Int J Ayu Pharm Chem RESEARCH ARTICLE www.ijapc.com e-ISSN 2350-0204 Clinical Evaluation of the Effect of Vidarikandadi Churna in Balshosh w .s .r. to Protein Energy Malnutrition in Children” 1 2 3 Divya*, Utkarsh Gupta and G.P.Garg 1-3Dept.of Kaumarbhritya, UAU, Gurukul Campus, Haridwar, Uttarakhand, India ABSTRACT Many diseases are known to affect human being including infection, metabolic, genetic and nutritional deficiency disorders. Out of these nutritional diseases are by far most common throughout the world, among them malnutrition is the commonest one. In Ayurvedic text PEM can be correlate with Balshosh. Due to indulgence of atyahaswapna, sheetambusevan, shlaishmikstanyasevan causes vitiation of shleshma. This will lead to mandagni. As a result of mandagni Balshosh occurs. In the present study 49 patients fulfilling the diagnostic and inclusion criteria were randomly divided into 2 groups i.e. 25 patients in Group-A & 24 in Group-B. 9 patients discontinued the treatment. Group-A was treated with vidarikandadichurna (granules) & Group-B with Hyderabad mix (granules). Results obtained after the clinical trial were analyzed statistically. Overall assessment of both drugs was done for both subjective & objective parameters based on the significance of the statistical test. In Group-A, 10% patients had excellent improvement, 70% had marked improvement & 4% had mild improvement. In Group-B, 25% had excellent improvement, 75% had marked improvement. Present study reflects that both the drugs –vidarikandadichurna (granules) and Hyderabad mix (granules) have good outcome on anthropometric index of children but Hyderabad mix showed better improvement. As a result, both vidarikandadichurna (granules) and hyderabadmix (granules) can be adopted as treatment modalities in the management of Balshosh. The study should further be conducted in larger sample size. KEYWORDS PEM, Balshosh, Vidarikandadichurna, Hyderabadmix, Nutrition. Greentree Group Publishers Received 07/06/19 Accepted 02/08/19 Published 10/09/19 ________________________________________________________________ Divya et al. 2019 Greentree Group Publishers© IJAPC Int J Ayu Pharm Chem 2019 Vol. 11 Issue 2 www.ijapc.com 239 [e ISSN 2350-0204] INTRODUCTION . We have selected the drug Nutrition signifies the dynamic process in vidarikandadichurna (granules) to treat which the food is consumed, absorbed, Balshosh. Constituents of metabolized and used for nourishing the vidarikandadichurna (granules) is body1.Adequate food and nutrition are vidarikand, godhum, yava, sharkara and essential for proper growth, physical ghrit. Description of development, optimum work capacity, vidarikandadichurna (granules) is normal reproduction, adequate immunity mentioned in ayurvedic text Yoga and resistance to infections. Ratnakar in balrogaadhikar. This Term malnutrition means to both over medicine is cost effective, easily nutrition as well as under nutrition. available and best suitable for Occasionally, Protein Energy malnourished children. Malnutrition (PEM) & Malnutrition are often used interchangeably with Under AIMS & OBJECTIVES nutrition. 1) To assess the efficacy of There is no specific description and term vidarikandadichurna (granules) on found in our Ayurvedic text for PEM, but Balshosh. some diseases are described by our 2) To draw a comparison of results Acharyas that are symptomatically between the effect of similar to PEM. Balshosh is one of them. vidarikandadichurna (granules) and First independent description of Balshosh hyderabadmix (granules) in Balshosh . is mentioned by Acharya Vagbhata in Asthanga Sangraha with its Nidan, MATERIALS & METHODS Samprapti, Lakshanand Chikitsa.2As per CTRI/2018/07/014702 [Registered on: Acharya Vagbhatanidan of Balshosh are 02/07/2018] - Trial Registered atyahadiwaswapna, sheetambusevan and Prospectively shlaishmikstanyasevanonidanas vitiation PLAN OF STUDY: of shleshma occur. This shleshma cause (A) Selection of Patients obstruction in rasvahistrotas occur. As a Source result mandagni and For the study, Balshosh affected children uttarotardhatukshaya occur. This were screened out clinically from O.P.D. condition is seemed to be as Balshosh. and I.P.D. of P.G. Department of ________________________________________________________________ Divya et al. 2019 Greentree Group Publishers© IJAPC Int J Ayu Pharm Chem 2019 Vol. 11 Issue 2 www.ijapc.com 240 [e ISSN 2350-0204] Kaumarbhritya, Gurukul Campus, UAU, Table 1 Contents of Vidarikandadi Churna Content Proportion Part Haridwar. Used Vidarikandadi 2 Tuber Age Group Godhum 2 Seed Children between 1-6 years were selected Yava 2 Seed Sharkara 6 for the study. Ghrit 1 Water QS Number of Cases Contents of Hyderabad Mix (granules) Total 49 patients of Balshoshwere National Institute of Nutrition- registered out of which 40 patients Hyderabad completed the study while 9 cases It contains wheat, Groundnut, Bengal discontinued at various stages of the Gram and Jaggery4 (As shown in Table study. No,-2) Grouping of Patients Table 2 Contents of Hyderabad Mix (granules) Content Quantity Part Used The cases registered for the study were Roasted Wheat 40gm Seed divided into two groups. Group-A Roasted Ground 10gm Seed Nut comprising of 25 and Group-B of 24 Roasted Bengal 16gm Seed children. 5 patients of Group-A and 4 Gram Jaggery 20gm Q.s. patients of Group-B discontinued. Dose of Drug-1gm/year/day (1gm each Group- A year and increased 1 gm every year up to In this group, trial drug 6 year)5 (Table No.-3) vidarikandadichurna in granules form Table 3 Dose of Drug Year Dose was administered to the patients with 1 to < 2 1gm 2 to < 3 2gm standard diet. 3 to < 4 3gm Group- B 4 to < 5 4gm 5 to < 6 5gm This group of patients were given 6 to < 7 6gm controlled and standard drug, . Standard diet was advised to both hyderabadmix, in granules form with groups according to the present and standard diet. expected body weight for age group with Contents of VidarikandadiChurna due recommendation to fulfil energy and (granules)9-3 protein requirements. Contents of VidarikandadiChurna are Aushadh Seven Kala –Adhobhakt vidarikanda, godhum,yava, Sharkara, (Bhojnouttara) ghrit. (Table No, 1) Route of Administration-Oral ________________________________________________________________ Divya et al. 2019 Greentree Group Publishers© IJAPC Int J Ayu Pharm Chem 2019 Vol. 11 Issue 2 www.ijapc.com 241 [e ISSN 2350-0204] Anupaan- Milk . Patients of Tuberculosis. Type of Study- Single Blind, Discontinuation Criteria Controlled . Patients not willing to continue. Duration of Study- 90 days . Appearance of any severe Follow up- The follow up of complication. the patients will be done at the . Any other severe acute illness. interval of 30 days. Leave against medical advice. Inclusion Criteria . Age between 1-6years. CRITERIA FOR ASSESSMENT . Grade 1 to 3 of The assessment of the trial will be done malnutrition.(I.A.P. on the basis of following parameters. 6 Classification) (1)Subjective . Signs and symptoms of (2)Objective Balshosh as per ayurvedic (1) Subjective Parameters- It included literature. assessment of clinical features of Exclusion Criteria Balshosh, Karshya as per ayurvedic text- . Exclusion Criteria . Arochaka(loss of appetite) . Patients with the evidence of Krimi & . Pratishyaya(Rhinitis) Grahanidosha will treated with medicine . Jwar(Fever) first and then, they will be included in . Kasa(Cough) this study. Shushyati(Poor weight gain) . Congenital anomalies. Shukla MukhaAkshi(pallor) . According to IAP classification, more . SnigdhMukhAkshi than 80% of expected body weight . Shushkta in Gluteal, Abdominal and (normal) and less than 50% weight for Neck region age (PEM grade IV) will be excluded. DhamniJalDarshan . Chronic diarrhea / malabsorption . Appearance syndrome. (2) Objective Parameters- The . Patients having systemic disorders, objective assessment will be done on the neurological disorders, endocrinal basis of anthropometric parameters, disorders& anatomical defects were hemato logical parameters and excluded. biochemical parameters. Juvenile Diabetes Mellitus. ________________________________________________________________ Divya et al. 2019 Greentree Group Publishers© IJAPC Int J Ayu Pharm Chem 2019 Vol. 11 Issue 2 www.ijapc.com 242 [e ISSN 2350-0204] (A) Anthropometric Parameters- between the mean of subjective . Weight in kg parameters of both the group. Height in cm Unpaired t-Test was applied to test . Chest circumference the significance difference between the . Abdominal circumference mean of objective parameters of both the . Mid upper arm circumference group. Mid calf circumference . Head circumference OBSERVATIONS (B)Hematological Parameters In the present study total 49 patients . Hb%, TLC, DLC, ESR, Mountoux test were registered. Among them, 25 were in if necessary. Group-A and 24 were in Group-B. In (C)Biochemical Parameters- Group-A, 5 patients Left Against Medical . Urine (routine/microscopic) Advice (LAMA). Whereas in Group –B, . Stool examination 4 patients LAMA. Hence, a total 40 (routine/microscopic) patients were registered.85% patients Observation- were Annad from Group-A and 100% The observations of patients were done were from Group-B whereas 15% were before, during and after completion of Ksheerannad from Group-A and nothing treatment. was found in Group-B. Sex wise Statistical Analysis distribution showed that in Group A 55% Statistical calculation was done by the were male 45% females from Group-A & SIGMA STAT software and GRAPH 50% from Group-B whereas patients PAD software.