Withania somnifera (L.) Dunal - Modern perspectives of an ancient Rasayana from Ayurveda.

ETHNOPHARMACOLOGICAL RELEVANCE: Withania somnifera (L.) Dunal, commonly known as Ashwagandha, is an important medicinal plant that has been used in Ayurvedic and indigenous medicine for more than 3000 years. According to Charaka Samhita, Susruta Samhita and other ancient texts, Ashwagandha is known as Balya (increases strength), Brusya (sexual performance enhancer), vajikari (spermatogenic), Kamarupini (libido-enhancing), Pustida (nourishing). AIM OF THE REVIEW: This review article documented and critically assessed W. somnifera regarding its ethnopharmacology, traditional use, botanical description, phytochemicals present, pharmacological activities, clinical trials, and marketed formulations. MATERIALS AND METHODS: The sources of information used in the study are traditional Ayurvedic books like Charaka Samhita, Susruta Samhita, Astanga Hridaya etc, government reports, dissertations, books, research articles and databases like Science-Direct, SciFinder, Web of Science, PubMed, Wiley Online Library, and ACS Publications on Ashwagandha and Withania somnifera (L.) Dunal. RESULTS: Traditional uses of Ashwagandha in Ayurveda are very prominent in several texts where formulations with various dosage forms have been mentioned in Charaka Samhita, Susruta Samhita, Astanga Hridaya, different nighantus etc. The drugs were identified based on their composition containing Ashwagandha as one of the major ingredients and their medicinal uses. Phytochemical studies on W. somnifera revealed the presence of important chemical constituents such as flavonoids, phenolic acids, alkaloids, saponins, tannins, and withanolides. The phytochemicals showed various pharmacological activities like anti-cancer, immunomodulatory, cardioprotective, neuroprotective, anti-aging, anti-stress/adaptogenic and anti-diabetic. Various clinical trials show that the plant extract and its bioactive compounds are used in the prevention and treatment of many diseases, such as arthritis, impotence, amnesia, anxiety, cancer, neurodegenerative and cardiovascular diseases, and others. CONCLUSIONS: Pharmacological data reviewed here revealed that W. somnifera is a potential source for the treatment of a wide range of diseases especially anxiety and other CNS disorders. From its ancient use to its modern application it has been proven to be non-toxic and effective clinically for human health and wellness. W. somnifera based herbal formulation has been marketed in the form of supplement, extract, capsule, powder etc. This review will be helpful to correlate the mechanism of action with the phytochemical profile of this well-known plant from Ayurveda.

Evaluation of antitussive activity of formulations with herbal extracts in sulphur dioxide (SO2) induced cough model in mice.

Cough is the most common symptom of respiratory diseases. When cough becomes serious, opioids are effective, but they have side effects like sedation, constipation, some addiction liability and also compromise the respiratory function. Therefore, there is need to have effective anti-tussive agent which do not have respiratory suppressant activity. The present study was carried out to evaluate anti-tussive activity of combination of herbal drugs as formulations in sulphur dioxide (SO2)-induced cough model in mice. Albino mice of either sex, weighing 25-30 g were divided into eight groups, (n = 6). Group 1 served as normal control, group 2 mice were given distilled water, group 3 was positive control and received codeine sulphate (10 mg/kg, p.o.) and group 4, 5, 6, 7 received coded 1 formulations 1, 2, 3 and 4 respectively at a dose of 0.3 ml/mice, orally, while group VIII was the vehicle control. Thirty minutes later, the mice were exposed to sulphur dioxide again for 45 sec. The mice were then placed in an observation chamber for counting of cough bouts, by two independent observers, for five minutes. All the formulations used showed significant antitussive activity in sulphur dioxide induced cough model. Thus, these formulations can prove to be useful for alleviating cough.

Development of Ayurveda - Tradition to trend.

ETHNOPHARMACOLOGICAL RELEVANCE: Ayurveda entails a scientific tradition of harmonious living and its origin can be traced from ancient knowledge in Rigveda and Atharvaveda. Ayurveda is a traditional healthcare system of Indian medicine since ancient times. Several Ayurvedic medicines have been exploiting for treatment and management of various diseases in human beings. The several drugs have been developed and practiced from Ayurveda since ancient time to modern practice as 'tradition to trend'. The potential of Ayurvedic medicine needs to be explored further with modern scientific validation approaches for better therapeutic leads. AIM OF THE STUDY: The present study was aimed to explore the various aspects of Ayurveda and inspired drug discovery approaches for its promotion and development. MATERIALS AND METHODS: We have reviewed all the literature related to the history and application of Ayurvedic herbs. Various aspects for the quality control, standardization, chemo-profiling, and metabolite fingerprinting for quality evaluation of Ayurvedic drugs. The development of Ayurvedic drugs is gaining momentum with the perspectives of safety, efficacy and quality for promotion and management of human health. Scientific documentation, process validation and several others significant parameters are key points, which can ensure the quality, safety and effectiveness of Ayurvedic drugs. RESULTS: The present review highlights on the major goal of Ayurveda and their significant role in healthcare system. Ayurveda deals with several classical formulations including arka, asavas, aristas, churna, taila, vati, gutika, bhasma etc. There are several lead molecules that have been developed from the Ayurvedic herbs, which have various significant therapeutic activities. Chemo-profiling of Ayurvedic drug is essential in order to assess the quality of products. It deals with bioactive compound quantification, spurious and allied drug determination, chromatographic fingerprinting, standardization, stability and quality consistency of Ayurvedic products. CONCLUSIONS: Scientific validation and the documentation of Ayurvedic drugs are very essential for its quality evaluation and global acceptance. Therapeutic efficacy of Ayurvedic herbs may be enhanced with high quality, which can be achieved by identity, purity, safety, drug content, physical and biological properties. Ayurvedic medicines need be explored with the modern scientific approaches for its validation. Therefore, an attempt has been made in the present review to highlight the crucial aspects that need to be considered for the promotion and development of Ayurvedic medicine.

Government policies and initiatives for development of Ayurveda.

ETHNOPHARMACOLOGICAL RELEVANCE: Ayurveda (Sanskrit: Ayus - life +Veda - knowledge) means the "True knowledge of life". Ayurveda deals with a complete self-sustainable system of medicine. The Government of India through its Ministry of AYUSH is responsible for policy formulation, development and implementation of programs for the growth, development and propagation of Ayurveda. AIM OF THE STUDY: This review aimed to highlight the various aspects of government policies and initiatives for development of Ayurveda. MATERIALS AND METHODS: We critically reviewed various books, annual reports, policy documents and various ancient Ayurvedic literatures. Besides the websites of Ministry of AYUSH, National Medicinal Plant Board, Central Council for Research on Ayurvedic Sciences (CCRAS) and AYUSH research portal have been searched and data was recorded. RESULTS: The vision of the ministry is to position AYUSH systems as the preferred systems of living and practice for attaining healthy nation. The ministry has identified its mission in terms of seven broad thematic functional areas of AYUSH activities. These are information, education and communication; drug administration, human resource development, medicinal plants, research and development, international collaborations, AYUSH services. Different programs have been taken up towards increasing visibility, acceptability and usage of Ayurveda vis-a vis its integration in the health system. Strategies to globalize and promote Ayurveda are being taken up through AYUSH clusters focusing its safety-efficacy-quality aspects and rational use of Ayurveda CONCLUSION: The government policies are taking firm steps towards promotion and development of Ayurveda. Research and development towards validation of Ayurveda is being projected as the thrust area.

Management of chronic hepatitis B with New Livfit in end stage renal disease.

New Livfit (NLF) is a standardized, poly-herbal formulation that has been found useful in the management of hepatitis. The aim of this placebo-controlled study was to evaluate its usefulness against hepatitis B virus in the patients of end stage renal disease (ESRD). Patients were regularly evaluated at 6, 12, 24 and 36 weeks of therapy. With 36 weeks of treatment of NLF, there was rapid clearing of HBV-DNA in a significant number of patients. Significant seroconversion of the other markers of hepatitis B and restoration of the raised levels of ALT and AST was observed. The study suggests the potential usefulness of NLF in the control of HBV infection in the patients of ESRD prior to renal transplant.

Efficacy and tolerability of oral sumatriptan in Indian patients with acute migraine : a multicentre study.

This multicentre, randomized, double-blind, cross over, placebo controlled study evaluated the efficacy and tolerability of oral Sumatriptan (100 mg) in 100 migraineurs. 59 patients completed the study. The results indicate that by 4 hours post-dose62 of patients treated with Sumatriptan achieved relief of headache, compared with 10 of patients treated with placebo. The results show that oral Sumatriptan is an effective drug for treatment of acute migraine in Indian patients, though smaller dosage may be more beneficial.

Role of Lipistat in protection against isoproterenol induced myocardial necrosis in rats: a biochemical and histopathological study.

A test drug (Lipistat) comprising of equal-proportions of extracts of Terminalia arjuna, Inula racemosa Hook, latex of Commiphora mukul, in three different doses (225 mg/kg; 350 mg/kg; 450 mg/kg) were administered orally daily for 6 days a week for 60 days in rats. Thereafter, the rats were subjected to isoproterenol (ISO) induced (85 mg/kg, s.c. for 2 days) myocardial necrosis. Gross and microscopic examinations (histopathology) were done along with estimations of myocardial tissue high energy phosphates (HEP) stores and lactate content. Gross examination showed significant (P < 0.05) cardioprotection in Lipistat treated animals. On microscopic examination no statistically significant reduction in myocardial damage by 350 and 450 mg/kg of Lipistat were observed although loss of myocardial HEP stores and accumulation of lactate were significantly prevented. The results of the present study suggest the potential usefulness of Lipistat in the prevention of ischemic heart disease.

Reversal of paclitaxel induced neutropenia by Withania somnifera in mice.

The effect of aqueous extract of Withania somnifera (L. Solanaceae) was studied against paclitaxel induced neutropenia in mice. After paclitaxel 1 mg/kg, i.v. administration significant fall in total WBC and absolute neutrophil count was observed on day 3 and day 5. W. Somnifera (200 mg/kg, p.o.) per se produced significant increase in neutrophil counts. W. somnifera (200 mg/kg, p.o.) when administered for 4 days before paclitaxel treatment and continued for 12 days caused significant reversal of neutropenia of paclitaxel. The findings of the study suggest the potential of W. somnifera as an adjuvant during cancer chemotherapy for the prevention of bone marrow depression associated with anticancer drugs.

Terminalia arjuna in cardiovascular diseases: making the transition from traditional to modern medicine in India.

The stem bark of Terminalia arjuna (Roxb.) is used by the Ayurvedic physicians in India for the treatment of various cardiovascular diseases, collectively referred to as hritroga. It has been extensively studied in animal models to demonstrate cardioprotective properties, ranging from positive inotropic- , hypolipdemic-, coronary vasodilatory- and antioxidant effects to induction of stress protein in heart. Various bioactive compounds, like triterpinoids, tannins, flavonoids and minerals have been isolated from the stem bark. A number of clinical studies have also reported its beneficial effects in patients of chronic stable angina, endothelial dysfunction, heart failure and even ischemic mitral regurgitation. However, there are some identified lacunae, like standardisation of the 'drug', toxicity studies along with pharmacological interactions with other drugs and large multicentre randomized clinical trials, before its use by modern medicine is acceptable.

Hepatoprotective effect of New Livfit, a polyherbal formulation, is mediated through its free radical scavenging activity.

The effect of New Livfit, a polyherbal formulation, was studied on pyrogallol-induced hepatotoxicity in rats. Administration of pyrogallol 100 mg/kg, i.p. caused a significant increase in liver enzymes as well as a significant increase in lipid peroxidation. Simultaneous administration of oral New Livfit and pyrogallol prevented these changes in hepatic damage. The results of the study showed that New Liv fi t(R) exerted a hepatoprotective effect against pyrogallol induced liver toxicity, which was mediated through its free radical scavenging property.