A prospective, randomized, double-blind study comparing the efficacy of diltiazem, glyceryl trinitrate, and lidocaine for the treatment of anal fissure in children.
Summary of "A prospective, randomized, double-blind study comparing the efficacy of diltiazem, glyceryl trinitrate, and lidocaine for the treatment of anal fissure in children."
PURPOSE:
Anal fissure (AF) is a common perianal condition in children. Although adult patients with AF have been treated successfully using diltiazem, it has not been studied in children. The present randomized, prospective, double-blind study assessed the response, side effects, and recurrence of diltiazem.
METHODS:
Ninety-three children with AF were randomly divided into three groups. Each group received topical ointment. Group GTN received 0.2% glyceryl trinitrate, group L received 10% lidocaine, and group D received 2% diltiazem ointment.
RESULTS:
Eighty-two patients completed the 12-month study. At the end of the first 8-week course, the healing rate in group D was significantly higher than that of the other groups (p < 0.0001, χ (2) = 19.82). Nonresponders received a second course of the same treatment. Group D showed significantly higher healing rates than the other groups (p < 0.05, χ (2) = 7.227) at the end of the second 8-week course. The group D recurrence rate was significantly different than that of the other groups (p < 0. 002, χ ( 2 ) = 12.79).
CONCLUSION:
Diltiazem application is effective and safe for the treatment of AF in children, and has a low recurrence rate. The smooth dose-concentration curve causes minimal side effects.
Affiliation
Çocuk Cerrahisi Anabilim Dali, Harran Universitesi Tip Fakultesi, Morfoloji Binasi, Yenisehir Kampusu, 63300, Sanliurfa, Turkey, cevikmuazzez@gmail.com.
Journal Details
This article was published in the following journal.
Name: Pediatric surgery international
ISSN: 1437-9813
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/22212494
- DOI: http://dx.doi.org/10.1007/s00383-011-3048-4
Medical and Biotech [MESH] Definitions
Prospective Payment Assessment Commission
The commission charged with evaluating issues and factors which affect the implementation of the PROSPECTIVE PAYMENT SYSTEM.
Double-blind Method
A method of studying a drug or procedure in which both the subjects and investigators are kept unaware of who is actually getting which specific treatment.
Prospective Studies
Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group.
Blind Loop Syndrome
A malabsorption syndrome that is associated with a blind loop in the upper SMALL INTESTINE that is characterized by the lack of peristaltic movement, stasis of INTESTINAL CONTENTS, and the overgrowth of BACTERIA. Such bacterial overgrowth interferes with BILE SALTS action, FATTY ACIDS processing, MICROVILLI integrity, and the ABSORPTION of nutrients such as VITAMIN B12 and FOLIC ACID.
Diltiazem
A benzothiazepine derivative with vasodilating action due to its antagonism of the actions of CALCIUM ion on membrane functions.
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