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.
Eczema; Koshtha Shuddhi; Rasayana; Vicharchika; Virechana Karma
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.
Agni karma; Gridhrasi; Panchadhatu Shalaka; Parshni Pratyanguli; Sciatica
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.
Pradhana Karma; Shodhana Karma; standardization; Vamana Karma; Vamana Vidhi
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).
Vicharchika; Rasayana; Koshtha Shuddhi; Shirishadi Decoction; Snuhyadi Lepa; Guduchi- Bhringaraja Rasayana; Eczema; Recurrence
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.
Eczema; vicharchika; virechana
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.
Basti Karma; essential hypertension; Raktapradoshaja Vikara; Virechana Karma
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.
Charmakeela; kshara jala; kshara sutra; lekhana karma; wart
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.
Shodhana; Purification; Processing; Poisonous herbs; Media
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.
Jalaukavacharana; leech therapy; osteoarthritis; sandhivata
Diabetes mellitus is a common chronic metabolic disorder prevalent all over the world. Virechana is the Shodhana procedure that is specific for the elimination of vitiated Pitta and Kapha doshas. Thus, in the present study, the Virechana process has been selected prior to the administration of Shamana drug. Nyagrodhadi churna is mentioned in Chakradatta, which is modified into Ghana form for easy administration and dose maintenance. The present study was conducted in two groups: Group A, Nyogrodhadi Ghana vati (Shamana therapy) and Group B, Virechana and Nyogrodhadi Ghana vati (combined therapy). A total of 42 patients were registered for the present study, in which 34 patients completed the and eight patients were dropouts. After evaluating the total effect of the therapies, it was observed that the Virechana and Nyagrodhadi Ghanavati (combined therapy) provided better relief in the patients of Madhumeha in comparison with Nyagrodhadi Ghanavati (Shamana therapy) alone.
Madhumeha; Prameha; Diabetes mellitus; Shodhana; Virechana; Shamana
Diabetes mellitus (DM) with its devastating consequences is a global health problem of this era. Presently India is having the largest diabetic population of 50.8 million. The characteristic features of DM have close resemblance with Prameha (obstinate urinary disorders including diabetes) in Ayurveda. Madhumeha is a Vatika subtype of Prameha that is most close to DM. One variety of this Madhumeha (DM) is Aavaranjanya (due to occlusion) in which Vayu aggravates due to occlusion by Pitta or Kapha. This type of Madhumeha (DM) can be managed if Samshodhana (bio-cleansing) is used in early stages of disease followed by palliative treatment. Vamana (emetic therapy) and Virechana (purgation therapy) are the Samsodhana Karma (bio-cleansing therapies) that are compatible to overcome this Aavarana (occlusion). A comparative study was planned to compare their efficacy in controlling blood sugar levels in patients with DM. Although none of them were completely able to control blood sugar in the long-term but the study yields some very interesting results in reducing the blood sugar levels which could be useful in the future studies related to DM.
Blood sugar control; Prameha; Vamana; Virechana
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.
Antiki; Dosha; Kapha; Laingiki; Madanaphala; Maniki; Pitta; Samsarjana Krama; Snehapana; Vasantika Vamana; Vegiki
Prakriti, for its tangible impacts upon decision making in Ayurvedic clinical practice, requires a thorough and fool-proof method of examination. Conventional methods adopted for Prakriti examination are found inconsistent with huge inter- and intra-rater inference variability. By observing the gaps in the field, the present study aims to develop a prototype Prakriti analysis tool and its evaluation on inter-rater validity grounds. The study observes that Vata and Pitta constructs of Prakriti identification in Ayurveda have a significant inter-rater correlation (P ` 0.001 and P ` 0.01), whereas Kapha has less (P ` 0.02) correlation. It is inferred that for less correlated variables like those of Kapha, a better understanding is required to reach a better consensus.
Prakriti; tool; validation
Cosmetology is the branch, which deals with the Beauty treatment, and Skin care is a part of it. Due to the social cosmetic awareness in the society, there is increase in the demand and utilization of the cosmetic products. Most of these products contain chemicals such as dibutyl phthalate, formaldehyde, lye (sodium hydroxide), ammonia, and coal tar which are known to cause hazardous side effects to the skin like Allergies, photosensitivity and also Malignancies. This is a matter of concern in the society and alternatives have to be thought off in the form of safe and effective cosmetic agents.
Amongst the Fifty Dashemanis told in Charak samhita, Varnya Dashemani is one. Chakrapani in his commentary says Varnaaya hitam Varnyam, meaning that the one which enhances the colour complexion of the body is varnya. According to Ayurveda the health of the skin is dependent on Rakta dhatu, Ojas, and Pitta dosha. Any derangement in these factors leads to a cosmetic ill health. References regarding the drugs of ‘varnya dashemani’ are been found in many of the Nighantus where the authors have clearly mentioned about the detail pharmacology and pharmacothereupetics. Taking these factors into consideration critical analysis of these drugs has been done.
After screening the pharmacology of the drugs told in this dashemani we find all these drugs are rakta prasadakara, Ojo vardhak and pitta shamak. Also recent researches have proven them to be possessing Anti Glycation, Anti oxidant, Anti microbial properties which are essential in cosmetic health and skin care.
Hence this study has been intended to critically analyse the drugs of ‘Varnya dasheman’, with an aim to provide an alternative to the harmful synthetic cosmetic products.
AIMS—To determine the prevalence of
gastrointestinal symptoms in children with eczema and the association
of such symptoms with the extent of eczema or skin prick test results.
METHODS—Sixty five children with atopic eczema
and a control group matched for age and sex were recruited. Their
parents completed a questionnaire about the children's
gastrointestinal symptoms. The children's skin was examined; their
weight, height, and abdominal circumference were measured; and skin
prick tests were carried out.
RESULTS—Gastrointestinal symptoms, especially
diarrhoea, vomiting, and regurgitation, were more common in the
children with eczema. Diarrhoea appeared to be associated with the
ingestion of specific foods. Gastrointestinal symptoms were related to
diffuse eczema and positive skin prick tests to foods. There was no
anthropometric differences between the patient and control groups.
CONCLUSIONS—A gastrointestinal disorder is common
in children with eczema, especially with diffuse distribution. This may
be responsible for substantial symptoms and may play a part in the
pathogenesis of the disease and in the failure to thrive with which it
is sometimes associated.
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).
Ekakushtha; Krutavedhana; Madanaphala; Panchatikta Ghrita; Psoriasis; Vamana Karma
In the context of Bhagna (fractures), Chikitsa sthana of Sushruta Samhita, a classical treatise of Ayurveda the entire protocol for management of different kinds of injuries is elaborated. Manjisthadi Lepa according to the mode of application either Ushna or Sita can facilitate the healing of soft tissue injury like Deep vein thrombosis, Cellutitis, Synovitis and Thrombophlebitis. It is proposed that symptomatic relief can be achieved with Sheeta Lepa in Acute conditions of Abhighata (injury)were Rakta and Pitta are mainly vitiated and UshnaLepa in Chronic conditions were Vata Kapha are vitiated.
Manjisthadi Lepa; Ushna Lepa; Sheeta Lepa; Deep vein thrombosis; Cellutitis; Synovitis; Thrombophlebitis
Vamana Karma is one of the five Pradhana Karmas of Panchakarma which is successfully used in treating Kaphaj disorders. Panchakarma is also indicated in healthy states. (C.Su. 16/13-16) for Shodhana. Textual references are available in Ayurvedic classics, but the procedure needs to be validated in the modern times when Ahara Shakti, Bala and Agni of the individuals have decreased considerably. So the effect of procedure was observed in 30 healthy volunteers of age group 18 to 60 years. Lakshanik, Vaigiki, Maniki and Antiki Shuddhi were observed and vomitus was analyzed macroscopically, microscopically and chemically.
Agni; Ahara Shakti; Bala; Kaphaj disorders; Panchakarma; Shodhana; Vamana Karma
‘Agni karma’, also known as ‘dahan karma’, is a process used in Ayurveda for various benign diseases that are characterised by pain or bleeding. In this process, the heated rods of gold, silver, iron, copper and pancha dhatu (five metals) are applied directly on the skin at the affected site. The temperature varies according to the process used and is lowest for gold and highest for silver. The ‘agni karma’ is not recommended for arbuda (tumour/malignancy). Here the authors present two cases of soft tissue sarcoma of lower extremity where ‘agni karma’ was tried in vain by traditional healers at their local village. Both the patients presented with progressive disease that was treated with wide excision and limb conservation, and the whole of the overlying skin scarred by previous healed burns of various degrees had to be sacrificed making a simple surgery difficult.
Kapha is dominant and vitiated in Vasant ritu as it is described in Ayurveda. Acharya Chakrapani has said in chapter six, that not only Vaman, but all the five biopurification methods of the Panchakarma should be practiced in Vasant ritu. Out of the two best seasons in a year for purification, Vasant is better one. This pilot research study was carried out to see the effect of this biopurification process on different disorders. The results were marvelous, as symptomatically 58% relief was achieved.
Vasant Ritu; Panchakarma; Biopurification
Hand eczema is the most frequently recognized occupational disease in Denmark with an incidence of approximately 0.32 per 1000 person-years. Consequences of hand eczema include chronic severe eczema, prolonged sick leave, unemployment, and impaired quality of life. New preventive strategies are needed to reduce occupational hand eczema.
We describe the design of a randomised clinical trial to investigate the effects of classification of hand eczema plus individual counselling versus no intervention. The trial includes health-care workers with hand eczema identified from a self-administered questionnaire delivered to 3181 health-care workers in three Danish hospitals. The questionnaire identifies the prevalence of hand eczema, knowledge of skin-protection, and exposures that can lead to hand eczema. At entry, all participants are assessed regarding: disease severity (Hand Eczema Severity Index); self-evaluated disease severity; number of eruptions; quality of life; skin protective behaviour, and knowledge of skin protection. The patients are centrally randomised to intervention versus no intervention 1:1 stratified for hospital, profession, and severity score. The experimental group undergoes patch and prick testing; classification of the hand eczema; demonstration of hand washing and appliance of emollients; individual counselling, and a skin-care programme. The control group receives no intervention. All participants are reassessed after six months. The primary outcome is observer-blinded assessment of disease severity and the secondary outcomes are unblinded assessments of disease severity; number of eruptions; knowledge of skin protection; skin-protective behaviour, and quality of life.
The trial is registered in ClinicalTrials.Gov, NCT01012453.
Atopic dermatitis is the most common inflammatory skin disorder in the general population worldwide and the majority of patients are colonized with Staphylococcus aureus. Eczema herpeticum is a disseminated herpes simplex virus infection that occurs in a small subset of patients.
The goal was to conduct proteomic profiling of atopic dermatitis patients based on Staphylococcus aureus colonization status and history of eczema herpeticum. We hoped to identify new biomarkers for improved diagnosis and prediction of eczema herpeticum and Staphylococcus aureus susceptibility, and to generate new hypotheses regarding disease pathogenesis.
Skin taping was performed on nonlesional skin of non-atopic controls and on lesional and nonlesional skin of atopic dermatitis patients. Subjects were classified according to history of eczema herpeticum and Staphylococcus aureus colonization. Proteins were analyzed using mass spectrometry; diagnostic groups were compared for statistically significant differences in protein expression.
Proteins related to the skin barrier (filaggrin-2, corneodesmosin, desmoglein-1, desmocollin-1, and transglutaminase-3) and generation of natural moisturizing factor (arginase-1, caspase-14, gamma-glutamyl cyclotransferase) were expressed at significantly lower levels in lesional versus nonlesional sites of atopic dermatitis patients with and without history of eczema herpeticum; epidermal fatty acid binding protein was expressed at significantly higher levels in patients with methicillin resistant Staphylococcus aureus.
This non-invasive, semi-quantitative profiling method has revealed novel proteins likely involved in the pathogenesis of atopic dermatitis. The lower expression of skin barrier proteins and enzymes involved in the generation of the natural moisturizing factor could further exacerbate barrier defects and perpetuate water loss from the skin. The greater expression of epidermal fatty acid binding protein, especially in patients colonized with methicillin-resistant Staphylococcus aureus, may perpetuate the inflammatory response via eicosanoid signaling.
Atopic dermatitis; mass spectrometry; proteomics; natural moisturizing factor; eczema herpeticum; tape stripping; skin barrier; filaggrin-2; epidermal fatty acid binding protein; methicillin-resistant Staphylococcus aureus
Johnson, M. L., and Wilson, H. T. H. (1971).Brit. J. industr. Med.,28, 122-125. Oil dermatitis: an enquiry into its prognosis. One hundred industrial workers who developed skin disease while working with soluble or cutting oils were seen. Between 6 and 13 years later 87 of these cases were contacted and their subsequent histories obtained. Of these, 42 had oil dermatitis, 10 had oil dermatitis and constitutional eczema, and 17 had constitutional eczema alone. The remainder were suffering from dermatitis other than oil or from folliculitis or could not be classified.
The groups with oil dermatitis and oil dermatitis and associated constitutional eczema had a similar outcome; 60% were clear, 23% better, and 17% unchanged, whereas of the group with constitutional eczema only 35% had cleared with 41% better and 24% unchanged. Of the cases with oil dermatitis 82% had changed their job. Those with mild oil dermatitis who had not lost work had the best prognosis. Of other factors that might influence prognosis there was no direct correlation with the length of time off work, the age of onset or the payment of compensation. However, if the worker continued to be exposed to oil for more than one year after the onset of the dermatitis the chances of subsequent clearing were less than if the exposure was shorter.
A 66-year-old male patient came to the anorectal clinic, Outpatient department, AVT Institute for Advanced Research, Coimbatore, Tamil Nadu, with complaints of prolapsing pile mass during defecation and bleeding while passing stool. The case was diagnosed as “Raktarsha” - 11 & 7 ‘o’ clock position II degree internal hemorrhoids, deeply situated, projecting one and caused by pitta and rakta; with bleeding tendency. Kshara karma (application of caustic alkaline paste) intervention was done in this case to internal hemorrhoids under local anesthesia. The pile mass and per rectal bleeding resolved in 8 days and the patient was relieved from all symptoms within 21 days. No complications were reported after the procedure. The patient was followed up regularly from 2004 onward till date and proctoscopic examination did not reveal any evidence of recurrence of the hemorrhoids.
Arshas; case report; Kshara karma; internal hemorrhoids; piles
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.
Normal individuals of the three most contrasting constitutional types were identified following phenotyping criteria described in Ayurveda in Indian population of Indo-European origin. The peripheral blood samples of these individuals were analysed for genome wide expression levels, biochemical and hematological parameters. Gene Ontology (GO) and pathway based analysis was carried out on differentially expressed genes to explore if there were significant enrichments of functional categories among Prakriti types.
Individuals from the three most contrasting constitutional types exhibit striking differences with respect to biochemical and hematological parameters and at genome wide expression levels. Biochemical profiles like liver function tests, lipid profiles, and hematological parameters like haemoglobin exhibited differences between Prakriti types. Functional categories of genes showing differential expression among Prakriti types were significantly enriched in core biological processes like transport, regulation of cyclin dependent protein kinase activity, immune response and regulation of blood coagulation. A significant enrichment of housekeeping, disease related and hub genes were observed in these extreme constitution types.
Ayurveda based method of phenotypic classification of extreme constitutional types allows us to uncover genes that may contribute to system level differences in normal individuals which could lead to differential disease predisposition. This is a first attempt towards unraveling the clinical phenotyping principle of a traditional system of medicine in terms of modern biology. An integration of Ayurveda with genomics holds potential and promise for future predictive medicine.