“A Comparative Clinical Study to evaluate the efficacy of Gandhaka Druti Pichu and Yastimadhu Taila Pichu in the management of Parikartika with special reference to Acute Fissure-in-Anoâ€

Parikartika is one of the most painful and commonest condition in Gudagata Vikaras affecting majority of the population in modern world. Acharya’s have explained it as one among the Vamana Virechana Vyapat and Bastivyapat. It is caused by Sthana Samshraya of vitiated Vata & Pitta Dosha’s in Gudapradesh, leading to Kartanavat Vedana and Daha in Gudapradesh. It can be correlated to fissure-in-ano based on signs and symptoms.

Fissure-in-ano is an elongated ulcer in longitudinal axis of lower anal canal associated with constipation, severe pain & burning sensation during defecation and bright red bleeding. In acute type pain is so severe that, patient develops fear for defecation and this further worsens the condition. Fissure-in-ano occurs most commonly in midline posteriorly, in males usually posteriorly 95%, anteriorly 5%, & in females posteriorly 80%, & anteriorly 20%. About 30–40% of the population suffers from proctologic pathologies at least once in their lives, in that anal fissure comprises of 10–15%. It occurs equally in both men & women and is common in all age groups especially adults of 15-40 years. The incident is supposed to be high in one who passes hard & dry stool.

In the Chikitsa of Parikartika, Acharyas have mentioned Madhura, Kashaya Rasa Sneha Yukta Dravya’s in the form of Piccha Basti, Anuvasana Basti, Pichu, Varti & Lepa, which pacifies Vata and Pitta Dosha’s. Acharya Sushrutha has mentioned Anuvasana Basti with Grithamanda & Yastimadhu Taila in Parikartika.

Acharya Sushrutha has mentioned Pichu Prayoga in the context of Shashti Upakrama, in the management of Vrana.

Yastimadhu Taila is having Vata-Pittahara Guna, Sheeta Veerya, which acts as Dahaprashamaka and Vranaropaka, hence it is taken as standard drug by previous research works done.

Gandhaka Druti is mentioned in Rasa Ratna Samucchaya in the context of Uparasas, It is Taila obtained of Gandhaka, which acts as Vedanasthapaka and Vranaropaka, so it has been selected in the treatment of Parikartika.

Hence the present study is under taken to evaluate and compare the efficacy of Gandhaka Druti Pichu and Yastimadhu Taila Pichu in the management of Parikartika w.s.r to Acute Fissure-in-Ano.