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   Table of Contents - Current issue
Coverpage
April-June 2021
Volume 4 | Issue 2
Page Nos. 37-76

Online since Monday, August 16, 2021

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EDITORIAL  

Holistic Ayurveda approach to face the post-COVID challenges ahead p. 37
Tanuja Manoj Nesari
DOI:10.4103/jacr.jacr_61_21  
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GUEST EDITORIAL Top

Growing demand of Ayurveda internationally and the importance of medical writing in this changing scenario p. 41
SN Gupta
DOI:10.4103/jacr.jacr_57_21  
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CASE REPORTS Top

Ayurvedic management of co-infection of Herpes zoster ophthalmicus in COVID-19 patient: A case report Highly accessed article p. 44
Shantala T. R. Priyadarshini, KK Remitha, S Priyanka
DOI:10.4103/jacr.jacr_51_21  
COVID-19 patients have cutaneous manifestations such as herpes zoster, urticaria, chilblains, purpura, livedo racemosa, chickenpox-like eruptions in very small percentage. However, the major focus is on pulmonary and cardiac symptoms as it leads to increased mortality. Globally, many cases of herpes zoster as coinfection of COVID-19 are observed. Here, a 65-year-old female with Herpes Zoster Ophthalmicus (HZO) managed by Ayurveda stand-alone treatment is reported. She tested RT-PCR (Real-Time Polymerase Chain Reaction) positive, had mild COVID-19 symptoms, and preferred home isolation and Ayurveda treatment. The patient was monitored twice daily through teleconference (zoom/video calls), photographs of the condition were procured, and guidance was sent in return. Initially, the patient complained of fever, pain, and burning sensation in scalp, left ear, and eye with left periorbital swelling. Once the fever subsided, the patient developed vomiting and loose stools as COVID-19 symptoms. There was complete relief from all the symptoms in four weeks, and the medicines for the postherpetic lesions were continued for another week. Treatment of herpes coinfection in COVID-19 under home isolation is in itself a challenge requiring leech application. However, the case was managed with Ayurveda oral medications and topical therapies such as Seka and Bidalaka to achieve relief from pain, burning sensation, and swelling. The drugs and therapies used in the above case assisted increasing circulation relieving pain thereby, assuring good sleep and faster respite from all symptoms. This case is reported to add to clinical literature and to showcase the importance of local therapies and teleconsultation in condition like HZO associated with COVID-19.
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Ayurvedic management to aid weaning of anti-depressants: A case report p. 50
S Akshatha, Suhas Kumar Shetty
DOI:10.4103/jacr.jacr_4_21  
Depression has become a common psychiatric disorder affecting people of middle-aged group, especially due to their psychosocial issues. Although there are many Allopathic medicines available for its management but these are not free from their adverse/side effects. So people are now looking for alternative medicines to avoid adverse effect of chemical medications. A combined approach of various traditional treatment principles along with psychotherapy will help to overcome the stressors. A 45-year-old male patient, agriculture officer by profession, was admitted to the inpatient department for reducing the dose of antidepressants [sertraline (200 mg) and agomelatine (50 mg)] which he was taking for the last three years. The patient complained of sleeplessness or difficulty in maintaining sleep, loss of appetite, lack of interest in doing daily activities, racing of negative thoughts, and at times experiencing irrational fear. Based on signs and symptoms and Dosha vitiation that is Vata and Kapha, the case was diagnosed as Vishada (~major depressive disorder) with mild features of Chittodvega (~anxiety). On admission, the treatment protocol included Snehapana (~internal oleation) followed by Virechana (~therapeutic purgation), Satvavajaya chikitsa (~psychotherapy), and Shamana aushadhi (~palliative treatment). After the course of treatment, there was considerable improvement such as involving in daily activities, reduced negative thoughts, and improvement in sleep with the reduction in Hamilton's Depression Rating Scale score from 12 to 3. The dosage of antidepressants was tapered after one month of follow-up.
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Ayurvedic management of recurrent anterior uveitis (Raktaja adhimantha) with bloodletting therapy: A case report p. 54
Akshatha K Bhat, V Krishnakumar
DOI:10.4103/jacr.jacr_7_21  
A 34-year-old female patient reported to the outpatient department with recurrent anterior uveitis who presented with blurred vision, severe pain, redness, watering, and unable to bear bright light since one day in the left eye. On examination, inflammatory changes were seen in the anterior chamber. These symptoms appeared alternatively in both the eyes; three to four times a year for consecutively two years. She was under pred forte 1% eye drops, homide eye drops, and prednisolone tablets during relapses as advised by an ophthalmologist. Further, she developed hyperglycemia and started medications for that. During this period, steroids were withdrawn. Considering the limited benefits, she opted for Ayurveda treatment. The condition was diagnosed with Raktaja adhimantha and treated with Jalaukavacharna (~leech therapy), Shirovirechana nasya (~intranasal drug delivery with cleansing action) with Shadbindu taila. Kaishora guggulu and Rasnaerandadi Kashaya were administered orally. The symptoms subsided within a week, while after a month, the signs of the anterior chamber were normalized. The oral medicines were continued for a month. She was asymptomatic for three years. A similar mild symptom appeared in the right eye that was managed in similar lines. Thereafter, no exacerbation was noticed till January 2021. Ayurveda bloodletting therapy along with Shirovirechana nasya and oral medicines is effective and safe as a stand-alone therapy in recurrent anterior uveitis and prolong the interval between recurrent attacks in uveitis.
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Two-staged surgical approach along with Ksharasutra therapy in the management of complex, non-specific, posterior, horse-shoe-shaped fistula-in-ano: A case report p. 58
Pragnaben Bhikhabhai Baria, Tukaram Sambhaji Dudhamal
DOI:10.4103/jacr.jacr_62_20  
Bhagandara is one of the Ashtamahagada (~eight grave diseases) that resembles with the anal fistula in modern parlance. Many surgical techniques are available in modern practice though management of the fistula is challenging due to its high recurrence rate and associated complications. This study aims to diagnose a case of fistula-in-ano and to treat the case by two-staged surgical approach along with Ksharasutra. A 28-year-old male patient came to out patient department (OPD) of Shalya tantra with complaints of painful swelling with pus discharge from perianal region, which was diagnosed as complex, nonspecific, posterior horse-shoe shaped fistula-in-ano with approximately 80 mm long track. The condition is not only difficult but also takes a longer period for complete cure with varied success rate, hence, two-staged surgical approach along with Ksharasutra has been employed. The fistulous track was completely healed by almost 13 weeks. Follow-up was done for the next three months. There was no recurrence of the condition, and normal sphincter tone was achieved. The result of the present case is encouraging, and the patient was treated effectively without any complications and without disturbing his daily social life.
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Ayurvedic management of bullous pemphigoid (Visphota): A case report p. 64
Meenakshi Sharma, Bhavana Sharma, Sisir Kumar Mandal, Arun Kumar Mahapatra
DOI:10.4103/JACR.JACR_28_20  
Bullous pemphigoid is a rare, potentially fatal autoimmune blistering disease in which the immune system produces antibodies to the fibers that connect the outer layer (epidermis) and next layer (dermis) of the skin. These antibodies trigger inflammation that produces the blisters and itching of bullous pemphigoid. It is uncommon in childhood. This manifestation has close resemblance with Visphota in Ayurveda. A case of five month-old female patient with chief complaints of multiple ruptured blisters or bullae and reddish black lesions over both upper and lower extremities, face, lower abdomen, lower back, and scalp for two months is presented here. Oral administration of Paripathadi kadha and Mahatikta ghrita to mother and local application of Rasonta (~decoction of Daruharidra) with milk and Jatyadi taila to patient simultaneously were prescribed. Complete recovery within a month with no signs of relapse after three months of follow-up was noticed.
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Ayurvedic management of subacute thyroiditis: A case report p. 68
Shashidhar H Doddamani, MN Shubhashree, Rinky Thakur, Raghavendra Naik
DOI:10.4103/jacr.jacr_65_20  
Subacute Thyroiditis (SAT) is an acute inflammatory disorder presumed to be caused by a viral infection or a postviral inflammatory process. Autoimmunity may play a secondary role in this disorder. Although, SAT is a self-limiting condition associated with a tri-phasic clinical course of hyper, hypo, and euthyroidism. It is a rare clinical entity involving symptoms such as fever, upper respiratory tract infection, and thyroid tenderness. Diagnosis is based on clinical findings and laboratory reports. A 23-year-old male with the symptoms of hyperthyroidism was under the consultation of endocrinologist, who prescribed medicines. However, the patient was reluctant to take allopathic medicine and approached for Ayurvedic intervention. After basic examinations, he was prescribed with Trikatu churna, Shiva gutika and Arogya vardhini vati for one year with the intermittent gap. As the thyroid values fluctuate from hyper to hypo, it is often perplexing for a treating physician unless proper follow-up is done by the same physician. This paper aims at bringing awareness among clinicians regarding the condition “SAT” to instill confidence. Management of SAT involves the administration of non-steroidal anti-inflammatory drugs or aspirin, thyroid hormone, and glucocorticoids. However, all these were avoided and were successfully managed with Ayurvedic medication. Such studies highlight the promising scope of traditional medicine in endocrinal disorders.
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Efficacy of Indukanta ghritam in the management of Jirna urdhwaga amlapitta: A case report p. 73
Punam Aggarwal, P Shinsha, Vitthal G Huddar, Pradeep Kumar Prajapati
DOI:10.4103/jacr.jacr_48_20  
Amlapitta (~hyperacidity) is a disease of Annavaha srotas (~gastrointestinal tract) that originates from Amasaya (~stomach). Mandagni (~low digestive fire) plays an important role in its manifestation. The disease is easy to treat in its early stage while difficult to manage in chronic stage. It can cause various complications if not treated early. The disease has close resemblance with acid peptic disorder or hyperacidity. Various treatment modalities are available in conventional medical science, but they have certain limitations. In Ayurveda, various herbs, minerals, and their compound formulations have been mentioned in its management, and Indukanta ghritam is one among such formulations. In the present case report, a 17-year-old female with complaints of Amlodgara (~sour belching), Hritkanthadaha (~burning sensation in throat and chest), Utklesha (~nausea) and Chardi (~vomiting), Avipaka (~indigestion), Shiroruja (~headache), and Vibandha (~constipation) visited outpatient department. The condition was diagnosed as Jirna urdhwaga amlapitta. Indukanta ghritam and wholesome dietary regimen were given to the patient for 28 days. The results suggested that the patient was benefited in all symptoms within 28 days. However, the Shamana therapy was continued for 50 days. The patient, after two months of follow-up, presented without any complications.
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