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      A Randomized open label parallel group pilot study to evaluate efficacy of Ayurveda interventions in the management of Asymptomatic and Mild COVID-19 patients-Experiences of a Lucknow based Level 2 hospital of Uttar Pradesh, India

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          Abstract

          Background

          Sars Cov-2 has emerged as a global threat since its onset in December 2019. India has also been severely affected by the dreadful Corona Virus and is currently battling one of the worst pandemics of history. WHO and the world medical fraternity are putting their efforts to materialize a treatment or vaccine for this novel virus. A randomized open label parallel group study was designed in a Lucknow based level 2 COVID hospital to evaluate the efficacy of Ayurvedic interventions in the management of asymptomatic and mild COVID 19 patients.

          Objectives

          To evaluate the efficacy of Ayurveda in the management of mildly affected COVID-19 patients.

          Materials and methods

          The current trial was an open label randomized 10-day study. Total 120 asymptomatic and/or mild Covid-19 positive patients fulfilling inclusion criteria were randomly grouped into three. RT-PCR of all the patients were done on 5 th, 7 th and on 10 th day respectively. The observations were noted and results were analyzed statistically. Kruskal-Wallis test and Wilcoxon Sign rank test were used for data analysis where applicable.

          Results

          Improvement in symptoms, enhancement in Agni and recovery from COVID infection was observed. The results obtained were encouraging and showed better viral clearance and control of symptom progression in the patients placed on Ayurvedic medications.

          Conclusion

          The promising results in the study showed that an approach involving Ayurveda can be helpful for the management of the mild COVID-19 patients. Ayurveda can be used to limit community spread and check disease progression to a more appalling state.

          Trial registration

          Trial was registered with Clinical Trials Registry- India (CTRI registration number: CTRI/2020/06/025800.

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          Most cited references 10

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          Vitamin C intake and susceptibility to pneumonia.

           H Hemilä (1997)
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            Anti-inflammatory effects of zingiber officinale in type 2 diabetic patients.

            Low-grade inflammation, a common feature in type 2 diabetes (DM2), causes some chronic complications in these patients. The present study was aimed to evaluate the effects of ginger (Zingiber officinale) on pro-inflammatory cytokines (IL-6 and TNF-α) and the acute phase protein hs-CRP in DM2 patients as a randomized double-blind placebo controlled trial. A total of 64 DM2 patients randomly were assigned to ginger or placebo groups and received 2 tablets/day of each for 2 months. The concentrations of IL-6, TNF-α and hs-CRP in blood samples were analyzed before and after the intervention. Ginger supplementation significantly reduced the levels of TNF-α (P = 0.006), IL-6 (P = 0.02) and hs-CRP (P = 0.012) in ginger group in comparison to baseline. Moreover, the analysis of covariance showed that the group received ginger supplementation significantly lowered TNF- α (15.3 ± 4.6 vs. 19.6 ± 5.2; P = 0.005) and hs-CRP (2.42 ± 1.7 vs. 2.56 ± 2.18; P = .016) concentrations in comparison to control group. While there were no significant changes in IL-6 (7.9 ± 2.1 vs. 7.8 ± 2.9; P > .05). In conclusion, ginger supplementation in oral administration reduced inflammation in type 2 diabetic patients. So it may be a good remedy to diminish the risk of some chronic complications of diabetes.
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              In vitro NADH-oxidase, NADPH-oxidase and myeloperoxidase activity of macrophages after Tinospora cordifolia (guduchi) treatment.

              It is believed that the enhanced microbicidal and tumoricidal capability of activated macrophages is related to the remarkable increase in the production of oxygen metabolites. Both the production of H2O2 and the oxidation of NAD(P)H are directly dependent upon NAD(P)H-oxidase. It has been established that the respiratory burst is due to activation of NAD(P)H-oxidase localised in the plasmalemma. Myeloperoxidase is believed to be involved in augmenting the cytotoxic activity of H2O2. It was observed that the macrophage cell line J774A.1 when treated with Tinospora cordifolia (guduchi) and LPS showed enhanced NADH-oxidase, NADPH-oxidase and myeloperoxidase production as compared to macrophages treated with medium alone. The direct drug treatment to J774A cells showed activation as assessed by biochemical assays. These results suggest that high NADH-oxidase, NADPH-oxidase and myeloperoxidase activities may account for tumoricidal and microbicidal properties via macrophage activation.
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                Author and article information

                Contributors
                Role: Chief Medical Superintendent
                Role: Consultant
                Role: General Manager
                Role: Associate professor
                Role: Statistician
                Role: Pathologist
                Role: Medical Superintendent
                Journal
                J Ayurveda Integr Med
                J Ayurveda Integr Med
                Journal of Ayurveda and Integrative Medicine
                The Authors. Published by Elsevier B.V. on behalf of Institute of Transdisciplinary Health Sciences and Technology and World Ayurveda Foundation.
                0975-9476
                0976-2809
                2 February 2021
                2 February 2021
                Affiliations
                [a ]Panchakarma Specialist, Panchakarma Unit, Lokbandhu Rajnarayan Combined Hospital, Lucknow, 226012
                [b ]Director General Health and Medical services, Uttar Pradesh, Lucknow
                [c ]LBRNCH, Lucknow
                [d ]State plan management unit, Mainstreaming of Ayush, NHM Uttar Pradesh, Lucknow
                [e ]Department of RSBK, All India Institute of Ayurveda, New Delhi 110076
                [f ]Department of Community Medicine, CIMS&H, Lucknow
                Author notes
                []Corresponding author. Panchakarma Unit, Lokbandhu Rajnarayan Combined Hospital, H.No. 293/28, Old Haiderganj, Lucknow 226003. . No.: 7060272769.
                Article
                S0975-9476(20)30143-1
                10.1016/j.jaim.2020.12.013
                8054441
                © 2021 The Authors

                Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

                Categories
                Original Research Article

                Complementary & Alternative medicine

                covid-19, ayurveda, randomized trial, immunity, agni

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