An anal fissure which does not heal with conservative measures as sits baths and laxatives is a chronic anal fissure. Physiologically, it is the high resting tone of the internal anal sphincter that chiefly interferes with the healing process of these fissures. Until now, the gold standard treatment modality is surgery, either digital anal dilatation or lateral sphincterotomy. However, concerns have been raised about the incidence of faecal incontinence after surgery. Therefore, pharmacological means to treat chronic anal fissures have been explored. A Medline and pub med database search from 1986-2012 was conducted to perform a literature search for articles relating to the non-surgical treatment of chronic anal fissure. Pharmacological sphincterotomy using Glyceryl trinitrate , Isosorbide dinitrate or calcium channel blockers are exciting alternative treatment , that relaxes the anal sphincter and, therefore, promote healing, the drawback of such medications are headache and poor compliance. With the introduction of Botulinum toxin as mean of chemical sphincterotom, topical injection of Botulinum toxin reduces the anal hypertonia which lasts for few months, allows the fissure to heal, thus eliminating the need for surgery without incidence of incontinence. Cure rates are over 60%, and the procedure can be repeated safely. Therefore, Botulinum toxin is a reasonable first-line management of chronic anal fissure and the relapses can be managed by surgery Keywords: Non-surgical treatment of anal fissure, fissure in ano, sphicterotomy,botulinum toxin in anal fissures, glyceryl trinitrate. Chemical sphincteratomy, pharmacological sphincteratomy.
An anal fissure which does not heal with conservative measures as sits baths and laxatives is a chronic anal fissure. Physiologically, it is the high resting tone of the internal anal sphincter that chiefly interferes with the healing process of these fissures. Until now, the gold standard treatment modality is surgery, either digital anal dilatation or lateral sphincterotomy. However, concerns have been raised about the incidence of faecal incontinence after surgery. Therefore, pharmacological means to treat chronic anal fissures have been explored.A Medline and pub med database search from 1986-2012 was conducted to perform a literature search for articles relating to the non-surgical treatment of chronic anal fissure.Pharmacological s
... Show MoreAn anal fissure which does not heal with conservative measures as sits baths and laxatives is a chronic anal fissure. Physiologically, it is the high resting tone of the internal anal sphincter that chiefly interferes with the healing process of these fissures. Until now, the gold standard treatment modality is surgery, either digital anal dilatation or lateral sphincterotomy. However, concerns have been raised about the incidence of faecal incontinence after surgery. Therefore, pharmacological means to treat chronic anal fissures have been explored.A Medline and pub med database search from 1986-2012 was conducted to perform a literature search for articles relating to the non-surgical treatment of chronic anal fissure.Pharmacological s
... Show MoreBackground: Although uncommon, diseases of the male breast engender a tremendous emotional response. Fortunately, most diseases present with a mass and are easily detected. Unlike the female breast, only ducts but no lobules are present.
Objectives: The aim of this descriptive study is to present the clinical, pathological and ultrasonographic features of different breast lesions amongst males.
Patients & methods: Data obtained from 93 male patients with breast disorders collected between the first of January 2008 to the end of December 2009 and based on clinical examination were done in surgical wards in Baghdad teaching hospital and the main referral training centre for early detection of breast tumors.
Results: Gynecomast
Blastocystosis is symptomatic infection caused by the protozoal parasite Blastocystis , which resides in the intestinal tract of its hosts and it is one of the most common parasites reported in humans. It’s prevalence ranges between (30 - 50%) of the population in developing countries. This genus has a worldwide distribution and often the most commonly reported human intestinal protozoan in children and adults, even infect infants
The purple pigment violacein is produced by Gram-negative bacteria, mainly from the Chromobacterium violaceum. Violacein is synthesized by fusing two Ltryptophan molecules using five different enzymes encoded by VioA, VioB, VioC, VioD, and VioE genes. These genes have transferred to genetically engineering microorganisms such as E.coli for high production of violacein. It is receiving greater interest because of its significant biological functions and therapeutic potential. The reviews outlining the biosynthesis, production, and biological significance of violacein are being published.
Background: The prevalence of thyroid nodules rise with age and different data available about the risks of thyroid surgery in old age people. In general, old age could be a predictor of perioperative mortality and morbidity. The aim of this study is to prove if there is increased risk accompanying thyroidectomy in elderly patients.
Subjects and Methods: Prospective study of one surgeon of study sample undergoing thyroid surgery at Al-Kindy teaching hospital and Saint Raphael hospital .This study was including two groups; group (A) involved patients 65 years and older, group (B) involved patients below 65 years old who were subjected to thyroidectomy. Taking in consideration hist
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Borago officinalis is highly interesting amongst nutritional and medical source relate to its high composition of some useful phytochemical compound. It is great plants with bright blue star-shaped flowers present in most world regions and usually known as borage. The Borago phytochemical analysis showed the presence of alkaloids, tannins, flavonoids, phenolic acids, essential oil, vitamins and others. Borage is cultivated all over the world and used in traditional medicine as a demulcent, diuretic, emollient, tonic, expectorant, for the treatment of coughs, inflammation and swelling, and other diseases. In herbal medicine, Borage seed oil (BSO) has been utilized for many progressive illnesse
... Show MoreThe rising prevalence of obesity-related glomerulopathy (ORG) occurs in accordance with the rising prevalence of obesity worldwide. Clinically ORG is manifested by slowly progressing microalbuminuria that may develop to clinically evident proteinuria. Pathological characteristics of ORG include glomerular hypertrophy in the presence or absence of focal segmental glomerulosclerosis (FSGS). ORG can develop into clinically overt chronic renal insufficiency or even end-stage kidney disease. This article reviews the most important mechanisms for the development of ORG; that are abnormal renal hemodynamics, stimulation of renin-angiotensin-aldosterone system (RAAS), impairment of insulin sensetivity, ectopic lipid deposition, adipose tissue cy
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