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Suvarnabindu Prashan; Ayurveda, Immunity; Growth; Development

Generally, in childhood, pediatric practice chronic and frequent respiratory disorders are major concerns. These concerns finally result in the immaturity of the immune system. Nowadays, changing lifestyles with excess intake of junk food, and the stress due to competition in various fronts of life also affects the immune system of a child [1]. Currently, due to the SARS-CoV-2 pandemic, there’s an increased demand amongst parents for immune boosters for their children [2]. Suvarnabindu Prashan (SBP) is the herbo metallic medicinal preparation for children. We get a reference for its use in an ayurvedic classical textbook Kashyap Samhita which dates to around 600 BC. SBP contains purified and incinerated gold (called Suvarna bhasma in Ayurveda) along with herbs, clarified butter (ghee), and honey. According to Kashyap Samhita this therapy is used in infants for mental, physical, intellectual ad spiritual development of the children. [3].

Though, Suvarnabindu Prashan is advised to be initiated as early as possible, an upper age limit of 16 years has been demarcated for the same in clinical practice. Though this concept is mentioned in ancient Ayurveda classics we didn’t see large-scale use of this in society. However recently some of the Ayurveda institutions in India promoted its practice and in the last couple of decades, it gained great popularity among parents for use in their children. Presently its use is so widespread in India that it can be said to be a part of public health practice. Now, this is not only practiced throughout India but there are reports of its use by some parents in other countries as well. In spite of its wide popularity and use in the masses, there is a paucity of published information regarding the prevalence of use of SBP and parents’ perspectives on the effect of SBP use. There are few studies that evaluated the effect of the formulation based on the clinical leads from the Ayurveda classical reference. However, we believe that a direct perspective of parents’ response to its effect on a child’s health will provide better leads to generate more evidence. The lack of this information is limiting the further scientific evaluation of this formulation. This cross-sectional survey seeks to systematically study the parent’s perspectives regarding their experiences with the effects on their children. The availability of this information will help us to properly understand the unmet medical need that this practice of administering the formulation is addressing. This will further help to plan further systematic preclinical as well as clinical studies to generate more evidence about its beneficial effect, safety, and probable mechanism of action which can lead to systematic clinical recommendations in pediatric practice.

A prospective survey was carried out on 100 children at Rasayu Ayurved Clinic, Pune, Maharashtra. Ethical clearance was obtained and additional assent was taken from the children above 10 years. Children between 1-16 years of age, who took SBP for at least 12 months and whose parents/guardians provided consent to participate in the study willingly, were selected for the study. Children with chronic and acute illnesses which warranted intensive therapeutic intervention, children with developmental disorders like autism, ADHD, or having congenital anomalies and genetic disorders.

Aministration of SBP: Detailed training was given to parents about the administration of SBP in the form of the package insert. SBP was administered for a period of 12 months, in the early morning time, with an empty stomach once a month (lunar month) on the day of Pushya constellation (pre-identified dates) for 12 months at Rasayu clinic, Pune. Parents were advised to avoid feeding their children for half an hour post-administration of Suvarnabinduprashan. Data related to parents’ experience with the effect of SBP administration on their children was collected with the help of a self-designed questionnaire based on all the clinical benefits mentioned in Kashyap Samhita (Table 1).

Table 1: Structured questionnaire for Parents

Table 2: Year wise dose concentrations

Parents’ subjective perception was recorded through a structural questionnaire (Table 1) and parents were provided with a selfadministered questionnaire having 13 questions of which 11 elicited categorical responses. The data obtained therein was assessed for the final analysis (Table 2).

Preparation of Suvarnabindu: Suvarnabindu Prashan (SBP), a herbo mineral formulation was prepared by Ayurved Rasayani, a GMP-certified Ayurveda pharmaceutical unit. The ingredients of the formulation were as follows

1. Pure ash of (Biocompatible gold or Suvarna Bhasma)

2. Pure honey

3. Extract of following herbs

Guduchi (Tinospora cardifolia),

Mandukparni (Centella asiatica),

Bramhi (Bacopa monnieri),

Yashti madhu (Glycyrrhiza glabra),

Vacha (Acorus calamus) etc.

4.Ghrita (clarified butter prepared from cows milk)

Results were analyzed by using simple percentages and tables. (Table 3).

Table 3: Reported observations of parents on multiple parameters of progress in the participating children

Based on the above questionnaire, the responses on reported observations of progress by the parents/guardians of the children participating in the study, across specific parameters, were tabulated as given in Table 3 and (Figure 1). While a few parameters were reported by direct estimation – such as duration of sleep, intake of food, and change in complexion, a couple of them were estimated based on proximal indicators. For example, an improvement in memory was estimated based on observed changes in the child’s perception of space and directions, time, own body, or forms and figures.

Figure 1: Progress parameters of participant children (As reported).

60% of parents reported an overall improvement in all parameters while 21.8% of parents found no improvement and 74.3% of parents reported an improvement in the overall health of their children.

It is important to note that of the participating 100 children, 58 parents had administered SBP monthly to their children for 12 months, while 27 parents administered it uninterruptedly for 6 months only and 15 parents discontinued it before the completion of 6 months. SBP was reported to be well tolerated by all the children.

Other changes reported by parents as noticed in the children-

An improvement in playfulness, freshness & activeness of the child, improvement in multi-tasking ability in the child, and adaptability to the immediate surroundings were some of the reported additional improvements by parents, in their children, after consecutive 12 months of administration of Suvarnabinduprashan.

The results need to be viewed in the light of the fact that full compliance to the entire length of the study was just below 60% and that analysis has been done based on self-reported data. Though it may not independently be sufficient to establish temporality, the results provide pointers on the potential positive impact that SBP as a procedure can have on the developmental milestones as well as immunity of children. Though the mechanism of action is not yet well understood in terms of conventional pathophysiology, Ayurveda pathophysiology can explain the effect of a compound based on the therapeutic properties of its ingredients. Ayurveda views the edifice of a healthy existence through the critical entity of Agni which can be broadly understood as the metabolic prowess of an individual, with its varied functionalities of assimilation, conversion, conduction, and absorption. A well-performing status of Agni ensures a rich nutritional pool within the body which, as a corollary, further leads to healthy and well-endowed tissues and a robust immunity [4]. Drugs or formulations in Ayurveda which positively embellish Agni (Agni vardhana) are considered to be therapeutically superior. The primary ingredients of SBP – Suvarna and Ghrita, both have immense Agni boosting properties. The Suvarna bhasma used in the formulation is also known to be having properties to improve the quality of the tissue, improve the disease-fighting ability of an individual and improve cognitive functions [4]. Based on these effects of the therapeutic ingredients mentioned in Ayurveda classics we can postulate a probable mechanism of action that further needs to be evaluated using conventional scientific methodology.

Improved Immunity, reduced frequency of illness, and improvement in cognitive functions stood out as reported parameters of progress by parents, in comparison with the others. This has been pointed out as a definitive long-term outcome of the use of this formulation, in classical Ayurvedic treatises. A similar significant reduction of episodes of illness has been documented in other studies [5-11], while a randomized control trial had pointed out marked improvements in infant-toddler quality of life (ITQOL) parameters by virtue of administration of this formulation [12]. The findings of this study support the findings of other studies on suvarnabinduprashan. Other additional findings of our study were playfulness, freshness & activeness of the child, improvement in multi-tasking ability, and adaptability to the immediate surroundings which indicates towards positive effect on cognitive functioning. These findings from our study provide the direct perception of parents towards the beneficial effect of SBP in children. These factors could be the important reason behind the popularity of this formulation amongst parents for improving the overall health of their child. However further preclinical and clinical evidence through placebo-controlled clinical studies is required to understand better the efficacy, safety, and probable mechanism of action. This data will help in making evidence-based recommendations for the utilization of SBP in pediatric clinical practice.

Source(s) of support: NIL

Presentation at a meeting: NIL

None

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