RANDOMIZED CONTROLLED CLINICAL TRIAL TO EVALUATE THE EFFICACY OF KADALI KSHARSUTRA ALONG WITH GUGGULU PANCHPAL CHURN IN THE MANAGEMENT OF BHAGANDAR W.S.R. TO FISTULA IN ANO

Present trend in the treatment of fistula in ano in modern medicine is the wide excision of the tract along with the adjacent tissues and wound is allowed to heal, many other surgical procedures example Fistulotomy ,Fistulectomy ,Seton techniques , Flap procedure ,LIFT procedure ,LASER , Endoscopic ablation , Fibrin glue , Bioprosthetic plug  were tried out but none could be adopted as a perfect and curative technique by most of the surgeons, usually inspite of best efforts on the part of the surgeon “the patient after some time again reports pus discharge from the same scar” the frequency of the recurrence is very high and anal continence can also be found in patients .

In spite of much advances in modern medical and surgical science, it is reported that it is not possible to prevent chances of post operative complications like its recurrence rate, high risk of impared continence and nonhealing of the wound after surgical treatment. In additions to this there will be severe post operative pain which persist for many days morever surgical treatment requires hospitalization, regular dressing and post op care for longer duration, to overcome such problems, surgical field is planning for some alternative technique to treat these cases with minimal operative complications, recurrence and failure.For proper healing of wound drug should have two properties as follows:

1]  Vrana Shodhan: for cleaning of the wound

2]  Vrana Ropan: for healing of the wound

It is important to find simple composition which have both vrana shodhan and vrana ropan, Vednahar  properties.

Ayurvedic line of treatment for bhagandara includes medical, para surgical and surgical management. Parasurgical management includes ksharakarma, agnikarma and varti  ksharsutratreatment in bhagandara is chemical fistulectomy rather than surgical fistulectomy. In sushrut Samhita ksharsutra procedure has been described as the best remedy for the disease of nadivrana. there are many ksharsutra which can be used in bhagandar eg guggul coated ksharsutra ,snuhikshir ksharsutra etc. Sushruta in Kshar Paka Vidhi Adhyaya has mentioned 23 drugs from which Kshar can be prepared.Among which Kadali is one of the drug. Kadali has Madhur Rasa, Guru and Snigdha guna , Sheeta Veerya , Madhur Vipaka and Pitta Vatahar properties. It is easily Available . Cost Effective.