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   Table of Contents - Current issue
October-December 2019
Volume 40 | Issue 4
Page Nos. 207-272

Online since Thursday, January 14, 2021

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Quality publications in Ayurveda: Need of the hour Highly accessed article p. 207
Mandip Goyal
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A retrospective analysis of the effect of the intervention of Arogya Kashayam in COVID-19 positive cases in Madhya Pradesh p. 209
Umesh Shukla, Sanjay Srivastava, Pankaj Gupta, Nitin Ujjaliya
Introduction: Coronavirus disease (COVID-19) is a newly identified strain of corona virus that causes illness ranging from the clinical features similar to the common cold to a fatal condition due to severe respiratory failure. According to the WHO, there have been more than 26.3 million confirmed COVID-19 cases in more than 190 countries to date. In light of the outbreak, various treatment modalities have been considered, including traditional medicine, which has been widely used in the pandemic of severe acute respiratory syndrome (SARS) and H1N1 influenza. Ayurveda contributes a measurable ratio in the world's traditional practices. As per the guideline of directorate of AYUSH, Government of Madhya Pradesh, cases of COVID-19 were intervened with Arogya Kashayam (AK-20), a decoction prepared from the herbs at 88 COVID Care Centers (CCC) across the state. Aim: To evaluate retrospectively, the effect of the intervention of AK-20 in COVID-19 positive cases as stand alone or in combination with hydroxychloroquine (HCQ) administered at CCC in Madhya Pradesh. Materials and Methods: It is a retrospective study with 4432 COVID-19 reverse transcription–polymerase chain reaction (RTPCR) tested positive cases including 2750 males and 1682 females between 5 and 80 years of age. All the cases were intervened with AK-20 as stand alone or in combination with HCQ. Moreover, these patients were also given Zinc and Vitamin C simultaneously. The intervention of AK-20 was made through the district level government AYUSH machinery, and the related data were collected in specially designed case report form. The data were analyzed retrospectively, and outcomes included the RTPCR testing or asymptomatic discharge from the CCC as per the prevailing ICMR guidelines. Results: The present study reveals that out of 4432 COVID-19 RTPCR-positive cases, 2817 (63.56%) received HCQ with AK-20 and 1615 cases (36.43%) received AK-20 as a stand alone treatment. Among the cases that received HCQ and AK-20, 2681 cases (94.17%) recovered completely in an average of 6.8 days and among those who were on standalone AK-20, 1502 cases (93.00%) recovered completely in the same average days. The Chi-square test showed that both the groups were equally effective (P < 0.01; F = 0.3764). Conclusion: The retrospective analysis showed that the treatment practices of AK-20 standalone or in combination with HCQ applied in COVID-19 positive cases at CCC in Madhya Pradesh were effective against SARS coronavirus 2 disease. A significant number of cases was tested negative or asymptomatically discharged from both the groups of interventions. Moreover, AK-20 alone has shown statistically equal results to that when used in combination with HCQ therapy.
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Effect of Brihatyadi Yapana Basti and Shivalingi (Bryonia laciniosa Linn.) seed powder in the management of female infertility (Vandhyatva) due to anovulatory factor: An open-labelled randomized clinical trial p. 216
Gaurav Balat, Laxmipriya Dei, Shilpa Donga, Tarak Bhagora
Back ground: Infertility is a global problem that has impact on quality of life, especially through the negative psycho-social consequences. One-third of infertile population attending infertility clinics are reported with anovulation. According to Acharya Sushruta, among four essential factors required for conception, Beeja (ovum) is the core stone of the female reproductive process and conception can not be achieved in its absence, despite of other factors. Aims and Objectives: To evaluate and compare the efficacy of Brihatyadi Yapana Basti (therapeutic enema) and Shivalingi (Bryonia laciniosa Linn) seed powder in the management of female infertility w.s.r to the anovulatory factor. Materials and Methods: Total 30 female patients suffering from infertility due to anovulation confirmed by trans vaginal sonography were enrolled in the present study and randomly divided in two groups i.e., in group A (n = 15), Brihatyadi Yapana Basti (400 ml) was administered for 15 days after menstruation for 2 consecutive cycles. In group B (n = 15) Shivalingi seed powder was administered in dose of 3 gms twice in a day with cow milk on empty stomach for 2 months with 2 months followup. The efficacy of the therapy was assessed on the basis of follicular study by trans-vaginal sonography (TVS) on the 12th , 14th, 16th and 18th days of menstrual cycle and/or on the basis of conception achieved. The obtained data was analyzed for statistical significance using Student's t-test. Result: In the Brihatyadi Yapana Basti group, ovulation was found in 80% of the patients and conception rate was 26.66% and in the Shivalingi seed powder oral group, ovulation was found in 64.28% patients and conception was not reported. Conclusion: It was concluded that Brihatyadi Yapana Basti is more effective in follicular growth, ovulation and also achieving conception than that of Shivalingi seed powder orally.
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Efficacy of Rituharitaki (seasonal adjuvant of Haritaki) on disorders of Varsha Ritu (monsoon) w.s.r. to quality of life: An open labelled randomized controlled clinical trial p. 223
AV Smitha, KV Dilipkumar
Background: Monsoon epidemics are always a serious concern in the public health sector. Administration of Haritaki with suitable vehicle as per season (Rituharitaki) is a simple, cost-effective preventive measure which can be used for such conditions. Aims and Objectives: Study objectives were to assess the effect of Rituharitaki in preventing the diseases in Varsha Ritu (monsoon) and its effect on the WHO quality of life BREF (QOL BREF), total leukocyte count (TLC), differential count (DC) and erythrocyte sedimentation rate (ESR) in healthy volunteers. Materials and Methods: From 82 participants, based on inclusion criteria, 60 participants were selected and randomly allocated into trial and control group of 30 each using a computer generated random number table. Intervention given was Rituharitaki (Terminalia chebula Retz) in tablet form-3 tablets of 1g each and Saindhava (rock salt) 1g with lukewarm water at 6.30 am on empty stomach to the participants of trial group for 60 days in Varsha Ritu in Kerala and were observed during this period. Results: The results were analyzed using Chi-square test and paired t-test. Significant results were obtained in the trial group in reducing the severity and frequency of common cold (p < 0.001), cough (p < 0.05), and fever (p < 0.001). In the WHO QOL BREF domain 1 & 4 showed significant result in the trial group (p < 0.05). Among the haematological parameters - total leukocyte count (TLC), eosinophil count and erythrocyte sedimentation rate (ESR) were statistically significant reduced (p < 0.05) in the trial group. Conclusion: Rituharitaki is found to be effective in reducing severity and frequency of diseases in Varsha Ritu and had effect on quality of life of patients.
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Immunomodulatory activity of Swarna Prashana (oral administration of gold as electuary) in infants - A randomized controlled clinical trial p. 230
Jyothy Kothanath Bhaskaran, Kalpana Shantibhai Patel, Rajagopala Srikrishna
Background: Swarna Prashana (oral administration of gold as electuary) is a form of electuary depicted in the classics of Ayurveda under the ambit of pediatrics. A specific action on immune system has been highlighted in infants if gold is administered along with Ghrita and honey for a period of 28 days. Aim: The present trial was conducted to assess the safety and efficacy of Swarna Bhasma (calcined powder), Madhu (honey) and Ghrita in infants with respect to anthropometrical, hematological and immunological parameters. Methodology: The trial was a randomized, controlled, single-blind study in 102 healthy infants allocated into trial and control groups. Trial group received a mixture of Swarna Bhasma, honey and Ghrita, while control group received a mixture of honey and Ghrita, both in drops form for a period of 4 weeks with 8 weeks follow-up. Safety was assessed on the basis of biochemical parameters and efficacy was based on the values of IgG before and after the treatment. Results: Anthropometrical and biochemical parameters did not showed any statistically significant difference between the effect of trial and control drugs, which suggested that the trial drugs did not hamper normal growth of the infants and were safe to be administered in infants. Both trial and control drugs showed statistically significant changes in IgG levels individually before and after the treatment; however, when compared between the groups, there was no significant differences. However, the number needed to treat (NNT) to assess the normalization of immunoglobulins, which is suggestive of its immunomodulatory activity, was 1 out of every 4.535 infants who received Swarna Prashana which was significant. Conclusion: Swarna Prashana did not interfere with normal growth of the infants. As evident by NNT, it showed immunomodulatory activity and was tolerated by the infants with no adverse effects during the trial or follow-up period.
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Management of hypothyroidism by Kshara Basti (therapeutic enema)– A case report p. 237
Karishma Singh, Adil Rais, Anup B Thakar
Hypothyroidism is emerging as a common health concern in India as well as worldwide. An autoimmune cause accounts for approximately 90% of adult hypothyroidism mostly due to Hashimoto's disease. This autoimmunity goes parallel with the theory of Ama (intermediatory product) in Ayurveda. A case of a 27-year-old female patient, presenting with pain in multiple joints, deformity in the right little finger, morning stiffness lasting for more than 3 h, reduced appetite, constipation, and lethargy, diagnosed with Amavata (rheumatoid arthritis), was subclinically diagnosed with hypothyroidism and treated with Deepana (stimulates digestion), Pachana (promots digestion) and Koshtha Shuddhi (mild purgation) for 5 days followed by Kshara Basti (therapeutic enema) for 5 days. Reduction in serum- thyroid-stimulating hormone (S. TSH) (31.1 μIU/ml to 16.6 μIU/ml) along with relief in clinical manifestations of the disease was the outcome. Koshtha Shuddhi followed by Kshara Basti has its efficacy in hypothyroidism, as it not only improved signs and symptoms but S.TSH level was reduced significantly. This case report proposes an innovative treatment modality for the management of hypothyroidism, which needs to be validated through a well-planned study on a large sample size.
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Panchakarma in autoimmune pancreatitis: A single-case study p. 242
Rajkala P Patil, Panchakshari D Patil, Anup B Thakar
Autoimmune pancreatitis (AIP) is the pancreatic manifestation of a systemic fibro-inflammatory disorder. AIP is a unique form of pancreatitis in which autoimmune mechanisms are suspected to be involved in the pathogenesis. AIP is a rare disorder, its exact cause is unknown, but it is thought to be caused by the body's immune system attacking the pancreas and it responds to steroid therapy only. In Ayurveda, although there is no synonym for AIP, but has a resemblance in clinical features of Grahani Dosha (derangement of duodenum and intestine). The cause of Grahani Dosha is Mandagni (hypofunctioning of Agni) and Panchakarma therapy increases Agni. As per Charaka Samhita, treatment for Grahani Dosha amongst the Panchakarma therapy is Virechana (therapeutic purgation) and Basti (medicated enema). The present case report is of a 30-year-old female, diagnosed as case of AIP with multisystem involvement with increased level of immunoglobulin G (IgG), glycosylated heamoglobin (HbA1c), cholesterol, triglycerides, low-density lipoprotein (LDL) and body mass index (BMI). The patient was on anticholinergic agents, antacids, levothyroxine, multivitamin along with iron and antihistamine drugs since 1 year, but with not much relief. Patient was treated with classical Virechana and Madhutailika Basti. It was observed after the completion of therapy, that there was decrease in IgG, HbA1c, S. cholesterol, S. triglyceride, low density lipoprotein (LDL) and body mass index (BMI). This shows that Virechana and Basti play a significant role in patient with AIP associated with other disorders.
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An experimental study to evaluate the effect of Nitya Sevaniya (daily consumable) and Nitya Asevaniya (daily non-consumable) food items on albino rats p. 247
Saylee Deshmukh, Mahesh Vyas, Mukesh Kumar B. Nariya
Background: As per Ayurveda, Nitya Sevaniya (NS) food items are recommended for daily intake while Nitya Asevaniya (NAS) food items should be avoided for daily intake due to their systemic wholesome and unwholesome effects after consumption, respectively. Aim and Objectives: The present study was conducted to perform in vivo safety evaluation of selected Nitya Sevaniya and Nitya Asevaniya food items. Materials and Methods: Thirty rats were randomly divided into five groups-each containing six Charle's Foster strain albino rats. Group 1 served as standard diet group, groups 2 and 3 served as test drug received groups namely NS50 and NS100, in which 50% and 100% mixture of Nitya Sevaniya food was administered, respectively. Group 4 and 5 as test drug received groups Nitya Asevaniya 50 (NAS50) and Nitya Asevaniya 100 (NAS100), in which 50% and 100% Nitya Asevaniya food mixtures was administered, respectively. The test diet was administered orally in the form of freshly prepared pellet twice a day ad libitum for 90 days. Parameters studied were gross behavior, body and organ weight, food and water intake, fecal and urine output, hematological and biochemical parameters, electrocardiogram and histology of various organs. Results: In the NAS100 group, a significant change was observed in 20 of 47 parameters in view of pathological aspect. Among them, three parameters, i.e., platelet count, serum glutamic-oxaloacetic transaminase (SGOT) and indirect bilirubin were above normal limits, while other parameters were within the normal limits. No significant change was observed in any of the parameters in the NS50 and NS100 group after 90 days of administration as compared with the control group. Conclusion: Considering findings of this study, it is concluded that selected NS food items are safe while consumption of only selected Nitya Asevaniya food items (when administered in 100% dose) for 90 days have the potential of inflammatory changes in the liver, spleen; fat deposition in kidney and impairment of cardiac and renal functions.
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In vitro antioxidant activity of Erycibe paniculata Roxb. – An ethnomedicinal plant p. 256
Minautee R Patel, Amit G Patel, Rakesh V Gamit, Mukesh Kumar B. Nariya, Rabinarayan Acharya
Background: Erycibe paniculata Roxb. (Family-Convolvulaceae) has been reported for its potential ethno medicinal value. Leaf, stem, bark, and root of this plant are being used either single or in the mixture of the whole part in different disease conditions by different tribes. Aims and Objectives: The aim and objective of this study is to assess the antioxidant activity of methanolic extracts of different parts (leaf, stem, bark, and root) of Erycibe paniculata Roxb (E. paniculata). Materials and Methods: Different in-vitro assay such as free radical-scavenging assay by 2,2-diphenyl-1-picryl-hydrazyl-hydrate method, reducing power, super oxide radical scavenging, nitric oxide, and hydrogen peroxide scavenging assays were used to determine the antioxidant activity of different parts of E. paniculata. Ascorbic acid, sodium nitrite, and gallic acid were used as the standards for antioxidant activity. Results: The percentage inhibition for all methods were plotted against different concentration and suggested that the obtained activities were concentration and dose depended. Inhibitory concentration (IC50) value of methanolic extract of leaf, stem, bark, and root of E. paniculata in different in vitro activities exhibited significant antioxidant activity. Methanolic extract of bark showed higher IC50 value in all antioxidant assays than other parts of E. paniculata. Conclusion: Methanolic extract of leaf, stem, bark, and root of E. paniculata has potential antioxidant activity.
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Screening of herbal medicines for potential allopathic antidiabetic adulterants: An analytical study p. 262
Girish Pamidimarri, Jayanthi Mathaiyan, S Manikandan, S Rajan, Gitanjali Batmanabane
Background: There are several reports worldwide on adulteration of herbal medicines (HMs) with allopathic drugs. In India, only a few studies have reported adulteration of HMs with antidiabetics and there are no systematic studies. Aims: To develop a rapid and validated method for detection of allopathic antidiabetic adulterants and to explore the extent of adulteration in HMs sold in South India. Materials and Methods: Standards and solvents were purchased from Sigma-Aldrich. Different brands of antidiabetic HM samples with manufacturing licenses were procured from dispensaries. Spiked drug free psyllium husk as solid and flask seed oil as liquid herbal matrices were used for method development. The spiked matrices with different concentrations were extracted with methanol and subjected to centrifugation. The supernatant was collected and analyzed by liquid chromatography-tandem mass spectrometry (LC-MS/MS). Isocratic elution was carried on a C18 column with 0.1% (v/v) formic acid:methanol (3:7, v/v) as a mobile phase. All drugs were monitored for two ion products in positive electrospray ionization mode using multiple reaction monitoring scans. Results: The retention time was 9 min. Limit of detection is 10 Pictograms (pg) for all analytes except for metformin, which was 370 pg. Recoveries of analytes range from 96% to 117%. Forty different brands of antidiabetic HMs were analyzed. Adulterant peaks were not observed in the mass chromatograms of HMs. Conclusions: A single-run method was developed by LC-MS/MS for the detection of proposed antidiabetics in HMs from licensed manufacturing units and online sold HMs across herbal dispensaries in Puducherry union territory, India. None of the HMs was found to be adulterated with proposed allopathic antidiabetic adulterants.
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