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.
The 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
... Show MoreDiabetic foot ulcer (DFU) or Lower limb ulcers are one of the major complications caused by diabetes mellitus especially when patients fail to maintain tight glycemic control. DFU is linked to multiple risk factors along with the genetic factors and ethnicity which play a significant role in the development of DFUs through their effects on multiple aspects of the pathophysiological process. This narrative review aimed to summarize all the previous studies within the last ten years associating gene polymorphism and DFU. Polymorphism associated with vascular endothelial growth factor (rs699947), the G894T polymorphism of the endothelial nitric oxide synthase gene, interleukin-6–174 G>C gene polymorphism, heat shock protein 70 gene polymorph
... Show MoreThe Financial systems can be classified into two types. The first is the market–oriented, which is applied in United States and United Kingdom. While the second is bank-oriented as in Japan and Germany.
This study tries to explain the reasons which make some countries adopt the first one instead of the second, and the contrary. So the study consists of three sections. The first deals with the concept of financial system and it are functions. The second displays the indicators which are used to classify the financial systems, while the third one is devoted to the factors that determine the type of financial system .These sections followed by some conclusions.
Abstract Aim: Autism is a neurodevelopmental disorder which affects communication and social interaction of children. It is a heterogeneous disease with various clinical presentations. Some genes are involved in its pathogenesis. It has been suggested that environmental exposure to lead can increase the risk of autism. The aim of our study was to compare blood lead levels among autistic and non-autistic children. Material and Method: This retrospective study included 107 children (60 with autism and 47 without autism) referred from the different Iraqi provinces, in the years 2015, 2016 and 2017, to the poisoning consultation center in Baghdad. Data collection including age, gender, residence, referral source, family history and blood lead l
... Show MorePulsatile drug delivery systems (PDDS) are developed to deliver drug according to circadian behavior of diseases. They deliver the drug at the right time, action and in the right amount, which provides more benefit than conventional dosages and increased patient compliance. The drug is released rapidly and completely as a pulse after a lag time. These systems are beneficial for drugs with chrono-pharmacological behavior, where nighttime dosing is required and for the drugs having a high first-pass effect and having specific site of absorption in the gastrointestinal tract. This article covers methods and marketed technologies that have been developed to achieve pulsatile delivery. Diseases wherein PDDS are promising include asthma, peptic u
... Show MoreVariation in DNA, and genes to a lesser or greater extent, can play an important role in most diseases; that is because this variation in will reflect and affect the function of DNA, and genes (combined genes and DNA or separately). This can be affected by environment, life style, as well as the inheriting from parents and previous generations. All these factors can contribute in human diseases. There are different alterations in genes, like imbalance and inequality in chromosomes, disorder in gene (deficiency in gene, which could be complex or single disorder), and cancer. In the last decades, scientists were focus on medicine and genetics; they pay an extensive attention to reach better understanding about diseases and their cause
... Show MoreUltrasound is a mechanical energy which can generate altering zones of compression and rarefaction along its path in the tissues. Ultrasound imaging can provide a real time screening for blood and multiple organs to aiding the diagnostic and treatment. However, ultrasound has the potential to deposit energy in the blood and tissues causing bio effects which is depending on ultrasound characteristics that including frequency and the amount of intensity. These bio effects include either a stable cavitation presented non thermal effects or inertial cavitation of harmful effect on the tissues. The non-thermal cavitation can add features in diagnostic imaging and treatment more than the inertial cavitation. Ultrasound Contrast agents are a micro
... Show MoreThe term "nano gold," also known as "gold nanoparticles," is commonly used. These particles are extremely small, with a diameter of less than 100 nm, which is only a fraction of the width of a human hair. Due to their tiny size, nano gold particles are often found in a colloidal solution, where they are suspended in a liquid stabilizer. This colloidal gold is essentially another name for nano gold. The main method for producing gold nanoparticles in a colloidal solution is the citrate synthesis technique, which involves combining different solutions to precipitate the gold nanoparticles. In biological systems, copper complexes play a significant role at the active sites of many metalloproteins. These complexes have potential applications in
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