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.