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   Table of Contents - Current issue
Coverpage
April-June 2021
Volume 9 | Issue 2
Page Nos. 67-149

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EDITORIAL  

DMIMS initiatives during the COVID-19 pandemic for higher education p. 67
Gaurav Sawarkar
DOI:10.4103/jism.jism_46_21  
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REVIEW ARTICLES Top

A comprehensive review on formulations containing Abhraka Bhasma p. 69
Krupali Jani, Prashant Bedarkar, Biswajyoti Patgiri
DOI:10.4103/jism.jism_34_21  
Background: Abhraka Bhasma, a mineral preparation commonly known in the classical texts of Ayurveda, is one of the most frequently used drugs in Ayurveda. To prepare the Bhasma, selective metallic/mineral origin materials are exposed repeatedly to Puta, which is a traditional method of Bhasma preparation. Aim: To prepare comprehensive data related to various formulations, indications, doses, anupan, etc. of Abhraka Bhasma recorded in various Ayurveda texts. Materials and Methods: This review comprises data from the Bharat Bhaishjya Ratnaker in a systematic manner related to various aspects of Abhraka Bhasma. Abhraka Bhasma is used as a major and minor ingredient in most of the formulations and a different percentage of Abhraka Bhasma in used in various Kalps of the text. Making a note of this, it has been decided to calculate the percentage of Abhraka Bhasma, anupan, dose, and therapeutic indications in different formulations. Results: It is observed that a total of 348 references related to various dosages and indications were observed, which includes various types of formulation such as rasa, Vati, gutika, leham, modak, avaleha, loham formulations, etc. In dosage form, Rasa was found the maximum, followed by Vati, Loham, Leham, Gutika, Modak, Parpatti, etc. It is also found that it is used in various disorders such as Arsha (Piles), Jwara (Fever), Prameha (Diabetes), Atisar (Diarrhea), Vaman (Emesis), Hridyaroga (Cardiac disorders), Jirnajwar (Chronic fever), Shola (Inflammation), etc. Conclusion: There are 337 formulations that are mentioned in Bharat Bhaishjya Ratnaker, in which Abhraka Bhasma is used as an ingredient and Madhu (Honey) and Godugdha (Cow’s Milk) are found to be the most commonly used Anupana (adjuvant/vehicle). About 78% of Rasa formulations have Abhraka Bhasma as an ingredient.
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Addressing the psychological consequences of COVID-19 pandemic through Ayurveda: a positive approach for a positive perspective p. 82
Shagufta Raahat, Meenakshi Sharma, Sisir K Mandal, Anand B More, Shalini Rai
DOI:10.4103/jism.jism_17_21  
Coronavirus disease (COVID-19) has challenged the medical systems worldwide due to its fast-spreading nature, with health issues emerging such as clinical presentation, the psychological impact of isolation, and post-COVID complications. It has also created an alarming situation in terms of socioeconomic crisis and resultant psychological effects, causing emotional annoyance, anger, irritability, depression, insomnia, stress, fluctuating mood, irritability, insomnia, insecurity, confusion, emotional isolation, social stigma, economic loss, inadequate resources for health care, and deficient distribution of essentials. These effects have an impact on mental health in both the general population and the frontline health-care workers (HCWS). Most of the health-care providers are vulnerable to emotional distress, given their risk of exposure to the virus for longer hours and concern about caring for their loved ones. In the current pandemic, the overall quality of life is also affected, potentiating the need of prevention from psychological distress as well as appropriate management of the disease and its sequela. Ayurveda is well known for its holistic approach toward disease prevention as well as its management through divine therapy (Daivavyapasraya Chikitsa), medicinal therapy (Yuktivyapasraya Chikitsa), and psycho-supportive therapy (Satvavajaya Chikitsa). These steps along with Medhya Rasayana and Yoga practices will help in efficient prevention and management of the psychological consequence of COVID-19. In this review, we put forward the integrative holistic modalities of Ayurveda for the prevention and management of psychological disturbances created by the current pandemic.
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Review on the importance of Mutra (urine) in Visha Chikitsa (treatment of poison) p. 90
Narsingh Patel, Amol Kadu, Seema Yadav
DOI:10.4103/jism.jism_32_21  
The present review is aimed at providing comprehensive information about Mutra of different animals that are used as a medicine for the treatment of different kinds of animate and inanimate poison, in the contemporary context. Different Ayurveda texts such as Charak Samhita, Sushruta Samhita, Ashtang Sangraham, Ashtang Hridayam etc. and their respective commentaries in Sanskrit as well as Hindi that have been referred for this literary work are compiled. Articles on different websites are also combined for this study. For the discussion, all of the gathered information has been reorganized and critically evaluated, with the aim of drawing some useful conclusions. The review method adopted was a critical review, in which classical and contemporary literature pertaining to pollution was extensively researched and critically evaluated. The conceptual contribution of Ayurveda in defining the antitoxic properties of urine has been symbolized. Formulations made with the help of Mutra are used through various routes, that is, Anjan, Pan, Nasya, Abhyang, Lepa etc., and these are indicated in different poisoning conditions. Thus, from the observation and results just cited, pertaining to eight types of urine given by Ayurveda, we can conclude that the urine of cows and goats possesses major poisonous destructive activity and other kinds of urine are not given much importance, especially in the context of Visha Chikitsa. In today’s context, these formulations are very useful in the condition of cumulative poison, concocted poison, and artificial poisoning. Mutra is used as an adjuvant in various antitoxic formulations, because it helps in proper digestion and absorption of drugs and food material, ultimately leading to an increased bioavailability.
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ORIGINAL ARTICLES Top

Effect of ayurveda treatment modalities in motor disabilities of children with cerebral palsy: A pilot clinical study p. 97
Shailaja Uppinakuduru, G R Arun Raj, Prasanna N Rao, Mangala Jyothsna, Vijayalaxmi Mallannavar, Nayan K Subrahmanya, Kannan Sagar
DOI:10.4103/jism.jism_112_20  
Background: Cerebral Palsy (CP), is umbrella term which encompasses a broad spectrum of neurological impairments which requires multiple line of treatment. Ayurveda interventions for improving the motor disabilities can contribute in bringing out a better result in this condition. Objective: To evaluate the effect of Ayurveda treatment modalities in motor disabilities of children with cerebral palsy (CP). Materials and Methods: A single-centered, open-labeled, prospective, clinical trial was conducted at a tertiary care teaching hospital attached to Ayurveda Medical College located in district headquarters. Overall, 15 subjects affected with CP were administered with Ayurveda treatment modalities that are inclusive of Udwarthana (dry powder massage), Sarvanga Abhyanaga (oil massage), Sarvanga Parisheka (pouring of warm liquid over a desired body part), Shirodhara (pouring of warm liquid over the head), Upanaha (warm poultice), Matra Basti (medicated enema), and Karnapoorana (administering warm oil into the ear canals) for a period of 15 days. The subjects were assessed before and after treatment for spasticity, muscle power, and range of movements of joints. The data were collected by using a case report form designed for the study. Such collected data were tabulated and analyzed by using Statistical package for social sciences (SPSS, version 20) by using an appropriate statistical test. Results: The intervention was found to be effective in reducing spasticity as well as in improving the movement of joints at P < 0.05. Conclusion: Holistic Ayurveda treatment modalities can be beneficially implemented for treating spasticity in children with CP.
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Clinical evaluation of Chyawanprash as a preventive measure during the COVID-19 pandemic: An open-label, multicentric, randomized, comparative, prospective, and interventional community-based clinical study on healthy individuals p. 104
Pawan Kumar Godatwar, Shailesh Deshpande, Pranita S JoshiDeshmukh, Vaishali Shailesh Deshpande, Raman Ghungralekar, Sanjay Tamoli, Arun Gupta, Sasibhushan Vedula, Padmanabha Rugvedi, Rajiva Kumar Rai
DOI:10.4103/jism.jism_27_21  
Background: Chyawanprash is a classical Ayurveda polyherbal formulation that has proven immunomodulatory potential. Aim: The present clinical study was conducted to evaluate Chyawanprash for prophylaxis of COVID-19 infection. Materials & Methods: It was an Open-label, Multicentric, Randomized, Comparative, Prospective, and Interventional Community-based Clinical Study. The study was conducted at five sites across Maharashtra, Gujarat, and Rajasthan between May 2020 and November 2020. Materials and Methods: A total of 771 subjects were screened in the study; of whom, 721 subjects were randomized into two groups. Subjects in the DCP group who fell into the category of 13 years to 70 years were given Chyawanprash as a study intervention to be taken in a dose of one teaspoonful (approx. 12g) twice daily and children aged 5 to 12 years were given ½ teaspoonful (approx. 6g) twice daily followed by a cup of milk (approx. 200mL). Subjects in the control group were advised to consume one cup of milk (approx. 200mL) twice daily. The incidence of COVID-19 was assessed by reverse transcription polymerase chain reaction (RT-PCR)/antigen testing, which was conducted as per applicable guidelines and the severity of infection was assessed by using the World Health Organization (WHO) ordinal scale. The incidence and severity of non-COVID-19 infections was also assessed during the intervention period of 90 days. Results: Overall, 696 subjects completed the study, of whom 351 subjects were in the Chyawanprash (DCP) group and 345 were in the control group. In the DCP group, out of the 351 subjects who had completed the study, 42 were tested with RT-PCR/antigen and one subject was found to be positive for COVID-19. In the control group, out of the 345 subjects, 28 were tested with RT-PCR/Antigen and eight subjects were found to be positive for COVD-19. In the DCP group, the incidence was statistically significant lesser as compared with the control group. A total of 43 subjects in the control group and 41 subjects in the DCP group had symptoms of Influenza Like Illness (ILI). The DCP group also showed a statistically significant improvement in quality of life (QoL), as assessed by the Quality of Life Enjoyment and Satisfaction Questionnaire – Short Form (Q-LES-Q-SF) when compared with the control group. Conclusion: The outcome of the present study suggests and supports the prophylaxis potential of Chyawanprash as one of the preventive remedies for COVID-19 as recommended by the AYUSH fraternity. The beneficial effects may be due to the synergistic effects of the potent herbs that are known to have immune-boosting effects in healthy individuals.
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Effectiveness of Saptamrita Loha on Panduroga (iron deficiency anemia) in children an open-label prospective clinical trial p. 114
Virupaxayya Hiremath, Reena Kulkarni
DOI:10.4103/jism.jism_105_20  
Introduction: Panduroga is a systemic disorder that presents with pallor; it is correlated to anemia. Iron deficiency is the most common nutritional deficiency on the globe that contributes to the highest incidences of anemia. Oral iron therapy is the treatment in iron deficiency anemia (IDA), which is associated with adverse reactions such as gastrointestinal irritations on long-term usage. Saptamritaloha is a frequently prescribed herbo-mineral drug from Ayurveda pharmacopeia in the context of eye disorders and it is also used to treat Panduroga. Hence, Saptamritaloha was subjected to a safety and efficacy trial. The aim of the trial was to evaluate the effectiveness of Saptamritalohavati in children with Panduroga (IDA). Materials and Methods: An open-label, controlled, prospective clinical trial in children aged 12–16 years was conducted over a period of two months. Assessment was done based on changes in clinical features and complete blood count analysis before and after therapy. The changes were assessed using paired and unpaired t test, Friedman test, and Wilcoxon sign-rank test. Results: A total of 43 children (22 in the study group and 21 in the control group) were registered in the trial, out of whom 20 in each trial and the control group completed the study. The present study shows that Saptamritaloha is effective in improving the clinical features and hematological parameters significantly and the results were comparable with the standard control used, namely Dhatriloha. The mean improvement in hemoglobin (Hb) was 1.17 g% in the trial group during the course of treatment (P < 0.001). No adverse drug reactions were noted in the study. Discussion: Saptamritaloha vati increases Hb and red blood corpuscles (RBC), packed cell volume (PCV), and mean corpuscular hemoglobin concentration (MCHC) by virtue of its ingredients. The herbal ingredients in the formulation, namely Triphala (group of three drugs, namely Haritaki [Terminalia chebula Retz.], Bibitaka [Terminalia bellirica (Gaertn.)Roxb], Amalaki [Phyllanthus emblica L], Yashtimadhu [Glycyrrhiza glabra L], Madhu [Honey], and Ghrita [Ghee]), possess Tridoshashamana, Anulomana, and Rasayana property, which aids in better bioavailability, drug absorption and also minimizes the gut irritation after oral iron usage. Conclusion: Saptamritaloha is effective in the management of Panduroga in children.
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A study on shelf life (Saviryatha Avadhi) of herbal drugs W.S.R. to Shatavari (Asparagus racemosus willd) Churna p. 120
Polepalli M Rao, K L Virupaksha Gupta
DOI:10.4103/jism.jism_23_21  
Background: Ayurveda texts clearly described the shelf life of various formulations. Ayurveda herbs lose their medicinal properties over a period of time. As per Sharangadhara Samhita, the shelf life (Saviryatha avadhi) of Churna is two months. As per the Drugs and Cosmetic Act, the shelf life of Churna is two years. Hence, this study is planned to ascertain Saviryata Avadhi of Shatavari Churna (powder), which is a commonly used dosage form. Materials and Methods: Organoleptic, physicochemical characteristics and high-performance thin-layer chromatography (HPTLC) techniques are employed for analysis. The results of fresh Shatavari Churna sample are compared with those of a sample of two months, six months, and one-year-old Churna is stored in five porcelain jars. Results: Total ash, acid-insoluble ash, Ph value, alcohol-soluble extractive, and water-soluble extract values almost fluctuate within the ranges mentioned in API, Part 1, Volume IV. Steroidal saponins are the main biologically active constituents of Asparagus; however, the percentages of saponins were 33.20%, 31.15%, and 15.10% in fresh, one-month-, two-month-, and six-month-old samples, respectively. In one-year-old samples, saponins are completely absent. The absence of steroidal saponins indicates the expiry of the sample. Conclusion: Shelf life of Shatavari Churna may be considered as six months based on the active component percentage, if stored as per classics.
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Clinical efficacy of Narayan Churna in alcohol addiction: a single-blinded randomized clinical trial p. 126
Sandeep Charak, Monika Sharma, Sharad Porte
DOI:10.4103/jism.jism_115_20  
Background: Alcohol, alcoholism, and alcohol withdrawal have been mentioned in Ayurveda under the heading of Madya (alcohol), Madatya (alcoholism), and Panapkaram (alcohol withdrawal), respectively. Alcohol abuse is widespread in most parts of the world, and alcohol addiction is one of the major problems in society. According to the WHO, 38.3% of the population in the world consumes alcohol. An individual older than 15 years of age consumed 6.2 liters of alcohol annually. In fact, there are dozens of risk factors that play a role in the development of alcohol addiction. Aim: To assess the clinical efficacy of Narayan Churna, Tagaradi Kwath Ghan Vati, and Bhumyamalaki Ghan Vati in alcohol addiction and withdrawal symptoms. Materials and Methods: The clinical studies were conducted by the single-blinded random control method; this method compared the clinical efficacy of Narayan Churna with Ashtang Lavan Churna. Supportive drugs such as Tagaradi Kwath Ghan vati and Bhumyamalaki Ghanvati have been given in both groups to manage the hepatotoxicity and they control the withdrawal effects such as insomnia anxiety and agitation, respectively. The clinical manifestations of alcohol withdrawal were assessed by the Clinical Institute Withdrawal Assessment-Alcohol revised (CIWA-Ar) scale before and after treatment. Clinical manifestation of alcohol withdrawals observed in between 5 and 10h of stoppage of alcohol was considered as a baseline for before treatment; clinical manifestation of withdrawals was considered after the completion of one month for after treatment. Result: In both the study and control groups, 13.3% of the patients showed excellent relief. In both the control and study groups, 26.6 % and 13.3% of patients showed moderate relief, respectively. Conclusion: Overall, 36.66% of patients were found to be de-addicted during the entire clinical trial, which is a big achievement for Ayurveda science.
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CASE REPORTS Top

Effect of long-term Yogic practices in type 2 diabetes mellitus: a single case study p. 135
Ketaki H Patil, Vidya Wasnik (Thatere), Vijay G Patrikar
DOI:10.4103/jism.jism_30_21  
Diabetes is a chronic noncommunicable disease for which there is not yet a cure. Type 2 diabetes mellitus (T2DM) is a heterogeneous metabolic disorder resulting from a defect in insulin secretion, insulin action, or both, resulting in abnormally high blood glucose levels. Madhumeha (Diabetes) described in Ayurveda texts is often compared with T2DM. Yoga, an ancient practice, is now emerging as a complementary therapy in noncommunicable diseases such as hypertension, diabetes, etc. In the present case study, a 51-year-old female patient with a known case of T2DM for the past one year presented with complaints of increased frequency urination, stress, burning sensation at soles, excessive sweating, hunger, thirst, and fatigue. A properly designed one-year Yoga module was provided to her by a certified Yoga trainer. Appropriate modifications were made in diet and lifestyle. After one year, fasting blood sugar dropped from 187 to 117 mg/dL and postprandial blood sugar dropped from 311 to 194 mg/dL. Weight reduced from 61 to 52 kg. The subjective symptoms also reduced remarkably. The results concluded that consistent long-term practice of a Yogic lifestyle can not only maintain the blood sugar levels of patients with diabetes but also improve the quality of life.
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Conservative management of a Galastha Vidradhi (~inflammatory neck swelling) through Ayurveda: a case report p. 140
Krishna R Sathya, Indu Sabu, Ashok K Panda, Kshirod K Ratha, Meda M Rao
DOI:10.4103/jism.jism_40_21  
Neck swelling due to various causes is common across age groups, and invasive methods are usually done in its management. An inflammatory swelling is considered in Ayurveda as Vidradhi (~abscess) or Vranasopha (~inflammatory swelling). A 27-year-old male patient with a solitary inflammatory neck swelling was successfully treated in 21 days with noninvasive methods like internal medicines and external therapies. Internal medicine like Trayanthyadikwatha, Gopichandanadi tablet, Sudarsanam tablet, Septilin syrup, Varanadikwatha, and Abhayarista were given as per the disease progression. Therapies like medicated lukewarm gargles, Murivena, and egg white external application were also done as per the stage of inflammation. The patient had a complete recession of the swelling without any discoloration or any other complication. The results of the present case report suggested that proper evaluation of Dosha and intervention at the right time key in managing such types of swellings from suppuration and avoid surgical intervention.
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A case study on management of Shushka Vicharchika (Eczema) through Shamana Chikitsa (palliative ayurveda treatment) p. 145
Uttamram Yadav, Santosh Kumar Bhatted, Kavita Sain
DOI:10.4103/jism.jism_85_20  
Eczema is a common, and at times challenging, condition to manage, and it is caused by a defect in skin barrier function; it is treated with corticosteroids and immunosuppressants in conventional medicine with periods of remission and flare-ups, which adversely affects the quality of life of patients and their families. Ayurveda classics have mentioned curative and safely management in the condition of Vicharchika (~Eczema). In this particular case of Shushka Vicharchika, oral Ayurveda drugs such as Mahamanjisthadi Kwatha, Panchanimba Churna, Gandhaka Rasayana, and Agasthya Rasayana (Ayurveda formulations) ere given for a period of two months. The assessment was done on the 0th day, 58th day, 98th day, and 123rd day; the criteria were EASI score and signs and symptoms of Shushka Vicharchika. The outcomes on EASI score per body region was found to be highly significant [BT(0th day)–4.5 AT3(123th day)-0.1] and improvement in cardinal sign and symptoms, total score was 8 on before treatment (0th day) which was reduced to 0 on 123rd day after the treatment. This study shows that oral administration of Shamana Chikitsa (Palliative Ayurveda treatment) is highly effective in the management of eczema, as evidenced by the reduction in EASI score assessed on the basis of improvement in both signs and symptoms.
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