^2nd Global Summit on Herbals & Natural Remedies October 17-19, 2016 Kuala Lumpur, Malaysia

Shashi K Agarwal has obtained his Board Certification in Internal Medicine in 1979 and Cardiovascular Diseases in 1981. He is also Board Certified with the American Board of Integrative Holistic Medicine and the American Academy of Anti-Aging Medicine. He has been awarded Fellowship of the American College of Cardiology, American College of Physicians and the American College of Nutrition. He has presented over 150 scientific abstracts and published over 30 scientific papers in peer reviewed journals. His interest is in scrutinizing and disseminating evidence based data regarding the therapeutic role of various complimentary modalities and encouraging their integration into contemporary medicine.

AbstractrnrnIntroduction: Cardiovascular diseases are the number one cause of morbidity and mortality in the world. Traditional herbal concoctiosns and herb derived drugs are commonly used in these ailments. These three abstracts review popular herbal remedies which have demonstrated beneficial cardiovascular effects and results have been validated by rigorous scientific studies.rnrnMethods: PubMed interrogation revealed 65,034 entries under ‘herbal medicines’ and 2,963 under ‘herbal and cardiovascular’. Relevant citations were reviewed. Other pertinent published scientific material was also consulted.rnrnResults: Aesculus hippocastanum (Horse Chestnut): The seed extract standardized to around 20 percent aescin is often used for its anti-inflammatory and free radical scavenging properties. Its primary use, however, has been as an efficacious and safe short-term treatment for chronic venous insufficiency. Although the mechanisms are still not well understood, venous contraction appears to be mediated through 5-HT (2A) receptors. Allium sativum (Garlic): Properties of garlic (allicin) include reduction in blood pressure, inhibition of platelet aggregation, enhancement of fibrinolytic activity, reduction of lipid synthesis and protection of the elastic properties of major arteries. It also stimulates nitric oxide generation and reduces inflammation. Clinically, there is an improvement in unstable angina, peripheral artery disease and coronary calcification progression. Crataegus (Hawthorn): Several clinical trials have indicated significant benefits in its adjunctive role in the treatment for chronic heart failure. Mechanisms include catecholamine contraction and endothelial-dependent nitrous oxide induction related vaso-relaxation.rnrnConclusions: Several herbal medicines have convincingly established their therapeutic role as cardioceuticals. Evidence based scrutiny has repeatedly validated their efficacy and safety in clinical trials.rn

Shashi K Agarwal has obtained his Board Certification in Internal Medicine in 1979 and Cardiovascular Diseases in 1981. He is also Board Certified with the American Board of Integrative Holistic Medicine and the American Academy of Anti-Aging Medicine. He has been awarded Fellowship of the American College of Cardiology, American College of Physicians and the American College of Nutrition. He has presented over 150 scientific abstracts and published over 30 scientific papers in peer reviewed journals. His interest is in scrutinizing and disseminating evidence based data regarding the therapeutic role of various complimentary modalities and encouraging their integration into contemporary medicine.

AbstractrnrnIntroduction: Cardiovascular diseases are the number one cause of morbidity and mortality in the world. Traditional herbal concoctions and herb derived drugs are commonly used for these ailments. These three abstracts review popular herbal remedies which have demonstrated beneficial cardiovascular effects and results have been validated by rigorous scientific studies.rnrnMethods: PubMed interrogation revealed 65,034 entries under ‘herbal medicines’ and 2,963 under ‘herbal and cardiovascular’. Relevant citations were reviewed. Other pertinent published scientific material was also consulted.rnrnResults: Commiphora mukul (Guggulipid): Z- and E-guggulsterones are the active ingredients and inhibit cholesterol synthesis in the liver via antagonism of the farsenoid X receptor and the bile-acid receptor. The extract has received regulatory approval for treating hyperlipidemia in India since 1987; while in the United States, guggulipid is available as a non-prescription dietary supplement. Digitalis purpurea (Common Foxglove): Digitalis is used for symptomatic chronic heart failure for patients with reduced systolic function, preservation of systolic function and combined with beta blockers in rate control for atrial fibrillation with a rapid ventricular response. Digitalis works by inhibiting sodium-potassium ATPase in the myocardium causing intracellular sodium concentration to increase. Ginkgo Biloba (Maidenhair tree): Its terpenes inhibit platelet-activating factor, decrease vascular resistance and improve circulatory flow, while the flavonoids reduce capillary permeability and fragility. Clinical studies support its use in treating cerebral insufficiency. It may also help peripheral vascular disease.rnrnConclusions: Several herbal medicines have convincingly established their therapeutic role as cardioceuticals. Evidence based scrutiny has repeatedly validated their efficacy and safety in clinical trials.rn

Shashi K Agarwal has obtained his Board Certification in Internal Medicine in 1979 and Cardiovascular Diseases in 1981. He is also Board Certified with the American Board of Integrative Holistic Medicine and the American Academy of Anti-Aging Medicine. He has been awarded Fellowship of the American College of Cardiology, American College of Physicians and the American College of Nutrition. He has presented over 150 scientific abstracts and published over 30 scientific papers in peer reviewed journals. His interest is in scrutinizing and disseminating evidence based data regarding the therapeutic role of various complimentary modalities and encouraging their integration into contemporary medicine.

rnAbstractrnrnIntroduction: Cardiovascular diseases are the number one cause of morbidity and mortality in the world. Traditional herbal concoctions and herb derived drugs are commonly used for these ailments. These three abstracts review popular herbal remedies which have demonstrated beneficial cardiovascular effects and results been validated by rigorous scientific studies.rnrnMethods: PubMed interrogation revealed 65,034 entries under ‘herbal medicines’ and 2,963 under ‘herbal and cardiovascular’. Relevant citations were reviewed. Other pertinent published scientific material was also consulted.rnrnResults: Rauwolfia serpentine (Indian snakeroot): Reserpine, a major alkaloid in Rauwolfia serpentine produces a strong and prolonged hypotensive effect in patients by decreasing cardiac output, peripheral vascular resistance, heart rate and renin secretion. The main mechanism for its sympatholytic and antihypertensive actions appears to be depletion of catecholamines. Rosmarinus officinalis (Rosemary): Although research on rosemary is scant, its diterpenoids, especially carnosic acid and carnosol have antioxidant activity that helps with stabilizing erythrocyte membranes and inhibiting superoxide generation and lipid peroxidation. Rosemary leaves contain high amounts of salicylates and its flavonoid pigment diosmin is reported to decrease capillary permeability and fragility. Rosemary may help retard atherogenesis. Ruscus aculeatus (Butcher\'s Broom): Ruscus aculeatus, through its vasconstrictive and venotonic properties may have a therapeutic role in ameliorating the symptoms of orthostatic hypotension and venous insufficiency. The active ingredients are two steroidal saponins, ruscogenin and neurogenin which antagonize histamine-induced increases in vascular permeability.rnrnConclusions: Several herbal medicines have convincingly established their therapeutic role as cardioceuticals. Evidence based scrutiny has repeatedly validated their efficacy and safety in clinical trials.rn

Shashi K Agarwal has obtained his Board Certification in Internal Medicine in 1979 and Cardiovascular Diseases in 1981. He is also Board Certified with the American Board of Integrative Holistic Medicine and the American Academy of Anti-Aging Medicine. He has been awarded Fellowship of the American College of Cardiology, American College of Physicians and the American College of Nutrition. He has presented over 150 scientific abstracts and published over 30 scientific papers in peer reviewed journals. His interest is in scrutinizing and disseminating evidence based data regarding the therapeutic role of various complimentary modalities and encouraging their integration into contemporary medicine.

AbstractrnrnIntroduction: Herbal products are commonly used by patients with cardiovascular diseases but most of them do not share this information with their physicians. Although often considered harmless, herbal medicines may cause adverse cardiovascular effects from an ingredient, a contaminant or herb-drug interaction. Ignorance and or misinformation is largely responsible for this potentially dangerous situation. This abstract reviews the known cardiovascular dangers of commonly used herbal cardioceuticals.rnrnMethods: PubMed interrogation revealed 65,034 entries under ‘herbal medicines’, 2,963 under ‘herbal and cardiovascular’ and 3,750 under ‘herbal toxicity’. Relevant citations were reviewed. Other pertinent published scientific material was also consulted.rnrnResults: Digoxin (Digitalis purpurea) may cause bradycardia, heart block and ventricular tachyarrhythmias. These can be potentially fatal. Dan-shen (Salviae miltiorrhizae): Potentiates blood thinner warfarin activity; may lower blood pressure. Garlic (Allium sativum): Increases the risk of bleeding especially when ingested as fresh garlic and when taken with blood-thinning drugs may also lower blood pressure. Maidenhair tree (Ginkgo biloba): Increases the risk of excess bleeding when taken with blood-thinning drugs. May abnormally raise or lower blood pressure. Hawthorn (Crataegus): Increases the risk of bleeding when taken with blood-thinning drugs may potentiate Digitalis effect.rnrnConclusions: There has been an extensive evidence based review of the potential adverse effects of herbal remedies in the recent years. Some if these have identified dangerous cardiovascular effects. Dissemination of this information is critical. Patients should disclose herbal remedy use and health care workers should discuss adverse effects of these naturoceuticals and monitor and identify possible herb-drug interactions.rn

Shashi K Agarwal has obtained his Board Certification in Internal Medicine in 1979 and Cardiovascular Diseases in 1981. He is also Board Certified with the American Board of Integrative Holistic Medicine and the American Academy of Anti-Aging Medicine. He has been awarded Fellowship of the American College of Cardiology, American College of Physicians and the American College of Nutrition. He has presented over 150 scientific abstracts and published over 30 scientific papers in peer reviewed journals. His interest is in scrutinizing and disseminating evidence based data regarding the therapeutic role of various complimentary modalities and encouraging their integration into contemporary medicine.

AbstractrnrnIntroduction: Herbal products are commonly used by patients with cardiovascular diseases but most of them do not share this information with their physicians. Although often considered harmless, herbal supplements may cause adverse cardiovascular effects from an herbal ingredient, a contaminant, or herb-drug interaction. Public ignorance and or misinformation is largely responsible for this potentially dangerous situation. This abstract reviews the known cardiovascular dangers of herbal remedies used for non-cardiac indications.rnrnMethods: PubMed interrogation revealed 65,034 entries under ‘herbal medicines’, 2,963 under ‘herbal and cardiovascular’ and 3,750 under ‘herbal toxicity’. Relevant citations were reviewed. Other pertinent published scientific material was also consulted.rnrnResults: Aloe: Abnormal heart rhythms. Arnica: Elevates blood pressure. Black cohosh: Lowers blood pressure. Feverfew: May interfere with blood clotting. Ginger: May increase bleeding and cause abnormal heart rhythms in high doses. Ginseng: High blood pressure and increased risk of bleeding with blood-thinners. Stinging nettle: May increase fluid retention in heart failure. Ephedra: Increases in heart rate and blood pressure. Goldenseal: May decrease or increase blood pressure & cause arrhythmias and increase risk of bleeding when taken with blood-thinning drugs. Licorice root: May raise blood pressure and cause cardiac arrhythmias.rnrnConclusions: There has been an extensive evidence based review of the potential adverse effects of herbal remedies in the recent years. Some of these have identified dangerous cardiovascular effects. Education is essential in this matter. Patients should disclose herbal remedy use information and health care workers should discuss adverse effects and monitor and identify possible herb-drug interactions.rn

Dr. Sandeep V. Binorkar is working as an Assistant Professor in the Dept. of Agadatantra & Vyavahara Ayurveda at Govt. Ayurveda College, Nanded, Maharashtra state, India. He has pursued his Post graduate [MD (Ayu)] in Agadatantra (Ayurvedic Toxicology) from the University of Calicut, Kerala state. He has honoured with 6 National Awards including Kerala Ayurveda Research Award-2007 for his research work during Post graduation. With teaching experience of 9 yr and 6 months, he has worked for various renowned institutes of Ayurveda over the country. Published more than 25 research articles in peer reviewed international journals, authored 5 books, has presented in number of National and international conferences and is one of the distinguished faculty on the

‘Dashanga Agada’ is one of the frequently prescribed herbo-mineral compound medications in variety of ailments including venomous bites and stings in south India especially in Kerala. The compound preparation is a contribution of Vagbhata’s Ashtanga Hridaya, Uttaratantra, chapter 37/28 which indicates is benefits and versatile applicability in various poisonous infectious insect bites. Keeping this in mind, the present study was planned to explore the in vitro antimicrobial, anti-fungal and anti-oxidant activity of this formulation. Agar-well method was used for screening in vitro antibacterial and antifungal activity. Zones of inhibition were observed in disc diffusion for antimicrobial investigation against selected standard bacterial strains of E. Coli, Bacillus Subtilis, Staphylococcus aureus, Salmonella typhi and Shigella, and fungal strains Asperigillus niger and Candida albicans. Cefpodoxime and Fluconazole were used as anti-bacterial and antifungal control with concentration of 10mg/ml respectively to compare the effects. The formulation – ‘Dashanga Agada’ showed average zone of inhibition ranging from 17-33 mm suggesting its activeness against the tested microorganisms and confirmed its antimicrobial perspective. Anti oxidant activity was calculated in terms of Ascorbic acid which was observed as 10.91 again suggesting its free radical scavenging potentials. rnrnKey Words - Dashanga Agada, Agadatantra, In-vitro, Anti-microbial, Anti-fungal, Anti-oxidant rn