Ayurveda is not what you think

Dr. Remya Krishnan PhD

For physicians of Ayurveda

• As physicians, whether serving individual patients or populations, we always have sought to base our decisions and actions on the best possible evidence.

• The data procured by random administration of treatment to a group is only medicine based data (evidence) and not evidence based medicine

• Treatment decision based on inbuilt science led evidence is Evidence Based Medicine in reality .The outbuilt data evidence procured after testing an unknown compound is only medicine (compound) based evidence and not Evidence Based Medicine

Bitter truth

• In the past and present, vast majority of Ayurveda doctors and vaidyas hardly acquired access into true science based intentions of Ayurveda.

• Those who have acquired access never succeeded in establishing true science based intentions and standardize them for clinical practice and research .

• Thus wide variability in medical decision making prevail in Ayurveda for many decades .

• Irrational prescribing and practices in Ayurveda are on rampage in every part of the world

Tradition misinterpreted as shasthra

• Tradition based Vaidyas decided how to treat patients using only their own judgement and experience, and blindly practised what they copied from their older generations instead of applying shasthra sahitha tarka themselves.

• But we know now that this is not the right way to practice Ayurveda, which is originally 100% standardised science based medicine . A langhana indicated situation is not indicated for brimhana at the same time

• This is because what tradition based thinking considers best for a patient is not what the inbuilt science based evidences in shasthra approve as right . This fact is proven and established in comparison of both the practices in SBEBA .

• And what Vaidyas and doctors used to think was the best thing to do, a few years ago and even today is recognised to be that disapproved by science based evidences ( shaasthraarthas) and even turn out to be harmful most of the times !

• The doctors hardly recognise their failure as they are unaware of what is success with respect to the practice of intended shaasthraarthas science based Medicine of Ayurveda

Key points about evidence-based medicinewhich is Science Based

• Evidence Based Medicine in Ayurveda is primarily inbuilt shasthra based and secondarily only outbuilt data based .

• When doctors appraise and apply shasthra based evidence pertinently before recommending a treatment only, they are practising evidence-based medicine in Ayurevda.

• Evidence-based medicine in Ayurveda carefully appraises systematically all that shasthra says about a disease , its state and stage and the patient and his state and stage .

• Evidence Based Medicine looks at and substantiate based on shasthra how and why the specific treatment is only pertinent for the situation rather than look for whether it works to produce some benefits and risks .

• The evidence based practice in Ayurveda tells you exactly what kind of decision making is pertinent in diagnosis as well as management in clinical situation, why and how .

Why evidence from shatshra is so important

• Ayurveda is a true shasthra with proven and established predictive theorems and aphorisms instead of incompletely proven theories and hypothesis .

• It can be dangerous to rely on what your neighbours or friends who claim to know Ayurveda and tell you. For example, just because a fever medicine worked for them, that doesn't mean it will work for you. What they are telling is only based on their experience . But truly Ayurveda is Science based Medicine . So every clinical situation requires to be appraised and calculated based on theorems of shasthra to arrive at pertinent clinical decision. Your neighbours or wellwishers never know that !

• Even Ayurveda doctors are yet to understand and learn the practice of THE VERY INTENDED Science Bsaed Medicine of Ayurveda! Right now what they practice is Experience Based Medicine or Tradition Based Medicine which is extremely risky for you

BITTER TRUTH

Qualified doctors of Ayurveda are also not taught the methodologies to practice Evidence Based Medicine which is science based !

• This has resulted in widely irrational prescribing and practices under the label Ayurveda

• There is no clinical audit undertaken in any of the Ayurveda institutions or clinics until today.

What friends and family say about Ayurveda can be wrong

• When you aren't well, your family and friends often give you advice and tell you about theirAyurvedic experiences. These stories can be very powerful. If your mother/grandma says that your son needs to have X arishtas with Y pills and Z choorna you may believe what she says because she is your mum and you think that Ayurveda is grandma’s experience .

• But as your mom is totally unaware of scientific decision making methodologies to diagnose the state and stage of your son and hence no matter how much affectionate she is, following her advice here could produce potent harm to your son.

• This is because Ayurveda is 100%Science Based Medicine and only Science Based Evidence based practitioner can fast reverse your child’s illness to health.

• Ayurveda is not Grandma’s medicine .

Listening to stories • For example, you often hear stories of people who have

survived some disease by certain herbs or Ayurvedic formulations. However, you are less likely to hear about people who followed the same and fell into danger. Because they are not around to tell their stories. It can be hard to follow an unscientific treatment as it may produce adverse consequences any time, every time. It may keep you from enjoying your life.

• The story tellers are practising and prescribing Experience based Medicine and not science based . Ayurveda originally has no responsibility there in causing your body damage . You yourself alone are responsible !

ACT SENSIBLY !

• What friends and neighbours and other people with your condition is all what they think and not what is proven and established in shasthra of Ayurevda as such.

• You shouldn't use this information on its own when you make decisions about treatment.

• As I told, even Ayurveda doctors are yet to start practice of Science Based Evidence Based Medicine .Then how about others ?????????

What your doctor of Ayurveda says

• Your doctor’s recommendations may be or may not be true

• It is miserable truth that there is no standardised science led decision making initiated in Ayurveda until today . Infact this crucial matter and methodologies are not even educated for Ayurveda doctors in teaching institutes.

• If your disease is not started showing favourable response in not more than 48 hours or started worsening in the first few hours of Ayurvedic prescription , going for second opinion is must !

What you need to ask your doctor of Ayurveda?

• What is happening inside my body during this disease ?• What are the specific intrinsic/extrinsic cause and

circumstances which favoured me to get this disease ?• What is the scientific explanation for prognosis of my case

mentioned in Ayurveda ?• What is my role in my recovery process and guidelines which I

should follow? • How can I be sure of that Iam getting scientifically right

treatment and how long it requires for the doctor for confirmation of the same ?

• The cost effectiveness of my treatment?

Science Based Evidence Based Ayurveda (SBEBA)

• SBEBA is a scientifically structured programme developed for the first time in Ayurveda to practice Evidence Based Medicine which is science based as intended by shasthra .

• The proposers of this programme are Dr. Remya Krishnan MD PhD and Dr.Rajkumar MD PhD , both faculties and clinicians of Ayurveda, currently working in RajivGandhi Ayurveda Medical college, Govt. of Puducherry

• The concept is about making sure that when clinical decisions are made they are made on the basis of the most up-to-date, solid reliable shathra led primary evidence. In the case of medicine or health care, these are the decisions about the care of individual patients.

• Shathra led primary evidence should guide medical practice of Ayurveda

Best evidence

• The best evidence in Ayurveda is the permanantly valid science based evidence

• Science in Ayurveda incorporates siddhanthas (theorems) which are proven and established and not incompletely proven theories or hypothesis . Shasthra incorporate the rationale for cause- mechanism –effect of every phenomena in the living body in health and disease .

• So the perfect evidence base in Ayurveda in shasthra based evidence.

Science Based Evidence Based Medicine

• Science Based Evidence-based medicine is the conscientious explicit and judicious use of Science based evidence pertinent to the clinical situation in making decisions about the care of individual patients in light of their own unique cause and circumstances.“

• Conscientious – being careful, and thorough, in what you do

• Explicit – being “up-front”, open, clear and transparent• Judicious – using good judgement and common sense

in shasthraarthas ( science based intentions)

Practice of SBEBA

• If Ayurveda doctors are going to practice in this way, they have to be able to recognise the pertient science based evidences appropriate to the situation of patients. They have to apply those evidences in various levels pertinently when making decisions about your patient.

• Until today, no specific knowledge and training is provided for Ayurveda community to understand and apply science based evidences in variable clinical situations .

Evidence Triad Approach

• For this reason, SBEBA proposers have developed a standardised methodology derived from shasthra to appraise the clinical situation in the individual patient which is technically termed as Evidence Triad Approach (ETA)

• The details of this technique are published in the book “Evidence Based Ayurveda &Rational prescribing” authored by Dr. Remya Krishnan, 2012

SBEBA WISDOM SERIES

• The proposers are also conducting training programmes for students of BAMS, MD and qualified medical professionals of Ayurveda labelled SBEBA wisdom series

• Many doctors, faculties and students are attending the programme from all over India and abroad

• The very objective of this programme is to enable Ayurveda practitioners and students learn and practice the very intended Science Based Medicine (SBM) of Ayurveda which is evidence based . This programme is hence titled as “Save Ayurveda Mission” .

Need of the hour

• SBEBA is the need of the hour!!For Ayurveda doctors

• For Ayurveda faculties• For Ayurveda students• For all patients who seek Ayurveda treatment• For the entire morbid world

Kindly support this noble mission • If you feel that the current pathetic situation in Ayurveda is to be

eradicated and practice of Evidence Based Medicine which is science based is to be initiated , please do support this mission by signing this petition !

• You need not be an Ayurveda doctor or student to sign this petition. Any well wisher of Ayurveda and humankind can support this noble mission

• By signing this petition , you are helping large number of patients to acquire the intended scientific treatment of Ayurveda at most minimum cost

• Let us make this reach Ministry of AYUSH, do sign it please !•

https://www.change.org/p/department-of-ayush-save-ayurveda-mission

• For more information on SBEBA ( SCIENCE Based Evidence Based Ayurevda ),

• Check this link http://www.slideshare.net/remyakrishnan336For all queries,Contact drremyaraj@gmail.comThankyou !

THANKYOU