Comparative Study of Ashwatha Ksheer Sutra and Udumber Ksheer Sutra in the Management of Bhagandara (Fistula in ANO)

Authors : Dr. Monika S. Meshram; Dr.Kiran Khandare; Dr.Pradnya Ghormode

Volume/Issue : Volume 7 - 2022, Issue 8 - August

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Bhagandar (Fistula in Ano) at modern parlance is a common anorectal condition prevalent in the populations worldwide and its prevalence is second highest after Arsha (hemorrhoids). Kshara Sutra is one of the chief modality in the treatment of Bhagandara in Ayurvedic science. Apamarga (Achyranthus aspera) Kshar Sutra is considered the standard Kshar Sutra; although this Apamarga Kshar Sutra has been a landmark success, it has certain drawbacks such as pain, burning sensation, and itching associated to it. Mechanical action of the threads and the chemical action of the drugs coated on the thread together do the work of cutting, curetting, draining, and cleaning the fistulous track, thus promoting healing of the track. Exploration of the new plants for the preparation of Kshara as a better substitute to Apamarga Kshara is the need of the hour. Even Snuhi Ksheer is used in Apamarga Kshar Sutra and it creates many problems during the preparation of thread. Udumber Ksheer Sutra application is a proven effective treatment for Bhagandar. However, Snuhi (Euphorbia nerifolia) creates many problems during the preparation of thread, for instance, a very small quantity is collected after the incision of the stem, it coagulates if not used early, and collection becomes more difficult in summer. Different research scholars have conducted investigations to find out other varieties of thread that can minimize pain and other undesired effects.Udumber Ksheer Sutra application is a proved effective treatment for Bhagandar, but Udumber creates many problems during the preparation of the thread. In view of easy processing, Ashwattha Ksheer sutra were opted for their clinical evaluation. Total 40 cases of Bhagandara were divided randomly into 2 groups, having 20 patients in each group. In Group A, Udumber Ksheera Sutra and in Group B, Ashwattha Ksheer sutra were used. Assessment was done on objective (Unit Cutting Time - UCT) and subjective parameters. Statistically insignificant difference was observed in the efficacy of treatment by subjective parameters like pain, discharge, itching . between the two groups. It was found that Ashwattha Ksheer Sutra. showed smiliar UCT as compared to UdumberKsheera Sutra. Thus Ashwattha Ksheer Sutra can be used as a substitute for UdumberKsheera Sutra can be employed in the recurrent cases of Bhagandara.

Keywords : Bhagandara, fistula in ano,UdumberKsheera Sutra, Ashwattha Kshara Sutra, Unit Cutting Time.


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