Azhar Shah.
A non-operative management of chronic anal fissure. a study of 50 cases at town teaching hospital, Peshawar.
J Gandhara Med Dent Sci Jan ;4(2):8-11.

OBJECTIVES: Assessment of efficacy of topical 0.2% glyceryl trinitrate ointment in the treatment of chronic anal fissure.PATIENTS AND METHODS: A prospective study was carried out at surgical outpatient department Town Teaching Hospital from January 2017 to July 2017. Fifty consecutive patients were treated with 0.2% glyceryl trinitrate ointment and reviewed at 3, 6 and 12 weeks interval. Data was collected on a designed questionnaire. RESULTS. At six weeks fissure healed in 70% patients. There was significant reduction in the symptoms of pain, bleeding and irritation. 30% Patient treated was not successful. At 03 months interval there was no recurrence with 70% healing rate. Patients whose fissure healed reported an improvement in bodily pain, health perception, vitality and mental health.CONCLUSIONThe use of topical 0.2% glyceryl trinitrate has proved to be as effective option in managing chronic anal fissure with 70% healing rate in this study bearable side effect and it leads to improvement in health related quality of life.

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