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CHARACTERISTICS AND CLINICAL MANAGEMENT OF FEMALE PATIENTS WITH FISSURE IN ANO IN AL-KADHIMIYA CITY, BAGHDAD

Author: Qahtan A. Mahdi قحطان عدنان مهدي
Journal: IRAQI JOURNAL OF MEDICAL SCIENCES المجلة العراقية للعلوم الطبية ISSN: P16816579,E22244719 Year: 2013 Volume: 11 Issue: 3 Pages: 238-242
Publisher: Al-Nahrain University جامعة النهرين

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Abstract

Background:Fissure in ano is a common painful anal problem in female patients.Objective:To study the sociodemographic variables of female patients with fissure in ano, and to identified the characteristic of anal fissure and their treatment among those patient in Al-Imamian Al-Kadhimiyian Medical City and two private hospitals.Methods:This is a prospective study that was carried out from May 2008 to May 2011. Two hundred fifty female patients with fissure in ano were interviewed regarding their age, marital state, address, level of education, clinical presentation and the subsequent management.Result:The commonest age of presentation in females was between 21-30 years. 78% of them were living at the peripheral areas of north of Baghdad, and 79.6% were of low level of education (primary school or below). The prevalence was found more in women with high parity especially when their child delivery was supervised by a midwife in their location. All patient has presented with anal pain, 55% were associated with bleeding per rectum and 64.2% with constipation. The location of fissures was 51.6% anterior, 48% posterior, 0.4% lateral in position. Less than half of patients underwent a surgical treatment. 77% of them were treated by lord dilatation under anesthesia and 23% by lateral sphinecteromty.Conclusion:Factors which had an impact on the clinical course and management of fissure in ano in female patients were found to be the social status, the level of education and the parity, therefore to prevent this illness, a cooperation between the heath services and the family health center and the government is necessary in order to overcome such a common problem.Keywords:Fissure in ano, Female

Keywords

Fissure in ano --- Female


Article
Chemical sphincterotomy is good alternative option to surgery In Management of chronic fissure in ana

Author: Ali Mahmood Ghazi علي محمد غازي
Journal: AL-yarmouk Journall مجلة كلية اليرموك الجامعة ISSN: 20752954 Year: 2017 Volume: 9 Issue: 9 Pages: 95-100
Publisher: College Yarmouk University كلية اليرموك الجامعة

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Abstract

Anal fissure is a common disorder which may cause symptoms at any age. Internal anal sphincterotomy is the gold standard surgical treatment which lowers the resting anal pressure and effectively heals the majority of fissures. However the post operative period may be marked by surgical risks, complications and late incidence of incontinence that is some times permanent. These complications have led to a search for alternative therapies for the treatment of chronic anal fissure. Chemical sphincterotomy has been tried using a variety of novel agents including topical glyceryl trinitrate (GTN), calcium channel blockers such as nifedipine or diltiazem and botulinum toxin. Some of these agents were found to be effective in healing chronic anal fissure with negligible side effects and are now considered as first line treatment for chronic anal fissure

استخدام العلاج الكيماوي في علاج الفطر الشرجي المزمن كبديل للعملية الجراحية وتبين لي ذلك من خلال دراسة اجريتها على مرضى في مستشفى الثورة التعليمي البيضاء ليبيا وفي مستشفى الكرامة التعليمي بغداد وعيادتي على مرضى يعانون من مرض الفطر الشرجي المزمن وعددهم 105 مرضى. النتائج سبعون مريض من مجموع مائه وخمسة مرضى استخدموا العلاج لمدة شهر ونصف تماثلوا للشفاء التام وكانت الدراسة من كانون الأول 2009 الى 2016. استنتاجات نستنتج من الدراسة بان العلاج الكيماوي للفطر الشرجي المزمن فعال وامن وبدون مضاعفات مقارنه بالعملية الجراحية التي ممكن يحدث فيها مضاعفات كعدم السيطرة على الهواء الذي يخرج من الشرج او البراز.


Article
Anal Fissure: Is it becoming a medical disorder?

Author: Ali Al-shaham, CABS*. Kadhim Jawad, CABS**, Serene A.A, MS***
Journal: Al-Kindy College Medical Journal مجلة كلية الطب الكندي ISSN: 18109543 Year: 2014 Volume: 10 Issue: 2 Pages: 1-4
Publisher: Baghdad University جامعة بغداد

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Abstract

An anal fissure which does not heal with conservative measures as sits baths and laxatives is a chronic anal fissure. Physiologically, it is the high resting tone of the internal anal sphincter that chiefly interferes with the healing process of these fissures. Until now, the gold standard treatment modality is surgery, either digital anal dilatation or lateral sphincterotomy. However, concerns have been raised about the incidence of faecal incontinence after surgery. Therefore, pharmacological means to treat chronic anal fissures have been explored.A Medline and pub med database search from 1986-2012 was conducted to perform a literature search for articles relating to the non-surgical treatment of chronic anal fissure.Pharmacological sphincterotomy using Glyceryl trinitrate , Isosorbide dinitrate or calcium channel blockers are exciting alternative treatment , that relaxes the anal sphincter and, therefore, promote healing, the drawback of such medications are headache and poor compliance. With the introduction of Botulinum toxin as mean of chemical sphincterotom, topical injection of Botulinum toxin reduces the anal hypertonia which lasts for few months, allows the fissure to heal, thus eliminating the need for surgery without incidence of incontinence. Cure rates are over 60%, and the procedure can be repeated safely. Therefore, Botulinum toxin is a reasonable first-line management of chronic anal fissure and the relapses can be managed by surgeryKeywords: Non-surgical treatment of anal fissure, fissure in ano, sphicterotomy,botulinum toxin in anal fissures, glyceryl trinitrate. Chemical sphincteratomy, pharmacological sphincteratomy.

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