A comparative evaluation of Marham-e-Basaliqoon versus lateral internal sphincterotomy in treatment of Shiqaq-ul-Maqad(anal fissure). A randomized comparative standard control study

Shuqāq-ul-maq‘ad (fissure in ano), according to the Unani system of medicine, is caused by Hararat-wa-Yabusat (hot & dry temperament) Khushk-Baraz or Shadeed-Qabz (dry hard stool), Waram-e-har (acute inflammation), Ishal (diarrhoea), Fasid-fuzlaat (Morbid substance), Waram-e-Barid-wa-reehi of anal canal, passage of Tez-Akhlāt and zarba-wa-sakta (trauma).

In Classical text books it has been mentioned by almost all Unani physicians that Anal fissure is shigaff(tear) in anal canal caused by various reasons among which most common cause is SÅ«-e-MizÄj-HÄrr-YÄbis of Maqád and passage of dry hard stool. Other causes include passage of AkkÄl khilt (corrosive humours), dietary habits of eating too much Khushk(dry), Tursh(sour), AkkÄlkhilt (corrosive humours), Qabiz(astringent) items, trauma, external BurÅ«dat and as a complication of BawÄsÄ«r & NÄsÅ«r . In Unani system of medicine the Usool-e-Ilaj (principle of treatment) of fissure in ano is almost same as in allopathic system of medicine, such as use of high fibrous diet and laxatives. Avoidance of Tursh (sour), Qabiz(Constipative) and Khushk (dry) items . In addition several single and compound Unani drugs are indicated for anal fissures treatment having property of Mundammil(Healing), Muhallil-e-Awraam(Anti- inflammatory), Muzliq(Lubricant), Murattib(Humectant), Mulayyin (Laxative) & Mujaffif (Desiccants).

Number of formulations are mentioned in classical literature of Unani system of  medicine for treatment of anal fissures. So, using these formulations for treatment will provide an inexpensive, effective and alternative way for the management of anal fissure. So, in view of common prevalence and drawbacks like non-availability of affordable and safe treatment of anal fissure in conventional system of medicine the present study is being designed to manage the anal fissure by application of a Unani formulation Marham-e-Basaliqoon  with main objective to find out a convenient non operative, painless, safe, affordable and efficient remedy and this classical medicine will be compared with Lateral internal sphincterotomy.