comparative study of different treatments of hemorrhoids

Hemorrhoid is a common anal problem in our country that is currently treated by many different methods. Three modalities were assessed in a randomized prospective trial in which 848 patients with a second-degree hemorrhoid were treated by rubber band ligation [470 patients], injection sclerotherapy [280 patients], or cryosurgery [98 patients]. The effectiveness of each method was assessed clinically at 3, 6, 9, and 12 months after initial treatment, and determined by improvement in presenting symptoms. All patients complained of rectal bleeding and prolapse of the hemorrhoid on defecation, but only 69% had anal pain and 14% suffered from pruritus ani. Rubber band ligation was found to be superior to the other methods, and displayed statistical significance when compared to injection sclerotherapy and cryosurgery

Electromyography of the rectosphincteric reflex in Hirschsprung's disease

In this study we evaluated 30 cases of clinically suspected Hirschsprung's disease by electromyography [EMG] of the rectosphincteric reflex [RSR] and rectal biopsy [including the internal sphincter]. In 27 cases an EMG study showed failure of relaxation of the internal anal sphincter on rectal distension while in the remaining three cases relaxation occurred during distension of the rectum with a large volume of air. Rectal biopsy confirmed the presence of the ganglia in these three cases only. Our experience confirms the reliability of EMG of the RSR in the diagnosis of Hirschsprung's disease [27 cases] particularly in the ultrashort segment cases which account for 18% [five cases] of these, and emphasize its importance in differentiating Hirschsprung's disease from acquired rectal inertia [three cases]