scholarly journals CHRONIC ANAL FISSURE

2011 ◽  
Vol 18 (04) ◽  
pp. 562-565
Author(s):  
ABID HUSSAIN ◽  
KISHWAR NAHEED
Keyword(s):  
Anal Fissure ◽  
Chronic Anal Fissure ◽  
Medical Center ◽  
Anal Verge ◽  
Symptomatic Relief ◽  
First Line ◽  
Detailed History ◽  
History Of ◽  
First Line Treatment

Objective: To determine the role of chemical syphincterotomy as non surgical management of chronic anal fissure. Study Design: Descriptive. Setting: This study was conducted at Margalla teaching Hospital and United Medical center .Rawalpndi. Period: 1½ years. Patients & Methods: This study included 70 patients of either sex. A personal bio data and detailed history of dietary and bowel habits were registered. Topical 0.2% GTN (Gylciryltrinitrate) was applied to anal verge 2 times per day for the period of two months and its effects were noted. Result: 58 patients (83%) got symptomatic relief and 12 patients (17%) did not get improvement. Conclusions: Chemical syphincterotomy heals majority of the fissure . Topical 0.2% GNT ointment is widely used as a first line treatment in U.K . It is generally accepted as an effective treatment for chronic fissure .

scholarly journals COMPARISON OF LATERAL INTERNAL PARTIAL SPHINCTEROTOMY AND TOPICAL USE OF GLYCERYLTRINITRATE OINTMENT (0.2%) IN THE MANAGEMENT OF CHRONIC ANAL FISSURE

1969 ◽  
Vol 4 (2) ◽  
pp. 487-491
Author(s):  
AJMAL KHAN ◽  
SAMIULLAH ◽  
MANZOORALI
Keyword(s):  
Anal Fissure ◽  
Chronic Anal Fissure ◽  
Symptomatic Relief ◽  
Prospective Trial ◽  
Anal Continence ◽  
First Line ◽  
Chi Square ◽  
Chi Square Test ◽  
Glyceryl Trinitrate Ointment ◽  
To Receive

OBJECTIVE: The objective of this study was to compare the results of surgical internalsphincterotomy with that of local 0.2% Glyceryltrinitrate ointment (chemical, sphincterotomy) in thetreatment of chronic anal fissure.STUDY DESIGN: This is a descriptive, comparative, prospective study.PLACE AND DURATION OF STUDY: The study was conducted in the Department Of SurgerySaidu Group of Teaching Hospital Saidu Sharif Swat from January 2011 to January 2014.PATIENTS AND METHODS: Total of one hundred and fortypatients between the age of 15 and 60years with chronic anal fissure were randomized in a prospective trial to receive either surgicalsphincterotomy or 0.2% Glyceryl trinitrate ointment locally. Patients were followed up at 2 weeks’interval for 14 weeks. Symptomatic relief, fissure healing and anal continence were the parameter forthe outcomes. Data was analyzed using SPSS version 16 employing chi-square test(X test). A p-valuebelow 0.05 was considered statistically significant.RESULTS: Surgical sphincterotomy was significantly more effective in providing pain relief and wasassociated with significantly better fissure healing at 6 weeks and 10 weeks, in all 66(100%)patients(both p<0.01). There were persistent problems with compliance in ointment group related to slowhealing ( 42(67.74%) patients} and longer time needed for symptomatic relief ( 50(80.64%) patients}.Minor incontinence was (4.54%) in sphincterotomy group and none inointment group (p>0.05).CONCLUSION: lateral partial internal sphincterotomy is an effective first line management for chronicanal fissure. This has excellent symptoms relief, a better healing response and low recurrence rates.KEYWORDS: Anal fissure, sphincterotomy, 0.2% GTN ointment

scholarly journals LATERAL INTERNAL SPHINCTEROTOMY

2011 ◽  
Vol 18 (03) ◽  
pp. 350-353
Author(s):  
SHAZIA JAHAN ◽  
MUHAMMAD ATEEQ
Keyword(s):  
Conservative Treatment ◽  
Anal Fissure ◽  
Chronic Anal Fissure ◽  
Symptomatic Relief ◽  
Lateral Internal Sphincterotomy ◽  
General Surgeon ◽  
Female Population ◽  
Internal Sphincterotomy ◽  
Female Patients ◽  
History Of

Objective: To observe the prevalence of anal fissure, and outcome of open lateral internal sphincterotomy in terms of symptomatic relief, fissure healing and complications of procedure in female population. Study Design: Cross sectional, Prospective interventional. Setting & Duration: Surgical Unit DHQ (Teaching) Hospital Rawalpindi, Women Medical Complex Sialkot over a period of seven years from 2003 to 2010. Methodology: Female Patients with chronic anal fissure with history of failed conservative treatment were included in the study after taking informed consent. All patients were evaluated and managed by consultant General Surgeon and were subjected to open lateral internal sphincterotomy (LIS). Results: Two hundred and seventy three female patients of mean age of 39.5 years with chronic anal fissure and history of failed / noncompliance to conservative treatment were enrolled in this study. All patients underwent open lateral internal anal sphincterotomy. Post operatively had excellent recovery, were ambulant on same day. Minor complications were noted in 44 patients (0.16%). Moderate pain at operation site was the commonest complication seen in 32 patients (0.11%). No major complication like permanent incontinence of flatus and feces or recurrence was reported in any of the patients. Conclusions: Lateral internal sphincterotomy remains an effective treatment for chronic anal fissure in the hands of experienced surgeon with highest patient satisfaction, and should be considered as the first line therapy in chronic and resistant / recurrent acute anal fissures.

A REVIEW ON THE ROLE OF TYROSINE KINASE INHIBITORS AVAILABLE FOR THE MANAGEMENT OF CHRONIC MYELOID LEUKEMIA

2020 ◽  
Vol 7 (2) ◽  
pp. 205-211
Author(s):  
Kaynat Fatima ◽  
Syed Tasleem Raza ◽  
Ale Eba ◽  
Sanchita Srivastava ◽  
Farzana Mahdi
Keyword(s):  
Chronic Myeloid Leukemia ◽  
Tyrosine Kinase ◽  
Protein Kinases ◽  
Tyrosine Kinase Inhibitors ◽  
Myeloid Leukemia ◽  
Kinase Inhibitors ◽  
Line Treatment ◽  
First Line ◽  
First Line Treatment

The function of protein kinases is to transfer a γ-phosphate group from ATP to serine, threonine, or tyrosine residues. Many of these kinases are linked to the initiation and development of human cancer. The recent development of small molecule kinase inhibitors for the treatment of different types of cancer in clinical therapy has proven successful. Significantly, after the G-protein-coupled receptors, protein kinases are the second most active category of drug targets. Imatinib mesylate was the first tyrosine kinase inhibitor (TKI), approved for chronic myeloid leukemia (CML) treatment. Imatinib induces appropriate responses in ~60% of patients; with ~20% discontinuing therapy due to sensitivity, and ~20% developing drug resistance. The introduction of newer TKIs such as, nilotinib, dasatinib, bosutinib, and ponatinib has provided patients with multiple options. Such agents are more active, have specific profiles of side effects and are more likely to reach the necessary milestones. First-line treatment decisions must be focused on CML risk, patient preferences and comorbidities. Given the excellent result, half of the patients eventually fail to seek first-line treatment (due to discomfort or resistance), with many of them needing a third or even further therapy lines. In the present review, we will address the role of tyrosine kinase inhibitors in therapy for chronic myeloid leukemia.

scholarly journals Balloon tracheoplasty for tracheal stenosis after prolonged intubation: a simple procedure, but is it effective?

2021 ◽  
Vol 29 (1) ◽  
Author(s):  
Abdallah Nosair ◽  
Mahmoud Singer ◽  
Mohamed Elkahely ◽  
Rezk Abu-Gamila ◽  
Waleed Adel
Keyword(s):  
Tracheal Stenosis ◽  
Balloon Dilatation ◽  
Simple Procedure ◽  
Symptomatic Relief ◽  
Additional Treatment ◽  
Prolonged Intubation ◽  
Midterm Outcome ◽  
History Of ◽  
Balloon Tracheoplasty

Abstract Background Tracheal stenosis following prolonged intubation is a relatively rare but serious problem. This condition is usually managed by surgical or endoscopic interventions. Bronchoscopic balloon dilatation for tracheal stenosis is considered a valuable tool used for the management of tracheal stenosis. In this article, we try to evaluate the role of balloon tracheoplasty in the management of tracheal stenosis and to assess the number of dilatation sessions usually needed as well as the short to midterm outcome. Results This study involved 40 patients with tracheal stenosis diagnosed by computed tomography (neck and chest) and bronchoscopy at the Security Force Hospital in Riyadh, KSA, between January 2013 and August 2018. Patients’ data were retrospectively reviewed and analyzed. Patients’ age ranged between 18 and 60 years. Thirty patients were males (75%); those patients underwent balloon tracheoplasty via dilatation of areas of narrowing using catheter balloon insufflation guided by fiber-optic bronchoscope. Ninety-five percent of the patients had initial success with acceptable dilatation of the stenotic area and improvement of the symptoms. There were no technical or major problems which resulted from the procedure, and no patient complained of severe pain or severe discomfort after the procedure. From the total of 81 BBD sessions, no in-hospital mortality is related to the procedure itself, and ICU stay ranged between 1 and 5 days post-procedure. Among those 40 patients, 16 patients (40%) needed one session, 10 patients (25%) needed two sessions, 8 patients (20%) needed three sessions, and 6 patients (15%) needed more than three sessions of balloon dilatation. Conclusion Balloon tracheoplasty is a simple, safe method and could be a promising and effective approach that offers immediate symptomatic relief for tracheal stenosis in cases with a history of prolonged intubation. It is worth mentioning that BBD is considered as a temporary measure, and most of the cases will need definitive or additional treatment either resection or stent placement.

scholarly journals The Role and Clinical Effectiveness of Multiline Chemotherapy in Advanced Desmoplastic Small Round Cell Tumor

2021 ◽  
Vol 15 ◽  
pp. 117955492098710
Author(s):  
Hyehyun Jeong ◽  
Yong Sang Hong ◽  
Young-Hoon Kim ◽  
Chan Wook Kim ◽  
Si Yeol Song ◽  
...  
Keyword(s):  
Medical Center ◽  
Complete Resection ◽  
Cell Tumor ◽  
Line Treatment ◽  
Round Cell ◽  
First Line ◽  
Round Cell Tumor ◽  
Small Round Cell Tumor ◽  
Small Round Cell ◽  
First Line Treatment

Background: A multimodal approach is the standard treatment for desmoplastic small round cell tumor (DSRCT); however, many patients are diagnosed with inoperable disease, which leaves chemotherapy as the only treatment option. There are limited data on the effectiveness of palliative chemotherapy, especially when used after first-line treatment. Here, we evaluated the clinical outcomes of patients with DSRCT treated with multiple lines of chemotherapy. Methods: We reviewed medical records of 14 patients with pathologically confirmed DSRCT at Asan Medical Center between 2004 and 2018. Results: The median age at diagnosis was 25, with males comprising 92.9% of patients. All patients had inoperable disease at presentation and received chemotherapy as the initial treatment. Four patients (28.6%) were treated with surgery, and complete resection was achieved in 1 patient. Median overall survival (OS) was 23.9 months, and 1-, 2-, and 3-year survival rates were 92.9%, 48.6%, and 19.5%, respectively. In patients receiving first- (N = 14), second- (N = 10), and third-line (N = 8) chemotherapy, median time-to-progression was 9.9, 3.5, and 2.5 months, respectively, and the disease control rates were 100%, 88.9%, and 75.0%, respectively. Factors associated with longer OS in the univariable analysis were ⩽2 metastatic sites at presentation (27.0 vs 14.7 months; P = .024) and surgery with intended complete resection (43.5 vs 20.1 months; P = .027). Conclusions: Although advanced DSRCT may initially respond to chemotherapy after first-line treatment, the response becomes less durable as the disease progresses. Individualized treatment decisions focused on palliation should be made.

scholarly journals Role of VAD Regimen as the First-Line Treatment in Multiple Myeloma

2013 ◽  
Vol 8 (2) ◽  
pp. 64-69
Author(s):  
SS Mahmood ◽  
AKM Abedin ◽  
H Islam ◽  
N Jubaida ◽  
NM Kawsar ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Line Treatment ◽  
First Line ◽  
First Line Treatment

DOI: http://dx.doi.org/10.3329/jafmc.v8i2.16357 JAFMC Vol.8(2) 2012 pp.64-69

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