Vikas Saroch - Ksharsootra in Ayurveda

8/12/2019 Vikas Saroch - Ksharsootra in Ayurveda

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Presented by -

Dr. Vikas Saroch

PG scholar

Dr.Shrinivas.M.Patil M.D.

lecturer

Shri. B.M.K. Ayurved College,

Shahapur, BELGAUM.

State Karnataka.





Aims and Objectives

• Preparation Of Rasashastriya Kshara Sutra

• Physicochemical analysis of prepared

Kshara Sutra

• Clinical studies on Prepared Kshara Sutra



Materials and Methods

• Compilation of literature available.

• Preparation of Kshara Sutra using

Rasaushadhis

• Physical and Chemical analysis of Prepared

Kshara Sutra

• Clinical Studies on Patients of Bhgandhara

( Fistula in Ano)



Review of literature

• Compilation of literature on ingredients of

Kshara sutra available in various texts of

Rasashstra.

• Selection of Ingredients by observing their

qualities and rationality with respect to

healing of Ano Rectal fistula



Ingredients

• Shudha Gandhaka

• ShudhaTankana

• Shudha Kankshi

• Madhu chisti



. Shudha Gandhaka- (Sulphur)

According to Bhavaprakasha

Nighantu Purvardha Shloka no . 111

- Jantukandu hara

According to Rasa Ratnasamuchhaya

- Kanduhara

- Vishahara

- Krimihara



. Shudha Tankana –(Borax)

– According to Rasa Tarangini

Taranga no. 23-

- Ushna, Teekshna, Sarak

- Vividha vrananashana



Shudha Kankshi –

(Alum)

According to Rasa Tarangini

Taranga no. 11 –

- Ushna, Vishadoshahanti

- Kandutihara

- Vranaropana

- Vranaharini



Madhu chisti –(Bees wax)

According to Bhavaprakash Nighantu

Purvardha –

madhuvarga- shloka no.30

- Bhutaghna

- Vranaropana



Preparation of Kshara sutra

Ingredients Qnty.

1 Shudha Gandhaka- 30 g

2 Madhu Chisti- 30 g

3 ShudhaTankana- 20 g

4Shudha Kankshi- 10 g

5 20 no. Surgical

cotton Thread-

q.s.



• About 6 inches long pieces of Surgical cotton thread (No.

20) were used.

• Shudha Kankshi and Shudha Tankana were mixed well

and to it sufficient qnty. of 95% ethyl alcohol is added to

make a homogenous thin paste.



• This mixture is taken in a stainless steel bowl and allpieces of thread are put in bowl. The threads are

moved well in bowl till they soak in it.

• This bowl is either kept in sun light or heated on mildtemperature at about 70 Degree Celsius ,By this all

alcohol get evaporated.



• The threads are then separated from each other. Dueto the coating of kankshi and tankana, the threadsappear stiff.

• In another stainless steel bowl, madhu chisti andshuddha Gandhaka are melted together with

constant stirring.



As soon as the mixture is melted, the threads coatedwith kankshi and tankana are dipped in the moltenmixture for about 5 to 10 seconds and then taken

out. They are held in a straight position till they arecooled and the mixture of madhu chisti andgandhaka becomes solid again. All the thread arecoated in this manner and they are stored in a cooland dry place.



Physicochemical Analysis

• Organoleptic characters-

colour- yellowish brown coloured thread

touch - smooth

smell – Pungent foul smell

• pH of the thread coated with Sulphur,Bee wax,Alum and Borax -8.89

• Total waxy material with Sulphur (Petroleum ether extractives) -66.4554%

• Weight of single thread coated with alum + borax + Sulphur + Bees'wax = 0.2609 g

• Weight of single thread without any coating = 0.0558 g



Clinical Studies

• Clinical studies of the prepared kshar sutra are conducted

at K.L.E.S. Ayurvedic Hospital ,Belgaum.

• The trials are conducted only on 15 patients of

Bhagandara as a pilot studies and results are as follow



Inclusive criteria

– Fistula in ano

with single opening

Exclusive criteria

- Fistula in ano with multiple

openings

- Patients with HIV Positive

- Patients of Tuberculosis



All the pre operative, operative and post operative

measures are conducted similar as in standard Kshar

sutra ligation.

Patients are called for follow up after every 7 days for change

of thread.

Out of 15 patients for first follow up

• 9 patients showed decreased purulent discharge and

inflammation.

• 4 patients showed decreased purulent discharge but

inflammation was still there.

• 2 patients showed no significant change in the complaints.



- When same patients were followed

up for 3rd thread change, they showed

significant cutting and healing action in

fistula with less granulated tissue

9 patients got healed in 4 thread changes.





Assessment of healing of fistula in ano was done onfollowing points.

• Reduction in purulent discharge and inflammation.

• Reduction in length between anterior opening of fistula

and anal orifice.

• Cutting (anterior wall of fistula) and Healing (posterior wallof fistula) action.

• Number of threads required for healing.

C l i



Conclusion• As we know in practice we are using Kshar sutra

containing Aushadhis like Snuhi Ksheera, Apamarga

Kshar and Haridra. Though this Standard Kshar sutragives good results in the ano rectal disorders like fistula in

ano i.e. Bhagandara, It is quite tedious job to prepare it.

Its most complicated part is the availability of Snuhi in

surrounding vicinity. And collection of Snuhi Ksheera. Also

Above mentioned Kshar sutra using Madhu Chisti,

Gandhaka, Kankshi and Tankana are easy to prepare and

their properties as mentioned in literature are quite

acceptable for the cutting and healing action in

Bhagandara.

• Another advantage of this Kshar sutra is the shelf life

period, When it is preserved in cool place it will not loose

any of its ingredient’s efficacy as all ingredients can last

for long time.



Vikas Saroch - Ksharsootra in Ayurveda

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