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ANAL FISSURE - ONE MORE LOSS FOR A SURGEON
OP KAPOOR
Ex. Hon. Physician, Jaslok Hospital and Bombay Hospital, Mumbai, Ex. Hon. Prof. of Medicine, Grant Medical College and JJ Hospital, Mumbai 400 008.
Many surgeons are losing their practice because of marked reduction in the surgery of prostate, appendix, DNS, etc.
The operation for anal fissure not only costs a lot of money but has a very painful post surgery period of recovery. Some patients may even relapse after surgery.
Now it has been convincingly shown that local application of Glycerine Trinitrate Ointment brings about a cure (by dilating the anal sphincter and giving rest to the area) as speedily and adequately, similar to patients who have undergone surgery. But the family physicians have to be careful and to remember that:
a. for heart patients, this ointment is supplied in the concentration of 2%.
b. for anal fissures, a 0.2% concentration is required.
Thus the chemist can be given the ointment told to dilute it 10 times. So, next time, you see a case of anal fissure, try a combination of:
1.Laxatives, to keep the stools soft.
2.Local fomentation to the area by sitting on a bucket of hot water filled upto the brim.
3.Local application of GTN ointment 0.2%.
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