Introduction
A 5 year-old male patient came to our hospital with complaints of difficulty in conversations, lack of eye contact, delayed speech development, poor social interaction, poor eye contact, repetitive hand movements, hyperactivity and not interested in peer group play. Patient was Vata-Pitta Prakriti with Avara Samhanana, Avara Vyayama Shakthi, Avara Satva and Avara Ahara & Jarana Shakthi.
Diagnosis assessment
Antenatal history: Baby born out of non-consanguineous parents. Mother’s age at time of birth was 33 years, and father aged 37 years. Birth history: Normal full-term forceps delivery at hospital. Baby cried immediately after birth, with no history of fetal distress, and birth weight was 3.150 kg. There was no history of seizures, pathological jaundice, hypoglycaemia, meningitis, etc. No family history of such a condition was found. Clinical findings and diagnostic assessment. Appearance of patient seemed to be irritated along with repetitive behavior, hyperactivity, lack of social communication, poor eye contact, poor cognition and only concentrate in his interested areas. Patient was conscious but not well-oriented of time, place, or person. He was inattentive and had lack of concentration. Milestones were normal up to age of 2 years and later onwards became slow and regressive in nature. Fine motor, social and communication, and language and speech development of patient were delayed. Higher mental functions were poor. Cardiovascular, respiratory, and abdominal examination was normal. He had irregular abdominal pain after taking food. Appetite was good but had poor digestion and undigested food particles present in stools. Sleep was normal. Indian scale for assessment of autism (ISAA) test manual was used to diagnose condition.
Intervention
Table 1: Internal medicines
| Medicines | Dose | Anupanam | Time |
|---|
| Kalyanakam Kashayam[1] | 10 ml | 30 ml warm water | Morning and evening before food |
| Rajanyadi Choornam[2] | 5 gm | Honey and ghee | Morning and evening before food |
| Vilwadi Gulika[3] | 1 | Tulsi Swarasam | Morning and evening after food |
| Saraswatharishtam[4] with gold | 5 ml | Nil | Morning and evening after food |
| Avipathi Choornam[5] | 5 gm | Warm water | Bed time |
Table 2: External therapies
| Abhyangam | Lakshadi Thailam[6] | 7 days |
|---|
| Thalapothichil | Panchagandha Choornam[7] + Takram | 7 days |
| Shasthikashali Pinda Swedam | Bala Kashayam | 7 days |
Pathya advised
It was advised to consume food which is less spicy, less oily, and easily digestible. That should be consumed at the proper time. GFCF[8] (gluten free and casein free) diet was advised to follow.
Follow-up and outcomes
All the procedures were monitored at the Panchakarma unit. A good response to treatment was noticed. The digestive and bowel complaints were relieved and considerable improvement noticed in communication skills and hyperactivity. ISAA score was reduced to 119 from 127.
Table 3: Indian scale for assessment of autism test manual (ISAA)[9]
| Domain | No. of questions | BT | AT |
|---|
| Social relationship and reciprocity | 9 | 34 | 30 |
| Emotional responsiveness | 5 | 19 | 17 |
| Speech-language and communication | 9 | 24 | 22 |
| Behaviour patterns | 7 | 28 | 24 |
| Sensory aspects | 6 | 12 | 8 |
| Cognitive component | 4 | 10 | 8 |
| Total score | 40 | 127 | 119 |
Discussion
Ayurveda therapy has been carried out to manage this condition and is presented in this case report. Deepana-Pachana, Anulomana and Vishagna medications were given as the child had complaints of digestive complaints. The appetite was improved and constipation was relieved. There was no adverse effect observed. The Kalyanaka Kashayam was given for improving Vak (speech), Medha (intellect), Smruti (memory), and Agni (digestive factors). Avipathy Choornam was prescribed for reducing hyperactivity. Saraswatharishtam was given for improving cognitive functions. Abhyangam was performed to alleviate Vata dosha. Talapothichil with Panchagandha Choornam was done for 7 days for alleviating the Pitta and Vata thereby reducing hyperactivity and for improvement of cognitive functions. Shashtikasali Sweda was done to improve the body strength and Vata Samana.
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