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===== Evidence based clinical practices =====

===== Evidence based clinical practices =====

   

   

A study reviewing anti-rheumatic formulations showed that 247 formulations are enlisted in Ayurveda texts. ''rasnasaptaka kwath'', ''ajmodadi choorna, vatavidhvanasana rasa, vatari rasa, sinhanad guggulu, yogaraj guggulu,  khandashunthyavaleha, amrit bhallatak, guggulu panchatikta ghrita, vishagarbha taila'' are common formulations used to treat rheumatic conditions. ''Yogaraja guggulu'' is used in 50% prescriptions for rheumatic cases.  

A study reviewing anti-rheumatic formulations showed that 247 formulations are enlisted in Ayurveda texts. ''rasnasaptaka kwath'', ''ajmodadi choorna, vatavidhvanasana rasa, vatari rasa, sinhanad guggulu, yogaraj guggulu,  khandashunthyavaleha, amrit bhallatak, guggulu panchatikta ghrita, vishagarbha taila'' are common formulations used to treat rheumatic conditions. ''Yogaraja guggulu'' is used in 50% prescriptions <ref> A. A. Raut, A. D. Joshi, D. S. Antarkar, V. R. Joshi, A. B. Vaidya, Anti-Rheumatic Formulations From Ayurveda Ancient Science of Life, Vol  No. XI No.1 & 2, July & October 1991, pp. 66 – 69 </ref> for rheumatic cases.  

A research on ''vatarakta'' concluded that the notion of ''margavarana'' (obstruction in pathway) can be correlated to the pathology of atherosclerosis, and the state of ''uttana vatarakta'' to that of peripheral arterial disease. Identical therapeutic efficacy of ''kaishora guggulu'' and ''amrita guggulu'' was observed in thirty patients of ''uttana vatarakta''.

A research on ''vatarakta'' concluded that the notion of ''margavarana'' (obstruction in pathway) can be correlated to the pathology of atherosclerosis, and the state of ''uttana vatarakta'' to that of peripheral arterial disease. Identical therapeutic efficacy of ''kaishora guggulu'' and ''amrita guggulu'' was observed in thirty patients of ''uttana vatarakta''. <ref> Ramachandran AP, Prasad SM, Prasad U N, Jonah S. A comparative study of Kaishora Guggulu and Amrita Guggulu in the management of Utthana Vatarakta. AYU [serial online] 2010 [cited 2018 Aug 15];31:410-6. Available from: http://www.ayujournal.org/text.asp?2010/31/4/410/82027 </ref>

Another study was carried out to evaluate the antioxidant effect of five ''kashayams'' (''kwaths'' - decoctions) ''manjishtadi kashayam'' (MK), ''rasna erandadi kashayam'' (REK),  ''sahacharadhi kashayam'' (SK), ''maharasnadi'' (or ''rasna dwiguna bhagam'') ''kashayam'' (MRK) and ''dhanwantharam kashayam'' (DK) used in the management of diseases manifested due to vitiation of ''vata'' and ''vatarakta'' (mostly diseases of connective tissues, bones, joints and nervous system). It concluded that the total phenolic content and the antioxidant property of the products justify the protective and corrective effects produced by the products in ''vata'' and ''vatarakta'' disorders. The phenolic content is highest in MK, followed by DK. The phenolic content of MRK, SK and REK are comparable. This shows the formulations act by scavenging the free radicals in rheumatic diseases.

Another study was carried out to evaluate the antioxidant effect of five ''kashayams'' (''kwaths'' - decoctions) ''manjishtadi kashayam'' (MK), ''rasna erandadi kashayam'' (REK),  ''sahacharadhi kashayam'' (SK), ''maharasnadi'' (or ''rasna dwiguna bhagam'') ''kashayam'' (MRK) and ''dhanwantharam kashayam'' (DK) used in the management of diseases manifested due to vitiation of ''vata'' and ''vatarakta'' (mostly diseases of connective tissues, bones, joints and nervous system). It concluded that the total phenolic content and the antioxidant property of the products justify the protective and corrective effects produced by the products in ''vata'' and ''vatarakta'' disorders. The phenolic content is highest in MK, followed by DK. The phenolic content of MRK, SK and REK are comparable <ref> Sruthi CV, Sindhu A. A comparison of the antioxidant property of fi ve Ayurvedic formulations commonly used in the management of vata vyadhis. J Ayurveda Integr Med 2012;3:29-32.</ref>. This shows the formulations act by scavenging the free radicals in rheumatic diseases.

==== Potential areas /scope for further research ====

==== Potential areas /scope for further research ====