Literary and Analytical Study of the Source Plants of Kshara (Alkali) for Ksharasutra Preparation in the Management of Fistula-in-ano
Abstract
The different surgical techniques and importance in disease treatment were explored by Sushruta, the father of surgery. Furthermore, Anushastra or parasurgical substances and methods from Ayurveda are distinctive in surgical fields as discovered by Sushruta. Kshara or alkali are useful for performing excision/removal, incision/cutting, scraping, alleviating three Doshas and several special procedures, and therefore superior to Shastra (sharp instruments) or Anu Shastra (accessory apparatuses). Also, Kshara is derived from diverse Ayurveda plants and applied in different ways to manage various diseases, including bhagandara (fistula-in-ano) and other numerous anorectal conditions. This study implemented a literary analysis of the plant sources employed to prepare Kshara sutra. There are 23 Kshara source plants provided by Sushruta. The specimens were identified by a comparison of the description to previously published Kshara sutra references. The data recorded encompassed botanical name, local label, location, pharmacodynamics, morphology characteristics, action, chemical constituents, and antimicrobial activity. There are three source plants provided by Sushruta to prepare Kshara sutra for fistula-in-ano management in this study including Curcuma longa Linn., Commiphora mukul, and Euphorbia antiquorum. It is possible to become a reference for Kshara sutra, a novel drug delivery system in Ayurvedic surgery for anorectal diseases and involves a thread smeared with kshara (alkali) applied to induce both mechanical and chemical cutting and healing.
References
Acharya VJT, Acharya NR. 2008. Sushruta, Sushruta samhita, Chikitsa Sthana, Bhagandara Chikitsa Adhyaya. 1st ed. Vol. 8. Varanasi: Chaukhambha Surabharati Prakashan. p. 441
Aggarwal BB, Yuan W, Li S, Gupta SC. 2013. Curcumin free turmeric exhibits anti-inflammatory and anticancer activities: Identification of novel components of turmeric. Molecular Nutrition & Food Research. vol 57(9): 1529–1542. doi: https://doi.org/10.1002/mnfr.201200838.
Ammon HP, Wahl MA. 1991. Pharmacology of Curcuma longa. Planta Med. vol 57 (1) 1–7. doi: https://doi.org/10.1055/s-2006-960004.
Araújo CC, Leon LL. 2001. Biological activities of Curcuma longa L. Memórias do Instituto Oswaldo Cruz. vol 96(5): 723–728. doi: https://doi.org/10.1590/s0074-02762001000500026.
Bagad AS, Joseph JA, Bhaskaran N, Agarwal A. 2013. Comparative evaluation of anti-inflammatory activity of curcuminoids, turmerones, and aqueous extract of Curcuma longa. Advances in Pharmacological Sciences. vol 2013: 1–8. doi: https://doi.org/10.1155/2013/805756.
Bai X, Oberley-Deegan RE, Bai A, Ovrutsky AR, Kinney WH, Weaver M, Zhang G, Honda JR, Chan ED. 2016. Curcumin enhances human macrophage control of Mycobacterium tuberculosis infection. Respirology. vol 21(5): 951–957. doi: https://doi.org/10.1111/resp.12762.
Banerjee A, Nigam SS. 1977. Antibacterial efficacy of the essential oil derived from the various species of the genus- Curcuma Linn. Journal of Research and Education in Indian Medicine. vol 12(1): 1.
Bansal S, Chhibber S. 2010. Curcumin alone and in combination with augmentin protects against pulmonary inflammation and acute lung injury generated during Klebsiella pneumoniae B5055-induced lung infection in BALB/c mice. Journal of Medical Microbiology. vol 59(4): 429–437. doi: https://doi.org/10.1099/jmm.0.016873-0.
Edwin S, Jarald EE, Deb L, Jain A, Kinger H, Dutt KR, Raj AA. 2008. Wound healing and antioxidant activity of Achyranthes aspera. Pharmaceutical Biology. vol 46(12): 824–828. doi: https://doi.org/10.1080/13880200802366645.
Gayathri DS, Archanah A, Abiramasundari P, Priya V, Uma K, Abirami T. 2009. Pharmacological activities of Achyranthes aspera, an overview. Indian Journal of Nutrition and Diebetics. vol 46(12): 485–490.
Khan MTJ, Ahmad K, Alvi MN, Mansoor B, Saeed MA, Khan FZ, Jamshaid M. 2010. Antibacterial and irritant activities of organic solvent extracts of Agave americana Linn., Albizzia lebbek Benth., Achyranthes aspera Linn. and Abutilon indicum Linn-A preliminary investigation. Pakistan Journal of Zoology. vol 42(1): 93–97.
Kimura I, Yoshikawa M, Kobayashi S, Sugihara Y, Suzuki M, Oominami H, Murakami T, Matsuda H, Doiphode VV. 2001. New triterpenes, myrrhanol A and myrrhanone A, from guggul-gum resins, and their potent anti-inflammatory effect on adjuvant-induced air-pouch granuloma of mice. Bioorganic & Medicinal Chemistry Letters. vol 11(8): 985–989. doi: https://doi.org/10.1016/S0960-894X(01)00111-1.
Kodjio N, Atsafack SS, Fodouop SP, Kuiate JR, Gatsing D. 2016. In vitro antisalmonellal and antioxidant activities of extracts and fractions of Curcuma longa L. rhizomes (Zingiberaceae). International Journal of Biochemistry Research & Review. vol 11(3): 1–4. doi: https://doi.org/10.9734/IJBCRR/2016/25106.
Krup V, Prakash LH, Harini A. 2013. Pharmacological activities of turmeric (Curcuma longa Linn): a review. Journal of Homeopathy & Ayurvedic Medicine. vol 2(4): 1-4. doi: http://dx.doi.org/10.4172/2167-1206.1000133.
Lobo SJ, Bhuyan C, Gupta SK, Dudhamal TS. 2012. A comparative clinical study of Snuhi Ksheera Sutra, Tilanala Kshara Sutra and Apamarga Kshara Sutra in Bhagandara (fistula in ano). Ayu. vol 33(1): 85–91. doi: https://dx.doi.org/10.4103%2F0974-8520.100319.
Malarvili T, Gomathi N. 2009. Effect of Achyranthes aspera (Linn) seeds on redox and oxidative status in plasma and selected tissues of rats fed with high doses of fructose. Biosciences, Biotechnology Research Asia. vol 6(2): 659–664.
Manjula M, Indira V, Dhasarathan P. 2009. Phytochemical characterization and antibacterial activity screening of Achyranthes aspera. Asian Journal of Microbiology, Biotechnology & Environmental Sciences Paper. vol 11(2): 365–368.
Misra TN, Singh RS, Pandey HS, Prasad C, Singh BP. 1992. Antifungal essential oil and a long chain alcohol from Achyranthes aspera. Phytochemistry. vol 31(5): 1811–1812. doi: https://doi.org/10.1016/0031-9422(92)83153-P.
Pillai NR, Santhakumari G. 1981. Hypoglycaemic activity of Melia azadirachta Linn (neem). Indian Journal of Medical Research. vol 74: 931–933.
Prasad SHKR, Swapna NL, Anthonamma K, Rajasekhar,D. 2016. Antimicrobial activity of Achyranthes aspera and Aerva lanata leaf and callus extracts. Biosciences Biotechnology Research Asia. vol 6(2): 887–891.
Prywer J, Torzewska A. 2012. Effect of curcumin against Proteus mirabilis during crystallization of struvite from artificial urine. Evidence-Based Complementary and Alternative Medicine. vol 2012: 1–8. doi: https://doi.org/10.1155/2012/862794.
Rath SK, Nagar L, Sinde A, Gahunge P, Lamo R, Khemani N. 2012. Review of source plants of kshara for kshara sutra preparation for the management of fistula-in-ano. International Journal of Research in Ayurveda & Pharmacy. vol 3(3): 333–340.
Samaranayake GVP, Pushpakumara AAJ, Pieris KPP. 2020. Comparative study on different treatment modules in the management of fistula-in-ano. International Journal of Current Advanced Research. vol 9(6): 22407–22411. doi: http://dx.doi.org/10.24327/ijcar.2020.22411.4417.
Saravanan P, Ramasamy V, Shivakumar T. 2008. Antimicrobial activity of leaf extracts of Achyranthes aspera Linn. Asian Journal of Chemistry. vol 20(1): 1–3.
Sarbhoy AK, Varshney JL, Maheshwari ML, Saxena DB. 1978. Efficacy of some essential oils and their constituents on few ubiquitous molds. Zentralblatt für Bakteriologie, Parasitenkunde, Infektionskrankheiten und Hygiene. Zweite Naturwissenschaftliche Abteilung: Mikrobiologie der Landwirtschaft, der Technologie und des Umweltschutzes. vol 133(7–8): 723–725.
Sharma JN. 1977. Comparison of the anti-inflammatory activity of Commiphora mukul (an indigenous drug) with those of phenylbutazone and ibuprofen in experimental arthritis induced by mycobacterial adjuvant. Arzneimittel-forschung. vol 27(7): 1455–1457.
Sunarwidhi AL, Sudarsono S, Nugroho AE. 2014. Hypoglycemic effect of combination of Azadirachta indica A. Juss. and Gynura procumbens (Lour.) Merr. ethanolic extracts standardized by rutin and quercetin in alloxan-induced hyperglycemic rats. Advanced Pharmaceutical Bulletin. vol 4(2): 613–618. doi: https://dx.doi.org/10.5681%2Fapb.2014.090.
Sidhu GS, Mani H, Gaddipati JP, Singh AK, Seth P, Banaudha KK, Patnaik GK, Maheshwari RK. 1999. Curcumin enhances wound healing in streptozotocin induced diabetic rats and genetically diabetic mice. Wound Repair and Regeneration. vol 7(5): 362–374. doi: https://doi.org/10.1046/j.1524-475X.1999.00362.x.
Tahiliani P, Kar A. 2000. Achyranthes aspera elevates thyroid hormone levels and decreases hepatic lipid peroxidation in male rats. Journal of Ethnopharmacology. vol 71(3): 527–532. doi: https://doi.org/10.1016/S0378-8741(00)00170-7.
Teow SY, Liew K, Ali SA, Khoo ASB, Peh SC. 2016. Antibacterial action of curcumin against Staphylococcus aureus: a brief review. Journal of Tropical Medicine. vol 2016: 1–11. doi: https://doi.org/10.1155/2016/2853045.
Wuthi-Udomlert M, Grisanapan W, Luanratana O, Caichompoo W. 2000. Antifungal activity of Curcuma longa grown in Thailand. The Southeast Asian journal of Tropical Medicine and Public Health. vol 31: 178–182.
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