Antisynthetase syndrome and interstitial lung disease: A case report.

Introduction: Myositis, Raynaud's phenomenon, fever, interstitial lung disease, mechanic's hands, and arthropathy are symptoms of Antisynthetase Syndrome (ASS), which is defined by the development of antibodies against t-ribonucleic acid (RNA) synthetase, particularly anti-Jo-1. Case presentation: The case is about 29 years female with 1 month history of non-productive cough and dyspnea on exertion which was later diagnosed as ASS. Discussion: The diagnosis of an inflammatory myopathy is based on clinical findings such as subacute development of symmetrical muscle weakness and signs such as laboratory investigations revealing skeletal muscle inflammation. Creatinine phosphokinase (CPK) is mainly used to demonstrate skeletal muscle involvement. Conclusion: Interstitial lung disease is a frequent occurrence and is associated with a bad prognosis during the course of antisynthetase syndrome.

Anterior wall STEMI in a patient with paroxysmal atrial fibrillation due to coronary embolism: A case report.

Introduction: Coronary embolism (CE) is a rare cause of acute ST-elevation myocardial infarction (STEMI). Atrial fibrillation (AF), left ventricular thrombus, septic emboli from infective endocarditis, myxoma, and paradoxical embolism can induce emboli in coronary arteries. Case presentation: Here we present a case of anterior wall STEMI secondary to paroxysmal AF in a 60-years-old female with a previous history of right-sided ischemic stroke. Discussion: The major criteria for diagnosis of coronary embolism include (1) non-atherosclerotic wall of coronary vessels under angiography; (2) concomitant involvement of multiple sites; (3) histological proof of venous thrombus; (4) imaging by echocardiography/CT/MRI showing intra-cardiac thrombus. The minor criteria include (1) <25% stenosis of other vessels supplying to infarct-free myocardium; (2) atrial fibrillation history; (3) risk factors like (prosthetic valve, bacterial endocarditis, patent foramen ovale, atrial septal defect, dilated cardiomyopathy). Conclusion: Our case highlights the importance of cardiac embolus as a diagnosis in a patient with a history of stroke secondary to atrial fibrillation as a cause of acute STEMI and its management.

Bhavana, an Ayurvedic Pharmaceutical Method and a Versatile Drug Delivery Platform to Prepare Potentiated Micro-Nano-Sized Drugs: Core Concept and Its Current Relevance.

Scholars of ancient Ayurveda (Indian system of medicine) were extremely reasonable and had strong scientific rationality in fundamental concepts, which are also applied to drug manufacture and therapy. Bhavana is a unique traditional method of transformation of raw material/substances into the drug by levigation or wet grinding of powdered drugs with juice/decoction/solution of plant, animal, or mineral origin. This method adds the unique capability of affecting the physicochemical and biological properties of a drug, making the drug quicker, augmented, and persistent action with minimal dose. Despite the fact that Bhavana has a wide range of applications in Ayurvedic pharmaceutics, there is only a limited amount of knowledge of its fundamental notions. A comprehensive review was performed on the core concepts of Bhavana, alongside its possible pharmacotherapeutic effects and relevance in drug development, by probing Ayurvedic claims in light of published pharmaceutical, analytical, and pharmacological reports. Various processes, such as thermo- and photochemistry, physicochemical reactions, and mechanic chemical changes, appear to occur during Bhavana.

Ethnopharmacological, Phytochemical, Pharmacological, and Toxicological Review on Senna auriculata (L.) Roxb.: A Special Insight to Antidiabetic Property.

Avartaki (Senna auriculata (L.) Roxb. syn. Cassia auriculata L.; Family- Fabaceae ) is a traditional medicinal plant, widely used for the treatment of various ailments in Ayurveda and Siddha system of medicine in India. Almost all the parts of the plant, such as flowers, leaves, seeds, barks, and roots have been reported for their medicinal uses. Traditionally, it has been used in the treatment of diabetes, asthma, rheumatism, dysentery, skin disease, and metabolic disorders. The principle phytochemicals in Senna auriculata (L.) Roxb. are alkaloids, anthraquinone, flavone glycosides, sugar, saponins, phenols, terpenoids, flavonoids, tannins, steroids, palmitic acid, linoleic acid, benzoic acid 2-hydroxyl methyl ester, 1-methyl butyl ester, resorcinol, α-tocopherol-ß-D-mannosidase, epicatechin, ferulic acid, quercetin-3-O-rutinoside, quercetin, proanthocyanidin B1. The extracts from its different parts and their isolated compounds possess a wide range of pharmacological activities such as antidiabetic, antioxidant, anti-inflammatory, antihyperlipidemic, hepatoprotective, nephroprotective, cardioprotective, anti-atherosclerotic, anticancer, antimutagenic, antimicrobial, antiulcer, antipyretic, anthelmintic, immunomodulatory, antifertility, anti-venom, and anti-melanogenesis. The toxicological findings from preclinical studies ensured the safety of the plant, but comprehensive clinical studies are required for the safety and efficacy of the plant in humans. The current review article aimed to provide up-to-date information about Senna auriculata (L.) Roxb. covering its ethnomedicinal, phytochemical, pharmacological, and toxicological aspects with special emphasis on its clinical implications in diabetes.

Potential implications of Ayurveda in Psoriasis: A clinical case study.

Immune response of a human body to the uncertain factors leads to the accelerated inflammatory proliferation of the ailing cells of the skin known as Psoriasis. Although the condition found described many decades ago, the etiology and treatment look under-researched. In Ayurveda, many herbs have proven efficacy in psoriasis, but the multifaceted etiology of the disease needs a multimodal treatment approach. We report about Ayurveda treatment in a 68-year-old female patient with plaque psoriasis presented with erythematous plaques on the anterior surface of the legs, right forehand, and neck region. The Auspitz sign and Koebner phenomenon were positive. The treatment protocol was adopted as per Ayurvedic samprapti (pathophysiology) and the patient cured completely without reporting any adverse events after the one year of treatment. No recurrence observed even after one year of the halted treatment. The importance of a wholesome diet as a health promoter is also revalidated. Photographic documentation was recorded with the proper consent of the patient during successive treatment and regular follow-ups. Altogether, multimodal Ayurveda treatment led to speedy and substantial recovery from a chronic case of psoriasis.

Enhancement of the functionality of bread by incorporation of Shatavari (Asparagus racemosus).

In view of the wider consumption of bakery products, they could be good choice for the delivery of functionality. The present study attempts to develop a functional formulation of bread by incorporation of shatavari (Asparagus racemosus Willd.), which is an important medicinal plant of India. Central composite rotatable design (CCRD) was used for experiments in which yeast and shatavari powder were taken as variables. Response surface methodology (RSM) was used to optimize the bread formulations on the basis of hardness, adhesiveness, springiness, chewiness and cohesiveness as responses. Qualitative tests were performed for assessing the presence of phytochemicals in shatavari bread. Sensory attributes of the shatavari bread were evaluated using descriptive analysis technique. The optimum acceptable level for shatavari and yeast in bread was found to be 3.5 % and 4.96 %, respectively. All the phytochemicals such as alkaloid, steroid, terpenoid and saponin present in original herbs were also present in bread. However flavonoids were not found in the bread when analysed qualitatively and using TLC.

Concepts of Dhatu Siddhanta (theory of tissues formation and differentiation) and Rasayana; probable predecessor of stem cell therapy.

To maintain health and to cure diseases through Rasayana (rejuvenation) therapy along with main treatment is the unique approach of Ayurveda. The basic constituent unit of a living being is always a functional cell. Question arises from where it is generated? How it attains its final specific differentiation form? As age progresses, various changes occur at every cell level and cell undergoes to adaptation accordingly. Microenvironment for cell nourishment diminishes with age or as disease condition persists. In this context, Acharyas had contributed and documented various facts and theories through their insight wisdom. Hidden secretes in the basic principles of any medical system are needed to be explained in terms of contemporary knowledge. Contemporary research areas should be opened to include various explanations of different fields of ancient thoughts to support these new doctrines, if any. This review may be helpful to open the door of future research area in the field of reverse scientific approach of Ayurveda in the context of Dhatu Siddhanta (theory of tissues formation and differentiation) and theory of stem cell.

The population decline of Gyps vultures in India and Nepal has slowed since veterinary use of diclofenac was banned.

Populations of oriental white-backed vulture (Gyps bengalensis), long-billed vulture (Gyps indicus) and slender-billed vulture (Gyps tenuirostris) crashed during the mid-1990s throughout the Indian subcontinent. Surveys in India, initially conducted in 1991-1993 and repeated in 2000, 2002, 2003 and 2007, revealed that the population of Gyps bengalensis had fallen by 2007 to 0.1% of its numbers in the early 1990s, with the population of Gyps indicus and G. tenuirostris combined having fallen to 3.2% of its earlier level. A survey of G. bengalensis in western Nepal indicated that the size of the population in 2009 was 25% of that in 2002. In this paper, repeat surveys conducted in 2011 were analysed to estimate recent population trends. Populations of all three species of vulture remained at a low level, but the decline had slowed and may even have reversed for G. bengalensis, both in India and Nepal. However, estimates of the most recent population trends are imprecise, so it is possible that declines may be continuing, though at a significantly slower rate. The degree to which the decline of G. bengalensis in India has slowed is consistent with the expected effects on population trend of a measured change in the level of contamination of ungulate carcasses with the drug diclofenac, which is toxic to vultures, following a ban on its veterinary use in 2006. The most recent available information indicates that the elimination of diclofenac from the vultures' food supply is incomplete, so further efforts are required to fully implement the ban.

Intellectual property rights and patents in perspective of Ayurveda.

Ayurveda is getting its due recognition as a rationale system of medicine worldwide despite the fact that medical and scientific fraternity of the globe has very strong opposite opinion regarding safety and efficacy of Ayurvedic medicines. Meanwhile, provisions of Intellectual Property Rights under World Intellectual Property Organization (WIPO) and Patents have attracted many individuals and organizations to explore possibilities of commercial benefits with Ayurvedic traditional knowledge. Although rules are not favoring to grant a patent on prior published knowledge, biopiracy managed grant of Patent on knowledge of Ayurvedic medicinal plants which has been successfully checked with references of data base of Traditional Knowledge Digital Library (TKDL). Current provisions of the Patent law of India are obstructive in nature for getting patent on Ayurvedic medicines. If we have to invite researchers from basic science to ensure quality, safety and efficacy of Ayurvedic medicines, there is an urgent need to amend laws of patent with pragmatic promotional policies. This will encourage more patents on numerous pharmaceutical, nutraceutical and cosmaceutical products based on Ayurveda. As every action of today's world is based on economic criteria so why stakeholders of Ayurveda should be deprived of it. New inventions would drive acceptance of Ayurveda as a global system of medicine.

A comparative review study of Sneha Kalpana (Paka) vis-a-vis liposome.

Ayurvedic dosage forms are very exclusive in its pharmaceutics and therapeutics. Sneha Kalpana is a group of products of medicated taila and ghee, these drugs are treating very wide range of diseases among patients of all age groups. Liposomal system of drug delivery is a new invention in conventional system of medicine. This system is also covering a high degree of objective of therapeutics at different targets successfully. Probably, here is very distinctive similarity between these two on account of their aqueous and oleaginous origin. Most likely, these are two faces of same coin. A brief survey of literature is done here to explore possibilities of further investigation in benefit of mankind by applying wisdom of both fields together. In fact, this is a review paper based on certain hypothesis which may be established or rejected factually by further researches.

Ayurvedic bhasma: nanomedicine of ancient India--its global contemporary perspective.

Ayurveda is one of the oldest systems of medicine, practiced in Indian sub continent. We are working to calibrate classical parameters of good manufacturing practices of Ayurvedic bhasma on parameters and language of contemporary science. Bhasma in accordance of classical expectation are Swarna bhasma, Makshika bhasma, Abhrak bhasma, Tamra bhasma and Louha bhasma. X-ray diffraction, TEM and particle size analysis revealed that these bhasma are in nanometer dimension. These bhasma may be considered as nanomedicine and are free from toxicity in therapeutic doses.

A progressive review of Sandhana kalpana (Biomedical fermentation): An advanced innovative dosage form of Ayurveda.

Sandhana kalpana (biomedical fermented formulations) are one of the best dosage forms of Ayurveda in practice since thousands of years. In order to prepare these medicaments, certain sets of conditions are prearranged, which lead to fermentation. Thus, products bequeath with self-generated ethyl alcohol, which potentiate these preparations (Asava-Arishta), pharmaceutically and therapeutically. Commonly, medicinal and commercial components of these formulations are prompting many researchers to contribute in manufacturing, quality control, safety, and efficacy of these formulations. To cope up with this, literature related to Asava-Arishta has been surveyed from the Vedic period to recent publications of Government of India, ie, Ayurvedic Formulary of India, and presented briefly here. In this review paper, we have discussed pioneering facts such as nature and amount of carbohydrate, type of containers, optimum temperature, variety and relevance of initiator of fermentation, manufacturing, regulatory rules, and business aspects of Asava-Arishta. After going through this basic information, any academician or researcher may show a way to further strengthen this dosage form.

Contribution of world health organization in the global acceptance of Ayurveda.

Amongst the mandates of United Nations, health of mankind is the thrust area of UN through World Health Organization (WHO). Planning and execution of policies for mainstreaming of traditional medicines (TRM) of respective countries along with conventional system of medicine (allopathy), first in the country of origin followed by the international arena, is the priority agenda of operations of WHO. Within Indian context, WHO accorded prime focus to Ayurveda in its activities related to TRM.Sponsorship and encouragement of studies substantiating parameters of standardization, safety and efficacy of herbal medicines of Ayurveda are under chief consideration of WHO. In this review, several guidelines of WHO are summarized. Department of Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homoeopathy (AYUSH), Central Council of Research in Ayurveda and Siddha and numerous other collaborative centers of WHO in India are assigned with several Appraisal Project Work (APW) and Direct Financial Cooperation (DFC) projects that will strengthen Ayurveda as evidence-based medicine for its global acceptance. Implementation of pharmacovigilance program in Ayurveda, publication of documents for rational use and initiatives to prepare consumer guidelines for appropriate use of Ayurvedic medicines are some other contributions of WHO toward advancement of Ayurveda at national as well as global level. Here, we suggest further exploration, interaction and interpretation of traditional knowledge in the light of contemporary core sciences and biomedical sciences that can pave the way for accreditation of Ayurveda worldwide as an established system of medicine.

Quality control of herbal medicines by using spectroscopic techniques and multivariate statistical analysis.

Herbal medicines play an important role in modern human life and have significant effects on treating diseases; however, the quality and safety of these herbal products has now become a serious issue due to increasing pollution in air, water, soil, etc. The present study proposes Fourier transform infrared spectroscopy (FTIR) along with the statistical method principal component analysis (PCA) to identify and discriminate herbal medicines for quality control. Herbal plants have been characterized using FTIR spectroscopy. Characteristic peaks (strong and weak) have been marked for each herbal sample in the fingerprint region (400-2000 cm(-1)). The ratio of the areas of any two marked characteristic peaks was found to be nearly consistent for the same plant from different regions, and thus the present idea suggests an additional discrimination method for herbal medicines. PCA clusters herbal medicines into different groups, clearly showing that this method can adequately discriminate different herbal medicines using FTIR data. Toxic metal contents (Cd, Pb, Cr, and As) have been determined and the results compared with the higher permissible daily intake limit of heavy metals proposed by the World Health Organization (WHO).

Herbo mineral formulations (rasaoushadhies) of ayurveda an amazing inheritance of ayurvedic pharmaceutics.

The one of the oldest system of medicine, Ayurveda is momentous in audience of worldwide on virtue of its holistic approach of life. Formulations of Ayurveda consist of substances of herbal, mineral/metal and animal origin which are processed pharmaceutical to have therapeutic effects. This is attribute of processes of Shodhan (purification/potentiation), Bhavana (impregation /levigation) and Marana (incineration/calcinations) of Rasa Shastra which acclimatize these toxic industrial matter to a effective remedies known as herbo mineral formulations (Rasaoushadhies) of Ayurveda. In recent past there is prevalence of some doubt on safety and efficacy of these medicines. In this review paper we tried to justify application of these medicines as these are time tested and showed wonderful clinical adaptability. We also attempted to establish new facts of figures of core science in explanation of these medicines.

Pharmacovigilance: Boon for the safety and efficacy of Ayuvedic formulations.

Pharmacovigilance is a corrective process originating in pharmaco-epidemiology. The 1997 Erice Declaration, presented at the World Health Organisation, became the basis on which the concept was implemented internationally for conventional systems of medicine. The increasing international acceptance of Ayurveda, led regulators to implement a similar program for Ayurveda, particularly as some medical professionals, scientists and members of the public reported adverse reactions after taking Ayurvedic formulations. The World Health Organisation therefore persuaded the Department of AYUSH, Ministry of Health and Family Welfare, Government of India, to implement a pharmacovigilance program for Ayurveda, as a means to ensuring the safety and efficacy of Ayurvedic medicines. After a year of due diligence, the pharmacovigilance program was launched nationally on 29 September 2008. Since that time, Ayurveda, Siddha and Unani medicines have been monitored according to the provisions of a protocol prepared by the National Pharmacovigilance Resource Centre, IPGTRA, Jamnagar, and approved by Department of AYUSH. The program was reviewed, first, on 21st January 2009 by the National Pharmaco-vigilance Consultative Committee for ASU drugs (NPCC-ASU), and again, on 15 Feburary, 2010, when an evaluation meeting effectively rubber stamped the program. Among the outcomes of these meetings were several suggestions of measures to improve the program's efficiency. Recent developments include the constitution of pharmacovigilance centers at all Ayurveda Teaching institutes and research centers.