Nida Javed, Ejaz Iqbal, Rauf Iqbal, Muhammad Umair Samee, Humaira Bilal 5 Khalid Mehmood Cheema.
Role of Counselling Session in the Conservative Treatment of Anal Fissure.
Pak J Med Health Sci Jan ;13(2):212-1.

Background: Anal fissure is prevalent disease in our community and its treatment varies considerably ranging from topical hydrocortisone, topical 0.2% GTN to Surgical intervention. Aim: To determine the effect of counselling session on the conservative treatment of anal fissure. Methods : Total of 174 patients presenting to surgical OPD of Sughra Shafi Medical Complex, Narowal were randomly assigned into 02 groups and the effects of treatment were monitored according to a proforma on subsequent follow up. All the patients consented for study. Results : The overall fissure healing rate in Group A (n=87) was 87% and in group B (n=87) healing rate was 74%. Total 30 (17.2%) patients who failed conservative treatment were subjected to surgery. No surgical complication was noted. However, one patient from Group B reported with relapse after surgery within one month of surgery who was again given a trial of conservative treatment after proper counselling. Conclusion : Most (87 ) % of anal fissures heal well with conservative treatment if their problem is given appropriate attention. Therefore on findings of our study, we strongly recommend topical 0.2% Glyceryl Trinitrate along with proper counselling as the first line of treatment for anal fissure.

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