hemorrhoids

Hemorrhoid disease is one of the most common anorectal diseases that affect millions of people around the world. Implementing a hemorrhoid management and prevention program using its data management system can be an effective step to improve the quality of care, control disease, and improve the society health. The present study aims to determine the minimum data set (MDS) for electronic health record of patients with hemorrhoid disease in Iran.

In this descriptive-analytical stud that was conducted in 2021, related papers and clinical records of patients with hemorrhoid disease in Iran were first studied. Then, the proposed MDS was validated using a researcher-made questionnaire based on a Likert scale with acceptable content validity and test-retest reliability (r=0.90), and by implementing the Delphi technique based on the opinions of 20 experts (internal medicine specialists and general practitioners in hospitals of Ferdous and Birjand cities and health information management specialists in Ferdous city). Sampling was not done due to the low number of participants. Finally, the findings were analyzed using descriptive statistics in SPSS software version 19.

A total of 43 data elements were finally selected for implementing the Delphi technique. Of these, two data elements were removed in the first round; therefore, 39 data elements as well as two data elements with a score of 50-75% and three suggested data elements entered the second round of Delphi. Of these, 42 were approved in the second round.

Determining the MDS for electronic health record of patients with hemorrhoid disease can be an effective step towards integrating the information of these patients in Iran and can improve their information management.

Anal pain is as a common clinical complaint, which occurs due to various causes. In Persian Medicine (PM), anal disorders have been explained in detail. The aim of this study is to investigate the viewpoint of PM regarding anal pain in order to achieve new, less complicated and effective treatments for this condition. Accordingly, one of the most important sources of treatments in PM, the book Exir-e Azam, was reviewed. Electronic databases such as Google Scholar, PubMed and SID were also searched. According to PM, anal pain is sometimes caused by factors in the anus and preanal region, such as hemorrhoid and fissure. Sometimes, it occurs due to causes outside the anus such as “Rih al-Bavasir”- a referred pain from the kidneys, and also intestinal ulcers. Moreover, causes of anal pain can be divided into two categories: physical factors such as fissures, and chemical agents such as passing feces containing burning substances through the anus. As a conclusion, categorizing types and causes of anal pain and based on the similarities with findings of modern medicine, along with easy, less complicated and diverse medicinal treatments that are found in PM sources such as Exir-e Azam, promise finding potential new treatments.

Spinal anesthesia is generally used for surgeries related to the lower abdomen, perineum, and lower limbs. The purpose of this study is to compare immediate and delayed supine positions on the hemodynamic changes of patients undergoing hemorrhoid and Fischer surgeries under spinal anesthesia.

The present study is a case-control study that was conducted on 60 patients who were candidates for hemorrhoid and fissure surgery in Motahari Hospital of Jahrom city by a specific surgeon. Patients were randomly assigned to one of two groups of 30 people in the immediate and delayed supine positions. After the spinal anesthesia, the patients in the delayed supine position group were kept in a sitting position for 3-5 minutes and then assumed the surgical position. In the immediate supine position group, the patients were placed in the supine position after receiving spinal anesthesia and were ready for surgery. Systolic blood pressure, diastolic blood pressure, respiration, arterial oxygen saturation, and pulse of the patient were measured and recorded before and immediately after the position and at 10, 5, 15, 30, 45, 60, and 90 minutes after the position. Data analysis was done using descriptive and inferential statistics tests at a significance level of P<0.05.

The study groups were similar in terms of age and body mass index variables. The mean trend of systolic and diastolic blood pressure in the immediate supine position and delayed supine position groups showed a significant difference from the time before spinal anesthesia to 90 minutes after the operation (P<0.001). The trend of mean MAP and heart rate in the immediate supine position and delayed supine position groups showed a significant difference from the time before spinal anesthesia to 90 minutes after the operation (P<0.001). The amount of ephedrine consumed in the delayed supine position group (10%) was significantly lower than in the immediate supine position group (50%) (P=0.003).

The present study has indicated that the use of a delayed supine position can significantly reduce the number of hemodynamic changes over time compared to the immediate supine position and minimize the amount of ephedrine used to compensate for pressure drop.

Constipation is one of the most common digestive problems in pregnant women which is commonly associated with hemorrhoids. Patients' non-compliance with lifestyle modification recommendations leads to failure of treatment with this method. Although therapeutic properties of coconut oil on constipation are discussed, but its scientific documentation has not been reported; therefore, this study was performed with aim to determine the effect of coconut oil ointment on the symptoms of constipation in pregnant women with hemorrhoids.

This randomized clinical trial study was performed on 60 pregnant women who referred to Mashhad Comprehensive Health Service Centers in 2018-2019. Eligible individuals were divided into two groups. The control group received only lifestyle modification recommendations, while the intervention group in addition to these recommendations used an applicator of coconut oil ointment twice a day for two weeks. The improvement of constipation symptoms including need for straining during defecation, hard stools and defecation less than 2 to 3 times a week was assessed using the Constipation Questionnaire in Pregnancy. Data were analyzed using SPSS software (version 16) and Chi-square, Fisher exact and Cochran tests. P< 0.05 was considered statistically significant.

The frequency of need for straining during defecation on the fourteenth day after the intervention in pregnant women in the coconut oil ointment group was significantly lower than the control group (p <0.05). In the intragroup comparison, it was found that in the group of coconut oil ointment, the difference in the need for straining during defecation and hard stools according to the day of measurement was significantly different (P <0.001), while in the control group, the difference in the need for straining during defecation and hard stools according to the day of measurement was not significant (p <0.05). In the intragroup comparison, defecation less than 2 to 3 times a week, although clinically was associated with a decrease in the coconut oil ointment group, but this decrease was not statistically significant (p=0.050).

Coconut oil ointment is effective in improving the symptoms of constipation in pregnant women with hemorrhoids, so its use is recommended in these people.

In 431 AH, after a 13-year struggle with the Ghaznavids, the Seljuk Turkic dynasty succeeded in defeating them decisively in the battle of Dandanqan and laying the foundation of a government that lasted until 590 AH. During the 159 years of Seljuk rule in Iran, 15 members of this dynasty officially came to power. Most of the rulers of this dynasty died as a result of various diseases. Some of them were killed during internal conflicts in order to gain power or in the process of confronting the foreign enemies of the monarchy. With a few exceptions, the deaths of both groups, and especially of the sultans who died an unnatural death, occurred at a young age. This caused most of the rulers of this dynasty to have an unstable monarchy. In the present study, an attempt has been made to study the manner of death of the Seljuk sultans and the relationship between the type of death of these rulers and their reign and life.

In the present study, using statistical methods, the most important sources of the Seljuk era have been studied and analyzed in order to achieve the objectives of the research.

Most kings who died a natural death had a history of various diseases; but they died as a result of a certain disease. The most important of these diseases were colic, hemorrhoids, tuberculosis, inflammatory fever, smallpox, diarrhea and sexually transmitted diseases. The group that died of abnormal deaths also sometimes had a history of certain diseases; however, before they died of the disease, they were killed by their opponents and rivals. The lifespan of those rulers who died a natural death was longer than the second group.

In the process of conducting this research, while observing the principle of fidelity in the use of resources, non-scientific and biased analyzes have been refused.

Out of 15 Seljuk sultans, 10 died due to various diseases. Colic with three cases, tuberculosis and fever with two cases each and other diseases with one case, caused the death of this group of kings. The average age of this group is 38 years and their average reign is 15.3 years. Although two of the other five Seljuk sultans had a previous illness, all five were killed abnormally by their opponents. Three of them were poisoned by the claimants to power, and two others were killed by swords in battle with foreign opponents of the monarchy. The average age of this group was 36 years and their average reign was 9.03 years.

Hemorrhoid is one of the most common problems in pregnancy, especially in the second and third trimesters. In the absence of timely treatment and proper follow-up, the problem leads to a chronic disease that can impose harmful effects on the individual, the family and the society. Considering the high prevalence of this problem among pregnant women and failure to review the new advocacy, especially pharmacological and aggressive methods over the past 12 years, this study was performed with to review a variety of non-pharmacological and pharmacological treatments of hemorrhoids in pregnancy and their effectiveness.

To achieve the aim of the study, databases of PubMed, Scopus, ProQuest, Google Scholar, Science Direct, SID and Magiran were searched using English keywords of Hemorrhoid, Haemorrhoid, pregnancy, Pregnant, Medical Treatment, Conservative, Life style, Diet, Nutrition, Surgery, Hemorrhoidectomy and their Persian keywords were searched individually and in combination, from the timeframe covered until October 2019.

There are several methods to treat hemorrhoids during pregnancy, but many of these methods are based on the results of clinical trials on the general population of patients with this condition, so, due to the lack of sufficient and powerful clinical studies on the application of some methods and the prohibition or caution of using some other methods during pregnancy, deciding about the choice of treatment depends on the condition of each patient and considering the criteria such as: gestational age, the severity and degree of sustainability of symptoms as well observing the hierarchy of treatment from conservative and non-invasive approach toward aggressive methods.

There are various methods for the treatment of hemorrhoids, but sufficient and robust studies to confirm the efficacy and safety of these methods to the specific population of pregnant women are limited.

Hemorrhoids is one of the most common problems during pregnancy. Lifestyle modification recommendations are associated with patients' noncompliance. The potential therapeutic properties of coconut oil on hemorrhoids have been suggested, but its scientific evidence has not been reported, therefore this study was performed with aim to determine the effect of coconut oil ointment on hemorrhoids symptoms in pregnant women.

This randomized clinical trial was performed on 60 pregnant women referred to comprehensive health services centers in Mashhad in 2018-2019. The subjects were randomly divided into intervention and control groups. In the intervention group, one applicator of coconut oil ointment was applied twice a day for two weeks; they also received lifestyle modification recommendations. The control group only received lifestyle modification recommendations based on national guidelines. The improvement of hemorrhoids symptoms was measured on the first, seventh and fourteenth days using Visual Analog Scale (pain, prolapse, itching and overall score of hemorrhoid symptom). Data were analyzed using SPSS software (version 16) and Mann-Whitney, Independent T and Friedman tests. P<0.05 was considered statistically significant.

The mean score of pain, prolapse, itching and overall score of hemorrhoid symptoms in coconut oil ointment group significantly decreased compared to the control group (p<0.05). In the intra-group evaluation, in the coconut oil ointment group, the pain score measured by day was significantly different (p<0.001) but in control group this difference was not significant (p=0.050).

Coconut oil ointment is effective in improving the hemorrhoids symptoms, therefore it is recommended for pregnant women with hemorrhoids grade 1 and 2.

Todays one of the most common anorectal problems is hemorrhoid. Minor symptom of disease can be treated by medical treatment but at high grade disease we should consider surgery. Although conventional surgery is standard operation for hemorrhoid, it is associated with some complication. Many techniques were designed to overcome these problems. One of these procedures stapled hemorrhoidopexy that this study was done to compare it with conventional hemorrhoidectomy. Subjects and This is a clinical trial study was conducted on 40 patients with hemorrhoids in Ahvaz Razi Hospital. Patients were randomly divided into two groups. Group A (n=20) was treated with stapled hemorrhoidopexy and Group B (n=20) was treated with conventional hemoroidectomy method. Sphincter tone, resting and pressing before and after surgery was measured and compared between two groups. . Data analysis showed that there was no significant differences in tone sphincter resting and pressing before and after surgery in stapled hemorrhoidopexy group and conventional hemoroidectomy group (P-value=0.32). Also, there was no significant difference between the mean scores of pain in groups (P-value=0.32). However, the loss of blood, the need for analgesic drugs and return to work in stapled hemorrhoidopexy group was significantly lower than that of conventional surgery group (P-value<0.001). Findings of study showed that stapled hemorrhoidopexy is an alternative and effective treatment that can be used in adult age groups to reduce pain, side effects, duration of hospitalization and time to return to work.

The hemorrhoid is referred to dilated parts of the anal canal veins, which help to control fecal excretion and is one of the most common digestive diseases. Since postpartum problems such as hemorrhoid have significant effect on physical health and psychological well-being, lactation, baby care, and communication with family and society and affect the health of mothers and children, and considering the importance of postpartum quality of life, and due to the limited studies in this field, this study was performed with aim to determine the association between the severity of hemorrhoid symptoms and quality of life in women with grade I and II internal hemorrhoids during postpartum period. This cross-sectional study was performed in 2017 on 131 women in postpartum period in Tehran. Clinical Therapeutic Clinical Evaluation Questionnaire and World Health Organization Quality of Life were used to collect data on hemorrhoid symptoms and quality of life. Data were analyzed using SPSS software (version 21) and Pearson and Spearman tests. P<0.05 was considered statistically significant. The highest and lowest mean score of quality of life was obtained in the sub-domains of environmental health and physical health, respectively. The lowest and the highest mean score for hemorrhoid symptoms was related to the symptoms of itching and the negative effect of hemorrhoids on the health of women. There was a significant negative correlation between the overall quality of life score with all the symptoms of hemorrhoids except pruritus (r = -0.2 to r = -0.28, p <0.05). There was also significant negative correlation between the symptoms of swelling in the anus and dimensions of social health (r = 0.24, p = 0.006) and environmental health (r = 0.20, p = 0.02) with the quality of life. There was also a negative and significant correlation between the symptom of discomfort in the anus and the subtype of physical health of the quality of life (p = 0.04, p = 0.18). None of the socio-demographic characteristics had a significant relationship with quality of life (p >0.05). The symptoms of hemorrhoids have negative effect on the quality of life in postpartum period.

Constipation and hemorrhoids are common problems during the postpartum period. Therefore, effective measures should be taken to diminish the deleterious effects of these complications on maternal health. In this study, we aimed to determine the efficacy of postpartum home care on the rate of constipation and hemorrhoids. This clinical trial was conducted in two phases on 276 women, who gave birth at hospitals, affiliated to Shahid Beheshti University of Tehran, Iran in 2013. The subjects were divided into intervention (n=92) and control (n=184) groups. First, a model of care was designed by comparative analysis and collection of data on home care guidelines for mothers and newborns, applied in different countries. In the second stage, women received home care services, based on the proposed model (on days 3-5 and 13-15 postpartum). On the other hand, subjects in the control group did not receive any services. The rates of constipation and hemorrhoids were recorded and compared via history taking and clinical examinations by midwives on day 60 following delivery. (IRCT:2013060313565N1) The mean age of the participants was 27±5 years. Based on the evaluation of outcomes on day 60 following delivery, constipation was reported in 13% of cases in the intervention group and 26.1% of subjects in the control group. Moreover, hemorrhoids were reported in 12% and 9.8% of women in the intervention and control groups, respectively; however, there was no significant difference between the two groups in terms of these complications. Based on the results of this study, postpartum home care, complemented with physical exercise, a healthy diet, and use of laxatives in unresponsive cases to supportive treatment, could reduce constipation, whereas hemorrhoids remained unaffected.