Full Title: The efficacy of Ayurvedic treatment for rheumatoid arthritis: Cross-sectional experiential profile of a longitudinal study.

CONTEXT: Allopathic and Ayurvedic physicians collaborated on a study of traditional medicine, which was sponsored by the World Health Organization. AIMS: The aim of the study was to test the efficacy and safety of Ayurvedic treatment for rheumatoid arthritis (RA). SETTINGS AND DESIGN: This study was conducted at the Ayurvedic Trust, Coimbatore, India. MATERIALS AND METHODS: In this unique study of classical Ayurvedic treatment for RA, allopathic physicians enrolled a total of 290 patients with a confirmed diagnosis of RA over a 7-year period, and once every 6 weeks evaluated Ayurvedic treatment outcomes on the basis of American Rheumatism Association criteria: grip strength, walking time, number of swollen and painful joints, joint count, functional class, erythrocyte sedimentation rate, and rheumatoid factor. Ayurvedic physicians administered individualized treatment, closely adhering to principles set forth in classical Ayurvedic texts. The duration of treatment varied from 1 to 6 months. STATISTICAL ANALYSIS USED: Due to limitations in computer technology in the 1970s, the data were not computerized. Therefore, data for 12 months at a time were analyzed, using repeated measures t-test. Measures of central tendency (means) and probability values were reported. Results from the patients enrolled and discharged at the end of the first year of the study (N = 33) are presented in this paper. RESULTS: There was statistically significant improvement in all parameters from admission to discharge. CONCLUSIONS: The results indicated that classical Ayurvedic treatment was effective in this first cohort of patients who completed treatment. Even patients with severe functional limitations showed significant improvement. Although there was no control group, the results are positive enough to warrant further study of classical Ayurvedic treatment for RA in controlled trials.

Int J Ayurveda Res. 2011 Jan;2(1):8-13. Krishna KP. BAMS, Ayurvedic Trust, Trichy Road, Ramanathapuram, Coimbatore, Tamil Nadu, India.

Pharmacovigilance is the outcome of a natural and implied willingness of a physician to ensure safety to his patient. This is a discipline in medicine which pragmatises the principle of first do no harm towards a wider and systematic application in clinical practice. It is however important to understand that despite of its huge potential in ensuring a safe practice of medicine through knowledge of avoidable causes of adversities, its path has never been easy. Applying principles of pharmacovigilance into the realm of traditional medicine particularly to Ayurveda is even more difficult for the issues of why and how of pharmacovigilance in light of historical practice and anecdotal evidences of safety in Ayurveda. Application of pharmacovigilance in Ayurveda thereby demands a careful and thoughtful observation of its needs and its methods of application in order to maximize its impacts to ensure the patient safety to every extent possible.

Int J Ayurveda Res. 2011 Jan;2(1):48-52. Rastogi S. Department of Kaya Chikitsa, State Ayurvedic College, Lucknow, Uttar Pradesh, India.

This paper examines the twin German institutions of the Kur (spa), and the 'lay' licensed healing practitioner or Heilpraktiker. Through an ethnography of a Heilpraktiker and his Ayurvedic spa in a small catholic village in Germany, where patients arrive in person or as body parts by post, it examines the poly-therapeutics of the practitioner, who seems to combine in his being a dizzy array of diagnostic and therapeutic possibilities. It argues that the while the Ayurvedic spa can be seen as a kind of variation of the traditional German Kur, the Heilpraktiker's poly-therapy has to draw upon the special nature of the practice of medicine in Germany, symbolised in part by the very figure of the Heilpraktiker. It attempts to show that the practitioner's panoply of therapies is partly a symptom of an epistemic impasse at the heart of biomedicine, leading patients on an itinerant quest toward different therapeutic locales, such as the Kur, or to different therapeutic possibilities, such as the ones offered by the Heilpraktiker. But while the Kur and the Heilpraktiker would be either fringe or alternative in the Anglo-American world, in Germany the Kur is part of orthodox medicine, and the Heilpraktiker is a legal entity; and the two together re-draw and make fuzzy what elsewhere seem to be clearly drawn boundaries between medicine and the spa, between pleasure and therapy, and medicine and alternative medicine.

Anthropol Med. 2011 Apr;18(1):67-86. Naraindas H. Centre for the Study of Social Systems, School of Social Sciences, Jawaharlal Nehru University, New Delhi 11067, India.

Abstract A recent methodological approach for human classification, diagnosis, and therapeutics through the combination of current Western constitutional psychology somatotypes and traditional Indian medicine (prakriti) body types and mind (manas) is herein presented. The striking similarities between psychologic somatotypes and Indian medicine body types permits proposal of a finite genopsycho-somatotyping of humans. Genopsycho-somatotyping of humans consists of a set of common physiologic, physical, and psychologic attributes related to acommon basic birth constitution that remains somewhat permanent during human lifetime, since it is proposed that this birth constitution is programmed in the person's DNA (genes). This mainly provides a tool for classifying the human population based on broad and finite phenotype clusters across different ethnicity, languages, geographical location, or self-reported ancestry. In spite of any social or environmental traumatic event, I propose for males that every basic constitution has an associated identification organ, a measured property or marker, a soma, and some psyche general tendencies suggesting specific behavior or recurrent conduct. Three (3) basic extreme genopsycho-somatotypes or birth constitutions are enunciated: mesomorphic or andrus (Pitta), endomorphic or thymus (Khapa), and ectomorphic or thyrus (Vata). The method further predicts that male andrus constitution across races shares similarities in androgen (An) nuclear receptor behavior, whereas thymus constitutions are mainly regulated by T-cells (Tc) nuclear receptor behavior. Moreover, it suggests that thyrus constitutions share similarities in thyroxine (Th) nuclear receptor behavior. These proposed nuclear receptors are expected to regulate the expression of specific genes, thereby controlling the embryonic development, adult homeostasis, and metabolism of the human organism in a very profound way. The method finally predicts small differences in measured property (An, Tc, and Th nuclear receptors behavior) within a birth constitution across different races to be expected by modulation effects in melanocyte-stimulating hormone receptor behavior.

J Altern Complement Med. 2011 May;17(5):465-8. Epub 2011 May 12. Rizzo-Sierra CV. 1 Unit of Innovation in the Health and Life Sciences (IESV), Department of Physics and Geology, University of Pamplona , Pamplona, Norte de Santander, Colombia .

Abstract Objectives: Many providers of Ayurvedic massage treatments make unsubstantiated claims regarding their potential psychologic and physiologic benefits. While these claims are based on ancient traditions of the Indian medical system as well as personal experience, no attempt had yet been made to verify the effect of Ayurvedic oil massage within the Western-scientific context. This pilot study assessed the single-dose effect of Abhyanga, the classic Ayurvedic oil massage, in terms of its impact on subjective stress experience. Design: Ten (10) healthy women (mean [M] 36.4 years, standard deviation [SD] 4.62) and 10 healthy men (M 37.0 years, SD 3.23) underwent a 1-hour Abhyanga massage treatment. The study employed a repeated-measures design for the collection of stress data using a validated and published questionnaire, as well as for the collection of heart rate (HR) and blood pressure (BP) values, immediately pre- and postintervention. Results: Subjects showed high statistically and clinically significant reductions in subjective stress experience. A consequent analysis of physiologic data indicated likewise reductions in HR, while a BP reduction was not recorded for the total sample, but was only found in the prehypertensive subgroup. Conclusions: Findings indicate that Abhyanga massage is promising in reducing subjective stress experience. It may be beneficial in lowering HR in all, and BP in prehypertensive subjects. The results of this pilot study encourage further research with more stringent methodology.

J Altern Complement Med. 2011 May;17(5):435-40. Epub 2011 May 13. Basler AJ. Marburg, Germany .

Abstract Obesity, metabolic syndrome, and diabetes mellitus are increasing to epidemic proportions globally. There are 400 million clinically obese adults worldwide and there are more than 220 million people who have diabetes. The global impact of these disorders is immense in terms of human suffering and economic burden. There is an urgent need for a more effective understanding of these disease processes and their management, including the use of natural strategies that are affordable and efficacious. The health care system known as Ayurveda has much to offer in this regard. Ayurveda describes a set of complex clinical disorders, collectively called Prameha, that are characterized by frequent abnormal micturition. The clinical conditions associated with Prameha correlate in many ways with obesity, metabolic syndrome, and diabetes mellitus. The etiology, classification, pathogenesis, and management of Prameha are discussed at length and in detail in the Ayurvedic texts. The theoretical background and comprehensive set of strategies Ayurveda utilizes to treat Prameha may be valuable in managing obesity, metabolic syndrome, and diabetes mellitus in an efficacious and cost-effective manner.

J Altern Complement Med. 2011 Jun;17(6):549-52. Sharma H, Chandola HM. 1 Center for Integrative Medicine and Department of Pathology, College of Medicine, The Ohio State University , Columbus, OH.

Full title: Double-blind, randomized, controlled, pilot study comparing classic ayurvedic medicine, methotrexate, and their combination in rheumatoid arthritis.

OBJECTIVE: : To compare classic Ayurveda, methotrexate (MTX), and their combination in a double-blind, randomized, double-dummy, pilot trial in rheumatoid arthritis (RA) for 36 weeks. METHODS: : Forty-three seropositive RA patients by American College of Rheumatology (ACR) criteria with disease duration of less than 7 years were assigned to the following treatment groups: MTX plus Ayurvedic placebo (n = 14), Ayurveda plus MTX placebo (n = 12), or Ayurveda plus MTX (n = 17). Outcomes included the Disease Activity Score (DAS28-CRP), ACR20/50/70, and Health Assessment Questionnaire - Disability Index. All measures were obtained every 12 weeks for 36 weeks. Analyses included descriptive statistics, analysis of variance, ?, or Student t test. The unique features of this study included the development of placebos for each Ayurvedic pharmacological dosage form and individualization of Ayurvedic therapy. RESULTS: : All groups were comparable at baseline in demographics and disease characteristics. There were no statistically significant differences among the 3 groups on the efficacy measures. ACR20 results were MTX 86%, Ayurveda 100%, and combination 82%, and DAS28-CRP response were MTX -2.4, Ayurveda -1.7, and combination -2.4. Differences in adverse events among groups were also not statistically significant, although the MTX groups experienced more adverse event (MTX 174, Ayurveda 112, combination 176). No deaths occurred. CONCLUSIONS: : In this first-ever, double-blind, randomized, placebo-controlled pilot study comparing Ayurveda, MTX, and their combination, all 3 treatments were approximately equivalent in efficacy, within the limits of a pilot study. Adverse events were numerically fewer in the Ayurveda-only group. This study demonstrates that double-blind, placebo-controlled, randomized studies are possible when testing individualized classic Ayurvedic versus allopathic treatment in ways acceptable to western standards and to Ayurvedic physicians. It also justifies the need for larger studies.

J Clin Rheumatol. 2011 Jun;17(4):185-92. Furst DE, Venkatraman MM, McGann M, Manohar PR, Booth-Laforce C, Sarin R, Sekar PG, Raveendran KG, Mahapatra A, Gopinath J, Kumar PR. From the *Geffen School of Medicine, University of California Los Angeles, CA; †University of Washington, Seattle, WA; ‡Ayurvedic Trust, Coimbatore, India; and §Department of Gastroenterology, Seth GS Medical College & KEM Hospital, Mumbai, India.

Full title: Withaferin A inhibits activation of signal transducer and activator of transcription 3 in human breast cancer cells.

We have shown previously that withaferin A (WA), a promising anticancer constituent of Ayurvedic medicine plant Withania somnifera, inhibits growth of human breast cancer cells in culture and in vivo in association with apoptosis induction. The present study builds on these observations and demonstrates that WA inhibits constitutive as well as interleukin-6 (IL-6)-inducible activation of signal transducer and activator of transcription 3 (STAT3), which is an oncogenic transcription factor activated in many human malignancies including breast cancer. The WA treatment (2 and 4 ?M) decreased constitutive (MDA-MB-231) and/or IL-6-inducible (MDA-MB-231 and MCF-7) phosphorylation of STAT3 (Tyr(705)) and its upstream regulator Janus-activated kinase 2 (JAK2; Tyr(1007/1008)) in MDA-MB-231, which was accompanied by suppression of their protein levels especially at the higher concentration. Exposure of MDA-MB-231 or MCF-7 cells to WA also resulted in suppression of (i) transcriptional activity of STAT3 with or without IL-6 stimulation in both cells; (ii) dimerization of STAT3 (MDA-MB-231) and (iii) nuclear translocation of Tyr(705)-phosphorylated STAT3 in both cells. To our surprise, the IL-6-stimulation, either before or after WA treatment, did not have an appreciable effect on WA-mediated apoptosis in MDA-MB-231 or MCF-7 cell line. The IL-6-stimulated activation of STAT3 conferred a modest protection against WA-mediated suppression of MDA-MB-231 cell invasion. General implication of these findings is that WA can trigger apoptosis and largely inhibit cell migration/invasion of breast cancer cells even after IL-6-induced activation of STAT3, which should be viewed as a therapeutic advantage for this agent.

Carcinogenesis. 2010 Nov;31(11):1991-8. Epub 2010 Aug 19. Lee J, Hahm ER, Singh SV. Department of Pharmacology & Chemical Biology, and University of Pittsburgh Cancer Institute, University of Pittsburgh School of Medicine, 5117 Centre Avenue, Pittsburgh, PA 15213, USA.

This review focuses on how the study of anatomy in India has evolved through the centuries. Anatomical knowledge in ancient India was derived principally from animal sacrifice, chance observations of improperly buried human bodies, and examinations of patients made by doctors during treatment. The Vedic philosophies form the basis of the Ayurvedic tradition, which is considered to be one of the oldest known systems of medicine. Two sets of texts form the foundation of Ayurvedic medicine, the Susruta Samhita and the Charaka Samhita. The Susruta Samhita provided important surgical and anatomical information of the understanding of anatomy by Indians in the 6th century BCE. Here we review the anatomical knowledge known to this society. © 2010 The Authors. Journal of Anatomy © 2010 Anatomical Society of Great Britain and Ireland.

J Anat. 2010 Dec;217(6):646-50. doi: 10.1111/j.1469-7580.2010.01294.x. Epub 2010 Sep 30. Loukas M, Lanteri A, Ferrauiola J, Tubbs RS, Maharaja G, Shoja MM, Yadav A, Rao VC. Department of Anatomical Sciences, School of Medicine, St George's University, Grenada, West Indies. mloukas@sgu.edu

Full title: EGLN1 involvement in high-altitude adaptation revealed through genetic analysis of extreme constitution types defined in Ayurveda.

It is being realized that identification of subgroups within normal controls corresponding to contrasting disease susceptibility is likely to lead to more effective predictive marker discovery. We have previously used the Ayurvedic concept of Prakriti, which relates to phenotypic differences in normal individuals, including response to external environment as well as susceptibility to diseases, to explore molecular differences between three contrasting Prakriti types: Vata, Pitta, and Kapha. EGLN1 was one among 251 differentially expressed genes between the Prakriti types. In the present study, we report a link between high-altitude adaptation and common variations rs479200 (C/T) and rs480902 (T/C) in the EGLN1 gene. Furthermore, the TT genotype of rs479200, which was more frequent in Kapha types and correlated with higher expression of EGLN1, was associated with patients suffering from high-altitude pulmonary edema, whereas it was present at a significantly lower frequency in Pitta and nearly absent in natives of high altitude. Analysis of Human Genome Diversity Panel-Centre d'Etude du Polymorphisme Humain (HGDP-CEPH) and Indian Genome Variation Consortium panels showed that disparate genetic lineages at high altitudes share the same ancestral allele (T) of rs480902 that is overrepresented in Pitta and positively correlated with altitude globally (P < 0.001), including in India. Thus, EGLN1 polymorphisms are associated with high-altitude adaptation, and a genotype rare in highlanders but overrepresented in a subgroup of normal lowlanders discernable by Ayurveda may confer increased risk for high-altitude pulmonary edema.

Proc Natl Acad Sci U S A. 2010 Nov 2;107(44):18961-6. Epub 2010 Oct 18. Aggarwal S, Negi S, Jha P, Singh PK, Stobdan T, Pasha MA, Ghosh S, Agrawal A; Indian Genome Variation Consortium, Prasher B, Mukerji M. Genomics and Molecular Medicine, Institute of Genomics and Integrative Biology, Council of Scientific and Industrial Research, New Delhi 110007, India. Collaborators (151)

Full title: Selective killing of cancer cells by Ashwagandha leaf extract and its component Withanone involves ROS signaling.

BACKGROUND AND PURPOSE: Ashwagandha is a popular Ayurvedic herb used in Indian traditional home medicine. It has been assigned a variety of health-promoting effects of which the mechanisms remain unknown. We previously reported the selective killing of cancer cells by leaf extract of Ashwagandha (i-Extract) and its purified component Withanone. In the present study, we investigated its mechanism by loss-of-function screening (abrogation of i-Extract induced cancer cell killing) of the cellular targets and gene pathways.

METHODOLOGY/PRINCIPAL FINDINGS: Randomized ribozyme library was introduced into cancer cells prior to the treatment with i-Extract. Ribozymes were recovered from cells that survived the i-Extract treatment. Gene targets of the selected ribozymes (as predicted by database search) were analyzed by bioinformatics and pathway analyses. The targets were validated for their role in i-Extract induced selective killing of cancer cells by biochemical and molecular assays. Fifteen gene-targets were identified and were investigated for their role in specific cancer cell killing activity of i-Extract and its two major components (Withaferin A and Withanone) by undertaking the shRNA-mediated gene silencing approach. Bioinformatics on the selected gene-targets revealed the involvement of p53, apoptosis and insulin/IGF signaling pathways linked to the ROS signaling. We examined the involvement of ROS-signaling components (ROS levels, DNA damage, mitochondrial structure and membrane potential) and demonstrate that the selective killing of cancer cells is mediated by induction of oxidative stress.

CONCLUSION: Ashwagandha leaf extract and Withanone cause selective killing of cancer cells by induction of ROS-signaling and hence are potential reagents that could be recruited for ROS-mediated cancer chemotherapy.

PLoS One. 2010 Oct 21;5(10):e13536. Widodo N, Priyandoko D, Shah N, Wadhwa R, Kaul SC. National Institute of Advanced Industrial Science and Technology, Tsukuba, Ibaraki, Japan.

The use of complementary and alternative therapies for depression is an issue of growing interest for practitioners who care for women. Postpartum depression is a serious and debilitating illness that affects many women, their infants, and families. Often, women do not report feelings of sadness or depression to their health care providers due to stigma. Some women have multiple concerns in using prescription drugs, especially if they are breastfeeding their infants. In addition, more women are educating themselves about the potential side and adverse effects of prescriptions drugs and are exploring complementary and alternative therapies. With the availability of information from multiple sources, whether accurate or not, women may be using these therapies inappropriately. Two major concerns in using complementary and alternative therapies are the purity and safety of the herbs and herbal formulations and the potential lack of communication between the client and health care provider.

J Psychosoc Nurs Ment Health Serv. 2010 Nov;48(11):30-6. doi: 10.3928/02793695-20100930-02. Epub 2010 Oct 22. Gossler SM. University of Tennessee, College of Nursing, Knoxville, Tennessee 37996-4180, USA. sgossler@utk.edu

Full title: Effect of a novel Omegacoeur®/Doluperine® nutritional combination on human embryonic kidney cell viability.

Holistica Laboratories (Eguilles, France) developed the nutritional supplements Omegacoeur® and Doluperine® based on two of the most ancient and unique dietary health traditions. Omegacoeur® is formulated to supply key active components of Mediterranean diet (omega 3,6,9 fatty acids, garlic, and basil) and the formulation of Doluperine® was based on the Ayurvedic tradition (curcuma, pepper, ginger extracts). Interestingly, recent studies suggest that an combination of the ingredients supplied by these two supplements could provide additional and previously unanticipated benefit through synergistic actions of some of their key components. However, the effect of such combination on human cell viability has not been investigated. In this present article, a review of the various effects of the individual compounds of the new combination and the reported active doses, and the result of a study of an combination of Omegacoeur® / Dolupérine® on Human Embryonic Kidney (HEK 293) cells. Incremental doses of 4 Omegacoeur® / Dolupérine® combinations prepared so that the molar ratio DHA (Docosahexaenoic acid) in Omegacoeur® / curcumin in Dolupérine® was kept constant, at 2.5 DHA / 1 curcumin, were added to the culture media. After 24h of incubation, cell viability was assessed by the trypan blue exclusion method. The data suggest that the combination of Omegacoeur® with Dolupérine® does not affect HEK 293 cells viability in the range of doses that have demonstrated beneficial effects in earlier studies.

Cell Mol Biol (Noisy-le-grand). 2010 Oct 5;56 Suppl:OL1400-9. Sottejeau Y, Patel AM, Gerber G, Pierre SV, Maixent JM. Department of Physiology and Pharmacology, College of Medicine, University of Toledo, Toledo, Ohio, USA.

Full title: Effect of a novel Omegacoeur®/Doluperine® nutritional combination on human embryonic kidney cell viability.

Holistica Laboratories (Eguilles, France) developed the nutritional supplements Omegacoeur® and Doluperine® based on two of the most ancient and unique dietary health traditions. Omegacoeur® is formulated to supply key active components of Mediterranean diet (omega 3,6,9 fatty acids, garlic, and basil) and the formulation of Doluperine® was based on the Ayurvedic tradition (curcuma, pepper, ginger extracts). Interestingly, recent studies suggest that an combination of the ingredients supplied by these two supplements could provide additional and previously unanticipated benefit through synergistic actions of some of their key components. However, the effect of such combination on human cell viability has not been investigated. In this present article, a review of the various effects of the individual compounds of the new combination and the reported active doses, and the result of a study of an combination of Omegacoeur® / Dolupérine® on Human Embryonic Kidney (HEK 293) cells. Incremental doses of 4 Omegacoeur® / Dolupérine® combinations prepared so that the molar ratio DHA (Docosahexaenoic acid) in Omegacoeur® / curcumin in Dolupérine® was kept constant, at 2.5 DHA / 1 curcumin, were added to the culture media. After 24h of incubation, cell viability was assessed by the trypan blue exclusion method. The data suggest that the combination of Omegacoeur® with Dolupérine® does not affect HEK 293 cells viability in the range of doses that have demonstrated beneficial effects in earlier studies.

Cell Mol Biol (Noisy-le-grand). 2010 Oct 5;56 Suppl:OL1400-9. Sottejeau Y, Patel AM, Gerber G, Pierre SV, Maixent JM. Department of Physiology and Pharmacology, College of Medicine, University of Toledo, Toledo, Ohio, USA.

BACKGROUND: Triphala (Sanskrit tri?=?three and phala?=?fruits), composed of the three medicinal fruits Phyllanthus emblica L. or Emblica officinalis Gaertn., Terminalia chebula Retz., and Terminalia belerica Retz. is an important herbal preparation in the traditional Indian system of medicine, Ayurveda. Triphala is an antioxidant-rich herbal formulation and possesses diverse beneficial properties. It is a widely prescribed Ayurvedic drug and is used as a colon cleanser, digestive, diuretic, and laxative. Cancer is a major cause of death, and globally studies are being conducted to prevent cancer or to develop effective nontoxic therapeutic agents. Experimental studies in the past decade have shown that Triphala is useful in the prevention of cancer and that it also possesses antineoplastic, radioprotective and chemoprotective effects. CONCLUSIONS: This review for the first time summarizes these results, with emphasis on published observations. Furthermore, the possible mechanisms responsible for the beneficial effects and lacunas in the existing knowledge that need to be bridged are also discussed.

J Altern Complement Med. 2010 Dec;16(12):1301-8. Baliga MS. Research and Development, Father Muller Medical College, Mangalore, Kankanady, Karnataka, India. msbaliga@gmail.com

BACKGROUND: Plant species have long been used as principal ingredients of traditional medicine in far-west Nepal. The medicinal plants with ethnomedicinal values are currently being screened for their therapeutic potential but their data and information are inadequately compared and analyzed with the Ayurveda and the phytochemical findings. METHODS: The present study evaluated ethnomedicinal plants and their uses following literature review, comparison, field observations, and analysis. Comparison was made against earlier standard literature of medicinal plants and ethnomedicine of the same area, the common uses of the Ayurveda and the latest common phytochemical findings. The field study for primary data collection was carried out from 2006-2008. RESULTS: The herbal medicine in far-west Nepal is the basis of treatment of most illness through traditional knowledge. The medicine is made available via ancient, natural health care practices such as tribal lore, home herbal remedy, and the Baidhya, Ayurveda and Amchi systems. The traditional herbal medicine has not only survived but also thrived in the trans-cultural environment with its intermixture of ethnic traditions and beliefs. The present assessment showed that traditional herbal medicine has flourished in rural areas where modern medicine is parsimoniously accessed because of the high cost and long travel time to health center. Of the 48 Nepalese medicinal plants assessed in the present communication, about half of the species showed affinity with the common uses of the Ayurveda, earlier studies and the latest phytochemical findings. The folk uses of Acacia catechu for cold and cough, Aconitum spicatum as an analgesic, Aesculus indica for joint pain, Andrographis paniculata for fever, Anisomeles indica for urinary affections, Azadirachta indica for fever, Euphorbia hirta for asthma, Taxus wallichiana for tumor control, and Tinospora sinensis for diabetes are consistent with the latest pharmacological findings, common Ayurvedic and earlier uses. CONCLUSIONS: Although traditional herbal medicine is only a primary means of health care in far-west Nepal, the medicine has been pursued indigenously with complementing pharmacology and the Ayurveda. Therefore, further pharmacological evaluation of traditional herbal medicine deserves more attention.

J Ethnobiol Ethnomed. 2010 Dec 13;6:35. Kunwar RM, Shrestha KP, Bussmann RW. Ethnobotanical Society of Nepal, GPO Box 5220, Kathmandu, Nepal. ripukunwar@gmail.com

Medicinal plants are nature's gift to human beings to promote a disease free healthy life. Many medicinal plants are present in a group of herbal preparations of the Indian traditional health care system (Ayurveda) named Rasayana proposed for their interesting antioxidant activities. Phyllanthus emblica Linn. (syn. Emblica officinalis), commonly known as Indian gooseberry or amla, family Euphorbiaceae, is an important herbal drug used in unani (Graceo - arab) and ayurvedic systems of medicine. The plant is used both as a medicine and as a tonic to build up lost vitality and vigor. Phyllanthus emblica is highly nutritious and could be an important dietary source of vitamin C, amino acids, and minerals. The plant also contains phenolic compounds, tannins, phyllembelic acid, phyllembelin, rutin, curcum-inoids, and emblicol. All parts of the plant are used for medicinal purposes, especially the fruit, which has been used in Ayurveda as a potent rasayana and in traditional medicine for the treatment of diarrhea, jaundice, and inflammation. Various plant parts show antidiabetic, hypolipidemic, antibacterial, antioxidant, antiulcerogenic, hepatoprotective, gastroprotective, and chemopreventive properties. Here we discuss its historical, etymological, morphological and pharmacological aspects.

Krishnaveni M, Mirunalini S. J Basic Clin Physiol Pharmacol. 2010;21(1):93-105. Department of Biochemistry and Biotechnology, Annamalai University, Annamalai nagar-608002, Tamilnadu, India.

The recent decade has witnessed many landmark observations, which have added to the scientific credentials of Ayurveda.It is however believed that instead of a retrospective approach of looking into the Ayurveda through the scientific reappraisals, a prospective approach through primary understanding of Ayurveda followed by a search into scientific linkage would be more appealing. This article brings the simplified yet scientific decoding of the core concepts of Ayurveda that form the framework of this ancient science of health.

Rastogi S. Int J Ayurveda Res. 2010 Jan;1(1):41-6. Department of Kaya Chikitsa, State Ayurvedic College and Hospital, Tulsi Das Marg, Lucknow - 4, Department of Holistic Medicine, BMCRC, Vatsala Hospital, Tulsi Das Marg, Lucknow, India.

In the present day scenario, Ayurveda is globally being perceived in several contradictory ways. Poor quality of Ayurveda graduates produced as a result of poorly structured and poorly regulated education system is at least one of the important factors responsible for this scenario. The present study was carried out to evaluate the 'Global challenges of graduate level Ayurvedic education' and is based on the responses of Ayurvedic students and Ayurvedic teachers from various educational institutions of India to a methodically validated questionnaire. As the study indicates, the poor standard of Ayurvedic education in India is definitely a cause of concern. The curriculum of Bachelor of Ayurvedic Medicine and Surgery (BAMS) course of studies is required to be reviewed and restructured. The syllabi are required to be updated with certain relevant topics like laws governing the intellectual property rights, basic procedures of standardization of medicinal products, fundamental methods of evaluating the toxicity of the medicinal products, essentials of healthcare management and the basics of cultivation and marketing of medicinal plants. Furthermore, the study suggests that the Ayurvedic academicians are required to be trained in standard methods of research and documentation skills, and the educational institutions are required to be encouraged to contribute their share in building up the evidence base for Ayurveda in the form of quality education and research.

Patwardhan K, Gehlot S, Singh G, Rathore HC. Int J Ayurveda Res. 2010 Jan;1(1):49-54. Department of Kriya Sharir,Banaras Hindu University, Varanasi, India.

A sensitive, simple, rapid, and efficient high-performance thin-layer chromatographic (HPTLC) method has been developed and validated for the analysis of berberine in marketed Ayurvedic formulations containing Berberis aristata DC for regulatory purposes. Chromatography of methanolic extracts of these formulations was performed on silica gel 60 F254 aluminum-backed TLC plates of 0.2 mm layer thickness. The plate was developed up to 66 mm with the ternary-mobile phase butanol-acetic acid-water (8 + 1 + 1, v/v/v) at 33 +/- 5 degrees C with 5 min of tank saturation. The marker, berberine, was quantified at its maximum absorbance of 350 nm. The limit of detection and limit of quantitation values were found to be 5 and 10 ng/spot. The linear regression analysis data for the calibration plot showed a good linear relationship with correlation coefficient = 0.9994 in the concentration range of 10 to 50 ng/spot for berberine with respect to peak area. The instrumental precision was found to be 0.49% coefficient of variation (CV), and repeatability of the method was 0.73% CV. Recovery values from 98.27 to 99.11% indicate excellent accuracy of the method. The developed HPTLC method is very accurate, precise, and cost-effective, and it has been successfully applied to the assay of marketed formulations containing B. aristata for determination of berberine.

J AOAC Int. 2008 Sep-Oct;91(5):1149-53. Rout KK, Pradhan S, Mishra SK. Utkal University, Pharmacognosy and Phytochemistry Division, University Department of Pharmaceutical Sciences, Vani Vihar, Bhubaneswar, Orissa, India.

'Ayurveda' is an ancient system of healthcare that is native to India. At present, in India, there are more than 240 colleges that offer a graduate-level degree (Bachelor of Ayurvedic Medicine and Surgery-BAMS) in Ayurveda. Even though the Central Council of Indian Medicine, the governing body that monitors the matters related to Ayurveda education, has imposed various educational norms and regulations, the standard of education has been a cause of concern in recent years. The mushrooming of substandard Ayurvedic colleges is the most important factor that is being held responsible for this kind of erosion in the standards. The present study is a mailed survey, which was carried out to evaluate the 'Extent of exposure to basic clinical skills during BAMS course' as perceived by the sample groups of students and teachers drawn from 32 Ayurvedic educational institutions spread all over India. A methodically validated questionnaire was used as the tool in the study, to which 1022 participants responded. The study indicates that there are some serious flaws in the existing system of the graduate-level Ayurveda education. Since the Ayurvedic graduates play an important role in the primary healthcare delivery system of the country, governing bodies are required to take necessary steps to ensure the adequate exposure of the students to basic clinical skills. Along with the strict implementation of all the regulatory norms during the process of recognition of the colleges, introducing some changes in the policy model may also be required to tackle the situation.

Evid Based Complement Alternat Med. 2009 Aug 17. Patwardhan K, Gehlot S, Singh G, Rathore HC. Department of Kriya Sharir, Faculty of Ayurveda, Banaras Hindu University, Varanasi 221005, India. patwardhan.kishor@gmail.com.

The effect of a tea fortified with five herbs selected from Indian traditional medicine (Ayurveda) for their putative immunoenhancing effect (Withania somnifera, Glycyrrhzia glabra, Zingiber officinale, Ocimum sanctum and Elettaria cardamomum) on innate immunity was investigated. Ex vivo natural killer (NK) cell activity was assessed after consumption of fortified tea compared with regular tea in two independent double-blind intervention studies. Both studies were conducted in India with healthy volunteers (age >/= 55 years) selected for a relatively low baseline NK cell activity and a history of recurrent coughs and colds. In a pilot study conducted with 32 volunteers, the consumption of Natural Care tea significantly improved the NK cell activity of the volunteers in comparison with a population consuming regular tea. These results were validated in an independent crossover study with 110 volunteers. Data from these two studies indicate that regular consumption of the tea fortified with Ayurvedic herbs enhanced NK cell activity, which is an important aspect of the (early) innate immune response to infections. Copyright (c) 2009 John Wiley & Sons, Ltd.

Phytother Res. 2009 Jun 5. Bhat J, Damle A, Vaishnav PP, Albers R, Joshi M, Banerjee G. Unilever Food and Health Research Institute, Unilever Research India, 64, Main Road, Whitefield, Bangalore 560066, India.

Full Title: Improvement of balance in progressive degenerative cerebellar ataxias after Ayurvedic therapy: a preliminary report

BACKGROUND: The treatment options for improving the balance in degenerative cerebellar ataxias are very few. Ayurvedic texts have described diverse treatment regimens for this disease. AIMS: To determine the change in balance indices, if any, by dynamic posturography (Biodex Balance System, USA) in progressive cerebellar ataxia following Ayurvedic treatment. MATERIALS AND METHODS: We performed a preliminary open labelled study on ten patients diagnosed with progressive cerebellar ataxia. The patients were treated over a period of one month. Treatment consisted of Shirobasti (therapeutic retention of medicament over the scalp) in male patients and Shirodhara (pouring of a steady stream of medicament on the forehead) in female patients with Dhanvantaram tailam (medicated oil) for 45 minutes daily, followed by Abhyanga (methodical massage) with Dhanvantaram tailam and Bhashpa sweda (steam bath), for 14 days. In addition, the treatment also consisted Abhyantara aushadha (oral medicines) of Maharasnadi kashayam 15ml thrice daily, Dhanvantaram capsules 101 two capsules thrice daily, and Ashwagandha tablet 500 mg one tablet thrice daily, for one month. The patients were assessed on the Biodex balance system before and after the treatment. Results were analyzed using paired samples 't' test. RESULTS: All patients tolerated the treatment well without any adverse events and reported subjective improvement in walking. There was a statistically significant improvement in the overall and anteroposterior balance indices of dynamic stability. CONCLUSIONS: Over the short period of the present study, Ayurvedic therapy was found to be safe and, showed improvement in the balance in patients with progressive degenerative cerebellar ataxia. Further randomized placebo-control double-blind studies are needed to validate the results.

Neurol India. 2009 Mar-Apr;57(2):166-71. Sriranjini SJ, Pal PK, Devidas KV, Ganpathy S. Department of Neurology, National Institute of Mental Health and Neurosciences, Bangalore, India.

Clitoria ternatea L. (CT) (Family: Fabaceae) commonly known as 'Butterfly pea', a traditional Ayurvedic medicine, has been used for centuries as a memory enhancer, nootropic, antistress, anxiolytic, antidepressant, anticonvulsant, tranquilizing and sedative agent. A wide range of secondary metabolites including triterpenoids, flavonol glycosides, anthocyanins and steroids has been isolated from Clitoria ternatea Linn. Its extracts possess a wide range of pharmacological activities including antimicrobial, antipyretic, anti-inflammatory, analgesic, diuretic, local anesthetic, antidiabetic, insecticidal, blood platelet aggregation-inhibiting and for use as a vascular smooth muscle relaxing properties. This plant has a long use in traditional Ayurvedic medicine for several diseases and the scientific studies has reconfirmed those with modern relevance. This review is an effort to explore the chemical constituents, pharmacological and toxicity studies of CT, which have long been in clinical use in Ayurvedic system of medicine along with a critical appraisal of its future ethnopharmacological potential in view of many recent findings of importance on this well known plant species.

J Ethnopharmacol. 2008 Dec 8;120(3):291-301. Epub 2008 Sep 20. Mukherjee PK, Kumar V, Kumar NS, Heinrich M. School of Natural Product Studies, Department of Pharmaceutical Technology, Jadavpur University, Kolkata, West Bengal 700032, India. pulokm@gmail.com

Ayurveda is the oldest system of Medicine in the world, its antiquity going back to the Vedas. It adapts a unique holistic approach to the entire science of life, health and cure. The areas of special consideration in Ayurveda are geriatrics, rejuvenation, nutrition, immunology, genetics and higher consciousness. The Ayurvedic texts describe a set of rejuvenative measures to impart biological sustenance to the bodily tissues. These remedies are called Rasayana which are claimed to act as micronutrients. Some of these Rasayanas are organ and tissue specific. Those specific to brain tissue are called Medhya Rasayana. Such Rasayanas retard brain aging and help in regeneration of neural tissues besides producing antistress, adaptogenic and memory enhancing effect. In addition to the long tradition of textual and experience-based evidence for their efficacy, certain recent studies conducted on these traditional remedies on scientific parameters have shown promising results which have been reviewed in this paper for providing lead for further studies. The popular Medhya Rasayanas are Ashwagandha (Withania somnifera Dunal), Brahmi (Bacopa monnieri Linn), Mandukaparni (Centella asiatica Linn) and Sankhapuspi (Convolvulus pluricaulis Chois).

Biogerontology. 2008 Dec;9(6):369-74. Epub 2008 Oct 18. Singh RH, Narsimhamurthy K, Singh G. Department of Kayachikitsa, Institute of Medical Sciences, Banaras Hindu University, Varanasi, 221005, India. rh_singh2001@yahoo.com

Ayurveda is the oldest system of Medicine in the world, its antiquity going back to the Vedas. It adapts a unique holistic approach to the entire science of life, health and cure. The areas of special consideration in Ayurveda are geriatrics, rejuvenation, nutrition, immunology, genetics and higher consciousness. The Ayurvedic texts describe a set of rejuvenative measures to impart biological sustenance to the bodily tissues. These remedies are called Rasayana which are claimed to act as micronutrients. Some of these Rasayanas are organ and tissue specific. Those specific to brain tissue are called Medhya Rasayana. Such Rasayanas retard brain aging and help in regeneration of neural tissues besides producing antistress, adaptogenic and memory enhancing effect. In addition to the long tradition of textual and experience-based evidence for their efficacy, certain recent studies conducted on these traditional remedies on scientific parameters have shown promising results which have been reviewed in this paper for providing lead for further studies. The popular Medhya Rasayanas are Ashwagandha (Withania somnifera Dunal), Brahmi (Bacopa monnieri Linn), Mandukaparni (Centella asiatica Linn) and Sankhapuspi (Convolvulus pluricaulis Chois).

Biogerontology. 2008 Dec;9(6):369-74. Epub 2008 Oct 18. Singh RH, Narsimhamurthy K, Singh G. Department of Kayachikitsa, Institute of Medical Sciences, Banaras Hindu University, Varanasi, 221005, India. rh_singh2001@yahoo.com

Ayurveda is the oldest system of Medicine in the world, its antiquity going back to the Vedas. It adapts a unique holistic approach to the entire science of life, health and cure. The areas of special consideration in Ayurveda are geriatrics, rejuvenation, nutrition, immunology, genetics and higher consciousness. The Ayurvedic texts describe a set of rejuvenative measures to impart biological sustenance to the bodily tissues. These remedies are called Rasayana which are claimed to act as micronutrients. Some of these Rasayanas are organ and tissue specific. Those specific to brain tissue are called Medhya Rasayana. Such Rasayanas retard brain aging and help in regeneration of neural tissues besides producing antistress, adaptogenic and memory enhancing effect. In addition to the long tradition of textual and experience-based evidence for their efficacy, certain recent studies conducted on these traditional remedies on scientific parameters have shown promising results which have been reviewed in this paper for providing lead for further studies. The popular Medhya Rasayanas are Ashwagandha (Withania somnifera Dunal), Brahmi (Bacopa monnieri Linn), Mandukaparni (Centella asiatica Linn) and Sankhapuspi (Convolvulus pluricaulis Chois).

Biogerontology. 2008 Dec;9(6):369-74. Epub 2008 Oct 18. Singh RH, Narsimhamurthy K, Singh G. Department of Kayachikitsa, Institute of Medical Sciences, Banaras Hindu University, Varanasi, 221005, India. rh_singh2001@yahoo.com

Aging is a complex phenomenon, a sum total of changes that occur in a living organism with the passage of time and lead to decreasing ability to survive stress, increasing functional impairment and growing probability of death. There are many theories of aging and skin remains the largest organ of the study. Skin aging is described as a consequence of intrinsic and extrinsic factors. The most common amongst visible signs of skin aging are wrinkles and there are various therapies including antiaging cosmeceuticals, sunscreens, chemical peeling, injectable agents, such as botox, fibrel, autologous fat grafting as also few surgical procedures have been used. Ayurveda, the Indian traditional medicine, describes aging with great details. This review provides modern and Ayurvedic perspectives on theories and management of aging.

Evid Based Complement Alternat Med. 2009 Feb 20. Datta HS, Mitra SK, Paramesh R, Patwardhan B. Chief Academics, Manipal Education, Manipal Towers, Bangalore 560 008, India. bhushan.patwardhan@manipalu.com.

Ayurveda, the traditional Indian medical system, is receivingincreasing attention worldwide. OBJECTIVE: A retrospective study was conducted to determine the effectiveness ofAyurvedic constitution-based diets on weight loss patterns of obese adults. DESIGN, SETTING, SUBJECTS, AND INTERVENTION: Records of 200 obese adults, both male and female, who had completed 3 months of the diet therapy at Ayurvedic clinics, were examined and data collated. Techniques used included a checklist of personality traits, physical signs, and food likes and dislikes to determine the dosha. Based on the predominant doshas, diets were prescribed and closely monitored for a period of 3 months. OUTCOME MEASURES: Records of height and weight and chest, abdominal, waist, arm, and thigh circumferences noted initially and after each month for the period of 3 months were obtained. RESULTS: Among the 200 subjects, 55 (27.5%) were vatta-, 83 (41.5%) were pitta-, and 62 (31.0%) were kapha-predominant. At the beginning, kapha and pitta people were heavier than vatta people. After the 3 months of therapy, the pitta group lost the most weight (9.84%). The decrease in all the anthropometric measurements was higher in pitta and kapha people than in vatta individuals. Hence, diets based on Ayurvedic constitution may prove useful in promoting weight loss. Though these promising findings support traditional Indian Ayurvedic scriptures, more closely controlled trials are needed to substantiate these findings.

Altern Ther Health Med. 2009 Jan-Feb;15(1):44-7. Sharma S, Puri S, Agarwal T, Sharma V. NutriHealth Systems, New Delhi, India.

The roots of Asparagus racemosus, Chlorophytum borivilianum, and rhizomes of Curculigo orchioides are popular for their aphrodisiac and immunostimulatory properties. The herbs have been traditionally used as Vajikaran Rasayana herbs because of their putative positive influence on sexual performance in humans. Lyophilized aqueous extracts obtained from the roots of A. racemosus, C. borivilianum, and rhizomes of C. orchioides were studied for sexual behavior effects in male albino rats and compared with untreated control group animals (total N = 60). The rats were evaluated for effect of treatments on anabolic effect. Seven measures of sexual behavior were evaluated. Administration of 200 mg/kg body weight of the aqueous extracts had pronounced anabolic effect in treated animals as evidenced by weight gains in the body and reproductive organs. There was a significant variation in the sexual behavior of animals as reflected by reduction of mount latency, ejaculation latency, post ejaculatory latency, intromission latency, and an increase of mount frequency. Penile erection (indicated by Penile Erection Index) was also considerably enhanced. Reduced hesitation time (an indicator of attraction towards female in treated rats) also indicated an improvement in sexual behavior of extract treated animals. The observed effects appear to be attributable to the testosterone-like effects of the extracts. Nitric oxide based intervention may also be involved as observable from the improved penile erection. The present results, therefore, support the folklore claim for the usefulness of these herbs and provide a scientific basis for their purported traditional usage.

Arch Sex Behav. 2009 Jan 13. Thakur M, Chauhan NS, Bhargava S, Dixit VK. Department of Pharmaceutical Sciences, Dr. H. S. Gour University, Sagar, MP, 470003, India.

Despite a growing body of literature on complementary and alternative medicine, there is still limited information on the use of Ayurveda in the United States. Because Ayurveda is one of the world's major traditional medical systems, knowledge of its use is important. In particular, information on utilization by Asian Indians living in the United States is needed due to increased immigration from India and related regions. Recent reports of heavy metal contamination of some imported Ayurveda products underscore this need. For this reason, an exploratory survey was conducted. DESIGN: A semistructured 21-item questionnaire was administered using face-to-face interviews. PARTICIPANTS AND SETTING: The study comprised a convenience sample of 64 Asian Indians living in Northern California. OUTCOME MEASURES: Main outcome measures included sociodemographic variables, questions on awareness, knowledge and use of Ayurvedic products or services, use of other nutritional/herbal products, and reasons for use. RESULTS: In the sample, 95% of the participants were aware of Ayurveda, 78% had knowledge of Ayurvedic products or treatments, and about 59% had used or were currently using Ayurveda. Only 18% of those using Ayurveda had informed their Western medical doctors. CONCLUSIONS: Given its common use in the United States by Asian Indians, its cultural relevance, potential therapeutic value, and possible safety concerns, physician and consumer education along with more empirical research is warranted.

J Altern Complement Med. 2008 Dec;14(10):1249-53. Satow YE, Kumar PD, Burke A, Inciardi JF. Department of Consumer and Family Studies/Dietetics, San Francisco State University, San Francisco, CA 94132, USA. yes@sfsu.edu

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.

J Altern Complement Med. 2008 Dec;14(10):1189-98. Uebaba K, Xu FH, Ogawa H, Tatsuse T, Wang BH, Hisajima T, Venkatraman S. Department of Presymptomatic Health Promotion, Institute of Natural Medicine, University of Toyama, Toyama, Japan. uebaba@inm.u-toyama.ac.jp

Ayurveda is an ancient system of personalized medicine documented and practiced in India since 1500 B.C. According to this system an individual's basic constitution to a large extent determines predisposition and prognosis to diseases as well as therapy and life-style regime. Ayurveda describes seven broad constitution types (Prakritis) each with a varying degree of predisposition to different diseases. Amongst these, three most contrasting types, Vata, Pitta, Kapha, are the most vulnerable to diseases. In the realm of modern predictive medicine, efforts are being directed towards capturing disease phenotypes with greater precision for successful identification of markers for prospective disease conditions. In this study, we explore whether the different constitution types as described in Ayurveda has molecular correlates.

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Ayurveda is an ancient system of personalized medicine documented and practiced in India since 1500 B.C. According to this system an individual's basic constitution to a large extent determines predisposition and prognosis to diseases as well as therapy and life-style regime. Ayurveda describes seven broad constitution types (Prakritis) each with a varying degree of predisposition to different diseases. Amongst these, three most contrasting types, Vata, Pitta, Kapha, are the most vulnerable to diseases. In the realm of modern predictive medicine, efforts are being directed towards capturing disease phenotypes with greater precision for successful identification of markers for prospective disease conditions. In this study, we explore whether the different constitution types as described in Ayurveda has molecular correlates.

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India has been recognized all over the world for spices and medicinal plants. Both exhibit a wide range of physiological and pharmacological properties. Current biomedical efforts are focused on their scientific merits, to provide science-based evidence for the traditional uses and to develop either functional foods or nutraceuticals. The Indian traditional medical systems use turmeric for wound healing, rheumatic disorders, gastrointestinal symptoms, deworming, rhinitis and as a cosmetic. Studies in India have explored its anti-inflammatory, cholekinetic and anti-oxidant potentials with the recent investigations focusing on its preventive effect on precarcinogenic, anti-inflammatory and anti atherosclerotic effects in biological systems both under in vitro and in vivo conditions in animals and humans. Both turmeric and curcumin were found to increase detoxifying enzymes, prevent DNA damage, improve DNA repair, decrease mutations and tumour formation and exhibit antioxidative potential in animals. Limited clinical studies suggest that turmeric can significantly impact excretion of mutagens in urine in smokers and regress precancerous palatal lesions. It reduces DNA adducts and micronuclei in oral epithelial cells. It prevents formation of nitroso compounds both in vivo and in vitro. It delays induced cataract in diabetes and reduces hyperlipidemia in obese rats. Recently several molecular targets have been identified for therapeutic / preventive effects of turmeric. Fenugreek seeds, a rich source of soluble fiber used in Indian cuisine reduces blood glucose and lipids and can be used as a food adjuvant in diabetes. Similarly garlic, onions, and ginger have been found to modulate favourably the process of carcinogenesis.

Krishnaswamy K. National Institute of Nutrition , Taranaka, Hyderabad, Andhra Pradesh, India. sri21kk@hotmail.com Asia Pac J Clin Nutr. 2008;17 Suppl 1:265-8.

Objective: To explore the supportive evidence for the use of Ayurvedic medicine in the management of existing and recurrent nephrolithiasis. Method: Nine Ayurvedic medicines commonly utilized in the management of nephrolithiasis were identified by discussions with Ayurvedic practitioners in India. Mechanistic and clinical studies evaluating the use of these agents were identified using the Medline database and bibliographies suggested by Ayurvedic practitioners. The articles were then critically reviewed and summarized. Results: Four in vitro mechanistic studies, eight animal studies, and seven human trials were identified. Phyllanthus niruri has undergone mechanistic in vitro, animal, and clinical trials that support its impact on calcium oxalate crystallization. Preliminary clinical trials have evaluated the role of Dolichos biflorus and Orthosiphon grandiflorus in the prevention of urolithiasis and fish stone as a method of stone expulsion, yet the treatment effect and mechanism of action remains to be elucidated. Conclusion: Ayurvedic medicine holds promise as a complementary approach to the management and prevention of nephrolithiasis. The best studied compound is P. niruri. Further controlled randomized clinical trials are justified to support or refute the potential benefits demonstrated in these initial studies.

Kieley S, Dwivedi R, Monga M. Department of Urologic Surgery, University of Minnesota, Minneapolis, MN 55455. J Endourol. 2008 Jul 11.

In many traditional schools of medicine it is claimed that a balanced modulation of several targets can provide a superior therapeutic effect and decrease in side effect profile compared to a single action from a single selective ligand, especially in the treatment of certain chronic and complex diseases, such as diabetes and obesity. Diabetes and obesity have a multi-factorial basis involving both genetic and environmental risk factors. A wide array of medicinal plants and their active constituents play a role in the prevention and treatment of diabetes. Salacia roots have been used in Ayurvedic medicine for diabetes and obesity since antiquity, and have been extensively consumed in Japan, the United States and other countries as a food supplement for the prevention of obesity and diabetes. Recent pharmacological studies have demonstrated that Salacia roots modulate multiple targets: peroxisome proliferator-activated receptor-alpha-mediated lipogenic gene transcription, angiotensin II/angiotensin II type 1 receptor, alpha-glucosidase, aldose reductase and pancreatic lipase. These multi-target actions may mainly contribute to Salacia root-induced improvement of type 2 diabetes and obesity-associated hyperglycemia, dyslipidemia and related cardiovascular complications seen in humans and rodents. The results of bioassay-guided identification indicate that mangiferin, salacinol, kotalanol and kotalagenin 16-acetate are at least in part responsible for these multi-target regulatory activities of Salacia roots. The evidence suggests that this unique traditional medicine fulfills a multiple-target strategy in the prevention and treatment of diabetes and obesity. Although toxicological studies have suggested minimal adverse effects of the herbal medicine in rodents, a clinical trial is crucial to further confirm the safety of Salacia roots. In addition, further mechanistic studies are necessary in order to allow a better understanding of how use of Salacia root may interact with other therapeutic interventions.

Life Sci. 2008 May 23;82(21-22):1045-9. Epub 2008 Mar 28. Li Y, Huang TH, Yamahara J. Faculty of Pharmacy, The University of Sydney, NSW 2006 Australia. yuhao@pharm.usyd.edu.au

BACKGROUND: Ayurvedic medicines are known to contain arsenic and concentrations up to toxic levels have been reported in certain formulations. However, clinical disease due to arsenic containing ayurvedic medicines has rarely been reported. We seek to highlight the existence of toxic levels of arsenic in certain ayurvedic preparations that can produce serious systemic manifestations. METHODS: An 11-year-old girl developed manifestations of arsenical keratosis (punctuate palmoplantar keratoderma and leucomelanoderma) and non-cirrhotic portal hypertension, 6 months and 18 months respectively after intake of ayurvedic medications, prescribed for epilepsy. The eight ayurvedic preparations consumed by the patient and her serum levels were analyzed for arsenic content. RESULTS: Arsenic content of ayurvedic medicines ranged from 5 mg/L to 248 mg/L. The serum arsenic level was 202.20 microg/L (normal < 60 microg/L). Skin manifestations improved after the discontinuation of ayurvedic medications. CONCLUSIONS: Ayurvedic medications should be consumed under strict guidance and supervision of qualified practitioners to prevent such catastrophies.

Int J Dermatol. 2008 Jun;47(6):618-21. Khandpur S, Malhotra AK, Bhatia V, Gupta S, Sharma VK, Mishra R, Arora NK. Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India.

ABSTRACT Background: Ayurveda, India's natural health care tradition, has a unique way of classifying human population based on individual constitution or prakriti. Ayurveda's tridosha theory identifies principles of motion (vata), metabolism (pitta), and structure (kapha) as discrete phenotypic groupings. Patwardhan et al. (2005) hypothesized in a paper published in this journal that there is a genetic connotation to prakriti and as proof of this concept showed a correlation between HLA alleles and prakriti type, establishing a rationale and preliminary experimental support for the concept of an association between HLA alleles and the Ayurvedic tridosha theory of individual prakriti types. This work is both part of and a catalyst for a wider revolution in the scientific investigation of Ayurveda in India, referred to as "Ayurvedic biology" and "AyuGenomics." Subsequently, Chen et al. (2007) reported a similar study in this journal using a classification based on Traditional Chinese Medicine (TCM) theory. Conclusions: The findings of a genetic basis for both Ayurvedic and TCM classifications indicate a commonality between Asia's great medical traditions in their diagnostic typologies and a genetic basis for Asian traditional medicine's theory of discrete and discernable groupings of psycho-physiologic differences. Accordingly, new horizons have opened for collaborative East-East research and for an individualized approach to disease management and activation of the full range of human potential, as articulated in Ayurveda and TCM.

J Altern Complement Med. 2008 Jun;14(5):571-6. Patwardhan B, Bodeker G. University of Pune, Interdisciplinary School of Health Sciences, Pune, India.