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रविवार, 21 फ़रवरी 2016

Acharya charak, Acharya Chakrapani , and modern review : Annāvr̥ta Vāta

Acharya charak, Acharya Chakrapani , and modern review : Annāvr̥ta Vāta: 
Āhar when taken in excess the prokinetic movement is reduced and the āhar is not propelled forward leading to strech reflex. The pain of obstruction of hollow abdominal viscera is classically described as intermittent food related abdominal pain followed by remission.
Mūtra-āvr̥ta vāta: These symptoms are seen in mūtravega dharan. Normal urine formation takes place but the patient does not evacuate it timely leads to the avarodha of vāta gati. Vāta is unable to contract the detrusor muscle thus there is mūtra apravriti and inturn bladder distension. This condition may also arise in neurogenic bladder.
Atonic bladder – Micturition reflex contraction cannot occur if the sensory nerve fibres from the bladder to the spinal cord are destroyed, thereby preventing transmission of strech signals from the bladder. When this happens, a person loses bladder control, despite intact efferent fibers from the cord to the bladder and despite intact neurogenic connections within the brain. Instead of emptying periodically the bladder fills to capacity and overflows a few drops at a time through the urethra. This is called overflow incontinence. Crush injury is the common cause.
Purishāvr̥ta Vāta: Dietary fibres adsorb water and this increases the bulk of stools and helps reducing the tendency to constipation by encouraging bowel propulsive movements. Diet low in fibres content reduces the healthy bowel movements. Stools are formed but due to slow transit there is hard and pelty stool formation which finds it difficult to pass out.
Malavega dharan may also cause the above symptoms. In Diabetes mellitus whenever there is neurogenic involvement, peristalsis are reduced creating the above symptom. Spastic colon may also be considered.


Prof. Dr. Satyendra Narayan Ojha ,
MD (KC), Ph.D.
Director , Yashawant ayurveda college , Post graduate teaching and research center ,
Kodoli ,Panhala , Kolhapur..
 drsnojha@rediffmail. com   –

GINGER

 GINGER

Ginger (Zingiber officinale) is a member of the Zingiberaceae family and is consumed widely not only as a spice but also as a medicinal agent (see also Chapter 7 on ginger). Other members of the family include turmeric and cardamom. Ginger’s cultivation appears to have begun in South Asia and has now spread to various parts of the world. It is sometimes called “root ginger” to distinguish it from other products that share the name. The principal constituents of ginger include [6]-gingerol, [6]-paradol, [6]-shogaol (dehydration gingerols), and zingerone. Several studies have investigated ginger’s antioxidant properties (Chrubasik, Pittler, and Roufogalis 2005). Gingerol has also been shown to decrease intracellular ROS formation in human keratinocyte cells (Kim et al. 2007), inhibit angiogenesis in human ECs, and limit nitrogen oxide synthase expression and epidermal growth factor-induced cell transformation and AP-1 transcriptional complexes in JB6 cells (Bode et al. 2001; Ippoushi et al. 2003; Davies et al. 2005; Kim et al. 2005).
Feeding NIN/Wistar rats a diet containing up to 0.5-5% ginger for 1 month significantly increased (p < .05) several liver antioxidant enzymes, including superoxide dismutase (76–141%), catalase (37–94%), and GPx (11–30%; Kota, Krishna, and Polasa 2008). Lipid and protein oxidation was inhibited in rats consuming ginger, as evidenced by significant decreases (p < .05) in liver and kidney levels of MDA (35-59% and 27-59%, respectively) and carbonyl levels (23-36%), compared to controls (Kota, Krishna, and Polasa 2008). Ippoushi et al. (2007) found that AIN-76 basal diets with 2% ginger decreased TBARS by 29% (p < .05) and suppressed 8-hydroxy-2′-deoxyguanosine (8-OHdG, a product of oxidative DNA damage) levels in Wistar rats. TBARS was also significantly decreased (p < .001) in Wistar rats fed with diets supplemented with 1% ginger following exposure to lindane, a pesticide that is a global pollutant, (Ahmed et al. 2008).
Various animal models have been used to examine the role of ginger in cancer prevention. For example, Ihlaseh et al. (2006) exposed male Wistar rats to N-butyl-N-(4-hydroxybutyl)-nitrosamine (BNN) and uracil salt to induce tumors resembling human low-grade papillary urothelial neoplasia. Rats fed with a basal diet supplemented with 1% ginger extract for 26 weeks had significantly fewer urothelial lesions compared to the controls or those fed with the diet with 0.5% ginger (p = .013; Ihlaseh et al. 2006). However, ginger does not appear effective in all cases, as evidenced by the lack of protection against proliferative lesions in the bladders of Swiss mice fed with a 1% or 2% extract and exposed to BNN/N-methyl-N-nitrosourea (Bidinotto et al. 2006).
Induction of phase I and II activities may partially account for ginger’s anticarcinogenic actions. Banerjee et al. (1994)found that providing 10-μL ginger oil daily for 2 weeks to Swiss mice increased aryl hydrocarbon hydroxylase activity about 25% (p < .05) and increased GST by 60% (p < .01). No significant increase in GST induction was observed in Swiss mice fed with 160 mg ginger/gram diet (Aruna and Sivaramakrishnan 1990).
Inflammation is a significant risk factor for cancer, including prostate cancer. Mitogen-activated protein kinase phosphatase-5 (MKP5) is implicated as a proinflammatory inhibitor in innate and adaptive immune response in vivo (Zhang et al. 2004). Providing [6]-gingerol upregulated MKP5 expression in normal prostate epithelial cells treated with 50 μM gingerol; likewise, it upregulated MKP5 expression in human prostate cancer cell lines (DU145, PC-3, LNCaP and LAPC-4; Nonn, Duong, and Peehl 2007). Ginger extracts, more so than their individual components, have been shown to inhibit lipopolysaccharide-induced prostaglandin E2 (PGE2) production to an extent similar to that of indomethacin, a nonsteroidal anti-inflammatory drug. Subfractions of ginger extract decreased LPS-induced COX-2 mRNA expression levels, although apparently not through the nuclear factor κB (NF-κβ) or activating protein 1 (AP-1) transcription factor pathways, because the ginger extracts did not inhibit TNF-α production (Lantz et al. 2007). [6]-paradol, another active compound in ginger, is reported to induce apoptosis in human promyelocytic leukemia cells, JB6 cells, an oral squamous carcinoma cell line, and Jurkat human T-cell leukemia cells in a dosedependent manner (Huang, Ma, and Dong 1996; Lee and Surh 1998; Keum et al. 2002; Miyoshi et al. 2003). It is unclear whether [6]-paradol has molecular targets similar to [6]-gingerol.
Ginger also appears to have antitumorigenic properties. Several cell lines have been examined for their sensitivity to ginger. For example, alcoholic extracts of ginger inhibited tumor cell growth for Dalton’s lymphocytic ascites tumor cells and human lymphocytes at concentrations of 0.2-1 mg/mL in vitro (Unnikrishnan and Kuttan 1988). In a study of cytotoxic activities of several compounds in ginger against four tumor cell lines (A549, human lung cancer; SK-OV-3, human ovarian cancer; SK-MEL-2, human skin cancer; and HCT-15, human colon cancer), [6]-shogaol was the most potent (ED50: 1.05–1.76 μg/mL), and [4]-, [6]-, [8]-, and [10]-gingerol displayed moderate cytotoxicity (ED50: 4.92-30.05; Kim et al. 2008). Adding [6]-gingerol (25 μM) has been reported to inhibit proliferation in rat ascites hepatoma cells AH109A and increase apoptosis at higher concentrations (50 μM; Yagihashi, Miura, and Yagasaki 2008). Likewise, adding [6]-shogoal (60 μM) to COLO295 cells has been reported to increase the expression of GADD153, a gene that promotes apoptosis (Chen et al. 2007). [6]-shogaol (>50 μM) also provokes DNA damage and apoptosis through an oxidative stressmediated caspase-dependent pathway (Chen et al. 2007). Similarly, incubation of HEp-2 cells with ginger (250 μg/mL, 500 μg/mL, or 1000 μg/mL) resulted in a dose-dependent decrease in nitrite generation, increased production of superoxide, and decreased GSH levels compared to untreated cells, indicating ginger-induced apoptosis through the generation of ROS (Chen et al. 2007).
Ginger is also recognized for its potential usefulness to reduce nausea. To determine whether ginger had antiemetic effects in cisplatin-induced emesis, Manusirivithaya et al. (2004) conducted a randomized, double-blinded, crossover study in 48 gynecologic cancer patients. The addition of ginger (1 g/day) to a standard antiemetic regimen has no advantage in reducing nausea or vomiting in the acute phase of cisplatin-induced emesis. In the delayed phase, ginger and metoclopramide have no statistically significant difference in efficacy (Manusirivithaya et al. 2004). In another study, 1000 mg of ginger was compared to 20-mg intravenous (IV) metoclopramide, and to 4-mg IV ondansetron in controlling nausea in patients receiving cyclophosphamide chemotherapy. Ginger was determined to be as effective as metoclopramide, but neither was as effective as ondansetron (Sontakke, Thawani, and Naik 2003).
Overall, while the anticancer findings of ginger are intriguing and several processes may be associated with the observed responses, additional studies are needed to clarify the underlying mechanisms and to determine overall benefits to humans (Pan et al. 2008).


Prof. Dr. Satyendra Narayan Ojha ,
MD (KC), Ph.D.
Director , Yashawant ayurveda college , Post graduate teaching and research center ,
Kodoli ,Panhala , Kolhapur..
 drsnojha@rediffmail. com  - See more at: http://infoayushdarpan.blogspot.in/2016/02/salient-features-of-amlapitta.html#sthash.AP6bCKCS.dpuf

शुक्रवार, 19 फ़रवरी 2016

Salient features of Amlapitta

Salient features of amlapitta ; The acid environment within the stomach leads to cleavage of the inactive precursor to pepsin and provides the low pH (<2) required for pepsin activity. Pepsin activity is significantly diminished at a pH of 4 and irreversibly inactivated and denatured at a pH of >7. Achlorhydria leads to hypergastrinaemia. Enterochromaffin- like (ECL) cell hyperplasia with frank development of gastric carcinoid tumors may result from gastrin trophic effects. Hypergastrinaemia and achlorhydria may also be seen in non pernicious anaemia- associated type A gastritis. Drugs containing katu rasa maintain required pH to activate pepsin for its action on protein digestion..therefore its known as deepaniya .. Proton pump inhibitors can develop mild to moderate hypergastrinaemia and in turn carcinoid tumors in some experimental animals.. ayurveda drugs effective in amlapitta never develop such side effects , only because of katu and tikta rasa.. katu rasa produces achchha pitta not vidagdha pitta... Heart burn and regurgitation are common symptoms of GERD (urdhvaga amlapitta). Inherent in pathophysiologic model of GERD is that gastric juice is harmful to esophageal epithelium. However , gastric acid hypersecretion is usually not a dominant factor in development of esophagitis. One caveat is with chronic H.pylori gastritis, which may have a protective effect by inducing atrophic gastritis with concomitant hypoacidity. Pepsin, bile and pancreatic enzymes within gastric secretion can also injure esophageal epithelium. Bile warrants attention because it persists in refluxate despite acid suppressing medications. Bile can transverse cell membrane , imparting severe cellular injury in a weakly acidic environment, and has also been invoked as a cofactor in pathogenesis of Barrett's metaplasia and adenocarcinoma. Hence, the causticity of gastric refluxate extends beyond hydrochloric acid.. kutaki , amrita , kiraatatikta , shataavari , aamalaki ,avipattikara churna , bhoonimbaadi kvaatha, daadimaadi ghrita , kushmaanda avaleha ,etc drugs are best options in urdhvaga amlapitta and to prevent metaplasia...

.Prof. Dr. Satyendra Narayan Ojha ,
MD (KC), Ph.D.
Director , Yashawant ayurveda college , Post graduate teaching and research center ,
Kodoli ,Panhala , Kolhapur..
 drsnojha@rediffmail. com - See more at: http://infoayushdarpan.blogspot.in/#sthash.6O6eCEsw.dpuf

Acharya charak and modern hypothesis of Bronchial asthma and COPD ( Shvaasa roga )

 Acharya charak and modern hypothesis of Bronchial asthma and COPD ( Shvaasa roga )

the considerable overlap between persons with asthma and those with COPD on airway responsiveness ,airflow obstruction , and pulmonary symptoms led to the formulation of Dutch hypothesis. This suggests that asthma , chronic bronchitis and emphysema are variations of the same basic disease, which is modulated by environmental and genetic factors to produce these pathologicaly distinct entities. The alternative British hypothesis contends the asthma and COPD are fundamentally different diseases ; Asthma is viewed as largely an allergic phenomenon, while COPD results from smoking-related inflammation and damage. Acharya Charak mentioned Rajasa (pollen grains/allergens) Dhooma ( smoking ) vaataabhyam.... etc as hetu of shvaasa roga.. as per acharya chakrapani ; rajasa ityaadinaa prayo vaata prakopakagano vichchhidyoktah gadaavimaavityantena , nishpaava ityaadinaa kaphakaaranatayaa hikka shvaasayoh kaphaprakopa hetu gano abhihitah ; tadanena vaatajanaka kaphajanaka hetu varga dvaya vichchhet paathena vaatakaphayoh atra svahetukupitatvena svaatantryam darshayati , na anubandhamaroopatvam.. it means two different groups of etiological factors induce shvaasa roga separately ; vaata and kapha are vitiated by their hetu separately to initiate disease process.. Both extrinsic and intrinsic factors are mentioned as hetu of shvaasa roga. In samprapti of shvaasa roga acharya charak mentions vishvagvrajati ( sarvato gachchhati ) , means nonuniform ventillation , discarded ventillation and mismatching between ventillation and perfusion , a cardinal pathophysiology of shvaasa roga.. in an other reference ( ch.chi 18/131) acharya refered Tamakah kaphakaase tu syaachchet pittaanubandhajah... when there is secondary infection occurs in patient with chronic bronchitis , airway obstruction develops and in turn manifests severe dyspnea similar to episode of bronchial asthma (earlier known as infective bronchial asthma ). Since centuries the concept about shvaasa roga is very clear in ayurveda.. Determination of the validity of Dutch hypothesis Vs. British hypothesis awiats identification of the genetic predisposing factors for asthma and /or COPD ,as well as the interactions between these postulated genetic factors and environmental risk factors.. acharya charak mentioned very clearly the role of vaata and kapha in shvaasa roga ; Yadaa srotaansi sanroodhya maarootah kaphapoorvakah. Vishvagvrajati sanroodhah tadaa shvaasaat karoti sah..maaroota , kapha  Hyperresponsiveness of bronchial smooth muscles and inflammation of airways  airway obstruction  shvaasa roga ( bronchial asthma and COPD)..Acharya charak mentions tila taila as hetu of hikkashvaasa ( ch.chi 17).. Nishpaava maasha pinyaaka tila tail nishevanaat are observed as hetu of pandu roga and shvaasa hikka.. Acharya charak mentioned the same hetu in vidhi shonatiya adhyaaya.. means these are causes of raktaja roga. I think these all nishpaavaadi are hetu of kapha prakopa and rakta dushti..its kaphaprakopaka hetu , very clearly told by acharya chakrapani..Tila may lead to histamine liberation by mast cells after allergen - IgE binding on surface of mast cells.. Hyperresponsiveness may be caused by tila or tila tail or any hetu mentioned in shvaasa roga.. Ie srotaansi sanroodhya/airway obstruction.. references ; Charak sanhita and Harrison 's principles of internal medicine...

.Prof. Dr. Satyendra Narayan Ojha ,
MD (KC), Ph.D.
Director , Yashawant ayurveda college , Post graduate teaching and research center ,
Kodoli ,Panhala , Kolhapur..
 drsnojha@rediffmail. com