This document summarizes a clinical study on using Nimbadi Pratisaraneeya Kshara, a medicated paste, to treat first and second degree hemorrhoids. 30 patients with hemorrhoids will be treated using the Kshara paste and evaluated based on symptoms like bleeding and pain, as well as the size and color of the hemorrhoid masses. The paste will be applied in the lithotomy position after cleaning the area. Patients will be reviewed alternately for 1 week then at 15, 21, and 30 days to assess recovery and for recurrence at 3 and 6 months. The study aims to evaluate the efficacy of the Nimbadi Kshara paste in treating hemorrhoids.

1. By
Dr. Srinivasa Reddy Bandhi
A Clinical Study on the effect of
Nimbadi Pratisaraneeya Kshara in the
management of Arshas wsr to I and II
Degree Haemorrhoids

2. Introduction
Arshas (Haemorrhoids) is one of the
commonest disease occurring in Ano-rectal
region.
Its incidence increases with advancing age, at
least 50% of people over the age of 50 years have
some degree of Haemorrhoidal symptoms.
Now a day’s most of the persons suffer from
any one of the complaints of piles during their
life time.

3. Sushruta, while describing the preparation of
Kshara, emphasized on the procedure of Kshara
Karma and mentioned that Arshas which are Mrudu,
Prasrutha, Avagadha, and Uchrita should be treated
only by Kshara Karma.
The effect of Kshara is praised so much that it can
replace SastraKarma, as it does the functions of
Chedana, Bhedana and Lekhana Karmas without using
Sastras.
Introduction..

4. Need of the Study
Till now the research studies have been carried out
by the use of Apamarga, Chitraka, Aragwadha, kutaja,
and Palasha Kshara in various centers in India and no
attention has been paid to other drugs particularly in
Arshas. Therefore there is a need to evaluate the
efficacy of other drugs.
 For this study I am using Nimbadi Pratisaraneeya
Kshara to evaluate its efficacy and advantages in
Arshas

5. Drug reiew
Ingredients of Kshara:
• Nimba twak
• Sudha(lime stone)
• Chitraka

6. Nimba twak ash + 6 times of water Filter 21
times
mild fire
Reduced to
2/3
+
1/10th
red hot
Sudha Reduced to 1/3rd
(Lime
stone)
+
1/10th part of chitraka kalka
Method of preparation
Nimbadi Kshara

7. Clinical plan
 30 patients will be randomly selected from the
Out-patient and In-patient Department of P.G
studies in ShalyaTantra, Dr.BRKR Gov. Ayur
College and Hospital, Hyderabad

8. Inclusive criteria Exclusive
criteria
 Age above 12years
 1st
and 2nd
degree
haemorrhoids
 3rd
and 4th
degree
haemorrhoids
 Carcinoma of
rectum.
 Uncontrolled
Diabetes
mellitus
 HBsAg
 Hypertension
 Retrovirus positive

9. Parameters
Subjective:
 Raktasrava (Bleeding)
 Ruja (Post operative
pain)
Objective:
 Size of the pile mass
 Color of pile mass

10.  Lithotomy position
 Aseptic solutions and draping done after local anesthesia.
Arshoyantra smeared with ghee
 The pile mass should be gently scraped or rubbed and cleaned
 Nimbadi Kshara will be applied
 Hundred Matra Kala
The color of Pakwa Jambhuphala.
 Irrigate with Nimbu Swarasa.
 Anal pack will be done with Yashtimadhu Taila.
Para Surgical Procedure

11. Two pile masses will be applied in a single
sitting.
If more than two, two pile masses in one
sitting and rest of pile mass will be applied in
second sitting after 1 week.
Sittings

12. Review:
Alternate day till 1st
week to assess post opreative recovery,
15th
day,
21st
day,
30th
day to assess the effect of treatment,
And on 3rd
and 6th
month to evaluate recurrence if any.

13. Conclusion
To evaluate the efficacy of Nimbadi
Pratisaraneeya Kshara in the
Management of Arshas.

14. A Clinical Study on the effect of Nimbadi Pratisaraneeya
Kshara in the management of Arshas wsr to I and II Degree
Haemorrhoids
By
Dr. Srinivasa Reddy Bandhi
PG Scholar(MS Shalya 1st
year)
Guide Co Guide
Dr. V. Sudha kumari MD(Shalya) Dr.B. Satyanarayana MD
(Shalya)
Reader,
Sr..Lecturer,
PG Dept. of Shalyatantra PG Dept. of Shalyatantra
DR.BRKR Govt Ayur College,
Hyderabad.