Clinical Efficacy of Apamarga Kshara Infiltration in the Management of Bhagandara W.S.R to Low Anal Fistula

Abstract

Bhagandara is considered difficult to be cured also it is found to be one amongst the Ashta Mahagada, where Aachaarya has explained the limitation of the treatment by considering it as Duschikitsya Vyadhi. Ksharsutra management is widely levelled procedure for Bhagandara and a number of research studies have been conducted on the same. But most of the times it was noted that the repeated thread changing and prolong duration of the treatment were inconvenient for the patients. Also there are many postoperative complications noted along with increasing number of recurrent cases after surgical management of fistula. Hence this study was proposed to evaluate the effect of Kshara Karma in Bhagandara by infiltration of Apamarg Kshara. Total 33 patients were enrolled for the study, 3 patients were excluded from the study. 30 Patients fulfilling the inclusion & exclusion criteria from OPD and IPD of ShalyaTantra from Parul Ayurveda Hospital, Khemdas Ayurveda Hospital, as well as from special surgical diagnostic camp and Parul Sevashram Hospital were registered for the study. The assessment was done on subjective criteria like pain and objective criteria as discharge, Unit Healing Time (UHT). On every 7^th day till complete healing of the track. Assessment of Pain, Discharge, and length of track showed 100% improvement in both pain and discharge with the mean healing time of 6.157days/cm. Apamarga Kshara infiltration has act equivalent to Pratisaraneeya Kshara Karma by Shodhana and Ropana resulting to complete cure of Bhagandara.