BACKGROUND: Sandhivata [osteoarthritis (OA)] is one of the Vata Vyadhi, which causes much suffering for a prolonged period. The cause of Sandhivata in Ayurveda is attributed to improper diet, lifestyle, and old age, leading to aggravation of Vata, and is associated with slow and steady decline in tissue quality and function. The disease specific symptoms of Sandhigata vata are very similar to that of OA. Treatment in OA is targeted for reviving joint function through halting the disease pathogenesis and promotion of joint health and vitality. OBJECTIVE: The objective of this study was to assess the clinical efficacy of Rasnadi Gutika (RG) and Chandrakala Lepa (CKL) in the management of Janusandhigata Vata [osteoarthritis knee (OA knee)]. MATERIALS AND METHODS: The study was conducted at two peripheral institutes of the Central Council for Research in Ayurvedic Sciences, viz., Central Ayurveda Research Institute, Bhubaneswar, Odisha and Regional Ayurveda Research Institute, Lucknow, Uttar Pradesh. A total of 120 patients between the age of 40 and 75 years suffering from primary OA knee joint were treated with RG and CKL. The duration of the therapy was 12 weeks, and follow-up was done on the 14th, 28th, 42nd, 56th, 70th, and 84th days. RG was administered orally in the dose of 1 g twice daily with lukewarm water, and CKL 10 g was applied locally twice daily for 12 weeks. Parameters such as chief complaints of the disease, viz., joint pain on movement, joint pain at rest, restricted joint, crepitus, swollen joint, stiffness, and bony enlargement; total WOMAC score; and quality of life through WHO QOL BREF score were assessed before and after the administration of therapy. RESULTS: The WOMAC score, the key outcome measure, showed statistically significant improvement (P = 0.001) on the 84th day of follow-up. Improvement was noted in all areas, including pain, stiffness, and physical functioning. The physical health, physiological and social relationships, and environmental areas of the WHO QOL BREF score for quality of life were also significantly influenced (P = 0.0001). No adverse drug reactions or adverse events were reported during the trial period. CONCLUSION: Oral administration of RG and external application of CKL are effective for the management of OA knee. However, further clinical study with sufficient sample size may be required to revalidate this study’s findings.

BACKGROUND: Coronavirus disease (COVID-19) pandemic has evolved as a unique, unprecedented global health crisis that has severely affected the economies and daily lives of people. AYUSH 64 is an Ayurveda formulation repurposed in the COVID-19 management because of its proven efficacy in influenza-like illness. MATERIALS AND METHODS: This was a prospective, open-label, single-arm, pilot study conducted at Ayurveda and Unani Tibbia College (A&U Tibbia) and Hospital, designated COVID-19 health center under the Government of National Capital Territory (NCT) of Delhi. The study population included 40 asymptomatic to mild COVID-19 cases of either sex aged above 18 years admitted to the hospital with positive nasopharyngeal swab test for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (reverse-transcription polymerase chain reaction [RT-PCR]) or rapid antigen test. AYUSH 64 tablets in the dose of two tablets (500 mg each) thrice a day after food with warm water were given to the participants for the period of 7–14 days, and once the patient got RT-PCR negative, the medicine was discontinued. RESULTS: Out of 36 completed cases, 28 participants were symptomatic, 39.28% of participants clinically recovered in 7 days of AYUSH 64 intervention, and 53.5% of participants clinically recovered in 14 days. The mean time for clinical recovery was 7.04 days (±2.88 days standard deviation). No adverse drug reaction was found in any of the participants. Serious adverse event unrelated to the trial drug was reported in two participants (5%) within 24 h of enrolment. CONCLUSION: Among asymptomatic and mild COVID-19 cases, the repurposing of AYUSH 64 was found effective and quite safe to alleviate infection with a significant clinical recovery within 14 days. Subsequent research on a larger scale is warranted for statistically robust evidences in the treatment of COVID-19.

Introduction: Central retinal vein occlusion (CRVO) is clinically classified into ischemic and non-ischemic varieties. Non-ischemic CRVO presents with the blurring of vision and posterior segment findings such as hemorrhages, tortuous blood vessels, cotton-wool spots, and macular edema. Sometimes, cystoid macular edema may be present. Patient Information: A 30-year-old man was diagnosed with non-ischemic CRVO and cystoid macular edema in his right eye. The patient had taken multiple rounds of intraocular injection. The visual acuity of the patient was LogMAR 0.602 in his right eye and LogMAR 0 in his left eye. Posterior segment examination of the patient showed cotton-wool spots, tortuous blood vessels, and some hemorrhages. Optical coherence tomography showed multiple cyst-like lesions at the macula. The patient was treated with four courses of inpatient therapy comprising Ayurveda oral medicines (Kvatha, Churna, and Gutika), Kriyakalpa (local ophthalmic therapies such as Seka, Ashchyotana, Pindi, and Bidalaka), and treatments for the head such as Siroveshtana and Lepa. After treatment the visual acuity readings of the patient was improved, and most of the posterior segment findings were found resolved. Conclusion: The patient experienced positive changes from the treatment. Ayurvedamanagement can be a therapeutic option for non-ischemic CRVO and cystoid macular edema.

This case report presents the treatment outcome of a 9-year-old diagnosed case of acute recurrent pancreatitis (ARP). The patient has suffered recurrent severe abdominal pain, vomiting, and constipation for the past 3 years. The high amylase and lipase levels in the serum, ultrasonography, and magnetic resonance cholangiopancreatography findings confirmed the diagnosis of ARP. The patient regularly took allopathic medicines, yet she had recurrent abdominal pain episodes that required hospitalization. The patient was treated with Ayurveda medicines, including Kamadudha Rasa (Mukta Yukta), Agnitundi Vati (twice daily before meals), and Nityam tablet at bedtime for 3 weeks. In the third week, the treatment was modified by replacing Agnitundi Vati with Kravyad Rasa and Kankayana Vati. The 8-month continued therapy resulted in complete clinical recovery. No adverse reactions or untoward effects due to Ayurveda interventions were reported during the treatment. There was no recurrence after a 90-day follow-up. Based on the results obtained in this case study, a clinical trial on Ayurvedic management of ARP may be planned to prove the efficacy of Ayurveda treatment regimen in treating ARP empirically.

BACKGROUND: Tolosa-Hunt syndrome (THS) is a rare disorder characterized by episodic periorbital pain associated with paralysis of either one or more of the III, IV, or VI cranial nerves. It is usually self-resolving, but relapse may be seen. In Ayurveda, a clinical condition “Vatahata Vartma” is narrated, resembling THS. Based on the resemblance, a diagnosed case of THS was treated by Ayurveda measures and treatment described for the management of Vatahata Vartma.MATERIALS AND METHODS: A 50-year-old man, who was previously diagnosed and underwent treatment for THS, presented with complaints of increased drooping and swelling at his left upper eyelid along with strenuous eyeball movements since February 2021. Drooping of the eyelids was measured by the amount of ptosis, margin-reflex distance, and the function of the levator palpebrae superioris. The patient was treated with Ayurveda oral medicines (herbal decoctions, herbal clarified butter, herbal powders, and herbal tablets), biopurification (therapeutic purgation and retention of medicine in the buccal cavity), and external Ayurveda ocular therapy (ocular irrigation, bolus sudation, eye drops, herbal paste over the eyelids, retention of herbal clarified butter over the eyes, collyrium, paste over the head, and irrigation over the head). The total duration of therapy was 11 months. RESULTS: Swelling and ptosis of the left upper eyelid were reduced, and the patient could do the normal movement of the left upper eyelid. CONCLUSION: THS can be treated with Ayurveda measures and interventions narrated in Ayurveda under Vatahata Vartma. A clinical study on large sample size is required to validate the result obtained in the present case study.

BACKGROUND: The manufacturing process of Ksharasutra is still predominantly manual, even in the current era. It inherently leads to small-scale production and restricted availability of this effective treatment. CCRAS has developed a prototype of an automated machine to manufacture the Ksharasutra on a large scale. OBJECTIVE: This clinical study will investigate the safety and efficacy of the Ksharasutra prepared through the automated machine and compare its efficacy with the manually prepared Ksharasutra. MATERIALS AND METHODS: This study is a double-blind, randomized controlled, parallel-group trial being conducted at the Central Ayurveda Research Institute, New Delhi. A total of 100 participants will be enrolled in the study. Individuals of any sex aged 18–60 years and diagnosed with fistula-in-ano complaining of perianal discharge, pain, tenderness, itching, and induration will be enrolled in the trial. The enrolled participants will be managed by the automated machine-prepared Ksharasutra in the trial group and the manually prepared Ksharasutra in the control group. The Ksharasutra will be changed every week till the fistula tract is completely cut off. The outcome measures include the change in the quality of life (assessed through the SF-36 questionnaire), unit cutting time of the fistula tract, the proportion of participants having complete healing of the fistula tract, and the incidence of adverse events. DISCUSSION: The conventional surgical treatment of fistula-in-ano is associated with a significant recurrence rate and a high risk of impaired anal continence. Compared with conventional treatment, Ksharasutra therapy is simple, cost-effective, and associated with minor post-operative care, minimal complications, and a low recurrence rate. However, small-scale manufacturing due to manual preparation, non-uniformity of techniques involved in the manufacturing of Ksharasutra, and so on limits the availability and quality of this therapy. Awareness regarding the benefits of Ksharasutra therapy and availability of surgeons experienced in this procedure can play a significant role in improving the accessibility of this para-surgical technique. TRIAL REGISTRATION: CTRI/2021/12/038414, dated 3 Dec. 2021