Current Science

S. R. Narahari , Terence J. Ryan , M. Guruprasad Aggithaya

Abstract

Integrative medicine (IM) is developing in India and has been described as frugal innovation contributing to the health design for well being of patients affected by chronic illness. There has been some claim that yoga protocols which are part of IM for lymphoedema are a reverse innovation. The Prince of Wales advocated for integrated health care. IM intensely engaged the most thoughtful of Indian Ayurveda and Yoga leaders. Albeit at the bottom of the evidence pyramid, there are a few success stories of Ayurveda treating patients who could not be managed by Allopathy.

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S. R. Narahari ¹, Terence J. Ryan ², M. Guruprasad Aggithaya ¹

Affiliations
1 Institute of Applied Dermatology, Uliyathadka, Madhur Road, Kasaragod 671 124, IN
2 Department of Dermatology, Churchill Hospital, Oxford, Headington OX3 7LE, GB

Abstract

This paper discusses the future research direction for integrative medicine. Structure of clinical methods and objective outcomes of biomedicine should be integrated for patient examination of Ayurveda. This helps to identify exact clinical features of the disease for selection of herbal formulations. Defining such a holistic clinical presentation is a prerequisite for patient selection before conducting reverse pharmacology studies. The latter will reveal underlying mechanisms of drug action and lead to 'holistic drug development'.

Keywords

Biomedicine, Complimentary and Alternative Medicine, Integrative Medicine, Physician Scientist, Reverse Pharmacology.

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S. R. Narahari ¹, Madhur G. Aggithaya ¹, Sara E. Morrow ², Terence J. Ryan ³

Affiliations
1 Institute of Applied Dermatology, Uliyathadka, Madhur Road, Kasaragod 671 124, IN
2 Chelsea and Westminster Hospital, London, GB
3 Department of Dermatology, Churchill Hospital, Oxford, Headington OX3 7LE, GB

Abstract

Doctors who use biomedicine with complementary and alternative medicine (CAM) in a carefully integrated way offer benefits from both systems to chronic patients without compromising on safety. The Institute of Applied Dermatology, Kasaragod has successfully developed a model of integrative medicine (IM) and effectively managed lymphoedema patients. This article describes the process of developing IM treatment adopting 'standard protocol items and recommendations for interventional trials'. All patients were examined by a team of doctors, biomedical and CAM, and nurses, thus enabling each patient's condition to be understood from these different perspectives, and diagnosis and management through an IM approach. A minimum of 30 min counselling is essential for every patient before informed consent is gained. The 'systems-based' conclusive process follows the standard guidelines in each therapeutic discipline. IM management is achieved following 'bedside discussion'. The minimum requirements for a clinical setting to conduct IM studies, documentation, patient selection and follow-up are described, utilizing biomedical outcome measures to demonstrate the effectiveness of IM. Components of the IM case record algorithm are described here. The process of clinical examination for Ayurveda is described along with comparative biomedical explanation. Biomedical confirmatory study, maintaining records of primary outcome measures, transcription of IM discussions and follow-up entries of patients under IM are also explained. Improving IM protocols for patient care has involved input from global experts together with feedback from patients who have received IM treatment. The IM treatment protocol should evolve as a patient-oriented approach. The protocol discussed here focuses on biomedical systems and structures to measure its effectiveness. This article provides a method for conducting evidence-based clinical studies to develop new IM therapies for chronic skin diseases.

Keywords

Integrative Medicine, Lymphoedema, Patient Care Protocol, Skin Diseases.

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S. R. Narahari ¹, Madhur G. Aggithaya ¹

Affiliations
1 Institute of Applied Dermatology, Uliyathadka, Madhur Road, Kasaragod 671 124, IN

Abstract

Evidence shows that Ayurveda and biomedical systems of medicine recognize the same disease albeit with minor difference in clinical description. We illustrate through clinical photos of Lymphoedema, Vitiligo, Psoriasis, Lichen Planus, bullous lesions, etc. the interpretation of diseases when both doctors of Ayurveda and Allopathy examine the patients together. Comparable clinical features in allopathy for Ayurveda's Vatha, Pitta and Kapha doshas are shown for different presentations in patients. This atlas is a guide for Integrative Medicine clinical methods to develop Sthaneeya vikruthi table, the first step in integrating Ayurveda and Allopathy for any disease and leads to the integration of Ayurveda and biomedicine at treatment level in dermatology irrespective of background understanding of the disease.

Keywords

Atlas of Skin Diseases, Ayurveda, Biomedicine, Clinical Pictures in Ayurveda, Integrative Medicine.

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