Management of Otitis externa with Ayurvedic formulation Gandhak Rasayana- A case report.

Otitis externa is an inflammatory and infectious disease that affects the external auditory canal. The term otorrhea refers to the outflow of discharge from the ear which is one of the main symptoms of otitis externa along with inflammation. External ear canal pathology or middle ear illness with tympanic membrane perforation is the etiological factor of otorrhea. Otorrhea is an indication of infection. Antimicrobial agents are the conventional treatment of various bacterial and fungal infections, but they have impediments such as resistance development, side effects, patient affordability, etc. The Gandhak Rasayana formulation mentioned in the Ayurvedic text can be a good option for the treatment of various infectious diseases. Karnasrava is a type of ear disease referred to as Vata predominant Tridoshaja disease and it is curable. The term Karnasrava signifies discharge from ear and is self-explanatory. Karnasrava consists of a wide spectrum of diseases and can have a near correlation with otitis externa as per signs and symptoms. Gandhak Rasayana exhibited significant antibacterial, antifungal and anti-inflammatory activity in otitis externa. Evaluating its antibacterial and antifungal activity can provide scientific evidence for the study through the present case report. A 31-year-old male patient registered in OPD at Sane Guruji Hospital, Hadapsar, Pune was clinically diagnosed as Karnasrava (Otitis externa) and pus culture positive for Klebsiella species. We started the treatment with Gandhak Rasayana-an Ayurvedic formulation of 250mg two tablets in the morning and evening with lukewarm water for 21 days. The outcome of the treatment was observed as a reduction in Karnashula (otalgia), Karnasrava (ear discharge), Karnakandu (itching), ear blockage and inflammatory changes. Post-treatment culture was negative for the organism. The improvement was noted in Brighton grading scale from grade III to grade I. Gandhak Rasayana showed significant antibacterial activity in the present case. Evaluating its antibacterial, antifungal and anti-inflammatory activity can provide scientific evidence for the study.

Computational screening of potential anti-inflammatory leads from Jeevaneeya Rasayana plants targeting COX-2 and 5- LOX by molecular docking and dynamic simulation approaches.

Inflammation plays a pivotal role in various pathological processes, ranging from routine injuries and infections to cancer. Cyclooxygenase-2 (COX-2) and 5-lipoxygenase (5-LOX) are two major enzymes involved in the formation of lipid mediators of inflammation, such as prostaglandins and leukotrienes, through the arachidonic acid pathway. Despite the frequent use of nonsteroidal anti-inflammatory drugs for managing inflammatory disorders by inhibiting these enzymes, there is a wide spectrum of adverse effects linked to their usage. Jeevaneeya Rasayana (JR), a polyherbal formulation traditionally used in India, is renowned for its anti-inflammatory properties. The present study aimed to identify the potential phytocompounds in JR plants against COX-2 and 5-LOX, utilizing molecular docking and dynamic simulations. Among the 429 identified phytocompounds retrieved from publicly available data sources, Terrestribisamide and 1-(9Z-octadecenoyl)-sn-glycero-3-phosphoethanolamine have shown potential binding affinity and favorable interactions with COX-2 and 5-LOX arachidonic acid binding sites. The physicochemical properties and ADMET profiles of these compounds determined their drug-likeness and pharmacokinetics features. Additional validation using molecular dynamics simulations, SASA, Rg, and MM-PBSA binding energy calculations affirmed the stability of the complex formed between those compounds with target proteins. Together, the study identified the effectual binding potential of those bioactive compounds against COX-2 and 5-LOX, providing a viable approach for the development of effective anti-inflammatory medications.

Ayurveda and Yoga management of chronic alcoholism sequelae - A case report.

Alcohol has always been a component in the dietary pattern of human civilization. It is widely used in society for celebration and socialization. Alcohol abuse is among the most serious problems in public health characterized by uncontrolled drinking which causes physical and emotional dependence on alcohol. Chronic alcoholics are at a higher risk of developing vitamin B1 deficiency due to malabsorption, poor diet, and an increased demand for nutrition. Vitamin B1(Thiamine) is an essential nutrient required for the body's energy metabolism and proper functioning of the nervous system. A person who excessively consumes madya (alcohol) and then abruptly discontinues drinking and takes recourse to drinking excess madya once again, suffers from Madatyaya Upadrava(chronic alcoholism) that is Vikshay. Here is a case report of an alcoholic patient who ceased drinking and then resumed alcohol in large amounts. He presented with symptoms of generalized weakness, body ache, aphasia, confusion, fever (on and off), thirst, cough, headache, and numbness. The patient underwent a two-month treatment regimen that combined Satvavajay Chikitsa, Yoga, and Shaman Chikitsa involving Rasayana medications and procedures including snehan (Oleation), swedan (fomentation), nabhi puran (filling oil with navel), nasya (nasal administration), shirodhara (continuous flow of liquid on head) and basti (medicated enema). The intervention outcome showed relief from the aforementioned symptoms and improvement in both symptoms and GCS(Glasgow coma scale) score. This treatment approach aimed to promote vitality, longevity, and an overall sense of balance and well-being. There are not many corroborating cases being reported and managed with Ayurveda. This case report highlights transforming health through the cumulative effects of Rasayana medicines, panchakarma, and yoga.

An Ayurveda approach in the management of avascular necrosis of bilateral hip joint-A case report.

Avascular necrosis (AVN) is the condition where an interruption of the sub-chondral blood supply leads to the death of cellular components of bones typically at the weight-bearing joints. Here we present a case of a 48 years old male patient suffering from AVN for the last two months. The patient had pain in bilateral hip joints which was gradually radiating to the bilateral thigh. The patient also felt difficulty in cross-legged, sitting, and squatting. The Ayurveda diagnosis of the case was established as Asthimajjagata-vata (∼disease due to vitiation of Vatadosha in bone and bone marrow tissues). Oral treatment was administred initially for eight months, followed by a course of Panchatikta-kshira basti (medicated enema enriched with milk) and Shalishastika panda swedana (a specific type of sudation with a poultice of rice bolus) for 24 days. Oral medications were continued during this duration and also for the subsequent 22 months. Kaishora guggulu in the dose of 750 mg twice a day with Dashamula kwath 40 ml twice a day, Ashwagandha churna (Powder of Withania somnifera Dunal) 3 g, Guduchi churna (Powder of Tinospora cordifolia L.) 1g, Chopchini churna (Powder of Smilax china L.) 2g and Shilajatwadi loha 500 mg with milk twice a day were advised to the patient. MRI scans of bilateral hip joints after 23 months of this treatment revealed changes in AVN grade, with the left hip joint transitioning from grade III-B to grade II, and the right hip joint progressing from grade IV-A to grade III. The range of motion at these joints was also improved significantly. Most of these medicines are Rasayana (∼immune-modulatory) in nature. The present case study suggests that Panchakarma procedures and Rasayana may be used for the treatment of AVN.

Mechanistic role and potential of Ayurvedic herbs as anti-aging therapies.

INTRODUCTION: Medicinal plants and herbs are the most important part of the Ayurveda. The term Rasayana in Charaka Samhita confers long life, youthfulness, strong body, freedom from diseases and the plants mentioned in Rsayana possess antiaging property. Aging is the collective term used for the complex detrimental physiological changes that reduce the functional ability of the cell. Oxidative stress, telomeres shortening, inflammation, and mitochondrial dysfunction are the main factors that regulate the aging process. Chronological aging is an irreversible process but the factors causing biological aging can be controlled. Ayurvedic herbs are better for the management of age-related problems. There are several natural bioactive agents present in plants that can delay the aging process in humans. They trigger actions like enhancing gene longevity and telomerase activity, ROS scavenging furthermore regeneration of tissues. CONTENT: The plants mentioned in the Rasayana of Ayurveda have antiaging potential and can be used to solve modern problems related to aging. Some Ayurvedic plants and their antiaging potential has explained in this review. The main causes of aging, medicinal plants and their use as potential antiaging mediator are covered in this study. SUMMARY: The process of aging is still an enigma. It is a complex, irretrievable, dynamic process that involves a number of factors and is subject to a number of environmental and genetic influences. Rasayana aspect has not been much investigated in clinical trials. Aging is considered to result from free radical damage. According to Charaka, Rasayana drugs open the partially or fully blocked channels. Many Rasayanas show free radical scavenging activity and has the potential to mitigate the effects of aging. It gives an overview of the significance of Ayurvedic medicinal plants as a source of inspiration and the use of these plants as remedies for antiaging. OUTLOOK: This study briefly outlooks the causes of aging and how medicinal plants can be used to reverse the aging process. In this study, we discussed the antiaging potential and mechanistic roles of Ayurvedic herbs. These herbs have the properties to slow down the natural process of aging and can successfully manage common age-related problems.

Mechanistic role and potential of Ayurvedic herbs as anti-aging therapies.

INTRODUCTION: Medicinal plants and herbs are the most important part of the Ayurveda. The term Rasayana in Charaka Samhita confers long life, youthfulness, strong body, freedom from diseases and the plants mentioned in Rsayana possess antiaging property. Aging is the collective term used for the complex detrimental physiological changes that reduce the functional ability of the cell. Oxidative stress, telomeres shortening, inflammation, and mitochondrial dysfunction are the main factors that regulate the aging process. Chronological aging is an irreversible process but the factors causing biological aging can be controlled. Ayurvedic herbs are better for the management of age-related problems. There are several natural bioactive agents present in plants that can delay the aging process in humans. They trigger actions like enhancing gene longevity and telomerase activity, ROS scavenging furthermore regeneration of tissues. CONTENT: The plants mentioned in the Rasayana of Ayurveda have antiaging potential and can be used to solve modern problems related to aging. Some Ayurvedic plants and their antiaging potential has explained in this review. The main causes of aging, medicinal plants and their use as potential antiaging mediator are covered in this study. SUMMARY: The process of aging is still an enigma. It is a complex, irretrievable, dynamic process that involves a number of factors and is subject to a number of environmental and genetic influences. Rasayana aspect has not been much investigated in clinical trials. Aging is considered to result from free radical damage. According to Charaka, Rasayana drugs open the partially or fully blocked channels. Many Rasayanas show free radical scavenging activity and has the potential to mitigate the effects of aging. It gives an overview of the significance of Ayurvedic medicinal plants as a source of inspiration and the use of these plants as remedies for antiaging. OUTLOOK: This study briefly outlooks the causes of aging and how medicinal plants can be used to reverse the aging process. In this study, we discussed the antiaging potential and mechanistic roles of Ayurvedic herbs. These herbs have the properties to slow down the natural process of aging and can successfully manage common age-related problems.

Effects of two Ayurvedic formulations, Dhanwantaram Kashaya and Saraswatarishta on life history parameters and toxic aggregates in Drosophila models of Huntington's and Alzheimer's disease.

ETHNOPHARMACOLOGICAL RELEVANCE: Ayurveda, the traditional healthcare system native to India, employs dosage forms containing multiple herbs in treating various clinical conditions. Dhanwantaram Kashaya (DK) and Saraswatarishta (SA) are two such formulations containing multiple herbs in varied proportions. Kashaya is a liquid decoction while Arishta is fermented liquid with permissible quantity of self-generated alcohol in it. Both the formulations have been reported to have clinical efficacy in age-related memory impairment. Other mental disorders having clinical presentations similar to psychoses are the other indications for these tested formulations. AIM OF THE STUDY: The present study was performed to evaluate the efficacy of two Rasayana formulations i.e., DK and SA, used by clinicians in different neurodegenerative conditions. We tested these formulations in Alzheimer's (AD) and Huntington's disease (HD) models of Drosophila melanogaster. MATERIALS AND METHOD: Initial experiments looking for life-history parameters in wild-type larvae were carried out in three sets with hundred larvae in each set. These parameters were also studied in diseased models in four sets with eighty larvae in each set. Aß plaques and polyQ aggregates were looked at with the help of immunostaining technique and images were captured using confocal microscopy. RESULTS: The results revealed that 0.25% concentration of both the formulations improve longevity in wild-type flies. Larval development and adult lifespan in Eye-GAL4>Aß42 (AD) and GMR-GAL4>127Q (HD) larvae/flies reared on 0.25% & 0.50% DK and 0.25% & 1.00% SA improved substantially. Reduced Aß plaques and polyQ aggregates indicate disease suppression. CONCLUSION: DK and SA enhanced longevity in Drosophila melanogaster. Suppression of disease aggregates suggests their potential utility in treating AD and HD. Further clinical and pharmaceutical studies are required to confirm these results, however, this is a workable model to test multi-herbal formulations of Ayurveda in the forms they are clinically used.

In vitro effect of Withania somnifera, AYUSH-64, and remdesivir on the activity of CYP-450 enzymes: Implications for possible herb-drug interactions in the management of COVID-19.

Ayurvedic medicines Withania somnifera Dunal (ashwagandha) and AYUSH-64 have been used for the prevention and management of COVID-19 in India. The present study explores the effect of Ashwagandha and AYUSH-64 on important human CYP enzymes (CYP3A4, CYP2C8, and CYP2D6) to assess their interaction with remdesivir, a drug used for COVID-19 management during the second wave. The study also implies possible herb-drug interactions as ashwagandha and AYUSH-64 are being used for managing various pathological conditions. Aqueous extracts of ashwagandha and AYUSH-64 were characterized using LC-MS/MS. A total of 11 and 24 phytoconstituents were identified putatively from ashwagandha and AYUSH-64 extracts, respectively. In addition, in silico studies revealed good ADME properties of most of the phytoconstituents of these herbal drugs and suggested that some of these might possess CYP-450 inhibitory activity. In vitro CYP-450 studies with human liver microsomes showed moderate inhibition of CYP3A4, 2C8, and 2D6 by remdesivir, while ashwagandha had no inhibitory effect alone or in combination with remdesivir. AYUSH-64 also exhibited a similar trend; however, a moderate inhibitory effect on CYP2C8 was noticed. Thus, ashwagandha seems to be safe to co-administer with the substrates of CYP3A4, CYP2C8, and CYP2D6. However, caution is warranted in prescribing AYUSH-64 along with CYP2C8 substrate drugs. Furthermore, preclinical and clinical PK studies would be helpful for their effective and safer use in the management of various ailments along with other drugs.

Identification of potential lead compounds against BACE1 through in-silico screening of phytochemicals of Medhya rasayana plants for Alzheimer's disease management.

Alzheimer's disease is a progressive and irreversible neurodegenerative disease that accounts for 70-80% of dementia in the elderly. According to recent clinical data, the incidence of the disease is exponentially increasing with age. Beta-site amyloid precursor protein cleaving enzyme1 (BACE1) is an important molecule involved in the pathogenesis of Alzheimer's disease due to its early role in the amyloid cascade. Cleavage of amyloid precursor protein by BACE1 is the rate-limiting step leading to the production and aggregation of amyloid-beta plaques. A number of natural products are being identified as non-competitive BACE1 inhibitors. In Ayurveda, Medhya rasayana is a group of medicinal herbs, specifically used for managing neurological disorders and is known to be effective in improving cognitivity and intellect. This study aimed to analyze the pharmacological activity of bio-active compounds in Medhya rasayana plants against BACE1, employing structure-based docking approach. 11 compounds out of 876 were identified as potential hits, based on docking scores, binding energies, and interactions with the critical residues of BACE1. Possible neurological activities of these compounds were predicted using PASS server. Out of the 11 compounds screened, two compounds, 'Convolidine' from the plant Convolvulus pleuricaulis Choisy and 'N-(4-hydroxybutyl) phthalimide' from Glycyrrhiza glabra satisfied the pharmacological parameters of Lipinski rule of filtering and ADMET prediction. The binding stability of these compounds against BACE1 was confirmed by molecular dynamic simulation and post dynamic MM/GBSA calculations. Detailed analysis of the interaction with the critical amino acids in the active site revealed the possible inhibitory potential of these compounds of medicinal plant origin against BACE1.

An Insight of Clinical Evidence of Ayurveda Interventions in the Management of COVID-19 Patients.

BACKGROUND: Coronavirus disease 2019 (COVID-19) was caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and patients with COVID-19 may be treated with traditional medicine like Ayurveda alone or in combination with standard allopathic treatment, as Ayurveda is one of the oldest traditional medicinal systems followed by millions around the world. METHODS: The literature was searched in databases such as LitCOVID, Google Scholar, Science Direct, EBSCO, Scopus, Web of Science, EMBASE, and reference lists to identify articles relevant to the use of Ayurvedic medicines in the management of COVID-19. RESULTS: Several clinical studies have determined the efficacy of Ayurvedic medicines and formulations in the management of patients with COVID-19. CONCLUSION: The Ayurvedic medicines and formulations with antiviral, antioxidant, anti-inflammatory, and immunomodulatory properties could be used along with standard allopathic medicines to assist in the earlier detection of virus, speedy recovery of patients with COVID-19, faster discharge from hospitals, and the prevention of further deterioration.

A randomised controlled trial to evaluate the effect of GandhakaRasayana rectal suppository in post operative pain management in ano-rectal disorders.

BACKGROUND: Poorly managed post-operative pain can lead to complications and prolonged rehabilitation. Pain Management after ano-rectal surgery becomes important as it could hamper day to day activities, disturb sleep, alter appetite and bowel evacuations and decrease the quality of life. According to Acharya Sushrutha, pain (Shoola) cannot be produced without Vata dosha and Shoola (pain) is inevitable after Shastra (surgical) Karma (procedure) for which Basti (enema) is usually the management of choice. Rectal suppositories are one such dosage form that are extensively used in post-operative pain management especially after ano-rectal surgery. MATERIALS AND METHOD: In the study, a total of 40 patients who fulfilled the inclusion criteria were randomly divided to two groups comprising of 20 patients each. Patients of Group A were treated with Gandhaka Rasayana rectal suppository and Group B were treated with Diclofenac Sodium rectal suppository for post-operative 5 days. RESULTS: The overall comparative results revealed a statistically significant improvement of 85% in Group A and 80.39% in Group B. Gandhaka Rasayana which is Tridoshashamaka, Vatamaya Nivaraka (ameliorates diseases caused by Vata dosha), Agnivardhaka (improves appetite and metabolism) and Shoolahara (reduces pain) attains micro particle size with 88 Bhavana (trituration) that can be readily absorbed by the rectal mucosa to exhibit the required therapeutic action. CONCLUSION: The Bhavana Dravya (medium of trituration) used in the preparation of Gandhaka Rasayana have proven analgesic, anti-inflammatory, anti-bacterial action and is also said to promote wound healing. The present study reveals that there is significant effect of Gandhaka Rasayana rectal suppositories in managing post-operative pain of ano-rectal disorders.

Chronic toxicity studies of gandhaka rasayana - A herbo-mineral preparation used in Ayurvedic practice.

BACKGROUND: Gandhaka rasayana (GR) is an important component of many Ayurvedic formulations besides being used as a standalone therapy. However, literature review revealed a chronic toxicity studies with longer duration. OBJECTIVES: To delineate the safety profile of GR for 180 days administration in rats. MATERIALS AND METHODS: Wistar albino rats of both sexes weighing 150 ± 10 g body weight in groups of 20 (10 male and 10 female) for each of the three GR dose levels i.e., 0.54 g, 1.08 g, and 5.4 g/kg were employed. Carboxyl methyl cellulose was administered to the control group in equal volume. Toxicity was assessed based on the changes observed, compared to control, in body weight gain, food and water consumption, organ weight and histopathology, clinical biochemistry, and hematological parameters as per AYUSH guidelines. RESULTS: GR repeated dose administration caused significant changes in body weight gain, organ ponderal changes, few hematologic and biochemical parameters. Male rats administered with GR at 1.08 g/kg dose showed a significant decrease in the MCV and MCH compared to control, whereas female rat's administred with 1.08 g/kg and 0.54 g/kg dose showed a significant increase in the MCV and MCH. GR administered at 0.54 g/kg showed a significant increase in the serum glucose level in male rats, whereas female rats showed a significant elevation in the cholesterol level. GR at 0.54 g/kg and 5.4 g/kg showed a significant elevation in the serum SGPT level in male rats. These changes were not observed in female rats. Histological examination revealed mild pathological changes in organs like kidney, liver, spleen and jejunum. CONCLUSION: The data generated shows that GR is safe and does not have any toxicity potential at the doses used in therapeutics. Some of the changes observed were at higher dose levels which is not likely to be used clinically.

Effects of two formulations containing Phyllanthus emblica and Tinospora cordifolia with and without Ocimum sanctum in immunocompromised mice.

BACKGROUND: Current pandemic has led us to explore the role of traditional system of medicine to look for formulations that enhance immunity. OBJECTIVE: The obejctive of this experimental study was to evaluate the immunomodulatory effects of two formulations, Tinospora cordifolia (Tc) and Phyllanthus emblica (Pe) with and without coating of Ocimum sanctum (Os). MATERIALS AND METHODS: After obtaining Institutional Animal Ethics Committee approval, present experimental study was conducted to evaluate the immunomodulatory effects of plant drug formulations against infection induced in mice subjected to major surgical stress. Hemisplenectomy was selected to induce major stress and the procedure for hemisplenectomy was standardized. A model of secondary fungal infection after hemisplenectomy was established followed by the treatment of mice with plant drugs and controls. They were subjected to hemisplenectomy or sham operation and 105 C. albicans were injected intravenously. The therapy continued for next 14 days. Kidneys were isolated to estimate fungal load. Fungal load of the kidneys was estimated on post-operative Day 15. RESULTS: The test formulations Tc + Pe and Tc + Pe + Os showed significant reduction in the fungal burden of kidneys as compared to hemisplenectomized control group. However, Tc alone exerted better degree of protection as compared to Tc + Pe and Tc + Pe + Os. CONCLUSION: The formulations, Tc + Pe and Tc + Pe + Os that were developed on the basis of theoretical concepts were not found to be superior to Tc. Though the individual ingredients have been shown to possess immunnostimulant activities, in combination, Pe and Os blunted the effects of Tc. The basis for this drug interaction needs further exploration. Thus, the current experimental study validates immunomodulatory role of Tc. However, the addition of Pe with bhavana of Os does not lead to any augmentation of immunomodulatory activity of Tc. This study also underlines the need to generate data on Ayurveda formulations to understand the rationality of the multi-ingredient Ayurvedic formulations.

Management of acute calculus cholecystitis with integrated Ayurveda and Yoga intervention: A case report.

Acute calculus cholecystitis (ACC) is a frequently reported medical condition in general practice. Approximately 20% of patients with gallbladder stones experience ACC in their lifetime. Ayurveda and Yoga are ancient traditional systems of medicine used for treatment of diseases and improving and maintaining health. There has been an increased use of Ayurveda and Yoga in the management of several health conditions in India and worldwide. The present case study is of 34 years female patient who had ACC. Post diagnosis of ACC patient was advised to undergo cholecystectomy; however, she approached alternative therapies with c/o vomiting, nausea, abdominal pain, jaundice, itching, and abdominal bloating with deranged liver functions. Ayurveda and Yoga intervention protocol was designed. Ayurveda treatment consisted of mild purgation (mruduvirechana) with trivrittalehyam for consecutive seven days, followed by oral administration of Tab Liv 52, Bhunimbadi Kadha twice daily, and Amalaki Rasayana in the morning for 45 days. Patients received 8 teleyoga sessions over a period of 45 days. A therapeutic diet was advised during treatment period. After two months patient reported complete recovery in symptoms, and all laboratory investigations reached to normal range. This case study suggests the positive role of Ayurveda and yoga intervention in the management of ACC. This case report warrants future clinical studies on integrative medicine in ACC.

Preventive aspect of ayurveda and yoga towards newly emerging disease COVID-19.

The ongoing coronavirus pandemic is caused by severe acute respiratory syndrome coronavirus 2 (SARS CoV 2) and unique in various facets. The earlier experience from the past severe acute respiratory syndrome (SARS) epidemics seem to be insufficient and there is need for better strategies in public health and medical care. Ayurved & Yog are well known for their preventive and therapeutic aspect, but not getting utilized properly for prevention of Covid 19 crisis which may also be helpful as supportive therapy along with current line of management. This paper is aimed at unrevealing the role of Ayurved and Yoga guidelines established by Department of AYUSH for prevention from SARS-CoV-2 by providing help to improving the quality of supportive/prophylactic therapy in relation with their immunity.

Exploring scientific validation of Triphala Rasayana in ayurveda as a source of rejuvenation for contemporary healthcare: An update.

ETHNOPHARMACOLOGICAL RELEVANCE: Ayurveda remains the classical and comprehensive part of the ancient Indian medicine system for well-being promotive, disease preventive, and revival approach for the human body. Triphala Rasayana is mentioned in Ayurveda, comprising fruits of three plant species viz. Phyllanthus emblica L. (P. emblica), Terminalia chebula Retz (T. chebula), and Terminalia bellirica Roxb (T.bellirica). Triphala Rasayana has been utilized in various traditional medicine systems, viz., Ayurveda, Siddha, and Unani. Traditionally Rasayana based drugs are utilized in different kinds of diseases without pathophysiological associations as indicated by current medication. Various medicinal attributes of Triphala Rasayana include antioxidant, anticancer, antidiabetic, antimicrobial, immunomodulatory, and anticataract and is also considered as a pillar for gastrointestinal treatment, specifically in functional gastrointestinal disorders (FGIDs). Due to Rasayana's accessible mode of administration, availability, and affordability, there is an increase in its global acceptance. AIM OF REVIEW: This review article summarizes the scientific validation, traditional uses, bioactive compounds, and ethnopharmacological properties of Triphala Rasayana. It also documents recent data on in vivo and in vitro pharmacological studies and clinical effects of Triphala Rasayana. MATERIAL AND METHOD: A literature review is carried out using PubMed, ScienceDirect, Scopus, web of science, Ayush Research Portal, and Clinical Trials Registry-India. In addition to an electronic search, traditional ayurvedic texts and books were used as sources of information. RESULTS: Traditionally, "Triphala Rasayana" is classified as a tridoshic rasayana and one of the most well-studied ayurvedic Rasayana. It showed various pharmacological activities such as anticancer, antioxidant, antibacterial, immunomodulatory, cardioprotective, and antidiabetic. Besides this, Rasayana has reported ethnopharmacological activities such as antimicrobial, anticataract, wound healing, and radioprotection. It has shown a good impact on the gastrointestinal tract (GIT) system with the reported pharmacological activities in gastrointestinal disorders such as constipation, gastric ulcer, and inflammatory bowel disease (IBD). Phytochemical studies of Triphala Rasayana revealed chemical constituents like gallic acid, ellagic acid, chebulic acid, chebulinic acid, methyl gallate, emblicanin A, and emblicanin B. Additionally, clinical studies found Triphala Rasayana to be effective against diabetes, constipation, and obesity. CONCLUSION: The present review revealed that Triphala Rasayana may treat a diverse range of diseases, especially GIT disorders. Considering the beneficial properties of Triphala Rasayana and it's proven non-toxic nature could be a source of rejuvenation in contemporary healthcare. Nevertheless, its clinical data effectively provided precious signals to correlate ayurvedic biology and modern medicine.

Efficacy of external application of oil and gel dosage forms of Aragvadhadi formulation in combination with Rasayana Churna in the management of Shwitra (vitiligo) - An open-labeled comparative clinical trial.

Introduction: Aragvadhadi Taila (ART) is one of the herbomineral formulations mentioned in Chakradatta indicated in Shwitra (vitiligo). Modification of Taila form into gel form reduces the risk of contamination in view of arsenical contents (Manahshila, Haratala) assures precise dose administration at desired site (by avoiding spreading). The gel is a comparatively acceptable dosage form than that of medicated oil. Aim: The aim of the study is to evaluate the comparative efficacy of Aragvadhadi formulation in Taila (ART: Aragvadhadi Taila) and gel (ARG: Aragvadhadi gel) dosage forms with the internal administration of Rasayana Churna in the management of Shwitra. Materials and methods: The study was a randomized open labeled, involving 66 patients of Shwitra that were randomly divided into two groups. Patients registered in group A (n = 34) were treated with local applications of ART and group B (n = 32) with ARG for 2 months. Rasayana Churna (3 g), along with the equal quantity of honey and Ghrita was given twice a day after the meal in both groups. Wilcoxon signed-rank test was applied to evaluate the effect of therapy in the individual group for subjective criteria like vitiligo area scoring index score, size and number of patches, Rukshata (dryness), Saparidaha (burning sensation), Bahalatva (thickening), Kandu (itching) while the comparison of results between the groups for the same by applying Coefficient of Variation (CV). Results: Group B showed better and consistent results in all signs and symptoms except Rukshata, Saparidaha in terms of Coefficient of Variation. In both the groups, statistically highly significant improvement was found in signs and symptoms of Shwitra such as Saparidaha, Kandu, size of patches and number of patches; however, the difference between the groups was statistically insignificant. Conclusion: Both the forms (ART, ARG) of Aragvadhadi formulation along with Rasayana Churna were found as a safe and effective treatment in vitiligo with significant pigment regeneration capacity as topical use for application over 2 months.

Add-on effect of Ayurvedic treatment protocol for diabetic retinopathy: A randomized controlled clinical study.

Background: Diabetic retinopathy (DR), the leading cause of visual disability in diabetics, is a significant complication of diabetes mellitus. Currently available conventional treatments for DR have certain limitations, considering which Ayurvedic treatment protocol was designed. Aim: The aim of this study was to evaluate the clinical efficacy of the Ayurvedic treatment protocol for DR. Materials and methods: This was a randomized, controlled, black box design clinical study conducted from April 2016 to September 2017 by the department of Shalakya Tantra of a tertiary academic hospital in Western India. A hundred patients of DR in the age group 30-70 years were randomly divided into two groups by simple random sampling using computer-generated random number tables. In the trial group (n = 70), the preparatory phase included Dipana-Pachana (stomachic and digestant), Koshtha Shodhana (mild therapeutic purgation), and Shiro Virechana (eliminative nasal medication). The treatment phase included Marsha Nasya (nasal medication) and Pratimarsha Nasya (nasal medication of mild dose) with Durvadi Ghrita, Takra Dhara (pouring medicated buttermilk over the scalp) with Siddha Takra, and intake of Rasayana Yoga (treatment duration - 3 months). In the control group (n = 30), patients were kept under conservative treatment and observed during the trial period of 3 months. Patients of both groups continued with their treatment for diabetes and DR if any. Two follow-ups were done at an interval of 15 days. The primary outcomes were objective signs like best-corrected visual acuity (BCVA); ophthalmoscopic signs such as superficial hemorrhages, dot-blot hemorrhages, hard exudates, cotton wool spots, neovascularization disc, neovascularization elsewhere, and fibrovascular proliferation; subjective symptoms such as diminished vision, blurred vision, frequent changes in presbyopia glasses, perception of flashes of light, floaters, and problem for dark adaptation. The secondary outcomes were fasting blood sugar (FBS), postprandial blood sugar (PPBS), urine sugar, serum cholesterol, hemoglobin (Hb), glycosylated HbA1C, liver function test, and renal function test outcomes were assessed before and after the treatment. Results: Ninety participants were included in the analysis of the primary outcome (62 in the trial and 28 in the control group). The trial group provided better results which were statistically significant on dot-blot hemorrhages, superficial hemorrhages, hard exudates, BCVA, FBS, and serum cholesterol. Both the groups provided almost similar effects in PPBS, Hb, HbA1C, and urine sugar which were statistically insignificant. Adverse effects were not reported in any of the patient among either groups. Conclusion: Ayurvedic treatment protocol is safe and effective in DR.

Sars-cov-2 host entry and replication inhibitors from Indian ginseng: an in-silico approach.

COVID-19 has ravaged the world and is the greatest of pandemics in modern human history, in the absence of treatment or vaccine, the mortality and morbidity rates are very high. The present investigation identifies potential leads from the plant Withania somnifera (Indian ginseng), a well-known antiviral, immunomodulatory, anti-inflammatory and a potent antioxidant plant, using molecular docking and dynamics studies. Two different protein targets of SARS-CoV-2 namely NSP15 endoribonuclease and receptor binding domain of prefusion spike protein from SARS-CoV-2 were targeted. Molecular docking studies suggested Withanoside X and Quercetin glucoside from W. somnifera have favorable interactions at the binding site of selected proteins, that is, 6W01 and 6M0J. The top-ranked phytochemicals from docking studies, subjected to 100 ns molecular dynamics (MD) suggested Withanoside X with the highest binding free energy (ΔGbind = -89.42 kcal/mol) as the most promising inhibitor. During MD studies, the molecule optimizes its conformation for better fitting with the receptor active site justifying the high binding affinity. Based on proven therapeutic, that is, immunomodulatory, antioxidant and anti-inflammatory roles and plausible potential against n-CoV-2 proteins, Indian ginseng could be one of the alternatives as an antiviral agent in the treatment of COVID 19. Communicated by Ramaswamy H. Sarma.

Addressing and targeting earnest condition of advance breast cancer-related anorexia and cachexia through Rasayana therapy.

Anorexia and cachexia are major clinical problems seen in a large proportion of patients with advanced cancer. Weight loss has also been identified as an indicator of poor prognosis in cancer patients. Around 20% of patients with advanced cancer present mortality from the effects of malnutrition rather than from cancer itself. Early nutrition intervention has seen to improve outcomes in cancer patients such as weight gain, treatment tolerance, and improved quality of life (QoL). Effective therapies for addressing these threatening conditions are lacking. Pharmacotherapeutic agents such as corticosteroids, megestrol acetate, and cyproheptadine have several adverse reactions and also lack satisfactory results. Rasayana therapy is known to prevent loss of body mass and at the same time help to improve appetite and increase patient's QoL. The Rasayana compound used by us to prevent cachexia mainly includes swarna sindoor, Hirak bhasma, and suvarna bhasma. To evaluate benefits of Rasayana therapy on these variables, we maintain complete documentation of different clinical variables in all cancer patients. Here, in this observational study, we analyzed the data collected from a group of stage IV breast cancer patients (n = 30) receiving Rasayana therapy. Patients were followed at an interval of every 15 days from baseline for 3 months. Furthermore, at each visit, there weight was recorded on calibrated digital weight balance. QoL in these patients was recorded at quarterly interval using functional assessment of cancer therapies questionnaire. It was seen that in the duration of 3 months patients appetite increased significantly (P = 0.03). Significant weight gain was seen in patients (P = 0.04). Significant improvement was also seen in QoL especially related to QoL subdomains of physical wellbeing (P = 0.01), emotional wellbeing (P < 0.04), and functional wellbeing (P < 0.001). Rasayana therapy was seen to be well tolerated by all patients.