Abstract

COMPARATIVE CLINICAL STUDY OF POLYHERBAL SUPPOSITORY IN POST OPERATIVE MANAGEMENT OF ANORECTAL DISEASES

*Dr Bharti muthal ** Dr K. Rajeshwar Reddy(*P.G. scholar (II year) Dept of Shalya Tantra, R.A.Podar Medical (Ayu) College,Worli Mumbai-18)

Ayurveda plays very important role in management of anorectal diseases and Shastrakarma is one of the chief modality to treat the anorectal diseases. In post operative management on withdrawn of anesthesia, patients have to face the problem of ano rectal pain, PR bleeding, local - burning & itching. Apart from parentral route of analgesic drugs, administration of locally acting drug need to be used.Rectal drug administration could represent a convenient, alternative route of drug administration over oral route which has its own drawbacks like intolerance, nausea, vomiting or gastric pain. In modern medicine, Diclofenac sodium suppository is used mostly to overcome such problems in spite of its adverse reactions. To overcome these side effects, we have prepared an ayurvedic suppository “polyherbal gudvatika” by correlating Aacharya charaka’s Mahakashaya Gana & Aacharya Sushrut’s Mishrak Gana. drugs which are common to both & having multiple properties along with analgesic & anti-inflammatory one, such drugs are taken in this study. We have found significant result in reducing various complaints faced by patients of post operative ano-rectal disease by using polyherbal gudavatika.

VIDEO PROCTOSCOPE – NEW INSTRUMENT FOR PROCTOLOGY.* Dr G K Daga (Daga Piles Hospital, Opp Dist Court, Adalat Road, Aurangabad.431001)

1. Disadvantage of Conventional Proctoscopeo Very minimum visual area so only the examiner can see through the proctoscope and also

chances of missing some pathology is more.o No provision to store the data or vision.o Very rigid so can’t be used in painful conditions ( Anal Stricture, painful fissure etc.)o Both Hands remain engage, so difficult to do some procedure by holding it.o Very difficult to focus the light inside the proctoscope.

2. Expectation of proctologist from new type of proctoscope.o Proctoscopic view to be enlarged and be able to save.o Proctoscope to be flexible with Good light inside.o External pathology can be demonstrated on screen and saved.o The procedure can be recorded and saved.

3. Advantage of Video proctoscope.o It is stable and provided with stand and high performance camera.o Internal as well as external pathology can be viewed very effectively.o Provided with the sinoscope with which one can view fistula track from inside and also see the

progress of treatment of abscess cavity.o Having recording facility and recorded vision can be saved.

A CLINICAL STUDY ON EFFICACY OF PICCHABASTI IN MANAGEMENT OF PARIKARTIKA

*Dr Prachi Yadav **Dr C. D. Jagddhane.(*PG scholar, Dept. of shalya-tantra, R. A. Podar medical college(Ayu), Worli, Mumbai-18)

Constipation leads to all types of ano-rectal diseases of which fissure in ano is commonest among all.In acute fissure, patients has to bear agonizing pain and burning at anal region with per rectal bleeding which is very annoying for the patient. The suggested conservative treatment by modern science is

purgatives and local application of analgesic ointments. This nearly takes at least a month to heal a fissure Or if severe spasm persists then patient has to undergo the surgical treatment which includes anal dilatation and spincterotomy.Which has its own complications and limitations Piccha basti is a para-surgical procedure which can be used in management of fissure in ano and gives instant relief in pain and burning simultaneously which heals the fissure wound in eight days. Open randomized study was carried out in 15 patients especially in high risk patients for the surgical management. Pichha basti not only relieved pain but also healed the fissure in eight days.

SIGNIFICANCE OF INTEGRATION OF TECHNIQUES OF MODERN & AYURVEDA SCIENCES

*Dr. Deepali. G.Agrawal, **Dr. Ujwal Barange(*Lecturer, Shalya dept., MGACH&RC, Salod,Wardha)

There are number of diseases like fistula in ano, frozen shoulder, chr. Non healing wounds, renal calculus which cannot treated with single technique or a remedy in a single science at number of times.For the same Sushruta has mentioned use remedies according to situations. If treatments are given in combination the results obtained are good, some results obtained for the same, in our hospital MGACH&RC, Salod, Wardha are as follows-

1) Partial fistulectomy with kshar sutra ligation in fistula in ano.2) Physiotherapy with agnikarma in frozen sholder.3) Skin grafting with application of Jatyadi tail application on donar & recipient site on chr. Non

healing wound.4) Antibiotics, antispasmodics & then use of herbal medicines in renal calculus.

It was found that by using this combination therapy- Treatment becomes more effective, economical and with less complication Rate of recurrence is less

Key words – Fistula in ano, Frozen sholder, Chr. Non healing wound, renal calculus.

ROLE OF KSHARKARMA IN MANAGEMENT OF Of ARSHA VYADHI*Dr. Deepika R. Singh **Dr. A.M. Lakhapati

(* P.G.Scholar, Dept. of Shalyatantra, Govt. Ayurved College & Hospital, Nagpur)The Shalya Tantra a prime branch and is rich in many aspects of modern surgical concepts. Ayurvedic classics have described various treatment modalities like medical, parasurgical & surgical in Arshas. Nowadays Parasurgical procedures like Ksharkarma, Ksharasutra, Agnikarma & Raktamokshana are more popular than other treatment modalities of Arshas. Acharya Sushruta has described four curative measures in the treatment of Arsha:

Bheshaja Kshara Karma Agni Karma Shastra Karma

Ksharkarma is more effective than the other modalities of treatment, because they can be administered both externally & internally. For this clinical study 10 patients were taken & kshara was applied over arsha for 7 days.

MANAGEMENT OF FISTULA IN ANO BY KSHARSUTRA COMBINE WITH MODERN SURGERY I.E. PARTIAL FISTULECTOMY

*Dr. Gupta Pankaj (Sushrut Anorectal Speciality Clinic, Akola)

High rectal fistula and multiple fistula in ano are challenging to treat by ksharsutra or by modern surgery i.e. fistulectomy. As ksharsutra takes long time for complete healing of fistula; and many complications were found after complete fistulectomy. To overcome these problem partial fistulectomy with ksharsutra ligation is used. It is very beneficial as the time required for complete cutting and healing of tract is become near about half than only by kshasutra ligation. It also provides wide drainage for track and chances of recurrence are very less. There is no incontinence or anorectal stricture is noted after this procedure.Conclusion -

1. Time require for complete cutting and healing of fistulous track is reduces to half2. No incontinence or ano rectal stricture noted3. Very much beneficial for high rectal, multiple as well as horse shoe fistula in ano.

Keywords : Partial fistulectomy, Ksharsutra, Fistula in ano

ETIOLOGY BASED STUDY OF HEMORRHOIDES” – AN AYURVEDIC PERSPECTIVE.*Dr. KRANTHI VARDHAN RENUKUNTLA

(Dr. B.R.K.R. Govt. Ayurvedic Medical College & Hospital, Erragadda, Hyderabad)‘Arsha’ is a gift of Modern Diets & Busy Lifestyles. It has been estimated that 50% of the population has Hemorrhoids by the age of 50 and > 70 % of people are suffering from some sort of Ano-rectal disorders. It may be simple Constipation to complex Carcinoma, in which prominent disorder is the ‘Arsha’.A Hemorrhoid is a disease of unknown etiology, though there may be many contributory factors responsible for it. In Modern Science, it is a surprise to note that principal etiological factor is still obscure and controversial for such a common ailment. Ayurveda is the ‘Science of Life’ and Arsha is described as ‘Asta Mahagadas’ and is difficult to cure. Ayurveda Acharya’s have enumerated vast number of etiological factors including Dietetic Ingredients, Habits, Therapeutic Abuses, Acts, Mechanical Factors, and Indulgences. The time has come to understand their keen perception, deep insight and scientific knowledge of the disease - hence the present paper. Etiology based study of 30 patients was carried out. After the detailed assessment, it was found that, more percentage of etiological factors of Rakthavaha Srotas, Rasavaha Srotas, Mamsavaha Srotas were found influenced than Manovaha Srotas and Medhovaha Srotas. Ayurveda symbolizes holistic approach towards treating the diseases, avoidance of Etiologies (Nidana Parivarjanam) is a first step in the Management & Control of Hemorrhoides. Key Words: Hemorrhoids Arshas, Etiology, Nidana, Ayurveda Pathophysiology.

MANAGEMENT OF CHRONIC ANAL FISSURE WITH EXT. PILES UNDER L.A*Dr. N. S. Jadhav

(Associate prof. Dhanwantri Ayurvedic Medical College & Hospital, Udgir Dist Latur)An anal fissure is a linear crack or ulcer in the cutaneous lining of lower canal, Which extends upwards from anal verge to dentate line. It generally heals with the conservative treatments like Hot sitz bath & mild laxative at night.But the cases of recurrent & chronic anal fissure with external piles generally need surgical intervention.The Recommended surgical procedures like four finger dilation under G.A & various methods of sphincterectomy have many complications like impairment of anal continence, rectal prolapsed & ano-rectal sepsis and complications of G.A. etcConsidering the nature of conventional procedures and their complications, An attempt was made to evaluate the technique of Anal dilatation and thread ligation in the cases of chronic fissure in ano with ext. piles under local anesthesia described in ayurvedic texts.The cases of chronic anal fissure with ext. piles were randomly selected .All these cases were statistically analyzed.

Key Words- Chronic anal fissure, Ext. Piles, Dilatation, Ligation, Local Anesthesia

PROTOCOL FOR GRADEWISE PROCEDURES OF PILES*Dr. Shubhangi P. Badole

(Associate Professor Shalyatantra Dept., Nallasopara Ayurved Medical College, Nallasopara)The Sushrutasamhita is pioneer literature of Shalyatantra –Surgery in Ayurveda.Acharya Sushruta had described the management of each disease in many ways ,but first preference is given for Medicine, then Para surgical measures and then Surgical procedures .In Arsha Chikitsa Adhyaya he has summarized the Arsha management by fourfold Aushadhi Chiktsa,Ksharakarma,Agnikarma & Shastrakarma.He has further specifically mentioned the Stages of Arsha & accordingly the specific treatment from above group.If we observe the today’s modern treatment of Piles – Hemorrhoids, it also follows the almost same views. Piles are treated either with Medicine or Sclerotherapy or IRC or DGHAL or Surgery and others.In this paper there is an attempt to put forward the comparative views of protocol for grade wise procedures of piles according to Ayurved and modern faculties KEY WORDS - Chaturvidha Chikitsa, Arsha

TO STUDY & DETERMINE THE ROLE OF ROUTINE HISTOPATHOLOGICAL STUDY IN PATIENTS WITH FISTULA IN ANO FOR DIFFERENTIATION OF ITS CAUSES

* Dr.Archana Gharge(Reader in Rog-nidan Dept.Dr.G.D.Pol Founations Y.M.T.Medical College, Kharghar,Navi Mumbai)

Fistula is an inflammatory track having an external (Sec.) opening in perianal skin & an internal (Prim.) opening in the anal canal or rectum. This track is lined by unhealthy granulation tissue & fibrous tissue. Usually fistula in ano originates from perianal abscess in intersphincteric space of anal canal from infection of the anal gland.The abscess is formed & ruptured by itself, the condition leaving a tiny discharging sinus. After few months, again abscess is formed, ruptured by itself & discharging opening is left behind. After few recurrent attacks, the discharging fistula fails to heal & continues to discharge. New abscesses may also result from inadequate incisions made for pus drainage resulting in multiple fistulae (commonly seen in tuberculous infection). Locally there is induration of skin & subcutaneous tissue around fistula. Granulation tissue may be seen pouting out of the fistular opening.The various other disorders causing fistula in ano are Ulcerative Colitis, Crohns disease, Tuberculosis of rectal canal & colloid carcinoma of the rectum.Aims & objectiveTo study histopathological changes in tissue specimen collected from fistula track of patients to rule out various diseases causing fistula including bacterial infection, U.C., Crohns disease, Tuberculosis, malignancy of rectum & to determine the role of routine histopathological study for diagnosis of various causes of fistula in ano.Material & methodsTissue specimen from fistular track will be retrieved during exploration & surgery for biopsy &examined under microscope to study the inflammatory & other changes in anal glandular epithelium acc. to different causes of fistula in ano.

TO EVALUATE THE EFFICACY OF KSHIRI-VRUKSHA PATRA (VATA, UDUMBARA & PEEPAL) IN THE MANAGEMENT OF ARSHA.

*Dr.Kailas M. Chopade **Dr.Subhash Y.Raut(M.S (Scholar), Govt. Ayurved College, Nagpur)

According to Indian Journal of surgery among 2000 consecutive proctological examination 72% incidence of haemorrhoids were found. About 50% population over age of 50 years of world is suffered from haemorrhoids.Acharya Sushruta “Father of Surgery” stated Arsha in “Ashtaumahagada”. i.e. Dushchikitsya.In this clinical study Bheshaja Chikitsa With Kshiri-Vruksha Patra (Vata,Udumbara & Peepal) used in the management of Arsha, As legitimate first line of treatment with acceptable resultThe improvement in the clinical features of disease was noted within the interval of seven days till the pts has got marked relief.the results were assessed according to following criteria:-Bleeding per annum, Inflammation, Discolouration, Discharge, Pain, Degree of prolapse with scores from 0-4.For clinical study 10 pts of Arsha were selected from OPD & IPD of G.A.C., Nagpur Key word:-Arsha(Haemorrhoid), Bheshaja Chikitsa, Kshiri-Vruksha Patra(Vata,Udumbara & Peepal).

JALAUKA AVCHARANA IN VARICOSE VEINS*Dr. Nehal P. Patel **Dr. Sanjeev R. Yadav

(P.G. Scholar, Anushalya Department,, Y .M.T. Ayurvedic Medical College, Kharghar, Navi Mumbai)Venous disease refers to any disease or injury to the venous system and can be caused by many factors. If a person is obese or person smokes, drinks excessive amounts of alcohol or eats fatty foods, it can lead to blood thickening and obstruction of the vessels by fatty deposits or plaque formations. Pregnancy as well as medication can also lead to problems of the venous system.Varicose veins are considered a venous disease, a condition where superficial veins bulge and can be further increased through pregnancy.Leech therapy has been proven to help patients suffering from varicose veins. It can help reduce the pain and the swelling felt from varicose veins, and can help dissolve blood clots that have formed. The saliva of leeches is known to contain beneficial enzymes. They have anti-coagulation properties that help prevent blood from coagulating or thickening. Aside from this, there is also enzyme that breaks up formed blood clots which can occlude the vein. These two properties function to make the blood thin so that it flows freely in the veins. To further aid this function, another enzyme acts as a vasodilator to allow better flow of blood. Leech saliva also has anti bacterial properties, which helps individuals who have open sores complicated by varicose veins.

Ayurvedic Herbal Treatment for Keloid*Dr.Shishir S. Paratane **Dr. Rekha Khade

(Final year P.G.(Dravyagun Dept), Dr.G.D.Pol Foundation’s, YMT Ayurvedic Medical College, Kharghar)A keloid is a growth similar to a scar and usually results after injury, surgery, infection of the skin, skin burns, and piercing or tattooing of skin. However, a keloid is different from a scar in that is in does not subside over time. Most keloids are pink or red colored, and have a shiny, dome shaped appearance. keloids tend to grow progressively and can be painful, itchy and tender. Keloids can usually be seen on the chest, back, shoulders or earlobes. Keloids which cover a large area of skin may develop infected sinuses within the growth. Surgical removal of keloids may not be curative, as most keloids tend to recur.A keloid usually results from uncontrolled growth of the scar tissue. Keloids are usually resistant to treatment, be it local applications or oral medications. Herbal medicines and herbo-mineral combinations are used which are best in treating uncontrolled growth, and gradually act on the keloid to remove the keloid tissue through the blood circulation surrounding the keloid. Local applications of herbal pastes and herbal oils can also be utilized as additional treatment.

ROLE OF RASAYAN IN GERIATRICS

*Dr.Ujjwala D. More **Dr.C.Y.Bangarwar(P.G. Scholar, Sharirkriya Dept, Dr.G.D.Pol Foundation’s, YMT Ayurvedic Medical College, Kharghar)

In today's modern mechanized world due to much advancement in modern treatment procedures, the lifespan of individuals are increased. This leads to decreased mortality rate. The number of aged persons increased Geerna-Vaya (old-age) is characterised by decline in Dhathu, senses, ojas, vitality, virility, retention, recollection, speech & understanding. Vatadosha is dominant & gradually body undergoes dengeneration. In Vriddavastha, Dhatu, Virya, Indriya, Bala & utsaha deereases day by day, loss of hairs, wrinkling of skin, senile cough & short breath etc. appears.Difference of opinion is there about Rasayana in Jara, There is no care for timely ageing & death. Degenerative process can be slowed down to some extent, but on never be reversed.It has for its specific object the prolongation of human life & the invigoration of memory & vital organs. It deals with recipes which enable a man to retain his manhood or youthful vigor upto a good old age.

THE LITERARY STUDY OF TUBERCULOSIS OF ANORECTAL REGION W.S.R TO AYURVEDIC TEXT (i.e. upadrava of rajayakshma)

*Dr. Jai Kini (Assoc. Professor, Dr. G D Pol Foundation’s YMT Ayurvedic Medical College & hospital, Kharghar)

The tuberculosis of ano-rectal region is caused by Mycobacterium tuberculli bacilli. This disease commonly occurs as the secondary involvement in pulmonary tuberculosis. The clinical presentation is chronic inflammatory process with swelling, caseation, abscess, sinuses and fistula formation as well as itching, localized pain, painful defecation and presence of purulent dischargeIn classical ayurvedic text, Upadrava is considered as a secondary disease to primary one. Explaining Rajayakshma, SHUSHRUTA ( U.S.41-23) AND VANGASENA (rajayakshma 79 pg no.232-233) both shows arsha, bhagandara and nadivrana are in practice upadravas ( secondary diseases). The variation in these diseases on the basis of DOSHANUBANDHA will be further discussed in the length of the paper.

USE OF JALAUKAVACHARAN IN EXTERNAL THROMBOSED HEMORRHOIDS*Vd.Amit B. Mahalle **Vd. Aparna N. Sathe

(Final Year PG Scholar, Department of Kayachikitsa, Y M T Ayurvedic Medical College, Kharghar, Navi Mumbai)Sushrutacharya narrated raktamokshana as the radical treatment in piles. Jalauvkavacharana has been mentioned in Ayurveda as one of the most effective measure to treat thrombosed piles.Hemorrhoids are dilated veins within the anal canal in the subepithelial region formed by radical of superior, middle and inferior rectal veins. Expose to etiological factors, causes enlargement of three main hemorrhoidal complexes. It results in the swelling of vessels and they bulge as a mass of the tissue. Similarly in the thrombosed pile mass, the blood may get coagulated in the perianal subcutaneous connective tissue due to injury or infection. It may be internal or external. Generally it appears as a painful swelling. When thrombosis is larger in size it needs surgical intervention. Jalauka is indicated in our classic for “Grathita avagadheshu”. It also reduces pain, swelling, and inflammation. This mechanism helps to subside the pathology. Hirudin, calin present in the saliva of the leech inhibits blood coagulation and resolves thrombus. For the study 15 cases between the ages of 18-60 yrs. were selected and Jalaukavacharana was done twice weekly. After application of Jalauka it was observed that there was remarkable relief in pain in the external hemorrhoids.

THERAPEUTIC STUDY OF CONSERVATIVE LINE OF TREATMENT IN HAEMORHOIDS* Vd. Aparna N. Sathe

(Reader, Department of Kayachikitsa, Dr.G.D.Pol Foundation’s YMT Ayu.Med. College, Kharghar, NaviMumbai)

Haemorrhoids are dilated veins within the anal canal in the subepithelial region formed by radical of rectal veins. Ayurveda believes Arsha as a local manifestation of systemic derangements. Aims and Objectives:

1) To study literary review of bhaishajya chikitsa in Arsha.2) To study the indications and limitations for bhaishajyachikitsa.3) To find out various formulations practiced for bhaishajya chikitsa.

Methodology: 1) Different medical procedures including local and systemic management in Arsha were studied.2) Various references from different samhitas are collected.3) Practical experiences from seniors were analysed theoretically.

Result and ConclusionThe literary study of conservative line of treatment in haemmorhoids proved to be an effective guideline in management of patients were surgery is contraindicated or disease is of recent origin.

TEXTUAL STUDY OF EFFECT OF AGNIKARMA IN PAIN MANAGEMENT*Vd. Nikhil Patil **Vd. Sambhaji Tike

(P.G. Scholar, Dravya Guna Dept, Dr.G.D.Pol Foundation’s, YMT Ayurvedic Medical College, Kharghar)In ayurved treatment with heat burns is called as Agnikarma .It is also called as dahan karma. In Sushrut samhita importance of Agnikarma has been highlighted. He has noted that those diseases which cannot be cured by medicine, surgery & Ksharkarma can beneficially be treated by Agnikarma. Such successfully treated disease has no recurrence or has rare recurrence.AIMS & OBJECTIVE:- To study the effect of Agnikarma & its mechanism in the management of pain. METHODOLOGY:-Textual references were collected on the effect of Agnikarma in management of pain.CONCLUSION:- From the textual reference collected for presentation; it can be concluded that Agnikarma is effective in management of pain. The details of which will be discussed in the presentation.

YASHTIMADHU GHRIT APPLICATION IN BURNS*Dr. Pradip Adhav **Dr. K. R. Reddy

(PG Scholar (Shalya Tantra), IIIrd year R.A.Podar Medical College, Worli, Mumbai-18)Burns are a common injury in the developing world and associated with the significant morbidity and mortality. Suśruta has mentioned the use of medicated ghŗuta not only in the management of wound, but also in burn wound and similar reference was found in Cakradatta. Yashtimadhu (Glycerhhiza glabra) is known for its healing, analgesic and anti-inflammatory effects and is an easily available herb.Aims and objectives:

To provide a cost effective herbal remedy for Burns. To propose the probable mechanism of action of Yashtimadhu ghrit application in burns.

Materials and methods:Study design: open randomized study10 patients of burns were selected randomly and were treated locally with the Yashtimadhu ghrit. All the patients were given oral antibiotic treatment. Results and conclusion:Results obtained from the observations made were put to statistical analysis and conclusions were derived

“TO STUDY THE EFFECT OF SHIROBASTI IN ‘BROWN SUGAR’ ADDICTS”

*Dr. Tushar V. Bodkhe **Dr. Prakash S.Tathed(*M.D. (Sch) Dept of Kayachikitsa, Y .M.T. Ayurvedic Medical College, Kharghar, Navi Mumbai)

(**Guided by Dean,Y .M.T. Ayurvedic Medical College, Kharghar, Navi Mumbai)Financial needs of the family require earning by both male & female partners, resulting into neglect of the kids leading to different types of addictions.The ‘Brown Sugar’ is one of them which is most addictive abuse for 3-4 times develops craving for the substance, being a opium derivative it is constipative resulting into Haemorrhoids. Many modalities are available for managing & de-addicting these addicts along with counseling & group therapy, but it seems that relapse is a rule in these patients also the medications used for treating withdrawals are addictive themselves hence are far from satisfactory.Ancient medical science advocates

“Padpadenabhyastam padpaden va tyajyet”It’s difficult to stop ‘Brown Sugar’ in small doses as the dose goes on increasing. Hence it’s necessary to stop indulging all of sudden & treat the physical & mental symptoms. 46 patients of Brown Sugar addiction were treated with Shirobasti, though there is no direct reference Shirobasti which seems to be the good modality to manage the withdrawals of the ‘Brown Sugar’ abusers.Aims & Objectives:- -To find out the optimum time required for achieving end points of Shirobasti.-To study the effects for inducing sleep.-To study its effects on ‘Brown Sugar’ withdrawals.Results & Conclusions:- 30 patients desirous and counseled for quitting ‘Brown Sugar’ were treated with Shirobasti. The time taken to complete the procedure and its effects on the sleep and other symptoms were studied & conclusions drawn will be presented.

CLINICAL MANAGEMENT OF SHVITRA W.S.R.T. VITILIGO* Dr. Prakash Thorat **Dr. Ninad Sathe

(*PG Scholar Bhaishajya- kalpana dept., YMT Medical college, Kharghar, Navi Mumbai.)Vitiligo is skin disease of concern because of its social stigma though it does not cause any major physical deformity. There are expensive modern medicines with many side effects therefore research for effective indigenous drug with fewer side effects is essential. Hence the study was aimed at evaluating clinical efficacy of Shvitrahar yoga in Shvtra (Vitiligo).Material and method-10 patients were selected randomly which were diagnosed as per signs and symptoms mentioned in ancient Ayurvedic text.Result – Partial improvement was seen in 4 patients and 4n patients were fully cured

Twak-Vikar & GuggulKalpa *Dr. Vikrant Relekar ** Dr.SheelaPargunde

(*PG Scholar Bhaishajya- kalpana dept., YMT Medical college, Kharghar, Navi Mumbai.)Guggul is miraculous drug which has been mentioned by Acharyas for multiple purposes in Ayurvedic Samhitas. Formulations having guggul as a major part are called as ‘Guggul-Kalpa’. These kalpas are used in various diseases like Vatvyadhi, Twak-Vikar etc., according to dosha (Vata, Pitta, Kapha) & disease Symptoms. Svayambhuvaguggul, Amrutaguggul & Panchtikta-Ghritguggul are guggul kalpas which are mostly used in twacha-Vikar. It is need to think on the exact conditions in which they are to be used. In this paper the contents of all three are studied in detailed & efforts are made to present the kalpas according to their Rasa, Veerya, Doshghnata & their role on specific symptoms. Surely this study will be beneficial for accurate selection of guggulkalpa in specific Twak-Vikaras._____________________________________________________________________________________

PROBABLE ACTION OF RASAMANIKYA TO CURE KUSHTHA

* Dr. Sunita Ghawate ** Dr. Monarani Chaurasia(*PG Scholar Rasashastra dept., YMT Medical college, Kharghar, Navi Mumbai)

Today in the time of modern civilization all are running to achieve their goals neglecting their sleep and food habits. Due to lack of time they are making themselves dependent on readymade foods available in the market irrespective of knowing what and how they are prepared. Many of them are incompatible (Viruddha Ahara). When this packed food is eaten constantly, excessively & during indigestion or in ‘Mandagni’, it can lead to formation of ‘Aama’ and can produce Kushtha. As Rasmanikya is well known drug to be prescribed by many physicians in skin disorders we tried to establish the probable action of Rasmanikya in this period of modern food substances having no affinity. Its ‘Ushna’ & ‘Tiksha’ guna can increase the digestion, ‘Deepan, Pachan’ properties will help in removing the assimilated ‘Aama’ and its penetration deeper into the unhealthy skin through blood can take place by its Sukshma, Vyavayi and Vikasi properties which normalises the vitiated Doshas leaving healthy skin behind.Key words: Kushtha, Rasmanikya , Viruddha ahara, Agnimandya.

ROLE OF MATRABASTI ON DIFFERENT ANORECTAL CONDITION *Dr.manisha V Urewar (BAMS, MS, NAGPUR)

In this competitive world everybody has to face competition and for that they do not pay attention to their lifestyle i.e. Dinacharya. They eat fast food which is harmful to them and they have to face many diseases like fissure (anorectal disorder) in their life. For that they go for modern medicine,and they get temporary relief from Pain, Bleeding, Constipation and finally undergoes surgery with some complication like stenosis , pain.In Ayurveda Matrabasti is useful for such patient, who does not have much time. Matrabasti is useful in anorectal condition eg.  we can minimise the pain while changing ksharsutra, as there is a lot of pain by its rubing action. With the help of different drugs, matrabasti helps in healing, minimizing pain.  

DETERMINING CHOICE OF ANAESTHESIA IN ANORECTAL SURGERIES*Dr. Yogesh D. Narkhede

(M.S. Shalyatantra,S.S.A.M. Ayurvedic Medical College & Hospital,Hadapasar, Pune.)Every major or minor surgery requires adequate anesthesia like,

1. Local anesthesia2. Spinal anesthesia3. General anesthesia.

The study was aimed towards detailed study of different types of anorectal diseases, their anatomical importance, and nerve innervations of different anorectal parts.Observations-

In case of high anal fistula it is difficult to achieve anesthesia by local anesthetic injection. Local anesthesia provides less muscle relaxation hence restricted field view. Local anesthesia provides good post operative analgesia. Spinal anesthesia provides good muscle relaxation. It causes post operative urine retention. Regarding General anesthesia, it provides good muscle relaxation, best suitable for surgeon but

requires expert anesthetist & contraindication in systemically compromised patient limits its usage.

“MANAGEMENT OF PILES IN PREGNANCY”* Dr.Padmashree k **Dr.Chandrakant halli

(II yr PG scholar P.G dept of Shalya tantra NKJ Ayurvedic College. Bidar, Karnataka)Haemorrhoids are irritating, painful condition that is very common during pregnancy due to various causes. The haemorrhoidal plexus get dilated and inflamed resulting in formation of haemorrhoids which

are very painful. If not treated at proper time may cause bleeding and protrusion of the hemorrhoids. In such condition, surgical and para-surgical procedures have the limitations and use of ushna and tikshna drugs in the form of oral medication are contraindicated in garbhini patients.Keeping in view these problems dhupana karma as mentioned in Charak chikitsa 14/49 was selected to evaluate the effect of dhupana karma in reliving the signs and symptoms of piles. Trial drug was used in the form of coarse churna for dusting on red hot charcoal and the fumes were exposed to pile mass.The present clinical trial was conducted on 30 patients randomly divided into two groups i.e group-(I) trial drug for dhupana karma and group-(II) control group for triphala kwath sitz bath. Assessment was done on the basis of subjective and objective criteria.There was significant reduction in size of pile mass & signs & symptoms without any untoward side effect.

TO STUDY THE ANTIMICROBIAL ACTIVITY OF KSHARSUTRA PREPARED BY CONVENTIONAL METHOD

*Dr. Rupa S. Kadam(Asso. Prof. Dravyagunavigyan, DR.G.D.Pol Foundation’s Y.M.T. Ayu Med. College., Kharghar)

Fistula in ano is a most commonly found anorectal disorder. Ksharsutra is one of its kind, specialties of ayurveda to treat the fistula.Fistula is a tract lined by unhealthy granulation tissue. ksharsutra dissolves the tough fibrous coat and ultimately drain the discharge. A lot of recent advances are introduced in this technique like replacing it with rubber band and treating the thread with other herbs. Conventionally prepared ksharsutra as we all know have healing and cleansening effect on the tract. The herbs applied to the thread, viz, Snuhi latex (API Euphorbia neriifolia), Apamarga Kshara (API Achyranthes aspera), Haridra (API Curcuma longa) all having good antimicrobial activity. So it will be interesting to see the combined effect of all these when applied locally in the tract.This study aims to study the antimicrobial action of ksharsutra on 3 pyogenic bacteria-Staphylococcus aureus, Pseudomonas pyogens and Escherichia coli.For this Ksharsutra was prepared by standard conventional method. This was tested for antimicrobial activity on 3 pyogenic bacteria through culture and sensitivity media.

EFFECT OF RAKTAMOKSHAN IN CALCANEAL SPUR.*Vd.Anil Tarale. **Vd.S.D.Waghmare

(*P.G.scholar (shalya-tantra).R.A.Podar medical college(Ayu).worli,Mumbai-18)Upcoming era is an era of IT, where life has become fast & strenuous, man is suffering from many diseases which are outcome of this fast life & calcaneal spur is one such entity. Calcaneal spurs are soft, bendable deposits of calcium that are the result of tension & inflammation in the planter fascia attachment to the heel. Usually anti-inflammatory drugs & corticosteroids are the main method to treat the inflammation caused by the heel spur. In Ayurveda, the symptom calcaneal spur can be correlated with Vatkantak as quoted by sushrut & Chakradatta has mentioned the usuage of raktamokshan in the management of vatkantak.The study primarily aimed at evaluation of role of Raktamokshan in calcaneal spur as vedanastapak & the results were amazing.

PATHYAPATHYA IN ANO-RECTAL DISEASES (DO’S & DONT’S)* Dr. Shruti.R.Joshi ** Dr. S.N. Ojha

(*P.G. Scholar Ayurved Samhita, Pad. Dr. D.Y. Patil, Ayurvedic College, Pimpri, Pune)There is lack of time due to busy & stressful schedules. Hence, everyone is dependent on ready-made food available in market irrespective of knowing their harmful effects & neglecting their hygienic levels.

People are moving away from cultural/traditional eating habits/ lifestyle & leading towards modern/ Western lifestyle. Women and Young girls put themselves on crash diets craving for food. Use of Artificial/ flavored foods has increased instead of naturally prepared as fresh fruits & vegetables. This type of lifestyle collectively affects the digestive capacity leading Anorexia, Constipation, etc. and most important Ano-rectal diseases. Keywords - Pathya Apathya, Lifestyle Management, Anorectal Diseases.

TO EVALUATE WOUND HEALING ACTIVITY OF TOPICAL APPLICATION OF HONEY.

*Dr. Kiran S. Kalyankar **Dr. Rekha R. Khade(*Final Yr M.D., Dravyagunavigyan Dept, YMT Medical college, Kharghar, Navi Mumbai)

Ayurved has made a large and comprehensive study of the medical advantages of honey, an ancient food and medicinal item since at least the last 2000 yrs.Honey has been extensively studied in the treatment of wound but efficacy in clinical practice is not fully established. The aim of the present study was to evaluate the efficacy of topical application honey the treatment of wound healing. Honey is stated to be effective in in different conditions such as Vrana (wounds or ulcers), Nadivrana (sinuses), Vidradhi (abscess), Visarpa (erysipelas), Upadamsha (syphilitic ulcers), Vranajakrimi (maggots in wounds), Dustavrana (septic wounds), Vranashotha (inflammatory changes of wounds), Vranavisha (cellulitis), Ugravrana (purulative ulcer), Netravrana (hordeolum or stye sepsis), Pramehapidaka (diabetic carbuncle), and Bhagandara (fistula-inano).Key words : Honey, Wound Healing, Alternative Medicine, Clinical Trial

TAKRA (BUTTERMILK) IN HAEMORROIDS* Dr. Krishna Deshpande **Dr. S.N. Ojha

(*Final Yr M.D., Ayurved Samhita Department, Pad.Dr.D.Y.Patil College, Pimpri, Pune.)‘Viruddha Aahar Vihar’ hamper the digestive power leading to Mandagni, which leads to formation of Ama. Mandagni causes Dosha Prakopa which affect the Sira (veins) of Gudasthana leads to Arsha formation. Takra (Buttermilk) is an important part of diet and medicine Haemorroids.Takra relieves Srotorodha (obstruction in Srotas) and allows the Ahara-rasa to mix with Rasa, Rakta etc. Dhatus, increase their strength and Nourishes them. It normalizes the vitiated Doshas (Vata, Pitta, Kapha). It’s preparation is different according to the Doshas. Takrarishta is also an important medicine in Haemorroids, Keywords- Arsha (Haemorroids), Takra, Agnimandya.

TO STUDY THE EFFICACY OF “YASHTIMADHU SIDHA TAIL BASTI” IN ACUTE FISSURE IN ANO .

* Vd.Sunil T.Dhavale **Vd.Vidya Dharne(*PG Scholar Anushalya dept. YMT Ayu. Medical college, Kharghar, Navi Mumbai,)

The patho-physiology of Fissure in Ano suggests severe pain in the anal region during defecation. Ayurveda describe the disease as “Parikartika” i.e. disease in with severe cutting pain is present.Ayurveda narrates that basti as the half treatment of the disease. Anuvasan basti helps to reduce the cutting pain in anal region. Total 15 patients of acute fissure in ano were selected from the OPD of Anushalya Tantra Dept. Of YMT Ayu. Medical college for pilot study.

Basti was given to the patients in a dosage of 30 ml. for 8 days.Kartanvat Vedna (Cutting pain in anal region), Vayuvishtambha, Aruchi symptoms which were present in the acute fissure in ano reduced significantly on the 1st day of treatment. After basti it was observed that above symptoms were relieved significantly.

TAKRA- MISCONCEPTIONS SURROUNDING IT AND ITS IMPORTANCE IN ARSHA VYADHI

* Vd. Sushant T. Maksane **Vd. Vijaykumar Sharma(*M.D. Scholar ( Dravyaguna), Smt. K.G.M.P. Ayu. Mahavidyalaya, Mumbai.)

Bhavprakash nighantu takravarg highlights the importance of takra. Consuming takra regularly never leads to diseases and diseases cured by it do not redevelop. Takra is compared to amrut consumed by GOD.Maharishi Charak mentions that there is no greater medicine than takra in arsha vyadhi.This itself optimizes the importance of takra. Despite it been given such importance do we really get appreciative results in patients? The answer is no, because takra advised to patients nowadays is not as mentioned in granths. Takra given today is something called “chachhika” which has entirely opposite guna dharmas to that of takra. Takra is ushna viryatmak whereas chachhika is sheeta viryatmak. The major fault lies in the making of takra ,its processing, drayas which should be mixed with it according to various doshas etc. This article would put light on various misconceptions surrounding it, which if cleared could lead to successful treatment of vyadhis like arsha.

ACTION OF AGNIKARMA IN TREATING KADAR * Dr. Vrushali Divekar ** Dr. Monarani Chaurasia

(*PG Scholar Rasashastra dept., YMT Medical college, Kharghar, Navi Mumbai)There are many diseases which are not treated with internal medicine. Surgical treatments are very costly & are non affordable to common man. Hence, it was decided to treat KADAR of foot with non invasive technique or with para surgical procedure of Ayurveda knows as AGNI KARMA. While describing about this procedure in shalyatantra it was clearly mentioned that those diseases which are not curable by Surgery, Kshar karma or Bhaishaj Karma can beneficially be treated by Agnikarma. Such successfully treated diseases have no recurrence or have rare recurrence. A corn is a specially-shaped callus of dead skin that usually occurs on thin or glabrous (hairless and smooth) skin surfaces, especially on the dorsal surface of toes or fingers. As it is of dead skin matter it was tried to burn this dead skin with Agnikarma the results of which will be displayed in poster.Key words:- Agnikarma, Kadar

MANAGEMENT OF CHRONIC ANAL FISSURE WITH SENTINEL TAG UNDER LOCAL ANAESTHESIA

*Dr.Narayan.S.Jadhav,MD (AYU), MBA(HHA)(Associate professor. Dhanwantri Ayurvedic Medical College & Hospital, Udgir Dist Latur)

Anal fissure is crack in the sensitive mucous membrane of the anal canal. The condition is very painful and this pain causes spasm of the underlying internal sphincter. As long as this spasm remains, the crack in the overlying mucosa does not heal. Thus a vicious cycle is set up. Hence a fissure, Which start as acute becomes chronic.Aims and Objectives -1) To assess the efficacy of anal dilatation and sentinel tag ligation under local anesthesia in the management of chronic fissure in ano with sentinel tag .2) To establish an effective and simple treatment modality for the management of chronic fissure in ano with sentinel tag.

Selection of Procedure -1) Anal dilatation - lord’s procedure: - four finger stretching of the anal sphincters under LA.2) Ligation of sentinel tag - Transfixation and ligation of sentinel tag by 20 no. linen barber under LA.Conclusion – The Anal Dilation and Ligation of sentinel tag in chronic fissure in ano is the most effective, simple, safe, economical, early ambulatory and parasurgical, complicationless line of treatment in chronic fissure in ano with sentinel tag.

APPLIED ANATOMY OF GUDAGAT PRADESH*Dr. Kranti Metkar

(*Reader, Dept. of Sharir Rachana, DR. G. D. Pol Foundation’s Y.M.T. Ayu Med. College., Kharghar)Introduction: Sushruta has described about guda (Anus) as sadhyupranhara marma. So all gudagat (Anoretal) vyadhi are said to be Kashtasadhya vyadhi by Ayurved samhitas even bleeding per anal (mild to severe) in pts with anorectal disease can lead to disterning condition. Marma is vital organ of the body. As per sushrutachrya marma is important stay of shalya tantra. Texts say that marma is meeting place of muscles, veins, tendons, nerves, bone and joints. Hence injury to marma can lead to life threatening conditions. This study include the compilation and study of diseases like piles, fissure, perianal abscess, T.B. infection and malignances, cyst, disease in skin layers and congenital anamolies at (anorectal) gudagat Pradesh. Aims and objects: To study applied anatomy of gudagat Pradesh (anorectal). Material and methods: various disease occurring at gudagat Pradesh i.e. Internal haemorrides (piles), / external haemorrides, portal and complete prolapse of the rectum, cancer of the rectum,rectal injuries, portal – systemic anastomosis, perianal hematoma, anal fissure, perianal abscesses,cystic tumour, rectocolic sphincter – between the lower end of the pelvic colon and the rectum,internal and external anal sphincters - surronds the lower part of the analcanal, sphincter ani externus, incontinence associated with rectal prolapse, incontinence after trauma, incontinence after spinal cord injuries, removal of anorectal foreign bodies, ulcers, leiomyoma, tailgut cyst- also called retrorectal cyst humartoma, rare congenital presacral lesion, dysplagia-anal canal intraepithelial neoplasia, inflammatory diseases crohn’s diseases- anal canal involved in 25% or more of patients with small intestinal crohn’s and 75% with colonic crohn’s.Anamolies ; Imperforated anus, stenosis, Persistent cloacca ( Failure of development of urorectal septum), Anal atresia( the anus is either not present or it is in the wrong place.) High (supralevator) anamolies (40%) also called anorectal agenesis. No anal canal, rectum ends above levator ani muscle causes severe obstruction will be compiled and discussed.

POSITIONS OF ARSHA* Dr. D. S. Mahajan **Dr.R.K.Patil

(*PG Scholar, Dept. of SharirRachana, DR. G. D Pol Foundation’s Y.M.T. Ayu Med. College., Kharghar)Definition - varicosities of the veins of the anal canal are known as Heamorrhoids. Hemorrhoids though present in anal canal, are related to the arterovenous Shunts hence have different positions clockwise.Positions –

3 o’clock 7 o’clock 11 o’clock

STANDARDIZATION OF TAKRARISHTA

* Dr. Sayli Karekar ** Dr. Sheela Pargude(*PG Scholar, Dept. of Bhaishajya Kalpana, Dr. G D Pol Foundation’s YMT Ayu Med. College, Kharghar)

Takrarishta, a fermented medicament prepared by Buttermilk is a classical Ayurvedic Formulation mentioned in Charak Samhita. It is mainly used in Agnimandya, Shotha & Arshas. As per market survey, Takrarishta is prepared by very few pharmacies. Also literature survey does not provide exact standards for the formulation. So, efforts are made through this poster to standardized Takrarishta on the basis of parameters available for Standardization of Asav-Arishta. In this study Takrarishta is prepared as described in Grahanichikitsa of Charak samhita. This study will be definitely beneficial for preparation of Takrarishta to various Vaidyas & pharmacies.

SIGNIFICANCE OF ANIMAL STUDY IN AYURVEDIC RESEARCH* Dr. Prajakta Bhogate ** Dr. Ninad Sathe

(*PG Scholar, Dept. of Bhaishajya Kalpana, Dr. G D Pol Foundation’s YMT Ayu Med. College, Kharghar)An animal model is a living, non-human animal used during the research and investigation of human disease, for the purpose of better understanding the disease without the added risk of causing harm to an actual human being during the process. The animal chosen will usually meet a determined taxonomic equivalency to humans, so as to react to disease or its treatment in a way that resembles human physiology as needed. Many drugs, treatments and cures for human diseases have been developed with the use of animal models. This type of study prior to clinical trial based on the stage of development which are considered necessary for international approval from the scientific and regulatory point of view. Even in ayurveda aacharya Sushruta had mentioned vedhana karma should try on dead animal’s vessel before on human bieng (ref.- Su. Su. 9/4). By this attempt an ayurvedic practioner or student can find the method of selecting subjects or animals for their drug research and drug development.Key word - animal model, ayurvedic research, drug development

RECTAL PROLAPSE*Dr. P. P. Bhole **Dr. S. Tike

(*PG Scholar, Dept. of Dravyaguna, Dr. G D Pol Foundation’s YMT Ayu Med. College, Kharghar)Various modalities are developed to manage proctological disorders and are being still developing, as all of them are far from satisfactory hence one has to resort to the most ancient method mentioned in classics.

MANAGEMENT OF ANOSCROTAL FISTULA BY KSHARASUTRA*Dr. Nilesh Pund

()Ano scrotal fistula occurs in between scrotum and anal canal and cause dis amberessement. The most commonly used surgical techniques for this disorder include Fistulecyomy. However, the risk of recurrence of developing an infectionof the wound after the operation is high. Also the patient requires longer hospitalization, and the procedure is expensive ; Acharya Sushruta has described Ksharsutra for nadivrana. So this method was triend in this patient, Know case of diabetes and with HTN and Obesity(130 Kgs )and was operated before 4 timess by surgeon. In this way, Ksharsutra has large potential in management of complicated fistula. It minimizes rate of complication and recurrence.

BASTI – THE ANATOMICAL VIEW

* Dr. Navin Banarase(*Lecturer, Dept. of ShariraRachana, Dr. G D Pol Foundation’s YMT Ayu Med. College, Kharghar)

Basti has great importance in Ayurveda. It is a treatment for different diseases. Basti are of majority two types:-1-SHODHANA BASTI - That basti can expels the doshas in the body through vein2-SHAMAN BASTI - that basti gives rejuvenation to body. The action of expulsion & absorption of material can occur in following ways.1) Expulsion of doshas can be done due to osmosis. The content of basti i.e. sodium chloride or lavana has important role. We already know that in osmosis fluid goes from higher concentration to lower concentration. This rule acts in SHODHANA BASTI.2) Shamana basti consist of many brumhan dravyas and sheha may consist of many fats soluble vitamins. Upper half part of rectum is drain by superior and middle rectal vein which joined with portal vein hence vitamins or brimhan dravyas in the shaman basti are directly stored into liver through portal vein.Inferior part or distal part of rectum is drain by inferior rectal vein to internal iliac vein to systemic circulation. So if you want to circulate brimhan dravya in whole body though systemic circulation should be given basti into lower part of rectum. In both condition the concentration of basti fluid is more than venous fluid and because of this it is easily absorbed by rectum.

INTEGRATED APPROACH OF YOGA THERAPY ON ANORECTAL DISEASES* Vd. Swati H. Deshmukh **Vd. Deepa R. Kale

(*PG Scholar, Dept. of Sharir Kriya, Dr. G D Pol Foundation’s YMT Ayu Med. College, Kharghar)The imbalance in panchkosha leads to psychosomatic disorders like anorectal diseases. The balance between panchkosha will overcome the diseased condition. The balance can be maintained with the help of integrated approach of yoga therapy which includes Balanced Diet, Asanas, Mudras, Bandhas, Kriyas, Pranayama, Dharna, Dhyan (Meditation) Emotional culturing, Jnana, Counseling and Karmayoga.Thus, integrated approach of Yogatherapy helps to prevent psychosomatic disorders like Anorectal diseases and also works as Apurnarbhav Chikista.

TO STUDY THE DIFFERENT TYPES OF ANO-RECTAL DISORDERS IN GYNAEC AND OBSTETRICS IN AYURVEDIC AS WELL AS MODERN CONCEPT (ALLOPATHIC VIEW)

*Dr.Seema Mehre **Vd. Deepa R. Kale(Professor and H.O.D, Dept. of Stree Roga & Prasutitantra YMT Ayu Med. College, Kharghar)

The most common ano-rectal disorders occurring in the field of gynaec and obstetrics are:1 Piles or Hemorrhoids ( Arsha )2 Fissure in ano (parikartika)3 Fistula in ano ( Bhagandar)4 Yoni arsha is also described in our texts; however, the explanation given is analogous to cervical

polyp and its four types. Hence we will restrict ourselves to the above mentioned disorders which are also very common and equally painful, embarrassing and difficult to treat.

To begin with, a Gynecologist has to treat these diseases mostly in obstetrics rather than gynaec unless of course the patient insists. Most of the patients will consult a surgeon or a physician for piles, fissure or fistula. Piles in pregnancy, Fissure in ano which most commonly occurs in the post-partum period, fistula in ano and vesico vaginal fistula which is the most common complication of a very prolonged and difficult labor and Caesarean section respectively, are some of the conditions when the gynecologist has to treat. Hence we will see these disorders first.AYURVEDIC VIEWCharaka and Sushruta have mentioned Aamgarbha prapatanat (in shotha prakaran) i.e. occurrence of abortions as an important cause of arsha. Kashyapa has described Different types of parikartika in pregnancy and its treatment in detail.

AIMS & OBJECTIVES - To select special references of ano-rectal disorders in gynaec and obstetrics from ayurvedic texts and give a comprehensive and complete study on the subject along with the allopathic view.RESULT & CONCLUSION - The related case studies and discussion will be described in the paper

PRELIMANARY CLINICAL STUDY OF ARSHOGHNA-KARMA OF HARITAKI IN THE MANAGEMENT OF ARSHAS

* Vd. Pampattiwar S. P **Vd. Bulusu Sitaram(*P.G. Scholar –2nd Year, P.G. Dept. of Dravyaguna, T.T.D’S S.V. Ayurveda College, Tirupati)

Our country is marching towards development and progress. A person in this mechanical life hardly gets any time to look after himself and his personal health. Life style has been changed in modern era. People use vehicles for fast communication and convenience. People works on computers for a long time. The diet habit has been also changed due to imitation of Western countries like fast and spicy food. Due to above etiological factors- “Arsha” is most predominantly found in daily practice. Acharya sushruta included Arsha in Ashtoumahagad. Yogaratnakara called it Gudakeelaka and Durnama is synonym for Arshas. Arsha is a disease of sadya pranahara marma which should be treated as soon as possible. Surgical treatment for piles is many times avoided by the patients for multiple reasons. Hence, we have decided to find out the treatment which will be affordable and safe. Sampraptibhanga is the main thing in Arsha chikitsa. So Deepana, Paachana and Anulomana are to be followed in Arsha chikitsa. So, we selected haritaki which posses above properties and it is abundantly available, cost effective, easy to prepare and easy for administration also.Key words: Arsha, Ashtoumahagada, Yogaratnakara, Sampraptibhanga, Sushruta

TO STUDY THE VRANASHODHANA KARMA OF PATOLADI GANA WITH SPECIAL REFERENCE TO FISTULA-IN-ANO

* Dr. Pradnya Kamat **Dr. Rupa Kadam(*PG Scholar, Dept. of Dravyaguna, Dr. G D Pol Foundation’s YMT Ayu Med. College, Kharghar)

Anorectal diseases are common in urban areas. One such common anorectal disease is fistula-in-ano. Fistula-in-ano is a condition of inflammation in the track which has an external opening (secondary opening) in the perianal skin and an internal opening (primary opening) in the anal canal or rectum. The fistula usually originates from the perianal abscess in the intersphincteric space of the anal canal from infection of the anal gland. Initially abscess is formed and gets ruptured automatically leaving behind a tiny discharging sinus. This condition gets repeated and finally a stage is reached when discharging fistula fails to heal.Sushrut described ganas in Sutrasthan Chapter No.38. Many of them have vranashodhak property. One of them is Patoladi Gana which contains Patol, Shweta Chandan, Rakta Chandan, Murva, Guduchi, Patha and Kutki.Patoladi Gana may be used in treatment of fistula-in-ano. It bears vranashodhak properties as all the dravyas in this gana are tikta rasatmak and ruksha. Tikta rasa bears kleda upashoshan, paichchhilya, dourgandhya nashan properties. So this gana can be used in the form by siddha taila & ghrita. This gana may also be useful for vranadhavan in fistula.

ACTION OF SAFED MUSHALI ON ARSHA (HAEMORRHOIDS)*

Arsha (haemorrhoids) are dilated veins within epithelial canal formed by radicle of superior, middle and inferior rectal vein. These are of mainly 2 types i.e. Bleeding and Non bleeding piles.

Safed mushali: L.N. : Chlorphytum borivillianum Family : Liliaceae Action on piles : Safed mushali rasa is madhur,kashay. virya is sheeta Safed mushali is rakta stambhak as well as it is guda roga jeet .It is used for curing bleeding piles as well as after haemorrhoidectomy to avoid recurrence of pile mass as it is balya for gudagat mamsa and rakta dhatu.Internally Churna of roots of safed mushali is used for bleeding piles as well as to avoid reccurence of the same after operation.churna should be given with 1 tsf of ghee mixed wid ½ cup of milk.Conclusion: Safed mushali is curative as well as preventive for haemorrhoids.

A New Interventional Kshar-Sutra Strategy to Combat Fistula in Ano – A Longitudinal Study.*Gopal Lokhande **Swati Gopal Lokhande

(*Proctologist &  Ano-rectal Surgeon ,Yashodeep Piles Hospital,Chikhali,Dist – Buldhana.443201)Fistula in Ano is one of the most complicated disease so called Bhangadra or Nasur in local language of India. Kshar-Sutra is one of the ancient, popular & effective therapy in the management of Fistula in Ano.It works in main three wayes 1] Curetting of track 2] It allows drain 3] Cuts the track. Kshar-Sutra thread has 8-9.4 ph. & rough surface property. But 1] Irritation & burning Sensation 2] Lenthey process 3] Weekly setting of Kshar-Sutra are lacuna in this therapy & to overcome these lacuna I have created a new  interventional kshar-sutra therapy in my “Yashodeep Piles Hospital, Khandala Road, chikhali  where we used rubber band  in the fistula track after 1st three settings of Kshar-Sutra. Patient does not need Curating property of Kshar-Sutra after first 3 settings because the over granulation of track was wash out. Rubber band has elastic property with smooth surface which has better performance in cutting & allowing drain of fistula track due to elastic property patients does not required weekly setting of band & due to smooth surface patient has no irritation & burning sensation.Aim & Objectives - to find out the result new interventational strategies.Material & Methods This study was carried out in Chikhali Block of Buldhana District. This record based Longitudinal study was carried out in April 2011.Data of Fistula in Ano Patient reported to Yashodeep Piles Hospital, Chikhali from January 2006 to December 2010.910 Patient are selected in Study. In which 450 Patients were treated by routine Kshar-Sutra therapy & 460 patients were treated by new method. Result - From the above Data it is found that 96.7 % Patient got relief with no recurrences.Patients which were treated with new method had less pain, irritation & burning sensation & they required 30% less time to recover.Conclusion - Thus from the above study it can be concluded that New Interventional Khsar-Sutra Strategy is more Efficient & Effective to combat the Fistula in Ano than the Ancient therapy.

CONCEPT OF GUDA: AYURVEDIC MANAGEMENT OF ANO-RECTAL DISEASES POINT OF VIEW

*Dr. Amol G. Kamble **Dr. C. D. Vaikos(*Final year, M.D. Sharir Rachana Dept. Govt. Ayurved College, Nanded.)

Since the Ano-rectal Diseases are very specifically located in Guda organ, the description of this organ has its own importance. While treating the ano-rectal diseases with Ayurvedic management we have to think about utppati (origin) of Guda i.e. constitution of Guda. Also we have to go through the Guda sahrir- marma relation, Guda sharir-srotas relation, Guda sharir-dhamani relation, Gudasharir-snayu relation etc. Every time it is not necessary to compare the Gud sharir with rectum and anal canal. The

detailed sharir of Guda and its other relation and importance for Ayurvedc management will be discussed at the time of presentation.Key word: Guda

EFFICACY OF PANCHATIKTA GHRUT MATRA BASTI IN THE MANAGEMENT OF PITTAJA ARSH

*Rhishikesh NagvekarPatients suffering from piles are increasing day and day out. Modern day eating habits are most important contributing factors. Such a group of patients suffering from pittaja arsh was taken and treatment with Panchatiktaghrut matra basti was done. The abstract is as below. Number of patients – 7Common clinical features seen –

1) Pain 2) Fever3) Tenderness4) Local redness5) Difficulty in defecation6) Occasional per rectal bleeding7) Generalised weakness

Panchatiktaghrut contents –Guduchi , Nimbamulatwak , Vasa , Kantakari , Patolpatra , Goghrut .Dosage – 20 mlDuration of study – 8 daysInterpretation – Symptomatic relief to the patient upto 40% on the third day. There was Reduction in size of piles and up to 80% relief by 7th day.

APPLIED ASPECT ON ARSHA *Dr. Manjeet Singh **Dr. R. K. Patil

(*PG Scholar, Dept. of Sharir Rachana, Dr. G D Pol Foundation’s YMT Ayu Med. College, Kharghar)Arsha gives pain to a person as an enemy. Due to modern life style people are more prone for the disease.In Ayurveda the disease is explained with the certain no. of refrences. Presenting the same in comparison with modern. Aims & Objects - Comparison between Ayurveda & modern aspect. Material & method - Sushruta Samhita, Modern text book of surgery. Result & conclusion - Derived from the study will be discussed in paper

CRITICAL STUDY OF GUDA VALI AND HOUSTON’S VALVE AND ITS CORELLATION*Vd. Gautam R. Sharma **Vd. Kranti G Metkar

(*PG Scholar, Dept. of Sharir Rachana, Dr. G D Pol Foundation’s YMT Ayu Med. College, Kharghar) In today’s world when the diet of a person is not in accordance to bodily constitution, causes conditions such as constipation, acute gastroenteritis, burning defecation, this regimen also affects the anatomical structures of the alimentary canal such as rectum and anal canal. Since the passage serves as the major one for elimination of kitta bhaga of Aahara we ingest, hence it is of great importance. So, for process of elimination of feces (mala) Guda vali plays a great role, which is also can be correlated with Houston’s valve in modern science.

STANDARDISATION OF CHITRAKADI GHRIT & LTS CLINICAL EFFICACY ON SANDHIGATAVAT

**Dr. Leena A. Nandeshwar(Asst. Prof. Dept. of Bhaishajya Kalpana, Dr. G D Pol Foundation’s YMT Ayu Med. College, Kharghar)

Bhaishajya Kalpana has an important place in Ayurveda from the point of view of drug formation. Swaras, Kalka, Kwath, Heema & Phanta are five basic formulations explained in this science on which various other formulations are designed. Sneha kalpana (Medicated oil, Medicated ghee)is fromed from the basic quath kalpana. Chitrakadi Ghrit is best vatroghar is mentioned in Charak Samhita, so to check its clinical efficacy on sandhigatavat its standardization was done as per the original text and with the help of modern analytical approach.Aims & Objects:

To prepare the chitrakdi Ghrit with special reference to Charak Samhita and search the probable methods to standardize it.

To see the clinical efficacy of Chitrakadi Ghrit on sandhigatavat.Conclusion - This Chitrakadi Ghrit showed very good results in tobacco addicted Sandhigatavat patients. Tobacoos Vishad & Ruksha guna decreases the Sneha guna of Sandhistha Shleshak kapha & develop Sandhigatavat. After giving Chitrakadi Ghrit, Sneha guna increased in their body and so these patients were relieved of their symptoms of Sandhigatavat.

INHIBITING FUNCTION OF GENES*Dr. Ashay. H. Nandeshwar

(M.D (Ayu) Lecturer Vasantdada Patil Ayurvedic Medical Collage, Sangli.)Aim - To inhibit the function of 11th gene in patient suffering from sickle cell disease. Object - To reduce the crisis of patient suffering from sickle cell disease by using Ayurvedic medicines.Treatment - In Allopathy there is no specific treatment, but when I started treatment with Ayurvedic medicines, we found the Morphological and Phenotypical changes in R.B.C and patient. The blood transfusion and the crisis of the patients stopped.

HAMSAPADI PATRA KALKA AALEPA IN THE MANAGEMENT OF DUSHTAVRANA*Vd. Manoj B. Kadam **Vd. Sethu Madhav Murthy C

Introduction

THE ANATOMY AND EMBRYOLOGY OF ANAL CANAL*Vd. Rupali Rathod **Vd. Kranti G Metkar

(*PG Scholar, Dept. of Sharir Rachana, Dr. G D Pol Foundation’s YMT Ayu Med. College, Kharghar)Why the knowledge of anatomy and embryology of anal canal is important in day to day practice ? CASE SCENARIO - A case of HURSHSPRUNG’S DISEASE (congenital aganglionic megacolon ) has come to OPD for punch biopsy, what anesthesia would you give? AND what is the best posture for defecation? squatting/ sitting.To know the answers it is essential to know the anatomy and embryology of anal canalAim & Objects :1.To study anatomy of anal canal.2. Embryology of anal canal.

3. Clinical anatomy of anal canal.Material and methods - Literary study of Sushruta Sharir and modern texts.

VESSELES & NERVE SUPPLY OF RECTUM & ANAL CANAL*Dr. Prashant Jagatap **Dr. Manoj Jagtap

(*PG Scholar, Dept. of Sharir Rachana, Dr. G D Pol Foundation’s YMT Ayu Med. College, Kharghar)The vessels & nerve supply are the most important part of the rectum & anal canal, because the diseases are mainly related to the vessels & nerve. e.g. .Piles, Hemorrhoids are mainly originated in the blood vessels, and when they get ruptured or bleed it will leads to severe pain. So to know this the study of vessels & nerve of rectum & anal canal is important.

DRUG OF CHOICE FOR ARSHA W.S.R. TO THEIR ACTIONVd. Tike S. K.

H.O.D. & PROFESSOR DRAVYAGUNA DEPT. DR. G D POL FOUNDATION’S YMT AYU MED. COLLEGE, KHARGHAR)

Bhallataka and Kutaj plays an important role in breaking the etiology of piles effectively.Bhallataka acts as a best treatment for vataj arsha.Its deepana,pachana and bhedana activitie removes obstruction to the flow of rasa.Obstruction caused by ama or kapha retards flow of rasdhatu through pratiharini siras (PORTAL VEINS)which leads to back pressure causing arsha,udara and gulma.Bhallataka due to its katu rasa vipaka,ushna veerya and teekshna guna causes pachana of ama and kapha and thus removes stasis in the strotasas.It stimulates normal flow of rasa in anal vessels,removes obstruction in them and thus nourishes muscle fibres present in the walls of these blood vessels.hence bhallataka should be used to correct and for giving strength to anal blood vesssels and reducing their fragility.Kutaja acts as a agnideepana and pachana, due to its tikta katu rasa and katu vipaka.It absorbs kleda and stops bleeding from pakvashaya due to its ruksha and sheeta guna and kashaya rasa.Hence should be used in pravahika,raktapravahika and arsha.Indrayana decoction should be used in arsha as agnideepana and raktasthambana.Its bark powder should be given with buttermilk in irritability of colon and rectum.It purifies blood due to its tikta rasa and acts as a raktasthambak.It is the best medicine in bleeding piles.

Transanal Haemorrhoidal Artery Ligation (THAL) – An Innovative minimal invasive technique for Haemorrhoid Ablation

*Dr. Amar P. Dwivedi , M.S.(Ayu.), Ph.D.(Scholar)Haemorrhoids constitute the most common proctological disease. The clinical feature includes Bleeding P/R, Painful daefication & Mass like growth around peri anal region.The traditional surgical technique (Haemorrhoidal tissue excision) have complications like severe post operative pain, Sphincter damage, Stenosis & need hospitalization. Similarly, para surgical procedures like Rubber band ligation, Sclero therapy, IRC etc.are although offering less painful alternatives, presented frequent relapse of the disease, because vascular peduncles were not tied.The innovative minimal invasive technique for Haemorrhoid Ablation i.e. THAL (Trans anal Haemorrhoidal Artery Ligation) ties the vascular peduncles, due to which the arterial inflow to the CCR drops, the piles collapse and the eventual bleeding stops. The decreased tension allows for the regeneration of the connective tissue within the cushions. This facilitates the shrinkage of hemorrhoids and induces permanent reduction of the prolapse. Also, THAL does not require the excision of Haemorrhoidal tissue & is performed proximal to the dentate line , hence does not cause post operative Pain.

Fianally, for all above reasons, the widening of the use of THAL, versus the traditional ones, will also expand the trend towards resolutive approach to Haemorrhoids, since patients will also become progressively less afraid to meet thier surgeon. Key words: Haemorrhoid, Haemorrhoidal tissue excision, Prognosis in Piles Surgery, Surgery complications, Para surgical techniques for Haemorrhoid.

EFFICACY OF KSHARASUTRA LIGATION IN THROMBOSED INTERNAL HAEMORRHOIDS

Dr. Meghana Narayana(*Arth Ayurvedic Hospital, Indira Nagar, Bangalore)

Thrombosis is almost always a complication of large prolapsing hemorrhoids and is believed to be due to their becoming nipped by the sphincter muscle while in the prolapsed position so that congestion and thrombosis results.If you do not have the expertise to deal with thrombosed hemorrhoids via hemorroidectomy, you may send him home or keep himin the hospital, ask him to take sitz bath, get bed rest, apply wrapped up ice packs, give him pain killers- either oral, injection, or intravenous – and suggest ways and means to avoid constipation, such as a high fibre diet and the use of laxatives for constipation. If you have the expertise in dealing with thrombosed internal hemorrhoids, then a hemorroidectomy for internal hemorrhoids should be performed. However, most thrombosed hemorrhoids will clear up of their own accord, with the clot re-absorbed back into the body. Thrombosed internal hemorrhoids can be effectively treated by Ksharasutra ligation.

BRIEF REVIEW OF ANAL ANATOMY A COMPARATIVE STUDY OF MODERN AND ANCIENT SCIENCE

*Dr. Mrs. Bhagal Lata **Dr. Kranti Metkar(*PG Student, Dept. of Anatomy, Dr. G D Pol Foundation’s YMT College, Kharghar, Navimumbai)

As you are aware that in medical fraternity the role of anatomy is how much important. Particularly, for the surgeon it is most important and essential knowledge required for skilled result. The anal anatomy is the most congested anatomical part of the body. The father of ancient surgeon Lord Sushruta has described this anatomy very well. Surprisingly, if you compare with modern anatomy they are very similar. The detail comparatively study will be presented.

COMPARATIVE CLINICAL STUDY OF SNUHI KSHEERA SUTRA & TILANALA KSHARA SUTRA WITH APAMARGA KSHARA SUTRA IN BHAGANDARA ( FISTULA IN ANO)

*Lobo Supreeth Joyal **Bhuyan C. B. ***Gupta S. K. ****Dudhamal T.S.(*Private practitioner, sudha-supreeth, uppinangady, puttur tq, karanataka)

Bhagandara(fistula in ano) at modern parlance is a common anorectal condition prevalent in the populations wordwide and its prevalence is second highest after arsha ( haemorrhoids). Kshara sutra is one of the chief modality for the treatment of bhagandara in ayurvedic science. Exploration of the new plants for the preparation of an effective alternative to apamarga k.s. in view of easy processing, a snuhi ksheera sutra without any kshara, advocated by chakradatta and the tilanala k.s. were opted for their clinical evaluation total 33 cases of bhagandara were divided randomly into three groups , having 11 patients in each group. In group A snuhi ksheera sutra; in group b tilanala k.s. & in group c apamarga k.s. were used assessment was done on objective ( unit cutting time ) & subjective parameters like pain discharge etc. between the three groups. It was found that tilanala k.s. showed higher uct (9.76days) while lower in snuhi ksheera sutra (7.42) as compared to apamarga k.s. (8.82) thus tilanala k.s.can be used as a

substitute for apamarga k.s.and snuhi ksheera sutra can be employed in the recurrent fibrosed cases of bhagandara. Key words; apamarga, bhagandara, fistula in ano, snuhi ksheera sutra, tilanala k.s. unit cutting time

ROLE OF AHAR IN PATHOGENESIS OF ARSHA*Dr.Abhishek jaybhay **Dr.meenal vaidya

(*2nd year MD Scholar, KAYACHIKITSA YMTAMC, kharghar, Navimbai)Arsha is one of the commonest diseases found in all strata of society. Despite variation in diet arsha commonly found in high to low socioeconomic classes. So, it is necessary to establish possible relation between Aahara and arsha. In ayurveda Aahar-vihara is the commonest cause behind any kind of disease.most of the people hide their problems from family members and family physician so it become very difficult to treat these patients by establishing proper diet routine it is possible to prevent and treat arsha.

A COMPARATIVE STUDY ON EFFECT OF KSHARSUTRA BANDHAN & RUBBER BAND LIGATION IN THE MANAGEMENT OF ARSHA (HAEMORRHOIDS)

*Dr. Praveen N.Sahave **Dr.Subhash Y. Raut(LECTURER ,Chattisgarh Ayurved Medical College, Rajnandgaon, (C.G.))

Introduction – According to Indian Journal of Surgery among 2000 consecutive proctological examination 72% incidence of haemorrhoids were found. Piles (arsha) is one among the highlighted distance in surgical texts of any age. Arsha is characterised by the hypertrophy of soft tissues at anal orifice (Adhimansa)According to modern surgery haemorrhoid is varicosity and dilatation of haemorrhoidal veins of anal canal. The principle objective of treatment of piles is to scarify the hypertrophied and bleeding pile mass. The Rubber band Ligation and Ksharsutra Ligation of pile mass arrest the distal blood supply due to ischemic necrosis.Hence the present study in undertaken to compare the effectivity of both therapies on identical parameters. This was purely a clinical single blind comparative study. Total 40 patients classified into Group A and Group B.Group A- 20 patients were treated with Ksharsutra Ligation on standard operative principles.Group B- 20 patients were treated with Rubber Band Ligation.The results were periodically assessed and compared.The final outcome shows both procedures are effective in the treatment of piles out of which ksharsutra ligation is very effective as compared to barrons rubber band ligation.As there is less bleeding, less cost of therapy chances of recurrence are less. In this regard future study on larger sample size may need to derive the more accurate conclusion.Key Words – Arsha, Haemorrhoid, Bandhan, Ligation, Ksharsutra, Rubber Band.

SAMPRAPTI OF ARSHA*Dr. Namrata sonawane **Dr.meenal vaidya

(*2nd year MD Scholar, KAYACHIKITSA YMTAMC, kharghar, Navimbai)Arsha is one of the ashtamahagada mention in ayurveda. While treating any disease samprapti vighatana plays key role.without knowing samprapti of any disease one cannot treat or eradicate that disease. The way of developement of disease is come to know by knowing its samprapti.it also helps in making choice of  drug which can cure diseases.as samprapti of arsha is very complex it make it essential to study it.

IMPORTANCE OF JATYADIGHRITA IN FISSURE*Dr. Abhishek M Shukla **Dr. Deepa Kale

(PG Scholar, Dept. of Sharirkriya, Dr. G D Pol Foundation’s YMT Ayu. Medical College, Kharghar, Navimumbai)Jatyadi ghrita has ropana activity as mentioned in Bhaishjya Ratnavali. By taking this reference we had tried the local application of ghruta in 15 patients at our OPD and found good results.

Jatyadi ghruta also gives good results in Dushta vrana and nadi vrana.The details will be discussed in the length of the paper.