Abstract
Background: Undernutrition, a major health risk according to the World Health Organization, is widespread in developing countries and can lead to various diseases. Instead of relying solely on medication, dietary modifications are crucial for treatment. Ayurveda offers a unique approach to childhood nutritional disorders through the concept of "Karshya," which resembles undernutrition. Ayurvedic remedies focus on qualities such as being appetizing, digestive (Deepana-Pachana), strength-promoting (Balya), muscle-building (Brimhana), and rejuvenating (Rasayana).
Aim: The purpose of this trial was to evaluate the efficacy of Priyalaadi Modaka in the management of Karshya, with special reference to undernutrition in children aged 13–60 months. The study specifically focused on anthropometrical, and subjective parameters for assessment.

Methodology: This study is a prospective, open label, randomized, parallel-group trial, clinical study of 225 malnourished children allocated into two groups. Participants of Group A received Health education material (Dietary guidelines). In Group B participants received both trial Drug (Priyalaadi Modaka) and health education material (Dietary guidelines).

Results
After 2 months of treatment, both Group A and Group B showed significant improvements in health parameters. Group A showed weight increased by 4.15%, while Group B demonstrated increase in weight by 7.55%. Both groups had significant height/length gains, with Group A increasing by 0.37% and Group B by 0.90%. BMI, subcutaneous fat thickness (SFT), and Mid-Upper Arm Circumference (MUAC) also improved significantly in both groups. Group A's BMI increased by 3.63%, while Group B's rose by 5.90%. SFT and MUAC changes were similarly significant, with Group B showing higher percentage increases than Group A (p<0.0001).

Conclusion
The present study provides credible evidence that the Ayurveda intervention of Priyalaadi Modaka effectively manages Karshya and enhances the symptoms, justifying the need for intervention of Ayurveda drugs in Karshya (undernutrition) with no adverse effects during the trial or follow-up period.

Key words: Karshya, Malnutrition, Priyalaadi Modaka, Health education material.