BACKGROUND Fistula in ano is one of the common problem faced in today's world. Fistula in ano is track lined by granulation tissue that connect deeply in the anal canal or rectum and superficially on the skin around the anus. It usually results from cryptoglandular infection causing abscess, which burst spontaneously or was drained inadequately. The study is conducted to find most common aetiological factor and to evaluate various surgical technique and their outcome. The aim of the study is to-1. Study the incidence of various aetiologies of fistula in ano. 2. Study the clinical presentation of fistula in ano. 3. Evaluate different modalities of surgical approach and their outcome. MATERIALS AND METHODS This prospective study was conducted at Late Lakhiram Agrawal Memorial Government Medical College, Raigarh, during the study period of July 2015 to July 2016. All the 50 cases were included in this study who were above 15 year of age diagnosed with fistula in ano on the basis of clinical examination who underwent surgical procedure. RESULTS In present study of 50 cases, 60% of cases were in the age group of 31-50 years. Male:female ratio was 9:1. 80% of cases belong to low socioeconomic status. The most common mode of presentation was discharging sinus in 96% of cases. 70% of patient had past history of burst abscess or surgical drainage of abscess. 90% of cases have single external opening. 80% of cases had posterior external opening. Most of the fistula are of low anal type, which was 92% and rest of the patient had an internal opening situated above the anorectal ring. The most common surgical approach done was fistulectomy. Only fistulectomy was done in 80% of patients. Fistulectomy with sphincterectomy was done in two patients. These two patients had associated anal fissure. Fistulectomy with seton placement was done in two patients of high level of fistula type. Fistulotomy was done in four patients (8%), these were of low fistula type and seton tightening was done in two patients (4%), these were of high fistula type. Complete healing period range from 2 weeks to 8 weeks. Maximum patients (72%) got healed in 3-6 weeks. The postoperative complication was very minimal. Recurrence of fistula was observed in two cases. Secondary infection in one case and postoperative bleeding in two cases. CONCLUSION The disease is common in the middle-aged group of 31-50 years with male predominance. Low socioeconomic status is one of the risk factor may be due to illiteracy and poor hygiene. Previously, burst abscess or inadequately drained perianal abscess is the main aetiological factor found. Low type and posterior type of perianal fistula is common with discharging sinus as a commonest mode of presentation. Fistulectomy is the commonest suitable procedure for low type of fistula with less postoperative complication.
The dietary pattern of human being aimed to maintain good health which came in practice after lot of evaluation including trial and error based consideration. The different culture of human civilization offered number of food preparations which help to promote health through different nutritional value. The traditional science of India Ayurveda also aimed to promote and preserve the health and longevity. The various conceptual belongings of ayurveda play vital role towards achieving this goal and dietary consideration is one of them. Ayurveda believe that the dietary consideration as per desha, kala and prakrirti, etc. not only help to promote health but also cure the diseases. Ahara sometimes also used as a curative measure therefore specific diet pattern recommended as prophylactic approach for the prevention of some common diseases. Good quality food stuffs improve memory, energy, digestive power, intellectual and ojas. This article summarized health benefits of food and various rules of ayurveda related to dietary consideration.
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