Journal of Ayurveda and Integrative Medicine
Latest articles in this journal
Journal of Ayurveda and Integrative Medicine; doi:10.1016/j.jaim.2021.01.014
Chronic wound is one of a leading cause of amputation worldwide. Successful management of chronic wound has become a challenge to all existing medical systems across the world. Sri Lankan Traditional and Ayurvedic medicine reveals many promising herbal and alternative remedies for chronic wounds. We hereby report a successfully managed case of an 80-year-old female patient suffering from a chronic wound for two years, when presenting has advised for amputation of the leg. The treatment protocol included the application of hirudotherapy along with the bark paste of Pongamia pinnata followed by Flueggea leucopyrus with recommended other external and internal remedies. At the end of the treatment protocol, pain, exudates, odor, burning sensation, and itching were reduced completely while swelling and wound size was reduced remarkably and showed a significant healing in the wounded area.
Journal of Ayurveda and Integrative Medicine; doi:10.1016/j.jaim.2021.01.009
Ayurveda has a holistic and person-centric approach towards health and disease, which in turn necessitates consideration of several factors in the process of a diagnostic workup. This concept of personalised diagnosis brings about a high level of variability among the clinicians with respect to their assessment methods and disease diagnosis. Developing and validating diagnostic tools for diseases enumerated in the Ayurvedic classical textbooks can help in standardising the clinical approach, even when attempting to arrive at a patient specific diagnosis. However, diagnostic research is a very less explored area in Ayurveda and there are no established standards for developing and evaluating diagnostic tools. This paper reviews the methodology for the development and validation of diagnostic tools, available in published literature and proposes to integrate this in the field of Ayurveda. The search was conducted on online databases including PubMed, Science Direct, Scopus, and Google scholar, with keywords - ayurvedic diagnosis, diagnostic tool development, validity, reliability, and diagnostic test assessment. The articles were screened based on their comprehensiveness, relevance, and feasibility, and the methodology elaborated in the selected articles was organized into a framework that can be adopted in Ayurveda. We have also tried to examine the methodological challenges of integrating the fundamentals of ayurvedic diagnosis within the current methods of diagnostic research and explored possible solutions. The proposed tool development process involves both qualitative and quantitative components, which may be carried out in three phases that include setting the diagnostic criteria, tool development and validation, and diagnostic test assessment.
Journal of Ayurveda and Integrative Medicine; doi:10.1016/j.jaim.2020.10.010
The excessive formation of Advanced Glycation End-products (AGEs) by non-enzymatic glycation mediates many health complications in the human body and the formation of AGEs largely accelerated under the hyperglycaemic condition. The prospect of the study to assess the strength of inhibiting the rapid AGE formations in four Ayurvedic medicinal plants, namely; Salacia reticulata (stems), Syzygium cumini (barks), Artocarpus heterophyllus (mature leaves) and, Cassia auriculata (flowers). Herbal decoctions of four medicinal plant materials were prepared by simmering with hot water as prescribed by the Ayurvedic medicine. The effectiveness of the decoctions was analyzed in vitro based on their Anti-AGE formation activity, glycation reversing, and anti-oxidant potentials. According to the results, the decoctions of S. reticulata, A. heterophyllus and C. auriculata indicated the strong Anti-AGE forming (IC50: 23.01 ± 2.70, 32.01 ± 2.09, 43.66 ± 2.11 mg/mL, respectively), glycation reversing (EC50: 183.15 ± 7.67, 91.85 ± 1.93, 252.35 ± 4.03 mg/mL, respectively) and antioxidant potentials in terms of total polyphenol content (TPC), total flavonoid content (TFC), ferric ion reducing power (FRAP), ABTS and DPPH radical scavenging activities. However, the decoction of S. cumini reported the significantly high (p < 0.05) Anti-AGE forming, (IC50: 9.75 ± 0.32 mg/mL), glycation reversing (EC50: 66.45 ± 4.51 mg/mL), and antioxidant potentials against the decoctions of the other three plant materials. S. cumini bark extract was identified as the best source in controlling the formation of AGEs excessively. Further, the other three plant extracts can also be effectively used as potential therapeutic agents to control the pathological conditions associated with AGEs-mediated health complications.
Journal of Ayurveda and Integrative Medicine; doi:10.1016/j.jaim.2021.02.008
Severe COVID-19 infection requiring oxygen support is reported to have high mortality. Chest Severity Score evaluated through CT scan has a predictive value about future outcomes in such cases. Score value ∼18 is predicted to have poor outcomes. We are presenting here a case of severe COVID-19 with all predictors suggestive of a bad prognosis including IL-6, D-Dimer, Ferritin and CRP in addition to 18/25 Chest Severity Score. Initially treated under ICU care at a tertiary care COVID hospital for about 14days, the patient was intervened with Ayurveda on his own insistence seeing the unsatisfactory improvements. Ayurveda intervention for 19 days along with standard ICU care resulted in complete clinical recovery of the patient besides the correction of biomarker levels. Rapid clinical and biochemical correction in this severe COVID-19 case against all odds is highly significant and warrants an urgent search for possibility of instituting the integrative management strategies for all those treated in an allopathic facility. This case also advocates an early institution of Ayurveda interventions in COVID-19 in order to prevent deterioration leading to complications.
Journal of Ayurveda and Integrative Medicine; doi:10.1016/j.jaim.2020.12.012
Journal of Ayurveda and Integrative Medicine; doi:10.1016/j.jaim.2021.02.007
Jwara is considered to be the ‘lord’ of diseases. Sannipata jwara refers to a condition where there is disturbance in all the three dosha. COVID-19 is an infectious disease caused by the most recently discovered corona virus and has already acquired an epidemic nature. In the present scenario there is no evidence that conventional medical system can prevent or cure the disease while the time tested traditional knowledge of Ayurveda can help in management and prevention of the disease. The primary objective of this report is to highlight the role of Ayurveda in the management strategy of Covid-19 as a standalone therapy in uncomplicated cases. This article represents the case of a 36 year old male patient, who tested positive for Covid-19 with symptoms like fever, headache, body pain etc successfully managed with Ayurveda medicines alone. The prime aim of the management was to improve the Agni and facilitate ama pachana with medicines like Indukantham Kashyam, Amrutharishtam and Sudarshanam tablet along with other medicines like Vettumaran tablet, Nasarsha tailam and Legrain tablet for symptomatic relief. Post Covid phase management was done using Agastya rasayanam and Haridrakhandam with an aim to strengthen the respiratory system. The management strategy was formulated adopting the principles of Jwara, Janapadodhwamsa etc mentioned in the classics. The scope of ayurveda in the management of the pandemic is enormous which needs to be incorporated in the mainstream healthcare system judiciously.
Journal of Ayurveda and Integrative Medicine; doi:10.1016/j.jaim.2021.01.013
AIAPGET 2019, an all India ranking entrance Test for MD/MS courses of Ayurveda, Unani, Siddha and Homeopathy stream was conducted by joint collaboration of National Testing Agency (NTA) and All India Institute of Ayurveda (AIIA). This exam was computer based conducted all over 25 centers across India. The question paper had 100 MCQs with 1 correct answer and 3 distractors for each item (Problem statement). In this article, we present the item analysis of AIAPGET 2019 Ayurveda stream MCQs. AIAPGET 2019 question paper of Ayurveda stream had a Difficulty index of 37.32 ± 16.11 Discriminatory Index of 0.46 ± 0.27 and Distractor Index of 89 ± 17.8. Our analysis showed that though ideal, the question paper trended towards difficulty side.
Journal of Ayurveda and Integrative Medicine; doi:10.1016/j.jaim.2021.01.012
Assessment of individual constitution (prakriti) has been an important basic construct of the Ayurveda system of medicine. The AyuSoft prakriti diagnostic tool has been extensively used in Ayurveda research. However, we could not find any literature regarding reliability of a prakriti diagnostic tool in patients with psychiatric conditions. One hundred and twelve patients (M = 70) suffering from various psychiatric disorders as per ICD-10 criteria were recruited (Depression = 31; Schizophrenia = 30, Anxiety disorders = 27; OCD = 9; BPAD = 15). The AyuSoft tool (developed by C-DAC, Pune, India) was applied to determine their prakriti after obtaining written informed consent. Two Ayurveda physicians independently assessed prakriti of the same patients through clinical examination. Inter-rater reliability was assessed between prakriti scores obtained from AyuSoft and those from the Ayurveda physicians by determining Cohen’s Kappa intra-class correlation coefficient (ICC). ICC estimates and their 95% confidence intervals were calculated using SPSS statistical package (version 24.0) based on a mean-rating (k = 2), consistency and two-way mixed-effects model. We observed that there was a significant correlation between dosha scores obtained through AyuSoft and those from the two Ayurveda physicians (for all three doshas: p < 0.01). Inter-rater reliability was moderately strong for vata (ICC = 0.72; Cronbach’s alpha = 0.83), good for pitta (ICC = 0.58; Cronbach’s alpha = 0.62) and comparatively weak for kapha dosha (ICC = 0.44; Cronbach’s alpha = 0.51) respectively. Prakriti diagnosis by AyuSoft was feasible in stabilized psychiatric patients and was found comparable to clinical diagnosis of prakriti by Ayurveda physicians in patients with psychiatric disorders.
Journal of Ayurveda and Integrative Medicine; doi:10.1016/j.jaim.2021.02.001
Alcohol is a widely abused drug with many health implications, mainly caused by the oxidative and nitrosative stress on different body parts. Ayurvedic herbalism authenticates the multiple therapeutic applications of Terminalia arjuna bark due to its rich phytochemical repertoire. To observe the extent of oxidative damage caused to erythrocytes by alcohol and assess the protective ability of T. arjuna bark powder aqueous extract (AETA) against the damage. Wister albino rats were categorized into four groups of eight rats per group; first group (control) was fed with glucose, second group was given alcohol at a dose of 20% v/v; 5g alcohol/kg b. wt/day, third group was co-administered with AETA (0.5 g/kg b. wt/day) and alcohol and the fourth group was kept on bark extract alone. Blood samples were collected and evaluated for different biochemical parameters after the completion of the treatment period. Alcohol significantly increased the erythrocyte membrane protein carbonyl and malondialdehyde (MDA) contents, along with a concomitant decrease in the membrane antioxidant status, when compared to the control group. Chromatographic analysis of the alcohol-treated rat erythrocyte membranes revealed altered membrane individual phospholipid contents and fluidity properties. Alcohol-induced morphological changes in the erythrocytes and its effect on decreasing the resistance of hypotonic shock induced by NaCl are evident from the hemolysis curves. However, AETA administration to alcoholic rats beneficially modulated the membrane properties anvd protected erythrocytes from damage. Results suggest that AETA protects erythrocytes from alcohol-induced oxidative stress, biophysical, and biochemical changes very effectively.
Journal of Ayurveda and Integrative Medicine; doi:10.1016/j.jaim.2021.01.011
“Cervical spondylosis” (CS) is a collective term used for non-specific neck pain post 30 age group. Management of CS is mainly non-surgical, particularly in mild to moderate severity that includes the oral anti-inflammatory drugs, exercises, manipulation, mobilization, or combination of these. The objective of the study is to assess the possible benefit of a selected group of asana in a group of patients over a short time frame and assess their functional outcome. An observational study of cohort of patients having mild to moderate CS, who visited the AYUSH department between May 2016 and November 2016 were included. “Selected group of Asana (SGOA)” was practiced for 30 min supervised and then home-based for a period of 8 weeks with usual standard treatment. Patients followed up fortnightly, and their degree of severity & disability assessed. Thirty patients with 19 males and 11 females having ages mean ± SD 45.61 ± 8.3 and 44.18 ± 9.78 having NDI score of mean ± SD 17.83 ± 4.749 at baseline (0 weeks) were included. Patients showed an improvement in NDI score to finally 7.40 ± 3.180, p-value = 0.0001. This improvement was also noted at various time intervals (p-value = 0.0001 each time), as seen in the post hoc analysis. Yogic practices “Specific Group of Asana” done for eight weeks on a home-based program could be useful in reducing pain and disability in people suffering from CS of mild to a moderate degree. However, more extensive, comparative, and multi-centric trials are required for establishing this as a treatment modality.