proliferation by cell cycle arrest in the G2 metaphase in a variety of malignant tumour. The free radical scavenging activity as well as inhibition of lipid peroxidation by curcumin has been reported. Conclusion: Haridra which is having anti-cancerous activity can be considered as an adjuvant therapy for cancer treatment as well as prevention. Use of Haridra as a part of biological safety, efficacy, its cost and effectiveness is known since years. Even experiments of it justify Haridra as 'The Golden Spice for Life'.

Keywords: Anti-cancerous, curcumin, Haridra, Golden spice for life, Lekhana, neoplasm,

   22. Free radical scavenging activity in prevention of Arbuda with special reference to cancer Top

Sankha Subhro Ghosh1, Pratibha Kulkarni2

1PG Scholar Kriyasharira, 2Professor and HOD Kriyasaharira, SDM College of Ayurveda and Hospital Hasssan, Karnataka

Corresponding author: Dr. Sankha Subhro Ghosh Email: [email protected]

Background: Cancer; a word that describes near to death is a neo growth which multiplies and destroys the whole homeostatic atmosphere of affected cells and their organ system impacting on the human life expectancy. Ayurveda is a holistic and logical science mentions it as Arbuda (tumour) which which is one of the surgical related diseases as described by Acharya Sushruta. Yet another part or a second face of the disease is to know about treatment, but the existence of treating cancer according to Ayurveda is just a hypothesis till today, with no cause of it found in this era of scientific world. Ayurveda believes in diagnosis first and later the treatment, so finding a cause before treating is very important and a basic necessity because Nidana parivarjana (avoid causative factor) is said to be the first line of management in all the diseases. Aims: To elaborate role of free radical scavenging activity in prevention of Arbuda with special reference to cancer. Material and methods: Classical textbooks of Ayurveda and contemporary science, online research papers were searched for elaboration. Results: Arbuda (tumour); a disease caused by vitiated Tridosha (three functional energy of body) along with Rakta & Mamsa (blood and muscle tissue) are involved in the part of pathogenesis. So the causative factors responsible for vitiation of Tridosha, Rakta and Mamsa will leads to Arbuda. Pathophysiology of Arbuda is intiated with the vitiation of Tridosha which in turn will have an impact over Agni leading to Ama, so this Ama probably possessing free radical activity starts the process of ageing of cells, where the Strotorodha (obstruction of macro & micro channels of body) occurs within the Rakta and Mamsa to form a Arbuda leading to the neoplasm or new growth which represents as that of an inflammation in initial stages and later on to the progression of disease. Measures to prevent, the first and foremost step will be avoiding the causative factors vitiating Tridosha and then later on focus towards prevention of Kha-Vaigunata (defective channels of transport) of Rakta and Mamsa Dhatu so that no progression takes places. The last part of the management will be towards the Ama where in preventing the cellular atmosphere from forming into a free radical. Conclusions: Nidana parivarjana and the free radical scavenging activity are the measures for prevention of Arbuda and in adjunct to it the drugs having anti-oxidant property will give a counter to free radical activity or reduces the risk of formation of free radicals.

Keywords: Ama, anti-oxidant property, Arbuda, cancer according to Ayurveda, causative factors as per Ayurveda, free radical activity,

   23. Anti-cancer activity of herbomineral formulations-a review Top

1Sunil Mandal, 2Sangamesh V. K, 2Govinda Sharma K

1PG Scholar, 2Faculty, Sri Dharmasthala Manjunatheshawara College of Ayurved & Hospital, Hassan

Corresponding author: Dr. Sunil Mandal, Email: [email protected]

Background: Ayurvedic treatment of cancer includes Shamana Chikitsa (pacifying treatment) followed by Shodhana Chikitsa (treatment for body cleansing) by using Ayurvedic medicine. Rasashastra has been successful from very early times in using various formulations in preventing or treating cancer. Aim: The aim of this work is to provide a general outline about management of cancer by herbomineral formulations. Materials and Methods: An extensive search for published review and research articles on anti- cancer activity of herbo-mineral formulations was done in both print and digital versions of indexed peer reviewed journals. Results: Total six published articles were found on cancer therapy with Rasoushadhi, among which three were in-vitro studies, one in-vivo study, one case report and one clinical study. 1. In-vitro study of Shatputi Abhraka Bhasma has shown significant anti-cancerous activity on prostate cells lines (Yogesh et al. 2017). 2. Another in-vitro anticancer study of ArkeshwaraRasa on cells of pancreas and skin showed significant effects (Nafiujj Aman et al. 2015). 3. Anti-cancer activity of aqueous extract of cruel capsules (proprietary medicine) on renal cell carcinoma showed anti-proliferative effects against renal cell carcinoma tumour cell lines in vitro (Shiva PrakashVerma et al. 2015). 4. In-vivo study cruel capsule showed inhibition of tumor progression and chemo preventive potential of formulation (Anita K Bakrania et al. 2017). 5. Compound Ayurvedic formulation consisting of Heeraka Bhasma, Swarna Bhasma, Abhrak Bhasma, Lauha Bhasma and Tamra Bhasma was proved effective in the treatment of Acute Lymphoblastic leukemia (Renu et. al. 2014). 6. Clinical study of Swarna Bhasma on solid malignancies have been proved and better response was recorded in rectal cancer group (Soumen Das et. al 2016). Conclusion: Abhraka Bhasma, Swarna Bhasma, Arkeshwara Rasa, Heeraka Bhasma and cruel capsule are the herbo-mineral medicines that have been proved efficacious in the management of malignancies. Hence this medicine can be used in the treatment of cancer. There may be many other works done on anti-cancer activity of herbo-mineral formulations but not published. Thus a vast area of research and publication is needed in this direction.

Keywords: Cancer, herbo-mineral formulations, Rasaushadhi

   24. Anti – cancer drugs in Siddha literatures -A literature review Top

Pratheep G1, Elavarasan K2, Pooja K3

1Project Associate-I, TKDL Unit, CSIR-CLRI, Central Leather Institute, Adyar, Chennai, 2Resident Medical Officer, National Institute of Siddha, Tambaram, Chennai. 3PG Scholar (MD Siddha), Dept. of Nanju Maruthuvam, Govt. Siddha Medical College, Palayamkottai.

Corresponding author: Dr.Pratheep G Email: [email protected]

Background: In Siddha system, Cancer is mentioned as-Puttru, Vippuruthi, Dhurmaangisam, Vansilanthi and so on. Siddhars have classified the anti-cancer drugs under various preparations mentioned in numerous books and Manuscripts. The research will not only assure the efficacy of Siddha drugs but can also lead to formulations for prescription as complementary. Aim: The purpose of the study is to create more awareness in anti-cancer drugs contents and motivated research in numerous medicines in Siddha system like Rasagandhi Mezhugu, Rasa Parpam, Veera Melugu, Velleeya Chenduram, etc. This paper is about compilation of Siddha preparations for cancer mentioned in various Siddha text books and also deals about the epidemiological survey of cancer deaths and growing need for studying Siddha drugs. Materials and Methods: 31 books in Siddha Medicine were shortlisted for the anti-cancerous drugs present in them with a detailed literature review of the medicines provided in the books which were taken for reference. Surprisingly, around 100 anti cancerous drugs are seen for different types of cancers in these books itself.It has been suggested that these issues could be tackled by subjecting drugs to scientific validation adopting modern tools. Result: In the above mentioned 31 texts for references, the above images show the 97 types of cancers mentioned along with the form of drugs for treatment like Parpam, Chenduram, Rasayana, etc. In which the most mentioned types are Linga Putru (Testical Cancer) and Yoni Putru (Vaginal Cancer), Puttru (Cancer) and most mentioned form of drugs are Chenduram (Red Calyx), Ennai (Oil), Parpam (White Calyx), etc. As this is a basic study with a limited amount of book references, we can expect more favourable results in further research in this field. Conclusion: Progressive and disseminated malignant disease has a substantial impact on a cancer patient's quality of life, and many cancer treatments may have severe side effects. The research will not only assure the efficacy of Siddha drugs but can also lead to formulations for prescription as complementary and also discovery of targeted molecular therapeutics in the reverse pharmacology approach.

Keywords: Dhurmaangisam, molecular therapeutics, pharmacology, Rasagandhi Mezhugu, Rasa Parpam, reverse Vippuruthi.

   25. Prospective of Vatsanabha (Aconitum ferox wall. Ex. Ser) in cancer treatment- A review study. Top

Prerok Regmi1, Ravikrishna Aithal2, Chaithra Hebbar3

SDM College of Ayurveda & Hospital, Udupi, Karnataka

Corresponding author: Dr. PrerokRegmi, Email: [email protected]

Background: Vatsanabha (Aconitum ferox Wall. Ex. ser) is a Mahavisha (most toxic) which is used in variety of Ayurvedic formulations after the procedure of Shodhana (purification technique). Indian variety has a great demand in the world markets. This species is referred to as the king of poisons due to the presence of highly poisonous alkaloids. Aim: The study aimed to investigate the up-to-date toxico-kinetic data of the toxic diterpenoid alkaloids and existing evidence of the applied nature of A. ferox. Materials and methods: The literature was extracted from the Pubmed indexed journals indexing “cancer and aconitum”. The major ingredients extracted from A. ferox species and their taxonomic significance particular to ingredients were reviewed. The Ayurveda literature and ethnobotanical study were analyzed specific to Vatsanabha. Results: Herbal drug practioners at higher Himalayas used as a universal antidote. The root is used to treat malignant tumours. Pseudoaconitine, aconitine, hypaconitine, mesaconitine, bikhaconitine, chasmaconitine, indaconitine etc. diterpenoid alkaloids are major constituents of A. ferox. These chemical constituents' responses are emerging as frontline treatment agents for cancer. Closely related species to ferox from extreme Himalayan mountain ecology has bore relevance to modern disease pathologies including inflammation, tumour and infections. A. ferox species is 1.5 times as active as Aconitum chasmanthum and seven times than Aconitum nepellus. in-vitro growth inhibitory activities of alkaloids on MCF-7 (human breast cancer cell line), HCT-116 (human colon carcinoma cells) and HepG2 (human hepatic carcinoma cell line) cell lines were obtained. The significant cytotoxicity in-vitro activity was observed. Particularly, hypaconitine (HpA) shows inactivation of the NF-&#S954;B signaling pathway. The alkaloids show protective autophagy through p53 activation, ERK1/2, and p38 MAPK signaling cascade. The synergistic combinations of drugs in formulation represent a promising way to enhance efficacy, overcome toxicity and optimize safety on cancer. Conclusion: The study shows the influence of Aconitum ferox containing most toxic alkaloids on the cancerous cell inhibition. The emerging technique of network pharmacology can serve as a valuable tool for the scientific understanding of Ayurveda on Vatsanabha.

Keywords: Aconitum ferox, cancer, diterpenoid alkaloids, Mahavisa

   26. Comparative studies of bioactivity of a few common medicinal plants Top

Zeena S Pillai, LeemaMohanan, Gopika G. S, Anandhu P. Dev,

Department of Chemistry, Amrita School of Arts and Sciences, Amrita ViswaVidyapeetham, Amritapuri

Corresponding author: Dr. Zeena S Pillai, Email: [email protected]

Background: Plants that possess therapeutic properties or exert beneficial pharmacological effect on the human body are generally designated as medicinal plants. They have been identified and used for the treatment of illness and diseases from prehistoric times. Aim: The purpose of present work is to compare the activity of a few well known, locally available plants (Malyalam)-Mukkuti-Biophytum sensitivum (L.) DC., Njavara-Plectranthus amboinicus Lour. Poovarish-Thespesia populnea (L.) Sol. ex Correa, Nochi-Vitex negundo L. and Lekshmitharu-Simarouba glauca DC. Materials and methods: As part of the preliminary investigation we had collected the extract of these plants using organic solvents like methanol, hexane etc by soxhlet extraction technique. Different components in each extract were monitored by thin layer chromatography and characterised by infrared spectroscopy. The antimicrobial activity was evaluated against gram-positive: Staphylococcus aureus and gram-negative  Escherichia More Details coli. The antimicrobial activity was investigated utilizing nutrient agar well diffusion method. The samples were prepared in nutrient agar plates with twenty four hour old cultures. The tested microorganisms were swabbed uniformly on nutrient agar- agar plates using a sterile cotton swab, then; wells in each plate of 6-mm diameter were created using sterile well borer. The samples were poured into the corresponding well. The plates were incubated at thirty seven degree C° for twenty-four hours and the diameter of the inhibition zones was measured. Results: There has been a few reports mentioning that oral administration of some of these plants have reduced the cancerous growth -a systematic study of which is lacking. Njavara and Nochi leaves exhibited same activity (14mm) with S. aureus whereas Mukkutti was slightly more active (20 mm). Lakshmi taru was found to be most active of the lot (30 mm). Poovarasu, surprisingly exhibited no activity at all. Conclusion: Future work is focussed on the isolation of the bioactive components and as well as carry out activity studies on cancer cells. Our overall objective is a thorough investigation of the structure activity correlation using advanced photochemical techniques.

Keywords: Antimicrobial, bioactive, natural product

   27. Udvartana as a palliative approach to post mastectomy lymphedema – A case report Top

Deepa J G1, Anandaraman P V2, Prathibha C K2

1PG Scholar, 2Professor, Dept of Panchakrma, Amrita School of Ayurveda, Kollam, Kerala

Corresponding author: Dr. Deepa J G, Email: [email protected]

Background: Lymphedema is the build-up of excess lymph fluid in body tissues because of obstruction of lymphatic drainage back into the bloodstream. The affected area can become swollen and distorted in shape. This can cause pain, heaviness, movement difficulty and affects activities of daily living (ADL). Secondary lymphedema results from illness or treatment that obstructs lymphatic drainage. Out of which cancer related lymphedema can occur according to the physical location of a tumour. 80% to 90% of women will develop lymphedema within 3 years of breast cancer treatment whether they underwent either lumpectomy alone or radical mastectomy. Case history: This case report discusses the effect of Udvartana on lymphedema of a 56 year old elderly lady who underwent radical mastectomy in 2009. After 18 months she noticed swelling of her right upperlimb along with heaviness and cosmetic imperfections. She came to the OPD in 2012 and 13 for the same complaint. Later on follow up was done in 2018. The case was diagnosed as Kaphaja Ekanga Shopha (localized oedema) and Kaphahara Langhana Chikitsa (fasting therapy for pacify to Kapha) was employed. Udvartana (therapeutic powder massage) is a Bahiparimarjana Langhana Chikitsa (avoid external sources) for of rubbing the body with powdered drug opposite to the directions of roots of hair follicles. Results: Assessment was done by circumferential measurement of both upper limbs each year before and after treatment and during follow up period and obtained significant change i.e., almost equivalent mid upper arm circumference (MUAC) of both upper limbs. Udvartana is Vata-Kaphahara thus reduces pain and swelling, strengthens body parts, brings compactness to muscular structures, dissolute fatty adhesions and strengthens skin. Due to which this may even helpful in preventing complications of lymphedema such as cellulitis and fibrosis unlike lymphatic massage. It channelizes lymphatic circulation; enhance blood circulation thereby reducing fluid accumulation, oedema and fatigue. Conclusion: Hence this case report suggests the possibility of considering Udvartana as a therapy in effectively managing post mastectomy lymphedema.

Keywords: Ayurveda , lymphedema, palliative care, Udvartana

   28. Yashtimadhu Kshirapaka; a promising drug for radiation induced gastritis: A review Top

Devipriya S1, Vineeth P.K2, Arun Mohanan3

1PG Scholar, 2Assistant Professor, 3Associate Professor, Rasasastra and Bhaishajya Kalpana, Amrita School of Ayurveda, Kollam, Kerala

Correspionding author: Dr.Devipriya S, Email: [email protected]

Background: Radiation induced gastritis is a serious complication and no standard treatment protocol has been established for the same. If it is not properly taken care of, then it may lead to ulceration. Aim: The actions of Yashtimadhu (Glycyrrhiza glabra L.) Ksheerapaka (processed milk with Yashtimadhu) have been reviewed to implicate its productiveness in radiation induced gastritis. Materials and methods: In the present review, evidences were collected by conferring databases such as Pubmed and Google scholar about Yashtimadhu, importance of milk, Yashtimadhu Ksheerapaka and radiation induced gastritis and eventually identified the merit of Yashtimadhu Ksheerapaka. Ten articles were reviewed. Results: Due to continuous exposure to radiation as a part of conventional treatment, it results in inflammation of stomach. Yashtimadhu Ksheerapaka mentioned in classics have been attributed with properties such as Madhura Rasa (sweet in taste), Sheeta Guna (cool property) and Rasayana (rejuvenating) property. The healing property, antiulcer, anti-inflammatory property of Yashtimadhu has been recognized. The methanolic extract, licochalcone A, glycyrrhiza polysaccharide, glycyrrhizin, various phenolic compounds such as hispaglabridin, isoliquiritigenin, paratocarpin B constituents of Glycyrrhiza glabra is shown to have apoptic potential, chemoprevention, tumour growth inhibition ,anti-inflammatory activity,anti-oxidant potential respectively.The presence of milk solids mainly casein has proven that the binding of drugs to casein increase their solubility and this characteristics of casein promises to be an excellent component for controlled drug delivery. So in conjunction both Yashtimadhu and Kshira as Yashtimadhu Kshirapaka can work productively. Conclusion: By considering the components we can deduce that Yashtimadhu Kshirapaka can reduce the side effect of conventional treatment. It is easy to prepare, bearable and economical. With further development of Kshirapaka to other dosage forms, we can increase the shelf life, ease in intake of the medicine and can offer a potential success in overcoming radiation induced gastritis.

Keywords: Gastritis, Kshirapaka, radio-protective, Yashtimadhu

   29. A review on underastanding Prakriti (Doshika constitution) in relation to cancer Top

Parvathy J1, Haritha Chandran2, Leena P Nair3

1PG Scholar, 2 Assistant Professor, 3 Associate Professor, Siddhanta and Moulika, Amrita School Of Ayurveda, Kollam, Kerala

Corresponding author: Dr. Parvathy J, Email: [email protected]

Background: In Ayurveda, assessment of Prakriti analysis plays a vital role in prognosis, diagnosis, treatment and prevention of many complex diseases. The body constitution or Prakriti may help to find the predominance of incidence of Cancer in different persons. Prakriti with respect to chromosomal patterns will help towards the classification of varied types of cancer in a concise manner. This will also help doctors to understand cancer both technically and clinically. Aim: This current review aims to understand the prognostic, therapeutic utility and scope of the knowledge of Prakriti patterns in relationship with the cancer. Materials and methods: Literature searches were carried out from different databases like Google scholar, Pubmed, AYUSH research portal etc.Keywords used were cancer, Prakriti, cancer and Prakriti, cancer and body constitution, Ayurgenomics and cancer, Prakriti and Arbuda. Total 1691 articles were found in different databases among those eight relevant papers were selected and three were selected for this review. Result: These relevant articles show a close relationship between Prakriti and cancer. A study which is published in World Journal of Pharmacy and Pharmaceutical Sciences in 2016 shows the result that the individuals of Kapha Prakriti are more vulnerable to breast cancer than Pitta and Vata Prakriti. Another study Published in IAMJ in 2016 compared the Prakriti pattern of cancer patients with that of normal volunteers. Pitta dominance is found in the Prakriti pattern of cancer patients followed by Kapha dominance. The prognostic therapeutic utility and scope of the knowledge of Prakriti patterns are also mentioned by the author. Another study which is published in Ancient science of life in 1987 proves that the Pitta dominant Prakriti has greater incidence of cancer followed by Kapha. Vata Prakriti people susceptible to bone cancer, Pitta Prakriti people susceptible to leukemia or blood cancer and Kapha Prakriti people susceptible to cancer involving other tissues like Meda are considered difficult to cure. Conclusion: From this review it is evident that development of cancer is strongly associated with Ayurveda concept of Prakriti. It is very helpful in prognostic as well as therapeutic field of science.

Keywords: Ayurgenomics and cancer, cancer and body constitution, cancer andPrakriti

   30. Clinical evidence based study of administration of Rasayana (rejuvenation) therapy along with chemotherapeutic agent's shows better anti-tumour activity without antagonising the anticancer property of chemotherapy- findings of an observational cross-sectional study. Top

Yogesh Bendale1, Vineeta Bendale2, Avinash Kadam3, Vaishali Dharashive4, Poonam Birari-Gawande5, Anandrao Patil5,

1Chairman, 2Managing Director, Rasayu Cancer Clinic, Pune, 3Senior Research Scientist, Rasayani biologics pvt Ltd, Pune, 4 Physician, 5 Senior Physician, Rasayu Cancer Clinic, Pune

Corresponding author: Yogesh Bendal, Email: [email protected]

Background: Those suffering from cancer are inclined to use complimentary alternative medicines (CAM) for better therapeutic outcome. According to statistical data 75 to 80 % of cancer patient in India use Ayurveda as alternative medicine along with conventional treatment. Some subject experts believe that concurrent use of Ayurvedic medicines along with chemotherapy may interfere with anticancer effect of chemotherapy thereby leading to poor therapeutic outcomes. However, to the best of our knowledge there exist no clinical studies which can evaluate if such interaction does exist. Aim: This current study was conducted to generate direct clinical evidence for tumour response in cancer patients who receive Ayurveda Rasayana therapy along with chemotherapy. Material and methods: Retrospective chart review of stage III and stage IV cancer patients was prepared who took Ayurveda cancer treatment at cancer clinic during year 2017 and 2018. Data of only those patients who have histologically confirmed diagnosis of cancer, radiological assessment before start of treatment and those who continued Rasayana (Rejuvenation) therapy for at least 6 months were included in the study. Patient's radiological reports were assessed for tumor response using RECIST criteria. Results: A total of 1107 advanced cancer patient approached for cancer treatment to Rasayu Cancer Clinic in the year 2018. Amongst them 236 patients took more than six months of treatment and 40 patients amongst them received Chemotherapy along with Rasayana therapy.Complete tumour regression was seen in 37.5% patients, whereas 40% of patients showed partial response. Stable disease was seen in 13% of cancer patients whereas 9.5% patients showed progressive disease. Conclusion: Complete response (CR) rates reported for cytotoxic chemotherapy for advanced stage cancer patients are generally low. Meta-analysis of 68 chemotherapy trials (total 2732 patients) in advanced stage cancer patients shows CR of around 11%. The findings of this study highlight that simultaneous intake of Rasayana therapy along with conventional chemotherapy synergizes with anticancer efficacy of chemotherapy. Rather the findings of this study points towards a better therapeutic efficacy in terms of complete response in advanced stage cancer patients.

Keywords: Anti-tumour activity, Ayurveda chemotherapy, Rasayana therapy, tumour regression,

   31. Behavioural risks in cancer: An Agada perspective Top


Asst. Prof., Dept of Agada Tantra, SDMCA, Udupi

Corresponding author: Dr. AmalaJyothi, Email: [email protected]

Background: Cancer and toxins go hand in hand in this era where behavioural risks or lifestyle proves to be a great threat to the health of the population. The personal choices one makes about the way they live, ends up being their behaviour, which exposes them to the dreadful world of toxins thus increasing or decreasing the risk of getting cancer. Aim: To find applicability of stages of Visha, Gara and Dooshi Visha lakshana from Ayurvedic classical texts for potential to know behavioural risk of development of Cancer.Material and methods: A thorough understanding was made on the exposure of toxin mainly due to the behavioural pattern of and individual. Among these toxins many are mutagens. This abnormal cell proliferation in cancer may be due to the DNA mutagen which hampers the tightly regulated and controlled physiology of cell cycle. The risk of getting cancer increases exponentially due to the presence of a wide range of carcinogenic toxins which is now an inevitable part of our daily life. Here an attempt has been made to understand the role of Visha in the pathophysiology of cancer and there by planning the management on similar lines. Results: While there is a classification of carcinogens as directly acting carcinogen, pro-carcinogen and co-carcinogen in the modern medical science, while understanding the classifications and Avastha of Visha in one's body, all these three can be clearly appreciated in context of Gara Visha and Dooshivisha. Conclusion: Understanding the cause cancer in the perspective of Agada may help to throw in some light to the pathogenesis of cancer and thus helping us formulate a better line of management of the condition.

Keywords: Cancer, carcinogen, mutagens, toxins, Visha

   32. A prospective survey study on the current status (2018-19) of cancer burden in Kulasekharapuram Panchayat, Karunagappally district of Kerala state, India Top

Sajida I1, Anusree Dileep2, Delvin T Robin 2

1PG Scholar, 2Associate Professor, Dept of Swasthavritta, Amrita School Ayurveda , Amritapuri, Amrita Vishwa Vidyapeetham, Clappana P O, Kollam

Corresponding author: Dr. Sajida I, Email: [email protected]

Background: The rural cancer registry was established in the 1990s, to investigate the cancer occurrence due to natural radiation on the coastal areas of Karunagappally, Kerala. The study done in 1990-2004 shows that, the rural area of Karunagappally district has a high cancer morbidity rate. The study again revealed the interplay of two risk factors, tobacco and alcohol were contributed for a variable extend of cancers. For breast cancer, the risk factors highlighted in the study were low parity, consumption of chicken meat and milk and frequent intake of roots and tubers except tapioca. After 14 years of this previous study, the diet pattern and lifestyle of people were changed from the 1990s and the cancer incidence is still rising. So it is essential to know the current status of cancer patients in this community. Aim: To survey the current status of cancer burden in kulasekharapuram, karunagappally Taluka, Kerala, India. Materials and methods: To assess the current status of cancer patients in this area a pilot survey study was conducted among 12 wards of Kulasekharapuram Panchayat, Karunagappally during the period of 2018 November 15 to December 19. Information was collected directly from public health centre (PHC), ASHA workers and personal household visit. Results: 55 patients were identified who were diagnosed within 5 yrs. Out of 55 patients, number of diagnosed cases in the last 2 years were 22(40%). The common cancers were of breast (44%), thyroid (12%), uterus (11%), oral cavity (9%) and gastro intestinal tract (8%) and others 16%. Specific regional pattern of disease in a ward or area showing a cluster of similar type of cancers was a noteworthy finding which has shown primarily in the breast and thyroid cancers. There was an increase in thyroid cancer and decrease in lung cancer than 1990s. Conclusion: The cancer burden and the morbidity rate in this community still show an increasing rate. Most of the etiological factors are preventable and there should be continued observation and evaluation in relation to modifiable risk factors of cancer. Reason behind the site specific cancer pattern also should be studied in detail. For the better understanding of considerable increase and decrease of different cancers, there should be multi-institutional collaborative researches.

Keywords: Cancer, Karunagappally, Kulasekharapuram

   33. Preventive management of barrett's esophagus–A single case study Top

Dr Sreelekshmi V S1, Dr Rabinarayan Tripathy2, Dr Rajeshwari P N3, Dr.Shaithya Raj3

1PG scholar, 2Professor and HOD, 3Associate Professor, Dept of Shalya Tantra, Amrita School of Ayurveda, Kollam, Kerala

Corresponding author: Dr Sreelekshmi V S, Email: [email protected]

Background: Constant stress super-added with unhealthy diet, cumulatively contribute to pathologies of gastro intestinal tract. Barrett's oesophagus is a pre-malignant condition associated with high incidence of transition to adenocarcinoma. It involves meta-plastic changes in the mucosa, from stratified squamous to simple columnar epithelium. Lax lower oesophageal sphincter leading to gastro oesophageal reflux disorder (GERD) causing erosion of mucosa is usually the major precursor of this condition. Case history: 30 year old female presented in the OPD with retrosternal pain and burning sensation, nausea and vomiting. Epigastric tenderness was also present. She had difficulty in taking normal diet as it exacerbated the symptoms. Endoscopy revealed lax lower oesophageal sphincter with antral gastritis. Advice started with medications normalizing the deranged Vata and eliminating excessive Pitta. Later on, 50ml of Yashtimadhu Ksheerapaka was advised twice daily. Treatment: She was restricted from diet, stimulating gastric secretions like coffee, chocolates, tomatoes, citrus fruits, fatty, hot and spicy food. The medication and diet plan continued for about 5 months. Result: After two weeks of the treatment the patient was able to consume normal diet without aggravation of symptoms. Three weeks after the internal administration of Ksheerapaka, moderate relief was noted. The patient gained weight. After five months of treatment, the symptoms were completely relieved. On repeating endoscopy after seven months, the result revealed mild antral gastritis. Conclusion: Glycyrrhizin has proven anti-inflammatory, antiulcer and anti H-pylori activities. It promoted healing of ulcers and prevented mucosal erosions. The medium of milk promoted absorption of lipid soluble active principles and corrected nutritional deficits. The intervention prevented further aggravation of symptoms and progression of the disease condition. Moreover, the patient was completely relieved of the signs and symptoms after five months of treatment.

Keywords: Barrett's esophagus, esophageal adenocarcinoma, GERD, Yashtimadhu Ksheerapaka

   34. Ayurvedic intervention on grade II buccal mucosal cancer – A case report Top

Dr Aswin T Das1, Dr Jayakrishnan A2, Dr Ashwini Bn3, Dr Sivabalaji K4

1PG Scholar, Department of Shalakya, Amrita school of Ayurveda , Kollam, Kerala, 2Shree RMD Ayurveda College and Hospital Waghaldhara, 3Associate Professor, Shalakya Department, Amrita school of Ayurveda , Kollam, Kerala, 4Assistant Professor, Associate Professor, Amrita school of Ayurveda , Kollam, Kerala

Corresponding author: Dr Aswin T Das, Email: [email protected]

Background: Squamous cell carcinoma of the buccal mucosa is common and with a higher recurrence rate. It is more prevalent in those who use tobacco and alcohol. Depending on the stage, it is treated with surgical excision, radiation therapy and chemotherapy. The use of cytotoxic drugs in chemotherapy may cause severe adverse effects in patient's quality of life. This includes mouth sores, loss of appetite and dysphagia. In this case report, an attempt has been made to study the effect of specific Ayurvedic treatment modality in improving the quality of life in grade 2 buccal squamous cell carcinoma in the post radiation and chemo period. Case history:46 year old male patient, not a known case of diabetic mellitus and hypertension with history of tobacco use since 12 years, complaints of swelling & pain on left cheek and gum region, bleeding and pus discharge from the lesion since 6 months. Consulted allopathic physician, they advised for cytology and histopathology tests. The reports shows squamous cell carcinoma grade II, in left retro molar trigone and started allopathic medication, repeat CT scan after 2 months. The CT reports showed significant increase in size & extension of lesion and completed 3 cycles chemotherapy. Post chemotherapy, he experienced difficulty in opening the mouth (Grade 2 Trismus) swelling & pain on left cheek and gum region, moderate Bleeding and pus discharge from lesion, fatigue and loss of appetite. Base line investigations were done and found normal and started Ayurvedic treatment on OPD Basis. Materials andmethods: Vaishwanara powder 15gms twice daily before food for three days, Panchatiktaka Ghrita 50gm, 75gm, 75gm, 100gm, 120gm, 130gm at morning for six days.Virechana with Trivrita Lehya 60gm, Drakshaadi decoction + Varnaadi decoction 15ml each twice daily before food for two months, Vridhivatikavati &Kanchanara Guggulu along with decoction.Madhusnuhi Rasayana 25gm with 1 pinch of Abraka Bhasma at bedtime for two months. Nimba, Bilva, Haridra, Shunthi, decoction for Kavala thrice daily for two months. Jaloukavacarana on the buccal region once in a week for two months.Triphala, Trikatu, Saindhava and honey as Pratisarana twice daily for two months. Result: During the treatment period of 2months there was marked reduction in swelling & pain on cheeks and gum region, bleeding and pus discharge from lesion, fatigue and loss of appetite within the period of two months and give a better living status to the patient.Trismus improved from grade 2 to grade 1.Improvement in fatigue and appetite was observed. Conclusion: The outcome of this case reveals that the side effects of chemotherapy in Grade II buccal mucosal carcinoma can be effectively managed by Ayurvedic treatment. This is only a single case report. Further studies are needed to assess the sustained results.

Keywords: Alternative therapy, Jalukavacharana, Squamous cell carcinoma,

   35. Emblica officinalis reduces the serum C-reactive protein, IL-6 and TNF -alpha levels in endothelial dysfunction –A pilot study Top

Rajeshwari P N1, Sharath S G2

1Associate Professor, 2Associate Professor, Dept of Shalya tantra, Amrita School of Ayurveda, Kollam, Kerala

Corresponding author: Dr. Rajeshwari P N, Email: [email protected]

Background: Endothelial cell's role as major regulators of tumour progression is appreciated in recent times. Healthy Endothelial cells promote vascular repair and inhibit tumour invasiveness and metastasis. Endothelial dysfunction is a cause for life style disorders and oxidative stress in chronic infective and inflammatory conditions. The C-reactive protein, IL-6 and TNF-alpha will suggest the active inflammatory responses in the body. The risk of cancer is increased in chronic infections and inflammatory diseases, settings in which sustained TNF -alpha production and CRP is common. Aim: Study aimed at the role of Emblica officinalis Gaertn., enriched with Vit-C in mitigating CRP, IL-6 and TNF-alpha in chronic inflammatory process. Material and methods: We examined four patients complaining of pain all over the body, tiredness and discomfort in right hypo-chondrium with swollen joints. The inclusion criterion was raised CRP level. The new drug was formulated using the fresh juice of Emblica officinalis Gaertn. and Terminalia Arjuna (Roxb.) Wight & Arn, as additive was administered for a period of 3weeks. Results: There was substantial change in the signs and symptoms of chronic infection and inflammatory conditions associated with systemic diseases like simple fatty liver (SFL) disease and rheumatoid arthritis (RA). Conclusion: The serum samples of these 4 patients before and after treatment were analyzed. The obtained result was promising in reducing the Serum concentration of CRP, IL-6 and TNF-alpha. Recent studies have suggested that CRP level is positively associated with cancer. Chronic inflammation and elevated CRP might have a causal role in carcinogenesis. The study was a hope for inflammation-associated oxidative damage, initiating carcinogenesis.

Keywords: Carcinogenesis, endothelial dysfunction, TNF-alpha,

   36. Immunomodulatory effect of Amalaki Rasayana and its implication in supraglottic carcinoma-A case report. Top

Mira Krishnan.M1, Sivabalaji K2, Ashwini B.N3

1PG Scholar, 2Assistant Professor, 3Associate Professor, Dept of Shalakya tantra, Amrita school of Ayurveda

Corresponding author: Dr. Mira Krishnan.M, Email: [email protected]

Background: Supraglottic squamous cell carcinoma, T2 denotes the tumour invading more than one adjacent sub site of supra glottis. It is mostly treated by radiation therapy, laser surgery or a partial laryngectomy with neck dissection. Side effects include neutropenia, dry mouth, hoarseness of voice and hair loss. Ayurveda offers a better management for these counter effects by Rasayana (rejuvenation) therapy. Staying mentally and emotionally healthy during and after cancer treatment is needed. The present study is to improve the quality of voice, minimize the radiation induced odynophagia and sore throat with Amalaki Rasayana. Case history: A patient followed for supraglottic cancer with liver metastasis treated in 2006. He was asymptotic until 2014, when he presented a progressive increase in hoarseness of voice, odynophagia and sore throat. Patient approached contemporary management for promoting quality of life in the post radiation and chemo period. Clinical evaluations were done before and after treatment. The intervention done was Amalaki Rasayana (12gms) with milk, once daily at bedtime for 2 months. Assessment is based on subjective and objective parameters, which are formulated for cancer patients as per guidelines for grading adverse effects by National Cancer Institute Oncology Group and Health Related Quality of Life Scale SF-6. Haematological estimation was done by assessing haemoglobin count, total red blood cells count and differential count. Result: Amalaki (Emblica officinalis Gaertn) has the potential to reduce the risk of metastasis induced by chemotherapeutics. It suppresses necrosis and delays mitotic progression. Being a Medhya (neuro tonic) drug, it yields a psychoneuropharmacological effect. These compounds are rich in vitamin C and bioflavonoids that exert potent antioxidant action. Conclusion: In the present study, counter effects of post radiation reduced to a marked extent by Amalaki Rasayana. It indicates that compounds with immunomodulatory activity are of great importance when used as an adjuvant in carcinoma treatment.

Keywords: Carcinoma, chemotherapy, radiation, Rasayana, supraglottic

   37. An Ayurvedic help in non-hodgkin's lymphoma- a case report Top

Dr. Amrutha .S. Babu1, Dr. Devipriya Soman2, Dr. Mahesh .C. Kundagol3, Dr.James Chacko3,

1PG Scholar, 2Assistant Professor, 3Professor, Dept of Kayachikitsa, Amrita school of Ayurveda

Corresponding author: Dr. Amrutha .S. Babu, Email: [email protected]

Background: Non-Hodgkin's lymphoma (NHL) is malignant tumour of lymphatic system classified distinctly from Hodgkin's Lymphoma. This study to highlight the clinical utility of Ayurveda drugs in a case of Non-Hodgkin's lymphoma. Case history: 66 year old male diagnosed as Non-Hodgkin's lymphoma (left supraclavicular lymph node) in a Modern hospital is managed with Trayantyadi deccoction, Kanchanara Guggulu and Ashwagandha powder for a period of one year. This clinical condition could be considered as Kapha-Pitta Dushti (vitiated due to Kapha-Pitta) and involvement of Rasa (plasma tissue), Raktha (blood tissue), Mamsa (muscle tissue) and Medo Dhatu (fatty tissue) where a Granthirupa Strothodushti (cyst affected) has occurred. The combinationof Trayantyadi decoction, Kanchanara Guggulu and Ashwagandha powder with its Tridosha Shamaka (pacify to Tridosha), Strotoshodhaka (cleansing of channels) and Raktaprasadaka (blood purifier) property will be an ideal intervention. PET scan was taken again after one year to rule out progression. Result: Non-Hodgkin's Lymphoma showed persistent size with no interval change in size when compared to previous PET scan done one year ago. Conclusion: Administration of Trayantyadi decoction, Kanchanara Guggulu and Ashwagandha powder is found to be beneficial in a case of Non-Hodgkin's Lymphoma.

Keywords: Ashwaganda powder, Ayurvedic management, Kanchanara Guggulu, Non-Hodgkin's lymphoma, Trayantyadi decoction

   38. Effectiveness of Jlaukavacarana and Brahma Rasayana in promotion of quality of life in grade three buccal carcinoma after radiation and chemotherapy: A case study Top

Dr Aswathy Krishna S1, Dr Vishnu Mohan2, Dr Ashwini B N3, Dr Sivabalaji K4,

1PG Scholar, Department of Salakyatantra,Amrita School of Ayurveda , Kollam, Kerala, 2Specialist Medical Officer, National Ayush Mission, Government Ayurveda Hospital, Thalavoor, 3 Associate Professor, 4 Assistant Professor, Department Of Salakyatantra, Amrita School Of Ayurveda , Kollam, Kerala

Corresponding author: Dr Aswathy Krishna S. , Email: [email protected]

Background: In present study, an attempt has been made to counteract these sufferings through ayurvedic treatment with Jalaukavacarana and administration of Brahmya Rasayana in a patient of grade 3 buccal squamous cell carcinoma in the post radiation and chemo period. Case history:A 56 yrs. old female patient diagnosed with grade 3 buccal squamous cell carcinoma, who had underwent radiation and chemotherapy presented with buccal ulcer ,severe fatigue, tiredness, hair loss and severe dryness of mouth. In cancer patients treated annually with chemotherapy, possibly 20% are cured and an additional 20% may experience significant prolongation of life, the remaining 60% have minimal or no benefit from cytostatic treatment and suffer from its toxic adverse reactions. Treatment was planned considering the healing of buccal ulceration and also to improve the quality of life by improving the immunity of the patient. Brahma Rasayana 12g twice daily before food with Anupana (vehicle) of milk, for two month. Jaluakavacharana externally over right buccal cavity (done on alternate days for three days). Assessment based on the subjective and objective parameters, formulated for cancer patients who have undergone Radiation and chemotherapy using Health Related Quality of Life Scale SF-6 and on the basis of pre and post images. Results: After treatment for one month with three sittings of Jalaucavacharana and internal administration of Brahma Rasayana. Granulation tissue appears after repeated Jalaukavacharana. There is progressive improvement in quality of life and improved level of immunity in patient with grade three buccal carcinoma after radiation and chemotherapy with the administration of Brahma Rasayana. Conclusion: Studies reveal that Rasayana (rejuvenation therapy) is bound to reduce the side effects of radiation and chemotherapy and also stimulates the immunity through nourishment of Dhatu (body tissue) and energizing the Ojas.

Keywords: Chemotherapy, buccal carcinoma, Jalaukavacharana, Rasayana, Radiation

   39. Role of Ayurvedic Rasayana in cancer management: A conceptual study Top

Gowthami Chakkooth

PG Scholar, Dept of Rasashastra and Bhaishajya Kalpana, Government Ayurveda College, Tripunithura

Corrersponding author: Gowthami Chakkooth Email: [email protected]

Background:Ayurveda identifies neoplasm as Arbuda (tumour)and advocates various treatment modalities as per the nature of Samprapti (pathogenesis) like Kaphahara (pacification of Kapha), Strotoshodhana (cleansing of channels) treatment, Rasayana (rejuvenation) therapy , Sattvavajaya treatment , Yoga and meditation , along with suitably planned nutrition and Pathyapathya (diet plan). Aim: This paper explores how ayurvedic Rasayana therapy can meet the challenges in cancer treatment. Material and methods: Data collected after referring review articles in various databases. Result: The use of ionizing radiation, which is the cornerstone of cancer treatment, is compromised by the radiosensitivity of normal tissues. Studies have shown that the Ayurvedic Rasayanas like Amritaprasham, Ashwaganda Rasayana, (Vayalil P.K et al) Brahma Rasayana ( Rekha P.S et al) Chyavanaprasha (Jagetia G.C et al ) Narasimha Rasayana (Vayalil P.K et al ) and Triphala (Jagetia G.C et al ) possess radioprotective effects. The use of these Rasayanas can protect normal tissues against radiation injury and will also permit use of higher doses of radiation to obtain better cancer control and possible cure. Another issue is cachexia that substantially impacts upon the quality of life and survival of cancer patients. Rasayana contain multiple active principles that may operate synergistically, producing therapeutic benefits and lowering the risks on such adverse effects. Moreover it is immensely helpful in addressing nutritive crisis arising in cancer patients due to uncontrolled proliferation of cancer cells. Moreover regular consumption of Rasayana can benefit humans against cancer, since incidences of most cancers are seemingly increasing with age. Conclusion: Rasayana therapy appears to have a logical, beneficial impact in cancer patients as adjuvant treatment and prevention method for improving their quality of life.

Keywords: Cancer, Rasayana therapy, radio-protective

   40. A review on the efficacy of Chyawanaprasha in oral premalignant cancer lesions Top

Aruna Devi D P

PG Scholar Dravyaguna, Mannam Ayurveda Co-operative Medical College, Pandalam, Pathanamthitta, Kerala

Corresponding author: Aruna Devi D P, Email: [email protected]

Background: The main cause cancer is malnutrition in cancer patients. The nutritional status of the patients can have an important impact on the efficacy of the cancer treatment. Aim: The present study is on “the efficacy of Chyawanaprasha in oral premalignant cancer lesions”. Chyawanaprasha an Ayurveda Rasayana used for the premalignant cancer condition to reduce the lesions and adverse health outcome. Materials and method: Authoritative texts of Ayurveda were searched for recipes, processes and technical details of Chyawanaprasha. Text books on oncology, Journals and Ayurveda research articles were also searched for clinical studies. Results: The problem of acute burning sensation in the mouth and the clinical presentations of oral precancerous lesions had almost disappeared. Conclusion: Chyawanaprasha, an Ayurveda Rasayana formulation can be used for treating the premalignant lesions of oral cancer. Chyawanaprasha Rasayana is prepared from more than 40 herbs, with Phyllanthus emblica, a rich source of antioxidants as one of its content. It can prevent formations of ions (free radicals) that damage DNA. Chyawanaprasha minimizes the premalignant oral cancer lesions.

Keywords: Chyawanaprasha, oral cancer, premalignant lesions

   41. A conceptual analysis on development of Bhasma as engineered nanoparticles in cancer therapy Top

Lekshmi C.S1, Vineeth P.K2, Ramesh N.V3

1 PG Scholar, 2 Assistant Professor, 3 Professor, Rasasastra and Bhaishajya Kalpana, Amrita School of Ayurveda , Kollam, Kerala

Corresponding author: Dr.Lekshmi C.S Email: [email protected]

Background: The advancement in the use of engineered nanoparticles in cancer therapy with alarming possible harmful effects highlights the importance of ancient application of nano-medicine in the form of Bhasma for the safer usage. Aim: The present attempt is to analyse the possible applications of Bhasma in the field of nano-medicine in cancer therapy with the help of an in-vitro safety profile protocol for assuring biological safety. Materials and methods: Pubmed was searched using keywords such as engineered nanoparticles, Bhasma (therapeutic processed ash) and cancer. Original research articles and review articles that are published within a period of 2013-2018 were selected. Out of the seven articles obtained in total, three articles were found relevant and were reviewed thoroughly. Results: Bhasma can be utilized in the field of nanomedicine with special reference to treatment of cancer as potential drug carriers. The anti-cancerous potential of Abhraka Bhasma (therapeutic mica ash) has been proved in cancer cell lines. The biological safety of Swarna Bhasma (therapeutic gold ash) has been critically analyzed using in-vitro methods. Applications of engineered nanoparticles have gained popularity in the field of cancer therapy as an effective targeted drug delivery system due to their better penetration within the body at a reduced risk when compared to conventional treatment adopted for carcinoma. The safety assessment of nanoparticles for human use has been taken into due concern with special regard to the development of engineered nanoparticles, since the possible toxic health effects due to them with human exposure are still unexplored and unknown. Bhasma, being considered as an organometallic ethno- nanomedicine can be explored for its applications as a nanomedicine in cancer. Swarna Bhasma has been studied upon for its cytotoxic property, cellular entry mechanism and blood compatibility and thus, has been proved inert. The inert nature of this Bhasma can be further utilised to develop them as drug carriers, for imaging and diagnostic methods and treatments. Conclusion: For initiating such advancement in this area, an in-vitro safety profile protocol can be adopted first for assuring the biological safety of Bhasma so that they can be further employed in cancer therapy as drug carriers.

Keywords: Bhasma, cancer, engineered nanoparticles,

   42. Anti – cancer activity of Amalaki fruit (Phyllanthus emblica) - A brief review Top

Rakhy Raj R1, Jayanti C K2

1 PG Scholar, 2 Associate Professor, Dept of Dravyaguna, Mannam Ayurveda Co-Operative Medical College, Pandalam

Corresponding author: Dr. Rakhy Raj R, Email:[email protected]

Background: The incidence of cancer has gradually been increasing over the last few decades posing itself as a leading cause of death and the statistics of WHO indicates an alarming ratio of 1:6. The conventional treatment methods are not only cost intensive but also leaves innumerable side effects. So the introduction of a suitable cost effective herbal drug therapy is the need of the hour. The recent researches have proved that Amalaki fruit is having anti cancerous effect. Aim: Purpose of the present paper is to review all the papers related to the anti-cancerous effect of Amalaki. Materials and methods: A thorough literary review has been done through various databases like pub med, science direct and Google scholar using appropriate Keywords and the result are tabulated. Results: It is inferred from the study that Amalaki fruit is having significant anti-cancer property and is effective against various types of carcinomaThe major constituents of Amalaki fruit extract, that have been identified by HPLC and formally characterized as having anticancer activity, are Tannin and Flavonoids. Conclusion: The recent studies reveal that Amalaki fruit extract exhibit significant cytotoxic activity against cervical, ovarian and breast cancer. Apart from the bonafide anti-cancer activity of Tannin and Flavonoids, the antioxidant activity of Vitamin C also contributes to the effectiveness of this drug.

Keywords: Amalaki, anti-cancer activity, Ayurveda, cancer, cytotoxic activity, Phyllanthus emblica

   43. Cancer: role of stress in survival and treatment- A review Top

Sujithra RM1, Vimala Ks2, Priya S2

1 PG Scholar, 2 Professor, Dept of Dravyaguna Vijnana, Amrita School of Ayurveda, Kollam, Kerala

Corresponding author: Dr. Sujithra RM, Email: [email protected]

Background: Cancer is the second leading cause of death throughout the world. Genetic changes leading to uncontrolled cell growth and tumour formation causes. Cancer, but it is mostly triggered by environmental factors. A study at Johns Hopkins reported evidence that random, unpredictable DNA copying “mistakes” account for nearly two-thirds of the mutations that cause cancer. The Ayurvedic concept of Karmaja Vyadhi (disease by action) caused by unknown influences is applicable to Cancer more than any other disease. An important and perhaps unseen factor that works from within the person in the development and progression of cancer is mental stress. Objective: An attempt is made here to review studies that assess the role of stress in survival of cancer patients and how it influences treatment outcomes. Materials & methods: Online databases like PubMed, DHARA, Google scholar with the keywords 'cancer' and 'stress' were searched. 3 papers from PubMed and 40 in Google Scholar directly related to the topic were reviewed. The term 'cancer' and 'psychology' did not yield relevant papers in databases. Results: Temperature Induced Stress impairs the efficacy of chemotherapy and anti-tumour response. Hormones like catecholamines play a pivotal role in tumorigenesis. Further, endoplasmic reticulum stress is directly found to affect the growth and multiplication of malignant cells. The relationship between inflammation of stress and cancer discovered centuries ago is now recognized as a facilitating characteristic of cancer. In addition, stress and the stress response are probable mediators of the effects of psychological factors on cancer and specifically on progression of cancer. These are some examples of research demonstrating the link between stress and cancer. Conclusion: It is not established whether stress can cause cancer by itself but it can certainly influence the progress of the disease and affect the treatment outcomes. According to Ayurveda, a stressed mind disturbs Vata which in turn provokes Rajas and Tamas and also the other Dosha leading to Ojakshaya or compromised immunity that can make the cancer patient prone to clinical deterioration and thus lead to adverse outcomes.

Keywords: Cancer, stress, Ayurveda

   44. Review on the effect of Ayurvedic lifestyle in prevention of cancer Top

Sreelakshmi C N1, Dr. Jayanthi C K2

1PG Scholar, 2 Associate Professor, Dept of Dravyaguna, Mannam Ayurveda Cooperative Medical College, Pandalam

Corresponding author: Dr.Sreelakshmi C N, Email: [email protected]

Background: Cancer is viewed as a deadly and entangled disease. It is caused by both internal factors and environmental/acquired factors. Instead of our genes, our lifestyle and environment account for 90–95% of cancer. Ayurveda have described elaborately about the daily routine as well as seasonal routine. It explains about the importance of Vyayama (exercise), Ahara (diet), Viruddha (opposite), Upavasa (fasting) etc. Aim: To find out the relevance of Ayurvedic lifestyle in prevention of cancer. Materials and method: The references regarding cancer, Dinacharya (daily rutein), exercise etc. were collected. Results: Arbuda (tumour) is a Medodhatu Dushti (aggravated fatty tissue) and Upavasa is the treatment. Fasting is a type of caloric restriction, which can influence cancer incidence. Dietary restriction, especially cancer, is a major modifier in experimental carcinogenesis and is known to significantly decrease the incidence of neoplasms. There is extensive evidence suggesting that regular physical exercise may reduce the incidence of cancer. Sedentary lifestyle has been linked with increased risk of cancer. Acharyas have explained the regular use of grains like Yava (Hordeum vulgare L.), Sashtika (Oryza sativa L.), Goduma (Triticum aestivum L.). Whole grains contain chemo-preventive antioxidants like vitamin E, tocotrienols, phenolic acids and phytic acid. The antioxidant content of whole grains is greater than that of common fruits or vegetables. Conclusion: From the above result it could be concluded that following Dinacharya helps in preventing cancer.

Keywords: Ayurveda, caloric restriction, cancer, Dinacharya

   45. Role of psychosomatic axis in the etio-pathogenesis of cancer and personalized Satvavajaya Chikitsa as a preventive model-A conceptual study Top

Swathy V1, Vandana Rani M2, Anusree Dileep3, Delvin T Robin3

1 PG Scholar, 2 Professor, 3 Associate Professor, Dept of Swasthavritta, Amritha School Of Ayurveda , Kollam, Kerala

Corresponding author: Dr. Swathy V, Email: [email protected]

Background: Ayurveda strongly emphasize that imbalance anywhere in the mind or with the mental faculty will reflect in the body as well. The emergence of psychoneuroimmunology (PNI) provides key mechanistic evidence about the physiological changes caused by the interaction of stressors and the negative emotions. Aim: The purpose of this paper is to understand the role of psychosomatic axis in the etio-pathogenesis of Cancer from an Ayurvedic perspective and to apply the principles of Sattvajaya Chikitsa (Ayurvedic psychotherapy) based on individual Manasika Prakriti (mental constituent) for preventing the risk of cancer. Material and methods: Thorough Literary searches were done from Charaka Samhita and Ashtanga Hridaya. Indexed and non-indexed journals were referred with keywords stress, cancer, Manasika Prakriti and Sattvajaya Chikitsa. Results: According to Maharshi Charaka, Ability to control and activate the mind is attributed to Vata. Emotional disturbance of any kind leads to impaired flow of Vayu/Prana (air respiration) leading to Agnimandya (loss of appetite), production of Ama (toxic product of improper digested food), Rasadi Dhatu Dushti (vitiation of body tissues), Stroto Dushti (vitiation of channels) , Stana Sanshraya (stage of localization of Dosha)of Kupita Dosha (aggravated Dosha) and manifestation of disease. Similarly the complex interaction of neurotransmitters, hormones, receptors and proteins results in a malignant neoplasm owing to a defective adaptation mechanism on exposure to chronic stress. Satvavajaya means successful control over the mind from unwholesome objects. The key focus of Satvavajaya Chikitsa is to uplift the mind through Jnana/Atma jnana (spiritual awareness), Vijnana (knowledge acquired through scriptures), Dhairya (courage to uplift the depressed mind), Smriti (remembrance), Samadhi (meditation/concentration).The intensity of these techniques has to be customized according to the individual Manasika Prakriti. Studies show that these techniques help to stimulate the production of happy hormones like serotonin, endorphins etc and neurotransmitters like dopamine which helps in maintaining the homeostasis of the body. Conclusions: The ultimate aim of everyone is to lead a joyful life. A mind dominated with Rajas (passionate) and Tamas (dull) tends to get vitiated easily. In due course of time they manifests as life threatening diseases like cancer. Hence the principles of Satvavajaya Chikitsa can be adopted effectively to reinvigorate and empower the mind.

Keywords: Cancer, Manasika Prakriti, Satvajaya Chikitsa, Stress

   46. A conceptual study of dysbiosis w.r.t. Ama in understanding cancer and its prophylactic treatment Top

Poonam D Patil1, Dr Anant S Amant2

1PG Scholar, Dept of Samhita and Siddhanta, SDM Ayurveda College, Hassan, 2Associate Professor, Dept of Samhita and Siddhanta, JJMagdum collage, Maharashtra

Corresponding author: Poonam D Patil Email: [email protected]

Background: Changing lifestyle has affected us in manifold, regarding food consumption habits, people are not aware of the dos and don'ts along with improper physical and mental activities. As cancer has ambiguous causative factor, comprehensive consideration of exact origin at the level of digestion and metabolism and the treatment principles furthermore is essential. Aims:This conceptual study to ocoused on dysbiosis w.r.t. Ama in understanding cancer and its prophylactic treatment.Materials and methods: Acharya have described 'Agni' as the prime factor for the all the micro and macro activities at different level of the digestion in the body. Grahani (duodenum) is the foremost where Agni has its function and disseminates all over the body in various extents. If the function of Agni gets reduced the ingested food materials will accumulate for long time and turns into Ama (toxic by-products of improper digested food). Ama circulates all over the body through Vyana Vayu (type of Vata Dosha) via different Strotas (channels) and disease will manifest depending upon variance of Strotovaigunya (defects in channel). The concept illustrated in ancient literature substantiates the modern researches held on dysbiosis in the pathogenesis of cancer. As per recent researches on cancer, healthy and balanced gut microbes play a protective role against varied diseases as these are the fundamental for digestion and metabolism along with many other important activities. Such microbes are present all over the body in different forms and proportion. Loss of balance in the microbiota will lead to dysbiosis by impaired inflammatory response where the pathology of cancer starts. Results: Altered dietary intake leads to impairment in the functions of Agni which further forms Ama and Langhana (fasting) and Shodhana (bio-purification) are the prime treatment for the same. This concept is justified in recent researches, cancer cells are shown to experience characteristic changes in their metabolic functions, including increased uptake of glucose, enhanced rates of glutaminolysis and fatty acids synthesis. This supports tumour cells growth and survival and fasting can inhibit the growth of cancer cells. Conclusion: Concept of Ama with the relation of dysbiosis clarifies the pathogenesis of manifestation of cancer.

Keywords: Agni, Ama, cancer, dysbiosis, gut microbions, Langhana

   47. Ayurveda management in enhancing the life expectancy of cancer patient's w.s.r. to rabdomyosarcoma – A case study Top

Beena Md1, Sudhakar Reddy2

1Reader, Dept of Kayachikitsa, 2Professor, Dept of Swasthavritta, JSS Ayurveda Medical College Mysuru

Corresponding author: Dr. Sudhakar Reddy, Email:[email protected]

Background: Cancer is the most dreadful, grave and tissue invasive disease which gradually hampers the quality of life and causes decreased life expectancy. In spite of giant strides made by the modern medicine, most of the problems of cancer still lack permanent solutions in advanced stages of cancer. Case history: 14 patients were seleted for this study.Study was conducted in Govt. Ayurveda Medical College, Mysuru to evaluate the combined effect of Brihatgulmakalanala Rasa, Kanchanara guggulu, Varunadi Kashaya (decoction), Madhusnuhi Rasayana and Amalaki and Amrita powder internally in 14 patients of IV stage cancer (Arbuda). The study duration was six months. The study treatment has proved to be of beneficial in improving the general condition, reducing the symptoms and shown a possible survival benefit compared to expected median survival as per extent of disease. This is a specific case of rabdomyosarcoma stage 4, terminally ill, where the prognosis of the patient was said to be very bad with short life expectancy of about 2-3 months (according to expert oncologist). The 'study treatment' was started after 2 month of chemotherapy. The initial signs and symptoms of the patient were dyspnoea, cough and loss of appetite, loss of weight, abdominal hard mass, pain and burning sensation along with severe edema of right lower limb. Patient received the treatment for 1 year 6 months. Result: The present treatment of cancer is highly expensive irrespective of the stage of disease, may not be affordable by all levels of community. Conclusion: On observation it can be said that the 'study treatment' in this case, could able to increase the life expectancy with quality of life and prevented the further growth of tumour.

Keywords: Arbuda, cancer, rabdomyosarcoma

   48. An Ayurvedic management for cervical intraepithelial neoplasia-3 in HPV positive woman-A case study. Top

Anju Raj1, Anilkumar Kala Akhila1, Anjaly Muraleedharan2, Hemavathi Shivapura Krishnarajabhatt3, Parvathy Unnikrishnan2

1PG Scholar, 2Assistant Professor, 3Professor, Department of Stri Roga and Prasuti Tantra,Amrita School of Ayurveda ,Amrita Viswa Vidyapeetham

Corresponding author: Dr. Anju Raj, Email: [email protected]

Background: Cervical intraepithelial neoplasia (CIN) is the dysplasia of cervical squamous epithelium by cells with varying degrees of atypia. Most commonly, it occurs at the squamo-columnar junction of the cervix and rarely in the vaginal walls and vulvar epithelium. Risk factors for CIN includes; increasing age, infections like HPV, HIV, HSV2, Chlamydia, multiple sexual partners, high parity, immune suppression etc. Over 99.7% of patients with CIN are found to be positive with high risk HPV-DNA. Women with CIN-3 co-existed with HPV are at high risk of cervical CA whereas the risk is very low when properly treated. In Ayurveda, based on the clinical presentations, it can be included under the broad term of Vrana.To find out the effect of an Ayurvedic treatment in Cervical Intraepithelial Neoplasia 3 (CIN-3).Case history: A 42 year old sexually active lady of Italian origin visited the OPD seeking suggestions from Ayurvedic system of medicine, as she was diagnosed with CIN3 and HPV positive. Per speculum examination revealed cervical erosion with nabothian follicles. She also complained of per vaginal discharge. Considering the present case under the concept of Yoni Vrana (vaginal wound) mentioned in Ayurvedic classics, a specific treatment modality was planned which included Sthanika Chikitsa (treatment for local application) like Yoni Prakshalana (cleaning of vagina) and Pratisarana Kshara along with internal medications for a period of 14 days. Pre and post assessment was done using Photographic documentation , Pap smear test and HPV DNA test. Results: Photographic documentation showed significant improvement, along with Pap smear test and HPV DNA test. Conclusion: In Ayurvedic literature, a vast description about different types of wounds, phases of wound healing and its management has been mentioned. Based on the clinical presentations, the present case can be considered under the concept of Yonivrana mentioned in Ayurveda. Here Yoni Prakshalana and Pratisarana Kshara was done to attain Vrana Shodhana (cleansing) and to promote Ropana (healing) by which the normal cervical cytology can be retained. Internal medications were given aiming at reduction of the infection as well as for the promotion of immunity of the patient. As the treatment showed its action at the cellular level, we can analyse that phase mannered wound management mentioned in Ayurvedic classics still stands true. Conclusion: Hence this study promises an effective alternative for current ablative and excisional methods.

Keywords: CIN, HPV, Kshara Karma, PAPS test, Prakshalana

   49. Systematic review study of plumbagin in cancer management Top

Anishma A S1, Haritha Chandran2, Leena P Nair3, Haroon Irshad3

1PG Scholar, 2Assistant Professor, 3Associate Professor, Dept Samhita and Siddhanta, Amrita School of Ayurveda

Corresponding author: Dr.Anishma A S, Email: [email protected]

Background: Plumbagin a cytotoxic element extracted from plumbago species which has the potential to selectively kill tumour cells. The roots of the medicinal plant Plumbago zeylanica L. (Chitraka) is the main source of this bioactive naphthoquinone alkaloid plumbagin, which is traditionally used in liver disease, body pain and inflammation, skin disease etc. Aim: The present paper is to summarise the experimental research progress of plumbagin and to assess the action of plumbagin in different types of cancer. Materials and methods: Literature search were carried out from various relevant classical literature of Ayurveda, data bases like Google Scholar, PubMed, Ayush research portal etc. This review were conducted on the most relevant papers related to this topic .Using the keyword plumbagin and P. zeylanica 136 articles found in PubMed , among this 39 are selected by adding the key word cancer treatment, relevant three articles are selected each from breast cancer , prostate cancer and lung cancer respectively. Results: Plumbagin modulates cellular proliferation, carcinogenesis and radio resistance. Plumbagin's effective chemo suppressive action has been demonstrated in breast cancer, pancreatic cancer, lung cancer and prostate cancer. Its activity in human breast cancer cells is by the up regulation of p53 and p21 and suppression of G1 cell cycle regulator. Another study shows its role in controlling human prostate cancer in association with modulation of cellular redox status and generation of reactive oxygen species. It inhibits cell growth and induces apoptosis in human lung cancer cells through an NF-κB-regulated mitochondrial-mediated pathway, involving activation of ROS. The strong anti-oxidant potential shown by the P. zeylanica extract demonstrates its ability to protect the non-target (normal) cells against oxidative stress, while the cytotoxic effects inhibit the growth of cancerous cells. Conclusion: From this review it is evident that plumbagin the alkaloid present in P. zeylanica, can meet the challenges in cancer treatment.

Keywords: Cancer treatment, plumbagin, Plumbago zeylanica

   50. A review on herbal down regulation of NF - KB cells- a break through in the management of tumorigenesis Top

Vahab R A1, Delvin T Robin2, Anusree Dileep2, Preethi Mohan3, Vandana Rani M4

1PG Scholar, 2Associate Professor, Dept of Swasthavritta, 3Associate Professor, Dept of Agada tantra, 4Vandana Rani M, Professor, Dept of Swasthavritta, Amrita School of Ayurveda , Kollam

Corresponding author: Dr. Vahab R A, Email: [email protected]

Background: Nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) is a protein complex that controls transcription of DNA, cytokine production and cell survival. The activation of NF-kB initiates inflammation and cancer. NF-kB cells express some proteins as gene signature which triggers the proliferation, inflammatory response as well as apoptosis in sequential manner. Down regulation of NF-kB cells is considered as a potential therapeutic target in cancer therapy. Generally down regulation of NF-kB cells is possible only through restricting multiple molecular mechanisms. So inhibition of all these mechanisms may cause harmful side effects in therapy. Identifying the specific pathway is essential for effective cancer therapy. Some Indian herbs plays crucial role in down regulation of NF-kB cells effectively and all of them were used in Ayurveda for tumour treatment. This concept of NF-kB natural suppression will be a boon to cancer research. Aim: The purpose of this study was to analyze the possible mechanism of down regulation of NF-κB through some Ayurvedic herbs. Materials and methods: A thorough search was made through Medline database, Science direct, using key words nuclear factor-kappa B, Ayurveda and cancer. Terms were combined using Boolean operators and after applying the filter 'review' 14 studies were obtained. Duplicates and reviews of any form were excluded. After screening, 10 experimental studies met the inclusion criteria were selected. Results: Ayurvedic herbs act through specific mechanism in down regulating NF-kB cells. It can be direct inhibition and indirect action through different proteins. Directly it inhibits the subunits of NF-kB as in guggulosterone. Indirectly it either suppresses the proteins that initiate the inflammatory pathway for proliferation as in pinitol or suppressing the nuclear translocation as in Berberine. Active principles of all the herbs reviewed suppressed the phosphorylation and degradation of NF-kB subunits (IkBα, IKKα) and prevented the metastasis. Conclusion: All these mechanisms should be researched further for finding out an effective remedy for cancer. Ayurvedic herbs as compound have potential effect on preventing the nuclear translocation of NF-k B, also maintain equilibrium of inflammatory mechanisms. Hence it can be concluded that natural suppression is an effective alternate choice in cancer therapy.

Keywords: Ayurveda, cancer, nuclear factor-kappa B

   51. Role of Ahara in prevention of Arbuda w.s.r. to n - nitroso compounds - A review Top

Dr Sreedhar Vasudevan1, Chandrakumar G2, Sreejith Satheesan3

1PG Scholar, 2Professor and HOD, 3Assistant Professor, Dept of Shalyatantra, Pankajakasthuri Medical College and Post Graduate Centre, Trivandrum

Corresponding author: Dr Sreedhar Vasudevan, Email: [email protected]

Background: Among the most potent dietary carcinogens are N - Nitroso Compounds. This review has been done to know how these compounds can enter human body and the necessary diet changes required to nullify these compounds, by searching the existing literature. Aims: To know about the different Ahara that are to be consumed with the objective of preventing Arbuda, with importance given to food that has or can produce N–nitroso compounds, which are notorious for their carcinogenic properties. Materials and methods: Peer reviewed articles, authentic websites, journals and classical texts are used as reference for this review study. PubMed was searched using the Keywords N–nitroso compounds, Cancer and Food. 278 articles were found, out of which, 74 were found to be relevant. PubMed was searched using the Keywords N–nitroso compounds, Vitamin C & Vitamin E. 18 articles were found, out of which, seven were found to be relevant. Results: Regulation of Ahara, specifically aimed at reducing both endogenous and exogenous N–nitroso compounds, has significant role in preventing Arbuda. Moreover, to prevent the nitrosation of natural precursors in food to form N– nitroso compounds, vitamins C and E are required. Conclusion: Ahara having predominance of or can endogenously produce N – nitroso compounds, should be avoided while forming a preventive strategy in Arbuda. They should also be rich in Vitamins C and E, to break the nitrosation in stomach.

Keywords: Arbuda, cancer, N–nitroso compounds, Prevention, Vitamin-C, Vitamin-E

   52. Long-term clinical response of stage IA cervical carcinoma to Ayurvedic treatment - A case report Top

Vishnu Govind. M1, K. V. Subhadra Antherjanam2,

1PG Scholar, 2Professor, Dept. of Shalakya tantra, Amrita School of Ayurveda, Kollam, Kerala

Corresponding author: Dr. Vishnu Govind. M, Email: [email protected]

Background: Stage IA cervical carcinoma [CC-IA] is surgically managed with radical hysterectomy [RH] or radical trachelectomy [RT], depending on the need to preserve fertility. Besides long-term adverse effects such as sexual or bladder dysfunction, pelvic cyst formation and lymphoedema of the legs, RH leaves the woman infertile. This report presents a case of the long term response of CC-IA to Ayurvedic treatment in a patient who was advised but unwilling to undergo RH. Case history: A 49 years old, multiparous woman was admitted because of abnormal vaginal bleeding, severe body pain, giddiness, nausea and loss of appetite. Gynaecological examination found bleeding from the endocervix. She had the bleeding, intermittently, for two years. D&C was done and the sample was sent to Government Medical College, Thiruvananthapuram [GMCT] for histo-pathological analysis. Histo-pathological analysis revealed CC-IA. Patient was referred to GMCT where she was advised radical hysterectomy with bilateral pelvic lymphadenectomy. The patient was unwilling to undergo surgery and approached Ayurvedic care. Results: Patient was under Ayurvedic treatment for one year. She was initially given Musalikhadiradi Kashayam with Chandraprabha Vati, Varadi Kashayam with Gokshuradi Guggulu, Asokarishtam and Vyoshadi Takram. Vaginal douche of Guduchyadi Kwatha and Yoni Pichu by Jatyadi Keram were administered for 14 days, monthly once. After two months, Virechana (therapeutic purgation) was done following Varunadi Ghrita Snehapanam. Continuing internal medicines, Virechana was done at definite intervals in next ten months. At sixth month of treatment, at the completion of treatment, and at six months after the treatment, she was referred to GMCT. On all three occasions, no malignant changes were observed in gynaecological and histopathological examinations. Patient lived for 25 years after completing the treatment, with no recurrence of any of the symptoms. Conclusion: This case suggests that patients with CC-IA may benefit from Ayurvedic treatment. Nonetheless, further pre-clinical and clinical studies are needed to assess the potential of the treatment.

Keywords: Ayurveda, Cervical cancer, Hysterectomy, Virechana

   53. A compilation study of review of anti-cancerous herbs and efficacy. Top

Sukanya Vilayath Pisharath,

PG Scholar, Dept of Swasthavritta, SDM Ayurveda College, Udupi

Corresponding author: Dr. Sukanya Vilayath Pisharath, Email: [email protected]

Background: According to Ayurveda, Cancer is clearly co related with Kataka Arbuda (tumour), which is due to vitiation of Tri-Dosha. Now a day, we can observe a greatest inclination for cancer treatment towards Ayurveda. However Modern medicine has numerous possibilities to treat this, but patient has to suffer a lot due to complications and side effects. Aims: The recent trend is to focus on scientific researches on herbs for its anti-cancerous properties and its efficacy. Here is the review and results of some researches on anti-cancerous herbs around the world. Materials and methods: This study is to compile all the anti-cancerous herbs and its efficacy for healing as well as how its role in cellular physiology of a cancer cell. Charaka described Arbuda. Sushruta provided more information on Arbuda (tumour). Granthi (cyst), Apachi (lymphadenitis), Gandamala (multiple lymphadenitis) also Cancer related conditions. Vagbhatta mentioned the Arbuda of nose, lips, tongue and breast etc. Microscopically, the presence of numerous mitotic figures suggests neoplasia in highly malignant tumours multi-centric division and other forms of typical mitosis may be seen at times. Malignant change is still cytological rather than histological, the disease is curable. Researchers have devoted many years of investigation of mechanism of cancer development ,process of cell life as DNA duplication , transcription and translation and concluded that binding of any molecule to DNA may influence cell life 'For better or for worse'. Results: These studies proved that herbs can specifically correct or arrest the cell disturbances at the nucleic acid level and of enhancing beneficial gene expressions. The challenge of the cancer cells must be met on three different lavel; 1. Cancer cell multiplication must be selectively arrested without injury to normal cells, 2. Competence of the immune system must be protected, 3. Enzymatic activity to maintain biological process efficiently. Here it is interesting to note that lot of special herbs on earth have the strong potency to fight with the pathological cellular profile of cancer cells. Various herbs extract shows cyto toxic effect and this will be delt in detail in discussion. Most of the Medicinal plants, which are screened for anti-cancerous activity are not indicated under the treatment of Arbuda in the original texts. A review has been made to explain the rationality behind the ancient approach on Cancer. 1. Manjishta (Rubia cordifolia L.), Tilaparni (Alstonia scholaris (L) R.Br.), Kutaja (Wrightia antidysentrica (L.) R.Br.), Mahanimba (), Champaka (), Bhoomyamalaki () etc are effective against Rakta Vikaras (blood infection). Arbuda is related to Rakta (blood), mamsa (muscle) over these aspects the drugs are effective. 2. Rasayana drugs which may act as antioxidants as well as immunomodulators may also acts as anti-cancerous. Eg; Brahmi (Bacopa monnieri (L.) Pennell), Mandookaparni (Centella asiatica (L.) Urban), Ashwagandha (Withania somnifera (L.) Dunal).Conclusion: Ayurveda states the use of herbs such As Arka (Calotropis procera (Aiton) W.T.Aiton), Guduchi (Tinospora cordifoila (Thnub.) Miers), Syonaka (Oroxylum indicum (L.) Benth ex kurz), Bilwa (Aegle marmelos (L.) Correa), Sigru (Moringa Oleifera Lam.), Bhallataka (Semicarpus anacardium Linn.) in cancer treatment. The compilation of these studies suggests the anti-cancerous property and mechanism. So it's the time to do inclination towards nature and aware about diet, lifestyle and environment

Keywords: Anti-Cancerous, cancer, carcinogenesis, herbs Ayurveda

   54. Role of Rasa Tailam in ' Puttru Noi'(malignancy) treatment Top

Pasupathy Thavakeethan1, Chandraprabhu.M2, Bharath Christian C.B.S2, Manoharan A3

1PG Scholar, Government Siddha Medical College, Palayamkottai, Tirunelveli, 2Medical Officer (Siddha), Dept of Pothumaruthuvam, Govt.Siddha Dispensary, Pallivasal, Idukki, 3Professor & Head of the Department, Dept of Pothumaruthuvam, Government Siddha Medical College, Palayamkottai, Tirunelveli

Corresponding author: Dr. Pasupathy Thavakeethan, Email: [email protected]

Background: The Siddha systems possess various medicines for the management & prevention of different types of Puttru Noi (malignancy). Patha Rasam (mercury -Hg) is widely used in Siddha system of medicine, especially in Perumarunthukal. Mercury contains the six types of Suvai (taste) and also have both Veppam (Hot) and thatpa (cold) Veeriyam (potency). Rasa Tailam (RT) is a medicine which contains purified Rasam and leaves paste of 3 medicinal plants. Siddhar Theraiyar clearly described the preparation and indications of Rasa Tailam in Therayar TailaVarka Surukkam (TTVS). Aims: The purpose is to evaluate the preclinical and in-vivo study documentation of the Siddha medicine “Rasa Tailam” against Cytotoxicity and anti-tumour activity in dalton ascetic lymphoma of male swiss albino mice models”. Materials and methods: Male Swiss albino mice (20-25 gm) were produced from animal experimental laboratory and used throughout the study. They were housed in micro nylon boxes in a control environment (25±2°C) and 12 hrs dark /light cycle with standard laboratory diet and water ad libitum. In the present study, cell lines induced cancer in mice was used to evaluate the anticancer activity of Rasa Thailam. Results: End results showed the safety profiles of Rasa Tailam in the management of DAL such as liver enzymes, lipid profile, haematological and other derived parameters [body weight & increasing life span (ILS)] in mices were noted. Conclusion: This study can be concluded that Rasa Tailam showed high inhibitory action of tumour size, decreasing the tumour cells and arresting metastatic (secondary) growth.

Keywords: Anti-tumour activity, cytotoxicity, Perumarunthukal, Puttru Noi, Rasa Thailam, Siddha

   55. Role of Ashwagandha in cancer management-A review Top

Dr Jithu S1, Dr Prathibha C K2, Dr Anantharaman P V2

1PG Scholar, 2Professor, Dept of Panchakarma, Amrita school of Ayurveda, Kollam, Kerala

Corresponding author: Dr Jithu S , Email: [email protected]

Background: Withania somnifera (L.) Dunal (Ashwagandha) is a medicinal plant that has been utilized in traditional medicine. It belongs to the family Solanaceae. It is Vrishya (aphrodiasac), Balya (strengthener) and Pushtida (nourishing) in nature. The main part used is the root, as the root powder being used in over 200 formulations in Ayurveda and other systems of traditional medicine for treating various ailments. The main phytoconstituents of Withania somnifera are withanolides and alkaloids. Among these, the significant pharmacological activities lie in two main withanolides, withaferin A and withanolide D. They possess anti-arthritic, anti-microbial, anti-mitotic activity and also possess special antitumor & anticancer property. Aims: To review the role of Withania somnifera in various stages of cancer management and also to illustrate possible mechanism of Ashwagandha in different types of cancer. Methods and methods: Literary researches based on anti-cancerous activity of Withania Somnifera. Results: Ashwagandha is found to be effective in cancer management in multiple ways. It is utilized in pre-cancerous stage, cancerous stage as well as in post-cancerous stage (palliative care). In pre-cancerous stage its components have the potential to arrest the growth and differentiation in glioma cells, which decreases the risk of brain tumour. Ashwagandha offers an effective differentiation therapy. In cancerous stage, Ashwagandha acts as a radio sensitizer, by making tumour cells more sensitive to radiation therapy and there by acting as a chemotherapeutic agent. In post cancerous stage during palliative care, it is found to enhance QOL and reduces radiation and chemotherapy induced fatigue, peripheral neuropathy, and other complications such as hepatotoxicity, sleep etc. as it is Balya (strengthening) and pushtida (nourishing). Conclusion: It is clear that Ashwagandha is effective in controlling cancer, as well as in reducing the adverse effects produced during cancer management. Withaferin A & withanolide D isolated from the extract showed significant antitumor and radio-sensitizing effects in experimental tumours in vivo, without any noticeable systemic toxicity. Considering its wide spectrum of anti-cancerous activity, there is a need for more researches in formulating a potent anti-cancerous drug from Withania somnifera.

Keywords: Ayurveda, Ashwagandha, Cancer

   56. Improving the quality of life of hepatocellular carcinoma through Ayurveda: A case report Top

Dr.Aswathy Y S1, Dr.Ananthram Sharma2, Dr. Prathibha C K2, Dr. Arun M3

1PG Scholar, 2Professor,Amrita School of Ayurveda , Amrita Vishwa Vidyapeetham, Kollam, Kerala, Assistant professor, Department of Kayachikitsa, Sree Narayana Institute of Ayurvedic Studies and Research, Puthur, kollam.

Corresponding author: Dr.Aswathy Y S, Email: [email protected]

Background: Hepatocellular carcinoma (HC) is a common primary malignancy of liver, which has a bad prognosis and is associated with co-morbidities. Treatment modalities like surgery, radiotherapy and chemotherapy has after effects which may be permanent or temporary , ranging from hair loss to systemic damage , which affects the quality of life (QoL) of a person.The aim of our treatment was to provide a supportive role for improve QoL of the patient. Case history: A 47-year-old male, chronic smoker and occasional alcoholic complain of persistent abdominal pain, for 1 year. In the last three months it is associated with nausea, vomiting, severe abdominal pain, episodes of fever and chronic constipation. The 'Child Pugh Score' was 6 and is of class A type. After undergoing CT abdomen, he was diagnosed with HC involving multiple liver segments and Non-Anatomical Resection of lesions of liver was done. After seven months, on subsequent CT scan he was diagnosed with multiple metastatic lesions spread throughout the liver parenchyma. Liver transplantation was suggested but the patient was unwilling for surgery. He was on pain relieving medication and anti-emetics at the time of reporting. Results: As Pitta and Rakta (blood) were involved, fresh Patolakaturohinyadi Kashaya (decoction) and Vasaguduchyadi Kashaya were given thrice daily. Drakshadi Panaka was given frequently, Madiphala Rasayana (half ts six hourly) was also given to the patient. As a result of continuous intake of medicines for three weeks, patient reported reduced pain, increased appetite, reduced fatigue and no vomiting. The Functional Assessment of Cancer Therapy-Hepatobiliary (FACT-Hep) score was 93 before treatment and got reduced to 88 after three weeks of internal medication. Conclusion: As the patient was of Alpa bala (low strength), the treatment was focused at Pitta Shamana (pacify to Pitta) and Agni Vriddhi (increase appetite) by keeping in view of Agni, Koshtha, Dosha, Dushya, Bala etc. The changes shown in the physical and functional wellbeing of the FACT-Hep score indicates the improvement in QoL. Hence the anti-emetics and analgesic drugs were stopped. Thus, the patient has showed an improvement in Quality of Life by consumption of Ayurveda medication as an adjuvant therapy.

Keywords: Ayurveda, hepatocellular carcinoma, quality of life, Shamana Chikitsa

   57. Design & development of turmeric - Triphala (oro-t) oral rinse for chemo & radiotherapy - induced mucositis: An evidence based approach Top

Shruthi M H1, Hariprasad V R2, Ashok B K3, Palaniyamma D4, Raghavendra P R5, Suryakanth D A3, Rafiq M6, Rangesh P7

1Research Associate, 2Research scientist, 3Senior Research Scientist, 4Medical Advisor, 5Principal Scientist, 6Group Leader, Discovery Sciences Group, R&D Centre, The Himalaya Drug Company, Bangalore, 7 Chief Scientific Officer, Himalaya Global Management Ltd. Dubai

Corresponding author: Dr. Shruthi M H, Email: [email protected]

Background: Oral mucositis, debilitating complication of cancer chemo and radiotherapy in patients of head and neck cancer significantly affects quality of life and a hindrance in cancer treatment. Aims: The study focused on developing evidence based herbal product with convenient dosage form to help bridge gap in conventional medicine, promote treatment adherence and improve quality of life in cancer patients. Materials and methods: The idea conceptualization arrived by understanding key ambiguities in conventional medicine for oral mucositis. By understanding of molecular mechanism of disease key therapeutic targets were identified. The actives for product were shortlisted based on the supporting traditional and contemporary literature data. The therapeutic efficacy of composition was screened by in-vitro and in-vivo methods. The TNF-α inhibitory property was checked in (human gingival fibroblasts 1: HGF-1) cells by challenging with Lipopolysaccharride: LPS (1μg/ml). The in-vivo effect of the composition was evaluated in 5-Flurouracil (5-FU) and acetic acid-induced mucositis in rats. Severity score of mucositis, inflammation score and size of wound was evaluated twice in a week. TNF-alpha was estimated in plasma on the last day of the experiment. Eventually, in two separate open label, comparative, parallel clinical studies, the product was clinically evaluated for safety and efficacy in subjects (n=111) with oral mucositis who are undergoing chemo and radiotherapy of head & neck cancer. The efficacy was determined using improvement in patient self-reported mouth and throat soreness (MTS) score, and PROMS questionnaire which assess limitations on daily functional activities. Results: Oral rinse showed inhibition of LPS induced TNF-α secretion in a dose dependent manner (in-vitro cell-line) suggesting strong anti-inflammatory effect. In case of in-vivo model, the oral rinse significantly improved parameters viz. inflammation, mucositis & wound size. The clinical studies showed a statistically significant relief from parameters (viz. pain, number of ulcers, difficulty in chewing & drinking, mucositis grading etc.) of oral mucositis in patients undergoing cancer chemotherapy and radiotherapy. Conclusion: The Turmeric - Triphala oral rinse product (Oro-T) designed and developed based on traditional wisdom, validated through rigorous scientific research was found to be safe and effective in treating cancer chemo and radiotherapy induced oral mucositis, fulfilling an unmet need in comprehensive cancer care.

Keywords: Head and neck cancer, oral mucositis, oral rinse, oro T, turmeric, Triphala

   58. Clinical application of Sushruta's maggot therapy in malignant fungating wounds- A conceptual study Top

Keerthi Raj1, Ananthraman Sharma2, Prathibha C.K2

1 PG Sholar, 2 Professors, School of Ayurveda, Amrita School of Ayurveda , Kollam, Kerala

Corresponding author: Dr. Keerthi Raj, Email: [email protected]

Background: Malignant fungating wounds are undeniably a terrifying complication to cancer patients. The wounds are tough to heal and hence are difficult to treat successfully. The psychological and physiological discomfort accompanying with immense pain, malodour, pruritus, pus discharge, bleeding, defacement further causes the patient to isolation, deteriorate the quality of life of patient and their adjacent family members. Even with the present day advancements in wound care, they are difficult to heal. The purpose of this conceptual study is for the better understanding effect of maggot therapy in cancer wounds. Aims: To review the clinical application of 'Krimibhakshana Chikitsa'' [maggot therapy] by Sushruta and its action on cancer wounds. Materials and methods: Sushruta Samhita and related research articles of maggot therapy from PubMed and Google Scholar were reviewed. Results: Sushruta practiced Krimibhakshana Chikitsa in Kaphaja Arbuda. Wounds having white colour, secretions with itching are mentioned to apply with the paste of Indian bean, lentil, horse gram, meat and whey, which would attract flies. In due course there will be the maggot formation over the wound which will eat away the slough and make the wound healthy. Krimibhakshana will change Dushta Vrana [non healing ulcer] to Shuddha Vrana [healing ulcer]. Subsequent treatments are Vrana Shodhana and Vrana Ropana for wound healing. Maggot therapy conventionally uses freshly emerged sterile larvae of Lucilia Sericata [green bottle fly] by using myasis in a controlled clinical situation. They believed to act by debridement, disinfection of wound and stimulation of healing. Debridement of dead tissue occurs by their plucking movements with mouth hooks and by secretion of proteolytic enzymes. Antibacterial substance present in the maggots secretion helps disinfection of wounds, also it adversely affect bacterial growth by increasing wound pH via ammonia excretion. It increases the tissue growth by increasing fibroblast proliferation and also by secretion of cytokines.Krimibhakshana Chikitsa is a Purvakarma (preprocedure / operate) of certain Vrana Chikitsa to make Vrana Shuddha (clean / disinfect). Contemporary system believes in the complete wound healing with this method. Even though there is a slight difference in the concept, the mechanism is same. Conclusion: Maggot therapy may be used as a supportive treatment in wound management in cancer.

Keywords: Arbuda, Lucilia Sericata, maggot therapy, malignant fungating wound, Sushruta, wound healing

   59. Identification and estimation of catechol (SA-3c) by HPLC in milk boiled with purified Semecarpus anacardium Linn. F Nuts Top

Sushma N.S1, Chinchu Bose2, Shyamasundaran K3, Rammanohar P4

1M.S. (Ayu.), Asst. Professor, Dept. of Shalakya Tantra and Research officer at Amrita Centre for Advanced Research in Ayurveda. Amrita School of Ayurveda, Amritapuri, Amrita Vishwa Vidyapeetham, Kollam, Kerala, India, 2Faculty Associate, Amrita School of Biotechnology, Amritapuri, Amrita Vishwa Vidyapeetham, Kollam, Kerala, India.3M.D (Ayu.), Asst. Professor, Dept. of Shareera Kriyaa and Research officer at Amrita Centre for Advanced Research in Ayurveda .4M.D. (Ayu.), Research Director, Amrita Centre for Advanced Research in Ayurveda , Amrita School of Ayurveda , Amritapuri, Amrita Vishwa Vidyapeetham, Kollam, Kerala, India

Correspondinmg author: Dr. Sushma N.S1, Email: [email protected]

Background: Semecarpus anacardium (SA) contains catechol 3-(8′(Z),11′(Z)-pentadecadienyl) - catechol (SA-3C), one of the components of urushiol, which has been found to exhibit anticancer activity. The purified nuts of SA were boiled in milk (Bhallataka Ksheera) and administered in increasing doses to manage conditions like cancer. Aim: This study was conducted to identify and estimate the quantity of catechol (SA-3C) in milk boiled with purified SA nuts. Materials and methods: An experimental study was performed using SA nuts samples included 1) semecarpus nuts without treatment (SWT), 2) semecarpus nuts after treatment (SWAT), 3) Semecarpus nuts decoction (SD), 4) Semecarpus nuts decoction with milk (SDM). SWT and SWAT were subjected to sequential extraction using solvents in a soxhlet apparatus. SD and SDM decoctions were extracted using ethylacetate followed by ethylmethyl ketone in a separating funnel and the solvent was removed using flash evaporator. Further analysis was done with TLC , HPLC , IR spectroscopy and LCMS/MS. Column chromatography conditions were similar for SWT , SWAT , SD and SDM. Results: Pentadecnyl catechol (Catechol SA-3C) and pentadecyldienyl, components of Urushiol are present in all samples. The LCMS/MS analysis gave molecular ion peaks at m/z 317 [M+H]+ corresponding to pentadecyldienyl catechol and m/z 319 [M+H]+ corresponding to pentadecnyl catechol. 25mg from SD 100ml and 375mg from SDM 100ml of urushiol were obtained. 10mg of urushiol was obtained from 100ml of SD and less than 100μg was obtained from 100ml of SDM.Conclusion: SWT, SWAT, SD and SDM samples contained catechol SA-3C. However, they were present in variable quantities before and after purification. SDM, administered in cancer patients contained the least amount of urushiol (100 μg per 100 ml). The maximum cumulative dose of MDTS is 500 μg. Further studies are warranted to establish whether urushiol can exhibit Anti-cancer activity at the available concentrations in SDM.

Keywords: Anti cancer, catechol SA-3C, Semecarpus anacardium, urushiol

   60. Concept of immunomodulators in cancer treatment: An Ayurved outlook Top

Prajeesh Nath E N1, Shyamasundaran K2, Sushma NS3

1Assistant Professor, Rasashastra and Bhaishajya Kalpana Amrita School of Ayurveda , Amrita Viswa Vidyapeetham, , Kollam, Kerala, 2Assistant Professor, Dept of Kriya Sharira, Amrita School of Ayurveda , Amrita Vishwa Vidyapeetham, Kollam, Kerala, 3Assistant Professor, Dept of Shalakya, Amrita School of Ayurveda , Amrita Vishwa Vidyapeetham, Kollam, Kerala

Corresponding author: Dr. Prajeesh Nath E N, Email: [email protected]

Background: Cancer is the name given to a collection of related diseases. Cancer cells proliferate hysterically and are mostly attributed to the accumulation of genetic alterations in cells. It encumbers the immune system and thereby prevents the body from functioning normally. Aims: The purpose of this study is to understand concept of immunomodulatory therapy in Ayurveda. Materials and methods: Classic Ayurveda texts and articles published in different peer-reviewed journals were analyzed for this study. PubMed, Google Scholar, and Google were searched with specific keywords. Results: Literary review revealed the concepts of cancer treatment modalities in Ayurveda and modern medicine. The treatments were based on the type of cancer, stage and the person's overall health includes chemotherapy, radiation and stem cell transplant. These therapies often cause variety of side effects. Immunotherapy uses the innate mechanisms of the immune system to overcome these effects including the progress of cancer. In immunotherapy, some boosts the immune system as a whole, while others try to combat specific types of cells in the tumours. Immunomodulators were potent tools for treating autoimmune disorders and cancer in Ayurveda. This was achieved by enhancing Vyadhikshamatva (immunty), Rasayana (Rejuvenation), Vajeekarana (aphrodisiac) and Ojovardhaka Chikitsa. Rasayana encompasses modifications in diet, drug, and lifestyle. Rasayana strengthens the Ojas, Bala and replenishes Rasadi Dhatu. Ayurveda describes varity of Rasayana and Ojovardhadhaka formulations, which were claimed to possess immunomodulatory effects for cancer like Amalaki Rasyana, Bhallataka Rasayana, Brahmya Rasayana, Shilajatu Rasayana, Triphala Churna, Indukanta Ghrita, Ashwagandhadi Churna etc. In a study by Rajesh et al, Regional Cancer Centre proved that Indukanta Ghrita possess immunomodulatory property in normal mice. Study by Chulet R et al , stated that Rasayana formulations seem to act through immunostimulant, immunoadjuvant, and immunosuppressant activities or by affecting the effector arm of the immune response which were having adaptogenic effects. Conclusion: The overall results of this study suggest Rasayana formulations to be multipotent inducer of immune responses and activating the non-specific and specific immune mechanisms. Cancer cells are predisposed in the body and it activates when immune system is weak. There is a wide scope to validate the immunomodulatory effect of Rasayana formulations through clinical studies.

Keywords: Ayurveda, immunomodulator, Rasayana

   61. Swarna Bhasma (gold nano particles) as an alternative medicine in the treatment of cancer Top

Dhanya S1, Abhaya Kumar Mishra2

1Assistant Professor, 2Associate Professor, Rasashastra and Bhaishajya Kalpana, Amrita School of Ayurveda , Amrita Viswa Vidyapeetham, Kollam, Kerala

Corresponding author: Dr. Dhanya S, Email: [email protected]

Background: Swarna Bhasma (classically processed gold) containing gold particles is an ultra-fine powdered Ayurvedic medicine made of 90% elemental/oxidized gold, treated with herbal extracts levgated and incinerated as per classical guidelines. It is a rejuvenator (Rasayana), it improves the quality of life, provides good body radiance, and physical strength. Swarna Bhasma can be prepared by Samskara (pharmaceutical processing) such as Shodhana (purification) and Marana (incineration) of Swarna with plant products. Aims: The present work is to assess the efficacy of Swarna Bhasma (gold nano particles) as an alternative medicine in the treatment of Cancer. Materials and Methods: An attempt is being made to review articles highlighting the therapeutic efficacy of Swarna Bhasma in cancer by searching text books and peer reviewed articles published in PubMed and Scopus [Jan 2009 to Dec 2018]. We have used the key words, Swarna Bhasma , Rasayana, gold nanoparticles and cancer for search. A total of 20 articles related to Swarna Bhasma and cancer were analysed. Results: A study was conducted at Calcutta Gastroenterology Research Centre, Kolkata by Soumen Das et al to detect the effect of Swarna Bhasma on solid malignancies. The response was best in rectal cancer group. Another study was conducted by Beaudet D et al on cellular entry of incinerated ancient gold particles (IAuPs) and chemically synthesized gold particles. Imaging studies revealed that IAuPs were in vesicles, cytosol, or in the nucleus. The study also revealed that larger IAuPs entered cells via macropinocytosis, while smaller particles entered via clathrin-dependent receptor-mediated endocytosis. Blood compatibility studies of Swarna Bhasma were conducted by Paul W et al and the results suggested the application of Swarna Bhasma preparations as a therapeutic agent in clinical medicine from the biological safety point of view. Conclusion: The review of the selected papers reveals that Swarna Bhasma has a potential in management of cancer. Further studies are needed.

Keywords: Cancer, gold nano particles, Rasayana, Swarna Bhasma

   62. Physical and psychological benefits of Pranayama in patients undergoing lung cancer treatment. Top

Meera S

Assistant Professor, Dept of Swasthavritta, Amrita School of Ayurveda , Amrita Viswa Vidyapeetham, Kollam, Kerala

Corresponding author: Dr. Meera S, Email: [email protected]

Background: Lung cancer is one of the major causes of cancer death worldwide. Pranayama (specific breathing process of Yoga) is an integral part of Yoga. It is the process of vital energy control. It implies slow, deep, continuous, rhythmic and controlled breathing. There is a need to coin effective strategies to reduce symptom burden such as respiratory distress in lung cancer patients. Also measures to improve their quality of life should be sought after. Pranayama offers multifold benefits at physical and mental plane. This holistic mode of treatment has not been adequately tested with lung cancer patients. Aims: To analyse the physical and psychological benefits of Pranayama in patients undergoing lung cancer treatment. Materials and Methods: An attempt is being made to understand the efficacy of Pranayama in quality of life outcomes and pulmonary functions in lung cancer patients. We searched pertinent, peer reviewed articles published in PubMed [Jan 1980-April 2018]. Authentic textbooks were also referred. Results: Besides pre-and post-treatment levels of distress, fatigue and sleep disturbances, overall quality of life (QOL) showed positive results. Significant improvements were noted in the area of spiritual well-being. Lung function which was assessed by spirometry also demonstrated considerable improvement. In yet another study, depression scale showed marked changes. 'Nissesha Rechaka' (exhale breath)an important variety of Pranayama offers advantages through brief intermittent hypoxia. Hypoxia induces p53 guardian genome. It has a protective role in DNA damage. Pranayama thus has multitude benefits in lung cancer. Conclusion: Evidences emerging from this review suggest that Pranayama offers curative and preventive benefits in lung cancer management. The potential of this simple cost effective non-pharmacological mode of treatment need to be studied.

Keywords: Hypxia, Lung cancer, Pranayama, Yoga

   63. Exemplification of understanding the Dosha involvement in cases of cancer through an example of cervix cancer Top

Shyamasundaran K1, Sushma N S2, Prajeesh Nath E N3

1 Assistant Professor, Dept of Kriyasharira, Amrita School of Ayurveda, Amrita Viswa Vidyapeetham 2 Assistant Professor, Amrita School of Ayurveda , Amrita Viswa Vidyapeetham, 3 Assistant Professor, Rasashastra and Bhaishajya Kalpana, Amrita School of Ayurveda , Amrita Viswa Vidyapeetham

Corresponding author: Dr. Shyamasundaran K, Email:[email protected]

Background: The stages of cancer (TNM classification) are based on the extent of spread and its clinical expressions vary from stage to stage. The treatment is also decided on these stages. Aims: A concept on understanding in Ayurveda is here derived to analyse the Dosha in each case. This has been analysed here as an example in the case of cervix cancer. Materials and methods: Ashtanga Hridaya Nidana Sthana 13/21, Sushruta Samhita Nidana Sthana 11/13-15, Google Scholar, PubMed articles were reviewed. Results: Ayurveda states that any condition where all the Dosha along with Rakta are vitiated, gets lodged in Mamsa Dhatu (muscle tissue), has mild or severe pain, does not suppurate in early stage and appears as a swelling is termed as Shopha (oedema). This could be seen in Gulma (lump of abdomen), Vidradhi (abscess), Arbuda (tumour), Granthi (cyst) or Visarpa (erysipelas). TNM classification is based on the extent of lesion, depth, local signs & symptoms and distant metastasis. In Ca cervix, high rate of spread is the most appreciated symptom. The cervical erosion in the initial stage due to the involvement of Pitta and Vata causes the high rate of spread. This causes excessive Ushnata (local temperature), expels Kapha and involves Rakta (blood tissue)in the Samprapti (pathogenesis). This results in Dhatu Paka (excessive catabolism). Eventually Leena Ama (absorbed toxic) is formed due to Dhatvagnimandya (poor digestion) as a resultant of Dhatu Paka. Shopha here is a sign and symptom which appears due to Visarpa where as in some other conditions of Ca, the Shopha appears as a resultant of some other Samprapti as in Arbuda, Vidradhi or so. The Samprapti differs in each case and thus will be the treatment. Conclusion: The assessment of Dosha has to be properly looked into to better understand the Samprapti rather than to only assess the condition according to the stage and treat.

Keywords: cancer cervix, Dosha, Samprapti, stages of cancer

   64. Need for prevalence studies on the use of traditional medicine (AYUSH) by cancer patients in India Top

Sarada Kolathu1, Rammanohar Puthiyedath2, Keechilat Pavithrana2

1Medical Oncology and Hematology,Amrita Institute of Medical Sciences & Research Centre, Kochi, 2Amrita School of Ayurveda , Kollam, Amrita Vishwa Vidyapeetham, India.

Corresponding author: Dr. Sarada Kolathu, Email: [email protected]

Background: Cancer is a dreadful chronic disease, 2nd leading cause of Death after cardiac failure. Disease as well as its treatment creates physical , psychological and socioeconomic stress on both patient as well as relatives of the patient, leading to the usage of both conventional and nonconventional modalities either as Complementary (along with conventional) or alternative(replacing conventional). CAM is the terminology used in western world but AYUSH (Ayurveda , Yoga, Unani, Siddha, Homeopathy) is the terminology much familiar amongst the Indian population. Aim:The study presents a review on the available literatures on CAM use in India and identify formulations, interventions that are used along with conventional drugs.Materials and methods:A comprehensive search of literatures was done in the following databases like Pubmed, OVID, Embase databases, Cochrane Library, Google scholar.Keywords used for search were Complementary medicine or alternative medicine or Ayurveda or yoga or unani or siddha or homeopathy and prevalence and cancer and India. Inclusion criteria used for selecting the studies were prevalence of complementary and alternative or AYUSH system of medicine use in Cancer. Results: Pubmed search showed 64 studies, Embase showed 26 studies but only 3 studies were included according to inclusion criteria. No study fulfilled the inclusion criteria on Cochrane search out of 555 studies. OVID search showed no Indian Studies on prevalence. Google scholar showed 442 studies, only 1 eligible which was already included. In total only 4 studies were considered, maximum amongst it were conducted in North India. Prevalence of CAM ranged from 7% – 57%. The CAMs used varied in each literature but Ayurveda was most commonly used in most of the studies though the formulation in specific was not discussed.Conclusion: In India, there is scarcity of literatures published on AYUSH use. With the available literatures, it is not possible to find out a specific formulation or product that causes interaction with specific conventional therapies used in cancer management. Methodology and definitions varied in most. We would suggest that more such studies have to be initiated in India, standardised definition, questionnaire and methodology should be formed in order to avoid variations in the study outcome and comparative purposes

Keywords: Prevalence, traditional medicine, complementary

   65. Integrative analysis of Samvruta Dhamani of Ayurveda with gene expression profiling during breast carcinogenesis: A meta-analysis Top

Vandana K.Vasudevan1, Parvathy Unnikrishnan2, Anjaly Muraleedharan2, Hemavathi Shivapura Krishnarajabhatt3

1PG Scholar, 2Assistant Professor, 3Professor, Dept of Stree Roga and Prasuti Tantra, Amrita School of Ayurveda , Amritapuri, Amrita Vishwa Vidyapeetham, India

Corresponding author: Dr. Vandana K.Vasudevan, Email: [email protected]

Background: Breast cancer (BC) is explained under the concept of Stana Roga (breast disease) in Ayurvedic classics. On explaining the pathogenesis of Stana Rogas, its absence in Kanya(virgin), or in a nulliparous woman, due to the inability of Doshas (functional energy of body) to spread in breasts, due to Samvruta Dhamani(closed channels of body)has been quoted. It is the leading type of cancer among Indian females with a mortality of 12.7 percent. Studies on incidence, demonstrate a clinically under-recognized transient increase in breast cancer risk in parous women in comparison with nulliparous women. The reasons are unclear but it was hypothesized that hormone-regulated genetic expression promotes tumorigenesis in parous on comparison with nulliparous women. Aims: The present review aims to identify the various causes leading to the short-term increase in risk of breast cancer after first pregnancy and to relate it with Ayurvedic perspective of Stana Rga. It also emphasizes on factors that contribute to breast carcinogenesis and the probable means of protection against Stana Roga mentioned in classics. Materials and methods: The literary research was done through published journals, research articles and classical references such as Samhita (ancient texts) and Nighantu (ancient encyclopedias) in relation to breast carcinogenesis in nulliparous women. Database search was carried out in PubMed, Google Scholar with Keywords such as ”Stana Roga”, “breast cancer,” “genetics,” and “parity” by applying filters such as “latest studies”, “full text available” and different Boolean operators. Among the 923 articles obtained, 28 of them were found relevant to the present review. Results: On comparing with a virgin gland, pregnancy and pregnancy mimicking hormone intake, acts as an initiator of tumorigenesis in breasts, by differentiation of susceptible stem cells, and as a promoter, by expanding the clone of initiated cells. Different hormonal mechanisms under genetic expressions present in the stromal microenvironment culminate in the distinct biology of post-parity tumours. Conclusion: It is speculated that thedifferent tumour tissue profiles that hosted immune-related and cell cycle-associated genes, many of which are hormone regulated. Several tumour suppressor genes-Caveolin 1, growth arrest-specific protein 1, p63 and a large number of ribosomal genes were expressed in nulliparous women. Down-regulation of immune response genes was also observed in postpartum breast cancer epithelium. In addition to targeting tumour cells, estrogen and progesterone contribute to tumour aggressiveness by targeting cell cycle and cell proliferation pathways in normal adjacent epithelia.

Keywords: Arbuda, breast carcinogenesis, genetics, gene expression profiling, parity, Stana Roga


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   1. A case report...
   2. Case series o...
   3. Effect of ind...
   4. Ayurvedic man...
   5. Gandoosha<...
   6. Evidence base...
   7. Formulation d...
   8. Clinical insi...
   9. Formulation a...
   10. Effectivenes...
   11. Understandin...
   12. A study on t...
   13. Applications...
   14. A descriptiv...
   15. Preventive o...
   16. Critical rev...
   17. Role of clas...
   18. Diet-nutriti...
   19. Holistic app...
   20. Effect of <...
   21. Haridra
   22. Free radical...
   23. Anti-cancer ...
   24. Anti –...
   25. Prospective ...
   26. Comparative ...
   27. Udvartana...
   28. Yashtimad...
   29. A review on ...
   30. Clinical evi...
   31. Behavioural ...
   32. A prospectiv...
   33. Preventive m...
   34. Ayurvedic in...
   35. Emblica o...
   36. Immunomodula...
   37. An Ayurvedic...
   38. Effectivenes...
   39. Role of Ayur...
   40. A review on ...
   41. A conceptual...
   42. Anti –...
   43. Cancer: role...
   44. Review on t...
   45. Role of psyc...
   46. A conceptual...
   47. Ayurveda man...
   48. An Ayurvedic...
   49. Systematic r...
   50. A review on ...
   51. Role of A...
   52. Long-term cl...
   53. A compilatio...
   54. Role of R...
   55. Role of A...
   56. Improving th...
   57. Design &...
   58. Clinical app...
   59. Identificati...
   60. Concept of i...
   61. Swarna Bh...
   62. Physical and...
   63. Exemplificat...
   64. Need for pre...
   65. Integrative ...

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