Date of Award

2016

Degree Type

Selective Evidence-Based Medicine Review

Degree Name

Master of Science in Health Sciences - Physician Assistant

Department

Physician Assistant Studies

Department Chair

John Cavenagh, MBA, PhD, PA-C

Abstract

OBJECTIVE: The objective of this systematic review is to determine whether or not topical glyceryl trinitrate is an effective treatment for reducing visibility of anal fissures in patients without heart disease compared to placebo.

STUDY DESIGN: Evidence based review of three randomized controlled trials published in 1999, 2001, and 2007.

DATA SOURCES: Three randomized controlled trials each evaluating the effectiveness of topical glyceryl trinitrate in the treatment of anal fissure, published in the English language, and containing exclusion criteria disqualifying participants with a history of heart disease.

OUTCOMES MEASURED: Healing was measured via visibility of fissure through examination and structured patient interview. The outcomes were measured by medical professionals, blinded consultants, or medical investigative interviewers.

RESULTS: Average healing rate is 71% for the GTN group and 43% for placebo/lignocaine group.

CONCLUSIONS: Based on the combined evidence this systematic review finds that topical glyceryl trinitrate is an effective treatment for reducing visibility of anal fissures in patients without heart disease compared to placebo.

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