| Topical diltiazem hydrochloride and glyceryl trinitrate in the treatment of chronic anal fissure. | |
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MedLine Citation:
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PMID: 19811710 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To compare the symptomatic relief, healing and side-effects of topical diltiazem (DTZ) and glyceryl trinitrate in the treatment of chronic anal fissure. STUDY DESIGN: Randomized controlled trial. PLACE AND DURATION OF STUDY: The Surgical Outpatient Department of Civil Hospital, Karachi, from March 2006 to February 2007. METHODOLOGY: Patients with chronic anal fissure were included in the study and randomized to two groups. One group was administered topical 2% diltiazem hydrochloride and other was given 0.2% glyceryl trinitrate (GTN), perianally twice daily for 8 weeks. Patients with anal fissure due to other diseases like inflammatory bowel disease, malignancy, sexually transmitted diseases, previous treatment with local ointment or surgery; patients who required anal surgery for any concurrent disease like hemorrhoids, pregnant women and patients with significant cardiovascular conditions were excluded. There were four follow-up sessions during the course of treatment. Healing and side-effects were recorded. Analysis was done by SPSS version 10 on intention-to-treat basis. Chi-square was used where appropriate. RESULTS: Eighty patients with symptomatic chronic anal fissure were included in the study and equally divided into two groups. After 8 weeks of treatment healing occurred in 31 of 40 patients treated with diltiazem and 33 of 40 patients treated with GTN (p = 0.576). There were less side-effects with DTZ (n=13) than with GTN (n=29, p < 0.001]. In particular, headache occurred more commonly with GTN (n=27) than with DTZ (n=9, p < 0.0001). CONCLUSION: Diltiazem hydrochloride and glyceryl trinitrate were equally effective in healing chronic anal fissure. Diltiazem caused fewer side-effects particularly headache than glyceryl trinitrate ointment. Diltiazem may be the first-line treatment for chemical sphincterotomy for the chronic anal fissure. |
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Authors:
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Masood Jawaid; Zubia Masood; Manzar Salim |
Publication Detail:
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Type: Journal Article; Randomized Controlled Trial |
Journal Detail:
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Title: Journal of the College of Physicians and Surgeons--Pakistan : JCPSP Volume: 19 ISSN: 1022-386X ISO Abbreviation: J Coll Physicians Surg Pak Publication Date: 2009 Oct |
Date Detail:
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Created Date: 2009-10-08 Completed Date: 2009-12-11 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9606447 Medline TA: J Coll Physicians Surg Pak Country: Pakistan |
Other Details:
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Languages: eng Pagination: 614-7 Citation Subset: IM |
Affiliation:
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Department of Surgery, Dow University of Health Sciences, Civil Hospital, Karachi. masood@masoodjawaid.com |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Calcium Channel Blockers
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adverse effects,
therapeutic use* Chronic Disease Diltiazem / adverse effects, therapeutic use* Female Fissure in Ano / drug therapy*, surgery Humans Male Nitroglycerin / adverse effects, therapeutic use* Vasodilator Agents / adverse effects, therapeutic use* |
| Chemical | |
Reg. No./Substance:
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0/Calcium Channel Blockers; 0/Vasodilator Agents; 42399-41-7/Diltiazem; 55-63-0/Nitroglycerin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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