Introduction: Fistula in ano is considered to be complicated and vicious due to its nature of recurrences and exacerbations. Ayurveda includes this disease under the list of AstaMahagada (eight serious diseases that are difficult to treat by nature itself ) due to this attribute. Ayurvedic literature offers various effective and safe management strategies for fistula in ano. Several works have been conducted to prove the efficacy and effectiveness of various treatment modalities mentioned in Ayurvedic texts. Kshara sutra, Kshara karma, Agnikarma, and Ksharavarti are a few to name in this list. A lacuna exists in not analyzing or compiling these works. Hence, the purpose of this systematic review is to generate evidence for efficacy, effectiveness, and safety profile of Ayurvedic interventions in the management of fistula in ano. Materials and methods: Electronic search from various online databases and clinical trial registers will be done. Manual search for gray literatures will be done from various colleges and universities. There will be no language restrictions. Three authors independently will screen all citations and abstracts to identify potentially eligible trials. Based on the inclusion criteria, full articles will be evaluated and disagreements will be discussed among the three authors. Data extraction from the included studies will be done by the three reviewers independently with extraction forms containing methods, participants, interventions, comparators/controls, and outcomes. Each of the included trials will be assessed for risk of bias. Primary data analysis will be done for both qualitative and quantitative data. Heterogeneity among trials will be assessed by inspecting forest plots. If heterogeneity is detected, and it is still considered clinically meaningful to combine studies, a randomeffects model will be used. Meta-analysis will be done for pooled estimates and others would be presented as narrative synthesis and shall be represented in tabular and graphical forms. Dissemination: The systematic review will be published in a peer-reviewed journal. It will also be disseminated electronically and in print. The review may guide healthcare practices and policy framing regarding the treatment of fistula in ano with Ayurvedic interventions. Study registration: PROSPERO registration no. CRD42019131911.

Introduction: Parkinson's disease (PD) is the most common form of a group of progressive neurodegenerative disorders characterized by motor, autonomic, and cognitive disturbances. The prevalence of PD is increasing with age and it affects 1% of the population above 60 years. In light of the demand for alternative measures to control PD, a systematic review is being planned to generate evidence for the efficacy, effectiveness, and safety profile of Ayurvedic interventions in the management of PD. Objectives: The primary objective of the present study is the systematic review of published clinical data in view of the safety, efficacy, and effectiveness of Ayurvedic interventions in the management of PD. Materials and methods: Electronic searches from various online databases and clinical trial registries will be done. A manual search for gray literature will also be done from various sources, e.g., printed journals, conference proceedings, colleges, university libraries, etc. Studies published in the English and Hindi language till March 2019 will be sought. Types of study include randomized controlled trials (RCTs), quasiexperimental trials, single group clinical trials, comparative clinical trials (CCTs), pragmatic trials, and review papers on Ayurvedic management of PD or Kampavata. Three investigators shall independently screen all citations and abstracts identified by a primary comprehensive search to sort out potentially eligible trials and eligible trials will be independently evaluated for inclusion in the review based on the inclusion criteria. Data extraction forms for individual study including methods, participants, intervention, comparator, and the outcome shall be prepared. Each of the included trials will be assessed for risk of bias. Primary data analysis will be done for both qualitative and quantitative data. Heterogeneity among trials will be assessed by inspecting forest plots. If heterogeneity is detected, and it is still considered clinically meaningful to combine studies, a random-effects model will be used. A sensitivity analysis, to investigate the robustness of the results to the quality components will be done, provided there are sufficient trials. A funnel plot will be utilized to indicate publication bias, heterogeneity of results, or differences in the methodological quality. Dissemination: The systematic review will be published in a peer-reviewed journal. It will also be disseminated electronically and via print. The review may guide healthcare practices and policy-framing in the treatment of PD with Ayurvedic interventions.

Background: Osteoarthritis (OA) is a chronic degenerative joint disease and is the commonest form of arthritis. It is the fourth leading cause of disability worldwide. Most of this disability burden is attributable to the involvement of the hips or the knee. Objectives: To assess the clinical efficacy of Upanaha with Vachadi Churna in the management of OA knee concerning pain and stiffness of joints. Materials and methods: It was an open-label, multicentric, single-arm, prospective, clinical study. Sixty subjects of primary OA knee aged between 35 years and 65 years fulfilling the diagnostic criteria of American College of Rheumatology (ACR) for OA knee and showing radiological changes of OA knee were enrolled in the study. Upanaha with Vachadi Churna was done over the affected knee for 14 days. The primary outcome was to see any change in pain and stiffness of joints which was assessed on the visual analog scale (VAS) and Western Ontario and McMaster University Osteoarthritis Index (WOMAC). The assessment was done on the 7th and 14th day and 1 week after completion of therapy, i.e., 21st day. Results: The mean pain score as assessed by VAS, reduced significantly from 64.48 at baseline to 31.95 at the end of the treatment period of 14 days (p value < 0.001). The mean stiffness score assessed on VAS also reduced significantly from 39.68 at baseline to 16.0 after 14 days (p value < 0.001). Significant change in total WOMAC score was also observed, which reduced from mean baseline score of 48.02 to 26.98 till the end of the intervention period of 14 days (p value < 0.001). Significant improvement in cardinal features of osteoarthritis was also observed after completion of therapy. Conclusion: This study substantiates the efficacy of Upanaha with Vachadi Churna in the management of OA knee.

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