Comparison of Topical Nifedipine With Oral Nifedipine for Treatment of Anal Fissure: A Randomized Controlled Trial

Golfam, Farzaneh; Golfam, Parisa; Golfam, Babak; Pahlevani, Puyan

doi:10.5812/ircmj.13592

Cited by 16 publications

(14 citation statements)

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“…28 Two patients with persistent ulcer, after two weeks of additional course were healed. In this study that 73 (44.24%) patients had their ulcer healed after 2 weeks of treatment.…”

Section: Discussionmentioning

confidence: 99%

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Effectiveness of conservative management of acute fissure in ano: a prospective clinical study of 165 patients

2017

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Background: Fissure-in-ano is a common yet troublesome condition; if acute, the severity of patient discomfort and extent of disability far exceed that would be expected from a seemingly trivial lesion. The present study was carried out to study the effectiveness of conservative management in symptom relief in acute fissure in ano.Methods: The study was conducted in 165 patients with acute fissure in ano attending Surgery OPD and/or admitted in surgical wards of Sanjay Gandhi Memorial Hospital associated with Shyam Shah Medical College, Rewa during the period from 1st August 2015 to 31st July 2016. It was a prospective clinical study. All the study subjects underwent extensive clinical examination and were prescribed conservative treatment regime. Follow up was done at the end of 2 weeks, 4 weeks and 6 weeks and the data was analyzed. 165 patients diagnosed as having acute fissure in ano. The outcome was assessed based on the following parameters; symptomatic relief, pain relief based on visual analogue scale and healing of ulcer.Results: Most of the patients were young adults with a slight female dominance. Pain during defecation and bleeding per rectum were the major presenting complaints. 73.94% of patients achieved symptom relief within 2 weeks of conservative treatment. At 6 weeks follow up after giving conservative line of management, 97.58% achieved symptom relief with healing of ulcer. Mean pain score was reduced from 9.5±0.71 at the start of therapy to 1.33±0.69 at the end of 6 weeks of conservative therapy.Conclusions: Acute fissure in ano can be easily cured with systematic usage of conservative treatment regime. A proper follow up along with patient education can help to achieve good remission and avoid unnecessary surgical intervention.

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“…28 Two patients with persistent ulcer, after two weeks of additional course were healed. In this study that 73 (44.24%) patients had their ulcer healed after 2 weeks of treatment.…”

Section: Discussionmentioning

confidence: 99%

“…27 In the study by Golfam F et al, pain relief was statistically significant at 4 th and 6 th weeks. 28 We have achieved mean pain score reduction from 9.5 to 4.09 within 2 weeks of initiation of treatment. The mean pain score was 1.91 after 4 weeks and 1.33 after 6 weeks in the present work (Figure 1).…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of conservative management of acute fissure in ano: a prospective clinical study of 165 patients

2017

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“…23 Topical delivery is preferred, given the lower incidence of systemic effects associated with topical calcium channel blockers (4.3% vs 38.0%; p < 0.0001). 22,24…”

Section: Recommendationsmentioning

confidence: 99%

The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Management of Anal Fissures

Davids¹,

Hawkins²,

Bhama³

et al. 2022

Diseases of the Colon &Amp; Rectum

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“…Kalsiyum kanal blokerlerinin keloidler ve yanık üzerine de etkileri araştırılmış ve ilaçların, ekstrasellüler matrikste kollajen depolanmasını önemli derecede azalttığı ve farklı kollajenlerin ekspresyonunu inhibe ettiği bildirilmiştir 58 . Nifedipin, diltiazem, ve lasidipin, anal sfinkter tonusunu düşürdüklerinden kronik anal fissürlerin konservatif tedavisinde oral ve topikal kullanılabilir 59 . Innocenti ve arkadaşları 60 da, kas hücrelerinde kronik kasılmaların önlenerek, kırışıkların derinliğinin azalabileceği hipotezi ile topikal %0,5 nifedipin kremi 64 kadın hastada 90 gün süreyle uygulamışlar ve perioküler kırışıklıkların derinliğinin azaldığını gözlemişlerdir.…”

Section: Renal Etkiunclassified

Pleiotropic Effects of Calcium Channel Blockers

Canbolat¹,

Atalık²

2019

Kafkas J Med Sci

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Calcium channel blockers are a group of drugs that commonly prescribed to treat cardiovascular disorders such as; hypertension, angina pectoris, peripheral vascular disorders and some arrhythmias. Calcium channel blockers, particularly the newer, longer-acting agents, are clearly effective in reducing elevated blood pressure with minimal to modest adverse effect profiles, therefore they are used extensively. These drugs reduce the amount of calcium entering cells of the heart and blood vessel walls, and they cause vasodilatation especially in arterioles. These drugs commonly block L-type of voltagegated calcium channels. Recent studies have shown that some calcium channel blockers also bind to N-and T-type channels. N-type channels are located in high amounts at the presynaptic terminals of neurons. T-type calcium channels known to be present in cardiac and smooth muscle, and also in many neuronal cells in the central nervous system. Blockage of these two types of channels leads to decreased glomerular capillary pressures, stabilization of the reninangiotensin-aldosterone system, and sympathetic nervous system. As a result, especially new generation of calcium channel blockers have effects that are defined as pleiotropic effects, such as reno-protective, vascular endothelial protective and cardio-protective effects.ÖZET Kalsiyum kanal blokerleri, hipertansiyon, angina, periferik vasküler bozukluklar ve bazı aritmiler gibi kardiyovasküler hastalıkların tedavisinde yaygın olarak kullanılan bir ilaç grubudur. Kalsiyum kanal blokerlerinden özellikle daha yeni, daha uzun etkili olanlar, daha düşük yan etki profilleri ile hipertansiyon tedavisinde oldukça etkilidir. Bu ilaçlar, damar düz kası ve kalp hücrelerinde, sitoplazma membranındaki voltaj-bağımlı kalsiyum kanallarına veya reseptörlere yüksek afinite ile bağlanarak kalsiyum girişini azaltırlar, özellikle arteriyollerde düz kasları gevşeterek güçlü vazodilatasyon yaparlar. Voltaj-bağımlı kalsiyum kanallarının çoğunlukla L-tipine bağlanırlar. Yakın zamanda yapılan çalışmalar, bazı kalsiyum kanal blokerlerinin N-ve T-tipi kanallara da bağlandığını göstermiştir. Bunlardan N-tipi kanallar sempatik sinir uçlarında, T-tipi kanallar ise kardiyak sinus nodu ile afferent ve efferent arteriyollerde bulunur. Bu iki tip kanalın blokajı, glomerüler kapiller basıncın azalmasına, renin-anjiotensin-aldosteron sisteminin ve sempatik sinir sisteminin stabilizasyonuna neden olur. Sonuçta, özellikle yeni jenerasyon kalsiyum kanal blokerleri, renoprotektif, vasküler endotel koruyucu etki ve kardiyoprotektif etkiler gibi pleiotropik etkiler olarak tanımlananan etkilere sahiptirler.

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Comparison of Topical Nifedipine With Oral Nifedipine for Treatment of Anal Fissure: A Randomized Controlled Trial

Cited by 16 publications

References 23 publications

Effectiveness of conservative management of acute fissure in ano: a prospective clinical study of 165 patients

Effectiveness of conservative management of acute fissure in ano: a prospective clinical study of 165 patients

The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Management of Anal Fissures

Pleiotropic Effects of Calcium Channel Blockers

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