Ayurpharmacoepidemiology en Route to Safeguarding Safety and Efficacy of Ayurvedic Drugs in Global Outlook.

Ayurpharmacoepidemiology is a new field developed by synergy of the fields of clinical pharmacology, epidemiology, and ayurveda. It will use the effects of ayurvedic medicinal products on large populations to describe and analyze the practices, evaluate the safety and efficacy, and carry out medicoeconomic evaluations. Good pharmacoepidemiology practices in ayurveda is projected to assist with issues of ayurpharmacoepidemiologic research. The embraced good pharmacoepidemiology practices guideline in this viewpoint will be able to provide valuable evidence about the health effects of ayurvedic herbs/drugs and consider different fields like pharmacovigilance, pharmacoeconomics, and drug discovery with ayurvedic reverse pharmacology approach, also pass out significant data for further basic sciences study in ayurveda biology, ayurgenomics, ayurnutrigenomics, and systems biology. Several unanswered questions about ayurvedic drug use and informed interventions or policies that can be addressed by informatics database, which will eventually demonstrate the credibility and rationality of ayurceuticals in the future.

Ayurnutrigenomics: Ayurveda-inspired personalized nutrition from inception to evidence.

Ayurveda proclaims food and drugs are intersecting concepts that are vital for human survival and for the prevention and mitigation of diseases. Food interferes with the molecular mechanisms of an organism's "physiome". It is consumed in large amounts compared to any drug. Hence, research on its effect and interaction with genome is highly relevant toward understanding diseases and their therapies. Ayurgenomics presents a personalized approach in the predictive, preventive, and curative aspects of stratified medicine with molecular variability, which embodies the study of interindividual variability due to genetic variability in humans for assessing susceptibility, and establishing diagnosis and prognosis, mainly on the basis of the constitution type of a person's Prakriti. Ayurnutrigenomics is an emerging field of interest pervading Ayurveda systems biology, where the selection of a suitable dietary, therapeutic, and lifestyle regime is made on the basis of clinical assessment of an individual maintaining one's Prakriti. This Ayurveda-inspired concept of personalized nutrition is a novel concept of nutrigenomic research for developing personalized functional foods and nutraceuticals suitable for one's genetic makeup with the help of Ayurveda. Here, we propose and present this novel concept of Ayurnutrigenomics and its emerging areas of research, which may unfold future possibilities toward smart yet safe therapeutics.

Ayurveda in changing scenario of diabetes management for developing safe and effective treatment choices for the future.

Ayurveda described diabetes mellitus (DM) as Madhumeha. This ancient evidence-based system of medicine enumerated various herbs and formulations for its management, which needs scientific validation. Whereas translational "bedside to bench" approach in biomedical research is an upcoming concept, its application in traditional and complementary medicine can be interesting. The intersecting concepts in the field Ayurveda and translational research needs "omics" approach. The Ayurvedic biology concepts about DM have its close relations with present systems biology approach. Metabolic changes causing tissue damage connected with genetic and immunological irregularities leading to insulin resistance coincide with ancient knowledge. Combinatorial therapy according to Prakriti type as elucidated by Ayurgenomics should be carried on for further research. "Bedside to bench" approaches in research utilizing metabolomics and pharmacogenomics approach can be a major step towards changing the therapeutic strategy towards diabetes. Prameha which is described as the pre-diabetic state is a novel concept in Ayurvedic etiopathogenesis, while metabolomic parameters like lipid level in urine can be a thrust area of research to have a pre-diabetic screening method in high-risk populations. This tradition-guided research paradigm can open up novel opportunities in traditional knowledge-inspired systems biology and drug discovery against diabetes.

Clinical studies on the effect of Neem (Azadirachta indica) bark extract on gastric secretion and gastroduodenal ulcer.

We have shown earlier that Neem (Azadirachta indica) bark aqueous extract has potent antisecretory and antiulcer effects in animal models and has no significant adverse effect (Bandyopadhyay et al., Life Sciences, 71, 2845-2865, 2002). The objective of the present study was to investigate whether Neem bark extract had similar antisecretory and antiulcer effects in human subjects. For this purpose, a group of patients suffering from acid-related problems and gastroduodenal ulcers were orally treated with the aqueous extract of Neem bark. The lyophilised powder of the extract when administered for 10 days at the dose of 30 mg twice daily caused a significant (p < 0.002) decrease (77%) in gastric acid secretion. The volume of gastric secretion and its pepsin activity were also inhibited by 63% and 50%, respectively. Some important blood parameters for organ toxicity such as sugar, urea, creatinine, serum glutamate oxaloacetate transaminase, serum glutamate pyruvate transaminase, albumin, globulin, hemoglobin levels and erythrocyte sedimentation rate remained close to the control values. The bark extract when taken at the dose of 30-60 mg twice daily for 10 weeks almost completely healed the duodenal ulcers monitored by barium meal X-ray or by endoscopy. One case of esophageal ulcer (gastroesophageal reflux disease) and one case of gastric ulcer also healed completely when treated at the dose of 30 mg twice daily for 6 weeks. The levels of various blood parameters for organ toxicity after Neem treatment at the doses mentioned above remained more or less close to the normal values suggesting no significant adverse effects. Neem bark extract thus has therapeutic potential for controlling gastric hypersecretion and gastroesophageal and gastroduodenal ulcers.

Role of 5-hydroxytryptamine in Moringa oleifera induced potentiation of pentobarbitone hypnosis in albino rats.

The role of 5-hydroxytryptamine (5-HT) in pentobarbitone (PB) sleeping time, gross behaviour, electrical activity of the brain and serum 5-HT level was studied in Holtzman strain adult albino rats following treatment with M. oleifera (MO). MO (350mg/kg) caused inhibition of awareness, touch response, motor activity, righting reflex, and grip strength. It significantly increased the PB sleeping time, serum 5-HT level (P<0.001) and alpha-wave activity. These observations indicate that the aqueous extract of MO potentiated PB induced sleeping time and increased the alpha-wave activity through 5-HT.

Changing scenario for promotion and development of Ayurveda--way forward.

ETHNOPHARMACOLOGICAL RELEVANCE: Ayurveda, derives from the Sanskrit words Ayus (life) and Veda (knowledge) is the most ancient system of traditional medicine of the world. It has been practiced in Indian peninsula since 5000 BC to offer natural ways to treat diseases and to promote healthcare. METHODOLOGY: We reviewed the literature on the history, principles and current status of Ayurveda. The data have been presented systematically including the initiatives from Government of India. Several aspects of administrative management, education, teaching and related aspects for promotion and development of Ayurveda and other Indian systems of traditional medicine have been discussed. RESULTS: This paper reviews on different aspects of development of Ayurveda. Presently, there are 2420 hospitals with about 42271 beds, 15017 dispensaries, 429246 registered practitioners, more than 320 educational institutions, 7699 drug-manufacturing units to promote Ayurveda into the health care delivery system in the country. Ayurvedic Pharmacopoeia of India is the official document for single Ayurvedic drugs (540 monographs) and different formulations (152 monographs). Several aspects in this regard for development of Ayurveda have been discussed. CONCLUSION: Considering the widespread use and popularity of Ayurveda worldwide, administrative management and infrastructure facilities, indigenous practices and standards for quality control and it's evaluation have been highlighted. In India, all such efforts for integration of Ayurveda provide potential role in the health care benefits.

Risk factors for under- and overweight in school children of a low income area in Kolkata, India.

BACKGROUND & AIMS: Socio-economic and individual lifestyle features associated with the nutritional state were examined in 7-9-year-old children of lower and lower middle-class families living under the international poverty line. Mild and moderate undernutrition was frequent but overweight also occurred. METHODS: Three groups of sex- and age-matched randomly selected children from the Kolkata Child Nutrition Study (data collection between April and November 2001) attending public primary schools of North Kolkata participated (42 children of low body mass index (BMI<12 kg/m(2),=LBMI), 100 children of intermediate BMI (14-16 kg/m(2); IBMI) and 51 children of high BMI (>16 kg/m(2); HBMI). Individual and social characteristics of the three BMI categories were assessed using a structured interview of their families. RESULTS: Families of LBMI children owned more TV (83.3% versus 60%; p-value: 0.007) and spent less money for rice (80.4% versus 52.5% of the families spent less than 11 Indian rupees (INR) for rice/day, p<0.003) when compared to families of IBMI children while income of the families of the 2 groups was similar. The families of HBMI children had more income per head per day (62.5% versus 32% earned more than 19 INR/head/day, p<0.02). CONCLUSIONS: Lifestyle and socio-economic differences in families are associated with distinct variations in body weight of their children in a population living in a low income area in Kolkata. Various degrees of poverty may lead to a propensity to develop both, underweight and modest overweight.

Initial exploratory observational pharmacology of Valeriana wallichii on stress management: a clinical report.

Valeriana wallichii, an Indian medicinal plant, has been on trial for its role in stress disorders in hospital based clinical set-up. Hamilton's Brief Psychiatric Rating Scale (BPRS) was used and thorough clinical investigations were carried out to screen the subjects. Thirty-three subjects (20 male and 13 female; average age 34.2 years) were medicated with the plant extract in a fixed dose regime (500 mg/capsule, twice daily, p.o. after meal). They were thoroughly investigated clinically and using standard questionnaires based on different psychological rating scale at baseline (day 0), mid-term (day 30) and final (day 60). The observations exhibited that, V wallichii not only significantly (p < 0.001) attenuated stress and anxiety, but also significantly (p < 0.001) improved depression and also enhanced the willingness to adjustment. Nevertheless it did not alter memory, concentration or attention of the volunteers. The results suggest that V wallichii may be useful in the treatment of stress related disorders in human and may be a promising anti-stress agent in near future.

Effect of Sonachandi Chyawanprash and Chyawanprash Plus--two herbal formulations on immunomodulation.

The immunomodulatory effects of Sonachandi Chyawanprash and Chyawanprash Plus--two herbal formulations have been evaluated. Both the drugs increased the macrophage activity and their number indicating enhancement of non-specific immune response and reduction of chances of infection. Besides that both Sonachandi Chyawanprash and Chyawanprash Plus efficiently protected Cyclosporine A induced immunosuppression suggesting the immunoprotective role of the aforesaid herbal formulations.