The effect of Nifedipine for treatment of anal fissure

INTERVENTION: 10 mg of Nifedipine TDS for 4 weeks Intervention 1: Nifedipine cream (0.5%) for 4 weeks. Intervention 2: 10 mg of Nifedipine TDS for 4 weeks. Nifedipine cream (0.5%) for 4 weeks Treatment ‐ Drugs CONDITION: Chronic anal fissure chronic anal fissure. ; Chronic anal fissure PRIMARY OUTCOME: Ulcer healing in anal fissure. Timepoint: 4 weeks (traetment period), 6 months (follow up). Method of measurement: visual score. SECONDARY OUTCOME: Blood pressure and pulse rate. Timepoint: 2 months, 6 months. Method of measurement: sphygnomanometer, physical exam, patient ducument. Headache. Timepoint: 2 months, 6 months. Method of measurement: visual, patient ducument. INCLUSION CRITERIA: INCLUSION CRITERIA: chronic anal fissure patients. Exclusion criteria: patients had history of sexually transmitted disease, TB, IBD, or medically related conditions such as gestation, migraine, cardiovascular and other chronic diseases, anorectal surgery or another anorectal disease.