Title : Barriers to cross between clinical microbiology and Ayurvedic medicine for the betterment of patient care
Abstract:
It is quite natural that Ayurveda, the oldest health care system in the world (about 5000 years old), does not have the word 'Antibiotics', But a curious search in its literature will definitely show the number of references stating that certain diseases are produced due to micro-organisms.
In recent global medicines, the antibacterial therapy has been challenged due to the emergence and spread of multidrug-resistant (MDR) bacterial pathogens. Hence, the MDR bacterial infections often resulted in high mortality and pre and post medical care with cost involving medical treatments.
Very importantly, multidrug-resistant microorganisms have created immense clinical problems during the treatments of infectious diseases. Therefore, medical researchers are enforced to search for convenient, appropriate, less cost-effective, and minimal or no side effects containing medicines to treat the diseases caused by such bacteria. Various parts of the plants like root, bark, seed, and leaves have been an important source of Ayurvedic medicine for thousands of years. So, in recent years a predominant interest has been observed in evaluating different plant extracts for their antimicrobial properties against bacteria and fungi. Keeping with that, when we observe the knowledge, attitude, and perception on antibiotic usage and resistance of Ayurveda health care staff in Sri Lanka, who don’t administrate antibiotics inpatient management, is satisfactory. However, attitude and perception on the practical application of antibiotics need to be improved.
To evaluate this self-administered questionnaire was distributed to 100 Ayurvedic health care staff including medical and nursing officers. Knowledge, attitude, and perception on antibiotic usage and resistance were correctly answered with averages of 83.99±5.87%, 59.89±20.36% and 62.64±18.12%, respectively. Statistical significance was observed in knowledge compared to attitude, and perception. The poor attitude was identified in the prescription of antibiotics during chest infection (30.77%). The poor perception was discovered on “When the doctor does not prescribe antibiotics for respiratory tract infections do you follow doctor’s Suggestion?” (10.99%), and “Giving antibiotics to friend/family for sickness” (23.08%).
Though Ayurvedic staff needs a knowledge improvement on antimicrobial resistance, they are using lots of medicinal plants to control antimicrobial resistance which needs a proper scientific evaluation. So, we planned a study which was aimed to evaluate the in vitro antimicrobial activity of methanol extracts of traditionally used endemic and native medicinal plants (Berberis ceylanica, Leucas zeylanica, Pongamia pinnata, Cynometra cauliflora and Morinda coreia) of Sri Lanka against Gram-positive and negative bacterial strains such as Pseudomonas aeruginosa, Staphylococcus aureus, Escherichia coli, Methicillin-Resistant Staphylococcus aureus (MRSA) and fungi Candida albicans. The study showed potently and diverse antimicrobial activities of methanol extracts of B. ceylanica, L. zeylanica, P. pinnata, M. coreia, C. cauliflora. The findings of the study, therefore, may be used to develop alternative therapeutics in the management of methicillin resistant S. aureus, Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa and C. albicans.
Apart from curative medicine, preventive medicine is also playing a very important part in clinical practice. Especially in this Covid pandemic situation, all medical personnel have to have satisfactory knowledge of infection control and prevention. Since Ayurvedic practice is not related to acute infections, evaluating their competence in managing Covid-19 patients is important. So, we did an assessment of the knowledge and applications of infection control in Ayurvedic health care staff working in Covid-19 intermediate centers, Sri Lanka
A self-administered questionnaire (comprised of six categories focusing on Covid-19 infectivity, vaccinations, standard precautions (SP), hand hygiene and disinfectants) was distributed to 100 Ayurvedic health care staff from 5 hospitals. Only 5.4% could recognize the biohazard sign. Only 55.3% had knowledge of Covid-19 infectivity while 30.9% didn’t know that Covid-19 is not transmitted by skin contact and 58.5% didn’t know that N95 masks are not mandatory to prevent Covid-19. Knowledge on SP was satisfactory (84.6%), with 86.2% could clearly understand the definition, 82.9% knew that those are designed to reduce the Hospital Acquired Infections (HAI). Hand washing was recognized by 79.8% as the best method to prevent HAI transmission. But only 26.6% could identify the correct application of my 5 movements. Knowledge of the usage of gloves is satisfactory (80.5%). Understanding on glove usage was poor (50.7%), (P < 0.05). Knowledge on identifying correct disinfectants for Covid-19 is satisfactory (89.39%). But the application of the disinfectant was poor (50.7%), (P < 0.05).
According to the results Ayurvedic health care staffs need to be educated on some areas related to basic infection control fundamentals. In addition to that, improvements in their skills and clinical training on the application of infection control practices can be recommended to prevent HAI including Covid-19.
The potential of Ayurvedic medicine needs to be explored further with modern scientific validation approaches for better therapeutic leads. Therefore, an attempt has been made in the present review to highlight the crucial aspects that need to be considered for the promotion and development of Ayurvedic medicine.
