Abstract:
INTRODUCTION: Bhagandara is one of the anorectal diseases which occur in the perineum region. Bhagandara is placed among Asta Mahagada, as it affects physical, psychological, socio–economical status of patient and hinders his quality of life. This condition is known for its recurrence rate even after employing the available best modalities due to various pathophysiological, dietary, psychological and other causes. The classical treatment modalities of Bhagandara are neglected in the wave of popularity of kshara sutra application even by the ayurvedic surgeons. Hence, this work was intended to assess the result, non recurrence rate and practical applicability of classical method patana followed by kshara karma over the popular fistulotomy and kshara sutra ligation. MATERIAL AND METHODS: Minimum 60 Patients of Bhagandara will be randomly divided into the following three groups. In GROUP A, 20 Patients were taken and Fistulotomy of the track and Apamarga Kshara karma was done. In GROUP B, 20 Patients were taken and Apamarga Kshara Sutra ligation and consequent change of thread was done. In GROUP C, 20 Patients were taken and Fistulotomy of the track was done. Ethical clearance was obtained from Institutional Ethics Committee (IEC No. PU/PIA/IECHR/2017/5), and this study was registered in Clinical Trial Registry of Indi (CTRI/2018/04/01346). RESULTS: The shortest wound healing period is observed in kshara sutra ligation group that is 34 days compared to 35 days in fistulotomy group and 37 days in fistulotomy followed by apamarga kshara pratisarana may be because simultaneous cutting and healing by the ksharasutra. Discussion:Even the bhagandara is counted among chhedhya and bhedhya vyadhi, kshara sutra application referred in the contexts of nadi vrana and shwaythu adhikara appears to be more acceptable because of its easy applicability, cost effectiveness and day care procedure. CONCLUSION: Even though among the 3 groups, kshara sutra ligation group(standard group 1) has got marginal edge over the trial group and standard group 2 with respect to wound healing time, all three groups were found equally effective in curing the disease. so, null hypothesis is rejected and alternate hypothesis is accepted.
