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Burtic SR, Castiglione L, Murariu M, Rosca O, Dumitru C, Neagoe O. Assessment of Quality of Life in Patients with Chronic Anal Fissures: A 1-Year Follow-Up Study before and after Botulinum Toxin (Botox) Injection. J Clin Med 2024; 13:316. [PMID: 38256449 PMCID: PMC10816032 DOI: 10.3390/jcm13020316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Revised: 01/02/2024] [Accepted: 01/03/2024] [Indexed: 01/24/2024] Open
Abstract
This longitudinal study aimed to assess the quality of life in patients with anal fissures treated with botulinum toxin (Botox) injections over a one-year period. The study hypothesized that Botox injections would significantly improve quality of life and that these improvements would be sustained over a year. Conducted as a cross-sectional study, it assessed adults diagnosed with chronic anal fissures unresponsive to conventional treatments. Participants received 25 U of Botox in two sessions and their quality of life was assessed using the WHOQOL-BREF, COPE-60, Hospital Anxiety and Depression Scale (HADS), and SF-36 surveys. Data were collected at baseline six months and one year post-treatment. The study involved 113 patients, with a mean age of 38.1 years. Significant improvements were observed in the WHOQOL-BREF scores across all domains from baseline to 12 months (physical domain: 49.4 ± 10.5 to 70.2 ± 10.6, p < 0.001; mental domain: 34.8 ± 11.2 to 61.9 ± 11.5, p < 0.001). SF-36 scores also showed significant enhancements in physical and mental health components (physical: 44.3 ± 7.5 to 56.9 ± 5.9, p < 0.001; mental: 41.1 ± 7.2 to 54.4 ± 6.3, p < 0.001). Additionally, significant improvements were noted in patient perception on quality of life from the perspective of various aspects including physical discomfort, pain management, and mood and emotional well-being. The study demonstrated that Botox injections significantly improved the quality of life in patients with chronic anal fissures, with sustained benefits observed over a year. These findings suggest Botox as an effective treatment modality for enhancing life quality in patients with this condition, highlighting the potential for broader applications in managing chronic anal fissures.
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Affiliation(s)
- Sonia-Roxana Burtic
- Doctoral School, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania;
- Department II, Discipline of Medical Communication, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Luca Castiglione
- Doctoral School, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania;
- Department of General Surgery, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania;
| | - Marius Murariu
- Department of General Surgery, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania;
| | - Ovidiu Rosca
- Department of Infectious Diseases, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania;
| | - Catalin Dumitru
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania;
| | - Octavian Neagoe
- Second Discipline of Surgical Semiology, First Department of Surgery, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
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Momayez Sanat Z, Mohammadi Ganjaroudi N, Mansouri M. The Effect of Topical Nifedipine versus Diltiazem on the Acute Anal Fissure: A Randomized Clinical Trial. Middle East J Dig Dis 2023; 15:121-125. [PMID: 37546514 PMCID: PMC10404091 DOI: 10.34172/mejdd.2023.330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 02/09/2023] [Indexed: 08/08/2023] Open
Abstract
Background: The anal fissure is one of the most common anorectal diseases that is associated with reduced quality of life and productivity loss. We aimed to compare the efficacy of topical nifedipine and diltiazem for the treatment of acute anal fissure (AAF). Methods: This single-blind randomized clinical trial was conducted at Ziaeian hospital, Tehran. Patients with an acute fissure diagnosis were allocated to two groups. Group A applied 3 grams of 0.3% nifedipine cream on the peri-anal area, three times a day, for 8 weeks. Group B also applied the same amount of 2% diltiazem-ointment on the peri-anal area for the same period. The primary outcome was fissure remission in the 8th week of the treatments. The duration of pain relief, the side effect of treatment, and the recurrence rate were also compared between the groups. Results: After 8 weeks of treatment, a remission rate of 77.4% was shown in the nifedipine group which was significantly higher than the diltiazem group with a remission rate of 54% (P=0.01). Applying nifedipine ointment is associated with earlier pain relief compared with diltiazem (P<0.001). After 6 months of follow-up, the relapse rate was not statistically different between the nifedipine and diltiazem groups (16.3% versus 21.4%, respectively). Conclusion: The application of topical nifedipine is associated with shorter pain relief and more remission rate for AAF compared with topical diltiazem. However, both methods were not different in terms of related side effects and AAF recurrence rate.
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Affiliation(s)
- Zahra Momayez Sanat
- Assistant Professor of Medicine, Digestive Diseases Research Institute,Tehran University of Medical Sciences, Tehran, Iran
| | - Negar Mohammadi Ganjaroudi
- Assistant Professor of Medicine, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Masoume Mansouri
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Shariati Hospital, Tehran, Iran
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Song M, Bai X, Wang D, Wang Q, Pan L, He P, Gong Y, Sun X, Xu X, Che J, Wang S. Combined application of moist exposed burn ointment and maggot therapy in wound healing. J Wound Care 2022; 31:S41-S52. [DOI: 10.12968/jowc.2022.31.sup10.s41] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: Hard-to-heal wounds are a global health challenge, and effective treatments are still lacking. Moist exposed burn ointment (MEBO) and maggots are traditional treatments for promoting wound healing. This study was a preliminary exploration of combined maggot therapy and MEBO in the treatment of hard-to-heal wounds. Method: A coexistence experiment was conducted to determine the survival rates of maggots in MEBO. The maggots were placed in two different existence conditions: one set in MEBO (MEBO group), and another set as the control group (no MEBO) to compare survival rates. Case reports describe the use of the combined application of MEBO and maggots in the treatment of patients with hard-to-heal wounds. Results: The coexistence experiment indicated that maggots in the MEBO group had a higher survival rate. From the therapeutic effect of the clinical cases (n=7), the combined application was safe and effective, with all the reported wounds eventually healing. Conclusion: Based on the findings of this study, we believe the combined application of MEBO and maggots is a promising way of promoting wound healing. Further studies and clinical trials are needed to elucidate the mechanism of the combined application in promoting wound healing and to more persuasively clarify the therapeutic effect.
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Affiliation(s)
- Mingzhi Song
- Department of Orthopaedics, the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, People's Republic of China
- 2 Department of Orthopaedics, the Third Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, People's Republic of China
| | - Xiaodong Bai
- 3 Department of Plastic Surgery, Southern University of Science and Technology Hospital, Shenzhen, Guangdong, People's Republic of China
| | - Deyu Wang
- 4 Department of Burn and Wound Repair Surgery, the Forth People's Hospital of Dalian, Dalian, Liaoning, People's Republic of China
| | - Qingxin Wang
- 5 The Second Department of General Surgery, the Fifth People's Hospital of Dalian, Dalian, Liaoning, People's Republic of China
| | - Liwen Pan
- 6 Department of Nursing, the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, People's Republic of China
- 7 Surgical Clinic, the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, People's Republic of China
| | - Ping He
- 6 Department of Nursing, the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, People's Republic of China
- 7 Surgical Clinic, the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, People's Republic of China
| | - Ying Gong
- Department of Orthopaedics, the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, People's Republic of China
- 6 Department of Nursing, the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, People's Republic of China
| | - Xiaohong Sun
- 6 Department of Nursing, the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, People's Republic of China
| | - Xiaoguang Xu
- 8 Research Center of High Altitude Medicine, Naqu, Tibet, People's Republic of China
- 9 People's Hospital of Naqu Affiliated to Dalian Medical University, Naqu, Tibet, People's Republic of China
| | - Jianzhong Che
- 4 Department of Burn and Wound Repair Surgery, the Forth People's Hospital of Dalian, Dalian, Liaoning, People's Republic of China
| | - Shouyu Wang
- Department of Orthopaedics, the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, People's Republic of China
- 10 Dalian Runxi Technology Development Co. Ltd, Dalian, Liaoning, People's Republic of China
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