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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.
  1,167 212 -
EDITORIAL
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  
  1,022 202 -
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.
  959 166 -
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
  892 146 -
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.
  788 126 -
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
  776 100 -
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
  740 118 -
PROTOCOL
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.
  646 185 -
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.
  642 169 -
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  
  685 104 -
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
  620 113 -
ORIGINAL ARTICLES
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].
  586 146 -
EDITORIAL
Ayurveda dataset items in clinical trial registry of India: An impetus for research in Ayurveda
Narayanam Srikanth
July-September 2021, 5(3):99-101
DOI:10.4103/jras.jras_109_21  
  587 89 -
ORIGINAL ARTICLES
Effectiveness of anal infiltration with Murivenna oil, internal administration of Triphala choorna, sitz bath, and fiber diet protocol in acute and chronic anal fissures: A retrospective observational study
Pratap S Kizhakke Meladam, Pratibha P Nair, Gayathri Sureshkumar, Devarakonda Sudhakar
July-September 2021, 5(3):125-130
DOI:10.4103/jras.jras_21_21  
BACKGROUND: Anal fissure (fissure in ano) is an excruciating manifestation among common anorectal presentations. The condition inflicts significant personal and social ill health causing considerable morbidity. This study aimed at documenting the effect of Murivenna oil infiltration and Triphala choorna oral use along with sitz bath and fiber diet protocol in the management of fistula in ano. MATERIALS AND METHODS: Retrospective analysis of 15 cases diagnosed with primary fissure in ano who underwent prescribed conservative Ayurvedic treatment between March 2018 and February 2019 at the National Ayurveda Research Institute for Panchakarma, Cheruthuruthy, is reported. All patients were managed with anal infiltration of Murivenna oil (30 ml), internal administration of Triphala choorna (10 g), sitz bath, and fiber diet. Retrospective outcome analysis of recorded change in each case on study variables, viz. pain, bleeding per rectum (BPR), anal discharge, inflammation and tenderness, and healing of fissure, was recorded in structured proforma, was carried out using the Statistical Package for the Social Sciences. A Friedman test for repeated measures, followed by Wilcoxon post hoc test, was conducted on the study variables. Results with P-value<.01 were considered significant. RESULTS: Data of 15 patients was used for analysis. Complete healing of the fissure was documented in 93% of patients by the end of their respective 30th day. There was significant relief in symptoms of inflammation, tenderness, anal discharge, and bleeding per rectum (BPR) in most of the patients within their first 7 days of treatment. Median pain level assessed on VAS was significantly reduced from 9 (on the 1st day) to 1 (on the 7th day) and eventually to 0 on the 30th day. Statistically significant difference was observed in the percentage healing of fissure measured on the 8th day (78 ± 11.464), 15th day (91.33 ± 9.904), and 30th day (99.33 ± 2.582). CONCLUSION: The observatory report provides significant elementary evidence on the effectiveness of an Ayurvedic conservative treatment in managing acute and chronic primary fissure in ano.
  504 77 -
REVIEW ARTICLE
A review on preventive and therapeutic potential of selected Ayurveda medicinal plants in viral pandemics
Shobhit Kumar, Uday Ravi Sekhar Namburi, Deepak J Londhe, Ashwin C Chiluveri, Amit K Rai, Sudha K Chiluveri, Shital Chinchalkar, Bhogvalli Chandra Shekar Rao, Narayanam Srikanth
July-September 2021, 5(3):102-116
DOI:10.4103/jras.jras_52_21  
BACKGROUND: Viral pandemics/epidemics are emerging as one of the biggest challenge for medical fraternity and health-care policy makers. This is high time to explore traditional medicine systems such as Ayurveda, wherein measures such as Dincharya (daily regimen), Ritucharya (seasonal regimen), Sadvritta (good conduct/behavior), and Rasayana (rejuvenation measures) which are said to influence the homoeostatic mechanism of the host defense system along with interventions that may have a promising role in managing such diseases. OBJECTIVES: This review attempts to provide an informative analysis of the daily regimen, seasonal regimen, moral conduct, and interventions recommended in Ayurveda scriptures which can be helpful for the prevention and treatment of viral pandemics. METHODS: A narrative review was conducted and comprehensive search of Ayurveda classical texts, including Bhrihatrayi, Laghutrayi, Dhanwantari Nighantu, Raj Nighantu, Kaiyadev Nighantu, and texts related to Dravyaguna was done. Electronic databases such as PubMed, AYUSH Research Portal, DHARA, and Google Scholar were also searched for relevant literature, pertaining to Ayurveda prophylactic and therapeutic measures in viral pandemics from 2001 to 2020. RESULTS: Prophylactic and therapeutic measures, including daily and seasonal regimen, good conduct/behavior, rejuvenation measures, Dhoopana Karma (medicated fumigation), and medicinal herbs, explained in Ayurveda may be utilized during viral pandemics. Critical analysis of the available scientific evidence suggests potential of Ayurveda interventions in context of immunomodulatory and antiviral activities. CONCLUSION: Unique preventive dietary and lifestyle practices recommended by Ayurveda can play an important role in maintaining the health status and improving the disease resistance capacity. Evidence from preclinical/clinical studies indicates that several herbs used in Ayurveda exhibit immunomodulatory, antiviral properties. The preventive and therapeutic measures narrated in Ayurveda can contribute significantly towards the management of viral pandemics. Generation of more scientific evidence through quality research studies is needed to evaluate the role of Ayurveda approaches for management of viral diseases.
  394 111 -
ORIGINAL ARTICLES
Clinical evaluation of the effect of Saptasaram Kashaya and Saraswatarishta in Kashtartava (primary dysmenorrhea)
Emy S Surendran, Sakshi Sharma, Mohanan C Soumya, Rajput Shivshankar, Arunabh Tripathi, Sarada Ota, Rakesh Rana, Bhagwan S Sharma, Shruti Khanduri, Adarsh Kumar, Bharti Gupta, D Sudhakar, Narayanam Srikanth, Kartar S Dhiman
July-September 2021, 5(3):117-124
DOI:10.4103/jras.jras_87_21  
BACKGROUND: Primary dysmenorrhea is defined as painful menstruation without any associated pelvic pathology. This debilitating gynecologic disease affects 45–90% of women of reproductive age. In classical texts of Ayurveda, formulations such as Saptasaram Kashaya (SPK) and Saraswatarishta (SSR) have been indicated in the treatment of Kashtartava (primary dysmenorrhea). Based on the classical claim, the present work was planned to assess the effect of SPK and SSR on the treatment of primary dysmenorrhea. MATERIALS AND METHODS: Unmarried girls of age between 13 and 20 years, suffering from at least three painful cycles of menstruation in the last 6 months with pain intensity more than 40 mm as per the Visual Analog Scale (700 mm) (VAS), were included in the trial. Ayurvedic formulations SPK in the dose of 50 ml twice daily before food from the onset of menstruation till next 7 days and SSR in the dose of 10 ml mixed with 20 ml of lukewarm water at bedtime daily were administered for 3 consecutive months. The effect on menstrual pain was assessed by VAS; improvement in quality of life was assessed using the SF-36 (RAND) questionnaire; and changes in the psychosomatic status were assessed using the Menstrual Distress Questionnaire and Hamilton Anxiety Scale. RESULTS: A total of 100 participants were enrolled at two study centers. The data of 96 participants who completed 6 months’ trial period were analyzed. At baseline, the mean VAS score for pain was 90.9 ± 12.3, which decreased to 33.4 ± 24 on the 90th day and further reduced to 23.8 ± 21.3 on the 180th day. The associated symptoms such as nausea, vomiting, anorexia, loss of appetite, giddiness, breast tenderness, diarrhea, flatulence, headache, fainting, frequent urination, and fatigue significantly reduced (P < 0.05) at the end of the treatment. The improvement in quality of life and psychological status at the end of 90th day was also significant (P < 0.001). No adverse events were reported during the treatment period. CONCLUSION: SPK and SSR have a positive effect in the treatment of primary dysmenorrhea.
  377 116 -
CASE REPORTS
Effect of add-on Ayurveda treatment in the management of chickenpox
Ranjita Ekka, Ekta Dogra, Parvathy G Nair, Amit K Dixit, Kuldeep Choudhary, Debajyoti Das, Peyyala Vara Venkatesh Prasad
October-December 2021, 5(4):173-178
DOI:10.4103/jras.jras_64_21  
BACKGROUND: Chickenpox is a contagious infection caused by the Varicella-zoster virus with the clinical manifestation of itchy rashes with fluid-filled blisters and fever. Although it is a self-limiting disease, to shorten the recovery period as well as to avoid complications, Ayurveda medicine could be effectively used in the management of chickenpox. In the present case study, the effects of Ayurveda add-on treatment are studied in treating chickenpox and in healing papules. CLINICAL PRESENTATION AND DIAGNOSIS: A 38-year-old woman presented to the Out-Patient Department (OPD) of Central Ayurveda Research Institute, Kolkata, with severe itchy and painful papules all over the body and malaise along with difficulty in swallowing because of pain in the throat since 15 days. On the basis of clinical presentation, it was diagnosed as a case of chickenpox. INTERVENTION AND OUTCOME: Before visiting the Ayurveda OPD, the patient took allopathic medicine (acyclovir 800 mg TID, paracetamol SOS, and calamine lotion local application) for 15 days, but the disease continued to progress and developed painful lesions with itching and other difficulties. The Ayurveda intervention started after 2 weeks of the onset of the disease. The patient was advised to take Tribhuvankirti Rasa (250 mg BD) before food for 7 days, Haridrakhanda (3 g BD) after food, Panchatiktaghrita (5 mL BD) after food, and Guduchyadi Taila for local application for 15 days. RESULTS: Papules of chickenpox were healed in 15 days of the treatment. After taking Ayurveda medicines, the patient got relief from severe itching and pain within 2 days and also completely recovered within 15 days. CONCLUSION: Results suggest that the Ayurveda interventions effectively reduced the signs and symptoms of chickenpox and hastened the healing process. It may be concluded that Ayurveda medicines either alone or as add-on give promising therapeutic results in the management of chickenpox.
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Central retinal vein occlusion and its management through Ayurveda: A case report
Sangita Kamaliya, Jetal Gevariya, Dharmendra Sinh Vaghela
October-December 2021, 5(4):179-184
DOI:10.4103/jras.jras_90_21  
Central retinal vein occlusion (CRVO) is a condition in which the main vein that drains blood from the retina closes off partially or completely. This condition is associated with sudden, unilateral, and moderate-to-marked or total loss of vision. In the present case report, a 58-year-old male patient suffered from CRVO with chief complaints of sudden painless diminution of distant and near vision of the right eye with a duration of 1 week and was treated with Ayurveda medications and therapeutic procedures. Oral medicines such as decoctions, herbal powder, and tablets were administered along with therapeutic procedures which include Nasya (medication through nasal route) therapy and local therapies such as Bidalaka (application of medicated paste on eye lids) and Shirolepa (application of medicated paste on head). Pre- and post-assessments were done by visual acuity (VA), posterior segment examination, and optical coherence tomography, which showed improvement at the end of 3 months’ treatment. At the end of the treatment, there is improvement noted in distance and near VA in the right eye. Ophthalmoscopic findings revealed a reduction in hemorrhages and edema in the right eye. The effectiveness of Ayurveda interventions observed in the present case indicates that CRVO can be treated with Ayurveda medication and therapeutic procedures such as Nasya, Bidalaka, and Shirolepa.
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ORIGINAL ARTICLE
An observational study to assess the demographic status and health-seeking behavior of SC women and children in Bhubaneswar Block of Odisha
P Binitha, Kshirod K Ratha, Banamali Das, Sarada Ota, Kishor A Gavali, Mrithyunjaya M Rao
October-December 2021, 5(4):164-172
DOI:10.4103/jras.jras_19_21  
BACKGROUND: The Scheduled Castes (SC) population of Odisha constitutes 17.3% of the total population of the state and is one of the most vulnerable groups with regard to health care due to the non-availability of affordable and quality health services. Reproductive health literacy is relatively poorer in adolescents and women, which impacts their reproductive health. OBJECTIVE: The core objectives of the study were to determine the socioeconomic status, living conditions, educational status, dietetic habits, lifestyles, and healthcare-seeking behavior of SC women and children, promote awareness regarding lifestyle and health, and also provide healthcare services at their doorsteps. MATERIALS AND METHODS: The study was conducted from January to December 2019 in the SC population-dominated areas of the Khurdha district of Odisha. The requisite information was documented by door-to-door visits from respondents who provided their consent for participation in the study, through a structured format. Awareness was created to the respondents through distribution of Information, Education, and Communication materials and public lectures. Ayurveda healthcare services were provided as per the initial screening, presence of risk factors, and presenting complaints, if any. The data gathered were analyzed through descriptive statistical assessment, i.e., measures of frequency and position of the data. RESULTS: A total of 5041 people were surveyed, including females and children only. Among these, 2758 were women of reproductive age and 2283 were children. Of the 2283 children, 1186 were male and 1097 were female. The causes of gynecological diseases in SC women are poor living conditions, environmental factors, poor hygiene, improper care during menstrual cycles, a faulty lifestyle, and a low socioeconomic status. The health indices were found to have improved due to the implementation of various women-centric welfare schemes by the government and institutional delivery. CONCLUSION: The Reproductive and Child Health program is pivotal for improving the health outcomes of the deprived and unreached segment of the SC women’s population. Supplementation of comprehensive and holistic health care through Ayurveda advocacy is sustainable and can improve health outcomes and reduce mortality and morbidity.
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PROTOCOL
Clinical evaluation of the efficacy of Shadbindu Taila and Chitraka Haritaki in the management of chronic rhinosinusitis: Protocol for a prospective, open-label multicenter single-arm trial
Shweta Mata, Harbans Singh, Deepa Makhija, Babita Yadav, Richa Singhal, Bhogavalli Chandrasekhara Rao, Rajput Shivshankar, Bharti Gupta, Narayanam Srikanth
July-September 2021, 5(3):131-138
DOI:10.4103/jras.jras_43_21  
BACKGROUND: The disease Pinasa (chronic rhinosinusitis disease) is a chronic nasal disease, which affects nasal canal and paranasal sinuses and the symptoms of this disease are similar to that of chronic rhinosinusitis. In Ayurvedic classics, the internal administration of Chitraka Haritaki Avaleha (CHA) and nasal instillation of Shadbindu Taila (SBT) are mentioned for the management of Pinasa. In view of the literary indication, the present work was carried out with the objective to evaluate the clinical efficacy and safety of CHA and SBT in the management of chronic rhinosinusitis. MATERIALS AND METHODS: A multicenter, single-arm, open-label clinical trial was proposed for the assessment of therapeutic efficacy of oral administration of CHA and nasal instillation of SBT. A total of 60 patients with chronic rhinosinusitis from Central Ayurveda Research Institute (CARI), New Delhi and CARI, Patiala were enrolled in this study. SBT Nasya (nasal drop to be given for three sittings, 7 days in each, with the interval of 7 days between each sitting) and CHA (6 g, twice daily after food) in the form of Avaleha (semisolid confection) were given to all participants for 42 days and the follow-up period was 28 days. The primary outcome was to assess change in SNOT (Sino-Nasal Outcome Test) scores. The secondary outcome was to assess change in RSDI (Rhinosinusitis Disability Index) scores and change in Lund-Mackay scores of computed tomography (CT) scan of paranasal sinuses. CONCLUSION: The effect of CHA and SBT nasal drop in treatment of Pinasa with special reference to chronic rhinosinusitis may provide an evidence-based complementary therapeutic approach for the management of the said condition.
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BOOK REVIEWS
Textbook of Shalya Tantra (surgery in Ayurveda): An informative treatise based on contemporary requisite
Dhirajsingh Sumersingh Rajput
July-September 2021, 5(3):148-151
DOI:10.4103/jras.jras_110_21  
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EDITORIAL
ICT initiatives of CCRAS
Narayanam Srikanth
October-December 2021, 5(4):157-163
DOI:10.4103/jras.jras_42_22  
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BOOK REVIEWS
Marmacikitsa: Basic tenets in Ayurveda and therapeutic approaches
Pratibha P Nair
July-September 2021, 5(3):152-155
DOI:10.4103/jras.jras_6_22  
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PROTOCOL
A multi-center collaborative double-blind study on clinical evaluation of AYUSH-SL in patients receiving mass drug administration for management of chronic filarial lymphedema—study protocol
Santanu K Tripathi, Renu Singh, Gurucharan Bhuyan, Achintya Mitra, Lalita Sharma, Chagam R Murlikrishna, Kshirod K Ratha, Sujata Dhoke, Bharti Gupta, Adarsh Kumar, Narayanam Srikanth
July-September 2021, 5(3):139-147
DOI:10.4103/jras.jras_46_21  
BACKGROUND: Lymphatic filariasis (LF) is caused by Wuchereria bancrofti, Brugia malayi, or B. timori, the parasitic nematodes that are transmitted through mosquitoes. The World Health Organization has recommended mass drug administration (MDA) as preventive chemotherapy strategy. In Ayurveda, LF has been narrated under the heading Shlipada, and the literature also includes detailed therapeutic measures. AYUSH-SL is a formulation prepared based on the classical information of herbs used in treating LF. MATERIALS AND METHODS: This is a multi-center, prospective, parallel-group, placebo-controlled, double blind interventional study. A total of 180 participants are planned to be recruited, and the duration of the study will be 2.5 years. Diagnosed cases of filariasis (as evidenced by a positive immune-chromatographic card test or enzyme-linked immunosorbent assay or microfilariae (MF) test report) of either sex within the age group of 18–65 years present with features of filarial lymphedema of Grade I and Grade II (lower limbs) will be included in the trial. The study group will be treated with MDA and AYUSH-SL tablet. The control group will receive MDA and a matching placebo. The duration of the therapy will be of 12 weeks, and a last follow-up will be done at the 24th week. OUTCOME MEASURES: The primary outcome measure is reduction of edema computed for analysis by percentage reduction from the baseline at 4th, 12th, and 24th week. The secondary outcome measures include improvement in quality of life (QoL), which will be assessed using the Lymphatic Filariasis Specific QoL Questionnaire, and prevention of recurrence of acute episodes, which will be assessed by probing the presence and severity of episodes in the past 4 weeks. DISCUSSION: The deformities and disability due to filarial lymphedema vanquish physically as well as mentally leading to hardships in normal life. Management of filarial lymphedema is required for preventing disease progression and episodes of adenolymphangitis. The study is expected to provide evidence on the coded Ayurveda drug AYUSH-SL in the management of chronic filarial lymphedema.
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Efficacy and safety of Ayurveda interventions for diabetes mellitus—A systematic review protocol
Shyam Gyanoba Kale, Kalpana Budhaji Kachre, Bidhan Mahajan, Parth Prakashbhai Dave, Azeem Ahmad, Milind Suryawanshi, Bhogavalli Chandrasekhar Rao, Narayanam Srikanth
October-December 2021, 5(4):192-196
DOI:10.4103/jras.jras_8_21  
INTRODUCTION: Ayurvedic treatments are in use to treat Diabetes Mellitus (DM), either as a stand-alone treatment or as an adjunct to conventional care. There is need for a comprehensive assessment of the efficacy and safety of Ayurvedic interventions in DM through a systematic review. Therefore present work is planned to create quality based evidence on the efficacy and safety of Ayurvedic intervention for DM. MATERIALS AND METHODS: The data for systematic review will be collected by a comprehensive search of databases will be made to get maximum research articles on clinical trials such as randomized, non-randomized controlled, multiple arm, and quasi-randomized controlled trials. The primary outcome will be treatment response on improvement in subjective criteria, i.e. associated symptoms with DM, effect on fasting blood glucose level, postprandial blood glucose level and HbA1C level. The secondary outcome will be the assessment of the health-related quality of life and safety of interventions. For the systematic review three reviewers will extract the data separately in a pre-determined format. For each included study, a narrative synthesis will be conducted. A meta-analysis will be performed if the collected data is suitable for meta-analysis. CONCLUSION: The systematic review serves as a representative of the evidence of safety and efficacy of Ayurveda interventions in treating DM. Outcome of the review may also provide scope for planning further researches. PROSPERO STUDY REGISTRATION NO: PROSPERO 2020 CRD42020159659
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