A STUDY OF EFFICACY OF 0.3% TOPICAL NIFEDIPINEOINTMENT IN PATIENTS OF ACUTE AND ACUTE ON CHRONICFISSURE-IN-ANO

Patel Kartavya G; Shalinder Koul; Rahul Yadav; Dr. Heenu Dhar; Gayatri Dua; Dr. Ankita Yadav

Authors

Patel Kartavya G Consultant General & Laparoscopic Surgeon, Divine Life Hospital, Adipur-Kutch, Gujarat, India. Author
Shalinder Koul Associate Professor, Department of Surgery, SGT Hospital, Gurugram, Haryana, India. Author
Rahul Yadav Assistant Professor, Department of Surgery, SGT Hospital, Gurugram, Haryana, India. Author
Dr. Heenu Dhar Professor, Department of Pharmacology, SGT University, Haryana, India. Author
Gayatri Dua MBBS, Department of Surgery, SGT Hospital, Gurugram, Haryana, India. Author
Dr. Ankita Yadav Assistant Professor, Department of Pathology, SGT Uni ersity, Haryana, India. Author

Abstract

Background: Fissure-in-ano is a common surgical problem all over the world & we in our surgical clinics in Gurugram & North India encounter lots of cases of all the age groups. Despite the high prevalence of acute and acute-on-chronic anal fissure in clinical practice, there remains a need for more effective and well-tolerated treatment.Nifedipine, a calcium channel blocker, has shown potential benefits when used topically for this condition. The main goal of treatment is to break the cycle of ischemia, spasm, and discomfort that is hypothesized to have contributed to the formation of fissure in the ano. Objective: To study the efficacy of 0.3% Topical Nifedipine ointment in patients of ACUTE AND ACUTE ON CHRONIC FISSURE-IN-ANO. All the patients were confirmed cases withclinical diagnosis of ACUTE and ACUTE ON CHRONIC FISSURE-IN-ANO. Methods: This prospective and comparative clinical study covers 100 cases of ACUTE and ACUTE ON CHRONIC FISSURE-IN-ANO who agreed for the trial in General Surgery outpatient Department at SGT Medical College, Hospital and Research Institute, Budhera, Gurugram,Haryana, India. This study spanned a period of 18 months. All the Cases were confirmed clinical diagnosis of ACUTE and ACUTE ON CHRONIC FISSURE-IN-ANO.Universal Pain Assessment Tool for pain relief and DRESS scoring done to assess Grading of Anal Spasm during follow up visits of 2, 4, 6, 12 weeks respectively. The Patients were classified into two groups, each consisting of 50 patients were subjected to 0.3% Topical Nifedipine Ointment. Finally we took 100 patients (50 patients in each group). GroupI:included patients diagnosed as Acute Anal Fissure and would be treated with topical application of 0.3% Nifedipine ointment thrice a day, for a period of 6 weeks. Group II:included patients diagnosed as Acute on Chronic Anal Fissure and would be treated with topical application of 0.3% nifedipine ointment thrice a day, for a period of 6 weeks. Results: There was significant reduction in pain in both groups patients over a period of 6 weeks and DRESS scoring showed significant reduction in spasm of anal sphincter in both the groups equally . Conclusion: The present study demonstrates that topical application of 0.3% Nifedipine ointment is an effective and safe treatment option for both acute and acute on chronic anal fissures. The study found significant reductions in pain scores over 6 weeks, with a low incidence of side effects and high rates of complete healing, particularly in acute fissures. The similar trend in DRESS score improvement between the two groups suggests that topical nifedipine was equally effective in promoting fissure healing, regardless ofwhether the fissure was acute or acute on chronic in nature.