Journal of Ayurveda and Holistic Medicine (JAHM)

Vanshatwakadi Agada in the management of Loota Visha (Spider bite poisoning): A narrative review.

2026-04-15T07:15:44+00:00

Background: In Ayurveda, 'Gada' refers to the disease or suffering, whereas 'Agada' refers to antidote which alleviates the effect of the disease or poison exposed locally or internally. There are various Agada or antidote formulations which are indicated to counteract both animate and inanimate poisons in Agada tantra (Clinical Toxicology). This branch is among the eight branches of Ayurveda and that is Ashtanga Ayurveda which commonly deal with bites and poison management. Vanshatwakadi Agada is one such formulation referenced from the Sushruta Samhita Kalpa-sthana (Sarpadashta Visha Chikitsa), indicated in Loota Visha (spider bite poison). The Agada combine eleven ingredients - Vansha twak (Bambusa arundinacea Willd.), Amalaki (Emblica officinalis Gaertn.), Kapitha (Feronia limonia Linn. Swingle), Kushtha (Saussurea lappa C.B. Clarke), Shunthi (Zingiber officinale Roxb.), Maricha (Piper nigrum Linn.), Pippali (Piper longum Linn.), Hemavati (Acorus calamus Linn.), Karanja (Pongamia pinnata Linn Merr.), Tagara (Valeriana wallichii DC), Shirisha (Albizzia lebbeck Bent.) with cow’s bile to alleviate sign and symptoms of Loota Visha. This article aims to discuss the role of Vanshatwakadi Agada as an antidote for reducing sign and symptoms of Loota Visha by analysing the pharmacological property and therapeutic utility of individual ingredients. Materials and methods: Several classical texts were referenced including Sushruta Samhita, Ashtanga Hridya, Ashtang Sangraha, Bhavapraksha Samhita, Sharangdhara Samhita and textbooks like Dravyaguna Vigyana and Agada Tantra. Jangama Visha, Loota Visha, Agada formulation, Chikitsa etc. were used as search terms in database search. Conclusion: The Vanshatwakadi Agada given in Sushruta Samhita have potential role in managing Loota Visha symptoms. The pharmacological characteristics and medicinal properties of Vanshatwakadi Agada are highlighted in this article in relation with contemporary concepts.

Transitional curriculum under NCISM's current status, need for updating, and gaps: A narrative review.

2026-04-10T06:54:06+00:00

Background: The changeover from higher secondary education to professional medical education requires significant changes in psychological, social, and academic components. Ayurveda as a profession is a lifelong commitment to connect deeply with classical texts and guide needy patients in their journey of healing. The students choosing a B.A.M.S. need to study the core of Ayurveda texts along with the modern perspectives and practices. Recognizing the challenges faced by young and new students, NCISM implemented the transitional curriculum “Ayurpraveshika -2025-2026” for first-year undergraduates. Objectives: This narrative review explores the current status of the “Ayurpraveshika 2025-26 transitional curriculum," the need for its implementation, and gaps to be addressed in the future. Methods: Related literature was identified through PubMed, Scopes, Google Scholar, and Research Gate using keywords "transitional curriculum" and "Ayurveda," which were reviewed to summarize trends, applications, and ethical concerns. Conclusion: The primary need for this curriculum arises as students entering this course are from diverse educational backgrounds, have limited exposure to Sanskrit-based classical texts, are unacquainted with Ayurveda's basic concepts and its future opportunities, are unaware of medical terminologies, and have inadequate preparation for the rigorous professional learning environment. This transitional curriculum is essential to improve learner confidence, make them goal-oriented right from the 1st year, reduce fear and anxiety of Ayurveda concepts, enhance academic and clinical skills, ignite the curiosity of health services, research, and entrepreneurship, and ensure holistic development among students with mindfulness.

Role of Nasya in Vata Vyadhi (neurological disorders): A critical narrative review

2026-03-06T05:34:58+00:00

Background: Nasya Karma which is one among the Panchakarma, has got an important role in the management of Urdhvajatrugata Vikara. Ayurvedic classics also describe the dissemination of Nasya Dravyas (drugs) through Shringataka Marma and various channels, indicating its potential for systemic action including Vata Vyadhi. Objectives: To highlight specific Ayurvedic formulations for Nasya and exploring its role in managing Vata Vyadhi. Methods: A critical manual review of classical Ayurvedic texts, including Brihattrayi, Laghutrayi and various Uttarkalina Samhitas for Nasya in Vata Vyadhi revealed 74 different entries. All 74 indications are analysed according to different formulations in various Vata Vyadhi w.s.r. to neurological disorders. Results: Out of 74 formulations, 30 formulations are mentioned in Brihattrayi and Uttarkalina Samhita each, followed by 14 Yoga in Laghutrayi. Maximum formulations i.e. 64 are of Sneha Kalpana, out of which 53 are of Tail followed by 9 of Ghrita, 1 of Vasa and Majja each. In addition to Sneha Kalpana, 5 of Swarasa, 3 of Kwatha, 1 formulation each of Churna and Sheetal Jala is mentioned. Conclusion: The analyzed classical references support the potential of Nasya in the management of Vata Vyadhi w.s.r to neurological disorders. Specifically, the results indicate the potential of Snehana Nasya in the management of various Vata Vyadhi, as formulations having Sneha predominance are repeatedly mentioned across different Ayurvedic texts.

Lepa Kalpana of Yogaratnakara: A narrative review

2026-04-10T17:35:48+00:00

Background: Acharya Charak has explained three treatment modalities, in which Lepa is one of the widely used models of Bahir-parimarjan (treatment modalities used externally). As other treatises Yogaratnakara is widely popular amongst ayurveda practitioners as a handbook for ayurveda treatments for various diseases. Objectives: To study conceptual foundation of Lepa Kalpana and to analyse data of compiled formulations of Lepa from Yogaratnakara. Material and methods: For conceptual study of Lepa chikitsa comprehensive review of Charak Samhita, Sushrut Samhita, Ashtang Hriday, Sharangdhar Samhita, Bhavaprakash Samhita and Yogaratnakara was done. Formulations of Lepa mentioned in various diseases in Yogaratnakara was compiled, analysed and reported in summarized view. Result: In Yogaratnakara 511 Lepa formulations are described for various diseases and conditions. Benefits of Mukhalepa are emphasized. Contraindications of Lepa chikitsa also explained. Generally, Lepa is a derivative of Kalk Kalpana, but in Yogaratnakara, various formulations of Bhaishajya Kalpana are described for the application of Lepa, like herbal juices, carbonised black coloured ash of herbs, decoction, oils, biomedical fermentations, etc. With Herbal ingredients major mineral, and animal sources are utilized for the formation of Lepa. Lepa chikitsa advised in various conditions of almost 61 diseases. On the basis of study, functions of Lepa are classified into 31 types. Lepa Chikitsa mainly has its local effect, but in some conditions, it shows a systemic effect. Conclusion: Lepa Chikitsa might not be a perfect first line of treatment in all diseases or conditions, but it will provide greater help as a supportive treatment.

Exploring the pathophysiology of valvular heart disease through the lens of ayurveda: A narrative mini review.

2026-04-04T05:57:34+00:00

Background: Cardiovascular diseases have become one among the leading global burden in the society with an estimated number of mortality and morbidity of 17.9 million lives per year. In the current era of modernization having sedentary life style, fat enriched diet, stressful jobs etc. further increase the incidence rate of cardiac disorder. Valvular Heart Disease (VHD) embodies the disorder afflicting cardiac valves. The patient is usually asymptomatic at the earlier stage but symptoms exacerbate with the severity of the disease. The contemporary science manages mild to moderate VHD with symptomatic medication and with the severity, surgical intervention for valvular repair or replacements are opted. The Surgical invasions are exceptionally high and also reported to have post-operative complications. Objective -The objective of this review article is to analyze the pathophysiological understanding of valvular heart disease bridging the various aspect of Hridroga (heart diseases) explained in the ancient ayurvedic classics. Materials and methods: The references related to hridroga and valvular heart diseases are collected from various ayurvedic texts, indexed journals and cardiology books. Keywords Valvular heart disease AND hridroga and VHD OR hridroga prevalence are used for searching the literature in PubMed. Results and Discussion: VHDs in ayurveda can be understood where the diseased valve may be stenosed or may develop laxity is usually due to improper kapha or vata condition. The risk factors and management are explained. Conclusion- Ayurveda can provide a novel approach in the management of Valvular Heart to enhance and improve the quality of life of VHD patients.

Double-Blind Randomized Controlled Trial Evaluating the Antipyretic Efficacy of Panchatikta Kashaya Rectal Suppository in Children Aged 1–5 Years: Study Protocol

2026-04-12T07:42:00+00:00

Background: Fever is a frequent pediatric presentation and, though physiologically protective, may cause adverse outcomes if inadequately treated. Conventional antipyretics are limited by tolerability and challenges in oral administration in young children. Ayurveda describes fever as Jwara, arising from impaired Agni (digestive fire), Ama (metabolic toxin) accumulation, and Dosha (humor) imbalance, for which Tikta-rasa (bitter taste) predominant formulations are indicated in early stages. Panchatikta Kashaya, described in Chakradatta Jwara Cikitsa, possesses antipyretic potential but has poor palatability. Rectal delivery, as Gudavarti (rectal suppository), offers improved absorption and compliance. This double-blind randomized controlled trial evaluates the antipyretic efficacy of Panchatikta Kashaya Gudavarti in children aged 1-5 years with mild to moderate fever, compared with Amrutottaram Kashaya Gudavarti. Objective: To compare and assess the antipyretic efficacy of a single administration of Panchatikta Kashaya Gudavarti with Amrutottaram Kashaya Gudavarti (rectal suppositories) in children aged 1-5 years. Methods: The ongoing study is a prospective, double-blind, randomized controlled, superiority, single-center, efficacy trial of a total 50 participants diagnosed with Jwara (Fever). The trial group will receive single administration of Panchatikta Kashaya Gudavarti, rectal suppository of 2 grams, and the antipyretic effect will be assessed 15 minutes, 30 minutes, 1 hour, 2 hours, and 3 hours post-administration based on the reduction in temperature. Control group participants will similarly receive Amrutottaram Kashaya Gudavarti of 2 grams, and will be assessed for reduction in temperature in the same way. The primary outcome is the reduction in temperature and other features of fever on GRASP fever chart and graded clinical parameters of Jwara. The secondary outcome measure is to note the comparative efficacy of Panchatikta Kashaya Gudavarti with Amrutottaram Kashaya Gudavarti. Conclusion: The study is expected to demonstrate the safety and efficacy of the Ayurvedic intervention Panchatikta Kashaya Gudavarti (rectal suppository) in reducing mild to moderate fever.

Integrative Management of Diabetic Foot Gangrene: A Case Report

2026-04-12T08:18:34+00:00

Background: Diabetic foot gangrene (DFG) remains a major clinical challenge, particularly in patients with coexisting peripheral arterial disease. This coexistence can delay intervention, which may lead to limb loss. In Ayurveda, this condition can be considered under the concept of Kotha and Dushtavrana. Ayurveda texts clearly state the multimodal management strategy for the same. Clinical Findings: A 41-year-old male with a history of Type 2 diabetes mellitus for 1 year presented with black discoloration of the first to third toes of the left foot associated with swelling, pus discharge, and sensory loss. Imaging and clinical features supported the diagnosis of both Buerger’s disease and Diabetic foot gangrene. After careful assessment, the overall presentation favored the diagnosis of DFG. Based on Ayurveda principles, the diagnosis of Vata-pittaja dushta vrana was made. Intervention: Chedana karma in the form of disarticulation of the second and third toes and debridement of the first toe was done, followed by conservative treatment. A single dose of prophylactic antibiotic was given before the procedure. It included Panchatiktak ghrita guggulu, Gandharva haritaki churna orally, Jatyadi ghrita application locally, and Jalauka-avacharana (leech therapy) for a total of seven alternate-day sittings. Management also included continuation of antidiabetic medication, smoking cessation, and routine supportive measures in the form of offloading using Microcellular rubber footwear and a diabetic diet. Outcome: Complete (100%) wound healing was seen within 14 days without any flap necrosis. Vibration perception threshold reduced from 30V (severe neuropathy) to 22 V (normal). The patient was able to resume his regular duties within a month. No adverse event was observed during the treatment. The patient was followed up for 1 year, and no recurrence of symptoms was observed. Conclusion: This case demonstrates integrative approach to the management of diabetic foot gangrene is beneficial in preventing major limb loss and disability.

Comprehensive Ayurvedic Management of Treatment Resistant Major Depressive Disorder: A Case Report

2026-04-04T10:56:10+00:00

Background:

Major Depressive Disorder (MDD), a frequently found severe psychiatric condition which leads to significant impairment in mood, cognition, daily functioning as well as overall quality-of-life. Features include depressed mood, loss-of-interest, feelings of worthlessness, guilt and reduced sleep. In Ayurveda, such conditions parallel with Kaphaja unmada involving vata and tama dosha. Clinical Findings: A 21-year-old-male presented with chief complaints of low mood, loss-of-interest, feeling of worthlessness, hopelessness, suicidal thoughts, feeling guilty and reduced sleep. His general appearance was poorly groomed, sad with reduced motor-activity. On examination reveals slow speech with low-pitch-voice, depressed mood with abnormal thought content. The severity was checked by assessment scales : Hamilton Depression Rating Scale (HAM-D) 32 and The Montgomery–Asberg Depression Rating Scale (MADRS) 30, reveals severe depression. Hamilton Anxiety Rating Scale (HAM-A) score 25 suggesting severe anxiety and Beck’s Hopelessness (BHS) 23 indicating moderate hopelessness. As per DSM-V-TR, diagnosed as MDD, characterized by depressed mood, loss-of-interest, feeling of worthlessness and insomnia. Intervention:Intervention encompassed comprehensive protocol spanning over 375 days with 2-in-patient admissions comprising Shodhana, External procedures, nasya along with oral medications, Satwawajayachikitsa (psychotherapy) and yoga. Outcome: Gradual improvement was observed in assessment parameters across multiple domains. HAM-D reduced to 13 from 32, MADRS reduced to 12 from 30, HAM-A reduced to 10 from 25 and BHS reduced to 8 from 13, at baseline, indicating clinical improvement in mood disturbances and anxiety. Conclusion: A chronic case of treatment-resistant severe depression with recurrent episodes, on combined therapy, showed marked improvement after comprehensive management, as assessed through HAM-D, MADRS, HAM-A and BHS domains without any adverse events. Long-term follow-up of 12 months shows sustained relief and improved daily functioning in MDD. This case explains the role of comprehensive Ayurveda protocol in the management of treatment-resistant severe depression.

Ayurvedic Approach to Schizoaffective Disorder, Depressive type, with combined with AUD: A Case report

2026-04-10T17:00:35+00:00

Background: Schizoaffective disorder, depressive type with comorbid alcohol use disorder, is a complex condition with overlapping psychotic, mood, and substance-use symptoms. Diagnosis and management are challenging. In Ayurveda, it aligns with Sannipataja Unmada, where there is a coexistence of psychotic and mood symptoms, including both positive symptoms like hallucinations, delusions, and negative symptoms like social withdrawal, impaired cognition, blunted affect, and it's a highly debilitating condition. Clinical findings: A 50-year-old alcoholic male with a known case of Type 2 Diabetes Mellitus and Hypertension for 15 years, on treatment with irregular adherence leading to suboptimal glycaemic and blood pressure control, presented with longstanding low mood, frequent anxiety, occasional hallucinations, paranoid ideation, and persistent alcohol use despite repeated medical advice. Mental health examination revealed impaired memory and concentration, partial insight, and mild psychomotor agitation. Standardised assessments revealed moderate-to-severe depressive symptoms (HDRS), mild anxiety, harmful drinking (AUDIT), cognitive impairment (MMSE), and positive suicidality (C-SSRS). Based on clinical presentation and ICD-11, Schizoaffective Disorder, Depressive Type with Alcohol Use Disorder was diagnosed. Intervention: protocol was administered alongside ongoing pharmacotherapy. This included Panchakarma (Nasya), external therapies (Shirodhara, Shiropichu, etc.), Shamana medicines (Brahmi Vati, Draksharishtam, etc.), Satwawajaya Chikitsa (psychotherapy), Marma therapy, and Yoga. Outcome: The patient showed significant overall improvement over 90 days of treatment, with cognitive function (MMSE) improving by 43.8%. There was a marked reduction in depressive (65.4%), anxiety (50%), insomnia (33.3%), alcohol use (46.7%), suicidality (90.9%), and psychotic symptoms (34.9%). These findings indicate clinical recovery and stabilization, but not remission, and thus require continued management. Alcohol dependence made abstinence challenging, though intake was reduced, with the last use before admission. Conclusion: A multidimensional Ayurvedic treatment approach can help to address and manage diagnostic and therapeutic challenges in schizoaffective disorder with alcohol use disorder. While outcomes are promising, validation through larger controlled studies is required.

Early Integrative Management of Visarpa (Herpes Zoster) with Jalaukavacharana (Leech Therapy): A Case Report

2026-03-25T11:06:19+00:00

Background: Herpes zoster is a viral infection characterized by painful vesicular eruptions unilaterally with a propensity for post-herpetic neuralgia despite standard antiviral therapy. It resembles the features of Visarpa in Ayurveda, and Raktamokshana is indicated as a line of treatment. This is a peculiar case of early leech therapy as an adjunct to conventional treatment in herpes zoster for its neural complications as well as pain relief. Clinical Findings: A 25-year-old female had an episode of severe burning pain associated with erythema and grouped vesicular eruptions over the left side of the neck as well as the upper chest for 2 days. Pain was severe (7 on Visual Analog Scale-VAS). Eruptions were limited to left C3, C4 dermatomes with no secondary infection. Intervention: Patient was treated with 3 sittings of Jalaukavacharana along with Kaishora Guggulu, Mahamanjishthadi Kashaya, and Avipattikar Churna. Shatadhauta Ghrita was applied locally from the 7th day. Antiviral therapy (acyclovir for 5 days) was given concomitantly for supportive purposes. Outcome: There is a considerable reduction in burning pain and erythema following initiation of integrative treatment, including Jalaukavacharana, internal Ayurvedic medications, and antiviral therapy. Vesicular lesions healed in due course. Lesions disappeared by 30 days. Overall, the VAS score was reduced to 0 by the 15^th day. There were no episodes of post-herpetic neuralgia during the 6-month follow-up period. No adverse effects were noted. Conclusion: Early application of leech therapy sittings at alternate intervals along with internal ayurvedic medicines for 1 month and supportive antiviral therapy had rapid pain relief, increased healing, and prevented post-herpetic neuralgia without any adverse events. This highlights the role of integrative management and Jalaukavacharana as early intervention in herpes zoster in order to accelerate the healing process and avoid complications, including PHN. Further large-scale clinical trials are needed to validate these findings.

Selection of Ayurvedic Formulations for the Management of Amlapitta (Functional Dyspepsia) Using the RAND/UCLA Appropriateness Method: A Modified RAND/UCLA Consensus Study

2026-02-27T11:22:37+00:00

Background: Functional dyspepsia is a highly prevalent functional gastrointestinal disorder characterized by heterogeneous symptom presentation; there is limited consensus on the optimal approach for long-term management. Classical Ayurveda describes such a condition as Amlapitta and recommends multiple formulations for management based on the predominant dosha. Lack of standardized, transparent criteria in order to select specific formulations for clinical research is a major lacuna in this context. RAND/UCLA Appropriateness Method provides a structured framework for integrating available evidence with expert clinical judgment in such scenarios. Objective: To identify classical Ayurveda formulations considered appropriate for management of Amlapitta based on dosha specific presentations using a modified RAND/UCLA Appropriateness Method to inform future clinical research. Methods: A structured Modified RAND/UCLA Appropriateness Consensus was conducted. Evidence was synthesized from classical Ayurvedic texts and biomedical literature. A multidisciplinary expert panel of 9 experts independently rated the appropriateness of shortlisted formulations for dosha-based presentations of Amlapitta on a 9-point scale. Ratings were carried out over 2 rounds with discussion intervening between the rounds. Agreement, disagreement, and final appropriateness classifications were arrived at by standard RAND criteria, including median scores, inter-percentile ranges, and disagreement parameters. Results: 6 Ayurvedic formulations were evaluated across 3 dosha specific types of Amlapitta: Vataja, Kaphaja and Vatakaphaja. After 2 rounds of consensus, 3 combinations were classified as appropriate, 7 as uncertain while none as inappropriate. Kamadugha Rasa, Leelavilasa Rasa and Shankha Vati were rated appropriate for Vataja, Kaphaja and Vatakaphaja Amlapitta respectively, each signifying strong agreement among panelists (DI <1). Conclusion: RAND/UCLA Appropriateness Method application in the selection of formulations for Amlapitta in the current study signifies how structured expert judgement can bridge classical Ayurvedic knowledge and contemporary research standards. Implications of this approach can strengthen methodological rigor, improve standardization, and enhance the credibility of future Ayurvedic clinical trials.