A CLINICAL STUDY TO EVALUATE THE EFFICACY OF APAMARGA KSHARA SUTRA LIGATION IN FIGURE-OF-EIGHT TECHNIQUE IN THE MANAGEMENT OF BHAGANDARA W.S.R. FISTULA-IN-ANO

Bhagandara, one of the Ashtamahagada described by Acharya Sushruta, is a chronic anorectal disorder that closely resembles fistula-in-ano in modern medicine. Despite numerous surgical techniques such as fistulotomy, fistulectomy, LIFT, VAAFT, fistula plug etc., recurrence postoperative pain, prolonged healing, and sphincter injury remain major concerns. Apamarga Kshara Sutra therapy is an established Ayurvedic treatment known for its low recurrence and sphincter preservation; however, its prolonged healing time remains a significant limitation. The present clinical study evaluates a modified Figure-of-Eight Kshara Sutra ligation technique designed by Dr. H.S. Bali (Professor and H.O.D, Department of post graduate studies in Shalya Tantra, Jammu institute of Ayurveda and Research, Nardani, Jammu) to accelerate healing while retaining the advantages of conventional Kshara Sutra therapy. The study demonstrated significantly shorter healing duration and lower Unit Cutting Time (UCT) in the modified technique, suggesting improved therapeutic efficiency.