From,
Sharvari Deshpande
Preliminary M.D. (AYU) Scholar,
Department of postgraduate studies in Kaumarabhritya,
S.D.M College of Ayurveda and Hospital,
Hassan 573201.
To,
The Registrar,
Rajiv Gandhi University of Health Sciences,
Bangalore, Karnataka.
Through,
The Principal and Head of the department of Kaumarabhritya,
S.D.M College of Ayurveda and Hospital,
Hassan- 573201.
Subject: Submission of completed Proforma for Registration of subject for
Dissertation.
Respected Sir,
I request you to kindly register the mentioned subject against my name for the submission of dissertation to the Rajiv Gandhi University of Health Sciences, Karnataka, and Bangalore for partial fulfillment of M.D (Ayu).
Title of the Dissertation:
CLINICAL STUDY ON ASSESSMENT OF
GROWTH AND DEVELOPMENT IN INFANTS
WITH SHASHTIKSHALYADI CHURNA AS WEANING FOOD
Here with, I am enclosing completed Proforma of Synopsis for Registration of subject for Dissertation.
Thanking You,
Yours faithfully,
Place: Hassan
Date: Sharvari Sunil Deshpande.
RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,
BANGALORE, KARNATAKA
ANNEXURE – II
COMPLETED PROFORMA FOR REGISTRATION OF SUBJECT OF DISSERTATION
1. NAME OF THE CANDIDATE : SHARVARI S. DESHPANDE
AND ADDRESS PRELIMINARY M.D (AYU)
SCHOLAR, DEPARTMENT OF P.G STUDIES IN KAUMARABHRITYA
PERMANENT ADDRESS : D/O SHRI SUNIL G. DESHPANDE.
Shree “Rajbaug” Bungalow;A/S/B
Plot 18, Ashwin Nagar,Nasik 422009.
Maharashtra.
2. NAME OF THE INSTITUTION : SDM COLLEGE OF AYURVEDA AND HOSPITAL HASSAN – 573201
KARNATAKA
3. COURSE OF STUDY & : M.D (AYU) KAUMARABHRITYA
SUBJECT
4. DATE OF ADMISSION :
TO THE COURSE
5. TITLE OF THE TOPIC : CLINICAL STUDY ON ASSESSMENT
OF GROWTH AND DEVELOPMENT IN
INFANTS WITH SHASHTIKSHALYADI
CHURNA AS WEANING FOOD
6.1 NEED FOR THE STUDY:
Complementary feeding means giving the child other nutritious foods in addition to breast milk. Breastfeeding alone is sufficient for first 6 months of life, thereafter concentrated energy dense complementary foods are essential in order to maintain an adequate velocity of growth for the infant . 1
Weaning is defined as the process of progressive transfer of the baby from breast milk to usual family or adult diet. Kashyapacharya has mentioned the introduction of semisolid food as Anna Prashana samskar (ceremonial initiation of complementary feeding). This takes place around 6 months of age. 2
WHO defines Complementary food as any food whether manufactured or locally prepared, suitable as a complement to breast milk or to infant formula, when either become insufficient to satisfy then nutritional requirements of the infant. Such food is also commonly called weaning food or breast-milk supplement .3
Weaning foods must be with desirable qualities like high in energy , easy to digest, low in bulk and viscosity, easy to prepare. The cereals form the important part of diet in various parts of India. They form an important source of energy, iron, protein, in the Indian diet and also supply certain amount of fat. 4
Establishing of appropriate and quality weaning foods that assist in motor skills and motor development will be important. There is a need for complementary foods which are with optimum nutritional value and also economically sustainable .They should have good acceptability by both mothers /caregivers. With all the above objectives, in mind preparation with Shashtik Shali and other drugs like Godhuma, Yava, Vidanga in churna form (powder) (along with advised diet and breast milk) as mentioned by Kashyapacharya has been selected.5
6.2 : REVIEW OF LITERATURE:s
WEANING FOODS
There are scattered refrences available in literature regarding the introduction of starting complementary feeds. In grihya sutra a simple principle is followed that food of all kinds of flavours should be mixed and given to the child. Most of Grhya sutras have advocated the use of various birds and other food articles for weaning.6Anna-prashana should be started around 6th or 8th month.Otherwise this samskara should be done according to the family.(according to own kula). 7. Advices to start weaning at 6th months of age , with food which is laghu(easily digestible ) and hitakara (beneficial) diet.8
The opinion to give the child solid food slowly , gradually , as much as it desires (without forcing it).In another context explanation says that with eruption of teeth , the child should be gradually weaned from breast.9,10. Advices that at physician should prescribe feeding(juice) of various fruits in 6th month and after the eruption of teeth or in 10th month, the feeding of cereals (Anna-Prashana) should be done . Mention of few yogas in this context is there with explanation of few lehyas in context.11 Some nighantu advices to give food for the first time at 6th or 8th month used as supplemental food for the child whose mother has deficient milk.12
Mention of shashtik shali as sheeta (cooling),snigdha (unctuous), laghu (easy to digest), sthiratmak (gives stability to body). Godhuma as Brihmana (strengthens body tissues), sheeta (cooling), swadu (sweet in taste) , jeevana (nourishes body tissues). Yava as sheeta (cooling), balya (strengthens body tissues), sleshma vikarnrut ( pacifies diseases of kapha ).13 Vidanga as vanhikara (generates digestive fire),krimihara( acts on intestinal worms.)14 From about 6 months onwards there is a gap between the total energy needs and energy provided by breast milk. This gap increases as the child gets older. Therefore introduction of weaning foods/complementary foods with qualities like high in energy, easy to digest, semi-solid consistency, low in bulk, fresh and clean in expensive and easy to prepare will bridge the gap.15
PREVIOUS RESEARCH WORKS :
1 Lekshmi, Effect of Priyaalamajjaadi Yoga in growth and development of children. Dept. of Kaumarabhritya. Univesity of kerela.2008.
2 Panot Bhavesh Nareshchandra, A study on growth and development with supplementation of modaka(containing priyala majja) during weaning. Dept. Of Kaumarabhritya ,Rajiv Gandhi University of health sciences, Karnataka. 2006.
6.3. OBJECTIVE OF THE STUDY:
To Assess the effect of Shastikshalyadi weaning powder on growth and development of infants.
7. MATERIAL AND METHODS:
7.1 SOURCE OF DATA:
Infants will be selected from OPD and IPD of S.D.M. College of Ayurveda and Hospital, HASSAN whose parents are ready to administer the Shastikshalyadi weaning powder .
7.2 METHODS OF COLLECTION OF DATA:
Diagnostic Criteria:
Apparently healthy infants of weaning period will be selected
Inclusion Criteria: Infants age group of 6 to 9 months who have not been put on weaning food.
Exclusion Criteria:
1: Infants of Premature birth
2: Infants having malnutrition disorders like Protein energy malnutrition, Marasmus, etc.
3: Infants having congenital disorders like cleft palate, etc.
4: Infants suffering from systemic diseases like tuberculosis; etc.
5: Infants having CNS disorders like cerebral palsy, mental retardation, congenital diseases.
6: Infants suffering from chronic diahorrea, increased B.M.R , or suffering from congenital heart disease, etc are excluded from study.
Grouping-
40 infants will be divided randomly into two groups, each consisting of 20 infants and weaning powder will be given as per the schedule given below:
GROUP A- (Trial group)
Shastikshalyadi weaning powder will be given in powder form orally in dosage of 15 g twice daily besides with breast milk.
Administration of weaning powder: Shastikshalyadi weaning powder comprises of equal parts of powders of Shashtikashali, Godhuma, yava and Vidanga. Its 15 gm will be mixed with 15 gm sugar and water (quantity sufficient) be cooked on mild fire, to make it paste consistency. The paste thus prepared will be mixed with ghee and administered to the child twice daily for a period of one month. In the second month the dose of Shastikshalyadi weaning powder will be increased to 30 g and in the third month it will be 45 g.
Preparation: (Malting) Each time small amount of grains of Shashtik shali, Godhuma , Yava will be soaked overnight in 2 times its volume of water .Excess water will be drained. Moist, swollen seeds will be germinated in dark environment till sprouts are visible .These grains will be dried in shade for 5-8 hrs. Then roasting of grains will be done lightly to remove surface moisture. Sprouts will be removed manually. Grains will be powdered and stored in airtight container16
GROUP B- ( Normal Control group):
20 infants from this group will be adviced to continue breast milk along with food from family pot and will be called for follow up once in a month for 2 months .
ASSESSMENT CRITERIA
The infants who are included into the study will be assessed before, during and after the study about the following growth and development parameters using Trivendrum screening chart17. Anthropometry measures according to WHO anthropometry software.18
Trivendrum screening chart is a simplified adaptation of the Border development screening system. It consists of 17 items selected from BSID Baroda norms.It is recommended to be used as mass screening test. This screening chart will assess the development of milestones accordingly.
Anthropometry will be done based on parameters like: 1weight for length.
2 weight for age.
3 Length for age.
4 BMI for age.
5 HC for age.
6 SSF for age.
7 MUAC.
8 TSF.
LABORATORY INVESTIGATIONS: Laboratory investigations will not be done.
STATISTICAL ANALYSIS: The data obtained will be tabulated and statistically analysed using WHO Anthropometry software and will be interpreted accordingly.
Duration of Study
All the infants will be given (of trial group) weaning powder for the period of 3 months.
Follow up Study:
After the completion of the study the parents and their infants will be asked to attend the OPD once in a month for 2 months to know whether the improvement provided by the weaning powder (churna) is sustained.
7.3 HAS ETHICAL CLEARANCE BEEN OBTAINED FROM YOUR
INSTITUTION? YES
8. LIST OF REFERENCE:
- Ghai OP, Paul V ,Bagga A. Ghai Essential Pediatric,ed 7th. New Delhi: CBS Publishers & distributors; 2010. P. 99.
- Sachadeva HPS,Chowdhary P. Nutrition in Children Developing country concerns, Reprint.ed. Delhi:BI Publications, 1994. p. 108.
- Sachadeva HPS,Chowdhary P. Nutrition in Children Developing country concerns, Reprint.ed. Delhi:BI Publications, 1994. p. 112.
- Sachadeva HPS,Chowdhary P. Nutrition in Children Developing country concerns, Reprint.ed. Delhi:BI Publications, 1994. p.109.
5. Tewari P.V. Kashyapa Samhita ,Reprint.ed. Varanasi: Chowkhamba Vishwabharti Oriental Publications; 2008. P. 599.
- Kumar A. Child Healthcare in Ayurveda , Reprint.ed . Delhi: Sri Satguru Publication; 1994. p 32-33.
- Nene GS. Manusmriti, Reprint.ed. Varanasi: Chauhkamba Sanskrit SansthanPrakashan; 1999. p. 44-46.
- Sharma PV. Sushruta Samhitha, Reprint .ed.Varanasi:Chaukhamba Vishwabharti Oriental Publishers; 2005. p. 235-36
- Murthy S.. Ashtanga Samgraha,Reprint.ed. Varanasi: Chowkhamba Orientalia publishers; 1999. P .9,11.
- Ashtavaidyan VC. Ashtanga Hridaya Indu Tik,,Reprint.ed. Varanasi: Chowkhamba Krishnadas Academy prakashan;2007 .p. 457.
11. Tewari P.V. Kashyapa Samhita , Reprint.ed. Varanasi: Chowkhamba Vishwabharti Oriental Publications; 2008. P. 599.
- Mishra B. Bhavaprakasha of Sri Bhavamishra. Reprint. ed. Varanasi: chowhkhamba Sanskrit Sansthan;2004. p.100.
13. Dwevedi L, Charaka Samhita , Reprint.ed. Varanasi: Chowkhamba Vishwabhrathi Oriental Publications; 2007. 211.
- Shastry J LN. Dravya Guna Vijnana, Reprint.ed.Varanasi: chowkhamba Orientalia Publishers; 2010. P. 320.
- Sachadeva HPS,Chowdhary P. Nutrition in Children Developing country concerns, Reprint.ed. Delhi:BI Publications, 1994. P109.
- Sachadeva HPS,Chowdhary P. Nutrition in Children Developing country concerns, Reprint.ed. Delhi:BI Publications, 1994. P113.
- Ghai OP, Paul K, Bagga Arvind. Ghai Essential Pediatrics, 7th ed. New Delhi:CBS Publishers & Distributos Pvt Ltd .2009. p 33.
18. sWHO Anthro for mobile devices version 2, 2007: Software for assessing growth and development of the world's children. Geneva: WHO, 2007 (http://www.who.int/childgrowth/software/en/).
9. SIGNATURE OF THE
CANDIDATE :
10. REMARKS OF THE GUIDE :
11. NAMES AND DESIGNATION
OF GUIDE :
11.1 GUIDE : Dr. SHAILAJA.U MD (Ayu), PhD.
Prof. and HOD Department of P.G
Studies in Kaumarabhritya,
S.D.M.C.A. Karnataka.
11.2 SIGNATURE :
11.3 H.O.D : Dr. Shailaja. U. M.D (Ayu), PhD
Prof. and HOD Department of P.G Studies
in Kaumarabhritya
S.D.M.C.A. & H. Hassan,
11.4 SIGNATURE :
12.1REMARKS OF THE CHAIRMAN
AND PRINCIPAL :
12.2 PRINCIPAL : Dr. Prasanna N . Rao MS(Ayu), Phd
SDM. COLLEGE OF AYURVEDA
AND HOSPITAL, HASSAN- 573201
12.3 SIGNATURE WITH SEAL :