LAUSR

To the Editor: It is an appreciable effort by the authors Roy et al. to bring out a reclusive incident of lead-induced toxicity in a Type 1 diabetic pediatric patient, due to naga bhasma [1]. India has a burden of elevated blood-lead levels in children due to toxic environment. A description of the region and sociodemographic background of the patient have been helpful in distinguishing other probable causes of lead poisoning. The dosage, duration of administration, and GMP certification of the pharma company were not specified. As the exact dose of naga bhasma is untold, the causation of bony changes seems difficult to validate [2]. Detailing NABL accreditation of the laboratory and the techniques used along with complete lab reports would have added credibility to the correspondence. Scientific studies reveal that during the preparation of naga bhasma, the crude lead undergoes repeated quenching, trituration, and calcination. That transforms it into nanocrystalline lead sulfide (PbS), a least-toxic form along with organic contents (helping in its bioavailability) and different nutrient elements coming from the herbs used during preparation. The histopathological in vivo study shows the nontoxic nature of the drug and few clinical trials support its efficacy in reducing the blood glucose level in diabetes [3, 4]. So, it is unclear whether the correspondence is pointing out the improper use of the tested medicine or that the naga bhasma itself is unfruitful. The lacunas in the preparation of naga bhasma and its injudicious use turn out to be a matter of concern. A case report would have been helpful in analyzing things more accurately and scientifically. As some opacity prevails in the correspondence, alleging a tested medicine and an entire medical system (Ayurveda) seems to be a nonconstructive criticism.