#in india, ayurveidc medicines have been used for thousands of years, and adverse drug reactions are also fewer in frequency and severity. these facts lead to the concomitant use of both ayurvedic and modern medicines by the patient without the physicians knowledge.
* this can ultimately lead to drug interactions which could be useful or harmful for the patient
*in observed 2 patients, which had well controlled seizures who presented with sudden loss of seizure control: a detailed history taking ;revealed that they had started taking shankhapushpi, a purported memory ehancer- animal studies with rats were carried out with single and multiple doses of the two drugs given alone and in combination. it was seen that on chronic administration both the antiepileptic effect and plasma levels of phenytoin were reduced by shankhapushpi. single dose administration of the drugs did not lead to any change in phenytoin levels. but decreased its antiepileptic effect. the interaction was found to be pharmacokinetic and pharmacodynamic.
*another marketed memory enhancer, mentat has been shown to increase phenytoin levels in rabbits.
*honey a substance widely used as a good vehicle for a given ayurvedic medicine has show to decrease the bioavailability of carbamazepine.
#in one study the first ultra structural evidences of neuroprotective properties in semecarpus anacardium and withania somnifera has been reported.ashwagandha ( w. somnifera) is gamma - amniobutryic acid - a( (gaba-a) receptor agonist, and katuka ( p. kurroa) has antioxidant action equal to alpha - tocopherol, which has an effect on glutathione metabolism in the liver and brain. subacute toxicity studies of groups like w. sominifera did not reveal any toxicity.
* a methanolic extract of w. somnifera root contains an ingredient that has a gaba mimetic activity.
* a clinical trial of rejuvenating drugs for the nervous system ( medhya rasayana) on epilepsy suggested that these medicines reduce the frequency duration and severity of seizures and have not shown any side effects.
*brahmi rasayana an ayurvedic preparation was studied in mice and rats its effect on the cns at oral doses ranging between 1 and 30g/kg. the study suggests an involvement of the gaba-ergic system in the medication of cns effects of brahmi rasayana.
* piperine, an active alkaloid of the piper longum and piper nigum exerted a significant protection against tetbutyl hydroperoxide and carbon tetrachloride hepatotoxicity by reducing both in vitro and in vivo lipid peroxidation, reducing enzymes leakage of glutamate pyruvate transaminase ( gpt) and alkaline phosphate ( ap) and preventing the depletion of reduced gluththione (gsh) and total thiols in intoxicated mice. piperine and its derivatives are effective anticonvulsant drugs that antagonize convulsions induced by physical and chemical methods. they also have sedative tranquilizing and muscle relaxing effects
**treatment of chronic epilepsy includes brahmi juice with honey and shatavari with milk,it is shown that the blood histamine level decreased from 0.9 to 0.37 ug/ml by vamana and the same is emitted in vomitus. this indicated elimination of toxic materials ( suksha mala) from the cellular level.
***first restore the activities of the heart mind and channels ( strotras) occluded by the dosha by using samshodhan chikitsa. vataja should be treated with basti, pittaja with virechana and kafaga with vamana. this is followed by medicinal recipes. primary therapy described in epilepsy is snehana where narayan tail is commonly used followed by swedana,in epilepsy where drugs are suitably prepared, a common vehicle is honey and salt,nasya is also an important treatment:anu tail, panchendriya vardhan tail and fresh juice of nirgundi are commonly used formulations. shirodhara is another part of the treatment.this is basically the pacificatory therapy:medicated oil, ghrita, decoctions of various suitable herbs and buttermilk are used
Sunday, March 29, 2009
treatment of ankylosing spondylitis w.s.r. to RA
RA is described as 'ama vata'
1.avoid formation of ama byincreasing body fire:chitraka,pippali mula,yava kshara,sunthi,maricha.
2. expelling the already formed ama:trifala
3. reduce joint inflammation:trifala,guggulu,chitraka taila
4. provide natural calcium supplement to rejuvente joint:guggulu,godanti bhasma,rasna,ashwagandha, bala.
*diet:
1.avoid curd,fish,milk,urad dal,jaggery,constipating foods.
2.avoid late nights nd afternoon naps.
3.avoid stress,to back or spine
4.do not control natural urges
5.do not consume opposite foods, horse gram,ginger,bitter gourd,drum stick.always use hot water to drink
*no treatment reliably stops progression of this disease,so management aims to delay further deformity thru good posture,stretching nd deep breathing exercises.
1.avoid formation of ama byincreasing body fire:chitraka,pippali mula,yava kshara,sunthi,maricha.
2. expelling the already formed ama:trifala
3. reduce joint inflammation:trifala,guggulu,chitraka taila
4. provide natural calcium supplement to rejuvente joint:guggulu,godanti bhasma,rasna,ashwagandha, bala.
*diet:
1.avoid curd,fish,milk,urad dal,jaggery,constipating foods.
2.avoid late nights nd afternoon naps.
3.avoid stress,to back or spine
4.do not control natural urges
5.do not consume opposite foods, horse gram,ginger,bitter gourd,drum stick.always use hot water to drink
*no treatment reliably stops progression of this disease,so management aims to delay further deformity thru good posture,stretching nd deep breathing exercises.
ROLE OF SHIRODHARA IN ALOPECIA TOTALIS
*panchakarma – panchakarma therapies like shiroabhyanga, shirodhara, shirovasti strengthens the hair roots ,relax the nerves and muscle fibres and provide nutrition to hair.
*nasyam – one of the panchakarma therapy is essential to remove the doshas from the above clavicle region and provides lubrication and nutrition internally as the medicated oil in nasyam goes directly in shirha(head).
#this study was publshed in the journal of alternative and complementary medicine under the heading:psychoneuroimmunologic effects of ayurvedic oil-dripping treatment
*objective: this study assessed the psychoneuroimmunologic changes achieved by shirodhara, an ayurvedic treatment, characterized by dripping oil on the forehead, in a randomized, controlled protocol involving a novel approach using a robotic system.
*methods: in the first experiment for the determination of the most appropriate conditions of shirodhara, 16 healthy females (33 ± 9 years old) underwent a 30-minute treatment. in the second study, another 16 healthy females (39 ± 9 years old) were assigned to either the shirodhara treatment or control supine position for 30 minutes, with monitoring of physiologic, biochemical, immunologic, and psychometric parameters including anxiety and altered states of consciousness (asc).
*results: the subjects receiving shirodhara treatment showed lowered levels of state anxiety and higher levels of asc than those in the control position. plasma noradrenaline and urinary serotonin excretion decreased significantly more after shirodhara treatment than in the control. plasma levels of thyrotropin-releasing hormone, dopamine, and natural killer (nk) cell activity were different between control and shirodhara treatment. the correlation between anxiolysis and the depth of asc was significant in the shirodhara treatment group (r = 0.52, p < 0.05, n = 16), while in the control no correlation was obtained (r = 0.13, p = 0.64, n = 16). the increase in foot skin temperature after shirodhara showed a significant correlation with anxiolysis and the depth of trance of asc (r = 0.58, p < 0.01, r = 0.43, p < 0.01, respectively). nk cell activity after shirodhara treatment showed a significant correlation with anxiolysis and the depth of trance of asc (r = 0.33, p < 0.05, r = 0.56, p < 0.01, respectively).
**conclusions: these results indicate that shirodhara has anxiolytic and asc-inducing effects, and it promotes a decrease of noradrenaline and exhibits a sympatholytic effect, resulting in the activation of peripheral foot skin circulation and immunopotentiation
*nasyam – one of the panchakarma therapy is essential to remove the doshas from the above clavicle region and provides lubrication and nutrition internally as the medicated oil in nasyam goes directly in shirha(head).
#this study was publshed in the journal of alternative and complementary medicine under the heading:psychoneuroimmunologic effects of ayurvedic oil-dripping treatment
*objective: this study assessed the psychoneuroimmunologic changes achieved by shirodhara, an ayurvedic treatment, characterized by dripping oil on the forehead, in a randomized, controlled protocol involving a novel approach using a robotic system.
*methods: in the first experiment for the determination of the most appropriate conditions of shirodhara, 16 healthy females (33 ± 9 years old) underwent a 30-minute treatment. in the second study, another 16 healthy females (39 ± 9 years old) were assigned to either the shirodhara treatment or control supine position for 30 minutes, with monitoring of physiologic, biochemical, immunologic, and psychometric parameters including anxiety and altered states of consciousness (asc).
*results: the subjects receiving shirodhara treatment showed lowered levels of state anxiety and higher levels of asc than those in the control position. plasma noradrenaline and urinary serotonin excretion decreased significantly more after shirodhara treatment than in the control. plasma levels of thyrotropin-releasing hormone, dopamine, and natural killer (nk) cell activity were different between control and shirodhara treatment. the correlation between anxiolysis and the depth of asc was significant in the shirodhara treatment group (r = 0.52, p < 0.05, n = 16), while in the control no correlation was obtained (r = 0.13, p = 0.64, n = 16). the increase in foot skin temperature after shirodhara showed a significant correlation with anxiolysis and the depth of trance of asc (r = 0.58, p < 0.01, r = 0.43, p < 0.01, respectively). nk cell activity after shirodhara treatment showed a significant correlation with anxiolysis and the depth of trance of asc (r = 0.33, p < 0.05, r = 0.56, p < 0.01, respectively).
**conclusions: these results indicate that shirodhara has anxiolytic and asc-inducing effects, and it promotes a decrease of noradrenaline and exhibits a sympatholytic effect, resulting in the activation of peripheral foot skin circulation and immunopotentiation
ROLE OF DUGDHIKA IN THE MANAGEMENT OF BLEEDING PILES
*the major flavonoid components of euphorbia prostrata extract are apigenin, luteolin, apigenin-7-glucoside and luteolin-7-glucoside. the major phenolic compounds present are gallic acid, ellagic acid and tannins.
*anti-hemorrhoidal activity : euphorbia prostrata extract has been clearly shown to have significant anti-hemorrhoidal activity as demonstrated by ano-rectal body: weight ratio model in rats.
*anti-inflammatory activity : various components of euphorbia prostrata extract are known to affect inflammatory response to antigen. apigenin-7-glucoside inhibits release of histamine, generation of hydrogen peroxide and leucocyte infiltration at inflammatory site. luteolin-7-glucoside decreases leucocyte infiltration.
*haemostatic activity : euphorbia prostrata extract on topical application significantly reduced the bleeding time. this effect could play an important role in arrest of bleeding. wound healing effect : topical application of euphorbia prostrata extract has been shown to have significant wound healing effect.
*vasoprotective activity : flavonoids tend to decrease capillary permeability and increase capillary resistance. several mechanisms have been proposed such as inhibition of ascorbic acid oxidation, blood cell aggregation and stimulation of pituitary-adrenal axis.
*sclerosing activity : tannins present in euphorbia prostrata extract cause sclerosis of the mucus membrane by virtue of their protein precipitating property.
*anti-oxidant activity : flavonoids and phenolic compounds of the extract have anti-oxidant property which also contributes in healing of inflammatory tissue damage in hemorrhoidal conditions.
*not recommended in children, during pregnancy and breast feeding, if allergic to any of the ingredients and in patients on anticoagulant therapy
*anti-hemorrhoidal activity : euphorbia prostrata extract has been clearly shown to have significant anti-hemorrhoidal activity as demonstrated by ano-rectal body: weight ratio model in rats.
*anti-inflammatory activity : various components of euphorbia prostrata extract are known to affect inflammatory response to antigen. apigenin-7-glucoside inhibits release of histamine, generation of hydrogen peroxide and leucocyte infiltration at inflammatory site. luteolin-7-glucoside decreases leucocyte infiltration.
*haemostatic activity : euphorbia prostrata extract on topical application significantly reduced the bleeding time. this effect could play an important role in arrest of bleeding. wound healing effect : topical application of euphorbia prostrata extract has been shown to have significant wound healing effect.
*vasoprotective activity : flavonoids tend to decrease capillary permeability and increase capillary resistance. several mechanisms have been proposed such as inhibition of ascorbic acid oxidation, blood cell aggregation and stimulation of pituitary-adrenal axis.
*sclerosing activity : tannins present in euphorbia prostrata extract cause sclerosis of the mucus membrane by virtue of their protein precipitating property.
*anti-oxidant activity : flavonoids and phenolic compounds of the extract have anti-oxidant property which also contributes in healing of inflammatory tissue damage in hemorrhoidal conditions.
*not recommended in children, during pregnancy and breast feeding, if allergic to any of the ingredients and in patients on anticoagulant therapy
treatment/management of thyroid disorders through ayurveda
#in ayurveda there is a metabolic dosorder (disturbed agni) known as bhasmaka and that has identical relation with hyperthyroidism.
*there is santarpanatmak treatment available in c.ci.15/221, in order to calm the increased metabolism or agni-take the oily seeds like almonds,wall nuts,and sesame seeds
*panchkarma:-charaka approves virechana with kali nisoth c.ci.15/231
#in hypothyroidismavoid- refined foods,saturated fats,sugars and white flour products,cabbage,brocooli,kale,mustard green, peaches and pears
*include-sprouts,salads,raw vegetables,food rich in vit.a,iodine rich foods,zinc and copper reverse to be followed in hyperthyroidism
#as mentioned by charaka "vikaranamkusalo" exact nomenclature is not neceesary for all the diseases.it insists on diagnosis of constitutional state of the disease.
*hypothyroidism:-
1.at hypothalamus-pituitary level(sec./tertiary failure)-(anti stress drugs,medhya-rasayana,nasya karma is beneficial.
2.at thyroid level(primary failure) thyroid stimulatory drugs are recommended
3.at metabolism level:deepana,pachana,ushna,teekshna,sukshma,lekhana, drugs to be given.
4.immuno modulatory drugs for AI related hypothyroidism
5. due to genetic and hereditary defect comes under adibala pravritta vyadhis and these are asadhyas
6.if due to congenital defects comes under janambala pravrita vyadhis,these are preventable if proper pathya apathya is followed during pregnancy.
7.the main cause of hypothyroidism is iodine deficiency,as per sarvada sarva bhavanam- iodine containing drugs like shigru,jalkumbhi are advised here.
8.kanchanara guggulu 250mg b.d. with shigru patra kwath 250ml b.d. for three months is very effective
*there is santarpanatmak treatment available in c.ci.15/221, in order to calm the increased metabolism or agni-take the oily seeds like almonds,wall nuts,and sesame seeds
*panchkarma:-charaka approves virechana with kali nisoth c.ci.15/231
#in hypothyroidismavoid- refined foods,saturated fats,sugars and white flour products,cabbage,brocooli,kale,mustard green, peaches and pears
*include-sprouts,salads,raw vegetables,food rich in vit.a,iodine rich foods,zinc and copper reverse to be followed in hyperthyroidism
#as mentioned by charaka "vikaranamkusalo" exact nomenclature is not neceesary for all the diseases.it insists on diagnosis of constitutional state of the disease.
*hypothyroidism:-
1.at hypothalamus-pituitary level(sec./tertiary failure)-(anti stress drugs,medhya-rasayana,nasya karma is beneficial.
2.at thyroid level(primary failure) thyroid stimulatory drugs are recommended
3.at metabolism level:deepana,pachana,ushna,teekshna,sukshma,lekhana, drugs to be given.
4.immuno modulatory drugs for AI related hypothyroidism
5. due to genetic and hereditary defect comes under adibala pravritta vyadhis and these are asadhyas
6.if due to congenital defects comes under janambala pravrita vyadhis,these are preventable if proper pathya apathya is followed during pregnancy.
7.the main cause of hypothyroidism is iodine deficiency,as per sarvada sarva bhavanam- iodine containing drugs like shigru,jalkumbhi are advised here.
8.kanchanara guggulu 250mg b.d. with shigru patra kwath 250ml b.d. for three months is very effective
adult hypothyroidism (galaganda)
the etiological factors in galaganda include climatic conditions, water supply, dietary conditions and other surroundings etc
*susrutha stated that rivers flowing towards east might give rise to the occurrence of galaganda. *bhela described that sleepada and galaganda are more common in prachya desa (eastern part) of the country,and the persons consuming predominantly fish are liable to develop galgaganda. *harita samhitakara described the role of dushtambu and krimi dosha in the precipitation of galaganda.
*kashyapa added that any part of the country which is cold, damp, with densely grown long trees, water stagnation and heavy rains may be prone for the development of galaganda.
* management:in this case may be iodine deficiency, as per sarvadha sarva bahvanam-iodine containing drugs like shigru, jalakumbhi should be given.shigru is a well-known plant in india. it is rich in iodine, which is an essential component of thyroid hormones, t3 and t4. it has deepana, pacahna, kapha vata hara properties. it is recommended in galaganda, kandu, sotha, apachi, vrana, medoroga, vidradhi, gulma etc.is selected as anupana along with kachnara guggulu. it appears to provide it with iodine, which the thyroid gland require.
selection of drugs acting at various levels:
*at hypothalamo pituitary level: anti stress drugs, medhya rasayana drugs, nasya karma may be beneficial.
*at thyroid gland level: thyroid stimulatory drugs are recommended here.
*at metabolism level: deepana, pacahana, ushna, teekshna, sukshma, lekhana drugs which pep-up body metabolism is recommended.
*immuno-modulatory drugs for autoimmune related hypothyroidism.
**yoga:sarvangasana is the most suitable and effective asana for the thyroid gland. an enormous pressure is placed on the gland by this powerful posture. as thyroid gland has one of the largest blood supplies of the any organ, the pressure has dramatic change on its function, improving circulation and squeezing out stagnant secretions. after sarvangasana practice of matsyasana and halasana is beneficial. other effective asanas include surya namaskara, pavanamuktasana with emphasis on head and neck exercises, yoga mudra, sputa vajrasana and all backward bending asanas.
**pranayama: the most effective pranayama is ujjayi. it acts on the throat and its relaxing and stimulating effects are most probably due to stimulation of ancient reflex pathways within the throat area, which are controlled by brain stem and hypothalamus. nadi sodhana pranayama is useful in re-balancing metabolism
**animal studies have revealed that guggul supports healthy thyroid function, mostly by increasing the conversion of less active thyroxin (t4) to more active triiodotyronine (t3) through increasing thyroid proteolytic activity and the uptake of iodine into thyroxin, and without increasing the production of thyroid stimulating hormone.
**selenium is required for a number of enzymes known as selenoproteins. the chemical reaction, which converts thyroid hormone t4 into t3, is catalyzed by specific selenoproteins. selenium deficiency can impair thyroid function. the drug pippali increases the absroption of selinium and this may be cause for the effectiveness of vardhamana pipppli in hypothyroid conditions
*susrutha stated that rivers flowing towards east might give rise to the occurrence of galaganda. *bhela described that sleepada and galaganda are more common in prachya desa (eastern part) of the country,and the persons consuming predominantly fish are liable to develop galgaganda. *harita samhitakara described the role of dushtambu and krimi dosha in the precipitation of galaganda.
*kashyapa added that any part of the country which is cold, damp, with densely grown long trees, water stagnation and heavy rains may be prone for the development of galaganda.
* management:in this case may be iodine deficiency, as per sarvadha sarva bahvanam-iodine containing drugs like shigru, jalakumbhi should be given.shigru is a well-known plant in india. it is rich in iodine, which is an essential component of thyroid hormones, t3 and t4. it has deepana, pacahna, kapha vata hara properties. it is recommended in galaganda, kandu, sotha, apachi, vrana, medoroga, vidradhi, gulma etc.is selected as anupana along with kachnara guggulu. it appears to provide it with iodine, which the thyroid gland require.
selection of drugs acting at various levels:
*at hypothalamo pituitary level: anti stress drugs, medhya rasayana drugs, nasya karma may be beneficial.
*at thyroid gland level: thyroid stimulatory drugs are recommended here.
*at metabolism level: deepana, pacahana, ushna, teekshna, sukshma, lekhana drugs which pep-up body metabolism is recommended.
*immuno-modulatory drugs for autoimmune related hypothyroidism.
**yoga:sarvangasana is the most suitable and effective asana for the thyroid gland. an enormous pressure is placed on the gland by this powerful posture. as thyroid gland has one of the largest blood supplies of the any organ, the pressure has dramatic change on its function, improving circulation and squeezing out stagnant secretions. after sarvangasana practice of matsyasana and halasana is beneficial. other effective asanas include surya namaskara, pavanamuktasana with emphasis on head and neck exercises, yoga mudra, sputa vajrasana and all backward bending asanas.
**pranayama: the most effective pranayama is ujjayi. it acts on the throat and its relaxing and stimulating effects are most probably due to stimulation of ancient reflex pathways within the throat area, which are controlled by brain stem and hypothalamus. nadi sodhana pranayama is useful in re-balancing metabolism
**animal studies have revealed that guggul supports healthy thyroid function, mostly by increasing the conversion of less active thyroxin (t4) to more active triiodotyronine (t3) through increasing thyroid proteolytic activity and the uptake of iodine into thyroxin, and without increasing the production of thyroid stimulating hormone.
**selenium is required for a number of enzymes known as selenoproteins. the chemical reaction, which converts thyroid hormone t4 into t3, is catalyzed by specific selenoproteins. selenium deficiency can impair thyroid function. the drug pippali increases the absroption of selinium and this may be cause for the effectiveness of vardhamana pipppli in hypothyroid conditions
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