Comparative Evaluation of the Healing Effect of Topical Jayanti (Tridax procumbens) Cream versus Topical Lignocaine and Nifedipine Cream in Parikartika (Acute Fissure in Ano): A Randomised Controlled Trial

Introduction: Fissure in ano is a common anorectal disorder, often characterised by the presence of an ulcer and increased anal sphincter spasm. The primary treatment goals focus on promoting wound healing and reducing sphincter spasm. Conservative management, including a fiber-rich diet and sitz baths, is effective in healing most cases. The disease typically presents with an ulcer in the anal canal as a key symptom. Aim: To evaluate the efficacy of topical Jayanti (T. procumbens) cream vs lignocaine and nifedipine cream in healing of Parikartika (acute fissure in ano). Materials and Methods: The present single-blind, doublearm, randomised controlled trial involved 70 patients with acute fissure in ano, and was conducted from April 2023 to November 2024. The patients were divided into two groups: Group A (Lignocaine 1.5% w/w and Nifedipine 0.3% w/w cream), and Group B (Jayanti (T. procumbens) cream), with 35 patients in each group. Statistical analysis was performed using the Statistical Package for Social Sciences (SPSS) statistical software v 29.0. A p-value of less than 0.05 was considered statistically significant. The evaluation parameters, including wound healing, anal spasm, per rectal bleeding, pain, and itching, were assessed. Results: In group A (n=35), the mean score for wound healing improved from 2.40 on Day 0 to 0.46 on Day 30, while in group B (n=35), the score reduced from 2.37 to 0.31 over the same period, both showing statistical significance with p=0.0001. Spasm scores in group A (n=35) decreased from 0.86 on Day 0 to 0.14 by Day 30, and from 0.74 to 0.14 in group B (n=35), with p=0.0001. Per rectal bleeding in group A (n=35) dropped from 2.00 on Day 0 to 0.29 on Day 30, and from 1.57 to 0.23 in group B (n=35), with p=0.0001. For group A (n=35), improvement in itching after treatment showed a reduction from 23 to five patients, and for group B (n=35), from 25 to 7. The Chi-square (c2) values were 19.28 for group A (n=35) and 16.64 for group B (n=35). However, a p-value of 0.751 indicated no statistically significant difference between the two groups at the 95% confidence level after treatment. Conclusion: Lignocaine and Nifedipine cream (Group A) and Jayanti (T. procumbens) cream (Group B) on the symptoms of Parikartika (acute fissure in ano) were found to be equally efficacious, with both treatments showing statistically significant improvements across the overall assessment criteria.