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Introduction: Ayurveda is an ancient science of medicine and surgery, here many of the treatment procedures are described for combat diseases, i.e., Ksharkarma (procedure with the help of base), Agnikarma (procedure with the help of fire), Siravedhan (procedure with the help of puncturing blood vessels), Panchkarma (purification proce- dure) etc. In this science Marma (vital point) therapy is like a blessing to a human being. It is a stimulation therapy of specific points. Now these days, stress arises as a major problem in COVID-19 recovered patients. It is very common to all age groups. Major causes are lack of proper classes of students, unemployment, lack of social inter- action due to isolation and health status anxiety during COVID-19 infection. It arises during and post COVID-19 but especially in the post period of infection. In stress, Marma therapy has an important role because it helps to maintain the equilibrium of the body by working on body humour. Objective: To provide costless, chemical-free and effective treatment for post-COVID-19 patients. Data Source: Relevant various Ayurvedic literature, Samhitas (classical books), modern literature, journals, magazines and online available materials. considered. Review Method: Relevant various data source materials were considered for this. Result: stress will be relieved because this therapy acts directly on hormones secretion which is responsible for relieving stress. Conclusion: By this ther- apy, a patient gets relief without any expenses and the most important is that without using hormonal treatment. Marma therapy in stress can relieve stress by maintaining calmness in the brain, it helps to maintain the brain's proper functioning. By this therapy, not only the stress but stress-related other complications can be treated. Keywords: Marma therapy, COVID-19, post-covid-19, stress.

Marma is a unique concept of Ayurveda. Marma is the site of prana. Prana is constituted by Agni, Soma, Vayu, Satwa, Rajah, Tamah, Bhuthatma and Panchendriyas. According to Acharya Sushruta, Shareera Dosha and Manasika Dosha along with Bhootatma reside in the Marma. So, if Marma gets injured all the Dosha gets vitiated. The Lohitaksha Marma in upper limb is the Shakhagata Marma Vaikalyakar in nature and it is a Sira Marma. It is two in number. The injury effect of this Marma is mentioned as RaktaKshaya and due to which Pakshaghata or Marana will be observed. In the Sira Vyadha context, Lohitaksha Sira is mentioned as Avedhya Sira in the limbs.

Ayurveda is an ancient science which deals with theoretical and practical knowledge with help of cadaver, structural and functional activity. In various Ayurvedic textbooks mention Marma (vital points of the body) which is a vital part of the body. Ayurveda is an ancient science which deals with theoretical and practical knowledge with help of cadaver, structural and functional activity. The detailed knowledge of Marma (vital points of the body) is important from the surgical point of view surgical procedures like Agnikarma (thermal cauterization), Ksharakarma (therapeutic application of caustic material), Raktamokshana (bloodletting), etc. are used as a part of the surgery. The aim of this study is to reconstruct the concept of Guda Marma in the light of current knowledge and studied the applied aspect of Guda Marma. Cadaveric study was done in 5 human cadavers to visualize all the structures (muscles, artery, vein, nerve, etc.) of Guda (Anus) Pradesh (Anorectal region) in terms of Ayurvedic sciences and Modern Medical Sciences. The exact location, reginal anatomy as well as applied aspect of Guda Marma in terms of surgery were analyzed and correlated with modern sciences. Guda (Anus) is the seat of Prana (the breath of life) and it has regarded as one of the ten Prana (the breath of life) yatan. Guda Marma is one among the Mamsa Marma (vital points of the body) and categorized under Sadhya Prana (the breath of life) hara Marma (vital points of the body). The importance of this region can be assessed by the fact that two of the diseases of Guda (Anus) (Arsha and Bhagandara) have been considered as Mahagada. Guda Marma is the vital organ or site of the human body having a rich blood supply which correct knowledge and applied aspects concerning anorectal injuries and disorders is essential.

Marma are the vital points present in the human body explained in different Ayurveda classical texts. These are not only present as surface landmarks in the body but these are deeply seated physio-anatomical structures. Marma is defined as confluence of Mamsa, Sira, Snayu, Asthi and Sandhi at a particular point and it is the seat of Prana. According to Ayurveda, there are 107 Marma in the body. They are classified into various groups depending on the region, structure, prognosis, number and measurement etc., mainly by Acharya Sushurta and Vagbhatta. In Aghata (injury) of Vishlyaghna Marma, the person survives till the foreign body/weapon is at the wound place and will die as soon as the weapon is removed. A person can survive only if the foreign body has dropped by itself after Paaka (suppuration). Vishalyaghna Marma is Vayu dominant Marma points. Sthapani is one of the Vishalyghna Marma. It is present between the two eyebrows or the superciliary arches. The word Varmam and Marmam holds the same meaning in Tamil language. Varmalogy is a therapeutic manipulation of Varmam points where the Pranic energy gets concentrated or blocked. When a particular Varmam point gets stimulated, this energy is released from there and brings relief to the affected area of a person by regulating the flow of this energy which is obstructed due to assault on specific points. According to Siddha science, Tilartha Kalam is present on the same location as of the Sthapani Marma (as per the Ayurveda science) i.e. Glabella region. Through this article, we will try to explore the structures undercover the Sthapani Marma and also try to correlate the Sthapani Marma according to Siddha science along with the methods to stimulate the particular Varmam point.

In the vast sea of the knowledge of Ayurveda, Marma is one of the extremely important topics. Marma points have been unanimously accepted as the ‘seats of life’ (Prana - the vital life force). If these locations are injured, then it may lead to severe pain, disability, loss of function, loss of sensation, or death. Therefore, the ancient scriptures have strictly directed that these vital locations should not be injured, and due care should be taken in this regard even while doing surgeries. However, recent researches indicate that if there is inflammation or pain at any Marma point, then stimulating its nearby Marma points can help in alleviating this pain. This Marma Therapy has been used in treating various physical and mental disorders, with encouraging results. In view of the importance of Marma Science mentioned in scriptures and with regards to surgeries, as well as the encouraging outcomes of Marma Therapy in recent times, the present study was undertaken for an in-depth study of the Science of Marma. Part-1 of this study gave an account of various ancient / classical Indian scriptures that mention different aspects of the Science of Marma. The present article, which is Part-2 of this study, gives a detailed description of the number of marmas, their location, structures involved, correlation with Panchamahabhutas, classification, as well as a detailed explanation of marmaghata or viddha lakshanas (effect of trauma), as given in classical texts written during Samhita kala. The anatomical correlation with modern science is also presented.

Joint pain is a world wide problem. Almost 70 to 80% of the world population suffer from it. Statistical analysis shows that by the age of 60 to 75 years, 80% of the population shows radiographic evidences of osteoarthritis. Osteoarthritis of the knee joint is characterised by gradual increase of pain in the joint, ‘grating’ may be felt or heard on movement. A plain radiograph is the only useful investigation. This may show some typical features of osteoarthritis, namely focal narrowing of joint space, marginal osteophyte, subchondral sclerosis cysts and osteochondral bodies. According to Ayurveda it is coined as Sandhigatavata where in Vata takes on the sandhisthana, it leads to the degeneration of asthi dhatu and decreases shleshaka kapha disturbing the normal structure and functions of the joints involved. As age advances Vatadosha triggers and accelerates dhatukshaya and balakshaya. Sandhigatavata is a madhyama rogamarga vyadhi involving the sandhi marma. Dhatukshaya in highly prevalent in vriddhavastha. Thus the involvement of Marma, Madhyama roga marga, vata dosha and dhatukshaya adds to the kashtasadhyata of the disease.

Background of study: Marma are those spots on the body which are painful on application of pressure and shows abnormal pulsation. Marma are conglomeration of Mamsa, Sira, Snayu, Asthi and Sandhi. [1] There are 107 Marma.[2] Individual Marma are catagorized on different groups on the basis of various aspects such as Rachananusara, Parinamanusara, Sthananusara, Pramananusara etc. Vitapa Marma is the Adhoshakagata, Vaikalyakara Marma[3,4] of 1 Anguli Pramana.[5,6] The explanation of the Vitapa Marma in the classical texts cannot specify the particular anatomical entity so the study is undertaken to fulfill the deficit knowledge. Objectives: To evaluate the Snayu & Sira component of Vitapa Marma. To evaluate structural entity of Vitapa Marma in relation to given Pramana and Viddha Lakshana. Materials and methods: Cadaveric Study. Observation of the structures exposed during cadaveric dissection and correlation with textual description were done and the conclusion was drawn. Results: Vitapa Marma lies on the inguinal region at the superficial inguinal ring. The anatomical components of this Marma are the structures related to and passing through superficial inguinal ring.

The Marma Vijnana (Science of vital points) has been dealt in Shareera Sthana of Ayurvedic texts like Sushruta Samhita (Textbook), Astanga Samgraha (Textbook) and Astanga Hridaya (Textbook). The ref-erences related to Marma are also available in Charaka Samhita. Almost all the texts of Ayurveda have mentioned the total number of Marma as 107. Out of these Lohitaksha Marma is considered under the Shakhagata Marma (vital points of the limb region). The concept of Marma is important in the clinical and surgical point of view. In this article an attempt is made to study the lohitaksha Marma and its Viddha Lakshana (Traumatic effect) by considering the related literature.

The word Marma denotes the vital spots of the body. Marma Shareera is widely discussed in Ayurveda. The structural entity of these spots is not clearly explained in the classical texts so we cannot rule out the exact structural components involved. Apastambha Marma is one among 107 Marma explained in Classical textbooks. According to Sushruta, it is classified under Sira variety and it is an Urogata Kalantara Pranahara Marma. But Vagbhata has mentioned it as a type of Dhamani Marma on the basis of its structural entity. It measures about 1/2 Angula Pramana. Acharya Sushruta mentions its location as Uras, bilaterally where two Vatavaha Sira (tubular structures carrying air) are seen. Vagbhata says that it is situated in the Uras on both sides of the Parshwa. The Viddha Lakshana of this Marma as per Sushruta is Vatapoornakoshtataya, Kasa, Shwasa and Marana. However, there is a difference of opinion with Vagbhata; he has explained Raktena Poornakoshta instead of Vatapoornakoshtataya. Result: The marked area for the Apastambha Marma is at the level of 3rd costal cartilage on both the sides of the chest just lateral to the midline. As the measurement in Angula (1 cm) is not apparent so it is taken as the lengthwise, breadth wise and depth-wise. Conclusion: The area of about 2 cm lateral to carina which is the common site of injury in the bronchus can be taken as the site of Apastambha Marma as rupture of the bronchus leads to pneumothorax and the individual will show symptoms of breathing difficulty such as Kasa, Shwasa and in severe cases it may lead to the death. This explanation holds true for the Viddha Lakshana mentioned by Sushruta. Taking Shonitapoornakoshta this into consideration, pulmonary and bronchial vessels can be taken as the structures involved in Apastambha Marma which also holds good for the explanation of structural composition as per Vagbhata also i.e., it is a Dhamani Marma. Thus, we can conclude that the two Principal Bronchus along with the pulmonary vessels and bronchial vessels should be considered as the site of Apastambha Marma.

Introduction: The aim of the study was to determine the time to and rate of the return to sports (RTS) after knee joint injury. The data obtained was analysed to fine line the commonly affected anatomical entity re-sponsible and to correlate with Janumarma. Methodology: The symptoms assessed from the case profor-ma and MRI were compared to the Janu Marmabhighatha Lakshanas. The grading of injury and Khan-jatha was determined with the help of unique scoring adapted for the study. Results: Based on literary re-view Khanjatha can be defined as a weakness in limbs resisting its complete functional mobility. Anterior Cruciate Ligament (ACL) was found to be the most vulnerable structure. Cadaveric dissection studies showed the morphological significance of ACL to be placed as a Kandara has been surmised. Conclusion: Khanjatha is concluded as the difficulty in regaining complete functional mobility, which was observed in 70% of ACL injuries highlighting the plausible correlation of ACL as Janumarma.

Science of Marma known as Marma Vigyanam is a dynamic part, specially described in Sushrut samhita and other Ayurvedic classics. According to Sushrut Mamsa, Sira, Snayu, Asthi, and Sandhi, these five elements collectively present at Marma point. This is the peculiarity of Marma.1 Marmas are the vital points on the body having importance regarding surgical procedure and traumatic effect. It is also known as Ayurvedic Accupressure. In this paper, three similar cases of pain and stiffness in shoulder joints are presented, who has attended OPD of District Hospital Shivaji Nagar, Bhopal. In during the clinical examination partially restriction of shoulder movement is also recorded. The case was initially treated with Marma therapy mainly the stimulation of bilateral Bahu Marma along withAmsa Marma for instant pain management. After the treatment of about ten minutes the patient got relief in pain and stiffness and felt lightness in surrounding area of painful place. Amsa Marma manipulation can be used to give instant relief from Shoulder pain effectively.

Ancient Ayurvedic literature described 107 vital regions of the body and considered them as a seat of prana (life force) and collectively termed them as marma. The applied aspect of this concept, marma chikitsa or marma therapy, is gaining popularity as it is being practiced by many clinicians in which these marma are stimulated in different ways to treat different diseases. Hypertension is one of the major disorders affecting majority of the world population. Inspite of available antihypertensive therapies, the hypertensive population of not only the older age group, but also of that of young adults is increasing. Blood pressure normalising effect of marma therapy is observed by clinicians practicing marma therapy due to its holistic effect on the body. Clinical data regarding efficacy of this therapy is very sparse and hence, its application in different diseases remained unexplored till date. This case report is of a young hypertensive male whose blood pressure significantly improved with Talahridaya marma therapy. This patient was detected with raised blood pressure on repetitive examinations. The volunteer was subjected to Talahridaya marma therapy where his classical Talahridaya marma point on left upper limb was physically stimulated in controlled way for 10 days and the patient was also taught to perform the therapy on himself. The blood pressure was recorded, both before and after giving the therapy on each day. The volunteer showed significant improvement in his blood pressure recordings.

The principal aim of Ayurveda is to maintain and promote positive physical and mental health as well as ensure the prevention of diseases. Sandhigata Vata is the commonest form of articular disorder. It is a type of Vatavyadhi which mainly occurs in Vriddhavastha due to Dhatukshaya, which limits everyday activities such as walking, dressing, bathing etc. It occurs due to change in lifestyle like unsuitable sitting, sleeping, standing and look upwards or obliquely in various professions. Osteoarthritis (OA) is degenerative joint disorder, represents failure of the diarthrodial (movable, synovial lined) joint. OA of the joints comes under the inflammatory group which is almost identical to Sandhigata Vata described in Ayurveda with respect to etiology, pathology, and clinical features. Marma therapy is one which gives instant relief from pain by balancing local Vata and Kapha Dosha without any untoward effects. In the present research work, total 15 diagnosed case of Sandhigata Vata were randomly selected from OPD and IPD of department of Shalya Tantra, Rishikul Campus, Uttarakhand Ayurveda University, Haridwar (U.K.) India, all these patients were treated with the application of Marma therapy. Result was observed on the basis of subjective and objective parameters and analysed statistically. No complications were observed in this clinical study.

Background: Vatavyadhis has been mentioned as one of the Ashtomahagada due to its notorious nature. Being a Vatavyadhi, located in Marma Asthi and Sandhi and its occurrence in old age makes it Kashta sadhya.Osteoarthritis is most common degenerative,disabling disorder in majority of people in 5-6 th decade of life.There is only conservstive treatment giving short term relief in pain and surgical intervention with lots of side effects..Sushruta has mentioned Agnikarma as best treatment for vata Kaphaj Vyadhis.Charaka, has mentioned Basti made up of Tikta Dravya, Ghrita and Kshira in Asthidhatu Dushti,. Keeping all these things in view Agnikarma and Panchatikta guggulu were selected for the treatment of Janusandhigatavata. Aim and objective: To evaluate the efficacy of Agnikarma and Panchatikta Guggulu in management of Janusandhigatavata ( osteoarthritis of knee joint). Materials & Methods: Total 43 diagnosed cases of osteoarthritis were registered out of which 41 patient completed the study .In group A 4 sittings of Agnikarma was done in 21 patients with Panchadhatu Shalaka.In group B 4 sittings of Agnikarma was done in 20 patients with Panchadhatu Shalaka along with Panchatikta Guggulu orally for 1 month. Result: The result was assessed by using wilcoxan, paired t test, Mann Whitney and unpaired t test.Significant relief was observed in both groups in all parameters. Clinically and percentage wise group B had shown better results. Conclusion: Study was concluded that Agnikarma alone has a definite role in reducing the knee joint pain and tenderness but addition of Panchatikta Guggulu found convincing results in stiffness, swelling and (ROM) of knee joint.

Objectives of the study include answer to the research question or to the hypothesis framed. Present study was conducted to evaluate the therapeutic effect of Shilajithu loha rasayana in reducing the affliction of Basti marma in patients with Prameha/diabetic nephropathy, also to evaluate the therapeutic effect of Shilajithu loha rasayana in reducing the blood sugar level in patients suffering from affliction of Basti marma in Prameha/diabetic nephropathy. Design: Study Type: Interventional, Estimated enrolment: 30 participants, Allocation: Non-Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Single Group Assignment, Primary Purpose: Treatment, Masking: Open Label. Participants: From October 2019 to January 2020, 30 patients of affliction of Basthi marma in Prameha/ diabetic nephropathy having symptoms of diabetic nephropathy (microalbuminuria, reduced eGFR, raised cystatin-c) with a minimum of 5yrs history of diabetes are taken up for the study. Intervention: Kosta shodhana on day 1: 20ml of Eranda taila added with equal amount of Shunthi kashaya is orally administered during early morning in empty stomach. Day 2 to 22: Shilajithu loha rasayana is orally administered half an hour before breakfast, in a dose of 12g with warm water. Patient was advised diabetic diet and to do brisk walking/jogging or light exercise for 45 minutes daily during the course of treatment. Results: Shilajithu loha rasayana was successful in improving renal functions by increasing the glomerular filtration rate and reducing cystatin-c in patients also was successful in reducing fasting blood sugar and symptoms of Prameha which was justified statistically with p value

Background: Cervical Spondylosis a degenerative disc disease, pain being the main first concern along with stiffness and decreased movements of neck. Marma chikitsa is done by employing electrical stimula-tion using TENS or adapting Varma chikitsa explained in Siddha system of medicine on Marma points ex-plained by Acharya Sushruta. Objectives: To compare the efficacy of Marma manipulation and electrical stimulation using TENS in the management of Cervical Spondylosis. Methods: 40 Subjects diagnosed with Cervical Spondylosis was divided into 2 groups of 20 each. Group A was treated with TENS and Group B was treated with Marma Chikitsa for 7 days respectively. Results: The outcome of treatment after 14 days was statistically significant based in criteria taken for study. Interpretation & Conclusion: Group A showed better effect in reducing stiffness, pain, and improves an-gle of flexion, extension, side bending, tendon reflexes, power of hand muscle and rotation of neck. Whereas Group B was effective in improving the restricted movements, tenderness and mild improvement on power of hand muscles.

Background: Janu Sandhigata Vata (Osteoarthritis of knee) is one of the most disabling musculoskeletal disorder. It is a type of Vata-vyadhi (Vata disorder), involving the Janu Sandhi (knee joint), whose symptoms include Shoola (pain), Shotha (swelling), Stabdhata (stiffness), and Atopa (crepitus). Ayurvedic texts recommend repeated use of Snehana (oleation) and Swedana (sudation) therapies for its management. In recent years, Marma Therapy has also been used for the management of various Vata disorders. Methodology: The present study explores the efficacy of Marma Therapy (on four Marma points of the legs, i.e. Kshipra, Gulpha, Indravasti and Janu) with Janu Basti (with Ksheerbala Taila) in the management of Janu Sandhigata Vata. The therapeutic procedure was administered for 9 days, with a followup of one month, when the patients did self-administration of Marma Therapy and massage at home. Twenty patients completed the study. Results: Significant improvement was observed in all the subjective parameters (Shoola, Shotha, Stabdhata, and Atopa) and objective parameters (WOMAC Index, Range of Motion, Walking Time) analyzed during the study. Mean values of all the parameters decreased continuously during the study period, including intervention time and follow-up. Verbal feedback taken about six months after the completion of the study period indicated almost complete relief for 4 patients (pursuing Marma Therapy regularly), and self-management by 10 others through regular Marma Therapy and massage. Conclusion: The present study illustrates the significant efficacy of the administered therapeutic intervention in the management of Janu Sandhigata Vata, both with regards to short-term relief, and long-term self-management.

Nasya karma is the special Panchakarma procedure where the drug is administered through Nasal Route. The medicated drug that is put into nostril moves in the channels up to the sringataka marma(Sira Marma) and spreads to whole of the interior of the head(Brain) and to the junction where all the channels related to the eyes, ears, oropharynx situated together thus shows influence on shiras by removing out the accumulated vitiated doshas localised in shiras of all sinuses in the skull.This action of Nasya karma is known as sirovirechana. According to Vagbhatacharya the nasal passage is considered as the Channel for head (brain) i.. e “Nasa Hi Siraso Dwaram’’. Therefore, Nasya Karma pacify all accumulated doshas and related diseases. Nasya Karma is a therapeutic procedure in which the medicated oils, Swarasa, Kwatha or Churna is administered through nasal cavity to eliminate the vitiated Doshas situated in Sira (Brain) for the treatment of urdhwa Jatrugata Vikar. The First Cranial nerve (olfactory nerves) are connected with the higher centers of the brain i.e., limbic system which contains amygdaloidal complex, hypothalamus and basal ganglia. so, the drugs administered through nose stimulate the higher centers of brain which in turn alters the endocrine and Central nervous system functions, by controlling the doshas. The medicated drug also enters into the systemic circulation, intracranial region by lymphatic and Vascular Pathway. The present review article is compiled from many articles and research papers collected from different websites along with related materials from ancient ayurvedic classics.

The concept of marma is one of the unique principles mentioned in ancient Ayurvedic texts. Marma are the vital sites in the body where there is confluence of mamsa, sira, snayu, asthi and sandhi where prana resides. These generate the symptoms from excruciating pain to fatal effect when exposed to trauma. Ancient ayurvedic seers have mentioned 107 such vital areas in the body. Apanga marma is one among them, present in the head region, at the area outer to lateral canthus and below the tail end of eyebrow within half angula dimension. It is a vaikalyakara marma and results in blindness or visual impairment on injury. Knowledge of marma is very important in clinical field in preventing the complications during the surgical and parasurgical procedures. Details are collected from ayurvedic texts and published papers aiming to provide a comprehensive overview on Apanga marma.

Acharya Sushruta has described 107 marmas. Marma is constituted as combination of Mamsa (muscle), Sira (vessels), Snayu (nerve, tendon, ligament), Asthi(bone) and Sandhi (joints).This five tissue participate to play vital role in any injury that occur to any of the marma. Kurpara marma is located at the junction of bahu (arm) and prabahu (forearm) i.e exactly at the elbow joint in both the upper limbs. Kurpara marma is one of the Vaikayalkara marma (loss of function). Vaikalyakara marma means the marma which causes deformity on getting injured.. An injury to this marma causes deformity, pain and swelling. The articulating surfaces that form the elbow joint occurs between the trochlea and capitulum of humerus and trochlear notch of the ulna and head of radius. Elbow joint is responsile of flexion and extension of the upper limb.Tennis elbow is one of the common disease that occur on lateral side of the elbow due to Sprain of radial collateral ligament and tearing of fibres of the extensor carpi radialis brevis.It causes pain and restricted moment of the hand. Preventive measures can be used to reduce the symptoms and lessen the pain.

Background: Hemorrhoids or piles are a common ailment among adults. More than half of men and womenaged 50 years and older will develop hemorrhoid symptoms during their lifetime. This disease Gudarshacomes under the heading of Mahagada, as it is Dirghakalanubandhi, Dushchikitsya in nature, Tridoshaj andinvolves the Marma and it is well known for the chronicity and difficult to treat. Aim & Objectives:- Toevaluate the effect of local application of Palash Kshar Ointment in Management of Abhyantar Gudrsha.Methodology:- The study is prospective randomized controlled clinical trial. Total 60 patients will beselected for this study, which will be further divided randomly into two groups. Each group consists ofabout 30 patients. In which group A, will be trial groups and group B will be control groups. Every patientwill be observed at regular follow up. On 7th, 14th, 21th, 28th Day.. Results– Results will be drawn from theobservations of objective parameters. Conclusion – Conclusion of the study will be drawn on the basis ofstatistical data calculated from the collected data.

Background The mental health status of indigenous people in Bangladesh has attracted little or no attention. The objective of the present study is to determine the extent of symptoms of anxiety and depression in the two largest indigenous communities in Bangladesh. Methods In total, 240 participants were recruited, 120 from each of the Marma and Chakma communities with an overall mean age of 44.09 years (s.d. 15.73). Marma people were older (mean ages 48.92 v. 39.25, p < 0.001). Participants completed the Anxiety Scale (AS) and Depression Scale (DS) that have been developed and standardised in Bangladesh in the Bangla (Bengali) language. Results Results indicated that anxiety and depression scores were elevated in both communities, 59.2% of the participants scoring above the cut-off for clinical significance on AS and 58.8% of the participants scoring above the cut-off for clinical significance on DS. Marma people compared to Chakma people were more anxious (M = 59.49 v. 43.00, p < 0.001) and more depressed (M = 106.78 v. 82.30, p < 0.001). The demographic variables of age, sex and socioeconomic status were weakly or inconsistently related to scores. In the Marma people, females scored higher on both AS and DS, but in the Chakma community, males scored higher on AS and the same on DS. Conclusion The finding of significant anxiety and depression in communities with such limited mental health services is a matter of concern and emphasises the need to formulate and implement appropriate mental health policies for indigenous people in Bangladesh and other parts of the world.

The integration of exponential technologies in the traditional manufacturing processes constitutes a noteworthy trend of the past two decades, aiming to reshape the industrial environment. This kind of digital transformation, which is driven by the Industry 4.0 initiative, not only affects the individual manufacturing assets, but the involved human workforce, as well. Since human operators should be placed in the centre of this revolution, they ought to be endowed with new tools and through-engineering solutions that improve their efficiency. In addition, vivid visualization techniques must be utilized, in order to support them during their daily operations in an auxiliary and comprehensive way. Towards this end, we describe a user-centered methodology, which utilizes augmented reality (AR) and computer vision (CV) techniques, supporting low-skilled operators in the maintenance procedures. The described mobile augmented reality maintenance assistant (MARMA) makes use of the handheld&rsquo, s camera and locates the asset on the shop floor and generates AR maintenance instructions. We evaluate the performance of MARMA in a real use case scenario, using an automotive industrial asset provided by a collaborative manufacturer. During the evaluation procedure, manufacturer experts confirmed its contribution as an application that can effectively support the maintenance engineers.

There are 107 vital points spread over the body called as MARMA. All the marmas are seat of prana. Owing to this close association of chetana, injury to marma will produce severe sufferings. KSHIPRA marma is one of the Shakhagat marma situated on both upper and lower extremities and are four in number. It is situated between the great toe and the second toe of the foot with a dimension of half Angula. Based on predominant structural entity it is a Snayu marma. While classifying on the basis of traumatic effect it is a Kalantara pranhara marma. Trauma to this marma causes death due to convulsions. Understanding marma is very important in clinical practice of Ayurveda. Even the prognosis of disease depends upon the extent of involvement of marma points. This review will give a complete summary of KSHIPRA marma regarding its location, structural entity and clinical application.

Marma means vital parts of the human body. There are 107 marma in human body. Marma hass been classified into 5 categories, i.e. Mansamarma, Siramarma, Snayumarma, Asthimarma & Sandhimarma. Vaikalyakara Marma are the points where injury causes structural functional deformity. These are 44 in number and there are 12 present in ADHOSHAKHAGA (lower body) i.e. 6 in each lower limb. They are Kurch, Janu, Aani, Urvi, Lohitaksh & Vitapa. Janu marma is considered as sandhi and vaikalyakar marma in Ayurveda and injury to Janu Marma causes Khanjatva. Khanjatva which means limping of limb. Thus, this topic is selected to study as to evaluate the actual structural changes and which further causes deformities

Ayurveda the ancient system of Indian medical science offers various principles and concept to remain healthy and live long life. Sports medicine is of the modality of Ayurveda science which deals with treatment and prevention of sport injury. The sports medicine is a novel concept of Ayurveda emerging from last few decades. Ayurveda offers various treatment modalities for sport injury such as; Marma therapy, oil massage, Yoga, Raktamokashana, Agnikarma, physiotherapy and herbal medication. The present article explores scope and utility of sport medicine as per Ayurveda.

In today’s era due to unending process of globalization, we are acquiring the western culture blinding like eating fast food, preserved food, late night sleeping or shifting duties and secondary life style with lot of stress, due to this, disturbances in metabolism occurs hence there is increasing incidences of life style disorders like Hypertension, Diabetes mellitus, Obesity etc. later in chronic condition this patients comes with chronic kidney diseases. As per Ayurveda CKD is disease of mutravaha strotasa and It correlated with Mutraghata. Formation and Excretion of urine is takes place in pakwashaya. Basti is one of the main marma out of three marma. If problem takes place in these marma it becomes life threatening. Hence it is need of era to find out supportive, rejuneuating treatment for such patients to expel the toxins from the body. Hence Pratham triphala rasayana this drug is chosen for CKD patients. It is Anulomak, its action on pakwashaya, it regulates Apana vayu hence toxins expel out from the body, because of rasayana effect datu vardhana also takes place. Pratham triphala rasayana contains Survary Haritaki, Aamalaki, Bibhitaki. As per Charak Aacharya one Surwari Haritaki is given in the morning empty stomach,2 Bibhitaki is given before meal and 4 Aamalaki is given after meal with honey and ghee respectively. Here Charakacharya has mentioned this does in the form of phala or fruit, since the size and weight of every fruit of triphala differs hence it is highly impossible to conduct clinical trial on it. Therefore we have decided to standardize the fruit(phala) and convert it into its churna form so that equal dose of this rasayana can be given to the patients which are under trial.

ObjectivesThis study aimed to estimate the prevalence of, and factors associated with, accessing maternal healthcare services (MHC) by Indigenous women in the Chittagong Hill Tracts (CHT), Bangladesh.DesignThis was a cross-sectional survey among Indigenous women of reproductive age.SettingTwo upazillas (subdistricts) of Khagrachhari hill district of the CHT.ParticipantsIndigenous women (15–49 years) within 36 months of delivery were surveyed about accessing MHC services (antenatal care, delivery and postnatal care) for their last pregnancy and delivery.Primary outcome measuresThe primary outcome for this analysis is the prevalence of accessing any MHC service and secondary outcome is factors associated with access to MHC services for Indigenous women during their last pregnancy and childbirth.ResultsOf 438 Indigenous women (220 Chakma, 100 Marma, 118 Tripura) who participated, 75% were aged 16–30 years. With an 89% response rate, a total of 258 (59%) women reported accessing at least one MHC service (Chakma 51.6%, Marma 28%, Tripura 20.5%; p=ConclusionFindings suggest that the prevalence of accessing MHC services is lower among Indigenous women in the CHT compared with national average. MHC access may be improved through better education and awareness raising of local services.

Aim- Study of Gulpha Marma and ankle joint. Objective- 1. Exact location of Gulpha Marma in limbs 2. Effect of injury to Gulpha Marma 3. Contemperory concept of Gulpha Marma and ankle joint 4. Concept of marma chikitsa in pain related to Gulpha Marma. Observation- Gulpha Marma is sandhi marma and rujakar marma. It is predominantly made up of sandhi i.e. the joint or components making the ankle joint. Injury to it causes stabhdata & khanjata. The location of Gulpha Marma is nothing but the joint between tibia, fibula and talus and other structures related to lateral aspect of ankle joint. Marma chikitsa gives tridosha triguna samanya as there is a site of prana at these points. This chikitsa acts as the pain reliever or preventional aspect of these vital sites or Marma. Conclusion- On dissection of ankle joint various structures were studied and were compared with Gulpha Marma. The injuries related to these marma’s can be studied under tendons, ligaments, vessels and bones. These can be considered as siravedhya and vatavyadhi and treated accordingly. Based upon the above observations and study we can conclude the exact location, effect of injury, relation with ankle joint of Gulpha Marma. Keywords- Marma, Gulpha Marma, Ankle Joint, Marma Chikitsa

Marma therapy is the original point system of healing in the body. “Marma” come from the sanskrit “Mru” and which means “To kill” the 107 Marma points are categorised in terms of their effect on the vitality of the body. Marma is one of the unique and important topics discussed in Ayurveda. It plays an important role in surgery. Hence it is rightly called as Shalya Vishayardha. Marma plays a significant clinical role and may be correlated to the Acupressure/Acupuncture. Marma are the critical points of body associated with different organs and nerves. Ayurveda describe use of Marma therapy for various diseases and identification of Marma points which is to be cured, since injury to these Marma points may causes serious harmful effect. Different types of muscles, veins, bones, ligaments and joints meets with each other at the Marma point thus these points acts as a physiological junction. Discussion of Marma points is found in most of the great texts of Ayurveda but the most famous text to explore the subject is the Sushruta Samhita. Vaidya Sushruta described ‘the locations of the Marma points, as well as how they influence Prana. He stated that it is important for the surgeon to have knowledge of these points for the purpose of avoiding them, so as to cut into them could result in a catastrophic outcome. This article summarizes various perspectives of Marma and their clinical importance as per Ayurveda.

– Sushrutacharya is the pioneer of Ayurved Rachana Sharir and Ayurvedic Shalya Tantra. He has mentioned various concepts in Rachana Sharir in the Sushrut samhita sharirsthan. In 7th adhyaya of the sharirsthan, he has given the meticulous information regarding the Siras of the human body. In the same adhyaya the Acharya has named some Avedhya Siras which should not be punctured during the treatment aspect. The Lohitaksha sira is one of them. So, it is essential to know the details of this lohitaksha sira which is present in shakhapradesh (Both extremities). So, for this purpose, this study is to clarify the perception of Lohitaksha sira with the help of modern anatomy. Lohitaksha is also a marma which is vital spot in the human body. So, lohitaksha sira can be called as marmashrit sira.

Marmas are the vital points in the body. The word Marma derived from the Sanskrit root “mru” and applies to a part or a spot of vital importance in the body, which if injured results in serious consequences. It also denotes the vital force of life. About 107 Marmas have been explained in Ayurveda, according to Acharya Sushruta Jathruurdva Marmas are considered as major places of Prana and Phanamarma is one of them belonging to Vaikalya-Karamarma, located on either side of nostrils. The term Phana means expanded side of the nose or expanded hood of the serpent. When we compare the site of Phana Marma there is an difference of opinion between Acharya Sushruta and Vagbhata (Astanga Sangraha) but both explained the similar Viddhalaxana, hence to clarify the doubt regarding its location the study is undertaken. As no such study regarding Phanamarma has been taken up by previous scholars, this subject has attracted me to conduct cadaveric study to ascertain its anatomical limitations, which will be definitely helpful for the future scholars, as lot of dark areas are highlighted concerned to this Marma.

Ashtanga Hridya identifies 4 major nerves in the feet that connect to the eyes. These nerves help in maintaining good eyesight and relieve eyestrain when subjected to soothing therapies like padabhyanga. Padabhyanga is a holistic therapy and a religious approach towards an effective psychosomatic healing. According to Charak and Vagbhatta it is described as drishtiprasadak and according to Sushruta chakshushya. It can be done with the help of ghrita or taila, eg- tila taila, ksheerbala taila, eranda taila, goghruta. Other than this kansya vati padabhyanga can also be done as it balances the tridoshas. Marma Vijgyana theory of Ayurveda is the base of Acupressure, Acupuncture and Reflexology treatments. These therapies include healing the diseases by massage on the marma points. The reflexology points of eye are situated on the undersides of second and third toes. Doing massage on these points maintains the eye health and benefits in digital eye strain, dry eye, computer vision syndrome, myopia, hypermetropia, presbyopia, astigmatism, amblyopia and many other eye diseases. The medicated ghrita or taila gets absorbed via the siras, reaches the structures of the eyes, pacifies the doshas, reduces strain and provides soothing effect by nourishing the eyes.

Background: Ashmari Roga is considered as one of the Ashta Maha Gada considered difficult to cure because of its Marma Ashrayatwa, due to the involvement of Bahu Dosha and Basti, which is one of the Tri Marma, Acharyas has specifically mentioned many treatment modalities for reducing the symptoms as well as eliminating the Ashmari from its root, in which Basti and Virechana is having prime importance. So here an attempt is made to compare and study the efficacy of Basti and Virechana in Mutrashmari. Objective: To study the effect of Avapidaka Snehapana followed by Virechana and Shamanoushadhi and Matrabasti followed by Shamanoushadhi in the management of Mutrashmari. Materials and methods: 40 patients diagnosed with Mutrashmari (urinary calculus) and fulfilling the inclusion criteria were selected and randomly divided into 2 groups. In Group A: Amapachana with Hingvastaka Churna, Avapidaka Sneha with Punarnavadi Ghrita and Virechana with Trivrut Mrudvika Rasa followed by Shuntyadi Kwatha as Shamanoushadhi, In Group B: Amapachana with Hingvastaka Churna, Varunadhya Taila Matra Basti followed by Shwadamstra Kwath as Shamanoushadhi. Pain (from loin to groin), Nausea, Dysuria, Haematuria, Burning Micturation, Number of stones, Size of stones, Site of stone, Hydroureter and Hydronephrosis were assessed before and after treatment. The total duration of the study was 60 days or up to expulsion of the stone with 45 days of follow up. Results: In this study, Group A shows statistically more significant result than Group B. Conclusion: Both Group A and Group B have shown significant outcomes in all parameters with proper diet and regimen. Reoccurrence of stone was not found in a single subject.

In the process of evolution from quadrupeds to bipeds, the forelimbs developed into upper limbs. In quadrupeds they serve the purpose of weight bearing and attack. In bipeds they serve fine functions, holding an object, attack and defense. It has been estimated by research group that the hand performs approximately thousand different functions in an ordinary day today’s activity. Apabahuka is one such disease which hampers most of the foresaid functions of the hand. Although any of the classics do not mention about the Shoola as a Laxana of Apabahuka, it still is a feature practically seen in Avabahuka patients. Chikitsa Sara Sangraha and Nidana Sara, clearly mentions about Svedana as a predominant Laxana of Avabahuka, along with other Laxana. It is often said that ‘the pain is often severe enough to disturb the sleep’. Amsa Marma is primarily involved in Avabahuka, it is a Snayu Marma and one of Vaikalyakara Marma, any trauma to this will produce disability or deformity of the shoulder joint. Management of pain is facilitated by Marma Chikitsa i.e. Nidana Parivarjana, Abhyanga, Swedana, Uttarabhaktika Snehapana, Vata Hara Oushadha Sevana, Marmabhighata Chikitsa, Brumhana, Nasya, Lepa, Seka, Nasya, Nasaapaana, Agnikarma, Siravyadha, etc.

Marma are vital areas of the body on which if any injury occurs may lead to Marana or Maranasadrishya Dukha (Death). As per the description given by Sushruta Samhita, Lohitaksha Marma (vital point in the near to femoral triang le) is situated in between the Urvi Marma (vital point of middle of thigh) an d Vankshana Sandhi (hip joint). Both Vagbhata have stated its location at Uroomula ( Root of Hip). The injury effects of Lohitaksha Marma (vital point in the near to femoral triang le) lead ing to Lohita Kshaya (blood loss), Marana (death) and Pakshaghata (paralysis). Therefore the regional and applied Anatomy of Lohitaksha Marma (vital point i n the near to femoral triangle) is reviewed in this paper.

Background: At present, only a limited amount of documentation exists that shed light on aspects of plants used by Traditional Healers (THs) in Bangladesh for treating general ailments. The current study is concerned with information on medicinal plants (MPs) used in Traditional Medicine (TM) by the Khumi, Marma and Tripura communities of Bangladesh. Aims: The study attempted to collect, analyze and evaluate Traditional Knowledge (TK) of the healing powers of plants used in TM in Thanchi upazila during August 2011 to January 2013; and to classify as far as possible the plants encountered in the study. Methodology: Semi-structured questionnaire was used to collect information through Focused Group Discussions (FGD) and one to one discussions with the selected indigenous

Vedhya Sira means puncturable vein used in the treatment of Vicarchika (eczema). Sirave dh is para surgical procedure in which suitable vein is punctured to release impure blood. Vicarchika is skin disease similar to Eczema in Allopathic medicine. Both are difficult to cure and need long term treatment. In Ayurved especially in Caraka samhita (text book of medicine) the disease is classified as Kshudra Kushtha (minor skin disease). Various remedies have been given to treat this disease. Sushruta has given Siravedh (vene puncture) of sira (blood vessel ) found two finger above of Khsipra Marma (vital sp ot in hand and dorsum of foot) in both limbs to alleviate the severity of disease. The statement is vague and does not indicate the exact structure and site of puncture (i.e. lateral, medial, dorsal or palmer surface of hand/foot). Here there are many structures like dhamani (artery), sira (vessels), strotas (conduits/channels), snayu (ligament) etc. Sharir sthanas (Anatomical Chapters) of Bri hatrayii (three major classical texts, viz Caraka , Sushruta and Vagbhat Samhita) includes basic knowledge o f structures and their clinical importance. Sushruta has explained 700 siras in body in which 100 sira is present in each limbs/shakha in which 4 vein/sira is non puncturable i.e. av edhya sira . Keeping all above points in mind it is necessary to identify a nd confirm the anatomical site of Vedhya sira and their application in Vicarchika by Siravedh (vene puncture) in the context of modern science. Keyword: Vicarchika , eczema, vedhya sira (puncturable vein), Siravedh ( vene puncture), kshipra marma