UNDERNUTRITION IN CHILDREN: AN AYURVEDIC PERSPECTIVE WITH SPECIAL REFERENCE TO KARSYA

Undernutrition is a major health problem affects particularly in preschool children (<6 years) with its dire consequences ranging from physical to cognitive growth and susceptibility to infection. Under-nutrition is a condition in which there is inadequate consumption, poor absorption or excessive loss of nutrients. Nutritional supplementation and nutritional interventions are the conventional method for preventing this condition. But even after providing proper nutritional requirements, under weight is getting a serious issue for parents. Kaumarabruthya considered health problems of children are different from adults because of their under developed body (Alpakayatha), immature Dhatus (Aparipakwa Dhatu), less Dosha, Dushya and Mala (Dosha Dushya Mala Alpatha), unstable digestive power (Aniyatha vahni) etc. Jatharagni become very weak in children so they cannot digest and assimilate most of the Guru Aharas. A Dhatu is evolved and transformed into next Dhatu as a result of Pakaprakriya (biotransformation). Vridhi and Kshaya of Dhatu depends on the strength of Jatharagni. If Agni impaired in Dhatus, such evolution cannot take place and leads to the formation of Ama and causing Srothorodha, which results insufficient production of Rasa Dhatu along with other Dhatus chronologically. Parigarbhika, Phakka, Balashosha, Shuska Revati and Karsya are the conditions mentioned in Ayurveda similar to under nutrition. Agnideepana, Pachana, Srotho-sodhana, Samsamana and Laghu Santharpana can be adopted as the line of management in Karsya

CONVENTIONAL AYURVEDIC MANAGEMENT IN SPASTIC CEREBRAL PALSY: A CASE STUDY

Cerebral palsy is a non-progressive but crippling neurological disorder in children. The prevalence rate of cerebral palsy has risen to well above two per thousand life birth. Spastic cerebral palsy is a disorder that causes muscle tightness. This condition prevents the normal development of motor function. It makes up over 70% of all cases of cerebral palsy. As per Ayurvedic classics, the spasticity is termed as Jadatwam and is one of the Vatha predominant Lakshana. The important causative factors are the improper diet and regimen followed during pregnancy, Akalapravahanam (untimely contractures during labour), head injury during delivery, Garbha sosham (Intrauterine Growth Retardation) etc. Due to these aetiology Dhadhu, Kshaya occurs followed by Vata dosha prakopa and produces symptoms like Praseka, Sosha, Jadatwam etc. In this study, based on the concept of Vathavyadhi chikitsa, Snehana, Swedana, Sodhana and Brimhana therapy with appropriate Panchkarma procedure was done. Physiotherapy was provided along with treatment, it helped to improve motor functions and activities of daily living of the patient. The spasticity was assessed through the range of motion of joints (ROM) by using the instrument Goniometer while the motor and mental developments were assessed by developmental assessment scales for Indian infants (DASII). Considering the ROM of joints of upper and lower limb, spasticity was reduced in the extension movement of the ankle, hip, knee, elbow, and shoulder. The motor and mental developmental quotient of the baby was improved after the treatment. This article is an attempt to highlight the efficacy of conventional Ayurvedic management in spastic cerebral palsy with Kerala specialties

EFFECT OF SANKHAPUSHPI (CLITORIA TERNATEA LINN.) CHOORNA IN THE WORKING MEMORY OF CHILDREN

The term “Working memory” refers to the ability of a person to hold information in mind and to manipulate it over short periods of time. Its deficit creates a high risk factor for educational underachievement as it is a better predictor of school performance than IQ. A clinical study was conducted to find out the effect of Sankhapushpi (Clitoria ternatea Linn.) choorna in the working memory of children. The study was conducted as therapeutic, interventional, non randomized, single group assignment, pre and post test and was carried out at the OPD of Dept. of Kaumarabhritya, Government Ayurveda College, Thiruvananthapuram. The study population included children in the age group 7 to 11years of both sexes with working memory deficit for their age when assessed by a clinical psychologist, selected from a population who presented with poor scholastic performance. The tools used were N back tasks for Verbal and Visuospatial Working Memory from NIMHANS Neuropsychological Battery and Visuospatial working memory span task and Working Memory Index tests in Wechsler’s Intelligence Scale. The trial drug, Sankhapushpichoorna was given twice daily in empty stomach in the dose 1-2 gm with plain ghee and honey for 2 months. They were assessed before and after intervention and after 1 month of follow up period and the difference in scores were assessed. Analysis of the data using the most appropriate statistical tests showed significant response (P<0.001). The trial drug sustained its potential action during the follow-up period also and thus its efficacy was proved

EFFECT OF BRAHMISOHALADI SIROLEPA IN CHILDREN WITH AUTISM SPECTRUM DISORDERS

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterized by impairment in social interaction and communication with restricted interests and repetitive behaviour. The prevalence of ASD has shown an alarming increase in the recent decades ending up to 1 in 90 children. In spite of enormous researches in contemporary medical field, no medicaments have proved to be effective in improving their social behaviour. In Ayurveda, ASD comes under the category of Unmada involving derangement of all the three Doshas (Vishama sannipatha) with predominance of Vata & Pitha. Child friendly and effective procedure based therapy in the form of Sirolepa (application of medicated paste on scalp) is being tried in children with ASD between 3 and 12 years selected from the outpatient cases of Dept. Of Kaumarabhrithya, Government Ayurveda College, Thiruvananthapuram. The present study empirically analysis the efficacy of Sirolepa with Brahmisohaladi with its classical reference in Arogyakalpadruma in the context of Unmada. Children with ASD satisfying the DSM V criteria and having a CARS score above 30 were selected for the study having duration of 28 days. There was an observable improvement in eye contact, attention span and sleep pattern with a marked reduction in hyperactivity. All of the children included in the study were receiving speech as well as psycho therapies and appropriate dietary advice throughout the treatment course. The clinical observation was supported by CARS (Childhood Autism Rating Scale) & ATEC (Autism Treatment Evaluation Checklist) recorded as pre- post evaluation. The changes in CARS and ATEC score were highly significant at 0.05% level (P<0.0005). The study provides the first potential evidence that Brahmisohaladi Sirolepa may be capable of modifying the core social and cognitive defects associated with ASD

BRONCHIAL ASTHMA IN CHILDREN- AN AYURVEDIC PERSPECTIVE

Childhood Asthma is the most common serious chronic disease in infants and children. Bronchial asthma (Swasa roga) referred to as a chronic lung disease, showcase an obstructed air pathway, which hinders the free flow of inhaled oxygenated air through the air channels in the lungs, as being inflamed, constricted and filled with mucous. Certain dietary practices and deeds/habits which both the parents and children tends to perform on a regular basis causes Kaphapitha Dushti which coupled with Aniyata Vahni (unstable digestive fire) of children, leads to Jataragni Mandya (indigestion) in children and results in the formation of Krimi (worms) in the stomach. These Krimi in turn worsens the Agnimandhya, thereby completely destabilizing the digestive and assimilative capacity of the gastrointestinal system. The Srotorodha produced by the vitiated Kapha Pitha Dosha along with Ama in the Amasaya, leads to Vataprakopa and thus a Doshic derangement happens in the Amasaya. As stated by Vagbhatacharya in Swasa Nidana, this Doshic derangement in the Amasaya, triggers a disease process in the previously indisposed, trigger awaiting Pranavaha Srotas, leading to Swasa Roga. Here in Swasa Roga, Ajeerna (indigestion) and Krimi (worms) acts as Sannikrishta Nidanas, whereas Pranavaha srotodushti act as Viprakrishta Nidana. The mainstay of treatment should be avoidance and clearance of Sannikrishta Nidanas and addressing the Viprakrishta Nidana. But most importantly, the drugs should have action over the respiratory system to strengthen and revitalize the system and make it immune and less susceptible to future attacks

GUT BRAIN AXIS IN AUTISM SPECTRUM DISORDERS - AYURVEDIC PERSPECTIVE

Autism spectrum disorder (ASD) constitutes a group of brain developmental disorders, and it is defined by stereotyped behaviour and deficits in communication and social interaction. The prevalence of ASD has shown an alarming increase in the recent decades ending up to 1 in 90 children. The exact cause of ASD is still not known. Research studies have focused on genetic causes, dysregulation of the immune system, inflammation, exposure to environmental toxicants, and the defective gut microbiota. Accumulating evidence demonstrates that gastrointestinal symptoms, such as abdominal pain, gaseousness, diarrhea, constipation and flatulence, are a common comorbidity in patients with ASD. The gut consists of millions of microbiota, and we hypothesize that the microbiota and its metabolites might be involved in the pathophysiology of ASD. In Ayurveda all Psycho social abnormalities have been included under the category of Unmada. A defective digestive and metabolic function is postulated as the root cause of Unmada, leading to systemic accumulation of metabolic wastes (Dhatugataama). The metabolic wastes act as systemic toxins and impair the functional integrity of brain. An observational study was carried out in the outpatient section of the Department of Kaumarabhrithya, Govt. Ayurveda College Hospital for Women and Children, Poojappura, Thiruvananthapuram in 122 children with ASD. Data pertaining to Socio demographic aspects and clinical manifestations were recorded and its prevalence rate was calculated. It was noted that 54% of the cases showed an evident disturbance in the digestive mechanism. Constipation was complained by 28% of cases, bloated abdomen by 16%, irritable bowel by 8%, increased flatulence by 7% and recurrent diarrhoea by 3%. Although these studies did not show a cause-effect relationship between GI symptoms and ASD, the findings suggest that the gut plays an important role in the etiology of ASD. Ayurvedic treatment strategies that modulate the gut microbiota might constitute a potential therapy for patients with ASD

Ayurvedic Management of STXBP1 Encephalopathy with West Syndrome - A Case Report

Developmental delay, intellectual disability, and epilepsy are hallmark features of STXBP1 encephalopathy. This condition is often associated with West syndrome, characterized by intractable epilepsy, developmental regression, and hypsarrhythmia on EEG. Even though timely intervention is crucial, Conventional medical systems lag behind to tackle the developmental regression and to gain control over the intractable epilepsy even with multiple anti epileptic drugs (AEDs). This is a case of a 7-year-old girl with an STXBP1 mutation, clinically diagnosed with West syndrome. She presented to the Kaumarabhritya OPD with significant developmental issues, including inability to sit without support, difficulty rising from a lying position, tremors, poor coordination, truncal ataxia, impaired speech, cognitive deficits, socialization issues, and intractable epilepsy. Ayurvedic management strategy was designed incorporating treatment principles of Apasmara (seizures), Unmada (insanity), Vatavyadhi (Vata disorders), and Sirakampa (head tremors), as an adjunct to ongoing AED regimen. Remarkable improvements were observed in motor, social, and language domains in a period of 4 months. Treatment efficacy was assessed using the Hague seizure severity scale, (improved from 24 to 49) and Gross Motor Function Measure score (increased from 18% to 30%). Receptive language age advanced from 0-1 month to 7-8 months, and expressive language age improved from 0-1 month to 10-12 months. Vineland Social Maturity Scale score improved from 3.5 to 8, and Indian Scale for Assessment of Autism score decreased from 130 to 105. This case report highlights the efficacy of Ayurvedic interventions in curtailing intractable epilepsy, arresting the neuronal regression and triggering the brain growth velocity