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INTRODUCTION: Insomnia is common among cancer patients, affecting about 50% undergoing cancer treatment. Insomnia can be due to various reasons, such as physical-pain, psychological-distress and medication side-effects. Insomnia has significant impact on quality of life of cancer patients. Even-though managed with hypnotics and antipsychotic drugs, they cause dependency with various short-term and long-term complications. Presenting a case throwing light on Ayurveda topical intervention as add-on to standard-of-care in insomnia during cancer chemotherapy. METHOD: A 51-year-old female patient with breast-cancer with extensive necrosis extending to subcutaneous areas was due for second cycle chemotherapy and was diagnosed with moderate-insomnia with a score of 21 as per Insomnia Severity Index in the Out-Patient-Department. Quality of sleep was assessed using Pittsburgh-Sleep-Quality-Index. Treated for 14 days during the break between cycle two and cycle three with Shirothalam (applied on the vertex) using Kachuradi Churnam with Kshirabala 101 and Padabhyangam (foot massage) using Kshirabala thailam as add-on to Tab Zolpidem5mg. Assessment was conducted on baseline and after 14 days of intervention. RESULTS: Assessment for insomnia before and after intervention was conducted with Insomnia-Severity-Index. The score improved from 21 to 2. Quality of sleep before and after intervention was assessed using global PSQI. It improved from 20 to 8. DISCUSSION: In Ayurveda, Nidranasam (loss of sleep) results from aggravation of Vata-Pitta (body humors responsible for movement and cognition and digestion, metabolism and heat of body), depletion of Kapha (body humor responsible for structural cohesion of body), derangement of Manasika-Dosa (mental constituents) and other diseases. All these etiological factors are attributed by Tikshna(sharp)- Ushna(hot potency) and Ruksha(dry) chemotherapy regimens. Vata-Pitta-hara (normalising Vata and Pitta) and Indriyaprasadaka (clearing senses) action of medicines used could induce sleep and effectively improve quality of sleep. CONCLUSION: Integrative-intervention was found to be beneficial in improving insomnia and quality of sleep without any reported complications or dependency in this case. After 14 days of ayurvedic intervention, the patient could get sleep even without taking zolpidem 5mg and external therapies. Same protocol could be considered for generalization so that it could modify or reduce usage of hypnotics and antipsychotic-drugs.
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OBJECTIVES: Gout is an inflammatory response to the Monosodium urate crystals formed secondary to hyperuricaemia. The prevalence of gout has increased in recent years. The current conventional medical management aims at symptomatic management. In Ayurveda, gouty arthritis has similarity to Vata-Pittadhika Vatarakta, owing to its comparable aetiology and clinical features and treatment was planned accordingly. The present study is designed to evaluate the combined effect of Ayurvedic formulations and therapy in reducing the signs and symptoms and uric acid level in Gouty Arthritis. METHODS: The study was a single group pre-post test design. The patients diagnosed on the basis of ACR EULAR Gout classification 2015 criteria. They were given Guduchi Siddha Ksheeravasthi (Therapeutic enema), Guduchi (Tinospora cordifolia) Kashaya (diluted decoction) and Punarnava Guggulu. Assessment of pain was done by Visual Analogue Scale and serum uric acid level was assessed on day 1 and on 31st day. Also, the change in symptoms were analyzed before and after the treatment. This study has been registered in the clinical trial registry-India. RESULTS: The obtained data were evaluated using paired t-test and Wilcoxon signed rank test. A significant improvement (p=0.0001) was observed in VAS scale (98.77%), serum uric acid levels (57.81%), subjective parameters. Moreover, erythrocyte sedimentation rate was observed to be normal level as compared to baseline of the therapy also with an enhancement of hemoglobin (Hb) levels. CONCLUSIONS: Thus, the present study revealed that Ayurvedic therapeutic interventions can play a major role in the management of gouty arthritis.
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OBJECTIVES: Various aspects of aging in Ayurveda literature has been explored and correlated it with modern biological understanding. CONTENT: The concept of longevity is better understood upon the baseline understanding of Aging ie. Jara. Manda Jara or Ajara is synonymous with longevity. Vriddhavastha/Jirnavastha/Jara (old age) is the period after 60 or 70 years of age. This stage of life becomes very crucial as degenerative changes occur in the body. Deterioration occurs to Dhatus, Indriya (perception power), Bala (strength), Virya (potency), Utsaha (enthusiasm), Paurusha (masculinity), Parakrama (valour), Grahana (reception), Dharana (retention), Smarana (memory), Vachana (speech). Brihatrayis and Laghutrayis were reviewed to analyze the various aspects of Ayu and Jara and correlated with research papers establishing the concept of aging in terms of evidence-based technological advancements. Databases like PubMed, Scopus were searched using keywords like Jara, Ayu Lakshana, Aging, Old age, Senescence, biomarkers, DNA, blood biochemistry, proteomics, genomics, microbiota, microbiome, androgen, estrogen, lipolysis, peripheral blood monocytes, collagen, cognitive function; with the help of Boolean operators. SUMMARY: Various aspects of Jara in Ayurveda have been analyzed by taking ample references from evidence-based technological advancements related to the physiology of aging. The indicators of biological aging based on recent researches like genomic irregularities, mitochondrial dysfunction, cellular senescence, altered protein expression, immunological markers, oxidative stress, pathological microbiota profile, telomere shortening in peripheral blood monocytes, lipolysis, and many other factors have been put forward for basic evidence in relation with Jara Lakshana. OUTLOOK: Understanding the physiology of aging will give the insight to manage the elderly. So, the need of the hour is to develop strategies or to conduct more researches which prevent senile disorders and thus increase the health span for the future generation.