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Pradnya Janardhan Bhagat*, Savita Udayshankar Sharma, Subhash Yashwant Raut, Arun Mahadev Lakhapati


Background: In Ayurveda classics, Parikartika resembles with fissure-in-ano having cutting and burning pain at Guda (anal region) which is mentioned as a sequel of some diseases or as a complication of some Panchakarma procedures. Acharya Sushruta defined the Kshara as the substance possessing Ksharana (localized cleansing properties) and Kshanan (debridement) properties. He advocated Kshara karma for the purification (Shodhana) of sore of a long standing ulcer which is of an indurated character. On this principle Kshara is used for purification (Shodhana) and local debridement (Lekhana) of fibrotic tissue seen in chronic fissure. Aim: To evaluate the efficacy of Kshara application in comparision with the established procedure of fissurectomy in chronic fissure-in-ano. Materials and Methods: Total 60 patients of chronic fissure-in-ano were selected and randomly divided into two groups (30 in each group). In group-A, patients were undergone by Kshara application; while in patients of Group-B Lord’s anal dilatation followed by fissurectomy was done under spinal anesthesia. The wound was treated for 4 weeks and assessment of the result was done on the basis of gradation adopted. Results: Significant pain relief was observed after 28 days in both groups. Bleeding and spasm was stopped in both groups within one week while in some patients of Group B bleeding was noted occasionally even after one week. In group B after fissurectomy ulcer healed in period of 3 week. Healing of ulcer in group B is found to be significant than Group AIn this study 40% of patients were cured. Conclusion: The symptom pain, bleeding and spasm were relieved in both groups equally. But healing of ulcer was found significant in fissurectomy group than Kshara application.

Keywords: Parikartika, Fissure in Ano, Kshara Application, Fissurectomy.

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