Description

• Rickets is the failure of mineralization of growing bones, caused by a lack of vitamin D, calcium, or phosphate. These nutrients are important for making healthy bones, thus resulting in delayed growth and softening and weakening of bones
• Occurs only in children( growth plates have not fused)

Types

The child will exhibit the following skeletal deformities like

• Craniotabes – softening of the skull
• Bending of primarily the long bones
• Widening of the wrist
• Bowleg
• Knock knee
• Developmental delay
• Pain in the spine, pelvis, and legs
• Recurrent upper respiratory tract infections 
• Rachitic rosary – bead-like distention of the bone cartilage junctions in the ribs
• Marfan sign – distention of the bone cartilage junctions in the joint
• Harrison sulcus – Depression of the thoracic outlet due to muscle pulling along the costal insertion of the diaphragm

Investigation

• Low Serum calcium (Normal: 8.0 – 10.5mg/dL)
• Low Serum phosphate (Normal: 3.8-6.0)
• 25-OH Vit D levels below 20ng/ mL are considered hypovitaminosis
• X-ray wrist- widening, cupping, fraying

Treatments

• 6 lakh units of Vit D as a single oral or IM dose

Ayurvedic Treatment

• Use of Tila(Sesamum indicum), Guda in diet

Choorna

• Ashta choorna, Thaleesadi choorna : 

• Infant: 2-3 gm
• Toddler- 5gm
• School going- 7-10gm
• Anupana: honey or water or along with food

Arishta

• Depending on the status of the child
• Mustarishta
• Abhayarishta
  • Up to 2yrs- ½ tsp arishta diluted with 1 tsp water
  • 2-5 years- 2.5ml-5ml diluted with 5 ml of boiled water
  • 5-10 years- 10ml
  • 10-15 years- 15ml

 Gandharva hasthadi kashaya as Vata anulomana :  

• Up to 1 year: for mother: 2tsp sookshma choorna is boiled in 2 glass water, strained and given to mother. If agni bala permits give 1 tsp thrice to the child
• 1 year to 5 years: ½ tsp powder boiled in 1 glass of water and given as divided doses mixed with sugar or jaggery
• 5 to 10 years: 1 tsp powder boiled in 1 glass of water and given as divided doses mixed with sugar or jaggery
• 10-15 years: 1 ½ tsp powder boiled in 1 glass of water and given twice daily mixed with sugar or jaggery

Brimhana therapies after correction of Agni:

Gritha 

• Indukanta gritha, Kalyanaka gritha

• Up to 1 years: given as drops: always one should have a proper assessment of agni before administering sneha kalpana -2drops to 5 drops depending on agni
• Above 1 year: always start with a minimum dose- even 2 drops will be sufficient to get the desired effect
• Properly monitor the status of agni and increase the dose

Preenana modaka: Priyalamajjadi modaka

Prashas and lehas: Chyavanaprasa ½ tsp to 2 tsp

Bhasma 

• Pravala bhasma-
  • Infant: 2gm
  • Toddler- 3gm, 
  • School going- 5g
  • Anupana: milk

Taila abhyanga

Dhanwantara taila, Mahamasha taila , Lakshadi taila

Department

Kaumarabhrithya