Overlooked contributions of Ayurveda literature to the history of physiology of digestion and metabolism.

Ayurveda is a traditional system of healthcare that is native to India and has a rich documented literature of its own. Most of the historians agree that the documentation of core Ayurveda literature took place approximately in between 400 BCE and 200 CE, while acknowledging that the roots of its theoretical framework can be traced back to a much earlier period. For multiple reasons many significant contributions of Ayurveda literature to various streams of biological and medical sciences have remained under-recognized while recounting the historical milestones of development. This is true in the context of the physiology of digestion and metabolism too. In this communication we try to reconstruct a picture of the processes of digestion and metabolism as had been understood by ancient Ayurveda scholars. Though this understanding was primitive and insufficient in many ways, we argue that this deserves to be documented and acknowledged. To help with grasping the importance of these contributions, we juxtapose them with the corresponding insights pertaining to this subject reported by prominent western scientists. The major contributions of Ayurveda that have been recounted in this paper are those related to the description of three distinct phases of digestion (Avasthapaka), multiple sets of transformative entities acting at different levels of metabolism (Agni), and the roles ascribed to various internal and external factors in executing these physiological functions.

Clinical Prediction of Type 2 Diabetes Mellitus (T2DM) via Anthropometric and Biochemical Variations in Prakriti.

Type 2 Diabetes Mellitus (T2DM) is a complicated multifactorial illness involving hereditary and external environmental variables. The symptoms typically appear gradually over a number of years without realizing it. This viewpoint is further supported by the Ayurvedic constitution concept (Prakriti). Prakriti explains the biological variability that is observed in different individuals. This study was conducted a retrospective investigation to examine if there was a link between type 2 diabetes and an individual's constitution based on anthropometric and biochemical characteristics. Physical and mental characteristics and anthropometric and biochemical markers were used to determine reported cases' prevailing Dosha Prakriti (constitution). Based on biochemical and anthropometric data, significant differences in Prakriti were found between the case (T2DM patients) and control (person without diabetes) groups. The incidence of numerous secondary problems linked with T2DM patients was also evaluated according to their Prakriti types, which revealed a positive relationship. The three primary contributing parameters, such as waist-hip ratio, postprandial blood sugar, and serum creatinine, were correctly classified all person with or without diabetes subjects to 90.6% of the time, whereas the constitution-wise study classified person with diabetes and without diabetes individuals of Pitta and Kapha Prakriti to 94.3% and 90%, respectively. A discriminant function was created to predict a person with diabetes and without diabetes based on these three contributing factors. The primary contributing biochemical parameters discovered by Prakriti in the current study could be used as a biochemical disease diagnostic for predicting type 2 diabetes susceptibility.

Explication on tissue nutrition in prenatal and postnatal life: An Ayurveda perspective.

Tissue nutrition is the continuous process which is established just after the conception and persists throughout the life. Ayurveda scholars have mentioned that the manner of tissue nutrition is not same in all phases of life. In prenatal life embryo gets nutrition by Upasneha (filtration) and Upasweda (percolation/secretion) and fetus by Garbhanabhinadi (umbilical cord) which is attached with the heart of mother via Rasavahanadi (blood vessels). Thus in intrauterine life the nutrition of embryo is histotrophic, whereas just after the formation of placenta nutrition becomes haemotrophic. In post-natal life nutrition is enteral means nutrients are taken in the form of food via mouth called Aahar. Ayurveda scholars have postulated theories to understand the mechanism of tissue nutrition are Ksheera Dadhi Nyaya (transformation of nutrients), Khale Kapota Nyaya (selective uptake of nutrients), KedariKulya Nyaya (transportation of nutrients via channels), Ek Kala Dhatu Poshan Nyaya (simultaneous supply of nutrients to whole body). The theories of tissue nutrition discussed in Ayurveda suggest that although tissues are nourished and replenished continuously at different rate as per the functional state of Agni by circulating nutrients obtained from Ahara, but tissues are also dependent on each other for their proper nourishment and metabolism. This concept has great implication in management of malnourishment and various other disorders. This manuscript is an attempt to explore the Ayurveda's view on tissue nutrition along with physiological and clinical significance of theories of tissue nutrition in a scientific manner.

Development, Validation, and Verification of a Self-Assessment Tool to Estimate Agnibala (Digestive Strength).

According to Ayurveda, the traditional system of healthcare of Indian origin, Agni is the factor responsible for digestion and metabolism. Four functional states (Agnibala) of Agni have been recognized: regular, irregular, intense, and weak. The objective of the present study was to develop and validate a self-assessment tool to estimate Agnibala The developed tool was evaluated for its reliability and validity by administering it to 300 healthy volunteers of either gender belonging to 18 to 40-year age group. Besides confirming the statistical validity and reliability, the practical utility of the newly developed tool was also evaluated by recording serum lipid parameters of all the volunteers. The results show that the lipid parameters vary significantly according to the status of Agni The tool, therefore, may be used to screen normal population to look for possible susceptibility to certain health conditions.

Weighted mean: A possible method to express overall Dhatu Sarata.

Several questions are being raised regarding the accuracy of the methods of diagnosis and reporting of various clinical parameters according to Ayurveda in recent times. Uniformity in reporting, issues related to inter-rater variability, uniformity in applying statistical tests, reliability, consistency, and validation of various tools, - are some of the major concerns that are being voiced. Dhatu Sarata is one such domain where no substantial work has been carried out to address these issues. The Sanskrit term "Dhatu" roughly translates as a "tissue." Sarata stands for the status of Dhatu in a given individual, i.e., it describes whether the status is excellent, moderate, or poor. In the available research literature, there are several gaps while dealing with and reporting the clinical assessment of Dhatu. Most of the workers group an individual into any one of the categories of Dhatu Sarata, and this approach neglects the contribution of other Dhatus to the overall Sarata in that individual. In this communication, we propose the usefulness of "weighted mean" in expressing the overall Sarata in an individual. This gives the researcher a freedom of not classifying an individual into any one group of Sarata, while also simultaneously allowing him/her to retain the focus on the status of an individual Dhatu.

Effect of walking (aerobic isotonic exercise) on physiological variants with special reference to Prameha (diabetes mellitus) as per Prakriti.

Walking is an isotonic aerobic exercise and has been associated with reduced blood sugar level in diabetic patients and other physiological changes in observational studies. A study was conducted to determine the effect of isotonic aerobic exercise (walking) on blood sugar level and other important physiological parameters as per Prakriti. This study was carried out in Department of Kriya Sharira and Kayachikita, S. S. Hospital; Faculty of Ayurveda, IMS, BHU and some cases were enrolled from Kashi Mumukshu Bhawan, Assi, Varanasi. A total 83 (32 diabetic control and 51 diabetic exercise) diabetic cases were included with age ranging from 35 to 65 years during January 2009 to January 2011. Control cases enrolled in this study had not performed any exercise. The results of the study revealed that, there is a strong association in between Prakriti, Blood pressure and certain other Biochemical parameters.

The ayurveda education in India: how well are the graduates exposed to basic clinical skills?

"Ayurveda" is an ancient system of healthcare that is native to India. At present, in India, there are more than 240 colleges that offer a graduate-level degree (Bachelor of Ayurvedic Medicine and Surgery-BAMS) in Ayurveda. Even though the Central Council of Indian Medicine, the governing body that monitors the matters related to Ayurveda education, has imposed various educational norms and regulations, the standard of education has been a cause of concern in recent years. The mushrooming of substandard Ayurvedic colleges is the most important factor that is being held responsible for this kind of erosion in the standards. The present study is a mailed survey, which was carried out to evaluate the "Extent of exposure to basic clinical skills during BAMS course" as perceived by the sample groups of students and teachers drawn from 32 Ayurvedic educational institutions spread all over India. A methodically validated questionnaire was used as the tool in the study, to which 1022 participants responded. The study indicates that there are some serious flaws in the existing system of the graduate-level Ayurveda education. Since the Ayurvedic graduates play an important role in the primary healthcare delivery system of the country, governing bodies are required to take necessary steps to ensure the adequate exposure of the students to basic clinical skills. Along with the strict implementation of all the regulatory norms during the process of recognition of the colleges, introducing some changes in the policy model may also be required to tackle the situation.

Global challenges of graduate level Ayurvedic education: A survey.

In the present day scenario, Ayurveda is globally being perceived in several contradictory ways. Poor quality of Ayurveda graduates produced as a result of poorly structured and poorly regulated education system is at least one of the important factors responsible for this scenario. The present study was carried out to evaluate the 'Global challenges of graduate level Ayurvedic education' and is based on the responses of Ayurvedic students and Ayurvedic teachers from various educational institutions of India to a methodically validated questionnaire. As the study indicates, the poor standard of Ayurvedic education in India is definitely a cause of concern. The curriculum of Bachelor of Ayurvedic Medicine and Surgery (BAMS) course of studies is required to be reviewed and restructured. The syllabi are required to be updated with certain relevant topics like laws governing the intellectual property rights, basic procedures of standardization of medicinal products, fundamental methods of evaluating the toxicity of the medicinal products, essentials of healthcare management and the basics of cultivation and marketing of medicinal plants. Furthermore, the study suggests that the Ayurvedic academicians are required to be trained in standard methods of research and documentation skills, and the educational institutions are required to be encouraged to contribute their share in building up the evidence base for Ayurveda in the form of quality education and research.