Muhammad Ali Nasir, Rehan Masroor, Yasir Arafat, Qasim Butt, Shakil Sarwar.
Injection Sclerotherapy Versus Rubber Band Ligation For Second Degree Hemorrhoids.
Pak Armed Forces Med J Jan ;67(6):996-1002.

Objective: To compare the efficacy of injections Sclerotherapy (IST) and rubber band ligation (RBL) for the treatment of 2nd degree haemorrhoids in terms of improvement in symptoms severity score (SS score) in OPD patients. Study Design: Randomized controlled trial. Place and Duration of Study: It was conducted in surgical OPD of CMH Kohat, from 15th October 2010 to 10th April 2011 Material and Methods: a total of 116 patients with symptomatic 2nd degree haemorrhoids were randomly divided into two groups, RBL and IST (58 patients each) respectively and a baseline symptoms severity score was noted for each patient. Patients in RBL group were treated with RBL while in IST group were treated with IST. the outcome measures were relief of symptoms and improvement in SS score. Results: in RBL group, baseline SS score was 4.67 ± 2.01 which reduced to final mean SS score of 1.34 ± 0.96 whereas in IST group the baseline SS score was of 4.31 ± 2.13 which reduced to a final mean SS score of 1.6 ± 0.97. 44 (75.95%) patients had complete recovery and control of bleeding in RBL group; whereas in IST group 32 (55.1%) of the patients had this response by the end of two weeks. Conclusion: Rubber band ligation was found to have better patient outcomes as compared to injections sclerotherapy in treatment of 2nd degree hemorrhoids.

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