<div><h3>Background</h3><p>Phytochemicals and their derivatives are promising target drugs for various ailments and have served as therapeutic agents for several decades. Using <em>in vivo</em> and <em>in vitro</em> models and molecular docking, this study investigated the pharmacological potential of a flavonoid-rich fraction of the ethanolic extract of <em>Sesbania grandiflora</em> (SG).</p></div><div><h3>Objectives</h3><p>This research aimed to determine whether flavonoid-rich whole-plant extracts of SGs have any cytoprotective or <em>in vivo</em> hepatoprotective effects. Additionally, the study was intended to elucidate the molecular connections between the discovered flavonoid flavonols and PPARα target proteins linked to liver problems, for which an in silico molecular docking investigation was performed.</p></div><div><h3>Materials and methods</h3><p>To separate the flavonoid components, the entire <em>Sesbania grandiflora</em> plant was first extracted using ethanol as a solvent by soxhlet extraction. The resulting ethanolic extract was then fractionated. The cytoprotective and hepatoprotective properties were evaluated via <em>in vitro</em> and <em>in vivo</em> experiments. SGOT, SGPT, triglyceride, bilirubin, and total protein levels were used to evaluate hepatotoxicity in animal models. <em>In vitro</em> studies on Hepatocellular Carcinoma G2 (HepG2) cell lines have examined their cytotoxic effects and antioxidant activity. The most promising flavonoid-flavanol compounds were identified by conducting molecular docking studies against PPARα target protein (PDB ID: <span><span>3VI8</span><svg><path></path></svg></span>) using MOE software.</p></div><div><h3>Results</h3><p><em>In vivo</em>, the serum levels of SGOT, SGPT, total triglyceride and total bilirubin were measured in experimental animals treated with the flavonoid-rich ethanolic extract of SG. Significant reductions in the levels of these hepatic injury markers were observed, indicating the hepatoprotective potential of the extract. Elevated levels of liver biomarkers in the untreated group indicated liver injury or dysfunction. The treated groups showed significant restoration of these biomarkers, suggesting the hepatoprotective potential of <em>SG</em>. The IC<sub>50</sub> value for the total flavonoid content of SG was 190.28 μg/ml, indicating its safety in inhibiting HepG2 cell growth. Flavonoid treatment decreased cell viability but did not affect antioxidant parameters in hepatocytes. In addition, SG restored the damaged hepatocyte architecture. Molecular docking studies revealed the binding affinities of flavonoids for PPARα. These findings suggest that a promising lead candidate for the development of therapeutic medicines against anti-TB drug-induced hepatotoxicity has been identified.</p></div><div><h3>Conclusion</h3><p>Our findings demonstrate the hepatoprotective potential of the flavonoid-rich fraction of <em>Sesbania grandiflora</em> both <em>in vivo</em> and <em>
{"title":"Hepatoprotective effect of flavonoid rich fraction of Sesbania grandiflora: Results of In vivo, in vitro, and molecular docking studies","authors":"Anitha Kuttiappan , Santenna Chenchula , Murugesan Vanangamudi , Shvetank Bhatt , Radhika Chikatipalli , P Shaila Bhanu , Nagaraju Bandaru","doi":"10.1016/j.jaim.2024.101036","DOIUrl":"10.1016/j.jaim.2024.101036","url":null,"abstract":"<div><h3>Background</h3><p>Phytochemicals and their derivatives are promising target drugs for various ailments and have served as therapeutic agents for several decades. Using <em>in vivo</em> and <em>in vitro</em> models and molecular docking, this study investigated the pharmacological potential of a flavonoid-rich fraction of the ethanolic extract of <em>Sesbania grandiflora</em> (SG).</p></div><div><h3>Objectives</h3><p>This research aimed to determine whether flavonoid-rich whole-plant extracts of SGs have any cytoprotective or <em>in vivo</em> hepatoprotective effects. Additionally, the study was intended to elucidate the molecular connections between the discovered flavonoid flavonols and PPARα target proteins linked to liver problems, for which an in silico molecular docking investigation was performed.</p></div><div><h3>Materials and methods</h3><p>To separate the flavonoid components, the entire <em>Sesbania grandiflora</em> plant was first extracted using ethanol as a solvent by soxhlet extraction. The resulting ethanolic extract was then fractionated. The cytoprotective and hepatoprotective properties were evaluated via <em>in vitro</em> and <em>in vivo</em> experiments. SGOT, SGPT, triglyceride, bilirubin, and total protein levels were used to evaluate hepatotoxicity in animal models. <em>In vitro</em> studies on Hepatocellular Carcinoma G2 (HepG2) cell lines have examined their cytotoxic effects and antioxidant activity. The most promising flavonoid-flavanol compounds were identified by conducting molecular docking studies against PPARα target protein (PDB ID: <span><span>3VI8</span><svg><path></path></svg></span>) using MOE software.</p></div><div><h3>Results</h3><p><em>In vivo</em>, the serum levels of SGOT, SGPT, total triglyceride and total bilirubin were measured in experimental animals treated with the flavonoid-rich ethanolic extract of SG. Significant reductions in the levels of these hepatic injury markers were observed, indicating the hepatoprotective potential of the extract. Elevated levels of liver biomarkers in the untreated group indicated liver injury or dysfunction. The treated groups showed significant restoration of these biomarkers, suggesting the hepatoprotective potential of <em>SG</em>. The IC<sub>50</sub> value for the total flavonoid content of SG was 190.28 μg/ml, indicating its safety in inhibiting HepG2 cell growth. Flavonoid treatment decreased cell viability but did not affect antioxidant parameters in hepatocytes. In addition, SG restored the damaged hepatocyte architecture. Molecular docking studies revealed the binding affinities of flavonoids for PPARα. These findings suggest that a promising lead candidate for the development of therapeutic medicines against anti-TB drug-induced hepatotoxicity has been identified.</p></div><div><h3>Conclusion</h3><p>Our findings demonstrate the hepatoprotective potential of the flavonoid-rich fraction of <em>Sesbania grandiflora</em> both <em>in vivo</em> and <em>","PeriodicalId":15150,"journal":{"name":"Journal of Ayurveda and Integrative Medicine","volume":"15 5","pages":"Article 101036"},"PeriodicalIF":1.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0975947624001517/pdfft?md5=0f7fc8a45bc8f15450e3737f599c90e3&pid=1-s2.0-S0975947624001517-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142145709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<div><h3>Background</h3><div>This cross-cultural study conducted in the diverse regions of Assam, Meghalaya, and Manipur sheds light on the common utilization of five specific medicinal plants among indigenous communities residing in these areas.</div></div><div><h3>Objectives</h3><div>The main focus of this study is to document and compare the traditional medicinal plant used and the knowledge and practices related to women's health issues in different cultures; to identify commonalities and differences in the use of medicinal plants across cultures and various medicinal plants used traditionally by the indigenous communities to treat women's health problems according to their indigenous name, scientific name.</div></div><div><h3>Materials and methods</h3><div>The study used a survey method and a pre-structured interview schedule through one-on-one interactive communication and field observation. The authors collected data from three different states, i.e., Assam (Karbi Anglong district & Udalguri district), Meghalaya (East Khasi Hills district), and Manipur (Senapati district) by personally meeting and interacting with traditional herbal medicinal practitioners. For this study, 10 practitioners from each area of study were interviewed. During the data collection process, the vernacular name of the medicinal plant, methods of preparation, mode of application, and probable dosage were compiled and documented involving practitioners belonging to four different communities, i.e, Bodo, Karbi, Khasi, and Poumai Naga of the selected states.</div></div><div><h3>Results</h3><div>A total of 39 plant species were meticulously collected and documented across the Karbi Anglong district and Udalguri district in Assam, East Khasi Hills district in Meghalaya, and Senapati district in Manipur. Turmeric (<em>Curcuma longa</em>), ginger (<em>Zingiber officinale</em>), gooseberry (<em>Emblica officinalis</em>), papaya (<em>Carica papaya</em>), and passion fruit (<em>Passiflora edulis)</em> have emerged as common medicinal resources within these communities. Poaceae, represented by 5 species, emerged as the dominant family among the collected plants, highlighting the diversity and significance of these botanical remedies. <em>Zingiber officinale</em> Roscoe " has the highest usage report of 18 with an RFC (Relative frequency citation) of 0.45.</div></div><div><h3>Conclusion</h3><div>The study's findings reveal a rich repository of traditional herbal knowledge in the northeast regions of India. Notably, the indigenous communities of these regions use plant resources to cure a wide range of ailments. This study emphasizes the necessity of documenting, preserving, and transmitting traditional herbal medicinal knowledge for both cultural and practical reasons. It also provides vital insights into the importance of cross-cultural study in promoting different cultures, the richness of traditional medicinal knowledge by engaging with diverse cultures and demonstrates
{"title":"Cross-cultural study on the uses of traditional herbal medicine to treat various women's health issues in Northeast India","authors":"Klaret Kropi, K.P. Jastone, Sweety Angelirie Kharumnuid, Hemanta Kumar Das, Moses M. Naga","doi":"10.1016/j.jaim.2024.101024","DOIUrl":"10.1016/j.jaim.2024.101024","url":null,"abstract":"<div><h3>Background</h3><div>This cross-cultural study conducted in the diverse regions of Assam, Meghalaya, and Manipur sheds light on the common utilization of five specific medicinal plants among indigenous communities residing in these areas.</div></div><div><h3>Objectives</h3><div>The main focus of this study is to document and compare the traditional medicinal plant used and the knowledge and practices related to women's health issues in different cultures; to identify commonalities and differences in the use of medicinal plants across cultures and various medicinal plants used traditionally by the indigenous communities to treat women's health problems according to their indigenous name, scientific name.</div></div><div><h3>Materials and methods</h3><div>The study used a survey method and a pre-structured interview schedule through one-on-one interactive communication and field observation. The authors collected data from three different states, i.e., Assam (Karbi Anglong district & Udalguri district), Meghalaya (East Khasi Hills district), and Manipur (Senapati district) by personally meeting and interacting with traditional herbal medicinal practitioners. For this study, 10 practitioners from each area of study were interviewed. During the data collection process, the vernacular name of the medicinal plant, methods of preparation, mode of application, and probable dosage were compiled and documented involving practitioners belonging to four different communities, i.e, Bodo, Karbi, Khasi, and Poumai Naga of the selected states.</div></div><div><h3>Results</h3><div>A total of 39 plant species were meticulously collected and documented across the Karbi Anglong district and Udalguri district in Assam, East Khasi Hills district in Meghalaya, and Senapati district in Manipur. Turmeric (<em>Curcuma longa</em>), ginger (<em>Zingiber officinale</em>), gooseberry (<em>Emblica officinalis</em>), papaya (<em>Carica papaya</em>), and passion fruit (<em>Passiflora edulis)</em> have emerged as common medicinal resources within these communities. Poaceae, represented by 5 species, emerged as the dominant family among the collected plants, highlighting the diversity and significance of these botanical remedies. <em>Zingiber officinale</em> Roscoe \" has the highest usage report of 18 with an RFC (Relative frequency citation) of 0.45.</div></div><div><h3>Conclusion</h3><div>The study's findings reveal a rich repository of traditional herbal knowledge in the northeast regions of India. Notably, the indigenous communities of these regions use plant resources to cure a wide range of ailments. This study emphasizes the necessity of documenting, preserving, and transmitting traditional herbal medicinal knowledge for both cultural and practical reasons. It also provides vital insights into the importance of cross-cultural study in promoting different cultures, the richness of traditional medicinal knowledge by engaging with diverse cultures and demonstrates ","PeriodicalId":15150,"journal":{"name":"Journal of Ayurveda and Integrative Medicine","volume":"15 5","pages":"Article 101024"},"PeriodicalIF":1.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0975947624001396/pdfft?md5=0d1e78e724747eaf81fd946f8f26c940&pid=1-s2.0-S0975947624001396-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142287932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01DOI: 10.1016/j.jaim.2024.100961
Ranjani Karthik Pandit
This is a case report of a patient who developed urinary incontinence after undergoing abdominal hysterectomy. This was successfully treated with Ayurvedic treatment procedures. A 63-year-old lady was suffering from urinary incontinence, which developed after hysterectomy. It did not subside even after undergoing trans vaginal taping. She was treated with Ayurvedic procedures and medicines for a period of 2 and a half months from 4th of March 2016 to 26th of May 2016. Matrabasti (medicated enema) and Madhutailikabasti (enema treatment with honey and oil), along with other palliative medicines – Sukumara ghrita, Chandraprabha vati,Shilajatu,Mahakalyanaka kashaya,Mamsapachaka ghana vati and Mahatiktaka ghrita were given to the patient. Urinary incontinence reduced to dribbling of urine after Matra basti and after the second course of Basti (medicated enema), that is after one and half months, patient stopped using diapers and was relieved from incontinence. This case report summarises the effective management of urinary incontinence by adopting basti (enema) treatment along with other palliative ayurvedic medicine.
{"title":"Management of post-hysterectomy urinary incontinence with composite Ayurveda treatment – A case report","authors":"Ranjani Karthik Pandit","doi":"10.1016/j.jaim.2024.100961","DOIUrl":"10.1016/j.jaim.2024.100961","url":null,"abstract":"<div><div>This is a case report of a patient who developed urinary incontinence after undergoing abdominal hysterectomy. This was successfully treated with Ayurvedic treatment procedures. A 63-year-old lady was suffering from urinary incontinence, which developed after hysterectomy. It did not subside even after undergoing trans vaginal taping. She was treated with Ayurvedic procedures and medicines for a period of 2 and a half months from 4<sup>th</sup> of March 2016 to 26<sup>th</sup> of May 2016. <em>Matrabasti</em> (medicated enema) and <em>Madhutailika</em> <em>basti</em> (enema treatment with honey and oil), along with other palliative medicines – <em>S</em><em>ukumara ghrita, Chandraprabha vati,</em> <em>S</em><em>hilajatu,</em> <em>M</em><em>ahakalyanaka kashaya,</em> <em>M</em><em>amsapachaka ghana vati and Mahatiktaka ghrita</em> were given to the patient. Urinary incontinence reduced to dribbling of urine after Matra basti and after the second course of <em>B</em><em>asti</em> (medicated enema), that is after one and half months, patient stopped using diapers and was relieved from incontinence. This case report summarises the effective management of urinary incontinence by adopting basti (enema) treatment along with other palliative ayurvedic medicine.</div></div>","PeriodicalId":15150,"journal":{"name":"Journal of Ayurveda and Integrative Medicine","volume":"15 5","pages":"Article 100961"},"PeriodicalIF":1.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142323999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01DOI: 10.1016/j.jaim.2024.101039
Hassan ul Hussain , Eman Ali , Areesha Tanveer , Syed Muhammad Ismail , Humam Furqan , Muhammad Nadeem Ahsan , Sadia Iqbal , Muhammad Sohaib Asghar
Type 2 diabetes mellitus (T2DM) is a multifactorial lifelong condition. Berberis vulgaris (BV) and Berberis integerrima (BI) regulate glucose levels with minimal adverse effects. In this systematic review and meta-analysis, we evaluate the effect of BV and BI on glycemic indices, weight, and body mass index (BMI) against placebo.
Four electronic databases were searched till September 24, 2023. Inclusion criteria for studies were: (a) T2DM patients; (b) berberis (vulgaris/integerrima) therapy as intervention; (c) control group of placebo or metformin; (d) outcomes including fasting blood glucose (FBG) levels, glycated hemoglobin (HbA1c%), Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), fasting serum insulin (FSI), 2-h postprandial glucose (2hPPG), fructosamine, weight, and BMI; (e) randomized controlled trials (RCTs). Data was pooled using a random-effects analysis model on Review Manager. The inverse variance statistical method was applied keeping weighted mean difference (WMD) as the effect measure. The Cochrane risk of bias tool evaluated the risk of bias. A p-value of less than 0.05 was considered significant.
Nine RCTs comprising 547 patients were included. Significant reduction was noted with berberis therapy in FBG (WMD: −14.52; 95% CI = −22.97, −6.07; P = 0.0008); HbA1c % (WMD: −0.30; 95% CI = −0.53, −0.07; P = 0.01); HOMA-IR (WMD: −0.97; 95% CI = −1.56, 0.37; P = 0.001). No significant differences were noted between the two groups in 2hPPG (WMD: 6.52; 95% CI = −21.57, 34.61; P = 0.65); FSI (WMD: −0.79; 95% CI = −1.80, 0.22, P = 0.13); Fructosamine (WMD: −12.57; 95% CI = −40.74, 15.60; P = 0.38); Weight (WMD: −1.89; 95% CI = −4.55, 0.76; P = 0.16) and BMI (WMD: −0.12; 95% CI = −0.90, 0.65; P = 0.76).
The data showed significant reduction in FBG and improved insulin levels but limited effects were observed in other glycemic indexes. More extensive RCTs are required globally to achieve a holistic comprehension of the connection between berberis and T2DM.
2 型糖尿病（T2DM）是一种多因素的终身疾病。小檗（BV）和非洲小檗（BI）可调节血糖水平，且不良影响极小。在本系统综述和荟萃分析中，我们评估了 BV 和 BI 与安慰剂相比对血糖指数、体重和体重指数（BMI）的影响。研究的纳入标准为(a) T2DM 患者；(b) 以小檗（庸俗草/integerrima）疗法作为干预措施；(c) 对照组为安慰剂或二甲双胍；(d) 结果包括空腹血糖 (FBG)水平、糖化血红蛋白 (HbA1c%)、胰岛素抵抗静态模型评估 (HOMA-IR)、空腹血清胰岛素 (FSI)、餐后 2 小时血糖 (2hPPG)、果糖胺、体重和体重指数 (BMI)； (e) 随机对照试验 (RCT)。数据采用《综述管理器》上的随机效应分析模型进行汇总。采用反方差统计方法，将加权平均差（WMD）作为效果测量指标。科克伦偏倚风险工具对偏倚风险进行了评估。九项研究纳入了 547 名患者。小檗治疗显著降低了FBG（WMD：-14.52；95% CI = -22.97，-6.07；P = 0.0008）；HbA1c %（WMD：-0.30；95% CI = -0.53，-0.07；P = 0.01）；HOMA-IR（WMD：-0.97；95% CI = -1.56，0.37；P = 0.001）。两组在 2hPPG （WMD：6.52；95% CI = -21.57，34.61；P = 0.65）；FSI（WMD：-0.79；95% CI =-1.80，0.22，P = 0.13）；果糖胺（WMD：-12.57；95% CI =-40.74，15.60；P = 0.数据显示，FBG 显著降低，胰岛素水平得到改善，但对其他血糖指数的影响有限。要全面了解小檗与 T2DM 之间的关系，还需要在全球范围内开展更广泛的 RCT 研究。
{"title":"Efficacy of Berberis vulgaris and Berberis integerrima on glycemic indices and weight profile in type 2 diabetic patients: A systematic review and meta-analysis of randomized controlled trials","authors":"Hassan ul Hussain , Eman Ali , Areesha Tanveer , Syed Muhammad Ismail , Humam Furqan , Muhammad Nadeem Ahsan , Sadia Iqbal , Muhammad Sohaib Asghar","doi":"10.1016/j.jaim.2024.101039","DOIUrl":"10.1016/j.jaim.2024.101039","url":null,"abstract":"<div><div>Type 2 diabetes mellitus (T2DM) is a multifactorial lifelong condition. <em>Berberis vulgaris</em> (BV) and <em>Berberis integerrima</em> (BI) regulate glucose levels with minimal adverse effects. In this systematic review and meta-analysis, we evaluate the effect of BV and BI on glycemic indices, weight, and body mass index (BMI) against placebo.</div><div>Four electronic databases were searched till September 24, 2023. Inclusion criteria for studies were: (a) T2DM patients; (b) berberis (vulgaris/integerrima) therapy as intervention; (c) control group of placebo or metformin; (d) outcomes including fasting blood glucose (FBG) levels, glycated hemoglobin (HbA1c%), Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), fasting serum insulin (FSI), 2-h postprandial glucose (2hPPG), fructosamine, weight, and BMI; (e) randomized controlled trials (RCTs). Data was pooled using a random-effects analysis model on Review Manager. The inverse variance statistical method was applied keeping weighted mean difference (WMD) as the effect measure. The Cochrane risk of bias tool evaluated the risk of bias. A p-value of less than 0.05 was considered significant.</div><div>Nine RCTs comprising 547 patients were included. Significant reduction was noted with berberis therapy in FBG (WMD: −14.52; 95% CI = −22.97, −6.07; P = 0.0008); HbA1c % (WMD: −0.30; 95% CI = −0.53, −0.07; P = 0.01); HOMA-IR (WMD: −0.97; 95% CI = −1.56, 0.37; P = 0.001). No significant differences were noted between the two groups in 2hPPG (WMD: 6.52; 95% CI = −21.57, 34.61; P = 0.65); FSI (WMD: −0.79; 95% CI = −1.80, 0.22, P = 0.13); Fructosamine (WMD: −12.57; 95% CI = −40.74, 15.60; P = 0.38); Weight (WMD: −1.89; 95% CI = −4.55, 0.76; P = 0.16) and BMI (WMD: −0.12; 95% CI = −0.90, 0.65; P = 0.76).</div><div>The data showed significant reduction in FBG and improved insulin levels but limited effects were observed in other glycemic indexes. More extensive RCTs are required globally to achieve a holistic comprehension of the connection between berberis and T2DM.</div></div>","PeriodicalId":15150,"journal":{"name":"Journal of Ayurveda and Integrative Medicine","volume":"15 5","pages":"Article 101039"},"PeriodicalIF":1.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142437851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01DOI: 10.1016/j.jaim.2024.101029
Sangeetha Gopal, Leon Ittiachen
Background
Sahacharadi Kwatha is traditionally employed in Ayurvedic therapy for "vata" related conditions such as back pain, herniated disc, palsy, sciatica, and paralysis. Classical Ayurvedic texts recommend the use of freshly prepared Kwatha for optimal patient benefits. However, in response to the commercialization of Ayurveda and the demand for convenient over-the-counter (OTC) formulations, various commercial preservatives have been incorporated by Ayurvedic manufacturers to facilitate OTC preparation and prolong shelf life.
Objectives
This study aims to comprehensively analyse and compare the quality parameters and preservative content in three prominent brands of Sahacharadi Kwatha available in the Indian market.
Materials and methods
Organoleptic and physicochemical properties, phytochemical content, and microbial load of the samples were analyzed following standardized procedures. Sodium benzoate levels in the samples were determined using both titrimetric and High-Performance Liquid Chromatography (HPLC) methods. High-Performance Thin-Layer Chromatography (HPTLC) profiles were compared to discern differences among the samples.
Results
The study revealed significant variations in organoleptic and physicochemical properties, HPTLC profiles, and microbial load among the tested samples. Sodium benzoate levels in all samples exceeded the FDA and API-approved limit. Additionally, substantial variations were noted in the phytochemical content of the samples.
Conclusion
This investigation underscores noteworthy disparities in quality parameters and preservative content within the tested market variants of Sahacharadi Kwatha. The findings emphasize the existence of unregulated standards in the preparation of Ayurvedic medicines available in the market, highlighting the imperative for standardization and validation of Ayurvedic formulations. Such measures are essential for enhancing consumer acceptability and fostering the overall development and growth of the Ayurveda industry.
背景Sahacharadi Kwatha 传统上用于阿育吠陀疗法，治疗与 "瓦塔 "有关的疾病，如背痛、椎间盘突出、麻痹、坐骨神经痛和瘫痪。经典的阿育吠陀经文建议使用新鲜制备的 Kwatha，以使患者获得最佳疗效。然而，随着阿育吠陀的商业化和对方便的非处方药（OTC）配方的需求，阿育吠陀制造商加入了各种商业防腐剂，以方便非处方药的制备并延长保质期。本研究旨在全面分析和比较印度市场上三种著名品牌的 Sahacharadi Kwatha 的质量参数和防腐剂含量。使用滴定法和高效液相色谱法测定了样品中的苯甲酸钠含量。研究结果表明，被测样品在感官和理化特性、HPTLC 图谱以及微生物量方面存在显著差异。所有样品中的苯甲酸钠含量都超过了 FDA 和 API 批准的限值。此外，样品中的植物化学成分含量也存在很大差异。调查结果表明，市场上阿育吠陀药物的制备标准不规范，因此必须对阿育吠陀配方进行标准化和验证。这些措施对于提高消费者的接受度、促进阿育吠陀产业的整体发展和增长至关重要。
{"title":"Analysis of quality parameters and preservative concentrations in Sahacharadi Kwatha: A comparative study of three commercial brands","authors":"Sangeetha Gopal, Leon Ittiachen","doi":"10.1016/j.jaim.2024.101029","DOIUrl":"10.1016/j.jaim.2024.101029","url":null,"abstract":"<div><h3>Background</h3><div><em>Sahacharadi Kwatha</em> is traditionally employed in Ayurvedic therapy for \"vata\" related conditions such as back pain, herniated disc, palsy, sciatica, and paralysis. Classical Ayurvedic texts recommend the use of freshly prepared Kwatha for optimal patient benefits. However, in response to the commercialization of Ayurveda and the demand for convenient over-the-counter (OTC) formulations, various commercial preservatives have been incorporated by Ayurvedic manufacturers to facilitate OTC preparation and prolong shelf life.</div></div><div><h3>Objectives</h3><div>This study aims to comprehensively analyse and compare the quality parameters and preservative content in three prominent brands of <em>Sahacharadi Kwatha</em> available in the Indian market.</div></div><div><h3>Materials and methods</h3><div>Organoleptic and physicochemical properties, phytochemical content, and microbial load of the samples were analyzed following standardized procedures. Sodium benzoate levels in the samples were determined using both titrimetric and High-Performance Liquid Chromatography (HPLC) methods. High-Performance Thin-Layer Chromatography (HPTLC) profiles were compared to discern differences among the samples.</div></div><div><h3>Results</h3><div>The study revealed significant variations in organoleptic and physicochemical properties, HPTLC profiles, and microbial load among the tested samples. Sodium benzoate levels in all samples exceeded the FDA and API-approved limit. Additionally, substantial variations were noted in the phytochemical content of the samples.</div></div><div><h3>Conclusion</h3><div>This investigation underscores noteworthy disparities in quality parameters and preservative content within the tested market variants of <em>Sahacharadi Kwatha</em>. The findings emphasize the existence of unregulated standards in the preparation of Ayurvedic medicines available in the market, highlighting the imperative for standardization and validation of Ayurvedic formulations. Such measures are essential for enhancing consumer acceptability and fostering the overall development and growth of the Ayurveda industry.</div></div>","PeriodicalId":15150,"journal":{"name":"Journal of Ayurveda and Integrative Medicine","volume":"15 5","pages":"Article 101029"},"PeriodicalIF":1.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142446553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01DOI: 10.1016/j.jaim.2024.101053
P. Gayani I. Dias , R.A. Upul J. Marapana , R.M. Udaya S.K. Rathnayaka , S.M.D. Sadhana Gayathri , N.G. Darshana Anuradha , Thilini C. Kananke , R.M. Kapila T. Rathnayaka , M.G.A. Namal Perera , Rasangani S. Sabaragamuwa , M. Nirmali Wickramaratne
Background
The influence of plant types and their ratios on the effectiveness of polyherbal formulations is a crucial yet underexplored area of research.
Objectives
This study aimed to identify the optimal ratios of Phylanthus debilis (PW), Osbeckia octrandra (HB), and Artrocarpus heterophyllus (WR) leaf powders for a polyherbal tea to achieve the best functional properties.
Material and methods
A three-level factorial design was used to examine the combined effect of three independent variables (PW, WR, and HB) on antioxidant, antidiabetic, and β-glucuronidase inhibitory activities. The variables were coded at three levels (−1, 0, +1), resulting in 10 experimental runs, with responses tested in triplicates.
Results
The highest antioxidant activity was observed in mixture 4 (PW: WR: HB = 4:1:1) for most assays. P. debilis exhibited the lowest IC50 values for α-glucosidase and β-glucuronidase inhibition, while O. octandra showed the lowest IC50 value for α-amylase inhibition compared to the mixtures. ANOVA indicated that the models and model terms of the mixture design are statistically significant (P ≤ 0.05) and the responses are well-fitted to the models (R2 = 0.8484 to 0.9993). The aqueous extractability of the polyherbal mixtures was higher than that of the individual herbs.
Conclusions
These study revealed that polyherbal formulations exhibit both synergistic and antagonistic effects on therapeutic efficacy. Mixtures 4 (PW: WR: HB = 4:1:1), 5 (PW: HB = 1:1), and 7 (PW: WR: HB = 1:1:1) were screened as the polyherbal mixtures having optimum values for selected functional properties. These combinations, along with individual herbal extracts, will undergo further testing to develop a tri-herbal tea formulation.
{"title":"Identification of the best plant ratios for a polyherbal tea mix to obtain optimum antioxidant, antidiabetic, and β-glucuronidase inhibition activities","authors":"P. Gayani I. Dias , R.A. Upul J. Marapana , R.M. Udaya S.K. Rathnayaka , S.M.D. Sadhana Gayathri , N.G. Darshana Anuradha , Thilini C. Kananke , R.M. Kapila T. Rathnayaka , M.G.A. Namal Perera , Rasangani S. Sabaragamuwa , M. Nirmali Wickramaratne","doi":"10.1016/j.jaim.2024.101053","DOIUrl":"10.1016/j.jaim.2024.101053","url":null,"abstract":"<div><h3>Background</h3><div>The influence of plant types and their ratios on the effectiveness of polyherbal formulations is a crucial yet underexplored area of research.</div></div><div><h3>Objectives</h3><div>This study aimed to identify the optimal ratios of <em>Phylanthus debilis</em> (PW), <em>Osbeckia octrandra</em> (HB), and <em>Artrocarpus heterophyllus</em> (WR) leaf powders for a polyherbal tea to achieve the best functional properties.</div></div><div><h3>Material and methods</h3><div>A three-level factorial design was used to examine the combined effect of three independent variables (PW, WR, and HB) on antioxidant, antidiabetic, and β-glucuronidase inhibitory activities. The variables were coded at three levels (−1, 0, +1), resulting in 10 experimental runs, with responses tested in triplicates.</div></div><div><h3>Results</h3><div>The highest antioxidant activity was observed in mixture 4 (PW: WR: HB = 4:1:1) for most assays. <em>P. debilis</em> exhibited the lowest IC<sub>50</sub> values for α-glucosidase and β-glucuronidase inhibition, while <em>O. octandra</em> showed the lowest IC<sub>50</sub> value for α-amylase inhibition compared to the mixtures. ANOVA indicated that the models and model terms of the mixture design are statistically significant (<em>P ≤ 0.05</em>) and the responses are well-fitted to the models (R<sup>2</sup> = 0.8484 to 0.9993). The aqueous extractability of the polyherbal mixtures was higher than that of the individual herbs.</div></div><div><h3>Conclusions</h3><div>These study revealed that polyherbal formulations exhibit both synergistic and antagonistic effects on therapeutic efficacy. Mixtures 4 (PW: WR: HB = 4:1:1), 5 (PW: HB = 1:1), and 7 (PW: WR: HB = 1:1:1) were screened as the polyherbal mixtures having optimum values for selected functional properties. These combinations, along with individual herbal extracts, will undergo further testing to develop a tri-herbal tea formulation.</div></div>","PeriodicalId":15150,"journal":{"name":"Journal of Ayurveda and Integrative Medicine","volume":"15 5","pages":"Article 101053"},"PeriodicalIF":1.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142446554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01DOI: 10.1016/j.jaim.2024.101055
Kejun Zhou , Mengyi Xie , Yu Liu , Lei Zheng , Juan Pu , Cheng Wang
Background
Hepatocellular carcinoma (HCC) is a primary liver malignancy commonly encountered in the setting of chronic liver disease and cirrhosis. Compound Kushen Injection (CKI) has been widely used in HCC, however, the underlying mechanisms are scarce.
Objective
To explore the molecular mechanisms of CKI for HCC.To explore the molecular mechanisms of CKI for HCC.
Materials and Methods
The chemical ingredients of CKI were reviewed from published articles and the potential targets were got from Herbal Ingredients’ Targets Platform. Coagulation-related targets were from Kyoto Encyclopedia of Genes and Genomes and HCC-related targets were from Therapeutic Target Database, Gene Expression Omnibus, and The Cancer Genome Atlas. Then the CKI-Herb-Target and CKI-Herb-Target-HCC networks were built. The shared targets between CKI and HCC were used for functional enrichment through Metascape and the shared coagulation-related target was used for molecular docking and survival analysis.
Results
A total of 23 chemical ingredients and 41 potential targets shared between CKI and HCC were obtained. The results of functional enrichment indicated that several canonical pathways of CKI mostly participated in the treatment of HCC. Furthermore, a chemical ingredient of CKI formed a stable hydrogen bond link with the ASN-189 on PLG, with a best binding energy of −4.7 kcal/mol. Finally, PLG was confirmed as the shared coagulation-related target and interrelated with the prognosis of HCC.
Conclusion
CKI probably improves HCC prognosis through PLG. Our research undoubtedly deepened the understanding of the molecular mechanism of CKI anti-HCC.
{"title":"Virtual screening and network pharmacology-based synergistic coagulation mechanism identification of multiple components contained in compound Kushen Injection against hepatocellular carcinoma","authors":"Kejun Zhou , Mengyi Xie , Yu Liu , Lei Zheng , Juan Pu , Cheng Wang","doi":"10.1016/j.jaim.2024.101055","DOIUrl":"10.1016/j.jaim.2024.101055","url":null,"abstract":"<div><h3>Background</h3><div>Hepatocellular carcinoma (HCC) is a primary liver malignancy commonly encountered in the setting of chronic liver disease and cirrhosis. Compound Kushen Injection (CKI) has been widely used in HCC, however, the underlying mechanisms are scarce.</div></div><div><h3>Objective</h3><div>To explore the molecular mechanisms of CKI for HCC.To explore the molecular mechanisms of CKI for HCC.</div></div><div><h3>Materials and Methods</h3><div>The chemical ingredients of CKI were reviewed from published articles and the potential targets were got from Herbal Ingredients’ Targets Platform. Coagulation-related targets were from Kyoto Encyclopedia of Genes and Genomes and HCC-related targets were from Therapeutic Target Database, Gene Expression Omnibus, and The Cancer Genome Atlas. Then the CKI-Herb-Target and CKI-Herb-Target-HCC networks were built. The shared targets between CKI and HCC were used for functional enrichment through Metascape and the shared coagulation-related target was used for molecular docking and survival analysis.</div></div><div><h3>Results</h3><div>A total of 23 chemical ingredients and 41 potential targets shared between CKI and HCC were obtained. The results of functional enrichment indicated that several canonical pathways of CKI mostly participated in the treatment of HCC. Furthermore, a chemical ingredient of CKI formed a stable hydrogen bond link with the ASN-189 on PLG, with a best binding energy of −4.7 kcal/mol. Finally, PLG was confirmed as the shared coagulation-related target and interrelated with the prognosis of HCC.</div></div><div><h3>Conclusion</h3><div>CKI probably improves HCC prognosis through PLG. Our research undoubtedly deepened the understanding of the molecular mechanism of CKI anti-HCC.</div></div>","PeriodicalId":15150,"journal":{"name":"Journal of Ayurveda and Integrative Medicine","volume":"15 5","pages":"Article 101055"},"PeriodicalIF":1.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142466222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Viral mediated diseases are continuously posing potent threat to human health. Nutraceuticals are being employed as novel therapeutics during viral outbreaks. MAM granules consist of Curcuma longa, Withania somnifera, and Piper nigrum, is one such patented Siddha nutraceutical supplement that has been proposed to be a therapeutic agent against viral diseases.
Objective
We characterised MAM for their phytochemical and physicochemical properties and evaluated its cytotoxicity via in vivo acute toxicity studies using Wistar rats and by cell-based MTT assays.
Materials and Methods
The antiviral properties of the aqueous extract of MAM were investigated against SARS-CoV-2 and chikungunya virus (CHIKV). Further, using ABTS radical scavenging, SOD enzymatic assays and measurement of intracellular ROS, we investigated the antioxidant potential of MAM extract and its ingredients in RAW264.7 cells. Additionally, production of inflammatory mediators was evaluated via NO release, PGE2 production and release of pro-inflammatory cytokines (IL-1β and TNFα).
Results
The MAM granules and aqueous extracts demonstrated no significant toxicity and demonstrated potent antiviral activity during co-incubation assay with SARS-CoV-2 and CHIKV. Moreover, we observed potent antioxidant and anti-inflammatory activity of MAM extract in a dose dependent manner. Further investigations on the individual ingredients with respect to their antioxidant and anti-inflammatory activities showed that all ingredients contributed synergistically and Withania somnifera showed most potent anti-oxidant activity.
Conclusion
The overall in vitro, and in vivo analysis demonstrated that MAM granules were non-toxic and possessed potent antiviral activity. Additionally, observed significant anti-oxidant and anti-inflammatory properties of MAM suggested the modulation of innate immune response in the host validating its use as an effective nutraceutical during viral outbreaks.
背景：病毒介导的疾病不断对人类健康构成严重威胁。在病毒爆发期间，保健食品被用作新型疗法。由莪术、睡莲和胡椒组成的 MAM 颗粒就是这样一种获得专利的 Siddha 营养保健品，已被建议用作病毒性疾病的治疗剂：我们研究了 MAM 的植物化学和物理化学特性，并通过使用 Wistar 大鼠进行体内急性毒性研究和基于细胞的 MTT 试验评估了其细胞毒性：研究了 MAM 水提取物对 SARS-CoV-2 和基孔肯雅病毒 (CHIKV) 的抗病毒特性。此外，我们还使用 ABTS 自由基清除、SOD 酶测定和细胞内 ROS 测量方法，研究了 MAM 提取物及其成分在 RAW264.7 细胞中的抗氧化潜力。此外，还通过 NO 释放、PGE2 产生和促炎细胞因子（IL-1β 和 TNFα）释放评估了炎症介质的产生：结果：在与 SARS-CoV-2 和 CHIKV 的共孵育试验中，MAM 颗粒和水提取物没有显示出明显的毒性，并表现出了强大的抗病毒活性。此外，我们还观察到 MAM 提取物具有很强的抗氧化和抗炎活性，其活性与剂量有关。对各种成分的抗氧化和抗炎活性的进一步研究表明，所有成分都具有协同作用，而睡茄的抗氧化活性最强：体外和体内的总体分析表明，MAM 颗粒无毒，具有强大的抗病毒活性。此外，还观察到 MAM 具有明显的抗氧化和抗炎特性，这表明它能调节宿主的先天免疫反应，因此可在病毒爆发时用作有效的营养保健品。
{"title":"Evaluation of Withania somnifera based supplement for immunomodulatory and antiviral properties against viral infection","authors":"Dileep Kumar Verma , Abdul Hasan , Manickavasagam Rengaraju , Shree Devi , Geetika Sharma , Vimal Narayanan , Sathiyarajeswaran Parameswaran , Thirumal Kumar D , Kanakavalli Kadarkarai , Sujatha Sunil","doi":"10.1016/j.jaim.2024.100955","DOIUrl":"10.1016/j.jaim.2024.100955","url":null,"abstract":"<div><h3>Background</h3><div>Viral mediated diseases are continuously posing potent threat to human health. Nutraceuticals are being employed as novel therapeutics during viral outbreaks. MAM granules consist of <em>Curcuma longa</em>, <em>Withania somnifera</em>, and <em>Piper nigrum</em>, is one such patented Siddha nutraceutical supplement that has been proposed to be a therapeutic agent against viral diseases.</div></div><div><h3>Objective</h3><div>We characterised MAM for their phytochemical and physicochemical properties and evaluated its cytotoxicity via <em>in vivo</em> acute toxicity studies using Wistar rats and by cell-based MTT assays.</div></div><div><h3>Materials and Methods</h3><div>The antiviral properties of the aqueous extract of MAM were investigated against SARS-CoV-2 and chikungunya virus (CHIKV). Further, using ABTS radical scavenging, SOD enzymatic assays and measurement of intracellular ROS, we investigated the antioxidant potential of MAM extract and its ingredients in RAW264.7 cells. Additionally, production of inflammatory mediators was evaluated via NO release, PGE2 production and release of pro-inflammatory cytokines (IL-1<em>β</em> and TNF<em>α</em>).</div></div><div><h3>Results</h3><div>The MAM granules and aqueous extracts demonstrated no significant toxicity and demonstrated potent antiviral activity during co-incubation assay with SARS-CoV-2 and CHIKV. Moreover, we observed potent antioxidant and anti-inflammatory activity of MAM extract in a dose dependent manner. Further investigations on the individual ingredients with respect to their antioxidant and anti-inflammatory activities showed that all ingredients contributed synergistically and <em>Withania somnifera</em> showed most potent anti-oxidant activity.</div></div><div><h3>Conclusion</h3><div>The overall in vitro, and <em>in vivo</em> analysis demonstrated that MAM granules were non-toxic and possessed potent antiviral activity. Additionally, observed significant anti-oxidant and anti-inflammatory properties of MAM suggested the modulation of innate immune response in the host validating its use as an effective nutraceutical during viral outbreaks.</div></div>","PeriodicalId":15150,"journal":{"name":"Journal of Ayurveda and Integrative Medicine","volume":"15 5","pages":"Article 100955"},"PeriodicalIF":1.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142400365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01DOI: 10.1016/j.jaim.2024.100960
Arathy Menon , Devipriya Soman , James Chacko , P.V. Anandaraman , Mahesh C. Kundagol , K. Sreejith
<div><h3>Background</h3><p>Excessive Daytime Sleepiness (EDS) is inferred as persistent sleepiness and often a general lack of energy during the day even after apparently adequate or even prolonged nighttime sleep. The subjects may not be identifying excessive daytime sleepiness but may present as feeling tired, lack of energy etc. They may seem apparently healthy and without any other systemic illness. The prevalence was found to be as high as 18 % in 2012 in United Kingdom. Also, it is a risk factor for diseases like Alzheimer's disease, Parkinson's disease and other neurodegenerative diseases. Conventional management (Modafinil, Sodium Oxybate and Stimulants) addresses only the subjective condition in EDS and is associated with adverse effects compromising the quality of life. In the current health scenario there is a need for alternative interventions to manage this disease. On analyzing this condition through <em>Ayurveda</em>, we could understand it as <em>Nidradhikya</em> (Excessive daytime sleepiness) which is caused due to vitiated <em>Kapha Dosha</em> along with <em>Vriddha Tamoguna</em> (increased <em>Tamoguna</em>) that can be managed by <em>Shodhana</em> (biopurification) followed <em>Shamana</em> (pacification) therapies.</p></div><div><h3>Objective</h3><p>This study was aimed to assess the combined effect of <em>Vamana</em> (therapeutic vomiting) and <em>Sarasvata Churna</em> in reducing Excessive Daytime Sleepiness.</p></div><div><h3>Materials and methods</h3><p>This was a single-arm exploratory open-label clinical trial. 10 subjects having EDS diagnosed using Modified Epworth Sleepiness Scale (MESS) with a score of 10–24 with proper exclusion were recruited from OPD and IPD, Department of <em>Kāyacikitsa</em>, Amrita School of Ayurveda. All the participants were clinically examined, sought for medical history and further checked biochemically to exclude any other systemic illness that may lead to this condition. Only healthy subjects with quality night sleep (assessed by PSQI) and without any other systemic illness were selected. The treatment protocol adopted was <em>Vamana Karma</em> followed by 30 days of <em>Sarasvata Churna</em> as <em>Shamana Aushadha</em> (medicine for pacification). Assessment was done using MESS on 0<sup>th</sup> day and after 30 days of <em>Shamana Aushadha Sevana.</em> After completion of treatment, the results were statistically analysed using Wilcoxon Signed Rank Test and final conclusion was drawn.</p></div><div><h3>Results</h3><p>On analysis of the symptoms using Modified Epworth Sleepiness Scale, the mean total score reduced from 14.8 to 2.8 with 81.08 % relief in these 10 subjects and a significant p value < 0.05 after <em>Vamana</em> followed by 30 days of <em>Shamana Aushadha Sevana</em>.</p></div><div><h3>Discussion</h3><p><em>Vamana</em> helps in <em>Kapha Nirharana</em> (expelling) which removes the <em>Avarana</em> (occlusion) of <em>Manas</em> seen in <em>Nidradhikya</em>. This results
{"title":"An exploratory single-arm open-label clinical study to evaluate the combined effect of Vamana and Sarasvata Churna in reducing excessive daytime sleepiness","authors":"Arathy Menon , Devipriya Soman , James Chacko , P.V. Anandaraman , Mahesh C. Kundagol , K. Sreejith","doi":"10.1016/j.jaim.2024.100960","DOIUrl":"10.1016/j.jaim.2024.100960","url":null,"abstract":"<div><h3>Background</h3><p>Excessive Daytime Sleepiness (EDS) is inferred as persistent sleepiness and often a general lack of energy during the day even after apparently adequate or even prolonged nighttime sleep. The subjects may not be identifying excessive daytime sleepiness but may present as feeling tired, lack of energy etc. They may seem apparently healthy and without any other systemic illness. The prevalence was found to be as high as 18 % in 2012 in United Kingdom. Also, it is a risk factor for diseases like Alzheimer's disease, Parkinson's disease and other neurodegenerative diseases. Conventional management (Modafinil, Sodium Oxybate and Stimulants) addresses only the subjective condition in EDS and is associated with adverse effects compromising the quality of life. In the current health scenario there is a need for alternative interventions to manage this disease. On analyzing this condition through <em>Ayurveda</em>, we could understand it as <em>Nidradhikya</em> (Excessive daytime sleepiness) which is caused due to vitiated <em>Kapha Dosha</em> along with <em>Vriddha Tamoguna</em> (increased <em>Tamoguna</em>) that can be managed by <em>Shodhana</em> (biopurification) followed <em>Shamana</em> (pacification) therapies.</p></div><div><h3>Objective</h3><p>This study was aimed to assess the combined effect of <em>Vamana</em> (therapeutic vomiting) and <em>Sarasvata Churna</em> in reducing Excessive Daytime Sleepiness.</p></div><div><h3>Materials and methods</h3><p>This was a single-arm exploratory open-label clinical trial. 10 subjects having EDS diagnosed using Modified Epworth Sleepiness Scale (MESS) with a score of 10–24 with proper exclusion were recruited from OPD and IPD, Department of <em>Kāyacikitsa</em>, Amrita School of Ayurveda. All the participants were clinically examined, sought for medical history and further checked biochemically to exclude any other systemic illness that may lead to this condition. Only healthy subjects with quality night sleep (assessed by PSQI) and without any other systemic illness were selected. The treatment protocol adopted was <em>Vamana Karma</em> followed by 30 days of <em>Sarasvata Churna</em> as <em>Shamana Aushadha</em> (medicine for pacification). Assessment was done using MESS on 0<sup>th</sup> day and after 30 days of <em>Shamana Aushadha Sevana.</em> After completion of treatment, the results were statistically analysed using Wilcoxon Signed Rank Test and final conclusion was drawn.</p></div><div><h3>Results</h3><p>On analysis of the symptoms using Modified Epworth Sleepiness Scale, the mean total score reduced from 14.8 to 2.8 with 81.08 % relief in these 10 subjects and a significant p value < 0.05 after <em>Vamana</em> followed by 30 days of <em>Shamana Aushadha Sevana</em>.</p></div><div><h3>Discussion</h3><p><em>Vamana</em> helps in <em>Kapha Nirharana</em> (expelling) which removes the <em>Avarana</em> (occlusion) of <em>Manas</em> seen in <em>Nidradhikya</em>. This results ","PeriodicalId":15150,"journal":{"name":"Journal of Ayurveda and Integrative Medicine","volume":"15 5","pages":"Article 100960"},"PeriodicalIF":1.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0975947624000755/pdfft?md5=614cdfc87ae8f05c98f54c92c8646586&pid=1-s2.0-S0975947624000755-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142270913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01DOI: 10.1016/j.jaim.2024.101023
Abhijit Dutta
Background
Case series is a valuable tool for sharing clinical experiences and generating research questions in the field of medicine. However, there is a lack of standardized reporting guideline for case series in homeopathy, which limits their utility and comparability. The aim of this study is to develop a reporting guideline for case series in homeopathy using a Delphi consensus process.
Method
A group of 21 experts, with experience in reviewing, publishing, or editing case reports or series in homeopathy, were participated in the study. A modified Delphi consensus process was conducted with three rounds of electronic surveys to gather feedback and opinions on the items to be included in the reporting guideline. The GRADE group's nine-point Likert scale was used to rate each item's importance and criticality.
Result
The Delphi process resulted in a consensus-based reporting guideline for case series in homeopathy, which includes recommendations for reporting case series in eleven sections, including 'Title,' 'Abstract,' 'Keywords,' 'Introduction,' 'Methods,' 'Results,' 'Discussion,' 'Conclusion,' 'Patient Perspectives,' 'References,' and 'Additional Information.' PITCH comprises a total of 59 items that achieved consensus agreement. Of these, 13 are optional items and 14 items are exclusively applicable for prospective type of case series.
Conclusion
The PITCH reporting guideline provides a structured and standardized approach for reporting case series in homeopathy. The authors, journal editors, reviewers, and educators are encouraged to adopt and implement the guideline to enhance the quality of case series in homeopathic publications.
{"title":"A consensus guideline on preferred items for reporting case series in homeopathy: The PITCH statement","authors":"Abhijit Dutta","doi":"10.1016/j.jaim.2024.101023","DOIUrl":"10.1016/j.jaim.2024.101023","url":null,"abstract":"<div><h3>Background</h3><div>Case series is a valuable tool for sharing clinical experiences and generating research questions in the field of medicine. However, there is a lack of standardized reporting guideline for case series in homeopathy, which limits their utility and comparability. The aim of this study is to develop a reporting guideline for case series in homeopathy using a Delphi consensus process.</div></div><div><h3>Method</h3><div>A group of 21 experts, with experience in reviewing, publishing, or editing case reports or series in homeopathy, were participated in the study. A modified Delphi consensus process was conducted with three rounds of electronic surveys to gather feedback and opinions on the items to be included in the reporting guideline. The GRADE group's nine-point Likert scale was used to rate each item's importance and criticality.</div></div><div><h3>Result</h3><div>The Delphi process resulted in a consensus-based reporting guideline for case series in homeopathy, which includes recommendations for reporting case series in eleven sections, including 'Title,' 'Abstract,' 'Keywords,' 'Introduction,' 'Methods,' 'Results,' 'Discussion,' 'Conclusion,' 'Patient Perspectives,' 'References,' and 'Additional Information.' PITCH comprises a total of 59 items that achieved consensus agreement. Of these, 13 are optional items and 14 items are exclusively applicable for prospective type of case series.</div></div><div><h3>Conclusion</h3><div>The PITCH reporting guideline provides a structured and standardized approach for reporting case series in homeopathy. The authors, journal editors, reviewers, and educators are encouraged to adopt and implement the guideline to enhance the quality of case series in homeopathic publications.</div></div>","PeriodicalId":15150,"journal":{"name":"Journal of Ayurveda and Integrative Medicine","volume":"15 5","pages":"Article 101023"},"PeriodicalIF":1.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142421108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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