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The authors concluded that botulinum toxin injections are effective on bruxism and are safe to use.

An evidence-based review of botulinum toxin (Botox) applications in non-cosmetic head and neck conditions.

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However, if an anal fissure does not heal after 6-8 weeks of medical therapy and the diagnosis is not in question, surgery may be indicated.

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NRS during the screening phase for worst anal pain associated with, or following, defaecation for the most recent 3 days on which the subject has defaecated.

In these instances, botulinum toxin (BTX) may help control the spasticity for approximately 3 months after injection.

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Surgical treatment was reported in patients with very severe symptoms refractory to pharmacologic treatment.

Persaud et al (2013) noted that botulinum toxin (Botox) works by blocking the release of acetylcholine from the cholinergic nerve end plates leading to inactivity of the muscles or glands innervated.

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Patients also completed a standardized quality of life questionnaire on incontinence and a VAS on the impact of bladder problems on daily life activities, and underwent urodynamic assessment, including pressure flow studies.

This was a case study; and the clinical benefit of botulinum toxin, if any, is confounded by the multiple therapies used in this patient.

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