Browsing by Author "Kishor Patwardhan"

Now showing 1 - 20 of 35

A case for testing and modifying theory in Ayurveda: Author’s response
(Forum for Medical Ethics Society, 2023) Kishor Patwardhan
This is my response to several recent criticisms that have challenged my views expressed in the article 'Confessions of an Ayurveda Professor' in this journal [1]. Some of these criticisms, such as the one by Karthik and Shajin, are directly expressed [2], while others, such as the one by Tubaki and Prasad, are indirect [3]. The criticism by Tubaki and Prasad is particularly significant because it is the only feedback I have received from the Ayush establishment thus far; and lists the President of the Board of Ayurveda, National Commission for Indian System of Medicine (NCISM), as an author. Additionally, there have been many reactions published on IJME’s website. I also address them in this response since many of them share a similar line of thinking. © Indian Journal of Medical Ethics 2023.
A Prospective Observational Study on BBV152 Coronavirus Vaccine Use in Adolescents and Comparison with Adults: Interim Results of the First Real-World Safety Analysis
(Adis, 2022) Upinder Kaur; Anju K.L; Mayank Chauhan; Aditi Joshi; Agniva Das; Sangeeta Kansal; Vaibhav Jaisawal; Kishor Patwardhan; Sankha Shubhra Chakrabarti
Introduction: The BBV152 coronavirus disease 2019 (COVID-19) vaccine (COVAXIN) has recently been approved for adolescents. Objective: We provide the first real-world safety data of COVAXIN use in adolescents and compare with adults. Methods: A prospective observational study was initiated in January 2022. Enrolled adolescents and adults were contacted by telephone after 14 days of receiving the BBV152 vaccine. The primary outcome was vaccine safety assessed as rate of adverse events following immunization (AEFIs). Severity grading of AEFIs was done using the Food and Drug Administration (FDA) scale. Interim results are presented. Results: A total of 698 adolescents and 326 adults were enrolled. AEFIs after the first dose developed in 243 out of 670 adolescents (36.3%), with 21% reporting only local AEFIs and 15.2% reporting systemic AEFIs. Among 340 adolescents who had received the second dose of vaccine, 129 (37.9%) developed AEFIs, with only local involvement in 20.3% and systemic involvement in 17.6%. Injection site pain and fever were the common AEFIs. The majority of AEFIs were mild-moderate. Nearly 0.9% of adolescents receiving the first dose reported severe AEFIs. Atypical AEFIs were observed in 0.6–0.9% of adolescents. The majority of the AEFIs resolved in 1–2 days. AEFIs were persistent in > 2% of adolescents at day 14 after the second dose, and also in 3.7% of adults overall at follow-up. No difference was observed in AEFI incidence and patterns between adolescents and adults. Regression analysis showed females and those with a history of allergy to be, respectively, at 1.6 times and 3 times increased risk of AEFIs among adolescents. Conclusions: COVAXIN carries an overall favorable short-term safety profile in adolescents. The observed AEFI rates in adolescents are much lower than that reported with mRNA vaccines, but head–head comparisons in the same population are required to generate relative vaccine safety data. Female adolescents and those with a history of allergy need watchfulness for severe and persistent AEFIs. With some AEFIs persisting at 14 days, a longer follow-up is recommended to strengthen the safety data of COVAXIN. © 2022, The Author(s), under exclusive licence to Springer Nature Switzerland AG.
A Scoping Review of Ayurveda Studies in Women with Polycystic Ovary Syndrome
(Mary Ann Liebert Inc., 2023) Vibhuti Samarth Rao; Mike Armour; Kishor Patwardhan; Birinder S. Cheema; Caroline Smith; Rashmi Sharma; Carolyn Ee
Introduction: Polycystic Ovary Syndrome (PCOS) is a complex disorder with diverse clinical presentations. Women with PCOS use traditional, complementary, and integrative medicines, including Ayurveda (traditional Indian medicine) to manage their symptoms. Therefore, it is important to understand the current evidence base and the potential areas that require further research. Objective: This novel study aimed at providing a description of the Ayurveda studies conducted on women with PCOS and identifying gaps for future research. Methods: This scoping review was undertaken using the Joanna Briggs Institute scoping review guidelines. Relevant electronic databases were searched for any peer-reviewed original research that examined the role of Ayurveda (interventions using single/compound formula of herbs or minerals or metals, Panchakarma procedures and other therapies, and Ayurveda-based diet and lifestyle) for managing symptoms of PCOS in women of reproductive age. Two reviewers independently screened the records, extracted the data on population, intervention, comparator, and outcome characteristics and descriptively summarized the data. Results: Of the 1820 records identified, 57 articles met the inclusion criteria; 32 case studies, 13 randomized controlled trials, 9 pre-post trials, 2 case series, and 1 non-randomized trial. Most studies were conducted in India and used either a compound formula or a complex intervention (e.g., panchakarma therapies and lifestyle modifications). The majority of the case studies/series used an Ayurvedic diagnostic approach that influenced the choice of Ayurveda intervention. Among the interventions, shatapushpa (dill seeds) and krishnatila (black sesame seeds) were the most used single herbs whereas kanchanara guggulu and rajapravartini vati were the most used compound formulas. Basti karma (therapeutic enema) was the most used complex intervention. Reproductive outcomes were the most studied; menstruation, PCOS-related infertility, and polycystic ovary morphology. Conclusions: There are a number of clinical studies on Ayurveda interventions for PCOS with a promising role in managing symptoms of PCOS. However, a few gaps were identified. Future research should aim at: (1) exploring a wider range of interventions, including Ayurvedic diet and lifestyle in different settings/locations; (2) exploring the effectiveness of Ayurveda treatments as an adjunct to biomedical treatments (3) a greater range of outcome measures such as obesity, type 2 diabetes, anxiety, depression, and quality of life needs to be further explored in women with PCOS; and (4) finally, safety and adverse event reporting needs to be undertaken rigorously and systematically. © Copyright 2023, Mary Ann Liebert, Inc., publishers 2023.
Allopathic, AYUSH and informal medical practitioners in rural India – a prescription for change
(Elsevier B.V., 2018) Shailaja Chandra; Kishor Patwardhan
This paper looks at the treatment seeking behaviour of rural households and presents factors that discourage them from using public health facilities. It also brings out how Allopathic medical graduates as well as institutionally qualified AYUSH doctors predominantly offer services in cities and townships which results in lakhs of village households having to depend on unqualified medical practitioners as the first line of medical treatment; also how this situation will continue unless the approach to providing medical treatment is modified. Continued dependence on unqualified practitioners is fraught with dangers of incorrect diagnosis, irrational drug use, resulting in the spread of multi-drug resistance. The reality that surrounds Allopathic practice by AYUSH doctors has also been described along with the educational underpinnings of accepting this approach. We opine that existing state policies that legitimise Allopathic practice by non-Allopathic practitioners do not help the rural poor to access proper medical treatment for acute conditions. Also, it does not enhance the credibility of the indigenous systems of medicine among which Ayurveda is the dominant system. First, we position our views in the context of the recently introduced National Medical Commission (NMC) Bill 2017 and provisions which call for the assessment of the need for human resources for health and building a road map to achieve the same. Second, we advocate re-inventing the pre-independence system of trained medical auxiliaries enrolled on a new schedule of the respective state medical register, authorised to give immediate medical treatment and making informed referrals for further diagnosis or specialised treatment. Finally, we recommend reinforcing the AYUSH systems to tackle emerging non-communicable diseases which are affecting all population cohorts adversely and, in whose prevention and management, the AYUSH systems are reported to possess special skills and competence. © 2018 Transdisciplinary University, Bangalore and World Ayurveda Foundation
Ayurveda education reforms in India
(Elsevier B.V., 2017) Kishor Patwardhan; Bhushan Patwardhan
[No abstract available]
Ayurveda education: Evaluating the integrative approaches of teaching Kriya Sharira (Ayurveda physiology)
(Elsevier B.V., 2013) Himanshu Joshi; Girish Singh; Kishor Patwardhan
Background: ′What is the ideal way of teaching Ayurveda?′ - has been a debated question since long. The present graduate level curriculum lists out the topics from ′contemporary medical science′ and ′Ayurveda′ discretely, placing no emphasis on integration. Most of the textbooks, too, follow the same pattern. This makes learning not only difficult, but also leads to cognitive dissonance. Objectives: To develop and evaluate the effectiveness of a few integrative teaching methods. Materials and Methods: We introduced three different interventions in the subject Kriya Sharira with special reference to ′cardiovascular physiology′. The instructional methods that we evaluated were: 1. Integrative module on cardiovascular physiology (IMCP), 2. case-stimulated learning (CSL), and 3. classroom small group discussion (CSGD). In the first two experiments, we subjected the experimental group of graduate students to the integrative instructional methods. The control group of students received the instructions in a conventional, didactic, teacher-centric way. After the experiments were over, the learning outcome was assessed and compared on the basis of the test scores. The groups were crossed over thereafter and the instructional methods were interchanged. Finally, feedback was obtained on different questionnaires. In the third experiment, only student feedback was taken as we could not have a control group. Results: The test results in the first experiment showed that the integrative method is comparable with the conventional method. In the second experiment, the test results showed that the integrative method is better than the conventional method. The student feedback showed that all the three methods were perceived to be more interesting than the conventional one. Conclusion: The study shows that the development of testable integrative teaching methods is possible in the context of Ayurveda education. It also shows that students find integrative approaches more interesting than the conventional method.
Ayurveda formulations: A roadmap to address the safety concerns
(Elsevier B.V., 2017) Kishor Patwardhan; Jigyasa Pathak; Rabinarayan Acharya
It is a matter of serious concern that the number of case reports pointing at a possible association between the clinical toxicity and the use of Ayurveda formulations is increasing significantly over the years in scientific medical literature. Though most of these cases are connected with the presence of heavy metals such as lead, mercury and arsenic in these formulations, there are also reports suggesting toxicity due to the presence of toxic chemicals of herbal origin. In the year 2008, the Government of India took an initiative of establishing the National Pharmacovigilance Programme for Ayurveda, Siddha and Unani drugs in a structured way. However, due to lack of sustained support, this program has now become defunct. This issue is of vital importance and needs to be addressed effectively on a priority basis. In this communication, we propose the following crucial policy interventions to be introduced at different levels: a. Amendments to Drug and Cosmetic Act, b. Issuing consumer guidelines, c. Issuing prescription guidelines, d. Issuing clinical monitoring guidelines, e. Implementation of good manufacturing guidelines, f. Promoting documentation of clinical safety, g. Identifying the sources of contamination, and, h. Provision for stringent punishment. If these policy interventions are taken up and implemented, a significant positive change in the scenario can be expected in the near future. © 2017 Transdisciplinary University, Bangalore and World Ayurveda Foundation
AYUSH advisory presents ominous outlook for research in traditional Indian healthcare systems
(Indian Academy of Sciences, 2019) S.C. Lakhotia; Kishor Patwardhan; Sanjeev Rastogi
[No abstract available]
Confessions of an Ayurveda professor
(Forum for Medical Ethics Society, 2023) Kishor Patwardhan
In this essay, I narrate my experiences of teaching Ayurveda physiology through an approach that involved laborious re-interpretation of ancient literature using the recent advances in the field of medical physiology. Though this approach made the ancient concepts and theories appear modern and relevant, it did not contribute much except for apparently reducing cognitive dissonance among students. I cite examples describing the processes of formation of shukra (semen) and rakta (blood) to show how we often overinterpret Ayurveda concepts to make them sound rational by proposing ad hoc conjectures. I illustrate why my previous writings were faulty by applying the falsification principle proposed by Karl Popper. I further explain how this approach made these concepts only verifiable but not refutable, and hence, nonfalsifiable. I argue that instead of using such re-interpretation to prove obsolete concepts, they can be dropped altogether from the curricula of Ayurveda programmes. There is a need to develop a reliable method to identify such outdated content. © Indian Journal of Medical Ethics 2022:.
Contesting predators: Cleaning up trash in science
(Mary Ann Liebert Inc., 2019) Bhushan Patwardhan; Kishor Patwardhan
[No abstract available]
Deep meditation as a valid “scientific” method: A flawed argument
(Forum for Medical Ethics Society, 2025) Kishor Patwardhan
An interventional neurologist recently responded to my two-yearold article suggesting that Ayurveda should be approached in a qualiacentric manner. He questions the fundamental assumptions of what he calls “Western” science yet tries to use the same to claim that ancient Ayurveda and Yoga masters gained the knowledge of the functioning of human body through deep meditation. He appears to consider deep meditation as a valid scientific method, despite it lacking external validity. At the same time, he advocates for external validity to test Ayurveda therapeutics. I draw attention to this contradiction in his argument. © 2025, Forum for Medical Ethics Society. All rights reserved.
Development, Validation, and Verification of a Self-Assessment Tool to Estimate Agnibala (Digestive Strength)
(SAGE Publications Ltd, 2017) Aparna Singh; Girish Singh; Kishor Patwardhan; Sangeeta Gehlot
According to Ayurveda, the traditional system of healthcare of Indian origin, Agni is the factor responsible for digestion and metabolism. Four functional states (Agnibala) of Agni have been recognized: regular, irregular, intense, and weak. The objective of the present study was to develop and validate a self-assessment tool to estimate Agnibala. The developed tool was evaluated for its reliability and validity by administering it to 300 healthy volunteers of either gender belonging to 18 to 40-year age group. Besides confirming the statistical validity and reliability, the practical utility of the newly developed tool was also evaluated by recording serum lipid parameters of all the volunteers. The results show that the lipid parameters vary significantly according to the status of Agni. The tool, therefore, may be used to screen normal population to look for possible susceptibility to certain health conditions. © 2016, © The Author(s) 2016.
Effects of two Ayurvedic formulations, Dhanwantaram Kashaya and Saraswatarishta on life history parameters and toxic aggregates in Drosophila models of Huntington's and Alzheimer's disease
(Elsevier Ireland Ltd, 2023) Swati Sharma; Girish Singh; Kishor Patwardhan
Ethnopharmacological relevance: Ayurveda, the traditional healthcare system native to India, employs dosage forms containing multiple herbs in treating various clinical conditions. Dhanwantaram Kashaya (DK) and Saraswatarishta (SA) are two such formulations containing multiple herbs in varied proportions. Kashaya is a liquid decoction while Arishta is fermented liquid with permissible quantity of self-generated alcohol in it. Both the formulations have been reported to have clinical efficacy in age-related memory impairment. Other mental disorders having clinical presentations similar to psychoses are the other indications for these tested formulations. Aim of the study: The present study was performed to evaluate the efficacy of two Rasayana formulations i.e., DK and SA, used by clinicians in different neurodegenerative conditions. We tested these formulations in Alzheimer's (AD) and Huntington's disease (HD) models of Drosophila melanogaster. Materials and method: Initial experiments looking for life-history parameters in wild-type larvae were carried out in three sets with hundred larvae in each set. These parameters were also studied in diseased models in four sets with eighty larvae in each set. Aβ plaques and polyQ aggregates were looked at with the help of immunostaining technique and images were captured using confocal microscopy. Results: The results revealed that 0.25% concentration of both the formulations improve longevity in wild-type flies. Larval development and adult lifespan in Eye-GAL4>Aβ42 (AD) and GMR-GAL4>127Q (HD) larvae/flies reared on 0.25% & 0.50% DK and 0.25% & 1.00% SA improved substantially. Reduced Aβ plaques and polyQ aggregates indicate disease suppression. Conclusion: DK and SA enhanced longevity in Drosophila melanogaster. Suppression of disease aggregates suggests their potential utility in treating AD and HD. Further clinical and pharmaceutical studies are required to confirm these results, however, this is a workable model to test multi-herbal formulations of Ayurveda in the forms they are clinically used. © 2023 Elsevier B.V.
Erratum: The Basic cardiovascular responses to postural changes, exercise, and cold pressor test: do they vary in accordance with the dual constitutional types of ayurveda? (Evidence-Based Complementary and Alternative Medicine (2011) 2011 (1))
(2011) Kishor Patwardhan; Piyush Kumar Tripathi; Girish Singh
[No abstract available]
Good practices of publishing AYUSH research: A practical checklist for authors
(Elsevier B.V., 2017) Kishor Patwardhan; Girish Tillu; Priyanka M. Jadhav
Since its inception, Journal of Ayurveda and Integrative Medicine (J-AIM) has been constantly striving to create an environment that inculcates and strengthens “Good Publication Practices (GPP)” amongst students, practitioners and researchers in AYUSH community. The J-AIM has been doing this in the form of conducting workshops on scientific writing and research methods on different platforms. This article is based on our experiences and varied discussions that we have had with students, teachers, practitioners and researchers during these interactive sessions, and is intended at addressing the gap that prevails in the domain. The need for such awareness is felt even more strongly ever since the Beall's list of predatory journals has been unpublished. This article tries to fill the void this disappearance has created. We analyze the current scenario of AYUSH publications, enumerate the common perceptions and concerns among the workers in the field, and consider the periodicals where the doctoral and postgraduate level of Ayurveda research works are being published at present. The article also presents a practical checklist that will be helpful for students and teachers to refer authentic resources and submit their work to an appropriate scholarly journal. © 2017 Transdisciplinary University, Bangalore and World Ayurveda Foundation
How practical are the "teaching reforms" without "curricular reforms"
(Elsevier B.V., 2010) Kishor Patwardhan
[No abstract available]
Introducing Hybrid Problem-Based Learning Modules in Ayurveda Education: Results of an Exploratory Study
(Mary Ann Liebert Inc., 2020) Varsha Raghunath More; Girish Singh; Kishor Patwardhan
Problem-based learning (PBL) is a well-known student-centered instructional approach that is known to enhance problem-solving skills among the learners. Because teaching/learning methods in most of the Ayurveda colleges in India are still didactic and teacher centric, the effects of introducing PBL have not yet been evaluated. The primary objective of this study was to develop PBL modules for Kriya Sharira (Ayurveda Physiology) and their implementation in a hybrid format. In this method, PBL is used as an add-on component along with didactic lectures. The secondary objective of the study was to compare the learning outcomes achieved through hybrid problem-based learning (HPBL) with those achieved through conventional teaching. Design: This is a prospectively planned post-test-only, controlled interventional design with nonequivalent groups. However, the results have been analyzed in a retrospective manner. Subjects: Students enrolled in the first professional Bachelor of Ayurvedic Medicine and Surgery program during two consecutive academic sessions 2016-2017 and 2017-2018 at the Banaras Hindu University were included in the study. While the cohort from 2016 to 2017 session served as the control group, the one from 2017 to 2018 session served as the experimental group. Interventions: The instructional method commonly known as HPBL was introduced to the experimental group. Outcome measures: Five test papers containing mostly Multiple Choice Questions for five different topics were used as the tools for evaluating the learning outcomes in both the groups. Feedback forms regarding the experiences of undergoing HPBL were obtained from experimental group. Results: While the test results for three topics showed that the outcomes of HPBL were comparable with conventional teaching, the results on other two topics suggested that HPBL was slightly better. Feedback obtained showed that there is a considerable acceptance for HPBL over conventional method. Conclusions: The study shows that it is possible to implement HPBL method in a large classroom in the context of Ayurveda education. The findings also indicate that students find HPBL as an acceptable teaching method. © Copyright 2020, Mary Ann Liebert, Inc., publishers.
Medical education in India: Time to encourage cross-talk between different streams
(Elsevier B.V., 2013) Kishor Patwardhan
Currently, India recognizes five different healthcare systems, collectively known as AYUSH (Ayurveda, Yoga, Unani, Siddha, Homeopathy), along with the conventional biomedicine. These systems have their own institutionalized structure for monitoring medical education and practice. However, because of the ′parallel′ kind of policy model that is followed in India, there is no formal provision for any cross-talk between the professionals belonging to these different streams. This situation has not only given rise to mutual misgivings among these professionals regarding the strengths and weaknesses of each other, but also has led to a poor appreciation of the historical and socio-cultural connections these streams share with the community at large. To tackle these issues and to promote adequate participation of biomedicine experts in AYUSH-related research projects, ′introduction of an AYUSH module in the current curriculum of MBBS (Bachelor of Medicine and Bachelor of Surgery) program′ has been proposed in this communication along with a possible roadmap for its implementation. It is also suggested that the experts in biomedicine be engaged for training AYUSH graduates in their respective specialties so that quality AYUSH education may be ensured.
Myth and reality of "theory-driven individualised practice" in Ayurveda: Mapping physicians’ approaches using case-based scenarios
(Forum for Medical Ethics Society, 2024) Mayank Chauhan; Vijay Kumar Srivastava; Kishor Patwardhan
Background: The curricula of Ayurveda programmes emphasise various theoretical constructs such as Tridosha (three factors determining the state of health), Agnibala (digestive strength), Samprapti (pathophysiology), among others. It is often argued that practitioners follow an individualised approach based on these principles while treating patients. Yet, dependable data on their realworld influence is lacking. The aim of this study was to record the extent to which these constructs drive decisionmaking among Ayurveda practitioners and to examine whether these constructs determine individualisation of the interventions. Methods: We employed an emailed survey to record physicians’ perceptions. Convenience sampling was chosen as the sampling method. Registered Ayurveda practitioners located across India with a minimum of five years of clinical experience were invited to participate. Five casebased scenarios depicting different clinical conditions were presented to the physicians. Questions that accompanied each case scenario asked the physicians to record clinical diagnoses, treatment plans, and the Ayurveda principles that determined their treatment. Results: A total of 141 physicians responded, from whom we received 152 responses as seven physicians responded to more than one scenario. The results suggest a significant lack of consensus among physicians regarding clinical diagnoses, interventions, and their understanding of pathophysiology in the given clinical scenarios. Many conflicting opinions were also noted. Conclusion: Theoretical constructs do not appear to determine either prescriptions or individualisation uniformly. Two ethical questions arise: “Is this situation due to an inherently weak theoretical framework of Ayurveda?” and “How can one justify spending hundreds of hours teaching these theories?”. © Indian Journal of Medical Ethics 2024.
Overlooked contributions of Ayurveda literature to the history of physiology of digestion and metabolism
(Springer Science and Business Media Deutschland GmbH, 2023) Aparna Singh; Sonam Agrawal; Kishor Patwardhan; Sangeeta Gehlot
Ayurveda is a traditional system of healthcare that is native to India and has a rich documented literature of its own. Most of the historians agree that the documentation of core Ayurveda literature took place approximately in between 400 BCE and 200 CE, while acknowledging that the roots of its theoretical framework can be traced back to a much earlier period. For multiple reasons many significant contributions of Ayurveda literature to various streams of biological and medical sciences have remained under-recognized while recounting the historical milestones of development. This is true in the context of the physiology of digestion and metabolism too. In this communication we try to reconstruct a picture of the processes of digestion and metabolism as had been understood by ancient Ayurveda scholars. Though this understanding was primitive and insufficient in many ways, we argue that this deserves to be documented and acknowledged. To help with grasping the importance of these contributions, we juxtapose them with the corresponding insights pertaining to this subject reported by prominent western scientists. The major contributions of Ayurveda that have been recounted in this paper are those related to the description of three distinct phases of digestion (Avasthapaka), multiple sets of transformative entities acting at different levels of metabolism (Agni), and the roles ascribed to various internal and external factors in executing these physiological functions. © 2023, Springer Nature Switzerland AG.