AMELIORATION OF KARSHYA (PROTEIN ENERGY MALNUTRITION) IN PRESCHOOL CHILDREN BY ADJUVANT THERAPY OF KRISHNADI GRANULES WITH SUPPLEMENTARY NUTRITION UNDER INTEGRATED CHILD DEVELOPMENT SERVICES (ICDS) SCHEME- A RANDOMIZED CONTROLLED CLINICAL STUDY
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Abstract
Background- Protein Energy Malnutrition (PEM) in children is great concern in India and worldwide. India combats this grappling issue through holistic and ambitious Integrated Child Development Services (ICDS). Ayurveda is successfully utilized to manage Karshya and PEM. Thus, a novel study was designed to integrate supplementary nutrition of ICDS with Ayurvedic formulation, Krishnadi Granules (Piper longum, Withania somnifera, jaggery and cow ghee). Its adjuvant efficacy was studied in malnourished preschool children compared with only supplementary nutrition.
Methods- 34 children (3-6 years age) with classical signs of Karshya and uncomplicated PEM (MAM and uncomplicated SAM) were randomized in 1:1 in study group and control groups. In this 90-days study, children were assessed fortnightly for changes in cardinal features of Karshya, anthropometric parameters and PEM gradation and laboratory parameters.
Results- The children from both groups exhibited significant improvement in Karshya, with superior effect size in study group. Appetite improved in study group children with 46.7 % superiority. Also, everyone upgraded to appearance grades 0 and 1. Significant improvement in anthropometric parameters (weight, height, and Mid Arm Circumference), was observed with superiority in study group. There was 3x improvement in weight for age and 2x improvement in Body Mass Index (BMI) and weight for height scores. Significant improvement in laboratory parameters, except random blood sugar and serum transferrin in both groups was observed.
Conclusion- The adjuvant treatment of Krishnadi Granules with supplementary nutrition improved Karshya and PEM grades with superior effect size. Such integration can be useful in towards mitigating PEM issue with expedite.
Study Registration-CTRI/2021/01/030309