Syeda Tooba Bukhari, Sheikh Atiq-ur Rehman, Muhammad Shoaib Abdullah, Syed Talha Bukhari, Javid Iqbal.
Anal Fissure; Comparison Of Effectiveness Of 2% Diltiazem Ointment To 0.2% Glyceryl Trinitrate Ointment In Treatment.
Professional Med J Jan ;24(9):1354-9.

Objectives: To compare the effectiveness of 2% Diltiazem ointment with 0.2% Glyceryl trinitrate ointment. Place & period: The study was conducted in surgical units, Bahawal Vicotria Hospital, Bahawalpur, Pakistan from 01-01-2016 to 31-12-2016. Material & Method: In this prospective comparative study, 160 patients with anal fissure were equally &randomly divided in two group A (received 2%diltiazem ointment) & group B (received 0.2% Glyceryl trinitrate ointment). The ointment had to be applied to anal verge twice daily for 6-8 weeks. Assessment was done at 2nd, 4th & 6th weekends for fissure healing, pain relief & side effects. Results: Complete fissure healing was observed in 80%of patients in group A & 70% in group B (P<0.15). Pain response was good & was fairly similar in both the groups. Headache occurred in 5% in group A & 20% in group B (P<0.002). Mean time taken for healing of fissure in group A was 5.5±0.28 weeks & in group B was 5.8±0.32 weeks (P< 0.237). Recurrence rate was 7.5% in group A & 17.5% in group B. Conclusion: Topical Diltiazem is preferred to topical Glyceryl trinitrate in the treatment of acute & chronic fissure, because it is associated with a few side effects.

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