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1.  Role of Virechana Karma in cure and prevention of recurrence of Vicharchika (Eczema) 
Ayu  2012;33(4):505-510.
Mandip and Chandola reported that administration of Rasayana (Guduchi and Bhringaraja) after Koshtha Shuddhi with Aragvadha Hima and simultaneous giving of Shirishadi decoction orally and applying of Snuhyadi Lepa externally provided complete remission to 22.6% patients of Vicharchika (Eczema) and checked the recurrences of the disease in the 89.5% patients. As in this group, cure rate was not up to the expectation; therefore, it was thought desirable to see whether performing of Virechana Karma instead of Koshtha Shuddhi prior to the administration of the above drugs enhances the cure rate for the Vicharchika (Eczema) patients. For the present study, 39 patients of Vicharchika (Eczema) were registered, of which 32 patients completed the full course of the treatment. These patients were given Virechana after preparing with the proper internal Snehana, Abhyanga, and Svedana as per classical method. After the Samsarjana Krama, they were administered the Shirishadi decoction and Guduchi-Bhringraja Rasayana powder orally with simultaneous local application of Snuhyadi Lepa on the eczematous lesions. The results of this study showed that when Virechana Karma was performed prior to the administration of Guduchi-Bhringaraja Rasayana and Shirishadi decoction orally and SnuhyadiLepa externally, it not only increased the cure rate to 81.3% in the patients of Vicharchika (Eczema) but also checked the recurrences to great extent as only negligible number of the patients reported the recurrence.
doi:10.4103/0974-8520.110526
PMCID: PMC3665194  PMID: 23723667
Eczema; Koshtha Shuddhi; Rasayana; Vicharchika; Virechana Karma
2.  PA03.01. A clinical study on the management of vicharchika (eczema) by brihat haridrakhanda and lepa of arka taila in children 
Ancient Science of Life  2013;32(Suppl 2):S70.
Purpose:
1.To find out an easily available and considerably low cost, safe and effective remedy for the treatment of Vicharchika. 2. Clinical assessment of the efficiency of Brihat haridrakhanda orally & Arka taila as per in the management of Dry eczema. 3. To evaluate the clinical efficacy of Brihat haridrakhanda ora lly & Arka taila as per in the management of Wet eczema. 4. To compare the effect of Brihat haridrakhanda orally & Arka taila on Dry & wet Eczema.
Method:
30 cases of Vicharchika were selected randomly from OPD and IPD of Kaumarabhritya S.D.M. College of Ayurveda and Hospital, Hassan. Study is carried out in two groups, each containing 15 patients. Dry group Patient with dry lesion (Shushka Vicharchika). Wet group Patient with wet lesion. (Sravi Vicharchika)Both groups had given Brihat Haridrakhanda orally & Lepa of Arka Taila for 1month along with follow up for 1 month and results observed. Dose:a) Brihat Haridrakhand: 5gms mixed with lukewarm milk; twice daily half an hour before food.b) Arkataila: required quantity for external application.
Result:
The study showed there was statistically significant improvement in Kandu (83.33 %),Pidaka (58%),Vaivarnata (55 %) Rookshata (66.66 %) & number of patches (50%) in dry group & there was statistically significant improvement in Kandu (63.63 %), Pidaka (40 %), Vaivarnata (59.26 %), Srava (60 %) & number of patches (50%) in wet groupThe study concluded that there was better improvement in the Dry group in reduction of Kandu, Pidaka, Daha, & Number of patches compares to wet group while in wet group there was better improvement seen in reduction of Vaivarnata & Area of patch compare to Dry group.
Conclusion:
Local application and oral medication is more effective. The drugs are having the property Kaphahara, Kandughna, Sravahara & helps in reduction of Rookshata. Brihat Haridrakhanda is sweet and easily palatable.
doi:10.4103/0257-7941.123893
PMCID: PMC4147544
3.  A comparative study of Agni karma with Lauha, Tamra and Panchadhatu Shalakas in Gridhrasi (Sciatica) 
Ayu  2010;31(2):240-244.
Sushruta has mentioned different methods of management of diseases, such as Bheshaja karma, Kshara Karma, Agni karma, Shastrakarma and Raktamokshana. The approach of Agni karma has been mentioned in the context of diseases like Arsha, Arbuda, Bhagandar, Sira, Snayu, Asthi, Sandhigata Vata Vikaras and Gridhrasi. Gridhrasi is seen as a panic condition in the society as it is one of the burning problems, especially in the life of daily laborers. It is characterized by distinct pain starting from Sphik Pradesha (gluteal region) and goes down toward the Parshni Pratyanguli (foot region) of the affected side of leg. On the basis of symptomatology, Gridhrasi may be simulated with the disease sciatica in modern parlance. In modern medicine, the disease sciatica is managed only with potent analgesics or some sort of surgical interventions which have their own limitations and adverse effects, whereas in Ayurveda, various treatment modalities like Siravedha, Agni karma, Basti Chikitsa and palliative medicines are used successfully. Among these, Agni karma procedure seems to be more effective by providing timely relief. Shalakas for Agni karma, made up of different Dhatus like gold, silver, copper, iron, etc. for different stages of the disease conditions, have been proposed. In the present work, a comparative study of Agni karma by using iron, copper and previously studied Panchadhatu Shalaka in Gridhrashi has been conducted. A total of 22 patients were treated in three groups. Result of the entire study showed that Agni karma by Panchadhatu Shalaka provided better result in combating the symptoms, especially Ruka and Tandra, while Lauhadhatu Shalaka gave better results in combating symptoms of Spanadana and Gaurava. In the meantime, Tamradhatu Shalaka provided better effect in controlling symptoms like Toda, Stambha and Aruchi. Fifty percent patients in Panchadhatu Shalaka (Group A) were completely relieved. In Lauhadhatu Shalaka (Group B), the success rate was 00.00%, and in Tamradhatu Shalaka (Group C), the percentage of success rate was 14.28%. After analyzing the data, Tamradhatu Shalaka was found to be more effective than Lauha and Panchadhatu Shalakas.
doi:10.4103/0974-8520.72408
PMCID: PMC3215372  PMID: 22131718
Agni karma; Gridhrasi; Panchadhatu Shalaka; Parshni Pratyanguli; Sciatica
4.  Role of Rasayana in Cure and Prevention of Recurrence of Vicharchika (Eczema) 
Ayu  2010;31(1):33-39.
Generally, skin diseases run a chronic course and the recurrence is very common. Mandip and Chandola (2009) reported that Shirishadi Decoction administered orally and simultaneously Snuhyadi Lepa applied externally to the patients of Vicharchika (Eczema) provided complete remission to 18.2% patients, marked improvement to 42.4% patients and moderate improvement to 36.4% patients but the recurrence rate was very high i.e. 80%. Charaka, in the context of the treatment of Apasmara mentions that in all the chronic diseases, Rasayana drugs should be prescribed. As eczema is a chronic disease and its recurrences are very common, therefore, it was thought desirable to evaluate the role of the Rasayana drugs in the cure and prevention of the recurrence of Vicharchika (Eczema). In this study, total 38 patients of Vicharchika (Eczema) were registered, among which 31 patients completed the full course of treatment. These patients were first subjected to Koshtha Shuddhi done with Aragvadha (Cassia fistula) Hima administered orally at bedtime for initial eight days. Thereafter 30 ml of Shirishadi Decoction and 6 gm of Guduchi (Tinospora cardifolia) and Bhringaraja (Eclipta alba) powder was given with Ghrita. Both the drugs were given twice daily after meals orally. Simultaneously, Snuhyadi Lepa was applied on the eczematous lesions. Results of the study showed that addition of Rasayana drugs provided complete remission to 22.6% and checked the recurrence of the disease in the 89.5% patients of Vicharchika (Eczema).
doi:10.4103/0974-8520.68207
PMCID: PMC3215319  PMID: 22131682
Vicharchika; Rasayana; Koshtha Shuddhi; Shirishadi Decoction; Snuhyadi Lepa; Guduchi- Bhringaraja Rasayana; Eczema; Recurrence
5.  PA02.01. Critical analysis of Doshik karma in twak 
Ancient Science of Life  2013;32(Suppl 2):S46.
Purpose:
In normalcy, dosha will be performing their own functions in their own specific site. In the verses related to the sthana of dosha we can easily find out that in all the 3 verses skin or the structure related to skin as the sthana of one or other dosha. By mentioning the various sthanas of the each dosha, different function performed by individual dosha in different sites has been emphasised. So there is the need to understand the hidden physiological aspects of dosha related to skin.
Method:
The bruhat trayi were scrutinised regarding the references for the sthana and karma of the dosha. Later, physiologico anatomical aspects of the skin were studied from modern physiology books. Later, supportive correlation was done between ayurvedic and modern views to build valid and reliable hypothesis regarding the physiology of the dosha in skin.
Result:
Among the list of vata stana the word ‘sparshanendriyam’ is used, which attributes all the sensory function to vata dosha. Among the list of sthanas of pitta dosha the word ‘sparshanam’ is used, by this acharyas intended to highlight the function of pigmentation. ‘Meda’ is considered as the sthana of kapha. This can be considered as the adipose tissue of skin/below skin, can also considered as the secretion from the sweat glands since sweda is mala of meda. Sweat maintains water balance which refers to kleda vidrathi function of sweda. In various conditions the cholinergic sympathetic nerves get stimulated and sweat is excreted out which is ksepta bahi malanam function of vata dosha.
Conclusion:
With respect to skin doshic physiology can be concluded as vata will be carrying out sensory functions and excretion of sweat, pitta will be carrying out function of pigmentation, kapha will carrying out the function of production of sweating which in turn maintains the water balance.
doi:10.4103/0257-7941.123861
PMCID: PMC4147517
6.  A study on Vasantika Vamana (therapeutic emesis in spring season) - A preventive measure for diseases of Kapha origin 
Ayu  2011;32(2):181-186.
Panchakarma is the most essential part of Ayurveda treatments. It is preventive, preservative, promotive, curative and rehabilitative therapy. Ayurveda believes in strong relationship between macrocosm and microcosm and states that the seasonal changes will influence the biological systems resulting into the accumulation and aggravation of particular Dosha in a particular season like accumulation and aggravation of Kapha in Hemant Rutu (winter season) and Vasant Rutu (spring season) respectively, accumulation and aggravation of Pitta in Varsha Rutu (rainy season) and Sharad Rutu (autumn season) respectively. Vasantika Vamana is done in spring season approximately in the month of March and April for the elimination of vitiated Kapha Dosha which in turn helps to prevent the forth coming Kapha disorders and associated Pitta disorders or diseases originating or settled in the place of Kapha like bronchial asthma, allergic bronchitis, rhinitis, sinusitis, migraine, hyperacidity, indigestion, anorexia, obesity, overweight, dyslipidemia, diabetes mellitus, acne vulgaris, psoriasis, eczema, urticaria etc. In this study, a total of 89 persons were registered and 69 volnteers/patients undergone classical Vamana Karma without any major complications. Average minimum, maximum, total dose and total days of Snehapana were 36.40 ml, 187.21 ml, 578.59 ml and 5.01 days respectively. Average quantity of Madanaphala, Ksheera, Yashtimadhu Phanta and Lavanodaka was 5.81 g, 1130.29 ml, 3202.9 and 2489.13 ml respectively. The results were encouraging; hence, further studies may be conducted including large population in this direction.
doi:10.4103/0974-8520.92562
PMCID: PMC3296337  PMID: 22408299
Antiki; Dosha; Kapha; Laingiki; Madanaphala; Maniki; Pitta; Samsarjana Krama; Snehapana; Vasantika Vamana; Vegiki
7.  OA03.14. A clinical study on the effect of vamanakarma with navakashyaguggulu in kitibha kustha 
Ancient Science of Life  2013;32(Suppl 2):S37.
Purpose:
In present era due to drastic advancement in science and technology the present population are prone to more of intellectual work than compared to physical work leading to increased levels of psychological stress added to that involving in irregular dietary habits, taking oily and spicy food etc resulting in increased incidence of psychosomatic disorders. One such disease is Psoriasis in ayurveda that can be correlated with Kitibha kustha it is mainly due to vitiation of vata and kapha doshas. Acharya chakradatta described a pancha kashaya kwatha vamana in 50/3 and Nava kashaya guggulu in 53/20 chapter, which is used to evaluate the effect in kitibha kustha.
Method:
Patients diagnosed as kitibha kustha according to classical signs and symptoms were selected from o.p. and i.p. department of panchakarma, Dr.B.R.K.R.Govt.Ayurvedic college,Hyderabad. They were underwent a vamanakarma with panchakashaya kwath followed by shamana chikitsa with Nava kashaya guggulu for oral administration for 45days.
Result:
The assessment of treatment procedure was based on change in classical signs and symptoms of kitibha kustha. The results were found encouraging as there is significant reduction in syava (redness), ugrakandu (itching), parusha of twak (roughness of skin).
Conclusion:
Kitibha kustha is kapha predominant disease with vatanubanda. For kapha predominant dosha vamanakarma is best shodhana treatment and hence vamana is adopted alongwith kusthahara property of Nava kashaya guggulu.
doi:10.4103/0257-7941.123852
PMCID: PMC4147507
8.  OA03.05. A clinical study on the effect of vamana in anartava wsr to secondary amenorrhoea 
Ancient Science of Life  2013;32(Suppl 2):S28.
Purpose:
Anartava have been described by Sushruta and Vagbhata as non appearance of artava. The doshas obstruct the passage or orifices of channels carrying artava (artava vaha srotasa), thus artava is destroyed. Aggravated kapha and vata obstruct the passage of artava, thus menstrual blood is not discharged. So anartava is a Kaphaavrittvata predominant disease. Panchakarma is the most essential part of Ayurveda treatments. It is preventive, preservative, promotive, curative and rehabilitative therapy. Vamana karma has been considered as the best line of treatment for the kaphaja disorders Vamana is clearly indicated in presence of Kaphaavritta vata lakshanas i.e. Anartava and Artava kshaya in our classics.
Method:
Research was conducted on 4 patients from IPD & OPD of Prasuti Tantra & Stree Roga department of SDM College of Ayuveda, Hassan. The selection was done on the basis of chief complaints of anartava (secondary amennorhoea) irrespective of duration. In pathological point of view USG was carried out before starting the course of treatment. As purvakarma snehana and swedana was carried out according to deha bala and prakrati of patients. Vamana was given to patients as pradhana karma and followed by samsarjana karma. The follow up was one week.
Result:
After treatment, out of 4 patients, 3 patients got their mensus within time period of one week and one patient was remain unchanged.
Conclusion:
Vamana is one among the Shodhana procedures, through which Doshas are eliminated through Urdha Bhaga. It is a Doshapratyanika Cikitsa for Kapha Dosha because the main seat of Kapha is Uras/Amashaya & principle is to eliminate vitiated doshas from the nearest route. Just like the flower, fruits and branches which are destroyed at once as soon as the tree is rooted out, the diseases originated due to excessive Kapha are subdued after the elimination of Kapha through the process of Vamana. So, Vamana removes kapha (saumya) substances resulting into relative increase in agneya constituents of the body, consequently artava also increases.
doi:10.4103/0257-7941.123842
PMCID: PMC4147497
9.  A comparative clinical study on standardization of Vamana Vidhi by classical and traditional methods 
Ayu  2012;33(4):517-522.
Vamana Karma (process of emesis) is considered as Pradhana Karma (prime procedure) meant for inducing therapeutic vomiting, indicated for the purification of Urdhwa Bhaga (upper part) of the body. It is the process by which contents of stomach, including Kapha and Pitta are expelled out of the body through oral route. Acharya Charak and Sushruta have advocated various procedures for Vamana Karma known as classical methods, whereas some traditional methods are also being followed. As very little works has been carried out in the direction of Vamana Karma and as not a single work has been carried out on standardization of Vamana Vidhi comparing to both classical and traditional methods, the present study had been selected. The clinical trial was conducted in a randomized sample of 50 individuals (Both patients and volunteers) resolved into two sub-groups, viz. individuals in Group A was performed Vamana with classical methods and Group B with traditional methods. From the observations and results obtained in the present clinical study, it can be concluded that the method mentioned in classics is very much beneficial from every point of view in comparison to the traditional method. It is very easy, safest, less time-consuming and clinically as well as statistically most effective method without producing any type of complications.
doi:10.4103/0974-8520.110531
PMCID: PMC3665202  PMID: 23723669
Pradhana Karma; Shodhana Karma; standardization; Vamana Karma; Vamana Vidhi
10.  A case discussion on eczema 
Eczema is a form of dermatitis where inflammation of epidermis occurs. The exact cause of eczema is not known. Although it is activated by the immune system and is related to allergic reactions, it is not the same as other allergic reactions. In Ayurveda, the disease is described by the name “Vicharchika.” Virechana is the best line of management for skin disorders. Controlling eczema more effectively can make a radical improvement to the patient's quality of life. A case report of 45-year-old male, who presented with complaints of rashes over dorsum of both foot associated with intense itching and burning sensation, oozing wound posterior to lateral malleolus and dorsum of left foot has been presented here.
doi:10.4103/0974-7788.76792
PMCID: PMC3059451  PMID: 21455456
Eczema; vicharchika; virechana
11.  PA01.80. The review of herbal anti-allergy and anti-histaminic drugs 
Ancient Science of Life  2012;32(Suppl 1):S130.
Purpose:
The symptoms of an allergic reaction communicate sensitization to certain antigens in the environment. Initiation of antigen reaction stimulates mast cells to release histamine into the blood which interacts with the cells to produce most of the symptoms of the allergy. Drugs that block only the action of histamine are known as antihistaminic while the drugs preventing mast cells from releasing histamine are considered as anti allergic agents. Ayurveda considers Mandagni (Jadharagni in hypofunctional state) as the root cause of the all diseases which produces Ama (Antigen/Visha). Drugs possessing Deepan, Pachan, and Vishaghna properties may prevent histamine release and allergic reactions. Udardaprashamana, Kandughna, Swasahara group of drugs may prevent acute histaminic reaction. Keeping this concept in view a critical review was made about the herbs mentioned in the classical Ganas and aushadhyogas of compilatory works of medieval India in addition to reported activities during 20th century research works. The study aims to identify herbs with Antihistaminic and Antiallergy activity and to discuss safety and efficacy of herbal anti histaminics over the drugs of modern medicine which may produce certain adverse effects like nausea, drowsiness, nasal burning etc.
Method:
Analysis of drugs mentioned in the management of pratishyaya, shwas, kasa, and skin conditions like Seetpitta, Udarda, Vicharchika etc. was made. Review of research data mentioned in various journals and monographs was also analysed.
Result:
Vishaghna and Udardaprashamana dashemani may have profound activity in controlling allergic reactions. Kandughna Dashemani may be useful to control fungal and allergic skin diseases. Pippali, Tulsi, Kantakari may be useful in the management of allergic disease of respiratory tract. Azadirachta indica (Nimba), Albezzia lebbeck (Shirish), Glycerrhyza glabra (Yashtimadhu) etc. have provided ample scientific evidence for antihistaminic activity.
Conclusion:
Recent researches confirmed Anti histaminic and Anti allergic activity of Adhatoda vasica (vaasaa), Aloe vera (kumari), Azadirachta indica (nimba), Curcurma zedoaria (karchura), Nigella sativa (upakunchikaa), Inula racemosa (pushkarmoola), Tinospora cordifolia (guduchi), Benincasa hispida (krushmanda) etc. which are safer to use.
PMCID: PMC3800886
12.  A critical review on two types of Laghupanchamula 
Ayu  2012;33(3):343-347.
A group of five roots of small plants i.e., Shalaparni, Prshniparni, Brhati, Kantakari and Gokshura or Eranda is known as Laghupanchamula under Mishraka Varga (group of drugs). It is used as such or with Mahat Panchamula i.e., Bilva, Gambhari, Shyonaka, Agnimantha and Patala, constituting Dashamula, a well recognized and popular Ayurvedic preparation or as an ingredient of different dosage forms. Classical texts of Ayurveda differs regarding components of this Mishraka Varga. Four out of five drugs of Laghupanchamula are similar in all the Ayurvedic texts, but either Gokshura or Eranda is considered as the fifth drug. So a comphrenesive review of Veda, Samhita Grantha, Cikitsa Grantha and Nighantus, with regards to synonyms, contents, Guna- Karma, origin of variation in contents and possible thought behind two kinds of Laghupanchamula, to throw light for rational use of either Eranda or Gokshura under Laghupanchamula was conducted. It was observed that both the traditions were in practice however Acharya Kashyapa and Ravigupta were in view of Eranda as a fifth drug of Laghupanchamula where as Acharya Charaka, Sushruta, Vagabhatta, Yogaratnakara and Chakradatta are in favour of Gokshura. Infact, the variation in content depends on the need i.e Dosha, Dushya and Vyadhi.
doi:10.4103/0974-8520.108820
PMCID: PMC3665092  PMID: 23723639
Brihatpanchamula; Eranda; Gokshura; Laghupanchamula
13.  OA01.03. Emergency management of pakshaghata - A case study 
Ancient Science of Life  2013;32(Suppl 2):S3.
Purpose:
To form a classical Ayurvedic protocol for the management of pakshaghata
Method:
Pakshaghata, is a vatavyadhi. It can be correlated to the biomedical cerebrovascular condition called ‘stroke’. The lakshanas include, ruja, vakstambha, etc. It's types are kaphanubandha and pittanubandha. Even though pakshaghata is a vata vyadhi, and mentioned in the nanatmaja vataja vikaras of charaka, it is not a shuddha vataja condition. There is samsarga of Pitta and kapha, clearly mentioned by Susrutha and Madhava nidana. In all the above explanations it is clear that raktadushti leading to vata prakopa is the underlying cause of the disease. The management of pakshaghata being reported in this paper is a case of ischemic stroke. Patient manifested with In the initial stage, treatment followed was teeksha nasya karma, which is akephepakavat chikitsa line of treatment as mentioned by Acharya Susrutha and Astanga sangraha for the purpose of reversing mada, murcha or sanyasa which is the pittaavrita vata stage of the disease. Once reversal of initial stage of pittavrita vata was accomplished, mridu virechana karma, svedana, abhyanga and basti were done for treating kaphaja and vataja stage of the disease and restore dosha balance. Nasya 8 drops in each nostril, Virechana Gandharva Hasta Eranda Taila 1030ml+30ml Dugdha, Agni alepa, Basti Anuvasana 80ml Brihat saindhava taila, Niruha 500ml mahamanjistadi kashaya.
Result:
After the course of treatment which lasted 15 days there was considerable reversal of symptoms. The recovery was promising and worth documenting. The results and discussion will be presented during the presentation.
Conclusion:
The above mentioned protocol to treat atyayika cases of pakshaghata is unique. The recovery was promising and worth documenting.
doi:10.4103/0257-7941.123815
PMCID: PMC4147499
14.  Efficacy of Virechana and Basti Karma with Shamana therapy in the management of essential hypertension: A comparative study 
Ayu  2013;34(1):70-76.
Considering high prevalence and the need to look for alternative medicine, essential hypertension was screened in light of Vata–Pitta Pradhana Rakta Pradoshaja Vikara as mentioned by Acharya Charaka. Comparing the etiological factors, symptomatology, and complications with Rakta Pradoshaja Vikara with that of essential hypertension, a striking similarity was revealed. To prove the practical approach of management of Vata–Pitta Pradhana Rakta Pradoshaja Vikara, a randomized open clinical trial on 33 uncomplicated subjects of essential hypertension was conducted. The subjects were allotted in two groups, viz. (Group A) Virechana group having 16 cases who underwent Virechana Karma by Trivrita, Aragvadha, Eranda Taila, and Draksha Kwatha as Sahapana; and (Group B) Basti group consisting of 17 cases who were administered Dashmoola Kala Basti in which Niruha with Dashmoola Kwatha and Anuvasana with Dashmoola Taila was done. Patients of both the groups were followed by Shamana Chikitsa (Arjunadi Ghanavati). The overall effect of the therapies on systolic and diastolic blood pressure showed that Virechana proved better relief (43.75%) as compared to Basti (29.41%). The response was encouraging and has created scope for further studies.
doi:10.4103/0974-8520.115455
PMCID: PMC3764884  PMID: 24049408
Basti Karma; essential hypertension; Raktapradoshaja Vikara; Virechana Karma
15.  Gene-Environment Interaction in the Onset of Eczema in Infancy: Filaggrin Loss-of-Function Mutations Enhanced by Neonatal Cat Exposure  
PLoS Medicine  2008;5(6):e131.
Background
Loss-of-function variants in the gene encoding filaggrin (FLG) are major determinants of eczema. We hypothesized that weakening of the physical barrier in FLG-deficient individuals may potentiate the effect of environmental exposures. Therefore, we investigated whether there is an interaction between FLG loss-of-function mutations with environmental exposures (pets and dust mites) in relation to the development of eczema.
Methods and Findings
We used data obtained in early life in a high-risk birth cohort in Denmark and replicated the findings in an unselected birth cohort in the United Kingdom. Primary outcome was age of onset of eczema; environmental exposures included pet ownership and mite and pet allergen levels. In Copenhagen (n = 379), FLG mutation increased the risk of eczema during the first year of life (hazard ratio [HR] 2.26, 95% confidence interval [CI] 1.27–4.00, p = 0.005), with a further increase in risk related to cat exposure at birth amongst children with FLG mutation (HR 11.11, 95% CI 3.79–32.60, p < 0.0001); dog exposure was moderately protective (HR 0.49, 95% CI 0.24–1.01, p = 0.05), but not related to FLG genotype. In Manchester (n = 503) an independent and significant association of the development of eczema by age 12 mo with FLG genotype was confirmed (HR 1.95, 95% CI 1.13–3.36, p = 0.02). In addition, the risk increased because of the interaction of cat ownership at birth and FLG genotype (HR 3.82, 95% CI 1.35–10.81, p = 0.01), with no significant effect of the interaction with dog ownership (HR 0.59, 95% CI 0.16–2.20, p = 0.43). Mite-allergen had no effects in either cohort. The observed effects were independent of sensitisation.
Conclusions
We have demonstrated a significant interaction between FLG loss-of-function main mutations (501x and 2282del4) and cat ownership at birth on the development of early-life eczema in two independent birth cohorts. Our data suggest that cat but not dog ownership substantially increases the risk of eczema within the first year of life in children with FLG loss-of-function variants, but not amongst those without. FLG-deficient individuals may need to avoid cats but not dogs in early life.
In two independent cohorts of children, Hans Bisgaard and colleagues show an association between mutations in the filaggrin gene (FLG) and ownership of cats, but not dogs, with development of eczema.
Editors' Summary
Background.
Eczema is a skin condition characterized by dry, red, and itchy patches on the skin. Eczema is associated with asthma and allergy, though allergy rarely plays a role in development or severity of eczema. Eczema usually begins during infancy, typically on the face, scalp, neck, extensor sides of the forearms, and legs. Up to one in five infants develops eczema, but in more than half of them, the condition improves or disappears completely before they are 15 years old. If eczema persists into adulthood, it usually affects the face and the skin inside the knees and elbows. There is no cure for eczema but it can be controlled by avoiding anything that makes its symptoms worse. These triggers include irritants such as wool, strong soaps, perfumes, and dry environments. A good skin-care routine and frequent moisturizing can also help to keep eczema under control, but in many cases, corticosteroid creams and ointments may be necessary to reduce inflammation.
Why Was This Study Done?
Eczema tends to run in families. This suggests that eczema is caused by genetic factors as well as by environmental factors. Recently, researchers discovered that two common “loss-of-function” variants in the gene encoding filaggrin (FLG) predispose people to eczema. People who inherit one or two defective genes make no filaggrin, a protein that normally forms a physical barrier in the skin that protects the body from potentially harmful substances in the environment. Might the weakening of this barrier in filaggrin-deficient individuals affect their responses to environmental substances to which the skin is exposed? In this study, the researchers test this potential explanation for how genetic and environmental factors (in particular, exposure to pets) might interact to determine an individual's chances of developing eczema.
What Did the Researchers Do and Find?
To test their hypothesis, the researchers studied two independent groups of infants during their first year of life—a high-risk group consisting of infants born in Copenhagen, Denmark to mothers with asthma and a group of infants born to women from the general population in Manchester, United Kingdom. The researchers determined which FLG variants each child had inherited and classified those with either one or two defective copies of FLG as having an FLG mutation. They determined pet exposure in early life by asking whether a dog or a cat was living in the parental home when the child was born (“pet ownership”) and then analyzed how these genetic and environmental factors affected the age of onset of eczema. In both groups, children with FLG mutations were twice as likely to develop eczema during the first year of life as children without FLG mutations. For children without FLG mutations, cat ownership at birth had no effect on eczema risk but for children with FLG mutations, cat ownership at birth (but not dog ownership) further increased the risk of developing eczema.
What Do These Findings Mean?
These findings show that FLG mutations and cat ownership at birth interact to determine the chances of a child developing eczema during the first year of life. They provide support, therefore, for the researchers' suggestion that the weakening of the skin's protective barrier that is caused by filaggrin deficiency increases the child's susceptibility to factors associated with cat exposure. Only a small number of children in this study carried FLG mutations and were exposed to cats from birth, so these findings need confirming in independent studies. In addition, it is still not clear how exposure to cats drives the development of eczema. Allergy was not the mechanism as the FLG-deficient children exposed to cat and who developed eczema did not develop cat-specific immunoglobin E antibodies. Nevertheless, these findings suggest that, to reduce their risk of developing eczema, filaggrin-deficient individuals should avoid cats (but not dogs) during the first few months of life.
Additional Information.
Please access these Web sites via the online version of this summary at http://dx.doi.org/10.1371/journal.pmed.0050131.
The MedlinePlus Encyclopedia has a page on eczema (in English and Spanish); links to further information are provided by MedlinePlus
EczemaNet is a comprehensive online information resource about eczema provided by the American Academy of Dermatologists
The US National Institute of Arthritis and Musculoskeletal and Skin Diseases provides information on eczema
The UK National Health Service Direct health encyclopedia provides information for patients on eczema (in several languages)
The Copenhagen Studies on Asthma in Childhood (COPSAC) and Manchester Asthma and Allergy Study (MAAS) Web sites provide more information about the children involved in this research
doi:10.1371/journal.pmed.0050131
PMCID: PMC2504043  PMID: 18578563
16.  A Randomised Controlled Trial of Ion-Exchange Water Softeners for the Treatment of Eczema in Children 
PLoS Medicine  2011;8(2):e1000395.
In a randomized trial evaluating the effect of installation of ion-exchange water softeners in the households of children with eczema, the researchers found no evidence of improvement in eczema severity as compared to usual care in the study population.
Background
Epidemiological studies and anecdotal reports suggest a possible link between household use of hard water and atopic eczema. We sought to test whether installation of an ion-exchange water softener in the home can improve eczema in children.
Methods and Findings
This was an observer-blind randomised trial involving 336 children (aged 6 months to 16 years) with moderate/severe atopic eczema. All lived in hard water areas (≥200 mg/l calcium carbonate). Participants were randomised to either installation of an ion-exchange water softener plus usual eczema care, or usual eczema care alone. The primary outcome was change in eczema severity (Six Area Six Sign Atopic Dermatitis Score, SASSAD) at 12 weeks, measured by research nurses who were blinded to treatment allocation. Analysis was based on the intent-to-treat population. Eczema severity improved for both groups during the trial. The mean change in SASSAD at 12 weeks was −5.0 (20% improvement) for the water softener group and −5.7 (22% improvement) for the usual care group (mean difference 0.66, 95% confidence interval −1.37 to 2.69, p = 0.53). No between-group differences were noted in the use of topical corticosteroids or calcineurin inhibitors.
Conclusions
Water softeners provided no additional benefit to usual care in this study population. Small but statistically significant differences were found in some secondary outcomes as reported by parents, but it is likely that such improvements were the result of response bias, since participants were aware of their treatment allocation. A detailed report for this trial is also available at http://www.hta.ac.uk.
Trial registration
Current Controlled Trials ISRCTN71423189
Please see later in the article for the Editors' Summary
Editors' Summary
Background
Eczema (sometimes referred to as atopic dermatitis) is a chronic, inflammatory skin condition that affects about 20% of school children in developed countries. Eczema is often associated with other conditions, such as asthma, hay-fever and food allergy and can cause intractable itching leading to thickened skin, bleeding, secondary infection, sleep loss, poor concentration, and psychological distress. Current topical treatments for eczema have side effects, for example, topical corticosteroids may cause skin thinning and the long term safety of topical tacrolimus and pimecrolimus has yet to be determined. Therefore, there is a lot of interest in exploring the benefits of non-pharmacological treatments that have no apparent side effects.
Water hardness (≥200 mg/l calcium carbonate) has become a recent focus of attention.
Why Was This Study Done?
In addition to some epidemiological evidence linking increased water hardness with increased eczema prevalence, there have been widespread anecdotal reports of improvement in the skin of children with eczema when the family has moved from a hard to a soft water area. In addition, some patients report how their eczema symptoms have rapidly improved following the installation of a water softener. However, to date there have been no relevant published trials evaluating the potential benefit of water softeners for eczema. Given the lack of evidence, the high public interest in their potential benefit and the low risk of adverse effects, the researcher conducted a study to assess whether the installation of an ion-exchange water softener reduces the severity of eczema in children with moderate to severe eczema.
What Did the Researchers Do and Find?
The researchers did a pilot study that showed that it was not possible to blind participants to their treatment allocation using real and “dummy” water softener units because the softened water produced more soap suds. So the researchers conducted an observer-blind randomised controlled trial in which they used trained research nurses to conduct an objective assessment of every participant's skin. The researchers recruited 336 children who all lived in hard water areas in England. Eligible children were aged 6 months to 16 years who had a diagnosis of eczema (in line with the UK working party's diagnostic criteria) and an eczema severity score of 10 or over. Participants were randomised to either installation of an ion-exchange water softener plus usual eczema care, or usual eczema care alone. Trained research nurses examined each child's skin at baseline and at 6, 12, and 16 weeks to record changes in eczema severity. The researchers also analysed any changes in symptoms over the study period such as, sleep loss and itchiness, the amount of topical corticosteroid/calcineurin inhibitors used, the Dermatitis Family Impact questionnaire and the health related Quality of Life (children's version).
Although both treatment groups improved in disease severity during the course of the trial, the researchers found no difference between the treatment groups in the main outcome—eczema severity. Similar finding were found for night movement (scratching) and the use of topical medications (creams/ointments applied to the skin), both of which were blinded to intervention status. Nevertheless, parents in the trial did report small health benefits, and just over 50% chose to buy the water softener at the end of the trial because of perceived improvements in the eczema and the wider benefits of water softeners. It is unclear how much of this effect can be explained by prior belief in the effectiveness of the water softeners for the treatment of eczema.
What Do These Findings Mean?
The results of this study suggest that water softeners provide no additional clinical benefit to usual care in children with eczema so the use of ion-exchange water softeners for the treatment of moderate to severe eczema in children should not be recommended. However, it is up to each family to decide whether or not the wider benefits of installing a water softener in their home are sufficient to consider buying one.
Additional Information
Please access these Web sites via the online version of this summary at http://dx.doi.org/10.1371/journal.pmed.1000395.
The UK's NHS presents information on eczema for patients and families
MedlinePlus gives information for patients, families, and caregivers on eczema and other similar conditions
The National Eczema Society in the UK provides information and a helpline for eczema patients, families, and caregivers
Medinfo provides information for eczema patients
Wikipedia has more information about water softening (note that Wikipedia is a free online encyclopedia that anyone can edit; available in several languages)
doi:10.1371/journal.pmed.1000395
PMCID: PMC3039684  PMID: 21358807
17.  A review on management of warts in Ayurveda 
Ayu  2011;32(1):100-102.
Human papilloma virus (HPV) is one of the common causes for the warts and most people will experience with this infection at some point in their life. In Ayurveda, warts can be compared with Charmakeela. The diagnosis is based on clinical examination and usually straight forward by visual inspection. The treatment of warts has to be done with endurance and careful selection of procedure according to the type and site of the disease; otherwise, it may lead to cosmetic derangement or recurrence of the ailment. Indications for treatment include pain, interference with function, cosmetic embarrassment, and risk of malignancy. Regarding the management of this disease, different types of treatment procedures are explained in contemporary science. In Ayurveda also, various treatment principles explained like administration of drugs internally, external application of drugs and parasurgical procedures [i.e. Raktamokshana (blood letting), Ksharakarma (chemical cauterization) and Agnikarma (thermal cauterization)]. These indigenous treatment methods are minimal invasive procedures which do not cause the scar formation, no recurrence and found to be more beneficial in the treatment of warts.
doi:10.4103/0974-8520.85739
PMCID: PMC3215404  PMID: 22131766
Charmakeela; kshara jala; kshara sutra; lekhana karma; wart
18.  Developmental Profiles of Eczema, Wheeze, and Rhinitis: Two Population-Based Birth Cohort Studies 
PLoS Medicine  2014;11(10):e1001748.
Using data from two population-based birth cohorts, Danielle Belgrave and colleagues examine the evidence for atopic march in developmental profiles for allergic disorders.
Please see later in the article for the Editors' Summary
Background
The term “atopic march” has been used to imply a natural progression of a cascade of symptoms from eczema to asthma and rhinitis through childhood. We hypothesize that this expression does not adequately describe the natural history of eczema, wheeze, and rhinitis during childhood. We propose that this paradigm arose from cross-sectional analyses of longitudinal studies, and may reflect a population pattern that may not predominate at the individual level.
Methods and Findings
Data from 9,801 children in two population-based birth cohorts were used to determine individual profiles of eczema, wheeze, and rhinitis and whether the manifestations of these symptoms followed an atopic march pattern. Children were assessed at ages 1, 3, 5, 8, and 11 y. We used Bayesian machine learning methods to identify distinct latent classes based on individual profiles of eczema, wheeze, and rhinitis. This approach allowed us to identify groups of children with similar patterns of eczema, wheeze, and rhinitis over time.
Using a latent disease profile model, the data were best described by eight latent classes: no disease (51.3%), atopic march (3.1%), persistent eczema and wheeze (2.7%), persistent eczema with later-onset rhinitis (4.7%), persistent wheeze with later-onset rhinitis (5.7%), transient wheeze (7.7%), eczema only (15.3%), and rhinitis only (9.6%). When latent variable modelling was carried out separately for the two cohorts, similar results were obtained. Highly concordant patterns of sensitisation were associated with different profiles of eczema, rhinitis, and wheeze. The main limitation of this study was the difference in wording of the questions used to ascertain the presence of eczema, wheeze, and rhinitis in the two cohorts.
Conclusions
The developmental profiles of eczema, wheeze, and rhinitis are heterogeneous; only a small proportion of children (∼7% of those with symptoms) follow trajectory profiles resembling the atopic march.
Please see later in the article for the Editors' Summary
Editors' Summary
Background
Our immune system protects us from viruses, bacteria, and other pathogens by recognizing specific molecules on the invader's surface and initiating a sequence of events that culminates in the death of the pathogen. Sometimes, however, our immune system responds to harmless materials (allergens such as pollen) and triggers allergic, or atopic, symptoms. Common atopic symptoms include eczema (transient dry itchy patches on the skin), wheeze (high pitched whistling in the chest, a symptom of asthma), and rhinitis (sneezing or a runny nose in the absence of a cold or influenza). All these symptoms are very common during childhood, but recent epidemiological studies (examinations of the patterns and causes of diseases in a population) have revealed age-related changes in the proportions of children affected by each symptom. So, for example, eczema is more common in infants than in school-age children. These findings have led to the idea of “atopic march,” a natural progression of symptoms within individual children that starts with eczema, then progresses to wheeze and finally rhinitis.
Why Was This Study Done?
The concept of atopic march has led to the initiation of studies that aim to prevent the development of asthma in children who are thought to be at risk of asthma because they have eczema. Moreover, some guidelines recommend that clinicians tell parents that children with eczema may later develop asthma or rhinitis. However, because of the design of the epidemiological studies that support the concept of atopic march, children with eczema who later develop wheeze and rhinitis may actually belong to a distinct subgroup of children, rather than representing the typical progression of atopic diseases. It is important to know whether atopic march adequately describes the natural history of atopic diseases during childhood to avoid the imposition of unnecessary strategies on children with eczema to prevent asthma. Here, the researchers use machine learning techniques to model the developmental profiles of eczema, wheeze, and rhinitis during childhood in two large population-based birth cohorts by taking into account time-related (longitudinal) changes in symptoms within individuals. Machine learning is a data-driven approach that identifies structure within the data (for example, a typical progression of symptoms) using unsupervised learning of latent variables (variables that are not directly measured but are inferred from other observable characteristics).
What Did the Researchers Do and Find?
The researchers used data from two UK birth cohorts—the Avon Longitudinal Study of Parents and Children (ALSPAC) and the Manchester Asthma and Allergy Study (MAAS)—for their study (9,801 children in total). Both studies enrolled children at birth and monitored their subsequent health at regular review clinics. At each review clinic, information about eczema, wheeze, and rhinitis was collected from the parents using validated questionnaires. The researchers then used these data and machine learning methods to identify groups of children with similar patterns of onset of eczema, wheeze, and rhinitis over the first 11 years of life. Using a type of statistical model called a latent disease profile model, the researchers found that the data were best described by eight latent classes—no disease (51.3% of the children), atopic march (3.1%), persistent eczema and wheeze (2.7%), persistent eczema with later-onset rhinitis (4.7%), persistent wheeze with later-onset rhinitis (5.7%), transient wheeze (7.7%), eczema only (15.3%), and rhinitis only (9.6%).
What Do These Findings Mean?
These findings show that, in two large UK birth cohorts, the developmental profiles of eczema, wheeze, and rhinitis were heterogeneous. Most notably, the progression of symptoms fitted the profile of atopic march in fewer than 7% of children with symptoms. The researchers acknowledge that their study has some limitations. For example, small differences in the wording of the questions used to gather information from parents about their children's symptoms in the two cohorts may have slightly affected the findings. However, based on their findings, the researchers propose that, because eczema, wheeze, and rhinitis are common, these symptoms often coexist in individuals, but as independent entities rather than as a linked progression of symptoms. Thus, using eczema as an indicator of subsequent asthma risk and assigning “preventative” measures to children with eczema is flawed. Importantly, clinicians need to understand the heterogeneity of patterns of atopic diseases in children and to communicate this variability to parents when advising them about the development and resolution of atopic symptoms in their children.
Additional Information
Please access these websites via the online version of this summary at http://dx.doi.org/10.1371/journal.pmed.1001748.
The UK National Health Service Choices website provides information about eczema (including personal stories), asthma (including personal stories), and rhinitis
The US National Institute of Allergy and Infectious Diseases provides information about atopic diseases
The UK not-for-profit organization Allergy UK provides information about atopic diseases and a description of the atopic march
MedlinePlus encyclopedia has pages on eczema, wheezing, and rhinitis (in English and Spanish)
MedlinePlus provides links to further resources about allergies, eczema, and asthma (in English and Spanish)
Information about ALSPAC and MAAS is available
Wikipedia has pages on machine learning and latent disease profile models (note that Wikipedia is a free online encyclopedia that anyone can edit; available in several languages)
doi:10.1371/journal.pmed.1001748
PMCID: PMC4204810  PMID: 25335105
19.  Provocative dietary factors in geriatric hypertension: A surveillance study 
Ayu  2012;33(4):530-536.
Hypertension is the most common psychosomatic disorder affecting 972 million people worldwide being more prevalent in old age. The present survey of hypertensive patients fulfilling the standard diagnostic criteria of WHO/ISH (2004) is carried out in geriatric age group from the Saurashtra region of Gujarat in India to observe the dietary pattern and provocative factors. Total 120 patients of 50 to 80 years of age having systolic blood pressure >140 mm Hg and ≤180 mm Hg and diastolic blood pressure >90 mm Hg and ≤110 mm Hg irrespective of gender and religion were selected for the present study. They were interviewed for list of provocative factors enlisted in Ayurveda. As observed, the study supported the facts described in Ayurveda that dietary etiological factors, such as excess intake of Lavana (salty), Amla (sour), Katu (pungent), Tikshna, Ushna (hot), Vidahi (producing burning sensation), Viruddha (incompatible), Snigdha (unctuous), Abhishyandi (leading to obstruction), Madhura (sweet), Guru (heavy to digest) dietary articles, Ajirnashana (taking diet before complete digestion of previous meal), Adhyashana (repeated eating at short intervals), will vitiate Rakta dhatu as well as Pitta dosha in the body leading to disorders like hypertension. Hypertension in old age is found to be a disease of Vata-Pitta dominant vitiation with the involvement of Rasa, Rakta, Meda as main Dushya (vitiated factors) and dietary factors can contribute to worsening of the disease. The etiological factors having role in the pathogenesis can also be applied for preventive guidelines for the management of hypertension.
doi:10.4103/0974-8520.110537
PMCID: PMC3665196  PMID: 23723671
Ayurveda; dietary factors; geriatric age group; hypertension
20.  PA01.02. Effect of Shodhana Karma in early Psoriasis– A case study presentation 
Ancient Science of Life  2013;32(Suppl 2):S43.
Purpose:
To show the effect of holistic Ayurvedic Treatment in a critical disease like psoriasis in early stage.
Method:
A patient of known case of psoriasis (not more than 2 yrs) given systematic Ayurvedic Shodhana Karma every 3 yrs.
Result:
After shodhana Karma, patient got both Subjective & objective relief from Symptoms for a long duration than modern medicines.
Conclusion:
Pure Ayurvedic Traditional treatment can give relief from symptoms of psoriasis for a longer time without any side effect.
doi:10.4103/0257-7941.123858
PMCID: PMC4147514
21.  Importance of Media in Shodhana (Purification / Processing) of Poisonous Herbal Drugs 
Ancient Science of Life  2010;30(2):54-57.
In Ayurveda, a series of pharmaceutical procedures which converts a poisonous drug into a therapeutically very effective medicine for various ailments is termed as Shodhana. Various medias are being used for processing the herbal poisonous drugs, are quite interesting to understand with modern scientific technology. The analysis of media before and after Shodhana (purification /processing) will give clear rationale behind the selection of the particular media for the particular drug. The change that takes place during the Shodhana process can be explored by modern analytical methods. Researchers have proved the presence of strychnine and brucine in milk after Shodhana of Nux-vomica highlighting the role media for Shodhana. Importance of Shodhana, the role of media used for Shodhana process of few poisonous drugs is dealt briefly with scientific view.
PMCID: PMC3336272  PMID: 22557427
Shodhana; Purification; Processing; Poisonous herbs; Media
22.  Efficacy of leech therapy in the management of osteoarthritis (Sandhivata) 
Ayu  2011;32(2):213-217.
Osteoarthritis (degenerative joint disease) is the most common joint disorder. It mostly affects cartilage. The top layer of cartilage breaks down and wears away. Osteoarthritis is of two types, primary (idiopathic) and secondary. In idiopathic osteoarthritis, the most common form of the disease, no predisposing factor is apparent. Secondary OA is pathologically indistinguishable from idiopathic OA but is attributable to an underlying cause. In Ayurveda the disease Sandhivata resembles with osteoarthritis which is described under Vatavyadhi. The NSAIDs are the main drugs of choice in modern medicine which have lots of side effects and therefore are not safe for long-term therapy. Raktamokshan, i.e., blood letting is one of the ancient and important parasurgical procedures described in Ayurveda for treatment of various diseases. Of them, Jalaukavacharana or leech therapy has gained greater attention globally, because of its medicinal values. The saliva of leech contains numerous biologically active substances, which have antiinflammatory as well as anesthetic properties. Keeping this view in mind we have started leech therapy in the patients of osteoarthritis and found encouraging results.
doi:10.4103/0974-8520.92589
PMCID: PMC3296343  PMID: 22408305
Jalaukavacharana; leech therapy; osteoarthritis; sandhivata
23.  OA01.06. A successful clinical case study of Asthenozoospermia + Oligozoospermia 
Ancient Science of Life  2013;32(Suppl 2):S6.
Purpose:
To enlighten hidden treasure of Ayurvedic treatment principles in present scenario diseases.
Method:
A male patient of 26 yrs age, came for treatment of Male infertility since three years. Obese, wt.100 kg, Kapha Pitta Prakruti, normal secondary sex characters, No any past history of major medical illness, No any habits, occupation – textile factory manager. Semen exam revealed Oligospermia (low sperm count) and Asthenozoospermia (Zero sperm motility). Thorough clinical examination and literature review discovered this condition as Shukragat Vaat Kshaya. He received sequential medications as Shukragat Vaat Chikitsa, Shukra Stroto Shodhana Chikitsa, Upadansha Chikitsa, Vajikaran Chikitsa, Kaphaj Paandu Chikitsa, Sthoulya Chikitsa.
Result:
Total duration of treatment was 16 months. Initial sperm count was 6 mill/ml, 100 % Non motile sperms. After treatment count was 58 mill/ ml, 85 % motile sperms. Being sperm count increased and motility was excellent forward progressive, ‘Garbhadhan’ occurred 4 months back.
Conclusion:
Ayurvedic Siddhantas are key to Clinical success. Mere Shukra Vardhan Chikitsa is not crucial regarding treatment of Asthenozoospermia, rather one has to think about other factors like Paandu, Upadansh, Shukragat Vaat Chikitsa, Avaran Chikitsa, Sthoulya Chikitsa.
doi:10.4103/0257-7941.123818
PMCID: PMC4147532
24.  Immunophenotyping of normal individuals classified on the basis of human dosha prakriti 
Background:
Human variations related to immune response and disease susceptibility is well-documented in Ayurveda. Prakriti (body constitution) is the basic constitution of an individual established at the time of birth and distinguishes variations, into three broad phenotype categories such as vata, pitta and kapha. Variation in immune response is often attributed to and measured from the difference in cluster differentiation (CD) markers expressed in lymphocytes. Currently, there are no reports available on the expression of CD markers related to prakriti.
Objective:
This is a pilot study performed to evaluate a panel of lymphocyte subset CD markers in dominant prakriti individuals.
Materials and Methods:
Immunophenotyping was carried out using whole blood from a total of healthy 222 subjects, who are grouped into kapha (n = 95), pitta (n = 57) and vata (n = 70) prakritis. CD markers such as CD3, CD4, CD8, CD14, CD25, CD56, CD69, CD71 and HLA-DR were analyzed using flow cytometry method. Differences between groups were analyzed using one-way ANOVA or Kruskal-Wallis analysis of variance (ANOVA) and multiple comparisons between groups were performed by Bonferroni or Mann-Whitney U test with corrections for type I error respectively. Significance was evaluated by ANOVA and Pearson's correlation.
Results:
We observed a significant difference (P < 0.05) in the expression of CD markers such as CD14 (monocytes), CD25 (activated B cells) and CD56 (Natural killer cells) between different prakriti groups. CD25 and CD56 expression was significantly higher in kapha prakriti samples than other prakriti groups. Similarly, slightly higher levels of CD14 were observed in pitta prakriti samples.
Conclusion:
Significant difference in the expression of CD14, CD25 and CD56 markers between three different prakriti is demonstrated. The increased level of CD25 and CD56 in kapha prakriti may indicate ability to elicit better immune response, which is in conformity with textual references in Ayurveda.
doi:10.4103/0975-9476.128857
PMCID: PMC4012362  PMID: 24812475
Cluster differentiation 14; cluster differentiation 25; cluster differentiation 56; immunophenotyping; prakriti
25.  A comparative study on Vamana Karma with Madanaphala and Krutavedhana in Ekakushtha (Psoriasis) 
Ayu  2011;32(4):487-493.
Vamana Karma (therapeutic emesis) is the best therapy for the elimination of vitiated Kapha Dosha. In the present clinical practice Madanaphala (Randia dumetorum) is mainly used for Vamana Karma. Apart from Madanaphala, five other drugs, and in total 355 formulations are described in Charaka Samhita; one of them is Krutavedhana (Luffa acutangula) kalpa (formulations). Krutavedhana is specially indicated in Gadha (compact) Dosha condition like Kushtha (skin diseases), Garavisha (slow poison), and so on, for Vamana Karma. The present study aimed to observe the effect on Vamana Karma and by that its effect on Ekakushtha (Psoriasis). Krutavedhana Beeja Churna (seed powder) was given with Madhu (honey) and Saindhava (rock salt) as Vamana Yoga (emetic formulation), to compare it with Madanaphala Pippali Churna (seed powder). After the Sansarjana Krama (special dietetic schedule), Panchatikta Ghrita (medicated ghee) was given as Shamana Sneha (pacifying oleation). An average dose of Krutavedhana was 5.9 g. Krutavedhana could produce a good number of Vega (bouts), Pittanta Lakshana (bile coming out at the end of Vamana), and Pravara Shuddhi (maximum cleansing) in a majority of patients. Madanaphala is the best among all Vamaka (emetic) drugs, but Krutavedhana showed a similar to higher effect on Vamana Karma in terms of Antiki, Maniki, Vaigiki, and Laingiki Shuddhi (cleansing criteria). Vamana Karma by Krutavedhana showed better relief in Matsyashakalopamam (silvery scale), Kandu (itching), and Rukshataa (dryness), while Madanapahala showed better relief in Krishnaruna Varna (erythema). After completion of the Shamana (pacifying) treatment, both the groups showed nearly the same effect on Asvedanam (lack of perspiration), Matsyashakalopamam, Kandu, Rukshataa, Krishnaruna Varna, and Mahaavaastu (bigger lesion).
doi:10.4103/0974-8520.96121
PMCID: PMC3361923  PMID: 22661842
Ekakushtha; Krutavedhana; Madanaphala; Panchatikta Ghrita; Psoriasis; Vamana Karma

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