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REVIEW ARTICLE
Scientific review on indication and therapeutic effects of selected nootropic herbs/drugs from Kashyapa Samhita
Shobhit Kumar, Uday Ravi Sekhar Namburi, Ashwin C Chiluveri, Deepak Londhe, Binod B Dora, Sudha K Chiluveri, Shital Chinchalkar
January-March 2021, 5(1):4-12
DOI:10.4103/jras.jras_39_21  
BACKGROUND: Ayurveda Samhita's has documented nootropic drugs, which may play crucial role in brain development during infancy and early childhood. Any deviation in brain development can affect the overall personality and result in low IQ, poor cognitive function, defective learning, impairment in memory, language, speech, and social communication in later life of child. As a result, knowledge of nootropic medicines is critical for dealing with memory-related symptoms in children. Objective: The present review is to explore the therapeutic domain of Medhya Rasayana (nootropic drugs) mentioned by Acharya Kashyapa in the light of recently reported contemporary evidence. Materials and Methods: Kashyapa Samhita was reviewed in terms of description of Medhya Rasayana or Medhya drugs including single and compound drugs. The electronic database such as PubMed and Google Scholar were searched for relevant literature published from time of their inception to 2020, with results restricted to report in English language and information was extracted from different published articles as per the search criteria. Results: Important nootropic drugs mentioned by Acharya Kashyapa are Brahmi (Bacopa monnieri (L.) Wettst.), Mandukaparni (Centella asiatica (L.) Urb.), Triphala (Phyllanthus emblica L., Terminalia bellirica (Gaertn.) Roxb., Terminalia chebula Retz.), Chitraka (Plumbago zeylanica L.), Vacha (Acorus calamus L.), Trivrut (Operculina turpethum (L.) Silva Manso), Shatavari (Asparagus racemosus Willd.), Shatapushpa (Anethum graveolens L.), Nagabala (Grewia hirsuta Vahl.) and Danti (Baliospermum montanum (Willd.) Müll.Arg.), Brahmi Ghrita, Kalyanaka Ghrita, and Pancha-Gavya Ghrita, etc. These herbs/drugs have a positive effect on memory; improve the intellect, learning, memory, language, and speech of a child. Moreover, these drugs have shown potential therapeutic actions like cognitive function, antiepileptic effect, antianxiety effect, sedative, tranquilizer, antidepressant, antioxidant, antistress, and adaptogenic effect. Specific medicinal herbs like Triphala, O. turpethum, and P. zeylanica under nootropic drugs are found to act through “gut-brain” axis. Conclusion: Nootropic drugs mentioned in Kashyapa Samhita is very unique contribution and in recent times these drugs are scientifically validated in pre-clinical and clinical trials, which plays an important role for brain development in pediatric age group. These drugs are clinically tested for promoting mental health since ancient times. Moreover, most of the pre-clinical/clinical studies have proved that nootropic herbs/drugs are useful in many diseases like epilepsy, attention deficit hyperactivity disorder, intellectual disability, autism spectrum disorders, speech disorders, etc. Clinical studies may be planned on pediatric psychological/mental health issues taking leads from the available anecdotal evidence as well as pre-clinical evidence to generate robust empirical evidence which can be used to promote better physical and mental health in a child. CLINICAL SIGNIFICANCE: Nootropic herbs/drugs are unique drugs mentioned by Kashyapa Samhita, which are having evidence for providing better mental health as well as in the treatment of many neurological disorders.
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EDITORIAL
Emphasis on integrative and inclusive health approaches: An essential current need
Narayanam Srikanth
January-March 2021, 5(1):1-3
DOI:10.4103/jras.jras_41_21  
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Scope and limitations of integrated research approaches for corroboration of Ayurveda
Narayanam Srikanth
April-June 2021, 5(2):55-59
DOI:10.4103/jras.jras_62_21  
  302 57 -
REVIEW ARTICLES
Development of practical approach of Sattvavajava Chikitsa for depressive disorders
Dipinti Singh, Jyoti S Tripathi
April-June 2021, 5(2):60-68
DOI:10.4103/jras.jras_17_21  
In today’s modern world, most people are confronted with mental illness at some point in their lives. Depression is a widespread problem that has a detrimental impact on a person’s ability to function and sense of well-being. It has become a worldwide public health concern. Sattvavajava Chikatsa (SC) is an Ayurvedic psychotherapy and psycho-spiritual therapy that promotes mental wellness as well as prevention, management, and treatment of mental disorders. SC works on five basic principles, i.e., promotion of spiritual knowledge, scriptural knowledge, patience, memory, meditation in any patient whenever needed. The concepts of SC are scattered throughout classical texts, making it difficult for Ayurvedic physicians to understand how to practice. This could be due to the fact that psychological diseases are less common than physical illnesses. The goal of this review is to describe and briefly explain the concept of SC, as well as to establish a practical approach/tools based on it, with a particular focus on the management of major depressive disorder (MDD). It will aid in a holistic knowledge of the SC principle, as well as a practical approach based on SC for the management of MDD.
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ORIGINAL ARTICLES
An observational study on health-related demography of women and children belonging to scheduled caste population in selected areas of Thiruvananthapuram district of Kerala state, India
Sinimol T Peethambaran, Pooleriveettil P Meghna, Kishore Gavali, Sarada Ota, Vinodkumar Shahi, Sudhakar Devarakonda, Narayanam Srikanth, Kartar Singh Dhiman
January-March 2021, 5(1):26-35
DOI:10.4103/jras.jras_34_21  
BACKGROUND: The scheduled caste (SC) population of India, especially women and children, lags behind others in the health scenario and the problem should be addressed with emergency concern. AIM: The aim of this article is to describe the health-related demography of women and children of SC population in selected areas of Thiruvananthapuram district of Kerala state, India during the year 2019. MATERIALS AND METHODS: The Reproductive and Child Health project team of Regional Ayurveda Research Institute for Lifestyle-Related Disorders, Thiruvananthapuram conducted health camps at four village panchayaths (village councils), namely, Maranalloor, Venganoor, Vilappil, Poovachal, and Neyyattinkara municipality of Thiruvananthapuram district, Kerala through 240 tours during the period January to December 2019 through a door-to-door household survey for collecting the information on socio-economic and health status. Medical aids were also provided to needy individuals. RESULTS: A total of 5145 individuals were surveyed, which includes 3662 women and 1483 children. In the survey, 62 disease conditions in women and 25 various disorders in children were diagnosed. The most common clinical manifestation found in women and children was Sandhigatavata (polyarthritis) and Agnimandya (digestive impairment), respectively. CONCLUSION: The women and children belonging to SC population in the areas of Thiruvananthapuram district where study was conducted have good health status. However, considering the prevalence of polyarthritis in women and digestive impairment in children, diet and lifestyle related-vigilance needs to be promoted. Ayurveda includes noteworthy guidelines regarding personalized as well as season-based diet and lifestyle. Therefore, increasing vigilance in rural population toward such Ayurveda guidelines along with use of relevant Ayurveda medicines can be a strategy to improve the health status of women and children. IEC number: 9–19/2012-ARIMCHC/Tvpm/Tech/220
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A randomized controlled trial to evaluate the prophylactic efficacy of Chyawanprash in healthcare workers during the COVID-19 pandemic
Arun Gupta, Amit Madan, Babita Yadav, Pallavi Mundada, Richa Singhal, Arunabh Tripathi, Bhogavalli C Rao, Bharti Gupta, Rakesh Rana, Bhagwan Sharma, Yogesh Pandey, Riju Agarwal, Narayanam Srikanth, Kartar Singh Dhiman
January-March 2021, 5(1):13-25
DOI:10.4103/jras.jras_47_21  
INTRODUCTION: Healthcare workers (HCWs) are high-risk individuals in the management of epidemics caused by highly contagious disorders such as coronavirus disease 2019 (COVID-19). Standard of care (SOC) for the prevention of exposure can be greatly supported with SOC measures to improve the immune response. The purpose of this study was to evaluate the effect of combining Chyawanprash, an Ayurvedic formulation, with SOC for prevention versus SOC alone among frontline HCWs through assessment of the proportion of COVID-19 cases among the trial participants during the trial period. METHODS: This open-label, randomized controlled trial was conducted from June 13, 2020 to September 21, 2020 in an Ayurvedic hospital that was functioning as a COVID-19 care center in New Delhi during the pandemic. HCWs between 25 and 60 years of age working in an environment with the possibility of direct exposure to COVID-19 cases were enrolled and observed for 30 days. The interventions compared were SOC as per institutional guidelines and based on their roles (Group I) and SOC in addition to Chyawanprash 12 g twice a day for 30 days (Group II). RESULTS: Out of the 193 participants who completed the study, no participant in both groups was COVID-19 positive at the end of one month. No adverse drug reaction or any serious adverse event was reported during the study. No clinically significant change in the safety parameters were observed. A statistically significant rise in serum IgG level was seen in Group II, but other inflammatory and immune markers did not show any statistically significant difference. In the post-intervention follow-up, four subjects in Group I and two subjects in Group II reported to have developed COVID-19 disease after 2 months of completion of the study period. CONCLUSIONS: Chyawanprash has an immunomodulatory effect in the intervention group, but a longer-term clinical trial with a bigger sample size is needed to confirm its adaptogenic and preventive efficacy as an add-on to standard prophylactic guidelines for prevention of disease. TRIAL REGISTRATION: Clinical Trials Registry of India: CTRI/2020/05/025275 [Registered on: 20/05/2020].
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A retrospective analysis of Ayurvedic clinical management of mild COVID-19 patients
Sumit Srivastava, Harbans Singh, Sanuj Muralidharan, Rijin Mohan, Shikha Chaudhary, Poonam Rani, Unnikrishnan Payyappalli, Narayanam Srikanth
April-June 2021, 5(2):80-86
DOI:10.4103/jras.jras_15_21  
BACKGROUND: The COVID-19 virus is a new contagious pathogen which has made a huge impact on health, economic and societal perspectives of our country. Early detection, rapid isolation, and adoption of effective infection prevention and control (IPC) measures are key to preventing and controlling COVID-19 infection. Patients are now receiving symptomatic treatment. This retrospective study aims to assess and comprehend the effectiveness of Ayurvedic interventions in the treatment of mild symptomatic COVID-19 patients. OBJECTIVE: The objective of this study is to analyze the outcome of Ayurvedic interventions in managing mild symptomatic COVID-19-infected cases. MATERIALS AND METHODS: COVID-19 patients (diagnosed through RT-PCR test) admitted at Shri Dhanwantry Ayurvedic College and Hospital, Chandigarh were treated with Ayurvedic interventions. The data were collected and have been analyzed retrospectively. Data collected were systematically analyzed and presented using appropriate software (SPSS version 21). RESULTS: The treatment given in this particular study were aimed at dissipating the pathogenesis based on Ayurvedic principles of management. Relief in major clinical symptoms such as fever, cough, and throat pain has been observed in studied cases of COVID-19. The clinical recovery rate observed in this study was 94.3%, which is comparatively high with reference to the current clinical recovery rate, i.e., 69.5% in Chandigarh (India). CONCLUSION: The Ayurvedic interventions, AYUSH-64, Agasthya Hareetaki Rasayana, and Anu Taila Nasya, may play a major role in managing mild symptomatic cases of COVID-19. IEC number: 8-55/2020-CARIRD/TECH/COVID/149
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Efficacy of Phala Ghrita and cow ghee in the management of oligozoospermia: A comparative clinical study
Jitendra Nathabhai Varsakiya, Mandip Goyal, Anup Thakar, Shilpa Donga
January-March 2021, 5(1):36-46
DOI:10.4103/jras.jras_13_21  
BACKGROUND: Oligozoospermia is one of the major causes of infertility in males. A special branch of Ayurveda called Vajeekarana (aphrodisiac therapy) is specially related to management of infertility. Phala Ghrita (PHG) is an Ayurved formulation specially indicated in infertility due to oligospermia, and it is also narrated that cow ghee (CG) also possesses spermatogenic efficacy. Therefore, the present work was planned to compare the clinical efficacy of PHG and CG on oligozoospermia. MATERIALS AND METHODS: Ninety-nine male patients suffering from oligospermia and having sperm count less than 15 million/mL were selected for the study. Patients’ underwent Ayurveda Bio-cleansing procedure by using Haritakyadi Yoga–a laxative Ayurveda formulation. PHG and CG at a dose of 10 g, twice daily were administered in 51 and 42 patients, respectively, with warm milk for 8 weeks. Assessment of seminal parameters were done before and after completion of treatment. RESULTS AND DISCUSSION: Statistical data showed that PHG and CG showed a significant (P < 0.001) change in sperm such as increase in sperm motility, decrease in abnormal forms of sperm, and increase in semen volume. However, the effect of PHG is found to be better than CG except in increasing semen volume. CONCLUSION: PHG and CG both have significant spermatogenic potential when administered after bio-cleansing of body by using Haritakyadi Yoga. Study registration: CTRI/20164/01/006559
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PROTOCOL
Efficacy and safety of Ayurveda interventions for acid peptic disease: A protocol for systematic review
Amit Kumar Rai, Harit Kumari, Azeem Ahmad, Richa Singhal, Bhogavalli Chandrasekhara Rao, Narayanam Srikanth
January-March 2021, 5(1):47-53
DOI:10.4103/jras.jras_4_21  
Background: Acid peptic disease (APD) has a negative impact on patients’ quality of life and general health status of the individuals. There are a number of case studies and clinical trials on efficacy of Ayurvedic interventions in the management of APD. However, a systematic review of these researches is not available which is needed to evaluate the clinical significance of those studies. Objective: The aim of this study is to conduct a systematic review of the available evidence for the efficacy and safety of Ayurvedic interventions for APD. Methods and Analysis: On the basis of the PRISMA-P statement, a systematic review protocol has been developed. Data from electronic databases such as PubMed, Cochrane Central Register of Controlled Trials, AYUSH Research Portal, DHARA, Shodhganga, Ayurvedic Research Database, Institute for Teaching and Research in Ayurveda, Gujarat Ayurveda University, Jamnagar, Clinical trial registries, and relevant journals will be used to find articles for systematic review. Only studies that have been published in English or Hindi will be considered for inclusion in the systematic review. Data from the selected studies based on study characteristics will be extracted separately by two review authors for data analysis and quality assessment of the studies. The risk of bias in the chosen studies will be evaluated using appropriate available tools. If studies that are qualified for meta-analysis are available during the review, then it will be done. If meta-analysis is not possible, then the findings will be presented in the form of a comprehensive qualitative synthesis. Conclusion: The findings of this study will aid in determining the current state of evidence on the efficacy and safety of Ayurvedic interventions for the treatment of APD. The review will also serve as a source for researchers while planning future studies in order to generate high-quality evidence on the efficacy and safety of Ayurvedic therapies in APD. Study Registration: PROSPERO 2020: CRD42020207484
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Safety and efficacy of Ayurveda interventions in diabetic retinopathy: Protocol for systematic review
Praveen Balakrishnan, Varsha Sumedhan, Thekkekkoottumughath P Sinimol, Azeem Ahmed, Sridevi Venigalla, Devarkonda Sudhakar
April-June 2021, 5(2):95-98
DOI:10.4103/jras.jras_28_21  
Introduction: Diabetic retinopathy (DR), a complication of diabetes mellitus, is a leading cause of blindness on a global level. Nonproliferative diabetic retinopathy (NPDR) and proliferative diabetic retinopathy (PDR), both with and without diabetic macular edema (DME), are the stages of DR. The conventional treatment strategies for DR include intravitreal injections, laser photocoagulation, and surgical approach. There are quite a few individual studies available in various databases showing the efficacy of Ayurveda intervention in DR. However, a systematic review of these studies is not available to date. The aim of this study is to perform a systematic review of various clinical studies of Ayurveda treatments in DR, along with meta-analysis, if possible. This shall help in providing more precise estimates of the effectiveness of management of DR using Ayurveda interventions. Methods and Analysis: A systematic review of randomized controlled trials (RCTs), quasi-randomized controlled trials (QRCTs), controlled clinical trials (CCTs), multiple arms clinical trials, and single-group studies on DR published/unpublished from January 1990 to November 2020 will be conducted. The database search will be performed using the words with Boolean operators: Ayurveda OR Ayurvedic AND Diabetic Retinopathy as title, abstract, or keyword. Clinical trials of patients fulfilling the diagnostic criteria based on signs and symptoms of DR in any of its stages, irrespective of age and either gender, will be selected. Studies that are based on the Ayurvedic treatments such as Shodhana (purification therapies), Shamana (pacification therapies), Netra Kriyakalpa (topical ophthalmic application of medications), Moordha Taila Prayoga (topical application of medicine on head), Mukha Kriya Kramas (usage of medicine on/in mouth and on face such as Mukhalepa, Kabala, Gandoosha) irrespective of dosage, type, schedule, drug, form, and advised Pathayapathya (lifestyle changes) as intervention or control will be selected. Response to treatment, both subjective and objective, is the primary outcome and onset of serious adverse events is the secondary outcome. Ethics and Dissemination: Ethical approval was obtained from the Institutional Ethics Committee. The results obtained will be published in a peer-reviewed journal. Trial Registration Number: International Prospective Register for Systematic Reviews (PROSPERO) number CRD42019136750.
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ORIGINAL ARTICLES
A multicenter clinical trial on the anti-diabetic efficacy and safety profile of Saptavimshatika Guggulu and Haridra Churna in the management of type 2 diabetes mellitus
Avinash K Jain, Surinder K Sharma, Dipsundar Sahu, Vinod B Kumawat, Om R Sharma, Pradeep Dua, Babita Yadav, Shruti Khanduri, Sarada Ota, Gurucharan Bhuyan, Rakesh Rana, Richa Singhal, Bharti Gupta, Madan M Padhi, Kartar S Dhiman
April-June 2021, 5(2):87-94
DOI:10.4103/jras.jras_40_21  
BACKGROUND: Madhumeha (diabetes mellitus [DM]) disease is one of the very few diseases, which has been found in the history and culture of India and across the globe. Since ages, even in the twenty-first century, this disease is a cause of concern to the world due to its morbidity and long-term complications. Traditional medicines are still found to be very useful in the improvement of quality of life (QOL) of the patients with Madhumeha. Ayurvedic formulations are found to be useful in the management of type II DM and in promoting health. OBJECTIVE: Saptavimshatika Guggulu (SG) and Haridra Churna (HC) were evaluated to assess their clinical effectiveness in the management of type 2 diabetes. A secondary objective was to assess the changes in the QOL of the patients with type 2 DM and the clinical safety of SG and HC. MATERIALS AND METHODS: This multicenter clinical study was critically evaluated to assay the clinical efficacy and safety profile of ayurvedic formulations, SG 500 g two tablets two times after food and HC 3 g with luke-warm water after food two times daily for 12 weeks in 146 participants, diagnosed with NIIDM, enrolled as per the selection criteria. RESULTS: The results were of highly significant in the regulation of FBS (BT-167.44 mg/dL, AT-152.83 mg/dL) and PPBS (BT-261.74 mg/dL, AT-240.59 mg/dL). Statistically highly significant result was found in the improvement of Diabetes Symptoms Questionnaire and SF-36 health survey score; no ADR or any complications were noted. CONCLUSION: SG and HC used on the subjects of type 2 DM (Madhumeha) are clinically effective, safe, and tolerable.
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REVIEW ARTICLES
Management strategies and critical appraisal of age-related macular degeneration (AMD): A systematic review
Bandahalli Madhusudhana Rao Bhavya, Shashidhar H Doddamani, Rajendra Kumar
April-June 2021, 5(2):69-79
DOI:10.4103/jras.jras_66_21  
INTRODUCTION: Age-related macular degeneration (AMD) is a degenerative disease of macula associated with aging. It is the most leading cause of the central vision loss and blindness in the developed countries above the age of 55 years. OBJECTIVES: The aim of this article is to critically analyze and to provide quality evidence in view of safety, efficacy, and effectiveness of Ayurveda interventions. MATERIALS AND METHODOLOGY: The study reviewed randomized controlled trials (RCTs), non-RCTs, and case studies on the management of AMD in Ayurveda. They were retrieved through Ayurveda research databases and Medical Journal databases such as MEDLINE, SCOPUS, Web of Science, and other directories of open access journals. Hand searching was done using predefined search terms. The search was limited to articles published till July 2021. Study selection followed the symptomatology of AMD. The data were documented and extracted using study ID and design, sample size, duration, interventions, outcomes, and result. The quality and the risk of bias assessment were done using available tools. Quantitative synthesis was not attempted as we aimed at only systematic review. RESULTS: There were 28 screened records of which 6 fulfilled pre-defined criteria. Most commonly adopted therapeutics include four studies on Nasya (medication through nose), five on Tarpana (lubrication of eye), and two studies focussing on Basti (therapeutic enema) as primary management. The results were categorized under Shodhana (purification therapy) and Shamana (palliative). Overall studies show a significant improvement in subjective parameters assessed through gradation index. Panchakarma combined with eye treatment showed better relief. CONCLUSION: The study outcome yielded considerable improvement in vision and also assisted in maintaining existing vision which is greatly appreciable in addressing the subject’s quality of life by controlling further progression of the disease.
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