Journal of Research in Ayurvedic Sciences

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2020 | July-September | Volume 4 | Issue 3

EDITORIAL

Novel COVID-19 Pandemic: CCRAS R&D Initiatives

[Year:2020] [Month:July-September] [Volume:4] [Number:3] [Pages:1] [Pages No:00 - 00]

PDF  |  DOI: 10.5005/jras-4-3-v  |  Open Access |  How to cite  | 

Survey Study

S Krishna Rao, Indu Sabu, Sophia Jameela, Jaiprakash Ram, Meda M Rao

A Cross-sectional Study on Knowledge, Attitude, and Practice among Ayurveda Fraternity in the Management of Viral Infections of Respiratory Tract w.s.r. to Pranavaha Sroto Vikara on the Backdrop of COVID-19 Pandemic

[Year:2020] [Month:July-September] [Volume:4] [Number:3] [Pages:17] [Pages No:77 - 93]

Keywords: Ayurveda, COVID-19, Knowledge, attitude, and practice, Pranavaha srotas, Survey, Viral respiratory infections

PDF  |  DOI: 10.5005/jras-10064-0107  |  Open Access |  How to cite  | 

Abstract

The world has been witnessing threats due to different types of viral infections of respiratory system like the recent coronavirus disease-2019 (COVID-19) pandemic. Unfortunately, the conventional system of medicine has not come up with a successful strategy for the management of cases or for effective prevention. The development of a successful drug or novel vaccine is imperative at this stage of the outbreak and numerous research activities are underway. Ayurveda has legacy in the prevention and management of different types of diseases including viral infections, but with little documented evidence. In this study, Ayurveda physicians knowledge, attitude, and practice (KAP) toward the management of viral respiratory infections using a self-developed online KAP questionnaire having 28 questions was assessed. Six hundred and three Ayurveda physicians all over India across different affiliation and practice settings participated in the survey with a 65% response rate. Majority of respondents (73.4%) manage different types of viral infections and 85.3% positively responded to the involvement of gastrointestinal (GI) symptoms in viral respiratory infections. Nearly all the participants (98%) confirm the involvement of Pranavaha Srotas in the pathogenesis and 73% confirm the role of Agni also. The viral respiratory infections of respiratory tract are correlated mainly to Jvara, Shvasa, Kasa, and Agantu Roga. 79.43% physicians positively responded to the involvement of diet and regimens in the management of viral diseases. Sixty-six percent of the respondents manage such infections in line of Jvara, while 96.28% recommends that there is a definite role of Rasayana drugs and formulations in the management. Among the line of treatment suggested in the management of COVID-19 like illness, Jvarahara, and immune-modulation were the most recommended ones. Ayurveda manages various novel infections by its customized strategies ranging from prevention and therapeutic intervention. Ayurveda uses different seasonal and daily regimens; Rasayanas, suitable Shamana, and Shodhana interventions are selected based on different assessments to evaluate various aspects of disease and specific attributes of the patient. Systematic documentation and evidence generation may shed light on the importance of Ayurveda in combating novel infections of the present and future.

REVIEW ARTICLE

Sudha K Chiluveri, Ashwin C Chiluveri, Shobhit Kumar, Deepak J Londhe, Rajeshwari Singh, Sumeet Goel, BCS Rao

Ayurveda Arsenal for Strengthening Host Defense System against SARS-CoV-2 Infection and Need for Whole System Research: A Narrative Review

[Year:2020] [Month:July-September] [Volume:4] [Number:3] [Pages:10] [Pages No:94 - 103]

Keywords: Antiviral, Ayurveda, COVID-19, Immunity, Rasayana, Vyadhikshamatwa, Whole system research

PDF  |  DOI: 10.5005/jras-10064-0108  |  Open Access |  How to cite  | 

Abstract

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has become a major public health menace. Along with the conventional medicine, Ayurveda is also exploring various single herbs and compound formulations against coronavirus disease-2019 (COVID-19). The present paper is an attempt to explore the Ayurveda arsenal in strengthening the host defense system against SARS-CoV-2 infection and the relevance and necessity for whole system research. For the present study, Ayurveda classics, Ayurveda Pharmacopoeia, and Formulary were probed to obtain an insight into the diseases as well as relevant therapeutic formulations. The electronic databases Google Scholar and PubMed were searched for relevant contemporary literature. The host response to SARS-CoV-2 infection is either well-coordinated healthy or dysfunctional immune responses. It is crucial to determine the host factors that influence the consequences of host–agent interaction. Factors conducive to the maintenance of good health (Swasthyam yena anuvartate) and preventing the attacks of diseases (Ajatanam Vikaranam Anutpattikara) mentioned in Ayurveda may be considered as pivotal factors influencing homoeostatic (Samayogavahi) mechanisms of host defense system (Vyadhi-Utpada-Pratibandhakatvam and Vyadhi-Bala-Virodhitvam). Furthermore, it is observed that current research practice of Ayurveda is predominantly drug-based, reflecting the perspective of conventional medicine module, however, compromising the core principles of Ayurveda. Finding effective solutions to COVID-19 pandemic, the Ayurveda arsenal for strengthening host defense system needed to be explored. The holistic method of Ayurveda followed in its clinical practice is needed to be adopted for clinical research as well, with focus on whole system research as compared to drug-based in order to generate tangible evidence.

REVIEW ARTICLE

Rashmi P Gurao, UR Shekhar Namburi, Shobhit Kumar, Nakul V Khode, Darshan M Mahulkar

Pathogenesis of COVID-19: A Review on Integrative Understanding through Ayurveda

[Year:2020] [Month:July-September] [Volume:4] [Number:3] [Pages:9] [Pages No:104 - 112]

Keywords: Ayurveda, Bhuta, Bhutabhishangaja jwara, COVID-19, Janapadodhwamsa, Nidana Panchaka, Pranavaha Srotodushti Lakshana, Shatkriyakala

PDF  |  DOI: 10.5005/jras-10064-0110  |  Open Access |  How to cite  | 

Abstract

COVID-19 is a new pandemic disease declared by the WHO as a global emergency and caused due to severe acute respiratory corona virus syndrome-2 (SARS-CoV-2). In India also, the grip of coronavirus is tightening day by day. The scientists worldwide are striving vigorously to ascertain the nuances in the etiology, spread, and pathogenesis of new COVID-19 disease and pragmatic utilization of this knowledge for the development of standard drugs as well as treatment protocols for its successful management. Ayurveda has laid emphasis on the Roga Parijnana in the context of Nidana Panchaka and Shatkriyakala in the management of any disease and it acts as a beacon especially in the case of novel diseases that surface from time to time. The present review study is to formulate the pathogenesis of COVID-19 in the light of Ayurveda through an integrated approach. The COVID-19 pandemic is considered as one type of Janapadodhwamsa. In Ayurveda, the microbial infection can be elucidated in the terms of Bhuta, Rakshasa, Graha, etc., having idiosyncratic manifestations. The coronavirus can be contemplated as distinct type of Bhuta affecting Pranavaha Srotasa and causing Bhutabhishangaja Jwara, which is one type of Agantuja Jwara. Later as the disease advances, it gets metamorphosed into Nija Vyadhi (endogenous form) exhibiting as different forms of Jwara depending on the extent of vitiation of Dosha along with extensive Pranavaha Srotodushtijanya Vikaras. The factors involved in pathophysiology of any disease mainly Nidana (etiology), Dosha, Dushya (Dhatu, Srotasa), and Agni are reciprocally interlinked with severity and stage of disease. It is crucial to recognize extent of vitiation of each of these factors in order to determine customized diagnosis and management for the patients of COVID-19. The integrative approach plays a vital role in meticulous comprehension of COVID-19 in terms of Ayurveda to recognize each stage for specific management.

REVIEW ARTICLE

Aleena Gauri, Pramod Yadav, Pradeep K Prajapati

Possible Potential of Tamra Bhasma (Calcined Copper) in COVID-19 Management

[Year:2020] [Month:July-September] [Volume:4] [Number:3] [Pages:8] [Pages No:113 - 120]

Keywords: Ayurveda, Calcined copper, Coronavirus, COVID-19, SARS-CoV-2, Tamra Bhasma

PDF  |  DOI: 10.5005/jras-10064-0111  |  Open Access |  How to cite  | 

Abstract

The complete genome sequence of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) is 82% similar to SARS-CoV-1. The emerging coronaviruses, including SARS-CoV-1 and Middle East respiratory syndrome coronavirus (MERS-CoV), have caused the recent pandemics of respiratory infectious diseases. Ayurveda makes use of metals and minerals in the form of Bhasma (calx) to treat various ailments. Ancient seers recommend Tamra Bhasma (calcined copper) and its formulations in various conditions including Kasa (cough), Shwasa (respiratory distress), Jwara (fever), Pinasa (chronic rhinitis/sinusitis), and as a Rasayana (rejuvenator). Rasa Bhasmas are claimed as biologically produced nanoparticles. The world is in need of an effective prophylactic and therapeutic agent for the prevention and control of coronavirus disease-2019 (COVID-19). This review article aims at suggesting Tamra Bhasma as a possible intervention in COVID-19. Calcined copper has been reported as sulfide and/or oxide of copper in major phases and some other trace elements. Safety aspects of calcined copper have been established previously. Copper was recognized in 2008 by the United States Environmental Protection Agency as the first metallic antimicrobial agent. Various studies show antimicrobial effect of copper, copper alloys, and various cupric and cuprous compounds against different viruses. Based on the evidences found in classical texts and preexisting antiviral studies, a lead can be made to employ calcined copper for its preclinical and clinical efficacy evaluation against the novel coronavirus SARS-CoV-2.

PROTOCOL

Azeem Ahmad, Amit K Rai, Himanshu Negandhi, Manohar S Gundeti, BCS Rao

Efficacy and Safety of Ayurveda Interventions as Stand-alone or Adjuvant Therapy in Management of COVID-19: A Systematic Review Protocol

[Year:2020] [Month:July-September] [Volume:4] [Number:3] [Pages:7] [Pages No:121 - 127]

Keywords: Ayurveda, COVID-19, SARS-CoV-2, Systematic review

PDF  |  DOI: 10.5005/jras-10064-0112  |  Open Access |  How to cite  | 

Abstract

Background: Coronavirus disease (COVID-19) is a highly infectious disease caused by the SARS-CoV-2 virus. World Health Organization (WHO) labeled it as a pandemic on March 11, 2020. Currently, there is no approved vaccine or treatment for the prevention and management of COVID-19, although multiple pharmacological/nonpharmacological options are being explored. Several clinical trials are going on in conventional as well as traditional medicines to find out an effective and safe treatment regimen. Aim: To study and identify Ayurveda interventions for the management of patients with COVID-19 as a stand-alone or an adjuvant therapy in clinical practice. Materials and methods: A systematic review protocol was developed based on the PRISMA-P statement. Articles for review will be selected from AYUSH Research Portal\'s “National Repository on AYUSH COVID-19 Clinical and Other R&D Initiatives” and other electronic databases, i.e., PubMed, Cochrane Central Register of Controlled Trials, DHARA, IndMED, Google Scholar, etc. Readily accessible peer-reviewed full articles published in English or Hindi will be included. There will be no restrictions on the type of study or study setting or date of publication. Data from the included studies will be extracted independently by two review authors on study characteristics (i.e., authorship, publication-related information, methodology, participants, interventions, comparators, outcomes, and results) in a prestructured format for assessment of study quality and data analysis. The risk of bias in included studies will be assessed through suitable existing tools. We will conduct meta-analysis only when the included studies will be sufficiently homogeneous in terms of design, study population characteristics, interventions, and outcome measures. If it is not possible to conduct a meta-analysis, we will summarize the results of included studies as systematic qualitative synthesis. Conclusion: The results generated from this review will be helpful in identifying the status of evidence regarding the efficacy and safety of Ayurvedic interventions for the management of COVID-19. It will also provide ideas for future research to generate good-quality evidence regarding the efficacy of Ayurvedic interventions in COVID-19. Study registration: Registered with PROSPERO - [CRD42020206588].

SHORT COMMUNICATION

Deepak J Londhe, Shobhit Kumar, Ashwin C Chiluveri, Sumeet Goel, Sudha K Chiluveri, Rajeshwari Singh, BCS Rao

Ayurveda Research Studies on COVID-19 Registered in Clinical Trials Registry of India: A Critical Appraisal

[Year:2020] [Month:July-September] [Volume:4] [Number:3] [Pages:7] [Pages No:128 - 134]

Keywords: Ayurveda clinical trials, COVID-19, Clinical Trial Registry of India, Ministry of AYUSH

PDF  |  DOI: 10.5005/jras-10064-0113  |  Open Access |  How to cite  | 

Abstract

Introduction: In search of effective therapeutics or vaccines to treat or prevent coronavirus disease-2019 (COVID-19), various National Governments, World Health Organization (WHO), and associated partners are working on war footing to coordinate the rapid development of medical countermeasures by conducting various clinical trials. To date, several clinical trials, both Western and traditional medicines, have been registered in Clinical Trial Registry of India (CTRI). However, the relevant literature regarding clinical trials involving Ayurveda intervention on COVID-19 has not been published. In the current article, attempt has been made to extract, review, and summarize the relevant data regarding registered clinical trials under CTRI involving Ayurveda for COVID-19. Materials and methods: CTRI has been searched comprehensively for the registered trials of COVID-19 involving Ayurveda Intervention from March 01, 2020 to June 25, 2020. For each study, the CTRI registration details, demographic characteristics, and study methodology including design are collected and summarized. Results: Till June 25, 2020, a total of 58 trials were identified in CTRI, and of them 52 (89.66%) are interventional trials and 06 (10.34%) are observational trials. Majority of the registered trials are Government sponsored 39 (67.24%). Interventional prophylactic trials were found to be registered in equal proportion to the interventional therapeutic trials (26 each of the total 52 registered interventional trials). Majority of trials are controlled (35, 60.34%), and the allocation of participants into treatment or controlled groups is done by randomization in (24, 41.37%) of controlled trials. The maximum proportions of trials are open-label trials (47, 81.03%), and only three trials are double-blind placebo-controlled trials. All the intervention prophylactic trials are standalone (26, 100%); however, majority of the intervention therapeutic trials are adjunctive (17, 65.38%) to standard of care (conventional medicine). Interventional agent in most of the trials is either multiple drug combinations (23, 44.23%) or compound drug formulations (21, 40.38%) compared to single drug administration (8, 15.38%). Conclusion: The article provides an insight into the CTRI registered trials involving Ayurveda and COVID-19 till June 25, 2020. Although certain issues have been observed related to the design of trials, however, the efforts put in by various stakeholders of Ayurveda, especially Ministry of AYUSH is laudable. Once completed, the results of these promising studies should be published at the earliest, and accordingly the policy makers from Traditional system of medicines should strategize effective solutions to benefit public health in these challenging times.