The concept of bioavailability enhancer is new to the modern system of medicine. Basically, this concept originated in Ayurveda and being used in this system of medicine since centuries. Bio-enhancers augment the bioavailability or biological activity of drugs when co-administered with principal drug at low doses. Ayurveda is using several drugs such as Piper longum Linn., Zingiber officinale Rosc., and Glycyrhhiza glabra Linn. as bio-enhancers and different methods for bio-enhancing since centuries. The bio-enhancement leads to reduction in therapeutic dose of principal drug, thus reducing the possibilities of toxicity and side effects of drug, potentiating the efficacy, reducing the resistance, decreasing the requirement of raw material for drug manufacture, and ultimately benefitting to the world economy by reducing the treatment cost. This review article attempts to consolidate different drugs as well as methods being used traditionally for enhancing bioavailability in Ayurvedic system of medicine and to discuss their possible mechanism of action. Authentic subject material has been reviewed from different Ayurvedic texts and from different related research and review articles. Thus, it is a humble effort to explore the different aspects of bio-enhancers including therapeutic techniques such as Shodhana, the drugs such as Pippali, and properties such as Yogavahi and Rasayana, which have been described in Ayurveda along with their mechanism of action and uses wherever available.

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Background: Cissampelos pareira Linn. is considered as an established source of Patha, whereas Cyclea peltata (Lam.) Hook. F. & Thomas is used as a source plant of Patha in the southern part of India. In classical texts, two different varieties of Patha, i.e. Rajpatha (C. peltata) and Laghupatha (C. pareira), are mentioned which possess almost similar properties. Objective: To compare antipyretic and analgesic activities of C. pareira and C. peltata in suitable experimental model. Materials and Methods: Powder (540 mg/kg) and ethanolic extract (200 mg/kg) of both the test drugs (C. pareira and C. peltata) were evaluated for antipyretic activity in Brewer's yeast-induced pyrexia model in rats. Analgesic activity was evaluated by radiant heat model in rats and acetic acid-induced writhing syndrome in mice. Results and Discussion: Result of the present study had shown that powder of C. pareira (540 mg/kg) has moderate antipyretic activity as compared to the powder of C. peltata and extract of both test drugs. C. pareira powder showed better analgesic effect than ethanolic extract (200 mg/kg) of both the test drugs in radiant heat model in rats, while in acetic acid-induced writhing syndrome, ethanolic extract (280 mg/kg) of both drugs showed pronounced effect as compared to powder form (780 mg/kg) in mice. Conclusion: Both C. pareira and C. peltata exhibited analgesic effects in experimental animals. The effect is more significant in C. peltata treated group compared to C.pareira. Antipyretic effect was observed with the pretreatment of C. pareira.

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Introduction: Bhasma, an Ayurvedic metallo-mineral preparation, is claimed to be biologically produced nanoparticles. Rajata (silver) is a noble metal known for its antimicrobial activity. Rajata Bhasma (RB) is expected to be composed of nanoparticles. With all these facts in place, this study was conducted to evaluate RB for the presence of silver nanoparticle (SNP) and its antimicrobial effect. Aim: The aim of this study is to analyze the physicochemical characterization, antibacterial activity of RB, and SNP. Materials and Methods: RB was commercially ordered and SNP was prepared by Turkevich method. Characterization of RB was carried out by scanning electron microscopy (SEM) and inductively coupled plasma-atomic emission spectroscopy (ICP-AES). SNP was characterized by ultraviolet (UV)-visible spectroscopy, transmission electron microscopy (TEM), and ICP-AES. Antibacterial activity of RB and SNP was carried out by well-diffusion method. Results: Analysis of RB by SEM revealed particles in range from 10 to 60 nm. UV-visible spectrum of the aqueous medium containing SNPs showed absorption peak at around 423 nm. The TEM analysis showed that SNP was spherical in the range of 5–50 nm and uniformly distributed without significant agglomeration. The content of silver in RB measured with ICP-AES was found to be 70.56% whereas in case of SNP was 65.23%. Staphylococcus aureus was found to be sensitive to both RB and SNP. Escherichia coli, Pseudomonas aeruginosa, and Enterococcus faecalis were found to be resistant to RB as well as SNP. Conclusion: The current study shows that RB does have silver particles in the size of nanometers and also has mild antibacterial activity.

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Introduction: The Drosophila melanogaster is one of the most extensively studied animal models for understanding the process of aging and longevity. This fly is being used for genetic studies since almost a century. Guduchi (Tinospora cordifolia [Wild.] Miers.) is an Ayurvedic drug used as Rasayana (rejuvenation) due to its antiaging effect. Aim: To explore the potential of Guduchi Churna (powder of T. cordifolia) on the life span of D. melanogaster using adult feeding method. Materials and Methods: For experimental setups, the regular food media were mixed with Guduchi Churna in different concentrations (0.25 g/100 ml, 0.50 g/100 ml, and 0.70 g/100 ml). Flies were exposed to these concentrations for 30 days. Results: Increase in the lifespan was observed in both parent and F-1 generation. Applying of ANOVA revealed significant difference between control and drug groups. The longevity effect, in the drug group was seen even on F-1 generation. Conclusion: Guduchi Churna enhances the life span of D. melanogaster in both parent and F-1 generation.

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Introduction: There has been an increase in a number of orphanages and children living in orphanages in last few years. The children living in orphanages often have psychological problems among which anxiety, depression, and low self-esteem are considered to be most prominent. Yoga is a noninvasive, cost-effective, and safe intervention among complementary and alternative medicine which is known to have a positive impact on psychological problems. Aims: The present pilot study intended to assess the effect of a two week Yoga intervention on anxiety, depression, and self-esteem of adolescents and young adults living in an orphanage. Materials and Methods: Adolescent and young adults participants who were the permanent residents of an orphanage (n = 34; males = 27, females = 7) between age ranges of 12–20 years underwent 2 week of Yoga intervention. Yoga intervention comprised Asana (Yogic postures), Pranayama (Yogic breathing practices), and Dharana-Dhyana (Yogic relaxation techniques) for 1 h daily over 15 days. Hospital anxiety and depression and Rosenberg self-esteem scale were administered at baseline and after the intervention to assess anxiety, depression, and self-esteem, respectively. Results: There was a significant reduction (P = 0.001) in anxiety, depression, and significant improvement in self-esteem (P = 0.001) at the end of 2 weeks Yoga intervention. Conclusions: This pilot study suggests that 2 weeks of Yoga practice potentially reduced anxiety and depression and improved self-esteem of orphanage adolescents and young adults. These findings need confirmation from studies with a larger sample size and randomized controlled design, which are implicated in the future.

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Background: Rhizophora mucronata is a salt-tolerant true mangrove which is widely distributed in Indian mangrove forest and traditionally used to treat diabetes and other health ailments. Aim: The aim of this study is to elucidate the role of Indian variety of R. mucronata leaves on glucose impairing metabolism during diabetes by in vitro and in vivo methods. Materials and Methods: The ethanolic fraction of R. mucronata leaves extract (RHE) was assessed for DPPH (1,1-diphenyl-2-picrylhydrazyl) radical scavenging and in vitro anti-diabetic action through α-amylase and α-glucosidase activity assessment. Oral glucose tolerance test (OGTT) and insulin sensitivity test (IST) were assessed and their counteraction with RHE (100 and 200 mg/kg, p.o) and glibenclamide (10 mg/kg, p.o) in streptozotocin (STZ) (50 mg/kg, intravenous) induced hyperglycemic rats were also monitored for 28 days. The data were analyzed statistically using t-test. Results: RHE dose-dependently inhibited α-amylase and α-glucosidase enzymes and lowered the area under the curve (AUC) for glucose on both OGTT and IST. RHE also significantly (p < 0.01) controlled glycemic index and thereby reducing diabetic complications as assessed by lipid profiles, atherogenic index, and coronary index in STZ rats. Conclusion: RHE at doses of 100 and 200 mg/kg/day for 28 days provided a significant decrease in diabetes complications and metabolic impairment.

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Ayurvedic medicines are often considered effective for chronic and lifestyle disorders. Hypertrophic lichen planus (HLP) is a rare inflammatory skin condition and develops into squamous cell carcinoma in few cases. It has resemblance with Charma Kushtha mentioned in Ayurvedic classics. Conventional therapy used in this condition is unsatisfactory and is not free from side effects. A case of long-standing systemic steroid-dependent HLP is presented here which was intervened successfully with Ayurvedic modalities.

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Background: Dyslipidemia, a major risk factor of coronary heart disease, is the leading single cause of death in the world. Currently available hypolipidemic agents have been associated with a large number of side effects. The radical Ayurveda Samshodhana Chikitsa as a treatment protocol can provide better effect. Therefore, the present study was designed to evaluate the effect of Virechana Karma and Lekhana Basti in dyslipidemia. Objectives: To evaluate the effect of Virechana Karma and Lekhana Basti in the management of dyslipidemia (Medoroga). Materials and Methods: Ninety patients of either sex in the age group of 20–60 years, fulfilling the study criteria were included in the study. The patients were randomly divided into three groups (thirty patients each). Virechana Karma was administered to patients in group A, Lekhana Basti was administered in group B and tablet Atorvastatin in group C. The effect of treatment was assessed by analyzing the complete lipid profile after completion of treatment and after the follow up in comparison to base line score. Results: All the three groups showed statistically highly significant result in the lipid profile after the treatment and after the follow up. Conclusion: Virechana Karma is effective in reducing triglycerides level, where as Lekhana Basti is effective in reducing the cholesterol level in particular.

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“Pandu” Roga is a disease entity described in Ayurveda which has clinical features similar to that of various types of anemia, in which there develops a pale-yellow discoloration on the skin. Besides the various etiological factors, Acharya Charaka has specially described some psychological causative factors among which Chinta (excessive worry), Bhaya (fear) and Shoka (grief) are three main factors, which play an important role in the pathogenesis of Pandu Roga. This paper aims to explore the scientific explanations for the above stated factors in the causation of Pandu Roga (anemia). Hence, a thorough search was made on the internet using the keywords anemia, psychological stress, anger, fear and some scientific studies were found on the concerned topic. It reveal that these factors disturb the process of iron distribution within the body and affects the process of erythropoiesis causing iron deficiency anemia.

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Introduction: The incidence rate of Gridhrasi (sciatica) is quite significant as more than three-quarters of the world's population are affected by the disease. It is characterized by the onset of Ruja (pain), Toda (pricking), and Stambha (stiffness), initially in Sphika (gluteal region) and then radiating distally to Kati-Prishtha (low back), Janu (knee), Jangha (thigh) till Pada (feet). The patients suffering from Gridhrasi have restricted movements due to painful limb, affecting the daily routine activities. Aim: To assess the role of Raktamokshana (blood letting) done by Ghatiyantra in the patients suffering from Gridhrasi. Materials and Methods: The study was conducted on twenty patients who had reported for the treatment of Gridhrasi at an Ayurvedic hospital. Raktamokshana was done on Sphik (gluteal region) or Kati (low back) region with the help of 18 no. needle and Ghatiyantra (Kanchapatra) in four settings (0, 5^th, 10^th and 15^th day). The sign and symptoms, namely Ruka, Toda, Stambha, and Spandana (fasiculation) were given scores depending on their severity. The patients were also assessed for straight-leg raise (SLR) test. Follow-up was done at an interval of 5 days for three times and the scores were noted down before and after treatment. The scores were analyzed by SPSS 18 software using Student's t-test. Results: Marked reduction in severity of mean scores of Ruja, Toda, Stambha, and Spandana was seen in the patients after the use of Ghatiyantra for Raktamokshana, which was statistically significant. Conclusions: Ghatiyantra is the simple and effective treatment (in adjunct to other treatment) for reducing Ruka, Toda, Stambha, and Spandana in Gridhrasi.

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Introduction: Ayurveda has described about the pathogenesis and the treatment of various disorders, the incidence of some of which have increased in the present scenario. Janu Sandhigata Vata correlated with osteoarthritis (OA) of the knee joint is one such chronic, degenerative, inflammatory disease which has a great impact on the quality of the life of an individual. Different modalities of treatment have been explained in the classics to tackle the condition effectively. Methodology: In the present study, an attempt has been made to review the various clinical research works done in the management of OA of the knee, which are registered in various research portal. In AYUSH Research Portal using the keywords Ayurveda-clinical research-musculoskeletal disorders-osteoarthrosis of knee-Janu Sandhigata Vata and in PubMed using clinical research – Ayurveda-OA. The studies reviewed were categorized depending on the treatment used in the management of the condition. Results: Fifty three research works were registered under AYUSH Research Portal with 34 full papers. There were 12 research papers in PubMed, out of which 6 papers which dealt with OA of the knee were reviewed. Among these six, three already existed in AYUSH Research Portal. The results were discussed by categorizing the studies as per the treatment used. Conclusion: Among the papers reviewed, most of them dealt with few modalities of treatment rather than the complete classical line of the treatment. The evidence-based research involving multimodality treatment with long-term follow-up covering various aspects of prevention and cure has to be conducted which is the need of the hour.

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Background: Sandhivata is a disease described under Vatavyadhi and resembles osteoarthritis (OA) in respect to etiology, pathology, and clinical features. Knee joints are more prone to be affected by this disease because it is the most frequently involved joint in daily works. Acharya Sushruta has indicated Agnikarma, when severe pain occurs in Twak, Mamsa, Sira, Snayu, Sandhi, and Asthi due to Vata Prakopa. Panchatikta Guggulu is a formulation mentioned in Chakradatta and Bhaishajya Ratnavali in the context of Kushtha Roga where it is also indicated for Sandhigata Vata and Asthigata Vata. Aims: The aim of this study is to evaluate the comparative effect of Agnikarma alone and Agnikarma along with Panchatikta Guggulu orally in Janugata Sandhivata (OA of knee joint). Materials and Methods: Thirty-three patients of Janugata Sandhivata were registered and randomly divided into two groups. In Group A (n = 18), Agnikarma was done with Panchadhatu Shalaka once every week for one month while in Group B (n = 15), Agnikarma along with Panchatikta Guggulu orally was given for one month. Weekly assessment was done for relief in Sandhishula (pain), Sparshaasahyata (tenderness), Sandhisphutana (crepitus), Sandhigraha (stiffness) by subjective gradation, and range of movement (ROM) was recorded in research proforma. Results: In Sandhishula, 86% relief was found in Group A whereas 77.78% relief was obtained in Group B. Sparshaasahyata was reduced by 69% in Group A while 87.78% in Group B. Nearly 39% improvement was seen in Sandhisphutana in Group A while 46.67% in Group B. In Sandhigraha, 63% relief was obtained in each of the groups. The patients got relief from the pain after first sitting of Agnikarma in both the groups. The relief was sustained for more than 3 months in most of the patients. There was no significant difference in radiological findings before and after treatment in both the groups. Conclusion: It was concluded that Agnikarma is effective in the management of pain in the Sandhivata. However, the addition of Panchatikta Guggulu in the treatment provides better efficacy on joint stiffness and crepitus. Further analysis showed that better relief in pain was observed in Group A while relief in tenderness, crepitus, and stiffness was found better in Group B.

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Background: Non-communicable diseases are expected to kill more people in the 21^st century which are the resultant of deranged lifestyle such as unhealthy dietary habits and wrong behavioral pattern. In Ayurveda, Ahara Vidhi (dietary rules) and Vihara (conducts) are described in detail which can be included under the heading of lifestyle. Agnimandya (indigestion) is considered as the root cause of all diseases like diabetes mellitus, obesity etc., which are few among the top ten lifestyle disorders. Aim: The present study is aimed at establishment of relationship between disturbances in lifestyle and Agnimandya and role of lifestyle modification in correcting the state of Agnimandya. Materials and Methods: The present study was carried out on 33 patients diagnosed with Agnimandya having disturbed lifestyle. Patients were divided into two groups with simple random sampling method. In Group A, lifestyle modification was advised with placebo capsules of wheat flour, while in Group B, patients were treated with 2 g of Shatapushpadya Churna for 2 weeks. Results: Both the groups showed statistically highly significant results on majority of the symptoms of Agnimandya, however, Group A provided better effect than Group B. Conclusion: Lifestyle has definite role in the manifestation and treatment of Agnimandya.

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