Efficacy of warm yashtimadhu ghrita for pain in ksharasutra use.

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Journal name: Ayushdhara
Original article title: The study on the efficacy of sukoshna (luke warm) yashtimadhu ghrita in the management of pain during application of ksharasutra in bhagandara (fistula in ano)
AYUSHDHARA is an international peer-reviewed journal. It focuses on research in Ayurveda, Yoga, Unani, Siddha, Homeopathy, Allopathy, and Pharmaceutical Sciences.
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Author(s):

Sri Jyothsna P M*
Lecturer, Sri Madakari Nayaka Ayurvedic Medical College and Hospital, Karnataka
S.Dattatreya Rao
Professor & HOD, Reader, Dept of Shalya, S.V Ayurvedic College, Tirupati, AP.
T.Udaya Kiran
Reader, Dept of Shalya, S.V Ayurvedic College, Tirupati, AP.


Ayushdhara:

(A peer-reviewed, bi-monthly open-access journal)

Full text available for: The study on the efficacy of sukoshna (luke warm) yashtimadhu ghrita in the management of pain during application of ksharasutra in bhagandara (fistula in ano)

Year: 2017

Copyright (license): CC BY-NC-SA 4.0


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Summary of article contents:

Introduction

The study focuses on the management of pain during the application of Ksharasutra in patients diagnosed with Bhagandara, which is analogous to Fistula-in-ano in modern medicine. Ksharasutra therapy has been highlighted in Ayurvedic texts as an effective treatment method; however, the procedure often causes significant local pain and discomfort to patients, leading some to avoid the treatment altogether. Traditionally, a 2% xylocaine jelly has been utilized to alleviate pain, but this solution provides only temporary relief and lacks any additional therapeutic benefits. This research aims to evaluate the efficacy of Sukoshna (Luke Warm) Yashtimadhu Ghrita as an alternative analgesic approach during Ksharasutra application.

Enhanced Pain Management through Yashtimadhu Ghrita

The primary objective of the study was to assess how Sukoshna Yashtimadhu Ghrita could ease pain and burning sensations in patients undergoing Ksharasutra therapy. Prepared according to Ayurvedic guidelines, the application of this Ghrita before Ksharasutra change was hypothesized to provide analgesic and healing properties due to the presence of active compounds in Yashtimadhu. The study employed a randomized single-blind design, enrolling 30 participants and comparing pain levels via a 10-point analog scale across four treatment sittings. Results indicated significant decreases in pain intensity and burning sensation, especially after the fourth sitting, suggesting a better alternative to conventional methods.

Statistical Significance of Findings

The findings reveal substantial improvements in patient pain experiences, with mean scores reflecting decreased intensity of pain and burning sensations, alongside enhanced overall wellbeing after treatment with Sukoshna Yashtimadhu Ghrita. Statistical analysis showed that the treatment produced highly significant results, with percentages of relief for intensity of pain, duration of pain, and pain relief days being particularly notable. The UCT (Ulceration Care Time) was not adversely affected, confirming the treatment's safety alongside its analgesic benefits. The study’s results underscore the potential of indigenous treatments to offer effective pain management strategies in traditional Ayurvedic practice.

Conclusion

In conclusion, the application of Sukoshna Yashtimadhu Ghrita demonstrates promising efficacy in alleviating pain associated with Ksharasutra therapy in Bhagandara patients. This research highlights an important step towards integrating indigenous medicinal practices into contemporary treatment methodologies. While the current study acknowledges limitations, it lays the groundwork for further research and larger trials to validate the use of traditional remedies in pain management and enhance patient comfort during Ayurvedic procedures. Thus, embracing these alternative approaches could pave the way for improved treatment outcomes and patient compliance in the future.

FAQ section (important questions/answers):

What is the purpose of using Sukoshna Yashtimadhu Ghrita in treatment?

Sukoshna Yashtimadhu Ghrita is used to alleviate pain and burning sensations during Ksharasutra application in Bhagandara (Fistula in Ano) patients, aiming to improve patient comfort and treatment compliance.

What are the key findings of the clinical study on this treatment?

The study found that Sukoshna Yashtimadhu Ghrita significantly reduced pain, burning sensation, and improved pain relief day during Ksharasutra therapy, demonstrating its effectiveness and non-invasive nature.

What were the inclusion criteria for the patient selection in the study?

Patients aged 20-70 years, diagnosed with Bhagandara and treated via Ksharasutra were included. Exclusions were made for those with uncontrolled diabetes, hypertension, or fistula due to other diseases.

Glossary definitions and references:

Scientific and Ayurvedic Glossary list for “Efficacy of warm yashtimadhu ghrita for pain in ksharasutra use.”. 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) Pain:
Pain in this context is a primary factor experienced by patients during and after the application of Ksharasutra therapy for treating Bhagandara (fistula in ano). The study aims to alleviate this pain using Sukoshna Yashtimadhu Ghrita, highlighting the necessity for effective pain management. [see source text]

2) Ksharasutra (Ksarasutra, Kshara-sutra):
Ksharasutra is an Ayurvedic treatment method for Bhagandara (fistula in ano). It involves the use of medicated thread to cut and heal the fistula tract. The study focuses on alleviating the pain associated with the frequent changing of Ksharasutra threads. [see source text]

3) Ghrita (Ghrta):
Ghrita is clarified butter used in Ayurvedic medicine. Yashtimadhu Ghrita, which combines ghrita with Yashtimadhu, was applied in this study to manage pain and burning sensation during Ksharasutra therapy for treating fistula. [see source text]

4) Burning sensation:
During Ksharasutra therapy, patients often experience a burning sensation along with pain. The study evaluated the efficacy of Sukoshna (luke warm) Yashtimadhu Ghrita in reducing this burning sensation, finding it significantly effective. [see source text]

5) Yashtimadhu (Yastimadhu, Yashti-madhu):
[see source text or glossary: Yastimadhu]

6) Bhagandara (Bhagamdara):
Bhagandara is the term for fistula in ano in Ayurvedic medicine. It is one of the Ashta Mahagadas. The study focuses on managing pain and reducing treatment-associated discomfort in patients with Bhagandara during Ksharasutra therapy. [see source text]

7) Drug:
In the study, Sukoshna Yashtimadhu Ghrita is considered the drug used to relieve pain and manage the burning sensation during and after Ksharasutra application for treating Bhagandara. [see source text]

8) Disease:
Bhagandara, or fistula in ano, is described as a grave disease in Ayurvedic texts. The study aims to provide non-invasive pain relief for this disease by using Sukoshna Yashtimadhu Ghrita during Ksharasutra therapy. [see source text]

9) Vranaropana (Vrana-ropana):
Vranaropana refers to wound healing properties. Yashtimadhu and Ghrita have Vranaropana properties, which potentially aid in pain relief and the healing process of Bhagandara in the context of the study. [see source text]

10) Apamarga:
Apamarga is a plant used in preparing the medicated threads for Ksharasutra therapy. Apamarga Ksharasutra is important in the treatment of Bhagandara, as mentioned in Ayurvedic practices. [see source text]

11) Prakriti (Prakrti):
Prakriti refers to the body constitution in Ayurvedic medicine. The study observed patients with different Prakriti types such as Vata-pitta and Pitta-kapha to assess the efficacy of Yashtimadhu Ghrita in managing pain during Ksharasutra therapy. [see source text]

12) Pitta:
Pitta is one of the three doshas in Ayurveda. The study found a significant number of participants with Vata-pitta Prakriti experiencing Bhagandara, emphasizing the relevance of understanding individual dosha balances in treatment. [see source text]

13) India:
The study was conducted in India, specifically involving medical institutions and patients from regions such as Karnataka and Andhra Pradesh. It reflects the use of traditional Indian Ayurvedic methods in managing Bhagandara. [see source text]

14) Ashta (Asta, Astan, Ashtan):
Ashta Mahagadas are the eight grave diseases in Ayurvedic medicine. Bhagandara, a focal point of this study, is classified as one of these diseases, highlighting its severity and the necessity for effective pain management strategies. [see source text]

15) Vata:
Vata is another dosha in Ayurveda. The study involved patients with Vata-pitta Prakriti, addressing how these doshic imbalances may affect the efficacy of Yashtimadhu Ghrita in pain management during Ksharasutra therapy. [see source text]

16) Diet:
Dietary habits such as mixed diets were noted among patients in the study. This information helps understand patient profiles and could influence Bhagandara treatment outcomes and overall health in Ayurveda. [see source text]

17) Vatapittahara (Vatapitta-hara):
[see source text or glossary: Vatapittahara]

18) Dattatreya (Datta-atreya):
S. Dattatreya Rao is one of the authors of the study and a professor involved in researching and evaluating the efficacy of Yashtimadhu Ghrita for pain management during Ksharasutra therapy in treating Bhagandara. [see source text]

19) Vatapitta (Vata-pitta):
Patients with Vata-pitta Prakriti were a notable group involved in the study. This dual dosha type may influence how they experience and respond to treatments like Yashtimadhu Ghrita during Ksharasutra therapy. [see source text]

20) Karnataka:
Karnataka is a state in India where the study's lead author, Dr. Sri Jyothsna P M, is affiliated, indicating the region's involvement in this Ayurvedic research on managing Bhagandara. [see source text]

21) Goghrita (Goghrta, Go-ghrita):
Go-ghrita is clarified butter derived from cow's milk used in Ayurvedic medicine. It is a key component in Yashtimadhu Ghrita, which was used in the study for pain management during Ksharasutra treatment. [see source text]

22) Tirupati (Thirupati, Tiruppati):
The study was conducted at S.V Ayurvedic College and Hospital in Tirupati, Andhra Pradesh. This location is significant for its contribution to the clinical research on the efficacy of Yashtimadhu Ghrita. [see source text]

23) Madakari:
Sri Madakari Nayaka Ayurvedic Medical College and Hospital in Karnataka is where the lead author, Dr. Sri Jyothsna P M, is a lecturer, indicating the institution's involvement in this Ayurvedic research. [see source text]

24) Samhita:
Susruta Samhita is an ancient Ayurvedic text providing guidelines referenced in the study for preparing Yashtimadhu Ghrita. It highlights traditional methods' relevance in modern Ayurvedic practices. [see source text]

25) Shalya (Salya):
[see source text or glossary: Shalya]

26) Nayaka:
Nayaka refers to the founder title of Sri Madakari Nayaka Ayurvedic Medical College, where research contributions were made. This reflects on the institution's dedication to Ayurvedic education and research in managing Bhagandara. [see source text]

27) Kapha:
Kapha is the third dosha in Ayurveda. The study involved patients with various Prakriti combinations, including Pitta-kapha and Vata-kapha, to evaluate Yashtimadhu Ghrita's efficacy in pain management. [see source text]

28) Vedanasthapana (Vedana-sthapana):
[see source text or glossary: Vedanasthapana]

29) Sushruta-samhita (Susruta-samhita):
Susruta-samhita is an authoritative Ayurvedic text that provides the foundational methods for preparing medicinal substances like Yashtimadhu Ghrita. The study references it for traditional preparation techniques. [see source text]

30) Shalyatantra (Salyatantra, Shalya-tantra, Shalyatamtra):
Shalyatantra is the surgical branch of Ayurveda, under which the Ksharasutra therapy falls. The study focuses on alleviating pain during this treatment for Bhagandara, emphasizing Shalyatantra's importance. [see source text]

31) Vranashodhana (Vranasodhana, Vrana-shodhana):
Vranasodhana refers to wound cleansing properties. Both Yashtimadhu and Ghrita possess Vranasodhana properties, aiding in the overall healing and pain management process in the treatment of Bhagandara. [see source text]

32) Tuberculosis:
[see source text or glossary: Tuberculosis]

33) Discussion:
The discussion in the study elaborates on the statistical significance and effectiveness of using Sukoshna Yashtimadhu Ghrita in alleviating pain and burning sensation during Ksharasutra therapy for Bhagandara patients. [see source text]

34) Shothahara (Sothahara, Shotha-hara):
[see source text or glossary: Sothahara]

35) Kharapaka:
[see source text or glossary: Kharapaka]

36) Inference:
Inference refers to the study's conclusions based on statistical analysis, showing significant pain and burning sensation reduction in Bhagandara patients treated with Sukoshna Yashtimadhu Ghrita during Ksharasutra therapy. [see source text]

37) Flavonoid:
Flavonoids are active compounds found in Yashtimadhu that exhibit pain-relieving properties. Their presence is a reason why Yashtimadhu Ghrita was effective in managing pain and burning sensation in the study. [see source text]

38) Ayurveda (Ayus-veda):
Ayurveda is the traditional Indian system of medicine. The study employs Ayurvedic principles and remedies, specifically Yashtimadhu Ghrita, to manage pain during Ksharasutra therapy in Bhagandara patients. [see source text]

39) Madhyama:
Madhyama khanda from Sarangadhara Samhita outlines the preparation method for Ghrita. This traditional Ayurvedic approach was used to prepare Yashtimadhu Ghrita in the study. [see source text]

40) Sthapana:
[see source text or glossary: Sthapana]

41) Ashtanga (Astanga, Ashtan-anga):
Ashtanga refers to the eight branches of Ayurveda. Shalyatantra, one of these branches, includes surgical practices like Ksharasutra therapy, essential for treating Bhagandara as discussed in the study. [see source text]

42) Medicine:
Medicine in this context refers to Ayurvedic treatments and formulations, such as Yashtimadhu Ghrita, used to alleviate pain in Bhagandara patients undergoing Ksharasutra therapy. [see source text]

43) Shodhana (Sodhana):
Sodhana refers to purification or cleansing properties. Ghrita is known for its Sodhana properties, which contribute to its efficacy in pain relief and wound healing as demonstrated in the study for Ksharasutra therapy. [see source text]

44) Tantra (Tamtra, Tantrism):
[see source text or glossary: Tantra]

45) Vedana:
[see source text or glossary: Vedana]

46) Nature:
[see source text or glossary: Nature]

47) Khanda (Khamda):
[see source text or glossary: Khanda]

48) Indian:
The study is based on the traditional Indian system of medicine, Ayurveda, demonstrating the use of indigenous remedies like Yashtimadhu Ghrita for managing pain in Bhagandara patients undergoing Ksharasutra therapy. [see source text]

49) Udaya (Uday):
Udaya Kiran is one of the authors involved in the study, contributing to the research on the efficacy of Yashtimadhu Ghrita for pain management during Ksharasutra therapy in treating Bhagandara. [see source text]

50) Kalka:
Kalka refers to the paste form of medicinal ingredients. In this study, Kalka of Yashtimadhu roots was used in the preparation of Yashtimadhu Ghrita, highlighting the traditional methods employed in Ayurvedic formulations. [see source text]

51) Ayus (Ayush):
[see source text or glossary: Ayush]

52) Glass:
[see source text or glossary: Glass]

53) Food:
Patients were advised to take light, digestible, and non-spicy food post-application of Ksharasutra. Dietary recommendations are part of holistic treatment approaches in Ayurveda for managing Bhagandara. [see source text]

54) Fire:
In the preparation of Yashtimadhu Ghrita, a mild fire is used to heat the mixture until the water content evaporates, indicating the traditional methods of Ayurveda. This is crucial for drug preparation in the study. [see source text]

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