This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Rectum and anal canal, Subject name: Surgery
[{'content': 'What are the similarities between fissure in ano and achalasia cardia? \nSelect and explain. \nA. Smooth muscle involvement, B. Use of Botox, C. Use of nitrates & calcium channel blockers, D. All of the above', 'role': 'user'}, {'content': "Answer: D \nExplanation: Achalasia cardia Fissure in ano - Absence of relaxation of LES - Spasm of internal anal sphincter - LES - Smooth muscle - IAS - Smooth muscle - Nitrates & CCB'S are used - 0.2 % Nitroglycerin; 2 % Diltiazem local application - Botox injection - | Ach - Relax sphincter -Botox injection - TOC - Laparoscopic Heller's myotomy|Circular fibers divided TOC- Notaras lateral sphincterotomy", 'role': 'assistant'}]