592SHARMA AND CHANDOLAshown promis<strong>in</strong>g results as adjuvants to the pr<strong>in</strong>cipal ther-conta<strong>in</strong> a detailed description <strong>of</strong> lifestyle management lor ; apy \ . patients with diabetes. In a survey study <strong>of</strong> 100 pa-with type 2 diabetes, disturbances <strong>in</strong> mental healthPmmeha. Sushruta Samhita emphasizes the importance <strong>of</strong> iriertaregular exercise, <strong>in</strong>clud<strong>in</strong>g brisk walk<strong>in</strong>g, jogg<strong>in</strong>g, sports, (e.g., I anger, grief, worry, fear, anxiety, <strong>and</strong> so on) were nowrestl<strong>in</strong>g, fenc<strong>in</strong>g, horseback rid<strong>in</strong>g, <strong>and</strong> so on. Patients areadvised to avoid laz<strong>in</strong>ess <strong>and</strong> a sedentary lifestyle. It is essential to perform exercise such as walk<strong>in</strong>g or jogg<strong>in</strong>g tobum extra calories <strong>in</strong> the body. Sushruta Samhita states that ifa person follows an active lifestyle, he/she can overcomeApathyanimittaja (acquired) <strong>Prameha</strong> "with<strong>in</strong> 1 year.5 Exercisebr<strong>in</strong>gs lightness to the body, reduces fat, <strong>and</strong> improves theability to work. Ayuroeda recommends stopp<strong>in</strong>g the workoutwhen slight sweat<strong>in</strong>g develops on the forehead. The Ayurvedictexts provide a cautionary note about the preservation<strong>and</strong> ma<strong>in</strong>tenance <strong>of</strong> hea'Ith for asthenic diabetics (type 1 diabetics) s<strong>in</strong>ce they are Vata-predom<strong>in</strong>ant. These patients arenot advised to undertake vigorous exercise, as it will furtherprovoke Vata <strong>and</strong> result <strong>in</strong> a poor prognosis.Meditation, Pranai/ama (breath<strong>in</strong>g exercises), <strong>and</strong> A
PRAMEHA IN AYURVEDA, PART 2Box 1. Research <strong>in</strong> Theses, CD-ROM, <strong>and</strong> WebsiteBhatia S, Ch<strong>and</strong>ola HM, S<strong>in</strong>gh G. A cl<strong>in</strong>ical study on the role <strong>of</strong> Manasa Bhava <strong>in</strong> the etiopathogenesis <strong>of</strong> Madhumeha<strong>and</strong> its management by Saraswata Choorna. MD(Ayu) thesis. Institute for Post Graduate Teach<strong>in</strong>g & Research <strong>in</strong>Ayurveda, Gujarat Ayurvcd University, Jamnagar, India, 2001.Plants <strong>of</strong> Ayurveda, version 1.0, CD ROM on Dravyaguna. Sponsored by M<strong>in</strong>istry <strong>of</strong> Environment <strong>and</strong> Forest, Government <strong>of</strong> India (New Delhi) <strong>and</strong> RGUHS (Bangalore). Designed <strong>and</strong> developed by FRLHT (Bangalore), 2005.S<strong>in</strong>gh B, S<strong>in</strong>gh G, Vyas SN, Ch<strong>and</strong>ola HM. The role <strong>of</strong> Virerhana <strong>and</strong> herbal drugs <strong>in</strong> the management <strong>of</strong> Madhumeha(diabetes mellitus). MD(Ayu) thesis. Institute for Post Graduate Teach<strong>in</strong>g <strong>and</strong> Research <strong>in</strong> Ayurveda, Gujarat AyurvedUniversity, Jamnagar, India, 1992.Marvvah B, S<strong>in</strong>gh G, Ch<strong>and</strong>ola HM. A cl<strong>in</strong>ical study on the role <strong>of</strong> certa<strong>in</strong> Ayurvedic drugs <strong>in</strong> management <strong>of</strong>Madhumeha (diabetes mellitus). MD(Ayu) thesis. Institute for Post Graduate Teach<strong>in</strong>g <strong>and</strong> Research <strong>in</strong> Ayurveda, GujaratAyurvcd University, jamnagar, India, 1990.Cl<strong>in</strong>ical Research on-<strong>Diabetes</strong> mellitus, reported on website <strong>of</strong> India's Central Council for Research <strong>in</strong> Ayurveda <strong>and</strong>Siddha. Onl<strong>in</strong>e document at: http://ccras.nic.<strong>in</strong>/Rcsearch_Activities/20081015_diabetes.htm Accessed June 12, 2010.Deka D, Ch<strong>and</strong>ola HM, S<strong>in</strong>gh G. A cl<strong>in</strong>ical study on Klaibya (male sexual dysfunction) <strong>in</strong> Madhumeha <strong>and</strong> Uccharaktachapa<strong>and</strong> its management by Vajikarana Yoga. PhD thesis. Institute for Post Graduate Teach<strong>in</strong>g <strong>and</strong> Research <strong>in</strong>Ayurveda, Gujarat Ayurved University, Jamnagar, India, 2004.Virani N, Ch<strong>and</strong>ola HM, Vyas SN, Jadeja DB. A cl<strong>in</strong>ical study on etiopathogenesis <strong>of</strong> erectile dysfunction (Klaibya) <strong>in</strong>diabetic <strong>and</strong> non-diabetic patients <strong>and</strong> its management with Ashvattha. MD(Ayu) thesis. Institute for Post GraduateTeach<strong>in</strong>g <strong>and</strong> Research <strong>in</strong> Ayurveda, Gujarat Ayurved University, Jamnagar, India, 2009.Dwjvedi KN. KiTect <strong>of</strong> Dashamoola on diabetic neuropathy. MD(Ayu) thesis. Institute <strong>of</strong> Medical Sciences, BanarasH<strong>in</strong>du University, Varanasi, India, 1986.Upadhyaya JM, S<strong>in</strong>gh K. Role <strong>of</strong> Saptamrita Lauha <strong>in</strong> Timira with special reference to myopia. MD(Ayu) thesis,<strong>in</strong>stitute for Post Graduate Teach<strong>in</strong>g <strong>and</strong> Research <strong>in</strong> Ayurveda, Gujarat Ayurved University, Jamnagar, India, 1993.Gupta Durgesh P. A cl<strong>in</strong>ical study on Akshi Tarpana with <strong>and</strong> without Nasya on Timira with special reference tomyopia. MD(Ayu) thesis. Institute for Post Gradviate Teach<strong>in</strong>g <strong>and</strong> Research <strong>in</strong> Ayurveda, Gujarat Ayurved University,Jamnagar, India, 2009.Anil Kumar E, Study on various preparations <strong>of</strong> Manjishthadi Kvatha <strong>and</strong> its effect <strong>in</strong> Tvak Rogas (sk<strong>in</strong> diseases).MD(Ayu) thesis. Government Ayurveda College, Kerala University, Triv<strong>and</strong>rum, India, 1985.Shr<strong>in</strong>gi MK. Therapeutic efficacy <strong>of</strong> leech application, Kaishore Guggulu, <strong>and</strong> Neem oil <strong>in</strong> sk<strong>in</strong> disorders [<strong>in</strong> H<strong>in</strong>di].MD(Ayu) thesis. National Institute <strong>of</strong> Ayurveda, Jaipur, India, 1996.Hota P. A cl<strong>in</strong>ical study on Vatarakta <strong>and</strong> its management with Kaishor Guggulu. MD(Ayu) thesis. Gopab<strong>and</strong>huAyurved Mahavidyalaya, Utkal University, Puri, India, 1997.type 2 diabetes, treatment with G. sylvestr? extract significantly reduced blood glucose, glycosylated hemoglob<strong>in</strong>, <strong>and</strong>glycosylated plasma prote<strong>in</strong>s, whereas with conventionaltreatment alone {i.e., glibenclamide or tolbutamide), thesevalues <strong>in</strong>creased or rema<strong>in</strong>ed the same. The patients receiv<strong>in</strong>g the herbal extract were able to decrease the dosage <strong>of</strong>their conventional drug, <strong>and</strong> 5 patients were able to discont<strong>in</strong>ue the drug entirely <strong>and</strong> ma<strong>in</strong>ta<strong>in</strong> their blood glucoselevels us<strong>in</strong>g only G. si/lvestrc.^ In 27 patients with type 1diabetes, G. sylvestre treatment reduced fast<strong>in</strong>g blood glucose, glycosylated hemoglob<strong>in</strong>, <strong>and</strong> glycosylated plasmaprote<strong>in</strong> levels. Insul<strong>in</strong> requirements decreased <strong>and</strong> serumlipids returned to near normal levels. Patients on <strong>in</strong>sul<strong>in</strong>therapy alone had no significant reduction <strong>in</strong> serum lipids,glycosylated hemoglob<strong>in</strong>, or glycosylated plasma prote<strong>in</strong>s.8SAqueous <strong>and</strong> alcoholic extracts <strong>of</strong> Cuducli't [T<strong>in</strong>ospora cordifolia(Willd.) Hook. f. & Thomson] reduced glucose levels <strong>in</strong>rats with alloxan-mduced diabetes. The antihyperglyccmiceffect may be due to pancreatic islet frec-radical-scaveng<strong>in</strong>gactivity. This herb also lowers the levels <strong>of</strong> tissue <strong>and</strong> serumcholesterol, phospholipids, <strong>and</strong> free fatty acids (Plants <strong>of</strong>Ayurveda, 2005; see Box i).86"89 Kiratatiktn [Swertia chirata(Roxb.) Buch.-Mam.; also known as Swertia chirayita (Roxb.)H. Karst] is a potent antidiabetic herb. In a pilot study,Swertia chirata produced a significant decrease <strong>in</strong> fast<strong>in</strong>g <strong>and</strong>postpr<strong>and</strong>ial blood glucose levels <strong>in</strong> patients with diabetes.81It conta<strong>in</strong>s swerchir<strong>in</strong>, a xanthone found <strong>in</strong> the Swertia species <strong>of</strong> plants. Xanthones are a unique class <strong>of</strong> biologicallyactive compounds with antioxidant properties. Research hasshown swerchir<strong>in</strong> produces a significant decrease <strong>in</strong> bloodglucose levels <strong>in</strong> rat models.'"' y A 60% decrease <strong>in</strong> bloodglucose <strong>in</strong>duced by swerchir<strong>in</strong> was accompanied by amarked depletion <strong>in</strong> /(-granules <strong>and</strong> <strong>in</strong>sul<strong>in</strong> <strong>in</strong> the pancreaticislets. Glucose uptake <strong>and</strong> glycogen synthesis by the diaphragm muscle was significantly enhanced <strong>in</strong> vitro by thescrum <strong>of</strong> swerchir<strong>in</strong>-treated rats. It was therefore concludedthat swerchir<strong>in</strong> lowers blood glucose levels by stimulat<strong>in</strong>g<strong>in</strong>sul<strong>in</strong> release from the islets <strong>of</strong> Langcrhans.9'1Shilajatu (Shilajit, Asphaltnm punjnbianiim) is a res<strong>in</strong>ous,m<strong>in</strong>eral-rich substance with vegetative orig<strong>in</strong>s that is found<strong>in</strong> the Himalayan mounta<strong>in</strong>s. It is recommended for manydiseases, such as Pramcha, Sthau!ya (obesity), Hridroga (heartdisease), <strong>and</strong> so on. It is an established treatment for diabetesthat not only mitigates morbid Kaphn <strong>and</strong> Meda, but also hasrejuvenat<strong>in</strong>g properties.911 In a cl<strong>in</strong>ical study on patients withdiabetes, Shilajit significantly reduced lipid peroxidation <strong>and</strong>significantly <strong>in</strong>creased levels <strong>of</strong> catalase, an antioxidant enzyme.9' In rats with diabftes, Shilajit produced a significantreduction <strong>in</strong> blood glucose levels as well as beneficial effectson the lipid pr<strong>of</strong>ile. Us<strong>in</strong>g Shiiajit <strong>in</strong> comb<strong>in</strong>ation with
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