Cerebral palsy (CP) is a common chronic motor disability among developmental disorder prevalent world widely among pediatric population. It is a group of condition characterized by motor dysfunction due to non progressive brain damage in its early developing period; often accompanied by other features like seizures, behavioral disorder, cognitive impairment and other secondary musculoskeletal problems restricting them from normal independency. The condition poses considerable therapeutic challenge to the treating physician. Currently there is no specific treatment available in modern medical science to counteract the brain insult leading to motor dysfunction in CP. The available therapeutic interventions are mostly symptomatic and costlier. Recent advances in Ayurvedic clinical research have shown increased understanding of etiopathogenesis, its causal pathway of presentation and the value of specific intervention strategies in the management of Cerebral palsy. Ayurveda recommends multiple treatment options for intervention at various levels. Out of them, Panchkarma therapy and oral herbal formulations with properties of anti spasticity, anti convulsant, neurogenerative capacity etc. plays a vital role in the management. This paper provides a critical review on the effect of currently available treatment modalities of Ayurveda that can efficiently manage Cerebral palsy.

Nephrotic syndrome (NS) is an important chronic renal disease prevalent among pediatric population. Nephrotic syndrome has emerged as immunological disorder. Researches on pathogenesis have shown T lymphocyte dysregulation and vascular permeability factors that might contribute the alteration in podocyte function and permselectivity resulting in NS. Prognosis of treatment depends upon steroid responsiveness. Most of them are sensitive initially but later on may relapse or become steroid dependent or resistant to it. Drugs like levamisole, cyclophosphamide, cyclosporine, long term alternate day corticosteroids etc. have been used in combination with various protocols to treat steroid dependent or steroid resistant NS with variable results outcome and more side effects. Hence an alternative therapy is needed. Ayurvedic polyherbal formulation with properties of immunomodulator, nephroprotective and antioxidant properties can prove more beneficial in treating steroid dependent or resistant cases of NS, as add on therapy with modern therapeutic drugs for better results.

Wound healing is a complex phenomenon. Only after defining the specific biologic processes of a particular wound the clinician can formulate a rational treatment. Therefore, a good clinician should have a very clear definition of the mechanism of wound healing. Irrespective of the type of wound and extent of the tissue loss, the healing of every wound is a continuous process. Division of the healing process into phases refers to the fundamental morphological alterations in the course of the repair process without reflecting the actual complexity of the process. The usual division is into four healing phases viz. haemostasis, inflammation, proliferation, and maturation. It is a complex process requiring the collaborative efforts of a number of different tissues and cell mediators. In Ayurvedic literature particularly in Sushruta Samhita a vast description of etiology, pathogenesis, classification and treatment of the wounds is available. So far as the healing of a wound is concerned detailed clinical features of each phase of healing have been mentioned. Understanding of these features is very important for the successful and uneventful management of the wounds. Even in today's highly sophisticated era when we have a vast knowledge of the mechanism of healing at the cellular level the clinical presentation as described in Ayurvedic literature is of immense value. Critical analysis of the phased mannered features of wound healing described in ancient Indian texts reveals that they still stand true in the present time. This paper is an effort to elaborate and interpret these clinical features of wound healing according to the present day understanding.

Objectives: Comparative study of Ashwagandha (Withania somnifera; WS) and hydroxychloroquine (HCQ) for chemoprophylaxis against COVID-19 in actively engaged high-risk health-care workers. Design: Randomized, multicentric, open label, active control, two arm parallel efficacy study of 16 weeks. Sample size was based on pre-set 15% non-inferiority margin to HCQ for prophylaxis against COVID-19 with 80% power and alpha < 0.05. Participants: 400 health-care workers from three sites who were asymptomatic and tested negative for a quantitative Reverse Transcription Polymerase Chain Reaction test (RT-PCR) for COVID-19 and SARS-CoV-2 antibodies (IgG) were randomized in a 1:1 ratio. Participants observed physical protection measures as per the national policy. All incident confirmed COVID-19 were withdrawn.Interventions: Two tablets of 250 mg standardized aqueous extract of WS, twice daily after meal or HCQ 800 mg loading followed by 400 mg weekly for 16 weeks as per the national guidelines. Main outcome measures: The primary efficacy measure was “failure of prophylaxis” as confirmed by RT-PCR at any time during the study. Both intention-to-treat (ITT) and per-protocol (PP) efficacy analyses were performed.Results: 95 participants in the Ashwagandha (WS) arm and 101 participants in the HCQ arm completed the study. Both groups were well matched at the baseline. 91 participants from the Ashwagandha arm and 84 from the HCQ arm were withdrawn because they received the COVID-19 vaccination. Four participants (2%; 95% CI 2.8 to 3.9%) in the Ashwagandha and 5 (2.5%; 95% CI 5.4 to 8%) in the HCQ arm developed confirmed COVID-19. This was within the prefixed non-inferiority margin and the 95% CI of the absolute risk reduction (ARR) was -2.9 to 3.8% intention to treat (ITT) and -5.9 to 7.5% per protocol (PP). The 95% CI of ARR for the total COVID-19 cases was -2.8 to 11.9% ITT and -5.7 to 20.3% PP. Several health measures, particularly anxiety and stress, improved significantly in the Ashwagandha arm. Seven out of 117 in the Ashwagandha and 59 out of 178 in the HCQ groups were reported to be possible drug-related adverse events (AE); there were significantly less gut-related AE in the Ashwagandha group. AE were mostly mild and did not cause withdrawal. All incident COVID-19 cases recovered without complications. Conclusions: Ashwagandha was non-inferior to HCQ in the chemoprophylaxis against COVID-19 in high risk health-care workers. It was significantly safer, well tolerated and improved quality of life measures. Ashwagandha as COVID-19 prophylaxis seems appropriate in high-risk populations. Trial registration: The Clinical Trials Registry India Number CTRI/2020/08/027163 dated August 14, 2020.

Background: Various clinical researches have been done in Ayurveda to study the effectiveness of Ayurveda intervention in attention-deficit/ hyperactivity disorder (ADHD), one of the most common neurodevelopmental disorders in pediatric population. However, to date, no comprehensive systematic review has been conducted to assess the quality of clinical trials conducted and to determine the strength and safety of Ayurveda interventions in ADHD. Materials and methods: Published randomized clinical trials (RCTs), non-RCTs, and unpublished data on Ayurveda intervention in ADHD will be searched by using electronic databases such as the Cochrane Library, Pubmed, CENTRAL, Science Direct, AYUSH research portal, and other Indian databases. It involves the hand-searching of Ayurveda journals, and PG/PhD dissertations, if available, will also be utilized. The selection of study, data extraction, and synthesis will be done independently by reviewers. Standard tools will be adopted to assess the quality of trials. Risk of bias assessment will be performed by using Cochrane tool of risk of bias for RCTs and risk of bias in non-randomized studies of interventions (ROBINS-I) tool for non-RCTs. A narrative synthesis of findings from included studies will be described by providing treatment effect size. If sufficient data are available, the meta-analysis will be performed by using Review Manager. Outcome: The proposed protocol will act as a guiding tool for reproducing the same results in a transparent manner and to provide information to healthcare practitioners and policy makers.