Journal of Ayurveda and Integrative Medicine最新文献

Background: Obesity is a rising risk factor for various diseases including cardiovascular diseases and Cancer. The limitations of targeted obesity-treatment approaches employed in the clinic presently underscore the importance of developing integrative management strategies for identification of specific biomarkers of obesity.

Objectives: Given the specificity of exosome/extracellular vesicle (EV) biomarkers, we aimed here to identify the EV biomarkers of Ayurveda treatment - Lekhana Basti - for Obesity.

Methodology: A total of eighteen 24-h urine samples from 6 participants with BMI>30 kg/m² were used in this study, collected over 3 time-points during the Lekhana basti (medicated enema for obesity) treatment. Urine EV were isolated using Polyethylene Glycol (PEG). The proteins were resolved by 1-d gel electrophoresis and identified using liquid chromatography coupled with tandem mass spectrometry (LC-MS/MS) and quantified by label-free methods. Significant Protein-Protein Interactions, KEGG pathway analysis and enrichment, functional gene ontology (GO) annotation were identified and shortlisted in comparison to Obesity reference genes from DisGeNET.

Results: With UniProt as a reference subsequent to LC-MS/MS-identification, a total of 210 exosome proteins were identified. Seventy-three proteins were overexpressed in pathway enrichment analysis. Further, GO functional annotation identified 15 common proteins involved. Finally, the 8 hub proteins associated with obesity were identified and their differential expression profile compared between three different time-points during Lekhana Basti treatment. Six protein markers overexpressed during obesity were downregulated post Lekhana Basti treatment, while 2 markers increased in abundance post-treatment.

Conclusion: To our knowledge, this is the first study to isolate and identify urine EV protein abundance profiles from obese female participants of India. The study results indicate significant changes in the differential expression profile of 8 hub proteins involved in obesity, after Lekhana Basti treatment. The biomarker signature of the pilot study indicates the role of Ayurveda treatment and the possible pathways involved in the treatment of Obesity. Further, this study underlines the specificity of urine exosomes/EV as diagnostic markers as well as the potential of Ayurveda treatment in effective management of obesity.

Background: Triple-negative breast cancer (TNBC) is a subtype of breast cancer clinically defined as lacking expression of Estrogen receptor (ER), Progesterone receptor (PR), and Human Epidermal growth factor Receptor (HER2). Psychological distress is a major risk factor of TNBC, patients diagnosed with TNBC are under tremendous stress due to the aggressive nature of the disease. Stress hormones decrease the efficacy of therapeutics. These facts underscore the need for mind relaxation treatment for TNBC patients.

Objectives: To find out the anti-anxiety activity of the Jatamansi Taila in TNBC patients.

Material and methods: This was a two-arm, open-labelled, parallel, prospective controlled clinical study, conducted on 70 patients of TNBC in the age group of 20-70 years who have completed conventional therapy and opted for Ayurvedic Treatment. Patients were divided into 2 groups. Thirty-five patients in Group A were treated with Oral Ayurvedic Medicines (Shamana Chikitsa) and Jatamansi Taila Shirodhara; whereas 35 patients in Group B were treated with only Oral Ayurvedic Medicines.

Results: Jatamansi Taila Shirodhara was found to be effective in relieving symptoms of Anxiety and Psychological distress (Chittodvega) immediately after the procedure, viz. sleep disturbance, difficulty in concentration, and fearfulness. Jatamansi Taila Shirodhara was found to be highly effective in improving Quality of Life (QoL), especially in improving functional ability, well-being and reducing symptomatology related to breast cancer, measured by scores of QLQ C30 and symptom score of QLQ BR23.

Conclusion: This study emphasizes the role of Jatamansi Taila Shirodhara therapy for mind and body relaxation in psychological distress seen in breast cancer especially, in TNBC patients.

Introduction: Male breast cancer (MBC) is an uncommon malignancy. In spite of conventional Allopathic treatment, long-term disease-free survival (DFS) of more than 10 years in MBC is rare, due to its aggressive nature.

Case presentation: We report a case of 56 years old, stage IIB and grade III invasive ductal cell carcinoma MBC (Lt) patient, operated for left modified radical mastectomy with axillary clearance followed by six cycles of chemotherapy during October 2010-January 2011. Patient was on hormonal treatment from March 2011 till May 2021. He opted for adjunct Ayurvedic treatment throughout the conventional treatments for the period of 10 years. Ayurvedic treatment in the form of treatment for pacifying imbalanced humors (Doshas) and disease (Shamana chikitsa) and treatment for immunomodulation (Rasayana Chikitsa); and periodic detoxifying treatment (Panchakarma Chikitsa) was given in this patient. He was also advised healthy diet and lifestyle at our center. The treatment chosen was mainly to reduce side effects of chemotherapy like anorexia, nausea, vomiting, constipation, diarrhoea, taste disturbance, mucositis, fatigue and fever. It also helped in improving quality of life and increasing DFS.

Conclusion: The long DFS of 10 years and 3 months with good Quality of Life and minimal side effects of conventional cancer therapy could be ascribed to the adjunct Ayurvedic treatment given to this patient. We have to observe the benefits in more number of patients in future to define usefulness of this treatment modality.

Surgery is the branch of medicine which involves correction of the diseases by means of interventions and by means of various instruments and methods. Surgery in latin is called as Chirugi and in the Indian context it is termed as 'Shalyatantra'. Surgery is the science as well as the tantra or technology. Ayurveda itself believes that, it is the technology by applying the word tantra to it. Shalyatantra is not only the technology, but it is the science with firm foundations; and the procedures or interventions involve the art within it. The philosophical insights from various Darshanas contributed to the derivation of foundational principles. The expert of surgery is called as 'Surgeon' and termed as 'Shalyatantragya' by Ayurveda. A surgeon has to master not only the science and art of surgical procedure; but also the philosophy, technology alongwith the details of medicines and drugs formulations. The procedures in surgery are the techniques, which have to be mastered by means of practice and by performing multiple operations. But this is not enough to become a good surgeon. The essential conditions for the expertise in surgery are, to master upon the surgical science and philosophy and to get acquainted with the advanced technologies also. In this particular article, the interconnections among surgical science, art, philosophy and technology and their applications are being discussed with special emphasis upon the ancient text of Sushruta, that is, Sushruta Samhita. Also it has been tried to critically analyse how the guiding principles from ancient Shalyatantra of Sushruta can be contributory to the surgery of the current medical practice.

Pilonidal sinus (PNS) is a nest of hair which typically presents as pits, pus discharge, and an abscess at the natal cleft region. In rare conditions where pilonidal abscess is not drained properly, it progresses posteriorly and reaches anal canal, eventually coexisting with anal fistula. Both are associated with a high recurrence rate despite surgical management. A 27 year old female patient presented with complaints of non-healing wound in the natal cleft region and pus discharge from wound for 2 months with a past surgical history for PNS. On local examination, a wound was seen at the natal cleft, secondary pit 3cm away with scar mark of the previous operation, and a digital rectal examination (DRE) revealed an internal opening at 6 o'clock position that was communicating with the previously operated PNS wound. The patient was diagnosed as a case of coexisting anal fistula and recurrent PNS. Patient was managed under spinal anaesthesia with interception of fistulous tract using Ksharasutra (Medicated alkaline thread), followed by Minimal Invasive Kshara Karma Technique (MIKKT) for PNS. Ksharasutra was sloughed out after the fifth week, and complete wound healing of PNS was achieved in six weeks. By interception of the fistulous tract, the length of the tract was reduced, which facilitated early wound healing and minimal scar mark formation. MIKKT also prevented bigger excision and wound formation, eventually reducing complete healing duration, and Kshara(a medicated alkali) applied caused chemical cauterization and hence prevented recurrence of pilonidal sinus.

Background: Terminalia catappa is an important medicinal plant. Plants from the genus Terminalia have been reported for antidiabetic effects.

Objective: To study effect of Terminalia catappa leaves aqueous extract in type 2 diabetic rats.

Materials and methods: High-fat diet (HFD) and a low dose of streptozotocin (35 mg/kg, i.p.) were used for inducing type 2 diabetes in rats; streptozotocin was injected after two weeks of dietary modification with HFD. HFD was continued throughout the study. Doses of 500 and 1000 mg/kg of aqueous extract of Terminalia catappa were used as a treatment for six weeks. At the end of the study, biochemical and oxidative stress parameters were estimated. Histopathology and immunohistochemistry of pancreatic tissue were performed.

Results: Significant decrease (p < 0.01, p < 0.001) was observed in glucose levels of diabetic animals treated with T. catappa extract at both dose levels when compared with diabetic control group. Treatment with aqueous extract reduced cholesterol levels significantly (p < 0.05). After receiving 1000 mg/kg of extract, the triglyceride level was significantly lowered (p < 0.01) in the diabetic rats. Extract treatment enhanced the insulin sensitivity index (ISI), while insulin levels and HOMA-IR were markedly reduced. Treatment with 1000 mg/kg of extract significantly enhanced the levels of GSH and catalase. Histopathological analysis of the pancreas showed that damage caused by hyperglycemia was prevented in the extract-treated groups. Pancreatic tissue showed an increased expression of SIRT1 in extract-treated animals.

Conclusion: The current study's findings prove that the extract has remarkable antidiabetic effects.

Background: Link Samahan® (LS), a product of Link Natural Products (Pvt) Limited, Sri Lanka contains extracts of 14 medicinal plants. It is used as a prophylactic against cold and cold related symptoms. It has immunomodulatory activity, specifically enhancing the humoral immune response.

Objective: To investigate the anti-inflammatory activity (AIA) of LS and related mechanisms.

Materials and methods: In vivo AIA was assessed by the inhibition of carrageenan-induced rat paw-edema. Mechanisms of AIA were assessed in vitro by the inhibition of reactive oxygen species (ROS) and reactive nitrogen species (RNS) production and expression of inducible nitric oxide synthase (iNOS) gene using rat peritoneal cells.

Results: LS showed an increasing inhibition in rat paw-edema up to 5 h compared to the biphasic pattern exhibited by the reference drug, Indomethacin. Inhibition by LS at the 1^st and 3^rd-5^th hours (44.7% and 73.0-74.6%) was comparable to indomethacin (47.4% and 83.6-76.5%; p > 0.05) whereas at the 2^nd hour, LS exhibited a significantly higher inhibition compared to indomethacin (66.7% vs 28.6%; p < 0.05). LS treatment significantly inhibited the ROS (superoxide; 47.2 ± 0.86%; p < 0.05) and RNS (nitrite; 54.0 ± 0.40%; p < 0.05) production in rat peritoneal cells. Further, specific inhibition of iNOS gene expression in rat peritoneal cells resulted in a significant reduction in RNS production whereas LS had lesser or no inhibitory effect on endothelial NOS and neuronal NOS gene expression.

Conclusion: LS has potent anti-inflammatory activity and selective inhibition of iNOS activity. AIA of LS shown here supports its use as a prophylactic against cold and cold related symptoms.

Background: Potentilla fulgens (Wall.) ex Hook. (Rosaceae), commonly known as 'Bajradanti' is native to the lower Himalayan regions inclusive of the North-East India. Traditionally, the plant is used to treat chronic ailments like diabetes and diverse wounds, including gastric and mouth ulcers, and injuries from tiger bites.

Objective: This study aims to assess the efficacy of P. fulgens root extract rich in polyphenolics in healing diabetic foot ulcer (DFU) in rats.

Methods: DFU was induced in streptozotocin-nicotinamide diabetic rat feet by open excision wound model. Rats were divided into eight groups (n = 6/group): normal, negative control, plain gel (placebo) control, 1% silver sulfadiazine, and P. fulgens treated with topical ethyl acetate (EAPF, 5% and 10%) and methanol extract (MEPF, 5% and 10%). The morphological, histological and various biochemical parameters associated with the wound healing process such as connective tissue repair and oxidative stress biomarkers were evaluated.

Results: Topical application of EAPF 10% and MEPF 10% over 21 days significantly (p < 0.05) reduced ulcer area in DFU rats compared to negative control. Furthermore, the extracts treated group notably (p < 0.05) increased levels of connective tissue biomarkers (total protein, hydroxyproline, hexosamine, and hexuronic acid) and antioxidant components (SOD and GSH), while significantly (p < 0.05) decreasing levels of lipid peroxidation (LPO) in foot tissue homogenate. Histological analysis of rats treated with the extracts revealed significant evidence of tissue repair, characterised by enhanced epithelial and collagen formation, along with decreased polymorphonuclear infiltration and edema.

Conclusion: In summary, treatment with EAPF 10% significantly improved foot ulcers by modulating oxidative stress and connective tissue biomarkers in DFU animals.

Psoriasis is a chronic systemic inflammatory skin disorder prevailing in 2%-3% individuals worldwide. Yet no permanent management has been established. Metabolic burdens and comorbidities have been found to be associated with Psoriasis, which make it more critical. The classical management of the disease in Ayurveda includes Vamana Karma (therapeutic emesis) and Virechana Karma (therapeutic purgation). This is a distinct case where a 52-year-old patient, suffering from Chronic Plaque Psoriasis (CPP), unfit for Vamana Karma was treated by VirechanaKarma only. The patient had suffered from Psoriasis since last 14 years and was present with symptoms of scaly lesions and intense itching. The patient was admitted in the IPD and planned for Virechana Karma. After Shodhana, Rasamanikya-125 mg, Vidanga Choorna 2 gm, Kaishora Guggulu-1000 mg, Kamdudha Rasa 250 mg, Khadirarishta-20 ml, and Punarnavadi Kwatha 40 ml, twice a day was advised with daily 3 times local application of Bruhad Marichyadi Taila as regular medication. The assessment was done by Psoriasis Area Severity Index (PASI) score, Dermatology Life Quality Index (DLQI) score and Numerical Rating Scale (NRS) for itching. The initial PASI, DLQI and NRS scores were 20.6, 18, and 8 respectively which was evaluated to be, 5.8, 4 and 2 respectively in the latest follow-up. This case study demonstrates that Virechana alone may also manage CPP.

Prolapsed intervertebral disc (PIVD) can lead to debilitating pain and functional limitations. While surgical interventions like Transforaminal Lumbar Interbody Fusion (TLIF) are often employed, recurrence of symptoms is not uncommon. This case report presents the successful Ayurvedic management of a 45-year-old female who developed recurrent lumbar radiculopathy six months after TLIF for PIVD. The patient presented with severe lumbar pain, disability, and bilateral leg discomfort. Diagnosed with "Prushthagraha" according to Ayurvedic principles, she underwent a 43-day treatment regimen. This included Ayurvedic medications and an initial eight-day course of Sarvanga Abhyanga-Mardana (therapeutic massage) and Swedana (sudation therapy). Post-treatment, the patient demonstrated significant clinical improvement, evidenced by a substantial reduction in Oswestry Disability Index (ODI) and Visual Analogue Scale (VAS) scores for both lumbar and leg pain. Furthermore, her walking distance increased from 80 m to 1000 m. This case highlights the potential of Ayurvedic interventions as a complementary approach for managing recurrent lumbar radiculopathy following surgical intervention for PIVD. However, further research with larger sample sizes and controlled study designs is warranted to validate these findings.