India-United States Dialogue on Traditional Medicine: Toward Collaborative Research and Generation of an Evidence Base.

Therapies originating from traditional medical systems are widely used by patients in both India and the United States. The first India-US Workshop on Traditional Medicine was held in New Delhi, India, on March 3 and 4, 2016, as a collaboration between the Ministry of Ayurveda, Yoga and Naturopathy, Unani, Siddha, and Homoeopathy (AYUSH) of the Government of India, the US National Cancer Institute (NCI), National Institutes of Health, and the Office of Global Affairs, US Department of Health and Human Services. It was attended by Indian and US policymakers, scientists, academics, and medical practitioners from various disciplines. The workshop provided an opportunity to open a dialogue between AYUSH and NCI to identify promising research results and potential topics for Indo-US collaboration. Recommendations that emerged from the workshop underlined the importance of applying rational and scientific approaches for drug development; standardizing traditional medicine products and procedures to ensure reliability and reproducibility; promotion of collaboration between Indian traditional medicine practitioners and researchers and US researchers; greater integration of evidence-based traditional medicine practices with mainstream medical practices in India; and development of training programs between AYUSH and NCI to facilitate crosstraining. Several positive developments took place after the thought-provoking deliberations.

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.

Azadirachta indica plant-assisted green synthesis of Mn3O4 nanoparticles: Excellent thermal catalytic performance and chemical sensing behavior.

The leaf extract of Azadirachta indica (Neem) plant was utilized as reducing agent for the green synthesis of Mn3O4 nanoparticles (NPs). The crystalline analysis demonstrated the typical tetragonal hausmannite crystal structure of Mn3O4, which confirmed the formation of Mn3O4 NPs without the existence of other oxides. Green synthesized Mn3O4 NPs were applied for the catalytic thermal decomposition of ammonium perchlorate (AP) and as working electrode for fabricating the chemical sensor. The excellent catalytic effect for the thermal decomposition of AP was observed by decreasing the decomposition temperature by 175 °C with single decomposing step. The fabricated chemical sensor based on green synthesized Mn3O4 NPs displayed high, reliable and reproducible sensitivity of ∼569.2 µA mM(-1) cm(-2) with reasonable limit of detection (LOD) of ∼22.1 µM and the response time of ∼10 s toward the detection of 2-butanone chemical. A relatively good linearity in the ranging from ∼20 to 160 µM was detected for Mn3O4 NPs electrode based 2-butanone chemical sensor.

Systematic Imaging Module in Complete Hindgut Duplication.

Complete hind gut and anal canal duplication is a rare entity, usually remaining asymptomatic till the disease comes to light due to associated anomalies or due to cosmetic reasons. Classical imaging consisting of barium enema examination served a limited role, in terms of depicting the length of gut segment involved. Technical advances in magnetic resonance imaging (MRI) with three-dimensional (3D) reformations cannot only solve the above purpose but further evaluate key points needed for surgical planning. The present technical report lays out a systematic module for evaluation of various aspects of complete hindgut duplication, critical for management. The role of 3D MRI is emphasized upon, for evaluation of pelvic floor and anorectum, even in infants with a distorted anatomy.

A magnetization transfer MRI study of deep gray matter involvement in multiple sclerosis.

BACKGROUND/PURPOSE: Gray matter involvement in multiple sclerosis (MS) is of growing interest with respect to disease pathogenesis. Magnetization transfer imaging (MTI), an advanced MRI technique, is sensitive to disease in normal appearing white matter (NAWM) in patients with MS. DESIGN/METHODS: We tested if MTI detected subcortical (deep) gray matter abnormalities in patients with MS (n= 60) vs. age-matched normal controls (NL, n= 20). Magnetization transfer ratio (MTR) maps were produced from axial proton density, conventional spin-echo, 5 mm gapless slices covering the whole brain. Region-of-interest-derived MTR histograms for the caudate, putamen, globus pallidus, thalamus, and NAWM were obtained. Whole brain MTR was also measured. RESULTS: Mean whole brain MTR and the peak position of the NAWM MTR histogram were lower in patients with MS than NL (P < .001) and mean whole brain MTR was lower in secondary progressive (SP, n= 10) than relapsing-remitting (RR, n= 50, P < .001) patients. However, none of the subcortical gray matter nuclei showed MTR differences in MS vs. NL, RR vs. SP, or SP vs. NL. CONCLUSIONS: The MTI technique used in this cohort was relatively insensitive to disease in the deep gray matter nuclei despite showing sensitivity for whole brain disease in MS. It remains to be determined if other MRI techniques are more sensitive than MTI for detecting pathology in these areas.

Thalamic involvement in multiple sclerosis: a diffusion-weighted magnetic resonance imaging study.

BACKGROUND AND PURPOSE: Injury to deep gray matter structures in multiple sclerosis (MS) has been suggested by recent neuro-imaging and neuropathology studies. Diffusion-weighted magnetic resonance imaging (MRI) can assess tissue damage with greater sensitivity than conventional MRI. The authors' objective was to assess thalamic gray matter damage by diffusion-weighted imaging in MS patients. METHODS: This was a retrospective study performed at a tertiary care, university-affiliated comprehensive MS center of 82 MS patients and 43 controls. The main outcome measures were thalamic apparent diffusion coefficients (ADCs), whole-brain atrophy (brain parenchymal fraction), fluid-attenuated inversion recovery (FLAIR) hypertense lesion volume, and clinical course. RESULTS: ADCs in the left thalamus were higher in MS patients (0.741 +/- 0.044 x 10(-3) mm2/s) than controls (0.723 +/- 0.036 x 10(-3) mm2/s) (P = .027) and higher in secondary progressive MS patients (0.761 +/- 0.044 x 10(-3) mm2/s) than relapsing-remitting MS patients (0.735 +/- 0.032 x 10(-3) mm2/s) (P = .029). ADCs in the right thalamus were higher in secondary progressive MS patients (0.784 +/- 0.069 x 10(-3) mm2/s) than controls (0.757 +/- 0.038 x 10(-3) mm2/s) (P = .033). In the MS group, left thalamus ADCs correlated negatively with brain parenchymal fraction (r = -0.30, P = .008), total left hemispheric FLAIR lesion volume correlated with ADCs in the left (r = 0.35, P = .001) and right (r = 0.39, P < .001) thalami, and total right hemispheric FLAIR lesion volume correlated with ADCs in the left (r = 0.31, P = .006) and right thalami (r = 0.22, P = .048). CONCLUSION: MS patients have increased water diffusion in the thalamus that is partly associated with clinical course, lesion load, and whole-brain atrophy. Both indirect and direct mechanisms of gray matter injury may play a role in the pathophysiology of MS.