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   Table of Contents - Current issue
Coverpage
January-March 2021
Volume 15 | Issue 1
Page Nos. 1-72

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EDITORIAL  

National accreditation board for hospitals and healthcare providers accreditation for ayurveda hospitals p. 1
Sanjeev Sharma
DOI:10.4103/joa.joa_64_21  
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PRE - CLINICAL STUDY: ORIGINAL ARTICLE Top

Antipyretic activity of mrityunjaya rasa prepared by various compounds of mercury in experimental animals p. 2
Manoj Kumar Dash, Namrata Joshi, Madhuri Vindhyaraj, Saroj M Parhate
DOI:10.4103/joa.joa_112_20  
Introduction: Mrityunjaya Rasa(MR) is a herbomineral Ayurvedic anti-pyretic formulation containing Shuddha Hingula (Purified Cinnabar), Shuddha Gandhaka (Purified Sulphur), Shuddha Tankana (Purified Borax), Shuddha Vatsanabh (Purified Aconite) Pippali (Piper lonum) and Maricha (Piper nigrum). Objective: The present pharmacological study was undertaken to study the comparative antipyretic activity of different samples of Mrityunjaya Rasa with slight variations in ingredients; Mrityunjaya Rasa 'A' (Hingula based), Mrityunjaya Rasa 'B' (Kajjali based), Mrityunjaya Rasa 'C' (Rasasindura based), Mrityunjaya Rasa 'D' (without metallic content). Material and Method: Pyrexia was induced by subcutaneous injection of 20% wt/v of Brewer's yeast in distilled water (10ml/kg) in 36 animals divided into 6 groups, each group containing 6 animals. Basal rectal temperature was measured before the injection of yeast, and the rise in rectal temperature was recorded after 18 hrs of yeast injection. Group 'A' treated as normal control while group 'B' as standard control (treated with Paracetamol) Group C, D, E, F were drug tested groups. Results: The data generated during all stages of study showed that all samples of Mrityunjaya Rasa (22.5 mg/kg per day) exert highly significant (P<0.001) decrease in temperature after ½ hour and 1 hr of administration except Mrityunjaya Rasa D which was non-significant after 1 hr. Mrityunjaya Rasa 'C' (Rasasindura based), was found to be significant (P<0.05) even after 3 hrs in comparison to standard drug (Paracetamol). Conclusion: The results of present study show the importance of mercury in intensifying the therapeutic efficacy of a formulation. Further, result obtained in Mrityunjaya Rasa containing Rasasindura group explains the importance of concept of gandhakaj jarana in rasashastra.
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CLINICAL STUDIES: ORIGINAL ARTICLES Top

A clinical study to assess the efficacy of satavari yoga in perimenopausal syndrome p. 9
K Rinku Kuwar, Vasudev Anand Rao Chate, Shrivathsa
DOI:10.4103/joa.joa_94_20  
Introduction: In Vedas priority has been given to women in all her walks of life. Women lifespan can be broadly categorized into 3 phases based on the reproductive function i.e. Kanya (stage prior to menopause), Patni or Mata (active reproductive stage) and Vridhavastha (menopausal stage). The Matrutva or Motherhood of women is well appreciated in Bharatvarsh. A mother who cares, protect and bring up a small life into a capable citizen needs the same care and protection in her old age. After 40 years women body undergoes physiological changes. In some women these physiological changes goes without a notice and in some women, it results in the manifestation of group of symptoms i.e. Perimenopausal syndrome which need Medical attention using HRT. Looking at the adverse effect of HRT and lack of scientific evidence to support or refute claims that the commonly used botanical product offer Therapeutic benefit in Perimenopausal syndrome Satavari-yoga was selected for the present study. Aims and Objective: Aim and objective of the study is to assess the efficacy of Satavari choorna in Perimenopausal syndrome. Method: The Present study is a single group, open label, clinical trial with pre-post follow up test design. Totally 36 subjects were diagnosed as Perimenopausal syndrome based on STRAW Scale and MRS (Menopausal rating scale), Subjects were intervened with Satavari yoga (Satavari choorna along with Gruta and Madhu) as mentioned in Kasyapa Samhita for the duration of one month with dose of 4 grams TID before food. Its effectiveness was assessed before treatment (0th day) and after treatment (31st day) and after follow up (61st day) using MRS. Results: The efficacy of Satavari-yoga was assessed based on the parameters provide in MRS. Before the intervention with Satavari yoga, mean was 17.61 and after intervention mean it reduced to 5.28 and After follow up (in absence Satavari-yoga) mean was raised to 10.19. This increasing and reducing of mean was highly significant with p value <0.001. Conclusion: Satavari yoga is highly beneficial in Perimenopausal syndrome.
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A randomized controlled trial to assess the effect of Pathya Ahara in Grahani p. 14
Mamta Saini, Agrawal Sarvesh Kumar, Sharma Kamalesh Kumar
DOI:10.4103/joa.joa_128_20  
Introduction: The disorders of digestion and absorption are broadly covered under the heading of “Grahani roga” in Ayurvedic classics. Grahani is the seat of agni. It retains the food till the food is fully digested and passed to Pakvashaya. Mandagni (weak digestive fire) causes improper digestion of food and leads to Grahani roga. In Grahani roga, mala is released in undigested form. The role of diet and Deepana-Pachana is very important, while treating the patient of the Grahani. Pathya Ahara, Bilva, and Panchakola Churna help to cure Grahani Dosha with considerable health benefits. Objectives: This study was conducted with the objectives to prepare a dietary module for the patients of Grahani and to study the clinical effect of the prescribed diet (Pathya Ahara) in Grahani. Material and Methods: A total of 60 patients of Grahani Dosha of either sex were registered. These patients were divided into two groups by random sampling method in Groups A and B. In Group A, patients were given Bilva and Panchakola Churna without any dietary modification, and patients of Group B were given a diet module to modify their diet along with Bilva and Panchakola Churna. All the patients were evaluated for subjective parameters. Results: Statistical analysis was done after the intervention of therapies for 6 weeks. Group B showed statistically significant results in all signs and symptoms as compared to Group A. Conclusion: Pathya Ahara improves the efficacy of the medicine in Grahani roga without the presence of any adverse effects.
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CLINICAL STUDIES: CASE REPORTS Top

Lower urinary tract symptoms complicated with obstructive uropathy and urosepsis managed through ayurveda p. 19
Nasreen Hanifa Barbhuiya, K Aishwarya, Rahul Sherkhane, Vyasadeva Mahanta, Sanjay Kumar Gupta
DOI:10.4103/joa.joa_19_20  
Introduction: Lower urinary tract symptoms (LUTS) are highly prevalent in men and the incidence increases with aging. The pathophysiology of LUTS is multifactorial and is characterized by voiding and storage symptoms. Acharya Sushruta described 12 types of Mutraghata along with its management in the form of single drug or compound formulations. Clinical Finding & Diagnosis: This is a case of LUTS secondary to benign prostatic hyperplasia; the patient was a known case of urosepsis, obstructive uropathy, and presented with LUTS with a Foley urethral catheter in situ for refractory urinary retention. Interventions: Despite the poor prognosis of the complicated LUTS, conservative treatment was given as per the management principles of urinary disorders in Ayurveda which showed a great potential in the management of complicated LUTS. Conclusion: The bothersome urinary symptoms of the patient were improved along with improvement in the quality of life and better compliance was observed by the patient.
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Ayurvedic management of vitiligo (Shvitra) p. 24
Meenakshi Sharma, Sisir Kumar Mandal
DOI:10.4103/joa.joa_89_20  
Introduction: Vitiligo is a common autoimmune disorder in which the destruction of melanocytes occurs, resulting in the formation of white spots on the skin. It has a major impact on the quality of life of patients, as they feel distressed and stigmatized by their condition. Treatment available in contemporary medicine has its own limitations and side effects. In Ayurveda, Shvitra is the term employed for the hypopigmentation disorders of the skin. Due to the holistic approach, Ayurveda has the vast potential to treat such autoimmune skin diseases. Here, a case study of chronic vitiligo treated successfully with ayurvedic interventions is reported. Main Clinical Finding: There were white patches measuring about 7x5 cm, 4x3 cm, 3x3 cm and 4x2 cm on right and left arm, neck, chest, forehead region respectively. There were multiple small patches on fingers of hand also. The spots and patches were asymmetric, well defined whitish-pink and without scaling and discharge. Diagnosis: The patches were spread on large area (bahala), colour of patches was white/whitish pink (tvaka vaivarnyata), no secretion from lesion (aparisravi) ,with no itching (kandu) and loss of hair (romavidhvamsha) on affected area, so the case was diagnosed as Shvitra kustha on the bases of observed sign and symptoms. Intervention: The management approach was personalized and holistic in nature incorporating Ahara,vihara and Aushadha. In Sanshamana chikitsa Pitta-kapha shamaka and Vyadhi pratyanika line of treatment including internal administration of Khadira sara, decotition of Amla and Udumbara Chhala and Shashilekha Vati with external application of Chakramarda beeja, Muli beeja and Vakuchi beeja lepa was incorporated. Outcome: After 3 months of interventions, skinny spots appeared between the white patches. After six months, patches of chest, neck and forehead almost disappeared and that of arms significantly decreased with no recurrence. No adverse effect was seen during treatment and in follow up period
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A variation: An extra tendon of extensor digitorum in between fourth and fifth digit in left hand p. 30
Rashi Sharma, Sunil Kumar
DOI:10.4103/joa.joa_77_20  
Introduction: Tendon variation of Extensor Digitorum muscle was observed in a 48yr old male formalin fixed cadaver, during the dissection at Anatomy Dissection hall. The tendons of Extensor Digitorum muscle shows anatomical variation most often and its knowledge is important to assess the diseased and traumatized hand. Incidences have shown that tendons of ED may be variably deficient but more often they are doubled or even tripled in one or more digits. The incidences of doubling are higher in index finger or in the middle finger. Very rarely a slip of tendon passes to the thumb. Methods: Regular dissection at Anatomy Dissection Hall. Result & Conclusion: In this present case in left forearm, the origin of muscle was normal but its tendon divides into five proximal to wrist which pass through a common synovial sheath deep to the Extensor Retinaculum. The extra tendon is in between 4th and 5th digit. The right forearm does not show any anatomical variation. This type of variation is rarely found. This particular variation is important for clinical perspective. This case study is useful for surgeons performing Tendon Graft Operations or Tenoplasty.
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SURVEY STUDY: ORIGINAL ARTICLE Top

Study of morbidity pattern of under 5-year children in Jaipur p. 33
Vinay Sharma, Nisha Kumari Ojha
DOI:10.4103/joa.joa_5_20  
Objectives: Early childhood under 5 years of age is a period of life with a high level of morbidity. Respiratory, gastrointestinal, and other infections are the most common morbidities in this age group. The present study aims to find out the morbidity pattern of under-5-year children in Jaipur and estimate the association between and also determine the factors affecting these conditions. Methods: A cross-sectional study was conducted on 1007 under 5-year children based on a duly prepared survey pro forma. Mothers and head of family of children between under5 years of age were enquired about the morbidity in the past 3 months. Results: In the present study, cough (34.4%), fever (27.7%), nutrition anemia (24.8%), malnutrition (22.8%), flu (19.5%), hard stool (18.8%), and diarrhea (11.1%) were common morbidities observed among under-five children. The following variables were significantly associated (P < 0.05) with the variable “morbidity:” age (year), height (cm), head circumference (cm), vaccination scar, duration of breastfeeding, birth order, and poor general hygiene. Conclusion: There was an association between morbidity and age, height, head circumference, vaccination duration of breastfeeding, and poor hygiene and no relationship found between socioeconomic status and other factors such as amenities, education of parents, and family size.
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SURVEY STUDY: REVIEW ARTICLES Top

A critical appraisal of Lakshanadhyaya of Kashyapa Samhita with special reference to pediatric examination p. 41
Sagar M Bhinde, Aniket Shilwant
DOI:10.4103/joa.joa_30_20  
Kashyapa Samhita is the only Ayurveda classical text, which deals exclusively with pediatric anatomy, physiology, pathology, and its management. Out of which, chapter number 28 - Lakshanadhyaya has a detailed description of anatomical and physiological features of the child and correlated it with clinical, professional, social, and spiritual fortunes. But, Lakshanadhyaya is incomplete at the end. Objective: To reveal the clinical importance of features mentioned in Lakshanadhyaya and to provide probable justification for particular future predictions given in Lakshanadhyaya. Data Source: Lakshanadhyaya of Kashyapa Samhita published by Chaukhambha Sanskrit Sansthan, Varanasi. Materials and Methods: Relevant materials were searched from sources such as published books, journals, and the Internet. A critical review was done over the same. Result: Acharya Kashyapa has predicted the quality and quantity of life by assessment of anatomical and physiological features of the child from birth till adolescence. All clinical points such as signs of gestational maturity (by examining the skin, hair, movement, and genitals), anthropometry (size of body parts), secondary sex characters (such as pubic hair, breast, and genitals), and systemic examinations (such as per vaginal, per rectal, musculoskeletal, and per abdomen examinations) are covered in Lakshanadhyaya. Conclusion: This article highlights that time to time examination of a child helps to predict their future life. The abdomen, vagina, nail, scrotum, penis, hair, joints, back, gait, etc., are important areas of examination for early detection of impending clinical manifestation.
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Review on Druti Kalpana with special reference to Gandhaka Druti p. 51
Dev Raj Kshetri, Mohar Pal Meena, Sanjay Kumar
DOI:10.4103/joa.joa_29_20  
Background: Dehavada and Lohavada are the two major aims of Rasashastra. Parada Samskara is essential for both Vada. Many herbs, minerals, instruments, and preparations are needed for processing Parada. Drutis are one of such essential dosage form, along with its therapeutic and other utilities. Druti Kalpana are the processes of converting metals, gemstones and minerals in a liquefied state with the help of Agni samskar and addition of few herbal drugs, Ksharas, etc. Among many Druti Kalpana, Gandhaka Druti is a well-known preparation. Different classical texts have described different methods for preparing it. To ascertain difference between them and to come out with a brief conclusion this review work has been made. Data Source: Classical texts of Rasashastra, various published research works on the topic and valuable dissertations were also referred for this review article. Review Methods: An extensive search of literature was done to collect scattered materials on Druti Kalpana under an umbrella. Advices were taken from the professors of Rasashastra for the review of literature and their correct understanding. Result and Conclusion: Detailed review on Druti and Gandhaka Druti has been made. Comparisions on different methods of Gandhaka Druti preparation and the best method for high yield was found. Depending on the uses Variations in themethod of Gandhaka Druti preparation was found.
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Analytical study of Kala Sharir on the principles of histology p. 55
Gaurav Soni
DOI:10.4103/joa.joa_69_20  
Background: Susrutha Samhita is the earliest treasure of anatomical concepts which illustrates the structures on both gross and microscopic levels. Susrutha has systematically described the process of dissection. This process of dissection gave a glimpse of all the body structures to Susrutha; which he dictated in further chapters of Sharir Sthana (a subunit related, especially with the description of anatomy) and other places wherever required. Several concepts are so unique to Susrutha that he is quoted as it in further hierarchal compendiums. Kala Sharir is one of such topics which despite the fact is being a miniscule structure, is described with supreme authority with location, enumeration, examples, and clinical utility. The exact efficacy of Gyan Chaksu (intellectual visualization) and Upmana Pramana (comparative tools) can be seen in the description of Kala Sharir, which after centuries and series of discoveries of the microscope has got its place in now days world as a separate entity of epithelium/tissue/membrane in histology, a subunit of anatomy. Objective: The objective was to study and analyze the structural entity and utility of Kala Sharir, in the illumination of the knowledge of contemporary histology. Data Source: Kala related literature from classical texts such as Susrutha Samhita, Ashtanga Sangraha, Ashtanga Hridaya, Bhavprakasha, and Sharangdhar Samhita. Histological texts of contemporary anatomy, journals, articles, internet material, and previous research papers related to these subjects. Review Methods: All the literature related to Kala Sharir is reviewed by comparing and analyzing the different meanings and thoughts of classical as well as contemporary authors. A separate analysis of commentaries on classical texts is done for better understanding. Results and Conclusion: The concept of Kala Sharir has here been studied analytically in the radiance of histology to understand its utility in clinics and understanding in contemporary view.
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ANALYTICAL STUDIES: ORIGINAL ARTICLES Top

Nutritional, anti-nutritional evaluation, and element analysis of Trichosanthes lobata Roxb. (Cucurbitaceae) through inductively coupled plasma-mass spectrometry technique p. 61
Aghil Soorya Aravindakshan, Sekar Thangavel
DOI:10.4103/joa.joa_239_20  
Background: The search for a drug from plant source starts with its investigations on primary and preliminary compositions that further lead the research in its right path. Objective: The objective is to investigate the organoleptic, proximate composition and to quantify the mineral, nutritional, and anti-nutritional values of Trichosanthes lobata Roxb. Materials and Methods: Organoleptic, macroscopic, microscopic, physicochemical, proximate, nutritional, anti-nutritional compositions of T. lobata leaves and stem were evaluated using standard methods. Further mineral composition of the species was analyzed using inductively coupled plasma-mass spectrometry technique. Results: The organoleptic, macroscopic, microscopic, physicochemical, and proximate analysis revealed the good quality, purity, and active principles in the T. lobata. All the evaluations concluded that the leaf of the species possess better compositions that the stem. The fair quantity of carbohydrate (27.32 mg GU eq./g), starch (32.44 mg GU eq./g), protein (52.49 mg bovine serum albumin eq./g), amino acid (33.77 mg LE eq./g), Vitamin C (12.68 mg ascorbic acid equivalent eq./g), and Vitamin E (8.21 mg α-TOP eq./g) were seen in leaves. Similarly, minerals such as magnesium, potassium, calcium, sodium, lithium, iron, zinc, aluminum, copper, nickel, and chromium were found in notable quantities in leaves. The anti nutritional analysis of trypsin inhibitors (0.013 TIU/mg), oxalate (0.002%), cyanogen (below detection level (BDL)), and phytic acid (BDL) indicates the low toxicity profile of the species. All the results satisfy the requirements and receive the toxicity boundaries set by the World Health Organization and EFSA. Conclusion: T. lobata leaves possess notable nutritional values.
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Formulation and standardization of Yashtimadhu Kalpa (Granule): A novel Medhya Rasayana p. 68
Mrudul Y Chitrakar
DOI:10.4103/joa.joa_201_20  
Background: Ayurveda, the Indian system of medicine, is the first recorded medical science widely practiced in India since ancient times. As per Ayurveda, the drugs that help to improve and preserve intellect, i.e., Medha are termed as Medhya. Yashtimadhu (Glycyrrhiza glabra Linn.) is one among the four Medhya Rasayana (memory promotive drugs) mentioned by Acharya Charaka. In the present study, an effort was made to prepare palatable and easily administrable formulation of Yashtimadhu Churna as Yashtimadhu Kalpa (granules) and to standardize the same. Materials and Methods: Raw material was procured and preliminary physiochemical analysis was performed. Yashtimadhu coarse powder was taken in the vessel and 16 parts of water were added to it. Yashtimadhu Kwatha was prepared by reducing it to 1/8th and filtered through a cotton cloth. Coarsely powdered Sita twice of Yashtimadhu Kwatha was added in it and heated on mild fire up to100°C. Heating was continued till it attained sticky consistency before the granulation stage. The mixture was taken out of the vessel and dried in a hot air oven. Then, it was sieved in the multi mill to obtain granules. To validate the safety of Yashtimadhu Kalpa (granules) for the internal use, the final product the Yashtimadhu Kalpa was standardized and microbial analysis was done. Results: Granulation was done with the help of a granulation machine, which took 3 h 50 min for granulation; thus, a total of 5 h 50 min were required to obtain a yield of 8.5 kg. The granules of Yashtimadhu Kalpa are solid crystalline free-flowing, cream color and characteristics smell, granules, characteristic sweet, soluble in milk, palatable, and tasty. Conclusion: The novel preparation Yashtimadhu Kalpa (granules) is palatable, tasty, soluble, well preserved, and free from microbes.
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