Randomized comparative clinical study to evaluate the efficacy of Jeevaneeya Ghrita Pratimarsha Nasya and Marma Chikitsa in children with Autism with special reference to social relationship and emotional responsiveness

•Autism is a developmental disability caused by hypoconnectivity in the brain . People with ASD experience myriad of  difficulties in communicating with others or understanding social cues.

•Autism is characterized by difficulties in initiating social interaction and communication; restricted interests and repetitive behavior which poses a great challenge to individuals and to societies not just in early ages but across lifespan due to its pervasive nature.

•Autism is the third most common developmental disorder. According to WHO, it is estimated that worldwide about 1 in 100 children has autism. In 2021 About 1 to 1.5 % of children aged 2 to 9 years are diagnosed with ASD, In 2023 about 18 million people in India are diagnosed with Autism.

•Social deficits in autism include initiating interaction, responding to initiations, maintaining eye contact etc. these social deficits make it difficult for the child to develop personal relationships, peer rejection, anxiety, depression etc.

•Along with social deficits they also face difficulties in emotional regulation and processing leading to difficulty in identifying and attributing emotions, lack of pragmatic understanding etc.

•Autism in Ayurveda is an Anuktha Vyadhi and it can be nearly considered under a state of Unmada spectrum conduct disorder where there is defective endowment called pervasive disorder or Jadatwa. This is dominated by complete Buddhi Nirodha by Tamoguna.

•Along with Manasika Doshas, Shareerika Doshas also play an important role in stabilizing the Manas and Indriyas. The balanced state of Pitta and Vata helps to control emotional imbalances and promotes wise social interaction. Jeevaneeya Ghrita mentioned in Pittaja Unmada is one such Yoga which promotes above benefits by its Madhura , Tikta, Snigdha , Brimhana , Ojasya properties.

•Administration of Jeevaneeya Ghrita in the form of Pratimarsha Nasya is more beneficial, as Nasa (nasal cavity) is the nearest route for Shiras, the drug administered through Nasa will have a quicker effect on Shirohridaya and helps in reducing Pittavataja Lakshanas of Unmada.

•There are certain special points called as Marma Sthanas in the body which control the endocrinal , neuromuscular activities of the surrounding areas . Stimulation of these Marmas facilitates the removal of Srotorodha and proper flow of energy resulting in cure of diseases. Marma Chikitsa is an emerging branch of supportive therapy which focuses on systematic stimulation of Marmas for achieving therapeutic effect.

•Clinically, performance of Marma Chikitsa on Sthapani Marma (Thilartha kalam) has shown improvement in clinical features of autism, but its effectiveness is not validated systematically.

•There is a strong need for intervention on developing the social skills and regulation of emotional states in children with ASD as they have life long implications and are extremely difficult to learn.

•Thus the current study aims at improving the emotional responsiveness and social relationship of children with autism by the use of Pittahara Brimhana Ghrita Pratimarsha Nasya and Marma Chikitsa and validating the findings on a standard scale.