Journal of Research in Ayurvedic Sciences

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2018 | January-March | Volume 2 | Issue 1

RESEARCH ARTICLE

Maheswar Thugutla, Avinash K Jain, Shashi Ghosh, Varanasi Subhose, Vinod B Kumavat, Rakesh K Rana, Bharti

Clinical Efficacy of Classical Ayurvedic Formulations Vatari Guggulu, Rasnasaptaka Kashaya, and Brihat Saindhavadya Taila in the Management of Rheumatoid Arthritis (Amavata): An Open-label Prospective Randomized Multicenter Study

[Year:2018] [Month:January-March] [Volume:2] [Number:1] [Pages:11] [Pages No:1 - 11]

Keywords: Amavata, Ayurveda, Ayurvedic formulations, Efficacy, Rheumatoid arthritis, Safety.

PDF  |  DOI: 10.5005/jp-journals-10064-0033  |  Open Access |  How to cite  | 

Abstract

Introduction: Rheumatoid arthritis (RA) is an autoimmune disease resulting in chronic inflammation of the joints and extra-articular tissues characterized by persistent inflammatory synovitis, usually involving the peripheral joints in a symmetric manner. The disease Amavata described in Ayurveda has similar symptomatology to that of RA. Aims and objectives: To a ssess t he c linical e fficacy a nd safety of Vatari Guggulu, Rasnasaptaka kashaya, and Brihat Saindhavadya taila in patients suffering from RA. Materials and methods: A prospective, open-label multicenter study was carried out at four peripheral centers of the Central Council for Research in Ayurvedic Sciences (CCRAS). A total of 230 patients of RA satisfying the selection criteria were enrolled from the outpatient department (OPD) of these centers and were administered Vatari Guggulu 1.5 gm (3 tablets of 500 mg each) twice daily after food with lukewarm water, and Rasnasaptaka kashaya 15 ml with 1 gm Shunthi churna twice daily internally before food in group I and in group II along with these two drugs, Brihat Saindhavadya taila 20 ml was used twice daily for external application over affected joints. The duration of the treatment was 12 weeks. Paired sample t-test was used to compare mean change in the subjective and objective parameters, Disease Activity Score (DAS-28), disability index (the Indian Health Assessment Questionnaire), change in acute phase reactants—erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and Health Questionnaire short form (SF)-36 score from baseline to the 84th day. A p-value <0.05 was considered significant. Results: At the end of treatment (after a period of 84 days), statistically significant change (p-value <0.001) was observed in DAS-28 score, Disability index (the Indian Health Assessment Questionnaire), and Health Questionnaire SF-36 score in both the groups. Slight change in acute phase reactants—ESR, CRP—was also observed as compared with baseline; however, it was statistically insignificant. Conclusion: Vatari Guggulu, Rasnasaptaka kashaya (with Shunthi churna prakshepa), and Brihat Saindhavadya taila given in the above-mentioned dose were found effective and safe in patients suffering from RA.

RESEARCH ARTICLE

Paravazhi Radhakrishanan, Varanasi Subose, Guru C Bhuyan

Evaluation of Vyoshadi Guggulu and Haritaki Churna in the Management of Dyslipidemia: A Multicenter Prospective Clinical Study

[Year:2018] [Month:January-March] [Volume:2] [Number:1] [Pages:8] [Pages No:12 - 19]

Keywords: Ayurveda, Dyslipidemia, Haritaki Churna, Medoroga, Quality of life, Vyoshadi Guggulu.

PDF  |  DOI: 10.5005/jp-journals-10064-0034  |  Open Access |  How to cite  | 

Abstract

Introduction: Dyslipidemia (DL) is a principal risk factor in the pathophysiology of cardiovascular diseases (CVD) and diabetes mellitus (DM). It may correlate with Medoroga, which is a risk factor for diseases like Prameha, Hridroga Jwara, Bhagandara, Vrana, Vataroga, etc. Aim: To assess the clinical efficacy of Vyoshadi Guggulu (VG) and Haritaki Churna (HC) in the management of DL and changes in the quality of life of the study participants. Materials and methods: It was a prospective, multicenter, single-arm study. The Ayurvedic formulations VG (2 tablets of 500 mg each TDS) after food with lukewarm water and HC (3 gm bd) were administered for 12 weeks with a follow-up of 2 weeks without interventions. Totally, 146 participants belonging to either sex, 18 to 70 years with low-density lipoprotein (LDL) 100 to 160 mg/dL and/or serum cholesterol 200 to 250 mg/dL and/or serum triglycerides (TG) 150 to 250 mg/dL and those willing and able to participate were included in the study. The outcome measures were changes in lipid profile, clinical safety, and changes in the quality of life. Results: There was a significant reduction (p < 0.005) in the mean serum cholesterol level, i.e., 214.8 reduced to 208.3 after 84 days of treatment and (p < 0.001) in the mean high-density lipoprotein (HDL), i.e., 46.3 reduced to 44.04 after 84 days of treatment. There was no significant change in the serum TG, LDL, and very-low density lipoprotein (VLDL) value. There is also improvement in the quality of life (p < 0.001) of the participants. There are no significant changes observed in the laboratory safety parameters. This corroborated that drugs are safe to use. Conclusion: Vyoshadi Guggulu and Haritaki Churna are effective in the management of DL and are safe to use. Clinical significance: The use of these drugs may lower the complications of DL.

RESEARCH ARTICLE

Clinical Evaluation of Three Source Drugs of Trivrut on Purishaja Anaha (Constipation): Randomized Comparative Double-blind Clinical Study

[Year:2018] [Month:January-March] [Volume:2] [Number:1] [Pages:7] [Pages No:20 - 26]

Keywords: Marsdenia tenacissima, Operculina petaloidea, Operculina turpethum, Shweta Trivrut, Shyama Trivrut.

PDF  |  DOI: 10.5005/jp-journals-10064-0035  |  Open Access |  How to cite  | 

Abstract

Introduction: Trivrut is depicted as the best drug among Sukhavirechana (mild laxative). Based on the color, two varieties, Shyama (black) and Aruna (red), have been opined, where Shyama is said to be drastic purgative and mentioned with some side effect in classical texts of Ayurveda. Rechaniya Dravya (laxative drugs) is advised in Purishaja Anaha (constipation). Aim: To evaluate the therapeutic efficacy of Operculina turpethum, Marsdenia tenacissima, and Operculina petaloidea in patients suffering from Purishaja Anaha. Materials and methods: Randomized comparative doubleblind study was conducted on 90 patients divided equally into three groups; 5 gm dose of root bark powder was administered for 3 days and follow-up was taken after 7 days. Result was assessed with Wilcoxon signed-rank tests for subjective parameters in single group and analysis of variance (ANOVA) followed by Dunnett\'s multiple comparison test for in-between groups comparison. Results: Moderate improvement was observed in 36.67% patients in O. petaloidea and mild improvement was observed in 70% patients in O. turpethum-treated group, whereas 63.33% patients in M. tenacissima group showed insignificant result. In the assessment of purgative effect of the drug, O. turpethum and O. petaloidea showed better result as compared with M. tenacissima. Conclusion: In all the studied parameters, O. turpethum showed better result.

RESEARCH ARTICLE

Sandhya Rani, Arun Bhadula, Vinod K Shahi, Bharti

Integration of AYUSH (Ayurveda and Yoga) with National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS): An Appraisal of Central Council for Research in Ayurvedic Sciences Research and Development Initiatives

[Year:2018] [Month:January-March] [Volume:2] [Number:1] [Pages:10] [Pages No:27 - 36]

Keywords: Integration, Lifestyle, Noncommunicable disease.

PDF  |  DOI: 10.5005/jp-journals-10064-0036  |  Open Access |  How to cite  | 

Abstract

Introduction: Noncommunicable diseases (NCDs) include cardiovascular diseases, diabetes, hypertension, stroke, cancer, etc. Such diseases mainly result from lifestyle-related factors, such as unhealthy diet, lack of physical activity, use of tobacco, etc. Changes in lifestyles, behavioral patterns, demographic profile, sociocultural and technological advancements lead to sharp increase in the prevalence of NCDs. These diseases, by and large, can be prevented by making simple changes in the way people live their lives or by simply changing our lifestyle. Aims and objectives: Central Council of Research in Ayurvedic Sciences, Ministry of AYUSH in collaboration with Directorate General of Health Services, Ministry of Health and Family Welfare has implemented and executed a program, viz., Integration of AYUSH (Ayurveda) component with National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) program in the identified districts of three states, viz., Bhilwara (Rajasthan), Surendranagar (Gujarat), and Gaya (Bihar), with an aim to cater health care services and to reduce the burden of NCDs by combining the strength of Ayurveda and Yoga. Materials and methods: This program has been implemented on a pilot basis in three districts of the three states at three district hospitals (DHs), 49 community health centers (CHCs), and 183 primary health centers (PHCs) (71 at Gaya, 37 at Surendranagar, and 75 at Bhilwara). In view of etiology of NCDs’ pharmacological and nonpharmacological interventions, lifestyle and Yoga have been advocated. Sixteen common Ayurvedic medicines were identified for the prevention and management of the NCDs. Training to human resource was provided through various training programs before implementation. Outcomes: The aforesaid program is successfully functional in 52 centers (49 CHCs and 3 DHs) of all the three identified districts. This program boosted the referrals and cross-referrals of patients among conventional and various AYUSH systems.

REVIEW ARTICLE

Konica Gera, Nellufar Siddique, Baldev K Dhiman

An Analytical Review of Acharya Charaka's Perspective of Diet in Pramehi W.S.R. to Honey, Semidigested Foods, and Aged Grains

[Year:2018] [Month:January-March] [Volume:2] [Number:1] [Pages:5] [Pages No:37 - 41]

Keywords: Diabetes mellitus, Glucose metabolism, Honey and diabetes mellitus, Insulin, Medicinal plants research, Prameha.

PDF  |  DOI: 10.5005/jp-journals-10064-0037  |  Open Access |  How to cite  | 

Abstract

Introduction: Acharya did mention the aushadha for the vyadhi but never skipped the ahara-vihara leading to the pathogenesis and necessary for healthy state. The importance of plants consumed in the form of ahara is highlighted by Acharya themselves at each step while explaining the etiopathogenesis of any disorder along with their cures. Objective: There is an urgent need to revalidate the concepts listed by Acharya by the parameters of the present era to facilitate their usage without any hindrances. Portrayal of concept of ahara-vidhana in Prameha, as given in Charaka Samhita, seems impractical and to enlighten the hidden reasons behind such special and contradictory diet concepts. Materials and methods: Charaka Samhita and available commentaries were explored for the analytical review of the references and in-depth understanding of the various ahara mentioned in the context of diabetes. Further exploration, interaction, and interpretation of traditional knowledge in the light of contemporary core sciences and biomedical sciences. Results and conclusion: Honey in diabetes mellitus (DM) seems to be contrary to the running trends, but compared with sucrose and glucose, because of its lower glycemic index and production of significant higher level of c-peptide, it may be used as sugar substitute in diabetic patients. Grain aging brings changes in the water absorption properties. The starch granules forming the major part of the endosperm of the grain can be damaged causing change in starch functionality and oxidation of components, including fatty acids and proteins. The concept of semidigested food seems to be scientifically rational. Clinical significance: The present integrative review strengthens the concepts of Acharya that seem impractical in the present era. The sound base of the evidences paves way for the clinical implementation of the concepts in the patients of Prameha with confidence.

REVIEW ARTICLE

Shital Chinchalkar, Raman Kaushik

Garbha Samskar: Ayurveda Way of Epigenetic Programming

[Year:2018] [Month:January-March] [Volume:2] [Number:1] [Pages:8] [Pages No:42 - 49]

Keywords: Antenatal care, Epigenetics, Garbhadan samskar, Garbhini Paricharya.

PDF  |  DOI: 10.5005/jp-journals-10064-0038  |  Open Access |  How to cite  | 

Abstract

Background: It is the need of the hour to establish the role of Ayurveda in antenatal care, which is under national rural health programs. Human evolvement throughout the conception to adulthood is conjoined association, shaped within cells, of nature [the deoxyribonucleic acid (DNA) we inherit] and nurture (the comprehensive nutritional, social, and physical environment). The augmenting field of epigenetic has perception that environment and individual lifestyle can directly interact with genome to influence epigenetic transformation. Ayurveda sighted the urge for the physical, mental, and spiritual anticipation of the mother to be for the momentous event of childbirth and emphasis has been given on care of mother during antenatal period. Aim: To ascertain the importance of Garbha Samskar with special reference to epigenetic programming and antenatal care. Results: Developing living being seems to have a wide range of perceptivity to epigenetic modulation. Befitting drift in epigenetic modifications is essential for embryogenesis, early fetal development, and early postnatal growth. Thereupon, the inappropriate endowment of epigenetic changes during critical developmental periods as a result of changes in maternal diet and other environmental components may induce pediatric developmental diseases and even influence health in adulthood. Garbha Samskar as explained in classical texts of Ayurveda involves the combination of Garbhadan samskar (preparation of to be mother and father prior 3 months of conception) and Garbhini Paricharya (planned program of observation, education, lifestyle modification, nutritional and medical management of pregnant lady). Conclusion: By adopting the custom of Garbha Samskar, antenatal care along with epigenetic programming can be done in order to have a healthy progeny. Clinical significance: Garbha Samskar may be considered as Ayurveda antenatal care and a novel preventive measure in the context of adverse epigenetic changes.

CASE REPORT

Anup Jain, Divya Gupta, Arun Gupta, Vishakha Wetal

Abhighataja Katigraha: A Case Study

[Year:2018] [Month:January-March] [Volume:2] [Number:1] [Pages:5] [Pages No:50 - 54]

Keywords: Katigraha, Kativasti, Marma chikitsa, Patra pind sweda.

PDF  |  DOI: 10.5005/jp-journals-10064-0039  |  Open Access |  How to cite  | 

Abstract

Rationale: Back pain is one of the common painful conditions experienced by people of all age groups. The commonest site of pain in the back is the lower lumber region, which is expressed as lumbago in medical terminology. The region is subjected to injury more frequently because this region possesses greater freedom of movement. The lumbosacral region is, therefore, subjected to mechanical strain, which is common after the 3rd or 4th decade of life. Surgical treatment in modern medicine may not guarantee previous level of activity. Ayurveda can provide a suitable treatment through appropriate panchkarma modalities useful in such disorders. Background: A female patient of 17 years, student by profession, came to the Panchkarma outpatient department (OPD). The patient was suffering from low back pain (LBP) with history of fall in bathroom 8 months ago. The patient complained of low backache radiating to bilateral lower limb associated with numbness, pain in L5-S1 area. Intervention and outcome: After appropriate analysis based on ayurvedic parameters, the patient was treated with patra pinda pottali sweda and kati basti with ksheera bala oil along with oral medication and Marma chikitsa. Before treatment her Oswestry\'s disability scoring was 34 and after treatment her score decreased to 6. Thus, the treatment module shows significant relief in the symptoms by 76.47%.

CASE REPORT

Riju Agarwal, Manju Rani, Kamini Dhiman

Idiopathic Isolated (Right) Complete Oculomotor Nerve Palsy Management with Ayurvedic Treatment

[Year:2018] [Month:January-March] [Volume:2] [Number:1] [Pages:5] [Pages No:55 - 59]

Keywords: Ayurveda, Ayurvedic treatment, Oculomotor palsy, Ophthalmology, Shalakya Tantra.

PDF  |  DOI: 10.5005/jp-journals-10064-0040  |  Open Access |  How to cite  | 

Abstract

Aim: To assess the efficacy of ayurvedic treatment in isolated complete oculomotor nerve palsy by subjective evaluation. Materials and methods: Prospective interventional case report supplemented by ayurvedic treatment. Using a subjective evaluation, outcome was defined according to patient\'s perspective based on improvement in eye movement and ptosis. A patient 33-year-old male resident of Delhi running a private business in marketing presented with complaints of not being able to open his right eye along with decreased movements. He was apparently well 2.5 months back, then he developed nausea and vomiting for 1 week and headache (on right half). With these complaints the patient came to Netra Roga outpatient department (OPD) no 15 (ophthalmology) of Shalakya Tantra Department at Ch. Brahm Prakash Ayurved Charak Sansthan. He took treatment for 2 months and got complete remission in his symptoms. Conclusion: Ayurvedic treatment definitely has a role in chronic disease like different types of palsies especially oculomotor nerve palsy. A case series or pilot study should be conducted in similar cases to validate the above case report, which may prevent or treat many cases of oculomotor palsies.

Book Review

Book Review

[Year:2018] [Month:January-March] [Volume:2] [Number:1] [Pages:2] [Pages No:60 - 61]

PDF  |  DOI: 10.5005/jp-jras-2-1-60  |  Open Access |  How to cite  |