Prilozi (Makedonska akademija na naukite i umetnostite. Oddelenie za medicinski nauki)最新文献

{"title":"Bleeding After Endoscopic Resection of Colonic Adenomatous Polyps Sized 4-10 mm.","authors":"Violeta Hristova Janik","doi":"10.2478/prilozi-2023-0035","DOIUrl":"https://doi.org/10.2478/prilozi-2023-0035","url":null,"abstract":"<p><p><b>Introduction</b>: Colonoscopy with polypectomy is an efficacious procedure in reducing the risk of colorectal cancer development, the precursor are adenomatous polyps. The most common method for resection of polyps measuring 4-10 mm are cold (CSP) and hot snare polypectomy (HSP). CSP has a lower incidence of adverse events, especially delayed post-polypectomy bleeding. <b>Aim</b>: To evaluate the presence of immediate and delayed bleeding in the cold snare polypectomy of sub-centimeter polyps of the colon compared with hot snare polypectomy. <b>Materials and Methods</b>: This prospective clinical study is comprised all patients who were incidentally detected to have adenomatous colonic polyps measuring 4-10 mm during a colonoscopy screening. Polypectomy was done with (hot snare) or without electrocautery (cold snare). After removal of polyps, immediate bleeding, delayed bleeding, and methods for were analyzed. <b>Results</b>: The CSP and HSP groups included 116 patients, 113 (54.4%) polyps in 61 (52.6%) patients with CSP while 95 (45.6%) polyps in 55 (47.4%) patients with HSP. 25 (22.1%) polyps after CSP had immediate bleeding. In 5 patients (20.0%), five hemostatic clips were inserted after CSP for bleeding longer than 150 sek. The average percentage difference between immediate bleeding versus total number of resected polyps using the cold snare method is not statistically significant (p<0.05) (Difference test, p=0.0000). Delayed bleeding was not registered using this method. In the second investigated group (HSP), one patient had delayed bleeding. This was stopped with 2 clips. Immediate bleeding was not registered. <b>Conclusion</b>: CSP is safer than HSP in resecting colon polyps sized 4-10 mm, without risk of delayed bleeding.</p>","PeriodicalId":74492,"journal":{"name":"Prilozi (Makedonska akademija na naukite i umetnostite. Oddelenie za medicinski nauki)","volume":"44 2","pages":"157-164"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10066207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of Prevalence and Risk Factors for Diabetic Retinopathy in Patients with Type 1 and Type 2 Diabetes Examined at a Tertiary Care.","authors":"Brankica Krstevska,&nbsp;Sasha Jovanovska Mishevska,&nbsp;Valentina Velkoska Nakova,&nbsp;Iskra Bitoska,&nbsp;Nevenka Laban Guceva,&nbsp;Irfan Ahmeti,&nbsp;Snezana Markovic,&nbsp;Biljana Todorova,&nbsp;Ivana Mladenovska","doi":"10.2478/prilozi-2023-0021","DOIUrl":"https://doi.org/10.2478/prilozi-2023-0021","url":null,"abstract":"<p><p><b>Introduction</b>: Diabetic retinopathy (DR) is a microvascular complication of diabetes mellitus and the leading cause of visual impairment and blindness. The aim of the study was to estimate and compare the prevalence of DR and to determine an association between DR and systemic risk factors in hospitalized type 1 (DMT1) and type 2 (DMT2) diabetic patients. <b>Material and methods</b>: We analyzed 260 patients with diabetes, 43 with DMT1 and 217 with DMT2. The following data were collected: age, gender, type and duration of diabetes, glycemic control, blood pressure, estimated glomerular filtration rate, ophthalmologic examinations and routine biochemical parameters. <b>Results</b>: Out of the total number of 260 patients, 77 (29.6%) had non-proliferative DR (NPDR), 21 (8.1%) had proliferative DR (PDR), 29 (11.1%) had diabetic macular edema (DME), and 69 (23.5%) had diabetic cataracts. Forty-three (16.5%) patients were previously diagnosed with DMT1 and 217 (83.5%) with DMT2. The duration of diabetes was not significantly longer in DMT1 (12.8±11.2 years) in comparison to DMT2 (11.07±8.1 years). The prevalence of NPDR and PDR did not differ statistically in either groups. DME was more prevalent in DMT2 than in DMT1 (P<0.05). Diabetic cataract was found in 26.7% vs. 6.7% of patients with DMT2 and DMT1, respectively (p<0.01). The duration of diabetes significantly correlated with NPDR and PDR in DMT1 (r=o.31, p<0.05; r=0.55, p<0.001, respectively). In DMT2, significant correlations were found between the duration of diabetes and cataract, NPDR, PDR and DME (r=0.31, p<0.001; r=0.43 p<0.01, r=0.16 p<0.05 and r=0.20 p<0.01, respectively). Fasting plasma glucose (FPG) significantly correlated with PDR (r=0.258, p<0.05), while HbA1c with DME (r= 0.15 p<0.05). <b>Conclusion</b>: The duration of diabetes and hyperglycemia were associated with DR in both types of diabetes.</p>","PeriodicalId":74492,"journal":{"name":"Prilozi (Makedonska akademija na naukite i umetnostite. Oddelenie za medicinski nauki)","volume":"44 2","pages":"23-30"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10011367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence and Prevalence of Vaginal Infections in Women of Reproductive Age in North Macedonia.","authors":"Jovana Albig,&nbsp;Megi Micevska,&nbsp;Sasha Jovchevski,&nbsp;Jadranka Georgiveska,&nbsp;Svetlana Cekovska,&nbsp;Aleksandar Stankov","doi":"10.2478/prilozi-2023-0027","DOIUrl":"https://doi.org/10.2478/prilozi-2023-0027","url":null,"abstract":"<p><p>In the available literature on this subject there are many studies which describe the effects of sexually transmitted infections on pregnancy and fertility of women. Because of the frequency of the infections with the atypical bacteria of the <i>Ureaplasma</i> Spp., <i>Mycoplasma</i> Spp., <i>Chlamydia Trachomatis</i>, as well as HPV infections in women of reproductive age, it is easy to underestimate their importance when establishing the basis of the genital health of women of reproductive age. In this prospective analysis, conducted from 2014 to 2018 in the laboratory for HPV and Molecular diagnostics at the University Clinic of Gynaecology and Obstetrics in Skopje, North Macedonia, we analysed the results of 10,387 patients of all ages, of which 973 patients were of reproductive age. A Panel analysis was also conducted (including the above-mentioned pathogens). An HPV analysis was also conducted on 643 patients in this group. Within the group of 643 patients, there was a positive result for HPV in 26.7% of them, while in 40.9% there was a positive result for one or more pathogens on the Panel analysis of bacterial pathogens. The statistical analysis of the results showed that the most frequent of all bacterial pathogens within the Macedonian population of women of reproductive age is <i>Ureaplasma</i> Spp, with an incidence of 33%, followed by <i>Mycoplasma</i> Spp., with 7.8%, while <i>Chlamydia Trachomatis</i> was present in 6.4% of the cases. We should highlight that a co-infection with HPV was present in 18.5% of all the patients where there was analysis of both diagnostic procedures. The analysis of the results in the patients co-infected with HPV and at least one bacterial pathogen on the Panel Analysis, showed a very high statistical correlation (p<001).</p>","PeriodicalId":74492,"journal":{"name":"Prilozi (Makedonska akademija na naukite i umetnostite. Oddelenie za medicinski nauki)","volume":"44 2","pages":"73-80"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10412443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of Cardiac Magnetic Resonance in Diagnosis and Treatment of Ball Thrombus in Left Atrium - Trust But Verify! - Case Report.","authors":"Ted Trajcheski,&nbsp;Lulzim Brovina,&nbsp;Biljana Zafirova,&nbsp;Saso Josimovski","doi":"10.2478/prilozi-2023-0039","DOIUrl":"https://doi.org/10.2478/prilozi-2023-0039","url":null,"abstract":"<p><p>Male patient with left atrial cardiac mass was in need of a quick diagnosis for individualized and effective treatment. Transthoracic echocardiography showed presence of а giant left atrial cardiac mass with atypical location for thrombus. Cardiac Magnetic Resonance (CMR) Imaging was performed for histological discrimination, and showed a large cardiac mass wall attached in the left atrium, homogeneous, with diameter of 3.4cm x 3.2cm. Late Gadolinium Enhancement sequences revealed black avascular tissue without signal, confirming the characterization of a thrombus. The patient refused hospital initiation of low molecular weight heparin treatment and started treatment with Rivaroxaban. Six weeks later he presented with NYHA class II, almost complete dissolving of the thrombus on CMR scan. Seven months from the initial CMR scan, echocardiography screen was done showing complete absence of the left atrial mass. With this case report we have demonstrated the significance of the CMR as one step further in the precise diagnostics of cardiac masses, solving critical clinical dilemma.</p>","PeriodicalId":74492,"journal":{"name":"Prilozi (Makedonska akademija na naukite i umetnostite. Oddelenie za medicinski nauki)","volume":"44 2","pages":"185-188"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10066205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Circulating Variants of SARS-CoV-2 Among Macedonian COVID - 19 Patients in the First Year of Pandemic.","authors":"Sanja Kiprijanovska,&nbsp;Gjorgji Bozhinovski,&nbsp;Predrag Noveski,&nbsp;Ivana Maleva Kostovska,&nbsp;Emilija Shukarova Stefanovska,&nbsp;Marija Vujovikј,&nbsp;Hristina Dichevska,&nbsp;Simona Jakovchevska,&nbsp;Natalija Jovanovska,&nbsp;Icko Gjorgoski,&nbsp;Dijana Plaseska Karanfilska,&nbsp;Aleksandar Dimovski","doi":"10.2478/prilozi-2023-0018","DOIUrl":"https://doi.org/10.2478/prilozi-2023-0018","url":null,"abstract":"<p><p>Genomic epidemiology has proven to be a useful tool for investigating pandemic outbreaks and tracking pathogen spread and evolution. This study describes the circulation of SARS-CoV-2 strains in N. Macedonia during a period of one year, encompassing three waves of the COVID-19 pandemic. A certain percentage (2-3%) of positive cases were continuously selected and analyzed by whole genome sequencing (WGS) technology. Using this approach, a total of 337 SARS-CoV-2 genomes were sequenced and 26 different lineages belonging to 7 clades were detected. During the first wave of the pandemic, the most dominant lineage was B.1.1, followed by B.1.1.70, which became the most dominant in the second wave. The B.1.1.7 lineage completely overpassed all other variants in the third wave. Our study strengthens the notion that the progression of COVID-19 pandemic is associated with emergence of new SARS-CoV-2 variants with increased virulence. The measure of the impact of this viral dynamic on the spread of the pandemic should be evaluated in association with other factors that might influence the transmission.</p>","PeriodicalId":74492,"journal":{"name":"Prilozi (Makedonska akademija na naukite i umetnostite. Oddelenie za medicinski nauki)","volume":"44 2","pages":"17-22"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10011363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biologic Therapy in Inflammatory Bowel Disease - Results from a Single Tertiary Care Center in North Macedonia.","authors":"Gjorgi Deriban,&nbsp;Dafina Nikolova,&nbsp;Fani Licoska,&nbsp;Emilija Trpcevska Nikolovska,&nbsp;Vladimir Andreevski,&nbsp;Kalina Stardelova,&nbsp;Vladimir Serafimoski","doi":"10.2478/prilozi-2023-0023","DOIUrl":"https://doi.org/10.2478/prilozi-2023-0023","url":null,"abstract":"<p><p>Medical therapies used for Inflammatory Bowel Disease (IBD) include conventional (e.g. 5-aminosalicylates, steroids, immunomodulators) and biologic (e.g. inhibitors of tumor necrosis factor - alpha, integrin inhibitors, interleukin inhibitors) medications. Biologics, due to their high cost, were unfortunately not covered by the public health insurance system in North Macedonia until 2019 and, therefore, not widely utilized for our IBD patients. In 2019, the University Clinic of Gastroenterology and Hepatology in Skopje developed a biologic therapy supply, provided by the National Health Insurance Fund, making this therapy available for a larger number of patients. This report presents the initial results of our prospective, single tertiary-care center study on the effects of biologic therapy in patients with IBD in North Macedonia. The study is focused on the evaluation of clinical outcomes after anti-tumor necrosis factor alpha (anti TNF-alpha) therapy in IBD patients with prior inadequate response to conventional medications.</p>","PeriodicalId":74492,"journal":{"name":"Prilozi (Makedonska akademija na naukite i umetnostite. Oddelenie za medicinski nauki)","volume":"44 2","pages":"41-46"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10011365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Web Platform for Gathering and Analyzing Data from the Neurogame Mobile Application.","authors":"Sofija Loleska,&nbsp;Nada Pop-Jordanova","doi":"10.2478/prilozi-2023-0040","DOIUrl":"https://doi.org/10.2478/prilozi-2023-0040","url":null,"abstract":"<p><p>Today's cell phones are now smartphones, providing a wide range of possibilities for their use, much more than just simple phones. The custom application for the Android operating system, based on an open-source platform for mobile devices is intended for the examination of cognitive functions: attention, concentration and fine motor skills in children of different age groups. The Neurogame application for mobile devices and web platform development is used for retrieving and analyzing mobile application data, providing relevant indicators for the executive functions of the respondents. <b>Material and methods</b>: The research included 50 children with the developmental disorders ADHD and dyslexia (study group) and 50 healthy children (control group), randomly selected, evenly represented by gender and age. Using the application, we determine attention, concentration and motor skills (reaction speed) as part of the executive functions of the respondents. The web platform has the purpose of gathering and processing the data from the mobile application, as well as their automatic visual representation. <b>Results</b>: The ANOVA test showed that there are no gender differences in all the studied groups. A statistical correlation analysis showed that age does not affect the results in healthy school children. In children with dyslexia, age affects positively for total hits and negatively for total misses. In children with ADHD, there is a positive correlation with age for all variables except total hits (t H). Student's T-test showed that there were significant differences for the variables' total hits (t H) and total reaction time (t h) in milliseconds between healthy school children and children with dyslexia. Additionally, Student's t-test indicated that there were significant differences for the variables' total tries (t T) and total hits (t H) between healthy school children and children with ADHD. Finally, Student's t-test indicated that there were significant differences for the variable total tries (t T) between children with dyslexia and children with ADHD. Multiple Regression Results showed a significant difference between healthy school children, children with ADHD and children with dyslexia for all variables (total tries (t T), total hits (t H), total misses (t M) and total reaction time in milliseconds (t h)). <b>Conclusion</b>: The Neurogame application provides a opportunity to assess the motor skills and concentration level, as well as the focus of the target population by measuring the total number of tries, the total number of hits, the total number of misses and the reaction time expressed in milliseconds which are defined as monitoring variables. The development of the web platform and the connection to the application enabled easier access and distribution of the analyzed results to the stakeholders (parents, teachers, therapists or health professionals) in order to further treat the ascertained condition.</p>","PeriodicalId":74492,"journal":{"name":"Prilozi (Makedonska akademija na naukite i umetnostite. Oddelenie za medicinski nauki)","volume":"44 2","pages":"189-201"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10011368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Percutaneous Onsite Insertion of Catheter for Peritoneal Dialysis - A New Method Introduction in the Country.","authors":"Vladimir Pushevski,&nbsp;Igor G Nikolov,&nbsp;Pance Karagjozov,&nbsp;Darko Dzambaz,&nbsp;Irena Rambabova-Bushljetik","doi":"10.2478/prilozi-2023-0031","DOIUrl":"https://doi.org/10.2478/prilozi-2023-0031","url":null,"abstract":"<p><p>Peritoneal dialysis (PD) is one of the options for renal replacement therapy (RRT) in the end stage renal disease (ESRD) patients. Compared to hemodialysis (HD), patients on PD experience a greater sense of well-being, an improved steady state in terms of extracellular fluid volume shifts and hemodynamics and it is preferred method for patients with problematic vascular access, bleeding tendencies, heart failure and elderly patients. In order to perform PD, a tunneled catheter should be placed through the abdominal wall and into peritoneal space, with positioning of the catheter within the most dependent portion of pelvis. Currently, there are several techniques available for PD catheter placement: open surgery, laparoscopic and percutaneous. We present for the first time in our country a case of 65 year old male patient to whom percutaneous onsite insertion of peritoneal catheter was performed. The idea is to emphasize that sometimes this should be a method of choice for RRT, especially in patients where general anesthesia should be avoid. Compared to other methods, percutaneous insertion is a simple procedure with no need for general anesthesia, and the benefits of quick recovery, earlier ambulation, and less delay in catheter placement.</p>","PeriodicalId":74492,"journal":{"name":"Prilozi (Makedonska akademija na naukite i umetnostite. Oddelenie za medicinski nauki)","volume":"44 2","pages":"107-112"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10066206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emotional Dysregulation is the Core Problem in Psychopathological Manifestations.","authors":"Nada Pop-Jordanova","doi":"10.2478/prilozi-2023-0020","DOIUrl":"https://doi.org/10.2478/prilozi-2023-0020","url":null,"abstract":"<p><p>The established opinion is that emotions are the gift given to us by nature in order to help us connect with other people. They are constantly generated, usually by stimuli in our intrapersonal as well as in external world. Problems raised in our relationships initiate emotions to help us to fix those problems. Almost all forms of human psychopathology are associated with dysregulated emotions. The failure to apply appropriate cognitive, attentive, and behavioural regulatory strategies is the core for emotion dysregulation. The brain regulates emotions through a biological mechanism. Emotions rise in intensity, peak, and then go flat once the emotion adaptive action tendency has been expressed. The aim of the therapist is to help clients express, face, and regulate their emotions, and to channel these emotions into healthy actions. The idea of this article is to present contributions from both affective neuroscience and psychotherapy in order to explain the ways how our emotions become dysregulated in life and how they can become regulated through psychotherapy.</p>","PeriodicalId":74492,"journal":{"name":"Prilozi (Makedonska akademija na naukite i umetnostite. Oddelenie za medicinski nauki)","volume":"44 2","pages":"7-16"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10011364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Value of Injection Therapy with Botulinum Toxin in Pain Treatment of Primary Chronic Anal Fissures Compared to Anal Dilation, and Local Nifedipine in Combination with Lidocaine.","authors":"Vladimir Andreevski,&nbsp;Ance Volkanovska,&nbsp;Gjorgji Deriban,&nbsp;Fani Licoska Josifovic,&nbsp;Gregor Krstevski,&nbsp;Dafina Nikolova,&nbsp;Magdalena Genadieva Dimitrova,&nbsp;Kalina Grivceva Stardelova,&nbsp;Vladimir Serafimovski","doi":"10.2478/prilozi-2023-0029","DOIUrl":"https://doi.org/10.2478/prilozi-2023-0029","url":null,"abstract":"<p><p><b>Introduction</b>: Anal fissure is a longitudinal tear of the mucosa of the anal canal extending from the outer anal orifice in the direction of the dentate line of the inner anal opening. Fissures are divided into primary and secondary, and acute or chronic. Besides minimal rectal bleeding, itching and soiling, primary chronic anal fissures (PCAF) manifest with anal pain as theirs main determinant. It is described as the most troubling symptom. <b>Aim</b>: To compare the effect of injection therapy with botulinum toxin A (ITBT) vs. anal dilation (AD), and local nifedipine with lidocaine (LNL) in pain treatment of PCAF. <b>Materials and Methods</b>: This controlled retrospective prospective longitudinal study covered 94 patients, divided in 3 groups. The first was treated with ITBT, the second with AD and third using LNL (31, 33 and 30 patients respectively). Clostridium botulinum toxin A was used, dissolved with saline to concentration of 200 U/ml. The solution was applied to both sides of PCAF at dose of 40U. Modified technique of AD was done using 3 fingers of a single hand, progressively introduced into the anal canal, followed by gradual lateral distraction during 1 min. LNL therapy was conducted using nifedipine (0.3%) with lidocaine (1.5%) ointment, applied twice daily for 3 weeks. To measure pain, a visual analog scale (VAS) was used. The follow-up period was 12 weeks with checkup at week 4. <b>Results</b>: The median age of participants was 46.6±13.9 years (50 males vs. 44 females). The type of therapy had a significantly different effect on pain at week 4 (p=0.0003). Severe pain was present in only 2 ITBT patients, 16 AD, and 6 LNL patients. Post hoc analyses showed different pain disappearance time by week 12 (p <0.0001). The mean time was shortest in ITBT group (6.1±1.5 weeks). Anal pain intensity significantly differed among the 3 groups (Fisher exact, p=0.002). Namely, 71% in ITBT group rated the pain as weakest (VAS score 1) compared to 18.2% in AD and 30% of patients in LNL group. The overall pain reduction significance was in favor of ITBT, due to the differences between the ITBT and AD groups (p=0.00024) and ITBT compared to LNL group (p=0.018). <b>Conclusion</b>: ITBT is superior to AD and LNL in reducing pain in PCAF.</p>","PeriodicalId":74492,"journal":{"name":"Prilozi (Makedonska akademija na naukite i umetnostite. Oddelenie za medicinski nauki)","volume":"44 2","pages":"89-97"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10364845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}