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. 2017 Apr-Jun;8(2):113-121.
doi: 10.1016/j.jaim.2017.01.013. Epub 2017 Jun 7.

Transrectal Ultra Sonography based evidence of Ksharasutra therapy for Fistula-in-ano - A case series

Aditya Nema  1 , Sanjay Kumar Gupta  2 , Tukaram S Dudhamal  1 , Vyasadeva Mahanta  1
Affiliations

Transrectal Ultra Sonography based evidence of Ksharasutra therapy for Fistula-in-ano - A case series

Aditya Nema et al. J Ayurveda Integr Med. 2017 Apr-Jun.

Abstract

Ksharasutra (parasurgical procedure using a thread treated by alkalies) is being practiced in Indian system of medicine since ancient time for management of ano-rectal disorders; particularly for Bhagandara, (fistula in ano), and generally difficult to treat. In this case series, standard Ksharasutra was prepared as per the Ayurvedic Pharmacopeia of India and used to treat the different cases of Bhagandara. In this case series total 6 patients of Bhagandara were treated with Ksharasutra and partial fistulectomy. The average Unit Cutting Time and healing (UCTH) was observed 7.86 days/cm. During treatment Panchawalkala Kwatha (decoction of five medicinal plant's bark), Shatdhautaghrita, Jatyaditaila and Erandabhrishtaharitaki Churna were used as adjuvant drugs. To generate quality evidence Transrectal Ultra Sonography (TRUS) was used in pre as well as post-treatment and showed remarkable tool to assess effect of treatment. Substantial clinical result was observed at the end of treatment and all the patients were free of fistula. No recurrence was observed in any case during the 12 follow up of 12 months. The treatment was reported safe and well tolerated in all the patients.

Keywords: Bhagandara; Fistula-in-ano; Ksharasutra; TRUS.

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Figures

Fig. 1
Fig. 1
Optimal and normal rectal wall layers with ultrasonography images.
Fig. 2
Fig. 2
a: Case 1-Pre-operative TRUS image. b: Case 1-Post-operative TRUS image. c: Case 1-Post-operative picture of Ksharasutra Threading. d: Case 1-Picture after complete remission.
Fig. 3
Fig. 3
a: Case 2-Pre-operative TRUS image. b: Case 2-Post-operative TRUS image. c: Case 2-Post-operative picture of Ksharasutra Threading. d: Case 2-Picture after complete remission.
Fig. 4
Fig. 4
a: Case 3-Pre-operative TRUS image. b: Case 3-Post-operative TRUS image. c: Case 3-Post-operative picture of Ksharasutra Threading. d: Case 3-Picture after complete remission.
Fig. 5
Fig. 5
a: Case 4-Pre-operative TRUS image. b: Case 4-Post-operative TRUS image. c: Case 4-Post-operative picture of Ksharasutra Threading. d: Case 4-Picture after complete remission.
Fig. 6
Fig. 6
a: Case 5-Pre-operative TRUS image. b: Case 5-Post-operative TRUS image. c: Case 5-Post-operative picture of Ksharasutra Threading. d: Case 5-Picture after complete remission.
Fig. 7
Fig. 7
a: Case 6-Pre-operative TRUS image. b: Case 6-Post-operative TRUS image. c: Case 6-Post-operative picture of Ksharasutra Threading. d: Case 6-Picture after complete remission.
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