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\def\RunningAuthor{Gheena S and Mohamed Arsaath N}
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\articleType{Original Article}
\receivedDate{01 Jul 2020}
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\title{Awareness on the possible role of ayurveda as an immunity booster in the covid19 pandemic}
\author{Mohamed~Arsaath~N\textsuperscript{1}, 
            Gheena~S\textsuperscript{*}\textsuperscript{2}~\\[5pt]{\textsuperscript{1}Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India}~\\{\textsuperscript{2}Department of Oral Pathology, Saveetha Dental College and Hospitals, Saveetha institute of Medical and Technical Science, Chennai, Tamil Nadu, India}}

\begin{abstract}
Covid 19 is pneumonia associated viral infection that originated from Wuhan city in December 2019. The virus appears to be spherical in appearance with proteins called spikes protruding from the surface. Ayurveda plays a vital role in boosting the immunity of our body against the pandemic outbreak covid19. This study was carried out to analyse the awareness of people on Ayurveda being a possible option for boosting our immunity. An online survey was conducted with a self-structured questionnaire using an online survey platform google forms. The link was shared through social media. A total of 100 responses were received. The reactions recorded and were analysed, and statistical analysis was performed. The responses recorded from the participants showed that the participants possess adequate knowledge about the covid19 infection, and they possess sufficient awareness of the possible role of Ayurveda on boosting immunity against covid19. 83.9\% of the respondents are aware of the pandemic outbreak covid19, and among them, 59.5\% believe that Ayurveda plays a role in boosting immunity against covid19. Around 50\% of the participants believe herbs used in Ayurveda are potential inhibitors against covid19. The study conducted concludes that during this pandemic outbreak most of the participants are aware of the origin, cause, mode of the spread and are also aware of the role of Ayurveda in boosting our immunity level.
\end{abstract}\def\keywordstitle{Keywords}

\begin{keywords}Ayurveda,\newline Covid 19,\newline Immunity,\newline Awareness,\newline Knowledge
\end{keywords}
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\makeatletter{\raggedright\textsuperscript{*}Corresponding Author\par Name:\ Gheena~S~\\ Phone:\ 9884033777~\\  Email:\ gheena@saveetha.com
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\section{Introduction}
The most infectious pneumonia associated viral outbreak SARS-COV-2 originated from Wuhan city in China in December 2019. The novel coronavirus was first described in 1966 by Tyrell and Bynoe, by cultivating the viruses from patients with common colds \unskip~\citep{857673:20064502}. The virus is named 2019- Ncov by the WHO, the international committee on taxonomy of viruses terms it to be SARS-COV-2. The pandemic global outbreak covid19 is a new human infecting betacoronavirus likely to be originated from the chrysanthemum bats \unskip~\citep{857673:20064507}. The novel virus SARS-CoV-2 is found to cause a type of pneumonia associated problem termed Severe Acute Respiratory Syndrome. The virus appears to be spherical and have proteins called spikes protruding from their surface \unskip~\citep{857673:20064495}. The pandemic outbreak COVID-19 spreads mainly by droplets produced as a result of coughing or sneezing of a COVID-19 infected person. The spread of novel coronavirus occurs through direct close contact with COVID-19 patients within one meter of the infected person, and the rate of spread is enhanced if they do not cover their face when coughing or sneezing. The novel virus also spreads by the droplets surviving on surfaces and clothes for many days. Therefore, touching any such infected surface or cloth and then touching one's mouth, nose, or eyes can transmit the disease. The Hydroxychloroquine, an old drug used for the treatment of malaria, had demonstrated marked efficacy, and it is accepted globally in treating COVID-19 associated pneumonia \unskip~\citep{857673:20064504}. The Ayurvedic medicine kabasura kudineer also proves to be an effective medicine against covid19.

In recent times various studies regarding covid19 origin, prevention methods, correlation of associated topics with coronavirus were conducted, and one among them is the research carried out to understand the connection between cancer and the covid19 condition \unskip~\citep{857673:20064492,857673:20064501,857673:20064497}. The recent studies carried out discovered that people who have cancer are more vulnerable to covid19 infection \unskip~\citep{857673:20064484,857673:20064491}. However, the recent studies also discovered that the aerosol generated in dental procedures reveals that the dental profession is at a high risk of developing viral infection due to enhanced transmission through these large droplets \unskip~\citep{857673:20064487,857673:20064486,857673:20064482}, but potentially oral biopsy procedure done in dentistry is useful in detecting covid19 among smokers by the procedure GS17913 and ACE which are found to be a receptor for the viral outbreak \unskip~\citep{857673:20064503,857673:20064496}. Also the teledentistry has proved to be a trusted source to improve the oral health of people to fight against the infection covid19 \unskip~\citep{857673:20064500,857673:20064499,857673:20064506}. It is also found that the presence of the covid19 infection can be identified from the gingival crevicular fluid \unskip~\citep{857673:20064485,857673:20064494}.

Ayurveda, the traditional Indian system of medicine practised by saints and monks from the Vedic period till date, it originated 3000 years back and in Sanskrit means knowledge or science of life. Many chapters in Ayurveda such as Charaka Samhita, janapadodhvimanan explains about the mechanism to fight against epidemic outbreak such as covid19 and the importance of immunity required to fight against the epidemic outbreak \unskip~\citep{857673:20064489}. Ayurvedic medicines such as Rasayana, usage of herbs, hot water and steam inhalation are the possible methods available to cope up with the respiratory illness by enhancing the immunity of our body \unskip~\citep{857673:20064505}.

Immunity is a balanced state in multicellular organisms possessing adequate capabilities to fight against any infection, disease or any other allergies. The immune system of a multicellular organism requires all nutrients in the quantities necessary to function correctly \unskip~\citep{857673:20064498}. The primary aim of this study is to stimulate awareness on the possible role of Ayurveda in boosting the immunity of our body to fights against pandemic outbreak covid19. This survey comprises the general population to understand the awareness, knowledge of Ayurveda used as an aid in the battle against covid19.
    
\section{Materials and Methods}
An online survey was conducted with a self-structured questionnaire with a sample size of 100 participants comprising the general population. The questionnaire consists of questions related to socioeconomic data, questions related to recent findings or updates in the prevention or treatment option against covid19, questions that correlate the connection between Ayurveda and immunity of our body to prevent covid19 and finally questions related to facts. The participants were given a short introduction about the traditional medicinal system of India-Ayurveda, and its role in boosting immunity, the importance of immunity level in fighting against covid19 or pandemic outbreaks. The questionnaire was validated in the usual manner. Measures such as the selection of participants randomly, steps to prevent asking irrelevant questions to the participants, placing restrictions over participant population and age groups are taken to minimise the bias occurring in sampling. The questionnaire was designed using the online survey platform" google forms''. Descriptive analysis was carried out using the statistical software" SPSS SOFTWARE VERSION 20''.the results of the survey was represented in the form of pie charts.


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\caption{\boldmath {Awareness regarding role of ayurveda in improving immunity among the study subjects }}
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\caption{\boldmath {Perception of the effectiveness of Ayurvedic medicine against Covid19}}
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\caption{\boldmath {Perception towards role of specific Ayurvedicmedicine in treatment against Covid 19}}
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\caption{\boldmath {Perception of the role of Tulsi In Boosting Immunity among study participants}}
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\caption{\boldmath {Perception of Importance of Herbs in Preventing Covid19 Infection}}
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\fixFloatSize{images/5cdca9e5-2ec2-43ad-b6cf-db706a9f3414-upicture11.png}
\begin{figure}[!htbp]
\centering \makeatletter\IfFileExists{images/5cdca9e5-2ec2-43ad-b6cf-db706a9f3414-upicture11.png}{\includegraphics{images/5cdca9e5-2ec2-43ad-b6cf-db706a9f3414-upicture11.png}}{}
\makeatother 
\caption{\boldmath {Perception of the role of Neem, Ginger in BoostingImmunity}}
\label{f-b406511195ca}
\end{figure}
\egroup

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\fixFloatSize{images/10c4c340-da93-4eea-a18f-bd87d48a989f-upicture12.png}
\begin{figure}[!htbp]
\centering \makeatletter\IfFileExists{images/10c4c340-da93-4eea-a18f-bd87d48a989f-upicture12.png}{\includegraphics{images/10c4c340-da93-4eea-a18f-bd87d48a989f-upicture12.png}}{}
\makeatother 
\caption{\boldmath {Perception of the effectiveness of Ashwagandha against Covid19 }}
\label{f-8a441068eee7}
\end{figure}
\egroup

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\fixFloatSize{images/f24344e3-c193-4f7e-8c8d-0fe80cd2eac6-upicture13.png}
\begin{figure}[!htbp]
\centering \makeatletter\IfFileExists{images/f24344e3-c193-4f7e-8c8d-0fe80cd2eac6-upicture13.png}{\includegraphics{images/f24344e3-c193-4f7e-8c8d-0fe80cd2eac6-upicture13.png}}{}
\makeatother 
\caption{\boldmath {Perception of Connect Between Ayurvedic Herbs and Covid19 }}
\label{f-004ea1d6a0a7}
\end{figure}
\egroup

\bgroup
\fixFloatSize{images/fba3abd8-eace-477f-99b6-c6abdb9c6659-upicture14.png}
\begin{figure}[!htbp]
\centering \makeatletter\IfFileExists{images/fba3abd8-eace-477f-99b6-c6abdb9c6659-upicture14.png}{\includegraphics{images/fba3abd8-eace-477f-99b6-c6abdb9c6659-upicture14.png}}{}
\makeatother 
\caption{\boldmath {Perception of the Success Rate of Ayurveda in curing Covid19 }}
\label{f-2bad0a5b924f}
\end{figure}
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\fixFloatSize{images/384a4878-8f31-4f1e-8152-b04d99a95a5d-upicture15.png}
\begin{figure}[!htbp]
\centering \makeatletter\IfFileExists{images/384a4878-8f31-4f1e-8152-b04d99a95a5d-upicture15.png}{\includegraphics{images/384a4878-8f31-4f1e-8152-b04d99a95a5d-upicture15.png}}{}
\makeatother 
\caption{\boldmath {Perception of the steps taken by Government to Prevent Covid19 }}
\label{f-55669ee41364}
\end{figure}
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\fixFloatSize{images/d9c4944c-9eeb-46bd-b489-4fd8880ef860-upicture16.png}
\begin{figure}[!htbp]
\centering \makeatletter\IfFileExists{images/d9c4944c-9eeb-46bd-b489-4fd8880ef860-upicture16.png}{\includegraphics{images/d9c4944c-9eeb-46bd-b489-4fd8880ef860-upicture16.png}}{}
\makeatother 
\caption{\boldmath { The association by chi square test between gender on the awareness about the role of Ayurveda in prevention against covid19 infection}}
\label{f-1c6797dcefae}
\end{figure}
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\fixFloatSize{images/82a81551-e750-4c28-8d8d-14b40629ab2d-upicture17.png}
\begin{figure}[!htbp]
\centering \makeatletter\IfFileExists{images/82a81551-e750-4c28-8d8d-14b40629ab2d-upicture17.png}{\includegraphics{images/82a81551-e750-4c28-8d8d-14b40629ab2d-upicture17.png}}{}
\makeatother 
\caption{\boldmath {The association by chi square test between gender on the perception of Ayurveda in prevention against covid19 infection among the participants}}
\label{f-9469fbe2d09c}
\end{figure}
\egroup

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\fixFloatSize{images/92f7b9ac-cb0b-44ac-8bd8-12ed0129eb2f-upicture18.png}
\begin{figure}[!htbp]
\centering \makeatletter\IfFileExists{images/92f7b9ac-cb0b-44ac-8bd8-12ed0129eb2f-upicture18.png}{\includegraphics{images/92f7b9ac-cb0b-44ac-8bd8-12ed0129eb2f-upicture18.png}}{}
\makeatother 
\caption{\boldmath {The association by chi square test between gender on the effectiveness of Ashwagandha in prevention against covid19 infection}}
\label{f-d6f0eec39cb3}
\end{figure}
\egroup

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\fixFloatSize{images/5644d118-2344-4399-b6fa-080c4682749d-upicture19.png}
\begin{figure}[!htbp]
\centering \makeatletter\IfFileExists{images/5644d118-2344-4399-b6fa-080c4682749d-upicture19.png}{\includegraphics{images/5644d118-2344-4399-b6fa-080c4682749d-upicture19.png}}{}
\makeatother 
\caption{\boldmath {The association by chi square test between gender on the role of Neem, Ginger in prevention against covid19 infection}}
\label{f-d7a88de3d41c}
\end{figure}
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\fixFloatSize{images/37e87c6f-fa3d-41ed-ac4a-9593078e81e6-upicture20.png}
\begin{figure}[!htbp]
\centering \makeatletter\IfFileExists{images/37e87c6f-fa3d-41ed-ac4a-9593078e81e6-upicture20.png}{\includegraphics{images/37e87c6f-fa3d-41ed-ac4a-9593078e81e6-upicture20.png}}{}
\makeatother 
\caption{\boldmath {The association by chi square test between gender on the perception of success rate of Ayurveda in prevention against covid 19 infection}}
\label{f-8cc0c3652974}
\end{figure}
\egroup

    
\section{Results and Discussion}
In the current study, Figure~\ref{f-7f7655eb3a7c} depicts that the number of male and female population ratio in the overall survey population was in the percentage of 78.6\% males and 21.4\% females. Figure~\ref{f-b2a6054add69} reveals the perception of the respondents about the link between Ayurveda, immunity and covid19,59.5\% of the participants perceive that Ayurveda plays an important role in boosting immunity against the pandemic, and 40.5\% disagree. The Figure~\ref{f-225d74127611} in the current study depicts about the recent identification related to covid19 to understand whether the population gets updated regularly about the pandemic,78.2\% of the population has proved that they regularly update about the covid19 21.8\% unaware of the recent findings. Figure~\ref{f-5fe1913c6b1b} reveals the role of herbs in boosting immunity, and 50\% population agree that herbs play a role in boosting immunity, and around 50\% of the population disagree. Figure~\ref{f-24c84c397f1b} depicts the people's perception towards the recent Ayurvedic medicine kabasura kudineer against covid19,50\% people agree that Ayurvedic medicine to be an effective step in preventing covid19 and about 35.1\% respondents think that this could be a better step and around 9.9\% disagree. Figure~\ref{f-8f45a91bb291} denotes the effectiveness of Viswanathan sudharana in reducing symptoms of covid19, 63.6\% of the population are aware of Viswanathan sudharana, and about 36.4\% of people were unaware. The results recorded for Figure~\ref{f-5be7f515d8f6} in the study reveals about the role of tulsi in boosting immunity and around 58.6\% believe that tulsi plays a major role in boosting immunity and around 27.9\% respondents think that it might play a role in boosting immunity. A proportion of around 13.5\% of the participants was unaware. Figure~\ref{f-3eab75bcad5a} of the study depicts the importance of few herbs in the process of boosting immunity,55.9\% of the participants are aware of these herbs role in boosting immunity and around 44.1\% people were unaware. Figure~\ref{f-2f63ecae078e} depicts the importance of a few herbs in boosting our immunity,71.8\% aware of the role played in boosting immunity by these herbs and 28.2\% of the participants unaware. Figure~\ref{f-b2abb2123283} depicts the chapter janapadodoh vimanam in Ayurveda to fight against covid19,57.7\% are aware of this chapter, and 42.3\% of the participants were unaware. Figure~\ref{f-b406511195ca} depicts the importance of neem ginger in boosting immunity,71.8\% of the participants are aware and around 28.2\%unaware. Figure~\ref{f-8a441068eee7} in the study displays the best herbs, which is highly effective in improving immunity 40.9\% answered all these might be the best herbs,40\% answered these are best herbs and 19.1\% unaware. Figure~\ref{f-004ea1d6a0a7} shows the link between Ayurvedic herbs and covid19,61.6\% of the participants are aware,38,4\% of the respondents are unaware. Figure~\ref{f-2bad0a5b924f} shows the belief people possess on Ayurveda curing covid19,58.9\% of the participants strongly believe that Ayurveda is effective in curing Covid19, and about 41.2\% of the people disagree. Figure~\ref{f-55669ee41364} shows the initiative taken by the government, such as kabasura kudineer for preventing covid19,68.5\% are aware, and about 31.5\% of the survey participants were unaware. The bar graphs through Figure~\ref{f-1c6797dcefae}, Figure~\ref{f-9469fbe2d09c}, Figure~\ref{f-d6f0eec39cb3}, Figure~\ref{f-d7a88de3d41c}, Figure~\ref{f-8cc0c3652974} depicts the association between gender on the perception of the role of Ayurveda in the prevention of Covid - 19, the role of ashwagandha, role of neem and ginger and the perception of the success rate of Ayurveda in treating Covid- 19 respectively. The association between gender on the role of ashwagandha in treatment of Covid 19 was statistically significant(\textit{p }value\textless\ 0.05). The rest of the associations were statistically insignificant (\textit{p }value{\textgreater} 0.05). 

In Figure~\ref{f-1c6797dcefae}, X axis represents the gender and Y axis represents the frequency of responses regarding the role of ayurveda. p value=0.248, p value{\textgreater} 0.05 hence statistically significant. In Figure~\ref{f-9469fbe2d09c}, X axis represents the gender of the participants and Y axis represents the frequency of responses. p value=0.170, p value{\textgreater}0.05 hence statistically insignificant. In Figure~\ref{f-d6f0eec39cb3}, X axis represents the gender and Y axis represents the frequency of responses. p value=0.007,pvalue{\textless}0.05 hence statistically significant. In Figure~\ref{f-d7a88de3d41c}, X axis represents the gender and Y axis represents the frequency of responses. p value=0.455, p value{\textgreater}0.05 hence statistically insignificant. In Figure~\ref{f-8cc0c3652974}, X axis represents the gender and Y axis represents the frequency of response. p value=0.006, p value{\textless}0.05 hence statistically significant.

 The study shows that it is inevitable that knowledge and awareness regarding the various aspects of a pandemic outbreak are very important among the masses to curb it. Ayurveda is the traditional medicinal system in India, has great importance in management and prevention of disease and health. In this present study, the link between Ayurveda, immunity and covid19 was analysed. Therefore, (Figure~\ref{f-b2a6054add69}) depicts that 59.5\% of the population think Ayurveda has a role to play with the prevention of covid19 by boosting the immunity of our body, the findings of our study was similar to the previous research which proves that amla, an important Ayurvedic material predominant in Ayurvedic medicine tends to improve the immunity of our body \unskip~\citep{857673:20064493}. 

In the previous study, an online survey was conducted to analyse whether the herbs such as cinnamon plays a role in boosting immunity and found that around 76 participants answered that adding 2mg each in 200ml increase the immunity level of our body to prevent covid19 \unskip~\citep{857673:20064483}. The findings of the previous study were similar to our results in the present study; 50\% of the participants think herbs such as black pepper, cinnamon act as an immunity booster against covid19.

The previous study performed proves that tulsi an Ayurvedic holistic herb plays a role in the management of covid19 \unskip~\citep{857673:20064490}. The findings of the study carried out previously matches with the results of our research that 58.6\% believe tulsi plays a significant role in boosting immunity against covid19. 

In the previous study performed to analyse the inhibition properties of plants and proved that plants possess inhibition property to a certain extent based on the affinity of turmeric, neem, ashwagandha and ginger to be potential inhibitors for covid19 \unskip~\citep{857673:20064488}. The findings of the previous study match with the results of the present study.
    
\section{Conclusion}
The study concludes that during this pandemic outbreak most of the participants are aware of the origin, cause, mode of the spread, treatment options and the initiatives taken by the government to prevent this pandemic and one among the actions taken by the government is the application of herbs used in Ayurveda such as neem, turmeric, cinnamon for the prevention of covid19 by boosting the immunity level of the body. So, therefore, it concludes that Ayurveda plays a significant role in the process of boosting immunity against covid19.

\textbf{Funding Support}

The authors declare that they have no funding support for this study.

\textbf{Conflict of Interest}

The authors declare that they have no conflict of interest.
    

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