Background: Anal fissures and hemorrhoids are common anal conditions. They cause significant morbidity, social embarrassment, and work absenteeism. In addition, they form a significant workload on the healthcare system. Nevertheless, the etiology of these conditions is still contentious. It has been observed that hemorrhoids and anal fissures are associated with prolonged sitting. This study aims to investigate this observation.Methods: This is a case–control study. We compared 81 patients with symptomatic and endoscopically proven hemorrhoids and/or anal fissures with 162 controls with no symptoms or endoscopic evidence of perianal disease. The study was conducted at Khartoum North Teaching Hospital (KNTH) endoscopy unit between January and December 2019. Demographic data, sitting hours per day, and endoscopic findings of patients and controls were recorded in a proforma. The cases and controls were matched for age, sex, and bowel habits. Data were analyzed and compared using the SPSS version 23.Results: The mean sitting hours for cases was 5.99 (SD 3.4) whereas that for controls was 4.0 (SD 3.0) with a highly significant difference (P < 0.001). Sitting for 5 hr or more per day (exposure) was associated with an increased risk of developing hemorrhoids and/or anal fissures [odds ratio 3.68, 95% CI: 2.1–6.47].Conclusion: The study showed that sitting down for 5 hr or more per day might increase the risk of developing hemorrhoids and/or anal fissures. This finding could help in the prevention and treatment of these diseases and the reduction of recurrences.

Background: Cirrhosis is a chronic liver disease in which diffuse destruction and regeneration of hepatic parenchymal cells have occurred. D-dimer is regarded as a diagnostic marker for Portal vein thrombosis in liver cirrhosis. Objective: To correlate plasma D-dimer levels as a hemostatic parameter with Child Turcotte Pugh (CTP) score of post hepatitis cirrhosis patients and occurrence of spontaneous bacterial peritonitis (SBP). Patients and methods: This was a case-control study that included 84 patients with hepatitis C-related cirrhosis who were admitted to Al-Ahrar Teaching Hospital in the period from November 2020 to June 2021. 28 apparently healthy subjects were included as control group.Results: There was a significantly higher level of D-dimer in each cirrhotic group; child A, child B and child C with median of 1.05 mg/l, 2 mg/l and 3 mg/l respectively compared to healthy control group with a median of 0.09 mg/l. The best cutoff of D dimer in prediction of Child C was ≥ 2.45 mg/l with area under curve of 0.986, sensitivity of 96.4%, specificity of 94%, positive predictive value (PPV) of 84.4%, negative predictive value of 98.8 % and accuracy of 94.6% (p < 0.001). There was a statistically significant association between SBP and D dimer, which was significantly higher among those with SBP. Conclusion: D-dimer was correlated with esophageal varices grades and degree of ascites. D-dimer could be a marker for severity of liver disease in patients with post hepatitis c cirrhosis as indicated by Child' score.