Evaluating Ayurvedic mouthwash and soda-salt mouthwash for oral mucositis in head and neck cancer: A randomized controlled trial.

BACKGROUND: Patients undergoing radiotherapy (RT) or concurrent chemo-radiation (CCRT) for head and neck squamous cell carcinoma (HNSCC) often suffer from side effects such as mucositis, xerostomia, pharyngitis, laryngitis, and pain, which are being managed symptomatically by alcohol-based mouthwashes. OBJECTIVES: To determine the effectiveness of Ayurvedic mouthwash "Draksha Guduchyadi Kashaya" in reducing the severity of oral side effects of chemo-radiation. MATERIAL AND METHODS: This concurrent parallel randomized controlled study was conducted at Sir Sunderlal Hospital, BHU, on 70 HNSCC patients scheduled to undergo RT/CCRT. Patients who met the inclusion-exclusion criteria were enrolled, and 35 were randomly assigned to either the intervention group (Ayurveda) or the control group using a simple random technique (lottery method). Blinding was not implemented in this study. Patients in the intervention group (Ayurveda) were instructed to perform kavala with 50 ml of "Draksha Guduchyadi Kashaya" for 2 min, ten times daily, while the control group performed 2-min gargling with soda-salt mouthwash ten times daily. RESULTS: Out of the 70 patients enrolled, data from 60 patients were analyzed, revealing statistically significant differences in the onset of mucositis (p = 0.049), pharyngitis (p = 0.034), laryngitis (p = 0.009) and intensity of variables such as mucositis (p = 0.000), xerostomia (p = 0.046), pharyngitis (p = 0.002), laryngitis (p = 0.035), and pain (p = 0.000). These findings indicate that Ayurvedic mouthwash may be beneficial in managing the oral side effects of chemo-radiation in HNSCC. CONCLUSION: This AYUSH financially supported trial (Reg No: CTRI/2020/04/024672) demonstrates promise as a safe and cost-effective alternative for managing oral complications of RT/CCRT, offering complementary treatment for comprehensive cancer care.

Evaluation for substitution of stem bark with small branches of Cassia fistula Linn for traditional medicinal uses: A comparative chemical profiling studies by HPLC, LC-MS, GC-MS.

Background: The Aim of the present research article is to proposing a conservative approach for the Cassia fistula by using of small branches instead of stem bark because of plant has many important chemical constituents which show different medicinal activity so consumption of plant is high. We studied here Comparative preliminary phytochemical screening test of the ethanol extract and aqueous extract of the stem bark and small branches of Cassia fistula obtained by cold maceration process. Physicochemical analysis of Cassia fistula was done to ascertain the quality of the raw material used in the study. Successive soxhlet extraction method used for the successive extraction of stem bark and small branches with different solvents for comparative chemical profile study by HPLC, LCMS, and GCMS. Molecular Docking Interaction of Abundant Medicinal Phytochemicals in the Liquid Chromatography-Mass Spectrometry (LC-MS) Analysis Data of C. fistula with the L. donovani Drug Target Proteins and Pancreatic lipase colipase target protein. Result: The pH of the small branches was found slightly higher as compared to stem bark and the percentage of other parameters like total ash content, acid insoluble ash, loss on drying at 105 °C, water soluble extractive and alcohol soluble extractive values were found fewer in the small branches as compare to stem bark of the plant. It was observed that the number of peaks in stem bark and small branches of the plant sample were almost similar and the retention time of each peak in stem bark was coincide with the retention of small branches of the sample. Therefore, similarity was observed in stem bark and small branches of the Cassia fistula plant in HPLC, LC-MS and GC-MS. The results obtained from HPLC analysis shows that stem bark contains 0.0084% and small branches having 0.0257% of rhein in Cassia fistula. Compounds 3, 9 and 12 are present in Stem bark as well as small branches of C. fistula and Compounds 22, 32 and 37 are present in small branches only. All the compounds have very good binding energy (Kcal/mol) with the respective target proteins. Conclusion: The small branches have more active chemical constituents than stem bark against particular target proteins.

AYUSH 64, a polyherbal Ayurvedic formulation in Influenza-like illness - Results of a pilot study.

BACKGROUND: Influenza-like Illness (ILI) refers to a wide range of viral infections with an important cause of morbidity and mortality worldwide. The global incidence of ILI is estimated at 5-10% in adults and 20-30% in children. In India influenza accounts for 20-42% of monthly acute medical illness hospitalizations during the peak rainy season. AYUSH-64, a poly-herbal drug, is in practice for 40 years for various clinical conditions like fevers, microfilaremia, and inflammatory conditions. OBJECTIVE: A pilot study was conducted to evaluate the safety and efficacy of Ayurvedic formulation, AYUSH-64 in clinically diagnosed ILI for accelerating the recovery. MATERIAL AND METHODS: A prospective, open-label, nonrandomized, single group, single-center pilot clinical study with pre-test and post-test design was conducted at Raja Ramdeo Anandilal Podar Central Ayurveda Research Institute for Cancer, Mumbai, an institute of Central Council for Research in Ayurvedic Sciences (CCRAS) between June 2018 and July 2019. A total of 38 participants of clinically diagnosed ILI (18-65 years) were studied with an one-week intervention of 'AYUSH 64' in a dose of 3 gm/day and three weeks post-treatment observation period. Assessment of parameters viz. improvement in the symptoms of ILI, frequency of usage of acetaminophen, antihistaminic and cough syrup, hematology, liver function and kidney function tests along with incidence of secondary complications, and time to return to a normal routine was done. RESULTS: One-week intervention of AYUSH 64 helped to recover from ILI symptoms with reduced frequency of usage of acetaminophen and antihistaminic. The intervention was safe on hematology and biochemical parameters. No serious adverse effects were observed during the study. CONCLUSION: AYUSH 64 along-with standard care in ILI is safe and efficacious and this may be used in other viral infections with pyrexia as add-on to standard care for early recovery and better outcome.

In silico evaluation of the compounds of the ayurvedic drug, AYUSH-64, for the action against the SARS-CoV-2 main protease.

BACKGROUND: Outbreak of Corona Virus Disease in late 2019 (COVID-19) has become a pandemic global Public health emergency. Since there is no approved anti-viral drug or vaccine declared for the disease and investigating existing drugs against the COVID-19. OBJECTIVE: AYUSH-64 is an Ayurvedic formulation, developed and patented by Central Council of Research in Ayurvedic Sciences, India, has been in clinical use as anti-malarial, anti-inflammatory, anti-pyretic drug for few decades. Thus, the present study was undertaken to evaluate AYUSH-64 compounds available in this drug against Severe Acute Respiratory Syndrome-Corona Virus (SARS-CoV-2) Main Protease (Mpro; PDB ID: 6LU7) via in silico techniques. MATERIALS AND METHODS: Different molecular docking software's of Discovery studio and Auto Dock Vina were used for drugs from selected AYUSH-64 compounds against SARS-CoV-2. We also conducted 100 ns period of molecular dynamics simulations with Desmond and further MM/GBSA for the best complex of AYUSH-64 with Mpro of SARS-CoV-2. RESULTS: Among 36 compounds of four ingredients of AYUSH-64 screened, 35 observed to exhibits good binding energies than the published positive co-crystal compound of N3 pepetide. The best affinity and interactions of Akuammicine N-Oxide (from Alstonia scholaris) towards the Mpro with binding energy (AutoDock Vina) of -8.4 kcal/mol and Discovery studio of Libdock score of 147.92 kcal/mol. Further, molecular dynamics simulations with MM-GBSA were also performed for Mpro- Akuammicine N-Oxide docked complex to identify the stability, specific interaction between the enzyme and the ligand. Akuammicine N-Oxide is strongly formed h-bonds with crucial Mpro residues, Cys145, and His164. CONCLUSION: The results provide lead that, the presence of Mpro- Akuammicine N-Oxide with highest Mpro binding energy along with other 34 chemical compounds having similar activity as part of AYUSH-64 make it a suitable candidate for repurposing to management of COVID-19 by further validating through experimental, clinical studies.

Evaluation of Substitution of Small Branches with Roots of Desmodium gangeticum (Physicochemical Analysis, HPLC, and GC-MS Profiling) and In Silico Study of Pterocarpans for Pharmacological Target.

The present research article proposes a conservative approach for the Desmodium gangeticum by using small branches instead of roots because the plant has many important chemical constituents that show different medicinal activity, so the plant's consumption is high. We studied here comparative preliminary phytochemical screening test and physicochemical analysis. The successive soxhlet extraction method was used for the successive extraction of roots and small branches with different solvents for comparative chemical profile study by HPLC and GC-MS. It was observed that many peaks in roots and small branches of the plant sample were almost similar, and the retention time of each peak in roots coincided with the retention of small branches of the sample. Therefore, the similarity was observed in roots and small branches of the Desmodium gangeticum plant in HPLC and GC-MS. The results obtained from HPLC analysis show that roots contain 0.00116% and small branches have 0.00026% of caffeic acid in Desmodium gangeticum. The small branches may have almost similar active chemical constituents like roots. In silico molecular docking study revealed that this plant's principal chemical constituents, pterocarpans, could be inhibitors of protein tyrosine phosphate kinase.

Identification and estimation of bioactive constituents Negundoside, Berberine chloride, and Marmelosin by HPLC and HPTLC for development of quality control protocols for Ayurvedic medicated oil formulation.

BACKGROUND: Anu Taila is an ancient medicated oil Ayurvedic preparation that is commonly used for nasya karma. It contains more than 25 herbs and goat milk as per the Ayurvedic Formulary of India (AFI). It strengthens the neck, shoulder, and chest muscles and improves the capacity of sense organs. It delays the aging process and reduces hair fall. Recent studies showed that it is also useful in COVID-19. In the current study, an attempt to develop quality control protocols and evaluate the standardization parameters like refractive index, iodine value, saponification value, peroxide value, acid value, rancidity, HPTLC fingerprint profile along with major bioactive compound and quantification of Berberine chloride, Negundoside, and Marmelosin by HPLC. Establishing quality protocol and standard parameters like physicochemical parameters and estimation of bioactive compounds of this preparation is significant for quality control. RESULTS: In this study, HPTLC identifies bioactive chemical compounds like Berberine chloride, Marmelosin, Negundoside, glycyrrhizin, and para hydroxybenzoic acid (PHBA), Lupeol, Embelin, and Solasodine, which were present in the Anu Taila formulation. HPLC was used to estimate the bioactive marker compounds Negundoside, Berberine chloride, and Marmelosin were present in the Anu Taila formulation. The quantitative evaluation of Berberine chloride (0.0013%), Marmelosin (0.0366%), Negundoside (0.0086%) is present in Anu Taila formulation. CONCLUSION: The study reveals that sufficient quality control parameters were followed during the preparation of the formulation. Physicochemical analysis was carried out as per the guidelines of Ayurvedic Pharmacopeia of India. HPTLC and HPLC profiles generated in this particular study can be considered as a preliminary tool ascertaining the authenticity of Anu Taila.

Mobile App-Reported Use of Traditional Medicine for Maintenance of Health in India During the COVID-19 Pandemic: Cross-sectional Questionnaire Study.

BACKGROUND: India follows a pluralistic system for strategic and focused health care delivery in which traditional systems of medicine such as Ayurveda, yoga and naturopathy, Unani, Siddha, Sowa Rigpa, and homoeopathy (AYUSH) coexist with contemporary medicine, and this system functions under the Ministry of AYUSH (MoA). The MoA developed a mobile app, called AYUSH Sanjivani, to document the trends of the use of AYUSH-based traditional and holistic measures by the public across India. Analysis of the data generated through this app can help monitor the extent of the use of AYUSH measures for maintenance of health during the COVID-19 pandemic and aid effective health promotion and communication efforts focused on targeted health care delivery during the pandemic. OBJECTIVE: The purpose of the study was to determine the extent of use of AYUSH measures by the public in India for maintenance of health during the COVID-19 pandemic as reported through the AYUSH Sanjivani mobile app. METHODS: Cross-sectional analysis of the data generated through the Ayush Sanjivani app from May 4 to July 31, 2020, was performed to study the pattern and extent of the use of AYUSH-based measures by the Indian population. The responses of the respondents in terms of demographic profile, use pattern, and benefits obtained; the association between the use of AYUSH-based measures and symptomatic status; and the association between the duration of use of AYUSH-based measures and the outcome of COVID-19 testing were evaluated based on bivariate and multivariate logistic regression analysis. RESULTS: Data from 723,459 respondents were used for the analysis, among whom 616,295 (85.2%) reported that they had been using AYUSH measures for maintenance of health during the COVID-19 pandemic. Among these 616,295 users, 553,801 (89.8%) either strongly or moderately agreed to have benefitted from AYUSH measures. Ayurveda and homeopathic measures and interventions were the most preferred by the respondents across India. Among the 359,785 AYUSH users who described their overall improvement in general health, 144,927 (40.3%) rated it as good, 30,848 (8.6%) as moderate, and 133,046 (40.3%) as slight. Respondents who had been using AYUSH measures for less than 30 days were more likely to be COVID-19-positive among those who were tested (odds ratio 1.52, 95% CI 1.44-1.60). The odds of nonusers of AYUSH measures being symptomatic if they tested positive were greater than those of AYUSH users (odds ratio 4.01, 95% CI 3.61-4.59). CONCLUSIONS: The findings of this cross-sectional analysis assert that a large proportion of the representative population practiced AYUSH measures across different geographic locations of the country during the COVID-19 pandemic and benefitted considerably in terms of general well-being, with a possible impact on their quality of life and specific domains of health.

Swasthya Assessment Scale (SAS)-Ayurveda based health assessment tool-insights on its development and validation.

Introduction: Ayurveda has a unique way of understanding the body, health, and diseases. Various determinants, including biological, ecological, medical, psychological, sociocultural, spiritual, and metaphysical factors, which depend on each other, have their role in determining health in Ayurveda. Currently, no validated health assessment scale, based on the principles of Ayurveda is available. This article, for the first time, reports the development, validation, and reliability testing of the Swasthya assessment scale - a health assessment tool developed in Ayurveda. Materials and methods: A thorough literature search and expert consultations were done to draft the items encompassing the concept of health in Ayurveda. A group of experts assessed the content validity of the drafted items. Cognitive de-briefing and pretesting were performed to modify the language and the content again. Reliability testing was done with an inter-observer agreement in a sample of 183 individuals. Results: The content validity index for items and the scale-level content validity index (S-CVI) were calculated. S-CVI for scale was excellent, with 85% agreement. The S-CVI/universal agreement was 0.45, and S-CVI/Average was 0.95. In inter-rater reliability, the percentage agreement was 73.7%. Pearson correlation coefficient was 0.808 showing a strong correlation. Conclusion: Following appropriate validation, the scale can be widely used in clinical practice to assess the patient's health status, guide the treatment plans, and monitor the progress of the health. It can also be used as a sensitive tool in the research of Ayurveda to assess the changes in patients brought about by Ayurveda interventions.

Review of health-care services for older population in India and possibility of incorporating AYUSH in public health system for geriatric care.

BACKGROUND: In a developing country like India, which has 10.11% population of >60 years age and a projection of rise of the same by 300% in 2050, health care of elderly is an enormous challenge. The developed world has evolved many models for elderly care, for example, nursing home care, health insurance, etc. Indian Government has also taken multiple measures in this direction by initiating National Policy on Older Persons, 1999, the Maintenance and Welfare of Parents and Senior Citizens Act, 2007, the Old Age Pension Scheme, Rashtriya Vayoshri Yojana 2017, etc. However, there is a necessity that, India must rapidly adapt to the complex health related, social and economic challenges caused by these demographic changes. This may be an opportunity for innovation in the health system by developing a perspective for healthy and active aging, though it is a major challenge. Health care of the older people cannot be achieved unless total health, i.e., physical, social, economic, psychological, and spiritual aspects are addressed. OBJECTIVE: The objective is to study current policies regarding geriatric health care in India and to propose the possibility to develop a model to provide comprehensive and dedicated health-care services to the older population by integrating conventional and indigenous systems of medicine dwelling in the country. MATERIALS AND METHODS: Electronic search in various scientific journals for research and review articles; electronic along with hand searching of conference proceedings, brochures, government policy documents, press releases, Ayurveda classical texts, etc., regarding geriatric health care in India and model health-care facilities in other countries and regarding of AYUSH systems in geriatric health care in India. RESULTS: There is an urgent need of adaptation and modification in the National Health System to cater the actual requirements of the elderly with plans and strategies dedicated to face their health-related challenges. Adoption of inclusive health-care interventions, can improve health outcomes by making it more acceptable, accessible, and affordable. CONCLUSION: Integration of AYUSH at various levels of health-care delivery system can potentially contribute to provide unique newer dimensions to the field of geriatric care in India.

Chemical characterization of an Ayurvedic herbo-mineral preparation- Mahalaxmivilas Rasa.

BACKGROUND: To protect the massive trust of patient in Ayurveda, a need aroused for the researches to ascertain the quality, safety & efficacy of herbo-mineral preparations on scientific lines. The rasa-aushadhis are having qualities such as instant effectiveness, requirement in very small dosage and ample therapeutic utility. Mahalaxmi Vilas Rasa [AFI, 20:27] has been used for treatment of a variety of ailments since time immemorial. OBJECTIVE: To prepare Mahalaxmi Vilas Rasa as per standard operating procedures (SoPs) mentioned in classical text and to characterize it chemically using modern analytical techniques. MATERIALS AND METHODS: The drug (Mahalaxmi Vilas Rasa) in three batches was prepared in GMP certified pharmacy. Physico-chemical analysis, HPTLC, Assay of elements by AAS & ICP-AES were carried out as per Ayurvedic Pharmacopoeia of India. Powder X-ray diffraction (XRD) was conducted using Rigaku Ultima-IV X-ray diffractometer. RESULTS: The elemental analysis shown the presence of Mercury, Sulphur, Calcium, Copper, Gold, Iron & Tin etc. and HPTLC revealed presence of organic constituents from plant material. The XRD had indicated that prepared drug contained free sulphur, cinnabar (mercury sulphide added as Kajjali), cassiterite (tin oxide, Vanga Bhasma), orpiment (Hartal, arsenic III sulphide) and mica (Leucite/ Zeolite, Abhrak Bhasma). The drug was also tested for residual pesticide and microbiological contamination which were found within permissible limits. CONCLUSION: Classical pharmaceutical procedures of Mahalaxmi Vilas Rasa showed converting the macro elements into therapeutically effective medicines of micro form. Standards laid down in this study certainly utilized as an important tool for standardization and quality assurance of this herbo-mineral formulation.

Effectiveness of an Ayurveda treatment approach in knee osteoarthritis - a randomized controlled trial.

OBJECTIVE: Ayurveda is commonly used in South Asia to treat knee osteoarthritis (OA). We aimed to evaluate the effectiveness of Ayurvedic treatment compared to conventional conservative care in patients with knee OA. METHOD: According to American College of Rheumatology (ACR) criteria knee OA patients were included in a multicenter randomized, controlled, open-label trial and treated in 2 hospital clinics and 2 private outpatient clinics in Germany. Participants received either a multi-modal Ayurvedic treatment or multi-modal conventional care with 15 treatments over 12 weeks respectively. Primary outcome was the change on the Western Ontario and McMaster University Osteoarthritis (WOMAC) Index after 12 weeks. Secondary outcomes included WOMAC subscales; the pain disability index and a pain experience scale, numeric rating scales for pain and sleep quality, quality-of-life and mood, rescue medication use, and safety issues. RESULTS: One hundred fifty-one participants (Ayurveda n = 77, conventional care n = 74) were included. Changes of the WOMAC Index from baseline to 12 weeks were more pronounced in the Ayurveda group (mean difference 61.0 [95%CI: 52.4;69.6]) than in the conventional group (32.0 [95%CI: 21.4;42.6]) resulting in a significant between-group difference (p < 0.001) and a clinically relevant effect size (Cohen's d 0.68 [95% CI:0.35;1.01]). Similar trends were observed for all secondary outcomes at week 12. Effects were sustained at follow-ups after 6 and 12 months. CONCLUSION: Results suggest that Ayurvedic treatment is beneficial in reducing knee OA symptoms. Further studies should be conducted to confirm the magnitude of the effect and to clarify the role of different treatment components and non-specific effects. REGISTRATION: at clinicaltrials.gov (NCT01225133; initial release 10/06/2010).

Clinical evaluation of Vatari guggulu, Maharasnadi kwatha and Narayan taila in the management of osteoarthritis knee.

BACKGROUND: In present era, pharmacological, bio-chemical and surgical interventions are not success remedy for Osteoarthritis (OA). Ayurveda and other complementary medicine have medication for OA. OBJECTIVES: The main aim of the study was to assess the efficacy and safety of therapeutic combination of Vatari guggulu along with Maharasnadi kwatha and Narayan taila with gentle massage for 15 min daily up to 12 weeks on affected knee joint pain assessed on Visual analogue scale (VAS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). MATERIALS AND METHODS: It was an open label, multicentre, prospective, clinical study conducted on 142 patients of OA Knee. Vatari guggulu 500 mg thrice in a day along with Maharasnadi kwatha 20 ml with equal amount of water twice daily and Narayan taila 20 ml twice in a day for external application with gentle massage for 15 min up to 12 weeks were used to all the study participants. RESULTS: VAS, WOMAC score and clinical symptoms were reduced significantly from baseline to end of the treatment (P < 0.001). CONCLUSIONS: The study provides good evidence in support of the efficacy and safety of the Vatari guggulu along with Maharasnadi kwatha and Narayan taila in the management of Osteoarthritis knee.

Pharmacognostical Standardization of Upodika- Basella alba L.: An Important Ayurvedic Antidiabetic Plant.

OBJECTIVE: To establish the pharmacognostic standards for the correct identification and standardization of an important Antidiabetic plant described in Ayurveda. MATERIALS AND METHODS: Standardization was carried out on the leaf and stem of Basella alba L. with the help of the macro-morphological, microscopic, physicochemical and qualitative phytochemical studies. RESULTS: Several specific characters were identified viz. clustered calcium oxalate crystals in the cortex region, absence of trichomes, succulent, thick, mucilaginous, fibrous stem. Rubiaceous type of stomata on both sides of the leaf. Quantitative microscopy along with physicochemical and qualitative phytochemical analysis were also established. CONCLUSION: The pharmacognostic standards could serve as the reference for the proper identification of the Basella alba L. which is an important anti-diabetic plant described in Ayurveda.

Adjuvant effect of Chakshushya Rasayana with beta-blocker eye drops in the management of progressive glaucomatous optic neuropathy: An open-label randomized controlled trial.

INTRODUCTION: Primary open angle glaucoma is an insidious and chronic vision-threatening eye ailment due to neuro-retino-optic nerve degeneration, which may be due to the raised intraocular pressure (IOP) or due to independent factors. Management of glaucoma is mainly concentrated on lowering IOP that requires lifetime topical medication, different ocular medicaments for lowering of IOP, and surgical interventions, but it has its own limitations to control the progression of glaucomatous optic neuropathy (GON), and this is the reason behind the use of alternative neuroprotective adjuvants. AIM: To evaluate the neuroprotective effect of Ayurvedic line of management of progressive GON. MATERIALS AND METHODS: Ingredients of trial drug Vara Fort powder (Chakshushya Rasayana) were procured from the Institute Pharmacy, except Swarnamakshika Bhasma, which was purchased from Dhootapapeshwar Pharmaceuticals. The patients fulfilling inclusion criteria, attending outpatient and inpatient departments, irrespective of their sex, race, religion, occupation, etc., were selected and divided into two groups with open-labeled randomization. In Group A, in addition to betaxolol (0.1%) or timolol (0.5%) (non-iobrim), Chakshushya Rasayana 6 g/day orally with Triphala Ghrita and honey along with Koshtha-Shuddhi (body-microchannel clearing treatment) protocol was tried. Nasya (oleation through nasal route) with Jeevantyadi Taila and Tarpana (eye satiation) with Go-Ghrita were also performed. In Group B (control), brimonidine (iobrim) 0.2% eye drop was used for 3 months. RESULTS: Significant improvement was observed in subjective parameters in Group A such as blurred vision, frequent change of presbyopic glasses, and delayed dark adaptation. CONCLUSION: Chakshushya Rasayana, if administered in a systematic approach along with a modern topical betaxolol or timolol eye drops, has a definite role in improving the lost retinal sensitivity as much as up to 12 dB in 3 months duration.

Shushkakshipaka (dry eye syndrome): A case study.

Ashru-tear secretion is an integral component of the ocular surface physiology; when compromised (quantitatively or qualitatively) lead to shushkakshipaka (dry eye syndrome) with various ocular discomfort symptoms and ultimately the patient may land in corneal blindness.Local, systemic and environmental factors play a major role in its pathogenisis. Vata& Pitta/Rakta vitiation as per Ayurvedic view point are the major contributing pathological factors in its manifestation. Contrary to the available modern medical treatment / management regimen; Ayurveda propounds a systematic systemic/ holistic treatment approach in the treatment of dry eye syndrome. A patient of shushkakshipaka was treated with such treatment protocol, is presented as a case study in this article.

A comprehensive review of Cataract (Kaphaja Linganasha) and its Surgical Treatment in Ayurvedic Literature.

Ayurveda the science of life, since its origin is serving the mankind throughout in health & disease state of life. Shalakyatantra, one of its specialized branch deals with the science of Ophthalmology, Otorhinolaryngology, Orodental surgery & Head; was contributed and developed by Rajrishi Nimi, the King of Videha, who was a colleague of Atreya, Punarvasu, Dhanwantri, Bharadwaja, Kashyapa etc. The available literature related to this speciality is reproduced from original text of Nimitantra in Uttartantra of Sushruta samhita. So Rajrishi Nimi deserves all the credit and regards for Shalakyatantra and for being the first eye surgeon on this earth. The fact regarding the technique of cataract surgery adopted by ancient surgeons is still a matter of debate. Most of the medical fraternity accepts cataract surgery of ancient surgeons as couching procedure but after going through forth coming pages, the prevailing concept will prove to be a myth. It started with extra capsular extraction through small incision during the period of Sushruta Samhita but later shifted to couching like technique by Acharya Vagbhatta. Secondly, the objective of this literary research paper is to find proper co-relation of the disease cataract to those mentioned in Ancient Ayurvedic classic. Linganasha has been inadvertently taken as cataract but this is neither logical nor in accordance with classics. We find detailed description of cataract's differential diagnosis, indications, contra- indications, pre/intra/post operative procedures and complication in ancient texts of Ayurveda. Not only this, vivid description of treatment of various complications of cataract surgery are also given. Needless to say, no other surgically treatable diseases & its complications except Kaphaja Linganasha are given this much attention.

Shad Garbhakara Bhavas vis-a-vis congenital and genetic disorders.

Despite the advancements in diagnostic techniques and therapeutic interventions, medical science has failed to keep the incidence of congenital malformations under control. Ayurveda, the ancient Indian medical system has given due emphasis on this and postulated various measures to minimize the risks. These measures start well before conception. According to Ayurvedic principles, proper preparation of the parents is an essential prerequisite for a healthy progeny. Pre-conception care is a set of interventions that identifies biomedical behavioral and social risks to the health of the mother and the baby. It includes both-prevention and management, emphasizing health issues that require action before conception, very early in pregnancy, for maximal impact. For meeting the objective of healthy progeny, Ayurveda scholars felt the importance of six procreative factors (Shadgarbhkarabhavas) such as Matrija, Pitrija, Aatmaja, Rasaja, Satmyaja, and Sattvaja. The conglomeration of these procreative factors is must for healthy progeny. The physical, mental, social, and spiritual well-being of the person, proper nutrition of the mother during pregnancy, and practice of a wholesome regimen, play a prime role in achieving a healthy offspring, thus structuring a healthy family, society, and nation. Negligence toward any of these factors becomes a cause for unhealthy and defective child birth. The present literary / conceptual study, thus focuses mainly on interpreting these observations, on the basis of modern scientific knowledge.

A clinical study to assess the efficacy of Triyushnadi Anjana in Kaphaja Abhishyanda with special reference to vernal keratoconjunctivitis.

Vernal keratoconjunctivitis / spring catarrh is a variety of exogenous allergic conjunctivitis, which is a very troublesome ocular disease of childhood and in the adolescent age group. The child suffers from intense itching, grittiness, discharge, redness, lacrimation, photophobia, and so on, thereby, decreasing his learning hours. The troublesome features are aggravated in the spring season / hot climate that lasts for years together and rarely persists after adolescence. Mast cell stabilizers, topical Nonsteroidal anti-inflammatory drugs (NSAIDs), and steroids are the available treatment options that too with symptomatic relief and potential side effects, which limits the long-term use of these medicines. The clinical picture of vernal keratoconjunctivitis / spring catarrh is very similar to Kaphaja Abhishyanda, and Triyushnadi Anjana Bhaishajya Ratnavali (B.R.), and its treatment was clinically tried on the patients attending the Netra Roga OPD of the R.G. Government P.G. Ayurveda College Hospital at Paprola (H.P.). A proper protocol and performa was adopted with strict inclusion and exclusion criteria. In the first phase, a pilot study was conducted on 38 clinically diagnosed patients with vernal keratoconjunctivitis, and it gave 100% relief in photophobia, foreign body (FB) sensation, and lacrimation, with marked relief in other features. Encouraged by this pilot work, Triyushnadi Anjana (TA) and 2% sodium cromoglycate (mast cell stabilizer) eye drops in the second-phase clinical trial on 32 patients were tried clinically to evaluate the comparative efficacy. In the second clinical trial, the patients were randomly divided into two groups and Group I was given sodium cromoglycate 2% eye drops and Group II was given TA. The outcome of this study verified the results of the first phase pilot study, and on comparison of the results of the two groups in the second clinical study it was observed that the TA-treated group showed better results. Transient irritation in the eyes was reported by all patients after application of TA, which was relieved by keeping the eyes closed for a few minutes. None of the patients reported any adverse action of the trial drug. Thus, it can be concluded that TA is a safe, cost-effective, and potent Ayurvedic alternative in the treatment of vernal keratoconjunctivitis / spring catarrh.