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.
Praise be to God, Lord of the Worlds, and prayers and peace be upon the Master of Messengers, and upon his family and companions
And whoever follows his guidance until the Day of Judgment. As for what follows: Islamic law commands Muslims to unite, reject disagreement, and not dispute, and to spread the spirit of tolerance and love among them. God Almighty said: “And hold fast to the rope of God all of you and do not become divided, and remember the favor of God upon you when you are enemies and He has joined your hearts.” So, by His grace, you became brothers (1), and He said: (And You will be like those who became divided and disagreed after the clear proofs had come to them. It is they - for them is a great punishment.) (2
... Show MoreBACKGROUND: Diabetes Mellitus is a complex chronic illness that has increased significantly around the world and is expected to affect 628 million in 2045. Undiagnosed type 2 diabetes may affect 24% - 62% of the people with diabetes; while the prevalence of prediabetes is estimated to be 470 million cases by 2030. AIM OF STUDY: To find the percentage of undiagnosed diabetes and prediabetes in a slice of people aged ≥ 45years, and relate it with age, gender, central obesity, hypertension, and family history of diabetes. METHODS: A cross sectional study that included 712 healthy individuals living in Baghdad who accepted to take part in this study and fulfilling the inclusion and exclusion criteria.
... Show MoreBackground: Chronic cough is often the key
symptom not only of chronic pulmonary diseases
but for other important extrapulmonary
pathologies, in particular upper airway and
gastrointestinal diseases.
Objective: This study was designed to
determine the etiology of chronic cough and the
usefulness of the available diagnostic tests in
reaching its causes.
Methods: One hundred patients presenting with
chronic cough at Baghdad Teaching Hospital
Outpatient Clinic were enrolled in this study. The
patients underwent a full clinical interview,
physical examination with indicated diagnostic
test(s) (such as chest x ray, bronchoscope, PFT,
GIT study, sinus X ray or CT).
Results: An etiology of chronic
The subject of the tagged research (becoming and integration of the film in postmodern cinema) is summarized by studying the transformations and complementarity of the film in light of the emergence of the concern of postmodernism. Then the need for it, as well as the objectives of the research and clarify its limits, as well as its importance. Then the transition to the theoretical framework, which included two sections, the first topic was entitled: Postmodern Cinema Formation and Completion, while the second topic was entitled: Paradox in Postmodern Film.
After completing the theoretical aspect, the research concluded with a number of theoretical framework indicators that were adopted as a tool for analyzing the sample, then th
... Show More
Summary
I wanted to address this topic because of creedal purposes importance,and its r le in regulating lives of individuals and society, and to talk about purposes of Almighty's saying:{It is easy for me},to simplify its meanings for general educated person to obtain the believe of the Creator’s power and his oneness.
Therefore,this research came,whichincludes:an introduction and topics, first :concept of creedal objectives and their divisions,second: creedal purposes in Almighty’s saying:{It is easy for me},and conclusion:in where most important results were included:
... Show MoreThe aims of the lecture should be clearly defmed. These will help to define the teaching methods and the structure. If, for example, the purpose of the lecture is to introduce new knowledge and concepts, then a classic lecture structure might be most appropriate. On the other hand, if the purpose is to make the students aware of different approaches to a particular clinical problem, a problem oriented design in which alternative approaches are presented and discussed might be a more appropriate fonnat.
Lectures are still a common teaching methOd in both undergraduate and postgraduak medical education. Properly done, the lectwe is a creative and personal work by the teachll:l modeled upon his intellectual scaffolding. Few other fonns o
Aim: The Aim of the study is to compare between Er,Cr:YSGG 2780 nm laser and carbide fissure bur in root-end resection regarding the morphological variations, temperature changes and the duration of resection process.
Settings and Design: 5 W, 25 Hz, 50% water, 80% air,25.47 J/cm2 .
Material and method: twenty-one extracted single rooted teeth endodontically were treated, twenty teeth were obturated and divided into two groups according to method of resection. Group 1 root-end resected using cross cut carbide bur while group 2 root-end resected using laser with MGG6 sapphire tip of 600 μm diameter. Temperature on external root surface and duration of resection were recor
... Show More
(5)
(4)
An observational study to discover the common conditions affecting the lumbosacral region that may affect lumbosacral position and tension. All the patients, underwent MRI exaamination (magnetic resonance imaging) in the supine position, were examined by the same consultant radiologist. The article was revised by the institutional ethical approval committee. The position of the nerve roots was observed, and the number of nerve roots was calculated anterior to a line passing between the mid-transvers process of L3(third lumbar vertebra). The number of nerve roots ahead of this line was calculated by the radiologist at the level of the right intervertebral foramen and at the left one. This procedure was applied to the normal group, an
... Show More
China occupies an area of 906 million square km. and lies east Asia. Its population approximately 1,388 people, according to census 2010. China was a global great power for centuries , then shrank its jurisdiction and occupied by European countries and Japan in the 19th century. It regained its strength and independence under the leadership and rule of the Chinese Communist Party since 1949. In the 21st century , the Chinese positions has risen universally due to its achievements in the economic and trade affairs . Nowadays, China became a largest exporting state in the world and a second economic power after USA.