bluuebunny/crossref_metadata_2025 huggingface dataset:
Primary signet ring cell carcinoma of prostate: A rare case report and review of literature
Authors: Gupta Monika , Budhwar Archana , Prasad Nikita , Prasad Sujata Kumari SP , Singh Sunita
Published: September 2023

Primary signet ring cell carcinoma (PSRCC) of the prostate is an extremely rare variant of prostatic adenocarcinoma. A PubMed search of the English language literature from January 2000 to June 2020 using the keywords “signet ring cell carcinoma” and “prostate,” identified 20 cases of PSRCC of the prostate. On the basis of the combined data from this study and the literature review, 21 such patients were evaluated for clinical characteristics, histologic diagnoses, special and immunohistochemical staining, and treatment. The mean age at the diagnosis was 68.47 years (range 50–85 years). The prostate-specific antigen (PSA) levels varied from 0.19 to 6658 ng/mL, with a mean of 509.15 ng/mL. Most (50%) presented with Stage 3 cancer. The most common Gleason grade group was 5 (Gleason score 9 to 10), seen in 61.5%. The extent of signet ring cell involvement of the specimen when reported was documented as more than 20% of the tumor-containing signet ring cells, with a range of 25%–90%. For pathologic diagnosis, the most common special stains performed were periodic acid–Schiff and Alcian blue, and among the immunohistochemical stains, the most common were PSA, CK20, and prostate-specific acid phosphatase. A detailed clinicoradiological and pathological workup is essential to rule out primary from other common sites, in view of its grave prognosis and lack of an established treatment protocol.
Evaluation of the relationship between γ-H2AX biomarker levels and dose received after radiation exposure in abdominal–pelvic and chest CT scans
Authors: Fardid Reza , Janipour Sara , Haddadi Golamhassan , Mahdavi Maziyar , Sharifzadeh Sedigheh , Lotfi Mehrzad , Rostamyari Maliheh
Published: September 2023

Background:

As one of the most informative diagnostic radiation instruments, computed tomography (CT) has seen considerable improvement since its implementation in the 1970s; however, the possibility of low-dose radiation risk after CT procedures is still challenging and little is known about the biological effects of CT exposure on patients. As a result, this research aimed to look at the biological and cytogenetic effects of low-dose abdominal–pelvic and chest CT scans on adults, focusing on the number of γ-H2AX foci formation.

Materials and Methods:

Blood tests were taken before and 10 min after CT exams on patients aged 25–55 who were undergoing abdominal–pelvic and chest CT exams with very low-ionizing radiation exposure (TLD doses of 15.67–63.45 mGy). Blood lymphocytes that had been isolated, fixed, and stained were dyed with γ-H2AX antibodies. Finally, the percentage of phosphorylation of histone H2AX as an indicator of double-strand breaks was determined using a cytometry technique.

Results:

Our findings showed that after CT examination, the mean value of γ-H2AX foci in patients increased (P < 0.0001). A statistically significant correlation between dose radiation and the number of γ-H2AX foci was also found (P = 0.047, r = 0.4731). The current study also found a pattern of elevated γ-H2AX foci in patients over 40 years of age relative to younger patients.

Conclusion:

A Significant activation of γ-H2AX foci was found in lymphocytes of peripheral blood samples of patients after CT compared to before CT scan. This increase in γ-H2AX foci levels in blood cells may be a useful quantitative biomarker of low-level radiation exposure in humans.
Measurement of Ambient Dose Equivalent in Compact Proton Therapy using In-house Neutron Moderator-based Poly Allyl Diglycol Carbonate
Authors: Tawonwong Tanawat , Suriyapee Sivalee , Dachviriyakij Tanapol , Pungkun Vithit , Ruangchan Sirinya , Sanghangthum Taweap
Published: September 2023

Purpose:

The high-energy proton produces the unwanted dose contribution from the secondary neutron. The main purpose of this study is to report the validation results of in-house neutron moderator based on poly allyl diglycol carbonate (CR-39) detector, Chulalongkorn University Neutron Moderator (CUMOD) through the ambient dose equivalent, H*(10) measurement.

Materials and Methods:

The Particle and Heavy Ion Transport code System (PHITS) Monte Carlo code was used to simulate the neutron response function. The CUMOD was calibrated with 241AmBe source calibrator in the range of 100–1000 μSv. The variation of neutron fields was generated employing different proton treatment plans covering most of the clinical scenarios. The ambient dose equivalents, H*(10), evaluated employing CUMOD were compared to those obtained with WENDI-II dosimeter.

Results:

The linear relationship between CUMOD and WENDI-II responses showed an R
2 value close to 1. The H*(10) per Gy delivered dose was in the range of 22–105 μSv for a 10 cm × 10 cm field.

Conclusion:

The in-house CUMOD neutron moderator can expand the neutron detection dose range of CR-39 detector for ambient dose equivalent. The advantage of CUMODs is its capability to evaluate H*(10) in various positions simultaneously.
Dosimetric Comparision of Coplanar versus Noncoplanar Volumetric Modulated Arc Therapy for Treatment of Bilateral Breast Cancers
Authors: Bharati Avinav , Rath Satyajeet , Khurana Rohini , Rastogi Madhup , Mandal Susama R. , Gandhi Ajeet Kumar , Hadi Rahat , Srivastava Anoop K. , Mishra Surendra Prasad
Published: September 2023

Introduction:

The purpose of this study was to compare the dosimetric parameters of volumetric modulated arc therapy (VMAT) treatment plans using coplanar and noncoplanar beams in patients with bilateral breast cancer/s (BBCs) in terms of organ at risk sparing and target volume coverage. The hypothesis was to test whether VMAT with noncoplanar beams can result in lesser dose delivery to critical organs such as heart and lung, which will result in lesser overall toxicity.

Materials and Methods:

Data of nine BBC cases treated at our hospital were retrieved. Computed tomography simulation data of these cases was used to generate noncoplanar VMAT plans and the parameters were compared with standard VMAT coplanar plans. Contouring was done using radiation therapy oncology group guidelines. Forty-five Gray in 25 fractions was planned followed by 10 Gy in five fractions boost in breast conservation cases.

Results:

No significant difference in planning target volume (PTV) coverage was found for the right breast/chestwall (P = 0.940), left breast/chestwall (P = 0.872), and in the total PTV (P = 0.929). Noncoplanar beams resulted in better cardiac sparing in terms of Dmean heart. The difference in mean dose was >1 Gy (8.80 ± 0.28 − 7.28 ± 0.33, P < 0.001). The Dmean, V20 and V30 values for total lung slightly favor noncoplanar beams, although there was no statistically significant difference. The average monitor units (MUs) were similar for coplanar plans (1515 MU) and noncoplanar plans (1455 MU), but the overall treatment time was higher in noncoplanar plans due to more complex setup and beam arrangement. For noncoplanar VMAT plans, the mean conformity index was slightly better although the homogeneity indices were similar.

Conclusion:

VMAT plans with noncoplanar beam arrangements had significant dosimetric advantages in terms of sparing of critical organs, that is Dmean of heart doses with almost equivalent lung doses and equally good target coverage. Larger studies with clinical implications need to be considered to validate this data.
Investigation of TG-43 Dosimetric Parameters for 192Ir Brachytherapy Source Using GATE Monte Carlo Code
Authors: Joya Musa , Nedaie Hassan Ali , Geraily Ghazale , Rezaei Hadi , Bromand Awaz , Ghorbani Mahdi , Sheikhzadeh Peyman
Published: September 2023

Purpose:

According to the revised Task Group number 43 recommendations, a brachytherapy source must be validated against a similar or identical source before its clinical application. The purpose of this investigation is to verify the dosimetric data of the high dose rate (HDR) BEBIG 192Ir source (Ir2.A85-2).

Materials and Methods:

The HDR 192Ir encapsulated seed was simulated and its main dosimetric data were calculated using Geant4 Application for Tomographic Emission (GATE) simulation code. Cubic cells were used for the calculation of dose rate constant and radial dose function while for anisotropy function ring cells were used. DoseActors were simulated and attached to the respective cells to obtain the required data.

Results:

The dose rate constant was obtained as 1.098 ± 0.003 cGy.h − 1.U − 1, differing by 1.0% from the reference value reported by Granero et al. Similarly, the calculated values for radial dose and anisotropy functions presented good agreement with the results obtained by Granero et al.

Conclusion:

The results of this study suggest that the GATE Monte Carlo code is a valid toolkit for benchmarking brachytherapy sources and can be used for brachytherapy simulation-based studies and verification of brachytherapy treatment planning systems.
Dosimetric Evaluation of Radiation Treatment Planning for Simultaneous Integrated Boost Technique Using Monte Carlo Simulation
Authors: Shende Ravindra , Dhoble S. J. , Gupta Gourav
Published: September 2023

Monte Carlo (MC) techniques have been recognized as the gold standard for the simulation of radiation transport in radiotherapy. The aim of the study is to perform dosimetric evaluation of Simultaneous Integrated Boost (SIB) radiation treatment planning using MC simulation approach. The geometrical source modeling and simulation of 6 MV Flattening Filter Free (FFF)beam from TrueBeam linear accelerator have been carried out to simulate Volumetric Modulated Arc Therapy (VMAT) plans using MC simulation software PRIMO. All the SIB plans have been generated using VMAT techniques for patients with locally advanced postoperative head-and-neck squamous cell carcinoma in Eclipse Treatment Planning System (TPS) retrospectively. TPS plans have been compared against their respective MC-simulated plans in PRIMO. The quality assessments of plans have been performed using several dose volume parameters, plan quality indices, and methods of gamma analysis. Dmean, D50%, and D2% received by planning target volume (PTV), PTV60, and PTV52 have been found significantly lower in TPS-generated plans compared to MC-simulated plans. D100%, D98%, and D95% received by PTV60 exhibit good agreement. However, PTV52 shows a significant deviation between TPS and MC plans. The mean organ-at-risk doses have been found significantly lower in TPS plans compared to MC plans. TPS and MC plans have been found in close agreement within gamma acceptance criteria of 3% Dose Difference (DD) and 3 mm Distance to Agreement (DTA). Dose distributions computed using MC simulation techniques are reliable, accurate, and consistent with analytical anisotropic algorithm. Plan quality indices have been found slightly compromised in MC-simulated plans compared with TPS-generated plans appeared to be a true representation of real dose distribution obtained from MC simulation technique. Validation using MC simulation approach provides an independent secondary check for ensuring accuracy of TPS-generated plan.
A Simplified Approach for Determination of Inflection Points of Flattening Filter-Free Photon Beam Using In-House Developed Software and Derivation of Reference Levels
Authors: Sharma Smriti , Dixit D. K. , Sharma S. D. , Sharma Amit , Sahani G. , Upreti Ritu Raj , Kinhikar R. A. , Sharma P. K. Dash
Published: September 2023

Aim:

This article aimed to present the salient features of the in-house developed Java program for the determination of inflection point and dosimetric parameters of flattening filter-free (FFF) photon beam. Reference levels for the dosimetric parameters of the FFF photon beams were also presented.

Materials and Methods:

Beam profiles of 6 MV FFF and 10 MV FFF photon beams for a collimator setting of 20 cm × 20 cm measured at 10 cm depth in an isocentric setup acquired from various institutions were analyzed using an in-house developed Java program and manual method. The values of reference dose value (RDV), field size, penumbra, and degree of un-flatness (defined as the lateral separation between 90% [X90%], 75% [X75%], and 60% [X60%] dose points on the profile) were calculated and compared. The reference values of field size, penumbra, and degree of un-flatness were also determined for Varian and Elekta medical electron linear accelerators (LINACs).

Results:

The maximum differences for RDV determined using the Java method and manual method are 2.4% and 2.7% for 6 and 10 MV FFF photon beams, respectively. The maximum difference between the values of field size, penumbra, and degree of un-flatness determined using Java and manual methods is within 1.3 mm. The reference values of field size and penumbra for Varian LINACs are 19.94 ± 0.10 cm and 0.83 ± 0.08 cm (6 MV FFF) and 19.95 ± 0.10 cm and 0.83 ± 0.08 cm (10 MV FFF). Similarly, the reference values of field size and penumbra for Elekta LINACs are 20.02 ± 0.09 cm and 0.94 ± 0.12 cm (6 MV FFF) and 20.03 ± 0.11 cm and 0.97 ± 0.16 cm (10 MV FFF).

Conclusions:

A software program was developed in Java for analyzing the beam profiles of FFF photon beams. The results of Java-derived values of dosimetric parameters of FFF photon beams were found in good agreement with the values determined using the manual method. The reference values of these parameters were also derived and quoted using a large cohort of the data.
Dosimetric Characteristics of Radiophotoluminescent Glass Dosimeters for Proton Beams
Authors: Oonsiri Sornjarod , Kingkaew Sakda , Vimolnoch Mananchaya , Chatchumnan Nichakan , Oonsiri Puntiwa
Published: September 2023

Purpose:

The purpose of the study was to investigate the dosimetric characteristics of radiophotoluminescent glass dosimeters (RGDs) for pencil beam scanning proton therapy. The RGD’s end-to-end testing of intensity-modulated proton therapy (IMPT) plans was also evaluated.

Materials and Methods:

The dosimetric characteristics of the GD-302M type glass dosimeter were studied in terms of uniformity, short-term and long-term reproducibility, stability of the magazine position readout, dose linearity in the range from 0.2 to 20 Gy, energy response in 70–220 MeV, and fading effect. The reference conditions of the spot scanning beam from the Varian ProBeam Compact system were operation at 160 MeV, a 2 cm water-equivalent depth in a solid water phantom, a 10 cm × 10 cm field size at the isocenter, and 2 Gy dose delivery. End-to-end testing of IMPT plans for the head, abdomen, and pelvis was verified using the Alderson Rando phantom. The overall uncertainty analysis was confirmed in this study.

Results:

The relative response of RGDs for the uniformity test was within 0.95–1.05. The percentages of the coefficients of variation for short-term and long-term reproducibility were 1.16% and 1.50%, respectively. The dose ACE glass dosimetry reader FGD-1000 showed a stable magazine position readout. The dose was found to be linear with R
2 = 0.9988. The energy response relative to 160 MeV was approximately within 4.0%. The fading effect was within 2.4%. For the end-to-end test, the difference between the treatment plan and RGD measurement was within 1.0%. The overall uncertainty of the RGD measurement for the proton beam was 4.6%, which covered all energy ranges in this study.

Conclusion:

The experimental study indicates that the RGDs have the potential to be used in the dosimetry of therapeutic proton beams, including end-to-end dosimetry.
One nation one health—Preview through Ayurveda
Authors: Dhaliya Ravi , Kaushik Sharma Bal Krishan , Dhakkad Gagan Singh
Published: September 2023

For many years, the definition of “health” has remained untouched as a narrow concept, encircling physical well-being from a medical context. Over the past years, different healthcare experts, whether groups or individuals, have developed and defended various definitions of what a proper state of “health” actually means in the present time. Human health cannot be separated from the health of our total planetary biodiversity in today’s world. Human beings live in an interdependent existence with the totality of the living world. We now know how liable our human well-being is to the “health” of the Earth’s energy exchange systems. The sustained good health of populations, along with the holistic approach to health and diseases, also requires a proper management of our social resources, economic relations, and the natural world because today’s public health has its roots in the same socioeconomic variations. India is known for its own traditional medicine, far older than modern medicine, with a state-owned education, practice, and research system. The world has recently recognized science’s efficacy in health and wellness. Ayurveda is not limited to medicine or therapy for a target organ; instead, it implies a holistic approach to life and living in harmony with nature. Ayurveda perceives human beings as the microcosm of the macrocosm and highlights how human life is interconnected and interdependent on nature. In achieving health, it always stresses this connection and uses strategies connecting humans to nature. Ayurveda practices assist individuals in taking control of their health and increasing self-reliance, and re-begin their relationship with the environment. Thus, Ayurveda can play an essential part in the One Nation, One Health System as the whole wellness of a nation and environment rather than individual health.
One Nation One Health—Journey of a Nation to equipoise health and disease
Authors: Yadav Chhaju R. , Resmi B. G. , Sharma Sanjeev
Published: September 2023

Being a developing country, India has faced many challenges since freedom concerning the economy, health, and education. Providing healthcare facilities to all strata of society was a monumental task. By formulating National Health Policy in 1983, India took its first initiative in this context. Timely revision of the policy in 2002 and 2017, according to the requirements and implementation of many national healthcare programs, has enabled it to advance in the healthcare system. India now aims at bringing uniformity in the healthcare facilities provided by the government to all the people anywhere in India at minimal expenditure. In this regard, universal health coverage has been introduced as a part of the Ayushman Bharat Yojana to reduce the cost of treatment to patients. Slowly, India is heading toward sustainability in terms of quality health care assessible to all sectors of society. To bring uniformity of health care by integrating different healthcare systems according to the choice and needs of the patients, with minimal financial burden and compromise in quality, the “One Nation, One Health System by 2030” agenda has been introduced. Here, the formulation of the National Health Policy and its timely renewal and the role of Ayurveda in achieving its goals have been discussed.
“One Nation, One Health System”
Authors: Prasad B. S.
Published: September 2023

Change is inevitable with time. When change happens, the needs, attitude, behavior, habits, etc., will also change. The same is the case with medical practices also. The public is well aware of the strengths and limitations of each medical system and is willing to accept multisystem or integrated systems of approach for their health needs. It is our duty to identify the strengths and limitations of each medical system and to complement the weakness of one system with the strengths of the other system. We aim to provide a holistic approach to alleviate suffering. It can be said that an ailing person is ready to seek advice irrespective of “pathy” or qualification and accepts medical pluralism, including advice from folk practitioners or tribal practitioners. In this method, where the patients seek pluralistic medical advice, there is a waste of time and money in consulting different systems. Also, there are chances of overdosage or synergetic or antagonistic actions of medicines. Unified medical practices that provide all types of medical services at one contact point ensure the utilization of the strengths of all medical systems at the same place, which would ultimately benefit patients. The unification or integration of medical practice needs to be done at a multilevel, and the medical systems should also be available as parallel services. The broad avenues of integration are at the practice level, medical education, and research. Integration is the key to having a patient-centric approach. The integration of medical systems has difficulties but is not impossible. Coordinated, collaborative, and accessible health care is inevitable in a patient-centered approach. Medical professionals from different systems must align their vision and values to benefit patients by crossing pathy barriers with openness. With unified medical systems in the “Indian Health Care System,” India can advance to be a global leader in the healthcare sector.
Approach to seeking global recognition for Ayurvedic medicines
Authors: Jauhri Anil , Gunawant Deepika G.
Published: September 2023

India is negotiating free trade agreements (FTAs) with several countries like the UK, Canada, European Union, and so on; one of the aims of these FTAs is more and easier access to Indian products. Ayurvedic medicines by themselves and especially given the COVID pandemic, which brought to the fore the importance of traditional medicines, represent one sector that needs to be taken up in these negotiations for access to trading partner markets. This paper is an attempt to present an approach to gain recognition of Ayurvedic medicines under FTAs and how it can facilitate easier access.
Efficacy of Pathyadi Churna and Trikatu Churna in the management of Amavata (rheumatoid arthritis)
Authors: Makhija Deepa , Borkar Preeti Sujit , Desai Priti , Singh Renu , Singhal Richa
Published: September 2023

BACKGROUND:

Rheumatoid arthritis (RA) is a chronic, progressive, systemic autoimmune disease primarily affecting the synovial joints. Clinical symptoms of RA are similar to Amavata- a disease mentioned in Ayurveda. As per the Ayurveda classical texts, the formation and deposition of Ama (biotoxin) play a significant role in the pathogenesis of Amavata (RA). Hence, Deepana (appetite stimulant) & Ama-pachana (interventions that digest the biotoxins) can be first line of treatment for managing RA. Being Deepana and Pachana, Pathyadi Churna and Trikatu Churna can mitigate the Ama, prevent its genesis in the body, and thereby break down the pathogenesis of RA. Both formulations have anti-inflammatory and analgesic action which is supportive while treating RA. The present study will compare the efficacy of Pathyadi Churna and Trikatu Churna in managing RA.

MATERIALS AND METHODS:

It will be a randomized, parallel-group comparative trial with a sample size of 110 participants. Patients of any gender aged 18 to 65 years diagnosed with Rheumatoid arthritis based on American College of Rheumatology (ACR) 2010 criteria and presenting with Sama clinical features of Amavata will be enrolled in the study. Participants will be divided randomly into two groups. In group I, Pathyadi Churna, and Group II, Trikatu Churna will be administered in 3 gm and 1 gm, respectively, twice daily after food with lukewarm water for four weeks. The efficacy of the study interventions will be assessed through the changes in Disease Activity Score 28 (DAS28) and Ayurvedic disease-specific parameters from baseline.

CONCLUSION:

The study will help generate evidence regarding the efficacy of Pathyadi Churna and Trikatu Churna in managing RA.
Integration of Ayush within national health care systems
Authors: Thyagarajan S. P.
Published: September 2023

The utilization of traditional knowledge is crucial for achieving universal healthcare, according to the World Health Organization (WHO) Traditional Medicine Strategy 2014–23. The Indian systems of Medicine—Ayurveda, Yoga, Unani, Siddha, and homeopathy (Ayush)—have been projected to play a significant role in universal healthcare due to the emphasis placed on preventive and promotive health, their reasonable cost, low level of technological input, and the rising popularity of naturally derived plant-based products. These systems are being recommended for inclusion in national public health policy. Traditional Medicine (TM) is being used more frequently, which has raised questions regarding its safety and toxicity potential, such as hepatotoxicity. Thus, under the Department of Ayush’s vision and mission-2030, it is intended to develop scientific evidence in Ayurvedic principles and drug therapies by integrating ancient wisdom with modern technology and to bring Ayurveda to the people through innovations related to diagnostics, preventive, promotive as well as treatment methods and introduce scientific research for sustained availability of quality natural resources, to translate them into practical applications as modern science solutions for ensuring international acceptance of Ayush systems and their integration into National Health System and Modern Medicine, achieving the goal of One Nation, One Health System. Ayurvedic biology, standardization through chemobiological fingerprinting, chemobiological assays, and Pharmacovigilance studies of herbal medicines are suggested.
Development of practical approach of Sattvavajava Chikitsa for depressive disorders
Authors: Singh Dipinti , Tripathi Jyoti S.
Published: September 2023

In today’s modern world, most people are confronted with mental illness at some point in their lives. Depression is a widespread problem that has a detrimental impact on a person’s ability to function and sense of well-being. It has become a worldwide public health concern. Sattvavajava Chikatsa (SC) is an Ayurvedic psychotherapy and psycho-spiritual therapy that promotes mental wellness as well as prevention, management, and treatment of mental disorders. SC works on five basic principles, i.e., promotion of spiritual knowledge, scriptural knowledge, patience, memory, meditation in any patient whenever needed. The concepts of SC are scattered throughout classical texts, making it difficult for Ayurvedic physicians to understand how to practice. This could be due to the fact that psychological diseases are less common than physical illnesses. The goal of this review is to describe and briefly explain the concept of SC, as well as to establish a practical approach/tools based on it, with a particular focus on the management of major depressive disorder (MDD). It will aid in a holistic knowledge of the SC principle, as well as a practical approach based on SC for the management of MDD.
An observational study to assess the demographic status and health-seeking behavior of SC women and children in Bhubaneswar Block of Odisha
Authors: Binitha P. , Ratha Kshirod K. , Das Banamali , Ota Sarada , Gavali Kishor A. , Rao Mrithyunjaya M.
Published: September 2023

BACKGROUND:

The Scheduled Castes (SC) population of Odisha constitutes 17.3% of the total population of the state and is one of the most vulnerable groups with regard to health care due to the non-availability of affordable and quality health services. Reproductive health literacy is relatively poorer in adolescents and women, which impacts their reproductive health.

OBJECTIVE:

The core objectives of the study were to determine the socioeconomic status, living conditions, educational status, dietetic habits, lifestyles, and healthcare-seeking behavior of SC women and children, promote awareness regarding lifestyle and health, and also provide healthcare services at their doorsteps.

MATERIALS AND METHODS:

The study was conducted from January to December 2019 in the SC population-dominated areas of the Khurdha district of Odisha. The requisite information was documented by door-to-door visits from respondents who provided their consent for participation in the study, through a structured format. Awareness was created to the respondents through distribution of Information, Education, and Communication materials and public lectures. Ayurveda healthcare services were provided as per the initial screening, presence of risk factors, and presenting complaints, if any. The data gathered were analyzed through descriptive statistical assessment, i.e., measures of frequency and position of the data.

RESULTS:

A total of 5041 people were surveyed, including females and children only. Among these, 2758 were women of reproductive age and 2283 were children. Of the 2283 children, 1186 were male and 1097 were female. The causes of gynecological diseases in SC women are poor living conditions, environmental factors, poor hygiene, improper care during menstrual cycles, a faulty lifestyle, and a low socioeconomic status. The health indices were found to have improved due to the implementation of various women-centric welfare schemes by the government and institutional delivery.

CONCLUSION:

The Reproductive and Child Health program is pivotal for improving the health outcomes of the deprived and unreached segment of the SC women’s population. Supplementation of comprehensive and holistic health care through Ayurveda advocacy is sustainable and can improve health outcomes and reduce mortality and morbidity.
Therapeutic evaluation of Rasnadi Gutika and Chandrakala Lepa in Janusandhigata Vata (osteoarthritis knee)
Authors: Das Banamali , Singh Sanjay K. , Meher Sudhanshu K. , Srivastav Alok K. , Ota Sarada , Rana Rakesh , Singhl Richa , Sharma Bhagwan S. , Khanduri Shruti , Kumar Adarsh , Rao Meda M. , Srikanth Narayanam
Published: September 2023

BACKGROUND:

Sandhivata [osteoarthritis (OA)] is one of the Vata Vyadhi, which causes much suffering for a prolonged period. The cause of Sandhivata in Ayurveda is attributed to improper diet, lifestyle, and old age, leading to aggravation of Vata, and is associated with slow and steady decline in tissue quality and function. The disease specific symptoms of Sandhigata vata are very similar to that of OA. Treatment in OA is targeted for reviving joint function through halting the disease pathogenesis and promotion of joint health and vitality.

OBJECTIVE:

The objective of this study was to assess the clinical efficacy of Rasnadi Gutika (RG) and Chandrakala Lepa (CKL) in the management of Janusandhigata Vata [osteoarthritis knee (OA knee)].

MATERIALS AND METHODS:

The study was conducted at two peripheral institutes of the Central Council for Research in Ayurvedic Sciences, viz., Central Ayurveda Research Institute, Bhubaneswar, Odisha and Regional Ayurveda Research Institute, Lucknow, Uttar Pradesh. A total of 120 patients between the age of 40 and 75 years suffering from primary OA knee joint were treated with RG and CKL. The duration of the therapy was 12 weeks, and follow-up was done on the 14th, 28th, 42nd, 56th, 70th, and 84th days. RG was administered orally in the dose of 1 g twice daily with lukewarm water, and CKL 10 g was applied locally twice daily for 12 weeks. Parameters such as chief complaints of the disease, viz., joint pain on movement, joint pain at rest, restricted joint, crepitus, swollen joint, stiffness, and bony enlargement; total WOMAC score; and quality of life through WHO QOL BREF score were assessed before and after the administration of therapy.

RESULTS:

The WOMAC score, the key outcome measure, showed statistically significant improvement (P = 0.001) on the 84th day of follow-up. Improvement was noted in all areas, including pain, stiffness, and physical functioning. The physical health, physiological and social relationships, and environmental areas of the WHO QOL BREF score for quality of life were also significantly influenced (P = 0.0001). No adverse drug reactions or adverse events were reported during the trial period.

CONCLUSION:

Oral administration of RG and external application of CKL are effective for the management of OA knee. However, further clinical study with sufficient sample size may be required to revalidate this study’s findings.
Clinical evaluation of the efficacy of Shadbindu Taila and Chitraka Haritaki in the management of chronic rhinosinusitis
Authors: Mata Shweta , Singh Harbans , Makhija Deepa , Yadav Babita , Singhal Richa , Chandrasekhara Rao Bhogavalli , Shivshankar Rajput , Gupta Bharti , Srikanth Narayanam
Published: September 2023

BACKGROUND:

The disease Pinasa (chronic rhinosinusitis disease) is a chronic nasal disease, which affects nasal canal and paranasal sinuses and the symptoms of this disease are similar to that of chronic rhinosinusitis. In Ayurvedic classics, the internal administration of Chitraka Haritaki Avaleha (CHA) and nasal instillation of Shadbindu Taila (SBT) are mentioned for the management of Pinasa. In view of the literary indication, the present work was carried out with the objective to evaluate the clinical efficacy and safety of CHA and SBT in the management of chronic rhinosinusitis.

MATERIALS AND METHODS:

A multicenter, single-arm, open-label clinical trial was proposed for the assessment of therapeutic efficacy of oral administration of CHA and nasal instillation of SBT. A total of 60 patients with chronic rhinosinusitis from Central Ayurveda Research Institute (CARI), New Delhi and CARI, Patiala were enrolled in this study. SBT Nasya (nasal drop to be given for three sittings, 7 days in each, with the interval of 7 days between each sitting) and CHA (6 g, twice daily after food) in the form of Avaleha (semisolid confection) were given to all participants for 42 days and the follow-up period was 28 days. The primary outcome was to assess change in SNOT (Sino-Nasal Outcome Test) scores. The secondary outcome was to assess change in RSDI (Rhinosinusitis Disability Index) scores and change in Lund-Mackay scores of computed tomography (CT) scan of paranasal sinuses.

CONCLUSION:

The effect of CHA and SBT nasal drop in treatment of Pinasa with special reference to chronic rhinosinusitis may provide an evidence-based complementary therapeutic approach for the management of the said condition.
A multi-center collaborative double-blind study on clinical evaluation of AYUSH-SL in patients receiving mass drug administration for management of chronic filarial lymphedema—study protocol
Authors: Tripathi Santanu K. , Singh Renu , Bhuyan Gurucharan , Mitra Achintya , Sharma Lalita , Murlikrishna Chagam R. , Ratha Kshirod K. , Dhoke Sujata , Gupta Bharti , Kumar Adarsh , Srikanth Narayanam
Published: September 2023

BACKGROUND:

Lymphatic filariasis (LF) is caused by Wuchereria bancrofti, Brugia malayi, or B. timori, the parasitic nematodes that are transmitted through mosquitoes. The World Health Organization has recommended mass drug administration (MDA) as preventive chemotherapy strategy. In Ayurveda, LF has been narrated under the heading Shlipada, and the literature also includes detailed therapeutic measures. AYUSH-SL is a formulation prepared based on the classical information of herbs used in treating LF.

MATERIALS AND METHODS:

This is a multi-center, prospective, parallel-group, placebo-controlled, double blind interventional study. A total of 180 participants are planned to be recruited, and the duration of the study will be 2.5 years. Diagnosed cases of filariasis (as evidenced by a positive immune-chromatographic card test or enzyme-linked immunosorbent assay or microfilariae (MF) test report) of either sex within the age group of 18–65 years present with features of filarial lymphedema of Grade I and Grade II (lower limbs) will be included in the trial. The study group will be treated with MDA and AYUSH-SL tablet. The control group will receive MDA and a matching placebo. The duration of the therapy will be of 12 weeks, and a last follow-up will be done at the 24th week.

OUTCOME MEASURES:

The primary outcome measure is reduction of edema computed for analysis by percentage reduction from the baseline at 4th, 12th, and 24th week. The secondary outcome measures include improvement in quality of life (QoL), which will be assessed using the Lymphatic Filariasis Specific QoL Questionnaire, and prevention of recurrence of acute episodes, which will be assessed by probing the presence and severity of episodes in the past 4 weeks.

DISCUSSION:

The deformities and disability due to filarial lymphedema vanquish physically as well as mentally leading to hardships in normal life. Management of filarial lymphedema is required for preventing disease progression and episodes of adenolymphangitis. The study is expected to provide evidence on the coded Ayurveda drug AYUSH-SL in the management of chronic filarial lymphedema.
A randomized controlled trial to evaluate the prophylactic efficacy of Chyawanprash in healthcare workers during the COVID-19 pandemic
Authors: Gupta Arun , Madan Amit , Yadav Babita , Mundada Pallavi , Singhal Richa , Tripathi Arunabh , Rao Bhogavalli C. , Gupta Bharti , Rana Rakesh , Sharma Bhagwan , Pandey Yogesh , Agarwal Riju , Srikanth Narayanam , Dhiman Kartar Singh
Published: September 2023

INTRODUCTION:

Healthcare workers (HCWs) are high-risk individuals in the management of epidemics caused by highly contagious disorders such as coronavirus disease 2019 (COVID-19). Standard of care (SOC) for the prevention of exposure can be greatly supported with SOC measures to improve the immune response. The purpose of this study was to evaluate the effect of combining Chyawanprash, an Ayurvedic formulation, with SOC for prevention versus SOC alone among frontline HCWs through assessment of the proportion of COVID-19 cases among the trial participants during the trial period.

METHODS:

This open-label, randomized controlled trial was conducted from June 13, 2020 to September 21, 2020 in an Ayurvedic hospital that was functioning as a COVID-19 care center in New Delhi during the pandemic. HCWs between 25 and 60 years of age working in an environment with the possibility of direct exposure to COVID-19 cases were enrolled and observed for 30 days. The interventions compared were SOC as per institutional guidelines and based on their roles (Group I) and SOC in addition to Chyawanprash 12 g twice a day for 30 days (Group II).

RESULTS:

Out of the 193 participants who completed the study, no participant in both groups was COVID-19 positive at the end of one month. No adverse drug reaction or any serious adverse event was reported during the study. No clinically significant change in the safety parameters were observed. A statistically significant rise in serum IgG level was seen in Group II, but other inflammatory and immune markers did not show any statistically significant difference. In the post-intervention follow-up, four subjects in Group I and two subjects in Group II reported to have developed COVID-19 disease after 2 months of completion of the study period.

CONCLUSIONS:

Chyawanprash has an immunomodulatory effect in the intervention group, but a longer-term clinical trial with a bigger sample size is needed to confirm its adaptogenic and preventive efficacy as an add-on to standard prophylactic guidelines for prevention of disease.

TRIAL REGISTRATION:

Clinical Trials Registry of India: CTRI/2020/05/025275 [Registered on: 20/05/2020].
Efficacy and safety of Ayurveda interventions for acid peptic disease
Authors: Rai Amit Kumar , Kumari Harit , Ahmad Azeem , Singhal Richa , Rao Bhogavalli Chandrasekhara , Srikanth Narayanam
Published: September 2023

Background:

Acid peptic disease (APD) has a negative impact on patients’ quality of life and general health status of the individuals. There are a number of case studies and clinical trials on efficacy of Ayurvedic interventions in the management of APD. However, a systematic review of these researches is not available which is needed to evaluate the clinical significance of those studies.

Objective:

The aim of this study is to conduct a systematic review of the available evidence for the efficacy and safety of Ayurvedic interventions for APD.

Methods and Analysis:

On the basis of the PRISMA-P statement, a systematic review protocol has been developed. Data from electronic databases such as PubMed, Cochrane Central Register of Controlled Trials, AYUSH Research Portal, DHARA, Shodhganga, Ayurvedic Research Database, Institute for Teaching and Research in Ayurveda, Gujarat Ayurveda University, Jamnagar, Clinical trial registries, and relevant journals will be used to find articles for systematic review. Only studies that have been published in English or Hindi will be considered for inclusion in the systematic review. Data from the selected studies based on study characteristics will be extracted separately by two review authors for data analysis and quality assessment of the studies. The risk of bias in the chosen studies will be evaluated using appropriate available tools. If studies that are qualified for meta-analysis are available during the review, then it will be done. If meta-analysis is not possible, then the findings will be presented in the form of a comprehensive qualitative synthesis.

Conclusion:

The findings of this study will aid in determining the current state of evidence on the efficacy and safety of Ayurvedic interventions for the treatment of APD. The review will also serve as a source for researchers while planning future studies in order to generate high-quality evidence on the efficacy and safety of Ayurvedic therapies in APD.

Study Registration:

PROSPERO 2020: CRD42020207484
Efficacy and safety of Ayurveda interventions for nonalcoholic fatty liver disease: A protocol for systematic review
Authors: Yadav Babita , Talekar Manisha , Ahmad Azeem , Jameela Sophia , Khanduri Shruti
Published: September 2023

This systematic review aimed is to find evidence about the efficacy and safety of Ayurvedic management for nonalcoholic fatty liver disease (NAFLD). This systematic review protocol was developed following the Preferred Reporting Items for Systematic Review and Meta-Analysis protocol statement. For this systematic review, articles will be selected from electronic databases such as Pubmed, AYUSH Research portal, Digital Helpline for Ayurvedic Research Articles, Ayurvedic Research Database, Cochrane Central Register of Controlled Trials, Google Scholar, Clinical trial registries, and clinical studies published in relevant journals. There will be no restriction on the study type or publication date. Two review authors will independently extract data from the selected studies on the study characteristics (publication-related information, methodology, participants, interventions, comparators, outcomes, and results) in a prestructured format for data analysis and assessment of study quality. The risk of bias in the selected studies will be assessed through suitable existing tools. The meta-analysis will also be conducted, if feasible. If meta-analysis is not possible, the results will be summarized as a systematic qualitative synthesis. This systematic review will summarize the available evidence about the safety and efficacy of Ayurveda interventions in treating NAFLD. It will also provide ideas for future research to generate good-quality evidence regarding the efficacy and safety of Ayurvedic interventions in NAFLD. Study registration: Registered with PROSPERO, Reg. No. CRD42022321063.
A review on preventive and therapeutic potential of selected Ayurveda medicinal plants in viral pandemics
Authors: Kumar Shobhit , Namburi Uday Ravi Sekhar , Londhe Deepak J. , Chiluveri Ashwin C. , Rai Amit K. , Chiluveri Sudha K. , Chinchalkar Shital , Rao Bhogvalli Chandra Shekar , Srikanth Narayanam
Published: September 2023

BACKGROUND:

Viral pandemics/epidemics are emerging as one of the biggest challenge for medical fraternity and health-care policy makers. This is high time to explore traditional medicine systems such as Ayurveda, wherein measures such as Dincharya (daily regimen), Ritucharya (seasonal regimen), Sadvritta (good conduct/behavior), and Rasayana (rejuvenation measures) which are said to influence the homoeostatic mechanism of the host defense system along with interventions that may have a promising role in managing such diseases.

OBJECTIVES:

This review attempts to provide an informative analysis of the daily regimen, seasonal regimen, moral conduct, and interventions recommended in Ayurveda scriptures which can be helpful for the prevention and treatment of viral pandemics.

METHODS:

A narrative review was conducted and comprehensive search of Ayurveda classical texts, including Bhrihatrayi, Laghutrayi, Dhanwantari Nighantu, Raj Nighantu, Kaiyadev Nighantu, and texts related to Dravyaguna was done. Electronic databases such as PubMed, AYUSH Research Portal, DHARA, and Google Scholar were also searched for relevant literature, pertaining to Ayurveda prophylactic and therapeutic measures in viral pandemics from 2001 to 2020.

RESULTS:

Prophylactic and therapeutic measures, including daily and seasonal regimen, good conduct/behavior, rejuvenation measures, Dhoopana Karma (medicated fumigation), and medicinal herbs, explained in Ayurveda may be utilized during viral pandemics. Critical analysis of the available scientific evidence suggests potential of Ayurveda interventions in context of immunomodulatory and antiviral activities.

CONCLUSION:

Unique preventive dietary and lifestyle practices recommended by Ayurveda can play an important role in maintaining the health status and improving the disease resistance capacity. Evidence from preclinical/clinical studies indicates that several herbs used in Ayurveda exhibit immunomodulatory, antiviral properties. The preventive and therapeutic measures narrated in Ayurveda can contribute significantly towards the management of viral pandemics. Generation of more scientific evidence through quality research studies is needed to evaluate the role of Ayurveda approaches for management of viral diseases.
Knowledge, attitudes, and practice of Triphala in the community
Authors: Mali Vaishali P. , Krishnan Anupama , Mali Pavanakumar N. , Wagh Ketki S. , Lekharu Sikha , Gupte Poonam A.
Published: September 2023

BACKGROUND:

Codified and noncodified information about Ayurveda practices and formulations is available and transmitted as science or folk claims. Triphala, a well-researched Ayurveda formulation, lacks studies reporting community perception regarding its usage. This study explores Triphala’s knowledge, attitude, and practice in the community.

MATERIALS AND METHODS:

This exploratory cross-sectional study involving 806 residents of Pune, New Delhi, Guwahati, Kottakkal, and rural areas of Rajkot was undertaken to evaluate Triphala’s knowledge, attitude, and practice in the community. A pretested and structured questionnaire addressing Triphala’s knowledge, attitude, and practice was administered through Google forms or a personal interview method. Data were managed and analyzed by SPSS 20.0, and descriptive statistics were generated.

RESULTS:

A total of 30% of participants demonstrated good knowledge, and 42% demonstrated positive attitude. A total of 41.84% of respondents knew the ingredients of Triphala, 68% knew its use in constipation, 26% in health maintenance, and 22.2% in weight loss. Also, powdered dosage form (93.6%) is used predominantly through the oral route with lukewarm water (94.1%) as a vehicle. Around half of the respondents have previously used Triphala for various health conditions. The knowledge regarding the proportion of Triphala ingredients, and other formulations containing Triphala, was less at all sites. A good number of people (38.9%) are ready to consume Triphala for health maintenance. The rural area had a lower response rate compared with the urban but with similar response patterns for most domains.

CONCLUSIONS:

A substantial proportion of people in the general population knew the ingredients of Triphala, its use in various health conditions, route of administration, adjuvants, and cost-effectiveness. A good number of people showed readiness for the consumption of Triphala daily. However, the research component of Triphala has not sufficiently percolated. Hence, empowering the public on the utilization aspects and research evidence of Triphala would propagate the evidence-based practice of Ayurveda for scientific sustainability.