Abstract BACKGROUND: The Ayurvedic concept of Ama refers to the accumulation of incompletely digested or metabolized substances in the body due to impaired Agni (digestive fire). Ama is described as a pathological entity that disrupts systemic homeostasis, leading to chronic metabolic and immune disorders. Modern medical science recognizes similar pathological processes, such as endotoxin accumulation, gut dysbiosis, metabolic endotoxemia, and inflammatory responses driven by advanced glycation end-products (AGEs), damage-associated molecular patterns, and oxidative stress. Despite advances in research and clinical interventions, metabolic and immune disorders like diabetes, metabolic dysfunction-associated fatty liver disease, inflammatory bowel disease, and autoimmune conditions continue to rise globally. Expanding the scope of Ama and its subtypes in relation to these disorders may provide novel insights for disease prevention, diagnostics, and therapeutic approaches. EXISTING KNOWLEDGE AND GAP: Ayurvedic texts elaborate on Ama as a primary etiological factor in disease progression, classifying it based on its origins, affinity, and systemic translocation. However, there is a lack of standardized clinical assessment tools to evaluate Ama in the context of modern disease models. Current biomedical research highlights the crucial role of gut health, intestinal permeability, microbial dysbiosis, and metabolic endotoxemia in the development of chronic diseases. Despite these parallels, there is minimal integrative research correlating Ama with measurable biochemical or molecular markers. Moreover, the role of Ama in immune activation and inflammatory disorders remains largely unexplored within a scientific framework. PROPOSED CONCEPT: This paper proposes an expanded classification of Ama , integrating Ayurvedic epistemology with modern biomedical understanding. Ama can be characterized as a gut-derived response antigen complex or gut-associated molecular complex, which includes toxic metabolites, undigested peptides, microbial toxins, and inflammatory mediators resulting from impaired digestion and absorption. The subtypes of Ama can be categorized based on the site of expression, cause of origin, specificity or affinity, Kaal , and its movement or translocation. Modern tools such as metabolomics, proteomics, transcriptomics, and computational systems biology models can be employed to validate Ama and its subtypes. Biomarkers such as HbA1c (paralleling Ama in diabetes), lipid oxidation markers, gut microbiome alterations, and inflammatory cytokines may serve as objective correlates of Ama . WAY FORWARD: Future research should focus on developing standardized clinical scales for Ama assessment, incorporating radiological, biochemical, molecular, and genetic markers. Systems biology approaches, such as network pharmacology and artificial intelligence-based predictive models, should be utilized to map the progression of Ama in metabolic and immune disorders. Ayurvedic interventions, such as Deepana, Pachana , and Shodhana therapies, should be studied for their impact on gut barrier function, microbiome modulation, and immune homeostasis. Bridging Ayurvedic concepts with modern scientific methodologies will enable the development of personalized diagnostic and therapeutic strategies for chronic diseases.
As generative artificial intelligence (AI) moves toward large-scale healthcare deployment, a central challenge is how to harness its benefits without eroding clinical expertise or accountability. This commentary, written from clinician and technologist perspectives, argues that responsible AI adoption must rest on two foundations: preserving human accountability for medical decisions and integrating machine learning with structured, explainable reasoning. AI offers significant promise in diagnostics, personalized therapeutics, workflow automation, and burnout reduction. Data-driven discovery and biotechnology advances further expand therapeutic possibilities. However, risks include hallucinations, automation bias, and progressive deskilling. Emerging evidence suggests sustained AI assistance may diminish unaided diagnostic reasoning, underscoring the need for safeguards that maintain core clinical skills. From an implementation standpoint, success depends less on technical novelty than on integration within established care pathways, regulatory clarity, and demonstrable safety. Governments and large health systems are well positioned to scale validated solutions. The most sustainable path forward is hybrid “neuro-symbolic” systems that combine generative AI’s conversational capabilities with transparent, probabilistic clinical reasoning. Trustworthy healthcare AI must remain explainable, auditable, and decisively human-led.
Abstract Saussurea lappa (C. B. Clarke) is an endangered perennial herb also known as Saussurea costus (Falc.) Lipschitz. It belongs to the family Asteraceae and is well known and widely used in Ayurvedic, Unani, Chinese, and Tibetan systems of medicine. In India, it is commonly known as “Kuth” and has been therapeutically used in various ailments such as inflammatory conditions, gastrointestinal disturbances, neurological complaints, and reproductive disorders. Its root is a pharmacologically potent raw drug and contains a wide range of bioactive phytochemicals. Extensive research has established its pharmacological effects which include antioxidant, anticancer, hepatoprotective, antimicrobial, immunomodulatory, and gastroprotective activities. Unfortunately, the species faces severe threats of extinction because of overexploitation, unregulated trade, and habitat destruction, resulting in its inclusion in Appendix I of the Convention on International Trade in Endangered Species of Wild Fauna and Flora. The article highlights its therapeutic significance by bridging ethnomedicine with modern pharmacology and underscores the urgent need for conservation and clinical research on this endangered Himalayan treasure. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement was considered to conduct this review. The objective was to make a critical and comprehensive overview of ethnopharmacology, phytochemistry, therapeutic potential, and conservation issues of Saussurea lappa . For this purpose, literature published was searched systematically in electronic databases such as PubMed, Scopus, Web of Science, Science Direct, and Google Scholar. This study revealed that Saussurea lappa has antimicrobial, antiviral, anti-inflammatory, anticancer, and other therapeutic potential. Conservation of this Himalayan treasure needs to be conserved before its extinction.
Katsaireya (Barleria prionitis Linn.) is mentioned in Ayurvedic classics for Krimighana (Antimicrobial), Vranaropana (wound healing), and Shothahara (Anti-inflammatory) indicating its antimicrobial, anti-inflammatory and wound healing properties. Another extrapharmacoepial Barleria species – Barleria lupulina Lindl. having similar phytochemical properties is compared with Barleria prionitis for antimicrobial action in the present study. Aqueous, ethanolic, and methanolic extracts of both the samples were tested against Escherichia coli (Gram Negative) and Staphylococcus aureus (Gram-Positive) bacteria using Kirby–Bauer Disc Diffusion and Agar Well Diffusion methods. Barleria lupulina exhibited greater antimicrobial activity than Barleria prionitis, with the aqueous extract showing the highest inhibition zone (22 mm) against Staphylococcus aureus and the methanolic extract significantly inhibited Escherichia coli. Antimicrobial activity increased with higher concentrations, and the Agar Well Diffusion method was found to be more effective than the Disc Diffusion method. The study concludes that Barleria lupulina possesses stronger antibacterial potential and may serve as an effective substitute for Barleria prionitis in Ayurvedic formulations targeting microbial infections.
Frozen shoulder, clinically designated as adhesive capsulitis, is a debilitating musculoskeletal disorder characterised by progressive pain, stiffness, and restriction of the glenohumeral joint, with an estimated global prevalence of 2–5% in the general population and up to 20% in individuals with diabetes mellitus. Despite decades of biomedical research, its aetiopathogenesis remains incompletely elucidated, and long-term outcomes of contemporary therapeutic modalities are inconsistent. Ayurveda, the classical Indian system of medicine, provides a conceptually rich framework for understanding shoulder joint pathologies through the conditions Avabahuka and Vishwachi, described in the Charaka Samhita and Sushruta Samhita. This literature review critically examines the classical Ayurvedic descriptions of Avabahuka (analogous to adhesive capsulitis/frozen shoulder) and Vishwachi (analogous to brachial neuritis/neuralgic amyotrophy) alongside contemporary biomedical understanding, with the aim of establishing a meaningful and evidence-informed correlation. The review synthesises classical textual sources, including Charaka Samhita (Chikitsa Sthana 28), Sushruta Samhita (Nidana Sthana 1 and Sharira Sthana 6), and Chakradatta (Chapter 21), alongside peer-reviewed biomedical literature published between 2013 and 2024. Pathophysiological analogies between Vataja Samprapti, fibrotic capsular changes, and neuroinflammatory mechanisms are drawn. The diagnostic criteria, staging systems, risk factors (particularly diabetes mellitus, thyroid dysfunction, and hormonal imbalance), and treatment approaches, including Panchakarma procedures such as Nasya, Basti, Snehana, and Swedana are systematically evaluated. Key gaps in integrative research are identified, and directions for future clinical investigation are proposed. This review demonstrates that Avabahuka and Vishwachi bear substantial conceptual congruence with frozen shoulder and brachial neuritis, respectively, and that classical Ayurvedic therapeutics may offer evidence-aligned, cost-effective, and holistic management strategies worthy of rigorous clinical investigation.
