EFFECTIVENESS OF AYURVEDA AND ALTERNATIVE MEDICINE IN ...

REPORT ON EFFECTIVENESS OF AYURVEDA AND ALTERNATIVE

MEDICINE IN COVID-19 MANAGEMENT

DISCUSSION ON FINDINGS:

The Ayurveda centres were 77.8% and other other alternative medicine were 22.2

% indicating the more availability of Ayurveda Hospital and Centre in comparison

to others. The Presence of Ayurveda centres are more and there are few

government other alternative centres. This is indicative of more Ayurveda service

delivery centres in comparison to other alternative medicine. 44.4% of the hospital

and centre had the facility of admitting the covid-19 patients and providing care

while 55.6% couldn’t admit the patients. The 44.4% were dedicated for covid 19

with special support but the normal admission capacity is less than that. This is

indicating the Hospital and centres generally do not have adequate facilities for

admission. Admission capacity in Ayurveda Hospital and centre was 76.35%

whereas 23.65% in other alternative medicine hospital. National Ayurveda

Research and Training centre had been prepared for the covid-19 that is the reason

of more availability of admission bed but all the centres, hospitals need support

and strengthen facilities. The percentage of service recipient in preventive aspect

from Ayurveda Hospital was 84.21% and from other alternative medicine was

15.79%. This may be due to wide range of publicity for Ayurveda preventive

approach and traditional acceptance to Ayurveda in community and families.

Alternative medicine hospital had only Mild, Moderate and Asymptomatic cases

whereas moderate to severe cases were also present in Ayurveda Hospitals. After

certain support from government and agencies National Ayurveda Research and

Training centre was able to admit the moderate cases, while Central Ayurveda

Hospital Naradevi had moderate to severe cases. Department of Ayurveda and

Alternative medicine covid 19 guideline and the same guideline with some changes

was mostly used. Department of Ayurveda and Alternative medicine guideline was

only followed in 5.86% centres, 21.7% had used DOAA with some changes while

other ways of their own was used.Other guidelines were also used . At National

Ayurveda Research and Training centre where the maximum number of cases of

admitted the guideline was not used. Although the similar approach was adopted

indicating less acceptance of guideline in practice. But other centres mostly used

the same guideline or with some modifications which is indicating national

acceptance and practice of guideline in isolation centres and hospital throughout

the country and all geographical regions. The referral of patients to Allopathic

hospitals in case of need was mostly from Ay urveda hospital. The moderate and

severe cases sometime needed additional supported for which there were referral.

The were no referral of patients among Ayurveda and alternative medicine centres

and hospital. This is because lack of tertiary specialized units and hospitals in

Ayurveda and alternative medicine centre which indicates the need for

development in this sector for the upliftment of Ayurveda and alternative

medicine. Significant percent 77.8% of the centres had adopted some specific ways

or steps for covid 19 prevention.22.8 % had used only the international and

national uniform guidelines for preventive measures only. 85.71% of the

preventive steps contribution was from Ayurveda centres while the remaining was

from other alternative medicine. The most frequent other approaches applied in

Ayurveda centre was yoga ,in Naturopathy also yoga, in Homeopathy was exercise

and diet and allopathy was also used as other approach in integrated approach in

prevention in one centre . Specific lifestyle counseling was done in 89.9% of

centres and no specific counselling was done in 11.1% centre. EFFECTIVENESS

OF AYURVEDA AND ALTERNATIVE MEDICINE IN COVID-19

MANAGEMENT Geo –Consult Pvt. Ltd. Kathmandu 67 77.80% of centres had

adopted specific dietary changes in patients and 22.20% had no only general

dietary guidelines but no specific changes. Patient Specific guideline was provided

during discharge from 55.6% centres but 44.45 had only general guidelines during

follow up. None of the centres had any reported case of recurrences of symptoms

in any discharge cases within 7 days of discharge which is indicating the successful

approach in covid-19 management. 55.6% of the centres responded the support

from government and other agencies as good while 22.2% were satisfied and

22.2% responded the support as excellent indicating a good overall response and

support. Excellent support for the dedicated covid 19 centres were received i.e

66.7% received excellent support and none of the centre was unsatisfied. During

covid 19 the preventive approach being highly accepted and believed the support

was also significant but the regular such support is the need for upliftment of

Ayurveda and Alternative medicine. All the centres had received positive feedback

from service recipients; significant number 66.7% had received the excellent

feedback from the service recipients while 11.1% centres had received the

satisfactory feedback. This is because of holistic approach in healing in Ayurveda

centre where not only the patient and disease is managed but all the physical,

social, mental and spiritual aspects are considered during management. National

Ayurveda Research and Training centre had the highest percentage of admission

capacity followed by Yogi Narharinath Yoga and Naturopathy Hospital dedicated

to covid 19 patients. Central Ayurveda hospital Naradevi had 50 bed dedicated to

covid 19 patients. Pashupati Homeopathic hospital had 6 bed capacity but was not

dedicated to covid-19. The highest number of patients care provided was from

National Ayurveda Research and training centre with 58.66 cases alone followed

by Yogi Naraharinath Yoa and Nature cure hospital. 84.21% of preventive

approach and home isolation approach cases was from Ayurveda Hospital and

other 15.79% was from Homeopathic Hospital. Most of the patients admitted were

mild to moderate symptoms. Only 1 centre had admitted patients with severe

symptoms. Patients with 7 days hospital stay was 15.05%, while 39.59 % had 10

days stay only 0.15% had hospital stay of more than 14 days. Only 2.41% of

patients were referred which is indicative of less referral and less number of cases

being moderate to severe during hospital stay. 77.78% of centres had adopted

specific preventive measures while 22.22% had general preventive approach.

Ayurveda and Yoga was the most frequent other approach used. Only 1 centre had

no specific lifestyle counselling but all others provided lifestyle counselling Only 2

centre had no specific dietary changes but all others provided dietary changes. 6

Centres received excellent feedback, 2 centres had received good while 1 had

received satisfactory which indicates the positive feedback from patients in all

centres. The low percentage of patient referral from these centres also indicates the

significance of Ayurveda and alternative medicine approach. Average duration of

hospital stay is also indicating the significant role of management approach. No

any recurrence in symptoms after discharge within 7 days also indicates the

efficacy of Ayurveda and alternative medicine approach in management.

CONCLUSION

Ayurveda and alternative medicine practices have significantly contributed in

COVID- 19 pandemic. There was excellent feedback of preventive approach used.

This has lead to the Increasing acceptance of the people towards Ayurveda and

alternative medicine. Ayurveda and Alternative medicine practices can be

efficiently used in COVID-19 management alone for mild to moderate cases or in

integrated manner for moderate to severe cases. This research is primarily for

assessment of effectiveness of Ayurveda and Alternative medicine in COVID 19

management but after the observation it is realized that priorities should be given

for strengthening the development of Ayurveda and alternative system of

medicine. Limited evidence to support the significant contribution from Ayurveda

and alternate medicine centre can be generated from this study being carried out at

limited centres of Ayurveda and Alternative Medicine due to time span, financial

constraint and lack of resources.

REPORT

ON

EFFECTIVENESS OF AYURVEDA AND ALTERNATIVE

MEDICINE IN COVID-19 MANAGEMENT

Prepared by

Geo –Consult Pvt. Ltd. Kathmandu

Submitted To:

Department of Ayurveda and Alternative Medicines, MoHP,

Government of Nepal, Kathmandu

EFFECTIVENESS OF AYURVEDA AND ALTERNATIVE MEDICINE IN COVID-19 MANAGEMENT


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ACKNOWLEDGEMENT

National priority with enormous efforts on COVID-19 a global challenge is on the

management through testing and preventing transmission, vaccination and supportive

symptomatic care. Although with numerous ways and resources Covid-19 pandemic is under

control in Nepal. The rich heritage of traditional knowledge and practice of Ayurveda and

Alternative medicine also has a significant role in prevention and management. Ayurveda

and Alternative medical practices have been popularly practiced in quarantine and isolation

centers and hospitals. As Ayurveda and alternative medicine believes in self defense

mechanism via immunity strengthening of an individual. Ayurveda is the science of life that

envisions to protect and promote the health of healthy individual and alleviate the disorders in

diseased. Ayurveda’s intensive information on preventive care drives through the vastness of

Dinacharya(Daily regime), Ritucharya (Seasonal regime) and Achar Rasayana (good

conduct) to maintain healthy life and enhance local immunity to resist with the threats and

pandemic condition to some extent. There was a need to perform a study to find what is the

impact of Ayurveda and alternative medicine practices in management of Covid 19, during

the pandemic in Nepal. Thus this research focuses on study on effectiveness of Ayurveda and

Alternative medicine in COVID-19 management.

During the process of research and report preparation data was taken from Ayurveda

Physician, Hospitals and Isolation centres including all three geographical locations.

Academia and other relevant stakeholders were deeply involved through series of

Conversation and meeting.

We deeply appreciate the great efforts and work done by Ayurveda and alternative

medicine sector doctors, Hospital staff and thank all those involved in covid-19 patients care

and preventive approaches.

We are thankful to Nepal Health Research council for approval to perform this research.

We are indebted to Hospitals and Isolation Centre for extending valuable co-operation and

support in whole process by providing data and opinion promptly.

This acknowledgement would be incomplete without expressing our immense

gratitude and cordial thanks to Dr. Siddhartha Kumar Thakur, Dr. Mithilesh Kumar Sah and

Dr. Nirmal Bhusal for their consultant service and also Department of Ayurveda &

Alternative Medicine for providing this responsibilty and all support.

Investigators

Geo- Consultant pvt.ltd



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TABLE OF CONTENTS

ACKNOWLEDGEMENT

LIST OF GRAPH

ABSTRACT

1. INTRODUCTION…………………………………………………………………...8

2. HYPOTHESIS……………………………………………………………………….10

3. RESEARCH OBJECTIVES/ PURPOSE/ AIM OF THE STUDY……………….10

a. GENERAL

b. SPECIFIC

4. MATERIAL AND METHODS………………………………………………….10-12

a. RESEARCH METHOD

b. TYPES OF STUDY

c. STUDY POPULATION/SAMPLING FRAME

d. STUDY SITE

e. SAMPLING METHOD

f. SAMPLE SIZE

QUALITATIVE

QUANTITATIVE

g. INCLUSION &EXCLUSION CRITERIA

h. INCLUSION CRITERIA

i. EXCLUSION CRITERIA

j. SAMPLE COLLECTION

k. STUDY VARIABLES

INDEPENDENT VARIABLES

DEPENDENT VARIABLES (OUTCOME)

l. EXPECTED TIME AND DURATION OF THE STUDY

m. TOOLS AND TECHNIQUES FOR DATA COLLECTION

n. DATA MANAGEMENT AND STATISTICAL ANALYSIS

o. BIAS

p. SAFETY CONSIDERATION

5. WORK PLAN/ GANTT CHART…………………………………………………....13

6. ETHICAL CONSIDERATION……………………………………………………...13

7. ETHICAL CLEARANCE NUMBER………………………………………………….13

8. REVIEW OF LITERATURE……………………………………………………….14-20

COVID-19: FROM AYURVEDA PERSPECTIVE

a. THE NATURAL HISTORY OF THE DISEASE (VIKAARA PRAKRITI)

b. CLINICAL STAGING OF THE DISEASE



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c. ADHISHTAANA - THE SITE

d. SAMUTHAANA VISHESHA – THE ETIOLOGY

MANAGEMENT PROTOCOL

COVID 19 FROM ALTERNATIVE MEDICINE PERSPECTIVE

SITUATIONAL REPORT ON COVID 19 IN NEPAL.

9. OBSERVATION & RESULT………………………………………………………. 21-65

10. DISCUSSION……………………………………………………………………………..66

11. CONCLUSION……………………………………………………………………………68



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LIST OF TABLE

Table 1: Ayurveda and Alternative Medicine Center.

Table 2: Cross tabulation of Region* No. of Patients Enrolled.

Table 3: Cross tabulation of Center*Admit/Not Admit.

Table 4: Total Admission Capacity at Alternative Medicine and Ayurveda Center.

Table 5: Cross tabulation of center*Preventive Measure.

Table 6: Cross tabulation of type of patient moistly admitted *Center.

Table 7: Cross tabulation of Which Guideline was followed *Center.

Table 8: Total number of Patients Referred to Allopathic hospital.

Table 9: Cross tabulation of Any Covid Preventive Measure adapted (Yes/No) * Center.

Table 10: Any Covid Preventive Measure adapted (If Yes).

Table 11:Cross tabulation of Names of Commonly prescribed Medicines * Center.

Table 12: Cross tabulation of Other Approaches in alternative Medicine * Center.

Table 13: Cross tabulation of Center * Any Lifestyle Counselling Done (Yes/No).

Table 14: Cross tabulation of Center * Any Dietary Changes Done (Yes / No).

Table 15: Cross tabulation of Center * Any Guidelines provided during discharge (Yes/No).

Table 16: Cross tabulation of Center * Any Recurrence in symptoms after discharge within 7

days (Yes/No).

Table 17: Cross tabulation of Center * Overall response and support from Government agencies

and other organization.

Table18: Cross tabulation of Center * Feedback from the service recipients/ Post Covid Patients.

Table 19: Tabulation of Name of the Hospital/ Isolation Unit * Total Admission Capacity.

Table 20: Cross tabulation of Name of the Hospital/ Isolation Unit * Admission / Not Admission.

Table 21: Total Number of patient enrolled till date (Admit/Not Admit)

Table 22: Name of the Hospital/ Isolation Unit * Preventive Measure (Home Isolation)

Table 23: Name of Hospital * Types of Patients mostly admitted.

Table 24: Name of Hospital * Guideline was followed.

Table 25: Name of the Hospital/ Isolation Unit* Average Duration of Hospital stay.

Table 26: Average Duration of Hospital stay

Table 27: Name of the Hospital/ Isolation Unit* Total number Patients Referred to

Table 28: Name of the Hospital/ Isolation Unit * Any Covid preventive measures adapted

Yes/No.

Table 29: Cross tabulation of Name of the Hospital* Other Approaches in alternative Medicine.



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Table 30: Cross tabulation of Name of the Hospital/ Isolation Unit * Any Lifestyle Counselling

Done (Yes)

Table 31: Name of the Hospital/ Isolation Unit* Any Dietary Changes Done (If Yes)

Table 32: Name of the Hospital/ Isolation Unit * Any Guidelines Provided during discharge (If

Yes)

Table 33: Name of the Hospital/ Isolation Unit * Names of Commonly prescribed Medicines

Table 34: Frequency of Feedback from the Service recipients/Post Covid Patients.

Table 35: Cross tabulation Name of the Hospital/ Isolation Unit * Overall response and support

from Government agencies and other organization.

Table 36: Efficiency of Ayurveda and Alternative Medicine Center



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List of Graph

Figure 1: Percentage of Pie-chart of Ayurveda and Alternative Medicine Center.

Figure 2: Percentage Pie-chart of Total number of patients enrolled in region.

Figure 3: Percentage of Pie-diagram of Admit and Not Admit Center.

Figure 4: Bar-diagram of Frequency/Percentage of Total Admission Capacity.

Figure 5: Percentage of Pie-chart of Preventive Measure.

Figure 6: Frequency Bar-diagram of Symptoms of Patients and center.

Figure 7: Frequency of Bar-diagram of Guideline followed and Center.

Figure 8: Percentage of Pie-chart of patients Referred to Allopathic Hospital.

Figure 9: Percentage of Pie-diagram of Any Covid Preventive Measure adopted (Yes/No).

Figure 10: Percentage of Pie-Chart of Any Covid Preventive Measure adapted (If Yes).

Figure 10: Percentage/Frequency Bar-diagram of Other Approaches in alternative Medicine.

Figure 11: Percentage of Pie-diagram of Any Lifestyle Counselling Done (Yes/No).

Figure 12: Percentage Pie-diagram of Any Dietary Changes Done (Yes / No).

Figure 13: Percentage Pie-diagram of Any Guidelines provided during discharge (Yes/No).

Figure 14: Percentage/ Frequency of Overall response and support from Government agencies


Figure 15: Frequency/Percentage Bar-diagram of Feedback from the service recipients/ post

Covid Patients.

Figure 16: Frequency of Name of the Hospital/ Isolation Unit * Total Admission Capacity.

Figure 17: Bar-diagram of Total Number of patient enrolled till date (Admit/Not Admit).

Figure 18: Percentage of Pie-diagram of Preventive Measure (Home isolation)

Figure 19: Percentage Bar-diagram of Types of Patients was mostly admitted.

Figure 20: Percentage Bar-diagram of Guideline was followed.

Figure 21: Percentage Bar- diagram of Average Duration of Hospital stay.

Figure 22: Percentage pie-diagram of Total number Patients Referred & not referred to

Allopathic hospital.

Figure 23: Percentage pie-diagram of Any Covid preventive measure is adapted (Yes/No).

Figure 24: Percentage Bar-diagram of Other Approaches in alternative Medicine.

Figure 25: Percentage pie-diagram of Any Lifestyle Counselling Done (Yes/No).

Figure 26: Percentage pie-diagram of Any Dietary changes Done (Yes/No).

Figure 27: Percentage / Frequency of Feedback from the Service recipients/Post Covid Patients.



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Figure 28: Percentage/ Frequency of Overall response and support from Government agencies


Figure 29: Bar-diagram of Total number of Patients and Patients referred to Allopathic Hospital.



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1. INTRODUCTION

The current COVID-19 is a rapidly evolving global challenge and like any pandemic, it

weakens health systems, costs lives, and also poses great risks to the global economy and

security. When the global focus has mostly been on testing, finding a cure and preventing

transmission; people are going through a myriad of psychological problems in adjusting to the

current lifestyles and fear of the disease. Although with limited resources on modern medicine

the Covid-19 pandemic is under control in Nepal. The rich heritage of traditional knowledge and

practice of Ayurveda and Alternative medicine may have a significant role in prevention and

management. Ayurveda and Alternative medical practices have been popularly practiced in

quarantine and isolation centers and hospitals. As Ayurveda and alternative medicine believes in

self defence mechanism via immunity strengthening of an individual. Ayurveda and alternative

medicine focuses on comprehensive principles of holistic management. This research focuses on

study on effectiveness of Ayurveda and Alternative medicine in COVID-19 management.

Nepal is among the least developed nation with a fragile health system, with unstable

political situation. In addition to this Nepal shares the border with China, country of origin for

COVID-19 and shares open border with India, the second populous country with most COVID

19 cases in South Asia, Nepalese people have open access across the border in between India and

Nepal for labour migration, cultural and religious trips, tourist destination etc. this makes Nepal

and Nepalese people as one of the highest risk areas for the cross-border transmission of

pandemic. Ayurveda’s intensive information on preventive care drives through the vastness of

Dinacharya (Daily regime), Ritucharya (Seasonal regime) and Achar Rasayana (good conduct) to

maintain healthy life and enhance local immunity to resist with the threats and pandemic

condition to some extent. In Nepal, the Ayurveda and alternative medicine, preventive and

curative approach is largely accepted and practiced in every household.People have been

practicing the lifestyle recommended by Ayurveda within their culture, food and festivals

knowingly or unknowingly to some extent. Similarly, same practices with supervision and

guidance of Ayurveda expert it has been practiced in quarantine centre, isolation centre and

Hospital for COVID-19 prevention and management. But due to lack of evidence based research

and documentation, impact of Ayurveda and alternative traditional practices for COVID

treatment and management are not being valued and not given much emphasis by health

authorities on case treatment and management. And this has made the efforts of the Ayurveda

and alternative traditional health system for management of COVID-19 undervalued. Thus there



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was a need to perform a study to find what is the impact of Ayurveda and alternative medicine

practices in management of Covid 19, during the pandemic in Nepal.

2. HYPOTHESIS:

H0: The Ayurveda and Alternative medicine practices have no effect in COVID-19

prevention and management.

H1: The Ayurveda and Alternative medicine practices have significant effect in COVID-19

prevention and management.

3. RESEARCH OBJECTIVES/ PURPOSE/ AIM OF THE STUDY:

General

To study effectiveness of Ayurveda and Alternative medicine practices in COVID-19

management in quarantine/ isolation centre and Hospitals in Nepal.

Specific

To assess impact of Ayurveda management practices in quarantine/ isolation centre and

Hospital in Nepal.

To determine the nature of practice against COVID-19 in Ayurveda and Alternative

medicine centre and Hospital.

4. MATERIAL AND METHODS

a. Research Method: The research method is of mix method of both qualitative and

secondary data analysis

b. Types of study- The nature of study is cross-sectional observational study.

c. Study Population/Sampling Frame-

Qualitative: The sampling frame for the qualitative aspect of the study was 12 numbers of

Key Informant Interview (KII) involved in management of COVID-19 in

quarantine/isolation centre and Hospital of Ayurveda and alternative medicine designated

for COVID-19 management in Nepal.

Quantitative: The sampling frame for the quantitative aspect of the study was the total

number of patient admitted to the various quarantine/isolation centre and hospital of

Ayurveda and alternative medicine designated for COVID-19 management in Nepal.

d. Study site –Total 9 centres were visited for data collection irrespective of province.

e. Sampling Method –Purposive sampling method.

f. Sample size-



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Qualitative: At least 12 KII per quarantine/isolation center and hospital of Ayurveda and

alternative medicine designated for COVID-19 management before Jestha, 2078, were

included in study.

Quantitative: Total patient who have been admitted in various quarantine/isolation

centre and hospital of Ayurveda and alternative medicine designated for COVID-19

management till Jestha, 2078 were included in the study.

g. Inclusion &exclusion criteria

h. Inclusion criteria:

a. KII from Isolation Centre and Hospital or units involving Ayurveda, Homeopathy,

Naturopathy or any Alternative medicine in management protocol before Jestha,

2078 during pandemic.

b. Data of Patient admitted in Ayurveda and Alternative medicine center designated

for management of COVID1-19 till Jestha, 2078 during pandemic.

i. Exclusion criteria:

a. Data and KII informants from Allopathic hospital and Isolation center with

Allopathic/ modern medicine Management.

b. Data of patients admitted in Ayurveda and alternative medicine centre after Jestha,

2078 during COVID-19 pandemic.

j. Sample collection- The survey sample includes9hospitals and isolation centres under the

Ayurveda and alternative medicine across Nepal. The medical directors/ focal person

were contacted in person or telephone or video call through messenger, and were

interviewed to answer questionnaires.

k. Study variables

Independent variables-

Demographic information: Total number of patients, management status, referral, death

numbers, average duration of hospital stay, medicine prescribed etc. were obtained

through secondary data.



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Dependent variables (Outcome)

Information regarding prevention and management of Covid -19 through

Ayurveda and alternative medicine was collected from stakeholders involved in Isolation

centre and Hospital involved in Covid 19 management.

l. Expected time and Duration of the Study–Six Weeks

m. Tools and techniques for data collection –Semi- structured interview guideline for KII,

structured questionnaire (template) to collect secondary data.

n. Data Management and Statistical Analysis:

Data was cleaned and edited on the same day of data collection for the errors if any then

coding, classification and tabulation were done.

Procedures for accounting for any missing or spurious data etc. - The care were taken

to avoid missing of any data. If any data is found missing the information of such

respondent was discarded.

Plan for Data analysis:

The qualitative data is analysed thematically as per the objective and hypothesis of the

study manually using MS-Excel. The quantitative data is analysed descriptively and

analytically in SPSS.

The statistical methods used for the analysis of data- Data analysis through appropriate

statistical test depending on the nature of data.

o. Bias: The care is taken to avoid biases as far as possible. Cross questioning was done to

minimize the respondent biases.

p. Safety consideration:

a. All standard safety measures were taken into consideration during data collection.

b. Researcher follows the public health preventive measures all the time during

primary and secondary data collection.

a. Interview was done via telephone where possible.

b. Data was asked to be submitted online.



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5. WORK PLAN/ GANTT CHART

Activities 1 2-3 3-4 4-6

Proposal Development and

Submission

Data collection and Analysis

Data management and analysis

Report writing

Final Reporting to DOAA

Note: Numbers indicate the weeks for the completion of Activities during research.

6. ETHICAL CONSIDERATION:

Regarding the human participants:

o Human participants required in this research are only for Key Informant Interview

o Secondary Data was collected from different Centres i.e. NARTC, Central

Ayurveda Hospital Nardevi, Homeopathy Hospital, Community naturopathy

hospital Rajahar, Yogi Narharinath Prakritik Chikitsayala Bharatpur, Provincial

Ayurveda Hospital Dang.

o The confidentiality of the research participants were guaranteed.

o Research participants were provided the phone number and contact address of the

members of research team so that they can contact in case any changes in data and

information

7. Ethical Clearance Number:

The study was registered in Nepal Health Research Council (NHRC) for ethical clearance

and it has been approved on 24th

June, 2021 with the ID no. 316-2021.



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REVIEW OF LITERATURE:

COVID-19: FROM AYURVEDA PERSPECTIVE

COVID -19 is an illness caused due to Novel Corona Virus 2, now called as Severe Acute

Respiratory Syndrome Corona Virus -2 (SARS CoV 2). It was first reported in Wuhan City,

China. It was declared as a pandemic by WHO on March 11, 2020, as it has confirmed its

presence in all continents except Antarctica.

Ayurveda has unique methods of approaching a newly detected disease. Rather than focusing on

the microbiological etiology, Ayurveda embraces a holistic technique for elaborating the details

of the disease at hand. In Ayurveda, epidemics are discussed under the term

of Janapadodhwamsa where it is mentioned that due to either of

deranged Vayu (air), Jala (water), Desha (habitat) and Kala (seasons), certain diseases arise

which kill mass of people. These diseases can be considered as either airborne or waterborne

infectious diseases or diseases occurring due to soil contamination or conditions arising due to

weather or seasonal hazards. Further, under the heading of Adidaivika Bala Pravritta

Vyadhi (diseases arising due to such causes that cannot be controlled by human intelligence),

terms such as Sansargaja and Upsargaja are mentioned which indicate that there are certain

diseases which can be transmitted directly from infected persons to healthy persons. Aupasargic

Rogas i.e communicable & contagious diseases in which it has been said that it can be

transmitted by touch or breath, or through partaking of the same bed, and eating and drinking out

of the same vessel with him, or through using the wearing apparel, unguents and garlands of

flowers previously used by a person afflicted with this dreadful disease. In Ayurveda, the

management of these infectious diseases can be either preventive or curative. It is mentioned that

collection of potent medicines should be done and if required, Shodhana (bio-purification)

and Rasayana (immunomodulatory changes) can be planned in the persons in the risk areas, so as

to improve the immunity and thus making the risk of infection low. It is noted that certain viral

infections occur in a specific period of year when either the weather is favourable for viral

potency or there are potent vectors to carry the infection or when immunity of the human body is

low. In newly emerging covid-19 where the direct description are not available on Ayurveda

Classical texts but a vigilant study of signs and symptoms described can help prepare the

management plan. Further, prevention and early detection may help for rapid implementation of

effective measures, which are the key to reduce the risk of distratous spread. The Signs and

symptoms of COVID-19 may appear two to 14 days after exposure and can include: Fever,



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Cough and Shortness of breath or difficulty breathing. Other symptoms are tiredness, Aches,

Runny nose, Sore throat, Headache, Diarrhoea, Vomiting, Some people have experienced the

loss of smell or taste which are more likely similar to different categories of Jwara described in

Ayurveda. The complications of Jwara are Swasa (difficulty breathing) , Murcha (Fainting) ,

Aruchi (anorexia), Vamana (vomiting), Trishna (Thrust), Atisaar (diarrhoea), Vishada

(depression), Hikka (hiccough), Kasa (cough), Angamardha (body-ache) which are the symptoms

of covid -19 also. Thus categorization of Jwara Awastha / Category and planning preventive,

curative and promotive aspects on the base of Ayurveda can provide a hope in the fight with this

pandemic. The Complications can include Pneumonia in both lungs and Organ failure in several

organs which is very much similar to Jwara Vyapada indicating difficulty in management.

Ayurveda and Alternative Medicine Guidelines of Preventive Measures and Curative

Management Protocol for COVID 19 in Nepal in reference to Ayurveda classical text has

suggested three pointed approach in the elaboration of an unknown disease.

1. The natural history of the disease (Vikaara Prakriti)

2. The site of the pathological process (Adhishtana) and

3. Etiological features (Samuthaana Visesha)

1. The natural history of the disease (Vikaara Prakriti)

Considering the Vikaara Prakriti, primarily, as Covid-19 has evolved itself into a pandemic,

affecting a large population irrespective of their physical features, dietary patterns, psychological

attributes etc., Ayurveda considers it as a Janapadodhwamsa Vikara esp. Rakshasadi Prakopa

Janya. It can be grouped under the class of Aagantuja Vikaara with special reference to the class

of Bhutabhishangaja (microbiological etiology).

The management of Aagantuja Vikaara should also follow the lines of Nija Vikaara. Hence,

identification of the suitable pathological model along with the associated features is important.

Referring to the details available from the places where the Covid-19 has maximally affected,

and especially from China, almost 40% of the cases were very mild with no symptoms of viral

pneumonia, another 40% of the cases were having moderate symptoms with mild pneumonia,

15% were having very severe symptoms and 5% were critical, at presentation. Generally 98%

patients were having mild to moderate fever (Jwara), 76% were having cough (Kasa) and 44%

were having myalgia (Anga Marda)and fatigue (Tandra).

Among those developed pneumonia, 99% were having fever (Jwara), 70% were having fatigue

(Tandra), 59% dry cough (Vatika Kaasa), 40% having anorexia (Aruchi), 35% having myalgia



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(Anga Marda),31% having dyspnea (Shwaasa) and 27% were having sputum production

(Kaphaja Kaasa).

In another report, the main clinical features suggested are fever (Jwara), cough (Kaasa), shortness

of breath (Shwaasa). If the situation aggravated , there will be labored breathing (Shrama

Shwasa), persistent pain or pressure in the chest (Uro Vedana), mental confusion (Moha),

inability to arouse (Sangynaas), cyanosis (Aasyashyavata), Diarrhea (Atisaara) and nausea

(Chhardi) are very minimal during the initial presentation.

Many patients reported with fever, dry cough and minimal respiratory distress. Later the fever

subsided, but the respiratory distress became severe and many died.

Considering all these factors, covid-19 can be considered as a Kapha-vata Samsargaja Jwara, of

course , with pitta association, in the beginning, considering and comparing with the clinical

features mentioned in classics. But it acquires the status of a full Sannipataja Jwara in certain

subset of patient population, as the condition progresses.

Going through the excerpts from the article written by doctors who managed the illness at China.

“Three adult patients presented with severe pneumonia and were admitted to a hospital in Wuhan

on December 27, 2019. Patient 1 was a 49-yearold woman, Patient 2 was a 61-year-old man, and

Patient 3 was a 32-year-old man. Clinical profiles were available for Patients 1 and 2. Patient 1

reported having no underlying chronic medical conditions but reported fever (temperature, 37°C

to 38°C) and cough with chest discomfort on December 23, 2019. Four days after the onset of

illness, her cough and chest discomfort worsened, but the fever was reduced; a diagnosis of

pneumonia was based on computed tomographic (CT) scan. Her occupation was retailer in the

seafood wholesale market. Patient 2 initially reported fever and cough on December 20, 2019;

respiratory distress developed 7 days after the onset of illness and worsened over the next 2 days

at which time mechanical ventilation was started. He had been a frequent visitor to the seafood

wholesale market. Patients 1 and 3 recovered and were discharged from the hospital on January

16, 2020. Patient 2 died on January 9, 2020. No biopsy specimens were obtained.”

These statements work as a pointer towards the nature of progression of the disease.

The worsening of the illness which culminates in death is mostly seen in the geriatric age group

as well as those with co-morbidities.

The patients who are having no co-morbidities are having an overall case fatality rate of 0.9%.

The case fatality rates of those above 60 years are as follows

A. 60-69 – 3.6%

B. 70-79 - 08%

C. >80 - 14.8%



17

while Younger age groups had lower fatality rate;

A. 50-59 -1.3%

B. 40-49 -0.4%

C. 10-39 - 0.2%

The case fatality rates of those with co-morbidities are as follows

a. Cardiovascular diseases – 10.5%

b. Diabetes mellitus – 7%

c. Respiratory diseases, hypertension, malignancies – 6%

Thus, the patients belonging to a geriatric age group and those with existing co-morbidities are

more prone to be in the group that worsens once the disease progresses. Hence, in that group the

clinical course can be charted as:

Another sequencing of the clinical course is -

An analysis of the clinical course can lead to the following conclusions

1. Rogi Bala deteriorated due to old age or co-morbidities are leading worsened condition in the

patient.

Symptomatic Mild Illness at Presentation

leading to Moderate Illness Culminating

in very Fatal Illness

Mild illness

Pneumonia

Severe pneumonia

Acute Respiratory Distress Syndrome (ARDS)

Sepsis

Septic

shock



18

2. Due to compromised Rogi Bala, the co-existing Pitta, even mild, is causing Syandana and

Shoshana in the chest progressively, which cannot be resisted by the body.

3. This process can be technically described as a Dhaatupaaka, a deregulated host response, from

the context of Sannipaataja Jwara.

4. This results in the rapid instability of Ojus leading to sepsis and eventually septic shock.

5. Because of the Syandana and Shoshana property of intervening Pitta, the Jwara may end up in

the fatal forms of Sannipaataja Jwara, of which two special fevers worth mentioned- Vata

predominant Sannipaataja Jwara titled as Visphaarakam and Vata–kapha predominant Sannipaata

Jwara titled Sheekhrakaari. Along with the change in the nature of Jwara, Shwasa which was a

feature previously, now becomes prominent as an Upadrava.

Thus the entire clinical course of covid-19 can be postulated as having these stages.

Clinical Staging of the Disease

When grading the stages of symptoms of Covid -19 the different types of Sannipataja Jwara

Awastha are seen. The Common symptoms mentioned by WHO fever, tiredness and dry cough,

shortness of breath, aches and pains, sore throat and very few people with diarrhoea, nausea or a

runny nose are very much same as in different types of Sannipataja Jwara. The duration of

Vataja, Pittaja, Kaphaja Sannipataja Jwara is 7 days, 10 days and 12 days ( or sometimes 14, 18

and 22 days ) respectively. If the fever and the symptoms get relief in the duration indicated then

the patient recovery is good but if the fever and symptoms persists even after the duration of 14,

18 and 22 days in each type the complication arise and the patient may die. Although there is no

clear cut evidence or finding to suggest with particular type of Jwara with Covid -19 but with the

symptomatology its management plan may be in these stages:

Stage 0: Kapha-Vataja Jwara (Patient with seasonal fever having positive travel history /

contact history / home quarantine/ isolation but no symptoms or very minimal symptom and test

negative for Covid -19)

Stage 1: Vata-Kaphaja Sannipatika Jwara (Fever with cough, tiredness and body ache at mild

level)

Stage 2: Aggravation of the already existing situation (Covid - 19 positive with specific

symptoms at moderate level)



19

Stage 3: Dhatu Paaka and Shwasa coming forwards as an Upadrava- Complications due to

unchecked activity of the Pitta Dosha (Covid -19 positive with severe symptoms with

respiratory distress etc. and progressive towards fatality).

Adhishtaana - The Site

The proper Adhishtaana of Covid-19 can be suspected as Koshta itself, but the manifestation

happens in Uras, which itself is a predominant site of Kapha. Many a time, it has been found that

Pitta Dosha exerts a significant pathological influence on Kapha. The Ushna Guna of Pitta, in

combination with the Sasneha and Drava Guna will exert a pathological effect on Kapha, thereby

making it Asthira (unstable) and Abadha (unbounded). Here also, as stated in the description of

the stages, Pitta can trigger this pathological cascade leading to the Syandana and further

Shoshana. This can lead to Dhatu Paaka and death.

Samuthaana Vishesha – The Etiology

The occurrence of a Kapha-vata predominant Sannipaataja Jwara as a Janapada-udhwamsa in

Vasanta Ritu points to the rapid and violent vitiation of Vayu, Udaka, Desha and Kaala due to the

activities that can be earmarked as Pragyanaparaadha.

Moreover, the predisposing factors such as the old age and co-morbidities are causes of

deteriorated Rogi Bala and which resulted in instability of Ojus and fatality.

MANAGEMENT PROTOCOL:

Ayurveda system of Medicine is an example of a well-organized traditional health care in both

preventive and curative aspect. The preventive component emphasizes the need for a strict code

of personal and social hygiene, the details of which depend upon individual, climatic, and

environmental needs. Bodily exercises, the use of herbal preparations, and Yoga form a part of

the remedial measures. The curative aspects of Ayurveda involve the use of herbal medicines,

external preparations, Panchakarma, and diet. It is a principle of Ayurveda that the preventive

and therapeutic measures be adapted to the personal requirements of each patient.

COVID 19 FROM ALTERNATIVE MEDICINE PERSPECTIVE

Healthcare system, currently has been under constant pressure because of the diverse challenges

posed by Covid-19. Enormous efforts are being taken by Governments, health care professionals,

and pharmaceutical companies to contain this disease across the world. Currently, we do not have

any approved drug or vaccine candidate for the treatment of COVID-19 but continuous efforts

are being made by the scientific world by conducting clinical trials with new interventions,

https://www.britannica.com/science/herbalism

https://www.britannica.com/topic/Yoga-philosophy

https://www.merriam-webster.com/dictionary/remedial

https://www.britannica.com/science/physical-therapy



20

including new vaccines candidates are being explored. Countries like China and India, with a rich

history of traditional medicine, are exploring the effectiveness of their traditional medicines to

treat COVID-19.

In Nepal National Health Policy 2074 defines Alternative system as Yoga, Naturopathy, Sowa

Rigpa, Homeopathy, Unani, Traditional Chinese Medicine, and other traditional medicine and

practices. Among these Yoga, Homeopathy and Naturopathy practice in Covid 19 was supportive

actively along with Ayurveda. According to a survey conducted by WHO, traditional healers

treat about 85% of the total patients in Nepal. Ayurveda, Amchi, Homeopathy associating with

Unani, Naturopathy are the important traditional health system existing in Nepal. Among them,

Ayurveda has been practicing since time immemorial. Although traditional medicines and

ethnomedicinal folklores have been serving rural people with its superiority, the secrecy of

healers about the traditional knowledge along with decreasing biodiversity and negligence of

youngsters toward the continuation of traditional knowledge are emerging challenges for the

conservation of ethno medicinal folklore and medicinal plants. Some previous studies carried out

in Nepal have shown that more than 50 % of the population use CAM because of culture, lack of

health facility and expensiveness of modern allopathic medicine and CAM practices are found

common in both the rural and urban areas of Nepal.



21

OBSERVATION

Table 1: Ayurveda and Alternative Medicine Center

Frequency Percent Valid Percent Cumulative Percent

Alternative Medicine Center 2 22.2 22.2 22.2

Ayurveda Center 7 77.8 77.8 100

Total 9 100 100

Figure 1: Percentage of Pie-chart of Ayurveda and Alternative Medicine Center.

Total of 9 Ayurveda and alternative medicine centers were enrolled in the study out of which the

Ayurveda centres were 77.8% and other alternative medicine were 22.2 % indicating the more

availability of Ayurveda Hospital and Centre in comparison to others.

Alternative Medicine Center, 22.2 %

Ayurveda Center, 77.8 %

Percentage Pie-chart of Ayurveda And Alternative Medicine Center



22

Table 2: Cross tabulation of Region* No. of Patients Enrolled.

Region No. of Patients enrolled Percent Valid Percent Cumulative Frequency

Hilly Region 2283 71.54 71.54 71.54

Mountain Region 455 14.26 14.26 85.80

Terai Region 453 14.20 14.20 100

Total 3191 100.00 100.00

Figure 2: Percentage Pie-chart of Total number of patients enrolled in region.

Total of 3191 patients were enrolled in 9 Ayurveda and alternative medicine centers out of which

71.54% of patients were provided services in hilly region followed by 14.26% in mountain

region and 14.20% in Terai region.

Hilly Region

71.54 %

Mountain Region

14.26 %

Terai Region

14 .20%

Percentage of Total number of Patients enrolled in region.



23

Table 3: Cross tabulation of Center*Admit/Not Admit.

Not Admit Admit Total

Alternative Medicine Center Count 1 1 2

% within Center 50.0% 50.0% 100.0%

Ayurveda Center Count 4 3 7

% within Center 57.1% 42.9% 100.0%

Total Count 5 4 9

% within Center 55.6% 44.4% 100.0%

Figure 3: Percentage of Pie-diagram of Admit and Not Admit Center.

Out of 9 Ayurveda and alternative medicine centers 44.4% centers had the facility of admitting

the covid-19 patients and providing care for Covid patients while 55.6% couldn’t admit the

patients.

Not Admit

55.6 %

Admit

44.4 %

Percentage of Admit and Not Admit Center



24

Table4: Total Admission Capacity at Alternative Medicine and Ayurveda Center.

Figure 4: Bar-diagram of Frequency/Percentage of Total Admission Capacity.

In 4 Ayurveda and alternative medicine centers total admission capacity was 406 out of which

Ayurveda centers have 76.35% capacity whereas 23.65% capacity was in alternative medicine

centers.

0

100

200

300

400

500

Alternative Medicine

Center

Ayurveda Center Total

96

310

406

23.65

76.35 100

Fre

qu

ency

/Perc

enta

ge

Center

Bar-diagram of Total Admission Capacity

Frequency

Percent



Ayurveda Center 310 76.35 76.35 100.00

Total 406 100 100



25

Table 5: Cross tabulation of center* Preventive Measure.

Preventive

Measure Percent

Valid

Percent

Cumulative

Percent


Center 37493 15.79 15.79 15.79

Ayurveda Center 200000 84.21 84.21 100

Total 237493 100 100

Figure 5: Percentage of Pie-chart of Preventive Measure.

Total of 237493 patients were provided preventive measures through Ayurveda and alternative

medicine out of which the percentage of service recipient in preventive aspect from Ayurveda

centers was 84.21% and from other alternative medicine centers was 15.79%.

Alternative Medicine Center

15.79 %

Ayurveda Center 84.21 %

Percentage of Preventive Measure



26

Table 6: Cross tabulation of type of patient moistly admitted *Center.


Center

Ayurveda

Center Total

Asymptomatic 0 1 1

Mild 0 1 1

Mild + Moderate 1 1 2

Mild + Moderate +

Asymptomatic 1 0 1

Mild +Asymptomatic 0 1 1

Mild + Asymptomatic 0 1 1

Moderate 0 1 1

Moderate + Severe 0 1 1

Total 2 7 9

Figure 6: Frequency Bar-diagram of Symptoms of Patients and center.

Out of 9 Ayurveda and alternative medicine centers Alternative medicine centers had only Mild,

Moderate and Asymptomatic cases being handled while moderate to severe cases were also

present in Ayurveda centers.

00.20.40.60.8

11.21.41.61.8

2

1 1

2

1 1 1 1 1

Fre

qu

ency

Symptoms



27

Table 7: Cross tabulation of Which Guideline was followed *Center.


Center

Ayurveda

Center Total

DOAA 1 2 3

DOAA With Some Specific

Changes 0 3 3

Specific only/Symptomatic only 0 1 1

Others 1 1 2

Total 2 7 9

Figure 7: Frequency of Bar-diagram of Guideline followed and Center.

Out of 9 Ayurveda and alternative medicine centers Ayurveda and Alternative Medicine

Guidelines of Preventive Measures and Curative Management Protocol for COVID 19 in Nepal

by Department of Ayurveda and Alternative medicine (DOAA) was followed by 6 centers with

some specific changes while 2 centers following other guidelines.

0

0.5

1

1.5

2

2.5

3

DOAA DOAA With Some

Specific Changes

Specific

only/Symptomatic

only

Others

3 3

1

2

Fre

qu

ency

Guideline followed



28

Table 8: Total number of Patients Referred to Allopathic hospital.



Ayurveda Center 76 98.70 98.70 100.00

Total 77 100 100

Figure 8: Percentage of Pie-chart of patients Referred to Allopathic Hospital.

Total of 77 patients were referred to Allopathic hospital by Ayurveda and alternative medicine

centers out of which 98.70% of patients referred to Allopathic hospitals in case of need was

mostly from Ayurveda hospital.

Alternative

Medicine Center

1.30 %

Ayurveda Center

98.70 %

Percentage of patients Referred to Allophatic Hospital



29

Table 9: Cross tabulation of Any Covid Preventive Measure adopted (Yes/No) * Center.

Alternative Medicine Center Ayurveda Center Total

No Count 1 1 2

% within Center 50.00% 14.30% 22.20%

Yes Count 1 6 7

% within Center 50.00% 85.70% 77.80%

Total Count 2 7 9

% within Center 100.00% 100.00% 100.00%

Figure 9: Percentage of Pie-diagram of Any Covid Preventive Measure adopted (Yes/No).

Out of 9 Ayurveda and alternative medicine centers significant percent 77.8% of the centres had

adopted some specific ways or steps for covid 19 prevention. 22.8 % had used only the

international and national uniform guidelines for preventive measures.

No 22.20 %

Yes 77.80 %

Percentage of Covid Preventive Measure adopted Yes/No



30

Table 10: Any Covid Preventive Measure adapted (If Yes).

If Yes

Alternative

Medicine Center

Ayurveda

Center Total

Arsenic album

Count 1 0 1

% within If

Yes

100.0% 0.0% 100.0%

Ayurveda based life style

Management & therapeutic yoga

Count 0 1 1

% within If

Yes

0.0% 100.0% 100.0%

Guidelines Provided by MOHP and

WHO with intake of decoction of

Guduchi, Yestimandhu, Trikatu for

Immuno Modulation.

Count 0 1 1

% within If

Yes

0.0% 100.0% 100.0%

Jesthavasadi/Mixture

Count 0 1 1

% within If

Yes

0.0% 100.0% 100.0%

NARTC'S Hero-mineral formulation

Count 0 1 1

% within If

Yes

0.0% 100.0% 100.0%

Trikatu Churna 1 gm QID with ghee

for non-symptomatic patients and

non-diagnosed people

Count 0 1 1

% within If

Yes

0.0% 100.0% 100.0%

Were Mask + Make physical distance

+ Lock down + Immunity booster

medicine

Count 0 1 1

% within If

Yes

0.0% 100.0% 100.0%

Total

Count 1 6 7

% within If

Yes

14.29% 85.21% 100.0%



31

Figure 10: Percentage of Pie-Chart of Any Covid Preventive Measure adapted (If Yes).

Out of 9 Ayurveda and alternative medicine centers 85.71% of the preventive steps contribution

was from Ayurveda centres while the remaining was from other alternative medicine.


Center

14.29 %

Ayurveda Center

85.71 %

Percentage of Covid Preventive Measure Adapted (Yes)



32

Table 11: Cross tabulation of Names of Commonly prescribed Medicines * Center.

Drugs Alternative

Medicine Center

Ayurveda

Center Total

Ayur Kwath + Ashwagandha Churna + Guduchi Churna

+ Sitopaladi Churna 0 1 1

Dilution 1 0 1

Godanti Bhasma + Mahasudarshan Churna + Talisadi

Churna + Giloya Satwa + Sitopaladi Churna 0 1 1

Guduchi Churna + Trikatu Churna + Mulethi Churna +

Sudarshan Churna + Sitopaladi Churna 0 1 1

Guduchi Ghana Vati + Trikatu Churna + Abhrak

Bhasma + Talisadi Churna 0 1 1

Jesthavasadi Churna + Sitopaladi Churna +

Ashwagandha Churna + Trikatu Churna + Guduchi

Churna + Chyawanprash + Yesthimadhu Churna + Tab.

Vit.C

0 1 1

Piper Nigrum + Liqurice + Ginger + Piper Longum +

Honey 1 0 1

Sitopaladi + Yestimadhu + Trikatu + Amrit tea + Vasa

Kwath + Tankan + Godanti + Tab. Laxmivilas Rasa +

Tab.Swaskuthar Rasa + Syp. Kanakasav + Syp. Kasarin

+ Tab. Swarnavasanta + Tab. Swaskaschintamani Rasa

+ Chyawanprash Avaleha

0 1 1

Trikatu Churna + Jesthimadhu Churna + Guduchi

Churna +Ashwagandha Churna + Mahasudarshan

Churna + Immunity power formulation

0 1 1

Total 2 7 9

Out of 9 Ayurveda and alternative medicine centers all Ayurveda centers have their own line of

treatment.



33

Table 12: Cross tabulation of Other Approaches in alternative Medicine * Center.

Alternative

Medicine Center

Ayurveda

Center Total

Allopathy (others) Count 0 1 1

% within Center 0.00% 14.30% 11.10%

Ayurveda and Yoga Count 0 6 6

% within Center 0.00% 85.70% 66.70%

Homeopathy ( Exercise

and Diet)

Count 1 0 1

% within Center 50.00% 0.00% 11.10%

Naturopathy and Yoga Count 1 0 1

% within Center 50.00% 0.00% 11.10%

Total Count 2 7 9

% within Center 100.00% 100.00% 100.00%

Figure 10: Percentage/Frequency Bar-diagram of Other Approaches in alternative

Medicine.

The most frequent other approaches applied in Ayurveda centre was yoga ,in Naturopathy also

yoga, in Homeopathy was exercise and diet and allopathy was also used as other approach in

integrated approach in prevention in one centre .

0

10

20

30

40

50

60

70

Allopathy (others) Ayurveda and Yoga Homeopathy

(Exercise and Diet)

Naturopathy and

Yoga

1

6

1 1

11.10

66.70

11.10 11.10

Per

cen

tage/

Fre

qu

ency

Cen

ter

Other Approaches in Alternative Medicine

% / Frequency of Other Approaches in alternative Medicine



34

Table 13: Cross tabulation of Center * Any Lifestyle Counselling Done (Yes/No).

Figure 11: Percentage of Pie-diagram of Any Lifestyle Counselling Done (Yes/No).

Out of 9 Ayurveda and alternative medicine centers specific lifestyle counselling was done in

89.9% of centres and no specific counselling was done in 11.1% centre.

Yes

89.90 %

No

11.10 %

Percentage of Any lifestyle Counselling Done ( Yes/No)

No Yes Total


% within Center 0.00% 100.00% 100.00%


% within Center 14.30% 85.70% 100.00%

Total Count 1 8 9

% within Center 11.10% 88.90% 100.00%



35

Table 14: Cross tabulation of Center * Any Dietary Changes Done (Yes / No).

No Yes Total


% within Center 0.00% 100.00% 100.00%


% within Center 28.60% 71.40% 100.00%

Total Count 2 7 9

% within Center 22.20% 77.80% 100.00%

Figure 12: Percentage Pie-diagram of Any Dietary Changes Done (Yes / No).

Out of 9 Ayurveda and alternative medicine centers 77.80% of centres had adopted specific

dietary changes in patients and 22.20% had no only general dietary guidelines but no specific

changes.

Yes 77.80 %

No 22.20 %

Percentage of any Dietary changes Done



36

Table 15: Cross tabulation of Center * Any Guidelines provided during discharge (Yes/No).

No Yes Total


% within Center 50.00% 50.00% 100.00%


% within Center 42.90% 57.10% 100.00%

Total Count 4 5 9

% within Center 44.40% 55.60% 100.00%

Figure 13: Percentage Pie-diagram of Any Guidelines provided during discharge (Yes/No).

Out of 9 Ayurveda and alternative medicine centers patient specific guideline was provided

during discharge from 55.6% centres but 44.45 had only general guidelines during follow up.

Yes

55.60 %

No

44.40 %

Percentage of Any Guidelines Provided during discharge



37

Table 16: Cross tabulation of Center * Any Recurrence in symptoms after discharge within

7 days (Yes/No).

No Total

Alternative Medicine Center Count 2 2

% within Center 100.00% 100.00%

Ayurveda Center Count 7 7

% within Center 100.00% 100.00%

Total Count 9 9

% within Center 100.00% 100.00%

Out of 9 Ayurveda and alternative medicine centers none of the centres had any reported case of

recurrences of symptoms in any discharge cases within 7 days of discharge.



38

Table 17: Cross tabulation of Center * Overall response and support from Government

agencies and other organization.

Good Satisfactory Excellent Total

Alternative Medicine Center Count 0 1 1 2

% within Center 0.00% 50.00% 50.00% 100.00%

Ayurveda Center Count 5 1 1 7

% within Center 71.40% 14.30% 14.30% 100.00%

Total Count 5 2 2 9

% within Center 55.60% 22.20% 22.20% 100.00%

Figure 14: Percentage/ Frequency of Overall response and support from Government


Out of 9 Ayurveda and alternative medicine centers 55.6% of the centres responded the support

from government and other agencies as good while 22.2% were satisfied and 22.2% responded

the support as excellent indicating a good overall response and support.

0

0.5

1

1.5

2

2.5

3

3.5

4

4.5

5

Good Satisfactory Excellent

5

2 2

55.60%

22.20% 22.20%

Per

cen

tag

e /

Fre

qu

ency

Overall Response & support from Government agencies & other organization

%/ Frequency of Overall Response & support from Government agencies & other

organization



39

Table18: Cross tabulation of Center * Feedback from the service recipients/ Post Covid

Patients.

Good Satisfactory Excellent Total

Alternative Medicine Center Count 0 0 2 2

% within Center 0.00% 0.00% 100.00% 100.00%

Ayurveda Center Count 2 1 4 7

% within Center 28.60% 14.30% 57.10% 100.00%

Total Count 2 1 6 9

% within Center 22.20% 11.10% 66.70% 100.00%

Figure 15: Frequency/Percentage Bar-diagram of Feedback from the service recipients/

post Covid Patients.

Out of 9 Ayurveda and alternative medicine centers all the centres had received positive

feedback from service recipients , significant number 66.7% had received the excellent feedback

from the service recipients while 11.1% centres had received the satisfactory feedback.

0

1

2

3

4

5

6

Excellent Good Satisfactory

6

2

1 66.70%

22.20% 11.10% Fre

qu

ency

/Perc

enta

ge

Feedback from the Service recipients/Post Covid Patients

% / Frequency of Feedback from the Service recipients/Post Covid Patients



40

Table 19: Tabulation of Name of the Hospital/ Isolation Unit * Total Admission Capacity.

Name of the Hospital/ Isolation Unit Total Admission Capacity Percent

Yogi Naraharinath Yoga & Nature Cure Hospital 90 22.17

District Health Service Office, Humla 30 7.39

Pashupati Homoepathic Hospital 6 1.48

National Ayurvedh Research & Training Center 215 52.96

Proviance Ayurveda Ausadhalaya, Surkhet 15 3.69

Central Ayurveda Hospital, Naradevi 50 12.32

Dhaulagiri Ayurveda Ausadhalaya 0 0.00

District Ayurveda Hospital Sankhuwasabha 0 0.00

Koshi Zonal Ayurveda Dispensarry 0 0.00

Total 406 100.00

Figure 16: Frequency of Name of the Hospital/ Isolation Unit * Total Admission Capacity.

National Ayurveda Research and Training centre had the highest percentage of admission

capacity followed by Yogi Naharinath Yoga and Naturopathy Hospital dedicated to covid 19

patients. Central Ayurveda hospital Naradevi had 50 bed dedicated to covid 19 patients.

Pashupati Homeopathic hospital had 6 bed capacity but was not dedicated to covid-19.

0

50

100

150

200

250 215

90

50 30

15 6

Ad

mis

ion

Cap

aci

ty

Name of Hospital / Isolation unit

Frequency of Total Admission Capacity



41

Table 20: Cross tabulation of Name of the Hospital/ Isolation Unit * Admission / Not

Admission

Name of the Hospital/

Isolation Unit

Not

Admission Admission Total

Central Ayurveda Hospital,

Naradevi

Count 0 1 1

% within Name of the

Hospital/ Isolation

Unit

0.00% 100.00% 100.00%

Dhaulagiri Ayurveda

Ausadhalaya

Count 1 0 1


Hospital/ Isolation

Unit

100.00% 0.00% 100.00%

District Ayurveda Hospital

Sankhuwasabha

Count 1 0 1


Hospital/ Isolation

Unit

100.00% 0.00% 100.00%

District Health Service

Office, Humla

Count 1 0 1


Hospital/ Isolation

Unit

100.00% 0.00% 100.00%

Koshi Zonal Ayurveda

Dispensary

Count 1 0 1


Hospital/ Isolation

Unit

100.00% 0.00% 100.00%

National Ayurveda Research

& Training Center

Count 0 1 1


Hospital/ Isolation

Unit

0.00% 100.00% 100.00%

Pashupati Homeopathic

Hospital

Count 1 0 1


Hospital/ Isolation

Unit

100.00% 0.00% 100.00%

Provenance Ayurveda

Ausadhalaya, Surkhet

Count 0 1 1


Hospital/ Isolation

Unit

0.00% 100.00% 100.00%

Yogi Naraharinath Yoga &

Nature Cure Hospital

Count 0 1 1


Hospital/ Isolation

Unit

0.00% 100.00% 100.00%

Total

Count 5 4 9


Hospital/ Isolation

Unit

55.60% 44.40% 100.00%



42

Table 21: Total Number of patient enrolled till date (Admit/Not Admit)

Name of the Hospital/ Isolation Unit Total Number of patient enrolled till

date (Admit/Not Admit) Percent

Yogi Naraharinath Yoga & Nature Cure

Hospital 412 12.91

District Health Service Office, Humla 400 12.54

Koshi Zonal Ayurveda Dispensary 109 3.42

Pashupati Homeopathic Hospital,

Kathmandu 23 0.72

National Ayurveda Research & Training

Center 1872 58.66

Provenance Ayurveda Ausadhalaya, Surkhet 41 1.28


Dhaulagiri Ayurveda Ausadhalaya 253 7.93

District Ayurveda Hospital Sankhuwasabha 55 1.72

Total 3191 100.00

Figure 17: Bar-diagram of Total Number of patient enrolled till date (Admit/Not Admit).

The highest number of patients care provided was from National Ayurveda Research and training

centre with 58.66 cases alone followed by Yogi Naraharinath Yoa and Nature cure hospital.

0

50

100

150

200

250

300

350

400

450 412 400

109

23 41

26

253

55



43

Table 22: Name of the Hospital/ Isolation Unit * Preventive Measure (Home Isolation)

Preventive Measure Percent

Pashupati Homeopathic Hospital, Kathmandu 37493 15.79


Total 237493 100.00

Figure 18: Percentage of Pie-diagram of Preventive Measure (Home isolation)

84.21% of preventive approach and home isolation approach cases was from Ayurveda Hospital

and other 15.79% was from Homeopathic Hospital.

Pashupati

Homoepathic

Hospital,

Kathmandu

15.79 %

Central Ayurveda

Hospital, Naradevi

84.21 %

Percentage of prventive Measure



44

Table 23: Name of Hospital * Types of Patients mostly admitted.


Isolation Unit

Type of patients

were mostly

admitted

Total Number of

patient enrolled till

date.

Percent Remarks

Yogi Naraharinath Yoga

& Nature Cure Hospital

Mild + Moderate +

Asymptomatic 412 12.91


Office, Humla Asymptomatic 400 12.54


Dispensary (Support ) Mild+Asymptomatic 109 3.42


Hospital, Kathmandu

(support)

Mild + Moderate 23 0.72

59.38 % National Ayurveda

Research & Training

Center

Mild + Moderate 1872 58.66

Provenance Ayurveda

Ausadhalaya, Surkhet Moderate 41 1.28

Central Ayurveda

Hospital, Naradevi Moderate + Severe 26 0.81

Dhaulagiri Ayurveda

Ausadhalaya (support)

Mild

+Asymptomatic 253 7.93

District Ayurveda

Hospital

Sankhuwasabha(support)

Mild 55 1.72

Total 3191 100.00



45

Figure 19: Percentage Bar-diagram of Types of Patients was mostly admitted.

Most of the patients admitted were mild to moderate symptoms. Only 1 centre had admitted

patients with severe symptoms.

0

10

20

30

40

50

6059.21

12.91 12.54 7.93

3.42 1.72 1.28 0.81

Per

cen

tag

e

Types of Patients were mostly admitted



46

Table 24: Name of Hospital * Guideline was followed.


Isolation Unit

Guideline was

followed

Total Number of

patient enrolled till

date.

Percent Remarks


Dispensary DOAA

109 3.42

5.86 % Pashupati Homeopathic

Hospital, Kathmandu DOAA

23 0.72


Sankhuwasabha DOAA

55 1.72


Office, Humla

DOAA With some

specific Changes 400 12.54

21.75 % Provenance Ayurveda


DOAA With some


Dhaulagiri Ayurveda

Ausadhalaya

DOAA With some



Nature Cure Hospital Others

412 12.91 71.58 %

National Ayurveda

Research & Training Center Others

1872 58.66


Naradevi

Specific Only/

Symptomatic only 26 0.81

Total 3191 100.00



47

Figure 20: Percentage Bar-diagram of Guideline was followed.

Department of Ayurveda and Alternative medicine guideline was only followed in 5.86%

centres, 21.7% had used DOAA with some changes while other ways of their own was used.

0.00

10.00

20.00

30.00

40.00

50.00

60.00

70.00

80.00

Others DOAA With some

specific Changes

DOAA Specific Only/

Symptomatic only

71.58

21.75

5.86 0.81

Per

cen

tage

Guideline was followed



48

Table 25: Name of the Hospital/ Isolation Unit* Average Duration of Hospital stay.


Isolation Unit

Average Duration of Hospital

stay No. of patients Percent


Nature Cure Hospital

Total number of patients with 14

days hospital stay 412 15.56


Office, Humla



National Ayurveda

Research & Training Center







Total number of patients with

more than 14 days hospital stay 4 0.15

Provenance Ayurveda





Naradevi




Sankhuwasabha



Total 2648 100.00



49

Table 26: Average Duration of Hospital stay

Average Duration of Hospital stay No. of patients Percent

Total number of patients with 7 days hospital stay 396 15.05



Total number of patients with more than 14 days hospital stay 4 0.15

Total 2632 100.00

Figure 21: Percentage Bar- diagram of Average Duration of Hospital stay.

Patients with 7 days hospital stay was 15.05%, while 39.59 % had 10 days stay only 0.15% had

hospital stay of more than 14 days.

0.00

5.00

10.00

15.00

20.00

25.00

30.00

35.00

40.00

45.00

50.00

Patients with 7

days hospital stay

Patients with 10

days hospital stay

Patients with 14

days hospital stay

Patients with more

than 14 days

hospital stay

15.05

39.59

45.21

0.15

Per

cen

tage

Average Duration of Hospital stay



50

Table 27: Name of the Hospital/ Isolation Unit* Total number Patients Referred to

Allopathic hospital


Isolation Unit

Number of patient

enrolled till date

Total number Patients Referred

to Allopathic hospital Percent


Nature Cure Hospital 412 0 0.00

District Health Service Office,

Humla 400 2 0.50


Dispensarry 109 0 0.00


Hospital, Kathmandu 23 1 4.35

National Ayurveda Research

& Training Center 1872 67 3.58

Provenance Ayurveda

Ausadhalaya, Surkhet 41 7 17.07


Naradevi 26 0 0.00

Dhaulagiri Ayurveda

Ausadhalaya 253 0 0.00


Sankhuwasabha 55 0 0.00

Total 3191 77 2.41

Figure 22: Percentage pie-diagram of Total number Patients Referred & not referred to

Allopathic hospital.

Out of 9 Ayurveda and alternative medicine centers only 2.41% of patients were referred which

is indicative of less referral and less number of cases being moderate to severe during hospital

stay.

Total number

Patients Referred to

Allopathic hospital

2.41 %

Total number

Patients not Referred

to Allopathic

hospital

97.59 %

Percenage of referred and not referred to Allopathic hospital



51

Table 28: Name of the Hospital/ Isolation Unit * Any Covid preventive measures adapted

Yes/No.

Name of the

Hospital/ Isolation

Unit

If Yes Yes No Percent

(Yes/No)

Yogi Naraharinath

Yoga & Nature

Cure Hospital

- 0 1 11.11 %

District Health

Service Office,

Humla

Were Mask + Make physical distance

+Lock down + Immunity booster

medicine

1 0 11.11 %

Koshi Zonal

Ayurveda

Dispensary

Trikatu Churna 1 gm QIDC ghee for

non-symptomatic patients and non-

diagnosed people

1 0 11.11 %

Pashupati

Homeopathic

Hospital,

Kathmandu

Assenic album 1 0 11.11 %

National Ayurveda

Research &

Training Center

NARTC'S Hero-mineral formulation 1 0 11.11 %

Provenance

Ayurveda

Ausadhalaya,

Surkhet

Guidelines Provided by MOHP and

WHO c intake of decation of

Guduchi, Yestimandhu, Trikatu for

Immuno Modulation.

1 0 11.11 %

Central Ayurveda

Hospital, Naradevi Jesthavasadi / Mixture 1 0 11.11 %

Dhaulagiri

Ayurveda

Ausadhalaya

Ayurveda based life style

Management & therapeutic yoga 1 0 11.11 %

District Ayurveda

Hospital

Sankhuwasabha

- 0 1 11.11 %

Total 9

77.78

%

22.22

% 100 %



52

Figure 23: Percentage pie-diagram of Any Covid preventive measure is adapted (Yes/No).

77.78% of centres had adopted specific preventive measures while 22.22% had general

preventive approach.

No 22.22 %

Yes 77.78 %

Percentage of Covid Preventive Measure adapted Yes/No



53

Table 29: Cross tabulation of Name of the Hospital* Other Approaches in alternative

Medicine.

Allopathy

(others)

Ayurveda

and Yoga

Home

opathy

Naturopathy

and Yoga

Tota

l

Central Ayurveda

Hospital, Naradevi

Count 0 1 0 0 1

% within

Name of the

Hospital

0.00% 100.00% 0.00% 0.00% 100.

00%

Dhaulagiri Ayurveda

Ausadhalaya

Count 0 1 0 0 1

% within

Name of the

Hospital

0.00% 100.00% 0.00% 0.00% 100.

00%

District Ayurveda

Hospital

Sankhuwasabha

Count 0 1 0 0 1

% within

Name of the

Hospital

0.00% 100.00% 0.00% 0.00% 100.

00%

District Health

Service Office

Count 0 1 0 0 1

% within

Name of the

Hospital

0.00% 100.00% 0.00% 0.00% 100.

00%

Koshi Zonal

Ayurveda

Dispensary

Count 0 1 0 0 1

% within

Name of the

Hospital

0.00% 100.00% 0.00% 0.00% 100.

00%

National Ayurveda

Research & Training

Center

Count 1 0 0 0 1

% within

Name of the

Hospital

100 % 0.00% 0.00% 0.00% 100.

00%

Pashupati

Homeopathic

Hospital

Count 0 0 1 0 1

% within

Name of the

Hospital

0.00% 0.00% 100.00

% 0.00%

100.

00%

Provenance Count 0 1 0 0 1



54

Ayurveda

Ausadhalaya

% within

Name of the

Hospital

0.00% 100.00% 0.00% 0.00% 100.

00%

Yogi Naraharinath

Yoga & Nature Cure

Hospital

Count 0 0 0 1 1

% within

Name of the

Hospital

0.00% 0.00% 0.00% 100.00% 100.

00%

Total

Count 1 6 1 1 9

% within

Name of the

Hospital

11.10% 66.70% 11.10

% 11.10%

100.

00%

Figure 24: Percentage Bar-diagram of Other Approaches in alternative Medicine.

In total of 9 Ayurveda and alternative medicine centers Ayurveda and Yoga was the most

frequent than other approaches used.

0

10

20

30

40

50

60

70

Allopathy (others) Ayurveda and

Yoga

Homepathy (

Exercise and Diet)

Naturopathy and

Yoga

1 6

1 1

11.10

66.70

11.10 11.10

Per

cen

tage/

Fre

qu

ency

Cen

ter

Other Approaches in Alternative Medicine

% / Frequency of Other Approaches in alternative Medicine



55

Table 30: Cross tabulation of Name of the Hospital/ Isolation Unit * Any Lifestyle

Counselling Done (Yes)


Isolation Unit

Any Lifestyle Counselling Done

(Yes) Yes No Percent

Yogi Naraharinath

Yoga & Nature Cure

Hospital

Calory Ristriction + Breathing

Exercise+Dietary Modification

1 0 11.11


Office, Humla

To Practice Breathing Exercise + To

Practice different Pranayama and

Asana of Yoga

1 0 11.11


Dispensary General 1 0 11.11

Pashupati

Homeopathic Hospital,

Kathmandu

Specific (some diet change) 1 0 11.11

National Ayurveda

Research & Training

Center

Yoga+Pranayam+Dhyan + Mantra

therapy+ Stress management

through Counselling

1 0 11.11

Provenance Ayurveda


Pranayam + Yoga + breathing

exercise+ Spirometry+Proning 1 0 11.11

Central Ayurveda

Hospital, Naradevi Music Therapy + Counselling 1 0 11.11

Dhaulagiri Ayurveda

Ausadhalaya

Dincharya+Ritucharya+ 40 min of

daily yoga practice for best

immunity+ Increase Spo2 level

1 0 11.11

District Ayurveda

Hospital

Sankhuwasabha

No 0 1 11.11

Total

9

8 1 9

89.90

%

11.10

% 100 %



56

Figure 25: Percentage pie-diagram of Any Lifestyle Counseling Done (Yes/No).

Out of 9 Ayurveda and alternative medicine centers only 1 centre had no specific lifestyle

counselling but all others provided lifestyle counselling.

Yes

89.90 %

No

11.10 %

Percentage of Any lifestyle Counselling Done ( Yes/No)



57

Table 31: Name of the Hospital/ Isolation Unit* Any Dietary Changes Done (If Yes)


Isolation Unit Any Dietary Changes Done (If Yes) Yes No Percent

Yogi Naraharinath

Yoga & Nature Cure

Hospital

Low Calorie Diet+ Natural Foods +

Avoiding Junk & Fast Food + Intermitted

Fasting

1 0 11.11 %


Dispensary General 1 0 11.11 %


Hospital, Kathmandu General (Healthy diet) 1 0 11.11 %

National Ayurveda

Research & Training

Center

High Proteins Diet+ fruits+low fat diet+

Milk With Turmeric

1 0 11.11 %

Provenance Ayurveda


Take c hing+Saindhav Lavan+ Jeera+

Amrit tea + Carrot + Lemon + Moong Dal

+ Masi Jaulo

1 0 11.11 %

Central Ayurveda

Hospital, Naradevi

Dietary changes According to patient

specific 1 0 11.11 %

Dhaulagiri Ayurveda

Ausadhalaya

Light & Leafly vegetarian diet +

Germinating seed + Cow ghee 1 0 11.11 %

District Ayurveda

Hospital

Sankhuwasabha

No 0 1 11.11 %


Office, Humla No 0 1 11.11 %

Total 9

7 2 9

77.78

%

22.22

% 100 %



58

Figure 26: Percentage pie-diagram of Any Dietary changes Done (Yes/No).

Out of 9 Ayurveda and alternative medicine centers only 2 centre had no specific dietary changes

but all others provided dietary changes.

Yes 77.78 %

No 22.22 %

Percentage of any Dietary changes Done Yes/No



59

Table 32: Name of the Hospital/ Isolation Unit * Any Guidelines Provided during discharge

(If Yes)


Isolation Unit

Any Guidelines Provided during

discharge (If Yes) Yes No Percent

Yogi Naraharinath

Yoga & Nature Cure

Hospital

Preventive Measure + Immune

Boosting Techniques + Yoga & Life

Style Coaching + Advise for

returning to Nature

1 0 11.11%


Office, Humla No 0 1 11.11%


Dispensary

General ( Discharge and Food

Schedule ) 1 0 11.11%

Pashupati

Homeopathic

Hospital, Kathmandu

No 0 1 11.11%

National Ayurveda

Research & Training

Center

Discharge and Food Schedule 1 0 11.11%

Provenance Ayurveda

Ausadhalaya, Surkhet No 0 1 11.11%

Central Ayurveda

Hospital, Naradevi

Follow up after 15 days + other

health measures 1 0 11.11%

Dhaulagiri Ayurveda

Ausadhalaya

Ayur Kurath+ Ashwagandha Churna

+ Jalaneti Once Week + Golden Milk 1 0 11.11%

District Ayurveda

Hospital

Sankhuwasabha

No 0 1 11.11%

Total 9 5 4 9

55.56 % 44.44 % 100.00%



60

Table 33: Name of the Hospital/ Isolation Unit * Names of Commonly prescribed Medicines


Isolation Unit

Names of Commonly prescribed

Medicines

Any Recurrence in

symptoms after

discharge within 7 days

(Yes/No)

Yogi Naraharinath

Yoga & Nature Cure

Hospital

Piper Nigrum + Liquorice + Ginger +

Piper Longum + Honey No

District Health

Service Office,

Humla

Jesthavasadi Churna + Sitopladi Churna +

Ashwagandha Churna + Trikatu Churna +

Guduchi Churna + Chyawanprash +

Yesthimadhu Churna + Tab. Vit.C

No

Koshi Zonal

Ayurveda Dispensary

Guduchi Churna+ Trikatu Churna +

Mulethi Churna +Sudarshan Churna +

Sitopaladi Churna

No

Pashupati

Homeopathic

Hospital, Kathmandu

Dilution No

National Ayurveda

Research & Training

Center

Guduchi GhanaVati + Trikatu Churna +

Abhrak Bhasma + Talisadi Churna No

Provenance Ayurveda


Sitopaladi + Yestimadhu + Trikatu +

Amrit tea + Vasa Kwath + Tankan +

Godanti + Tab. Laxmivilas rasa +

Tab.Swaskutharrasa + Syp. Kanakasav +

Syp. Kasarin + Tab. Swrnabasanta + Tab.

Swaskaschintamani rasa +

Chyawanprashavaleha

No

Central Ayurveda

Hospital, Naradevi

Godanti Bhasma + Mahasudarshan

Churna + Talisadi Churna + Giloyasatwa

+ Sitopaladi Churna

No

Dhaulagiri Ayurveda

Ausadhalaya

Ayur Kurath+ Ashwagandha Churna +

Guduchi Churna + Sitopaladi Churna No

District Ayurveda

Hospital

Sankhuwasabha

Trikatu Churna + Jesthimadhu Churna +

Guduchi Churna +Ashwagandha Churna

+ Mahasudarshan Churna + Immunity

powder

No



61

Table34: Frequency of Feedback from the Service recipients/Post Covid Patients.


Good 2.0 22.2 22.2 22.2

Satisfactory 1.0 11.1 11.1 33.3

Excellent 6.0 66.7 66.7 100

Total 9.0 100.0 100

Figure 27: Percentage / Frequency of Feedback from the Service recipients/Post Covid

Patients.

Excellent feedback from patients and service recipients were mostly received i.e 66.7%

0

1

2

3

4

5

6


6

2

1 66.70%

22.20% 11.10%

Fre

qu

ency

/Perc

enta

ge





62

Table 35: Cross tabulation Name of the Hospital/ Isolation Unit * Overall response and

support from Government agencies and other organization.

Good

Satisfactor

y

Excellen

t Total

Central Ayurveda

Hospital, Naradevi

Count 0 1 0 1

% within Name of

the Hospital/

Isolation Unit

0.00% 100.00% 0.00% 100.00

%

Dhaulagiri Ayurveda

Ausadhalaya

Count 1 0 0 1

% within Name of

the Hospital/

Isolation Unit

100.00

% 0.00% 0.00%

100.00

%

District Ayurveda

Hospital Sankhuwasabha

Count 0 0 1 1

% within Name of

the Hospital/

Isolation Unit

0.00% 0.00% 100.00% 100.00

%


Office, Humla

Count 1 0 0 1

% within Name of

the Hospital/

Isolation Unit

100.00

% 0.00% 0.00%

100.00

%


Dispensary

Count 1 0 0 1

% within Name of

the Hospital/

Isolation Unit

100.00

% 0.00% 0.00%

100.00

%

National Ayurveda

Research & Training

Center

Count 1 0 0 1

% within Name of

the Hospital/

Isolation Unit

100.00

% 0.00% 0.00%

100.00

%


Hospital

Count 0 1 0 1

% within Name of

the Hospital/

Isolation Unit

0.00% 100.00% 0.00% 100.00

%

Provenance Ayurveda


Count 1 0 0 1

% within Name of

the Hospital/

Isolation Unit

100.00

% 0.00% 0.00%

100.00

%

Yogi Naraharinath Yoga

& Nature Cure Hospital

Count 0 0 1 1

% within Name of

the Hospital/

Isolation Unit

0.00% 0.00% 100.00% 100.00

%

Total

Count 5 2 2 9

% within Name of

the Hospital/

Isolation Unit

55.60% 22.20% 22.20% 100.00

%



63

Figure 28: Percentage/ Frequency of Overall response and support from Government


Excellent support for the dedicated covid 19 centres was received i.e 66.7% received excellent

support and none of the centre was unsatisfied.

0

1

2

3

4

5

6


6

2

1 66.70%

22.20% 11.10%

Fre

qu

ency

/Perc

enta

ge




Geo –Consult Pvt. Ltd. Kathmandu 64

Table 36: Efficiency of Ayurveda and Alternative Medicine Center

Centers Total

patient

Average Duration of

Hospital stay

Patients Referred to

Allopathic hospital

% of

Referred

Any Recurrence in symptoms

after discharge within 7 days

Feedback from the

service recipients

Yogi Naraharinath

Yoga & Nature Cure

Hospital

412 Patients with 14 days

hospital stay 412 0 0% No Excellent

District Health

Service Office,

Humla


hospital stay 400 2

0.5 %

No Good

Koshi Zonal

Ayurveda

Dispensary

109 No Admit 0 0 No Satisfactory

Pashupati

Homeopathic

Hospital, Kathmandu

23 No Admit 1 4.35 % No Excellent

National Ayurveda

Research & Training

Center

1872

Patients with 7 days

hospital stay-396

67 3.58 No Excellent


hospital stay - 520


hospital stay - 794

Patients with more than

14 days hospital stay - 4

Provenance

Ayurveda

Ausadhalaya,

Surkhet


hospital stay 41 7 17.07 No Excellent

Central Ayurveda

Hospital, Naradevi 26


hospital stay 26 0 0 No Excellent

Dhaulagiri Ayurveda

Ausadhalaya 253 No Admit 0 0 No Excellent

District Ayurveda

Hospital

Sankhuwasabha


hospital stay 55 0 0 No Good



Figure 28: Bar-diagram of Total number of Patients and Patients referred to Allopathic Hospital.

Out of 9 Ayurveda and alternative medicine centers below 14 days of hospital stay was observed in all the centers followed by maximum of

17.07% referral and no any recurrence in symptoms after discharge. Six centers with 66.67% got excellent feedback from service recipients.

0 2 0 1 67

7 0 0 0

412 400

109 23

1872

41 26 253

55 0

200

400

600

800

1000

1200

1400

1600

1800

2000

YogiNaraharinath

Yoga & NatureCure Hospital

District HealthService Office,

Humla

Koshi ZonalAyurveda

Dispensarry

PashupatiHomoepathic

Hospital,Kathmandu

NationalAyurvedh

Research &Training Center

ProvianceAyurveda

Ausadhalaya,Surkhet

CentralAyurvedaHospital,Naradevi

DhaulagiriAyurveda

Ausadhalaya

DistrictAyurvedaHospital

Sankhuwasabha

Total number Patients Referred to Allopathic hospital Total no. patients



66

DISCUSSION

The Ayurveda centres were 77.8% and other other alternative medicine were 22.2 %

indicating the more availability of Ayurveda Hospital and Centre in comparison to others. The

Presence of Ayurveda centres are more and there are few government other alternative centres.

This is indicative of more Ayurveda service delivery centres in comparison to other alternative

medicine. 44.4% of the hospital and centre had the facility of admitting the covid-19 patients and

providing care while 55.6% couldn’t admit the patients. The 44.4% were dedicated for covid 19

with special support but the normal admission capacity is less than that. This is indicating the

Hospital and centres generally do not have adequate facilities for admission. Admission capacity

in Ayurveda Hospital and centre was 76.35% whereas 23.65% in other alternative medicine

hospital. National Ayurveda Research and Training centre had been prepared for the covid-19

that is the reason of more availability of admission bed but all the centres, hospitals need support

and strengthen facilities. The percentage of service recipient in preventive aspect from Ayurveda

Hospital was 84.21% and from other alternative medicine was 15.79%. This may be due to wide

range of publicity for Ayurveda preventive approach and traditional acceptance to Ayurveda in

community and families. Alternative medicine hospital had only Mild, Moderate and

Asymptomatic cases whereas moderate to severe cases were also present in Ayurveda Hospitals.

After certain support from government and agencies National Ayurveda Research and Training

centre was able to admit the moderate cases, while Central Ayurveda Hospital Naradevi had

moderate to severe cases. Department of Ayurveda and Alternative medicine covid 19 guideline

and the same guideline with some changes was mostly used. Department of Ayurveda and

Alternative medicine guideline was only followed in 5.86% centres, 21.7% had used DOAA

with some changes while other ways of their own was used.Other guidelines were also used . At

National Ayurveda Research and Training centre where the maximum number of cases of

admitted the guideline was not used. Although the similar approach was adopted indicating less

acceptance of guideline in practice. But other centres mostly used the same guideline or with

some modifications which is indicating national acceptance and practice of guideline in isolation

centres and hospital throughout the country and all geographical regions. The referral of patients

to Allopathic hospitals in case of need was mostly from Ay urveda hospital. The moderate and

severe cases sometime needed additional supported for which there were referral. The were no

referral of patients among Ayurveda and alternative medicine centres and hospital. This is

because lack of tertiary specialized units and hospitals in Ayurveda and alternative medicine

centre which indicates the need for development in this sector for the upliftment of Ayurveda and

alternative medicine.

Significant percent 77.8% of the centres had adopted some specific ways or steps for

covid 19 prevention.22.8 % had used only the international and national uniform guidelines for

preventive measures only. 85.71% of the preventive steps contribution was from Ayurveda

centres while the remaining was from other alternative medicine. The most frequent other

approaches applied in Ayurveda centre was yoga ,in Naturopathy also yoga, in Homeopathy was

exercise and diet and allopathy was also used as other approach in integrated approach in

prevention in one centre . Specific lifestyle counselling was done in 89.9% of centres and no

specific counselling was done in 11.1% centre.



67

77.80% of centres had adopted specific dietary changes in patients and 22.20% had no only

general dietary guidelines but no specific changes. Patient Specific guideline was provided

during discharge from 55.6% centres but 44.45 had only general guidelines during follow up.

None of the centres had any reported case of recurrences of symptoms in any discharge cases

within 7 days of discharge which is indicating the successful approach in covid-19 management.

55.6% of the centres responded the support from government and other agencies as good while

22.2% were satisfied and 22.2% responded the support as excellent indicating a good overall

response and support. Excellent support for the dedicated covid 19 centres were received i.e

66.7% received excellent support and none of the centre was unsatisfied. During covid 19 the

preventive approach being highly accepted and believed the support was also significant but the

regular such support is the need for upliftment of Ayurveda and Alternative medicine.

All the centres had received positive feedback from service recipients; significant number 66.7%

had received the excellent feedback from the service recipients while 11.1% centres had received

the satisfactory feedback. This is because of holistic approach in healing in Ayurveda centre

where not only the patient and disease is managed but all the physical, social, mental and

spiritual aspects are considered during management. National Ayurveda Research and Training

centre had the highest percentage of admission capacity followed by Yogi Naharinath Yoga and

Naturopathy Hospital dedicated to covid 19 patients. Central Ayurveda hospital Naradevi had 50

bed dedicated to covid 19 patients. Pashupati Homeopathic hospital had 6 bed capacity but was

not dedicated to covid-19. The highest number of patients care provided was from National

Ayurveda Research and training centre with 58.66 cases alone followed by Yogi Naraharinath

Yoa and Nature cure hospital. 84.21% of preventive approach and home isolation approach

cases was from Ayurveda Hospital and other 15.79% was from Homeopathic Hospital. Most of

the patients admitted were mild to moderate symptoms. Only 1 centre had admitted patients with

severe symptoms. Patients with 7 days hospital stay was 15.05%, while 39.59 % had 10 days

stay only 0.15% had hospital stay of more than 14 days. Only 2.41% of patients were referred

which is indicative of less referral and less number of cases being moderate to severe during

hospital stay. 77.78% of centres had adopted specific preventive measures while 22.22% had

general preventive approach. Ayurveda and Yoga was the most frequent other approach used.

Only 1 centre had no specific lifestyle counselling but all others provided lifestyle counselling

Only 2 centre had no specific dietary changes but all others provided dietary changes. 6 Centres

received excellent feedback, 2 centres had received good while 1 had received satisfactory which

indicates the positive feedback from patients in all centres. The low percentage of patient referral

from these centres also indicates the significance of Ayurveda and alternative medicine approach.

Average duration of hospital stay is also indicating the significant role of management approach.

No any recurrence in symptoms after discharge within 7 days also indicates the efficacy of

Ayurveda and alternative medicine approach in management.



68

CONCLUSION

Ayurveda and alternative medicine practices have significantly contributed in COVID- 19

pandemic. There was excellent feedback of preventive approach used. This has lead to the

Increasing acceptance of the people towards Ayurveda and alternative medicine. Ayurveda and

Alternative medicine practices can be efficiently used in COVID-19 management alone for mild

to moderate cases or in integrated manner for moderate to severe cases. This research is primarily

for assessment of effectiveness of Ayurveda and Alternative medicine in COVID 19 management

but after the observation it is realized that priorities should be given for strengthening the

development of Ayurveda and alternative system of medicine. Limited evidence to support the

significant contribution from Ayurveda and alternate medicine centre can be generated from this

study being carried out at limited centres of Ayurveda and Alternative Medicine due to time

span, financial constraint and lack of resources.



69

REFERENCES

1. https://thehimalayantimes.com/nepal/nepal-vulnerable-to-new-china-virus-warn-

doctors/cited on 16/04/2020.

2. https://news.abplive.com/news/india/coronavirus-outbreak-is-ayurveda-key-combat-covid-19-

pandemic-1194698cited on 16/04/2020.

3. "WHO Director-General's opening remarks at the media briefing on COVID-19 – 11

March 2020". World Health Organization. 11 March 2020.

https://www.medscape.com/viewarticle/926666 cited on 16/04/2020.

4. Paradakara. H.S.S. Ashtangahridaya (A compendium of the Ayurvedic System) of

Vagabhatta with commentaries: Sarvangasundara of Arundatta & Ayurvedarasayana of

Hemadri. Sutra Sthana, Doshabhediya, Chaukhamba Surbharti Prakashan, Varanasi,

India, 2011, pp 206.

5. Singh. R.H. Charaka Samhita of Agnivesh with Ayurvedadipika Commentary of Shri

Chakrapanidutta. Vimaana Sthaanam, Janapada-udhwamsaniyamvimanam,

Chaukhamba Surbharati Prakashan, Jawaharnagar, Varanasi, India, 2011, pp 242.

6. Singh. R.H. Charaka Samhita of Agnivesh with Ayurvedadipika Commentary of Shri

Chakrapanidutta. Chikitsa Sthaanam, Jwarachikitsitam, Chaukhamba Surbharati

Prakashan, Jawaharnagar, Varanasi, India, 2011, pp 407.

7. Huang C et al, Clinical features of patients infected with 2019 novel corona virus in

Wuhan city, China, Lancet, January 2020.

8. https://www.cdc.gov/coronavirus/2019-ncov/index.html cited on 16/04/2020.



Hemadri. Nidana Sthana, Jwaranidanam, Chaukhamba Surbharti Prakashan, Varanasi,

India, 2011, pp 451.



Hemadri. Chikitsa Sthana, Jwarachikitsitam, Chaukhamba Surbharti Prakashan,

Varanasi, India, 2011, pp 545.



Hemadri. Chikitsa Sthana, Jwarachikitsitam, Chaukhamba Surbharti Prakashan,


https://news.abplive.com/news/india/coronavirus-outbreak-is-ayurveda-key-combat-covid-19-pandemic-1194698

https://news.abplive.com/news/india/coronavirus-outbreak-is-ayurveda-key-combat-covid-19-pandemic-1194698

https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020

https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020

https://en.wikipedia.org/wiki/World_Health_Organization

https://www.medscape.com/viewarticle/926666

https://www.cdc.gov/coronavirus/2019-ncov/index.html



70

12. Na Zhu et al; A novel corona virus from patientswith pneumonia in China; N Engl J Med

2020;382:727-33.

13. https://www.cdc.gov/coronavirus/2019-ncov/index.html cited on 16/04/2020.

14. Clinical management of severe acute respiratory infection (SARI) when COVID-19

disease is suspected: Interim guidance V 1.2., World Health Organization.



Hemadri. Chikitsa Sthana, Raktapittachikitsitam, Chaukhamba Surbharti Prakashan,




Hemadri. Nidana Sthana, Jwaranidanam, Chaukhamba Surbharti Prakashan, Varanasi,

India, 2011, pp 459.

17. Upadhyaya. Y. Madhava Nidanam of Shri Madhavakara with commentaries: Madukosha

of Shri Vijayarakshita and Shri Kanthadutta and Vidyotini by Shri Sudarshana Shastri.

Parishishtam, Saamaanya-sannipaata Jwara Bhedam, 4-6.

18. Upadhyaya. Y. Madhava Nidanam of Shri Madhavakara with commentaries: Madukosha

of Shri Vijayarakshita and Shri Kanthadutta and Vidyotini by Shri Sudarshana Shastri.

Parishishtam, Saamaanya-sannipaata Jwara Bhedam, 13-14.

https://www.cdc.gov/coronavirus/2019-ncov/index.html



71

Bibliography

Charaka Samhita of Agnivesh with Ayurvedadipika Commentary of Shri

Chakrapanidutta. Chaukhamba Surbharati Prakashan, Jawaharnagar, Varanasi, India,

2011.

Ashtanga Hridaya- Vagbhatacharya Virachita Ashtanga Hridaya , Sarvangasundara

commentary of Arunadatta Acharya and Ayurveda Rasayana commentary of Hemadri

Acharya, published by Choukhamba orientalia, Varanasi, U.P. 2005.

Madhava Nidanam of Shri Madhavakara with commentaries: Madukosha of Shre

Vijayarakshita and Shri Kanthadutta and Vidyotini by Shri Sudarshana Shastri.

Bhaishajya Ratnavali: Author- Govinda Das, edited with Hindi commentary by Prof.

Siddhi Nandan Mishra, published by Chaukhambasurbharati Prakashan, Varanasi , 2007.

Sahasrayogam: Edited by Ananthapurathmoothakoyithamburan, K. V. Krishnanvaidyar

and Ankkaleel S Gopala Pillai, Published by Vidyarambham publishers, Alappuzha.

Rasa Tarangini: Author- Sri Sadananda Sharma, edited by Dr. Ravindra Angadi,

Published by Chaukhamba Surbharati Prakashan, Varanasi. 2015.

Rasaratnasamuccayam: Author- Sri Ambikadatta Sasthri, Choukhamba Amarbharati

Prakashan, Varanasi. 2015.

Sidha Bheshaja Manimala: Author Sri Kaladharabhatta, Choukhamba Krishnadas

Acadamy, Varanasi. 2008.

Rasendra Sara Sangraham: Author Sri Gopal Krishna, Edited by Dr.Asok D Satpute,

Choukhamba Krishnadas Acadamy, Varanasi. 2009.



72

ANNEX 1 (INFORMED CONSENT FORM)



73

INFORMED CONSENT FORM

Effectiveness of Ayurveda and Alternative Medicine in Covid-19

Management

I, …………………………………………………………. from ………………………

…………………………….. hereby confirm that I have read and understood the information

sheet and consent form for this research being conducted in favour for the Department of

Ayurveda and Alternative Medicine, MOHP, Government of Nepal, Kathmandu and have

had the opportunity to ask questions about it.

I hereby declare that,

1. I understand that my participation in the study is voluntary and that I am free to withdraw at

any time, without giving any reason, without my medical care or legal rights being affected.

2. I understand that the researchers, the IRC and other regulatory authorities will not need my

permission to look at my health records both in respect of the current study and any further

research that may be conducted in relation to it, even if I withdraw from the trial. I agree to

this access. However, I understand that my identity will not be revealed in any information

that will be published or released to the third parties.

3. I agree not to restrict the use of any data or results that arise from this study provided that

such use is only for scientific purpose(s).

4. I agree to take part in this study.

Signature of the authorise person of Health

Centres

Investigator

Signature: ……………………………

Name: …………………………………………

Date: ……………………………

Signature: ……………………………

Name: …………………………………………

Date: ……………………………

Office Stamp



74

ANNEX 2

(PERFORMA)



75

Study on

Effectiveness of Ayurveda And Alternative Medicine practices in

Covid-19 Management

Date:

Name Of the Hospital/ Isolation Unit:

Address:

Total Admission Capacity:

Covid Dedicated since:

Head of the institution:

Focal Person:

Contact Email: Phone No-

Interview Guideline:

1. What was the Total Number of patient enrolled till date:

2. What type of patients were mostly admitted –

A) With Mild Symptoms

B) With Moderate Symptoms

C) With Severe Symptoms

D) Asymptomatic

3. Which Guideline was followed

A) DOAA

B) DOAA With some specific Changes

C) Specific Only/ Symptomatic only

D) International Traditional Medicine Guidelines only

E) Others

4. Average Duration of Hospital Stay

A). Total number of patients with 7 days hospital stay-

B). Total number of patients with 10 days hospital stay-

C). Total number of patients with 14 days hospital stay-

D). Total number of patients with more than 14 days hospital stay-

5. Total number of patients Referred to Allopathic hospital –

6. Total number of patients to other Ayurveda and Alternative medicine

Centre/ Hospital-



7. Any Covid preventive measures adapted yes/ No

If Yes what was the measures or medications ....

8. Names of commonly prescribed Medicines.

9. Other Approaches in Alternative Medicine.

A) Ayurveda and Yoga

B) Homeopathy

C) Naturopathy and Yoga

D) Traditional Medical

Practice

E) Others

10. Any Lifestyle counselling Done Yes / No

If Yes - Specific or General

If Specific What new or modification done.......................

11. Any Dietary changes Done Yes / No

If Yes - Specific or General

If Specific What changes done.......................

12. Any Guidelines provided during discharge Yes / No

If Yes - General

Specific

13. Any recurrence in symptoms after discharge within 7 days. Yes/No

If Yes, No of such cases-

14. Overall response and support from Government agencies and other

organization

A) Not Good

B) Good

C) Satisfactory

D) Excellent



77

15. Feedback from the Service recipients / Post Covid Patients

A) Not Good

B) Good

C) Satisfactory

D) Excellent



78

ANNEX 3

(COVID 19 STATUS)



ANNEX 4

(PHOTOGRAPHS)



1. National Ayurveda Research & Training Center,

Kirtipur



2. Pashupati Homeopathic Hospital, Kathmandu



ANNEX 5

(APPROVAL LETTER)



ANNEX 6 (PROPOSAL INFORMATION)



ANNEX 7 (CONSENT FORM)

Total Pages 10

Proposal InformationProposal Id 316 2021Title of The Proposal Effectiveness of Ayurveda and Alternative medicine

in COVID-19 managementCreated Date May 20, 2021Applied Date May 21, 2021Duration June 5, 2021 to July 20, 2021

Screening Does your research relate to health? Yes

Is there any international researcher involved inyour study team ?

No

Is this your thesis ? NoEducation Level Other

Administrative Information Investigator Full Name Siddhartha Kumar Thakur

Investigator Type Principal InvestigatorIdentification CitizenshipIdentification Number 12592161Investigator's Qualification MD AyurvedaCountry NepalTelephone No. 9844330022Mobile No. 9844330022Email Address [email protected] Name Department of Drug Administration MOHPDesignation Ayurveda PhysicianInstitute Postal Address Bijulibajar Kathmandu

Image

Signature

Page 1/10

Investigator Full Name Mithilesh Kumar Sah

Verified at June 2, 2021, 11:27 pm

Investigator Type Co-InvestigatorIdentification CitizenshipIdentification Number 75767267Investigator's Qualification MD AyurvedaCountry NepalTelephone No. 041523930Mobile No. 9851220616Email Address [email protected] Name Ayurveda Campus, IOM, TUDesignation Assistant ProfessorInstitute Postal Address Kirtipur, Kathmandu

Image

Signature

Investigator Full Name Nirmal Bhusal

Verified at May 21, 2021, 11:13 pm

Investigator Type Co-InvestigatorIdentification CitizenshipIdentification Number 41455Investigator's Qualification PhD AyurvedaCountry NepalTelephone No. 9860460417Mobile No. 9860460417Email Address [email protected] Name Ayurveda Campus, IOM, TUDesignation Assistant Professor

Page 2/10

Institute Postal Address Kirtipur, Kathmandu, Nepal

Image

Signature

List the name(s) and institutional affiliation to the researcher(s)(other than co-investigator) toassist your project in Nepal and abroad

List the name(s) of nepali researcher(s)(other than co-investigator) or NepaleseInstitution/hospital/NGO(s) etc. from whom you may seek co-operation

Page 3/10

List the major equipment(s) in relation to your research project you plan to bring/import toNepal

Financial Details Human Resource Cost: Rs 25000

Field cost: Rs 40000Laboratory Cost: Rs 0Data management cost: Rs 10000Report writing and dissemination Cost: Rs 10000Logistic cost: Rs 0Monitoring and evaluation cost: Rs 0Miscellaneous cost: Rs 10000Ethical Approval cost: Rs 5000Total budget of research: Rs 95000.00Is this research funded? YesWhat is the total amount funded? Rs 100000.00Funding Organization Name Department of Ayurveda and Alternative MedicinePostal Address Teku, MOHPPhone No. 015352525Contact Person Dr. Vasudev UpadhayaContact Designation Director GeneralMobile No. 9851273278Email [email protected]

Technical Details

Title of Research :

Effectiveness of Ayurveda and Alternative medicine in COVID-19 management

Research Area :

Ayurveda and other traditional and Complementary Medicine

Summary of the proposal (Structured):

Summary :

Page 4/10

The current COVID-19 is a rapidly evolving global challenge and like any pandemic, it weakens healthsystems, costs lives, and also poses great risks to the global economy and security. When the global focushas mostly been on testing, finding a cure and preventing transmission; people are going through amyriad of psychological problems in adjusting to the current lifestyles and fear of the disease.Althoughwith limited resources on modern medicine the covid-19 pandemic is under control in Nepal. Therich heritage of traditional knowledge and practice of Ayurveda and Alternative medicine may have asignificant role in prevention and management. Ayurveda and Alternative medical practices have beenpopularly practiced in Quarantine centre, isolation and hospitals. As Ayurveda and alternative medicinebelieves in self defense mechanism via their immunity strength of an individual .Ayurveda and alternativemedicine focus on comprehensive principles of holistic management. This proposal focuses on theeffectiveness of Ayurveda and Alternative medicine in covid 19.

Introduction:

Background :

The current COVID-19 is a rapidly evolving global challenge and like any pandemic, it weakens healthsystems, costs lives, and also poses great risks to the global economy and security. When the global focushas mostly been on testing, finding a cure and preventing transmission; people are going through amyriad of psychological problems in adjusting to the current lifestyles and fear of the disease. Althoughwith limited resources on modern medicine the Covid-19 pandemic is under control in Nepal. The richheritage of traditional knowledge and practice of Ayurveda and Alternative medicine may have asignificant role in prevention and management. Ayurveda and Alternative medical practices have beenpopularly practiced in quarantine and isolation centers and hospitals. As Ayurveda and alternativemedicine believes in self defence mechanism via immunity strengthening of an individual. Ayurveda andalternative medicine focuses on comprehensive principles of holistic management. This proposal focuseson study on effectiveness of Ayurveda and Alternative medicine in COVID-19 management.

Rational/justification :

Nepal is among the least developed nation with a fragile health system, with unstable political situation. Inaddition to this Nepal shares the border with China, country of origin for COVID-19 and shares open borderwith India, the second populous country with most COVID 19 cases in South Asia, Nepalese people haveopen access across the border in between India and Nepal for labour migration, cultural and religious trips,tourist destination etc. this makes Nepal and Nepalese people as one of the highest risk areas for thecross-border transmission of pandemic.Ayurveda’s intensive information on preventive care drives through the vastness of Dinacharya (Dailyregime), Ritucharya (Seasonal regime) and Achar Rasayana (good conduct) to maintain healthy life andenhance local immunity to resist with the threats and pandemic condition to some extent. In Nepal, theAyurveda and alternative medicine, preventive and curative approach is largely accepted and practiced inevery household. People have been practicing the lifestyle recommended by Ayurveda within their culture,food and festivals knowingly or unknowingly to some extent. Similarly, same practices with supervisionand guidance of Ayurveda expert it has been practiced in quarantine centre, isolation centre and Hospitalfor COVID-19 prevention and management. But due to lack of evidence based research anddocumentation, impact of Ayurveda and alternative traditional practices for COVID treatment andmanagement are not being valued and not given much emphasis by health authorities on case treatmentand management. And this has made the efforts of the Ayurveda and alternative traditional health systemfor management of COVID-19 undervalued. Thus there is a need to perform a study to find what is theimpact of Ayurveda and alternative medicine practices in management of Covid 19, during the pandemicin Nepal.

Conceptual Framework

Page 5/10

Conceptual Framework

General Objective :

• To study effectiveness of Ayurveda and Alternative medicine practices in COVID-19 management inquarantine/ isolation centre and Hospitals in Nepal.

Specific Objective :

• To assess impact of Ayurveda management practices in quarantine/ isolation centre and Hospital inNepal.• To determine the nature of practice against COVID-19 in Ayurveda and Alternative medicine centre andHospital.

Research Hypothesis

H0: The Ayurveda and Alternative medicine practices has no effect in COVID-19 prevention andmanagement. H1: The Ayurveda and Alternative medicine practices has significant effect in COVID-19prevention and management.

Study Variables

Independent variables- Demographic information: Total number of patients, management status, referral,death numbers, average duration of hospital stay, medicine prescribed etc. will be obtained throughsecondary data. Dependent variables (Outcome) Information regarding prevention and management ofCovid -19 through Ayurveda and alternative medicine will be collected from stakeholders involved inIsolation centre and Hospital involved in Covid 19 management.

Research Method :

mixed

Study site and its Justification :

Isolation centres and Hospitals in Nepal to take secondary data and also the response from patients sothat the course of treatment can be evaluated whether it is effective or not.

Qualitative Research Design :

Combined

Quantitative Research Design :

Qualitative: The sampling frame for the qualitative aspect of the study will be …… numbers of KII involvedin management of COVID-19 in quarantine/isolation centre and Hospital of Ayurveda and alternativemedicine designated for COVID-19 management in Nepal.Quantitative: The sampling frame for the quantitative aspect of the study will be the total number ofpatient admitted to the various quarantine/isolation centre and hospital of Ayurveda and alternativemedicine designated for COVID-19 management in Nepal.

Number of participants and Justification :

Secondary data will be collected from at least five Isolation centers and Hospitals under Department ofAyurveda and Alternative Medicine, MoHP, Nepal.

Page 6/10

https://erb.nhrc.gov.np/researcher/proposal/download-conceptual-framework/6846

https://erb.nhrc.gov.np/researcher/proposal/download-conceptual-framework/6846

Description of research design :

This is a cross-sectional observational study which will be done in the quarantine/isolation center andhospital of Ayurveda and alternative medicine designated for COVID-19 in Nepal, till Jestha 2078. At leastfive centers will be visited for data collection irrespective of province. The medical directors/ focal personwill be contacted in person or telephone or video call through messenger, and will be interviewed toanswer questionnaires. Total number of patients, management status, referral, death numbers, averageduration of hospital stay, medicine prescribed etc. will be obtained through secondary data forindependent variables followed by information regarding prevention and management of COVID -19through Ayurveda and alternative medicine will be collected from stakeholders involved in Isolation centerand Hospital involved in COVID 19 management as dependent variables will be collected within six weeksthrough semi-structured interview guideline and structured questionnaire with consent from therespective centers.

Specify type of Study

The nature of study will be cross-sectional observational study.

Study Population

Qualitative: The sampling frame for the qualitative aspect of the study will be 12 numbers of KeyInformant Interview (KII) involved in management of COVID-19 in quarantine/isolation centre and Hospitalof Ayurveda and alternative medicine designated for COVID-19 management in Nepal. Quantitative: Thesampling frame for the quantitative aspect of the study will be the total number of patient admitted to thevarious quarantine/isolation centre and hospital of Ayurveda and alternative medicine designated forCOVID-19 management in Nepal.

Sampling unit

Isolation centre and Hospitals under Department of Ayurveda and Alternative Medicine, MoHP, Nepal.

Sample size

Qualitative: At least 12 KII per quarantine/isolation center and hospital of Ayurveda and alternativemedicine designated for COVID-19 management before Jestha 2078, will be included in study.Quantitative: Total patient who have been admitted in various quarantine/isolation centre and hospital ofAyurveda and alternative medicine designated for COVID-19 management till Jestha, 2078 will be includedin the study.

Number of participants and Justification :

Secondary data will be collected from at least five Isolation centers and Hospitals under Department ofAyurveda and Alternative Medicine, MoHP, Nepal.

Sampling Technique

Purposive sampling method

Criteria for sample selection

i. Inclusion criteria: a. KII from Isolation Centre and Hospital or units involving Ayurveda, Homeopthy,Naturopathy or any Alternative medicine in management protocol before Jestha 2078 during pandemic. b.Data of Patient admitted in Ayurveda and Alternative medicine center designated for management ofCOVID1-19 till Jestha 2078 during pandemic. ii. Exclusion criteria: a. Data and KII informants fromAllopathic hospital and Isolation center with Allopathic/ modern medicine Management. b. Data of patientsadmitted in Ayurveda and alternative medicine centre after Jestha 2078 during COVID-19 pandemic.

Data Collection Technique

The survey sample will include atleast 5 hospitals and isolation centers under the Ayurveda andalternative medicine across Nepal. The medical directors/ focal person will be contacted in person ortelephone or video call through messenger, and will be interviewed to answer questionnaires.

Page 7/10

Data collection tools

Semi- structured interview guideline for KII, structured questionnaire (template) to collect secondary data.

Pretesting

Not applicable

Validity and reliability of tool

Semi- structured interview guideline for KII, structured questionnaire (template) to collect secondary datais developed under expertise of Ayurveda and others.

Potential Biases

The care will be taken to avoid biases as far as possible. Cross questioning will be done to minimize therespondent biases.

Limitation of the study

• This research will be carried out at limited centres of Ayurveda and Alternative Medicine due to timespan, financial constraint and lack of resources. • Research data will be based on centres entry andresponse of key respondents; therefore, the researcher will have no control over how carefully or honestlycentres has recorded the data and key informants has responded the study questionnaire. • Some of thekey respondents may decline to take part in the study.

Plan for supervision and monitoring

a. Consultation with expert will be done if needed. b. Few interviews will be analysed to supervised andmonitored to assure information being collected is up to the objective of the study.

Plan for data management and analysis

Data will be cleaned and edited on the same day of data collection for the errors if any then coding,classification and tabulation will be done. Procedures for accounting for any missing or spurious data etc. -The care will be taken to avoid missing of any data. If any data is found missing the information of suchrespondent will be discarded. Plan for Data analysis: The qualitative data will be analysed thematically asper the objective and hypothesis of the study manually using MS-Excel. The quantitative data will beanalysed descriptively and analytically in SPSS. The statistical methods proposed to be used for theanalysis of data - Data analysis through appropriate statistical test depending on the nature of data.

Expected outcome of the research results

• Status of Ayurveda and alternative medicine practices has impact in support in human health systemduring COVID- 19 pandemic. Efficacy and overall feedback of Immune booster used in Quaratine centreand Isolation. • Reasons behind Increasing acceptance of the people towards Ayurveda and alternativemedicine. • The study may be helpful in establishment of priorities and development of Ayurveda andalternative system of medicine.

Plan for utilization of research findings

• This research is primarily for assessment of effectiveness of Ayurveda and Alternative medicine in COVID19 management, upon the positive findings the Ayurveda and Alternative medicine in COVID-19management this will generate evidence to recommend the Ayurveda and Alternative medicine practicesin COVID-19 management

Ethical Consideration

Page 8/10

Are human participants required in this research?

No

Are there any risks involved for the participants?

No

How informed consent is obtained from the research participants?

written

Please specify

The consent will be taken from respective allocated person of institution

Who is responsible for obtaining informed consent?

Data Collector

Is there anything being withheld from the research participants at the time the informedconsent is being sought?

No

Is the research sensitive to the Nepali culture and the social values?

N

Is health insurance (if applicable) being made available to the research participants?

Not Applicable

Is Investigation going to be conducted in Nepal ?

N

Is there going to be a transfer of any biological materials from the country?

No

Does the study involve transfer of DNA sample?

No

DocumentS.N Name Document1. Flow diagram Yes2. Data collection tools Yes3. Agreement letter with donor, If it

is funded study Yes

4. References Yes5. Work Plan Yes6. Conceptual framework Yes

Page 9/10

7. Informed consent form Yes

Study TimelineStart date End Date2021-06-05 2021-07-202021-06-05 2021-07-202021-06-05 2021-07-20

Status HistoryS.N Date Status Description Document1. November 30,

-0001Draft Proposal is saved as

a draft N/A

2. May 22, 2021 Under_administrative_consideration

Proposal fromresearcher isaccepted by NHRC.

N/A

3. June 29, 2021 Approved 94 Expedite ReviewDate: 24 June 2021

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