Ayurveda and in silico Approach: A Challenging Proficient Confluence for Better Development of Effective Traditional Medicine Spotlighting Network Pharmacology / 中国结合医学杂志

Coalescence of traditional medicine Ayurveda and in silico technology is a rigor for supplementary development of future-ready effective traditional medicine. Ayurveda is a popular traditional medicine in South Asia, emanating worldwide for the treatment of metabolic disorders and chronic illness. Techniques of in silico biology are not much explored for the investigation of a variety of bioactive phytochemicals of Ayurvedic herbs. Drug repurposing, reverse pharmacology, and polypharmacology in Ayurveda are areas in silico explorations that are needed to understand the rich repertoire of herbs, minerals, herbo-minerals, and assorted Ayurvedic formulations. This review emphasizes exploring the concept of Ayurveda with in silico approaches and the need for Ayurinformatics studies. It also provides an overview of in silico studies done on phytoconstituents of some important Ayurvedic plants, the utility of in silico studies in Ayurvedic phytoconstituents/formulations, limitations/challenges, and prospects of in silico studies in Ayurveda. This article discusses the convergence of in silico work, especially in the least explored field of Ayurveda. The focused coalesce of these two domains could present a predictive combinatorial platform to enhance translational research magnitude. In nutshell, it could provide new insight into an Ayurvedic drug discovery involving an in silico approach that could not only alleviate the process of traditional medicine research but also enhance its effectiveness in addressing health care.

Process optimization of physicochemical properties of spray-dried Hydrocotyle umbellata L. extract

Abstract Hydrocotyle umbellata L., Araliaceae, is a species that is recommended in Ayurvedic medicine for its effects on the central nervous system, such as anxiolytic and memory-stimulant effects. Despite the medicinal potential of this species, its phytopharmaceutical and technological potential to produce standardized extracts has not been investigated. This study analyzes the influence of spray drying parameters on the contents of the chemical markers (total phenolic, total flavonoid, and hibalactone) and the functional properties of H. umbellata extract. The optimization of drying conditions was performed using a central composite design combined with response surface methodology and desirability function approach. The mathematical models fitted to experimental data indicated that all the evaluated drying parameters significantly influenced the chemical contents. The optimal conditions were: inlet temperature of 120 °C, feed flow rate of 4 mL min-1, and colloidal silicon dioxide:maltodextrin ratio of 16%:4%. Under these conditions, the powder samples had spherical particles and desirable physicochemical and functional properties, such as low water activity and moisture content, good product recovery, reconstitution, and flowability. Thus, spray drying might be a promising technique for processing standardized H. umbellata extracts.

Nano-ayurvedic medicine and its potential in cancer treatment / 中西医结合学报

Nano-ayurvedic medicine is an emerging field in which nanoparticles are functionalized with active principles of potent ayurvedic herbs to enhance their efficacy and target-specific delivery. Scientific advances in the past couple of decades have revealed the molecular mechanisms behind the anticancer potential of several ayurvedic herbs, attributed chiefly to their secondary metabolites including polyphenols and other active substances. With the advancement of nanotechnology, it has been established that size-, shape-, and surface-chemistry-optimized nanoparticles can be utilized as synergizing carriers for these phytochemicals. Nano-ayurvedic medicine utilizes herbs that are commonly used in Ayurveda to functionalize different nanoparticles and thereby enhance their potency and target specificity. Studies have shown that the active phytochemicals of such herbs can be coated onto the nanoparticles of different metals, such as gold, and that they work more efficiently than the free herbal extract, for example, in inhibiting cancer cell proliferation. Recently, an Ayurveda, Yoga & Naturopathy, Unani, Siddha and Homeopathy (AYUSH)-based clinical trial in humans indicated the anticancer potential of such formulations. Nano-ayurvedic medicine is emerging as a potential treatment option for hyperproliferative diseases.

Diretriz Latino-americana sobre o Diagnóstico e Tratamento da Alergia Ocular ­ Em nome da Sociedade Latinoamericana de Alergia, Asma e Imunologia (SLAAI) / Latin American Guideline on the Diagnosis and Treatment of Ocular Allergy ­ On behalf of the Latin American Society of Allergy, Asthma and Immunology (SLAAI)

A alergia ocular, também conhecida como conjuntivite alérgica (CA), é uma reação de hipersensibilidade mediada por imunoglobulina E (IgE) do olho desencadeada por aeroalérgenos, principalmente ácaros da poeira doméstica e pólen de gramíneas. Os sintomas geralmente consistem em prurido ocular ou periocular, lacrimejamento e olhos vermelhos que podem estar presentes durante todo o ano ou sazonalmente. A alergia ocular tem frequência elevada, é subdiagnosticada e pode ser debilitante para o paciente. É potencialmente danosa para a visão, nos casos em que ocasiona cicatrização corneana grave, e na maioria dos pacientes associa-se a outros quadros alérgicos, principalmente rinite, asma e dermatite atópica. É classificada em conjuntivite alérgica perene, conjuntivite alérgica sazonal, ceratoconjuntivite atópica e ceratoconjuntivite vernal. O diagnóstico procura evidenciar o agente etiológico e a confirmação se dá pela realização do teste de provocação conjuntival. O tratamento baseia-se em evitar o contato com os desencadeantes, lubrificação, anti-histamínicos tópicos, estabilizadores de mastócitos, imunossupressores e imunoterapia específica com o objetivo de obter o controle e prevenir as complicações da doença.

Ocular allergy, also known as allergic conjunctivitis, is an immunoglobulin E-mediated hypersensitivity reaction of the eye triggered by airborne allergens, primarily house dust mites and grass pollen. Symptoms usually consist of ocular or periocular itching, watery eyes, and red eyes that may be present year-round or seasonally. Ocular allergy has a high frequency, is underdiagnosed, and can be debilitating for the patient. It is potentially harmful to vision in cases of severe corneal scarring, and in most patients, it is associated with other allergic conditions, especially rhinitis, asthma, and atopic dermatitis. It is classified as perennial allergic conjunctivitis, seasonal allergic conjunctivitis, atopic keratoconjunctivitis, and vernal keratoconjunctivitis. Diagnosis seeks to identify the etiologic agent, and confirmation is given by conjunctival provocation testing. Treatment is based on avoiding contact with triggers, lubrication, topical antihistamines, mast cell stabilizers, immunosuppressants, and specific immunotherapy with the aim of achieving control and preventing disease complications.

Why the "sugars" in traditional Unani formulations are a pivotal component: A viewpoint perspective / 中西医结合学报

Traditional medicine systems around the globe, like Unani, Ayurveda and traditional Chinese medicine, include a number of sugar-based formulations, which contain a large amount of saccharide-containing sweetener, such as honey, sucrose or jaggery. With pervasive lifestyle disorders throughout the world, there have been discussions to consider alternative sweetening agents. Here, from the perspective of Unani medicine, we discuss how the saccharide-based sweeteners may be an essential component of these traditional preparations, like electuaries, which may be deprived of their bioactivities without these saccharides. With contemporary researches, it is known that apart from their own therapeutic effects, saccharides also form deep eutectic solvents which help in enhancing the bioactivity of other ingredients present in crude drugs. In addition, they provide energy for fermentation which is essential for biotransformation of compounds. Interestingly, the sugars also increase the shelf-life of these compound drugs and act as natural preservatives. On the basis of this review, we strongly believe that saccharide-based sweeteners are an essential component of traditional medicines and not merely an excipient.

Tratamiento ayurveda (Virechana y Basti) y cambios de la microbiota intestinal a nivel de Phylum y especie / Ayurveda Treatment (Virechana and Basti) and Changes of Intestinal Microbiota at Phyla and Species Level

Introducción: Se han analizado terapias ayurvédicas y prácticas médicas para un grupo de pacientes en Japón. La característica del tratamiento ayurvédico es una desintoxicación con una gran cantidad de tratamiento con aceite mediante un masaje con aceite en la superficie del cuerpo y una terapia de purificación con ghee o aceite de hierbas especialmente preparado. Los cambios de la microbiota intestinal durante estos tratamientos no han sido bien estudiados. Mé- LA PRENSA MÉDICA ARGENTINA Ayurveda Treatment (Virechana and Basti) and Changes of Intestinal Microbiota at Phyla and Species Level 79 V.107/Nº 2 todo: Los participantes fueron reclutados de la Clínica Hatai Ayurveda en Tokio. La terapia de Virechana, una terapia de purificación o la terapia de Basti (decocción y enema de aceite) se llevó a cabo en 13 pacientes con diversas manifestaciones. Todos los participantes proporcionaron el detalle de su estilo de vida, hábitos dietéticos, enfermedades pasadas y presentes mediante el cuestionario, y se registró la condición precisa durante la admisión al final del campamento. Se tomaron muestras fecales a la entrada, durante el tratamiento, al alta y tres semanas después para analizar la microbiota intestinal por el gen seqyebcubg 16srRNA. Resultados: el peso corporal disminuyó aproximadamente un 5% con la terapia de Virechana, mientras que no ocurrió con Basti, pero la grasa corporal aumentó un 4% (2,2 kg) en promedio en ambos grupos. Varias manifestaciones clínicas de los participantes mejoraron, especialmente en una erupción cutánea y un cambio atópico. El paciente deprimido también remitió mejoras en sus ganas de vivir. En su mayoría son vegetarianos y tenían más Bacteroides (48.09 ± 7.51%), Firmicutes (38.27 ± 10.82%) y Actinobacteria (3.30 ± 3.58%) que los omnívoros que tenían más Proteobacteria (10.73 ± 4.75%), Fusobacteria (2.40 ± 6.25%) y cianobacterias (0,09 ± 0,24%). Cuando los grupos se dividieron por el consumo de aceite, los usuarios de ghee mostraron más Fusobacterium y menos Firmicutes y Actinobacteria. La terapia con Virechana provocó cambios notables en la microbiota después del pretratamiento, como la disminución de Firmicutes y el aumento de Proteobacterias. A nivel género-especie, destacan el aumento de Enterobacteriaceae y la pérdida de Akkermansia municiphila. Niruha Basti y Matra Basti disminuyeron Firmicutes y aumentaron Proteobacteria (p = 0.096). Fusobacterium también aumentó. Después del alta, la Proteobateria se mantuvo alta, pero Firmicutes regresó al 30% en promedio, oscilando entre el 25% y el 50%. Tres semanas después, la variedad aumentó con Fusobacterium, Verrucomicrobia, Tenericutes y Lentisphaerae. La variedad de especies también aumentó tres semanas después. Conclusión: Varias quejas de los participantes mejoraron por el tratamiento ayurvédico con una gran cantidad de tratamiento de aceite por masaje de aceite de superficie corporal y terapia de purga. Causó cambios en la microbiota intestinal y los metabolitos bacterianos pueden afectar las lesiones cutáneas y la salud mental como la sensación depresiva

O som dos maracás (homenagem a Ailton Krenak): medicinas indígenas e saúde pública / The sound of maracas (tribute to Ailton Krenak): indigenous medical practices and public health

Resumo Durante a última década assistimos ao retrocesso paulatino das políticas públicas de atenção à saúde indígena no Brasil, principalmente no que concerne aos pilares básicos da sua formulação, construídos a partir da década de 1980: atenção específica e diferenciada, participação e controle social. Este texto, apesar de citar alguns momentos críticos desse processo, dá ensejo a algumas reflexões sobre os modos como as políticas e as práticas, essencialmente biomédicas, podem ser compreendidas no contexto mais geral das sociedades indígenas no país.

Abstract Over the past decade, we have seen the gradual setback of public policies for indigenous health care in Brazil, especially with regard to the basic pillars of its formulation, developed from the 1980s onwards: specific and differentiated attention, participation, and social control. This paper, despite mentioning some critical moments in this process, offers an opportunity for some reflections on how policies and practices, essentially biomedical, can be understood in the more general context of indigenous societies in the country.

Management of rectal prolapse (Guda Bhramsa) through Kshara Karma (chemical cauterisation): a case study / Manejo do prolapso retal (Guda Bhramsa) usando Kshara Karma(cauterização química): um estudo de caso

Abstract Rectal Prolapse is a condition where the rectum protrudes beyond the anus. The explanation of this condition can be traced back to ancient Ayurveda text like Susruta Samhita, Ebers Pappyrus of 1500 B.C., etc. The exact cause of rectal prolapse is unclear but it is predominant on female gender and on people having constipation, previous anorectal surgeries etc. Both partial and complete varieties of rectal prolapse are extremely debilitating because of the discomfort of the prolapsing mass and variety of symptoms like rectal bleed, intermittent constipation or fecal incontinence. Although, diverse modalities of surgical management of rectal prolapse are present, no single optimal procedure is proved and the choice of operation is determined by the patient's age, sex, degree of incontinence, operative risk, as well as by the surgeon's experience. In Ayurveda, Guda Bhramsa (Rectal prolapse) is explained by Acharya Susruta under Kshudra Rogas (chapter of minor diseases) and has elaborated it's conservative management very beautifully. In this case, a female with partial rectal prolapse was treated with Kshara application and managed without complications. So, Kshara application can be a safe and effective alternative for the management of rectal prolapse.

Resumo O prolapso retal é uma condição em que o reto se projeta para além do ânus. A explicação desta condição foi relatada em antigos textos Ayurveda como Susruta Samhita e Ebers Pappyrus, datados de 1500 aC. A causa exata do prolapso retal não é clara, mas essa condição é predominante no sexo feminino e nas pessoas com constipação e histórico de cirurgias anorretais anteriores. Tanto o prolapso retal parcial quanto total são extremamente debilitantes devido ao desconforto da massa prolapsante e da variedade de sintomas como sangramento retal, constipação intermitente ou incontinência fecal. Embora diversas modalidades de tratamento cirúrgico para corrigir o prolapso retal tenham sido relatadas na literatura, nenhum procedimento é consensual; a escolha da operação é determinada pela idade, sexo, grau de incontinência, risco operatório e experiência do cirurgião. Na Ayurveda, Guda Bhramsa (prolapso retal) é explicado por Acharya Susruta no Kshudra Rogas (capítulo de doenças menores) e seu manejo conservador é descrito de forma bastante completa. No presente caso, uma paciente do sexo feminino com prolapso retal parcial foi tratada com aplicação de Kshara e administrada sem complicações. Assim, a aplicação de Kshara pode ser uma alternativa segura e eficaz para o manejo do prolapso retal.

Mente e Awareness nos Tantras Indianos: fundamentos da Meditação, do Hatha Yoga e do Ayurveda / Mind and Awareness in Indian Tantras: foundations for Meditation, Hatha Yoga and Ayurveda

Apesar da crítica à concepção cartesiana do ser humano, faltam modelos teórico-conceituais que superaram suas limitações, a despeito do destaque dado à integralidade no Brasil. A base filosófica que fundamenta as abordagens dominantes é implícita, até nos modelos orientais importados como nas medicinas tradicionais e Práticas Integrativas Complementares (PICs) que, a partir de 2006, são promovidas no SUS pela Política Nacional das Práticas Integrativas Complementares e portarias. Descontextualizadas, as adaptações e criações de novas modalidades de PICs orientais se desfiguram a partir de interesses comerciais e desconhecimento de seu histórico. A integralidade é perdida, pois a PIC é fragmentada e isolada no modelo biomédico mecanicista e biologicista. Este artigo objetiva apresentar as premissas filosóficas indianas dos tantras em seu contexto histórico, como fundamento para o Ayurveda, e as práticas contemplativas que visam o desenvolvimento espiritual. Sua breve contextualização baseia-se nas análises acadêmicas de textos históricos em sânscrito, como também de autores e mestres de tradições espirituais asiáticos e ocidentais. Os conceitos de mente, corpo, awareness e energia integram esta abordagem não dual, onde predomina a imanência. Revelam uma compreensão da natureza humana integrada com o universo de modo complexo e dinâmico, desenvolvida e pesquisada ao longo de milhares de anos.(AU)

Abstract Despite the widespread critique of the hegemonic Cartesian view of human nature, no alternatives adequately surpass its limitations in the field of health. The philosophical base which informs these western dominant approaches is implicit, even when eastern health practices are imported. These have been acknowledged and promoted in the public healthcare system in Brazil since the 2006 health policy and later government decrees. Adaptations and western creations based on eastern practices are severed from their original tenets, fueled by commercialism and ignorance of its history. In the process, its integrative approach is lost, as the complementary health practice is used in psychology or in the mechanical and biologizing biomedical model. This article thus presents the philosophical Indian tenets of the Tantras in their historical context, as a foundation for Ayurveda and the contemplative practices aimed at spiritual development. Its brief and necessarily incomplete contextualization is based on academic analysis of historical sanskrit texts by scholars, Indian, American and Tibetan authors and teachers of lineage traditions. The concepts of mind, body, awareness and energy compose this nondual approach to human nature integrated with the universe in a complex and dynamic way, developed and researched throughout thousands of years.(AU)

Analysing the antidepressant and drug efflux competence of Clitoria ternateaL. as P-glycoprotein inhibitor to facilitate blood brain barrier

Clitoria ternateaL. is a vital ayurvedic herbfeatured with a wide spectrum of mental health benefits. The present study investigates the competence of the plant against depression and to inhibit the membrane efflux protein P-glycoprotein (P-gp) that can regulate and restrict drug permeation into the brain. Antidepressant competence of the aqueous plant extract was assessed by animal despair studies on depression induced female mice models. The P-glycoprotein inhibitory potential of active phytocompounds was evaluated by molecular docking assay and substantiated by a cell line study. The in vivostudies exhibited a significant difference in the immobility time thereby establishing antidepressant activity. The histopathological sections from cortex region of treated brain showed decreased degenerative changes. Ten imperative phytocompounds facilitated docking complexes against P-glycoprotein among which Kaempferol 3-O-(2״,6״-di-O-rhamnopyranosyl) glucopyranoside exhibited a finest docking score of -12.569 kcal mol-1. Conversely it was attested by the rhodamine transport assay that demonstrated the inhibitory potential to surpass blood brain barrier. The outcome of the study endorses the efficacy of Clitoria ternateaL. as an idyllic brain drug and facilitates brain permeability.

Herbal Supplement Sales in US Increase 8.5% in 2017, Topping $8 Billion. Strongest sales growth in more than 15 years bolstered by continued popularity of Ayurvedic herbs and new formulations of botanicals with general health and nutrition benefits

In 2017, retail sales of herbal dietary supplements in the United States surpassed $8 billion for the first time, reaching an estimated total of $8.085 billion. Consumer spending increased by approximately $633 million, or 8.5%, from 2016 ­ the strongest US sales growth for herbal supplements in more than 15 years. Total US retail sales have increased every year since 2004, and since then, consumer spending on herbal supplements has nearly doubled.

Ayurvedic concept of Shatkriyakala: a traditional knowledge of cancer pathogenesis and therapy / 中西医结合学报

The term Kriyakala refers to the recognition of the stage of a disease's progress, which helps to determine appropriate measure to correct the imbalance in Doshas (biological factors). It is a compound expression, comprised of Kriya and Kala, where Kriya means the choice to treatment (medicine, food and daily-routine) used to improve the disturbance in Doshas, and Kala refers to the stage of progress of a disease. Sushruta, an ancient Indian surgeon, has described the concept of Kriyakala in Varnaprashnadhyaya, an ancient Vedic Sanskrit text, which seeks to explain the incidence of Varnas in terms of Doshic disturbances. Varna, in modern parlance, may be described as an inflammatory process that may lead ulceration and chronic inflammation, promoting all stages of carcinogenesis. Abnormal interactions between Prakriti (genotype) and environmental factors vitiate the Doshas and impair immunity, which can lead to aberrant cell growth and cancer. Moreover, the interaction between vitiated Doshas and weak Dhatus (body tissues) manifests as cancers of a specific organ. Shatkriyakala (six stages of progress of a disease), on the other hand, provides a framework to assess the cancer and its pathogenesis in different stages. According to Ayurvedic concepts, all cancer therapies treat the affected tissues indirectly by eliminating vitiated Doshas, rejuvenating Dhatus and restoring immunity in cancer patients. The present review describes the six stages of Shatkriyakala in detail, with an emphasis on research areas to validate the concept of Shatkriyakala. This traditional knowledge can be utilized with modern technologies to detect predisposition for cancer or diagnose cancer in its early stages.

Comparative study on morpho-anatomy of leaf, stem and root of Boerhaavia diffusa L. (Nyctaginaceae) and its adulterant plants

ABSTRACT Punarnava (Boerhaavia diffusa L.- Nyctaginaceae) is a promising drug to rejuvenate new cells in the body. It is well known in Ayurvedic medicine and locally called Tambadivasu. Superficially it is similar to other species of Boerhaavia and species of Trianthema and Sesuvium. Due to the minute morphological differences, the above plants are erroneously used in medicine as Punarnava, and at times on purpose as an adulterant. Therefore, it is necessary to highlight the anatomical features of Punarnava for proper identification of the medicinal plant species for local people and for scientific research. Due to the ambiguity in local names and similar apparent appearance, market samples of Punarnava are often adulterated with various species of Trianthema and Sesuvium. These adulterated samples contain neither the Punarnavine alkaloid, nor does it possess anisocytic stomata but possess paracytic stomata. Comparative study of stem anatomy showed two main characteristic differences. First, plenty of starch grains can be seen in both the ground parenchymatous tissues present in between successive cambia and xylem parenchyma of Punarnava which is not observed in species of Trianthema, and second, the phloem around the xylem of Punarnava root has semi-circular or eccentric patches, while that of Trianthema only has narrow strips. This study is focused on comparative SEM study of leaf morphologies and anatomy of leaf, stem, and root of Boerhaavia diffusa L., Trianthema portulacastrum L. and Sesuvium portulacastrum L.

Studies on metals and pesticide content in some Ayurvedic formulations containing Bacopa monnieri L / 中西医结合学报

<p><b>OBJECTIVE</b>Ayurvedic formulations are preferred over other formulations as well as commercialized on broad level to treat various ailments. The World Health Organization has established certain guidelines for quality control of heavy metals and pesticide residues. Bacopa monnieri, a popular herb with immunomodulator and memory-enhancing properties is the chief constituent of several Ayurvedic formulations, which include Brahmi Vati (BV), Brahmi Ghrita (BG) and Saraswat Churna (SC), etc. In view of the World Health Organization guidelines, two products of each formulation from six different manufacturers were purchased from Ayurvedic Pharmacy, Bulanala-Varanasi, India for testing heavy metal and pesticide residue.</p><p><b>METHODS</b>In the present study, all the formulations--BV, BG and SC--were selected for estimation of four heavy metals namely lead (Pb), cadmium (Cd), chromium (Cr) and nickel (Ni) by a plasma emission spectrophotometer. Organochlorine pesticidal residues were estimated for dichlorodiphenyl trichloroethane, isomers of hexachlorocyclohexane (HCH) and α-endosulfan, etc. in total 12 samples of test formulations containing Bacopa monnieri L. using gas chromatography technique.</p><p><b>RESULTS</b>Out of 12 samples, Pb, Cd, Cr and Ni were present in all samples but below the permissible limit. Although atrazine, aldrin, dialdrin were in below detection limit, but other pesticides were detected in some samples as oxamyl, hexachlorocyclohexanes (α-HCH, β-HCH and γ-HCH), dichlorodiphenyl trichloroethane and dichlorodiphenyl dichloroethylene.</p><p><b>CONCLUSION</b>The presence of heavy metals in the formulations was low to cause toxicity. However evaluation of heavy metals and pesticide residue in every batch is necessary.</p>

An Aspect of the History of Medicine in Ancient Korea as Examined through Silla Buddhist Monks'Annotations on the “Chapter on Eliminating Disease (除病品)”in the Sutra of Golden Light (金光明經, Suvarṇabhāsa-sūtra) / 의사학

Nearly nothing is known of medicine in ancient Korea due to insufficient materials. With several extant prescriptions and esoteric methods of treating diseases alone, it is impossible to gauge in depth the management of medicine during this period. If one exception were to be cited, that would be the fact that the annotations for understanding the contents on Indian medicine in the “Chapter on Eliminating Disease” in the Sutra of Golden Light, a Buddhist sutra originating from India, reflected the medical knowledge of Buddhist monks from Silla (新羅, 57 BC-935 AD) who were active immediately after the nation's unification of the two other kingdoms on the Korean Peninsula (668 AD) such as Wonhyo (元曉, 617-686 AD), Gyeongheung (憬興, 620?-700? AD), and Seungjang (勝莊, 684-? AD). Along with those by other monks, these annotations are collected in the Mysterious Pivot of the Sutra of Golden Light (金光明經最勝王經玄樞), which was compiled by Gangyō(願曉, 835-871 AD), a Japanese monk from the Heian era (平安, 794-1185 AD). Representative versions of the “Chapter on Eliminating Disease” in the Sutra of Golden Light include: a classical Chinese translation by the Indian monk Dharmakṣema (曇無讖, 385-433 AD); the eight-volume edition by Chinese monk Baogui (寶貴), which differs little from the preceding work in terms of the contents of the “Chapter on Eliminating Disease”; and the ten-volume edition by Yijing (義淨, 635-713 AD), who had full-fledged knowledge of Indian medicine. When the contents of the annotations thus collected are examined, it seems that Wonhyo had not been aware of the existence of the ten-volume edition, and Gyeongheung and Seungjang most certainly used the ten-volume edition in their annotations as well. Especially noteworthy are Wonhyo's annotations on the Indian medical knowledge found in the “Chapter on Eliminating Disease” in the Sutra of Golden Light. Here, he made a bold attempt to link and understand consistently even discussions on Indian and Buddhist medicine on the basis of the traditional East Asian medical theory centering on the yin-yang (陰陽) and five phases (五行, wuxing). In accordance with East Asia's theory of the seasonal five phases, Wonhyo sought to explain aspects of Indian medicine, e.g., changes in the four great elements (四大, catvāri mahā-bhūtāni) of earth, water, fire, and wind according to seasonal factors and their effect on the internal organs; patterns of diseases such as wind (vāta)-induced disease, bile (pitta)-induced disease, phlegm (śleṣman)-induced disease, and a combination (saṃnipāta) of these three types of diseases; pathogenesis due to the indigestion of food, as pathological mechanisms centering on the theory of the mutual overcoming (相克, xiangke) of the five phases including the five viscera (五藏, wuzang), five flavors (五味, wuwei), and five colors (五色, wuse). They existed in the text contents on Indian medicine, which could not be explicated well with the existing medical knowledge based on the theory of the five phases. Consequently, he boldly modified the theory of the five phases in his own way for such passages, thus attempting a reconciliation, or harmonization of disputes (和諍, hwajaeng), of the two medical systems. Such an attempt was even bolder than those by earlier annotators, and Wonhyo's annotations came to be accepted by later annotators as one persuasive explanation as well. In the case of Gyeongheung and Seungjang, who obtained and examined the ten-volume edition, a new classical Chinese translation produced following Wonhyo's death, annotated the “Chapter on Eliminating Disease” based on their outstanding proficiency in Sanskrit and knowledge of new Indian and Buddhist medicine. This fact signifies that knowledge of the eight arts (八術) of Ayurvedic medicine in India was introduced into Silla around the early 8th century. The medical knowledge of Wonhyo, Gyeongheung, and Seungjang demonstrates that intellectual circles in contemporary Silla were arenas in which not only traditional East Asian medicine as represented by works such as the Inner Canon of the Yellow Emperor (黃帝內經, Huangdi Neijing) but also Indian medicine of Buddhism coexisted in almost real time.

Evaluation of immunostimulatory activity of Chyawanprash using in vitro assays.

Chyawanprash is an ayurvedic formulation used in Indian traditional medicinal system for its beneficial effect on human health. We investigated the immunostimulatory effects of Chyawanprash (CHY) using in vitro assays evaluating the secretion of cytokines such as Tumor Necrosis Factor-alpha (TNF-α), Interleukin-1beta (IL-1β) and Macrophage Inflammatory Protein-1-alpha (MIP-1-α) from murine bone marrow derived Dendritic Cells (DC) which play pivotal role in immunostimulation. The effects of CHY on phagocytosis in murine macrophages (RAW264.7) and Natural Killer (NK) cell activity were also investigated. At non-cytotoxic concentrations (20–500 µg/ml), CHY enhanced the secretion of all the three cytokines from DC. CHY also stimulated both, macrophage (RAW264.7) as well as NK cell activity, in vitro. In conclusion, the data substantiates the immunoprotective role of CHY at cellular level mediated by immunostimulation in key immune cells viz. dendritic Cells, macrophages and NK cells.

Efficacy & safety evaluation of Ayurvedic treatment (Ashwagandha powder & Sidh Makardhwaj) in rheumatoid arthritis patients: a pilot prospective study.

Background & objectives: In the traditional system of medicine in India Ashwagandha powder and Sidh Makardhwaj have been used for the treatment of rheumatoid arthritis. However, safety and efficacy of this treatment have not been evaluated. Therefore, the present study was carried out to evaluate the efficacy and safety of Ayurvedic treatment (Ashwagandha powder and Sidh Makardhwaj) in patients with rheumatoid arthritis. Methods: One hundred and twenty five patients with joint pain were screened at an Ayurvedic hospital in New Delhi, India. Eighty six patients satisfied inclusion criteria and were included in the study. Detailed medical history and physical examination were recorded. Patients took 5g of Ashwagandha powder twice a day for three weeks with lukewarm water or milk. Sidh Makardhwaj (100 mg) with honey was administered daily for the next four weeks. The follow up of patients was carried out every two weeks. The primary efficacy end point was based on American College of Rheumatology (ACR) 20 response. Secondary end points were ACR50, ACR70 responses, change from baseline in disease activity score (DAS) 28 score and ACR parameters. Safety assessments were hepatic function [alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), bilirubin and β2 microglobulin], renal function (urea and creatinine and NGAL) tests and urine mercury level. Results: The study was completed by 90.7 per cent (78/86) patients. Patients with moderate and high disease activity were 57.7 per cent (45/78) and 42.3 per cent (33/78), respectively. All patients were tested positive for rheumatoid factor and increased ESR level. Ashwagandha and Sidh Makardhwaj treatment decreased RA factor. A significant change in post-treatment scores of tender joint counts, swollen joint counts, physician global assessment score, patient global assessment score, pain assessment score, patient self assessed disability index score and ESR level were observed as compared to baseline scores. ACR20 response was observed in 56.4 per cent (44/78) patients (American College of Rheumatology criteria) and moderate response in 39.74 per cent (31/78) patients [European League Against Rheumatism (EULAR) criteria]. Ayurvedic treatment for seven weeks in rheumatoid arthritis patients showed normal kidney and liver function tests. However, increased urinary mercury levels were observed after treatment. Interpretation & conclusions: The findings of the present study suggest that this Ayurvedic treatment (Ashwagandha powder and Sidh Makardhwaj) has a potential to be used for the treatment of rheumatoid arthritis. However, due to small sample size, short duration, non randomization and lack of a control group as study limitations, further studies need to be done to confirm these findings.