Journey of Journal of Indian System of Medicine Srihari Sheshagiri Journal of Indian System of Medicine 2019 7(1):1-2

Evidence-based Ayurveda: Way forward...... Ramesh B Devalla Journal of Indian System of Medicine 2019 7(1):3-4

Incidence of fissure-in-ano among night duty workers Kiran B Khandare, Vasudha S Umate, Pooja P Shrivastav Journal of Indian System of Medicine 2019 7(1):5-7 Background: Anal fissure is commonly seen in today’s era. The incidence of fissure is 10% of the total cases attending proctology clinics. Lifestyle has an important impact on anorectal diseases along with improper dietary habits. Aims: To analyse whether there is any relation between night awakening and fissure-in-ano or not, this study was undertaken. Materials and Methods: A total of 100 subjects who were working at night since at least 6 months were selected. A prepared questionnaire was given to the subjects and they were asked to fill it genuinely. Subjects who were having fissure-in-ano were observed and noted. Different groups were formed on the basis of the days of night duty of the employees per week, type of night duty, and dietary habits of the individuals, and assessment was carried out. Observation: Sixty-two subjects were found to have some of the complaints listed in the questionnaire. They were examined. Among those 62 subjects, 43 subjects were diagnosed with fissure-in-ano. Conclusion: The study revealed that 8.68% is the incidence of fissure-in-ano in night duty workers, which is found to be significant.

Experimental study on effect of Naga Bhasma (lead calx) on hematological and biochemical parameters Dhirajsingh S Rajput, Nilesh Mahakal, Biswajyoi J Patgiri Journal of Indian System of Medicine 2019 7(1):8-19 Background: In recent decade, a lot of concerns has been raised regarding heavy metal content in Ayurveda medicines, especially Bhasma (metallic calx). Naga Bhasma (lead calx) is of the metallic preparation primarily indicated in treating chronic ailments such as Kamala (jaundice), Vatarakta (gout), Grdhrasi (sciatica), Kustha (skin diseases), and Prameha (diabetes). As being a compound of lead, its chronic toxicity study was planned to find out the effect of Naga Bhasma on serum biochemical and hematological parameters. Material and method: Naga Bhasma was prepared by Parada (mercury) and Gandhaka media (NBP) and Vasa Swarasa (juice of Adhatoda vasica Linn.) as herbal media (NBH) in seven Puta (incineration cycles). Chronic oral toxicity study was carried out as per Organization for Economic cooperation and Development (OECD) 408 (90-day oral repeated dose toxicity study). Wistar strain albino rats (Rattus norvegicus) were used for the experimentation. The study was conducted at three dosage levels, therapeutically effective dose (TED) of NBP and NBH was 45 mg/kg body weight of rat, TED × 5 and TED × 10. On 91st day, blood was collected by supraorbital puncture with the help of microcapillary tubes under mild ether anesthesia for estimation of serum biochemical and hematological parameters. Observation and results: Among hematological parameters, significant decrease was observed in MCV (Mean corpuscular volume), MCH (Mean corpuscular haemoglobin), and mean corpuscular hemoglobin concentration by NBH-treated group, whereas in biochemical parameters, both test drugs significantly increased BSL (Blood Sugar Level), SGOT (Serum Glutamic-Oxaloacetic Transaminase), and serum ALP (Alkaline Phosphatise) activity. Hematological and biochemical analysis indicates that both test drugs (prepared in seven incineration cycles) were not found completely safe, especially at higher dosage where the drug affected renal and hepatic functions. Conclusion: For the safety purpose, it is suggested that Naga Bhasma prepared in less number of incineration cycles may not be used for therapeutic purpose.

In vivo anticancer activity and toxicity of Ayurveda compound W.S.R. to leukemia Monika Sharma, Sharad Porte, Sandeep Charak Journal of Indian System of Medicine 2019 7(1):20-27 Introduction: A diseased caused by an uncontrolled division of abnormal cells in any tissue of any organ of the body is called cancer. There are various types of cancers on the basis of primary abnormal growth in tissues. Leukemia is a type of cancer of blood, which is caused by the rapid production of abnormal white blood cell. In Ayurveda, the reference of the cancer and blood cancer is found indirectly under the heading of Arbuda (cancer) and Rakta Arbuda (leukemia), respectively. In Ayurveda, there are so many herbo-mineral drugs that are useful in treating cancer. Aims and Objectives: To study the in vivo anticancer (blood cancer) activity of Ayurveda compound. To compare the toxicity of Ayurveda compound with injection/tablet arsenic trioxide. To evaluate, elaborate, and discuss the etiology of leukemia as per Ayurveda. Materials and Methods: An in vivo study was conducted in Institute of Biomedical and Industrial Research. The in vivo antileukemic effect was carried out by using benzene-induced (carcinogen) model in Swiss albino mice and the acute toxicity study was conducted according to fixed single-dose toxicity. The herbo‑mineral drugs has been prepared by using purified arsenic (arsenic trioxide), Vinca rosea, and Urginia indica to study in vivo anti-leukemic effect and toxicity. This study was conducted according to organisation for economic co-operation and development Guidelines 423 and the antileukemic activity was carried out by benzene-induced leukemia in albino mice after animal ethical clearance. Result: The highest dose of the test drug (2000mg/kg) in the acute toxicity study shows minimal adverse effect of toxicity on liver and no adverse effect was found on kidney and spleen. The result was found better in study group 1 having myelocytic leukemia than study group 2 having lymphocytic leukemia. Conclusion: The effect of study drug shows good antileukemic activity, although standard drug was found better than study drug. Overall, the study was found safe and effective on blood cancer.

A critical analysis of Raktadhara Kala in perspective of Acharya Sushrut Deepali M Giri, Namrata B Chouragade Journal of Indian System of Medicine 2019 7(1):28-32 Literature of Ayurveda contain a treasure of concepts. Many Ayurveda scholars and experts are continuously working on various concepts. Still the scope of research seems to be unending. Some topics have been studied lesser and Kala Sharir (membranous structures in body) is one of them. Though many people have worked a lot on this topic, we wanted to concentrate on the basic concept of Raktadhara Kala (a fine membrane that lines the blood vessels) and its relation with Mool Sthana of Raktavaha Strotasa (vital component of the Raktavaha Strotasa). We have tried a critical analysis of the concept of Raktadhara Kala described by Acharya Sushruta. The concept is studied in conjunction with the study of histology. A thorough literary study of Samhitas has been done. The histological aspect of the tissues that has similarity with Raktadhara Kala and with the Mool Sthana of Raktavaha Strotasa (a system that is related to circulation, production of blood) was also studied. According to Ayurveda, Strotasa (a system of channels) play an important role in a person’s health. Strotovikriti (abnormality in system of channels) lead to diseases. Kala and Strotasa are closely related. If we could correlate the Kala and Strotasa with the tissues, it will be helpful in diagnosis and treatment of many ailments.

Critical review on pharmaceutical prospects of acid formulations described in Ayurveda classics with respect to Draavak Kalpas Bhagyashree Ratan Jibkate, Bharat Jagdishji Rathi, Anita Santoshrao Wanjari, Dhirajsingh Sumersingh Rajput Journal of Indian System of Medicine 2019 7(1):33-42 Rasashastra, the pharmaceutical science, deals mainly with the processing and therapeutic utilization of metals and minerals. It aims at designing novel drugs with better curative attributes at minimum doses. Draavak Kalpas (acid formulations prepared by Ayurveda method) are rarely utilized Ayurveda formulations that claim to have specific therapeutic attributes. In spite of being acid preparation, the convenient form of administration and doses of Draavak Kalpas are more acceptable and can increase its usage to prevent and cure diseases of gastrointestinal tract. Draavak Kalpas are liquid preparations obtained by processing Lavana (salt) and Ksharas (alkaline materials). Forty different formulations, ingredients, methods of preparation, and its indications along with dose and Anupanas (adjuvant) are the peculiarity of this review. Distillation process and application of proper heat is the foremost method to obtain good quality of Draavak. Draavak Kalpas is the specialty of Rasashastra as they are mentioned only in the texts of Rasashastra. This review is carried out for the future research, so that its actual efficacy and utility of indications can be acknowledged.

Review on role of Agnikarma in pain of various musculoskeletal disorders Natasha A Rathod, Vaishali V Kuchewar Journal of Indian System of Medicine 2019 7(1):43-46 Pain is the cardinal feature of most of the musculoskeletal disorders. Pain is the factor for which patient generally approaches a doctor. Pain is defined as “an unpleasant sensory and emotional experience, which is generally associated with actual or potential tissue damage.” It can affect the quality of life; hence, its preventive measures are of prime importance in health care. In Ayurveda, the word “pain” can be correlated with Ruja, which is caused due to vitiation of Vata. Use of heat therapy for various ailments was found in Ancient Ayurveda treatises. There are different treatment modalities in Ayurveda, which are described by acharyas, Agnikarma (heat therapy) is one among them. Acharya Sushruta has mentioned use of Agnikarma in various disorders such as Granthi (tumor), Arsha (hemorrhoids), Bhagandar (fistula), Arbuda (tumor), Shlipad (filariasis), Antra Vrana (internal injury), and Nadi Vrana (sinuses) in detail. There are different materials that are used, such as Pippali (Piper longum), Aja Shakrut (goat excreta), Godanta (gypsum), Shara (arrow), Shalakha (metal rod), Kshaudra (honey), Guda (jaggery), and Sneha (oil/fat), for giving Agnikarma to various parts of the body such as skin, muscles, blood vessels, and ligaments. As Agnikarma is a parasurgical procedure, Acharya Charak has not described it in separate chapter but has described it as one of the treatment measures in different Vatavyadhis (neuromusculoskeletal disorders) such as Gridhrasi (sciatica). If the drugs such as nonsteroidal anti-inflammatory drugs, which are generally used for relieving pain factor in musculoskeletal disorders, are used for longer duration they can cause potential side effects on the body; hence, there is an emerging need to search for a safe option for the same. In this article, an attempt has been made to search the researches conducted on Agnikarma related to musculoskeletal disorders to establish its role in musculoskeletal pain.

Proficiency of Khanduchakka Ghrit in the management of Parikartika: A case report Suraj V Tichkule, Kiran B Khandare, Pooja P Shrivastav Journal of Indian System of Medicine 2019 7(1):47-50 Background: Fissure-in-ano is a common anorectal disease. It is mainly of two types: acute and chronic. Chronic fissure-in-ano is difficult to treat and most of the time, it is associated with sentinel tag, which guards the fissure from healing, resulting in nonhealing ulcer, which calls for surgical intervention. Khanduchakka (Ehretia laevis) is a folklore plant that is used popularly by the tribal people for the healing of the nonhealing ulcers. Using that reference in this research work, Khanduchakka Ghrit was used as a local application for managing chronic fissure-in-ano and its efficacy was evaluated. Materials and Methods: In this case report, a patient with chronic fissure-in-ano was treated by Khanduchakka Ghrit, which was used as a local application, after all the mandatory investigations, and its efficacy was evaluated on the basis of clinical parameters such as pain, bleeding, itching, and healing. Results: The patient showed significant results in the clinical parameters evaluated. She got relief in pain, itching, bleeding per rectum, and fissure within 20 days. Even on follow-up assessment, no signs of recurrence were reported. Conclusion: From the aforementioned case, it was concluded that simply applying Khanduchakka Ghrit over a chronic fissure-in-ano is able to heal it. This study revealed that it not only acts as a Ropana (healing agent) but also acts as a Lekhandravya (scrapping agent), which helps in removing slough present at fissure bed and simultaneously helps in the healing of chronic fissure-in-ano.

A case report on management of recurrent anal fistula by Nyagrodha Ksheer Sutra Dhananjay D Deshmukh, Kiran B Khandare, Pooja P Shrivastav Journal of Indian System of Medicine 2019 7(1):51-55 Background: Fistula in ano is defined as an inflammatory tract lined by unhealthy granulation tissue having its external opening in the perianal region and internal opening in the anal canal or rectum. In Ayurveda, it can be correlated with Bhagandar (fistula in ano). Various surgical as well as para-surgical treatments are in rage to treat anal fistula but have certain limitations and risk of recurrence. Critical recurrent anal fistula is one among the toughest and rare anal fistula to treat and still stand as a challenge in front of surgeons. Materials and Methods: In this case report, critical recurrent anal fistula is managed by Nyagrodha Ksheer (Latex) Sutra (medicated seton) after all the mandatory investigations, and its efficacy was evaluated on the basis of clinical parameters such as pain, itching, pus discharge, and cutting rate. Results: Patient showed significant results in clinical parameters evaluated. Even after 1-month follow-up assessment, there were no signs of recurrence. Conclusion: As seen in many cases, it is very difficult to manage the anal fistula because of its high recurrence rate. In this case also, it was evident that the patient was having the same complaint of recurrence of fistula after multiple surgeries. In order to find out a minimal invasive technique, an attempt was made to treat the critical recurrent fistula with the help of Nyagrodha Ksheer Sutra. From the aforementioned case, it is concluded that Nyagrodha Ksheer Sutra is efficient in treating critical recurrent anal fistula. It also revealed that Nyagrodha Ksheer acts on the basis of its Shodhan (wound cleaning) and Ropan (wound healing) property to heal critical recurrent anal fistula.