Kavithalaya, K (2022) Clinical Evaluation and Therapeutic Management of Baala Vatham (Paresis) by Mahaanaluruva Chooranam (Internal) alongwith Chennagarapattai Ennai (External) in Children. Masters thesis, National Institute of Siddha, Chennai.
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Abstract
Paresis is a condition typified by a weakness of voluntary movement, or by partial loss of voluntary movement or by impaired movement. Neurologists use the term paresis to describe weakness, and plegia means paralysis in which all voluntary movement is lost. The term paresis means 'letting go' from 'to let go, to let fall'. ❖ Spasticity defined as increased, involuntary, velocity dependent muscle tone that cause resistance to movement is a complex condition that often cause pain, contractures, and impairment of basic self-care activities of daily living, such as eating, dressing and attending to the personal hygiene. Spastic paresis is broader, including muscle over activity, dystonia and co- contracions. ❖ Disability prevalance is higher in developing countries; people with disabilities are more likely to experience adverse socioeconomic outcomes such as less education, poor health outcomes, lower levels of employment, higher poverty rates. ❖ Children with multiple disabilities associated with impairments which range across sensory, motor, physical, socio emotional, behavior and cognitive domains known as “Special children” There are many physical disabilities that can affect children. But paresis is the most common mental disability in childhood. ❖ However, modern drugs can be said to partially fulfill desirable requirements in some extent. It is in the context that we have undertaken a review of the Siddha formulation which could help management of baalavatham (paresis). In the view of the above, great efforts have been made to find out the alternate Siddha medicines and methodologies to improve the life style of special children with baalavatham. ❖ Siddha literature suggested the internal and external therapies which include the Maha analuruva chooranam and Chennagarapattai ennai Thokkanam. Children who are attending the outpatient department of Kuzhandhai Maruthuvam in National Institute of Siddha having the complaints of baalavatham (Paresis) as weakness of any one or more limbs, difficulty in walk, difficulty in climbing stairs, pain or tingling sensation in both limbs, stiffness of muscles, gait disturbances, acquired speech and lost it. Clinical diagnosis of baalavatham was done on the clinical features described in Siddha texts. ❖ The Authentication of ingredients of the trial drug Maha analuruva chooranam and chennagarapattai ennai was obtained from Medicinal Botanist, National Institute of siddha, Chennai. Purification of raw drugs and preparation of trial drug was done at Gunapadam Laboratory, Department of Gunapadam, National Institute of siddha, Chennai, under the supervisor of the guide & supervisor. ❖ The Maha analuruva chooranam (Internal medicine) is a typical medicine indicated for baalavatham in the Siddha text book Agathiyar vallathi 600 and Chennagarapattai ennai (External medicine) is placed in Madhalai noi thoguthi III. In treatment aspect all the cases were treated with this medicine for 48 days. The observation made during this study showed that the trial medicine and procedure were clinically effective. It is showed safe and efficacies in treating paresis children. ❖ Biochemical Qualitative analysis of trial drug was done in Biochemistry Laboratory, Department of Biochemistry, National Institute of Siddha, and Chennai-47. Physicochemical analysis and phytochemical analysis was done in Noble Research Solutions, Chennai-11. Heavy metal analysis, aflatoxin analysis is done at ITC labs, Panchkula; there is absence of heavy metals and aflatoxins in this maha analuruva chooranam. ❖ The trial medicine Maha analuruva chooranam shows the presence of Sulphate, chloride, sulphide, fluride and oxalate, Carbonate by acidicradi calstest. Iron, Calcium, ZincMagnesium, potassium, ammonium and Aluminium present by Basic radicals test. The Miscellaneous test shows the presenc eof Starch, Alkaloids, tannic acid, unsaturated componds. ❖ Evaluation of the drug maha analuruva chooranam (internal) and chennagarapattai ennai (external medicine) was done after getting approved by IEC of National Institute of Siddha. The IEC No is 21-12-2020; NIS/IEC/2020/D-20 and the trial are registered in Clinical trial Registry of India with Reg. No CTRI/2021/08/035549. ❖ Paresis Children were treated with trial drug Maha analuruva chooranam with dosage 350 mg for 3-4 years, 500mg for 5-7 years and 750mg for 8-12 years bid with honey for 48 days. The external therapy thokkanam also given for 48 days. ❖ Assessment of spasticity based on MAS, MRC muscle tone, Dynamic gait index, Gross Motor Function Classification System (GMFCS), selective assessment of upper and lower extremities. After the treatment of 48 days, the assessment of clinical study shows all the Paresis childrenhadimproved. Based on the Modified Ashworth scale – Totally 30 children were treated for Balavaatham no children were reported with Grade 0 (No increase in muscle tone) Grade 1. Out of 7 (23.33%) children reported with Grade 2 at 0th day and no improvement in 24th day. out of them 10 (33.3%) children had which exhibits Grade 1, and 2 (6.67%) children had Grade 1+ at the end of the treatment which good improvement. Out of remaining 23 children, 6.67% children were reported with grade 1+ on 0th day no improvement in 24th day, after 36.6% children were improved at 48th day. Out of 9 children with Grade 3 at 0th day. No improvement in 24th day 5 (23.33%) child improved to Grade 1 and (91.6%) children had improvement to Grade 1+. Out of 5 children with grade 4, no improvement in 24th day, 6.67% children were improved in grade 2, 1+. As there is a very good improvement after treatment as noted above it can be concluded that the drug has reduced the spasticity of the affected children. ❖ After the treatment they were reduced symptoms are stiffness of muscles, weakness of limbs, pain during flexion or extension, difficult to walk, stand, climbing stairs, difficult to hold the objects, semi-circumduction gait. The result of the study showed that severely affected 30 children had turned to moderate state. The trial drugs have showed good response in treating the baalavatham, it showed reduced spasticity. CONCLUSION: In Siddha literature Paresis is under the Vatha disease therefore, the therapeutic management is considered to be internal medicine, (Thokkanam) massaging. Siddha system of medicines has certainty with safer medications to treat children. Children with paresis have multiple symptoms for which no curative treatment exists. Manipulative and body-based methods such as Thokkanam, Podithimirthal to improve the quality of life of paresis children. ❖ The trial drug Maha analuruva chooranam along with chennagarapattai ennai massage was treated to the children. Maha analuruva chooranam is primary used to enhance neurological function. The Alkaloids, Quinones, Diterpenes, Flavanoids, Saponin, Carbohydrates are responsible for increase in the muscle tone through enhancing the nerve impulse transmission. ❖ Massage with Chennagara pattai ennai which soothe the sensory nerve endings, they produce a hyperaemic effect causing the arterioles dilate in musculature, and reduce stiffness. Massage is also thought to provide a soothing, sedative, invigorating feeling and can give the comfort. In clinical analysis we observed motor function like spasticity, muscle tone, Gross motor function analysis and Gait analysis showed significant improvement in children. But the results had shown significantly differed each other. ❖ However, children had shown significant improvement in all clinical parameters in children. Thus, Siddha protocol of management can provide some benefit by giving possible improvement in the present condition and minimize the disability of those innocent children and improve their quality of life and give active and self-supporting happy life.
| Item Type: | Thesis (Masters) |
|---|---|
| Additional Information: | Reg.No.321914203 |
| Uncontrolled Keywords: | Clinical Evaluation, Therapeutic Management, Baala Vatham, Paresis, Mahaanaluruva Chooranam, Chennagarapattai Ennai, Children. |
| Subjects: | AYUSH > Kuzhanthai Maruthuvam |
| Depositing User: | Subramani R |
| Date Deposited: | 01 May 2023 16:13 |
| Last Modified: | 24 Feb 2024 05:54 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/21189 |
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