Background and Aims: Chronic anal fissure (CAF) is usually managed with surgical modalities but it imposes huge cost with recurrence rates. Hence, topical therapies are preferred is such cases which has a good patient acceptability rate. The present study aims to compare the topical metronidazole (MTZ), diltiazem (DTZ), and glyceryl trinitrate (GTN) in terms of healing rate and pain reduction in CAF patients. Methods: This was a randomized and prospective study conducted on 90 patients with CAF. The patients were grouped as follows (n=30), Group 1; 1% MTZ gel, Group 2; 0.2% Nitroglycerin ointment, and Group 3 (n=30): 2% DTZ ointment. The patients were evaluated at 2, 4, and 6 weeks for pain using visual analogue score (VAS) and healing rate. The results were compared and p<0.05 was considered as significant. Results: The VAS scores between the groups was found to be non-significant (p>0.05), however the VAS scores where markedly reduced within the group at 6 weeks. The healing rate was higher in MTZ group (90%) as compared to GTN (83.3%) and DTZ group (83.3%) but it was not significant. Regarding side effect, burning sensation was observed in MTZ and GTN, DTZ groups were devoid of side effects. Conclusion: The MTZ was more effective with good healing rate but with few side effects. Regarding the pain reduction, all the groups displayed equivocal effects. Thus topical MTZ is a suitable agent for the faster healing of CAF and thus avoids the requirement of surgical options.

Objective: Lichtenstein method is a gold standard surgery modality for the management of inguinal hernia but it is associated with post-operative complications such as groin pain, abdominal wall thickness, and surgical site infections. Desarda method is a physiologic non-mesh repair with no anticipated mesh related complications. The present prospective randomized study was conducted to compare short term outcomes of Desarda with Lichtenstein technique for the management of inguinal hernia. Methods: This was a prospective randomized study conducted on 60 patients undergoing surgery for inguinal hernia. The patients were allocated into two groups as follows, Group A (n=30) patients undergoing Desarda’s repair for inguinal hernia and Group B (n=30) patients undergoing Lichtenstein’s repair. The following outcome was measured, post-operative pain (Day 1, Day 3, Day 5) – visual analog scale, duration of hospital stay and complications. p value <0.05 was considered significant. Results: The demographics characteristic were similar in both the groups and not significant. The hospital stay duration was lower in Desarda group as compared to Lichtenstein groups and was significant (4.07±0.83 vs. 6.87±1.87 days). The post-operative VAS score at day 1, 3, and 5 were significantly lower in Desarda group as compared to Lichtenstein group. The incidence of complications were lesser in Desarda group as compared to Lichtenstein group but not significant. Conclusion: The Desarda technique was superior when compared to Lichtenstein method in terms of early recovery, post-operative pain, and complications for the management of inguinal hernia.