International Journal of Health Sciences and Research www.ijhsr.org ISSN: 2249-9571

Review Article

An Analytical Study of Bal-Sanskara W.S.R to Physio-Anatomical Changes for Assessment of Developmental Milestones

Gaurav Soni1, Neelam2

1P.G. Scholar, Department of Sharir Rachana, National Institute of , Jaipur, 2Junior Resident, Department of Dravyaguna, Faculty of Ayurveda, IMS, BHU, .

Corresponding Author: Gaurav Soni

Received: 23/06/2015 Revised: 13/07/2015 Accepted: 15/07/2015

ABSTRACT

India has a prosperous cultural heritage in which have developed such a pattern of lifestyle that is perpetual imperative. Every aspect has been related to service of almighty God so; that it is followed with great passion and indemnity. Hindu tradition describes various Sanskara (sacraments) outlined from birth to death of an individual. Out of the sixteen Sanskara described eight are for children. In Ayurveda, the word Sanskara is introduced as “SamskaraohiGunaantradhyanam” which means qualitative enhancement carried out by incorporating the precise qualities (transforming of the qualities). Though principally considered as religious rites, they were significant in perspective of child health and provided chance for routine examination of growth and developmental milestones of child at regular intervals. In Sanskara ceremonies invitees are Vaidya, aged ones and other respective members of society, who were mature enough that they can examine the growth and development of child. A thorough review of childhood Sanskara reveals that they were aimed at preparing the baby for proper feeding habits, ensuring adequate nutrition, preventing diseases, adapting baby to environment, gave individual identity and educated the child. It took care of not only physical but also mental, social and spiritual development of child thus making him an individual of good moral fibre, who proves to be an asset to the humanity.

Keywords: Bal-Sanskara, JataKarma, Annaprashan, Developmental Milestones

INTRODUCTION Sanskara is introduced as Ayurveda is Upveda of , “SamskaraohiGunaantradhyanam [ 1]”which which is “science of life”, describes the means qualitative enhancement carried out holistic approach towards life. Many by incorporating the precise qualities principles of Ayurveda are related with (transforming of the qualities). Sanskara go religious rituals of ancient India. Ancient a long way in fulfilling the four pursuit of describes sixteen life i.e. (righteousness), Sanskara (religious rites) for a person (wealth), (work and pleasure) and sequentially; thus summarizing lifestyle to (salvation). [ 2] fulfil one’s role from the commencement to Though principally considered as the end of life. In Ayurveda, the word religious rites, they were relevant in context

International Journal of Health Sciences & Research (www.ijhsr.org) 563 Vol.5; Issue: 8; August 2015 of child health and provided opportunity for accepted and consensus among routine assessment of child at regular scholars of Ayurveda. intervals. Sanskara ceremonies invite many persons including spiritual , learned Sanskara performed in intrauterine persons, elderly ones and other people life consists of (conception which provide a great opportunity for them acceptance ceremony), Punsavana to get a look of child. [ 3] The learned one (ceremony of graceful care of embryo for instantaneously notices any irregularity or achieving desired progeny) and lack in developmental milestone. Seemantonayana (for improving intelligence In matter of fact these milestones of foetus). Those performed in children were are principally anatomical and physiological Jata (birth rites), Namakaran developmental change signs. There are (naming), Nishkraman (taking baby out of many anatomical changes occurring in home), Annaprashan (starting solid neonate while coming from intrauterine life feeding), Chudakarma (head shaving), to extra uterine life, which are necessary for Karnavedhana (piercing of the ear), survival. These changes are in synchronized Upanayan (thread ceremony) and manner and are achieved within certain Vedarambha (start of formal education). [ 4] range of time period. Sanskara prepare one Those performed in youth and later for the next stage of growth. Thus, a detailed lives consist of Samavartan (ending of study of the classical portrayal of Sanskara formal education/ ceremony to accept the is obligatory to appreciate its significance in grown-up as a qualified individual), Vivaha child health and its aptness in present era. (marriage), (introspection and reassessment of the goals of life), Sanyas MATERIALS AND METHODS (leaving family life/complete renunciation) The literary material is collected and Antyeshti (last rites after death). Of from the various classical Ayurvedic text, these entire Sanskara Ayurvedic treatise contemporary Anatomy and Paediatrics described only Garbhadhana, Punsavan and texts, magazines and research journals. After the Bal- Sanskara. going through classical description a Here in this article we are only scientific analysis on their anatomical and concerned only with Bal Sanskaras which physiological development is undertaken. are-Jata Karma (birth rites), Namakaran After which classical description is (naming), Nishkraman (taking baby out of correlated with changes in developmental home), Annaprashan (starting solid milestone as per contemporary texts. A table feeding), Chudakarma (head shaving), is prepared for easier understanding. Karnavedhana (piercing of the ear), Upanayan (thread ceremony) and LITERATURE REVIEW Vedarambha (start of formal education). The number of Sanskara varies in different Hindu religious texts; it is about 16-40. DISCUSSION & CRITICAL  In Grihya there is mentioning ANALYSIS OF EACH SANSKARA of 18-21 Sanskara. The detailed analysis of each  In Manusrimiti, 13 Sanskara, classical description & their  In Gautama Grihya Sutra, 40 significance in examination of different  The 16 Sanskara explained by developmental and growth milestones is as Maharshi Dayanand are widely follows- 1. Jata Karma Sanskara International Journal of Health Sciences & Research (www.ijhsr.org) 564 Vol.5; Issue: 8; August 2015

The word ‘Jata’ means born or brought into movements and activates the gut. Swarna existence. [ 5] This is the first Sanskara (gold) bhasma gives physical protection to performed after birth of a baby. According baby, enhances brain development and is in to Charaka, after the initial nano particles which is easily absorbable by stabilization of baby (Prana Pratyagamana) baby`s intestine. and cord cutting, Jata Karma should be This Lehana (licking of medicine performed. First of all, the child should be preparations) also gives an opportunity to given Madhu and Ghrita. Thereafter, milk physician to assess the rooting and sucking from the right breast should be given to the reflex of neonate. Breast feeding is to be child. [ 6] Acharya Sushruta has opined Jata given on the first day so as to ensure proper karma as cleaning the vernix on newborn`s nutrition and protective immunoglobulin body, clearing newborn`s mouth by present in colostrums. [ 11] Saindhava (rock salt) and Sarpi (ghee) and placing a ghee soaked cotton on baby`s 2. Namakaran Sanskara head. [ 7] This is followed by cutting of Acharya Charaka, [ 12] Sushruta and umbilical cord at distance of eight Angula Vagbhatta have described Namakaran on from baby`s skin and tying it by thread 10th [ 13] and 10th or 12th day respectively. which is tied to baby`s neck. [ 8] After this [ 14]. baby is make to lick gold Bhasma mixed Analytical view: Name of an individual with honey and ghee. signifies his identity and individuality which Analytical view: Jata karma is the birth rite acts as stimulus for various examinations. which helps the baby transcend from This is the time when child has successfully intrauterine life to extra uterine life. passed the vulnerable early neonatal period Clearing the mouth of secretions clears (birth to seven days) which bears maximum airway and prevents aspiration. Cleaning the risk of infections, sepsis, neonatal jaundice, vernix provides tactile stimulation to the etc. Neonatal physiological jaundice appears baby to make it breath or cry. [ 9] Placing on second day of birth, reaches peak on 4th cotton soaked in ghee on head maintains or 5th day and disappears by 10-14 days. [ 15] temperature of the baby and provides Bathing of mother and baby with insulation. It prevents heat loss from baby`s medicated water also ensures hygiene and head, which has the largest surface area, disinfection. Lodhra used has Shothnashaka thus preventing hypothermia. [ 10] (reduces inflammation) and Vranaropaka Only after the baby is stabilized cord (wound healing). [ 16] Keeping the baby`s was cut, emphasizing on resuscitative head towards north or east where maximum measures. Tying the cord to baby`s neck by illumination of sunlight is present makes any thread prevents bleeding from cord and inflammation on head like un-subsided minimizes chances of infection of cord by cephalo-hematoma visible. soiling in stool and urine. Swarnaprashan given to baby by 3. Sanskara gold Bhasma, honey and ghee serves the It is the ceremony to expose the new comer purpose of both nutrition and immunization. to the exterior world. [ 17] In the fourth month Honey also serves as a mild allergen, which after giving bath, the baby should wear new gives the first opportunity to baby`s body to cloths and ornaments and should be taken to start the synthesis of antibodies, thus the family temple, i.e. out of the house for shielding the baby from infections. Also this the first time. A paediatrician should be first feed initiates gastrointestinal present when the baby comes back home. [ 18] International Journal of Health Sciences & Research (www.ijhsr.org) 565 Vol.5; Issue: 8; August 2015

Analytical view: Nishkramana Sanskara is  rolling over, taking out the baby in fourth month which is  sitting with own support in tripod appropriate as by this time baby develops fashion, enough immunity and tolerance to external  Bidextrous reach, environment. The presence of a Vaidya  stranger anxiety and (paediatrician) on this occasion provides an  Monosyllabic speech at sixth month. opportunity for routine check up and  Smiles at mirror image examination of normal milestones Teeth eruption in children also begins development in baby like around this age. Hence proper dentition is  presence of neck holding, also to be looked for.  no head lag when pulled to sit, Similarly, at tenth month  head above the plane of trunk on offers assessment of- ventral suspension,  Bisyllabic speech,  hand eye coordination,  waving bye-bye,  bidextrous grasp approach to a  immature pincer grasp and dangling ring,  Standing with support.  laughing loud,  Weight of child can also be assessed.  social smile and  Recognition of mother. 5. Karnavedhana Sanskara During this Sanskara the baby gets Pricking of the ears serves both ornamental in an unfamiliar environment when his purposes as well as protect baby from reaction in form of social smile, anxiety, diseases. [ 21] Our Acharya have fear, laugh or reaction to sound of bell can recommended sixth, seventh or eighth be observed. Persistence of primitive month for this rite in cold climate. [ 22] The reflexes, if any can also be noticed. child should be held in lap and ear pricked in centre of lobule, avoiding blood vessels 4. Annaprashan Sanskara and nerves by seeing it against sunlight. [ 23] The physician should prescribe feeding of Analytical view: First of all above described various fruits in sixth month. Later after 10 month’s landmarks are to be examined. eruption of teeth or in tenth month, [ 19] Also, ear piercing inflicts a small injury and feeding of cereals should be started. Food triggers active immune mechanism of baby. should be mashed properly before giving It thus prepares the immunity of baby and mouth should be cleaned by water after against any possible infection or injury. feed. Diet amount should be increased Modes to increase the pierced hole offer gradually. Acharya Vagbhatta as well as lubrication and prevention of wound Sushruta opine sixth month as appropriate infection. Selection of winter for the time for Annaprashan. [ 20] procedure also decreases chance of Analytical view: Cleaning by Jal Acamana infection. Holding ear lobule against sun (water) indicates the highly developed sense visualizes course of fine vessels, to avoid of oral hygiene. Specific food which is bleeding. beneficial in respective diseases is also prescribed. Starting the intake of fruits 6. Chudakarma Sanskara offers energy as well as vital vitamins and This is head shaving ceremony. [ 24] This is minerals to baby. This ceremony can also be performed in the first or third year according useful for assessment of developmental to Grihya sutra and Paraskar sutra milestones like respectively. International Journal of Health Sciences & Research (www.ijhsr.org) 566 Vol.5; Issue: 8; August 2015

Analytical view: Acharya Sushruta opines signifies the student`s commitment to that Shikha (special arrangement of hair on learning and the teacher's to teaching. [ 27] top on scalp which is left during Analytical view: Starting formal education Chudakarma Sanskara) is the site of Sira at five years is apt in today`s era also, as by (vessels) and Sandhi (sutures) and this hair this time a normal child learns to walk, run, acts as a protective layer. climb stairs, tell his name and gender, play This Sanskara gives a chance for co-operatively in a group, copy simple examination of skull and growth of hair. diagrams, use pencil, say song, poem, story, Detection of abnormalities like feed by himself and can go to toilet alone. It craniocynostosis, wide sutures, is also time for assessment of mental growth microcephaly, macrocephaly, elevated or of child. depressed fontanelle etc. Palpation of scalp DEVELOPMENTAL PROFILE OF carefully may also reveal cranial defects or BRAIN: [‎28] As normal development of craniotabes. During scalp examination, newborn depends directly on development inspect any cutaneous abnormalities such as of brain as it the main centre of control of cutis aplasia or abnormal hair whorls as they each function of body. All reflexes and may suggest an underlying genetic disorder actions are controlled by central nervous and it also offers protection of the child. [ 25] system so, its normal growth is now what we have to consider, as various milestone 7. Sanskara are basically the signs of development of It is school entrance initiation ceremony. It particular portion which depicts that helps control the fear of separation from function. So, it is as follow- parents, and to help overcome the anxiety of  Early brain stem and cord- birth: entering a strange place. It is also called light reflex, startle reflex, Babinski Yajnopaveet Sanskara. This Sanskara helps reflex, reflex movement, reflex birth the child to enter student life with perfect cries and grasp reflex. [ 26] discipline.  Visual, auditory, tactile, mobility, Analytical view: After the Upanayana is language and manual competences performed, the young lad becomes a  Brain stem and early subcortical i.e. twice born as this Sanskara signifies areas- 2.5 months spiritual rebirth. The brain growth of the  Midbrain and subcortical areas- 7 child gets completed up to the age of 5 months years. So, Manu`s opinion of starting the  Initial cortex- 12 months education by 5 years seems to be more  Early cortex- 18 months logical.  Primitive cortex- 36 months

 Sophisticated cortex- 72 months 8. Vedarambha Skill Achievements [‎29] It is also called Vidyarambha,

Akshararambha or Akshara lekhana  Gross motor- neck holding, sitting, standing, walking, running etc Sanskara. This is education enrichment ceremony which is undertaken when the  Fine motor- grasping, intentional child is of five years age. In this Sanskara, reaching, holding etc each student, according to his lineage,  Language- turns to sound, cooing, masters his own branch of the Veda. It monosyllables, word meaning etc  Social- social smile, recognizing mother etc

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Table No. 1 Showing functional correlation between Sanskara and Key developmental Milestones S. No. Sanskara [‎30] Sanskara KEY DEVELOPMENTAL MILESTONES [‎31] Kaala 1. Jata Karma 1st day Clearing the mouth provides tactile stimulation preventing hypothermia rooting and sucking reflex 2. 10th day physiological jaundice regaining of weight caput succedaneum ends 3. Nishkramana 4th month social smile(2 month) cooing(3month) recognizing mother(3month) Neck holding(3month) Grasps a rattle when placed in hand(4month) 4. Annaprashana 6th month Sitting with support(5month) Bidextrous grasp(5month) Monosyllables-ma, ba (6 month) Smiles at mirror(6 month) 5. Karnavedhana 6-7-8th month Palmar grasp(7month) Sitting without support(8month) Pincer grasp(9month) Bisyllables-mama(9month) Waves bye bye(9month) Standing with support(9month) 6. Chudakarma 1-3 years Walking with support(10month) crawling(11month) standing without support(12month) two word with meaning(12month) plays simple ball game(12month) Walking without support(13month) running(18month) ten words with meaning(18month) walking upstairs(24month) simple sentence(24month) riding tricycle(36month) telling story(36month) knows gender(36month) 7. Upanayana 5years social way of living develops 8. Vedarambha 5years make friends ready for schooling

CONCLUSION Sanskara improve a person while removing Sanskara are rites performed with an his undesirable attributes. objective of imparting positive qualities in a These milestones are basically person. The Sanskara are a series of anatomical and physiological developmental sacraments, sacrifices and rituals that serve signs. There many anatomical changes as rites of passage and mark the various occurring in neonate when he comes from stages of the human life and to signify entry intrauterine life to extra uterine life. These to a particular . Indian seers have changes are in synchronized manner and are developed such a pattern of lifestyle that is achieved within certain range of time period. perpetual essential. Every aspect is Lagging behind in time of these milestones correlated with almighty God so that it is signifies some deformity either at cranial or followed with great enthusiasm, surety. at local level. [ 32] These should be checked at regular interval.

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The childhood Sanskara aim at Chaukhamba Surbharti Prakashan, preparing the baby for extra-uterine life Sharir Sthana chapter 8, verse 46, Pp. successfully, develop proper feeding habits, 349 ensure adequate nutrition, prevent diseases, 7. Susruta: Susruta : with adapt to environment for further survival, commentaries Nibandhasamgraha by Dalhana and Nyayacandrika by give individual identity and educate the Gayadasa: edited by Vaidya Yadavji child. Thus, we can see that knowledge of Trikamji Acharya, reprint (2012), milestone was clearly and elaborately Varanasi, Chaukhamba Surbharti described in Ayurveda classics under the Prakashan, Sharir Sthana chapter 10, heading of Sanskara. This concept is both verse 13, Pp. 388 scientifically proved and is everlasting 8. Susruta: Susruta Samhita: with important. So, identical significance should commentaries Nibandhasamgraha by be given in process of Sanskara by parents Dalhana and Nyayacandrika by and clinicians, along with immunization Gayadasa: edited by Vaidya Yadavji process for healthier upbringing of child. Trikamji Acharya, reprint (2012), Varanasi, Chaukhamba Surbharti Prakashan, Sharir Sthana, chapter 10, REFERENCES verse ,12, Pp. 388 1. Agnivesa: Caraka Samhita: Rev. by 9. P Ghai, editor, Ghai Essential Pediatrics, Caraka and Dradhabala with New Delhi, edition 6th , reprint 2008, Ayurvedipika commentary by CBS Publishers & Distributors, Ch7, Cakrapanidatta: reprint (2011).Varanasi, Pp.140 Chaukhamba Surbharti Prakashan, 10. A Parthasarathy, editor in chief, B Vimana Sthana chapter 1, verse 21-2, Bhat, chapter editor IAP Pp. 235 Textbook of Pediatrics, New Delhi, 2. Agnivesa: Caraka Samhita: Rev. by edition-5th , 2013, Jaypee Brothers Caraka and Dradhabala with Medical Publishers (P) Ltd, Ch 2.3, Pp. Ayurvedipika commentary by 31 Cakrapanidatta: reprint (2011), Varanasi 11. A Parthasarathy, editor in chief, B Chaukhamba Surbharti Prakashan, Sutra Vishnu Bhat, chapter editor IAP Sthana chapter 1, verse 15, Pp. 6 Textbook of Pediatrics, New Delhi, 3. Vrddha Jivaka: Kasyapa Samhita, edition-5th , 2013, Jaypee Brothers revised by Vatsya, with “Vidyotini” Medical Publishers (P) Ltd, Ch 2.3, Pp. Hindi Commentary by Ayurvedalankar 32 Srisatyapala Bhisagacharya, Reprint 12. Agnivesa: Caraka Samhita: Rev. by (2010), Varanasi, Published by Caraka and Dradhabala with Chaukhambha Sanskrit Sansthan, Khila Ayurvedipika commentary by Sthana, Ch 12, verse 4-5 Pp. 316 Cakrapanidatta: reprint (2011), 4. Mishra D.N., Kaumarabhritya, 2nd Varanasi, Chaukhamba Surbharti edition 2008, New Delhi: Chaukhamba Prakashan, Sharir Sthana, chapter 8, Sanskrit Prathisthana, ch 6, pg 123 verse 50, Pp. 350 5. Williams Monier. Sanskrit-English 13. Susruta: Susruta Samhita: with Dictionary. Edition 2002. New Delhi. commentaries Nibandhasamgraha by Munshiram Manoharlal Publishers, P- Dalhana and Nyayacandrika by 417. Gayadasa: edited by Vaidya Yadavji 6. Agnivesa: Caraka Samhita: Rev. by Trikamji Acharya, reprint (2012), Caraka and Dradhabala with Varanasi, Chaukhamba Surbharti Ayurvedipika commentary by Prakashan , Sharir Sthana, chapter 10, Cakrapanidatta: reprint (2011), Varanasi verse 24, Pp. 390

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2013, Jaypee Brothers Medical 31. A Parthasarathy, editor in chief, KN Publishers (P) Ltd, Ch 3.5, Pp. 97 Agarwal, chapter editor IAP Textbook 29. P Ghai, editor, Ghai Essential Pediatrics, of Pediatrics, New Delhi, edition-5th , New Delhi, edition 6th , reprint 2008, 2013, Jaypee Brothers Medical CBS Publishers & Distributors, Ch1, Publishers (P) Ltd, Ch 3.5, Pp. 99 Pp.44 32. P Ghai, editor, Ghai Essential Pediatrics, 30. Mishra D.N., Kaumarabhritya, 2nd New Delhi, edition 6th , reprint 2008, edition 2008, New Delhi: Chaukhamba CBS Publishers & Distributors, Ch1, Sanskrit Prathisthana ch 6, pg 123 Pp.48

How to cite this article: Soni G, Neelam. An analytical study of bal-sanskara W.S.R. to physio- anatomical changes for assessment of developmental milestones. Int J Health Sci Res. 2015; 5(8):563-571.

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