Kuposhanjanya Vyadhies (Balashosha) in Children w.s.r. to P.E.M.

[Full title: Kuposhanjanya Vyadhies (Balashosha) in Children w.s.r. to P.E.M. : A Literary Review]

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[Find the meaning and references behind the names: Sandhu, Meet, Low, Mar, Asia, Chaudhary]

REVIEW ARTICLE Mar-Apr 2020 Journal of Ayurveda and Integrated Medical Sciences | Mar - Apr 2020 | Vol. 5 | Issue 2 166 Kuposhanjanya Vyadhies ( Balashosha ) in Children w.s.r. to P.E.M. : A Literary Review Dr. Kulvinder Sandhu 1 , Dr. Minakshi Chaudhary 2 1 MD Kaumarbhritya, Ayurvedic Medical Officer, Himachal Pradesh, 2 Sr. Lecturer, Dept. of Kaumarbhritya, R.G.G.P.G.A.C. Paprola, Himachal Pradesh, INDIA. I NTRODUCTION Protein-energy malnutrition (PEM) is a form of malnutrition that is defined as the range of pathological conditions arising from coincident lack of dietary protein and/or energy(calorie) in varying proportions [1] PEM is an important nutritional problem among preschool age children. It is a range of condition occurring when intake of one or more nutrients doesn’t meet the requirements. It is not only the deficiency of proteins but inappropriate food Address for correspondence: Dr. Kulvinder Sandhu MD Kaumarbhritya, Ayurvedic Medical Officer, Himachal Pradesh, INDIA. E-mail: kulvinder 1315@yahoo.com Submission Date: 14/03/2020 Accepted Date: 22/04/2020 Access this article online Quick Response Code Website: www.jaims.in Published by Maharshi Charaka Ayurveda Organization, Vijayapur, Karnataka (Regd) under the license CCby-NC-SA (low in energy density, protein and micronutrients, Vitamin A, Iron, Zinc) both quantitatively and qualitatively. Nutrition is a basic human need that remains unmet for vast numbers of children, who are thus unable to achieve their full genetic development potential. Although it is more common in low-income countries, children from higher income countries are also affected, including children from large urban area in low socio-economic neighbourhoods. More than 1/3 of the world’s population is affected. For all indicators of PEM, a total of 80% of the children affected live in Asia (mainly in southern Asia). 43% of children in developing countries are stunted. 50% of child deaths in developing countries are related to malnutrition [2] Undernutrition makes the child susceptible to infection and complements its effects in contributing to child mortality. This effects for 22% of the burden of disease in India and adversely effects the economic growth of the country with an estimated health productivity loss of 1.4% of GDP. A B S T R A C T Nutrition is a basic human need that remains unmet for vast numbers of children, who are thus unable to achieve their full genetic development potential. Abnormal nutrition may cause both over and under nutrition hazards. It causes more than half of the nearly 11 million deaths each year among children under age five. Nutritional deficiency disorders are viewed under Kuposhanjanyavyadhies. Ancient Acharyas explained diseases related to nutritional deficiency disorders such as Phakka, Parigarbhika, Balashosha etc. in different Samhita . Ayurveda - the ancient science of life emphasizes on diversified aspects of dietetics and nutrition viz. Quality, quantity, processing methods, rationale of combination of food articles, emotional aspects, nature of the consumer, geographical and environmental conditions etc. Which are pivotal in preservation and promotion of health and prevention of disease. Health promoting regime ( Pathya Vyavastha ) is the hallmark of Ayurvedic therapeutics. Specific diet and lifestyle guidelines are always prescribed along with the drugs and therapies to facilitate restoration of homoeostatic bio-mechanisms ( Dhatu-Samyata ) and wellbeing. Key words: Kuposhanjanya Vyadhies, Nutritional deficiency disorders, Balashosha.

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[Find the meaning and references behind the names: Gomez, Vega, Rasa, Rupa]

Dr. Kulvinder Sandhu et al. Kuposhanjanya Vyadhies (Balashosha) in Children w.s.r. to P.E.M. : A Literary Review ISSN: 2456-3110 REVIEW ARTICLE Mar-Apr 2020 Journal of Ayurveda and Integrated Medical Sciences | Mar - Apr 2020 | Vol. 5 | Issue 2 167 Classification of PEM PEM is a spectrum of conditions ranging from growth faliure to overweight, marasmus or kwashiorkor. Various classifications are given [3] 1 IAP classification 2 Welcome Trust or International Classification 3 Gomez’s Classification 4 Syndromal Classification ▪ Kwashiorkor ▪ Nutritional marasmus ▪ Marasmic Kwashiorkor ▪ Pre-kwashiorkor ▪ Nutritional dwarfism Nidana (Etiology) The etiological factors of nutritional deficiency disorders can be broadly classified under as: 1. Aharaja Ruksha Annapana, Langhana, Alpashana, Pramitasana, Anashana, excessive intake of Kashaya, Katu and Tikta Rasa. 2. Viharaja Kriya Atiyoga, Vega Nighraha, Ati Adhyayana, Langhana, Atibharagamana. 3. Manasika Pramilaka, Atikrodha, Bhaya etc. 4. Others Krimi Roga, Visuchika, Grahani, Ksheeralasaka and Chirakalina Vyadhi. Samprapti [4] Rupa (Clinical features) In Balashosha there is Vridhi of Kaphadosha as well as Kshaya of Rasadhatu and further Dhatus . Thus Balashosha exhibit the clinical features of Rasa Kshaya. The following Rupas are enumerated in Astanga Hridaya [5] ▪ Aruchi (anorexia) ▪ Pratishyaya (coryza) ▪ Jwara (pyrexia) ▪ Kasa (cough) ▪ Shosha (emaciation) 0 10 20 30 40 50 60 Stunted Underweight Wasted NFHS-2 NFHS-3

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[Find the meaning and references behind the names: Netra, Sri, Gupta, Kumar, Nil, Abhimanyu, Med, Chandra]

Dr. Kulvinder Sandhu et al. Kuposhanjanya Vyadhies (Balashosha) in Children w.s.r. to P.E.M. : A Literary Review ISSN: 2456-3110 REVIEW ARTICLE Mar-Apr 2020 Journal of Ayurveda and Integrated Medical Sciences | Mar - Apr 2020 | Vol. 5 | Issue 2 168 ▪ Snigdhamukha (paleness of face) ▪ Singdhanetra ▪ Shukla Netra Chikitsa Sutra (Treatment Principle) The Ancient Indian System of Medicine literally means “The Science of Life (or Living)”, which actually represents a way of life that incorporates the art of healing through harmony with nature and the environment (comprising all the living forms existing on planet Earth). The principle of treatment lies in eradicating the cause and normalization of the Doshas and Dushyas. The principle of treatment of Balashosha is as follows [6] 1. To stimulate Agni - After removing the obstruction of the Srotas , attempts are made to stimulate Agni for correction of diminished metabolism of the Dhatus . This is achieved through Deepana and Pachana drugs [7] which increase jatharagn i and thereby Dhatwagni as well. 2. To relieve obstruction of Srotas - Shodhana Karma should be done to relieve the obstruction of Rasavahi Srotas . The children are delicate. So the full-fledged Panchakarma therapy may not be undertaken here. However, for Shodhana purpose, a purge by medicated milk is given. 3. Use of Brimhana Drugs - As the Agni is corrected by Deepana and Pachana drugs, now the child is able to digest and metabolize his diet. So nutrient therapy is administered for promotion and strengthening of the Dhatus through restorative drugs or nutrient tonic ( Sthiradighrita and Brahmyadighrita). [8] CONCLUSION Kuposhanajanya Vyadhies are described in scattered manner in Ayurvedic text. A systemic study of these conditions provide insight into hazards of nutritional deficiencies and represent different aspects of Vyadhies and proper understanding of pathogenesis of the condition provides valuable key for the effective management . REFERENCES 1 Clinical cases in pediatrics by R. Rajamendran, Jaypee brothers medical publishers (P) LTD,First edition 2014, printed at Sanat Printers, Kundali. Case no.1. 2 IAP Text book of Paediatrics by A. Parthasarathy, Jaypee Brothers Medical Publishers, New Delhi, 5 th Edition, 2015. 3 Clinical cases in pediatrics by R. Rajamendran, Jaypee brothers medical publishers (P) LTD, First edition 2014, printed at Sanat Printers, Kundali. Case no.1. 4 Astanga Hridaya with the commentaries (Sarvanga sundara) of Arundutta and Ayurveda rasayana of Hemadri, Published by Chaukhamba Orientalia, Varanasi, 7 th Edition, 1982. 5 Ashtanga Samgraha: (Part-I), Hindi commentary by Atrideva Gupta, Published by Satyabhama Bai Pandurang, NirnayaSagar Press, Bombay, 1 st Edition. 1951. 6 Child Health Care in Ayurveda by Dr. Abhimanyu Kumar, Published by Sri Satguru Publication, Delhi, 1 st Edition, 1994. 7 Charaka Samhita, Ayurveda dipikaAyushi Hindi commentary First part by Vd. Harisha Chandra kushawaha, Chaukhambha orientalia publisher Varanasi, First edition 2005, Sutra sthana 8 Astanga Hridaya with the commentaries (Sarvanga sundara) of Arundutta and Ayurveda rasayana of Hemadri, Published by Chaukhamba Orientalia, Varanasi, 7 th Edition, 1982. ******************************* How to cite this article: Dr. Kulvinder Sandhu, Dr. Minakshi Chaudhary. Kuposhanjanya Vyadhies (Balashosha) in Children w.s.r. to P.E.M. : A Literary Review. J Ayurveda Integr Med Sci 2020;2:166-168. Source of Support: Nil, Conflict of Interest: None declared.

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Dhatu, Agni, Ayurveda, Anasana, Dushya, Rasakshaya, Shrota, Rasadhatu, Krimiroga, Kaphadosha, Child-mortality, Kasa (cough), Ancient Acharya, Etiological factor, Developing countries, Nutritional deficiencies, Panchakarma Therapy, Shodhana Karma, Deepana and Pachana, Chikitsa sutra, Ayurvedic text, Review article, Aruchi (anorexia), Jwara (Pyrexia), Dhatu samyata, Deepana and Pachana drugs, Protein energy malnutrition, Balashosha, Nutritional marasmus, Ayurvedic therapeutic, Nutritional Deficiency Disorder, Atikrodha, Ayurvedic Medical Officer, Low income countries, Pathya vyavastha, Key-word.