Review on shayyamutrata: childhood disorder and its multi-drug management.

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Journal name: World Journal of Pharmaceutical Research
Original article title: Review on shayyamutrata-childhood disorder and its management through multidrug regimen and satvayavajay chikitsa
The WJPR includes peer-reviewed publications such as scientific research papers, reports, review articles, company news, thesis reports and case studies in areas of Biology, Pharmaceutical industries and Chemical technology while incorporating ancient fields of knowledge such combining Ayurveda with scientific data.
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Author:

Dr. Varsha Bagal and Dr. Sandeep Patil


World Journal of Pharmaceutical Research:

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Full text available for: Review on shayyamutrata-childhood disorder and its management through multidrug regimen and satvayavajay chikitsa

Source type: An International Peer Reviewed Journal for Pharmaceutical and Medical and Scientific Research

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Summary of article contents:

Introduction

Nocturnal enuresis, commonly referred to as bedwetting, is defined as the involuntary discharge of urine during sleep after the age when bladder control is typically established. While it is not physically harmful, it can significantly impact a child's psychological well-being, social behavior, and self-esteem. In Ayurveda, this condition is associated with a Kaphavrit Vat imbalance and the influence of Tama. The study underlines the necessity for a multidimensional treatment approach rather than a singular focus on medication, exploring the efficacy of Ayurvedic treatments in managing Shayyamutrata, as described in classical texts, such as the Sharangdhara Samhita.

Understanding Shayyamutrata

Shayyamutrata, despite being a relatively common occurrence in children, has profound psychological implications, affecting the child’s mental health and social interactions. The classification of enuresis according to the DSM-IV highlights that it must occur at least twice a week for a duration of three months in a child over the age of five, and not be attributable to physiological conditions. Most cases are attributed to delayed maturation in bladder function, which may be influenced by various factors including excessive sleep, anxiety, and emotional distress. Ayurvedic texts indicate a disruption in the control of micturition, which is usually moderated by the mind and specific doshas, such as Prana, Vyana, and Apana.

Treatment through Multidrug Regimen

The management of Shayyamutrata necessitates a comprehensive treatment plan that integrates multiple therapeutic methods, including herbal formulations. In the case study presented, a 9-year-old male patient with chronic nocturnal enuresis underwent a holistic treatment regimen involving Brahmi Churna and Shankhpushpi Churna, both of which act as nervine tonics, alongside Chandraprabha Vati for urinary control. The combination of these treatments aimed not only to alleviate symptoms but also to address the psychological factors contributing to bedwetting through Satvayavajay Chikitsa, which emphasizes mental well-being and emotional support.

Physiological and Psychological Benefits

Over a course of five weeks, the mentioned Ayurvedic treatment showed significant improvement in the patient. Follow-up assessments indicated a reduction in bedwetting frequency and enhanced bladder control, with the child eventually experiencing dry nights and improved confidence. The herbal treatments employed possess neuroprotective properties and antidepressant effects, thereby improving the child’s cognitive functions and social interactions. The results stress the importance of addressing both the physiological and psychological components of nocturnal enuresis, fostering a supportive environment for the child.

Conclusion

The study exemplifies the effectiveness of applying Ayurvedic principles in treating nocturnal enuresis, demonstrating notable improvements in both symptoms and emotional well-being over a five-week period. By utilizing a combination of herbal therapies and psychotherapy, the treatment not only alleviated the primary condition but also restored the child’s confidence and social standing. This case underscores the potential of integrated approaches to manage childhood disorders like Shayyamutrata, highlighting the significant role of holistic health practices in enhancing the quality of life for affected children.

FAQ section (important questions/answers):

What is Shayyamutrata and how does it affect children?

Shayyamutrata, or nocturnal enuresis, is a childhood disorder characterized by involuntary bedwetting. It negatively impacts a child's mental health, self-esteem, and social behavior, leading to feelings of embarrassment and shyness.

What are common causes of nocturnal enuresis in children?

Common causes include delayed bladder maturation, abnormal sleep cycles, inadequate bladder capacity, and emotional issues like stress or anxiety. Genetics may play a role, as many cases have family histories.

What treatment was used in the study for Shayyamutrata?

The treatment involved a combination of Ayurvedic remedies, including Brahmi Churna, Shankhpushpi Churna, and Chandraprabha Vati, along with Satvayavajay Chikitsa, aimed at addressing both physical and psychological aspects of enuresis.

How was the effectiveness of the treatment assessed?

Effectiveness was assessed through parameters like bedwetting frequency, nocturnal awakenings, and feelings of shame, graded from 0 to 3 before and after treatment to measure improvements.

What were the results of the Ayurvedic treatment for nocturnal enuresis?

After 5 weeks of treatment, the patient experienced significant improvement, including reduction in bedwetting frequency, better bladder control, and decreased feelings of shame, achieving all dry nights.

What is the significance of Satvayavajay Chikitsa in treatment?

Satvayavajay Chikitsa emphasizes psychotherapy and counseling, addressing the psychological aspects of enuresis, which helps improve the child's mental health and aids treatment effectiveness.

Glossary definitions and references:

Scientific and Ayurvedic Glossary list for “Review on shayyamutrata: childhood disorder and its multi-drug management.”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.

1) Shame (Same):
Shame is a significant emotional response in children suffering from Shayyamutrata, which can lead to decreased self-esteem and social withdrawal. The disorder often creates feelings of embarrassment, leading children to avoid social gatherings and impacting their overall mental health, as illustrated in the case study of a 9-year-old boy.

2) Study (Studying):
The study is a detailed analysis conducted to explore the condition of Shayyamutrata and its treatment through Ayurvedic methods. It aims to gather empirical evidence on the efficacy of a multidrug regimen and psychotherapy on nocturnal enuresis, thus contributing to the broader field of pediatric health and Ayurvedic medicine.

3) Drug:
Drugs refer to the Ayurvedic formulations used for treatment in the study. The combination of various herbal compounds aims to target multiple symptoms associated with Shayyamutrata, reinforcing the importance of multi-drug regimens in managing complex childhood disorders in Ayurveda.

4) Candraprabha (Candra-prabha):
Chandraprabha is an herbal formulation used in Ayurveda primarily for urinary disorders. It is believed to improve bladder tone and reduce urgency, making it relevant in managing Shayyamutrata. Its inclusion in the treatment regimen highlights the application of classical Ayurvedic principles to address contemporary medical issues.

5) Vati:
Vati refers to a form of Ayurvedic medicine that is typically in the form of tablets or pills. This preparation is significant as it is used in the composition of Chandraprabha Vati, showcasing the traditional methods of creating concentrated herbal remedies aimed at treating specific ailments like nocturnal enuresis.

6) Medicine:
Medicines encompass the various treatments employed in Ayurveda to address health concerns. In managing Shayyamutrata, a combination of herbal medicines is essential for achieving effective symptom relief and long-term resolution of the disorder.

7) Brahmi:
Brahmi (Bacopa monnieri) is a revered herb in Ayurveda known for its cognitive and neuroprotective properties. In the study, Brahmi Churna is utilized for improving the mental state of children suffering from Shayyamutrata, emphasizing its role in addressing the psychological aspects of bedwetting.

8) Apana:
Apana refers to one of the vital airs (vayu) in Ayurveda responsible for downward movement in the body, particularly in the digestive and excretory systems. Its role is crucial in understanding the physiological underpinnings of Shayyamutrata, as it might be vitiated or underdeveloped in cases of nocturnal enuresis.

9) Samhita:
Samhitas are comprehensive texts in Ayurveda that document various aspects of medicine, including diagnosis, treatment, and plant knowledge. They are crucial resources for practitioners treating conditions like Shayyamutrata and reinforce the established nature of Ayurvedic medical practices.

10) Vyana:
Vyana is another vital vayu in Ayurvedic belief, responsible for circulation and distribution of energy throughout the body. Its proper functioning is essential for overall health and balance; disturbances may contribute to conditions like Shayyamutrata, highlighting the interconnectedness of physiological systems in Ayurvedic medicine.

11) Prana (Pran):
Prana is the life force in Ayurvedic philosophy that governs vital functions in the body. Its regulation is essential for the management of conditions like Shayyamutrata. Understanding its dynamics helps address the root causes of the disorder by focusing on the balance of bodily energies.

12) Maharashtra (Maharastra, Maha-rashtra):
Maharashtra is the Indian state where the study was conducted and where the LRP Ayurvedic College is located. The region plays a role in disseminating Ayurvedic knowledge and practices, making it a relevant backdrop for innovative research on childhood disorders and treatment methodologies.

13) Ayurveda (Ayus-veda):
Ayurveda is an ancient holistic system of medicine from India that emphasizes balance in bodily systems and the use of natural remedies. The study applies Ayurvedic principles to treat Shayyamutrata, demonstrating the relevance of this system in contemporary healthcare settings.

14) Vidanga (Vidamga):
Vidanga (Embelia ribes) is an herb recognized in Ayurvedic practice for its deworming properties. In the context of the case study, it is included to improve the overall health and digestive properties of the child, indicating the multifaceted approach of Ayurveda to treat underlying issues.

15) Kapha:
Kapha is one of the three doshas in Ayurveda, associated with water and earth elements. Its imbalance can lead to various disorders, including Shayyamutrata, as it may encircle Apana, the downward-moving vayu. Understanding Kapha's role is essential in devising effective treatment strategies.

16) India:
India is the cultural and geographic context for the study, where Ayurveda is a widely accepted and practiced health system. The socio-cultural environment impacts children's health and can therefore influence the manifestation and management of conditions like Shayyamutrata.

17) Male:
In the study, the patient was a 9-year-old male child. The gender aspect can be significant as studies indicate that bedwetting may have different prevalence and psychological impacts in boys compared to girls, influencing both social interactions and treatment approaches.

18) Mental disorder:
The term mental disorder refers to conditions that affect mood, thinking, and behavior. In the context of Shayyamutrata, associated emotional issues like shame and embarrassment are critical to address for successful treatment, highlighting the interaction between physical and emotional health.

19) Observation:
Observation in the study involves the assessment of symptoms and responses to treatment over time. Carefully monitoring changes in bedwetting frequency, emotional health, and other parameters helps practitioners understand the effectiveness of their treatment strategy using Ayurvedic principles.

20) Vitiation (Vitiated):
Vitiation refers to the disruption or imbalance of a bodily process, in this case, the control over micturition. Understanding how vitiation occurs due to factors like Kapha disturbance helps in identifying effective Ayurvedic treatments to restore balance and prevent Shayyamutrata.

21) Gathering:
Gathering refers to social interactions and events the child might avoid due to the stigma associated with bedwetting. Reducing feelings of shame connected to Shayyamutrata can encourage participation in social activities, which is crucial for a child's development and mental well-being.

22) Nighantu (Nighamtu):
Nighantu refers to a type of Ayurvedic text that lists medicinal plants along with their properties and uses. It serves as a valuable reference for practitioners, informing them about potential treatments for conditions like Shayyamutrata, thus aiding in drug formulation and selection.

23) Activity:
Activity generally refers to the actions and interactions of the individual. In a therapeutic context, both physical and psychological activities can influence Shayyamutrata, stressing the need for comprehensive treatment approaches that include lifestyle and behavioral modifications.

24) Varsha (Varsa):
Varsha is the name of the lead author of the study, Dr. Varsha Bagal. The contributions of individual researchers are important in advancing knowledge and practice in fields like Ayurveda, particularly when addressing common children's disorders such as Shayyamutrata.

25) Family:
Family dynamics can significantly impact a child's mental health and emotional well-being, especially regarding conditions like Shayyamutrata. Supportive family environments can help reduce feelings of shame and encourage positive treatment outcomes through understanding and collaborative approaches.

26) Sharman (Sarma, Sharma, Sarman):
Sharma is a common surname in India, associated here with Dr. Sharma who may have contributed knowledge to the study or Ayurvedic practices. The expertise and backgrounds of practitioners play a vital role in implementing effective treatment strategies in Ayurvedic medicine.

27) Birth:
Birth is a critical life phase that can affect long-term health outcomes, including susceptibility to conditions like Shayyamutrata. The patient's birthing history, including factors like delivery method and early feeding practices, provides valuable context for understanding his current health issues.

28) Tama:
Tama refers to one of the three Gunas in Ayurveda representing darkness or inertia. In the context of Shayyamutrata, high levels of Tama can be implicated in emotional disturbances and vitiation of bodily functions, influencing both the condition and its treatment.

29) Katu:
Katu refers to a taste associated with pungency in Ayurveda, often linked to therapeutic properties in herbal preparations. Understanding the different tastes and their effects is essential when formulating medicines for treating ailments like bedwetting within Ayurvedic practice.

30) Vata:
Vata is another of the three doshas, representing air and space, and is linked to movement and control functions within the body. Its balance is crucial for preventing issues like Shayyamutrata, highlighting the importance of doshic harmony in Ayurvedic healthcare.

31) Food:
Food plays a significant role in Ayurveda as it influences health through nutrition and the body’s constitution. The choice of dietary practices can affect the symptomology and management of childhood disorders like Shayyamutrata, guiding the dietary recommendations of Ayurvedic treatment.

32) Fear:
Fear is a significant emotional response that may exacerbate Shayyamutrata, influencing behavioral patterns in children. Addressing underlying fears through therapy is vital for recovery, helping alleviate the psychological burden and restoring a child's confidence.

33) Mental health:
Mental health encompasses emotional, psychological, and social well-being, influencing how children think and feel. For cases like Shayyamutrata, improving mental health through supportive therapies is crucial for holistic healing and achieving a better quality of life.

34) Avalambakakapha (Avalambaka-kapha):
Avalambaka Kapha is related to the mucus and lubrication that supports bodily structures. Its imbalance might contribute to conditions like Shayyamutrata, emphasizing the interconnectedness of doshas and the need for proper management of Kapha in treatment strategies.

35) Mandukaparni (Manduka-parni, Mamdukaparni):
Mandukaparni, or Centella Asiatica, is praised in Ayurveda for its cognitive benefits. Its inclusion in treatments reflects the importance of using herbs that promote mental clarity and stress reduction, both critical in the management of conditions like Shayyamutrata.

36) Vyanavata (Vyana-vata):
Vyana-vata is vital for the circulation and distribution of energy in the body. Its significance in maintaining physiological balance highlights the need for a comprehensive Ayurvedic approach that considers the interaction of various vata types in treating childhood disorders.

37) Apanavata (Apana-vata):
Apana-vata is essential for the elimination processes in the body. Understanding its role helps in addressing challenges in managing Shayyamutrata since disturbances in Apana can lead to issues with bladder control and micturition.

38) Avalambaka:
Avalambaka is a specific function of Kapha that provides support and stability. Its adequate functioning is crucial in managing bodily processes and maintaining health, particularly in cases like Shayyamutrata where control over bodily functions can be compromised.

39) Bhaishajya (Bhaisajya):
Bhaishajya refers to the knowledge and practice of medicine in Ayurveda. This term reflects the holistic approach of the Ayurvedic system wherein various medicinal plants and therapies are utilized in treating conditions like Shayyamutrata effectively.

40) Samprapti:
Samprapti refers to the pathogenesis or progression of a disease in Ayurveda. Understanding the Samprapti of Shayyamutrata allows practitioners to target specific factors contributing to the disorder, guiding effective and individualized treatment planning.

41) Stambhana:
Stambhana refers to the property of medicines that help control or suppress excessive bodily functions. In treating Shayyamutrata, drugs with Stambhana properties are crucial for addressing the involuntary urination issue and reestablishing bladder control.

42) Substance:
Substance typically refers to any material or medicine utilized in treatment. Understanding the properties and interactions of different substances in Ayurvedic practice is vital for effective treatment strategies, especially in complex conditions like Shayyamutrata.

43) Shilajit (Silajit, Shila-jit):
Shilajit is a mineral-rich substance in Ayurveda with rejuvenating properties. Its inclusion in formulations like Chandraprabha Vati underscores its significance in enhancing therapeutic efficacy, aiding overall health, and supporting treatment goals associated with Shayyamutrata.

44) Tridosha (Tridosa, Tri-dosha):
Tridosha is a fundamental concept in Ayurveda representing the three primary doshas: Vata, Pitta, and Kapha. Understanding how these energies interact is crucial in diagnosing and treating conditions like Shayyamutrata, ensuring a balanced approach to health.

45) Shalmali (Salmali):
Shalmali refers to a type of tree valued in Ayurvedic texts for its various properties. Its relevance may extend to broader Ayurvedic herbal medicine applications, reinforcing the comprehensive nature of treatment strategies in managing disorders like Shayyamutrata.

46) Varanasi (Varanashi):
Varanasi is a historic city in India known for its cultural and spiritual significance. Its association with Ayurveda and traditional medicine makes it a notable reference in Ayurvedic literature, contributing to the foundation of medicinal practices employed in the study.

47) Rasayana (Rasa-ayana):
Rasayana refers to rejuvenation therapies in Ayurveda aimed at promoting longevity and health. Its principles can enhance treatment strategies for conditions like Shayyamutrata, focusing on restoring balance and vitality to individuals undergoing therapy.

48) Shailaja (Sailaja, Shaila-ja):
Shailaja is likely a reference to Dr. Shailaja, a contributor or authority in the field related to Ayurveda. Recognition of individual expertise within the scope of the study underscores the collaboration that enriches Ayurvedic practice and research.

49) Avarana:
Avarana refers to the obstruction or covering that affects the flow of energies in the body. In the context of Shayyamutrata, Avarana may hinder the normal functioning of Apana, emphasizing the need to identify and treat underlying blockages in Ayurvedic therapy.

50) Snigdha:
Snigdha describes a quality of being unctuous or oily in Ayurvedic texts, often associated with nourishment and comfort. This quality is important in formulating treatments that aim to provide holistic benefits for conditions such as Shayyamutrata.

51) Samaka (Shamaka):
Shamaka refers to balancing qualities that restore stability and health. In treating Shayyamutrata, the identification of Shamaka properties within herbal drugs is essential for promoting overall wellness and addressing the primary imbalances contributing to the disorder.

52) Kashaya (Kasaya):
Kashaya represents a taste that is astringent in Ayurveda, often used in medicinal preparations for its therapeutic properties. Understanding Kashaya's impact helps in creating effective formulations that target specific conditions like Shayyamutrata.

53) Disease:
Disease in this context refers to Shayyamutrata, specifically nocturnal enuresis in children. Understanding the disease's nature, causative factors, and its effects on mental health is crucial for developing effective interventions and treatment plans within Ayurvedic practices.

54) Meeting:
Meeting refers to gatherings or interactions that the child may avoid due to the shame associated with bedwetting. Addressing social withdrawal through successful treatment is essential for improving their confidence and quality of interactions with peers.

55) Jaggery:
Jaggery (Guda) is a traditional sweetener used in Ayurvedic medicine to enhance the flavor of herbal formulations. It is included in treatments because it not only improves palatability but may also offer additional health benefits, contributing to overall well-being.

56) Anxiety:
Anxiety is an emotional condition that can exacerbate symptoms of Shayyamutrata. Understanding the psychological component is vital for treatment, emphasizing the need for comprehensive management that addresses both the physical and emotional aspects of the disorder.

57) Science (Scientific):
Science refers to the systematic study of the structure and behavior of the physical and natural world through observation and experimentation. In the context of this study, the integration of scientific methods and Ayurvedic practices showcases an evolving approach to understanding and treating childhood disorders.

58) Madhya:
Madhya signifies a moderate quality, often associated with balance in Ayurveda. In the case of Shayyamutrata, achieving Madhya in treatment strategies illustrates the importance of equanimity in addressing the emotional and physiological states of the child.

59) Vipaka:
Vipaka refers to the final metabolic transformation of food after digestion, determining its effects on the body. Understanding Vipaka is crucial for practitioners when formulating herbal treatments for conditions like Shayyamutrata, helping predict their therapeutic outcomes.

60) Medhya:
Medhya relates to medicines that promote cognitive functions and mental clarity. Its application in treating Shayyamutrata emphasizes the importance of addressing mental health aspects alongside physical symptoms for effective Ayurvedic treatment.

61) Nature:
Nature emphasizes the inherent qualities of substances used in Ayurveda. Recognizing the unique characteristics of herbs and their therapeutic properties is essential in formulating treatments for conditions like Shayyamutrata effectively.

62) Kalpa:
Kalpa refers to a type of Ayurvedic preparation that includes various herbal formulations designed for specific health outcomes. Understanding Kalpa enables practitioners to combine elements effectively to create comprehensive treatment regimens for issues like Shayyamutrata.

63) Tikta:
Tikta describes a bitter taste in Ayurvedic texts, often linked to detoxifying properties in herbs. Recognizing and utilizing Tikta qualities in formulations can enhance treatment effectiveness for health issues like Shayyamutrata by promoting purification.

64) Ushna (Usna):
Ushna represents the qualities of being hot or heating in Ayurveda, often associated with stimulating metabolic processes. Its role in formulations can be essential for specific conditions like Shayyamutrata, demanding careful balance with cooling properties.

65) Mridu (Mrdu):
Mridu denotes a gentle or soft quality in Ayurvedic medicine, often associated with soothing actions. Its incorporation into treatments for conditions like Shayyamutrata highlights the importance of addressing both physical and emotional facets of healing.

66) Gupta:
Gupta is a common surname in India, likely representing an author or practitioner contributing to the study. It highlights the collaborative effort in Ayurvedic research, underscoring the significance of shared knowledge in advancing healthcare practices.

67) Virya:
Virya refers to the potency or strength of a drug in Ayurveda, influencing its therapeutic effectiveness. Understanding the Virya of various medicines is crucial for practitioners to devise appropriate doses and strategies for treating conditions like Shayyamutrata.

68) Varga:
Varga refers to a category or class of substances in Ayurvedic texts. This classification helps practitioners select appropriate ingredients and formulations for treatments, ensuring targeted approaches to manage specific health conditions.

69) Grahin (Grahi):
Grahi is a term for medications that possess binding or controlling qualities, often used in Ayurvedic treatment for diarrhea or frequent urination. Understanding this property is relevant for managing conditions like Shayyamutrata, highlighting the focus on improving bladder control.

70) Patil:
Patil is likely in reference to Dr. Sandeep Patil, the guide in the study. The collaboration among practitioners is integral in advancing treatment practices in Ayurveda, showcasing shared expertise in the management of conditions like nocturnal enuresis.

71) Water:
Water in Ayurveda is essential for sustaining life and is often considered in formulations. Hydration and proper fluid intake are key components in the management of Shayyamutrata, influencing bladder function and overall health.

72) Honey:
Honey is commonly used in Ayurvedic preparations for its natural sweetness and potential therapeutic properties. Its use in treatments helps improve palatability, making herbal medications more acceptable and easier to consume for children undergoing treatment.

73) Hindi (Himdi):
Hindi is the language commonly spoken in many parts of India, including where the study was conducted. Language plays a crucial role in disseminating Ayurvedic knowledge, making it accessible to a wider audience and enhancing the understanding of treatments for conditions like Shayyamutrata.

74) Pulse:
Pulse refers to the rhythmic contraction of the heart, an important vital sign in health assessments. In the context of Shayyamutrata, monitoring pulse can indicate underlying conditions and help practitioners evaluate the holistic health of the patient.

75) Nish (Nisa, Nis, Nishe, Nisha):
Nisha might refer to a name or represent knowledge aspects in Ayurveda. The inclusion of various contributors’ names highlights the collaborative nature of Ayurvedic practice, emphasizing the shared responsibility in treating conditions effectively.

[Note: The above list is limited to 75. Total glossary definitions available: 79]

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