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   Table of Contents - Current issue
Coverpage
April-June 2020
Volume 3 | Issue 2
Page Nos. 43-80

Online since Friday, October 16, 2020

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EDITORIAL  

Promoting Ayurveda for care and cure in COVID-19 pandemic period p. 43
Tanuja Manoj Nesari
DOI:10.4103/jacr.jacr_77_20  
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CASE REPORTS Top

Ayurvedic management of moderate COVID-19 infection: A case report Highly accessed article p. 46
Meenakshi Sharma, Sisir Kumar Mandal, Charu Sharma, Shalini Rai, Anand More
DOI:10.4103/jacr.jacr_59_20  
The global community is facing the pandemic of novel coronavirus disease (COVID-19) caused by Severe Acute Respiratory Syndrome Corona Virus - 2 (SARS- CoV- 2). In spite of worldwide efforts to contain it, the pandemic is spreading rapidly, and there is an urgent need for the development of evidence-based therapeutic strategy. The dimensions of this pandemic require an urgent harnessing of all knowledge systems available globally. So far, no cure specific to COVID-19 has been developed either in modern western medicine or in traditional medicine. In this case report, a 30-year-old male health worker, diagnosed with COVID-19, was managed with Ayurveda intervention within six days. The patient reported with predominantly moderate symptoms of COVID-19, and the management approach was personalized and holistic in nature incorporating diet, lifestyle, and Samshamana aushadha (~pacifying treatment) along with Satvavajaya chikitsa (~psychotherapy).
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Effect of an Ayurveda treatment in palmoplantar psoriasis: A case study p. 51
Guruprasad C Nille, Anand Kumar Chaudhary, Laxmi Narayan Gupta
DOI:10.4103/JACR.JACR_24_20  
Psoriasis is an immune-mediated disease characterized by chronic inflammatory changes in the skin. Around 5% of all the psoriasis sufferers have palmoplantar psoriasis, which is challenging to treat a variety of psoriasis. Ayurveda is rich in herbs having proven anti-psoriatic action. However, the complex and multifactorial pathogenesis of psoriasis needs a multimodal treatment approach. In the present case report, a 45-year-old female patient presented with soles of feet partially covered, thickened, red skin having sharp, and noticeable borders demarking the psoriasis patches from unaffected skin. There were painful cracks over the soles and thickened erythematous plaques on the right elbow. Clinical examination revealed the involvement of Tridosha (~three biological humors) in the Samprapti (~pathophysiology). The multimodal treatment including Patolakaturohinyadi kashaya, Kaishora guggulu, Mahatiktaka ghrita, Gandhaka rasayana, and Khadirarishta as internal medicines, whereas Winsoria oil and Panchavalkala kwatha as external medicines showed promising results. Within six months of the treatment, the psoriatic lesions and associated signs and symptoms healed effectively. Altogether, multimodal Ayurveda treatment can be an effective and safe solution for palmoplantar psoriasis.
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Rapid normalization of thrombocytopenia following Ayurveda treatments in leptospirosis suspect: A case report p. 57
Praveen Balakrishnan, D Sudhakar, Pratap Makhija
DOI:10.4103/JACR.JACR_45_20  
Leptospirosis, a public health issue, is an infectious condition caused by bacteria of genus Leptospira. The disease comes under the category of acute febrile illness and manifests with fever (~Jvara), chills (~Jadyata), headache (~Shirahshula), myalgia (~Angamarda), vomiting (~Chardi), or diarrhea (~Atisara). The advanced form of the disease threatens life by causing either liver or kidney failure or meningitis or respiratory distress. Ayurveda classical literature provides an in-depth stage-wise description and treatment of Jvara (~febrile illness). This is an evidence-based case report of the rapid normalization of decreased platelet count by administering Amruthotharam kashayam and Punarnavadi kashayam in low frequent dose in a case of leptospirosis suspect.
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Gojihva (Launaea nudicaulis [L.] Hook.f.), a potential herb for chronic wound healing: A case study p. 61
Vishal Kumar, Shivani Ghildiyal, Rahul Sherkhane, Tanuja Manoj Nesari
DOI:10.4103/JACR.JACR_14_20  
Chronic wounds are becoming challenge for scientific community due to their economical and psychological burden. Contemporary science tried hard to cop up with this difficult situation by the use of tissue engineering, cell-based therapy, plasma therapy along with various dressings, and surgical procedures, but the results are not very promising. Wounds are described under the heading of Vrana in Ayurveda along with various herbs and herbomineral preparations for their management. Gojihva (Launaea nudicaulis [L.] Hook.f.) is an herb mentioned to be useful in various diseases as well as for wounds. It is also practiced ethnomedicinally for wound management in various countries. A 60-year-old male having non-healing wound on his dorsal surface of the forearm for the past 45 days was treated with dressing of Gojihva kwatha (~ decoction) for 28 days. Bates–Jensen Wound Assessment Tool (BWAT), wound tracing and digital photography was used to asses wound healing on every week. BWAT score was 52 before treatment and 13 after the treatment. The surface area was 42.9 cm2 before treatment and nil after treatment. The wound was completely healed in 28 days without any complications.
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Management of multi-relapsed chronic pancreatitis through Rasaushadhis: A case study p. 66
Vaidya Balendu Prakash, Vaidya Shikha Prakash, Sneha Tiwari, Shakshi Sharma, Vaidya Pooja Jaryal
DOI:10.4103/JACR.JACR_49_20  
Chronic pancreatitis is the long-standing inflammation of the pancreas, leading to irreversible damage of the gland. The disease is characterized by loss of exocrine and endocrine functions of pancreas owing to fibrosis and parenchymal damage. Clinical manifestations of the disease include abdominal pain, episodes of acute pancreatitis, nausea, vomiting, steatorrhea, indigestion, weight loss, and uncontrolled blood sugar. No authentic tools have yet been identified to predict the course of the disease, frequency of acute exacerbations, and rate of disease progression. Pancreatic enzymes, supplements, and a low-fat diet are usually prescribed to patients of pancreatitis. However, patients continue to experience unpredicted flare up of symptoms that are managed by IV fluids, antibiotics, and painkillers in case of acute exacerbations. Surgical intervention and stenting might also be done in some cases to bring relief to patients. However, these have limited effect, and the disease continues to progress and causes pancreatic cancer and casualties as well. Despite advances in medical science, the prognosis of the disease remains variable and unclear. Studies indicate a mortality rate of 17% in 5 years, 30% in 10 years, and 55% in 20 years after the diagnosis of chronic pancreatitis. Here, a case of chronic pancreatitis that was treated in lines of Ayurveda is presented. The patient has not suffered any attack after the commencement of Ayurvedic treatment and completes nine years of symptom-free status with no signs of progression in radiological tests.
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Management of microalbuminuria in Stage-2 Diabetic Nephropathy by Ayurveda formulation and Pathya ahara (Plant- based diet): A case report p. 70
Manisha Shukla, Vyasadeva Mahanta, Rahul Sherkhane, Sanjay Kumar Gupta
DOI:10.4103/JACR.JACR_16_20  
Microalbuminuria is one initial diagnostic marker of progressive Diabetic Nephropathy (DN). Urine Albumin Excretion (UAE) between 30 and 300 mg/24 h is found in Stage 2 DN. In Ayurveda, no description is found, which can be directly correlated with DN, but Nidana and Samprapti of Prameha can be correlated for its manifestation. In this case, a 56-year-old male patient visited to Shalya Tantra OPD with complaints of type 2 diabetes and 135 mg UAE in 24 h with estimated Glomerular Filtration Rate (eGFR) of 77 ml/min/1.73 m2. This case report was aimed to evaluate the effect of Ayurveda formulations (Gokshuradi guggulu, Haritakyadi kwatha, Bhumyamalaki churna, and Gokshura churna) with Pathya ahara (Plant-based diet) in the management of microalbuminuria in DN Stage 2. This formulation was given for one month and Pathya ahara advised for two months. UAE significantly decreased and came to normoalbuminuria state. eGFR increased up to 87 ml/min/1.73 m2. The present study suggested that using Ayurveda formulations with Pathya ahara is effective in the management of microalbuminuria in DN Stage 2.
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Management of xerosis cutis with cream of cashew shell oil: A case report p. 75
Jwala Jayaram, S Swathy, MS Soumya, Shaithya Raj, Rabinarayan Tripathy
DOI:10.4103/JACR.JACR_36_20  
Xerosis cutis is one of the common clinical conditions in clinical practice. Reduced skin hydration is the alarming characteristic of xerosis, that if ignored, can lead to insidious onset of cutaneous infections and chronic ulcers. Although various studies have been in vogue in this field, no standard method of treatment has yet been formulated. An abundantly available drug, cashew shell oil, has been used as a folklore practice in various parts of Kerala, for this condition. This case study is an attempt to evaluate the efficacy of cashew shell oil in cream form in the management of xerosis cutis of plantar surface. A 31-year-old female presented with the complaints of dry skin in the plantar region of the right foot with deep cracks, fissures, and flakes in the skin for two years. Diagnosis was done based on the clinical examination. Pre and post assessments were done based on DermaLab Combo parameters, namely hydration, transepidermal water loss (TEWL), skin pH, elasticity, temperature, skin color, videoscope, and Specified Symptom Sum Score system (scaling, roughness, redness, crack or fissure). Cashew shell oil cream was applied for a period of 30 days. Skin hydration levels improved and TEWL reduced after treatment. Skin pH, though raised during the period of intervention, came to normalcy by the end of treatment. There was improvement in skin viscoelasticity (VE), with reduced retraction time. The oil constituent being an antioxidant, reduces lipid peroxidation and protects from cell membrane damage, thus maintaining skin barrier function. Digital images evaluated using the DermaLab Combo parameters also depicted flaky dry skin being replaced by normal Stratum Corneum (SC) cells, with increased skin hydration. Cashew oil, though being a skin irritant, can be efficiently used in skin conditions, especially xerosis cutis, when administered in appropriate dose and formulation.
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