From ancient India to the present Modern age, Ayurveda has always had a significant place in treatment of illnesses. Ayurveda has successfully reached many heights in the cure of diseases. I decided to investigate the claims of an Ayurvedic doctor of curing Sickle Cell Disease, which is one of the most deadly diseases on Earth wiping off thousands of lives every year. To investigate the proposed treatment of the doctor I have carried out a survey with the help of a questionnaire and also a scientific experiment for observing the decrease in the number of sickle shapes RBCs in the body of a patient. To make the judgement fair, I have also criticized the treatment in the conclusion part of my essay. As I could not gain access to advanced scientific instruments, which would have refined my results and made them accurate, I have list of all possible limitations I could account for. I have also mentioned the extensions to the concepts and procedures used in the Appendix part of my paper.
When in my Biology class I was taught about Sickle-Cell Disease, as a junior high school student, I was much struck with the fact that Sickle-Cell Disease and most of the genetic diseases are incurable. Most of the genetic diseases are caused by mutation in the genetic material. The knowledge I gained about base substitution mutation in DNA and the Human Genome Project, showed me light to the possibility of a cure to the disease. Stem Cell Therapy was the first thing that came into my mind, while thinking of a cure to SCD. Eventually I found that researches about using stem cell therapy for curing SCD were already being carried in various academic and research institutions across the globe. As a result, bone marrow transplant became a ray of hope for the sufferers of the disorder; but still, the scientists and doctors would assert the non-existence of a definite cure to the disease. Sickle cell disease is a major public health concern.
Sickle-Cell Disease (SCD) is one of the most life-threatening diseases ever discovered. The disease not only disturbs the life of the patients but also his family. As there has been no definite treatment or cure for the disease till date, the patients are very frequently admitted in hospitals and have to undergo unbearable pain. Some forms of Sickle-Cell Disease tell us that it is even more fatal than Cancer and AIDS. In spite of being a very deadly and widespread disorder in many parts of the country, Government of India has not taken any serious steps regarding eliminating or researching on the treatment and cure of SCD.
The change of the biconcave shape of RBCs to crescent and sickle shape is known to be because of the defect in the Chromosome 11. Chromosome 11 is considered as one of the most disease-rich chromosome in human genome. As per the Dr. Nandeshwar's theoretical claim, his ayurvedic drugs inhibit the function of Chromosome 11. Ayurveda has been known to be a field of medicine where the treatment hardly causes any kind of side-effects. As compared to Allopathy, the treatment last for a longer duration but the treatments are very effective. These are the facts that are commonly said and are believed in Indian society.
The disease occurs in about 1 out of every 500 African Americans births, and about 1 out of every 36,000 Hispanic Americans births. The trait of SCD occurs in about 1 in 12 African Americans. From 1989 through 1993, there was an average of 75,000 hospitalizations due to sickle cell disease in the United States, costing approximately $475 million. During 2005, medical expenditures, in the US, for children with sickle cell disease averaged $11,702 for children with Medicaid coverage and $14,772 for children with employer-sponsored insurance. Sickle cell-related death among African-American children less than 4 years of age fell by 42% during 1999 to 2002. This coincides with the introduction of a vaccine that protected against invasive pneumococcal disease in 2000. The disease can be found in people living in parts of the world where malaria is or was common. It is believed that people who carry the sickle cell trait are less likely to catch malaria. [1]
General Observations about the treatment:
It was observed that after about 1 year of this treatment the patients stopped having blood transfusion as their haemoglobin level was rising. The crisis of the patients has also reduced during the first year of the treatment drastically. The patients reported to be fully cured from the basic problems cause by SCD such as join pain, fever and weakness.
2. Methodology
2.1 Objectives of study:
To verify if the Ayurvedic medicines composed of plant extracts cure Sickle-Cell Disease.
To investigate the extent to which the Ayurvedic medicines cure SCD.
To find out the rate at which they cure SCD.
2.2 HYPOTHESIS
HYPOTHESIS 1: The Ayurvedic medicines to a large extent will help cure SCD.
HYPOTHESIS 2: All the symptoms which are directly related to abnormality in shape of RBCs will be cured.
HYPOTHESIS 3: The medicines will show evident effects on the shape of RBCs in a year.
Survey:
20 patients for each of the below symptoms and complications who have been undergoing treatment since 1 year at the clinic were surveyed about the prognosis of their health problems. The following were the results:
Symptoms
Cured or not
Chronic shortage of RBCs (Anaemia)
Partially cured
Episodes of pain/crisis
cured
Hand-foot syndrome
Partially cured
Jaundice
Cured
Complication
Cured or not
Strokes
Cured
Acute chest syndrome
Cured
Pulmonary hypertension
Cured
Organ damage
Only the further damage could be reduced
Blindness
Not cured
Skin ulcers
Partially Cured
Final Experiment:
To verify why the symptoms subsided in SCD cases, an experiment was conducted. In the experiment I planned to use the blood samples of 10 different patients, which were collected by Doctor Ashay Nandeshwar. The samples were collected of 10 patients at a regular interval of 2 months.
2.3 Variables:
Dependent Variables (DV)
Total number of blood cells in the sample.
Number of defected cells in the sample.
Number of normal cells in the sample
Controlled Variables
Independent Variables
(IV)
Amount of blood used to prepare each slide.
No blood transfusion while undergoing the treatment.
Fixed Variables
(Constants)
Number of blood cells in the sample over a period of time
Uncontrolled Variables
Density of blood
Room temperature
Humidity
Slight Impurities
Drops of solutions clinging on to the walls of test tubes, syringe and beakers.
Materials:
Slides
Droppers
Leishman stain
Distilled water
Syringe with needles
Cotton
Spirit
Procedure 1: Preparing the blood smears (carried out by the Doctor)
Distilled water was used to clean all the slides. The slides were then kept open to dry
5 ml syringes were used to take out blood from the patients. In adult patients, the blood was taken out from a vein in the arm; and in young children the blood was taken from finger tips.
About 0.5 ml of blood was taken out from each patient.
Each blood sample was then added into a test-tube (cleaned and dried).
Separate droppers were used to transfer 1 drop of blood from each sample from the test-tubes to the slides.
With the thumb and forefinger of the right hand, hold the end of a second slide against the surface of the first slide
Draw the second slide back to contact the drop of blood. Allow the blood to spread.
Push the second slide forward until all of the blood has been spread into a moderately thin film.
The blood was smeared on the slides as shown in the below figure. The slides were then covered with Leishman stain, and were then allowed to dry for about 30 minutes each.
Procedure 2: Viewing the smears under a microscope and counting the cells
The prepared slides were then viewed under an optical microscope.
A digital camera was used to capture the images from the eye-piece.
The digital images were then zoomed on a computer and then counted.
3. Data Collection and Processing
At the start of treatment:
Total number of RBCs observed
Number of defected cells observed
Number of normal Cells
% of defected cells
129
74
55
57.36434168527132%
Two months of treatment:
Total number of RBCs observed
Number of defected cells observed
Number of normal Cells
% of defected cells
131
61
70
46.5648855%
4 months of treatment:
Total number of RBCs observed
Number of defected cells observed
Number of normal Cells
% of defected cells
93
43
50
46.23655914%
6 months of treatment:
Total number of RBCs observed
Number of defected cells observed
Number of normal Cells
% of defected cells
109
24
85
22.01834862385321%
8 months of treatment
Total number of RBCs observed
Number of defected cells observed
Number of normal Cells
% of defected cells
108
21
87
19.44444444%
10 months of treatment:
Total number of RBCs observed
Number of defected cells observed
Number of normal Cells
% of defected cells
128
15
113
11.71875%
12 months of treatment
Total number of RBCs observed
Number of defected cells observed
Number of normal Cells
% of defected cells
110
11
99
10%
14 months of treatment:
Total number of RBCs observed
Number of defected cells observed
Number of normal Cells
% of defected cells
105
6
99
5.714285714%
16 months of treatment:
Total number of RBCs observed
Number of defected cells observed
Number of normal Cells
% of defected cells
101
5
96
4.95049505%
18 months of treatment
Total number of RBCs observed
Number of defected cells observed
Number of normal Cells
% of defected cells
87
4
83
4.597701149%
20 months of treatment:
Total number of RBCs observed
Number of defected cells observed
Number of normal Cells
% of defected cells
133
2
131
1.503759398%
22 months of treatment:
Total number of RBCs observed
Number of defected cells observed
Number of normal Cells
% of defected cells
134
1
133
0.7462686567%
Statistical Analysis:
No apparent trend can be observed in the above statistics. The symptoms of the disorder would decrease in a gradual manner unlike the pattern seen in the above graph.
4. Conclusion and Evaluation
The hypothesis 1 is proved to be correct. This could be seen by the results of the survey as well as in the images of the blood smears. The percentage of the defected cells drastically reduced till the end which shows that the treatment successfully works. Sickle cells are fragile and break apart easily. They eventually get washed off the body through various means. Sickle cells die after only 10 to 20 days. The total number of cells in each of the image of blood smears had decreased after initial few months, which may be an indication of the defected cells successfully being washed off the system slowly. This is a possibility as the amount of blood used for preparing the smears was kept constant.
The hypothesis 2 is proved to be correct. All the symptoms that were directly related to abnormality in shape of RBCs were cured. The other symptoms and complications which were cause indirectly were either partially cured or the further damage was successfully prevented. This only proves that the ayurvedic medicines were successful in short term (span of 2-3 years). As I have discussed about the short lifespan and replacement of RBCs, it solves the problem of chronic shortage of oxygen and thus also Anaemia. As the number of defected cells get washed off the body, the chances of blockages in blood vessels also reduce and hence the changes of crises too. The same occurs for Hand-Foot Syndrome also. The patients I have surveyed did not have any kind of severe liver damage because of sickle shaped cells which the reason why the problem of Jaundice was easily cured within a year.
The hypothesis 3 is also proved to be correct. The medicines did show evident effects in the shapes of the RBCs. At the beginning of the treatment the percentage of defected cells in the image of the blood smear was 57.36%. Whereas, the percentage of defected cells in the image of the blood smear which was made after 12 months of treatment was only 10%.
Limitations of the treatment:
There are standardized laboratory and clinical tests to be conducted on a drug before being brought into use. To my surprise the drugs used in this ayurvedic treatment were directly brought into clinical trials. Before trails on human beings a drug is testing on cell cultures and animals, which was not done in the development of the drugs involved in the mentioned treatment. This is one of the dangerous consequences of corruption in a country. The Research, Development and Testing of new drugs is a lengthy as well as a costly procedure which controlled by government of different countries. In India it usually happened that to save money in small scale clinics new drugs are directly brought into use for treatment. Unless a drug has undergone all the testing properly its usefulness and safety cannot be determined.
Through testing, an effective range of doses of a drug is established where the side effects and toxicity are monitored. A value (lethal dose in 50% of the population) of the drugs was unknown, which is a very dangerous limitation of the treatment in itself.
Along with the unknown value, unknown chances of tolerance added to greater chances of discrepancy.
Through interaction with many patients I found out that the drugs did not alter sensory sensation in an evident way. But the drugs may still have it including to the alterations in moods, emotions and consciousness. The long term effects on sensory sensations are unknown as treatment has been carried on since just 2 and half years.
Limitations and improvements in the procedure:
The biggest limitation in the procedure was the discrepancy in the counting of blood cells which could have been solved to a large extent with the help of a haemocytometer or the most accurate instrument Coulter counter which were unavailable to me.
The use of needle and syringe pose a risk to health and safety as needle injuries could be caused. It would have been better if a Pasteur pipette was used, which is also as accurate as a syringe.
The physical fitness of the patient has a considerable amount of effect on the conclusion results and conclusion of my experiment. The higher level of stamina of human body means that more oxygen is being carried in the body, which in turn means that large amount of red blood cells are produced by the bone marrow. Erythropoirtin (EPO) is the hormone which makes the bone marrow to produce the RBCs. Regular exercising stimulates the production of EPO.
As the blood smears were only random samples from a huge population of RBCs my investigation, there is a very high level of uncertainty involved. This problem could have been reduced to a large extent, if I would have carried out my investigation on more than one sample.
The investigation was carried out only on one patient.
Before using them the slides should be washed with an acid, then rinsed in distilled water and then air-dried. This is done to make the slides free of alkaline substances if the cells are going to adhere.
The slide should be made as soon as possible after the cells have been taken from the patient and collected in ethylenediaminetetraacetic acid (EDTA). If you wait too long, the cells will lose their shape and the true shape is extremely important for diagnosing. This was a very big limitation in the experiment. [2]
The blood cells were not properly spread out in the above slides. This is was a very significant limitation of the experiment. Due to the over-lapping of the blood cells some there definitely must have been an error in counting. To overcome this limitation a thin capillary tube should have been used to take out the blood sample on to the slide.
The Science Advisory Board has laid down specific protocols for preparing blood smears. According to the protocol the procedure should include the use of Smear Fix© on the wet preparation or the slide gently into a coplin jar of acetic alcohol (3% acetic acid in 95% methanol). These two solutions are fixative which helps to keep the blood cells stable. [3]
Bibliography
"What is Sickle Cell Anemia?." Sickle Cell Anemia (2011): n. pag. Web. 4 Jan 2011. <http://www.nhlbi.nih.gov/health/dci/Diseases/Sca/SCA_WhatIs.html>.
"Leishman's stain for blood cells and parasites." Protocols (2011=0): n. pag. Web. 4 Dec 2010. <http://www.scienceboard.net/resources/protocols.asp?action=article&protocol_id=313&criteria=>.
