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.
Abstract
The goal of current research to describe and diagnose the level of attention of doctors to design and regulatory dimensions, (strategic vision, organizational structure, organizational processes, business systems, personnel), and the performance of hospitals and dimensions, in six hospitals in medicine and selected a sample for research, as well as identify organizational design effect in the performance of hospitals and dimensions (efficiency, the development of human resources, patient satisfaction, achieve financial results, quality of health care).
Research has focused in part theoretical on key variables to look organizational des
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Acromegaly is ametabolic disorder characterized by an acquired progressive somatic disfigurement, mainly involving the face, extremities and many other organs, that are associated with systemic manifestations, caused by excessive secretion of growth hormone and a resultant persistent elevation of insulin-like growth factor-I concentrations. In more than 90% of cases originates from a monoclonal benign pituitary adenoma. Aim of this study to assess the level of insulin-like growth factor-I (IGF-I) in saliva of acromegalic patients, and to compare it with the basal levels of serum IGF-I. Sixty specimens of serum and saliva collected from two groups of subjects (forty acromegalic patients and twenty healthy persons). The specimens were
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The research aim to the usage educational method for jump shooting and it effect on speed strength in basketball for the specialist students in College Sport of Dayla University, which used the following statistic treatment (The T.test for compatible specimens), so after statistic treatment which appears theres a tow moral differences in speed strength and jump shooting tests results to (legs & arms) for the before and after tests, and after that the conclusions we positive and the second the special drills effect immaterial speed strength to legs and arms, so the tow researches recommended to looking after the best for educational methods that used in our sport colleges in Iraq.
Foreign direct investment (FDI) has been viewed as a power affecting economic growth (EG) directly and indirectly during the past few decades. This paper reviewed an amount of researches examining the relationships between FDI and EG, especially the effects of FDI on EG, from 1994 up to 2012. The results show that the main finding of the FDI-EG relation is significantly positive, but in some cases it is negative or even null. And within the relation, there exist several influencing factors such as the adequate levels of human capital, the well-developed financial markets, the complementarity between domestic and foreign investment and the open trade regimes, etc.
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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Type 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.
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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