AYURAKSHA, a prophylactic Ayurvedic immunity boosting kit reducing positivity percentage of IgG COVID-19 among frontline Indian Delhi police personnel: A non-randomized controlled intervention trial.

Objective: The world continues to face the COVID-19 crisis, and efforts are underway to integrate traditional medicine interventions for its effective management. The study aimed to determine the efficacy of the "AYURAKSHA" kit in terms of post-interventional percentage of COVID-19 IgG positivity, immunity levels, and quality of life (QoL) against COVID-19. Method: This was a non-randomized controlled, prospective intervention trial, done after the distribution of 80,000 AYURAKSHA kits (constituent of Sanshamani Vati, AYUSH Kadha, and Anu Taila) among Delhi police participants in India. Among 47,827 participants, the trial group (n = 101) was evaluated with the positivity percentage of IgG COVID-19 and Immune Status Questionnaire (ISQ) scores as a primary outcome and the WHO Quality of Life Brief Version (QOL BREF) scores along with hematological parameters as a secondary outcome in comparison to the control group (n = 71). Results: The data showed that the percentage of COVID-19 IgG positivity was significantly lower in the trial group (17.5 %) as compared to the control group (39.4 %, p = 0.003), indicating the lower risk (55.6%) of COVID-19 infection in the trial group. The decreased incidence (5.05%) and reduced mortality percentage (0.44%) of COVID-19 among Delhi police officers during peak times of the pandemic also corroborate our findings. The ISQ score and WHO-QOL BREF tool analysis showed the improved scores in the trial group when compared with the controls. Furthermore, no dysregulated blood profile and no increase in inflammation markers like C-reactive protein, erythrocyte sedimentation rate, Interleukin-6 (IL-6) were observed in the trial group. However, significantly enhanced (p = 0.027) IL-6 levels and random blood sugar levels were found in the control group (p = 0.032), compared to a trial group (p = 0.165) post-intervention. Importantly, the control group showed more significant (p = 0.0001) decline in lymphocyte subsets CD3+ (% change = 21.04), CD4+ (% change = 20.34) and CD8+ (% change = 21.54) levels than in trial group, confirming more severity of COVID-19 infection in the control group. Conclusion: The AYURAKSHA kit is associated with reduced COVID-19 positivity and with a better quality of life among the trial group. Hence, the study encourages in-depth research and future integration of traditional medicines for the prevention of the COVID-19 pandemic. Clinical trial registration: http://ctri.nic.in/, identifier: CTRI/2020/05/025171.

Prevention of in vitro glucose-induced cataract by Vasanjana prepared by Yashtimadhu Kalka (paste of Glycyrrhyza glabra Linn).

BACKGROUND: Cataract is a major cause of blindness worldwide. Researchers received much attention from the traditional systems such as Ayurveda for the solutions of cataract through antioxidant activities apart from the surgical extraction. AIMS: A To study, the anti-cataract activity of Vasanjana (VK) prepared with Yashtimadhu (Glycyrrhyza glabra Linn) Kalka (paste) in Vasa (fat) of the domestic fowl (Gallus gallus) on glucose-induced cataract in ovine (sheep) lenses. MATERIALS AND METHODS: Artificial aqueous humor with 55 mM glucose was used to induce cataract in sheep eye lenses. Treatment was given with cow ghee (CG), plain fat, Vasanjana, and Vitamin E to the same media and lenses were incubated at the room temperature for 72 h. Biochemical parameters studied in the lens were total proteins, malondialdehyde (MDA), Na+ K+ ATPase activity and electrolytes (Na+ and K+). Photographic evaluation was also done. RESULTS: The complete opacification induced by the glucose in ovine lens was observed in 72 h. Cataractous lenses showed significant increase in Na+, MDA level and significant decrease in Na+ K+ ATPase activity and total protein content. Lenses treated with Vasanjana showed non-significant increase of total protein content and decreased MDA level and prevented formation and progress of cataract by glucose, as evidenced by photographic evaluation. Glucose-induced biochemical changes were found to be reversed in statistically significant manner in CG and Vitamin E treated lenses. CONCLUSION: The anti-cataract activity of Vasanjana and CG may be because of the antioxidant and free radical scavenging activity. Further in vitro and in vivo studies in various experimental models are required to validate their anti-cataract activity.

Clinical study on primary open-angle glaucoma with Ashchyotana, Tarpana and oral medication.

INTRODUCTION: Glaucoma is the second leading cause of irreversible blindness worldwide and third leading cause in India. The disease progresses even intraocular pressure (IOP) is well under control; hence, now modern medicine is looking for strategies that are neuroprotective in glaucomatous optic neuropathy (GON) management. AIM: This study aimed to propound the concept of Chakshushya Rasayana and diuretic therapies and also evaluate the neuroprotective and IOP-lowering effects of Ayurvedic line of management in primary open-angle glaucoma (POAG). MATERIALS AND METHODS: In this randomized parallel-group trial, patients having POAG were randomized with equal probability to one of the two treatment groups. Participants were assessed on the basis of subjective parameters such as blurred vision, frequent changes of presbyopic glasses (FCPG), delayed dark adaptation (DDA), visual field defect (VFD) and headache; objective parameters such as best-corrected visual acuity (BCVA), IOP and optic nerve head changes and perimetry findings such as mean deviation (MD) and Glaucoma Hemifield Test. In Group A, after Koshtha Shodhana and Nasya, Tarpana and Ashchyotana with Shigru Pallava Arka were done locally and Punarnavashtaka Kwatha and Gokshuradi Guggulu were given internally for 52 days along with modern antiglaucoma eye drop and in Group B, patients already taking antiglaucoma eye drop were kept under observation for 2 months. RESULTS: Patients in Group A showed better results in blurred vision, FCPG, DDA, VFD, headache, BCVA, IOP and MD. Patients in Group B showed better results in blurred vision and FCPG. A comparison of both groups showed significant results in blurred vision, DDA, VFD, BCVA, IOP and MD. CONCLUSION: The clinical study concludes that Ayurvedic treatment protocol along with antiglaucoma eye drop in Group A patients was found to be more effective in reducing the IOP and controlling the progression of GON along with modern anti-glaucoma eye drop. Early diagnosis and proper management can prevent, arrest, or delay progression of POAG.

Ayurvedic management of papilledema.

The term Shotha ordinarily means a swelling which may be because of inflammatory process in any part of the body or may be general, due to causes other than inflammatory. A diagnosed case of papilledema (Kapha-Pittaja Drishti Nadi Shotha) was treated on the lines of Shotha Chikitsa. The patient was given Dashamoola and Punarnavashtaka Kwatha internally and locally Nasya and Takradhara for 3 months. At the end of 3 months, papilledema completely regressed. Follow-up of the patient for more than 3 years, no recurrence has been reported.

A pilot study on Ayurvedic management of oral submucous fibrosis.

INTRODUCTION: Oral submucous fibrosis (OSMF) is a chronic debilitating disease and a well-recognized potentially premalignant condition of the oral cavity. Various medical and surgical treatment modalities have been used in modern science, but results are not satisfactory owing to recurrence, adverse effects, and sometimes worsening the condition. On analyzing the disease condition with Ayurvedic approach, it seems to be nearer to Vata-Pitta dominant chronic Sarvasara Mukharoga and needs to be treated at local as well as systemic level. AIM: To evaluate the effect of proposed Ayurvedic treatment protocol in the patients of OSMF. MATERIALS AND METHODS: It was an open-label nonrandomized clinical trial with black box design comprising of holistic Ayurvedic approach in which 22 patients of OSMF completed the treatment. In all of them after Koshthashuddhi (mild purgation) and Shodhana Nasya (errhine therapy); Pratisarana (external application) with Madhupippalyadi Yoga, Kavala (gargling) with Ksheerabala Taila and internally Rasayana Yoga were given for 2 months and followed for 1 month. RESULTS: It revealed statistically highly significant relief in almost all signs and symptoms as well in inter incisal distance improvement. Furthermore, sustained relief was found in follow-up. CONCLUSION: Ayurvedic treatment protocol is effective in the management of OSMF.

Etiopathogenesis of cataract: an appraisal.

Natural eye lens is a crystalline substance to produce a clear passage for light. Cataract is opacity within the clear lens of the eye and is the dominant cause of socio-medical problem i.e., blindness worldwide. The only available treatment of cataract is surgery. However, insufficient surgical facilities in poor and developing countries and post-operative complications inspire researchers to find out other modes of treatment for cataract. In this review, an attempt has been made to appraise various etiological factors of cataract to make their perception clear to build up counterpart treatment. Present study is an assortment of various available literatures and electronic information in view of cataract etiopathogenesis. Various risk factors have been identified in development of cataracts. They can be classified in to genetic factors, ageing (systemic diseases, nutritional and trace metals deficiencies, smoking, oxidative stress etc.), traumatic, complicated (inflammatory and degenerative diseases of eye), metabolic (diabetes, galactosemia etc.), toxic substances including drugs abuses, alcohol etc., radiation (ultraviolet, electromagnetic waves etc.) are implicated as significant risk factors in the development of cataract.

A comparative study of Dashana Samskara Choorna Pratisarana and Dashana Samskara paste application in the management of Sheetada (Gingivitis).

Sheetada is the early stage of periodontal diseases. This occurs due to negligence of oral hygiene, changing life-style, habits, and addictions. It is Kapha Rakta Pradhana Vyadhi. In modern dentistry papillary or marginal gingivitis can be correlated with Sheetada, on the basis of similarities in symptoms, involvement of anatomical structure, etiology and prognosis. The epidemiological studies conducted by American Academy of Periodontology shows that gingivitis of varying severities is nearly universal. It is estimated that over 80% of the world's population suffers from gingivitis. In this clinical study, 106 patients were registered among them 103 completed the treatment and were randomly divided by lottery method into two groups. In Group-A, Dashana Samskara paste local application on gums and in Group-B, Dashana Samskara Choorna Pratisarana on gums was given. After enrollment of the patients in the study cardinal symptoms of Sheetada (gingivitis) such as, Raktasrava, Krishnata, Prakledata, Mriduta, Mukhadaurgandhya, and also the objective criteria such as oral hygiene index, Gingival Index (GI-S), and Gingival Bleeding Index (GBI-S) were studied before and after the treatment. While considering comparative effect on subjective parameters such as Raktasrava, Dantamamsa Shiryamanata, Shotha and Chalata statistically significant results were obtained in Group-A than Group-B. In objective parameters such as, GI-S and GBI-S also showed statistically significant results in Group-A. Observations in follow-up study confirmed that the recurrence rate in the Group-Awas significantly lesser than the Group-B.

A comparative study of Bilvadi Yoga Ashchyotana and eye drops in Vataja Abhishyanda (Simple Allergic Conjunctivitis).

Simple allergic conjunctivitis is the most common form of ocular allergy (prevalence 5 - 22 %). It is a hypersensitivity reaction to specific airborne antigens. The disease Vataja Abhishyanda, which is due to vitiation of Vata Pradhana Tridosha is comparable with this condition. The management of simple allergic conjunctivitis in modern ophthalmology is very expensive and it should be followed lifelong and Ayurveda can provide better relief in such manifestation. This is the first research study on Vataja Abhishyanda. Patients were selected from the Outpatient Department (OPD), Inpatient Department (IPD), of the Shalakya Tantra Department and were randomly divided into two groups. In Group-A Bilvadi Ashchyotana and in Group-B Bilvadi eye drops were instilled for three months. Total 32 patients were registered and 27 patients completed the course of treatment. Bilvadi Ashchyotana gave better results in Toda, Sangharsha, Parushya, Kandu and Ragata as compared with Bilvadi Eye Drops in Vataja Abhishyanda.

A clinical study on Krimidanta with reference to dental caries and its management with Jatipatradi Gutika and Yavanadi Churna.

Dental caries is progressive destruction of enamel, dentine and cementum, initiated by microbial activity at the tooth surface. It is one of the major problems in dentistry. On the basis of clinical features, it can be compared with Krimidanta which is one among the eight diseases of tooth. In the management of Krimidanta, Krimighna, Vataghna and Ushna Veerya dravyas are to be used which can relieve the toothache and discoloration. In this study, the trial drugs used were Jatipatradi Gutika for Pratisarana and Yavanadi Churna for oral administration. In this study, the patients of Krimidanta (dental caries) were selected from OPD of Shalakya Department and allotted randomly in different groups. In Group A, the patients were treated with Jatipatradi Gutika for Pratisarana for 30 days. In Group B, the patients were treated with Yavanadi Churna orally and Group C patients were treated with combined therapy for 30 days. The clinical study has shown that combined therapy gives better results than individual therapies.

A clinical study on "Computer vision syndrome" and its management with Triphala eye drops and Saptamrita Lauha.

American Optometric Association (AOA) defines computer vision syndrome (CVS) as "Complex of eye and vision problems related to near work, which are experienced during or related to computer use". Most studies indicate that Video Display Terminal (VDT) operators report more eye related problems than non-VDT office workers. The causes for the inefficiencies and the visual symptoms are a combination of individual visual problems and poor office ergonomics. In this clinical study on "CVS", 151 patients were registered, out of whom 141 completed the treatment. In Group A, 45 patients had been prescribed Triphala eye drops; in Group B, 53 patients had been prescribed the Triphala eye drops and SaptamritaLauha tablets internally, and in Group C, 43 patients had been prescribed the placebo eye drops and placebo tablets. In total, marked improvement was observed in 48.89, 54.71 and 06.98% patients in groups A, B and C, respectively.

A comparative study of Agni karma with Lauha, Tamra and PanchadhatuShalakas in Gridhrasi (Sciatica).

Sushruta has mentioned different methods of management of diseases, such as Bheshaja karma, Kshara Karma, Agni karma, Shastrakarma and Raktamokshana. The approach of Agni karma has been mentioned in the context of diseases like Arsha, Arbuda, Bhagandar, Sira, Snayu, Asthi, Sandhigata Vata Vikaras and Gridhrasi. Gridhrasi is seen as a panic condition in the society as it is one of the burning problems, especially in the life of daily laborers. It is characterized by distinct pain starting from Sphik Pradesha (gluteal region) and goes down toward the Parshni Pratyanguli (foot region) of the affected side of leg. On the basis of symptomatology, Gridhrasi may be simulated with the disease sciatica in modern parlance. In modern medicine, the disease sciatica is managed only with potent analgesics or some sort of surgical interventions which have their own limitations and adverse effects, whereas in Ayurveda, various treatment modalities like Siravedha, Agni karma, Basti Chikitsa and palliative medicines are used successfully. Among these, Agni karma procedure seems to be more effective by providing timely relief. Shalakas for Agni karma, made up of different Dhatus like gold, silver, copper, iron, etc. for different stages of the disease conditions, have been proposed. In the present work, a comparative study of Agni karma by using iron, copper and previously studied Panchadhatu Shalaka in Gridhrashi has been conducted. A total of 22 patients were treated in three groups. Result of the entire study showed that Agni karma by Panchadhatu Shalaka provided better result in combating the symptoms, especially Ruka and Tandra, while Lauhadhatu Shalaka gave better results in combating symptoms of Spanadana and Gaurava. In the meantime, Tamradhatu Shalaka provided better effect in controlling symptoms like Toda, Stambha and Aruchi. Fifty percent patients in Panchadhatu Shalaka (Group A) were completely relieved. In Lauhadhatu Shalaka (Group B), the success rate was 00.00%, and in Tamradhatu Shalaka (Group C), the percentage of success rate was 14.28%. After analyzing the data, Tamradhatu Shalaka was found to be more effective than Lauha and Panchadhatu Shalakas.

Role of Pradhamana Nasya and Trayodashanga Kwatha in the management of Dushta Pratishyaya with special reference to chronic sinusitis.

Dushta Pratishyaya is the chronic stage of Pratishyaya, which occurs due to neglect or improper management of the disease Pratishyaya. In modern science, chronic sinusitis can be correlated with Dushta Pratishyaya on the basis of the signs, symptoms, complications, and prognosis. Changing lifestyles, rapid urbanization, and the increase in cases of antibiotic resistance are responsible for the rise in the prevalence of sinusitis. In the present clinical study, 37 patients were registered and were randomly divided into three groups: A, B, and C; of the 37 patients, 31 completed the full course of treatment. In group A, Trayodashanga Kwatha with Madhu was given orally; in group B, Pradhamana Nasya with Trikatu + Triphala Churna was administered; and in group C (combined group), Pradhamana Nasya was administered initially, followed by oral Trayodashanga Kwatha with Madhu. In group A, complete relief was observed in 10% of the patients; in group B, marked improvement was observed in 81.82% of patients; and in group C, marked relief was observed in 60% of patients. In comparison to other groups (Group A and Group B), Group C showed percentage wise better results in most of the symptoms.

Effect of Mahayavanala Roma Kshara and Dhanyaka Gokshura Ghrita in benign prostatic hyperplasia.

Vatastheela is a disease of Mutravahasrotasa, one among the 12 types of Mutraghata disorders elaborated by Sushruta in his seminal work, the Sushruta Samhita. Vatastheela, as described in Ayurveda, closely resembles benign prostatic hyperplasia (BPH) of modern medicine in its signs and symptoms. It is a senile disorder and chiefly affects individuals above the age of 40 years. The symptoms are those of bladder outflow obstruction, with increased frequency of micturition, dribbling, hesitancy, and the features of chronic urinary retention. Surgical management has been accepted as the standard management but is associated with many disadvantages as well as complications, which may not be acceptable at this age. Conservative management with modern medicines is also not free from side effects. So, in this age-group, there is a need for much safer alternative method of management. In this regard, many works have been carried out and shown that the Ayurvedic approach, using natural medicines, is a far better approach. We carried out a comparative study of Mahayavanala Roma Kshara (MRK) and Dhanyaka Gokshura Ghrita (DGG), which are the compounds prescribed for Mutraghata in Ayurvedic literature. The patients were randomly selected from the OPD and IPD of IPGT and RA hospital, Jamnagar, Gujarat, and divided into two groups. In first group, one (500 mg) capsule of MRK was given twice a day with lukewarm water for 45 days; in second group, 10 gm of DGG was given orally twice a day with lukewarm water for 45 days. DGG showed significantly greater relief in the subjective parameters as per International Prostate Symptoms Score (IPSS) than MRK. However, reduction in the size of the prostate and in the volume of the post-void residual urine was found much better in the MRK group.

A clinical study on Akshitarpana and combination of Akshitarpana with Nasya therapy in Timira with special reference to myopia.

Myopia, commonly referred to as shortsightedness, is the most common eye disease in the world with substantial social, educational, and economic impact. Some of the clinical features of Timira can be correlated with myopia. An open randomized clinical trial was conducted to evaluate the role of Tarpana with and without Nasya in patients suffering from myopia. In total, 41 patients were registered in two groups, out of which 30 patients completed the treatment. In Group A, Tarpana with Mahatriphaladya Ghrita and in Group B, Nasya with Abhijita taila followed by Tarpana with Mahatriphaladya Ghrita was administered. After enrollment of the patients in the study, the cardinal signs and symptoms of Timira - myopia, that is, visual acuity, clinical refraction, were evaluated before and after the treatment. Comparatively, more relief in the signs and symptoms were found in the Nasya group followed by the Tarpana group.