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शनिवार, 11 जून 2016

SUVARNAPRASHAN

Empower Baby’s health with Ayurvedic ‘SUVARNAPRASHAN’

Prof. Dr. Usha Deshmukh
M.D., D.C.H. (Ayu)
Prof. & H.O.D. Pediatrics
R.A. Podar Medical College, Worli, Mumbai
+919423107039
drusha1954@gmail.com

Children are wealth of the nation. Health of this new generation is a major concern towards the development of the country. Hence empowering future generation in terms of physical fitness and intellectual abilities is of immense importance. Children constitute about 40% of the total population of the country. Considering this scenario, undoubtedly, future of the country is solely dependent on supreme health and dynamic brains of the children. Swami Vivekanand said “A model man is one who possesses creative brain, skillful hand and an affectionate heart”. Hence it’s high time to execute skilful, safe and scientific plan to achieve this goal of a model man.

Looking through the medical angle, genetically inherited qualities and environmental factors contribute equally in making a model personality. Exceptionally intelligent and smart child is a daydream of every parent. Due to several social factors, the family size is restricted to one or two children only.  During infancy the body system and tissues are like clay which can be molded in proper shape by advocating optimum care, appropriate nutrition and natural wellness regimens. Keeping this goal in mind, Ayurveda an ancient health science was unfurled and a formulation elaborated for infants and children to enlighten their future was discovered.

While understanding the need and importance of this issue, the topic was discussed with various departmental heads including Medicine, Gynecology & Obstetrics, Pharmacy etc. along with associate faculties in my own Pediatric department. The project was blessed and guided by Hon. Dr. Kuldeep Raj Kohali, Dean, M. A. Podar Hospital. Way back in 2010, we initiated massive brainstorming in focused direction and concluded with a concrete formula with all best inputs from concerned authorities.

The study was as deep to recognize even the particle size of Suvarna Bhasma in the composition. The use of ‘Brahmi Ghruta’ instead of plain Cow ghee was yet another added feature to excel the therapeutic value of this formula. The dosage recommended in the original text as “स्वपाणितल” (quantity which fills the palm of baby) was found to be pretty expensive and hence we used only 4 drops per subject. As on date, at Podar Hospital, Mumbai, over 100,000 children are immunized with Suvarnaprashan and have benefited to restructure their immunity and have gained outstanding health profile.

During deep thinking on the project from various angles, a new dimension of therapeutic role came forward. As the foundation of entire Nervous System sets during embryonic stage, it will be wise to initiate Suvarnaprashan from third gestational month up to completion of sixth months. This view was reestablished with textual references and was supported by Prof. Dr. Subhash Marlewar from the Dept. of Gyn and Obs. Hence I strongly recommend that Suvarnaprashan should be advocated from the beginning of 3rd gestational month till the completion of 6th month. Further, it should be initiated since birth and to be continued till 5th birthday on daily basis.

In the recent past, Suvarnaprashan has gained vast popularity in the country. Many companies have started manufacturing and marketing numerous brands and variety of authentic and many substandard formulations for commercial interest. The concept of advocating this treatment only on the “Pushya Nakshatra” is rather misleading. The development of physiological elements in the body is an ongoing process and need not be governed by any such barrier. It is rather misinterpreted because purchase of Gold is considered auspicious on this day. I am of an opinion that it will be obviously inadequate dosage if given only on a particular day of a month.

Considering the benefits of Suvarnaprashan, we were looking forward to popularize it on wider platform which was not possible due to the organizational structure. It is indeed a pleasure that Akshay Pharma Remedies; Mumbai, have shown keen interest in this project. We were happy to share the formulation and technical details to them. Now Akshay Pharma Remedies has introduced this authentic Suvarnaprashan under the brand name “HemPrash”.

This text summarizes the observations of Suvarnaprashan in brief:

The central nervous system develops far ahead of the other systems. First spurt of development is during the prenatal period, around third trimester. Further, a significant amount of brain building is happening during the first 2 – 3 years of childhood, wherein the foundations for intelligence region and language is established. The groundwork for brain development begins at the day one of conception.

According to the developmental pattern, prenatal spurt and postnatal spurts depend upon the nutrition. Children are most vulnerable to infections owing to low immunity and maturity with risk factors like poor hygiene and nutritional inadequacies. Nuclear family structure, busy professional commitments and competitive educational system also contributes a lot to stress related problems in children. These eventually result in poor health profile and performance. Thus, promotion of overall health and intelligence is the need of this hour. Ayurveda always emphasizes on promotion of health and disease prevention.

“Suvarna-Prashan, is one of a splendid methods, specially mentioned for newborn babies and infants. It is also useful in early prenatal period with the aim to boost their immunity and overall health including higher mental health. Acharya Kashyap was the first ancient pediatrician in the world. He has advised Suvarna-Lehena with honey and ghee. Charaka Samhita and Ashtang Sangraha has also described Suvarna-lehana after birth.

आमथ्य मधुसर्पिर्भ्यां लेहयेत् कनकं शिशुम् l सुवर्णप्राशनं ह्येतन्मेधाग्निबलवर्धनम् ll
आयुष्यं मङ्गलं पुण्यं वृष्यं वर्ण्यं ग्रहापहम् l मासात् परममेधावी व्याधिभिर्न च धृष्यते ll
षड्भिर्मासैः श्रुतधरः सुवर्णप्राशनाद्भवेत् l काश्यप – सूत्रस्थानम् १८

Development is a constant process from birth to maturity which begins at the gestational phase. It depends upon maturation and myelination of brain which continues up to two years of age. Myelin acts as insulation, making it possible for the nerves to carry information from one part of the brain or body to another. DHA and Omega 3 fatty acids are vital for growth, development and maintenance of the brain tissue. Cow ghee, prepared by traditional Indian method is identified as natural and rich source of DHA and Omega 3 fatty acids along with many other nutritional assets for the brain. Hence, Ghee provides the right substance for manufacturing myelin i.e. the fatty sheath that surrounds nerve fibers. It is a part of diet which improves texture and radiance of the skin, termed as OJA in Ayurveda.

Ayurveda has mentioned the properties of cow ghee as follows.

शस्तं धीस्मृतिमेधाग्निबलायुः शुक्रचक्षुषाम् । बालवृद्धप्रजाकान्तिसौकुमार्यस्वरार्थिनाम् ॥ क्षतक्षीणपरीसर्पशस्त्राग्निग्लपितात्मनाम् । वातपित्तविषोन्मादशोषालक्ष्मीज्वरापहम् ॥
स्नेहानामुत्तमं शीतं वयसःस्थापनं घृतम्।

As mentioned earlier, we have used Brahmi Ghruta in place of plain Cow Ghee of which the properties are described as below:
Consuming Cow ghee processed with Brahmi, Siddharthak, Vekhand, Anantamool, Kushtha, Saindhav and Pippali improves voice, intellectual ability and memory. It also extends the life span, corrects vision defects, uplifts immunity against microorganisms, attains mental stability. The property of correcting vision defects may probably nullify the childhood vision errors.

ब्राह्मीसिद्धार्थकवचासारिवा कुष्ठसैन्धवैः । सकणैः साधितं पीतं वाङ्मेधास्मृतिकृद् घृतम् ।।
आयुष्यं पाप्मरक्षोघ्नं भूतोन्मादनिबर्हणम् ।  अष्टांगहृदय, उत्तरस्थान १/४३

Suvarna (Gold) is cool in action; possess aphrodisiac, strength promoting, heavy, tonic properties. The taste is sweet along with bitter and astringent with sweet after-taste (Vipaka), slummy property, auspicious, anabolic, improving vision, memory and intellect promoting, good for heart muscle, imparts longevity, skin texture, stability, antitoxic and recommended for treating tuberculosis, achieves balancing of all the three doshas, good for treating fevers and hoarseness of voice. Gold bhasma prepared by authentic Ayurvedic manufacturing process has numerous health benefits.

The textual verses are as follows.

सुवर्णं शीतलं वृष्यं बल्यं गुरु रसायनम् । स्वादु तिक्तं च तुवरं पाके च स्वादु पिच्छिलम् ।।
पवित्रं बृंहणं नेत्र्यं मेधास्मृतिमतिप्रदम् । हृद्यमायुष्करं कान्तिवाग्विशुद्धिस्थिरत्वकृत् ।।
विषद्वयक्षयोन्मादत्रिदोषज्वरशोषजित् । . . . . भावप्रकाश, धात्वादिवर्ग १०, ११

Honey is a food item containing more sugar, iron and Vitamin A.
आजन्मसात्म्यात्कुरुते धातूनां प्रबलं बलम् l बालवृद्धक्षतक्षीण वर्णकेशेन्द्रि यौजसाम् ll
प्रशस्तो बृंहणः कण्ठ्यः स्तन्यसन्धानकृद्गुरुः l आयुष्यो जीवनः स्निग्धः पित्तानिल विषापहः ll अहृ.सू १०/८

It does SadyaTarpana (Instant nutrition). Its use in initiating active immunization is well studied. Honey is cooling, easily digestible, sweet in taste, useful in diarrhoea, weight reducing, vision improving, appetizer, voice cleanser, wound cleansing and antiseptic, imparts luster, promotes rapid assimilation, astringent after-taste, imparts pleasant feeling, improves skin radiance, accelerates memory, improves vigor, possesses cleansing property and improves the taste. It is recommended in various illnesses like skin diseases, piles, cough, diseases of Pitta, blood borne diseases, diseases of Kapha, Prameha, weakness, worms, obesity, dryness of throat, vomiting, hiccup, diarrhoea, indigestion, burns, bronchiectasis and acts as a catalyst to increase the efficacy of the formulation.

The properties of Honey mentioned in Ayurveda are –
मधु शीतं लघु स्वादु रूक्षं ग्राहि विलेखनम | चक्षुष्यं दीपनं स्वर्यं व्रणशोधनरोपणम ||
सौकुमार्यकरं सूक्ष्मं परं स्रोतोविशोधनम् | कषायानुरसं ह्लादि प्रसादजनकं परम् ||
वर्ण्यं मेधाकरं वृष्यं विशदं रोचनं हरेत् | कुष्ठार्शःकास पित्तास्र कफ मेह क्लमकृमीन् ||
मेदस्तृष्णा वमिश्वास हिक्काऽतीसारविड्ग्रहान् | दाहक्षतक्षयांस्तत्तु योगवाह्यल्पवातलम् || भावप्रकाश, मधुवर्ग २/५

Summary of the project -
"Suvarnaprashan" consists of brain boosting compounds which ensures the babies intellectual upliftment and provide supreme immunity. Multi-point heat treated Ghee, Suvarna and Honey i.e. Suvarnaprashan are rapidly distributed throughout the intra-and extracellular spaces.

In 1890, the German bacteriologist Robert Koch discovered that compounds made with gold inhibited growth of the bacillus that caused tuberculosis and he was awarded the Nobel Prize in medicine for his discovery. Some researchers are placing Gold on critical conditions. Every day the unique qualities of Gold are helping millions of people live longer, healthier and productive lives. Over 5000 years ago, Egyptians ingested gold for mental, bodily and spiritual purification. It is used in surgery to patch damaged blood vessels, nerves, bones and membranes and noticed that it has direct effect on cardiac health by improving coronary blood circulation.  It is beneficial for rejuvenating the sluggish organs, especially the brain. In newborn baby, circulatory system is established first. It is used to improve mental attitude and emotional status. Gold increases mental supremacy and the ability to concentrate. Gold is thought to strengthen mental function by increasing the conductivity between nerve endings in the body and on the surface of the brain.

Benefits of SUVARNAPRASHAN:
1) Medha-janana – (Promotion of memory, intellect and talent). The properties of honey, Ghee and Gold are equally favorable to the mental progress of a child. Honey, ghee are rich sources of carbohydrates and fat respectively, these may provide energy to the child even used in small quantity.
2) Ayushya – (For longevity): It is for ensuring a long, healthy and happy life for the child.
3) Strength – (For physical strength to the newborn). Physician may observe for routine in terms of improved sucking and swallowing reflexes of neonate.
4) Immune system - (To improve Rog Pratikar Shakti). Immune systems towards diseases become very powerful.
5) Recall memory becomes very strong (ShrutaDhara).
6) Improves digestion power.
7) Tones up skin colour (Fair and radiant skin)
8) Growth of Mind and body faster than usual.
9) Anti-toxic power increases.
10) Imparts strong protection against variety of infections.
11) It provides a protection shield during seasonal changes and diseases attributed to these changes.

शुक्रवार, 10 जून 2016

PCOS (Classification)

Dr Rupali Mahadik.
MD ( Streerog )
Amrutwel Women's Clinic Kharaghar.
Ex Prof and HOD streerog Dept.
D.Y.Patil Ayu College Nerul

PCOS (Classification )

Polycystic Ovary Syndrome (PCOS)  is an incompletely understood enigmatic disease.

It is usually, but not necessarily ; characterized by
- Oligomenorrhea
- obesity
- hyperandrogenaemia
- infertility

Although pathogenesis is unclear , chronic hyperandrogenaemia either due to

-Erratic high LH levels
  or
- insulin resistance with compensatory hyperinsulinaemia,
Is a predominant feature of this syndrome.

Both LH and Insulin act at the Thecal compartment of Ovary to stimulate hyperandrogenaemia.

Moreover the small and intermediate follicles predominate the PCOS scenaria and they gradually proceed to atresia rather than follicular dominance.

* Classification of PCOS -
Based on Endocrine and Sonographic  landmarks following classes of PCOS subjects are arbitrarily identified with gradation of hyperandrogenism , individual approach of treatment is needed.

1- PCO

Normoandrogenic, normoestrogenic and non obese subjects.

Do not exhibit usual manifestation of hyperandrogenaemia,
menstrual delay/ Oligomenorrhea ,

But anovulation is present.

These subjects have bilateral active ovaries with no evidence of follicular dominance or ovulation .

No significant alteration is expected in the hormonal profile.
Constitutes 80% of PCOS subjects and form the link between normal and significantly androgenised PCOS subjects.

2- PCOD

These are definitely hyperandrogenic and relatively obese.
Oligomenorrhea
anovulation are almost certain.
Evidence of high LH to FSH ratio
Higher testosterone levels
Ovaries large  with evidence of homogeneous polyfollicular enlargement with significant Thecal hyperplasia .
Necklace pattern in USG

20% of PCOS Pt gave the typical features of PCOD.

3. - Hyperinsulinaemia

Picture same like PCOD with Endocrine difference of hyperinsulinaemia instead of high LH levels.

4- Hyperthecosis

These subjects with Ovarian Hyperthecosis are much more androgenised, with testosterone levels bordering that of tumor range( > 1 ng/ml).

Sonographically they present with sparse Ovarian follicles and predominant thecal excess.

These patients could manifest insulin resistance and acanthosis Nigerians.
Hence condition is known as Hairan syndrome.

Less then 5 % among PCOS population .

5- Hyperprolactinaemia

Borderline Hyperprolactinaemia and hypodopaminergic state could co exist in nearly 5% PCOS subjects.

They may or may not be galactorrhoeic and may not evidence significantly high prolactin levels.
Represents like type 1 PCO case but with borderline/ Hyperprolactinaemia.

6 - High DHEAS

Few pts may present with Congenital adrenal hyperplasia, a genetic defect in 21- hydroxylase enzyme in adrenal cortex.
Only 3% have this defect and they present with high DHEAS levels ( between 250 and 800 ng/ml), .
They are usually thin , hirsute with ovulatory dysfunction, and an alternate presentation is that a thin adolescent subject with symptomatology of hirsutism.

7 - Tumour

Occasionally a Virilizing ovarian or adrenal tumours present with features of virilism , and  these subjects have serum testosterone (1.5 ng/ml or more) or DHEAS ( 9000 ng/ml or more) respectively.
Easily spotted at routine sonographic study of ovaries and adrenal in all PCOS subjects.

According to this the treatment protocol differs.