International Delegate Assembly: An overview of two decades.

Globalization of Ayurveda is a continuous process. It happens due to committed collaboration of expert vaidyas from India and abroad, professionals from different countries, pharmaceutical suppliers, and patients. The obstacles to practise, regulate and educate Ayurveda, differ from country to country; however there are some common threads. The International Delegates Assembly through the platform of World Ayurveda Congress strives to bring the stakeholders together biannually to discuss the issues and find solutions. The present narrative sheds light on the objectives, status and expectations of the stakeholders and provides insights into the process.

A randomized controlled pilot study of add-on therapy of CIM-MEG19 (standardized Andrographis paniculata formulation) in mild to moderate COVID-19.

Background: Traditional knowledge and scientific shreds of evidence strongly support the repurpose of Kalmegh (Andrographis paniculata, CIM-MEG19) as an alternate therapy for prophylactic management and treatment of severe acute respiratory syndrome coronavirus (SARS-CoV) and associated health disorders. Purpose: The study aimed to assess the efficacy and safety of the CIM-MEG19 (standardized A. paniculata extract formulation), a proprietary Ayurvedic medicine in the COVID-19 management, clinical recovery, and outcomes in terms of hospitalization days as well as any sign of severity due to drug-drug interaction between CIM-MEG19 TM and standard of care (SoC). Methods: A randomized, parallel-group, active-controlled interventional pilot clinical study was conducted. The Group-A subjects were assigned to CIM-MEG19 add-on to SoC treatment using modern medicine without antiviral drug whereas Group-B patients with SoC treatment using modern medicine and recommended antiviral drug for COVID-19 management. Eighty RTPCR (real-time polymerase chain reaction) positive and eligible COVID-19 patients of age >18 years, having mild or moderate severity, were enrolled. Results: Clinical improvement in reduction of symptoms showed significant (p<0.0001) results in the average days in subjects of group-A (Investigational intervention arm) compared to Group B (SoC). The RT-PCR investigation exhibited COVID negative for 50 % in CIM-MEG19 add-on and 47% in SoC treatment after 8-11 days. Similarly, biochemical investigations showed that CIM-MEG19 group-A had a significant (p ≤ 0.05) effect on C-Reactive Protein (CRP) and Interleukin-6 (IL-6) after 14 days of treatment. Additionally, improvement in D-Dimer, ESR, and LDH in CIM-MEG19 add-on therapy was also observed. Conclusions: The study demonstrated an excellent safety profile, declining the severity of the infection and halting the disease advancement/progression. CIM-Meg19 might be used as a potential natural drug for treating COVID-19.

Nanoparticles of biotite mica as KrishnaVajraAbhraka Bhasma: synthesis and characterization.

BACKGROUND: Bio-inorganic nanoparticles or metal nanoparticles are used in medicine for diagnostic and treatment purposes. The nanomedicines from traditional Ayurvedic system are termed as bhasma. Rasashastra, the branch of inorganic medicines of Ayurveda, has documented monographs of metal-mineral bhasmas as potent drugs. However there is lack of scientific analytical data of the end products. OBJECTIVES: Present study was aimed at finding out the morphological, structural, elemental and chemical composition of the Krishna vajra abhraka bhasma (KVB). MATERIALS AND METHODS: Bhasma of KVB (Biotite Mica) was prepared in our laboratory using biotite mica sheets befitting selection criteria and carrying out further processes with strict SOPs as per AFI. RESULTS: The bhasma complied with the confirmatory tests from Rasashastra. The physical and physicochemical tests correlate with the results obtained by instrumental analytical methods. SEM revealed square shaped nanoparticles of mean size of 92.3 nm. EDAX showed presence of Si, Mg, O, Fe, Ca, Na, C, K and Al. XRD revealed the crystalline nature of bhasma with mixture of various individual oxides and spinel shape of the crystal. DLS showed that the nanoparticles are unimodal in nature. FTIR and NMR showed the organic functional groups obtained from cow milk and selected herbs, indicating unique bio-inorganic nature of the KVB. CONCLUSION: The therapeutic potential imparted to the formulation could be due to the cow milk and specific herbs utilized during the manufacturing process.

Nanostructured gold in ancient Ayurvedic calcined drug 'swarnabhasma'.

BACKGROUND: Swarnabhasma (calcined gold) is a famous ancient Ayurvedic medicine. However, its detail characteristic investigations are very limited. OBJECTIVE: Herein, investigation of swarnabhasma is demonstrated using ancient and ultramodern techniques to understand the physicochemical nature of this drug, and to understand whether the mercury [Parada] used during preparation method marks its presence in swarnabhasma. MATERIALS AND METHODS: The investigated swarnabhasma was prepared by repeated incinerations of Au-Hg-Lemon juice amalgamation and sulphur. The bhasma was tested by all traditional tests of rasashastra. It was characterized by X-ray diffraction (XRD), Field Emission Scanning Electron Microscope (FE-SEM), Field Emission Transmission Electron Microscopy (FE-TEM), Inductively Coupled Plasma Atomic Emission Spectroscopy (ICP-AES), Energy Dispersive X-ray Fluorescence (EDXRF), Fourier Transform Infrared Spectroscopy (FTIR), and gravimetric analysis. RESULTS: Traditional tests of rasashastra were complied by the sample. XRD confirms that swarnabhasma consists of principally pure gold at nanoscale. FE-SEM showed agglomerated particles. FE-TEM showed that swarnabhasma contains highly crystalline nanostructured gold comprised with spherical gold nanoparticles of size, 5-20 nm. ICP-AES exhibited absolute absence of Hg and presence of Au, Si, Ag, Al, Ca, Cu, Fe, K, Mg, Mn, Na, P, Sr, Ti, and Zn. EDXRF confirmed the absence of mercury and confirmed the presence of Au, Si, Zr, Nb, S, Cl, K, Ca, Fe, and Ni. FTIR confirmed presence of water molecules adsorbed over surface of bhasma. Gravimetric analysis confirmed presence of 95% gold. CONCLUSION: Nano-structuring of gold enhances the surface area as well as activity. The present investigation shows that the entire process from rasashastra confers the unique nanostructure to gold and same is responsible for its medicinal potential. This nanomedicine is highly stable, which is specified as niruttha and apunarbhava in rasashastra.

Assessment of bioavailability of gold bhasma in human participants - A pilot study.

Bioavailability of the well-known Ayurvedic drug Swarnabhasma (gold bhasma or calcined gold) is unknown. It is orally administered either sublingually or directly with various Anupanas like black pepper powder (Piper nigrum Linn.) and cow ghee in the dose range of 15-240 mg by Ayurvedic physicians. Study of bioavailability of Swarnabhasma is necessary as this metal-derived drug is administered for long duration for rejuvenation. The pilot study was carried out in healthy human male participants to assess bioavailability of Swarnabhasma in three doses, viz. 30 mg plain sublingual, 30 mg oral dose mixed with black pepper powder (250 mg) and cow ghee (2.5 gm); and 240 mg oral dose mixed with black pepper powder (250 mg) and cow ghee (2.5 gm). Blood samples were withdrawn at 0, 1, 2 and 4 h after administration of dose. Estimation of gold levels in blood was carried out by inductively coupled plasma mass spectrometry (ICP-MS). Results show that gold is absorbed in traces from single dose of Swarnabhasma. Maximum concentration of gold was bioavailable from 30 mg sublingual dose with Cmax 0.983 µg/L at 2 h (Tmax). Oral dose of 30 mg Swarnabhasma mixed with black pepper powder and ghee showed faster absorption with Tmax at 1 h and Cmax 0.867 µg/L, and 240 mg dose with black pepper and ghee showed Cmax 0.668 µg/L and Tmax at 2 h.

Hyaluronidase and collagenase inhibitory activities of the herbal formulation Triphala guggulu.

Myrrh (guggulu) oleoresin from the Commiphora mukul tree is an important component of antiarthritic drugs in Ayurvedic medicine. Clinical data suggest that elevated levels of hyaluronidase and collagenase type 2 enzymes contribute significantly to cartilage degradation. Triphala guggulu (TG) is a guggulu-based formulation used for the treatment of arthritis. We assessed the chondroprotective potential of TG by examining its effects on the activities of pure hyaluronidase and collagenase type 2 enzymes. Triphala shodith guggulu (TSG), an intermediate in the production of TG, was also examined. A spectrophotometric method was used to assay Hyaluronidase activity, and to detect potential Hyaluronidase inhibitors. Aqueous and hydro-alcoholic extracts of TSG showed weak but dose-dependent inhibition of hyaluronidase activity. In contrast, the TG formulation was 50 times more potent than the TSG extract with respect to hyaluronidase inhibitory activity. A validated X-ray film-based assay was used to measure the gelatinase activity of pure collagenase type 2. Hydro-alcoholic extracts of the TG formulation were 4 times more potent than TSG with respect to collagenase inhibitory activity. Components of Triphala were also evaluated for their inhibitory activities on hyaluronidase and collagenase. This is the first report to show that the T2 component of Triphala (T.chebula) is a highly potent hyaluronidase and collagenase inhibitor. Thus, the TG formulation inhibits two major enzymes that can degrade cartilage matrix. Our study provides the first in vitro preclinical evidence of the chondroprotective properties of TG.

Experimental Evaluation of Hingvadi Ghrta in Behavioral Despair Using Animal Models.

CONTEXT: Depression, a sustained mood disorder caused by selective diminution of specialized cells in brain is increasing at an alarming rate. It will be the second largest morbid illness by next decade and is the leading cause of suicidal deaths. The available antidepressant medications benefit only a third of its recipients and have many side effects. Hence, it is imperative to search in Ayurveda for leads. AIM: To evaluate Anti- depressant activity of Hingvadi Ghrta in vivo . SETTINGS AND DESIGN: Comparative preclinical study. MATERIALS AND METHODS: Hingvadi Ghrta (HG) was prepared using standard operating procedure, physicochemically analyzed and assessed. Tail Suspension Test (TST) model with Swiss albino mice and Forced Swim Test (FST) model with Wistar albino rats were used to assess anti-depressant activity. Imipramine hydrochloride in dose of 15 mg/kg for TST and 10 mg/kg for FST, was the standard drug and Ghee as vehicle control in dose of 0.1g/20g for TST and 0.72g/200g for FST orally. Hingvadi Ghrta in doses of 0.05g/20g (x/2), 0.1g/20g (x) and 0.2 g/20g (2x) for TST and 0.36g/200g (x/2), 0.72g/200g (x) and 1.44g/200g (2x) for FST was administered to 3 test groups for 21 days orally except Plain control group which received only distilled water. Duration of immobility in seconds for TST and number of rotations for FST were noted for assessment. STATISTICAL ANALYSIS USED: One way ANOVA followed by Dunnets test and Paired t test. RESULTS: HG was significantly effective at dose of 0.1gm/20gm for TST (P = 0.0037; P < 0.01) and 0.72g/200g for FST (P = 0.0055, P < 0.01) comparable to Imipramine hydrochloride. CONCLUSIONS: HG displayed potent anti depressant activity comparable to standard drug Imipramine Hydrochloride.

Ayurvedic hydro-alcoholic anti-asthmatic medicine Vasarishta built upon Mritasanjeevani Sura: Development and evaluation.

INTRODUCTION: Vasarishta built upon Mritasanjeevani Sura (MS) is a polyherbal hydro-alcoholic anti-asthmatic formulation which is administered in a dose of 1 ml instead of standard dose 40 ml, generally advocated for any "Asava-Arishta" in Ayurveda. AIM: The present study was aimed at finding out rationale for the peculiar distillation process to manufacture MS followed by Sthapana process to make Vasarishta. It was further aimed to find out difference in Vasarishta samples manufactured by purely fermentation process and the peculiar method mentioned above. MATERIALS AND METHODS: Three batches of MS and subsequently three batches of Vasarishta were prepared. Basic standardization and development of standard operating procedure for the same were achieved by doing pH, percentage of alcohol and total reducing sugar, specific gravity on both MS and Vasarishta, during and after completion of process. Finally, MS and Vasarishta (built upon MS) made in laboratory were compared with marketed samples of MS and Vasarishta using gas chromatography. RESULTS: The types of alcohols and volatile acids in MS and Vasarishta, prepared in laboratory, are similar but the proportions differ, which is taken as an indicator of process standardization. Values of furfural, ethyl acetate, and 1-butanol in lab samples are within permissible limits as against the values of the market samples. CONCLUSIONS: The textual process for the production of Vasarishta proved to produce organoleptically acceptable product which is virtually free of toxic compounds such as furfural.

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.

Differential growth inhibitory effects of W. somnifera root and E. officinalis fruits on CHO cells.

The Chinese Hamster ovary (CHO) cell line is widely used for measuring drug cytotoxicity and resistance. Therefore, the effects of two major Ayurvedic drugs (W. somnifera root and E. officinalis fruits) on the short and long-term growth of these cells were investigated. A standard 96-well plate assay was used to measure short-term growth. For assessment of long-term growth, the colony formation assay (CFA) was used, which measures clonogenic potential. This assay is the best measure of the cytotoxicity of anticancer drugs and the radio-sensitivity of tumor cells. As reported by others, the aqueous extracts of both herbal drugs were found to have short-term growth inhibitory effects on CHO cells when added to cells at the time of cell plating. However, this is the first report showing that these two herbal drugs have significantly different effects on the long-term growth of CHO cells. Thus, extracts of W. somnifera root, but not E. officinalis fruit, caused a reproducible, dose dependent, inhibition of colony formation of CHO cells.