Immunological & metabolic responses to a therapeutic course of Basti in obesity

Selective Adjuvant Ayurvedic Treatment Modulates Immune Response and Oxidative Stress in a Patient with Carcinoma of the Pyriform Fossa, Undergoing Radiotherapy: A Case Study

INTRODUCTION

Hypopharyngeal squamous cell carcinoma, stage III has poor prognosis with only 25% chance of 5 years of relative survival in such patients in spite of conventional treatment including radical surgery, radiotherapy, and concurrent chemotherapy.

CASE PRESENTATION

A chronic tobacco-betel nut chewer 62-year-old male patient had dysphagia with hoarseness of voice diagnosed with stage III, grade II malignant pyriform fossa. The patient underwent 9 cycles of neoadjuvant chemotherapy with Inj Paclitaxel 100 mg and Inj Cisplatin 40 mg. He was then referred to our institute for Radical Radiotherapy with concurrent chemotherapy with adjunct Ayurvedic treatment. A total dose of 70 Gy of radiation with cobalt 60 source was administered to the bilateral face and neck, in 35 fractions. Patient also received 6 cycles of concurrent weekly chemotherapy with Inj Cisplatin 40 mg. He received well-planned adjunct Ayurvedic treatment in the form of oral Ayurvedic medicines (OAM) and detoxifying treatment, Panchakarma. All the measured adverse effects of radiotherapy such as Stomatitis, Xerostomia, Taste Alteration, Dysphagia, and Nausea were observed to be remarkably low during and post radiotherapy in this patient. Karnofsky and Quality of Life (QoL) scores revealed patient's well-being throughout the treatment course. After 5 years, PET CT scan revealed no FDG avid locoregional recurrence or distant organ involvement implying disease-free survival (DFS). Various chemokines, cytokines, and oxidative stress markers were assessed during the course of treatment to observe tumour microenvironment.

CONCLUSION

The present case of Head & Neck Cancer (HNC), stage III, and grade II belonged to high-grade, high-risk hypopharyngeal cancer with poor prognosis. The patient opted for Ayurvedic treatment besides radiotherapy, which continued thereafter for 5 years. We therefore emphasize that in this case, minimum side effects of radiotherapy, immunomodulation, and reduction in inflammation and oxidative stress along with good quality of life can be attributed to OAM and repeated detoxifying Panchakarma treatment supported with healthy diet and good lifestyle. The highlight of the study is the marked effect on the patient's immune response and reduction in oxidative stress, leading to 5 years and beyond of DFS.

Evaluation of Comparative Efficacy of Levothyroxine Versus Kshar Basti and Kanchanar Guggul in the Treatment of Hypothyroidism: Protocol for a Randomized Controlled Trial

BACKGROUND

The thyroid gland is an endocrine gland that has an impact on the body's general metabolism. Thus, the secretions of the thyroid gland can modify the overall metabolism of the entire body. The prevalence of hypothyroidism is increasing quickly, with rates of 2%-5% in affluent countries and 11% in India. Individuals diagnosed with hypothyroidism need to take medication for the rest of their lives, resulting in significant stress. Therefore, conducting a study in this area is imperative.

OBJECTIVE

This study aims to assess the effectiveness of the therapeutic enema (Kshar Basti) and oral Kanchanar Guggul in the treatment of hypothyroidism.

METHODS

The trial group (n=45) will receive a therapeutic enema (Kshar Basti) followed by oral Ayurvedic drugs for 180 days. The control group (n=45) will be given levothyroxine tablets at a dosage of 1.6 µg/kg/day for the same duration. The objective is to examine the alterations in thyroid stimulating hormone (TSH) levels before and after the treatment.

RESULTS

Any deviation of the serum TSH by more than 20% from the initial values, while keeping triiodothyronine (T3), and thyroxine (T4) levels within the normal range, will be deemed statistically significant. Consequently, we anticipate a statistically significant variation in serum TSH levels between the therapeutic enema and Kanchanar Guggul treatments. Presently, the drug preparation operations are in progress. We expect to start enrolling patients in June 2024, do data analysis in December 2025, and acquire results by early 2026, marking the end of this trial.

CONCLUSIONS

This study will evaluate the efficacy of the therapeutic enema, specifically Kshar Basti, in treating hypothyroidism. Furthermore, more research can determine the efficacy of a therapeutic enema (Kshar Basti) in treating overt hypothyroidism and hypothyroidism during pregnancy.

TRIAL REGISTRATION

Clinical Trials Registry India CTRI/2023/05/052389; https://ctri.nic.in/Clinicaltrials/pmaindet2.php?EncHid=Nzk1NjY=&Enc=&userName=052389.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

PRR1-10.2196/57287.

Successful Management of Severe Low Back Pain with Ayurveda in Lumbar Spondylosis: A Case Report

Lumbar spondylosis is a common condition that is quite prevalent, affecting 57% of Indian men. Ayurveda, an indigenous medical system, is highly efficient in treating this ailment when it is in a mild to moderate state. This case report aims to provide a detailed account of a successfully managed case of lumbar spondylosis characterized by severe lumbar pain. A 59-year-old man, who has been suffering from lumbar spondylosis for the last 8 years, was presented with complaints of severe to moderate low back pain, disability, and pain in both legs. According to Ayurvedic principles, the condition was diagnosed as "Katigraha," and a nine-day treatment plan, including three Niruha Basti consecutively, followed by one Anuvasan Basti with the use of Ayurvedic medications was suggested. The lumbar pain severity fell from 8 to 2 points, while the leg pain decreased from 7 to 1 point. The Oswestry Low Back Disability Index (ODI) showed a significant reduction, from 49 to 18. The flexion and extension range of motion grew from 1 to 3 cm, and from 1 to 2 cm, respectively. The case study indicates a reduction in severe low back pain, but further investigation is required to determine the underlying mechanisms.

Acute exacerbation of bronchial asthma with infective focus treated with holistic Ayurveda approach: A case report

While there are numerous published clinical trials investigating the efficacy of Ayurveda in managing bronchial asthma, a paucity of published case reports, case series, or randomized controlled trials (RCTs) concerning Basti (medicated enema) therapy in conjunction with Dhumapana (fumigation therapy) exists on PubMed.This scarcity of data hinders the comprehensive evaluation of this specific Ayurvedic approach for asthma management. A 69-year-old female patient with a known case of bronchial asthma and hypertension presented with complaints of breathlessness on and off for 3 years, cough, urgency of micturition, constipation for 7 days, and fever for 3 days. The patient was treated according to the treatment principles of Tamakshwas (bronchial asthma) and Jwara (fever). Basti, Dhumapana, and oral Ayurvedic formulations were administered. Significant improvements in symptoms, the mMRC dyspnea scale, and the pulmonary function test were observed. This case provides new insight into clinical diagnosis and management through gut modulation in respiratory diseases and vice versa.

The clinical evaluation of Basti along with Rasayana on symptoms of post-COVID-19 syndrome: an open-labeled proof of concept pragmatic study-a study protocol

BACKGROUND

Post-COVID-19 syndrome is a result of triggering various immune pathways and metabolic disturbances. Basti is an important per rectal Ayurveda-based treatment having multi-targeted actions. Basti and Rasayana treatment modulate immune responses by regulating pro-inflammatory cytokines, immune globulins, and functional properties of T cell. We propose to study the clinical evaluation of Basti along with Rasayana (rejuvenation therapy) on symptoms of post-COVID 19 syndrome.

METHODS AND ANALYSIS

We designed a prospective, open-labeled proof of concept pragmatic study. The study duration is 18 months, and the intervention period are 35 days from the day of enrollment of the patients. The patients will be treated on the basis of Ayurvedic classification of Santarpanottha (over nutrition) symptoms and Apatarpanottha (lack of nutrition) symptoms. The Santarpanottha group will be treated within 3-5 days of oral Guggulu Tiktak Kashayam followed by 8 days of Yog Basti treatment and then 21 days of Rasayana therapy with Brahma Rasayan. The Apatarpanottha group will be treated within 3-5 days of oral Laghumalini Vasant, followed by 8 days of Yog Basti treatment and then 21 days of Kalyanak Ghrit. The outcome measures of this study will be to evaluate the changes in fatigue severity scale, MMRC dyspnea chest pain scale, pain score assessed by VAS scale, smell and taste scale, WOMAC scale, Hamilton depression scale, Hamilton anxiety scale, Insomnia Severity Index, change in Cough Severity Index, facial aging scale, dizziness scale, Pittsburgh Sleep Severity Quality Index, functional status scale, and heart palpitation scale. All adverse events will be monitored at each time throughout the study visit time. A total of 24 participants will be recruited to demonstrate with 95% confidence interval and 80% power.

DISCUSSION

Ayurveda treats Santarpanottha (originated from over nutrition) symptoms and Apatarpanottha (symptoms originated from undernutrition) symptoms differently; hence, inspite of the same disease or symptom management, changes depend upon the type of the origin. This pragmatic clinical study is developed on the fundamental grounds of Ayurveda.

ETHICS AND DISSEMINATION

Ethics approval was obtained through the Institutional Ethics Committees of Government Ayurved College and Hospital on 23 July 2021.

TRIAL REGISTRATION

The trial is prospectively registered with the Clinical Trial Registry of India on 17 August 2021 [CTRI/2021/08/035732] after the Institutional Ethics Committee approval [GACN/PGS/Synopsis/800/2021 Date 23/7/2021].

Ayurveda management of large endometrioma - A case report

Endometriosis is an unusual feature of retrograde menstruation that affects nearly every woman of reproductive age. Endometrioma, a severe form of endometriosis, is a common cause of infertility. Surgery is the recommended treatment for large endometrioma, which most women prefer to avoid. A 23-year-old unmarried patient had right side rapidly enlarging endometrioma measuring 6.9 × 5 cm with acute intermittent abdominal pain diagnosed as udavarta yonivyapada. Yoga basti (eight medicated enemas) and Kuberaksha vati were the primary treatments. Yoga basti is the treatment of choice for pain, inflammation and all the pelvic diseases related to fertility caused by vata aggravation. Alleviation of pain avoided the surgery. After discontinuation of medicines, the endometrioma size increased to 10.3 × 5.5 cm The second Yoga basti was administered before wedding. The patient conceived within four months after the marriage and had a full-term normal delivery with no acute pain episodes. The endometrioma size was reduced by 2 cm within one year and further reduced to 7.6 × 5.2 cm in the first trimester. Ayurvedic conservative treatment for endometriosis can manage pain and may also prevent retrograde menstruation. It can be a minimally invasive alternative prior to surgical removal, that has long-term beneficiary effects. As a seasonal regimen, yoga basti can also help fertile women with primary and secondary dysmenorrhea enhance the quality of life.

Ayurveda treatment can be helpful in management of snoring, obesity and type 2 Diabetes Mellitus: A case report

Sleep is responsible for proper metabolic balance. Disturbances in sleep causes insulin resistance, beta cell dysfunction and obesity through various pathways. Snoring is one of the important indicative symptoms of sleep apnoea that leads to disturbances in sleep. A 54-years old male patient was presented to Kayachikitsa casualty Government Ayurveda College Nagpur with complaints of snoring, difficulty in breathing while climbing stairs since 10 years. After evaluation he was diagnosed as obese with type 2 Diabetes mellitus (DM). Sleep study revealed presence of sleep apnoea. We treated this patient following the principle of VyadhiHetuSankar (∼one cause for many diseases). In such a case treatment of Hetu (∼cause of disease) can be principle of treatment. Snoring was subsided in patient after one -month of treatment. Significant reduction in HbA1c, fasting and post prandial blood glucose level were observed along with reduction in Lipid levels and BMI in three months. Ayurveda concepts can bring major breakthrough in treatment of metabolic disorders. Various Ayurvedic concepts of gut, lung endocrinal pathways and Agni (∼metabolic power) can generate future studies in this direction.

Rectal administration of buttermilk processed with medicinal plants alters gut microbiome in obese individuals

OBJECTIVE

To evaluate the effect of rectal administration of buttermilk processed with medicinal plants on gut microbial composition and thereby on weight in obese individuals.

METHODS

With ethics committee approval, 16 obese individuals in the age group 20-50 years (BMI ≥30 kg/m2) were recruited who received a course of 15-enemas over 15-days. Of these, 1st, 8th and 15th enemas were of sesame-oil administered after food, while other enemas were of buttermilk processed with medicinal plants administered before food. Outcome variables viz. anthropometry, body composition, blood glucose, insulin and lipid profile were evaluated on day 0, 16 and 45. Also, microbial composition of buttermilk preparation and faecal samples of patients collected on day 0, 16 and 45 were studied with the help of 16S rRNA gene sequencing.

RESULTS

The circumferential measures and skinfold-thickness showed a decrease on day 16, which remained lower as compared to baseline till day 45. A gradual decrease in blood-glucose was seen, which was statistically significant on day 45, while insulin levels increased on day 16 and fell to baseline on day 45. There was an overall increase in bacterial diversity on day 16 that settled back to its original composition by day 45.

CONCLUSION

Our findings suggest that buttermilk administration per rectum is effective for a specific period and may have to be repeated for sustained benefits.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s40200-021-00879-z.