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ABSTRACT:
Introduction: Acute anal fissue presents with severe disabling anal pain in all individuals of either sex. Anal fissure poses a peculiar problem to the patient and the surgeon due to severe pain and bleeding. It short of self inspection as lesion lies outside field of vision of the patient and allows only gentle inspection with almost no palpation by the surgeon .There are apprehensions in the minds of patients regarding modes of treatment like medical or surgical and of their outcomes. Anal fissures present with intolerable anal pain, spasm due to hypertonicity and hypertrophy Internal Anal Sphincter and bleeding in the form streak along with stools.A sinister cycle of preferring painful act of defecation, hardening of stools and further extending of fissure line deepens crisis. The symptoms are out of proportion to signs limiting or postponing examination by the surgeon and necessitating administration of immediate pharmacotherapy. Aims and Objectives: The study evaluated and compared the effects of topical nifedipine-lignocaine combination(Anorelief) with topical sucralfate-lignocaine(Sucralano) combination in patients of acute anal fissure. Material and Methods: Fifty patients of acute anal fissure were studied. They were randomly divided into two groups of 25 patients each. In one group, patients undergone treatment with topical nifedipine (0.3%)- lignocaine (1.5%) cream(TNLC) and in second group,topical sucralfate (7%)-lignocaine(4%) cream .The patients were instructed to apply cream locally into the anal canal twice daily for 3 weeks passing stools. The patients were assessed for pain, bleeding, discharge, constipation, fissure healing and any side effect at 1st, 2nd and 3rd weeks of follow up. Results and Conclusion: Results were seen more promising with nifedipine- lignocaine cream (Anorelief) as compared to sucralfate - lignocaine cream (Sucralano) in acute anal fissure due to better improvement in pain, bleeding and better fissure healing.
Key Words: Acute anal fissure; Topical Nifedipine -Xylocaine cream(Anoreief);Topical Sulcralfate -Xylocaine cream (Sucral ano)
INTRODUCTION
Anal fissure is notorious for severe pain, short of self inspection due to its location and allows only gentle inspection with almost no palpation by the surgeon. There are apprehensions in the minds of patients regarding modes of treatment medical or surgical and their outcomes.
Anoderm is richly innervated with somatic sensory nerves for light touch and pain.1 The posterior anal commissure is poorly perfused, while Internal...