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   Table of Contents - Current issue
Coverpage
April-June 2015
Volume 34 | Issue 4
Page Nos. 185-246

Online since Wednesday, July 15, 2015

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EDITORIAL  

Backing up Ayurveda with good science: The modus operandi p. 185
P Ram Manohar
DOI:10.4103/0257-7941.160861  
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REVIEW ARTICLE Top

Śodhana: An Ayurvedic process for detoxification and modification of therapeutic activities of poisonous medicinal plants p. 188
Santosh Kumar Maurya, Ankit Seth, Damiki Laloo, Narendra Kumar Singh, Dev Nath Singh Gautam, Anil Kumar Singh
DOI:10.4103/0257-7941.160862  
Ayurveda involves the use of drugs obtained from plants, animals, and mineral origin. All the three sources of drugs can be divided under poisonous and nonpoisonous category. There are various crude drugs, which generally possess unwanted impurities and toxic substances, which can lead to harmful health problems. Many authors have reported that not all medicinal plants are safe to use since they can bear many toxic and harmful phytoconstituents in them. Śodhana (detoxification/purification) is the process, which involves the conversion of any poisonous drug into beneficial, nonpoisonous/nontoxic ones. Vatsanābha (Aconitum species), Semecarpus anacardium, Strychnos nux-vomica, Acorus calamus, Abrus precatorius etc., are some of the interesting examples of toxic plants, which are still used in the Indian system of medicine. Aconite, bhilawanols, strychnine, β-asarone, abrin are some of the toxic components present in these plants and are relatively toxic in nature. Śodhana process involves the purification as well as reduction in the levels of toxic principles which sometimes results in an enhanced therapeutic efficacy. The present review is designed to extensively discuss and understand the scientific basis of the alternative use of toxic plants as a medicine after their purification process.
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ORIGINAL ARTICLES Top

Hepatoprotective and antioxidant activity of Karisalai Karpam, a polyherbal Siddha formulation against acetaminophen-induced hepatic damage in rats p. 198
Saikat Sen, Raja Chakraborty, Ganesh Thangavel, Sivakumar Logaiyan
DOI:10.4103/0257-7941.160863  
Background: The usage of Siddha medicine in Tamil Nadu and several parts of Southern India has considerably increased over the past two decades and it is steadily crossing the various geographies owing to its inexpensiveness compared to conventional medicines and has fairly high acceptance rates because of its herbal origin and therefore its nontoxic nature. Aim: This study aims to investigate the anti-hepatotoxic and antioxidant potential of the Karisalai Karpam formulation. Materials and Methods: Karisalai Karpam tablet at 50, 100, and 200 mg/kg/day, p.o. doses were administered orally to rats for three consecutive days. Single dose of acetaminophen (3 g/kg, p.o.) was administered on the 3 rd day. Animals were sacrificed 48 h after the administration of acetaminophen, and their serum bilirubin, different hepatic enzymes and in vivo antioxidant activity were estimated. Statistical Analysis: Data were evaluated using analysis of variance, followed by Tukey tests. A level of P < 0.05 was considered statistically significant. Results: Pretreatment with Karisalai Karpam tablet showed dose-dependent hepatoprotective activity. Karisalai Karpam tablet (200 mg/kg) reduces serum glutamic oxaloacetate transaminase, serum glutamic pyruvic transaminase, alkaline phosphatase and total bilirubin, direct bilirubin by 67.8%, 72.3%, 47.6%, 61.3% and 62.9% respectively compared to disease control group. A significant increase (P < 0.001) in antioxidant enzyme level was observed in Karisalai Karpam treated animals. At higher doses, Karisalai Karpam prevented the depletion of glutathione in liver tissue. Conclusion: Results confirmed that Karisalai Karpam tablet could protect the liver against acetaminophen-induced oxidative damage possibly by increasing the antioxidant defence mechanism in rats.
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Formation and validation of questionnaire to assess Jāṭharāgni p. 203
HT Eswaran, MB Kavita, TB Tripaty, Shivakumar
DOI:10.4103/0257-7941.159829  
Background: Jāṭharāgni (metabolic fire) is of the prime importance in the maintenance of health as well as causation of diseases. Food which is consumed by the person shares the major responsibility for being healthy or manifestation of diseases. The relation between food and health is mediated by Jāṭharāgni (the metabolic agent in Ayurveda). There are four different states of Jāṭharāgni viz, Mandāgni (mild or weak state of metabolic fire), Viṣamāgni (irregular state of metabolic fire), Tīkṣnāgni (sharp or intense state of metabolic fire), and Samāgni (Normal state of metabolic fire). Samāgni (Normal state of metabolic fire) is said to be the normal State and maintains the health of an individual. All the other states are considered as abnormal. Objectives: To frame and validate a Questionnaire to assess the state of Jāṭharāgni. Materials and Methods: A qualitative research that involved interview method and cluster sampling method. A total of 500 volunteers of either gender in two groups viz., apparently healthy and unhealthy were assessed for their Jāṭharāgni. Questionnaire was framed with 64 items. A total of 14 questions under Viṣamāgni (irregular state of metabolic fire), 13 under Tīkshṇāgni, 13 under Mandāgni and 24 questions under Samāgni were framed. The questionnaire was in optional format with 5 item likert's scale pattern and the validation was done by Cronbach's Alpha for internal consistency. Result: The internal consistency of the questionnaire using Cronbach's Alpha was 0.916. The internal consistency of Viṣamāgni domain was 0.909; Teekshnagni domain was 0.873; Mandāgni domain was 0.894; and Samāgni domain was 0.876. Conclusion: The internal consistency of the questionnaire was 0.909 which is indicative of the excellent internal consistency of questionnaire. The lacuna of tool to assess state of Jāṭharāgni in Ayurveda is filled by this questionnaire.
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Evaluation of prakṛti and quality-of-life in patients with irritable bowel syndrome p. 210
Sudatta G Shirolkar, Raakhi K Tripathi, Nirmala N Rege
DOI:10.4103/0257-7941.160865  
Objective: To evaluate the prakṛti of irritable bowel syndrome (IBS) patients and its association with IBS subtypes and quality-of-life (QOL). Methodology: IBS patients with the consistent subtype in the last 6 months were recruited. Prakṛti assessment with a 24-item questionnaire was performed and depending on the scores the patients were categorized into vāta predominant, pitta predominant, and kapha predominant prakṛti. QOL was assessed with prevalidated disease-specific 34-item questionnaire scored on a 0-100 scale. Results: Of 50 IBS patients enrolled, with mean age of 43.5 ± 12.8 years, and male: female as 43:7, 22 patients were of vāta and pitta predominant prakṛti each while six patients had kapha predominant prakṛti. IBS-C was diagnosed in 24 patients, IBS-D in 21, and IBS-M in five patients. In vāta predominant group, IBS-C was found in 13 patients, IBS-D in 8, and IBS-M in 1. In pitta predominant group, IBS-D was found in 13, IBS-C in 6, and IBS-M in 3. In kapha predominant group, IBS-C was found in 5 patients and IBS-M in 1. The median QOL in IBS-C group was 48.897, IBS-D was 38.97, and IBS-M was 66.911. The median QOL score 52.205, 42.27, and 55.51 in vāta, pitta, and kapha predominant group, respectively. Conclusion: Majority of the vāta predominant patients had developed IBS-C, pitta predominant patients had developed IBS-D. QOL was better in pitta predominant individuals of all IBS-disease subtypes. With this, we find that prakṛti examination in IBS helps in detecting the proneness of developing an IBS subtype and predicting their QOL accordingly.
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Efficacy of herbomineral compounds and pathya (Ayurvedic dietary regime and physical exercise) in the management of Yakṛt Roga (Non-alcoholic fatty liver disease) p. 216
Pragya Singhal, Tanuja Nesari, Girja Shankar Gupta
DOI:10.4103/0257-7941.160866  
Background: Nonalcoholic fatty liver disease (NAFLD) also called as hepatic steatosis is a manifestation of excessive triglyceride accumulation in the liver. NAFLD has been described by histological features ranging from simple fatty liver, nonalcoholic steatohepatitis, progressive fibrosis, and liver failure. Objective: The objective was to evaluate the effect of herbomineral drugs and pathya0 (Ayurvedic dietary regime and physical exercise) in the management of NAFLD. Materials and Methods: It is a randomized, retrospective, open-ended study. A total of 32 patients presenting with raised alanine transaminase (>1.5 times normal levels) combined with sonological evidence of fatty liver in the absence of any other detectable cause of liver disease were included in the study. The recruited patients were randomly divided into two groups - The patients in Group-A (n = 21) were given a combination of herbomineral drugs Ārogyavardhinī vaṭi and Triphalā Guggulu along with prescription of pathya (Ayurvedic dietary regime and physical exercise); the patients in Group-B ( n = 11) were advised only pathya. Results: Group-A (combined therapy group) showed statistically significant improvement in clinical symptoms, biochemical parameters-liver function test, lipid profile, fasting blood sugar, and body mass index (P < 0.001) in comparison to Group-B (pathya group). Conclusion: Combination of herbomineral drugs along with pathya has shown promising results toward the effective management of this metabolic disorder.
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Pharmacognostical evaluation of aerial parts of Graptophyllum pictum (L.) Griff. (Syn: Justicia picta Linn.): A well-known folklore medicinal plant p. 223
Pradeep Singh, Ratan L Khosa, Garima Mishra, Keshri K Jha
DOI:10.4103/0257-7941.160868  
Objective: Graptophyllum pictum (L.) Griff. (Family-Acanthaceae) occupies a key role in traditional system of medicine. Since an extensive literature survey did not provide any information about studies on its standardization. Therefore, we designed the current study to establish the quality control parameters of G. pictum aerial parts. Materials and Methods: The investigation included determination of various standardization parameters such as macroscopic and microscopic studies, physicochemical parameters as well as phytochemical analysis of the crude drug. Results: The microscopy study of aerial parts revealed that stem shows typical dicotyledonous characters with prismatic crystals of calcium oxalate in the cortical region and dorsiventral leaf. Physicochemical constants such as moisture content, ash values, fluorescence analysis, and extractive values were established. Preliminary phytochemical analysis confirmed the presence of alkaloids, flavonoids, saponins, tannins, etc. Conclusion: The present study suggests establishing the parameters for pharmacopoeial standardization of G. pictum.
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CASE REPORT Top

Ayurvedic approach in the management of spinal cord injury: A case study p. 230
Sarvesh Kumar Singh, Kshipra Rajoria
DOI:10.4103/0257-7941.160870  
Spinal cord injury (SCI) is associated with consequences such as full loss of spinal movements, incontinence of bladder functions, bed sores, etc. There is no satisfactory treatment available in biomedicine with only limited treatments only for enhancement of spinal cord function. These treatments have many limitations. Ayurvedic drugs and Pancakarma procedures have been in use to treat such conditions since a long time. We present a case of SCI with lesion at C4 level which was treated for 2 months with an Ayurvedic combined intervention. The combined treatment plan involved Ayurvedic oral medications (Brhadvātacintāmaṇi rasa - 125 mg, Ardhanāgavātāri rasa - 125 mg, Daśamūla kvātha - 40 ml, Aśvagandhācūrṇa [powder of Withania somnifera DUNAL] - 3 g, Amṛtā [Tinospora cordifolia WILLD] - 500 mg, Muktāśukti piṣṭi - 500 mg and Trayodaśāṅga guggulu - 500 mg) twice daily. Combined procedures involved such as śāliṣaṣṭika piṇḍasvedana (sudation with medicated cooked bolus of rice) every day for 2 months and Mātrā basti (enema) for first 15 days with Aśvagandhā oil. From 16 th day, Mustādi yāpana basti (MYB, enema with medicated milk) was given for 16 days. After an interval of 7 days, MYB was further repeated for next 16 days. Substantial clinical improvement was reported after 2 months of the Ayurvedic treatment in existing neurological deficits and in quality of life.
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CONVERSATION Top

A Conversation with Dr. (Med.) Valdis Pirags, Head of Internal Medicine Department, Paula Stradiņa Klīniskā Universitātes Slimnīca, Riga, Latvia p. 235
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CONFERENCE REPORT Top

The First International Research Seminar on Ayurveda (2014), Birstein, Germany p. 238
Antonio Morandi
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BOOK REVIEW Top

Consultations in Ayurvedic dermatology p. 245
Sandeep V Binorkar
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