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   Table of Contents - Current issue
Coverpage
January-March 2022
Volume 10 | Issue 1
Page Nos. 1-75

Online since Thursday, March 31, 2022

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ORIGINAL ARTICLES  

Effect of Vaaluka Svedana followed by Katiprishthatrika Basti in management of Katiprishthatrika Graha w.s.r. to Ankylosing Spondylitis: A prospective randomized open-label clinical study Highly accessed article p. 1
Naveen Bansal, Santoshkumar Bhatted, Prasanth Dharmarajan
DOI:10.4103/JISM.JISM_98_21  
Background: Ankylosing spondylitis is a chronic inflammatory disease involving sacroiliac joints and spine causing severe pain, stiffness, and deformities in patients in later stages of life. Symptomology of ankylosing spondylitis is similar to Katiprishthatrika Graha in Ayurveda. Materials and Methods: A prospective open-label study was carried out in the All India Institute of Ayurveda on 31 diagnosed cases of ankylosing spondylitis. Vaaluka Svedana followed by Katiprishthatrika Basti with Dhanvantara Taila was administered for 7 days each. Participants were assessed based on pain score, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), and Bath Ankylosing Spondylitis Patient Global Score (BAS-G score) scores on the 1st day and 14th day of study. Paired sample t tests were used for statistical analysis. Results: Statistically significant results were obtained at the end of trial (P < 0.001) in pain scores as well in quality of life scores (BASDAI, BASFI, and BAS-G scores). There was a 2.20, 1.37, 1.30, and 1.13 point’s reduction in BASDAI, BASFI, and BAS-G scores, respectively. Conclusion: Vaaluka Svedana followed by Katiprishthatrika Basti is effective in the successful management of pain and improving quality of life in patients with Katiprishthatrika Graha.
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A comparative study to evaluate the efficacy of an oral Ayurveda compound and Panchakarma procedures in conjunction with physiotherapy in delayed milestones status of cerebral palsy p. 6
Vidya Bhushan Pandey, Abhimanyu Kumar
DOI:10.4103/JISM.JISM_95_21  
Introduction: Cerebral palsy (CP) presents the basic problem of gross delay in the achievement of milestones according to age, especially the motor ones. The study was planned to assess the comparative efficacy of Ayurveda drugs and procedures in the achievement of milestones in conjunction with available standard management physiotherapy (PT). Materials and Methods: Three basic milestones neck holding, sitting, and standing was assessed over statistical parameters with the help of the CDC scale of milestone development. Three groups (Gp.) A B and C were made, Gp. A having PT alone was compared with Gp B with Panchkarma (PK) and PT and Gp. C with PK, PT, and oral drugs. Standard available treatment PT was provided in all the groups. Treatment was provided for 6 months and follow-up after every 2 months. Results within the group were assessed with the Student’s t test and intergroup comparison with ANOVA. Results: Total 51 cases registered and randomly allocated to different groups having 17 cases in each, 6 cases in each group have discontinued and the results were drawn having 11 cases per group. After 6 months, Gp. C presents with maximum improvement 75%, 75%, and 85% for neck holding, sitting, and standing, respectively, and holds statistically better results (P < 0.05) in the neck holding scale in intergroup comparison. Discussion: Multimodal treatment is required for the management of primary and associated problems of CP. No sole treatment plan can result in the expected outcome; however, Ayurveda drugs and procedures with PT can provide safe, effective, and speedy achievement of delayed milestones ultimately gaining functional capacities.
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Clinical study to compare effect of Haridradi lepa and Shringatadi tailam along with Shwadanshtradi churna in Keshashatan (hair fall) p. 12
Rajveer Sason, Anita Sharma
DOI:10.4103/JISM.JISM_87_21  
Background: Hair loss affects people of all gender, ages, and ethnicities, and it has both physical and psychological consequences. In today’s world, chemical hair treatments such as bleaching, straightening, relaxing, or permanent waving are very popular. Aims and Objectives: The purpose of this study was to evaluate the effect of Haridradi lepa and Shringatadi tailam along with Shwadanshtradi churna on hair loss and to research the literature on hair loss. Materials and Methods: A total of 90 patients with hair fall diagnosed clinically were enrolled and divided into two groups randomly. The duration of the trial was 2 months. There were 45 patients in each group. Cases were diagnosed using clinical signs of hair loss as described in classics. For male pattern baldness, the modified Norwood–Hamilton scale was used. For female hair loss, the Ludwig scale was used. Results and Conclusion: The percentage relief of the Sammuchya lakshnas (overall symptoms) was maximal 35.6% with P-value 0.0156 for the Study Group A patients and 44.6% with P-value 0.0136 for Study Group B patients, according to the research. The statistical study revealed that both groups improved significantly.
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REVIEW ARTICLES Top

Critical review to understand the twenty-four Ayurveda treatment modalities for the management of snake bite p. 19
Narayan Pandey, Anita Sharma, Vd. Amol Kadu, Shankar Gautam
DOI:10.4103/JISM.JISM_81_21  
Background: Snakebite is a major problem worldwide, and a common medical emergency. There are many treatment modalities available for snake bites, among them Chaturvimsati Vishachikitsopakrama are Ayurveda treatment modality mentioned in Charaka Samhita. The concept and procedures of few Upakramashas also been clearly defined in other Samhitas like Sushruta, Astangasamgraha, Astangahrdaya. Aims and Objectives: To understand the role of Chaturvimsati Vishachikitsopakramain the management of snake bite with the help of Bruhatravi, Laghutrayi and contemporary scienceMaterials and Methods: The keywords such as snake, snake bite, Chaturvimsati Vishachikitsopakrama, management of snakebite were searched from literary of classical text books like CharakaSamhita, SushrutaSamhita, Astanga Hridaya, etc with its responsive commentators, various databases (PubMed, Google scholar, Research gate, Ayush Dhara). Results: There are few traditional healers who are practicing some of the treatment modality of Vishochikitsopakram such as Mantra, Arista, Aaushad etc. Same procedure has been advocated in contemporary science with different terminology. In other hand few treatment modalities mentioned to avoid in snake bite management such as Utkartan, Chushan etc. Conclusion: Among the classical 24 treatment modalities, few are scientifically validated whereas few need to be studied and some are found irrelevant in the current scenario. Many Upakramas are scientifically approachable, easily accessible, cost effective, time saving and can be performed anywhere. So, these treatment modalities should be researched and implemented with the advancement of this era.
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Understanding the pathophysiology of insomnia (Anidra) with special reference to primary insomnia using neurotransmitter sleep theories: a narrative review p. 27
Shruti Jhawar, G Gopala Krishna, Umesh Chikkanna
DOI:10.4103/JISM.JISM_75_21  
Sleep is a primordial requirement for human sustenance and its role in health is inevitable. Despite its importance, inadequate sleep is one of the most common complaints across the globe. Ayurveda identifies Nidra (sleep) as one of the three supporting pillars of life and attributes its maintenance not only to health but also to longevity and prosperity; in contrast, Anidra (disturbed sleep) is one of the contributing factors for disease. Ayurveda clearly identifies the factors in Anidra which are vitiation of Pitta or Vata (fundamental humors of the body), Manasantapa (psycho-social stress), Kshaya (debilitating factors), or Abhighata (injury/trauma). Insomnia is characterized by reduced quality or quantity of sleep and has effects on the quality of life of the affected individual. It can be the difficulty of sleep initiation, sleep maintenance, or early morning awakening, which can have a significant impact on the daily activity of the individual. The contemporary science is yet to give a definite theory for the physiology of sleep and the pathophysiology of insomnia. The most widely accepted and researched concept is the role of neurotransmitters such as gamma-aminobutyric acid, serotonin, acetylcholine, dopamine, norepinephrine, melatonin and their effects in the regulation of sleep–wake cycle. These neurotransmitters and their effect on sleep physiology and pathology of insomnia need to be further explored in order to improve its management strategies. Hence, this review aims to determine the possible relation between the concepts of Nidra (sleep) and Anidra (disturbed sleep) mentioned in Ayurveda and these neurotransmitter sleep theories. This will help in improving the understanding of the pathophysiology of insomnia, developing Ayurveda management protocols for insomnia, and also in explaining the pharmacodynamics of Ayurveda drugs better. The method used for review is by sourcing and analyzing the available data from Ayurveda and contemporary literature on the topic in discussion.
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Ayush Kwath to combat COVID-19: The current understanding and potential therapeutic action p. 33
Charu Sharma, Meenakshi Sharma, Sisir K Mandal, Leena Nanoti
DOI:10.4103/JISM.JISM_51_21  
Background: Public health crises threatening the world have emerged as Covid pandemic. The present analysis is aimed to analyze and summarize the therapeutic potential of the herbal formulae—Ayush Kwath as a preventive, curative, and restorative intervention. The treatment for COVID-19 should primarily aim for the resolution of symptoms, arresting the pathogenesis at the earliest and shortening the recovery phase. With these objectives, the clinical efficiency of Ayush Kwath is being traversed in this study. Materials and Methods: A thorough search of classical text and databases was done using key terms Ayurveda, Jwara, Tulsi, Sunthi, Dalchini, and Krishna Marich. Results: The study found that Ayush Kwath can serve as an empirical drug for the disease. Our findings are categorized under (1) clinical perspectives of Ayush Kwath, (2) pharmacology and reverse-pharmacology of the formulation—its role in therapeutics of COVID-19, (3) psychoneuroimmunological mechanism of the formulation w.r.t. each of the constituents’ drugs, (4) therapeutic potential of the formulation—levels of prevention. Conclusion: From this review, efficacy of traditional medicines in Covid pandemic might be evidenced. This can back the clinical evidence of Ayurveda management of COVID-19. The drug can be labeled under “Vyadhiviprita chikitsaupakrama” and its application is a function of a Vaidya’s rationality. Considering lower economical value, therapeutic efficacy, and good availability of the drug makes it a potent entity to deal with a public health concern such as coronavirus disease.
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Importance of Ghrita (clarified butter) as an antitoxic medicine in Visha Chikitsa p. 40
Seema Yadav, Amol Kadu, Narsingh Patel
DOI:10.4103/JISM.JISM_61_21  
Background: Ghrita (clarified butter), which is being used as a medicine or as an adjuvant in various Agad formulations for the treatment of different poisoning conditions such as animate and inanimate poisons and for establishing its action with a contemporary view. Settings and Design: The review method adopted was a critical review in which classical and contemporary literature was extensively researched and critically evaluated. The conceptual contribution of Ayurveda science in the field of toxicology has been symbolized. Methods and Materials: The classical texts, mainly Charaka, Sushruta, Ashtanga Samgraha, and Ashtang Hridaya, were researched along with their commentaries in Sanskrit as well as Hindi. All collected matter of various research articles were searched and scrutinized for discussion, and an effort is made to exert some productive conclusions. Results and Conclusions: Ghrita used with various formulations plays an important role in Visha Chikitsa because of its Vishaghna (antipoisonous), use in skin disease, cardioprotective, and blood-purifying properties. It is used as an antidote having an antipoisonous property either as medicine or as an adjuvant by various routes such as oral, local application and Nasya, Anjana (corrylium). Ghrita is not only used in all kinds of poison, but it is also used in all states of poisoning. Different therapeutic measures such as Santrasan (mild purgation), Pralepa (external application of paste on skin), Bhojya (food), and Aushdh (drugs) should not be utilized without adding Ghrita for the management of different poisoning conditions.
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An inclusive review on Guduchi Satva: A distinctive drug dosage form of Ayurveda pharmaceutics p. 49
Anu Joy, Rabinarayan Acharya
DOI:10.4103/JISM.JISM_13_22  
Background: In Ayurveda pharmaceutics, Satva is one of the pharmaceutical preparations obtained from certain plants and it is frequently used in the management of various disease conditions. Among various satva bearing plants, Guduchi (Tinospora Cordifolia (Wild.) Miers) is considered the most potent and is used the most. Almost all classical texts of Ayurveda highlight the use of Guduchi satva in combating different disease conditions, such as Prameha, Jwara, Rajayakshma etc. This review provides single-hand information on Guduchi satva. Materials and Methods: Various properties, preparation methods, and therapeutic applications of Guduchi satva are mentioned in 91 classical texts of Ayurveda, comprising 9 Samhitas (treatise), 17 Chikitsa Granthas (compendia of Ayurveda), 35 Rasagranthas (compendia related to Rasashastra), and 30 Nighantus.Results: It is observed that Satva (solid aqueous extract) has properties such as Swadu rasa (sweet), Seeta (cold), Laghu (lightness) Guna, and Seeta veerya (cold potency). Generally, Guduchi satva is prepared from fresh Guduchi stem. During the preparation of Guduchi satva, fresh Guduchi stem is cut into small pieces; it is then crushed well. After crushing, it is immersed four times in water, macerated well, and kept aside for 12 to 16 hours per day. Then, it is filtered and kept aside for 4–6 hrs. Next, the excess water is removed and the sediment portion is collected. More than 111 formulations, having Guduchi satva as an ingredient, are used to treat almost 39 varied disease conditions. Among these diseased conditions, the maximum are indicated for the management of Prameha, Rajayakshma etc. Conclusion: The available data may encourage researchers and also practitioners to enhance their knowledge and use the various dimensions of the present findings to flourish the various applications of Guduchi satva that have not been scientifically explored till date.
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Biomedical waste management in Panchakarma practice: Present scenario and scope p. 57
Diksha N Kabra, Santosh K Bhatted, Prasanth Dharmarajan
DOI:10.4103/JISM.JISM_36_21  
Ayurveda is a traditional medical system of India. In Ayurveda, Panchakarma (fivefold detoxification treatment) procedures are designed for internal purification and cleansing. As per the Indian government’s initiative (launched in September 2014), Ayurveda is part of wellness industry. There is a constant rise in the number of Ayurveda clinics, hospitals, wellness centers, and spas in India. The various Panchakarma procedures performed in these hospitals, clinics, wellness centers, and spas generate biomedical wastes (BMW). Metropolitan areas in India bring about 62 million tonnes of wastes annually, and this figure is predicted to rise to 165 million tonnes by 2030. Forty-three million tonnes of the municipal solid waste are collected every year, of which 31 million are disposed of in landfills and only 11.9 million are treated. Pharmaceutical wastes are one among them. Reports from the Indian medicinal plant industries indicate that presently more than 9000 plant industries are registered in India, which produces a huge amount of waste each year. This has created a need in the proper management of waste generated. Here is the description and discussion of categorization, classification, and treatment options for waste generated during Panchakarma procedures in Ayurveda hospitals. Effective and proper management of the BMW is necessary to maintain personal as well as environmental health. The current available techniques for the treatment of waste generated during Panchakarma procedure are sewage drainage, incineration, and landfill. Nothing turns around to be waste until it is being not used further with intelligence. The natural cycles of life taught us the same through science: utilizing of three Rs of ideal waste management. While further advancement can include the use of phytoremediation, composting, vermicomposting, biofiltration, bioaugmentation and use of solar energy in waste management.
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CASE REPORTS Top

Varicose ulcer and stasis eczema ayurveda perspective: A case report p. 62
Gautam Subhashchand Jogad, Sumeeta G Jain
DOI:10.4103/JISM.JISM_43_21  
Varicose ulcers occur due to chronic venous occlusion. This insufficiency leads to ischemia in the vascular supply of the leg, which results in regurgitation of blood through venous valves. When this happens in the cephalous group of veins, it results in varicose ulcers of the leg. The prevalence of chronic venous ulcers in the leg is 70%–80%. If these ulcers are ignored, they can land into cellulitis, gangrene. In Ayurveda perspective, varicose ulcers can be defined as with Vrana developed due to Siragat Vat and also with Vatatrakta. Varicose ulcers can be treated with Ayurveda principles effectively. Its recurrence is common so it also can be prevented by Ayurveda principles. This case was treated on the line of Vatarakta and Dushta Sirajanyavrana. The first target was to correct the Vrana so the drug having property to Vrana Shodhan and Ropan (wound healing and cleaning) was selected. Kleda Nashak and Shothahar (edema), and Raktashodhak and Prasadana (blood purify and circulation). Raktamokshan (bloodletting) helps in the removal of Utkleshit (vitiated) Dosha of site of disease and thus cures the disease faster. By applying these principles, this case shows a marked improvement in all clinical presentations of varicose ulcer and stasis eczema. These are the outcomes of this case. Present case was treated with Ayurveda principle and less period of time, details of case are discussed here. Allopathic medicine can leads to recurrence of diseases as shown in the present case but with the help of Ayurveda treatment chances of recurrences are minimized that is why this is unique case. This case report proposes an innovative treatment protocol to treat varicose ulcers, which needs to study on large scale.
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Ayurveda multimodal treatment approach for the management of generalized plaque psoriasis: a case report p. 66
Nikhil A Mehere, Sarika M Makwana, Swapnil Y Chaudhary, Prashant Bedarkar, BJ Patgiri
DOI:10.4103/JISM.JISM_94_21  
Background: Plaque psoriasis typically presents with large, oval-circular plaques over the scalp, trunk, and extensor body surface. In Ayurveda, all the skin diseases depict under the heading “Kustha” (skin diseases). Among them, “Ekakustha” (psoriasis) is further explained under the title “Kshudra Kustha” (minor skin diseases). It is characterized by the hyperproliferation of the epidermal cells resulting in plaque formation over the lesions and may get severe and progress into the pustular subtype. Aim: Plaque psoriasis is compared with Ekakushtha in Ayurveda because of its resemblance to disease condition that is described in the Ayurveda classics. The aim of this study was to treat a patient with Ayurveda multimodal treatment approach. Materials and Methods: We, herein, reported a case of a woman aged 29 years complaining about reddish lesions over the scalp, peripheral area of eyes, trunk, back, and upper and lower extremities with intense pruritus since the last 8 months. Itching leads to scaling and trickling of blood from lesions. The patient was diagnosed with generalized plaque psoriasis. This case was treated by internal as well as topical medicament with the cessation of known etiological factors. Results: A significant reduction in the symptoms within 98 days of treatment without reported relapse manifestation of previous symptoms. The scores of 18, 10, and 2 were observed before treatment, after treatment, and after follow-up period, respectively, on the symptomatic relief in signs and symptoms of Ekakushtha. The Psoriasis Area Severity Index (PASI) score was adopted as the assessment of severity of case. The PASI score is zero after the treatment and 12.2 before the treatment. The Ayurveda multimodal treatment approach gives miraculous result in this type of complex nature of psoriasis disease.
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BRIEF COMMUNICATION Top

Event report of international webinar on “Update neurology in Ayurveda 2022” p. 74
Rajkumar B Gupta
DOI:10.4103/JISM.JISM_18_22  
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