Journal of Ayurveda and Integrative Medicine

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https://imsear.searo.who.int/handle/123456789/150201

Editor: Professor Bhushan Patwardhan

ISSN: 0975-9476

Frequency: Quarterly

Language: English

Official Journal of the Institute of Ayurveda and Integrative Medicine, Bangalore

Open Access Peer-reviewed journal

Web site: https://www.jaim.in/

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A systematic review and meta-analysis focusing on the use of ayurvedic medicine in cerebral palsy
(Elsevier B.V., 2024-09) Rocha, A.M.O.; Len, C.A.; Santos, F.H.; Iglesias, S.B.O.; Bissoto, J.R.
Integrative practices have been incorporated into palliative care to provide holistic and multidimensional care for patients. This study aims to identify the scope of integrative practices, specifically whole medical systems, and demonstrate its safety and efficacy, specially in children with cerebral palsy. Key databases, including Embase, Cochrane, Medline/PubMed, Scopus, Google Scholar, Lilacs and Scielo were searched using specific terms. Only randomized and non-randomized clinical trials were included for meta-analysis purposes. Case-control, cohort, cross-sectional or retrospective observational studies were also included for the systematic review. Participants included children aged 0–18 years receiving palliative care for cerebral palsy and undergoing Ay- urvedic Medicine practices. Descriptive analysis was conducted, including data such as year; author; design; sample size; intervention and comparison; outcomes and conclusion. Two interventional studies compared Ayurvedic practices with each other or with physiotherapy in children with cerebral palsy. The meta-analysis demonstrated an improvement in spasticity for children using Ayurvedic medicine. However, there were limitations in terms of heterogeneity in interventions, control groups, and assessed outcomes. Integrative practices, including Ayurvedic medicine have the potential to improve quality of life, manage disease symptoms and provide emotional support. However, more robust evidence is needed to support their widespread use. The use of Ayurvedic medicine showed evidence of improvement in spasticity for children with cerebral palsy.
Millets as a dietary supplement for managing chemotherapy induced side effects
(Elsevier B.V., 2024-01) Tavhare, Swagata Dilip
Millets, the nutria-cereals, are one of the oldest utilized grain. Millets are reported to possess nutraceuticals health benefits which include improvement in functioning of digestive system, reduction in cholesterol, pre- vention of heart disease, protection against diabetes, lowering risks of cancer etc. With the widespread commemoration of the International Year of Millets in 2023, the Indian government is moving towards the global recognition of millets in light of its medicinal value in correction of lifestyles diseases. One of the common non- communicable diseases is cancer. Chemotherapy is used as adjuvant, neo-adjuvant or as a combination, in metastatic settings. It is linked to outcomes, but it also has unfavorable side effects that lower a patient’s quality of life. The reported chemotherapy side effects includes loss of appetite, nausea, vomiting, weakness, hair loss, osteoporosis, immunological suppression and gastric disturbances such as dry mouth, altered taste, ulcers, constipation etc. The effectiveness of tumor therapy and the extension of treatment are both influenced by side effect management. One way to help cancer patients with their polypharmacy load is through dietary man- agement. Rich in phytochemicals, fiber, vitamins, and minerals, millets can be suggested as a dietary therapeutic intervention in addition to chemotherapy. Being widely accessible, cost effective, nutrient-dense, high in fiber, gluten-free, anti-inflammatory, antioxidant, lipid lowering, gastro-protective, immunomodulator in action, millets can serve as a good diet choice to minimize side effects of chemotherapy.
A consensus guideline on preferred items for reporting case series in homeopathy: The PITCH statement
(Elsevier B.V., 2024-09) Dutta, Abhijit
Background: Case series is a valuable tool for sharing clinical experiences and generating research questions in the field of medicine. However, there is a lack of standardized reporting guideline for case series in homeopathy, which limits their utility and comparability. The aim of this study is to develop a reporting guideline for case series in homeopathy using a Delphi consensus process. Method: A group of 21 experts, with experience in reviewing, publishing, or editing case reports or series in homeopathy, were participated in the study. A modified Delphi consensus process was conducted with three rounds of electronic surveys to gather feedback and opinions on the items to be included in the reporting guideline. The GRADE group’s nine-point Likert scale was used to rate each item’s importance and criticality. Result: The Delphi process resulted in a consensus-based reporting guideline for case series in homeopathy, which includes recommendations for reporting case series in eleven sections, including ’Title,’ ’Abstract,’ ’Keywords,’ ’Introduction,’ ’Methods,’ ’Results,’ ’Discussion,’ ’Conclusion,’ ’Patient Perspectives,’ ’References,’ and ’Addi- tional Information.’ PITCH comprises a total of 59 items that achieved consensus agreement. Of these, 13 are optional items and 14 items are exclusively applicable for prospective type of case series. Conclusion: The PITCH reporting guideline provides a structured and standardized approach for reporting case series in homeopathy. The authors, journal editors, reviewers, and educators are encouraged to adopt and implement the guideline to enhance the quality of case series in homeopathic publications.
Classical ayurveda management of TCH (taxane, carboplatin, and herceptin) based chemotherapy induced peripheral neuropathy- A case report
(Elsevier B.V., 2024-09) Buch, Zankhana; Hegde, Suprabha; Lakshmi, Aishwarya; Bhat, Swathi
Although empirical data on the influence of Ayurveda on Chemo/Radiotherapy-induced side effects are limited, its methodological framework, grounded in a ’systems thinking’ perspective, enables the precise delineation of the pathogenic stage of these side effects. This, in turn, facilitates the development of a strategy to address the decline in the quality of life parameters commonly associated with cancer treatment. Ayurveda personalized approach to disease management typically involves providing customized diets, lifestyle adjustments, medica- tions, and detoxification therapies that target the entire body. We present a case involving a patient with numbness and pain in the right hand after undergoing chemo- therapy who was referred to us by an oncologist for symptom management. This case report demonstrates the Ayurveda approach for establishing the etiology, pathogenesis, pathophysiology, and treatment of Chemotherapy-Induced Peripheral Neuropathy (CIPN) resulting from taxane-based chemotherapy. Following Ayurveda intervention, the patient exhibited significant improvements in symptoms and quality of life parameters. This case report systematically illustrates the application of Ayurveda approach in CIPN management.
Ayurinformatics Laboratory- A synergy platform for Ayurveda and technology
(Elsevier B.V., 2024-09) Gupta, Prashant Kumar; Nesari, Tanuja Manoj
The Ayush sector has attained buoyant growth in the past decade as a science, public health, medicine, and industry. Artificial Intelligence, computational drug designing, and other combinatorial techniques could further accelerate the sector’s growth. In this edition, we delve into the confluence of Ayurveda and technology, a theme that resonates profoundly in the contemporary healthcare and wellness landscape. The fusion of Ayurveda, an ancient system of medicine rooted in holistic well-being, with cutting-edge technology, is not just a paradigm shift but a necessary evolution in pursuing an integrated healthcare system where all systems have their defined, recognized, and respected contribution. Here, We are highlight one-such fusion initiative "Ayurinformatics Laboratory".
Product development and characterization of a lipid-based Ayurvedic polyherbal formulation: Kalyanaka Ghrita
(Elsevier B.V., 2024-09) Singh, Yashika; Ansari, Amzad Ali; Sharma, Rajendra Prasad; Parhate, Saroj Moreshwar; Singh, Thakur Rakesh
Background: Kalyanaka Ghrita (KG) is polyherbal oleaginous medicament consisting of extracts from twenty-eight different plants, indicated for management of psychosomatic disorders like Unmada (Schizophrenia), Apasmara (Epilepsy) and numerous other ailments. Objective: To develop and validate standard manufacturing procedure of KG by following Ayurvedic principles in three batches to ensure process uniformity and standards. Materials and methods: Three batches of KG were prepared by adopting principles of Ashtanga Hrudya and Ay- urvedic Formulary of India to ensure consistency in manufacturing process. Observations during process such as temperature, duration were recorded. KG was subjected to chief desired characteristics, organoleptic (color, odour, taste, texture, touch), physicochemical (acid value, peroxide value, iodine value, saponification value, loss on drying, refractive index, specific gravity, mineral oil, rancidity test, viscosity) as per pharmacopeial standard. Chromatographic screening and fingerprinting of KG were conducted through GCMS whereas quantification of curcumin and chebulagic acid biomarkers were assessed through HPLC. Results: Average yield of KG was 83.41%, with average intermittent heating duration of 20.35 h subsequently divided into three days. Temperature throughout preparation ranged from 66 ?C to 101 ?C. KG was pale olive in colour, exhibiting pleasant taste, characteristic smell, and soft texture. Organoleptic and physicochemical characters were comparable for three batches of KG while safety parameters were found within permissible limits. Conclusion: Pharmaceutical standardization of Kalyanaka Ghrita is necessary for establishing biological and chemical profile of formulations. Present study recommends use of coarse powdered ingredients for optimal yield during pharmaceutical process, and heating up to Madhyama Paka stage calibrated over three days with average temperature of 85 ?C. The data obtained from this study may contribute to future research and development activities, serving as a basis for manufacturing standards of KG.
Management of congenitally fused cervical vertebrae with Ayurveda intervention - A case report
(Elsevier B.V., 2024-09) Ekka, Ranjita; Bhushan, Shakti; Ekta, Ekta; Nair, Parvathy G.; Dixit, Amit kumar; Prasad, P.V.V.
A 42-year-old male patient presented with complaints of vertigo, neck pain, swallowing difficulties, and diffi- culty in maintaining an upright posture. The patient took allopathic consultation for the complaints and was advised to undergo MDCT scan of brain, hematological and audiological evaluations. No abnormalities were detected in the investigations and he was given some medications for symptomatic management. As no relief was noted, the patient took an Ayurveda consultation. After clinical evaluation, the patient was advised to perform an X-ray of the cervical spine and was diagnosed with congenital block vertebrae at C3 – C4 vertebral bodies and posterior appendages with hypoplastic intervening disc space. He was advised to take Ekangveerarasa 250 mg BD before food with honey, Trayodashang guggulu 1 gm BD after food, Vishatinduka vati 250 mg BD after food, Aswagandha churna 3 gm BD after food with milk.The patient was also advised to do light massage and mild hot fomentation in the neck region twice a day with Mahavishagarbha oil. Remarkable relief was observed with all signs and symptoms including a reduction of score in the Neck Disability Index (NDI) within a very short duration of treatment. Considerable improvements were noted in the quality of life of the patient as confirmed by the WHO QOL BREF score. This case report shows that Ayurveda can offer safer and more effective symptomatic treatment for conditions like congenitally fused vertebrae.
Reverse pharmacology based clinical protocols for noninvasive integrative management of low grade cervical precancer lesions: Rationale and outcomes
(Elsevier B.V., 2024-09) Joshi, J.V.; Raut, A.A.; Paradkar, P.H.; Jagtap, S.S.
Prevention is the most efficient and cost-effective method to combat cervical cancer for which High Risk Human Papilloma Virus (HR-HPV) infection is identified as the major causative factor. HPV vaccination is for primary prevention whereas surgical ablation of precancer is for secondary prevention after HPV infection has occurred. Screening of women for early detection of Squamous Intraepithelial Lesions (SILs) with Papanicolou smear (Pap smear) is a desirable pre-requisite. Surgical ablation which invites invasive procedures is not accessible nor affordable to the larger section of the population. We propose here a non-invasive integrative management approach for the early phase of cervical pre-cancer. In tune with the reverse pharmacology approach, ‘experience-exploration- experimentation’, we have conducted five clinical studies related to Turmeric extracts for chemo-preventive activity and non-surgical feasibility. We were able to achieve arrest or regression in Low-grade SILs in all 41 women participating in these studies. The unique features of this integrative management approach were i) Avoidance of surgery-associated trauma, cost and complications ii) Standard of care for associated genital infections iii) Feasibility when surgery was not accessible iv) Scope for repeating the noninvasive treatment.
Ayurvedic management of systemic sclerosis - A case report
(Elsevier B.V., 2024-09) Parmar, Jagruti R.; Upadhyay, Naiya; Patel, Manish V.; Gupta, Shivenarain N.
Scleroderma, an autoimmune connective tissue disorder, leads to skin and tissue thickening. In this autoimmune disease condition, the defense mechanism works against the body itself and mistakenly attacks normal cells. Ayurveda links it to vatarakta, initially affecting tvak, rakta, and mamsa. Vata is primarily involved, but as the disease progresses, all doshas and dhatu get involved. A 45-year-old woman presented with skin hardening, skin depigmentation all over her body, limb stiffness, weakness, arthralgia, anorexia, constipation and burning in the chest region for the last three years. She was diagnosed with diffuse systemic sclerosis (SSc) but as per Ayurveda we can correlate with aamvata and vatarakta based on her lakshanas(symptoms). Ayurvedic treatment commenced with vardhamana pippali(Piper longum)rasayan, svedana karma, and virechan karma, followed by basti(enema) chikitsa (pathyadi kvath niruh basti) and oral ayurvedic medication viz., Man- jisthadi kvatha, kaishora guggulu, Jatamansi(Nardostachys Jatamansi) churna, mishreya(Foeniculum vulgare) arka, dashang churna with water for local application and daily shamanarth panchtikta ghrit. After 8 weeks, depigmentation was reduced, new hair growth emerged, mild skin softening occured, chest burning, anorexia, sleeplessness was decreased and enhanced mental well-being. The treatment aimed to balance vitiated doshas and dhatu while alleviating symptoms, and enhancing overall well-being, demonstrating the efficacy of the holistic approach in managing scleroderma through Ayurveda. Auto-immune disorder, scleroderma, chronic complications, skin tightness, salt pepper depigmentation, sclerodactyly.
Management of post-hysterectomy urinary incontinence with composite Ayurveda treatment – A case report
(Elsevier B.V., 2024-09) Pandit, Ranjani Karthik
This is a case report of a patient who developed urinary incontinence after undergoing abdominal hysterectomy. This was successfully treated with Ayurvedic treatment procedures. A 63-year-old lady was suffering from uri- nary incontinence, which developed after hysterectomy. It did not subside even after undergoing trans vaginal taping. She was treated with Ayurvedic procedures and medicines for a period of 2 and a half months from 4th of March 2016 to 26th of May 2016. Matrabasti (medicated enema) and Madhutailika basti (enema treatment with honey and oil), along with other palliative medicines – Sukumara ghrita, Chandraprabha vati, Shilajatu, Maha- kalyanaka kashaya, Mamsapachaka ghana vati and Mahatiktaka ghrita were given to the patient. Urinary incon- tinence reduced to dribbling of urine after Matra basti and after the second course of Basti (medicated enema), that is after one and half months, patient stopped using diapers and was relieved from incontinence. This case report summarises the effective management of urinary incontinence by adopting basti (enema) treatment along with other palliative ayurvedic medicine.
A scoping review of Ayurvedic rasayana adaptogens in oncology
(Elsevier B.V., 2024-01) Wu, Cairn; Mulakaluri, Ashley; Chaurasia, Pranay; Suryanarayana, Sindhu; Singh, Ambreen; Krauss, Nicole; Tahir, Peggy; Elder, Charles; Puthiyedath, Rammanohar; Dhruva, Anand
Introduction: Rasayanas are Ayurvedic natural products that have adaptogenic effects. The extensive research on rasayanas in oncology is not currently well summarized. The aim of this review is to investigate the range and nature of the current body of research, identify gaps in knowledge, and to summarize the existing literature as it relates to Ayurvedic rasayanas and oncology. Materials and methods: A comprehensive literature search of fifteen Ayurvedic adaptogen rasayanas was con- ducted using three main concepts: Ayurvedic herbal terms, neoplasm terms, and oncological pathways. After screening was performed, key variables were extracted (tagged) including type of adaptogen, cancer type, type of study design, constituent type, and mechanisms of action (MOA). The results were synthesized and summarized using descriptive statistics and narrative summaries. Results: Five hundred and eighty-four articles were reviewed and tagged. The two most tagged adaptogens were Glycyrrhiza glabra (Yashthimadhu/licorice) (n = 166 (28.4 %)) and Withania somnifera (Ashwagandha) (n = 151 (25.9 %)). The most frequently tagged cancer diagnostic categories were gastrointestinal (n = 175 (30 %)), and breast (n = 126 (21 %)). Most of the articles focused on in vitro studies (n = 470 (80.3 %)). Of the 12 MOA tags, the most frequently tagged was apoptosis (n = 298 (29.2 %)). Conclusion: A large body of pre-clinical literature exists on adaptogen rasayanas in oncology, indicating this field of research is still in its early phase. Comparatively few studies focused on the effects on the immune system. Given the growing interest in immuno-oncology therapeutics and the potential impact of adaptogen rasayanas on the immune system, future research may focus more in this area, along with work that is more directly linked to future clinical studies.
An exploratory single-arm open-label clinical study to evaluate the combined effect of Vamana and Sarasvata Churna in reducing excessive daytime sleepiness
(Elsevier B.V., 2024-09) Menon, Arathy; Soman, Devipriya; Chacko, James; Anandaraman, P.V.; Kundagol, Mahesh C.; Sreejith, K.
Background: Excessive Daytime Sleepiness (EDS) is inferred as persistent sleepiness and often a general lack of energy during the day even after apparently adequate or even prolonged nighttime sleep. The subjects may not be identifying excessive daytime sleepiness but may present as feeling tired, lack of energy etc. They may seem apparently healthy and without any other systemic illness. The prevalence was found to be as high as 18 % in 2012 in United Kingdom. Also, it is a risk factor for diseases like Alzheimer’s disease, Parkinson’s disease and other neurodegenerative diseases. Conventional management (Modafinil, Sodium Oxybate and Stimulants) ad- dresses only the subjective condition in EDS and is associated with adverse effects compromising the quality of life. In the current health scenario there is a need for alternative interventions to manage this disease. On analyzing this condition through Ayurveda, we could understand it as Nidradhikya (Excessive daytime sleepiness) which is caused due to vitiated Kapha Dosha along with Vriddha Tamoguna (increased Tamoguna) that can be managed by Shodhana (biopurification) followed Shamana (pacification) therapies. Objective: This study was aimed to assess the combined effect of Vamana (therapeutic vomiting) and Sarasvata Churna in reducing Excessive Daytime Sleepiness. Materials and methods: This was a single-arm exploratory open-label clinical trial. 10 subjects having EDS diagnosed using Modified Epworth Sleepiness Scale (MESS) with a score of 10–24 with proper exclusion were recruited from OPD and IPD, Department of K ?ayacikitsa, Amrita School of Ayurveda. All the participants were clinically examined, sought for medical history and further checked biochemically to exclude any other systemic illness that may lead to this condition. Only healthy subjects with quality night sleep (assessed by PSQI) and without any other systemic illness were selected. The treatment protocol adopted was Vamana Karma followed by 30 days of Sarasvata Churna as Shamana Aushadha (medicine for pacification). Assessment was done using MESS on 0th day and after 30 days of Shamana Aushadha Sevana. After completion of treatment, the results were statistically analysed using Wilcoxon Signed Rank Test and final conclusion was drawn. Results: On analysis of the symptoms using Modified Epworth Sleepiness Scale, the mean total score reduced from 14.8 to 2.8 with 81.08 % relief in these 10 subjects and a significant p value < 0.05 after Vamana followed by 30 days of Shamana Aushadha Sevana. Discussion: Vamana helps in Kapha Nirharana (expelling) which removes the Avarana (occlusion) of Manas seen in Nidradhikya. This results in Hrit Shuddhi (purity of heart) that helps in bringing the equilibrium of Mano Gunas (qualities of mind) (Satvoudaryam Tamojayaha) which forms the line of management. Sarasvata Churna which was administered as Shamana Aushadha possesses Medhya (Nootropic), Buddhi Smriti Dhriti Vardhaka (intellect, memory and patience promoting) attributes and is being indicated in Vicetas. Most of the drugs in Sarasvata Churna are Rasayana (rejuvenation) that imparts Indriya Bala (strengthening of senses) and Priti (contempt) to Manas by Prinana (nourishing) of Rasa Dhatu. Conclusion: From this study, we could conclude that the combination of Vamana Karma followed by Sarasvata Churna administration is effective in reducing EDS.
Hepatoprotective effect of flavonoid rich fraction of Sesbania grandiflora: Results of In vivo, in vitro, and molecular docking studies
(Elsevier B.V., 2024-09) Kuttiappan, Anitha; Chenchula, Santenna; Vanangamudi, Murugesan; Bhatt, Shvetank; Chikatipalli, Radhika; Bhanu, P Shaila; Bandaru, Nagaraju
Background: Phytochemicals and their derivatives are promising target drugs for various ailments and have served as therapeutic agents for several decades. Using in vivo and in vitro models and molecular docking, this study investigated the pharmacological potential of a flavonoid-rich fraction of the ethanolic extract of Sesbania grandiflora (SG). Objectives: This research aimed to determine whether flavonoid-rich whole-plant extracts of SGs have any cytoprotective or in vivo hepatoprotective effects. Additionally, the study was intended to elucidate the molecular connections between the discovered flavonoid flavonols and PPAR? target proteins linked to liver problems, for which an in silico molecular docking investigation was performed. Materials and methods: To separate the flavonoid components, the entire Sesbania grandiflora plant was first extracted using ethanol as a solvent by soxhlet extraction. The resulting ethanolic extract was then fractionated. The cytoprotective and hepatoprotective properties were evaluated via in vitro and in vivo experiments. SGOT, SGPT, triglyceride, bilirubin, and total protein levels were used to evaluate hepatotoxicity in animal models. In vitro studies on Hepatocellular Carcinoma G2 (HepG2) cell lines have examined their cytotoxic effects and antioxidant activity. The most promising flavonoid-flavanol compounds were identified by conducting molecular docking studies against PPAR? target protein (PDB ID: 3VI8) using MOE software. Results: In vivo, the serum levels of SGOT, SGPT, total triglyceride and total bilirubin were measured in exper- imental animals treated with the flavonoid-rich ethanolic extract of SG. Significant reductions in the levels of these hepatic injury markers were observed, indicating the hepatoprotective potential of the extract. Elevated levels of liver biomarkers in the untreated group indicated liver injury or dysfunction. The treated groups showed significant restoration of these biomarkers, suggesting the hepatoprotective potential of SG. The IC50 value for the total flavonoid content of SG was 190.28 ?g/ml, indicating its safety in inhibiting HepG2 cell growth. Flavonoid treatment decreased cell viability but did not affect antioxidant parameters in hepatocytes. In addi- tion, SG restored the damaged hepatocyte architecture. Molecular docking studies revealed the binding affinities of flavonoids for PPAR?. These findings suggest that a promising lead candidate for the development of thera- peutic medicines against anti-TB drug-induced hepatotoxicity has been identified. Conclusion: Our findings demonstrate the hepatoprotective potential of the flavonoid-rich fraction of Sesbania grandiflora both in vivo and in vitro. This study provides valuable insights into its mechanism of action, high- lighting its promising therapeutic application in the management of liver disorders. This study highlights the hepatoprotective and cytoprotective potential of the total flavonoid-rich fraction of SG.
Clinical metabolomics investigation of rheumatoid arthritis patients receiving ayurvedic whole system intervention
(Elsevier B.V., 2024-07) Rastogi, Sanjeev; Verma, Ankita; Trivedi, Rimjhim; Shukla, Anuj; Kumar, Dinesh
Background: Arthritis is a common clinical condition seen in Ayurveda clinics. Clinical trials have reported Ay- urvedic interventions to be of benefits in many arthritic conditions including Rheumatoid Arthritis (RA). No mechanistic details however are available about how such interventions on their own or as a combination of whole system Ayurveda might be working. Objective: The study aims to evaluate simultaneously the clinical outcome of Ayurveda whole system (AWS) intervention in RA patients and identifying the serum metabolic signatures which could be useful for diagnosing the disease and monitoring treatment response. Material and methods: RA patients (n = 37) simultaneously diagnosed as Amavata fulfilling the specific inclusion and exclusion criteria were recruited in the study and were given Ayurveda whole system (AWS) intervention comprised of oral medicines, local therapy and dietary recommendation for 3 months. The clinical and serum metabolic changes were investigated for pre-treatment RA patients (baseline RA group, n = 37) and post- treatment RA patients (following treatment of 6-weeks (RA_F, n = 26) and three months (RA_T, n = 36). For comparative serum metabolomics analysis, 57 normal healthy control (HC) subjects were also involved and the serum metabolic profiles were measured at high-field 800 MHz NMR spectrometer. The serum metabolic profiles were compared using multivariate statistical analysis and discriminatory metabolic features were evaluated for diagnostic potential using receiver operating characteristic (ROC) curve analysis. Results: A significant reduction in DAS-28 ESR, AAM Score, total swollen joints, total tender joints were observed following AWS intervention. The clinical outcomes were concordant with changes in metabolic profiles of RA patients as these were also shifting towards the normal levels following the intervention. Compared to healthy control (HC) subjects, the sera of baseline RA patients were characterised by increased circulatory level of succinate, lysine, mannose, creatine, and 3-Hydroxybutyrate (3-HB) and decreased levels of alanine. The present study also evaluated the serum metabolic ratios for their discriminatory and diagnostic potential and notably, six metabolic ratios (KHR, KThR, KVR, GHR, PTR and SHR) were found significantly altered (elevated) in baseline RA patients. However, in RA patients receiving AWS treatment, these metabolic changes showed marked convergence towards the metabolic signatures of healthy controls. Conclusion: This first of its kind study clearly shows the clinical efficacy of Ayurvedic Whole System (AWS) intervention in the management of Rheumatoid Arthritis (RA), as demonstrated by significant improvements in key clinical parameters. The intervention not only alleviated symptoms but also induced a profound metabolic shifting towards normalization; thus, underscoring the potential of AWS intervention to modulate cellular metabolism in a manner that facilitates a return to homeostasis in RA patients. However, future studies are imperative to confirm these preliminary observations and delineate the underlying mechanisms of action of intervention in cases of RA.
Cross-cultural study on the uses of traditional herbal medicine to treat various women's health issues in Northeast India
(Elsevier B.V., 2024-09) Kropi, Klaret; Jastone, K.P.; Kharumnuid, Sweety Angelirie; Das, Hemanta Kumar; Naga, Moses M.
Background: This cross-cultural study conducted in the diverse regions of Assam, Meghalaya, and Manipur sheds light on the common utilization of five specific medicinal plants among indigenous communities residing in these areas. Objectives: The main focus of this study is to document and compare the traditional medicinal plant used and the knowledge and practices related to women’s health issues in different cultures; to identify commonalities and differences in the use of medicinal plants across cultures and various medicinal plants used traditionally by the indigenous communities to treat women’s health problems according to their indigenous name, scientific name. Materials and methods: The study used a survey method and a pre-structured interview schedule through one-on- one interactive communication and field observation. The authors collected data from three different states, i.e., Assam (Karbi Anglong district & Udalguri district), Meghalaya (East Khasi Hills district), and Manipur (Senapati district) by personally meeting and interacting with traditional herbal medicinal practitioners. For this study, 10 practitioners from each area of study were interviewed. During the data collection process, the vernacular name of the medicinal plant, methods of preparation, mode of application, and probable dosage were compiled and documented involving practitioners belonging to four different communities, i.e, Bodo, Karbi, Khasi, and Poumai Naga of the selected states. Results: A total of 39 plant species were meticulously collected and documented across the Karbi Anglong district and Udalguri district in Assam, East Khasi Hills district in Meghalaya, and Senapati district in Manipur. Turmeric (Curcuma longa), ginger (Zingiber officinale), gooseberry (Emblica officinalis), papaya (Carica papaya), and passion fruit (Passiflora edulis) have emerged as common medicinal resources within these communities. Poaceae, rep- resented by 5 species, emerged as the dominant family among the collected plants, highlighting the diversity and significance of these botanical remedies. Zingiber officinale Roscoe " has the highest usage report of 18 with an RFC (Relative frequency citation) of 0.45. Conclusion: The study’s findings reveal a rich repository of traditional herbal knowledge in the northeast regions of India. Notably, the indigenous communities of these regions use plant resources to cure a wide range of ailments. This study emphasizes the necessity of documenting, preserving, and transmitting traditional herbal medicinal knowledge for both cultural and practical reasons. It also provides vital insights into the importance of cross-cultural study in promoting different cultures, the richness of traditional medicinal knowledge by engaging with diverse cultures and demonstrates the possibilities for incorporating traditional medicine into modern healthcare systems, particularly in treating women’s health issues across these culturally diverse regions.
Chronic inflammation: Cross linking insights from Ayurvedic Sciences, a silver lining to systems biology and personalized medicine
(Elsevier B.V., 2024-07) Nair, Pratibha P.; Krishnakumar, V; Nair, Parvathy G.
Precision in personalized medicine is a crucial subject that needs comprehensive discussion and scientific validation. Traditional healthcare approaches like the Ayurvedic Sciences are often contextually linked with personalized medicine. However, it is unfortunate that this knowledge concerning Ayurveda and personalized medicine is restricted to applying systems biology techniques to ’prakriti’ the phenotypic expression and characterization detailed in the literature. There are other significant constructs besides prakruti that interest an Ayurvedic physician, which accounts for crafting precision in evidence-based medicinal practices. There is this influential model of Ayurvedic healthcare practice wherein the physician maps specific personalized characters in addition to prakruti to deduce the host responses to endogenous and exposome conditions. Subsequently, tailored protocols are administered that bring about holistic, personalized outcomes. The review aimed to determine the effective methods for integrating Systems Biology, Ayurvedic Sciences, and Personalized Medicine (precision medicinebased). Ayurveda adopts a holistic approach, considering multiple variables and their interconnections, while the modern reductionist approach focuses on understanding complex details of smaller parts through rigorous experimentation. Despite seeming extremes, ongoing research on lifestyle, gut health, and spiritual well-being highlights the evolving intersection between traditional Ayurvedic practices and modern science. The current focus is on developing the fundamental concept of Ayurveda Biology by incorporating Systems Biology techniques. Challenges in this integration include understanding diverse data types, bridging interdisciplinary knowledge gaps, and addressing technological limitations and ethical concerns. Overcoming these challenges will require interdisciplinary collaboration, innovative methodologies, substantial investment in technology, and cultural sensitivity to preserve Ayurveda’s core principles while leveraging modern scientific advancements. The focus of discussions and debates on such collab- orations should be breakthrough clinical models, such as chronic inflammation, which can be objectively related to specific stages of disease manifestations described in Ayurveda. Validating patient characteristics with systems biology approaches, particularly in shared pathologies like chronic inflammation, is crucial for bringing prediction and precision to personalized medicine
Evaluation of Withania somnifera based supplement for immunomodulatory and antiviral properties against viral infection
(Elsevier B.V., 2024-09) Verma, Dileep Kumar; Hasan, Abdul; Rengaraju, Manickavasagam; Devi, Shree; Sharma, Geetika; Narayanan, Vimal; Parameswaran, Sathiyarajeswaran; D, Thirumal Kumar; Kadarkarai, Kanakavalli; Sunil, Sujatha
Background: Viral mediated diseases are continuously posing potent threat to human health. Nutraceuticals are being employed as novel therapeutics during viral outbreaks. MAM granules consist of Curcuma longa, Withania somnifera, and Piper nigrum, is one such patented Siddha nutraceutical supplement that has been proposed to be a therapeutic agent against viral diseases. Objective: We characterised MAM for their phytochemical and physicochemical properties and evaluated its cytotoxicity via in vivo acute toxicity studies using Wistar rats and by cell-based MTT assays. Materials and Methods: The antiviral properties of the aqueous extract of MAM were investigated against SARS- CoV-2 and chikungunya virus (CHIKV). Further, using ABTS radical scavenging, SOD enzymatic assays and measurement of intracellular ROS, we investigated the antioxidant potential of MAM extract and its ingredients in RAW264.7 cells. Additionally, production of inflammatory mediators was evaluated via NO release, PGE2 production and release of pro-inflammatory cytokines (IL-1? and TNF?). Results: The MAM granules and aqueous extracts demonstrated no significant toxicity and demonstrated potent antiviral activity during co-incubation assay with SARS-CoV-2 and CHIKV. Moreover, we observed potent antioxidant and anti-inflammatory activity of MAM extract in a dose dependent manner. Further investigations on the individual ingredients with respect to their antioxidant and anti-inflammatory activities showed that all ingredients contributed synergistically and Withania somnifera showed most potent anti-oxidant activity. Conclusion: The overall in vitro, and in vivo analysis demonstrated that MAM granules were non-toxic and possessed potent antiviral activity. Additionally, observed significant anti-oxidant and anti-inflammatory prop- erties of MAM suggested the modulation of innate immune response in the host validating its use as an effective nutraceutical during viral outbreaks.
Antidiabetic effect of combined extract of Coccinia grandis and Blumea balsamifera on streptozotocin-nicotinamide induced diabetic rats
(Elsevier B.V., 2024-07) Putra, I Made Wisnu Adhi; Fakhrudin, Nanang; Nurrochmad, Arief; Wahyuono, Subagus
Background: Coccinia grandis and Blumea balsamifera are two medicinal plants that have been known to have good antidiabetic properties. Combining these two plant extracts may generate a greater effect that can increase ef- ficacy and decrease the dose. Objective: This research investigated the antidiabetic activity of the combination of C. grandis and B. balsamifera leaves extracts on experimental diabetic rats. Materials and methods: The dried leaves of C. grandis and B. balsamifera were powdered and macerated with ethanol 70% (v/v). A diabetic condition in male Wistar albino rats was generated by intraperitoneal injection of a single dose of streptozotocin (65 mg/kg) followed by nicotinamide (110 mg/kg). Diabetes-confirmed rats were then given glibenclamide (4.5 mg/kg), C. grandis extract (300 mg/kg), B. balsamifera extract (150 mg/kg), and the combined extracts with a dose ratio of 1:1, 1:3, and 3:1. The treatment was performed for 28 days and fasting blood glucose was tested once a week. The pancreas and liver organs were taken on day 29 for antioxidant, histological, and immunohistochemical assessment. Results: Among all the extracts, the combined extract with a ratio of 1:3 showed the greatest glucose lowering effect. This combination also lowered malondialdehyde levels while increasing superoxide dismutase and catalase levels in the pancreas and liver organs. Histological examination showed this combination regenerated the islet of Langerhans. It also increased pancreatic insulin expression in immunohistochemical evaluation. Conclusion: This study revealed that the combined extracts of C. grandis and B. balsamifera exhibited enhanced antidiabetic activity via ameliorating oxidative stress, regenerating ?-cells, and increasing insulin expression.
Effectivity of oral ginger supplementation for chemotherapy induced nausea and vomiting (CINV) in children: A systematic review of clinical trials
(Elsevier B.V., 2024-07) Hardi, Harri; Estuworo, Geraldine Kenyo; Louisa, Melva
Chemotherapy-induced nausea and vomiting (CINV) affects over 50% of pediatric patients undergoing chemo- therapy, a higher proportion than in adults. CINV often occurs despite adequate antiemetic prophylaxis, hampering patients’ willingness to continue the chemotherapy regimen. As an ayurvedic medicine, ginger (Zingiber officinale) has an antiemetic effect by inhibiting serotonin in gastrointestinal nerves and as an NK1 antagonist. Therefore, we aimed to review oral ginger supplementation in children with CINV systematically. Systematic searching was performed in June 2023 from Pubmed, Embase, CINAHL, Cochrane, and hand searching. The search consisted of PICO “children chemotherapy”, “ginger”, and “CINV incidence”. We limited the search to only human studies. Studies that meet inclusion and exclusion criteria were included for analysis. Out of 116 studies found with our selection criteria, four were compatible with inclusion and exclusion criteria. Two studies had a small Risk of Bias (RoB), while the others had a high RoB. All studies statistically significantly reduced acute and delayed CINV with the number needed to treat (NNT) 2–4. No adverse effects were reported. However, these studies still had high heterogeneity based on cancer treatment, chemotherapy regimen, ginger dosing, and ginger processing. Ginger has the potential to reduce both the acute and delayed phases of CINV in children. Additional research employing standardized methodologies is recommended to validate this effect.
Trigonelline, a Fenugreek Bioactive compound protects Heart tissue against alcohol intoxication: An in-vivo study focusing on antioxidant perspective
(Elsevier B.V., 2024-07) Sekhar, Meesala Guru; Shanmugam, Kondeti Ramudu; Chakrapani, Inavolu Srinivasa
Background: Trigonella foenum-graecum, commonly known as fenugreek and it is used as a spice. It has antioxi- dant, anti-diabetic, antilipedemic and other pharmocological properties. Objectives: The aim of the study was to detect the cardio protective activity of Trigonelline (TG) a bioactive compound of Trigonella foenum-graecum (TF) in alcohol intoxicated rats. Material and methods: The young wistar strain albino rats are divided in to 5 groups and treatment was given as per the experimental protocol. Antioxidant enzymes, superoxide dismutase (SOD), glutathione peroxidase (GPx), catalase (CAT), glutathione reductase (GR), glutathione (GSH), malondialdehyde (MDA) levels are estimated in cardiac tissue of all experimental groups. Cardiac markers creatine kinase-MB (CK-MB), troponin-T (TT), troponin-I (TI), myoglobin (MG) and serum markers alanine transaminase (AAT), aspartate transaminase (AST) and alkaline phosphatase (ALP) are estimated. Free radical scavenging activities like 2,2-diphenylpicrylhydrazyl (DPPH), hydrogen peroxide (H2O2) and hydroxyl radical are estimated in ethanolic extract of Trigonella foenum- graecum. Results: SOD, CAT, GPx, GR, GSH activities are depleted and MDA, CK-MB, TT, TI, MG and AAT, AST, ALP ac- tivities are elevated in alcohol intoxicated rats. Trigonelline supplementation to alcoholic rats for 30 days elevated antioxidant enzymes, depleted MDA, cardiac markers and serum markers in alcohol intoxicated rats. Free radical scavenging assay also reported that Trigonella foenum-graecum possess free radical scavenging ac- tivity. Furthermore, our histopathological evidence also proved that TG protected the cardiac tissue from alcohol induced toxicity in all the experimental rats. Conclusion: Our study concluded that TG may be useful to the alcoholic and myocardial infarction subjects.

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