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 surgeryKeywords: Non-surgical treatment of anal fissure, fissure in ano, sphicterotomy,botulinum toxin in anal fissures, glyceryl trinitrate. Chemical sphincteratomy, pharmacological sphincteratomy.
Background: The iron deficiency anemia along with hyperphosphatemia are the main complications of dialysis patients. Traditional iron supplement has been failed to correct iron deficiency anemia, therefore, the current study aimed to investigate the efficacy and tolerability of new phosphate binder, ferric citrate, in a sample of Iraqi patients with end stage renal disease on maintenance hemodialysis. Method: Prospective, randomized, open label, active controlled trial was conducted in one center for dialysis in Babylon governance. Patients were randomized to receive ferric citrate with dose of 6 g/d and calcium carbonate with dose of 3 g/d for eight weeks. Hemoglobin concentration, mean corpuscular hemoglobin concentration and count o
... Show MoreBackground: Chief complaint of patients attending dental clinic represents the first step towards treatment plan. However, most of patients are not aware but the extent and severity of periodontal disease, which could be also, misdiagnose by the dentist. Aim of the study: To investigate whether reported chief complaint(s) are consistent with oral hygiene status Materials and methods: Records of 1102 patients, attending periodontics clinics in the college of dentistry/ university of Baghdad, were used to determine ten most commonly reported chief complaints. Sample of patients was further subdivided according to gender and age. In addition, plaque and gingival index were recorded to determine oral hygiene status. Results: Patients mostly
... Show MoreObjective: To identify causes of maternal death in Mizan Aman and Gebretsadik shawo general hospitals
Methodology: A case control study on 595 charts, 119 cases and 476 controls was conducted in Mizan
Aman & Gebretsadik shawo general hospitals. Data was analyzed by STATA 13.1. Propensity score
matching analysis was used to see causes of maternal death.
Results: Hemorrhage were the main direct causes of maternal death which accounts 47.9% (β =0.58
(95% CI (0.28,0.87)) in hospital but when projected to population based the sample (β =0.26 (95% CI
(0.22,0.31)). Followed by infection 36 (25.21%) (β = 0.50 (95% CI (0.08, 0.92)). when projected to
population based the sample PIH 7.6%) is significant cause (β = 0.16
Objective: To determine the ability of uVDBP to discern SRNS from steroid-sensitive nephrotic syndrome (SSNS) in Iraqi children. Materials and Methods: This cross-sectional study enrolled children with SRNS (n=31) and SSNS (n=32) from the pediatric nephrology clinic of Babylon Hospital for Maternity and Pediatrics over three months. Patients' characteristics in terms of demographics, clinical data, and urinary investigations were collected. Quantitative analysis of uVDBP levels was undertaken via a commercially available ELISA kit. Results: The median uVDBP values were significantly higher (p-value<0.001) in the SRNS group (median=10.26, IQR=5.91 μg/mL) than in the SSNS group (median=0.953, IQR=4.12 μg/mL). A negative correlati
... Show MoreThe current research aims to identify the effectiveness of a computerized program in developing mathematical skills among the first cycle students in basic education schools in the Sultanate of Oman. The two researchers used the quasi-experimental approach on an intentional sample consisting of (40) male and female students at Al Kawakeb School for Basic Education (1-4). Two of the basic fourth-grade classes and then randomly distributing them into two groups, one is experimental (20) male and female students who followed the computerized interactive program, and the other is (20) male and female students followed the traditional way. On the other hand, its reliability has reached (0.81), and the results of the research have concluded th
... Show MoreThis study aims to identify the role of forensic accounting in resolving banking disputes in the Iraqi environment, and to achieve this goal, the fiel
d survey method was used, as it is the most appropriate for studying the phenomenon in question and achieving its objectives. A sample of (50) male and female employees was selected, distributed among five banks listed on the Iraq Stock Exchange in the Baghdad governorate. The questionnaire tool prepared for this purpose was applied to them, which consisted of two main axes. The first axis included paragraphs of questions related to the importance of forensic accounting. The second axis relates to disputes At the end of the research, we reached a set of conclusions, the most import
... Show MoreManagement Representations Letter plays a significant role as an evidence to get conclusions the Auditor is looking for. These conclusions could show the professional opinion of auditor over the fairness and integrity of financial statements for many issues and numbers that management claims, Hereby, the research aims at highlighting the importance of Management Representations Letter and the way of using as an evidence with expressing its meaning and means of application in addition to identify the Responsibility of Auditor on that Letter, This research discusses also the effect of Management Representations Letter on the credibility of financial statement and enhancing the credibility of the submitted reports, From other side, in the t
... Show MoreObjectives: The study aimed to clarify the role of Al-Sayyid Al-Ajall and his family in the service of the Mongol Empire. They worked to develop its administrative and military institutions, benefiting from their extensive experience in administration, politics, economics, and urban affairs. Due to their capabilities, they received the patronage of Genghis Khan and subsequent generations, earning the confidence of the ruling Mongol authority. As a result, they were granted significant powers within the state. Methods: The study relied on the analytical method to analyze historical texts, compare them with others, and discuss them accurately. Results: The study yielded several results, including the minister's keen interes
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