Outcome of Chemical and Surgical Lateral Internal Sphincterotomy for Acute Anal Fissure
Bibliographic record
Abstract
Anal fissures are common causes of morbidity in the surgical units.The severe pain during and after defecation greatly impacts on the quality of life of many patients.Acute anal fissures responds poorly to medical treatment and are therefore best managed using surgical methods.Lateral internal sphincterotomy is the gold standard in the treatment of anal fissures.Aim: To compare the efficacy of chemical and surgical lateral internal sphincterotomy in patients of acute anal fissure.Methods: A Randomized controlled trial conducted at Department of Surgery, Unit-II, Fatima Memorial Hospital, Lahore.The duration of the Study was over a period of six months from 10-09-2018 to 09-03-2019.A total of 100 patients (50 in each group) were included in the study.Group-A was treated with chemical sphincterotomy local application of glyceryl trinitrate 0.2 percent ointment and Group-B was treated with surgical lateral internal sphincterotomy.Results: Patients were ranged between 15-60 years of age.Mean age of the patients was 36.64±10.05and 33.42±11.47 in group-A and B, respectively.In group-A 13 patients (26%) and in group-B 15 patients (30%) were male and 37 patients (74%) in group A and 35 patients (70%) were female.Efficacy was observed in 16 patients (32.0%) of group-A and 50 patients (100%) of group B. There was a statistically significant difference between two groups (p<0.001).Conclusion: In conclusion, surgical sphincterotomy was significantly more effective in providing postoperative pain relief (p<0.001).However, chemical sphincterotomy is a non-invasive, cost-effective, easier to apply, well-tolerated and effective therapy for anal fissure and is a first line treatment especially in patients who are unwilling or unfit for surgery.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".