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 current study included a review of the registration and description of the Theretra alecto Boi, 1827 (Levant hawk moth), samples were collected from various areas of the Baghdad belt and the provinces of the Middle Euphrates, confirmation in the description was on the most important parts of the body included the head and it's appendages, pronotum, wings as well as male and female genitalia. The morphological characteristics under study were enhanced by illustrations and images. Information on the locations and date of the collection was also confirmed. This study aims to identify the most important characteristics of the diagnosis of the species and the review of appearance variations, especially the analytical style of wings, coupling
... Show MoreType 2 diabetes is a global public health problem especially in middle east countries and Iraq has not spared from this pandemic. The prevalence in Iraq. and rank in Middle East. Beside increasing in prevalence- also poor glucose control. Nutrition plays a critical role. This paper narratively review variables that affect reduce the incidence of T2DM in Iraq and affect nutritional status among Iraqi withT2DM. The factors contribute to T2DM were high rates of obesity and overweight, as well as levels of body fat indicate a high prevalence of poor glycemic control. Likewise, levels of physical activity are low among older Iraqis.
A Pap test can identify the pre-cancerous and cancerous problem in the vagina and uterine cervix. Cervical tumour is the easiest gynecologic disease to be diagnosed, treated and prevented using regular screening tests and follow-up. This review aimed to explore the opinion of specialists about cytological changes and the precancerous lesions with Pap smear test and visual inspection of the cervices, also to determine the relationship of this malignancy with demographic characteristics of patients. Results showed that few cervical cancer and pre-cancer were with women in postmenopausal period, but more were with women in the premenopausal period. Visual inspection of the cervix can show erosion lesions by gross inspection. Upon cytology exam
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Objective: To review and see the pattern of histopathological diagnoses of one year appendectomy specimens.
Methodology: This retrospective study was carried in Sulaimani Teaching Hospital over the period of one year (from 1st
of January to 31st of December 2009). All pathological reports were reviewed retrospectively for patient’s age, sex,
histopathological diagnosis and operative findings (if present). Histopathological diagnoses then were classified into
either positive or negative for acute inflammation. Any associated findings or any surgical specimen removed with the
appendix was recorded. The obtained data were analyzed by using the statistical package social sciences (SPSS) version
19; with Chi square to test
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Background: Tumor necrosis factor-alpha (TNF-α) and interleukins play important roles in the pathogenesis of rheumatoid arthritis (RA). Genetic research has been employed to find many of the missing connections between genetic risk variations and causal genetic components. Objective: The goal of this study is to look at the genetic variations of TNF-α and interleukins in Iraqi RA patients and see how they relate to disease severity or response to biological therapy. Method: Using specific keywords, the authors conducted a systematic and comprehensive search to identify relevant Iraqi studies examining the genetic variations of TNF-α and interleukins in Iraqi RA patients and how they relate to disease severity or response to biolo
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Thyroid hemiagenesis (THA) is a rare congenital anomaly in which one lobe of thyroid gland fails to develop during embryological stage. Agenesis may be unilateral, total or isthmic. Left thyroid lobe is more commonly involved than right lobe in hemiagenesis. Agenesis of the isthmus was seen in 50% of cases. Left sided hemiagenesis is more common than right sided hemiagenesis with a Left to right ratio of 4:1. Clinically patients can be euthyroid, hypothyroid or hyperthyroid. Often it is diagnosed as an incidental finding during ultrasonography (USG) study of neck, which can easily diagnose this condition.
Actual incidence of THA is unknown; most cases are diagnosed in patients admitted for thyroid scan or thyroid surgery because
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