A CRITICAL REVIEW ON THE EFFICACY OF NIMBADI TAILA AND DURVADYA TAILA IN THE MANAGEMENT OF PARIKARTIKA (FISSURE-IN-ANO)

Abstract

Background: Parikartika (fissure-in-ano) is a painful anorectal disorder described in classical Ayurvedic texts. Conventional surgical and pharmacological options often provide only temporary relief or carry postoperative complications. Classical formulations such as Nimbadi Taila and Durvadya Taila are frequently cited for their Śothahara (anti-inflammatory), Ropaṇa (wound-healing), and Śūlaśamana (analgesic) properties, yet their comparative evidence base has not been comprehensively summarized. AIM AND OBJECTIVES, AIM - To critically evaluate the efficacy of Nimbadi Taila and Durvadya Taila in the management of Parikartika (fissure-in-ano). OBJECTIVES To review classical references of Parikartika and its treatment. To compare the composition and actions of Nimbadi Taila and Durvadya Taila. To assess pharmacological properties of both formulations. To analyze clinical studies on their use in fissure-in-ano. To identify research gaps and future scope. Methods: A narrative critical review was conducted. Electronic databases (PubMed, DHARA, AYUSH Research Portal, Google Scholar) and gray literature were searched up to June 2025 for studies evaluating either or both oils in fissure-in-ano or analogous anorectal wounds. Inclusion criteria encompassed clinical trials, observational studies, case series, and relevant pharmacological investigations published in English or Sanskrit. Data on study design, intervention details, outcome measures (pain score, healing time, bleeding, recurrence), and safety were extracted and qualitatively synthesized. Risk-of-bias was assessed using adapted Joanna Briggs Institute tools. Results: Eleven studies met eligibility (4 randomized controlled trials, 3 quasi-experimental studies, 4 observational/case reports; total n = 438). Across trials, topical application of Nimbadi Taila showed a 45 – 70 % reduction in pain and a mean healing time of 7–10 days, whereas Durvadya Taila demonstrated a 40 – 65 % pain reduction with healing in 8–12 days. Two head-to-head trials favored Nimbadi Taila for faster symptomatic relief (p < 0.05) but found no significant difference in complete wound closure at 4 weeks. No serious adverse events were reported; mild transient burning sensation occurred in <5 % of applications. Pre-clinical assays reveal significant tannin-mediated astringent effects for Durvadya Taila and limonoid-driven anti-inflammatory activity for Nimbadi Taila. Methodological limitations include small sample sizes, heterogeneous outcome metrics, and inadequate blinding. Conclusions: Current evidence—though limited by moderate risk-of-bias—suggests both Nimbadi Taila and Durvadya Taila are safe and potentially effective for accelerating pain relief and wound healing in Parikartika. Nimbadi Taila may offer marginally quicker symptomatic benefit. Rigorous, adequately powered, multicenter randomized trials with standardized outcome measures are warranted to confirm these findings and elucidate mechanisms of action.