\documentclass[twocolumn,twoside]{article}
\makeatletter\if@twocolumn\PassOptionsToPackage{switch}{lineno}\else\fi\makeatother

\usepackage{amsfonts,amssymb,amsbsy,latexsym,amsmath,tabulary,graphicx,times,xcolor}

%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
% Following additional macros are required to function some 
% functions which are not available in the class used.
%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
\usepackage{url,multirow,morefloats,floatflt,cancel,tfrupee}
\makeatletter


\AtBeginDocument{\@ifpackageloaded{textcomp}{}{\usepackage{textcomp}}}
\makeatother
\usepackage{colortbl}
\usepackage{xcolor}
\usepackage{pifont}
\usepackage[nointegrals]{wasysym}
\urlstyle{rm}
\makeatletter

%%%For Table column width calculation.
\def\mcWidth#1{\csname TY@F#1\endcsname+\tabcolsep}

%%Hacking center and right align for table
\def\cAlignHack{\rightskip\@flushglue\leftskip\@flushglue\parindent\z@\parfillskip\z@skip}
\def\rAlignHack{\rightskip\z@skip\leftskip\@flushglue \parindent\z@\parfillskip\z@skip}

%Etal definition in references
\@ifundefined{etal}{\def\etal{\textit{et~al}}}{}


%\if@twocolumn\usepackage{dblfloatfix}\fi
\usepackage{ifxetex}
\ifxetex\else\if@twocolumn\@ifpackageloaded{stfloats}{}{\usepackage{dblfloatfix}}\fi\fi

\AtBeginDocument{
\expandafter\ifx\csname eqalign\endcsname\relax
\def\eqalign#1{\null\vcenter{\def\\{\cr}\openup\jot\m@th
  \ialign{\strut$\displaystyle{##}$\hfil&$\displaystyle{{}##}$\hfil
      \crcr#1\crcr}}\,}
\fi
}

%For fixing hardfail when unicode letters appear inside table with endfloat
\AtBeginDocument{%
  \@ifpackageloaded{endfloat}%
   {\renewcommand\efloat@iwrite[1]{\immediate\expandafter\protected@write\csname efloat@post#1\endcsname{}}}{\newif\ifefloat@tables}%
}%

\def\BreakURLText#1{\@tfor\brk@tempa:=#1\do{\brk@tempa\hskip0pt}}
\let\lt=<
\let\gt=>
\def\processVert{\ifmmode|\else\textbar\fi}
\let\processvert\processVert

\@ifundefined{subparagraph}{
\def\subparagraph{\@startsection{paragraph}{5}{2\parindent}{0ex plus 0.1ex minus 0.1ex}%
{0ex}{\normalfont\small\itshape}}%
}{}

% These are now gobbled, so won't appear in the PDF.
\newcommand\role[1]{\unskip}
\newcommand\aucollab[1]{\unskip}
  
\@ifundefined{tsGraphicsScaleX}{\gdef\tsGraphicsScaleX{1}}{}
\@ifundefined{tsGraphicsScaleY}{\gdef\tsGraphicsScaleY{.9}}{}
% To automatically resize figures to fit inside the text area
\def\checkGraphicsWidth{\ifdim\Gin@nat@width>\linewidth
	\tsGraphicsScaleX\linewidth\else\Gin@nat@width\fi}

\def\checkGraphicsHeight{\ifdim\Gin@nat@height>.9\textheight
	\tsGraphicsScaleY\textheight\else\Gin@nat@height\fi}

\def\fixFloatSize#1{}%\@ifundefined{processdelayedfloats}{\setbox0=\hbox{\includegraphics{#1}}\ifnum\wd0<\columnwidth\relax\renewenvironment{figure*}{\begin{figure}}{\end{figure}}\fi}{}}
\let\ts@includegraphics\includegraphics

\def\inlinegraphic[#1]#2{{\edef\@tempa{#1}\edef\baseline@shift{\ifx\@tempa\@empty0\else#1\fi}\edef\tempZ{\the\numexpr(\numexpr(\baseline@shift*\f@size/100))}\protect\raisebox{\tempZ pt}{\ts@includegraphics{#2}}}}

%\renewcommand{\includegraphics}[1]{\ts@includegraphics[width=\checkGraphicsWidth]{#1}}
\AtBeginDocument{\def\includegraphics{\@ifnextchar[{\ts@includegraphics}{\ts@includegraphics[width=\checkGraphicsWidth,height=\checkGraphicsHeight,keepaspectratio]}}}

\DeclareMathAlphabet{\mathpzc}{OT1}{pzc}{m}{it}

\def\URL#1#2{\@ifundefined{href}{#2}{\href{#1}{#2}}}

%%For url break
\def\UrlOrds{\do\*\do\-\do\~\do\'\do\"\do\-}%
\g@addto@macro{\UrlBreaks}{\UrlOrds}



\edef\fntEncoding{\f@encoding}
\def\EUoneEnc{EU1}
\makeatother
\def\floatpagefraction{0.8} 
\def\dblfloatpagefraction{0.8}
\def\style#1#2{#2}
\def\xxxguillemotleft{\fontencoding{T1}\selectfont\guillemotleft}
\def\xxxguillemotright{\fontencoding{T1}\selectfont\guillemotright}

\newif\ifmultipleabstract\multipleabstractfalse%
\newenvironment{typesetAbstractGroup}{}{}%

%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%

\usepackage[authoryear]{natbib}



\newif\ifnokeywords\nokeywordsfalse

\makeatletter\input{size10-pointfive.clo}\makeatother%
\definecolor{kwdboxcolor}{RGB}{242,242,242}
\usepackage[hidelinks,colorlinks=true,allcolors=blue]{hyperref}
\linespread{1}                 
\def\floatpagefraction{0.8}

\usepackage[paperheight=11.69in,paperwidth=8.26in,top=1in,bottom=1in,left=1in,right=.75in,headsep=24pt]{geometry}

\usepackage{multirow-custom}

\makeatletter

\def\hlinewd#1{%
  \noalign{\ifnum0=`}\fi\hrule \@height #1%
  \futurelet\reserved@a\@xhline}
\def\tbltoprule{\hlinewd{1pt}\\[-14pt]}
\def\tblbottomrule{\noalign{\vspace*{6pt}}\hline\noalign{\vspace*{2pt}}}
\def\tblmidrule{\hline\noalign{\vspace*{2pt}}}



\let\@articleType\@empty
\let\@journalDoi\@empty
\let\@journalVolume\@empty
\let\@journalIssue\@empty
\let\@crossMarkLink\@empty
\let\@receivedDate\@empty
\let\@acceptedDate\@empty
\let\@revisedDate\@empty
\let\@publishedDate\@empty
\let\@copyrightYear\@empty
\let\@firstPage\@empty
\def\articleType#1{\gdef\@articleType{#1}}
\def\journalDoi#1{\gdef\@journalDoi{#1}}
\def\crossMarkLink#1{\gdef\@crossMarkLink{#1}}
\def\receivedDate#1{\gdef\@receivedDate{#1}}
\def\acceptedDate#1{\gdef\@acceptedDate{#1}}
\def\revisedDate#1{\gdef\@revisedDate{#1}}
\def\publishedDate#1{\gdef\@publishedDate{#1}}
\def\copyrightYear#1{\gdef\@copyrightYear{#1}}
\def\journalVolume#1{\gdef\@journalVolume{#1}}
\def\journalIssue#1{\gdef\@journalIssue{#1}}
\def\firstPage#1{\gdef\@firstPage{#1}}
\let\@issuelogo\@empty%
\let\@issuelogoex\@empty%
\def\issuelogo#1{\gdef\@issuelogo{#1}}
\def\issuelogoex#1{\gdef\@issuelogoex{#1}}


\def\author#1{%
  \gdef\@author{%
    \hskip-\dimexpr(\tabcolsep)\hskip5pt%
    \parbox{\dimexpr\textwidth-1pt}%
    {\fontsize{11}{13}\selectfont\raggedright #1}%
  }%
}


\usepackage{pharmascope-abs}
\usepackage{caption}
\usepackage{lastpage}
\usepackage{fancyhdr}
\usepackage[noindentafter,explicit]{titlesec}
\usepackage{fontspec}

\setmainfont[%
BoldFont=cambriab.ttf,%
ItalicFont=CAMBRIAI.TTF,%
BoldItalicFont=CAMBRIAZ.TTF]{Cambria.ttf}
\lefthyphenmin = 3

\def\title#1{%
  \gdef\@title{%
      \vspace*{-40pt}%
       \ifx\@articleType\@empty\else{\fontsize{10}{12}\scshape\selectfont\hspace{8pt}\@articleType\hfill\mbox{}\par\vspace{2pt}}\fi%
       \minipage{\linewidth}
         \hrulefill\\[-0.7pt]%%{\includegraphics[width=75pt,height=50pt]{ijrps_logo.png}}\hfill
         \mbox{~}\hspace{5pt}\parbox{.1\linewidth}{\IfFileExists{images/\@issuelogo.\@issuelogoex}{\includegraphics[width=79pt,height=61pt]{images/\@issuelogo.\@issuelogoex}}{\includegraphics[width=75pt,height=50pt]{ijrps_logo.png}}}\hfill
         \fcolorbox{kwdboxcolor}{kwdboxcolor}{\parbox{.792\linewidth}{%
          \begin{center}\fontsize{17}{17}\selectfont\scshape\vskip-7pt International Journal of Research in Pharmaceutical Sciences\hfill\end{center}%
          \vspace*{-10pt}\hspace*{4pt}{\fontsize{8}{9}\selectfont Published by JK Welfare \& Pharmascope Foundation\hfill  Journal Home Page: \href{www.ijrps.com}{\color{blue}\underline{\smash{www.ijrps.com}}}}\hspace*{4pt}\mbox{}}}%
       \par\vspace*{-1pt}\rule{\linewidth}{1.3pt}%
       \endminipage%
    \par\vspace*{9.2pt}\parbox{.98\linewidth}{\linespread{.9}\raggedright\fontsize{14}{17}\selectfont #1}%
    \vspace*{-8pt}%
  }
}


\setlength{\parindent}{0pt}
\setlength{\parskip}{0.4pc plus 1pt minus 1pt}

\def\abbrvJournalTitle{Int. J. Res. Pharm. Sci.}

\fancypagestyle{headings}{%
  \renewcommand{\headrulewidth}{0pt}%
  \renewcommand{\footrulewidth}{0.3pt}
  \fancyhf{}%
  \fancyhead[R]{%
    \fontsize{9.12}{11}\selectfont\RunningAuthor,\ \abbrvJournalTitle,\ \ifx\@journalVolume\@empty X\else\@journalVolume\fi%
    \ifx\@journalIssue\@empty\else(\@journalIssue)\fi%
    ,\ \ifx\@firstPage\@empty 1\else\@firstPage\fi-\pageref*{LastPage}%
  }%
  \fancyfoot[LO,RE]{\fontsize{9.12}{11}\selectfont\textcopyright\ International Journal of Research in Pharmaceutical Sciences}%
  \fancyfoot[RO,LE]{\fontsize{9.12}{11}\selectfont\thepage}
}\pagestyle{headings}

                                                         
\fancypagestyle{plain}{%
  \renewcommand{\headrulewidth}{0pt}%
  \renewcommand{\footrulewidth}{0.3pt}%
  \fancyhf{}%
  \fancyhead[R]{%
    \fontsize{9.12}{11}\selectfont\RunningAuthor,\ \abbrvJournalTitle,\ \ifx\@journalVolume\@empty X\else\@journalVolume\fi%
    \ifx\@journalIssue\@empty\else(\@journalIssue)\fi%
    ,\ \ifx\@firstPage\@empty 1\else\@firstPage\fi-\pageref*{LastPage}%
  }%
  \fancyfoot[LO,RE]{\fontsize{9.12}{11}\selectfont\textcopyright\ International Journal of Research in Pharmaceutical Sciences}%
  \fancyfoot[RO,LE]{\fontsize{9.12}{11}\selectfont\thepage}
  \ifx\@firstPage\@empty\else\setcounter{page}{\@firstPage}\fi
}


\def\NormalBaseline{\def\baselinestretch{1.1}}
\usepackage{textcase}
\setcounter{secnumdepth}{0}

\titleformat{\section}[block]{\bfseries\boldmath\NormalBaseline\filright\fontsize{10.5}{13}\selectfont}
{\thesection}
{6pt}
{\MakeTextUppercase{#1}}
[]
\titleformat{\subsection}[block]{\bfseries\boldmath\NormalBaseline\filright\fontsize{10.5}{12}\selectfont}
{\thesubsection}
{6pt}
{#1}
[]
\titleformat{\subsubsection}[block]{\NormalBaseline\filright\fontsize{10.5}{12}\selectfont}
{\thesubsubsection}
{6pt}
{#1}
[]
\titleformat{\paragraph}[block]{\NormalBaseline\filright\fontsize{10.5}{10}\selectfont}
{\theparagraph}
{6pt}
{#1}
[]
\titleformat{\subparagraph}[block]{\NormalBaseline\filright\fontsize{10.5}{12}\selectfont}
{\thesubparagraph}
{6pt}
{#1}
[]

\titlespacing{\section}{0pt}{.5\baselineskip}{.5\baselineskip}  
\titlespacing{\subsection}{0pt}{.5\baselineskip}{.5\baselineskip}  
\titlespacing{\subsubsection}{0pt}{.5\baselineskip}{.5\baselineskip}  
\titlespacing{\paragraph}{0pt}{.5\baselineskip}{.5\baselineskip}  
\titlespacing{\subparagraph}{0pt}{.5\baselineskip}{.5\baselineskip}

\captionsetup[figure]{skip=1.4pt,font=bf,labelsep=colon,justification=raggedright,singlelinecheck=false}
\captionsetup[table]{skip=1.4pt,font=bf,labelsep=colon,justification=raggedright,singlelinecheck=false}

\def\bibyear#1{#1}
%\def\bibjtitle#1{#1}   %%Publisher request
\def\bibauand{}
\setlength\bibsep{3pt}
\setlength\bibhang{8pt}

\makeatother
\date{}


\usepackage[flushleft]{threeparttablex}

\usepackage{float}

\begin{document}


\def\RunningAuthor{Dhirajsingh Sumersingh Rajput}
\firstPage{86}
\articleType{Review Article}
\receivedDate{25 Mar 2020}
\acceptedDate{02 May 2020}
\revisedDate{28 Apr 2020}
\journalVolume{2020, 11(SPL)}
\journalIssue{1}
\journalDoi{ijrps.v11iSPL1.2227}
\copyrightYear{2020}
\def\authorCount{1}
\def\affCount{1}

\def\journalTitle{International Journal of Research in Pharmaceutical Sciences}

\title{Evolution, Ayurveda, immunity, and preventive aspects for emerging infectious diseases such as COVID-19}
\author{Dhirajsingh~Sumersingh~Rajput\textsuperscript{*}~\\[5pt]{Department of Rasashastra and Bhaishajya Kalpana, Mahatma Gandhi Ayurved College Hospital and Research Centre, Datta Meghe University of Medical Sciences (Deemed to be University), Salod (H), Wardha, Maharashtra {\textendash} 442001, India}}

\begin{abstract}
 Evolution is a continuous process of changes in structural and physiological mechanism in the living being. Microbes/pathogens can evolve naturally or artificially and become resistant to various medicines. The novel corona virus is such evolved pathogen of corona virus group. Enough strong immunity is needed to prevent or survive from COVID-19 pandemic. Ayurveda provides ways for evolving physiological responses to built immunity. Present work is a brief attempt to increase insight in this filed. Present review was done based on the simple theory of evolution, recent updates regarding prevention of COVID-19, Ayurveda aspect toward infectious diseases and Ayurveda ways towards prevention of infectious diseases with special reference to COVID-19. Person with impaired immunity is more susceptible for COVID-19 and thus immunity is an important preventing factor. Ayurveda \textit{Rasayana } (rejuvenation) herbs, Yoga exercises, \textit{Pranayama } (special breathing exercise)\textit{, }daily regimens and personal hygiene guidelines can be helpful strategies in controlling the spread of COVID-19. The preventive aspects of pandemic situations are narrated in Ayurveda with enough details. They need to be scientifically explored and refined for precision. As prevention is always better than cure, Ayurveda ways can be considered for future strategies to avoid pandemics such as COVID-19. There is a great need for research on Ayurveda medicines on COVID-19 like diseases.
\end{abstract}\def\keywordstitle{Keywords}

\begin{keywords}Ayurveda,\newline Immunity,\newline COVID-19,\newline Rasayana,\newline Yoga,\newline Ayurveda daily regimens
\end{keywords}
\twocolumn[ \maketitle {\printKwdAbsBox}]
\makeatletter{\raggedright\textsuperscript{*}Corresponding Author\par Name:\ Dhirajsingh~Sumersingh~Rajput~\\ Phone:\ +91-9130956706~\\  Email:\ dhirajsingh.rajput@dmimsu.edu.in
        \par}\vspace*{-11pt}\hrulefill\par{\fontsize{12}{14}\selectfont ISSN: 0975-7538}\par% 
        \textsc{DOI:}\ \href{https://doi.org/10.26452/\@journalDoi}{\textcolor{blue}{\underline{\smash{https://doi.org/10.26452/\@journalDoi}}}}\par%
        \vspace*{-11pt}\hrulefill\\{\fontsize{9.12}{10.12}\selectfont Production and Hosted by}\par{IJRPS |~\href{www.ijrps.com}{www.ijrps.com}}\par%
        \vspace*{-2pt}{\fontsize{9.12}{10.12}\selectfont\textcopyright\ \@copyrightYear\ $|$ All rights reserved.}\par%
        \vspace*{-11pt}\rule{\linewidth}{1.2pt}
        \makeatother
        
    
\section{Introduction}
It can't be an exaggeration to mention that almost all visible living species on the earth are surrounded by tiny species which are invisible to naked eyes and those are called as micro-organisms. Few species of micro-organisms are living synergistically in the body of macro-organisms. On the other hand, few species are responsible for causing various illnesses in immunocompromised or even in healthy ones. The human body is not an exemption to this. The human body is a host for micro-organisms such as Bacteria \textit{[Actinomyces viscosus,} \textit{Cyanobacteria, A.naeslundii}, lactobacillus species etc. \unskip~\citep{764758:18188261}, Archaea \textit{[Methanobrevibacter smithii, Methanosphaera stadtmanae } etc. \unskip~\citep{764758:18188422}, Fungi [e.g. Candida species \unskip~\citep{764758:18188279}, and Viruses Aichi virus, Cosavirus A, Dengue virus, Hepatitis A, B, C, and E virus etc.). \unskip~\citep{764758:18188268}].

Every living species on the earth is continuously in contact with such micro-organisms no matter whether the species is aquatic, amphibian, or terrestrial. According to Darwin's theory of ``Survival of the fittest'', it is clear that all these microbes are constantly engaged in a war to overcome the immunity of the host to live and reproduce. Similarly, the body of the host (macro-organisms/human/animal) is also fighting the war and this war sharpens its immunity. In other words, there is a continuous evolution in all living organisms to develop physiological mechanisms required for survival. 

However, it is clear that the process of evolution is very slow, and it requires a longer duration to cause even the smallest physiological or anatomical change. For example, 1\% change in the amino acid sequence requires 20 million years \unskip~\citep{764758:18188281}. This rate increases with an increase in the rate of reproduction. In other words, smaller the animal more will be the reproduction rate and faster will be the process of evolution \unskip~\citep{764758:18188264}. In simple terms, mankind is evolving and also facing the evolving world of micro-organisms.\textbf{\space }

The recent outbreak of Anthrax, H1N1, SARS, and novel corona virus has highlighted the risk caused by genetically engineered viruses in various virology laboratories. Indeed, there are few significant positive outcomes from such researches, but the risk cannot be ignored. Ayurveda clearly states that properties and applications of knowledge, vapors, and water are depending on who is holding them. 

Ayurveda has already discovered and strongly recommended living harmonically with the rules of nature, and the same way has been found applicable in the pandemic conditions caused by the new strains of viruses. The \textit{Rasayana } (rejuvenating drugs) of Ayurveda are significantly helpful in strengthening the immune system and thereby offers a natural way for the prevention of pandemic diseases. Considering these aspects, an attempt has been made to present the relationship between evolution in living beings, Ayurveda, and prevention of emerging infectious diseases such as COVID-19.
    
\section{Material and Methods}
The present review was done based on the simple theory of evolution, recent updates regarding prevention of COVID-19, Ayurveda aspect towards infectious diseases, and Ayurveda ways towards prevention of infectious diseases with a special reference to COVID-19. Information collected from WHO, Ministry of AYUSH, news updates, and opinions of experts are utilized as sources for this review. As immune-compromised persons have a higher risk of COVID-19, the herbal \textit{Rasayana } drug, which has proven immunomodulatory activity, is also compiled in the present study. Review of Ayurveda formulations which might help in the prevention and cure of COVID-19 is intentionally avoided due to lack of direct strong scientific evidence.

\textbf{Observations and Results}

Since the 18\ensuremath{^{th}} century, the world has faced 13 pandemics caused by different viruses and resulted in a few thousand to million deaths (Table~\ref{tw-307af924b7eb}). The world is currently facing COVID-19, and most of the countries have been completely locked down to stop the spreading of the infection. The death rate due COVID-19 is the highest among ecumenically top countries with the best health facilities such as Italy (16,523), Spain (13,798), USA (10,943), and France (8,911) \unskip~\citep{764758:18188256}. 

Personal hygiene, social isolation, few Yoga exercises, and administration of immunity booster medicines are the preventives aspects \unskip~\citep{764758:18188271}. The detailed treatment guidelines for mild to severe symptoms of COVID-19 have been provided by the WHO on March 13, 2020 \unskip~\citep{764758:18188266}. Considering the significant role of immunity in the prevention of COVID-19, the Ministry of AYUSH, Government of India has published guidelines for Ayurveda's immunity-boosting measures for self-care during COVID-19 crisis \unskip~\citep{764758:18188259}. In Ayurveda, there are 27 commonly utilized herbs which have proven immunomodulatory activity (Table~\ref{tw-aa3375640d9e}). 

Few Ayurveda daily practices which are very easy to follow are depicted in Table~\ref{tw-1f940086be01}. These practices may help avoid exposure, reduce risk, and increase local (at the skin) and general immunity, which are major aspects for the prevention of COVID-19.


\begin{table*}[!htbp]
\caption{\boldmath {All major pandemic diseases occurred from 18\ensuremath{^{th}}century till date } }
\label{tw-307af924b7eb}
\centering 
\begin{threeparttable}

\def\arraystretch{1.1}
\ignorespaces 
\centering 
\begin{tabulary}{\linewidth}{p{\dimexpr.0978\linewidth-2\tabcolsep}p{\dimexpr.21839999999999996\linewidth-2\tabcolsep}p{\dimexpr.20330000000000002\linewidth-2\tabcolsep}p{\dimexpr.29050000000000004\linewidth-2\tabcolsep}p{\dimexpr.19\linewidth-2\tabcolsep}}
\tbltoprule \rowcolor{kwdboxcolor}S.N & Name & Time period & Type / Pre-human host & Death toll\\
\tblmidrule 
1 &
  Cholera Pandemics  &
  1817-1923 &
  V.cholerae bacteria &
  1M+\\
2 &
  Third Plague &
  1885 &
  Yersinia pestis bacteria / Rats, fleas &
  12M (China and India)\\
3 &
  Yellow Fever &
  Late 1800s &
  Virus / Mosquitoes &
  100,000-150,000 (U.S.)\\
4 &
  Russian Flu &
  1889-1890 &
  Believed to be H2N2 (avian origin) &
  1M\\
5 &
  Spanish Flu &
  1918-1919 &
  H1N1 virus / Pigs &
  40-50M\\
6 &
  Asian Flu &
  1957-1958 &
  H2N2 virus &
  1.1M\\
7 &
  Hong Kong Flu &
  1968-1970 &
  H3N2 virus &
  1M\\
8 &
  HIV/AIDS &
  1981-present &
  Virus / Chimpanzees &
  25-35M\\
9 &
  Swine Flu &
  2009-2010 &
  H1N1 virus / Pigs &
  200,000\\
10 &
  SARS &
  2002-2003 &
  Coronavirus / Bats, Civets &
  770\\
11 &
  Ebola &
  2014-2016 &
  Ebolavirus / Wild animals &
  11,000\\
12 &
  MERS &
  2015-Present &
  Coronavirus / Bats, camels &
  850\\
13 &
  COVID-19 &
  2019-Present &
  Coronavirus  &
  70,600 (April 6)\\
\tblbottomrule 
\end{tabulary}\par 
\begin{tablenotes}\footnotesize 
    
\item{M=Million,M+= More than a million}
\end{tablenotes}
\end{threeparttable}

\end{table*}

\begin{table*}[!htbp]
\caption{\boldmath {Herbs which have proven immunomodulatory activity} }
\label{tw-aa3375640d9e}
\def\arraystretch{1.1}
\ignorespaces 
\centering 
\begin{tabulary}{\linewidth}{p{\dimexpr.07883333333333331\linewidth-2\tabcolsep}p{\dimexpr.26313333333333333\linewidth-2\tabcolsep}p{\dimexpr.14803333333333333\linewidth-2\tabcolsep}p{\dimexpr.07963333333333332\linewidth-2\tabcolsep}p{\dimexpr.2651333333333333\linewidth-2\tabcolsep}p{\dimexpr.16523333333333333\linewidth-2\tabcolsep}}
\tbltoprule \rowcolor{kwdboxcolor}S.N. & Plant Name & Part used & S.N. & Plant Name & Part used\\
\tblmidrule 
1 &
  Hibiscus rosasinensis \unskip~\citet{764758:18188433} &
  Flowers &
  15 &
  Asparagus racemosus\unskip~\cite{764758:18188284} &
  Root\\
2 &
  Cleome gynandra \unskip~\cite{764758:18188424} &
  Aerial parts &
  16 &
  Boerhaavia diffusa \unskip~\cite{764758:18188267} &
  Whole plant\\
3 &
  Tinospora cordifolia \unskip~\cite{764758:18188258} &
  Stems &
  17 &
  Curcuma longa \unskip~\cite{764758:18188434} &
  Balb\\
4 &
  Balanite roxburghi \unskip~\cite{764758:18188260} &
  Leaf &
  18 &
  Eclipta alba \unskip~\cite{764758:18188255} &
  Whole plant\\
5 &
  Aloe vera \unskip~\cite{764758:18188277} &
  Leaves &
  19 &
  Mangifera indica \unskip~\cite{764758:18188429} &
  Stem bark\\
6 &
  Picrorhiza scrophulariiflora \unskip~\cite{764758:18188252} &
  Whole plant &
  20 &
  Withania somnifera \unskip~\cite{764758:18188432} &
  \\
7 &
  Tinospora cordifolia \unskip~\cite{764758:18188425} &
  Stem &
  21 &
  Azadirachta indica \unskip~\cite{764758:18188426} &
  Leaf\\
8 &
  Ocimum sanctum \unskip~\cite{764758:18188428} &
  Whole plant &
  22 &
  Boswellia carterii \unskip~\cite{764758:18188423} &
  Bark\\
9 &
  Bauhinia variegate \unskip~\cite{764758:18188265} &
  Stem bark &
  23 &
  Tinospora cordifolia \unskip~\cite{764758:18188421} &
  Stem\\
10 &
  Citrus aurantifolia \unskip~\cite{764758:18188431} &
  Fruits &
  24 &
  Emblica officinalis \unskip~\cite{764758:18188270} &
  Fruit\\
11 &
  Tinospora cordifolia \unskip~\cite{764758:18188285} &
  Whole plant &
  25 &
  Centella asiatica \unskip~\cite{764758:18188435} &
  Whole plant\\
12 &
  Aloe vera \unskip~\cite{764758:18188285} &
  Leaves &
  26 &
  Piper longum \unskip~\cite{764758:18188276} &
  Fruit\\
13 &
  Allium sativum \unskip~\cite{764758:18188273} &
  Whole plant &
  27 &
  Terminalia arjuna \unskip~\cite{764758:18188427} &
  Bark\\
14 &
  Andographis paniculata \unskip~\cite{764758:18188254} &
  Whole plant &
   &
   &
  \\
\tblbottomrule 
\end{tabulary}\par 
\end{table*}

\begin{table*}[!htbp]
\caption{\boldmath {Ayurveda daily practices for prevention of COVID-19} }
\label{tw-1f940086be01}
\centering 
\begin{threeparttable}

\def\arraystretch{1.1}
\ignorespaces 
\centering 
\begin{tabulary}{\linewidth}{p{\dimexpr.10149999999999999\linewidth-2\tabcolsep}p{\dimexpr.23950000000000003\linewidth-2\tabcolsep}p{\dimexpr.3567\linewidth-2\tabcolsep}p{\dimexpr.3023\linewidth-2\tabcolsep}}
\tbltoprule \rowcolor{kwdboxcolor}S.N. & Ayurveda Practice & Correlation & Significance\\
\tblmidrule 
1 &
  Hasta-Pada Dhavan &
  Washing of hand and legs when came from outside or any guest who came at others home &
  To avoid spread of infection which one gets from outside*\\
2 &
  Aushadhi youkta Jala Snana &
  Bathing by using medicated water such as by adding leafs of Azadirecta india  (Neem) &
  Body disinfection through water soluble extracts of medicated herbs which is similar to use of soap\\
3 &
  Abhyanga  &
  Whole body massage by medicated oil &
  Same as above. It also strengthen skin by increasing blood flow. The sweating caused during massage help to remove toxins from blood.\\
4 &
  Kavala-Gandusha &
  Mouth rinses and gargles &
  Cleansing effect on oral cavity as well removes extra mucous. Coronaviruses are abundant in nasal and mouth mucosa, removing them may decrease severity of SARS\\
5 &
  Nasya &
  Medicated nasal drops &
  Disinfection of nose as well as reaches to blood stream and als helps in decreasing respiratory manifestations\\
6 &
  Trividha Kukshi Ahara &
  Leaving 1/4th part of stomach empty for digestion &
  Improves metabolism and thereby nutrition of body and thus increases immunity which an important factor for prevention of COVID-19\\
\tblbottomrule 
\end{tabulary}\par 
\begin{tablenotes}\footnotesize 
    
\item{*Also recommended by WHO}
\end{tablenotes}
\end{threeparttable}

\end{table*}

\bgroup
\fixFloatSize{images/87cfef9e-c0a4-442c-a58a-ec7146d574c4-upicture1.png}
\begin{figure*}[!htbp]
\centering \makeatletter\IfFileExists{images/87cfef9e-c0a4-442c-a58a-ec7146d574c4-upicture1.png}{\includegraphics{images/87cfef9e-c0a4-442c-a58a-ec7146d574c4-upicture1.png}}{}
\makeatother 
\caption{\boldmath {Probable helpful Ayurveda measures for COVID-19 crisis}}
\label{f-40d039666226}
\end{figure*}
\egroup
\textbf{Discussion}

It is clear from the history of infectious diseases that pandemic infectious diseases such as COVID-19 are results of evolved viruses. The evolution is either nature by law of survival of the fittest or by artificial i.e. by induced by research laboratories with aim to find solution for some diseases. In both case it is vivid that the micro organisms are evolved but not human beings. Neither immunity nor the daily life of human beings is prepared to fight against such infections. It is because of the too much increased dependence on medicines and very less focus on development of body. This is where Ayurveda holds its far major focus compared to other medical sciences. 

According to Ayurveda principles, prevention of diseases by increasing immunity is of first priority and second priority is given to treating the disease. The distinguishing feature of Ayurveda in increasing body strength is the utilization of simple daily ways most of which are without medicines. For example daily Yoga exercise, rules regarding diet, personal hygiene's, guidelines regarding awaking as well as sleeping etc. These ways helps in maintaining strength of body (immunity) which in turn helps in combating pandemic conditions such as COVID-19. 

Ayurveda has clearly narrated pandemic diseases under the heading \textit{Janapadodhwansa.} The cause varies but the medium through which such pandemics spread are same which humanity has faced in the history of pandemic i.e. water, air, soil and living beings. Ayurveda has recommended boiling of water before its utilization for any purpose (disinfection of water), \textit{Yadnya's } (rituals done with hymens in front sacred fire) were done to control spread of air born infections. Cow urine mixed with ash of specific herbs was utilized to control infection spreading through soil. Simple daily regiments which are depicted in Table~\ref{tw-1f940086be01} Ayurveda daily regimens three are followed to avoid infection through contact. 

Therefore it can be claimed that Ayurveda deals with evolving physiological functioning of body and mind towards strengthening immunity and thereby prevention of pandemic infections such as COVID-19. Brief Ayurveda modalities for prevention of COVID-19 are depicted in Figure~\ref{f-40d039666226}. These modalities have limitation that their exact extent of utility is not known and it can be discovered by undertaking retrospective survey studied during or after the pandemic is over. 

\textbf{COVID-19 and evolution}

 Human corona virus has been known since long time but the RNA of the current pandemic causing virus has been evolved and thus it has been resistant to the medicines which are generally indicated for human corona virus. The fact highlight that there is faster process of evolution among microbes either in artificial or natural environment. In fact, the industrialization done by human has much changed the environment. It is simple assumption that body of every living organism is attempting to adopt with these changes. 

However, in case of human beings, the assumption varies based on developmental state of individual countries. The well developed countries have enough facilities to avoid continuous long contact with changed environment and thus peoples of such countries have less chances or slower rate of adoption. On the other hand peoples of developing and underdeveloped countries are living more with nature. The difference in incident and mortality rate among developed, developing and under developed countries is supportive of the assumption of adoption. Ayurveda emphasizes on utilization of natural resources in natural forms and living with nature. In other words, Ayurveda recommends ways for adoption and thereby evolution to make us enough suitable to face pandemics.

\textbf{The \textit{Rasayana} (rejuvenating anti-oxidant and immunomodulator) herbs}

 Large numbers of immunomodulator herbs has been discovered and readily available in Ayurveda treatise. Few of the selected herbs are compiled in Table~\ref{tw-aa3375640d9e}, on which scientific researches on immunomodulatorty action has been done with positive results. This is significant gift of Ayurveda to increase the immunity especially in current pandemic situation for the healthy individuals. 

Administration of these herbs in specific dosage forms or the formulations prepared from them under Ayurveda physicians guideline can be a strong measure for prevention of further spread of COVID-19 among healthy individuals. In other words, \textit{Rasayana } herbs can be a strong effective tool in avoiding as well as fighting stage third of this pandemic. 

\textbf{Yoga exercises, immunity and respiratory system}

 One of the significant contribution of Indian ancient seers is the discovery of Yoga. Actually Yoga is systematic slow exercise which exerts slow but steady stress among all vital organs. In other words, Yoga is a way to strengthen vital organs and the immunity depends on normal functioning of all these vital organs. 

\textit{Pranayama } includes several types of Yoga which are related to respiration such as \textit{Bhastrika } (forceful fast breathing)\textit{, Anuloma-Viloma } (sequential breathing by alternate closing of each nostril)\textit{, Ujjayi } (ocean breath)\textit{, Sitali } (the cooling breath)\textit{\space } etc. All these \textit{Pranayam } are helpful in cleaning the excess mucus accumulated in bronchial alveoli and helps in increasing their elasticity. It means \textit{Pranayama } is a tool to increase total lung capacity. In case of COVID-19, SARS is an sever manifestation which is the cause for death. Therefore claim can be made that a person is likely to manifest SARS in less sever extent if he/she have better lung capacity. This will give chance and enough time to mange COVID-19 by the available medications and life saving care. Hence it can be strongly advisable to include \textit{Pranayama } in preventive strategies suggested for COVID-19.

\textbf{Focusing on future}

 It is very hard and risky to prepare for a war when the actual war has begun. Those who cares for safety always make arrangements before emerging the problem. Currently world is facing COVID-19 pandemic and thus it is difficult to follow preventive guidelines and ensuring the safety. Ayurveda guidelines offers a way to prepare mankind to get possible safety in current situation but these guidelines promises much more safety in prevention of similar pandemic in future. 

Along with fighting current situation, the scientific minds in the word are expected to start preparing strategies for future too. Ayurveda can play significant role in future strategies because most of the preventive strategies for COVID-19 has clearly showed that the ancient seers of Ayurved had already provided those guidelines and few more too which are yet to be accepted and recommended by world scientific committees. 
    
\section{Conclusion}
Cure of an illness matter much more but prevention is always better than cure. Ayurveda offers simple natural ways (daily regimens), herbal combinations, herbo-mineral formulation and exercises such as Yoga for prevention of COVID-19. The curative role of Ayurveda needs to be systematically studied. However based on the precision in Ayurveda principles, it can be claimed that Ayurveda may have a definite cure for COVID-19 and there is great need to find and establish it.

\textbf{Acknowledgement}

Nil

\textbf{Funding Support}

\textbf{\space }Nil

\textbf{Conflict of Interest}

There is no conflict of interest. 
    

\bibliographystyle{pharmascope_apa-custom}

\bibliography{\jobname}
\end{document}
