Botulinum toxin injection versus lateral internal sphincterotomy in the treatment of chronic anal fissure: a non-randomized controlled trial

BACKGROUND: Although lateral internal sphincterotomy is the gold-standard treatment for chronic anal fissure, intrasphincteric injection of botulinum toxin seems to be a reliable new option. The aim of this non-randomized study is to compare the effect of lateral internal sphincterotomy and botulinum toxin injection treatments on the outcome and reduction of anal sphincter pressures in patients with chronic anal fissure. METHODS: Patients with chronic anal fissure were treated with either botulinum toxin injection or lateral internal sphincterotomy by their own choice. Maximal resting pressure and maximal squeeze pressure measurements were performed before and 2 weeks after treatments by anal manometry. Patients were followed for fissure relapse during 14 months. RESULTS: Twenty-one consecutive outpatients with posterior chronic anal fissure were enrolled. Eleven patients underwent surgery and ten patients received botulinum toxin injection treatment. Before the treatment, anal pressures were found to be similar in both groups. After the treatment, the maximal resting pressures were reduced from 104 ± 22 mmHg to 86 ± 15 mmHg in the surgery group (p < 0.05) and from 101 ± 23 mmHg to 83 ± 24 mmHg in the botulinum toxin group (p < 0.05). The mean maximal squeeze pressures were reduced from 70 ± 27 mmHg to 61 ± 32 mmHg (p > 0.05) in the surgery group, and from 117 ± 62 mmHg to 76 ± 34 (p < 0.01) in the botulinum toxin group. The fissures were healed in 70 percent of patients in the botulinum group and 82 percent in the surgery group (p > 0.05). There were no relapses during the 14 months of follow up. CONCLUSION: Lateral internal sphincterotomy and botulinum toxin injection treatments both seem to be equally effective in the treatment of chronic anal fissure

Self-referential processing in false recognition and source monitoring: Self-other differences

The present experiment examined the effect of self, close other, and unknown other-references on false recognition and source monitoring in the Deese-Roediger-McDermott (DRM) paradigm. In the present study, participants were shown items with their own name, the name of a closely known other, an unknown other, or alone. Then, they were asked to recognise the items and the reference conditions. The results showed that the items paired with oneself and a closely known other lead to higher true recognition scores compared to other two conditions. Moreover, the source of the items in the self and the close other-reference conditions were more likely to be attributed to the correct sources than the latter two. However, the self and the close other-referenced items increased false recognition and source misattribution scores. The findings indicate that referencing the self and close others may lead to memory illusions via distorting source monitoring abilities. © 2021 Informa UK Limited, trading as Taylor & Francis Group

Juvenıle polyposıs colı wıth atypıcal features

A 22-year-old woman was found to have 25 polyps involving the rectum and the entire colon. Pathologic examination revealed numerous polyps that were predominantly of juvenile type with hyperplastic, adenomatous, villous and tubulovillous features in addition to a villous adenoma. These observations emphasize the relationship between these polyps and the neoplastic potential of juvenile polyposis. Additionally, this is the first case report of juvenile polyposis in association with cervical rib