Abstract

THE EFFICACY OF ASITA MUSHKAKA KSHARA SUTRA IN THE MANAGEMENT OF BHAGANDARA (FISTULA-IN-ANO) A CLINICAL CONTROLLED TRAIL

P. Chudamani*, K.V. Vijaya Bhakara Reddy and Renu Dixit

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Abstract

Bhagandara (Fistula-In-Ano) is classified as one of the Ashtamahagada diseases in Sushruta Samhita, recognized for its complexity and challenging prognosis. Fistula-in-Ano is characterized by an abnormal communication between two epithelial-lined surfaces in the anorectal region. Conventional surgical interventions, such as fistulectomy, are often associated with complications, including recurrence, anal sphincter incontinence, and postoperative infections. The Kshara Sutra technique, a parasurgical approach, has demonstrated greater efficacy in the management of Fistula-In-Ano. Among the various Kshara Sutras, Apamarga Kshara Sutra is widely utilized, composed of Apamarga Kshara, Snuhi Kshira, and Haridra. However, the preparation of Apamarga Kshara is labor-intensive and time-consuming. Acharya Susuruta also mention Asita Mushkaka (Elaeodendron glaucum) as first choice of drugs and a potential Kshara Dravya for Kshara Sutra preparation. Asita Mushkaka, being a large and readily available tree, presents a costeffective alternative with properties conducive to Kshara formulation. This study evaluates the clinical efficacy of Asita Mushkaka and Apamarga Kshara Sutras in the management of Bhagandara, offering insights into their therapeutic potential.

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