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Pilonidal sinus means nest of hairs also called Jeep-bottom because it was very common in jeep drivers. It is an acquired condition commonly found in hairy males. Different surgical methods have been described for this disease such as excision and primary closure and excision with reconstructive flap, etc. However, the recurrence after surgery is very high. There is similarity between Pilonidal sinus and Shalyaja nadi vrana described in Sushruta Samhita. Acharya Sushruta has described minimally invasive Para surgical procedure viz. Kshara Sutra for Nadi vrana (Pilonidal sinus). This treatment not only minimizing the complications and recurrence but also enables the patient to resume work quickly with less discomfort. The patient attended Shalya tantra OPD of Rishikul campus, Uttarakhand Ayurved University, Haridwar and was treated with the Guggulu Aragvadha Kshara Sutra. The patient recovered well with complete excision of the tract within span of seven weeks. Key words: Pilonidal sinus, Nadi vrana, Guggulu Aragvadha Kshara Sutra.

Ashmari comes under Mutravaha srotovikara and Ashtamahagada as described in Susruta Samhita.The prevalence of urinary stone is approximately 3 to 5% in general population and is increasing across the world mainly due to metabolic derangement, global climatic changes. Acharya Susruta said, before attempting surgical procedures one should try with oral medications like ghrita, paneeyakshara, taila etc. which possesses properties like chedana, lekhana, bhedana and mutrala for facilitating the disintegration of urinary stones. A 39 years old male patient came to OPD at Taranath Govt. Ayurveda Medical College, Ballari on 20 May 2021 presented with complaints of pain in right flank region, pain in right loin radiating to groin, burning micturition, orange coloured urine for 2 days, diagnosed as Urolithiasis and advised for surgery. He visited our hospital to avoid the surgery and for the treatment of the same. Kokilaksha Paneeya Kshara and Punarnavadi Kashaya given to patient for 28 days and got relief from symptoms. Key words: Ashmari, Ashtamahagada, Paneeya kshara, Punarnavadi Kashaya.

Panchakarma forms an integral part of the holistic system of medicine, Ayurveda. Not only the body purification procedures but also the pharmaceutical preparations affect the outcome of Panchakarma therapy. Although Panchakarma and Rasashastra are not included in the Ashtanga Hridaya, their utility is found in all the eight branches. This article deals with the Rasadravyas meant for Panchakarma procedures like Vamana, Virechana, Basti, Nasya, Abhyanga, Dhuma, Lepa etc. To have a critical review of Herbomineral drugs and their Pharmaceutical Application with special reference to Panchakarma. The ancient Ayurvedic literature as well as modern references was searched to have a critical study of the herbomineral drugs, their pharmaceutical preparations, Panchakarma procedures, rationale of using Rasadravyas in Snehakalpanas, classical as well as the traditional dosage forms. Also the selection of formulations according to Dosha- Pradhanya, Vyadhi-Pradhanya (Pradhana/ Mridu Shodhana), Shamana, Brimhana and Rasayana has been discussed at length. These Rasaushadhi preparations are used internally (for Deepana, Pachana, Snehapana, Shodhana, Shamana, Brimhana) or externally (Abhyanga, Kavala, Gandusha, Karnapurana, Moordhni Taila

Vatarakta is a disease mentioned in Ayurveda involving Vata Dosha imbalance affecting Rakta Dhatu, where the Vayu is exacerbated by long distance rides on animals such as elephants, camels, horses, and Rakta or blood is vitiated by the ingestion of Lavana, Amla, Katu, Kshara, etc. The Vata, whose passages are covered by Rakta further undergoes vitiation and further contaminates the Rakta or blood. Vayu's vitiated blood later burns the entire blood in the body and gravitates towards the limbs later. This vitiated Vata and Rakta is called Vatarakta. On the basis of etiopathology, Vatarakta may also be linked to Gout. A 52 years old female patient approached the OPD with the chief complaints of: Acute pain in all major and minor joint and Deformity on upper limb fingers in the last one year. The patient was given completely Ayurvedic medicines and Panchakarma therapies for 10 days, and Only Ayurvedic medicines on discharge were later moved and the findings were noticeably seen. Hence this study was taken to prove that Ayurvedic management with Mustadi Yapana Basti has remarkable results on Vatarakta (Gout). Observations and outcomes were drawn on the basis of measurement criteria. During analysis, discussion was carried out on the basis of whole findings. On the basis of the outcome, conclusions were taken.

Introduction: In the present study, Praval is used as a raw material to form Praval Bhasma. Praval (Coral) is the calcareous skeleton of the minute marine organism called Anthezoa polypus and belongs to phylum coelenterate. It is a natural source of rich calcium widely used in Deepan, Pachan, Amlapitta Raktapitta, Yakshma, Kasa, Netra Roga and Hridaya Roga (1)and Calcium deficiency diseases etc. it is administered in the form of Bhasma and Pishti. Method: Shodhan of Praval is done in Sarjika kshara. The Pravala bhasma is prepared by two different method by triturating it with Kumari Swaras and Guduchi Kashay and incineration in Muffle furnace. physico-chemical tests like Total Ash, Acid Insoluble Ash, Loss on Drying, and Qualitative analysis of praval bhasma by NPST (Namburi Phased Spot Test) are done. Result & conclusion: Praval bhasma prepared by two different medicines shows potency, efficacy for further clinical use.

Snuhi (Euphorbia neriifolia Linn.) and its compound formulations are widely used in Ayurvedic classics to treat variety of disease conditions. Information pertaining to the formulations of Snuhi can be traced in various classical texts, under different chapters. In most of the formulations it is used as an ingredient. Snuhi Kshara is a single drug formulation of Upavisha Snuhi mentioned in Rasatarangini and Ayurvedsarasangraha. Kshara obtained from Snuhi is one of its dosage modifications, advocated in classics for therapeutic objectives. Very few attempts are made to formulate Snuhi Kshara. The present work has been carried out to provide the Standard Manufacturing Process and a systematic standardization profile for Snuhi Kshara. Snuhi Kshara was prepared according to procedure described in Sharangadhara Samhita followed by analytical standardisation. Standardization was done using guidelines of API, by employing tests like organoleptic (Colour, Odour, Taste), physicochemical (Loss on drying, Acid-insoluble ash, pH), Assay (Sodium, Potassium, Iron) and Thin Layer Chromatography. Findings of this work may enrich to documentary research as well as act as detailed scientific data about standardization of Snuhi Kshara for further studies.

Analytical study of Ayurvedic formulation is the need of present scientific era. Though the Ayurvedic drugs are time tested and have been used successfully in the management of various ailments, it is now necessary to prove their quality, efficacy and safety to the scientific world through various parameters. Agadtantra is a branch of Ayurveda dealing with classification, mode of action, clinical manifestations and treatment of various poisons. Arka (Calotropis procera) is included in Upavisha by Rasatarangini. Arka Kshara is an alkaline preparation of Upavisha Arka (Calotropis procera) described in treating many disorders. Till date no data is available regarding analytical profile of Arka Kshara. So, the present study is planned to prepare Arka Kshara and develop its analytical profile. These findings will be useful in establishing quality control standards and standardization of Arka Kshara in future.

The word ‘Kshara’ can be derived from either of the two roots, Ksarana or Kshanana. Ksharana means to dislodge, to melt away and Kshanana means to kill or to destroy. The literal meaning of the word ‘Kshara’ is the substance which is corrosive, caustic, pungent, saline and acrid in its properties. This Kshara Kalpana is known to have a wide scope in Shalya Tantra branch of Ayurveda. Because of this wider scope many research works are at present undertaken in order to treat many ailments and avoid few surgical procedures. Apamarga Kshara is mainly used in practice and many experiments are already done on the same, in order to study the properties and effects of other drugs or Ksharas, one such drug is chosen here i.e., Kutaja. Ksharas are superior to Shastras, Anushastras, because of their capability to perform Chedana (excision), Bhedana (incision), and Lekhana (scraping). It alleviates all the three Doshas. Ksharas can be used where Shastra Chikitsa is contra-indicated or where instruments cannot be used i.e., Marmasthana, for women, children or on those who are afraid of surgery. Acharya Susruta, while describing the process of Kshara extraction has mentioned 23 drugs and Kutaja is first and foremost drug. There are no direct references of properties and extraction of Kutaja Kshara in classics and other compilation done on the same were also not found while searching through internet. Present paper throws light on the complete description of Kutaja as a Kshara and preparation of Kshara Sutra mentioned in different texts of Ayurveda.

Diabetic foot ulcer is a serious devastating complication of diabetes mellitus (DM) when it involves deep tissues and bone which may require amputations. In this case report a 70 year old male patient presented with non healing ulcer of sized (3.5 *3.2) cm2 at dorsum of the left foot since last 4 years. The ulcer was on the dorsum having most movable part in daily activity so it was reluctant to meal by all means of conventional management. So patient consultant to Ayurveda OPD and he was treated with local dressing of Apamarga Kshara Taila till wound healing for 50days. Along with local dressing patient prescribed with Haritaki Churna 5gm at night with luke warm water and Punarnavashtak Kwatha 40ml twice in a day on empty stomach for 50 days. Inj. wosulin 12 units thrice in day and Inj. basalog 14 units at nigh were continued simultaneously as prescribed by diabetologist during the treatment. Complete wound healing was achieved within 50days with unit healing time 4.46 day/cm2. This single case report showed wound healing potential of Ayurvedic medicine in diabetic wound.

Kanji (sour rice gruel) is an acidic fermented preparation mentioned in many of the Ayurveda classics for various purpose like therapeutic use, pharmaceutical processes etc. A special method of kanji preparation is mentioned in Rasaratnasamuchchaya commentary by Acharya Dattatreya Anant Kulkarni and similar preparation is also mentioned in Rasayansara book recommended for the Parada samskara (mercurial processes) with some difference in ingredients. Kshara (alkaline preparation/ alkali) is an important preparation mentioned in classics. In Rasayansara text, Acharya Shyamsundar Vaishyaji has described a unique method of Kshara nirmana out of the leftover material of the Kanji. This kind of innovative methods should be adopted to recycle the leftover waste matters. It will help in regenerate the new pharmaceutical product. Here an attempt has been done by preparing the kanji and the kshara out of its residue material as mentioned in Rasayansara. First Kanji was prepared as per the reference of Rasayansara book and the leftover after filtration was dried. The kshara was prepared out of this dried leftover. Organoleptic and physicochemical analysis of the prepared kshara was done. The average yield of obtained kshara was 4.88%. The moisture content of the final product found very less while total ash value found on higher side. The pH value suggests its alkaline nature. It shows good solubility in various solvents and good water-soluble extractive value. Exploration of such innovative procedures where waste stuff is been recycled should be increased in present time.

Health status of women is essential for healthy society. In today's fast and competitive world, there is change in the lifestyle of women which leads to their physical and mental stress, women mostly get affected by this environment and are prone to gynaecological problems. Common health problem or gynaecological problem in women is white discharge, foul smell discharge, itching at vulvar region, burning micturition. Cervical erosion is a condition seen in the age group of 20-40 years with more of Kapha dominance. Kandu, Yoni Srava and other features of Kapha Pittadushti are seen in cervical erosion. It is seen as red circular granular surface surrounding the cervical os bathed in discharges. On the study of etiological factors, sign and symptoms the disease is found to be caused by Kapha – Pittadosha Prokopa affecting Yoni and Garbhasayamukha leading to Samprapti which manifests as cervical erosion. Based on symptomatology, cervical erosion can be correlated with Karnini Yonivyapad. Karnini is an abnormal proliferation of cervical epithelium which may produce abnormal discharge, alter the vaginal pH and cervical mucus plug. Chikitsa of Karnini Yonivyapad is Yoni Prakshalana,Yoni Pichu Dharana, Yoni Varti Dharana, Agni Karma and Kshara Karma. Kaphahara line of treatment should be done. Diet also plays an important role in cervical erosion so proper Pathya Apathtya are to be followed.

Nasal synechiae or nasal adhesions are among the most common unwanted outcomes following functional endoscopic sinus surgery (FESS) with an incidence rate of 10%–40%. Approximately 500,000 patients per year undergo FESS for the treatment of chronic rhinosinusitis (CRS). A wide number of research studies support the utility of endoscopic sinus surgery to improve health-related quality of life (HRQoL) in patients with CRS. However, failures are still reported at a rate up to 26%. About 50% who present with synechiae in the middle meatus require revision endoscopic sinus surgery. A case report of a 48-year old-male has been presented here with complaints of nasal blockage and difficulty in breathing, diagnosed as nasal synechiae after anterior rhinoscopy and endoscopic examination and managed with Ayurvedic intervention. Kshara karma with Apamarga Kshara is the choice of management in case of nasal polyp and turbinate hypertrophy [1]. But in nasal synechiae, since we have to cut open the adhesion precisely, Kshara Sutra, which is meant for cutting open the tract in case of fistula-in-ano was chosen. Nasal synechiae which was managed only with electrocautery or other surgical procedures where there is a chance of recurrence can be successfully managed with an Ayurvedic intervention viz., Kshara Sutra which is strictly new to this site of occurrence (nose).

Kshara is mentioned only in post-Vedic literature. Whilst Charaka Samhita applies only to Detailed description of its preparation, classification, indication and description for Kshara In Susruta Samhita, contraindications are available. Kshara is defined as one of the Upayantras or AnuSastras. It is a medicine, prepared out of the dried plants water soluble ashes by a special process known as Kshara kalpana.It is considered to be between Shashtra and Pradhan because of its Chedana, Bhedana, Lekhana and, Anushashtra Karma, as it is said, to be Tridoshaghna and for special techniques to be used. Susruta has characterised"TatraKsharanatKshananadva Kshara" The medication has distinctive Ksharan or Kshanan properties. Ksharan, meaning either good or unhealthy, kills fleshy mass. Paneeya Kshara is indicated in good number of diseases by ancient Acharyas. Tilanal Paneeya kshara is mentation in Rasatarangini and used in various diseases.

Arshas being the most common grievous ailment and one of the eight most intractable disorders (Ashta Mahagada) explicited by Acharya Susruta & Vagbhata. Haemorrhoids are the dilatation of the anal and perianal venous plexus. The disturbance of Jatharagni is the most accepted cause of ano rectal problems, which further contributes to constipation. Constipation increases the back pressure into the haemorrhoidal veins to produce piles. Arsha requires a surgical technique in modern treatment, such as haemorrhoidectomy, rubber band ligation, and so on. Kshara is a caustic chemical, alkaline in nature, derived from medicinal plant ashes. The effect of Kshara karma is highly commended, it can replace the Shastra karma as it does the functions of Chedana, Bhedana, Lekhana karmas without using Shastras. Kshara karma can be utilised efficiently in individuals who are afraid of surgery as a complement for surgical operations. A 48years-old male patient presented with complaints of some mass coming out during defecation and bleeding while passing stool to the anorectal unit, OPD, National Institute of Ayurveda, deemed to be university Jaipur Rajasthan. The patient was treated successfully with Kshara karma application. The pile mass and per rectal haemorrhage was gone in 8 days and the patient was free of all symptoms within 18-20 days. The findings revealed that there are maximum advantages which are shared in this case study.

Mutrakrichha is a disease in which Mutra is voided with much Dukha (discomfort). The word Mutrakrichha comprises of two words, Mutra and Krichha, which means Krichha pravritti of Mutravahana (difficulty in micturition). Mutrakrichha comes under the disorders of Mutravaha srotas and mainly deals with Shool (pain) and Krichhata (dysuria). Mutrakrichha can be an independent disease as well as associated symptom in other disease. In the contemporary science, the disease with similar signs and symptoms are Lower urinary tract infection. Lower urinary tract infection is the most common infection known to mankind and a common condition seen in general practice. Urinary tract infection affects more than 150 million people every year worldwide. It is well explained by all the Acharyas. Charaka has described eight types of Mutrakrichha. Acharya Sushruta in Uttra-Tantra has separately described Mutraghata and Mutrakrichha. Acharyas have mentioned drugs having antibacterial and diuretic property in Mutrakrichha chikitsa. Paniya kshara is an age old treatment modality used since ancient times. To evaluate the role of Paniya kshara in Mutrakrichha, a total of thirty patients were selected with complaints of painful micturation, fever, urgency and tenderness. Patients were given Paniya Kshara. The study revealed highly significant results in terms of pain, fever, urgency and tenderness.

Ayurveda, the science of life is as old as the Vedic age and now a days Ayurvedic medicines are becoming popular day by day all across the world. The Ayurvedic therapeutics are mainly based on various kinds of dosage forms. Panchavidha kashaya kalpana is the basic form and many formulations are developed over time having long shelf life, stability, strong action etc. Kshara kalpana is the alkaline substance obtained from the ash of plants, minerals and animal products and has been widely used due to its minimal dose and potential action. Kalyanaka Kshara is a widely used formulation mentioned in our classics which is prepared by Antardhooma vidhi. In the present study Kalyanaka Kshara has been prepared using puta method as well as using muffle furnace. Physicochemical characterization of both the samples were done.

Kshara Sutra is a unique para surgical procedure mentioned in Ayurveda. Kshara Sutra is defined as a medicated thread coated with herbal alkaline drugs. Kshara Sutra prayoga is mentioned by Acharya Sushrutha in the management of Shalyaja Nadi Vrana. Acharya Sushrutha has explained Shalyaja Nadi Vrana as a complication of Vrana Shopha. Shalyaja Nadi Vrana is manifested due to presence of Bala (hairs) and puya (pus) in Twagadi dhatus. Pilonidal Sinus can be correlated with Shalyaja Nadi Vrana as they have same clinical features. Pilonidal Sinus is managed by radical excision of tract or Z plasty or by using rhomboidal flap of skin. Even by all these management in contemporary science expected results is not seen. To overcome the complications like recurrence, hospitalization and long-term post-op dressing, a Kshara Sutra can be used as a better treatment modality as it minimizes many of the complications. Many established herbal Kshara Sutras are available in market. Guggulu based Gandhamliya yashada kshara sutra has Gandhamliya yashada as Kshara which is a Rasaushadi. Gandhamliya Yashada Kshara has properties which will be helpful in lysis of tissues, reduces the discharge and also helps in wound healing in Shalyaja Nadi Vrana. So, this study is taken up to explore the combined effect of a herbo mineral Gug-gulu based Gandhamliya yashada kshara sutra in Shalyaja Nadi Vrana.

Ksharsutra is a Medicated seton which is made by coating the Barbour thread with 21 coatings of Kshara i.e. an herbal alkaline powder, turmeric and latex of Euphorbia nerrifolia. Ksharsutra application is a minimal invasive well established procedure in management of fistula-in-ano. Research on Ksharsutra started since 1968 and it is being used till date with high success rate. In this case report the patient was asymptomatic before 15 years but then a boil developed at perianal region which spontaneously bursted and pus discharge was seen from the boil. Patient was diagnosed with Grade 5 St. James’s university hospital classification of perianal fistulae. This was a case of high anal horse shoe fistula. In this case Fistulectomy or Fistulotomy would cause incontinence. So in this case the Ksharsutra was used but with a modification of classical technique called as IFTAK (Interception of fistulous track with application of Ksharsutra) technique. In which a window was created at 6o’ clock and intersphincteric tract was identified and in that tract Ksharsutra was placed. This technique cures such types of complex Fistula in ano with minimal tissue damage and duration of healing is also reduced.

Avascular necrosis (AVN) of femoral head is the most common type of necrosis affecting the bones. Avascular necrosis of the bone is the death of osteocytes due to impaired blood supply. It usually affects people between 30-50 years of age. It is associated with long term use of steroids, medications and exces-sive use of alcohol. It will be asymptomatic in early stages, as the condition progresses there will be gradual increase in pain and restricted range of movement of hip joint in end stage total joint destruction resulting in only surgical treatment. AVN treatment management aims at preserving the structural-functional integrity of bone and relief from the pain. Treatment modalities include administration of pain killers, anti-inflammatory medications (NSAIDS), core decompression (bone graft), modified Whitman or Colonna re-construction, insertion of prosthesis and total joint replacement surgery are carried out as a treatment but causes financial burden and poor prognosis. Here we present a case of 19 years old male diagnosed with AVN of left hip joint. Clinical features in this case of AVN was merely correlated with Ashtivahasroto-dushti (Bone channel-musculoskeletal system) and Majjagatavata and treated with different treatment mo-dalities explained in the context of Majjagatavata and Gambeeravatarakta such as Virechana and Bas-tiChikitsa and treatment outcome was found to be encouraging in the terms of pain relief, relief from ten-derness stiffness, flexible hip movement (improved gait) and no reoccurrence after 2 years in MRI.

Juvenile Spondyloarthropathies are the inflammatory arthritis before the age of 16 years and are characterized by the involvement of both synovium and enthesis leading to spinal and oligoarticular peripheral arthritis, principally in genetically predisposed (HLA-B27) individuals. These arthropathies are having poorer chance of remission with conventional treatment in comparison to other juvenile arthritis; with less than 20% going into remission within five years of diagnosis. This paper is a retrospective observational study of this condition in one patient receiving Ayurvedic treatment in Paediatric Unit of Ch. Brahm Prakash Ayurved Charak Sansthan. A 15 years adolescent boy with the complaints of inability to stand and walk due to pain and swelling in large joints of body; was carried to Balroga OPD by parents. On the basis of history, physical examination and investigations, the condition is diagnosed Aamavata as per ayurvedic approach and juvenile spondyloarthropathy as per modern medical science. This case is managed on the principle of treatment of Aamavata with administration of Ajamodadi churnam and Mishreya ark as deepana-pachana drugs followed by administration of Simhnad Guggulu and Lakshadi Guggulu with Maharasnadi kashayam and Dashmoolaristam for 3 months. Rheumayoga gold was also given from 4th week onward for 3 months. Panchkarma in the form of Baluka swedana and Kshara basti was also administered for 2 weeks after one month of oral medication. This treatment results in complete remission of all the signs and symptoms including pain and swelling of joints. The case is followed up for next three years without any relapse or progression in the disease. The case study infers that early intervention of Ayurvedic treatment in juvenile spondyloarthropathies may result in complete remission as well as may prevent progression of the disease. The case study provides a good hope for the management of this ailment as well as new ray for research.

Stasis ulcers of the gaiter zone are difficult to heal due to deoxygenated blood congestion in peripheral areas and lack of oxygenated blood supply. Venous ulcers occur due to insufficiency of distal peripheral veins in legs. This manuscript refers to three cases of nonhealing venous leg ulcers treated with local application of Apamarga Kshara Taila along with some oral drugs. Three patients of nonhealing venous ulcer of the gaiter zone were treated with ayurvedic treatment protocol. In all patients after Panchavalkala Kwatha wound wash, Apamarga Kshara Taila was applied locally on wound once daily up to complete wound healing. In this series, wound healing was achieved in 96 days, 27 days, and 38 days, with a unit healing time of 4.311, 7.287, and 3.677 days/cm3, respectively. For the past 8 months, all three patients are living symptom-free life without any reoccurrence. On the basis of these cases, it can be said that Ayurveda principles of ulcer management have shown a promising role in wound healing and resuming improved quality of life without any untoward effects.

Ever since the evolution of the species Homo sapiens, anal problems have been a source of constant anxiety. Contrarily there seems to be an increasing incidence of the commonest of all anal disease, i.e. Arshas, a kind of disease which is very unkind towards mankind. Ayurvedic literatures have described Arshas as Mahagada and can be compared to Haemorrhoids in modern medicine. The various therapies show that there is no universally acceptable technique in the management of Haemorrhoids and also these have many side effects and demerits. Pratisaraneeya Kshara the alkaline group of medicinal substances has been emphasized throughout the classical literature for Arshas, as a substitute for surgical procedure and can be used safely in patients who are afraid of surgery, old and weak also. This work includes preparation of Apamarga and Palasha Pratisaraneeya Ksharas; evaluation of the efficacy of Apamarga and Palasha Pratisaraneeya Kshara and comparing the results in the management of Arshas. The effects of Apamarga Pratisaraneeya Kshara and Palasha Pratisaraneeya Kshara were evaluated clinically in 30 patients, 15 in each group randomly divided. The study concluded that in patients suffering from Arshas both Apamarga Pratisaraneeya Kshara and Palasha Pratisaraneeya Kshara showed statistically highly significant results (p < 0.001) in terms of the improvement in Mass per rectum, Pain and Size of pilemass and 80% of the patients treated with Apamarga Pratisaraneeya Kshara got complete remission from the disease, while with Palasha Pratisaraneeya Kshara 46.7% patients showed complete remission. Though there won’t many differences statistically, the comparison of individual criteria ‘s percentage and the relief obtained, Apamarga Pratisaraneeya Kshara showed an upper hand in managing the Arshas.

This article attempts to clear the dogma that exists in the preparation of Kshara Ghrita with reference to its critical final stage of Siddhi Laxanas. Palasha Kshara Ghrita (PKG) prepared from the Kshara of Palasha (Grewia asiatica) mentioned in Rasa Tarangini, which is indicated in the treatment of Granthi (tumor) is taken for the study. The present article is an extract of all the observations made during the pharmaceutical study of PKG. All these observations will be of great help when we go for large scale production. The study has tried to establish the ratios of Dravadravyas with Kshara, besides addressing the type of vessels appropriate in such preparations. After preparation of sample in different vessels, these were subjected to analytical study using relevant analytical parameters to find out any difference. During pharmaceutical process Copper vessel was found appropriate on the lines of pharmaceutical preparations. The analytical report of samples reveals no much difference in the parameter findings except pH of PKG 7.00, 9.91 and 9.46 in the vessels such as copper, iron and mud pot respectively. The particle size of Kshara was in between 429.7 to 667 nm under 15.00KV magnification 7.5 KX and EDAX report of Phalasha Kshara under 400 μm potassium Wt% 40.05 and Oxygen is Wt% 39.12. Under 50 μm potassium Wt% 48.91 and Oxygen Wt% 33.40. Under 70 μm potassium Wt% 27.90 and Oxygen Wt% 37.78. As per this study copper vesse l is found better for PKG than Iron and Mud pot for assessment of end process and also on analytical parameter.

Gall bladder polyps are growths or lesion resembling growths in the wall of the Gall bladder. Most small Polyps (less than 1 cm) are not cancerous but the most dreaded complication of the Gall bladder Polyp is Adenocarcinoma1. Direct reference of Gall bladder polyp is not available in Ayurveda. The disease can be correlated to Pittashoshaja shola. In this case study, a 25-year-old female diagnosed with Gall bladder Pol-yp was administered Paaneeya Kshara for 28 days. Assessment was done for pain and size of Polyp. Sig-nificant improvement was observed after treatment.

Aacharya Sushruta, the father of surgery has described few diseases under the heading of Kshudraroga, meaning that category of diseases that do not need major attention and the diseases that are simple and do not result in any complications or cause threat to life. Diseases like Charmkeela (warts) are not causing any noticeable discomfort but still their impact on body and mind is such that the individual suffering from such diseases falls into a state of distress. Aacharya Sushruta has been described a para-surgical proce-dure- Kshara Karma for the management of unwanted growths. Today advanced techniques and surgical procedures like sclerotherapy, laser therapy, cryosurgery, polypectomy etc have been innovated for the management of such type of unwanted growths which have their own disadvantages & limitations. These unwanted growths have peculiar tendency of recurrence despite of their surgical removal. So, to avoid the surgical removal of unwanted growths and recurrence, the present work has been undertaken.

Fistula in ano is an abnormal communication between anal canal or rectum and the perianal skin which mostly follows previous ano-rectal abscess. Chief complaints include intermittent discharge, history of pre-vious pain, swelling and recurrent abscess that ruptured spontaneously or was drained surgically. Various surgical and para-surgical methods are available now a days to treat this disease. In the vast literature of Ayurveda same symptoms are described as Bhagandara. At first it appears as Pidika around Guda and when it bursts out, it is called as Bhagandara1. Acharya Sushruta has counted this disease in Ashta Ma-hagada suggesting its difficulty to treat2. There are many options available to treat fistula in ano ranging from seton application, fistulotomy, fistulectomy, fibrin glues, LIFT technique, advancement flaps etc. Acharyas has used Agni karma, Kshara karma, Shastra karma and Aushadha karma in Bhagndara. But in this case Kshara Sootra application was done to treat Bhagandara. Application of Kshara Sootra not only lessen rate of recurrence to a significant level but also free from almost all major post-operative complica-tion.

Dushtavrana is a commonly and often encountered problem faced in surgical practice. The presence of Dushtavrana worsens the condition of the patient with different complications which may become fatal and life threatening. Local factors on wound like slough, infection and foreign body which affect the nor-mal process of healing. A healthy and fresh wound in a normal body heals earlier with minimal scar as compared with contaminated wound. Therefore, in the present study all efforts are made towards to keep the wound clean during various stages of healing. Good wound healing with Minimal Scar formation with minimal pain effectively is the prime motto of every surgeon. Acharya Sushrutha has explained 60 proce-dures for the management of Vrana at different stage. Kshara Karma is one among them which is men-tioned by Acharya Sushrutha and which is indicated in Dushtavrana due to its Chedana, Bhedana, Lek-hana & Tridosghna properties. Which does the Shodhna of Dushtavrana.

Amavata is a crippling condition where simultaneously aggravated Vata and Ama associated with each other settles in Sandhis and produce Sandhishoola, Sandhishotha, Sparshaasahitwa, which is similar to Rheumatoid Arthritis. The present study has made an attempt to find an effective Ayurvedic treatment modality through Kshara Vasti and Vaitarana Vasti along with Shamanoushadhi. A total of 30 Patients were randomly divided in two groups with 15 patients in each group. In Group A, Kshara Vasti and in Group B, Vaitarana Vasti was given in Yoga Vasti schedule followed by Shamanoushadhi Simhanada Guggulu 500mg twice and Rasna Saptak Kwatha 40ml as Anupana for 45 days in both the groups with 1 month follow-up period. Both Group A and Group B provided highly significant results in all parameters of assessment but Kshara Vasti showed better improvement in the symptoms of the disease Amavata. 63.33% of patients got marked relief, 30% of patients got moderate relief. 56.66% of patients got marked relief in grip strength and 66.66% of the total number of patients got marked relief in tenderness. All the patients of both the groups responded well after Kshara Vasti and Vaitarana Vasti and the result were highly significant. The sustained affect of Vasti was very clearly evident after administration of Vasti along with Shamanoushadhi. Hence the modalities of our treatment can be recommended to all the patients of Amavata.

Kasharasutra is being practiced in Indian system of medicine since ancient time in various ano-rectal disorders. In this case series, 2 patients of arsha (internal external haemorrhoids) underwent ksharasutra trans fixation at 3,7,11 o’ clock under spinal anaesthesia. Ksharasutra prepared as per the ayurvedic pharmacopeia of India (API). Ligated pile mass sloughed out on 5th post-operative day. Wound healed within 30 days. Panchavalkal kwatha for sitz bath, jatyadi taila for local application, gud haritaki were used as adjuvant drugs. Follow up after 4 weeks, no recurrence was observed, sphincter tone was normal and there was no evidence of anal stricture after complete wound healing.

Warts are benign epithelial hyperplasia manifesting mostly due to infection with human papilloma virus (HPV). The condition may affect the patient with or without pain, itching etc. Wart can became a stressful cosmetic problem. The references of Charmakeela in Kshudraroga adhikara in the Ayurvedic classics have a very close clinical proximity with warts. Kshara is one among the treatment choice for Charmakeela and used in Pratisaraneeya kshara form. Subcutaneous intralesional injection is one among the upgraded modalities of Pratisaraneeya ksharakarma. Kshara used as Ksharodhaka for this procedure. A 24 years old female patient with a common wart over the thumb visited the Salyatantra OPD, Govt. Ayurveda College Hospital Tripuithura in June 2019. The lesion was painless and without itching and was developed within a period of one month. The patient was undertaken for subcutaneous intralesional injection of Aragwadha ksharodhaka following proper lab investigations. The patient did not developed any adverse reactions or pain during the procedure. It was observed that, the wart shed off within a period of 7 days. There was no visible ulceration over the site of wart and healing happened leaving a minimum scar. Also there was visible healthy skin formation.

Introduction: Pippali (long pepper), Kshara (alkali) andLavana (salt) are referred to as “Trini Dravyani Na Ati Upayunjita” by Charakacharya. It is quoted that when these Dravyas are consumed in excess produces ill-effects to the body. In present era people are going blank in the context of differentiating greed and need of the body. So people are going behind the fast food (spicy and salty food). It makes food delicious. It is used as an appetizer and digestive agent. The National Academy of Sciences United States recommended that adult dietary sodium intake should be below 2300 mg/day with 1200 to 1500 mg/day being considered an adequate intake for optimal health. Charakacharya mentioned excessive intake of Lavana leads to Khalitya. As Lavana is having Ushna and Teekshna property, it does Pitta Prakopa leading to Khalitya. Hence the study has been taken up as an attempt to assess the role of excessive intake of Lavana leading to Khalitya. Aims and Objectives: To review the literatures on Trini Dravyani Na Ati Upayunjita, Lavana, Pippali, Kshara and disease Khalitya and to evaluate the effect of Atisevana of Lavana as a causative factor for Khalitya. Results: In classics excessive intake of Lavana is said as one of the causative factor leading to Khalitya. This is revalidated by the results obtained. Conclusion: Survey study conducted on 100 patients of Khalitya provides significant impact of Lavana in causing Khalitya.

Cholelithiasis is a crystalline concretion formed within the gall bladder by accretion of bile components. Cholelithiasis can be considered as Pittashaya Ashmari, but there is no direct reference of this condition available in Ayurveda. In Ayurveda the effective treatment is Paneeya Kshara. Surya and Navasadara Paneeya Kshara is standard one and which is highly effective treatment in the management of Cholelithiasis but, persisting pain, presence of calculi has limited in its use. To overcome the lacunas present study has been carried out. This study was conducted at SJIIM Hospital Bengaluru and total of 40 patients were randomly allotted into two groups namely Group A with trial drug i.e. 2grams each of Narikela Lavana, Navasadara, Yava Kshara orally with Jala once daily in empty stomach in the morning, every day for 28 days and Group B with control drug i.e. 2grams of Surya and Navasadara Paneeya Kshara orally with Narikela Jala once daily in empty stomach in the morning, every day for 28 days. Assessment was made on Subjective and Objective parameters. Observations were made before the treatment and on 15th day and 30th day to know the efficacy of the treatment. The combination of Narikela Lavana, Navasadara Yuktha Yava Kshara showed a positive result.

Astamahagda, group of eight dreadful clinical conditions told in all Ayurvedic classics. Aacharya Sushruta enlisted Arsha in Astamahagada. Arsha is known as haemorrhoids in modern parlance. The altered lifestyle in this modern world is the leading cause in the incidence of Haemorrhoids (Arshas). Symptoms of internal haemorrhoids closely resemble to clinical features of Abhyantara Arshas. Aacharya Shusruta described four types of treatment modalities for the management of Arsha, they are Bheshaja Karma, Kshara Karma, Agni Karma and Shastra Karma. Kshara is one of the most essential methods that can be used safely. An attempt has been made in this study to test the effectiveness of Vasa Pratisaraneeya Teekshna Kshara in the management of Abhayantra Arsha. In this study, 15 patients suffering from Abhyantra Arsha were selected from OPD and IPD of the PG Department of Shalya Tantra, NIA, Jaipur. The data obtained have been statistically analyzed and it has been observed that Kshara Karma is effective in curing the disease, preventing recurrence and cost-effective Para-surgical procedure. The outcome of Kshara Karma interference is motivating.

Abscess is a collection of the pus in cavity and it is an acquired condition seen all over the body. The clini-cal features of abscess are swelling, pain, redness, tenderness, and local temperature. The aggravated Doshas vitiate the skin, blood, muscles, fat and bone tissue, become localised and produce a troublesome swelling - deep rooted, painful, slowly bulging called VIDRADHI. The abscess which is developed in peria-nal regions is called perianal abscess. Treatment of perianal abscesses requires prompt surgical drainage. However, there is no evidence that uncomplicated perianal abscesses can be safely treated only with drain-age. For this reason, it is important to identify the causative organisms in pre- post I&D Pratisarani-yakshara karma there-fore, we accessed the microbiological analysis of this patient. Here in this case the Ayurvedic management of Pratisaraniyakshara was applied post I and D considering it as a DustaVrana keeping in the mind to avoid the reoccurrence and complication.

Amavata is a disorder where in lot of similarity is seen with Rheumatoid arthritis. This is a systemic chronic inflammatory joint disorder which affect predominantly to synovial joints. Cardiac involvement, symmetrical involvement of joints along with pain, stiffness and swelling with number of systemic complications resembles the disease Amavata. Methods: A total of 15 patients considering inclusion and exclusion criteria were selected to study Amavata in detail according to Ayurvedic texts and Rheumatoid Arthritis of modern medicine. Kshara Vasti schedule followed by Shamanoushadhi Simhanada Guggulu 500mg twice and Rasna Saptak Kwatha 40ml as Anupana for 45 days was given for 38 days with 1 month follow-up period. Results: Out of 15, 11 patients (73%) falls under marked relief category, 3 patients (20%) falls under moderate relief category and lastly 1 patient (6%) falls under mild relief category in subjective parameters. In the objective parameters, 9 patients (60%), 11 patients (73.33%) falls under marked relief category of grip strength and tenderness respectively. 03 patients (20%), 2 patients (13.33%) falls under moderate relief category of grip strength and tenderness respectively. 03 patients (20%), 2 patients (13.33%), 14 patients (93.33%) falls under mild relief category of grip strength, tenderness and E.S.R respectively. 1 subject (6.66%) falls under no relief category of E.S.R. Conclusion: All parameters of assessment but Kshara Vasti showed better improvement in the symptoms of the disease Amavata.

Vrana ( wound and ulcer) & process of healing is the soul of Shalyatantra Chikitsa (Surgical treatment ). Dushta Vrana means getting vitiated by Dosha & hence Dushta Vrana or infected wound is characterized by bad smell, abnormal color with profuse discharge, severe pain and longer healing time. The severity of infected wounds and their vast range of etiologies, The treatment is cleaning & dressing the wound or it can be more extensive. It may require surgical intervention to close the wound and stabilize the patient. Acharya Sushruta defines Kshara as the substance possessing Ksharana and Kshanan properties. Ksharaplota formulation was selected and applied over the affected infected wound with the help of gauze piece. During the preparation of Ksharaplota, it is coated with Snuhi kshira, Apamarga kshara & Haridra. All these drugs are Shodhana & Ropana. It was observed that Ksharaplota has the properties as sustained release of drug, absorbs discharges, less painful & easily acceptable by the patient with excellent Sodhana & Ropana Karma. The clinical study has been done on 438 patients, selected randomly and divided in two groups. Group A 220 patients i.e. trial group, were treated with local application of Ksharaplota. The Group B 218 patients i.e. control group, were treated with Gold standard. The clinical assessment was done on the basis of clinical presentation of Dushta Vrana, (Infected wound) before and after the treatment. As grading used for assessment of parameters which were ordinal in nature, “Wilcoxon Signed Ranks test” was used for within the group assessment (i.e. before and after treatment of a group). For between the group assessment of parameters, Mann Whitney – U test was applied. We had tested hypothesis for each parameter and result was interpreted accordingly. The level of significance was kept at 5% (P=0.05). And the result of the present study found significant.

Kshara sutra is one of the para surgical procedures in Ayurveda and it has been proven as an effective and first choice of treatment in the management of Fistula-in-ano. The preparation of Kshara sutra has undergone many changes and has passed through various stages before it reached the present standard of scientific manufacturing. Now Kshara sutra is considered as simple, safe and sure treatment modality for Fistula-in-ano Key words: Kshara sutra, Fistula-in-ano.

Urinary tract infections (UTI) affect men and women of all ages. The disease varies dramatically in their presentation and sequel. They are common cause of morbidity among people and can lead to significant mortality. E. coli is the most common organism causing UTI. The symptoms from a urinary tract infection include dysuria, frequent urination, burning sensation, urgency, hematuria and fever. Mutrakrichra which is having similar symptoms to UTI is widely described in Ayurveda classics. It is a tridoshaja vyadhi. Kshara is one among the important formulation that can be effectively used for the treatment of Mutrakrichra. Patala Paneeya kshara is indicated in treatment of Kaphaja Mutrakrichra by Acharya Vagbhata. A 43-year-old male got admitted with IP No.1069 in the hospital with symptoms of dysuria, suprapubic pain, urgency and increased frequency of micturition. After urinalysis condition was diagnosed as UTI. Prakruti of the patient was assessed as Vatakaphaja and found out to be suitable for internal administration of kshara. Patient was administered 500 mg capsules of Patala paneeya kshara twice daily for a period of 10 days and analyzed the condition. Along with reduction in number of pus cells great symptomatic relief was obtained. With the indigenous properties of kshara it can be effectively used in treatment of UTI.

An umbilical granuloma is a most common umbilical abnormality in neonates which occurs due to overgrowth of umbilical tissue during the healing process. In Ayurveda, umbilical granuloma can be correlated with conditions like Pindalika(one of the complication of improper cutting of umbilical cord) or NabhigataArsha(extra growth on umbilicus). Aneight-years-old male child presented with a complaint of reddish swelling on umbilicus with discharge and occasional bleeding from umbilicus sincebirth. On examination a single swelling on umbilicus measuring 1 × 0.8 × 0.5 cm, cherry red in color with serous discharge was present. It was soft, non-tender and moist. Surrounding skin was occupied with unhealthy accumulation of chronic discharges.Under aseptic precautions, Apamarga Pratisaraneeya Kshara (alkaline preparation having Achyranthes aspera plant) was applied on the umbilical granuloma. This treatment procedure was repeated for next two days. At seventh day from the first day of the Kshar application, it was completely healed. Umbilical granuloma was successfully treated with Kshara Karma.

Moles are a commonest skin condition. They are usually small, dark brownish, black spots and are caused by groups of pigmented cells. Mole can appear anywhere on the skin either alone or in groups. They usually appear in childhood and adolescence. In Ayurvedic classics it is usually correlated with Masaka. Masaka (elevated mole) are caused by vitiated Vatadosha as painless, black gram colour elevated and stable identity. In the present study a male patient aged about 42 years came complaining of a blackish brown coloured growth with irregular margins present on right side of his face (infraorbital region). With time the discoloured growth gradually increased its size in last 15 years. In contemporary medicine various treatments of this condition are available but no promising management is updated till date. Keeping this in mind the patient was advised to undergo Agnikarma and Kshara karma. By help of Agnikarma the mass was excised and later Kshara was applied. Since moles usually reoccur after excision also, Application of Kshara plays a pivotal role here since it leaves less possibility for it to regrow. After the above said treatment patient was advised to apply Jatyadi tail which is very good Vrana Ropak. After the follow up of 2 months it was found that there was no reoccurrence. The aim of study is to highlight the role of Agnikarma and Kshara karma in Masaka with special reference to elevated mole.