Management of Fistula in Ano by Kshar Sutra, Para Surgical Procedure. (Bhagandar)
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ClinicalTrials.gov Identifier: NCT01880398 |
Recruitment Status :
Completed
First Posted : June 19, 2013
Last Update Posted : December 24, 2013
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Background: Fistula in ano is one of the most common diseases of the ano rectal region. Treatment of Fistula in ano has puzzled the medical fraternity due to its complex nature. Commonly prevalent surgical treatment for anal Fistula, that is "Fistulectomy" does not provide successful cure for the disease, post operative complications and recurrences being common. Acharya Sushruta an ancient Indian Surgeon has described in his text ' Sushruta Samhita' about an ancient Ayurvedic technique of medicated thread called Ksharsutra treatment for Bhagandara ( Fistula in ano). Treatment of anal Fistula (Bhagandara)and Nadi-Vrana(Sinus) with Ksharsutra was practiced by Sushruta (1000-600B.C.) .
Hypothesis: Aycharya Sushruta advocated Kshar Sutra therapy in Fistula in ano and in various types of Fistula.
Condition or disease | Intervention/treatment |
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Fistula in Ano | Other: Kshar Sutra |
A 48 years old female patient, came with complaints of painful discharging boil at left side of Perianal region with pain.
She gave a surgical history of incision and drainage for gluteal abscess done in before four month. On local examination Patient had discharging sinus at 3 o' clock position on left side of Perianal region. Before planning the treatment other aetiologies were ruled out.
Diagnosis was confirmed by Fistulogram, suggestive of high anal fistula with internal opening in the anal canal. Under spinal anaesthesia probing was done. Internal opening of Fistula was confirmed by injecting Methylene Blue dye through external opening. The track was directed upward in the anal canal without any tributaries. Length of the tract was 9cm.
Then Kshar Sutra was tied covering the entire underlying track for cutting and healing under all aseptic precaution. The patient was discharged on the next day of procedure. The Kshar Sutra was changed weekly. To promote healing and to reduce pain and inflammation oral antibiotics, anti-inflammatory medicine were also prescribed.
The total period of Kshar Sutra treatment was 5 month. The Kshar Sutra was a standard medicated thread smeared with Kshar of Apamarga (Achyranthus aspera), Shnuhi (Eforbia Nerrifolia) which has quality of cutting and Haridra(Curcuma Longa) which is used as a antiseptic. The ph value of the thread thus prepared was determined and its sterilization effected by ultraviolet rediation. The alkalinity of Kshar Sutra was 9.2ph.
Study Type : | Observational |
Actual Enrollment : | 1 participants |
Observational Model: | Case-Only |
Time Perspective: | Prospective |
Official Title: | Case Study of Fistula in Ano Managed by Kshar Sutra, Para Surgical Procedure |
Study Start Date : | June 2011 |
Actual Primary Completion Date : | October 2011 |
Actual Study Completion Date : | October 2012 |
Group/Cohort | Intervention/treatment |
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Kshar Sutra
The Kshar Sutra was a standard medicated thread smeared with Kshar of Apamarga (Achyranthus aspera), Shnuhi (Eforbia Nerrifolia) which has quality of cutting and Haridra(Curcuma Longa) which is used as a antiseptic. The ph value of the thread thus prepared was determined and its sterilization effected by ultraviolet radiation. The alkalinity of Kshar Sutra was 9.2ph.
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Other: Kshar Sutra
The Kshar Sutra was a standard medicated thread smeared with Kshar of Apamarga (Achyranthus aspera), Shnuhi (Eforbia Nerrifolia) which has quality of cutting and Haridra(Curcuma Longa) which is used as a antiseptic. The ph value of the thread thus prepared was determined and its sterilization effected by ultraviolet radiation. The alkalinity of Kshar Sutra was 9.2ph.
Other Name: Medicated Thread |
- Efficacy of Kshar sutra in Fistula in ano [ Time Frame: 5month ]Cutting and healing of the Fistula track.
- Recurrence of Fistula in ano [ Time Frame: 1year ]By observing patient for 1 year.

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Ages Eligible for Study: | 48 Years and older (Adult, Older Adult) |
Sexes Eligible for Study: | Female |
Accepts Healthy Volunteers: | Yes |
Sampling Method: | Non-Probability Sample |
Inclusion Criteria:
- Diagnosis of Fistula in ano without tributeries.
Exclusion Criteria:
- Multiple fistula and associated ano rectal conditions

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT01880398
India | |
Government Ayurved Hospital | |
Nagpur, Maharashtra, India, 440015 |
Principal Investigator: | Nita M Kedar, M.S.(Ayu) | Government Ayurved Hospital |
Responsible Party: | Dr.Nita Mahadevrao Kedar, Associate professor, Government Ayurved College and Hospital |
ClinicalTrials.gov Identifier: | NCT01880398 |
Other Study ID Numbers: |
2468 |
First Posted: | June 19, 2013 Key Record Dates |
Last Update Posted: | December 24, 2013 |
Last Verified: | December 2013 |
FIstula in ano; Bhagandar |
Rectal Fistula Fistula Pathological Conditions, Anatomical Intestinal Fistula Digestive System Fistula |
Digestive System Diseases Intestinal Diseases Gastrointestinal Diseases Rectal Diseases |