Prakriti Analysis of COVID 19 Patients: An Observational Study.

RATIONALE & OBJECTIVE: The concept of Prakriti is unique to Ayurveda, which is used for deciding the preventive and curative strategy to be adopted in the treatment of patients. It is the total of anatomical, physiological, and psychological domains of an individual. The diseases often manifest by susceptibility that depends upon Prakriti of individuals. COVID 19 is a new disease, where the status of the susceptibility of its victim in terms of Prakriti is not known. This study has been undertaken to determine the Prakriti of COVID 19 positive patients. METHOD: The validated instrument CCRAS Prakriti assessment scale has been applied to the COVID 19 positive patients admitted between 16 May 2020 to 10 June 2020 at COVID hospital. RESULT: Data of 117 patients aged 10 to 80 years have been analyzed. The ratio of male-female patients was 1.8:1. Most patients belonged to Vata-KaphaPrakriti (27%).Individuals with their Prakriti found in order of frequency were Pitta-Kapha (21%), Kapha (20%), Vata (13%), Vata-Pitta (11%), Sama (4%) and Pitta (3%). CONCLUSION: Patients with Vata-Kapha, Pitta-Kapha, and Kapha dominant Prakriti have been found more in COVID19. The treatment strategies can be accordingly decided in respect of each patient.

Psoriasis and Cardiovascular Diseases: A Literature Review to Determine the Causal Relationship.

Psoriasis is a chronic, complex autoimmune disease characterized by erythematous, scaly patches over extensor aspects of skin and is associated with joint involvement in about one-third of patients. An association between psoriasis and cardiovascular diseases (CVD) has been a topic of dilemma, and many studies have shown an increased risk of cardiovascular morbidity in patients with psoriasis. There is increasing evidence that psoriasis is associated with higher risk of CVD and increased prevalence of cardiovascular risk factors, as compared with the general population. We provide an extensive review of the literature and adhere to Gordis guidelines to show a positive association between psoriasis and cardiovascular events.

Cloning, expression, purification and characterization of Plasmodium spp. glyceraldehyde-3-phosphate dehydrogenase.

Plasmodium spp. solely rely on glycolysis for their energy needs during asexual multiplication in human RBCs, making the enzymes of this pathway potential drug targets. We have cloned, over-expressed and purified Plasmodium falciparum glyceraldehyde-3-phosphate dehydrogenase (PfGapdh) for its kinetic and structural characterization. ∼ 30-40 mg pure recombinant enzyme with a specific activity of 12.6 units/mg could be obtained from a liter of Escherichia coli culture. This enzyme is a homotetramer with an optimal pH ∼ 9. Kinetic measurements gave KmNAD=0.28 ± 0.3 mM and KmG3P=0.25 ± 0.03 mM. Polyclonal antibodies raised in mice showed high specificity as was evident from their non-reactivity to rabbit muscle Gapdh. Western blot of Plasmodium yoelii cell extract showed three bands at MW ∼ 27, ∼ 37 and ∼ 51 kDa. Presence of PyGapdh in all the three bands was confirmed by LC-ESI-MS. Interestingly, the ∼ 51 kDa form was present only in the soluble fraction of the extract. Subcellular distribution of Gapdh in P. yoelii was examined using differential detergent fractionation method. Each fraction was analyzed on a two-dimensional gel and visualized by Western blotting. All four subcellular fractions (i.e., cytosol, nucleus, cytoskeleton and cell membranes) examined had Gapdh associated with them. Each fraction had multiple molecular species associated with them. Such species could arise only by multiple post-translational modifications. Structural heterogeneity observed among molecular species of PyGapdh and their diverse subcellular distribution, supports the view that Gapdh is likely to have multiple non-glycolytic functions in the parasite and could be an effective target for anti-malarial chemotherapeutics.

Food vacuole associated enolase in plasmodium undergoes multiple post-translational modifications: evidence for atypical ubiquitination.

Plasmodium enolase localizes to several sub-cellular compartments viz. cytosol, nucleus, cell membrane, food vacuole (FV) and cytoskeleton, without having any organelle targeting signal sequences. This enzyme has been shown to undergo multiple post-translational modifications (PTMs) giving rise to several variants that show organelle specific localization. It is likely that these PTMs may be responsible for its diverse distribution and moonlighting functions. While most variants have a MW of ~50 kDa and are likely to arise due to changes in pI, food vacuole (FV) associated enolase showed three forms with MW~50, 65 and 75 kDa. Evidence from immuno-precipitation and western analysis indicates that the 65 and 75 kDa forms of FV associated enolase are ubiquitinated. Using mass spectrometry (MS), definitive evidence is obtained for the nature of PTMs in FV associated variants of enolase. Results showed several modifications, viz. ubiquitination at K147, phosphorylation at Y148 and acetylation at K142 and K384. MS data also revealed the conjugation of three ubiquitin (Ub) molecules to enolase through K147. Trimeric ubiquitin has a linear peptide linkage between the NH2-terminal methionine of the first ubiquitin (Ub1) and the C-terminal G76 of the second (Ub2). Ub2 and third ubiquitin (Ub3) were linked through an atypical isopeptide linkage between K6 of Ub2 and G76 of Ub3, respectively. Further, the tri-ubiquitinated form was found to be largely associated with hemozoin while the 50 and 65 kDa forms were present in the NP-40 soluble fraction of FV. Mass spectrometry results also showed phosphorylation of S42 in the cytosolic enolase from P. falciparum and T337 in the cytoskeleton associated enolase from P. yoelii. The composition of food vacuolar proteome and likely interactors of enolase are also being reported.

Comparative study of Vamana and Virechanakarma in controlling blood sugar levels in diabetes mellitus.

Diabetes mellitus (DM) with its devastating consequences is a global health problem of this era. Presently India is having the largest diabetic population of 50.8 million. The characteristic features of DM have close resemblance with Prameha (obstinate urinary disorders including diabetes) in Ayurveda. Madhumeha is a Vatika subtype of Prameha that is most close to DM. One variety of this Madhumeha (DM) is Aavaranjanya (due to occlusion) in which Vayu aggravates due to occlusion by Pitta or Kapha. This type of Madhumeha (DM) can be managed if Samshodhana (bio-cleansing) is used in early stages of disease followed by palliative treatment. Vamana (emetic therapy) and Virechana (purgation therapy) are the Samsodhana Karma (bio-cleansing therapies) that are compatible to overcome this Aavarana (occlusion). A comparative study was planned to compare their efficacy in controlling blood sugar levels in patients with DM. Although none of them were completely able to control blood sugar in the long-term but the study yields some very interesting results in reducing the blood sugar levels which could be useful in the future studies related to DM.

Importance of Rookshana Karma (dehydrating therapy) in the management of transverse myelitis.

In Charak Samhita, all the treatment modalities have been classified broadly into six types, i.e., Langhana (depleting therapy), Brimhana (nourishing therapy), Rookshana (dehydrating therapy), Snehana (oleation therapy), Swedana (sudation therapy) and Stambhana (astringent therapy). Out of these six types, Rookshana is of the same importance as others but is used less frequently as main line of treatment. Since decades, Ayurveda treatment is considered most promising treatment for neurological disorders. Most of the neurological disorders are generally considered to be Vata Vyadhis in which Snehana Karma is recommended. In case of neurological disorders if symptoms are suggestive of Kapha dominance, then Rookshana must be done initially. Transverse myelitis is a neurological disease, which has an autoimmune process involved in its pathology. It is an acute, subacute, generally monophasic inflammatory disease of the spinal cord. In the present case of transverse myelitis, the patient was found having Kapha dominant symptoms such as coldness of feet, loss of appetite etc., and so the patient was subjected to Rookshana Karma in various forms. Just after 15 days, all these symptoms were subsided and tremendous improvement was found thereafter. The paraplegic patient under study was able to walk independently in just two and half months of treatment. All other typical features related to the disease were also improved. This particular case has proved the importance of Rookshana therapy in neurological disorders.

Efficacy of Ayurvedic treatment using Pañcakarma combined with balance exercises for disability and balance in progressive supranuclear palsy.

A 55-year-old female presented at Department of Pañcakarma with diagnosis of progressive supranuclear palsy (PSP). For assessing disability, progressive supranuclear palsy rating scale (PSPRS) was used and balance was assessed by using Tetrax Interactive Balance System (IBS) posturography. Ayurvedic treatment was given along with Pañcakarma and balance exercises for 3 months. As part of Ayurvedic treatment, first Virecana karma was done with classical method and then Matra basti, Sirobasti, and other palliative treatment was given for 3 months. Amanatidine was not continued during Virecana karma but started thereafter. On comparison with pre-intervention scores, there was a significant improvement in the patient post-treatment. The features which mainly showed improvement were: Eye movements, spontaneous episodes of laughing, dysphagia, dysarthria, double vision, and neck rigidity. Balance showed significant improvement and there was a remarkable decrease in the postural sway. This case study may present new possibilities for treatment of neurodegenerative diseases by Ayurveda.