Journal of Ayurveda and Integrated Medical Sciences

Introduction

Urinary tract infections are among the most common infections of childhood^[1] About 2-8% of children suffer from UTI and one- third children with febrile UTI have vesico-ureteric reflux. It is estimated that 2% of boys and 7% of girls have one UTI by 7 years.^[2]

The diagnosis is missed in infants and young children since symptoms are minimally expressed and non-specific. Over 80% of community -acquired UTI is caused by E. coli. Organisms such as Klebsiella, Proteus, Enterobacter, Staphylococcus and Streptococcus faecalis are also identified as the cause for infection.

The symptoms of UTI in younger children are nonspecific and require a high index of suspicion. Recurrent fever, diarrhea, vomiting, abdominal pain, poor weight gain and urinary symptoms such as burning, urgency, frequency, flankpain, turbid urine, recent onset of enuresis are the clinical features.^[3]

Younger age, inadequate antibacterial therapy, recurrent infections, and delayed diagnosis often lead to complications. The condition can be almost correlated to Mutrakricchra in Ayurveda. The disease has been extensively explained by Brihatrayees. Dukhena Mutra Pravrrti - any discomfort /difficulty in urination which is pain dominant is understood as Mutrakricchra.

Diagnosis of Mutrakrcchra in infants is explained in Vedanadyaya of Kasyapa Samhitha.^[4] Mutrakrcchra Chikitsa Adyaya of Kasyapasamhita explains the types and treatment of Mutrakrcchra as Vata, Pitta, Kapha, Raktaja Dwandaja and Sannipataja.^[5]

In all types of Mutrakrcchra - common symptoms are emaciation, uneasiness, anorexia, mood changes, thirst, pain, and depression.^[6]

Materials and Methods

Drug review

Nirgundyadi Kashaya^[7] (Sahasrayoga) Yoga which is mentioned in Sahasrayoga. There are 17 ingredients in the Yoga which are the common drugs in various formulations.

Discussion

Yoga on analysis shows predominantly Laghu, Ruksa Guna; Katu, Tikta, Kashaya Rasas; Usna Virya; Katu Vipaka; Kapha Vatahara, Dipana, Pachana and Krimihara in action.

The Lakshanas of simple UTI can be correlated more to Kaphadika Mutrakrcchra Lakshanas which includes white and thick urine in excess quantity with mild discomfort associated with heaviness and inflammation of Basti.

The vitiated Kapha Pradhana Tridoshas along with the state of Agnimandya invariably produce Ama. The Sama Dosha produces symptoms such as yellowish urine, burning micturition, turbid urine etc. The Rasapanchaka of the Yoga shows its capability to break the Samavastha of Doshas and show significant relief in the symptoms. Thus, the Krimihara Yoga can be effectively used as anti-infective therapy.

Conclusion

The critical analysis of the Yoga offers scope to research works on the clinical efficacy of Nirgundyadi Kashaya in UTI. The Rasapanchaka evaluation explains the Samprapti Vighatana of Mutrakrcchra. Further clinical trials can be carried out to identify the effect of the yoga in specific bacterial colonies. Kashayas can be administered as Sharkara Kalpanas for palatability and easier administration in paediatric age group. This may enhance the acceptability of the medicine in clinical practice in the field of Kaumarabhritya.

References

1. Parthasarathy A.et al. IAP Textbook of Paediatrics, 5thed. Gwalior: IAP National Publication House; 2013.P.825

2. Gupta Piyush. PG textbook of paediatrics,2^nd Newdelhi: Jaypee the health sciences publisher; P.2373

3. Gupta Piyush. PG textbook of paediatrics,2nd ed. Newdelhi: Jaypee the health sciences publisher; P.2373-74.

4. Tewari P V. Kasyapa samhita sutrasthana; vedanadyaya: chapter 25, Verse.21 Varanasi: Chaukhamba viswabharati; 2018. P.55.