TRADITIONAL SRI LANKAN MEDICINE INTERVENTION IN THE MANAGEMENT OF KNEE OSTEOARTHRITIS (JANU SANDIGATAVATA): CASE SERIES

Background: Osteoarthritis (OA) of the knee is a degenerative disease, which significantly restricts the functions of the joint.  Janu Sandigatavata (JS) is considered to be the close equivalent in traditional medicine to OA in modern medicine. The aim of this case series was to report the effectiveness of Traditional Sri Lankan Medicine (TSM) on JS patients attend to National Ayurveda Teaching Hospital. Method: Reported cases (n=10) were at the age range of 45years to70 years and both female (n=8) and male (n=2) patients were diagnosed as having JS of the knee joints. Radiology (X-ray) reported by a radiologist confirmed that they were in Kellgren-Lawrence grade III or less. TSM treatments were given as regimens up to 86days. At the end point, external treatment of oleation and herbal immune enhancing drugs were further continued over 8 weeks. Visual analogue scale for pain, knee scores in Knee Society clinical Rating System (KSS) and Ayurveda clinical assessment criteria were used to evaluate the effects of treatment. Results: Reductions of visual analogue scale for pain was observed between baseline and the 86 days endpoint. Clinical assessment criteria and the KSS scores of pain, movement and stability were also improved up to good level and function score were improved up to excellent level. During the follow-up period, joint symptoms and signs and the knee scores were remaining unchanged. Conclusions: Study explored that substantial decrease in clinical parameters of OA in knee and improved patients’ quality of life by the intervention of the TSM

Exploration for analysis of medicinal foods used to manage dyslipidaemia in Sri Lankan traditional medicine

The medicinal foods used to manage non-communicable diseases in Sri Lankan traditional medicine are slowly but steadily disappearing from the country due to many reasons. This study is the first stage of the research project aimed to explore and analyze the medicinal foods used to manage dyslipidaemia in traditional medical practices of Sri Lanka. A qualitative study covering the whole island was conducted cross-sectionally, supplemented by a document review including ancient textbooks and talipot palm (Corypha umbraculifera) leaf manuscripts. The study included all the registered traditional medical practitioners of the country, more than 55 years of age. Practitioners with poor memory and feeble health and those who were not in current practice were excluded. The first participant was selected purposively and the rest by using the snowball sampling technique. The investigator administered, validated, open-ended, semistructured questionnaire was the tool used, and the interviews were conducted face to face or using either telephone, zoom, or WhatsApp technology. The saturation was achieved by the 25th participant and data were analysed using the framework analysis technique. Nine medicinal foods including three herbal congees, one herbal beverage, one green leaf salad, and four curry preparations with antidyslipidaemic effects were explored. Sri Lankan native medicine possesses many medicinal foods with antidyslipidaemic effects and they should be explored, scientifically studied, and used as evidence-based management for the smooth control of diabetes mellitus

A traditional Chinese medicine versus Western combination therapy in the treatment of rheumatoid arthritis: two-stage study protocol for a randomized controlled trial

<p>Abstract</p> <p>Background</p> <p>The common randomized controlled trial design has distinct limitations when applied to Chinese medicine, because Chinese medicine identifies and treats 'Chinese medicine patterns' rather than diagnosed diseases. Chinese medicine patterns are a group of associated symptoms, tongue appearances and pulse characteristics. These limitations could be overcome by developing new strategies to evaluate the effect of Chinese medicine. The idea behind pattern-based efficacy evaluations may optimize clinical trial design by identifying the responsiveness-related Chinese medicine patterns.</p> <p>Methods/Design</p> <p>This is a two-stage multi-center trial of Chinese herbal medicine for the management of rheumatoid arthritis. The stage one trial is an open-label trial and aims to explore what groups of Chinese medicine information (such as symptoms) correlates with better efficacy, and the stage two trial is a randomized, controlled, double-blind, double-dummy clinical trial that incorporates the efficacy-related information identified in the stage-one trial into the inclusion criteria.</p> <p>Discussion</p> <p>The indication of a Chinese herbal formula is a specific Chinese medicine pattern and not a single disease and stratifying a disease into several patterns with a group of symptoms is a feasible procedure in clinical trials. This study is the first to investigate whether this approach in the design of Chinese herbal medicine trials can improve responses.</p> <p>Trial registration</p> <p>ChiCTR-TRC-10000989</p

A model for the introduction of Ayurvedic and Allopathic electronic health records in Sri Lanka

Fully integrated electronic health records EHR provide healthcare providers and patients access to records across a health care system and promise efficient and effective provision of health care. However, fully integrated records have proven to be very expensive and difficult to establish. The only EHR’s to have been developed solely accommodate Western medicine events. These barriers impact on the introduction of EHR’s in Sri Lanka, where health budgets are already stretched and Ayurvedic medicine is routinely practiced alongside Allopathic medicine. This article identifies requirements for EHR in the Sri Lankan context and advances a model for the introduction of EHR’s that particularly suits that context. The model is justified by drawing insights and experiences with EHR in Western nations

Evaluation of the In Vitro

Sudarshana powder (SP) is one of the most effective Ayurveda powder preparations for paediatric febrile conditions. The objective of the present study was to evaluate the in vitro and in vivo antioxidant potentials of SP. The in vitro antioxidant effects were evaluated using ABTS radical cation decolourization assay where the TROLOX equivalent antioxidant capacity (TEAC) was determined. The in vivo antioxidant activity of SP was determined in Wistar rats using the Lipid Peroxidation (LPO) assay in serum. The in vitro assay was referred to as the TROLOX equivalent antioxidant capacity (TEAC) assay. For the in vivo assay, animals were dosed for 21 consecutive days and blood was drawn to evaluate the MDA level. The in vitro antioxidant activity of 0.5 μg of SP was equivalent to 14.45 μg of standard TROLOX. The percentage inhibition against the radical formation was 50.93±0.53%. The SP showed a statistically significant (p<0.01) decrease in the serum level of thiobarbituric acid-reactive substance in the test rats when compared with the control group. These findings suggest that the SP possesses potent antioxidant activity which may be responsible for some of its reported bioactivities

Comparative Phytochemical Analysis and Antioxidant Activities of Tamalakyadi Decoction with Its Modified Dosage Forms

Background and Objective. Tamalakyadi decoction (TD) is a classical formulation mentioned in authentic traditional medicine text Sarasankshepaya under nasal diseases and used as a remedy for allergic rhinitis. It consists of 12 plant ingredients. Decoction preparations are widely used in Sri Lankan traditional system and considered effective and safe for treating many disorders. However, decoctions have to be used only in fresh state due to shorter shelf life and loss of stability. This decoction preparation method leads to decreasing the patient compliance and is also time consuming. Hence, the objective of the present study was to convert TD to consumer friendly novel dosage form, namely, freeze dried, spray dried, and traditional ganasara forms. Methodology. Therefore, we compared the phytochemical constituents and antioxidant activities of TD with its modified dosage forms. The chemical comparison of four dosage forms comprises phytochemical screening, TLC and HPTLC fingerprint profiles and the antioxidant activities by DPPH free radical scavenging activity, Ferric reducing antioxidant power (FRAP), total polyphenol content (TPC), and total flavonoid content (TFC). Results. Phytochemical screening revealed the presence of alkaloids, saponins, tannins, steroids, flavonoids, phenols, and terpenoids in all dosage forms. However, the saponins, alkaloids, flavonoids, terpenoids, and steroids were more prominent in TD and freeze dried preparation than the other two preparations. HPTLC fingerprint pattern of freeze dried dosage was more similar with HPTLC fingerprint pattern of TD in terms of number of peaks and their intensity compared to that of spray dried and ganasara dosage forms. Antioxidant activities such as DPPH, FRAP, TPC, and TFC were higher in decoction and freeze dried preparation than in spray dried and ganasara preparation. Conclusion. Freeze dried TD is the most suitable ready to use preparation having similar chemical properties and antioxidant activities to TD

Acute and Subchronic Oral Safety Profiles of the Sudarshana Suspension

Sudarshana powder (SP) is an Ayurvedic preparation, which contains 53 herbal ingredients along with 50% of Andrographis paniculata and is clinically used with bees honey. This study was aimed to determine the safety profile of the SP, and its novel preparation Sudarshana suspension (SS) on male Wistar rats and tolerance studies were conducted for healthy adult volunteers. Acute and subacute toxicity studies of the SS and hot water extract of SP were assessed in Wistar rats by observing the general behavior, analyzing biochemical and haematological parameters, and pathological observation. Healthy consented adult volunteers (n = 35) of either sex were selected, and tolerance studies of SS were tested by measuring the biochemical and haematological parameters. There were no significant (p>0.05) changes observed in the treated animals with SS and hot water extract of SP compared with control in body weights, food intake, and water consumption as well as the biochemical and haematological parameters. Histopathological studies revealed no significant (p>0.05) changes in the liver, heart, and kidney tissues. The experimental results suggest that novel formulation SS was potentially safe for chronic administration in rats, and no significant differences (p>0.05) were observed in tested parameters on day 3 and day 8 when compared to the day 0 (baseline) values in healthy volunteers. Healthy volunteers did not report any adverse effects or any other complications during the treatment period and the follow-up period. Therefore, it can be concluded that the novel preparation Sudarshana suspension does not cause any significant toxic effects on the blood parameters in animal and human models

A visual grid to digitally record an Ayurvedic Prakriti assessment; a first step toward integrated electronic health records

In recent years, factors including globalization and economic growth in India and Sri Lanka have driven an important modernization of Ayurvedic Medicine, characterized by increases in evidence-based research and initiatives to standardize remedies and procedures.1 Ramakrishna et al2 provide an important example of this trend with the standardization and validation of a questionnaire for the assessment of Prakriti. Prakriti represents an individual's unique personality, constitution or connection with the universe and is described on three dimensions or Dhosas; Kapha, Vata and Pitta. 3 Ayurvedic clinicians assess a patient's Dhosa profile in order to customize diagnoses and customize treatments. Conventionally, a Dhosa profile is described using linguistic phrases such as Kapha-Vata, or Pitta-Vata Prakriti..