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   Table of Contents - Current issue
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April-June 2022
Volume 16 | Issue 2
Page Nos. 85-174

Online since Monday, July 4, 2022

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EDITORIAL  

Faculty development programs and student centered approach in teaching can improve the learning experiences in the students p. 85
Sanjeev Sharma
DOI:10.4103/joa.joa_156_22  
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PRE - CLINICAL STUDY: ORIGINAL ARTICLE Top

An In vitro study to compare the antibacterial activity of Kaphaketu Rasa and its combination with Rasa Sindura in selective respiratory pathogens Highly accessed article p. 87
V Sreeja Kaimal, Amal S Chandran, PK Vineeth, Unnikrishna Pillai, KP Skandhan
DOI:10.4103/joa.joa_94_21  
Introduction: Respiratory tract infection refers to any infectious disease involving the respiratory tract. The adverse effect of antibiotics and antibiotic resistance are the difficulties faced by the medical profession. It is the need of the hour to identify the antibacterial potential of the herbo – mineral drugs. So, this study is an effort to compare the efficacy of Kaphaketu rasa alone and its combination with Rasasindura against the bacteria causing respiratory infections such as Staphylococcus aureus and Streptococcus pneumoniae. Methods: Rasasindura and Kaphakethurasa were prepared according to the classical reference. For Rasasindura preparation Kupipakva method was done. Kaphaketu rasa was prepared after doing bhavana of sodhita Vatsanabha, Tankana, Pippali and Sankha Bhasma with Ardraka swarasa. Antibacterial activity of Kaphaketu rasa, Rasasindura and its combination were tested by the agar well diffusion method. Results: Aqueous extract of Kaphaketu rasa and combination of Kaphaketu rasa with Rasasindura have zone of inhibition against both S. pneumoniae and S. aureus, which shows the antibacterial activity of the drugs. Aqueous extract of Rasasindura alone did not show any zone of inhibition against both bacteria. Conclusion: Kaphaketu rasa has significant antibacterial activity against the respiratory pathogens S. aureus and S. pneumoniae. The findings suggest that Kaphaketu rasa can be used in respiratory tract infection and Rasasindura can be added with it for an additive effect.
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CLINICAL STUDY: ORIGINAL ARTICLES Top

An open-label randomized comparative clinical study of Triphaladi vati and Jatyadi gandusha on Tobacco Chewing-Induced Mukhapaka w.s.r. to stomatitis p. 92
Sunita Kumari Bijarniya, Sushil Kumar Jangid
DOI:10.4103/joa.joa_347_21  
Introduction: According to Ayurveda, tobacco plant (Sthavara Patra Visha) has properties such as Tikta and Katu rasa, Laghu, Tikshna, Vyavayi, Sara, Vikashi, and Ushna guna; all the properties match with Dushi visha (slow poison) induces chronic toxicity to the gastrointestinal tract on chronic use. Tobacco chewing causes Mukhapaka (Sarvasara roga) which is the clinical condition identified with Paka, Lalima (redness), Daha (burning sensation), Sphota (mouth ulcers/blisters), Ksharokshit kshatsam (erosion of buccal mucosa), Vedna (pain), Tikta vaktrata (bitter taste), difficulty in chewing, and enlargement of lymph nodes. Mukhapaka is a Pitta Pradhana Sansargaja vyadhi. Gandusha and Virechaka drugs are found effective to treat Mukhapaka. Triphaladi vati and Jatyadi gandusha are defined as Mukha roga treatment as the both Yogas have Rasayana (immunity booster), Deepana (appetizer), Vishaghna (detoxifier), Vranaropana (wound healing), Pittasamsrana (anti-inflammatory), and Sandhanakara (healing) properties useful in Mukhapaka (stomatitis). This study aims to access and compare the efficacy of Triphaladi vati and Jatyadi gandusha in Mukhapaka treatment. Methods: (i) Design: Open-labeled randomized comparative clinical trial of 30 patients of either sex. (ii) Intervention: 30 clinically diagnosed and Rajasthan Ayurved University (Jodhpur) outpatient department-registered patients of Mukhapaka (stomatitis) who were randomly divided into two groups (Group A and Group B) of 15 patients each. (iii) Duration: 45 days. Results: Both the selected preparations were found very effective in the treatment of Mukhapaka, but the most efficacy was seen in Group B which was given Jatyadi gandusha. Conclusion: The present study supports the use of both Yogas in treating Mukhapaka with the good acceptance by all treated patients.
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A comparative clinical evaluation of “Varuna Kwatha” and “Kanchnara Triphala Kwatha” in the management of Dhatvagnimandhya with special reference to hypothyroidism p. 99
Rani Gurmeet, Sahu Kumar Ajay, Mutha Rashmi
DOI:10.4103/joa.joa_202_21  
Introduction: Hypothyroidism is one of the most common thyroid disorders in India, its incidence increasing day by day. The current issue was chosen for research and its treatment by using Ayurvedic principles due to the vast range of the disease and its high incidence in society. The aim of the present study is to compare the efficacy of Varuna Kwatha and Kanchnara Triphala Kwatha in the management of Dhatvagnimandhya (Hypothyroidism). Methods: This was a randomized, interventional type and comparative study, in which 30 confirmed hypothyroidism patients with elevated serum thyroid-stimulating hormone >.5 μIU/ml were selected and treated with Varuna Kwatha and Kanchnara Triphala Kwatha for 30 days. To measure the unbiased impact of treatments, patients were instructed to stop using any hypothyroidism medications they were consuming. Results: Both the groups showed statistically highly significant (P < 0.001) improvement in tiredness, weakness, dyspnea, and dry coarse skin, while in a hoarse voice, hypomenorrhea, menorrhagia, oligomenorrhea, and cold intolerance, the groups showed the insignificant result. In objective parameters, both groups showed highly significant results (P < 0.001) in decreasing weight and body mass index. Both the groups showed insignificant result in T3, T4 parameters. Group A showed a 5.08% decrease in TSH, but statistically, it was insignificant, while Group B showed a significant result (P = 0.0234) with 30.54% relief. Conclusion: Kanchnara Triphala Kwatha showed better results than Varuna Kwatha.
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A randomized controlled trial to evaluate the laxative effect of prescribed diet compared with Triphala Churna in Vibandha with special reference to constipation p. 106
Pooja Saini, Sarvesh Kumar Agrawal
DOI:10.4103/joa.joa_163_20  
Introduction: Constipation is a common gastrointestinal complaint in apparently healthy population as well as in patients with various predisposing disorders with approximately 12%–19% global prevalence. Constipation is defined as “delay or difficult defecation causing significant distress to the patient.” In Ayurveda, various clinical conditions such as Krurakoshtha, Apanavayudusti, Vishtabdhajirna, Grahani have symptom of constipation called Vibandha. The presently available laxative drugs are habit-forming and financial burden to the patients. Treatment of constipation cannot be continuing for a longer period; therefore, it is a better option to put the patient on proper diet having laxative action in the condition of constipation. The objective of this work is to prepare a dietary module for patient of constipation and to evaluate the laxative effect of that prescribed dietary module (Pathyahara) in constipation. Methods: This study was conducted in two groups. Group A (Control): 3–6g (½ Karsh) Triphala Churna was given orally at night after meal daily with lukewarm water. Group B (Trial): Prescribed Dietary Module was advised as a daily diet. Results: Very significant result was found in both groups on all assessment parameters except weekly frequency of bowel movements in which result was significant in group A and no significant difference was there in all assessment parameters except weekly frequency of bowel movements and colic pain where the effect was more in Group B. Conclusion: Triphala Churna and prescribed dietary module having laxative effect in constipation. The effect was statistically more in prescribed dietary group on two parameters.
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SURVEY STUDY: ORIGINAL ARTICLES Top

Role of Aharaja Nidana in etiopathogenesis of premature aging w. s. r. to skin health: A survey study p. 112
Archana Singh, Pawankumar Godatwar, Reetu Sharma
DOI:10.4103/joa.joa_235_20  
Introduction: Modern gerontologist accepted aging as a natural phenomenon which cannot be avoided. In Ayurveda, it is mentioned as Jara and believed as Svabhavika Vyadhi. There are various factors mentioned in Ayurveda which accelerates the process of aging and results in Akalaja jara. The sign of aging reflects the first on the skin in the third decade of life. The present study was intended to identify the potential factors that may accelerate the process of aging in the context of food habits, with special reference to skin health. Methods: A Nidanatmaka study was conducted at NIA Jaipur in which 492 participants aging between 30 and 65 years, having signs of aging were included after informed consent, and the data were collected to measure the prevalence of the etiological factors of early aging by incorporating a well-designed questionnaire. Results: Majority of participants were of the age group 30–39 years (64.43%), belong to middle socioeconomic class (66.05%) and urban habitat (95.32%) and having graduate level (24.79%) of education. Majority of participants were female (61.78%), married (85.97%), and homemakers (40.44%). The majority of the participants reported excessive intake of Guru Ahara (46.13%), Snigdha Ahara (59.75%), and Ushṇa Ahara (56.30%) sometimes, while rare intake of Ati Shita Ahara (54.47%) was reported in majority of participants. Most of the participants reported Lavaṇa as dominant Rasa (49.59%) and practicing Viṣamasana (50.20%). Conclusion: These data advocate the fact that faulty food habits contribute toward accelerated intrinsic aging which reflects on skin health.
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Knowledge, attitude and practice survey of prashana survey of prashana in neonates among Ayurvedic practitioners p. 119
Chris Antony, Anubha Chandla, Kavita Vyas, Rajesh Sannd
DOI:10.4103/joa.joa_369_21  
Introduction: Neonatal period is the most vulnerable period for infections. India is the first among top 10 countries with the highest number of newborn deaths in 2019. Ayurvedic newborn care measures like prashanas should be explored for extending quality affordable care to newborns. Methods: A descriptive cross-sectional study in the form of knowledge, attitude, and practice survey of prashana in neonates was carried out using self-administered questionnaire containing 28 questions through Google Forms among 402 Ayurvedic Practitioners of India following CHERRIES checklist. Validated questionnaire was pretested before fielding it. Results and Conclusion: 55.4% of the participants agreed that prashana should be administered to all neonates and 91.5% agreed that it improves the health of the neonates. 53.4% preferred Swarna bhasma and 30.8% preferred elemental gold rubbed on stone in prashana. The dose of ghee was one to three drops (46%) and of honey was one to five drops (52%). 87.4% reported no adverse events due to prashana. Reduction in illnesses, improvement in intellect or school performance, growth, speech, etc., were the major positive responses received. Majority followed Acharya Kashyapa in prescribing prashana. The survey has brought to light the various methods of practice of prashana and also the lack of precise doses of Swarna bhasma, ghee, honey, etc. It will help in guiding the practitioners in implementing prashana in neonates and future research on its effects on neonatal mortality and morbidity including long-term effects on immunity, intellectual and behavioral outcomes.
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ANALYTICAL STUDY: ORIGINAL ARTICLES Top

Physico-chemical standardization and nutritional assessment of Devdarvadyarishta p. 126
Chinky Goyal, Namrata Joshi, Khem Chand Sharma
DOI:10.4103/joa.joa_14_21  
Introduction: Devdarvadyarishta is a honey based anti-diabetic formulation enlisted in Ayurvedic lexicon. Sandhana Kalpana is mentioned under both Ahara and Aushadha Varga, and Asava-arishta were used as food supplements since Vedic period. Devdarvadyarishta was prepared as per conventional method and was subjected to various analytical parameters and nutritional parameters to develop a standard. Methods: Three samples of Devdarvadyarishta were prepared in accordance with Bhaishjya Ratnavali and compared with the market sample on various physico-chemical and phytochemical parameters, high-performance thin-layer chromatography (HPTLC) profiling as well as nutritional value. Results: Respective mean values of prepared samples and market sample were found to be pH – 3.86 and 3.80, specific gravity – 1.0953 and 1.0934, refractive index − 1.41943 and 1.41910, total solid content % w/w − 22.05 and 22.92, reducing sugars 18.18 and 18.50, nonreducing sugars 0.84 and 0.91 and total phenolic content – 0.180% and 0.185%, alkaloids – 0.037% and 0.042%, tannins – 0.11% and 0.10%, saponins − 0.082% and 0.080%, flavonoids – 0.011% and 0.013%, terpenoids − 0.046% and 0.055% and Glycosides – 0.11% and 0.17%. Nutritive value showed mean carbohydrate % of 21.45, fat − 0.21%, protein − 0.07%, and total energy being 86.82 K cal in prepared samples whereas market sample showed 22.97% carbohydrate, 0.25% fat, 0.10% protein, and 88.35 Kcal energy. HPTLC analysis showed two major peaks at Rf 0.87 and 0.90 with Chloroform: methanol solvent system. Conclusion: Physicochemical data for standard of Devdarvadyarishta was set in as a Quality specification for the same. Nutritional value of Devdarvadyarishta, i.e., 86.82 kcal energy supports the ancient views of Sandhana products being used as food adjuncts.
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Detection of nonpermitted food color metanil yellow in turmeric: A threat to the public health and Ayurvedic drug industry p. 134
Abhineet Verma, Satyen Saha, Shobha K Bhat
DOI:10.4103/joa.joa_77_21  
Introduction: The food products available in the market today are made attractive by adding food colors. Fruits, vegetables, spices, sweets, and even the commonest drugs used as medicine in day-to-day life are adulterated with nonpermitted colors. Haridra or turmeric is the most popularly used Vishaharadravya/antitoxic drug which is taken internally almost every day both in diet and as medicine. Metanil yellow (MY) is a “nonpermitted” food colorant used extensively as an adulterant in different spices, especially turmeric. Though the quantity of intake would be small, when taken continuously, it may lead to several adverse life-threatening effects in humans. Methods: 20 different samples of Haridra (Turmeric) were collected randomly from markets in and around Varanasi. The presence of nonpermitted food color-MY in these turmeric samples was first tested with preliminary color test followed by ultraviolet-visible spectroscopic studies. The color change and change in absorption spectra have been used to identify the contaminated samples. Results and Conclusion: Two out of twenty samples of Haridra were found to be adulterated with MY. Food adulteration in daily diet is a matter of great concern and is a strong cause for Garavisha. Mass awareness has to be raised on the issue. Our results suggest that special care has to be taken by the turmeric-based Ayurveda manufacturers to avoid the use of such contaminated turmeric.
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Insight into the Ayurveda theory of “Dravyasamgrahakala” on Shatavari (Asparagus racemosus Willd) root with reference to quality standard parameters p. 140
Kinjal Parsotam Unadkat, Dilip Jani, Hari Om Gupta, Neha Parmar
DOI:10.4103/joa.joa_88_21  
Introduction: India has been known to be the richest heritage of medicinal plants. Globally, there is a universal rise in the use of Ayurveda system of medicine. According to the WHO, it has been evaluated that 80% of world's population relies on traditional medicines. There are many factors such as geographical variations, place, habitat, season, and temperature can affect the quality of medicinal plants. The study is an endeavor to compare the effect of seasonal variations on plants on the basis of quality standard parameters to validate the basic principle of Ayurveda “Dravyasamgraha kala.” This study aims to evaluate analytical changes and compare the data of different samples of Asparagus racemosus Willd. collected in different seasons according to Ayurveda classics. Methods: In Ayurveda texts, there is also a description about parts of the plants that should be collected in specific seasons. For the purpose, Shatavari (A. racemosus Willd.) was selected for the study. In the current research, four samples of roots of A. racemosus were collected in four different seasons-Grishma, Pravrut, Sharad, and Shishiraritu (May, June, October, and January) to compare the data and find out whether there is any similarity or difference in analytical profile. Results and Conclusion: The quality difference including physicochemical parameters, phytochemical identification, and high-performance thin-layer chromatography was remarked in the samples. It can be concluded that chemical constituents make a unique revelation from different seasons. Proper time period of the collection of plant is very important to obtain good quality drug. The season has a significant role to validate the factors that influence the potency of the drug.
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REVIEW ARTICLES Top

Amrutikarana of Ayurvedic metallic preparations: A systemic review p. 147
Om Pandey, Prashant Bedarkar, Biswajyoti Patgiri
DOI:10.4103/joa.joa_260_20  
Objectives: Ayurvedic metallic preparations are always a concern for the safety issue. A special process was also designed in the ancient classics of Rasashastra to remove the blemishes of such metallic preparation known as Amrutikarana. Different materials and methods are elucidated for this purpose which modifies the efficacy and glance of the incinerated metals and minerals. Data Sources: Eighty one Ayurvedic classical text books and published research studies were searched in the context of Amrutikarana. Online search engines namely J gate, Google scholar, Pubmed, DHARA online and AYUSH research portal were used for data mining of published research works. Review Methods: References and studies including the methods of preparation, safety, efficacy or toxicity studies of 'Amrutikarana' or 'Amritikarana' of Ayurvedic Bhasma were reviewed. Results: Amrutikarana process was invariably seen in the contexts of Abhraka, Lauha and Tamra Bhasma only in few texts. Research articles show that there are various physico-chemical changes involved in this process along with variations in the elemental level of Fe, Cu, C, oxides and particle size. Pharmacological studies clearly support the claim that Amrutikarana helps in reducing the toxicity of metallic preparations. However, clinical data is not available in support of the increased efficacy by this process. Conclusion: Amrutikarana process of metallic Bhasma preparations is an important tool to counteract the possible ill effects by changing its physico-chemical property but the scientific published data still lacks the Standard manufacturing procedures of Amrutikarana for such Bhasma and efficacy evaluations on clinical grounds.
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Comprehensive review on physioanatomical aspects of Manipura Chakra p. 154
Sanchita , Anju Thomas, Remya K Simon, PS Jigisha
DOI:10.4103/joa.joa_261_20  
Introduction: Chakra (wheel) is the energy points which are present in the subtle body and are seven in number. Out of the seven Chakra, Manipura Chakra is the third one. It has control on several functions of the digestive system. Objectives: The objective of the study is to evaluate the physioanatomical aspects of the Manipura Chakra. To find out the relationship between Manipura Chakra and celiac plexus. Data Source: Textbooks related to awakening and healing of Chakra, Sat Chakra Nirupana, Sushruta Samhita, Charaka Samhita, Ashtanga Hridaya, B. D Chaurasia's Human Anatomy, Articles, and Internet sources. Review Methods: The present work is done by reviewing the literature on the basis of data compiled from classical texts, contemporary science, published research works, articles related to Manipura Chakra, and celiac plexus. The obtained literature was critically analyzed, interpreted, and presented. Results: The position of Manipura Chakra is said to near the navel. The fire is mentioned as the main attribute of the Manipura Chakra, which in the form of Pachaka Pitta with the help of Samana Vayu governs all the functional aspects of digestion and metabolism. On the basis of positional, structural, and functional similarity, Manipura Chakra can be considered as celiac plexus. Conclusion: Blockage of center of Manipura Chakra can impair gastrointestinal functions which in turn may lead to diseases such as irritable bowel syndrome and constipation. Stimulation of Manipura Chakra by means of Beejamantra recitation, Yogasana, and Mudra assists in overcoming diseases related to the gastrointestinal tract and promotes health.
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CASE REPORTS Top

A multi-dimensional approach to endometrial polyp through Ayurvedic intervention – A single-case study p. 157
KM Susdev, Sunitha Joshi
DOI:10.4103/joa.joa_34_22  
Introduction: Endometrial polyps (EPs) are epithelial proliferation arising from endometrial stroma or glands. They may be responsible for 57%–60% cases of abnormal uterine bleeding. A 36-year-old female patient diagnosed with EP was managed successfully through Ayurveda. In modern science, they are giving oral contraceptive pills or advising for surgery. In this case, we managed with Ayurvedic medication for the span of 3 months and relived completely. Main Clinical Finding: Presented with complaints of intermenstrual bleeding along with heavy menstrual bleeding for the past 1.5 years Diagnosis: The patient was already diagnosed with EP; correlated to Yoni Arshas in Ayurveda classics. Interventions: The patient was treated with internal medicines Kanchanara guggulu, Lodrasava, Jahar mohra pishti, and Panchatikta ghruta guggulu along with Matravasti with Chandana bala lakshadi taila, and Uttaravasti with Kshara taila. Outcome: After 3 months of treatment got complete relief in symptoms with normal USG findings. Conclusion: Ayurvedic treatment regime may be adopted as an alternate to surgical interventions in the management of EP effectively
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One-and-a-half syndrome and its management with Ayurvedic treatments: A case report p. 161
Manjusree Radhakrishnan Parappurathu, Aravind Kumar, Krishnendu Sukumaran, Kavya Rama Varma
DOI:10.4103/joa.joa_263_21  
Introduction: One-and-a-half syndrome is a condition characterized by horizontal gaze palsy and internuclear ophthalmoplegia. Its risk factors include conditions that predispose to pontine lesions and demyelinating conditions. The symptoms include blurred vision, diplopia, and oscillopsia. Management is addressing the underlying symptom and relieving the symptoms. The case of a 46-year-old hypertensive male who was diagnosed with one-and-a-half syndrome and who underwent inpatient management at an allopathic hospital is presented here. He initially approached Sreedhareeyam's OP division and was prescribed medicine and inpatient management. Main Clinical Findings: On examination, he had blurred vision, diplopia, and one-and-a-half syndrome. Intervention: He underwent an inpatient Ayurvedic protocol comprising of oral medicines, external therapies, and eye exercises. Outcome: Results at discharge and at three subsequent follow-ups demonstrated gradually improved ocular movements and relief of symptoms. Conclusion: This case illustrates that Ayurveda treatments may be explored for this condition.
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Ayurvedic management of infertility due to polycystic ovaries and tubal block: A case study p. 170
Pushpalatha Buduru, Bharathi Kumaramangalam, Shalvi Sharma
DOI:10.4103/joa.joa_276_21  
Introduction: Various factors responsible for Vandhyatva (infertility) are explained by Acharya Charaka, such as yonidosha (gynecological disorders), Mansika-Abhitapa (mental stress), Shukra-Artavadosha (disorders of sperm and ovum), Ahara-Vihara Dosha (food- and lifestyle-related disorders), Akalyoga (inappropriate timing), Bala-Kshaya (decreased strength). Two major factors which are associated with fertility problems are anovulation and defect in tubal patency. In the present article, there is a case study of ayurvedic management of infertility due to bilateral polycystic ovaries along with the bilateral tubal block. Main Clinical Finding: A 29-year-old female patient reached the hospital with the complaint of wants issues for 2 years, she also had increased intermenstrual interval and weight gain for 2 years. Diagnosis: Her ultrasonography finding revealed bilateral polycystic ovaries, delayed ovulation in the follicular study, and hysterosalpingography findings showed bilateral fallopian tubal block. Interventions: Ayurveda treatment, including a combination of oral medications (Ashwagandha Ksheerapaka, Shatpushpa churna, Avipattikara churna, Pittantaka churna, tablet Leptaden, tablet Aloes compound, Phalasarpi, Pushpadhanva rasa, and Balabeej churna) at different stages of menstrual cycle and Sthanika Chikitsa by Yonipichu (Dhanvantaram taila) application, was planned for 3 months. Outcome: The patient missed her period after 2 months of treatment and urine pregnancy test was found positive. Conclusions: Timely ovulation and tubal patency are important factors for successful fertilization and conception. Hence, oral medications consisting of Aagneya and Vatanulomaka drugs along with Yonipichu with Dhanvantaram taila are effective in correcting both of these factors.
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