Published Paper Details:

Background: Bhagandara (fistula-in-ano) is a chronic and recurring anorectal condition categorized under Ashta Mahagadas in Ayurveda. Despite advancements in modern surgical techniques, high recurrence rates and postoperative complications remain challenges. Ayurvedic parasurgical techniques like Kshara Sutra offer a promising alternative. Objective: To evaluate the clinical efficacy of Chincha (Tamarindus indica) Kshara Sutra in managing Bhagandara and compare its outcomes with the standard Apamarga (Achyranthes aspera) Kshara Sutra. Methods: A randomized clinical study was conducted on 40 patients diagnosed with low anal fistula. Patients were divided into two groups: Group A received Chincha Kshara Sutra, while Group B received Apamarga Kshara Sutra. Clinical parameters including pain, discharge, itching, induration, tenderness, Unit Cutting Time (UCT), and Complete Healing Time (CHT) were assessed. Results: Both groups showed significant relief in subjective symptoms, with over 90% improvement in pain, discharge, and itching. Group A (Chincha) had a mean UCT of 9.59 days/cm and CHT of 32.15 days, whereas Group B (Apamarga) had a mean UCT of 7.55 days/cm and CHT of 26.30 days. Statistical analysis confirmed the efficacy of both treatments, though Apamarga showed slightly faster healing. Conclusion: Chincha Kshara Sutra is an effective, safe, and economical alternative to Apamarga Kshara Sutra in treating Bhagandara. Its comparable efficacy supports its use in clinical practice, especially in settings where Apamarga is seasonally unavailable.