Ghrit-kumari ksharsutra in bhagandara; a critical review

Ayurveda, the science of life, evolved from the quest of man to have a happy life, through a deep understanding of evolution, creation and its maintenance, perceived by the Maharishis of ancient India. The progressive establishment of scientific Ayurveda began in the Vedic period. It is a traditional healthcare system of Indian medicine since ancient times. Several Ayurvedic medicines are being exploited for management of various diseases in human beings. Among these various diseases Bhagandar roga is one important ailment with gradually increasing incidence in present era. It is a condition that commonly affects Bhaga, Guda, and Basti Pradesh, which starts as Pidika then suppurates in due course of time menifests as Bhagandar roga. This disease is closely associated with Perianal fistula. Fistula is a frequent benign anorectal condition with major clinical manifestations of local pain, inflammation, sero-purulent discharge and distressful patient quality of life. The most common cause is nearly always by a previous anorectal abscess. It is a burning issue with a high proportion of cases in India, and there is still no convinced solution in modern surgery. Among all parasurgical techniques, Kshar-Sutra Parasurgical process has shown to be most effective in treating anorectal fistulas. Kshar-Sutra is a preliminary exploration of sphincter sparing technology. It works by the action of excision, scraping, draining, penetrating, debridement and healing. During the past decades, several Ayurvedic medicated thread have been investigated with respect to Physio-chemical standardization, pharmacological effect, safety and efficacy. In this regard, an attempt has been made to explore characteristics of three different drugs for preparation of a new Kshar-Sutra.