Ayurvedic management of a refractory skin disease clinically diagnosed as Cutaneous Lichen Planus-A case report.

This study reports the successful management of a recurrent, refractory skin disease diagnosed clinically as Cutaneous Lichen Planus (CLP) in a female patient with Ayurvedic treatment. A 42-year-old home maker from Coimbatore presented with blackish-red pigmented skin rashes and white streaks. Though mucous membranes were not affected, she did not respond to homoeopathic and biomedical treatment. The lesions were spread all over the body except for the face, scalp, axillary and genital region. In addition, she complained of dry skin, pain, and itching. The condition was treated as Kapha-Pitta dominant Tridoshaja Kushta based on Ayurvedic clinical assessment. The patient recovered after one year of conservative Ayurvedic intervention. After six years, there was a relapse, and the patient was admitted for a full course of Ayurvedic treatment and recovered within six months. Ayurvedic interventions should be considered an option in refractory skin diseases like Cutaneous Lichen Planus.

Chyawanprash: A review of therapeutic benefits as in authoritative texts and documented clinical literature.

ETHNOPHARMACOLOGICAL RELEVANCE: Chyawanprash (CP), a traditional immune booster recipe, has a long history of ethnic origin, development, household preparation and usage. There are even mythological stories about the origin of this recipe including its nomenclature. In the last six decades, CP, because of entrepreneurial actions of some research Vaidyas (traditional doctors) has grown to industrial production and marketing in packed forms to a large number of consumers/patients like any food or health care product. Currently, CP has acquired a large accepted user base in India and in a few countries out-side India. AIM OF THE STUDY: Authoritative texts, recognized by the Drugs and Cosmetics Act of India, describe CP as an immunity enhancer and strength giver meant for improving lung functions in diseases with compromised immunity. This review focuses on published clinical efficacy and safety studies of CP for correlation with health benefits as documented in the authoritative texts, and also briefs on its recipes and processes. MATERIALS AND METHODS: Authoritative texts were searched for recipes, processes, and other technical details of CP. Labels of marketing CP products (Indian) were studied for the health claims. Electronic search for studies of CP on efficacy and safety data were performed in PubMed/MEDLINE and DHARA (Digital Helpline for Ayurveda Research Articles), and Ayurvedic books were also searched for clinical studies. RESULTS: The documented clinical studies from electronic databases and Ayurvedic books evidenced that individuals who consume CP regularly for a definite period of time showed improvement in overall health status and immunity. However, most of the clinical studies in this review are of smaller sample size and short duration. Further, limitation to access and review significant data on traditional products like CP in electronic databases was noted. CONCLUSIONS: Randomized controlled trials of high quality with larger sample size and longer follow-up are needed to have significant evidence on the clinical use of CP as immunity booster. Additional studies involving measurement of current biomarkers of immunity pre- and post-consumption of the product as well as benefits accruing with the use of CP as an adjuvant are suggested.

Comparative Evaluation of Specific Phytochemical Indicatives in Cirivilvadi Kasaya Prepared Freshly and at Commercial Scale.

Kasaya or decoction is an Ayurvedic dosage form, prescribed based on the stage of the disease according to the principles of Ayurveda. This dosage form is traditionally prepared fresh and consumed on the same day but for the sake of convenience; the process of preparation has been modified so that it can be stored with longer shelf life, easy availability and produced in large quantities. There is a need to understand the implications of this modification in terms of chemical changes. This work attempted to check the phytochemical profile of both freshly prepared decoction and commercially available decoction with reference to some analytical parameters like pH, total soluble solids, phenols, alkaloids, potassium and to assess the changes in the thin layer chromatography profiling of the decoction. The results showed that phenols and potassium are found to be two fold higher in freshly prepared decoction, compared to commercially available decoction diluted to dosage in practice (1:4 ratio). However, the total alkaloid content was found to be approximately ten fold higher in commercially available decoction. It was observed that the thin layer chromatography profile of decoctions was extracted into petroleum ether and chloroform was similar and consistent with different batches though the bands in commercially available decoction were slightly more intense compared to freshly prepared decoction. The total soluble solids in commercially available decoction were four times higher than freshly prepared decoction. The study reveals that there are differences in the phytochemical profiles of the freshly prepared decoction and commercially available decoction of the same formulation. However, the significance of these differences can be determined only by further clinical studies. On the other hand, the study lends support to the practice of diluting the commercially available decoction to make it equivalent to freshly prepared decoction.

Posological Considerations of Ocimum sanctum (Tulasi) as per Ayurvedic Science and Pharmaceutical Sciences.

A study in 2010 reported that administration of 2 g of O. sanctum leaves for 30 days to laboratory male albino rabbits showed adverse effect on sperm count and male hormones. The dose and duration at which this testing was reported was commented upon as being high. It is learnt that basis this publication a few European regulators have imposed restrictions on usage of O. sanctum. Recognizing the need for evaluation, a review has been made of the posological considerations related to decision on dose of a drug in pharmaceuticals (drug development stages) and in Ayurvedic science as part of history of use and current usage. Specifically, we report the dose range as per documented tradition, marketed products containing O. sanctum as an ingredient and current clinical practice. Greater consultation is suggested before deciding the studies on Ayurvedic herbs. Regulatory action of banning use of O. sanctum needs a review and may need to be replaced with an advisory.

Post-surgical management of pontine hemorrhage with Ayurvedic treatment.

A female aged 30 years, consulted the Govt. Ayurveda Hospital, Perinthalmanna with complaints of left side of the body totally paralysed along with severe shivering of the right hand and head and the patient was bedridden for 1½ years. She was diagnosed earlier with spontaneous pontine hematoma (on 10(th) Nov 2007) and had undergone midline sub occipital craniectomy (on 13(th) Nov 2007) as an emergency treatment. She developed neurotrophic ulcer in the right eye with lagophthalmos post-surgery. The patient showed no improvement to treatment but further developed stromal abscess and hence paramedian tarsorraphy (4(th) Jan 2008) was done. The deficits in the right eye led to diminution of vision of that eye after Allopathy treatment. The patient sought Ayurvedic treatment for a better prognosis. The patient was under Ayurvedic treatment from 5(th) Mar 2009 to 24(th) Nov 2009. During that period Ayurvedic treatment such as abhyanga (oil massage), patra pottali sveda (use of poultices) and mrdu virecana (purgation) was also done. After a period of 8 months of internal medication and treatment, the shivering of the right hand and head resolved. She could move the left leg and left hand and started walking without support. There was gradual loss of vision during the course of Ayurvedic treatment. At present, the patient is able to move around and do household works on her own.