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   Table of Contents - Current issue
Coverpage
October-December 2022
Volume 16 | Issue 4
Page Nos. 267-338

Online since Saturday, December 17, 2022

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EDITORIAL  

Kalabhojanam − Effective intervention to minimize the metabolic disorders p. 267
Sanjeev Sharma
DOI:10.4103/joa.joa_292_22  
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PRE - CLINICAL STUDY: ORIGINAL ARTICLE Top

Exploration of antimicrobial potential of snuhi ksheer according to ksheer sangrahan kaal - A comparative study p. 269
Neelam , Mita Kotecha, Kamal Nayan Dwivedi
DOI:10.4103/joa.joa_225_21  
Introduction: Snuhi, botanically identified as Euphorbia neriifolia L., is a deciduous tree or shrub, belongs to the family Euphorbiaceae, commonly known as milk hedge. Snuhi is one of the constituents of Kshaarasootra, which is used to treat anal fistula. In Charaka Samhita, Snuhiksheera (latex) collection is mentioned specifically at the end of Shishir Ritu (mid-Jan-mid March); on the other hand, the Ksheera collection of any medicinal plant for therapeutic use should be collected in Sharad Ritu (mid-Sept-mid Nov). The study aimed to compare the antimicrobial activity of Snuhi Ksheera collected in Shishirante and Sharadritu. Methods: The antimicrobial efficacy was evaluated against three bacterial strains (Staphylococcus aureus, Streptococcus pyogenes, and Pseudomonas aeroginosa). The study was evaluated using Agar well diffusion method. For samples preparation, 5% solution (ciprofloxacin 500 mg) was used as positive control and 20% dimethyl sulfoxide was used as the negative control. Mueller-Hinton agar medium was used as a culture media for microbes. Results: The results showed that both the ksheera (Shishirante and Sharadritu) have a significant zone of inhibition (ZOI) and Activity Index (AI), but Shishirante collected Snuhi Ksheer have relatively higher ZOI and AI. Hence, both Ksheera can kill the pathogen, but Shishirante collected Snuhi Ksheer showed more potent antimicrobial activity. Conclusion: Antimicrobial activity was better shown by Shishirante collected Snuhi Ksheer against all three microorganisms.
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CLINICAL STUDY: ORIGINAL ARTICLES Top

A comparative clinical study of Vasa Paratisarneeya Teekshna Kshara and Apamarga Paratisarneeya Teekshna Kshara in the management of Abhyantara Arsha (Internal Piles) p. 274
Himadri Mudgal, P Hemantha Kumar
DOI:10.4103/joa.joa_22_20  
Introduction: Ayurveda has become a cornerstone of our history and played a significant function in defining our environment. Aacharya Sushruta has described the concept of Ashta-Mahagada. Arsha. Aacharya Sushruta has described various types of treatment modalities for Arsha, which include Kshara Karma. The present study was planned and carried out to compare the efficacy of Vasa and Apamarga Paratisarneeya Teekshna Kshara (VPTK and APTK) in the management of Abhyantara Arsha. Methods: For current study total 30 patients were taken and allocated into 2 groups (Group A and Gtoup B). Time plan for the study was 1 month including follow-up. Follow-ups were done on 2nd, 3rd and 4th week. In 1st Group (A), 15 subjects having 1st, 2nd & 3rd degree internal pile were taken and it was kept as a control group. Here Apamarga Pratisaraneeya Teekshna Kshara was applied and in 2nd group (B) Vasa Pratisaraneeya Teekshna Kshara was used. The sign and symptoms were evaluated before and after accomplishment of treatment. Results: In reduction of bleeding, Group B (96.25 %) showed better result than Group A (91.90 %). For reducing size of pile mass, Group A (92.50%) was better than Group B (89.00%). But in post-operative pain, Group B caused less pain (100%) than Group A (75.18%).
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Vatari guggulu and mahaushadhi kwatha in amavata (Rheumatoid Arthritis): An open-label, single-arm clinical study p. 280
Vibhu Powar, Girish Koppa Jayaprakash, Lakshmiprasad L Jadhav, KS Sreedevi, Rashmi Bhatt
DOI:10.4103/joa.joa_157_21  
Introduction: Amavata (rheumatoid arthritis [RA]) is a painful disease which is caused due to vitiated vata and Ama. Amavata has been correlated to RA in modern medical parlance. The prevalence of RA in adults of the developed world is around 0.5%–1%, amid which around 40% are registered disabled within 3 years, while around 80% are moderate to severely disabled within 20 years. Based on the pathogenesis of Amavata, the treatment shall be focused mainly on ama-pachana (digestive) and agni dipana (carminative). Most of the ingredients in vatari guggulu and mahaushadhi kwatha are katu (pungent), tikta (bitter) rasa (taste), and ushna virya (hot potency), which helps in ama pachana (digestive) and agni dipana (carminative) action. Ingredients namely gandhaka (Sulphur), guggulu (Commiphora mukul), haritaki (Terminalia chebula), and amalaki (Emblica officinalis) are having rasayana property; while shunti (Zingiber officinale), guduchi (Tinospora cordifolia), guggulu, haritaki, vibhitaki (Terminalia bellerica), and amalaki have anti-inflammatory property. Methods: Thirty patients were administered vatari guggulu 1 tablet (1 g) along with mahaushadhi kwatha 15 ml thrice daily after food with warm water as anupana (adjuvant) for 15 days. Ordinal data were analyzed with Friedman's test followed by Wilcoxon sign rank test as post hoc; continuous data were analyzed with repeated measures ANOVA after applying Bonferroni correction with paired t-test as post hoc. Results: There was statistically significant improvement in the primary outcome measures, in disease activity and functional ability indices. Conclusion: Vatari guggulu and mahaushadhi kwatha are effective in the management of Amavata.
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Study of Trayodashanga Guggulu and Sahacharadi Kwatha with and without Greeva Basti in the management of Greevasandhigata Vata with special reference to cervical spondylosis: A randomized comparative clinical trial p. 293
Ashok Kumar, Bharatkumar Chhaganbhai Padhar, H M. L. Meena, Sunita Rawat
DOI:10.4103/joa.joa_198_21  
Introduction: Cervical spondylosis is a common age-related condition characterized by degenerative changes in the intervertebral discs. Neck discomfort is the most prevalent symptom, and it continues to be one of the top causes of disability and growing health-care expenses. About 10 million persons per year suffer from cervical spondylosis in India. The incidence of neck pain is 25%–50% per year in the adult population. Nonsteroidal anti-inflammatory drugs are being used to provide relief in neck pain. The study was planned to assess the effect of Ayurvedic interventions in the management of cervical spondylosis. Methods: A total of 40 clinically diagnosed patients of Greeva Sandhigata Vata were randomly divided into two equal groups by computer generated randomization method. In Group A, patients were treated with Tryodashanaga Guggulu and Sahacharadi Kwath. In Group B, patients were treated with Tryodashanaga Guggulu and Sahacharadi Kwath, along with Greeva Basti (Prasarini Taila). Results: Tryodashanaga Guggulu and Sahacharadi Kwatha had provided 45.24% relief in pain (P = 0.001), 52.92% improvement in Neck Disability Index (P = 0.001), while Tryodashanaga Guggulu and Sahacharadi Kwatha along with Greeva Basti (Prasarini Taila) showed 56.47% relief in pain (P = 0.001) and 64.33% improvement in the Neck Disability Index (P = 0.001) which were statistically highly significant. On comparison, the difference in improvement in Pain (P = 0.007) Neck Disability Index (P = 0.026) was statistically significant. Conclusion: Tryodashanaga Guggulu and Sahacharadi Kwatha along with Greeva Basti (Prasarini Taila) are more effective in the management of cervical spondylosis (Greeva Sandhigata Vata) as compared to Tryodashanaga Guggulu and Sahacharadi Kwatha without Greeva Basti (Prasarini Taila).
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ANALYTICAL STUDY: ORIGINAL ARTICLES Top

Morphological and ethnomedicinal study of Berberis napaulensis (DC.) laferr. (Syn. Mahonia nepalensis DC.) p. 299
Kiran Paudel, A Ramamurthy, Gaurav Sharma
DOI:10.4103/joa.joa_215_21  
Introduction: Berberis napaulensis (DC.) Laferr. (Syn. Mahonia nepalensis DC.) belonging to the family Berberidaceae. In the Kathmandu Valley of Nepal this shrub plant is used in the alternative medicinal systems. It is found in Temperate Himalaya, Altitude 4000–8000 ft. in height from Garwhal, India to Bhutan. B. napaulensis DC. is sparingly branched shrubs having erect stems. Leaves are pinnately compound. Methods: The current survey study is based on the Berberry plants with the help of different Scholars of Botany, Ayurveda, Medicine, and Traditional Ayurveda Practitioners. Field trips were made with experts on the dense forest of Kathmandu Valley. The Collected Plant specimens were compared with Specimens of KATH and TUCH, KTM, Nepal, and CSIR-NIScPR, New Delhi, India. Results: The Survey study identified, recorded, and collected the common Berberis and Mahonia in Hilly area of Kathmandu valley. Berberidaceae family species have a valuable status in the Hilly area and Mountainous area of Nepal and India. Mahonia Plant Stem Bark was commonly used in Jaundice and Liver related Diseases, Ophthalmic Problems, Neurological Disorders, and Metabolism Disorders. Conclusion: Berberidaceae family has diverse numbers of species. In Ayurveda, Berberis aristata DC. signifies the name of Daruharidra but in the different field visits shown that any species of Berberry were used as Daruharidra (Nepali: Chutro). Commonly, Berberis aristata DC is substituted by Berberis asiatica Roxb. ex DC. as the name of Daruharidra Veda. In the absence of Berberis asiatica Roxb. ex DC., Mahonia nepalensis DC. is used in Kathmandu valley.
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Microbial study of Bhallatakarishta formulate by two different liquid media p. 306
Dharmishtha Bopaliya, Dipali Parekh, Meera Cholera, Biswajyoti Patgiri
DOI:10.4103/joa.joa_255_21  
Introduction: Asava and Arishta (fermented formulations) are unique dosage forms of Ayurveda due to their indefinite shelf-life. The self-generated alcohol of these preparations is potentiating both the level pharmaceutically and therapeutically. Aim: The aim of the study is to carry out the stability of Bhallatakarishta (BA) prepared by two different liquid media with respect to its stability against microbial contamination. Methods: Both these BA samples were prepared and studied to check for microbial contamination at regular intervals. Results: Each time, the sample was subjected in microbial study from the day of preparation to the date of the last microbial study. No contamination was found in a microbial study in water media. In the one batch of Kanji (fermented sour gruel) media out of two batches, microbes were found after the 5th month date of preparations. Discussion: A current study was conducted to observe the stability of BA regarding microbial contamination for sample preparation and storage under different climatic conditions and temperatures. Thus, the basic microbial profile was studied at regular intervals for the consumption of the prepared drug. At the end of the study, it was found that the samples were not shown for the presence of any microorganisms in most of the collections. Conclusion: During the study period, no microorganisms were isolated from aerobic culture, and no fungal pathogens were identified from fungal culture in any batches of water media. Thus, these data support the long shelf-life of AsavaArishta formulation.
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REVIEW ARTICLES Top

Hortus Malabaricus – A Treasure of Anukta dravya Practices p. 312
P Aswathy, S Aravind
DOI:10.4103/joa.joa_292_20  
Objective: Hortus Malabaricus is a Latin book exploring the natural plant wealth of Malabar region of Kerala which contains detailed illustrations of 742 plants with their medicinal uses. This book contains details of unexplored Anukta Dravyas which was not mentioned in Samhitas and classical textbooks of Ayurveda. Thus the study was designed to explore the unexplored clinical practices of drugs mentioned in Hortus Malabaricus. Data Source: The data was collected from the twelve volumes of Hortus Malabaricus, related published journal articles, proceedings, and books. Review Method: The method of data collection includes literature review of Hortus Malabaricus and online literature search of journal articles and proceedings using Mesh terms. Conclusion: The results showed that Schagericottam, Karinjotta, Kattumayilellu, Neeruri, Mayilellu, Pavatta, Kurutu pala, Tindapariva, etc., explained in different volumes of Hortus Malabaricus had medicinal importance. These documented traditional knowledge practices in Hortus Malabaricus are to be scientifically evaluated for the betterment of public health.
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A study on medovaha srotas W.S.R.To its moolastana p. 316
S Prasanna, M Madhu
DOI:10.4103/joa.joa_327_20  
Objectives: (1) Critical study of medovaha srotas. (2) To review the anatomy of medovaha srotas and its moolastana, also to fix its anatomical limitation based on modern parameters. Data Sources: Secondary. Review Methods: Literary method is adopted in the present study from the Ayurvedic literature and contemporary science. Results: Anatomical limitation of Medovaha srotas is assessed based on anatomical and functional points and its moolastana is justified with scientific analysis. Conclusion: Medo dhatu exists throughout the body and moola is only the places of significance. Intestine, lymph vessels, blood vessels, liver, and adipose tissue act as Medovaha srotas/channels at different stages in a particular given time. There are different opinions mentioned by different acharyas based on the most important structural and functional observations made by them.
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Rishyagandha: A Powerful Herb to Reverse Prameha p. 321
Aditi Raidani, Swati Vyas
DOI:10.4103/joa.joa_328_20  
Objective: India is well recognized for its traditional medicine system based on the medicinal plants with long therapeutic history. Rishyagandha (Withaniacoagulans) is one such plant traditionally used for curing various aliments particularly diabetes. Diabetes is silent killer affecting quality of life, characterized by life-long medication associated with the number of side effects. Thus, traditional healing medicinal system such as Ayurveda is often recommended. Data Source: Ayurvedic texts referred include Charaka samhita, Nighantu, Chikitsa Grantha, and Astanghridaya. Different published review articles in journals, evidence-based online published articles, and various websites were explored. Review Methods: Literary reviews, including qualitative, experimental, and observational researches highlighting the therapeutic, pharmacological benefits of Rishyagandha were analyzed. Conclusion: Rishyagandha (Withaniacoagulans), also known as Indian cheese maker, is a rich source of coagulan, withacoagin, withasomidienone, and withaferin. It has shown to exert antibacterial, wound healing, cytotoxic, free radical scavenging, hypoglycemic, antitumor, and hypolipidemic effects. Hence, the present review article aims to project botanical, morphological description, traditional uses, and pharmacological studies of Rishyagandha. The pharmacological action of the plant is well established due to the presence of different phytochemicals. The extensive review advocates that the fruits may be prescribed as accompaniment in the drug treatment and dietary therapy for the management of diabetes mellitus.
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Analogy – Susruta perennial and elementary methodology in anatomy apprehension p. 327
Neha Udainiya, Gaurav Soni
DOI:10.4103/joa.joa_316_21  
Objective: To justify the use of art of analogy or Upmana in studying and understanding Rachana Sharir by the ancient sages and creating awareness for its incorporation in the present curriculum. Data Source: Published sources such as samhitas, ancient texts, magazines, periodicals, peer-reviewed journals, and the Internet. Review Methods: A narrative style is being adopted by using the abovementioned secondary data sources. Results: Since time immemorial where there was a lack of technological advancements, this technique has been efficiently used in Ayurveda and Rachana Sharir by the sages and Susruta being the pioneer of Rachana Sharir has imbued his treatise with numerous and relevant analogies which not only accomplishes the purpose of grabbing the anatomical structures thoroughly by academicians but also recoups to some extent the need of models, specimens, and dissection procedure for a while. Conclusion: This age-old and time-bound technique of the Susruta analogy should be incorporated in present-day anatomy apprehension by alluding and exemplifying several analogical affairs.
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CASE REPORTS Top

Management of guillain-barre syndrome in a child through ayurveda intervention – A case study p. 334
Bhimrao Meshram, Rajagopala Shrikrishna, Arun Kumar Mahapatra
DOI:10.4103/joa.joa_185_22  
Introduction: Guillain-Barré syndrome (GBS) is an acute, postinfection, autoimmune polyneuropathy disease. GBS reveals a greater rapid and severe course, with common involvement of respiratory muscles and cranial nerves and a slightly autonomic nervous system. Main Clinical Findings: The female patient, an 8-year-old child, had been complaining of swaying while standing, inability to grasp, reduced strength in both upper and lower limbs, and inability to walk, stand or run quickly for 1 month. Diagnosis: She was diagnosed and treated for acute inflammatory demyelinating polyneuropathy (GBS). According to Ayurvedic classics, GBS can be correlated with Sarvanga Gata Vatavyadhi. Intervention: The principles of Vatavyadhi Chikitsa were used, i.e., Panchakarma procedures and internal medicines. Outcome: The patient showed remarkable recovery in the complaints, i.e., improvement in muscle power, strength, general condition, and daily activities. Conclusion: The Ayurveda intervention showed good clinical improvement. This further confirms the correlation between disease, the treatment principle adopted, and the procedures and drugs chosen for managing the GBS symptoms.
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