Vaidyaratnam P.S. Varier Ayurveda College

Travel behavior plays an important role in transportation planning. Mode choice analysis is the process of arriving at a decision about which mode to use under a set of circumstances. Choice of a particular mode by a commuter affects the general efficiency of travel within the city. Various techniques are available in the literature for mode choice modeling. Among these, multinomial logit models are found to be efficient in estimating the different mode shares in a scenario where more than two choices of modes of travel are available for a commuter. The present study used multinomial logistic regression to analyze the mode choice behavior of commuters in Thiruvananthapuram, a typical Indian city. The findings from the study revealed that as age increases preference to car increases and preference to two-wheelers decreases in comparison with public transport. Increase in time per distance and increase in cost per distance cause the commuters to switch to car and two-wheelers from public transport. Identification of such factors and its variations will help city planners to formulate effective transport policies to improve the transport within the city.

Abstract 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.

Many plant-based products have been suggested as potential antidiabetic agents, but few have been shown to be effective in treating the symptoms of Type 2 diabetes mellitus (T2DM) in human studies, and little is known of their mechanisms of action. Extracts of Gymnema sylvestre (GS) have been used for the treatment of T2DM in India for centuries. The effects of a novel high molecular weight GS extract, Om Santal Adivasi, (OSA(R)) on plasma insulin, C-peptide and glucose in a small cohort of patients with T2DM are reported here. Oral administration of OSA(R) (1 g/day, 60 days) induced significant increases in circulating insulin and C-peptide, which were associated with significant reductions in fasting and post-prandial blood glucose. In vitro measurements using isolated human islets of Langerhans demonstrated direct stimulatory effects of OSA(R) on insulin secretion from human ß-cells, consistent with an in vivo mode of action through enhancing insulin secretion. These in vivo and in vitro observations suggest that OSA(R) may provide a potential alternative therapy for the hyperglycemia associated with T2DM.

(HAPZ) in cisplatin induced nephrotoxicity was analyzed in Swiss albino mice. Treatment with higher dose (400 mg/kg) of HAPZ significantly reversed the adverse effect of cisplatin on kidney weight, serum urea and creatinine, indicating their renoprotective effect. The antioxidant effect of the drug is evident from its significant effect on Catalase, Glutathione peroxidase and lipid peroxidation activities.

In vitro bioaccessibility of Pb, As, Cd and Hg in five traditional Indian medicine samples was measured as a determinant of bioavailability. The method is based on simulation of human digestion in the passage of material from the gastric to intestinal portions of the gastrointestinal tract. Total concentration and concentration in extracts from gastric and intestinal phases were analyzed for Pb, As and Cd by dynamic reaction cell inductively coupled plasma mass spectrometry (DRC-ICP-MS) and for Hg by direct mercury analyzer (DMA). Total lead ranged from 1.9 to 36000 µg g(-1). In each of the samples bioaccessibility of lead was significantly higher (range 28-88%) in the gastric phase than in the intestinal phase (range 1.4-75.4%). Only Ekangvir Ras had measurable arsenic (304 µg g(-1)). Its bioaccessibility in the gastric phase and intestinal phase was 82.6% and 78.1%, respectively. Only Ayu-Nephro-Tone had measurable cadmium (14.4 µg g(-1)). Its bioaccessibility in the gastric phase and intestinal phase was 80.5% and 2.2%, respectively. Three samples had measurable mercury (range 37 µg g(-1)-10000 µg g(-1)). Mercury in these samples was not bioaccessible. For the samples with measurable amount of metal, the estimated daily amount of bioaccessible (EDAB) metal was calculated. When compared with the most liberal published safety guideline, EDAB-Pb in Mahayograj Guggulu and Ekangvir Ras were 37 and 45 fold greater. When compared with the most conservative published safety guideline, all samples had higher EDAB-Pb or EDAB-As than the suggested limits. The EDAB-Cd and EDAB-Hg were acceptably below published safety limits.

OBJECTIVES: To study the antiglycating, antidiabetic and antioxidant properties of Aegle marmelos Correa leaf extract and identify the bioactive constituent. METHODS: The effect of the chloroform extract of Aegle marmelos Correa was studied in streptozotocin-induced diabetic rats through evaluation of biochemical parameters. Antiglycation activity was assessed in vitro through measurement of total and specific advanced glycation end products, protein carbonyl formation and collagen solubility tests. Antioxidant potential was evaluated using the ferric-reducing antioxidant power assay and 2,2-diphenyl-1-picrylhydrazyl radical (DPPH) assays. Identification of the bioactive component was attempted through silica gel column chromatography and GC-MS analysis. RESULTS: In-vivo studies for 60 days revealed that the extract prevented kidney damage and other secondary complications. The chloroform extract at 16 μg could inhibit protein glycation by 44.33% and pentosidine formation by 59.31%, and could effectively inhibit protein carbonyl formation. It could scavenge DPPH radicals up to 85.26% (IC50: 26 μg). Bio-guided fractionation revealed limonene as the bioactive component, which could account for the antiglycating activity shown by the chloroform extract. CONCLUSION: The chloroform extract of Aegle marmelos demonstrated antidiabetic antiglycating and antioxidant activity, effectively preventing kidney damage and establishment of cataracts. Limonene is reported for the first time as possessing potent antiglycating activity and is non-toxic at the concentration used.

Emerging evidence on molecular biology related to tumors, inflammation, and immunity, highlights their architectural commonality shifting cancer treatment paradigms toward more economical prevention than treatment. Statistical surveys reveal exponentially growing herbal drug supplementation in cancer worldwide as vast pre-clinical and clinical data unravel their multi-mechanistic pharmacology. The integrative oncological approach calls for more "holistic" principles to be amalgamated into cancer care. New cancer drug development from herbs need not be limited by the archetypal 'RCT-Standardization' bottlenecks. Based on comprehensive literature scoping as per Prisma-ScR guidelines, we herein concurrently reviewed evidence-based research reports of selected Indian Traditional Medicine (ITM) herbs of anticancer repute in parallel with their holistic therapeutics; a rationalistic exploration of ITM's scientific genre. Their synergy effect on cancer revisited using a trans-pharmacological approach validates ITM's seemingly simplistic health/disease equation model, showing a fresh new avenue for re-purposing whole herbal drug complexes in cancer management. Herbal drugs as per ITM are natural matrices whose dynamics of interaction in the etiopathology of cancer are conceptually and mechanistically integrative. Lateral perspective to the same as laid out in this review holds the key to their effectual development as more tangible cancer chemopreventives/new drug targets/leads if not as new pharmacological tools.

The Journal of Alternative and Complementary MedicineVol. 26, No. 12 CommentaryFree AccessThe COVID-19 Pandemic and the Relevance of Ayurveda's Whole Systems Approach to Health and Disease ManagementUnnikrishnan Payyappallimana, Kishor Patwardhan, Prasad Mangalath, Christian S. Kessler, Rama Jayasundar, Anupama Kizhakkeveettil, Antonio Morandi, and Rammanohar PuthiyedathUnnikrishnan PayyappallimanaCentre for Local Health Traditions & Policy, University of Transdisciplinary Health Sciences and Technology, Bengaluru, India.Search for more papers by this author, Kishor PatwardhanDepartment of Kriyashareera, Banaras Hindu University, Varanasi, India.Search for more papers by this author, Prasad MangalathDepartment of Shalakya Tantra, Ashtamgam Ayurveda Vidyapeetham, Palakkad, India.Search for more papers by this author, Christian S. KesslerCharité—Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute for Social Medicine, Epidemiology and Health Economics, Berlin, Germany and Immanuel Hospital, Department of Internal and Integrative Medicine, Berlin, Germany.Search for more papers by this author, Rama JayasundarDepartment of Nuclear Magnetic Resonance, All India Institute of Medical Sciences, Delhi, India.Search for more papers by this author, Anupama KizhakkeveettilDepartment of Ayurveda, Southern California University of Health Sciences, Los Angeles, CA, USA.Search for more papers by this author, Antonio MorandiAyurvedic Point, Milan, Italy.Search for more papers by this author, and Rammanohar PuthiyedathAddress correspondence to: Rammanohar Puthiyedath, MD (Ay), Amrita Centre for Advanced Research in Ayurveda, Amrita School of Ayurveda, Amrita Vishwa Vidyapeetham, Vallikkavu, Clappana PO, Amritapuri, Kollam 690525, India E-mail Address: [email protected]Amrita Centre for Advanced Research in Ayurveda, Amrita School of Ayurveda, Amrita Vishwa Vidyapeetham, Kollam, India.Search for more papers by this authorPublished Online:9 Dec 2020https://doi.org/10.1089/acm.2020.0370AboutSectionsPDF/EPUB Permissions & CitationsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookXLinked InRedditEmail The Current Pandemic, the Indian Health System, and the Role of AyurvedaThe COVID-19 pandemic has fuelled global initiatives to develop vaccines and identify pharmacotherapies. The National Institute of Health Clinical Trials website currently lists 3489 clinical trials as of September 30, 2020. According to the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP)1 website, "there is a need to ensure that all inform decisions about the health care of the available evidence." Many drug candidates are being repurposed to manage COVID-19 by expedited observational studies and clinical trials across different populations worldwide, even as the search for vaccines is gathering momentum.2 The urgency of the current pandemic demands immediate and pragmatic clinical responses. A surprising dissonance between conventional medical research and clinical practice can be observed during this pandemic, challenging fundamental assumptions of evidence-based medicine and conventional biomedical practice.3 Might this development lead us to a pier of practice-based evidence (PBE) focusing on patient-centered care on compassionate grounds? Or does the global medical community need to strike a better balance between those two approaches to optimizing therapeutic responses to this pandemic? A recent editorial in PLOS Medicine reads, "It is surely time to turn to a more fit-for-purpose scientific paradigm. Complex adaptive systems theory proposes that precise quantification of particular cause–effect relationships is both impossible (because such relationships are not constant and cannot be meaningfully isolated) and unnecessary (because what matters is what emerges in a particular real-world situation)."4Harnessing medical resources effectively and other safety measures is particularly critical for emerging countries, which are ill-equipped to meet the multifaceted challenges of an escalating pandemic. India is now the second most affected country globally after the United States5 and faces a challenging situation of inadequate medical infrastructures, insufficient health care investments, and social structures.6 The mainstream public health care machinery in India is already overwhelmed in major cities across the country. It has led to various pandemic response guidelines based on local realities in different Indian federal states.7 In such a scenario, it is essential to mobilize all available resources, including traditional medicine systems in India and in all countries with pluralistic health care systems.According to the WHO traditional medicine strategy (2014–2023) midterm review report8 (based on the inputs from 179 countries), 88% of the 194 WHO member states have acknowledged the use of traditional and complementary medicine (which corresponds to 170 member states). However, there appear to be no systematic efforts globally or nationally—except in China9—to explore the potential of traditional and integrative health care practices during the pandemic.10,11 In a recent development, the "Regional Expert Committee on Traditional Medicine for COVID-19 formed by the World Health Organization (WHO), the Africa Centre for Disease Control and Prevention and the African Union Commission for Social Affairs has endorsed a protocol for phase III clinical trials of herbal medicine for COVID-19 as well as a charter and terms of reference for the establishment of a data and safety monitoring board for herbal medicine clinical trials."12The PBE building exercise that has been evoked by the COVID-19 pandemic puts all medical systems—conventional medicine and traditional medicine systems—on more or less level ground. An unprecedented opportunity is emerging for a constructive dialogue between the systems and coevolution and systematic collaboration within a synergistic framework. The PBE and the complexity research approaches, which are primary methods of Ayurveda and other traditional medical systems, need to complement the conventional research.Traditional medicine systems such as Ayurveda have a highly developed theoretical and methodological framework to study new diseases and develop treatment guidelines based on rationale derived from clinical medicine principles and therapeutic experience since millennia. Epidemics have been described at large even in the classic canonical texts of Ayurveda13 and have provided a substantial repertoire of treatment strategies that not only have a long history of safe use but also have proved efficacious in similar pathologies.14,15 The application of systematic protocols to formulate clinical practice guidelines from Ayurveda and their integration into COVID-19 patients' treatment could fill gaps and unmet needs in the official health response systems. The WHO sanctions and lays down the criteria for using interventions not based on robust evidence, described as a "Monitored Emergency Use of Unregistered and Experimental Interventions (MEURI)."16 MEURI has been endorsed by the Indian Council of Medical Research (ICMR) as per the National Guidelines for Ethical Committees for Reviewing Biomedical and Research During the COVID Pandemic,17 which could, in principle, approve such Ayurveda studies with appropriate ethical reviews.Ayurveda-Related Initiatives in IndiaThe National Interdisciplinary Research and Development Task Force for AYUSH research in COVID-19 was constituted in India on April 202018 to streamline AYUSH's COVID-19 response (Ayurveda, Yoga and Naturopathy, Unani, Siddha, and Homoeopathy). The primary rationale was that all AYUSH interventions for COVID-19 should be rigorously built on robust research for which systematic cooperation between AYUSH and biomedical physicians and scientists is necessary. Clinical trials have been initiated to evaluate the efficacy of Asvagandha (Withania somnifera (L.) Dunal) and AYUSH 64 in prophylaxis, Guduci/Pippali (Tinospora cordifolia (Thunb.) Miers/Piper longum L.), and Yashtimadhu (Glycyrrhiza glabra L.) for the management of COVID-19.19 Clinical Trials Registry India lists 107 studies (as on August 20, 2020) on Ayurveda initiated by various institutions using the guidelines issued by the Ministry of AYUSH.20 General clinical practice guidelines have also been formulated.Ayurvedic treatment is generally multimodal in its approach, and treatments are decided based on varying clinical presentations, stages of disease progression, and customized according to the patient's characteristics. An exclusive focus on modern pharmacologic approaches based on evaluating a single molecule's activity on a specific biological mechanism of a disease overlooks such a person-centric multifactorial approach. The whole systems approach and complexity research suited for evaluating Ayurvedic interventions' therapeutic efficacy are currently not well represented in the research protocols recommended to generate evidence for Ayurvedic interventions in COVID-19.A clinical study that had earlier assessed complex Ayurvedic interventions in rheumatoid arthritis had demonstrated that rigorous studies are possible with the classical Ayurvedic approach to treatment.21 Publications that emerged from this study had shown unambiguously that the outcomes of a whole systems intervention show a trend of better efficacy compared with administering single herbs or formulations for management of rheumatoid arthritis.22 Other studies, for example, on osteoarthritis or obesity, have also shown the importance of whole system trials.23,24The flurry of knee jerk claims of efficacy and product-based marketing efforts from various Ayurveda institutions and physicians on popular media has rightly led the Ministry of AYUSH to prohibit anyone from making claims regarding the efficacy without systematic evidence.25 The Ministry of AYUSH released the "Guidelines for Ayurveda Practitioners for COVID-19" with detailed protocols for managing different target groups. However, its implementation has been varied at the state level. Different states in India have taken divergent standpoints regarding Ayurveda practitioners' engagement in providing care for COVID-19 patients. In the absence of unified legislation regarding Ayurveda practitioners' empowerment to offer clinical care to COVID-19 patients, clinicians and patients find it challenging to make the right choices in demanding situations.In some Indian states and specific sublocalities, there are reports of Ayurveda protocol-based interventions being administered for prophylaxis and care of COVID-19.26 The informal reports of these preventative approaches are promising. Such reports point to the importance of Ayurveda's salutogenic vision and its positive contributions to the health and well-being of the population through conscious self-management, leading to healthier families and societies.27 Nevertheless, in the absence of proper documentation and research, one is left with a paucity of rigorous data to draw substantial conclusions.Need for a Whole Medical Systems Approach for AyurvedaAs a primary step, new diseases such as COVID-19 need to be also studied from within Ayurveda's theoretical framework. It has been demonstrated that clinical profiling of COVID-19 from an Ayurvedic perspective is possible.13 Pragmatic treatment protocols have already been suggested,15 and Ayurvedic treatment outcomes in a COVID-19 patient have been published as a case report,28 pointing out the need to consider Ayurveda's holistic approach to offer care for COVID-19 patients. However, clinical exposure to COVID-19 patients is essential for Ayurveda physicians to study and understand the disease. The absence of official access to COVID-19 patients makes it difficult for Ayurvedic physicians to develop a comprehensive treatment strategy based on Ayurvedic principles.With the surge in COVID-19 patients in India, there are increasing number of reports of patients turning to Ayurveda physicians for care. Systematic data relating to the Ayurvedic clinical management of COVID are still in process and not yet available in a format to be presented in a research journal. Longer time is required to generate replicable PBE. Ayurveda researchers and clinicians must publish practice-based data and learn from clinical experiences as case reports and case series. Meanwhile, there is a need for consensus-based flexible best rationale approaches in collaborative clinical care and systematic documentation and publication. The treatment guidelines should be developed based on the disease's clinical profiling from the Ayurvedic perspective and structured on Ayurveda treatment principles (cikitsasutra of Ayurveda).13 A rigorous documentation system for capturing data from the point of care will be of paramount importance in generating PBE regarding the relevance, effectiveness, and safety. As treatment outcome data emerge from the realm of clinical care, research studies based on Ayurveda's whole system approaches could be developed to generate more rigorous evidence.ConclusionIn the wake of an escalating pandemic such as COVID-19, a populous country like India, with >1.3 billion people, cannot afford to wait for lengthy clinical trials to produce evidence to sanction clinical care of patients. In the case of conventional medicine, this inevitable dilemma between medical research and clinical medicine has been resolved by the parallel development of the pragmatic standard of care guidelines for clinical practice while at the same time pursuing rigorous research protocols to generate higher levels of evidence. A similar approach should also be adopted in Ayurveda's case to enable the practitioners to meet challenges when the need arises. This calls for the empowerment of Ayurveda practitioners to offer clinical care for COVID-19 patients to support well-formulated official advisories. The clinical practice guideline should be based on the clinical profile understanding based on the Ayurvedic approach to study a new disease. This guideline should be appraised in the light of the outcomes reported from the point of care that preserves the individualized multimodal approach in Ayurvedic therapeutic interventions. Simultaneously, efforts should be taken to bring the whole systems approach into research methodologies to effectively generate evidence supporting Ayurveda interventions for COVID-19.Author Disclosure StatementNo competing financial interests exist.Funding InformationNo funding was received for this article.References1. WHO. International Clinical Trials Registry Platform (ICTRP). 2020. Online document at: https://www.who.int/ictrp/en/, accessed September 3, 2020. Google Scholar2. Lythgoe MP, Middleton P. Ongoing clinical trials for the management of the COVID-19 pandemic. Trends Pharmacol Sci 2020;41:363–382. Crossref, Medline, Google Scholar3. Zagury-Orly I, Schwartzstein RM. Covid-19—A reminder to reason. N Engl J Med 2020;383:e12. Crossref, Medline, Google Scholar4. Greenhalgh T. Will COVID-19 be evidence-based medicine's nemesis? PLoS Med 2020;17:e1003266. Crossref, Medline, Google Scholar5. WHO. WHO coronavirus disease (COVID-19) dashboard. 2020. 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Acta Pharm Sin B 2020;10:1149–1162. Crossref, Medline, Google Scholar12. Online document at: https://www.afro.who.int/news/expert-panel-endorses-protocol-covid-19-herbal-medicine-clinical-trials, accessed September 30, 2020. Google Scholar13. Puthiyedath R, Kataria S, Payyappallimana U, et al. Ayurvedic clinical profile of COVID-19—A preliminary report. J Ayurveda Integr Med 2020:S0975-9476(20)30039-5. Medline, Google Scholar14. Tillu G, Chaturvedi S, Chopra A, et al. Public health approach of ayurveda and yoga for COVID-19 prophylaxis. J Altern Complement Med 2020;26:360–364. Link, Google Scholar15. Rastogi S, Narayan Pandey D, Singh RH. COVID-19 pandemic: A pragmatic plan for ayurveda intervention. J Ayurveda Integr Med 2020;S0975-9476(20)30019-X. Google Scholar16. WHO. Guidelines for Managing Ethical Issues in Infectious Disease Outbreaks. Geneva: World Health Organization, 2016. Google Scholar17. ICMR. National Guidelines for Ethical Committees for Reviewing Biomedical and Research During the COVID Pandemic. New Delhi: Indian Council of Medical Research, 2020. Google Scholar18. G. Ministry of AYUSH. 2020. Online document at: https://icssr.org/sites/default/files/Notification%20on%20task%20force002.pdf, accessed August 8, 2020. Google Scholar19. G. Ministry of AYUSH. 2020. Online document at: https://pib.gov.in/PressReleasePage.aspx?PRID=1621492, accessed August 8, 2020. Google Scholar20. ICMR. Clinical Trials Registry—India. ICMR National Institute of Medical Statistics, 2020. Online document at: http://ctri.nic.in/Clinicaltrials/advancesearchmain.php, accessed August 20, 2020. Google Scholar21. Furst D, Manorama V, Krishnaswamy BG, et al. A blueprint for placebo-controlled double-blind studies of complex, individualised interventions. Focus Altern Complement Ther 2011;16:49–50. Crossref, Google Scholar22. Furst D, Venkatraman M, McGann M, et al. Double-blind, randomized, controlled, pilot study comparing classic ayurvedic medicine, methotrexate, and their combination in rheumatoid arthritis. J Clin Rheumatol 2011;17:185–192. Crossref, Medline, Google Scholar23. Kessler CS, Dhiman KS, Kumar A, et al. Effectiveness of an Ayurveda treatment approach in knee osteoarthritis—A randomized controlled trial. Osteoarthritis Cartilage 2018;26:620–630. Crossref, Medline, Google Scholar24. Rioux J, Howerter A. Outcomes from a whole-systems ayurvedic medicine and yoga therapy treatment for obesity pilot study. J Altern Complement Med 2019;25(S1):S124–S137. Link, Google Scholar25. G. Ministry of AYUSH. 2020. Online document at: https://www.ayush.gov.in/docs/clinical-protocol-guideline.PDF, accessed August 8, 2020. Google Scholar26. Priya R, Sujatha V. AYUSH for COVID-19: Science or superstition? Indian J Public Health 2020;64:105–107. Crossref, Google Scholar27. Morandi A, Tosto C, Sarsina PR D, et al. Ayurveda, the paradigm for personalized medicine. EPMA J 2011;2:459–465. Crossref, Medline, Google Scholar28. Girija P, Sivan N. Ayurvedic treatment of COVID-19/SARS-CoV-2: A case report. J Ayurveda Integr Med 2020;S0975-9476(20)30042-5. Medline, Google ScholarFiguresReferencesRelatedDetailsCited byQuestioning global health in the times of COVID-19: Re-imagining primary health care through the lens of politics of knowledge21 May 2023 | Humanities and Social Sciences Communications, Vol. 10, No. 1Is reinfection negligible effect in COVID‐19? A mathematical study on the effects of reinfection in COVID‐1914 August 2023 | Mathematical Methods in the Applied Sciences, Vol. 46, No. 18Ayurveda research: Emerging trends and mapping to sustainable development goalsJournal of Ayurveda and Integrative Medicine, Vol. 14, No. 6Machine Learning Based ADMET Prediction in Drug DiscoveryAyurvedic Herbs and Spices: A Promising Approach for the Treatment of COVID-19The Natural Products Journal, Vol. 13, No. 3YUDH: Multi-utility Tool to Reassure Serenity in the COVID-19 Pandemic22 September 2022Altmetric attention analysis of Ayurveda and COVID-19 scholarly publications: A comprehensive review of top 50 high-attention publications12 December 2023 | Journal of Research in Ayurvedic Sciences, Vol. 7, No. 4Graph Convolutional Neural Network-Based Virtual Screening of Phytochemicals and In-Silico Docking Studies of Drug Compounds for HemochromatosisIEEE Access, Vol. 11Safety and efficacy of COROPROTECT kit as an add-on therapy in the management of mild-to-moderate COVID-19: A randomized, placebo-controlled trial21 February 2024 | AYU (An International Quarterly Journal of Research in Ayurveda), Vol. 44, No. 1Scaling of Rapid Tests During Pandemics Using Application: Conceptual Resolving of Irremediable COVID-19 Circumstances—PRATIDHI5 January 2022Alternative Medicine: A Recent Overview27 October 2021A survey among Ayurveda wholesalers and retailers in Pune city for understanding the demand for Ayurvedic medicines during the COVID-19 pandemicJournal of Indian System of Medicine, Vol. 9, No. 3The Relevance of Complementary and Integrative Medicine in the COVID-19 Pandemic: A Qualitative Review of the Literature11 December 2020 | Frontiers in Medicine, Vol. 7 Volume 26Issue 12Dec 2020 InformationCopyright 2020, Mary Ann Liebert, Inc., publishersTo cite this article:Unnikrishnan Payyappallimana, Kishor Patwardhan, Prasad Mangalath, Christian S. Kessler, Rama Jayasundar, Anupama Kizhakkeveettil, Antonio Morandi, and Rammanohar Puthiyedath.The COVID-19 Pandemic and the Relevance of Ayurveda's Whole Systems Approach to Health and Disease Management.The Journal of Alternative and Complementary Medicine.Dec 2020.1089-1092.http://doi.org/10.1089/acm.2020.0370Published in Volume: 26 Issue 12: December 9, 2020Online Ahead of Print:October 27, 2020 TopicsAyurvedaCOVID-19Disease management programsWorld health organization PDF download

The present study aimed to evaluate standardized aqueous Tribulus terristris (nerunjil) extract on the pain threshold response in streptozotocin (STZ)-induced diabetic neuropathic pain model in rats. After a single injection of STZ (40 mg/kg; i.p.), Wistar male rats were tested by the thermal and chemical-induced pain models. Diabetic rats exhibited significant hyperalgesia, and these rats were left untreated for the first four weeks. Thereafter, treatment was initiated and continued up to week-8. All the rats except the vehicle-treated group received insulin 5 IU/kg/day to maintain plasma glucose levels. Treatment with nerunjil (100 and 300 mg/kg; p.o.) for 4 weeks significantly attenuated the nociception in behavioural models. Nerunjil also inhibited the tumour necrosis factor-α and interleukin-1 beta levels. The effect of nerunjil (300 mg/kg) is comparable to the standard drug Pregabalin (100 mg/kg). Nerunjil increased the superoxide dismutase, catalase, glutathione peroxidase, reduced glutathione, and decreased the lipid peroxide levels in dose-dependent manner. Insulin alone-treated rats failed to attenuate hyperalgesic response. In comparison to insulin alone-treated rats, nerunjil exhibited significant increase in the pain threshold response. It could be concluded that in controlled diabetic states, nerunjil attenuated the neuropathic pain through modulation of oxidative stress and inflammatory cytokine release.

Introduction:Andrographis paniculata Nees is an important medicinal plant belongs to the family Acanthaceae. It is being used in traditional medicine, as a remedy for the cold, fever and detoxification of the body since time immemorial. Kalmegh has successfully halted the spread of 1919 Indian Flue (Influenza) pandemic. Drug has immense therapeutic potentials such as immunomodulatory, antibacterial and anti-inflammatory, laxative, depurative, prophylactic, hepatoprotective and cardiovascular effects. Most of the biological actions of Andrographis paniculata have been ascribed to its principal chemical constituent, Andrographolide. Objectives: The present work has been designed to delineate the Pharmacognostic profile of the leaves, stem, and root of Andrographis paniculata Nees. Materials and Methods: Macroscopic, microscopic evaluation, powder analysis, fluorescence standards of the drug and quantitative microscopy were carried out using the stem, root and leaves of Andrographis paniculata Nees Results: The presence of eucamptodromous pinnate venation with small, polygonal shaped areoles, upper epidermis lacking stomata, abaxial diacytic stomata, small palisade ratio, small stomatal index and fairly large Cystoliths in both upper and lower epidermis were features characteristics of the species. Quadrangular stem with dense collenchyma strands at the angles, uniseriate medullary rays with greater quantities of lignified fibers in the wood, abundant deposition of calcium oxalate in characteristic sites of the epidermal tissues of the lamina, ground tissues of petiole, stem, secondary xylem vessels of the root are also diagnostic characters of the taxon. Conclusion: The present study on botanical pharmacognosy of stem, root and leaves of Andrographis paniculata Nees thus provides useful information for quality control parameters for the crude drugs. Macro, microscopic, powder, quantitative and fluorescence standards discussed here can be considered as identifying parameters to substantiate and authenticate the drug. It could also fill the lacuna of our understanding about botanical pharmacognosy of Andrographis paniculata Nees.

Different theories have been proposed to explain hypertension from an Ayurvedic perspective, but there is no consensus amongst the experts. A better understanding of the applied physiology and etio-pathogenesis of hypertension in the light of Ayurvedic principles is being attempted to fill this gap. A detailed review of available Ayurvedic literature was carried out to understand the physiology of blood pressure and etio-pathogenesis of hypertension from the perspective of Ayurveda. Many parallels were drawn from the concepts such as Shad Kriyakala (six stages of Dosha imbalance) and Avarana of Doshas (occlusion in the normal functioning of the Doshas) to the modern pathogenesis of hypertension to gain a deeper understanding of it. Hypertension without specific symptoms in its mild and moderate stages cannot be considered as a disease in Ayurveda. It appears to be an early stage of pathogenesis and a risk factor for development of diseases affecting the heart, brain, kidneys and eyes etc. Improper food habits and modern sedentary lifestyle with or without genetic predisposition provokes and vitiates all the Tridoshas to trigger the pathogenesis of hypertension. It is proposed that hypertension is to be understood as the Prasara-Avastha which means spread of vitiated Doshas from their specific sites, specifically of Vyana Vata, Prana Vata, Sadhaka Pitta and Avalambaka Kapha along with Rakta in their disturbed states. The Avarana (occlusion of normal functioning) of Vata Dosha by Pitta and Kapha can be seen in the Rasa-Rakta Dhathus, which in turn hampers the functioning of the respective Srotas (micro-channels) of circulation.

Amavata is a disease caused due to the vitiation or aggravation of Vayu associated with Ama. Vitiated Vayu circulates the Ama all over the body through Dhamanies, takes shelter in the Shleshma Sthana (Amashaya, Sandhi, etc.), producing symptoms such as stiffness, swelling, and tenderness in small and big joints, making a person lame. The symptoms of Amavata are identical to rheumatism, which include rheumatoid arthritis and rheumatic fever. It is observed that rheumatism is an autoimmune disorder, which is among the collagen disorders having strong and significant parlance with Amavata. Various drug trials were already carried out on Amavata, yet there is a lacuna in the management of Amavata. Hence, in the present clinical study, 28 patients were selected and kept on 'Amrita Ghrita'. All the patients were investigated for complete blood count (CBC), rheumatoid arthritis (RA) titer, Antistreptolysin O (ASO) titer, C-reactive protein (CRP) titer, platelet count, urine routine, and microscopic, before and after treatment. The collected data was distributed according to age, sex, and prakruti, and a t-test was applied for the clinical assessment of the subjective and objective parameters of 'Amrita Ghrita,' and it has shown significant reduction in the positivity of the RA titer (t > 5.09, at the 0.001% level), ASO titer (t > 4.08, at the 0.001% level), and CRP titer (t > 4.82, at the 0.001% level), and weight gain (t > 5.12, at the 0.001% level), as also an increase in Hb% (t >9.22, at the 0.001% level), and platelet count (t> 5.90, at the 0.001% level), and decrease in ESR (t > 9.70, at the 0.001% level).

This work was designed to assess the efficacy of Nasya in reducing the signs and symptoms of cervical spondylosis. The patients attending the O. P. D of Department of Kaya Chikitsa and Panchakarma, Government Ayurveda College Hospital, Thiruvananthapuram were enrolled and subjected to the treatment schedule. Total duration of treatment was 21days. The schedule for the first 14 days was similar in both the groups. It included Rooksha Sveda for 7days followed by Patra Pottali Sveda for 7days. During this period, 90 ml Gandharvahastadi Kashaya twice and Guggulu Tiktaka Kashaya once were given internally. After this, in the Nasya group Nasya was done for 7days with Dhanwantaram Tailam (21times Aavartita), MriduPaka in Madhyama Matra (8Bindu). Along with this Guggulu Tiktaka Kashaya was given thrice. In the control group, Guggulu Tiktaka kashaya alone was given thrice daily. Assessments were done with regard to pain, tenderness, radiation of pain, numbness, range of movements and hand grip strength. These were done before treatment, before nasya, after treatment and after 1month follow-up. The statistical hypothesis was tested using paired 't' test and 'Z' test for proportion. The trial proved that conventional management along with Nasya was more efficacious than conventional management alone in reducing the signs and symptoms of cervical spondylosis.

Anthocyanins (ACNs) have attracted considerable attention for their potential to modulate the immune system. Research has revealed their antioxidant and anti-inflammatory properties, which play a crucial role in immune regulation by influencing key immune cells, such as lymphocytes, macrophages, and dendritic cells. Moreover, ACNs contribute towards maintaining a balance between proinflammatory and anti-inflammatory cytokines, thus promoting immune health. Beyond their direct effects on immune cells, ACNs significantly impact gut health and the microbiota, essential factors in immune regulation. Emerging evidence suggests that they positively influence the composition of the gut microbiome, enhancing their immunomodulatory effects. Furthermore, these compounds synergize with other bioactive substances, such as vitamins and minerals, further enhancing their potential as immune-supporting dietary supplements. However, detailed clinical studies must fully validate these findings and determine safe dosages across varied populations. Incorporating these natural compounds into functional foods or supplements could revolutionize the management of immune-related conditions. Personalized nutrition and healthcare strategies may be developed to enhance overall well-being and immune resilience by fully understanding the mechanisms underlying the actions of their components. Recent advancements in delivery methods have focused on improving the bioavailability and effectiveness of ACNs, providing promising avenues for future applications.

Self-renewal and proliferation of neural progenitor cells occur throughout humans' lives. However, aging, stress, and degenerative diseases can hinder or stop the process. If you can accelerate neurogenesis in adults, this is a promising way to recover from neurodegeneration and cognitive impairments. As the demand for a safer and natural therapeutic product has increased over the past decade, medicinal plants seem to be a viable alternative to synthetic medicines. Since early human civilization, various herbs have been used as medicines and are still a basis for different modern medications. With the advancements in science, researchers can isolate the active compounds in an herb and predict these herbs' line of action when used as a drug. Our current knowledge of medicinal plants with neurological functions is many, but only a few are scientifically validated. A review of the scientific literature explaining plants' bioactive compounds that show neurogenesis was executed. All published data till the year 2021 have been taken to consideration. PubMed, Scopus, ScienceDirect, and Google Scholar directories were used to explore literature published using relevant keywords. Plants like Panax ginseng, Lycium barbarum, Acorus tatarinowii, Curcuma longa, Salvia miltiorrhiza, Centella asiatica, Bacopa monnieri, Ginkgo biloba, Cuscuta japonica, Radix Astragali, Hericium erinaceus and Banisteriopsis caapi have shown to induce neurogenesis. The information on plants compiled in this review pertains to those with a therapeutic value that can be used for drug development to cope with neurodegenerative diseases and memory impairment.

Oroxylum indicum(Linn.) Vent , the plant used in this study is one among the group of ten drugs named Dasamoola, widely used in Ayurvedic system of medicine. The officinal part of this plant, the root bark is often adulterated with the stem of the plant. Hence this comparative study of root and stem of this plant becomes highly significant.The Physico-chemical parameters, Thin Layer Chromatography and High Performance Thin Layer Chromatography studies of stem and root were carried out in this study separately. The TLC studies of three different fractions were isolated - (1) Lipids, fats and waxes (2) Glycosides, Terpenoids and Phenols (3) Alkaloids TLC studies showed that the phytochemicals isolated from root and stem separately are different from each other, thus helping to distinguish the part used.The review of Ayurvedic classical literature also reveals that the therapeutic actions of stem and root are different. The antibacterial activity of alcoholic extracts of stem and root were carried out separately using agar well diffusion method and found that the stem extract has more antibacterial activity especially against organisms causing diarrhea than root extract. This further validates therapeutic indications mentioned in Ayurveda.

BACKGROUND: Osteoarthritis (OA) is the most common joint disorder. In Ayurveda the disease Sandhigata Vata resembles with OA, which is described under Vatavyadhi. Treatment provides symptomatic relief, but the underlying pathology remains unchecked due to the absence of effective drugs. In the management of Sandhigata Vata, all the Acharyas have described the employment of Bahya Snehan, Swedana, Abhyantara Tikta Snehapana, Basti treatment and Guggulu Prayoga. AIM: To evaluate the effect of Ksheerbala Taila Anuvasana Basti in Sandhigata Vata. MATERIALS AND METHODS: In the present study, 30 patients of Sandhigata Vata were given Anuvasana Basti with Ksheerabala Taila. Subjective assessment of pain by visual analog scale and swelling, tenderness, crepitus and walking velocity were graded according to their severity. RESULTS: Significant results (P < 0.05) were found in all the cardinal symptoms - Pain (Sandhiruja), Swelling (Shotha), tenderness, crepitus and walking velocity. Radiological findings showed no significant changes. CONCLUSION: Anuvasana Basti with Ksheerabala Taila was significant in the subjective symptoms of Sandhigata Vata.

Herbal medicines are referred as Herbalism or Botanical Medicine or Phytomedicines. With the increasing use of Herbal Medicines, its marketing and safety has become a major concern for health authorities. The WHO estimates that 4 billion people about 80 % of world population use Herbal Medicines for some kind of primary healthcare The WHO developed a strategy on traditional medicines for the period 2002-2005. One of the major objectives was to promote safety, efficacy and quality of Traditional Medicine. The safety and efficacy of Ayurvedic herbal medicine can be achieved by proper Storage and Handling of herbs for various Ayurvedic Dosage Forms. The storage and handling of raw Ayurvedic Herbal drugs can be improved by emphasizing on good storage house for storage of herbs, packaging of raw herbs, testing of raw herbs as per API format, removal of microbes from raw herbs, processes of sterilization and tips for good storage of herbs etc. The assessment of quality, safety and efficacy of medicinal plants can be established and improved by regulating the storage, packaging and handling of raw herbs for various Ayurvedic herbal drugs which is the most important aspect in this direction. The standardization of storage, packaging and handling of raw herbal drug results in highly safe, effective and quality herbal products which would accelerate the global acceptance of Indian system of Medicine.

BACKGROUND: Environmental exposure to toxicants poses high risk to develop reproductive and developmental chronic toxicity in man. Toluene is one of the commonest industrial agents whose exposure is attributed with potential to induce reproductive and developmental toxicity. Since they contaminate the immediate environment of air and water to which humans are exposed, its containment is of great public health importance. Conventional treatment modalities fail owing to the difficulty to detect these highly volatile agents in environment and human body. The peril of such hazardous exposures is evident only when irreversible structural and functional damages have incurred. In such instances, prevention gains an upper hand when compared to therapeutic interventions. Several natural compounds derived from medicinal herbs possess potential to curb toxicities induced by such xenobiotic agents. Among them Boerhavia diffusa Linn. is a widely distributed and common herb attributed with antitoxic potential and capability for antioxidant defence. A study was performed on the prophylactic efficacy of aqueous extract of B. diffusa in curbing toluene induced developmental toxicity in Drosophila melanogaster. METHODS: of toluene was assessed and a sublethal dose of 200ppm was fixed for the study. Four doses of BDAE; 25, 50, 100 and 200mg/ml designated as Low dose, medium dose 1, medium dose 2 and high dose was used for the study. The parameters used for the study included the determination of larval period, pupal period, percentage of egg hatching, morphometric analysis of egg, larvae, pupae and adults, fertility, fecundity, lifespan and levels of antioxidant enzymes such as catalase, glutathione-S-transferase and superoxide dismutase. RESULTS: of toluene was found to be 430ppm in this study. BDAE at medium dose 2 and high dose significantly prevented the deterioration of reproductive and developmental toxicity parameters of larval period, pupal period, percentage of egg hatching, morphometric characters of larva, pupa and adult, fertility, fecundity and lifespan in drosophila. Also the drug significantly elevated the levels of antioxidant enzymes. CONCLUSION: Toluene exposure during lifetime is inevitable. B. diffusa, equipped with its rich active ingredients prevented toluene induced developmental and reproductive toxicity in Drosophila. This medicinal herb provides a ray of hope in preventing environmental toxin induced reproductive and developmental toxicity.

Ayurveda has a holistic and person-centric approach towards health and disease, which in turn necessitates consideration of several factors in the process of a diagnostic workup. This concept of personalised diagnosis brings about a high level of variability among the clinicians with respect to their assessment methods and disease diagnosis. Developing and validating diagnostic tools for diseases enumerated in the Ayurvedic classical textbooks can help in standardising the clinical approach, even when attempting to arrive at a patient specific diagnosis. However, diagnostic research is a very less explored area in Ayurveda and there are no established standards for developing and evaluating diagnostic tools. This paper reviews the methodology for the development and validation of diagnostic tools, available in published literature and proposes to integrate this in the field of Ayurveda. The search was conducted on online databases including PubMed, Science Direct, Scopus, and Google scholar, with keywords - ayurvedic diagnosis, diagnostic tool development, validity, reliability, and diagnostic test assessment. The articles were screened based on their comprehensiveness, relevance, and feasibility, and the methodology elaborated in the selected articles was organized into a framework that can be adopted in Ayurveda. We have also tried to examine the methodological challenges of integrating the fundamentals of ayurvedic diagnosis within the current methods of diagnostic research and explored possible solutions. The proposed tool development process involves both qualitative and quantitative components, which may be carried out in three phases that include setting the diagnostic criteria, tool development and validation, and diagnostic test assessment.