scholarly journals MODIFIED KSHARSUTRA TECHNIQUE IN COMPLEX FISTULA IN ANO - A CASE STUDY

2020 ◽  
Vol 8 (10) ◽  
pp. 4939-4943
Author(s):  
Rashmi Gupta
Keyword(s):  
Success Rate ◽  
Recurrence Rate ◽  
Fistulous Tract ◽  
High Success Rate ◽  
Treatment Modalities ◽  
Daily Routine ◽  
Fistula In Ano ◽  
Complex Fistula ◽  
Minimal Complication

Fistula in ano is an anorectal disorder in which two openings are present. One is located near perianal re-gion and another is at anal canol or rectum. Fistula in ano is itself a challenging disease for patients because of mortality is not associated but daily routine life of patients become crushed. Ayurveda also said about Bhagandar (fistula in ano) that it is Kashta Shadhya Vyadhi i.e. difficult to treat because its take time and recurrence rate is also associated. But Ayurveda has described the Kshar sutra therapy for the treatment of fistula in ano which have high success rate, but time taken. With time, revolution has also come in Ayurve-dic treatment modalities for anorectal fistulas. A modified Ksharsutra technique is new technique for treatment of complex fistula in ano. The name of this technique is interception of fistulous tract and appli-cation of Ksharsutra (IFTAK). This technique has high success rate with minimal complication, early re-covery and there is no recurrence is associated. Cosmetically, this technique is good.

Managament of Bhagandara (Fistula-in-Ano) by Palasha Ksharasutra prepared with Arkaksheera - A Case Report.

2017 ◽  
Vol 2 (1) ◽  
Author(s):  
Ganapathi Rao ◽  
Vijay Kumar ◽  
Ashok Naikar ◽  
Chandrakanth Halli
Keyword(s):  
Quality Of Life ◽  
Case Report ◽  
Success Rate ◽  
Spinal Anesthesia ◽  
Curcuma Longa ◽  
Weekly Interval ◽  
Butea Monosperma ◽  
Fistula In Ano

A standard Ksharasutra is practiced in treatment of Bhagandara (fistula-in-ano) with high success rate and minimum recurrence rate. In previous research it was noted that Pittaja Prakruti patients sometime might cause more perianal irritation due to Apamarga Ksharasutra. So in this study Palasha Ksharasutra prepared in Arkaksheera was prepared by Palasha Kshara (Ash of Butea monosperma), Arka Ksheera (Calotropis gigantic) and turmeric powder (Curcuma longa). This Ksharasutra was prepared as per the API guidelines and preserved in air tight tube. A patient of Pittaja predominant Prakruti with fistula-in ano having two external opening at 6 and 7 O’ clock position of anus was treated with application of Ksharasutra. The Palasha Ksharasutra prepared in Arkaksheera was applied in these two opening under spinal anesthesia. Then Ksharasutra was changed by weekly interval under local xylocaine jelly 2%. The length of thread was measured weekly and noted in the case to assess the unit cutting time (UCT). The unit cutting time (UCT) of first thread was 7.5 days/cm and second one had UCT 6.8 days/cm. During the treatment patient was doing his job regularly without hampering the quality of life. After 2 months patient was free from all symptoms of fistula with normal scar and without any complications. This case study demonstrated the utility of Palasha Ksharasutra prepared in Arkaksheera in multiple fistula-in ano.

scholarly journals LONG-TERM OUTCOMES OF LIGATION OF INTERSPHINCTERIC FISTULA TRACT FOR COMPLEX FISTULA-IN-ANO: MODIFIED OPERATIVE PROCEDURE EXPERIENCE

2018 ◽  
Vol 31 (4) ◽  
Author(s):  
Ke WEN ◽  
Yun-Fei GU ◽  
Xue-Liang SUN ◽  
Xiao-Peng WANG ◽  
Shuai YAN ◽  
...  
Keyword(s):  
Success Rate ◽  
Operative Procedure ◽  
Cleveland Clinic ◽  
Fistula Tract ◽  
Long Term Outcomes ◽  
Fistula In Ano ◽  
Complex Fistula ◽  
Intersphincteric Fistula

ABSTRACT Background: It is important but difficult to treat complex fistula-in-ano due to the high recurrent rate and following incontinence. Ligation of the intersphincteric fistula tract (LIFT), a novel surgical procedure with the advantage of avoiding anal incontinence, has a variable success rate of 57-94.4 %. Aim: To evaluate the long-term outcomes of modified LIFT operative procedure - ligation of intersphincteric fistula tract - to treat complex fistula-in-ano. Methods: Retrospective analysis of 62 cases of complex fistula-in-ano. The group was treated with the modified approach of LIFT (curved incision was made in the anal canal skin; purse-string suture was performed around the fistula; the residual fistulas were removed in a tunnel-based way) and had a follow-up time of more than one year. Patient´s preoperative general condition, postoperative efficacy and their anal function were compared. Results: The median age of the participants was 34, and 43 (69.4%) cases were male. Forty-one (66.1%) cases were of high transsphincteric fistula, four (6.5%) cases of high intrasphincter fistula, and 17 (27.4%) cases of anterior anal fistula in female. The median follow-up duration was 24.5 (range, 12-51) months. The success rate in the end of follow-up was 83.9% (52/62). The anorectal pressure and Cleveland Clinic Florida Fecal Incontinence (CCF-FI) evaluated three months before and after the operation did not find apparent changes. Conclusions: Compared with LIFT, the modified LIFT remarkably reduces postoperative failure and the recurrence rate of complex fistula with acceptable long-term outcomes.

scholarly journals A prospective clinical study of fistula in ano: comparing different treatment modalities in a tertiary care hospital

2019 ◽  
Vol 6 (7) ◽  
pp. 2411
Author(s):  
Hareesh G. S. R. ◽  
Siva Prasad Naik Nenavath
Keyword(s):  
Tertiary Care ◽  
Treatment Modalities ◽  
Prospective Clinical Study ◽  
Care Hospital ◽  
College Hospital ◽  
Common Procedure ◽  
Fistula In Ano ◽  
Low Level ◽  
Complex Fistula ◽  
A Prospective Study

Background: Fistula in ano is one of the common anorectal condition, which is easy to diagnose but difficult to manage because of post-operative complications like incontinence and recurrence. Also numerous procedures have been described for its treatment so as to individualize treatment options.The aim of the study was to assess the efficacy of different treatment modalities in fistula in ano.Methods: This is a prospective study carried out in a tertiary medical college hospital where 75 patients with fistula in ano are analysed for clinical features and surgical modalities compared.Results: Total 75 patients are studied. 82.70% patients presented with discharge in perianal region. Posterior fistulas are seen in 93.30% and anterior in 6.70% patients. 94.70% patients have low level fistula, 84% patients had simple fistula & 16% had complex fistula. 49.30% patients were treated with fistulectomy. 36.0% have undergone fistulotomy. 8.0% had LIFT and 6.7% had SETON. Recurrence is seen in 6.70% of patients.70.70% patients have stayed 4-6 days.Conclusions: Most of the fistulas are simple, posterior and low level fistulas. Fistulectomy is the most common procedure performed. Newer procedures like LIFT and Seton application show promising results with less complications. 

Enuresis — A Case Study

1987 ◽  
Vol 12 (1) ◽  
pp. 15-16
Author(s):  
Joy Rainey
Keyword(s):  
Success Rate ◽  
High Success Rate ◽  
Treatment Procedure ◽  
Professional Supervision ◽  
Enuresis Alarm

This paper centre around a particular treatment procedure for a 6 years old boy with primary enuresis. According to Hudson (1980) the term “enuresi” mean “persistent wetting of the bed by children over the age of 3 or 4 years in the absence of any demonstrable organic pathology”. (P. 70).Although there have been various ways of handling this over the centuries (mostly unsuccessful), according to many modern researchers, the bell and pad or enuresis alarm has the best record of success. Hudson claims “a continually demonstrated high success rate of approximately 75%” (p.18). He does emphasize, however, that these figures are for good quality equipment, used with professional supervision.

scholarly journals Išangės fistulės kamščio metodo taikymas sudėtingai išangės fistulei gydyti

2010 ◽  
Vol 8 (4) ◽  
pp. 0-0
Author(s):  
Edgaras Palubinskas ◽  
Narimantas Evaldas Samalavičius ◽  
Lina Gudelytė
Keyword(s):  
Randomized Controlled Trial ◽  
Success Rate ◽  
Anal Fistula ◽  
Controlled Trial ◽  
Fistula In Ano ◽  
Randomized Controlled ◽  
Fistula Plug ◽  
Complex Fistula ◽  
Anal Fistula Plug ◽  
Vilnius University

Edgaras Palubinskas1, Narimantas Evaldas Samalavičius2, Lina Gudelytė1 1 Vilniaus universiteto Medicinos fakultetas, M. K. Čiurlionio g. 21, LT-03101 Vilnius2 Vilniaus universiteto Onkologijos instituto Chirurgijos klinika ir Vilniaus universiteto Medicinos fakulteto Vidaus ligų, šeimos medicinos ir onkologijos klinika,Santariškių g. 1, LT-08406 VilniusEl. paštas: [email protected] Tikslas: Tyrimo tikslas buvo įvertinti išangės fistulės kamščio (IFK) efektyvumą, gydant aukštas išangės fistules. Metodai: Į apžvalgą iš viso įtraukta 19 darbų iš 31, išspausdinto 2006–2010 m. Iš įtrauktųjų 8 yra retrospektyvinės studijos, 9 prospektyvinės, viena dvigubai akla randomizuota studija ir viena prospektyvinė nerandomizuota kontrolinė studija. Bendras į šias studijas įtrauktų ligonių, gydytų išangės fistulės kamščio metodu, skaičius yra 551. Rezultatai: Pooperacinio stebėjo laikas buvo nuo 3 iki 24 mėnesių. Gydymo išangės fistulės kamščiu sėkmingumas – nuo 15,6 % iki 88 %. Iš 551 IFK gydytų ligonių 300 (54,4 %) pasveiko. Kriptoglanduliarinės kilmės (K) fistulės buvo sėkmingai išgydytos 55,1 % atvejų, o įvairios kilmės (I) – 54,9 %. Neaptikome patikimo ryšio tarp sėkmingo gydymo rezultatų ir paciento lyties, amžiaus, fistulės ilgio ar kilmės. Išvados: Išangės fistulės kamščio metodas yra patikimas gydyti sudėtingas fistula-in-ano. Ateities tyrimai turėtų padėti aiškiau apibrėžti gydymo išangės fistulės kamščiu metodo vietą išangės fistulių chirurgijoje. Reikšminiai žodžiai: fistula-in-ano, išangės fistulės kamštis, ligos atkrytis, tiesiosios žarnos lopas. Anal fistula plug for the treatment of complex fistula-in-ano Edgaras Palubinskas1, Narimantas Evaldas Samalavičius2, Lina gudelytė1 1 Vilnius University Medical Faculty, M. K. Čiurlionio str. 21, LT-03101 Vilnius, Lithuania2 Vilnius University, Institute of Oncology, Clinic of Surgery,Santariškių str. 1, LT-08406 Vilnius, LithuaniaE-mail: [email protected] Purpose: The aim of the study was to evaluate the efficacy of the anal fistula plug (AFP) for the treatment of fistula-in-ano. Methods: A total of 31 studies, published since 2006 to 2010 were extracted and 19 of them were finally included in this systematic review. 8 were retrospective case series, 9 prospective studies, 1 prospective non-randomized controlled trial and 1 randomized controlled trial. In these 19 studies, a total of 551 patients were included, who were treated with anal fistula plug. Results: The follow-up period ranged from 3–24 months. The AFP procedure had a success rate ranging from 15.6–88 %. From 551 patients treated with AFP, 300 (54.4 %) were cured. The success rate in patients with cryptoglandular origin (K) was 55.1 % and the success rate in patients with fistulas of other origin was 54.9 %. We did not notice difference in success rate between age, gender, fistula anatomy and etiology. Conclusion: The anal fistula plug method is a reliable method in treat of complex fistula-in-ano. Future studies should help to clarify the place of anal fistula plug in anal fistula surgery. Key words: Fistula-in-ano, anal plug, recurrence, advancement flap.

Multiple Fistula-In-Ano treated by Kshara Sutra - A Case Report

2017 ◽  
Vol 2 (2) ◽  
Author(s):  
Rajesh Yadav ◽  
Mayur Barve ◽  
K. R. Ramchandra
Keyword(s):  
General Practice ◽  
Case Report ◽  
Social Problems ◽  
Curcuma Longa ◽  
Treatment Modalities ◽  
Fistula In Ano

Fistula-in-ano is a chronic and troublesome disease encountered in general practice. It consists of 1.6% of all surgical admissions and leads to physical, psychological and social problems. The management includes various treatment modalities with variable outcomes. Ksharasutra is a medicated thread used in ano-rectal disorders particularly for the management of fistula-in-ano in Ayurveda. In this study Ksharasutra was prepared by Apamarga Kshara (Ash of Achyranthus aspera Linn.), Snuhi Ksheera (Euphorbia neriifolia Linn.) and turmeric powder (Curcuma longa Linn.). A patient with multiple fistula-in-ano was treated by application of Ksharasutra. This case study demonstrates the utility of Ksharasutra in Multiple Fistula-in ano.

scholarly journals Pharmacological approach in the Management of Katishula (Low back ache) - A case study

2020 ◽  
Vol 11 (1) ◽  
pp. 124-129
Author(s):  
Narahari B R
Keyword(s):  
Treatment Modalities ◽  
Daily Routine ◽  
Low Back ◽  
Major Health ◽  
Oral Medications ◽  
Appropriate Treatment ◽  
Back Ache ◽  
History Of ◽  
The Right

Katishula (low back ache) is one of the major health problems now a days which affects approximately 60 – 85% of adults during some point of their life causing trouble to their daily routine. It is shosha (degeneration), sthamba (stiffness), and shula (pain) predominant vyadhi (disease). It is clearly stated in the classics that the pain is produced due to stiffness which is produced by sama or nirama vayu movement in the kati (low back) region. Ayurvedic classics have mentioned appropriate treatment modalities for kati shula. A 24 year old female patient with katishula was treated conservatively with internal medicine and panchakarma (treatment procedure). Patient presented with low back ache for 1 year with aggravated symptoms like shooting pain, pain while standing and pain in the left leg. SLR was positive being 20 degree on the left leg and was negative in the right leg. There was no history of any kind of trauma. Management was done in 2 rounds where the first part included  matra basti and oral medications, through which the symptoms got reduced around 40 – 50% and in the second part of the treatment patient was managed only with the oral medications which gave very good results where the patient was almost completely relieved.

scholarly journals Outcome of Seton in the Management of Complex Fistula in Ano in a Tertiary Care Center in Bangladesh

2021 ◽  
Vol 12 (1) ◽  
pp. 15-19
Author(s):  
Md Armanul Islam ◽  
Md Mahfuzur Rahman Khan ◽  
Md Mustafizur Rahman ◽  
SM Quamrul Akther ◽  
Md Mozammel Hoque ◽  
...  
Keyword(s):  
Anal Fistula ◽  
Care Center ◽  
Fistulous Tract ◽  
Tertiary Care ◽  
Fistula Tract ◽  
Internal Opening ◽  
Narcotic Analgesics ◽  
Cross Sectional ◽  
Fistula In Ano ◽  
Complex Fistula

Background: The management of high and complex anal fistulas remain a therapeutic challenge as it is often associated with recurrence and anal incontinence. The oldest and theoretically the simplest technique is to use a seton. The aim of this study is to find out the outcome of seton in the treatment of complex fistula in ano. Materials and methods: This cross-sectional study was done in surgical units of ShSMCH and colorectal surgery units of BSMMU from September 2014 to August 2015. Fifty patients with high anal fistula having internal opening above dentate line and with multiple fistulas tract were included by purposive sampling. Patients with low anal fistula, fistula in ano associated with Crohn’s disease, active abdominal tuberculosis, carcinoma of rectum, previous radiation therapy, with recurrent fistula in ano and in whom the internal opening could not be located were excluded. After initial evaluation, the fistula tract and opening were located. The skin and anoderm overlying the fistulous tract were incised. This double-strand seton was then tied over itself on the sphincter without excessive tension. The long end of each suture was tapped to the patient’s medial thigh. Postoperatively warm sitz bath after each bowel movement was advised. The patients were informed in detail about the presence of seton prosthesis and they were warned about the possible serous discharge that would continue until the seton dropped, and the wound healed. Data were recorded on the predesigned questionnaire and analyzed using SPSS version 16. Results: Among 50 cases mean age was 41 years, M: F was 4.5:1. Discharge from perianal sinus, pain, swelling and itching were common clinical presentation. All of the patients were discharged on the third postoperative day. None required readmission or needed narcotic analgesics after discharge. The average time for the seton to cut through the sphincter was 1 to 3 months. 28% had complete healing at 1 month and 66% at 3 months postoperatively. Flatus Incontinence was noted 16% cases followed by recurrence (6%), liquid stool incontinence (4%) and postoperative anal stricture was (2%) of cases. Conclusion: This study found that the seton is a safe and low morbidity option for the treatment of high and complex fistula-in-ano, having higher healing rates, with good quality of life. It can therefore be recommended as the standard treatment for complex fistula-in-ano. J Shaheed Suhrawardy Med Coll, December 2020, Vol.12(1); 15-19

THE IMPLEMENTATION OF MYORGANIC: A CASE STUDY OF KOPERASI ABSB

2018 ◽  
Vol 13 (Number 2) ◽  
pp. 78-87
Author(s):  
Sabariyah Hoyaeli ◽  
Zakirah Othman ◽  
Iswandi Anas ◽  
Shafini M. Shafie
Keyword(s):  
Qualitative Method ◽  
Daily Routine ◽  
Staple Food ◽  
Farming Practices ◽  
Organic Farms ◽  
External Audit ◽  
Agriculture Industry ◽  
The Government ◽  
Organic Standards

Rice is a staple food and daily routine for Malaysians. Currently, the increasing population in Malaysia has led to the need to increase rice production with more quality. Therefore,the government established a scheme with national organic standards, MS 1259: 2015 which is myOrganic certification to recognize organic farms. Koperasi ABSB is the first rice farm that obtained this certification. Thus, the aims of this study are to explore the implementation of myOrganic in Koperasi ABSB and the barriers faced by this cooperative to implementing myOrganic certification. Qualitative method is used in this case study through interviews and observation. The finding showed that the implementation of myOrganic is as follows, by register myGAP, register myOrganic, Department of Agricultural Malaysia (DOA) will send a supervisor, prepare nine files or records, perform internal and external audit, and renew myOrganic. This study is expected to increase awareness of organic farming practices and promote the implementation of myOrganic in agriculture industry especially for the new farmer who wants to register and obtain myOrganic certification.

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