Background: Kati Sandhigata Vata (lumbar spondylosis) is the most common spinal disorder, which progresses with age. Vitiated Vata gets localized in the lumbar region; later clinically, it presents in the form of lumbar pain, lumbar numbness, lumbar stiffness, and restricted lumbar joint movement). Agnikarma (thermal microcautery) and Raktamokshana (bloodletting) both are noninvasive treatment modalities described in Ayurveda for the management of lumbar spondylosis. To assess the efficacy and to minimize the research gap of validation of traditional modalities, these procedures are being elected for symptomatic management of lumbar spondylosis. A current study is being carried out. Objective: The objective is to evaluate and compare the clinical efficacy of thermal microcautery with Panchadhatu Shalaka (specialized metallic rod made of five metals: copper – 40%, iron – 30%, zinc – 10%, lead – 10%, and tin – 10% and bloodletting with Chinese cups in the management of lumbar spondylosis. Methods: Thirty-two diagnosed patients of lumbar spondylosis were registered and allocated into two groups in 1:1 ratio. In Group A, thermal microcautery was done with specialized metallic rod, while in Group B bloodletting was performed with the help of Chinese cups. Assessment in relief of signs and symptoms was done after completion of therapy and was statistically analyzed. Results: Compared to baseline, both the modalities significantly improved their quality of life as reported after completion of the study on chief complaints and Oswestry Disability Index; however, on comparing effect of therapy on chief complaints, lumbar pain ( P = 0.05), lumbar stiffness ( P = 0.12), lumbar numbness ( P = 0.08), and restricted lumbar joint movement ( P = 0.30), there is a nonsignificant difference noted among them. Conclusion: At the end of the trial, it is observed that both therapies do not have any significant difference statistically; however, clinically thermal microcautery provided better results than bloodletting.

Abstract Outcome of Ayurveda management in Guillain–Barre syndrome (GBS) is studied. A 43-year-old female patient diagnosed with GBS for 10 days approached our hospital. History revealed that the patient was immediately managed in an intensive care unit of a tertiary care hospital for 9 days and was intervened with antibiotics, glucocorticoids, and intravenous immunoglobulins, but the patient’s attenders were not satisfied with the clinical improvements. The patient has a sensory deficit in the whole body below the neck level, loss of power in all extremities, and hypotonia with loss of deep tendon reflexes in all limbs and was diagnosed as Sarvāṅga vāta. Treatment was with panchakarma procedures such as Sarvāṅga alēpa (medicated paste applied to the whole body), Pariṣēka (medicated liquid poured over the whole body), abhyaṅga (therapeutic whole-body massage), Ṣaṣṭika śālī piṇḍa svēda (sudation massage using bolus of boiled rice with balā mūla decoction and milk), Nirūha basti (type of enema therapy), Anuvāsana basti (enema therapy), Grīvā Basti (oil pooling at cervical region of spine), Śirōtalam (medicated paste applied over the scalp), and oral medications. Usually, clinical worsening is observed in the first 2 weeks and then reaches a plateau and recovery might begin. The patient got total relief from the symptoms on the 80th day of the treatment. The patient was observed for the next 175 days. Assessments through the Barthel index, modified Rankin Scale, NIH Stroke Scale, and nerve conduction study showed complete recovery. Ayurveda treatment was effective in total recovery of GBS.

Lumbar disc disease (LDD) is a common cause of chronic or recurrent low back and leg pain most likely to occur at the L4-L5 and L5-S1 levels. The pain may be located in the lower back only or may refer to the leg, buttocks, or hip. There is less improvement with modern medicines and recurrence due to surgical decompression. Various Ayurvedic drugs along with required pañcakarma procedures have been proved useful for these manifestations. We present a case of LDD (kaṭi asthi sandhi gata vᾱta) having acute severe lower back pain above left hip joint radiating towards the left thigh and calf muscle since 14 days. His visual analog scale (VAS) score was 10 when he arrived at the hospital. The case was treated for 3 months with a combination of ᾱyurvedic drugs and pañcakarma procedures. Ayurvedic treatments, in this case, were directed toward alleviating pain and to reduce disability to walk. The patient was considered suffering from kaṭi asthi sandhi gata vᾱta (vᾱtaj disorder involving lumbar region) and was given harītakī cῡrṇa 5 g with lukewarm water on the first night for vᾱtᾱnulomana. ekāṅgavīra rasa, punarnavādi maṇḍūra, rᾱsnᾱsaptaka kvᾱtha, balāriṣṭa, ajamodādi cūrṇa, orally have been given with saindhavādi taila for local application for 3 months. For śodhana cikitsā sarvāṅga abhyaṅga and sarvāṅga patra piṇḍa svedana (PPS), kaṭi basti with pañcaguṇa taila and kᾱla basti (nirῡha with rᾱsnᾱ eraṇḍādi kvᾱtha and anuvᾱsana with dhānvantaraṃ taila) for 16 days is given. Patient's condition was assessed for symptoms of kaṭi asthi sandhi gata vᾱta and VAS scale for pain, Fukushima lumbar spinal stenosis scale-25, and 6 min walking test before and after the treatment which showed substantial improvement. This study shows that the cases of lumbar disc disease which may be successfully managed with ayurvedic treatment.

Overweight and obesity have become major health problems that can lead to or aggravate other medical problems such as Hypertension and Diabetes Mellitus. Hypothyroidism is defined as failure of the thyroid gland to produce sufficient thyroid hormone to meet the metabolic demands of the body. A female patient aged 36 years and was a housewife reported to the Panchakarma O.P.D. of Rishikul campus, Haridwar with complaints of increase in weight, heaviness in the body, pain and stiffness in joints and sore throat with known case of hypothyroidism and was on medication of thyroxine 25μg OD for 2 months. She had earlier taken hormonal therapy (progesterone) for infertility. The patient had undergone Virecana Karma (medicated purgative therapy), in which dīpana–pācana (increasing digestive fire for digesting undigested material) with Pancakola Phāṇṭa, snehapāna (internal oleation) with goghṛta (cow's butter fat), virecana (medicated purgative therapy) with Trivṛt Leham, Kuṭakī, Āragvadha, jaggery and Icchābhedī Rasa followed by anupāna ( drink taken with or after medicine) of Drākṣā was given. After saṃsarjana krama ( a diet regimen after Pancakarma for improving digestion and regaining strength of patient), Ārogyavardhinī Vaṭi was introduced for 7 weeks in a dose of 2 tablets twice in a day (Each tab 250 mg) with lukewarm water. There was marked relief in the symptoms of heaviness, pain, stiffness, weight reduction from 76 kg to 72 kg with significant improvement in TSH level from 7.98 μg/dl to 2.07 μg/dl after completion of saṃsarjana krama (a diet regimen after Pancakarma for improving digestion and regaining strength of patient). 18 days after it, TSH level become 3.83 μg/dl and weight reduced to 70 kg. Again after seven weeks TSH was 2.99 μg/dl and weight was 67 kg. Six weeks after discontinuation of Ārogyavardhinī Vaṭi TSH was 2.32 μg/dl and weight was 67 kg. Virecana (medicated purgative therapy) is effective in management of obesity and Thyroid level.

Background:Over the last century, human life style and food habits have drastically changed which lead to various chronic diseases. Diabetes mellitus is one such disease which is causing serious problems to human health. Allopathic drugs are not much effective in handling the disease and its complications. Hence focus has been turned towards the traditional system of medicine. Medicinal plants play an important role in the management of diabetes mellitus.Methods:Experimental studies conducted on species of Artemisia on diabetic animal models and human published since the year 2000 until April, 2017 were reviewed. Each article was critically appraised by two independent reviewers for their methodological quality using the JBIMAStARI tool.Result:A total of 14 studies were included in this review and the blood glucose data obtained from these critically reviewed studies clearly showed that both the aqueous and alcoholic extracts of species of Artemisia produced significant hypoglycemic effects in alloxan, Streptozotocin and high fat diet induced diabetic animals and diabetic humans with different mechanisms of action as compared to standard antidiabetic medications.Discussion and Conclusion:The antidiabetic effect of single or multiple doses of aqueous and alcoholic extracts of Artemisia species was due to the active compounds of these plants and they all are effective in lessening the blood glucose level in all of those experimental studies. Despite the presence of known antidiabetic medicines in the pharmaceutical market, therapeutic remedies from these medicinal plants have been utilized with success to treat this disorder and its complications with a relatively less side effects.

Background: Anogeissus pendula Edgew has ethnomedicinal importance in various parts of India. It is used in diarrhoea, dysentery, cough, wound healing, burns, skin diseases and gastric disorder. No attempts have been made regarding pharmacognostic investigation of the plant till date. Aim: The present study aimed to perform the pharmacognostic study of leaf and stem bark of Anogeissus pendula Edgew. Settings and Design: The study was designed in accordance with standard procedures. Materials and Methods: Pharmacognostic studies viz. organoleptic, macroscopic, microscopic, physicochemical and chromatographic fingerprinting on fresh and dried plant parts along with the hydroalcoholic extracts were conducted. Results and Conclusions: A. pendula has dorsiventral oblanceolate to obovate leaves arranged in opposite pairs while the stem bark has rough appearance and ash to greyish white in colour. Leaves have anomocytic type of stomata. The characteristic microscopic features of leaves were observed to be epidermal cells, palisade and spongy parenchyma, vascular bundles, xylem and phloem cells. Stem bark microscopy revealed the presence of periderm, secondary cortex and secondary phloem. Chromatographic fingerprinting of extracts showed the presence of flavonoids (Rutin and Quercetin) and they were quantified. Rutin was found to be 6.23% w/w in leaves and 9.97% w/w in stem bark extract while Quercetin to be 27.29% w/w and 51.62% respectively. The present study evaluated various pharmacognostic parameters which will help in quality control (standardization) of A. pendula Edgew in crude form, in herbal formulations and also aid in the preparation of an herbal monograph for the species.

Context: Registration of clinical trials is recommended at or before the first participant enrolment. There is limited data available on the registration of Ayurvedic clinical trials in Clinical Trials Registry of India (CTRI). Aim: The aim of this analysis was to determine the proportion of retrospectively and prospectively registered Ayurvedic clinical trials in CTRI. Methods: This was a cross-sectional analysis of Ayurvedic clinical trials registered in CTRI. List of trials registered in CTRI was accessed from 2012 to 2016 (n= 4713; last accessed on 21 June 2016) and screened to identify Ayurvedic trials. Other AYUSH trials were excluded from the analysis. Following data was collected - registration type (retrospective/prospective), study site (state), postgraduate thesis (yes/no), type of trial (interventional/observational), and study design. Data was summarized using summary statistics. Results: A total of 507 (10.8%) Ayurvedic trials were included in this analysis. The registration of Ayurvedic clinical trials increased from 9.3% (2012) to 19.9% (2016). Of 507 trials, 373 (73.6%) were registered retrospectively and remaining 134 (26.4%) were registered prospectively. A total of 277 trials were part of postgraduate theses (220 retrospective; 57 prospective) and 229 were not (152 retrospective; 77 prospective); 481 trials were interventional (357 retrospective; 124 prospective); 320 were randomized (236 retrospective; 84 prospective). The 507 trials had 686 sites, highest being in Gujarat (38.3%), followed by Maharashtra (19.2%), and Karnataka (10.1%). Conclusions: Results from this study showed that majority of Ayurvedic clinical trials have been registered retrospectively, however there is increase in prospective registration. More than half of the study sites of CTRI registered trials were located in Gujarat, Maharashtra and Karnataka reflecting limited registration in other parts of India.

Background: To establish a marker guided standardization technique to assess whether the marketed concentrated kaṣāyam (decoction) prepared in large scale is providing the same phytochemical values of a Laboratory Reference Standard (LRS) kaṣāyam prepared classically from raw materials of Pharmacopoeial quality. Objectives: Manufacturing and standardization of LRS ' Ciruvilvādi kaṣāyam' , including marker assays and its comparison with four different marketed samples. Materials and Methods: pH, Brix and Total solids of samples were determined and compared. HPTLC profile comparison and quantitative comparison with HPLC were done with Gallic acid and Piperine as standards. Results and Conclusion: Results of Brix and Total solids imply that, the manufacturing process of sample IV was significantly different from other samples and LRS. pH value of sample III showed a significant difference as compared to other samples and LRS, indicating a difference in phytochemical contents. Quantification of Piperine and Gallic acid revealed that sample III has a very low Gallic acid concentration and zero Piperine concentration. Sample IV showed a very high concentration of Gallic acid when compared to other samples and LRS. Sample I, II and IV had piperine content but significantly lower when compared to the LRS. In conclusion, the samples (1-IV) which showed difference with the LRS should be made phytochemically comparable to in-house LRS or Pharmacopoeial standards by adopting the marker assay standardization technique. This method helps to identify and rectify the problems related to raw material, in process and finished product quality control.

The text “Vaidyavallabha” is an authoritative work on Ayurvedic therapeutics written by Hastiruci, a Jain scholar. It belongs to the time period of 1673–1726 CE. Different physical and mental ailments with their treatments are addressed in the 274 verses spanned over eight chapters in this work. In this text many unique, special and simple medicinal preparations for different diseases are given. Many drugs which were easily available in the local area are given much more importance in the treatment. Added to this, method and uniqueness of naming the diseases in the text stand differently when compared to other texts. Even though the text seems to be small, the contribution to the field of Ayurveda practice is priceless.