The mediating role of Hope between Loneliness and Anxiety during Covid-19 among younger adult (18-25) and older adults (65-80)

 The mediating role of Hope between Loneliness and Anxiety during Covid-19 among younger adult (18-25) and older adults (65-80) 

This is my own unique work. Donot plagiarize.

 Since December 2019, the lives of people all around the globe have been altered because of severe Acute Respiratory Syndrome Coronavirus-2 followed by COVID-19 pandemic. As of today, more than 177 million people worldwide have been tested positive for this virus where 3 million people have lost their lives while medical professionals report that actual number is much higher than this (https://COVID-19.who.int/). Because of this novel condition, people for the first time in their lives faced forced and prolonged self-isolation which is against the human nature.  While the social isolation has been especially intense for older and younger adults who had potential contact with the virus. Going against the nature always has consequences and as day-by-day new vaccines are rolling, people are going back to normal life, yet it does not free human from the psychological effects such as anxiety, uncertainty and loneliness they experienced during COVID-19. These psychological consequences of COVID -19 will likely persist in society even after the pandemic ends as the physical restriction will impact the psychological well-being of individuals (Leigh-Hunt & Colleagues, 2017). Same trends have been seen in past where there has been evident surge in anxiety and depressive disorders during SARS in 2003 (Cheung et al., 2008), similar effects were seen during Ebola epidemic in 2014-2016 (Jalloh et al., 2018) and currently due to induced loneliness, increase in depression and anxiety disorders was also predicted with further growth in future yet more studies are needed to see the influence of loneliness on anxiety and other factors playing their role to influence this relation. (Tso & Park, 2020). 

Despite of being a neighbor of country from where the pandemic of COVID-19 started, Hong Kong reported much less positivity rate (11,881 cases) and mortality (210 cases) (Kong, 2021). Hong Kong has strictly followed the rule to slow down the spread of pandemic (Luchettiet al, 2020) and was relatively successful in mitigating transmission early in the outbreak of COVID-19 (Lai et al, 2020). People habit of wearing masks after SARS infection also played significant role in curbing the pandemic in Hong Kong. However, it was alarming to see that Hong Kong has experienced the highest level of psychological distress in comparison to USA, Korea and France despite of very low prevalence rate of COVID-19 (Dean, et al., 2021). The social isolation because of high mortality and morbidity rate has left the vulnerable population such as older adults predisposed to more psychological illness (Moutier, 2021) as compared to adults (Bu et al., 2020; Li & Wang, 2020). However, because of lock down adult had to start working from home as well, which deprived them of social gatherings and connections, thus the senses of loneliness, hopelessness, as well as anxiety is consequently widespread among the public in different levels. Also, other reason is perhaps associated with the SARS outbreak and ongoing political unrest in Hong Kong (Tso & Park, 2020).

Human is considered as social animal. Since early years philosophers and psychologist have narrated that by being lonely, human depicts the fundamental failure of achieving the sense of belongingness with their loved ones and in the world, which impacts their capacity of maintain wellbeing (Baumeister & Leary, 1995). Loneliness has been defined in the literature using various definitions, yet all the definitions of Loneliness have three vital components (Peplau & Perlman, 1982). The features are:

A)   loneliness is a byproduct of perceived lack of social skills 

B)   it is subjective

C)   loneliness is a negative and painful experience which cause significant distress

However, for this study the definition by Perlman and Peplau (1982) is considered which defines loneliness as “the negative emotional response to a discrepancy between the desired and achieved quality of one’s social network”. This definition states that the discrepancy between actual and desired social skill is the basic reason behind loneliness. Also, this definition contains both the affective and the cognitive factors pertaining to the loneliness and differentiates the construct of solitude, where solitude is an objective and a positive state while loneliness is a subjective and negative state (Goosens, 2006; Goossens & Marcoen, 1999). Ample of research showed that loneliness is linked with unpleasant and distressing experience and have adverse psychological outcomes (Rokach, 2012). It has also been linked with decline in cognitive abilities and early advent of dementia among older adults (Cacioppo et al., 2010). Similarly, loneliness among adolescents is linked with low self-esteem which becomes more evident in adulthood (Mustaq et al., 2014). Associations of loneliness with mental health conditions such as increased perceived stress, constant fear of being negatively evaluated, anxiety, anger, high pessimism and diminished self-esteem has been also highly reported as well (Hawkley & Cacioppo, 2010). However, the level of loneliness is different among age groups and follow a certain trajectory (Heinrich & Gulline, 2006).

Loneliness tends to follow a “U” curve in its trajectory. Loneliness has been said to reach at its peak in adolescence, then decrease in middle adult hood and surge again in elderly (Heinrich & Gulline, 2006). However, the literary evidence to provide concrete information on trajectory of loneliness is still scarce, but the literature up till now showed that loneliness scores are rather low and stable from kindergarten to 6 years of age (Kochenderfer-Ladd & Wardrop, 2001). The same pattern is followed from age 7 to 12 years (Bartels, Cacioppo, Hudziak, & Boomsma, 2008). After this time, the decline in loneliness was observed from early to middle adolescence (Van Roekel et al., 2010) and then increased significantly in later years of life. However, there is lack of longitudinal research pertaining to adolescent to young adulthood. The interesting part is this phase of life is linked with various social challenges and making new friends is somewhat normal. Based on this information, it is assumed that individual is less lonely during this phase of life (Bayat, Fokkema, Mujakovic, & Ruiter, 2021). However, contrasting results reported that loneliness also peaks during this phase of life (Barreto et al., 2021, yang and Victor, 2011). Nonetheless, the peak levels of loneliness during this period are among those individuals who faced victimization and had problematic relationships with peers (Vanhalst et al.,2014). Such distressing event negatively impact the capacity of adolescent to interact with people thus further perpetuating loneliness (Harwood, 2012). Close friends and family members and quality student teacher relation is considered as a detrimental resource against the loneliness (Bayat, Fokkema, Mujakovic, & Ruiter, 2021). Similarly, loneliness in later years is associated with aging, loss of friends and family, physical and cognitive decline. It is experienced by most of the adults of the age and has been named as “loneliness pandemic”. More than 5% of adult population reported being feeling lonely and recently this figure has increased up to 17%-57%. Social isolation or loneliness can impact the wellbeing and physical health of older adult in negative manner and may result in increased blood pressure, depression, obesity and substance abuse (Berg et al., 2020). In Pandemic, lock down has further exacerbated the loneliness among adults and the levels of loneliness and psychological distress have significantly increased among older adults of Hong Kong (Wong et al., 2020). Similarly, studies have also found that age act as a moderating role while exploring the relation between health worry and anxiety among older adults during Covid -19 (Robb et al., 2021). For older adults, statistics showed 12.8% increase in depression levels and 12.3% increase on anxiety levels among older population

During Covid-19, the level of loneliness among all ages increased owing to social isolation. Preliminary studies conducted on Chinese and Italian population reported high prevalence of PTSD, anxiety, depression and stress among COVID survivors (Bao et al., 2020; Rossi et al., 2020). Also, pre and post pandemic studies have pointed towards the impact of social isolation in form of increased mental health issues among general population (Gao et al., 2020) and showed association of loneliness with depression and anxiety (Killgore et al., 2020). Elevated levels of depression, stress, anxiety and loneliness were reported among Hong Kong residents as well (lee et al., 2020; (Tso & Park, 2020). However, the causal relation between loneliness and isolation is difficult to understand and perhaps moderated by other psychological factors as well such as anxiety or hope (Tso & Park, 2020).

Anxiety can be viewed as the perceived inability to predict or control the outcome of the situation which results in subjective perception of the event being a threat and accompanying negative effect. Anxiety emerges as a consequence of interaction between individual and the environment. Irrespective of loneliness, anxiety has cognitive, psychological and behavioral component (Konstam, Moser, & De Jong, 2005). Studies have shown that with increased isolation and lack of social contact significantly increases the anxiety levels. It is argued in literature that perhaps loneliness is the reason behind anxiety (McWhirter, 1990). Recent research has also reported anxiety as a byproduct of loneliness (Hawkley & Cacioppo, 2010; Heinrich & Gullone, 2006). Similarly chronic anxiety can have significant impact on physical health and is related to quality of life, mortality and depression. Because of this Loneliness has been proven a significant risk factor for depression, anxiety and its comorbidity during COVID-19 (Plagi et al., 2020). Similarly, Holmes (2020) suggests that social isolation and loneliness are strongly associated with anxiety across the lifespan. When such feelings like loneliness and increased anxiety levels during the pandemic is not well coped, a bigger mental health issue could be triggered. Hawryluck (2004) has shown that 29% of 129 interviewee who were put in quarantine were later diagnosed PTSD and depression after the SARS outbreak in 2003. Similarly Meterns et al., (2020) reported link between fear of COVID-19 and anxiety which later lead to depression. It can be said that fear of Covid is associated with higher anxiety scores as compared to depression scores (Mamun and Griffith, 2020) which point towards the need of exploring this construct in various population. Owing to cultural differences (collectivist vs individualistic society) it was expected that South Asian population will have higher levels of anxiety and depression as compared to European countries. Study showed moderate to severe level of anxiety symptoms were present among Chinese population (Huang and Zhao, 2020). However it is possible that education and age of individual may result in different output as Study by Chen et al., (2020a) showed undergraduate students being more fearful of covid with high scores in anxiety as compared to graduate students. Similarly when viewed anxiety within context of Covid-19 and loneliness associated with it. 56.4% adults reported perceived isolation while 36% of adults reported loneliness. However, study showed no relation between COVID-19 related anxiety and social isolation which perhaps point towards the argument that perceived isolation of COVID-19 may exacerbate the already present clinical symptoms but it may not be a predisposing factor of anxiety among older population (Gaeta & Brydges, 2020). According to Wong et al., (2021) it is worth looking at other moderating variables that might be mitigating the relationship between the two variables (loneliness and anxiety) and proposed that the amount of information consumed from social media is directly related to the levels of COVID related anxiety among older adults. As the COVID has pushed the older adults to be in isolation and with no human contact they relied heavily on the social media for updates which might have consequently increased the levels of anxiety among adult population (Wong et al., 2021). No studies are found among younger adults and their level of anxiety within context of COVID loneliness. However, it is possible that younger adults mostly have families (wife and kids) with whom they were isolated which might have mitigated their levels of anxiety as low as compared to older adults. However, further researches are required to confirm or reject this hypothesis. Nevertheless, some individuals have positive psychological strengths that allow them to resist anxiety and loneliness (Karababa, 2020). Hope has been studied extensively in this context (Schofield, Stockler & Zannino et al., 2016).

Human behaviour is motivated by the identification and pursuit of goals and define hope as “pathways thinking, or the capacity to identify strategies to pursue one’s goals and agency thinking, or the motivation to effectively pursue one’s pathways to achieve goals” (Snyder, 2002). The factors mentioned in the definition are bidirectional in nature and enhance the motivation and promote the goal directed movement. As in past there has been number of models proposed but the model given by Snyder (1991) was most compelling. According to Snyder all human put an effort to move towards the goal on basis of Hope. It is a universal process that involves conscious efforts and extend psychological advantages to all(Lopez, 2013; Snyder, 1994; Snyder et al., 1991). Snyder theory have been supported by empirical evidence as well and mention it as adaptive process specially among adults (e.g., Snyder, 1994, 2002; Snyder et al., 1991). Many studies in past have reported hope as the buffer between the relation of maladaptive processes and unhappy conditions in adults. Muyan et al. (2016) In his study found that hope is the significant predictor f depression and interaction of loneliness and hope presicts the anxiety symptoms and not the depressive. However, for concrete results, further replication would be required.

According to Snyder et al. (1991), hope reflects a cognitive set composed of two relatively distinct ways of thinking about a goal as measured by their Hope Scale. Agentic thinking involves thoughts related to one’s successful determination or resolve about reaching goals, whereas pathways thinking involves thoughts about one’s effective ability to pursue different means to obtaining goals. Within Snyder et al.’s (1991) hope theory, it is important to consider both types of cognitions as they relate to behavior and outcome. Accordingly, an important tenet of Snyder’s (1994) model is that the perception of goal attainment will be, in general, positively associated with greater levels of both agentic and pathways thinking, which in turn will result in each of the hope components being associated with psychological adjustment (e.g., greater life satisfaction). Indeed, findings from a number of studies examining Snyder et al.’s (1991) measure of hope have consistently provided support for a two-dimensional model (e.g., Babyak, Snyder, & Yoshinobu, 1993; Gana, Daigre, & Ledrich, 2013; Gomez et al., 2015; Kato & Snyder, 2005; Martos, Lakatos, & Tóth-Vajna, 2014; Roesch & Vaughn, 2006; Sun, Ng, & Wang, 2012). 

Hope is related to various psychological constructs such as resilience, self-efficacy, and hope. There is a significant literature that suggests relation between high levels of hope and low levels on anxiety. It can be said that hope lets an individual to solve problems in better ways in the face of adversity. A study conducted on French population showed negative correlation between hope and anxiety (Gana, Diagre, & Ledrich, 2013). Similar findings were seen in Saudi Arabia as well ( Abdel-Khalek & Snyder, 2007). Few studies pointed towards negative association of hope, optimism and wellbeing in face of COVID stress among college students and emphasized that being hope full is a potential source of high scores on wellbeing among Younger adults (Genc & Arsla, 2021)

 

While studying the moderating role of anxiety with social isolation and wellbeing among adolescents, no effect was found which indicate that chaos and uncertainty adolescent faced during COVID-19 is much greater than the hope influencing relation between loneliness and anxiety. However, the study was limited to 12-14 years of age group and cannot be generalized over older or younger adult population (Huack, 2020). However, there is a gap in literature which explores the impact of pandemic on the younger adults and its relation to the loneliness, anxiety and hope and how hope play its role to alleviate the levels of anxiety during Global Pandemic (Mirhosseini et al., 2020). 

This study aims to look at the moderating role of hope in relation between loneliness and anxiety while comparing the levels among younger and older adults in Hong Kong. The analysis between two age groups will also help to see the trajectory and trends of the loneliness, anxiety and hope. This study where it will validate the results of previous studies conducted with adults, while adding incremental value by exploring these factors among younger adults which is a neglected population within context of COVID pandemic.

 

 

 

 

 

 

 

 

 

 

References

 

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Bender Gestalt Test using Image Analysis Technique.

Bender Gestalt Test using Image

 Analysis Technique.

kindly follow blog and comment your email id down for its scoring and interpretation method

RQ (Relationship Questionnaire)

The RQ can either be worded in terms of general orientations to close relationships, romantic

relationships, or orientations to a specific relationship. It can also be reworded in the third

person and used to rate others' attachment patterns (See Bartholomew & Horowitz, 1991 or

Scharfe & Bartholomew).

Scale: Following are four general relationship styles that people often report. Place a checkmark next to the letter corresponding to the style that best describes you or is closest to the way you are.

 ____ A. It is easy for me to become emotionally close to others. I am comfortable depending on them and having them depend on me. I don’t worry about being alone or having others not accept me.

 ____ B. I am uncomfortable getting close to others. I want emotionally close relationships, but I find it difficult to trust others completely, or to depend on them. I worry that I will be hurt if I allow myself to become too close to others.

 ____ C. I want to be completely emotionally intimate with others, but I often find that others are reluctant to get as close as I would like. I am uncomfortable being without close relationships, but I sometimes worry that others don’t value me as much as I value them.

 ____ D. I am comfortable without close emotional relationships. It is very important to me to feel independent and self-sufficient, and I prefer not to depend on others or have others depend on me. Now please rate each of the relationship styles above to indicate how well or poorly each description corresponds to your general relationship style.
          Style A                 1                   2                   3                 4              5           6              7
                            Disagree Strongly             Neutral/ Mixed                                    Agree Strongly
          Style B                 1                    2                  3                 4              5           6              7
                            Disagree Strongly              Neutral/ Mixed                                    Agree Strongly
         Style C                1                      2                  3                  4              5           6              7
                            Disagree Strongly              Neutral/ Mixed                                    Agree Strongly
         Style D                1                     2                   3                  4              5           6              7
                            Disagree Strongly              Neutral/ Mixed                                    Agree Strongly

SCORING
Each item have score range from 1 to 5 and each paragraph donates one attachment style
style A shows secure attachment style
style B shows fearful attachment style
style C shows preoccupied attachment style
style D shows dismissing attachment style

You can also measure internal working models of self nd other through this scale

 Self Model = (secure + dismissing) MINUS (fearful + preoccupied)]. 

Other Model = (secure + preoccupied) MINUS (fearful + dismissing)

A-RSQ (Attachment Relationship Scale Questionnaire)

The following is a copy of the Adolescent Relationship Scales Questionnaire (A-RSQ) — a revision of the original Relationship Scales Questionnaire . The continuous scales reflect the degree of security, fearfulness, preoccupiedness, and dismissingness and typically is NOTused to categorize individuals into attachment categories.  I have used this scale in a clinical sample of adolescents and preliminary results between the continuous scales from this measure and interview attachment ratings are available by email.

Think about all the people in your life. Now read each of the following statements and rate how much it describes your feelings.

(you may wish to use a 5– to 9-point scale fromnot at all like me to very much like me)

1. I find it hard to count on other people

2. It is very important to me to feel independent

3. I find it easy to get emotionally close to others

4. I worry that I will be hurt if I become too close to others

5. I am comfortable without close emotional relationships

6. I want to be completely emotionally close with others

7. I worry about being alone

8. I am comfortable depending on other people

9. I find it difficult to trust others completely

10. I am comfortable having other people depend on me

11. I worry others don’t value me as much as I value them

12. It is very important for me to do things on my own

13. I’d rather not have other people depend on me

14. I am kind of uncomfortable being emotionally close to people

15. I find that people don’t want to get as close as I would like

16. I prefer not to depend on people

17. I worry about having people not accept me.

You can calculated the underlying attachment dimensions can be derived using the following equations:

  Self Model = (secure + dismissing) MINUS (fearful + preoccupied)].

 Other Model = (secure + preoccupied) MINUS (fearful + dismissing)

Ayurvedic medicine- Medical anthropology

Introduction

Ayurvedic medicine (also called Ayurveda) is one of the world’s oldest medical systems. It originated in India and has evolved there over thousands of years. In the United States, Ayurvedic medicine is considered complementary and alternative medicine (CAM)—more specifically, a CAM whole medical system. Many therapies used in Ayurvedic medicine are also used on their own as CAM—for example, herbs, massage, and specialized diets. This fact sheet provides a general overview of Ayurvedic medicine and suggests sources for additional information.

Key Points

• The aim of Ayurvedic medicine is to integrate and balance the body, mind, and spirit. This is believed to help prevent illness and promote wellness.
• Ayurvedic medicine uses a variety of products and techniques to cleanse the body and restore balance. Some of these products may be harmful if used improperly or without the direction of a trained practitioner. for example, some herbs can cause side effects or interact with conventional medicines.
• Before using Ayurvedic treatment, ask about the practitioner’s training and experience.
• Tell your health care providers about any complementary and alternative practices you use. Give them a full picture of what you do to manage your health. This will help ensure coordinated and safe care.

Background

Ayurvedic medicine, also called Ayurveda, originated in India several thousand years ago. The term “Ayurveda” combines the Sanskrit words ayur (life) and veda (science or knowledge). Thus, Ayurveda means “the science of life.”

In the United States, Ayurvedic medicine is considered a type of CAM and a whole medical system. As with other such systems, it is based on theories of health and illness and on ways to prevent, manage, or treat health problems.

Ayurvedic medicine aims to integrate and balance the body, mind, and spirit; thus, some view it as “holistic.” This balance is believed to lead to happiness and health, and to help prevent illness. Ayurvedic medicine also treats specific physical and mental health problems. A chief aim of Ayurvedic practices is to cleanse the body of substances that can cause disease, thus helping to reestablish harmony and balance.

Ayurvedic Medicine in India

Ayurvedic medicine, as practiced in India, is one of the oldest systems of medicine in the world. Many Ayurvedic practices predate written records and were handed down by word of mouth. Two ancient books, written in Sanskrit more than 2,000 years ago, are considered the main texts on Ayurvedic medicine—Caraka Samhita and Sushruta Samhita. The texts describe eight branches of Ayurvedic medicine:

• Internal medicine
• Surgery
• Treatment of head and neck disease
• Gynecology, obstetrics, and pediatrics
• Toxicology
• Psychiatry
• Care of the elderly and rejuvenation
• Sexual vitality.

Ayurvedic medicine continues to be practiced in India, where nearly 80 percent of the population uses it exclusively or combined with conventional (Western) medicine. It is also practiced in Bangladesh, Sri Lanka, Nepal, and Pakistan.

Underlying Concepts

Ayurvedic medicine has several key foundations that pertain to health and disease. These concepts have to do with universal interconnectedness, the body’s constitution (prakriti), and life forces (doshas).

Interconnectedness. Ideas about the relationships among people, their health, and the universe form the basis for how Ayurvedic practitioners think about problems that affect health. Ayurvedic medicine holds that:

• All things in the universe (both living and nonliving) are joined together.
• Every human being contains elements that can be found in the universe.
• Health will be good if one’s mind and body are in harmony, and one’s interaction with the universe is natural and wholesome.
• Disease arises when a person is out of harmony with the universe. Disruptions can be physical, emotional, spiritual, or a combination of these.

Constitution (prakriti). Ayurvedic medicine also has specific beliefs about the body’s constitution. Constitution refers to a person’s general health, the likelihood of becoming out of balance, and the ability to resist and recover from disease or other health problems.

The constitution is called the prakriti. The prakriti is a person’s unique combination of physical and psychological characteristics and the way the body functions to maintain health. It is influenced by such factors as digestion and how the body deals with waste products. The prakriti is believed to be unchanged over a person’s lifetime.

Life forces (doshas). Important characteristics of the prakriti are the three life forces or energies called doshas, which control the activities of the body. A person’s chances of developing certain types of diseases are thought to be related to the way doshas are balanced, the state of the physical body, and mental or lifestyle factors.

Ayurvedic medicine holds the following beliefs about the three doshas:

• Each dosha is made up of two of five basic elements: ether (the upper regions of space), air, fire, water, and earth.
• Each dosha has a particular relationship to bodily functions and can be upset for different reasons.
• Each person has a unique combination of the three doshas, although one dosha is usually prominent. Doshas are constantly being formed and reformed by food, activity, and bodily processes.
• Each dosha has its own physical and psychological characteristics.
• An imbalance of a dosha will produce symptoms that are unique to that dosha. Imbalances may be caused by a person’s age, unhealthy lifestyle, or diet; too much or too little mental and physical exertion; the seasons; or inadequate protection from the weather, chemicals, or germs.

The doshas are known by their original Sanskrit names: vata, pitta, and kapha.

The vata dosha combines the elements ether and air. It is considered the most powerful dosha because it controls very basic body processes such as cell division, the heart, breathing, discharge of waste, and the mind. Vata can be aggravated by, for example, fear, grief, staying up late at night, eating dry fruit, or eating before the previous meal is digested. People with vata as their main dosha are thought to be especially susceptible to skin and neurological conditions, rheumatoid arthritis, heart disease, anxiety, and insomnia.

The pitta dosha represents the elements fire and water. Pitta controls hormones and the digestive system. A person with a pitta imbalance may experience negative emotions such as anger and may have physical symptoms such as heartburn within 2 or 3 hours of eating. Pitta is upset by, for example, eating spicy or sour food, fatigue, or spending too much time in the sun. People with a predominantly pitta constitution are thought to be susceptible to hypertension, heart disease, infectious diseases, and digestive conditions such as Crohn’s disease.

The kapha dosha combines the elements water and earth. Kapha helps to maintain strength and immunity and to control growth. An imbalance of the kapha dosha may cause nausea immediately after eating. Kapha is aggravated by, for example, greed, sleeping during the daytime, eating too many sweet foods, eating after one is full, and eating and drinking foods and beverages with too much salt and water (especially in the springtime). Those with a predominant kapha dosha are thought to be vulnerable to diabetes, cancer, obesity, and respiratory illnesses such as asthma.

Treatment

Ayurvedic treatment is tailored to each person’s constitution. Practitioners expect patients to be active participants because many Ayurvedic treatments require changes in diet, lifestyle, and habits.

The patient’s dosha balance. Ayurvedic practitioners first determine the patient’s primary dosha and the balance among the three doshas by:

• Asking about diet, behavior, lifestyle practices, recent illnesses (including reasons and symptoms), and resilience (ability to recover quickly from illness or setbacks)
• Observing such physical characteristics as teeth and tongue, skin, eyes, weight, and overall appearance
• Checking the patient’s urine, stool, speech and voice, and pulse (each dosha is thought to make a particular kind of pulse).

Treatment practices. Ayurvedic treatment goals include eliminating impurities, reducing symptoms, increasing resistance to disease, and reducing worry and increasing harmony in the patient’s life. The practitioner uses a variety of methods to achieve these goals:

• Eliminating impurities. A process called panchakarma is intended to cleanse the body by eliminating ama. Ama is described as an undigested food that sticks to tissues, interferes with normal functioning of the body, and leads to disease. Panchakarma focuses on eliminating ama through the digestive tract and the respiratory system. Enemas, massage, medical oils administered in a nasal spray, and other methods may be used.
• Reducing symptoms. The practitioner may suggest various options, including physical exercises, stretching, breathing exercises, meditation, massage, lying in the sun, and changing the diet. The patient may take certain herbs—often with honey, to make them easier to digest. Sometimes diets are restricted to certain foods. Very small amounts of metal and mineral preparations, such as gold or iron, also may be given.
• Increasing resistance to disease. The practitioner may combine several herbs, proteins, minerals, and vitamins in tonics to improve digestion and increase appetite and immunity. These tonics are based on formulas from ancient texts.
• Reducing worry and increasing harmony. Ayurvedic medicine emphasizes mental nurturing and spiritual healing. Practitioners may recommend avoiding situations that cause worry and using techniques that promote release of negative emotions.

Use of plants. Ayurvedic treatments rely heavily on herbs and other plants—including oils and common spices. Currently, more than 600 herbal formulas and 250 single plant drugs are included in the “pharmacy” of Ayurvedic treatments. Historically, Ayurvedic medicine has grouped plant compounds into categories according to their effects (for example, healing, promoting vitality, or relieving pain). The compounds are described in texts issued by national medical agencies in India. Sometimes, botanicals are mixed with metals or other naturally occurring substances to make formulas prepared according to specific Ayurvedic text procedures; such preparations involve several herbs and herbal extracts and precise heat treatment.

Concerns About Ayurvedic Medications

Ayurvedic practice involves the use of medications that typically contain herbs, metals, minerals, or other materials. Health officials in India and other countries have taken steps to address some concerns about these medications. Concerns relate to toxicity, formulations, interactions, and scientific evidence.

Toxicity. Ayurvedic medications have the potential to be toxic. Many materials used in them have not been thoroughly studied in either Western or Indian research. In the United States, Ayurvedic medications are regulated as dietary supplements. As such, they are not required to meet the safety and efficacy standards for conventional medicines. An NCCAM-funded study published in 2004 found that of 70 Ayurvedic remedies purchased over-the-counter (all manufactured in South Asia), 14 contained lead, mercury, and/or arsenic at levels that could be harmful. Also in 2004, the Centers for Disease Control and Prevention reported that 12 cases of lead poisoning occurring over a recent 3-year period were linked to the use of Ayurvedic medications.

Formulations. Most Ayurvedic medications consist of combinations of herbs and other medicines. It can be challenging to know which components are having an effect and why.

Interactions. Whenever two or more medications are used, there is the potential for them to interact with each other. As a result, the effectiveness of at least one may increase or decrease in the body.

Scientific evidence. Most clinical trials (i.e., studies in people) of Ayurvedic approaches have been small, had problems with research designs, lacked appropriate control groups, or had other issues that affected how meaningful the results were. Therefore, scientific evidence for the effectiveness of Ayurvedic practices varies, and more rigorous research is needed to determine which practices are safe and effective.

HALWA GHEEKWAR (ALOE VERA KA HALWA)- Medical Anthropology

HALWA GHEEKWAR (ALOE VERA KA HALWA)

Myristica fragrance (Nutmeg) (Mace)	5 mg.
Withania somnifera (Ashwagandha)	11 mg.
Elettaria cardamom (Elaichi Choti)	11 mg.
Curculigo orchoides (Kali Musli)	11 mg.
Triticum sativum (Gundam)	11 mg.
Myrtus caryophyllus (Laung)	14 mg.
Gossypium herbaceum (Binaula)	108 mg.
Asparagus racemosus (Satawar)	108 mg.
Prunus amygdalus (Badam)	270 mg.
Clarified Butter (Ghee Desi)	1.087 g
Acacia arabica (Gond Kikar)	1.302 g
Trapa bispinosa (Singhara)	1.302 g
Aloe vera (Gheekwar)	1.630 g
Milk Roasted (Khoya)	3.260 g
Phoenix dactylifera (Khajur)	3,912 g
Sugar	11.926 g
Pandanus odoratissimus Distillate (Arq Kewra)	q.s.

METHOD:

·         Take a pan and put ghee for heating

·         Then add aloe vera and sativum in it and stir for 20-25 min till it get brown in color

·         On thickening add milk, condensed milk, sugar ,cardamom powder, nutmeg and mace powder , ashwagandha, curculigo orchoides, Myrtus caryophyllus (Laung), Acacia arabica (Gond Kikar), Trapa bispinosa (Singhara), Asparagus racemosus (Satawar), Prunus amygdalus (Badam) and Phoenix dactylifera (Khajur)

·         And cook for 5-7 min.

DOSAGE: 20 g in the morning or at night with 250 ml milk

DESCRIPTION: Removes rheumatic pain and lumbago. Also useful in backache.

INGREDIENTS EXPLANATION:

Myristica fragrance

English name: nutmeg and mace

Punjabi/Urdu Name: Jaiphal and Jawitri

TEMPERAMENT: Warm

Nutmeg and mace both come from nutmeg tree. The genus (Myristica fragrance) comprises about 100 species found throughout the tropics, especially in the Malayan region; but of these, Myristica  fragrans alone contains enough of an aromatic essential oil to make it valuable for cultivation. Nutmeg is the dried seed of the plant; mace is the dried aril surrounding the shell enclosing the seed.

Ground nutmeg which is granular orange-brown powder with characteristic aroma is a widely-known kitchen spice. It has a warm aromatic, slightly bitter taste and is often added to custards, certain vegetables, and milk drinks like egg-nog. Whole nutmeg, depending on the variety, contains from 5 to 15 per cent of a volatile oil that accounts entirely for the aroma and flavor of the spice.

Mace also a popular spice. It is a brownish-yellow or brownish-orange granular powder with a strong aroma closely resembling but not identical to that of nutmeg. The flavor of mace is softer and some-what less pungent than the flavor of nutmeg. It is used in the manufacture of pickles and tomato ketchup, in meat and fish sauces, in chocolate dishes. Whole mace contains from 4 to 14 per cent of a volatile oil very similar to that found in nutmegs, along with moisture, fat, starch, etc.

Mace and nutmeg and mace are used for treatment of inflammation of the bladder and urinary track, diarrhea, nausea, stomach spasms and pain, and intestinal gas. They are also used for treating cancer, kidney disease, and trouble sleeping (insomnia); increasing menstrual flow; causing a miscarriage; as a hallucinogen; and as a general tonic. Nutmeg and mace are applied to the skin to kill pain, especially pain caused by achy joints (rheumatism), mouth sores, toothache.

Withania somnifera

English: Winter Cherry

Punjabi/Urdu: Henbane, Kakink , Asgandha or Asgund

Temperament: Warming

Withania somnifera, known commonly as Ashwagandha which means sweat of Horse, and it is thought that this refers to the strength and sexual vigor of the horse. Other names for Withania somnifera are Indian ginseng, poison gooseberry or winter cherry. It is used as an herb in Unani medicine. Its root extract is widely used as a tonic and in numerous ailments. (Chopra RN, Nayar SL, Chopra IC, 1956) It is cosmopolitan and grows throughout drier parts and of subtropical India considered a potential crop.(Nigham K.B. 1989) In Pakistan it grows wildly on fields sides and uncultivated lands and reach a height of about 5 to 6 feet. (Chopra RN, Nayar SL, Chopra IC, 1956) It has small, alternate, oval-shaped leaves and tiny flowers with light green calyxes and white pistils. They bloom near the upper levels of the branch, close to the core stem. Its red berry fruits, known appropriately in ancient Assyrian as harhumbashir, or “red coral,” are encased by an inflated calyx that resemble small lanterns. The fruits contain tiny seeds which are orange-yellow in color, and round and flat in shape. (Ratsch, Christian, 1998)

Ashwagandha is used for arthritis, anxiety, trouble sleeping (insomnia), tumors, tuberculosis, asthma, leukoderma, bronchitis, backache, fibromyalgia, menstrual problems, hiccups, and chronic liver disease. Some people also use Ashwagandha for improving thinking ability, decreasing pain and swelling (inflammation), and preventing the Temperaments of aging. It is also used for fertility problems in men and women and also to increase sexual desire. Winter Cherry helps support the reproductive systems and adrenals and is a diuretic. Apart from boosting the male semen count and helping with erectile dysfunctions, it also stabilizes the fetus and later boosts a nursing mother’s supply of breast milk. It can cure gastric ulcers according to recent medical research, and can help to stop a fever. Ashwagandha is applied to the skin for treating wounds, backache, and one-sided paralysis (hemiplegic).

Elettaria cardamom

English: Green Cardamom

Urdu: Elaichi, Alachi, Choti Alaichi

Temperament: Warm And Dry

Elettaria cardamom is native to the Western Ghats of southern India. It has been introduced to other parts of tropical Asia and is widely grown for its aromatic seeds. It is grown as a crop in many countries, including Guatemala, Sri Lanka, Papua New Guinea and Tanzania. Cardamom is the third most expensive spice in the world and is considered as the “Queen of Spices”. The seeds have a sweet aroma and slightly pungent taste. It’s essential oil is obtained by steam distillation of cardamom seeds. The oil and left over resin is used in processed foods, liqueurs and perfumes.

When used as a home remedy it helps cure various ailments like indigestion, nausea, lightheadedness, etc. Cardamom is known to allay burning sensation and is a mouth purifier and deodorant. It is also a carminative, digestive, diuretic, anti-emetic, anti-spasmodic, aphrodisiac and expectorant agent. Cardamom is also known to possess mild analgesic, anti-inflammatory and cardio-tonic properties. In both Ayurvedic and Unani systems of medicine it is used in number of diseases.

Traditional use:

The dried ripe fruits of cardamom have been used as a spice and in medicines since the 4th century BC.

In Unani medicine, cardamom is use to treat disorders of the stomach and urinary system, asthma, bronchitis and heart problems. When mixed with neem and camphor, cardamom is used as a nasal preparation to treat colds. An infusion of cardamom can be used as a gargle to relieve sore throats, which has led to its use in cough sweets.

Cardamom seeds have been used in a range of preparations. Roasted seeds were boiled with betel nuts (fruits of the palm Areca catechu) to make a drink that is used to treat indigestion and nausea. They are also added to tea to make a tonic to relieve the symptoms of stress due to overwork or depression. Cardamom seeds are given to patients with bad breath and a capsule of cardamom taken with honey is reputed to improve eyesight. The traditional uses of cardamom to treat skin conditions have attracted the attention of those developing plant-based cosmetics, especially as it has been used traditionally to treat areas of the body that have red-pigmentation. It is often incorporated into soaps and hand creams.

Curculigo orchoides

English: Golden Eye-Grass, Curculigo.

Urdu/Punjabi: (Kali Musli)

Temperament: Warm And Dry

This plant drug is used for treatment of disease since times immemorial. Due to over exploitation, destructive mode of collection and other biotic and abiotic factors, a number of medicinal plants is facing genetic erosion and under threat of extinction. (Saba Arshad, J Singh, S P S Khanuja, 2005) Curculigo orchoides (Kali Musli) is an endangered medicinal plant and are required to be conserved and domesticated. Kali musli is naturally grown in sandy areas, with good amount of moisture, on the grassy slopes of hill slides (KumarS, Singh J, Shah NC and Ranjan V, 1997)  It is extensively utilized as nutritive tonic for strength, vigor and vitality. (Kubo M Namba and Nagamoto N Nagao, 1983)In recent times, many novel chemical constituents have been isolated and characterized and many pronounced biological activities such as anti cancer, antihepatotoxic and immunomodulator activities have been reported from the plant. It is ingredient for many Unani medicines for example majun mochras used for leucorrhoea and hab asgand that is prescribed in lumbago, rheumatism and gout. (KumarS, Singh J, Shah NC and Ranjan V, 1997)

Traditional use:

Curculigo orchoides is not only known for being part of the Vajikarana Rasayana system of medicine, where it is used as an aphrodisiac herb in many herbal preparations, it is also known for being part of many traditional Chinese medicine preparations for post-menopausal osteoporosis (Cao DP, Zheng YN, Qin LP, Han T, Zhang H, Rahman K, Zhang QY)

Curculigo is also part of the Unani system of medicine (Vijayanarayana K, Rodrigues RS, Chandrashekhar KS, Subrahmanyam EV.) A traditional medicinal system used in South Asia and based in the teachings of Greek physician Hippocrates and the Roman physician Galen (Wik). Last but not least, Curculigo orchoides is part of Kampo medicine (Chauhan NS), the Japanese adaptation of the traditional Chinese medicinal system.

In the Indian traditional system of medicine it is also used as anti-asthmatic and anti-inflammatory (Venkatesh P, Mukherjee PK, Kumar SN, Nema NK, Bandyopadhyay A, Fukui H, Mizuguchi H). The traditional Ayurvedic system of medicine has used Curculigo orchoides also as tonic, Seeth veeryam, for nervous diseases and white leprosy, and in Chinese medicine it was used for impotence, lumbago and joint pain (Tova Navarra) From Hippocrates some of these ancient traditional medicinal systems have inherited the discipline and professionalism that let them pass over the years as reliable systems of medicine.

Triticum aestivum:

English: wheat

Urdu/Punjabi: Gundam

Temperament: hot and dry

Wheat is a good source of mineral nutrients. It has ant bilious, antihydrotic, antipyretic, sedative and stomachic properties. It contains significant amounts of iron, phosphorus, magnesium, manganese, copper and zinc; iodine and cobalt are present in trace amounts. It is also a good source of thiamin and nicotinic acid, tocopherols with high vitamin-E potency that nourishes and prevents loss of moisture from the skin (Priyabrata Das, Ashis Mukhopadhyay, Suvra Mandal, Bikas Chandra Pal, Raghwendra Mishra, Debarati Mukherjee, Soma Mukhopadhyay, Jayasri Basak and Manoj Kar). The oil is used to tone and soften the lips and has a potent antioxidant activity. This protects the skin from scavenging free-radicals, prevents premature aging and reduces ultra violet rays induced damage. It helps in proper drainage of secretions from the sebaceous and other glands of the skin and thereby helps in preventing black heads. The plant is also rich in antioxidants, and may have anticancer properties. Supplementing with Wheat Grass, a safe and natural alternative to mass-produced vitamins, can boost your energy levels, and improve the function of your immune system. (N Singh, 2012)

Myrtus caryophyllus :

English: cloves

Urdu/Punjabi: Laung

Temperament: warm and dry

Cloves are analgesic, anodyne, antibacterial, antiemetic, antifungal, anti-inflammatory, antioxidant, antiseptic, antispasmodic, antiviral, aphrodisiac aromatic, astringent, brain tonic, cardio tonic, carminative, diaphoretic, digestive, exhilarant, expectorant, germicide, hepatic, stimulant and stomachic. They increase circulation, raise blood-heat, promote digestion of fatty and crude food, promote nutrition and relieve gastric and intestinal pains and spasms. They stimulate the skin, salivary glands, kidneys, liver and bronchial mucous membrane. Cloves have been studied for use in the prevention of blood clotting and coagulation, and for their chemo protective (protecting healthy tissue against anticancer drugs), and fever-reducing Temperaments.
Cloves are a stimulant to the mind (improving memory) and to the body as a whole, and have been used as an aphrodisiac. Eugenol is the largest and most important component of the volatile oil. It is strongly rubefacient, anesthetic and antiseptic and, therefore, useful as an application in pain relief for toothache, rheumatic pains, sciatica, lumbago, headaches and neuralgia and as an antiseptic for many conditions. (dehlvi naturals)

Gossypium herbaceum

English: cotton

Urdu/Punjabi: binaula

Temperament: The Temperament of Seeds of Gossypium herbaceum Linn. is, warm and moist

It is also known as cotton plant, belongs to the family Malvaceae, and occupies an imperative place in Unani medicine system. The plant is widely distributed throughout western India, Africa, Middle East countries, central Asia and graded availability is found in Iran, Afghanistan, Russian and Turkistan. (Gossypium herbaceum Linn.) The qualitative photochemical study of this plant extract indicates the presence of carbohydrates, saponins, steroids, glycosides, phenolic compounds such as tannins and flavonoids.

This herb is being used traditionally from antiquity, in the treatment of inadequate lactation, bronchial asthma, and dysmenorrheal, diaeehea, dysentery otalgia, sexual debility, general weakness, and diabetes, lung and skin diseases. It chiefly possesses anti fertility, galactagogue, anti diabetic, anti viral and anti bacterial activity. (Rahman Khaleequr, Sultana Arshiya, Rahman Shafeequr, 2012)

Asparagus racemosus:

English: Asparagus

Urdu/Punjabi: Satawar

Temperament: warm and dry

Asparagus racemosus (A. racemosus) belongs to family Liliaceae and commonly known as Satawar, Satamuli, Satavari found at low altitudes throughout India. The dried roots of the plant are used as drug. (Shashi Alok,Sanjay Kumar Jain, Amita Verma, Mayank Kumar, Alok Mahor and Monika Sabharwal, 2013)

Asparagus racemosus  is an herb used in Unani  medicine. Supplementing Asparagus racemosus will aid digestion, since the plant has anti-ulcer Temperaments. It will also aid the immune system when antibodies are fighting off a threat. Asparagus racemosus also has aphrodisiac, antidepressant and anxiety-reducing Temperaments. But for anxiety, depression and libido, Asparagus racemosus is outclassed by other herbs. For example, Ashwagandha is more Temperamentive at reducing anxiety and depression, while Panax ginseng provides more physical benefits. Though Asparagus racemosus has been used as a galactagogue to increase breast milk production, this area needs further research before Asparagus racemosus supplementation can be specifically recommended.

Prunus amygdalus

English: almond

Urdu/Punjabi: Badam

Temperament: moist and warm.

References to almonds are found in the Old Testament. They were prized as an ingredient in breads served to the Pharaohs in Egypt, and they have maintained religious, ethnic, and social significance throughout history.  The almond tree is native to western Asia. It was brought to California from Spain in the 1700s. (Clemetson, C. A., de Carlo, S. J., Burney, G. A., Patel, T. J., Kozhiashvili, N., and Taylor, R. A., 1978)

Traditionally, almonds have been used for a variety of their properties including antibacterial, aphrodisiac, bladder cancer, breast cancer, chapped lips, colon cancer, demulcent, heart disease, increasing sperm count, mild laxative, mouth and throat cancers, or pharyngeal cancers, phytoestrogen, skin care (emollient), skin moisturizer, solvent for inject able drugs, and uterine cancer. (Natural Standard) Topically, sweet almond is used as and emollient for chapped skin, to soothe mucous membranes (as a demulcent), and as a weak antibacterial.  Parenterally, sweet almond is also used as a solvent for injectable drugs (Teotia, S. and Singh, M. , 1997)

Clarified Butter

English: butter

Urdu/Punjabi: Ghee Desi

Temperament: hot and moist

Ghee is the same as clarified butter. Clarified butter is also known as drawn butter and resembles oil more than butter. Clarified butter starts with unsalted butter that has been slowly melted into three layers. The top layer is the water that evaporates as the butter slowly cooks. The milk solids form the bottom layer which is removed, and the middle layer is pure butterfat which is the clarified butter

There are several ghee health benefits. In fact, ghee has been used in Indian culture for many years in meal preparation as well as in holistic remedies.

Ghee contains vitamins A and E as well as carotenoids. These are all antioxidants that are great for boosting your immune system as well as promoting skin cell growth and better vision.  Ghee also helps in transporting some herb mixtures that are used in Hindu holistic medicine to cells and organs. Ghee helps to minimize stomach acid while also repairing the stomach's lining. Ghee also produces digestive enzymes which help food digest properly and reduces episodes of indigestion. 
Since the water has been evaporated from the butter, ghee can be added to popcorn without causing it to be soggy. Also, ghee rice is a popular Indian dish that includes ghee, onion and several exotic spices. Ghee has been used in medicine as a cure for blisters and burns. It helps to heal and soften irritated skin when applied topically.

Acacia arabica (Lam.) Willd.

English: Acacia, Acacia(E), Milfoil, Wattle Bark, Yarrow.

Urdu/Punjabi: Gond Kikar, Babul

Temperament: dry

Babul tree is widely seen in Arabia and West Asia. In India, it grows wild in the forests of Punjab and parts of Rajasthan. It is known for its gum, which is made from the hardened sap taken from the tree. The tree is planted for its bark, which yields the babul gum. This gum has several other uses apart from being used for the treatment of injuries and for therapeutic purposes. Babul trees can flourish in dry and arid regions. They are medium-sized trees; reaching an average height of about 12 m. Babul trees find use in households as well as in farms and fields for shelter and foraging purposes.

The gum is analgesic, antidiarrhoeal, antimicrobial, antipyretic, aphrodisiac, astringent, cooling, demulcent, emollient, expectorant, haemostatic, and liver tonic, mucilaginous, nutritive, styptic and tonic. It is traditionally used, as a strong decoction, in the treatment of gonorrhea with edema, cough, diarrhea, as a gargle for spongy gums, aphthous stomatitis, cancer and sore throat, or as a douche or enema in gonorrhea, cystitis, vaginitis, leucorrhoea, piles, and anal prolapsed. It is helpful in managing conditions involving hemorrhagic ulcers and wounds, dysentery, diabetes mellitus, conjunctivitis, intermitted fever, burns, bleeding, catarrh, urinogenital discharges, sexual debility, seminal weakness, spermatorrhoea, nocturnal emission and genitourinary complaints. It is considered a remedy that is helpful for treating premature ejaculation.

Trapa bispinosa Roxb:

English: Singhara Nut, Water Chestnut.

Urdu/Punjabi: Singhara, Gaonri, Kesru, Pani-Phal

Temperament: cold and moist

Water chestnut (Trapa bispinosa.) commonly known as Singhara in India. It is an annual, floating-leaved aquatic plant of temperate and tropical freshwater wetlands, rivers, lakes, ponds and estuaries. Native to Eurasia and Africa, water chestnut has been widely gathered for its large nutritious fruits since the Neolithic. It is now a species of conservation concern in Europe and Russia. It has been used in traditional system of medicine like Unani and Ayurveda since centuries for many medical conditions like strangury, dysuria, polyuria, sexual debility, general debility, sore throat, lumbago, bilious affections and dysentery etc. Modern researches have supported its traditional uses and also explored other important properties such as Analgesic, antibiotic, antidiabetic, immunomodulatory, neuroprotective etc. (Shaikh Imtiyaz, 2013)

Aloe vera (Gheekwar)

English:aloes

Urdu/Punjabi: aloe vera, gheekwar

Temperament: cold

Aloe Vera has amazing health benefits. The herb is known for its medicinal properties and is useful in several health conditions. It helps in halting growth of cancer tumors, eases inflammation, helps in arthritis, lowers cholesterol, prevents kidney stones, soothes ulcers, lowers blood pressure in people suffering from high blood pressure, hydrates skin, provides essential minerals to the body, helps in preventing colon cancer, heals intestine, lubricates digestive tract and ends constipation. Aloe Vera is also helpful in stabilizing sugar levels in diabetics.

Health benefits include:

It has been studied around the world and results show that aloe vera offers wonderful support for our immune system and helps ward off illness of all sorts. Aloe vera is a versatile plant that can be used both internally and externally, offering multiple benefits for the skin as well as for the inside of our bodies. The benefits of aloe vera have been broken down into three groups, including, anti-bacterial, anti-viral and anti-inflammatory. When used on the outside of the body, aloe vera can help cure many ailments dealing with the skin. Conditions of the skin that may benefit from the use of aloe vera are minor cuts, scrapes, burns, sunburns, razor burn, acne, dandruff, dry skin, eczema and psoriasis.

When taken internally in the form of a juice, aloe vera can offer even more rewards. Because the aloe vera is so rich in nutrients it is able to serve many purposes. Aloe vera helps the body release pepsin, which is the gastric juice enzyme that we need to digest our food. This helps conditions such as ulcers, irritable bowel syndrome, heartburn, constipation, colitis and any other digestive tract irritations. Those with HIV or other diseases that cause the immune system to be weakened can benefit from taking high doses of aloe vera.

Phoenix Sylvester’s Roxb:

English:  Date Sugar Palm, Dates

Urdu/Punjabi: Chuhara, Katal, Khajur, Khurma

Temperament: moist and warm

The sugar content of ripe dates is about 80%, the remainder consists of protein, fat and mineral products including copper, sulphur, iron, vitamins A, B and D, magnesium and fluoric acid. Dates are high in fiber and an excellent source of potassium. Dates are considered demulcent, expectorant, laxative, nourishing, and very nutritious, spermatogenic and tonic and are used in respiratory diseases like asthma, bronchitis, tuberculosis, cough, fever and low vitality.

Dates are also regarded as antianaemic, antioxidant, aphrodisiac, astringent, diuretic, emollient, estrogenic, pectoral, refrigerant and sweet. Useful in anemia, catarrh, weakness of eyesight, fatigue, sterility, stomachache, thirst, urogenital ailments and vaginitis. Dates are also reported to be used in cases of memory disturbances. They are Temperamentive for both diarrhea and constipation due to malnutrition of the bowels. (ahmad ateeq, soni dutta sunil, singh K Varun, Maurya K Santosh, 2013)

Pandanus odoratissimus Distillate

Urdu/Punjabi: (Arq Kewra)

Kewra water is an extract that is distilled from Pandanus flowers. It is a transparent liquid, almost similar to rose water. Although Pandanus trees grow almost everywhere in tropical Asia, kewra water is still mainly a Northern Indian flavoring that is not used anywhere else. In Western cooking, kewra water makes a fine alternative to the flower essences like rose or orange essence. It can be substituted with kewra essence, which is more concentrated.

Kewra is said to have antioxidant properties and helps fight cancer. Its floral fragrance gives a calming Temperament, thus helps in mental relaxation.

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