Introduction
Mental retardation is defined by the American Association on Mental Retardation (AAMR) as “significantly sub average intellectual functioning existing concurrently with related limitations in two or more of the following applicable adaptive skill areas: communication, self-care, home living, social skills, community use, self-direction, health and safety, functional academics, leisure and work,” with such limitations manifested “before age 181.
Mental retardation is one of the most common disabilities occurring in childhood2. Intellectual disability is one the great burden for the parents, caretakers, society, and finally to the nation because of limitations in the awareness and treatment hence present study has been taken to add something to existing therapies to manage this condition. In Ayurveda, there are ample evidence of many treatment modalities and nootropic drugs used for improvement and enhancement of mental sub capability, among various treatments Panchabhautika ghritha3 has been selected which is mentioned in Kashyapa Samhita to treat clinical conditions like Jadatva (Intellectual disability). It is well established in Ayurveda classics, that there is a close relationship between the nāsā (nose) and śiras (brain),nāsā is one among the pañcajñānendriyas (five sense organs) whose function is not limited to olfaction and respiration but is also the pathway to śiras. The medicine administered through the nostrils reaches up to śṛṅgāṭaka marma, spreads all over ūrdhvajatru, and eliminates the deep-seated doṣas4. Hence Nasya karma is been choosed and ghritha is best in Manasa vikara hence ghritha Nasya is selected. So Panchabhautika ghritha has been taken to validate/ prove its effect on mental retardation there by to make the child more enough to perform the activities of daily life by improving the mental sub capability.
Objectives
To assess the clinical effect of Pancha Bhautika ghritha Nasya in the management of intellectual disability.
Methodology
Study design
The children with intellectual disability attending to OPD and IPD of Kaumarabhritya dept, SJG Ayurvedic medical college and Hospital will be selected after taking consent from parents/guardians for the present study.
Sample size :
Total 15 children with intellectual disability will be selected for the present study
Selection criteria:
Inclusion criteria:
- Children with intellectual disability in the age range of 05-16 years of either gender.
- Children displaying symptoms of mild to moderate intellectual disability, like delayed milestones, speech disorders, hyperactivity and mental development and behavior not proportionate with chronological age as per the conditions laid down by Diagnostic and Statistical Manual of Mental Disorders - V, will be included.
Exclusion criteria:
- Cases with uncontrolled epilepsy, hyperkinesis, psychosis, and organic brain diseases, aminoaciduria and other inborn errors of metabolism, encephalitis, etc.
- Children with other severe systemic disorders.
- Children of mental impairment other than intellectual disability.
- Profound intellectual disability.
Drug preparation and posology:
Panchabhautika ghrita will be prepared as per Ghritha Kalapana mentioned in sarangadhara samhitha by using these drugs of jeevaka,vrishabaka, draksha, Madhukar, pippali, Bala, prapoundarika, brihati, manjista, twak, punarnava, sarkara, amshumati, medha, vidanga, neela, utpala, gokshura, saindhava, rasna, and nidhigdhika .
Posology:
6-8 drops of ghritha will be instilled in each nostril in the morning with empty stomach according to age of the child.
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Treatment is planned for 2 sittings with gap of 15 days.
Procedure will be carried out for 7 days continuously and same treatment will be repeated after 15 days from the last day of 1st sitting.
Follow-up period - 1 month from the last day of treatment.
Total study duration - 2 months
Assessment criteria:
Parameters will be assessed by using Wechsler′s Intelligence Scale for Children (WISC) before treatment (1st day)and after first sitting (7th day)and after 2nd sitting (30th day).and appropriate statistical test will be applied.
Implications
Mental retardation is one of the challenging problems in the society When the scientists all over the world are turning to other systems of medicine in fields where Allopathy has failed to make a dent with the hope of finding new therapeutic measures, drugs or procedures mentioned in Ayurveda are to be validated and they are worth experimenting hence present drug has been selected for nasya as many uses mentioned under this drug like muka,jadatva, various akshi roga nidra nasa,ardhitha can be treated effectively by using Nasya with panchabhoutika tail/ghritha, so initiative step has been taken to prove its efficacy.
And future research will be done on remaining diseases under the indications of this particular drug.
References
- Kiely M. The prevalence of mental retardation. Epidemiol Rev. 1987;9:194–218.
- Chen J, Simeonsson RJ. Prevention of childhood disability in the People's Republic of China. Child Care Health Dev. 1993;19:71–88.
- KashyapSamhita, edited by Shri SatyapalBhishagacharya with Hindi commentary Vidyotini, Reprint edition, Choukhmbha Sanskrit Series, Varanasi, Kalpa sthana,shatkalpa adhyaya /40 sloka.
- Trikamji AJ, editor. 5th ed. Varanasi: Chaukhamba Sanskrit Sansthan; 2006. “25th Adhyaya” Chikisthasthana. Charaka Samhita.
- Malin AJ. Malin's intelligence scale for Indian children (MISIC) Manual. Lucknow: Indian Psychological Corporation; 1969
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