Effect of Phaltrikadi Kwatha in the management of Pandu in Children - An Open...

[Full title: Effect of Phaltrikadi Kwatha in the management of Pandu in Children - An Open Clinical Trial]

[[[ p. 1 ]]]

[[[ p. 2 ]]]

[Find the meaning and references behind the names: Vikas, Netra, Shri, Guna, Kumar, Main, Rasa, Pandu, Market]

ORIGINAL ARTICLE July-Aug 2020 Journal of Ayurveda and Integrated Medical Sciences | July - Aug 2020 | Vol. 5 | Issue 4 7 Effect of Phaltrikadi Kwatha in the management of Pandu in Children - An Open Clinical Trial Dr. Vikas Kumar 1 , Dr. Pankaja P. Savanur 2 1 Final Year Post Graduate Scholar, 2 Reader, Department of Kaumarbhritya, KAHER’s Shri. B.M.K. Ayurved Mahavidyalaya, Shahpur, Belagavi, Karnataka, INDIA. I NTRODUCTION Pandu Roga can be effectively compared with Anemia on the ground of its similar clinical presentation. Pandu is a Pitta Pradhana Tridhosaja and Varnopalakshita Vyadhi where in paleness is pathognomonic. Anemia is a disease that has similar Address for correspondence: Dr. Vikas Kumar Final Year Post Graduate Scholar, Department of Kaumarbhritya, KAHER’s Shri. B.M.K. Ayurved Mahavidyalaya, Shahpur, Belagavi, Karnataka, INDIA. E-mail: vikas.k.mechu@gmail.com Submission Date: 08/07/2020 Accepted Date: 12/08/2020 Access this article online Quick Response Code Website: www.jaims.in DOI: 10.21760/jaims.5.4.2 paleness, constitutional symptoms, pathogenesis and etiology. Symptoms of Pandu are Panduta of Twak, Netra, Nakha, Anana, Daurbalya, Shrama, Bhrama, Swasa, Arohanaayasa, Aruchi, Pindikodvestana and in Pandu line of treatment are Shamana, Shodhana and Pathya. [1] According to 3 rd National Family Health Survey 79% of Indian children are affected from Anemia including 71% of urban children and 84% of those in rural area [2] By observing high prevalence of Anemia, Government of India launched National Nutritional Anemia control Programs [2] Mandagni is the main cause for Pandu Roga . Most of the drugs which are advised in the management of Pandu Roga possess Katu Rasa, Tiksana, Snigdha and Laghu Guna, Kaphavatahara and are having Deepana, Pachana, Rasayana properties. Drugs available in market have their own limitations and adverse effects A B S T R A C T Background: Pandu (Anemia) is one of the commonest and most prevalent diseases in Pediatric population in India. Drugs available in the market used for treating Anemia ( Pandu ) have untoward effects like constipation, non-palatability, intolerance, loss of appetite etc. It is today’s need to safely treat the Pandu (Anemia) in children with herbal preparations which are mentioned in many Ayurvedic Classics which are economical and safe. So Phalatrikadi Kwatha a formulation mentioned to be useful in the management of Pandu Roga was used in the present study . Aim and Objectives: Primary: To evaluate the efficacy of Phalatrikadi Kwatha in Pandu in children. Secondary: To evaluate the Efficacy of Phalatrikadi Kwatha in different Prakruti in Pandu in children. Methodology: This study was an interventional open labelled clinical trial and conducted on 30 diagnosed Patients of Pandu for a period of 30 days. Follow up was done on 10 th , 20 th , 30 th days of study on the basis of subjective criteria and Hb% before treatment and after treatment. Results: Symptoms of Anemia and Hb% level were statistically analysed for any change before treatment, after treatment and during the follow up. Statistically significant changes (p<0.05) were observed in subjective (Dourbalyata, Aruchi) and objective (Hb%) parameters of Pandu Rogi . No significant difference was observed in different specific Dosha dominant Prakruti . Conclusion: Phalatrikadi Kwatha was found effective in the treatment of Pandu in children, thus showing significant results with respect to symptoms like Dourbalyata, Aruchi and increase in Hb%. Key words: Pandu Roga, Anemia, Phalatrikadi Kwatha, Hb%.

[[[ p. 3 ]]]

[Find the meaning and references behind the names: Brown, Honey, Good]

Dr. Vikas Kumar et al. Effect of Phaltrikadi Kwatha in the management of Pandu in Children ISSN: 2456-3110 ORIGINAL ARTICLE July-Aug 2020 Journal of Ayurveda and Integrated Medical Sciences | July - Aug 2020 | Vol. 5 | Issue 4 8 like non-palatability, intolerance, loss of appetite, constipation etc [3] Phalatrikadi Kwatha is preparations in the management of Pandu Roga . The pharmacodynamic study of individual constituents of this drug has revealed a wide range of actions in Pandu Roga . It is a herbal combination, containing Triphala, Amruta, Vasa, Tikta, Nimba, Bhunimba , which has properties of Deepana, Pachana and Kaphavata Shamana . This drug was selected because it is economical as well as palatable with good safety profile. A quick overview through the indications clearly reveals that it is an apt formulation for the management of Pandu Roga . Therefore, the present study was an effort made to gather and to study and to document the effect of Phalatrikadi Kwatha in Pandu Roga with respect to reduction in signs and symptoms M ATERIALS AND M ETHODS Study Design An open clinical trial Selection of cases Based on the clinical features of Pandu Roga the patients were selected for the study. Inclusion Criteria 1 Patients of either sex between the ages 6 -16 years. 2 Patients fulfilled diagnostic criteria were selected. 3 Hb between 8 gm % to 10 gm %. Exclusion Criteria 1 Haematological disorders like sickle cell Anaemia, haemolytic anaemia etc. 2 Anaemia child who requires any form of Emergency management, PICA 3 Acute/chronic severe infections like Pneumonia, T.B. 4 Children having any known congenital disorders like CHD etc. Selection of drug Phalatrikadi Kwatha is mentioned in the context of treatment of Pandu Roga in Cakradatta. [4] The formulation was preserved with help of preservatives for easy administration. Honey mentioned as Anupana in original text were giving separately to the patients. Phalatrikadi Kwatha was taken as trial drug for the present study Approval of institutional ethical committee Institutional Ethics committee’s approval was taken for the open clinical trial. Procurement of the drug Trial raw drug was collected from pharmacy Authentification was done in Central Research Facility, KAHER’s Shri. BMK Ayurveda Mahavidyalaya, Belagavi. The trial drug were prepared as per classical method in the attached GMP certified Ayurveda Pharmacy of the institute. After that preservatives (Methyl Paraben, Propyl Paraben, Sodium Benzoate) added as per standard. Packaging was done in bottles as per required dose. Analytical study of the trial drug The trial drug was subjected to various physiochemical analytical tests to evaluate the standards of drugs was done in central research facility belagavi. The reports of analytical test of the trial drug Phalatrikadi Kwatha are mention below; Nature of the preparation: Kwatha (liquid) Organoleptic parameters ▪ Colour - Brown ▪ Odour - Fragrent ▪ Taste - Bitter Table 1: Physiochemical Properties Ph 4* Specific gravity 1.028* Total solid 7.762* * These value are mean value of freshly prepared 3 samples. Microbial stability test was done in subsequent month upto 1 year and their finding was in normal limits.

[[[ p. 4 ]]]

Dr. Vikas Kumar et al. Effect of Phaltrikadi Kwatha in the management of Pandu in Children ISSN: 2456-3110 ORIGINAL ARTICLE July-Aug 2020 Journal of Ayurveda and Integrated Medical Sciences | July - Aug 2020 | Vol. 5 | Issue 4 9 Qualitative test was also done for organic and inorganic compounds. Qualitative Analysis Table 2: Test for Organic Compounds Calcium Present Magnesium Absent Sodium Present Potassium Absent Iron Present Chloride Present Sulphates Present Carbonates Absent Nitrates Present Phosphate Present Laboratory investigations: Hb% A SSESSMENT C RITERIA Subjective Parameters 1 Pandutwa (Pallor) 2 Daurbalyata (weakness) 3 Aruchi (loss of appetite) 4 Shrama (Fatique) Objective Parameters 1 Hb% Grading of Assessment Crieteria 1. Pandutwa (Pallor) Table 3: Grading for Pandutwa Symptoms Grading No Pallor 0 Conjunctiva slightly pale, nail and other mucous membrane not pale 1 Conjunctiva slightly pale, nail and other mucous membrane slightly pale 2 Conjunctiva slightly pale, nails, mucous membrane pale 3 2. Daurbalyata (weakness) Table 4: Grading for Daurbalyata Symptoms Grading No daurbalyata 0 Not able to perform strenuous activities (E.g.- Outdoor games, lifting wt.) 1 Not able to perform moderate activities (E.g. climbing, Running etc.) 2 Cannot perform moderate but can perform mild activities without difficulty (E.g. routine works like bathing, walking, eating food etc.) 3 Even mild activities cannot be performed (Routine work cannot perform 4 3. Aruchi (loss of appetite) Table 5: Grading for Aruchi Symptoms Grading Take normal diet. 0 Less oral intake compare to routine diet. 1 Sometimes takes food properly, most of time avoid. 2 Patient avoid food. 3 4. Shrama (fatique) Table 6: Grading for Shrama Symptoms Grading No fatigue 0 Fatigue but not affecting patient daily activities. 1 Fatigue affecting patient daily activities 2 Activity reduced due to fatigue. 3 Analysis of data and use of statistical methods ▪ Willcoxon matched pairs test: used for comparison between the follow ups.

[[[ p. 5 ]]]

[Find the meaning and references behind the names: Mann, Hindu]

Dr. Vikas Kumar et al. Effect of Phaltrikadi Kwatha in the management of Pandu in Children ISSN: 2456-3110 ORIGINAL ARTICLE July-Aug 2020 Journal of Ayurveda and Integrated Medical Sciences | July - Aug 2020 | Vol. 5 | Issue 4 10 ▪ Paired t test: used for Haemoglobin for comparison between before and after treatment. ▪ Kruskal Wallis ANOVA followed by Mann- Whitney U test: used for comparison between 3 groups ( Vata, Pitta, Kapha ) in term of assessment criteria at different follow up. O BSERVATIONS In demographic data gender wise distribution, 10 (67%) children were male & 20 (33%) children were female. Age wise distribution of 30 children 16 (53%), children belonged to the age group more or equal to 11 yrs and 14 (46.67%) children belonged to the age group less or equal to 10 yrs. In this study 27 (90%) children were from Hindu community and remaining 3 (10%) children were from other communities. 27 (90%) children were having Mandagni and 3 (10%) children were having Samagni . Nidra indicated that 24 (80%) children were having normal Nidra and 6 (20%) children having Atinidra. 14 (46.67%) children were having Kapha dominant Prakruti , 12 (40%) children were having Pitta dominant Prakruti and 4 (13.33%) children were having Vata dominant Prakruti . R ESULTS Pandutwa scores have shown statistically nonsignificant results from 0 th day to subsequent follow ups (10 th , 20 th , 30 th day) with p value (>0.05) and have shown statistically non-significant results from 10 th day to subsequent follow ups (20 th , 30 th day) with p value (>0.05). Table 7: Pandutwa scores from 0 th day to subsequent follow ups by Wilcoxon matched pairs. Treatment time Median IQR Mea n SD Zvalue pvalue 0 th Day 2.00 0.00 1.83 0.38 10 th Day 2.00 0.00 1.83 0.38 -- -- 0 th Day 2.00 0.00 1.83 0.38 20 th Day 2.00 0.00 1.83 0.38 -- -- 0 th Day 2.00 0.00 1.83 0.38 30 th Day 2.00 0.00 1.80 0.41 -- -- 10 th Day 2.00 0.00 1.83 0.38 20 th Day 2.00 0.00 1.83 0.38 -- -- 10 th Day 2.00 0.00 1.83 0.38 30 th Day 2.00 0.00 1.80 0.41 -- -- 20 th Day 2.00 0.00 1.83 0.38 30 th Day 2.00 0.00 1.80 0.41 -- -- The mean scores decrease of Pandutwa was present in all the 3 Prakruti ( Vata , Pitta , Kapha ) but during pairwise comparison between Kapha - Vata , Kapha - Pitta , Pitta - Kapha it was not statistically significant with p value >0.5. Table 8: Comparison of Pandutwa mean scores b/w 3 groups ( Kapha , Pitta , Vata ) Daurbalyata scores have shown statistically nonsignificant results from 0 th day to 10 th with p value >0.05, followed by statistically significant results b/w 0 th day to subsequent follow ups (20 th , 30 th day) with p value 0.0001(i.e <0.05) which is highly significantand have shown statistically significant results from 10 th

[[[ p. 6 ]]]

Dr. Vikas Kumar et al. Effect of Phaltrikadi Kwatha in the management of Pandu in Children ISSN: 2456-3110 ORIGINAL ARTICLE July-Aug 2020 Journal of Ayurveda and Integrated Medical Sciences | July - Aug 2020 | Vol. 5 | Issue 4 11 day t subsequent follow ups (20 th , 30 th day) with p value <0.05, followed by statistically significant results b/w 20 th to 30 th day with p value <0.05 Table 9: Daurbalyata scores from 0 th day to subsequent follow ups by Wilcoxon matched pairs test. Treatment time Media n IQR Mea n SD Zvalue pvalue 0 th Day 2.00 1.7 5 1.53 1.0 1 10 th Day 2.00 1.7 5 1.50 1.0 1 -- -- 0 th Day 2.00 1.7 5 1.53 1.0 1 20 th Day 1.00 2.0 0 1.07 0.8 7 3.295 8 0.0010 * 0 th Day 2.00 1.7 5 1.53 1.0 1 30 th Day 1.00 1.0 0 0.80 0.6 1 4.106 9 0.0001 * 10 th Day 2.00 1.7 5 1.50 1.0 1 20 th Day 1.00 2.0 0 1.07 0.8 7 3.179 8 0.0015 * 10 th Day 2.00 1.7 5 1.50 1.0 1 30 th Day 1.00 1.0 0 0.80 0.6 1 4.014 5 0.0001 * 20 th Day 1.00 2.0 0 1.07 0.8 7 30 th Day 1.00 1.0 0 0.80 0.6 1 2.520 5 0.0117 * The mean scores decrease of Daurbalyata was present in all the 3 Prakruti ( Vata , Pitta , Kapha ) but during pairwise comparison between Kapha - Vata , Kapha - Pitta , Pitta - Kapha it was not statistically significant with p value >0.5. Table 10: Comparison of Daurbalyata mean scores b/w 3 groups ( Kapha , Pitta , Vata ) Aruchi scores have shown statistically significant results from 0 th day to subsequent follow ups (10 th , 20 th , 30 th day) with p value 0.0001 (i.e. <0.05) which is highly significant and also have shown statistically significant results from 10 th day to subsequent follow ups (20 th , 30 th day) with p value <0.05, followed by statistically significant results b/w 20 th to 30 th day with p value <0.05 Table 11: Aruchi scores from 0 th day to subsequent follow ups by Wilcoxon matched pairs The mean scores decrease of Aruchi was present in all the 3 Prakruti ( Vata , Pitta , Kapha ) but during pairwise comparison between Kapha - Vata , Kapha - Pitta , Pitta - Kapha it was not statistically significant with p value >0.5. Treatment time Median IQR Mean SD Z-value p-value 0 th Day 1.00 1.00 1.23 0.63 10 th Day 0.00 1.00 0.47 0.57 4.1973 0.0001* 0 th Day 1.00 1.00 1.23 0.63 20 th Day 0.00 0.00 0.20 0.41 4.5407 0.0001* 0 th Day 1.00 1.00 1.23 0.63 30 th Day 0.00 0.00 0.03 0.18 4.5407 0.0001* 10 th Day 0.00 1.00 0.47 0.57 20 th Day 0.00 0.00 0.20 0.41 2.5205 0.0117* 10 th Day 0.00 1.00 0.47 0.57 30 th Day 0.00 0.00 0.03 0.18 3.1798 0.0015* 20 th Day 0.00 0.00 0.20 0.41 30 th Day 0.00 0.00 0.03 0.18 2.0226 0.0431*

[[[ p. 7 ]]]

Dr. Vikas Kumar et al. Effect of Phaltrikadi Kwatha in the management of Pandu in Children ISSN: 2456-3110 ORIGINAL ARTICLE July-Aug 2020 Journal of Ayurveda and Integrated Medical Sciences | July - Aug 2020 | Vol. 5 | Issue 4 12 Table 12: comparison of Aruchi mean scores b/w 3 groups ( Kapha , Pitta , Vata ) Shrama scores have shown statistically non significant results from 0 th day to subsequent follow ups (10 th , 20 th , 30 th day) with p value (>0.05) and was shown statistically non significant results from 10 th day to subsequent follow ups (20 th , 30 th day) with p value (>0.05). Table 13: Shrama scores from 0 th day to next follow ups by Wilcoxon matched pairs test. The mean scores decrease of Shrama was present in all the 3 Prakruti ( Vata , Pitta , Kapha ) but during pairwise comparison between Kapha - Vata , Kapha - Pitta , Pitta - Kapha , it was not statistically significant with p value >0.5 Table 14: Comparison of Shrama mean scores b/w 3 groups ( Kapha , Pitta , Vata ) The mean score of Hb% was improved from 9.29 to 9.55 which is statistically significant with p value 0.0001. Table 15: Comparison of Hb% age at before and after treatment by Paired T test. The mean increase of Hb% was present in all the 3 Prakruti ( Vata , Pitta , Kapha ) but during pairwise comparison between Kapha - Vata , Kapha - Pitta , Pitta - Kapha , it was not statistically significant with p value >0.5. Table 16: Comparision OF Hb% b/n three group ( Vata, Pitta, Kapha ) Treatment time Median IQR Mean SD Z-value p-value 0 th Day 1.00 0.75 1.00 0.74 10 th Day 1.00 0.75 1.00 0.74 -- -- 0 th Day 1.00 0.75 1.00 0.74 20 th Day 1.00 0.75 0.97 0.72 -- -- 0 th Day 1.00 1.50 1.00 0.74 30 th Day 1.00 0.75 0.90 0.66 1.6036 0.1088 10 th Day 1.00 1.50 1.00 0.74 20 th Day 1.00 0.75 0.97 0.72 -- -- 10 th Day 1.00 1.50 1.00 0.74 30 th Day 1.00 0.75 0.90 0.66 1.6036 0.1088 20 th Day 1.00 0.75 0.97 0.72 30 th Day 1.00 0.75 0.90 0.66 -- -- Treatment time Mean SD Diff. mean Diff. SD Paired t p-value 0 th Day 9.29 0.68 30 th Day 9.55 0.66 -0.26 0.21 -6.8538 0.0001*

[[[ p. 8 ]]]

[Find the meaning and references behind the names: Bala]

Dr. Vikas Kumar et al. Effect of Phaltrikadi Kwatha in the management of Pandu in Children ISSN: 2456-3110 ORIGINAL ARTICLE July-Aug 2020 Journal of Ayurveda and Integrated Medical Sciences | July - Aug 2020 | Vol. 5 | Issue 4 13 DISCUSSION Discussion on observation Age: In present study incidence of anaemia was found in age group 11 yrs or more (53.33%) probably it may be due iron requirement due to rapid body growth and poor iron absorption which is required for haemoglobin synthesis [5] Agni: 27% of the children in this study had Mandagni assessed by their poor appetite. According to Ayurveda, all the diseases occur due to presence of Mandagni. It does improper digestion & improper absorption of nutrients & minerals [6] Prakruti : Anaemia was found in 46.67% children of Kapha dominant Prakruti , 40% of Pitta dominant Prakruti . Prakruti plays a vital role in vitiation of Doshas and children with certain diseases. This finding revealed predominance of Pitta Dosha in pathogenesis of Pandu [7] Gender: The present study showed the ratio between Males to females 1:2 while it has been shown that the prevalence of anemia is greater among females as compared to males, the current study findings are not representatives of this possibly due to small sample size Religion: This data shows that Pandu is more prevalent in Hindu community (90%) compared to other communities. This may be due to the larger Hindu population in this region Nidra : In this study 20% children had Atinidra , while 80% children had Samyaka Nidra . This Atinidra may be because in Pandu there is Agnimandya due to this weakness occurs due to obstruction in Uttarotara Dhatuposhana which leads to Atinidra Discussion of effect of therapy Symptoms were scored and statistically analysed for any change before and after the study. In the group statistically significant change (p<0.05) was observed. All children showed good improvement Effect of drug on Daurbalyata (Generalized weakness) Among 30 patients, all the patients were having Daurbalyata . This symptom might be more prominent in Pandu Rogi because of Dhatu Kshaya and Ojo Kshaya which is the result of pathogenesis of Pandu. In subsequent follow up, there is 28.66% relief from 10 th to 20 th day and 25.23 % from 20 th to 30 th day with p<0.05 which is statistically significant. In Phalatrikaadi Kwatha Amalaki, Haritaki, Guduchi are having Balya and Rasayana property, it might replenishes and rejuvenate impaired Dhatus which ultimately increases Bala and decreases the weakness. Most of the drugs in the formulation are having Deepana, Pacana property which increase the Agnibala & decrease Aruchi in food which leads to Uttarotara Dhatupoashana ultimately decreasing Dourbalyata . Effect of drug on Aruchi Among 30 patient 27 patient were having Aruchi , this may be because Pandu is occurring mainly due to Mandagni. Among 27 patients after treatment there is 97.56% relief in aruchi with p< 0.05 which is statistically significant. This may be due to Deepana, Pachana drugs in formulaton. Pandu occurs due to Agnivikruti, Varnahani, Prabhahani, Utsahahani and Krishata are seen. In this formulation most of the drugs having the properties like Deepana, Pacana, Ruchya which improve digestion and assimilation. All ingredients in this formulation are having Tikta Rasa and Laghu, Ruksha Gunas. So it may help in Jivha Mukha Shodhana which might inturn lead to improvement in Aruchi. Nimba, Vasa, Katuki having Tikta Rasa which act as Pitthara, Deepana and Pacana which may be helpful to increase the appetite. Effect of drugs on haemoglobin Among 30 patients after treatment there is increase Hb% in 83.33% there is mean increase in 0.26% with p

[[[ p. 9 ]]]

[Find the meaning and references behind the names: Madhu, Rao, Prakashan]

Dr. Vikas Kumar et al. Effect of Phaltrikadi Kwatha in the management of Pandu in Children ISSN: 2456-3110 ORIGINAL ARTICLE July-Aug 2020 Journal of Ayurveda and Integrated Medical Sciences | July - Aug 2020 | Vol. 5 | Issue 4 14 value < 0.05 which is statistically significant but clinically not significant. Prakruti wise there was more increase in Hb% in Vata Prakruti due to Balya and Rasayana action of the drugs present in the formulation. But this was not statistically justified because of non-uniform distribution of patients in different Prakruti categories. As the formulation which is containing aminoacids and iron content it might be helpful in the production of haemoglobin. Amalaki is Amla Rasa Pradhana , being a rich source of Vit. C. which helps to increase the absorption of iron which may help in Pandu Roga. [8] According to modern science honey contains vitamins-B 6, K, B 12, A, C, Riboflavin, Niacin and minerals (Cu, Zinc, Pottasium & Iron etc) as we know Cu and Zinc play important role in Pandu (Anemia), Vitamin C increases the iron absorption from Gastrointestinal tract. Thus honey seems to be beneficial in Pandu . Probable mode of action Phalatrikadi Kwatha In the pathogenesis of Pandu Pitta Prakopa is one of the major entity and in this study, the used formulation is having the drugs with predominance of Tikta Rasa , which has Pittashamana effect and will help to alleviate the Pitta Dosha in body. Tikta Rasa also having Amapacana effect so it will help in proper formation of Rasa Dhatu and thus the subsequent Raktadhatu formation. Guduchi does the Shamana of Raktagata Pitta it also does Raktaprasadana (enhance the quality) and ultimately nourishes the subsequent Dhatus . Krimi is one of the reason for the manifestation of Pandu, Nimba might help in such cases, which acts on Raktaja and Kapha ja Krimi due to its Prabhava and also having Pittakaphahara property. In Pandu as there is Srotodhoosti caused due to excessive or aggravated Doshas , due to Shodana and Bhedana property of Katuki that is why it may act as Shrotoshodana ultimately Samprapti Vighatana . Pandu being a Santarpanajanya Vyadhi , the line of treatment mentioned in Pandu is Tikshna Virechana and Vamana ( Apatarpana Chikitsa ). The formulation contains Triphala, Tikta, Bhunimba which acts as Mriduvirechaka which might have helped in the Vighatana of Samprapti of Pandu . Mode of action of Anupana (Honey) It contains fructose, digestive enzymes; which facilitate quick absorption of medicine as Yogawahi. [9] Madhu is having Tridoshara, Ruksha, Laghu Guna, Kasaya Anurasa act as Deepana, Pachana, Yogavahi, Shorotovishodhana may be helpful in treating Pandu by reducing Shrotodusti and Aruchi thus increasing absorption of drug and food. CONCLUSION Phalatrikadi Kwatha was found effective in the treatment of Pandu in children, thus showing significant results with respect to symptoms like Dourbalyata, Aruchi and increase in HB%. No conclusion could be drawn on Phalatrikadi Kwatha in different Prakrutis due to non-uniform and less distribution in the category of different Prakruti. REFERENCES 1 Agnivesha, Charak samhita edited by Yadavaji trikamji Acharya with Ayurvedadipika commentary by Chakrapanidatta, Chaukamba prakashan Varansi 2009, Chi.16/3, 4, P. 13-16. 2 Black J, MuthayyaS, ShethA, Determinants of anemia among young children in rural India. http:paediatrics publications.org. 3 Tripathy K D, Pharmacology, fifth edition, Jaypee Publication 2004, P.583 4 G. Prabhakara Rao Cakradatta, Edn. 2014, Chapter 8, P. 117 5 Ghai O P, Essential Paediatrics, Eighth Edition, CBS Publishers, P.330. 6 Tripathy B. Charaka Samhita, Agnivesha, Chaukhambha, Ed. 2004, Vimanasthana, Chapt.8, Vers E,15, P.513.

[[[ p. 10 ]]]

[Find the meaning and references behind the names: Dinanath, Nil, Med, Green]

Dr. Vikas Kumar et al. Effect of Phaltrikadi Kwatha in the management of Pandu in Children ISSN: 2456-3110 ORIGINAL ARTICLE July-Aug 2020 Journal of Ayurveda and Integrated Medical Sciences | July - Aug 2020 | Vol. 5 | Issue 4 15 7 Vaidya Phadke G A, Dravyaguna Shastram, 1 st Edn, Vaidya Vamanrao Dinanath Shuddh Ayurveda Pathyakrama Prakashan, Mumbai. 8 Ajayi O A, effect ascorbic acid supplementation on haematological response 1990;34:32-6 9 International Journal of Green Pharmacy, Vol.-12, Issue- 2018. ******************************* How to cite this article: Dr. Vikas Kumar, Dr. Pankaja P. Savanur. Effect of Phaltrikadi Kwatha in the management of Pandu in Children - An Open Clinical Trial. J Ayurveda Integr Med Sci 2020;4:7-15. http://dx.doi.org/10.21760/jaims.5.4.2 Source of Support: Nil, Conflict of Interest: None declared. Copyright © 2020 The Author(s); Published by Maharshi Charaka Ayurveda Organization, Vijayapur (Regd). This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Other Health Sciences Concepts:

[back to top]

Discover the significance of concepts within the article: ‘Effect of Phaltrikadi Kwatha in the management of Pandu in Children - An Open...’. Further sources in the context of Health Sciences might help you critically compare this page with similair documents:

Rasa, Nimba, Panduroga, Balya, Vasa, Agnimandya, Triphala, Tikta, Rasayana, Pathya, Mandagni, Kaphaja, Rasadhatu, Atinidra, Pittaprakopa, Pachana, Guduchi, Aruchi, Ruchya, Dhatukshaya, Agnibala, Krishata, Vatadosha, Pittadosha, Kaphadosha, Utsahahani, Amruta, Prakruti, Analytical study, Hindu community, Anemia, Pathogenesis, Constitutional symptoms, Herbal preparation, Adverse effect, Clinical feature, Gastrointestinal Tract, Tikta Rasa, Raktaja Krimi, Etiology, Mode of action, Original article, Follow-up, Significant result, Herbal combination, Indian children, Age-group, Inclusion criteria, Exclusion criteria, Diagnostic criteria, Assessment criteria, Charak Samhita, Ethical committee, Statistically Significant, Open clinical trial, Rasayana action, P Value, Gender-wise distribution, Deepana, Clinical presentation, Laboratory investigation, Paired T test, Samprapti Vighatana, Ayurveda Mahavidyalaya, Laghu Guna, Subjective Criteria, Apatarpana Chikitsa, Deepana Pachana, Phalatrikadi Kwatha, Santarpanajanya Vyadhi, Subjective parameter, Pitta Pradhana, Objective parameter, Kaphavatahara, Institutional Ethical Committee, Ojo Kshaya, Qualitative test, Iron absorption, Mean score, Good safety profile, Ruksha Guna, Kaumarbhritya, Shamana Shodhana, Statistical method, Ayurvedic classic, Agnivikruti, Wilcoxon matched-pairs test, Selection of drug, Daurbalyata, Pharmacodynamic Study, Digestive Enzyme, Interventional trial, Physiochemical properties, International Journal, Vata Prakruti, Median score, Kaphahara property, Kruskal Wallis ANOVA, Creative Commons Attribution, Department of Kaumarbhritya, Creative commons, Treatment time, Ayurvedadipika commentary, IQR, SD, Mann-Whitney U-test, Deepana, Pachana, Organoleptic parameter, Pitta Dosha in.