E-ISSN:2456-3110

Research Article

Ghanavyoshadi Khanda

Journal of Ayurveda and Integrated Medical Sciences

2022 Volume 7 Number 7 August
Publisherwww.maharshicharaka.in

A randomized comparative clinical study to evaluate the effect of Ghanavyoshadi Khanda over Vidarikandadi Khanda in Karshya w.s.r. to Underweight Children

Aparna K.1*, Puranik P.2, Nagaratna S.3, Shetty S.4
DOI: http://dx.doi.org/10.21760/jaims.7.7.2

1* KP Aparna, 3rd Year Post Graduate Scholar, Dept. of Kaumarabhritya, Shri Dharmasthala Manjunatheshwar College of Ayurveda, Udupi, Karnataka, India.

2 Prathviraj Puranik, Guide, Professor & HOD, Dept. of Kaumarabhritya, Shri Dharmasthala Manjunatheshwar College of Ayurveda, Udupi, Karnataka, India.

3 SJ Nagaratna, Co-Guide & Assistant Professor, Dept. of Kaumarabhritya, Shri Dharmasthala Manjunatheshwar College of Ayurveda, Udupi, Karnataka, India.

4 Sandesh Shetty, Assistant Professor, Dept. of Swasthavritta, Dept. of Kaumarabhritya, Shri Dharmasthala Manjunatheshwar College of Ayurveda, Udupi, Karnataka, India.

Background: Undernutrition is one of major causes of increased morbidity & mortality among children. One of most emerging issues in present scenario is having long-term effects on physical & cognitive development. Underweight is one of cardinal determinants of under nutrition. According to a 2019 report, India is ranked 102 out of 119 countries. As per NFHS 4 in India shows 35.7% under 5 children were underweight, 38.4% were stunted & 21% were wasted. Karshya is an Apatarpana Janya Vyadhi. The trial was proposed to study comparative effect of Ghanavyoshadi Khanda & Vidaryadi Khanda by using specific parameters for Karshya w.s.r. to underweight. Objective: To evaluate comparative effect of Ghanavyoshadi Khanda over Vidarikandadi Khanda in management of Karshya. Materials & Methods: Children of age group 2-5 years were selected from Kaumarabhritya OPD of SDM College of Ayurveda & Hospital, Udupi, also from nearby Anganwadi’s & preschool of Udupi. Selected subjects were randomly allocated into 2 groups of 15 patients each. Group A will be administered with Ghanavyoshadi Khanda along with Sukoshna Ksheera as Anupana twice daily before food and group B with Vidarikandadi Khanda along with Sukoshna Ksheera as Anupana twice daily after food for 1 month. Results: Children showed improvements in all aspects of Karshya w.s.r. to underweight like weight, height, MUAC, & BMI. Both groups showed highly significant improvement in Kshut, Abyavarana Sakti & significant changes in Badhavitt. Insignificant changes in Alpapranaschakriya, Pipasa & Nidra. Conclusion: It was concluded clinically consumption of Ghanavyoshadi Khanda & Vidaryadi Khanda along with Sukoshna Ksheera are equally effective in the management of Karshya w.s.r. to underweight in children.

Keywords: Undernutrition, Ghanavyoshadi Khanda, Vidaryadi Khanda, Karshya, Underweight

Corresponding Author How to Cite this Article To Browse
KP Aparna, 3rd Year Post Graduate Scholar, Dept. of Kaumarabhritya, Shri Dharmasthala Manjunatheshwar College of Ayurveda, Udupi, Karnataka, India.
Email: 		KP Aparna, Prathviraj Puranik, SJ Nagaratna, Sandesh Shetty, A randomized comparative clinical study to evaluate the effect of Ghanavyoshadi Khanda over Vidarikandadi Khanda in Karshya w.s.r. to Underweight Children. J Ayu Int Med Sci. 2022;7(7):10-19.
Available From
https://jaims.in/jaims/article/view/1917

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2022-06-27 2022-06-28 2022-07-05 2022-07-12 2022-07-19
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
Nil Nil Yes 19%

© 2022by KP Aparna, Prathviraj Puranik, SJ Nagaratna, Sandesh Shettyand Published by Maharshi Charaka Ayurveda Organization. This is an Open Access article licensed under a Creative Commons Attribution 4.0 International License https://creativecommons.org/licenses/by/4.0/ unported [CC BY 4.0].

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Introduction

Ayurveda, the Vedic science deals with preventive & curative measures which promote a healthy long life. Kaumarabhritya, one of the branches of Astanga Ayurveda deals with complete nutrition as well as the health of child.[1] Growth is a fundamental character & an indicator of optimum health of child.[2]

Nutrition is the process by which living organisms assimilate food & use it for growth, metabolism & replacement of tissues. Food is considered the foundation of good health & disease-free life. Human growth & development require both nutritional & psychosocial support. The body is nourished by 3 processes digestion, absorption & transport. Mechanical digestion by mastication & movement of food to GIT by peristalsis; chemical digestion by enzymatic action. Absorption involves the passage of food nutrients from the intestine to the mucosal lining of the intestinal wall. The absorbed nutrients are transported throughout the body by blood circulation.[3]

Adequate food & nutrition are essential for proper growth & development, optimum work capacity, normal reproduction, adequate immunity & resistance to infection.[4] Good health depends on adequate food supply which depends on sound agricultural policy, food distribution & proper health education. A solid healthy youth with a developed body, mind & brain in the basement for a great future.[5]

Undernutrition is one of the most widespread health & nutrition problems. It causes disease & disability in children that prevents them from reaching full intellectual & productive potential.[6] Ayurveda explains multiple diseases which occur due to derangement in the multiple developing systems of a child under the heading of Kuposhanajanya Vyadhi. This can be described under these heading – Dushta Stanyapana Janya Vikaras, Garbhaja Phakka Roga, Vyadhija Phakka, Parigarbika, Karshya. All these conditions finally lead to failure in growth & development. The child fails to acquire locomotor stability with inadequate neuromuscular coordination.

Underweight is one of the cardinal determinants of under nutrition. It means the children who are malnourished but don’t possess any symptoms of

kwashiorkor & marasmus or the weight of child less than -2 standard deviation at her/ his age on the WHO growth chart. Due to a complex interplay of interacting & related factors in the individual, family & community like poverty, ignorance, illiteracy, early weaning, poor hygiene, maternal malnutrition, high birth rate, and inadequate medical facilities.[7]

Undernutrition is a widespread health problem having international consequences because it is an essential determinant of wellbeing. In India, childhood under nutrition is an underlying cause of 45% of all death among under 5 children. According to a rapid survey of children- in 2014 about 29% of Indian children are underweight.[8] According to NFHS (2015-2016) survey, about 36% of Indian children are underweight.[9] The Global Hunger Index -2017 reported by the International Food Policy Research Institute, in which India is ranked 100th out of 119, shows a very low state of hunger.[10]

Pre-school age is a dynamic period of physical development as well as mental development of the child. The mortality rate in this age group is significantly high due to increased susceptibility to infection, frequent episodes of illness & longer recovery period.[11] The risk of under nutrition is more in 2 years of life because they are weaned from the breast & mother loses the ability to produce enough milk to maintain the nutrient demand of a growing child.

Ayurveda considers Ahara, Nidra, and Bramacharya as the 3 supporting pillars of the body throughout its lifetime by providing Bala, Varna, and Upachaya.[12] Out of this Ahara is given the foremost & prime importance. It is said to be the life of all living beings. Acharya Kashyapa, considers Ahara as Mahabhaishajyam, which is responsible for the growth, development, and enhancement of Ojas.[13] Acharya Vagbatta opines consumption of Alpamatra Ahara will lead to Vata Vikaras, Ojonasha.[14] Food is the cause of stability for all living beings. Proper maintenance of the power of digestion also depends on the proper diet. Bala, Arogya, Ayu, and Prana are totally dependent on Agni.[15] Proper metabolism of Annapana act as fuel for the Jwalana of Agni.

As per contemporary science, diet modification is the only way to manage underweight children. Our Acharyas have stressed the properties of drugs possessing Deepana, Pachana & Vatanulomana


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as per the treatment & also explained various medical formulations possessing the same properties which improve the appetite, proper digestion & assimilation of the ingested food in the children thereby balancing the nutritional requirements, immunity thus enhancing the overall health. Ayurveda put forth the measures to improve the Vyadhikshamatawa like Rasayana, Lehana, Stanya, Samskaras, Jeevaniya, Balya, Vayastapana, Hitahara upayoga, Deepana, Pachana drugs.

Hence, the present study intends to evaluate the effect of Ghanavyoshadi Khanda & Vidarikandadi Khanda in underweight children, as the drugs are having the Deepana, Pachana & Vatanulomana properties it will improve the digestive capacity, helps in assimilation & absorption of food. The ultimate aim of the study is to improve the digestive thereby improving body weight.

Objectives

1. To evaluate the effect of Ghanavyoshadi Khanda in the management of Karshya.

2. To evaluate the effect of Vidarikandadi Khanda in the management of

3. To evaluate the comparative effectiveness of Ghanavyoshadi Khanda over Vidarikandadi Khanda in the management of Karshya.

Materials and Methods

Source of data

Children of age group 2-5 years, were selected from Kaumarabhritya OPD of SDM College of Ayurveda & Hospital, Udupi, also from nearby Aganwadi’s & preschool of Udupi.

Study design

An open-labelled double-arm prospective clinical study with pre-test & post-test design.

Method of collection of data

30 children were randomly divided into 2 groups, Group A – Ghanavyoshadi Khanda (study group) & group B- Vidaryadi Khanda (control group) with 15 children each.

Inclusion criteria

  • The children of either gender between the ages of 2-5 years.
  • Weight of child less than expected as per the age i.e., Grade 1 (71-80%) and Grade 2 (61-70%) according to IAP classification of Malnutrition.
  • Clinically stable children having 2 or more symptoms mentioned under diagnostic criteria.
  • BMI of 15-18.5%.

Exclusion criteria

  • Children with Grade 3 (51-60%) and Grade 4 (<50%) malnutrition.
  • Children having other acute & chronic systemic illnesses or requiring emergency management.
  • Children with developmental disorders like cerebral palsy, intellectual disability etc.
  • Children with an inborn error of metabolism, congenital abnormalities.
  • Children with neurobehavioral disorders like ADHD, autism etc.

Assessment criteria

Subjective criteria[16]

  • Kshut (state of hunger)
  • Abhyavarana Shakti (capacity to eat)
  • Alpapranacha Kriya (interest in activities)
  • Baddhavit (irregular bowel habits)
  • Pipasa (thirst)
  • Nidra (sleep)

Objective criteria

  • Anthropometric Parameters
  • Weight (in kg)
  • Height (in cm)
  • Mid arm circumference (in cm)
  • Chest circumference (in cm)
  • BMI

Intervention

Drug: Ghanavyoshadi Khanda & Vidaryadi Khanda

Drug source: GMP certified SDM Pharmacy, Udupi.

Collection & Standardization of raw drug: The ingredients were obtained from S.D.M Pharmacy. Macroscopy, microscopy & HPTLC of the ingredients were done at Sri Dharmastala Manjunatheshwara centre for research in Ayurveda & allied science, Udupi.


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Dose: Dose is fixed by considering the age & adult dose, by applying young’s formula.

For a 2- year child- 4 g twice daily

For a 3-year child- 5g twice daily

For a 4-year-old child- 6 g twice daily

For a 5-year-old child- 7 g twice daily

Anupana: Sukhoshana Ksheera was advised as Anupana.

Duration of stud: Total duration of study is 2 month, 1 - month intervention next month follow up.

Period of Assessment: The child was assessed before treatment (day 0), after treatment (day 30) & followed by follow-ups on 60th day.

Statistical methods: Statistical analysis was carried out using the statistical package for social science (SPSS) VER.20.

Observations

Among 30 children, 44% of children belong to the 4-5 age group can be due to schooling & were more exposed to the sources of infections and allergens which may negatively impact their health status. 96% of children had reduced appetite; due to Nidana, Agni has hampered.

So, the craving for food will be reduced. Refusal of food is an indicator of the status of Agni. 93.3% of subjects were poorly built. Krishata is the result of Shoshana of Rasadhatu causing Shoshana of Mamsa Dhatu in the Sareera. Most of the subject (53.5%) in the study suffers from altered bowel habits. It can be due to low quality & quantity of food, low fibre content food and poor sanitation & drinking facilities. 21 (70%) subjects had a history of previous illness / hospitalization.

Research explains underweight is associated with impaired gut functions, low level of plasma component, atrophied thymus etc.[17]

Hence, they will be prone to infections. 92% of children were consuming food in Hina Matra. Acharya has quoted that Hina Matra Ahara can lead to different types of Vata Vikaras & ultimately hampers Bala & Ojas. 24 (80%) had already taken deworming medicine before the study.

The study reveals that maybe worm infestation was not the main pathology behind under nutrition. 3 (10%) mothers had a history of infection/ disease- a history of vaginal infection, gestational diabetes, and anaemia. 9 (30%) subjects’ mothers were moderately nourished.

They have reported a deficiency of iodine, iron & folate. Out of this, 5 subjects were premature, with low-birth-weight babies, with a history of long hospital stay. 8 (26.6%) children were SGA; the majority of the children were born healthy and later they developed Karshya, therefore, the Dosha Balapravrita factor has played a larger part than the other factors. Only 4 subjects were given top feeds in initials of birth due to some maternal illness, reduced milk production & caesarean section. 26 are breastfed in this study, it does not have an impact on Karshya.

Early initiation of breastfeeding will act as a complete nutrient to the baby, provide warmth, promote bonding, prevents hypoglycaemia & hypothermia, increases the level of antibodies, immunity etc. Weaning age plays a crucial role in being underweight.

Among 30 children, 2 (6.6%) children in the 5th month 14 (46.6%) children in the 6th month, 5 (16.6%) in the 7th month, 7 (23.3%) in the 8th month & 2 (6.6%) children on 9th month. Early & late introduction of complementary feeds reflects in under nutrition.

Results

Effect of treatment on Subjective parameters

Within the group

1. Kshut

Table 1: Shows effect of Kshut within the groups

Parameter Negative Ranks Positive Ranks Ties Total Z value P-value Inference
N MR SR N MR SR
Ghanavyoshadi Khanda
BT-AT 15 8 120 0 0.0 0.0 0 15 -3.53 0.00 HS
BT-FU 15 8 120 0 0.0 0.0 0 15 -3.53 0.00 HS
Vidaryadi Khanda
BT-AT 15 8 120 0 0.0 0.0 0 15 -3.50 0.00 HS
BT-FU 15 8 120 0 0.0 0.0 0 15 -3.58 0.00 HS



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2. Abhyavaharana Sakti

Table 2: Shows the effect of Abhyavaharana Sakti within the groups


Parameter Negative Ranks Positive Ranks Ties Total Z value P-value Inference
N MR SR N MR SR
Ghanavyoshadi Khanda
BT-AT 10 5.5 55 0 0.00 0.0 5 15 -3.16 0.002 S
BT-FU 10 5.5 55 0 0.00 0.0 5 15 -3.16 0.002 S
Vidaryadi Khanda
BT-AT 3 2 6 0 0.00 0.0 12 15 -1.7 0.083 S
BT-FU 3 2 6 0 0.00 0.0 12 15 -1.7 0.083 S


3. Badhavitt

Table 3: Shows the effect of Badhavitt within the group


Parameter Negative Ranks Positive Ranks Ties Total Z value P value Inference
N MR SR N MR SR
Ghanavyoshadi Khanda
BT-AT 4 2.5 10 0 0.0 0.0 11 15 -2.0 0.04 S
BT-FU 4 2.5 10 0 0.0 0.0 11 15 -2.0 0.04 S
Vidaryadi Khanda
BT-AT 7 4.5 31 0 0.0 0.0 7 15 -2.1 0.034 S
BT-FU 7 4 28 0 0.0 0.0 8 15 -2.6 0.008 S


Subjective Parameter between the Groups

1. Kshut

Table 4: Shows effect of Abhyavarana Sakti between the groups


Parameters N Ghana Vyoshadi (N) Vidaryadi (N) Mean rank Sum rank U Z P Interpretation
BT-AT 30 15 15 13.73 17.2 206 259 86 -1.28 0.2 NS
BT-FU 30 15 15 13.73 17.2 206 259 86 -1.28 0.2 NS

2. Abhyavarana Sakti

Table 5: Shows effect of Abhyavarana Sakti between the groups


Parameters N Ghana Vyoshadi (N) Vidaryadi (N) Mean rank Sum rank U Z P Interpretation
BT-AT 30 15 15 12 19 180 285 60 -2.5 0.01 S
BT-FU 30 15 15 15 15 232.5 232.5 112 0.00 1 NS


Objective Parameter

1. Weight

Table 6: Shows effect of weight both the groups


Weight (Mean score group A) N SD S.E.M Mean difference % T P Interpretation
BT AT 15 0.26 0.67 -0.48 3.9 7.08 0.00 HS
12.1 12.6
BT FU 15 0.29 0.77 -0.75 5.9 9.73 0.00 HS
12.1 13.0

 

Weight (Mean score group B) N SD S.E.M Mean difference % T P Interpretation
BT AT 15 -0.43 0.47 -0.43 3.3 9.1 0.00 HS
13.0 13.4
BT FU 15 -0.74 0.56 -0.74 5.6 13.1 0.00 HS
13.0 13.7

2. Height

Table 7: Effect of height


Height (Mean score group A) N SD S.E.M Mean difference % T P Interpretation
BT AT 15 0.271 0.070 -0.17 0.17 2.4 0.027 S
95.6 95.7
BT FU 15 0.275 0.071 -0.20 2.0 2.8 0.014 S
95.6 95.8

 

Height (Mean score group B) N SD S.E.M Mean difference % T P Interpretation
BT AT 15 0.10 0.028 0.07 0.07 2.5 0.022 S
99.3 99.4
BT FU 15 0.27 0.94 0.18 0.18 2.5 0.022 S
99.3 99.4

3. Mid upper arm circumference (MUAC)

Table 8: Effect of midarm circumference on both groups.


MUAC (Mean score group A) N SD S.E.M Mean difference % T P Interpretation
BT AT 15 0.507 0.83 0.086 0.52 4.02 0.001 HS
15.10 15.18
BT FU 15 0.501 0.129 0.180 1.0 4.32 0.001 HS
15.1 15.28


 


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MUAC (Mean score group B) N SD S.E.M Mean difference % T P Interpretation
BT AT 15 0.94 0.243 0.12 0.77 4.9 0.00 HS
15.4 15.5
BT FU 15 0.96 0.248 0.17 1.1 6.9 0.00 HS
15.4 15.6

4. Body mass index (BMI)

Table 9: Effect of BMI in Ghanavyoshadi Khanda

BMI (Mean score group A) N SD S.E.M Mean difference % T P value Interpretation
BT AT 15 0.37 0.237 0.55 1.3 5.7 0.00 HS
15.01 15.23
BT FU 15 0.34 0.259 0.80 1.9 8.9 0.00 HS
15.01 15.3

 

BMI (Mean score group B) N SD S.E.M Mean difference % T P Interpretation
BT AT   15 1.8 0.507 0.4   1.8 .507 HS
15.3 15.6
BT FU 15 1.9 0.509 0.5 2.6 -5.9 0.00 HS
15.3 15.7

Objective Parameters between the Groups

1. Weight

Table 10: Shows the comparative effect on weight

Weight Group N M.D S.E.M T P Interpretation
BT-AT Ghanavyoshadi 15 0.48 0.06 0.56 0.57 NS
Vidaryadi 15 0.43 0.04
BT-FU Ghanavyoshadi 15 0.82 0.09 0.66 0.51 NS
Vidaryadi 15 0.74 0.05

Effect of treatment on Subjective parameters

Within the groups - statistically, both showed highly significant changes in Kshut, Abhyavarana Shakti & significant changes in Badhavitt. Insignificant changes in Nidra, Pipasa & Alpapranaschakriya. Between the groups, statistically both the groups are showing non-significant. But clinically both groups are showing significant improvements in the management of Karshya.

Discussion

Undernutrition is one of the major causes of increased morbidity & mortality among children. One of the most emerging issues in the present scenario is having long term effects on physical & cognitive development.[18]

Undernutrition is defined as a condition where the body lacks the required amount of nutrition due to insufficient intake or improper intake of food that lacks nutrients. It includes stunting-low height for age, wasting- low weight for height & underweight -low weight for age.[19]

Globally, about 667 million under 5 children are malnourished. Out of this 159 million, were stunted, 41 million were overweight, and 50 million were wasted.[20] In South Asia, India is one of the most affected countries. Annually International food policy & research institute publishes the global hunger index.

According to a 2019 report, India is ranked 102 out of 119 countries.[21] As per NFHS 4 in India shows 35.7% under 5 children were underweight, 38.4% were stunted & 21% were wasted.[22] In developing countries like India, the nutritional status of children depends on socioeconomic status, awareness of diseases, parent’s education, safe drinking facility & hygienic sanitation facilities.[23]

The impact of covid 19 further intensifies the condition. Countrywide lockdown led to the sudden cessation of the economy & triggered unemployment. People started to purchase less food, food with low nutritious contents & skip the number of meals in a day. The hindrance to the food supply, labor shortage, and limited production affect pregnant women & children adversely. All these factors lignite the under nutrition & lowers immunity which further made them prone to infections. So, to cope with this condition more administrative & political support is required.[24]

Ahara is the most important factor for the survival of life. It is described as the supreme pillar among Trayopasthambha which supports & balances life.[25] Food is considered a Pranadha / life supporter. Acharya Kashyapa elaborated Ahara as Mahabhaishajya - by proper administration of food, it is possible to cure hundreds of diseases.[26] Ayurveda described Ahara & Vihara as the major causes of every disease.

Ayurveda has described numerous diseases under an umbrella term - Kuposhanajanya Vyadhi. This can be described under these heading - Dushta Stanyapana Janya Vikaras, Garbhaja Phakka Roga, Vyadhija Phakka, Parigarbika, Karshya. Karshya is one of the nutritional disorders explained in the classics.[27]


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It is described as an Apatarpanajanya Vyadhi. There is no direct reference for Karshya in Bala. Most Acharyas are considered a symptom of the disease / condition. Karshya is an Apatarnajanya Vyadhi & Rasa Pradoshaja Vyadhi. It is the nutritional disorder explained in the classics. Acharya Charaka is described under Asthanindhita Purusha.[28] Acharya Kashyapa mentioned the Vyadhija Phakka.[29] which can be related to Malnutrition. Acharya Vagbhata is described as Balashosha & Ksheeraja phakka.[30] Similarly, in Astanga Samgraha is mentioned as Parigarbhika & Garbhaja Phakka[31] caused by a child on feeding breast. Charakacharya opines it as a Vataja Stanyadushtivikara[32] Susruthacharya in Sutra Stana mentioned that due to excessive intake of dry food, fasting, low caloric diet, excessive, forcible/ voluntary control of natural urges, loss of sleep, fear, etc, derangement of Agni occurs which hampers the production of Rasadhatu in terms of quantity and quality.[33]

The etiological factors of Karshya aggravate Vayu which ultimately vitiates the Agni causing Mandya of Agni, subsequently leading to the formation of Ama. Following the absorption of Ama into the system from the gastrointestinal tract, the body considers the Ama as a toxic material and spread throughout the body channels. Ama having the quality of Daurgandhatva, Picchilatva, Tantumatva, and Guruta, obstructs the Srotas.[34] Due to, the movement of Ama the nutritive materials cannot reach their destination. Ultimately there is a hindrance in the sequence of formation of Dhatus. Consumption of food that is of no nutritive value is incapable to form Raktadhatu. This sequential malformation / degeneration of Dhatu ultimately lead to Karshya.

Ghanavyoshadi Khanda

Acharya Vagbhatta has mentioned Ghanavyoshadi Khanda in Uttara Stana 2nd chapter in the management of Karshya. It is a combination of Ghana, Shunti, Pippali, Maricha, Patha, Murva, Satavari, Payasya, and Prithakparni.

  • Majority of the drugs are having Madhura Vipaka with predominant of Prithvi & Jala Mahabhuta. Having the qualities like Brimhana, Jeevana, and Preenana. It is considered as Ajanmyasatmya at all stages of life & helps in
  • Most of the drugs are having Snigdha Guna which is Kledana, Mardava in nature & improves the Bala & Varna.
  • Trikatu drugs are having Katu Rasa, Ushna Veerya & having the qualities like Deepana, Pachana, Rasayana, Vrishya, Rechaka & Krimigna property.
  • Payasa, Satavari & Prithakparni are having Madhura Rasa, Madhura Vipaka, Sheeta Veerya, Snigdha Guna. They are having the qualities like Pushti Vardhaka, Rasayana, Medya, Balya.

Vidaryadi Khanda

Yoga is mentioned in Yogaratnakara Balaroga Adhikara. Drugs used in this formula are Vidarikanda, Yava, Godhuma & Pippali.

Acharya Charaka rightly advised the administration of Mridu Samshodhana. Considering the fact Brimhana therapy in the form of Vidarikandadi Churna has been given.

  • Pippali enhances the Agni and does the Deepana, Pachana and Srotoshodhana.
  • Probable mode of action of Brimhana Dravya's can be accessed by Guna Panchaka. The majority of ingredients have a predominance of Guru, Snigdha, Shita and Manda Guna, Madhura Rasa and Madhura Vipaka causing Dhatuvardhana, Rasayana
  • The research on Vidarikanda suggests significant anxiolytic and anti-stress properties, Vidarikanda has immunomodulatory and anti-oxidant, cardioprotective, hypolipidemic, hepatoprotective, neuroprotective, and nootropic properties.

Result

Children showed improvements in all aspects of Karshya w.s.r. to underweight like weight, height, MUAC, & BMI. Both the groups showed highly significant improvement in Kshut, Abyavarana Sakti & significant changes in Badhavitt. Insignificant changes in Alpapranaschakriya, Pipasa & Nidra.

Conclusion

Both drugs were seen with positive results in the management of Karshya especially Kshut, Abhyavara Sakti, Badhavitt.

Hence, it can be concluded that both drugs with proper dosage according to the age helps to improve in gaining weight; proper growth & development.


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