{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T23:35:21Z","timestamp":1777332921057,"version":"3.51.4"},"reference-count":17,"publisher":"Georg Thieme Verlag KG","issue":"02","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Homeopathy"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Acute anal fissure (AF) causes significant pain and discomfort, sometimes requiring invasive treatment. This study evaluates the usefulness and safety of homeopathic Paeonia officinalis mother tincture (Q) in the management of acute AF.<\/jats:p>\n                  <jats:p>An open-label, prospective, pre\u2013post comparison cohort study was conducted on 34 participants diagnosed with acute AF. Paeonia officinalis Q was administered orally (10 drops in 50\u2009mL of water, once daily) for 12 weeks alongside supportive care that included dietary advice. Outcome measures were: pain intensity assessed using a Visual Analog Scale (VAS; range: 0\u201310); level of strain during defecation using the Defecation Strain Score (DSS); Outcome Related to Impact on Daily Living (ORIDL) score for main complaint and overall well-being; and degree of healing of fissure (HoF) by visual clinical examination.<\/jats:p>\n                  <jats:p>VAS score reduced significantly from baseline (8.94\u2009\u00b1\u20090.81) at 12 weeks (0.11\u2009\u00b1\u20090.32), with a mean decrease of 8.82\u2009\u00b1\u20090.13 (p\u2009&lt;\u20090.001), while DSS decreased from a median of 3 to 0 (change, 3; inter-quartile range [IQR], 2\u20133; p\u2009&lt;\u20090.001). ORIDL scores for main complaint increased from 2 to 4 (change, 1; IQR, 1\u20132) and well-being from 3 to 4 (change, 1; IQR, 1\u20131; p\u2009&lt;\u20090.001). By 12 weeks, fissures healed completely in 30 (88.2%) participants, with no serious adverse events reported.<\/jats:p>\n                  <jats:p>Homeopathic Paeonia officinalis Q, combined with concomitant care advice, appears useful in reducing pain and straining while promoting fissure healing in acute AF patients. The potential influence of confounders limits attribution of positive outcomes to the homeopathic intervention alone.<\/jats:p>","DOI":"10.1055\/a-2587-5592","type":"journal-article","created":{"date-parts":[[2025,8,20]],"date-time":"2025-08-20T22:46:00Z","timestamp":1755729960000},"page":"089-094","source":"Crossref","is-referenced-by-count":0,"title":["Paeonia officinalis for Acute Anal Fissure: A Prospective, Single-Group, Open-Label, Pre\u2013Post Comparison Study"],"prefix":"10.1055","volume":"115","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5957-9198","authenticated-orcid":false,"given":"Ashish Kumar","family":"Dixit","sequence":"additional","affiliation":[{"name":"Department of AYUSH, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Moorat Singh","family":"Yadav","sequence":"additional","affiliation":[{"name":"Department of General Surgery, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Danish","family":"Javed","sequence":"additional","affiliation":[{"name":"Department of AYUSH, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Barkati Md","family":"Tarique","sequence":"additional","affiliation":[{"name":"Department of AYUSH, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2025,8,20]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1016\/S0889-8553(05)70172-2","article-title":"Anal fissure","volume":"30","author":"M Jonas","year":"2001","journal-title":"Gastroenterol Clin North Am"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"605","DOI":"10.1007\/s10151-017-1664-2","article-title":"A systematic review and meta-analysis of the treatment of anal fissure","volume":"21","author":"R L Nelson","year":"2017","journal-title":"Tech Coloproctol"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"1335","DOI":"10.1002\/bjs.1800831006","article-title":"Aetiology and treatment of anal fissure","volume":"83","author":"J N Lund","year":"1996","journal-title":"Br J Surg"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1007\/s12262-015-1319-3","article-title":"Local and oral antibiotics with avoidance of constipation (LOABAC) treatment for anal fissure: a new concept in conservative management","volume":"78","author":"P Garg","year":"2016","journal-title":"Indian J Surg"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1055\/s-0031-1272820","article-title":"Anal fissure","volume":"24","author":"K N Zaghiyan","year":"2011","journal-title":"Clin Colon Rectal Surg"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1186\/1471-230X-4-7","article-title":"Botulinum toxin injection versus lateral internal sphincterotomy in the treatment of chronic anal fissure: a non-randomized controlled trial","volume":"4","author":"A Giral","year":"2004","journal-title":"BMC Gastroenterol"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"294","DOI":"10.1055\/s-0043-1771249","article-title":"Reducing pain and promoting healing in acute anal fissure with individualised homoeopathic treatment: a case series","volume":"36","author":"A K Dixit","year":"2023","journal-title":"Homoeopath Links"},{"key":"ref8","first-page":"276","volume-title":"Encyclopedia of Pure Materia Medica","author":"T F Allen","year":"1878","edition":"Vol. VII."},{"key":"ref9","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1186\/s12906-021-03227-z","article-title":"MEBO versus topical diltiazem versus a combination of both ointments in the treatment of acute anal fissure: a randomized clinical trial protocol","volume":"21","author":"M H El Charif","year":"2021","journal-title":"BMC Complement Med Ther"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"3899","DOI":"10.18203\/2349-2902.isj20175160","article-title":"A prospective non-comparative study to assess the effectiveness and safety of combination laxative therapy containing milk of magnesia, liquid paraffin and sodium picosulphate (Cremaffin-Plus\u00ae) in the management of constipation in patients with anal fissure\/hemorrhoids\/obstructive defecation syndrome","volume":"4","author":"R Patankar","year":"2017","journal-title":"Int Surg J"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1186\/1472-6963-7-139","article-title":"Outcome related to impact on daily living: preliminary validation of the ORIDL instrument","volume":"7","author":"D Reilly","year":"2007","journal-title":"BMC Health Serv Res"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"1074","DOI":"10.1007\/BF02234624","article-title":"A randomized trial of oral vs. topical diltiazem for chronic anal fissures","volume":"44","author":"M Jonas","year":"2001","journal-title":"Dis Colon Rectum"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1007\/s10151-010-0604-1","article-title":"Optimal treatment duration of glyceryl trinitrate for chronic anal fissure: results of a prospective randomized multicenter trial","volume":"14","author":"G Gagliardi","year":"2010","journal-title":"Tech Coloproctol"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"1453","DOI":"10.1016\/S0140-6736(07)61602-X","article-title":"The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies","volume":"370","author":"E von Elm","year":"2007","journal-title":"Lancet"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1016\/S0007-0785(71)80037-6","article-title":"Guidelines in the homoeopathic treatment of ano-rectal disorders","volume":"60","author":"H M Blaqui\u00e8re","year":"1971","journal-title":"Br Homeopath J"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"175","DOI":"10.33545\/26164485.2022.v6.i4c.657","article-title":"Role of homoeopathy in the management of anal fissure","volume":"6","author":"S G Patil","year":"2022","journal-title":"Int J Homoeopath Sci"},{"key":"ref17","doi-asserted-by":"crossref","first-page":"770","DOI":"10.1007\/BF02560104","article-title":"Diet and other risk factors for fissure-in-ano. Prospective case control study","volume":"31","author":"S L Jensen","year":"1988","journal-title":"Dis Colon Rectum"}],"container-title":["Homeopathy"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2587-5592.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T22:39:40Z","timestamp":1777329580000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2587-5592"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,20]]},"references-count":17,"journal-issue":{"issue":"02","published-online":{"date-parts":[[2026,4,27]]},"published-print":{"date-parts":[[2026,5]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2587-5592","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["1475-4916","1476-4245"],"issn-type":[{"value":"1475-4916","type":"print"},{"value":"1476-4245","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,20]]}}}