Observational research on the effect of an Ayurvedic treatment protocol in patients of hereditary pancreatitis.

BACKGROUND: Hereditary pancreatitis (HP) is a chronic and recurrent inflammatory disorder caused by genetic abnormalities, often accompanied by severe symptoms and complications. Conventional treatments offer limited relief but fail to halt disease progression. An Ayurvedic Treatment Protocol has been reported to be effective in treating various types of pancreatitis. OBJECTIVES: This observational clinical study is aimed at assessing the efficacy of a year long Ayurvedic treatment protocol (ATP) in mitigating attack frequency and intensity in Hereditary Pancreatitis patients. MATERIALS & METHODS: The study enrolled 151 patients across diverse age groups and genders, subjecting them to a comprehensive Ayurvedic treatment protocol at a specialized center. The protocol incorporated Metal-Based Ayurvedic Formulation (MBAF) named Amar, alongside supportive Ayurvedic compounds and dietary adjustments. Patients underwent pre- and post-treatment evaluations involving interviews, medical records, blood tests, radiological imaging, and symptom assessments. Notably, pancreatic enzyme use was discontinued prior to initiating Ayurvedic treatment. RESULTS: Among 151 patients, 88 completed the year long ATP, resulting in significant enhancement of their quality of life. There was a marked 98.7% reduction in emergency hospitalizations and a notable 92.8% decrease in attack frequency (p < 0.0001). Radiological assessments indicated pancreatic health stabilization, while no adverse effects were reported, highlighting the intervention's safety and tolerability. CONCLUSION: The study furnishes promising evidence supporting the efficacy and safety of ATP, especially the MBAF, in managing Hereditary Pancreatitis. The observed decline in attack frequency, absence of adverse effects, and stabilization of pancreatic health underscore the potential of Ayurvedic medicine. Subsequent research, including randomized controlled trials, is warranted to substantiate these findings and elucidate underlying mechanisms.

Facile fabrication of Nishamalaki churna mediated silver nanoparticles with antibacterial application.

Antimicrobial resistance (AMR) is one of the most serious threats to today's healthcare system. The prime factor behind increasing AMR is the formation of complex bacterial biofilms which acts as the protective shield between the bacterial cell and the antimicrobial drugs. Among various nanoformulations, green synthesized metallic silver nanoparticles are currently gaining research focus in safely breaking bacterial biofilms due to the inherent antimicrobial property of silver. In the current work, the aqueous extract of the ayurvedic formulation Nishamalaki churna is used to exhibit one pot green synthesis of silver nanoparticles. The physicochemical characteristics of Nishamalaki churna extract mediated AgNPs were evaluated using various analytical techniques, like UV-Visible spectrophotometer, FT-IR spectroscopy, SEM, XRD, DLS-Zeta potential analyzer etc. The synthesized spherical AgNPs were well formed within the size range of 30 nm to 80 nm. Furthermore, the synthesized AgNPs showed potent antibacterial effects against two primary AMR-causing bacterial species like Staphylococcus aureus and Pseudomonas aeruginosa with the successful destruction of their biofilm formation. Additionally, these AgNPs have shown profound antioxidant and anti-inflammatory activities as desirable add-on effects required by a prospective antibacterial agent.

Assessment of the systemic toxicity of Laghu vishagarbha taila, an Ayurvedic medicated oil formulation after dermal exposure.

Laghu vishagarbha taila (LVT) is a medicated oil preparation used in the Ayurvedic system of medicine and applied topically for the treatment of painful musculoskeletal and inflammatory disorders. It contains some mildly poisonous phytoconstituents which may show untoward effects upon application. The present study evaluated the toxicity of LVT in the acute, subacute, and subchronic dermal toxicity study in Wistar rats. LVT was tested for its compliance using physicochemical and analytical parameters as per standard methods prescribed in Ayurvedic Pharmacopoeia of India, while acute, subacute, and subchronic toxicity studies were carried out as per OECD 402, 410, and 411 guidelines, respectively. In the acute dermal toxicity study, a single dose of LVT (2000 mg/kg) was applied topically to rats, while in subacute and subchronic dermal toxicity study, the rats were topically applied LVT (1000 mg/kg) up to 28 and 90 days, respectively. LVT did not cause any alterations in clinical signs and no mortality or moribund stage was observed. The change in weekly body weight was insignificant compared with the vehicle control group. In subacute and subchronic dermal toxicity study, there were no significant changes in behavior, body weight, feed consumption, biochemical and hematological parameters, organ weight, and histological parameters compared with vehicle control rats. Topical application of single and repeated doses of LVT in rats did not exhibit adverse effects and suggests that the LD50 of LVT is more than 2000 mg/kg in the acute dose and NOAEL is more than 1000 mg/kg/day in repeated dose application.

Effectiveness of polyherbal formulations for the treatment of type 2 Diabetes mellitus - A systematic review and meta-analysis.

BACKGROUND: The mortality and morbidity rate of diabetes patients is increasing worldwide which requires an ideal treatment to prevent the disease worsening. Traditional medicine is gaining more attention in diabetes due to its efficacy and safety. We, therefore performed a systematic review study of clinical trials to assess the comparative effect of polyherbal formulations in type 2 Diabetes mellitus. OBJECTIVES: To find the effectiveness of polyherbal formulations in blood sugar and lipid level for type 2 Diabetes mellitus. MATERIAL AND METHODS: PubMed, Scopus and CINAHL databases for clinical trials investigating the effect of polyherbal formulations in Type 2 Diabetes mellitus patients were searched. Meta-analysis of eligible trials was conducted employing Revman 5.2 software. RESULTS: Fourteen randomized controlled trials were found eligible for meta-analysis. Meta-analysis of findings showed a significant effect of polyherbal formulations on blood sugar level compared to control group. The estimated standard mean changes at 95% confidence interval, following polyherbal formulations treatment were -0.59, (-0.91 to - 0.27) mg/dL; for fasting blood sugar(p < 0.001), -0.69, (-1.18 to -0.21) mg/dL; for postprandial blood sugar (p = 0.005) and -0.46, (-0.88 to -0.04) gm%; for glycated haemoglobin (p = 0.03). The reduction in postprandial sugar and glycated haemoglobin was statistically significant with polyherbal formulations compared to metformin treatment but not for fasting sugar. Similarly in lipid profile the reduction for total cholesterol and triglycerides was statistically significant with polyherbal formulations compared to control group but was not significant for HDL and LDL whereas in other group of polyherbal formulations and metformin only HDL was favouring polyherbal formulations. CONCLUSION: Polyherbal formulations occurred to be effective in lowering blood sugar level in Type 2 diabetes but their further efficacy in managing diabetes needs to be validated. Therefore, a qualitative, long term, randomized placebo-controlled trials of adequate sample size are necessary to determine the efficacy of polyherbal formulation in managing diabetes.

Biomarker Analysis Based Chemoprofiling of Polyherbal Ayurvedic Formulation Containing Vitis vinifera L. by Validated UPLC-MS/MS Method.

BACKGROUND: Drakshasava is one of the commercial Ayurvedic medicines from India, prepared from grapes and spices. It is believed to address health imbalances and claimed to be beneficial for weakness, bleeding disorders, and various inflammatory diseases. It has been reported to possess pharmacological activities such as diuretic, cardioprotective, and antimicrobial. Being a polyherbal mixture, it faces challenges in its standardization and quality control. OBJECTIVE: The aim of the present study is to develop a validated UPLC-MS/MS method for simultaneous quantification of 10 polyphenolic biomarkers in Drakshasava. It explores the effect of Vitis vinifera L. and additional herbs on fermentation with respect to bioactive compounds through the successive addition method. METHODS: The MS methods were optimized in multiple-reaction monitoring (MRM) mode with ESI while chromatographic separation was achieved on an Acquity UPLC BEH C18 column using both isocratic and gradient elution in water and acetonitrile containing 0.1% formic acid. RESULTS: The developed method was validated as per ICH-Q2B guidelines and found to be within the assay variability limits. Gallic acid was found to be the most abundant marker in all the samples followed by resveratrol. The content of all the markers has been found to be increased significantly post-fermentation, compared to decoction except kaempferol. The successive addition of prashpeka drvya (minor herbs) in the formulation showed variability at different stages with respect to the selected markers and did not exhibit major changes in the chemical profiling of the final product. CONCLUSION: The developed method was found to be rapid, accurate, reliable, and highly sensitive for the simultaneous quantification of selected biomarkers in Drakshasava. The research is the first chemometric report on the standardization of Drakshasava by validated UPLC-MS/MS method. It may prove to be a useful tool for the development of new phytopharmaceutical drugs and further quality control of other polyherbal formulations.

Compounds of Citrus medica and Zingiber officinale for COVID-19 inhibition: in silico evidence for cues from Ayurveda.

BACKGROUND: The nasal carriage of SARS-CoV-2 has been reported as the key factor transmitting COVID-19. Interventions that can reduce viral shedding from the nasopharynx could potentially mitigate the severity of the disease and its contagiousness. Herbal formulation of Citrus medica and Zingiber officinale is recommended in an Ayurvedic text as a nasal rinse in the management of contagious fevers. These herbs are also indicated in the management of respiratory illnesses and have been attributed with activity against pathogenic organisms in other texts. Molecular docking studies of the phytocompounds of C. medica and Z. officinale were done to find out whether these compounds could inhibit the receptor binding of SARS-CoV-2 spike protein (S protein) as well as the angiotensin-converting enzyme 2 (ACE-2), as evidenced from their docking into binding/active sites. RESULTS: The proteins of SARS-CoV-2, essential for its entry into human cells and highly expressed in the goblet and ciliated cells of nasal epithelium, play a significant role in contagiousness of the virus. Docking studies indicated that the specific compounds present in C. medica and Z. officinale have significant affinity in silico to spike protein of virus and ACE-2 receptor in the host. CONCLUSION: In silico studies suggest that the phytochemical compounds in C. medica and Z. officinale may have good potential in reducing viral load and shedding of SARS-CoV-2 in the nasal passages. Further studies are recommended to test its efficacy in humans for mitigating the transmission of COVID-19.

Herbalome of Chandraprabha vati, a polyherbal formulation of Ayurveda prevents fibrillation of lysozyme by stabilizing aggregation-prone intermediate state.

Lysozyme amyloidosis (ALys) is caused by the deposition of amyloid-like fibrils of lysozyme in the tissues of the gastrointestinal tract, liver and kidneys. The treatment/prevention of ALys is not known yet. Therefore, searching for therapeutic agents for amyloidosis is of great value. In this study, we have examined the ability of the aqueous extract of herbalome (thirty herbal components) of Chandraprabha vati (EHCV), a polyherbal Ayurvedic formulation, to prevent fibrillation of lysozyme. Transmission electron microscopy and multiple biophysical techniques were used to examine the processes. We found complete inhibition of the fibrillation by EHCV, whereas none of the thirty ingredients of EHCV was able to prevent the reaction, solely. We also found the EHCV induced and stabilized secondary structures of aggregation-prone state (APS) of lysozyme. Moreover, an increase in the secondary structure and stability of APS were found to correlate with the inhibition reaction. We conclude that EHCV modulates the structure and stability of APS and converts it into an aggregation resistant state (ARS). We hypothesized that herbal components of Ayurvedic formulation may provide a combination of molecules, which could efficiently prevent aggregation reaction.

Turmeric based oral rinse "HTOR-091516" ameliorates experimental oral mucositis.

BACKGROUND: Prevalence and incidence of oral mucositis (OM) are rigorously increasing and there is no effective treatment. The herbal formulation "HTOR-091516" containing Curcuma longa, Triphala and honey were evaluated for the treatment of OM. AIM: The aim of this study was to evaluate the safety and efficacy of HTOR-091516, employing cellular model, human gingival fibroblasts-1 (HGF-1), and 5-fluorouracil (5-FU)-induced mucositis model in rats. MATERIALS AND METHODS: The cell viability was assessed using 3-(4, 5-dimethylthiazolyl-2)-2, 5-diphenyltetrazolium bromide (MTT) assay and the inhibitory effect of HTOR-091516 on tumor necrosis factor-alpha (TNF-α) was evaluated using TNF-α bioassay in lipopolysaccharides-induced HGF-1. 5-FU and glacial acetic acid were used to induce OM in rats. Animals were divided into two groups, group 1 served as mucositis control and group 2 was treated with HTOR-091516 at the dose of 200 µl and TNF-α was estimated in plasma samples. RESULTS: The in vitro safety of HTOR-091516 was evaluated in reconstructed human oral epidermis and was found to be nontoxic and exhibited concentration-dependent TNF-α inhibition in HGF-1. The treatment with HTOR-091516 reduced mucositis scores and mortality rate and also decreased the plasma TNF-α level. CONCLUSION: The present data indicate that HTOR-091516 is effective in the treatment of OM.

Preparation and Characterization of Suvarna Bhasma Parada Marit.

OBJECTIVES: The goal of this study was to characterize Suvarna Bhasma Parada Marit by using the Ayurvedic test parameters, physico-chemical tests, and various instrumentation techniques. METHODS: Suvarna Bhasma, an Ayurvedic formulation manufactured as per Bharat Bhaishajya Ratnakar 5/8357 (BBR), has been studied using various instrumentation techniques: X-ray diffraction (XRD), scanning electron microscopy (SEM), energy dispersive X-ray analysis (EDAX), laser particle size distribution (PSD) analysis, fourier transform infrared spectroscopy (FT-IR), and atomic absorption spectroscopy (AAS), and physico-chemical parameters, such as the loss on drying (LOD), loss on ignition (LOI), and acid insoluble Ash (AIA) were determined. In addition, Ayurvedic tests, such as Rekhapurnatva (enterable in the furrows of the fingers), Varitaratwa (floatable over water), Nirdhoomta (smokeless), Dantagre Kach-Kach (gritty particle feeling between the teeth), were performed. RESULTS: The XRD study showed Suvarna Bhasma to be crystalline in nature and to contain more than 98% gold. The mean size of the gold crystallites was less than 10 microns, and the morphology was globular and irregular. Suvarna Bhasma contains gold as its single and major element, with EDAX and FT-IR spectra showing that it is more than 98% pure gold. The moisture content (LOD) is less than 0.5%, the LOI is less than 2%, and the AIA is not less than 95%. The Ayurvedic tests, as specified above, helped to confirm the quality of Suvarna bhasma prepared as per the text reference (BBR). CONCLUSION: This chemical characterization of Suvarna Bhasma performed in this study by using modern instrumentation techniques will be helpful in understanding its pharmacological actions and will help in establishing quality protocols and specifications to substantiate the safety, efficacy & quality of Suvarna Bhasma.

Preliminary Screening of a Classical Ayurvedic Formulation for Anticonvulsant Activity.

BACKGROUND: Epilepsy is a serious and complex central nervous system disorder associated with recurrent episodes of convulsive seizures due to the imbalance between excitatory (glutamatergic) and inhibitory (GABAergic) neurotransmitters level in the brain. The available treatments are neither competent to control the seizures nor prevent progress of disease. Since ages, Herbal medicines have remained important sources of medicines in many parts of world which is evidenced through their uses in traditional systems of medicine i.e. Ayurveda, Siddha, Unani, Homeopathy and Chinese etc. AIM: A polyherbal formulation (containing Terminalia chebula Retz., Asparagus racemosus Willd., Embelia ribes Burm. F, Acorus calamus L., Tinospora cordifolia (Willd.) Miers, Convolvulus pluricaulis Choisy, Saussurea lappa C.B.Clarke, Achyranthes aspera L.) is mentioned in Ayurvedic classics Bhaisajya Ratnavali. The aim of the study was to evaluate the anticonvulsant activity of the formulation in Maximum electroshock and Pentylenetetrazole induced convulsions in rats. MATERIALS AND METHODS: In the present study, a polyherbal formulation was developed as directed by classical text and evaluated for the anticonvulsant activity using Maximal Electroshock Shock (MES) and Pentylenetetrazole (PTZ) induced convulsions in rats. Statistical comparison was done by one way ANOVA followed by the Tukey's multiple comparison test. RESULTS: The obtained results showed that the PHF had a protective role on epilepsy. Treatment with PHF significantly improves antioxidant enzymes activities of superoxide dismutase (SOD) and glutathione (GSH) levels significantly as compared to controls. PHF also significantly decreased malonaldialdehyde (MDA) levels in the brain. Moreover, it also attenuated the PTZ-induced increase in the activity of GABA-T in the rat brain. CONCLUSION: These findings suggest that PHF might have possible efficacy in the treatment of epilepsy.