­­­A Comparative Evaluation of Antimicrobial Effect of Snuhi-Apamarg-Ksharsutra and Udumbara-Ksheer Sutra in the Management of Bhagandara (Fistula-In-Ano)

Bhagandara one of the eight grave disorders, pertaining the perianal region is arduous to treat, has been described in detail by Acharaya Sushruta. The Ayurvedic description of Bhagandara can be identified as associated with an anal fistula. An anal fistula is defined as an internal opening in the altered skin or mucosa of the anal canal or rectum and an exterior opening in the perianal skin region. Among the various modalities available for the treatment of bhagandara, ksharasutra is described as gold standards for treatment and cure. The ksharasutra possess antimicrobial properties and can be established as first line of treatment for bhagandar(fistula-in-ano). The modern approach for fistula-in-ano is surgical procedure. Antibiotics are commonly used along with surgery for the treatment of fistula-in-ano.  The aim of this study was to comparatively evaluate the antimicrobial properties amongst Snuhi-apamarga kshar sutra and Udumbara ksheer sutra. A total no. of 60 participants were enrolled as per the criteria for the study and pus samples were collected as per the standard operating procedure. Samples of Snuhi-apamarga kshar sutra and Udumbar ksheer sutra were already given in laboratory for testing the sensitivity. Reports were collected and analyzed on different parameters and conclusion was drawn accordingly. It was concluded that gram positive monomicrobial infections were more common especially involving staphylococci. Also, in the culture and sensitivity test Snuhi- apamarga ksharsutra was found to be more effective in comparison to Udumbara ksheer sutra as the microbes were highly sensitive to the Snuhi Apamarga kshar sutra. This can be contributed to the multiple contents in Snuhi Apamarga kshar sutra.