Anti-Mullerian hormone (AMH) produced by granulosa cells of preantral and antral follicles acts as a potential marker for ovarian reserve useful in predicting ovarian response to controlled ovarian stimulation. A woman undergoing in vitro fertilization (IVF) with low AMH has poor success rate and ultimately the couple is left with the only option of IVF with a donor egg. The signs and symptoms of a patient with low AMH level can be compared to Dhatukshayajanya Vandhyata. The present case report documents the efficacy of an Ayurvedic treatment protocol in improving the AMH value, which is a prerequisite for assisted reproductive technique (ART) without a donor egg. The patient with low AMH level was subjected to Ayurvedic management protocol including Shamana for 3 months and Shodhana procedure for 21 days. The follow-up was done for 3 months. A marked improvement in the AMH level was noted in the first 3 months and also after the follow-up period, thus making her eligible for ART with her own egg.

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Introduction: Monosodium glutamate (MSG), an extensively used flavor enhancer, produces degenerative changes in cell and causes neural death which cause imbalance in endocrine system and disturb the body system. While taking consideration of its potency and affinity, it falls under the category of Dooshi Visha, which leads to various diseases among which Kshapayet Shukram is one and can be correlated with disturbance in reproductive system which may be endocrinological or related to gametes. Dooshivishari Agada (DVA) is a herbomineral formulation which is mentioned for the treatment of Dooshi Visha. Aim: The aim is to evaluate the efficacy of DVA in MSG-induced female reproductive toxicity in Wistar rats. Materials and Methods: DVA was prepared and analyzed for preliminary physicochemical, organic and inorganic tests. Twenty-four rats were divided into four groups. Up to 14 days, MSG (0.20g/kg) was given to all groups except control group. From days 15 to 42, DVA (216mg/200g) was given to the third group and in the fourth group no intervention was given to evaluate auto recovery. The second group was considered as disease control. At the end, Follicle-stimulating hormone test and histopathology of ovary were done. Results: There was a significant increase in primary follicle count and decrease in atretic follicle count in DVA group. Secondary follicle count, tertiary follicle count and Graafian follicle count were increased in DVA group but the increase was not statistically significant. Conclusion: MSG mainly acts as a neurotoxic component by oxidative stress. Mostly, the ingredients of DVA have anti-oxidant properties, which counteract the oxidative stress caused by MSG in cell. Many ingredients such as Pippali, Tagara and Kushtha have neuroprotective property which corrects the neurodegeneration and balances the endocrine system.

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Background: Parikartika is a common painful condition among anorectal diseases which resembles with fissure-in-ano. In the present era, due to changing lifestyle such as sedentary work pattern, increased stress, improper dietary and sleep habits, various lifestyle disorders are increasing continuously. Aim and Objective: The aim is to assess the effect of Yashtimadhu Ghrita in comparison with lignocaine–nifedipine ointment in the management of Parikartika (Acute fissure-in-ano). Materials and Methods: A total of 36 patients of acute fissure-in-ano were selected and randomly allocated into two groups (18 in each group). In Group A (n = 18), local application of Yashtimadhu Ghrita in fissure bed (Parikartika) twice a day after sitz bath for 4 weeks was given. In Group B (n = 18), local application of lignocaine–nifedipine ointment in fissure bed (Parikartika) twice a day after sitz bath for 4 weeks was given. Results: Patients of Group A (Yashtimadhu Ghrita) taken more time than the patients of Group B (lignocaine–nifedipine ointment) to get relief from pain in ano. Ulcer in ano healed earlier in patients of Group A (Yashtimadhu Ghrita) in comparison with patients treated with lignocaine–nifedipine ointment application. Patients of both groups have taken similar time to get relieved from bleeding PR. Complete remission of symptoms of Parikartika was more in patients treated with Yashtimadhu Ghrita than lignocaine–nifedipine ointment. Conclusion: Both the interventions Yashtimadhu Ghrita and lignocaine–nifedipine ointment are equally effective in symptomatic relief in Parikartika (acute fissure-in-ano).

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Introduction: Glaucoma is the second leading cause of irreversible blindness worldwide and third leading cause in India. The disease progresses even intraocular pressure (IOP) is well under control; hence, now modern medicine is looking for strategies that are neuroprotective in glaucomatous optic neuropathy (GON) management. Aim: This study aimed to propound the concept of Chakshushya Rasayana and diuretic therapies and also evaluate the neuroprotective and IOP-lowering effects of Ayurvedic line of management in primary open-angle glaucoma (POAG). Materials and Methods: In this randomized parallel-group trial, patients having POAG were randomized with equal probability to one of the two treatment groups. Participants were assessed on the basis of subjective parameters such as blurred vision, frequent changes of presbyopic glasses (FCPG), delayed dark adaptation (DDA), visual field defect (VFD) and headache; objective parameters such as best-corrected visual acuity (BCVA), IOP and optic nerve head changes and perimetry findings such as mean deviation (MD) and Glaucoma Hemifield Test. In Group A, after Koshtha Shodhana and Nasya, Tarpana and Ashchyotana with Shigru Pallava Arka were done locally and Punarnavashtaka Kwatha and Gokshuradi Guggulu were given internally for 52 days along with modern antiglaucoma eye drop and in Group B, patients already taking antiglaucoma eye drop were kept under observation for 2 months. Results: Patients in Group A showed better results in blurred vision, FCPG, DDA, VFD, headache, BCVA, IOP and MD. Patients in Group B showed better results in blurred vision and FCPG. A comparison of both groups showed significant results in blurred vision, DDA, VFD, BCVA, IOP and MD. Conclusion: The clinical study concludes that Ayurvedic treatment protocol along with antiglaucoma eye drop in Group A patients was found to be more effective in reducing the IOP and controlling the progression of GON along with modern anti-glaucoma eye drop. Early diagnosis and proper management can prevent, arrest, or delay progression of POAG.

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Introduction: Diabetes is prevalent in India. This study was conducted to assess the impact of ingestion of fenugreek seed on fasting blood glucose levels and glycosylated hemoglobin (HbA₁C) levels in patients of Type 2 diabetes mellitus controlled with diet, exercise and oral hypoglycemic agents (OHAs) or insulin. Aims: Assessment of impact of ingestion of Trigonella foenum-graecum or fenugreek seed in patients with Type 2 diabetes controlled with OHAs and insulin on fasting blood sugar levels and HbA₁C levels. Settings and Design: Prospective, randomized control trial in a single center. Materials and Methods: Total sixty patients of Type 2 diabetes mellitus diagnosed at least 6 months prior and on OHAs and insulin were included in the study. Patients were randomized to receive 10 gm of fenugreek seeds soaked in hot water and another group was not. Strict dietary and exercise controls were followed as per the guidelines of American Diabetic Association protocols. The parameters assessed were demographic profile on the first visits and fasting blood sugar levels and HbA₁C every month till 6 months. Results: A total of sixty patients were enrolled in the study divided into two groups each containing thirty patients. One group of patients received 10 gm of fenugreek seeds soaked in hot water every day, while the second group did not received. Statistical analysis shows that there is significant reduction in fasting blood glucose levels in the 5^th month in the study group (P = 0.0421) while significant reduction in HbA₁C in the 6^th month (P = 0.0201). Conclusion: A simple complementary addition of fenugreek seeds can have a synergistic effect along with diet control and exercise on fasting blood glucose and HbA₁c but is of delayed occurrence.

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Background: Amlapitta is a lifestyle disorder caused due to vitiation of Pitta and Kapha by Ama. Objective: The objective was to assess the role of Doshik predominance in the management of Amlapitta. Materials and Methods: Patients who had fulfilled the inclusion criteria were registered primarily for this study. Out of them, those who were selected only by the presence of cardinal features of Amlapitta were allotted randomly in Group C-1 and Group C-2 and rest of them were allotted in Group A and B after diagnosed by typical features of Kapha and Pitta Dosha predominant Amlapitta and had been treated with Shunthikhanda and Vasakhanda Kushmandaka granules, respectively. Results: Regarding overall effect of therapy, marked positive improvement in Group A was 35.29%, in Group B, 26.47%, in Group C-1, 23.08%, and Group C-2, 16.67%. No improvement was observed only in Group C-1 (4.76%) and C-2 (5.56%). Complete remission (2.56%) was observed only in Group C-2 (5.56%) Discussion: Out of 112 registered patients with a mean age of 42 years, 107 had completed their treatment. Maximum patients were male (66.96%), Hindu (83.93%), married (94.64%), middle class (43.75%), and educated (93.75%) from Jangala Desha (96.43%) and used to take Viruddha Ahara (83.04%). Patients of Group A and Group B, who were diagnosed and treated according to the Doshik predominance, showed better improvement than of Group C-1 and Group C-2 where patients were diagnosed and treated as per the cardinal features of Amlapitta only. Conclusion: Treatment of disease according to Doshik predominance is more effective than of only cardinal features.

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The present paper is aimed to ascertain the proper identity of Muladhara Chakra by a meticulous search. Proceeding in that direction, a review of the Muladhara Chakra was carried out in the texts of tantric literature, modern literature, journals and online publications. After going through various literatures, it is found that hindrance in normal body physiology may occur due to deactivation of Shat Chakra. Anatomically, each Chakra represents various plexus and sub-plexuses which are concerned with certain organs and its supply. Hence, there is a need to find each and every anatomical structure related to Chakras. Acharya Gananath Sen in his commentary Pratyaksha Shariram concluded that all the pelvic organs closely resemble with Muladhara Chakra. A cadaveric dissection has been carried out to correlate and establish that the anatomical structures which closely resemble the Muladhara Chakra can be thought of as inferior hypogastric plexus and its sub plexuses.

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Anti-phospholipid antibody (APLA) syndrome is defined by the presence of thrombo-embolic complications and pregnancy morbidity in the presence of persistently increased titers of APLA syndrome. Its clinical presentation can be diverse and any organ can be involved with a current impact in the most surgical and medical specialties. Here, the case of a 34-year-old young lady with APLA syndrome presented with the cerebral venous thrombosis and subsequently deep vein thrombosis of the left leg veins. Three classes of APLAs (IgG, IgM and activated protein C) were elevated. There were no clinical or laboratory evidence for other autoimmune or systemic illnesses. The patient is under treatment of Ruksha Tikshna Virechana (purgation) with Haritaki (Terminalia chebula Retz.) and Goarka (extract of cow's urine) with the concept of Kaphaja Shotha (nonpitting edema) and got significant result in both subjective and objective parameters.

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Introduction: Education in the field of Ayurveda is regulated by the Central Council of Indian Medicine (CCIM). The weightage of Sanskrit subject in first Bachelor of Ayurvedic Medicine and surgery (BAMS) course has been decreased from 250 marks to 100 marks by CCIM notification in 2012. Decrease in weightage of marks of Sanskrit subject from 250 marks to 100 marks may affect the knowledge of Sanskrit subject. Aims: To established a causal relationship between knowledge of Sanskrit language and results of Bachelor of Ayurvedic Medicine and Surgery examination. Material and Methods: Comparisons of knowledge, attitude and practice (KAP) scores and average marks in BAMS examination of two groups of students of 2nd and 3rd year BAMS and who have passed 1st year BAMS professional examination with Sanskrit subject of either 250 marks or 100 marks regarding were done. The relationship between prior exposure to Sanskrit at school level and average marks in BAMS examinations was also assessed through this study. It was a cross-sectional KAP questionnaire study. KAP questionnaire to assess KAP toward Sanskrit subject was developed and was reviewed by expert faculties. A total of 200 students of various Ayurvedic colleges from Mumbai and Navi Mumbai were enrolled in the study. The data was analyzed by appropriate statistical tests. Results and Observation: It was observed that in spite of decrease in weightage of marks of Sanskrit subject, there was no significant difference in KAP score as well as average marks in BAMS examination in both the groups. There was significant difference in number of students who had studied Sanskrit subject and who had not studied it at school level. There were significant differences in KAP score and average marks in BAMS examination in those two groups. Conclusion: Students who have studied Sanskrit at school level find it easier to get good marks in BAMS examination, and particularly Sanskrit subject. Due to less weightage of Sanskrit subject, although syllabus is not decreased to that extent; there is very limited scope to ask various questions to judge the understanding level of students. Existing or previous syllabus of Sanskrit do not make any difference in understanding of subject and also in marks in University examination.

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Introduction: Ayurveda has a rich and comprehensive concept of life and health. Callosity is a French word meaning a local thickened or hardened part of the skin. It is a plaque of hyperkeratosis caused by repeated friction or pressure. It is assumed that frictional forces induce hyperkeratosis leading to thickening of stratum corneum of the skin over certain areas prone to mechanical stresses. Kadara, as described by the Samhitas, can be closely related to lesions of the skin caused by hyperkeratosis. Kadara has been enumerated and described in the classical literature under the heading of Kshudra Roga. Agni Karma has been mentioned for the proper management of Kadara. Aims and Objective: The management of Kadara is aimed at removal of the hyperkeratosis lesion by Agni Karma along with or without Shastra Karma. Material and Methods: Pippali has been mentioned as a Dahana Upakarna in Sushruta Samhita and Ashtanga Samgraha. It was a randomized, prospective, single-blind and clinical trial. Fifteen patients suffering from hyperkeratosis lesions were selected according to the conditions mentioned under inclusion and exclusion criteria and Agni Karma procedure was carried out for them. Assessment of the lesion was done before treatment and after 7 days and 14 days of treatment. Results and Observation: Based on the study, it was observed that Pippali can be used to create superficial burns only. The extent of tissue destruction due to burning with Pippali is very minimal. Hence, it was observed to be effective for treating superficial Kadara lesions. It was observed that eventually in 7 days the area of the lesion turned soft with reddish black discoloration. Softening of the lesion and its discoloration might be due to penetration of the volatile oil and active principles of Pippali into the affected area while doing the Agni Karma procedure. It was further observed that the area of lesion eventually dried and peeled off along with the Kadara tissue within about 15 days. Conclusion: Hence, Pippali was able to provide satisfactory results in case of superficial hyperkeratosis lesions.

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Introduction: Bronchial asthma is a highly prevalent disease, and in most of the etiopathogenesis and symptomatology, it can be correlated with Tamaka Shvasa. Ikshvaku (Lagenaria vulgaris [Manila] Standley.) is an annual herbaceous climbing plant with a long history of medicinal uses for the treatment of various ailments including jaundice, diabetes, ulcer, piles, colitis, asthma, insanity, hypertension, congestive cardiac failure and skin disorders. Its fruit pulp is used both as an emetic and as a purgative. Aims: To study the efficacy of Vamana Karma with Ikshvaku (Lagenaria vulgaris [Manila] Standley) Ksheera Yoga. Materials and Methods: A total of 15 patients fulfilling the diagnostic criteria for bronchial asthma were selected from outpatient and inpatient department of Panchakarma Department. The sign and symptoms, mainly breathlessness, cough and rhonchi were given scores depending on their severity. The patients were also assessed for lung function test to determine pulmonary impairment. For Vamana, they were given Deepana and Pachana with Trikatu Churna for 3 days and then they were subjected to Snehapana with lukewarm cow's ghee. After the completion of Snehapana, the patient were given Abhyanga, Vashpa Swedana and diet with predominance of Kapha (Kapha Bahula Ahara- diet mixed with milk or curd), which was then followed by Vamana with Ikshvaku Ksheera Yoga and Samsarjana Krama. Follow-up was done at an interval of 15 days for three times and t scores were noted before and after the treatment. The scores were analyzed using Wilcoxon signed-rank test for subjective parameters and Student's paired t- test for objective parameters. Results: The trial drug has shown statistically highly significant reduction in breathlessness, cough, rhonchi, and significant changes in lung function tests. Conclusion: The test drug proved its emetic effect on the patients of bronchial asthma and thus relieved the symptoms of the disease immediately. It has reduced frequency of episodes of breathlessness and severity of symptoms.

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Background: Asthma is a chronic inflammatory respiratory disease characterized by periodic attacks of wheezing, shortness of breath and a tight feeling in the chest. The current study is based on the effect of Yoga on quality of life in asthmatics in Northern India. Materials and Methods: A total of 300 participants of mild-to-moderate persistent asthma (FEV₁ >60%) aged between 12 and 60 years were recruited from the Department of Pulmonary Medicine. Their quality of life was assessed with the help of mini asthma quality-of-life questionnaire (AQLQ) at baseline and then after 3^rd and 6^th month from baseline. Forty-five participants were dropped out during the study while 255 participants completed the study successfully. Results: In “the Yoga group,” significant improvements were found in all the subdomains of AQLQ at 3^rd month and at 6^th month in comparison to “the control group.” The number needed to treat was found to be 2.67 for the total AQLQ score which was greater than the minimal important difference. Conclusion: “The Yoga group” got significantly better improvement in asthma quality-of-life scores than “the control group.” Thus, Yoga can be used as an adjuvant therapy in the management of asthma.

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The human body defends itself from harmful agents such as microorganisms present in the environment, which otherwise damage the individual's health. This defensive mechanism is the immune response mediated by the activation of T-cell and B-cell antibody production. The body recognizes and destroys these antigenic harmful agents. The defensive response is altered sometimes in the presence of allergens, causing hypersensitive reactions. The allergens are antigens. The hapten-carrier adduct often behaves as an allergen-producing hypersensitivity with a manifestation of sign and symptoms those are at times lethal. Garavisha is an artificial type of poison formed by combination of two nonpoisonous substances as depicted in the treaties of Ayurveda. It has identical characteristics to that of hapten-carrier adduct. In the present article, Garavisha is substantiated with conceptual reference to hapten-carrier adduct and hypersensitivity.

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Aim: The aim of this study is to find out the anti-Alzheimer's activity of isolated karanjin and embelin. Materials and Methods: Karanjin isolated from Pongamia pinnata (L.) pierre and embelin from Embelia ribes Burm.f. and their purity was confirmed by ultraviolet spectrophotometric and Thin layer chromatography based study. Anti-Alzheimer's activity of isolated compounds were evaluated through elevated plus maze and Morris water maze model on Swiss albino mice. Diazepam (1 mg/kg body weight, intraperitoneally) was used for the induction of Alzheimer's like effects (amnesia) on Swiss albino mice and piracetam (200 mg/kg body weight, oral) used as a standard treatment. Results: In EPM, embelin and karanjin decrease the transfer latency time in dose dependent manner and escape latency time in MWM method. A significant (P < 0.01) reduction in amnesia with an anti-Alzheimer's effect found when results of isolated compounds were compared with standard and vehicle control. Diazepam (1 mg/kg) treated group showed significant increase in escape latency and transfer latency when compared with vehicle control; which indicates impairment in learning and memory. Conclusion: Both isolated compounds and standard significantly reversed the amnesia induced by diazepam and improved learning and memory of mice in dose and time dependent manner. This study supports the ethnobotanical use of these two plants in India for the management of nerve or brain related problems.

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Introduction: In endodontics, despite careful instrumentation and antimicrobial irrigation, root canals still harbor cultivable microorganisms. Such cases require intra canal medicament that eliminates the microbial inhabitants from the canals. Recent trend advocates the use of herbal extracts due to easy availability, cost-effectiveness, low toxicity, and lack of microbial resistance. Hence, in the present study, Neem, Tulsi, and Guduchi extracts were used as intracanal medicaments. Aim: This study aimed to evaluate and compare the antibacterial efficacy of Neem, Tulsi, Guduchi extracts, and chlorhexidine against Enterococcus faecalis, when used as intracanal medicaments. Materials and Methods: One hundred and twenty-five extracted human teeth, inoculated with E. faecalis, were divided into four experimental groups and a control group (n = 25 in each group). The experimental groups were treated with chlorhexidine, Neem, Tulsi, and Guduchi extracts and their antibacterial property was evaluated by estimating microbial counting (CFU/ml). Results: The reduction in bacterial count for chlorhexidine, Neem, Tulsi, and Guduchi groups was 60.76%, 51.98%, 37.73%, and 34.93%, respectively. Statistically significant difference in reduction of bacterial count was observed in all the groups, when compared with the control group. Conclusion: Among all the herbal extracts, Neem was found to be the most potent medicament followed by Tulsi and Guduchi. However, chlorhexidine was found to be at epic.

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Background: Acne vulgaris is almost a widespread disease occurring in all races. Propionibacterium acnes initiate acne and inflammatory mediators aggravate it. Conventional therapies for acne include comedolytic, anti-inflammatory, and anti-biotic agents. Due to adverse effects of these therapies, people are searching for alternative options. In this context, a polyherbal formulation AHPL/AYTOP/0213 cream was developed for the treatment of Acne. Objective: The objective of this study is to study anti-inflammatory and antimicrobial activities of AHPL/AYTOP/0213 cream. Materials and Methods: Skin irritation study was conducted on AHPL/AYTOP/0213 cream as per OECD guidelines. (1) Anti-inflammatory activity: Anti-inflammatory activity of AHPL/AYTOP/0213 cream in comparison with diclofenac sodium cream was assessed in carrageenan-induced rat paw edema model. (2) Antimicrobial activity for P. acnes: P. acnes were incubated under anaerobic conditions. Aliquots of molten brain–heart infusion with glucose agar were used as the agar base. Formulation and clindamycin (10 μg/ml) were introduced in to the Agar wells randomly. (3) Antimicrobial activity for Staphylococcus epidermidis and Staphylococcus aureus: bacteria were incubated under aerobic conditions at 37°C. Tryptic soy broth with glucose agar was used as the agar base. A volume of 0.5 ml of formulation and clindamycin (10 μg/ml) were introduced in to the wells randomly. The antibacterial activity was evaluated by measuring zones of inhibition (in mm). Results: AHPL/AYTOP/0213 cream is nonirritant. Significant reduction in rat paw edema (43%) was observed with AHPL/AYTOP/0213 which was also comparable to diclofenac sodium cream (56.09%). Zone of inhibition for formulation was 20.68 mm, 28.20 mm, and 21.40 mm for P. acnes, S. epidermidis and S. aureus, respectively, which was comparable to clindamycin. The minimum inhibitory concentration of formulation AHPL/AYTOP/0213 obtained in anti-microbial study was 2.5 mg/mL. Conclusion: AHPL/AYTOP/0213 cream is nonirritant and possesses significant anti-inflammatory and antimicrobial activities, which further justifies its role in the management of acne vulgaris.

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Background: Beauty is not only a source of joy but also gives confidence to some extent. Ayurvedic cosmetology starts from mother's womb and continues with Dinacharya (daily routines), Ratricharya (diet and regimen for night), Ritucharya (seasonal diet and regimen), etc. The symbiosis between cosmetology and Ayurveda is the most ancient one. With this research interest, the present study has been undertaken to assess the efficacy of Mukhakantivardhaka Lepa and Patoladi Ghanavati in Tvakvaivarnya (hypermelanosis). Objectives: To evaluate the efficacy of Mukhakantivardhaka Lepa and Patoladi Ghanavati in Tvakvaivarnya (hypermelanosis). Materials and Methods: This study was a double-armed clinical trial in which 62 patients having signs and symptoms of Tvakvaivarnya were selected belonging to the age group of 16–40 years and received Mukhakantivardhaka Lepa and Patoladi Ghanavati for 60 days with follow-up after every week. For the purpose of perfect diagnosis and assessment of all aspects of the disease, a special research proforma was prepared. Results: Both the groups showed 100% improvment in associated symptoms. Regarding the overall effect of therapy in both the groups, moderate improvement was high following marked improvement. No adverse reactions were documented. Conclusion: Mukhakantivardhaka Lepa and Patoladi Ghanavati work excellently on Tvakvaivarnya (hypermelanosis) and improve skin complexion.

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