{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,24]],"date-time":"2025-08-24T22:54:05Z","timestamp":1756076045651,"version":"3.37.3"},"reference-count":22,"publisher":"Maad Rayan Publishing Company","issue":"3","content-domain":{"domain":["mejdd.org"],"crossmark-restriction":false},"short-container-title":["Middle East J Dig Dis"],"published-print":{"date-parts":[[2024,7,31]]},"abstract":"<jats:p>Background: Fissure-in-Ano is a common condition of the anorectal region. Most of the time, it is managed non-surgically. There are various drugs used for the treatment of anal fissures. Calcium channel blockers are one of them that reduce the tone of sphincter muscles. The present study compares the efficacy of oral diltiazem and topical 2% diltiazem ointment in patients with chronic anal fissures. Methods: Patients were randomized into two groups. Group A (n=25) received treatment in the form of oral diltiazem, while group B (n=25) received treatment in the form of 2% (weight\/volume) diltiazem ointment for local application in addition to other conservative methods like sitz bath and stool softeners. Outcomes in the form of success of treatment and complications were assessed. Statistical analysis was done using MedCalc software version 14.0. P value of&lt;0.05 was considered significant. Results: The mean age of patients was 32.00\u00b110.67 years in group A and 30.64\u00b19.53 years in group B. Pain relief was significantly better in group B than in group A at the end of the first week (P=0.00018), but at the end of 6th week, no significant difference was observed. Fissure healing was more significant in group B than in group A after 6 weeks (P=0.0152). Conclusion: Local diltiazem ointment is a better option than oral diltiazem for anal fissures with respect to better outcomes and lesser complications.<\/jats:p>","DOI":"10.34172\/mejdd.2024.383","type":"journal-article","created":{"date-parts":[[2024,10,8]],"date-time":"2024-10-08T08:33:15Z","timestamp":1728376395000},"page":"160-165","update-policy":"https:\/\/doi.org\/10.34172\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Comparative Evaluation of Effects of Oral Diltiazem and Topical Diltiazem (2%) Ointment in the Treatment of Chronic Anal Fissure: A Prospective Randomized Study"],"prefix":"10.34172","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-2802-7828","authenticated-orcid":true,"given":"Ekta","family":"Sharma","sequence":"first","affiliation":[{"name":"Department of General Surgery, Government Medical College and Hospital, Sec-32, Chandigarh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pankaj","family":"Dugg","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Government Medical College, Amritsar, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nisha","family":"Rani","sequence":"additional","affiliation":[{"name":"Civil Hospital, SAS Nagar, Punjab, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-5453-6333","authenticated-orcid":true,"given":"Vivek","family":"Pahuja","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Adesh Medical College and Hospital, Vill Mohri, Tehsil- Shahbad, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sushil Kumar","family":"Mittal","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Adesh Medical College and Hospital, Vill Mohri, Tehsil- Shahbad, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harnam Singh","family":"Rekhi","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Government Medical College, Amritsar, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"20123","published-online":{"date-parts":[[2024,7,31]]},"reference":[{"key":"R1","doi-asserted-by":"crossref","unstructured":"Essani R, Papaconstantinou HT. Fissure-in-ano. In: Yeo CJ, ed. Shackelford\u2019s Surgery of the Alimentary Tract, 2 Volume Set. 8th ed. Amsterdam: Elsevier; 2019. p. 1864-70. doi: 10.1016\/b978-0-323-40232-3.00159-x.","DOI":"10.1016\/B978-0-323-40232-3.00159-X"},{"key":"R2","first-page":"2391","article-title":"Common anorectal conditions: part I Symptoms and complaints","volume":"63","author":"Pfenninger JL","year":"2001","journal-title":"Am Fam Physician"},{"key":"R3","doi-asserted-by":"publisher","DOI":"10.1007\/bf02587197"},{"key":"R4","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2168.1997.02484.x"},{"key":"R5","first-page":"13","article-title":"Nitroglycerin and other nonoperative therapies for anal fissure","volume":"8","author":"Stein BL","year":"1997","journal-title":"Semin Colon Rectal Surg"},{"key":"R6","doi-asserted-by":"publisher","DOI":"10.1007\/bf02050639"},{"key":"R7","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2168.2001.01736.x"},{"key":"R8","doi-asserted-by":"publisher","DOI":"10.1016\/s0016-5085(98)80026-7"},{"key":"R9","first-page":"136","article-title":"Surgical management of chronic anal fissure: a descriptive study","volume":"8","author":"Chaudhary SH","year":"2014","journal-title":"Pak J Med Health Sci"},{"key":"R10","doi-asserted-by":"publisher","DOI":"10.5812\/ircmj.13592"},{"key":"R11","doi-asserted-by":"publisher","DOI":"10.1111\/ans.14292"},{"key":"R12","doi-asserted-by":"publisher","DOI":"10.1016\/j.amsu.2020.08.010"},{"key":"R13","doi-asserted-by":"publisher","DOI":"10.7860\/jcdr\/2013\/7656.3698"},{"key":"R14","doi-asserted-by":"publisher","DOI":"10.5604\/01.3001.0014.7879"},{"key":"R15","doi-asserted-by":"publisher","DOI":"10.14260\/jemds\/2014\/3644"},{"key":"R16","doi-asserted-by":"publisher","DOI":"10.1007\/bf02234624"},{"key":"R17","doi-asserted-by":"publisher","DOI":"10.4240\/wjgs.v4.i11.251"},{"key":"R18","doi-asserted-by":"publisher","DOI":"10.2009\/jcpsp.614617"},{"key":"R19","first-page":"280","article-title":"Outcome of 02% glyceryltrinitrate cream versus 2% diltiazem cream in the treatment of chronic anal fissure","volume":"29","author":"Khan MS","year":"2017","journal-title":"J Ayub Med Coll Abbottabad"},{"key":"R20","doi-asserted-by":"publisher","DOI":"10.1046\/j.0007-1323.2001.02042.x"},{"key":"R21","doi-asserted-by":"publisher","DOI":"10.1007\/s00595-006-3431-2"},{"key":"R22","first-page":"1747","article-title":"Topical diltiazem versus topical glyceryl trinitrate (GTN) in the treatment of chronic anal fissure: prospective study","volume":"3","author":"Suvarna R","year":"2012","journal-title":"Int J Biol Med Res"}],"container-title":["Middle East Journal of Digestive Diseases"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/mejdd.org\/index.php\/mejdd\/article\/view\/2854\/2363","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/mejdd.org\/index.php\/mejdd\/article\/view\/2854\/2363","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,10,8]],"date-time":"2024-10-08T08:33:20Z","timestamp":1728376400000},"score":1,"resource":{"primary":{"URL":"http:\/\/mejdd.org\/index.php\/mejdd\/article\/view\/2854"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,31]]},"references-count":22,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2024,7,31]]}},"URL":"https:\/\/doi.org\/10.34172\/mejdd.2024.383","relation":{},"ISSN":["2008-5249"],"issn-type":[{"type":"print","value":"2008-5249"}],"subject":[],"published":{"date-parts":[[2024,7,31]]},"assertion":[{"value":"Iranian Association of Gastroerterology and Hepatology","name":"journal_owner","label":"Journal Owner"},{"value":"Iranian Association of Gastroerterology and Hepatology","name":"journal_publisher","label":"Journal Publisher"},{"value":"2023-09-09","order":1,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-06-08","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-07-31","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}