Classical vs. Chandan Kshar Sutra for hemorrhoids: post-ligation pain.

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Journal name: World Journal of Pharmaceutical Research
Original article title: A comparative study of classical kshar sootra and chandan kshar sootra ligation of arsha (hemorrhoid) in relation to post ligation burning sensation
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Author:

Dr. Kapil Sharma, Dr. Preeti Sharma, Dr. Vikas Chandra Gupta,Dr. Rajni Bala


World Journal of Pharmaceutical Research:

(An ISO 9001:2015 Certified International Journal)

Full text available for: A comparative study of classical kshar sootra and chandan kshar sootra ligation of arsha (hemorrhoid) in relation to post ligation burning sensation

Source type: An International Peer Reviewed Journal for Pharmaceutical and Medical and Scientific Research

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Summary of article contents:

Introduction

Hemorrhoids, a prevalent ailment affecting a significant portion of the population, can lead to discomfort and necessitate medical intervention, with many patients requiring surgical treatment. In Ayurveda, hemorrhoids are termed "Arsha," and the texts of Charaka and Sushruta elaborate on its characteristics, classification, treatment options, and etiology. A plethora of surgical techniques for treating hemorrhoids exist, yet Ayurvedic methods, particularly Kshar Sutra ligation, offer advantages such as lesser invasiveness and reduced postoperative complications. This study aims to compare the effectiveness and patient experiences of different Ayurvedic Kshar Sutra formulations in managing post-ligation burning sensations in hemorrhoid patients.

The Role of Kshar Sutra in Hemorrhoid Treatment

Kshar Sutra, a traditional Ayurvedic treatment, is a medicated thread applied to hemorrhoids, incorporating various herbal ingredients to facilitate healing. This study divides patients into three groups to evaluate classical Kshar Sutra, Shweta Chandana Kshar Sutra, and Rakta Chandana Kshar Sutra. The primary focus is on assessing the post-ligation burning sensations experienced by patients, as this discomfort can significantly impact recovery and overall satisfaction with the treatment. The findings suggest varying levels of post-operative pain relief, with distinct formulations yielding different levels of efficacy.

Comparison of Treatment Groups

The study found that patients in the group treated with Rakta Chandana Kshar Sutra reported the most significant relief from post-ligation burning sensations, particularly notable on the second, third, and fourth days following the procedure. In contrast, the classical Kshar Sutra group displayed similar levels of burning sensation but did not match the relief experienced by those treated with the novel formulations. The data points to the effectiveness of incorporating specific herbal components, such as Rakta Chandana, in improving treatment outcomes for hemorrhoids.

Significance of Formulation Variants

Additionally, the study established that Shweta Chandana Kshar Sutra also offered a marked improvement over the classical Kshar Sutra, particularly in reducing discomfort during the initial postoperative days. The differential effects of these herbal combinations underline the importance of individualized treatment approaches within Ayurvedic practices. Understanding these variances emphasizes a modern perspective on traditional methods, accommodating patients' comfort while addressing their medical conditions effectively.

Conclusion

In conclusion, the comparative study of various Kshar Sutra formulations highlights the potential benefits of integrating regional herbs such as Rakta and Shweta Chandana into traditional Ayurvedic treatments for hemorrhoids. The results have shown that these formulations can lead to superior patient outcomes with reduced post-ligation discomfort compared to classical methods. Future research with larger sample sizes is suggested to further validate these findings, potentially paving the way for enhanced treatment protocols that combine the wisdom of traditional medicine with contemporary clinical needs.

FAQ section (important questions/answers):

What is the purpose of this comparative study on Kshar Sutra?

The study aims to evaluate the effectiveness of classical Kshar Sutra and different variations in treating hemorrhoids, focusing particularly on post-ligation burning sensations experienced by patients.

What are the inclusion criteria for patients in this study?

Patients included were diagnosed with third or fourth degree hemorrhoids, presenting classical symptoms or previously treated for complications non-surgically, without any associated severe illnesses like diabetes or tuberculosis.

How were the Kshar Sutra threads prepared for the treatment?

The preparation involved applying alternating coatings of herbs like Haridra, Kshar, and either Rakta or Shweta Chandana on the thread, ensuring no significant differences in pH among the variations.

What were the significant findings in post-ligation burning sensations?

Group C, using Rakta-Chandana Kshar Sutra, showed significant improvement on the 2nd, 3rd, and 4th days post-operation compared to the other groups, indicating better pain management.

What conclusions were drawn from the study regarding treatment options?

The study concluded that Rakta-Chandana Kshar Sutra is more effective than classical Kshar Sutra in relieving post-ligation pain and recommends further investigation with larger patient groups.

How does this study contribute to existing Ayurvedic practices?

This research introduces a new Kshar Sutra preparation method, potentially enhancing treatment outcomes for hemorrhoids by utilizing effective traditional herbs, encouraging future studies for more extensive validation.

Glossary definitions and references:

Scientific and Ayurvedic Glossary list for “Classical vs. Chandan Kshar Sutra for hemorrhoids: post-ligation pain.”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.

1) Burning (Burn, Burned, Burnt):
Burning refers to a sensation experienced by patients, often post-surgery or treatment, particularly in the context of Kshar-Sutra ligation. It's crucial in assessing pain levels and recovery progress, influencing treatment adjustments and patient comfort following hemorrhoid procedures, as evidenced in the study presented.

2) Table:
Table refers to organized data presentation in the study, typically summarizing patient outcomes, statistical analyses, or comparative results across treatment groups. It enhances comprehension of the findings, allowing for easy reference when evaluating the effectiveness of different Kshar-Sutra treatments over time.

3) Post:
Post indicates a time frame following a particular event, such as surgery. In this context, it identifies the period after Kshar-Sutra ligation when various effects, sensations, or indicators relevant to patient recovery, like burning sensation or discomfort, are monitored and evaluated.

4) Snuhi:
Snuhi, known as Euphorbia tirucalli, is a medicinal plant whose extracts may be utilized in Ayurvedic practices. In this study, Snuhi is mentioned in relation to its use in creating Kshar-Sutra, contributing therapeutic properties potentially aiding pain relief and healing for hemorrhoid patients.

5) Burning sensation:
Burning sensation describes the uncomfortable feeling reported by patients after undergoing Kshar-Sutra ligation. Tracking this sensation is vital for understanding patient experience, measuring post-operative pain, and assessing the effectiveness of various treatment methods and herbal additives in minimizing discomfort.

6) Sutra:
Sutra refers to a thread or line in Sanskrit, often associated with medicinal practices in Ayurveda. In this study, it specifically describes Kshar-Sutra, a specialized herbal thread used for the ligation of hemorrhoids, combining skillful techniques with traditional healing properties.

7) Arshas (Arsa, Arsas, Arsha):
Arsas relates to Arsha, focusing on the patients and conditions being treated. The term indicates the study’s emphasis on understanding and addressing the various manifestations of hemorrhoids encountered, guiding individualized approaches in Ayurvedic care.

8) Haridra:
Haridra, also known as turmeric, is a key Ayurvedic herb recognized for its anti-inflammatory and antimicrobial properties. Its inclusion in Kshar-Sutra preparations signals its role in augmenting healing, alleviating pain, and reducing post-procedural complications in patients with hemorrhoids.

9) Guda:
Guda pertains to the anal or rectal region in Ayurveda. Its association with conditions like Arsha underlines the need for targeted treatment strategies in understanding diseases affecting this area, essentially guiding practitioners in offering effective remedies for hemorrhoids.

10) Rakta:
Rakta signifies the theme of blood in Ayurvedic contexts. In this study, its mention alongside Rakta-Chandana emphasizes the relevance of blood properties in treating conditions like hemorrhoids and underscores the role of certain herbs that support the body's healing processes.

11) Disease:
Disease signifies any pathological condition manifesting in the body. In the study, it highlights the medical understanding of Arsha as a clinical entity, fostering a basis for exploring Ayurvedic treatments and evaluating their effectiveness in combating specific health challenges like hemorrhoids.

12) Dosha (Dosa):
Dosha refers to the three fundamental bodily energies in Ayurveda: Vata, Pitta, and Kapha. The balance or imbalance of these forces is crucial in understanding the onset and progression of diseases like Arsha, guiding effective therapeutic interventions tailored to restore equilibrium.

13) Study (Studying):
Study refers to the clinical research exploration conducted on the efficacy of different Kshar-Sutra preparations. It emphasizes systematic methodologies, patient observations, and statistical analyses as essential steps in validating traditional Ayurvedic practices, contributing to scientific understanding of treatment outcomes.

14) Jatyadi:
Jatyadi refers to a specific Ayurvedic formulation or herb combination known for wound healing and anti-inflammatory effects. Its application in post-operative care emphasizes the integration of traditional healing methods to mitigate pain and promote faster recovery in hemorrhoid patients.

15) Bleeding:
Bleeding indicates one of the primary symptoms associated with hemorrhoids. The study addresses this vital concern as a measure of treatment effectiveness, documenting the pre- and post-treatment bleeding levels in patients as a key outcome influencing surgical decisions.

16) Ushnodaka (Usnodaka, Ushna-udaka):
Ushnodaka translates to 'warm water' in Ayurveda. The use of Ushnodaka in post-defecation practices helps facilitate comfort and hygiene for patients recovering from procedures like Kshar-Sutra ligation, showcasing its role in Ayurvedic post-operative care.

17) Ayurveda (Ayus-veda):
Ayurveda, the ancient Indian system of medicine, focuses on holistic healing practices and natural remedies. The study showcases Ayurveda's relevance in treating hemorrhoids through traditional techniques and herbal preparations, emphasizing its therapeutic potential and guiding principles in patient care.

18) Dressing:
Dressing refers to the method of applying protective and healing materials on surgical sites. In this context, it highlights the importance of appropriate wound care following Kshar-Sutra ligation, as it aids in preventing infections and promotes healing during recovery.

19) Shastra (Sastra):
Shastra in Ayurveda often signifies texts of authority that guide medical practices. In the study, Shastra is referred to regarding surgical techniques, emphasizing the foundational principles derived from ancient knowledge for safe and effective treatment of patients with Arsha.

20) Cutting:
Cutting refers to surgical interventions that involve incisions or removals. In contrast, Kshar-Sutra ligation is highlighted as a less invasive procedure, showcasing the study's focus on exploring methods minimizing trauma while addressing conditions like hemorrhoids effectively.

21) Sharman (Sarma, Sharma, Sarman):
Sharma denotes one of the authors involved in the study, indicating collaboration among medical experts for research. The presence of multiple contributors signals the interdisciplinary approach essential for investigating Ayurvedic treatments and improving healthcare practices related to hemorrhoid management.

22) Taila (Thaila):
Taila means 'oil' in Sanskrit, representing the use of medicated oils in Ayurvedic practices. Its usage in dressing and post-operative care supports skin healing and symptom relief, emphasizing Ayurveda's holistic approach to patient comfort following medical interventions.

23) Water:
Water serves as a fundamental component in Ayurvedic therapies, often used for hydration and cleansing. Its reference in the study underscores the importance of using warm water for post-operative care, enhancing comfort, and promoting healing for patients post Kshar-Sutra treatment.

24) Picu:
Pichu refers to a medicated cotton pad soaked in herbal oils used in Ayurveda. Its application post-surgery aids in localized healing, pain relief, and the overall recovery process for patients undergoing procedures like Kshar-Sutra ligation for hemorrhoids.

25) Diet:
Diet plays a critical role in Ayurveda for maintaining health and preventing disease. The study indicates dietary influences on the development of Arsha, underscoring the necessity for dietary management alongside surgical treatments to ensure lasting recovery and well-being.

26) Vitiation (Vitiated):
Vitiated denotes the disturbance or imbalance of doshas leading to health issues. In the study, it relates to how vitiated dosha conditions contribute to the development of Arsha, emphasizing the need for therapeutic approaches aimed at restoring balance to enhance patient outcomes.

27) Mandagni (Manda-agni, Mamdagni):
Mandagni refers to the weak digestive fire in Ayurveda, often linked to various health conditions. The study includes this term to illustrate its impact on fecal stasis in Guda, contributing to conditions like Arsha and emphasizing the need for holistic dietary and therapeutic interventions.

28) Chandra:
Chandra, referring to one of the authors, indicates the collaborative effort in conducting the study. Authors like Chandra contribute their expertise in Ayurveda, reinforcing the importance of interdisciplinary teamwork in researching effective treatments for hemorrhoidal conditions.

29) Kshara (Ksara):
Kshara refers to an alkaline substance utilized in Ayurveda for therapeutic procedures. In the study, it highlights its application in Kshar-Sutra preparation, integral in treating conditions like hemorrhoids, by providing effective chemical action that aids in tissue healing and patient recovery.

30) Karma (Karman):
Karma denotes action or technique in Ayurveda. The study outlines various karmas (procedures) employed in treating hemorrhoids, illustrating the significance of specific techniques in enhancing patient outcomes while emphasizing the ethical aspects of medical practice.

31) Gupta:
Gupta, another of the authors, emphasizes the collaborative research effort within the study. It reflects the contribution of medical professionals in advancing Ayurvedic practices and exploring innovative treatments for conditions like hemorrhoids through collective expertise and knowledge.

32) Apana:
Apana is one of the five types of Vata in Ayurveda responsible for downward movement in the body. Its reference in the study relates to its role in the physiological processes affecting Guda, elucidating the interconnections between bodily functions and conditions like Arsha.

33) Prana (Pran):
Prana signifies the vital life force in Ayurveda, essential for health and well-being. Its mention in the study reinforces the holistic view of treatment, where maintaining Prana is crucial in managing diseases like hemorrhoids and ensuring effective recovery following surgical interventions.

34) Vali:
Vali, referring to the anatomical region involving Guda, describes a specific area in the body affected by Arsha. The term's usage emphasizes the localized nature of treatment required for this condition, highlighting the anatomical significance in Ayurvedic healing practices.

35) Hari (Harin):
Hari denotes one of the authors, contributing to the collaborative nature of the research. Authorial inclusion indicates the interdisciplinary engagement required for effective studies in Ayurveda, enhancing the understanding and application of traditional methods for treating hemorrhoidal conditions.

36) Vayu:
Vayu embodies one of the three doshas associated with movement and biological activity in the body. Its relevance in the study ties into the physiological aspects impacting hemorrhoid formation, advocating for treatments that restore Vayu balance and promote overall health.

37) Line:
Line refers to a boundary in identifying symptoms or classifications of conditions such as hemorrhoids. In the clinical context, precise definition of lines enables medical practitioners to delineate between various degrees or types of Arsha for effective treatments.

38) Accumulation (Accumulating, Accumulate):
Accumulation is a critical concept regarding the buildup of waste or toxins within the body. This notion is vital in the study as it relates to digestive health, linking poor diet and lifestyle with the development of conditions like Arsha, underscoring treatment implications.

39) Calculation:
Calculation pertains to the statistical methods applied in the study to analyze patient data and treatment efficacy. It encompasses methodologies ensuring accurate interpretations of results, enhancing the validity of findings about the effectiveness of different Kshar-Sutra treatments.

40) Bhagandara (Bhagamdara):
Bhagandara denotes a condition that often accompanies rectal diseases. Its mention in the study signifies broader considerations in the assessment and treatment of patients, illuminating the complexity of management when dealing with conditions related to hemorrhoids.

41) Discussion:
Discussion represents the reflection on findings, comparisons with existing literature, and implications for practice. In the study, discussing results fosters understanding of treatment efficacy, paves the way for future research, and encourages ongoing dialogue about Ayurvedic methods in modern medical applications.

42) Antibiotic (Antibacterial):
Antibiotic refers to medication used to prevent or treat infections. In the context of the study, it emphasizes the advantages of Kshar-Sutra ligation being less invasive, highlighting the potential to reduce reliance on antibiotics normally associated with conventional surgical procedures.

43) Nadivrana (Nadi-vrana):
Nadivrana implies a type of wound or injury discussed in Ayurvedic texts. By referencing Nadivrana, the study connects traditional wisdom with contemporary surgical practices, promoting a holistic understanding of wound care and healing processes post hemorrhoid surgery.

44) Adhimamsa:
Adhimamsa refers to a condition involving excessive tissue growth. Its underline within the study highlights the complexities of diagnosing specific diseases like Arsha and informs the application of Ayurvedic treatments to address distinct pathologies effectively.

45) Suffering:
Suffering signifies the discomfort and pain experienced by patients, particularly related to hemorrhoids. Recognizing suffering as a central element holds importance in the study, guiding the selection of treatments aimed at providing effective relief and improving overall quality of life.

46) Sadananda (Sadanamda, Sada-ananda):
Sadananda, referring to another involved author, adds to the collective expertise in the study. The inclusion of diverse professionals signifies the collaborative spirit essential for researching and advancing Ayurveda as a valid and effective medical practice.

47) Affection:
Affection conveys the impact of doshas on body tissues and functions. The relevance of affection in the study emphasizes understanding how imbalances can lead to conditions such as Arsha, thus directing effective treatment planning in Ayurveda.

48) Vagbhata:
Vagbhata represents an ancient Ayurvedic physician and author whose works illuminate foundational Ayurvedic principles. Invoking Vagbhata highlights the historical relevance of classical knowledge in current practices and informs the ongoing efficacy of Kshar-Sutra treatments for hemorrhoids.

49) Ashtanga (Astanga, Ashtan-anga):
Ashtanga refers to the eight-fold path in Ayurveda that includes principles of diagnosis and treatment. Its inclusion in the study underscores the structured methodology guiding practitioners in addressing patient conditions like Arsha through a systematic approach.

50) Hridaya (Hrdaya):
Hridaya signifies the heart in Ayurveda, symbolizing both physical and emotional aspects of health. Reference to Hridaya in the study reminds practitioners to consider holistic factors when treating conditions like hemorrhoids, where emotional well-being is also significant in recovery.

51) Dhamani:
Dhamani refers to the blood vessels in Ayurveda, particularly associated with circulatory and systemic health. Understanding Dhamani's role aids in comprehending how symptoms present in conditions like Arsha and aligns with strategies to enhance proper blood flow and healing.

52) Praroha:
Praroha implies a growth or sprouting condition in Ayurveda, relevant in understanding diseases like Arsha. This concept is significant in the study, enabling better identification of the nature of symptoms and guiding therapeutic interventions aimed at resolving such conditions.

53) Raktaja:
Raktaja indicates blood-related conditions in Ayurveda. In the study, it emphasizes the understanding of how blood pathologies could affect conditions like hemorrhoids, directing the appropriate use of herbal treatments for effective symptom management and resolution.

54) Pradhan:
Pradhan refers to the primary or chief aspects of treatment or methodology. Its mention relates to prioritizing certain interventions in managing conditions like Arsha significantly, directing awareness toward effective strategies that yield promising results in Ayurveda.

55) Dealing:
Dealing encompasses the management or treatment of specific medical conditions. In this study, it underlines the strategic approaches taken to address hemorrhoids, emphasizing the importance of skillful and sensitive handling of patient care practices.

56) Vikara:
Vikara implies pathology or changes in health related to diseases. The study illustrates the role of Vikara in understanding conditions like Arsha, fostering the development of effective treatment methods aimed at restoring balance and wellness to affected individuals.

57) Shotha (Sotha):
Shotha translates to swelling or inflammation in Ayurvedic terms. Its significance in the study lies in evaluating conditions like Arsha, where inflammation plays a critical role in disease progression and necessitates effective management strategies for symptom alleviation.

58) Powder:
Powder in the study likely refers to the form of herbal preparations used in Kshar-Sutra applications. This term emphasizes how traditional herbal medicine is tailored for specific treatments, illustrating practical application in the management of conditions such as hemorrhoids.

59) Seat (Seated):
Seat refers to the plce of affliction in Ayurvedic terminology. In the context of the study, ‘seat is significant in identifying localized treatments tailored for conditions like hemorrhoids, guiding practitioners in precise interventions vital for efficacy.

60) Pitta:
Pitta embodies one of the three doshas primarily responsible for metabolic functions in Ayurveda. Its relevance in the study underscores the interconnectivity of bodily functions and how Pitta imbalances may contribute to the formation and progression of hemorrhoids.

61) Kapha:
Kapha signifies the dosha associated with structure and stability in Ayurveda. Discussion regarding Kapha in the context of Arsha highlights the importance of understanding each dosha's involvement in health and its implications for developing effective treatment strategies.

62) Dhara:
Dhara generally pertains to flow or movement in Ayurveda. Its inclusion may illustrate the focus on ensuring proper bodily functions, enhancing health by promoting effective flow of vital energies necessary for combating issues like hemorrhoids.

63) Marma:
Marma represents vital points in the body acknowledged in Ayurveda. Understanding Marmas is essential when conducting procedures like Kshar-Sutra, guiding practitioners on where to direct therapeutic efforts for maximum effectiveness in treating conditions like Arsha.

64) Rajni:
Rajni refers to one of the collaborating authors in the study. The inclusion of various experts signifies the interdisciplinary effort vital for conducting comprehensive research, enhancing the scope of Ayurvedic practices, and evaluating effective treatments for hemorrhoids.

65) Marga:
Marga implies the pathway in Ayurvedic terms, often connected to the routes taken by doshas in the body. Its reference underscores the significance of understanding the pathways in managing diseases effectively, contributing to targeted therapeutic methodologies in hemorrhoid treatment.

66) Veda:
Veda refers to the ancient texts of wisdom and knowledge foundational to Ayurveda. Highlighting the Vedic origins enhances the credibility of Ayurvedic practices, reflecting how traditional insights inform modern techniques in treating conditions such as hemorrhoids.

67) Roga:
Roga stands for disease or disorder in Ayurvedic literature. In this context, it emphasizes the necessity for targeted strategies when addressing specific ailments like Arsha in the study, guiding formulations and interventions that aim to alleviate patient issues.

68) Gati:
Gati indicates the movement or mobility aspect in Ayurvedic practices. Recognizing Gati's role in assessing conditions like hemorrhoids fosters a comprehensive understanding of how bodily movements can influence symptom development and tailoring treatment approaches accordingly.

69) Agni:
Agni embodies the digestive fire critical in Ayurveda, influencing metabolism and health. Its mention signifies the essential role of digestive health in preventing conditions like hemorrhoids, highlighting Agni's importance as a focal point in treatment paradigms.

70) Kaya:
Kaya refers to the body or physical form in Ayurvedic philosophy. Its inclusion reinforces the need for holistic approaches that address both physical and psychological dimensions of patient health when managing hemorrhoidal conditions.

71) Rasa (Rasha):
Rasa, representing flavor or essence, holds significance in Ayurveda concerning dietary and herbal treatments. Its acknowledgment in the study underlines the importance of incorporating palatable and effective herbal formulations to enhance patient adherence and satisfaction in treatment regimes.

72) Bala:
Bala indicates strength or vitality within Ayurvedic contexts, referencing the need to support bodily resilience when managing ailments. In understanding conditions like hemorrhoids, considering Bala fosters strategies enhancing overall patient strength during treatment and recovery phases.

73) Medas (Meda, Medash):
Meda translates to the bodily substance of fat in Ayurveda. Its focus in the study may denote the need to address issues related to excess Meda in managing conditions like Arsha, influencing diet and lifestyle recommendations for patients.

74) Mala:
Mala refers to waste products or impurities in Ayurvedic terms. Its significance lies in understanding how accumulation of Mala contributes to the development of conditions such as hemorrhoids, thereby informing comprehensive treatment strategies targeting dietary and lifestyle modifications.

75) Vata:
Vata denotes the dosha characterized by movement and change in the body. Understanding Vata’s role is crucial in addressing conditions like Arsha, as its imbalance may lead to the exacerbation of symptoms, guiding practitioners toward effective therapeutic interventions.

[Note: The above list is limited to 75. Total glossary definitions available: 78]

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Discover the significance of concepts within the article: ‘Classical vs. Chandan Kshar Sutra for hemorrhoids: post-ligation pain.’. Further sources in the context of Science might help you critically compare this page with similair documents:

Bhagandara, Causative factor, Highly significant, Group A, Group (b), Group (c), Inclusion criteria, Exclusion criteria, Clinical study, Statistical Significance, Ayurvedic Medical College, Improvement percentage, Paired T test, Unpaired 't' test, Protrusion of mass, Vitiation of Dosha, Hot fomentation, Anal dilatation, Group-A treatment, Group-B treatment, Cost effectiveness, Normal diet, Cryosurgery, Kshar Sutra, Sensitivity test, Long term complication, Therapeutic abuses, Statistical calculation, Surgical technique, Anal Route, Lithotomy position, Associated morbidity, Jatyadi Taila Pichu, Dietary ingredient, Mean comparison.

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