Effectiveness of Individualized Homoeopathic Medicines in Management of Moderate Acute Malnutrition with Personalized Diet plan among children: An experimental non controlled study.

Introduction: Moderate Acute Malnutrition (MAM) is a prevalent condition that arises when individuals do not receive adequate nutrients to maintain optimum health. It is characterized by weight-for-height or BMI-for-age deficits, predisposing individuals to increased morbidity, impaired immunity, and developmental delays. Malnutrition remains a significant public health concern, particularly in the childhood, where rapid physical and cognitive development demands adequate nutrition. It is particularly prevalent in developing countries and is often exaggerated by factors like poverty, food insecurity inadequate access to healthcare.

Mild and moderate malnutrition make up the greatest portion of malnourished children and account for more than 80% of malnutrition associated death. It is therefore vital to intervene in children with mild and moderate malnutrition at the community level before the develop complications. There was a low reduction in undernutrition in the country over the past years, especially in stunting. Yet we continue to have the highest burden of childhood undernutrition in the world.

Homoeopathy is a system of medicine which is considered as safe and effective form of treatment from children to adults. Homoeopathy has distinct advantage for treatment of ailments of children, the therapy is safe, effective and economical.

In conventional system of medicine, supplementing foods and vitamins are the modes of treatment in nutritional problems.

Supplementary therapy with food and vitamin should be given continuously as it is seen that whenever supplement stop the disorder reappears gradually and sometimes adverse effect of supplement are also seen. These supplements are costly, so low socioeconomic people cannot afford it, meanwhile nutritional problems are seen in poor population. Homoeopathic constitutional approach will solve this issue Since this problem is dealt at the fundamental miasmatic level by giving homoeopathic similimum in the form of potent medicines, leading to correction in mal-absorption and mal-assimilation indirectly, correcting the metabolism errors of constitution, and maintaining the nutritional status of a person more effectively for a long lasting.

Primary Objective: To study the effectiveness of Individualized Homoeopathic medicines with personalized diet plan in the management of Moderate Acute Malnutrition among children.

Secondary Objective: To study the patterns in assessment of growth among children.

Methodology:

I) Type of study design: Experimental Non-Controlled Study

II) Study setting: Out Patient Department of Institution.

III) Duration of study: 18 Months

IV) Study population: Clinically diagnosed cases of Acute Moderate Acute Malnutrition in children 5-10 Years of age.

V) Method of selection of study subjects

a) Inclusion Criteria: 1. Clinically diagnosed cases of MAM according to WHO growth standards & IAP (BMI For age <-2SD OR Weight-for-Height Z Scores between -2SD to -3SD) 2. Patients of 5-10 years of age. 3. Patients of all genders. b) Exclusion Criteria: 1. Suspected cases of congenital anomalies like cystic fibrosis, Phenylketonuria, Inborn errors of metabolism, Turners & Downs Syndrome. 2. Patient with endocrine disorders such as Growth hormone deficiency, Hypothyroidism, Hyperthyroidism, Juvenile Diabetes. 3. Patients with metabolic disorders like Galactosemia, Homocystinuria. 4. Suspected cases of malignancy. 5. Sever acute malnutrition. 6. Suspected immunocompromised patients. VI) **Operational Definition:**Moderate Acute Malnutrition (MAM) is defined as a weight-for-height z-score (WHZ) between -2 and -3 standard deviations below the median of the WHO child growth standards, or a mid-upper arm circumference (MUAC) between 115 mm and 125 mm in children aged 6–59 months, without the presence of bilateral pitting oedema.

Specification of instruments & related measurements:

1)Weight Measurement

a)Instrument: UNICEF-recommended electronic weighing scale with a precision of 100 g.

b)Procedure: The child is weighed with minimal clothing, without shoes.

c)Measurement Unit: Kilograms (kg) to the nearest 0.1 kg.

2)Height/Length Measurement

a)Instrument: Stadiometer for children over 2 years b) Procedure: Measured barefoot with the head in the Frankfort horizontal plane.

c)Measurement Unit: Centimeters to the nearest 0.1 cm.

3. Body Mass Index (BMI) Formula:

a)BMI = Weight (kg) / [Height (m)] ²

b)Instrument: Uses measurements from weight and height instruments described above.

c) Unit: kg/m²

Sample size:Though total sample size calculated os 48, in this study minimum 50 patients will be taken.

Sampling technique:Non probability Purposive sampling

Study instrument/ Data collection tools:

1. Complete Homoeopathic Case Taking Proforma to form totality.

2. Anthropometric measurements will be used to assess before and after the treatment for MAM.

3. UNICEF-recommended electronic weighing scale with a precision of 100 g & a stadiometer will be used to measure weight & height respectively.

4. Appropriate reference books like Paediatrics textbooks, Homoeopathic Materia Medica books, Homoeopathic Repertory books, Medicine books, Surgery books, Pathology books, different Homoeopathic journals, research articles will be considered.

5. Appropriate software will be used for repertorization of case

Data management and analysis procedure:

1. Framing of Totality of symptoms- Will be done as per the guidelines of Homoeopathy.

2. Selection of Remedy- Individualized Homoeopathic Medicines based on Totality of symptoms.

3.  Potency will be selected based on the susceptibility of each case & will be changed when required.

4. Duration of Study- 18 months.

5. Duration of Each Case- 4 Months.

6. Duration of Follow-up of each case- Every two weeks.

Purpose of trial: While numerous studies have explored conventional therapeutic approaches, including micronutrient supplementation and therapeutic feeding, limited evidence exists regarding the role of homoeopathy as an individualized treatment. Most existing research focuses on the efficacy of homoeopathic remedies in managing general health conditions rather than specific nutritional disorders like MAM. Additionally, there is a lack of well-designed, large-scale clinical trials that evaluate the synergistic effects of homoeopathic treatments alongside tailored dietary interventions. This gap hinders the development of evidence-based guidelines for integrating homoeopathy into malnutrition management strategies, especially in resource-constrained settings where access to conventional therapies may be limited.